12240 SW KATHERINE STREET I
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CITY O F T I G A R D MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : MEC99-0321
DATE ISSUED: 08/06/98
PA"!CEL: 2SI03BB-10500
'EjITE ADDRESS. . . : 12240 SW KATHERINE ST
SUBDIVISION. . . . : YE OLDE WINDMILL ZONING: R-4. 5
BLOCK. . . . . . . . . . . 1-0-r. . . . . . . . . . . . . :V125 JURISDICTION: TIG
-------------------------------------------------------------- --------
CLASS OF WORK. , :OTR FLOOR FURN. . . . : 0 EVAP COOLERS; 0
TYPE OF USE. . . . :SF L)NI' HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R'3 VENTS W/O ADPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS) HOODS. . . . . . . : 0
FUEL TYPES--------,------ 0-3 11P. . . . - I DOMES. INCIN: 0
:ELI-' 3-15 HP. . . . : 0 COMML. INCINi 0
MAX INPUT: 0 BTU t5-30 HF-,. , . . : 0 REPAIR UNITS: 0
FIRE DAMPERS'). . : 30-50 HP— : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50* HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS---------- AIR HANIA-1Nr UNITS OTHER UNITS. : 0
j7jj'0—kI ( 100K BTU: 0 10000 cfm: 0 GAS OUTLETS. : 0
I
FURN ) =100K BTU: 0 > 10000 cfmc 0
Remarks : Installation of I a/c unit, must comply with standard setbacks.
Owner: FEES
SINHA, RAVI & SARI S type amount by date recpt
12240 SW KATHERINE PRMT $ 25. 00 DEB 08/06/98 98-308079
TIGARD DR 972213 5PCT $ 1. 25 DEB 06/06/98 98-308079
Phone #:
Contra-:tor:
BELL HEATING
(GREG MILLETT)
15550 SE PIAllA AVE 26. 275 TOTAL
CLACKAMAS OR 97015
Phone #- 656-11.84
Reg #. . : (AOOOOO
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Spe-ialty Codes and all other Coolirg Unt Insp
appliCdbl@ laws. All work will be done in accordance with Final Inspection
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 952-88I-0010 through OAR 952-88I-8888. You may
obtain copies of thirse rules or direct questions to OLINC by calling
J"'ItC)
1. SSPermittee Signature :
Ua L- 7
..............4.........................................4.................144......4
Call 639-4175 by 7:00 p. m. f,.)r inspections needed the ne,4t business day
.....................................I.......................4-++4........4.......
ns 29/98 FRI 10;05 FAX 503 598 1960 CITY OF TIGARD 14 003
Plan Che
r:l"Y OF TIGARD Mechanical Permit Application Recd B:,l �
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P E. ____
Date
(503) 639-4171, x304 Permit#t /
#
Print or Type Called
w
incomplete or illegible applications i0will not be accepted
Nam.ulow.
