10670 SW DERRY DELL COURT I
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10670 Derry Dell Ct.
CITY OF TIGARDELECTRICAL PERMIT
DEVELOPMENT SERVICES FIERMIT #: ELC98-0246
JAM13125 5W Hall Blvd., Tigard,OR 97223 (503)539-4171 DATE ISSUED: 05/11/98
PARCEL: 2S103DA-02900
sITE ADDRESS. . . : 10670 SW DEFRY DELL CT
SUBDIVISION. . . . :DERRY DELL FLAT 2 ZON I NG r R-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :0;51 JURISDICTION: T I G
F'ro.j ect De ser i pt i on: Relocation of 288 amp or less service, and 15 branch
circuits.
-- -TEMP, SHVC/FEEDERS----- ------MISCELLANEOUS-----
1,000
-----MISCE_•LLANEOUS-----
1.000 SF OR LESS. . , . : 0 0 _ '200 amp. . . . . . . : 0 PUMP,/T RR T GAT I ON. . . . r 0
EACH ADD' L 500SF. . . : 0 201 -- 40th amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 0 601+81ps-1000 volts. : 0 MINOR LABEL ( 10) . _ : 0
-- -SERVICEi �'EDER---- ------BRANCH Ctki;UITS---- - ---ADD' L INSF,f.:CTIONS---
2,00 amp. . . . . . : 1 W/SLRVICE OR FEEDER: 15 PIER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 FIER HOUR. . . . . . . . . . . : 0
401. - 600 amp. . . . . . : ill EA ADD' L- BRNCH CIRC- 0 IN F'LANT. . . . . . . . . . . 0
601 - t000 amp. . . . . : 0 ------------------FLAN REVIEW SECTION-----------------
1000+ amp/vol.t:. . . . . : 0 ) =4 RES UNITS. . . . . . . . : i 600 VOLT NOMINAL. . :
Reronnect only. . . . . : 0 SVC/FDR ? = 225 AMF,S. . : CLASS AREA/SPEC OCC. -.
Owner: -_____.---------________----_____ -------_._.__--•___-- FEES
RONALD l_ AND TAMMY G GUSTIN type amoi-int by date reel t
10670 SW DERRY DELL CT F'RMT $ 135. 00 DEB 05/ 11/98 98-305637
T IGARD OR 97223 5F'CT $ 6. 75 DEB 05/11 /98 98-305637
Phone #:
Contractor: -------__.__.__.---------._._____--
OK BROTHERS ELECTRICAL. $ 141. 75 "'OTAL.
CONSTRUCTION
PO BOX 231 133 -------- REQUIRED I NSF'ECT I ONS ---
TIGARD OR 97281 Rol.igh-in Elect' 1 Final
FIhone #: 697-487:', Fleet' ] Service
Reg #. . . 123430
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State cf 0•egon Specialty Codes and all other
applicable laws. All we,!, will be den@ in accordance with approved plans. This persit will expire if work is not started within 188
days of issuance, or if work is .ospended for sore than 198 days. ATTENTION: Oregon 1Am_requires you to follow the rules adopted by
the Oregon M ility Notification Lcnter. lh se rules ar t forth in BAR 952-88! 8 through•.rAN 952-881-1987. You may obtain a copy
of these rules or direct questions to by ca 11
( 1246j§N7.P e r m i t t e e fignati-ir'e : x � -- I s s"'e i
-------------------------------OWNER INSTALLATION ONLY ------------- -- -- _.___ _
The installation is being made on property T own whi-; is nit intended for
Sale, lease, or rent.
OWNER' S SIGNATURE: -__ __— DATE:
1
---- ---------- ------- -CONTR7TOr' Ll_ TION ONLY---------------------_ _..
