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12140 SW KATHERINE STREET 4 I I� �I m z m { C 12140 SW KATHERINE ST CITYOF TIGARD _ M1=CHA;iIGALPERMIT DEVELOPMENT SERVICES PERM:T#: MEC2004-00672 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED 10/6/2004 SIS t ADDRESS: 12140 SW KATHERINE ST PARC'!_: 2S03BB-10300 SUBDIVISION: YE OLDE WINDMII-L ZONING: R-4.5 BLOCK: LOT: 02.3 JURISDIC PION: TIG CLASS OF WORK: OTR 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: 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: _ AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: <_ 10000 cfm: OTHER UNITS: > 10000 ,J171: GAS OUTLETS: I Remarks: In.,tailatiun of gas piping for cooktop. Owner: FEE3 _ KEITH V\/OLF UE scription Date Amount 12140 SW KATHERINE ST ---- TIGARD, OR 97223 1f;S'!FClIJ Fcrnlit FCC 10!6/200 %2.50 [TAXI � Stutc tiurchart 10/6/200- 5.8U Phone: 503-579-I9711 Total $78.30:::= Contractor: 78.30 - Contractor: R A WARNER PIPE CO PO BOX 820785 VANCOUVER, WA 98682 REQUIRED INSPECTIONS Phone: 360 X96-0370 Gas Line Insp Final Inspection Reg#: [!C 151329 This permit is issued subject to the regulations contained in the Tigard A,1unicipal Code, State of Orc. 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 ft r more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utilay Notification Center. Those rules are set forth in OAR 952-001-001(1 through OAR 952-001-0100. You may Obtain cnpies ni these rules or direct questions t( OUNC by raiii-ig (50)246 6699. sued By: � : Permittee Signature: Call (503) 639-4176 'y y 7:00 P.M. for inspections needed the next business day Mechanical Permit Ap lication Vok QFFICF 11SE ONLY City of Tigard - - Received -\ �s 6 ,_ is Permit Nc 13125 SW Hai'Blvd., rigard,OR 97223 DateB.: ,_ G a4 h/F �e -DG .o7. Phone: 503.639 4171 Fax: 503.598.1960 Plan Review Other Permit: DateBy: Inspectioc Line: 503.639,4175 Date Ready/By: to ® See Page zsur-� Internet: www.ci.tigard.or.us Notified/Method Supple mental Information TYPE OF WORK � COMMERCIAL, FEE* SCHEDULE - USE CHECKLIST - Mechanical permit fees*arc based on the value of the work ❑New construction ddition/alteratiun/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Dtmolitlor 0 Other: mechanical materials, ,quipment,labor,overhead,and profit, C' 'lt>� ORY OF CONSTRUCTION Value 5 a,td 2-famll—dwwellm - _ _ J RESIDENTIAL EQUIPMENT/SYSTEMS FEES- 1-1. g []Commercial/industrial ❑ Accessory building, --- — For special information use checklist Eltih.tti-family ❑ NLtster builder ❑ Other. --- -_ Description Qty I Ea, I Total JOB SITE"INFORMATION AND LOCATN)N Heating/cooling------- - -------'----- -- --- J..it site address. '2 ( Air conditioning or heat pump (� i t x11 `� (,y Z�c�ctr a �( (requires site plan showing placement 14.00 City/State/ZIP: s (Ayt A , Furnace 100,000 BTU ducts,vents) - 14.00 ----- Furnace 100,000+BTII durwvents 11,90 Suite/bldg./apt.no.: Project name: Gas heat pump 14.00 _ Cross street/directions to job site: Duct work _ 14.00 H dronic hot water cystem 14.00 Residential.boiler(radiator or h dronic) 14.00 -- -- Unit heaters(fuel-type,not electric), in-wall,in-duct,:suspended,etc. 10.00 Subdivision: —— Lot no.: — Flu-/vent for any of above 10.00 -_— ---- Other: 'rax nip/par el no, Other fuel appliances —, ---- — DESCRIMON OF WORK Water heater —` -- > --�� Gas fireplace H1 IOAO Flue vent for water heater or gas fireplace 10.00 _-- --- ------_—.--- ____----_____--------_-_-- Log lighter( as) 10.00 _ Wood/pellet stove 10.00 Wood fireplace/insert 10,00 Chi mne /liner/flue/vent 1000 !7j PROPERTY G'WNER ❑ 'TENANT r ' h Other: 10.00 — Name. (� e( r� (�J U F _ ! Environmental exhaust and ventilation 7 t U- i c,J� rl,.F.L• ♦ C,t- - - -- Re i.uud/other kitchen Address: 1 �__ t --_.