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16714 SW JORDAN WAY-1 i G ! y K, I 1:1719 SW ,JORDAW WY r,ITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - BUP — -Date Requested—Ll/' L > AM PM BLD - ----V Location5c✓ Jc rdon Suite _ �_— MEC 60C> /ZU Contact Person _ _ _—_ Ph I rJ n 7 PLM Contractor— _ — Ph _ SWR _ BUILDING V� Tenant/Owner J era,>/ GA//�4- ELC Retaining Wall ELR -__-_— Footing Access FPS Foundation — -- - Ftg Drain -- --- SGN Crawl Drain Inspection Notes. Slab —.___ __.---_-�- SIT Post&Be-im —--— Ext Sheath/Shear Int Sheath/Shear Framing i S 1,f ie ✓c� ,r- Insulation Drywall Mailing _�T, 2 - Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling -_ — Roof A- Misc: Final PASS PAR r FAIL ---- PL.UMBING v-- Por.t 8 Beam Under Slab Top Out -- Water Service — Sanitary Sewer Rain Drains Final PASS PART FAIL Post& Beam - - - - --- - Rough In fi► Gas Line Smoke-,Dampers P S PART FAIL_ -- �;e..rvlce Rough In UG/Slab _— ._-------.-_---- Low Voltage FireAlarm -_ _._ _�__--.—_ - -- -- - - -- ----------- --- -- ._ - --- -.. Final PASS PART FAIL ------ --------- --- - - .._.. _------SITE E3ackfdl/Grading _— , ----------- ------- -------------_�-__.. __-- ------- _�.... Sanitary Sewer Storm Drain [ ]Reinsbection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ [Please call for reinspection RE: [ [ Unable to inspect-no access ADA Approach/Sidewalk - „„/�J. other Date `L_= ?� ` Inspector_ �,- ____—r__ —.r— Ext _-- Final PASS PART FAIL DO NOT REMOVE !his inspection -ord from the job site. CITY OF TIGARD BUILDIN(. INSPECTION DIVISION 24-Flour Inspection Line: 639-4175 Business Lino: 639-4171 MST - Elup --- Bate Requested 7 ''d AM- — FM �'� BLD -- Location �/C� - -- __y—.�_ J . �-,— = _-- Suite MEC Contact Person _ _ _ —_ _ — Ph ��, r'Z ? 3 — PLM -- -- Contractor_— / Ph � h � (' _— :`SWR _ __--- BUILDINC= — Tenant/Owner ELC /- Ll i y Retaining Wall ELR Footing Access -.. --- Foundation FPS Ftg Drain ---------- Crawl Drain Inspection Notes: "' SGN Slab -_--_------- SIT Post&Beam I' ---- Ext Sheath/Shear AlL COQ, j - Int(;heath/Shear ------- Framing - -_--- Insulation -- L --- -�i- -------- --.---- Drywall Nailing Firewall / -- ---- Fire Sprinkler --___--- /4,66mz)C,/r�-� Fire Alarm Susp'd Ceiling Roof — ---- --__ -- - Misc: _- - Final - -----__---- PASS PART FA!!- PLUMBING ---._.�.-- Post& Beam Under Slab - Top Out - -- ---- Water Service Sanitary Sewer Rain Drains Final PASS PARI FAIL , MECHANICAL - I'ost&Eieam -- Rnugh In --- Gas Line Smoke Dampers Final PASS PART FAIL - �- RI AL ___ _ ------ - Service Rough In --- - - - -- UG/Slab Low Voltage -- in F' PASS P RT FAIL Backfill/Grading - - -- - ------ ----- _ Sanitary Sewer _ -- Storm Drain I Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line f 1 Please call for reinspection RE:-_ I I Unable to inspect-no access ADA Approach/Sidewalk Other Date 115 D - � --Inspector 7_ , Fxt Final - PASS PART FAIL DO NOT REMOVE this inspection reca rd from the job site. r ri. CITYITY O F T I GA R D MECHANICAL 1 RMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00120 13125 SW Hall 3:v J , Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/13/2001 PARCEL: 2511 6AD-24900 SITE ADDRESS: 16714 SW JORDAN WY SUBDIVISION: BLDFORD GLEN ZON!NG: BLOCK: LOT: 015 JURISDICTION: KIN CLAISS OF WORK ADD 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 TYPES0 3 HP: DOMES. INCIN: GAS _ 3 15 HP: COMML. INCIN: MAX INPUT: B7 U 15 - 30 HP: REPAIR UNITS: FIRE DAMiPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 1UOK BTU: _ AIR HANDLING UNITS OTHER UNITS: URN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: INSTALLA.TICN OF GAS LINE TO FIREPLACE. Owner: r_ -- --_-- FEES ETTESTAD, LYLE L + LINDA A Type By Date Amount Receipt 16714 SW JORDAN WAY PRMT 1F13 04/13/20( $72..50 KING C'TY TIGARD, OR 97224 5PCT BFB 04/13/20( °5.80 