Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00163
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/1/2007
PARCEL: 2S112BB -04000
SITE ADDRESS: 14500 SW HALL BLVD B ZONING: R -12
SUBDIVISION: EDGEWOOD MANOR APARTMENTS LOT: 005 JURISDICTION: TIG
PROJECT: EDGEWOOD MANOR
Project Description: Install low voltage fiber optic cable 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:
WIEK FAMILY LTD PARTNERSHIP NORTH SKY COMMUNICATIONS INC
BY GUARDIAN MGMT CORP PO BOX 87550
4380 SW MACADAM #380 VANCOUVER, WA 98687
PORTLAND, OR 97201
Phone: Contact #: PRI 503 209 - 7521
FAX 866 - 743 -3974
Reg #: ELE 17- 154CLE
FEES LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 6/1/2007 $75.00
[TAX] 8% State Surcha 6/1/2007 $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: � / / / Permittee Signature: / . / A , /),
—
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.
JUN-01-07 10:03AM FROM-North Sky Communication 3602545097 T-399 P.003/004 F-408
. .,
-' • City of Tigard Received c)u... .
, (0 1 6Th (. pi, No., a j2200 - co 1 (eD3
; r . ,-,3,„ SW Hall Blvd., Tigard, OR 97. E) Plan Review
2 ; : Phone: 503.639,4171 Fax: 503.5*1 41
6c0 COVE Date/13y: Other Permit:
TIC 1.RD Inspection Line: 503.639.4175 Date Ready/By: lull G __ El See Page 2 for
,r
Internet: www.tigard JUN 0 1 2007 Notified/method: Supplemental Information
pply (bp s f pin w/
,Pi ..?..!"7.'..;11T.,r.i4.:!),iR24:1.:MgiV4;','1'•'.A,4?'t5,::!t":4i',41..i).i. ' ... :1 t: 11 * ,• • 11 g .'.2i : 42 . 1 .':i '' att '6 i 4 gS I T ,0 *.M. !'. :Rl A
it
4`-'.'"' - . - _. ._ pl. check ;In that Asuit Z ets oas item s checked blow):
e
Ci New construction dditi 1
°flia'regUIL/DRIfSelSRICSION 0 Service or feeder 400 amps or more El Building over three stories.
0 Demolition 0 Other where die available fault Curren( Clmarinss and boatyards,
[iltMii6V4erlIt•;,<Aniaq44!:..t",,;;W1*:01:41Attikil■r:;:iPaii+4Mg:02.01:1:'./4" exeeedz 10,000 amps at 150 volts Car 0 Flowin buildings.
less to ground. or exceeds 14,000 0 Commercial-use agricultural 1
0 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
XMulti-farniIy 0 Master builder 0 Other: ID Fire pump. 0 installation oF75 KVA or
, 1,,..4',) , 2 , .„ q ;I .,,,,,s 0 Emergency Nystin, larger separately derived system.
i'. 000 '.i.;, 0 Addition of new motor load of
Job no.: Job site address: 111500 SW -Hal t 1.71
- 0 I 00ITP or more occupancy. .
Six or more residential units.
0 Recreational vehicle parks.
City/State/ZIP (tA' \ 11 0 ._ 0 1 ?..- i 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldgJapt. no. V- ) Projcct name: 0, OL" „ j t . i I ., DY- 0 Service or feeder 600 amps or more.
-ia •
:;
Cross street/directions to job site: 8 8 n , ,, , Qty.) Fee 1 Total I •
- New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot n�.: 1,000 sq. ft. or less 145.15 4
• Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map/parcel no.: .
.
.,, . Limited residential
75.00 2
- '; : .. " .,:ii•. : ::',i‘:*'4it . :'.",; . `.i:.`Al,!:! : .:.".:!'.'s...' i 0)00 . qW0tjg::.A.tiO'...44 . 5 ho
.:::.:.i.:6',? ted ener , siden
7;;1;1;i'cr (with ,,y. it.)
11/IV(CLef2- /0 1 19b/ \ Limited energy, multi
residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
.. •, ..- . ....•••
A;'.' i 201 amps to 400 amps 106.85 2
160.60 2
401 amps to 600 amps
Name: -
601 amps to 1,000 amps 240.60 2
Address: Ovcr 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
Owner signature: Date: _. Branch circuits - new, alteration, or extension, r panel
A. Fee for branch circuits with
1 / 4 1 )1' 0'f *Ni f '',i:.' , l'fr:f [ J;". • ilill - i . 7, 6 2 '. .',Er r ecii4 At'diiW6*p .:),;:i7j'ii above service or feeder fee,
665 2
each branch circuit
Business name: hi to ,. : furyk 1 f f B. Fee for branch circuits -
• • p ' without service or feeder fee,
Contact name: ' 1iM; .14v.:, j . . first branch circuit 46.85 2
Address: . 1 ,' ' - i• .
1 1 i 1 g S e, IPA. 1 t 04' 40L In ••,1 A -- \:c<2, Each addl branch circuit
6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: \10..nt\V. V\I.A 'A Lo 1 Each manufactured or modular
90.90 2
, dwelling, service and/or feeder
Phone: ( 665 0),,,0 - -*2, it Fax : (CIO . ,;,1 4.. Recoriliec, c„rdy 66.85 2
E 4S;:elk.:40\ SaSY . Gb n(1 Pump or inigation circle 53.40 2
0,1W17 Sign or outline lighting 53 40 2
Signal circuit(s) or limited-
Business name: ti•nft-e.. et.. (), v L energy panel, alteration, or
Address: extension. Describe: 1 Page 2 le 2
City/State/ZIP: Each additional inspection over allowable In any of the above
Per inspection 62.50
n
Phoe: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: \ /4\ vi 1 Electrical I ic.: Suprv. Lic.: Industrial plant per hour 73.75
a ;: ' . .. 7..l'ATAS.0.
Suprv. Electrician signature, required:
Subtotal:
Plan review (25% of permit fee):
Print name: Date:
, a)
State surcharge (8% of permit f 1 ee): u.
Authorized signature:
TOTAL PERMIT FEE: %1 ,...."'
Print name: ..-'f IS . K ri . F7 . ),, , -1. C. c - Date: 1 ..--- 1 -- 01 This permit application expires ifs permit is not obtained within Iflo
days after It has been accepted as complete.
' Number of inspections allowed per permit_
I: OuildingTermits \ELC-PerroltApp.doc 05/2346 440.46151(11/05/CONYWEB
■
.!:!-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00163
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1/2007
Phone: (503) 639 -4171
Ai @�i�yl�il
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/6/2007 TIME: 7:01AM PAGE: 59
SITE ADDRESS: 14500 SW HALL BLVD B CLASS OF WORK:
SUBDIVISION: EDGEWOOD MANOR APARTMENTS LOT #: 005 TYPE OF USE:
PROJECT NAME: EDGEWOOD MANOR
DESCRIPTION: Install low voltage fiber optic cable for Verizon (appartment numbers 21 -40).
OWNER: WEK FAMILY LTD PARTNERSHIP, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503-209-7521
Inspection Request Scheduled For: Date: 6/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 049661 -01 503 -519 -7466 Y
Corrections /Comments /Instructions:
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ztij PASS ❑ PARTIAL APPROVAL n CANCEL I I NO ACCESS
I l FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: G' / (503) 718- ` 1"�
p Date: Phone #: (5 ) 2- Ii434-1