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13649 SW HILLSHIRE DRIVE
w 0 H r r H L•] U { 1 1364Y SW HILLSHIRE DR C11Y ®FGIRD TEMPORARY CERT IFI CATE." COMMONITY DEVELOPMENT DEPARTMENT OP OCCUPANCY 13125 SW Hall Blvd.Tigard,Oregon 97223@8129 (503)830-4171 PERM IT #. . . . . . . . MST94 r1n:'tr, 113 DATE ISSUED: I " C, ,C, PARCE=L.. : r?'3 1 04CA).. 00900 I T I ADDRESS. . . : 1.3649 SW 1-411.1-GHIRE DR 'Jor) 'rt I SKIN. . .. . : H I LLSIA I RE ESTATES 70NING- R7 PD . . . . . . . . . . : LOT. . . . . . I . . . . . . 001) A G''�') OF WORK. cNEW ,PL OF" USE. . . -CIF, ik,'CUPANCY GRP. CR3 OCCUPANCY LDAD tiii7 4 i`f_-'.'NAN T NAME. . . z Idemarkst 'TEMPORARY OCCUPANCY VOR qo 14-lyf; f MIN DA (F 01 .1�-.)CjUANUJ_ 14AW DEVELOPMENT CO 14780 SW OSPREY DR 4L-,gorr Ij BEAvEp-rON OR 97007 I.-Iharip 44; 503-271) -`3001 ;AAW DEVFILOPMENT' CO 4760 SW 05PREY DR 1111`117 2925 4.'AVt.RTON CIR 97007 :)une #. 379-5001 ,pq #_- 47396 11c.-cf-IFiancy of the above refe)-c-riced buildinq is hereby given, an-1 certifies the cnmplianue with the State Of Oi-egan Speci.alty Codeq for the grul.fp, t)cr_t_tpAn ,y, 6:11-1d USP Under, which the r-eferersred permit wKs Jss�kiprj. 11 G I 11TETTA 10rt I I C I i- t_ P017,'r IN CONSPICUOUS PLACE INSPECTION NOTICE \� City of Tigard Building Departaent 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-0-Phone): 639-4175 Business Phone: 639-4171 Inspection:--------- - ----- -- -- Rooting Plbg. Underslab Mech. Rough-in Ar.pr/Sdwlk Pound. P3g. Top Out Gas Line AL i' Post/Beam St.ruct. San. Sewer Framing Mg. Post/Beam Mech. Rain Drain insulation -Plumb. i Plbg. Underfloor Nater Llne G Bd. (�M� Date Requested:_ �I�,�_ _ _Time: AN PN Address•—_ � �rl��I•�+al'..C�V'��1.J1Y_-,D)C Pe1'Oi.t ti��. � 1 THE FULLONING ODRRECTIONS ARE REQUIRECs /0�) Inspector y �J Date[ /"\APPROV1tD _ DISAPPROVED APPROVED SU&lZ T TO ABOVE —Call For Reinsp- CITY OF TIGARD Mf4bTER PERMIT COMMUNIT( DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MG T 9 4 9171411 13125 SW Hall Blvd.Tigard,Oregon 97223.8190 -(tM)8'34-4171 DATE ISSUED: 04/11/94 PARCEL: 2Sl04CD--009021 GTTE ADDRES[� . . . J.".3649 SW HILLSHIRE DR SUBDIVISION. . . . : HILLSHIRE ESTATES ZONING: R-7 r--'D BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..009 BUILDING ---•----------•- _.___._____.______._-_.__._ REISSUE: -------------- REISSUE: DWELLING UNITG: I BASEMENT. . . . . . . . :0 sf CL"SS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . :824 sf TYPE OF USE. . . :SF FLOOR AREAS------------ REQUIRED SETBACKS_.-_.-.- __-._-.- TYPE OF CONST. :5N FIRST. . . . . '2:'492 sf LEFT. . :8 ft RIGHT. : 10 ft OCCUPANCY GRP. :R SECOND. . . :0 sf FRONT. :20 ft REAR. . : tC, f t, STORIES. . . . . . . : 1 Tvi I RD. . . . :0 s f REQU I RED HEIGHT.. . . . . . . . ..27 ft TOTAL-------- - - --:549 2' sf SMOKE DETECTORS. :Y FLOOR LOAD. . . . ".40 psf VALUE. . . . . 4 : 129464 PARKING SPACES. . : 1 I-44TH I PLUMBING S I N K93. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFI-'JW PREVNTRS. . :0 I-AVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TU11/st-inWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH RASING. . . . . . . :0 WATER CLOSETS. . .-3 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . till DISHWASHERS. . . . : 1 WATER LINE (ft) . i IOLA OTHER FIXTURES. . . . . ..0 UPREIAGE DISP. . . : 1 RAIN DRAIN (ft ) . sO WASI 41 NG MACH. . . : I SF RAIN DRAINS. . 