Permit illi .� CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00185
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/8/2007
PARCEL: 1 S133DB -07400
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG R ZONING: R -25
SUBDIVISION: SUMMER CREEK APARTMENTS LOT: JURISDICTION: TIG
PROJECT: SUMMER CREEK APTS
Project Description: Install low voltage 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:
SUMMER CREEK LLC NORTH SKY COMMUNICATIONS INC
121 SW MORRISON STE 1000 PO BOX 87550
PORTLAND, OR 97204 VANCOUVER, WA 98687
Phone: Contact #: PRI 503 209 - 7521
FAX 866 - 743 -3974
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 6/8/2007 $75.00
[TAX] 8% State Surcha 6/8/2007 $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: /A Permittee Signature: Si2t, fl pp) 11 7
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.
06/07/2007 THU 10:19 FAX 360 254 5097 North Sky Communications 2017/020
i'ILu5tiT •'CI liS DA 'O '2. -5/,
Electrical Permit Application -- OFFICE USE ONLY
l yel City of Tigard f - t, ' ;_�11 1, Received r,
• 4 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 50 Date/By: /l � � - WI t PermitTlo,: �L�2�^�_ S'.5 ..ax: 3.598.1960 N 7 2007 Plan RReview •`�''� --- � U'�1 � L 2��/ UatelEy: Other Permit:
TI GARD Inspection Line: 503 639 4175 Data Ready/By: Juris PI See Page 2 for
Internet www.ttgard-or.gov • ,, ` 0 Notified/Method: 1 ' �� Supplemental Information
Sr ;�3sy a , vim. m x Ta k w $ k •< tr, -
? W '�b?�'V �w g �.s � r� � ' y 1 t s�r'�. `' t'a r � ■�s'� �'"� �'6 L 'r F� ,� sL ti i r . �z +� E
. ?i .,.._..._ 0 ° `'4aRi Vati� k c , i h a,� $�, a "t if .W M �,.�" ` i4FR:," l` ''�` t.q , ` r t ar , .�.=. ,� rs,
�4's�.d.�iin:^: ... �. :.. ..,1;�4�"S.�*,; ... �. t �R... .c � '�'�x.,,�., c- p�Y .a:`t.'`,$�•H;�x T� �' tr " r y �.�{ .,-,
0 New construction Addition/alteration /re lacement �t sw /i checked ` °v
p Please check all that apply (submit � sets of plans w /items checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
(� �' y O th �� p �, a f t , , s �"` where the available fault current ID Marinas and boatyards.
.1 5= ? i � rt ,rya ',- :6 * t ti �i :` �1 aq ; "�' "'" � 4 exceeds grou 10 d, o a r n exceed
tes at 1s 1 4 v ,0 o 00
lts or ❑ Floating buitdiris.
� '�' less Yo
❑ 1 and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building O Commercial -use agricultural
amps for all other installations, buildings.
Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
z �,�,��
x
4
;�����ta���� y�p.s� � o d r�l �``�`r,,�. �'��,r�r �R 1!(' � t�v s�� k � ��„< ❑Emergenc system. J ar er separately derived system.
�.ys ..«� WW.r�`._,wrx <P ,n e .[ _ :ix,.s'; ❑ Add oy f new motor load of g P Y Y
� � . . A ., ,. .. _ ..
Job no.: r$ os,"_, Job site address: 91 / �, �1 100HP or more. occupancy.
AA. �� • ❑Six or more residentia l units. ❑Recreational vehicle parks,
EMEDIMIMEWOMEIVER111111111111111111 ❑ Health -care facilities. ❑Supply voltage for more than
pp pp((
El Hazardous locations 600 volts nominal
S U1te/bldg. /apt. no.: , Project name: % �GTi !'/ ❑ Service or feeder 600 emps� men: p
Cross street/directions to job site:
1111 Ell. Description I , Fee. To tai
New sidenti sine - r
i• Includ re es attached al gaglrago multi - family dwelling unit.
