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Permit U' CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00148 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2008 PARCEL: 2S 110AA -02500 SITE ADDRESS: 11040 SW GAARDE ST 1 ZONING: R -12 SUBDIVISION: JOLENE APARTMENTS LOT: JURISDICTION: TIG PROJECT: JOLENE APARTMENTS Project Description: Units: 1 - 10. 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: CORBETT HOUSE LLC NORTH SKY COMMUNICATIONS INC 621 SW MORRISON ST #800 11818 SE MILL PLAIN BLVD STE 4 PORTLAND, OR 97205 VANCOUVER, WA 98687 Phone: Contact #: PRI 360 - 254 -6920 FAX 1- 866 -530 -4325 FEES Reg #: ELE 17- 154CLE LIC 14117 Description Date Amount [ELPRMT] ELR Permit 6/6/2008 $75.00 [TAX] 12% State Surch 6/6/2008 $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:/ � j ' rmittee Signature: f 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. JUN 05 2008 11:58 PM FR TO 5035981960 P.03 t RECEIVE s .. Electrical Perm ' . - ..• •• ..- -.:,......, FOR OaICE USE ONLY J. Rtrn City of Tigard JUN ®5 200 Received vcReceived n i t No,; l ' 144 • t- . ' , Iie ,,JJ e : st 13125 SW Hail blvd„ Tigard. OR 97223 ^� EE h/ DmMI) : Ce lX ! . , Phone: 503.639.4171 Fax: 503 ) O� I tGAHLJ Other Permit: TIGARD Inspectio 503.639.4i'I I I`� DIVISION Dut " Ready /139: 11f See Page 2 mr i„,,,,,,,.; www,tigafd- or,gov B 1J l � ,,— 1. t,-? !-P ! Noiincd /Mcchod: ll Supplemental Information • , ;..'.TYPE .QF WORIC .. � •` PLAN REVIEW. '' ❑ New construction GI A(Idition /alteration /Lepla em(`nt Prase check all tha1;tpply (submit 2 Sets o1' plans nu/wow cheel/ed below): © Service or (ogler 400 amps or owns Gl )baiter Log over three atorier. El Demolition © Other: where Ube availabic Rauh current 0 marinas and hrtaeyantx. • . ' . :. . : 1 : ' exceeds 10,000 amps at 150 rolls or 0 F•linnin bnitdin "a CA'tE(;ORY'OT'.LUNSTRUCTION s m Inc to ground, in exceeds 14,000 0 Commer;ist -use agricultural © I - and 2-family dwelling ❑ Commercial /inciustrial Ej Accessory building amp: for all ether i1191all11110113. buildlllg6, IS Multi- family ❑ Master builder ❑ Other: El fire pump, El Imialtatcon of 75 KVA or 0 Emergency cycicnt. larger separaccly derived xy:acro. ' ` : ' ` : '' ` JOB SITE 'INFORMATION AND LOCATION :. ` . 2: © Addition ornaw rumor load of Q - A" "B", "' I -2 ' I -3" occupancy. � tOpHPun Job no.: Job site address: 1.! t—t 1 W GAARDE ST w, I''1 $iX Or more MSidC Ulial mlitd, 4.J iZcGY'vlionnl veld,: le tr;vks. City /State /ZIP: TIGARD, OR, 97224 ©Hcnith -cnec rctaitities. ❑ Supply voltage for more than ,.,.. -_.__. 0 Hamill/its lecatiuna, (470 whit,; nominal. Suite/bldg./apt. no.: 1 -1 Project name JOLENE APTS ❑ Scrvieo Or feeder 600 auto nrtthpnl. Cross street /directions to job site: l)excrlptlu, I Qty. I Pec. i 'I'stal 1 • • — New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: lot no.: 1.000 sry, ft. or Less 145.15 4 Ea. add'i 500 sq. It. or portion 33,40 I Tax map/parcel no.: Limited energy, residential 75.00 2 DESCRIP'T'ION OF WORK ' (with a6ovc sq, ft) INSTALL FIBER OPTICS FOR VERIZON Lil r e si denergy, tnabovennity 75.00 2 residential with above, sti , 0.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 '© PROPERTY OWNER • • ' • .. 0 TENANT • . . 201 amps to 400 amps 106.85 2 Name: �i.. (L L 40 t amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: , d - ( • • r e •� ..,li � ,A Over 1.000 amps or volts 454.65 2 City /State /ZIP: # - aO - 'Temporary services or feeders i nstallation, altera and /or M . .4. relocation Phone: ( ) 200 amps or les 64R5 1 Owner installation: This installation is being made on property that l own which is not 201 amps to 400 amps 100.30 2 intended for sate, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 I 2 owner 4ign 1tu, C:- [ranch circuits - new, alteration, or extension, Per panel A. Fee for branch circuits with ' 0 APPLICANT : .. •.. ` • • GA CONTACT PERSON . above service or feeder fee, 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. E Pee for branch circuits — — without nervier or feeder fee, R YAN ROBERTS Contact name: final branch circuit 46•65 2 Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'1 branch circuit 6,65 2 Miscellaneous (service or feeder 1101 it City/State/ZIP: VANCOUVER, WA 98684 ranch manufactured or modular 90 F ..._._� d , navies and/or feeder Phone: (503) 519 -5264 Fax :: (— )1 - 905 -4907 Reconnect only 66.55 2 ? B•niau; mduorp o -h O l)L.Cem Pomp or irrigation circle . 53.19_ 1 2 . CONTRACTOR ' Sign or outline lighting 53.40 2 Business mane: NORTH SKY COMMUNICATIONS INC. energy panel, energy panel, ttlreraliett, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City /Slate/ZIP: VANCOUVER WA 98684 Each additional inspection over• allowable in any of the ab Per inspection , 62.50 Phone: ( 360) 254 -6920 Pax: ( ) 1-866-530-4325 Investigation per hour f i hr min) 62.50 CCB Lie.; 14117 Electrical Lic_17 -154CL a Suprv. Lie.: 173LEB lndusteitd plant per hour 73.75 i ' . . ELEC'T'RICAL PERMIT GELS •'. -- " Subtotal: $75.0 Print name: JACK CAGLE Date 6-5-08 review (25% of permit fee): 6-5-08 State surcharge (12% of permit fee): $9.00 Authorized sinature r� TOTAL PERMIT FEE: permit appticatiun aspires if a permit is not ot,taincd w ithin MO ETHON Print name: A. DOLPH pate 6 -5 - 08 (lays niter it h:iv been :tccepied :ix ctimplerc. * N t,t bm' of inspCClionn alluivcd Per perniit. Talkdldlrg ivrcoL,N'i.Calr,,sapp.uoc mirninG .14r1•4615IYt INS /cosarw 313 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008 -00148 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/62008 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6116/2008 TIME: 7:00AM PAGE: 34 SITE ADDRESS: 11040 SW GAARDE ST 1 CLASS OF WORK: SUBDIVISION: JOLENE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: JOLENE APARTMENTS DESCRIPTION: Units: 1 -10. installing fiber optics for Verizon. OWNER: CORf3ETT HOUSE LLC, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: :60 -254 -6920 Inspection Request Scheduled For: Date: 6/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 100 Electrical final 07/409-01 503-209-7014 Y Corrections /Comments/ Instructions: SS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Ins p ector: _ � Date: 6 /I' Phone #: (503) 718 - �� _