Permit 71 �� CITY OF � ' ® ELECTRICAL RESTRICTED ENERGY PERMIT
3'`'' COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00056
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/14/2008
PARCEL: 2S 102AA -03400
SITE ADDRESS: 12375 SW HALL BLVD 8 ZONING: CBD
SUBDIVISION: TIGARD TOWNE HOUSE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: TIGARD TOWN HOMES
Project Description: Install fiber optics for Verizon, Units 8 - 14.
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:
TIGARD TOWNHOMES INC NORTH SKY COMMUNICATIONS INC
PO BOX 2907 11818 SE MILL PLAIN BLVD STE 4
POULSBORO, WA 98370 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 - 530 -4325
FEES Reg #: ELE 17- 154CLE
L1C 141171
Description Date Amount
[ELPRMT] ELR Permit 3/14/2008 $75.00
[TAX] 12% State Surchai 3/14/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.246.66 or 1.800.332.2344.
Issued : tj Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: -
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03/13/2008 THU 8:16 FAX 0003 /004
E"
Electrical Permit Appli V . �'@� ' i<•oR OFFICE' USE OW y''''::'
City of Tigard BAR 1 r. o■. , Received Daid8 : Q 0 PermitNo.: Ea o 2DGs'=00 5
. 33125 SW Hall Blvd., Tigard, OR 97223 ry
I MI MI 503.639.417 ( Fax: 503.
",,r111/610 �� ' ii♦���V Pinn Review
Phone: Other Permit:
.5 �+
TIGARD Inspection Line; 503,639.4175 BV����Gp � Dule Uatc18 Reedyl9y, ® See is5ge2for
Internet: www.tigard- or.gov O 1 Nutificd /Metlwtl: Supplemental information
.
TYPE .OF WORK : .::; _ . . :, PLAN :REVIEW .•
❑ New construction 1151 Addition /alteration /replacement Manse check ant that apply (subunit 2 sets of plans widows checked below):
0 Service or feeder 400 amps or more Q Building over three stories,
❑ Demolition ❑ Other: where dm available fault current ❑ Marinas and boatyards.
=Y ,. ' :.,... CA'TEGO$X;UF C O NS TR UC TION..
exceeds 10000 amps at 150 volts or 0 Floating buildings.
less m ground, or exceeds 14,000 CJ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building : for all other installations. buildings.
I9' Multi- family ❑ Master builder ❑ Other: ❑ Fire pump 0 Installation of 75 KVA or
. . el) derived y em.
Emergency sys larger scpant � s st
: ...:, ': ,': JOB: SITE. INFORMATION. :'AND :LOCATION . : , ' '..'. :, • .:, • w molar load of .4 . "1.3"
.. . ❑ Addition of now [� "A" "F ", ,
Job no.: Job site address:12375 SW HALL BLVD 100HPormom. occupancy.
.. C Six or more residential traits. ❑ Recreational vehicle parks.
City /State /ZIP: PORTLAN D, OR 97223 0 Health -care facilities. ❑ Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite /bldg. /apt, no. #8 - 14 Project name:TIGARD TOWN HOUSES 0 Service or feeder 600 amps or more.
a'`FEE SCHEDULE, -'.. .
Cross street /directions to job site: Docription i Qly. i Fee. I Total i •
New residential single- or multi- fancily 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 I
Tax map /parcel no,: Limited energy, residential •
' : DESCRIPTION OF• WORK (with above sq. R.) 75.00 2
Limited energy, multi- family 75 00 2
INSTALL FIBER OPTICS FOR VERIZON residential (with above sq,R,)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
.:::':` :.. ;''„ .:PROPERTY' OWNER. :. . :I. - - : 1 '0 :TENANT: 201 amps to 400 amps 106.85 2
Name: / e . ,2 / e t. ,3 1 H g._, /J� 401 amps to 600 amps 160.60 2
f 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 t
Owner installation: This installation is being made on property that I own which is not 201 amps 10400 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
Q..
APPLICANT,':.: SI CONTACT.. PERSON •. ._ above service or feeder fee, 6.65 2
each brunch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
without service circuit feeder fee,
Contact name: MONET VIVEROS
first brunch circuit 46.85 2
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each add'! branch circuit 6.65_ 2
Miscellaneous (service or feeder not included)
City /State/ZiP:VANCOUVER, WA 98684 Each manufactured or modular 90.90 2
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
'.:i: > ;: ;.''. :'CONTRACTOR': :.:: ~, Sign or outline lighting 53.40 2
-
Business name:NORTH SKY COMMUNICATIONS INC. Signaleircuit(s)orlimited-
r 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 (1 hr. min) 62.50
CCB Lic.:14117 Electrical Lia17- 154CLE Suprv, Lie,: 1 73LEB I plant per hour 73.75
. ` ... ELECTRICAL : PERMIT : .FEES... . .
Suprv. EIectrician signature. required: ri Subtotal: $76
Print name: JACK CAGLE Date: 3/13/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): $9
Authorised sis• .! TOTAL PERMIT FEE: $84.00
Print name: T ERI A. M I KU LI C bate: 3/13/08 This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete,
T ° Number of inspections allowed per permit.
IAN dt,nng'crnunat Ponnhnpp.loe 55181506 440.4615ThI uOS /COMnven
-• - •
• 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008-00056
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: :
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/21/2008 TIME: 7:01AM PAGE: 37
SITE ADDRESS: 12375 SW HALL BLVD 8 CLASS OF WORK: -----
SUBDIVISION: TIGARD TOWNE HOUSE APARTMENT LOT #: TYPE OF u/
PROJECT NAME: TIGARD TOWNHOMES
DESCRIPTION: Install .fiber optics for Verizon, Units B - 14. •
OWNER: TIGARD TOWNHOMES INC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2546920
Inspection Request Scheduled For: Date: 312112008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 067104-02 503-i)49
Corrections/Comments/Instructions:
•
:kkirKSS El PARTIAL APPROVAL 111 CANCEL • 0 NO ACCESS
n FAIL El CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
•
InSpector: Date: 3- j, .) Phone #: (503) 718-
, .