---- e ui mv.' _ 10.00 City/State/ZIP: "� c�,A� t _ Clothes dryer .tiaust 10.00 — Single-duct exhaust liathrounis. Fax:( ) toilet coLnarp tments,t.Aity rooms 6.80 'Opacol =— n ❑ ;C(ll!(IACfi —PERSON Attic/crawispace tans 10,00 i3usiness reme: �_w Other: 10.00 1 �r� 't�' FuelIpip[ 2 _ Contact name: lC eL C"JCt- �- SS.40 for first four;$1.00 for each additional_ Address: Furnace,etc T- _ �j Gas heat pump _ City/State/ZIP: C j J� G z Wall/sus ended/unit_(ester Phone:(y(,. ) q --r ) < Water heater _ - r Fax i >AL ,. C. St _L -_- Fireplace _ - E-mail: Rue CC)4TRAC TGR � �Barbecue -� rusmessn:me: �� /L f. z ) ' r V Clothe;dr er as)__ �7 Other Address: U (; f U Ci _ >Li'A.krCAL P SEES" City/State/ZIP: ellA.". C/r-- �► Ad 2_ ---�--_ -- �---- Subtwai Phone:(3( _� Fax.( ) S( ,` Mimtrum permit fee($72 5T Plan review(25%of permit fee) CCB lic.: , E i ?-2 - - State surcharge(8%of permit fee) , O- _ TOTAL PERMIT FEED Authorized s�gnaturc / This permit application expires If a permit Is not obtained within I90 days after It has been accepud a composes. Print name: ,n �� j/Z�l �� Date: �(j -C Pee methodology set by Tri-County Building Industry Service Board i tBuildhg\PermiutR4l6C-P-a,#,Ppdoc 17/03 440-461 r n im✓Convwenl Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: _ Total valuation: Pe_r_m►t_Fee: $1.00 to$2,000.00 Minimum fee$72.50 _ _ $2,001.0r)to$5,000.00 $72.50 for the fust$2,000.00 and$2.�j for each additional$100.00 or fraction thereof,to and including$5,000.00. $' )01.00 to$10,000.00 $141.50 for the first$5,000.00 and $1.80 for each additional$100.00 or fraction thereof,to and including _ __ _ $10,000.00. _ $10,001.0,,to$50,000.00 $231.50 for the first$10,000.00 and $1.35 for each additional$100.00 or fraction thereof,to and including $50,00-0-0-0. $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or fraction thereof,to and inOuding $100 000.00, _ $100,000.01 and up $1,396.50 for the first$100,000.00 and $1.10 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sats of plans. i:\Building\Permits\MEC•PertnitApp.doe 12M 2 CITY OF TIGARD PLUMBING PERMIT — DEVELOPMENT SERVICES PERMIT#: PL-M2004-00464 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/6/2004 SITE ADDRESS: 12140 SW KATHERINE ST PARCEL: 2S103BB-10300 SUBDIVISION: YF. OLDE WINDMILL ZONING: R-4.5 _-_ BLOCK: LOT: 023 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WA l'ER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Installation of plumbing fixtures for kitchen remodel. Owner: -----.FEES _ KEITH WOLF Description Date Amount – 12140 SW KATHERINE ST 1111.1!11111 I'.rmit PCC 10/6/2004 $72.50 TIGARD, OR 97223 ITAX1 8 Statr tiurch u1 10/6/2004 $5.80 Total $78.30 Phone : 503-579-1979 --- _ -- Contractor: R A WARNER PLUMBING PO BOX 820785 VANCOUVER. WA 98682 REQUIRED INSPECTIONS Phone : 360-896-0370 Rough-in Insp Top-out Insp Reg#: LIC 151329 Final Inspection N %1 37-521 P13 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 F-Ispended 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 952.0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (.503) 246-6699. Issud By: � Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the,/next business day Building Fixtu.resRE �EfVED Plumbing Permit App cation FOR OFFICE USE ONLY ' City of Tigard "��''' Received •J g Dete/3 /O G�o y Pernut No.P �i70 -DD y�y 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review - Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No 24-Hour Inspection Line: 503,639,4175 Date Read/B Jura - Intemet tvww.ci tiorus S gard. . Ready/By: See Pana 2 I Natifled/Method � �� Supplemental Information TYPE OF WORK FEE" SCHEDULE ❑New construction ❑ Demolition For special information use checklist — -— Description Ea, Total Addltion/alterationircplacemcnt _ ❑Other. - New 1.2-family dwellings(includes 100 fl.