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Permit C IT\ OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00123 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/20!2008 PARCEL: 1 S135DA -04600 SITE ADDRESS: 11157 SW HALL BLVD BLDG A ZONING: R - SUBDIVISION: VILLAGE @ WASHINGTON SQ. APART LOT: 001 JURISDICTION: TIG PROJECT: VILLAGE AT WASHINGTON SQUARE Project Description: Unit: Office. Installed 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: / its � � Permittee Signature: t� 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. 05/19/2008 MON 14: FAX 360 509 North Sky Communications 0005 /005 ki , - ‘1 RVED . Electrical Permit Application F OROl'FlCl U Y `. Er City of Tigard MAY 2008 _ _ ` 13125 SW Hall Blvd., Tigard, ,OR;97223. Plan Review _ ffl� �' / ` sm- ee Phone: 503.639.4171 Tax: 503.598.1960 �- t - � p ame /B : Other Permit: - TIGARD Inspection Line: 503,639.4175 : < -, . 4;:,i'°SBOI�Y DatelteadyIUy; � See Page 2 for Internet: www.tigard- or.goPc "�- Notified /Method: IFIMI Supplemental Information .... ..:..•.., , ...:;,: TYPE.OF WORK' ::PGANREYLTf''W: ❑ New construction El Addition /alteration/replacement Please chuck all that apply (submit 2 seta of plans w/itcnts checked below): 0 Service or feeder 400 amps or more ❑ Building over than stories. El Demolition ❑ Other: where rate available fault current ❑ Marinas and boalyanls. exceeds 10,000 amps at 150 volts or ❑ Floating buildings. :;';(' A1EGOR .�''.OF:,CONST$U.CTIONr:..`.' i.`.`. :;';;!t .';` >'::'.:.' less to ground, or exceeds 14,000 In Commercial apiculture! ❑ l- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building :unps For all other installations. buildings. 0 Multi - family ❑ Master builder E.J Other: 0 Firupump. 0 Installation of 75 KVA or ❑ Emergency system. larger separately derived "'tent r' . , JOB: ' SITE; YFOR141TION:, AND ..LOCATION`:`:.`:'..:::: :': motor 1 , ©Addition of new Q "A", "N" , f -�" •3' Job no.: Job site address: 1 1 163 SW HALL BLVD 100HPormoro. occupancy. o Six or mere residential units. 0 Recreational vehicle parks. City /State/ZIP:TIGARD, OR 97223 0 Health -earn facilities. © Supply voltage for more than 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.OFFICE Project name: VILLAGE @ WASHINGTON SQUARE El Service or feeder amps or tacre. "..`': : ::SEE : SCIIEDULfi:2: ;.::•.•:: >' .:.; :, : : `:.. ::': Cross street/directions to job site: Description I Qty. 1 Fee, I Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no,: 1,000 sq. ft. or less 145.15 1 Tax tna steel no,: Ea. add'( 500 sq. ft. or portion 33.40 I IVp Limited energy, residential ' : DESCRIPTION : WORK .: (with above sq. 0,) 75.00 2 Limited energy, multi - family 7S 00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. fr.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 `: ?Q;t)PROETf[tTY `nWNER': ' , _ `,'' ; :'.', ': i:❑ ;TEIYAN C' ` : y ':'i = '�: 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/ZlP: 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 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 ., ...':: 0 :.APPL1CQN'I'. : - :., :: .1: ,`..';: :; : CONTACT PERSON ,..`. _ii. ': 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 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 /StatelZlP: WA 98684 Each manufactured or modular 9090 2 dwelling, service and/or feeder Phone: (360) 254 -6920 Fax: : ( ) 1- 866- 530 -4325 Reconnect only 66.85 2 E -mail: mviveros @northskycomm.com Pump or in'igation circle 53.40 2 • : <; >`; Sign or outline lighting .... .. ..... .... .;... .......'CONTRACTOR'. ?:: .., .. . . g 53.40 2 Business name: NORTH SKY COMMUNICATIONS, INC. energy circul r 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 Phone: (360) 254 -6920 Fax: ( ) 1- 866 - 530 -4325 Investigation 62.50 1 nvn par hour (t hr rain) 62.50 CCB Lic.:14117 Electrical Lic.17 154CLE Suprv. Lie. : 173LEB Industrial plant per hour 73.75 , • ELECTRICAL .PERMIT:FEES ;'. :'f' Suprv. Electrician signature, required: Subtotal: $75,00 Print name: JACK CAGLE Date: 5/19/08 Plan review (25% of permit fee): State surcharge (12% of permit fee): $9.00 Authorized si` . T TOTAI, PERM ITFEE: $84.00 This permit application expires if a permit is not obtained within 180 Print name: TE RI A. I KU L I C Date: 5/19108 days after it has been accepted as complete, s Number of Inspections allowed per permit. I 1. 1ftuitding \PcnnitslSt_C•PannitApp.doc 03/29/06 440.1615T(I I /05 /COMAVEB CITY OF TIGARQ BUILDING DIVISION PERMIT #: ELR2008 -00123 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/200£3 Phone: (503) 639-4171 u fu��ii�V i Inspection Requests (24 Hrs.): (503) 639 -4175 ��� LL __,. INSPECTION WORKSHEET FOR DATE: 5/23/2008 TIME: 7:00AM PAGE: 12 SITE ADDRESS: 11157 SW HALL BLVD BLDG A CLASS OF WORK: SUBDIVISION: VILLAGE a WASHINGTON SQ. APART LOT #: 001 TYPE OF USE: PROJECT NAME: VILLAGE AT WASHINGTON SQUARE DESCRIPTION: Unit: Office. Installed fiber optics for Verizon. OWNER: CAI'IN, MARVIN & MAJORIE PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360 - 2546920 Inspection Request Scheduled For: Date: 5/23/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 070326-01 603.969 -55989 N • Corrections /Comments /Instructions: ) 1n\ • ® PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL — CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cs—API N6g Date: 61 2 3`(31 ) Phone #: (503) 718- 2-y w