Permit f----,.ip u CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00331
'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/9/2008
PARCEL: 25101 DB - 00801
SITE ADDRESS: 13325 SW 72ND AVE A ZONING: R -25
SUBDIVISION: HAMPTON RIDGE APARTMENTS LOT: JURISDICTION: TIG
a- PROJECT: HAMTON RIDGE
Project Description: Units: A - J. Installing fiber optics 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: 1
Owner: Contractor:
HAMPTON RIDGE APARTMENTS LLC NORTH SKY COMMUNICATIONS INC
15952 SW PARRISH LN 11818 SE MILL PLAIN BLVD
SUITE 410
VANCOUVER, WA 98687
Phone: Contact #: PRI 360- 254 -6920
FAX 1- 866 -530 -4325
Reg #: ELE 17- 154CLE
FEES LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 12/9/2008 $75.00
[TAX] 12% State Surch 12/9/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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. • • • • or .: $0.332.2344.
Issued B • - ;_'/ Permittee Signature: % / C,(7`j
�/ 'rl
OWNER INSTALLATION ONLY
The installation is being made on property 1 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.
- • .. . RECEIVED
fr aS 1°05 - uc c o(
,SEC 0 9 20
Electrical Permit Applicatio
: FO1t OFFICE USG ONLY :. ;;
City f Tigard Itcccivcd ,
y I , O F TIGiARD 2 • .0% Perm N » .: .
117 't 13135 SW Hall Dlvtl„ 'rigor pat ef0 I do. :. 0033
Phone: 503.639.4171 Fax �� G DIVISION Plan Review ual Olhn' Permit:
aDy:
TIGARD Inspection Line: 503.639.4I75 Date Ready /0y: /Wi.: ® Sec Page 2 for
Internet: www.tigard- or.gov Notified /Mcl T l Supplemental Information
TYPE OF WORK • 'PLAN REVIEW ...
❑ New construction 17I Addition /alteration /replacement Please check all that apply (submit 2 sets of plaeu w /iteniv checked below):
0 Service or reader 400 amps or more ❑ (minding over duct stories.
❑ Demolition ❑ Other: where the available Iaudi current ❑ M»rinas and boatyards.
• • CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Ices tat ground, or exceeds 14.090 0 Counncreiol -use nuletihurd
❑ 1- and 2- funnily dwelling ❑ Commercial /industrial ❑ Accessory building ;cops for: it other instalhWwts. buildings.
Q Multi-family ❑ Master builder ❑ Other: ❑ fire pump. ❑ Installation of 75 KVA o
JOB SITE INFORMATION AND LOCATION O F ncrgl c cy system. larger scpat:ucly derived system.
❑ Addition or new mater load of ❑ "A" "1:" "I • ?,• "I.3
Job no.: Job site address: 13325 SW 72ND AVE. Icx3Hpormom. occupancy.
❑ Sts or mart residential units. ❑ !tccrcmiunn! vehicle 'mkt
City/State/ZIP: TIGARD, OR 97223 ❑ Hoahh.cate facilities. ❑ Supply vohaec for Moro than
0 Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: A -J Project nave: HAMPTON RIDGE ❑ Service or feeder 600 amps yr more.
• FEE SCHEDULE '
Cross street /directions to job site: nescri new,
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft. or ICSS 145.15 4
Ea. add'I 500 sq. 0. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential -
75.00 2
DESCRIPTION OF WORK (with above sq. 0.)
INSTALL FIBER OPTICS FOR VERIZON
Limited energy, urolti.0anily 7500 " 2
residential (with above q. n.)
Services or feeders installation, alteration, and/or relocation
200 amps or less r 80.30 2
P R O P I R I Y O W N E R L •
0 ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps
160.60 2
Name: I •' I
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 turps or volts 454.65 2
City/Stale/ZIP: Temporary services or feeders installation, alteration, and/or
, relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being i nane on property that I own which is not 201 amps In 400 amts 100 30 2
intended for sale, lease, real, 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: ___ - - -_ —..
-- ' -- - - -• - - -- A. Fee for branch circuits with
0 APPLICANT 1 p+ CONTACT PERSON above service of reader ice, 6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. D. Fee for bratnchcircuits 1
without service or feeder fee,
Contact name: RYAN ROBERTS first branch circuit 46.85 2
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'l branch citettil 6.65 2
Miscellaneous (service or feeder not Included)
1 City /State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90.90 2
dwelling, service and /or (ceder
Phone: (503 ) 519 -5264 Fax: : ( )1- 866 - 905 -4907 Reconnect only 66.85 j 2
"ail: mduor Pump or irrigation citcic 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or li'tined-
Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, ahcratian. or
Address: 11818 SE MILL PLAIN BLVD. STE 410 exicnsiotl. Describe: 1 Page 2 $75.00 2
City /State /ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phonc: (360) 254-6920 Fax: 0 ( ) 1 -866- 530 -4325 2.
Investigation per houl'(l hrn,in) G_ 50
CCB Lic.: 14117 Electrical Lic.1 -154CL Suprv. Lic.: 173LEB n,d»si did prant per hour 73,75
ELECTRICAL. PERMIT FEES
Suprv. Electrician signutute, required: Subtotal: $75,00 ._.
Print name: JACK CAGLE putter Plait review (25% of permit fee):
12 -9 -08 Sue surcharge (12%b of permit fee):
$9.00
Authorized signature: 0le _ TOTAL PERMIT FEE: $84.00 _or
Pt inl name: Date: This permit application expires if a permit is not obtained within 180
ETHON A . DOLP 12 -9 -08 clays »flee it has been accepted ms complete.
` Numbet of inspections altuwcd per permit.
l■aoill■naU 'cool„ \I:1,C.1'rntia. \'p.doe Ob23/116 .141.401 %l•(11 /nt /( :OM0Vlin
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008-00331
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/9/2001I
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: in/2009 TIME: 7:01AM PAGE: 16
SITE ADDRESS: 13326 SW 72ND AVE A CLASS OF WORK:
SUBDIVISION: HAMPTON RIDGE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: HAMPTON RIDGE
DESCRIPTION: Units: A-J. Installing fiber optics for Verizori.
OWNER: HAMPTON RIDGE APARTMENTS LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360..254.69�
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 079467-01 503 N
VA °‘ P L-
Corrections /Comments/ Instructions:
\ \
\`_ \
,
7 /
V
pi PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
ri FA fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: . \1\) 0(),€) L__- Date: ‘/-) 9 Phone #: (503) 718- liii-Po
. .