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 249.20 '01-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00 C1Accessory building ❑Mul amity SPR(3)bath 399.00 -- - - ��-❑ Master builder Other Each additional both/kitchen 45.00❑ —. --�---- --- Fire sprinkler(-_sq,ft.) Page 2 — JOB SITE INFORMATION AND LOCATION Site utilities Job site address: (�U - E/c�f w Su� — Catch basin or area drain 16.60 City/State/ZTP: '- Drywell,leach line,or trench drain 16.60 Suite/bldg./apt.no.: Project name: Footing drain(no.linear fl.: __) Page 2 J / Z[ S f Manufactured home utilities 11000 Cross street/directions to job site: ----- Manholes 16.60 Rain drain connector 16.60 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear fl.: Page 2 Subdivision: Lot no.: Water service(no.linear It.:_) Page 2 ---- --- Tax map/parcel no.: Fixture or Item ------- -------•- Absorption valve 1660 DESCRIPTION OF WORK _ Backflow preventer Page 2 ( Backwater valve 16.60 -- ...------------ Clothes washer 16.60 Dishwasher 1660 PROPERTY OWNER ElTENANT Drinking fountain 16.60 ----- . Ejectors/sump 16.60 Name: �li� i7;q Expansion tank 16.60 Address: (Z.l'4 O sw � ,� { -l 1 Fixture/sewer cap 16.60 City/State/ZIP: Floor drain/floor sink/hub 16.60 Phone:(��; ) _-� 9 �q r� Fax:1 ! Garbage disposal ( 16.60 /b, G0 [IAPPLWANT ❑ CONTACT PERSON Hoge bib 16.60 - Ice maker 16.60 Business name: —f� &4- ( (� �` Iv Interceptor/grease trap_ 16.60 Contact name: 24 C ((- C,-- - Medical gas(value.S_) Page 2 Address: PO q t u? 1�- Primer 16.60 City/State/ZIP: CI-Lw tfL oo rain(commercial) 16.60 Phone:(?b d) ���j + e 3 7 u Fax::( ) 5' -- Sinlvh sin/lavatory 16.60 /6 . G 0 / ower/shower pan 16.60 E-mail: ----- Urinal 16.1:0 CON'TRA ----^ - Water closet 16.60 Business name: �� VA v e-CtL 4)(P,(--. CC, Water heater 16 a0 Address: � �� �,zlU7E �� -- -- - Other. 06 City/StaCity/State/ZIP: �,L Subtotal � �� rL L yfl ,PO Minimum permit fee: $72.50 7a 50 Phone:(�j�-� ) i v U 7 7 C Fax:( ' Residential backflow minimum permit fee 536.25 CCB Lic.: /S`( 7 " -4 d Plumbing Lic.no.: 7-S"2 i, of Plan review (25%of permit fee) Authorized signature: 51-61 0 r State surcharge(8%of permit fee) —11-000 4j TOTAL PERMIT FEE r 30 Print name: QbAtA 14 �,v, ,rtaDate: i U - L ,y This permit application expires if a permit Is not obtained within 180 days after It hr been accepted as complete. *Fee methodology set by Tri•t-ounty Building Industry Service Board i�Buildin`\Pertnits�PLMF-Permitnpp doe 12103 440d616T(1oto21C0M/WE8) Plumbing Permit Application - C• of Tigard Pale 2 - Supplemental Information Fee Scliedule: __ Residential Fire Suppcession Systems: ca Total — - Site Utilities i _— Qty. Fee t ) T — Square Footage: Permit Fee: Footing drain-I" 100' 55 00 0 to 2,000 $11500 - T- F'ootingdrain-each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer-1st 100' 55A0 7,201 and greater __ $309.00 — Sewer-each additional 100' 46.40 Water Service- I st IOC' 55.00 Medical Cas S •stems: Water Service-each additional 100' 46.40 r--'----'—'� -- Valuation: _ Permit Fee: _ Storm&Rain Drain-I st 100' 55.00 $100 to$5,000 00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each Fixture or Item Qty. Fee(ea) Total additional$100.00 or fraction thereof,to and including$10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to 525,000.00 $148.50 for the first$10,000,00 and$1.54 for Residential Backflow Prevention Device a each additional$100.00 or fraction thereof,to minimum permit fee$36.25 27.55 and including$25,000.00 _ Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1 45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to specially requested inspections•pet hour 72.50 and including$50,000.00. Subtotal: $50,00100 