11 MECHANICAL FEES FUEL TYPEE33-- UNIT HTRS. . -0 type amount by date V-ecpt /GAS/ VENTS . . . . . :0 TIF $ 1520. 121121 SW 04/11/94 MAX I NPUI :CA STU VEN 1* FPNS). . :4 B P RT $ 308. 0121 SW 04/I 1/94 r:URN ( 100K . . -,0 HOODS. . . . . . : 1 9PLC t 330. 20 JLH 02/03/94 94 --248461 FURN ) =100K . . : I WOODSTOVES. :0 B5PC $ 2.5, 40 SW 04/11/94 -- FLOOR TURN. . . . :0 CLO DRYERS. : 1 1—ISDC $ 280. 00 SW 04/11/94 BOIL/CMP � 3HP:0 OTHER UNITS: 1 PARK $ 500. 00 SW 04/11/94 GAS OUTL.FTS: 1 MPRT $ 45. 00 SW 04/11/94 ownet. $ 11. 55 SW 04/11/94 SHAW DEVELOPMENT CO MEPC $ 2. 25 SW 04/11 /94 14730 SW OSPREY DP PPRI $ 155. 00 SW 04/ 11/94 #2114 5 P'5PC $ 7. 75 SW 04/11/94 BEAVERTON OR 9*7007 Phone #: 503-279-5001 Contractor-: SHAW DEVELOPMENT C.3 14780 51-1 1'19PREY DP SUITE 295 sr--,nVERION OR 97007 Phone #: 579-15001 Reg #. . .- 4*7398 $ 3384. 85 TOTAL This pewit is issued :ubject to the regulations contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Grp. Specialty Codes and all other f=oot/found Insp Fireplace Insp applicable laws. All aorto will be done in accordance with approved Post/Beam Strutt Gas Line Insp plans, TriS OprgIt Will expire if worl, is not started within 180 Post/Beam Meehan Insk.ilat ion ln�,l, days of issuance, nr if work is suspend fir are t_An 188 d YPlm/t-tndslab Insp Gyp Board Insp 14 '-SF1LM/Underf1oo - Rain drain lns p Ppr,mittee SiqnatLt e : Mechanical ITISP Water Line Insp -tmb Top Clot Appr,/Sdwli( Insp lssi..ted Bv - Framing Insp Mechanical Final Call fo,,-, inspection — 639-4175 CITY OF TIGARD SEWER PERMIT TICJt\I F'E C=.M I T COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : SWR94-0057 13125 SW Hall Blvd.Tigard,Oregon 97223.8100 543)1(1)l il7ll DATE ISSUED: 04/11/94 PARCEL : 2S104CD-00900 SITE ADDRESS. . . : 13649 SW H l L.LSH I RL_ DR SUBDIVISION. . . . : H I LLSH I RE ESTATES ZONING: R--7 PD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :009 TENANT NAME. . . . . : USANO. . . . . . . . . . . FIXTURE UNITS. . . . CLOSS OF WORT:. . . :NEW DWELL I NG UN ITS. . : 1 TYPE OF USE. . . . . :SF NO. OF BU I LD I NGS: 1 INSTALL TYPE. . . . :BL.JSWR IMPERV SURFACE. . : i Remarks : PATH I Owner: ---._._.____.__ __.------- ______________.____.._._____._._._.-___-. FEES SHAW DEVEL_OPME:N'r CO type amol_rnt by date r•ecpt 14180 SW OSPREY DR PRMT $ 2200. 7.10 SW 04/11/94 #295 I NSP $ 35. 00 SW 04/11 /9A - BEAVERTON OR 9;1007 I='hone #: i0?,-c7�1-5001 Cont rac t or C(?NTRAr,TOR NOT ON FILE f-hone #r t 2235. 00 TOTAL REQUIRED I NSPELT I ONS _ This Applicant agrees to comply with all the rules and regulations Sewev- Inspection of the Unified Sewage Agency. The permit expires 188 days, frau __•_ _��_� ___ _ ___ the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the �__` —•� _ _ side sewer laterals. If the sewer is not located at the measurement given, the installer- shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a 'Tap and Side Seger" Permit and the cy will 5t I at, I er-m ! L t e e SiynatutI e : I e.r. 1_red BV : Ca11 for, inspection - 639-4175 Pesidential Building Permt AWlication City of T�garci 13125 8N Hall Blvd. Tigard, OR 97223 (503) 639-4171 fb) Jobsite Address: Subdivision: Lot # •� r � Office Use Only t / � valuation. Plandc/Rec;# _1 _ Permit Owner: Reissue of Address C-7)SI-er'f r-, 0V iq-z!