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InitiallyGood T T t 00 rn w O 7. �3 n] CT] H �I I I r 8643 SW AVON STREET �/� CITYO F T I G A R DELECTRICAL PERMIT PERMIT#: ELC2000-00654 DEVELOPMENT SERVICES DATE ISSUED: 1112.9/00 E '�'� 13125 SW Hal; Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S11 iDn-03200 SITE ADDRESS: 08643 SW AVON ST SUBDIVISION: CHESSMAN DOWNS ZONING: R-7 BLOCK: LOT : 008 JURISDICTION. TIG Proiect Description. Rnmove and replace spa disconnect only. RESIDENTIAL UNIT _ TEMP SR_VC/FEE_DE_RS _ MISCELLANEOUS 1000 SF OR LESS: _ 0 200 arnp: _ PUMP/IRRIGATION EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICEiF'_EDER _ _ F•iANCH CIRCUITS _ _ ADD'L INSPECTIONS 0 - 200 amp: 1 W/3ERVICE OR FEEDER: PER INSPECTION: _ 201 - 400 arnp: 1 st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000•* amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect onl�L_ SVC/FDR?= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: FREEMAN, VERNO'.'•, :./SLISAN M JPC ELECTRIC 8643 ISW AVON STREET PO BOX 905 PORTLAND, OR 97224 BEAVERCREEK, OR 97004 Phone: Phone: 503-632-8138 Reg #: ELE 3-424C LIC 136798 SUP 41e1S FEES _ Required Inspections Type By Date Amount Receipt EI�- ecYl Service PRMT CTR 11/29/00 $80.30 :720000000( I FlPctl Final 5PCT CTR 11/29/00 $6.43 2720000000( -v ------ Total $86.73 1 his Permit is i sued subject to the regulations contained in the Tigarr' Municipal Code State of OR Spe dty C ties and all other applicable laws All work will be done in accordance with apr,oved plans This permit w:':expire if work is not started with 180 days of issuance,or I work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by 1 )regon Utility Notification Center Those rules are set forth in OAR 952 001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct question;to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE ! — I UEi58Y (.,.ill � OWNER INSTALLATION ONLY _ —The installation is being rnade 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: LICENSE NO: ----- Cail 639-4175 by 7-OOpm for an inspection the next business day Electrical Pcrinit Appli ation ��_--11- jived: // Zq Permit no.: City of Tigard Project/appl.no.: Expire date: n, of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 1 "' nate ssuc& By: t-(� Receipt no, Phone: (503) 639-4171 --- —� Fax: (503) 598-1960 Case fi{c no.: Payment type: Land use approval: LW I &2 Gamily dwelling or accessory U Commercial/industrial U Mulli-(artily U Tenant improvement U New construction U Addilion/alteralicm/replacentertl U Other: U Partial e t Job address: vto -i Itld mono.: uu n., ' 1'ax neap/tax lot/account no.: Lot: Black: Subdivision: Project nano•. Ory 4.J..,j,o, Description and location of work on prenuses. + A I J A"L'i't a t' u ►-t Estimated date of contplCtiun/inspectiom. tSCHEDULE Job no: ' 15 I rr nt:r. Business name: n „ Description (py. (ea.) total no.ins r �5 T 'e �l� — NeNresidential-single or multifamllyper -- Address: 0 K UIj dnellingunit.I ncludesattachedgarage. City: Lr cr-v-k Siate:8(L ZIr- Service Included: Phone: 3 L- %1-4 Fax: 32-Y 11 E•mai : G -,-EC re I rR; I W)sq It (it less 4 ew r.c Each additional 500 sq.ft.or portion thereof CCBno.: i ')�l ' Elec.bus. IIC.IIO: 3 Z4 