Permit �*~ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
n
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00057
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 15 ZONING: CBD
SUBDIVISION: TIGARD TOWNE HOUSE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: TIGARD TOWNHOMES
Project Description: Install fiber optics for Verizon, Units 15 & 16.
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
LIC 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 $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.246.6699 or :ss 332.2344. r.
Issued By: / /L` / _� Permittee SignatureC
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03/13/2008 THU 8: 17 FAX 3004/004
Electrical Permit Apptl t>i ' FOR OFFICE USI ONLY''..' .
City of Tigard MAR 1 3 L UU6 aa ta/ : /3 0$ - 5/ Permit No.: gt,k.A.
4 13125 SW Hall Blvd., Tigard, OR 37�223 ry Plan Review
N.. Phone: 503.639.4171 Fax: 5t,, 98V T10firiti Dare/By: Other Permit:
TCGARD Inspection Line: 503.639,41r75l 1MGDIVIS.ION DateReady /By: nods: S7 See Page 2 for
Internet: www.tigurd- or.govD4O L L� sl Notified /Method: - I frt, Supplemental Information
T.YPE.OF WORK :. , PLAN REVIEW
❑ New construction D Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /itmus checked below):
❑ Service or feeder 400 amps or ntora ❑ Building over three stories,
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
" exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
'' •" (ATEGORX;OF;CONS,TRUC'CCON
d 14 000 C l !
' . • � less to ground, or exceeds ❑ onuuercia .use agdcu otra I
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for alt other installations, buildings,
6. Multi - family ❑ Master builder 0 Other: 0 Fire pump. ❑ Installation of 75 KVA or
larger separately derived system.
. a
,.. ....-.- '....:..' . JOB;SCTE': INFORMATION: AND :LOCATION : (:, ... . ' :.:..:.. ❑ Gnmrgcucysysl m
Addition of new motor load of ❑ •'A" °F" ^1-2 "I.3•'
Job no.: Job site address :12375 SW HALL BLVD 100HP ormore, occupancy.
❑ Six or inert ,csidenlitd units. ❑ Recreational vehicle parks.
City /State /ZIP: PORTLAN D, OR 97223 ❑ ttcalth•care facilities. ❑ Supply voltage for more than
.. ❑ Hazardous locations. 600 volts mOminal.
Suite /bldg. /apt. no.#1 5-16 Project name: TIGARD TOWN HOUSES amps ormore.
— _ Service or feeder 600 „ : F EE SCFIEDULE' ' ..:77.
Cross street /directions to job site: ucril
xilion __,_ .__L%i y - I Fee. l 'faint f
New residential single. or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft, or less 145.15 4
La. add'I500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential _.v._.._.
. ... DESCRIPTION OF. WORK '' . • : (with above sq, R) 75.00 2
Limited energy, multi - family
INSTALL FIBER OPTICS FOR VERIZON residential (with above sq. R.) 75'00 2
Services or feeders installation _alteration, and/or relocation
200 amps or less 80.30 2
PROPERTY; OWNER Q .TENANT. , .. ', _ 201 amps to 400 amps 106.85 2
Name: /�e. el- /L� Uw� ado I-4 C4 i N -- 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 I
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 will
`` 0 r ;APPLICANT : ' , . ..•.-, ,` ` 0 CONTACT. PERSON ...::' .. ,' .: above service or feeder fee, 6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
— without service or feeder fee, 46.85 2
Contact name: MONET VIVEROS first branch circuit
Address: 11818 SE MILL PLAIN BLVD. STE 410 Each add'l branch circuit 6.65 [ 2
Miscellaneous (service or feeder not included)
City /State /ZIP:VANCOUVER, WA 98684 Each manufactured ormodular 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 in'igation circle 53.40 2
: : .... . .
. CONTRACTOR .:..:;:.,,:.'.:_:.'.: ::, • .` -- :;:.::: 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 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 (I hr min) 62.50
•
CCB Lie 14117 Electrical Lic.17- 154CLE Suprv• Lie.: 173LEB Industrial plant per hour 73.75 _
Suprv. Electrician signature, required: Subtotal: $75.00
Print name: JACK CAGLE Date: 3/13/08 — Plan review (25% of permit fee):
_ State surcharge (12% of permit fee): $9.00
Authorized si2u;..•i:v... ” r — TOTAL PERMIT PEE;: $84.00
Print name: TERI A. MIKULIC Date: 3/13/08
This p ermit application expires if a permit is not obtained within 180
days after it 1ms been accepted as complete,
4 " Number of inspections allowed per permit.
1:\ minding \PcrmiiOtiLC- Permit,vpp.dOc 55/21/06 440.4615T(I /(15 /COMAV6n
CITY OF TIGARD - : , ...
. ._
BUILDING DIVISION PERMIT #: ELR2008-00057
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2000
Phone: (503) 639-4171
.1,19 -
Inspection Requests (24 Hrs.): (503) 639-4175 16
INSPECTION WORKSHEET FOR DATE: 3/21/2008 TIME: 7:01AM PAGE: 36
SITE ADDRESS: 12375 SW HALL BLVD 15 CLASS OF WORK: 0 .--.--- - ----
SUBDIVISION: TIGARD TOI.NNE HOUSE APARTMENT LOT #: TYPE OF USE:," .
PROJECT NAME: TIGARD TOWNHOMES
DESCRIPTION:, Install fiber optics for Verizon, Units 15 & 16.
OWNER: TIGARD TOWNHOMES INC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 3/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 067104-03 503-849-2025 Y
Corrections/Comments/Instructions:
gl
fl PARTIAL APPROVAL El CANCEL ill NO ACCESS
7 FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date:
:.)) — 11 — pr Phone #: (503) 718-
t4/9'4'L