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11621 SW PACIFIC HIGHWAY ADDRESS: i:\records\microflm\targets\building.doc 1 7 ELECTRICAL PERMIT RMlT #: EC96-0396 CITY OF T I GARD DA PETI: ISSUED:L06/20/96 COMMUNI -Y DEVELOPMENT DEPARTMENT' 13125 SW Hall Blvd.Tigard,Oregon 97223o8189 (503)619-4171 PARCEL: IS136DB-00800 SITE F-41)D HE_S S ' - - - - I 1621 SW PPL.1 -IL HWY SUBDIVISION. . . . : ZONING:R-12 BLOCV. . . . . . . . . . : L01.. . . . . . . . . . . .. . Project Description : Installing one branch circuit. ----------------------------------------------------------------- UNIT--.-.-- ---TEMP' SRVC/FEEDERS----- -----MISCELLANEOUS----- 1000 ----MISCELLANEOUS----- 1000 SF OR L.ESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADDIL 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . :* 0 401 - 600 amp. . 1 . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 v S. : 0 MINOR LABEL (10) . . . : 0 _ -----SERVICE/FEEDER----- -------BRANCH CIRC, ----ADD' L INSPECTIONS--- 0 NSPECTIONS—0 - 20QI amp. . . . . . 3 0 W/SERVICE OR FELijCR: 0 PIER INSPECYION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER 1-40UR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRCs 0 IN PLANT. . . . . . . . . . . il 0 601 - 1000 amp. . . . . : lb REVIEW 1000+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NIIMJNAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMP'S. . : CLASS AREA/SPEC OCC. : Owner: -------------- ------------------------------------------- FEES GALVAN type amount by date recpt 11621 SW PACIFIC HWY PRMT $ 35. 00 CJS 06/20/96 96-280807 50CT $ 1. 75 CJS 06/20/96 96-280807 TIGARD OR 97223 Phone #: 620-6429 Contractor: WESTSIDE ELECTRIC $ 36. 75 TOTAL 7518 SW MACADAM AVE ------- REQUIRED INSPECTIONS PORTLAND OR 97219 Wall Cover Elect' l Final Phone #: 503-245-3385 Elect' l Service Rey #. . : 13306 This pereit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and dl! ether i,pi mittee Signature applicable laws. All work I,,Il' be done in accordance with approved plans. This persit will expire if work is not started within 180 days of issuance, or if work is ,uspended for sore r-6n rle than 180 days. Issued By .------.---.--OWNER INSTALLATION ONLY.__--.-_._.__..-__--_-____......_._.__._._...__._.__ The installation is being made on property I own which is not intended for, b.ile, lease, or rent. OWNER' S SIGNATURE: DATL: --------------------------CONTRACTOR INSTALLATION ONLY----------------------------- SIGNATURE OF SUPIR. ELECIN: DATE: i-ICENSE NO: .............. 639--4175 Call for inspection CITY OF TIGARD BUILDING IN3 TION NOTICE Inspection Line: 639-4175 Business Phone: 639-4.171 SAL. Footing Rain Drain Cover/Ser ice Foundation Water Line Ce ng -Plumb. Post/Beam Mech. Shear/Sheath Framing Mec . Plbg.Und/Fir/Slab Plbg.Top Out Insulation Elez`.1' Post/Beam Struct. ech. h-in Gyp. Bd. -Bldg. San. Sewer Appr/Sdwlk Reins, Other: Date: A.M. —P.M. Entry: _ Tenant: Ste:_— MST: BLIP: Con/Own: � �(� C� MEC: '"`� PLM: SLC: — THE FOLLOWING CORRECTIONS ARE REQUIRED: ELK Inspector: ____ Date: /f —C-1414PROVED DISAPPROVED!CALL FOR REINSP. CF CO eel Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. #9,(,,- Permit 9Permit # -Q-A-76 Phone (503) 639-4171 Date Issued F- AO - 96- CITY 4F TIGARD FAX (503) 684-7297 Issued by rh r. l-s 5. TDD No. (503) 684-2772 Inspection (503) 639-4175 _ I 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Address QU Items Cost(ea) Sum City/State/Zip )e <{/7 4a. Residential-pet unit " t, / 1000 aq It or less $110 Co r/ CEach additionel 500 eq It or Name (or name of business) !!!