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10900 SW 76TH PLACE
SGtC: I'�Ju=o"' CiT"Y. OF T?fY'*A-n'D w �i''3rro+fed i ......... Cn I } \A''y Apn.r.o..v..e..d..,. ...w..ww w..lr•wr��NNw��ti♦.•Naw r��..��'• ........��►.....t..lw.NMw�N.wsw�wwAOw.e� �• Ect ploy the wo- ' ee^ f ilbed h: PERMIT NO !�_ G o L Si'ri+.r letter LW. ,}r1!S .:tl�:i, .........•...e.e....r..e...�r►�r.to e...a..►...rr eE �e Gama,--1,— S ..... .•e...,.......w.a��w.�.�w.�:+sw�..w��.E �• Job gk d 'aw: 1—:z L pAeA:ivc- fig - = Bili ILII aet/u4- HOVF A US i ��J`�3 5� i7 �r` Z bit . 1 l3 � � I 7' 10 1624V 401 lz s� ....r . .; LAW" 5. 0141% ♦()' LAwrw S?eLttfry 1t+L (j r LAwN } � f l G-rC iO --�� ,F. `of r` . A fie.e4 o F= &J ew �"`r tiJL �r vv q, O• _i v /7 z I ! 7 I i f +I•r'._,,`l''' S.L I1, I 'J6� I .��ta.�7ra.'C� SOC iAG C� [i�J (y Zn' 6 nf'd `'o• 2O' fc20' 3•vLrr� e `•'N. j O137P'l aR'tl 29 9 I�8' 1 ; J_ LC' 150 �� 1 iu- ,� r�acK It/G I fAK r./L/.' .28 � -► � LAWN � . I -. �r, • C,,�• I �t• Y/ �'�'L..�i e z5 t ;�2O' ( 1 a! 5e���.r , 2J I 1 O� 110 �Vd '7 I°l., V(546 X S -f,LS.0 1 �j •S 2-Z LAW4 ,q µ8 47 e.FCE,c �z .s ,�� A o 7 Pctx �7 _ -xs BLpg ark ��.•.t.,; n s' � o• �r2 39 J ��o' fir 7 ,�s' t7' J3 uww �I&' Z: j '�I2.�z�S', .� G�w•.t5 +!S „S' +..fin 224 i _ � - , zo' <'� J* .'.S e°' 4 ' E302S IJ E K-L Lt—"` P%/LTIrr-, n -72 CyZ tri»(JS gOtLAGC � 5. N �.�3 O �c-+c► �LJ•��J 4-s 1-7 . _..,.....-.-_y.r-.a.++...._•. .... ' ..ntidrr.: r:win..:,.. ..:,.,:...:��+rt."�N��:;i...�;.nrt!.L.CA.`6�'a .:a.Gi: _.; ,...., ..�., � .. ,..FL�eu,;J'.i7, ^'reu'r+'Y'4i�;... stiWll+r+kcp9q�ysroa�'. _ a _ - NOTICE: IFTHE PRINT ORTYPE ONANY TlfTil � fli , ilf ill � ► li f1t1111 f � f ' fli 11111-�T fl �� rlr i-I-r l� [TI-1 1-T 111 ,1TI .� 1i i1 � r11 i1 � r ( i L.rI.-:� Ii Ilt , Ii � Il 111 IIt T1.TT[ f* .L. LIQ F r I .I_ f1- I. 1 T ,� r r I i i t i( I I � � ��r � r � I r � I I I IP "AGE.IS NOT AS CLEAR AS THIS NOTICE, 1 2 3 !4 � 6 7ti � IT IS DU - —_ g 9 - 10 11 12• E TO THE QUALITY OF THE No.36 ORIGINAL DOCUMENT E 6Z 8Z LZ 9Z 5Z � Z EZ ZZ iZ OZ 6T $ i L � (IIIlliltillllllllllsillllllllillllllllll[Il �I� IIJIl�f11111. 11111!11I11 111 I � sil yT ` T i s 8 L 1111 .11111111 IIILIIIIIII� IIII Illi IIII1111 .IIII1111IlILIIII IiIIIIII I.ri !!II 11111111 Illi �l ll�� l.l1� 111.1. 1.LLlIIIIC�II Will- f r t CITY O F T I G A R D _ ELECTRICAL PERMIT PERMIT#: 1 00085 DEVELOPMENT SERVICES DATE IS51I2/8/01ED: 2/8/01 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1 S 136CA-06100 SITE ADDRESS: 10900 SW 76TH PL 21 SUEDIVISION: SLEEPY HOLLOW ZONING: R-25 BLOCK: LOT : 009 JURISDICTION: TIG Proiect Description: Installtion of one branch circuit for new a/c unit. _ RESIDENTIAL 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: SIGNAL/PANEL: MANF HM/SVC/ FDF:: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER 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: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+ amp/volt: i >=4 RES UNITS: - > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: _ Owner: Contractor: SF PROPERTY INVESTMENTS LLC FRANKLIN ELECTRIC BY HARSCH INVESTMENT CORP 2889 SE 18TH CIRCLE 10900 SW 76TH PL #65 GRESHAM, OR 97080 '-! /`,RG, OR 97223 Phone: Phone: 492-4651 Reg#: LIC 140170 ELE 25-10410 SUP 2260S FEES_ Required Inspections _ ' Type e By Date Amount Receipt R — _ Rough-in PRMT CTR 2/8/01 $46 85 2720010000( Elect'I Final 5PCT CTR 2/8/01 $3.75 2720,010000(1 Total $50.60 This Permit is issued subject to the regulatio ,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 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 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503) 246-1987 ) PE_RMITTEF'S SIGNATURE � �- ) ISSUED 16Y: _ OWNER INSTALLATION ONLY I Iif� installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: _ CONT C-'-9R !NSTALI.ATION ONLY SIGNATURE OF SUPR. ELEC'N: / 4 YDATE: LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application LeeivetJ: ! A� Permit no.:City of Tigard appl.no.: Expire date: Cio,of Tigard Address: 13125 SW Fall Blvd,Tigard,OR 97223 ued: Ry: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type- Land use approval: — 2 family dwelling or accessory U Commercial/industrial U Multi family U Tenant improvement U New construction U Addition/alteration/replacement U Othcr: U Partial JOBSITEINIF ORNIATION Job address: /Q Q,f (� 7 - .# ITax map/tax lot/account no.: Lot: Block: Suhdivision: Project name: Description and location of work on premises: et,,o csi 4C F.' im:ited date of completion/inspection: Job no: Fee Max Business name: t�esrri�rfloil Qty. (ea.) Total no.in%p Address: 28 S �' ��C�i� New residential--inRkormulri family per dwelling unit.Includ•,attached garage. City: Statoo ZIP: Serviceincluded: Phone: FaxE-mail: 1000 sq.ft.of less I CCB no.: Elec.bus. tic.no: �- Each additional 500 sq,It.or portion thereof __ Limited energy,residential _ 2 City/Metro lie.no.: Limited energy,non-residential 2 Each manufactured home or modular dwelling — �� §i7g—nkture of supervising el trician(re uircd) Date Service and/or feeder 2 — Su, edecl.namr(printl: License Services orfeeders-Installation, m: alteration or relocation: 200 amps or less Name(print): 201 amps to 400 amps -- --- ---- -- 4o f amps to 600 amps 2 Mailing address - -- 601 amps to I(xx)amps 2 City: �- —�Slale': 7111: Over l(x)0 amps or volts 2 Phone: Fax: G mail: Recorutectonly I Owner installation:The installation is[icing made on property I own Temporary serricmorfeeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,670,701. 200,trmps of Icss------ T z 201 amps to 4!x1 any-,— 2— Owner's signature: _ Date: 401 to e(x)am s 2 Branch circuits-new,alteration, or extension per panel: Name: — A. Fee for hrarch circuits with purchase mf Address: service or feeder fee,each branch circuit 2 Cify: ),Stale �7(P: B. Fee for hranch circuits without purchase -- - - _ - of service or feeder fee,first branch circuit: 2 Phone Fnx I: nutil: trach additional branch circuit: Mhc.(,Service or feeder not Included): U Service over 22 i amps cununcrcial 1.J I Iculdt-cmc facility 1-inch pump of irrigation circle 2 UService over 320omps-rating of 1&2 UNazardouslocation Each sign or outlinelightinj— _ 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,orextension• 2 U Ruilding over three stories U Feeders.400 amps or more *Drscrition: U fkcupant load over 99 fx:rsons U Manufactured structures or RV pnrk Fich additional Inspection over the allowable In any of the above: U 1-ureaMightingplan U Other --- Perins tion (—T-- = Submit_sets of plans with anv of the a1mve. Investigation fee _ The above am not applicable to temporary construction service. other ------ """"' Vermil fee............ $ Not all jurisdictions arcept cmfit tarda,piesar can iuriadirtion for int"informatlon Notice:'Phis permit application U Visa U MasterCard expires if a permit is not obtained Plan review(at — %) $ Credit card number _ —L__/ within 180 days after it Itis been State surcharge(8%)....$Name _ of amboOf as shown�, -- accepted as complete T'OTAI. .......................$ 4 CaWholder dEnaume /(mount 44(}1615 MRID COM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF'WORK INVOLVED -RESIDENTIAL ONLY _ p Restricted Energy Fee................ ..................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Resideatial-per unit II 1000 sq,ft or lese _ $145.15 ___ 4 l J Audio and Stereo Systems Each additional 500 sq.fl or portion thereof _ $3340 1 U Burgiar Alarm Limited Energy _ $7500 Each Manufd Home or Modular Garae Doer Opener* Dwelling Service or Feeder $SO 50 2 d p Services or Feeders i-ieating,Ventilation and Air Conditioning System" Installation,alteration,or relocation 200 amps or iess $80.30 2 201 amps to 400 amps _ $106.85 _—�– 2 Vacuum Systems` 401 amps to 600 amps $16060 2 —�'-- 601 amps to 1000 amps _ $240.60 2 011ier Over 1000 amps or volts _ $45465 _ 2 Reconnect only $66.85 _ _ 2 Temporary Services or Feeders i TYPE OF WOPK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system............ ............................................. $75.00 200 amps or less $6685 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ _ $100.30 _ 2 d01 amps to 600 amps $133.75 2 Check Type of Work Involved. Over 600 amps to 1000 volts, see"b"above. n Audio and Stereo Systems Branch Circuits New,alteration or extension per panel LJ Boiler Controls a)The fee for branch circuits I with purchase of service or L_I Clock Systems feeder fee. Each branch circuit $6.6.5 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service L� Fire Alarm Installation ur feeder fee. First branch circuit __ $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous L J Instrumentation (Service or feeder not Included) Each pump or Irrigation circle _ $5340 C� Intercom and Paging Systems Each sign or outline fighting $53,40 Signal circuit(s)or a limited energy ^� panel,alteration or extension $75.00 _ El Landscape Irrigation Control' Minor Labels(10) _ $12.5.00 � Each additional Inspection over Medical the allowable In any of the above Per inspection _ _ $6250 Nurse Calls Per hour ^A $62.50 In Plant —T $73 75 Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ _- Number of Systems 25%Plan Review Fee Fee"Plan Review"section on $ � No licenses are required Licenses are required for all other Installations front of applirrition -�--- Fees: Total Balance Due $ —��—— Enter total of above tees s ❑ Trust Account IY ._- 8%State Surcharge s_ Total Elialance Due i i 41sts\forms4lc-fecs.doc 10/09/00 CITY O F T I G A R D ELECTRICAL PERMIT- RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2000-00215 13125 SW Hall Blvd.,Tiqard,OR 97223 (503) 639-41'71 DATE ISSUED: 9/18/00 PARCEL: 1 S 136CA-06100 SITE ADDRESS: 10900 SW 76TH PL -25 SUBDIVISION: SLEEPY HOLLOW ZONING: IG BLOCK: LOT: 009 JURISDICTION: TIG TIG Proiect Description: Installation of landscape irrigation control. A.RESIDENTIAL B.COMMERCIAL - AUDIO & STEREO: AUDIO &STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: X GARAGE.OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: _ TOTAL#OF SYSTEMS: 1 Owner: Contractor:— SF PROPERTY INVESTMENTS LLC TEUFEL NURSERY INC b`.' HARSCH INVEST..IENT CORP 12345 NW BARNES RD 10900 SW 76TH PL #65 PORTLAND, OR 97229 TIGARD, OR 97223 Phone: Phone: 646-1111 Reg#: LIC 41669 ELE NA FOR IRRIGATION FECS T �^ Required Inspections Type By Date -Amount Receipt Low Voltage Inspection PRM' CTR 9118/00 $75.00 27'.0000000 Elect'/ Final 5PCT CTR 9/18100 $6.00 27L0000000 Total $81.00 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 riot 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 CAR 952-001-0010 through OAR 952-0010080 You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987 i, ` Issued by � Z{ ' C__ _ _ Permittee Signature� �•: a-�..