14090 SW FANNO CREEK PLACE i
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14090 SW FANNO CREEK U%CE
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SNS Hall Blvd., Tigard,OR 97223 (503)639.4171
I
EXPIRED
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLvn. Rec'd By
TIG,"RD OR 97223 Date Rec'.i
Date to P.E. _
Phone (503)639-4171, x304 Print or Type Date to DST _
Inspcction (503) 639-4175 Permit#
Fax (503) 684-7297 Incomplete or illegible will not be accepted Called
1. Job Address: F4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name(or name of business) �'rc _1l Uf f C��C� •'/�;�. Service included: Items Cost rum
Address .VI70 C'.0pW '. l&ce - 4a. Residential-per unit
CI /SZl ,c 7 7�1 t 1000 sq.ft.or less -_ $11ri.00 _ -- 4
tytate/ p Each additional 500 sq.It.or
Commercial Cl Residential portion thereof $25.00 1
Limited Energy $25.00 _
Each Manuf'd Home or Modular
Dwelling Service or Feeder 368.00 2
2a. Contractor installation only:
(Attach copy of all curren)Iic nee ) 4b.Services or Feeders
Electrical Contractor <� Installation,alteration,or relocation 1
Address 2 200 amps o,less $60.00 2
CI ! ! State Zj 'i201 amps to 400 amps $80.00 _ 2
City- [ / , p � 401 amps to 600 amps $120.00 _ 2
Phone No., 601 amps to 1000 ampn $180.00 _ 2
Job No. 11-1-AV- > > Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. ( If Exp.Date _ nocol,nect only _ _ $50.00 _ 2
OR State CCB Reg No.1 Z Exp.DateW 4c.Temporary Services or Feeders
COT Business Tax or Metro No,. Exp.Date Installation,alteration,or relocation
290 amps or less $50.00 2
Signature of Supr. Elec'n_ __ 201 amps to 400 amps _ $75.00 _ 2
-- 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr Exp.Date_ _____ see"b"above.
Phone N( _11',.Lir -
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner instailations: EX P I R F n n)The fee for branch circuits with
purchase of service cr
Print Owner's Name _ feeder fee.
Addrflss Each branch circuit $5.00 2
b)Tho fae for branch c1mults
City_ State_-!_ Zip__ __. without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The Installation is being made on property I own which is not Each additirnal branch circuit_ $5.00 _
Intended for sale, lease or rent. 4e.Miscellaneous
(service or leader nl.included)
Owner's SignatUYe Each pump or Irrigation circle $10.00
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):' Signal clrcull(s)or a limited energy-
panel,alteration or extension $40.00 _ ;>
Please check appropriate item and enter tee in Minor Labels(10) $100.00 section 5B, --
4 or more residential units In one structure 4f.Each additional Inspection over
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 A $55.00
"Submit 2 sets of pinns with application where any of the above apply. Jam. Fees:
Not required for temporary construction services, 5a.Enter total of above fees $ S'
5%Surcharge(.05 X total fees) $ -t-
NOTICE Subtotal $ --.
5b.Enter 2..5%of line So for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS PInn iaeviewLrea ' (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY O 0
TIME AFTER WORK IS COMMENCED, Q Trust Account#_ r-- ig.
Total balance Due 7/� S���/
IADSTMELC06 APP Ra WN
RECEWEC)
NOV 0 r 1997
COMMUNITY UtV�LoPMENI
CITY OF TICARD BUILDINCC INSPECTION ECTIC)N UL VISION
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requested: - 7 A.M. P.M. MST:
Location: BUP:
Tenant: _ Suite: Bldg: _ MEC: Z
Contractor:_5 1
471� Phone: L4 PLIA:Tf-o4�/e
Owner:_ _ Phone: �^ ELC:
tt
ELR;
T W St _.
