15505 SW 109TH AVENUE (J1
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15505 SW 109"' Avenue
i
I
I` MECHANICAL PERMIT
CITY OF TIGARD - ------
DEVELOPMENT SERVICES
PERMIT#: MLC2002 00n�
DATE I iSUED: 10/17/02
(
13125 SW Hall Blvd., Tigard, OR 97223 503 639-4171
g PARCEL: 2511 ODD-13700
SITE ADDRESS: 15505 SVS 09TH AVE
SUBDIVISION: SUMMERFicLD NO 14 ZONING: R-25
BLOCK: LOT: 707 JURISDICTION: TIG
CLASS OF WORK: O-,R 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: ::0 + HP: CLO DRYERS:
FURN < 100K BTU: t AIR HANDLING UMTS OTHER UNITS:
F!tRN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm.
Remarks: Installation of gas furnace; a,-.d a/c.
Owner: i FEES
SCHLUETER, JAMES A + PATRICIA J Description Date Amount
15505 SW 109TH AVE [MECH] Permit fee 10/17/02 $72.50
TIGARD, OR 97224 [MECH] Permit Fee 10/17/02 $0.00
[TAX] 89()StateT'ax 10/17/02 $5.80
Phone: [TAX] s Srue'Fiix 10/17/02 $0.00
Contractor: Total $78.30
PIONEER GAS FURNACE
3615 NE BROADWAY
PORTLAND,OR 97232 REQUIRED INSPECTIONS
Phone: 249-5000 Heating Unt Insp
Cooling Unt Insp
Reg #: 36102 Final Inspection
This permit Is issued 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 approver!
plans. This permit will expire if work is not strr rted within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregcn law requires you to follow rules adopted in the Oregon
Utility Nettreatfon Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. Yo may gbtain op es of those rules or direct questions to OUNC by calling
(,r1
0 )246-6699.
Permittee Si nature:
Call (502! 639-4175 by 00 �.M. fog inspections needed the next business day
07:31%2002 09:56 FAX 51135981960 uu3
1Vl echanicalFermit Application ONEME
fhtercccived. ; EMPermitno.: More '✓OA"al;
faint of Tigard 13mr h"L no.. Expire due,
Cityofl-agard Address: 13125 SW Hall Blvd.Tigard,OR 97223
Phone: (.503)639.4171 Dae'"8� By: Itecaiptno.:
Fax: (503) 598-1960 ,.'� Case file no.: - Payment type-- ---
Land use approval: 1�u Iding permit eo.:
O'l &2 family dwelling or accessory 0 Comme cial/irtdustnal U Muld-famEy U Tenuit improvement
U New constntctiou ]Additiou;;sHeradon/replacement 13 Other.
Job add SS: indicate equipment quantities in boxes bte e�o% . Indicethe dollar
dno.: Suite no.:
.� - �'-`y value of all mechanical materials,equipment,labor.overhead,
Hlg. _.___.._-_ W p _
Tax_may/tnx lot/WxGunt no.: profit.Value.
Lot: Block Subdivision: °See checklist for im,)rxtHnt pplirAtinn information and
Project name tt- jurisdiction's fee schedule for residential permit fee.
Ci /coon ZdP 722-q r
Detieripdon a location of work on pt+etrtis t r
1'-rj I-P ��yy _ vee(ea.) TOW
aft
Ek date rf oetttp(etioa/inspecd Oestri QU, Rea.url Rev
Teasat improvement of change of use: RVA_ Em
Is cAstin space heatrd or conditiorw A?0 Yes 0 No Air handling unit CFM S �•
g P Alt rsorting(altc lantoq
it existing apace insulated?U Yei U No Alteration of cxtat,eg IRVkC system
Ek,
er'lcompressor..
