Permit Ey! CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00178
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 J 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
Reg #: ELE 17- 154CLE
FEES 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.
Air
Issued By: ", / " I Permittee Signature: J„ Q� //pp) i <k+
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 10:15 FAX 360 254 5097 North Sky Communications 00 10/020
. • .. $ F l .ubt/TG9' - Q(I -1 t:. • 'O'2-
Electrical Permit Application- - n FOR OFFICE USE ONLY
City of Tigard uc 'v +fi Receives
Date /By• Permit No.:
IN ..- n 13125 SW Hall Blvd., Tigard, OR 97223 � ! U " ' � I V E Z - [�77i
t Phone: 503.639.4171 Fax: 503.598.1960JN OP 7 200 Plan Rev Other Permit:
Date/By:
TIGARD Inspection Line 503 639 4175 r' Date Read
z � ® yBY Supplemental S [
Notified/Method: � See Page 2 for
Internet: www tigard or gov
RB 0 ` l ,""t f Pl 6-- Information
Ri d„ r 21 r. ,d'sz WI 'r, �i Y�l'a iiZ: "+t�: ' t. :. r t :-; � -..},: 1 1 d.?i45.rr' Sy 65.', a,..0 }. ;, . , z. ,i � �ie, .Z§ u , 1 7 . '
,.. acv4Sa...; ;:',.it. � .4:&':. e } V s i, f «4rFfw .. ° ';';:‘, , fir . • c ?,}. - x %��.. X n f . c iG :
i;... e ., ' $ V a•`, ,110 . , '" 0 2+., p t ^ , � 2 .. .., g xs wZ 3, . i , & . ? . .
tire < �ua�.x,.'.�+...c. . r-. �� � : .._ 3r �` � ,'�.a�'�:�,.��3r.::"���; ,rt �r.�x.�.ru;�' a3p.su{K1 '',.r �����ax�:.�!�:��: ?� " + t' �,. r ui.' .'.��1i�:A'�a�zf�arC�.�? �:w i
❑ New construction ►� • ddition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below);
0 Service or feeder 400 amps or more Q Building over three stories.
❑ Demolition 0 Other:
5?;
z 3T x xz - ti,R + r x where the available fault current
0 Marinas and boatyards.
3 M = "a fg f''*S R i g a + �� 'fi i3 t Risg4 ,t{t � t� .5 N ` i'� ° '' :� exceeds 10,000 amps at 150 volts or El Floating buildings.
- " °} less to round, or exceeds t 4,000
1: g 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building g O Cold al-use agricultural
amps for all other installations. buildings.
il. Multi ❑ Master builder _ ❑ Other 0 Fire pump.
❑ Installation of KVA or
1 ,t 1 ,; o, t ,Z` � : ltu w jF { 3 X '- l; 0 Emergency m. arger parate eved system.
.._„ v,. ,_. tt <n:,�s�._..1 �+ �r�2e^ �rR��. -��_� �.�.:t"�f��� ❑Addition of syste new motor load of D l .. A ,. �.
Job no.: 9A 4f/ Job site address: 9 2 / v . r j n toOHP or more. occupancy.
-/ ❑ Six or more residential units. ❑Recreational vehicle parks.
City /State /ZIP: T i O S 1 I I I I 111 I I I I I I I I I 0 Health -care facilities. 0 Supply voltage for more than
0 Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: . Project name:C - r ,//, , Ai �/ 0 Service or feeder 600 amps or more
Cross street/directions to job site: A / vv �C v :` e"tC 5 j i�: et �4. " aW it c. f ia . .l :a' a�i 7
Description Qty. Pee. Tete]
,,�' New residential s ingle - or multi family dwelling unit.
rl! J► Includes attache garage.
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
Limited energy, residential
RN e .F 4 n !RG IORR vha � , U f y E h M, !tcc , 1 :k (with above sq. ft) 75.00 2
Limited energy, multi-family r�` & i.e ee V ^ 1 , ft 75.00 2
� residential (wi abo sq. R)
Services or feeders Installation, alteration, and/or relocation
4` a d Y m4ecv;'i2ti ry x i I e $ €te tW 200 amps or less 80.30 2
l �: r rs 1 t,� k . t 141 1:711 `.A z .s11L- .i ;`, 'rrh4 .,: to t 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
I 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 A. Fee for branch circuits with
Fig' : �€x ' ,t' r t`� i �, °` �t''� INOP t�,.hv V! A efr ..; it .0 . ` t y t ' y �, ■ .' a.. . r . t 1.1- x . e sa ; ; � 3 � _r , .ti 1 ,� C ∎.9 , " t .1i .:. ,2 r i ,' above service or feede fee
Business name: j
' each branch circuit 6.65 2
#j.� : ' i+ B. Fee for branch circuits '
Contact name: y, 1 /�- without service or feeder fee,
l first branch circuit 46.85 2
Address: ( d , .. lv ti i t i t 'T Each add'] branch circuit - 6.65 2
I _ Miscellaneous (service or feeder not included)
: 11 ��
City / State/ZIP: i . a. V
� Each manufactured or modular
dwelling, service and /or feeder
Phone: 90.90 2
(6 ) - i Fax: (� . 01 W i ` 1
EMEFF �����I�������� Reconnect only 66.85 2
N Li� tl�1l(I� 0 Ai C-b YYl Pump or irrigation circle 53.40
o-r,�t `� 5 s257. L'trj ^ i x x r��i u3M �j �'iV1y t.f �t ,a iA : � t2 sw 5 '�iPt } ;X7";{'S' t.� r 2
>�,e,..,� ��.._.�.;:p��.�.r.bs'��- ._�..a k�:lrY�•E`,�.,> sa�i_� �r :fv�.i�7�3t;� Sign or outline lighting ss 53.40
2
Business name: �� i rV� Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Paget 16 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.: 44, Electrical Lic.: Suprv. Lie.: Industrial plant per hour 73.75 Si�
J " 1'• 1 41 0 ,. ` v" $i �' 1 0 Sul T xvt � :
Suprv. Electrician signature, s ice., ,., .. �, _:.t >�?�! 5 11 a u ,�
p required: -
Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): 16r
Authorized signal ,` TOTAL PERMIT FEE: • ` -
Print name: ....r. ( , , 1 (/ t,'D - Date: / / / All This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete.
l:taulldiagtPermltslEr GYerntitApp.dec 05/23!06 * Number of inspections allowed per permit.
440- 4615>r(J J /05 /COM/WEB
X 255 ✓
______ ________-_ ' _- - __ ' ___-___-_-____ ___ -_ --___ _ ~ _-- _ ____ _____
CITY OF ��mn m v�`u mm����ma��
' BUILDING DIVISION 4 ,1-J7-'~�~~-� '- -
PERMIT #: ELR2007-00178
i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A- 1.1—
INSPECTION WORKSHEET FOR DATE: 5/18C007 TIME: 7:04AM PAGE: 1
�
SITE ADDRESS: 13456 S�/ HAVVK'��BEAF�QST0LD<� ` 00 0 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 CREEKLLC. PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503-289-7621
Inspection Request Scheduled For: Date: 6/18/3007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 (9
9 Low �[�X ( 050410'01 503.519q466 Y / ' ��'� '~~�/
Corrections/Comments/Instructions:
.
I PARTIAL APPROVAL ri CANCEL ri NO ACCESS
-0 FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
� �
Inspector: .
�
� / ' � _� |�_ _y
^~��~L[W� Date: / �� Phone #: (503) 718-
■ ^