BUILDING BLDG(con't) % UMBING " MECHANICAL ELECTRICAL SITE
Site I'ost/Bcam �1�sNfiauti`"J Pos cam Cover/Service Sewer/Storm
Footing RoofRough-In Ceiling Water Line
Slab Framing op Out Uas Line Rough-In UO Sprinkler
Foundation Insulation ewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service 1VIISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/round Dr Heat Pump Low Volt
ApprovedPIF Approved Approved
Appr/Sdwlk Not Approved NoLAp roved Not A?proved Not Approved Not Approved
FINAL FINAL A FINAL FINAL
CI Cali for reinspection O Renispe—lion fee of S required befort aspection O Unable to inspect
Inspector: `✓r""" _ Date: t�- �1� -1 page-- -Of '
r
a"ry O TiGARD MECHAN I CnL
DEVELOPMENT SERVICES PERMTT
13125 SW HaN Blvd., Tigard,OR 97223 (503)639.4171 r'ERM I T #. . . . . . . : MEC97--0407
DATE ISSUED. 10/16/97
f'i1RCEL: 2S 1 12BB- 12:200
",ITC n1C)DRES ;. . . : 14090 SW Ff1NNO CREEK Pl-
'iUBD I V I S I ON. . . . : COLONY CRFFK ESTATES NO. 4 ZONING: R--7
�_OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 102 JURISDI.CTION: TIC
LASS OF WORt;. . :f1LT 171-00R r-L1RN. . . . : 0 FVAr' Ct7CLE.RS: 0
-'Yr,F OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FMS. . . : 0
1CrUPPNCY GRE'. . :R.?, VENTS W/O (IM : 1 Vt NT 5Y TE MZ): 0
'_.TORIES. . . . . . . . : 0 DOI1_ERS/COMPRF_'G!rORS HOODS. . . . . . . : 0
'"UEt_. 1"YPES_.._._..__._____.._..___-_-- 0--3 Hr'. . . . : 0 DUMPS. TNCIN: 0
u-15 HF', . . 0 COMML. INCIN: 0
'IAX I NPt.IT: 0 PTU 1 '1 _70 I iP. , . . 0 REr'A I R UNIT17): 0
. : "7,0-50 I-AP. 0 WOODSTOVES. . : 0
IRE nAMr'ERS''.
.AS r'RE1,3GURE. . . : W4 I-lr'. . CA-0 DRYER;. . : 0
'10. OF L.JNIT - ___.__......_. _..__.. AIR HONDL.ING LAM') OTHt=R UNITS. : 17..!
I.JRN ( 1.001!. BTU: 0 (- 10000 c_'fm : 0 GAS OUTLETS. : 1
' URN ) -100tC BTU: 0 > 10000 r_.f m : 0
�P m a r k : Vent not included in appliance pereit and gas piping to an existing
-ingle fasily dwelling.
FEES ._...
1OI:iy CCOTT I Ljc' 'Amc 1111t lay dal-0 r c pt.
40"-30 rW Fi1NNO CREEK r'I_ACF F,PMT $ .7'C,. 00 U[=0 10/16/97 n7--:001
rIriART) OR '777 5P(7,T $ 1 . 15 GE0 11X'/1!,i ]? 97 31;101
A--myiv #: 639--1288
c"'Ot_UMB I A HEFT I NG R COOL-I NG INC
-,0 BOX 230397 _.____.._._ __.... _.._.___..__._....._.