C, l.imiledencrgy,residential 2 City/IttCtro Ile.tlo`_; �t �_ Limited energy,non-residential 2 Each manufactured home or modular dwelling Signal re of srtpervising a ectricci—qutrcd) Date Service and/or feeder Su t'Iect.name. nn1 (SIS Services or feeders-Installation, III P (p �P C-OOY License no; alteration or relocation: All 200 amps or less 2 Name g address: 401 61 K)amps 201 amps to 400 wrIps 2 Mailing address: __ 601 amps to 0t>n amps 2 City: State: ZIP: Over 1000 amps or volts 2 Phone: Fax: I E-mail. Reconneclonly I Owner installation:The installation is being made on property I ov,117 Temporary wrvlces or feeders- which is not intended for sale,lease,rent,or exchange according to Installation.alteration,or relocation: ORS 447,455,479,670,701. 2txt amps or less 2 201 amps to 400 amps 2 Owner's signature: Date:_ 401 to 600 ams 2 Branch.clrcults-new,alteration, or extension per panel: P18mC1 u A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit _ City: Stale: ZIP: B. Fee for branch circuits without purchase Plume', Pas: E-mail: I- of service or feeder fee,first branch circuit Each additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-commercial J Health-care facility Each pump or irrigation circle 2 U Service over 120 amps rating of 1&2 U Hazardous location Each sign or outline lighting 2 familydwellings U Building over 10,000 square feet four or -Signal circuit(s)or a limited energy panel. O System over 6tx)volts nominal more residential units in one structure alteration,or extension" 12 U Building over three stones U Feeders,400 amps or more *Description. U Occupant load over 99 persons U Manufactured structures or RV patio Each additional Inspection over the allowable In any of the above: U Egress/lightingplan U Other Perinspection subrnit--sets of plan+with any of the above. Investigation fee The above are not applicable to temporary construction servlet-. Other -- - Permit fee............... f Not all jurisdictions accept credo c as plea-w--'-can tunuhction for marc information. Notice:this permit application "" '$ -- ° U Visa U MasterCard expires if a permit is not obtained Plan review(at _ 9h) $ _ Credit card number. I / within 190 days after it has been Suite surcharge(8%)....$ Expires accepted as complete. TOTAL .$ '7?_ -- r Name of c Iden es shown,on credit c-0 S Cardholder signature' Amount 4404615(ISKI LOOM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY 0171p�P.te Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 i Number of Inspections per f)ermit allowed (FOR ALL SYSTEMS) Service included: Itims Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft or less $145 15 a ❑ Audio and Stereo Systems Each additional 500 sq,it or portion thereof —__ $33.40 1 ❑ Burglar Alarm I imUed Ent rgy $75,00 Each Manufd Home or Modular C7 Garage Door Opener' Dwelling Se•+Ice or Feeder $90.90 2 Services ar Feeders Heating,Ventilation and Air Conditioning System' installation,alteration,or relocation 200 amps or less _L $8030 � 2 201 amps to 400 amps —_ $106.85 2 ❑ Vacuum Systems 401 amps to 600 amps $16060 2 a 601 amps to 1000 amps $24060 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $6685 ! 