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Permit
111 . CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 3 COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00209 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/15/2008 PARCEL: 25111 BB -01301 SITE ADDRESS: 14120 SW DRIFTWOOD CT ZONING: R - SUBDIVISION: DRIFTWOOD TERRACE APARTMENTS LOT: 8 -9 JURISDICTION: TIG PROJECT: DRIFTWOOD TERRACE Project Description: Units. 4 -6. 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: CAMILLE FISCHER NORTH SKY COMMUNICATIONS INC P O BOX 520 11818 SE MILL PLAIN BLVD DUNDEE, OR 97115 SUITE 410 VANCOUVER, WA 98687 Phone: Contact #: PRI 360 - 254 -6920 FAX 1- 866 -530 -4325 Reg #: ELE 17- 154CLE FEES LIC 14117 Description Date Amount [ELPRMT] ELR Permit 7/15/2008 $75.00 [TAX] 12% State Surch 7/15/2008 $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: �r Permittee Signature: .� 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. JUL 14 2008 9:34 PM FR TO 5035981960 P.07 Electrical l erinit Applicati �c, -.. Ck, i7 ' ' '.. ' City of Tigard �F!� t I ' f � �. 13125 SW Hail Blvd., Tigard. 0 i � - `!I 2 ` ' Phone: 501639 4 17 1 Fax 503.598.1960 pthua Permit: 'T1 GARD inspection Unix, 505.639.4175 11 j 1 Z OO Imo Rcaayn3y. ,ee Page 2. for ww.t iga,�l. Pr, goy J NedCcdrMcn tt; ®, ^� _• $app mculUl Information p oS}J n crnl w i "' �r1 Se i gMll N „, , TYPE OF '' r � emitter 400 0 Scrvieu or e Dib � `� Yt t PLAN REVIEW t V 0 New GonstructioR Addition /ai �' I i •> - - -- Ian a pply (submit 2 Sett Or plan w /ucm: cheel.cel kilo,): t--t g mi ,ups or more ❑ funding over anti° sta•ans- . u Demolition Other: whcrc Ihc:availulnc Itudt SW 0 blannas hnaty;nds. CATEGORY UE CONSTRUCTION exceeds 10.000 .t1 150 w,ttx to ❑ Flouting building,. El y I - an 2-family dwelling building less to ;tound. orcxcecds 14,0(10 ❑Co arlicultund g ❑ Cot71)ttercial /Indust U Acces sory building ramps for ill Uthcl 1nb11dlnllotiS, buildiii s I7 Multi - family ❑ Master builder Other: 0 Fi,t pmnp. ©! at 7$ KVA u1 JOB SITE INFORMATION AND LOCATION �e`g ° "cy xrstc,„ larger sel>uatciy etc ived : ;15 n,, ' © Addition of new crnxni limit of ❑ �" p^ .n ,• e.} Job no.: Job site addross. 14120 SW DRIFTWOOD CT. I00HP or inset, iCCaapan[y. m� - • L'IS.a er more rc i,ll units. D R c vchiClt parka. City /State /TIP: TIGARD, OR 97223 ❑ Hcalal -cam taciritics, 0 Suppl veliage for more than — _ ❑ l a idnes Ire:A sin. 000 volts nominal. Suite /bldg. /apt, no.: 4 -6 Project name: DRIFTWOOD TERRACE 0 Seviroorfecdcr600 limns ol more, - FEE SCHEDULE " CrOSS Street /directions to job site: llaxwpnw,a I Qty. I tor. - 1 - r,n.ai I New residential single- or multi - family dwelling unit. ... _ ,_ Includes attached garage. Subdivision: Lot no,: _ t,U00 sci ft. or Icss 145,1$ 4 Ea. add'I 500 sq, ft. or portion MEI - IIII is map /parcel nom Limited encigy, icstdential DESCRIPTION OF WORK (watt i,lxrrc , ,ii. n.) 75.00 2 INSTALL FIBER OPTICS FOR VERIZON l. itni( enei - gy, tttuln ly 7500 2 � .M y lCSidentini weth.alx,vasry tt,) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 _^ ^ 0 PROPERTY, OWNER ' ' • 0 TENANT 201 i amps to 400 a mps 106,83 2 Name: _. w,__. tO f amps to 600 snips 160.60 ? 