Permit ;CI 11 CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00092
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 19 ZONING: R - 4.5
SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG
PROJECT: FOUR OAKS APARTMENTS
Project Description: Units 19 -22: 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: r Permittee Signature: QAJ,97 }-% /c9n/.S
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.
0 4 / 1 6 / 2 0 0 8 WED 12: 17 FAX --- CITY OF TIGARD 0008 /009
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Electrical Permit Applicatitm,Ev i Es _,-,,,,,,..„,,,,,„,,,,......,,,,,,,,,,,tt.,....s
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City of Tigard
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q 13125 SW Hall Blvd.. Tig'ard, OR 97223
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2 . • 1 6 z0 08 Received -
Date/B : ‘ /Cf ' teef 42 . Pcnn" N°. heR° 2 000/ 9-- '1 0 9 '
Plan Review
Phone: 503.639.4171 Pax: 503. 6C
Date/By: , Other Permit:
.,... ' Inspection Lino' 503 639 4175 V"
TipAKD , • " Dale Read5 reds: El See Page 2 for
interne: www.tigard-or.gov TIGARD Notified/Method: i /6"'" Supplemental Information
r 'ipitsi 11-::••••::.:.....-::,..: :: :REVIEW:.'s:.; .--:•'::: • : .: ' • -..: ..:
0 New construction El Adabatiotitr`ePiaCetnent Please cheek all that apply (submit 2 sets of plans \ v/items checked below):
0 Ser vice or feeder 400 amps or some 0 Building over three stories.
0 Demolition Cj Other: where time available fault current 0 Marinas and boatyards.
OA:TEOORY OF CONSTRUCTION.. - - - : - ' .;.-..; ' '.. ,. .... :::.:r:S. exceeds 10,000 amps at 150 volts or 0 Homing buildings.
less to ground, or exceeds 14.000 0 Commercial agricultural
0 I - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder EI Other: 0 Fire pump. 0 Installation of 7S KVA or •
.. . , . . . ,.., , . ... , „.. . 0 Emergeitcy system. Niger separately derived system.
::,::,: --,;::..:.:' .:- , :::: .., ,.. JOB,, SITE INFORMATION. AND:LOCATION . ; : ... --. : :.: . . 0 Addition of new motor toad of 0 "A", "H", "1-2", "1-3",
Job 00.: Job site address:11575 SW GREENBURG RD 100HP or mom, occupancy.
0 six or more residential oaks. 0 Recreational vehicle tmarks.
City/State/ZIP:TIGARD, OR 97223 0 licattb•carc facilities. 0 supply voltage for mom than
0 Hazardous tocetio»s. 600 volts nominal.
Suite/bldg./apt. no.# 19-22 Project name: FOUR OAKS APTS. 0 Service or fccder 600 anms or more.
FEE SCITEDULF
Cross street/directions to job site: omot 1 Qty. j rec I Total I .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft. or less 145.15 I 4
Ea. add' I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: .
e
75.00 2
..._''. l ....:. .;•• . •:' .- ..:•l l . DESCRIPTIONPF. WORK' '• : - , ' . : Limited energy, residntial
: . .• . • :•.:.. ... (with above sq, 11,)
Limited energy, multi-family
INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. ft.) 75%00 2
. • Services or feeders installation alteration, and/or relocatio
200 amps or less 80.30 2
l :- :.:' ' -, ...I •:::
..... ' '.".-.•,' 0 TENANT :- - :1 - - • '[..: 201 amps to 400 amps 106.85 2
Name: I "C CO (.1 b0 ' S Luc_ 401 atnps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: i /08'35 sw wy Gce Sr- Over 1,000 amps or volts --- 1 7- 1.54T5 ---
City/State/ZIP: r3 M 1 t ie._ 9700 7 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
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: Date: A. Fee for branch circuits with
•I l l•:: : .1, I' l l:: . 0 APPLICANT :'1..::. .• . : • ': ,: - .. a CONTACT PERSON ';;.:-:., .:::.:• libove service or feeder fee,
6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for. branch circuits
without seivice or feeder fee,
Contact name: MONET VIVEROS first branch circuit 46.85 2
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each adclil branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP:VANCOUVER, WA 98684 Each manufacturer' or 'nodular -
90.90 2
dwelling, service and/or feeder
Phone; (360 ) 254-6920 Fax: i ( ) 1-866-530-4325 Reconnect only 66.85 2
E-mail: mviverosanorthskycomm.com pomp or irrigation circle 53.40 2
.;.;'. l l :;:l : . l . l..: • :•.-'l;l:CONTRACTOR . :. *.:, s, ...:•:.••• :'.-,. ". '. :' :..: .:,-..,:..- ':::' Sign or outline lighting 53.40 2
Signal circuit(s) or
Business name: name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or I
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: Page 2 $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 (1 lir min) 62.50
CCI3 Lic.:1 41 1 7 Electrical Lic.1 -154 LE Suprv. Lie.: 173LEB Industrial plant per hour 73.75
- . . - ..":' : , ..-1',.. : -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): $9,00
Authorized signtter. . .. 7' --- - ..._. _.
TOTAL PERMIT FEE: $84.00
This permit Application expires if a permit is not obtained within 180
Print name: TERI A. MIKULIC Dale: 4/16/08 days after it has been accepted as cOmptele.
' Number of inspections allowed per permit
1:10initting\Perinital.C.PetioitApodoc 05/23/06 440.40 I Sli i/05/COMAvEit
CITY OF TIGARD
„
BUILDING DIVISION PERMIT #: EIR2000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2001:
Phone: (503) 639-4171 It\
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/24/2008 TIME: 7:01AM PAGE: 10
SITE ADDRESS: 11575 SW GREENBURG RD 19 CLASS OF WORK:
SUBDIVISION: FOUR OAKES APARTMENTS LOT TYPE OF USE:
PROJECT NAME: FOUR OAKS APARTMENTS
DESCRIPTION: Units 19-22: Inaallation of fiber optics for Verizon.
OWNER: KEN CONDO'S LLC, 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 068854-07 603-333-8808
Corrections/Comments/Instructions:
•
A
PASS PARTIAL APPROVAL El CANCEL El NO ACCESS
n FAIL fl CALL FOR INSPECTION 11] ADDITIONAL FEES ASSESSED
Inspector: 6- 00 Date: k( 2- 4 0 Phone #: (503) 718- 1.14116