TIGf1RD OR '77�:0"i
Pl,o rr e 0: 624--2704
00076;:,
_ l
-_._...... ..._ RFQU I RFP I NSr,7"'CT i C?NS --
c� pereit is issued subject to the regulations contained in the Gi-.s Line I n s p
Tigard Municipal Code, State of Ore. Specialty Codes and al'. ether Mecha n.i ca l I n s r'
applicable laws. 411 work will be done in accordance with Mis,,.--. I1)spect i Lin _—
approved plass. This pereit will expire if work is not started Final Iri-:pec_•t i or, —_,—
within 180 dais of issuance, or if wo-k is suspended for sore
.han 180 days. ATTENTION; Oregon r.aa requires y^,j to follow rules
idopt-id by the Oregon Utility Notification Centr-% Those rules are
set f,lrtt in OAR 952-001-•0010 throuc,h OAA 952-001 0080. You say
nbtain copies of these rules or di,ect questions to OUNC by calling
�h??'4E,-9187. __..__.._—.—__• —..._
Lss�_rp R : r'ermitteE� Sign _
+++•4 ++4-Ff+•1 + f+4++++++4.4. 1-++•4-+ F+•F+++++++++i +-I-++-++•+d-++4 +f h++++++t•+++++++++++++
C al I 6,39--4175 by 7:00 p. m. for inspect ions needed + I-,e riemt tmsi.tie ss day
+..+..+•++ t+4 +++ f L.1_-}.+.+.4-1 r F F.I.+ h+-l-+++-F +I --.l 4+-1 .1. .1..4.4-t-4 1_! 1 ! i 1-+i-+i ++++++++ 1-+
Plan Check#
CITY OF TIGARD Mechanical Perm. Application Recd By
13125 SW HALL BLVD. Commercial and Residential Da'.e Recd
TIGARD, OR 97223 DzIe to P E.
(503) 639-4171, x304 Date to DST �e
Print or Type Permit
_ Incomplete or illegible applications will not be accepted Called
Ne t 0evelopmevl/profeea Description
F ' Table to Mechanical Code QTY PRICE AMT
Job street Addre n suns° A) Permit Fee -0- -0- 1000
Address /�y o� 1 ' ) -i f-11
Bldge citylslole Zip 1 ) Furnace to 100,000 BTU 600
d. � r ;2 _ncluding ducts 3 vents
a wr name of business 2.) Furnace 100.000 BTU+ _ 750
Owner �i,f ��- including ducts&vents
Mailing Address �) 3) Floor Furnace 603
` 5 uj l % t1k including vent
g�ty,slate r Zip Phone 4) Suspended heater,wall heater 600
or floor mounted heater_
N s ^r name of busnessl 5) Vent not included in appliarCA permit 3.00
Occupant Mailing Address 6) Boller or comp,heat pump,air Gond. 6.00
_ to 3 HP:absorb unit to 100K BUT
7)Zip Phone' 7) Boiler or comp,heat pump,air cond. 11.00
3.15 HP:absorb unit to 500K BTLj^
Contractort°i 8) Boller or comp,heat pump,air cond. 1500
(Prior to } -',� � 15-30 HP:absorb und.5-1 and BTU"
issuance rg'Addreu_ 9) Boiler or comp,heat pump,air cond 22.50
applicant / �r; �),�'! 30-50 HPabsorb unit 1-1 75mi1' U"
must provide all ,state Zip Phone 10.1 Boller or comp,heat pump,air 'md. 3750
contractor �� j ,a ? ti �,,- >50 HP absorb unit 1.75 mil BTU-
-"7A
license Ore on Const Cont Board L c e Exp One 11 ) Air handling unit to 10,000 CFM 4.50
information 0`7 �, ; -d-117 -
for CO r C Business Tax or Metro a Ex Date 12.) Air handling unit 10.000 CFM 750
database;
Architect N°i^° 13) Non-portable evaporate cooler 4 50
or Mailing Address 14) Vent fan connected to a slnole duct 300
Engineer cay,State Zip Phone 15) Ventilation system not included in 450
appliance permit
Describe work New O Addition O Alteration O f fair O 16) Hood served by mecharnca' haust 4.50
to be done Residential O hon-residential U t
Additional Description of work 17) Domestic incinerators 750
18) C nercial or industrial type 30 00
Incinerator
Existing use of 191 Repa!r units 4 50
budding or property _
20) Wood stove 4 50
rroposed use of 21 ) C,othes dryer,etc 4 50
building or property_i
22 i Otter units 4 50
Type of fuel-oil O •iatural gas 0 LPG O elr�ctnc O 23) Gas pioing one to four outlets _ rr 200
I hereby acknowledge that I have read this application,that the 24) More than 4•oer outlets(each) 50
information given is correct.that I am the owner or authorized agent cf
the owner that plans submitted are in compliance with Oregon State I QTY SUBTOTAL
laws
Sii natu of OwnerlAaent Late *SUBTOTAL
r 5%SURCHARGE
( f.0 Person N o Phone PLAN REVIEW 25916 OF SUBTOTAL
- cfL(�11TOTAL /
i Idsttrrle0iltimt.doc (rev 9 'Minimu permit►le is$25+5%surcharge
Residential AIC requires site plan showing placement of unit.