2 Temporary Services or feeders Installation,alteration,or relocation TYPE OF WORK INVOLVED -COMMERCIAL ONLY 200 amps or less $6685 _ 2 Fee for each system.................... .................................... $75.00 201 amps to 400 amps $100.30 2 (SEE OAR 918-260-260) 401 amps to 600 amps _ $133 75 2 Over 600 amps to 1000 volts, Check Type of Werk Involved: sea"b"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ a)The fee for branch circuits Boiler Controls with purchase of service or, feeder fee. ❑ Clock Systems Each branch circuit _ $665 2 b)The fee for branch circuits ❑ Data Telecommunication Installation without purchase of service or feeder fee. ❑ Fire Alarm Installation First branch circuit $4685 Each additional branch circuit $6.65 _ ❑ HVAC Miscellaneous (Service or feeder not Included) ❑ Instrumentation Each pump cr irrigation circle $53,40 Each sign or outline lighting _ $53.40 Signal circuit(s)or a limited energy — ❑ Intercom and Paging Systems panel,alteration or extension $7500 Minor Labels(10) $12500 ❑ Landscape Irrigation Control' Each additional Inspection over ❑ Medical the allowable In any of the above Per inspectinn $6250 Per hour $6250 ❑ Nurse Calls In Plant $73 75 ❑ Outdoor Landscape Lightlnb' Fees., Protective Signaling Enter total of above fees $ 8%State Surcharge $ ❑ Other 25%Plan Review Fee ________—.__plumber of Systems See"Plan Review"section on $ front of application ' No licenses are required Licenses are required for all other installations Total Balance Due $ Fees: ❑ Trust Account 1 Enter total of above fees $ 8%State Surcharge $ Total Balance Due S_ _ i'\dsts,,fomuulc-fees.doc 10109/(X) CITY O " T'IGARD MECHANICAL DEVELOPMENT SERVICESPERMIT PERMIT #. . . . . . . : MEC98-0033 1 13125 SW Hall Blvd., Tigard,OR 9722.3 (503)639.4171 DATE ISSUED: 01/30/9B PARCEL: 25111DD-08200 SITE ADDRESS. . . : 08643 SW AVON ST SUBDIVISION. . . . : CHESSMAN DOWNS ZONING: R-7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :008 JURISDICTION: T I G CLASS—OF'—WORK. . :AL..T---------FLOOR—FURN. . . . EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 nrr1 WTINCY GRP. . : R3 VENTS W/O AP'PL-: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/CUMPRESSORS HOODS. . . . . . . : 0 FUEL_ TYPES--------------- 0-3 HP'. . . . : 0 DOMES. I NC I N: 0 3-15 HP'. . . . : 0 COMML. I NC T N: 0 MAX INPUT : 0 BTU 15-30 HP. . . . 0 REPAIR UNITS: 0 F IRE DAMPERS?. . : 30-50 HF,. . . . : 0 WOODSTOVES. . : 1 GAS PRESSURE. . . : 50+ HP. . . . : 0 CI_0 DRYEP.S. . : 0 NO. OF LJN I TS--•----•----- - AIR HANDLING UN I TS OTHER UNITS. : 0 FURN ( 100K BTU: 0 (= 10000 cfm : 0 GAS OUTLETS. : 0 TURN ) =100K BTU: 0 > 10000 cf m - 0 Remarks : Add pellFt stove insert with full chimney liner to and eiuistinq single family dwelling. Owner ; ----- ----------- - -- -- ------ --- FEES - -- - -- - VERN FREEMAN - _ type nmol-Int by date rec.pt PF.43 SW AVON ST PRMT $ 25. 00 GEO 01 /30/98 98-302900 1 . 'aRD OR 97224 SPCT f 1. 25 GEO 01/30/98 98-302900 Phone #: 8e3.-7489 Contractor: -------------------------------..._ TOM BISHOP' CONSTRUCTION 11525 SW CANYON -.--____-__-----_---_--•-__-.-- f 26. 