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12570 SW GLACIER LILY CIRCLE N t UI t' O cn s r D n H r ZJ r H r r-� H [1 r m r j a 6 i 9 �7�N T� JC'II7 V313VID res OLqZT CITY OF TIGARD DEVELOPMENT SERVICES ELFCTRTCAL PERMIT PERMIT #: EL-C97-0067 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 02/05/97 PARCEL: 1S133DA-214400 '3 11-E ADDRES)S. . . 12570 SW GL_ACIFR LILY C I R 91JI3D I V 15 T ON. . AMA RT SUWiE RLAKE Z ON I NG:I-,-- -1 LCT. . . . . I . . . . . . . :66 ProJect Desct,iptiori : INS*ri-. 2 BRANCH CIRCUITS TOB # 98356 SRVC/FEEDERS------ 1.000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/I RRI GATT ON. 0 EACH ADD' 500SF. . . : 0 201. 4.00 amp. 111 SIGN/OUT LINE LTG. 0 1-,.TMTTED ENERGY. . . . . : CA 401 600 amp. . . . . . . : 0 SIGNAL./PANEI... . . . . . . : 0 'IAWF-. 11M./ 9YI'VFDR. 0P1 I NOR L.ABFI- ( 1.0) : 0 rn,01.+amps volts. : 0 -----SERkI10E/FEEDER---- -.---BRANCH CIRCUITS-----.-- INSPECTIONS— 0 17'00 amp. . . . . . : 0 W/SERVICE OR FrEDER: 0 PER INSPECTION. . . . . : 0 201 400 amp. . . . . . :, 1 first W/O SRVC OR FDR. . I PER HOUR. . . . . . . . . . . : 0 401 600 . . . . . . . 111 17.0 ADD' L. IARNCH CTRt.. - 1 IN P1_AW1 . . . . . . . . . . . : 0 C01 1 1 ;b LA amp. . . . , : 0 --.------PLAN REVIEW J O . t000+ amp/volt. . . . 0 ) =4 4ES UNITS. . . . . . . . : 6.00 VOLT NOMINAL_. . : Rpc.�onnect only. . . . . : 0 SVC/F*DR > = 225 AMPS. . : CLASS PREWSPEC OCC. : Owner : -- - ..-- -- - -- -- - - --------- - - FEES TAMES/LOTS WINGO type am a I-tilt by date t-eept l, 570 EW GLACIER L I LLY CIR P R M 1' 40. 00 TAIOf-/05/97 97289954 5PCT 2. 00 TAT 02/05/97 97-289954 1CARD OR 97224 71flonv #: _ontr-actot `,31..INSF*I' U1_ECTRl(_- $ 42. 00 TOTAL. '). K. A OREGON EL-U-,'CTRICAI.. CONS)TR GRP 1635 SE ENTERPRISE CIRCLE REDUIRED INSPECTIONS HILt-SPOR0 OR 971;P".31 Ceiling (-ovet, Under,gr-oi.(nd Cove Clhone #: 503-648-0735 Wall Cover- Elec,t' 1 -.-)ev,vic!e 000002 This permit i! iss iod subject to the regulations contained in the ligdrd Municipal, Code, State of Ore. Specialty Codes and all other FIL-I'm i t t S i gna t I. All work will be done in acrord3nce with applicable Jaws, /J, approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than IN nays. T y _....._..........__._-OWNER TNSTALL.PTTON ONLY- Che installation is being made on property I ci�,qr, wl-ijch is not intended for ,iale, leas ,, oi� rent. OWNER' S SIGNATURE:. DATE: 14 NFTAL.LAT I ntl o1\1[,_y STGINATUR�` OF SUP R. ELEC' Ns DATE: LICENSE" NO: Call fat- inspection 639-4175 Community -welopment ELECTRICAL PERMIT APPLICATION 1'07!1 S\Pv' Hall Blvd _ Tigard, OR 97223 Permit 1 Date Issued Phone (503) 639-4171 FAX (503) 684-7297 CITY OF TIGARD TDD No (F03) 684-2772 Inspection (503) 639-4175 1. Job Address: 1t 4. Complete Fee Schedule Blow: ,l� I 60/5 Name of Development K/�'1 � Number of Inspections pe permit allowed Address 5"7o 1.5 ,-t r i�l �� C'./ke�C Service included Items Cost(( Sum f� Cily/State/Zip=e/ 4a. Residential -per unit 1000 sq. It or less 1 r"`°' Name (or name of business) Eech additional sq ft or portion thereoff $2500 Commercial F-1Residential �� Limited Energy $2500 Each Manurd Home or Modular Dwelling Service or Feeder $6800 2a. Contractor installation only: 4h. services or Feeders ` / Installation alteration.or relocation Electrical Contractor �C /tn L ^l 200 amps or less 16000 Address / 5"�� t& Kam ' /ZC te 201 amps to 400 amps $80 00 2 401 amps to 600 amps $12000 2 City / State Zip / 7G� 601 amps to 1000 amps 11eo oa 2 Phone No. 6 Over 1000 amps or volts $34000 2 .lob NO.