Permit y � CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00160
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/10/2008
PARCEL: 2S 115AA -01100
SITE ADDRESS: 16105 SW 108TH AVE 113 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 027 JURISDICTION: TIG
PROJECT: OAK TREE APARTMENTS
Project Description: Units: 107 - 114, 207 - 214, 307 - 314. Installing fiber optics for Verizon.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MICHAEL ELTON NORTH SKY COMMUNICATIONS INC
BY MDE INSTITUTIONAL 11818 SE MILL PLAIN BLVD STE 4
6950 SW HAMPTON ST STE 320 VANCOUVER, WA 98687
PORTLAND, OR 97223
Phone: Contact #: PRI 360 -254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 6/10/2008 $75.00
[TAX] 12% State Surch 6/10/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / j� i1— Permittee Signature: / 4
0eX
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
JUN 07 2008 3:48 AM FR TO 5035981960 P.14
'" A --
OCEIN'E
Electrical Permit Application ,f, (1 . : `,.;„...1 ti$*
.W 6 1-1)u Roceivcd ,
. :' ,'''' City of Tigard D 0' '113 ; - /3 - t ,I : - 4 (DO
::: ."I 13125 SW Hull Blvd., Tigard, OR 97223
O ' IIGN n
t • ' . Phone; 503,639.417 I Fax 503-598,1900 ---V MiSlx.J ()lift P°Iitil:
7,
'Ft CARD fospecttor■ Line: 503.639,4175 .-' 1DI DI N l' Dthe Itcady/1.3y: HI See l'age 2 for
. . Internet; www.tigard-or. goy BU1 Nolittethwictimiti BM Supptemetitai information
- Pleaxe check all lieu apply (submit sets of piaibi vditenix checked below):
D Now construction 0 Addition/alteration/replacement
0 Service or fecacr'400 amps or more ID Building over three stones,
0 Demolition El Other: where the available fault current U MuOmis end hoinynoh,
--,—,,--
:.''.,...',....' L..' , ' .01' : CONSTRUCTION :' .'.. '': .. '' ' •.'..:: ‘..... ' ;,,:' excced$ 1(0.10 ;filmg; ili 150 volts or 0 kqoatill$ bllitditl
. .
loot to ground, or exceeds 14,0(10 Cl cniiiinerd:th,we victim:rat
0 1- and 2-family dwelling El Co Commercial/inclustrial 0 Accessory building amps rue ail Dater imitate' Mar, buildings,
_ 12 Multi-fatnily 0 Master builder 0 Other: Prim pump. 0 Wien:Ilion 0175 KVA or
---— , , , . . , ''- 0 Emergency system, lar:Ter Ncrwaicly derived syiniu.
. IOB:SITE INFORMATION AND • LOCATION : ''..1'.. ' • , .'• ,' ., ':..••••. , rn
1_1 Addition or new mmor load 01
, •
" 1001-19 or muic. oecoparicy.
Job no.; Job site address' 16105 SW 108TH AVE o Six or mom resirlernial uniis. El ici.,,,maiimmi vetildc p.irkx_
Cy/Slate/ZIP' TIGARD, OR, 97224 0 Haalth•carc I'm:links. 0 Supply voltage for more Man
in Hamlet* ioculiem. rim vin, nonnind.
SUitCrblagiOK no.: 6,107-114 Project riat'ne.. OAK TREE 1 & 2 APTS [J Serviee or feeder 600 :imps or luoie,
--
Cross strect/dirations to job site: 207-214, 307-314 Oncripttun I I Fee. ___1 Tulin 1 .
New residential single. or multi dwelling unit.
Includes attached garage.
. .
Subdivision; Lot
LOGO sq. II. or less 145.15 4
no...
Ea. tald'1500 sci. I). or portion 33,40 I
Tax map/parcel 110,: Limited energy, residential
- . „ . 70 2
DESCRIMON OF WORK ' (with above sq. ft.) _
Limited energymulti-faMily . 7 ._
• ,
INSTALL FIBER OPTICS FOR VERIZON residential (with above so, 11.) 2
. .
