Permit r •,
(. ' II CITY b F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00257
T[GARD DATE ISSUED: 9/10/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S135CA 01400
SITE ADDRESS: 11410 SW GREENBURG RD 1 ZONING: R -12
SUBDIVISION: GREENBURG TERRACE APARTMENTS LOT: 6 -7 JURISDICTION: TIG
PROJECT: GREENBURG TERRACE
Project Description: Units 1 -4. Install 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:
NORMAN &ANN WONG NORTH SKY COMMUNICATIONS INC
2433 NE 11TH 11818 SE MILL PLAIN BLVD
PORTLAND, OR 97212 SUITE 410
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 9/10/2008 $75.00
[TAX] 12% State Surcha; 9/10/2008 $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 rut e s t`h in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.24 .6699 or 1.800.3 . •
tt I
Issue By: I f Permittee Signature•4.1111M, , • 1l>t/ //IJ/
,' .
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
''t -,.:::,,r.::m.rt...i:,,immv-....,.10-Rk*it„..,,,:x.1..,,,,,w,,.....::...,..,,,,,,f,g,...ie::.,...........a>si,Ag.p.A•i.R.A,,,ti:.,,,..ef:-.;.*
: City of Tigard '' GT Iktiwil No.: Ez.k,Ag -00.0757
a "AlZ Date/By:
13125 SW Hall 13Ivd .. Tigard. OR 9 7,213 0 1_
1 1111
, 1:v112i:wk.,.
Odic( R.'rinii:
; . : • Phone: 503.639.4171 Fax: 503.3%%:1. oatc/liy:
TIGARD Inspection Lino: 5 03.639. 417 5 DoSee V
te Ready/13y: /one El So 2 for
Internet: ww■v.ligarti-Or.aov v of 1kG14:11AN Notificd/Method: Supplemental Infom n - ratio
• TYPO u 01 PLAN REVIEW
El New construction ili Addit - 1/ I ration/replacement Please cixt:k all iliac pply Gt:balit 2 sett of plans it:at:checked 5110w):
CliQl*Vi(lt; Or lectlet .100 amps or low,: 013nildinl! (wet thgv.e itoeics.
0 Demo litimt E) Other:
where ale avaitatdel'ailii ClitfC01 0 M;IfiglaS :opt ho;ityalth.
..
• • CATEGORY OF coNsTRuctioN exceeds 10,050 amps :It ISO totts ti 01.1outin. bailding.s.
- - - le, to ground, or essei;etk 1 0 C000lic.teial-use Agticulto,:it
LI I - titc.1 2-family dwelling 0 commercirwindugulat LI Accessory building any, ti n oll main iithtallations. building..
GI NI tilli -family 0 Master builder 0 Other: 0 Filo pimp. 0 10S1:111:111011 01 75 KVA 01
0 (..11101conq :;rsktm. litror scpxfately closed ...yoem.
JOB SITE INFORMATION AND LOCATION
0 Addition 0100w 01tIVIC 10:111 al
Job no.: I Job site address: 11410 SW GREENBURG RD. 100111 0/ intim tit:cop:titer.
CI SiN or MOIC :CS:at:116,d milli. 0 ReVIV:10031:11 Mtk k mohs.
City/Slate/ZIP: TIGARD, OR, 97223 0 14,00,-.„,, r,ciiiii, 0 s,,,,,l 0,1115 ,-,,,. :ours Illall
0 ti,,,,,,,!,,,,, t,,,,,ii.. b00 volts nootio,i1.
Suite/bldg./apt. no.: 1-4 Project 'tame: GREENBURG TERRACE DSC! vice Of :■:C(Iir 600 amps or more.
- '-- FEE SCHEDULE
Cross street/directions to job site:
inwriontot - 1 - iii7.7 R. L...1.,,,, I
- - _ ..........________...
a New residential single- or inulti-fandly dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. n. or less I45.1.5 4
- Eit. att(1 500 sq. ft. or portion 33.40 I
Tax inap/parcel no.:
1 atoned energy, residential
75.00 2
DESCRIPTION OF ‘VORK twilit shove .5. it.)
-- -
L11111681 energy, multi-famay .
I 2
INSTALL FIBER OPTICS FOR VERIZON - 75.00 residential (wror "1" to
_...._............_______
Services or feeders installation, alteration, and/or relocation 1
_ 200 ;imps or 11155 F 80.30 2 .!
