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Permit i n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00351 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2008 PARCEL: 1 S 135CD -00900 SITE ADDRESS: 11517 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: 11517 & 11519. 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: 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 Reg #: ELE 17- 154CLE FEES LIC 14117 Description Date Amount [ELPRMT] ELR Permit 121181200E $75.00 [TAX] 12% State Surch 12/18/200E $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: J g. ></ s Permittee Signature: O Q 1 J\ 11Y t 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. o �� FO OF US EIectricaI Permit Applicati ONLY Cif of rri and � ` Received Y Daten1 /i'� /4 e 1 Pcnnit NO.: F� j� ,- 25— r 13125 SW Hall Blvd„ Tigard, c3 .1& ��++�^wvv ,N 1 Plan Review Phone: 503.619.4171 Fax: 503.598, It TA Date/f3y Other Permit: • TIGARD in Line: 503.639.4175 �• � � 1 to R my /By: Jn El See Page 2 for Internet: www.tig:u'd- or.gov e , , t ificdlNfcnunl: Supplemental Information 1 4 • TYPE OF NO i Gp\\i‘ PLAN REVIEW 0 New construction 01 Addition/at 115 0)ltl ,meat Please check; all l apply (submit 2 sets or plan; w /items checked below): ❑ Service or feeder 400 amp( or ruse ❑ Building Over (lime stories. d Demolition ❑ Other: where the available bath emrtent a Muricuas and boatyards, CATEGORY OF CONSTRUCTION exceeds 1 10000 sops at ISO volts u, 9Pk1)atiug less to ground, or exceeds 14,000 ❑ Conuuerci;d•usc agricultural 0 I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building mops for nil other instehtauimis. bu ildings. 12 Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KvA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. hrger separately derived system. Q Addition of new motor load of [f "A" "li" "I °..., I •; Job no.: Job site address: 11511 SW 98TH AVE, 100HPor occupancy .. - �.w,_ ❑ Six or more residential units. ❑ croa ni vehicle parks. City/State/ZIP: TIGARD, OR 97223 ❑ Heallb.caae faciGtics, ❑ Supply vohage for more than ' 9 Hazardous locatium. 60O volts nominal. Suite/bldg./apt. no.: 11517,11519 Project name: GLACIER LILY ❑Scrvico feeder 600amps or more. FEE SCHEDULE Cross street /directions to job site: Description I Qtv. 1 fee. 1 raw 1 • J New residential single - or multi- family dwelling unit. I is Includes attached garage. _ _ Subdivision: Lot no.: 1.000 sq. ft. of less 145.15 4 Es. tidal 500 sq. h, or portion 33.40 1 Tax map /parcel no.: — Limited energy, residential DESCRiPTION OP WORE (with above ill. a.) 75,00 2 INSTALL FIBER OPTICS FOR VERIZON Lintite<lenergy, neulli- rm,nily 7500 2 residential (wish idiom sq. a.) Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER • ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 • 2 601 :amps 10 1,000 amps 240.60 2 Address: Over 1,000 mops or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or Icss 66.85 l Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 snips 100.10 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 t 133.75 , - 2 ' Kfanch circuits - new, alteration, or extension, per panel Owner signature: �.Dalc: _ -- A. Fce for branch circuits with © APPLICANT I In CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits Contact name: first branch RYAN ROBERTS taailvr „r, rer�itcircuit or feeder rem, 46.85 branch ir Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'! 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 Phone: (503 ) 519 -5264 Fax: : ( )1- 866 - 905 -4907 Reconnect only 66.85 2 E -mail: rnduor a(� northskvcomm.com Pomp or imgzbtion circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: NORTH SKY COMMUNICATIONS INC. energ y pane it energy alteration, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2 City/State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above ( 360) 254 -6920 ( ) 1 -866- 530 -4325 Per inspection 62.50 Phone: Fax: investi per hoot' (I hrnail) 62.50 CCB Lie.: 14117 Electrical Lic.17- 154CLE Suprv. Lic : 173LEB industrial plant per hour 73,75 r_ ELECTRICAL PERMIT FEES - 0 Suprv. Electrician signature, required: ,ff�E�^ J _ sebtotaa $75.00 Print name: JACK EAGLE Dale: Plan review (25% of permit fee): 12 -16 -08 p 12% State surcharg ( c of $9 - Authorized signat � r� / TOTAL pPERMIT M rT fee): rtar:, $84.00 1 permit application expires if a permit is not obtained within 180 Print name: ETH ON A. DOLPH Date: 12 -16 -08 da artev It has been aeeeptea as complete. Number of inspections allowed per per 'Mad ingiher vnnsUthC•Pcimadpp.ahue 09?..VO6 - ,40.413! 'r(IIa1S/COWWct) CITY OF ��mo o ��w� mu����mm�� BUILDING PERMIT ~�~°"~~~°""~~° DIVISION : ELR2008-00351 13125 SW Hall Blvd., Tigar . OR 97223 DATE ISSUED: 12/ 18/2U0G Phone: (503) 639-4171 A, Inspection Requests (24Hsj: (503) 639-4175 _V INSPECTION WORKSHEET FOR DATE: 1/6/2809 TIME: 7 PAGE: 17 SITE ADDRESS � � 1|517 S��8&TH� V� CLASS SUBDIVISION: LOT TYPEOFUSE � GL�\O(�� L|LYAP��ThA EWT� #: USE: PROJECT NAME: GLACIER LILLY APARTMENTS DESCRIPTION: install fibwi optics for Verizon. This is for units: OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #: CONTRACTOR: NORTH SKY COMMUWICATIONS INC PHONE #: 360 Inspection Request Scheduled For: Date: 1/612009 Pour Time: Code # Inspection Description Confirm # Contact # Message ' 136 Low voltage 07E40712 503 N Corrections/Comments/Instructions: . �� PASS �� PARTIAL APPROVAL �� CANCEL | NO ACCESS | �� �� �� / / El FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED � — wJ� �� ��� Inspector: �� ' x�»� Date: p~��^ �� � Phone #: (603) 718-