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Permit ry a CITY OF F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00188 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/2/2008 PARCEL: 2S 102CC -01000 SITE ADDRESS: 13660 SW PACIFIC HWY 53 ZONING: C - SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT: JURISDICTION: TIG PROJECT: FIR GROVE APARTMENTS Project Description: Units: 50 -56. 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: KUBIN CARON NORTH SKY COMMUNICATIONS INC 520 SW 6TH AVE #400 11818 SE MILL PLAIN BLVD PORTLAND, OR 97204 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 7/2/2008 $75.00 [TAX] 12% State Surch 7/2/2008 $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 B Permittee Signature: �pez" d ■ 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. JUL 03 2008 12:09 AM FR TO 5035981960 P.07 El V D : ONLY, • C , Electrical Permit AA ixcatio ; : .... :...: .... City of Tigard 2 2 008 DatciO� 7'FJ�I 67 P nnit No.; t �—(t t I, . . 4 13125 SW Hall Blvd., Tigard. OR 97223 JUL 0 Plan Review Other Permit :.., Phone: 503,639.4171 Fax: 503.598.1960 Dawn : 13 See rage t for Inspection Line: A Date Roady/By: TIGARD Internet: www.tigatd- nr.gov T1G Ckd/Nterhotl: �� Supplcmcnlollnforrruttion RtlIl CITY OF Pi Tim_ Noti :..:. ....... ... •....... ,. ;. TYPE :O>: DIN :: PLAN RE 1r1EW " ..;' •. , :.. Pteaw chaos all that apply (suhntit j sets of plans wlitcm± checked below): New construction Addition /alturatiolt/replatx tent Q 'Service or (ceder d00 amps ormute ❑Buiwing over threestones. ❑ Demolition ❑ Other where the available fault current O Morinar rind bootyaNS, „�- O pp amps u 1s5°147111.0 or Q It o t ang euihli t s. ..... .. . .. . ...... • CATEt.ORX: CONSTRUCTION • ••• :::.:: t It cseccde , .... lice w grournl, ore ❑ Caumercis -uw agricu iron ❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for at otter iluiat:uions. buildings. 17 Mufti- family ❑ Master builder ❑ Other: ❑ Fite pump. 0Instaltatiwr of75 KVA or ©Ennag6aoy systen4 larger separately derived system. -. d013 SITE INFORMATION AND. LOCATION p Addition of Pew muter bad or © 10014P or inure. nccupmtcy. Job no.: ( Job site address; 13660 Pacific Highway 99 0 Six Or mrorc nsklent irl units, ❑ Kecreatiunal vehicle parks, City /State/ZiP: TIGARD, OR 97223 ❑ Hsarh-carc I sallies. ❑ Supply volt40 for more ihan 0 Hazardous locations. NO vacs nominal. Suitc/bld$Japt. tl a.: 50 5 6 Project netts: FIR GROVE APTS. O Savit.nor feeder 60o amps ormule. FEE SCHEDULE ~. . Cross street/directions to job site: ua¢rlpru.a 1 ow. 1 ro*. t - final 1 • New residential single- or multifamily dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. R. or less 145.15 4 Ea, ndd'I 500 sq. R. or portion 33.40 1 W Tax map /parcel no.; Limited energy, residential 75,00 2 DESCRIPTION OF WORK (with above sq. rt.) . Limited energy, multi- family 75,00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with eh,vc.a n,) Services or feedersinstellatio alteration, and/or relocation 200 amps or less 80.30 2 - .... •• 0 PROPERTY OWNER I D' TI N.ANT 201 amps to 400: imps 106.85 2 • -- • - - - 40l 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 Temporary services or traders installation, isles anion, and/or City/State/ZIP: relocation Phone: ( ) I Fax: ( ) 200 amps or less 66,85 I 201 amps to 400 amps 100.30 2 Owner installation: This installation is being made on property that i own which is not 5 to to 599 amps 133.75 2 (avoided for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. Branch 401 amps s circuits 5 - new, alteration, or extension, eon pastel _ Owner signatory: ., —Drug: • A. Fen for btanelt circuits with i Et •CONTACT PERSON above service of feeder fcc, 1 _ ©AirPLICANT • ": each brunch carotin i 6.65 2 Business nettle: NORTH SKY COMMUNICATIONS, INC. B. Foe for branch circuits widhow service or feeder fee. 4G 85 2 Contact name: RYAN ROBERTS lint branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each :uld'I branch circuit 6.65 I 12 Miscellaneous (service or feeder not included) City/State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90.90 l 2 dwalline. service and/or feeder Phone: (503) 519 -5264 rFax:: ( )1- 866 - 905 -4907 Reconnect only - 66,85 2 E -mail: m • uor Ct • rth • m • rrl _ Pump */ irrigation circle 53.40 2 .. .... , 'CONTRACTOR . • _.. 53. 40 2 Sign or outline lighting --� Signal circuit(S) or limited - Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration. or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension, nescrlbe: 1 Page 2 $75.00 2 City/State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above - Per inspection 62.50 Phone: ( 360) 254 -6920 Fax: ( ) 1- 866 - 5304325 investigation per 1lour(1 hr min) — 62,50 - CCB Lie.: 14117 Electrical Lic.17 -154CL Supt'v. Lie.: 173LEB Industrial plant per hone - 73.75 ----- ... EL CCfRICALPERMIT PEitiS • Su pry. Electrician signature, required: Subtotal: _375.00 — . Plan review (25% of p fee): Print name: JACK CAGLE ` o °1e 7 -2 -08 S tate surcharge (12% of permit fee): $9.00 Authorized signature: ' - TOTAL PERMIT Fen: $84.00 _. . This permit aPPriedlioa expires if a permit is got o1,ta;oal.vturin to Print name: ETHON A. DOLPH Date: 7 -2 -08 clays after it has been neccpted as complete. ° Number of inspections allowed per pemtiL 1Mu&liVits".403LC:- P.A"A 05n.3,06 141)4613l'(I I/eSH:OMN/CP l CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008- 00188 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/ Phone: (503) 639- 4171 n , g'I Inspection Requests (24 Hrs.): (503) 639 -4175 �'i L. INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:00AM PAGE: 47 SITE ADDRESS: 13660 SW PACIFIC HWY 53 CLASS OF WORK: SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: FIR GROVE APARTMENTS DESCRIPTION: Units: 50.56. Installing fiber optics for Verizon. OWNER: KUBIN CAROM, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360. 254 -6920 Inspection Request Scheduled For: Date: 7/1612008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 072690 -02 503849-2025 N Corrections /Comments /Instructions: � 'V PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G-- I Date: Phone #: (503) 718- YT`�v