Permit 11 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00063
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/20/2008
PARCEL: 2 S 102 D B - 00 301
SITE ADDRESS: 13070 SW ASH AVE 9 ZONING: R -
SUBDIVISION: ALDERBROOK APARTMENTS LOT: 008 JURISDICTION: TIG
PROJECT: ALDERBROOK APARTMENTS
Project Description: 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:
GEORGE & GWENDOLYN CARNEY NORTH SKY COMMUNICATIONS INC
BY NORRIS + STEVENS REALTORS 11818 SE MILL PLAIN BLVD STE 4
520 SW 6TH #400 VANCOUVER, WA 98687
PORTLAND, OR 97204
Phone: Contact #: PRI 360 - 254 - 6920
FAX 1- 866 -530 -4325
Reg #: ELE I7- 154CLE
FEES L1C 141171
Description Date Amount
[ELPRMT] ELR Permit 3/20/2008 $75.00
[TAX] 12% State Surch 3/20/2008 $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.
A 1
Issued BS:C� -=� Permittee Signature: c
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.
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Electrical Permit Application c .•,,, - . , '- 7 '. ..i'i,'" ' . -.; ' ,FOR OFFICE USTONLY' . ''.'••••H'' ' , -..,
" ''. Cit of Tigard \ %l' o rkeceived -.7*. No.: I a
Na . > Ag 0 A p.mit i Ct) . 6
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1, . 13125 y SW Hall Blvd., Tigard, 124 ,<R.... - ,,.. .,,..,..
k c, ft• %
2 21 ne: 503.639.4171 Fax: 503.5 .1960 \ ' .‘ ■\ .' Other Permit:
TIGARD
Inspection Line: 503.639,4175 o' va c' c i Date Ready/By; tuns: ET Sec Page 2 for
Internet: www.tigard-or, gov
G\--‘V..,C1‘ Notified/Method: Supplemental Information
•':'', . .' ..,X,._ . ;,:... ,..: , Y.. ...:.:-.;,:•..::. ::',..::}:., ;.:::-:.:
El New construction ei Addition/al tcration/4Yement Please check all that apply (submit 2 sets of plaits wAtems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
:...CATEGORY 'Of',.CONSTRII.CTION .... :. • ,:_ : : • .. ..:. •::•:•:...:,. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial.use agricultural
0 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
11 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation 0175 KVA or
. . . ... . .., .. .. 0 Emergency system, larger separately derived system.
.
• , - , j. -• :.:•-• •• •., : :. ...• ,., • jon.:$ITEIINFORMATION :AND LOCATION.. : .' ..• . -.• :'. • ':-..' 0 Addition of new motor Wit of 0 "A", "P.", " I -2", "I-3",
1(X)HP or mon:. occupancy.
Job no.: Job site address: 13070 SW ASH AVE.
0 Six or inore residential units. 0 Recreational vehicle narks.
City/State/ZIP:PORTLAND, OR 97223 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. Ci00 volts nominal.
Suite/bldg./apt, no.#9-12,12A-1E Project name! ALDERB ROOK APTS. 0 Service or feeder 600 amps or sore.
— — FEE SCHEDULE
Cross street/directions to job site; Vemriptton I Qty. I Fee. i Totill I . '
New residential single. or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft. or less I 145.15 — 1 4
Ea. add' I 500 sq. ft. or portion 33.40 1
Tax trap/parcel no.:
Limited energy, residential
75.00 2
•,•: . 7: ' '. l': ' .,1; ••,:-.... ,':• ': '.. :,'• DESCRIPTION .0F. WORK . ••'. : . , ' •• • -:' •••• (with above sq. fl.)
,
INSTALL FIBER OPTICS FOR VERIZON Limited energymulti-family residential (win, above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
•";:':' ': .::.::.'1: i' :,l1?:•..-:..1.%'•;' I..... ". :•••':..:.•:. 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240,60 2
Address: Over I ,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Pax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not ' 201 ant s to 400 am P' P s 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
..'.:0:APP.1.iICAiNT.....:; ‘: ::, .: ..'::: 151 CONTACT PERSON : 2..''':• above service or feeder fee,
6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. e. Fee for branch circuits
without service or feeder
Contact name: MONET VIVEROS first branch circuit foe, 46.85 2
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each addl branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP:VANCOUVER, WA 98684 Each manufactured or modular
9090
dwelling, service and/or feeder
Phone: (360 ) 254-6920 Fax! : ( ) 1-866-530-4325 Reconnect only 66.85
2
E-mail: mviveros@northskycomm.com Pump or irrigation circle 53.40 2
CONTRACTOR ::::• ,•,:•-•; -':; Sign or outline lighting 53.40 2
Business name: NORTH SKY COMMUNICATIONS, INC. Signal circuit(s) or limited-
ertergy panel, alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2
City/State/ZIP: VANCOUVER, WA 98684 Each 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 lsr min) 62.50
CCB Lic.:14117 Electrical Lic.17 Suprv. Lic.: 173LEB Industrial plant per hour 73.75
.;'.'•',::.:••'',.: ',' ••• FEES :.: ,' •:: i': . • ' ' ::
Suprv. Electrician signature, required: - .. Subtotal: $75.00
Print name: JACK CAGLE Date: 3/19/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): $9.00
Authorized sigi.,=,,. TOTAL PERMIT PEE: $84.00 _
Print name: TERI A. MIKULIC _ Date: 3/19/08 This permit application expires if a permit is not obtained within 180
days after it hits been accepted as complete.
. Number of inspections allowed per permit.
lAllaildingWeimit:al:LC.NnaltApp,doe 05/23/06 440.46151111/05/COMAYE13
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELR20013
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /2a
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/27/20013 TIME: 7:03AM PAGE: 45
SITE ADDRESS: 13070 SW ASH AVE 9 CLASS OF WORK:
SUBDIVISION: Al.l.)ERk3ROOK APARTMENTS LOT #: 008 TYPE OF USE:
PROJECT NAME: ALDERF3ROOK APARTMENTS
DESCRIPTION: Installing filar optics for Verizon, Units 9 thru 12 & 12A thru 16.
OWNER: CARNEY, GEORGE & GW NDOLYN PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360.2E-8820
Inspection Request Scheduled For: Date: 3/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 99 Electrical final 067394-01 971 - 663.9326 N
Corrections /Comments /Instructions:
(/_.,
PASS (l PARTIAL APPROVAL ❑ CANCEL P NO ACCESS
❑ FAIL ❑ CALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: °2-7 / Phone #: (503) 718-