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",pleas:indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity b Fi re ork Performed Fixture Type: Replare _ New Moved Existing rapped (comments regarding fixture work: Liars_,tr.Font� — - Bath -Tub/Shower -- -- ---- ------�-- J -- lacuzzi/Whirl ool Car Wash -Each Stall -Drive Thru - -- — — -- Cus idor/Water Aspirator Dishwasher -Commercial -Domestic - --__ _— -- --- — Drinking FountainEye Wash Floor Drain/sink 2" i" Car Wash Drain _ — - -----— - — Garbage -Domestic Disposal -Commercial *Note: if the fixture work under this permit results in an -industrial Ice Mach./Refri .Drains increase of sewer EDUs,a sewer permit «ill he k%tied and Oil Separator Gas Station fees assessed for the sewer increase must ire paid before the Rec.Vehicle Dump Station _ plumbing permit can be is..ued. Shower -Gang - -Stall -- --- Sink -Bartuvatory Quantity Total -Bradley Isometric or riser diagram Is required if fixture uantity -Commercial B 9 9 -Servitc total is>9. Swimming Pool Filter Washer-Clothes Water Extractor — Plan Review Water Closet-Toilet Plan review is required if fixture quantity total is>9. Urinal_ _ Other Fixtures: i\aw0dina1P"niiPLM•PevniiApp doe Lo! CITE( OF TIGARD ELECTRICAL PERMIT PERMIT#: 10/6/2 04-00644 DEVELOPMENT SERV;CES D'�TE ISSUED: 10/F12004 13125 SW Hall Blvd., Tiqard. OR 971223 (503) 639-4'171 PARCEL: 25103BB•10300 SITE ADDRESS: 121,, SW KATHERINE ST SUBDIVISION: YE OLDE WINDMILL ZONING: R-4.5 BLOCK: LOT: 023 JURISDICTION: TIG Project Description: Installation of(6)branch circuits for kitchen remodel. 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 HMI SVC/FOR: 601+amps -1000 volts: MINOR LABEL (10): SERVICE/FEFrlc:r" — __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.P!:NCH CIRC: 5 IN PLANT: 601 • 1000 amp: __—_— _ PLAN REVIEW SECTION_ •1000+ ampIvolt: =4 RES UNITS: >600 VOLT NOMINAL: Reconnect only. SVC/FDR —225 AMPS: CLASS AREAISPEC OCC: Owner: Contractor: KEITH WOLF BOONES FERRY ELECTRIC INC 12140 SW KATHERINE ST PO BOX 628 TIGARD,OR 97223 WILSONVILLE,OR 97070 Phone: ( ��, JC79 -/j Phone: 503-682-4936 Rog #: SUP 4918S FEES LIC 88482 F I TI 3-2230 Description Date Amount I I I I'I2.M f J Fa..0 Permit 10/6/2004�6l2004 $80.10 Required Inspections--- — 1 A\j 8%State Surcharge 10/6/2004 $6.41 Rough-in Elect'I Final Total $86.51 L _____j I This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503) 246-6699 or 1-800-332-2344}}/ Issued By: ,�r' ! r'�`ZllUk Permit Signature: c14-' OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ — DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _iDATE:-- LICENSE ATE: _LICf_NSE NO: Call 639-4175 by 7:00pm for an inspection the next business day 1 f _204M 9.OCa j( O ES FERRY ELECTRIC N��. 19'6 P, 1 '2 City of Tigard 13123$w Hall Blvd.,Tigard,OR 9 Pnrinit No.,4tV!::!0n 1-OD(u y Phone; 503 639,4171 Pax; 503.398.1960 Plan Review Inspection Line: 503.639.4175 1 Date Otlaarpermlt: Internet: WwW,d.4gard Or.ua Date Ready/B7, 7u�it a_Zl/,� ® gee Page'to, NolittedlMethed k Supplcmntal lofarmatiap_J Tr ❑,Ne w construction dal otl/altetstton/replacement Please check all that apply, -� ❑Demolition ❑Other, ©Service over 225 a s,comm'1 trap QHazardous location ❑Service over 320 amps-rating 0110ring over 1u,000 sq.ft. y of t-and 2-family dwellings 4 or more new residential 1 and 2-family dwelling ❑ConunerciaVindustrial Accessory building ❑oystem over 600 volts normnal units in one structure Lj Mulct-fatrul ❑Master builder ❑Otber, ❑Building over three stories ❑Feedeti,400 amps Of Mort ❑Occupant load over 99 pereons ❑Manufactured structures or Job no: ❑Egrem lighting plan RV park Jot)site address: �.2 ❑I4calth-caro facility ❑Other _ S W k�I he�,n¢ Subrnit 2 seta of plans wit!,any of the above