S T GNATURE OF SUFIR. ELEC' N: DATE:
I_. I CENSE NO-
...............4....... ..........#-+4-4.......................4.......4++++++++-++4++
O:+++++++++++++++++++++-F+++++++++•t+i-i.+++++.+++++++++++++++++.++++++++++++++++++++
ra11 639--4175 by 7:00 p. in. for an inspection needed the next bt-isiness clay
+++++++++++++i-+-1 +t++++++4+++++-++ a++++++ +4-+-++++4+++++i+++++++++++++++++++++++++++
i
CITY OF TIGARD Electrical Permit Application ,Y PlanCheck
13125 SW HALL BLVD. (�j Rec'd By\�--
TIGARD OR 97223 ��, , i� Data Recd--5-// -9P
I (
Phone (533)639-4171,x304 J Date to P.E.�� � Date to DST
Inspection (503) F39-4175 Print or Type � IX Date
Permit ll CL Cr -���j0
Fax (503) 684-7297 Incomplete: or illegible will not be accepted Called__
1. Job Address: rr 4. Complete Fee Schedule Below:
Name of Development_ C�V� ja Q�L� _ Number of In:pectlons per permit al►oweo
Name(or name of business) _ Service included. Items Cost Sum
Address I O l('j D_ S,_�_br,.ZN t L `_ 4a. Residential-per unit
10(x)sq.ft.or less $110.00 q
City/State/Zip 2.Z _ Each additional 500 sq.ft.or -�-
Commercial El Residential portion thereof $25.00 __ 1
Limited Energy $25.00
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $68.00--
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical�yntraCtof f�K f S Installation,alteration,orggipCauen �w-
Address �"�' 2-�11�i - 200 amps or less t $60,00
City G r _ State ►� Zj r^ 201 amps to 400 amps $e0,00
p j�Z 5t�3 L 401 amps to 600 amps $120.00
Phone No. 1 -4fa 1 3 _ 601 amps to 1000 amps a $160.00 --.-_ 2
Over 1000 amps or volts 2
Job No. $340 c0
Elec.Cont. Lice. No. 3 C_ Exp.Date ►� �, Reconnect only _._ $50.00 2
OR State CCB Reg. No. 12 1JJQ _Exp.Date /�_�- 4c.Temporary Services or Feeders
COT Business Tax or Metro No. _,51L, Exp.Date 1J� Installatlor,alteration,or relocation
200 amps or less $50.00
Signature of Supr. Elec'n 201 amps to 400 amps $75.00
i - - 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License Nr _Exp.Date _ see"b"above.
Phone Nr -X3_%!1�G:, ----- 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name_ _ leederfee.
Address - 5ach branch circuit $5.00
----- h1 The fee for branch circuits
City _ _ Sfafr Zip -- without purchase of
Phone No. - service or feeder fee.
First branch circuit $35.00
The installation is being made on property I own which is not Each additional branch circuit- $5.00
intended for sale,lease or rent. 4e.Miscellaneous
Owner's Signature____ _ _ �
(Service
Each ordirrigation er not circled ) - $40.00
Each sign or outline lighting $40.00
3. Plan Review section (if required):* Signal circuit(s)or a limited energy
panel,alteration or extension _- $40.00 _ 2
Please check appropriate item and enter fee in section 58. Minor Labels(10) $100.00
4 or more residential units in one structure 4f.Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Por inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00 __ M
as described in N.E.C.Chapter 5 In Plant $55.00
"Submit 2 sets of plans with application where any of the above apply. 5. Fees: / Z S �
Not required for temporary construction services. >
ba.Enter total of above fees $
5%Surcharge(.05 X total fees) $ -
NOTICE Subtotal $ -- ------
Sb.Enter 25%of line Ss for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reguired(Sec.3) $ -NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ 7-
-
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account it
Total balance Due s
l%03TS%ELC96 APP nm.!V%
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CITY a F TI GA R D MECHANICAL
DEVELOPMENT SERVICES PERMIT
PERMIT #, . . . . . . : MEC97-0347
13125 SW Hall Blvd., Tigard,OR 977.23 ('503)639-4171 DATE ISSUED: 09/16/97
PARCEL: 2Sj.J3DA--02900
SITE ADDRESS. . . : 10E70 SW DERRY DELL CT
SUBDIVTSION. . . . : DERRY DELL PLAT 2 ZONING: R-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3.1 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FUPN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :9F UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . -R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES-------------- 0-3 HP. . . . : 0 DOMES. INCIN: 0
3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR 'JNITS: 0
F IRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
OPS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 141
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 121
FURN ( 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS. : I
TURN ) =100K BTU: 0 10000 cfm: 0
Remarks : Add natural gas furnace and gas outlet to existing single family
dwelling.
