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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 ;�''�
Footing Rain Drain Cover/Service d
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mach.
Plbg.Und/Flr/Slab Pibg,Top Out Insulation lect,
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Apnr/Sdwlk Reins.
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4: Other: d
Date: A I z. 1 (R _ A.M. P.f Entry:_
Address: 16 to
Tenant: _ _._ Ste:_ M
Con/Own: •�
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: Date:
iROVED DISAPPROVED/CALL FOR REIN °. CF O
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C G INSPECTION NOTICE
ection Line: 639.4175 usiness Phone: 639 4171
ra,gYi � Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing 4 ec .
Plbg.Und/Fir/Slab Plbg.-Top Out ',�Sulation -Elect.
op '
Post/Beam Struct. We--ch. Hou Gyp. Bd. -Bldg. .
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: A
Date: 9 A.M. P.M._-'-JArfntry:
Address: --- (]aS71
Tenant:_ .e: - MST:
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Con/Own: o� d ' O s--D- BLIP:— MEC
PLM: _
ELC:
T E FOLLOW`k,G,CORRECTIONS ARE REO IRED: LRi
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{ Inspector: --_--_-- _ -- _ - Date
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APPROVED _DISAPPROVEDiCALL FOR REINSP. CF CO
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MECHANICAL
PERMIT
CITY CSF TIGARD PERMIT #. . . . . . . : MEC96-00'79 •
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08,113/96
13126 8W Hall Blvd.Tlgord,Oregon 97223.8199 (503)839-4171
PARCEL: cS 1 1 0DD- 06 100
1
SITE ADDRESS. . . : 10635 SW HIGHLAND DR
SUBDIVISION— . - SUMMERF'"IE:LD NO. 4 ZONING: R_7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 161
,LASS OF WORK. . ADD 1=L_.00R FURIV. . . ,. 0 EVAP COOLERS: 0
T'YF'E OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS— : 0
OCCUPANCY GRP. . : R3 VENTS W/O APPI_: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPEi._-------___......_. 1�.--3 HP. . . . : 0 DOMES. I NC I h',: 0
3-15 HP. . . . : 0 COMML. JNCSN: 0
MAX INPUT: 0 BTU 15-50 HP. . . . : 171 REPAIR UNITS,. 0
F I RE DAMPERS'?. . : 30-•50 HP. . . . 0 WOODS'TOvE S. . 0
GAfi PRESSURE. . . : 50.1- HP. . . . 0 CLO DRYERS. . : 0
NO. OF UN I l'5---- -- - -- - AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 1. <. 10000 cfm : 0 GAS OUTLETS. : 0
FURN ) -100K BTU: 0 > 1.0000 c.,fm : 0
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Remar,lts : Addition cf a f`U1-nac_a to 1001: ATUS-
Owner: _.________.------__________..___...__________._____.__.-.----_____.__._. FEES -- - _--_-•_...___
FRANK TUCKER type alno"lnt by date r-ecpt
10635 SW HIGHLAND DR V,RMT 9 25. 00 CJS 08/13/96 96-282854
5PCT 4 1. 25 CJS 08/133/96 96--282854
T I GARD OR 97,224
Phone #:
i
C�'clntractcr;
ANCT I L_ SHEET METAL. CO
43;:'0 N WILLIAMS AVE
FORT LAND OR 97C*"17
Phone #: 503-281 -075'- 26. 25 TOTAL.
Rey 0. . : 008897
INSPECTIONS
This permit is issued subject to the regulations containers in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection �____�•
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.
1 =i s l_r p cj B v : 4_'r2 :✓�r_ s.�r _�. _ �.__�. �_ __�_�_�,_. �_ _�. _� ....��_
Call for- inspection 639--4175
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City of Tlga(d MECHANICAL PERMIT Planck/Rec. # -y- a`ra.�ssy 6 1
13125 SW Hall Blvd. APPLICATION Permit # 0),cr9,1-'--C-)
Tigard, OR 97223
(503) 639-4171
•'^• escription
Table 3A Mechanical Code QTY PRICE AMT
Ad&-.
