12765 SW BULL MOUNTAIN ROAD-1• 4
1 ,
y
1
12765 SW BULL 1
CITY OF TIGARD BUILDING INSPECTIrNi D,VISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST _
Date Requested__ '�' BUP AM M ------
ELD
Location Z? l(•�r ,$r�,, f�� �� ,�. IL- Suite — ---
--- ------ — MEG
Contact Person Ph G� ;) —' ---
G—t civ �uu/ly�
Contractor _ Ph "...Y_ SWR
BUILDING Tenant/Owner ELC
Retaining Wall— — --
IFooting Access: ELR
Foundation Acc -
Ftg Drain FPS
crewl Drain Ir,spection NTte SIGNSlab _
Post& Rpam --- --- - SIT
Ext Sheath/Shear
int Sheath/Shear
(Framing ------- -- ---
!r.sulation ---------- -- ---
Drywall Nailing
Firewall ------ -_—__----------- --
Fire Sprir,;;!c -- - - -
Fire Alarm ------ -- _ --- - ---- .- -
Susp'd Ceiling -
Roof - - --- -----_ --- ------ - ---- -
Misc: - -
Final
P/,$ PAR7 FAIL. - --_-- -
PLUJIQ¢ING.. -- _
ost& Beam
Under Slah
h •Top Out
Water Service
----
Sanitary Sewer
Rain Drains
AANICAL
PART FAIL - --
Post R Beam - -
Rough In
Gas Line -_ -
Smoke Damr irs -- - - ----
Final
PASS PART FAIT. ---
ELECTRICAL - - --
Service --- -
Rough In -._--- .
UG/Slab --`
Low Voltage
Fire frlarm
Final
PASS PART FAIL - -
SITE -- -- - -
Backfill/Grading --- _
Sanitary Sewer
Storm Drain [ )Refnspectlon fee of$ required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd
Catch Basin -
Fire Supply Line [ )Please call for relnspectinn RE: [ J Unable to inspect-no access
ADA
Approach/Sidewalk /� a
Other _ Dane -L>— Inspector Ext
Final -._
PASS -PART FAIL DO NOT REMOVE this Inspection record from the joky 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 Zoll- 5 `"�' ��_K��I� PN .3uite _ -- _ MEC —
Contact Person Ph —; ? 3 2 r V PLM —
Contractor _^ -_ r-h SWR
BUILDING Tenant/Owner FSC �!✓rry-vy�. � �"
Retaining Wal; - ELR _
Footing Access.
Foundation FPS
Ftg Drain —
Crawl Drain Inspectior Notes: SGN _
Slab
Post&Beam ------ -- _ ----..._--- --- SIT ---�
Ext Sheath/Them
Int Sheath/Shear -
Framing - -�
Insulation - -
Drywall Nailing
Firewall
Fire Sprinkler 1z'
Fire Alarm -
Susp'd Ceiling
------------------
Roof _ --- --
Misc.: ------- - -- --- � '"---
Final
PASS PART FAIL __------ -------------_--- ------- _-_--
PLUMBING
Post& Beam
Under Slab
Top Out - —----------- -- - -
Water Service
Sanitan/Sewer
Rain Drains
Final --- -
PASS PART FAIL
MECHANICALS - - - --
Post& Beam ---------- _ -
Rough In —
(,as Line
moke Dampers
Fi,al --- -- - ---- _
PASS -E T FAIL.
Service
Rough In -
UGrSlab
Low Voltage
Firelqrm -----------.�. ------ - - _ --------------_ --- --
in
S ART FAIL _-
Backfill/Grading - ----------
Sanitary Sewer
Storm Drain I J Reinspection fee of$ required before next inspection. Pay at City Hall, 13525 SIN:-+all Blvd
C.Ach Pasin
Fire Supply Line [ J Please call for et'nsJection RE: _ [ J Unable to inspect-no access
ADA
Approach/Sidewalk /
Date �" Ins ertor_ '�
Other D _ — P _ -�-------_._ Ext
Final
PASS -PART__ FAIL 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --
r'' BUP
__Date Requested '(� Z-� / -AM_ PM -_ BLD _
J
Location _ C Z E.•1.,('Q r 't L�_f� Sui_6 -/ / MEC ��L
�
Contact Person LPh �G��'T lt�� I'LM -------- --
Contractor Ph — SWIR _
BUILDING _ — Tenant/Owner -- LLC
Retaining Wali ELR
Footing Access: FPS
Foundation ---- ---
Ftg Drain SGN
Crawl Drain Inspection Notes. -- - -—
ISlab ___ �_--- _ SIT
Post&Beam ---- -...
