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islrecords\micrjfln;4argolslbuilding.doc
CITY OF T I GARD MECHAN IDERMI CAL
I T
-COMMUNITY DEVELOPMENT DEPARTMENT PLRMIT #. . . . . . MEC950441.6
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 DATE ISSUED:
PARCEL: ES111AD--0-4600
STTF ADDRI-73S. . . : 14435 5W 92ND AVE
SUBDIVISION. . . . : PENMAR TERRACE ZONING- R--4. 5
BLOCI-.. . . . . . . . . . : LOI.. . . . . . . . . . . . . : 13
CLASS OF WORK. ALT Fl...00R FU-N. . . . . 0 17VAP COOLERS: 0
TYPE OF (AGE. . . . :SF UNIT HEATERS. . - 0 VENT FANS— : 0
OCCUPANCY GRP. . :R3 VENTS W/O 11PPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPPESSORS HOODS. . . , . . . : 0
FUEL TYP'r_-C.;--------------- r71.-? HP, . . . : L") DOMES. INCTN. 0
- /GAP, " 3-15 HP. . . . 0 COMML. TNCIN: 0
MA)! INPUT: W!210121 BTU 13-30 HR. . . . : 0 REPnIR UNITS: 0
FIRE DAMPERS;'. . : 30-50 HFA. . . . : 0 WOODSTOVE.S. . : 0
GAS PRESSURE. 50+ HP. . . 0 CLO DRYERS. . : 0
NO. OF AIR HANDLING UNITS 01HE:R UNITS. : 0
!=URN < 1001-'\ BTU: 1 10000 C:flTl : 0 GAS OUI'LETS. . .1
FURN ) =100K BTU: 0 > 10000 cfm : 0
RemaHcs : Connect aas ft,ir-nace (REPLACE OLD FURNArE WITH NE,4)
Owner— FEES
NANCY LIEUALLAN type 'Altial-tnt, bV nate r-erpt
14435 SW 92ND PIRMI $ 25. 00 JMH 12/0'r3/95 95-274377
5PCT $ 1. 25 JMH, 12'/28/95 95--274377
TIGARD OR
P'lliane #i
contt-actot-:
TEASDPLE S & T GAS SERVICE. INC.
a5iE!8 SW 190TH AVENUE
SFAVERTON OR 97007
17.11-irrie #,- F,42 -72'43, �-.'6. 25 TOTAL
Rpa 0. . : 91104
F FOL)I RED nj 7pr-r--r T nr.l—,
This permit is issued subject
iect to the regulations contained in the Gas Line Ins
Tjoard Municipal Code, State of Ore. Specialty Codes and all other MechianicAl Insp
aoolicable laws. All work will be done in accordance with Final Inspection
aoDroved Mans. his oermit will Mire if work is not started
within 180 days of is;,Ance. or if work is susoended for more
'han 180 days.
le i--m i t;t;e e 5 1 n TI At i.kt,e (071-
C,a 11 f ci t- inspection 639--41 .75
CITY OF TIGARD BUILDING INSPECTION NOTIC''
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_ —
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer r;a; Line -Bldg.
Plbg. Underfloor Rain Dram Framing -Plumb.
Alam Water Line Insulation ecfa.
Undertlr. Insul. Shear Wall –,ip. Bd. Cr--
�Y v
Date Requested: j 1 �f�- Time: AM PM
Address:
Builder. (y }–` 7,� LT�1Ct.� Permit
THE FOI�OWING CORRECTIONS ARE REQUIRED: `��� S- D6S7
�C
J
Inspector. /- Date:
/APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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City of Tigard M EOHAN ICAL PERMIT PlancWRec. # N
13125 SW Hall Blvd. APPLICATION Permit # ME�t,95-oqq
Tigard, OR 97223
(503) 639-4171
scrlpaori
Table 3A Medwwcal Code QTY PRICE AMT
Job _ A 1) Permit Fee -0- •o- 10.00
Address jo
2) Supplemental�Pwrmtt 3.00
w ww 1 lunare 10 1 W,Vw B 1 IJ—'-
p•yti ! it?? [-i 9�� 1) incl.ducts It vents 6.00 L,).—Tunwxi 155,665 BTU
Owner vl (o SY-4' 1,- 2) incl.6xxs 8 vents 7.50
{ urnance
04- X11 +�a 3) incl. Vera --- --- 6.00
« Suspendedse ,walfFeater
41 or floor mounted heater 6.00
Occupant «, o�rit not aa�Tc 7n_ -
ti) appitawoo pommit 3.00
pact of lmi,g,-rWrig.
