Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00175
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/$/2007
PARCEL: 1S133DB-07400
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG F 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 $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: %p// (zJi
. s'
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
06/07/2007 THU 10:14 FAX 360 254 5097 North Sky Communications 2007/020
, ' ., . • ' g i Y O L u b . i Q(1 lib I f c 2 . -V
Electrical Permit Application FOR OFFICE USE ONLY
Imo fir. t� P ii 7 [i -
City of Tigard { " m - 1 . Received / - J
a 7� .z - R . - ' - ?, t - Date/By: iew
( Permit No.: CI— i�ZOCss —($OI L
1 3125 SW Hall Blvd., Tigard, OR 97223 ` Plan Rev
- Phone: 503.639.4171 Fax: 503.598.136bN G r 2007 Date /BV:
Other Permit:
Inspection Line 503 639 4175 &I S ee Page 2 for
TIGARD Ju. Date Beady /By g
Internet www.tigard-or.gov c ' e t, RD Not{fied/Method: Supplemental Information
��� I 'i�� �a1T��i1. F��"r1Y�+�' 4`�`�A l ,:r +� nr ,� ',i' 4!'Jd , �R� � �z +^� '1^ ax. =.;s� ^5r p� re,._ .�,. -x—,« . s , .,
'"iw�+�.�Ots" _�:,. at n � q ., °�+ x' . � t.. Sq ��., d 'v v..11;a� � jy r y �.t �i' - (' r� �"iL �... - x ;.,y �'x :. . �3r�`��r . .i, ;ksu - '7'L., t �.�. -�.B.W s,.y. x t'4`" b�h�g`..r "'�,." ^, :. i
` *s. »i :.cd....a_.ro` .C+_.S}R ..,yis:a... . �w ,W, #a3S Fux,'' 'iv::.t:' „a�Yi`e'tYl� {i� %�i9ti`a .enN ''' } ;1 7 i�q kiVi!a ' �'t . � XF .'aid_> ,. a ' 5 xr '•
❑ New Construction n Addition/alteration /replacement 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.
- ,`^�f * g c � � t.,s ,, ��pl� ��,��. ,� ,� " � U * x x � where the available fault current ❑Marinas and boatyards.
� � i( ,Aggea, „e r 44:1 0 ty ❑ Oth �, , `a'11tt d al AC s J 1 (, eggie exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ i - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
►: Multi family ❑ Master builder 0 Other: ❑ Fire pump. O Installation of 75 KVA or
� � cL � � ry {, 6 f P w ` ,,,i4mf a t la8l( �� i - `r- � '_ ❑ Emergency system, largerseparately derived system.
�'w;1�riA ...a...x.4•4tx. ti4 . . 4e.tt 1 0 .1 . -AS ltlbc ,- I.v..,.v tetl0.1 ; d, l' '
r,�, El of new motor load of ❑ "A ", " E ", "1 -2 " , "1 -3 ,
Job no.:9A 6 +,0, ,2 / , / !�� 100HP or mare. occupancy.
r 1 Job site address: ❑ Six or more residential units. 1:1 Recreational vehicle parks.
r I r ❑ ealth - care faci{ities. ❑ Supply voltage for more than
❑ Hazardous locavoits 600 volts nominal
Suite/bldg. /apt. no.: 11 Project name: rr,^�,Ai it , (/ ❑ Service or feeder 600 amps or more '_ )P
►Y1 /t �tO � P/ th�}tt�arr f y yateWtkr
Cross street/directions to job site: : 1'. M <tAr�, A " E c . , { r tf;�.
Description qty. Fee. Total a *
New residential single- or multi- family dwelling unit.
+` � i � ILVVW Includes attached garage.
Subdivision: 1 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
M r� x caz 4 Limited energy,
'� $Y, 75.00 2
4`r ?'`�h�o-�t'.^. 'k'��ss Sre�..,. U; ?i4S�. 4' t" yt��FJ��- rr "`�,�D�l�l�x'�'i7PV- w!'n�'„ti,�� a �"yxtk���'`,x 47x� .'�� � -�n
`�•.5:: r , . t,. t'a,. Fai�.� ` � ..� ? ?i5�.,,�5�t�:.;'?:;:ii'�'s� ?�..Yi��= '.l'"�.,ii (with above sq. ft.)