Ext Sheath/ShearI
Int Sheath/Shear
Framing �'��4 �L��1 --.sG ��t�',�S_� =1i•GT� crs" !e 0
Insulation _
Drywall Nailing -----
Firewall r i'
Fire Sprinkler _ _—
Fire Alarm --
Susp'd Ceiling -------
Roof
Misc:_ --- ---- --- --- -----
Final -----------
PASS PART FAIL --- --— -- --- --- --- -- — --- ---------
PLUMBING --- --.. --- --_— — ----------
Post&Beam
Under Slab ------ --- - _------ ------- -
Top Out
Water Servi,,,e
Sanitary Sewer
Rain Drains
Final --- -- ---
PASS PART FAIL - --- - ------------- -------- -�- _
Post&Bea,n --- --- ---- - --_- - - - - --
Rough In
GasLine - - ------------....---- --- --- ---- ---- ---
Smoke Dampers
WSSASS FAIL
. CTRICAL -- -- -- - ------_- ..-- .-.. --
Service _ _ -- ------ -- -
Rough In
UG/Slab ---- --..- - --- --- --
Low Voltage
Fire Alarm _-. - -- - --
Final
PASS PART FAIL_ -___- --
SITE _
Backfill/Grading --_-- -
Sanitary Sewer
Storm Drain f )Riinspection fee of$ __— required before next inspection. Pay a,r,ity Hall, 13125 SW Hall Blvd
Catch Basin ect-no access
Unable to i�.s
Fire Supply Line I ] Please call for reinspection RE: —_� —_� ) ) P
ADA L�
Approach/Sidewalk Dateector Ins Ext _
Other _--- — C� ---._ p _ -- - - --
Final
PASS PART FAIL DO CiOY REMOVE this Inspection record from the job site.
CITYO F TI GA R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES
PERMIT#: P�lEC199900163
13125 SW Hail Blvd., Tigard, OR 97223 (5031 n,9-4171 DATE ISSUED: 4/15/99
SITE ADDRESS: 12765 SW BULL MOUNTAIN RD PARCEL: 2S109AD-01000
SUBDIVISION: ZONING: R-7
BLOCK - LO r: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: _ EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VEN rS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
_ FUEL TYPES0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 • 30 HP:
FIRE DAMPERS?: 30 -50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + Hp: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDL NG UNITS CLo DRYERS:
FURN >=100K BTU: <= 10000 cfrn:� OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installing furnace
Owner: -----FEES
SCHAER, JOHN ARLEN + CHRISTI A Type By Date Arnount Receipt
12765 L MTN RD PRMT BON 4/15/99 $25 00 99-314542
TI��ARD, URR 97224 5PCT BON 4/15/99 $1.25 99-314542
Phone: _ — Total _ $26.25
Contractor:
SUNSET FUEL CO
F0 BOX 42287
PORTLAND, OR 97242 _ REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503-234-0611 Final Inspection
Reg #: LIC 00002374
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 clays. ATTEN-t ION: Oregon law requires you to follow rales adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-X1080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: �Vl�✓_AL.U-ti Permittee Signature: l '���� (�•1`` ��-
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
RECEIVIED
Plan Check#
(CITY OF TIGARD Mechanical Permit Application Recd By
13'$25 SW HALL. BLVD.APR U _ 19'' Commercial and Residential Date Recd _
TIGARD, OR 97223 COMMUNITY UVEi nit"M Date to P.E.
