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16075 SW ROYALTY PARKWAY , Z G7 C7 16075 5W ROYALTY PK'VIY KING CITY CI TY OF TIGAR D ELECTRICAL PERMIT PERMIT#: ELC200200576 DEVELOPMENT SERVICES DATE ISSUED: 10/29/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110CC-04400 SITE ADDRESS: 16075 SW ROYALTY PKWY SUBDIVISION: ZONING. BLOCK: LOT: 018 JURISDICTION: KIN Project Descriptioi- Install 3 branch circuits Moving elec.outlet and adding 2. RESIDENT'AL UNIT_ TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: _ PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MANF IiM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICEIFEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION_ 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp. EA ADD'L BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: __ PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: — Reconnect only: SVC/FDR—225 AMPS. CLASS AREA/SPEC OCC: Owner: Contractor: MARTIN,GERALD AAND ()WNFR BEVERLEY L 16075 SW ROYALTY PARKWAY KING CITY,OR 97224 Phone: Phone: Reg #: FEES _ Description Date Arnount Required Inspections �I i l'itM'I'J LLC'Panni 10/29/02 $60.15 —'��_ I A\1 8 tiIate Tai 10/29/02 $4 81 Rough-in ----- Elect')Final Total $64.96 This Permit is issued subject to the regulations oontained 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 952.001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246.6699 or 1-800-332-2344. Issued By: �� _ Permit Signa`ure: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: e ��.4�` _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR, ELEC'N: DATE: LICENSE NO: Call 639-4175 by 7:00prn for an inspection the next business day Electrical Permit Application ---�- - ---��- µ-- I)ate received. Pcinut n,1. -062 & City of Tigard Project/appl.no.: Expncdate: Cityof7'igaed Address: 13125 SW Hall Blvd,Tigard,OR 97223 vteissued: By:� Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ TVP1E OF PERMIT., U I &2 family dwelling or accessory U Commercial/industrial _1 alt lu I.uuily U Tenant improvement U New construction U AcJdition/ahcratiun/rept;+c cat nl J Othel. U Partial JOB SFII F.INFORMATION Jot)address: rp D'15 .• a: r� BIdE. no.: Suite no.: I ax nnal)ltax lot/account no.: I.cnl: Block: u ision: 1 v Project name: _ _ Description and location of work on premises: I-stimated(title of cor" letion/inspecticm. UONTRACMON FEE SCHEDV14E Job no: D cr ntax Business flame: - ----- Description Utv. (eA.) loW no.insp —------- -- -- New residential-single or multi-family per Address: _ dwelling unit.lurlude%Attached garage. City: State: ZIP: Service included: Phone: Fax: I E-mail: I(")sq.ft.(it less 4 I{ach additional 5(10 sq.ft.or portion thereof CCB no.: — - Elec.bus,lic.no: Irmiledenergy,residential 2 City/metro Ile.no.: Undied energy,non-residential 2 Each manufactured home m modular dwelling 5i nature of su ervisin electrician(required) - Dale Service and/or feeder 2 Sup.elect.name(print)- I ice.nse no: Services or feeders-Installation, 1 alteration or relocation: 200 amps or less Z Name(print): L 201 amps to 4IX1 amps 2 - Mailing address: 401 amps to 600 amps 2 _—_ 601 stops to 111110 amps _ 2 City: -! Slalc: ZIP: Over 10(x)amps or volts - 2 Phone: I-itt: E-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to lnstnllntIon,alteralion,orrelocation: ORS 447,455,479,6 0,701. 2(X)+unpsrn Icss 2 201 amps to 41X)amps 2 (hancr's signature: "l� - t.� Jhltr: (f.) 2`�_,'% 2_ 4ili b 600 ams 2 ___ -- Branch circuits-new,alteration, or extension per panel: Naflle' ___ A. Fee for branch circuits with purchase of Address:_ service or feeder fee,each branch circuit 2 City: Slate: ZIP: _, B. Fee for branch circuits without purchase l - — _ of service or feeder fee,first branch circuit: / 2 Phone: I;tx: E-mail: Lack additional branch circuit: - Misc.