Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00280
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/1/2008
PARCEL: 2S 102AA - 03301
SITE ADDRESS: 12345 SW HALL BLVD 9 ZONING: CBD
SUBDIVISION: TIGARD TERRACE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: TIGARD TERRACE APTS
Project Description: Units: 9 -12. 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:
GREENVIEW INVESTMENTS, INC NORTH SKY COMMUNICATIONS INC
5229 SE HILL RD 11818 SE MILL PLAIN BLVD
PORTLAND, OR 97267 SUITE 410
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 10/1/2008 $75.00
[TAX] 12% State Surch 10/1/2008 $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:, "" /4X
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.
• ..
Electrical Permit Applicvi
RECEIVED
.,....:.„.....,,,„az.,:t...akAp.,„E...„,,„.k:A.,„......,.....,,::.„....„,......„,....„,,..,o.„...„,.....„.....„...... 0 ...„...„........„,..„,.....x.
City of Tigard Roc,:ivcd 7
ia, ''"'"'-:." .■ 13 125 SW i hill Blvd.. Tigard. 2 OR 972 , 4- 1 0 Divell3y
II 12atilly:
l'Iiiii Review , / . oyi lk:rinii No,: '61 • .... • , ;Ili
:-: • * : ''•:,. P1 us 503.639/1171 is 503.59S tt0 II Din,: Permit:
. i
•,•::::
• -•'-- ' lospection 1.ine: .50.1.630 4175 Date Reiuly/kyi 0 Sec Page 2 for
• : .--- , Intetinet: www.ugard-or ere: ,.,/ OF 'TIGARD Notiricirtmethon. rre Suppleinental Inform:Ilion j
• 'FY P E PLAN REVIEW
ittiING
Ple,oe cheek all t he apply G‘ihniit 2 sell or 110111 wiiicine clJi•ed below):
0 New eonsIrtioli on a AdditioNWeration/replacement
1 Sri We or ibeder .11)1) .inpo or lairs 0 Building over tInv.e.. ,:10ri01.
El Demolition E 011101': wile, the atile. 1 C111fC111 0 Mafina, ,uvi homy:nth.
CATEGORY OF CONSTRUCTION exceeds ;imps in 150 eolis or 0 1 buildings
---- •---- !C`w 10 gionnd. or exceeds 1 Q C0111111C11:1:11•11■12 331 i011111501
I - and 2-I' oil dwelling E ] Commercial/industrial 1 : 1 Accessory Building 1, 1 ['or el 1 oilier insiallaiions. building,
11 Multi-family 111 Master builder [" Other: I Ei l'iie wimp. 0 linitiillinion "1'75 l< VA n
- 0 Rinergency i:y110111. lorgier Nepalateiy derived vstein.
JOB srrE INFORMATION AND LOCATION
, 12 Addition or ,::w motor load or
1101-1P or aloie. occupancy.
Job no.. Job ' ndd 12345 SW HALL BLVD. ID Six or mule resideniial mini. 0 Recrci.itiinul vehicle paik.s.
City/State/Z1P: T/ GARD, OR 97223 El iteatm-care inn:ties. 0 soppl 1 10r :01M:111,01
• , -- 0 11.1/.101100:i 1 01;a1I00S. 600 von, noinina1.
Su ite/bIdg./npt. no,. 9-12 Ploicel 11111110: TIGARD TERRACE ns,a vice or ciler MO:nous 01111010.
- -
FEE SCHEDULE
Cross street/directions te job site: 1)c./ 01on )1,.. I 1,..,. I
- • New residential single- or multi-family dwelling unit.
Includes at garage.