b 2. D '5'cr / Table 1A Mechanical Code -_ _ QTY r P10E AMT
Job Street Address 1� suite# A) Permit Fee 0- -0- 10 00
Address -- -- - -
Sidg# Clty/State zip 1.) Furnace to 100,000 BTU 6.00
including ducts a vents
Name(or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner V/ Including ducts&vents
Melling Add,m 3.) Floor Furnace 6.00
/ 2-10(61 F/U'Lr14- Including vent
CRyrstate zip rnone 4.) Suspended heater,wail haater 6,00
v 5,17-) 3 70 or floor mounted heater
rName(or name of business) 5) dent not Included In appliance permit 3.00
Occupant Mailing Ad s 6.) Boller or comp,heat pump,air Gond. 6.00
to 3 HP;absorb unit to 100K Bt T•"
CAyrsta ,�, zip Phone 7) Boller or comp,heat pum alr
3.15 HP;absorb unit to 500K BTU**
-fJ.me 8.) Boiler or comp,heal pump,air Gond. Do
Contractor ,�� 15-30 HP;absorb unit.5-1 mil BTU"
Prior(,permit Meiling Address 9.) Boiler or comp,heat pump,air cond. 22.50
issuance,a copy m )014-714 30-50 HP;absorb unit 1-1.75m1 BTU'*
of all licenses CRyrstet0� zip P one 10.) Boller or comp,heat pump,air cond. 37.50
are required If `'J""' >5011P;absorb unit 1.75 frill BTU" -
exp, ad in COT Oregon Const.Cont.eoerd OL-0 F Dat 1 ;.) Air handling unit to 10,000 CFM 4 50
database _ U �O
;architect NOW 1Z) Air handling unit 7 50
_ 10,Uu. -TM,
or MailingAaD,ea. 13.) Non-portab., -vaporate cooler 4.50
Enelneer City/State 21p Phone 14.) Vent fan conneced to^single duct _ 3.00
De:..-dbe work New O Addition O Alteration O Repair O 15) Veotllatlon system not included 4.50
to be done Residential O Non-residentlei O In appliance permit
Additional Description of work: 16.) Hood served by mechanical exhaust 4.50
17.) Domestic incinerators 7.50 �~!
Existing use of ~�^ 18.) Commercial or Industrial 30.00
building or property � _ e incinerator - -- - q 50
19.) Repair units
Proposed uee of 20) Wood stove 4 50
i
building or property `-- 4.50
21 ) Clothes dryer,etc
22.) Other units 4.50
TypeofIuel-oilO naturalgas0 LPOO electric
1 hereby acknowledge that I have read this application,that the Information 23.) Gas piping one to fo.ir outlets 2.00
given Is correct,that I am the owner or authorized agent of _ 50
the owner,that plans submitted are In compliance v,ilh Oregon State laws 24.) More than 4 per outlet(each)
9lgneture of O vir/afll�gant / /l. ( Date 'SUBTOTAL [+
AV 6°h SURCHARGE /
Contar.,t Person Narra Phone PLAN REVIEW-25'/-OF St1BTOTAL
Required for all commercial ermits on .TOTAL
'N""mum permit fee is$25+5%surcharge
**Residential A/C requires site plan showing-placement of unit.
I:Vr echprmt.doc rev 4115198
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CITY OF TIGARD ELECTRICAL. PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98--0452
13125 SW Hall Blvd., Tigard, OR 97223 (503)639 4171 DATE ISSUED: 08/04/98
PARCEL: 2S1L13BB-10500
SITE ADDRESS. . . : 12240 SW KATHERINC ; 1
SUBDIVISION. . . . :YE OLDS WINDMILL ZONING:R-4. 5
BLOCK. . . . L_OT. . . . . . . . . . . . . :02`, JURISDICTION: TIG
Project De scr:.pt ion: Add two (2) branch circuits to an existing single family
dwelling.
--RESIDENTIAL UNIT-- — ---'TEMP SRVC/FEEDERS---- - --- -MISCEI_LAIJEOUS----
1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201. - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
----SERVICE/FEEDER---- ---—BRANCH CIRCUITS----- ---ADD' L. INSPECTIONS-----
0 — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
20.1 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . „ . . . . = 0
401 — 600 camp. . . . . . : 0 EA ADD' L_ BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 — 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION----------------
1000+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR )= 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: -------------------------------------------------------- FEES
SINHA, RAVI & SARI S type amount by nate recpt
12240 SW KATHERINE PRMT $ 40. 00 BEO 08/04,"98 98-307993
TIGARD OR 97223 SPCT $ 2. 00 GEO 08/04/98 98-307993
Phone #:
Contractor: ---------------------------------
PHOENIX ELECTRIC CO $ 42. 00 TOTAL
7379 SW TECH CENTER DR.
---- -- REQUIRED INSPECTIONS --
TIGARD OR 97223 Elect" l Set-vice
Phone #: 684-3600 Elect' l Final
Reg #. . : 000522
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Sts-t! of R,•egon 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 188
days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-881-9818 through OAR 952-881-1987 ou may obtain a copy
of these rules or direct questions to OUNC by callin 5831246-1987.