(503) 639-4171, x3104 Date to DST
Print or Type Permit#jyre 11,11 0-165
Incomplete or 'illegible applications will not be ar cepted Called –
_ Name of Devt:upment!Projoat DeLcription
Table lA Mechanical Coae_ _ _ Oty Price Amt_
Job / DNIStreet Addrer• p p SufletY A) Permit Fee 10.60
Address / .) 7&5 it [� 1) Furnace to 100,000 BTU C�
inrludin ducts&vents see footnote 1,2 6.00
BWglr Cnystate ZIP 2) Furnace 100,000 BTU+
including ducts&vents see footnote 1,2 7.50
Name(or name of>�Ina ) 3) Floor Furnace
Owner t.�Z,h II -,!X',,-h/?to including vent see footnote 1,2 6.00
Mailing Address4) Suspended heater,wall healer
or floor mounted heater see footnote 1,2 6.00
5) Vent not Included in appliance permit
Cnyistate JP Phone 3.00 _
Check t 1 that apply: 'Boller Heat Air
Na (or name of business) For Item.•6-1ee 0,sor Purnp Cond Qty Price An it
footnotes 1,2 Com ""
_ 6) 3HP;absorb unit to
Occupant Mailing Address 100K BTU _ 6.00
7)3-15 HP;absorb unit
cnylState Zip Phone 100k to 500k BTU 11.00
8)15-30 HP;absorb
unit.5-1 mil BTU _ 15.00
Contractor Na' I 9)30-50 HP;absorb
���f/IjE� r•f� - unit l-1.75 mit BTU 22.50
Prior to permit Malling Address I G'r/ess ,, 10)>50HP;,absorb unit
issuance,a copy 15 t d+- I >1.75 mil BTU _ 37.50
^ 7
of all licenses rState P�t�+� I 11)Air handlin•i unit to 10,000 CFM
are required if t *b f"rCa r`A 4.50
expired In Co,r conn.Cord.e�►�� FxP•Dat d — 12)Air handling unit 10,000 CFM+
database _ 3 "1 7.50
Architect Name 13)Non-portable evaporate cooler
_ 4.50 1 _
or Ma,irty Aadroes J– 14)Vent fan connected to a single duct 3.00
15)Ventilation system not Included in
Enginf,er CRY/State zIv Phare SPPIien a It _ 4.50
16)Hood served by mechanical exhaust
4.50
(k+scrit�e work to be done -- --
17)Domestic incinerators
New* Repair O Replace with like kind: Yes O No O _ 7.50
Residential O Commercial O 18)Commercial or Industrial type incinerator
30.00
Additional information or description of work 19)Repair units
4.50
20)Wood stove
NOTE: For Commercial projects only;Units over 400 lbs.require 4.50
structural gas calcis 21)Clothes dryer,etc.
Type of fuel oil O natural gas LPG O electric O
22)Other units
I hereby acknowledge that I have read this application,that the information
given is correct,that I am the owner or ouihorized agent of 23)Gas piping one to four outlets
the owner,that plans subrnitted are in compliance with Oregon Stale laws. See footnote 1 2.00
24)More than 4-per outlet(each)
Signature of Owner/Agent Date .50
� tZt
Minimum Permit Fee$26.00 SUBTOTAL
Contact Person Name Phone l
5%SURCHARGE
PLAN REVIEW 25%OF SUBTOTAL
Foonotes for commercial projects only: Required for ALL commercial permits only _
1 Provide full schematic of existing and prnposed gas line and pressure. TOTAL
2 Provide drawings to scale showing existing and proposed me;hanical _ 1�
units. _ 'State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
1 4nechpemi.doc rev 02!4199
_ ELECTRICAL PERMIT
CITYOF T I C3Z A■ �R D PERMIT#: ELC2000-00292
DEVF_Lr1PN!1ENT SERVE^ES DATE ISSUED: 6/5/00
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 6394171
PARCEL: 2 S 109AD-01000
SIT1r ADPRr.SS: 12765 SW BULL MOUNTAIN RD
SUPUIVISIGN: ZONING: R-7
BLOCK: LOT : JURISDICTION: TIG
Proie,:t Description: Insiari 1 service/feeder and 4 branch circuits in single family dwelling.
RESIDENTIAL UNIT — _ _TEMP SRVC/FEEDERS _ _ MISCELLANEOUS
F.
—1000 SF OLESS: _ 0 - 200 atrp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
L MITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANS HM/SVC/ FDR: 601+amps - 4,000 volts: MINOR LABEL (10):
SERVICEIFEEDER BRANCH CIRCUITS ADD'L INSPECTIONS__
0 - 200 amp: 1 W/SERVICE OR FEEDER: 4 _ PER INSP7CTION:
2U1 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - '1000 amp: _ PLA_ R REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: _ _ SVC/FDR >= 225 AMPS: CLASS ARFA/SPEC OCC: _
Owner: Contractor:
SCHAER, JOHN ARLEN + CHRISTI A CRAFT ELECTRIC INC
12765 SW BULL MTN RD 11077 N. VANCOUVER WAY
TIGARD, OR 97224 SUITE 21
PORTLAND,OR 97217
Phone: Phone: 283-2784
Reg #: LIC 006845 ORIGINAI
SUP 3480S
ELE 26-579C
FEES _--� Required Inspections
Type By Date r Amount Receipt Elec1'I Service
PRMT KJP 6/5/00 $85.65 0002677 Elect'I Final
5FCT KJP 6/5/00 $6.85 0002677
_-- - Total $92.50--1-_-
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 ATTENTIONOregon law requires you tc follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-001-0010 through OAR 9c;2-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503)
246.1987.
