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10825 SW HALL WULEVARD
/ CITY OF T i GA R D _ ELECTRICAL PERM!T
DEVELOPMENT SERVICES ATE IS UIED: 3/8/00 00-00096
13125 SW Hall Blvd., Tigard, OR 972.23 (503) 639(��IGJAI�
PARCEL: 1S135AD-02100
SITE ADDRESS: 10825 SW HALL BLVD
SUBDIVISION: METZGER ACRE TRACTS ZONING: R-12
BLOCK: LOT : 002 JURISDICTION: TIG
Proiect Description: Installation of one branch circuit for a/c unit.
_ RESIDENTIAL UNIT _TEMP SRVC/FEEDERS_ _ 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/FEEDER _ _ BRANCH CIRCUITS
----- ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER 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 _ __ _
L
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:._�Reconnect or l :: __—SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: _
Owner: Contractor:
MICHAEL R. HAND OWNER
11654 SW PACIFIC HWY#2
TIGARD, OR 97223
Phone: Phone:
Req #:
`EES _ Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 3/8/00 $37.50 0000541 Elect'I Final
5i CT DEB 3/8/00 $3.00 0000541
Total $40.50
L_
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 i;>suanoe,or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted-by the Oregon Utilit•/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 ruestions to OUNC at(503)
246-1987.
PERMITTEE'S SIGNATURE
�lXit.rQ1 I,S U E D BY:
OWNER INSTALLATION ONLY
The installation is being 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: Y_
Call 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan eck# _
'13125 SW HALL BLVD. Rsc' By
y
TIGARD OR 97223 DateRec'd
Phone(503)639-4171, x304 Date to P.E.Date to OST
Inspection(503)639-4175 Print of Type Permit 0 CY2�GL2 1
Fax (503)598-196U Incomplete or illegible will not be accepted called
1. Job Address: l 4. Complete Fee Schedule Below:
Number of Ins per permit allowed
Name of Development _ _ Inspections r
Name(or name of business)_�? - Service included: Items Cost Sum
Address / J _ 4a. Residential-per unit
City/State/Zip7 4t n OR Q`7'J,yfi,3 1000 sq.ft or less s �,7 _ 4
- - Each additional 500 sq,ft.or
Commercial❑ Residerltial, Limited
thereof $ 2s I
mped Energy $ 80.0000
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 z
(Prior to permit Issuance,applicants must provide contractor license 4b.Services or Feeders
Information for COT data base). Installation,alteration,or relocation
Electrical Contractor _ _ 200 amps or less $ 64.25 z
Address 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City State Zip 801 amps to 1000 amps $ 192.50 2
Phone No. Over 1000 amps or volts _ $ 36375 2
Job No. Reconnect only _ _ $ 5350 _ 2
Elec. Cont. Lice. No. Exp.Date 4c,Temporary services or Feeders
OR State CCB Reg. No. Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less _ $ 53.50 _ z
201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n _ Over 600 amps to 1000 volts,
see"b"above.
License No Exp.Date 4d.Branch Circuits
Phone NO _ New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
cfeeder fee.
Print Owner's Name ICA., Each branch circuit $ 535
Address M S Y, ltd b)-.he fee for branch circuits
without purchase of service
City t 1 State O Zip 17 71 or feeder fee.
