12200 SW 127TH AVENUE CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP _
Received Date Regcasted AM__ _—_ PM BUP
�(_ _
Location a O .L L7 � t4"L Suite_ MEC
Contact Person __— i -�� Ph( ) 9- -(_ PLM
Contractor — Ph( ) _ SWR
BUILDING Tenant/ ELC - �
Footing --
Foundation ELC
Ftg Drain ACCHSS:
Crawl Drain ELR t
Slab Inspection Notes: SIT �
Post& Beam
Shear Anchor
Ext Sheath/Sham
Int Sheath/Shear —
Framing -
Insulation (/ L
Drywall Nai!int) -
Firewa!I \ --
Fire Sprinkler
FireAlarm
Susp'd Ceiling - -
Roof
Other: _ ----_ ----
Final
PASS PART FAIL - — - —
PLUMBING
-Post 8 Beam
Under Slab
Rough-In -'---
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole -
Storm Drain
Shower Pan
Other:
Final -
PASS PART FAIL
FAECH, _ICA_
- - -
Post& Beam - -_
Hough-In
Gar Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In
UG/Slab --- -- —
Low Voltage
-- ._—
F.I. Alarm
A PART FAIL U Reinspoction fee of$__ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE- Please call for reinspection RE:— _ Unable to Inspect-no access
Fire Supply Line
ASA
Approac:i/Sidewalk Date y Inspect of, MiltOther: —
Fii nl DO NOT REMOVE this Inspection record from the b site.
PASS PART FAIL
CITYOF T I OA R D MECHANICAL PERMIT _-
PERMIT #: MEC27/3/0? 2 00285
DEVELOPMENT SERVICES
DATE ISSUED: 7;3102
--� M 13125 --W Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104AA-09000
SITE ADDRESS: 12200 SW 127TH AVE
SUBDIVISION: BELLWOOD NO. 2 ZONING: R 4.5
BLOCK: LOT: 095 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 50 + HP: CLO DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITSOTHER UNITS:
FURN >=100K BTU: <= 10000 ctm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install extenur A/C unit. Cannot be placed within the required set backs.
Owner: FEES
BRADFORD, JOHN F AND Type By Date - Amount Receipt
DONETA L PRMT CTR 7/3/02 $72.50 2720020000
12200 SW 127'ri-i 5PCT CTR 7/3/02 $5.80 2720020000
TIGARD OR 1?7223 =— --
Total ~_ $78.30
Phone.
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND. OR 97212 REQUIRED INSPECTIONS _
Mechanical Insp
Phone:284-2173 Cooling Unt Insp
Reg #:LIC 222 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 approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTEITION- Oregon law requires you to fallow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: .` �',_t_Li.cL � L't Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
id)002
t 1 I iinl J.1': ur 1,A15n15Pb19Gt� CIati OF T1G!lRD
Mechanical Permit Applies lflon
City
(1 1 ''Urd r � ptojxdappl.rw.: Expfredate.
Cljy,T'Mfard AdiUWUAMU 13125 SW Hall AI d, Dateinued. By:j Receiptnu.:
phrnte: (503)639-4171
Pall: (503) 398-1960 Cusefilenc.: ►1tl8"thee .__
AuildinSpennituo-'
Land use approval: _.--,-,��..1,�, --�.�r:,.�.-r.,-;-
l ?iwuly dwellial%or aoacssory 7 Ct7tn�rnet�iaUindustrial D,lquld-family ❑Tcuapt improvement
J 11r.w c.onstiucuun C1�3 Itliti0nit:'tetaa G�hrplflcenu�nt Ll Other- ------. �- _
,lob addfvss: ��-f JCS 1J - _d_L t _- Indic de,,Nuiprnent qunntideF to t�nxe,b0ow.Ludiuite the.Mali;�z
Bld .nv._ SttIOD rio. - value of all mecna,tic:al materials,e9ui,mens,labor,overhead.