PERMITTEE'S SIGNATURE ISSUED BY:
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. El_EC'N: L�Z C`� J -- DATE: -- ---------
LICENSE NO: —_ �—_�_ ----------
Call 639-4175 by 7:00pm for an Inspection the next business day
JUN-02-2000 15:57 CRnFT ELECTRIC
CITY OF TIGAIRD Electrical Permit Application Plan Check�
13125 SIN HALL. BLVD. Recd By
TIGARD OR 97223 Date Recd
Phone(503)63"171, x504 oats to P.E.
Date to DST _
Inspection (503)639-4175 Print of Type Permit# Li ta> (!Z �_r1_i_•
Fax (503) 558.1960 Incomplete or illegible will not be accepted Called
- 1
1. Job Address: 4. stump/etre Fee Schedule Below:
Name of Development T __ Number of Inspections per permit allowed
Name(or name of business) ire, Service included: Items Cost Sum
Address - 0G-� �1+,� ,bQ Q ENS .'Residential•per unit
1000 sq,fl.ur less S 117,75 n
City/Stdtel1lp _ -1 i�(� _ Each addWonal 500 sq.N or - -
portion thereof _ S 26.25 _
Commemal ❑ Residential llrrmhed Energy f 60.00
Fath Manuf d Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder S 72.75 2
(Prior to permit issuance,applicants must provide conitaclor license 4b.Services or Feeders
Infomsadon for COT data bass). Installation,alleration,or relocation
Electrical Contractor Craft Electric 200 amps or lees _�_ $ 64,25 1j 2
Address 11077 N Vancouv t--��-S..�e_:_z1.
201 amps to4U0amps S 85.50 2
�
- 401 amps to 000 amps = 128,50 2
City_paz tLand State---OR --. .Zip 97217 Flat amps to 1000 amps f 102.50 2
Phone No 283-.2784 / Over 1000 amps or volts -`� s 363.75 _ 2
Job No -V "l a 01 _ Reconnect only f 53.60 _ 2
Elec, Cont. Lice, No.2 6-5 7 9 C Exp.Date 110 4c.'remporary Services or Feeders
OR State CC13 Reg. No 68695_____Exp.Date it a' I 1R11a
alteration,or relocalion
COT Business 1 ax or Metro No. ��_E�tp.Dete� 200 amps or less $ 5350 2
201 amps to 400 amps S 00.25 2
Signature of Supr. Elec'n_ ✓ 401 amps to 600 amps s 10700 2
Over 600 amps to 1000 volts,
license No. 3 4 8 0 S _Exp.Dete i i lot nee"b"above.
Phone No. 283-2784 ext, 11 ad.BranchCin.uits
New,alteration or enension per panel
a)The fee for branch circuits
2b. For owner installations: WIth purchase of service or
feeder fee. .-1 �I
Pent C)wner's Name Each branch circuit f 535 Q 1 ,' 0 2
- - -- h)The fee for branch circuits
Address without purchase of servlcP
City -_.- State Zip or feeder fee.
