11950 SW KATHERINE STREET i
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11950 SW KATHERINE ST
ELECTRICAL -
PERM
CITY OF TI(3*ARD RESTRICTED ENE IGY
DEVELOPMENT SERVICES , PERMIT#: ELR2G02-00026
13125 SW Hall Blvd., Ticlard, (",'% 97223 (503) 639-4171 DATE ISSUED: 3/4/02
SITE ADDRESS: 11950 SW KA-i HERINE :3T PARCEL: 1S134CD•03600
SUf3DIVISION: LERON HEIGHTS NO.3 ZONING: R-4 5
BLOCK: LOT: 063 JURISDICTION: TIG
Proiect Description: Low voltage to A/C.
A. RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: — INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDVvrN i-ANDSC LITE-
OTHER: MVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
_.-- --_,------ __ i OTAL #OF SYSTEMS_ —
Owner: Contractor:
FRANKI BACCE�LIERI
11950 SW KATHERINE
TIGARD, OR 97223
Picone: Phone:
Reg #:
FEES— — i Required Inspections
Type By Date _ _ Amount Receipt Wall Cover
PRMT CTR 3/4/02 $75.00 2720020000 Lova Voltage Ir spection
5PCT CTR 3/4/02 $6.00 2720020000 Elect'I Final
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spy cialty Codes
and all other applicable 1-,ws. All work will be done in accordance with approved plans. This ,ermit will .,empire if work is
not started within 180 days of issuance, or it work is Suspended for more than 180 days. ATTENTIO V: Oregon law
requires you to follow rules adopted by tfie Oregon Utility Notification Center. Those rule are set forty, in O
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or dct questions to O v� at (503)
246-1987. ,- r. ///� ,1�_
Issued by ` ; r - d� .�sa.LUt� Permittee oignature'
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended fc.r sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. EL.EC'N DATE:
LICENSE NO: ----- ---
Call 639-4175 by 7:00 P.M. for an Inspection needed the next business day
Electrical Permit Application
Dale received: �J v Permit no.&2 - C-
City of Tigard /C 7, ProjrcUappl.no.: Expire date:
C.irynfTrl mrd Address: 13125 SW Hall Blvd,Tigard,0 7923
Pho1e: (50?) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: payment type:
Lane, use Ppproval: —
TYPE 019
PERMT
V 1 &2 family dwelling or accessory ❑Commercial/indus(rial U Multi-family CI Tenant improvement.
'qew construction )"dition/alteration/replace ment U 011ier• U partial
in ' t t
lob address: Bldg. no.: Suite^n.: Tax map/tax lot/account no.:
I'o Block: I subdivision: -
-ect name: -- -
J Descnp(ion and location of work on premises:
Estimated date of coo Ietion/ins cgz_tzjded,
UONTRWFOR APPLICATION
Job no: FEE t
-- I'cc i11av
BUSIt1e55 nan1C:-- -Yr�� 1 , O "Ins I)cscripliun (Jlv. (r•a.) Total no.insp
Address: �pp7® 5✓ Tv� s w Rte_ Nen nyidential-.single or norm-i:mile IK'r
City: doellioranit.lacludecattathedr;a;ge.
Slatc:O n- !ZI Q Q 6 1 SciOvelnc:uded:
Phone: WILt 1000:q rt.or Ics:.