CityiStata/ZIP� ; E r 0 9 7 z'� s� The above are not applicable to temporary construction service. Suite/bldg./apt.no Project mune -� Kf . Cross street/directions to job site, unenpnon thy. Pee —Total Now maidenti-1 etagle-or multi-family dwelling unit - Includas attathed gars e. _ 1,000 sq.ft or less Ia5,15 4 Subdivision: _ Lot no.: Ea.add'1500 sq.R or portion 33,40 1 Tax map/parcel oto Limited energy,residential 75.00 Limited energy,non-residential __ 75.00 2 i Each uMI.Ifactumd or rrrodular p �p ' dwelling,stTvlce tend/or feeder 11 90.90 2 -- '- - Services or feeders in,ttallatio_n,alteration,and/or relocation 200 strips m less 80,30- 2 201 amps to 400 amps 106.85 2 Name- 1`1 r -) 401 a s to 600 s 160,60 2 I f s- A re 1,000 a s 240 60 _ 2 \ddress: s fad 1E-f zz Q �dta 3 Over 1,000 strips or volts a54.65 z City/State(zl-f', r Reconnect only 2 66 83 'S of 7i�ft ifr�/1/� -S L` Temporary a-rvlcq or feeders tnat■llatloo,alt-rattan,and/or Phone: -_ r ( ) relocatloo _ OWner installation:This installation is being made on property 200■traps to less., 66 85 1 p perry that I own which is not 201 amps to 400 a s !00.39 2 intended for sale, fuaac,rent,or exchange,according to OIt9 447,449,670,and 701. Owner signahue: a01 -n a to 600 amps 133,7—75 2 Dater Branch circuits-new,literatloa,or extension,per panel --K—F,:,for branch circuits Wath Business name eenice or feeder fee,each -__ branch cirnuit 665 2 Contact name: - - B Fee for branch circuits ------ - - _ without service or feeder fee, Address: each branch circuit J 46.85 �6, S 2 - •- Clry/StatelZIp; Bach add'!branch circuit 2 y Miscellaneous(service or feedar sot intJud Phone:( ) Pax. ;( -- Putripor irritation circle 53,40 2 sign or outline lighting 53.40 2 signal circult(s)or litrtited- energypanel,alteration,or Business flame: gU011eS Ferr gc extension Describe: Paget 2 y E 1 ft,�i c _. P.0. H OX 6 2 E Per addit&pCCti en■I in action over allowable In any of the above- -city/state/ZIP, Wilsonville OR 97070 Per inspection _ - - --- 62.50 _ investigation per hour(r hr min) ;Subt.t, 62.50 phone:(.g.03) 682-4936_ Fart'(503) 6$2-7946 lndusMal !stat hour 73,75 CCB Lia_88482 Electrical Lie. 2 Suprv.Lie,; �f - ' Suprv.Electrician signature,Irequired, n-7 l 3 4 , 0 _ Plan review(25%of p"Mit fee) — Ptmtnems S Date: b ,S- p �, -~ g ( p ) 6- H�L•lion State surcharge 846 of el'retitfee 4 Authorized sipature. TOTAL PERrgrl'FEE 96 . S Thla permit applieadoa erprree If a petetlt If not obtelned within 110 Print name; days after it has been accepted at complete Fee ttuthudo)ogy set by Tri-Cennty Building Industry Service Board l uraildin vemdtal!t rp "Number of impor.ttoo6 per parmit allowed, a ffn1itAppdoe 12/03 11o�615T(l4nfYCOlWwgg CITY OF TIOARD 24-Hour — BUILDING Inspection One: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST II TV BUP Received -____ Q-to Reque te, __ 1S -_ AM __ PM_.�_____ BUP Location __._,Il �FFG __. �`�l _ - -� ��Suite— (k—E � 0(; Contact Person Ph ) Cl 9_ y Contractor_–� �' _–� -- I( �) --+�—`���G- SWR -- _ BUILDING Tenant/Owner _ ` Q 6�b © � _ ELC�I Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain ---- —------ Slab Inspection Notes: SIT Post& Beam -- - - - - --------------- ---- Shear Anchors -- - --- f_xt Sheath/Sheaf Int Sheath/Shear Framing Insulation Drywall Nailing ---- Firewall �� -- - - Fire Sprinkler �l � '� -- -- I_-_tJ I� --�.'lt1 S GYM Fire Alarm Susp'd Ceiling -- - - -- — Roof Other: - - - - -- — Final PASS PART FAIL M ---- Post& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains - --------- Catch Basin/Manhole - Storm Drain - --- -- -- Shower Pan Other. ART_FAIL CH CAL s & Beam ---- --- Rough-In -- ----- — --- Gas Line S e Dampers - ---.