Phone No. First branch druuls - 1 37.50
Each additional branch circuit $ 5.35
The Installation is being made on property I own which is not 40.Mtecananeourr
Intended for sale, lease or rent. (Serving or feeder not inducted)
Each pump or Irrigation circle S 42 75 _
Owners Signature- ---�_ _ _.-,----- Each sign or outAne lighting 1 42 75 -
Signal draiills)or a limited energy
tlon required):*f panel,alteration or r ctension _ f 60.00
3. Plan Review seC
�, Minor Labels(10) L ta3,A0
Please check appropriate item and enter No in section 58. 4f.trach additional Irapec.-Uon over
4 or mote rrrsidenbal units in one structure the allowable In any of the above
_--^ Service and feeder 225 drnps or more Per Inspection - -^ f 50.00
Per hour $ 5000
System over 600 volts nominal In Plant 1 5900
Classifred arena or%trudure containing special ucv.upai1ry an
desctlhed in N F C Chapter 5 5. Fees: �
So,Enter total of above fees
Submit 2 sets of plans wittt appllcarlon whore any of the 41hnve apply. AW Surcharge(e16aUgtal fees) f lo, 1,-)Not required for Esnlporary eonstructlon servicers Subtotal 'O S _
5b.Erne►25%of Ina so for
NOTICE Plan Revkew i(required(Sac 3) f
PERMITS BECOME VOID IF WORK OR CONSTRUCTION ACfiT40WE-U subtotal f �
15 AOT COMMENCED WITHIN 160 CLAYS,OR IF CONSTRUCTION OR C'1 Trust Acco�nl r,S,Q Q� �
WORK 15 SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS
AT ANY TIME AFTER WORK IS COMMENCED Total balani Due $ C1
-- - - ----- - .t4r-i f% _'"4.r%v.A A* r, , r,... hr it. -t 1^a..A 11 l
TnTHL P.01
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00201
1312.5 SW Hall Blvd.,Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 5/25/00
PARCEL: 2S109AD-01000
SITE ADDRESS: 12765 SW BULL MOUNTAIN RD
SUBDIVISION: ZONING: R-7
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
OD
GAS PRESSURE: 50 + HP: CLO DRYERS:
RYS:
FURN < 100K BTLI: AIR HANDLING UNITS C
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
GAS
> 10000 cfm: OUTLETS: 1
Remarks: Kitchen remodel - move gas for cooktop.
Owner: __ FEES
SCHAER, JOHN ARLEN + CHRISTI A Type By Date Amount Receipt
12765 SW BULL MTN RD PRMT DEB 5/25/00 $50 00 0002461
TIGARD, OR 97224 5PCT DEB 5/25/00 $4.00 0002461
Total $54.00
Phone: ----------
Contractor:
OREGON CITY PLUMBING
E 1 1 7TH ST
OREGON CITY, OR 97045 _REQUIRED INSPECTIONS
Gas Line Insp
Phone:656-8558 Final Inspection
Reg#:LIC 2132
()
This permit is issued subject to the regulations contained iii the Tigard Municipal Code, State of Ore.
Specialty Codes and all ether applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 1E0 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law require, you to follow rules adopted in the Oregon
Utility Notific;attQp Center. Those rules are set forth in OAR 352-001-0010 through OAR 952-001-0080.
You v ay obtain dies of hese rules or direct questions to DUNC))�y-t:an' g (503)246-91
Iss�e By: ��� Permittee Signature:
all (503) 639.4175 by 7:00 P.M. for inspections needed the next business day
,.
CITY 4F: TIGARD Mechanical Permit Application Plan C ck#
1:3125 5'N HALL BLVD. PP Recd By and Residential Date Rec'd_u
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, X304 Date to DST
Print or Type Permit V
Incomplete or illegible applications will not be accepted Called
e Name of Development/Prolect DQSCriptron --
Table 1A Mechanical Code OTY PRICE AMT
,Jolt' Stroet Addrese - SudeN A) Permit Fee -i
Address Z-� lot) _ -0- 10.00
EIdg71 CRY/State Zip 1.) Furnace to 100,000 BTU -
_- f� 472 Zl� 6,00 -
Name(or name of business) - L _including ducts 8 vents -
Owner 2.) Furnace 100,000 BTU+ -750
including duds 8 vents
Maung Address _„_ _
3.) Floor Furnace 6 00
including vent
p
rtr�r;;tate z Phos° 4.) Suspended heater,wall heater -
(v - 6 U0
_ or floor mounted heater
Name(or name of buaineast 5.) Vent not included in appliance permit
�'�-� •IC�rs� y}{3G1� � 3.00
Occupant Mailing Address
_6T Boller or comp,heat pump,air c:ond.
