Permit l .„ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00120
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/20/2008
PARCEL: 1 S135DA -04600
SITE ADDRESS: 11157 SW HALL BLVD 1 ZONING: R -12
SUBDIVISION: VILLAGE @ WASHINGTON SQ. APART LOT: 001 JURISDICTION: TIG
PROJECT: VILLAGE AT WASHINGTON SQUARE
Project Description: Units 1 -16: 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.
Issued By: ermittee Signature: - f-of
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 5 / 1 9 / 200 8 MON 14:22 FAX 360 254 5097 North Sky Communications 2002/005
:•
*ir 0
FCEED ,.
Electrical Permit Applica V -
i- - - -, FoicorricEiusloiNLY.. -• , • : •:•• v :: ',
, City of Tigard MAY 1 9 2008 Received '
Dte/B : ITAMMIZEFAM77=1 •
IN 13125 SW all Blvt.I., Tigard, OR 97223 Plan Review
, 31 , ' Phone: 505.639.4171 Fax: 503.59.8.1960 „.... - .,- c pi A ;,3 t 0 ; ' Date/Et : Other Permit:
TIGARD
Inspection Lino: 503.639,4175 LA i Y U ilutiirle-' Date Ready/Ety: Elf See Page 2 for
- 1111 www•tiRatd-orq;" BUILDING DIVISION Notified/Method: Supplemental information
' ;';' .:, ::. ':::.' : ,::::::' -:.::::::' : ?.'lv.::e :.] ;:::.:;:i.::::,' :. 1:- :::: I :• i: .' . .: ;::.:-.1.& :-::•':; ,,'• ; :pg.i)1/4/ ■ 1 xtE1/1)
0 New construction 1::: Addition/altcration/replacement Please check all that apply (submit 2 sets of plans wAtenis checked below):
0 Service or feeder 400 amps or store 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
dXerE06.12.i(;0\..co..r,sikiluic.TFoN:::::,.!.,.,.:,,:::.....:,..::,.,;:;.,:i.:::::.:‘;.: exceeds 10,000 amps at 150 volts or 0 Floating buildings.
. - less to ground, or exceeds 14,000 0 Commercial msc agricultural
0 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings,
0
Multi-family El Master builder 0 Other: 0 Fire punip, 0 Installation of 75 KVA or
, „ . ' 0 Emergency system.
1 44.::SOk :. :1iNTORM.;141,:*. s. .AND..16.6.:AT/014 .:•:''•.:;::.-:• • '.•:.'' . ::.-:.':,..: 0 Addition of now motor lam o f 0 . "cm.
Job no.: Job Site address: 11157 HALL BLVD 100HP or atom. occupancy.
0 Six or mom tesidential units. 0 Recreational vehicle parks.
City/State/ZIP:TIGARD, OR 97223 ID Health-mare facilities. 0 Supply voltage for MOM than
0 Hazardous locations. 600 volts nominal,
Suite/bldg./apt. no.1-16 Project name: VILLAGE @ WASHINGTON SQUARE El scrk° or feeder 600 amps" cows.
4".EE'SCITEDULE.: ..: :'';':.::::
Cross street/directions to job site: uescrtirtion I Qty. L Far. I Tail r •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: IMO sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
Limited energy, residential
75 2
:. :•:.‘.':::' ..' '.•,: .'..::,..:':'.: i ,:j.11)ESCRIPTION-OF..:WORKf :-....: : - . ':. .*:.' ... :, '...-:•.':.,:,.....::• (with ilbov6sq. 0.) .00
Limited enrgy, multi-family
(AAOS i ( 6 : INSTALL FIBER OPTICS FOR VERIZON reside
ntial (with above sq, ft,) 75.00 2
Services or feeders installation, alteration, and/or relocation ,
200 amps or less 80.30 2
: '..:..'','-::::::: :T 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160,60 2
601 amps to Istoo amps 240.60 2
Address: Over 1,000 amps or volts _ 454.65 2
_ . .
City/State/ZIP: Temporary services or feeders inshdlation, 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, per panel
Owner signature: Date:
A. Fee for branch circuits with
12 ::.•:::::'::. .: ,:::' : ,:.::::::: f:]: above service or feeder fee,
each brunch circuit 6.65 2
. Business name: NORTH SKY COMMUNICATIONS, INC, B. Fee for branch circuits
ithout service or
Contact name: MONET VIVEROS w feeder fee, . first branch circuit 46.85 2
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/Z1P: VANCOUVER, WA 98684 _ Each manufactured or modular
90.90 2 .
dwelling, service
Phone: (360 ) 254-6920 Fax: : ( ) 1-866-530-4325 Reconnect only 66.85 .
2 .
. and/or feeder
E-mail: mviveros@northskycomm.pom Pump or irrigation circle 53.40 2
..;,.::,.::::_.:::. ' :;':".:•:y: ..... ... ::..,'::',.:...:...::',''..'•:: Sign or outline lighting 53.40 . 2
Business name: NORTH SKY COMMUNICATIONS, INC. Signal circuit(s) or limited-
, energy panel, alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2
City/Statc/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 (1 lir min) 62.50
CCB Lic.:1 41 1 7 Electrical Lic.. - 54 Suprv. Lie.: 173LEB Industrial plant per hour 73.75
, !•; . :'''.:',..:. 1 .. ,,, ' -1. : :: :': . :ELECTRICAV:PER14111TITEES':: -. ......::::.:,•,''.
Suprv. Electrician signature, required: • Subtotal: $75
Print name: JACK CAGLE Date: 5/19/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): $9,00
Authorized sigttR- --------- .4-. TOTAL PERMIT FEE: $84.00 •
Print name: TERI A. MIKULIC Date: 5/19/08 This permit application expires if a permit is rat obtained within 180
days after it has been accepted as complete.
• t Number of inspections allowed per permit.
Peuirding1PormilAFIC•Per mit App.doc 05/21/06 440-4615T( I Igo/cowl/se
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008-00120
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2008
Phone: (503) 639-4171 1111
Inspection Requests (24 Hrs.): (503) 639-4175 jJ IL
INSPECTION WORKSHEET FOR DATE: 5/27/2008 TIME: 7:01AM PAGE: 24
SITE ADDRESS: 11157 SW HALL BLVD 1 CLASS OF WORK:
SUBDIVISION: VILLAGE (iia• WASHINGTON SO. APART LOT #: 001 TYPE OF USE:
PROJECT NAME: VILLAGE AT WASHINGTON SQUARE
DESCRIPTION: Units 1-16: Installing fiber optics for Verizon. ‘`q,
OWNER: CAHN, MARVIN & MAJORIE 1" • PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2646920
Oei■i
Inspection Request Scheduled For: Date: 5/27/2008 Pour Time:
Code # Inspection Description Corii # Contact # Message
135 Low voltage 070360-01 503-96-5989 y
(‘R
Corrections/Comments/Instructions:
t o
ir■ PASS PARTIAL APPROVAL 7 CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION Ei ADDITIONAL FEES ASSESSED
Inspector: GM NeSe Date: t • Phone #: (503) 718-1
•