=�S Map & TL # C7,�� t - Approvals Required Phone: �=1_. Planning Contractor: Engineering Address: �7 r v ��w �`C_ e��- Other �...� items Required Phone: �'( S 22- - Cubcontractors } Contractor's License #_ ��(� _ (attach cop, of current Oregon license) Truss Details Subcontractors. Other Plurnbing ._. _v�d� � ✓)�"��LrJ -- M, chanical: (attach copy of current OR Cobtractors License) hitect/E n�ln�r:_ " �1 Ck D Address: C/�-�o C _L" _ rLA. p h Phone: C(' _NTS: ( •tib 1 -�(_J t'�•wr - � ----- App icani Signature & Phone number Received by: `Y _ Date Received. 7� Perm(t # Account Description Amount Amt. Pd. Bal. Due' �5s'fr/ O ttl Bldg. Permit (BUILD) .:0�• v✓ / SOc�', �u Plumb. Permit (PLUMB) ev Mech. Permit (M--CH) S`d State Tax (TAX) U / S. qo Bldg: ;o, .q P:Ljmb: J. 7S Mech: / Plan Gheck (PLANCK) 3�� U Bldg: Plumb: Mech: 5wt1�/ �� . % Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Sov i Storm Drainage Chg (SDSDC) 1 Residential TIF (TIF-P,) 4/o / /��/U Mass Transit TIF (TIF-MT) / / 0 Commercial TIF (TIF-C) Industrial TIF (TIF-1) _ Institut. ial TIF (TIF IS) _ OfN.e TIF (TIF-0) _ Water(duality (WOUAL) WaOr Quantity (WOUANT) _ Fire District (FIRE) TOTALS: s(! I�. C5 L' i _jlo CITY OF TIGARD PLUMBING PERMIT PERMIT #. . . . . . . : MST94--904t-� COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/11/94 13125 SW Hail Blvd.Tigard,Oregon P7223.8199 (503)839-4171 PARCEL: �'S104CD--•0070111 511L ?)lJRLbS. . . : 13649 SW HiLLSH1RL DR SUBDIVISION. . . . : HILLSHIRE ESTATES ZONINC• R--7 Fill BLOCK,. . . . . . . . . . : LOT. . . . . . . . . . . . . :009 CLASS OF WORK. . :NEW GARAAGE DISPOSALS. . : 1 TYPE OF USE. . . . :SF tiASHINS MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . :0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . .. 1 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0 FIXTURES------------------ LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1 SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0 LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0 TUB/SHOWERS. . . . : SEWER LINE (ft,) . . . . :0 WATER CLOSETS. . o 3 WATER LINE (ft.) . . . . : 100 DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0 Remarks : PATH I OWNER: ------------___-_._._._-___.____-- __---.________-._____FEE5----------_-- -_ SHAW DEVELOPMENT CO TIF t 1520. 00 SW 04/11/94 - 14180 SW OSPREY DR BPRT f 508. 00 SW 04/11/94 - #295 L-PLL $ 3,30. cILI JLH 0c:/03/9 4 94-2484b.l BEAVERTON OR 97007 B5PC f 25. 40 SW 04/11/94 - Phone #: 503-279-5001 SSDC 4 =80. 00 SW 04/11/94 - PARK 4i 500. 00 SW 04/11/94 - Plumb) Mj Contr - tor: _._.___..._._.. ------ MPRT $ 45. 00 SW 04/11/94 - MPLC 4 11. 2 ; SW 04/11/94 - Namebtt* M5PC f 2. 2.5 SW 04/11/94 - . _ Prid ress : -- PPR1 $ 155. 00 SW 0.4/11/94 C i t y : -- _ State : _-. D5PC $ 7. 