..._
SU bdi vision: Lot no.: 1,000 sq. P. or less
1 - 145.15 4
. :E 1. ac1(1 500 sq. U. or portion 33.40
Tax map/parcel no,: : _
Limited energy Ic,adniial
75.00
DESCRIPTION OF WORK i (with shove ,ci. ft) _
- -
---- Limited energy, tulti-Nniiy 1 2
INSTALL FIBER OPTICS FOR VERIZON residenual (wit n h Ithok.e q.:).1.1 75,00 I
- 7;11vicelo114;ed era iti alteration, and/or rel
200 amps or less 80.30 ') 1
0 PROPER'FY OWNER ' . ___...._
El TENANT 201 :imps III 400 amps 106.115
2 _1
Name: .10) amp:: to 600 amps I 60.60 2
- 601 amps to 1,000 amps 240.60 2
Address: - Over 1,000 amps 01 volts 454.65 2
Cit y/State/ZIP: Temporary services or feeders installation, alteration, and/ it.
relocation
_ _
Phone: ( ) I Fax: ( ) 200 amps, or less 66.85 I _
p 1 2
Owner installation : This : his instrdlation t a bcinP, made on proporty that I own which 201 amps to 400 ams 00.30 is not -
intended for sale, lease, rem, Or exchange, according to ORS -147, 449, 670, and 701. 401 -amps to 599 amps 133.75 2
Branch circuits- new, alteration, or ext e»sion, e_er panel
Owner signature: 1)11e:
1
• ,_:_::_,,, -_,:._ A. Pee for brunch circuits with
0 APPLICANT I:I CONTACT PERSON ..lbov e. service or ;Ceder Ice,
6.65 2 •
each branch circuit
Business flame: NORTH SKY COMMUNICATIONS, INC. 13. Fee lor branch circuits 1
- irdhour service or Ceeder Ice, 1
(011(011111,3 ta name: RYAN ROBERTS ra:a branch ei..aiii 46.85
i---- 2
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ad(ri brand, circuit 6.65 2
, - Miscellaneous (service or feeder lint included)
City/State/ZIP: VANCOUVER, VVA 98684 Each mann I:ten:red or m(1dultw 1
90.90 1 2
dwelling. service and/or 1
____
PhOne: (503 ) 519-5264 I Fax. : ( )1-866-905-4907 Reeom,eci omy feeder : 66.85 1
..,_.2 .
1 E mduornorthskycomm.com pomp or irrigauou circle i 53.40 1 2
--:
'
i CONTRACTOR Sign or outline lighting 1 53.40 1 o
- Signal eirenit(s) or limiled- i
i t3 n NORTH SKY COMMUNICATIONS INC
■
............... energy panel, altertnion, or 1
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: Page 2 $75.001 2
City/State/ZIP: VANCOUVER, WA 98684 ' F additional inspection over altoivith le in any of the above
Per inspection 62.50
Phone : ( 360) 254-6920 1 ( ) 1-866-530-4325 1(150.1 111011 per hour (i Ii loin) 6
CCB 1-1(1 14117 EleCIi'ICSI Lici 7-1 54CLd sow* Li e , : 173LEB 1,,d,wihil plan, p..h..„, 73.75
•
......_.... PERMIT FEES
Suprv. Electrician sigii utoiC, i equi rod:
Sublotal. $75._00
P1111 review (25% of pel mit fee):
Prim 11(11110: JACK CAGLE Dale: 9-30-08
Stuto surcharge ( }2% ol pawl; fee): $9.00
Authoi•izcd signature: ,.......-. #:_,OtieZ._.__. TOTAL PERMIT FEE; $84
-- .6111 i;e■;;;Iiapplic;Iii■; copiers i a permit ;snot otaained %culu ;80
Pi .ii " ETHON A. DOLPH Date: 9-30-08 115 Aflee it im, berm) accepted :Is completv.
- - ' Number el impatiens allowed pcnua .
1.01,01 011/11/1:6 7.10-111131( 1 Itai(C0NVW1:13
, .
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
ELR2008-00280
13125 SW Hall Blvd., Tigard, OR 97223 : . , - DATE ISSUED: 10/1/2008
. Phone: (503) 639-4171 antlillit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: 7:01AM PAGE:
10/9/2008 13
SITE ADDRESS: CLASS OF WORK:
12345 SW HALL BLVD 9
SUBDIVISION: TIGARD TERRACE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: TIGARD TERRACE APTS
DESCRIPTION: Units: 912. Installing fiber optics for Verizon.
OWNER: GREEN VIEW INVESTMENTS, INC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 101912008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 076482-02 603-209-7014 N
Corrections/Comments/Instructions:
V PASS El PARTIAL APPROVAL 0 CANCEL pi NO ACCESS
n FAIL fl CA FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: or Date: Phone #: (503) 718-