Permit Ir CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00279
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TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 1 S135DD -01600
SITE ADDRESS: 11580 SW HALL BLVD ZONING: R -
SUBDIVISION: SILVER CREEK APARTMENTS LOT: JURISDICTION: TIG
PROJECT: SILVER CREEK APTS
Project Description: Install low voltage fiber optics for Verizon. Units 1 -10.
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:
CACH, GERALD C AND JOAN L NORTH SKY COMMUNICATIONS INC
12525 SW MAIN PO BOX 87550
TIGARD, OR 97223 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 - 6920
FAX 360 - 254 -5097
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 7/3/2007 $75.00
[TAX] 8% State Surcha 7/3/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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: 1 // Permittee Signature: d0j_/ / / C r)
PP
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.
07/02/2007 MON 19:01 FAX 00 02/002
ii.111(0,,_ - e i'1>L(A5 �-' KA if,INCC" 'O 'z'- L , -. 5 -0"
Electrical Permit Application FOR OFFICE USE ONLY
City f Tigard Reoeivea ] c / ' 1 yj �/y�
V y g ' � , Date/B 1 J Ci/3 Permit No.: FLPZe `- o2
13125 SW Hall Blvd., Tigard, O' ,7. 2 Pfau Review
Phone: 503.639.4171 Fax: 50 .5 • ..1960 Received
Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 JUL L 0 2 2007 Date Ready /By: tut' �� 0 See Page 2 for
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
-,r^91)
.. TYP.E.OF. l
❑ New construction Additionla re`lacement
Please check all that apply (submit a sets of plans wlitems checked below):
❑ Service or feeder 400 amps or mote ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
i' , - ...:.CATEGORY' CONSTRUCTION - • _ .. .. exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
X p r•
• Multi- family U Master builder ❑Other: Fire pump. ❑ Installation of75KVAor em
. ..
❑ Emergency system. larger separately derived system.
' : • JO SITE IN[�ORMATION`AND LOCATION
El Addition of new motor load of ❑ "A" "F" "1 -2° "I -3"
I00HP or more, occupancy.
Job no.: Job site address: -)0(,,,:t 0�R , O 1� 0 Recreational vehicle parks.
_ or Six more residential units.
City /State /ZIP: '� } C " 7 D Health -care t ❑ Supply voltage for more than
9 �i ❑Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.:i,j= H c Project name: 3 11 ),(,,:,/ y.e pi, S - sn ❑ Service or feeder 600 amps or ore.
» ;. FEE SCHEDULE'...•._,. ;..
Cross street /directions to job site: Description I orv. I Fcc. I Total l '
New residential single- or multi - family dwelling unit.
Includes attached garage. .
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION ;OF i'JORK' (with above sq. 0.)
( (' Limited energy, multi -famil
'i•• ;1 J I: ( , /f ( f t. ) ;� . \ / '� residential (with above s y 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
• • ❑ . PROPERTY- OWNER : ❑ TENANT .. 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 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
❑ ; :APPLICANT .: , 0 CONTACT PERSON ' above service or feeder fee,
{,.. -. each branch circuit 6.65 2
Business name: l` ir•k. ; (' (i_;:;ti't t F \ L, '•. ° " t: ( . .t ut, l ' , - B. Fee for branch circuits
without service or feeder fee,
Contact name: ' \tA t \ \ rS first branch circuit 46.85 2
Address: ( t / �`' l 'l. t < < i t ( I {0 , ' • • r,' Each add'I branch circuit 6.65 12
(service service or feeder not included )
r , ; -
City/State/ZIP: Y \ e, k_,,. ; , t 'k f t ; ,)1) ,A/ ti \I . A •:) ; C 1
. / (; 7 t Each manufactured or modular 90.90 2
_ 1 dwelling, service and /or feeder
Phone: ( '' • 1 0 , Fax:: 1 w iS - , SZ Reconnect only 66.85 2
E - mail: erJ t r\ O / r- • C . l O1 \ . Cb'\ Pump or irrigation circle 53.40 2
- CONTRACIT I R Sign or outline lighting -
Business name: 53.40 2
n /
I. Signal circuit(s) or limited -
O O� r �. b— c o O• ) i- -' energy panel, alteration, or
Address: extension. Describe: ' Page 2 16 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (111r min) 62.50
CCB Lic.: \(A -\ \-1 1 Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
... . ELECTRICAL PERMIT' FEES
Suprv. Electrician signature, requited: Subtotal:
• Print name: Date:
Plan review (25% of permit fee):
State surcharge (8% of permit fee): t7-1
na tut'e• ` `"'.. ,�' 7
Authorized si ,: . n
• ...�;e � `......, °' », P _ 'I'OTALPERMIT FEE: % \
g x
/ ( This permit application expires if a permit is not obtained within 1R0
Print name: 1 I
/)� ( A ( /. -( l : l% k �' , C �.: ~) Date:
O L „(� days after it has been accepted as complete.
” Number of inspections allowed per permit.
I :\ Building \Pcnnits \ELC- PcmitApp,doc 05/23/06 440- 4615T(II /05 /COM'WE3
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CITY OF ��n m n n��n TIGARD
BUILDING DIVISION ° PERMIT #: ELR2007-00278
13126SVV Hall B|vd, Tigard, ORQ7223 DATE ISSUED: 7/3/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7Y6/2007 TIME: 7:06Ahd PAGE: 34
SITE ADDRESS: 11680EW HALL BLVD CLASS OF WORK:
SUBDIVISION: SILVER CREEK APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: SILVER CREEK APTS
DESCRIPTION: Install low voltage fiber optics for Verizon. Units 1-10.
OWNER: CACH, GERALD C AND JOAN L, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360
Inspection Request Scheduled For: Date: 7y8/2007 Pour Time:
Code # Inspection Description __Confirm if Contact # Message
199 Electrical final 06152401 971'565-9962 Y
Corrections/Comments/Instructions:
1 p�N
ri PARTIAL APPROVAL CANCEL NO ACCESS
/' �� FA|L ri CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
^~�__ mJ ���� 1 ,�,y�.� ~��y
Inspector: ~~� ^ �� ��K�D��� Date: o �� ���� Phone #: (503) 718-1-4*