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13775 SW Fairview Court
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-417E Business Line- 639-4171 -------- ~-- ---
BUF
_. Date Requested '3_ —AM— PM _ !- BLD
Location l3l 7�' �;.<� Qry Vr�w __--
�_ �' Suite MEC
Contact Person Ph _7 a3 z,�c(-2( 7S PLM
Contractor K L t rt/L-/c.'_- _ Ph _ SIYR _--
BUILDING Tenant/Owner _ ELC L)/0}
Retaining Wall i ELR
Footing Access:
Foundation �; -• � FPS
-- - -
Fog Drain
Crawl Drain Inspection Notes: SGN
Slab _— r - [ --- SIT
- --- - --
Post 8 Beam
Ext Sheath/Shear
Int Sheath/Shear ---
f=raming
Insulation ---_- - --.. _
Drywafi Nailing _
Firewah - - -- - - -----
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling _
Roof D
Misc: --
Final
PASS PART FAIL
PLUMBING
Post&Beam — -'
Under Slab
Top Out ---- ----- ---- -
Water Service
Sanitary Sewer -- ---- "'--
Rain Drains
Final
PASS PART FAIL
MECHANICAL — ------------ - - -------" —__---
Post'l Beam
Rough In
Gas Line —-- - - -- ----
Smoke Dampers
Final - --- ---- -- --- -- - --
P PART FAIL
-----
Service
Rough Ir;
I.IG/Slab
Low Voltage
Zlarm7)
PART FAIL _� —.- — ------_— _--
lE
Backfill/Grading -
Sanitary Sewer
Storm Drain [ ]Reinspection f; -of$ required before next inspection. Pav at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please caP'�r reinspection RE:____ ]Unable to inspect-no access
ADA
Approach/Sidewalk Date S� 7 r��
Other / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the Job ske.
CITY OF
T I G A R D MECHANICAL_ PERMIT
PERMil'#: MEC2001-00044
DEVELCPMENT SERVICES
DP Tom. ISSUED: 22/0
13125 SW Hall Blvd.,Tigard, ()R 97223 (503) 639-4171
PkRCFL: 2S103CD-
3CD-01700
SITE ADDRESS: 13775 SW FAIRVIEW CT
SJBDIVISION: HOLLYTREE ZONING: R-4.5
BI-OGK: 01 LOT: 015 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VE:NTS WIO APPL. VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS_ _ HOODS:
FUEL TYPES 0 - 3 HP' DOMES. INCIN:
LPG 3 15 NP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE 50 + HP: CLU DRYERS:
FURN < 100K BTU: 1 AIR_HANDLING UNITS OTHER UNITS:
FURN >=100K BTU' <= 10000 cfm GAS OU1 LETS:
> 10000 cfm:
Remarks: Replace existing furnace with like kind.
Owner: FEES
L.ANTZ, ERIK V+ Type By Date Amount Receipt
COMBS-LANTZ, SHERI L PRMT CTR 02/05/20( $72 50 272001000C
13775 SW FAIRVIEW CT 5PCT CTR 02/05/20( $5.90 2720010000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 RF'.QUIRED INSPECTIONS
Mechanical Insp
Phone:284-2173 Final Inspection
Reg #:LIC 222
This permit '^ issued subject to the regulations contain-3d in the Tigard Municipal Code, :;tate of Ore.
Specialty Codes and all cther applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days Of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain.c ie s of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: 11 �;� _ _ Permittee Signature: ?//'� c'`� T�ex)ILL
Call (503) 635-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Datereceived: 02///,o / Permit no.yELr2 -4OQy
City of Tigard Project/appl.no.: Expire date:
Address: 13125 SW Hall Blvd,Tigard,OR '�,"i
City nfTignrd Date issued: By: eccipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 rr�', Case file no.: Payment type:
approval: permit no.:
Land use approva
— TYPE OF FEURNil
f� 1 &2 family dwelling or accessory U Commercial/industrial OV U Multi-family U Tenant improvement
U New construction U Addition/,tlm;ration/replaceinent U Other: ..
