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Permit
v CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00184 TI G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/2/2008 PARCEL: 2S102CC -01000 SITE ADDRESS: 13660 SW PACIFIC HWY 10 ZONING: C -G SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT: JURISDICTION: TIG PROJECT: FIR GROVE APARTMENTS Project Description: Units: 10 -16. 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 By: ` - Permittee Signature: S 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 12:08 AM FR TO 5035981960 P.03 - ENE D Electrical Permit Application REC tc.> City of Tigard J k IL 0 2 2008 7� ; ��� � . es 13125 SW Hull Blvd., Tigard. OR 97223 • • Phone: 503.639.4171 Fix; 503.598.1960 'TiGAR other Pcrmit: 71 t3 /�RD Ins Line: 503. �r OF to Ruawy /Ry: ®Sec In z Tor fntcma: www,ti3and -oroov Cll NGD iV1 irrcdI cifuid: �� SupplemcnlntInt'ormntion • '''.....'•.';•••;•;.:••:::........ ,... , :•:..TYPE PP .W K : ' .: "' .... ...:::.. . 7. ::. .PLAN REVIEW. •`: •... ; :... .:.•. :•• . © New constitn ion i Addition/alteration/replacement einent Please check all dot apply (submit; sets of plume wrtc » Limited below): 0 Service or rood& 400 amps or mom a Building over three stories. El l }molition © Other: where ilia available fault current a Murinas a d boatyanlr, ' .. ....1'•:,.....,.....: ": CATEGORY 'OF .. .CONSTRUCTION, , .. . .. . *. exceeds 10,000 amps et 150 volts or Ci touting building. . less to ground. or exceeds 14.000 ❑ Couttncicetl -nsc agricultural ❑ I- and 2- family dwelling 0 Commerciallndustrial 0 Accessory building amps thrall outer installations. buildings. El Multi - family ❑ Master builder ❑ Other: 0 Sic pump. 0 Installation or75 KVA sir emergency system. lard scpardety de rived'ystem. • • '. `'JOB • SITIC •INFORMATION AND LOCATION ' • ❑ Add ition of new manor mad nr ❑ - A . `C" "1 ..I.3° lob no.: Job site address: 13660 Pacific Hi hwa 99 10131.1 . or o owe navpvi g y ❑ Six or muro esidcminl onus. ❑ Recreation veltick i>,vki. City /State/ZIP: TIGARD, OR, 97223 ❑ Henitl< are rxilitics. D Supply wimp for mum than 13 Hasorcluus location, lino suite naminal- Suite/bldg. /apt. nn.: 10 -16 I Project name: FIR GROVE AP TS . p scrviccorfcodcr 600 amps ormorn, . ... . ' : FEE SCHEDULE Cross street /directions to job site: Description I On. I per. I Twat I • - New rosidentlid single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: .. 1,000 a4. R. or less 145.15 a Ea. uxlcrl 500 sq. ft. or portion 33.40 1 Tax map/parcel no - : Limited energy, residential 75,00 2 DESCRIPTION OF WORK (with shove w. ft.) Limited energy, multi•faniidy 75.00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with Alwyn sq. DI Services or feeders installation. alteration, and/or relocation 200 amps or less 80.30 2 ' 0 PROPERTY; OWNER . ' '.Q" TENANT 201 anips to 400 amps 106.85 _ 2 Name: 401 amps to 600 amps 160.60 2 — 601 amps to 1,000 amps 24040 2 Address: Over 1,000 amps or volts 454.65 2 City /StatIra: Temporary services or feeders installation, alteration, and/or relocation _ Phone: ( ) I Fax: ( ) 200 amps or less 66,83 I I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 7 - intended for sale. least. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 mops to 599 snips 1.33.75 2 Branch circuits - new, alteration. or extension, per panel Owner signature: Date: . - _ A, Fee for branch circuits ,virlr . 0 APPLICANT • • ;: I `• o' CONTACT PF,RSON • above service or feeder fees 6.65 • each branch circuit Business name; NORTH SKY COMMUNICATIONS, INC. B. Foe for brnneh circuits without service or feeder foe, COntaut name: RYAN ROBERTS first branch circuit 46.85 2 Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'I branch circuit 6.65 2 Misceflaneousiscrviee or feeder not included) City/State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 9090 2 dwelling, service and/or feeder Phone: (503) 519 -5264 Pax: = ( ) 1 - 905 -4907 Reconnect only 66.85 2 E -mail: mduor a - tom Pump or irrigation citele 53.40 2 ' • CO NTRACTOR .. • •• .. Sign or outline lighting 53.40 2 Signal circuits) or limited- Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or 1 Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: Page 2 $75.00 2 City /State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowa in any of the above Per inspection Phone: ( 360) 254 -6920 f Fax: ( ) 1- 866 - 530 -4325 investigation o per hour (I hr .tin) - r 62.50 CCB Lie.: 14117 Electrical Lic.17 -154CL = Suprv. Lit.: 173LEB Industrial plant per hour 73,75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, rtxluired: ` ... Subtotal: _ g;75 = 00 Print name: JACK CAGLE Date: 7 -2 -08 Plun review (2S95 of permit fee): ,State Surcharge (121b of permit fee): $9.00 Authorized signature: -_� i TOTAL PERMIT FREE: $84.00 -�' - This permit application expi ca if a permit is not obtained within no Print name: ETHON A. DOLPH Dote; 7-2-08 . days alter II has been ucceptcd as complete. - .. • Number of innpcaiotu allawcd per permit. i:\ muihsifv , , , ,n,... , e.C-I , Tn,i,App,,4C osaa/arl sat}y(t 5rtt inli/CnaIAVI:n CITY OF TIGARD BUILDING DIVISION PERMIT #: ELIR2008 001f34 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2/2008 Phone: (503) 639 -4171 Attair Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/15/2008 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 13660 SW PACIFIC HWY 10 CLASS OF WORK: SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: FIR GROVE APARTMENTS DESCRIPTION: Units: 10-16. Installing fiber optics for Verizon. OWNER: KUBIN CARON, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360 - 2546920 Inspection Request Scheduled For: Date: 7/15/20013 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 07264503 503- 849 -2025 N Corrections /Comments/ Instructions: ` ►j 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL , OR INSPECTION ❑ ADDIT ONAL FEES ASSESSED fi Inspector: Date: • Phone #: (503) 718- • i