CCB no.: :5\9-Z _ FJec.bus.IiC.t)o: - 1L _Each additional 500 sq.A.or portion thereof -
- -- Limnedenergy,residcmial
City/nietp Ilc.no.: IJmiiedenergy,non-residential 2
'' 2manufactured home or modular dwelling
gitature o st ,cr sing clrctriciun(required) �'- jute _ Service mrd/or feeder
�-I ----
2
Su1 elecrnann•ihnnli I-esServlccsorteeders-b,stallatlon,
alteration or relocation:
200 amps or less 2
Name(print): _ 201 amps to 400 amps 2
Mailing address: -- 401 amps to 6(x1 amps - 2
60:Jrnps to 1000 amps
City: 'v—- .-- Stale: ZIP over 1010 amps or voits 2
_ - 2
Phone:- — _--- hex: E-mail: �— Reconneclanl - j
Owner installation:The installation is being made on property I own Temporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,aiteratlon,orrelocation:
ORS 447,455,479,670,701. 20J amps or less 2
201 amps to 10 amps 2
Owner's signature: " Date: 401 to 600 nm s 2
' Branch circuits-new,alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address:— service or feeder fee,each brvtch circuit
City:! _ StatC: 7.1I' 11. bee for branch circuits without purchase
- - - -- of service or feeder fee,first branch circuit:
Phone: Pax: ►'-mail: _ 2
Each adrlitimnal branch circwL -"
MISC.(Service or feeder not included):
U Service over 22.,mops cornmercial U Health-carcfaciliiy hath pump ar irrigation circle 2
U Service over 323 amps-rating of I&2 U Ha7xclouslocatiorr, Each sign or outime lighting 2
Iamilydwell{ar,s U Puildingove, 10,()O square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal more resirential units in nne structure alteration,or emension• 2
U Building over three lories U Feeder„400 an tis or more •Ikscription:__
U(4cupent load over 99 persc ns U Manufactured structures or RV park Loch Willonal Inspection over the allowable In any of the above:
U Fgres-fiRhtingpinn U Other:
--- F'er m:;rctiun
Submit—sets of plans With Any of the above. Investigation fee —-'
The above are not applicable to temporary construction service. other
"Not—all'udsdicuoos accept crrdir pard:,please +dl junscilco-707mese inrnrrmuan. Notice:This permit application PC,:nll fe.e.....................$ —���� uCJ-.
U Visa ft MasterCard expires if a permit is not obtained Plan review(at -_ %) n
Credit card eumber -- within 180 days after it has been Stale surcharge(8%)....$
-- "pi. accepted as complete. TOTAI. .......................$ (J
Name cr cud ri-�ii_t u'shown cred{t carts
----- Car�iler signature � -s Amount
—r�- 440-4615 1601ICOM1
CITYOF T I G,A R U MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-000:10
13125 SW Hall Blvd., Tigard, OR 97223 (50) 639-4171 DATE ISSUED: 3/4/02.
PARCEL: 1 S 134CD-03600
SITE ADDRESS: 11950 SW KATHERINE ST
SUBDIVISION: LERON HEIGHTS NO.3 ZONING: R-4.5
BLOCK: LOT: 063 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS. VENT FANS:
OCCUPANCY ";RP: R3 VENTS W/O AVPL: VENT SYSTEMS:
STGRIES: 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 -4. HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfIn:
GAS OUTLETS:
> 10000 cfm:
Remar islallotion of A/C. Unit cannot be placed in the required set backs.
Owner: FEES
FRANKI BACCELL IER1 Type By Date Amount Receipt
11950 SW KATHERINE PRMT CTR 3/4/02 $72.50 272002000C
TIGARD, OR 97223 5PCT GTR 3/4/02 $5.80 2720020000
Total $78.30 i
Phone: ----- – — --
Contrar•tor:
ARROW MECHANICAL
10330 SW TUALATIN RD
T-UALATIN, OR 97062 REQUIRED INSPECTIONS
Mechanical Insp
Phone:692-1565 Cooling Unt Insp
Rt.1 #:LIC 5193 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon la, , requires you to follow rules adopted in the Oregon
Utility Notification Center. P-.-)se rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questio 'to OI.JNIC�.<by calling
rrNni»an-ai Ra , ..����� !'
Issue By: `' i �s:�It1.=1 Lc_ Permittee Signature:
Call (50"' 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Applicatiqln
� \ Datereceiv 'y Permitno.: "a pp �U O J�'J
City of Tigard4 ( Project/aprl.no.: Expiredale:
CIA )/ii;an/ Address: 13125 SW Hall Blvd,T-ard,OR --
Phone: (503) 639-4171 hate issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no,: Payment type:
Land use approval _ _ Building permit no.