� 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 7:00 P.M.for an inspection needed the next business day CITY OF TIGARD Restricted Energy Electrical Application Recd by: 13125 SW HALL BLVD Date Rec'd: TIGARD OR 97223 Incomplete or illegible applications Permit#: G/t?o orJ- ea z.45 V-503-639-4171 X304 will not be accepted Cust.Call'd: F-503-598-1960 Name of Development ProLip TYPE OF WORK INVOLVED -RESIDENTIAL ONLY F- t_ _ Restricted Energy Fee........................................ $75.00 JOB Street�Addre=ss �y Ste# (FOR ALL SYSTEMS) ADDRESS lo9or. -4W Check Type of Work Involved City/State dipp Phone# ,CcR2, C-A `+7 Z,3 Audio and Stereo Systems Name Burglar Alarm OWNER Mailing Address Garage Door Opener' rty/State (LZip Phone# Heating,Ventilation and Air Conditioning System' 1L,� v —�— Name Vacuum systems- CONTRACTOR Mailing Address Other CUNTRAGTOR = _ RSL`� TYPE OF WORK INVOLVED -COMMERCIAL ONLY (Prior to issuance a ty/State ' I� Phone# copy of all licenses &L are required if Oregon Conic. Brd Lic.# Exp.Date Fee for each system.............................................. $75.00 expired in C.O.T. y/ ( �_— (SEE OAR 918.260-260) database) Electrical Contr.Lic # Exp.Date Check Type of Work Involved, C.O-Tor Metro Lic.# "Exp. ❑ l_ Audio and Stereo Systems ---— Owner's Name ❑ Boiler Controls OWNER - Mailing Address - APPLICANT [] Clock Systems City/Stale Zip Phone# F-1 Data Telecommunication Installation This permit is Issued under OAE 918-320-370.This applicant agrees to Fire Alarm Installation make only restricted energy installations(100 volt amps or less)under this permit and to do the following HVAC 1 Only use electrical licersed persons to do installations where required Certain residential and other transactions are exempt from licensing Instrumentation These have asterisks('). All others need licensing; Intercom and Paging Systems 2 Call for Inspections when installation under this permit are ready for Landscape Ir inspection at 503-639-4175Irrigation Control' 3 Purchase separate permits for all installations that are not ready for an E] Medical inspection why:, the inspector is out to inspect under this permit, 4 Assume responsibility for assuring that all corrections required by the Nurse Calls inspector are done,and, L� Outdoor Landscape Lighting' 5 Assume retnonsibility for calling for a final inspection when all of the Ej Protective Signaling corrections aje completed Permits are non-transferable and non-refundable and expire if work is not Other --- started within 180 days of issuance or If work is sispended for 180 days —Number of Systems 1 he person signing for this permit must be the applicant or a person No Licenses are required l.ir enses are required for a I other installations authorized to bind the applicant FEES: —" ENTER FEES $ 8%SURCHARGE(.08 X TOTAL ABOVE) f _ TOTAL $ _— Authority if other than Applicant A - r klsisvormsvesele doc 8/00 CITYOF TIGARD PLUMBING PERMIT { DEVELOPMENT SERVICES PERMIT#: PLM2000-00345 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9!18/00 PARCEL: 1 S136CA-06100 SITE ADDRESS: 10900 SW 76TH PL SUBDIVISION: SLEEPY HOLLOW ZONING: R-25 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3 OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBlSHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of commercial backflow prevention device.----- --FEES evice._ -- FEES Owner: _ — Type By Date Amount - Receipt SF PROPERTY INVESTMENTS LLC PRMT CTR —118/00 $139.20 27200000000 BY HARSCH INVESTMENT CORP 5PCT CTR 9/18/00 $11.14 27200000000 10900 SW 76TH PL #65 — — TIGARD, OR 97223 Total $150.34 Phone 1: Contractor: TEUFEL NURSERY INC 12345 NW BARNES RD PORTLAND, OR 97269 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 646-1111 Final Inspection Reg#: LIC 00005133 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 issuance, or if work is suspended for more than 180 days. AT i ENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: _ � 'r °,'�_� Permittee Signature: c_._ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 08/:10/99 MON 13:05 FAX 503 598 1960 CITY OF TIGARD 0003 CITY OF TIGARD Plumbing Permit Application Plan Check S 13125 SIN HALL BLVD. Commercial and Residential Reed By Date Reed TIGARD, OR 97223 Date to P.E. (503) 639-4171 Date to DST Print or Type Permit# .__o Incomplete or illegible applications will not be accepted Related SWR =777 7--= 7 Name of nevelopment/Project e— Sink Job -) I �_ Lavatory 1 50 t rest "Ife 11.50 Tub_orTut)/Shower Comb. Address ?jp 111-50 Bldg V /State Shower.Only 11.50 Water ciosevurinal (Specify)- ' -- ob Address S) 'of t Ad d a 0 '0� ment"P role 61,XlAm �5tate jp J�A M 11.50 44, Dishwasher 11.50 suite S �—APhon. Rating Address ulte Urinal -- 11,60 Owner 'JW/0"'AsLi" Garbage Disposal Zip 11.50 City to e Zip Phone L 2undry Troy 0i , 7 1 4 WashingM chirm&aundry Tray (SPccify) 11.50 0 --- — Name Floor DralrVI'loor Sink 2" 11.50 11.50 Malting Address Sultc 3' Occupant 11.50 CltylStale Zlp hone Water Heater 0 conversion j like kind, 11.50 Gas I I re ulre,,a Separate mechanical permiL Narms MFG Home New Water Service 28.00 MFG Home NewSan/Storm Sewer 28.00 Contractor MailingAddress sulto Hose Bibs 11.50 Phone Root Drains 11.50 Prior to permit CRY,(Yale 11.50 Issuance,a copy .41AA,1 n Drinking Fountain Oregon Comet,Cont.Board IJc.# Exp.Dale 15.00 (if all hcensev are. 7 other Fixtures(Specify) tecluired If 41 L►Ir E expired In COT PIL;-Mbi U database ofl-N, Nerne Architect Sewer-1st 100' 35.00 32.00 SUNS -Melling—Address Sewer-each additional 100' or star Service-tat 38. 0 Phone 3200 Engineer City/State Zip Water Service-each additional 200' 38.00 Storm&Rain Dral" -lot 100' Descrtby work to be done _6F,1_n _*Ws�SdcjNlonal IOU 32.00 New Repair 0 Replace with like kind: Yes 0 NO 0 Storm&Rain Residential 0 Commercial 0 Commercial B—._,j-Flow f;r y.rd I—own Device 9.0 Adddl Residential Backliow Prevention Device' rr��Ov_, 11110 6,q fl(-f Catch Basin Insp.of Existing Plumbing or Sped;wy Requested 50.00 re Ayou Capping,moving or mpla ng any fixtures? r" Yes 0 No �O Inspnctions H yen. see back of form to indicate work performed by Rain Dialn,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 111.50 WORK COULD RESULT IN INCREASED SEWER FEES__ QUANTITY TOTAL I hereby_..kn.Wgth-1 lhave read this sppli�catn,Piet 114"lfllii;�a lGarnearicor riser diagram If required"OusolAy Total Is>a given is correct,that I Am#"r.wvner or a uthadred agent of the Own0t,and __------sUBt6TAL !hat plana submitted are in .-mpliance with Ckjpon§tote Laws. 1lqnaWre of Owns gent Data SURCHARGESURCHARGE Phone It n Name **PLAN REVIEW 26%OF SUBTOTAL Oquitel only d WqT_qty fatal is>9 A' TOTAL USE�ITIRo ATAOUSFir —$ 0.0 _ ll.: OuVr-$zn5,0 .11- 4. G 1 $50 jurdiarge,ext;V01 ReSidgmilml w Ptilil"filn ji, t ", , 111111nirmurn Wir. nq a lin. unib ilu�'; Device,which Is$25 4 1%surrhsfgO I- torn aqwa��,,,.j w6tvir'sorv, whh iso"Wric or rizat diagram and -All NVw Conif"gfolal Buildings requ"PionsV12m p&An ivNew 08/30/99 MON 13:06 FAX 503 598 1960 CITY OF TIGARD .j 004 PLEASE COMPLETE: NA&. P I r / �5f !�INNAq `}tA1KK10K ti^1' � K lf'N` i lw fF K�_ li �' ��. l .�� r '' !.