75 SW 04/11 /94 - zip: Phone#a Reg #1 ------- REQUIRED INSPECTIONS -This permit is issued subject to the reg- ulations contained in the Tigard Municipal Fout/found :Insp Rain drain ln�.p Cade, State of Gr1 • Specialty Codes and all Post/Beam Struc` Water Line Insp f,f"-dr applicable laws. All work will be done f=rost/Beam Mechan Appr/Sdwlk Insp in iaccordance with approved plans. This Pim/undslab Insp Mechanical Final permit will expire if work is not started PL.M/Underfloor Plumb Final wi.tliiii 180 days of issuance, or if work is Mechanical Insp Building Final suspended for more than 180 clays. Plumb Top Out Erosion Control Framing Insp Crawl Drain Fireplace Insp Gas Line Insp -- Insulation Insp Gyp Board Insp __ - - ------- A�_lthorized Plumbing Contractor Signature Call for inspection 6:39-4175 Contractor Notes : » Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # Phone (503) 639 4171 Date Issued FAX (503) 684-7297 Issued by c� CITY OF TIGARD TDD No. (503) 684-2772 Inspection (503) 639-4175 I 1. Job Address: 4. Complete Fee Schedule 6'e/ow: l Name of Developm,.ot_ _\� Y� Number of Inspections per permit allowed — AddressTl y3 rvlca it,IudPd: Items Cost(ea) Sum 1 C�(�e51_ � v 4a. Residential- per unit 4 City/State/Zip r, l000 n or Isco �_ $110 �n t`',CSC` Name (or name of business Each thereof Each additional f rn n of r portion herool E?5 00 (�(,)-Untri Commercial❑ Residentialw Each $25 00 Energy — T1 Cil Each Manul'd Home or Modular Dwelling Sennrx or Feeder SM 00 2d. Contractor installation only: 4b.Services or Feeders installation,alteration,or relocation a � •� �;- 1 amps or lees $�00 1 Electrical Contractor c F 1 _ Address ' — " \ ME t 201 amps to 400 amps &0 00 401 amps to 800 amps S12000 2 City (?,P_tf aj E'.��U n Stated Zip 601 amps to 1000 amps $18000 = 2 Phorie No. l`N 1 inL HR, Over 1000 amps or volts $740 00 _ 2 Contractor's License No. '4 L� - Pleconrectonly E5000 Contractor's Board Reg. No. 4c.Temporary Services or Feeders ' Irutallebon.alteration,or relocation Signature of Supr. Elec'n 200 gmps or Ins $5000 r 201 amps to 400 amps $75 00 Li^ense No. 3 R70 IS— Phone No. 4 1 401 amps to 600 rips $10000 Over 800 amps to 1000 eons 2b. For owner installations: Rep's;above 4d. Branch Circuits Print Owners Name New,alteration or extension per panel Address a)The lee for branch circuits with City State Zip parchaN of service or hldor he. Each branch circuit $500 Phone No. h)the'as for branch arcuds without The installation is being made on property I own which is purchase of servlcs or Feeder W. First branch circum E not intended for sale, lease or rent. Each aidd $500 innal branch circuit E5 00 Owner's Signature4e. Miscellaneous (Service of feeder not included) J. Plan Review section (if f equired): Each pump or irrigation circle $4000 _ Each sign or ouliine lighting $40 00 Signal circuit(s)or it limned energy ? Please check appropriate Item and enter fee in section 5B. panel alteration or extension $400() 4 or more rosldenhal units in one structure Minor Labels(10) $10000 — Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the ;.bove as described in N E.C. Chapter 5 Per hour Per hourinspon $O5 00 -�� $51100 In Plant E55 00 — Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: NOTICE 5a. Enter total of above fees $ 5%Surchar,jP(05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORI7ED IS NOT COMMENCED WITHIN 130 LAYS,OR IF Sb. Enter 250/.of line A for CONSTRUCTION OR WORK IS SUSPENDED OR i rBANDONED F OR Plan Review if requirec (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTL, WORK IS Subtotal $ COMMENCED ❑ Trust Accountill $ Balance Dai@ l $ i AL PERMT Q'TY of TIGARD PERMIRI#: ELC96I0363 COMMUNITY DEVELOPMENT DEPARTMENT DA-i E ISSUED: 06/11/96 1?125 SW Hall Blvd.Tigard,Oreg, -, 07223.8190 (503)830-4171 PARCEL: 2S 104CD-00900 ^ITE AUDRE6':'). . . : 1,3649 SW HILLSHIRL JI SUBDIVISION. . . . : HILLSHIRE ESTATES ZONING:R-7 PD BLOCK. . . . . . . . . . . LOT— . . . . . . . . . . . :009 Project Descriptions Installing one branch circum. ---RESIDEIJTIAL UNIT---- ---TEMPI SRVC/FEEDERS---- -----MISCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADOI L 500SF. . . s 0 201 - 400 amp. . . . . . ., s 0 SIGN/OU? LINE LT[ . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 7IGNAL;PANEL. . . . . . . : 0 MANE. HM/ SVC/FDR. . . 0 601+amps-1000 volts. s 0 MINOR LABEL (10) . . . : 0 -_--SERVICE/FEEDF_R---_ ---_-.-BRANCH CIRCUITS---- - ---ADD' L INSPECTIONS— ..0 - 2@0 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 I-,ER INSF'E:C'TION. . . . . e 0 201 4010 amp. . . . . . : 0 1st W/O 5RVC OR FDR. : 1 PER HOUR. . . . . . . . . . . e 0 401 - 600 amp. . . . . . : 01 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . s 0 6,211. - 1.000 amp. . . . . : 0 ----_------ -- - PLAN REVIEW SECT ION---____-__---_ 1000+ amp/volt. . . . . : 0 !=4 HES UNITS. . . . . . . . : ) 600 VOLT NOMINAL . , a Reconnect )nly. . . . . : 0 SVC/PDR ) = 225 AMPS. . : CLASS AREA/SPEC n(:',.-. : Owners ------------------------------------------------------ FEES RON NEWBERRY type amount by slate recpt 13649 SW HILL.SHIRE DR F'RMT $ 35. 00 CJS 06/11/96 96-280443 5F'C1 $ 1. 75 CJS 06/11/96 96-280443 I IGARD OR 97223 Phone #: Contractors -____-____._---__.--_--____,.._______________._--____-----____________ PHOENIX ELECTRIC CO 36. 75 TOT14L F'O BOX 1436' - ----_- REQUIRED INSPECTIONS -_._._._._.._. 1UALATIN OR 97062 Wall Cover Elect' 1 Final Phone #: 503-69 -5882 Elect' 1 Service Reg #. . : 52288 lhis pewit is issued subject 10 the regulations contained in the _ Tigard Municipal Code, Stat,! of Ore. Specialty Codes and all other Permittee Signature applicable laws. AP work will be done in accordance with approved plans. This permit will expire if work is not started wit' in 188 days of issuance, or i' s suspended for sore CJ2a,rJ'e4 [�.,•�_�_� _ .............. than 188 days. IsSLled By .__._OWNER INSTALLATION ONLY--------------__.___._______---__ the installation is being made on property I own which is not intended for sale, lease, or rent. OWNER' S SI ONO TORE: __ _ _._-- DATE e INSTALLATION S I[3NAT UHE OF SL FSR. ELEC' 14: _.Qa��[��re cl DATE: LICENSE NO: Cull for inspection - 639-4175 Cc,mmunity Development ELECTRICAL PERMIT APPLICATION 13125 S\N Hall Blvd. Tigard, OR 97223 Permit # FLC 4f; D 3e, — Date ISSUed c-- I Phone (503) 639-4171 FAX (503) 684-7297 CITY OF TIGARD TDD No (503) 684-2772 Inspection (503) 639-4175 r 1. Job Address: 4. Complete Fee Schedule Below: Name of Development_ ___ Number of Inspections per permit allowed Address Service included Items (ost(ea) Sum - � City/State/Zip -- .— 4a. Residential -per unit T— 1000 sq. ft. or Icss 31 to no A Nameor name of business Each additional 500 sq ft or Name (or �� portion theroof $25 00 _ T Commercial U Residential ❑ Limited Energy _- $2500 Each Manurd Hcme or Mot"ilar Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Ser,ices or Feeders Installation,alteration,or relocatlor Electrical Contractor 200 amps or less $6000 Address p r 201 amps to 400 amps $80 00 � ""— 401 amps to R00 amps $120.00 Cityt State/.