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Permit i CITY OF TIGARD 7` ' ELECTRICAL RESTRICTED ENERGY PERMIT / COMMUNITY DEVELOPMENT Permit #: ELR2009-00250 131 25 SW Hat Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2009 .,. . , I} Parcel: 1S 135CA00800 Jurisdiction: Tigard Site address: 11255 SW GREENBURG RD OFF Subdivision: Lot: 0 Project: Walnut Tree Apartments Project Description: Install fiber optics for Verizon. Owner: FEES ANDEREGG JOINT LIVING TRUST Description Date Amount BY ANDEREGG, FRED CHARLES /BEULAH CO, Restricted Energy Permit 07/31/2009 $75.00 17146 SE HWY 212 12% State Surcharge - Electrical 07/31/2009 $9.00 PHONE: Contractor: NORTH SKY COMMUNICATIONS INC 11818 SE MILL PLAIN BLVD, SUITE 410 VANCOUVER, WA 98687 PHONE: 360- 254 -6920 . FAX: 1- 866 - 530 -4325 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: y Fire Alarm: N HVAC: N Instrumentation: N Total $84.00 Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Other Desc: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 throug OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: CY�Y Q .(j, bik, Permittee Signature: ': 5` L . 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' 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. f t.T T' ECE!VE D Le JUL 2 9 2009 CITY OF TIGARD • ► Electrical Permit Application ffiffi'' FOR' Oil I /10E U5EQIVLY , r 1'i and � alt P CC City ot' Pe rmit No s. 11125 SW 3l 7 Fax: 1, Tigard, OR 97223 o bo Rcv,ow . • 1110110: SU3,0,G39.41.4171 503.59RJ9G0 mclRy: On,crPCrnnil: TIGARD Inspection n UalO Read /S ; 1 Line: 503.639.4175 y y lb Sec tbg< z for nf -- Internet; www.Il 114 or.9cv NudncdMctlInd: - 1 I SupptemcMM totem - With � • ,..: TYPE 'PE WORK , •.' . :.. ;.',:: • . +.'Pl,.1N REY.If?W.`i „':' .. 0 I:J New construction Addition /alteration /replacement PIcsc cirock;dhihuaptly ( solidi 2,OCteof /itelnscl,eckerlbclow): []D0-11101iti0ll © Usher, 0 Scrvlec 01 (mks Oda amps or (11110 0 nulhlinti' over throe .1101100. wi ern 1110 wadable ount current 0 J4nrinus and boatyards. • ''' : CATEGORY or CONSTRUCTION , . .: > • t : •.: - ,'.: '• '.: • = • exceeds 10,000 amp ;d 150 +111/S or 0 Flualing 4uiltliugs. 1:11 I - and 2- ).11(111 dwelling 1Cr, to go vnJ, or sstax, t 14,000 0 Colonist-ad,. :Iv Icohutt) y g ❑Cominct•cinl /industrial ❑A ccessorybuilding clap far n80110rh1001116uns. buildinxs. CI Mclti- funily 0 Master builder 0 Other: 0660 paltp 0 Ina ;dinliunof >0KVAor 0 flonergeocy ryctom. tar r ec eel delved want, •.' JOB SITE IN AND LOCATION b° p' "` y y' ` . , . � [] AJdimal of new mmnr In:ul a [I "A" "I('',...1 3" "I.1•' Job no,: ( Job site address: 11255 SW GREENBURG RD WOW ornlusv. t,<cnp,tncy. D Six nr nwrc (ctidCnlFd Ioln<, 0 IteC01U1 is nal vehicle pBrktr. City /Slale/ZIP: TIGARD OR 97223 c Hcatlh -Ca r0 facilItics. 