13780 SW 115TH AVENUE-1 !-S
ADDRESS:
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ELECTRICAL PERMIT
-#.- E Sa
. CITY O F T IGARD PERMIT DATE ISSUEDL:C96Q18/L2305/96
COMMUNITY DEVELOPMENT DEPARTMENT
1.3126 SW Hall Blvd.Tigard,Oregon 97223*6199 (503)639-417ilT '. PARCEL: LS103DC-05300
L--. I-il.,L i,L._7-. . . . .1. -,. . L 1 1
SULAD I V I S 1 ON. . . . . V I EWMOLJNI ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . .43
Pr-oject Desc�ripticn: Installing two branch circuits.
-----------
UNIT—— ----TEMP SRVC/PEEDERS----- ------MISC:ELLANEOUS------
1000 SF OR LESS. . . .: 0 0 - 2,00 yam P. . . . . . . : 'a PUllf--.1/I RRIGAT ION. . . . : 0
EACH ADD' L 5009F. . . : 0 201 - 400 amp. . . . . . . .. 0 SIGN/OUT LINE LTG. . : 0
LIM! '21-1 ENE'R137Y. . . . . : 0 401 -- 600 amp. . . . . . . : ID 1;1 GNAL/PANEL.. . . . . . . : 0
MANE. P.M/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : �71
--------BRANCH CIRCUITS-----_ ----(-)DD' L INSPECTIONS--
L71 - i:f012I ramp. . . . . . : 0 W/SERVICE OR FEEDER: 111 VIER INSPIECIIUN. . . . . . L,1
- LI-00 amp. . . . . . : 0 1st W/O SPVC OR FDR. : I PER HOUR. . . . . . . . . . . Ill
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: I IN PLANT. . . . . . . . . . . . 0
601 3.000 .-Amp. . . . . : 0 REVIEW
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . . ) 600 VOLT NOMINAL. . !
Reconnect only. . . . . : 0 SVC/I:-"DR > = 225 AMIDS. . : CLASS AREA/S1'_',EC U(-(--.
Owner: FEES
GEORGE PULIGELLA t ype amol.tnt by da4-e r-ecpt
1,3780 sw iit;TH AVE PRMT it 40. 00 CJS 06/23/96 r)6iR83,j,,.,jo
51-ICT a L'. OIZI cis 08/23/9L, 96-28:,, 20
TIUARD OR 97223
Ph a n e #:
GIRF ELECTRIC 11 42. 00 TO TAL
154,60 SE PARADISE L1\1
REUWREL) INSPECTIONS
MLILIAO OR 97042 Wall Cover' Elect' t Final
V-1hone *0 5111:i •13i_9• Elect, I Gier , t-,e
Re -it. 10154.3
This permit is issued subject to the regulations contained in tnt
Tigard Municipal Code, State of Ore. Speciaity Codes and all other Plet,mittee SignatUre
applicable law.;. All woril,, w,11 ba done in accordance with
";.proved plans. This pernit will expire if work is not started
within 180 days of issua-ce, m if work is suspended for, more
than. 180 days, ISSLtpd B/
INSTALL-nilON
The installation is being made on property .1 own whic�i is rot intended for-
sale, lease, or rent .
(JWNL R' 2i i)I UNA T LJRF_ DATE:
_-CONTRACTOR INSTALLAI-ION ONLY--
S I GNOTURL J�' SUPR. E LELI N
UATE:
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7n !- 1 CENSL NO.
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Cal I for inspection — 639-4175
CITY OF TIGARD BUILDING INSPECTION NO ICE
Inspection Lire: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing �ech
Plbg.Und/Flr/Slab Plbg. Top Out InsulationZEIe .
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other.-
Date:
ther:Date: qbs' �_ A.M. P.M._-)t Entry:
Ado ess: �3"7� —�1y5 5
Tenant: Ste: MOT:
G'/Own: Z.g —S��3 - MEC: _ ..
PLM:q-�-
ELC: f-'e 0
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR•
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Ir' pector. - _ Date:
vAPPROVED _DISAPPROVED/CALL FOR REINSP, CF CO
r. I it: 1,11, 1.1101t it IN I
NAME 1 R 11; 1,1`4:-O fiINWHIA1
A DD RE."b I If Vv PIV.141
jI I I it)I
1!14
.1( $4 1 1 it'll,11.1114 1 1
PURPOI-113-., Of P 1.1 v mi..H I I 1�1-1 11) Pi
40 OVI W
13780 S-W IJ1,0STI-I +o.1[
101AL 14141,111N1 1-441P 00
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # Q-cgr--0 S 53
Date Issued -, - 96
Phone (503) 639-4171
CITY OF TICARD FAX (503) 684-72.97
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: p 4. Complete Fee Schedule Below:
NamegS 2ue1up }int -F rC e- J--Lffl-a Number of Inspections per permit allowRd
Address ' �Z ~/ t A? �_-f r! Service included: Items Co:.*(ea) Sum
City/State/7_ip_TI (A Q _ 4a. Residential -per unit
-1 1 p 1000 sq ft or less $110,oc 4
Name (or name of business)_, / (/�J� L e_,(,{p__ Each additional 500 sq ft or $25 00
�/ portion thereof _ �.