--- __ =ina PART FAIL F,iLECTRVAL AL Rough-In — UG/Slab Low Voltage 6SPART FAIL El Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd SITE _ ❑ Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA �1 �.Z _ InllprCtOr Approach/Sidewalk Date ---- -- Other Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - - — _ BUP Date Requested AM PM BLD _ Location_ lu Suite MEC tq y OL Contact Person - �LC�-►� _ Ph 1 D/,� PLM Contractor_ Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftq Drain _ Crawl Drain Inspection Notes: SGN Slab _ _ _ Post& Beam -- SIT -� Ext Sheath/Shear Int Sheath/Shear - -- Framing Insulation --��-- - - Drywall Nailing Firewall Fire Sprinkler i Fire Alarm Susp'd Ceiling Roof ------..._____— Misc: --------- -- .. . Final T PASS PART FAIL - - ... ---- - - - ------ ---- -- ,?LUMBING Post& Bearn Under Slab Top Out Water Service Sanitary Sewer -- Rain Drains Final ---_- --------- - --. PASS PART FAIL MECHANICAL Post&Beam ----- --- Rough In Gas Line Smoke Dampers ^ - _AAS PART FAIL. T �� ELECTRICAL -- - -- __._--- Service. -- Rough In ------_ -_ UG/Slab Low Voltage ._�----- -- -------- - Fire Alarm ' Final -- PASS PART FAIL SITE - ------------------ Ba-.kfill/Gralii ig ---__.—� Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City HPII, 13125 SW Hall Blvd Catch Basin Fire Supply Line I J Please call for reinspection RE:_ [ J Unable to Inspect-no access ADA AppraEach/Sidewalk pate —Ext Other r Inspector - �-- Final PASS PART FAIL 00 NOT REMOVE thk"s Inspection record from the job site. CITYOF TIGARD MECHANICAL PERMiT DEVELOPMENT SERVICES PERMIT#: MEC1999 00436 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/14/99 SITE ADDRESS: 11950 SW KATHERINE ST 0 PARCEL: 1 S134CD-03600 SUBDIVISION: LERON HEIGHTS NO 3 0 ZONING: R-4.5 BLOCK: LOT: 063 / JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O ADPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COAAML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE.: 50 + Hp; WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN >=100K. BTU: <. 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Installation of gas piping. Owner: — - _ FEES _ �~ FRANK BACCELL.IER Type By Data Amount Receipt 11950 SW KATHERINE ST PRMT DEB 10/14/99 $50.00 99-319092 TIGARD, OR 97223 5PCT DEB 10/14/99 $4.00 99-319092 Phone: 579-2015 – Total $54.00_ Contractor: HOLMES INSTALLATION SERVICE RAYMOND FLANDERS 33535 NW VADIS ROAD REQUIRED INSPECTIONS ___ CORNELIUS, OR 97113 Gas Line Insp Phone-647.9320 Final Inspection Reg #:LIC 00102.473 This permit is issued s-rbject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and ali other applicable laws. All work will be done in accordarice 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 OAP 952-001-0010 through OAR 952-001-0080. You may obtain ropes of t1Y6s_ riles or irect questions to OUNC -J�y calling (503)246-9189. Permittee Signature: -- _ Call (503) 69-4175 by 7:00 P.M. for inspections needed the next business day PlanC`KC#_ CITY)OF TIGARD Mechanical (Permit Application Recd®y r . 13125 SW HALL BLVD. Commercial and Residential Date Recd icy-r*(/ T IGARD, OR 97223 Date to P.E. — (503) 639-4171, x304 Date to DST Print or Type Permit# [ in/rlyil-�i✓� Incomplete or illegible applications will not be accepted Called _- Name of Development/Projed Description Table to Mechanical Code Qty Price Amt Job Street Address yr Sunek A) Permit Fee _ °' ! 