BSt,ite hoHer pe mit no
Bmirtess natio: - HP Tons 13IL'/H
Address: Et "re/sn+okeca-- nrtstnokc_etectorb
�,: S catpu ettep anrequitedj -
phone: , - 0 Fa><:� -$ -rrtall: nat-:"hap aca�iuni Tburne �/
T�aluding ductworidvent liner U Yes U No 7- 7.7
CCB no.: .3[o/QZ In lac: ocatt cause-suspend ,
tN
y/nieu'o lic.no.: i wall,or floor mouotcd
me lea tint) vent or Tianaeo erthanfnmace --
At+sorptivanc. / n f!"ilteax _-__ tw
dreAs: 1� n a[lAt�ty: State: ZIP. App6aacevmtoac: Fax: E-►tm �3r-craxT»iai
00 ., a res Itt�Lwat
limad rite supptrssion w:ytu M
Num: ��O&,K-- Rihaust fan with single duct(bath fans;
M at r8µ: haust s o a n m h' at AC
71P" TAi
-F4- r Ma up to outleu)
S Tyle I OG _- NO Oil _
}rh=: B-mail sr.! ipingear`ii addition M'0f4pl�eti
'f�tYt! (sChcn+aticre•Tn'
Number of tntthAs
Name: —
� UecorativeCnsplocc -
Fwooftovdmuet State: ZIP: -t now" y _ _
liamrs siglsantre - Date_/ —/ ,"L
--
perm t five.....................S
',nW wn.*fts wens aft Wk OM M lin am&%"Naw
�,� .rtaaserrue V
Minimum fix..............)$tperyk aI"eaien
expieif a _— -
permit is rot nhfained Plan,eview(at
L.-6 so W Awr _-- — -- ; w{lhx Ito Myr efiru it has bean 3tatra a ndtarr o f+; $
uca*W m vmnkbt TOTh?,?, ..S
— NOOil(6UlMUJMI
PTONEEER FURNACE
A/C SITE ?LAN FOR THE ADDRESS OFs 2!2 Zo96e
CUSTOMER NAME AND PHONE
Zo��
HOUSE
i
Street
3615 N.E. Broadwav 9 Portland Oregon 97232 503/2.49-5000
CIT OF TIGARD ELECTRICAL PER MIT
DEVELOPMENT SERVICES PERMIT #: ELC2002-00577
13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171 DATE ISSUED: 10% 9/02
SITE ADDRESS: 15505 SW 109TH AVE PARCEL: 2S 110DD-13700
SUBDIVISION: SUMMERFIELD NO.14 ZONING: R-25
BLOCK: LOT: 707 JURISDICTION- TIG
Project Description: Install 2 branch circuits for AC.
RESIDENTIAL UNIT TEMP SFcVC/FEEDERS MISCELLANEOUS
— 1000 SF O tTip: Z,TT:-
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LANE LTG:
LlMiTED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10):
_— SERVICE/FEEDER —^ V BRANCH CIRCUITS _ ADD" INSPECTIONS
0 - 2.00 amp W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HO !R:
401 - 600 amp. EA ADO'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: '--=_4- UNITS:—
Rec.;nnert only: SVC/FDR—225 AMPS:
CLASS AREA/SPEC OCC:
Owner: Contractor:
SCHLUETER,JAMES A+ PATRICIA J aOB'S ACTION ELFCfRIC INC
15505 SW 109TH AVE 2700 NE BURTON ROAD
TIGARD,OR 97224 STE A
VANCOUVIER,WA 98662
Phone: Phone: 360-254-7200
Reg#: til'1' 43221
FEES - 11• 53116
171('
Description Date Amount
Required Inspections
I{ 'It t 'crmir III%_'11112 --- 53.50 - _._-.___
I AX I Mi.Hate I Ax 10/19/02 $4.28 Rough-In
-- Elect'l Final
Total $57.78
This Permit is issued suol rct to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws. All
work will be done in accurt once with approved plans. This permit will expire f work is not started within 180 days of issuance,nr If work Is suspended
for more than 180 days. A'TENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-00 0 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)2466699 or
1-800-332-2344.