< <+ O portion therenl $2500 ' Commercial❑ Residential LimilEn 'Iderg $2500 Each Home or Modeler 2 Each Manuld Dwelfino Service or Feeder $66 00 2a. Contractor installation only: 4b.Services or Feeders / Inslallation,alteration,or relocation 2 Electrical Contractor �% J C1� C 200 amps or leas $6000 2 Address f-7 —/ ti C />� r 201 amps to 400 amps 0000 _ 2 401 amps to 600 amps $12000 _ 2 State $1B0 GOCity Phone N0. / Over 1000 amps or volts S34000 _ _ 2 0 Reconnect only $6000 Contractor's License No. ;-/. ;-�- Contractor's Board Reg. No j.Sl 4c.Temporary Services or Feeders I Installation,alteration,or ialocaIt(m 2 200 amps or less $50 00 2 Signature of ,C^�upr. Elec'n - _�- ------ 2 License No. �J CEJ ne No. i'y� — j✓ 201 amps 10 aoo amp $r5 00 _—_ � 401 amps to 600 amps $1 on nn Over 600 amps to 1000 Vons 2b. For owner installations: Rej V above 4d. Branch Circuits Print Owner's Name Nn,v alteration or e.tension per panel Address a)The lee for branch circuits with State — purchese of eeryke or feeder Me. Ciltyl�—_ `__ .tateZip Each branch circuit __ $1,100 Phone No. _ u)The fee for branch circuits without The installation 1 lb ot!ing made on property I ewn which is purchase of eervke or Awder fee. not intended for sale. lease or rent. Eire'branch arced —1_ t 5 Uo !� Each additional branch circuit f5 UO Owner's Signature 4e. Miscellaneous (Service or feeder not included) 3. flan Review section (if required): Fara,pump or Irrigation circle w $4000 ? Each sign or outline lighting $4000 Signal circuil(s)or a limited energy Please check appropriate item and enter fee In section 5B. panel,alteration or eMension $ao on I 4 or more residential units in one structure Minor Labels(to) f1',u 00 Service and feeder 225 amps or more 41. Each additional inspection ab over System over 600 volts nominal Clvssified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 nr rMrrr ..... �—__— hni In slant s55 no Submit 2 sets of plans with applirntion where any of the above e apply. Not required for lempora,y construction services. $. Fees: So. Enter total of above fees $ ,S NOTICE 5%Surcharge(.05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b.Er-ter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDEf. OR ABANDONED FOH P6tn Revlew if required(Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtoral---- $ >� COMMENCED Trust Account 8 Balance Due $ —t—owipj­ .ear+ I I y Ot I I!A)HO NAME WF.S I SE F(J.1 rttil;Itl,.F;S 151 a Sw 411*1 OVI POR"I LANI) HMOUNI Pf4XV 01111.0 Jill I 1) 14.V T1 Rl GAL PI.RM 11 I J sw 11.4 It IF I U 1-1 V1 101'AL. AMOUN't 1-4110 MECHANICAL CITY OF TIGARD Pr.. . . . PERMIT #. . . : MEC96­0187 COMMLNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/18/96 13125 SW Hall Blvd.Tigard,Oregon 97223.6199 (503)839-4171 PARCEL: IS136DB-00800 SITE ADDRESS. . . : 116.z.1 SW PACIFIC HWY SUBDIVISION. . . . : ZONING: R-Ik'-= BLOCK.. . . . . . . . . . : 1-01 . . . . . . . . . . . . . ------------------------ CLASS OF WORK, . :ADD FLOOR FURN. . . . . 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . , : 0 OCCUPANCY rRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL 0-3 HP. . . . : 0 DOMES. INCIN: 0 :/GAS/ 3-15 HP. . . . : VA COMML. INCIN: 0 MAX INPUT: 0 13TU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . e 0 GAS PRESSURE. . . . 