11680 SW NORTH DAKOTA STREET-1 1S fiO)ida HIHON MS 09916
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11680 SW NORTH DAKOTA ST
CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
PERMIT M. . . . . . . c MEC98-0459
13125 SW Flail Blvd.,7798id,OR 97223(503)63941;+ DATE ISSUED: 10/12/98
P14RCEL: 1 S 134CA--0349"i
SITS ADDRESS. . . : 11860 SW NORTH DAKOTA ST ZONING: R-4. 5
SUBDIVISION. . . . : BURLWOOD NO. 2
BLOCK.. . . . . . . . . . : LOT. . . . . . . . . . . . . :007 JURIl3DICTION: ---
____ -------------------
CLASSOFWORK. . :ALT — — FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :k3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL_ TYPES-----------'-- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
-GAS 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS% . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : i
FURN ( 100K BTU: 0 (= 10000 cfim: 0 GAS OUTLETS. : 1
FURN ) =100K BTU: 0 > 10000 cfms 0
Remarks: Installation of gas tirtplace insert.
--- FEES ----•----------
JILL C GOODHOUSE type amount by date recpt
11860 SW NOR•rH DAKOTA PRMT ! 25. 00 DLH 10/12/98 98-309924
! 1. 25 DLH 10/12/98 98-309924
TIGARD OR 97;'23 SPCT
Phone M: 590-2703
Contractor: ----------------------_--
JOSEPH FETTERS ____
-------------
THE FLUE BUG
3540 SW EASTWOOD PL_ ! 26. 25 TOTAL
C RESHAM OR 97080
Phone #: 667-9019
Reg k. . : 52104 _ _
_--- — RE@UIRED INSPECTIONS -- .----
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical I n s p
applicable laws. All Mork will be done in accordance with Final inspection
a approved plans. This permit will expire if work is not started
within IN days of issuance, or if work is suspended for more
N than 198 days. ATTENTION¢ Oregon law requires you to fallow rules
adopted by the Oregon Utility Notification Center. Those rules are !�
set forth in OAR 952-881. 818 throu,h OAR 952-81•-t898. you BAY
m obtain copies of these rules or dirrA questions to QUC by calling
15831246-9187. ----
W
J
Issue By: A0 _.__ __ Permittee Signature
+++++++++i•++++++++++++++++++++++++i-+++++++++++++++++++++++++f+++++.•++++++++++++
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
++++++++++++++i•+++++++++++++++++++•1•++++++++++++++++++++++++++4+.•1++++++++++++++
CITY OF TIGARD Mechanical Permit Application Plan Check t, _
PP Recd By
13125 SW HALL BLVD. Commercial and Residential Date Ree'd
TIGARD, OR 97223 Dstp to P.E.
(503) 639-4171, x304 I D&Wto DST
Print or Type j #&C-g:
Incomplrte or Illegible a plications will not be accepted Cam —
Name of Developnent/Proled Description -
Table 1A Mechanical Code (h PdrA Amt
Job Street Addr°es — Rea A) Permk Fee 10.00
Address p S 1) Furnace to 100,000 BTU
/ /A Including ducts a vents 8.00
eldgN cRy/staie Z4) '_.t 2) Furnace 100,000 BTU+
CJ7J including ducts it vents 7.50
Name(or name of business) 3) Fhor Furnace
Owner J 111 G 16 oe dAincluding vent 6.00
Mailing Address 4) Suspended heater,wall heater
or floor mounted heater 6.00
/��'3 5) Vent not Included In appliance permit
CM tale zip phone
Q 3.00
I ✓j Q+� % v.Z70_5 CHECK A!L •Boiler Heat Air
