Permit r. � a� 7sr,j�ti
"` CITY O F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00127
C 'xA retDo 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/11/2007
PARCEL: 1S135DA-02402
SITE ADDRESS: 11155 SW HALL BLVD 33 -40 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 $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B4i/Mb /// Permittee Signature: 4 p p liCrJ 1
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
MAY -11 - 07 10:20AM FROM -North Sky Communication 3602545097 T -371 P.006 /017 F -380
E1ectricaI Permit Annlication E C l I Lm - f ;,! ° _,.: , '_ , . - �- r taiegi o!
Cl O T'aard Date/B Permit No.: City Y: 5 5L Eu2 Z(�U' 'CSI 24, �V v 13125 SW Hall Blvd., Tigard, OR R 97223 Ptah Revi Q� (�3
;n ... .. r Phone: 503.639.4171 Fax: 503.598.1960 �` - t 1 1. 1 2007 Date/By; Other Permit: ewe. 2W'_ -
Iuris: H Sce Page 2 for
? I ° ARn• Inspectio w w . 503.639.4175 �i 1 Y Ur I t lr (_ ; Notified/Method: '�� � supplemental 4,. ..tat .. imemet www.ttgard C '� t� '
r P 77fir41r,i Lxr.. -r r .7 c+ x t ' k. TO7... '. �, h „- 'i`'"` ,. 'G ,t ttty0.4i
t ,,,, ; :V•• l.;Y� �.�..77 •�j, y a, 424$ j ,
7�' t e F Ji �1 a ?;: 1�, t 9'�"T'. ♦ti , ti,��}y d,s•: Y .-, ,, t c F t f �� , .+M1 1 4_qy 1 ✓ 2.�i+. f�� � r1' 1.ir
� '; T {� "��i4i�L1�t��,;. y5 � �t1+ r � ,�4 ? t } Lt .1ti1 :�1'�7 J � ,. I�: �u�tiS"' �F. kl. rf4 ;�.���f��ii�.,' 6.�''�f�, !`! ��56r� - - Y1 :���. t . �.- � ,.�7�.�� �1r7 i l��iva
i -L •.. `° Please chock all that apply (submit 2 sets ofplans w /items checked below):
❑ New construction ir - ddition/alteration/replaeement
❑ Service or reader 400 amps or more 0 Building over three stories.
Q Demolition ❑ Other: where the available fault current ❑ Marinas am' boatyards.
t' n ,+ + r- w. ?y .+ , i c "N ` iY t y!, i ttl� r ' a W : o- ( ., , , exceeds 10,000 amps at 150 volts or ❑Floating buildings.
,,s2:11 n err , ° ' ' r i, , v °� 't - ) �v less to round, or exceeds 14,000 ❑ Commercial -use agricultural
tA�l I Fat e'S� V. r � fTIf i c ki � o- ii x 'k,' y °M ad. , „ y
F
❑ 1- and 2- family dwelling ❑ C ❑ Accessory building steps far all other installations. buildings.
Kw Multi—family ❑ Master builder 0 Other 0 Fire pump. ❑ Installation of 75 KVA or
urger separately derived system.
y y } r ". , - ❑ ey stcuL
s�rG LL` )r Ai 1'' AVIV a s v a je pr a W I r.:.' .. 0 7 14 i .. a •' . -, V •� •4 J a hu' :' ` ❑ Addition of now moto load of
V ' 4? 4F>` R.• , "A° ,. 2• - 1 - 3 ,.
IOOHP or more. occupancy. no.: Job site address. y �, ( 1 �L i • ❑ Six or mots residential units. ❑ ticcreational vehicle park:.
City/State/ZIP: `\ '� �(
A p,1 /1 - ❑ Health -care fi 0 locations, cilities. 0 supply voltage for more than
� J (/� 600 volts uominal.
❑ Service or feeder 600 amps or morn.
