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Permit • CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 2 COMMUNITY DEVELOPMENT Permit #: ELR2009 -00205 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16106 SW 108TH.AVE 1 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 yQ of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: act) (\ ( -,I` X J V�-� Permittee Signature: - 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. • • '1'9IVED Electrical Permit Appileatioq ^ 909 'FOIt OFFICE USE UIVLY City of Tigard r t r. T . : O uc / i reran nn,: _ . . . a 13125 SW Nail Blvd„ Tigurd, OR 47223 - • • ' � t sA I Pine Review l„ ' , �� di 11 11 + ' Phone: 503.639.4171 Pax: 503.5 ,3 t�,(� - , ,GB , Other Permit; flGAR inspection Usti 503.639A 175 'tt.ai • t / :VIsli is _ _ Sl See Page Zfor interact: www.il3md- or.gnv Supplemental information • ,.. ,. , . TYPE OF WORK . 71,: • : . ..., , .., : - PLAN REVIEW. ‘0.'.'Z', ' ' .... . . • 0 Novi construction l] Addition/alteration /replacement Please cheek allthat apply (submit ;seu Al' Milos vntetnr eheckedslow): Demolition 0 Other; SOMce or fixdce 400 amps or mote ❑ Building overtime stoats, Wiest the :wailahie Chub ewrmni (3 Mnn+ws not hnmy;nds, r•� I - and 2 - family dwelling "•�' l''': CATEGORY •OF= (..ONS'1't(UC' I• ION . ,. meccas 10.000 amps vi 150 was ur 0 Fleming lwadinps, D building • leo; w ground. or cacccds td.eeo 0 Counncsclat•uso agilculutml C E1 omntercinl /industrin c Accessory building Ampsfor till whet' Iittullutian. bnihtingc. 151 Multi-family CI Master builder 0 Other: 0 Fitt pu„xc. a lntt:dhuiwtor7SKVA ur . : ', ?:: • ' .. '-'fOE S1TE•INFORMATION AND LOCATION ': ❑anwrgtntysyaomro taryericpatatctyacdvedyutont. ' . . . . - ... ❑Adtl(tlnn of nMV nxuer Inui of [3 "A'• "1s' •"1•'t" '� I 1 ^ Job no.: i Job site address: 16106 SW 108TH AVE 100HF n mom. 1t't "panes' City /State/ZIP: TIGARD, OR 97223 ❑Sk is mom at(ccit,iesa. ❑Su unite, D t y vo iunalge l b e packs. [iHoalc@eith. n: ft,• more than CI Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no, 1 -8 ' i Project name: ERIGHTWATERS © REDHAWK 0scrrico0( owns drnaut, `' -. • ' '••FEE'SCtICDULE • • • Cross street /directions to job site: Oto ,nun , 1. Par. 'Not r New res dentin s ogle- or mu I • ant y dwelling uull. Includes attached garage, • Subdivision: Lo{ no.; 1,000 so, IT, or less 145.15 4 Tint coal — Via. atld' 1 500 sq. It. or portion , 33.40 I p/parcoi no.: Limited many, nesideatial DESCRIPTION 01r WORK • (with :time sti,It.) 7100 2 United trial (somehow. 75.00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with tnvau al, 9.J Strokes or feeders ins1atlntlon, altcrutlnn, and/or reloecdin 200 amps orless 80.30 2 •''© PROP)iR'1'Y:OWNER •' : •.• - 0 - TENANT ' ` +. 201 Amps to 400 coupe 106.85 2 Name: 401 mope to600 mops 160.60 2 — 601 atop, to 1,000 am 240.60 2 Address: Over 1,000 amps or volts - 454.65 2 City /State /21P: Temporary Oct vices or feeders insiallatlon, alteration, and/or relocation Phone: ( ) I Pox: ( ) 200 amps 6e test 662$ 1 t Owner instullation: This installation is being trade on p roper ty that I own which is not 201 maps to 400 amps 100.30 2 ' intended for salu, lasso, rent. or exclumge, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 13175 2 - Owner signature: ____ _Ague: Branch elrculte new, alteration or extension Cr anal — , ' :' . © A. Fee for circuits r f APPLICANT ' ': ni CONTACT PERSON above service or r feeder fee. 2 • n Business mao: Weltbnnwhciroait NORTH SKY COMMUNICATIONS, INC, B. Fee for branch CitChilx Contact antne! wit oaf service or feeder fee, 46.85 2 ERIK SCHENCK dintbmnchcifcuit Address: 11818 SE MILL PLAIN BLVD STE. 410 each add'! brunch ciscutit 6.65 ___ _ btiscetlatteous 4E0.40 or feeder nod included) _ City /Statc/ZIP: VANCOUVER, WA 98684 v Such manufactured ormodular dwelling, service orxi /or feeder 90.90 2 Pinola: (503 ) 969 - 7729 i Fax :: ( 866 ) 452 - Recotmeot only 66.85 2 Boll": fnduo p)northSkycom171.com .. Pump or irrigation 53.40 2 CONTRACTOR Sign or outlinelIghdng 53.40 2 Buainass mm�0: si eircuit(a) or /hilted- _ NORTH SKY COMMUNICATIONS, INC. energy panel, alter:Mum ur Address: 11818 SE MiLL PLAIN BLVD. STE 410 esiension, Describe: 1 Paget $75.00 2 City /Slare/ZIP: VANCOUVER. WA 98684 Each additional inspection oven' allowable in an of tlteabove • Phone: ( 360) 254 -6920 ',Fax: ( ) 1- 866 -530 -4325 _ Per inspoa inwallowed 62 wallowed ed nn pxu itohr (1 to mini 62,50 CCBLie.: 14117 I Electrical ue.:17- 154CL Suprv.Lie.: 173LEB lnthtsuriai Oast per hour 73.75 • 'ELECl'RICAL, PERMIT FEES 7777 ' Suprv. Electrician signature, required: w Subtotal: $75 00 Print outrun JACK CAGLE Dale : 7/29/09 Plat review (25% of permit fee): State surcharge (12% of permit fee): $9,00 Authorized signature: /_ ` ' TOTAL prnt)rtl'rPSIS; $84.00 Print nnmc: ETHAN A. IDOL PH I Data 7/29/09 'rids t rormft npplkat(un expins if t oermlt Lc not obtained watt 180 ._._ days after It has been omitted as complete. • Number ol'inipe iluni utloncd per pennlb In0, raIAng0 'orusantil,C•sbrmOApp,rinr a.4).tbd 440.46IYI'(1Ia1,tft'o5hw811