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12150 SW ALBERTA AVEN
�II� G� CITY OF TIGARD BUILDING INSPECTION DIVISION MST
I ^4-Hour Inspection Line: 639-4175 Business Line: 639-4171 — --
J/ BUP
�c�✓�-t't Date Requested _AM PM __—_ BLD
Location
,J'p 802!A AUA5isuite _ (10Ec?
Contact Perscr; _ ST�E/Jl� i NF; Ph PLM _
Contractor Ph ------- SWR
BUILDING Tenant/Owner — ELC _
Retaining Wali M ELR —_
Footing NOT REQUESTED FPS
Foundation �- -------
Ftg Drain FOUND DLJRING RFSEARCII
SGN
Crawl Drain NO INSPECTION(s) IN FILE. - -
Slab AN SIT —_ --- ---
Post&Beam
Ext Sheath/Shear -- — -- -- --- - - - ----
Mt Sheath/Shear
Framing ----— - -- --------- ---
Insulation
Drvvall Nailing -- --- - - --- - - - -- --------
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- -- - -------- - - --
Roof
Final
PASS PART FAIL. — -.--------- --. __- ----- -
PLUMBING -------
Post&Beam
Under Slab _-- -- --
Top Out
Water Service -
-------------
Se Aary Sewer
Rain Drains ------
Final
PASS PART FAIL -
A
Post&Beam t.'�L - -
Rough In K►�"
Gas Line -----
4"Dampers
PASS PART FAIL I —
ELECTRICAL - —
Service
Rough In
UG/Slab ----- ---- --- -- --
Low Voltage
Fire Alarm
Final
PASS PART FAIL --_
SITE _
Backfill/Grading
Sanitary Sewer
Storm Drain I 1 Reinspection fee of$— required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin i Please call for reinspection RE:_ —___ L ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector _Ext _
Other
Final
PASS PART FAIL DO NOT REMOVE this insp,Fction ,ecord from the job site.
—
'75-'Z)
CITY nF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: — Q�" '77 A.M. P.M. MST:
location: BUP:
Tenant-- _ Suite: Idg: MEC:
Contractor. Phone: y�_ PLM:
Owner:_ —Puone: "-r _. ELC:
C.
ELK:
SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ,-"—ELECTRICAP SITE
Site Post/Beam Post/Beam Post/Beamice Sewer/Storm
Fooling Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Ftrmace Temp Se,-vice MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/.iheath Fire Spklr/Alm Crawl/Found Dr IIcat Pump Low Volt
Approved Approved Approved Approve a Approved
Appr/Sdwlk Not Approved Not Approved Not Approved oT'�roved Not Approved
FINAL FINAL FINAL
---
O Call for reinspection 'nternspection fee of S —_required.before next utslxxtion C7 i Inahle to inspect
Inspector: �_–` Date: /tJ U 1'11ge---_-----of
CITY OF TIGARD ELECTRICAL. PERMIT
DEVELOPMENT SERVICES PERMIY #: ELC97-0618
DATE ISSUED: 09/ 19/97
13125 SW Hall Blvd., ilgard,OP 97223 (503)639-4171
PARCEL : 2SiO3BC-02800
SITE ADDRESS. . . : 1 -150 SW ALBERTA AVE
SUBDIVISION. . . . :CANOGA PARK Z ON I NG: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :002 JURISDICTION: URB
i Project Descr,i pt ion: Add two (21 branch circuits to existing singie family
dwelling.
---RESIDENTIAL_ CJNII`----- TEMP SRVC/FEEDERS------- .-------MISCELLANEOUS---------
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . 0 PUMP/IRRIGAT ION. . . . : 0
1=:ACH AUD' L 500SF. . . : 0 2N1 - 400 amp. . . . . . . 0 SIGN/OUT LI14E LrG. . : 0
I_.IMTTED ENERGY. •. . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . , . : 0
MANF. HM/ SVC/FDR. . : 0 601.+amps- 1000 Volts. : 0 '"INOR LABEL ( 10) . . . : 0
-_-SERV ICE/FEEDER--_._.. -__-_BRANCH CIRCUITS------- ----AD'" L INSPECT IONS-----
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 .DER INSPECTION. . . . . : 0
'01 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER DOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
E'01 - 1000 amp. . . . . : 0 - - -- --____._______--_p'LAN REVIEW SECT 1'ON-__-___-___---____.__._
1.000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: ___-----___._.-------------------.--_--_---_______._..___.___ FEES
L_:D STRENDING type amol_rnt; by date recpt
12150 SW ALBERTA PRMT f 40., 00 GEO 09/19/97 97-299393
ABARD OR 5PCT $ 2. 00 GEO 07/ 19/97 97--299393
1='hone #:
Contr,actor-:
JPC ELECTRICAL_ SERVICES INC f 42. 00 TOTAL
41 2'0 SE INTERNATIONAL WY
STE A- 107 ------- REQUIRED INSPECTIONS - -
M I LWAUK I EOR 97222
Phone 4: 654-3325 _-
Reg #. . : 093774
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This peroit will expire if wnrM is not stared nithin 180
days of issuance, or• if nark is suspended fur more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in CZAR 952-001-0010 through DAR 952-0011-1987. You may obtain a copy
of these rules or direct questions to SIC by calling (503)246-1987.
