15855 SW 80TH AVENUE E.
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ADDRESS:
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I:Vecordsktticrotlmktargetsybuilding.doc
CITY OF TIGARD MECHANICAL
PERMIT
DEVELOPMENT SERVICES PERMIT it. . . . . . . : MEC98-034.0
0i 13125 SW Hall Blvd., Tigard,OR 97223 (603)6394171 DATE ISSUED- 08/12/98
PARCEL.: 2SI12CC-04300
SITE ADDRESS. . . : 15855 SW BOTH AVE
SUBDIVISION. . . . . BOND PARK NO. 3 ZONING: R-1 C'
BLOCK. . . . . . . . . . . L_01.. . . . . . . . . . . . . .071 JURISDICTION-, TIG
-------------
CLASS OF WORK. . :OTR FLOOR FURN. . . . - 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY ORP. . : R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS;COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES--------- 0-3 HP. . . . : 1 DOMES. INCIN: 0
.GAS 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15--30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?— 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 1016K BTU: 0 <= 10000 cfm : 0 GAS OUT'
E T S. % 0
FURN >=I0011 BTI_): 0 > 10000 cfni: 0
Remar-ks : Installation of a/c unit, oust comply with standard setbacks.
Owner-,. FEES
SEAN VANDERHEIDEN type aMOIAnt by date recpt
15855 SW BOTH AVE PRMT $ 25. 00 DEB 08/12/98 9830B22:11
TIGARD OR 97223 5FICT $ 1. 25 DEB 08/12/98 9830822.1
Phone #: 620-5705
Contractor: --------------------------------
(I It A HEATING & COOLING
P. 0. BOX 1266 ---_—__—._-----._---_.__________________
$ 26. 25 TOTAL
SANDY OR 97055
Phone #r
Rey #. . : 000870
REQUIRED INSPECTIONS
This permit is i, -und subject to the regulations contained in the Cooling Unt Insp
ligard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 1B8 days of issuance, or if work is suspended for more
than 180 days. ATTFNTION: Oregon law requires
res you to follow rules
rn adopted by the Oregon Utility Notification Center. Those rules are
set forth in DAR 952-001-0010 through OAR 952-80I-0080. You may
obtain copies of these rules or direct questions to O11NC by ralling
_J (503)246-9187.
I -,s t.i e, By -
P r mi. ttee Signatt.tre :
11<� "__
4..............4...................................................4-++-f.........++
Call 639-4175 by 7:00 p. m. for inspections needed the next bl.isinesr day
..........................................4 +A..........4........4.........4......
A
Plan Che
CITY OF TIGARD Mechanical Permit Application Recd BvFK�x ___
13125 SW HALL BLVD. Commercial and Residential Date RecdEt,;� —
TIGARD, Ok 97223 Date to P E
(503) 639-4171, x304 Date to DST
Print or Type Permit a_ � _n r
Incomplete or illegible applications will not be acceptftd Called_ --
Name of CeveioomenvProiect ^� Description —�
Table to Mechanical Code oTY PRICE AMT
Job Street Address suite* A; Permit Fee -0- -0- TO-0 0
Address �i" `��i ',>w 1blt 4�10_ .
Bldgs I CdyiStale Z. B) Supplemental Permit 300
)v- U J 72 j.'1
Name tor name of busir t 1 ) Furnace to 100 000 BTU 6011,
Owner Q 9 incl ducts 3 vents
Mawng address f 2 1 Furnace 100.000 BTU+ — 110
CL rlf, incl ducts&vents _
Cit tStateup Phone 3) Floor Furnace 6.00
(. 6. -51'1 incl vent
Na[[t-e for name of busnessi 4) Suspended heater,wall heater 600
Ir52�_ or floor mounted heater
Occupant 1 aiiny aadrefs 5.) Vent not incl.in 3.00
_ appliance permit
C,tyrsime i Zw Phone 6.) Boder or comp,heat pump,air cond I 5 00
to 3 HP absorp unit to 100K BTU
Contractor Na1T1e 7) Boiler or comp,heat pump,air cond 11 00
(Pnor to c"IV 1 3-15 HP:absorp unit to 500K BTU
issuance M dmA Addresses 8) Boder or comp heat pump air cond 1500
