Permit a
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00279
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/1/2008
PARCEL: 2S 102AA -03301
SITE ADDRESS: 12345 SW HALL BLVD 1 ZONING: CBD
SUBDIVISION: TIGARD TERRACE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: TIGARD TERRACE APTS
Project Description: Units: 1 - 8. 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:
GREENVIEW INVESTMENTS, INC NORTH SKY COMMUNICATIONS INC
5229 SE HILL RD 11818 SE MILL PLAIN BLVD
PORTLAND, OR 97267 SUITE 410
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 10/1/2008 $75.00
[TAX] 12% State Surch 10/1/2008 $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: `i - Permittee Signature: - —
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.
. .
.i-i„
Electrical Permit Application . i .-• : • ii . mlii . v.:04 , 1 11 m;;:l.w..,,.. t ingtioknieRusroNveklocrt-,04-11 , 0--V
'II ga rcl RtCEIVED R„,,,,,,,et, A
f . ' ' - " 11125 SW Ilall 1310., Ttgard, OR 97223 L I; ) 1 . .;.:1 1 1 1:t i i l l i S i 3 e y Y N , .: c sv -1 Cir
• - - " :,. Pone: 503. 63 9.4 17 1 Fit K: •03. S9'• 10 60 k
F 7 - c.rinit No.:
chliot Peni:
S: h
' Inspection Line: 503.639.4175 SEP 3 0 2008 1),Itc Ready/By.
.,,,,■•• 0 Sec. I'm4t 2 fin'
TIOARD, ,
- .,-. in(ovnet: www.tigard-or.gov Notiried/Mohotl: =22 Sunpletownl Inf ormatinq
TYPE oCITMOF TIGARD . .... . ..... ________ ...... ...._ .....„. „
Pl.,AN REVIEW
0 New construction f AdditigUILDIN41.11VINION }-1,,,,, ,,,„., ,,,, tIIII aplfly t;.:1,init 2 ,e(s or plat7;;;C:u, ,•1■7.Ti:ed brIm
0 Sc i ■.iee or fuck, :WO amps or toore 0 Building over tlwee stofies.
0 Demolition D mei.: he ,,,, ii ,, b1 , 1.1( ou rem 0 mm. ,,,,,,,, .d h.y..d,•
CATEGORY OE CONSTRUCTION I mceols 10,000 n o at 1 50 volts 00 ID 1.1111inl!building5.
-- -- les:, 10 gmund. or e00001: 11,000 0 COIntIlCiei:tl.t,C ft, i0111111t AI
..._.
01- and 2-family dwelling 0 Cominercial/industrial 0 Accessory building i :imps nio idi ntIme installations. Wilding,.
i 0 ..,
0 Mtilli-falliily 0 Master u
builder 0 Other: i hire pawn. 0 loseiliatiea oi'75 KYA or
I 0 Emageecy system. 11nge0 scp'ateiy deer/cd 15010,11.
JOB SITE INFORMATION AND LOCATION .
0 o\ domino of COW mnior iniet on
. a ....._
Job no.: - I Jc sik' a 12345 SW HALL BLVD. if:01.11 or won:. occupancy.
0 Six or maze res:dential units. 0 Recreational witicle
City/State/7A0): TIGARD, OR 97223 0 liniin.c.,,c iaeinties. Cil 50111115 011100 itu tuuru 10.m
0 I tu zurt 0.,...0ioni. 000 uult:; amninal.
SI tc/bldg./apt. no.: 1-8 Pr() nall) TIGARD TERRACE 01 Sel vice Ill :'vecIrl 51011.110 Cl mom.
- FEE SCHEDULE
cr,,,, street/directions to job site:
...il. „,, i ,,,,m, L J -r„,„,_, J •
-
Nov residential single- or multi.family dwelling 111111.
Includes attached garage,
Subdivision: I Lot no.: , I .00) sq. ft, or less
.....a. 145.15 4
......
ER. ad111 500 Cl). ft. or portion 33.40 I
Tax map/parcel 110.:
i 7 lesideniial
75.00 7
DESCRIPTION OF WORK (wiih ;1111,00 :q. It.)
75 00 1 '
Limited energy, multi-M[1)1[y
INSTALL FIBER OPTICS FOR VERIZON
........__..._. ---
Services or feeders installation, aBera ion, and/or relocation i
200 amps or less 80.30 2 1
[j PROPERTY OWNER ' .[ ' .. 0 TENANT 20) amptt 10 400 amp
- 106.85 2 .
