Permit . .F I uI
CITY OF T I GA R D : f --• ELECTRICAL RESTRICTED ENERGY PERMIT
I ° `. COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00065
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/19/2008
PARCEL: 2 S 102 D B -00301
SITE ADDRESS: 13070 SW ASH AVE 25 ZONING: R -12
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
FEES Reg #: ELE 17- 154CLE
L1C 141171
Description Date Amount
[ELPRMT] ELR Permit 3/19/2008 $75.00
[TAX] 12% State Surch 3/19/2008 $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: Permittee Signature: .:=' ury
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.
.03 / 19 / 2008 WED 8: 59 FAX 0005/ 006
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Electrical Permit Application ‘. • C.- ‘, -. ." , ::....:. : ' , .: : ::.•::::: , i.i.::: ma. OFFICk USE ONEX
City of
1312SW Hall Tigard Tig iligt.
4 5 Blvd., ard, • ( 3
lir
I Phone: 503.639.4171 Fax: 503:598.19600,
c \-%- L
n% % t ii) a
& WI P itkReview
.erntit No.: 5 .
' .,...„ 4 , ..----
11=111
I I GA R D
Inspection Line: 503,639.4175 .„.._-(N.--- G into Ready/By: huh: fd See Page 2 for
Internet: www,tigard-or,gov rvc .......S4 N Notified/Method: Supplemental Information
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s ':.1 . :: : " . : : : . ,-:.:1-.:- . ..::: . ::: : : ', A:J'.: :, .', • ::.' ':: ,.. 'l:• :. .': . .T.y0g.,.,.::vvole.. , .:::,.., - ; . ,....: . ..:-,. :;;;::. . ;'::1 :'....••• 1 ; • ::: . ';•.- ; : .:
0 New construction El Addition/alteratiVrIlkensent Please check all that apply (submit 2 sets of plum so/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition Li Other: where the available fault current 0 Marinas and ImalYards.
'- ''.•-..:: 6TEUORY,:OF .CONSTRUCTION'''' ' • •••:' ' ' :: ., .,. ,....., .:.. : ..• : . exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial-use aancuhural
El I- and 2-family dwelling 0 Commercial/industrial El Accessory building an for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
.::,i,: .: .,..‘:.,..::::., : ,,...:.. ... . .. , . ,.. , . ,., „. . . 0 Emergency system. larger Separately derived system.
.,
• . • ...... • i.10P AND .LOCATION , • - . ,• • ..- .- •.: ......: 0 Addition of new motor load of
Job no.: Job site address: 13070 SW ASH AVE. IGOHP or mole. occupancy.
p
0 Six or inure residential units. 0 Recreational vehicle arks,
City/State/ZIP:PORTLAND, OR 97223 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locutions. 600 volts nominal.
Suite/bldg./apt, no.#25-28 Project name: ALDERBROOK APTS. 0 Service or feeder 600 amps or more.
S' : - L::: • -• ; ., •: - ...- 1 .::::: : : : . FEE . : ' ' 2 -, • . :: -.• .•::,...; .
Cross street/directions to job site: uowiatioa I Qty. I Fm. I Total I • '
Now residential single- or multi-family dwelling unit.
Includes attached garage.
--- _
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
En. add'I 500 sq. ft. or portion 33.40 I
Tax map/parcel no.: Limited energy, residential 75.00
(with shave sq. CO 2
INSTALL FIBER OPTICS FOR VERIZON
Limited energy, multi-family
residential (win, abeve sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocatio
200 amps or less 80,30 2
:': ::...•.:-.12VPROPERTY -,- :::-.• .-.:, 1 .::'..:':...::: a. :-:!::::''-, ..: ...: 201 amps 10 400 amps 106.85 2
Name: , 401 amps to 600 amps 160,60 2
601 mops to 1,000 amps 240.60 2
Address: Over 1,060 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
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 amps to 400 amps 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'.::;APPLICANT.1. :..-.•:'..::: ' n CONTACT PERSON ,..: • :.%-.::.: above service or feeder fee,
6.65 2
- each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
without service or feeder fee,
Contact name; MONET VIVEROS (list hranch.circuit 46.85 2
•
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP:VANCOUVER, WA 98684 Each manufactured or (nodular
90.90 2
dwelling, service and/or feeder
Phone: (360 ) 254-6920 Fax: I ( ) 1-866-530-4325 Reconnect only 66.85 2
E-mail: mviveros@northskycomm.com Pump or irrigations circle 53.40 2
,::.._;.:I;,: ‘;:,y.-‘:::,.:,'..-: .,:.:.::'::. :...,-;: .CONTRACTOWi'. f: . . :: - :. '''': ..... ',: ::1'1::.... : ':,;' Sign or outline lighting 5340 2
—
Signal circuit(s) or
Business name: name:NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or 1
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 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 in - min) 62.50
CCB Lie.: 141 17 Electrical Lic.17-154CLE Suprv. Lie.: 173LEB Industrial plant per hour 73.75
.'.:.'.' ELECTRICALTERMIT: TEES :', -...:::
Suprv. Electrician signature, required: Subtotal: 375
Print name: JACK CAGLE ate: 3/19/08 Plan review (25% of permit fee):
Slate surcharge (Irk of permit fee): $9
Authorized signatttre: . ..- P —,, ..,-!'" - ---- •:----- _.
TOTAL PERMIT FEE: $84.00
Print name: TERI A. MIKULIC Date: 3/19/08 This permit application expires if a permit is not Wanted within IRO
days after it has been accepted as complete.
..,: Number of inspections allowed per potion.
IMId 'Wing \PerteihAELC.PemetApp.doc 05/23/06 410.4t EMI I/05/COMAVEB
CITY OF
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BUILDING DIVISION PERMIT #: BLR20080006
13125SVV Hall 8lvd, Tigard, ORO7223 DATE ISSUED: 3/19/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 - AIL
INSPECTION WORKSHEET FOR DATE: 312712008 TIME: 7:03AM PAGE: 43
SITE ADDRESS: 13070 SW ASH AVE 25 CLASS OF WORK:
SUBDIVISION: ALDENDR(}OKAPARlMENT8 LOT #: 008 TYPE OF USE:
PROJECT NAME: ALDERBROOK APARTMENTS
DESCRIPTION: Installing fiber optics for Verizon. Apartment numbers 26'28.
OWNER: CARNEY, GEORGE & GWENDOLYN PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 3/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
139 Electrical final 067394'03 971'663-9326 �
Corrections/Comments/Instructions:
•
PASS Li PARTIAL APPROVAL CANCEL NO ACCESS
pi FAIL ri CALL FOR INSPECTION Ell ADDITIONAL FEES ASSESSED
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|napecfoInspector: K�� / Date: ~7=�� / /y�� Phone #: /503\ 718-