Permit Ir CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00250
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/27/2007
PARCEL: 2S112BD -00100
SITE ADDRESS: 07520 SW BONITA RD ZONING: R -12
SUBDIVISION: BONITA VILLA APARTMENTS LOT: 065 JURISDICTION: TIG
PROJECT: BONITA VILLA APTS
Project Description: Install low voltage fiber optics for Verizon. Apartment numbers 1 -24.
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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B. • �i / / Permittee Signature: /),ofJ//
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 13:13 FAX ll034 /038
1 - vgA i7 !NC; D 2G L' �v
Electrical Permit Application FOR OFFICE USE ONLY
City T i and Received 7 -t 1'ermif No.:
y f ' �� DateiBy: :O 12 ' /O SLI & G6 - r0L�J6
.. 13125 SW Hall Blvd., 97223 Plan Review
Date /By: Other Permit:
Er
Phone: 503.639.4171 Fix: 503.598.�1960
TIGARD Inspection Line: 503.639.41753UN 6' 6 % ' Date Ready /By: Julia: 0 See Page 2 for
Internet: www.tigard or.gov 11 Notified /Method: TIEr Supplemental Information
'I'YPi✓QV*,(,)RKt*ifi) PLAN 'RVIE
EW
❑ New construction 0,Additlon /alteration /
e i P� ""i replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
,
:CATE •O F' C exceeds 0.000 amps �t 150 volts Floating , , .- 3 its o buildings.
less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
%Multi-family ❑ Master builder ❑ Other: 0
_ .: . system.
-; JOB SITE:iNFORMATION. AND •LOCATION • Fire pump. Installation of 75 KVA or
❑ Emergency system, larger separately derived s s
0 Addition of new motor load of ❑ "A" "G' "1 -2" "1 -3"
Job no.: Job site address:1..-' `t'O S1 'fib 1iI 100HP or more.
❑ occupancy.
�t Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: . (( p \4 i /� q - ❑ Health - care facilities. ❑ Supply voltage for more than
l v t t r ❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no. ect name; ❑ Service or feeder 600 amps or more.
Cross street /directions t Job site: Description I Qty. I Fee. I Total I *
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 eq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: , energy, residential
... . :: 5. 2
" , . ,; .. `. DESC.RI :OF: :WORK,.:: ` . ., . .. . . ' (with above sq. ft.)
A Limited energy, multi- family
l :-4/1 ), 0 /, � „ I residential with above s . R. 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
. _ ';;' ❑ PROPERTN ..oy%'N • ❑ ;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, Cr panel
Owner signature: Date:
A. Fee for branch circuits with
.. ::. ❑:,A.PP.4,1,, CANT: ' :: :` ....... .: ' .I'`' .' •PERSON : '' '. - ' ,.: above service or feeder fee,
6.65 2
a each branch circuit
Business name:
c
( i ) ; , \t £ S1t,i /•t t?
���� i:s1 If �"k ��,,,, ,. L• F 1 \ I �'; t , :t ( r ,. 1 l,T t B. Fee for branch circuits
[ i .,. without service or feeder fee,
Contact name: 0.
Aat,,fnl_l . . ,..l- A � ,.
, s v,•• +,`,1,`e�k I first branch circuit 46.85 2
Address: i J C /'� C / " S \J - o , ■ '. 1 l / k ) i a t ( A 'O '/ ,.'.�• Each add'I branch circuit 6.65 2
i. 1 Miscellaneous (service or feeder not included)
City /State /ZIP: \ i!'j ,j',,1' ") ,.V(j,/ r� t, C 1 ) l t / 2 t / Each manufactured or modular 90.90 2
g,
f dwelling, service and /or feeder
Phone: ())) I/0 •.:1 -' ° � ��, t ' 1,. \ Fax: : (CW -1 4.}' (b „ 2,..j....1 i-li-- Reconnect only 66.85 2
E -mail: V • ,e / 1)k I'W} -\ f) (DVA)/\Y-- { C O v C(a PA Pump or irrigation circle 53.40 2
CONTRACT R S ign or outline lighting 53.40 2
0 , � Y'J - . Signal circuit(s) or limitcd-
Business name:
(,) ('1✓Y'• t , f , et.. n
energy panel, alteration, or
Address: extension. Describe: ( Page 2 1G 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (i hr rain) 62.50
CCB Lic.: \ f \ 1� I Electrical Lic.: Suprv. Lie.: Industrial plant per hour '73.75
ELECTRICAL: PERMIT.' FEES .: .
Suprv, Electrician signature, required: Subtotal:
Plan review (25% of pennit fee):
Print name: Date: - State surcharge (8% of pennit fee): la a)
Authorized sign ,.,,,;s^' - _ ” < _';`�,1-^ - _ - - -. NC_ M : TOTAL PERMIT FEE:
' --- ` fhis permit application expires if a permit is not obtained within 180
Print name: ��'� I � 1 (� , I ( . �' T) Date: k (� Lf 1^ days after it has been accepted as complete.
* Number of inspections allowed per pennit.
I: \Building1Permits \ELC-t'erm it App doe 0523/06 440.4615T( i I /05 /COM'WEO
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR2007 -00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2007
Phone: (503) 639 -4171 av'viral,i
Inspection Requests (24 Hrs.): (503) 639 -4175 = °`:_
INSPECTION WORKSHEET FOR DATE: 7/16/2007 TIME: 7 :04A1 PAGE: 39
SITE ADDRESS: 07520 SW BONITA RD CLASS OF WORK:
SUBDIVISION: BONITA VILLA APARTMENTS LOT #: 065 TYPE OF USE:
PROJECT NAME: BONITA VILLA ARTS
DESCRIPTION: Install low voltage fiber optics for Verizon. Apartment numbers 1 -24.
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 052023.02 503 - 849.5198 N
Corrections /Comments /Instructions:
1 -ASS n PARTIAL APPROVAL n CANCEL NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( tf2-4e9A Date: Phone #: (503) 718-