Permit g'. y CITY O F TI GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
' ° ' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00135
DATE ISSUED: 5/11/2007
`TtGpRDA 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S135DA -02402
SITE ADDRESS: 11155 SW HALL BLVD 97+ 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: c--- f , _ / �./ Permittee Signature: P. r � f;r cr
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.
WY- 11 -07, 10 :23AM FROM -North Sky Communication, • . 3602545097 T-371 P.014/017 F-380
• 1 V ° it O R F F I C O 1 ' :
Electrical Permit Appllcai m b. # �F „� .. ,,.. „_ 0 ..�:...- .rte_
l } City of 'Tigard.
Received
oate/By 5 1 1 C, /n Perrnit 3--- 15
., J LY
11111 1 3125 SW Hall Blvd., Tigard, OR 97223_.. I_ LU Q�
1 Plan Review Other Permit: E ! ,a - .ti
5. I Phone: 503.639.4171 Fax: 503.598.1960 Datc/B ,
Inspection Line: 503.639.4175 V I (Y OF H I G f H D Date Ready /BY. � El See Page 2 for
p ^'
TIGARD.' N Noufiad/Method fl Suppkmentallnformat,on
yRtr +tom.�s Internet: www.tigard -or•gov BUILDING DI IIS
. i •:.17''� -:... - i a "-^ „ r A T? ,7 f r . tfT'+� T. 1 In a ,T N I ,,,.�rf ,5 ; 1 . r • a mac..,/* R 7' 7 .4 , R4 7 4^�.St. II
• t. . _ T I, t I ; �I t . � , ll t!{. ; Ir , • � , t +j;.{ I t '!I 4 S t J��r !,'jt rti l L f��' � r t ry, rul' a ` r ;V �;�,�b 54 S� � Jo �� I , '
,
'!rt t h � �i{ M'�.�J'�a14'I� f ar,127 �1tf,3r L�'1� I, ,i7�fr T,.S�EJ t,.r•,F�,�;r,>JS. Rc ,�;�,1:1ik iinl:,.'.iliunr'i��f:u.. }11 �1irY ,l.�. X4,.5 r all that .t,�,�,- (submit _ ,. t 27 la n s mr . �
' ": 1� l�u.� u Please check all that apply (submit set of plans w /items checked below):
0 New construction f„ P.ddition /alterarion/replacement
❑ service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other- where the available fault current ❑ Marinas and boatyards.
'''' . r .1
i >, r l it f ,' I' ,' iMfi n'. S�a iiMaf 'e: C;r . ii t irl l `tti -09�L r l', 4„ ,1 ... )r f r 1 exceeds 10,000 amps at 150 calls or ❑ Floating buildings.
ilr, #; t; l',11,n4, .:t 1:.Li:Pi .•,.., Y ���ir; 24:avl iro: ,!., ,, ;b't• 4kA .L6 , z a c 1 less to ground, or exceeds 14,000 Q Commet:ial•usc agricultural
❑ 1- and 2- family dwelling ❑ Commeraiallindustrial ❑ Accessory building amps for all other installations. ❑b Installation � of 75 KVA or
Multi- family ❑ ^77 r7.7 0 Em Emergency lug= system.
Ivlaster builder [] Other:
�� Ewer n derived s rem.
76,, .L- i w tl 17 ' a i :1 x" t rF ,, ltw m ` (g aTiO'•; 1 1141 4 '' .4 -, ,, t l }t;st 0 Additi of new motor Load of ❑ "A.., `E", se "1 separately derived
1001iP or mons. occupancy
Job no.: Job site address: . r " 4 O Sin or more r idenr al units. ❑ Recreational vehicle parks
I] liealdt -care catn facilities. ❑ Supply voltage for more than
City/State/ZIP: / ( �1 Q Hazardous locations. 600 volt nominal
Suite/bldg. /apt no.: , k i Project ,tame �1 / ❑ Service or feeder 600 amps or more.
j • s�Ti . `J' - # I �� ! . ra r95+, ` 'rs a_t: Y
Cross street/directions to job site: neser(rnan Qty Per total •
-
Ncw residential single or multi - family dwelling unit
'Y ( � J Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
- Ea. add'l 500 sq. ft or portion 33.40 1
Tax snap /parcel no Limited energy, residential r 75.00 2
.Us.�i T r t ,F { 1R nth /,a ,. 'o o e I 0 r t )a � )` r • � `7+:'T Y r, F �n � T A t ( whit ith above ,. ft.