6.00
to 3 HP;absorb unit to BUT
cnyr,tee, zip phone 7.) Boim
ler or coa.heat pump,,a air Gondd
_
3-13 HP;ab r,)rb unit to 500K BTU- 11.00
Contractor Name / 8.) Boder of camp,heat pump,air Gond. - _
✓ 15.00
�+��+ 1 C / - r 15-30 FIR absorb unft.5-1 mil BTU"
Prior to permit Maeing Addreaa ---`7� 9.) Bodsr or comp,heat pump,air cond.
issuance,a copy J . 22.50
30-50 HP;absorb unit 1-1.75rnil BTU'"
of all lia+r.3ss cnyrstme -- z Phone 70.) Boder or comp,heat pump,air Gond.
are required if t�Jez(mOIV Bo �¢ � ".- D >50 HP;absorb unit 1.75 mil BTU- 3750
expired in COT Orogon Connt.Cont.Board .ic 0 Exp Date OGT- 11 ) Air handling unit to 10,000 CFM
database _ Z( ;;Z 1 Grp 4.50
iArchitect Nome 12.) Air handling unit --
10,000 CTM+ - 7.50
or Mailing Addre,gc - 13.) Non-portable evaporate cool6r
4.50
Engineer Cnyrst,n° Zip Phone 14) Vent fan connected to a single dud -300--
Describe
00Describe work ^sew C Addition O Alteration p, Repair O 15.) Ventilation system not included
to be done Residential O N)n --'{
-residential O 4.50
-_ _ in appliance permit
AddRtonal Description of work: 16.) Flood served by mechanical exhaust
4.50
17.) Domestic incinerators 7.50
Existing use of 18) Commercial or industrial --
building or propa.,ty,- pe incinerator 30.00
---- _
19) Repair units-_______-----_ _ 4 SU
Proposed use of 7.0.) Wood stove
building or property - - - 4.50
21.) Clothes drier,etc. - -- 4.50
Type of fuel-oil O nat WgasK LPG i) electric O 22.) Other unds 4 50
I hereby acknowledge that I have read this application,that the information 23.) Gas pip;ng one to four outlets -
-
given is correct,that I am the owner or authorized agent of pinve 61:5 200 _
the owner,that plans submitted are in compliance with Oregon State laws. 24 More than 4-per outlet(e�-- 50
Slg%i!na of Owner/Agent Date
•
- --�-- SUBTOTAL
i -
�J
Olt 7t/ Cr A' w.•. /Z S�Q]�l ----- 5%SURCHARGE 1 ':X"> -
Contact Person..
- Phone PLAN REVIEW 259�o OF SUBTOTAL ;
_
ILIA p �-� Required for all commercial permits only +)
� j - G`� - p,5�- ---- TOTAL
yuW$25
, Y
Minimm permit fee is 325+5°46 surcharge
"Residential A/C requires site plan showing placement of unit, 4'-, e,
I:\mechpmtt.doc rev 4115198 /
CITYOF TIGARD __ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2000-00169
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE. ISSUED: 5/25/00
SITE ADDRESS: 12765 SW BULL MOUNTAIN HD PARCEL: 2S109AD-01000
SUBDIVISION: ZONING: R-7
BLOCK: LOT_ — ^_ JURISDIC r 11N: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R31 FLOOR DRAINS; TRAPS-
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRANS:
LAVATORIES: OTHER FIXTURES: 2
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Kitr;,en remodel -other fixtures are hose bib and ice line.
_Owner: _ _ FEES
SCHAER, JOHN ARLEN + CHRISTI A Type By Date Amount Receipt
12765 SW BULL MTN RD MENU DEB 5/25/00 $50 00 0002461
TIGARD, OR 97224 5PCT DEB 5/25/00 $4.00 0002461
Total $54.00
Phone 1: _ -` --
Contractor:
OREGON CITY PLUMBING
611 7TH ST
OREGON CITY, OR 97045
REQUIRED INSPECTIONS
Phone 1: 656-8558 Top-out Insp -----------_---
Reg #: LIC 0002132 Final Inspection
PLM 3-20PB
nR1C1 �� f; �..
This permit is i:;sued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and al! other applicable laws. All work will be done in accordance with approved pians
This permit will expire if work is not st,-ted within 180 days Of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregol 1w requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 throragh OAR 952-0001-0080.
You n}ay obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issue y: permittee Signature: `
Call (503)639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGAR.D Plumbing Application Recd 6y
13125 SW HALL LAND. Commercial and Residential Date Rer,'d sem..—.00
to P.E.
---""—"'
TIGAF(D; OR 97223 Date e to D.S
(503) 63;,4171 Permit#_Nil
Print or Type Related SWR#
incomplete or illegible applications will not be accepted Called_--__
Name of Development/Pro)ect On back Indicate Work Performed by fixture.