-----1 Reconnect only $5000 2 contractor's license NO._ �_-__ 4c. Temporary Services or Feeders Contractor's Board Reg. N U - —__ Installation.alteration or relocatinn Signature, of Supr. Elec'n --A -- IGG4/� 200 amps or less 201 amps to 400 amps $5000 License No. ?C'� S PhNo. �y .-Lone .��L �. 401 arn9s l0 600 amps _ A_ $IS 00 2 Over 600 amps to 1000 volts $10000 --- 2b. For owner installations: see 'b"above 4d. Branch Circuits Print Owners Name _ _ IJew,alteration or extension per pane Address at The fee for branch circuits with City_. State Zlp - - purchase of service or feeder lee. Each branch circuit _ $500 Phone No. b)The lee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. First branch circuit r $3500 < c not intended for Rale, lease Or rent. Each additional branch circuit _�_ $500 Owner's Signature__ ___ 4e. Miscellaneous (Service or feeder not Included) 3. Flan Review section (if required): Each pump orinigatloicircls $40.00 " Each sign or outline lig)tlrg $4000 signal circuits)or a limn to energy Please check approprlete Item and enter fee in section 5B panel,alteration or extension S4000 4 or more residential units In one structure Minor Labeis i 101 i $100 00 Service and feeder 225 amps or more 4f. Each additional inspection over System over 800 volts nominal the allowable in arty of the above Classified area or structure containing special occupancy __._. Per inspection _ $3500 _ as described in N.E.C. Chapter 5 Per hour $5500 -� In Pant $5500 _ Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: NOTICE 5a. Fnter total of above fees $ 1 U.lJ 5%Surcharge (05 X total fees) 9 L� Subtotal � PERMII'S BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter Subtotal or line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (;iec.3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Re $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subt COMMENCED w�a�cme.�wo 1 Trust Account it pm�� Balance Due r!T1% OF TIGARD BUILDING INSPECTION DIVISION MST 24-Flour Inspection Line: 639-4175 Business Line: 639-4171 -��----- -_---- /'� BUP — _— Date Requested_�?�7' AAA^lam PM BLU Location / Z. S 7 U 5�✓ lam!G/-rte Cl. Suite —_� MEC L/U ,' Contact Pe.son _—.—_ — Ph 1_L_� fit% PLM - --�_— Contractor Pli SWR BUIL<11NG �— Tenr 't/Owner _ EL(C Retaining Wall — ELR Footing Access: S r ro fl,'i/ rc J'Ac Ye 7u ',.,,— _-- Foundation - -r .�a u. f /;r.�..✓ r� r r/rwr i i I•/r-.� FE'S Ftg Drain SGN Crawl Drain Inspection Notes: -- — — - --- Slab SIT Post&Beam -------- ------- _ Ext Sheath/Shear Int Sheath/Shear _ Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: - - --- -- Final PASS PART FAIL -- - r y'' _. tls'_r-� L��---- ---- — PLUMBING Post& Beam Under Slab ---- - , i�" ----- ---- -- -- Top out Water Service ---- Sanitary Sewer Rain Drains Final ` PA PART FAIL ANLGAL t' Post& Beam -- - Rough In j Gas Line 0 -- Dampers fi — PASS PART FAIL I'tECTRICAL _ Service Rough In Y _ UG/Slab Low\ oltage Fire Alarm Final PASS PART FAIL ---------- -_------ ------_.