Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
`` ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00089
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/18/2008
PARCEL: 1 S135DC -03000
SITE ADDRESS: 11575 SW GREENBURG RD 10 ZONING: R - 4.5
SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG
PROJECT: FOUR OAKS APARTMENTS
Project Description: Units 10 -14: Installation of 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:
KEN CONDO'S LLC NORTH SKY COMMUNICATIONS INC
16835 SW IVY GLEN ST 11818 SE MILL PLAIN BLVD STE 4
BEAVERTON, OR 97007 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 4/18/2008 $75.00
[TAX] 12% State Surch 4/18/2008 $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: Permittee Signature: QA/ ,9-7
/ 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.
04/16/2008 WED 12:16 FAX - -- CITY OF TIGARD 2005 /009
4 ,
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` ► Electrical Permit Application , _ I'a„ o ,'r , ►u , >usr• U1vLY r
City of Tigard Dntc /B �r7 J � Pctnut No. oC(✓DO �OOt! /
" 13125 SW Nall Blvd., Tigarli 97223 Plan Rcvic
•
Phone: 503.639.4171 Fax: 503.598.(9 1 6' 'ta� Dole/a ; Other Perini!:
TIGARD Inspection Line: 503.639.4175 I 1 ` Dale Ready /By: liESI fil Sec Page 2 for
Internet: www.tigard- or.gov ' i .• 11.
Not ified /Method: Supplemental Information
T.YPE 1,.. �i , 4 r . .PLAN, REVIEW
�Ip �t� �. a t e: . ' t*�+1�Ot�3'11+�
❑ New construction ID Addlll lrta taF1'Jfeptac nCnt - Please check all that apply (submit 2 sets of plans w /items checked below):
0 Service of feeder 400 amps ur noun 0 Build over three stories.
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
C/1TE.G.QClY;UF,,CONSTRU( ICON r... ' ' ;: less to ground, or exceeds 14,000 0 Commercial•uscagricultural
❑ 1 - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building ;imps for all other installations, buildings.
III. Multi - family ❑ Master builder ❑ Other: 0 Fire pump. 0 Installation of75 KVA or
. - - 0 Emergency cyclone. Imgor separately derived system.
..
• '......: JOA ;.SITE.INI'ORMATION. AND LOCATION.. s : ,'., : ' , ' (] Addition of new motor load of 0 "n" ^h'" ^1- "1.1
lob no.: Job site address: 11575 SW GREENBURG RD 100HP ormore occupancy.
Q Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP:TI GARD, OR 97223 0 Hcaldt• care facilities. 0 Supply voltage for morn than
0 Hazardous locations. (100 volts nominal.
Suite /bldg. /apt, not 10 -14 Project name: FOUR OAKS APTS. 0 Service or feeder 600 amps ornore.
FEE SCHEDULE:. .' :'
Cross street /directions to job site: u5srr1,tien I Qt .1 Ref. I Total I •
New residential single- or multi - family dwelling lout.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ira. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION - OF .WORK (with above sq.11.) 75.00 2
INSTALL FIBER OPTICS FOR VERIZON Lims t bo family 75.00 2
residc nliai (with about sq. R.)
Services or feeders installation alteration, and/or relocatio
200 amps or less 80.30 2
,; r ROPERTY: OWNER 5' ''. :'. :' ' 'U ` ;' 201 amps to 400 amps J 106.85 2
401 amps to 600 Amps 160.60 2
Name: 1‹.0.1 Co i s L Le_ 601 amps to 1,000 amps 240.60 2
Address: 161 ,S ct i ivy 6.--c E--Ks 9T• Over 1,000 amps or volts 454.65 2
City /State /ZIP: BE-AVE-1270 N 0/2- 97 oo 7 temporary services or feeders installation, alteration, and/or
relocation
Phone; ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 imps 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: Date: A. Fee for branch circuits with
0 ::APPLICANT.': `>`., O. CONTACT PERSON
above service or feeder fee, 6.65
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. TB. Feefoe- branchcircuits
without service or feeder fee, 46.85 2
Contact name: MONET VIVEROS first branch circuit
Address: 11818 SE MILL PLAIN BLVD, STE 410 Each add'I branch circuit 6.65 2
Miscellaneous (serv or feeder not included)
City /State /ZIP:VANCOUVER, WA 98684 Each manufactured or modular 90.90 2
Re cuing, service and /or feeder
Phone: (360) 254 -6920
Fax:: ( ) 1 -866- 530 -4325 Reconnect Only 66.85 2
E -mail: mviveros ,northskycomm,com Pump or irrigation circle 53.40 2
..'5.'..!::::-i::-:.1•.:5., ' . . . . Y , . , : , , : : . - : . - '.'::CONTRACTOR':: . : ' - - ..s•. ' : ' : : : . " Sign or outline lighting 53.40 •
INC. Signal p a l te r limited-
Business name: NORTH SKY COMMUNICATIONS, energy panel, alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2
City /Statc/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above
Per inspection 62.50
• Phone: (360) 254 -6920 Fax: ( ) 1 -866- 530 -4325 Investigation per hour (I lirmin) 62.50
CCB Lie.: 14117 Electrical Lic.1 1CL uprv. Lie.: 173LEB Industrial plant per hour 73.75
`•ELECTRICAL""PERMIT: FEES - :. - ::''-': '.' '
Suprv. Electrician signature, required: ,,, Subtotal: $75.00
Print name: JACK CAGLE Date: 4/16/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): $9
Authorized sig • •. �!` . -.-._, -` TOTAL PERMIT FEE: $84.00
This permit Application expires if a permit is not obtained within 180
Print name: TERI A. MI KU LIC Dale: 4/16/08 days after it has been accepted ns complete.
" Number of inspections allowed per permit.
I: lanildingV 'erohin \tiLC•PerutitApp doe 05/23/06 440 - 40151'( I Il05 /COhtiwrn
CITY OF TIGARD
BUILDING DIVISION A..
PERMIT #: ELR2008-00089
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1812008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 .„,1111- -IL
INSPECTION WORKSHEET FOR DATE: 4/24/2008 TIME: 7:01AM PAGE: 13
SITE ADDRESS: 1 SW I3REENE3URG RD 10 CLASS OF WORK:
SUBDIVISION: FOUR OAKES APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: FOUR OAKS APARTMENTS
DESCRIPTION: Units 10-14: Installation of fiber optics for Verizon.
OWNER: KEN CONDO'S LL.C, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2546920
Inspection Request Scheduled For: Date: 4/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 0688M 503,333-8888
Corrections /Comments/ Instructions:
r.\\
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X PASS n PARTIAL APPROVAL CANCEL pi NO ACCESS
n FAIL CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: 64 Date: 1 4 (A Phone #: (503) 718- -DILA,
_ . . . .