Name name or bus sa) — THAT APPL`/: or Pump Cond Qty Price Amt
i II i G. dh u crNn -
8)<3HP;ebsorb unit to
Occupant Melling Address 100K BTU _ _ 6,00
r4 4) S Id r� `A ( 7)3-15 HP;absorb unit
CRY/ ale zip Phone 100k to 500k BTU 11,00
;7-a GJU_Z p�� B)15-30 HF_absorb
unR.5-1 mil LiTU 15,00
Contractor ° i 9)30-50 HP;acsorb
unit 1-1.75 mil B):l _ 22.50 _
Prior to permit Mailing Address —_ �� 10)>50HP;absorb un'
issuance,a copy 37
ole - � u ' >1.75 mil BTU 37.50 _
of all licenses fns // zip hone 11)Air handling unit to 10,000 CFM
are required If i ye.5 H d l�r�. 6 S -}fit j 4.50
expired in COT OregonC° et.cons a rd Lk.N Exp.Date 12)Air handling unit 10,000 CFM+
database_ J Z Z y
— — _ 7.50
Architect Nan- 13)Non-portable evaporate cooler
_ 4.50
or Melling 4ddruss 14)Vent fen connected to a single dud
3.00
15)Ventilation system not Included in
Engineer CRY/State zip Phone a pliance permit _ 4.50
16)Hood served by mechanical exhaust
Describe work to be done' 4.50
17)Domestic incinerators
New O Repair O Replace with like kind: Yes O No O _ 7.50
Residential O Commercial O 18)Commercial or industrial type indroerator
30.00
Aoqitional infom a:! c,description of work: 19)Repair units
20)Wood stove —4.50
P44 ct 1 N SQ
(� / 21)Clothes dryer,etc. _
1Z _ 4.50
Type of fuel: o110 natural gas LPG O electric O 22)Other units
_�. - ----- 4.50
I hereby acknowledge that I have read this application,that the Information 23)Ga.t piping one to four outlets
J given is coned,that I am the owner or authorized agent of 2.00
m_ the owner,that pians submitted are in complianoe with Oregon State laws 24)More than 4--per outlet(each)
W Signature of CWnerlAgqpt Date
` Minimum Perm!(Fae:25 SUBTOTAL
5%SURCHARGE
ontact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
Required for ALL commercial permits
�J ✓ V d D��GZ�S/� j �3y '1 7 D 3 TOTAL
*State Contractor Boller CertNkatbn rttpuhad
"Residential A/C requires eke plain silo M 1 pbcerrtent of unit
1:lmechperm.doc rev 07/20/98
CITY OF TIGARD BUi,.DING INSPECTION DIVISION MST
24-Hour Inspection Line: 639;175 Business Line: 639.4171 '—
/-
�1�
SUP
2 Date Requested �
]quested «!� AM _PM BLD
Loca;,an— Suite EC
Contact P3raon _ Ph,
Contractor Ph SWR
I BUILDING Tenant/Owner ELC „
Retaining Wall ELR _
Footing A 'ces
Foundation /Iz?M Q a,+ �� FPS
Fig Drain SON
Crawl Drain Inspraction Notes:
Slab — y� SIT
Post&Beam
'Ext Sheath!Shear
Int Sheath/Shear
Framing Vag 6z"',%.e5' 'Z' 1-7 7I94.rT' � ��.- �sc+r� �S►�—�
Insulation 'l
Drywall Nailing ��T �j,
Firewall
Fire Sprinkler l AXZ-IW Ll�/L. T 2__ —
Fire Alarm
Susp'd Ceiling Y-d l��X�S T'i i 041—fit-_
Roof
Misc: -- _
Final
PASS PART FAIL --- ------
PLUMBING
Post&Beam - -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final —
PASS FAIL _ __—
i
Post&Beam n -- --
Rou h In., ,�
as Li �' --- -- - — --
Smoke Dampers V !�
OAW> PART" Atr
ELECTRICAL - - —
a Service
Rough In
N UG/Slab
Low Voltage - -- —
Fire Alarm
Final
m PASS PART FAIL
W� SITE
..J Ba kfill/Grading - ---
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$— required before next Inspection. Pay at City Hall, 13125 SW He"Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE:— - — [ J Unable to inspect-no access
