15975 SW QUEEN VICTORIA PLACE 15975 SW Queen Victoria Place
CITY OF TP 24-Hour
spa tion Line: (503)639-4175
BUILDING MIST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Received Date Re uested��� AM- PM_—_. BLIP
s r,,i �, ✓/ C Pe ' .uite MEC U2-610 3! -
Location ..
Contact Person S/r� i4 dc . ph 23� 3J PLM _—
" --- SWR _
Contractor—__ /___.____ _.__ Ph BUILDING Tenant/Owner _ ELC
Footing ELC
Foundation Access:
Fig Drain ELR — _—
Crawl Drain SIT
Slab Inspection Notes: - -� ---
Post&Beam —
Shear Archors
Ext Sheath/Shear — —
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm �L#IA1111 k 11 �_
—
Susp'd Ceiling
Root y �W i�•'� '� p �dT ��G _ V
Other:
Final
PASS PART FAIL
(P-
_PLUMBING__ -
Post&Beam
Under Slab
Rough-ht
Water Service
Sanitary Sewer
Rain Drains -- --- —
Catch Basin/Manhole _
Storm Drain -- -
Shower Pan — �� 1 '`
Other: -�
Final �f' �___ _— A, --
PASS PARTFAIL
L---
Post&Bearn `-�1'y�,, 9� w+./� • ------- ---___---- — — —
Rough-In
n r
Smoke Qe,,,np4i1r,
P_ASSjP_A_RT/ FALL ---~ -
ELECTI f — ----
Service
Rough-In
iJG/Slab
Low Voltage -- — - -- -- --------- - ---
Fire Alarm
Final Reinspection fee of _-__ required before next inspection. F ay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE F-1Pleaserail for reinspection RE:— Unable to inspect no access
Fire Supply Line
Y ----�
ADproarh/Sidewalk Date L I O Inspector `---
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY O C T I G A R _ _MECHANIC L PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00517
13125 SWHall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/18102PARCEL: 2S110CC-12300
SITE ADDRESS: 15975 SW QUEEN VICTORIA PL
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 03(; JURISDICTION: KIN
CLASS OF WORK: OTR FLOOR FURN:� EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES _ 0 - 3 HP: t DOMES. INCIN:
LPG �T 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE_ DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
F URN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfn^•
Remarks: Conversion to gas furnace, venting and gas piping. 11-21-02 AC unit addea to permit.
Cwner: _ FEES
^ALLAN HOVDE Description Date Amount
15975 SW QUEEN VICTORIA IML'CIII Permit Fee 11/18/02 $72.50
KING CITY, OR 97224 [MrClll Permit Fee 11/18/02 $0.00
I'm N 1 9%,State]a 11/18/02 $5.80
Phone: I'IAX1 8%.State l'ax 11/18/02 $0.00
Contractor: _ Total $78.30
JACOBS HEATING +A C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS .
Gas Line Insp
Phone: 503-234-7131 Heating Unt Insp
Reg #: 1441 Cooling Unt Insp
Misc. Inspection
Final Inspection
This permit is issued cuwjcci 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 follow rules adopted in 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 by calling
(503)246-6699 r. t
Issaed By: ( Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for Inspections needed the next business day
Nov-20-02 10:45A Jacobs Heating 1I8139258 P . 01
Nov 18 02 11 : 37A Ja cobs Heating II •1, 8139258 P .01
Mechanic:,,) Permit Application
r,att roceisrod: Plendt no.:h"pf"J'10" -
C:ty of Tigard R F O f-�I V E 1.:t --
r Address: 13125 SW Hall Hlvd.Ti ,rd, OR, r,72 Pro�oct/appl'no'• _ Expiredate: 0t�'l ?1
:uy,, Tigard g. 23 --
Phone: (503)6394171 ) balrtuued: By Receipt no
Rax: (501) 598-1960 NUV 2 0 1UU Cam fileno.. — PsymenIrype
Land use approval: - CITY 1;GAR( Ituildingp«mhno —�
2 family dwelling,or a,rrs.sory JCommrtl taUlnduat::al U Multi-farrill
i U New cc-Itstructiom J Addutun/aitrraucuvrrplacxment U(fir. y U Tenant impmvernent
[MINE 04yunlikTIT117W
Job ad
BI _ as. fudicate eyuipntent quantities to Iwxcs below,Indicate the dollar
BI x ma • Suite no. value of all mechuucal materials• ui
Tax map/lax tax lo1/accuttnt no.. ---- W pment,labor.averfirad,
_ profit. Value S
.-fit Block: Subdivision: *See heckhst for important -_
' Pro ct name: - --- Po epplia;lnn information and
jurisdie,ion's fee schedule for residential permit fee.