.lob FIXTURES (individual) a QTY Pf210E AMT
Address S:,eat Address Suite Sink — t 9,00
2 _ Lavatory 9.00
Bldg# CitylStaie Zlp --- -
/ Tub or Tub/Shower Comb. 9.00
N.me Shower Only 9.00
— -
Nater Closet 9.00
Owner Mailing Address Suite Dishwasher _—` 9.00 a7 —
_ , P— 4 /� — Garbage Disposal 9.00 c
City/State Zip Phone
i 3 Washing Machine Ai- 9.00
-- Name -- Floo Drain 2 9.00
Occupant Melling Address Suite 4'— s o0
City/Siete Zip Phone
Water Heatei O conversion O like kind 900
--~
_-
Laundry Room Tray 9.00
Name / Urinal 900
c% (6 1F ff�f r,�{)j f,� _ Other Fixtures(Specify) - 9.00
Contractor Mailing Addres'liT Suite 9.00
Prior to permit City/State Zip Phone /_fes t -It 9'00
issuance,a copygm�Cc F X'-'oe y+ (o .�� — 9.00
of all licenses are Oregon Const. > nt.Board Lick Exp.Date 9.00
required If x L Sewer- A 100" 3000
expired In COT Phamt,ing Lic.# Exp.Date ------
database .3- ?- }'? Sewer-each additional 100' _ — 25.00
Name Water Service-1 st 100' 30.00 -�
Architect Water Service-each additional 200' 25.00
Or Mailing Address Suite Storm&Rain Drain- 1st 100' 30.00 ~�
Storm&Rain Drain-each additional 100' 25.00
Engineer City/Slate Zip -i Phone Mobile Home Space — 25.00
IL— Commercial Back Flow Prevention Device or Anil- 2500
Describe work New 0 Addition O Alteration,1111_ Repair O Pollution Device _
In be done: Residential O Non-residential O _ Residential Backflow Prevention Device 1500
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin! 9.00
Insp.of Existing Pluml'nq 40.00
per/hr
Existing use of / Specially Requested Inspections 40.00
building or property_ J _ per/hr
Rain Drain,single family dwelling 3000
Proposed use of - —
luild,ng or property Grease Traps 9,00
QUANTITY TOTAL
I hereby acknowledge that I have read this application,that the;nfomiation Isometric or riser diagram is required if puenity Total is .>9
given is correct.that I am the owner or authorized agent of the owner,and -"-- - _
that plan,•submitted are in compiianue with Oregon State awe. -- "SUBTOTAL r- r
Slgna;uro IIf nor/Ago --
- Dao 5/ SlRCH_AR_GE s L -
L PLAN REVIEW 2516 OF SUBTOTAL
Contact Person Naffwl Phone
�l Required only N fixture gty_totat Is>9 _
re
t'c5�r F - -- TOTAL
'Minimum permit fee is$25+5%surcharge,except Residential Backflov�'
Prevention Device,which is S15 4 5%surcharge i
I VitlilvimxW doe SM
RL.—EASE_QDRP1,ETFY.
Fixture Type _ — _ Quantity by Work Performed _ J
_ — New Moved— — Replaced Rem%red/Capped
Tub or Tub/Shower Combination —
Shower Only —�
Water Closet —
i
Dishwasher - --- --- -- -- - --r — - --
Garbage Disposal
Washing Machine —_-- --�- _---- - ---- �--- - __— _--
Floor Drain— 2„
Water Heater ------- �-�- ------ ----- — —_�_
Laundry Room Tray �— -- -----
Urinal__ -- — —
Other Fixtures (Specify)
COMMENTS REGARDING A3'*OVE:
sroylmaop dm". 7
/^\ CITY OF TIGARD — ELECTRICALPERMI'r
PERMIT#: EL02000 00274
DEVELOPMENT SERVICES DATE ISSUED: 5/26/00
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S133DD-07100
SITE ADDRESS: 12682 SW DANBUSH CT
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 ZONING: R-4.5
BLOCK: LOT : 110 JURISDIrTION: TIG
Proiect Description: Ir..ta,lation of three branch circuits.