25 TOTAL BFAVERTON OR 97005 Phone #: 503-626-4652 Req #. . : 000546 REOlJ1RED TNSF'ECTIDNS - ----- This permit is issued subject to the regulations contarnec, in the Woodstove Insp �_. � —__ Tigard Municipal Lode, State of Ore. Specialty Codes and ;ll other Misc. Inspection applicable laws. All work will he done in accordance with Final Inspection approved plans. This permit will expire if work is not started - within I8A dans of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow rules ---- adopted by the Oregon Utility Notifiration Center. Thnse rules are -- set forth in OAR 952-01-018 through OAR 952-801-W. You may ^ obtain copies of these rules or direct questions to OX by calling - 15031246-9187. IZIIss�.ie By :� i i`� _ Permittee Signati_rre : _. +++ f++++++++++-►•++++++++++++•++++++++++++•�+++++++++++++++++++++++++++++++++++++++ Call 639-41?5 by 7:00 p. m. for inspections needed the next b+_rsiness day +++4+++++++++++++.4-+++++•++++•1'•+++++++++++++++++++++++++++++++++++++++++++++++++++ 12, 09,'96 11:01 $503 6134 7297 CITY OF TIGARD 11002%002 Plan Cho"e CITY OF TIGARD Mechanical Permit Application Redd By 13176 3W HALL BLVD. Commercial and Residential Data RUA TIGARD, OR 97223 Date to P.E. (503) 639-4171, x304 Date to DST permn'�� l� Print or Type Called Vat r /lt i _Incomplete or illegible a plications will not be accepted _ r�1 Norm Gf Description T -- _ aotele 1A1A Mechanical Code OTM PRICE AMT Job street Aodress Suites ) Permit Fee -0- -0- 1 . Address rc. 'JON ' d , abgr cityrstane Zip ) Supplemental Pennn Name lar neme or DusInsse) 1.) Furn000 to 1C .600 BTU Qwner V✓e)f v Y t(i vV vv� jai Ind.duds ale vents MMunq Aeoreaa 2.) Furnace 100.000 BTU .60 -r -w _- incl.ducts 6 vents_ Crtytstna 7 is hone .) Floor Furnace 6.00 Jc ( �l7v��' (c6 inel.vent or nam•of business) 47) uspended Heater.wall neater 5.00 or floor mounted heater _ Occupant Med rsu 5.) Vent not incl.in 3.00 •-t N appliance permit lip none 6.) Boiler or comp,hoot pump,air coed. 0 to 3 HP;absorb unit to 100K BTU erne -T-J -B&Ier or gomp,haat pump,air oond. 11.00 7 0 j.),'41 vn shyu r h o 3.15 MP:obsorp unit to 500K M contmetor Melina Adars•a ) Baw or pomp,haat pump,air oond. .00 ('G pts 15.30 MP'obsorp unit,5.1 mil BTU _ (p to Igloo Zio pnene 9.) Boiler or romp,heat pump,$W oW. `•� asuanoo a copy btt ,h(L)r'\ C', `I krL 30.60 HP;obsorp unit 1.1.75 mil OTU of as ker"M are Oreyon Conan CWL Board Uc.a UP Onto 10.) Par or comp,heat pump,air Gond. 37.50 mqunvd 0 , >80 HP;abserp unit 1,78 mill BTU ' expired in C.O.T 0 �weq Tax or Maeoa p. els 11.) Air hand g unit to 4.50 data bass) 10,000 CFM Architect "•'"• - 12.) Air handling unit 7.5 10.000 CTM+ or Mottling Address -� 13.) Non portable 4. evaptaats Walter Engineer aylstate - o Pone -- 14) Vern fan cannscted_ 3. _ to•sfn le duct _ Describe work New O Addition 0 Alteration 0 Repair' 15.) Ventilation system not 4.80 to be done Residential O Non,'sidential O inducted In apollonce permit IAdditioml Desoiptlon of work 14J Hood served by nwhonicel exhaust 4.50 11) Domestic indnerators7. Existing use of 1 ) Commerdal or Indusbtaftype �• 30. building or prop". 