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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line• 71
pry ' ;2 1
BUP
Date Requested �h " ( i AM —P-NIS _ BLD �/
�7 ct Suite MEC l -a) 6
Location � � � 'a � J .5 r�' Imo,_� / — _!_1 ��
Contact Person L-E�`4►',W J RPh to a) "�Lj- PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS —
Ftg Drain - SGPr
Crawl Drain Inspection Notes:
Slab _— — - SIT _
Post& Beam
Ext Sheath/Shear L
Int Sheath/Shear
Framing —_ — -- -- -
Insulation
Drywall NailingVol-- -- —� - - —
Firewall
Fire Sprinkler --- - --- --- --
Fire Alarm _ -1� , n
Susp'd C ailing �_LS�
Roof
Misc -- -- -
Final to
PASS PART FAIL --- - - - ----
PLUMBING
Post& Beam —�--- ---- -- -- ----_ _---- —
Under Slab
Top Out
Water Service _
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
F HAN
Post& Beam --- -- - - - - -
Rough In
Gas Line - -- - - -
Smok, Dampers
PASS PART FAIL
Service ---
n Rough In
v~ UG/Slab
Low Voltage
~ Fire Alarm
AS PART FAIL
M-
Li
-' Backfil!/Grading --- -'
Sanitari Sewer
Storm Drain I 1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I ) Please call for reinspection RF _ -___-__--` [ Unable to inspect-no access
Fire Supt?ly Line
ADA
Approach/Sidkswalk Date Inspector _ Ext _
Other - -
1 ,;Sr ina!
PA
PART FAIL 00 NOT EMOVE: ibis inspection record from the job site.
CITYOF TIGARD MECHANICAL HERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999-00415
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/05/1999
PARCEL: 1 S136CB-06100
SITE ADDRESS: 11230 SW 83RD AVE
SUBDIVISION: STEVE + HUGHIE'S PLACE ZONING: R-4.5
BLOCK: LOT: 033 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES _ 0 - 3 HP: 1 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: 1 _ AIR HANDLIN�3 UNITSOTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace existing furnace and install a new air conditioning unit. A/C units cannot be placed within the required
setback areas.
Owner: FEES
DUNN, CHARLES A + TAMARA S Type By Date Amount Receipt
11230 SW 83RD PRMT DST 10/05/19 $50.00 99-318854
TIGARD, OR 97223 5P(T DST 10/05/19E $4.00 99-318851
Phone: Total $54.00
Contractor:
SPECIALITY HEATING + FABRICTN
9528 SW TIGARD
TIGARD, OR 97223 REQUIRED INSPECTIONS
Heating Unt Insp
Phone:620-5643 Cooling Unt Insp
Reg #: LIC 00066578 Final Inspection
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LL This permit is i�sl led subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This pe,-mit v ill expire if work is not started within 180 drys of issuance, or if work is suspended
for more than 18G days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Genter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: �� �� � C'L— Permittee Signature:
Call (503) 634-4175 by 7:00 P.M. for inspections needed the next business day
Plan Check#
DITY.OF TIGARD Mechanical Permit Application Rec'dBy
-13125 SW HALL BLVD. Commercial and Residential Darr.Recd_
TIGARD, OR 97223 Date to P.E,
(503) 639-4171, x304 r Date to DST _
Print or Type
Permit#,Pf �` J�jS
Incomplete or illegible applications will not be accepted Called _
Name of Development/Project - Cfl
Tab1A -
Table 1A Mechanical Code Qty Price Amt
Job Street Address/ l Su te# A) Pcrmit Fee v '` 16.00
Address 11.235 SW 8.3 � 9U- . 1) Furnace tc cls& 0 BTU
_ -__ includingducts vents see footnote 1,2 � 9.65
Bldg4 Coy/Slate zip 2) Furnace 100,C00 BTU+
IQQ Yd flw"' q j�� including ducts&vents see foomot-1,2 12.00
Name"(or name of buslncss)-J ' 3) Floor Furnace
Owner C►L((,Y I F$ 4- Yy(,l K 14 including vent Eee footnote 1_2_ 9.65
Mailing Audiess 4) Suspended heater,wall heater
r la p J� g3 /)!/P or floor mounted heater see footnote 1,2 9.65
FI 5) Vent not included iii appliance permit 4.75
CHyrState Zip Phone Check all that apply: 'Boiler Heat Air
