Permit 7 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00121
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/20/2008
PARCEL: 1 S135DA -04600
SITE ADDRESS: 11159 SW HALL BLVD 20 ZONING: R -
SUBDIVISION: VILLAGE @ WASHINGTON SQ. APART LOT: 001 JURISDICTION: TIG
PROJECT: VILLAGE AT WASHINGTON SQUARE
Project Description: Units 20 - 26: 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:
MARVIN & MAJORIE CAHN NORTH SKY COMMUNICATIONS INC
5795 SW CRANBERRY CT 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 14117
Description Date Amount
[ELPRMT] ELR Permit 5/20/2008 $75.00
[TAX] 12% State Surch 5/20/2008 $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. fr.t/
IMP Issued By i is Permittee Signature:, �" Y_ `'
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.
05/19/2008 MON 14:22 FAX 360 254 5097 North Sky Communications 2004 /005
t t'
•
electrical Permit Aprilicatl a l V ® - . mils aFhtct, - USIA 0,;,, , �,;h ,, t '
City of Tigard Received
g Daie /t3 : /
i o 13125 $W Hall Blvd., Tigard, OR 9722U 4Y 1 9 2008
Plan Review
2 Phone: 503.639.4171 Fax: 503.598.1960 Date/8 : Other Permit:
TIOARD Inspection Line: 503,639,4175 Date Ready /By: ® see Page 2 for
Internet: www•tigard- or•gov CtIN a GAH i.I Notified /Method: -Mill Supplemental Information
�. ULAN;:REVIEW's:;
• ., .. TYPE- _ ' ; . .....
❑ New construction Ci Addition /altcration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps ur morn 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
A EGORY OF: CON UC'TIO . .... ... . .. exceeds 10,000 amps at 150 volts or ❑ Floating buildings-
" Ices to ground, or exceeds 14,000 ❑ Commercial-use agrtculiural
❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
I Multi - family El Master builder ❑ Other, D Fire pump. ❑ Installation of 75 KVA or
❑Emergency system. larger separately derived system.
- • - .. :'JOB:SI'i' .;1NFORh1A2'tON:Atl'iD:' LOCATION:._' :t :.•, : : ?.:; ".':;.. ° Addition of newtnotor ❑"A" '"F° `I -� "t•3"
Job no.: lob site address: SW HALL BLVD 100HP or more. occupancy.
Job
❑ Six or more residential units. ❑ Recreational velticio parks.
City /State/ZIP:TIGARD, OR 97223 ❑ Health.care facilities. ❑ Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.20 - 26 Project name:VILLAGE @ WASHINGTON SQUARE ❑ Service or feeder 600 amps orowe.
Cross street /directions to, job site: nescr;zrtion I coy. I Foe. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft. or less 145.15 4
Fax map /parcel no.: Ea. add'1 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
i ,t DESCRIPTION :OF:'WORK:: .. .? ..' ' : ;: ; ... ..1'. . (with above sq. fl.)
Limited energy, multi - family
CA.44 3 20 ! INSTALL FIBER OPTICS FOR VERIZON residential (with above ti- fam sq, ft.) 75.00 2
Services or feeders installation and/or relocation
200 amps or less 80.30 2
: p; PROPERTYs VVNRB : , ;. ,` . .:,1
: :..•' . . ;:•; ' . �
...,. . 4 ' - ;:'.=: TENANT .:;r::. ":;'t';.::. 20l amps to400amps 106.85 2
Name: 401 amps to 600 snips 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, er panel
Owner signature: Date:
A. Fee for branch circuits with
. t : 0_::APPLICe01T::>; ' 1 ';;' .'` :: `:: F4 CONTACT PERSON..: .'::: •:, %::• . above service or feeder fee, 6.65 2
each brunch circuit
Business name :NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits -
Contact name; MONET VIVEROS w#hnter service or feeder fee, 46.85 2
first brunch circui
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:VAN000VER, WA 98684 Each manufactured or modular
dwelling, service and /or feeder 90'90 2
Phone: (360) 254 -6920 Fax: : ( ) 1- 866 -530 -4325 Reconnect only 66.85 2
E- mail: mviveros @northskycomm.com . Purnpor irrigation circle 53.40 2
. .::':..`:.:.';' "•:CONTRACTOR:'::: `:-.•::' }`..':': ... Sign or outline lighting 53.40
Business name: NORTH SKY COMMUNICATIONS, INC. Signal circuit(s)orlimited-
energy panel, alteration, 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(( hr min) 62.50
CCB Lic.: 14117 Electrical Lic.17- 154CLE1 SuPrv. Lie.: 1 73LEB Industrial plant per hour 73.75
..':'ELECTRICAL:PER FEES "`t:,:_•,.:.:'.:
,.,
Suprv. Electrician signature, required: j � Subtotal: $75.00
Print name: JACK CAGLE Date: 5/19/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): $9 "00
Authorized sip -- - - . -. �!!!!!r '---- --
TOTAL PERMIT FEE: $84.00
Print name:
T ERI A. M I KU LIC Dat 5/19/08 This permit application expires If a permit is not obtained within ISO
days after it has been accepted as complete.
* Number of inspections allowed pert,enntt.
L•l nuilding \PcrmitesELC- Pcrmtisnn.doc 05/29!06 440.4615T(I I/OS /COM/WEE(
,
CITY OF TIGARD
BUILDING DIVISION J PERMIT #: EL.R2008- 00121
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/20/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/23/2008 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 11159 SW HALL. BLVD 20 CLASS OF WORK:
SUBDIVISION: VILLAGE @WASHINGTON SQ. APART LOT #: 001 TYPE OF USE:
PROJECT NAME: VILLAGE AT WASHINGTON SQUARE
DESCRIPTION: Units 20-26: Installing fiber optics for Verizon.
OWNER: CAHN, MARVIN & MAJORIE PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 5/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 070326 -02 503 - 963.5989 N
Corrections /Comments/ Instructions:
l i
PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: S 1 7/b, Phone #: (503) 718- 14