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Permit • • CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 111 111 Its - COMMUNITY DEVELOPMENT Permit #: ELR2009 -00211 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16124 SW 108TH AVE 49 Subdivision: DURHAM PARK APARTMENTS Lot: 36 Project: Brightwaters at Red Hawk Project Description: Install fiber optics for verizon. Owner: FEES DHP TERRACE LLC & Description Date Amount DHP ANNEX LLC, BY AKAWIE & LAPIETRA PC, Restricted Energy Permit 07/30/2009 $75.00 13 HERON DR 12% State Surcharge - Electrical 07/30/2009 $9.00 PHONE: Contractor: PHONE: FAX: Type of Use: MF Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: Y Fire Alarm: N HVAC: N Instrumentation: N Total $84.00 Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Other Desc: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344, Issued By: n Permittee Signature: Q 0 OWNER INSTALLATION ONLY 1 V The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. RECEIVED Electrical Permit ApplicatiodUL 2 9 2009 -: PORor tcEUSEONLY` :.:.::•:.:''.• City of'tigard r• ' 1111111111111111 • • .. Ate , 00 1 13125 SW Kill Dlvd., Tigard, oiCdi N OF TIGARD Pkrt tt,n,n IN a • Phuac: 303.639.4171 Fox: G DIVISION Dxcr OnwrPennit: ens eoct)on Line: 503.639.41 'rIGAAD I D:aoR /Ilya l7l See 8axeZtor Interact: www.e!gtird- or.gnv Nwhietl /Mab Jnr' rel: A SupplememelInfornewteo • "' A: `:•,'"L.,.• ,.. .. , ' TYPE OF WORK - 0,:t• . .. .. •... •. . t•.: PLAN RRV.IRW ' • :‘ ': . 0 Now OonstuUClion 0 Addition /alteration /replacement P(cuue check ail that apply (tuh,uit I acts aprons Wilems lacked he(uw): 0 Sory too or realer CO amps or nave 00 uliain/ over alto moos. Demolition 0 Other: where do Available Nub Cancan (] Wino amt boatyards. ..,::' ::::':',: ,i:, CATEGORY •OF.CONS%ItUCTION. • , . •. '•1 exceeds 10,000 amps ,e ISO %Vittnr 0 P10111ny buiWiupa. ❑ 1- and 2 family dwelling Q Commercial /industrial Accecxor building on e w aned of e rexet lk o onx. Qtau tiogs, -ate ag.roaamral Y $ ma,px forallot'ICrinslalWaimu, buildings, o Multi- farnily Q Muster builder ❑ Other: Qpno pwap. 0 fnstwlla ioa of 75 KVA of . ` "' • ;: BITE- INFORMATION AND LOCATION <?' ='- (, ( temcrgcia:ysyalom. lafgcrsepu lelxystam. • ' � ' ' • • • • A &lillnn of new,munr bra of ❑ "A" "I " " ". "1•.. , 13 dva kb no.: .1lob site Address: 16124 SW 108TH AVE IMP orloom occupancy. City /Stnte/ZIP: TIGARD, OR p Six or more resid tial unite, 0Itearewhmel vehicle parks. 97223 ry moahh•owo redo r, [I supply vetw h go far more a(tao [,} Nmo - donn iucodone. 600 voile noulino). Suitt/bldg, /Apt, no, 49 -56 I Project mime: BRIGHTWATERS Q REDHAWK ❑ Sorviteetfoeder(00 mot urmsae. • -- -' " FRE'SCflEDULE '• Cross street /directions to job site: : e' I qtr. I Pry. I 'rand I r . New residential single. or and 8- fondly dwelling unit. Includes attached gauge, Subdivision: I Lot no.: 1,000 sq. 0. or loss 145.15 4 i lie. add'I 500 sq. 0. or portion 33,40 1 Tex uueplpltreu! no.: Limited energy, residential 75,00 2 DESCRIPTION OP WORK ' (with abate sit, m) • ... Limited c:xo y,muhldnmity, 7340 ? INSTALL FIBER OPTICS FOR VERIZON residential (with above tv.A.) Services or feeders insta11ntionotternllnn, mxl/or noloeotnn_ 200 amps or less 80.30 2 , 1".3 PROPA:R'I'Y'OWNER . ..I ' •.• '.[] TC • • '`• t 201 Minh 400111110$ 106.85 2 Name: 401 amps to 600 Amps 160.60 2 - 601 amps to 1,000 amps 240.60 2 I Address: Over 1,000 amps or volts 434,65 — 2 City /Sento/ZIP: Temporary service* or feeders Installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or ices 1 I 66.85 t Owner installation: This installation is being made on Property that i own which is not 201 amps to 400almps ( 100.30 12 intended for sate, lease, rent, or exulutogc, according to ORS 447, 449, 670, and 701. 401 a we to 5 amps ii 133.75 2 Owner signature: __Date: french circ new, idleratloo. or extension, per panel A. Fee for brunch circuits with • ' © APPLICANT • ' ::. :, • : . , a. • • "in PERSON ' above service et' feeder fee, 665 2 Rusin" "Me: each branch circuit �. NORTH SKY COMMUNICATIONS, INC, B. Pee for bombeimaitx —_ T Conenetname: ERIK SCHENCK withoutncrvice feeder fee, 4685 2 ,- first boater circuit _ -_ Address: 11818 SE MILL PLAIN BLVD STE. 410 eacilndd'i br(mchcircttit 6.6 2 - Miscmnnaeous (service or reader not Included) City /Slate/ZIP; VANCOUVER, WA 98684 Each tnanuftclurod or modular ' 0040 2 ' dwelling, service and /or fade,' Phone: (503 ) 969 -7729 I Fax:: ( 866 ) 452 -4853 Reconnect only 66.85 2 Le•tuail: mduor( northskycomm,com Pweip orinigotioncirri* 53.40 2 ' CONY:RACTOR ' ' Sign or outline lighting 53.40 2 8ueinoen name: NORTH SKY COMMUNICATIONS, INC, Sigmdoircuh(s) ortnited- energy panel, alteration, or Addreuee: 11818 SE MILL PLAIN BLVD. STE 410 extension, Describe: 1 Page 2 $75.00 2 City /Stato/ZIP: VANCOUVER. WA 98684 Each additional inspection over allowable In an , the above Per inspection 62.50 Phone: ( 360) 254 -6920 Fox: ( ) 1-866.530.4325 Investigation per hour(' 00410 6350 " CCB Lie•: 14117 I Electrical Lic• .1 -154CL Suprv. Lie.: 1 73LE6 Indttstlial plane per hour 73.75 _ • ...., '• 'CfdtC RICAL PRRMIT FEES •- Suprv. Electrician signature, required: Subtotal: $75.00 Prittt mime: JACK CAGLE Date: 7 /29/09 Plan review (2596 of permit sea): • State surcharge (1296 of permit fee): $9,00 Authorized signature: TOTAL PrftRMI'rME: , $$4,00 D ate: 7 /29/09 - "'�t'I omit application expires If a perm t h not 'Mottled uilhlo 180 Printnnrnc: ETHAN A. DOLPH days after it Imo bcen ecceid easeel /Tit . IaOadhttn N4naA,n ?t,C•pvueA ate etrarov ° Number ofloepe :Ituas u4Wwed Mr/wink. L iY 4i0.a615•r(tinrvOO�fAViat