5 F� incinerator 19.) spair units 4.50 Proposed use of _ 20) Woodstove 4.50 building or property _ 21 bthas dryer,etc. 4.60 Type of fuel-oil O natural gas 0 LPG O 00dric O 22) Cither units 4,50 1 hereby acltnow)edga ihvt 1 have read this application,that the 23) Gas piping one to four outlets 200 information givens Correll.that I am the owner or authorized agent of the owner.that puns submitted are in compllance with Oregon State 24) More than 4-per outlet (etch) g0 laws, gignatuit of OYvr+eN nt TOTAL _ SUBTOTAL cc Contact Peron Nbme Phone 96 S CHARGE LAN R 1 28%O U TOTA.. 1 � f/ %L - f �NN T .'ijAe nechpn+t. ee (rev 7W •M wit pannit fillet is 25.0 sutef vp 08/08/1957 14:55 5038255747 GRF ELECTRIC PNCE ill CITY OF TIGARD Electrical Permit Application Plan Check a ,- 13125 SW HALL BLVD. Rec d - Oslo Recd---. TIGARD OR 97223 Dat«to P E -_ Nhonn (503) 639-4111. x304 Print or Type Date to OST Inspection (503) 639-4175 Incomplete or Illegible will not be accepted Permit Fax (503) 684 7297 _ _ _ -- 1. Job Address: 4. Complete Fee Schedule Below: Nmmn of De-elopmenl Number of Inspeatons per perrtdt allowed Name (cis nr me of buFinefh)_EQ e Yn M/ Service Included. Items Coat Sum `` � �__ _—_ Address �Q y1� J�Vor� -- -- w• Reald.ntlel•pw unit 1000 NQ n n,less —p $1 10.00 _ 4 Each eAdlthrial 500 ey n or t - portion thereof $21.100 1 Commercial ❑ Residential Unified Energy $25.00 Each Menut'd Mom*or Modular — Dwelling Servlr- or Faader $69.00 2a. Contractor Installation only: 4b.Sof-ices or Feeders (Attach copy of all current Ilceneea Installation,altaration.or rok)catlon ElectrlGnl Co trn(lorC. ---.._- 200 amps u; less 9450.00 __. 2 Address S F'a r t�d is! - h 701 amps to 400 amps — sw'oo 2 City State Zip q-W t z.- ___ 401 amps to 800 amps —_ $120.00 2 Phone No. fi= r - 601 amps to 1000 amps $18000 2 Over O emps or volts sue 00 d Job NO. r — MO only -- $50.00 2 Elec, Cont Lice. No Exp Date OR State CCA Rng. No. /Q/_J�j _Exp Dnte 9. 4c.Temporary Services or Fewievs COT businet;s Tax or Metro No _Exp.Date f7--. Installation,alteration or minc'ntion 200 amps or less 55000 -- _ 2 201 amps to 400 amps S7500 Signature of 5upr FIF c'n _ 4000 1 amps lo 600 amp. $1a?.n0 —_ ._____ 2 / Oyu 8amps to 10X]0 volts, Licen9n No. L�3 5 E Date_1Q�_ Phone No �O 3 RZ _ �2— — 4d.erenre Circuits Now altotaiion or arienslon per panel 2b. For owner Installations: the ler In,branch cirudts wIrM purchase of service or Pnnt Owner's Narne- _� _- ta Fa'h h' Ge Addre;s h1 Thi Ins+In+b+dncri Urcunr City_ ,_ State Z)P without purchase of Phone No __� .�� _ service or lewder Ise. S� First Drench circull $35.00 ✓ �_ 2 Thr_ installation Is being made on property I own which Is nor E ach additional branch clrcuh $5.00 2 intended for geie, Iriese or rent 4*.Miscellaneous (Service or lea9er n,A Included) OWnnr,: Slgneturn T- ,--- Lech pump or Irrtgailon circle 940 00 2 Each sign of outline lighting W 00 -- 2 3. Plan Review section (I1 roqulred):' Signal cimull(a)or a limited energy 00 penal,alteration or artenatnn $4402 Minor I ahela(10) __- 61 OD 00 Please check appropriate Item and enter fee In section S8 4 o+mors rwildontlal uMts in une strucfufo 4f. Each addMlonal Inspectlon ave. Service and teener 225 amps or more the allowable In any of V"above System over A0 vriffs nnminal P•r Inspecilun 935.00 Classiflad arise or soucture containing special uccupary y e'e(hour as described In N E C CMpter 5 In Prem $5500 _—_—_-- Submit 2 sets of plana with oppllcaAcin where any of thi above apply. S. Fees: 5,o 7 Not r*qulred