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13643 SW ASHBURY LANE
CITY
�� �����D ELECTRICAL PERMIT
/ PERMIT#: ELC2000-00101
DEVELOPMENT SERVICES DATE ISSUED: 03/10/2000
1:.3125 SW Hall Blvd.,Tigard, OR 97223 (5031, 639-4171 PARCEL: 1S133CD-03100
SITE ADDRESS: 13643 SW ASHBURY LN
SUBDIVISION: COTSWALD MEADOWS ZONING: R-25
BLOCK: LOT : 029 JURISDICTION: TIG
F'roiect Description: First branch circuit
RESIDENTIAL UNIT TEMP SRV_C/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'11- 500SF. 201 400 amp: SIGN/OUT LINE I-TG:
LIMITED E14ERGY: 401 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _ _ _ ADD'L INSPECTIONS _
- 0 200 amp: W/SERVICE OR FEEDER PER INSPECTION:
201 400 amp: 1st V410 SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 .000 amp: _ PLAN REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
LReconnect c��ly_ SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: _ Contractor:
STIMEK, SUSAN M RURAL ELECTRIC INC
13643 SW ASHBURY LN 5285 NE ELAM YOUNG PKWY
T';ARD, OR 97223 HILLSBORO, OR 97124
Phone: Phone: 648-6696
Reg #: LIC 00047478
SUP 4062S
ELE 34-82C
FEES -_ Required Inspections
Ty By Date Amount Receipt Flect'I Service
PRMT BON — 03/10/200( $37.50 0000579 Elect'I Final
5PCT BON 03/10/200( $3.00 0000579
-�
Total $40.50 ORIGINAL
-_j
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and ail other applicable laws
All work will be done in acwrdance with approved pians This uermit will expire if work is no,started within 180 days of issuance,or if work is
suspended for rnore than 180 days ATTENTION Oregon law rtiquires you to follow rules adopted by the Oregon Utility Notification Center 'Those
rules are set forth in OAR 952-001-0010 through OAR 952.001-0080 You may obtain r)Dpies of these rules or direct questions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATURF ISSUED BY: a
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: 1 Ci � � __ DATE:—
LICENSE
ATE:—
LICENSE NO: --.— — -- - --- ---. —.-----------
Call 639-4175 by 7:00pm for an inspection the next business day
CITYOF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By a'(L
TIGARD OR 97223 Date Recd1L Z cC c r
Phone(503)639-4171, x304 Date to P.E.
Inspection (503) 6394175 Date to DST
Print of Type permit a_1
Fax (503) 598-1060 Incomplete or illegible will not be accepted Called
1. Job .Address: v 4. Complete Fee Schedule Below:
Name of Development _ I Number of Inspections per permit allowed
Name(or name of business) S,-3 Sterrick Service Included: Items Cost Sum
Address 1 3 6 4 3 SW A s h b u r y Lane 4a. Residential.per unit
City/State/Zip T i g a r d, Or 97223 1000 sq.It or less S 117 75 _ 4
Fach additional 500 su ft or
portion thereof $ 26.75 1
Commerrlal Residential Oxxlimited Fri A 60.00
Each Manufd Home or Modular
2a. Contractot instao'lation only: Dwelling Servi,:e or Feeder ` _ $ 7275 — 2
(Prior to permit Issuance,,pplicants must provide contractor Ilcerme 41p.Services or Feeders
information for COT data base). Insta!lallon,alteration,or relocation
Electrical Contractor RURAL ELECTRIC r
INC. 200 amps or less S 6425 2
Address 5285 NE Elam Younq Pkwy #A900 201 amps to 400 amps S 85.50 —_ 2
City Hillsboro _State OF, rp 971.24 401 amps to 600 amps S 12850 2
Phone No. 503/648-6696 — 601 amps Io 1000 amps $ 19250 2
Job No- 0 0-121- "— Over 1000 amps or vows i $ 363.75 -_ 2
-- — Reconriect onty 3 53.50 _ 2
Flee. Cont Lice. No. 34-82C Exp.Date _ 4c.Temporary Services or Feeders
OR State CCB Reg.No 47478 Exp.Date— lnstava(ron,atteratim),or rr_iocatron
COT Business Tax or Metro No. 5287 Exp.Date 200 amps or less 5 5350 2
201 amps to 400 amps $ 8025 2
Signahure of Supt Elec'n 401 amps to 60o amps $ 100.00 _—_�" 2
---- Ov►r 600 amps to 1000 volts
License No 4062-5 Exh.Date Soo"ll above.
Phone No 503/648-6696 4d.Branch circuits
- - -- New,altoration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
tealiw fow,
Print Owner's Name _ Each branch circuit S 5 35 _ 2
Address_ b)The fee for branch circuits
w/Olouf purchase olservice,
City _ _ _ Stale___Zip _ _ or feeder lee.