�� / # Limited energy, multi family 75.00 2
residential (with above sq. It)
Services or feeders installation, alteration, and /or relocation
a n t a ,-0 200 amps or less
ivy ' GI�t� 7 � arc r e t u rta a. � 'n'1 w.y p 80.30 2
t zt „SC M . I ,,. °`, .t" t c 4� i ' I s , ta ,I 3� �.i 6* a .:' a'�I�,.s,_ t$I9, z v , R.1 201 amps 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: ( ) 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 1 100.30 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, alteratioty or extension, per panel
a�
A. Fee for blanch circuits with
��.: ' ' #�k�.''tS t �e�� ��'l�� �,? �a� � �.c�. 4 'SYri a x�. �r �r €x �, rk � g �y
:� �vJ .c xa s 1° is ,;�i -lat P s �� O' t'> g� r is ? above service or feeder fee,
� a ..ti, u,d ,R�a u 6.65 2
hV lftlr l each branch circuit
Business name:
Itt11s�' [ ( u i ° • B. Fee for branch circuits
Contact name: without service or feeder fee,
�� .`� . 14 4 first branch circuit 46.85 2
Address: 1 tt , l' I /} _, ..d'1 r Each add'! branch circuit 6.65 2'
City/State /ZIP: `A , 1 �" ! I L °`a / Miscellaneous (service or feeder not included)
W I, ( j ` Each manufactured or modular 90.90 2
Phone: ( f'0,) C3 ^" si ` Fax: : (n' r - 1 � f r1 ' I , Reconnect
dwelling, service and /or feeder
IMMIMM.M. Mira— _ , f 1 �P Q "r Pump or it only 66.85 2
�� V h C b m Pump or irrigation circle 53.40 2
. �'� `�'�'�� �'x�r � �r�- � �sd�'1'�� �'�- , '� �`,a.t i � a eti g C".r^ 3 ys xs^ 3^ u^-�x-
' . at? ,.4t.,,t a..,?`a .,� f ? 8 .`� ��E ki: R U. sY �' .`; : Sign or outline lighting 53.40 2
Business name: r ` % , 1,v-e, Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: t Page 2 16 2
City/State/ZIP:
Each additional inspection over allowable In any of the above
Phone: ( ) Fax: ( ) Per inspection 62.50
Investigation per hour (1 hr min) 62.50
CCB Lie.: 1 1_4i Electrical Lie.: Suprv. Lic.: Industrial plant per hour 73.75
p ie ;n o : ( t blq. S x � ° G �S' `s `.' R
Suprv. Electrician signature, required:
Subtotal:
Print name: Date: Plan review (25 %of permit fee):
r State surcharge (8% of permit fee): (g
Authorized signs -- --_� TOTAL PERMIT FEE: '%1 i'
Print name: .''''C' ' t k �� Date: This permit application expires if a permit is not obtained within 180
• days after it has been accepted as complete.
* Number of inspections allowed per permit.
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BUILDING DIVISION PERMIT #: ELR2007-00175
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/812007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 27
SITE ADDRESS: 1545GSW HAWK'S BEARD ST BLDG F CLASS OF WORK:
SUBDIVISION: SUMMER CREEK APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: SUMMER CREEK APTS
DESCRIPTION: InstaH low voltage fiber optics for Vorizon.
OWNER: SUMMER CREEK LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503-209'7521
Inspection Request Scheduled For: Date: 6/22/2007 Pour Time:
Code # Inspection Description Contact # Message
199 Electrical final 503'619-7466 N
Corrections/Comments/Instructions:
•
\ • \.)
PASS - —
\ `
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111 PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
�\v��^ °�~ � ����y�
Inspector: ^ ��x~m��K~�� Date: vx ^~- ^ ~~ .w o _ Phone #: (503) 718- 2 u4440
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