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CITY i O F ! I OA R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00148
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/25/04
PARCEL: 2S 102CC-02300
SITE ADDRESS: 10130 SW HILLVIEW ST
SUBDIVISION: FRE.LEON HEIGHTS NO.2 ZONING: R-3.5
BLOCK. LOT: 008 JURISDI^TION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OC(;UPANCY GRP: VENTS W/O APF L: VENT SYSTEMS:
STORIES: _ _BOILE_R_S/Cr+M_PRESSORSHOODS:
FUEL TYPES ~ 0 3 HP: , DOMES. INCIN:
-- _-- _ --- ---- 3 15 HP: COMML. INCIN:
MAX INPUT: BTU ;5 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS � OTHER UNITS: 1
FURN >=100K RTU: <= 10000 Lim.
> 10000 cfrn: GAS OUTLETS:
Remarks: Install exterior A/C:. Do not place%kohin the rekluned setbacks
Owner: _ �---�-- - FEES
CAROL JULIAN Description Date Amount
S
10130 W HILLVIEW
10130 S, H 97223 [MECHI I'ennit I c; 3/25/04 $72.50
TIGA [TAX) K 1;t,iic 3/25/04 T5.80
Total $78 30
Phono: 503-6-',9-1602 - ------- -----
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone. iO3-640-3607 Finalln..pect.ion
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code. Statk. 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. 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
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
;, 03)246-6699.
Issued By: �jL �_ Permittee Signature:
Call (503) 6394175 by 7:00 P.M. for inspections n coded the next business day
lec halnical Permit .A > ) icatiop e
' Receiv �lccnan r:.l
PI nn9 �Approynl Try >tf Tigard '�� �� PlanninDuilding
13125:W Hall Blv naicJg : Petmit No.:
T1;ard, Oregon 972 ; J Plan Review ther.
Dat Pctmit No,:
Phone: 503-639-4171 Fax: 503"5981460 Post-Review Land Use -` --1
I111erriet www.ciAigard,or.us �Nanie/Mctho&
Case No.:
24-hour Inspection ILcquect: 503-639-4175 loris.. 'ice Page 2 for -
ti, Su Icmentallnformation.
TYPE QF t'1rO.I><K.
'co MMERI-TA1:<FEE+SCNEbULE-USE C6tEEC1CLIST
❑New construction _ Demolition Mechanical permit fees"arc based Sn'the total value E the work
Add�tion/alteration/replacement ❑Otht1. Performed, Indicate the value(rounded to the nearest dollar)of All
:CATC.CG_0-4I_OF'C0N5TItU411Uh1 z' mechanical materials,equipment,labor,overhead and profir.
�
'1 , 2-Famil, dwellin Cot;lmercia0rldustrial value: S Sec page 2 for Fee Schedule
Ac
ssory Building Multi-Family RE9IDENTIALy TLIHIMMISYST'MS FT F+SCHWDUI.E
Li Muh.cr Builder 0t11cr: 1)escri rico1 Fee an. Total
308.517E INFOR111A 1 ION tidtl I;OCATYON le Coolin
Job sift: lddress: n p , Furnace add-on it condirionin 14 %0
t. v �) (�yr t.J f f Gas heat um }-�J 1 .00 �.
Suite ft: -L-r-
$ld ,/Apt.#: Duct work 14.00
Proleet 1 Jamt; H dronic hot waters stem t 4,00
Cress sttcet/Directions to job site. Residential boiler o.