1
N
401 amps to 600 amps 160.60
ame;
1/01 amps 10 1,000 amps 240.60 i 2
Address:
Over 1,000 amps or volts 454.65 1 2
City/State/Z117: , r entporary services cm' fenders in slalhition, Ate; tion, and/or
_ relocation
Phone: ( ) Fax: ( ) 200 amps Or less [ 66.85 I
1 2
Owner installation: 'This installation is being. made on propoisy that I own which is not -19. " 1110 1 2i 0 i "" 00.30
)
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 extentd911, pee panel
owner signature: Date:
t A. Fee for hooch circuits with 1
0 APPLICANT C) CONTACT PERSON above, se( vice or l'eeder 'co.
1 6.65 '2
0. each branch circuit I
l3uslIIo'.S n'Inie: NORTH SKY COMMUNICATIONS, INC. 1i Fee. 1 branch ell cults i
_ -
tlotti service of reeder Cce.,
Contact name: RYAN ROBERTS i 46.85 2
first branch circuit
-1-----
Address: 11818 SE MILL PLAIN BLVD STE, 410 F.ach add' I branch circuit I 6.65 -
2
Nliscellaneritis (service or feeder not include(l)
____.._ ...
1 CitY/S VANCOUVER, VVA 98684 Each manufactured Cl modular 90.90 2
1 dwelling, service and/or feeder ..;.
PhOne: (503 ) 519-5264 Fax: , ( )1-866-905-4907 Reconnect 01115 2 y .•
. 66.85 1 ,_.......
..._.......
E'illail: mduornorthskycomm.corn Pomp or III 111011 circle I 53.40 1 2
CONTRACTOR Sign or niiiiinc lighting I 53.40 i 2
_ .............
Signal circuit(s) or limited- 1
I Business name: NORTH SKY COMMUNICATIONS, I NC .
1-- energy panel, ;thermion. or
Address 11818 SE MILL PLAIN BLVD. STE 410 cxteii,,i0ii. ix:scribe, 1 Page 2 $75.001 2
City/State/ZIP: VANCOUVER, WA 98684 _Each additional inspection over allowable in any of the 11)000
• Per m5.11ection 69.50
Phone: ( 360) 254-6920 Fax: ( ) 1-866-530-4325 ____ .
invesi per hour (l hi inito 6
CCB Lie 14117 11i -leen'icill Lic-17-154CL supt 173LEB inclutdrull 71 III) per hoer 73.75
- -- --- ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: $75,0.0. .
_......._ _
Plan
Print 1)1111)1..: JACK CAGLE Dale: 9-30-08 1051010' (25% 0)110111/I Ole)
.........., ...........____
Siam suichafge (12% of permit (ee): 1 $9,00
AuthorPtcd signature: a/ TOTAL Pl IT FEE: $84.00
,.
-
1.1,1; 1111 permit is not olytaitml within ISO
P61 "" ETHON A. DOLPH Date. 9_30_08
11050 diet. it lilu: ben e accepted as coniplece
- . -
Number of inspuctioni 51100011 50) 5001111.
1:kiliiicling \ NI ini,‘F.I.C-IWW:t 411.13c 05/2.;160 4404111%T( I 1111111 ONIA.1•11
CITY OF TIGARD
BUILDING DIVISION #: LLr2a> az
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1/2000 Phone: (503) 639 -4171 III "�'�`�
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 10/9/2008 TIME: 7:(t9AIv1 PAGE: 14
SITE ADDRESS: 12345 a HALL BLVD , CLASS OF WORK:
SUBDIVISION: IICARD TERRACE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: TIGARD TEF RACE.APTS
DESCRIPTION: Units: 1 -I3. Installing fiber optics for Verizon.
OWNER: GREENVIEW INVESTMENTS, INC, PHONE #:
CONTRACTOR: NORTH f�H SKY COMMUNICATIONS INC PHONE # : 360.2E4
Inspection Request Scheduled For: Date: 101913000 Pour Time:
Code # Inspection Description Confirm # Contact # Message 11i kk
199 Electrical final 076482-01 503-209.7014 Y ti 0
D -6\
Corrections /Comments /Instructions:
( 0)
I ____/
��,PASS ❑ PARTIAL APPROVAL — CANCEL NO ACCESS
❑I FAIL . ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
. %
Inspector: a . Date: /1 � : : Phone #: (503) 718-