Permit 1 111 q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
�. COMMUNITY DEVELOPMENT Permit #: ELR2009 -00131
Date Issued: 05/12/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S134AB00100
Jurisdiction: Tigard
Site address: 10980 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
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
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 952-0,01-0100. You may oobtaain copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ml / i� \- I �+�Q- - 1 Permittee Signature: R Q 11 `
COA�)
OWNER INSTALLATION ONLY 1
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.
, ,MAY 08 2009 2 : 32 AM FR TO 5 0 3 5 9 8 1 9 6 0 P . 0 5
, .
. RECEIVED
Electrical Permit Application rAY 07 0)H 014.1c t.: ( I.., oNLY .
I . City of Tigard TinAiti
I ---. 4 13123 SW Hall Blvd.. rem!. OR 97223 CrrY OF . AU 16wicw
mow 03.639.4171 3 FLOC 50159&194BuILDING Divis
..,., , . Omar Panic
• r 1 (3 ,,., I( c Inspection Line: 501.639.41/3 /Mc - I lil Sto Poie I Me
intent= www.tigard-orgov Ned1Mothisek 11 ri 1 suotamemai worm*.
.... . 0v •woRK : :::::.,..: : PLAN REVIEW .::.• *, .' .
Pt= check oll thai imply Whim it /aux ofplans Winos clicdcil bc106):
0 New consuuctiOn CI Addition/alterationirepIncemcni
DSc:vim. &oder 450 cmps or awe 0 BuIldins owe dour twos.
0 Demolition 0 ()Mu: wlicic Ilic milidilo WA MONO CI btarli66 cad Canards.
.• ' i : :...::' CATICORY ' CONSTRUCTION :.. '' .'.. ;'-:'.'.: ::;.; . ....;‘.:...i'..'";..:: "cogs MAW aM 1" 1 I " "I" uf a l quidin 8 bo minis.
losi to gmaai cc exccah 14.000 CI Cd 114C1C01111rAl
El I - and 2-family dwelling 0 Connnercial/IndustrInl 0 Accessory building amps rat an other hcc claims, buildingi.
W Multi-family 0 Master buiWcr 0 Other: f:1 peso. 0 btolltudon of 73 Min w
. CI &Magary 1
.."..' ' ; . ; ... i. 'JOU SIM. INF.ORMATION AN LOCATION ::: ''.::.:'-- '.' :;',..':::::..,..: .:, CI Mall Ian Of =tn. limil of el " ' r'. -1..r, - "gam
Job no.: I Job site taldresS: 10960 SW SPRINGWOOD DR. 1110HP or more. occupancy.
0 Six or Nun resiticoicial mita 0 0CCOO111111111 vehicle pudo.
City/State/ZAP: TIGARD, OR 97223 PHsanticar facilities 0 Supply wigs tbr two than
— CI Harmlowi locutions 500 volts noothud.
SuiteibidgJapt. 110.3o055 EVEN1 Ptoject name:ENGLEWOOD TERRACE APARTMENTS 0 Sa ac feed°. 600 " 1143 47
Cron strectAlirections to job site: Outerlolion I Otin I ft& I l't■OrI I •
''New residential single- or milli-family dwelling unit.
lutiodua snaked pram
.
Subdivision: I Lot no.: _1.000 sq. it or less 143.13 4
' . Ea. twill 500 uq. It. orimnion 3140 1
Tax map/pareol no.: • Limited weep, residential 73.00 2
ocsourrioN OF WORK . - (mat above sq. It) .
' Limited energy, mulli.lhmlly •
INSTALL FIBER OPTICS FOR VERIZON residcadal Loa show 1111. R.) 75.00 2
Servkas or feeders installation, altareMn, ondlor rdomilon
2430 amps of lets 80.30 2
' :,:::. ' • .
'0 PROPERTY.'OWNSII .: ' , ' :••• ' 1..‘... : • ',.. a TRNANT • ' ', . -' amps to 400 amps 106.8$ 2
401 amps to 600 amps
Name: 160.60 NM 2
601 amps to 1,000 On . LI 240.60 MEN 2
Address: . . Over 1.000 amps or volts 454.65 2
City/State/7NA: Tel services or feeders instatlinkte, alteration, andfor
relocation
-
Phone: ( ) I Fax; ( ) 200 amps or less 0635 1
Ow
n** installation: This installation in being tu
;ttle on property that I own which is itot 201 VII 1°400 amps 1 1 100.30 2
Intended for sate. lam rent. or exchange, according to ORS 447. 449. 670. and 701. 401 amps to 399 imps 13175 2
Brooch circuits new. alteration, or ostelmlon,*r camel
Owner signature: . . •C --- A. FCC for branch cittuin will,
'. -; -: ' ::... . ' . • 0 APPLICANT : . ...'..; '';' :" • s'. 41 - •. :... 0 -CONTACT PIRISON ' : ' above service or reeler OA 6.65 2
- ettr,b brunch circuit
ausiness "ale: NORTH SKY COMMUNICATIONS, INC. 1). Fat for brunch circuits
wirdow service of feeder kg. 4610 2
Cmtade mune RYAN ROBERTS : lien byanch circuit
Addrom 11818 SE MILL PLAIN BLVD STE. 410 Emit add, branch circuit 6.65 2
. Misccitaneons (sank* or feeder not Included)
QV/slide/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90.90 ' 1
dwelling, service andlor feeder
Pllette: (503 ) 519-5264 I Fax: : ( )1466 Reconnect any 66.135 2
E•gooil: fridUOTOFIOdtISKYCOMMOOM Purnpor i n nigatio circle 33.40 -
• 53.40 — 2 -
Signal OltO8110) or limited-
841 "ma: NORTH SKY COMMUNICATIONS, INC. emu panel. altention. Or 'I
Address: 11818 SE MILL PLAIN BLVD. STE 410 odeasion. Describe: Page 3 $75.00 2
agYiStaterZIP: VANCOUVER. WA 98684 - irch adillticand inspection over aRowable Insert the above •
, Per hopoctiOn 6150
1410 Th:: (360) 254-6920 I Fax ( ) 1-868-5304325 Invesilsation per hour 0 le aim - 6150 • CC Li" 14117 I Electrical Uc.17.454CL Suiro• Lic.: 173LEB InanarbdPimgm'Imir 73,75
- '.'.:...., ". • ", .1.. Etzenue.Ai. maim raga ''%
Suprv. Magician signature, required: • • .• _ S°"I s75.00
NM Muriel JACK CAGLE MC 5-7-09 Nan ravkw (7516 of permit feeh
Some undergo (120 of ponnil ree)t $940
Autborizod signature:
,1 de /q(e.,..7 • Tara'. mbar rca: $84.00
- Inn permit application mans ir 0 poem is rot oblolool within 150
Paint name. ETHAIIA. DOLPH Datm 5-7-09 days onion Me Oafs orceptal so essoperm
• timber of Insimaloos allowed gice /monk.
k‘OolOOVOItrOodle,C41/4naltAoodoo coVIAOS 140 tittatOOVW136