Permittee Signature : Issi_ied By.
--------------------------OWNER INSTALLATION ONLY------____------____------_.___.._-
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURES DATE:
INSTAL1_0T'ION
SIGNATURE OF SUPIR. EL..EC' N: _d"'7,LL _ DATE:
L I CENSE NO:
i+.++++++++.+++.+++++++++++++++++,}++++++.+'F+++++++++.++++++++4+++++++i.+++++++++..
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
.....+++ti.+++i.++++,}+.+++f+f+.++f++f+++4-. .+.++++t i......+++-F+-F.....F+++++++f ++++-i +4
AUG-04-98 TUE 11 32 AM PHOENIX ELECTRIC CO FAX N0, 1503684361' P, 02
CITY OF TIGARD Electrical Permit Application Plan Chock N�
13125 SW HALL BLVD. peed By
TIGARD OR 57223 //1 Date Recd
Phone (503)639-4171, x304 )CF�tI/� ���1 1/ Date to P.E.
Print or Type Date to DST
Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit NEG-C Q-
Fax (503)684-7297 Called-
1. Job Address: 4. Complete Fee Schedule Below:
NamA of Development If (..1G P E C4 AIPW e I � S Number of Inspections per permit allowed
t
Name(or name of buslness) c� �r� Service included; Items Cost Sum
Address ) SLS •t�� _ 4a. Residential•per unit
CI /State/TJ �� Each
additional
d M.or less $1,10.00
y
ty p - Each q.M.oh less
500 sq.IL or
❑ ResidentiafA.l portion thereof s25.00
Commercial Limited Energy 525.00
Each MHomo or Modular
J Dwellingng Se Sery+ce or Feeder x68,00 z
2a• Contractor installation on y:
(Anach copy oI
f a I current licensee ns servleea or Feeders
Electrical onlraetOr c� T nstallation,alteration,or relocation
1 200 amps or less 560.00 2
Address 201 amps(0 400 amps 580,00
City c __r 1 e p 401 amps to 600 amps 9120.00 2
Phone No`. �. ���.. a 601 amps to 1003 amp" $IW.00 2
Over 1000 amps or volts 5340.00 2
Job No- — Reconnect only $50.00
Elec.Cont.Lice.No. - xp.Date 2
.
OR State CCB Reg. NC —Exp.Dat9 4c.Temporary Services or Feeders
COT Business Tax or Metro No.__ Exp.Date Installation,alteration,or relocation
200 amps or less S50.00 2
Signature of Supr. Elec'n v 201 amps to 400 arrps $75,00 2
401 amps to 600 amps _�. $100.00 2
Over 600 amps to 1000 vol(;,
License Nc e4 �O� Exp.Date see"b"above.
Phonn Nr � � _ __.
- td.Branch Circuits
New,alteration or ertenslon per penal
2b. For owner installations: a)The lee for branch circuits with
purchase or service or
Print Ov.nees Name leader fee.
