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Permit r a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00186 TIGARD 13125.SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/2/2008 PARCEL: 2S 102CC -01000 SITE ADDRESS: 13660 SW PACIFIC HWY 30 ZONING: C - SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT: JURISDICTION: TIG PROJECT: FIR GROVE APARTMENTS Project Description: Units: 30 - 37. Installing 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: KUBIN CARON NORTH SKY COMMUNICATIONS INC 520 SW 6TH AVE #400 11818 SE MILL PLAIN BLVD PORTLAND, OR 97204 SUITE 410 VANCOUVER, WA 98687 Phone: Contact #: PRI 360- 254 -6920 FAX 1- 866 -530 -4325 FEES Reg #: ELE 17- 154CLE LIC 14117 Description Date Amount [ELPRMT] ELR Permit 7/2/2008 $75.00 [TAX] 12% State Surch 7/2/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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. i Issued By: __ _ .A,,,,,,- � f `_� - ermittee Signature: 5 7� 7%cli✓ �I 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. JUL 03 2008 12:08 AM FR TO 5035981960 P.05 RECEIVED Electrical Permit Application p 2 20 08 ..: . : :..; ; . Fait o 3Ul city of Tigard f� 13125 SW Hall Blvd., Tigard, OR 97223...,/ OF GARD Plan Review Phone: 503.639.4171 Ent: 503.598.( 1 i VIII UmdD Other Permit: T GARD inspection Line: 503.639A175 5 t ILD1 G D :uc RcadyB ld Se Page 2 for s Internet: www.tiaard- or.gov Notified/Method: it / Supplemental Information f' >'::':;::•, :77 OF .WORK ` '..•.• :.: '.. , •••••• PLAN REVIEW ': :; : ::.• • New construction DI Addition/alteration/replacement mare check all that apply (aubntit seta of Muni w/ mma checked below): ❑ 0 Service of feeder 400 amps or more Q rtuihling over three r!eu iOS. El Demolition ❑ Odder wee me available malt current 0 Mnri rus and boatyards. • :. :.. :. : :. : :. ; .: , CA rEGOItX OF :I,ONS 1'RUCTION : . : :• ' .,. csecrxta 10,000 amps :a ISO Kohn or CI Flaring buildings- b _ lots to ground, ur oxeceds 14,000 ❑ f;ommctci :d•usc agricu un 1 Q I, and 2- family dwelling Q Commercial /industrial ❑ Accessory building amps for an °diet iosudIntionls, buildings. 17 Multi family Q Master builder Q Other: _ 0 Eire pump. 0lnstaIlmion of 75 KVA or ❑ Emergency system. larger separately derived system. J018 Sri is INFORMATION AND LOCATION ❑ Additinn of new nxrror hut! or ❑ ° A" "P" "1.2 ' I -3" Job site address: 13660 Pacific Highway 99 IW urCron:. Rma�y. Job no.: U Y ❑ Six or more tCaitlenlial amts, ❑ Recrcatiunal vclriela Mks. City/State/ZIP: TIGARD, OR 97223 ❑ Heallb•are facilities. 0 Stmply vuhago for ntorc than 0 Haaanlurns locutions. 600 volts nominal. Suitc /bldglapt. no.: 30 -37 Projoet name: FIR GROVE APTS. 0 &Him or feeder 600 amps or mere. : FEE'SCHCDULE Cross street/directions to fob site: neeri tan Ka11111111=1111 Total • New residential single- or multifamily dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1.000 sq. ft. or less 145.15 4 — Ea. udd'l 500 so. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, msidential - DESCRIPTION OF WORK ' (with above sq. a.) 75.00 Limited energy, multi family 75.00 2 INSTALL FIBER OPTICS FOR VERIZON t'CSidentialhvith above sq.lt.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 •'© PROPERTY 'OWNER .. '•0'•TENANT • •' " 201 amps to 400 amps 106.85 2 "'"' .. .. . 401 antes to 600 amps 160.60 2 Name: 01 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 I Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sate, lease, rem, 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 cheuirs with • • ' ."0 APPLICANT . ••••.; - o' CONTACT PERSON ' above service or feeder foe, 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits - without service or feeder fee, 46.85 2 Contact name: RYAN — ROBERTS first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90 dwelling, service and/or feeder '' Phone: (503) 519 -5264 I Fax: : ( )1- 866 - 905 -4907 Rceonnect 66.85 . 2 E -mail: mduor( northskvcomRl_cOm Pump or irrigation circle 53.40 2 . • ' • ' • 'CONTRACTOR . • `• Sign or outline lighting 53,40 2 Signal circuit(s) or limited Business name: NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or Address' 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Pagc2 $75.00 2 City /Statc/VP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above Pkw inspection 620 Phone: ( 360) 254 -6920 Fax: ( ) 1 -866- 530 -4325 _ Investigation per hour (I hr min) — 62.50 CCB Lic.; 14117 Eiecttical Li(.1 -154CL Suprv. Lip•: 1731_03 Industrial plant per hour 73.75 r ELECTRICAL PERMIT FEES Suprv. Electrician signature, required:, Subtotal: $75.OQ Print name: JACK CAGLE Date: Plan review (25% of pet foe): . 7-2-08 - State surcharge (12% of permit fee): $9.00 Authorized signature: � � TOTAL PERMIT PEE: $84.00 This permit upplicatinn expires If a permit is not obtained within 1t10 Print name: ETHON AwDOLPH Date: 7 -2 -08 days after it has been accepted as eomplete. • Number of inspc tinn. :dluwed per permit, lnfl ildin4Uln•nu,Ut.C..Ferma %pp.doc 05/:}1175 •14O 6IST(I IAWCOM/WUa CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008 00186 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 712./2008 Phone: (503) 639 - 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/15/2008 TIME: 7:00AM PAGE: 29 SITE ADDRESS: 13660 SW PACIFIC HWY 30 CLASS OF WORK: SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: FIR GROVE APARTMENTS DESCRIPTION: Units: 30-37. Installing fiber optics for Verizon. OWNER: KUBIN CARON, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360 -254 -6920 Inspection Request Scheduled For: Date: 7/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 072645-01 503~849.2025 N Corrections /Comments /Instructions: 7 / ' X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ' ❑ FAIL ❑ CALL FO INSPECTION ❑ ADDITION FE S ASSESSED l Inspector: Date: `� Phone #: (503) 718 -