Permit .111V `' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: ELR2008 -00258
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/10/2008
PARCEL: 1 S135CA -01400
SITE ADDRESS: 11410 SW GREENBURG RD 5 ZONING: R - 12
SUBDIVISION: GREENBURG TERRACE APARTMENTS LOT: 6 - JURISDICTION: TIG
PROJECT: GREENBURG TERRACE
Project Description: Units 5 -12. Install 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:
NORMAN &ANN WONG NORTH SKY COMMUNICATIONS INC
2433 NE 11TH 11818 SE MILL PLAIN BLVD
PORTLAND, OR 97212 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 9/10/2008 $75.00
[TAX] 12% State Surcha: 9/10/2008 $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 e 1.200.332. 344.
Issued By Oi_41Li, Permittee Signature: J��1
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.
; %"'. 4 •
. to
J 4 -' •
Electrical Permit Application
•'
city of 'Tigard _
1312: sw Il Bl Ti oR
::i.:. none: ,503.639.4 171 Fax: ■ , ;98.etp)
o g
D.v.effi 7
Nan Itevicw
1)4telliy: • y R No.: EL-/a
()tilci. Venni': —
inspection I e: 50:L(139.7 .
'FIGARTP,; 41 • Date Ready/11y: .t.,..- _ 0 See t";l4e, 2 fPr
!walet: ■ I • '
VWW.ti.g.m.-ot.gov ,,_ i lq 'i) NOlifiediMait(Itl,
i. ..... — — 'TO' Supple= tunl Information i
TYPE OF vediR r _..., . ,aD PLAN REVIEW -
Please check all that apply (submit sets f'fl plans whm.: chccked below),
CI New constructio n ill AtIclition/alteratioV
f2seiviee oi ilithittr 4 °0 ;MIN: or inorc 0 Itlitning ovor (Ill \2c swrics,
Ej DoAnolition El olher: Grc l'
. ,. IDIAllkSO ,,,,,, 1,;; ,,,,,i(abk fa;iii courent 0 Nindnds and ihsync/s.
_
CATEGORY t OF MO' laill14vON esceetis 10,00natoits at bin vote, en [3 t'isnnin:,f tntildings,
— -- less to ynolunnel, or exceeds 14.11110 0 CiWitiriel'etilt.liiie 38 i inilltieat
n I - and 2-ramify dwelling 171 Comm.retalfindust (101 Et1 Accessory building 1 t'ups col till on.' instailutions. bnildings.
al Multi-family ID Master builder E Other: 0 Fire 'moll). El 111501;a ion of 75 KVA oi
0 rtlein'gCliqy eymisi.
litt ',op,. noSy ttett i.Y
' JOB SITE ENFORNIA'FION AND LOCATION El Addition of new !nolor toad oi
. .. . .,
Job ne.: I Job Sit '' ndthCSS: 11410 SW GREENBURG RD. )(:0111' or mow, ncopincy.
El Six or mote Ns:dont:al units. 0 ReCietiliiltitti vehicle 11;111.'i.
Ci(Y/State/ZIP: TIGARD, OR 97223 (3 licalth.c:no i'acilnie,. 0 sliml voliat2e. tor inure Wan
Ejiliiiiiiranvg imiiiiien. 0n1) vote; nominal
Suite/bldg./apt. no.: 5-12 Project name: GREENBURG TERRACE 0 Servi,e. or :ceder 600 amm. of molt.
--__ FEE SCHEDULE
Cross street/directions to job site: misoipaiiii L91,_ iota 1 .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: [Lot no.: I 1,000 sq. fc or less I i5'5 4
---- En. aCld 500 sq. It. or pot (ion 33. 1
Tax map/parcel no.: .
1.nuited energy, residential
_
75.00 -,
DESCRIP'FION OP WORK (wins atta, sq. n.) -
1,inliml cner, y 75.00 ,
INSTALL FIBER OPTICS FOR VERIZON residctitifil cwiffi A.. multi-1;111111
---------- Services or feeders installation, alteration, tlildiOt relocation
200 amps or less 80.30 2
PROPERTY OWNER " ' CI TENANT 201 :duly; lo 400 anim —
- -- i 1 06.R5 2 1
Name: Po 24.44- Q /4 10 ?.) (Aa, )43 401 anms to GOO ainps _ 1_160.60 2
601 amps to I,000 amps 240.60 2
Address: 6 i3F_ 11.6 4 Of. Over 1,000 amps Or volts 454.65 2
_
Temporary tierr ieeti Or ter net'S it ti
lijntiltiOn i alien lion, and/ n.•
City/State/ZIP: 1)1 Oa_ q.v./ 9— retocntion
P60110: ( ) Fax: ( ) 200 amps or less 1 66.115
Owner i 1 '
— .....,
.