K'er•mittee Signatr.rre : �''.21� V Issared By 4el
__..._-------------____--__-.-OWNER INSTALLATION ONLY--------- - ------ ------ __.__
Che installation is being made on proper-ty T own which is not intended for
sale, lease, at- vent.
OWNF R' S SIGNATURE- _- — -_- DATE:
- ----------------------CONTRACTOR INSTALLA) ION ONLY-------------------__._._______
SIGNATURE. OF SUPIR. ELECT' N: __ ?✓ `__� DATE:
LICENSE N0:
+-i.++++++++-++++• . . --+F+++++++++++f+i ++++++++-+++-1-+...f+++++++++++++++++++++++++++. -4
Call 639-417f) by 6:00 p. m. for an inspection needed the next blAsiness da
+++++++++.4 ++4+++++++++++4++A-+++++++i+3-+++++++++4-+++4++++4-+++++++++++++4 ++++++++
!TY OF TIG INRD Electrical Permit Application Plan Chlack0
3125 SW HALL BLVD. Rec'd By__
Date REc'd-
IGARD OR 07,223 1" ' ��-1 ----
Date to P.E.
Phone (503)639-4171, x304 rf`17"Q-7
Print or T�r� � 5'�- ;-_ Date to DST
I spection (503) 639-4175 r ,Te ,w ` Permit#,f-z=
plate or illeaihle will not be accepted ---=
x (503)684-7297 Called _
Job Address: tit. ComiCrlete F=ee Schedule Below:
.J
Name of Development _ Number of Ivsl)ections per permit alloweJ ---
Name(or name of business') ) j r IL END I N `� Service included: Items Cost Surn -
Address c Q W L�L�C �� `r��T 4a. Residential-per unit
1000 sq.ft.u,boss - $110.00
City/State/Zip TI !I CA O 2 __- - -
_ Each additional 500 sq,It or
Commercial ❑ Residential ® portion thereof $25.00
Lii
mited Energy $25.00
Each Manut'd Home or Modular
Dwelling Service or Feeder $68.00
2a. Contractor installatiuff only: �- '
(Attach copy of all cu�r{ent licenses 4b.Services or Feeders
1'
Electrical Contractor C ELECT P:l 01 L Si_Q V 1 Lt;,`b Installation,alteration,or relocation
Address 411JU SC Z'NTE rL-&,9L wAy 5,jeplot 200 amps or less $60.00 _ _ 2
201 amps to 400 amps $80.00 2
C11yL1,I,6JQ ____St2tP,_��Zip_ !j7 23 401 amps to 600 amps $120.00 2
Phone No. (�J __�_ l a�_ 601 amps to 1000 amps $180.00 2
Job No. _1
Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. _'` = I Exp Date_ I Reconnect only $50.00 2
OR State CCB Reg. No_("'I I I i Exp.Date_, 4c.Temporary Services or Feeders
COT Business Tax or Metro No.� 1�{�-i , Exp.Date_jt:)1Xf1_ Installation,alteration,or relocation
200 amps or less $50.00
Signature of Supr. Elec'n� _ �=:j 201 amps to 400 amps $75.00 _
401 amps to 600 amps $100.00
License No. L/ Over 600 amps to 1000 volts,
� .-Exp.Date JD l qfi see"b"above.
Phone No 1�' �.cz�J 4d.Branch Circuits
Now,alteration or extension per panel
2b. For ownmr i,7stallations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name_ feeder fee.
Address Each branch circuit $5.00
- -- b)The lee for branch circuits
City Stat@____ ip without purchase of
Phone No. _ _ service or feeder W.
