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Permit " `i EL v Ma C OF I G/"� ® ECTRICAL RESTRICTED ENERGY PERMIT - . ' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00124 TFGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/11/2007 PARCEL: 1S135DA-02402 SITE ADDRESS: 11155 SW HALL BLVD 9 - ZONING: R -12 SUBDIVISION: ST. JAMES APARTMENTS LOT: 010 JURISDICTION: TIG PROJECT: ST. JAMES APTS Project Description: Installation of fiber optic 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: Owner: Contractor: JOHNSON, LYNNE AND R BLAKE NORTH SKY COMMUNICATIONS INC TRUSTEES PO BOX 87550 2445 -A MAKIKI HEIGHTS DR VANCOUVER, WA 98687 HONOLULU, HI 96822 Phone: Contact #: PRI 503 -209 -7521 FAX 866- 743 -3974 FEES Reg #: ELE 17- 154CLE LIC 141171 Description Date Amount [ELPRMT] ELR Permit 5/11/2007 $75.00 [TAX] 8% State Surcha 5/11/2007 $6.00 REQUIRED ITEMS AND REPORTS Total $81.00 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 B , �� Permittee Signature: cAl 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. MAY -11 -07 10:19AM FROM -North Sky Communication 3602545097 T -371 P.003 /017 F -380 Electrical Permit Appu , 2 001 1N • Rt10I1 ! �, ^!�. �Ir kry; _ �r ; _.s AJ5IV v■• * P ermit No " City of Tigar C l fY OF flG� ��i Bea A y 5 It 0 4 61.0 1 _Ail- - 1_ 1Z - . / 4 13125 SW Nall Blvd., T igard, OR 97223 Plan Review Phone 503.639.4171 Fax: 50 1.598.I1UI LD I N G D I V I S I O llate/gy: other Permit E J ?gyp}. -00121 ' •�v:;.. Inspection Line: 503.639.4175 Date Ready/By: curia: 0 See Page 2 for Ti l3nR D ' Internet W W W tigard-0r.gov m s: Notified/Method: Supplemental Information +� - �, .. ra7 ,i ' s .. T .,.., ^-�? , "C7r� "ate`' i '�t i : r' C �' t . d . ��1' 1,., V)i. �y.4• , t ' i ,� ,i y., S'∎ViWZI .wf I kf,,t t ,i r .. V � � t�}�r {�???' r gtr.t� �w�,. ,� ,,�li!, h ' E � �r �, j;ti , , F N ' ,(1 �. i ,{ 4! 4 r C s fii . ' 4 v i j ' u 1AtI 1'0 ,+ 12. 1 , y " t ! y - .I�S��s 4� Y i $ tl�tcLirJ�Jr ;M; 1 3�Z . y� 17 1�u awu�9L ill ve! {rl7 „S IrdlCiU14:t5t`lu oE Si {i« yr. ' tLti�l ,e r� {W�.L N Please cheek all that apply (submit 2 sets of plans writems checked below); ❑ New construction irt • ddition/altetation/replacrment ❑Service or leader 400 amps or more ❑Building over three s rorica. ❑ Demolition ❑ Other: where the available fault current Q Marinas and boatyards. 'i 49'F h � � � r ;e.�' + r �,��t, � °' t; '! - rt , d 10000 exceeds , amp a Q Floating buildings. a r , r-}f ,� - '"lG `r� 1 . , f �I f * I,7i..g1 " ? 4i '� l,1- r ,. ".'r�- d 1: 0 `7C` h.; 7���at�. 1 r .l ,� .V i ' ',..., '� P at 1 SO votes ' �'r52wt ' �� +.,� =" =�i1 ui9+!���•�•�' . �, " r , . L M t.,. -� f u: +,l.ztalj�tar3 �' less to ground, or exceeds 14,000 ❑ Commerr:ias.usc agricultural ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. n Multi -family ❑Master builder ❑ Other: ❑ Fin: pump. ❑ installation of 75 KVA or -- ri s;:' „ , r-r *n ❑Emergeocysystem• larger separately derived system. P� ..yy 4 4 F V ,7+� h:'ik r a • "tl �tj.VO (1x 174 Y,y',r„�i''', i � X. tw "� <<.i j ..44, - 7';1 % :� u�ti • � E } ,i 7y,. s � � , tl - O l E 4 A , de.. t a Addition of new motor Inad of ❑ "A ", ..E ", "1.2 "1 -3 1,1 1 � _ p n * d S ix or Or enure. occupancy. Job no -: Job site address: J ��(� ❑ Six or more residential units. ❑ Reercatiooal vehicle park ii. City / State/ZIP; / 1 \ � vpi, ❑ Healthcare facilities. 0 Supply voltage for more than _ g Q Ba7 nlous locations. 600 volts nominal. t no.: - 0 Service or feeder amps oore Suite,/bid / � Project name: � .�p� ��, 'W� fd 600 or more. _,,,. , 41r Cross street/directions to job site: fl ieriptton I Qry. 1 _ Fee. J rota[ 1 ' ri �., "�' Ncw residential single- or multi - family dwelling unit. 1'1 1- 1 L12 Includes attached garage. Subdivision: Lot no_: 1,000 sq. ft. or less -I 145.15 4 Ea. add'' 500 S4. ft or p0itio11 33.40 1 Tax map/parcel no Limited energy, residential 1 , : I r ,rq c . , ��;,r r ' .