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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00129 T t G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/12/2009 Parcel: 1 S134AB00100 Jurisdiction: Tigard Site address: 10940 SW SPRINGWOOD DR Subdivision: Lot: 0 Project: Englewood Terrace Apartments Project Description: Install fiber optics for Verizon. Owner: FEES HARRINGTON, THOMAS E TRUST Description Date Amount BY HARRINGTON, THOMAS E TR, 105 Restricted Energy Permit 05/12/2009 $75.00 FREMONT AVE #B 12% State Surcharge - Restricted Energy 05/12/2009 $9.00 PHONE: • Contractor: NORTH SKY COMMUNICATIONS INC 11818 SE MILL PLAIN BLVD, SUITE 410 VANCOUVER, WA 98687 PHONE: 360 - 254 -6920 FAX: 1- 866- 905 -4907 Type of Use: MF Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: Y Fire Alarm: N HVAC: N Instrumentation: N Total $84.00 Intercom/Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Other Desc: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throu h 0 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. � /1 � Q � � *)01,i 11 OWNER INSTALLATION ONLY Issued By: Q k_ L �, �`'� Permittee Signature: 0 0 CQ I 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. MA Y. 08 2009 2 : 3 1 AM FR TO 5035981 960 P . 03 RECEIVED t ,( 0 7 2009 Electrical Permit Application FO1(t)Fytct: Ust: (.):\ IA . City of Tigard CITY OF TIGARD ilmbod v: s 7.Oc tit C I � Y .001 i 13125 sw Nap Blvd., Tigwrt. o 1! am 1 ING DIVISION P aei� on er Peru: ' L Phone: 303.639.4171 Fax: .598. weft: t even Liitc 303439A175 Cow 1to adyl9y: - "� 9J S.o Paso 1 rbr ':' I C:.� i 1 D tnicma www.tlgaad•or.gov NwIOcdlMothod: 1 I Su � �+l melloa ',. C:.' •TYPE.OF WORK'" ••••'..• .. :i ,. �:. ; • :.. 'N; T•.' ; :::. +•::PLAN Rt:Yaaw.NIt..• ?;; ,.:; '.. :::C , CI Newconstruction 1 ri Additionlntterationlrcpiac mcol Ptwsa atria an Max apply (submit $ sou ofptem waken cheesed teams); a San ice or rider 400 amp or rams 0 Beading OM OM •to ksi. 0 Demolition 0 Otter. wine oho available atilt Mot 0ldnrinar owl bo crirds. * ..;', ..,;';i':;: :.; , . CATec0RY;OP: CONSTRUCTION : ; • - > •••'-.; ' , .. . - a caoh 14000 oatpr 11 1.5°14.000 vdu or (� Plnnllne bulw mgv. • i' Iasi to g rams or t:x 0 CammctvW.. a g,icn maw 121i - and 2- family dwelling ❑ Commercial/Industrial ❑ Accessory building rums tor all ester Iettellelbnr, buildings. ra Multifamily ©Magtcr builder CI Other. C Re RV. ❑ loslgU etion of 75 KVA or O bpy rye laryWr &yam* derived mum. .. `; ::.: - '.'TOR gr1'&INFORMATION AND. LOCATION . •• • :;':-'. '::,...: 13 Addition or now mow Mod or O A . °O', r. Job no,: Job site address: 10960 SW SPRINGWOOD DR. loop or wens may 0 Six or me r aidentlot units. O Reaaelon d vehicle puma.. City/State/ZIP: TIGARD, OR 97223 O ltsnal•cacorae;iit:e.. 0S r`mole drart 0 bvn linui locations Suite/bldg./apt. M. 1)40-1013511 EVEN Project norm ENGLEWOOD TERRACE APARTMENTS ❑S4Wnosir rcader600na65Otazure' : VW 'SCHEDULII Cross street /directions to job site: nendpth. I Ott'. t Ikr, t n.aI I • New residential single. or multldamlly dwelling unit. [Wades attached garage. Subdivision: Lot no.: 1.000 r0. R. or lose 145.15 4 E;t. add, 500 cq. R. or portion 33.40 1 Tax map/parcea no.: Limited energy, residential 73.00 2 DESCRIPTION OF WORK • (with abut) ell hJ •) • INSTALL FIBER OPTICS FOR VERIZON � resi 'tl'attrotml 75'00 2 cxitlrn tial (with at•.va •a R n somas or feeders Installatlon�eltergad* en. aad robe *don 200 amps or lea 80.30 2 •..i `Q pROPF.Lir(OWNER' . '•l�'TENANT -' 201 amps to 400 amps I 106.83 2 401 amps to 600 ramps 160.60 2 601 snipe to 1,000 ramps 24060 2 Over 1,000 amps or 401111 454 2 CitylState!!IP-. Temporary ser.iees or kedere installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 6643 I Owner installation: This installation is being trade on property that l own which is not 201 amps he 400 mope 10030 2 intcaded for sale, tease. rent, or exclumge, according to ORS 447, 449, 670, and 701. 401 maps to 599 amps 133.75 - 2 Owner signature: Dom: Broads ebudts - new. alteration, er ext panel A. Foe for branch circuits with . ❑ A P P L I C A N T : ' • • • • , . : " • . '' .. ..CONTACT PERSON above o rriceO feeder fro, 6.65 2 ' each breach circuit Business m NORTH SKY COMMUNICATIONS, INC. 0, Fee tar brawn circuits ` without service or feeder fee. 405 2 Contact name: RYAN ROBERTS first brunch circuit Armes: 11818 SE MILL PLAIN BLVD STE. 410 Each WWI branch """h 6.69 2 Miscellaneous (ettrvleo or feeder not included) Cny/SlatdZtP: VANCOUVER. WA 98684 Enclacurred ormodular - 9090 2 dwelling, service md/or feeder Phone: (503) 519 -5264 Fax :: ( )1- 866.905 -4907 Remand only 66.85 ' 2 fit • • • • t�! e.• e. t .� �• tt fit �• tl Puma or irrigation thick 53.40 2 - • • CONTRACTOR • ' ' ' Signor aniline Wiling 53A0 2 trb"itlnsx Itaam: Agent c'Ircvids) or bimited- B NORTH SKY COMMUNICATIONS INC. maw panel, Aeration, or 1 2 $fig ap 2 Address: 11818 SE MILL PLAIN BLVD. STE 410 .. 1_. Bads • Ba additional inspection over allowable in aureola') above • now ( $601 254-6920 Fax: ( ) 1- 866 - 530 4325 per hour at nth* ' 6 Ph 00 EM EZENRINIMIEMEM Suprv. Lic. 173LEB Indus'. nat,Innt per hour - , 73.75 . . • • ELECTRICAL PERMIT FEELS Suprv. Electrician signature, required: C. - T r Subtotal; E76.� �. � Plea review 03% of pm,nil fee): Print music: JACK CAGLE Datca 5-7-09 Sire surcharge. (t2 4 of penis ree : . $940 Authorized signature � TOTAL PFRMfT M $84.00 AIIIIIIIIIIIIIII n Print name: _ Late: 5 - 7 - Etta ° d�e attrr um � am a commis ~(flog 1110 �' • ' ► i o • Numsar of Impculo.0 allowed per penes. IZnpl4tt gW 0tdW.OP0m pp.bo 0:WASS ta►•O irtt unocounvan