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Permit (2) C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00329 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/9/2008 PARCEL: 25101 DB -00800 SITE ADDRESS: 13301 SW 72ND AVE OFC ZONING: R -25 SUBDIVISION: HAMPTON RIDGE APARTMENTS LOT: JURISDICTION: TIG PROJECT: HAMPTON RIDGE Project Description: Unit: Office. 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: HAMPTON RIDGE APARTMENTS LLC NORTH SKY COMMUNICATIONS INC 15952 SW PARRISH LN 11818 SE MILL PLAIN BLVD SHERWOOD, OR 97140 SUITE 410 VANCOUVER, WA 98687 Phone: Contact #: PRI 360- 254 -6920 FAX 1- 866 -530 -4325 Reg #: ELE 17- 154CLE FEES LIC 14117 Description Date Amount [ELPRMT] ELR Permit 12/9/2008 $75.00 [TAX] 12% State Surch 12/9/2008 $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 503.24.•. •9 or : .0.332.2344. Issued By: Permittee Signature: ,r " �L La 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. �ECEI � � Electrical Permit Application - FORO FFIC)v USE ONLY City Of all I3I Pf) DEC 0 t Receiv'd 1 PermitNo I .130323 UmNB ^ C?✓ 'r 1 3 1 2 5 S W Nall Blvd., Tigard, OR 97223 Plan ttevtew Phone: 503.639.4171 Fax: 503.598.1960 T a _t Odtcr Pcnni(: TIGARD Inspection Line: 503.639.4175 �' OF 1 c7 -'t, y /Oy: 1nri.: ® See l'nge2for Internet: www.tigard- or.gov BUI 1 1 ;►.tt r to: •�'f Supplemental In( ormnlion l� tt alc in _ • TYPE OF WORK • - . PLAN REVIEW ❑ New construction 01 Addition /alteration /replacement Please check all that ap ply (submit E scu nl'pfans w/ilems checked below): ❑ Service or feeder 400 amps or more ❑ Building over (love stories. ID Demolition ❑ Other: totete the available rata( CmTCllt ❑ Marinas and boatyards. • • CATEGORY OF CONSTRUCTION exceeds 10,000 amps m ISO ribs or ❑ Floating buildings. • • its t ground. or exceeds 14,000 ❑ Cunmtcrci:d-usc agticulurnl ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other insudlat buildings. 12 Mutti- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation 0175 KvA or • ' JOB SITE INFORMATION AND LOCATION ❑ Emergency system. !argot separately derived system. ❑ Addition or nnvnmmrlad nr ❑ "A" "(;" "I -�" "I•] ". Job no.: Job site address: 13301 SW 72ND AVE. IuoHPormote. occupancy. ❑ Six ur nWre residential unty. ❑ Re: mm4mo' vehicle parks. City /State /ZIP: TIGARD, OR 97223 ❑ Health-cam ravilires, ❑ Supply vo11 50 rev More than ❑ Hazardous Iucauuln. 600 volts nominal. Suite /bldg. /apt. no.: OFFICE Protect name: HAMPTON RIDGE ❑ Service or feeder 600 mops or more. FEE SCHEDULE Cross street /directions to job site: J Iltserltltlon 1 Q(y. 1 1'ce. 1 Tidal I • New residential single- or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. 0. or less 145.15 __- 4 Ea. adtl'I 500 sq. R. or portion 33.40 1 Tax map /parcel no.! L mitcJ energy, residential 75.00 2 DESCRIPTION OF WORK (will above sq. It.) INSTALL FIBER OPTICS FOR VERIZON Limite<lenergy, multi•falluly 75.00 2 residential (with above sq. IQ Services or feeders installation, alteration, and /or relucation 200 amps or less 80.30 2 ❑ PROPERTY OWNER • l _ ❑ TENANT 201 a,nps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: I I 601 isms to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /State /Z)P: Temporary services or feeders installation, alteralion, 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 10 400 amps 100 30 2 intended for sate, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 ;amps { 133.75 2 Branch circuits - Itew, altefati tit, of extension, per panel Owner signature: _---- _ _-- _ _ - _ - ..