Subdivision;
Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'! 500 sq. ft. or portion 33.40 1
Limited energy, residential
_ k�i�3 5 � •1F ,E-' 4 ` eJ pt 030 g i W y i� a YrA4 a ,,� ° a ,rc rk " Y
v i i
���� �ta' �, ��' r�. �.' �,. a ,�3?.���.a�.a:.,�dM >_:>s,zr�`�� (with above a
MAW. ► L energy, mult - fam 75.00 2
ly 75.00 2
� residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
.�� �+" i �� tT � '�" 1s�'�k ^ra- 'S a R t } .+.+ r e 200 amps Or Less 80.30
x�l�i.5 . �5a� a'_.4n_ Is, H °4�x nt3�ki��aFSttt��ta�m amps to400 amps 2
-
s a n., a .: ._teen,,. tip" -4t of q 1.silt. )!z ... �zd 4. Y, l 201 P p 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address: 601 amps to 1,000 amps 240.60 2
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 1 1 100.30 1 i 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, pe panel -
Fg 8� i;a n r a , K rr� , 9 A. Fee for branch circuits with
i k r� AT z s t ;$� 1r yea �tti i 9� _ M' •t9__� �` t 5 i i I `1 ; w �*a r�r r above Hu" L 3�£- ��. .�vz ti .c.,..a, �._�,.nc; .`xa1�- �'@.�i �s:xs*�c�._ i,.r '>,...a »n >.. �:, � ..,.. a,:. o k p�..'.�*.'.\ u r,..'i��ti ' service or feeder fee,
Business name:
each branch circuit 6.65 2
B. Fee for branch circuits
Contact name: �l 1 / >< � wi tFro r service or feeder fee, 46.85 2
Address:
I r I first branch circuit
i t l 1 A , r 1 in r i � Each 2
add'l branch circuit 6.65
City/ State/ZIP: , ` iej i' tl V t , i Lo 't D M iscellaneous (service or feeder not Included)
W v Each manufactured or modular
Phone: ( ) 1.O -- 1 \ Fax: (P r 1 41/6 , r /' - Reconnect service and /or feeder 6 6.8 5 2
•,�v J "r Reconnect only 66.85 2
1 7 0.,0 OIL l CAD Pump or irrigation circle 53.40 2
a.iTO ��.Z;. "_:Z? �_,: ` t;*INOM,'4 AtattiN'' rHEM a `? �3 ' s j _ Sign or outline lighting 53.40 2
Business name: ' (1 / ��� Signal circuits) or limited -
CU energy panel, alteration, or
Address: extension. Describe: ( Page 2 /\i 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Phone: ( ) Per inspection 62.50
Fax. ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: 14 Electrical Lie.: Supt Lic.: Industrial plant per hour 73.75
y
Suprv. Electrician signature, required: Y ` xu' "u 1 u `£ ° {.'�6`
Subtotal:
?S k9fi,Y��"�y'a' °k , ,."c
btotal:
Print name: Date: Plan review (25% of permit fee):
4�► State surcharge (8% of permit fee): I
Authorized sign. •
�� I TOTAL PERMIT FEE:`
Print name:‹ l i , Date: +.� This permit licatlon expires if a permit is not obtained within 180
r days after It has been accepted as complete.
* Number of inspections allowed per permit.
I: 1 Duidinglpe rmits1FLC.Permitppp•doe 05/23/06 440.4615T(11 /COM/wEB
Q2C * 25(x✓
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00105
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/012007
Phone: (503) 639 -4171 /u m�iiull�f " �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/27/2007 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG R CLASS OF WORK:
SUBDIVISION: SUMMER CREEK APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: SUMMER CREEK APTS
DESCRIPTION: Install low voltage fiber optics for Verizon.
OWNER: SUMMER CREEK LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503
Inspection Request Scheduled For: Date: 6127/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051039 -01 503 - 519 -7466 N
Corrections /Comments /Instructions:
A;►■ PAS) PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Q 1-, Date: 6'2� Phone #: (503) 718- 14%