Owner-: FEES
RONALD L AND TAMMY G DUSTIN type amot.trit by date recpt
10670 SW DERRY DELL CT PIRMT $ 25. 00 GEO 09/16/97 97-299268
TIGARD OR 97223 5PCT $ 1. 25 GEO 09/16/97 97--299268
Phone #:
Contractor-: -----------------------------
OWNER
----------------------------- ---------
$ 26. 25 TOTAL
Phone #:
Reg #. . : 999999
REQUIRED INSPECTIONS
This permit is i.;supud subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Grp, Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if work is not started Misc. I!i5pection
within 186 days of issuance, nr if work is suspended for more Final Inspection
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 9521-301-0616 through OAR 952 AN1 488. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-9187.
Issi-le By : Permittee Sign e:
4..................... -4.............4+++4+4-4++4.+++4.+-4.........+++++4......4 4
Call 639-,4175 by 6:00 p. m. for inspection-, needed the next bi.isiness day
++++++++++++.1-+++++++++++++.4-+++++++++++++++++++++-+•++•+++++++++++++•i-+•++++++++ F++++
Plan Check M
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 Date to DST
Print or Type Permit
called
Incomplete or illegible applications will not be accepted
( Name of O svatopmenl/Proiect Description
Table 1A Mechanical Code CITY PRICE AMT
job Street Address Suesr A) PNrrnd Fee -0- -0- 10.00
Address � ` L � l � _
Baps [S s ZIA 1.) Furoate to 100.000 BTU 6.00
G �o� � inclu_dinduds C vents
Name(or name of business) 2.) Furnace 100,000 BTU+ 750
i - including ducts&vents
Owner . i:' � _ Y �1� inc
� l Y _ _
e uq Addis 3.) Floor Furnace 6.00
l r l C including vent
cltyrsuft Pp Phans 4) SusDbnded heater,wall heater 6.00
>s( �r SLC or floor mounted heater
N (ori d business) 5.) Vent not included in appliance permit 3.00
,
Occupant etlina Address 6) Boiler or comp,heat pump,air Gond. 6.00
Address
( � ( to 3 HP;absorb unit to t00K BUT-
'Cifyistate zap Phone 7.) Boiler or comp,heat pump,air cond. 11.00
3-15 HP:absorb unit to 500K BTU"
Contractor Nar11e 8.) Boiler or romp,heat pump,air Gond. 1500
(Prior to '.5-30 HP,absorb und.5-1 mil BTU"
issuance Mailing Address 9.) Boiler or comp,heat pump,air Gond. 22.50
applicant _ _ 30-50 HP;_absorb unit 1-1.75mil BTU"_
must provide all cilprstate Zip Phone 10.) Boiler or comp,heat pump,air cond. 3750
contractor _ >50 HP;absorb unit 1.75 mil BTU" _
license Oregon Const Cont Board t.ic is Exp Oise 11.) Air handling unit to 10,000 CFM 4 50
information if
expired in
COT GOT B .nest Tax or Metro K Eap Oslo 12) Air handling unit 10,000 CFM 7 50
database)
Architect Na'"a 13.) Non-portable evaporate cooler 4.50
or Mailing Address 14) Vent tan connected to a single duct 3.00
Engineer cityistate �- Zip Phone 15.) Ventilation system not included in 4 50
_ _ appliance permit _
Desaibe work New O Addition O AReratton ip Repair O 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non-residential 0
Additional Description of work 17.) Domesh:incinerators 7.50
18) Ctxnme,cial or industrial type 30.00
Incinerator
Existing use of 19) Repair units 4 50
huilding or property _--
20) Wood stove 4.50
Proposed use of ( 21 ) Clothes dryer,etc -` 4 50
building or property �.1(��
22.) Othe,unite 4.50
Type of fuel-oil O natural gas LPG O electric O 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application,that the F4) More than 4-per outlets(each) 50
information given is correct.that I am the owner or authorized agent o.'
the owner.that plans submitted are in compliance with Oregon State QTY SUBTOTAL _
laws
Signature of OwnertAgent Date *SUBTOTAL
5°'o SURCHARGE - � -
Contact Person Name Phone PLAN REVIEW 25%-0 F SUBTOTAL
--- - TOTAL r�
i dstVrte<hpmt dot (rev 9 'Minimum permit fee is$25 *5%surcharge
"Residential AIC requires site plan showing placement of unit.