ADA
Approach/Sidewalk Date pe
Other
./ In>s Ctor !Ext _
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4176 Business Line: 631-4171
BUP
Date Requested AMP LD _
Location 1 � �C ty Lek AtEK Suite MEG A
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing —
Foundation Ar FPS
Ftg Drain in NOT REQUESTED - SGN
Crawl Drain FOUND DURING RESEARCH
Slab NO INSPECTION(s) IN FILE SR
Post 8 Beam
Ext Sheath/Shear
Int Sheath/Shear y
Framing _
Insulation
Drywall Nailing 'C✓ X66 12' f l C.a�►Z [ CAL . n ^l i&
Firewall
Fire Sprinkler
Fire Alarm ')
Susp'd Ceiling s zx/s
Roof
Misc:
Final
3 PART FAIL — —_
PLUMBINGJ��r�`I'���`1 't��Z. I=MA:1 s S
Post 8 Beamm
Under Slab
Top Out —
Water Service
Sanitary Sewer
Fain Drains
Final
PASS PART FAIL
MECHANICAL
Post$Beam -- ---
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL —
Service
Rough In
W UG/Slab _
Low Voltage
Fire Alarm
Final
PASS PART FAIL
WSITE
Backfill/Grading — —
Sanitary Sewer
Storm Drain [ ]Peinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW HON Blvd
Catch Basin on Please call for reins RE:
Fire Supply Line [ ] I _ [ ]Unable to Inspect-no aoceaa
ADA
Approach/Sidewalk
Other Date /� 5_ O (� Inspector
f ! 1
Final
PASS PART FAIL_j DO NOT RE61OVE this Inspeation rsoeid*am the job oft.
CITY Q TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Nell Blvd.,77prd,OR 97223 (503)W4171 PERMIT #. . . . . . . a MEC96-0369
DATE ISSUED: 10/29/96
PARCEL: 1S134CA-03400
SITE ADDRESS. . . : 11860 SW NORTH DAKOTA ST
SUBDIVISION. . . . : BURLWOOD NO. 2 ZON I N(;: R-4. 5
BLOCK.. . . . . . . . . . . LOT. . . . . . . . . . . . . :7
---------------------------------------------------------------------------------
CLASS OF WORK. . :ADD FLOOR FURN. . . . : 0 EVAP COOLERSs 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . t 0
OCCUPANCY ORP. . :A1 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . 1 0
FUEL_ TYPES------------- 0--3 HP. . . . a 0 DOMES. I NC I N: 0
• 3-15 HP. . . . a 0 x COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . a 0
GAS PRESSURE. . . : 50+ HP. . . . a 0 CLO DRYERS. . : 0
140. OF UNITS---------- A I R HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 1 (= 10000 eFm: 1 GAS OUTLETS. : 2
FURN >=100K BTU: 0 > 10000 cfm: 0
Remarks : ADDING NATURAL GAS LINE TO LOCATION
Owner: --------------------------------------------------- FEES --------------
JILL GOODHOUSE type amount by date recpt
11860 SW NORTH DAKOTA STREET PRMT $ 25. 00 TAT 10/29/96 96-285830
5PCT t 1. 25 TAT 10/29/96 96-285830
TIGARD OR 97223
Phone #a
Contractor: ------------------------------
CONTRACTOR NOT ON FILE
------
Phone #: : 26. 25 TOTAL —
Reg #. . :
------- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all 0her Mechanical I nsp
applicable Ims. All work Mill be done in accordance t4th Mise. Inspection
IL approved plans. This permit Mill expire if work is n(t started Final Inspection
within 189 days of issuance, or if work is suspended `or uvre _
N than 189 days.
m Permittee Signa arLe.