Phone No. -1 First branch circuit l $ 37.50 ;
Fach additional branch circuit $ 5.35 _
The installation is being made on property I own which is not 4e.Miscellaneous w
intended for sale, lease or re �"" '*'"I (service or feeder not included) ---
Each pump or irrigation circle $ 42 75
Owner's Signature t Each sign or outline ligh!ing $ 4275
Signal circuft(s)or a limited energy
panel,alteration or extension S 6000
3. Plan Review section (if required):* Minor Labels(10) $ --
Please check appropriate item and enter fee In section 5B. 4f.Each additional fnspoction over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Pei inspection $ 5000
— - Per hour � $ 5000
System over 600 volts nominal In Plant $ 5900
Classified area or structure containing special occupancy as
described in N.E C Chapter 5 5. Fees:
Be.Enter total of above lees $
« Submit 2 sets of plans with application where any of the above apply. Surcharge!.6661(total fees) $ ,
Not required for temporary construction services. Subtotal 4 $
5b Enter 25%of line Ba for
NOTICE Plan Review if required(Sec,3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ _
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust ACCOUnt#_
AT ANY T14E AFTER WORK IS COMMENCED Total balance Due $
I\dsts\Ibrms\clectrfc doc
CITY OF TIGARD ORIG
^MECHANICAL PERMIT
DEVELOPMENT SEERVICES PERMIT#: MEC2000-00072
11VA
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 4ATE ISSUED: 3/8/00
PARCEL: 1 S135AD-02100
SITE ADDRESS: 10825 SW HALL BLVD
SUBDIVISION: METZGER ACRE TRACTS ZONING: R-12
BLOCK: LOT: 002 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:
L PG _ T 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
ODS
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN --100K BTU: <= 10000 ctm:
GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas furnace, a/c unit and associated gas piping. Placement of a/c unit must comply with
standa v setbacks.
Owner: FEES
MICHAEL R. HAND Type By Date Amount Receipt
11654 SW PACIFIC HWY #2 PRMT DEB 3/8/00 $50.00 0000540
TIGARD, CR 97223 5PCT DEB 3/8/00 $4.00 0000540
Phone:639-9371 Total $54.00
Contractor:
ABLE HEATING + COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS _
Gas Line Insp
Phone:579-2250 Heating Unt Insp
Reg#:LIC 00108535 Cooling Unt Insp
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. 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 cppies of the�s/e�rules or direct questions to OUNC by calling (503)246-9189.oe
j
Isey: PErmittee Signature:
B ��_ 1 - Cep' g ' ,,
��...- nature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Plan C ck#
CITY OF TIGARD Mechanical Permit Application Recd _
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
Date to DST
(503) 639-4171, x304 } 9 17.E
Print or Type Permit#caned
Incomplete or illegible applications will not be accepted
Name of DevelopmenUProjed Description
Table 1A Mechanical Code QtY Price Amt
A Permit Fee 16'00
Street Address
Job a 1) Furnace to 100,000 BTU
Address 102Z15 5 w Qct) includingducts R vents see footnote 1,2 _ 9.65
Bidgll CRY/'late Zip 2) Furnace 100,000 BTU+
Q _ Q� including ducts&vents see footnote 1,2 12.00
-'- game(or name of usln as) 3) Floor Furnace
�j�"I includingvent see footnote 1,2 9.65
Owner /0 t" e1 ` ` ---- 4) Suspended heater,wall heater
Mailing Address �/ ,I or floor mounted heater see footnote 1,2 9.65
5 Vent not included in a Italica ermit 4.75
Cnv'State Zip Phone Check all that apply: 'Boller Heat Air
c • For Items 6-10,see or Pump Cond Qty Price Amt
X37.r3
37 footnotes 1,2 Com
Na a(or name of business) 6),3HP;absorb unit to
100K BTU 9.65
occupant Malting Address 7)3-15 HP;absorb unit 1765
look to 500k BTU _
CRY/state Zip Phone 8)15-30 HP;absorb
unit.5-1 mil BTU 24.15
9)30-50 HP;absorb
Contractor Names //� tr unit 1-1.75 mil BTU 36.00
/7 10)>50HP;absorb unit
Prior to permit Meiling Address
>1.75 mil BTU 60.15
issuance,#copy �;''r/ r' ! . 4f/j t� 11 Alr handling unit to 10,000 CFM 700
of all licenses CRY/Slade Zlp Phone _
1 t,� IP. ' '� 12)Air handling unit 10,000 CFM+
are re^aired if �� 17�it 11.75
expired in COT Oregon Const Cont Board Lk M Ex Date,
�' 7 r' 13)Non-portable evaporate cooler
_database � 7.00
Architect Name --
14)Vent fan connected to a single duct
4.75
or Malling Address 15)Ventilation system not included In
appliance permit 7.00
Engineer CRY/State ZIP Phone 16)Hood served by mechanical exhaust 7.00
17)Domestic incinerators 12.00
Describe work to be done: _
New Re air O Replace with like kind: Yes O No�l -
18)Commercial or Industrial type incinerator 40 25
Resld5ritia Commercial O 19)Repair units
8.40
AddRlonal infomtatlon or description of work: LGas
gas FP/other units/clothe dryer/etc.
