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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appri dwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in C' IF NAL:
Post/Beam Mech. San. Sewer Gas Line s 9.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation (:-=Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: -r/6 �/ 6 Time: A PM
Address: — J �� s �� y k -,)l xc
Builder: , ,-c `�� iZY� Permit #:Al e�C. -%5_-O Y3
THE FOLLOWING CORRECTIONS ARE RFOUIRED../ /-� C_
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Inspector:_ Date:?//6 ;
VIED DISAPPROVED `APPROVED SUBJECT TO ABOVE
Call For Reinsp.
ELECTRICAL PERMIT L�
CITY OF TIGARD DATE=I 95
ISSUED:C12/20/95
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: �S I i l AC-0G 100
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
:SITE ADDRESS. . . . i 2 130 SW '),--:IUD AVEC
SUBDIVISION. . . . : LAUNALYNDA PARK ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . :29
Project Description: One branch circuit.
----------------------------------------------------------- -- --- ----------- ------
---•RE.S IDENTIAL UNIT---- ----TEMP SRVC/FEEDERS------ ------MISCELLANEOUS-----
•
10k�ir AF (]R LESS. . . . . 0 LI i — w:liiC'', amp mp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5005F. . . s 0 201 -• 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 17, 4.01 -- 000 amp. . . . . . . : 0 SIGNAL_/PANFI._. . . . . . . : 0
MANF. HM/ SVC/FDR. .: 0 601+amps-1000 volts. : 0 MINOR LABEL. ( 10) . . . : 0
_.- --SERVICE/FEEDER---- ----BRANCH CIRCUITS----- ---ADD' I_ INSPECTIONS---
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 -- 400 .amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L. BRNCH CIRC: 0 IN PL.ANT. . . . . . . . . . . : 0
601 - 1000 .amp. . . . . : 0 -----------------PLAN RE_VIE:W SECTION---.-__---_-_.----.
1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL.. .
Reconnect only. . . . . : 0 CVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC.
Owner: __________.________-_-____._-___ ____ _______ ______ ___. - FEES
JARMLR ELECTRIC type amount by date recpt
5105 SW 45TH AVE PRMT f 35. 00 CJS 12/20/95 95--274111.
5PCT t 1. 75 CJS 95-274111
PORTLAND OR 97221
Phone #:
Contractor: __-_--._.___-_____.._--____._--___--------------------------------_.---__--__-__.-.
JARMER ELECTRIC INC f 36. 75 TOTAL_
5105 SW 45TH
--------- REQUIRED INSPECTIONS -------.PORTLAND OLZ 972; '1 Ceiling Cover Eler-t' 1 Service
Phone #: Wall Cover Elect' 1 Final
Rea #. . :
This permit is issued subject to the regulations contained in the _
Tigard Municipal Code. State of Ore. Specialty Codes and all other Permittee S i gnat ur e
applicable laws. All work will he done in accordance with
approved plans. This permit will expire if work is not started
within 180 days cf Issuance, or if work is susFended for more
than 180 days. Issued 6v
. .........................nWNf_R INSTALLATION ONLY------------------------
The installation is being made on property 1 own which is not intended for
sale, lease. or rent.
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OWNER' S SIGNATURE _.._.. DATE:
INSTALLATION
IGNA?URL OF SUER. ELEC' N: DATE: _./a - ..
M
LLS I CENSE: NO:
Call for inspprtinn - 639-4175
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #` �F
Permit # 9 ' GAG y
Phone (503) 639-4171 Date Issued _/,) - 3io -gs
CITY OF TIGARD FAX (503) 684-7297 Issued by C/��-orf jr X" all
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development _ Number of Inspections per permit allowed
Address 13 C% ( �; �� jt Service included Items Cost(ea) Sum
City/State/Zip�� 1 _ 4a. Residential- per unit 4
1000 sq It or leers $11000
Name (or name of business) Q/Y1 Each additional 500 sq If or
portion thereof $25 00 1
Commercial (� Residential Limited Energy $2500
Each Manuld Home or Modular 2
Dwelling Service or Feeder _ fE18 00
2a. Contractor installation only:
4b. Services or Feeders
Imlallation,alteration,or relocation 2
Electrical Contractorii; 200 amps or less $6000 2
Address FUb201 amps to 400 amps $8000 2
City StateL Zip(I-7ja,L 40f amps to 600 amps $12000 2
601 amps to 1000 amps $18000 2
Phone No. ` - Over 1000 amps or volts -- $34000 2
Contractor's License No. Reconnect only $5000
Contractor's Board Reg, No. 1 _ 4c. Temporary Services or Feeders
/j/�� Installation,allerat,on,o•rel matron 2
Signature of Supr. Elec'n / 200 amps or lees $5000 2
201 amps to 400 arms $75 00
License No. , 42L F Phone Nord (o'�)�K/� 401 amps to 800 amps $10000
Over 600 amps to 1000 volts
2b. For owner installations: see•b•nbove
4d. Branch Circuits
Print Owner's Name Vero alteration or extension per panel
Address a)The tee for blanch circuits with
silty V State Zip purchase of service or feeder W. 2
Each brarv-h circuit V no
Phone No. b)The fee for branrh circuits wflhouf
The installation is being made on property I own which is purchase of service or Awdw fee. 7
1_ `�
not intended for sale, lease Or rent. First branch circuit $3500 2Each additional branch arcual $500
Owner's Signature 49. Miscellaneous
(Service or feeder not mciuded) 2
3. Plan Review section (if required): Farr Pump or irrigation circle $4000 2
Each sign or outline lighting $4000 r