11 1
Job address:� __ Indicate equipment quantities in boxes below.Indicate thr.dollar
Bldg.no.: Suite no.: value of all me,.hanii l materials,equipment,labor,overhead,
Tax map/tax lat/ttccount no.:
profit.Value$
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule liar residewh l 1-ir it tri•
City/county: ZIP: r
Celli, Wo0ollikiri.imillif
Inscription and location of work on premises,, .
C. iMs7t Irc(ea.) 1ttRal
F--date of c plelion/inspection: O L• Z-77417 12747 Ikuri direr Qty. Res.only Res.only
Tenant improvement or change of use: Air handling unit _ CFM
Is existing space heated or conditioned?U Yes U No Air conditioning(s to plan required—)
Is existing space insulated"U Ycl; U Nit test ono cxtsnng system —
01 er compressors
State boiler permit no.:
rAdd 1l
ame: a,_ _ HP Tons BTU/I I
t � > it smo aamper uct smo a erectors
_, Statt. ZIP:( �J , Heat pump _ sire )
J I Fax:; �. E-mail: nsta pace urnac rner
Phone;.) Includin r vent liner U Yes U No
CCB no,: ( ,�,)„� _ nsta rep Tc re ocaIe eaters--suspended,
City/metro lic.no.: woll,or floor mounted
Name lease rint): vent ora Nance of er t an wnace
e gest on:
Absorption units BTU/Il _
Chillers-__—
(,.inHI'
Name” -- -
ressors HI'
Address. . �� ' >` nv ronmer exhaust an vent at on:
1
City: �? L v Sta(C:1
ZIP:( Arplinncevcnt
Phone: Fax: E-mail: ryerex aust
0o s, ype res. itc en/ azmat
hood fire suppression system
Nath` .�.�� ` Qi _ Exhaust fan with single duct(both fens)
-Exhaust system a art Irom eating or AC
Mailing nddress: u_e p p ng and distribution(up to 4 out ets)
City: --` Slat ZIP: t a ' T LPG NO Oil -
Photle' mail: ucp pingeach additional over 4 outlets
roellpiping(sc ematicrequirer)
Number of outlets
Name: -D-jWerJWWappIIance or equipment:
Address: Decorative fireplace
City: State: ZIP: nsert-type
Fax: Email: oo stov Ire et stove
Phone: Ot—ier ._
_Applicant's signature: Date: - ter:_ -
-. -
Permit fee.....................$
Not art Jurisdictions accept credit card%,ptea%c call Jurisli tion for mom infurmenon. Notice:This permit application Minimum fee................$
U Visa U MamerCard _lam_ expires if a permit is not obtained Plan review(al _ %) $ �- -
Credit cord number___ —.---- apdrts within 190 days after it has been
State surcharge(8%)..•.$
--- accepted as complete.