•lw a — - ,,��pp'• Sink _ — Lavatory -- Tub or Tub/Shower Combination -- S�iower Onli Water Closet _ — D►shwasher_ -- _Urinal — Garbage Disposal _ --- Laundry Room Tray ---- Washing Machine -- FloorDrain/Floor Sink 2" �_ — _ — ---- ------' _T— 3„ Water Heater --- Other Fixtures --- COMMENTS REGARDING ABOVE: CELECTRICAL PERMIT CITY O F T I�A R D PERMIT#: ELC2000-00578 DEVELOPMENT SERVICES DATE ISSUED: 10/6/00 13125 SW Hall Blvd.,Tigard. OR 97223 (503i 639-4171 PARCEL: 1S136CA 06100 SITE ADDRESS: 10900 SW 76TH PL SUBDIVISION: SLEEPY HOLLOW ZONING: R-25 BLOCK: LOT : 009 JURISDICTION: TIG Proiect Description: Installation ol 8 branch circuits. _ RESIDENTIAL 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: SIGNAL/PANE: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER 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: f, 401 - 600 amp: EA ADD'L BRNCH CIRC: 7 IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+ amplvolt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVCIFDR >= 225 AMPS: _ CLASS_AREA/SPEC OCC: Owner: Contractor: SF PROPERTY INVESTMENTS LLC BEAR ELECTRIC BY HARSCH INVESTMENT CORP P O BOX 389 10900 SW 76TH PL #65 DONALD, OR 9702 TIGARD, OR 97223 Phone: Phone: 503-678-1355 Reg #: LIC 20919 ELE 24-107-- SUP 3162-S FEES Required Inspections Type By� Date Amount Receipt Rough-in PRMT CTR 10/6/00 $93.40 2720000000( Elect'I Final 5PCT CTR 10/6/00 $7.48 2720000000( - � 'Total $190.88 --�_ This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codcs 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 18C 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-p01-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-1987 / PERMITTEE'S SIGNATURE f 'I� J/, �' ` IcSUED BY: �r �, 1En �. OWNER INSTALLATION ONLY The nstallation 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: `. !1 I r—_— DATE:— _ LICENSE NC: - — — -- — ----- Call 639-4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Ch �p Rec'd ._ 13125 SW HALL BLVD. Date Recd TIGARD OR 97223 � •n� RECEIVED Date to P.E Phone (503)639-4171, x304 Date to DST Inspection (503)639-4175 Prin'' of Type Sj p `� r QCT Permit# f 1-0deoo-Co`7 Fax (503)-598-1960—� �— Incomplete or illegible will not M acceptsd — caned _ _ �pMMUfdt1Y DE�tUNMLW t. Job Address: / / 4. Complete Fee Schedule Below: Name of Development �!p �'/GIr d� Number of Inspections per permit allowed Name(or name of business) Service included: Items Cost Sunt Address fin 90 p ,S,!y 7 /�. __�� 4a. Residential-per unit 1000 sq it or less $ 117.:5 4 City/State/7_ip 7 i z 3 - Each additional 500 sq fl.or portion thereof $ 26.25 1 Commercial Residential ❑ Limited Energy _ $ 60.00 Each Manurd Home or Modular 2a. Contractor installation only: Dwelling Service or Feedor $ 72.75 2 (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders information for COT data¢ase). _ Installation,alteration,or relocation Electrical Contractor a Etc hQ 200 amps or less _ $ 6425 _ 2 201 amps to 400 amps $ 85.50 _ 2 Address W__& o - 401 amps to 600 amps $ 12850 2 City_1�r�nuState __Zip-1Zp 2a _ 601 amps to 1000 amps $ 192 50 2 Phone No. '/.3 SS �_—_�—_-- Over 1000 amps or volts $ 36375 2 .lob No.— � _ _�_ �__ Reconnect only _ $ 5350 _ 2 Elec Cont. Lice. No. �y-/�, 7!'- Exp.Date_L-/ 4c.Temporary Services or Feeders OR State CCB Reg No _2.j2" Exp.Date zo -0 Installation,alteration,or relocation �__.. COT Business Tax or Metro No. Exp.Date 200 amps or less $ 5350201 350201 amps to 400 amps _ $ 80 25 _ 2 401 amps to 600 amps $ 10700 2 Signature of Supr Elec'n ✓ A.:� V�-G�---�-t� _ Over 800 amps to 1000 volts. see"b"above. License No jl�Z� Exp.Date LO ' / 'y� ad.Branch Circuits Phone NO New alteration or extenslon per panel a)The fee for branch circuits 2b. For owner Installations: with purchase of service or feeder fee. Print Owner's Narne Each branch circuit $ 5 35 —W 2 b)The fee for branch circuits `y Address _ -- without purchase of service ; D City _ _State__ZIP or leader lee. y` '�• Phone No. First branch circuit E 87 80 3 7•Sc� - Fach additional branch circuit 7 $ .638• 3-7. YS The installation is being made on property I own which is not 4e.Miscellaneous intended for sale, lease or rent (Service or feeder not included) Each pump or Irrigation circle $ 42 75 Owner's Signature _ Each sign or outline lighting _----- $ 42 75 Signal circuit(s)or a limited energy panel,alteration or extension $ 6000 3. Plan Review section (if►evuired):* Minor i.abels(10) -� $ tem _ Please cheek appropriate item and enter fee in section 5B. 4f.Each additional Inspection over 4 or more residential unira in one structure the allowable in any of the above — Per inspection _ E 5000 Service and feeder 225 amus or more Per hour E 5000 System over 600 volts nom,lei In Plant $ 5900 _--Classified area or structure(ontalning special occupancy as it 3�p described in N E C Chapter 5 5. Fees: lSa.Enter total of above fees $ 7 a ldal lees) 5 ` 9uSubmitlt 2 sets of plans with appllc Won where any of the etc. 4%Surcha apply. r9 1 Z� Not required for temporary const uction services. Subtotal $ _ ab.Enter 25%of line Ita lot NOTICE Pian Review if required(Sec 3) $ PERMITS BECOME VOID IF N ORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WIT►?iN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS T rust Arcount*__ _ u AT ANY TIME AFTEr,WORK IS COMMENCED Total balanc Due �2 i-\dsts\fbrms\eIc:trlc.doc CITYOF TI GA R D __MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00048 1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/7/01 PARCEL: 1 S 136CA-06100 SITE ADDRESS: 10900 SW 76TH PL 21 SUBDIVISION: SLEEPY HOLLOW ZONING: R-25 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT BEATERS: VENT FANS: OCCUPANCY GRP: VENTS 1110 APPL: VENT SYSTEMS: STORIES: BOILERS_/COMPRESSORS HOODS: FUEL_TYPES 0 - 3 HP: DOMES. INCIN: LPG _ 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: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Installation of gas piping for kitchen range. Owner_ _ ~ FEE_S SF PROPERTY INVESTMENTS LLC Type By Date Arriount Receipt BY HARSCH INVESTMENT CORP PRMT CTR 2/7/01 $72..50 272001000C 10900 SW 76TH PL #65 5PCT CTR 2/7/01 $5.80 272001000C TIGARD, OR 97223 _ Phone: Total $78.30 ----_—_ Contractor: JAY'S GAS PIPING 11525 SW CANYON BEAVERTON, OR 97005 REQUIRED INSPECTIONS Gas Line Insp Phone:626-4652 Final Inspection Reg#:LIC 119836 This permit is issued subjiect to the regulations contained in the Tigard Municipal Code, Mate of Ore. Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance. or if work is suspended for more than 180 days ATTENTION. Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center Those rules a,e set forth in OAR 952-001-0010 through OAR 952 001-0080 You may obtain copies of these rule or direct cuestions to OUNC by calling (503)246-91 . Issue By: �'U�C _ Permittee Signature: Call(503)039-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Datereceived: Permit no.: FLr'f /�40y City of Tigard Project/appl.no.: Expire dace: City(?f Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Gate issued: By:�r eccipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case fileno.: Payment type: Land use approval: _- - Building permit no.: t 'J 1 &2 family dwelling or accessory U Conuncrciai/industrial U Multi-family U Tenant improvement U New construction Add ition/altcrationlre piaccnwit t U Other: 0 Job address: / X9/21)_ _ Indicate equipment quantities in boxes be Bldg.no.: low. indicate the dollar Suite no.: value of ali mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: --_ - profit. Value$ Lot: Block: Subdivision: *See checklist for important application information and Project name: (G ' jurisdiction's Ice schedule for residential permit fee. City/county: ZIP: Description"d location of wr�on prrmisc--s:r-It Fee(ea.) Total Est.date of comp tionhntspection. lk-scriplion _ Qt . Ree.only R ec.only Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit �_. CFM Is existingspace insulated?U Yes U No Aite conditioning ofexi(sine plan C system �P A leration of existtngl�system 3oiler compressors State boiler permit no.: Business name: _ HPTons_-Wruni Address: �S AS i�//V _ Fir smo e-dampe_uctsmoke detecto-s -- City: Slate: ZIP: Heat pump(site•,plan requires- --- reone; _ ax: E-mail: nstall/rcplaccfurna�Ciurner_—_BTI-1/11 CCB n" i Including ductwork/vent liner U Yes U No ^- �' / 0 osis rep ace/re ocate suspended,eaters- - City/metro lie.no.: wall or Door mounted - Narno(ph.:, print --- - Venl Grr a lance other than furnace efriRent on: Absorption units___ Il'flllll Name: j i , L Chillers_!- t: Address: Com pressors HI' -- Environmental ex sot and vent at on: City: Stale: ZIP:__ Appliance vent Phone:S 3("1 c'7 ax: E-mail: )rycrcx oust 0o s,Type res. itc arout hood fire suppression system Name: Exhaust fan with single duct(bath fans) _ Mailing address: Exhaust s stem a vt from healin or AC' City: State. ^ ZIP: _ Fuelpiping an pct ut on(up to 4 out els► Type: -__LPG _— NG __ ()if Phone: Fax: E-mail: Fuel i fn enc a flfonal over 4 outlets roceccpiping(schematicrequire ) Number of outlets Nartte: _ ter Wiled app once or equipment: uipment: Address: __ Decorative fireplace _ City: State: 7.IP: Y-- Phone: J E-mall oo stov pe et stove - -- - Other Applicant's signature: �,�. Date: C7 � )t :r, Name (print); :a. C' ^-- ---- -- e' >Q Not all Judadirhtma Crept credit carets,pkaae call)utiedicUno ha nNre infnnneaiun ; PPermit fee.....................}� — z U Visa U MasterCard Notice:'this pennit application Minimum fee................$ Credit card nmtrMr - expires if a permit is not obtained Plan review(at -... %) $ - — - �- pJ-w l - within 180 days aller it has been t' p State surcharge(89F)....$ Name of cardholder au shown on credit cud $ accepted as compete. 1'OTA1, $ --- –�c'udii der 44144617(w"k.UM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: v Description: - Price "total $1.00 to$5,000.00 Minimum fee$72.50 Table na Mechanical 0 BT _ 4b (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to cls& 0 BTU $1.52 for each additional$100.00 or including ducts&vents_ _ - 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ _ ___ $10,000.00. including ducts&vents 17.40 - _$10.001_00 t_o_$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or includin vent _ _ 14.00 fraction thereof,to and including 4) Suspended heater,wall heater _ $25,000.00. or floor r*.ounled hea!or_ 14 00 $25,001.00_to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or _ G.80 fraction thereof,to and including 6) Repair units _ $50,000.00. 