-_—_- SITE Backfill/Grading --------` -- -- —.— -- — Sanitary Sewer Storm Drain [ J Reinspection fee of$ _required before next inspectior Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE: _ _ [ J Unable to inspect -no access ADA Approach/Sidewalk Date Ins ctor Ext-?ee Other ___-- _ Pe ,__-- Final PASS PART FAIL DO NOT (REMOVE this ins;>tection record from the job site. CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2000-00431 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/01/2000 PARCEL: 1 S 133DA-04400 SITE ADDRESS: 12570 SW GLACIER LILY CIR SUBDIVISION: AM.ART SUMMERLAKE ZONING: R-7 BLOCK: LOT: 066 JURISDICTION: TIG CLASS OF WORK: ALT FLnOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APDL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRESSORS _ HOODS: _ FUEL TYPES 0 3 HP: _ Y DOMES INCIN: LPG _ 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: 1 AIR HANDLING UNITS^_ OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Replace gas furnace. Owner: FEES WINGO, JAMES R AND LOIS F Type By Date Amount Receipt 12570 SW GJACIER LILY CIR PRMT CTR 11/01I20i $72.50 272000000CTIGARD, OR 97223 5PC1 CTR 11101/20( $5.80 212000000C I! _ Phone: Tota! —_,$78.30 _ Contractor: GEORGE MORLAN PLUMBING 9806 SW TIGARD TIGARD, OR 97223 REQUIRED INSPECTIONS Mechanical Insp Phone: 503-624-6895 Final Inspection Reg#:LIC 00002734 PLM 26-60p This permit is issued Subject to the regulations contained in ;he Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All wo,k will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work i-- zuspended for more than 180 days. ATTENTION Oregon law requ„-es you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 th-ough OAR 952.001-0080. You may obtain copies of these rules or direct questions to r', INC by calling (503)246-9189. Issue By: ' ' C"•,• ` -� Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day M,echamical Permitlip iic ;011Ducreceiv0d:"�." pc=t . of regard �� praJoct/appl.no.: �e„k: city• AAdte+ts: 13125 SW Hall Blvd.'I1i$er4 OR 97223 put issued: By; Recript oo.: CIIYUfTiz°rd ptsone: (503) 639-4171 # f' �5 — tgrpe FAX:(503) 598-1960 ��0 �� Q cue ale no.: �° Building permit DO.; Land use approval: ❑Mint,-fvnily Ln Tenant i�rrrricascnt 7)(1 2 fatatily dwelling°':accessory O Commercial/industrial - — m construction ❑Addition/s]ttaztien/replacernent O OQter. t r�� Indlcam equipment quantities in boats below.Indlcau die dollar Job addrrss:1 rLt,t_1 --:x F nlue of all mochaaical maten.sls,equipmt:nt.labor.overbcutl, Bldg.no.. - Suite n .: I ro t.Yslut S Tax map/ux lot/WCOU tt po.: - - •Sce checklist for important applicndoa information sad Lot Block Subdi%lnoa: juritdidion's fee schedule for traidrntial perrult fee project narru:: amity/counry. Z[P' 11 1' t � Des,cnpUoo pend to au of wOdt on prcrmses: Fa(at.) Total S DeaeripCoa Qty. RM.mty Res. Est.daic of tom letioditu aion: A ; Tenant improvement or chaogc of use: Airhandling unit - CFM is exiuiAs space heated or:ondititmed'O Yes ❑No Air con 660=9(sate ptsn fe`awnd) Is CILsdAg apace imWated7 Q Yes U Ido Allenaon a ej tUng H V AT syltets Bml oompressars Seale boiler per=t no.:TonABTU/h Add,rss: �IF42�q-_.