Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00093
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/18/2008
PARCEL: 1 S 135DC -03000
SITE ADDRESS: 11575 SW GREENBURG RD 23 ZONING: R - 4.5
SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG
PROJECT: FOUR OAKS APARTMENTS
Project Description: Units 23 -24: 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
Reg #: ELE 17- 154CLE
FEES 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: zC � Permittee Signature: ,'//C e9-77o
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.
p
04/16/2008 WED 12: 17 FAX -' -.-' CITY OF TIGARD
'Nsm+
Electrical Permit Applrcaren > I't) I u� eJSr UNI.Y
City of Tigard Rc Received
Or
��� � .....:. .., /►(� off
y Dete/(ty: 7 ed- ' Permit No.: �O�- DOt!"�C.s7
APR 16 2008 s
n 13125 SW Hall Blvd Ti OR 9722 Plan Rcvic
° Phone: 503.639.4171 Fax: 503.598.1960 Date /t ;y, Other Permit:
TIGARD Inspection Liao: 503,639.0.175 ��� �� TIGARD p ®p-ti Date Ready /Ay: lurk: ® See ['age 2 for
Internet: www.tigard- or.gov 11 B171fAG1gJ N /Me thod: 7 7 Supplemental Information
T v.,.0 .nn
YPE.Oti
❑ New construction { Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
0 Service or feeder 400 amps or mom 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
.. ... .... . oxceeds 10,000 amps at 150 volts or D Floating buildings.
c nTEC,o?Y:.OF c... .RU.c . loN:
less to ground, or exceeds 14,000 0 Commerciabuse agricultural
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
I7; Multi - family ❑ Master builder ❑ Other: 0 fire pomp. 0 Installation of 75 KVA or
Emergency system. larger separately derived system.
. ..'': ,1018 SITE INFORMATION. AND "LOCATION ..
Emcr 1' s st
❑ Addition or new motor load of 0 "A", "E", "1-2", "1-3",
Job no.: Job site address: 11575 SW GREEN BURG RD 100HPormore. occupancy.
D Six er more residential units•. 1 Recreational vehicle parks.
City /State /ZIP:TIGARD, OR 97223 ❑ Health -care facilities. 0 Supply voltage for more than
0 Haitu'dous locations. 600 volts nominal.
Suite /bldg. /apt, no.# 23 -24 Project name: FOUR OAKS APTS. 0 service or (ceder 600 amps or Whore. _
Cross street /directions to job site: Ucseri nion I . roe, Total '
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft, or less 145.15 Ili
----- Ea. add'! 500 sq. ft. or portion 33.40 _ Q
Tax map /parcel no. Limited energy, residential
75.00 7
.. DESCRIPTION -OF 'WORK :': (with above at, 0.) -.__..
Limited energy, multi-famil 75.00 2
INSTALL FIBER OPTICS FOR VERIZON residential (wilh above
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
. PROPERTY " :OWNER :r :. ❑ TENANT 'l' . 201 turps to 400 amps 106.85 2
n 401 amps to 600 amps 160.60 2
Name: iCEN Co /J .�0 S LLe_
601 amps to 1,000 amps 240.60 2
Address: / 6 f'3 5 fit) I V ' G- (,J sr • Over 1,000 amps or volts 454,65 2 •
City /State /ZIP: B EA 7'O 0 2 9 )CO ° 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 cups 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 1 33.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
.`0 ;APPLICANT- ':': '.`.:; : :'.. :: t7 ...CONTACT..PERSON ., • • . .`: above service or feeder fee, 6.65 ?
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
without service or feeder fee, 46.$5 2
Contact name: MONET VIVEROS rag bunch circuit
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP:VAN000VER, WA 98684 Each manufactured or modular 90.90 3
dwellin_, service and /or feeder
Phone: (360) 254 -6920 Fax: : ( ) 1- 866 - 530 -4325 Reconnect onl 66.85 2
E -mail: mviverosP,northskycomm.com Pump or inigation circle 53.40 2
. , . . . ,::..CONTRACTOR : ' : : " .' • ;:' . ;;;:':.::.: , . ' Sign or outline lighting 53.40 2
INC. e circuit(s) alte 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 /State /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.17- 154CLE Suprv. Lie.: 173LEB Industrial plant per hour 73.75
i � �� =- � ' � ...ELECTRICAL :rERMIT: FeES .: ;: :.'.. .
Suprv. Electrician signature, required: Subtotal: $75.00
4 /16/08 Plan review (25% of permit fee):
Print name: JACK CAGLE Date: State surcharge (12% of permit fee): $9,00
Authorized si I. atu' -: •- .'-''� - - -. TOTAL PERMIT FEE: $84.00
This permit application expires if a permit is not obtained within 180
Printname: A. MIKULIC Date: 4/16/08 days after it has been accepted ascomplele.
" Number of inspections allowed per permit.
l: \nvi /ding \PcrmitAttLC•Pcrndtnppdoc OS/23106 440.4615131 l /115 /COMAVEn
CITY OF TIGARD
BUILDING DIVISION •
PERMIT #: ELR2008-00093
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1812008
Phone: (503) 639-4171 4411111
6 I
Inspection Requests (24 Hrs.): (503) 639-4175 - . 1 14. .1 •
INSPECTION WORKSHEET FOR DATE: 4/2412008 TIME: 7:01AM PAGE: 9
SITE ADDRESS: 11575 SW GREENBURG RD 23 CLASS OF WORK:
SUBDIVISION: FOUR OAKES APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: FOUR OAKS APARTMENTS
DESCRIPTION: Units 23-24: Installation of fiber optics for Verizon.
OWNER: KEN CONDO'S (IC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 4/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
'199 Electrical final 068854-08 603-333-138813 8888
Corrections /Comments/ Instructions:
•
`‘.
•
PASS n PARTIAL APPROVAL fl CANCEL NO ACCESS
fl FAIL El CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 6 I N Date: 4 Phone #: (503) 718- 14
, .