Job D ?-- 1) Permit Fee -0- -0- 10.00
Address
2) Supplemental Permit 3.00
^• d^'^•^ t-urnace to 100,000 BTU
kAC 1) incl. dr-ts &vents ��l t- n.00 GC' •
Owner 2) incl. ducts &vents 7.50
•• n oor Furr,ance
Cir ��` 3) incl. vent 6.00
U."•J. Suspended heater, w I I Fe-Ber
j4) or floor mounted heater 6.00
' •+•�� lent riot incl. in --
Occupant 5) appliance permit 3.00
Repair of seating, re ng.
6) cooling, absorption unit 6.00
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Boiler or comp, heat pump, air con .
I u 1A 1,. 7) to 3 HP; absorp unit to 100K BTU 6.00
° "' "'• of er or comp, eat pump, air cond.
Contractor Ik-L4 1 8) 3-15 HP; absorp unit to 500K BTU 11.00
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Boiler or comp, eat pump, air cond.
I CT--t t,A1\ C' 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
ZAy F- T..No Boiler or comp, heat pump, air cond.
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CITY QF TIGARD _
ELE=CTRICAL PIER141T
PERMIT #: ELC96--111533
COMMUNIrYDEVELOPMENT DEPARTMENT
HATE ISSUED: 11th/1 a/96
13126 SW Hall 6r.d.Tigard,Oregon 97223.6199 (503)639-4171
� P'ARCI L: �S 1 1 k.•OJ)--OG 1��
SITE ADDRECS. . . : 106.35 SW HIGHLAND DR
i SUBDIVISION. . . . : SUMMERFIELD IV0. 4 ZONING:R-7
BLUCK, . LOT. . . . . . . . . . . . . : 16 1.
P'ro.Ject Description: Adding two branch circl.I.
_--RE51L) TIgL-UNIT---- �' ---.-TEMP' `SRVC/FEE:DEFRS----- -----MISCELLANEOUS--..-
1.017.10 SF LESS. . . . : K7 - 21710 amp. . . . . . . : 0 PUMP'/IRRIVA'TIOIV. , . .
EACH ADD' L 5006F. . . : 0 x:01 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY, . . . . : 0 41711 600 amp. . . . . . . : 0 SIGNAL/h'ANEL. . . . . . . : 0
MANF7. HM/ SVC/FDR. . : 0 601+,amps-1000 vel.ts- : 0 MINOR LABEL ( 10) . . . : 0
__.......-SL-:RVICE/FEEDER-____._ -_-.-.--DRANCH CIRCUITS---__._...- -__...-ADD' L INSPECTIONS--_..
0 _ K"L,0K amp. . . . . . : 0 W/SERVICE OR FEEDER: 71 PER INSPECTION. . . . , : 0 �
201 _. 40171 rkmp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
40, - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
C, - 10+7.10 amp. . . . . : 171 _______ _.._._._._.____.__.._....r'LAN REVIEW SECT
1000+ amp/volt. . . . . : 0 ) --4 RES UNITS. . . . . . . . > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . CLASS AREA/SPEC OCC. :
Owner,: ____.___ . . _._._____-_---___.____._.._..._._._.___.._____.__._____._._.___.._-_ FEES __.__.___--_-.---------
FRANK TUCKER type amol-Int by date recpt
10635 SW HIGHLAND DR PRMT $ 40. 00 CJS 05/13/96 96-282853 ;.
5PCT $ 2. 00 08/13/06 96-062,'2 53
TI6ARD OR 07�=.` 4
P'ho-,e #: ('
E_LEC,TRICAL.DIMEIN TIONS INC 4.=. 010 1-01-AL
PO BOX 12,146
,3961 SW WILLAMS AVE _.__.__-_ REQUIRED INSP'ECTIONS --_-_-._-
PORTLAND OR 9;312 Wall Coven El.ec_t' l Final
Phone #: 503-288-7255 Elect' l Service
Rey #. . : 44006 i
i
This pers*t is issued subject to the regulations contained in the
Tinard Municipal Fede, Gtate of Ore. Specialty Codes and all other Permittee Si gnat L1r^e
applicable laws. All work will be done in accordance rtith
approved plans. This pereit will expire if work is not started
within 180 days of issuance, or if work is suspended for sore
than 180 days. I s s L`e d By
INSTALLATION
The installation is being made on proppr-ty I own which is not intended for
1 sale, lease, or r.'ent .