��— �Lg +�-s1 �r seta cCnmperyduetsmoledettaon c�tt �, rico iimp(tier Wsn tr-uueti) Cary: lnstnJllrcp cc aoolaurnrr TUM ' 1?Fnottc: Fax: ap &rnzil: loch dunworklvent Meter �l,No CCB Do.: 3 last�l"Ifto oc.aaoatcs-Ntpeaded Wall.or Dow mounted _ Clry/metro He.no.: vent tar once o a inn ase rune(pLeam S erao.ec AhMption unib_——• /N ChWCrs - Nnsnc: Caaaartstor.._ -.-- HP Addre ss: _ ia'Mare N esmaat and watllatLotl: C�7 State: ZIP. ADpl�vent Fstx & ryerc null Phone: it, -t! Type U lures. ttlledh�smrt hnodfin ntppreniongstr�n o d 6xhtust fs z with Liter duct(bwh full) Nome: l� t'xhaust C 11 1=C1 irom can air A MxiLn_�addtass: O r�C ' / t�.t C kail on ( p to 4 outs) sine• zip 3 TypeLPG NO Phooe: pex F.maiL FveIIIIIIIIIIIIenc aaaiooaxl tripe 4 outlets 1'tooeS!pgtat=(tehrma4o req Number of outlets Name: - tall aapttuee or egatpsacsir: Decoretivef, IteC Address: �_ tnsctt-t e - Cit : Sant' ?TP b-mail: oo ro•yot tstavc Phase: Fax Uma AP piicant's swature: L1xte uts►er N�rne (petal): r - permit fee...................S NM W ren.brMW err"to Cir 59-ft rZ}jr+6a..rar.wee�•rw,tia. rlotier This permit apptiealion feC................$ ❑vac. o MtuoxC+rd wj&Lnt Ua ar a is not obtained p�egutch (u 16) _ ra.ew ere aratba: vvitbin 110 days alta d has bora Stale aurchaw(!!%)....S c,ra accepted as mmDleu ......i I ewN�— f r ze CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection bne: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/9eam Mech. Shear/Sheath Framing -MPch. Plbg.Und/Flr/Slab Pibg. Top Out Insulation -Elea, Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line App r/Sdwlk Reins. Other: �Y2L�L Date: A.M. P.M. E itry: Address: __. 1 —'(j Tenant: Ste: _ MST: Con/Own: -,�� i MEC: PLM: ELC: - 125. THE FOLLOWING CORRECTIONS AE REQUIRED: ELR: ----.._T -----�_ -In pector'_-:�', -- Date 4', 1 PPROVED _DISAPPRO ED/CALL FO REINSP. CF CO CITY OF TIGARD ELECTRICAL PERMIT ;ns PERMIT#: ELC2003-00381 DEVELOPMENT SERVICES DATE ISSUED: 6/23/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S133DA-04400 SITE ADDRESS: 12570 SW GLACIER LILY CIR SUBDIVISION: AMART SUMMERLAKE ZONING: R-7 BLOCK: LOT : ow JURISDICTION: TIG Project Description: 108 NO.J15671 JVIRE A/C UNIT __ RESIDENTIAL UNIT — TE_M_P_SRVCIFEEDERS _ Y _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: FU OR EACH ADD'L 500SF: 201 - 400 amp: SIGN/OU1 LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 6014-amps - 1000 volts: MINOR LABEL (10): -___ —_SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS_ 0 200 amp: V','/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: IN PLANT: 601 - 1000 amp: —.-PLAN REVIEW SEC rlON 1000+ amp/volt: -4 RES UNITS: >600 VOLT NOMINAL: Reconnect only, SVC/FDR>_225 AMPS: CLA`iS AREA/SPEC OCC: Owner: Contractor: WINGO,JAMES R AND LOIS F WEST SIDE ELECTRIC CO INC 12570 SW GLACIER LILY CIR 1834 SE 8TH AVE TIGARD,OR 97223 PORTLAND,OR 97214 Phone: 503-524-6477 Phone: 231-1548 Reg #: LIC 13306 FEES SUI, 2663S I ELE 26-135c Description Date Amount Required Inspections (f'.I.I'RM"I'1 FIX'Permit n _'1 nt $46.85 I \X j 8"'o State Tux r. t n t $3.75 Elect'I Final Total $50.60 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these