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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00177 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/8/2007 PARCEL: 1S133DB-07400 SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG H 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• �jp� Permittee Signature: / f, r �tj 'lam 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 10:15 FAX 360 254 5097 North Sky Communications 0009/020 " fJIti 5 ,f gi1 117I 0'2' —50'. Electrical Permit Application n I\ iii FOR OFFICE USE ONLY City of Tigard Datem =owl IN, A .• " ' •"• E Received / ' Permit No.: E � ^ � _ 60 J T ? 1 w : 't 13125 SW Hall Blvd., Tigard, OR 972231 r. Plan Review T Phone: 503 F a x: 5 V o O l Date /By: Other Permit: TIGARD Inspection Line 503 639 4175 r r n „ rw r0 ® Date Ready / : See Page 2 for Internet www.tigard-or.gov DI B Notified/Method: ' 'i 1 i 1flPl Supplemental Information �� ` 3 kaa '. 'r -" ^`r'�' za.' z , ,ya i 4' ws . .as...„ a ' - F,-�.r, r < .1. .sq ',•; : ..' �: �.r 1". ; °. - n -,.'�` �� �4 � � Rd.�"}��a �, .., z � �. J�' r c sh EF� k��� fd . � fi .�� s- :�' �''i{ .�� 4 G� � 2 �' 'tea_ a..... s °,ta..§�- ?nSl�- t- �r'C�,.;;M �st„� i� >,9p.. ^';. 3, �, a�� ' LM��. r.. ��v.. r����.�`tc.:kAs�'-^°.'�., ---�� �!"`�vi' , }�r , Yi�hz."�k a �� s ; �•. u„� i �� ,� '���'�- 'u�o-� ❑ New construction OAddition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Other: it G [� { 4 r { where the available fault current ❑ Marinas and boatyards. � 4A ? � 4:41 �c O � 5 :1 1 3 llt�r: '7161 r7 - rr a� t l f� 000 amps ,� . exceeds 10, a ',, - •- '"' -'' ' ,' a 4'1A:.'•. : 1.'; =' " "'+. ,k: '',rte `,'''} , 'st [ t50 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. 1E4 Multi family ❑ Master builder ❑ Other: El Fire pump. ❑ Installation of75 KVA or �t 3 v> "= . t ss ti tY n ? i"'fs Ya $y of ❑ Emergency system. • € r - tq�� 1 � 1 t c LI� ' + tlgri rv t n r:��t k 8 Y Ys m• larger separately derived system. -- �^.7 - t - ..,,,_ . c ti r<.,wr , a,3 _trW,:; i. ❑ Addition of new motor load of 0 "A ", "E" "1 -2" "1 -3" Job no.: olioj,►, Job site address: �th / /��� /' 5� tOOHP more occupancy. t r �'��L'a� El Six or or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: - A I r 0 ` 0 Health -care facilities. El Supply voltage for more than ■ ■■ / p 0 Hazardous locations, 600 volts nominal Suite/bl /apt.no.: / � Project name: 1� / C "e." t� .— 0 Service Cross street/directions to job site: i ' entf'�y����liP Fee. l�'�n � �3�, Description Qty. Fe Total New residential single- or multi - family dwelling unit. S_CZ / I+ Includes attached garage. Subdivision: , I Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'1 500 sq. ft. or portion 33.40 1 Limited energy, residential - , g ale �q ak a t 8 s ' r r it'' I t Vi c ` � t , ek . gY N-_:E° : � -3r .s y .�s d ° 'n- v.' iw e ?r .a M#2?. . ? 1 la: , IV ' r 'A ( above sq.."' 75.00 2 N i i � MI �� " ` v residential ential with a energy, mu sq .lft . 75.00 2 �; t +-+ [ d bove sq. ft) _ Services or feeders Installation, alteration, and /or relocation _ 200 amps or less 80.30 2 a . „._..,..4, ...Sre_ to .; x,a rc t e2 s3 t 4 ?<•st gig P `G ., �K � � �u��'l� ���'�ti,t� � '` ' � � � j� .,�,• ����,���i.��.ixa�,�._:t�..�1 201 maps to 400 amPS 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: ( ) I Fax: ( ) 200 amps or less 1 66.85 1 Owner installation: This installation is being made on property that I own which is not 20I 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, per panel 1 ,,; A. Fee for branch circuits with l � r$ .. " v nr Y' i r G!"'�i jf a,;l'R .wK , #i � i . ° s a� x' i i ` t �3 x a°7 �. -:�$xa service or feeder fee 6.65 2 ti x ..x 1 .. t.. u a l , ., . :: f `I ,. ( � s i ' each n / J/ � each branch circuit Business name: c , p0 t A y � VMA ( B. Fee for branch circuits Contact name: .. ( ( f) r , ` without branch circuit or feeder fee, 46.85 2 Q ' ` 9 fast branch circuit •Address: 1 , S' & 1 � /� i < k p � p 1..� Each add'I branch circuit _ 6.65 2 i t � ' t t,,,r (�+ 1t l Jt �' iVliscellaneous (service o feeder not included) City /State/ZIP: V/5 ' Y 9 % k,4 , �iS J J , j • �[ I Each manufactured or modular � dwelling, service and /or feeder 91).90 2 Phone: ( 61)) '� 't�j'2. ‘ Fax: : ( '1 � ” J� Reconnect only 66.85 2 E -mail v 0 r 0" b m Pump or irrigation circle 53.40 2 � A:� f� eifiy r {'�..i� � �^,' ,� .` ,� �ei. �, �» e � � �. � p a �y = �...i.� ax�zr:.fwe.a•r�. ` `a.x: ... lt,.i'.,L.x.hI1HH 6 ''` ,7p' n4 k��1{53�'C . *ter ..,3 ,,.`, i Sign or outline lighting 53A0 2 Business name: S b..5. •v C Signal circuit(s) or limited - C energy panel, alteration, or Address: extension. Describe: Page 2 /16 2 City/State /ZIP: Each additional inspection over allowable In any of the above I Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lie.: ' 41 k-1 I I Electrical Lie.: I Suprv. Lie.: Industrial plant per hour 73.75 Su Suprv. Electrician signature, r z: ] �' �" p gnature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): (p Authorized sign-- ----."�,--`s...... TOTAL PERMIT FEE: Print name; This permit application expires if a permit Is not obtained within 180 t �/V l N . Ian �i (� GA Da / ,L■ days after it has been accepted as complete. ( * Number of inspections allowed per permit. l:\ uillutg\Permits\ELC- PennitApp.doe 05/23/06 440- 46]3T(t1ro5 /COMAVEB .LC . X2558' ✓ CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007 -00177 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/812007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/272007 TIME: 7:03AM PAGE: 26 SITE ADDRESS: 13456 SW HAWKS BEARD ST BLDG H 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 #: 503206 -7521 Inspection Request Scheduled For: Date: 6/22/2007 Pour Time: Code # Inspection Description onfirm Contact # Message 199 Electrical final 05077403 503-5197466 N Corrections/Comments/Instructions: • NN \c ' _ I PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ' V�1 Date: 'b' 2-1-- J Phone #: (503) 718- �tilikp