OWNER' S SIGNATURE: DATE;
INSTALLATION
S I GNATURL OF SUPR. ELEC' N: _ _ w DATE:
t
I_I CENSE NO:
Call for inspection 6.39-4175
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Community Development ELECTRICAL PERMIT APPLICATION t 0
13125 SW Holl Blvd.
'Tigard, OR 97223 PIanck/Rec. # r- P�s
Permit # --0 g 33
Phone (503) 639-4171 Date Issued ��-J3-- SIC
1 CITY OFTIOARD FAX (503) 684-7297 Issued by C"l�� rlyC <"G/;y.�✓--
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address Sen ice included: Items Cost(ea) Sum j
City/State2ip_�ICgj�,&?- t�r,312— 4a. Rwidential- per unit 4
1000 eq It or lose $110.00 �
r' Each additional 500 sq It or
Name (or name of business)_ U Ci�� L
portion thereof $26.00 �_-
y Commercial Residential Lim'ted 6lergy, $2500
3 Each Manut'd Home or Modular 2
Dwelling Service or Feeder $88 00
2a. Contractor Installation only:
4b.Services or feeders
Installation.allorali,n,or relocation 2
Electrical ontractorfir t;_ "r a�f iM r�►�>lU 200 a•,ps or ess $so 00 2
Ad S 1'Z 201 amps to 400 amps $8000 _ 2
a401 amps to 600 amps $12000 2
City Staten_ Zip_fL721-?— 601 amps to 1000 amps $18000 2 J
aPhone No. Over 1000 amps or volts _ $34000 2 j
Contractor's License No. - "7r Reconnect only $5000
Contractor's Board Reg. No. 414-oc)FR _ 4c.Temporary Services or Feeders
Installation,alteration,or relocation 2
Signature of Supr. Elec'n 200 amps or loss $5000 2
201 amps to 400 amps $75 00 -- 2
License No. 1(d Phone o.:'}— 2 -�' A=
401 empa l0 800 amps $10000
Over 600 amps to 1000 volts
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2b. For owner Installations: ase•b•above 4
4d.Branch Circuits
Print Owner's Name New,alteration or extension per panel l
Address a)The lee for branch circuits with
City State 7_ip purchase of service or feeder fee. 2
Each branch circuit $500
Phone No. b)the fee for branch circulus without
The installation is being made on property I own which is purchase of service or feeder fee. .e 2
ri sl bi-Anch circuit I $3500 2
not intended for sale, lease or rent. Fah atdil onal branch,clrruit �_ $500 x
Owner's Signature 4e. Miscellaneous fff
(Service or feeder not included) 2
13. Plan Peview section (if required): Each pump or Irngalion circle $4000 2 ;
Each sign or outline tighfimg $4000 1
Signal cirruil(s)or a limited energy 2 i
Please check appropriate item and enter fee in section 5B. panel,alteration or extension $4000
4 or more residentit,,i Anits in one structure Minor Labelr(lr) $10000
Service and feeder 225 amps or rr,ore
System over 600 volts nominal 41. Each additional inspection over
! Classified area or structure containing special occupancy the illowable in any of the above
as, criber+,i N.E C. Chapter 5 Per inspection $3500
hour �— $5500
Submit 2 sale of plans with application whore any of In Plant $5500
•h-above --
apply. Not required for temporary construction services. 5. Fees:
r,Cl
NOTICE Sa. Enter total of above fees $ t _)
5%Surcharge(05 X total lees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtorol $Sb. Enter 25%of line A for
AUTHORIZED IS NOT COMMENCED WITHIN b%DAIS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ +
COMMENCED ❑ Trust Account N $ I{
Bi lance Due
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