601 amps to 1,000 amps 240,60 2 Address; ,mm 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 of less 66,85 Owner installation: This in6lallalion is being made on property that I own which is not 201 amps to 400 amps 1003() intended fox sale, letlsc, rem, or exchange, according to O1,S 447, 449, 670, and 701. 401 amps to 599 amps 133,75 Brandh circuit', flew, alteration, Or extension, per panel Owner signature: --- ,,,,- ,___ Date. ---- - -- A . Fee for htanch circuits tcirlr . ' 0 APPLICANT in CONTACT PERSON above set vice or feeder Pee. 6.65 2 each branch circuit Bttsinmname; NORTH SKY COMMUNICATIONS, INC- 13, Pee ter brancheireuiis Contact nano: RYAN ROBERTS witho n service or feeder fen, 46.85 2 _. ._ . lost branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 E,R hadd' iblanchcircttit 6.65 _�2 ------ Miscellaneous (service or feeder nut included) City/State/ZIP: VANCOUVER, WA 98684 Each manuritc(urcti o modal,)( ' I 90.90 1 3 Phone: Rcconncc (503) 519 -5264 Fax: _ ( )1 -866- 905 -4907 dwelling, t 'vice and/or fccdc t only 66 85 2 F -mail: andLOr. nolthskvcom1Tl_pg _ Pump Qr. irri5Stionarils 7 - 53.40 2 CONTRACTOR Sign Of Outline lighting 53.40 2 El u s rnassname: NORTH SKY COMMUNICATIONS INC, signal eirenit(s) or limited- �• "- W " "" -- - - a. energy panel, ,dictation, of Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe, 1 Pngc2 $75.00 2 City/Stare/ZIP: VANCOUVER, WA 98684 Each additional iit,ection over allowable in any of tlee 3 60) Per inspection 62,50 Phone: ( 254 -6920 7 Fax' ( ) 1-866-530-4325 nvosligi,tton per hour (t I mi,i) 62.50 CCR Lc - 14117 Electrical Lic.:17 -154CL Suprv, Lic,: 173LEB industtiai plant plant per hour _ 73.75 • ELECTRICAL PERMIT FEES Supr-v. f;lecirician signature, required: Subtotal: ry 75.00.,,... Pant name: JACK CAGLE J Dan:: Plan review (25% Of permit ree). __�_ 7-14-08 ^_ - State sumhatge ( o permit fee) $9.00 Ant hot ized signature' . � / TOTAL PERM rr i l_l:: $94 00 Print mum:- ETHON A. DOLPH Dafe: 7 -14 -08 ti - �a 1 n lie -.if„ a,.it,it;( t..n r,tninedwithin150 days after it hnx been veM'pteti 1x cwnpletc. V NR1nicr Vf mi$Niniein .Illowed per permit l ;g1aiiiiing\1ci i i ACLC.ra madpp Unc 05/2 23106 .1.111- P15'r(1,/d3 /COM /W it CITY OF ��n n,m n�`m o m��m���m�� BUILDING DIVISION - PERMIT #: ELR2008'00209 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7Y1512008 Phone: (503) 639-4171 1#441* APipp Inspection Requests (24Hoj:(503) 630'417S .J lt INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7:02AM PAGE: 49 SITE ADDRESS: 14120SWQR}FTV1000CT CLASS OF WORK: SUBDIVISION: DRIFIWOOD TERRACE APARTMENTS LOT #: 8 - 9 TYPE OF USE: PROJECT NAME: DRIFTWOOD TERRACE DESCRIPTION: Units: 4-6. Installing fiber optics for Verizon. OWNER: FISCHER, CAMILLE PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 380-254'6920 Inspection Request Scheduled For: Date: 7123/2808 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 073038-02 503'849-2025 N Corrections/Comments/Instructions: fs PASS El PARTIAL APPROVAL 7 CANCEL fl NO ACCESS | I FAIL -- CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: Cr-- � k �° Date: ��^ T3^V% Phone #: (503) 718' / .'‘