10875 SW NORTH DAKOTA STREET I
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1S nowa HISON MS 51806
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10875 SW NORTH DAKOTA ST
ELECTRICAL PERMIT
-0272
C11y O TIGARD DATEIISSUED:C96-O5/O1/96
COMMU��*NgqITY DEVELOPMENT DEPARTMENT PARCEL: 1 S 134DB—OO1O1fi
SITE 31 UDWRESS d.T�.ro,1 Y7252We I�OR�1�639-4171
D KOTA ST
SUBDIVISION. . . . : ZONING:R-4. 5
BLOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . .
Project Descriptions INstalling three branch circuits.
---RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS---- -----MISCELLANEOUS ----
1000 SF OR LESS. . . . s 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5O0SF. . . s 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . s 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
201 — 400 amp. . . . . . s 0 1 st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . ,. a 0
401 — 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRCs 2 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . s 0 -----------------PLAN REVIEW SECTION---.--__.-----._.___.
].000+ amp/volt. . . . . : 0 )-4 RES UNITS. . . . . . . . a ) 600 VOLT NOMINAL. . s
Reconnect only. . . . . : 0 SVC/FDR ) - 225 AMPS. . s CLASS AREA/SPEC OCC. :
Owners ---•--------••---------•---------------------------------- FEES -----------------
.JOHN AND KATHY DORR type amount by date reept
10875 SW NORTH DAKOTA ST PRMT $ 45. O0 CJS 05/01/96 96-278817
SPCT f 2. 25 CJS 05/01/96 96-278817
TIGARD OR 97223
Phone #: 639-5037
ContTact or s -----------------------------------------------------------------------
PORTER ELECTRIC INC $ 47. 25 TOTAL
407 NW 78TH ST
------- REQUIRED INSPECTIONS --------
VANCOUVER WA 98665 Wall Cover Elect' l Final
Phone #s 503-574-1366 Elect' l Service
Reg #. . : 46678 —This permit is issued subjec, to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 far more
than iPA days. Issued By
_..._._-------------------------OWNER INSTALLATION ONLY---------------------------------
The installation is being made on property I own which is not intended for
Q. sale, lease, or rent.
OWNER' S SIGNATURE: DATES
U)
INSTALLATION ONLY----------------------------
_m SIGNATURE OF SUPR. EELEC' N» ��� s�,�Qa v_ I)PTEs
J LICENSE NO:
Call for inspection — 639-4175
Z-ommunity Develupment ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
y Tigard, OR 97223 Planck/Rec. # YL ;)7b'Hl7_ _e
Permit # E4.'-46-oaZ i
Phone (503) C-39-4171 Date Issued 5- l - 96 _
CITY OF Tit3/!RD FAX (503) 684-729'7 Issued by ch,:,, le,
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development // /� Number of Inspections per permit allowed
Address �l�P / U (0. /VQP7// 00d 7,tO/ Service included: Items Cost(ea) Sum
City/State/Zip _ 4#L Res{dentlel-par unit 40 4
I) � K.�) SW n 10aq ft or leas
or name ot1 t0 00
Name f business Use Each aMillonsl aq or
( ). -- perlion thereof _ $2600
t
Commercial❑ ResidentialLmered Energy — $2500
t✓/'� Each MemA'd Home or Mod4ar 2
lxJ
pw*NwV Barvice or Feeder Ses 00
2a. Contractor Installation only: 4b.Serb.,or Feeders
Installation,aheration,or rebcali0n 2
Electrical Contractor Ory r'r &E(/,Fl( -ZINC• 200 amps or lees see 00 _ P.
