Permit i
Er CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00181
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 M 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
Reg #: ELE 17- 154CLE
FEES 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: i 16 Permittee Signature: 5 0 R 1 / ( ;tin
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 10:17 FAX 360 254 5097 North Sky
^ Communications
s i -5D-. I�J013/020
(LUbt/ t { rt J
or► l t t 'c e 2
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard •- 7, r[7 Received
4 J g ± ,...- y' . ' ' , l{ Date /BY Perm No.:
a 1 = ) ( o� $� t'� E L22GO9 - boi $
13125 SW Hall Blvd., Tigard, OR 97223_ T Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TIGARl7
Inspection Line: 503.639.4175 JUN 0 7 2007 Date Ready/By: y El See Page Z for
rar�v
Internet www tigard or gov NotifiedJMethod:
FA y{ y,t �� � � � ? J L �� c � � r ` c � � Supplemental Information
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❑ New constructionAdditioll /alteration/replacetrient V Please check all that apply (submit Z sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other:
: r . gt ,, where the available fault current ❑ Marinas and boa
, c t. r "qx' 4•:1,iN.' ' ': �v � �' r 3 xk ra , r boatyards.
>`� 1t£ 'i.- 111.:2'1 4 ? 1 b V � '`. n �, 1 r^ rx1k ;`
ti '` , v n -i exceeds round, amps e s 1 voile or ❑ Floating buildings.
� "� � "'=� less to round, or exceeds 14,000
dwelling g 0 Commercial -use agricultural
❑ 1- and 2-family g ❑Commercial /industrial 0 building amps ibr an other installations. buildings.
Kit Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
F7 ^ ,' `s " •z l' 1 bit ,. w. , ."`. ,."
. . t 3 2 a ,9 � a '' 0 ' "e ag,T; i a dye 4- - (,', a _ 4 CI Amergon of new larger separately derived system.
���m �� �.�.,, b �,� .t. _Y.z.... -u��. �,.�..l�ual� �,,:... �.� .. ., '��x_.:�a >_ �i �'��3i ❑ Addition ofnew motor load of ❑ .. .. ,. .. _
i 0 :�� if Job site address: I , ++ i or or more
occupancy.
Job no.:
i 4 1M,11 ❑ S i x or rnore residential units. ❑ Recreational vehicle parks.
i r `' t f �� p t/ ❑ Health -care facilities. ❑ Supply voltage for more than
/a t. no.: /
Suite/bld Project name: ���1.( ' VV +G i'/ ❑Hazardous locations b00 volts nominal.
g P J ❑ Service or feeder 600 amps or more
� � ��'"' �?� � a x rev �p ar .cv ^S ��h �,y t� ''rw�a e �.r
Cross street/directions to job site: �r -i t ��ro`' a ° 'Q �a. Total A`�,xt
_ Description Qty. Fes Total
� ,�� New resi dential single- or multi - family dwelling unit.
' Olt / J: MFA !i Includes attached garage.
Subdivision: + Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
(
4 - ar e , e, �� r Limited energy, residential
l ; .� v v } } � 1 q 4W , o � V4W0, "1 u Y e sit ,� r r v2Iall i' 75.00 2
h�. � � MOV ,:�.� �w..,A .r -w� J� ,�t2��tl;_ > ..� . - .�.. "t�r.'?� wi lh above sq. $.)
Limited energy, ,multi-family ) 75.00 2
W
� t I r residential (with above sq. ft
Services or feeders Installation, alteration, and /or relocation
Sti 200 amps or less 80.30 2
�x s ..�����'�F? �ur� � tl �r,•��� "�� r r^ ro '�S�}[e's t5 r�x m °r � T�..� � t: �p-Ptti � �'� a ��`�r
1R.Uf. _ vz umrg tel: r" . ab} J1..i.. O , ? q ` r lni ,k rt`1 g -Y�r '' i.014fi . ;OrJ T 4�4 k' n 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
_ 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
i � s k A. Fee for branch circuits with
..s Wi , i'3, � - t titt e ,?, . r gnr � ilia : i: t e 18 c 9 'r 3s `i' „> xis. •C �zrt x y "
... ra .,r _ a ::: , r ,M r N t ,.o 2:1.:41,`,..n #£!1 lIk4 e ` ' 6.65 2
.ink: , above se or f ee d er fee,
a each branch circuit
Business name: t O 'A ...A • B. Fee for branch circuits
Contact narlle: y L ; e J without service or feeder fee,
I fast branch circuit 46.85 2
Address: ( I t Each branch circuit 6.65 2
t �J 7 ach a
Miscellaneous (service or feeder not included)
City /State/ZIP: �.:. I J ./ ' i . I Each manufactured or modular
90.90 2
Phone: (6�) � r -. - *Z-1 Fax :: (• , , i t �L " 1 _ Reconnect t only service and /or feeder
��j „ " n ' / � � :7 R�onnect onl 66.85 2
� G ��1'tl�l V 1 l Cb t t t Pump or irrigation circle 53.40 2
t � w�?°,^� �°a o �� � � P^s 1 r s �. "vq1°$ r s xxr< -^-4 � L .
i ,, . . 1�� O S.:t -a I `x,,ai f i M ES . a t s >fi - `' . `Pt � � 3 Sign of outline lighting 53.40 2
. :x.�.�x�'�'�.�, ..�ca, n, �S�t.. s,; kt. � .���Y�o�m.y.u*sr�.t€1��.�i�,�ra
Business name: ' 0 r t V 1� Signal circuits) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 /le 2
City / State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: `1.4 Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
r�.r.`i�'��,Y�` �+'"'`' r k 5Y U _ A t -'� � ate"'
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
S State surcharge (8% of permit fee): Lo 0)
Authorized signal -• �� ---•_ •"` ��_ TOTAL PERMIT FEE: %1
Print name: -1 t , ' '6/ tom, - Date: I / / MIII 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
t: 1Boitdiag \Permits\ELC- PermilApp.doc 05/23/06 440-4615T(t 1/05 /COM/WEB
2.Q,C. 4 25 (0
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR2007 -00181
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 618/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 II
INSPECTION WORKSHEET FOR DATE: 6/28/2007 TIME: 7:01AM PAGE: 4
SITE ADDRESS: 13466 SW HAWK'S BEARD ST BLDG M 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 #: 503.203.7521
Inspection Request Scheduled For: Date: 6/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051144 -01 503.519 -7466 N
•
Corrections /Comments/ Instructions:
PASS PARTIAL APPROVAL CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 0 N c S L Date: 1.2' O1 Phone #: (503) 718 - A'FO