Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00262
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 2S 110AC -01200
•
SITE ADDRESS: 11424 SW BULL MOUNTAIN RD * ** ZONING: R -25
SUBDIVISION: BULL MOUNTAIN HGTS. APARTMENTS LOT: JURISDICTION: TIG
PROJECT: BULL MOUNTAIN HEIGHTS
Project Description: Install low voltage fiber optics for Verizon. Units 111 -114, 211 -214, & 311 -314.
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:
ANDREWS MANAGEMENT LIMITED NORTH SKY COMMUNICATIONS INC
11336 SW BULL MOUNTAIN RD #103 PO BOX 87550
TIGARD, OR 97224 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 7/3/2007 $75.00
[TAX] 8% State Surcha 7/3/2007 $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 By: 4/ Permittee Signature: 0 , An9
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.
07';402/2007 MON 18:40 FAX lJ004 /011
s' Y R u5 , 7k PAr 1 MG ?to- zc5 -- 5vo —
Electrical Permit Application Fog OFFICE USE ONLY
R ece i ve d
City of Tigard Permit No.:
1 3125 SW Hall Blvd., Tigard, 9 23 Plait Review
i-I - )O r SLID &it?..0 7 — oa2(0 7
g Plan Review
^
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: ' Phone: 503.639 "4171 Fax: 50d.523..11 = 9 Date/BY: Other Permit:
TIGARD inspection Line: 503.639.4175 j1 ` ® 2 2001 Date Ready /By: 1w'is' 0 See Page 2 for
Internet: www.tigard or.gov ` . Notified/Method: Es' Supplemental Information
TYPE O.F. Y a : y ' .. el t ; r... (� 1 _ PLAN REVIEW ' .
la �+� �. ,Aect4��
e n ear n.nt v Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction Addition /aptn� placement
❑ 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 rolls or ❑ Floating 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.
J Multi- 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 ". "1 -2 ", "1 -3 ",
��� 100HP or more. occupancy.
❑
Job no.: Job site address: ,v " t — � , )�`�1 0 Six or more residential units. Recreational vehicle parks.
i
City /State /ZIP: t �' ❑ H ealth -care facilities.
.---- 0 Supply voltage for more than
I ( C� Y i �/ � �� ❑ Hazardous locations. 600 volts nominal.
Suite/bld /a t. no. ` Project name: �J , ` 1 1 �. i ❑Service orfeeder600ampsortnore.
g• P 1� _�Ir 6 J t� +��y1������(�� l . S FEE SCHEDULE
Cross street /directions to job s - 2A.-1..-1-4 , t ' I �J Description ( Ors. I Fee. I Total I
New residential single- or multi- family dwelling unit.
` [ ---3 4 Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
. . DESCRIPTION OF WORK •• • • (with above sq. ft.)
� Limited energy, multi - family 75.00 2
1 ' 1� ' '•. 12_I I "" , P !+' `') )"\ . i. , . '( )'� 1� r ` I 2-0() residential (with above sq. R.)
Services or feeders installation 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 /o'
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: A. Fee for branch circuits with
' ..' ❑ APPLICANT ' ' " iCONTACT PERSON above service or feeder fee, 6.65 2
/ " 1 each blanch circuit
l? . k/
Business name: t\ 1/ ,/ +:1, t ' (€ i.;%; ":. t` . 1.1 r 6 B. Fee for branch circuits
mono 1 \\, e without service or feeder fee,
Contact name: w\) (� � S first branch circuit 46.85 2
,r
�• f: i r Each add'I branch circuit 6.65 2
Address: I' 6 \ I: , ( ^t
I , a \ i 1 ( t /-: , f s , f f j CD , , , 1)(,) ..
Miscellaneous (service or feeder not included)
City /State/ZIP: \ it, ,,% , j 1..1, C .. 1 ' E ach manufactured or modular
' � � ' } r ' ( / 1 dwelling, service and /o• feeder 90.90 2
Phone: (��j ,'� " '; 2 Fax:: ?)(00 2 . tgyri Reconnect only 66.85 2
��s Pump or irrigation circle 53.40 2
E -mail: , +t ie.:'CoS CJ
� , x 11 ��i(� �Y n rl Pu Si nor outline lighting 53.40 2
ONTI 1'Ci r . g g g •
Business name: /1'` n �t� Signal circuit(s) or limited-
���, n �!(.t • 06-,\ WAt t0 \(..it V energy panel, alteration, or
Address: extension. Describe: \ Page 2 16 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) investigation per hour (l hr min) 62.50
CCB Lic.: \ H. l 0 Electrical Lic.: Suprv. Lic.: industrial plant per hour 73.75
ELECTRICAL' PERMIT:FEES
Suprv. Electrician signature, required: _ Subtotal: _
Print name: Date: Plan review (25% of permit fee):
- Slate surcharge (8% of permit fee): IP D * )
Authorized signature :.,..:: 4:_'.... . c:.. ._._. _ �-- - _ TOTAL PERMIT FEE: �'
/ r � This permit application expires if a permit is not obtained within 180
Print name: --1 / ( N. . (V1• \/ I,,, r, S,T ) Date: 1--.'Z •0? days after it has been accepted as complete.
K Number of inspections allowed per permit.
r;\ Building \Permits \ISLC- PermilApp.dnc 05/23/06 440- 4615T( I r /OS /COM /WEB
Case Activity Listing 7/27/2007
� E L 11:13:31AM
Case #: ELR2007 -00262
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ELR1010 Application received 7/3/2007 None RECD FAX 7/3/2007
SLN
ELR1020 Permit created 7/3/2007 None DONE SLN 7/3/2007
SLN
ELR1030 Check for parcel tags 7/3/2007 None DONE SLN 7/3/2007
SLN
ELR1280 Issue permit 7/3/2007 None DONE SLN 7/3/2007
SLN
ELR2135 Low voltage 7/25/2007 7/26/2007 7/26/2007 None PASS GN 7/26/2007 052812 -01 — 503 -849 -5198 — VM -
GN Y
ELR1740 Case finaled 7/26/2007 None DONE GN 7/26/2007
GN
tee_
Page 1 of 1 CaseActivity..rpt
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• CITY ��`�� �U��������
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BUILDING DIVISION PERMIT #: BR2007-0026
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/3/2007
;
Phone: (503) 639-4171
Inspection Request (24Hra�:(503)83S'4176 _��«�
INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:03AM PAGE: 27
SITE ADDRESS: 11424BVV BULL MOUNTAIN RD°" CLASS OF WORK:
SUBDIVISION: BULL MOUNTAIN HGTS. APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN HEIGHTS
DESCRIPTION: Install low voltage fiber optics for Verizon, Units 111-114, 211-214, & 311-314.
OWNER: ANDREWS MANAGEMENT LIMITED, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 350
Inspection Request Scheduled For: Date: 7/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 052812-01 503-849-5198 Y
Corrections/Comments/Instructions:
C t .
�� �� El PARTIAL APPROVAL n CANCEL NO ACCESS
^'
• | | FAIL | I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector:. ^ N c)6 ^� " - h Date: 6~� Phone #: 0503\ 718- 1 - 1 1 1- 00 '-��- �� m
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