AddreANo. Q-
N 201 amps to 400 amps $80 00 2
101 amps to a00 amps $52000 2
State Zip 001 amps to low amps $180 00 2
PhoneOver 1000 amps or volls $14000 2
Contractor's License No. 317 3 3 y C Reconnect or*y sw on
Contractor's Board Reg. No. L 4 :z8 4c.Temporary Servicso or Feeders
Installalron,nNera:.jn,or relocation 2
Signature Of Supr. Elec'n.( 200 amps or We woo 2
? 11 Phone No.S•+ 201 amps l0 400 amps $75 00
License No. �, D �f 401 amps to 000 amps $10000
rver 000 amp to 1000 voNe
2b. For owner Installations: ase'b'above
4d.Branch Circuits
Print Owner's Name Naw,alteration or exlenaion per panel
Address a)Tho fee for branch circuits with
CI State ZipPW94080 at rrrks or foeda M. 2
ry _ _ Eads branch dreuit $500
Phone No. _ b)The fee for Manch c+rcuis WthouI
The installation is being made on property I own which is puletwee or owvka r. tftedler tie.. DO 2
Fish Manch
not intended for sale, lease or rent. b :3500
Each stat�onmt rvtl Manch drwil $600
Owner's Signature 4e. Miscellaneous
(GorAce or leader not included) 2
3. Plan Review secHon (If required): Each pump or Irrigation cirde -- $4000 -- 2
Each sign or oulfire lighting $4000
Signal cimuil(s)or a IimiNd energy 2
Please check appropriate Item and enter fee In section 58. penal,aNeretion or eeaneion !_ $4000
_ 4 or more residential units in one structure Minor LntwM 110) _ $10000
IIS. —Service and fowler 225 amps or more
LY -_--_-�System over 600 molts nominal 4f.Earh additional Inspection ovr,r
Classified area or structure containing special occupancy the allowable in any of the sloe e
as described in N.E.C.Chapter 5 Per inspersion $35 00Per hen $5500
In Plant $5500
J Sl llroll 2 sets of plans with application where any of the above --�
ED app,.. Not required for temporary construction services. 5, Fees:
a iia. Enter total of above fees $
W NOTICE 5%Surcharge(.05 X total tees) $
.a
P=RM TS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
A�,THORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Sb.Enter 25%of line A fnr
CONS I-RUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Soc 3) $ _
It PEFIIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account A $
Balance Due $ ,
.pdV.ondrNWtpm t<q
ELECTRAXAL PERMIT
CITY OF DATE �lr,IGARD PE.RrAll- C-1-cu -01-1
lisuD: 03/cl/9c
COMMUNITY DEVELOPMENT DEPARTMENT
IJ125 OW H&N Blvd.Tlgjird,Oregon 9722398199 (503)ON 4171 rARCCL: Inl"7413r, 00100
. . ; I Q11175
ZONrNG,.R 4. 5
LOT. POOR QUALITY ORIGINAL
WjVLL DeSCI,ipti0l): V'ir'St 1, Additional branch circuits
[JC3E 4,_.A
1D 1'� , L UNIT—— - TL11( SRVC/FEEDER,") --MISCELLANEOUS-
, 'oo Sr or Lr_00. . . . 0 0 L,200 amp. . . . . . . 1 0 rUMP/IRPICATION. . . . . 0
LAC14 ADD' L 55001-1F. 0 201 400 amp. . . . . . . : 0 SIGN/CUT LINE LTG- : Q,
L.TMITED ENCROY. . . C 401 600 amp. . . . . . . a 0 SIGNAL/PANEL. . . . . . . : 0
')Nr. 14M/ CVC:FDR 0 60148Mpq -1000 volt 1;- 1 0 MINOR LASEL ( 10) . . . . 0
— OrRv I Cr7/1'[-:CDC CIP::UITS ADD" L INSrCCTION7
C20 eAmp. . . A . . : 41 wmnvic— OR FEEDER: o r,'-R INCPECTION. . . . . : 0
.131 400 Ani p. . . . . . S C, Iiit W/O 13""RVC On FDR. . I r5cr I IOU R. . . . . . . . . . . .. 0,
"iii EA AAD' DRNCH CIRC: 2
GOO amp. . . . . . 3 0 ICJ PLANT. . . . . . . . . . . 0
11 1000 amp. . . . . : 0 REVIEW SCCT'A0N ----
,300+ amp/volt. . . . .:. 0 =4 RES UNTTS. . . . . . . . i ) 600 VOLT NOMINAL. .
aconnec.t 0 OVC/FDP ) z2c AMPS. . -. CLnSS AREA/SPEC
4ners ____.____' _ ... . - .. ..-__-__1. - rEC3
,IHN AND KATHY CORR type amount by date I-Ncpt
N LION 03/ 1 '96�296277,2*8y,"
.17n ��W NORTH DAKOTA S T PRMT $ 45. 00
tON 03/211 /16 r
!3PCT t '3 r, C .