Toff mapJtout lOf/eccotlnt ao.: profit.V gluts
1pt; Block 5ttbdiviston: 'See checklist for important application inform rtion mid
YtU t frame Pi t) � � - jtrr9ediotion'e fee edtedulc fit residential 1><,rn it tre,
ci Icotlnty (� Q zip: -
Descriptiru awl locadon of wocir on
Sr,g1.�_�}11Z COpJ -t I& __ F�.(.�) TOWM
ESL date of C�inspectics: Qry lttw�.tlt us ooh
Debtriod
s
-ESL
impmvamcnt or change of use: Air haaming utut _— "-I-M-,
Ts eftisung space heated or f neV(�*es D No Airco eg(sid:plan u�d)
Is existing Space msulated7 I Yee D No bcraWn exn ny- Acwxtew
iter comprasaorn
Sw-holier p<amit no.:
susirtesc.neat: /\^A, YI `f 1'NcY r C.U�LI /-' f lit Tons_ HM/H
AddresS: , I E L Z (-� ice/etne cd urtasna 0etecton
`�_-• S ZIP 21 K�� vmp site an
Cwt : P(J K T L��n 1�.._� BTM
FAX- •1 S-mtell: -las m4 ncc vi.ec en1 user----
Pttot►e: including duatwttrYJvmt ilncr O Yns 0 No
netsll reiocntehesten-cu>
Q /trMta+O lit.no.: wall,or floor mounted _
Nttttlt deeas dM): D 1'1 1J Z?!}!� vt at a once ooifiix'ttirxi are
Abaotptfon uu"--- _ BTU/H
Natio: -- ---- -- Cbmtnes.or►. HP
City."— _ Stoic: l.[f' A lianccvow
Phone: Fe>z: &aoAdl: n Auer _
k kW`i7,i jrpc ft" tc izrnet
hood fico supprei.ion--jUm
axltaustfan with 9ingte duct(ttsth runs)
- '�"— v ■YVVTin sp,n�iiam boot n w
Mailin-�/addr+�a: I Q1 i� - amt up to m c1a —
Ci
tiC Oil
�nE• V••• 1 r"o+r•:+_ li.'mall: �nlrl i - eaCJf a
PRt1OlipMW(scbemshe racinwonj
Nimbi of outleu _
Address: _ Dtx nrntive lux_ _
City -- - SMe, Y1P f-'- type
. _ . toYr Ct sort Ve
Fax: -
Applicant's gf aWts L i- -
Nerve(psint)1) )/•� �!-)/� -.7 -- �--)_ 111 11�.._--_._._..._ __ .
_ __......__- Permit tet.....................t
eta as ooefttlew.. *-00-d%rums on Iwhdk-!- rer mar UVsenat+an Notice: i-hin permit application Minimum tee.... . ........S �Imo?
7 Mastet�.eR eft im's if0 rttiit is not nlNaigld
t]VIM p tk 1'latl R!VIeW(e[_— 7i:) s
CAW11 r.e.•'roar__._._- -_-_-- within 180 days after it has beenl3
State sutCiWge(85b) ....$ --
-of i>tadeof ru m c accepted as compietc. TOTAL ....••.S .
............. �elaal4(etgrcvntn
AAA "Heating and Cooling Air Conditioning Site flan
Customer �DNrT-A `►-. '�"®�,Ap -
dress a22or� S' Cit ` �t zip 97233
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CITY �� �I���D ELECTRICAL PERMIT
PERMIT#: ELC2002-00306
DEVELOPMENT SERVICES DATE ISSUED: 7110/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104AA-09000
SITE ADDRESS: 12200 SW 127TH AVE ZONING: R.4.5
SUBDIVISION: BEI_I-WOOD NO. 2
BLOCK. l_OT : 095 JURISDICTION: TIG
Proiect Description: 2 branch circuits Utility and garage. —_
RESIDENTIAL UNIT TE
r----- — MISCELLANEOUS
_ h�P SRVC11 EEDERS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'r_ 500SF: 201 - 400 amp: SIGN/OUT LINE Ll'G:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS_ ADD'L INSPECTIONS __-
0 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 410 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: — PLAN REVIEWSECTION___
1000+ amp/volt: >=4 RES UNITS _ > 600 VOLT NOMINAL:
L_ Reconnect only: SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
BRADFORD, JOHN F AND ROSE CITY ELECTRIC CO INC
DONETA L 4012 NE CULLY BLVD
12200 SW 127TH PORTLAND, OR 97213
TIGARD, OR 97223
Phone: Phor►e.
Reg#: 28?�-6147S
LIC 3567
ELE 26-113C
FEES_ _�— Required Inspections —
Type By Date _ --Amount Receipt Rough-in
_ Wall Cover
PRMT CTR 7/10102 $53.50 2720020000( Elect'I Final
SPCT CTR 7/10/02 $4.28 2720020000(
Total $57.78
This Permit is issued subj:rt 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 accordance with approved plans This permit will expire if work is not startea within 180 days of issuance,or 6 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 952-001.0080 You may obtain copes of these rules or direct questions to OUNC at(503)
246.6699 or 1-800-332-2344
By:
By
Permit Signature: Issued` --
_ OWNER INSTALLATION ONLY
The installation is beinc; made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:_
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: _ c
Call 639-4175 by 7:00prr iur an inspection the next business day
^� Electrical Permit application
L+,ar+,�t:P.!• Date received: i �; i— Permitno.:�/�'• l
City of Tigard Project/appl.no.: Expire date: �Cr3
City ofTigard Address: 13M-SW Hall Blvd,Tigard,OR 9722? Date issued: f3y?,i '� Receipt no.:
Phone: (54) 639-4171
Fax: (503) 960-'---- Case file nc : Payment type:
Land use approval:
U 2 family dwelling or accessory O Commercial/industrial U Multi-family U'renant improvement
U New construction U Addition/alieratiun/replaccment U Other: U Partial
JOB 1
Job address_ 1 Z2_0 0 �1 1,. - Bldg,no.: I Suite no.: ITax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: ire s�-----_ascription and location of work on premises: P-
Estimated date of completion/inspection:
S�ON URAU'll Oil All!".LICL
111[Ebt LF
Job ao: & '�L U _ Fee n>,x
lhscriptiun_ (Jty. (ca) Total no.insp
Business name: ROSE ITC Y FLF.CTBT C t^n T NC
Nerresidrnlial-sinrleormulti-family per
O 2
Address: dwelling unit.Includes attached garage.