riles or direct questions to OUNC at(503)246-6699 or 1-800-332-2344. Issued By: Permit Signst,ire: �.1• , . _ 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: DATE:_.. LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day Flectrical Perinit Application OFFICE 1jSE ONLY, naw n-ccived: City of Tigard Prglect/appl. no.: P%Ilirn dole: - ,•n/rikard Address: 13125 SW Hnh Blvt' Tigiird,(1{( 97223 Date issued: By �Itccclpt nn.: Phone.: (503) 639-4171 --- -� -- Pox: (503) 59H-1960 Cnw file no.: f;yincnl Ivpc: -_ - Land use approval:-- _ 1 Nr.2 family dwelling or accessory LXommercial/industrial U Multi-family U Tenant improvement U New construction U AdtGtion/alteration/replacement U Other: ❑i'artial JOB SITE INFORMATION Job address: I 2 tp U 6 t� nldg. no.: Suite no,: Tux reap/tae Iot/account no.: [,of: {flock: Subdivision: • X _ Protectnam_c: yLAJ,. Dcftcription and lucotiun of'work on promises Lslimated dote of rvm •lion/inspcctivu. ICONTRACYOR APPLICATION FEC SCHEOULE Job no: • S 11�-7 1 fee M1lax _ WEST IDE ELECTRIC C.O. W-.rrtptinn (e•.) Total nn.IMrl Business nurt+c: r� -fimilly per Addro•s: 1834 SE 8TH AVE. - N ellinpdvnfiI ludo a tlachc iCaraCc. dwlllinQunit Include w atlachcd(;arTa�c. City; PORTLAND stntc:OR ziP:97214- •t(ycrdtYin0ndu: Phvnc: Fax:736-06771 L mail; Ll CCrI n��3306 Cleo.boos lie.no: _ _ CjC Pesch addlllonnl Stll+ i. n re pnr+iun Uwlwd I,MIMI cr,cr),y, IenWcnlial c:it / tr_v lie,no.: _ _ µ _ = y _ :.imilcd energy, nen-reside.rdial A titi�� --��r_ Tach manul>tcttned hoax or m,glul:u (ImAlm, SIPLa llrc of a Ire )ring clmanOto (rel uircA) DnrC ��-- Servreu m%Ver-Icn1Cr 2 Shpt olml.name(r int).Bf�UCE ZIMM Liethrec no: 2663S sarvlceaorfeedera-Inafallalian, rrfteration ur rt•hrcolinn: 1 1 2fNl nm i�r nr less- 2 Name(print): w N��,_ .'set w.tx 5 ,J _ 201 amps to 400 amps __ 1 -7 nm Io 001 amp.. 2 Mailing addrosE: 401, ) 601 amps to 1000 amp. -- , . ..— _ city: '- -, Slates j� LlI'.�t Over 1 amp car voh< 1 pht)n�- Fax: 1:-mail: Reconneo only _ I Owner Installation 'I he installuliun it:being made on property I own 'I'emporary%ervicea or feeders- which is not intended for Sulu,lease,rent,or exchange according lo in9tallation,altcratiun,or rrrorutlow ORS 447,455,479,670, 701. 200 aha or Ice 1 201 Amp,In 4191 emus 2 Ownet'S sil;natum, hate: 401 to(,W amps - ! Branch cirruity-new,alteration, ares taaaion per panel: A Pec for branch circults with pi r;hnan of Ad-dic' s' %cniec or fader fee,each branch cirtuit City; ti. Pee For branch circuits w10a9n pur luisc ' �/ 3- - - of scr,,im or foeder fees fires-brunch Orvidl: �, phnne: Fax L-mail 1%Ch 1,11thlilmal bnirh.lt bl'Cuit: _ PIAN REVIEW(Plow check all that apply), I Misc.(3erviceorfeeder not included): U Service (vrr 115 facility I-Ach pump or initiation circle — 2 U Service neer 721)nmrw.rntiryt of A2 U Hatanl(Ars Im-pil i Each sin or wrtline Ilghhnv.— 7 family dwellinbh U Building over 10,000%tt:aue feel four or Sy;nnl ctr uit(%)or a hinited energy panel, U System Jiver M91 Voll%nnnlitud inott roidcntial unite In me%1nwlury alteration, or extension' — - U npilding nvcr Ihren Aticic% 6s-readers,4,')mryn or more a1)C%cfl lino: U Occu"ro toms-nvcr"raX•nirr% U Manullluurod Iamoure"m av pork Mach additional inspection over Ike Allowable lntiny for the above, - U IlgnwAlghn..g plan U Other—.