On 972.2- 3
one
'O!._L0 CL.CCTRIC 47. 215 TOTAL
S
4�.-'ND AVE
REQUIRED INSPECTIONS
ON 0712,'73 Ceiling Covet- r1ectl 1 S(#,-vi(:e
'Julie #s Wall Cover EleLt' l Final
is issued subject to the regulations contained in the
.lard Pzicipil Cade, State of Ore. Specialty Lades and all al.hir ni, L
adplicat;e lams. All work will be done in accordance P.1th
appi-DWed plant. This pernit mill expire if work is not starteJ
'hin 130 days 7r iisliance, or if work is sjspFrded for aor-
TN73TAL.L11T1CN ONLY,
L ie installation is being made or, -( operty I own which is not ' intondod for
OIGNATURt.7.-
CONTPACTW THSTnLLOTTON ONLY
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Call for inspection —., 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. r�
Tigard, OR 97223 Permit # LC
Date Issued
A. Phone (503) 639-4171
CITY OF TIQARD FAX (503) 684-7'297
TDD No. (503) 684-2772
Inspection (503) 639-4175 _ Y_
1, Job Address: 4. Complete Fee Schedule Below:
Name of Development --__ __ Number of Inspections per permit allowed
Address 0715—,7r�� �j Service included. Items Cost(ea) Sum
City/State/Zip^ t l 15!A-�'� _1 l& --1-1—zz- 4a. Residential • per unit
T-- 7 1000 sq, R. or less $110.00 A
Name (or name of business)_ Each additional 500 sq ft M —
portion thereof $2500
Limited Energy $25.00 1
Commercial ❑ Residential Each Manufd iMrna or Modular
Dwelling Service or Feeder S".00 2
2a. Contractor,installation only:
/t� 4b. Services or Feeders
J /� Installation,alteration,or relocation
Electrical Contractor r O(.�-�� e- l /C 200 amps or least Seo 00 2
Address < 2cf e^-ns to 400 emps $e0 00 --- 2
A01 amps to am emps $120.00
City State If.. zip 801 amps to 1000 amps A-- $150.00 2
Phone No. n over 1000 amps or volts $340.00 2
Job NO. Reconnect only --- $50.00 2
contractor's license NO. - 4c. Temporary services or Feeders
Contractor's Board Reg. No. Installation,alteration,or relocation
200 amps or less 2
Signature of Supr. E ec � -- - z
License No. 4 7 Phone 201 amps to 400 amps �— $50.00
401 amps to I=amps $75.00 2
Over 000 amps to 1000 volts $100.00
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner"3 Name— _ Now,anwation or extension per pane
Address a)The fee for branch circuits with 2
-- -- purchase of swvfcs or hada-Iles.
City_-----.___-- State ZiPEach branch Grcidl _ $500
Phone No. b)The lee for branch cimunst wlfhetrf
purchase of servles or Medar hs. 2
The installation is being made on property I own which is °�- z
Fbranch cal branch
hc � $ 500
not intended for sale, lease or rent. Each additional branch cun $ss 00 '
Owner's Signature___ __ 4e. Miscellaneous 2
(Service or feeder not included)
Each pump or lrrtgallon circle $4000 2
3. Plan Review section (if required): Each sign or outline lighting $4000
2
Slgnel chcult(s)or■Iknited energy
IL
Please check appropriate Item and enter fee In section 68. panel,anereflon or extension $4000
4 or more residential units in one structure Minor t ehels(ro) $1013,01) _
1—^ _Service and feeder 225 amps or more 4f. Each additional inspection over
U) _ —System over 600 volts nominal
_ Classified area or structure containing spacial occupancy the allowable In any of firs above
as described In N.E.C. Chapter 5 Per Per hour hourinspion $35 00
J _— 555.00
In Plant � 'S55 tN1
Submit 2 sets of plans with application where any of the above
Wapply. Not required for temporary construction services. 5. Fees; 0�
1 6a. Enter total of above fees $
NOTICE 5%Surcharge (.05 X total fees) S
Subtotal
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 6b. Enter 25%of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review If required (Sec 3) _
CONSTRU(:TION OR WORK IS SUSPENDED OR A13ANDONED FOR Subtotal
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. ❑ Trust Account#
r.m.� $ �5
Balance Due t Y7
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 8W HsN Blvd.Tigard,Oregon 97223.6199 (603)630-4171 MECHANICAL
PE RMI T'
PERMIT #. . . . . . . s MEC95-0012
639-4171 DATE ISSUEDs 01/11/95
PARCEL.- 161;:41!6-0121100
Lji l E 1ADDRESS. . . : 10(:1!5 !: W NORTH DAKOTA ST
SUBDIVISION. . . . : ZONING- R-4. 5
BLOCK LOT. . . . . . . . . . . . . .
---------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT FLOOR TURN. . . . : EVAP COOLERS:
TYPE. OF USE. . . . sSF UNIT HEATERS— s VENT FANS. . . s
UCCUPANCY GRP. . R3 VENTS W/O APPI_: VENT SYSTEMS:
SJUNiE5. . . . . . . . : I BOILERS/COMPRESSORS HOODS. . . . . . . .