--- Zin - �a�3 — — II 801 amps to 1 000 amps $16000 Phone No._ �_ / Over 11X10 amps or volts $34000 _ Reconnect only $5000 Job NO — contractor's license NO. _ I - 4c. Temporary Services or Feeders Contractor's Board Reg. Nc. _ installation,alteration,or relocation Signature of Supr. Elec'n, '� __ 200 amps or leas -- ---- 201 amps to 400 snipe $5000 License No. 411416] hone No. S&L)b 401 amps to 600 amps $7500 —Over 600 amps to 1000 volts $10000 — -- 2b. For owner installations: see"b"above 4d. Branch Circuits Print Owner's Name _ New,alteration or e.tenslon per pane Addressa)The fee for branch circuits with -- purchase or service or reader fee. City_ State Zip Each branch circuli $500 Phone No. b)The fee for branch circuits without The installation is being made on property I own which is purchase or service or feeder No ��• First branch circuit J— $3500 3 5 not intended for sale, lease or rent. Each additional branch circuit $500 Owner's Signature __ __ 4e Miscellaneous (Service or feeder not included) 3. Plan Review section (if required): Each pump or line lig tingcIrc _. $40 00 Poch elfin or ou line lighting $40 00 7 dgnsl circu8(,;ur a limited energy Please check appropriate Item and enter far in section 5B panel,alteration or extension $4000 _ S or more residential units l one structwe Minor Labels(10) $10000 _Service and feeder 225 amps or more 4f. Each additional inspection over System over 600 volts nominal Classified area or structure containing special occupancy the allowable in any of the above _-..--.._ i'p,uispedion $3500 as described in N E C. Chapter 5 -— $5500 — r tall► $5,900 Submit 2 sets of plans with application where any of the above apply. Not required for tempor:nry construction services. 5. Fees: NOTICE 5a. 5a. Enter total of above fees $ 5% Surcharge ( 5 X total fees) $l $ - PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal Sb. Enter to% of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec 3) $ _ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. * �1 Trust Account # 4 Balance Due 1='ERMll --� �:ITY OF TIGARD DATEIISSUED:. 06/20/966-0190 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hell Blvd.Tigard.Oregon 07223.8190 (503)838.4171 PARCEL-. . S 104CD-00900 SITE ADDRESS. . . : 13643 SW Hl.t-1-SH114' FGR SUBDIVISION. . . . : HILt_SHIRE ESTATES ZONING: R-7 P1' BL—QCK. . . . . . . . . . . LOT. . . . . . . . . . . .. . ..009 CLASS OF WORK. . :ADD FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRI='. . :R3 VENTS W/O APPI_: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPEL; - -- --_.___.._.__.. 0-3 HP. . . . : 1 DOMES. INCIN: 0 : /GAS/ / / 3-15 HP. . . . : 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 GRS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . . 0 NO. OF UNITS------------- AIR HANDLING UNITS OTHER UNITS. : 0 FURN ( 100K RTU: 0 10000 cfm : 0 GAS OUTLE-f S. : 0 FURN ) --•100K BTUs 0 ? 10000 cfm: 0 Remarks : Installing one gas comp. to 3Hp. Owner. -__._-______.__.___.___..._.__ _..__.._____.______----__._.______-- FEES -----------_-__ RON NEWBERRY type amorint by date recpt 1:3649 AW HILL.SHIRE. DR PRMT t 25. 00 CJS 06/c0/96 96-280808 5PCT f 1. 25 CJS 06/20/96 96-260801-{ TIGARD OR 97223 Phone #: 503-226-4650 t:ontractor: BELL HEATING 15550 SE. PLAZZA AVE CLACKAMAS OR 97015 _-----____.