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Permit t . C ITY OF TI G A R D ELECTRICAL RESTRICTED ENERGY PERMIT J III 2. COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00087 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/18/2008 PARCEL: 1 S 135DC -03000 SITE ADDRESS: 11575 SW GREENBURG RD 3 ZONING: R - 4.5 SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG PROJECT: FOUR OAKS APARTMENTS Project Description: Units 3 -4: Installation of 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: KEN CONDO'S LLC NORTH SKY COMMUNICATIONS INC 16835 SW IVY GLEN ST 11818 SE MILL PLAIN BLVD STE 4 BEAVERTON, OR 97007 VANCOUVER, WA 98687 Phone: Contact #: PRI 360 - 254 -6920 FAX 1- 866 -530 -4325 FEES Reg #: ELE 17- 154CLE LIC 141171 Description Date Amount [ELPRMT] ELR Permit 4/18/2008 $75.00 [TAX] 12% State Surch 4/18/2008 $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 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: ,4 Al / 51- 7 0/ 6 La. C.9-770 ,j 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. 04/16/2008 WED 12: 15 FAX -•-■-• CITY OF TIGARD U003 /009 f Electrical Permit Application ItORUI�I rc i US1� ONLY �yq Clt of Ti and Ninth No. O 13125 SW Flul! Blvd Tiga O ; " Plan Review � Phone: 503.630.4171 Fax: 503. 9 `. 1 DatdBy: Other Permit: TIGARD [nspcctionLine:503,039,4175 A PR 16200 DateRcndylpy; � See Page 2 for Internet: www.ligard or.gov Notified /Method: IIEM Supplemental Information . ' T YPE.OF W A (y hry�- ?���*r PAN' REVIF,W ❑ New construction Ei Addition /alt t, n r e dl le 'n ^ n Please check all that apply (submit 2 sets of plaits w /items checked below): 11 11 r'el u Islo more 0 Service or feeder 400 amps or ore 0 Building over three stories. Demolition ❑Other: �t ll L i where the available fault current © Marinas and boatyards. exceedto s grou 10 ,000 dw amps exce at d 15t) 14 volts or 0 Floa buildings. le :,: CATEGORY qF CONSTRUCT. ION: l n es ,000 0 nrcia•us agricultural 0 I- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building ; for all other installations, buildings. E Multi - family 0 Master builder ❑ Other: 0 Fire Pump. 0 installation (>1'75 KVA or 0 Emergency system. larger separately derived system. :.- ,JOB:. SITE; I LOCATION ". :..., f 3 ....; . - ..:...� " .`�..� .. �.;:. , . � .. ; 0 Addition of new motor load o ❑ "A" °F" "I _�" "I , Job no.: Job site address:11575 SW GREENBURG RD 100HP more. occupancy, 0 Six or more residential wets. 0 Recreational vehicle parks. City /State /ZIP:TIGARD, OR 97223 0 Healthcare facilities. 0 Supply voltage for store than 0 Hazardous locations. G00 volts nominal. Suite /bldg. /apt. no.# 3 -4 Project name: FOUR OAKS APTS. ❑Service or feeder 600 amps or more. Cross street /directions to job site: ueseapGvn I Qty. I Fee. I Total j • New residential single- or multifamily dwelling unit. Includes attached garage. _ Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 , 4 Tax map /parcel no,: Ea. add' 1500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 • ' .. :. DESCRIPTION ,OF WORK:' •'.-. ? • (with abuvc sq. (t.) _ Limited energy, multi - family 75.00 2 INSTALL FIBER OPTICS FOR VERIZON residential (with abovesq.A) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 • • . : . . . . . : . PR(1PERTY: ; OWNER ' . ? ' . ; , ' :: [] PENANT.•.., •: .1 •. 201 amps to 400 amps 106.85 2 Name: KEN' c©rt 1 cos' L(_� 401 amps to 600 amps iG0.G0 2 ' GUI amps to 1,000 amps 240.60 2 Address: 1 10 35 S&i) ) I) / GLEN Over 1,000 amps or volts 454.65 2 City /State /ZIP: ('? ��1✓� f�'�1 t� o I � 9 -7 0 - Temporary services or feeders installation, alteration, and/or •7 �� 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 sate, 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, Cr panel Owner signatu e: ., ,,,..._____ -- Date: A. Fee for branch circuits with :: ,'.. [1: APPLICANT.'': •': ?,; . -. 12 ' CONTACT. PERSON . :. above service or feeder fee, 6.65 3 • each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits without service or feeder fee, Contact name: MONET VIVEROS first branch circuit 46.85 2 Address: 11818 SE MILL PLAIN BLVD. STE 410 Eschadd'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /Z WA 98684 Each manufactured or modular 9090 0 dwelling, service and /or feeder Phone: (360 254 -6920 Fax: : ( ) 1 -866- 530 -4325 Reconnect only 66.85 2 E -mail: mviverosanorthskycomm.com Pu mp Or irrigation circle 53.40 2 :' :.,:.>,.:.... : :•. <..:::'..:'.:CUNTRACTOR'.:. ;::',':,:..:. ., ....: .'. ;.` - .' ` ' ::' Sign or outline lighting 53,40 2 Business name: NORTH SKY COMMUNICATIONS, INC. enalcircuit(s)r energy panel, alteeration, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $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 hr min) 62.50 CCB Lie.: 14117 Electrical Lic.17- 154CLE Suprv. Lie.: 173LEB Industrial plant per hour 73.75 ,, r ." ELECTRICAL:PERMIT: FEES'- :.`: Suprv. Electrician signature, required: 7r�r Subtotal: 75.00 7 Print name: JACK EAGLE Da 4/16/08 Plan review (25% of permit fee): State surcharge (12% of permit fee): $9.00 Authorized si • • . ' •---w•' - -. TOTAL PERMIT FEE: $84.00 ' - fins permit application expires if a permit is not obtained within 180 Print name: TERI A. M I KU L I C Date: 4/16/08 days after it has been accepted as complete. "-' " Number of inspections allowed per permit. I;\ Duilding \Permita\GLC•P4nnitnpp.dne 05/23/06 4150.451ST( I I /05ICOMIVCD CITY OF TIGARD A BUILDING DIVISION PERMIT #: ELR2008•00087 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/24/2008 TIME: 7:01AM PAGE: 15 SITE ADDRESS: 11575 SW GREENBURG RD 3 CLASS OF WORK: SUBDIVISION: FOUR OAKES APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: FOUR OAKS APARTMENTS DESCRIPTION: Units 3-4: Installation of fiber optics for Verizon. OWNER: KEN CONDO'S LLC, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-7.54-6920 Inspection Request Scheduled For: Date: 4124/2008 Pour Time: • Code # Inspection Description Confirm # Contact # Message 199 Electrical final 068854-02 603- 333,8868 • Corrections/Comments/Instructions: • PASS I I PARTIAL APPROVAL n CANCEL NO ACCESS I I FAIL ID CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G- 0 6 LE' Date: 4 06 Phone #: (503) 718- lif%