Permit • IN 4 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00294
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/15/2008
PARCEL: 1 S135CA - 01701
SITE ADDRESS: 09800 SW NORTH DAKOTA ST ZONING: R - 12
SUBDIVISION: GREENBURG HEIGHTS LOT: 008 JURISDICTION: TIG
PROJECT: DAKOTA KNOLL APARTMENTS
Project Description: Units: A1 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:
DAVIS, PETER S & KAREN M BOROSKE NORTH SKY COMMUNICATIONS INC
14570 SW HART RD #257 11818 SE MILL PLAIN BLVD
BEAVERTON, OR 97007 SUITE 410
VANCOUVER, WA 98687
Phone: Contact #: PRI 360- 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- I54CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 10/15/200E $75.00
[TAX] 12% State Surch 10/15/200E $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: AJJ/res.2cGY'v
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. .
. . Electrical Permit r1 �1 QEI VE - -` �� - �:' -
t FOR QF,FICE i)SE ONLY u .� ; : •
City f Tigard
r; r` i 14 2008 Received Permit � o RY
TIGAR
paalB .
't 13175 S W Hall 131vd.. Tigard, OR 97221 Phan ucv: v
Insp c t S ion O. b39 503.6.
" b1 �i o1� 1' I �D part Illy: Other Permit:
l? . Inspccl I.inc: r 1 part Ready/0y: Mil:: BJ Sec Page 2 for Internet: wwlv.lignrd -or. S DIUISIQN Notifcdlh4<thnd: �
- -_� & Supplemental Information
• TYPE OF WORK PLAN REVIEW
0 New construction 0I Addition/alteration/replacement Plow check all Mat apply ($alunit 2 sots or plaits wlitcah checked below):
❑ Set vice or Iceder 400 amps 01 latirs ❑ Building over duce sterios.
3enictlili(Nt —_ - -- ❑ Other: where the available lruh current ❑ Mecinas and h , ag ;uds.
• CATEGORY OF CONSTRUCTION exceeds I(t•oUO amps at 150 rolls 01' ❑ Homing builliugs.
1555Iground. orexceeds14.0(10 0Couuncrci:l - use apticulnlyd
1 - and 2 - fatni ly dwelling ❑ Commercial/industrial ❑ Accessory building 1 ramps for all other insialhltions. buildings.
Q Nlultt- fond I
ly ❑ Master builder ❑ Other: ()Fire pump. ❑ Installation of 75 KVA nu
JOB SITE INFORMATION AND LOCATION ❑ Emergency spent larger scparuciy :krivcd system.
-- .. —_ -- ❑ Addition of new !tumor load of ❑ •,,�,. ,.(,., •' I.2" .. I t"
Job no.: Job site ad ,n
<h'css: 9800 SW NORTH DAKOTA ST. 100HPorure. occupancy.
— ._ • —• - -- ❑ Six ur more rex:demi:11 units. ❑ Rccte.tionnl %chicle pinks.
City/Slate /ZIP: TIGARD, OR 97223 ❑ Hen,u,.ca,ofacilities. 0 Supply ,•„haso for mom Mao
❑ Nazau!ous lootions. (500 volts nominal.
Suite /bldg. /apt. no.: A 1 - Project "'Ile: DAKOTA KNOLLS ❑ Service or feeder 600 limps ormore.
FEE SCHEDULE
Cross street/directions to job silt: DewsItnn Qt T I'er. I Twat I -
_—. New residential single- or multi - Tinnily dwelling unit.
— — _ — .-- ___- - -_ - - - -_ — Includes attached garage.
________ --_-..__....._—
Subdivision: I Lot no.: 1.000 sq. or less 145.15 4
— Ea. ;KIWI 500 sq. I't. or portion 33.40 — — I
Tax map/parcel nn,; — _ l Limited cncrgy, residential - -- — •_..._._._.