(for radiator or h dronic sstem 14,00
Unit heaters(fuel,not electric)
in wall in-duct sus ended etc) 14.nn
Irl vent for any ofa ove) 10.00
Lot
Subjli i oriRepair units: 12.15
#:
1'ax mai,parcel #' Other Fuel A Ilancos
DE9C11Lt1°Tt71Y FU watlr hector WV's Gas fire Tact: ---" -- i0,00
_ 10.00
Flue vent "water heater/ as fire lace) 10.00
- - �•-�� Lo Ater as)
Wood/Pellct grove tO.nU
--- I O.UO
Wood Ftreplace/inscrt 10.00
11TY t7WNiEt2 Chlmnev/liner/fluc/vent `
T)NANT, 10.00
+.. .�•' ,;r - .,.'�. Uthcr� 10.00
Envitromncntal Exhaust&Ventilation
Add-ess: i Range hood/other kitchen equipment 10.00
CitI'Stat�,iZ p:
Clothes dryer ex oust —76_00
Phone: 3 - a L Fax: Single duct exhaust
A>E'PLICII'NT —�-- (bathrooms,toilet compartments,
uriU roomst__
Nart11°, - Attic/crawl ace fans 6.80
Addy BSS Other; I o.UO
l o.00
Cit /$tIItt/Z_p: PuelPi lu '
Phone: FaX: Futnacc,etc, SS.%v ror first 4,s1.0o each additional
E-mail; �Gas hccaar_ ump
CUNTRAC_f_p[t:� alW Usu ndcd/unit heater •"
�3U5ir eSs )4mlIe: Water heater
C�� _ '{!C•--1yr,r_ Fire lace "•
Aon e ..
City/! a Zitls �, f= BBQ
Phone: p . ' Clonc�s d er as) ..
Fax: �.3 Other
CCB Lic. a: - U�i�;c
nut tori red-i pp Total:
Sivnaturc Zl`tL lc.Z. Meehaetcal Ferm{t Fees•_
i �'� _ date' `f r'� Subtutat: S
Minimum Permit Fee S72.SU S
Plan Review Fec 25%of Pcrmit Fee S
(Please print name) ` State Surchar a 8%of Permit Foe S
Notice: '"his pt emit application esplres If a permit is not obtainedwithinM-1
O AL PFRytT FEE $
180 days after i has been accepted as complete, Fee tnethodology tet by TH-County Auilding lndnstry Service Board.
i',DstsTc•rmt F,rnsNecPcrrmtA rP Jnc C�1 303 Site plan required for exterior A/C Unita.
F
2 -d B t LO E'BS COS Su t ZeaH r,z 1 e t oa01S dGs t 10 {r0 i2 -few
SITE .FLAN
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------------
STREET
Specialty .Heating & Cooling,, Inc.
9528 SW Tigard Street t
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.
11111S�)O10 Phone Spa . 0718
640-3607 Fax 503.681 .0793
E: C1 SILO 865 E05 aut%QaH R%1WT0a4S dLStIO b0 1—, �w
CITY OF
TI /� ryHrt D � ELECTRICAL PERMIT
r VPERMIT#: ELC2004-00152
DEVELOPMENT SERVICES DATE ISSUED: 3/26/04
13125 SW Hall Blvd.. Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S102CC-02300
SITE ADDRESS: 10130 SW HILLVIEW ST
SUBDIVISION: FRELEON HEIGHTS N0.2
ZONING: R 3.5
BLOCK: LOT : 008 JURISDICTION: TIG
Project Description: Job No. 2562
A/C and plug
RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS MISCELLANEOUS_
1000 SF OR LESS: 0 -200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE,.-EEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION.
201 - 400 amp: 1,, WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN_REVIEW SECTION
1000+ arnplvolt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/S11-EC OCC:
Owner: Contractor:
CAROL JULIAN HILLSBOR3ELECTRIC
10130 SW HILLVIEW 21185 NW EVERGREEN PARKWAY
TIGARD.OR 97223 HIL.LSBORO OR 97124
Phone: 503-639-1602 Phone: 503-439-9666
Reg #: ELL 34-43990
— FEES LIC 134481
SIJP 4'415
Description Date Amount Required Inspections
�111'11 I I:LC'Permit i 'o u-1 $53.50 — ------1
IA\IS",,Ctatc Surchori,c � 10 04 $4 2-1
Elect'I Final
Total $57.78
L
This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other ap;Lcable laws
All work will be done in accordance with approved plans This permit wail expire If work is not started within 180 days of issuance,or if work is
suspended for more than 180 days ATTENTION Oregon law requnes you to follow rules adopterby the Oregon Utility Notiftc2tion Center. Those
rules are set forth in OA R 952-001-0010 through OAR 952-001.0100 You may obtain copies c'.nese rules or direct questions to OUNC at(503)
2466699 or 1-800-332-2344
Issued By: ��/y ��_.. Permit Signature: ,Z
_ OWNER INSTALLATION ONLY _
The installation is tieing 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:
Call 639-4175 by 7:00pm for an inspection the next business day
From:HILLS80R0 ELECTRIC LLC. 5036013680 03/25/2004 11:12 #334 P.001
Electrical Permit Api Ali 1 ati�n M1t.0FFK!1;'1JSEe ONLY
Received Electrical ��'"
�
tt iuO bste23�_— _ Permit No.-4k) q—OOiSa
t Planning Approval Sign
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. I I l Ut (IIaAF�'' PlanRve ew -' Other
Tigard,Oregon 97223 Fit�Il.)IN(I DIVISI(ki Date/Bv, _ _ Permit Not&;foZ Y-ge I14�
Phone: 503-639-4171 Fax: 503-598.1960 Post-Rc aw — Land Use
Internet: www.ci,tiglard.or.us Vale/By: _ Cut No.:
24-hour Inspection Request: 503.639-4175 Contact. ,loris.; 2g hoe page 2 for
l4mc/Method: Supplemonlal Information.
