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Permit CIT OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00091 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 17 ZONING: R -4.5 SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG PROJECT: FOUR OAKS APARTMENTS Project Description: Units 17 -18: 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 $84.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions_ to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: �// 1 ; - - Permittee Signature: QP✓ /9/ /C'o OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 04/16/2008 WED 12: 17 FAX -,-∎- • CITY OF TIGARD 0007/009 1 , Electrical Permit Applic do - -. - 1\ f Eli ., iroxoriit c ,�usti. p iy� r City of Tigard Datc /B : ��0 • f 'Or Permit No. _1.. d /6 X 01) . " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Rcvie' °':.' Phone: 503.639.4171 Fax: 503.598.1 AT 162008 Date /By: Other Pcrmit: TIGARD Inspection Line: 503.639.4175 Date Rcady /Ay: 1vris: El See Page 2 for Internet: www,tigard or.gov Notified /Method: jig' Supplemental Information IX OF.11G TYPE 0, I pv r'' �1$t O PLAN: REVIEW i onYA ' ti /r c W Please check au apply (submit 2 sets of phis w /items checked below): ❑ New construction 0 Addit ❑ Service or feeder 400 amps or nave ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY :' OF CONSTRUCTION - . . exceeds 10,100 amps at ISO volts or 0 Floating buildings. . . ... " . toss to ground, or exceeds 14,000 i] Comn,crcial•use agricuaural ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. Di Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA or . - Emergency system larger separately derived system. ....• •:.. .. :: . ... JOIs; _SITE? INFORMATION 'AND:'LOCATION '.. '.... :'. i. : ❑ Addition of new 0501cr load of 0"A" "F.", "1.2" • Job no.: Job site address:11575 SW GREENBURG RD 100HP onumro. occupancy. ❑ Six or more wsidential volts. © Recreatiaml vehicle parks. City /State /ZIP:TIGARD, OR 97223 ❑ Heatd,•carc facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.# 1 7-1 8 Project name: FOUR OAKS APTS. °Service or feeder 600 amps or more. . FEE SCIIE0CLE: ;' : ', :. . '.... •.. . . Cross street /directions to job site: oescriptiou Lc l . I Psc I Tet+d_I ! New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ha. add'I S00 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential • 2 ' ,: ' DESCRIPTION :Oh • WORK • ' .. (with abuve sq. It.) 75, Limited energy, multi- family 75.00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. 0J Services or feeders installation alteration, and/or relocation 200 amps or less 80.30 2 ,, . ' •.: . PROPERTY: OWNER :: :'.: `.... ". - ' .''::.:.: :.:: ❑ TENANT •; .`, '.,..-:..'..'•:.. 201 amiss to 400 amps 106.85 2 Name: i t 1 amps to 600 amps — 160.60 2 � �� S L.L.I' L� 601 amps to 1,000 amps 240,60 2 / Address: I t0 ,3 3 5 S GJ' Ivy G(..E - /J ST. . Over 1,000 amps or volts 454.65 2 City/State/ZIP: VET-To q ^7 Temporary services or feeders installation, alteration, and/or y l� { 7d / 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 steps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ... : 0 ;APP.LICANT , ::, .. O CONTACT.. PERSON .' ' :. above service or feeder tree, 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. 8. Fee for branch circuits without service or feeder fee, Contact name: MONET VIVEROS first branch circuit 46.85 2 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 2 dwelling, service and /or feeder Phone: (360) 254 -6920 Fax: : ( ) 1- 866 -530 -4325 Reconnect only 66.85 2 E -mail: mviverosnorthskycomm.com Pump or irrigation circle 53.40 2 :.... •CONTRACTOR.', ;. . . Sign or outline lighting 53.40 2 Business name: NORTH SKY COMMUNICATIONS eg INC. Signal er circuit(s)orlintit d- 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 0 in min) 62.50 CCB Lic,: 14117 Electrical Lic.17- 154CLE Suprv. Lie.: 173LEB Industrial plant per hour 73.75 '• ELECTRICAL- PERMIT. :. I . . Suprv. Electrician signature, required: /,�� get Subtotal: $75,00 �"'" �` Pl review (25% of permit fee): Print name: JACK CAGLE Date: 4/16/08 __.._ _.W ___ __ State surcharge (12% of permit fee): $9,00 Authorized sigt •, "- Y ....... •- -- _, — TOTAL PERMIT PEE: $84.00 This p ermit application expires if a permit is not obtained within ISO Print name: TERJ A. M IKULI C Date: 4/16/08 days after it has been accepted as complete. ' Number of inspections allowed per permit. t: 111milding■Perntits \ELC•Perulitnpp.doe 05/25/06 440.4615T(1 I/O5 /COM /1VEB CITY OF TIGARD A , BUILDING DIVISION . PERMIT #: ELR2008-00091 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/24/2008 TIME: 7:01Afil PAGE: 11 SITE ADDRESS: 11.575 SW GREENBURG RD 17 CLASS OF WORK: SUBDIVISION: FOUR OAKES APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: FOUR OAKS APARTMENTS DESCRIPTION: Units 17-18: Installation of fiber optics for Verizon. OWNER: KEN CONDO'S LLC, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 36�2646920 Inspection Request Scheduled For: Date: 4/24/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 068854-06 503-333-8888 Corrections/Comments/Instructions: j - /1 IAPASS n PARTIAL APPROVAL n CANCEL n NO ACCESS I I FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: (0•2:4 Date: 1- at Phone #: (503) 718- 7-9 . .„