12.15 $50,001.00 and up _ $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see yr Pump Cond frac_tion thereof. _ footnotes below. c_a_m�* -� - 7)<3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to look BTU - 14 00 8)3-15 HP;absorb Value Total unit 100k to 500k BTL/ 25.60 Descrip ion: Qt Ems- Amou d 9)15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU 35.00 ducts&vents 10)30-50 HP;absorb Furnace>100,000 BTU including 1,170 unit 1-1.75 mil BTU 52.20 ducts&vents 11)>50HP: orb Floor furnace includin�N ent 955 unit>1.75 r til BTU 87.20 Suspended heater,wall heater or 955 --�- - 12)Air handling unit l0 10,000 CFM floor mounted heater _ 10.00 Vent not lud Inced In applirance 445 13)Air handling unit 10,000 CFM+ 17.20 Repair units _ 805 -_- 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 i0.00 _ to 100k BTU 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, 1,700 6.80 _ 101k to 500k BTU -.--- 16)Ventilation system not included in 15-30 hp;absorb.unit,501k to 1 2.310 a lianre permit 10.00 mil.BTU 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 1000 _ 1-1.75 mil.BTU18)Domestic Incinerators >50 hp;absorb.unit, V 5,725 i _ 1740 _ >1 75 mil.BTU- 19)Commercial or industral type Incinerator Air handling unit to 10,000 cfrn _ 656_ J� 6995 Air handling unit>10,000 cfmY T 1,170 pOj pN�r units,Including woad stoves Non�ortable evaporate cooler _ 656 _ 10.00 _ Vent fan connected to a single duct _446 _ 21)Gas piping one to four outlets Vent system not Included In 655 540___ appllance_ ermit 22)More than 4 per outlet(each)�� Hood served by mechanical exhaust 656 _ 1.00 Domestic Incinerator _ _ 1,170 _ Minimum Permit Fee$72.50 SUBTOTAL: $ Commercial or Industrial Incinerator 4,590 Other unit,Including wood stoves, 655 - 8%State Surcharge Y $ Inserts etc. Gas ng 1-4 outlets 3602.5°/.Plan Review Fee(of subtotal) $ Each additional outlet v 63 -_ _ Required for ALL commercial permits only TOTAL COMMERCIAL r+ a TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other Insipeg I1neped Feed: 1 Inspections outside of normal business hours(minlmurn charge two hours) $72 50 per hour 2 Inspections for which no fee is specifically Indicated (minlmurn charge-half hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum charge-one-half hour)$72 50 per hour "State Contractor Boller Certification raqulmd for units>200k BTU. "Residential A/C requires site plan showing placement of unit. i,ldsts\formsUnech fees doc 10/11/00 CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: /8/01 1-00052 2 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/8/01 PARCEL: 1 S 136CA-06100 SITE ADDRESS: 10900 SW 76TH Pl_21 SUBDIVISION: SLEEPY HOLLOW ZONING: R-25 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: 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: AIR HANDLING UNITS OTHER UNITS: FURN >=100K 13TU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation of exterior A/C unit. Unit cannot be pliced in the required setbacks. Owner: _— FEES SF PROPERTY INVESTMENTS LLC Type By Date Amount Receipt BY HARSCH INVESTMENT CORP PRMT CTR 2/8/01 $72.50 2720010000 10900 SW 76TH PL #65 5PCT CTR 2/8/01 $5.80 272001000CI TIGARD, OR 97223 -- --- Total $78.30 � Phone: --- -- Contractor: MR FURNACE HEATING INC 16285 SW 85TH AVE TIGARD, OR 97223 — REQUIRED INSPECTIONS Mechanical Insp Phone:684-9014 Final Inspection Reg #:LIC 87907 'This permit is issued subject to the regulations contained in the "Iigard Municipal Code, State of Ore Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuancF�, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-00 iO through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9 9, Issue By: /�' L2 }-1�_. _ _ Permittee Signature: _– ��_�. I I"— - Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application "remceived: / 7E.p.rcdoat Cary of Tigard City of Tigard Address.: 13125 SW Hall Blvd,Tigard,OR 97223 - -- Phone: (503) 639-4171 _.—dDate issued By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type_ Land use approval: - Building permit no.: ;tl &2 family dwelling or accessory U Commercial/industrial U Rlulti-family U Tenant improvement U New construction U Addition/alleration/replacement la Other:.- 1011 ther:,_ INFORMATION Job address: ` `i/-,T � _ _._ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: _ uitc no.: Y J value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ ,- Lot: Block: Subdivision: 'See checklist for important application information and Project name: — - __- jurisdiction's toe schedule for residential permit fee. City/county: +''�s ' Z1[ � 21 _ PERMIT Description and'Tocatioli of work on premises:_Q/L. tT 141, 11 t Fee(ca.) Total Est.date of completion/inspection i I — Description Qty. Res.only Res.only Tenant improvement or change of use: .Air handling unit _CFM is existing space heated or conditioned?U Yes J No Air :onditioning(site plan required) Is existing space insulated?U Yes U No Aiteration of existing A .system Kill of er,compressors - State boiler permit no.: Business name: Mj HP -_—Tons BTU/H Address: A; 4-h it smo a amper uct smoke detectors - City t State• ' e- I ZIP: C? Heat pump(site plan requite ) Phone: fax: -/) 1 Email' — nsta 1 replace Iurn ac urncr HTUI Including ductwork/vent liner U Yes U No CCB no.: I? 790 7nstA lI i epl ace/rcl ocate heaters-suspended, City/metro lic.no.: _ wall,or floor mounted Name(please Vent for as furnace e r+gent lion: Aabik Absorption units BTU/II _ Chillers—___ --- Address: -_— ` " CoremseII'n n:nota exhaust an vent a City: State: ( ZIP: _ Appliance vent Phone: !�e Fax: Y E-mail: -- Dryercx aunt Dods, ype U trs. itchen/hazmat hood fire suppression system Name: '51 /Yl,-,,7 i cerin eAc'� Exhaust fan with single duct(bath fans) Mailing address: 3-3" - x gust system apart from heating or AC SLxj /j'� Cly ristri—�, Stale: t ZIP: 'are piping stns drainouuoo tarp to out cls) City: 1"Dr �r=. v — Type: __LPO __ NO _-- Otl ` Phonc:�3 Fax: E-mail: - 'uTciin sac o iuona over 4 outlets rocess p p nR(sc ematic require ) — Name: Number of outlets cher-wed ap{ance or equ pn—T rent: Address: _ Decorative fireplace _ City_ - State: ZIP: Phone: Fax: Entail: Woodstove/pelletstove�_ -r:--'— Applicant's signature: _ Date: Uttelter: Name (print): d all puisdictiom acttpl credil cards,please call Jurisdiction GK more inframaurm. Permit (l`i ........... ......... N ❑Viso U MasterCardNotice:This hermit application Mininttun fee................$ �. 5 C) Credit card number: / / expires if a permit is not obtained I'lan review(al ',9-) - $ Expires within 180 days alter it has been State surcharge(8%) ....$ — N.me or-c_u_&o�drr u shown on c it c $ accepted a9 complete. TOTAL. .......................$ ley .3 1 ——— Csrdholdrr dgnalure Amours 491-4617(IS ICOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: & 2 FAMILY DWELLING FEE SCHEDULE: Description: - Price Total TOTAL VALUATION: _ FEE: _ �- Table 1A Mecnanical Code oh (Ea) Amt $1.00 to$5,000.00 Minimum fee$72.50 1) Fumace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vends 14.00 _- $1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+ fraction thereof,to and including including ducts 0 vents 17.40 $10,000.00. 3) Flour Furnace $10,001.00 to$25,60-6.00 $148.50 for the First$10,000.00 and including vent - 1400 - $1.54 for each additional$100.00 or 4) Suspended heater,wall heater fraction thereof,to and including or floor mounted heater 14.00 $25,000.00. 5) Vent not includ3d in appliance permit $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 6,80 $1.45 for each additional$100.00 or 6) Repair units fraction thereof,to and including 12,15 $50,000 00. Boiler Hea-t Air $50,OU1.00 and up $742.00 for the first$50,000.00 and Check all that apply: $1.20 for each additional$100.00 or For inotes below.tems 7-11, com * Pump Cond fraction thereof. _._ _ !T -- --- 7)13HP;absorb unit 14 00 to 100K BTU - ASSUMED VALUATIONS PER APPLIANCE: 8)3.15 HP;absorb 25.so Value Total unit 100k to 500k BTU_ - _ Qt Ea Amount Description: �_ 9)_I" HP;absorb 35.00 Furnace to 100,000 DTU,including 955 unit.5-1 roil BTU -- ducts&vents _ _ _ - 10)30-50 HP;absorb 52.20 Furnace> 100,000 BTU including 1,170 unit 1-1.75 mil BTU -- duras&vents_ 11)>50HP:absorb 87.20 Floor furnace including vent___ 955 - unit>1.75 mil BTU Suspended neater,wall heater or 955 12)Air handling unit to 10,000 CFM Floor mounted heater _ _ 10.00 -_ Vent not included in applirance 445 _ 13)Air handling unit 10,000 CFM+ 17.2(1 _ _Repair units_ -� _ 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 1000 to 100k BTU ---- 15)Vent fan connected to a sirgle duct 6.80 3-15 hp;absorb.unit, 1,700 -_ 101k to 500k BTU _ ---- 16)Ventilation system not Included in 10.00 15-30 hp;absorb.unit,501k to 1 2,310 appliance per -- mil.BTU - 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 _- 10.00 1-1.75 mil.BTU -- 18)Domestic.,Incinerator s >50 hp;absorb.unit, 5,725 _ 17.40 >1.75 mil.BTU 19)Commercial or industrial type incinerator Air handlinunit to 10--,000 cfm 656 _ ____6995 --Q----- --- 1,170 � - Air handling unit>10,000 cfm 20)Other units,including wood stoves Non-p(rtable eva orate cooler 10.00 Vent fan connected to a single duct 446 21)Gas piping one to four outlets 5.40 Vent s-ystem not Included to 656 -- appliance permit 22)More than 4-per outlet(earh) 1.00 Hood served t; mechanical exhaust _ _ 856 __ _ 5--- _Domestic Incinerator 1,170 Minimum Permit Fee$72.50 SUBTATAL: Commercial or industrial Incinerator 4590 _ Other unit,Inludin cg wood stoves, 8%State Surcharge $- inserts,etc. - - $ Gas�tiping 1 4 outlets _ __360 25%Plan Revlew Fee(01 subtotal) _Each additional outlet _ _ 83 Required for ALL commercial permits only - TOTAL COMMERCIAL S TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION_ Other Insuectlons and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour 2 Inspecilons for which no fee is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by chnnpns,additions or revisions to plans(minimum charge-one-half hour)$72 50 per hour *State Contractor Boller Certification required for units>200k BTU. "Residential A/C requires site plan showing placement of unit. I:\dsts\formsVnech-fees.doc 10!11/00 I 'V LL _- l CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PE*RMTT #: ELC96-074I_::' DATE ISSUED: 11/21 /96 SITE ADDRESS. . , : 10900 9W 7(--,TH PI_ PARCEL: IS136CA-061vhO SIABD I V I S I ON. . . . : SLEEPY HOLLOW ZONING: R-23 BLOCK. . . . . . . . . . : 1-0 T. . . . . . . . . . . . . :9 Project Desc; iption . Installing first branch Cit-CLtit UNIT.