Signal circuit(s)or a limited energ 2
Please check appropriate item and enter fee in section 5B. panel,elle ahon or eidension $4000
4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each ad•litional inspection.over
Classified area or structure containing special occupancy the allowable in any of the above
- as described in N E.C, Chapter 5 "r mapeC mit $3500
Par hour $5500
J Submit 2 sets of plans with application where any of the above n seism
E55 00
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ Q11
-� NOTICE 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 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 LJ Trust/account#
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Balance Due $
erprl�Er11MN�f�1m�(1
CITY OF TIGARD MECHANICAL
Pe:RM z-r
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MEC95-0437
13125 SW Hell Blvd.Tigard,Or*gon 97223.8199 (503)839.4171 D(-)1 E ISSUED: 127'/��'7/9 5
PARCEL: 2S 1 1 1 AC.-06100
SITE ADDRESS. . . : 15130 SW 92ND AVE
SUBDIVISION. . . . : LAUNALYNDA PARK K Z ON I NG: R-.4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :?9
CLASS OF' WORK. . :ALT FLOOR TURN. . . . : 21 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTS W/O ADPL: 0 VENT SYSTEMS : 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL_ TYPES -_- - ----- - 0--3 HP. . . . Q) DOMES. I NC I N. 0
: /GAS/ / / 3-15 HP. . . 0 COMML_. TNCIN: 0
MAX INPUT: 0 RTU 13-30 HP. . . . : 0 REPAIR UNIT 7: 0
F"1 RE DAMPERS?. . : 30-•50 HP. . . . 0 WOODSTOVES. . : VI
GAS PRESSURE. . . 1.30+ HP. . . . : 0 CLO DRYERS. . : 17,
NO. OF UNI"FS----- - - -- AIR HANDLING UN17S OTHER UNI-r . : 0
TURN < 1001'1 BTU: 1 < 10000 (::fm . 171 GAS OUTLETS. : 1
FURN ) -100K, RTU: 0 ) 10000 cfm: 0
Remari•cs : Residenti.,al alteration of a fl.trnar,e to 100K STU .and gas piping one to
fol-(r outlets.
Owner,: - __ _.._..-------..__.____.____._._______._..__.____.______._.__-___._._.__.___._-- FEE:
CHUCK HAMS(?N type, amol_tnt by date r^er_pt
15130 SW 92ND PRM'r s 25. 00 CJS 12/27/95 95--474328
5PCT $ 1. 25 CJS 12/ 9,:5 95-2 74:;28
T'IGARD OR 97.7-23
Phone #i: 503-524-•73170
Cont rar_t or,:
S & T• GAS SERVICE, INC.
1.485 SW 1771'1-1 C JENUE
ALOHA OR 97007
Phone 26. 25 TOTAL
Req #t. . : 91104
REQUIRED INSPECTIONS ----•----
This permit is issued subject to the regulations contained in the Gas Line Irlsp
Ticard Municipal Code, State of Ore. Specialty Codes and all other Mi-r—li rnicai Inap
clicable laws. All work will be done in accordance with Misc. Inspection
=cved clans. This permit will expire if work is not started Final Inspection
R within 188 days of issuance, or if work is suspended for more
I than 180 days.
ormittee rignof. 1( 1.7 ea'
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Js l.t e d D y 7 __._......___........... ..._..._._.._._.
Call for insDection - 639-4175
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City ot'Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hail Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
14—-' scription
Table 3A Mechanical Code QTY PRICE AMT
Job 3i O � z 1) Permit Fee -0- -0- 10.00
Address � -
Q 2) Supplemental Permit 3.00
Furnace lo 165.000
1) incl.duds&vents 6.00 (y�
umace 100,000 BTU t
Owner �7 f�J > 2) incl.duds&vents 7.50
urn nce
(;2 I cos 3) ind.vent 6 00
«"•"• S`i spor�odFhealor,wall i�-
4) or floor mounted heater 6.00
Occupant w Vent not .in
5) appliance permit 3.00
zW Repair of healing,rong.
6) cooling,absorption unit 6.00
Boiler or comp, heat pump,air cond-
T-
a;� �M-¢, 7) to 3 HP absarp unit lo 100K BTU 6.00
pp e" Boiler or maip.beat pum p,air con
Contractor
l)S ✓ d'll' k. cw .) 8) 3-15 HP absorp unit to 500K BTU 11.00
dBodor or comp,boat pump,air cond.
r"LSrn� 700 9) 15 30 HP absorp unit.5-1 mil BTU 15 00
"fft Boiler or comp,boat pump,air cond. �—
()1104 2f, A 10) 3050 HP absorp unit t-1.75 mil BTU 2250
here6y aowlodgo that I have read is application.that the Boiler or comp,hoat pump,air cond.
information given is coated,that I am the owner or authoiizod agent 11) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner,that plans submitted are in compliance with State Air hanclwg uM to
laws,that 1 am registered with the Construction ContracWs Board, 12) 10,000 CFM 4.50
that the number given is correct (If exempt from State rogistration, Air u" ing unit
please give roason below.) 13) 10,000 CTM* 7.50
Non p«— E
14) evaporate cooler 4.50
ent an con
15) to a singlo dud 3.00
Ventilation systom not
1 1 `rJ S 16) included in appliance permit 4,50
17) mechanical exhaust 4.50
Describe work new addition alteration cepa ,ommercral or inclustirW
to be done residential Q nonresidential 18) type incinc"tm 30.00
isbng use oT' Othei,i.e-, stove,water
building or property-- —� _ 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to bur outlets 2.00 ).
building or property _
T of fuel-oil 21) More than 4-per oudel
...
Type Ll natural gas O LPG O electric(�
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co NOTICE
w Min' um Fee$25.00SUBTOTAL U
J PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCIIARGE Z
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
ig TOTAL
Special Concftions _—
Date issued_/,Z by- �S