Issued By: _
J � '
11 for inspection — 639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Hall Blvd. APPLICATION Permit # _ aa-
Tigard, OR 97223
(503) 639-4171
scrip ion
Table 3A Mechanical Code OTY PRICE AMT
Job < <^ 1) Permit Fee 40- -0- 10.00
Address / .,
IC• _ Z '� 2) Supplemental Permit 3.00
Furnace o 100.000 STU
ZI.—W 1) Incl. ducts d vents 6.00
•^• urnace luu,000 STU+
Owner 2) Inc;. ducts &vents 7.50
•• * Floor Furnance
3) Oet. vent 6.00
•T• �•�•• • -5—uspinded heater, wall heater
4) or floor mounted heater 6.00
.... ••• Vent not incl. in
Occupant 5) appliance permit 3.00
.-7 - Repair of heating, re g.
6) cooling, absorption unit 6.00
m.
Boiler or comp, ea pump, air cond.
7) to 3 HP; absorp unit to 100K B11J 6.00
Boiler or comp, a pump, air con .
7 8) 3-15 HP; absorp unit to 500K BTU 11.00
Contractor . Boiler or comp, nest pump, air con .
1 - 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
• .,. • - oiler or comp, hCat pump, air cond.
L L14 aij10) 30.50 HP; absorp unit 1-1.75 mil BTU 2250
',ereby ac now a ge that I have read is application, inat th@ Boiler or comp, ea pump,-airy cond.
info-nation given is correct, that I am the owner or authorized 11) >50 HP; absorp u,•it 1 75 mil BTU 31.50
agent of the owner, that pians submitted are in compliance with Air handling uni o
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50 rJ lJ
Board, that the number given is correct. (If(,xempt from State Air handling unit
registration, please give reason below.) 13) 10.000 CTM+ 750
-- on portable
14) evaporate cooler 4.50
Vent an connecte
15) to a single duct 3.00
Ventilation system no
C4 A Cl� &LA 16) included in appliance oermit 4.50
.. aVow Hoodserved by
17) mechanical exhaust 450
Describe work new ) ad io aeration repair Commercial or in us ria
to be done reside dia non-residential Q 18) type incinerator 3000
Existing use of Other i.e., wriodstove. wper
IL building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 2M Gas piping one to four outlets 1 2.00 .w
t4- -
building or property
� 21} More than 4-per outlet (each) 2.00
JType of fuel -oil Q natural gasq� LPG Q electric Q
M 0_
� � Minimum Fee $25.00 SUBTOTAL
J PERMITS BECOME VOID IF WORK OR CONSTRUCTION -
AUTHORIZED IS NOT COMMENCED WITHIN 1.80 DAYS. OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 26%OF SUBTOTAL.
AFTER WORK IS COMMENCED. In
TOTAL
Special Conditions
Date issued by
M 1LOGWOSTlVAECHNAT
1-20�•� ACiz f!'- EA i 1 N Cs
I L( 7-1 S G 0 o-L C,4 - �dC.✓U
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CITY OF TIGARD
• DEVELOPMENT SERVICES ELECTRICAL PERMIT
19125 SW Hail Blvd.,17pard,OR 97M (503)=4171 PERMIT #: ELC96-0708
DATE ISSUED: 11/04/96
PARCEL: 15134CA-03400
SITE ADDRESS. . . : 11860 SW NORTH DAKOTA ST
SUBDIVISION. . . . : BURLWOOD NO. c ro,. ZONINGeR-4. 5
BL.00H. . . . . . . . . . . LOT. . . . . . . . . . . . . :7
Project Description: adding c branch circuits
------------------------------------------------------------------------------------
- --RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 2201 -- 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . e 0 601+amps-1000 volts. : 0 MINOR LABEL (10) . . . : 0
----SERV ,CE/FEEDER---- ----BRANCH CIRCUITS----- ---ADD' L. INSPECTIONS---
0 — 200 amp. . . . . . 1 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . 1 0
201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 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. . e
Reconnect only. . . . . : 0 SVC/FDR ) - 225 AMPS. . r CLASS AREA/SPEC OCC. :
Owner: ------------------------------------------------------- FEES --- -
JILL GOODHOUSE type amount by date recpt
11860 SW NORTH DAKOTA STREET PRMT f 40. 00 TAT 11/04/96 96-286070
5PCT $ 2. 00 TAT 11/04/96 96-286070
TIGARD OR 97223
Phone #:
Contractore ---------------------------------- -----.------------------------------
