Permit kW CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
i ! COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00126
DATE ISSUED: 5/11/2007
j D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DA-02402
SITE ADDRESS: 11155 SW HALL BLVD 25 - 32 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 S75.00
[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 By: e -yr // , :` Permittee Signature: $4Z, { ty/J1 64 tii)
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 -0T 10:20AM FROM-No r tyori 3602545097 T-371 P.005/017 F-380
Eielctrical Permit App c o - ' j e rvAiro e 1 ` ' , , r �,-
.�� •, � , .,,,,,t,..
- ter ,
503.639.4175
Ci ty of Tigard 1 ; Date/By Si N 1 ° 1 S Peters Nn _ ��- - Co 1,
.y - 2007
a 1 3I25 SW Hall Blvd., Tigard, OR 97223 Play Review
� p � ,p Other Permit E( .QU4 - fro 123
t r A te Phone: 503.639.4171 Fax: 50 3 T V' f I G A R d Da te/By:
«'4 Inspection Line: BUILDING DIVISION Date Ready /By: �� Supplemental Information
H See Pace 2 for
TI•. Inttcreel www.tigard- or.gov UILDNG D Not p _ p
- � F r.i *in 4 �, •• 6 y� �R, Ic ^ l7 °.. {�ti� i'f .�tM1 i 1;���r�C�%7., `!�;'Pr •��t", v `.. 'r' i L � :6��L �3•,�� �
Y, ,1 3a.6= ir:'i:. iv-r ,,,.,,,1,rfi "'1" I. r i ,ti �., . q,i . S� .��'�.1: �4 , r l�., .I 1, :L, �, Lr•�+ '4,t '. t7,_,.. l {;,r j! 1 .... 6 1. Nb
'� , �1 {lyk 11r IN !d1. .�} !.S AU�i .YJ9'J eP
�� � A. CF��ft +ii4i�.'��'.�1��lh�G r !l�`i,�fNn.`�"�-'.� „�t 1i�iL'a'� e d«L..a::7t.,...r....J...0 . w. �....�. trT k'.
�:...,.a'.7.r.�'uh.f!,�; I�;� +Y,� .,�,�u�dh, 4. i*:�'r'�'b����,s�.�.:iti '1��"�
Please check all that apply (subm 2 sets of plans w /items checked below);
❑ New construction rI-�-Il Additiot ✓alteration /replacemtalt ID
or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other: where the available find( currant ❑ Marin;ts and boatyards.
12. % ` ":1t 1 f 1 , t '` �r� :ll
" # e •- r 1 1a. a 47 � ' vri)' I� w c ,,, ;, exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
.16' ;. �,5, i i k . .� 1 l � r4,+' es.4 Ma I r' . r
}r ", al' tttU +. 0,. , 't
' less to ground, of oeeods 14,000 ❑ Corttmcrcial -use agricultural
❑ 1- and 2- family dwelling ❑ CommerciaVindustrial 0 Accessory building amps for all other installations. buildings. 0 Fire pump. ❑ [ 75 KVA or
n Multi -family ❑ Master builder El Other: Emergency system. larger separately derived system.
v c . -erne r rt , " t `s " i ? ❑ r etgen
•Ara..7. T. tM1 'y ti ,"; r.`� , 9 P�
1 ° , a�' S"� ;;( r ?1 .ttasr r t, .. ',O • e , �. • a ' t a r�Y6, P. . . KHj ❑ Addition of new motor load of p"A,. r,E„ . -2•',' .
��Ir?'trn��l�d�r��lrx+�!.'? ( , '�. di • • �'' _ �.,.. ti I1iY1u.X
A . . . •
r J .pM 100HP or more. occupancy.
Job no.: Job site address. l
❑ Six or more residential units. ❑ Recreational vehicle parka.
City/Stare/ZIP: , � �' �/ • El Healthcare facilities.
0 Supply voltage for more titan
tY � ['Hazardous locations, 600 volts nominal.
❑ Service or feeder 600 amps or more.
Suite/bldg. /apt. no.: 1 IF Project name: % i it 0 1 du 'Ai r i r, : c
Cross street/directions to job site: Description Q . Fee. Tatar -
IF
.. New residential single- or multi - family dwelling unit.