applicant ((J f! Q(�(.L 15-30 HP.absorp un-t 5-1 and BTU
must provide all �r8tate Zlp Phone 9) Boder or comp heat pump,air cond 2.2 50
contractor 1 Y (J r37,. " r( ) 30-50 HP absorp unit 1-1 75 incl BTU
license o Const Cont Board Lic$ Erp Daie 10) Coder or comp, heat pump,air cond. 37 50
information �t U) // t >50 HP.absorp unit 1 75 and BTU
for COT C Business ax dr, erre a EX 11 ) Air handling unit to 41,
database) _ "1 10.000 CFM
Architect Name 12) Air handling ri,t 1 7.50
10.000 CTM+ _
C,r M.ding Address 13) Non portable 4.50
evaporate cooler
Engineer Cdylsfate Zip Phone 14) Vent fan connected 3.00
to a single duct
Describe work New C Addition O Alteration 16 Repair O 15) Ventilation system not 4 50
to be done Residential O Non-residential O included in appliance permit
Additional Description of work 16) Hood served by mechanical exhaust 450
171 Domestic incinerators _ _ 7 50
Existing use of 18) Commercial or mdustnaltype 3000
budding or property -� J incinerator
19) Repair units 4 50_
Proposed use of 201 Woodstove 4 50
budding or property
i-- 2t 1 C,othes dryer.etc 450
V, -- — —
Type of fuel-oil O natural gas LPG O electric�) j '.21 Other units 450
H
I heresy acitnowleage that I nave read this application,that the 23) Gas pioing one to four outlets 2 00
information givens correct.that I am the owner or authorized agent of
the owner,that plans submitted are in compliance with Oregon State 24) More than 4-per outlet (each) u0
t' laws
Signature of Owner/Agent Date i QTY.SUBTOTAL –C7
�5
^^ 'SUBTOTAL
ll
Contact Person Name Phone ~V 5%SURCHARGE
PLAN REVIEW 25°,OF SUBTOTAL
TOTAL
dst mechpmt clot rev 7,96) �� Mirnmum permit fee is 525 w 5 o surcharg
C-D
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98-0486
13125 SW Hall Blvd., Tigard,OR 57223 (503)639.4171 DATE ISSUED: 08/1.2/98
E'ARCE:L: 2S 1 12CC-04300 I
SITE ADDRESS. . . : t5855 SW BOTH AVE
SUBDIVISION. . . . :BOND PARK NO. 3 ZONING: R-1
BLOCK,. . . . . . . . . . . LOT.. . . . . . . . . . . . . :O71 JURISDICTION: TIG
F'ro.j ect De scr i pt i.on : Installation of 1 branch circait for a/c unit.
--------------- -----------
---RES I DF_NT I AL UNIT---- ----TEMP SRVC/FEEDERS—_.-- ---.--MISCELLANEOUS-----
1000
--.--MISCELLANEOUS------
1000 SF" OR LESS. . . . : 0 0 — 00 amp. . . . . . . : 0 PUMP'/IRRIGATION. . . . : 0
EACH ADD' L 5O0SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401. — 600 amp. . . . . . . : 0 SIGNAL./PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601-+amps-1000 volts. : 0 MINOR L.-ABEL ( 10) . . . : 0
-------SERVICE/FEEDER-•--- -----BRANCH CIRCUITS-----_ ---ADD' L INSPECTIONS------
0 ._. 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . : 0
201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FUR. : 1 PIER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 — 1000 amp. . . . . : 0 --__.__.__-_.__..—_—_—_F'L.AN REVIEW SECTION— __________.-.---.._.__
1000-+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
CC. :OReconnect only. . . . . : 0 SVC/FDR ) = 225 AMT'S. . : CLASS AREA/SPEC OCC. -
Owner:
wner: ___________..__.____________.___.____-_—_---.___._______.___._ FEES -----_.______-_—_--
SEAN VANDF_RHE:IDEN type amoLrnt by date recpt
15855 SW 80TH AVE PRMT $ 35. 00 DEP 08/12/98 98-3082=1
TIGARD OR 97223 5P,CT $ 1. 75 DEB 08/1.2/98 98-3O8221
Phone #: 620-5705
Contractor: -----------------------------
SHARPE ELECTRIC INC $ 36. 75 TOTAL.
22605 SW RIGGS
-------- REQUIRED 1 NSF'ECT I ONS ------
BE.AVERTON OR 97007 Elect' 1 Set-vice
Phone #: 642-7937 Elect' 1 Final.
