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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00122 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/20/2008 PARCEL: 1 S135DA -04600 SITE ADDRESS: 11161 SW HALL BLVD 18 ZONING: R -12 SUBDIVISION: VILLAGE @ WASHINGTON SQ. APART LOT: 001 JURISDICTION: TIG PROJECT: VILLAGE AT WASHINGTON SQUARE Project Description: Units 18 - 19: Installing 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: MARVIN & MAJORIE CAHN NORTH SKY COMMUNICATIONS INC 5795 SW CRANBERRY CT 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 14117 Description Date Amount [ELPRMT] ELR Permit 5/20/2008 $75.00 [TAX] 12% State Surch 5/20/2008 $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: �QQ 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. 1 _05/19/2008 MON 14:22 FAX 360 254 5097 North Sky Communications fdj003 /005 r t: pE►' Electrical Permit Application - EOR OFFICE USE'ONLY ` .' City of Tigard MAY 2005 outeja S" A17111-1111111k. i Permit No.: - , e 1 , cO a 13 (25 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone 503.639.4171 Fax: 503.598:1960 Datc/B : Other Permitr , .ri GARD Inspection Line: 503,639.4175 kill p I T L r ,` h l� Date Ready /By: la See Page 2 for Internet: www.tigard-or.gov B J I LD 8 J ,^ ,) ; ,1/ t ks) 3ie Notified/Method: �1 Supplemental Information OR , :PLAN >RE. •I ❑ New construction t _l Addition /alteration/reptacement Please check all that apply (submit 2 sea of plans w /items checked below): • ❑ Service or fender 400 amps or morn ❑ Building over three stories. ❑ Demolition ❑ Other: i where the available fault current ❑ Marinas and boatyards. E ORY OFD CONST t).CI' CON' ?r. r : :` ;: , ::,'i'.r,:'", : ?`::`?.,`,. cxccais 10,000 amps at 150 volts or El Floating buildings. :.CAT G.. R . ;:: .iti` `:::;1,:.`.� �: - - - .. ; less to ground, or exceeds 14,000 ❑ Comrncrclal -use aeticulturxl ❑ 1- and 2- family dwelling ❑ Commercial /industrial El Accessory building amps for all other installations. buildings. • S Multi - family ❑ Master builder ❑ Other: Q Fire pump. ❑ ttutallation of 75 KVA or Q Emergency s ystem- larger .. separatel derived system. :,y : ..: O ....:.,. �: :: ` ;1, .B:;SlTE:;INCsORMATIQN:: AND; LUCATION.. ::\ `:.'.:: '.:.i. :.::,:;`. : ` ❑Additiono£ncwtno © ., A» E .. .. t.3 ^ Job no.: Job site address:11161 HALL BLVD 100HP or mote. occupancy. 0 Six or more residential units. ❑ Recreational vehicle parks. • City /State/ZIP:TIGARD, OR 97223 ❑ Health -cum facilities. 0 Supply voltage for more than ❑ Hazardous locations. 000 volts nominal. Suite/bldg. /apt. no.18 -19 Project name: VILLAGE @ WASHINGTON SQUARE 0 S e rviccor fccder600ampsor sore, .... ,.. '.:':::;r • :SCIHEDULE::.S: t: : u:'.:::' :•: z `:. Cross street /directions to job site: Ucactipfron I Qtr. I Bee. I rotas 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,: F :a. add'l 500 sq. ft. or portion 33.40 ` I Limited energy, residential ,1. DESCRIPTION ..OF:': :WORK::: • :. :. . . . (with above sq. 0.) 75 2 Limited energy, multi - family 75.00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. it.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 • 2 • :` : V PROPERTY: ;OWNER'c': • "•; `:' : '.' .,; ...': `.`i c TENANT. - :-: ;.(, ; `:; :: :> 201 amps to 400 amps 106,85 2 Name: 401 amps to 600 amps 160.60 2 ' 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 • City/State/ZIP: 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 strips 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 :• ?10 ;AI'PLiCANT::,'C; .'• ::'. ?::.:'.;': ;` o 'CONTACT. PERSON ". ;.: above service or feeder fee, 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits without service or feeder fee, Contact name: MONET VIVEROS first brunch 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 /StatetzIP:VAN000VER, WA 98684 Each manufactured or nodular 9090 2 dwelling, service and/or feeder Phone: (360) 254 -6920 Fax: : ( ) 1-866-530-4325 Reconnect only 66,85 2 E - mail: fI1VIVefOS @florth3kyCOfI1t11.00113 Pump or irrigation circle 53.44 2 ......... .- ...,. :.;.'': ?- .:.; :`.;: :.CONTRACTOR:':':::';::: : :,i:; ",;'.;.' Sign or outline lighting 53.40 2 Businessname:NORTH SKY COMMUNICATIONS, INC. Signal circuit(s) or limited - 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 (1 hr min) 62,50 CCB Lie.: 14117 Electrical Lic.1 7-1 54C LEI Suprv. Lac. :173LEB Industrial plant per hour 73.75 • ».r::.::,:,;,::; " ELECTRICAL'.PERMIT:.FEFS . ; °.::; :i `: Suprv. Electrician signature, required: Subtotal: $75.00 • Plan review (25% of permit fee): Print name: JACK CAGLE Date: 5/19/08 State surcharge (12% of permit fee): $9.00 Authorized si TOTAL PERMIT FEE: $84.00 This permit application expires if a permit is net obtained within )S0 Print name: TERI A. M I KU L I C Date: 5119108 days after it has been accepted as complete. c Number of inspections allowed per permit. l:trolldinglPcrmilstEi.c4eu itnnp.doe 0•12 1/06 4404615T(11/0.S/COMAVEa • i • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008- 00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5, }0013 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/23/20013 TIME: 7 :00AM PAGE: 10 SITE ADDRESS: 11161 SW HALL BLVD 18 CLASS OF WORK: SUBDIVISION: VILLAGE @WASHINGTON SQ. APART LOT #: 001 TYPE OF USE: PROJECT NAME: VILLAGE AT WASHINGTON SQUARE DESCRIPTION: Units 11 -1t?: Installing fiber optics for Verizon. OWNER: CAHN, MARVIN rk MAJORIE PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360 -254 -6920 Inspection Request Scheduled For: Date: 5/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 070326-03 503.969.5989 Y Corrections/Comments/Instructions: • • 4 `� PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: N tR) Date: 617;61 O Phone #: (503) 718-