1
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction ,*Mdolition/alteratiun/repiaccrue tit U Other: .-____
JOB SITE.INFORMATION1VALUATION
i<', idl;ss: �.) Ko, r;ne S Indicate equipment quantities in boxes below. Indicate the dollar
13IdP no.: j Suite no.: value of all mechanical materials,equipment,labor,overhead,
'i ax map/tax lot/account no.: profit.'Value$ —
Lot: Block: Sundivision: 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: Mw ZIP: q"�Z2I A 2 FAMILV DWELLING PERMIT FEE SCHEDULE
Description and lobation of work on premises:__
Fee(ea.) Total
Est.date of completion/inspection: ul��- _ Ikscriplion Qty. Ftcx.only Res.only IIVAC:
Tenant improvement or change of use: am
Air handling unit _ ('f T1___„_
Is existing space heated or conditioned?X'es U No Air conditioning(site plan re(juired)
Is existing,space insulated'!"Kxes U No Alteration of existing IIVACsysteni -
Boiler%compressors �-
Business name: f State boiler permit no.:
HP __Tons BTU/14
Address 10320 .5Lj TV W P4 — Virelsmoke damperTductsmo edetectors
City: Alj State:Ott I ZIP Ilew pump(site plan required)
Phone: 6ej(_�p�9 Fax .�L-ij6 mail: Install/replace of ruac umer
CCB no.: �`— - - Including ductwork/vent liner U Yes t]No
nsla rep ace rc ocate eaters-suspended,
City/metro lic.no.: wall,or Boor mounted
Nene(please print): I Vent for ailp i�ance other titan furnace
CO1
Refrigeration:
Absorption milts—_,—__ WHIM
Name: �"f Chillers
` � III'
Address:
-- - -- - -- - _ --- - Com ressors HI'
"vironmental exhaint ana ventilation:
City:
--_. Appliancevent
1'i rtre: IQ r 1'. mail: hryerex aunt _--�-
1 a, lloods,Type /11/res. itchen/hazmal —
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mulling address: Exhausts stem a ar from heating or AC
-City. Stater 1/I1' Fuelpiping an kiln ruUtoon(up 4 out els)
— - -- — Type: _ LPG - NG Oil
Phone: I5s I ntai I- Foal piping each additional over 4 outlets
rocess piping(sc a notic required)
Minis Nuniherof outlets
-. -- Tear 9-_de lappUsince or equ pment:
Address: _ De c o rati v e f i rep I ac e
C'ily: A----- Stat • ZIP: insert-type
Phone: F4 —-- fi mail: - -insert
llc_ietstove
Other:
Applicant's signature: L&tq I Date: Other:
Name(print): _'R�kAlll — _
Not all juriurirlinns aeceM credit cards,please call junsdretitm for more information Permit fee.....................$
U Visa U Mastercard Notice:This permit application Minimum fee................$
expires if a permit is not obtained ,
Cledit card numFtec �[ Man review(al ._ n,6) $ _.
within 180 days after it has been ,-
�—Name State surcharge(896)....$
of c o .l-sown on credit cad�- accepted as complete.
ar Ier u
S TOTAL .......................$
Cad der dsnou re _ —Arnow 4404611(CsR WOM)
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CITY OF TIGARD 24-HUur
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (703)639-4171
cyBI1P
Received __ _ ____Date Requested Z a AM----- PM BUP
Caj)
Location _ 1 U _ uite--___-_____.-._ _ MEC
Contact Person . Ph PLM _
Contractor` _ Ph( ) SWR
BUILDING Tenant/Owner
Footing i
FoundationCceI ELC
Ftg Drain �: U ELR6
Crawl Drain r_
Slab Inspe tion Notes: ^ j J SIT
Post&Beam
Shear Anchors (l
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 Drains -- - - -�--- - ------ - —_
Catch Basin/Manhole
Storm Drain - -- —
Shower Pan
Other: ---
Final -
N _ FALL
HANi
am
Rough-In ---- -- _—�_ --------
Gas Line
Srr�pke Dampers -- - - - — — -
i
FAIL ----- -------- -- --
Rough-In
UG/Slab - --
Low Voltage
ire Alarm
(1-inIL Reinspection fee of$ _._ -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
$ PAR T FAIL
lJ Please call for reinspection RE: Unable to inspect-no acpess
Fire Supply Line !1
ADA
Approach/Sidewalk Data__ _� (o— inspect Ar (_-- -_--- Ext-
�-
Other:
Final DO NOT REMOVE this Inspection record y rove the job site.
PASS PART FAIL