Permit III a CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00272
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/3/2007
PARCEL: 1S136CC-00200
SITE ADDRESS: 08410 SW PFAFFLE ST ZONING: R - 25
SUBDIVISION: CARRIAGE HOUSE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: CARRIAGE HOUSE APARTMENTS
Project Description: Install fiber optics for Verizon. Units 111 - 116.
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:
ANDREWS MANAGEMENT LTD NORTH SKY COMMUNICATIONS INC
11336 SW BULL MOUNTAIN RD #103 PO BOX 87550
TIGARD, OR 97224 VANCOUVER, WA 98687
Phone: Contact #: pRI 360 - 254 -6920
FAX 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 7/3/2007 $75.00
[TAX] 8% State Surcha 7/3/2007 $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 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: )Q Afe r `ii oyi
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.
07/02/2007 MON 18:55 FAX 0004/009
Electrical Permit Applica ECE \ ED FOR OFFICE USE ONLY
r '`�� Received
City of Tigard 1111�LL11 0 / ,, , Date/By: I R b1 Permit No.: EL-0..-.9607 �--
Er
° 13125 SW Hall Blvd., Tigard, OR 9Z .- Plan Review
Phone: 503.639.4171 Fax: 503.598.196 Other P tit.
Inspection Line: 503.639.4175 C %T ` Cr i ((`��' Date Ready /By: / ' • I I ® See Page 2 for
TIGARD
Internet: www.tiard-or.gov g g S�ICD`li` 6 I�Inn Notified/Method: l Supplemental Information
TYPE .OFWORK ... ..':: •, ;:. ": `'
❑ New construction Addition /alteration /replacement
Please check all that apply (submit a sets of plans w /items checked below):
❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 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 alt other installations. buildings.
%Multi-family 0 Master builder 0 Other: ❑ Fire pump. 0 Installation of 75 KVA or
❑ Emergency system larger separately derived system.
. ' ' JOB SITE 'INFORMATION AND LOCATION
'\ (`�, Addition of new motor load of "A" "E" "i - 2" "I - 3"
Job no.: Job site address sl/�! �-r(I �� �� IOOHP or more. occupancy.
t t `„ ❑ Six or more residential units. ❑ Recreational vehicle parks.
/State/ZIP: �
Cit -�7 ❑ Health -care facilities. ❑ Supply voltage for more than
Y � ,Y(/ i u a� L� .' D Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no. j' i i ( Project name: C (j ; 0 P At k Sp • 1- f s . ❑ Service or feeder 600 amps or more.
C ' . FEE SCHEDULE `:
Cross street/directions to job site: .2,1 -2 Description I Q7. I Pee. 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'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
7
5.00
• • DESCRIPTION OF WORK (with above sq. fl.)
�� -/r I\ Limited energy, multi- family
it Af, C ' (d e • .. ; l./ Py/u L r )' : l i „ T)✓ �.i off i f2Dn. residential (with above sq. n.) 75.00 2
Services or feeders Installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ ' TENANT • ' 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
Cit /State/ZIP: Temporary services or feeders Installation, alteration, and/or
Y • '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
Branch circuits - new, alteration, or ex tension, per panel
Owner signature: Date: A. Fee for branch circuits with
' 0 , APPLICANT CONTACT PERSON above service or feeder fee, 6.65 2
p ( each blanch circuit
Business name: t \tYJ li )V L6Ij(„ij v>. ),.- r [ l� t B. Fee for branch circuits
without service or feeder fee,
Contact name: / MONO t A e''VoS first branch circuit 46.85 2 .
( f , ' I f\ I Each add'I branch circuit 6.65 2
I
Address: i 16 1 fl. 1 , t ( 1) t 4 }' ','3 1..•
l r • � 7 Miscellaneous (service or feeder not included)
City/State/ZIP: �r:
Cit Ii !'' ' �i / t t /' (\C• 1 C (' - 1 Each manufactured ortnodular
3.• !• "7 V {,N 1� I J> L _ ' _ . dwelling, service and/or feeder 90.90 2
Phone: (3(t' 3) 2,C54 •(0C1' Fax: � : : (( 'b�)C�, l.{ . y(1 Reconnect only 66.85 2
E -mail: e L) C. ,,,mot' ' vy tm .Um'✓� 1 . r e
«C NT
Pump o irrigation ciicl 53A0 ..... , ....:... S ign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: 1� f () n J,)V, -, energy panel, alteration, or
Address: extension. Describe: Page 2 16 2
City /State/ZIP: Each additional Inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lic.: \ "•\ -1 I Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
1 ,: ELECTRICAL' PERMIT:FEES • '•':'.' [`.: `•
Suprv. Electrician signature, required: Subtotal:
Date: Plan review (25% of permit fee):
Print name: State surcharge (8% of permit fee): ti 19)
Authorized sign ;;'""' _ -Ars: _ :.- -•_._ TOTAL PERMIT FEE: %I
This permit application expires if a permit is not obtained within 180
Print name: ‹' j'A/ i • 1t\n t 1i,.t,(,��t 6. / C , 5' ; I Date •_�. , G Z. (}'4. Joys after it has boen accepted as complete.
•
Number of inspections allowed per permit.
I:\ Building \Pernits\ELC- PcnnitApp.doe 05/23/05 440- 461ST(II /0S /COM/WEB
r
CITY OF TIGARD _.
BUILDING DIVISION PERMIT #: ELR2007 -00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/3/2007
Phone: (503) 639 -4171 A tt Inspection Requests (24 Hrs.): (503) 639 -4175 �' I
INSPECTION WORKSHEET FOR DATE: 7/1612007 TIME: 7:04AM PAGE: 15
SITE ADDRESS: 08410 SW PFAFFLE ST CLASS OF WORK:
SUBDIVISION: CARRIAGE HOUSE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: CARRIAGE HOUSE APARTMENTS
DESCRIPTION: Install fiber optics for Verizon. Units 111- 116.
OWNER: ANDREWS MANAGEMENT LTD, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360. 2546920
Inspection Request Scheduled For: Date: 7/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 052056 -02 503-519-7466 N
Corrections /Comments /Instructions:
IN ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1/5 Date: -� � Phone #: (503) 718