__---_.-.- Phone #: 503-656-1184 t 26. 25 TOTAL Reg #. . : 000447 - --- REQUIRED INSPECTIONS - This permit is issued subject to the regulations containe0 in the Gas Line Insp Tigard Municipal Lode, State of Ore. Specialty Codes and all other M er:h a n i c a l Ins p applicable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if werk is not started within 188 days of issuance, or if work is suspended for more than 180 days. Permittee Signature: Issi.ted By : Call for inspection - 639-4175 C' / of Tigard MECH/kNICAL PERMIT PlanclJRec. # V! 3;; SW Bali Blvd. APPLICATION Permit At W C�yG Cy90 Tigard, OR 97223 (503) 639-4171 — `av- — — escnPtion Table 3A Mechanical Code QTY PRICE AMT J(•b ! I(A x1l ce OIL 1) Pennit Fee -0- -0- 10.00 Address 2) Supplemental Permit 3.00 urnace to TDIT70TBTS 1) incl.ducts d vents 6.00 «. F umace 100,000 b I IJ+ I y� �� ll(S,y!/Zf' rYi 2) incl. ducts&vents 7.50 Ownaf ar Fumance 1-k,h N+ Cj--^--- 3) incl.vent 6.00 .. .,�. S Suspended heatw,wall boater 4) or floor mounted heater 6.00 Vent not iFO, in Occupant 5) appliance permit 300 _ ap ----Repair of heat ng,re ng. j6) cooling,Absorption unit 6.00 — Honer ur comp, ai pump,a. cur, 7) to 3 HP;absorp unit to 100K BTUL� 6.00 er or comp,heat pump,air cond. S 4 r/A?'A 6 S ULc/ B) 3-15 HP;absorp unit to 500K BTU 1100 - Contractor Boiler or comp,heat pump,air condl. (` ,t c _u� 9) 15.30 HP;absorp unit .5-1 mil BTU 15.00 r Boiler or comp,heat pump,air cond. 10) 30.50 FiP;absorp unit 1-1.75 mil BTU 2250 erey ac iow ge ahave yea is app iEa- on, a tho Boller or eomp,hiepump,air cond, information given is correct,that I am the owner or authorized anent 11) >50 HP;absorp unit 1.75 mil BTU 37.50 of the owner,that plans submitted are in compliance with States a an ing unit to la•Ns,that I am registered with the Construction Contracto's Board, 12) 10,000 CFM 4.50 that the number given is correct. (If exempt from State registration, itan ing unT— please give reason below.) 13) 10,000 CTM+ _ 7.50 --' on portal5fe- 14) evaporate cooler 4.50 +—V-enTTan con— nec-W �-- 15) to a single duct 300 - Ventilation system not 16) included in appliance pennit 450 17) merhanical exhaust450 --- escriewor new U 3ailion(.j- ra on repair ommercial or in ustnaT to be done residential(;' non-residential O I 18) type incinerator 30.00 -_ xis ng use oT'— - ier i.e.,woodstove,wa building or property �t —_ 19) heater,solar,do�has dryers,etc. _— 4.50 Proposed use of 20) Gas piping one to four Outlets — 2.00 budding or property 21) More than 4-per outlet _ Type of fuel oil O natural gas Q l PG O electric O - -- — — ------- I Minimum Fee$25.00 SUBTOTAL r0` PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR &%'SURCHARGE IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIMEPLANREK�EW 2596 bF SU810TAL AFTER WORK IS COMMENCED. ---- TOTAL Special Conditions 1C Date issued = --by yuEc�Pui �eUa�• v D o D D 2 cti c � D F N y o W n cua o n � o m C?) r to v) D D m m b fl1 0 to w O d W W � O A� C V Wd � m rn rn C o a z 0 �o N m m m m m $ $ $ $ w Ul § \ \S \$ / \ - § \ k k @ E G / / w a 2 21 S m 9 K [ T ± m « CD % / ( 7 E I 21 0 w \ CD \ 0 0 \ s # ( ( ( # � E @ > R ~ g n % k < � $ a Q / ■ n LA. 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