FUEL TYPES---------______. 0-3 HP. . . . : 1 DOMES. I NC I N:
: /GAS/ELE/ / 3-15 HP. . . . : COMML. INCIN:
MAX INPUT : DTU 15-30 HP. . . . : REPAIR UNI1-9:
F 1 HE DAMPERS?. . : 30--50 HP. . . . s WOODSTOVES. . s
GAS PRESSURE. . . : 50+ HP:.. . . . . CLO DRYERS. . s
NO. OF UNITS-------- -- AIR HANDLING UNITS OTHF R UN I TS. s l
FURN ( 100K FTU: 1 <= 10000 cfm: GAS OUTLETS.
TURN )=100K BTU: > 10000 cons
Idem ar-k s : INSTALL NEW GAS FURNACE & O I R CONDITIONER WITH DUCT WORK OWNER TO I IVIS 1 A
t-L
I HE NEW WATER HEATER
Owner-: ---- - ._.__.________.____________.___---________.____ __._._-- FEES
JOHN DORR type am-),ant by date r•ecpt
10875 SW NORTH DAKOTA ST PRMT f 28. 50 JG 01/11/95
5PC1' S 1. 43 .TG 01/11/95 -
T IGARD OR 97223
Phone #: 639--5037
Contractor: ----------------------------__-
MORRIS HEATING AND A. C.
'4bb9i S. MCCORD ROAD
ui4E60IV Ll I Y OR 97045
Phone #: 655-5616 t 29. 93 TOTAL
Peg #. . 73184
IL - - ----- REQUIRED INSPECTIONS ---------
This permit is issued subject to the regulations contained in the Gas Line Insp
v1 Tigard Municipal Cnde, State of Ore. Specialty Lodes and all other Mectlanical Insp
applicable laws. All Mork will be done in accordance with Final Inspect i ort
approved plans. This permit will expire if work is not started
M within 180 days of issuance, or if work is suspended for more
0 than 180 days.
IN
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c:rmittee .�-i nat�_r-e
s 1_t a(d 13 :
.511 tut- inspection - 639--4175
City of Tigard MECHANICAL PERMIT Planck/Rec. # _
13125 SW Hall Blvd. APPLICATIOI a' Permit # _
Tigard, OR 97223
(503) 639-4171
Description
C . /-If�,' Table 3A Mechanical Code OTY PRICE AMT
Job ! e �s��, 1) Permit Fee -0- -0. 10.00
Address aa
2) Supplemental PerMh 3.00
umwe to 100.000 U I Um
�} Q� 1) incl. ducts&vents 6.00
Furnace 100,000 BTU+
Owner 2) Ind.ducts 6 vents 7.50
- Floor Furnancis
3) Ind. vent 6.00
5UsF*ndi2 heater,wall
ea — --
4) or floor mounted heater 6.00
Vent no i .in
Occupant J A
P 5) appliance permit 3.00 r
DO r of heating,ro ng.
6) cooling,absorption unit 6.00
-- —'— Boiler or com Tp ap"C�ump,a_w cor.'
7, to 3 HP;absorp unit to 100K BTU 6_00
oar or comp, a pump,air cond.
8) 3.15 HP;aosorp unit to 500K BTU 11.00
Contrat:tor or comp, a. pump,err , T
L 9 � 9) 15-30 HP;absorp unit.5.1 mil STU 15.00
Boiler or comp. a pump,arr co
7= 10) 30-50 HP;absorp unit 1-1.75 ml BTU 22.50
hereby ac ow ge a ave rea is'app ic`lTt�ie i er or comp, a pump,air cond.
information given is correct,that I am the owner or authorized agent 11) >50 HP;absorp unit 1.75 mil BTU 3750
of the owner,that plans submitted are in compliance with State Air ian ing uni V_ r
laws, that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air haniTing unit
please give reason below.) 13) 10,000 CTM+ 7.50
--Bonn portable`
141 evaporate coder 4.50
, Vent fan cornet ed
15) to a single duct _ 3.00
l enu a0on system no
/ 16) Included In appliance permit _4.50
o sery a
17) mechanMal exhaust 4.50
escri work nave—Q••-a ion(i aeration repair U Commercialor industrial `
to be done residential non-residential 0 18) type incinerator 30.00
Existing use o - Other i.e.,wo5aslove,water -
CL building or property 19) heater,solar,clothes dryers,etc__ 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
U) building or property
J 21) More than 4-per outlet
Type of fuel - nil Q natural gas ifLPG Q electric Q
Minimum Fee$25.00 SUBTOTAL
W -
J PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DA'✓S,OR 5X SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED. -'
TOTAL
Special Conditions_ -- - -- -'--�_ ---�—--
Date Issued by
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