Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111 11 ° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00172
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 C 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 By: "// Permittee Signature: i4 /2l /' pcAdi O
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 10:12 FAX 360 254 5097 North Sky Communications 0004 /020
ra YILubxr :I le7 Ca 0°2 -5t
Electrical Permit Application P.r, P FOR OFFICE USE ONLY
lr ice®
City Of Tigard Received J/
q Date/By. !D Permit No.: L L.A2.00�- - Oa I'• 2
13125 SW Hall Blvd., Tigard, OR 97223 U N l 7 20 07 Plan Revi
Phone: 503.639.4171 Fax: 503.598.196 Date/By: Other Permit:
TZGARD Inspection Line: 503 639 4175 ,
Date Read B
run'
Internet: www tt and or o v I0 6 r a D y o 67 See Page 2 Information
g g RI III VllhI`, DIVISION Notified/Method: f ` Supplemental nforroation
,,,-.4.;',6, • 3`I . c -- � „ F .." ? . $ t ' h u � C�-c ¢ S _ "t i S ' 1
r .Y',n t N a ;;'r• '' .'`S i u Y h* ate' `. R l ".�? 4 :,:.. ,r• �?-,' �.: _
r . r` 7 : .. F.,c $z .a , .: t £ `ark. k. } R . , . a h :'7S- va 7.7 .i. ?.
n -ii I . •f � 0� , tt ' . G. ' �, i MK r _ :a fi x , t i . 1 1 r x . t E . i t s '.'.� _ , w m) . ,:.
9 ., s 5. � _...,.:!��u< k,vss„u� "��6t�w:�C%u h�'•�,_� �iJ_' , ?:e5� °.i ..s � ,P:S.�i�{.';.s�� �i',_ .�..v � n I }�f��41u J' , �'uY �n z��`S`�{�y ,, y x S ,
� k ew construction ti - �'� s l w /it checked 3 ow):
❑ New • ddition / alteration /replacement Please check all that apply (submit 2 acts of plans wlitems checked heJow):
❑Service or feeder 400 amps or more D Building over three stories.
❑ Demolition ❑ Other:
�c� � a :ex � , �a�°q >y� o z �x�� �r s } ,� where the available faun current ❑ Marinas and boatyards.
`�',. `' 93z a ca 31 0 0 l l 9 a60 "6t�7g i '
�'t uk °" r a V1' exceeds 10,000 amps at l50 volts or
a �'��? �.^�r= �i����� F�,<;"-. ��! ��,.. "d.�t�'�fa"�,x;'��� P ❑ Floatiogbuildings.
ry buildin am less so ground,
of er exceeds ons. Commercial-use agricultural
❑ i - and 2- family dwelling ❑ Commercial /industrial ❑ Accesso
� building amps for all other installations. buildings.
t1. Multi family ❑ Master builder ❑ Other: ❑ Fire pump.
[] Installation of 75 KVA or
i� f t Ed f � t S av d of iH,� t3 ': OE � ` Tt tt tea taniA x ` 4 ` � e g ❑ timer enc s stem,
a'�.� a � � � > � g Y Y arger separate d erived system,
Job no.:
9A �r.3� " DAdditionofnewmotorloadof D l< A < E „< i_2 „ 13"
Jo site a ddre ss:' ) IoOHP or mote. deco anc ,
?A � jp,i ' .I � %' i P Y
S ix or moro residential units 0 vehicle parks
City/State/ZIP: - A / VI r , ti 1 I: health -care facilities. ❑ Supply voltage for more than
C rA^ D Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Vl.t/V V "► p' � £ , ❑ Service or feeder 600 amps or morn
Cross street/directions to job site; '' < =" • .n.� r. ar �- ,c ,, �, r IN
Description Qty. Fee. Total
>~ New residential single- or multi- family dwelling unit.
� " Includes attached garage.
Subdivision: . / Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. R. or portion 33.40 1
m 4r �a� , Limited energy, residential
t s e ¢i cl¢ p , ]w to m il ,' s n 3 '� r �,ft''' �} , w 5 wvr - a i ! 75.00 2
� ��� . r �'£���.i,, �`<�;. 3�;;� Y,�a r..i ��'�,..� I��`.,,�:��`' x,* � �� t s r �+� � rl) (with above sq. it.) _
♦ ► Limited energy, multi - family 75.00 2
'�+ " J residential (with above sq, ft.)
Services or feeders installation, alteration, and /or relocation
tt ,f� ��r �°� a c i 200 amps or less r 80.30 2
t„ f ¢u si:� E � 2 , .�s B ; ;la j ; .a -'s�i �' F��, 1`,z 201 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 I 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
� t st r � p �� w m A. Fee for branch circuits with
r �. 'k .a, xk-c ..1; `. awn.v ' .. ,'� t"? �' r as r `I par t t a. t' I i t ' ( ti ilPf , above service or feeder fee, 6.65 2
Business name: (J �/ each branch circuit
y `' f ` W B. Fee for branch circuits
Contact name: . r � without service or feeder fee, 46.85 2
! first branch circuit
�' g 1
Address: ( Y k‘ti i /j ., In Bach add'I branch circuit 6.65 2
City/ State/ZIP: ' ( t _ Q i Miscellaneous (service or feeder not included)
�� a C .t J ( , (} Each manufactured or modular
Phone: ( 6 f 9) • , ii , Fax: : (pl _ � 1 i1n .., /yl _ dwelling, service and/or feeder 90.90 2
����r D�? �T J :� I Reconnect only 66.85 2
i I�IIGIM� 0 at Ci b rn Pump or irrigation circle 53.40 2
In' . f t wT< i M �,Y`r'i; s t i� ,Y„{ tj t'r D te^ PY�x �E {� ' a^ s z Sign or outline �� ..� .....,�.. z.t�. �.j ,t,� Ytl,�1,� • .,��"�tkl: ;. �` ��+ �� :��„�:�., ;?����i.'�`��:ti�;��:' lighting , 53.40 2
Business name: ' ` C , L +v i Signal circuits) or limited -
S) energy panel, alteration, or
Address: extension. Describe: I 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
EMMIEMIII Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
tNEMIS a7Er!.r4 ^ANA 1 '� 9�"�tk�Tm"`.�, -.. < k"a.7
Suprv. Electrician signature, required: _ - ?�� < «.
Subtotal:
Print name: Date: Plan review (25% of permit fee):
_► State surcharge (8% of permit fee): (s 6 " )
Authorized sign al
IMIEMEINIMMEINIIMil `_� TOTAL PERMIT FEE: • C/ �
Date: / / / /�■ This permit expes a if permit not oe
• days application after it has ir been accepted is as combtainpleted within 180 .
' Number of inspections allowed per permit.
r:\ Buddiag \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /OS /COM/wEa
ke 2553 V
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00172
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 61W2007
Phone: (503) 639 -4171 "01111
1 1 1
Inspection Requests (24 Hrs.): (503) 639 -4175 J 4 __
INSPECTION WORKSHEET FOR DATE: 6/26/2007 TIME: 7:00AM PAGE: 2
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG C 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
199 Electrical final 050958 -02 503- 519 -7466 N
Corrections /Comments/ Instructions:
•
•
( PASS El PARTIAL APPROVAL n CANCEL f NO ACCESS
❑ AIL El CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
Inspector: v Nv`�
Date: b Phone #: (503) 718-