(service or feeder not included): U Service over 225 amps-connnc•rcial U Hcalth care facility "ch pump or irrigation circle _ 2 U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting - 2 fond lydwell Ing% U Building over 10,000 square feet four cr Signal circuits)or a limited energy panel. ❑System over 61x)volts nnminal more residential units in one structure alteration,or extension• _ 2 O Building over three stories U Feeders,4(x)amps ormore tkscri tion. lJ Occupant load over w)persons U Manufrrc lured suuctures or RV pale f`ich additional Inspection over the allocable In any of the above: U F.greWlightbngplmn U Other ----- perinspection I—�r`--�- Submlt—sets of plans with Atli of the abuse. Investigation fee The above are not applicable to tempcmary construction service. Other -- - Permit fee $ Not rd'iu.- fictions accept credo cads,pleaw cnll X+nsclicnm on for more infotatien. Notice: 1 h15 permit application ..................... .r U vis, U MasterCard expire::if a permit is not obtained Plan irview(at _ %) $ �— Credit cud number I within 180 days after it has been State surcharge(8%)....$ Expires accepted as complete. TOTAL . $ Name of cardiol r as shown on credit cud S Cardholder slRnaoue Amount - --- 440-4fiI5 I(vtXU('()MI ELECTRICAL PERMIT- FEES: LIMITED ENERGY PERMIT FEES: T-----' - -- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee......................................................_—$75.00 Number of Inspections per pormit allowed) (FOR ALL SYSTEMS) Service includcd: Items Cost Total y Check Type of Work Involved: Residential-per unit 1000 sq It or less $145.15 •1 ❑ Audio and Stereo Systems Each additional 500 sq.ft.or portion thereof $33.40 I ❑ Burglar Alarm Limited Energy $75.00 Each Manut d Home or Modular ❑ Garage Door Opener' Dwelling Service or Feeder $90.90 7 Services or Feeders Heating,Ventilation and Air Conditioning System* Installation,alteration,or relocation 200 amps or less $80.30 _ _ 2 F1 Vat UUm Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 �� Other Over 1000 amps or volts u $45465 2 Reconnect only __ $65.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Feefor each system............................................. ............ $75.00 Installation,alteration,or relocation 200 amps or less a $6685 _ % (SEE OAR 918.260-260) 201 amps to 400 amps $100,30 Check Type of Work Involved: 401 amps to 600 amps $133.75 Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems see'b"above. Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for branch circuits ❑ with purchase of service or Clock Systerns feeder fee. Each branch circuit _ $6.65 ❑ Data Telecommunication Installation b)The fee for branch circuits without purctrase of service ❑ Fire Alarm Installation or feedor fee. First branch circuit $46.85 ` It Each additional branch circuit $6.65 ❑ HVAC Mlscellaneatis ❑ Instrumentation (Service or fe3der not Included) Each pump or iripetion circle $53.40 ❑ Intercom and Paging Systems Each sign or outline Ilglding $53.40 Signal circuit(a)or a limited energy ❑ Landscape Irrigation Control" panel,alteration or extension $75.00 Minor Labels(10) $125.00 ❑ l_ Medical Each additional Inspection over :he allowable In any of the above Nurse Calls. Per Inspection $62.50 Per hour _ $62.50 In I-rdnt — $73.75 Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above toes $ I ❑ Other_ 9 State Surcharge $ Number of Systems 25%Plan Review Fee I ' No licfmses are required Licenses aro required for all other Installations See"Plan Review"section nn $ front of application. _ ____.