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12369 SW King George Drive
�\ CITY OF TIGARD MECHANICAL PERMIT -
DEVELOPMENT SERVICES PERMIT#: MEC2002-00112
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/20/02
PARCEL: 2S110CC-15300
SITE ADDRESS: 12369 SW KING GEORGE DR
SUBDIVISION: KING CITY NO. 5 ZONING:
BLOCK: LOT: 007 JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O ADPL: VENT SYSTEMS:
STORIES: �BUILERS/COM,-IRESSORS i GODS:
_
FUEL TYPES_ _e 0 - 3 HP 1 DOMES. INCIN-
LII , _ 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
I IRE. DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSukE: 50 + HP:
FUP.N < 100K BTU: 1 AIR HANDLING UNITS CLO DP.YERF
FURN >=100K BTU: c- 10000 cfm:� OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Replacement of gas furnace and add A/C. 1 gas outlet.
Owner: FEES
DON FABER Type By Date Amount Receipt
12369 SW KING GEORGE DR. PRMT BLD 3/20/02 $72.50 KING CITY
KING CITY, OR 97224 5PC'f BLD 3/20/02 $5.60 KING CITY
Phone-503-639-7864 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONG
Cas Line Inst
Phooe:620-5643 Mechanical Insp
Reg #.LIC 66578 Heating Unt Insp
Cooiit Unt Insp
Final inspection
This permit is issl ed 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 fellow rules adopted in the Oregon
Utility Notification Center. Those rules are set for',h in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
Issue By: L y 1 Permittee Sigrature.4-,�
Call (503) 839.4175 by 7:00 P.M. for inspections needed the nixt business day
03/20/2002 0'3:52 5036393771
CITY OF KING CITY PAGE 02/02
I KI-C.UUNTY
SERVIaaNTER Nlechan,�ca1 Permit Application
city of King City 1�received'
-w- Permit no.1�1C�
ti +� 13 2.5 SW Hull Blvd. I'ro)=t/appl.no.: Expire date
Clackamas Tigard, OR 97223 Dale issued: By Ratxipt no.:
�lultnotnatl Phone: (503)639-1171, PAX: (503)684-7297 Care file no: s Payment t
rpe:
Washington -----
u U t , e s Land use apk,roval: Building permit no.:
l & 2 family dwelling or accessory Q Commercial/industna O Multi family O Tenant irnurnvernent
U New construction ddition/altcmtion/replacemer,t 0 Other: _
JOB SM INFORMATION COMMEkCUIL VALUATION SCIMIDULE
Job address'
hQ � [r,.i:,.ue equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials,equipment, labor,overhead,
Tax map/tax lot/account no.: �- profit. Value S
Lot: —�la lock: �ub ,u,ton "See checklist for itnporrant application information and
Project name: -� jurisdiction's fee schedule for residendal permit fee.
city/county: ' �4S �. _ ZIP: 7d__ t ' t
Descriptlon and Icxatio '`�f work oa re ses;�- t t l I r s 3 t
t a F'eelet.) Total
,sL dat�lletionrnspection: ,�� Deaa•I dou , , tiet�.Cilia Ree.Holy
tenant improvement or change of use: H1 AC:
fs exisdng space heated or condit)onedi� Yes 0 No Air handling unit CFM
Art con r "T'- (site Ian requtr ) _
Is existing space insnlatrti" 1'e, Nr, A tendon ofexist:ng AC systtm
CONTRACTOR of erlcompresso s
ILLSIness name: C_ ,�ti�jidd
' � y1L State boiler perm t no.:
�`�`- Sr � -- �� HP Toas $TUMkddress:q5�; W Flrelsmoke darnpers/duct smoke detectors
try: i1 !M�^ State:GMS ZIP: y7�3 eat ump Cs to plan required) -"
!1oneyJ Fax:.igfr�J� E mall: natal replace mac urne�
_
Including durtwork/vent liner es❑No
CB no.: &6-5-1 f1
ityime[to lie. nn : elmlocale eaters-suspended.
_ wail,or floor mounted
ame(f•!ease print) ` 0/'�_/ q- ent or ep lance o er than ace
CONTACT PERSON efrigerration:
Absorption units I1TU11I
true;: Chillers — _HP
Jdress: p d%t��- v Compmsson _HP
- Eo onmea exbomt and veatila oa:
Appliance vent
F_-mai): Dryer exhaust _
oo vpe 1 Ccs.k tcheni a27nat
hood fire suppmssion system
Exhaust fan with single duct(�baLh fannss) __�
,Uintr address;a-V Sail �lF7? G f'/ x gust system apart from heatin or AC-
9 I
- - �� �� d
T,: N G�7" SW
ZIP _-j 7 Tire piping anL�stt;- ygon(up to Outfit J)
me: � Fax: 1 E•mall: zl {/ NG Oil'
il _
ur piping ach a d done over s outlets
Proms piping i schematic required)
Number of outlets
ne: — -
--- — --.-
Other ItsW appiUnce nr equ pmeat:
Decorative flrt tlatx
TState. 21P nrcrt-type ;
___, •._dx I E-mail: oo�stage/pellet stove -
t5rher. 1 --
iiccrnt's stgnnJure.: (,� -�(/� )ale. D f7'�• C�thrr• �_
un*aietwou.icccot crWit cads pl&aac calf iurivl,cdun for mare inriml-At,on R!rmit fee......................