for temporary vonatruc-llon*ervie" ba. Lnler total of above test 5%Surcharge(.05 x total tee v) Nfl11f�L subtotal a - 6b.Enter 25%of line 6s for PERMI r5 ULGOML VOID If WORK OR CONSTRUCTION AUTHORIZED IS Plan Revimv altilaUL1?Q ISK 3) $ NOT COMMENCED vdITHIN 1R0 DAYS,OR IF CONSTRUCTION OF;WORK $ubrotall $ IS SUSPENDED OR ARANDONFD FOR A PFRIOD OF 1 An DAYS AT ANY IT�R'l Tryst A event e �r 7�- TIME AFTER WORK 13 COMMENCI'0 -- Total balance Duo CITY OF TIGARD Electrical Permit Application Plan Check# 13125 SW HALL BLVD. Recd By_ Date Recd TIGARD OR 97223 Date to P.E. Phone (503)639-4171, x304 Date to DST Inspection (503) 639-4175 Print or Type Permit#_i= (-IncompleteI� '1-0,) q illegible will not be accepted or = H Fax (503)684-7297 -� �___ Called- 1. alled ___ 1. Job Address: 4. Complete Fee Schedule Below: Ne,me of Development Number of Inspections per permit allowed ----� Name(or n�a/m/e- of business) Ile I- B a Q e Vy')0--,A/ Service included: Items Cost Sum Address O l!1 i J Ll) AV a,,- - r __ 4a. Residential-per unit J �, ) 1000 sq.It.or less $110.00 4 City/Stat@/Zip c 1 C)rz- -t 7 g- 1 ______ Each additional 5o0 sq.ft.or portion tnereol $25.00 Commercial ❑ Residential Pa Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2a. Contractor installation only: (Attach copy of all current licenses 4b.Services or Feeders EI@CtrIC81 CO tractor ' E �. Installation,alteration,or relocation 200 amps or less $60.00 Address ! S ` el r ar S L 201 amps to 400 amps $80.00 _ 2 City-14" r State UP- Zip_ )` _ 401 amps to 600 amps $120.00 %3 ' - 4-10601 amps to 1000 amps $180.00 Phone N0. Job No. r K; Over 1000 amps or volts $340.00 Reconnect only $50.00 _ Elec.Coot. Lice. No. Exp.Date OR State CCB Reg. No./ _.Exp.Date 4c.Temporary Services or Feeders COT Business Tax or Metro No. --�Exp.Date Installation,alteration,or relocation 200 amps or less $50,00 _ 201 Limps to 400 amps $75.00 - 2 Signature of Supr. Elec'n _ 401 amps to 600 amps $10000 Over 600 amps to 1000 volts, License No. :3 �Exp.Date ` see"b"above. Phone NO.__ _ ,j[ 3 fir `7- `1 i � _.�____. ---__ 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of service or Print Owner's Name feeder tee. AddreSS� _-_ ___ Each branch circuit $5.00 - -- -- b)The fee for branch circuits City _ State__ Zip without purchase of Phone No. _ __ _ service or feeder lee. First branch circuit $35.00 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) $4000 Owner's Signature Each pump or irrigation circle e Each sign or outline lighting $40.00 _. 3. Plan Review section ►f required):* Signal circuity s)or a limited energy panel,alteration or extension $40.00 Minor Labels(10; $10000 -.. Please check appropriate item and enter fee in seztion 5B. 4 or more residential units in one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable in any of the above -System over 600 volts nominal Per inspection _ $35.00 _ _.- _Classified area or structure containing special occupancy Per hour _ ` $55.00 as described In N.E.C.Chapter 5 In Plant $55.00 *Submit 2 sets of plans with application where any of the above apply. I 5. Fees: 3 J r Not required for temporary construction set vices. 5a.