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Permit r ELECTRICAL RESTRICTED ENERGY PERMIT 4 CITY OF TIGARD I ° COMMUNITY DEVELOPMENT • Permit*: ELR2009 -00271 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009 Parcel: 2S 110AB00100 Jurisdiction: TIGARD Site address: 14040 SW 112TH AVE 34 Subdivision: PARKWOOD COURT APARTMENTS Lot: 0 Project: Parkwood Court Project Description: Units 34 - 43: Installation of data/telecommunications. FEES Owner: ALRANCO, INC Description Date Amount BY JOHN R RICHES, 2601 ORCHARD HEIGHTS Restricted Energy Permit 08/18/2009 $75.00 RD NW 12% State Surcharge - Electrical 08/18/2009 $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 - 530 -4325 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 through OAR 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. Issued By: Permittee Signature: �� � C rte/ 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' Date: LICENSE NO. Call 603.639.4176 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. a _ � ,, AUG 1 7 2009 CITY OF TIGARD Electrical Permit APPlicatiou .. .:' -_ F OR; ; O ht �ICE U SE ON L Y ;_ : : : ` ': ' ; :,. :; , EEnIP� .7 .... City of Tigard IREIrrinro 7 /I/ crm4 N,,,6- ' 0200 - ...... ego A.f/ 1.- 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review • ' Plume: 503.639.4171 fsts: 503.598. 1000 oamroy: Oilier Venal: TIGARD Inspection tine: 503.639.4175 Ualo Ready /11y: Solo. 0 See Pop 2toe Internet: www.rlgunl- or.gov Nwlfied /Mcihlul: _Vire' Supptementnt Information .. TYPE, OF WORK : : '.. .. • ••. PLAN REVIEW •i:::.': 0 New construction O Addition /altercation /replacement Nose chock ;di Mut apply (submit Intl of plans writca,rcea4cdedmv): 0 DdIh0111 Wt1 ❑ Other: Strike or feeder 41.19 amps or mow 0 n,dldity over Once umles, teem dm ,vajluhle Chen current 0 Marius nod bnmyards. ' • CA f GORY • Of :CONSTRUCTION • c.uuudo 10,000 on at ISO tolls , or a Rusting buildings. sic in ground. or curds 14,000 Q Cunnnereta•ase addeuburat Q I- and 2- lousily dwelling ❑ Commercial /indistrinl ID Accessory building Napr Ibr nll other 111%111111111011S. b1lllalnys. III Multi•fnmily ❑ Master builder ❑ Ober OFite in v. D Installation of 75 KVA m I74mergelvy ryrtom. IaiSor ssp 41 nrrd "°"'' "" ., . "''•':''':'. • JOB SITE INPURyIATION AND LOCATION '' '' " • .' . : ❑Addition nl new many tort n( ❑ "d" "Iti', "I•:!" "t• Job no.: lob she ndtlrecs: 14040 SW 112TH AVE I'16HP Of 11101V.. occopaney. 0 six or awe resihlaniaf unite, 0 Ramatiullal vehicle orkc. City/Slate/ZIP: TIGARD, OR 97224 lI,1 •coc Natter. 0Sapply dun voltage ❑ Harvdons locutions. MD rolls nomi,wl. Suite /bldg. /o no. q- © Project name: PARKWOOD COURT 0 Swvicoot feeder 600mosormom. ' FEE •ScIIEDULB • • Cross street/directions to job silo: u■ergnlen I Olv. I Phi. I • rah,l I - New reuldentlul single• or mu ltl•fnmlty dwelling mitt, Includes attached garage. Subdivision: Lot no.: 1,000 sq. It or less 145.15 1 4 Tax map/parcel no.: --- Ea. add'l 500 sq. 11. or portion 33.40 I Limited vitro, residential 75.00 D'G \CRIPI•loN OF WORK ' (with !limn itl.IL) INSTALL FIBER OPTICS FOR VERIZON liltlitetlenergy, ntulli- Illtaily 7500 ' residential (sing imam et. n.) Services or feeders inslallntIon mtd%or relocldinn 200 mops or Ica, I 80.30 2 • • ...ID PROPkR'I'Y•'OWNER I :. • ' • .. • 0' TENANT 201 amps 10400 limps I 106.85 2 Name: 401 amps m 600 snips 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 snips or vMls - 454.65 __ 2 City /Stale/ZIP: Temporary services or feeders Inslullallun, alteration, and /nr relocation Phone: ( ) I Fax: ( ) 200 amps or leas 66.85 I Owner instnllntlon: This installation is being made on properiy that 1 own whlch i s not 201 amps to 400 amps 100.30 2 (mended for sole, Tense, run, or escl uutge, according to ORS 447, 449, 470, and 701. 401 amps to 599 amps 133.75 2 Owner signature: �. __... - - - D uc: Branch circuits - new• nitermlon, yr extension, per panel A. lea for branch circuits icerh ' ! • • . 0 APPLICANT ' . • • : ' :1 . . . . . O N T A C T PERSON above service or feeder fee. 6.65 2 • each broach circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits Concoct name: ERIK SCHENCK ',whom service or feeder fee, 46.85 2 hat branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ttdd't branch citcuit I - 6.65 T blisecllatteous (service or feeder nut included) City /Slate /ZIP: VANCOUVER, WA 98684 buck muni0lculred or modular 90.90 2 Phone: (503 ) 969 -7729 I Fax:: ( 866 ) 452 -4853 Reconnect only t only null /or feeder ecounc 66.85 _ 2 entail: mduoraenorthskvcomm.com Pump orilripationcircle 53.40 2 CONTRA(7OR •• • ' Sign or outline naming 33.40 2 Business Ilamtlo: NORTH SKY COMMUNICATIONS, INC. energy limited. elter);y p alta:,liu16 vl Address: 11818 SE MILL PLAIN BLVD, STE 410 extension. Describe: 1 Page 2 $75.00 2 City /Scate2IP: VANCOUVER WA 98684 Ene tt additional Inspection over allownbloInan ofilicabove Phone: ( 360) 254 -6920 I Fax: ( ) 1 -866- 530 -4325 Per im 62.50 Invcsligndonl>erhour 62.50 CCB Lie.: 14117 I Electrical Lir.17 154CL sminv. Lie.: 173LE6 IudlalrMplant per hair 73.75 ' • ELECTRICAL PERMIT FEES • - Suprv. Electrician signnturc, required: Subrolnl: $75.40 Print name: JACK CAGLE Datw $/17/09 Phu review (2596 of permit fee): Slate surcharge (125b of (tennis (cc): $9,00 Authorized signature : r) _ TOTAL PERMIT Flat $84.00 Print name: ETHAN A. DOLPH I Me: 8/17/09 ' 1' hh oar ndluppllrndun mho/ II' a0urmh not ebrnlntdMHb111180 days after It Ito bsen lueepred Alf eumPlete• Nuodxr of lmpcclluns nllwsed It<r pennm. InQ■dtllnlu 'rru■hnlil.C•t4vm+Appulne au: sos u44oti NiX11x1..cosvwf>ll