Issued By: Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on propertv I own which is not lnten a or sa e, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: v
Call 639-4175 by 7:00pm for an inspection the next business day _
`S
Aj
1
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Received _ _ Date Requested___I i l _._AM _PM BLIP
Location �� -5 c_��l ''� Py_ `-C Suite MEC
Contact Person __� '�'�� Ph(�) _ ��UG PLM
Contractor _.— ___—__ Ph(--) —__ SWR
BUILDING _ Tena►Nfhvner _ -__-. ELC 0c) �7 _
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawi Drain
Slab Inspection Notes: SIT
Post$Beam
Shear Archors / r
Ext Sheath/Shear
Int Sheath/Shear � , /✓ /� T?,
Framing ---
Insulation
Drywall Nailing I - --
Firewall
Fire Sprinkler
Fire Alarm Z(2-.oiling --
Sus
Ro.,r
Other: --
Final -
PASS PAP,t FAIL
PLUMBING
Post R Beam
Under 31ab --- -_—___--- --- -_.
Rough-In
Water Service --- - — -- ---
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - --
Shower?an
Other:
Final
_PASS PART FAIL
MECHANICAL
Pest&Beam
Rough-In ---------- --- -- - __—
Gas Line
Smoke Dampers —
Final
PASS PART FAIL -- -----
ELEC_TRICAL
Service--- -- ----- -----•
Rough-In --- ---------- --- - -- -
UG/Slab
Low Voltage
Fire Alarm -
`? u
PART FAILReinspection fee of required before next inspection, Pee at City Hell, 13125 SW Hall Blvd,
n please call for reinspection RE: ---_ E] Unable to inspect-no accdss
Fire Supply Line IJ
ADA
Approach/Sidewalk Date � �-1�'� _- Inspector _ Y c Ext -
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
//\\ CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT#: ELC2002-00577
SERVICES DATE ISSUED: 10/29/02
f
ADEVELOPMENT, 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S110DD-13700
SITE ADDRESS: 15505 SW 109TH AVE
ZONING: R-25
SUBL'VISION: I
BLOCK: LOT : 7W JURISDICTION: TIG
Project Description: install 2 branch circuits For AC.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS
1070 SF OR LESS: 0 - 210 amp_ PUMP/IRRIGATION:
EACH ADD'L 500SI 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIyNS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTk N:
2.01 - 400 amp. 1st W/O Sr<VC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BR '�H CIRC: IN F'-ANT:
601 - 1000 amp: _ _ _ _ PLAN REVIL-W SECTION
1000+ amp/volt: -4 t<EF UNITS: ? 600 VOLT NOMINAL:
Reconnect only: _ SVC/FDR_225 AMPS: --- CLASS AREA/SPEC OCC:
Owner: Contracto-
SCHLUETER,JAMES A+ .PATRi-'IA J BOB'S ACTION ELECTRIC INC
1',505 SW 109TH AVE 2700 NE BURTON ROAD
,ARD,OR 97224 STE A
VANCOUVER,WA 98662
Phone: Phone: 360-254-7200
Reg #: ELE 37-431C
FEES
Description Uate ArT,ount
_ — Required Inspections
I I PRMTJ I Lc' Pcrtnit l u "i(1_' $53.50
I A\)80"0 state Tax 1(] „1 n' $4.28 Rough-in
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard 'unicipal Code,State of OR Specialty Codes and all other applicable laws.
All work will be done In accordance with approved plans This hermit will expire if work is not started within 180 days of issuance,or I work is
suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001.0010 through OAR 952-001.0100 You may obtain copies of these rules or direct questions to OUNC M(503)
246-6699 or 1$00- 234LA-0—
Issued By: — �� ./l� Permit Signature:
OWNER INSTALLATION ONLY _
The installation is being made on property I own which is riot attended for sale, lease, or rent.