_ a_J X q7aa_3 a 39- �o�J For Items�-10,see or Pump Cond Qty Price Amt
Na (or name of business) footnotes 1,2 Com
bsorb unit to
100K BTU9 65
Occupant Mailing Address 7)3-15 HP;absorb unit
I OOk to 500k BTU � _ _ 1_7.65
CAy/State Zip Phone 8)15-30 HP;absorb
unit.5-1 mil BTU 24.15
Name 9)30-50 HP;,absorb
Contractor unit 1-1.75 mil BTU 30.00
S e C t-1 L4 10) 50HP,absorb unit
Prior to l ermit Mailing Address >1.75 mil BTU 60.15
issuance,a copy q S its �_I G Ol r(� J 11 Air handling unit to 10,000 CFM
of all licenses cn rslate / zip Phone 7.00
are required if ( Q,(0. L) 9 71 _5 12)Air handling unit 10,000 CFM+
expired In COT Ordon Const Cont Board Lic p Exp Date 11.85 -
_ database 13)Non-portable evaporate cooler
Architect Name _ 7.00
14)Vent fan connected to a single duct
�' � ---- 4.75
or Mailing Address --
15)Ventilation system not incluo�u in
appliance permit 7.00
Engineer City/State zip Phone 16)Hood served by mechanical exhaust
_ 7.00
Describe work to be done17)Domestic incinerators
� 12.00
New O Re air Q Replace with like kind: Yes Q(No O 18)Commerual or industrial type incmeralor
Residential V Commercial O _ _ 48.25
19)Repair units
Additional information or description of work _ _ _ 8.40
20)Wo-(A-love/g is FP/other untts/clothe dryer/etc.
7.00
NOTE: For Commercial projects only,Units over 400 lbs require 21)Gas pip ng one to four outlets
_structural gas talcs See footnote 13.75
Ln Type of fuel oil O natural gas 46 LPG O electric O 22)More than 4-per outlet(each) - 75
} Minimum Permit Fee$50.00 SUBTOTAL
~ I hereby acknowledge that I have read this application,that the information 8%SURCHARGE
given is correct,that I am the owner of authorized agent of PLAN REVIEW 25%OF SUBTOTAL
the owner,that plans submitted are in compliance with Oregon State laws Required for ALL commercial permi's on
_
TOTAL
SI nature of Owner/Agent Date -- 1` -
f Other Inspections and Fees:
/'o4 js ! q -1 1. Inspections outside of normal business hours(minlnum charge-two
Contact Person Name Phone hours) $50.00 per hour
2. Inspections for which no fee Is specifically Indicated (minimum
�t epi �K�./�►j f?i/ �o� - S�,q 3charge-half hour) $50.00 per hour
Foonotes for commercial projects only: V 1. Additional plan review required by :.nanges,additions or revisions to
1 Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. 'State Contractor Boller Certification required
"Residential A/C requires site plan showing placement of unit
I lmechperm doc rev 7/19199
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TY O F T I C9 A R D ELECTRICAL PERMIT
PERMIT#: ELC1999-00593
DEVELOPMENT SERVICES DATE ISSUED: 10/05/1999
13125 SW Hall Blvd., T°card, OR 97223 (503) 639-4171 PARCEL: 1S136CB-06100
SITE ADDRESS: 11230 SW 83RD AVE
SUBDIVISION: STEVE + HUGHIE'S PLACE ZONING: R-4.5
BLOCK: LOT : 033 JURISDICTION: TIG
Proiect Description: Add a first branch circuit.
_ RESIDEN- !QL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMD/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ _ _ BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 - 200 amp: W/FERVICE 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 arip: PLAN REVIEW SECTION__
1000+ amp/volt: >=4 RES UNiTS: > 300 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS' CLASS AREA/SPEC OCC _
Owner: Contractor:
DUNN, CHARLES A + TAMARA S SHARPE ELECTRIC INC
112.30 S\N 83RD 22605 SW RIGGS
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 642-7937
Reg #: LIC 000815
SUP 3344S
ELE 34-217C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DST 101'05/199 !37.50 99-318854 Elect'I Final
5PCT DST 10/05/1995 $3.00 99-318854
Total $40.50 ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State o`OR Specialty Codes and all other applicable lav,s.