PHOENIX ELECTRIC CO $ 42. 00 TOTAL
7379 SW TECH CENTER DR.
-------- REQUIRED INSPECTIONS -- - ----
TIGP91) OR 9'1223 Ceiling Cover Elect' 1 Service
Phone #: 503-684--3600 Wall Cover Elect' 1 Final
Reg #. . : 2647
This pereit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i S i g n a t
applicable laws. All work will be done in accordance with
approved plans. This pereit will expire if work is not started
` within 188 days of issuance, or if work is suspended for mere _
than 188 days. I s ed By
INSTALLATION ONLY----- — -----_._----------------.__
The installation is being made on property I own which is not intended for
sale, lease, or rent.
3 OWNER' S SIGNATURE: DATE:
0
- -------------------- ------CONTRACTOR INSTALLATION ONLY---------------------•---------
SIGNATURE OF SUPR. EL.EC' N: DATES
LICENSE NO: _
Call for inspection — 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued
Phone (503) 6394171
CITY O�T14ARD FAX (503) 684-7297
TDD No. (503)684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Develop, -nt Number of Inspectlone per permit allowed
Address Service Included: Items Cost(ea) Sum
City/State/Zip. V C 4s. Residential -per unit
1000 sq R. or loss 1
Name (or name of business) Each additional 500 sq h or
hill porllnn tharoo/ $25 00 11
Commercial ❑ Residential L"ad Energy -- $25.00
Each Memurd Hone or kl!Wular
Dwelling Service or Feeder be11.00 2
2a. Contractors installation only:
4b. Services or Feeders
Electric+ Co tra or
Installation,gn mss,'or relocation or Fgss ileo 00
2
(( ��� 701 amps to 400 amps $110.00 2
Address t A3 lot amps to 400 amps
f120.W 2
City- State i 801 amps to 1000 amps -"" $1111000 2
Phone NEA7f,I - Over 1000 amps or voRL -__ $340.00 2
Job NO. Reconnect only
$50.00 2
contractor s license NO. 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Inslatlatlon,alteration,or rorocstion 2
Signature of Supr. Elec'n o-� 2W amps or"res
201 amps to 400 amps $50.00 2
License No. Zf/ 6. S one No. 401 amps to eoo amps 575.00 2
Over 800 amps to 10W volts $100.00
2b. For owner installations: see"b"above.
nd. Branch Circuits
Print Owner's Name ___ _ Now,sllerstion or extension pc pane
Address a)The fee for branch circuits wf h
Purchase or seMce or edisr An.
2
City StateZip hEach branch circult $5.00
Phune No. b)The fee for branch circuits wfMouf
The installation is being made on property I own which is purchase ofaerviceorPsadsrfw. dO 2
Fern Manch c
not intended for sale, lease or rent. $35.00
Each additional
branch circuit _ $5.00
Owner's Signature _._. 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump ocyAl"14lon kV $40.00 2
Each sign or cxrillne Ilght"q 110.00
SI,-al clrcull(s)or a limited energy 2
Please check appropriate Item and enter fee In section 6B. p-nel,atlerstion nr extension _ $40.00
ta. 4 or more residential units in one structure Minor Labels(10) $100.00
Service and feeder 225 amps or more
411.Each additional Inspection over
System over 600 volts nominal
_ Classified area or structure containing special occupancy tiro allewahle in any of the above
as described in N E C Chapter 5 PPeer hour
n =� $35.00
our $55.00
In Plant $55.00
Submit 2 sets of plans with applications where any of the above
apply. Not required for temporary construction services. 5. Fees:
W 6a. Enter total of above fees S
J NOTICE 5%Surcharge (05 X total fees) 9
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal ti -
AUTHORIZED IS `NOT COMMENCED WITHIN 180 DAYS, OR IF 6b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) S
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Su6totaf s
COMMENCED. -A�d uor,c Trust Account#
mm
S
Balance Due : r---