Permit ir C ITY O F TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00180
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/8/2007
PARCEL: 1S133DB-07400
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG L ZONING: R -25
SUBDIVISION: SUMMER CREEK APARTMENTS LOT: JURISDICTION: TIG
PROJECT: SUMMER CREEK APTS
Project Description: Install low voltage 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:
SUMMER CREEK LLC NORTH SKY COMMUNICATIONS INC
121 SW MORRISON STE 1000 PO BOX 87550
PORTLAND, OR 97204 VANCOUVER, WA 98687
Phone: Contact #: PRI 503- 209 -7521
FAX 866 - 743 -3974
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 6/8/2007 $75.00
[TAX] 8% State Surcha 6/8/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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: / r Permittee Signature: � iQptp 11 �k 6
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.
06/07/2007 THU 10:16 FAX 360 254 5097 North Sky Communications ZI012 /020
0 i'ILc.5V - 1 2( Iii DA lO "2- M'.
Electrical Permit Application �, , r �( t��� FOR OFFICE USE ONLY
City of Tigard I I . ' t Received � i t MOSE MO, Permit No.: ' L / .oIC - II i V
" 5 rte 13125 SW Hall Blvd., Tigard, OR 97223 , Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 UN VJ 7 2007 Date/By: Other Permit:
TIGARD Inspection Line: 503 639 4175
Nate Ready/By:
/ M etho a tal Information
i m{^ wSi �', ,, " T . ? � r V i : :, . dds _. a t�ir�-i _,K ..0.4: a'
m .0 i �1. a tl ;; l e -', ^ v {41 t s 7 . 1 t.. } ..�. a `ur WI' F�, r>, w? ^ : ' e . n ,4�
5„ U..Z:..�. §.,n,. , _: F`.sc., S.< xis u �`.',;.V.',u.1;L ..i'EP 4 =rte' 4."�8 ;∎10; -,: .4 , .p d e *1 g r AA's; d9, /V i,i.;i �i .MV }`u
x a�'c:' l'f: �".. S.S .a. rn"e n:.u.P...w.. ..p5! &,.a., .� ..C,. .
❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition El Other:
El Service or feeder 400 amps or more ❑ Building over three stories.
$i" nx F ir+ av x
.r •3,1 :Mil ['�7IJ`y �`r`�) �'ic {4f g h • �f"I� 4' t. I� IW ilfa 4 1 1, V 4"'i'i' - �'Y' Mi lOa where the available fault current ❑ Marinas and boatyards.
l
i w ti �r;.r � a .- - A1.1b::a � a4 :6 r,'r #4 ,.. ' '' : exceeds ground, amps at 150 volts or ❑ Floating buildings,
El 1- and 2 - family dwelling El Commercial /industrial amps s o ground or installations. ons, ❑ Commercial-use agricultural
0 building amps far all other installadotrs. buildin
IZI Multi family ❑ builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
"`t Uliit ;? asks 1 p t N r�- 5Vii,iii t : + ; ` tr f + +F r'' x 1 :KV6'� `° T^ ❑ Emergency system. larger separately derived system.
€lLg 3i S `4t, ,.,:�L. "C. w x „ si£�Zli t�, RI �' 6 .�, ".5''k?�.�a:.>.407 @r i 4 n i ..r �... y " , '1 - i,5 C a `�4�� i t M r l <
�Lt. k >���t, `� ��n3z,y�+.Y ❑ Addition of new motor load of ❑ ",9, " &" °'1_z» , •1_3 , •
Job no.: / �" ,l , Job site address: 9 1 lOO or re occ nc
/ �„� / 1 � ❑Six or more mo residential units. ❑ Roc vehicle parks.
City/State /ZIP: - f 9 '' S ❑ Health -cam facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: • � ect name: Project ^ �,,, i . oe /
1 C N p "f l / 0 o feeder 600 amps or more.
=, r lei 3a : J'Snk- "��ra�l`f�`� v^i3�d .s,+i �.. iiwinffirmiwili Cross street/directions to job site: .t
Description tv. :. �i .,,.`ter. „_., ,. Qty. - , e,..r F c , - �, t
Fee. Total '
New residential sin or multifamily dwelling unit,
1/ > Includes attached g aa g e.
