Permit pp CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00261
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 2S 110AC -01200
SITE ADDRESS: 11344 SW BULL MOUNTAIN RD 2-A*** ZONING: R -25
SUBDIVISION: BULL MOUNTAIN HGTS. APARTMENTS LOT: JURISDICTION: TIG
PROJECT: BULL MOUNTAIN HEIGHTS
Project Description: Install low voltage fiber optics for Verizon. Units 105 - 110, 205 - 210 & 305 - 310.
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:
ANDREWS MANAGEMENT LIMITED NORTH SKY COMMUNICATIONS INC
11336 SW BULL MOUNTAIN RD #103 PO BOX 87550
TIGARD, OR 97224 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 7/3/2007 $75.00
[TAX] 8% State Surcha 7/3/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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: 1 '// Permittee Signature: 0Q Pep b Ca-Pi an
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.
• 07/82/2007 MON 18: 39 FAX 2003 /011
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Electrical Permit Application FOR OFFICE USE ONLY
ReceiDarnley: ved J •� 7 A ' City of Ti g ar 9 3 ECE VE [ / J 0 �l..l �r -, . " 13125 SW Hall Blvd., Tigard, OR 9 Plan Review Permit No.: E
Phone: 503.639.4171 Fax: 503.598.19C>JO L ® ty � 7 Date /By: Other Permit:
TIGARD Iltspection Line: 503.639.4175 4 / Date Ready /By: Jail PI See Page 2 for
Internet: www.tigard- of.gov CITY O T1(4490 Notifted/Method: 'H ( Supplemental Information
_. TYPE ;,OF i o • ii'1IC'J�s�VIS'IC�I�1 . .. ` PLAN REVIEW '
❑ New construction Addition /alteration /replacement Please check a that apply (submit Z sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
• CATEGORY OF CONSTRUCTION ' • • • exceeds 10,000 amps at 150 volts or El Floating buildings.
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
� ❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
X ('Zy Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
• JOB SITE INFORMATION. AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: { 1' <}L� i_` 1�1 ��t11 1 ��7.11 t C 100HP or mare. occupancy.
�< t1 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: GC( fl 0 'O 7 ❑ Health -care facilities. ❑ Supply voltage for more than
Cit
y 't VA 1 `^ (Ili ❑ Hazardous locations. 600 volts nominal,
Service or feeder 600 amps or more.
Suite /bldg. /apt, no.:11:10 . -110 Project name: t,\ \ ,�� (\ -\� ■ ∎ ):,(:) s ❑ p
FEE SCHEDULE
Cross street /directions to job site L C •- L' Description I Qtv. 1 Fee. I Total I
New residential single- or multi - family dwelling unit.
1 1'2-'0-3- i 0 Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'1 500 sq. ft. or portion 33.40 i
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK • • • • ' . (with above sq, ft.) 75,00 2 •
4
i f� r r t ) Limited energy, multi - family
1''k a . {d. . \: 1 : �' , � � lt i 1 ,! 't j � '` � r 1 � � residential (with above sq. 0.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY : OWNER ❑ TENANT 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 1,000 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
' ❑ APPLICANT • ' iCONTACT PERSON above service or feeder fee,
6.65 2
t; ( �� (::';‘./..,41 r ; 1`/; Fee for branch circuits each branch circuit
Business name: i' \1 �1' � \ (,;;_ � +, I t \ ,,, (0_,�. t 1 •. 1 ' B.
c without service or feeder fee,
Contact name: < monepi -- N �� 46.85 2
C. S f ast branch circuit
S r r` , , Each add'I branch circuit 6.65 2
Address: i ( • , F ` 1 - ` ` V I. 11 t I, LA, t 11 t j o f (, y /' „; ).-
`' { /i r > Miscellaneous (service or feeder not included)
City /State/ZIP: \ i,'., ,,,/ I`)jJ..t/- ,'/ V,,1 ii ' ) :, t (' / Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ('. ((/0) •'2 • (/ f9 Fax: : (00 2 , h Reconnect only 66.85 2
E-mail: _ n mp or irrigation circle 53.40 2
rc\Qyvc? �s Cn& � camm.0211-n Pu
TRACT x Sign or outline lighting 53.40 2
Business name: \, rt / C 1, ft n n /1 Signal circuit(s) or limited -
V " t ! -1 l' W� \,1YF• }��' \�`�,( lf++ �(.' V energy panel, alteration, or
Address: extension. Describe: + Page 2 '\ (- 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 Iv min) 62.50
CCB Lie.: `(...\.\ 1I ` Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
- ELECTRICAL` PERMIT .FEES - .. -.
Suprv. Electrician signature, required: Subtotal:
Plan review (25% of permit fee):
Print name: Date: State sucharge (8% of permit fee): t73
•'
Authorized signatre: ..... 1
u.. .,,`,, _. .:.; TOTAL PERMIT FEE:
Print name: --f'it, This permit application expires if a permit is not obtained within 180
( �� / I ( �/ / .� it �.; r�i''( days after it has been accepted as complete.
111 Date: i� a Number of inspections allowed per permit.
7:1Buitding \Permits \ELC- PermilApp.doc 05/23/06 440.4615T( l i /05 /COM +W£13
7/27/2007
Case Activity Listing
D EL 11:14:10AM
Case #: ELR2007 -00261
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ELR1010 Application received 7/3/2007 None RECD FAX 7/3/2007
SLN
ELR1020 Permit created 7/3/2007 None DONE SLN 7/3/2007
SLN
ELR1030 Check for parcel tags 7/3/2007 None DONE SLN 7/3/2007
SLN
ELR1280 Issue permit 7/3/2007 None DONE SLN 7/3/2007
SLN
ELR2135 Low voltage 7/24/2007 7/25/2007 7/25/2007 None PASS GN 7/25/2007 052683 -01 — 503 - 849 -5198 — VM -
GN N
ELR1740 Case finaled 7/25/2007 None DONE GN 7/25/2007
GN
CaseActivi t
Pa 1 of 1 Y••m
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00261
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 71312007
Phone: (503) 639 -4171 �iijh
I Inspection Requests (24 Hrs.): (503) 639 -4175 __1.
INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:02AIVI PAGE: 60
SITE ADDRESS: 11344 SW BULL MOUNTAIN RD 2 -A CLASS OF WORK:
SUBDIVISION: BULL MOUNTAIN HGTS. APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN HEIGHTS
DESCRIPTION: Install low voltage fiber optics for Verizon. Units 105-110, 205-210 & 305-310.
OWNER: ANDREWS MANAGEMENT LIMITED, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360 -254 -6920
Inspection Request Scheduled For: Date: 7/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 052683 -01 503 -B49 -5198 N
Corrections /Comments /Instructions:
\\
N A
# e'
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: IV (1/4)e L' Date: If nJ Phone #: (503) 718- . 24 1 1 4 0
I