------ ---TEMP SRVC/FEEDERS----.-- --------MISCELL-A',N4EOtJS--.-.--.- 10,1710 SF OR LESS. . . . : 0 0 2,00 amp. . . . . . . : it PIUMPI/IRRTGAT ION. . . . : 0 EACH ADD' L.. 5005F. . . : 0 201 400 amp. . . . . . . : o SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 GOO Amp. . . . . . . : o SIGNAL./PANEL........: 0 MANE. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 - ------SERV ICE/FEEDER,--- CIRC(JITS-.--.-- -----ADD1I.. TNSPECTIONI�, ..--- 1,71 200 amp. . . . . . : 0 W/SERVICE OR FEEDER- LA PER INSPECTION.....: 0 1400 amp. . . . . . : 0 Ist W/O SRVj'-, OP FDR. : i. PIER HOUR. . . . . . . . . . . : 0 I.- 401 600 amp. . . . . . : 0 EA ADD' L. BRNCIA CIRC: 0 IN PLANT. . . . . . . . . . . 601, 1000 amp. . . . . : 0 --------------.__..-PLAN REVIEW SECT 1.000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. Reconnect only. . . . . : 0 SVC/FDR ) :- 225 AMPS. . : CLAS5 AREA/SPEC OCC. : Owner: ---------------------------------------------- FEES SF PROPERTY INVESTMENTS type amni.int by date recpt 206 NW '2J ST PRMT $ 35. 00 B 11/21/96 96-286810 5PCT $ J- 75 B 11/21/96 96-286810 PORTLAND OR 97209 I-,hone #: 274-9947 (,ontrartor: BROADWAY ELECTRIC $ 36. 75 TOTAL. P. O. BOX 33524 REQUIRED INSPECTIONS SEATTLE WA 98133--05 Wall Cover Elect' 1 Service I-1hone #: Undergroo-trid Cove Elect' I Final Reg #. . : 072542 This persit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signa Ai�re- applicable laws. All work will be done in accordance with approved plans. This pervit will expire if work is not started within IN days of issuance, or if work is suspended for tore than 180 days. Isso.Avd By INSTALLATION ONLY------- fl-ie installation is being made on property I own which is not intended for t:.ile, lease, or rent. ('-)WNERIS SIGNATURE, DATE.- TNSTALLPTTON ii-INATURE OF SUPIR. ELEC' Ne -OVI- id/ DATE: LICENSE NO: Call for inspection -- 639-4175 CITY OFTIGARD Electrical Permit Application Plan Check III 13125 SW HALL BLVD. Recd By f' `T v b=-- TIGARD OR 97223 Date Recd 1' Date to P.E. Phone (503)639-4171, x304 Print or Type Date to DST Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit n_f� Fax (503) 684-7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development:�z #iZ�2& fJ Number of Inspections per permit allowed Name(or name of business) /fr111;x, ��i r7(z 'H Service included: Items Cost Sum Address d tr r)_- L"?-, - 4a. Residential-per unit 1000 sq.ft.or less $110.00 4 City/State/Zip___ Each additional 500 sq.ft.or r ,1 Commercial Residential portion thereof $25.00 - t ��I ❑ portion Energy $25.00 Each Manuf'd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $68 00 2 (Attach copy )f all c Trent licenses) 4b.Services or Feeders Electrical Contractor---U-,2z;(4;(4 01-CA, b L lY,< <i4i-1 Installation,alteration,or relocation 200 amps or less $60.00 2 Address L L k @ X7ar Iy 201 amps to 400 amps 00.00 2 City_'.41yTt-Aw17 State elvc -Zip_ `/ 7'Z+�/ _ 401 amps to 600 amps $120.00 _ 2 Phone,N0. 2 -Aa-&5LL6f 601 amps to 1000 amps $'80 00 2 Job No, 1 7 :! _!c./7 bo Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec,Cont Lice. No._72-15;4, z... Exp.Date5_PC— `3 >> - OR State CCB Reg. No. -3 2 s4ege Exp.Date__j6Lnj- !%2 4c.Temporary Services or Feeders COT Business Tax or Metro No. ;�6, ?z 7jExp.Date_-._-.. Installation,alteration,or relocation 200 amps or less $50.00 2 Y J 201 amps to 400 amps $75.00 Signature of Supr. Elec'n 401 amps to 600 amps $100.00 CY Over 600 amps to 1 J00 volts, License No_- _ 4-S --_Exp.Date_ see"b"above. Phone No .--- ----- 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The foe for branch circuits with purchase of service or Print Owner's Name feeder fee. Address_ - Each branch cirrult $5.00 _. -- b)The fee for branch circuits City_- State Zip _ without purchase of Phone No. service or feeder fee. �, 1 First branch circuit 4- $35.00 The installation is being made on property I own which is not Each additional branch circuit $5.00 2 intended for sale, lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature_ _ _ Each pump or Irrigation circle $40.00 Each sign or outline lighting _ $40.00 2 3. Plan Review section (if required):' Signal circult(s)or a limited energy panel,alteration or extension $40.00 -- - -- Please check appropriate Item and enter fee In section 5B. Minor Labels(10) $10000-` 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 Per Inspection $35.00 _Classified area or structure containing special occupancy Per hour $55.00 ss described In N.E.C.Chapter 5 In Plant _ $55.00 °Submit 2 sets of plans with application where any of the above apply. S. Fees: 7 Not required for temporary construction services. 5a.Enter total of above fees $ J CT 5%Surcharge(.05 X total fees) $ -1►-15= NOTICE Subtotal $ 5b.Enter 25%of line 5a for PERMITS BECJME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reauired(Sec 3) $ ----NOT COMMENCED WITHIN 180 DAYS,OH IF CONSTRUCTION OR WORK Subtotal $ ----- IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFrER WORK IS COMMENCED. ❑ Trust Account p G y" Total balance Due 110SMELC96 APP RM WK ^' _-- CITY OF TIGARD — PLUMBING PERMIT _ DEVELOPMENT SER v 1CiES PERMIT#: PLM2000 00382 DATE ISSUED: 10/18/00 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639-4171 PARCEL: 1 S 136CA-06100 SITE ADDRESS: 10900 SW 76TH PL G-1 SUBDIVISION: SLEEPY HOLLOW ZONING: R-25 BLOCK: LOT: 009 JURISDICTION: TIG _ CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 37 ft WATER CLOSETS: WATER LINE: as ft DISHWASHERS: RAIN DRAIN: Remarks: Replace 37'of sewer line near unit#52. _ FEES _ Owner: _ Type By Date Amount Receipt SF PROPERTY INVESTMENTS LLC PRMT CTR 10/16/00 $72.50 2720000OGo O BY HARSCH INVESTMENT CORP 5PCT CTR 10/16/00 $5.80 27200000000 10900 SW 76TH PL #65 PRMT CTR 10/18/00 $37.50 27200000000 TIGARD, OR 97223 5PCT CTR 10/18/00 $3.00 27200000000 Phone 1: Total $118.80 Contractor: CLACKAMAS PLUMBING 14510 SE WAGNER LN MILWAUKIE, OR 972.67 REQUIRED INSPECTIONS Sewer Inspection Phone 1: Water Service Insp Reg#: LIC 00113502 Final Inspection PLM 3-332PB 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 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 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling 503) 246-1987, Issued By: 1�r _ ,i Permittee Signature: ' Call (5U3) 639-4175 by 7:00 P.M. for an inspection needed the next business day ^,K j Plumbing Permit Application �DateTeceivv,,.': �Pemiito.: L17�100 DO�-City �-- of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Nall Blvd,Tigard,OR 97223 — - Ciry of T i,r;ard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: : }, t''" ,Receipt no.: Land use approval: _-_ Case file no.: Payment type: ❑ I &2 family dwelling or accessory U Commercial/industrial ❑Multi-family U Tenant iniprovemrnt ❑New construction U Add ition/alteration/replacemenl ❑Food service "W Other: 4 1q T- 1 ' Job address: /000 -5-.1 77- 0 P14 c G- i Descri tion - Fee(ea.) Total Bldg.no.: !- '3 Suite no.: New I-and 2-family dwellings only: (includes 100 ft.foreach utility connection) Tax map/tax iot/account no.: W -36 C4_ C�0 SFR(1)bath �( Lot: Block: Subdivision: -_ _ SFR(2)bath — - -- - Project name: rj/f'CC p(�p�l - -_-_ SFR(3)bath City/county: / ZiP: 7L L Each additional bath/kitchen Description and ocation of work on premises: 1,21 Sheirdlities: 13e.6.21,s _ _ Catch basin/area drain Est.dale of completion inspection: /c/.17/00 Drywells/leach line/trench drain Footing drain(no. lin. ft.) J Manufactured home utilities Business name:.Sy/�m, r Fes. �s/�. /7�k �wr c Manholes _ Address: 53 1 a S c I IV)AC4% �V�2- Rain drain connector _ Cil A►ne '3fate: Zip: ''7 yy l Sanitary sewer(no. lirt. Phone:Z2_3.9,2tl� FaxZ�3�°19Q E-mail:_ Storm sewer(no. lin.ft.) - CCB no.: Plumb.bus.re Y.no: Water service(no.lin. ft.) City/metro lic.no.: — Fixture or stent: Absorption valve _ C.,dtinctor's.rere_sen�tative signature -• _ Back flow prevcnter -_- Print name: p<- i C Date:/0 6 -06 Backwater valve - r� log Ba.,ins/lavatory _ A,_ � Clothes washer Name: 1 Z� ��C'I--- - j� - _� A/��, Dishwasher Addresv: --i Cit State:ey 7.1 P: Drinking fountain(s)_- y__ -__- Ejectors/sump Phone:`Z _99S16 1 Faxi&I E-mail: Expansion tank Fixture/sewer cap _ Name(print): S ue'_'6 e/eAE�(� iS©C ��- Floor drains/floor sinks/Itub _- - Mailing address: 5320 5G,ti,/ /'' rA04*1A L Garbage dispos;r! -�— Ilose bibh City:r' rj���t/ _ _ Stale:� ZIP: 2_0 I Ice maker -- - __-- - Ph„n-:$p;aQJj Fax:A? 13-'�'Q,�` F-mail: ti� Interceptor/greasetrap- _ Owner installation/residential maintenaiwe only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on die prr'grcrty I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: _ Sum _ Tubs/showcr/shower pan _ Name: Urinal —_-_ ----------------- - - Water closet Address: / v-_ _ _ _ Water heater--` --- City: State: ZIP: Other: - Phone:_ Fax:- jE-mail:- - - Total f 55- '; Non all)urisdicnom accern credit cards,piety call iurindicnon for n"r infor moon. Notice:this permit application Minimum fee................