�+ 75.00 2 -AA . L. t ', t . .`, 1 l i � ' r tin ` f � 'zr� 1:.' i3,`d -; ! • D A., , 1 ) 'e r ' r • + ' : :a1:Jai w y ' fid 4 , , (with above sq. ft) ` � . - 1 imited energy, multi- family 75.00 2 • 1 / . ' I � C1 r/ fC w [ !/t;/` J residential with ab s . ft Y Services or feeders installation,altcration, and/or relocation 200 amps or less 80.30 2 i y� m'p' g 1 uy a •• o ti , o , +I'I'I. ° g • , !,t u .14.4 jCI �, x;1-1. . '1 it ; r ' 1 `' yt `r , „ " + � : 'El'. 201 amps to 400 amps 106.85 2 �iiJ:rti ,, .n v1. � n . 1_ 1 k .' li g_. - ,, . i ,,, h' 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 • CI /StatcIZiP: Temporary services or feeders iWWStallation, alteration, and /or LY _ relocation Phone: ( ) I 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, rcnt, 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 "'ti• , ,Ir w T 'rr:r�, ti t f j 'M r +!' . ' �. . fee, 14 of l :` t, i *,l f fr1�L7 w,!n 't" :l..1Jret i at' �r t N + .[4aC ft t; � n , .rl` ' above Service or feeder f each ,f /l l_l }] L �l1tn" s, : a�- � 4 A "- °� r�� ' !rya �1 each branch circuit 6.G5 2 Business name: N �tl l t/ • t ( ail' B. Fee for branch circuits without service or feeder fec, es 2 Contact name: .rJM. A ,, ...branch circuit Address; J 4 ' t 41 S i W‘.1\ l (,Jtr1 6. q,• '1�i Each ndd'l bnmch circuit 6.65 2 _ � l ` ' � ` - S �t Miscellaneous (service or feeder not Included) City/State/ZIP: ` i � Y J 7 ill 1 Each manufactured or modular 90.90 2 * _, , ,1 dwelling, service and/or feeder Phone: (6(h) '7) ' -! r !i k Fax:: ( p1 CAL - ? j � 4. Reconnect only 66.85 2 E-mail: y SM j 0 A 1 . CIS Pump or irrigation circle 53.40 2 r1;4,Ji l.`�t•)4 4 � y rm a tt E s .,,,, 41.1. PAI ;'47, Sign or outline lighting 53.40 2 hl.l F ,r l�'/ �.>n r.,t� fi i~���'���4tk' 'rT 3 ... Pa . dj /� Signal clt0uit(g) or limited - Business name S (`�/m,� �� t�/ energy panel, alteration, or Address: extension. Descn I Pagc 2 /1 2 City/ State/ZIP; Each additional inspection over allowable ill any of the above - Per inspection 62.50 Phone: ( ) Fax ( ) �, Investigation per hour (1 br min) 62.50 CCB Lic_: 1 41 ` I t l Electrical L, c.: II - I5/} Ct.E Strprv. Lic.: Industrial plant per hour 73.75 Suprv. Electrician signature, required: Subtotal: Print name: Plan review (25% of permit fee): Date: e p-- State surcharge (8% of permit fee): [p Authorized s l TOTAL PERMIT FEE I I . r •Thla permit application expires if a permit is not obtained within 180 Print name: �.�� 1 I 4t� G 1 l nr� V Date: �,� �� days after it has been accepted as complete_ • Number of inspections allowed per permit. 1:\BuitdingWa.diu C3ennitApp.doo 0583/06 4•0 461ST(I1/n5/COM/WFB CITY OF TIGARD BUILDING DIVISION PERMIT #: EL_R7-0s07- 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2007 Phone: (503) 639 -4171 '�I Inspection Requests (24 Hrs.): (503) 639 -4175 .- -'£M'- ^:_ . INSPECTION WORKSHEET FOR DATE: 5/21 /2007 TIME: 7:02AM PAGE: 40 SITE ADDRESS: 11155 SW HALL BLVD 9-16 CLASS OF WORK: SUBDIVISION: ST. JAMES APARTMENTS LOT #: 010 TYPE OF USE: PROJECT NAME: ST. JAMES APTS DESCRIPTION: Installation of fiber optic for Verizon_ OWNER: JOHNSON, LYNNE AND R BLAKE, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503-209-7521 Inspection Request Scheduled For: Date: 5/21/2007 Pour Time: Code # Inspection Description Confirm Contact # Message 199 Electrical final 048691 -02 \\ 503. 849.5198 N Corrections /Comments /Instructions: N,,-..._______- / , 4 A PASS 1 1 PARTIAL APPROVAL ❑ CANCEL NO ACCESS n FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED Inspector: GTht '" 0)(—G Date: 61 2 4101 Phone #: (503) 718- 2'