-- -__ - - -- A. Fee for branch circuits with 0 APPLICANT I 0 CONTACT PERSON above service or feeder I'cc. (7.65 2 each branch circuit Business name' NORTH SKY COMMUNICATIONS, INC. 13. Fee for brnnchcircuits Contact name: RYAN ROBERTS without service or !Ceder fee, 46.85 2 lirst branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'Iblanch 6.65 1 1 2 Miscellaneous (service or feede r not Included) City /State/ZIP: VANCOUVER, WA 98684 • each (0000 Iaelured or modular 90.90 ? t dwelling, service and/or fccdcr Phone: (503 ) 519 -5264 Fax:: ( )1- 866 -905 -4907 Reconnect only 66.85 2 E -mail: md(.lor(anorthskvcomm.com Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuits) or limited - Busincssname: NORTH SKY COMMUNICATIONS, INC, energy panel, alteration. or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City /State /ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above 6 - 3 60) 254 -6920 ( ) 1 866 - 530 -4325 Per stiga t:tlon 62.50 Phone: ( Fax: Investigation per hear (1 {sr min) G2.50 ccla Lic.: 14117 Electrical Lic.17 -154CL Suprv. Lic.: 173LEB Industrial plain per hour 73.75 ELEC'T'RICAL PERMIT FEES Suprv. Electrician signature, tequired: Subtotal: $75,00 Print name: JACK CAGLE Date: Plan review (25% of permit fee): 12 -9 -08 Stale surcharge (12% of permit fee): $9.00 Authorized signature: / TOTAL PERMI ) SEE: $84.00 This permit application expires if a permit is not obtained within 180 Print name: ETHON A. DOLPH D 12 -9 -08 da after 11 hos been accepted nscomplete. ' Nu iibtr of inspections allowed per permit. Inn.a,tlnsw4rm ;a arl.C.Port14App.ane 0 922106 - 14(1J61.01'(11A13 /COMAVG11 CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 uro Inspection Requests (24 Hrs.): (503) 639 -4175 ._J R__.. INSPECTION WORKSHEET FOR DATE: 111111106 ': � TIM PAGE: SITE ADDRESS: 3 30 1 SW W La- ) �-� CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: h DESCRIPTION: )J Lf r kerA er Qep/a&ed OWNER: 14 ;cle f-t-p 5, PHONE #:5 - /lp CONTRACTOR: T" M kt YI.I�D L� ry_i .P S PHONE #: Inspection Request Scheduled For: Date: / /— g Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: LcLc Ji © -C Oa) J 1Vo00A j7/ & 11 i + - 15 DCf.,cup'ed 0 See 1tit CWCa 9er Dr c_55 i c I leas ' n`3 Ce ( e . U4/1,;,19 a F / d .-mac 1 /// / g; PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: — C/ Date: Phone #: (503) 718- CITY OF �wmm m ��m� mmn�M���m�� BUILDING DIVISION PERyN|T# ~°~°"~~~~""~~= ~�"~"~°"~~"~ #: ELR2008'00329 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121912009 Phone: (GO3)G3Q'4171 � Inspection Requests (24Hnuj:(5O3)G30'4175 At INSPECTION WORKSHEET FOR DATE: 1/9y2009 TIME: 7:01AM PAGE: 20 SITE ADDRESS: CLASS OFVVOR� � 1�D�l �\�7� �[)�V� 0F{� WORK: SUBDIVISION: LOT TYPE USE � M�KHPT( N RIDGE #: USE: PROJECT NAME: HAMPTON RIDGE DESCRIPTION: Una: Office. lristlling fiber optics for Vmhzmn. OWNER: HAMPTON RIDGE APARTMENTS LLC, PHONE # : CONTRACTOR: NORTH SKY C0K8IVIUN)CAT(ONS|NC PHONE #: 3511254_6920 Inspection Request Scheduled For: Date: 1/9$2009 Pour Time: Code # Inspection Description firm # Contact # Message 199 Eledhm'Uncy 079640-02 971-653-4083 N Corrections/Comments/Instructions: \ \` / LIPASS . E PARTIAL APPROVA 0 CANCEL NO ACCESS ri FAIL ri CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED � MJ�� � � � |Inspector: K��-� ^��K�w����� Date: °'-�^ Phone #: (503) 718- 144;)_