Permit 7 'q CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
,1 COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00271
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 1 S 136CC - 00200
SITE ADDRESS: 08364 SW PFAFFLE ST ZONING: R -
SUBDIVISION: CARRIAGE HOUSE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: CARRIAGE HOUSE APARTMENTS
Project Description: Install fiber optics for Verizon. Units 107 - 110.
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:
ANDREWS MANAGEMENT LTD NORTH SKY COMMUNICATIONS INC
1.1336 SW BULL MOUNTAIN RD #103 PO BOX 87550
TIGARD, OR 97224 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 -254 -6920
• FAX 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 7/3/2007 $75.00
[TAX] 8% State Surcha 7/3/2007 $6.00 REQUIRED ITEMS AND REPORTS
• Total $81.00
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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: a Gc7
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.
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07/02/2007 MON 18:54 FAX 0003/009
iiivAsLic9 IN / ,p °2 -5v
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard GEW Received ? 01 Permit No.: ii_12.9007 2-7/
I
13125 SW Hall Blvd., Tigard, OR 7 2 Plan Review
lIl ' • Phone: 503.639.4171 Fax: 503.598.1�1�t `- 0 2+ 20 07 - Date/By: Other Permit:
inspection Line: 503.639.4175 Date Ready /By: turb: El See Page 2 for
TI GARD p RD Notified/Method: (( S upplemental Information • Internet: www.tigard or.gov Cr 1IGR
C t l,yili3vlQr Noti , .... . ,
TYPE OF Amami : +([1r� . . .. ..:: • • PLAN REVI : : .::.-.• : :.: ;;:: -. •.:.
❑ New construction Addition /alteration /replacement Please check all that apply (submit ii sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over tltree stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY. ;OF : CONSTRUCTION'
. ' exceeds 10,000 amps at ISO volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ F ire p ump. ❑ Installation of75 KVA or
Multi family ❑Master builder ❑Other: Etrxrgchrcy system motor larger separately derived system.
-,:::"••••••:•.".•' JOB SITE 'INFORMATION • AND • LOCATION
❑ Addition of new r load of ❑ "A" "E" "1 - 2" "i - 3"
Job no.: I Job site address ( N I c,'� IOOHP or more.
❑
occupancy.
❑ Recreational X Six H more units. Recreational vehicle parks.
City /State/ZiP: -- , / on -a-, ❑ Health -care facilities. ❑ Supply voltage for more than
I G , 'a ,,� i g.- � ., ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.t1 110 Project name: C . cv cy O ,J A. ,� ❑ Service or feeder 600 amps or more.
1 ( J :. FEE SCHEDULE
Cross street/directions to job site: . site: A 204. -20 Description 1 Qty. I Fee. I Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
• DES OI °WORD .. ... ( with above sq. fl.) energy, multi-family / l ((N /)�l .. ) Limited ener y 75.00 2
1. ArCi �.6...2..f.'. . . : `: 2 &/ sJi \ t. 1 .••�t'r ;✓ Ve l/ 1 // residential (with above sq. ft.)
Services or feeders installation and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ' • l • . . ' '• ❑ 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
Cit /StatelZlP: Temporary services or feeders installation, alteration, and/or
Y • 'relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 am 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
'CONTACT • PERSON above service or feeder fcc,
b .APPLICANT t ::: .., �y 6.65 2
I / 9e / each branch circuit
Business name: t4 l,'Ji/k1f\ (4,,,; { �1 L 1('yrj,�, ' I� l�1 ?il B. Fee for branch circuits
I / ', A ol t ' - „ (1 without service or feeder fee,
Contact name: v1 V L - VI e�/ fitstbranch circuit 46.85 2
I t ( :'t F , / 1 }v t f ` 't f .,:. . _. Each add'! branch circuit 6.65 2
Address: i' ( �� -� VA VA ,j h . ; !' �` . ) Miscellaneous (service or feeder not included)
City /State/Z1P: \l C_. ( r^ '- Each manufactured or modular
F, ;. \ •>� W �/� �/; �: 1 90.90 2 • _ dwelling, service and/or feeder
Phone: c3(, 6 ' L( •(p -i'U Fax: : ( _ LI , 5yti.: Reconnect only 66.85 2
E -mail: t l te,vt%S CL s,� Pump or irrigation circle 53.40 2
--y.-....•..-: oo rn.� - u ` • Sign or outline lighting 53.40 2 • Signal circuit(s) or limited -
Business name: ` et!� 0 n energy panel, alteration, or
extension. Describe: 1 Paget 16 2
Address:
City /State/ZIP: Each additional inspection over allowable in an of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: \N•1 0 1 I Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
'‘ELECTRICAL : -:PERMIT:-PEES ....... •
Suprv. Electrician signature, required: Subtotal:
Plan review (25% of permit fee):
Print name: Date: d0
(8% State surcharge (8 of permit fee): (p
- � , _ ---.?- .„— _.:-: -- =� TOTAL PERMIT FEE: %1
Authorized signa�ure �" _.� r. ,,. .� -: - - -.---.
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1 (� 1' r ' V Date: This permit application expires If a permit Is not obtained within 180
i l 1
Print name: 1 ( -(,d/t / r -�- .0 Z' per days after It has been accepted as complete.
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Number of inspections allowed per permit.
1:\ Buitd ing\Pamits \GLC- PermitApp.doe 05/23/06 440.461ST(t I/05 /COMM'EB
' CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00271
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/3/2007
Phone: (503) 639- 4171rsy
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'�W F'I��
INSPECTION WORKSHEET FOR DATE: 7/19/2007 TIME: 7:03AM PAGE: 47
SITE ADDRESS: 08364 SW PFAFFLE ST CLASS OF WORK:
SUBDIVISION: CARRIAGE HOUSE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: CARRIAGE HOUSE APARTMENTS
DESCRIPTION: Install fiber optics for Verizon. NallEMIEMB
OWNER: ANDREWS MANAGEMENT LTD. Pfr4 PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360- 254 -6920
Inspection Request Scheduled For: Date: 7/19/2007 Pour Time: .
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 052346 -02 503 - 519 -7466 Y
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
41Q-14---- Date: 7 —/ Qf . Phone #: (503) 718-