'?
.,
nstallation: This installation is bein m
g ade on propteriy Mat I own which is not 201 at»ps (0 400 amps 100.30 ._...,
-- -
intended for sale, lease, rent, or exchange, according to OHS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 '
,
iiitanell circuits - neiv, alteration, or extension, per panel
Owner signature: Date:
1
A. Pee for branch circuits with
0 APPLICANT i
n CONTACT PERSON above service or feeder fee,
i 6.65 2
each branch circuit
--
n " i Ile " Ine: NORTH SKY COMMUNICATIONS, INC. II. Fee for branch circuits
without service or feeder fee,
Contact name: RYAN ROBERTS ny.st branch 6rcuit i 46.85
i 2
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each awl branch circuit j 6.65 2
Miscellaneous (service or feeder not inclittlell)
CilY/Stalo/ZIP: VANCOUVER VVA 98684
, Each maiwl'actured or modular 1
90.90 1 2
dwettine, service and/or
Pboiloi (503 ) 519-5264 Fax: : ( )1 feeder 1 -866-905-4907 P.econnect only 66.85 1 2
E mduornorthsiKvcomm.corn pifinp or irriptiOn circle 1 53.40 j 1
...
CONTRACTOR Sign or outline lighting I 53.40 i 1 2
------- ,.....
— Signal circuit (s) or limited- 1 i
BuSinCSS nalne: NORTH SKY COMMUNICATION
S INC. energy panel. alteration, or i
.... __ .......___...... i
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe 1 Page 2 $75.00 i 2
___.........._
City/State/ZIP: VANCOUVER WA 98684 Cacti additional inspection over allowable in any of the ahove
Per inspection 62.50
Pliono (360) 254-6920 PaK: ( ) 1-866-530-4325 ____________________....._....._....... .....
investi per itOtir (i in min) 62.50
__.... _.......................
CcE Lie.' 14117 rieetrienl [IC 17-1 54CLE Sufwv. L-i 173LEB industrial plant per hour I . 73,75 — 11111 .
ELECTRICAL PERMIT FEES
Suprv. E an lectrici signature, required: --]0?'-
Sulmothli
r $75 0C1
Print 11111010: JACK CAGLE Date: 9-9-08 nit, review (25% of perinit fee):
Stine suirhaige ( 12% of permit fee), $9.00_
Authorized signature: ..--r_ r
... OcIZ TOTAL Pi N.I IT ri--A::: `.84.00
— ftsiS - perTnii - ;; - 1 ;11; . (..;fi411 CNI/Trri: it' pvrinit is slot oblniocil within 186
Prink naille: ETHON A. DOLPH Date: 9_9_08
dt,,,,A, i Inct been :tett...fined nix comp} elf.
' Number of inspections :Mowed per permit.
Iteliailiting\ 1'i:flint:, \ ri,C.nti'lriii\ pint 00/2350 iliIS-ifirM I I /17:KO5lAVER
e •
CITY OF TIGARD
BUILDING DIVISION A . , f
PERMIT #: EIR2008-09258
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/10/2008
Phone: (503) 639-4171 ,
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 25
SITE ADDRESS: 11410 SW GREENBURG RD 5 CLASS OF WORK:
SUBDIVISION: GREENBURG TERRACE APARTMENTS LOT #: 6-7 TYPE OF USE:
PROJECT NAME: GREENBURG TERRACE
DESCRIPTION: Units 5-12. Install fiber optics for Verizon.
OWNER: WONG, NORMAN & ANN PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 075672-01 503-209-7014
Corrections/Comments/Instructions:
•
l k PASS 0 PARTIAL APPROVAL • CANCEL fl NO ACCESS
FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: 11 Phone #: (503) 718-