Permit CI TY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00274
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 1 S136CC -00200
SITE.ADDRESS: 08332 SW PFAFFLE ST ZONING: R -25
SUBDIVISION: CARRIAGE HOUSE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: CARRIAGE HOUSE APARTMENTS
Project Description: Install fiberr optics for Verizon. Units 125 - 130.
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
11336 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 •
•
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 40i/odor? n / 4
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 jobsite until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.
07/02/2007 MON 18:55 FAX 0006/009
i ....
.4 w '' VIV 1 Q( i-te2 ra / o - 2
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard r.:IVED ...v. 4
, A 0 . 7
EL f 1/ Penni( No.: Et,,A,9 -.00)#
1,1 " 13125 SW Hall Blvd., Tigard, ORREC eb`'" Plan Review
1 • 12 ' - Phone: 503.6394171 Fax: 503.598.196Q Date/By: Other Permit:
TIGARD
Inspection Line: 503.639.4175 JUL 0 2 200 i Date Ready/By: lui ,,, ID See Page 2 for
Internet: www.tigard Notified/Method: ILA Supplemental Information
.. . .. cmi ,.. . 7 .■ , 77a.-9n. . . .. .... . . ....... ......,
.'.. • • ' • ' :: TYri 0111;t9Iiiitit VAISIOK . •. • .. ..• •-• - •••....,. '-:• '' • : • : PLAN:. REVIEW.. : ' :: .'•;: •: • • ' ..; '•',.:,';
0 New construction jgAddition/alteration/replacement Please check all that apply (submit a sets of plans w/itetns checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
.. . .
'..' .- .' .': ::..--.::.:•••:.: •::''. ' :':. . '. CATEGORY OF CONSTOCTION. - : • ..' . ' ... .• exceeds 10,000 amps at ISO volts or 0 Floating buildings.
• less to ground, or exceeds 14.000 0 Commercial-use agricultural
0 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
%Multi-family 0 Master builder p Other 0 Fire pump.
. .. ... . . . .,. 0 Installation of 75 KVA or
. • ••.•. , - -, -• • - ..• - • •• larger separately derived system.
" • . ' .. - -- ' , .' ••• ; '''. JOB SITE 'INFORMATION • AND 'LOCATION - • • ':.. 0 Addition of new motor load of
Job no.: Job site address:g - 6 . 2 . . 3kK\ KOS c.,k. 100HP or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: 117Xv a IN 0, 00 22 0 Health-care facilities. 0 Supply voltage for more than
tj
i 0 Hazardous locations. 600 volts nominal.
Suite/bIdg./apt. no
,
• i 1 C Project name: CATIQC-e, ,.• t 0 Service or feeder 600 amps or more. SCHEDULE
• 'D. 3 \i1Ak ed
Cross street/directions to job site: Ve 22t.; -2,36 Description I OtY. I Fee. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. arld'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: . . Limited energy, residential 75.00 2
:-....:. %.' . • :•::-.. ..... .... • •• . • ' OF WORK • s. . • . : • . .. . ' ' • • .•• . . :• :..• -. (with above sq. ft.)
, A , A /,--- % f \ Limited energy, multi-family
'' V C, ici,..61 1 .e. .. r)P1 t)7( 1 i )1-3i \ielv t 0.0n
• , . ,, , residential (with above sq. ft.) 75.00 2
Services or feeders Installationolteration, and/or relocation
200 amps or less 80.30 2
. .
.. •
• • . - . 0 PROPERTY OWNER I .' - 1 • - • 3 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
Temporary services or feeders Installation, alteration, and/or
:
City/State/ZIP • .
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 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
.. . . . , . . , • -• • - . • •• ..... ,
..• . • ' -..•::•-• .
1 :APPLICANT .' ' • I .. • .. '.•:. ' : 'pzICONTACT PERSON - above service or feeder fee,
6.65 2
'L. ( ).. each branch circuit
Business name: Nt.-0,v -by ( Ut ji \ ivi I r {I B. Fee for branch circuits
i _ without service or feeder fee,
Contact name: / i\b A evil, first branch circuit 46.85 2
Address: 1 1 i ( 6 I e i. F..4; 61 V (i ' 1 \I ,-- Y/ 9 . -. ) . Cf -)-- . F.ach addi branch circuit _ 6.65 _ 2
Miscellaneous (service or feeder not included) _
I , ) ,, , • , c -; ..1
City/State/ZIP: \ i p, t' r- ,Vr v\i p k..f k r... , 1, . i Each manufactured or modular
90.90 2
. dwelling, service and/or feeder
Phone: (3(0) '2,614 .011,0 Fax: : rb(c,0 2,(L1 . Ryil. Reconnect only
66.85 , 2
E-mail: .-- (NoW\44.-curniy).1,,mr,-"Y\ Pump or inigation circle 53.40 • 2
x
'..':••••••••:':',...... --'• %:.:'•::.';:::-'-.' -: - ‘• ••••• :..•:.• - ..: :. : , ONTRAC K !-.: i .• .. .. ,.:. - . , . .' - - • :•. : .....-:...••., ...: Sign or outline lighting 53A0 2
0 Signal circuit(s) or limited-
Business name: ) Ok/YA -9- b-So . 0 -e- energy panel, alteration, or
Address: extension. Describe: t Page 2 '\ 6 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lie.: \ 41 v --1 1 Electrical Lic.: Suprv. Lic.: Indusuial plant per hour 73.75
"'•'•.•-•••••••:' •••- :.-:." :,-.'-...'!•':•-::.-:
Suprv. Electrician signature, required: Subtotal:
Plan review (25% of permit fee):
Print name: Date:
State surcharge (8% of permit fee): IP 6v -
•,_.---. "". ..) .
Authorized signatire::::::Z TOTAL PERMIT FEE
Print name: - IN . WI . k \I ___v_,( (_.. ,A C 5 I Date: --1... , 0 z ey
This permit application expires if a permit Is not obtained within 180
days after tt has been accepted at complete.
1 .." i -,
• Number of inspections allowed per permit.
IM3uilding \ Permits \ ELC-Pennit App.doc 05/23/06 440-0615T( I I /05/COM/WEB
' CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00274
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/3/2007
Phone: (503) 639 -4171 A II
Inspection Requests (24 Hrs.): (503) 639 -4175 .. F:..
INSPECTION WORKSHEET FOR DATE: 7/19/2007 TIME: 7:03AM PAGE: 46
SITE ADDRESS: 08332 SW PFAFFLE ST CLASS OF WORK:
SUBDIVISION: CARRIAGE HOUSE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: CARRIAGE HOUSE APARTMENTS •
DESCRIPTION: Install fiberr optics for Verizon. [Jnits 125 130, \
OWNER: ANDREWS MANAGEMENT LTD, 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 -03 503-519 -7466 Y
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
p
Inspector: Date: 7- /?.- 7 Phone #: (503) 718-