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMPING PERMIT
13125 SW Hall Blvd., Tigard,OF 97223 (503)639.4171 PERMIT #. . . . . ' . . p'LM97--041 B
DALE ISSUED: 0/ '_ 6/97
PARCEL: 261 12BB•-i 22Ok
':;ITE ADDRESS. . . : 14090 SW FANNU CREEK' PL_
�UBDIVISI;7N. . . . : COLONY CREEK. ESTA r'E73 NO. 14 ZONING: R -7
1'LOCI<. . . . . . . , . . . LOT. . . . . . . . . . . . . : 1O2 JURISDICTION: TIG
CLASS OF WORK,. . :ALT___.__-_GARBAGE YD I SPOSAL.S. :_.. ';"I_...._. MOS I L..E HOME SPACES. .—171- ^— -
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY ORP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STnR I E5. . . . . . . . . 0 WATER HEATERS. . . . . . 1 CATCH BAS I NSi. . . . . . . , 0
LAUNDRY TRAYS. . . . . : 1� 5F 1,1TINI DRAINS. . . . . : 0
SINKS;. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. ., . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUg/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RnIN DRAIN (ft ) . . . : 0
Rr:.mar-k5 : P plar_'e P><isting t-rnt water. heater for, an exi ;tirlq Siny] f f@1TJ ] y dt-JF. 11. in
y•
Owner-.: FEES _.___.._..__._.___. ......._.
ROPY SCOTT ilype amoo.int by d<.ite recpt
14030 SW FANNO CREEK, PLACE PRMT $ 25. 00 GE'O .10/16/97 97--300 14 1
TTGARD OR 97724 7-jPCT ti 1, 2`i GEO 10/16/97 97- ",17101 ri 1
mione #: 639•--1238
Contr-act or- _.__..__...._._.._.._.._.......__._....._._._....._ .-.._..._. ... __.... ..
COLUMBIA HEATING R CnOL_I NG INC
ro soy ;:",7,,a 7"F..)7
1900 SW B1.1RNH()M nT �;TF F-. 110
1IGARD OR 97281-0397 __._...._.__....._.. . ._.....
Phone #: 624-2704 $ t7'6. i'S TOTAL.
Reg #. . : 000763
_._...---.--.._. REOU I RED I NSPECJ T ON�;
This 1!rmit is issued subject to the regulations contained in the Gas 1_.ine
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misr. Inspection
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 952-0001-0010 through OAR 9524001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
IssI_ted By • �6�� Frr•m>.tte�, . i n� 1
+•+4-++•+-+++++-1.4-++-i+++++ 1++4'+++++•+++++++++++-F.+++++++++4-f++-1-+- 4+-f-++++++++++ +-1-+
Call. 639- 4175) by 7:00 p. m. for, an inspection neAdpd _testa . next b�.1s iness da",
++++++++i•+•+++ .+++#
TY OF TIGARD Plumbing Application deed By----
125 SW P-.'XLL BLVD. Commercial and Residential Oslo Recd —
'sARD, OR 97223 Date to P E.