6) cooling,absxxption uvt 6.00
Bode(or comlp,FWY,pump,air
Z! O�,1Q�V icy 7) to 3 HP absorp unit to 100K BTU 600
W1 �� Jer a oanp, oat pump,air oo .
ContractorF S46 L'Y-o ` Ut-`- (pit 2-721+3 8) 3-15 HP absorp urwt to 500K BTU 11.00
cop"" apBoaw or comp,beat pump,au cond.
9) 15 30 HP absorp unit.5-1 and BTU 15.00
er or oump.I"pump,air coed.
10) 3050 HP absorp unit 1-1.75 mil BTU 22-50
re y acknowl5age that I luivo read this anplicaoon,that the —Boi erg.Imat pump,air cond.
information given is orxhvcl,that 1 arr Me owner or aut"bod agent 11) >50 HP absorp unh 1.75 mil BTU 31.50
of Me owner,that plant submitted arta in compliance with Stave unit 4o
laws,drat I am registered with dw Construction ContrncWt Board, 12) 10,000 CFM 4,50
that the number given Is oomact. (If exempt from State registration, AWhanding unto --
please give reason below.) 13) 10,000 CTM+ 7.50
Z 2 Non Pori"
14) evaporate coo(rr 4.50
ent fan coniZaiJ—
�0/wj van wrd/l- 15) to a single duct 3.0?
1 /i ( iait axm on tyttonot
QQ (4.Kc:_, 1 )J'' 16) im-luded in app"wo punnit 4.50
U— 1100d seirved by
> 17) rtsedhanical exhaust 1.50
scribe w nawa tion a torelion ) or s a
to be done retib On non-residential Q ` e 18) type incinerator 30.00
xisong use O - ser ie.,woo levo,wafer
building or property 19) heater,solar,dodhes dryc.-c elc 4.50
Proposed use of n 20) Gas pipng one to lar outlets 2.00
building or property k/
r Type of fuel -oil Q nattxal gas LPO Q elecdtic Q 21) More clan 4J outlet
NOTICE
.�
on M&AM tie=25.00 _ SUBTOTAL
1LO
0 PERMITS BECOME VOID IF WORK OR CONSTRUCTK)N
__j AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE Z
IF CONSTRUCTION OR WORK IS SUSPENOEO OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 2 M Of SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special conditions
Dale issued ti 6 by
4f: 95- 657
CDATE
.CITY OF T I GARD DATE ISSUEDELIC
: 12/2:108/95
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL:
13125 SW Hall Blvd.Tigard,Oreg 7n 97223*8199 (503)639-4171
144.:,.j aW I)CZ.NE- 1-4',,L ZONING: R--4. 5
PIENMAR TERRACE
L 0 C V. . . . . . . . . . * I OT. . . . . . . .
r,o i ect Description : Connect Qas furnace
—.-RESIDENTIAL LJNI,r---- ---TEMP SRVC/FEEDEP.S------ -----MIFCEL-ANEOUS----
l?Q0 SF OR LESS. . . . 0 201-
4) amp. . . . . . . : L 71 PUMP/I RRIGATION. . .
— 400 amp. . . . . .-ACH ADD' L 5009F. 0 21 0 SIGN/OUT LINE LTG. . : 0S I GNAL/PANEI..., . . . . . . : 171
.IMITED ENERGY. . . . . : 0 401 — 600 amp. • . . • • : 0
1ANF. HM/ SVC/FDR. . : 10 601+amPS--1000 Volts: l'):, 0 MINOR LABEL ( 10) - - -
___--SERV I CE/FEEDE R__._ - -----BRANCH CIRCUITS—— INSPECTIONS—-
200 amp. . . . . . : 0 W/SERVICE OR FEEDER: CA PEP TNSPFCTION. . . . . . 0
0
400 amp. . . . . •. . 0 ist W/O SRYC OR FDR. PER HOUR. . . . . . . . . . .
1,00 amp. . . . . . 0 EA ADD' L SRNCH CIRC: 0 IN PLANT. . . . . . . . 0
,01 1000 0 --FLAN REVIEW SECT ION
!
1000+ Amp/volt. — . : 0 ) =4 RES UNITS. . . . . . . . : ) 601D VOLT NOMINAL. .
