10440 SW 69TH AVENUE i
1
ADDRESS :
10 SWGfN
J
CO
f .
cA
Li!
J
i\records\microflm\targets\buiIding.doc
\
z
R G
\ } j
2
) £ 3 3
�
�
)\
�
_
m /
� &
) /
A
� £
U ,
w E +
� o ,
Q) \
� � E
U
q $ a
$ a a
0 0 {
� �
�
@
� 2
�> £
v
Q } .
j
2
/
/
_2
/
/ f
\ o
~ CL f §
\ \ f \
f_ f o 2
6 \ \
� / $
CITY OF TIGARD MECHANICAL
PERMIT
PERMIT 4. . . . . . . : MEC93-0316
COMMUNITY DEVELOPMENT D PaQ►HTMEf NT DATE ISSUED: 11/09/93
13125 SW Hall Blvd.Tigard,Oregon 97223.8189 (503)839-4171
i
PARCEL: 15136AD-01200
S1 TF ADD'c SS. . . 1044O SW 69TH AVE
SUBDIVISION. . . . : VILLA RIDGE ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1
CLASS OF WORK. . :ALT FLOOR FURN. . . . : EVAP COOLERS:
TYPIE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . -
OCCUPANCY
ANS. . . :OCCUPANCY GRP. . :R3 VENTS W/O APPI_ : VEIuT SYSTEMS:
STORIES. . . . . . . . :2 BOILERS/COMPRESSORS HOODS. . . . . . . :
FUEL TYPES-------------- 0-3 HP. . . . : DOMES. I NC I N:
- /GAS/ / / 3-15; HP. . . . : COMML. INC 1 N:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. . . . : WOODSTOVES. . :
GAS PRESSURE. . . : 50+ HP. . . . : CLQ DRYERS. . :
NO. OF' UNITS----------- AIR HANDLING UNITS OTHER UNITS. :
FURN < 100K BTU: 1 <= 1O000 CFM : GAS OUTLETS. : 1
FURN > =1O0K BTU: 1 10000 cfm:
Remarks:
Owner-: ------------------------------------------------------- FEES
J KILF'ATRICK type amount by date --^—r-er-pt�-
230 FOREST COVE RD PRMT $ �c, OO JH 11/09/93
WEST I_INN OR 97068 50CT A 1. 25 JH 11 /09/93
Phone #:
Contractor: _.._____._--__-----------------------
COLUMBIA
----------__.—
COL_UMBlA HEATING
8900 SW BURNHAM
SPACE E-110
TIGARD OR 972E3
Phone #: 624—c704 $ 26. 25 TOTAL ---_--�—_
76359
------ - REQUIRED INSPECTIONS -------
This permit is issued Subject to the regulations contained in the Gas Line Insp
Tigard Municipal Codt, State of Ore. Specialty Codes and all other Mechanical Ins p
applicable laws. All work will be done in accordance with Final Inspection �^
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. — --- -
I 'eI'm ittep Si gnat(.Ar ek.: `-t)/
Isst.ted Ley . --
Call for inspection — 639-4175
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693.4415
PHONE: 503;848-8fi81" �I f' . L-7 J�
OREGON Page : �i cif/
Date 11/15/93
Time 09: 49
Permit Type Residential Electrical Permit Permit # 05046788
Permit Status APPROVED Applied 11/15/93
Situs Address 10440 SW 69TH AV Ti Issued 11/15/93
Permit Title SNR - CIRCUIT Completed
Permit Descr. JOB 1105-013 To Expire 05/14/94
Project Title SNR - CIRCUIT Project # P0035977
Project Descr. JOB 1105-013 * EROSION
Parcel Number 2S1'TI - Land Use District
Valuation U
Legal Descr .
Owner INSPECTION - TIGARD Construction : OTH
Applicant Name WEST SIDE ELECTRIC Classification : 900
Applicant Addr. : '7518 SW MACADAM Occupancy
PUR'TLAND, OR 9'/219 Validated by : PH
Applicant Phone: 245-3385 Inspector Area :
CON'TRAC'TOR : WES'TSIDE ELECT. Lic. C 26-1350 245-3385
Fee description Units Fee/Unit Ext fee Data
----------------------------------------------------------------------------
1st Branch W/out Feeder [Enter #1 1 35 . UU 35 . 00
Subtotal Electrical Nees : U 35 . 00
State Surcharge of 5% U 1 . 75
Total Electrical Nees : U 36 . 75
*** Fees Required *** *** Nees Collected & Credits AAA_
Receipt No . Date Payment
11/15/93 36 . 75
TOTAL THIS DATE *****>ttt** 36 . 75
Fees : 36 .75
Adjustments : . 00 Total Credits : . 00
Total Fees : 36 .75 Total Payments : 36 . 75
Balance Due: . 00
c..