Phone No. _ —� _ First branch circuit / S 37.50
Fach additional branch circuit $ 53S ~_
The installation is being made on properly I own which iS not 4e.Miscellaneous _
intended for sale, lease or refit. (Service or feeder not included)
Each pump or irrigation circle $ 42.75 _
Owner's Signature_ _ _ Each sign or outline ugtrariq _ — S 42.75 A�
— ---- - Signal circurifs)or a limited energy
3. Plan Review section (if requiredt:# ,.abration or extension S 60.00
w*wwtrot $s 10000
Please cheek appropriate item and enter fee In section 5B. 4f.Each additional Inspection over
- 4 or moor realdIM"rnl ur1As in one st Mop theralik w►able in erry e►t'he abrfve
Service and feeder 225 amps or more Per inspection S 50.00 —
Per hour $ 50 00
System over 6(10 voR'norrwnal I•r Plant S 59.00
Classified area or structure containing special occupancy as —
desCJlhed in N.E.C.Chapter 5 5_ Fees:
5a.Ertei total of above fees S J t/
Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(08 X total fees) $
Not requiredfrniwmpmary consrruct)on services. Subtotal $
6b.Enter 25 of Ione 5a for
NOl ICE Plan:Review d res !t f Isar-A) $ —
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal S _.
15 NOT COMMENCED`AlTHIN 180 DAYS OR IF CONSTRUCTION OR �-7
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Ll Trust Arcount>Y
AT ANYTIME AFTER WORK IS COMMENCED Total balance Due $ U r J
i•`tlsts�fnrms!electrtC.doc
MECHANICAL PERMIT
CITY OF TIGA►RD _ _
DEVELOPMENT SERVICES
PERMIT#: MEC2000-00083
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 DATE ISSUED. 151S133 2000
3CD-03100
SITE ADDRESS: 13643 SW ASHBURY LN
SUBDIVISION: COTSWALD MEADOWS ZONING: R-25
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
1 YPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL• VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS!
FUEL.TYPES_ 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCiN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS'?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN —100K BTU: <= 10000 cfrn
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of an air conditioning unit, A/C units cannot be placed within the required setback areas.
Owner: FEES _
STIMEK, SUSAN M Type By Date Amount Receipt
13643 SW ASHBURY LN PRMT GEO 0114/20( _$50.00 0000655
TIGARD, OR 97223 5PCT GEO 03/14/20( $4.00 0000655
Phone:
Total $54.00
' - -----
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 503-281-0752 Final Inspection
Reg #:LIC 008897
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 in the Oregon 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 questions to OUNC by
calling (503)246-9189
Issue By: �-- Permittee Signatur _–
C Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Plan Check# _
CITY OF TIGARD Mechanical Permit Application Recd By _-
13125 SW HALL BLVD. Commercial and Residential Date Rec'd�
TIGARD, OR 97 223 Date to P E
(503) 639-4171, x304 Date to DST
Print or Type Permit#__`—_^.
Incomplete or illegible applications will not be accepted Called
Name of Developm ntlpm ect Description
a4 Table 1A Mechanical Code Qty Price Amt
Job Street Address A) Permit Fee 16.00
Address 3 ,�(v 1) Furnace to 100,000 BTU
Bldgp cuyrstare Zip — Includingducts&vents 9.65 _
2) Furnace 100,000 BTU+
LG Including ducts&vents 12.00
Name(or name of bus ^sa 3) Floor Furnace
Owner / `�f f including vent 9.65
Mailing Address 4) Suspended heater,wall heater
or floor mounted heater _ 9.65
5) Vent not included in appliance ermit _` 4.75
Cnyfstate zip Phono Check all that apply `Boiler Heat Air
For Items 6-10,see or Pump Cond Qty Price Amt
Name or name of b siness) — footnotes 1,2 Com
6)Repair units
_ l 8.40
OccupantMelling Aderes a 7)<3HP;absorb unit to
136 7L ' / 100K BTU 9.65
CNylstate Zip one 8)3-15 HP;absorb unit
5,1b_ 100k to 500k BTU 17.65
Contractor "a �( 9)15-30 HP;absorb
/,, /f unit.5-1 mil BTU 24.15 _
10)30-50 HP;absorb
Prior to permit Mailing Addres unit 1-1.75 mil BTU 36.00
issuance,a copy _ 11) 50HP;absorb unit>1.75 mil BTU
of all licenses sta a Zip Phone 60.15
are required if 12)Air handling unit to 10,000 CFM k�
expired in COT Oregon Const Cont Bo&d Llc 0 Exp,Date IV 7.00
database F99 6 13)Air handling unit 10,000 CFM+
Architect flame 11.85
14)Non-portable evaporate cooler
or Mailing Address 7.00
15)Vent fan connected to a single duct
4.7.5