16.00 Address ' C' �,✓ �' 1) Furnace to 100,000 BTU cluding ducts&vents see footnote 1,2 _ 9.65 Bldgs 2)zip in 2) Furnace 100,000 BTU+ 6 LVL incPading ducts&vents see footnote 1,2 _ 12.00 Name(or name of business) 3) Floor Furnace Owner u(e��,(� ' including vent see footnote 1,2 _ 9.65 ailing Address -- 4) Suspended heater,wall heater ��jj or floor mounted heater see footnote 1,2 965 l�1.7 .S w' ��(�N �,'��, �'.r 5) Vent not included in pliance permit _ _4.75 City/Stale _Zip Phone Check all that apply, 'Boiler Heat Air I�j For items 6-10,see or Pum Cot Price Amt Y '`y— — /L Z�l5 footnotes 1,2Com p .nd �m y Name(or name of business) _ 6)<3HP;absorb unit to __,_ __ 100K BTU _ _ _ 9.65 Occupant Mailing Address 7)3 1.5 HP,absorb unit 100k to 500k BTU _ __ 17.65 Cny/State Zip Phone 8) 15-30 HP,absorb —� - unit.5-1 mil BTU _ 24.15 Contractor Keme — 9)30-50 HP,absorb unit 1-1.75 mil BTU _ 36.00_ ��,o iV, L C 10)>50HP,absorb unit --�-- Prior to permit Melling dre ^ n >1.75 mil BTU _ _ _ j 60.15 issuance,a ropy .j .3 1-t,, Cl ✓' s /'�14 11 Air handling unit to 10,000 CFM v of all licenses cnyfstato zip Phone _ 7.00 are required if LL �r �LU Alc7, 6 Z?e) 12)Air handling unit 10,000 CFM+ expired in COT Oregon Const Cont Board Llc# Exp Date 1 1 X75 _ databasev ?Yi 0 -J"' 13)Nor."portable evaporate cooler Architect Name _ _ 7.00 14)Vent fan connected to a single duct Or Mailing Address _--- 4.75 _ 15)Ventilation systern not included in _ appliance permit 7.00 Engineer En (nCnyllate '--" zip Phone '� — �— ---- 9� —_--- e 16)Hood served by mechanical exhaust — _ Describe work to be done 17)Domestic incinerators 12.00 NBW O- Repair O Replace with like kind. Yes O No O 18)Commercial or industrial type incinerator Residential jA Commercial O _ 48.25 _ _ 19)Repair units Additional information or description of work _ 8.40 _ 20)Wood stove/gas FP/other units/clothe dryer/etc. _ _ _ 7.00 NOTE: For Commercial projects only,Units over 400 lbs require 21)Gas piping one to four outlets J structural gas oaks _ See footnote 1 _ _ 3 75 r Type of fuel oil O natural gas� LPG O electric 0 22)More than 4-per outlet(each) .75 _ Minimum Permit Fee$50.00 SUBTOTAL " I hereby acknowledge that I have read this application,that the information _ _ 8%SURCHARGE_ given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL the owner,that plans submitted are in compliance with Oregon State laws __Required for ALL commercial ermlts only TOTAL Slonature of Owner/Agent —� Date Other Inspections and Fees: 1. Inspections outside of normal business hours(mInlnum charge-two hours) $50.00 per hour ontact Person Name Phone P 2 Inspections for which no fee Is specifically Indicated (minimum rharge-half hour► $50.00 per hour Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to 1 Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour 2 Provide drawings to scale showing existing and proposed mechaniral units "State Contractor Boiler Certification required ��-------- - -- "Residential A/C requires site plan showing placement of unit 1:lmechpenn doc rev 7/19/99 CITY OF T I GA R D ELECTRICAL PERMIT DEVELOPMENT SERVICES DATE ISSUED:ED:PERMIT 3/28/02 2 00135 13125 SW Hall Blvd.,Ticiard, OR 97223 (503)639-4171 PARCEL: 1S134CD-03600 SITE ADDRESS: 11950 SW KATHERINE ST SUBDIVISION. LERON HEIGHTS NO.3 ZONING: R-4.5 BLOCK: LOT : 063 JURISDICTION: TIG Pruiect Description: Reconnect furnace and wire to new heat pump. RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS —1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT SINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI 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 SR/C OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+amplvolt: >=4 R,:_-'S UNITS: > 600 VOLT NOMINAL: L_ Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: FRANKI EACCELLIF_RI JC ELECTRIC INC 11950 SW KATHERINE 118 NW 184TH STREET TIGARD, OR 97223 RICjEFIELD, WA 98647 Phone: Phone: 360-887-7889 Reg#: SUP 4289S ELE 37-724C LIC 118452 _ FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 3/28/02 — $55.30 2720020000( Elect'I Final 5PCT CTR 3/28/02 $4.43 2720020000( Total $59.73 This Permit is issued subject to the mgulatioi s contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws Ail work will be done in accordance with approved plans This permit will expire if work is riot started within 180 days of issuance,or 6 work is suspended for more than 180 days ATTENTION Oregon law requires you m 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 obtain oopies of these rules ordirect questions to OUNC at(503) 246-6699 or 1-800-332 2344. Permit Signature: 1 Issued By: OWNER INSTALLATION ONLY i he 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 a i Inspection the next business day Mar 27 02 03: 2.5p JC Electric Inc 1 360 887 5584 P. Lj )%'17/2002 09:61 FAX 5015981980 CS'fY Of TIGAP, IJ001 Electrical Permit App"Vic. Wn ,35 .r.._.�., pennd no.:11 , � ) Litt' of Tigard " 14ojoct/stppino Esthredete' _ cfry��r;6nr,J Addmt;- 13125 SW Hall Blvd,Tigard,OR 9712? Daftfssuod. By, Receipt".: _ Phone: (503) 639-4171 _____ _ Fmr. case file no. (503)596 1960 , Paym6nttypc: (,) 1 , '. i e' Land use approval. C) 1 do 2 family dwelling or accessory U Commerctal/industnal O Multi-family l7'Tenant improvement U New construction (A Additionlaltcranon/ropincornent n Jrheu- -- u Partial Job addrvws�\\qSC� K P(1 11 't Bldp no•: Sui[e no.. Taa ma�f/lax latlaccount no. _ int 1TB—Lock: _ Subdivision' _Project name: i )N) C V Deswontlon and location of work on pramiscs: (L�t X tt(1Y;.f"\ 1 USttl_«~ 1.►�K irfllmai ed date of cam letiurt/ms tion ", '"Q; �(I`� 41!f Q n'' A WV He �* Job tint :�)tij.+ MtGt rout ao.1 -..- IUsefi�►fwa _. Ifuslnes9 nsfne: _S.� C\R\C. .� ---_-.. eq •sjt6Mart•oltl•h�y"j� Addty(tit��ji ___ tlnettlosrrhlnclu/restd°hdpraSe• City ft.1g47.ft'.L0 r5taroa 1 ZIP 1't.l�t+_S), Seeriasiaelaba c- 1000 a nor less _ a - ai'�nor nn q. . thorsof Iec CCB no.: F. Msa.tic.na:_��� `l L limited energ,ta�deMisi 1 Cit Imett Itc.na. 1C�Y� --_-_ 1{m+t.e �nrn•rsstdenusl _ 1 E"TunV(setu"A home m modufa,rwellfea 2 $ilnsruro a Mainsetnntk in trequvod) -_psto t+ Bailee rrdlor readw_ _ p P' •Net•Aieaafftftts>1tMra1 101 a st°"W", Owns Name(Pmt): Mallin�addrcss _ _ - 60l.nips rn 1000 stnpl ar 1000 runts yr volts �_v •- -- Plftmt.- _._�_ 'rT•—�, E mall: tloa+onnea� - --� setnsAewry sss+fo•e•e renden Owner inetsdlatiow The installation is being made on properly 1 own irrhUafb•,•henll e,wfnloeatloa which is nrtt intrnded for salt,tease,tent,of caohtalpe actnrQing to X00 a s ��N�� 1 ORS 447.455,4'19.670, 701. 101 a to 490amP% Owner's si aturo '-W-039—." 1 F= peltourisu•awre, Iteraden, or•trvmlws rw p•••1: _Name: A. Fan fa bn,roh citeulu with putVhue of Addrtss' _ servla or reader he.sadt brrtoh cirwR _ .— _ ---- B Pec fw brach etRulY a'�1 schwa City: -__ of, wf Mdss t Sla1C' ZIP. far first bench ciretlYt: Pb•.oe: rax: Gntcil. chaddithssltltsttslchtc5fcsit: arfrMaran )_ _� or{ni atlon circle _ ? O Service ovm US rnpe-oomrns+aial t]HeaHh cm r•cl1{ry __fN_ -- t79arviaoverJlOompsr•dngvflRl dHtr:aldoutlacation each sign ccar nn i atl —_ runllyd,vett{nS. t7 9ndMarovsr lo.tl00squwa!tees(e•ror 9iand cucuMts)"r a lYmi emtfy Pond system 0v61 600 Volo"mind ttmm m6dentlel units In one suueturo sthrsadon,or;ttetaion'— Building ovcs dune stone: ❑r-cedars,400 aropr of me on, t1trauptwthad ovrt"Persons ❑Muwr InrMstrutNmsorRvprk arertMsNo«d mart'of We, -M-s-e-: *EgmssAlpbtingpi.n to Outer. ..�,1..- snbttmit sift of pleas""ll my of The ab"e, tnvsu mom GO_._.. — Tu abifne are mot mppBable le ttlfRpo�t mPwticflom ear.lsc. ol,r �_._ ---- --- -- Permit IPPA ..... ...... 00101 trri.s.euotls•corp rndt esd.vteaar r.M Ierl 01Ata,fw mac ins—Auaa Nvtiew 1Tia permit spf+liesslnn Ilan review(at 16) f Viu U Muut^1rd within Ifo penult to not e$been R i within 110 dais ttRtt►Q ho been StatC tufrlutge(N96)...,f �•-• rwdlt ewd nsmbn __--- - TOTAL ......._ ...., S r �__y W. occupied a oompkte. Aar rw