Permit Er CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00187
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 T 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
L1C 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 B • Permittee Signature: 3 0 p / j (A fi°!
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 10:20 FAX 360 254 5097 North Sky Communications 2019 /020
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Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard r �` 6/g '
FR '" " ,, Received Permit No
Da f a R2�'7_co/ g�
1 ' s 13125 SW hall Blvd., Tigard, OR 97223 • , : - plan Review
Phone: 503.639 I .4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection 503,639.4175 �� y y�� Et SeePage2for
TIGARD p JUN � % Z��� Date ReadlB Jar'•
Internet www tigard -or gov Notified/Method
Supplemental Inform a tton
,�`�(G �"� .�;� � ��... � k�Fa2?"� fq ' §n` t l`i'"� _1. r��r`''t i�r�y: �-vT �.Sm -yi ^g ��^.+ r,i k .,n � -s. t '�.> v"� 7+ ".: �.l'a 5 s .� r - r -y� 'v�.. .,� • _ �,.
".iis.:.,c, ...Y_ % t Y �. 4 a1 ^,:1 a i'~ :. -.. 3� 1 . f . a�tbt ",�'V`,1 ,k-.�y a, s • -:v i:. , .: �.. t.... 53 i ... l ti r i .. v � ' ,b. tjj r�.u ;., i-`e �. ":'Y " 'T n Yr7T^F�� e <..' t }
Vryfld t " � s s "'- d" .t"�1 s `�x�ti�..�`.. .,��F�ia gj�y r3 .. ,.�$.{.,.��",. r,�wi.�i`t.,�ait:'NAY L�'u�txl�,���} �� 1? I"., �� '� �. ���1'c. ,L;;'::
a..,. Y- �_s,..,.�.�TS,...A�..a: . -o 9 � v._. c.�.�« -. .a a �.y ....�� -4 _ ti��� : f r a s
❑ New construction grAdditiotl /alteration /replacement Please check all that apply (submit 2 sets ofplana w /items checked below):
❑ Demolition ❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Other: where the available fault current ❑ Marinas and boatyards.
`' , '` r 4 .t R �'�J r ' Q 'A, o ),A +s : e r d
��, exceeds 10,000 amps at 150 volts or
.'.ht� a- _2b.<n.w�rr.s .'�:.. ..r ��rnt ` � a £.,, �s an. a{ �_< 3 ..... , r.ti. �k, ' .� " .. � .= .ac� P ❑Floatingbulldin $ s.
El l - and 2 - family dwellin less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
dwelling 0 Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
V: Multi family ❑ Master builder ❑ Other: D Fire pum
,� �„`� � i � � ���„� � � ❑ installation of 75 KVA or
�
t a t x � � = , r }� , �'� ��, � �_ i : ❑ Emergencysystem. 17:477t_;[,, vedsystem.
*....xj;.,� �t�l?,: « ..:�r� ��'^5�� a��4r..�„as�nn ��,�{ �y� ,�� ❑ Addition of new motor load of ❑ •` -3 ",
Job no.: l��� i f Job site address: � . / ' 100HP or more. occupancy,
❑ Six or more residential units. ❑ Recroatiotial vehicle parks.
City /State/ZIP: ' , y i S 0 Health -care facilities. ❑ Supply voltage for more than
��p /+ �p (� 0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ° I Y 1 I c, vee!' . 0 Service or feeder 600 amps or more.
`iT�' t, `,7MC l 1� 9 n C r il+3i m A7n.
Cross street/directions to job site: �1 '�,_ ,_, M: :
� ,E� asp_.., �.. r,_u t.f. 9rA.1 u. : �%i`
Description QLy. Eee, Total
New residential single- or multi- family dwelling unit.
1
Includes attached garage.