7.00
NOTE: For Commercial projects only;Units over 400 Ibs require ne tofour outlets 3.75structural as talcs. e 1- er outlet(each) 75 .
Type of fuel: oil O natural gas LPG O electric O Minimum Permit Fee*00.00
SUBTOTALL_-
A SURCHARGE
1 hereby acknowledge that I have read this application,that the information pLAN REVIEW 25°�OF SUBTOTAL
given is correct,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance wnh Oregon State laws. Required for ALL commercial permft oniTOTA
1
Signature oAgent Date
„�}y/ (� _� hGH Other inspections and Fees:
1. Inspections outside of normal business hours(minlnum charge
•two
ontact Person Name Phone hours) $50.00 per hour
C
2. lnspections for which ro fee is specifically Indicated (minimum
A_ charge-half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical State Contractor Boiler Certification required
units. -Residential A/C requires site plan showing placement of unit
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP
Date Requested �� �1 AMPM --- IBLD
Location ri 9 Z' 5W !/ iz�k'2 ----- Suite _ _ MEC �G OG 7 Z
r _
Contact Person /yIl Ph y – 5 S J� PLM
Contractor Ph SWR
BUILDING Tenant/Owner —
Retaining Wall ELR -
Footing Access: FPS
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post&Beam
Ext Sheath/Shear -
Int Sheath/Shear
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - - --
Roof
Misc:
Final
PASS PART FAIL - --
PLUMBING _
Post&Beam -
Under Slab 6.-------------_._...
Top Out _._------- -�
Water Service
Sanitary Sewer
Rain Drains
Final
P
A;5-
RAAl3_7L,
)
FAIL
�
MECHeampers
fAAT FAII
,_
- -_ -
ELECTRIC(Jg
ough In
Low Voltage
Fire Alarm
PART FAIL
SITE
Backfill/Grading —
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ J Please call for reinspection RE: [ J Unable to inspect-no acces,
Fire Supply Line
ADA
Approach/Sidewalk Date nspector Ext _-
Other
Final
PASS PART FAIL IDNOT REMOVE this inspection record from the job site.
CIT`t OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -----�--�
BUP
Date Requested _ h� _AM PM BLD _�__-------_---_.��
Location C% Z ) �1- � � !�/ v a Suite MEC
Contact Person Ph � > >2PLM
Contractor Ph i SWR
BUILDING Tenant/Owner _ � � _
ELC W GU-
Retaining Wall EL.R
Footing Access: _
FPS
Foundation
Ftg Drain Ale
SGN
Crawl Drain Inspection Notes ( -- -"-- --
Siab _._ ------ - SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall Nailing - -- --- --- — --- - _
Firewall
Fire Sprinkler —_.- .... ------ - --- - - -
Fire Alarm
Susp'd Ceiling -- --- - - - --- - - - -
Roof
Misc: ___ -- --- -- -
Final
PASS FART FAIL - --
PLUMBING
[lost& Beam
Under Slab
T op Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL ---------------- --
MECHANIC:AL-- _
Post& Beane
Rough In
Gas Line ---------___.-----------------
Smoke Dampers
Final ____.._.--------
PASS FSA FAIL
, LECTRICAL
Rough In
UG/Slab —
Low Voltage
Fire Alarm ----
S PART FAIL
SITE.
Backfill/Gradwg -------
Sanitary Sewe:
Storm Drain [ ]Reinspection fee of ro requir art before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RF -_ _�— [ ]Unable to inspect-no access
Fire Supply line
ADA �;� '�.�
Approach?Sidewalk Date __Ll1
Other nn Inspector � �"�_�_ -_Ext
_•_ ----- _
Final
PASS PART FAIL DO Idol REMOVE this inspection record from the job site.