Permit iv CITY OF TIGAR1 „ ..
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00134
TitroamD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/11/2007
PARCEL: 1 S135DA -02402
SITE ADDRESS: 11155 SW HALL BLVD 89 - 96 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 By: /I i 1� Permittee Signature: � a l i �'�, ; h�
I�
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 10:22AM FROM -North SkRdrijn1 l�.iv 3602545097 T -371 P.013 /017 F-380
Electricals Permit Application .� a
- if Li
: OFFICEUS)r • i` i rd ... .. 1"14
l I , : ; Received � J t'ermltNo.. 1"; 4 s Ci of 'Tigard 2001 DatdBy. 1l I I b .7 r , � D
1141 ' N a 13125 SW Hall Blvd., Tim, OK 97223 1 -r y r i r Plan Review
Phone: 503.639.4171 Fax: 503_595,176 `'0 - U \ R D Date/B , Other Permit .' - �(
U i L. D I N G D I V i S i D ate Ready/By; • 11a,s: Ea Sec Pace 2 for
Inspection te : ww ne: 503.639.4175 Uhl ' ler Supplemental Information
TIGARD �r ov Notified/Method: � R ��a,•r Internet; www.tigard .g
�.�n.. ., t 9 > ,,.' t . ., � . 1 1 .7 , 7m•e7 �C7 7 - - �-
„- • ,'/.'� - T ,, ,, 'r, _ l t , ; . tr C fi ; �} FI Y t7
. I r . -1 -S { r e'- c. •, - s 't ' l:`"T^ ( - + ,43,4 . '.ii 4 ., ,.gy�pp,4,0-,..•, � L , ., 11, ,1.. t x91. ,,, ul' q
1 ^ .' .?. L: aV �, '10 f l� i" r, ,11, i4�t"'V.'" N y �•
7 , P 'IN M Nr " 4 I r k I } 'Ac �• i L ` . Pt 7 }7 2 s.1 I .rat . J . ,1I J!�� 4.. .._,.•� : S.. . ' . : . • - .@. I. �...i. . :�.� . r .. ....;u�5 - .,,J .. Y..... ∎,, ,.lM.�/ r....
.. � �'•� ,� l n7'j � Y l. '� I/ r ap ,.. ' ( . y .i: L r+r:.a..�. } i��..._,j) u•
Please cheek all that apply (submit a sets of plans w / checked below):
❑ New construction , Addition :alteration/replact:ment ❑ serviCe or feeder 400 amps or mere ❑ Building over three .Aeries.
❑ Demolition ❑ Other where the avaibnble fault current ❑ Marinas and boatyards.
f( r, T jf Si �'° �J " {t I W f "" 1^ , 5 °�(� L"-' w ,r rtr7" q0.i' e7� , ra 1 ; :�"P . ?P V. exceeds 10,000 amps at 150 volts or ❑ Floating baildiog -
f fi ' y,t.t N'II• " ! , dj M I. �� t tr 0 6 ti 6a (0 6 i e �1r t , 7 �
°'1;N Al6,Q1,1 y /l b 1.{IF � � ( � ..F" r, ,, 1 :JL. its t u ,. d , less to ground. or exceeds i.
E „ „ ,,,�,. • �,,, ,., ...exceeds 14,000 0 Commercial-use agricultural
0 1- and 2- family dwelling ❑ Commertial/industrinl ❑ Accessory building amps for all other installations, building.
■_ Minn family ❑Master builder ❑
Other: ❑ Fire pump. ❑ Installation of 75 KVA or
c - r *tr 1 w a iv. t' r' w ` y �L�F(r� 0 Em system. larger separately derived sYs�m.
-- r .,,..,.,„ q ` c I ' d })r I ,l 1 t i I ZTr �• O z ', rd t "' u is r t� (" 7 , ;.Iz . , y v �. ,F 'rFF • ❑ Add i tion of new merit load of ❑ "A ", ..E....1.2,...1_3..
tis',Ta /sa 1. r.,v,, , ,. Occupancy.
I I DOH or mots P cY•
Job no.; Job site address: i , 1 V I ❑ Six or more residential unite. ❑ Recreational vehicle parks.
❑ limo... ❑ Supply voltage for more than
City /StateJZIP: ` / j `� ��' f� ❑Hemrdous locations. 600 volts nominal.
Pro ect r carne: / ❑ Scrvitx or feeder 60C) amps or mole.
Suitclbldg.lapt. no.: J %„1,1 I L 0 4. Iki t I 7 �o r 606 a I ,r _ g d e , ' ' S `1 ti" K .t
-- ,..4 • .L:..aJird• � �. d JIM ENT
� '
Cross strce,t/di ectlons t0 job Site; pl4Cripdan Qty. Fee. Tornl
Lin - New residential single - or mufti - family dwelling unit. -
Includes attached garage.