KING CITY Total $78.30 Phone: — ��-�--- Contractor: MODERN PLUMBING CO D + D ACQUISITIONS INC 11129 SW INDUSTRIAL WAY REQUIRED INSPECTIONS TUALA.TIN, OR 970E2 Gas Line Insp Phone:691-616G Final Inspection Reg #:LIC 00087906 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 glans. This permii 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 caliirg (503)246-9189. Issue By: 1 z� Permittee Signature:G Call (503) 639-4175 by 7:00 P.M. for inspections nes'd�e–d`�the 7next business day CITY OF KING CITY PAGE 02/02 04/1'2/2001 13:09 5036393771 City of Tlger� tgnoi;/ano 04/71/2001 16:01 FAX 8036847297 A. Mechanical Perna*Applicstion Dutr-tc=ivrd+12a Pernit no.My-.b/_( City of Tigard Ptnjectlappl. - Expirtdetc. _, C(yn/71ga►d Addre,Rs' 1312.5 SW Hall Blvd. 11gard,OR 97Y21 Datelasual r 8y: eiptno„ phone. '501) 619.4171 Peymnntlypo: 59(i19fj CAaerrlano.-- -- _._-- -- Duilding permit no.: Land uv-aper oval: - -- -- -- - — — � r181 2 family dwelling ar acne::+sury J�mcnerciavindu^trialU Multi-fatndy (�Tenant ttttptI,-rur.nt I '_1 construcuan tiAddlt.Inn/e:tnmd,nn/repinrerne.nt Ci Other; ",-M, lndiultc a ptipment q tantities n boxes below.Irtdir_stc tlu dnll:v Jab address: ,� {r 1 I N /fit. >�y_ -..-_-__ $1d .n�.: Sui^e nn.: value of all trrectuuuc.ul materials,equipment,l;tbor,crvr_thead, - profit,valua 3 Tau-P//ta:t lovaccount no, _-_ Lot• Block: �U,�IIIVM-101 :` - ,- -^ 'See otwokL':n for itaportard application mforrnation and jurisdiction's fix schedule tot m�identiol p emit fcr pnaj¢cr nmm��C YL _ � TA� ------ - �ity/cu ZIP: _ - -- ')rscn tion rttld locadon of work an pretniser. llctrcr tun r E.Sr-,ate of romp�etloNins tion; - Tr.nant improvement or chub$&of usc; Airh ndll urut %1777 ClM is ts,tisting space heated or conditioned'J Yes (J Nn icon omng o,ret�_enro.,xigTtng&pace insulated?Cl YesU No [mutono tatirtlngNVAC Aoilmr1cotnpressors • ^p StetnhoiMrpermlenn: Bttsirtev name:fsyyA Q.C! =� -- - -- 1{1' _-_Tons _c3TV/H _ --Ulan �\ _ - - PiteJsmnke damnt�rxlAur.r ernnke dcT�mrs ___ ___ - S_tnte 7.�:q7 C a l._ .��u__m,pp.__s__to��len�u r �tvln�tel flallarnTumu mer____ BT U114 blrone: �• l� F' 'r �1 F m�'. 1 u' naluding ductworkhant liner 0 Yea O Nn CCB nu.; __-___-- tteu p ncclre.lncereheaters-suspr.at�ed. City/metro lie._no.: 1 wall or floor mcxmted R u R 05� nr n•ii ^ we n at ref ar,,rrisc9 _ Nattte( leLae tint , r/{r ention.. Abso rpdon unite BTU/N C1tiPras_ HP - Narne: _ _ __ t^nm assn______^ zy.1dres _ - vtrortsetotel eaelau>tt amt ve oar r'ity: 19tale: _- 71P: ---- A liancevent ` --- - ------- --- o aunt Phone: Fax: �rr�s�`ype reu tc rizzetnnt hood fire.euppreesion System - Name: Wthnwr tan with single duct(bath fans) _ -- 1 0.i lT A btam t1TnLahr_ Mallinf.addttuTwl p1plMud 0=01mui uppToa out cts City: LAO; f11' GLI C) 17 Phone;--� F'ua. L-tua11: hu plpTns eacF a�1i don;ti over rni _ -r-a-<wpipng(wilrmauc rc' u� re Number of nutlem _ _ - Name: T... t-i111n Iltl,�l a ttrarc ur rgnT inn Addrestt: _ gecoran••ctycpincc _- _,,,� _ ._--- City: Stale; on�ovelQ�"ic - phone. � ax .•- Data; other: ppplir.ant's stgnulur T_ -- -. Name (print) --- --• ._- --. _- __- -• --- _ �- d'crntil(er.... .................S ....r..._: N■t alli,rri++A4rimc�ecsprawa.mb,plem edl iurieiaru.K.rx mike tnhuardne Nnlicr 71,it pr,mir npplira-ien Mininii,rn fir: 7 � I'I tna� n w".ear►R;aM a t1 rreu ex em„t u,nut ribb ino�l p P Plyi review(r+,±. Ctadh cord m,rnM+; --_ 1'_"_L- within I so joys unci k hr.!boon - Y --- 6a►;,� su,t��,��htttiEt•oar)., $ l$.- -- acv,1[rti ns rnrrmlctc, T,UTU r Name of urdbn4lri u aena+o no 4rtAi,earl ..,••• •......• .... l< -••--- -�pmeunr _ 404617(iAe±COM1 C�T�Y SJ F `�I G A f�G ELECTRICAL PERMIT — PERMIT#: ELC2001-00192 DEVELOPMENT SERVICES DATE ISSUED: 4/17lU1 13125 SW Ha'I Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S116AD-24900 SITE ADDRESS: 16714 SW JORDAN WY SUBDIVISION: BEDFORD GLEN ZONING: BLOCK: LOT : 015 .JURISDICTION: KIN Proiect Dpscription: Installation of 4 branch circuits. _RESIDENTIAL UNIT_ _ TEMP .