Name of ce tot r as s own on c n ter S TOTAL .................•..•..$
Cmdhnlder signature _ Amour 410-4617(6100/Com)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Vi Description: Price Total
OtY (Ea) Amt
$1.00 to$5,000.00 _ Minimum fee$72.50 _ Table Mechanical Code _
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace
ce t0 BTU
ducts
&
Includingdducts 8 vents 14.00 �r
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction thereof,to and Including Including ducts&vents 17.0
---$10.000.00. _
$10,001.00 to 525,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
Including vent 114.00
$1.54 for each additional$100,00 or 4) Suspended heater,wall heater t
fraction thereof,to and including or floor mounted healer �•'00
$25000.00.L
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and including 6) Repair units
12.15
$50,000.00. -
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.000 For Items 7-11,see or Pump Cond
fraction thereof. _ footnotes below. Comp*_
_,---_-� 7)-.3HP;dbs(,rb unit
to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb
Value Total unit 100k to 500k BTU 25.60
Descqp_Uon: Q Ea Amount 9)15-30 HP;absorb
Furnace to 100,000 BTU,Including 955 unit.5-1 mil 5TU - 35.00
ducts&vents 10)30-50 HP;absorb
Furnace>100,000 BTU including 1,170 unit 1-1.75 mil BTU 52.20
ducts I vents 11)>50HP:absorb
Floor furnace Including vent _955 unit>1,75 mil BTU 87.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not inclurled In appliance 445 13)Air handling unit 10,000 CFM+
ermit 17.20
Re air units _ 805 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 10.00
to 100k BTU 15)Vent fan connected to a singe duct
3.15 hp;absorb.unit, 1,700 6.80
101k to 500k BTU 16)Ventilation system not Included in
15-30 hp;absorb.unit,501k til 1 2,310 appliance permit 10.00
mill.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00
1-1.75 mll.BTU 18)Domestic Incinerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU 19)Commercial or industrial type Incinerator
Air h ling unit to 10,000 dm 656 69.95
Air handlin unit>10,000 Cfmi 1,170 ?.0)Other units,Including wood stoves
Nun-portable bvdputate cooler 656 10.00 r
Vent fan connected to a single duct 446 21)Gas piping one to tour outlets
Vent system not Included In 656 5.40
appliance permit 22)More than 4-per outlet(tach)
Hood served 1r mechanical exhaust _ 656 _ 1.00
Domestic incinerator 1,170 Minimum Permit Fee$72.50 SUBTOTAL: �L
Commercial or industrial Incinerator 4,590
Other unit,Including wood stoves, 656 8%State Surc►iarge
Inserts,etc.
Gas plping_1-4 outlets360 26%Plan Review Fee(of subtotal) S
Each additional outlet 63 Required for ALL commercial permiLS only
TOTAL COMMERCIAL - TOTi,I_ RESIDENTIAL PERMIT FEE: -30
d
VALUATION: -------
Other Inspections and Fees:
1 Inspections outside of normal business hours(minimum crarge-Iwo hours)
$72 50 per hour
2 Irrepeclions for which no fee is specifically indicated (minlm,,m charge half flour)
$72.50 per hour
3 Additional plan review required by changes,additians or revisions i-!plans(minimum
charge-one-half hour)$72 50 per hour
"State Contractor Boiler Certification required for units>200k BTU.
"Residential A/C requires site plan showing placement of unit.
1:\dsts\formslmech-fees.doc 10/11/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP
Date Requested - �� 7 AM v PM BLD
Location_ j 7 t i.i I v V I "� [ I' ' Suite _ MEC Zei � b(.tJ y y
Ph •Z3 Y '2125 PLM
Contact Person - —
Contractor_ Ph — SWR
UILDING ^� Tenant/Owner ELC
B
ELR
Retaining Wall
Footing Access: FPS _
Foundation
Ftg Drain SIGN —
Crawl Drain Inspection Notes:
Slab SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Insulation
Drywall Nailing IS !