0 Supply vblt,eo fnr muCC than 0 Haro,th)a, 1°Ca {Ina, (Al soil, nnnlinnl, Suite /bldg. /apt, no. OFFICE J Project name: WALNUT TREE APTS DScrviceoc feeder Eno nmpsur more: • •: • -FEsE SCHEDULE ' ' ' Cross streellctireclio0s to job site: -_ u<•adprtrn I Ow. I rr I ram New residential ;Ingle. or nu lti•family lIwelling mill. includes attached garage, Subdivision: Lot no.: 1.000 so, Il. or less 145.15 - 4 Tnx pulp /parcel no, ; - -- L''a, add'I 500 sq. I't. or portion 31.40 i Limited energy. residcnlial 75.00 2 DESCRIPTION OF WORK (Will, 161100 <(t. II.) INSTALL FIBER OPTICS FOR VERIZON Limited "'ergy,Inahl- e n ;ly 75.00 2 ' residential (with 1111 St'. n,) Services or feeders instntinilen, uftorntinn. 11 td/nr rehteatinn 200 amps or less 11111 80.30 MINI 2 '0 PROPERTY:(1WNER '' .. -0 TENANT 201 amps to 400 amps 106.85 ME 2 Nance: 401 amps to 600 au is 160.60 2 `"' --"' (10) mobs to 1,000 mops 240.60 2 Address: Over 1,000 amps or vnI Is 454.65 2 City /Stale /ZIP: Tcmpnt'nry 0000)000 or feeders 4%10114 0m, alter:llou, and/or relocation Phone: ( ) l Fax' ( ) 2(10 amps or itcc Gfi.RS l - Owner instltltnt)on: This instnlIntian is being made on property that I own which is not 201 61090 to 400 amps 100.30 2 intended for sate, lease, rent, or exchange, according to ORS .147, 4.19, 670, and 701. 401 ;imps to 599 limns 133.75 2 w Brunch circuits - new, ulteradon, or extension, er panel Oman. signature; _.Date: _ p "'"" - - "`- - A. Fee for branch circuits will? `' !' 0 APPLICANT ' ' ' ` "0 CONTACT PERSON above service or feeder l'c0, • Mil brmlch circuit 6.65 2 RCsinessmmle: NORTH SKY COMMUNICATIONS, INC. B. Fee for brunch circuits - Contact name• u'illrourscrvicc fccdcr fee, 2 ERIK SCHENCK first branch circuit 46.85 Address: 11818 SE MILL PLAIN BLVD STE. 410 Emil mkt. I brmnchcitcult 6.65 2 '- ^- MI CCllauc°us (service or feeder uml included) City /State /ZIP; VANCOUVER, WA 98684 rink manufactured ormodular I d we lli ng, serv an / or f cc d cr 90'90 2 Phone: (503 ) 969 - 7729 Fos : ( 666) 4 52 4853 Reconnect only 66.85 2 Email: mduorC northskycomm,com Pump 01I0gation 53.40 2 CONTRACTOR Sign or outline UUghAng 53.40 2 Business name: NORTH SKY COMMUNICATIONS, INC, C1grdctteuit(s)urlimited- Sy panel, attention, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension, Describe: 1 Paso 2 $75.00 2 City/State/ZIP: VANCOUVER WA 98684 Each additional inspection over allowisido In any of tile above • Investigation Phone: ( 360) 254 -6920 Poe: ( ) 1- 866 -530 -4325 I s tignl(on 62.50 gec mvl>crlmur(Iluain) 62.50 COB Lie,: 14117 Electrical Lic.17 - 154CL Suply, Lie.: 173LES htdlcstuat plant ptvhot»' 73.75 - - -� -- ?y I ELECTRICAL PERMCT FEES '' Suprv, Elcctrieinn signature, required: Subwtni; $7.5 00 Print nmtu1: JACK CAGLE Date: 7/29/09 Hutt review (25% of permit fee): State surcharge (127 of permit fee): $9.00 Authorized signature: fi / $84.00 � TOTAL puroorr 11:1S: Print nnntc, ETHAN A. DOL P H Date: 7 /29/09 'fills poralt uppitcnnuu osphtf If It omit I.c not otltnima within 180 dnyc otter 8 :lax brew accepted AV cun»dem•. • Number of IC.pcclluni idiom! !kr p<nmIt, IaWtIhlin6V '<nubdlii,C•p.•nnSAltp,dne 0c0V00 440.461yr(1 Ila1.VCOMAYt111