City/county: t LIP
t Description and location of ork on p :rntseti _
FAt.date of completioNinspection:_ F!gcv.) -Cots)
Tenant impmvetnem or cltattKr of usr.: VAQ
- dint. Ret•onh
I Is existing space heated or conditiuned'r U Yes ❑No Alrhandling unit CpM -Is existing space insulated'U Yr. J No Air c ttlonm s to an requtrc )
Alterot(on o extsh A system
ILI of v compressor -
Buslness natrte { State boiler purnit no.:
Address: -14
`y ----- HP Tons R)l',H
Cit ite/smo am uct Imo a electors --
City. S e: ZIP. eatpump(siteptlnrequpho _ -
m" Iaz: Email --- - r.itaturepace umacc 6urite;-" ---
CCR no. `---- Includin ductworbvent liner Yes V No
C::y;mctro bc.n0.; --- - f nsu I/rep a re ovate ters-s en C , ---
r
Name( wall,or floor mounted
(p lease pNnf) V�' C �..v.C VW,74—a tattoo ter an7urnace -- -—
nton
Name:
Ahsnrptinnunits _ 14TUN
)w�, 4\ !, � HP
Address:� . _ t'nn rttiurrs_ _ � HP
-City: atC. ZII' er,ta en aul r rent t oto:
77onc: E trail _.-._- -- A Rance vent
fag. erex gust
s. ype res tic aLNnme hood fire:uptr mion system_ Exhaust fan with single duct(bath fans)ing real: �r_�ia��"e.a� x st s aero an tom t n of
1 _- 4
5ta z p ` k., FuelP ae up to a outleul
Phone: i F x: E-mail: w Type LPG NG oil
uel t in eac a u ons over oul ets - --
rocees tse rock jequirr )
Name' Number of nwleis `— 1
Address: - — --- - — t �itenY or equ ' -
Uecamtivefir lace
City: _--� - Stntr 1.1 ntert-ty �— --
Phone; Fax E•mall. tov pe et stove
Appt:canl's sig a u .-
I-Narne (prin" 01111 to
U. s
NN All tunsdknom au.,ep fteaa rard, Meer salt naltQc,m r,v owe:Ater ,Mon rmtt fie ..-,....t _
7 via U MasterCard Notice'chis permit application Minimum fee — —
cRmt,.,a AaL
expires,1 x permit is not obtained Ilan review(at ,_ �) � - --�-_
- �pOee within 180 days alter it has been
Ninrr iif cv,>rni-dei y iAo+e�n rreAli rdd - /t�tCcept[d 7LS[ mplet State surcharge(9%) ...,3 =._�
- " s �a ro�AlL ... s
_. Crdholri sl{twrrr -------- Amount - C` C � 17
I CI
�.3v
Nov-20-02 1.0 :45A Jacobs Heating 8139258 P _ 02
e��cliv�J
rfau SE
PRvNT
30
rn A v-F_
A J c
l�� 2! _S.E• NDL.GFITE
f CIZT" OR . 1??02
5o3 - Z3Y- "733 i
r"qx _S03- 23.1- ��15Z-
CITY OF T I G p►R Ll ELECTRICAL PERMIT _
PERMIT#: EI_C2002-00613
DEVELOPMENT SERVICES DATE ISSUED 11/22/02
13125 SW Hall Blvd..Tiqard. OR 97223 (503) 639-4171 PARCEL: 2S110CC-12300
SITE ADDRESS: 15975 SW QUEEN VICTORIA PL ZONING-
SUBDIVISION:
BLOCK: LOT : 936 JURISDICTION: KIWI
Project Description: 2 branch circuits to AC and furnace.
