Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
: : COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00132
TIGARD DATE ISSUED: 6/5/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135DC -02000
SITE ADDRESS: 11865 SW 91ST AVE OFC ZONING: R - 7
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT: JURISDICTION: TIG
PROJECT: GREENBURG OAK APARTMENTS
Project Description: Office - 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:
VILLA LA PAZ LIMTED PARTNERSHIP NORTH SKY COMMUNICATIONS INC
BY COMMUNITY PARTNERS FOR 11818 SE MILL PLAIN BLVD STE 4
AFFORDABLE HOUSING INC VANCOUVER, WA 98687
TIGARD, OR 97281
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 6/5/2008 $75.00
[TAX] 12% State Surchai 6/5/2008 $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
503.246.66 . 00.33 2344.
Issued B Permittee Signatur • i g, i , / Ali
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.
„ JtiN 04 2008 3:87 AM FR TO 5035981960 P.03
1 ' ' r
Electrical Permit A li CEIVED I~ORt'.)F '1lCEuSk' ONLY. '..
City of Tigard Received rA.g Permit No.;
,tert3 : 1 ' o�Pe�l •
`t 13125 SW Hall Blvd., Tigard, OR 9/FT iant Review Other Permit: � 2 ` • Phone; 503.639.4171 f=ax; 503.59g`t 0 3 2008 P 0 Date /E3 I
Inspection Line: 503.639,4175 onto Ready /fay: Jui ' RI See Page 2 for
TiGARD interact: www.tigard ^or.gov CITY OFTIGARD Noli0cdrMcthud: la Suppicmcnitll lnto
TYP a Y, TI�1' ! a..,l :. • - PLAN REVIEW ;:
Q New cnvtruction 13 Addition /alteration /replacetncnt
k'loaxe chock WI Ihu( apply (subunit 2 sett ol'plues wlttcros checked helow):
rr--tt •--� 17 SCYVitc or !ceder 400 amps or mtuc 0 end(i)ng over throe 3tOrlCD,
Lt Demolition El Other: whom the availshle I ?nuts current ' 0 Marinas and hnityarrls.
. cxeceox 10.000 ampx at ISO von% of 0 Plwning buildings-
' CATEGORY Of 'CONSTRUCTION, i ' •” . , ''' - . " ' - .. lets to ground, orcxcc0dx 14.000 [] Cwamercial -uu; aoric0uural
❑ i- and 2- family dwelling CI Commercial /industrial 0 Accessory building amps furuli uthcr inxtallmionv. buildings.
17 Multi - family 0 Master builder I-J Other; CI Fire pump. 0 Installation of 75 I(VA ue
y c
'AND • LOCATION `
• 'JOB SITE 'INK - - -' A, n new mntni lo,d of "1-2", I .
[emergency system larger scparne y t crrvc s xt .
m
�Igb�S� 91ST STREET 1(101-1P O r mot rest occupancy.
Job no,; Job site adtlrca'
Q Six Or mote rcaitlanial unit + - ❑ )teen ationul vehicle perks.
CityfSlate/ZIP: TIGARD, OR, 97223 0 Hanllh -cats iacilitict. 0 Supply vohage for more than
❑ Haaalxtous IoCaticns. 600 vohx nr
Suite/b1dg. /apt. no.: OFFICE Project name: GREENBURG OAKS APT uapsormom.
- - Sc rvicc Of feeder G00_ FEE - SCL�LAt1LL '.
CrOtiti street/directions to job site; nexorl tan 4t . UNE= - fatal e
.. °' -• New residential single- or multi - family dwelling uit.
Includes attached garage. age.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 4
Ca. ttdd'I 500 sq. R. or portion 33.40
fax rtlap /pilrcel no•: Limited energy, residential
DESCRIPTION OF WORK(' with alxrvcst,ft.) III 75.00
l
dy' ca e
�i
INSTALL FIBER OPTICS FOR VERIZON Limited lte n, multi-family inmin 1111 7500 5 •
r idea c (with nl >vc n.)
Services or feeders installation, alteration, and/or relocation
200 amps or less III. 80.30 MN=
o PROPERTY ••OWN■at • Wl • .. ' 0' TENANT '' ` 201 amps to 400 amps 106. _ li
401 amps so 600 amps M 160.60 —Q
Name:
601 amps to 1,000 amps 240.60 — IIII
Address: Over 1,000 amps or volts Ell 454.65 IIIIMfl
Cit /State /2 (P: Temporary services or feeders Installation, alteration, and /or
y relocation
Phone: ( ) Fox: ( ) 200 amps or less MIEll�
IIIII
Owner install This installation is being made on property that I own which is not 20 amps to 400 amps 100.30
intended for sate. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 um is
+ ttttPflcw v�nA nlutt�Rt�lXd�tlpitr� tsu tnttti {trtw'
• ti mmi
Owner ,tgnaturC: _Dale: A, Fee for branch circuits With
. .0 APPLICANT 11 4t) NTACr PERSON ' above service or feeder fee,
6.65
each brunch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits II
Contact name: RYAN ROBERTS first bran branch ci cuit t'ctYler fee, 46.85
Address: 11818 SE MILL PLAIN BLVD STE, 410 Each aaa'I branch circuit - 6.65 _p
- - - Miscellaneous service or feeder not included
City /State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90.90
dwelling, service anti /or feeder
Phone: (503 ) 519 -5264 Fax: : ( )1 -866- 905 -4907 Reconnect only 66.85
B -mail nd Opf h. k ( mrrl.CQfll pump or irrigation circle _ 53.40 -
Sign or outline lighting 53,40 2
CON'1'RAG'TOR 8 3 p ..
Business name: NORTH SKY COMMUNICATIONS, energy
signal prcl, ;t or limited-
ner panel, hcratron, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2
City /State/ZIP: VANCOUVER, WA 98684 Each additiOnasl inspection over allowable in any of the above •
Per inspection 62.50 I.
Phone: ( 360) 254 -6920 Pax: ( ) 1 -866- 530 -4325 fit vcatigation per hour ( hr win) 62.50 -
CCO Lic.: 14117 Electrical Lic.17 -154CL Suprv. Lie,: 173LEB industrial plait per hour 73.75 -
FEES
Suprv. Electrician signature, required: ELECI'ftI( AL PERMIT Subtotal: $75.00
��� Plan review (25% or permit fee):
Print name: JACK CAGLE Date: 6 -3 -08 State surcharge (12%of pct'tnit fee); $9.00
Authorized signature: TO TAL PERM t-ltta; ', 84,00 1
i 1'111% p application eg if a permit is trot Ohm 11..I within ISO
Print. name.: ETHQN A. DOLPH Dine' 6-3-08 days after It 11ns been accepted ns COlnplele.
Number of inspections tdlo Ix:r permit.
IRtl,,65ngTohnitOIh.C.Pnr IApp,IIOC 09:3106 .140- 461)'1(1105 /c n/WOO
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200B -00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/5/2008
Phone: (503) 639 -4171r
Inspection Requests (24 Hrs.): (503) 639 -4175 : ' W F 'I I..
INSPECTION WORKSHEET FOR DATE: 6/13/2008 TIME: 7 :01AM PAGE: 53
SITE ADDRESS: 11865 SW 91ST AVE OFC CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAK APARTMENTS
DESCRIPTION: Office - Installing fiber optics for Verizon.
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360.254 -6920
Inspection Request Scheduled For: Date: 6/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 071318 -01 503 -209 -7014 N 1
Corrections/Comments/Instructions:
0
M PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: er / Date: 6. (/ 3 / D Phone #: (503) 718 - a y Ve