OWNER'S .31GNATURE: — DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N: 1— a, - DATE:—
LICENSE NO:
Call 639-4175 by 7:00pm for an Inspection the next business day
V
,If;/27/01 It ED 1.4:44 1-AX 503 598 loon cin 017 TIGAI20 fdJ0n2 q
Flcctrical 1' ffrraait Art ical ion
_ n Dnlerecelve 1. Q--p?i Petntit n11'ru
Gity of .jligartiECFIVED Project/appl.no.: L'xpf-eclnlc:
Cin,n/Tigard Address: 1:3125 SNr I(till Blvd,'I'igar 1.0I2 97223 Date Issued. 8Y7A-1t2rceiirtno:
Phone: (503) 639.4171
rax: (503) 598-1960 C'asc file no.: Cayman t)))c:
Il Y Ut• I IGA
t,anfl ase approval: _ __._._.
1 mff
1
I k 2 Nuily dwelling or nccessoty O Comm(rciallmdustim p �Iulti family ❑'1'ennnt ImpmN,eme..nt
ID'Jew construction O Additirn/nitrralion/rel Liceme.nt C1 011ier. . U Pnitial
---
M= 0
Juh address: 15505 SW 109th Ave. --_ rildg.no_:_ Suite no.: n" mnp/tax lot/nccount no.:
l.ol: Dlock: Subdivisinic
Project name: _ Demil:tiou and Incation if work on premises: 2 circuits or A ---
I�stintated e!au�.c,f com)Ietion/i:. oectirnl:
1 ►
rob nn: _ 02-889 _-- --__— - rcc Milt
Itcscrlpnun Qty. (en,) Tntnl no.InR +
tfusinessnome: Bob's Action Electric _ Nr+trrstdeutlal•strRlrmmnlfl-fuillyper
Addietis: 27CO NE Burtot, ltd. "All fill ellh+rmdt.IncluI"fillnthedRntnxe.
Cit': Vancouver Stalc:WA 711:98662 $emiceh+cludrd:
l(xtnet1tt lit
I'hone360-254-7200 lax: 2 -8219 I:•ntnil; 1.
• barb ndchUenaSnU/q.rt.or pyrlk�r utereul'
C'C:13 no.:_ 53136 ��hlec bus. lie.ttu: 37-431C Limitedcnrrft�,rrddeminl 2
Cil)'/tttCUU lie. to. 0003861_ Limitedenetgy,nvn•lesidcnliul 2
_JLLZ13�aZ_ [rich manufactured hams or modulnrdwallinq
5ignnhlre orsu e,visin electriclnn trequlred Dille 5ervi:eandlF-- -er 2
Sup.elecl.nnntr( dni) Kevin Broselle Li-eneem: 4322S Sen'Icesortcclers-Inslntlullmt,
nllerntlou or relocnllon:
1 20l+mnps or lees _ 1
201 amps In 4ud nrg+! 2
Nvnc(print): James Schlueter 401 an,psinrtnnnit+l+s 2
Mnilingltcldress:r i5505 SW 109th Ave. _ -601,mt:1•Io1000nnil,R 2
City_ Tigard J5In1e: OR ','.IP: 97224 U+ei lo9Urntgnt%nils 2
Photic: 620-8684 f lx: r Illall:_+ Ilecunnectanl•y l
I'empnrftry RerticuR or ferden-
p,vner inslallntiun: The inslnlltllinn ie being mule at pit+poly 1 uwtt btRlnlln+Im,,ni,r:�ticr.,a•retecnlluu:
whish is nui intended Irn sale,Iense,Icnt,or exchtinre aoccr(Ifnu to tn0 tor_ b.cR _ ____•'
ORS.147,455,471),070,701.•• 2m ungq 10 400 umilit
owne's si ImILI e: (ltlr 401 to600ortips 2
Prvnch elrrulls•licit,nhetullan,
lir rRtenRlon per panel:
Name: _-_ 4 1 rt:far brunch circuits wirA purchnar of
Address: — service or lerder rer,each brant it cucuil J 2_
City: -- SlnlC: SII'. ii rev rot Itimi h circuitl INMinut puithnRe
— — lir service m feeder frr,flt8I binneh clrtuil 1 6.8
nc7nr I at: E-mail =--bi4rcnN: 1 —
1011,111 111M I w NIIle.(Seri Ice or fertile nal Inrbrtltd►:
Goth esti+ Olhli
O Seiv ice over 215 nnqvs•,�nunen unci-11 OI Ieullh carr facNlry I P M winntIICIO
--
0 5emicc m ri 120 it 1111I.:r iilip of I R! U llnrnrtlnus locnn,m Each eI til or rutiinr I lithilug —- --
fmntlydwellurps U nuHdinF uvet 10(100 syuarr feet tout of Sipnnl clrcuihs)or a lindrrd rnerpy prima,
0 5vsternnver ntlU v dts nominul nx,rr tesidentinl uths In pile siroonre ahelntinn,ur extensimr' _ _— 2
rJ Pulldinp over dare stories U reetlers.4m,umim or nime '[ksui hufe
U Ckrupnnt Innd river 49 persons o munuracumea scut full-%of kV park ach eddlllnnsl Intpecllrot liter the alln.+nble tit tour of the nbeve:
O[pfrRRfli4lalllpIII mt f-I Olher: —_-.—.--•--.._. - Per mirettion _ ---S111111111---__—RctR orr+Inns pith tiny nrlhe nhrrm luvestl ntlonfee —
"Me above tire 1101 nppllcnble to Irsnporury 001141 rncl Inn Rerrlce, (nher
Petmil Ic^.... ........ ... ....$ —_
Nui nit luflsdicdr»u Inept ereeii c,vdr,please colt pu sdielhM tar nraft III bnnnd�o NaliCe:7)115 permit nprlictilfntt Plait revirw(at
p Vm U MnsterCn+d e\pites irn pcnnil is rtrd obtained — —---
Cmilu nrd oumhe, wilhih INTI dnys ortel it has been Sole.ctnch,rlge(8%)
�i2tilts nrcerleduscomplele 'TOTAL, . .... ....... . . .... � 57,78
—_iinme til reed r r ns s nftvn on eret t tmt - S —_
l'nrJlrrc {nnhue ,_ �...Auouut
lit)4r,IR(nnNu,nr1)
CITY OF TIGA►RD 21-Hour
BUILDING inspection Line: (503)639-4175
MST ------ ----
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received _ _ __ _—_—_Date Requested `'� S AM —PM— BUP
i D 9 rt'L1� Suite MEC s[��
Location ��_ �d►� ------
Contact Person ��4tEfc, Ph( ) �el --!;,4) Dy PLM
Contractor Ph( ) SWR
BUILDING ELC - ---
Footing ELC - - - —
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam — -- -- _
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shea
Framing
Insulation
Drywall Nailing ---- _.._ - --- -- — ---. ----
Firewall
Fire Sprinkler -- -� — — -
Fire Alarm
Susp'�Ceiling
Roof
Other:
Final - ' �Jvr -- -- --
PASS PART FAIL
------
Pcst& Beam —
Under Slab ---
Rough-In
Water Service - — -- — ---
Sanitary Sewer
Rain Drains ------- —"
Catch Basin/Manhole
Storm Drain ---------- — -- T
Shower Pan
Other: —
Final
PASS PART FAIL —
Post& Beam
Rough-In ---- -- -- --------- - —
Gas Line
Smoke Dampers ----- -- --- - - -- — -
9CTRICAL
PART FAIL
___-_ -- ---- ------
Service
Rough-In --- -- - - - --- -- -- —
UG/Slab
Low Voltage ---- - ----- _.._-— -- --
Fire Alarm
Fii at Reinspection fee of E-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PAIiT FAIL
SITE ----_ ❑ Please call for reinspection RE: _ _—_______ _____._--_ Unable to inspect- no access
Fire Supply Llne
ADA
Approach/Sidewalk
Data txt
Insp�clor � __- - - ----
Other:
Final On NOT REMOVE this Inspection record from the job site.
PASS PART FAIL