50+ PP. . . . : 0 CLO DRYERS. . : 0 NO. OF' UNITS---------------- AIR HANDLING UNI FS OTHER UNITS. - 0 FURN ( 100K BTU: 1 10000 cfm : 0 GAS OUTLETS. : 1. FURN )=10121K BTU: 0 > 10000 cfm: 0 Remarks : Installing fi.ir,nace and gaS piping Owner— FEES MERCEDES GALVAN typ , amount by date r-ecpt 11621 SW PACIFIC HWY PR117 $ 25. 00 B 06/18/96 96-280'714 5PCT $ 1. 25 B 06/18/96 96-2817171.11 TIGARD OR 972:11-7-13 Phone #: 62'0-6429 Contr-actor: COLUMBIA HEATING PO BOX 230397 TIGARD OR 97281 Phone #: 624--2704 $ TOTAL Reg #. . : 76359 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the bas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp 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 thai-, 180 days. ........ .............. Pler,mittee Siunatl.ti,e : 1 s s i..i e d Sy JIto, . .......... V.- ....... ......... ------ Call, for, inspection 639-4175 J City of Tigard MECHANICAL PERMIT PlanclVRec. # 13125 sw Nall B. .1- APPLICATION Permit # (V\EZO-0/0 Tigard. OR 97223 (503) 639-4171 °P - �esuipuon- ( Table 3A Mechanical Code QTY ?RICE AMT Job Address f ' 1) Permit Fee _ -0 -0- 10.00 1 2) Supplemental Permit 3.00 ° Furnace to W0,000 E31U i 1) incl. ducts&vents I 6.00 �� uurnace 10 + Owner ���f `7 2) incl. ducts&vents 7.50 ap Floor Furnance 3) incl. vent 6.00 j))V) 4) or floor mounted heater __ 6.00 an no .me in Occupant 5) appliance permit 3.00 - T- --Repair oTFeaung, 9Trig. 6) cooling,absorpL'on unit 6.00 boiler or comp,heat pump,a r con _ 7) to 3 HP;absorp unit to 100K BTU 6.00 _ Boiler or(.omp heat pump,air con f 8) 3-15 HP; absorp unit to 500K BTU 11.or, Contractor _ EU301 or or comp, heatump, air con ---- j " y � 91 15.30 HP;absorp unit 5.1 mil BTU 15.00 eboiler or comp,Tieat pump, air con . 7 I' �� 0�- 3/',6 10) 30.50 HP;absorp unit 1-1.75 mil BTU 22.50 hereby acknowIFxIg:e-ffi-aTI have--roaa this application f -a`Tie boiler or comp-1-Fe-5pT ump,-air cond. - information given is correct,that I am the owner or authorized agent 11) >50 HP;absorp unit 1.75 mil BTU 37.50 of the owner, that plans submitted are in compliance with State Air handling unit'o laws, that I r n registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50 that the nun oor giver is conect. (If exempt from State registration, itar ing urn -- please give reason balow.) 13) 10,000 CTM+ 7.50 on porta—Tim 14) evaporate cooler 4.50 Vent tan con nec a —1-- 5) to a single duct 3.00 rent,at,ol nsystem not - — — / appliance P 16) included in a emit 4.50 o seryY — _ 17) mechanical exhaust 4.50 escn wor new U addition alteration�--repair ommerrra or industrial ~� to be done residential(D non-residential Q 18) type incinerator 30.00 Existing use of Other i.e, voo s o� -— building or property_ 16) heater, solar, clotl,as d;,ers, etc. 4,50 Proposed use of 20) ;as piping one to four outlets 2.00 1 building or property— -- -- - - Type of fuel -oil 21) More than 4-per outlet - - yp G natural gas Q I_Pr Q electric Q Minimum Fee$25.00 SUBTOTAL rJ' PERMITS BECOME VOID IF WORK OR CONSTRUCTION - -- AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE IF CONSTRUCTION OR WORK IS SUSPENDED OR — - ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME P 1N REVIEW 25 OF SUBTOTAL AFTER WORK IS COMMENCED. � •-- - TOTAL Special Conditions -- Dato issue 1 _by k.MECHPMT •aidaanMv h' j"I I t'll (Al Ill 1 .1 '1111 111 1. 1) ho (.1,11 I. 1, 1 0 11 11 II'l I /K. NAME ;i Utlo 11111 114 l'il"Ai wI1'0jIf1•Ij 31 0. A 1)1)R E S w40 I it 1)I'll- of.) I B POWO-,N I ifs kA IV!I I It I 1 I I MEC HAN I CAL. VIV7. FSI AIME INC", Pf 1411 1- 1 It k MF-.C46--@1A7 MEC96--O '111,31AI. AMOON,I :.411fl