____ Fees Total Balarce Due $ I Enter total of above fees $ l._J Trust Account ft J 8%Slwte Surcharge ' Total Balaulce Due All New Commercial Buildings require 2 sets of plans. i:klsts\farms\elc-fees.doc 08/30/01 KING CITY 15300 S.W. 118th avenue,King City,Oregon 97224.2693 Phone:(503)639-4082•FAX(503)8.39.37'1 Notice To Contractors Working In King City Due to an intergovernmental agreement with the Citv of Tigard, mann building related permits for projects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW. simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create the permit. issue the permit. and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible application «ill be returned to King City staff for correction and no processing will occur until a complete. legible application is received. If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a King City staff person. King City staff will simple sign this form indicating land use approval. Take this signed form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd. Tigard. to submit applications and plans. Development Services Technicians are available at 639-4171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue pen-nits at the City of Tigard Building Department for the following project: -2mAV) �rUc_I1�2.,\J _ ' C lti� located at: ��Ul� ,?, S (�.> > C P Kine Citv Representative I N SKUNSTDOC CITYF T I G A RD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: M 000 52 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/22 2/002/00 PARCEL: 2S1 I OCC-04400 SITE ADDRESS: 16075 SW ROYALTY PKWY SUBDIVISION: KING CITY NO. 3 ZONING: BLOCK: LOT: 018 JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 3 HP: DOMES. INCIN: 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: FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation of a new furnace, and re-route gas service overhead. _Owner: _ FEES __---- GERALD MARTIN Type By Date Amount Receipt 16075 SW ROYALTY PKWY PRMT GEO 2/22/00 $50.00 KING CITY KING CITY, OR 92'7224 5PCT GEO 2/22100 $4.00 KING CITY Total $54.00 Phone:503-6201966 Contractor: PRACTICAL PLUMBING 935 NE 6TH PLACE CANBY, OR 97013 REQUIRED INSPECTIONS Gas Line Insp Phone:503-266-5440 Heating Unt Insp Reg#:LIC 135151 Final Inspection ORIGINAL 1 his Wrmit is issued 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 issu:jnce, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to folio i rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain�opie of these rules or direct questions to OUNC by calling (503)246-9189. ' , Issue By: 1 Permittee Signature: Call (5Q3) 639-4175 by 7:00 P.M. for inspections needed the next business y ;i+.y �:f King City FAX;503 639 3771 PAGE Plan Check 0. CITY OF 71GARD Mechanical Permit Application Reed Bye-L�. Corrlmelcial and Residential Date Redd a -I -ob 13125 5W HALL BLVD- I Date to P E. ' "I�8'00 TIGARD, OR 972231 Date to DST_._ (503) 639-4171, x304 permit Print or Type Called — - Incomplete or illegible applications will not be accepted -' Name Of be4clovmenwroira DescriptionQ 1 Price Amt Table 1A Mechanical Code 1600 A) Permit Fee Job street Addrens 1) Pu mace to 100,000 6TU 9,65 Includl ducts_8 vents see footnote 1,2 Address - l ,dam csY tate zit 7) Furnace t00,000 fiTU+ 12,00 includin dp uct%&vents see footnote 1,2 -- 3) Floor Furnaces 9.65 - Na (rr name of business) Ineludln vent see footnote 12 _ Owner Y.�4► ' - _ 4) Suspended heater,well Heater 9 s5 — Maiting Address or floor mounted heater st a footnote 1,2 4,75 .,L 5 Vent not included in a lianoe milt f�a LJ--a- �} P anon+ Check all that apply; "Boller Heat Air P GeYr9iala For items 6-10,soe or Pump Cond Qty Price mt ►n Cj ..LI�L�— footnotes 1,2 Comp — -- Na or nam Wslness) 6)c3HP;ebsorb unit t0 100K BTU g'66 Maflina Address 7)3-15 HP;absotb unit 17.65 Occupant took to 50ok BTU ctlYrstare - rix ^"^ 8)15-30 HP;absorb 24.15 unk.5-1 mil BTU 9)30.50 HP;absorb 36,00 Contractor N'm' unit 1.1.75 mil BTU �Q�o-t• •�2 10)3,50HP;absorb unit 60,15 Adore^e — T,i 15 mil BTU Prior to permit s t� 11 Ah handling unit to 1 ,000 CFM osuance,a c0PY 7,00 cnrrsrata f�P_ �'nD"" of all licenses 12)Alt hen ling unit 10,000 CFM+ are required it O ,__ia, 11.85 expired M COT O,„eon co cnM.Beard LInN v 13)Non portable evaporate cooler database.. .. >351�1 --- ---- 5�- - 7.00 Architect an70 ta) ant tan ooMeated to s single duct 4,75 or Matlksg Address J 18)Ventilation system not included to appliance permit 7.00 Engineer CITY sda Lit, Phone 16)Hood se ad by mechanical exhaust 7 .00 17)bo nestic Incinerators 1200 Describe work to be done: r Uutt� _ _. 