12880 SW 107TH COURT-1 r
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Flour Inspection Line: 639-4175 Business Line: 639-4171 —
/' BUP
Date Requested_ �'�" —AM PM BLD _
I-ocation— 12�(Clc Suite MEC
Contact Person Ph PLM _
Contractor Ph SWR
BuiLDING Tenant/Owner ELC
Retaining Wall ELR
Footing Acess.
Foundation FPS _
Ftg Drain SIGN
Drain Inspection Notes: --
Slab --^— — — — SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
FramingC'.'l[_ _r=�
Insulation
Drywall Nailing —_—
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: -- --- - ----
Final
PASS PART c"'.L ------- --
PLUMBING
Post&Beam -- —.-
Under Slab
TopOut --------- ---------- ---- ------- -- —
Water Service
Sanitary Sewer
Ran Drains
--------- --
Fina! - ------------- ----- -
PASS PART FAIL
Post& Beam - - -- -- -
Rough In
Gas Line -
Smoke Dampers
A ART FAIL
ELECTRICAL _ --
Service
(lough In --- ----
`) UG/Slab
Low Voltage
J Fire Alarm ---- ----- ----- -- _
Fina!
PASS PART FAIL
SITE - -- -
J
Backfill/Grading ---- "-- — --------- -
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ _required befire next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]
Fire Supply Line Please call for reinspection Rte: _ [ ]Unable to inspect-no access
ADA
Approach/Sidewalk Date 5;'9 Inspector .yam Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION vIVISION MST
24-Hour Inspection Line: 639-4175 1311si:,ess Line: 639-4171
BUP _
_
Date RequestedU�AM _PM BI_D —
Location Suite MEC
Contact Person _ (�, .t' � Ph il-l J�, PLM
Contractor oh _ SWR
i _
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Focting Access:
Foundation T FPS
Ftg Drain �� I SGN
Crawl Drain Inspection Notes:
SlabSIT
iPoF'.& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall NailingFirewall / f
Fire Sprinkler �` e �o✓L �y [ /' 6 s�� ��.'��
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
PASS PART FAIL —
MECHANICAL
Post& Beam -- -- i----
Rough In
Gas Line —
Smoke Dampers
Final --- - - —
PASS PART FAIL
LCTRIGA
R. 'iervice ---- -- - — —
Rough In
UG/Slab - -_-- — —
Low Voltage
Fire Alarm ----
-j T- -
cc
PASS ART FAIL_
Backfill/Grading — -----
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ requi-ed before e 'nspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I ]Please call for reinspection RE. _--__ _ [ ]Unable to inspect-no access
Fire Supply Line
ALS
Approach/Sidewalk Date r 7 Inspector _ - Ext
Other --
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES DATEPERMIT #: D: 03/0129
DATE ISSUED: 03/23/98
13125 SW Nall Blvd., Tigard,OR 97223 (503)63r-4171
PARCEL_: 2SIO3AD-04900
S J TE ADDRESS. . . : 1286O SW 1.07TH CT
SUBDIVISION. . . . :PATHFINDER ZONING:R-4. 5
BLOCK. . . . . . . . . . . ;_OT. . . . . . . . . . . . . :039 JURISDICTION: TIG
Project Description : Add a first branch circuit to .in existing single family
dwelling.
-------------------------------------------------------------------------------------------
- --RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 'UMP/IRRIGATION. . . . : 0
EACH ADD' L 5OOSF. . . ,, 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. 14M/ SVC/FDR. . : " 601+amps-1.000 volts. : 0 MINOR LABEL_ ( 10) . . . : 0
----SERVICE/FEEDER----- ----BRAhICH CIRCUITS----- ---ADD' L INSPECTIONS---
0 - 200 amp. . . . . . : lb W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 - 4O0 ;amp. . . . . . . 0 1st W/O ERVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 ------------------PLAN REVIEW SECTION-----------------
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SFIEC OCC. :
Owner: -.__._-----._______._----_---._._.--.-_--________._______._.____._ FEES
CLAUDE SHANNON type amoi.rnt by date r•ecpt
12860 SW 107TH COURT F'RMT $ 35. 00 GEO 03/23/98 98-304315
TIGARD OR 97223 SPCT $ 1. 75 GEO O3/23/98 98-30431.5
Phone #:
Contractor: ----------------- -------------------------------------------------
WESTSIDE ELECTRIC CO INC f 36. 75 TOTAL_
1834 SE 8TH AVENUE
-------- REQUIRED INSPECTIONS -----
PORTLAND OR 97214 I.lndergroi_rnd Cove Elect' 1 Final
Phone #: 231-1548 Elect' l Service
Reg #. . : 000133
This permit is issued subject tc the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Cod•% end all other
applicable laws. All work will be done in accordance rith approved plans. This permit will expire if work is not started within IN
days of issuance, or if work is suspended for mor-, than IN days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those ru:;s .:,v set forth in OAR 952-MI-018 through OAR 952- 81-1987. You may obtain a copy
of these rules or direct questions to ODIC by calling 31246-1987.