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 roves adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR J52-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503)
246-1987.
PERMITTEE'S SIGNATUI M'�,� ISSUED BY:
J
OWNER INSTALLATION ONLY
The installation is being made on property I own which is riot intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATJRl= OF SUPR. ELEC'N: c° "'� rs ___ DATE:_
LICENSE NO: ---
Call 639-4175 by 7:00pni for an inspection the next business day
CITY OF TIGARD Electrical Permit Application PlanCheck#_
13125 SW HALL BLVD. Recd By
Tt'GARD OR 97223 Date RecdDate to P E
Phone(503)639-4171, x304
1 Date to DST _
Inspection (503)639-4175 Print of Type � ! Permit#Ae(.,X l-65c 23
Fax (503) 598-1960 Incomplete or illegible will not be accepted Calle
?. Jod Address: 4. Complete Fee Schedule Below:
Name of Development_ 4
Number of Inspections per permit allowed
- �-------
Name(or name of business) Service included: Items Co':t Sum
r -
A lri!PS� .S(� 83/' v Il 4a. Residential-(ger unit
1000 s� ft.or less $ 117 75 4
City/State/Zip-.LM/0,15Z O k g ' 2- Z a ----
Each additional 500 sq.ft.or
portion thereof _ $ 26.15 1
Commercial ❑ Residential 1P Limited Energy $ 60.00
Each Manurd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
;i-rior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
inforrnation for COT data base). _ Installation.atteralion,or relocation
Electrical Contractor S 2 oze � (G.. 200 amps or less $ 64.25 - 2
Address L2(,NQS s t,cJ 'Cl S /P� 201 amps to 400 amps $ 85.50 2
p 401 amps to 600 amps S 128.50 2
city Stare Zip 7 /roO 7 _ 601 amps to 1000 amps $ 192.50 _ z
Phone No. !�0 3nzr a' 7�3� Over 1000 amps or volts $ 363.75 4 2
Job No. �_aS,rj 7 7_ — A Reconn• A only � $ 53.50 2
Elec. Cont. Lice. No. —3 17_C Exp.Date_11�-zw tl`- � 4c.Temp,-rary Services or Feeders
OR State CCB Reg. No. a-,LS/ W, Exp.Date 5/6�_ Instal, ':_ i,alteration,or relocation
130T Business Tax or Metro No.&52/ Exp.Date ZT 200 amps or tens $ 53.55 2
201 amps to 400 amps _ $ 80.25 2
Signature of Supr Elec'n ( / 401 amps to 600 amps $ 157.55 __ 2
Over 600 amps to 1000 volts,
License No.33q qS Exp.; see"b"above.;ate 40 cr
Phone No
4u.3ranch Circuits
(t ,Z= Z� _-_ _ New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder tee.
Print Owner's Name Each branch circuit _ $ 5.35 2
Address b)The fee for branch circuits
without purchase of service
qty State Zip — or feeder fee.
Phone No. First branch cirr.rlt _ $ 3750
Each additional branch circuit $ 535 _
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, ler-3e or rent. (Service or feeder not Included)
Each pump or Irrigation circle $ 42 75 _
tOwner's SignatureEach sign or outline fighting $ 42 75
- – - Signal circuit(s)or a limited Pnergy
, Plan Review section if required):* panel,alteration or extension _ $ 60 00
3
rx; � Minor Labels(10) � $ 107.00
h—
in Please check appropriate item and enter fee in section 5B, 4f.Each additional inspects,).i over
4 or more residential units in one structure the allowable In any of the above
_
Service and feeder 225 amps or more Per Inspection $ 50.00Per hour $ 50.00
System over 600 volts nominal In Plant $ 5900
Classified area or structure containing special occupancy as
LL desc•ibed in N.E.0 Chapter 5 5. Fees:
sa.Enter total of above fees $ ,!
* Suhmit 2 sets of plans with application where any of the above apply `)t/o Xf Surcharge(05 X total fees) $
Not required for temporary construction services. Subtotal $
5b.Enter 25%of line file for
NOTICE Plan Review If required(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS ❑ Trust Account# _
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $
0611s0 fnrms\eleetric.doc