ir.1f ,:,
t ++� U, r: , c: f l r•" '' Gt rt` ;' 4. ?..11' , . y , ti�l1 ,..d[, �k. 3 s.,. -411.,�F:, E 111 ,, t.,,,..�. � ted en ulri - famiL
Llrrri �Yr m Y 75.00 2 i p
A A �� i ` 1 co �� ^� res i d rn tial (with above sq. tt)
Services or feeders installation, alteration, and /or relocation
200 amps or less . 80.30 2
fit''" �'R t y 'x � n- '� r . r � �i' r �`1{1'A'
+t�;;tf, �� ? e � { + �r�" �, e 7 i� 1 � �dlt) �..y�,r't:lSwlir:,l..n 201 amps [o 40Uamps 106.85 2
i4G..T 'f = ,.'!rhl ri,,.+'... r � ' -1 :e ft1riSL;;`Y. ,aga.:h.. .S
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
City/ Statc/ZIP: Temporary services or feeders installation, alteration, and
'relocation
Phone: ( ) Fax: ( ) 200 amps or Tess 66.85 I
201 amps to 400 amps _ 10030 2
Owner installation: This installation is b: ing made on property that I own which is not 401 amps to 599 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - ne , alteration, or extension, per panel
Owner Signature Date: A. Fee for branch circuits with
T n , F L, ti r 1 :P + iE111 '�'r['^ J� r ` i , '' �, r r a bove service or feeder fee,
hu$ � I 6 i { c , 9 � i fi r,y.,..��1 r i � t CFf - ..•. " 40 � 13 0, ` , 'a t i +" 6.65 2
f lV ]1 Wt FJ �� „f Al Pi3 yri �LUa:dfl):`. ,, ,u:'.i .r�r+. ..e.••it.: a -' r'.r _ each branch circuit • Business name: Nth/61 Ii j tk t/ i L, B. Fee for branch circuits
without service or feeder fee, 86.85 2
Contact name: �.0 • e first branch circuit
ll /� / Each ad'I branch circuit 6.65 2
Address: I � .11/� t ! .11u� L4Tiscellancous (service or feeder not included)
City /State/ZIP: } 4 A. I /L. to ' W , r < ,, la D 1 Each manufactured or modular 90.90 2
�L r� J� M dwelling, service and/or feeder
Phone: (502) 1 1,10 ( ' 1G-J 1G-J I Pax:: (! . • r' 'I '7 rb ' f 4 Reconnect only 66.85 2
Pump or irrigation circle 53.40 2
E mail I =NIP M g IP l 1 I C.t) M ? ` � , sl { r Si or outline lighting 53.40 2
r at rr c "r•'v'>` 7.:74. 'r " ,T'� p�r :r , i
G +:w .,,,,- 1,q,...x .- - ;:t...q,..`rf 9 0..: O. a
.- . f . r w a. n ' b„RW.1 , 1 � ? JM i t, � ;y , ,,
r r " ( /� Signal circuil(s) or limited -
Business name: ' 1 S • •Ci energy panel, alteration, or •
Address: extension. Describe: ‘ Page 2 /t6 2
City / State/ZIP: Each additional inspection over allowable in any of Cite above
Per inspection 62.50
Phone: ( ) _ Fax: ( ) Invmarigation per hour 0 hr min) 62.50
ECIETEMIll Electrum] Lc.: I4 -151 cLE Suprv. Lic.: Industrial plant per hour 73.75
etWi�.•.:; . :77- A'i i t:l ? ' ' Ml "r irEi
Suprv. Electrician signature, required subtotal:
D ate: Plan review (25% of permit fcc):
Print name: State surcharge (8% of permit fee): ti 6V
Authorized stl.,.. -. �� TOTAL PERMIT FEE:_
t. This permit application expires if a permit Is not obtained within 180
Print name: - '1" l ( 1 �j CO pace; c.) 1� .411 This after it k m been accepted as complete.
• Number of iaspectioa allowad pet permit
te\Buuaiacu'ermitr■ELe.Pe rmitAyvdoe 05/23l06 440 -46 t sip 1/05/cot ervwD
CITY OFTIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00135
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2007
Phone: (503) 639 -4171 A rs
Inspection Requests (24 Hrs.): (503) 639 -4175 "�' ■•
INSPECTION WORKSHEET FOR DATE: 6/16/2007 TIME: 7:00AM PAGE: 57
SITE ADDRESS: 11155 SW HALL BLVD 97+ CLASS OF WORK:
SUBDIVISION: ST. JAMES APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: gr. JAMES ARTS
DESCRIPTION: In.,tallation 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: 5/16/2007 Pour Time:
Code # Inspection Description Confrn # \ Contact # Message
199 Electrical final 048363 -03 ) 503.849 -5199 N
\ /
Corrections /Comments /Instructions:
P
t1 PASS n PARTIAL APPROVAL — CANCEL 1 1 NO ACCESS
FAIL H CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: . N156 Date: Si 1 P hone #: (503) 718 - 4 •
, . .