Permit •
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00174
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008
PARCEL: 1 S135CA -01800
SITE ADDRESS: 09710 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 $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / Permittee Signature:
Se
• OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
•
• JUN 26 2008 3:52 AM FR TO 5035981960 P.05
RECEIVED
Electrical Permit Application JUN 2 5 200 R, .,,e ,.
City of Tigard Dow; , oi708 ":71111:1 7r
' 13125 SW Hall Blvd., Tigard, OR 97223 a Review
Phone: 503.639.4171 Fax; 503.598.1960CITY OF TIGAR Iuat or8 : °fux permit:
TIGARI) Inspection Line: 503.639,4175 BUILDING DIVIS 1. 3 . :'eRcadyIey ® see �e2for
inicmet: www.tigard- or.gov N iincd1Mahod: fM Supplemental tnforraation
::TYPE - ..OF WORK . . `' : •:;•; • ••' RE VIEW.
[] . � • .. n construction 01 Addition /alteration /re lacement Please cheek all that apply (submit 2 sets or plans w /items checked bcknv);
New wnstnlction P [7 service or (ceder 400 amps or more O Building over three storic5.
❑ Demolition [] Other: where the available 19th current ❑ Marinas and boatyards.
.. : , ... . exceeds i0,000 11111p$ at I50 wltx or flouting buittin,,t
CA7'ECORY •OF:CONS'xRUCfiON. : . '.::': ;:: �`.. :'.`: -:: .`; less ro wound, or exceeds la.Ono ❑ Coot nxrciat.useagrictrhur:tl •
❑ 1- and 2- family dwelling [] Commercialrndustrial ❑ Accessory building amps for all other ittstellri ions. buildings.
o Multifamily ❑ Master builder ❑ Other: 0 Cie mini). ❑ leeialLttiun of 75 KVA or
❑ Entergencysystem. target separately derived system.
: . : JOB SITF. INFORMATION AND • LOCATION . •::..:-.',:::::-.•:-...'..• ❑ Addition of new motor lnxt of ❑ 'A", S - 1.1", 1.3'
S ix rp er more, occupancy.
❑
Job no.; 1 Job site address: 9710 SW NORTH DAKOTA ST neuuariunal vehicle
Q or
more residcntial uni
Cic /State/ZIP: TIGARD, OR 97223 ❑ ltealIh.eare ftcililies, Cl Supply voltage for more lien
Y r ° ❑ Hazardous locations. 600 votes nomiital.
Suite/bldg ./apt- no.: A-C I Project name: THE BISMARCK APTS °Service or feeder 600 amps or more.
r .. : FEE:SCHEDULE
Cross street/directions to job site: ' nnc urn 19w• I Per. I . oust ,,L:
New residential single. or nudti- family dwelling unit.
Includes attached garage.
-
Subdivision: Lot no.: 1.000 sq. ft. or less 145.15 4
Ea. Mal 500 eq. ft. or portion 33.40 I
Tax ntap/parcol no.; _ Limited energy, residential 7500 2.
DESCRIPTION OP WORK • (with above w. n•) ,
Limited energy, multi famil 75.00 2
INSTALL FIBER OPTICS FOR VERIZON residentwswith above FA. n.)
Services or feeders installation. alteration, and/or relocatio
200 amps or less 80.30 2
. 0 PROPER'rY.'OWNER 0 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 volts 454.65 2
City/State/ZIP: Temp ry services or feeders installation, alteration, and /or
Phone: ( ) I Fax: ( ) 200 am or less 65.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.:10 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 alms to 599 amps 133.7 2
Branch circuits - new, alteration, ur extension, per panel
Owner signature; - ,Date. A. Fee for branch circuits tvidr
' ' ❑ APPLICANT : ' • • • ' " El "CONTACT PERSON above service or feeder fee. .
6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee For branch chcuits
without service Contact name: RYAN ROBERTS - first branch circuit 46.85 fee, 46 8S 2
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 9090 2
- Phone: (503) 519 -5264 I Fax: : ( )1 866- 905 -4907 Reconnect only e and/or feeder 66.85 2
E - mail: mduorenorthskvcamrrl.cOm Pump or irrigation ei rek 53.40 _ 2 • • ' ' CONTRACTOR ' . • Sign or outline lighting 53.40 2 •
t3usiness name: NORTH SKY COMMUNICATIONS, INC. Signal circuit(s) or (imiletl-
energy panel, alteration, Or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Pagc2 $75.00 2
City /State/ZIP: VANCOUVER, WA 98684 Each additional ins' - etion over allowable in any of the above
Pax inspection 6250 I'll
Phone: ( 360) 254 -6920 I Fax: ( ) 1-866-5304325 Investigation per hour (i hr min) II 62.50
Ccr3 Liu.: 14117 Electrical Lic,17 -154CL Suprv. Lic,: 173LEB Industrial Plant par hour 1111111 .
•• • • ELECTRICAL PERMIT PEES
Suprv. Electrician signature, required: Subto 75.00
Plan review (2556 of permit roc):
Print name: JACK CAGLE Date: 6 -25 -0$ state surcharge (12%ofpcnnil fee): $9.00
Authorized Signature: . ' / TOTAL PERMIT FEE: $84.00
'i l ; - This permit application expires it a permit is not obtained within 180
Print name: ETHON A. QQLPH , Date: 6-25-08 days After Il has be enacceptedaxcomplete.
• Number of inspections allowed per ncrmil.
I:VS,j,l4is. rrmii45I. - Penninpp.doe 0923 440461.S't'tI IIIWCO.M wItn
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008 -00174
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6./2Ed200t3
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 W F 'I I ..
INSPECTION WORKSHEET FOR DATE: 7/2/20013 TIME: 7:01AM PAGE: 36
SITE ADDRESS: 09710 SW NORTH DAKOTA ST A CLASS OF WORK:
SUBDIVISION: BISMARCK COURT APARTMENTS LOT #: 0013 '- 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 - 6920
Inspection Request Scheduled For: Date: 7/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072124 -03 503-209-7014 N
Corrections /Comments /Instructions:
tkiE'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /l Date: 1 7 ' 2 ' P Phone #: (503) 718-