City: PORTLAND Statc:OR Z�72].3 Servicrincluded:
PhBiG3 287 61.641603 2-82 1 ®ail: 1000 sq.ft.or leas 4_
Foch additional 500 sq.ft.or portion thereof
CCB no.: Elcc.bus.lie.no: C Limited crrcrgy,residential 2
oqpCity/m O.: —� Limited energy,now"idential 2
J� Each manufactured home or modular dwelling
SignirturfoPiniOrvising electrician(re aired) Date Service and/or It eder 2
Sup,elect.name(print): R L Gotham I License no: 2 1S Services or feeden—Installation,
alteration or relocation:
200 amps or less 2
Name(print): (� �V'I! 201 amps to 400 amps— --- 2
Mailing address/), 401 amps to 600 amps 2
s Z --
601 amps to 1000 amps 2
City: I 9tate:6iYZIP. L Over 1000 amps or volts 2
Phone:14,
? i I E-mail: Reconnect only 1
Owner Installation-The installation is being made on property I own Tempnraryservices orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocadon:
ORS 447,455,479,670,701. 200 amps or less 2
201 amps to 400 amps 2
Owner's si`nature: ____ _ Date: 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: _ service or(seder fee,each brunch circuit �5 2
City: _ _ State: ZIP: B. Fee for branch circuits without purchase y
Phone: I .t E-mail: of service or feeder fee,first branch circuit: 2
Each additional branch circuit:
Mlac.(Service or feeder not Included):
O Service over 225 snips umuneruul U Health-care facility tach ump or irrigation circle _ 2
U Service over 320 amps-rating of I U U Hazardous location Each sign or outline lighting 2
family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel.
U System over 600 volts ruminal rnom residential units in one structure alteration,or extension• 2
U Building over three r.orles U Feeders,400 amps or more •Descri ton: _
U Ckcupant load ovrr 99 persons U Manufactured structures or RV park Fjeh additional Inspection over rhe allowable In any of thr above:
U Egteas/lightingplan ❑nUnec Perina coon
Submit_aMn of plane with any of the above. Investi aeon fee
7Le above are not Applltsble to temporary construction service. other
Not all)uridktioru accepi credit cards.please cdl)urisdkaon for mute informWan. Notice:This permit application Pe,7nit fee.....................$ a -�
U Visa U MasterCard expires if a permit is not obtained Plan review(at ___, %) $
Credit card number _ _ �— within 190 days after it has been State surcharge(8%)....$
Nowspire' accepted as complete. TOTAL
oTcar�:Jlda Y shown[emit e�—
S
CrdholrTer slgannr a Amount 4404615(MC'OM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL 0R11-Y`
Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved:
Residential-per unit
1000 sq R.or less —__ $145.15 4 ❑ Audio and Stereo Systems
Cacti additional 500 sq.ft or
portion thereof $33.40 1
Limited Energy $75.00 F-1 Burglar Alarm
Each Manufd Home or Modular
Dwelling Service or Feeder $9090 2 ❑ Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Con iitioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 r�
201 amps to 400 amps $106.85 z l Vacuum Systems'
401 amps to 600 amps $160.60 2
601 amps to 1000 amps � $240.60 � 2 F-] Other
Over 1000 amps or volts $454.65 2
Recoraect only $66.85 2
iemp:)rary SerAces or Feeders — TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Foe for each system.......................................................... 575.00
500 amps or less $66.85 2 (SEE OAR 918-260-250)
:01 amps to 400 amps — $100,30 2
401 amps to 600 amps $133.75_ 2 Check Type of Work Involved
Over 600 amps to 1000 volts,
see"b"above. ❑� Audio and Stereo Systems
Branch Circuits E] (toiler Controls
New,alteration or extension per panel
a)The fee for branch circuits
with purchase o/service or ❑ Clock Systems
feeder fee.