$ U Visa U Miwet 'ard expires if a permit is not obtained Plan review(al -_- %) $ _ Cmdu card number: _ __ -_.Ll_._ within IRO days filler it has been State surcharge(8%) ....$ ,��v Expires $ � yL� -- - - accepted 0 complete. TOTAL .................... '� Now of eudlulokr u Jhown on credit cua- S Cardholder iignatu'rc L p t 4404616(600R70M) -- - R.'el(Ce aP�MX( Ic .37 'b PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT for each utilityconnection) _ Lavatory - - 16.60 - One 1 bath $249.20 Ir",or TublShower Comb. 16.60 Two(2)bath _ _ $350.00 _ 16.60 Three 3 bath $399.00 Shower Only Water Closet 16.60 Urinal 16.60 _ 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25'/.OF SUBTOTAL - __ TOTAL _ Garbage Disposal 16.60 --- Laundry Tray 16.60 Washing Machin© - 16.60 FloorDrain/Floor-Sink 2" 16.60 PLEASE COMPLETE: o" 16.60 4" 16.60 Quantic b Work Performed Water Heater O conversihn O like kind 16.60 Fixture Type: tNew Moved Replaced Removed/ Gas piping requires a separate morhanical _ Capped permit. - Sink - MFi3 Home New Water Service 46.40 - 46.40 Lavatory _ - MFG Home New SaNStomi Sewer _ Tub or Tub/Shower Hose Bibs 1660 Combination _ Roof Drains 16.60 Shower Only --- 16.60 - Water Closet -- - Drinking Fountain Urinal - Other Fixtures(Specify) 16 b0 Dishwasher - -- Garbage Disposal - �- Laundry Room Tray _- - Washin8 Machine _ Floor Drain/Sink: 2" - - Bawer-1st 100' 55.00 5S.Oa 3" -- Sewer-each additional 100' 46.40 4 55.00 - Water Heater _ Water Service 1st 100' Other Fixtures Water Service-each additional 200 46.40 S ec1 _ --- Slorrn 8 Rain Drain-1st 100' 55.00 --- Siorm 8 RainDrain-each additional 100' 46.40 ---- Commercial Back Flow Prevention Device _ 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Re uested Inspectlo_ns - per/hr COMMENTS REGARDING ABOVE: -_ Rain Drain,single family dwelling - 65.25 Grease Traps 16.60 -_ -- - -_ QUANTITY TOTAL -- Isometric or riser diagram Is requlrod If Quantity Total is >9._ -- - --- 'SUBTOTAL 8%STATE SURCHARGE ""PLAN REVIEW 25%OF SUBTOTAL. - Rsdrod only If Iixture qty Intal is>g TOTAL $ 'Mlnlmum permit fee Is$72 50 4 B YI state surcharge,except Residential HackAow Prevention r?evlce,which Is$ . +e%state surcharge -**AltNo"ammefehdFu-dinga require plans with Isometric,or riser diagram and plan review I:\dsts\forms\plm-fees.doc 10/10/00 CITY ®F T I GA R D ELECTRICAL PERMIT P[ RMIT#: ELC2002-00193 DEVELOPMENT SERVICES DATE ISSUZD- 5/3/02 13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 PARCEL: 1S1360A-90531 SITE ADDRESS: 10900 SW 76TH PL 53 SUBDIVISION: TIGARD WOODS A CONDO COMM ZONING: R-25 BLOCK: LOT : 053 JURISDICTION: TIG Proiect Description: Relocate house panel to outside of building. _ RESIDENTIAL 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 FNFRGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: 7 PER INSPECTION: 201 - 400 amp: 1 st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: MIKE MCKINNA BEAR ELECTRIC 592.0 SW MACADAM 20985 BUT EVILLF_ RD NE DONALD, OR 97020 Phone: 503-223-7666 Phone: 503-678-1355 Reg #: LIC 20919 ELE 24-107C SUP 3162-S FEES — Required Inspections Type By Date Amount Receipt Rough-in PRMT CTR 5/3/02 $126.85 2720020000( Wall Cover Elect'I Service 5PCT CTR 5/3/02 $10.15 2720020000( Elect'I Final -- — Total $137.00 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 issuance,or it work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Nolificaton Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-6699 or 1.800-332-2344 Permit Signature: ,.. ; Issued By: — OWNER INSTALLATION ONLY rhe installation is beinq 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:: 61 1 O-A1ii __---__ DATE:_ LICENSE N O: Call 639-4115 by 7:00pm for an inspection the next business day Electrical Permit Application T--- Date received: peanut no.: City of Tigard Pmject)appl. $xpirc date: Lith afTigard Address: 13125 SW HMI Blvd,Tigard,OR 9722.3 Uatciscued. Rye Receiptno.� Phone: (503) 639-4171 ----'-- Fax: (503)598-1960 Case file no: paymenttype: Land use approval: U 1 &2 family dwelling or accessory 0 Commercial/indusErlai Multi-family ❑Tenant improvement O New construction foal.Addition/alterari:,n/replaccmcnt U Other:�_—�. O Partial MWAITE INFORMATION Job address: 6 O1� SCe9 �h /. 7?4ah Bldg.no,:53 �f1itc no.: 7 aX it)ap/(ax lot/account no.: Alock: SitbrGvision: --- - _�--�----, — Projeet name: rae��y�rt�.e'.t Description and location of work on premises: Estimated date 6f completionhnspe.tlon: oe' 1 1 1 Job 1]O: _ _ Business,tame: `ep Y Er�CC7rt SNC'- Descrl t(on llty. (ea.) Total no.insp New residential-sinpJe or snutti-family per Address RO _ 3 e 9 dwelti,t unit,tneWdesattachedgar>er. City: __ State:p ZIP: Q�l� 5cniocincluded: Phone:678-l 3SS Fax{��- /08' Email: - 1000 sq.ft,nr less - 4 y�'v Each additional 500 sy.R or portion thereof CCE no p Q Elec.bus,tic,n� 7C Uynitcdenergy,residential z C' metro tic. no.: 30 S?_ Limited energ ,non-residential 2 Each manufactured home or modular dwelling all Signatute of suocr%,sing electneian(required) Date Sen ice.antiforfeeder __ 2 -----T Services or feeden-installation, Sup.elect.name(print) p &S-fW 1"ceps,nn:S y�o b alteration orreloratlon! 200 amps or less ^--- �,� 2 f, • 201 amps to 400 amps ?_ Name(print): 401 amps to 600 amps Mailing aduress: tj 3�(j Sl(� h�tn 601 amps to IOW amp, 2� ��ty; State; ZIP%7w/ Over 1 snaps or volts ---` -- - --- 2 Phone: ?A3-7& FRx: Email: Reconncctonly Owner installation:The installabon is being made on property I own Tenpoearytervtcesorfeeder-, which is not intended for tale,lease,rent,or exchange according to IntiUllafion'atMntioa,ormloc+non: 200 amps or Ims ORS 447,455,479,670,701. — ---- 201 amps to 400 snipe 2 _ Ownehs signature; Date: _ 401 to 600.imps — 2 Branch circuits-new,alteralion, Or extension per panel: Nime: __- A tire fur branch circuits with purchaseof r Address- actvicr,or feeder fee,earth branch citcuit 2 City: state: _ ZIP e. Fee I'm brvtch circuits without pur•Chane ofsrrvicc nrfeeder fee.firstbranch circuit 2 Phone: -� Fez Email: Each additional branch circuit. PJAN HEI IEAV'(Pleasc clieck all that apply) Mist.(Service ar[serer not Included): Each um or irrigation circle 2 O S^rvimover 225amps commercial U Hrilth-cuP.farilsty per' 2 U Service over 320amps-ratingof I&2 U Hazardouslocation Each sign or outline lighting A fatnilyriwdlings O Building over 10,0)0 srprare feet four or Signal circuit(s)nra limited energy panel. d 5ymmover600volts nonfinalrnnretesidimfialunitsin4nestructure alterati�n,orextemsion` - - _ 2 U Building over thre stoney O Freders,400 snips or tr,om onescripuon: u Occupant load over 99 persons J Manutachued structures o!RV park Each additional insprctlon over the allnwable in any of IN above: 0 Egress/liglitingplan J Other. Per inspection Submit %els of plans with say of the slave. Investigation fee - "r above are not applicable to tempor=ry coallttractloa atutAM other - Permit fee 5 - -- NM all jtuitdkueat arapt rterllr Catdt.i*are nal)wm tsdictaa rat arc IMrxuuiieo. Notice:This permit application Visa U Mast urd expires if a pcttnit is not obtalnrd Plan review(at 96) $ . die card n ner:'- L ���' do A L within ISO days after it has been State surchal ge(8%) ...•$ :7& ros ncceptedase4mplele. TOTAL ............. .........$ .017 0�— R)rNu"a,o c o der ae ehtwo on credit eerd- _ ` G(, Lr+lvt�� _ � l. i --- cad eta two Amount 440 tR15(6p0lt..oM 13UILDING PERMIT CITY PERMIT #. . . . . 0. 8/. .. SUP196 -0,'i CP3 OF T IGARD DATE ISSUED: 26/9 6 COMMUNITY DEVELOPMENT DEPARTMENT P,ARCEL: 13125 SW He ? -4171 P I)Ivd.*rigard,Oregon R722 eir n':J. j V1 L, 1(5 3),�39 . ZD?i b )Ub01vIa1JN. . . . : SLL.EPIY HOLLOW ZONING:R--25 LOCK. . . . . . . . . . ; LOT. . . . . . . . . . . . . .9 E I SSUE FLOOR AREAS------ EXTERIOR WALL CONS T RUCTI 01\1 LASS OF WORK. :0TR FIRST. . . . : 48 sf N: S, L: W: YPIE OF USF_'. . . ;COM SECOND. . . : o 5f PROTECT 0PENING79?-------- YPE OF' CONST. :5N . . . : 0 5f N: 5: L.. W: .iCCUPANCY GRP. :U1 48 s f- ROOF CONST: F I RE RET? .)CCUPANCY LOAD: 0 BASEMENT. : 0 Sf AREA SEP. RATED: ;TUR. : 0 HT , 10 Izt GARAGE. . . - 0 S OCCU SEP. RATED: M - S1y1T?.- ME:ZZ?: REDD SETBACKS-------------- REWIRED--.------__-__._____- I_OOR ED-------------------- LOOR LOAD. . . . : 0 pst LEFT: 0 ft RGH T : 'A ft F I R SPIJI-:1\1 ',;MCJK DET. . :N oWELLING UNITS: 0 F RNT: 0 ft REAR: 0 ft FIR ALRM:N HNDICP ACC:y 1.�EDRIYIS: 111 BATHS: 0 IMP, SURFACE: 0 P.RO CORR:N PARKING: 0 ALUE. $ 9 L71 0(ZI e m at-,k s Jwner,: FFES 'F PROPERTY INVESTMENTS type 'AM 0 I.AY)t by date recpt :06 NE 1-:011ST P,RMT $ 74. 50 JD vv//11/96 9628155, PLCK $ 48. 