Permit 4 l
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
r ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00090
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 15 ZONING: R - 4.5
SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG
PROJECT: FOUR OAKS APARTMENTS
Project Description: Units 15 -16: 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 que 4?5)/747.0.1""2--- tions to OUNC at 503.246.6699 or 1.800.332.2344. /
Issued By: Permittee Signature: e",‘,/ ,9—, ALjC4i - 77o'
OWNE R 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 2006/009
:A ECEIVED ............
4 Electrical Permit Application _, . . .: . Fo uS ON Y r
Tigard
APR 1 � 2008 Q , , , . f _�:. _ ,
City of Date/0 : �d Q� i� r Permit No. r , �DOiI •%! "/
v 13125 SW Hall Blvd., Tigard, OR 97223
Plan Rcvic •
Phone: 503.639.4171 Pax: ;>; TIGARD Received Dnte1[3
TIGARD Inspection Line: 503.639 D N DIVISION Date Ready /By: 63 See Page 2 for
Internet: www.tigard- or.& I, l.fgy� /Method; IIM Supplemental Information
... • TYPE.OF•WORK' .. :.: .:PLAN REVIEW.
0 New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
0 Sol vice on feeder 400 amps or more 0 Building over three stories.
0 Demolition Q Other; where the available fault current 0 Marinas and boatyards.
'' ' `' ' ` ""' ': i "
' '` '
''' ' TEC ON exceeds 10,000 amps at 150 volts or 0 Floating buildings.
CA ORY OF. CQNSTRIJCTC
''' ' "' ' ` less to ground, or exceeds 14,000 0 Commercial-use agricultural
0 I- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building amp, for all other installations. buildings.
a Multi - family Q Master builder ❑ Other: 0 Fire pump. 0 Installation of 75 KVA or
. - . system. larger separately derived system.
„erganrycyst „
> :.. J OB.:SITE ` 'INFORMATION AND LOCATION .., ' 0 Addition of new motor loan of D "A" °N" "l - "I.3"
Job no.: Job site address: 1 1 575 SW GREENBURG RD I00HPor occupancy.
0 Six or more ,esi dential units. 0 Recreational vehicle parka.
City /State /ZIP:TIGARD, OR 97223 0 Health-care facilities. 0 Supply voltage for more than
D Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.# 1 5 -16 Project name: FOUR OAKS APTS. 0 Service or feeder 600 amps or more.
, ... . ;'.::FEE :SCIIEDULE':.i `' '
Cross street /directions to job site: ucxn�,tioa I Oly I r . 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 4
Tax map /parcel no.: Ea. add'I 500 sq. ft or portion 33.40 I
Limited energy, residential 75.00 2
DESCRCPTCON OF WORK ':: (with above sq. n.)
Limited energy, multi - family 75.00 2
INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. yJ
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
: / PROPERTY''WNER•:.. . • :
D :TENANT........, - 201 amps to 400 amps 106.85 2
Name: t 401 amps to 600 amps 160.60 2
K � `S LZ .- 601 amps to 1,000 amps 240.60 2
Address: / b' 3 S so j V y l S �N t ST Over 1,000 amps or volts 454.65 2
City /State /ZIP: a E-2( m 0 l2 9 700 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 1 own which is not 201 amps 10 400 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, p panel
Owner signature: __.__ Date: A. Pee for branch circuits with
. .:.. 0 APPLICANT ., • ...' ; . a CONTACT.• PERSON.. .. ;..:'.. i. above service or feeder fee, 6.6S 2
cacti branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
wit/tout 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 ?
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, INC. energy circui,alterlimited-
, 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 (t hr min) 62.50 _
cca Lie.:14117 Electrical Lic.17- 154 Suprv. Lie.: 173LEB Industrial plant per hour 73.75
... : : ELECTRICAL `PERMIT :`FEES :'-
Suprv. Electrician signature, required: Subtotal: $75.00
Plan review (25% of permit fee):
Print name: JACK CAGLE Date: 4/16/08
state surcharge (12% of permit fee): $9.00
Authorized sit m ::v,,,.. • ^ -` - — TOTAL PERMIT PEE; $84.00
Print name:
T ER I A. M KU L ICi Date: 4/16/08
•Phis permi application expires if a permit is not obtained within 180
/08 days after it has Leen accepted as complete.
__._ - ° Number of inspections allowed per permit.
I:\ Building\ Pcnnits1ELCPcnaitApp.doc 05/23/06 440.4015Th 1 /05/COMAVEn
CITY OF TIGARD
A ,,
BUILDING DIVISION PERMIT #: ELR2008.00090
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2008
Phone: (503) 639-4171 heitlAW
Inspection Requests (24 Hrs.): (503) 639-4175 1.1 't.!..
INSPECTION WORKSHEET FOR DATE: 4/24/2008 TIME: 7:01AM PAGE: 12
SITE ADDRESS: 11576 SW GREENBURG RD 15 CLASS OF WORK:
SUBDIVISION: FOUR OAKES APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: FOUR OAKS APARTMENTS
DESCRIPTION: Units 15-16: Installation of fiber optics for Verizon.
OWNER: KEN CONDO'S LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360.2E46920
Inspection Request Scheduled For: Date: 4/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 068854-05 503.333-8888 N
Corrections/Comments/Instructions:
\ ,
(1 ,
3 Zct PASS 0 PARTIAL APPROVAL E CANCEL 0 NO ACCESS
0 FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G I € LA Date: LAI l 2- 1 1(01,1 Phone #: (503) 718- MLA*