r RESIDENTIAL UNIT TEMP SRVCIFEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 ^200 amp: PUMPIIRRIGATION:
EACH ADD'L. 500SF: 201 - 400 amp SIGN/OUT LINE LTG:
LIMITFD ENERGY: 401 - 600 amp: SIGNALIPANEL:
MANF HMI SVC/FDR: 801+amps- 1000 volts: MINOR LABEL (10):
SERVICEIFEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp. WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: list W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L RRNCH CIRC. 1 IN PLANT:
601 - 1000 amp: _ PL_AN REVIEW SECTION
1000+ amp/volt. >=4 RES UNITS: >600 VOLT NOMINAL:
LReconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ALLAN HOVDE WEST SIDE ELECTRIC CO INC
15975 SW QUEEN VICTORIA 1834 SE 8TH AVE
KING CITY,OR 97224 PORTLAND,OR 9714
Phone: Phone: 231-1548
Reg it: ELE '.r I t�•
FEES
Description Date Amount Required Inspections
['TAX]F State Tax 11/22/02 $4.28 Rough-in
11:1 1'RMT1 FLU Pennit 11122M2 $53.50 Electt'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Spedalty Codes and all uther 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)
246.3090 or 1 A00-3.32-2344
Issued By: Permit Signature:
_ _OWNER INSTALLA I ZION 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 inspection the next business day
CITY� �� �' rG��� ELECTRICAL_PERMIT
PERMIT#: EL02002-00613
,. DEVELOPMENT SERVICES DATE ISSUED: 11/22/02
13125 SW Hall Blvd.,Tiaard, OR 97223 (503) 639-4171 PARCEL: 2S110CC-12300
SITE ADDRESS: 15975 SW QUEEN VICTORIA PL ZONING,:
SUBDIVISION
BLOCK LOT : 036 JURISDICTION: KIN
Project Description: 2 branch circuits to AC and furnace.
RESIDENTIAL UNIT _ TEM_P SRVC/FEEDERS MISCELLANEOUS
1000 SF UR LESS: J 0 200 amp: PUMP/IRRIGATION:!
EACH ADD'/- 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANE HMI SVC/FOR: 601+anips - 1000 volts: MINOR LABEL (10):
_ SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SEP.VICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FOR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ PLAO REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: — SVC/FDR>=225 AMPS: _ CLASS AREA/SPEC OCC: _
'owner: Contractor:
WOVDE WEST SIDE ELECTRIC CO INC
.,vV QUEEN VICTORIA 1834 SE 8TH AVE
NG CITY,OR 97224 PORTLAND,OR 97214
Phone: Phone: 231-1548
Reg
FEES --
Description Date Amount Required Inspections
(TAX)80,6 Stift"I' 11/22/02 $4'28` Rough-in
(I.ITRNIT(FLC Pernut 11/22/02 $53.50 Elect'I Final
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 issuanoe,or H 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 1-800-3�Z'2344.
Issued 9y: r Crf �i.t(ti J, i�,�L-�� Permit Signature:
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
ATE: —CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:_
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application '
potc received: _ (J' Permit no 1 3
City of Tigal Project/appl• no._ Hxpire date:
City of 77gunl AddrMs's; 1312.` W 1 8 d��, ) 23 Date ibsued: ay;,A;V Rceolpt nn,:
Phono: (503) 639.4171
Pax: (503) 598-190Castefile;no.: Payment type;
NOV 2 0 2002
Und -.rtc approval; _
l r
TZ31
1:2 family dwelling or accessory ❑Commcreial/industrial U Multi-family a Tenant improvement
w construction UAddinun'alrcr;+nt,n tcpinrrn,r„r U Other; J Partial
f
Job Tam
address: / c (nidi, nu.. 5uitc nu.; x ap/las IuUact:vunt nit
Lot. Block; Subdivision;_ ---- - -
PrtI ci;t nutnC; TDeNcription and location of work on premises: �/;v_� ( f� �.t ✓t`2��'___ __
I{sthnated date cif coCON I RACI OR mpletit,n;ig��nectinn
tSCHEDVLE
Job no: _ f Z
/tllldrgltti; ' — — -
Business name. \ c � . Dtrcrilit .