�F24GlrcEDERS _ _ MISCELL4NEOUS — 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: i i IWTED FNERDY: 401 - 600 amp: SIGNAL/PANEL: MANF I,M/ SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10): _ —^>E'RVICE/FEEDER_ _ BRANCH_CIRCUITS -- ADD'L INSPECTIONS —_— j 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st �N10 SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'I_ BRNCH CIRC: 3 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amplvolt: — >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: _--___SVC/FDR >= 225-AMPS. _— CLASS ARE4ISPEC OCC: Owner: Contractor: ETT FSTAD, LYLE L + LiNDA A TUALATIN ELECTRIC 16714 SVV JORDAN WAY PO BOX 655 TIGARD OR 97224 WILSONVILLF_, OR 97070 Phone: Phone: 682-2955 Reg #: LIC 00065650 SUP 3483S FLE 3-268C FEES _ Required inspections Type Dy Date Amount Receipt Rough-in PRMT CTR 4/17IrJ1 $66.80 2720010000( Elect'I Final 5PCT CTR 4117/01 $5.34 2720010000( _ --- Total $72.14 This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 aays of issuance,or if work is suspended for more than 180 days. ATTENTION Oregon law requhes 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 obta o copies of these rules ordirect questions to OUNC at(503) 246.6699 or 1-800-332-231-1•1 Permit Signature: Issued By: `- OWNER INSTALLArION ONLY The installation is being made on property I own which is not intended for sale, 'ease, or rent. OWNER'S SIGNATURE: __— _._ —__ _. — DATE:_ —_.— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: —_ ___— _ DATE:—_ L.I C E N S E N O —-------- —---- ---— --r_--_--------- --- Call 639-4175 by 7:00pm for an inspection the next business day C � o Electdca_1 Permit Application / Datereceived: J /. Permit no.: City of Tigard Project/appl.no.: Expire date: CiryvfTigard Address: 13125 SW Hall Blvtl,Tigard,OR 97223 Date issued: B Feceiptno.: Phone: (503) 639-4171 — Fax: (503) 598-1960 Case file no.: Pay menttype: —I Land use app-oval: ��. MOM 1=familywelling or accessory U Comndercial/industrial U Multi-family UTenant improvement U Non U Addition/alteration/replacement U Other: _ U Partial lien Job address: l t 1.A c_ lo. 1 E no.: Suite no.: iTay,reap/tar,loVaccount no.: Lot: Block Subdivision: a Project name: [ 7bescriptio an an rad location of f workon premises: Estimated slate of completion/inspection: Nit , t r 1 Job no: �,' �� fee Max --- -- _ Description Business name: �� ► Qty. (ca.) f„tRl 'to.dusp �T�"”' ��-_�- �- --- — — New mcidenlial-single or mull-famlly per Address: a ��,/ (O - dwellinguniLlmcludesattachedgarage. CityIS tate: ZIP:q 1 p Serviceinciode& Phone: kc:,, r65 r%X: 1000 sq.ft.or less �� -F-,h additional 500 sq.it.or pu,tion thereof CCB no.: 16'G6-3U � Elec.bus.lie.no: itcdeuergy,residendal 2 City/metro lie. n.: Limited_energy,non-residential 2 Each rnaimfnctured home or modular dwelling Signature of supervisin, xtrician(required) Uate Service and/or feeder 2 Su elect.name rind ''V, � C)V�. Licen%cno Services orfeeders-Installation. P (P ) 34��J alteration or relocation: 200 amps or less Name(print): , 201 amps to 400 an ips 2 401 amps to 6110 ar.tps 2 Mailing address: o-A in,r, 601 amps to IOU I amps 2 City: 1 r e,. State-6J4 1 ZIP: '7 Over 1000 amps or volts - 2 Phone: n Fax: E-mail: Reconnect only --µ — - I Owner installation:The installation is being made on property I own Temporarywrvfe m or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocation: ORS 147,455, 479,670,701. 200 amps or less 2 201 amps to 400 amps - y— Owner's sl nature: Date: 1-4011.600 ams 2 Branch circuits-new,alteration, or extension per panel- Name. A. Fee for branch circuits with purchase of ,Il rc _service or feed•r fee,each branch circuit 2 City:` -__ '! State: ZIP: P. Fre for blanch circuits without purchase tt''/, of service or feeder fee,first branch circuit:,% I moi. y�r a 2 Phone: Fax: E-mail: Each addititaal branch circuit: JW.iajkl:.