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CITY * T I CARD DATEPERMIT ISSUED:•
08116MEC9196-&br--.
6
COMMUNITY DEWFLOPMENT DEPARTMENT
113125 M Hall Blvd.Tigard,Oregon 67223*8199 (503)639-071 PARCEL: 2S103,DD--06500
SITE ADDRESS. . . : 10G.-'17 ',.-)W GARDEN PARK PIL
SUBD1VISILN. . . . : KAREN PARK ZONING. R-4. 5
DI-00-11. .. . . . . . . . . . . . .
CLASS OF WORK. . :NDD FLOOR FURN. . . . 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF* UNI T HEATERS. . 0 VENT FANS. . . : 0
OCCUPANCY GRP. - : R3 VENTS W/C) APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : BOILERS/COMPRESSORS HOODS. . . . . . . : 0
0-3 HI='. . . . : I DOMES. INCIN: 0
3-15 HP. . . . - 0 COMML. INCIN- 0
MAX INPUT: 0 BTU 15-30 HP. 0 REPAIR UNITS: 0
FIRE DAMPERS?— : 30-50 HP. IZI WOODSTOVES. . : 0
GAS PRESSURE. . . 50+ HP. . . . 0 CLO DRYERS. . -. 0
NO. OF AIR HANDLING UN I TS OTHER UNITS. : 0
FURN ( 1001( BTU.- 0 10000 CfM : IZI GAS OUTLETS. : 0
FURN ) =100K BTU: 0 > 10000 cfm : 0
Adding one sump. to 3Hp.
Owner: FEES
JIM WELLS type amol-Int by ciate r-ecpt
,10627 SW GARDEN PL. PRMT $ 25. 00 CJS 08/15/96 96-282946
SPCT $ 1. 25 CJS 03/15/96 96-282946
IIGARD OR 972L3
f"hone #:
Lontr,actor:
UNIVERSAL 1AEATIN(5 A A/C
4435 SE 25TH AVE.
PORTLAND OR 97202
Phone it- 232-1944 $ 2 G.. C25 TOTAL
Req 012031
REQUIRED INSPECTIONS --------
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approverl plans. This permit will expire if work is not started
within .30 days of issuance, or if work is suspended for more
than 180 days.
P e v-in i t t e e S 3 i q n a t 1-1 r-F
I s s 1.1 e d By -
Call for inspection 639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Hall Blvd. APPLICATION Permit # n)Fc--r-C_r ,
PO Box 23397
Tigard, OR 972.23
(503) 639-4171
esaipUon
_ Table 3A Mechanical Code _ CITY PRICE AMT
Job l; T U-, ct cd-Q n 1) Permit Fee -0- -0- 10.00
ACIdrRSS
,,O7 2) Supplemental Permit 3.00
Furnace to 100,000 BTU
/� 1) incl. ducts&vents 6.00
lf,WN MO.. /! urnace 100,0 i
Owner 1l.)li l 2 o(k l,- 2) incl.ducts&vents 7.50
'^ ' Zo cor Furnance
P -/ 7 3) incl. vent 6.00
--P;F77="' 1 Suspended heater,wall heater
or floor mounted heater 6.00
Vent not inc in
Occupant 5) appliance permit 3.00 '
' zw Repair o eating, re R �I
6) cooling,absorption unit 6.00
_ � /) � 7) to Boiler or comp, eat pump,air con
3 HP absorp unit to t00K BTU � 6.00
Boiler oomp, seat pump,air c
C. on .
Contractor / t �'��/ 8) 3-15 HP absorp unit to 500K BTU 11.00
Boiler or comp, Teat pump,air cond.
-7 Z0 2 9) 1530 HP absorp unit.5-1 mil BTU 15.00
NO C4y •''" — Boiler or comp, heat pump,air cond,
10) 3050 HP absorp unit 1-1 75 mil BTU 22.50
hereby acknowledge that I have rea us pp ication,that the Boiler or comp,heat pump,air cond,
inlormation given is correct,that I am the owner or authorized agent 11) > 50 HP absorp unit 1.75 mil BTU 31.50
of the owner,that plans submitted are in compliance with State Air handling unit to -
Iaws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50 r
that the number given is correct. (If exempt from State registration, Air handling unit - — -
please give reason below) 13) 10,000 CTM+ 7.50
on portab e
14) evaporate cooler 4.50
-- �— enI an-T connecter
15) to a single duct 3.00
//
Ventilation s alem riot
c� �1c' 16) included in appliance permit 4.50
°,.,„,OF.6�i Hood served by
17) mechanical exhaust 4.50
Describe work Flow 0 addition IeY alteration _ repair Commercial or industrial
to b,done residential Q non-residential 0 18) type incinerator 30.00
xist ng .sem-� ter i e.,wo stove,water
building or piopeity 19) healer, solar,clothes dryers,etc 450
Proposed use of 20) Gas piping one to lour outlets 2.00
building or property
Type of fuel oil 21) More than 4 per outlet —`
yp Q natural gas Q LPG Q electric Q
NOTICE
Minimum Fee$25.00 SUBTOTAL ,
PERMITS BECOME VOID IF WORK OR CONSTRUCTION —
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE 7
IF CONSTRUCTION OR WORK IS SUSPENDED OR -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 259 OF SUBTOTAL
AFTER WORK IS COMMENCED --- —
TOTAL k J,)Special Conditions -- -- —
Dara issued ---by
k.MFd4PMT
�an1`wnM�v
ELECTRICAL PERMIT
CITY OF T DATE I ISSUED: 08/15/96
rOMMUNITY DEVELOPMENT DEPARTMENT
126 SW Hall Blvd.Tigard,Ortgon 67223.8199 (503)630-4171 1-1ARCEL: 2113'1030D-06500
SITZ::. I-iDDRE. ;�_ . : 11116-1 ;::W 1;f.:kULN {'Ww, PL
SUBDIVISION. . . . : KAREN PARK ZONING:R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :5
Project Description: Installing one branch circr.lit.
