Permit Ir CITY OF TI G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00457
TiGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/12/2007
PARCEL: 2S 101 DB -00201
SITE ADDRESS: 07582 SW HUNZIKER RD OFF ZONING: C -P
SUBDIVISION: HILLCREST APARTMENTS LOT: JURISDICTION: TIG
PROJECT: HILLCREST APARTMENTS
Project Description: Install low voltage fiber optics for Verizon. Office and manager unit.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: DATA : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
PETRUSHKIN, SUSAN RO SE NORTH SKY COMMUNICATIONS INC
7315 SW 27TH AVE PO BOX 87550
PORTLAND, OR 97219 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 360 - 254 -5097
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 12/12/2007 $75.00
[TAX] 8% State Surcha 12/12/2007 $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. 46.6699 or 1.800.332.2344.
Issued By • / / / / Permittee Signature:
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.
t.i ,212/2007 WED 12:13 FAX 002/O11
...;,... Pt 1 tro txt / /-,
Electrical Permit ApplicatiACtj '' ,..' L 0 .. OFFICE USE ONLY
, City of Tigard Received
9722DEC 1 .-7 ow
Pennit No.6 a mr--,L57-
!Ipl q 13125 SW Hall Blvd,, Tigard, OR 2007 Date/B ; Z ji,' I
Plan Review
; . 2
• • Phone: 503.639.4171 Fax: 503.598.1.96t0 Dale/By: Other Permit:
Inspection Line: 503.639.4175 LA I Y OF TIGARD Date Ready/By: W1
TIGARD ifisi ___. See Page 2 for
Supplemental Information
Internet: www.tigard-orgov BUDDING DIVIStON Notified/Method:
(
i , 1*.. , ,0'.. - WcijiiC' , .• . ...,::;: . ..':.•.:.::...: : - '-''' ';' '
0 New construction 2:.Addition/alteration/replacement Please check all that apply (submit a sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGOIiY - '..':: •--: ' ' ..,•'',,; ',"'', ': - exceeds 10,000 amps at 150 volts or 0 Floating buildings .
less to ground, or exceeds 14,000 0 Commercial-use agricultural
0 1- and 2-family dwelling CI Commercial/industrial 0 Accessory building amps for all other installations. buildings.
%Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 installation of 75 KVA or
0 Emergency system. 0 larger A,, s E epar l at_e 2 1? , d system.
)iik
Ni4irios '':-:' i;:r '',., : ..,. ., 0 Addition of new motor load of
100HP or more. occupancy.
Job no.: Job site address715a_SILL4
c.) • 0 Six or more residential units. 0 Recreational vehicle parks.
--'---..
City/State/ZIP 1 9 ,,,, (y -,i 6 e__ i c , -12,Z 0 Health-care facilities.
0 Hazardous locations. 0 Supply voltage for more than
600 volts nominal.
Suite/bldg./apt. no. kp OW LI Project name: ,.1 \ ( A., 0 Service or feeder 600 amps or more.
' #tt.
Cross street/directions to job site:
Description I Qty. I Fee. I Total I '
• New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: [ Lot no.: 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 energy, residential
75.00 2
)".*gC.001ON'O.;'#610:: ..:':::,:.•.:.•.,::;:',:1,::::;,:'.'::',::'::",':;:::,:::;.:,:':, Li (with above sq. fl.)
Limited energy, multi-faml 75.00 2
iy
IliSt.b./4 • / \ 9P1 b)11 1 /,'( TP/ VPA/ nOn residential (witit above sq. n.
A j -
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
:.:,' 21. . , : • --- .:,,',,, i :1=1,)?1ROPEBTy,..!0'NElt.':.:-•;:"'•.;',;:'- 1 ''.:.; 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: ( ) I 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 10 400 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
, A. Fee for branch circuits with
.0 A . ' ' ' .. ''' !,' S; '::::. :': . ''' I ': -- *7P:)i ' .7:r Cr PLR SON 1 : : . : .. above service or feeder fee,
6.65 2
t each branch circuit
A f',
Business name: t \In '.1 ( i I tAri,,) ( a ; $(.-,119`(( B. Fee for branch circuits
,,_ , ,., I //,. without service or feeder fee,
Contact name: k\Auv‘til VO(0* first branch circuit 46.85 2
{ (' ,„' ,,a ,
Each addl branch circuit 6.65 2
Address: S'E. N\ '111 \. 4 (I, '
Miscellaneous (service or feeder not included)
City/State/ZIP: \k apve W.A (.,--)., I .(; / Each manufactured or modular
90.90 2
, dwelling, service and/or feeder
Phone: j Fax: : (v ) 5.2,0.. ? 2-5 , Reconnect only 66.85 2
E-mail: . C,W6 Pump or inigation circle 53.40 2
Sign or outline lighting 5340 2
Business name: 0
c ) ci,ron -I', b,co 0101,-)V11-, Signal circuit(s) or limited-
energy panel, alteration, or
extension. Describe: Page 2 16 2
Address: 1 \ S 1, . yw\ -\\ icA Q \(6,
City/State/ZIP: WACO \A \kV vo V\ 98(pg- Each additional inspection over allowable in any of the above
! Per inspection 62.50
Phone: (7)6 ) 1) Fax: ( V,00) 24 -- ' 1 Investigation per hour (1 hr min) 62.50
CCB Lie,: \ 41 \ 11 Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
.tix(.:TRICAL;
Suprv. Electrician signature, required:
Subtotal:
Plan review (25% of permit fee);
Print name: Date:
_
State surcharge (8% of permit fee): tg 6)
Authorized sign&
TOTAL PERMIT FEE: ). ----
- "-- --"--"---••-•-, --------..7-----, ,
T appneation expires if a permit is not obtained
Print name: - "I•i ) . /v . ( t) . \ fl' il i .. , (Al/ , C. C ' Date: 12 . (7 , 0 his permit within 180 1 days after it has been accepted as complete.
i -
* Number of inspections allowed per permit.
1: \ BuildingWerrnits 1 ELC-Permit App.doc 05/23/06 440.4615T( I I /05/COM/WEB
CITY OF TIGARD
BUILDING DIVISION .. ..
PERMIT #: ELR2007-00457
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211212007
Phone: (503) 639-4171 ,_ .‘„„tinvittilff
Inspection Requests (24 Hrs.): (503) 639-4175 —_,III■ I.L.
INSPECTION WORKSHEET FOR DATE: 12/28/7007 TIME: 7:00AM PAGE: 64
SITE ADDRESS: 07582 SW HUN.ZIKER RD OFF CLASS OF WORK:
SUBDIVISION: tilLI_CREST APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: HILLCREST APARTMENTS
DESCRIPTION: Install low voltage fiber optics for Verizon. Office and manager unit.
OWNER: PFTRUSHKIN, SUSAN RD SE, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 350-2546920
Inspection Request Scheduled For: Date: 12120/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
135 Low voltage . 062236.06 503-20%9546 N
Corrections /Comments/ Instructions:
laid tiqqg A/75
I, PASS 0 PARTIAL APPROVAL CANCEL 0 NO ACCESS
I I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: G . V. (1 2) 1--Z Date: 2 - - 2 - S ' tn Phone #: (503) 718- 1-444)