Permit i CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00171
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 B 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: / / Permittee Signature: App / nth f y n
< /
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 10:11 FAX 360 254 5097 North Sky Communications 1003/020
® V litub - r El I1 lib to 0°2 -5D'
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard iE• y1 VIE ) Received.
n Date /By: • Pennit N to
t 13 SW Hall Blvd., Tigard, OR 97223 L IQ 200. -
7 2007 D anBeview
.. .� k Phone: 503.639,4171 Fax: 503.598.)r9�ON 0 ( Date/By: Other Permit:
Inspection Line: 503:639.4175 y la See Page 1 for
TIGARD Date Ready/By: kris- Internet www tigard or gov CITY ,ryr� e dJMeto:
.,r iS51r5r7 Notifihd -- ii Supplemental Information
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❑ New construction CI • ddition/alteration/replacement Please check all that apply (submit 1 sets of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over tbree stories.
1i io } s 1 /fi c� tle 'Ri ' e r J i ` a where the available fault current Marinas and boa ards.
' a ... > . � s��a
'�' , W tr �+ i i }}��r4 `z k .l � r � 'F`i r; ➢ f ,. _ t
^ * •.,, . 3a�sxx, � �. ., i,� _��•� a H �« � �'�`"� 1 �' � � exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
� ' t "� less to ground, or exceeds 14,000
❑ 1- and 2- family dwelling ❑ Comnnercia] /industrial ❑ Accessory building ❑ Commercial -use agricultural
� amps for all other installations. buildings.
OM Multi family r ❑ Fire pump.
:, --�: rz ���7,� j y �# k,,� ❑ Master builder ❑ Other: � � $ � _ _ ❑Installation of 75 KVA or
rm t.'_tW s 7 �, RN. 01 t i 3t , t y$ 1 Lea 3� ,� ❑ Emergen system. tar ar se a t deri s stem,
" -� �' '�`� � ' - F � �� i � :,,,��;, ❑Addition of cy new motor load of ❑ "Ag "1;'p °.1_l, "1 3^ ved Y
Job no.: ataap.�, Job site address: I� / A I `!'+ J ix or o more. ze upancy.
(]Six or more residential unify. ❑Recreational vehicle parks.
City/State/ZIP: `/„ k / ,ti/ 0 1 ❑ Health -care facilities. ❑ Supply voltage for more than
l/ "4 l (/ (' �� /J(�
0 Hazardous locations 600 volts nominal
Suite/bldg, /apt no.: Project name: ��q t Y \'1 /V / VV �L 1`/ ❑ Service or feeder 600 amps or more. }a
Cross street/di etions to job site: ' li gE50 dim 1 , 1' �#
Description Qty. Fee. Total
New residential single- or multi - family dwelling unit.
IL A ` � � Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel n o.: Ea. add'1500 sq. ft, or portion 33.40 1
" � xA � -� n ‘- e - .F . . , nM y ' Limited energy, residential
�` 2 .. t xt r� S � I r k rr stirs s sv�, , r i (with above sq. ft.) 75.00 2
N� _ � .:`,,, w4�, � w� 'I D OK E u ,J f1 d S 4' �t�t@b � �, y rxt+J - �` ,� Z�`� r s i + #� .
;,ss� =rte L� ? .'`�, � , am�a� ,u..µ.�; Y.��u.�k snua- __�...�,..� „�S. �L,•�,.�c��?
!"fi Y i Limited mealy, (with above sq. multi-family 75.00 2
"j t � � �� r residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
u i W s s ?3 �s ' L x1 A AI a' ry,'''" '� t . �iV zi ` a °4 '" 201 am amps
s o 400 amps 80.30 2
S ;',1,i ddl iau_,t t. emu• :r', a ; "^ l rz ":nQ._'Lla� n am P 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: ( ) I 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 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
a by v e r A. Fee for branch circuits with
} ' i2. "'i`+�a I� S �'<�j C »x ik '� c` 3 F 3C at e •� :'"4YS `RrjJl.. r n',"M1. i' - -
f�
.�` �' .. �' 1 T.<� � .. �'_. � . �* F Et" � ��,C�7� 0 � �,'�rr���;� . 9 � . c� b r,.�t�ar above service or feeder fee,
i x w .�.�:� `�� ,. �3 �^ � � ? .ro, .a ..,r..° 6.65 2
Business name: t/il�r l each branch circuit
• ' f `� C B. Fee for branch circuits
Contact name: t'j1 ^ i�A� fi i without service or feeder fee,
46.85 2
f��� first branch circuit
- Address: 1 f 1 g SG O A 1 i / , -, - v y
1f t�`" " 11+ $ Each add'I branch circuit 6.65 2
IVEscellaneous (service or feeder not included)
City/State/ZIP: 0 /� , , / j i • ) } cz - Each manufactured or modular
4+ v s� v j� t to 90.90 2
Phone: (6t ) VA " 1 t 2.' ( � ^ 11 4 Reconnect ne, service nl and/or feeder
" — � Fax: : F `T b � d Reco only 66.85 2
E - mail {- el � • y 04 k Cb 01 Pump or irrigation circle 53.40 2
_I zed . a Mira 'r 'r �vY�3' . �E w. . inaJ �.e';,sYt "�'.v`'isl t: `13 n..��, �K,r tai t..''�li,.``eil't�..i i si lighting 53.40 2
Business name:
'`i� r �+ �+� �. "1.� �,� a�.� d t .�., •1, 3 � � ��� Si or outline li t
(� p g.,., \ C �-(.r /L , +r / Signal panel, t(s) or limited -
(� L L� % V energy panel alteration, or
Address: extension. Describe: 1 Page 2 16 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 Lic.: ‘141 \ i f 1 Electrical Lie.: j Suprv. Lie.: Industrial plant per hour 73.75
��wsr k�•v�...^1�- {�'�.'�1�� rr"'"'1 � €��5 �d����"�', r� � �w _r .
Suprv. Electrician signature, required: v ��.cr< ���,r,.. ei �h �.itera : ,,,rt. 06K o . ' ,� tg M f i r
Subtotal:
•
Print name: Date: Plan review (25% of permit fee):
...
State surcharge (8% of permit fee): (Q q"
Authorized sign-- a .
' _: - -------....'-■•■••••••• TOTAL PERMIT FEE: i 1
Print name: 1".e: - ( Ac 1 , ' i ,y, fi C1 • Date: / / / Ell This permit application expires if a permit is not obtained within 180
i days after it bas been accepted as complete.
r7 ' 1PermitsiFT C - * Number of inspections allowed per permit.
r:1Bu
ding PermitApp.dec 05/43/06 440 -46 I5T(t il05(Co1,41WEB
Rey -2-552 ✓
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00171
13125 SW HaII.Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2007
Phone: (503) 639- 4171dNNitl�j�h�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/29/2007 TIME: 7:00AM PAGE:
SITE ADDRESS: 13456 SW HAWKS BEARD ST BLDG B 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
Inspection Request Scheduled For: Date: 6/29/2007 Pour Time:
Code # Inspection Description g-Confirm-.# Contact # Message
199 Electrical final 7 05121501 503- 519.7466 N
Corrections /Comments /Instructions:
►� PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY tv (16 Date: 6' ,/C. I Phone #: (503) 718- hi-1'0