.:J i,tatterCard h'orur rhi.r;•r mit appltcddon Minimum fee ................S
l txrplres if a pern.:t it not obrditned
arJ numherl � ,� r_� Flan review(at — %) S
Eip,rn Wlt/tllr 18/1 dayr after it hot been ,. 89c
,tate surcharge( ).....S _—
Name Or wilhoWer ea tho-ii no cred.t card acrtpted at complete.
C•udhulderaI=nature Am
CITY OF II OA R D __ ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: ELC2002-00117
DATE ISSUED: 3/20/02
13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171
SITE ADDRESS: 12:69 SW KING GEORGE DR PARCEL- 2S110CC-15300
SUBDIVISION: KING CITY NO. 5 ZONING:
BLOCK: LOT : 0017 JURISDICTION: KIN
rProiecl Descri-fiom Electrical to gds furnace and A/C.
I ^!_RES. UNIT TEMP SRVC./FEEDER_S MISCELLANEOUS
1000 SF OR LIE.,& 0 �- 2.00 amp: PUMP/IRRIGATION:
EACI4 ADD'L 500SF: 2.01 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL./PANEL:
MANF HMI SVC/ FDR: 15501+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/0 SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ArD'L BRNCH CIRC: I IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: :>=4 RES UNITS:a� > 600 VOLT NOMINAL:—
Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC UCC: _
Owner: Contractor:
DON FABER SHARPE ELECTRIC INC
'12369 SW KING GEORGE DR, 22605 SW RIGGS
KING CITY, OR 97224 BEAVER'ON, OR 97007
Phone: 503-639-7864 Phone: 642-7937
Reg#: LIC 81518
SUP 3344S
ELE 34-2170
_ _FEES _ Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 3/20/02 $53.50 2720020000( Elect'I Final
5PC T CTR 3/20/02 $4.28 2720020000(
Total $57,78
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 952-001-0080. You may obtain copies of these rules or direct questions to
Permit Signature: ri `J t -j, Issued
Issued B
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 inFpection the next business day
s■tll��
Electrical Permit Application
— Drtereceived.] 4"' Permit
City Of Tigard Project/appl.no.: Expit a date:
Crtynf'Pigard Address: 13125 SW Wall Blvd,Tigard,OR 97223 Date issued: By:(J6 1 Receiptno.:
Phone: (503) 639.4171 —
Fax: (503) 598.1960 "fes. Case file no.: Payment type: —
Land use approval:
1-YPE OF PERMIT
�1 &2 family dwelling or accessory U Commercial/industrial Q Multi-family ❑Tenant improvement
U New construction Addition/alteration/replacement U Other: U Partial
lob address: /�t.30� j14� t✓ C p t Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: I Block: Subdivision:
Project name: 'fl !e Description and Ito ation of vacrk on premises: [j ct-'JGt i )'10 r' ! C_
Estimated date of completion/iii Lection:
CONTRACTOR 1 1
Job no: G% ,( rer Max
Business name: 5/xrpeL-le�crP_k -_1_[L�- - Description Qtv. (ea) total nu.Insp
New residential-single or multi-family per
Address: dwellinganiLIncludes:dtacbedgarage.
City: ° �� 1 t�'r►t.- later ZIP: 97c(-
Serviceinclurkvl:
Phone:Sc 3 ✓r Ljj 7?411 Fax I E-mail: 1000 sq it or less .1
CCB no.: Elco.bus. lie.no: 3q —
Each additional 500 rq.ft.or portior thereof
5 j / C i
Limited energy.residential 2
City/metro lie.no.: rj),5.3/ — Immicdenergy,nun-residential �
Tach manufactured home or mo(mlar dwelling
Si ntiture of supervise g electrician(required l Date Sen ice and/or feeder 2
Sup.elect.name(print): l.-� ` �� License no, c S ServIcesorfeeden-Installation,
alteration or relocation:
PROPIE�Iry OWNER 200;unps or Icss
201 am s to 400 am s
Name(print): .��,�l � f�-_ �_ _ P p
401 amp.;to 600 amps —
Mailing address: t '(, , t- 6�9 �'� '/y-r" / - err! ;imps to 1000 Imps —
City: Ifln (4 — Slate:(",tZIP: U/2 2 UvcrIOOOarnpcorvolts
Phone: /p_'3Y �; F'ax: E-mail: ttecomrectonly 1
Ulmer installation:The installation is being mate on property I own Temporaryservicesorfeeden-
which is not intended for sale. (case,rent,or exchange according to Installation,alteration,orrelucation:
ORS 447,455.479,670,701. .'00 amps or less 2
2nl amps to 400 amps 2
OwSI nature: vale: JUln,(,00.un+s 2
Branch&cults-new,aUeralion.
or extension per panel:
Name: A Fee for branch circuits with se purchaof
Address: service or feeder fee,cacti branch circuit ' 2
- --- —7- --------�r--
Clh cit:ttty' ZII'' ){ Fee for branch circuits without purchase /
-- - --- - of service or feeder fee,first branch circuit: 2
I'Ir ,ii I i I nail.