43 JD 07/ 11/96 96--2815'5, ,OHTLAND OR 97216 FIRE * 29. 80 JD 07/11/96 96-28 1' 'hune #: 5P`CT $ 3. 13 J114H 08/26/96 96- cry ,W-CISION CONSTRUCTION, INC. +04.5 NE KILLINGSWORTH AVE 11W0 LAND OR 97218 llhmie 503-2.53-482/ $ 156. 46 TOTAL REUUI RED 1NSP,EC,7IONS nit pereit is issued subject to the regulations contained in the Faot/Fal.tnd Irisp igard Municipal Lode, State of Ore. Specialty Codes and all other Fram inq Ivisp 3ppiicable laws. All work will be done in accordance with Root riai .1n; q Insp approved pians. This pervit wiil expire if work )s not started Final Inspectim'i __,__— within 180 days of issuance, or if work is suspended for tore than 180 Cam er-mittee biqnati-ir-e - J Li�;isljted By : U For Inspectio 1 A Commercial Building Permit Agelication City of Tigard �^ 1'3125 SW Hall Blvd. ( / Tigard, OR 97223 l �/ , (503) 6394171 V Jobsite Address: 7(, V, t' � Tenant: I `. 1 �'J (.vtiV suite#_ Office Use Only Valuation: PlanckfRec # •1 v ` (� py2oPermit# �.` () ` qk-rtlOwner: `� E h(-'w1/VrV" yllfcN 15 Map & TL # Address: �1 C) L l S'r Approvals Required 0v-::T q�,:)da Planning Phone. /f 7 Engineering Other contractor: C15<(21 CyVI SJ Address: G� I•C k<(.C f& C7 r7 K(--yI t7 "(72 l r Type of const: �� Occupancy class: (� Spr.nklered? Yes ` No Contractor's License # �> _ (attach copy of current Oregon license) Sq. ft of project: 46 Contact name & phone: 7 Story (1st. 2nd, etc.) Proposed use. N1 ✓�i L 15t•'X Architect/Engineer: Previous use: Address: _— �� v� Note: Plumbing & mechanical plans must be submitted at time of building permit application hone _IOD DESCRIPTION I 't� ' r,' `_ Tl Ft t tI 1 t ;(.r ��ppllcant ja ature & PYone number Received by: - `/ ` Date Received: i _! �� � E 35MM ROLL #21 FOR OVERSIZED DOCUMENT i �N to _ I j b N { I 0 R d � TI r 4 n i � � Z n � .. N I i I I L N OJ I ` l I I � j v _ � n r _ 17 --�----moi -�- I I IIell l l co 0 tic f% CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- �- G� BUP _Date Requested - ,/ -AM PM BLD Location ez . Suite MEC Z C, Contact Person --��^ Ph _ Contractor ,��� c<: 7� SWR �'r ���,../ � �_- � Ph [BUILDING — Tenant/Owner ELC A-1 -C, Retaining Wall ELR _--_ Footing Access: Foundation FPS _--_ Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT ___. — _—_—_ _—____�.�_ SIT Post& Beam Ext Sheath/Sheer -- -- Int Sheath/Shear Framing Insulation Drywall Nailing —-_ Firewall L C Fire Sprinkler Fire Alarm / Susp'd Ceiling - Roof 7Z_ l /�� LC-� Misc: --- Final PASS PART FAIL --------- - -- -- - - PLUMBING -- --- �_�- -�_� �' C' G' _ -- i ost A Bearn Under Slab I op Out r` Water Service Sanitary Sewer Rain Drains final PASS,APART FAIL ------ --._.....-_----_ -- MC_ANICAL ,> k's�tiLB..Beerr --- - -- - ---- ---- Rough In Gas Line - - ---_ --- ----- - --•--- ------_— Srnoke Dampers Fin __-_----- --_.--- --- -- -- -- AS PART FAIL Sc rvice / --- --- -- ---- Ro4gh In k c at UG/Slab w� --- — - — -— --Low Voltage / Fira,Alarm ----- in PART FAIL ___--- ------------------- --_ - flackfilllGradii g _----- Sanitary Sewer Storm Drain f 1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin inspect-no access Unable to ins f ire Supply Line I )Please call for reinspection RE —.-- I 1 P ADA i Approach/SidewalkDate _ �` -_, Inspector Ext Other — - `- Final PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone. 639-4171 Footing Rain Drain Cover/Service FINAL Foundation Water Line Ceiling Plumb. Post/Beam Mech. Shear/Sheath Framing Mech. (� PIbg.Und/FIrlSlab Plbg.Top Out Insulation Idc� PosVBeam Struct. Mech. Rough-in Gyp. Bd. -Bldg. A r/Sdwlk Reins. San. Sewer Gas Line PP Other: _T _ A.M. _P.� Entry: Date: -- Address: Tenant:._ __ Ste: MST ----- BUP MEC - Con/Own: PLM _. ELC THE FOLLOWING CORRECTIONS ARE REQUIRED ELR r v� _. ., [late: Inspector,9 2C-.---- __—_---- APPROVED ___DISAPPROVED/CALL FOR REINSP /C co CITY OF TIGARD BUILDING INSACTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service Foundation Water Line Ceiling -Plumb. Post/Beam Mech, Shear/Sheath Framing -Mech. Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect. Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: _ C /J/��1..�•/_-L 1�- �� �{ i Date: / A.M. _P.M.`__� nit Address: Tenant: - Ste.---- MST- BLIP Con/Own; ,�.� u��� //► LL MEC? ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: Inspector: __ Datt`z/Z OVED __DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION DIVISION -ho:!r Inspection Line: 639-4175 Business Line: 639-4171 MST _—_— BLIP DE;e Requested "- AM PM _ BLD Location 0 f S w 76 ok. _ Suite MEC Contact Person — Ph13�_J +PLM _ Contractor _ jt'.+Q-�_ Ph _ SWR _ BUILDING Tenant/Owner _ ELC Retaining Wall ELR Footing _._ Foundation ACCess: FPS Ftg Drain -- ---- Crawl Drain Inspection Notes: SIGN Slab �-�!<-- -� --- - — `� (s ac 51T _ Post&Beam — — _ `— Ext Sheath/Shear Int Sheath/Shear -- --- Framing Insulation --^--- ---- --_ ---- Drywall Nailing Firewall —'-- -- — - ----- Fire Sprinkler Fire Alarm --- —- - — - Susp'd Ceiling Roof /J ---------- Misc: I inal -- PASS PART FAIL PLUMBING Post& Beam Under Slab Top Out --_.�_-� Water Service Sanitary Sewer — --_- — Rain Drains Final ---- PASS PART FAIL MECHANICAL ----- - -�----T-- - �----- � - Post& Beam Rough In Gas Line Smoke Dampers Final _ -------- - ___ PASS PART FAIL — e-- ue Rough In UG/Slab Low Voltage —__.�--- --------------- - -- Fire Alarm PASS PART FAIL SITE ----...—.—_----____— - — Backfill/Grading ----- ------ -- - --- _ _ Sanitary Sewer Storm Drain ( J Remspertion fee of$— _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I J Please call for reinspection RE: — ( J Unable to inspect- no a^-cess ADA Approach/Sidewalk Date Other _�__�3 / ��_ Inspector e� Ext Final — -- PASS_ FART, FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-1. •ur Inspection Line: 639-4175 Business Line: 639-4171 -- ''UP _ Date Requested --Z— AM PM — FOLD �— Location ey Suite MEC _ Contact Person ,5�{�� Ph 3/ _ c • o PLM Ii -C"v.3Y Contractor _ Ph SWR BUILDING Tenant/Owner ELC — Retaining Wall EL R Foundation Footing - ---_--._ Access: ! FPS Ftg Drain O�" --- Crawl Drain Inspection Notes: SGN Slab -- ---- — SIT Post&Beam -- — Ext Sheath/Shear Int Sheath/Shear --� Framing Insulation -� --_ __ _ -------_- - - Drywall Nailing ^_ Firewall Fire Sprinkler ___----------..- -_--__-._ Fire Alarm — `-- Susp'd Ceiling --_------- -._._ -- ----- - Roof -- ----- Mise Final _ _E&§S PART FAIL - - - - - - PLUMBIN 'ast& beam - - Under Slab I op Out - - -- - --- ---- --- _ ------- Water Service Sanitary Sewer F rains S PART FAIL 110MANICAL - --- Post& Beam Rough In — Gas Line Smoke Dampers Final -- PASS PART FAIL. ELECTRICAL - - Servire Rough In -- UG/Slab Low Vc ltage --�` Fire Alarm ---------------- Final PASS PART FAIL SITE -----_-----_----- - --- --------- - Backfill/Grading Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection Pay at Cita Hall, 13125 SW I fall Blvd Catch Basin Fire Supply Line f J Please call for reinspection RE: [ J Unable to inspect-no access ADA Approach/Sidewalk //. � Other Date / — Inspectors Ext Final ._-- PA33 PART FAIL I DO NOT REMOVE this inspection record from the jab site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-1-lour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ Date Requested yZU�— Z' AM PM BLD Location�U T Go _54,.,, Z ,!`^ Suite MEC Contact Person —,� _ Ph 533— % I—/) PLM _ Contractor Ph SWR _ BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: FPS Foundation / r, -- - -- Fog Drair (fl, G /S 4s� / A-it SGN Crawl Drain Inspection Notes:,, 1 —� Slab 1'3e SIT _._,------- Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing ---_.-_ _-_ _._--T -_-- --------- ----- _._. Insulation Drywall Nailing _ ----_ ----- _— _.-_------- ----- ___._� ----- Firewall Fire Sprinkler ---------.- ._- ----__ __ -_—�__-- Fire Alarm Susp'd Ceiling - Roof ----- - ctQ - - -- Misc: -- - ------ -- ---------- - Final PASS PART FAIL —---_� _-- -- - --__-. --__ PLUMBING s� - Post&Beam Under --- - ---- -� - ----- ----- ---�-._- Under Slab Top Out -----------_...__._- ---- Water Service _�-___------ ----------- --------- -- --- _-_-__.._-------- Sanitary Sewer Rain Drains ------_ - --- ------------ -_�-_s T._ - --. Final PASS PART FAIL. MECHANICAL Post& Bearn ----- Rough In Gas Line -- - -- - - - - ----- :._.. ----- --- - -- Smoke Dampers Final FART FAIL -nrvice Rough In UG/Slab - ---- - --..---.--_ Low Volta i 777 Tatm ---- -__--- - - _— - S PART FAIL -� r--- --- STT Backfill/Grading ---`- --"- - ---- �----_-- Sanitary Sewer Storm Drain [ ] Reinspectiolr fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RF I ] Unable to inspect-no access Fire Supply Line --- ADA Approach/Sidewalk Date Other _._. Inspecior ___ _ _._..—Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD 24-Hour BUILZ, *`G Inspection Line: (503)639-4175 4 INSPECtION DIVISION Business Line: (503)639-4171 BUP _-- Received _____-__—Dart�equested=-_—.1 -0 -t, _ AM. _ PM— _ BUP _ --- Location __. 0 .--1 Suite __ __ MEC Contact Person __— _-- Ph PLM — Contractor _. _'_� _ >� Ph (2 3 S — SWR — BUILDING Tenant/Owner _—___ —_—_ —___ _- -- ELC Footng ELC -- Foundation Access: Ftg Drain ELR Crawl Drain - SIT Slab Inspection Notes: - Post&Beam --- --- ------ --- ---. -- Shear Anchors Ext Shee th/Shear ---- ` Int Sheath/Shear Framing -- Insulation Drywall Nailing -- - � - --- Firewall S Fire Sprinkler - —----- --- - --� -`/T Fire Alarm -- Susp'd Ceiling - - t Root ------ Other Final - - PASS PART FAIL PLUMBING - ----- Post& Beam _ Under Slab — -—�- Rough-In _ Water Service _ Sanitary Sewer Rain Drains -_- -- -- - Catch Basin/Manhole _. Storm Dram - -�----- --- i Shower Pan Other: Final -- PASS PART FAIL MECHA_NIC_AL -_--- _-_.