Qtv. ( .l
Ne"residentialmulti-fndlper
;jXlCIE� %: m
City. 1 ( t- .�A I State:0 ftl ZIP; tj 7 L 1 t�! ycrvittiryhalal;
Phone: rlix;1`6 -U.7 L-moil:
n .n bar __ 4
— I;uch addoronai %)o wl.It.lir portion Ihunyd'
CCD no.; 1 ri0�' C1CC.bUs.Ila.nU; (��/' 1�� I inuttd cnvrpy, n%idcnliAl _
Uitylrn n tic.110.: 1.till l once)! , ixn+•rernknliul i 2
lSseh mutulicturcd home or meduhu dwelling
tii ialwe 7.1f litrpeKisior, electrician (required) Uale - Servlve untl/or I(xNler _ --
--�c— ..� Kervieev or feederu-lnvlallatioa,
Sup. elect,name(print) S�'.t [. ' +wtp'ttom, License no: Z U,f
xitera.lon lir relura(Ioo:
PROPER k V OWNER21X1 ttmpr lir Ilrr — - 1
1J_ A t i 1111 uuyrt lu•IINI mope '(
Name(print): r9 V. ►`[`i< `i`t _._._..- ------._. .
� ��� 401 Ames to 6110 nmtw �
MuilinE,addru+N�I�ZZ` J �:Y•^—'r�ri .���!�..: c3 ._ 601 un In 1(NNtemps 2
1 11y' 4,. �StateD-W rL1P_C11L�(� fiver IfNNI amp%or vollr
••� C_'' —-- --'-- -- - I
Phtiiic
<1 Cl Jc _ (� h'ax Email ucuntnt� 1tn-
Owner installation: The installation is being made on property I own w reloralion;n
ll
ll
ll
tanon,aeru .feamporaryvcrvleesorfeederr-
ltu
which is not intended for sale,tense,rent,lir exchange uccordinbq to inv1
11X1;unp.%or Ivw
OIZS 447,455,479,670,701. ----.----_ -
Owner'!. signaturc Data 401 h,nen un+ r 2.
Tell 011;� Branch circuit%-new,Alteration,
lir t AW1141ua per Panel;
Narne: A Pcc for blanch un.uit%w1111 puttaa.,d
•arvicu or Pleader lite,t n..h h inch cirtwil 2
_ .1_—
( i1V $t11tC; y1P; 11 Per fill hnutch ureuil%w+IMan
of�rmtu lir Itn%k•r Pet', Ilrrt hearth Ctn•.utl{ • .l _ 7..
I'IMP Pax' 1:-Iltail' bath nddm.rnul hnmLh 01`11"t t— —
N11,c.(Service orIooderant inrluded)
U~twice over 229 imp--usmmc,:i;ll U HeaWt-care fm:ility 'iuh pump or lrripUirol circle 2
U Service over 320 amps rifting o1 U2 U HURIldous location Bach sign nt outline lighting 2
ramify dwellings U fiullding over 111.11(10 t+quarc feet fear or signal clrcult(r)or a limited energy panel.
mon:residential 1061%in line etnttaute ulletuliue, lir.:alcu%ion• 2
U SveYCm over(100 volts nominal
U 13ultding over three attxies U Feeders,400 snips or more •Dcscri+lion.
U(kcupu,t load liver 99 perwvns U manuraeturcti Arueluret rn'RV park Eachadditional tnrprrtion ovrrthr allowabklnanyoftheabovei
U 1'gtc%v/lihhting plus ❑fillers Per inspeown I—T= _:..J
Submit_.._NetN of plrnN wNh any of the above. my %Iryubun The above are not applicable to temporary conxtruction service. Other
YM All w4Athrholle„ee�Tl eildn comb,plebe mll o rwimion tier in A mtiNtnAhun.
Notice: This permit npplicution
Permit flee ......................S e� ' U
Xviru U Ma%tcr<�utd cxpdre., if a perwit is oot obtained Plan review(lit (9t1"/n”/t) _ —T—
40/�2_ �-�7/�Lt'.1_Lt /bs/U s within INF dos miller It has been ~tate surcharge ).....5 r
(lctln r."d numlhtr g Y
,r I:aN'rt
j �._ _ uCrcptoJ as cumplefo, TOTAL..................... ...S 7.
--- Nn 1�Jiler nw nM cI nal y,yr -
L T r11 r - z l 1
_-- ('nnlholdur d•ua we _ mouol 1 4a0-4619(tJUWlrrM)
t •d GL90-9EL 1 E051 '00 01;J20a l 3 ap t S 2sal9 W2e t SJ 20 02 Aopl