Permit C ps
CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00251
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/27/2007
PARCEL: 2S 112 B D - 00100
SITE ADDRESS: 07560 SW BONITA RD ZONING: R -
SUBDIVISION: BONITA VILLA APARTMENTS LOT: 065 JURISDICTION: TIG
PROJECT: BONITA VILLA APTS
Project Description: Install low voltage fiber optics for Verizon. Apartment numbers 25 -48.
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:
WASHINGTON CO. HOUSING AUTHORITY NORTH SKY COMMUNICATIONS INC
111 NE LINCOLN ST PO BOX 87550
#200 -L, MS63 VANCOUVER, WA 98687
HILLSBORO, OR 97124 -3082
Phone: 503- 846 -4794 Contact #: PRI 360 - 254 -6920
FAX 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 6/27/2007 $75.00
[TAX] 8% State Surcha 6/27/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 uestions to OUNC at 503.246.6699 or 1.800.332.2344. /n/"
Issued B Permittee Signature: Sk App';
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.
•
06/26/2007 TUE 13:14 FAX 1x1035 /038
1)1 ! u5L -1- ? IrJI L. /V ` 2.c — 5v
Electrical Permit Application 1Q i- FOR OFFICE USE ONLY
City Of Tigar F � 1 � Date /By: �� / S i Perm" No.: ►/J — �5 f
'r 13125 S W Hall Blvd Tigard; OR 97223 Plan Review 1 � -
Phone: 503.639.4171 Fax 50 � � 8b0 V Date/By:
Other Permit:
TIGARD inspection Line: 503.639.4)11}5 r Date Ready /Ey: tu El See Page 2 for
Internet: www.tigard- or.gov �`U F U' t .. t . y o� ita Notified /Method: I I Supplemental Information
tl" nlal
:
.. : ' tr -e igEW(WORK .. . • PLAN: REVIEW,, ..
❑ New conshvction Addition /alteration /replacement
Please check all that apply (submit 2. sets of plans w /iterns checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
` "' ::, :.. `CATEGORY...OF CONSTRUCTION .
exceeds 10,000 amps at 150 volts or Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
XMulti-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
. .. . ❑ Emergency system. larger separately derived system.
' :JOB SITE INFORMATION AND LOCATION
❑ Addition of new motor load of ❑ "A ", "E ", "i -2 ", "1 -3 ",
Job no.: Job site address o yy W Ve 100HP or more, occupancy.
'j(� ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: •. f GI ��' t ❑ Health -care facilities. ❑ Supply voltage for more than
i ❑ Hazardous locations. 600 volts nominal.
/ no. r,
• Suite /bld a ❑ Servic or feeder 600 amps or more.
g p 9 � l � ', •= name: �dYtI�7� Villa :
FEE' SCHEDULE. .•
Cross street /directions to job site: Description I Qty. I Fee. i Total I *
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot 110.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential
DESCRIPTION .OF WORK • ` , (with above sq. ti.) 75.00 2
�(( ,t • l /y Limited energy, multi- family
V 1 , S. (A C. - ('\9
. • 't f/ - 1 i ; 1 j . %• 1 1 i ����� V t � l :.1/ I residential (with above sq, ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80,30 2
❑ PROPERTY OWNER • ❑ TENANT • _ 201 amps to 400 amps 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 volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
Fee for branch circuits with
.
• i_ ❑ . _APPLICANT $ CONTAC T PERSON above service or fee fee, 6,65 2
each branch circuit •
Business name: ,j t. (`'s/ s 1 rh "� 1.;, A s A7 t
�� �i f�1 t j c T't fi : !, l ) 1 l,:. { �j.• B, Pee for branch circuits
c
without service or feeder fee,
Contact name: ( ' f,.+ ( 1 ..-t ` a - •' ( ' 1' first branch circuit 46,85 2
' ' J1 r` / 1 Each add'1 branch circuit 6.65 2
Address: 1 ( 1 'Is, ,`f,T 'V t6, 1 `i t " 1 j�v 1 f \ 1 _) , 4 ti ,`'?I '/'• ,1
* ? Miscellaneous (service or feeder not included)
City /State /ZIP: \[ )„ .,; '• 1 tw ,V-e/vi 4t"\J it ( {/..., 1, c '(, 1 Each manufactured or modular 90.90 2
- ,,, dwelling, service and /or feeder
Phone: ( ((�1�,,ti.) 4 ?.?_) ` 1� "�.1
i %
Fax:: (�p r -� !- � j ■ {'j Reconnect only 66.85 2
E -mail: 1' Ji• ,(.} I(0 l
/) ; Oli�� \ J!-..` I (O \A/} . Ct Y\� Pump or inigatio circle {
0
,.. •. ........:C NTRACT R , . ' :; .`::. • : ......... Sign o outline lighting
r outlin 53.40 2
Business name: �• //
c . pp C•, -e-- Signal circuit(s) or limited -
�1 ✓(I� L.- l `� energy panel, alteration, or
Address: extension. Describe; \ Page 2 i6 2
City /State /ZIP; Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: \ Electrical Lie.: Suprv. Lie.: lndusttial plant per hour 73.75 _ • ELECTRICAL `PERMIT FEES:.' •; .,
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of pennit fee): IP r7)
, TOTAL PERMIT FEE: � \ �
Authorized signa�itie : :- .; : :%'��'� _ - - ..::. - _ � - _
r \ This permit application expires if a permit is not obtained within 180
Print name: <.CA/ I N . ``/ n 1 1K . C D d "E 1 l(!` �J c. t � Date: 9 w I !ti- days after it has been accepted as complete.
* Number of inspections allowed per permit.
I: \Building \Permits \ELC- PermitApp.doc 05/23/06 440.4615T( I 1/05 /COM'W0t
'CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00251
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2712007
Phone: (503) 639 -4171 44411 I �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/16/2007 TIME: 7:04AM PAGE: 40
SITE ADDRESS: 07560 SW BONITA RD CLASS OF WORK:
SUBDIVISION: BONI - TA VILLA APARTMEI\ITS LOT #: 065 TYPE OF USE:
PROJECT NAME: BONITA VILLA APTS
DESCRIPTION: Install low voltage fiber optics for Verizon. Apartment numbers 25-48.
OWNER: WASHINGTON CO. HOUSING AUTHORITY, PHONE #: 503.846 -4794
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 1/16/2007 Pour Time:
Code # Inspection Description . Confirm # Contact # Message
135 Low voltage 0520211.01 503 - 843.51313 N .
Corrections /Comments/ Instructions:
PASS U PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: ikelde54 Date: Phone #: (503) 718 -