Firewall
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling --
Roof
Misc — —�
Final
PASS PART FAIL -- _
PLUMBING
Post&Beam
Under Slab
Top 0-it
Water Service
Sanitary newer
Rain Grains --_—
Final
PASS PART FAIL --
Post 8--e-am
Rough In _ --
Gas Line —
Smoke Dampers
PART FAIL —
ELFCTRICAL
ice — —
Rough In
/Slab — -- —
Low Voltage
Fire•Alarri --- -- ---
Final
PASS PART FAIL —_--•-----
Backfill/Grading -- —
Sanitary Sewer
Storm Drain Reinspection fee of$ wired before next inspection. Pay at City Hsll, 13125 SW Hall Blvd
[ ] — _required
Catch Basin [ j Please call for reinspection RE: [ ]Unable to inspect-no access
Fire Supply Line
ADA
Appronch/sidewalk pate 3 7— c' / Inspector Ext
01her
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
ELECTRICAL PERMIT �
CITY ®� T���RD PERMIT#! ELC2001-00103
DEVELOPMENT SERVICES DATE ISSUED: 2/21/01
13125 SW Hall Blvd., Tigard, OR 97223 (503, 639-4171 PARCEL: 2S103CD-01700
SITE ADDRESS: 13775 SW FAIRVIEW CT
SUBDIVISION: HOLL-YTREE ZONING: R-4.5
BLOCK: 01 LOT : 015 JURISDICTION: TIG
Proiect Description: One branch circuit
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ _MISCELLANEOUS
1000 SF OR LESS: 0 - 200 ,-,no: PUMP/IRRIGATION: —
EACIH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMIT ED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANE HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER —_ _ BRANCH CIRCUITS � _ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER ^^ YPER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+ amp/volt: — SVC/FDR
RES UNITS: -�- > 600 VOLT NOMINA__L- -
_ Reconnect only: R >= 225 AMPS: CLASS AREA/SPEC OCC: J
Owner: Contractor:
LANTZ, ERIK V + OWNER
COMBS-LANTZ, SHERI L
13775 SW FAIRVIEW CT
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES — — Required Required_ Inspection.
Type By Date Amount Receipt Rough-in 4 _
PRMT CTR 2/21101 $46.85 27200100001 Elect'I Final
5PCT CTR 2121101 $3 75 2720010000(
Total $5060
This Permit is issued subject 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 started within 180 days of issuance,or if 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 copies of these rules ordirect questions to OUNC at(503)
246-1987.
PERMITTEE'S SIGNATURE ISSUED BYE
OWNER INSTALLATION ONLY
The installation is being made on property I own hi„li+s not intended for sale, lease, r ren .
OWNER'S SIGNATURE __
i-L - ----- DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:_
LICENSE NO:
Call 639-4175 by 7:00pm for an Inspection the next business day
Electrical Permit Application
— TProjicctifappl.
ccived: Z Permit no. •�op _
City of Tigard no.: Expire date:
City(?fTigard Address: 13125 SW hall Blvd,Tigard,014 97223 Date issued: B)W Receipt no,:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no. Pa m type
Land use approval:
t ,
'W'I &2 family dwelling or accessory U Commercial/uulush ial U Multi-I•amily U Tenant improvement
U New construction U Addition/alteration/replacement U Other: U Partial
'JO1 SITE INFORMATION
_Joh address: I ' L-Z-a . I Itldg,no.: Suilc no.: Tax map/tax IoUaccount no.:
Lrrt: 131ock: Subdivision: I
I'loiect none; ___7Descrinfidli and location of work on premises: 'Wf%-r
Lstin,a(ed date of complet-ion/insilection.
SCHEDULE
Job no: ,r Fee 151:rx
---- - - I)kscripNon Qly. (Co.) lbinl no.imp
Business name: _ New residential-single or nmlli-family per
Address: _ dwellingunh.Inc ludesattached garage.
