Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00340
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2008
PARCEL: 1 S135CD -00900
SITE ADDRESS: 11463 SW 98TH AVE ZONING: R -
SUBDIVISION: GLACIER LILY APARTMENTS LOT: JURISDICTION: TIG
PROJECT: GLACIER LILLY APARTMENTS
Project Description: Install fiber optics for Verizon. This is for units: 11461 & 11463.
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:
SHARON DEVELOPMENT CO, LLC NORTH SKY COMMUNICATIONS INC
5795 SW CRANBERRY CT 11818 SE MILL PLAIN BLVD
BEAVERTON, OR 97007 SUITE 410
VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 12/18/200€ $75.00
[TAX] 12% State Surch 12/18/200€ $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: 46'1 1 j jJ Z, Permittee Signature: See 4 0_0A,710 (o
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.
f
Electrical Permit Application O FOR OFFICE USE ONLY
of T! a d o*. ttecoived d Y �+ 1)s1e/(i /i /G tdg " Permit No.: Es-4-2068-003 •
v 13125 SW Hail Blvd., Tigard, q g Plan Review /
1 i ' Phone: 503.639,4171 Fax: 50 654 Dato/8y: Other Permit:
TIGARD Inspection Line: 503.639.4175 - • ate Ready/By: lnris: 81 See Page 2 for
td-
Internet: www.tigaor.gov ...cc. os • /Method: /A SupplementelInformation
G l Xa , t
TYPE OF WORK Ca PLAN REVIEW
Q New construction 01 Addition /alteratic l VW" Please check that apply (submit 2 sets of plans w/;kms checked below):
0 Service or seeder 400 amps or more 0 Building over trice stories.
❑ Demolition ❑ Other:
�`� where the available fault current Q Murilms and boatyards.
CATE(;ORY OF CON UCTION . cxccals 10.000 imps nl 150 volts or I] I' buildings.
Ices to gmuad.orexceeds i4,000 0Commercial•use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps Coe ell ether installations. buildings.
Q Multi- family ❑ Master builder ❑ Other: l Fire pump. 0 installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION . 0 Pmergency system. larger separately derived system.
Q Addition of new motor load of ❑ "A" "E' 1.2" "I
Job no.: I Job site address: I SW 98TH AVE. nr ti or more, occupancy.
0
❑ Six or more residential oohs. Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 9722 0 Health -care 11cilities. 0 Supply voltage for more titan
Q Hazardous locations. 600 wills mntinal.
Suite /bldg. /apt. no.: 11461, 11463 Project name: GLACIER LILY ❑ servit:c or rode, 600 amps or man.
-�
FEE SCHEDULE
Cross street /directions to job site: Description 10ty. i I'm. i Total I •
New residential single- or multifamily dwelling unit.
.._.. - Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or 145.15 4
Ea. :WWI 500 sq. ft. or portion 33.40 I
Tax trap /parcel no.: Limited energy, residential
DESCRIPTION OP WORK (with above sq, 0.) 75.00 2
INSTALL FIBER OPTICS FOR VERIZON Lim)tcde nlu q. 7500 2
rosidemiaf (widtnlx 0.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
`f PROPERTY OWNER • • , . 0 TENANT 201 amps to 400 amps 106.85 2
Name: tit 0� 'J F tJ LoPN / CCU A �. C, • 401 amps to 600 amps 160.60 2
Address: �J ,, " LL � nr 601 amps to 1,000 amps 240.60 2
9s Arc (-rHtly 6d-E y (/ Over 1,000 amps or volts 454.65 2
City /SialeJZIP: /a't� 02 9 700 7 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 mops or less 66.85 1
Owner installation: This installation is being made on property that i own which is not 201 amps to 400 tamps 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
Owner signature: _______Date: _ •_Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
0 APPLICANT I ii " CONTACT PERSON above service or feeder fee,
6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Pee for branch circuits
Contact name: RYAN ROBERTS w ithout service or feeder fee,
46.85 2
first brunch circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City / State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Pltgne: (503) 519 -5264 I Fax: : ( )1 - 866- 905 -4907 Reconnect only 66.85 2
E - mail: md uorna northskvoomm.cam Pomp or irrigation circle 53.40 ' 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: NORTH SKY COMMUNICATIONS, INC. n circuit(s)orlimited-
p e energy panel, alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: Paget $75.00 2
City / State/ZIP; VANCOUVER, WA 98684 FACIA additional inspection over allowable in any of the above \
Per inspection 62.50
Phone: (360) 254 -6920 Fax: ( ) 1 -866- 530 -4325 Investigation per hour (I hr min) 62.50
CCB Lie,: 14117 Electrical Lic.1 -154CL Suprv. Lie.: 173LEB Industrial plant per hour 73,75 -
�,r/ ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: i Subtotal:
$.75.00
Print n JACK CAGLE Date: Plan review (25% of permit fee):
12 16 08 Some surcharge (12tH of permit fee):
$9.00
Authorized signature: / X' /'�, TOTAL PERMIT t -EE: $84.00
' This permit application expires if u permit in not obtained within I80
Print name: ETHON A. DOLPH Date: 12 -16 -08 days idler 11 has been accepted as complete.
. Number ul inspections allowed per permit.
b \tlnilti ingu'erntbAlll.C•P :nni appdoe 03721/ec 410 -sr, l r •(t U05/COM/WPn
•
CITY OF TI.GARD
BUILDING DIVISION PERMIT #: ELI ?7OOt3.00 4O
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1'?./ 1i:3 woos
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .J —$
INSPECTION WORKSHEET FOR DATE: 1i&2OO9 • TIME: 7:00AIk1 PAGE: 28
SITE ADDRESS: 114I63 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: GLACIER LILY APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GLACIEI? LILLY APARTMENTS
DESCRIPTION: Install fiber optics for Veriron. This is for units: :1 Iii fi
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360,254.692O
Inspection Request Scheduled For: Date: 1 /6.s200 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13f) Low voltage 079407 -01 6O3634082 Y
Corrections /Comments/ Instructions:
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - N QQ Date: 1-' Phone #: (503) 718- -4%
CI. F TIGARD
-
BUI DIVISION
Al) PERMIT #: FI.R2008•00340
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/10/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 -
INSPECTION WORKSHEET FOR DATE: 17/19/2008 TIME: 7:00AM PAGE: 15
SITE ADDRESS: 1'1463 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: GLACIER LILY APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GLACIER LILLY APARTMENTS
DESCRIPTION: Insiall fiber optics for Verixon. This is for units: 11461 & 11463.
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE'#: 360-254 6920
Inspection Request Scheduled For: Date: 12/19/2008 16(A. Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 079154-01 503-2097014
Corrections/Comments/Instructions:
r
X41
PASS El PARTIAL APPROVAL ANCEL 0 NO ACCESS
n FAIL 0 CALL FOR INSPECTION El ADDITIONAL F ES ASSESSED
Date: ( 1 . 12 "
Inspector: v attA' hone #: (503) 718-