Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• a COMMUNITY DEVELOPMENT Permit #: ELR2009 -00207
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009
Parcel: 2S115AA00100
Jurisdiction: Tigard
Site address: 16112 SW 108TH AVE 17
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 *AR 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: `� GM Ill. a .` 1 . L Permittee Signature: o� � c% j >
OWNER INSTALLATION ONLY 1 1
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.
P
D.
EIVED
Electrical Permit Application 9 2009 me, oiA>etcz usEaiulLir ` . -
ill City of Tigard r . 1rIGAR t TOM ��, 01 pr , r ' Tiga
.N_5 SW Hall Blvd., rd, OR 97223 - C
I �
tJt Plum: 503.639A171 iris:503.r0.l%0_, ! GDIVIS m.p.g.: m.p.g.: r tc tt fn torti cou Line: W 03g I Su Soc •.tt
Rumen 1 5.63
i 01 .os , ov pplc,ates 2 for
tnf8rnta1lvu
': : . 7 :. ' TYPE OF WORK ;i:1. :'' : ',:.. . , ?. - -r , -- ' t . , l'. ':'!.f.',..-,..:.;:,;* • Pf.AN RIiwiLtw.';.; %;:;`i
.' •.:' L
0 New consti Lotion in Addition /alteration /replacement Please ettnck,alt that apply (submit 3 acts nft,lan: w0tanc lurked txMw):
G Senvtco or feet1or 400 amps or mate 0 aunaitb; over Lame Morita.
0 Demolition ❑ Other:
aho :n ate available lain currem Q Morino ail boatyards.
• ,'•: :,, : :.' !':, CATEGORY •01 ?CONSTRUCTION .. exceeds l0000anmsor1SOtltrur ❑ Malin buildinrs.
0 I -and 2- rnmiiy dwchin COInnICI'C1Al /incluslrial font ii a ti, ora :rwJr 14,000 CI Commwalla-me awkulmrtt
g ❑ C] Accessory betiding moos forma osier iuslatknimn. bwiktingr.
U Multi - fancily 0 Master builder 0 Other: . a Pho pu n o. 0 to raltanun of 75 KVA of
"' ' : ''. ,; : -c <• ` '• ,SOB SITE •INFORMATION AND LOCATION :. o ':' i l7 bnurgc,u:yrtom. UrguroetoiydcrivoJsystan,
. . •. .. : .. .. Q Arklflinae ys facwnt<HOrkiadM C] "A" •Yi " pota "t.2•
Job no.: i Job site address: 16112 SW 108TH AVE wow or was. ta;cnpanc y,
Q Six Of wort reskkmiai units. t.) Itesomilmod statute lurks.
City/State/ZIPS TIGARD, OR 97223 in HeAltivenco racillrr,. Cl S'vpply volarjo for more tbau
❑ Ha,.atdnas sot:aliomr. 600 Mu minima.
Suite /bldg. /apt. no. 17 -24 I Project name: BRIGHTWATERS p REDHAWK i 7Ser v ica isfuaderilnouiips
'..Eton SCHEDULE • .
Cross sateen /directions to job site: _ oa t1j_den 1 Qtr. I net, L 'rand 1 r
New rosfdentlul single. or mtdr6tandly tnveiing uuH.
Includes attached garage.
Subdivision: I Lit no.: 1.000 sq. fl. Or tons 145.15 4
Tax ttnlp /p ante nod
"'–^" Ea. old'! 500 sq. ft. or ',onion 33.40 , 1
Willed energy, m%1I10iutal 75.0 2
DESCRIPTION OF WORK (ito,,, ce s,j, n,)
INSTALL FIBER OPTICS FOR VERIZON Ln ne i oc(ni ( wi mold-family , o a 75'°°
- Services or feeders ins1elintlonoltorattan, and/or relocation
200 mops or less 80.30 2
'•L] PROPL74't'Y ` - I :, - .. _•.13 TENANT 201 106.85 2
Name: _ 401 amps to 600 amps 160.60 2
601 hmpx to 1,0001onpo 240.60 2
Add CM: Over 1,000 nips or voles 454.65 __ 2
City /Stale /ZIP: Temporary services or factors Installation, alterrufon, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This inslnilation is being made on (iroperly that 1 own which is not 201 r to 400 ;apps 10030 2
intended for sate, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 oar to 599 amps 133.75 2
Owner signature: Date: ftt'ancli clecalls - new, niterat(on, or extension, per panel
A. Pee for branch ci with
. • - . CI APPLICANT . r:.' •' : :I - • ' •'I:1°CONTACT PERSON ' above service or feeder rco, 6.65 2
Rosiness name: t each branch circuit -
NORTH SKY COMMUNICATIONS INC. )3.FOCMfbtnn0hcit0uits
Contract name: ERIK SCHENCK without service or feeder foe, 46.85 2
lints branch circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Hach trdd'ibrunchcircuit —' 6.155 - '" 2
biisecnnncous (service or feeder not included)
City /Stale/ ZIP: VANCOUVER, WA 98684 Each lnunsfacturod or 'nodular
dwelling. service manor feeder 90.90 2
Phone: (503 ) 969 -7729 I Fax:: ( 866 ) 452-4853 Isecoonocr only 66.85 2 '
Email: mduorttnorthskycomm.com Pump or irrigation circle 53.40 2 '
CONTRACTOR • • Sign or tuitlino lighting 53.40 2
Buainosa name: NORTH SKY COMMUNICATIONS, INC. energy panel, or 'ion, Molted-
or
energy pnnol, alteration, Or
Address: 11818 SE MILL PLAIN BLVD. STE 410 wanton. Describe: 1 rago2 $75.00 2
City /State/ZiP: VANCOUVER. WA 98684 Each additional inspection over aU of mnthie In any ilw above '
- Phone; ( 360) 254 -6920 Pax: ( ) 1- 866- 530 -4325 62.50 Per inspection 62,50
Arvcsdatalat Dar Mari et mho
CCB Lie.: 14117 I Electrical Lac.. 154Ci Stq)rv, Lie.: 1731E8 Industrial plant per hour 73.75
• 'ELECTRICAL PERMIT PEES _ ••
Suprv, Blectr)cinn signature, required;
Subtotal: $75.00
Pratt name: JACK CAGLE Data: 7/29/09 Phut rnviow(2$ %cif permit foe):
/ Slate meriti rg° (12rb orpennf feu): $9.00
Authoriicd sign alur6: '�- TOTAL Prawn' Plin:
$84.00
i Print nnrne: ETHAN A . DOLPH Date: 7/29/09 'ITrly Permit uppltra( lutwaphvytfu0 41141tIs not olHaltot
i deys otter it sue brew ,tcroylcsl as duutl,lcir.
. NU1111X1Oni1410eani nrfuwed r nth,
i,nou. hriny mr app.dac 0512Y06 ndu- 441,tris au5f'uasMry;D 1K p¢