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Permit e `, C ITY OF T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT • ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00173 T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008 PARCEL: 1 S135CA -01800 SITE ADDRESS: 09704 SW NORTH DAKOTA ST A ZONING: R -12 SUBDIVISION: BISMARCK COURT APARTMENTS LOT: 008 JURISDICTION: TIG PROJECT: BISMARCK COURT APARTMENTS Project Description: Units: A,B,C. Installing 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: ROGER & BRENT JAUCH NORTH SKY COMMUNICATIONS INC 10648 SW 41ST AVENUE 11818 SE MILL PLAIN BLVD PORTLAND, OR 97219 SUITE 410 VANCOUVER, WA 98687 Phone: Contact #: PRI 360 - 254 -6920 FAX 1- 866 -530 -4325 FEES Reg #: ELE 17- 154CLE LIC 14117 Description Date Amount [ELPRMT] ELR Permit 6/26/2008 $75.00 [TAX] 12% State Surch 6/26/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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: ��C, ��f� /C-:;.1/ . 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. a JbN 26 2008 3:52 AM FR TO 5035981960 P.04 f RECEIVED . Electrical Permit Application ;: . FOR'OF'ICEUSEO.NLY .'... . : City of Tigard JUN 2 5 Z008 B Received /'o Ar 12211 3 n (3125 SW Hall blvd„ Tigard. OR 97223 Plan Role Phone: 503.639.4171 Fax: so3.5 1� OF TIGARD nate/D ; Odic, PCntlit: T t C n.o Inspection Lino: 503.639.4175 1e ttcacl /py Sec Page z for interact: www- ueard- or.gov BUILDING DIVISION NolirtadsMahod: IIM Supplemental lam .. `.:TYPE `.OF .WORK ' . • i! i.. - • '.:: •• ....PLAN REVIEW' '.:. '. r • ..:'..-;' .:: . • [] New construction Ell Addition/alteration/replacement chcck un lieu apply (submit 2 sou of main w /items checked below): Q Service or feeder 400 snips or ram 0 building ovOr Once storks. ❑ Demolition ❑ Other: where the imitable fault current CJ Marinas and boatyards- , :.•:':.:.::..:':.,'.',..;:-:.!...;:.:•,':::':', :.. •. ;•CATEGORY `UF `.CONSTRUt;T[ON , " .::•:•:.::.:.:...'....,,..,...,... ceeeeds 10,000 a,hps s ISO volts or Q Ilealinp bi,,Wing : ass to v or cxec�ds 14 ,0°0 ❑ Cumemrci:d -use a ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building anpsforell oterillsleliations - buildings, r4 Multi - family ❑ Master builder ❑ Other: 0rare pump, ❑ lnpallatiun of 75 KVA or C] eutergeney 6yrteol. lard r separately derived system- JOB SCEE INFORMATION AND LOCATION Q Addition of new motor toad or ❑ "A ", "E " I •11", "r A. 9 704 S W NORTH DAKOTA ST t0°Hp r ` orr' neereuu;y. Job no.: 'Job site adclness: ❑ R ecreatio nal vehicle ruts. ❑ Six ur m r whit+ � City/Stare2IP: TIGARD, OR, 97223 ❑ Health -care faeiIitleft. ❑ Supply voyage for Mtn than ❑ Haza,dous locations. 500 volts nominal. Suite/bldg./apt-no.: A -C I Project name: THE BISMARCK APTS o Servinro ar fecdcr GOO amps or mo.c. . . FEE SCIIIEIDL)[,E • Cross street /directions to job site: ntrertprem, I OM. I Fee. I Toed 1 • •-- '---- New residential single- or multi- family dwelling unit. Includes attached garage. _ Subdivision: Lot no.: 1.000 sq. ft. or less 1 4515 4 - ' 1:a. odd'I 500sry• ft. Oe portion 33.40 1 Tax map/parcel n0 -: Limited energy. residential DESCRIPTION OF WORK • (with above 01. ft.) 75,00 Limited energy, multi- fiuni(y 7500 INSTALL FIBER