TYPE OF WORK' _ PLAN REVIEW III se check all that apply)
New construction I LJ Q=olition Service over 225 amps- Health-care faci:ity
Additlon/altaratiorJrG lacement Other: commercial ❑Hazardous location
P ❑Service over 320 amps-rating of ❑Building over 10,000 square feet,
CATSOMY OF CONSTRUCTION 1 de z family dwcilings four or more rraidentin!unite in
I &2-Family dwelling CommercialAndustrW ❑System over 600 volts nominal one structure
building over three stories Ll Feedera,400 arr.pi or more
Accessory Building Multi-Family Occupant load over 99 persons ❑Manufactured structures or RV part
Master Builder El other: ❑EBresanighting plan LJ Other
J B SITE INFORMATION and LOCATION' Submit_sets of plant with any of clic above,
�T The above are not applicable to tomeorsry construction service.
Jobsite address: i o I c — FZE*SCH.WULE`
Suite#: T3Idg./Apt.#: -T Number oft actions per Pe1-mit allow,
Project Name: t' u«<r ioP Qty Fee(es.) Total—
Cross BtCECtMird ti0r15 to Ob site: New residenCAI-single or multifamily per
dwelling unit.Includes attached garage,
Service Included:
1000 s . it or Irotr _ 145.15
Each additional 50038 or ponion the 4V
Limitad energy,residential 5.00
Subdivision: _ _ 1✓ot#: _ Limited c oa residential - 75.00
Ta_xmap/pAieel#: Each manufactured home or modular dwelling —
D&SCA5IP�CJf0111.Ok WAS' :''k i? cervica anA/or feeder 9090
— Services or feeders-installation,
alteration or relocation:
200 amps or Im 80.30
106.85
1 s s to 600 am e a 160. _
PRCOPER3">�, I4'IV$R„Y; ti `' TRN,tI►N Ct, rte iR 601 ernye w IOOO amFa --__ .60
U Over 1000 Amos or volts _ 454.65
Name: -1J. i_ Reconnect only _ 66.55
Address: I U i ,I Li ^ ( )9 Temporary services or feeders-Installation,
Ci /State/Zi , t ^ ^ alteration,or relocation:
�1 ri,of 3 Z00 amps or less 66.55
_... -- —
Phone: —1� , ax: 20�to 400 amps 100.
AP'PLIC' T';i? CONTACT PEEt50N'i';"a�:,, 401 to f00 ams 133,75
Branchcircuits-n--w,alteration,or
Name: extenslon per panel:
Address: — A.Fee fur branch circuits with purchase of 6.65
service or feeder foe each branch circuli
City/State/Zip: n.Fee for branch circuits without purchase of
service or feeder feefirst branch circuit 46,85
Phone: Fax: such switional branch circuit 1 6.65 (.
E..mail; Miso(Service or fbeder not inclvdod)•
RACOr h D or irrigation circleCO --
!
Each alar-or outline Iighting $3,40
Job No:'a���., _ Signal circuit(s)or A limited enmV panel,
Business Name: ra Eltv- usration,orextension _
ecripdon:
Address:
ch additional Inspection over the allowable!!Anx of the above-
Cit /Mate/Zi i coonmer hour(min, 1 SO
_
lax ' f�'� ttion fee!Phone iO3 38
CCB 13c. #:IN-4 It 1 I Lic. L.