N
Permittee S i g n a t i_r r••e : ,f-7p I s s U e d B y�",if�--1 � � •---
INSTAL.L.ATIOhJ ONLY--------_--_-------------------
�? The installation is being made ori property I own which is not intended for-
sale, lease, or, rent.
-� OWNER' S SIGNATURE: DATE:
_____________--_--_-_--_.-_CONTRACTOR INSTALLATION ONLY-------------------------- ----
SIGNATURE OF SUPR. ELEC' Ne C''"J -��� DATE:
LICENSE NO:
+++++++++++++++++++++++4+-++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639--4175 by 7:00 p. m. for an inspection needed the next business da
+++++++++++++++++i+++++++++++++++++=1++++++++++++++++++++++++++++++++++++++.+++++
CITY OF TIGARD Electrical Permit Application Plan ChLc4 a
13129 SW HALL BLVD. Rec'd64jiL -'-1
1IGARD OR 97223 Date Recd_
Dat"iF1.Fq ninnTC„
Phone (503)639-4171, x304
Print or Type Date to Dui'
Inspection (503) 639-4175 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
C
Name(or name of business) L i- �o� yoowm Service included: Items Cost Sum
Address_ 12,�LO SVv `Q�M (X . 4a. Residential-per unit
-�-r 1 1000 sq.ft.or less $110.00 4
City/State/Zip IJ1(� ��J�C g1ZZ� Each additional 500 sq.ft.or
Commercial F1 Residential portion thereof $25.00 1
Limited Energy $25.00 _
Each Manul'd Home or Modular
Dwelling Service or Feader ,_ $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) C 4b.Services or Feeders
Plectrical Contractor h� -3T �u2n. r f,k,ItVA[ Installation,alteration,or relocation
Address 3R fd^ r1 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City th!.2� State Cn. Zip 9-1214 401 amps to 600 amps $120.00 _ 2
Ph)ne No. Z 3 1- tai 601 amps to 1000 amps $180.00 2
Job No. 31°►-G10 Over 1000 amps or volts $340.00 _ 2
Reconnect only $50.00 2
Elec.Cont. lice. No..�6 1 i Exp.Date
OR State CCB Reg. No. 13 3 cy Exp.Date _ 4c.Temporary Services or Feeders
COT Business Tax or Metro No. _Exp.Date Installation,alteration,or relocation
200 amps or less $50.00 _ 2
Signature of Supr. Elec'n 0 201 amps to 400 amps $75.00 _� 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
I icense Nr Exp.Date_ see"b"above.
Phone Nr 3r_ / yk _ - qo,Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a)The lee for branch circuits with
purchas9 of sorv/ce or
Print Owner's Narne feeder fee.
Address_ Each branch circuit $5.00
b)The lee for branch circuits
city _^ State _ Zip without purchase of
Phcne Nr._ service or feeder fee.
First branch circuit ( $35.00 31' 2
The installation is being made on proporty I own which is not Fach additional branch circuit_ $5.00 2
Intended for sale,lease or rent. 4e.Miscellaneous
(Service or leader ncr Included)
Owner's Signature _ Each pump or lydgatwn circle $40.00 -_ .----- 2
Each sign or outline lighting $40.00 _ 2
3. Plan Review section (if required):* Signal circuif(s)or a limited energyi
panel,alteration or extension $40.00
N Minor Labels(10) 8100.00
Please check appropriate item and enter lee in section 58.
4 or more residential units in one structure 4f.Each additional Inspection over I
.� Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal per Inspection $35.00 _
Classified area or structure containing special occupancy per hour $55.00 _
as described in N.E.C.Chapter 5 In Plant $55.00
rl;
J ' Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. So.Enter total of above tees $
5%Surcharge(.05 X total fees) $ --L--'�
NOTICE Subtotal $ -
5b.Enter 2591.u(line So for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it reguir (Ser..3) $ -
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION nR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED, ❑ Trust Account 0 6 1 T
Total balance Due $
I\n5T,5\ELCgfi APP n1w'.V9A
F
CITY OF TIGARD MECHANICAL
DEVELOPMENT SEFIVICES PERMIT . . . . . . . : MEC98-0147
13 125 S W Hail Blvd.,Tigard,OR 97223 (503)639.4171 DATE I 1-D: 03/24/98
PARCEL: 25103AD-04900
SITE ADDRESS. . . : 12 860 SW 107TH CT
SUBDIVISION. . . . : PATHFINDER ZONING. R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :039 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES-------------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
:GAS —15 HP. . . . : 0 COMML_. I NC I N: 0
MAX INPUT: 0 BCU 1E-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN < 100K BTU: 1 10000 cfm : 1 GAS fIUTI ETS. : 0
FURN i =100K BTU: 0 > 10000 cfm: 0
R e m ar-1<s : Installing furnace and exterior A/C unit. A/C unit must not encroach
into 5' side or rear yard setback.