___- - ------ - ---- Post&Beam Rough-In -� _----- ---- — - ---- ----- Gas Line Smoke Dampers Final ELE�PART FAIL - ^- ICAL _ — - - -- - ---- -�� Rough-Ir' __ ------ -- - -- - ----- —---- UG/Slab Low Voltage _ -- _- Fire Alarm J Reinspection fee of$_ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ART FAIL SITE Please call for reinspection RE:_ __..r___ L J Unable to inspect-no access Ore Supply Line _ ►'". 91 Ext ADA Data$- C..` © "L Inwpecfd� — Approach/Sidewalk '' T Other -- Final DO NOT REMOVE this Inspection record trom the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — BUP Date Requested t1U ' Z AM —PM — BLD Location A9 O"-C) '5 w Suite �— MEC, Contact Person _ /�G+� ( Phzs- G(IIlgI` Contractor Ph _ SWR _ i - �,�_ �— BUILDING TCL i ZELC — Retaining Wall -'� ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection !dotes Slab ---------------...----- -- Sfr Post&Beam - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall --- Fire Sprinkler —_-_—__ _-_ Fire Alarm Susp'd Ceiling -- ----------------.___._-_. Roof Misc: - - ---- -- - --- -- - - Final v�_.----- _PA PART FAIL - -- -- -- PLUMBI _ '� Post—& Beam --- - -- -- - -- - - - - Under Slab Top Out Water Service �� --- - - - Sanitary Sewer� Rain DrainG'✓ Fiqakn f-�ASJ PART FAIL . iANICAL Post& Beane - -- ---- - -- Rough In VA Gas Line -- -- �— _ Smoke Dampers Final --- PASS PART FAIL � — ELEC rRICAL - - -- --_ _ - Service Rough In LIG/Slab _ Low Voltage Fire Alarm Final _.-.- Final PASS PART FAIL SITE Backfill/Grading ----- — ---.- -- -- —_ _ -- Sanitary Sewer Storm Drain i j Reinspection fee of$— _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I j Please call for reinspection RE:—_ ( J Unable to Inspect-no access Fire Supply Line ADA Approach/Sidev,alk d Inspector Ext'--3 J �- Other Date -.f--,- i_ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD _ ELECTRICAL PERMIT _-- \ T TIGARD #: ELC2004-00013 DEVELOPMENT SERVICES DATE ISSUED: 1/13/04 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: '1S136CA-90601 SITE ADDRESS: 10900 SW 76TH PL 60 ZONING: R-25 SUBDIVISION: TIGARD WOODS A CONDO COMM BLOCK: LOT : 060 JURISDICTION: TIG Project Description: Reconnect. RESIDENTIAL.UNIT _ TEPPP_SRV C/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: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601+arTrps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH C'RCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+ amp/volt: 4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: 1 SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SPRUCE TERRACE ASSOCIATES,LLC OWNER 5320 SW MACADAM AVE.#200 PORTLAND,OR 9720.1 Phone: 503-233-9980 Phone: #: FEES___ --- F_E_ES Description Date Amount — _�_. _ Required Inspections I AXI 8%State Surchargc I I + 04 $5.35 Elect'I Final Total $72.20 This Permit is issued subjeri 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 Asuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notiircetion Center. Those rules are set forth In OAR 952-001-0010 throe igh OAR 952-001.0100 You may obtain copies of these rules or direct n9 to OUNC at(503)246-6699 or 1-800.332.2344. Issued By: , , � ������ �,.�w��.Qr_ 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 INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: r'� r ' DATE LICENSE NO'. —_ Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application FOR OFFICE USE ONLN Received 11 City of Tigard DateB : l `"I �Oq 1 PemnitNo., � 0(� -t)pp I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 Date Ready/By: 1u' ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information — TYPE OF WORK — PLAN REVIEW -- -- Please check all that apply. ❑New construction ❑Addition/alteration/replacement ❑Service over 225 amps,comm'I [I Hazardous location ❑ Demolition ❑Olhcr: ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft., CATEGORY OF CONSTRUCTION of I-and 2-family dwellings 4 or more new residential E]System over 600 volts nominal units in one structure ❑ I-and 2-family dwelling ❑Unnitnercial/industrial ❑Accessory building []Building over three stories []Feeders,400 amps or more MMu_lti-family ❑ Master builder ❑Other: _—_ []occupant load over 99 persons ❑Manufactured structures or JOB SITE INFOILMATION AND LOCATION ❑Egress/lighting plan RV park c y c'—='�j�� ❑Health-care facility ❑Other. Job no. lob site address: O�t}J 1r� : Submit_L sets of plans with any of the above. City/Slate/ZIP: q/e,/ tai 1' 7� 3 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg./apt.no,: 6 (-), l Project name: lU A-)C'0,-r)S. Description Q') F Pee. I Tma1 Cross strect/directions to job site: New residential single-or multi-fandly dwelling unit. Includes attached garage. 1,000 sq,fl.or less— 145.15 4 Subdivision: Lot no.: Ea.add'I 500 sq.ft.or portion 33.40 I _ - Limited energy,residential 75.00 2 I Tax map/parcel no.: _T _ Limited energy,non-residential 75,00 2 T DESCRIPTION OF WORK rich manufactured or modular dw�ellin ,service and/or feeder 90.90 Services or feeders Installation,alteration,and/or relocation 200 amps or Icss 80.30 2 201 amps to 400 amps 106.85 2 ' TY OWNER ;❑ TENANT —_ 401 amps to 600 amps 160.60 2 Name: /t(J G E ✓�=,[�C rc) �}SSGCrrJ JL S, L z C- _! — 60I amps t 1,000 amps 240.60 2 Address 5�3�U 5,-, /921)44> 1, cnamps or volts 454.65 2 _ 41n� Re / Reconnect nnectett only 66.83 2 City/5tdre/ZIP: Al r,._� (h% e' 1'J� Ternporrry services or feeders installation,alteration,and/or relocation _ Phone:( 03) .??5& X 1-Cl Fax:( 5Z)3) 7 3 %%S 200 amps or less 66.85 I Owner Installation:This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 133 75 2 Owner signature: _ Date: __ Branch_circuits-new,alteration,or extension,per panel `- _= - -- -C�---� AFee for branch circuits with ❑ APPLICANT �T LJ 4ONTACT PFRSUN .service or feeder fee,each -- --r r / / / 6.65 2 Business name: `�(Jyv//�i 1 L - d u /fj �Iv�i branch r train — �--- nee for branch circuits Contact name:: -�C' without service or feeder fee, 46.85 2 --- each branch circuit Address: t, 2j J d " d f )C;1'/041'l""e 1 J Each add'l branch circuit 6.63 2_ C W/State/ZIP: 1 e-, J Miscellaneous(service or feeder not Included) --F Pump or irrigation circle 53.40 2 Phone:( ,��j ?'L3 S'J X/ h Fax: :( Suzy 7 1 3 7 r✓ Sign or outline lighting 33 40 2 I;_Inai��bt - i�'N't pµ - — Signal circuit(s)or limitcd- _ TA- --- energy panel,alteration,or Curt'rK _- --.- extension Inscribe: Paget Business name: c -- - --- _ ---- � -- — Erch additional-inspection over allowable In any of the above Address: Per inspection 62.50 City/State/ZIP: Investigation per hour(I hr min) 62.50 _ -- - — Industrial plant r hour 73.75 Phone:( a) .� -( ) -- ----- ', '' ,� r���., CCB Lic.: �Rlectrical Lic.: _ Suprv.Lic_ -^, subtotal Suprv.L%cirician signature,required; Plan review(2 5%of permit fee) Suite surchatge(8'!a of per'rTlll fee) / 5 Date: / /3 TOTAL PERMIllFEF Authorized signatul — - This permit application expires if a permit N not obtained within too days after it has been accepted as complete Print name: A1. 1 .E �ete: r 17 J ace methodology set by 1'ri•C homy ixuiW{ng InJuvuy Service mused f-,- t ! ••Number of inspects ms per permit allowed 118ulldia1%Pem*v%L('Perm11App doc 1110! N0• Sal n�nl/CUM exon Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PFRM1T FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined........ !f75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* [J Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY!F Fee for each commercial system....................... $75.00 (SBE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication InEtallation ❑ Fire Alarm Installation ❑ HVAC [] Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other-- Total number of commercial systems: *No licenses are required. I,Icenses are required for all other installations i'Huildin�`PermiF:LCMmNApp,wu iai� CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MSl — ---- INSPECTION DIVISION Business Line: (503)639-4171 BLIP - - - --_T Date -tt n , M_amP BLIP Received � d A - MEC Location ' Gulte ----------- - - - -- PLM _ (�3) (�_���- Ph __ ------ Contact Person �' ? SWR Contractor _ Ph( ) -- ` ELC* — BUILDING TenanUOwner ELC Footing Foundation Access: ELR - Ftg Drain Crawl Drain SIT - - --- — Slab Inspection �Jotes: Post&Beam Shear Anchors - -- Ext Sheath/Shear Int Sheath/Shear - - - Framing _ - Insulation Drywall Nailing Firewall Fire Sprinkler _ Fire Alarm Susp'd Ceiling Roof __- Qther._— ----- � _ Final -- PASS PART FAIL - PLUMBING ---_ -- / Post&Beam _- Under Slab Rough-In Water Service - - Sanitary Sewer Rain Drains -^ Catch Basin/Manhole -_ --~ Storm Drain _ - Shower Pan —_ ------- -- Other:_ - -- Final - - — PASS PART FAIL MECHANICAL Post&Beam Rough-In Gas Line ----- Smoke Dampers Final --- PASS PART FAIL _ ELECTRICAL SIC COY-4_ �. ------------ - 'Sa co)----__- Ro- -In UG/Slab ,1� ------- r Low Voltage -----'�-�- - FJra Alarm required before next inspection. Pay at City Hall, 13125 SW Hell Blvd. Reinspection tee of ARTFAIL Unable to inspect-no access Please call for reinspection RE:_- - ADA Inspect Ext Line Q�( Inspect DA _ Approach/Sidewalk Other - — DO NOT REMOVE this Inspection record from the Job iilte. Final PAt38 PART FAIL