110710E This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 180 day% Once construction ham started.
' the permit becomes null and void If cons:uctlnn Is Interrupted for a period of 180 days. 1 certify that the Informallon presented by the applicant and
his agent or ngenls In support of this r,..mit Is true and coarect to the beat of our knowledge 1 acknowledge that the,Building Department's reliance
upon false and misleading Informatl.,n may Invalldalu this permit. All provisions of applicable laws and ordinances governing the construction and us-,
of this building or struclum will'a compiled with whether or not specified on the pians or nolad on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority In access private property or to use easements. 1 further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval Is given by the Building Official. i further arknowledge that a Ifen may be placed on the title of the property upon which the permit to Issued
specifying that the use or occupancy of the building Er stnlcture Is provisional and revocable until the satislactlon of all Inspection requirements
APPLICANT'S SIGNATURE
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section155 North First (� A�
Hillsboro, OregonvP9712435012 A�I LICAT�®!i
Information: 503 640.1, V Fax: 503 693.441
Numbt/Penn t S
Number �7f�'/� Date
1. Location of installation4. Complete Fee Schedule below
Address '7 l� t-"� /' �"� Number of Inspections per permit allowed
Building Service included: Items Cost(ea.) Sum
City r�_ �"r' Suite No.
- A. Residential-per unit
Tenant Name
(if commercial) 1000 sq.ft,or less $110.00 a '
Each additional Sro sq.h
Tax Lot Map NO, or portion thareof $25.00 -
Limited Energy $25.00 _ _-_. 1
Thomas Map Book: Page: Section: Each Manufd Home or Modular
Directions _ _. Dwellin6 Service or Feeder —_— $68.03
B. Services or Feeders
Commercial ❑ Residential❑ Installation,alterations or relocation
200 amps or less $60.00 2
2a. Contractor installation only: 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120,00 2
Electrical Contractor _- 601 amps to 1000 amps -- $160.00 2
Address —4-- _ Over 1000 amps or volts $340.00 2
Date Job Number �; Reconnect only $50.00 2
Property Owner / • C. Temporary Services or Feeders
Contractor's License No. _ r
Contractor's Board Reg. No. �.._ Installation,alteration or relocation
200 amps or less $50.00 21
201 amps to 400 amps $75.00 _
Signature of Supr. Elec'n _ -._ 401 arr,ps to 600 amps $100.00 2
License No. Phone No, _ . Over 600 amps to 1000 volts see W above
2b. For owner installations: D. Branch Circuits
New,alteration or exter Sion per panel
Print War's ems
— — ---- -- a) The fee for branch circuit+Wth
Phonn_Nr
l-
of service cr feeder fes.
A3drela - ——- Each branch circuit $5.00
b) The fee for branch circuits without
y State Zip purchase of service or feeder fee.
First branch circuit $35.00 _
The installation is beingmade on property 1 own Each add'nl branch circr4t__ $5.00
which is not intended fr sale, lease or rent. E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle $40.00 2
Owner's Signature _ Each sign or outline lighting $40.00 2
Signal cirrult(s)or a limited
3. Plan Review section (if required) energy panel,alteration
Please check appropi•late hem and enter fee In section 5B. or extension $40.00 2
1 & 2 family dwellings over 320 amps s/c meter F. Each additional inspection over the allowable
4 or more residential units In one structure in any of the above
Per inspection $35.00
Service over 225 amps; feeder 400 amps or more Per huur $55.00
r _ System over 600 volts nominal In Plant $5500
_ Building over 3 stories in height 5. Fees
_ Building over 10,000 sq. ft.
Occupant load over 99 persons A. Enter total of above fees $
Manufactured Structures Park or Recreational 5% Surcharge (.05 X total tees) $
Vehicle Park; new, addition or alteration Subtotal $
,J Classified area or structure containing special B. Enter 25% of line A for
occupancy as described in N.E.C. Chapter 5 Plan Review it required (Section 3) $
Suhmh .'subtotal $2 sets of plans with application where any of the less Bulk Label Fee $
above apply. Not required for temporary construction
services. Balance Due $
For Inspections call This permit becomes null and vold Il the work authorized by the permit Is not commenced
within 100 days from dote of Issuance of such permit or It the work authorired is
640-3561 or 693-4415
suspended or abandoned of any Nn a after work is commenced for a perlod of t90 days.
24-hou, f ec tzi der,ons working day In advance of need Electrical permas are non rsfundable and non-h snorer able
5/93