_
'PROPERTY OWNER ' . D TENANT 201 mop; to , 100 aMps i 106.85 2 I
Name: I
• . 11 - ik.) 0 ),)C_ 401 ;intim to 600 amps
11111M En i11111)N 1 160.60
240.60 2 1
2
Address: 1 ,■ i r AOC, Over 1,000 amps or volts 454.65 2
City/Stater/AP: ■ o 7 p-/ .
, .... _
f empurary services or feeders installation , alteration, arid/or
I 0 . ) e q 2- relocation
Phone: ( ) Fax: ( ) 200 :imps or less 1 66.83 _
1
201 a amp
Owner installation:•this installation is being made on property mat i own which is not sips to 400 s )00.30 1
I .... ._
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. ; 401 ;toys 10 599 amp 133
s ,75 I 2
Branch circuits - mos% alteration. or extension,per panel
Owner siglinture;_. ..... . ...... _ ...... . ....... . ..... _ ......,..........______ .. Dzite:
_ _ A. Fee for twitneli ci rcuits teirb
0 APPLICANT 0 CONTACT PERSON above service or Feeder Ice,
I 6.65 2
eax It tqanc.I) Cu cut t
13 usIlleSs name: NORTH SKY COMMUNICATIONS, INC. 13. Fee l'or branch circuits I
tenhota service or leder lee,
Contact nettle: RYAN ROBERTS I 46.8.5 2
Iiist branch circuit
I Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ;1(1(1'1 branch ciicui( I 6.65 7
-- Miscellaneous (service or feeder noi inclu)1ed)
I C'D'iSfaleIZIP: VANCOUVER, WA 98684 Each inandaettired ot modular I
90.90 1 - 2
e I
1 Vh ax: ____ one: (503 ) 519-5264 F : ( ) 1-866-905 dwelling. servic and/or feeder
-4907 Re.c.ouneci onl l 66.8.5 .___.
2
______
I
Entail: mduornorthskvcomm.com Pump or in igzitioo citcle _ i _ 53.40 I /
; CONTRACTOR .. Sign or outline liohnfi ti t 53.40 1 I 1--
-------- Si cntil circoit(s) or limited- i
I Business name: NORTH SKY COMMUNICATIONS INC. ,",- • 1 ti - • •
L , _ onao pain. , a toation, oi
I Address: 11818 SE MILL PLAIN BLVD. STE 410 125I11O100. ii110er11.1C: 1 Page 2 $75.00 2
..........._
City/State/ZIP: VANCOUVER WA 98684 Each additional inspection over a llowilble in any of the abo -e
--- Per los.peruon I 62.50
Phone: (360) 254-6920 Fax: ( 3 1-866-530-4325 1,,, verhour(riu.,,,i,,) 62.50
......
CC2 Lie.: 14117 ElecIdeal lie:1 7- 154CL Soprv. Lie.: 173LEB indiwiiai plant per hour L 73.75
_.__ ELECTRICAL PERMIT FEES
. Suprv, Electrician signature, required:
St■Lootal: $75.QQ.
Plan review (25% of permit fee):
Print name.: JACK CAGLE Dale: 9_9_
_ State surcharge (12%, of permit fee): a9.00 1
AutImi signature: ___ A, 0
/___ TO"I'AL PI:RIMIT l' $84 j
Print name ETHON ADOLPH 1 Date 9_9_08
. 19.11:; ( ;°;ii . :1 1 ) 1 111 - c;;IiT111(1xpirtlt if a permit is itot oittaiotil 6illiiii 180
: . i :
th,,,, zlilf;1 if ha., been nfeeptCa ith , ;0111plet,
Ntimbei of inspections allowed per permit.
i:tit:dMintilomilal,c..P.:ooliAllp.doc 01/2005 .1.1041t iSiii ifit:VCOMN:1111
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008 -00257
f 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/10/2008
Phone: (503) 639-4171 itiIti u l l
Inspection Requests (24 Hrs.): (503) 639 -4175 =__..
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 11410 SW GREENBURG RD 1 CLASS OF WORK:
SUBDIVISION: GREENBURG TERRACE APARTMENTS LOT #: 6-7 TYPE OF USE:
PROJECT NAME: GREENBURG TERRACE
DESCRIPTION: Units 1 -4. Install fiber optics for Verizon.
OWNER: WONG, NORMAN & ANN PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2M-6920
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 075671-01 503 -209 -7014 N
Corrections/Comments/Instructions:
NN\N
0 PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: & • I006r Date: 9l (ci 1 _ Phone #: (503) 718- Z'ILlU