Subdivision: I ,',j Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: v Ea. add, 500 sq. ft. orpoltion 33.40 1
t c �k Y : ps « i c # Limited energy, residential
�� . x r , + gi'�„tit t) t8 i � , a s` ' d � g 3 � r� : ; � ` l t n4+ ` l } ,`kil t 75.00 2
3.. <- ,.�,�...��._ �r �/s ...,,,.iz, M1 y ..,�z� r, �;n° ...a'�'1 n . ,�!'.�;:o-?�:".,.,°t�' � �t (withabove sq, tL)
Limited energy, multi - family
''+j a" .0 - �f' Y F i 0 residential (with above sq. ft)
75.00 2
1Y Services or feeders installation, alteration, and/or relocation
t �; 200 amps or less ' 80.30 2
N . Di :' tikia ;�e' +,A` �� ° t'F ,` ��' t ^,�. ` `east " �v '� i f �" h t 1� iii 'k
3 tee., ,h k. AS.. as G u. tars rtrm„ 4a � + u . rd v> r t _,. £ksJ�l :a:....pg� J 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: 0 Ova 1,000 amps or volts 454.65 i 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) pax: ( ) 200 amps or less 66.85 l
Owner installation: This installation is being made on property that I 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
� r A. Fee for branch circuits with
't 7 m r ,�.b v -u"v iiiK6 t.i.:..a. -r � , i 4dv aJ 1 ; 0b01,T 6�t 4 p: Yi dc,�(4�i t. K.ki" "; above service or feeder fee, 6.65 2
Business name: ,�/{ each branch circuit
-" ` 'La $ . r k VT `' B. Fee for branch circuits
Contact name: M , i ,f� without service or feeder fee, 46.85 2
first branch circuit
Address: y i i g wt i / .., �' � Each add'1 branch circuit 6.65 2
�°� I • Miscellaneous (service or feeder not included)
City/State/ZIP: AL k 7 Each manufactured or modular iLikt 90.90 2
Phone: (iJ ) A "1 '1s I Fax:: ((?)(.0 � 11 ' , r . � Reconnect 113 M Ill 1 only 66.85 2
' di a A C b m Pump or irrigation circle 53.40 2
€dx '�'��".,��.� w• p�er, },cf'v^.'th iw r oe �, � � - R�+"��' �: ^° c' 7 � 1 a• �' -i Hi � i
i zs.. ; '�S"}c.`S i �' n - Sf B Mf'�,1 (771,v y �`�f M ' u$w+: ii. ii �tx71 ri } �•� r { f)i 9i f �`�$ Sin or outline lighting l sign .� ,.w�.3{. s::, r 3,....�' � ?.�rt...is "�f.. ��'u a1.�.e. «, g g 53.40 2
Business name: A A ' A , 6 Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: ( Page 2 16 2
City/State/ZIP: Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) _
Investigation per hour (1 hr min) 62.50
Electrical Lie,: Suprv. Lie,: Industrial plant per hour y j 73.75
F.
ARa i se to ? E 1 x � ,`t«IL �t6�3 4 u ;z a r }'F
Suprv. Electrician signature, required:
Subtotal:
Print name: Date: - Plan review (25% of permit fee):
State surcharge (8% of pennit fee): V
Authorized signal' -- `, -`��� TOTAL PERMIT FEE: • %1 i
Print name: - 1 6 C, C, RD - Date: / / / 1 ••A. This permit application expires if a permit is not obtained within 180
days after it has heel] accepted as complete.
* Number of inspections allowed per permit.
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. _ .
CITY OF TIGARD ... :, .
BUILDING DIVISION PERMIT #: ELR2007-00187
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 6/8/2007
Phone: (503) 639-4171 Alo,
,_,Iliit
Inspection Requests (24 Hrs.): (503) 639-4175 ._
INSPECTION WORKSHEET FOR DATE: 6/26/2007 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG T 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: 6/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
139 Electrical final
6)5()958-03 503-519-7466 N
Corrections/Comments/Instructions:
•
I 1/4
\. .
k\tDASS PARTIAL APPROVAL 0 CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 6' . 0 0(?) Date: kli . 1)0 .1 °1 Phone #: (503) 718- 1 -4*
, . . . „ . . -