225 AMPS. - : CLASS AREA/SPEC OCC.
�Pc:onnect onlv. . . 171 GVC/FDR ------ FEES
r-
,.)wnet-, type -rkmount by date V-eCp`1_.
NANCY LIEUALLAN
PRMT 0 371. 00 JqI) 12/28/95 95-274368
1,4435 SW 92ND 9 5 9G-27 4,36 8
517,(-T $ 1. 795 JSD 1
.LGARD OR
1-hone
$ 36. 75 TOTAL
rARMER ELE[_.TRIC INC.,'
`�105 SW 45TH REQUIRED INSPECTIONS
Ceilinq Cover, iripc7t' I Final
PlIRTLAND OR 1)72;":1J.
Phone #: Wall Cover,
This hermit is Issuea sutiject to the reaulations contained in the
7inard Municioal Code. State of Ore. Soecialty Codes and all other Pev,mittee Signat erre
anolicable laws. All wo-k will be done in accordance with
aDrrovpd plans. This permit will exvirp if work is not started
within 160 days of iss-lancP, or if work is suso?nded for more
than 180 days. I I ted
INSTALLATIO I
The installation is beint _h i-, not intended for
.1 made 011 W-OPP"tv I own whir
_h
1pasp. or- rent.
,
UWNERIS SIGNATURE: DATE
INGTALI_ATION ONLY---------------------------
CIO
SIGNA"11ARE OF' SUPR. FLECIN: DATE:
LICENSE NO:
Call for itisrection -- 639-4175
ew.
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Community development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # _
Permit # L% L C ;Sr,—C ��
Phone (503) 639-4171 Date Issued I CS'
CITY OF TIC3ARD FAX (503) 684-7297 Issued by
l"DD No. (503) 684-2772
Inspection (503) 639-4175 _
1. Job Address: 4. Complete Fee Schedule Blow:
Name of Development 7 Number of Inspections per permit allowed -
Address_�t�3 ��� C% Z2 X, Service included Items Cost(ea) Sum
City/State/Zi4a. Residential- per unit 4
/ �1 1000 aq fl of lase $11000
`
,
Name (or name of business)X)4x 1/ LES[/TLS Tach additional 500 sq It or 1
portion thereof $25 00
Commercial ❑ Residential Limited Energy $25;00
Each Monu'd Home or Modular ?
Dwelling Service or Feeder $6800
2a. Contractor installation only:
4b. Services or Feeders
fnstallahan,alteration,or relocation
2
Electrical Contractor_ .lf zoo amps or less $6000 2
AddreL) -f 201 amps to 400 amps $80 00 — z
City r State Zi 722 401 amps to 600 amps $120 00 — 2
z
L� �� p Over amps 00to 10e ora p $180 00 2
Phone No. 24 —:5—,3 d ( Over1 00 only 34000
Contractor's License No. 2 4--/We—
Contractor's Board Reg. No.. Z _ 4c.Temporary Services or Feeders
installation alteration,or relocation 2
Signature of Supr. Elec'rpoozo/ _ 200 amps or leas $5000 2
License No.��_n_ Phon , - 401 amps to 400 amps $ 00
401 amps to 600 amps $1 no no 00
(her 600 amps to 1000 vults
2b. For owner installation . see,W aboO e
4d. Branch Circuits
Print Owner's NameNew,alteration or extension per panel
Address n)The fee for branch circuits with
City State Zip purchase of smilcr or boder(tee.
Each branch dreu t $500
Phone No. h)The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fes.
First branch circuit $3500
not intended for sale, lease or rent. Each addAional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included)
3 Plan Review section (if required): Each pump or irrigation circle $4000
Each sign or outline lighting $40 00
Signal circurt(s)o•a timiled energy
Please check appropriate item and enter feu In section 5B. panel,alto s on or extension i S4000
t1 4 or more residential units in one structure Mmor Labels(10) $11)000
Service and feeder 225 amps or more
ice- _System over 600 volts nominal 4f. Each additional inspection over
v1 —
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E C. Chapter 5 par inspection $3500
1- Per hour $5500
►-� n Plant $5500
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services.
5. Fees:
LLl 5s. Enter total of above fees $
NOTICE 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal L
AUTHORIZED IS NOT COMMENCED WITHIN too DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Accountilli $
Balance Due $ 310 77
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