Permit ,_
.., ,
71 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00019
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/24/2008
PARCEL: 2S102BD - 01001
SITE ADDRESS: 09955 SW WALNUT ST 7 ZONING: R -12
SUBDIVISION: WALNUT COURT APARTMENTS LOT: 007 JURISDICTION: TIG
PROJECT: WALNUT COURT APTS
Project Description: Units 7 - 10. Fiber Optics for Verizon
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:
BLINE, RONALD G + NORTH SKY COMMUNICATIONS INC
SAGUN, JUDITH L 11818 SE MILL PLAIN BLVD
2190 SKYLINE DR VANCOUVER, WA 98687
SEASIDE, OR 97138
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 1/24/2008 $75.00
[TAX] 12% State Surch 1/24/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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:
4,4 Permittee Signature: orn �. i t"
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.
01/23/2008 WED 11:11 FAX 0003 /005
Electrical Permit Application � � � volt OFFICr USE ONLY
City of Tigard ( Received •
• 13125 SW Hall Blvd., Tigard,' �'�JJ \\\. Plum Rovi• v
: d Phone: 503.639.4171 Fax: Sr:,. :.1 F ",t GI, 1 Other Permit:
9 60 d Dale/ :
TI C'i A R U Inspection Line: 503.639.4175 , 1 1 �� n' Dale Ready /By. lurlsc ® Sec Page 2 for
Internet: www,tigard- or.gov OV 0� \ ®® Notified/Method: T Supplemental Information
. - : , ' TYPE OF• W • : \i `WA w • • . •.:,' ; . ,,. PLAN - REVIEW. • ". ' . ,, • , •
New consttvction ❑ ` ❑ Addition /alte 114 e P lacement Please cheek all that apply (submit 2 sets of plans w /itenss checked below) -
❑ Service or feeder 400 amps or time ❑ Building over three stories.
❑ Demolition ❑ Other. where the available fault current ❑ Marinas and bomyanls.
. : ; , • CATEGORY,OF CONSTRUCTION , ' , • , • - ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Comnerclal•uso agricultural
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
Q Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB _SITE INFORMATION AND, LOCATION ' , ❑Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ • "A•' •'F" "I .2", "1-3'',
Job no.: Job site address: 9955 -'SSW WALNUT ST. 100HPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP:TIGARD, OR 97223 ❑ Health•carc facilities. ❑ Supply voltage for more than
❑ Hazardous locutions. 600 volts nominal.
Suite /bldg. /apt. no.BLDG 2 \I Project name: WALNUT COURT APTS. O Sorviceor fecdcrd0O snips or note.
' 'FEE. SCHEDULE
Cross street /directions to job site47 -10 ix...d stn I Qtr. I Fee. I Tote{ I •
New residential single• or multi-family dwelling tsttit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Fa. add'I 500 sq. R. or portion 33.40 1
Tax snap /parcel no.: Limited energy, residential 75.00 2
' . • , • . • ' DESCRIPTION OF WORK • . - . • . , . (with above sq. a.) •
Utnited energy, multi - family 75.00 2
INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. a)
Services or feeders installation and/or relocation
200 amps or less 80.30 2 • • , via PROPERTY: OWNER ,- ❑ •'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
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
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 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
• '❑ APPLICANT • ' • I : •, o . CON TACT PERSON. a b o ve service or feede fe e, 6.65 2
each brunch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
without service or feeder fee.
Contact name: MONET VIVEROS first branch circuit 46.85 2
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP:VAN000VER, WA 98684 Each manufactured or modular
90,90 2
dwelling, service and/or feeder
Phone: (360) 254 -6920 Fax: : ( ) 1-866-530-4325 Reconnect only 66.85 2
E -mail: mviverost'anorthskycomm.com Pump or irrigation circle 53.40 2
. , '• •:, ' . . • • ,• CONTRACTOR ' . ' ' . . . Sign or outline lighting 53.40 2
Business name: NORTH SKY COMMUNICATIONS, INC. energy p
r energy p alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Pagc2 $75.00 2
City /State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (360) 254 -6920 Fax: ( ) 1- 866 - 530 -4325
Investigation per hour (I hr lain) 62.50
CCB Lic.:14117 I Electrical Lic.17 154CLE Suprv. Lic.: 173LEB Industrial plant per hour 73.75
t v. Electrician signature, required: ELECTRICAL .PERMIT. FEES''
Su '
P S 4 Subtotal: $75.00
J ACK CAGLE
Print name: Date: 1/23/08 Plan review (25% of permit fee): State surcharge (12% of permit fee): $9.00
Authorized sigt. TOTAL PERMIT PEP.: $84.00
Print name:
TERI RI A. M KU L IC Date:
I 1/23/08 This permit application expires if is permit is not obtained within 180
days after It has been accepted as complete.
• Number of inspections allowed per penult
I :StlulldingSPermnslL•LC•Permunpp doe 05/73/06 440.461STt l t /0$/COMAVED
•
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: El -0001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/24/2008
Phone: (503) 639 -4171 iNh
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/1/2008 TIME: 7:02AM PAGE: 69
SITE ADDRESS: 09955 SW WALNUT ST 7 CLASS OF WORK:
SUBDIVISION: WALNUT COURT APARTMENTS LOT #: 007 TYPE OF USE:
PROJECT NAME: WALNUT COURT APTS
DESCRIPTION: Units 7 -10. Fiber Optics for Verizon
OWNER: 1BLINE, RONALD G +, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 2/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 064332 -01 971 -563 -9326 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 2 ` \ ' 011 Phone #: (503) 718- 14