Commercial ❑ Residential Imo( Limited Energy $25.00 1
r
Each Menufd Home or Modular
Dw-lling Service or Feeder $66.00 2
2a. Contractor installation only
E
tom' 4b. Services or Feeders
Electrical Contractor Cr> r�-1^ 1f; l_� Installation, or lesion,or relocation 2
1 �1..Lr_e.. 200 amps or less y $60.00 _J
Address �-�� i a5, I �i r/e �j i tet'_ ?u1 amps to 4D0 amps _^ $60.00 2
401 amps to 600 amps $12000
_
State-44 Zip3O! 601 amps to 1000 amps -- $18000 2
Phone No. C( (_ t„v Over 1000 amps or volts $340.00 2
Job NO Reconnect only $5000
contractor's license NO. (i _ S--7�T,C. 4c. Temporary Services or Feeders
Contractor's Board Reg. i!o. l
/ i6. Installation,alteration,or relocation
Signature of Supr. Elec'n 200 amps itn less 1
201 amps o 400 amps 150 00 2
License No. ?(m 3 -S _ hone o. 401 amps to 600 amps —� $75 Do — 2
4 Over 600 amps to 1000 volts $10000
2b. For owner installations: see•,b„above
Print Owner's Name 4d. Branch Circuits
_. New,alteration or extension per pane
Address a)The fee for branch circuits with
purchase of service or Feeder fee. 2
City State Z!p_ Each branch circuit $500 _
Phone No. _ b)The fee for branch Acults without
The installation is being made on property I own which is purchase at service or feeder fee - 2
2
First branch circucircuit ~ $3500
not intended for sale, lease or rent. - l
Each additional branch circuit _i 35.00
Owner's Signature____ 4e. Miscellaneous
(Service or feeder net Included) 2
3. Plan Review section (if required): Earn pump or Irrigation circle $4000 _ 2
Fach sign or outline lighting $4000
Signal circulus)or a limited energy 2
Please check appropriate item and enter fee In section 5B. panel,alteration or extension $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 4t. Each additional Inspectic n over
CIL, Classified area or structure containing special occupancy the allowable In any of the above
V) as described in N E C Chapter 5 Per hourinsplion 355 10
Per hour 355.00
? In Plant $5500
t— S•.lbmit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ �
C7 NOTICE I 5%Surcharge (05 X total fees) $ y -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION I Suer 25 $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 2 line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Revvieww if required (Sec 3) $ _ T
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Suhtotat $
COMMENCED [_l Trust Account #
ry^^nn
Balance Due $
i
1YIELHiANI CAL
CITY OF T I GARD
P E RM IT
PERMIT #. . . . . . . : ME-C96--0E:93
JCO-AMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/26/96
M.!S SW Hall Blvd.Tigard,Oregon 97223.8199 (503)039-4171 PARCEL: 2S102ADC-05500
11'17-'.' ADDRESS- - 13780 SW 115"I'l-A ()VE
,1Ji-.%11 I V I S I ON. . . . - V I EWMOUN T ZONING: R-4. 5
. . . . . . . .. . . LOT. . . . . . . . . . . . . :43
CLASS OF WORK. . :AL-F FLOOR rupi,4. FYAP COOLFRS: 0
1 YPE OF USE. . . . »SF- UNIT HEATERS— : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . . 0
HP. . . . 0 DC)Ml'.-'-'S. IhICIN: 0
COMML. INGIN: 0
/GOS/ 3--15 HF'. . . . 0
MAX INPUl": V, BT 1-1 15-310 VID 0 RLI-AIR UNITS: Q,
F I KIE DAMPERS?. . » 30-50 HP. . . . 0 WOOD53TOVE5. . - 0
GAS) PRESSURE. . . » 1:50+ HP. . . . : 0 CLU DRYFERS. . : V,
NO. OF AIR HANDLIN15 UNITS OTHER UNITS. : 0
FURN < 100K BTU: 1 <== 1.0000 ctm : 1. GAS OUTLETS. : I
TURN ) =100K BTU: 0 1000111 cfm : 0
Remar,ks . Altet,atj.on of a fi-tr-nance, air handling f-mit and, gac piping.