Date to OST
,3j 639-4171
Print or Type Related SWR: _
lmorriplete or illegible applications will not be accepted called—__,
Nance of 0evelopmentfPropc2— M.NRES.,(Individualt_i ylpr"`,l:rt sl rt 4 PSE_;
Job r , Shit _ 9.00
Address Stmt AddAm Suite Lavatory 9.r0
. , 6z., `= 1 1 ' f1lTub or ruwsnoww coma. 900
—
Bldg a 1 cilyistate Zlp Shower Gny -`----- 9 00
c CRs 14 Water Gr set
9.00
Dlehtwaaher 9.00
Owner Me" Garbage Olaposal -�- - 9.00
()C A1111 I0 Waahwip Machine 9.00
GtyfstaaP Phone Fkxx Drain 2•
- -
1
�7 f1o�r� C __ 9.00
3' 9.00
4- 900
Occupant NGWV-Afteas Ulte Water Heater -� — g_Op
Landry r Pom Tray -9-00
GtylSbta ZIP Urinal -�� 900
F ame Other Fixtures(specify) -- --- 9.00 1
19.00
l .C1Lnl f Il(i k Pry
ontractor MAwl Ammu - - 9.00
Prw to Issuance /Mate p ----- --
applicant must 6) : i '"' 1� &),q -�r - - - 9.00
provide all Ordgon Conal Cant.Board Lief Exp.Oats 9.00
contractors -1 „-,. ], y —_`i- -- -
_ 9.00
inf1cen tse tktnb"Lim 0 �, Exp.Dan Sower-tst coo• 30 00
(5 -j/
Sewer-each addNlonal 1 OU'
for COT CQT Bilott s Tax or Metro f Exp.Date YVef�Servwb.1st 100' 25.80
30.pp
Name WSW#`Service-each additional 200' 25.00
Architect Storm&Rain Drain-1st 100' 30.00
or Marling Addrie" Suits Strum Win Drain-each aWAbnal 100' _- 25.00
Mob"Home Space 25.00
Engineer cityrState Zip Phone m
Camertiala Flow Pra•renice uon Day"or Ann- _+ 25 00
Pollueon Device
esaibe work New 0 Addlf cin O Altetatlon O r2epau C Residential Backflow Prevention Oevir7s' - 155.00-
0 De done: Resderttlal q Non•resdentiai O Any Trap or Waste Not r;or _1i to a F',xcure --
1,CddionAl description of work
Catch Basin - --- 9.00- --
Insp.of Existing Pkor," 40.00
_ per/hr
rstlng use Of Specialty Requested Inspedlons- — - ---- 40-00 --
oerfhr
Idlrrg or property--- _
Rain Drain,suvjle family dwelling 30.00 —
loosed use of Grease Trap. 900
ding nr property
v you carp", mow rx _ lswvvy.lirnwr QUANTITY TOTAL
moving replacing any fbriures7 Yes[] No p _ diagram s reetrued if Ouantr taw is >9 f'.iio
if see sack of form?_ "SUBTOTAL _
"reby Acknowledge M �,have read this application,that the information -_.- _._ :. r
-wens coned.Tut I am the owner or authorized agent of the owner and 5%SURCHARGE
at olans rued are in cWApilence wiUi Oreaon State Laws.
ignatu dAgent 1 p� -- PLAN REVIEW 25%OF SUBTOTAL
QeoUfeo onN I chive li r total a>9
�( )- TOTAL
_- on Name Phone C
`) 'i 'Minimum permit fee is$25• 5%surcharge.except Resderrnal Bacidlrrw
11(7iU11 �`� )�� (W�� -� J Prevention[?evice.which is s15•5%surcharge
Llplmapp.doc 1196 (dst)
'LEASE COMPLETE AS APPROPRIATE t4�ROJECT:
`Fixtures to be capped, moved or replaced Qty
Sink
Lavatory �---
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal —
Washing Machine
Floor Drain 2"
Water Heater _
Laundry Room Tray
Urinal
Other Fixtures (Specify) -
-OMMENTS REGArDING ABOVE:
1:'plrnipp.doc 12'96 (dst)