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Permit 1 III .� CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00134 TIGARD DATE ISSUED: 6/5/2008 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135DC -02000 SITE ADDRESS: 11895 SW 91ST AVE 13 ZONING: R - SUBDIVISION: GREENBURG OAKS APARTMENTS LOT: JURISDICTION: TIG PROJECT: GREENBURG OAKS APARTMENTS Project Description: Units 13 - 24: 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 Surchar 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. Spedalty 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...9 or 1.819.33 344. A Issued , _ _ 'r ! .V �� _i Permittee Signat e: �� �� l � � - 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. ''J 04 2008 3:08 AM FR TO 5035981960 P.05 • RECEIVED Electrical Permit Application ..OR`(WIICEIIS i t � t, // City of Tigard O !!: (� Di : ty'/� Permit No / -GF.J/ ' J` 131 ZS 5W Hall , 4 1 171 TFag: 5 03 - OFTIGARD Er hhonc: 503.63 Fax: 03 Otbcr Permit: Inspection Line: 50.639,4175 BUILDING DIVISION (�at1e Rcad la See Page 2 for TIGARA? Notified/Method: Supptemcnl4l Information Internet www.tigard- or.gov 1'YPE `.OF .WORK PLAN REVIEW GI Ati ditionlalreratiohlre IaCCstlCnt "" pl. e c {rock all that apply (aabmit 2 sans r4 phtna ,vliterm stacked below); © New construction l El ❑ Service or feeder 400 amps or more 0 Building over three stories. El u Demolition Other: where the aviiilahlc fault cm•ren( O Mnrina3 and hoaty :: CA'I'T( ;ORY OF'. CONSTRUCTION : ccccedt h0.W0 amps at 150 Pubs or ❑ Mailing buildin rues ie ground, or moo d; 14.000 11 commercial-use agrlcuht,at) El 1- and 24arniiy dwelling ['Commercial/industrial El Accessory building amps tbi au Label mstatrattona. buildings. 13 Multi- family [l Master builder ❑ Other: LU fire pump. 0 installation el 75 KV A or . mncrgcmey .yatom. larger es sepv;nay derived system. JOB SITE SITE INFORMATION AND LOCATION Addition of new WW1 load of "A" ' '1 . 7 1 -t . © 1001-1P or nuotc, occupancy. Job no.: Job site address: 1 1895 SW 91ST CT=FT ❑ Rc runmional vchick I , rka. - S;.e or m ore res it i cnooi uni - Cit /State /ZIP: TIGARD, OR, OR 97223 0 Health -caws facilities, 0 Supply voltage for more than y - — mod. S I r', `' CI Hazardous locations. 0(10 calls naminnl. Suite /bldg. /apt. no,: 13-24 Project name: GREENBURG OAKS APTS D Scrviec or facdcr000 amps ec more. FEg scllEnvLl; Cross street/directions to job Sire: Duierlppra, I Qtv. I Fee, I Tenet I • " New residential single. or multi•famity dwelling; unit. 1 Includes attached garage. Subdivision: Lot no.: 1.000 sq. A, or less _ 145.15 -- 4 _.• -. En. ntki'i 500 e(.1. ft, or portion 33.49 I Tax map /parcel no,: Limited energy, mcs s itlenliml 75.00 2 pF..SCRWI`ION OF WORK ' wilt above A . hi) ,„,,,, l.imresid residential N,nluh;-esit,y 75.00 INSTALL FIBER OPTICS FOR VERIZON ,CStdC11tIA1 (wikV,;mtxwcttl• Ih) Services or feeders installation, alteration, and/or relocation 200 ;nips or less 80.30 2 • ❑ PROPERTY :OWNER • '. I :,• 0 •ENANT " 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 turps - 160.60 2 - 601 : to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /Scarce /Z1P_ Temporary services or feeders i nstallation, alteration, and/or relocation phone: ( ) Fox: ( ) 200 amps or less 64.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 slops _ _ 100.30 2 intended for sate, lease, rent, or exchange. according to ORS 447, 440, 670, and 701. 401 amps to 599 amps 133.75 2 ((ranch circuits - new. alteration or extension, per panel Owner signature: �.�. - Date: -- _...r. S A. Fce for &mien circuits mvidt 0 APPLICANT • ' 4 • . I!1' CUN1fACr PERSON above service or feeder fee, 6,65 each branch circuit Business name_ NORTH SKY COMMUNICATIONS, INC. a. Pee for branch circuits - without service or feeder fee. 4G.8S 2 Contact name: RYAN ROBERTS first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add. ibranch 6.65 , 1 2 Miscellaneous (service or feeder not included) ,• City/State/ZIP: VANCOUVER, WA 98684 Each manufactured or int7dt&lar 90.90 2 dwelling, service and /or feeder phone: (503) 519-5264 I Fax:: ( )1-866-905-4907 Reconnect only ---,-• . 66.85 _ 2 Email; mduQ north SkyCQmrn.com Pump orinigationcircic 53,40 - 2 CONTRACTOR ' ' ' • Sign or oudino lighting 53.40 2 Signal c ;truit(s) or limited- Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or Address: 118 SE MILL PLAIN BLVD- STE 410 extension.Desor;be: 1 Paget $75.00 2 City/State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in an of the above Per inspection 62.50 Phone: (360) 254 -6920 Fax: ( ) 1 -866- 530 -4325 investigation per hour 0 hr mint 62.50 - CCIl Lie 14117 Blearkal ic.17 -154CL Suprv• Lie,: 173LEB rnam,tritd, >tin( per hour 73.75 • - . •• ELECTRICAL PERMIT FEES • Suprv. Electrician signature, required: • Subtotal: $ 75.00 Prim name: JACK CAGLE Onto: Plan review (25% of permit fee): 6 -3 -08 State surcharge (12% of permit foe); $9 00 Authorized signature lC7't'f \t PERMIT PEE: 84.00 This permit ajpplisatiun expires it a permit is not obtaimcd within loll Print name. ETHON A- DOLPH Date: 6 -8'-08 days after It has been mu:epted n ;lumber of inspections allowed par permit. 1 un,6ldingtl'crn+ it '. \Si.C.Nm14.tpp deli: (mOOSO6 '•I0-45151(1 ,n1$K:OMtWild CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008•00134 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/5/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6113/2008 TIME: 7:01AM PAGE: 50 SITE ADDRESS: 11895 SW 91ST AVE 13 CLASS OF WORK: SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: GREENBURG OAKS APARTMENTS DESCRIPTION: Units 13 - 24: 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 071318-03 603-209-7014 Corrections/Comments/Instructions: PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS pi FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: Date: 6' 7/ 0 Phone #: (503) 718- c? 1N4