City: _ Stale: 211'. Service Include:
4
I(xx)sq h mle%s
Phone: Fax; E-mail --
Each addrtional50(1sy.Ir of p,wuarlhereol'
CCD no.: 7Elcc.bus.lic.no: _ Limiledenergy.residential 2
City/metro lie.n0.: _ Urnitedenergy.non-residential 2
Each manufactured horse or modulardwelling
Service and/or feeder 2
SI Holme of su rvisin electrician(required) bate _
Licenses-, Services or feeders-installation,
su .elect.name( riu): alteration or relocation:
11111LUME[RIMILIA 111121111114 200 am s or less 2
201 amps to 400 amps 2
Name(print): t.' ,�f�C V 1 C1.1" 401 amps to 600 amps _ 2
Mailing address:I= --t ` V'2 1> V`l` 601 amps to 1000 amps 2
City"'- I State: W I ZIP:r Z_Z �' Over I WO unips or volts 2
Phone
econnrctonl
Owner installation:The instillation is being made otr property I own Temporsryservicesorfeeders-
Installation,alleralIon,or relocation:
which is not intended for sale,lease,5uti"pt exchange according to 200 amps or less 2
ORS 447,455,4119,yt70;701, , -� 201 amps to 41x1 amps _ 2
(hvnel' _ {� Dale: z 401 to 600 ams 2
Branch clremits-ne".r dleration,
or extrnalan per panel:
N an a A. Fee for branch circuits with purchase of
Address: service at feeder fee,each branch circuit
Slate: ZIP: B. Fee for branch circuits without purchase
City: _ of service or feeder fee.first branch circuit:
Pntrne I'ax: F-snail: Each additional branch circuit
Misc.(Service or feeder not Included):
Uservice over 225 amps-commercial U Health-care facility Each rum or irrigation circle
U E.
service over 3211mnpsaatingof l&2 U Hasurdouslocation Each sign or outline lighting
familydwellings U Building over 10,00(1 square feet four or Signal circuins)at a limited energy panel,
U System over 60t1 volts mmnlinal morr residential units in one structure alteration,or extension"
U Building over three stories U Feeders.410 amps or marc "Description: —
U occupant load over 49 persons U Manufactured structures or RV park FAch additional Inspection over the allowable In any of the above:
U Egrrss/lighlingplma J Other ---_-- -- Per inspection
Submit_.—sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. other
it fee
Not all Jurisdictions accept credit earls.pleas call Jurisdiction for more in6mnanan Notice:This permit application Plain review(rat ,.................. $
U Visa U MoaterCar.l expires it'a permit is not obtained
Credit cant number within 190 days alter it has been State surcharge 1K"G)
(.spire+ accepted as complete. TOTAL .......................$ t5 Q
-- ane of carmoT r as a awn on cre it card $
— Crrdholder slAnature— Amaum 4404615(WIDICOM)
Electrical Permit Fees: Limited Energy Fees:
------ TYPE TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
I Complete Fee Schedule Below:
Restricted Energy Fee...................................................... $75.00
Number of Inspections her permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq ft or less _ $145.15, 4 ❑ Audio and Stereo Systems
Each additional 500 sq.ft.or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy _ $75.00
Each Manurd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $90.90 _ 2
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2 —Over 1000 amps or volts _ $454.65 2
only o
Reconnect _ _ $66.85 2
sorFeeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary nly
Fee for each system.......................................................... $75 00
Installation,alteration,or relocation
200 amps or less — $66.85 2 (SEE OAR 916-260-260)
201 amps to 400 amps $100.30 2 Check Type of Work Involved:
401 amps to 600 amps $133.75_ 2
Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems
see"b"above.
Branch Circuits ❑ Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑ Clock Systems
with purchase of service or
feeder les.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 1 ❑ HVAC
Each additional branch circuit — $6.65
Miscellaneous ❑ Instrumentation
(Service or feeder not Included)
Each pump or Irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s)or a limited energy ❑ Landscape Irrigation Control'
panel,alteration or extension $75.00
Minor Labels(10) $125 00 ❑
Medical
Each additional inspection over
the allowable In any of the above ❑ Nurse Calls
Per Inspection $62.50
Per hour $62.50 El Plant $7375 _ Outdoor Landscape Lighting'
Fees: ❑ Protective Sigraling
Enter total of above fe-s $ "P5 ❑ Other
8%State Surcharge $ ______.,Number of Systems
25%Plan Review Fee ' No licenses are required Licenses are required for all other Installations
See"Plan Review"section on $ _
front of application -
Fees:
Total Balance Due $
----- Enter total of above fees
Trust Account p_.__- V.State Surcharge :
Total Balance Due S
i dsWforms\elc•feesAoc 10A)90)