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line 59 for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if require (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 0 Trust Account#_ $ Total balance Due I'%eStS\FLc96 APP Rev&9r, RECEIVED AUG 1 4 1997 COMMUNITY OFOLOPMENI Mian k;nek:r,a CITY OF TIGARD Mechanical Permit Application Recd By�� /' - 13125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 97223 Date to P E. (503) 639-4171, x304 Dale to DST Permit S/YIL Print or Type called — _ Incomplete or illegible applications_will not be accepted Name of DevelopmenuProleo Description T _ Table 1A Mechanical Code CITY PRICE AMT Job Street Address Sudor/ A) Permit Fee A -0- •1000 Address - `? l D 81d9e City/Slate Zlp 1 ) Furnace to 100,000 BTU 6.00 including duds&vents _ N (or name of twwieul 2.) Furnace 100.000 BTU+ 750 Owner 1 (��LJ01 t including duds&vents y a Ada a�� 3) Floor Furnace 600 C 'S CJ ,j _including vent cAyfstate Zip I Phone 4) Suspended heater,wall heater 6.00 C> 3 or floor mounted heater artie name or buaateaal 5.) Vent not included in appliance permit 3 00 Occupant Mailing Address i a 6) Boller or comp,heat pump.air cond. 6.00 to 3 HP:absorb unit to 100K BUT" CrtyrBtate ZipPhoria 7) Boiler or comp,heat pump,air cond. 11.00 _ 3.15 HP:absorb unit to 500K BTU— Contractor NofAe 6) Boller or comp,heat pump,air cond. 1500 (Pnor to ' eN let ? ti 15-30 HP:absorb urnL5-1 mil BTU" issuance M ling Address 9) Boiler or comp,heat pump,air cond 2250 applicant 1 1 n 30-50 HP:absorb unit 1-1.75mil BTU" must provide all Phone 10) Boiler or comp,heat pump,air cond. 3750 contract >50 HP:absorb unit 1.75 mil BTU" _ license Oregon,�onat.Cont.Board Lic N Exp.gets 11.) Air handling unit to 10,000 CFM 4.50 Information 4 for COT COT Ta►a tvlevo M p.Dau , 12.) Air handling unit 10,000 CFM 750 _database) _ Qs / 5 _ Architect NOR1e 13) Non-portable evaporate cooler 450 or Mailing Address 14.) Vent fan connected to a single dud 3.00 Engineer Upstate zip Phone 15.) Ventilation system not Included in 450 _ appliance permit Describe work New O Addition .) Alteration O Repair O 16) Hood served by mechanical exhaust 450 rj be done Residential O Non-residential O Additional Description of work 17.) Domestic lnc,nerators 750 1 B) Commercial or Industrial type 3000 Incinerator Exlsbng use of ro9 f Repair units 450 building or oroperty _p 20) Wood stove 450 Proposed use of 21 ) Clothes dryer etc 450 budding or property 22) Other units 4 50 Type of fuel-oil O natural gas O LPG O electri 23) Gas piping one to four outlets 2 OC I hereby acknowledge that I have read this application.that the 24) More than 4-per outlets(each) 50 Information given s correct,that I am the owner or authorized agent of the owner.that plans submitted are In compliance with Oregon State OTY SUBTOTAL 'aws _ Signature of Owner/Agent Date �� _ •SUBTOTAL 5%SURCHARGE Contact arson Name Phone PLAN REVIEW 254 OF SUBTOTAL j — — TOTAL I kdst\rnechpmt doc (rev 9 M'-imum permit fee Is S25�5%surcharge "Residential A/C requires site plan showing placement of unit. J i t7 ' J i I r� �J I �'A -pw,,k CITY OF TIGARD BUILDING INSPEC ON DIVISION 24.1four Inspection Linc: 639-4175 Business Phone: 6394171 i Date Requested: 7 /_-A A.M. � P.M. MST: -- `�'�,� L`1 LlLll �— I,xatiott: BIJP: Icnant:.