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Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT NI - ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00143 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2008 PARCEL: 1 S135CD -03900 SITE ADDRESS: 11909 SW 95TH AVE 4 ZONING: R -4.5 SUBDIVISION: DOVE COURT APARTMENTS LOT: 008 JURISDICTION: TIG PROJECT: DOVE COURT APARTMENTS Project Description: Units: 4 - 6. 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: HOUSING AUTHORITY OF NORTH SKY COMMUNICATIONS INC WASHINGTON COUNTY 11818 SE MILL PLAIN BLVD STE 4 111 NE LINCOLN ST #200 -L VANCOUVER, WA 98687 HILLSBORO, OR 97124 Phone: Contact #: PRI 360 - 254 -6920 FAX 1- 866 -530 -4325 Reg #: ELE 17- 154CLE FEES LIC 14117 Description Date Amount [ELPRMT] ELR Permit 6/6/2008 $75.00 [TAX] 12% State Surch 6/6/2008 $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 503.246.6699 or 1.800.332.2344. ,/ Issued By: Nermittee Signature: _ 7-1 C.-41•2f 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. .JUN 05 2008 11:50 PM FR TO 5035981960 P.04 • _ ECELVE' Ele Pe rmit A l ica h J OR Off USE ONLY City Of Tigard JUN d 5 2008 wy, � ,� .. K? rt 13125 SW Hall Blvd.. Tigard, OR 97223 � � ` Phone: 843.639.4171 1 ax: 503.548' oy Other Pcnm1: • � -' . I i � • Et Se'- e 2 for Page TI GARD Inspection line: 503.639.4175 Date RoaclY /Dy: 6 Interact: www.tigard- 0t.gOv NotifcdtM0Ilmd: r Supplemental Information TYPE OF WORK' :: !, PLAM REVIEW. `` Q New construCtion O tit( Iditiott /alter "dtiotl /replacclnent Plcasc cheek ail that apply (submit 2 sus ol' pleas w/ucmr checked below): 0 Service or feeder 400 amps or more CI Building over three stories. 0 Dc'SIn0lition 0 Other: where the available fault Cement 0 Marinas and boatyards, . � crwcctk lU,WO amps :H ISO oohs or t' -lwti ng baiWinBs- CATEGORY 'OF CONSTRUCTION . • CJ bush, smooth or exceeds 14,000 © Ccaamoroial - mso agricultural ❑ 1- and 2- family dwelling ❑ Commercial /indislrial ❑ Accessory building amps for an outer inoaltaliuns. buildings- LI Multi-family ❑ Mager builder [] Other: [I tiro pump. 0 tnsutnatton of 75 KVA or ' JO B 'SITE INFORMATION AND LOCATION ©A system. Larger separately derived system . .... []AdditionaP now manor lcratnl Q •'A ", - 't3', •t•3 ",•'1 -3 - '. tOHP ormore. occupancy- Job no.: Job site address: © 11909 SW 95TH AVE Si% or nWtc residential units. ❑ Rccrcatiaaat vehicle parks. City/State/ZIP: TiGARD, OR 97223 0 Hcahh -care facilities. 0 Supply voltage for more than . 0 H :oar tons locations. 600 volts mining. Suite /bldg./apt. no.: 4 -6 Project name: DOVE COURT APTS ❑ Scrvao or feeder 600 amps or more, -- �. -°-- -�- --.- - - .:FEE . E •SCHEDULE Cross Stt'eei /directions to job sire: tk:Kriptltrn 1 Qty„ l per. J • total 1 • . - - - - New residential single- Or multi- family dwelling unit. Includes attached garagt. Subdivision: Lot no.: 1,000 sq. Pt, or less NM 145.15 4 Ea. add'I 500 so. ft. or portion Mill 33.40 1 Tax map /parcel no.: - - limited energy, residential DESCRIPTION OP WORK (with sq, n.) 75.OD 2 :tx INSTALL FIBER OPTICS FOR VERIZON I - ' i " ii ` d elter gy .tnulti-t.tn,il y 75.00 j 2 residential (with above sq. II.) J Services or feeders installation. alteration, And /or relocation 200 amps or less 80.30 2 ❑ PROP)'' R EV•''OWNER •I :,: Q TENANT amps 201 am s to 400 wraps 106.55 _ 2 -�' 401 antler to 600 amps 160.60 2 Name: - . 601 amps to LOGO amps 240.00 2 Address: Over 1,000 amps or volts • 454.65 2 Cit /State /ZIP: Temporary services or feeders installation, alteration, and/or y ... relocation Fax: ( ) 200 amps o leas 66.85 l Phone: ( ) Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100,30 2 intended for sale, IMO, rent, or exchange. according to ORS 447, 444, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits- new, allertltiun, or extension. per panel Owner signature: W _ Date: A. Fee for branch circuits with ' 0 APPLICANT .: • 0 CONTACT PERSON above service or feeder fee. 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for brunch circuits wilHpw service or feeler fee, 46 R5 2 Contact name: RYAN ROBERTS __ Address' first branch circuit _ 1 1818 SE MILL PLAIN BLVD - STE. 410 Each add'l branch eircuit 6.65 2 Miscellaneous (service or feeder not included) - City/Stale/ZlP: VANCOUVER, WA 98684 Each manufactured or modular 90.90 2 ' dwelling, Service stdfor feeder Phone: (503) 519 -5264 Fax: ( ) 1-866-905-4907 Reconnect only 66.85 2 Pam or irrigation circle 53.40 2 E-mail: md�,rlrt'a northskY�Qq�m.com p 5140 2 ' CON TRACTOR Sign oro - _` _ I N ORTH SKY COMMUNICATIONS, INC. Signal lt(a ) e r alteration. g or us i rtess Hanle: energy panel, alicr;uiou, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. 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: ( ) 1 -866 -530 -4325 invcsiigatirnt per hour (1 hr min) 63.50 CCB Lie.: 14117 EFT: mica' Lic.1 -154CL Suprv. Lie.' 173LEB Industrial plant per hour 73.75 . • ELECTRICAL mow FEES Suprv- Electrician signature, required: Subtotal: $75.00 . print flame; JACK CAGLE l Date: 6 5-0$ Plan review (254h of pumit fee): / ,Frair........,,‘___Ole State surcharge (12% of permit fee): $9.00 Authorized signature: TOTAL PGRMCr PEE: 84,00 This permit rppncnuon expims if a permit is net Otltnincd within 150 Print name: ETHON A. DOLPH p 6 -5 -08 days tiller it'ho hcenneceptNi aascomplete- Nunnc.r of ins allowed pot permit. 1; tant kitaiWcnnliwl:LC- Nrnia,tltp,dac oSesses 4404615r(I I'm/WNW/1 3n CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008 -00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2008 Phone: (503) 639 -4171 /0//441/,‘ p Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/13/2008 TIME: 7:01AM PAGE: 39 1 SITE ADDRESS: 11909 SW 95TH AVE 4 CLASS OF WORK: SUBDIVISION: DOVE COURT APARTMENTS LOT #: 008 TYPE OF USE: PROJECT NAME: DOVE COURT APARTMENTS DESCRIPTION: Units: 4-6. Installing fiber optics for Verizon. OWNER: HOUSING AUTHORITY OF, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360 Inspection Request Scheduled For: Date: 6/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 07134002 503.572 -3632 N Corrections /Comments /Instructions: 7( K r PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS p FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,4 Date: 1'/f9/6 Phone #: (503) 718 - / Y.4