Address, Each branch circuit __ 65.00
b)The fee for branch circuits
City _ State _ ?Jp_ without purchase of
Phone No. service or feeder No,
First branch circuit _1_ $35.00 �!� 2
The Installation is being made on property I own which is not Each additional branch circuit �_ $500 2
intended for Salo, lease or rent. 4e.Miscellaneous
(Service or fsedsr not Included)
Owrines Signature Each pump or Irrigation circle ^� $40.00 _�,_ 2
Each sign or outline lighting 840.00 2
3. Plan Review section (if required):' Signal circult(s)or a limited snarg„j
panel,alteration or Mansion 940.00 2
Please check appropriate item and enter fee In section 5B. Minor labels(10) $100.00
_ 4 or more residential units in one structure 4f.Each additional Inspection over
Sarvieo and feeder 225 amps or more the allowable In any of the above
System over 800 volts nominal Per Inspection $135.00
Classified area or structure containing special occupancy Per hour 11169,00
as described In N E C.Chapter 5 In Plant $5500
Submit 2 seta of plans with application where any of the above apply, S. Fees
Not required for temporary corlstructlon services, ba.Enter total of above fees S T
8`/.Surcharge(05 X total fees) $
NOTICE subtotal S
Sb.Enter 25•r.of 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review I r ra r (See.3) S
NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR WORK subtotal 8
IS SUSPENDED OR ABAf-'DO?.c.0 FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK It;COMMFl`;(.ED Trust Aceounl if
Total balance Due j
1109t61ELC90 APV Aw gilt _
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 —
r _ BUP
lol Date Requested - - AM� PM BLD
Location �� L7 l/�-) y �. eMEQd �
n
Contact Person —_ Ph LM
Contractor _ _ Ph SWR
BUILDING - Tenant/Owner 1/��1 ELC
Retaining Wall ELR _
Footing Access: i
Foundation /�D� � • i1�� q` ' L FPS -----
Fig Drain /� t-C �.� /' l yj1
Crawl Drain Inspecticn Notes: SGN _
Slab _ --- -- --- SIT
Post& Beam �-
Ext Sheath/Sheer
Int Sheath/Shear
Framing
Insulation c
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final __—
PASS PART FAIL - ----- -
PLUMBING
Post&Beam -- -_. -
Under Slab
Top Out -- - -- - -
Water Service
Sanitary Sewer
Rain Drains
Final -
P . FAIL
JAE-CMANICAL
Rough In
1�7
as me —
Se Dampe
Final - — --- --- - -
J i,S PART FAIL
Rough In
UG/Slab
Low Voltage
Fire Alarm
A PART FAIL
STM
Backfill/Grading
Sanitary Sewer
Storm Drain ( j Reinspection 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 Date --- '�_ Inspector Ext
Other ---
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-1171
BUP _
-
Date Requested_ _7 AM PM _ BLD
Location 17- 2, cS66' 6AJ,t. Z _- Suite 'MEC
C:nntact Person Ph PLM_ — —
Contractor _ .� _ Ph Cl' SWR
BUILDING -�� Tenant/Owner j ''r'�� EL.0
Retain —-L ELR
Footing Access FPS
Foundation
Ftg Drain --- SGN —
Crawl Drain Inspection Notes.
Slab _ -_—---- ...---- -- - SIT --_
Post&Bearn
Ext Sheath/Shear ----- - - - -
I..t Sheath/Shear
Framing -- — -- -- —_-�-- --- ----- ----
Insulation
Drywall Nailing
Firewall
- ---(� ,
Fire Sprinkler --
Fire Alarm '
Susp'd Ceiling
Roof
Misc --- -- - ----- ---- ------
Final - `-- -
PASS PART FAIT_ ------- ------- _ - ---__. -
PLUMBING _-- _ _-.___—_.-------._-- -----_.
Post & Seam --
Under Slab --- --
Top Out
Water Service -
Sanitary Sewer
Rain Drains _— -- ---- ----- ._.._.. -- -
Final
PASS PART FAIL.
MECHANICAL
Post&Hearn
Rough In
Gas Line -
SRIOke Dampers
-
Final
f ASS PART FAiL
ELECTRICAL
Service -
Rough In
UG/Slab
Low Voltage
Fire Alarm _-- ------.-
Fin�a-T-
PASS PART FAIL ------
SITE
-SITE
backfill/Grading � ------- ---------- -_--`-__----- __-.--
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$— required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ,r�ninspect- no access
Fire Supply Line
able to ns lose call for reinspection RE: -_______ �'1� p
ADA All
Approach/Sidewalk �`� S? R Ins actor d-�� F Ext
[nate
Other - L___._ . p
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.