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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT g COMMUNITY DEVELOPMENT Permit #: ELR2009 -00206 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16108 SW 108TH AVE 10 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: WC a9 IA .9 l t kj.` I Permittee Signature: Lk11 Sc . � - OWNER INSTALLATION ONLY 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. .9 RECEIVED • Electrical Permit Application 9 2009 FOR . OFFICE USE ONLY:: .'' :.;;', • ' ':: , `; City ofTigard l !i1 ' r OA - 0 `e !� s 4 t112s sw li thud Ti OR 9 , TY OF TIGA' 1 �� l . e lan aavlew Phune: 503.639,4171 Fax: 503.5 ��ugt••c /a Oth renter: ftGARD Inspection Llnet503.639.4175 tj ING DIVISI , •lii w attylli a 62 Sac Pagc2 for Interact wwwsign+rl rxgnv NwifiedOda hal+ I (5 11 rivpptemantni Infarmanai '` :.'. 't • TYPE On WORK :i• ;', , :•.•a:•:.. •...; • .: REVIEW '! +:' ? : '.; ..' ' Nowlrot el10R 17 Addition /aiteratiott/reptacetnent Picnic chock WI that apply (submit 2 settnl ' lire,uwn+emtchockadbeiuw): [ Demolition C3 Other: °Sorvko or feeder 400 amps us mint l] anJldilts over thaw AWL'S. where Oro avuiiahlc flail curtonl R Msnmr mild bt tlyantr, '11 ... 4 .;,'.1 , ...::' , .. : •::' , i :.• '• CATEGORY •or:(ONS'1 IWC'I'ION,. - ......• • - exc.wir 10000 amps al ISO sviu,v D ftnatln lraiWb,rs, ❑ ! - and 2- family dwehia COmtllerCiai /ihtlm5[rlal lox to wawa). oruxaocdv 14,000 ❑Caonnv,cl.l -use nadeuharol 8 © ❑Accessorybuilding n+psroenn alwr hnmlhniws. bhildingi. El Multi - family 0 Master builder 0 Other: CI rim pap, Q himikdi00 7S KVA or :``'! "': -'• JQB SLTF iNEORMATlON AND LOCATION �cn +crgc,uyryarom, iargorsepamtdy ttorivedsystom, • - QAddiannnrOnvmmts Woof CI "A", "K" •'1 -S" "14", Job no.: I Job site undress: 16108 SW 108TH AVE alOMP arnw,a. acanay, 0 Sig or uwrc (crkkntiul unit, 0 tIttuwmtirmal vehicle parks CIty /Stnte/22P: TIGARD, OR 97223 aKonllh<a,eneitniar. I:1sr/p,ty voltage for more thou • t10, 9 1$ CI Hazantmn locations. MOvnitx nominal. Suite/bldg./apt, IProjectname:BRIGHTWATERS( R EDHAWK C) Servivont (eeder600unpi orman. •.'"•":.:•,:•.'•'• . '..Ft.E'SEtrEDULE -' ' Cross street /directions to job site: na 1 +• I Pte, I 'nd,J I • '-` New residential single• or multi-fondly dwelling mutt. Includes attached gat -age, Subdi vision: I Lot Ito.: 1.000 xq, t, or USN 145.13 —" 4 Tax tamp/parcel mesa I Ea, tale)'! 50014 11 or portion 33,40 1 Limited energy. residential 75.00 2 DESCRIPTION OF WORK ' (will, dime sq. tt.) INSTALL FIBER OPTICS FOR VERIZON tindrettctlorgy, mull- ramify 75,00 2 , residential (with otxnsr slid a.) Servkee or feeders iniallgaon glteratlnn, afttl/or rotoctttie 200 amps or less 80.30 2 . '''D PROP).R'fV .. 'Er TENANT ' ` . 201 amps to 400 amps 106.85 2 Name; 40( mops to 600 niups 160.60 2 Address: 601 an f x to 1,000 amps 240.60 2 Over 1,000 snips or volts 454.63 2 City/State/ZIP: 'ronrpnrary services or feeders Inslnllatlun, attetrttion, and/or relocation _ Phone: ( ) I Fox: ( ) 242!0 amps or leas _ . 66.83 Owner installation( This instnlltuiun is being made on property that 1 own which is not 2 20 1 amps to 400 nn 100.30 2 intended for sates lease, Mt, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 13175 2 ' Owner si nature: Brd -t $ Date: neh circuits- new. alteration or extenion, per panel _ -- •— A. Fee for branch circuits uwith r ' '.' • a APPLICANT ' : •' : ... • • '" ,+(� CONTACT PERSON ' above service or feeder fee, 6.65 2 ' • naat Business o: each branch circuit NORTH SKY COMMUNICATIONS, INC, B. Fee for Wog circuits Contact name ERIK SCHENCK ',whom service or feeder fee, 4(185 2 first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ;WI branch circuit I - 6.65` .- " ---- Mrsecllatteous (service or feeder nut included) City /Statc/ZIP, VANCOUVER, WA 98684 L.icI, manufactured or modular dwetlina, service minter feeder 00.90 2 Phenol (503 969 -7729 i Pod; ; ( 866 ) 452-4853 Reconnect only 66.85 2 Email; fpduorc northSkycomm.com Pump or irrigation circle 53.40 2 CON'1`RA4'TOR Sign or wane lighting 53.40 2 Buxinacx nnuw; Sigurd circuh(x) or limited- NORTH SKY COMMUNICATIONS, INC, energy panel. eltoretion.ur Address: 11818 SE MiLL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City /Su"/ZIP: VAC VER WA 98684 of Roth additional (uspection over allowable to an tilt above • 254 -8920 Per Inspection 02.50 Phone: (360) Fax :( ) 1 -866- 530 -4325 Investigation Krltott omaven 62.50 CCB Lie.; 14117 I BLactrical Lic.7 7 -154CL Suply, Lie,: 1731 - � S Industrial pram per hour 73 '••i• -: ... .` ' ELECTRICAL PERMIT PEES Suprv. Ctectricinn signature, requited; Subtotal; $75,0!) Print name: JACK CAGLE Date: 7/29/09 Plan review (Mk of permit fee)' Suite surcharge (12%ofmonk fee): $9.00 Authorized signature: /.._ - .Af TOTAL PERMIT Pte: $84.00 Print nnt7u : ETHAN A. DOLPH Date: 7/29/09 . 'flits hermit eindirnnu aspires If a permit In not WOW itStbin Ise days nnar it has ken accelnad ar tuupdde, tna 0anica tpp.rtae Ol,wes 441 -If 1¢7n lms/COaInw,:tl • Nuaibrr al'INSpalaimis allowed per penult,