Permit v CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00186
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/8/2007
PARCEL: 1S133DB-07400
SITE ADDRESS: 13456 SW HAWKS BEARD ST BLDG S 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. g Permittee Signature: 4 ,op)( � , /i �
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 2018/020
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Electrical Permit Application ,- , -. y !-as- FOR OFFICE USE ONLY •
City of Tigard b---1.,___ . • ` ,. . Received /_ Permit ^ 113125 SS a lal Blvd., Tigard, OR 97223 1 U • ri Pan Review
At. i �� r
h one. 639.4171 Fax: 503.598,1960 ° /00/
DatemBy Other Permit:
TIGARD Inspection Line: 503.639.4175 �.. : `� Date Ready/By: 1 H See Page 2 for
Internet: www hgard or gov ' Notified/Method: Supplemental nformation
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<:i_�?8'�....7... ��ti::� � .E.�,u. <a�':c�,i'�t'Sx�� :�'ti� . �. �<: fi+ ..�...a.: e�i;. ��b ��, a` ��a�'��- �? - ""'��"1t '">�'.;
❑ New construction OAdditic n/alteration/replacement Please check all that apply (submit 2 sets of plans w /item checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other
a a ;m Kz n F x $ � t where the available fault current ❑ Marinas and boatyards.
a -'sa�� ' e '' 4 7 U 0 ,, . ul + ,, r fq�':`;' :, .,.,=•!;t s n .':' �41 exceeds 10,000 amps at 150 volts or ❑ Floating building.
� `� - r∎ 41 " q ` '` ' 3 less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building g
ry g am s for all other installations. buildings.
,�., I,. Multi family ❑ Master builder i❑ Other: El Fire Pump. ❑ Installation of 75 KVA or
`'? \g�Z` 4 _ r Hi� A ° tlA�t C �'``- ❑Emergency system, larger separately derived system.
.'
'' � : 1 TOW ° - , .'... li ` A 1 %i,r s; a Addition of new motor load of ❑ "A ",'•E" -1_2”..1_3"
Job no.:9A i � "� , Job site address:' / ��� � ` r� IOOHP or more. occupancy.
'r a'+��a� ❑ Six oir more residential units. ❑ Recreational vehicle parks.
f! I , M 1 ❑ } ealth -care faclities. ❑ Supply voltage for more than
❑ ervi dons locations 600 volts nominal
Suite/bldg. /apt. no.: a Project name: P- V r ,,,ev, ❑ Servtccor feeder 600 amps o a r more
V iC.. . •qii Description t .t , ig tl ikili v R e e, � � , .
Cross street/directions to job site: a,r�' . e �,,, b � _
Description qty. Fe e. Total
G y .r Incl New udes residatt aential chesind gle - or multi- family dwelling unit.
garage.
Subdivision: i 1 000 s
Lot no.: sq. fl. or less 145.15 4
Tax map /parcel no.: Ea. add'1500 sq. R. or portion 33.40 1
C f g Limited energy, residential
T " `
��1� ��'�� b'r���v ? a� � � � "���--y`y,, � '�1'�`P, nnr k s � � c- gY
e_;� r~ d ...v�.,!I. V , `°Y i.� � .i° i ii � u. {' . n ° ,ER + i (with above sq. R. ) 75.00 2
Limited energy, multi- family
''+ residential (with above sq. ft) 75.00 2
Services or feeders installation, alteration, and /or relocation
q H 200 amps or less 80.30 2
z�s � �v.4V sl`'g
1 v r r'� ' y"y„ 5 ' t� � �� A' '
` i : •: > k. ,. �r � ^*l , t ` 1 1 k
'�...r �: _.� � •, ,. d ■.�.s.y..,�.. � z.l,:.�,,,... n � ,., .,a�3: � a .,.�,,rsa�,_ " .x . ..._.; nx E.. ;a. >,���,.� .. •_,_� :�. �.,,4 _ 20] 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: 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 I 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
�� x k� A. Fee for branch circuits with
�ii ` ,"l * e. Y ?'�,an. �'i.U:'; 3e: ; _a:.:1i(I' �, , 4 %A P. .., : `.!. s a 1 _ i
: E:c r 4 ,i ']c � ( } i , above service
�, U " ' °� "' each branch circuit
or feeder fee,
Business name: G.65 2
, `i y ' , , B. Fee for branch circuits
Contact name: _ r without service or feeder fee, 46.85 2
first branch circuit
Address: I d o 1 fi rr WI . 11 1 , t fl, .r il� � Each add'l branch circuit 6.65 2
City/ State/ZIP: A 1 1.fJ _iQ�`^�J Miscellaneous (service or feeder not included)
LA ter la p 1 Each manufactured or modular
ntt
dwelling, and /or feeder 90.90 2
Phone: ( ) ° �i 'Z
' �,, Fax: : ( ..• � 4 �. � Reconnect only 66.85 2
X1 v O 0 &L 1 Cet) I1 1 1 Pump or irrigation circle 53,40 2
t,��n •'��':i-t�"�''�s { °._4y"rT,"N«?l :t'rpr EQ7 �3�.P�`r +k it 5 a x.71 1s ljry .k"�`',+ c;g -
z _._ :?_. Iz,_,T .r,:.'�i�:.d;�v._a . c . U�id...._ . ..ir�.x .:S a. •t;;,„ P t?ir«,: R -?t , "Ei z,�, its Sign or outline lighting 53,40 2
Business name: AA r ` 0 •.U Signal circus) r mited -
energy panel alte or
Address: extension. Describe: Page 2 le 2
City /State/ZIP: _ Each additional inspection over allowable in any of the above
Phone: ( ) Fax: ( ) Per inspection 62.50
Investigation per hour (1 hr min) 62.50
CCB Lie.: \u s Electrical Lie.: Suprv, Lie.: Industrial plant per hour 73.75
Suprv. Electrician signature, required: iti ' a /a � 1 • F
Subtotal: ) ` "`
a x, ..,.__.rn.. .x-,x :�.xr �;s�::�' 0 t.� 1�.,ia'.:us ;a' Skn"if`.
ubt
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): ii7 co
Authorized signal'-' .41 41111
� TOTAL PERMIT FEE: $ 1 /
Print name: -1 ( , Date: / r f OA. This permit a pplication expires if a permit is not obtained within 180
days after it has been accepted as complete.
r:lnuitdiag\Pamits\Ht,C PetmitA dvc osf13ro6 * Number of inspections allowed per permit. v/
�• 440.4615T(11 /05/COM/WF-13
mac .* 2 (0-3-
CITY OF TIGARD
BUILDING DIVISION ,r,
PERMIT #: ELR2007-00186
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2007
Phone: (503) 639-4171 4 2010 it;
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/2/2007 TIME: 7:02AM PAGE: 2
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG S CLASS OF WORK:
SUBDIVISION: SUMMER CREEK APARTMENTS LOT #:' - 4 „, 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 #: 503-209-7621
Inspection Request Scheduled For: Date: 7/2/2007 Pour Time:
Code # Inspection Description ,..—G-onfirm,.# Contact # Message
199 Electrical final 051302-0; 503-5197466 Y
'I
,
Corrections/Comments/Instructions: __.--,' 1 (0 0 , :3 a
rAI PASS 0 PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS
I J FAIL H CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
9 •2 --01
Date: Phone #: (503) 718-
, . ,