1 - 7 U r3 `�� a )] - ; - )` t Includes attached garage-
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'I 500 sq. ft or portion 33.40 1
Tax map /parcel no.: {{ ,�, q�r� r frith above sq. to energy, residential 75.00
4.1.E �xy i1T) ,1r K F. r t,la illin•4 • - rei,,4'� 3,"i"rA a '' y ' I . ; ' t ^��ny' 1 . r i. i'
t ' -�' to 2
i�i .it. �t 1. �5J1f ...' 1._ , y�j: ui. ■
Limited energy, multi- family LIVM 11i
�I� E�. a�A� jj 0A i� Mk I i residential (with above sq. R.)
75.00 2
Services or feeders Installation, altcration, and /or relocation
200 amps or less 80.30 2
IC "1 i'li4 057,5•0-
ei i4Ort .a'r a`z�rc.lss ''3r 4 e y ie t t �4 t • ,1 .- 4,.t•4 3, g,� Y A r„ A 201 amps to 400 amps 106.85 2
Name: 401 amps to.690 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts __ 454.65 2
Ci /State/ZJP: Temporary services or feeders installation, alteration, and /or
tY relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is b.. ing made on property that 1 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
�1 4
V , :( p "r FTW4 -r T F r (49 .4 , 11a t ° ►:,, S r'��dj�"c - d Ai r above service or feeder fee, 6.65
-. ;4I � ,a:.efl LS,I 5e, 'r1, . 0.'_''' a: i ♦ 2
Business name: �QClrt j y �:r} each branch ecircuit '. B. Fee for branch circuits
� without service or feeder fcc,
Contact name: r � �} A ` � `J . 46.85 2
first branch circuit -
Address: F1► t
`a•A ' 1 t F
� ` 1 l ,/14$1 j 4 )0,,r Each add'I branch circuit J 6.65 2
lYlisecllancous (service or feeder not included)
City/State/ZIP: V V 1 • I. 1.a• Q 6 1 Each manufacwred or modular 90.90 2
dwelling, service and/or feeder
Phone: (rj(1j) /. ' 12 % Fax: : ( LA ) 1 W i 3Q1 4. Reconnect only 66.85 2
Gtr _
E-mail: V I A i Pump or itrigatioxt circle 53.40 2
R+ �. ri /� .;. " a e: 3 ° o r ; .ask, , •'•, yg '`' -g • wp Sign or outline lighting 53.40 2
Signal circuits) or limited -
Business name: .6.14A. � LAP •V.e-' energy panel, alteration, or
Address: extension. Describe: 1 Pag -1 2
City /State/Z1P: Each additional inspection over allowable in any of the above -
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCI3 Lic.: \ Electrical Lic.: i: -1540z Suprv. Lic.: Industrial plant per hour !� !C 73.75
Suprv. Electrician signature, require& Subtotal:
Date: Plan review (25% of permit fr e):
Print name: ^_ State surcharge (8% of permit fee): 1., &
Authorized st -t -. • - -I _�_ -' 1 " . • ---L: :: ! : ' ------"'�-_ TOTAL PERMIT FEE: 1 -" ^ �� This permit application expires if a permit is not obtained within 180
Print name: -V l ai 1 L 1 i 4� v Date: y i `o - cloys after it tra3 been accepted as complete
• Number of inspections allowed per permit
I 1Bm7dinEtpcnomaitre- PUmirApp.dne OS/23/06 440.4615T(I1/05/COM/WEB
•
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: ELR2007 -00126
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2007
Phone: (503) 639 -4171 I�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/17/207 . TIME: 7:00AM PAGE: 7 fi
SITE ADDRESS: 11155 SW HALL BLVD 25 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 - 2037521
Inspection Request Scheduled For: Date: 5/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 048451 -01 ) 503 - 849 -5198 N
Corrections /Comments /Instructions:
. k PAS' n PARTIAL APPROVAL 1 I CANCEL I NO ACCESS
n FAIL U CALL FOR INSPECTION 1 I ADDITIONAL FEES ASSESSED
Inspector: G"--' 4� Date: din( On Phone #: (503) 718- Z 1 / V