Each addnuunal branch cucuul.
1:0 AAA 111"11 W Misc.(Service or feeder not included):
U Sen ice ucer 2 .unps-wnumeta,d Iealth-cine lacil ty @udl pumpor irrigation circle
J lien ice over 120 amps•r,ung of I+\2 i I lazatdous location leach sign or outline lighting _ I
t,unfly dwellings J Huddmit over IIi.mo square feet tour or Sigcal+.ircuul s)or a limned energy panel.
J"'vstem over mix)vr{ts nonunal mare residential units in one structure I
J Ituddutg nverthn,e stones J Feeders,41x)amps or mitre 'Descnoti.ut
J r kcunant load s er tnr;+er,mr; -1 Manufactured structures or RV park LAch additional Inspection over the allowable in anv of the simse:—
J I rcavheinml,plan -i other __------__----
I':nuspcen,n
Submit —.vets of pians with any of the above. Insesngatran teeThe above are not applicable to temporary construction service. I c nrler
--- — Permit fee........... ;
Not.tq cep+ctedir cards,please call)unsdredon for more mtorrnatam Notice. Illy,nerrllll application --------"�"--
review(at
J vis:. J�fastcul:anl expires.t,r nenn)t is not obtained Plan rev — - --------
rredn c,ad mitithm --i----_—_--- --- r / within 180 da%s,.fitter it has been State surcharge(l' t i
rxpir's accepted as complete. TOTAL ,.
Name of cardholder as shown on credit raid
S _
Cardholder signature �� Amount 4-U)4615 rrytxl/Ct)bb
i
CITY OF TIGARD 24-Hour
BUILDING In-;pec;ion Line: (503) 639-4175
INSPECTION DIVISION Burin ss Lina. (503) 639-4171 MST
2 BLIP
Received 3��7 Date Requested �+ J _ AMPM
Location .,IoZ3 �w tt-I�J-�o cow, _Suite MEC
Contact Person
_ Ph ( -- - ---) �-j�� PLM
Contractor �l-1�Lat,+_� �c Phl---) _ �0�4-78� _ SWR - -
BUILDING Tenant/Owner ELC
Footing
Foundation Access: E LC
Ftg Drain
Crawl Drain ELFT
Slab Inspection Notes: SIT
Post& Beam -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Frarring I! — ---- - - ---- ----
Insulation --
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:_
Final
PASS DART FAIL
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service _
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL - --.. - - .. -- ---
MECHANICAL
Cogg
m --
---
S e Dampers
m _
A'S T FAIL
6LEC RIC L
Service --
Rough-In
UG/Slab -`- -
Low Voltage
Fire Alarm �_-- - -
Final Reinspection fee of$ required before next inspection. Pay at City Halt, 13125 SW Hall Blvd.
PASS PART FAIL
[� Please call for reinspection RE: — Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date _ ___ Inspeetor__� Ext
Other: _
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received , Date Requested_ BUP _
Location —1�'� 9 �at� Kt tJ22 �' '� --Suite _ MEC
Contact Person 1 q-70-L�1:63 Ph(. ) t�� —56 q 3 PLM
Contractor 9,:�tziio w
Ph( —) � - � g�� SWR
BUILDING Tenant/Owner __—.� _ _— —____—____.. ELC - �O�r
Footing —
Foundation ELC —
Ftg Drain ACC@SS: ELR —
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam — ---- _--------____-- -- _--.-__. _^_
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear —
Framing - -- --------In zulation
Drywall Nailing — t`-u- -- -�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -.........
__ ---- - ----- - ------ - .__._.. ...
Roof
Other:
Forel --------- _
PASS PART FAIL _�._--- --____ ------ ---- - ----- -- -- - ----`..___._- --------
PLUMBMNG_ —_— - -- - - _
Post& Beam
Under Slab ------------- _.
Rough-In
Water Service --- -- ------ _ _ _ -_ __. .._..._.._
Sanitary Sewer
Rain Drains
Catch Basin r Manhole
Storm Drain - --- - -
Shower Pan
Other. ---------
Final
PA:SPART FAIL
MECHANICAL
—
Post&Beam - -
Rough-In ----- - - ----
Gas line ----------- -- — __,
Smoke Dampers
Final
PASS PART FAIL - --------- --- _.-_ _
ELECTRICAL
Service — __— ___-�_ -------- - — ---- -- ---- -
Rough-In
UG/Slab
Low Voltage ------------ ---— --- ------ --
Fir larm
PART FAIL
FIReinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: — �— _ Unable tc,inspect-no access
Fire Supply Line
ADA _ •� rd
Approach/Sidewalk Date -sem. _- .— Inspector _tltt
Other:
Final -- - DO NOT REMOVE this Inspoetlon record tom tho b she.
PASS PART FAIL