� q Misc.(Ser-ice or feeder not Included): U Service over 225 amps commercial U Health-care facility Each pumpot irrigation( cle 2 U Service over 320 amps-rating of 1&2 ❑Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, OSystem over 600volts nominal more residential units in one structure alto-atiun,orextension*_ 2 U Building over three stories U Feeders,400 amps or more •Dcscri tk:-: _ U Occupant loud over 99 persons U Manufactured structures or RV park Fitch additional Inspection over the allowable In any of the&Love- 0 Egress/Ilghungplan J ether Perinspection _ Submit___sets of plans with any of the above. Investigation fee _ The above ire not applicable to temporary construction service. Other Na all juriubcoons accept credit cards,please call jurisdiction for more information. Notice:This permit application Permit fee.....................$ _ �J U visa U MasterCard expires if a permit is not obtained Plan review(at , %) $ _ Credit card number: within 180 days after it has been State surcharge(8%)....$ of. oar I r u shown on credit c pi" accepted as complete. TOTAL . $ �_ Cardholder al`nalure Amount _ 440 4613(6=/('OM) 111111111111M _'9aimm�-i�104 Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee... ------- Number of Inspections per permit lowed _ (FOR ALL S"STEMS) Service included: Items Cost Total Check Type of 1,Vurk Involved: Residential-per unit 1000 sq.ft or less $145 15 —_ 4 Audio and Stereo Systems Each additional 500 sq.ft.o portion thereof $33.40 _- 1 ❑ Burglar Alarm Limited F tergy $75.00 Each!,Sanurd Home or.Modular Dwolling Servi,x nr Feeder _ $90 9r0 _ 2 l J Garage_ -oor Opener' Services or F,teders I ❑ Heating,Ventilation and Air Conditioning System' Installation,0eration,or relocation 200 amps or less $80.30 _ 2 El 201 amps.n 400 amp3 _ $10685 _ -`_ Vacuum Systems' 401 amps to 600 amps $160.602 601 amps to 1000 amps $240.60 ? ❑ Other — --- - -- Over 1000 amps or volts $45465 heconnocl only _ $66.85 Temporary Services o:Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alto-ation,of relocation Fee for each system.......................................................... $75.00 200 amps or less — $6685_ 2 (SEE OAR 918-260-290) 201 amps f-)400 amps $100.30 __ 7 401 amps w 600 amps $133 75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"t"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel Ej Boiler Controls a)The fee for branch circuits with pc chase of service or ❑ C tock Systems feeder fee. Each branch circuit $6 65 2 Pata Telerommunication Installation b)The fee for branch circuits without purchass of service ❑j Fire Alarm Installation or feeder lee. F imt branch circuit _ $46 F5 ❑ f-ach additional branch circuit $6135 HVAC Miscellaneous Instrumentation (Service or feeder not included) Each pump or Irrigation circle $53.40 ❑ Each sign or outline lighting $5340 Intercom and Paging Systems Signal circuit(e)or a limited energy panel,alteration or extension. $7500 — ❑ Landscape Irrigation Control' Minor Labels(10) _ $12500 Medical Fach additional Inspection over ❑ the allowable In any of the above ❑ Per inspection _ $62 50 ----- Nurse Calls Per hour $62.50 In Olant .❑— $73 75 �_ _ Outdoor Landscape Llghtiog' Fees: ❑ Protective Siqnalinq Enter total of above fees $ _ ❑ Other H%Stale Surcharge $ _ _ Number of Systems 25 Plan Review Fee No licenses are required, Licenses are required for all other installations See'Plan Review"section on $ front of application - -- Fees: Total Balance Due $ -----_-- Enter total of above fees $ ❑ Trust Account# 8116 State Surcharge --- ----�-- ----��..— --- -- ---` Total Balance Due $ i:klsts\forms\etc-fees doe 10/0a/00