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Permit
• 74 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00185 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/2/2008 PARCEL: 2 S 102CC -01000 SITE ADDRESS: 13660 SW PACIFIC HWY 20 ZONING: C -G SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT: JURISDICTION: TIG PROJECT: FIR GROVE APARTMENTS Project Description: Units: 20 - 27. 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. / I� Issued By: ` ��� y i� � �; Permittee Signature: % � .7�n/ 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.04 Electrical Permit Application rte r IJSE:ON v CIty of Tigard RECENED R 7A . 4// - S 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Kevicw - - ' • Phone: 503.639.4171 Fur 503.598.196 , a 2 2008 oatcre . Oche` Permit: r I G ARD (meow Line: 503.639.4175 JU pate Italy/BY: '� ° a See Page 2 for (•ow www.Iigard- or.gov Nottfled/Metha . i "t Information TYPE :ot� vtf�kk ( art OF A ' PLAN REVIEW Supplemental O New construction Eli Addition/3,1%1111a cn tt Please chest: an that apply (submit g sets or t>ldos wrn°ms checked below): ❑ Service or feeder 400 amps or mom ❑ Building over times mode. ❑ Demol ition ❑ Other; wham the avail Ihult current Q Marinas and bnatyanls. .. ':::',...:':?..;;.:.,j:'...:......, .... , .. c A'rECOR>r OM :( oN3TRUCTION ` exceeds 10,000 amps at 150 volts or Q Floating baiWingr. ' IcSS to ground. or exceeds I4,000 0 Cwnmarcctl.usc agricuhuial [] 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building angn for all other installations. buildings. o Multi - family ❑ Master builder El Other: ❑Fire pump. ❑ tnuallati00 or 75 KvA ur . . t6t Y argcnc system lar w separately ekrivcd system. .•.. • .. c 7Uli SITE INFORMATION AND LOCATION ::.:i:: ❑ Addition or tmw motor toad or 0 "A" - ", - t - 2", - 1.3" 1 3660 Pacific Highway 99 ix°, m `�nOfe' Caney. Job no.: lob site add �/ 9 I ❑ Siz or mote residential units. ❑ lircmatiwud vehicle Parks. City /State/ZIP: TIGARD, OR, OR 97223 Q Health -pro taci5i,ca. ❑ Supply voltage for mum than (:1 Hazardous locations. 0(10 vet; mammal Suite/bldg. /apt -no.: 20-27 Project name: FIR GROVE APTS. ❑ Scrviceor feeder 690uniaS . - ..:.` : FFTs'SCHEDULE Cross street /directions to job site: 0es I Qty. [ reg. 1 natal I • ; New residential single• or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. ft. or Icss 145.15 4 .- E. add'I 500 se. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 . DESCRIPTION OF WORK ' Swdh above sq. it.) Limited energy, multi - family 75.00 ? ' INSTALL FIBER OPTICS FOR VERIZON residential (with abovcxlbn.) Services or feeders installation,_alteration. and/or relocation 200 amps or less 80.30 2 ' © PROPERTY: OWNER • ❑ • TENANT • 201 amps to 400 amps 106.85 2 Name: " 40l 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; Temporary services or feeders installation, alteration, and/or , relocation Phone: ( ) I Pax: ( ) 200 amps or less 66.83 I Owner installation: 'Phis installation is being made on property that I own which is tot 2 pt amp to 400 amps 100.30 2 intended for sale, lease, rent. or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature:, . __„Date: A, Fee for branch circuits with • • ❑ APPLICANT . •.. ":I . . ' f4' CONTACT PERSON above service or feeder fix, 6.65 2 . each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits -- withour service Of Fader fee, 4G 8S Contact name: RYAN ROBERTS first branch circuit Address: 11818 SE MILL PLAIN BLVD STE, 410 Each add'r branch circuit 6.65 f 2 Miscellaneous (service or feeder not included) City/State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular dwelling, service and/or (ceder 90.90 _ Phone: (503) 519 -5264 I Fax:: ( )1- 866- 905 -4907 Reconnect only 66.05 2 E -mail: mduor(ct�northskvcomm,com Pump or irrigation circic 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 - N ORTH SKY COMMUNICATIONS, INC. e il'cu papal, a B usinesti name: , energy panel. ur Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City/Statc2IP: VANCOUVER, WA 98684 Each additional inspection over allowuble in any of the above Per inspection 62,50 Phone: (360) 254 -6920 I Fax:( ) 1- 866 -530 -4325 inmitidation per hour (l hr ink) 6 2.50 CCB Lie.: 14117 Electrical Lic.17 -154C Suprv. Lic.: 173LEB Industrial plant per hour 73,75 ELECTRICAL PERMIT FEES ' ` . • Suprv, Electrician signature, required: Subtotal: _ $75 00_ Plan review (2598 of permit fee): Prim name: JACK CAGLE I Date: 7 - - 5muc tvrdt,ugc (12% of permit fee): $9.00 Authorized signature: /!_ I ' % TOTAL pentvtrr rim: $84.00 - vas permit implication expoN if a permit is not obtained within ISO Print name: ETHON A. DOLPH Date: 7 -2 -08 Ilays aver it has been accepted PS Complete. • Number of inspealoos allowed per permit. tl) dingsPermit.lft.GPYatuApryeoe 05/23/06 440.4151(t1rosicoWWGa CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008- 00185 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/212008 Phone: (503) 639 -4171 a '�° "hl j Inspection Requests (24 Hrs.): (503) 639 -4175 - INSPECTION WORKSHEET FOR DATE: 7//512008 TIME: 7:00AM PAGE: 28 SITE ADDRESS: 13660 SW PACIFIC FIWY 20 CLASS OF WORK: SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: FIR GROVE APARTMENTS DESCRIPTION: Units: 20.27. Installing fiber optics for Verizon. OWNER: KIJBIN CARON, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360. 254 -6970 Inspection Request Scheduled For: Date: 7/15/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 072645.02 503-849-2025 N Corrections /Comments /Instructions: &C- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � Date: .1 (0 Phone #: (503) 718-