_
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS _
1000 SF OR LESS: 0 - 200 amp: — PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY-. 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: J
.)caner: Contractor:
JIM ESSENBERG PORTLAND STATE ELECTRIC
12682 SW DANBUSH CT PO BOX 230933
TIGARD, OR 97223 TIGARD, OR 97281 \\`
Phone: Phone: 233-8030
Reg#: LIC 96644 ` `$
SUP 4125s
ELE 26-854C
FEES Required Inspections
Type By Date Amount_ Receipt Elect'I Service
5PCT DEB 5/26/00 $3.86 0002488 Elect'I Final
PRMT DEB 5/26/00 "x48.20 0002488
v— Total $62,06
This Permit is issued subject to the regulationp contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws
All work wil;be dote in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or 1 work is
suspended fir mora than 1P0 days ATTCt4TION Oregon law requires you to follow rules adoptegl_b�the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain oopi" _fthese ytrles ordirect questions to OUNC at(503)
246-1987
> ( I
PERMITTEE'S SIGNATURE ISSUl3p BY: � ,/ /�` /��`
U_ L/ .
OWNER INSTALLATION ONLY _
I lw of tallation is being inade on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPS! ELEC'N. "0-CL ) _ DATE:—
LICENSE
ATE:LICENSE NO: 4;7�J
Ca., 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan ch
13125 SW HALL BLVD. Recd
TIGARD OR 97223 Date Recd 37'4'6577-
Date to P.E.
Phone(503)639-4171, x304
Date to DST
Inspection (503)639-4175 Print of Type Permit# ` �_L
Fax (503) 598-1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development _ Number of Inspections per permit allowed
Name(or name of business) .� 5� Ems_ Service included: Items Cost Sum
Address 1.2_(p :L 'S•YJ• �RN '3�lLS r►01r• 4a. Residential-per unit
City/tate/Zip _CCq7 z 1000 sq.ft.or less _ 117.75 _ 4
/ Each additional 500 sq.fl.or
r-v portion thereof $ 26.75 1
Commercial ❑ Residential L Limited Energy _ $ 60.00 _
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit is,suanre,applicants must provide contractor license 4b.Services or Feeders
Information for COT data ase). /^1 - Installation,alteration,or relocation
Electrical ontractor T . &*re C, leo• 200 amps or less $ 64.25 2
Address __•_�djnX Z 30 9 3.3 201 amps to 400 amps - $ 85.50 2
City_T 0 Prg�p State -� ZI - 401 amps to 600 gimps _ -_ $ 126.50 2
1 9 -� 601 amps to 1006 amps _ $ 192.50 2
Phone No. -9,53_-403 ^ Over 1000 amps or volts $ 363.75 2
Job No.-__ __ _ __ Reconnect only V_ _ $ 53.50 2
Elec. Cont I.ice. N0 _ v .651
'fCExp.Date 0-01-00 4c.Temporary Services or Feeders
OR State CC13 Reg No 60 62 Exp. 2-8-O I Installation,alteration,or relocation
COT Rusiness Tax or Metro No. 3/''D Exp.Date 200 amps or less - $ 53.50 2
201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 100.00 2
Signature of Supr. Elec'n _ ` Over 600 amps to 1000 volts,
see"b"above.
License No �'2�'�� _Exp.Date��[-9� 4d.Branch Circuits
Phone No _ 2 =�, New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder tee.
Print Owner's Name Each branch circuit 4. $ 535 <
--.-- - - - b)The fee for branch circuits
Address -- ---- without purchase of service
City _ -- Stale_- ---Zip or feeder fee.
Phone No. _ _ _ _ First branch circuit $ 37.50
-- Each additional branch circuit �a� $ 5 35 1Q
The installation is being made on property I own which is not 4e.Miscellaneous
Intended for sale, lease or rent (Service or feeder not Included)
Each pump or irrigation circle $ 42.75
OwnrWs SignatureEach sign or outline lighting $ 42.75
Signal circuit(s)or a limited energy
* panel,alteration or extension $ 60.00
3. Plan Review section (if required): Minor Labels(10) - $ 100.00 --
Please check i.ppropriate item and enter fee In section 58. 4f.Each additional Inspection over
_ 4 or more;residential units in one stru-ture the allowable in any of the above
Service and'eeder 225 amps or more Per inspectinn $ 50.00
Per hour $ 50.00
_System owr 600 volts nominal m Plant $ 59 0�)
Classified area or structure containing special occupancy as
described in N E C Chapter 5 5. Fees:
6a.Enter total of above fees $ .20
' Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(.08 X total fees) c •Q6
Not required for temporary construction services. Subtotal $ 5z• o(p
6b.Enter 25%of line Ba for
NOTICE Plan Review if requi (Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 5 5u
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR rr,,
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS U Trust Account#
AT ANY TIME AFTFR WORK IS COMMENCED total bola9nre Due $
( lAdsts\formskelectric.doc
i