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS------ -----MISCELLANEOUS-------
1000 SF OR LESS. . . . : 0 0 - X2100 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH RDD' L 500SF. . . : 0 201 -- 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
I_IwiITED ENERGY. . . . . : 0 401 •- 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : V_I
MANE. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
--SERVICE/FEE:DER---__ _._._._BRANCH C.IRCUITra--.._.,-- ----ADD" L INSPECTIONS -.__.
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
a-01 1100 amp. . . „ . .• 11) 1st W/O SRVC UR FDR. : 1 PER HOUR. . . . . . . . . . . . 0
401 - 600 amp. . . . . . . 0 EA ADD' L PRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . : 16 --- -- .._______------PLAN REVIEW SECTION-----•---__-_----__._._..
1000+ amp/volt. . . . . : III )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC.
Owner, ------------------------------------------------------ FEES
JIM WELLS type amount by date recpt
10627 SW GARDEN PARK. PRMT $ 35. 00 CJS 08/14/96 96-� 8c`:10c
5PCT $ 1. *75 CJS 08/14/96 96 -2821.)0, '
TIGARD OR 97223
Phone #:
Contractor:
GRF ELE=.CTRIC $ 36. 75 -TOTAL..
15460 SE PARADISE LN
------- REQUIRED INSPECTI014S .____.... _. _...._,
MII!_..IiNiO VR 97042 WaJ 1 Cover Elect' 1 Final
'hone #: 503-829--41.46 �-.:iect' 1 Service
Rey it. . : 101543 _........ ......______._.
This permit is issued subject to the regulati,,ns contained in the __ �,�__ —___ _ __
Tigard Municipal Code, State of Ore. Specia'ty Codes and all other Permittee S i gnat 1.1r^E:
applicable laws. All work will be done in .iccor•dance 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. Issued By
_OWNER INSTALLATION ONLY.-_--__------__--.___- .---_-...__.._. _.
The installation is being made on proper-ty I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
_.__.CONTRACTOR I NSTALI-AT I OI'J
SIGNATURE OF SUPR. ELEC' N e Q2es.!JL'�_ _ --_----..__-�_ DA7 E
LICENSE NO: .___ .._.__ _____.__^__.____.__.____._...__
Call for inspection - 639-4175
J
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Pernnit #
Phone (503) 639-4171 Date Issued -� — — -----
CITY OF TIOARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: pD 4. Complete Fee Schedule Below:
Name nf_DeuolppR�ent _ L' � Number of Inspections per permit allowed
Address / Sa Y-fitelfl PA Service included Iterns Cost(ea) Sum
r� r�
City/State/Zip / 1 A L1= } I �i 4a. Residential -per unit —
J 1000 Sq, ft or less _ siinno
Name (or name of business)___ Each additional 500 sq ft.or
portion thereof $25 00
Commercial Residential Limited Energy rm _ $25 00
Each Menurd Home or Modular
Dwelling Service or Feeder $68 00 _ 2
2a. Contractor installation only: 4b. Services or Feederb
I� t' C _ Installation,alteration,or relocation
Electrical Contractor 1 200 amps or less $6000 2
Address (L {. 12 bl r i, A,'-,e 201 amps to 400 amps $8000 2
y-- p
Cit t I U State /1 P Zi �7 U 401 amps to 600 amps $12000 2
-�T�- 601 amps to 1000 amps _ *180,00 2
Phone No. over 1000 amps or volts -- $34000 2
ss0 00 2
Job NO. Reconnect only
contractor's license NO. L 7 C
—.-- --� 4c. Temporary Services or Feeders
Contractor's Board Reg. No. (' .,} Installation,alteration,or relocation
Signature of Supr. Elec'n 200 amps or lest 2
License No. hone O. 201 amps to 400 amps $5000 2
401 amps to 600 amps $7500 2
Over eoo amps to 11100 volts $10000 —
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Name _ New,alteration or extension per pane
Address s)The fee for branch circuits with
purchase of service or Mder Poe. 1
City _ State Zip_- _ Each branch circuit $500
Phone Nr I. b)The fee for branch circuits without
The instillation is being made on property I own which is purchase of service or feeder fee.Firsl 1
not Intended for sale, lease or rent. Each
branch circuit
branch
$35 00
Each addltlonel branch circuit $500
Owner's Signature4e, Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or irrigation circle -- $40 00
Each sign or outline lighting $4000
Signal cirqutt(s)or a limited energy
Please chock appropriate Item and enter fee In section 5B. panel,alteration or extension $40 00
4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 4f Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described In N E C Chapter 5 Per inspection _ _ $_`0o
Per hour S5500 _
In Plant $5500
Submit 2 sets of plans with application where any of the above —"--
apply. Not required for temporary construction services. 5• Fees:
5a. Enter total of above fees $ > r
I
NOTICE 5%Surcharge (05 X total fees) $
PERMITS BECOME:VOID IF WORK 014 CONSTRUCTION Sul%-,)f&1 $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. Tru • Account #
Mm MV $ /
Balance Due S 3 S