Reg #. . : OOO815
This permit is issueu ',ubject to the regulations contained in the Tigard Municipal Code, State of Oregon 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: you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 10 through OAR 2-001-1987. You may obtain a copy
of these rules or direct questions to OUNC by cQa-llliing �(5j031�4G-1987. �+
p e r m i t t e e S i.g n a t i_i r e :
r.:
F— ---------------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: ---
m
co
LL; —__-----_.-.----------------CONTRACTOR INSTA LATION ONLY-----------_---_.__--_------
J � �G
y I GNATURE OF SUPR. ELEC' N:
LICENSE NO: 53�VS1
+++++++++++++++++++++++++i++++++++++++++++++++++++++++++++-F++++++++++.1++.++++++
Call 639-4175 by 7:00 p. m. for an inspection needed the next bi_isiness day
+++++++++++++++++-++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
CITY OF TIGARD Electrical Permit Application Plan CI�Ck a
13125 SW HALL BLVD. Recd KNV
Date Rec'd
TIGARD OR 97223 Date to P.E.-•
Phone (503)639-4171, x304 Date to D ��
Inspection (503) 639-4175 Print or Type Permit# .
Fax (503) 684-7297
Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development, - Number of Inspections per permit allowed
Name(or name of busines`s)_ C'(/� 7 Ny 2 �hr] Service included: Items Cost Sum
Address_ '25 5(U C�"' /` �1/✓r- _ 4a. Residential-per unit
1000 sq.ft.or less $110-00 4
City/State/Zip- 7 1 _ Each additional 500 sq.h.or
❑ Residential portion thereof $25.00 1
Commercial
Limbed Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of al rrent licen 5( Ins Services or Feeders
r ���✓ (�t t Installation,alteration,or relocation
Electrical Contractor - 200 amps or lass $60.00 2
Addre 5 ' n J 201 amps to 400 amps $80.00 2
City 63, State Zip ` � _._ 401 amps to 600 amps $120.00 - 2
Phone No. L'1..2 • 7"t 3 601 amps to 1000 amps -_ $180.00 2
7
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 __ 2
Elec. Cont. Lice. No. ""�Exp.Date - `
ri
_
���L�LS_ Exp.Date 4c.Temporary Services or Feeders
OR State CCB Reg. N�0
COT Business Tax or Metro No. 1 / _Exp.Date I- Installation,alteration,or relocation
200 amps or less $50.00 s- 2
Signature of Su r. Elec'n �1a, C_/ 201 amps to 400 amps $ 00.0
Si -
g p 401 amps to 600 amps $1 t 00.00 _ 2
Over 600 amps to 1000 volts,
License No. 33q Exp.Date it)-l- see"b"above.
Phone NO. ----- 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name _.__, feeder tee.
Each branch circuit $5.00
Address --------- b)The fee for branch circuits
City ___ State __ Zip without purchase of ? 1
Phone No. _ service or feeder fee.
I irst branch circuit $35.00 2
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
3. Plan Review section (if required):' Signal clrcuit(s)or a limited energy
3. alteration or extension $40.00
a Minor Labels(10) $100.00
Please check appropriate item and enter fee In section 5B.
FR- _4 or more residential units in one structure 41.Each additional Inspection over
N Service and feeder 225 amps or more the allowable in any of the above
y System over 600 volts nominal Pw inspection $35.00
.~, Classified area or structure containing special occupancy Per hour $55.00
r~
as described in N E.C.Chapter 5 In Plant $55.00
LL 'Submit 2 sets of plans with application where any of the above apply. Jr. Fees:
J Not required for temporary construction services. 5e.Enter total of above fees $
5%Surcharge(.05 X total fees) $ Z
NOTICE Subtotal $
5b.Enter 25%of line So for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reaulred(Sec.3) $ -----
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account M >
TIME AFTER WORK IS COMMENCED. $ �1�r
Total balance Due
I W5TMELC96 APP "ft 9/9A
CITY OF TIGARD BUILDING INSPECTION DIVISION 7� T Sr
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Requested - AM M h
� BLP
Location I�n J 5 W r�n-fl't Suite MEC iJ v
Contact Person _ Ph PLM
Con`ractor F-Pi Ct— c_ Ph y -7` 37 SWR
BUILDING Tenant/Owner
Retaining Wall f ELR _
Footing ACces
sj-
FoundationCn Mt S � C FPS
Fty Drain X. .� � (,J (fi�
Crawl Drain Inspection Notes: / h SGN
Slab _ ��u,N h j SIT
Post&Beam
Ext Sheath/Shear _--- --
Int Sheath/Shear r
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: —
Final
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains _
Final -'
PA FAIL
MECHA .._--
Post& Beam
Rough In
Gas lineP
Dampers
S'b` PART FAIL
--
= Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
r
FREES:54ART FAIL
S
Backfill/Grading -
Sanitary Sewer
Storm Drain j J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin j ]Please tail for reinspection RE:
Fire Supply Line — ( J Unable to inspect- no access
ADA "�
Ext
Approach/Sidewalk Date �1- _-
Inspector
Other -7 _�- p _ _ _ _ -
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.