OPTICS FOR VERIZON residential (wills nhovo sq. It.) Services or feeders installation alteration, and/or relocatio 200 amps or less I 80.30 2 . . ' ❑ PROPERTY:OWNER • . .. • 'El TENANT ' 201 amps to 400 amps 106 -85 2 • Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or votes 454,65 2 City/Suite/ZIP: /StstteIZlP: Temporary services or feeders installation. alteration, and/or Y relocation Phone: ( ) I Fox: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made out property that I own which is not 201 amps to 404 amps 100.30 2 intended for sale. !case. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 an s w 599 amps 133.75 2 Branch circuits - new, alteration, or extension, r panel Owner signature: ,,,Date: A. Fee for branch circuits with © APPLICANT :; `.. a CONTA PER SON ' . ' above service or feeder fee, 6.65 12 each brunch circuit Businesssname; NORTH SKY COMMUNICATIONS, INC. B. Fee for branch eireuits Contact name: without service or feeder fee. 4G 115 2 R YAN ROBERTS first btutuh circuit Address: 11818 SE MILL PLAIN BLVD STE, 410 Eachadd'I branchcircuit 6.65 2 Miscellaneous (service or feeder not included City/State/ZIP: VANCOUVER, WA 98684 butch manufactured or modular 90.90 3 . dwelling, service and/or feeder Phone: (503) 519 -5264 ( Fax:: ( )1- 866 - 905 -4907 Reconnect only 66.85 2 E -mail: mduor )northskycomm -cam Pump or irrigation circle 53.40 2 ` ... • • ' CONTRACTOR Sight or outline lighting 53.40 2 Signal cireuids) or limited- Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2 City/State/ZIP: VANCOUVER, WA 98684 Each additional i • tion over allowable in any of the above Per inspection 6250 Fhone: (360) 254 -6920 Fax: ( ) 1- 866 - 530 -4325 ' investigation per hour (i hr min) 62,50 17 -154CL Q CCs Lie.: 14117 Electrical Lic. Su rv. Lic.: 173LEB Industrial plant per hour 73.75 ,. • • ELECTRICAL PERMIT FR.FS Suprv. Electrician signature, required: Subtotal; $75.00 Print Warne: JACK CAGLE Date: Plan review (25°.h of permit fee): 6'25 -08 Sta surcharge (12Rb of permit fee); $ 9.00 Authorized signature: / TOTAL PERMIT FEE: $84.00 t � t � c" Thb permit application expires if a permit is not °Wined within ISO Print name: ETHQN A. DOLPH Date: 6 -25-08 days ancrIt ban been accepted ascomplete, I. Number of inspections Allowed per penuit- I;Wvipttngttenug:rF.1.0 -rim, pp.dac Os/ a 6 •1.1tNOI IT( 1 uaS/COM/WG8 CITY OF TIGARD } BUILDING DIVISION PERMIT #: ELR2008 -00173 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/26/2008 Phone: (503) 639 -4171 v-m i 1 l + � Inspection Requests (24 Hrs.): (503) 639 -4175 ` :_.. INSPECTION WORKSHEET FOR DATE: 7/2/2008 TIME: 7:01AM PAGE: 35 SITE ADDRESS: 09704 SW NORTH DAKOTA ST A CLASS OF WORK: SUBDIVISION: BISMARCK COURT APARTMENTS LOT #: 000 TYPE OF USE: PROJECT NAME: BISMARCK COURT APARTMENTS DESCRIPTION: Units: A,B,C. Installing fiber optics for Verizon. OWNER: JAIJCH, ROGER & BRENT PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360- 254 -6920 Inspection Request Scheduled For: Date: 7/2/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 072124 -04 503 - 209 -7014 N • Corrections /Comments /Instructions: • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4/14'14 Date: 7- 2 - Phone #: (503) 718-