Suite/bIdg. /apt no.: Project name: g 04101 S �� T €y �:,��• �� ,� 1 �,. ,.- t
V ,, �..sur ,•lei 0 501k ri. . • .. iii, l i" ,c, 1 M
Cross street/directions to job site Ursula/ion qtr. Fee. Tram! '
New residential single- or multi- family dwelling unit.
p , Includes Attached garage. 1 40
Subdivision: 0 Lot no.: 1,000 sq. 11. or less 145.15 4
T
—.. - Ea. add'1 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
r a +yn7^t'> v , "'x r ' ti7 .+ 5 " r "; ' "" s "la (with above it) 75.00 2
f!' ).�� `} il, 'i' �'r,ra5 +1.` i�f �r}t7, " .I�l r tbn+ t
Limited enapy, multi-family 75.00 2
1 1 i 0I 1 f . I, , ` ' residential (with Above s•cLtL)
Services or feeders instailation, alteration, and/or relocation
200 amps or less 80.30 2
,-, , iry �, n 'rt t • s , r r 201 amps to 400 amps 1, t„ t i � (? . . a , e 1 +3 h! /E.. , a .' d l < . • •F '63 h��air;3�c I '� •')"' s 106,85 2
1 p
Name: 4Q1 amps to 600 amps _ 160,60 2
- 601 ampA 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 i 66.85 1
Owner installation: This installation is bt:ing 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 70I. 401 amps ro 599 amps 133.75 2
Branch circuits — new, alteration Or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
Y'q t - rs F ',,zi: 4 , ,a ' m t r y , m w +ti• 7,' t �' Il above service o,
,,v } rrF,ti y EO iy rS e� r � !4: �' ��'a �I'�. :U !�(a - a'• • . b vie r feeder fat 6.65 2
:.ifa �! 4i.1Efirrr11 .. L'us � �dl' ;l� 1i a u a 7 t n a
N t r �t A - each branch circuit
irc
Business name: s v ! B. Fee for branch circuits
without service or !coder fee,
first branch circuit s 46.85 2
Contact name: k
L u l I ; t
F�
Address: 1 <11S S w , 1 t I OCI it _ [ eJ Each add'l branch circuit L L 6.65 1 2 .
�/ [ ' Mlsccllancous (service or feeder not included)
Ciry /State/ZIP: (� �(t �J [0 S -7 Each manufactured or modular 90.90 2
s " t '�` ` _ n dwelling, service and/or feeder
Phone: ( 666 ) -1 4 4 , C� 'l Fax: ( l 1 l j , ?j� �.- Reconnect only 66.85 2
E 1/ 17MPAiral . a 0 A i Cb M Pump or irrigation circle 53,40 2 ,
T' n , /' ;'+ y " •: t y 'S1!S� ff �tti IS t, i O r4 't�' ; y y f�'' • ' y w 'g' :a•w' ', .,� Sin Or outline li
• sign 53.40 2
S�rd'StJ J:��l i) sGI :I � Z ry iS ,. . Al 's?�, - tn �J re. ,•, • ALi , .w.1. • $, If - a 97, r _
�t ( i •v n Signal circuit(s) or limited -
Business name: L X/ energy panel, alteration, or
Address: extension. D Page2 -1G 2
Ciry /Statc /ZIP: Each additional i ... ection over allowable in an of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr rein) 62.50
CCB Lic.: \IA/I17 t Electrical Lic.: II - - 54/4 Suprv. Lic.: Industrial plant per 73.75
-yw;� rr� i• r
i. -7jv4 Pi= (a��i ld!,• C'� - ' t`„u, 4A ii •}1 •ba"' F x ;� i l, • .4`121
Suprv. Electrician signature, required: Subtotal:
Date: - Plan review (25% of permit fee):
Print name: _ State surcharge (8% of permit fee): 111 a
Authorized sl l 63mce `� TOTAL PERMIT FEE: 1
....
�� This permit application expires if a permit Is ooh obtained within 180
Print name: ��/ i - f ( j 1 G ' CO Date: / 1 V days after it has boon accepted as complete.
• Number of inspections allowed per permit
I En.i.doetpermluneLC Permitnpp.doo 0523/06 M0- 4615T(I I /0S /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00127
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2007
Phone: (503) 639 -4171 '- .
Inspection Requests (24 Hrs.): (503) 639 -4175 e112
INSPECTION WORKSHEET FOR DATE: 5/17/2007 TIME: 7:OOAM PAGE: 75
SITE ADDRESS: 11155 SW HALL BLVD 33 CLASS OF WORK:
SUBDIVISION: ST. JAMES APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: Si . 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: 5/17/2007 Pour Time:
Code # Inspection Description Confirm_# Contact # Message
199 Electrical final 048451 -02 \ 1 503 - 849.5198 N
Corrections /Comments /Instructions:
-- A)
PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G 1441 "*I Date: Gin n Phone #: (503) 718- ZL I Lib