Lot no.: - 1,000 sq, ft, or less 145.15 4
Subdivision: Ea. add'1500 sq. ft. or portion 33.40
Tax map /parcel n0 p Limited energy, residential 75.00 2
'1:•�i 1 Y 41 �� h , () Y 1'� � � ' � f��1 t�, 1 "
;.1? : `7177P 't F ,, t t . t 4 7 1i ,rig:_ lt '. . er 6 ` a ' jl ,h� . t!`" r , I 1 ,F'i F R - .� , (with above sq. R}
Ld i.dZ tier P 1.-i�i a . ll ;•• .. i .`••` "' I iluited energy, multi- family
t w � , residential (with above sq. it) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or Ies 80.30 2
TIi11i / Mat~ S e "�° , ` `I ,: 1aSrf,} � p u7 :� " 4Ert � t - ,,'` "� 4;a 201 amps to 400 am I06.$5 2
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
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: - .r relorrtlon
Phone: ( ) -
Fax; ( ) 200 amps or leas 66.85 1
Owner installation: This installation is bring 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 - ncw, aliening!, or extension, perJJAttel
Owner signature Date A. Fee for branch circuits with
i 7', i t C f C as , I P,7,7: (, I - 6 `W n r .N •t!'E , above service Of feeder fee, 6.65 2
, li.; r �,'Jc ? N,11`! - � i l li'l J•,. a.r. a ._1 1e.I.Vr.., . ll a l es . ,...) .i.' .. .y „C.,L G 1: t , �r?...�
� " "' O il " " '' each branch circuit
Business name: tiOki �'� y ,b ,ll v [ B. Fee for brunch circuits
without service or feeder fec, 46.85 2
Contact n ame: 'tea ., A .1 / le j lust branch circuit
Address: I i ' 1l 6
ii t T �13`li /� ! 1 Each add'I brannh cirCcircuit t 6.65 2
'
Misccllancous (service Os feeder not included)
City /State/ZIP: j , A .lit J j UPI l ♦ , i' Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (6j®j)'J,499 '' 1 1 Fax :: (iLp , 1 OA i $1:) Reconnect only 66.85 2
Email V I7i rj MA / 0 ,(I 1 Cb Pump or irrigation circle 53.40 2
ii.E t/( {In. ' sj . S �� y lib i 2 F "! !`I, I "` e ��� �t 'eli.'s `, ;,, a t , *r41 u..J iy. Sign orourlinc lighting 53.40 2
., c.. :x+.,41iir!MJe41 "f (` •.�V
S M^ L A . /AP•L / Y � Signal p t(s) l, alt e r limited -
B usiness name: W t energy p or extension. Describe: 1 Page ^ 16 2
Address:
City /State/ZIP: Each additional inspection over allowable In any of the above
Fer inspection 62.50
Phone: ( ) 1 Fax: ( ) Investigation per hour (1 br min) 62.50
t Electrical Liu. uprv. Lk._ Industrial plant per hour 73.75
cT7 (� ' ri "!t iri•'1 � [ i� t " Ji '��ll 'l�d� '_�,.+5.� t I � � ��t�r!,N',
,;,Ir••I ,�F�e.;.e;.,,riF� .�.,,�.1'�ra�A:^e,��,.S�,G,... ' '�icl�i'
� f':•J`1, I
Suprv. Electrician signature, required Subtotal
Date: Plan review (25% of permit fee):
print name: State su charge (8% of permit fee): J0
Authorized sl = - •: - '" �. TOTA 1 PEltM1T FEE: 5k
� � j t,/ '' � This pi application expires if a permit is not obtained withi a 180
Print name; <- ( ∎ , , L l c, t /f Date: /• 1 V , days after it has been accepted as complctc-
--/ • Number of inspections allowed per permit.
latuiltLanTc mits3Et.C- Pesmitnpp.doe 0523/06 440 - i5T(7 v05/COM'VEB
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: ELR2007 -00131
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5111/2007
Phone: (503) 639 -4171 ' `�� ;��>„i����
Inspection Requests (24 Hrs.): (503) 639 -4175 �'' "',...
INSPECTION WORKSHEET FOR DATE: 5/16/2007 TIME: 7:O0AM PAGE: 66
SITE ADDRESS: 11155 SW HALL BLVD 89 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 #: 503209 -7521
Inspection Request Scheduled For: 7 .- - Date`: -- --5/16/2007 Pour Time:
Code # Inspection Description / Confirm4M Contact # Message
199 Electrical final i 048363.04 ) ` 503-849-5198 N
Corrections /Comments /Instructions: \
•
► \ PASS PARTIAL APPROVAL n CANCEL Ill NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-- •
Date: 5 I 1'0( 0 I Phone #: (503) 718 -7-1_Fv