Owner-: FEES
GEORGE F'ULICELLA type amot.trit by date t-ecpt
137812, SW 115TH AVE PRMT $ c:5. 00 CJS 08/26/96 96-283303*
13 P C T $ 1. 25 CJ S 0 6 9 6 9 6 '13 3 0:3
-11 G A R 1) OR 9`72 23
Phone #:
ROSE HEATING CO
13945 NE 6TH DR
FORT LAND OR 97211
P'Tione 0- 503—K...'83-5183 4 26. 25 TOTAL
Req #. 0020BAi
REUL)IRED INSPECTIONS
This pertit 1, issued subjlect to the regulations contained in the bas Line Insp
Tigard Municipal Lode, State of Ore. Specialty Coats and all other Mechanical Insp
applicable laws. All work will be done in accordance with Misc. Inspection
approyvd plans. This persit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for sort
than 180 days.
Per-mittee Siqnati.ir,e : fu
CIL:
V)
Cal '. for inspection 639-4175
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ulo-IND — RVAJAP'l UIP POYMEN1
1-1 W.'Gh 1-011.11,041
NAME 3 ROSE HE AVIN(i CUMPANY INC C4614 W11:11INI
ADDRESS s 9945 W I til X DPIK D
PORTLAND OP
PURI It UN P 0-1 Y Pli-,14 1 14MOUNI Pk 11) P1 IHP(lbt.. til 1.114,t Olt I
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Ilii 96 -OP93
1 .-1 ,1130 Sw W-M 1lk,4.
KIM[— (4MOUNI 110-11)
City of Tigard MECHANICAL, PERMIT Planck/Rec. #
13125 SW Hail Blvd. APPLICATION Permit # MR-96-1-L2223
Tigard, OR 97223 I,
(503) 639-4171
escr ption
1 1 1 r Table 3A Mechanical Code OTY PRICE AMT
^J '• \ I�S.
Job 1) Permit Fee -0- -0- 10.00
I �.. � \rpt —
Address �[�'��- •�• -`
2) Supplemental Permit 3,00
Furnace to 1.,3.0 enc
1) incl. ducts &•,ents 600
I
,�, ,<., �• Furnace 106,000 BTU +
2) inct ducts &vents 7 30
Owner
Floor Furnance
3) incl. vent — 600
eater, wa neater
4) or floor mounted heater 6.00
Vent not inc. in
Occupant 5) appliance permit 3.00
repair of ng, re rig.
6) cooling, absorption unit 6.00
Boiler or romp, heat pump, air con .
i
7) to 3 HP: absorp unit to 100K BTU 6.00
or comp, heat pump, air ;on
��C\ •<G- T� �• 8) 3.15 HP: absorp unit to 500K BTU 11 00
Contractor ,, „• p of er or comp, heat pump, air Cori .
9) 15-30 HP, absorp unit .5-1 and BTU 15.00
i Boiler or comp, heat pump, air con .
l 10) 30.50 HP, absorp unit 1-1.75 mil BTU 22.50
hereby ac now edge that have ea t this app ication, at the oiler or comp, eat pump, air con Ili
information given Is correct. that I am the owner or authorized 1 1) > 50 HP: absorp unit 1.75 mil BTU 37.50 T
agent of the owner, that plans submitted are in compliance with r handing unit to 1 450 G�
State laws, that I am registered with the Construction Contractors 12.) 10.000 CFM
Board, that the r amber given is correct. L!r exempt from State Air rianclTitig unit
registration. please give reason below) 13) 10.000 CTM + - 750
Non porta�TTe
1 a) evaporate cooler 450
ent an connected
15) to a single duct 300
Ventilation system not
16) Included in appliance permit 4 50
Roca served by
mechanical exhaust - 4 50
eecn a worknew lJ ad ition V alteration repay V
Commercial or industnal 3000
to be done residential � non-residential U 18 ype mc,nerator
-'--T
xisting use of ter i e., woo stove. water
building or property 191 heater, solar, clothes dryers. etc 4 50
G�C7
Proposed use of 20) Gas piping one to four outlets 2 00
building or property
``` 21) More than 4-per outlet (each) 2.00
Type of fuel - oil () natural ziss 3\ LP U electric 0
>
NOTIC
Minimum Fee S2500 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION F
` AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR 5% SURCHARGE 1
IF CONSTRUCTION CR WORK IS SL --ENDED OR
-u ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25", OF SUBTOTAL
AFTER WORK IS COMMENCED
TOTAL
Special Conditions
Cm rte ;ssuerl by _-- -- a
H LMW0lt4ME:.0MT