Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: ELR2008 -00086
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 1 ZONING: R -4.5
SUBDIVISION: FOUR OAKES APARTMENTS LOT: JURISDICTION: TIG
PROJECT: FOUR OAKS APARTMENTS
Project Description: Units 1 -2: 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 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: QA/ /9 iC 4-770 N
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.
0 4/ 1 6 / 2008 WED 1 2: 1 5 FAX -4- CITY OF TIGARD 2002 / 009
, .
Electrical Permit Application
.;,
• ,, City of Tigard il V ,;. ..I.E..m; a i, A
Date/By: 7 to' / , 1- Petni1N° - 00 - --/ i i • 9 .
a 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
f '• 2 .!: Phone: 503.6394171 Fax: 503.598.1960 APR 1 6 2001 DalelBY: Other Pernik:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: lode 63 See Page 2 foe
Internet: www.tigard-or.gov O F T1GA Notified/Method: 776:- Supplemental Information
- -
0 New construction Si Addition/alter a to APPcertileift it./ t to 1 m...+ION Please check all that apply (submit 2 sets of plans w/itents checked below):
0 Set vice or feeder 400 amps or time 0 Building over three stories.
F.: Demolition 0 Other: where dm available limit cut rent Q Marinas and boatyalds.
6TEGORY. :OF COP7S.T.RIXTION.: -.•:. . . :: .., :,:.: r...:•:, :::.,' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 El Commercial-use agricultural
0 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for :di other installations, buildings.
El Multi-family 0 Master builder 0 Other: El Fire pump. 0 Installation of 75 KVA sir
, . , .. . , . . 0 Emergency system. linger separately derived system.
-..i , lJOBI,SITR':INFORMATION : .AND.:10,CATION :: ', ' .: . .• . ,.... :::.-..' a Addition anew motor load of 0 ''.7,", "v.", -1-2", "1.3",
Job no.: Job site address: 11575 SW GREENBURG RD • 100HP or mote, occupancy.
.13 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:TIGARD, OR 97223 0 Health-care facilities. 0 Supply voltage for more than
0 Iluardous locations. 600 volts nominal.
Suite/bldg./apt, no.# 1-2 Project name: FOUR OAKS APTS. 0 Service or feeder 600 amps or more.
FEF SCHEDULE
Cross street/directions to job site: Oeseription I (Vv. I fee. 1 Total I .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq, ft. or less 145.151 4
— Ea. add'1500 sq. ft. or portion 33.40 I
Tax map/parcel no,: IS ‘35 be.- P3000 Limited energy, residential
........ .. ; ..... ' ,1 ' DESCRIPTION ,OF WORK .. •.'. ; • , ' ''..: . • --- '• .. ' ' '.: (with above sq. n.) 75.00
,
INSTALL FIBER OPTICS FOR VERIZON Limited energy multi-family
residential (with above sq. fl.) 75.00 2
Services or feeders installation, alteration, anti/or relocatio
, 200 amps or less 80.30 2
.1 : •. : ....,ptPROPERT141:lliN.F.R .. -:.‘, : ::,' : :,..il -: :, .-:. -:,. ; 'O. •, ' ,‘% . 1 ,' 201 amps to 400 amps 106.85 2
Name: ke.I c .>0 's I_Le... 401 ainps to 600 amps . ,_ 160.60 2
601 amps to 1,000 amps 240,60 2
Address: if j g 5 S 1 V 1 GLe-,j 5T Over 1,000 amps or volts 454.65 2
. 0 _ -7
City/State/ZIP: 13 N j Temporary services or feeders installation, alteration, and/or
. $e el
relocation
Phone: ( ) Pax: ( ) 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.. :::...:.:: .'.., • .:. ::: '. -,•••:••.. •-.' 0 CONTAL above teL 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 first branch 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 modular
90,90 1
dwelling, service and/or feeder
Phone: (360 ) 254-6920 Fax:: ( > 1-866-530-4325 Reconnect only 66.85
2
E-mail: mviveros@northskycomm.com Pump or irrigation circle 53.40 2
' .: ,' ..,' ::- 1: ,., , .' , • ,..1•.::: l• - •,,: - , -• : s':; Sign or outline lighting 53.40 2
Signal circuit(s) or Business name: name:NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 ra $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 () hr num 62,50
CCB Lie,: 14117 Electrical Lic,1 7-154CLE Suprv, Lic.: 173LEB Industrial plant per hour 73.75
.' .1, :• :.:::.: •.••ELECTRICAL :PERMIT
Suprv. Electrician signature, required: .,.-,,„,,, Subtotal: $75
it f
of (25% review ( o permee
Print name: JACK CAGLE Date: 4/16/08 Plan rev):
State surcharge (12% of permit fee): $9.00
Authorized sig -....- — ... - TOTAL PERMIT FEE; $84.00
Print name: TERI A. MIKULIC Date: 4/16/08
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
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. . .
CITY OF TIGARD
BUILDING DIVISION Av PERMIT #: ELR2008-00086
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2008
Phone: (503) 639-4171 / ,
Inspection Requests (24 Hrs.): (503) 639-4175 -414- - 1 I
INSPECTION WORKSHEET FOR DATE: 4/24/2008 TIME: 7:01AM PAGE: '16
SITE ADDRESS: 11515 SW GREENBURG RD 1 CLASS OF WORK:
SUBDIVISION: FOUR OAKES APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: FOUR OAKS APARTMENTS
DESCRIPTION: Units 1-2: Installation of fiber optics for Verizon.
OWNER: KEN CONDO'S LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2E46920
Inspection Request Scheduled For: Date: 4/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 ' Electrical final 068854-01 503-333-8888 N
Corrections/Comments/Instructions:
\\
' V
Kt PASS fl PARTIAL APPROVAL Ei CANCEL 0 NO ACCESS
I I FAIL El CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: Cr " N (Se L Date: 1 1 2 -J11 4 14 Phone #: (503) 718- 144