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Permit " N CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ill ' COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00161 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/10/2008 PARCEL: 2S115AA -01100 SITE ADDRESS: 16205 SW 108TH AVE 220 ZONING: R -25 SUBDIVISION: WILLOW BROOK FARM LOT: 027 JURISDICTION: TIG PROJECT: OAK TREE APARTMENTS Project Description: Units: 115 - 122, 215 - 222, 315 - 322. 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: MICHAEL ELTON NORTH SKY COMMUNICATIONS INC BY MDE INSTITUTIONAL 11818 SE MILL PLAIN BLVD STE 4 6950 SW HAMPTON ST STE 320 VANCOUVER, WA 98687 PORTLAND, OR 97223 Phone: Contact #: PRI 360- 254 -6920 FAX 1- 866 -530 -4325 FEES Reg #: ELE 17- 154CLE LIC 14117 Description Date Amount [ELPRMT] ELR Permit 6/10/2008 $75.00 [TAX] 12% State Surch 6/10/2008 $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: , ../41111• _ -.or `j _ Permittee Signature: .V2/, Gq,��.i� I 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: 1 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 07 2008 3:48 AM FR TO 5035981960 P.15 . ... Iv `T ES Electrical Permit ApplicationR�C FOR OFFIC:'1 USE ONLY " City of Tigard 11 11 0 6 ' • i .', , Q J� Permit NO,: e . . e -, 16 13125 SW Hull Blvd, Tiprd, OR 97223 .A. Plait Review ' 2 Q , Other Permi Pisntrc: 503.639.4(7 Fax: 503- 598.196Q GAP • D telQ Tt1A eetiOn Lim:: 503 - 639.4175 ' c Rattly/Br IIGAAD I O 0 11 H See Page 2for Internet: www_[igartl or.00v CO DI � C ' DI NntificdtMethod: j� � Supplemental lnforrnatien © New construction �I ACldi [ion /alteratiotl/replaCCment __.._ Please check all lieu apply (submit 2 sets of plans write mu decked below): 0 Service or (ceder 400 amps or more 0 Auihhnb over dime vtories. 0 Demolition 0 Other: aims the available fault current l Marinas soil booty:lni'l. CATEGORY OF : CONSTRUCTION.. exceeds 10000 amps at 150 volts or ❑ Flouting buildings. toss to ground, or exceeds 14,000 ❑ Contntereiat- useagricuitut'al El 1- and 2- family dwelling Ij Commercial /industrial ❑ Accessory building amps for all other installations. buildings. El Multi - family D Master builder O Other: ritzily pump. 0 Installation of75 KvA or ht JOB SITE INFORMATION AND LOCATION © Addit t ncy n m. larger separately dcnvea .ystem. ' ❑ Addition of new motor' I of ©_A "G" "1 1 3 Job no.: lob site address: 16205 SW 108TH AVE 100FIP Or mum occupancy. © Sig or MOM residential units. 0 Recreational vehicle pakz. City /Ststtc/VP: TIGARD, OR, 97224 I] Hcnith -cttrc l witilics. 0 Supply voltage fee more than Cl Hazardous lec.niuns, 0410 volts nominal. Suite/bldg./apt. no.: 8115 -1221f roject name: OAK TREE 1 & 2 APTS ❑ Service or feeder 6001ttnps 01 mntm. FEE SCHEDULE Cross street /directions to job site: 215 31 -322 Omar! Mau I Uri - I Fee 1 Total ) • New residential single. or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. ft. or less 145,15 A Ea. add'I 500 sq. ft. or portion 33,40 I Tax map/parcel n0,; l.,ituited energy, residential oescRIlvrXoN Or WORK • 75.00 (with nlxnc sq. It) , - Limited energy, multifami ly I INSTAL FIBER OPTICS FOR VERIZON residential (with n.) 75.00 2 l���AA: I ✓ —, dot 5^ ? 2. .4._ ,S�a'7ervices or feeders installation. alteration. and/or retocniioa 20 0 amps or less 80.30 2 . 0 PROPER'rY`OWNER [ 0 TENANT 201:utgrsto4001tiips 106,85 2 Name: 401 amps t0 600 amps 160,60 2 601 amps to 1,000 amps _ 240,60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or reit:Kaden Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 soups to 400 amps 100.30 2 intended for sale. lease, rent, or exchange. according; to ORS 447, 449, 670. and 701. 401 amps to 399 mops 133.75 2 • [(rand( circuits.- ttl;w,_alteralion, or extension, per panel Owner signature: Date: _ A, Fee for branch circuits with . © APPLICANT El CONTACT PERSON above service or feeder fee. 6.65 N ORTH SKY Fee circ Busin ss Warne: COMMUNICATIONS, INC. I3, Fac forbru3ch circuits woliour service or scaler fee, Contact name: RYAN ROBERTS _ _ i first branch circuit 46.85 2 Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ;Ldd l brunch circuit 6.65 , 2 Miscellaneous (service or feeder not included) City/Stale/ZIP: VANCOUVER WA 98684 Each manufactured or modular - - ' dwelling. service and /or feeder 90.90 0 Phone: (503) 519 -5264 Fac :: ( ) i -866- 905 -4907 Reconnect only 66.$5 2 E - mail: mduoranorthskyco mm. com Pump or irrigation circ 53.40 2 — CONTRACTOR . • • • — Sign or outline lighting - 53A0 2 ausiness name: NORTH SKY COMMUNICATIONS, INC. signal :nralt(s)oramite � anorg panel. idiw;tlion, or signal Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City/Stale/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above Ace inspection 6250 Phone: ( 360) 254 -6920 Fax: ( ) 1 - 866 -530 -4325 F � " lnvesi4:xion per hour 0 hr rots -� 62,50 CCE Lic.: 14117 Electrical Lic_17-154CL Sltprv. Lie.: 173LEB industrial plant per hour 73,75 ELECTRICAL, PERMIT FEES ' Supt v. Electrician Signature, required: Subtotal. $75 Print ((hire: JACK CAGLE bate Km review (25% of permit fee): 6 -6 08 - Slate sur'chillge (i2% of permit fee); Authorised s tn i$nri[ti: ' . � -"` 84 0 _ TOTAL YeRIVll PEE,: $84.00 lilts permit application expires it a permit is n01 Obtained within 180 Print name: ETHON A. DOLFSH Date: 6 -6 -08 days after it has been accepted on complete, " Number or inspections allowed per permit. 11 0nLk11ngWCnnilAt it.C•I'cnv0,tpp.tlno ouaasoG 340.451%I'II IioeicnsVw1'13 . CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008-00161 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 611W2008 Phone: (503) 639-4171 . teutilitilii Inspection Requests (24 Hrs.): (503) 639-4175 „_.0.- IL. • INSPECTION WORKSHEET FOR DATE: 6/ 11/2008 TIME: 7:00AM PAGE: 25 SITE ADDRESS: 16205 SW 108TH AVE 220 , CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 027 TYPE OF USE: PROJECT NAME: OAK TREE APARTMENTS DESCRIPTION: Units: 115-122, 215-222, 316-322. Installing fiber optics for Verizon. OWNER: ELTON, MICHAEL PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920 Inspection Request Scheduled For: Date: 6/110008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 071214-03 971-563-4082 N ICT\ C 04\L--- Corrections/Comments/Instructions: i N N N. c\\' \N • I \ l PASS n PARTIAL APPROVAL 0 CANCEL I NO ACCESS FAIL ri CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 6—, Nb€31 Date: 1414 pi Phone #: (503) 718- .- — ..- ..