Permit q ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00264
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 2S 110AC -01200
SITE ADDRESS: 11418 SW BULL MOUNTAIN RD 5 -B ' 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 121 -124 & 221 -224.
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.
c - , &
Issued By: , J7.e Permittee Signature: Q )1g (t i an
OWNER INSTALLATION ONLY Apia
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.
07/02/2007 MON 18:40 FAX 0006/011
F
Electrical Permit Applicatio; FOR OFFICE USE ONLY
City of Tigard DatefB 5 Permit No.: ale/ r / 7 —/y)2(014
g ) U L 0 y ed
13125 SW Hall Blvd., Tigard, OR 9722 Plan Revies,, Other Permit:
""� Phone: 503.639.4171 Fax: 503.598. }L960 a (�A� Date/By:
TIGAILD Inspection Line: 503.639.4175 t i 1 Or l• LIr. PFdy® Date Ready /By: !urn: El See Page 2 for
Internet: www.tigard- or.gov BUILDII4,^. DIVISION' Notified /Method 7 /6-- Supplemental Information
TYPE OF WORK • PLAN REVIEW'
❑ New construction Addition /alteration /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.
" CATEGORY•:OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial agricultural
❑ 1- and 2 - family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
XMulti ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION _AND LOCATION ❑ Emergency system. larger separately derived system.
'
❑ Addition of new motor load of ❑ "A "• "E ", "I -2 ", "l -3 ",
i n `n 100HP or more. occupancy"
Job no.: Job site addres
si t g i t �1w t \f(Ii1 -A ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ('�' U� �� ❑ Health -care facilities. ❑ Supply voltage for more than
t ) 1 '( W•r , l� l Z ❑ Hazardous locations. 600 volts nominal.
uite/bld / a t. n0. } Pro'ect name: ` j
S ❑ Service or feeder 600 amps or more
g' p �L lZ� I t 1t 1 ,�'`,f�t�l� I,�1.'S ' FEE SCHEDULE • ' • .
Cross street /directions to job site ZZ t, -2 " Description 1 Q t y . I Fee. I Total I
New residential single- or multi- family dwelling unit.
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 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK .. ' (with above sq. ft.) 75,00 2
Limited energy, multi- family
{ r, 1 . f , 'l ,I t , ■ r \ 75.00 2
1. C , !:.x- r 1 .. ; 1f . / \_ I Al i s t! j / /I ) residential (with above sq. ft.)
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 I
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
Brands circuits – new, alteration, or extension, per panel
Owner signature: Date: A. Fee for brands circuits with
❑ APPLICANT I : $ICONTACT PERSON above service or feeder fee, 6.65 2
t (, < � , each branch circuit
Business name: t'\ i t - & . V \ - ".tl ,/, � t !'' I l i \' i : " 1
`, 1 , 1 - '1'. B. Fee for branch circuits
l without service or feeder fee,
Contact name: ` M 1�i 1� \ 'Q r � S first branch circuit 46.85 2
Address: 3 (c; i � i: (,:; i'> iii‘ l ? 1 , V 1(./t' t / 1 – — 1_)� l - t ''` F - 5 j Each add'I branch circuit 6.65 2
7 r C: Miscellaneous (service or feeder not included)
I .; n f . �:vT: � C
City /State /ZIP: \ i ?'.. 1 .14_2 l � (; 1 i Each manufactured or modular
,:.. , ! , ,. r : V / � ; '•, �. 90.90 2
dwelling, service and /or feeder
Phone: ( ) '�, -4';(097,,c Fax: : ? 2, i j 5 * , �' --� Reconnect only 66.85 2
� Pusn or ini atiou circle 5340 2
E -mail: . Q \ve \� )s c'(1(`.,•o1SY.�6cvc l`('(�torn ` p g
COT x . 1 Sign or outline lighting 53.40 2
Business name: 4' Signal circuits) or limited -
��, I� - � � �� Wi k �� .( � 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 (1 hr Irvin) 62.50
CCB Lie.: \ ( -.;,, j t Electrical Lie.: Suprv. Lie.: ]ndusttial 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 permit fee):
Authorized signature:. ,, 7 '_ ,. ,. __„ - . _ TOTAL PERMIT FEE: � I
f ` i II Date: This permi application expires if a permit is not obtained within 180
Print Warne: �D/
l/ ✓ t 1'\ . 1� 11_.AL l/I ( -' , C, l 1. i 1 -' _. -O ` - days after it has been accepted as complete.
I o Number of inspections allowed per permit.
I:\ Building \Permits \ELC- PermitApp.doc 05/23/06 440.46IST(I I /05 /COM'WEB
• CITY OF TIGARD n
BUILDING DIVISION PERMIT #: ELR2007- 00264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/3/2007
Phone: (503) 639- 4171uiioi#
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/23/2007 TIME: 7 :06AM PAGE: 32
SITE ADDRESS: 11418 SW BULL MOUNTAIN RD 6-B "''* 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 121 -124 & 221 -224.
OWNER: ANDREWS MANAGEMENT LIMITED, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 7/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 35 Low voltage 052611 -01 603 - 8419 -6198 N
Corrections /Comments /Instructions:
•
PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
F I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: w 6 v t-G Date: if 301 Phone #: (503) 718 -