Services or feeders installation, alteration, and/o relocatlo
107 (/q 9 vi 507-3/ "( 200 amps or less 80.30 2
—
'1:1 PROPERTYOWNER • ' '' ' : :,'. O TENANT ' '' . '. . • ., ': 2(11 amps to 400 :Imps 106.85 2
Name:
— — ., .. _ . .
401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address:
Over 1,000 amps or volt*: 454,65 2
City/State/ZIP: Temporary services or feeders installation, alteration, arid/ or
iTioeation _
- . „ ...._
Phone: ( ) Fax: ( ) 200 amps or less 66.85 t
_
1 2
Owner installation: This installation is being made on property that I. own which is not 201 ttr1111S 10 400 amps 00.30
intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 anipX 10 599 amps _ 133.75 2
Rranch circuits - new, alteration, or extension, per panel
Owner Signature: , Date: A. Fre for branch circuits will,
' • • '• • . - ' • ' • 0 APPLICANT . ';:.".'' :' •••: •''' 'CONTACT PERSON ' ' above service or feeder fee,
6.65 2
each branch circuit
Business n AMC: NORTH SKY COMMUNICATIONS, INC_ B. Fee for branch circuits
-
without service or feeder
Contact name: RYAN ,_ ROBERTS --_
ROBERTS first branch circuit __ fee, 46.85 2
_
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each athri branch circuit 6.65 2
Mit:MI:mous (service or fettle not included)
City/State/ZIP: VANCOUVER, WA 98684 Each tnanithictured or modular
90.90 2
— — ing. Service a
PhOnel (503 ) 519-5264 Fax: : ( ) 1-866-905-4907 dwell ncvor feeder Reconnect only 66,85 2 '
E-mail: mduoranalusicamrasom Pump or irrigation circle 5140 2
--
_
'. ' •• ...' • ' '' '' ' • . .coNTRAcTOR - - ., - ' . . • .. • - . ' • " Sign <)r ontline ligming 53,40 2
Sival circuit(s) or limited-
Bwi name: NORTH SKY COMMUNICATIONS INC. energy panel, alteration, Or 1
Aadre4s: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: Page 2 $75,001 2
City/Slate/ZIP: VANCOUVER WA 98684 E ach additional inspection over pllowahle in any of the above
Pet inspection 67..50
Phone: ( 360) 254-6920 Pax! ( ) 1-866-530-4325 Investigation per hour (I hr nilit) 62,50
CCB l' 14117 Electrical Lic.17_154ct supry. Lic.: 173LEB industrial plant per hour 73.75
'.: '''' ' -.. .' • . ELECTKICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: $75,00
Print ail review (25% or permit fee):
nt name: JACK CAGLE D a': 6-6-08 ........_ State surcharge (1252 of permit fee)! .. $9.Q0
Authorized siguntom: ____zgZ._X 0 TOTAL PER/v1tT rac; $64.00
_
Thislictant iipplication wires if a permit is not ohtal fled within 150
Print name! ETHON A DOLPH Dot 6-6-08 rlay$ tiOcr It has been accepted os complete.
— . - A. . . —
• Number of inspection allowed per penult.
hibuilibatmentiiimix 0503/06 440.451 vr3 lif55/CO51tWiln
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El_,R200 3 00 160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6110/2008
Phone: (503) 639- 4171r+ll�lpi�� +
Inspection Requests (24 Hrs.): (503) 639-4175
WORKSHEET FOR DATE: 6/1112008 TIME: 7: 00/011 PAGE: 28
SITE ADDRESS: 16105 SW 108TH AVE 113 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 027 TYPE OF USE:
PROJECT NAME: OAK TREE APARTMENTS
DESCRIPTION: Units: 107 -114, 207 -214, 307 -314. Installing fiber optics for Verizon.
OWNER: ELTON, MICHAEL PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 6/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 07121402 971- 563 -4082 N
Corrections /Comments /Instructions:
'}
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ni5eLLI Date: 6 6/ Phone #: (503) 718- 2-41-ii)