DESCRIPTION OF WORK (with alwve RI. fl) 75.00 2
INSTALL FIBER OPTICS FOR VERIZON '" ), ttitcclCncl 'gy,Intllti- I ;In,it)' 75.00 I 2 '
residential (with ahn,e ul. IL)
— — Services or feeders installation, alteration, and /or reloc:ttioo
200 amps or less _8_0.30 2 1
❑ PROPERTY OWNER ❑ Tf NAN'P 201 amps to 400 amps - -- 106.85 2
Name: -- - - -` — -- - —_. ___- 40t stops w000;imps 160.60 2
601 amps to 1,000 ;cups 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /Slate /ZIP: - -- Temporary services or feeders installation, alteration, and /or•
_____ relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 lI ,
Owner installation: 'Chit; installation is being made on properly that I own which is not 201 amps to 400 amps 100.3(1 I 1,
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75
r Branch circuits- new, alteration, or ex ion, per panel
Owner s, 0nnturc: ......... ......_ - _
- A Fee for branch circuits 'via/
❑ APPLICANT ❑+ CONTACT PERSON above sei vies or feeder rec., 6.65
each branch circuit j
Business name: NORTH SKY COMMUNICATIONS, INC. 13. Fee for branch circuits
RYAN ROBERTS
without service or feeder fcc, 46.85 2
Contact name:
- -_ -- -- lir >I bt:,cb circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Eitehadd'' branch circuit 1 6,(5 _..—
_____ .. -' .. -- - --- Miscellaneous (service or feeder not included)
City /Stale/LIP: VANCOUVER, WA 98684 Each manufactured or nodular
Phone: (503 ) 519 -5264 raX:: ( _ > 1- 866 - 905 -4907 clvelltne. service anal /or feeder
90.90 1_.. —
Reconnect 66.85 I 2
it,ail: mduor(c�northskvcomm,com Ptumir1 01 irrigation circle 53.40I 2
CONTRACTOR Sign oroullinc lighting I 53.40 I 2
Business name: NORTH SKY COMMUNICATIONS, INC. Signal circuit(s) ale rail„itcd- i —
, - -- -- -- _...._. __ -- energy P anel , alteration, or I
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00L2
2
City /State /ZIP: VANCOUVER WA 98684 _ Each additional instadon over allowable in any of the shove
1 Per inspection - - -- 62.50
Phone: (360) 254 -6920 Fax: ( ) 1-866-530-4325 " °'
--� Investigation per hour (1 tai min) 6 2.50
CCD Lie.: 14117 Electrical Lic.17 -154CL Sultry. Lie.: 173LEB Iuidutnial plant per hour — 73.75
--' — - ELECTRICAL PERMIT FEES —
Suprv. Electrician signature, required: Subtotal:
- - -- —_ $75.Q0.
Plan review (25% or permit fee):
Print twine: JACK CAGLE Dade: 10 -14 -08
State surcharge (12% of permit fee): $9.00
Authorized signmure: ale_ TOTAL Ptitt Nll•1' 17iti: $84.00
Print "a "'< : ETHON A. DOLPH Date: 10-14-08 — This permil application expires if a permit is not oblaincd „itbin 180
day., after it has been accepted as complete.
— ' Number of inspections allowed per pencil.
1s 001 1. t ;na\re,mi:W:1- e•t \rnG,App.,lne of /2:/06 4-II)-16 l 5i'( t uudrrosMMY:n
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI_R200$00294
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/15/2008
Phone: (503) 639 -4171 I l I �
Inspection Requests (24 Hrs.): (503) 639 -4175 �. P _
INSPECTION WORKSHEET FOR DATE: 10/21/2008 TIME: 7 :00AM PAGE: 16
SITE ADDRESS: 09800 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: GREENBURG HEIGHTS LOT #: 008 TYPE OF USE:
PROJECT NAME: DAKOTA KNOLL APARTMENTS
DESCRIPTION: Units: A1-4. Installing fiber optics for Verizon.
OWNER: DAVIS, PETER S & KAREN M BOROSKE, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360
Inspection Request Scheduled For: Date 10/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message 1Giv
199 Electrical final 076978.05 971.563 -9326 Y I
Corrections /Comments /Instructions:
C r'
Xli PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date(06 Phone #: (503) 718 -