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Permit �l . CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00175 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008 PARCEL: 1 S135CA -01800 SITE ADDRESS: 09714 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: v j ` _ ittee Signature: 79//%4752791/ 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. .AIJN 26 2008 3:52 AM FR TO 5035981960 P.06 a, • RECEIVED Permit A licatio 2 5 2008 r ii O :FIC psi: :ONJ. r Electrical P pp SUN �� . "':': City of Tigard �.�±� OF TIGARD � I/�/ 08 �t� ' S • 13125 SW hall Blvd., Tidrrd. ORC97i�3• Other Permit: a Phone: 503.630.4171 sax: 5( BING DIVISION T t C.G ARD Inspection Zinc: 503.639,4175 Dole Rea4y /By: RI Sec Page 2 for Internet! www.ligari- or.gov Notifed/Mediva: B Supplemental Information ..., f...:'..."' - , ..;.... .. ,. • .:TYPE OF .WORK : .. ,: PLAN REVIEW • � ! Addition/alteration/replacement lacuna nl Please check all tat h apply (submit 3 sett M• plbas writems ducked below): ❑ New construction RI Service or feeder 400 amps or more ❑ Building over theec stories. E] D'L'Inolinon 0 Other: where me availahle fault Current ❑ Marinas and boatyards. : •'. CATEGORY :OF:CONS 'RUCTION,: ':.: •: ..'••` -. cutter 10, 000emps;sl50volts ❑Floutin tear to prouad. or exceeds 14.0 ❑ Conlaren;iauildit -use a 0 I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amp for au otter installations. buildin, . o Multi- famil ❑ Master builder ❑ Other: 0 Fits pomp. ❑ tnstatlatiun of >5 KVA or ©Emargaucy syst= huger separately derived sy:aem- ''• JOB 'SITE INKIRMATION AND • LOCATION Q Addition of new molar mad of C] "A". "6". "1 - 1.3 - 10011P or taro. occur attcy Job no.: Job site address: 9714 SW NORTH DAKOTA ST ❑ Six or more rrridCmial units. ❑ Recreational vehicle parks. City /State/ZIP: TIGARD, OR, 97223 ❑ Health-cam 13cibiic.. ❑ Supply voltage for more den 0 nazanlous locations. 600 Wlls nominal. Suite/bldg /apt. no.: A-C I Project name: THE BISMARCK APTS °Ser r react 600 amps ormore. : rEE SCREDULls Cross street/directions to job site: nomcn I oa I rro I real T- --" New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: I ,000 sq. ft. or less 145.15 4 Ea. udct'I 500 sq. It. or portion 33,40 1 Tax map /parcel no.: • Limited energy, residcniial 75.00 2 r - DESCRIPTION OP WORK ' (wi ha bove sq. P ) INSTALL FIBER OPTICS FOR VERIZON ui r e si d en er gwias multi-family .) 75'oo 2 Services or feeders installation. alteration. and/or relocation 200 amps or less 80.30 2 . ❑ PROPERTY.'OWNER :.: '1 e•. • • • I]' VIVANT • 201 amps 10 400 amps 106,85 2 401 amps to 600 amps 160.60 _ 2 Name: ' 601 amps; to 1,000 amps • 240.60 2 Address: 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 1 Owner installation: This installation is being made on property that I own which is not 201 mops to 400 amps 100.30 2 intended for sate, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2 (knurl circuits - new, alteration or extension, per panel Owner signature: _„Date: ' A. Fee for branch circuits will, ❑ APPLICANT : . : '"` ' . ....CONTACT PERSON above service or feeder fix, 6.65 2 • each branch circuit .. Bttsinessna NORTH SKY COMMUNICATIONS, INC. B.Feeforbranchcircuits R YAN ROBERTS without service or feeder fee, 46 85 2 Contact name: first brunch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'i branch circuit 6.65 _ 2 Miscellaneous (service or feeder not included) City/Stale/ZIP: VANCOUVER. WA 98684 Each manufactured or modular 90.90 , ewe Phone: (503) 519 -5264 Fax:: ( )1- 866 - 905 - 4907 nee c service and/or feeder only 66.85 2 E-mail; mduoranorthskvCOmm.COm Pump or irrigation circle 53.40 , 2 ••' ''' ' : ' CONTRACTOR . '. - . • . Sign or outline lighting 53.40 2 Signal circuit(s) or limited- Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration. or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2 City /State/ZIP: VANCOUVER, WA 98684 Each additional ins. don over allowable in any of the above Per inspection Phones (360) 254 -6920 Fax: ( ) 1- 866- 530 -4325 Investigation per hour ( t Ir nun) 62..50 CCB Lie.; 14117 Electrical Lic.17 -1 54CL Suprv. Lie.: 173LEB Industrial plant pet hour 73,75 _ . . • ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 575.00 Print name: JACK CAGLE 1)111e: 6-25-08 review (25% of permit fec): 6 -25 -0$ State surcharge (12% of permit fee): _ $9,00 Authorized signature: . s' / TOTAL PERMIT PEG: $84.00 i.:74174 - Tbts p ermit application expire: if a permit is not obtained within RIO Print name: ETHON A. DOLPH Date: 6 -25 -08 days alter it has been accepted as complete. * Number or ins-peelings allowed per permit. to8uimineeknitart,rwern itMpdoc O..savx, 441.4615T11 1N.VCOArwiin . CIT Y OF TIGARD BUILDING DIVISION PERMIT #: ELR2008 -00175 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/26/2008 Phone: (503) 639-4171 �"1 ��i� Inspection Requests (24 Hrs.): (503) 639 -4175 =�� _.. INSPECTION WORKSHEET FOR DATE: 7/2/2008 TIME: 7:01AM PAGE: 37 SITE ADDRESS: 09714 SW NORTH DAKOTA ST A CLASS OF WORK: SUBDIVISION: BISMARCK COURT APARTMENTS LOT #: 008 TYPE OF USE: PROJECT NAME: BISMARCK COURT APARTMENTS DESCRIPTION: Units: A,B,C. Installing fiber optics for Verizon. OWNER: JAUCH, 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 -02 503 - 2037014 N Corrections /Comments /Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /1-94-644 Date: ' - d Phone #: (503) 718-