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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT N �_ COMMUNITY DEVELOPMENT Permit #: ELR2009 -00132 T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/12/2009 Parcel: 1S 134AB00100 Jurisdiction: Tigard Site address: 11002 SW SPRINGWOOD DR Subdivision: Lot: 0 Project: Englewood Terrace Apartments Project Description: Install fiber optics for Verizon. Owner: FEES Description Date Amount Restricted Energy Permit 05/12/2009 $75.00 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 throug OAR 952 : 001 - 01100.. You may obtai a�co / of tth mules or direct questions to OUNC by calling 5�9 or 1.800.332.2344. 1 Issued By: JAL J Permittee Signature: ! , ko 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. 41AY�08 2009 2:32 AM FR TO 5035981960 P.06 • Electrical Permit A�policatlon D 1 f)R OL'l'll'h l;til'.()1L • CI of Tigard MAY 0 7 2009 7� 131 SW HalBlvd.. 'Tigard, OR 97223 l: Olha talc f Phone: 503.639A171 Ca IDade . (ropeotloa cane So 3.639417 TIGARD Dare i /e5- RI Met 3(•r ` 1(,:s1 ° Lrn �•� amat gara«.Bov BUILDING D 1 .. N°1111:44411" pdN°1111:44411" TA 1 s tmenatiatarroolon '''.: - ∎.' `•TXPR .AF WORK ''illi':': • :::::, .. . ., : :; ;, > : •;;_` :;',`: Z. .. PLAN SYY.• I. :;; :•. '.: New r onclrttetian Addition/altorationlrepTtttx men! risaw c that apply (gut and 3 AM ofetaas Wilma tad Wow): D &wee or ex.der 400 leper nen 0 Bidding owe atm owl= 0 Demolition ❑ Otber. . •-•:•;.,:•,...;'::..,:•;::,:•,;,,,.,:.; ..1:: ;' " ORY :OF: CONSTRUCTION ::: •; ,, ; 2 exa S° 14:::: w D t Nn u f A o otr kewr+r ❑ I. and 2- fancily dwelling 0 Commercial/Industrial © Accessory building amts far all other instaiRdions. buildings. al Multi -famil 0 Master builder ❑ Other. D Am u' ❑ Ins lts:6o of 75 KvA a O tbrtagonoy qrt� arau eop�mtr derived wane. • - .?'''•''.'`< - '• 'JOB SITE. INFORMATION AND - LOCATION .. OAddhar,afaaw C{`A °.ati'.'t:X'. "1 -1 ". Job no.: Sob site address: 10960 SW SPRINGWOOD DR. looltP or snort. nasrymlcr. /. p AR O Sit a atOnl tesklendel units, D cr Remodeled re**, psis. city/State/ZIP: TIGARD, OR 97223 0 MeaOMC*m iliciii6es. a supply whop for nwm tnsa D Mimtdoas l 6110 wen nominal. Suite /bldg./apt.na.i , oo2- t + o2o Ever+ Project naznc:ENGLCW000 TERRACE APARTMENTS CI Service 0( WO ano •tign or MM. `a:• . T ; PER 'SCHEDULE . Cross street /directions to job sue: nos;MPter t urt. I r Ra I 'Nat t_ Nee residential single or mull - family aweait% unit. Includes attached gams- , Subdivision: 1,000 sq. t1. or less ,. 145.15 4 Ea. All 500 sq.11. or portion 33.40 I Tax map /parcel no.: • lhaitrd energy, residcatisl • . DESCRIPTION OF WORK ' (wtmCO above 73.00 2 INSTALL FIBER OPTICS FOR VERIZON United energy, (with al ehowstN. Q.) 75'00 2 ServlcCs or feeders Ittttallepak ulleraIlon, aadIor rebellion 200 amps or kss 8030 2 • : :<.. •• ' ❑ PROPF.RTU-'OWNER , • . • .• '- a-TENANT ' 201 stops tu400 maps 106.85 2 EEIIIIIIIIIMIIIIIIIIIIIIIIIIIIMIII 40l amps to 6°"56 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or vain 434.65 12 City/State/ZIP: 'temporary services or faders imeallatlon, alteration, a„dlor relewnon Phony ( ) 200 align or less 66.85 I Owner IasluU tIon: This installation is being muck on property that I own which is not 20i "'I to 400 amr'g 100.30 2 ^ intended for sate. lease. rent. or exchange. according to ORS 447, 449, 670, nod 701. 401 amps to S99 novo , 133.75 2 (fronds circuits - new. altertUIen, or extension, per panel • Owner signature: watt= - A. Fat: far branch circuits wen • 0 APPLICANT : ,•';' . •' PERSON - above savior or feeder fee, 6b5 2 • each bench dreuit Business mmnm NORTH SKY COMMUNICATIONS. INC. 6. Fee for brawn circuits or Wet Coarser. are RYAN ROBERTS without i t it f �' ct 4455 2 Address: 11818 SE MILL PLAIN BLVD STE. 410 • gild Wel Nandi circuit 6.65 2 Mlscena °roes (service or feeder not lmcioded) — CitylS4ateTZiF VANCOUVER, WA 98684 " Each mawfaaoundarmneular 90.90 2 dwell, service andke feeder Phan: (503) 519 -5264 Fax: : ( )1-866-905-4907 Reconnect coy 66.85 2 Irini u,• • t! s +.U.l .4 :uu u • u Pomp or inigatioaardo 53.40 2 CO R,u�OR t Sign or oat8ne lighllag 53.40 �� 2 ss panto Sig ed or limited - Busine N ORTH SKY COMM NICATIONS INC. enery panel, aliamian.or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Dube` 1 Page 2 575.00 2 City/StawIZW: • VER WA 986 Bash additional Inspection over allowable in arty! Inn °born • Per inspection 6150 Phony~ (360) 254 -6920 Fax: ( ) 1-866.530 -4325 Invenigddon per hour 0 or a4,r) 62.50 CCB Lie.: 14117 1113=EMEMM Suprv. Lie.: 173LEB Ind" lea pelr hour 73.78 ••'«• "„ ELECTRICAL, Mawr FEES ' Stirprv. D Ctitciaa sigrttiwre, required Subtotal 5.00 Dote 5-7-09 Ptat review (25lb of permit foe): Stare surcharge (12%df ptmalt feet $9.Q0 Toms. PERMfT Pm $84,00 Date: 5-7.09 9111• p+•illtt + idea boa been n000p•d l alttsloed Waldo NO doth • Newbew of 1n•p=da m;Mwed Per P•.w41- 1:,er9stwaNbnneder tvbrwtl,rpp,ar 4+6N111 sso.+orrrtt VuM O b MIA