Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00182
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 N 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.
Issued By: 01, Permittee Signature: S l ( on
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 10:17 FAX 360 254 5097 North Sky Communications 014/020
.,, - ,.. ' AP t ( fG( te7 ►/ /c' ° 2 -5D-,
D''.
Electrical Permit Application rte. _ -- -, R t-7 1 FOR OFFICE USE ONLY
11,1 City of Tigard IL--` --- = Received ■ Permit �u� Z
n I3125 SW Hall Blvd., Tigard, OR 97223 Date/B : / 1s t ( 3 _ 1 8
JUN d) 7 Z007 Plan Review
'- Phone: 503.639.4171 Fax: 503.598.1960 D ate /B y: Other Permit:
TIGARD Inspection Line: 503.639.4175 - . > {, 1 - Date Ready/By: ] ® See Pa
Internet www tigard or gov ' ;1 Nohfred/Method. Snpplementat Information
i���,�� � �'. �€ �t��� : x � >� ' �� mss. �' "r+�° � »' :� � ��s �
. ": .. »v ..i� a�+.' i a t _ i 'N , j�a*>. a' - ® kl,! � tix .? .}:' L,'. `^ E ta Ec n,.. s k, h �'-' „ .. '" _,: t, -. e _ n �.v u f+ ,, -4,
no's' it 3 "i �d� �.5-�- . ..
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❑ New construction . A. ddition/alteration/replaceme.nt Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boa
4t x i' � KR.I E �� t `iii •7 "'sa d + f ss ' ie�v a5,1V F tye[ds.
e. , . . a9 ,,, :s. 1"a',,'_ , ,l , . k t tl' lr' s a e i , y wcoeeds IO,OOO amps et (SO volts or • � �a �� ,�_ ;, , , ;i �tk x :, CI Floating buiiditRga.
less o ground. exceeds ons ❑ Commrcial -use agricultural
❑ 1 -and 2- family dwelling ❑ Commercial /industrial El Accessory building amps s for all other er insta►latiotts. buildings.
11. Multi family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
%rA �ik�� ; h L ;l to . �"(,3 3a�x 1 ��, i . � i � a r E
❑ mer enc =Tow largerseparatel de ve
��.`ze � �ar�'x'fif� � x.�.0 � i" '�� o � .:+1.,_ � -tx „ ❑ Addition ofnew motor load of Q " , '• fi „ •< •• -3ri•, d system.
Job no.: Job site address: l ll , ` f ,I ]OOIiP or more. Deco anc
�+,��' / r 0 Six or more �csidcntial units. 0 Recreational vehicle parks.
City /State/ZIP: ` A r , ' S 0 He-care facilities. ❑ Supply voltage for more than
�/ 0 Hazar dous locations 600 volts nominal
SUlte / bld /apt no.: , Project name: � 0 Service or feeder 600 amps
so or rm more �g
Cross street/directions to job site: , � -�`� �t it 5 ., n - � , w . t y F ee . 'lp"'`'xm.ry`' whY
,_. .M A I k�s::.ss:_ iE«,tn R`e;�u :'_w.f 35�ibe l
Description Qtr, Fee, Total *
- 1 9Y New residential single- or multi- fanuly dwelling unit.
J Includes attached garage.
Subdivision: 0 Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: _ Ea. add'l 500 sq. ft, or portion 33.40 1
S ��:'p�+. �( �r "y , „� ,, �,,.. ,c. Limited ener , residential
z.JS.*' k�fi`"7nMP °i� C��y 1 7.. N��4 C''�. g ptt�l b, &�! } 'F `y � 'K" `�."LP 4 4 V T trJ
r 3 is to "S:P it � rV i s fi..,.:� ,' »,: >a � 5 4n t tih fix 1. y .3t 3 4i (with above sq. ft.) 75.00 2
LAM Limited energy, multi - family
Y residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
i a „� 4 200 amps or less 80.30 2
R f F's- M ' 3" Mt, x' �t' �d S kk T ' 1 ' Z: y ' 1 -t 'sR s +x.� ir ``II la9 xt�aat��y� ;f ` _
.k,.n. ,, sl...{d.. 3 .l fn_4:a�rZal.ytEae �, 2 01 amps to400amps 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 i 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 h � e A. Fee for branch circuits with
,� ;a`.. �. !t: ;nt �,,.,�.::tw.... �'pslil «` : s: riles s a 1�,,a'ntu.l1 tS .�4t44'" '•PI 9 ,.alW t�t g le
r " � �� ��+r �� „_,.,,, �_ j�r< )t��,�< � �,,� above service or feeder fee
��/ m ' ''' om °� each branch circuit
Business name: 6.65 2
t) "`^ A�},/�
i� �l � ` � � I ° • B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Q first branch circuit
Address: 1 P , % WO /� �, ;tF'� f' � Each add'l branch circuit 6.65 2
t+ ' 6 �i�li ►ti72, Miscellaneous (service or feeder not included)
City /State/ZIP: t jui. 0 / W i . C. tr S 1 Bach manufactured or modular '
Phone: () "1 Fax: : (9, dwelling, service and/or feeder 90.90 2
r v0 ' J Reconnect irrigation 66.85 2
b. u v a'�5t t� 0 * b Pump or irrigation circle 53.40 2
1); x'r.,;!€ w ��`''" x `15"x- 1e 9 u s �' r 1 ..i ' en 4 cx • x�7' *v xr' fig C y `l i v�1 '^t:'.<
����c� :_ _ t. �..3,_.�,sa.�. eii�3_.t; rt`���},__,_?:� -, `..��';t `' r;:3.'�tsaa`u �a � � 4 �, �"�,� � Ens g g � 53.40 2
xx ,� -, �}� -y ���,� sr� �� _��_ Sign o r outline li h '
Irt `� Signal circuit(s) or limited-
t‘ +V energy panel, alteration, or
Address: extension. Describe: t Paget 16 2
City/ State/ZIP: _ Each additional inspection over allowable in any of the above
Phone: ( ) Fax: ( ) Per inspection 62.50
IMEIMPIEll Investigation per hour (1 hr min) 62.50
Electrical Lie,: Suprv. Lie.: Industrial plant per hour 73.75
_
- . 54 ' R"ft glen, ttF ` i A i ` f ?" - k E
Suprv. Electrician signature, required:
Subtotal:
Print name: Date: Plan review (25% of permit fee):
�► State surcharge (8% of permit fee): (�j la)
Authorized signa - TOTAL PERMIT FEE: %1
Print name: _• i 1, . i 1 (A1/ L C„ V - Date: / / / M This permit appli cation expires if a permit Ins not obtained within 380
days after it has b een accepted as complete.
* Number of inspections allowed per permit.
1 : 18 tuOdieg \Pumita\ELC- PeemitApp.doc 05/23/06 4404613T(Il/05 /COM/WEa
4 2s(40s
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00182
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 61812007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6,120/2007 TIME: 7:04AM PAGE: 9
SITE ADDRESS: 13466 SW HAWKS BEARD ST BLDG N 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 -203 -7521
Inspection Request Scheduled For: Date: 6/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050583-01 503 - 519.7466 N
Corrections /Comments/ Instructions:
%PASS . ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: CT7 t 6 Uri Date: 6 • 20 ' 0 1 Phone #: (503) 718- 2.I44 j