16)Cortunerdel or industrial type incinerator 40,z5 New O RepairX Replacr.with like kind: Yes O No O _ _ RewidentialR COmmercial O 1g)Repair unite 8,40 Additional information of description of work: _ Y0j yyood stove/gas FP/other units/clothe dryer/etc, 7,00 eta on Units over 400 lbs require Z1)Oea piping one fe four outiets 375 NOTE: For Commercial pm)e only; See footnote 1 --- 75 structural as talcs, - z2 More than 4"r Outlet(each) Type of fuel: ell O netura LPO O eleetric O - Mlnlmum Permit pee:50.00 SUBTOTALr-'►'X _ e re __ 6%SURCHAROF •<.r 11 I hereby awl cknoedge that I havad this application,that the Information pIAN REVIEW 25%OF SUBTOTAL f given is correct,that I am the owner or authorized agent of Regubred for ALL commercial permits on( the owner,that plans submitted are In compliance with Oregon State laws TOTAL 1l+ 'r kjj,' 'x S at .of Owner'AAnt _ Date Other Inspectlons and Foes - I -, Q 1. Inspections outside of normal business hours(minimum charge-two _ jnon hours) Ss0.00 per hour d pninlmum Contact Person Name ` 2. Inspections for which no fee Is specifically Indicate � l )_ /�_0 charge-half hour) 550.00 per hour �.?� .i `_ �.3�,� 1. Additional plan review required by changes,additions or revisions In Fenno or commercial pro)ecfs only: places(minimum charge-one-half hour)550.00 per hour 1. Provide full schematic cf existing and proposed ryas line and pressure 7. Provide drawings to scab showing existing arra props-eA1 mochanical *state Contractor Holler Certification requued units -'Residential A/C requlras site plan showing placement of unit I,vnerhpemr.doc rev 7119/99 CITY OF TIGA,RD Inspection Line: (503)639-4175 BUILDING MST _ INSPECTION DIVISION Business Line: (503)639-4171 BLIP -- Received Date Requested\'Tan AM —PM— BLIP ----- -___ Location _� Suite —__-_—_ MEC ----- _ Contact Person Ph( ) PLM Contractor - C Pa Ph --) - SWR _ BUILDING_ Tenant/Owner `_-__ _._. _ ELC Footing ELC _-- -_ Foundation Access: Ftg Drain ELR Crawl Drain _ Slab Inspection Notes: SIT Post&Beam --- — Shear Anchors Ext Sheath/Shear --- Int Sheath/Shear Framing - Insulation X .- Drywall Nailing Firewall Fire Sprinkler "— Fire Alarm Susp'd Ceiling —� Roof -.-_. Other.—____— op Final PASS PART FAIL PLUMBING ---- Post&Beam Under Slab — Rough-In Water Service -------- --- —_ Sanitary Sewer Rain Drains - - —---- - -- --- -- Catch Basin/Manhole Storm Drain — ------ —_ _— W----�—�—_-- — Shower Pan Final _ --_-- PASS PART FAIL MECHANICAL Post&Beam Rough-In — -- Gas Line Smoke Dampers — Final PASS PART FAIL --- --.._— - -- ELECTRICAL Service Rough-In ----_�--- —_— --— UG/Slab Low Voltage --__ --- -- - — ----- Fire Alarm E] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PARI FAIL u Please call for reinspection RE: Unable to inspect-no access Fire Supply Line �j ADA D�Z;04t 6_ g 7� ' Inspector "'��-o �l► t Cf� -__.-. Ext Approach/Sidewalk ) ) Other: _ Final -- DO NOT REMOVE this Inspection record from the job site, PASS PART FAIL CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NOR PAC ELECTRIC 7264 SW 204TH AVE #1 ALOHA, OR 97007 Electrical Signature Form Permit #: ELC2002-00576 Date Issued- 10129102 Parcel: 2S110CC-04400 Site Address: 16075 SW ROYALTY PKWY Subdivision: KING CITY NO. 3 Block: Lot: 018 Jurisdiction: KIN Zoning: Remarks: Install 3 branch circuits: Moving elec. outlet and adding 2. Your company has been indicated as the electrical contractor for the permit indicated above. In order for thf_: electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER- ELECTRICAL CONTRACTOR: MARTIN, GERALD A AND NOR PAC ELECTRIC BEVERLEY L. 7264 SW 204TH AVE #1 16075 SW ROYALTY PARKWAY ALOHA, OR 97007 KING CITY, OR 97224 Phone #: Phone #: 503-430-5841 Reg #: 1:1 1 12596J tiuP 40515 i.tc 102184 AN INK SIGNATURE IS REQUIRED ON THIS (FORM X c ) gbare of Supe icing Electrician If you have any questions, please call (503) 639-4171, ext. # 310