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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Aec-O-Phone): 639-4175 Business Phone: 639-417
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Inspect�n:_
Footing Susp. Ceiling ;e;,c;h_;Ro�LAjgh-in
Sprink.Rouugh-in Appr/Sdwik
Foundation Plbg. Underslab � Fireplace
Post/Beam Struct. Pibg. Top Out e . ugh in FINAL:
Post/Beam Mech. San. Sewer asG Line _) -Bldg.
Plbg, Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation Mech.
Underflr. Ins.!. Shear Wall Gyp. Bd. �p Elect.
Date Recloested:_ - Time: \"'AM PM
Address_ / olo (,7 ,�L znri_,1
Builder: Permit #:a 16:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
73
Inspector: Dale:* _'7
APPROVED LBTSAPPROVED _APPROVED SU13JECT TO ABOVE
___. —Vall For peinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 63 -41 1
Inspection:
Footing Susp. Ceiling Sprink. Rough-in y Ik
Foundation Plbg. Underslab Mech, Rough-in Fireplace
Post/BGam Struct. Plbg. Top Out Elec. Rough-in NAL'
Post/Beam Mech. San. Sewer Bldg
Plbg. Underiloor Rain Drain ; ;3ming Plumb.
Alarm Water Line Insulation Mech.
Underflr. Insul. Shear Wall Gyp. Bd. Elect.
Date Requested: [� (p �t _Time:x& PM
Address: G)
Builder. ( a(o -7 Permit #tv cJ s C-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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tor: � Date:PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE -
_Call For Reinsp.
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MECHANICAL
- CITY OF TIGARD PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MEC95,Q1i9_
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)6394171 DATE ISSUED: 06/21/93
PARCEL: IS136CB-02600
:51TIZ ADDRESS. . . . 11110 SW 821\1D AVL
SURD I V I S I ON. . . . : RANCH V►iLLEY ZONING: R--4,. 5
A-11-OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :7
CLASS OF WORI-1%. . :ALT FLOOR FURN,, EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT 11EATERS. VENT FANS. . . -
OCCUPANCY GRP. R3 VENTS W/O APPL-, FENT iYSTEM'3' :
TORIES. . . . . . . . : I BO I LERS/COI 1PRE,5SORS W5ODS. . . . . . .
0--1-1) 1AP. DOM,7- INCIN,.,
3-15 :;P. COMML. INCIN:
MAX INPUT- BTU HP. . . . REPAIR UNITS:
71 RE DAMPERS?. 30-50 HP. WOODSTOVES. . :
(.-JAS PREaGURE. . . 50+ HP. CLO DRYERS. . :
NO. OF AIR HANDLYNG UNITS OTHER UNITS. : 1
PURN ( 1000 LTU. 1 t= 10000 cfm ; GAG OUTLETS.
,--URN > =100K BTU: > 10000 cfln :
Relnar�ks : ITIFtallir,;4 f1.n1nac:e to 100, 01,7116 BTU and gas piping.
Owner-: FEES
JOHN CNYDER type arno'.111t by date r^ecpt
11100 SW 02ND AVE. PIRMT $ 25. 00 B 06/21/95
SPCT $ 1. L,5 B 0)6/21/95
I*IGARD OR 97C.2_2
"'lone #:
—untt-actor-:
PORTLi�IAD 14ETRO -AIRE
17117110 SW BE AVERTON HILLSDALE HWY
,,L.A'VERTON OR 97005 -------------
711--lone it: 62G -7818 $ 2C, 21 15) TOTAL_
7
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insip
'igard Mun cipal Code, State of Ore. Specialty Codes and all other Mectianical ITISP
applicable laws. All work will be done in accordance with FiTIE11 Inspection
approved plane. This permit will expire if work is not started
Nit',in 180 atys of issuance, or if work is suspended for more
than 160 days.
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Pr-m i t t e e L(1-V
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gall for- i n s peL.:tion 639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13"25 sw Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
escnpuon
'y"'-I Table 3A Mechanical Code CITY PRICE AMT
Job 1) PermitFee (} 0.0
0- 10
Address �—+—
2) Supplemental Permit 3.00
rumace to ,
y)L') ie 1) incl. ducts &vents 6.00
,.. umace +
l 0o ��� 1 2) incl. ducts &vents 7.50
Owner oor mance
4Lk � 7 3) incl. vent 6.00
Suspended eater, wail eater
4) or floor mounted heater 6.00
,ory, ... vent not incl. in
Occupant 5) appliance permit 3.OJ
Repair of hea6ng, re
6) cooling, absorption unit 6.00
or comp, heat pump, air cond.
o �-t .��- ✓ 7) to 3 HP; absorp unit to 100K BTU 6.00
,., — —' '-- Boiler or comp, ea pump, air cond.
vv IL",
+ %15 HP; absorp ---it to 500K BTU 11.00
S�� �v--Itli� h �;��� 1051�.
Contractor 13b,9r or comp, heat pump, air cond.
9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
—Gtr. Boiler or comp, eat pump, air con .
t j Z 10) 30-50 HP; absorp unit 1.1.75 mil BTU 22.50
ereby a now ge at have readtis a,, dcation, the
Boiler or comp, ea pump, air cond.
information given is correct, that I am the owner or authorized 11) •• 50 HP; absory unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with lir nan i`g unit to
State laws, that I am registered with the Construction Contractor'k 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from Star Air handling unit
registration, please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler _4.50
-- Vent an —i
connect
15) to a single duct 3.00
Ventilation system not
16) included in appliance permit n 50
Hood served by —
17) n echanical exhaust 450
Describe work new addition al eranor repair U Commercialor industrial 30.00
to be done residential 12 non-residential (7 _ 18) type Incinerator
Existing use o —Iffier re., wo stove, water
building or property 19) heeter, solar, clothes dryers, oft. 450
Proposed use of
20) Gas piping one to four outlets ) 2.00
building or property -----
21) More than 4-per outlet
Type of fuel -oil Q natural gas 4,4 LPG (D electric Q
NOTICE
Minimum Fee S25.00 SUBTOTAL 2 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION `
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5°,e SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR F_
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Spec al Conditions
Date issued L, by
„yr ArsrnM•
CITY OF Tlri"RD - RrCEIPT OF' PAYWNT RFC;FIPT 1\10.