Owner-: - --_.____._._...._--_--_________.--_—_--.___________,___________ FEES
CLAUDE SHANNON type amount by date recpt
12860 SW 1077H COURT PRMT f 25. TO DEB 03/24/98 98-304371
TIGARD OR 972:3 5PCT $ 1. 25 DEB 03/4/98 98--304371
Phone #:
Contractor: ------------------------------
MR FURNACE HEATING INC
16285 SW 85TH AVE ----------------------------------------
$ 26. 25 TOTAL
TIGARD OR 972237
Phone #: 684--9014
IReg #. . : 000879
REQUIRED INSPECTIONS
-_—_---
This permit is issued subject to the regulations contained in the Mechanical Insp _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp _
applicable laws. All work will be done in accordance with Cooling Unt Insp
approved plans. This permit will expirt if work is not started Misc. Inspection
within 188 days of issuance, or if work is suspended for more Final Inspection
than 180 days. ATTEN110N: Oregon law requires yo11 to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set fort;, in OAR 952-N01-010 through OAR 952-001-8080. You may
obtain copies of these rules or direct questions to OUNC by calling _
(503)246-9187. ~
0
Issue B L Jck F'e r m i t t e e 5 i g n a t u r e:
44•++++^F+++++++++4+4++++++++++++++++++++++++.4 ++++++4•++++++++++++++++++++4•+++t+t+
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++.+++++++++++++++++++++.I-+++++++++++++++++
Plan Check#
CITY OF TIGARD Mechanical Permit Application Rec'dBy
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD,UR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST
Print or Type Permit#MCC
Incomplete or illegible applications will not be accepted Calle:
e of/p�efelopm UPro)ea Description
' 'v " �l( gable 1A Merhanical Code OT'r PRICEAMT
Job Street Address Suite# A) Permit Fee 0 0 10 00
Address
BId9# City'Staro zip 1.) Furnace to 100.000 BTU / 6.00
elf including duds 8 vents _
Nam,Jnr name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner < �.� - y- - including ducts&vents
Mailing Address 3) Floor Furnace
6.00
+ b -7 4 It ill including vent _
Clryy/Statezip IPhone 4.) Suspended heater,wall heater 6.00
c'G0 C �� 2 '� - `, ¢� or flocr mounted heater
Nam or name of business) 5.) Vent not Included in appliance permit 3.00
Occupant Mailing Address r-677-:oiler or comp,heat pump,air cond 6.00 _
to 3 HP;absorb unit to 100K BUT"
c ryrstate zip Phone 7.) Boder or comp,heat pump,air cond. 11.00
3-15 HP;absorb unit to 500K BTU"
Contractor Neme 8) Boiler _or comp,heat pump,air cond. 15 00
M r � 15-30 HP;absorb und.5-1 Ind BTU"
Prior to permit Mailing Address_ 9.) Boiler or comp,heat pump,air cond. 22.50
issuance,a copy / SC�� 34 _ 30-50 HP;absorb unit 1-1.75rnil BrU--
of L,I licenses CVState zip Phone ,f 10.) Boiler or comp,heat pump,air cond. 37.50
are required if (015 >50 HP;absorb unit 1.75 mil BTU"
expired in COT ore on const.Cont,Board Lic M Exp Date / 11.) Air handling unit to 10,000 CFM 450
database
Architect Name 13.) Non-portable evaporate cuoler 4.50
Or Melling Address 14.) Vent fan connected to a single dud 3.00
Engineer city/Stale '- Zip Phone 15.) Ventilation system not included In 4.50
_ appliance permit
Describe work New O Addition O Alteration-0 Repair O 16.) Hood served by mechanical exhaust 450
to be done Residential O Non-residential O
Additional Desrtption of work: 17) Domestic incinerators 7 50
18) Commercial or industrial type 30.00
Incinerator
Existing use of 19) Repair units 4 50 T
building or property
20) Weiod stove 4 50
Proposed use of 21 ) Clothes dryer,etc 4.50
budding or property
22.) Other units 450
Type of heel-oil O natural gas 0 LPG O electric O 23) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(eac;i) 50
information given is correct,that I am the owner or authorized agent of
the uwner,that plans sub mitt are in compliance with Crayon State QTY SUBTOTAL
laws_ 7 �__.__-' -:' `� - ^'
' Slgnature oif0wrter/Agent Date 'SUBTOTAL
' Sm
5%SURCHARGE
Contact Person Name Phone-� PLAN REVIEW 25%OF SUBTOTAL
TOTAL
i'vnechpmt doc (,ev 9 'Minimum permit fee is S25+5%surcharge
"Residential A/C requires site plan showing placement of unit.
FMP
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