Permit Elpi CITY O F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00349
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/14/2007
PARCEL: 2S 112CC -01600
SITE ADDRESS: 08371 SW DURHAM RD ZONING: R -12
SUBDIVISION: DURHAM ESTATES APARTMENTS LOT: JURISDICTION: TIG
PROJECT: DURHAM ESTATES APARTMENTS
Project Description: Data telecommunications.
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:
KNEBEL, WERNER + INGE B NORTH SKY COMMUNICATIONS INC
7483 SW ASHFORD ST PO BOX 87550
TIGARD, OR 97224 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 360 - 254 -5097
Reg #: ELE 17- 154CLE
FEES LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 9/14/2007 $75 00
[TAX] 8% State Surcha 9/14/2007 $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: /O Z. / /
Or j Permittee Signature: .9-0/ e
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.
09/1.3/2007 THU 10: FAX 0005/005
t° V Ia' Lk tt;= ( ItC7 LEG; % -Seri& 5 -'j
Electrical Permit A ..lie I .. - :TOR OFFICE USE orii.Y n
7.
City of TI and Received . ,^�
g s Date /By: 9//3/e 7 4r- . Permit N `
o.: � n a00 7 -t70 . o� 4 /
13125 SW Hail Blvd., Tigard, OR 97223 Plan Review
■
o `' Phone: 503.639.4171 Fax: 503.598.196¢[ j 20 Date /By: Other Permit:
TIGARD Inspection Line: 503 639 4175 JG Nate Ready /By: Jerk 1 See Page 2 for
R
Internet: www.tigard- or.gov 1 ` 1 1 V s ���°�_ l if ed/Method: Supplemental information
r ' p
.'TYPE,OI U 1,' - ti I I -, ' • • ` PLAN REVIEW, -
❑ New construction SAdditioort tC� of / itiNeYerf Please check all that apply (submit 2 sets of plans w /items checked below)
• 'V * ❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition ❑ Other: where the available fault current
❑ Marinas and boatyards
CATEGORY OF •CONSTRUCTION' : • •' ' • exceeds 10,000 snips at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Connnercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings.
%Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
: • :JOB SITE INFORD9ATIOT9 • AND'LOCATI ON ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "E" "l -2" "I -3"
Job no.: Job site address 31 \ GI bush m occupancy.
t [] or Six residential units ❑ Recreational vehicle parks.
City /State /ZIP: '--.c.VA VQ Q i' " l--.4- ❑ Health -care facilities ❑ Supply voltage for more than
+ j ❑ Hazardous locations. 600 volts nominal
Suite /bldg. /apt. no.: WY IA jj Project name: V) �,Y \t . r in G� \- . - ( ❑ Service or feeder 600 amps or more
Cross street/directions Yo yob site: rE�c.SCIIEDIILE
tal
J k i �f Description 1 Qty. 1 Fee. I To � -. • "
. 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 1
Tax map /parcel no.: Limited energy, residential
75.00 2
,. .DESCRIPTION OF 'WORK ' • (wish above sq. It ) • ) Limited energy, multi - family
� n(� I / . / f ! ) 75.00 2
'( 1 ' ]i j t.(/ �. t - ���,M ; - -' l .'' Zr� � J! / V l // � residential (with above sq. tt )
� , /r, ' , ��! �77 o! J Services or feeders installation, alteration, and /or relocation
W /V� 6 ,, v 200 amps or less 80.30 2
PROPERTY OWNER • ' I . • ❑ TENANT 201 amps to 400 amps 106.85 2
Name: / •JF2/✓E'72- ' /A/CE A'AiER9 EL- 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Ad 4 6 L.�t.S /7 /oA ,62 Over 1,000 amps or volts 454.65 2
City /State /ZIP: 776.6 ex._ ! / z`.zr Tempor services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps of 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: pate; _ A. Fee for branch circuits with
• ❑APPLICANT ' ' ,CONTACT PERSON • above service or feeder fee, 6 65 2
t each branch circuit
Business name: 0,E- ,`),..AA (', (.,t s' ,(, ,;`;,,?, i 0..`i:1131/4 t� B each blanch
branch circuits
Contact name. MbV\ ` \�re.M� c. .0 ',.16°' without service or feeder fee, 46.85 2
( � JJ first branch circuit
• '` ' \ i q -i J Each add'l b c i r cuit 6.65 2
Address: i_. - SV rd /,.• _
Cit /State/ZIP: d` ' C\ Ci ' C. 1 Miscellaneous (service or feeder not included)
y ��.1 ��� Ott{ `� f> �J (; 1 Each manufactured or modular 90 90 2
/, �/� Reconnect only dwelling, service and /or feedet
Phone: (.601)2...514--- ( w \ Fax:: ( $b(? ) �✓ ✓ Y
66.85 2
E-mail: \� ,`1') r ov/1)A l : um , Cif , on Pump or u'igation circle 53.40 2
- > •� _ ',CONTRACT .it,,‘.:',.: i ' :: , Sign or outline lighting 53.40 2
Business name: n r Signal circuits) or limited-
(> l`I✓Y�� t ., ll •- Z�`l _ energy panel, alteration, or
Address: , , U 1 % S e, \/\A \\ � /), Q\ vC /t extension. Describe: i Page 2 16 2
City /State/ZIP:� (An Ova.e \/ \k\ n
\ '"\ 9e(1 e,' Each additional inspection over allowable in any of the above
i Per inspection 62.50
Phone: (72 ) 7 L --( - 1.0 - 1.0 ' � Fax: ( Cl) Lt �_ 0 Investigation per hour (l lu min) 62.50
CCB Lie.: \41 \-1 I Electrical Lie.: Suprv. Lie : hrdushial plant per hour 73.75
' ELECTRICAL' PERMIT : • ;
Suprv. Electrician signature, required:
Subtotal:
Print name. Date: Plan review (25% of pennit fee):
State surcharge (8% of permit fee): 1,4 n'7
Authorized sign ai'•e :. -„ ;-, "' y " = �� - -• im TOTAL PERMIT FEE: �)
.. "
/ `nl /� / This permit application expires if a permit is not obtained within 180
Print name: � N fAi l 1 l /, ` . ck-c) Date: ^ I �- 01 days after it has been accepted as complete.
* Number of inspections allowed per permit.
t.\ Buddmg\Pcrmits \ELC- PcrmnApp.doc 05/23/06 440 4615T(r1/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I= LR2007.O039
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 94114/2007
Phone: (503) 639 -4171 1400 41441 l,�
Inspection Requests (24 Hrs.): (503) 639-4175
.1%. ! °` .L
INSPECTION WORKSHEET FOR DATE: 10/2/2007 TIME: 7vAM PAGE: 7
SITE ADDRESS: 08371 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: DURHAM ESTATES APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: DURHAM ESTATES APARTMENTS
DESCRIPTION: Data telecommunications.
OWNER: KNEBFL, WERNER + INGE B, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 10!01 2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 056751 -04 503-9695989 Y
Corrections /Comments /Instructions:
q A i
❑ PASS PARTIAL APPROVAL CANCEL ❑ NO ACCESS
I I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: 1 U 1-- Date: t 6 1 1 401 Phone #: (503) 718- -2.44 to