CIAECK AMOUNT t 63. ov)
NAME. s PORTI—AND METRO—AIRE CASH AMOUNT t IA. 00
11 D 1)RE G5 7 11?►O10 SW 9rAVCP'1"f3N HL.SDL. MY. POYMENT DATE
W:-.f)VERI-ON, OR 9LJBD I V I S T(IN
97005--
PUPPLISF, OF PAYMENT AMOUNT PAID PURPOSE OF P4'Y'MENT AMOL114T PAID
-95-0191 P5. 00 ST. BUILD PFR
ELECTRTCAL. Pf-PMIT 35. OIA ST. BUILD PER
I I 100 !"m 822ND AVE.
TUIAL AMOUNT PAID 63. 00
C11Y OP' TIGARD -- Rf-CFTPT OF PAYME-NT RLT--.CFIr--T No . :95-0*67076
CHECK AMC.UN-r 63. 00
NAME-- t PORTI-OND METRO -AIME CASIA AMOUNT a Ia. 00
A D r)F4 F,9 r� : 10010 SW BEAVEPTON HLSDL. HW'Y'. PAYMEENT DATE a 06/E1/915
BEAVEERTON, OR SCIODTVISION
970019-
PURPLIS�E Of: P(.)YMF'NT AMOUNT PAID PORPOSF (IF PAYMEN1 AMOUNT PAID
MEJ-HANlCfU- 5-019 1. L.Zp. 00 ST. BUILV P15 i
v,.. 'To,ftA(- vvRmi'r 33. 00 ST. AU11-1) Pr-P 1 . IS
LD
J It 00 SW 82M) OVEN,
TOTAL AMOUNT F"nj t) 63. 00
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation e
Electrical Inspection Section APPLICATION
155 North First Avenue, k350-12
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412
Permit
PLEASE AIN:r It I Number ��-�, -1-T Please corhiplete all sections, I through 5. 1 ?3 Date 2 j�
4. Complete Fee Schedule below
1. Location of installation Number of inspections per permit allowed
Address_ f f f�'�L7 S a t~ tt Service included: Items Cost(ea.) Sum
Building A. Residential - per unit
City ❑ ct --r- Suite No.
1000 sq.ft.or less _ $110.00 _ 4
Tenant Name Each additional 500 sq.ft -�
(if commercial) or portion thereof $25.00
G Limited Energy $25.00 1
Map No ""C - Tax Lot - Each Manut'd Home or Modular
Thomas Map Book: Page:._ Sections Dwelling Service or Feeder -- $68.00 2
Directions __�____ __ -.--__ - B. Services or Feeders
---- Installation,alterations or relocation
200 amps or less $60.00 2
Commercial ❑ Residential 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
601 amps to 1000 amps -- $160.00 2
2a. C017tractor installation qn/
/� J' Over 1000 amps or volts $340.00 2
Electrical t,ontractor '�"�� �t`�l�' /��Y-G� Reconnect only _ $50.00 2
Address �Y> �• ,i -
City - 1--,-e,tNv State Q ZIP "7n ` C. Temporary Services or ceders
Date_l J'---7.i- Job Wmber Installation,alteration or relocation
Property Owner f k 1� �N Yt�' � _ 200 amps or legs $50.00 2
Contractor's License No. _ �,y-�ti�� �� 201 amps to 400 amps $75.00 2
Contractor's Board Reg. NO,
� I -, � 401 amps to 600 amps _ $100.00
L Over 600 amps to 1000 volts see•B•above -
Signature of Supr. Elec'n ( ( itJZ? c D. Branch Circuits
License No._ ' ] t_c, Phone No. r� :Zf- MZ_ Now,altoration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder fee.
Each branch circuit $5.00 �_ 2
Print Owner's Name Tone No.
b) The fee for branch circuits without
purchase of service or feeder fee, r�
Addresb First$)ranch circutl --4_ $35.00 _ _ 2
Each add'nl branch circuit $5.00 _ 2
city �toie �- - -� F. Miscellaneous (Se., ice or Feeder not included)
Each pump or irrigation circle $40.00 _ 2
The installation is being mare on property I own Each sign or outline lighting $40.00 _ _ 2
which is not intended for sale, lease or rent. Signal circuit(s)of a limited
energy panel,nllnration
Owner's Signature _�_ or extension $40.00 r_
F. Each additional inspection over the allowable
Nin any of the above
3. Plan Review section (if required) Per irtspeclion $35.00
Per hour $55.00 Y
Please check appropriate hem and enter fee In section 5B. In Plant $55.00
J
4 or more residential units in one structure
LL and feeder, 800 amps or more 5. Fees 7 ` 1
_System over 600 volts nominal A. Enter total of above fees $
-J -Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ --
above apply. Not required for temporary construction Subtotal $
services. [l Tru-t Account $ r _,
Balance Due $
For inspections call This permit becomes null and void If the work authorized by the permit Is not commenced
640-3561 or 693-4415 within 180 days from data of iaeunnce of such permit or H the work suit,»Ized Is
erupandad or obandcued of any time after work is commenced for•nerlod of 180 days.
24-hour recorder, one working day in advance of need Fledrkd Permiis are nom refundable and non-transfershlo.
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