Engineer CHy/Slate Zip Phone 16)Ventilation system not Included In
a plianceep milt 700
Describe work to be done 17)Hood served by mechanical exhaust
7.00
New O Rep9KO Replace with like kind: Yes O No O 18)Domestic incinerators
Residential%/ Commercial O Modification O nrA0r`]I"] 12.00
19)Commercial or industrial type incinerator
Additional information or description of work. _ 48.25–__
20) Other units,including wood stoves
700 _
NOTE: For Commercial projects only;Units over 400 Ibs„located on the 21)Gas piping one to four outlets
roof,require structural talcs.prepared by licensed engineer,
Type of fuel oil O natural gas O LPO O electric O 22)More than 4-per outlet(each) 75
Minimum Permit Fee$50.00 SUBTOTAL ee
I hereby acknowledge that 1 have read this application,that the information 8%SURCHARGE '..' _ 1 '" _
given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL
the owner,that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
Signature of Owner/Agent Date V TOTAL
Other Inspections and Fees
Contact Penson Name Phone
- 1 Inspections outside of normal business hours(minimum charge-two hours) ESo 00 per hour
2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
$50 00perhour
OonoteS fffr commercial projects only: 3 Additional plan review required by changes additions or revisions to plans fminimum
1. Provide full schematic of existing and proposed gas line and pressure. charge-one-half hour)$50 00 per hour
2 Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units. "Residential A/C requires site plan showing placement of unit
1:Unechperm doc rev 11/1/99
Recti/
CCft#8897 4320 N Williams Avenue,Portland,OR 97217 0MCe 503.281.0752 fox 503,282.5722
lobi, 4066 Slicinik- Residence
Address: 13643 SW.-.Ashb.w. .-v-I.anc
Tigard,Qfcgon 97.22-3-
_-1
Nmih
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 635-4171MST ------- —
BUP
Date Requested Z i? < _AM PM BLD
Location– 1 LI- Z� Suite MEC —
Contact Person / Ph _ _ PLM
Contractor �t�t� -✓L z < Ph SWR
BUILDING Tenant/Owner
Retaining Wall ELR
Footing Access'
Foundation FPS
Ftg Drain -
Crawl Drain Inspection Notes-, SGN -------_ __
Slab ----- != v rtJ� --- SIT
Post&Beam -- -- ----__._----- _—
Ext Sheath/Shear
Int Sheath/Shear _-- - ---�
Framing
Insulation
Drywall Nailing
Firewall --------------___------
Fire Sprinkler
Fire Alarm - _ -_._------.--_- _
Susp'd Ceiling - ---- - -- ---------- -
Roof -
Misc: -- - ----- �'���-'�-k-__-�� - —_-------------- --
Final -
PASS PART FAIL --
PLUMBING —
Post& Beam
Under
- --- - --
Under Slab
Top Out --- - ----�-- -----
Water Service
Sanitary Sewer - ---
Rain Drains
Final
PASS PART FAIL
MECHANICAL ---------------- ----- ---
Post& Beam
Rough In
Gas Line --
Smoke Dampers
Final ------------ -----
P FAIL
LE TRIC
ervice
Rough In _ -- —----
UG/Slab
Low Voltage
Fire Alarm _
Fi
ASS -, PART FAIL
I Backfill/Grading - - i- -- ---
Sanitary Sewer
Storm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f ) Please call for reinspection RE. _4 ]Unable to inspect-no access
ADA .,
Approach/Sidewalk
heDateInspector Xt
Final �1
PASS PART FAIL-: 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BUP
Date Requested_ AM PM BLD
Location ? Suite �MEc ? LSD -�fJg
Contact Person Ph (���i PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall 6 ELR
Footing
Foundation Access: �� C / FPS
Ftg Drain
Crawl Drain Inspection Notes: /_ L 1 S q
Slab _ lv I I -6 urro ►� �1 _ SITS
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear V ---
Framing _
Insulation 0O 1 O 1 /� 1
Drywall Nail"�g �/ (i („/�J V `� \� J
Firewall y^ .Q,, Q
Fire Sprinkler V V!'�.� U -1 CC /` C l�J� ��5
Fire Alarm
Susp'd Ceiling �'� LW�fG�--� S •'�\ �,.
Roof
Misc.
Final —_---�-- _
PASS PART FAIL - -- _
PLUMBING
Post& Beam
Under Slab
Top Out –
Water Service
Sanitary Sewer "--- --
Rain Drains
Final
PASS PART FAIL
M
—
Rough In
Gas Line -
Smoke Dampers
A PART FAIL
'EnCTRiCAL� _ - -
Service.
Rough In —
UG/Slab _
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading — ----
Sanitary Sewer
Storm Drain ( j Reinspection fee of$_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Please call for reinspection RE. Unable to inspect- no access
Fire Supply Line nspec -- -- --- _ )
ADA
Approach/Sidewalk Ext--3/.'
Other Other Date Inspector_ ,��_ - Ext--
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.