Each branch circuit -, $6 65 _ 2 ❑ Data Telecommunication Installation
h)The fee for branch circuits
without purchase of service ❑
or feeder fee. Fire,alarm Installation
First branch circuit $46.85
Each additional branch circuit $6,65 E] HVAC
Miscellaneous f-1
Instrumentation
(Service cr feeder not included)
Each pump or irrigation circle _ $5340
Each sign or outline lighting - - $5340 ❑ Intercom rd Paging S ystems
Signal circuit(s)or a limited energy i
panel,alteration or extension _ $7500 n Landscape Irrigation Control'
Minor Labels(10) $12500
Each additional inspection over F-] Medical
the allowable In any of the above
Per inspection $6250 _-T I ❑� Nurse Calls
Per hour $6250
In Plant --- i"7:; Outdoor Landsr.apP Light'nq'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑� Other
8%State Surcharge $ _ —Number of Systems
25%Plan Review Fee
See"Plan Review"sectior on $ No licenses are required Licenses are required fur all other installations
front of epplicalir:n
------ Fees:
Total Balance Due
`- Enter total of above fees =
Trust Account#_ __-_ 0%State Surcharge s-
�+ Total Balance Due i
r AstsUorms\cic-rets doc 10/09/00
Electrical Permit Application
Datereceived: I /r. Permitno.: 40C
�J._
City of Tiga ,d NtojccVappI.no.: _—_ Expire date: til?3
y I Address: <) 639-401171
W all Blvd.Tigard,0R 97223 ') Receipt no.:
Cit n fi ani Date issued: 1171!>� p
Phone: (S
Fax: (503Case file nu Payment type:
Land use approval:
.0'1`&2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction. U Addition/alteration'replacement U Other: J Partial
Job address: 1 L ) I 1 Bid no.: Suite no.: Tax ma /t ix lot/account no.:
k jc ✓ b - -- P
Lot: Block: Subdivision:
Projr_cl name: ( inscription and location of work on L 441t
Estimated date of completion/inspection:
0NIRAC70H APPLICATION FEE SCHEDULE
Job no: ((J Fee INstx
Business name: Descript_on Vty. (ca.) 'lotai no.insp
Nen resideniial-sirigk or multi-family per
Address; 012 NE CULLY HL D dwellingunit.locludesattached garsge.
City: PORTLAND State:OR ZV7213 Serviceincluded:
P1643 287 616 listicl 3 282 ®ail: loon sq.ft.or less a_
CCB no.: 3 5 6 7 1 Elecbuslic.no: 2 6 113 C Each aduiuonal 500 sq.ft.or onion thereof
Limited energy,residential 2
City/mg"4.: Limited energy,non-residential 2
OZ— Fach manufactured home or modular dwelling
Si n to o'sd rvisin electrician(re wired) Date Service and/or feeder _ 2
Sup elect.nam.:(print): -o 1 am License no: o
5 Services oree a installation,
alteration or rctocation:
200 am s or less 2
Name(print): L iI 1' 201 am a to 400 amps J.
401 amps to 600 ams 2
Mailing address/').-2 ZLT 1 2 601 amps to 1000 amps 2
City: I 9tate:6;YZIP. _ over 1000 amps or volts. _ 2
Phone: ' i E-mail: Reconnectonl I
owner installation: a installation is being made oto property I own instTemporaryservices
more to -
which is not intended for sale,lease,rent,or exchange according to 200allds or le alteration,or relocation:
ORS 447,455,479,670,701, eon ames or Ices -� 2
201 amps to 400 amps �� _ 2
Owners signature: bate: _ 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of '
Address: service or feeder fee,each I:ranch circuit if y 2
City: State: ZIP: + _ B. Fee for branch circuits without purchas
e y
T�- of service or feeder fee,first branrh circuit: ' _ p - 2
Phone: Fax: E••mail: F,ach additional branch circuit:
Misc.(Service or feeder not Included):
U Service over 225 sups commercial U Health-care facility Fach pump or irrigation circle 2_
•Service over 320 amps-rating of 1&2 U Haurdous location Each sign or outline lighting
familydwellings U Building ova 10,000 square feet four or Signal circuit(s)or a limited energy panel.
U System over 600 volts nominal more residential units in one structure alteration,or extension$
O Building over three stories U Feeders.400 amps or more •Descri tion
U Occupant load river 99 peens U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: _
U 4reasllightingplan U Other - Per inspection
Submit__W sets of plana with any of the above. Investigation fee —_
The above are not applicab:e to temporary construction service. odor
r—Na "d jurisdictions accept cred+t•wits,pleae call junsdiction for more information. Notice:This permit application Ilertnitfee......................$ �+-
U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
credit cud number within ISO days after it has been State surcharge(8%) ....$ _.
1Jutsc d cat�iof3rr
accepted as complete. TOTAL, ............ ..........$
W own on Clain C
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-�frdholdersianatum w-- — �mouni 4104b1S(6ffilICOmM)