First branch circuit ( $35.00
The installation is being made on property I own which is not Each additional branch circuit $5.00 - 2
Intended for sale, lease or rent. 4e.Miscellaneous
Owner's Signature_------_- (Service or feeder not included)
Each pump or irrigation circle $40.00
Each sign or outline lighting $40.00
3. Plan Review section (if required):* Signal circuit(s)or a limited energy
panel,alteration or extension $40.00
_
Please check appropriate item and enter fee in section 5B. Minor Labels(10) $100.00---'
4 or more residentia units in one structure I 41.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 tip) -- --
Classified area or structure containing special occupancy Per hour $115010 -----
as described in N.L.C.Chapter 5 In Plant
*Submit 2 sets of plans with application where any of the above apply. 5. Fees: fib, [rr J
Not required for temporary construction services. 5a.Enter total of above fees $
5 Surcharge(OS x total fees) g -
N_OT_LreL Subtotal $ -
5b.Ente. 25°0 of line Sa for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it required(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 CL)
TIME AFTER WORK IS COMMENCED. 1-1Trust Account
K �
Total balance Due s
11AMELCM AFP Rev 9,86
I j ` C110'ry
O MECHANICAL
PERMIT
_ DEVELOPMENT SERVICES PERMIT #. . . . . . . : MEC97-0341.
13125M1,all Blvd„ Tigard,UR972'3 (503)639.4171 DATE ISSUED• 09/ 1.5/97
PARCEL: 2 S 1 O:3bC--0::'600
SITi ADDRESS. . . : 1.2,150 SW ALBERTA AVE ZONING-. R--4. 5
SUBDIVISIOt\I. . . . : CANOGA PARK JURISDICTION: URB
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . ..2
----__
CLASS OFTWORK. . ,ALT FLOOR FURN. . . . :— — —0 EVAP COOLERS: 0
UNIT HEWERS. . : 0 VENT FANS. . . : 0
TYPE= OF U.�E. . . . : �F
OCCUPANCY GRP. . :iR3 VE=NTS W/O APDL: 0 VENT SYSTEMS: 0
MPRESSORS HOODS. . . . . . . : 0
BOILERS/CO
STORIES. . . . . . . . : 0 DOMES. INCIN• 0
FUEL TYPES------------- 0-3 Hp'. - . 1
3-15 HF'. . . . 0 COMML. INCIN: 0
:GAS REPAIR UNITS: 0
MAX INPUT: 0 PTU 15-30 HP. . • • : 0 WOODSTOVES. . : 0
'_'IRE DAMPERS'. . : 3�c`—00 HF'. . . : 0
GAS PRESSURE. . .
50+ yip• _ , • 0 CLO DRYERS. . : 0
NO. OF UNITS—---_ AIR HANDLING UNITS OTHER UNITS. : 0
10000 c fm : 0 GAS OUTL.E:TS. : 1
FURN ( 100K BTU: 1
FURN ) =1O0K BTU: 0 > 1.0000 cfm : 0
Remarks : Conversion to gas
FFE ---- —_—_----_ _
Owner: ---------_-___.___- type amount by date recpt
ED STRENDING
c 150 SSW ALBERTA PRMT f 25. 00 JSD 09/ 15/97 97--`992
12150
2150 OR SPCT f 1. 25 JSD 09/15/97 97-•2992c-
1
Phone #:
Contractor-: ------
HOLLAND' S HEATING —_ __ ___ _----
-----------
c:1420D NW NICHOLAS CT N0. 9 $ 26. 25 TOTAL
HILLSBORO OR 97124
Phone #: 645-8363
(leg #. . : 000752 REQUIRED INSPECTIONS —
This permit is issued subject to the regulations contained in the Gas Line Insp _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp _
applicable laws. All worN will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if worN is not started Cooling Unt Insp
within 186 days of issuance, or if worN is suspend?d for more Final Inspection _
that 180 da}s. ATTENTION: Oregon law requires you to follow rules ---
adopted by the Oregon Util,ty Notifiration Center. Those rules are
set forth in OAR 952-001-9010 through OAR 95?-901-@W- You may
obtain copies of these rules or direct questions to O(W by calling _ ---- — -(503)246-9187.
---_—
1ssIAe Py : Permittee Signat 1_i r e •
f-++++++++++.-++++++++++++++-+++++++++++++++++++++++++++++++-F•+++++++++++++++++++++
Call 639-4175 by 6:00 P. m. for- inspections needed the next btisiness day
++++++++++++++++++++++++++++++++ +++++++++++++++ +++++++++++-a++++++++•++++++++++
T
Plan Check k
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd /:f 5
TIGARD, OR 97223 Date to P E.