— _-•_-. p�Y i,icpectinn _ [--r snbnrft_..es of plum ahb.ny of the aeon. tnveati ,on fee life above are not applicable to temporary cow0rudion service. Other _- ._ _ Not Ml.inrilditiionl atexrit rxeAh untr,pkuae wu)uhm nl��9ion rnr mora+nrnraunn. Notice: This pennir application fco............... Sion ""' - U visa 13 MasterCard expi" if a permit is not nhhmed Plan review(al_ %) S _ .. Credit card number , /_ / within 180" days after it has been State surchurge(8%).. ..$ r Ra fres accrpled as(r,nplete• TOTAL.. ......................5 flame e!cardhul,kr u ah,rwn iM errs d Mit f Amnnni 44",15(001AY)M) Z 'd LL90-9ELiE0S) •00 01.120a13 aptS osaM zo* :90 EO EZ unC CITYOF TI GA R D MECHANICAL. PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00345 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-417, DATE ISSUED: 6/23/03 PARCEL: 1 S 133DA-04400 SITE ADDRESS: 12570 SW GLACIER LILY CIR SUBDIVISION: AMART SUMMERLAKE ZONING: R-7 BLOCK: LOT: 066 JURISDICTION: 1-1(_, CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: ` TYPE jF USE: SF UNIT HEATERS: VENT FANS. OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE. DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + VIP: CLO DRYERS: FURN < 100K BTU: _ AIR HANDLING' UNITS OTHER UNITS: 1 FURN >=100K B—L: <= 10000 cfm: GAS OUTLETS > 10000 cfm: Pernarks: Install exterior A/C unit. Do not install itlim the require!setbacks Owner: _ FEES WtNGO, JAMES R AND LOIS F Description Date Amount~ 12570 SW GLACIER LILY CIR — — TIGARD, OR 97223 IMEC1II Permit I-ce 6/23/n3 $72.50 TAX) W!'D StateTax 6/23/03 $5.8u Phone: 503-524-6477 Total $78.30_ Contractor: JACOBS HEATING +A/C 4474 SE MILWAUKIE AVE PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone: 501-214-"331 Final Inspection Reg#: LIC 1441 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 952-001-00 Issued By: - L, -)j'. 1 : _ Permittee Signature: y �A Call (5073`) 639-4175 by 7:00 P.M. for inspections needed the next' usfness day .I1t1-i-20-03 01 : 17P P . U% -Mechanical Permit Application. Rorxivcd mochaoiral Pertttit No/n Planning Approval Building C by of Tigard 11125 SW Hall Blvd Plan zciew Other V. Permit No.: Tigard,Oregon 97223 Datc/L►__ J_ _ Phone'. 503-639.4171 Fax: 503.596.1960 D kevicw glee Use Datc/Liy, — --- Case No.: -- --- Internet; www.ciAgard.or,us Contact -Juris I 2g see Page 2 for 24-hour lnspcction Request: 503-039-4175 Name/Mcthal: —� SupPlemcnlal In�ormallon.- 1'YPF OF WORK %('OMMI,RciAI,FEE.*,SCIIEVUI F%'USF-CHkCKLI 1l •-l':; aA constnictirnl Ut,ntolitiwl Mechanical pcmilt fees•are based on the total value ofthe work ition/alteratio replacctttent Otlier: performed. Indicate the value(rounded to the nearest dollar)of all (ATILGU1tY OF CUNS'I'Rt1CT'ION mechanical materials,equipment,labor,nvcnccud and profit. 2-1'tiinl dwelling ❑Comet+ercial/Industrial VYIUe; �, _—_ See Page 2 for Fec Cchedult IMSiDENTIAL Accessory Huilain� Multi-Family �UnrMSYSTEMSIFEE•9DULF, MU "E I)c%crlp n 1vtfee(e11. ( Total Master DuilderLJ Uthet: Ilea-Inc.talin JOR SITE 'FURMATIOPI dti ,IACAV N rurnoce-add-on nit conditionitl• 14.00 Jv_)site address ` C:,[f � was heatyuutp [4•UO - Suite#: HI_d/Apt.