Supervising electrician " Ela leaLPe Subtotal
signature required: _ Plan Review 25%of Permit Fee
Print Name; Lic.i#: State Surcharge 8%of Permit Pee S r _
TOTAL PERMIT FEE I S
Authorized Notica- This permit application expires If a permit Is not obtained within
Signature: — Date: 180 day.after It bas been accepted as complete.
*Cee methodology set by Tri-County Building industry Service Board.
-- -- (Please print name)
i:\DvuTertWtForrtw\McPcrmitApp.doc 01/03
w•n�w
CITY OF TIGARD 24-Hour
BUILDING inspection Line: (503) 639-4175
MSS
h.�PECTION DIVISION Business Lime: (503) 639-1171 --
Blip — --- -
Received =' y� Date Request9d J -� SAM ) PM ---.. 3UP
Location _Suite MEC
Contact Person J Ph O �'� f" �l�lo PLM
Contractor— Ph( ) ___- SWR
BUILDING Tenant/Owner ELOS�'7J��l S-2
Footing �- >? vy�p ELC
Foundation Access:
Ftg Drain EL9
Crawl Drain
Slab Inspection Notes: SIT -__-
Post& Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation
Drywall Nalling -- - -
Firewall 1
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling -
Roof
Other:
Final
_PASS PART FAIL
PLUMBING __
Post&Beam
Under Slab -- --
Rough-In
Wate, Service -- --
SanlUry Sewer
Rain Drains --- - - -- - _
Catch Basin/Manhole
Storm Drain -- -'
Shower pan
Other: _ --- - — ----
Final �-
PASS PART FAIL —
MECHANICAL
Post&Beam
Rough-In -- - ----
Gas Line
Smoke Dampers - -- - - ---— ------ ---
Final
PASS PART FAIL - ---
ELECTRICAL —�
Service
Rough-In
UG/Slab
Low Voltage
arm
SS PART FAIL Reinspection fee of$ required before next inspect?on. Pay at City Hall, 13125 SW Hall Blvd.
SIT [� Please call for reinspectionZell
_.— Unable to inspect-no access
Fire Supply Line ADA / ;iApproach/Sidewalk aa _ Inspector
Other: _
Final DO NOT !'EMOVE this Inspection, record tfromtee Job AIte-
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639- 117 —
BLIP - _
Received _ .� y�l Date Reyuested��� Un.L� AMPM -- BUP _
z 3, ( L4d.(, �( Suite-- - -- MEC.-26Z. V 00 /Y�
Location -
Contact Person _ Ph ( ) _____ _ PLM
Contractor—_ — ___ Ph(---) SWR
BUILDING Tenant/Owner __ ELC
Footing ELC
Foundation � - - - ---
Access:
Fig Drain ELR
Crawl Drain _
Slab Inspection Notes: � SIT
Post&Beam
Shear Anchors -- -- - - -- - _.
Ext Sheath/Shear � �����
Int Sheath/Shear -
Framing ---
Insulation
Drywall Nailing --- - - ---- --- --
Firewall
Fire Sprinkler - - -- - - - --- --- ---- - - - - _
Fire Alarm All
Susp'd Ceiling ----- -
Roof
Other: ---- - ----
Final ------_---
PASS PART FAIL - - - -- -
PLUMBING_ --__
Post& Beam-
Under Slab
Rough-In
Water Service - --- ---- ---
Sanitary Sewer
Rain Drains - --
Catch Basin/Manhole
Storm Drain _
Shower Pan
Other: -- -------- -- -- --
Final ------------ I
PASS HART FAIL - -� _------ - ----_ ------ -
MECHANICAL —
Post& Beam
Rough-In -- - - - -
Gas Line
Smoke Dampers --- - -- -
Fin,
PART FAIL - -- - ---
ELECTRICAL _—
Service
Rough-in -- _
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: _ --_ Unable to Inspect-no access
Fire Supply LineADA V...Specter
Approach/Sidewalk Data - _` _ �___-�1E,ct
Other:
Final DO NOT REMOVE this Inspection record from the,fob 6Ite,
PASS PART FAIL