Subdivision: / �� / Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'! 500 sq. ft. or portion 33.40 1
� � Ni E ' �� y t' s 4 � 1 � zbt °� t 4 ,„ Limited energy, residential
21IS , .s '�,.' tb <,a wlu..rt:.c'L �. . ;rl OBt sty' 4yn't i`�"s�> f z , , o ) :: t i �a (with aboves R.) 75.00 2
�, i , �� ! Limited energy, multi- family 75.00 2
t� 1(� residential (with above sq. ft.)
Services or feeders installation, alteration, andlor relocation
y � ;' r 4 �la•,1..1 fl sr s ;Fyn o`f axl"nA:'t_S i9[ 1 3tu ,G -" .e r Y '4 J w T3 .� 7 200 amps or less 80.30 2
.. n , .> 1 .- i �¢? ( : t `rr .jlr. r r I g'1 z.;: 13 +: W1 '1 20I amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address:
601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: a 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 amps to 400 amps 1 100.30 1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
P ' iZu i at' z [ s ...� -o-+2y rt* c i ' 1�tfl v � iiS 7 r rzo Sty , � 1 ;
A. Fee for branch circuits with
gr� ._Sum`s` rN,:.A :i . s ; .1,tlty: w " ar; :gf11 -- :� ';wl... 'w, 4 - t . t: fit`6. i z,,:i�r above service or feeder fee, 6.65 2
Business name: IA t each branch circuit
t j 3 ; ' B. Fee for branch circu
Contact name: I� ; , ��`- without service or feeder fee, 46.85 2
first branch circuit
Address: 1 i } s WA i5 I f� ,� '3 Each add'1 branch circuit 6.65 2
City/ State/ZIP: 4.1 t f/ D _ Miscellaneous (service or feeder not included)
.. 1 A Y V f �"' 4'.., t 1 Each manufactured or modular
90.90 2
Phone: ( 60)) *� " -1 1 Fax: (�j l , 1 / t r L , 2 Reconnect service and /or feeder
REIM ���� �P ` y T �� � J Reconnect only 66.85 2
M V ll 'OMRR V � C' (1 1 Pump or irrigation circle 53.40 2
J
�,�' �.�4 iY,��A'p+'pPis�j. `�„ ,�4'�"v � ,a �� - k ` t e -�:Ma �' � f.E�' ■ s• Sign outline li .,.a'S 'h2,''`.`S`"i,.� -s ?v ;�. aY { s u ? ��'fi y 7 ��t ri a� , i K `'I FSj'T .1 Y i ? . i i + n "" t _ -
�z; .,1� �l� :.�..�,�.a,_ u..�,��>..� �ia:�� �t�l.. ".". rir.���:�i?�Y /r -;YZ� g g g 53.40 2
Business name: , , �` 1 � Signal circuit(s) or limited -
Address: V energy s onDesc or
Paget 1 6 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Phone: ( ) Fax: ( ) Per inspection 62.50
Investigation per hour (I hr min) 62.50
CCB Lie.: 1 Electrical Lie.: Suprv. Lie.: Industrial plant .e 73.75
hour _
Suprv. Electrician signature, required:
Subtotal:
w Ki.+,r..rw..Cli r ' _"�'=,'`1<t T -2' 5u bto o t y'd-�S i 'i7�is �t}.�r�.'.t .:.v"'., !{.�
utal:
Print name: Date: Plan review (25% of permit fee):
��► State surcharge (8% of permit fee): (o 6°
Authorized signs TOTAL PERMIT FEE: ' c ` i
Print name: � ' l 1 t Date: / This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
* Number of inspections allowed per permit.
1: 1Building \PennitslELGPermitApp.doe 05/23/06 - 440 -4615T(l1/05 /COM/WRB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00180
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/812007
Phone: (503) 639-4171 t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/28/2007 TIME: 7:01AM PAGE:
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG L CLASS OF WORK:
SUBDIVISION: SUMMER CREEK APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: SUMMER CREEK APTS
DESCRIPTION: Install low voltage fiber optics for Verizon.
OWNER: SUMMER CREEK LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503-209-7521
Inspection Request Scheduled For: Date: 6/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051144-04 503-519-7466
Corrections/Comments/Instructions:
•
•
PASS PARTIAL APPROVAL II CANCEL pi NO ACCESS
El FAIL I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: • G Date: I) 1.1). 0 Phone #: (503) 718- 1
, _ _