#: Duct work 14.00 Pro'cct_Name. H dronic hot water system 14.00 kcsidentisl boiler Cross strect/pirections to job site: for radiator or hydropic systcJ 14.00 Unit heaters(fuel,not electric) Ln wall in-duct suspended,etc. - 14.00 `_ Flue/vent for any of above 10.00 1 _ Subdivision: Lot#: kc air units 12.15 Z s)C alit / BICC)#: Other Fad A Ilences Water heater _ 10.00 RM 00 l I N I2 ', Oita Creplaca _ _ 10.00 Fluc vent(water hcatedgaa fisc race 10,00 ^— Log 1g if;hter as 10.09 _ —--- —— Wood/1'cllct stove _ 10.00 Wood tircpince/inscri Chininc e/liner/fluc/vent X _NEW-k � 1� _ Cdter; IO.OU 8r11C' i Environmental F:shaust&ventilation t^^� ' ) ' Range hood/other kitchen equipntcnt 10.00 Address: N - --- �t Clothes dryer exhaust 10,00 L /Sitatc/' i _ 7� 'i� ;a Single duct exhstist -- P ,nt : 1 Fox: (buthrooms,tollct compartments, Pl'L1C: T CONTACT PERSON utility roan's fi.fSU Aitic/crawl apace tens t�173 RRAddress: ocher: v 00 _ �_.t -- Fuel wplRg ;ity/Statc/Z�t 1 - (.:��J t/\ "(55.410 for fret 4,$1.00 each addltiansl Furnace,etc. � Phone: -- Ora heat ump '• _, E-mail: Wall/sus ndcd/unit heater _ •• _ "CONTRA ;,.%i'rtt `Nater heater _ - — •• l BU13iriCSS Nam *1 ' , -, Fireplace _ •' Flange •• Address: ErZi, `Z 4 ..00„A K e. nom ---- -- •. — C'il '/State/Z;r: �. . (2, t-j"1 ,�.C3 �:� Clothes dr'ycr ivi _ Phone: .�L_ 1 Fax: tAtha Total: CC13 Lic. # - _ c-� Authorised Meelsaaiest Permit Feesi Subtotal; SSignature - 1 Dtt� �-= Minimum Pernut Fee$72.50 S Plan Review Fee(25%or Pcrtnit Fee $ (Plcxsr print Hamel _ State Surchar c S( %of Permit Fee S -� _ TOTAL PF.kMrr FEE S Notice: This permit applirathn expi•em it a p-rinli Is not ohtsined within 'Fee methodology tet by Tri-County Building IN, Se r ar fi 180 days after It has been serepted a-complete. -Site pian required for exterior A1C units. t AntsTertnit Fottn%\Mcr.Pernt(tApp d.-c 01/03 Jun-20-03 01 : 17P P . 03 rn �JIQl1�l Uf� 1 vRnNT' M(A E- �fAGc s N r� * AI 4 �y �► _5.�. No�.t��TF_ 2.511- 6,P5Z— CITY OF TIGARD 24-Hour BUILDING Inspection-Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP - ---- ----- Received Date Req,3sted�__ �� ~ AM PM SUP Location _ Jt'-76 -- -� - Suite-� C MEC 3 - 003 .� _ Contact Person _ Q�YY ) IAJ ' Ph q_77_1 PLM _--. Contractor .- __- --__-- Ph(__ ___- ) _ SWR rBUILLNING Tenant/Owner _ -_ --_ ELCFooting ELC ELC Foundation Access: Fig Drain C�' ELR - -- --_. Crawl Drain _ - -- SIT Slab Inspection Notes: — Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler - - Fire Alarm Susp'd Ceiling - Roof Other: Final PASS PART FAIL_ PLUMBING Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain L ains Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL -_ Post& Beam - - Rough-In Gas Line Smoke-DDampers .-PASSJPAHT FAIL - _ - - --- - - �.__ ELECTRICAL Service Rough-In \ _1�•�-- _ UG/Slab r` `• �_ Low Voltage �� -__`7L � —�— - - -- Fire Alarm Final- PART FAIL Reinspection fee of$ required before neat Inspurstion. Pay at City Hall, 13125 SW Hail Blvd. SIT �] Please call for reinspection RE Unable to inspect-no access r7ire Supply Line / ADA ' Approach/Sidewalk Date —C- c Inspo or _1�-' ftt Other: Final DO NOT REMOVE this Inspectlon record from the Job site. PASS PART ;;I1