—^ -- -_-- Suite:-- --Bldg: _ MEC: _` ` Contractor:_ Phone: _—_ _Q ' PLM: �3:� Owner:—_� --._--. ` Jt -�/1�-J---- Phone: _S u CI Fl,C:_1_�1L-✓FYI EI.R: SIT: _ BUILDING BLDG(con's) PLUMBING —� MECHANICAL " ELECTRICAL SITE Site Post/Beam Post/Beam Post/1 ► ''e'lVer1,41 rvrLc Sewer/Storni Footing Roof Undl l/Slab —Rough-In Ceiling'_ Water Linc Slab Framing Top Out (ins line Rough-In UG Sprinkler Fou,.dation Insulation Sewer Ilood/Duct Reconnect Vault Bsmt Damp Drywall Storni furnace I'emp Smite MISC. Masonry Ceiling Rain Drain 1A,Slab Shear/Sheath Fire Spklr/Alm Crawl/1'ound Dr a-,ttP l ow Ut Approved Approved ` Approved Approved Approved Arpr/Sd\\ll Not Approved Not Approved �`II�tApxrovcd �troved Not Approved FINAL FINAL FINAL 'NINAL FINAL 4 I CJ O Call for reinspection /C7 Reinspection fee of S required before next inspection C3 Unable to inspect of Inspector:,YL�; / `T l I.I. Dater^` Page_ 1' �L� tl7q CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 639-4175 Business Phonq 6r- 71nx)� VW_k_.1 � Date Requested: P.M. MST: -- Location: BlJP: 'I Suite, —Bldg: MFC: VV Contractor:— Phone: PLM: Phone, br:�. V ELC: ELR:_ srr: BUILDING BLDG(con't) PLUMBING LqmECHft_A_NICAL AL SITE .rpu. __ ,I j Site Post/BeamPosUlleam Pos cam Cover/Service Sewer/Storni Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas 1, 0 Rough-in IJG Sprinkler Foundation Insulation Sewer I Reconnect Vault Bgmt Damp Drywall Storm I'MaLC Temp Service misc. Masonn' Ceiling Rain Drain AW W;Slab °;Iiear/S'heatli Dire Spkli/Ahn Crawl/Pound I)r I Icat Pump I A)W Volt Approved Approved Approved Approved Approved Appi-/Sdwlk Not Approved Not Appr.pved No mroved Not Approved Not Approved FINAL FINAL Teo FINAL, Cl call for M I'1 Reinspection Reinspcction fee of S required before next inspectionC1 Unable to inspect el, Inspector. Date 'age—of CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 539-4175 Business Line: 639-4171 MST _ BUP Date Requested AM_ PM — BLD Location— �U�►✓�- Suite _ MEC - ,ontact Person Ph L 3 PLM �— r;ontractor _ 1�� f' �r-c_ IZT Ic _-- Ph - SWR --- -__ BUILDING Tenant/Owner - . C : C.,5 Retaining Wall ELR Footing Access: — Foundation FPS Ftg Drain — Crawl Drain Inspection Notes SGN - Slab IT Post& Beam -- --- - —------- Ext Sheath/Shear Int Sheath/Shear (Framing Insulation ---- — — Drywall Nailing Firewall -- _ — -- --- Fire Sprinkler --_.-___._ _ ✓��2 Fire Alarm -- Susp'd Ceiling Roof -- Mise: Final — PASS PART FAIL -- -- --— — — �_ PLUMBING Post&Beam -- -"—..-- — — Under Slab fop out ---- -----.— ---�^ _ — Water Service Sanitary Sewer ----- Rain Drains Final PASS PART FAIL MECHANICAL ------ ------ _--- --- _ ------ -- --- PoSt & Beam --- ---.__—..---------------_ — Rough In Gas Line _--— --- — — -- — — — Smoke Dampers r-inal --- — PA,Sa PART FAIL j ELECT --- . ervice Rough In - �_— --- - - — — — — UV/Slab Low Voltage — Fi rn A� PART FAIL -311 E Backfill/Grading — -- — — ---------- Sanitary Sewer Storm Drain ( J Reinspection fee of$— required before next inspection Pav at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE. [ Unable to inspect- no access ADA Approach/Sidewalk ' Other Date ` % - Inspector L/f "�-u-{ ��_ _ Ext _ Final --- ~_ PASS PART FAIL DO NOT REMOVE this inspection record from the job site.