(503) 6394171, x304 Date to DST
Print or Type Permit# r1eC-97-b`{�/
Called
Incomplete or illegible applications will not be accepted
�� ----- Name of DeveropmentiProMcrtier scription
Table to Mechanical Code OTY PRICE AMT
Job S3"Address SuMe/ A) Permit Fee -0 -0- 10.00
Address �L�I-� J' !`aC�eu- _
Bldg* p 1 ) Fumaoc to 100,000 BTU I 600
including duds&vents
Name for name of business) 2.) Furnace 100,000 BTU+ 7.50
{ includin ducts 8 vents
Owner L� �-,f L >`/Ol�./S g I
Mailing Add rer/, ' . 3.) Floor Furnace 6.00
/ [-+�C /� including vent
nyistate t ACI Phone 4.) Suspended heater,wall heater 6.00
T ll r7�L -�S( or floor mounted heater _
Name(or name of bu eu) 4C 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6) Boder or comp,heat p4lfiw,_ajr _ --Co-0
_ to 3 HP;absorb unit to 100K BUT-
City/Stale ZipPhone 7.) Boder or comp,heat pump,air cond. 11 00
_ _�� _3.15 HP;absorb and to 500K BTU"_
Contractor Name 8.) Boder or comp,heat pump,air Gond 1500
(Prior to L IQS !f 'i /ZC- 15-30 HP;absorb unit 5-1 and BTU
msuanoe Mailing Address 9.) Boder or comp,heat pump,air Gond. 22.50
applicart '/", i(� lG' M��ak '�f 7- _30-50 HP,absorb unit 1-1.75mil BTU_" _
must provide all Citpstate fJp Phon 10) Bniler or(prnp,heat pump air Gond 37.50 —
contractor �z j/ y 44171 1� 50 HP;absorb unit 1.75 mil BTU" _
license Dragon Cmat.Cor' Bow Lr* Exp.Data 11 ) Air handling unit to 10,000 CFM — 4._50-
Information if
expired in
COT COT Buse"Tax or Metro* Exp Qate 12.) Air handling unit 10.000 CFM w 7 50 -
_database)
Architect 13) Non-pudab$e evaporate cooler 4.50
or Mating Address 14) Veot fan connected to a sing,c duct - 300
Engin+:zr Cityistaie' Zip Puone 15) Ventilation system no;included in 4 50
_ — appliance permit _
Describe work New O Addition O AneratiorA Repair O 16) Hood se-ved by mechanical exhaust 4.50
to be done Residentiax Non-residential U _
Addrhonal Description of work 17) Donk;tic ina,erar,R 750
18) Commercial or industnal type 3000
Incinerator
Existing use of 19) Repair units 4 50
building or property
20) o1 oil stove 450
Proposed use of 21.) Clothes dryer,etc 4 SO
building or property
22) Otner units 450
Type of heel-oil O natural gas LPG O electric O 23) Gas piping one to fc yr outlets / 200
I hereby acknowledge that I have read this application,that the 24) More than 4-oer outlets(each) a 50
nfo".ation given:s correct.that I am the owner or authorized agent of _
the owner,that plans submitted are in compliance with Oregon State -� _ CITY SUBTOTAL —
laws
Signature of Owner/Agent Date 7 7 — 'SUBTOTAL O�
���/v►� 1�!%'�'�G!(.)S /n/� 5°/,SURCHARGE I /
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
ASTC 8 �� --- _ TOTAL �'>
r L
i cdst\mechpmt doc (rev 9 'Minimum permit fee is S25+5°h surcharge
"Residential AX requi es site plan showing placement of unit.
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HOLIANDIS HEATING & AIR CONDITIONING, INC .
HID WORKSHEET
CUSTOMER NAME--______.__�_ PHONE ___SQFT
ADDRESS CITY/STATE 0K9 _
MIN --SIN
EXISTING FURNACE BTU--. 000 FLU—"W/HEATER— UP / DOWN
NEW HEA'T'ING EQUIPMENT
A/C OR HIP
LOCATE O.D
P.AISE FURNACE FLU
COIL
LINE SET 30ft 40ft 50ft AND MISC COPPER FITTINGS
RUN LINE SET—
T STAT & WIRE
CONDENSATE PTJMP TUBING_ " GRAVITY
CONCRETE PAD O.D. LINE SET COVERING!
EXTRA' S —
EXTRA'S
MATERIAL COST TOTAL X % _ • $
S/A DUCT R/A DUCT
DUCT FABRICATING/METAL/LINER/SHOP TIME
RUN_ _LENGTH. '
ELECTRICAL SKINNIES
PANEL _ BREAKER _WHIP__DISCON_FUSES_ ROOM _
PERMIT yes no_—_ DRAWINGS REQUIRED yes _ no__—
EXTRA' S
LABOR day (s) total _—Journeymen T-te leer
3%
TOTAL $ X % = FINAL, TOTAL $_
I