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' a CITY OF TIGARD BUILDING INSPECTION NOTICE 's
Inspection Line: 639-4175 Business Phone:639-4171
nw°) S'v"i; (t mgrp "�
I r j { Footing Rain Drain Cover/Service FI ,
Foundation Water Line Ceiling Plumb. y,k, } ��,4 ,
s, Post/Beam Mach. Shear/Sheath Framing -Mach. ).
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1(° Plbg.Und/Flr/Slab Plbg. Top Out Insulation ct,`a
>" � ,0ars,
'xf Post/Beam S'ruct. Mach. Rough-in Gyp. Bd. -Bldg, }�
San. Sewer Gas Line Appr/Sdwlk Reins.,'"`;M
Other
Dme: AM P.M, Entry,
1 -1 Address:
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Tenant: St ._ — MST:
7 BLIP: N,
+� Con/Own: LGl� MEC: fir''°�"si+"t
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PLMWX:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: �+'�
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APPROVED DISAPPROVED/CALL FOR REINSP. CF CO '4f°+,,
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CITY OF TIGC,RD BUILDING INSPECTION NOTICE 417
Inspection Line (Rec-O-Phone): 639-4175 Business Phone. 639-4171 C`
Inspection:
i Footng Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struci. Plbg. Top Out Elec. Rough-in FINAL: l
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbq. Underfloor Rain Drain Framing -Plumb
Alarm Water Line Insulation. "
Underflr. Insul. Shear W II Gyp. Bd. -Elect.
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Date Requested: �� Tim e:— Phi r
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Address. �C�__-_--�—�^�'/� �
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Builder.—�.�_L_ r ��=_I Permit #: r � C� 3 � '
TI4E FOL LGVVING CORRECTIONS ARE REQUIRED:
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Inspector._
APPROVED DISAPPROVEDpPROVED SUBJECT TO ABOVE_
Call For Re:nsp.
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MECHANICAL
PERCITY OF TIGARD PERMIT #. . .. . . : MEC9503 1
j COMMUNITY DEVELOPMENT DEPARTMENT DATE. I SUED: 10/_10/95
13126 SW Hall Blvd.Tiputi,Grspan 97223.6190 (503)639-4171
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PARCEL: 2S 1 10DD--08500
SITE ADDRFSa. . . : 15790 SW HIGHLAND CT
SUBDIVISION. . . . : SUMMERFIELD NO. 6 'LINING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .301
CLASS OF WORK. . ALT FLOOR TURN. . . . : EVAP C.,^OOLE=R S:
TYPE OF USE. . . . :SF UNIT HEOTERS. . . VENT FANG. . . e
OCCUPANCY GRP. . -R3 VENTS W/O ADPL: VENT SYSTEMS:
STORIES. . . . . . . . : BOILERS/COMPRESSORS HOODS. . . . . . . : 4
FUEL TYPES---___.__._.....___.- 0- HI. . . . DOME 5. I NC I N:
: /GAS/ / / 3-15 HP. . . . C;OMML. INC:IN:
MAX BTU 15-70 I-JF,. . . . REPAIR UNITS:
FERE DAMPERS?. . : 30-50 HP. . . WOOD STOVES. . :
ELAS PRESSURE. 50•+- HP. . . . : CLO DRYERS_ :
NO. OF UNITS- ____._._.__. AIF' HANDLING UNITE) OTHER UNITS. :
F'.'RN i 1 k�OK BTU: 1 10000 (.f m . GAS OUTLETS. :
F JRN ) =100K ETU: > 10000 r_f m:
flt�m�rF<� : Install my fl_n^pace to 100, 0(7'0 11TU
FEES
BUD LIEFIELD tVr) Wm01_(nt by (date r^ecpt
15790 SW HIGHLAND CT PRMT $ 25. 00 A 10/26/95 9.5--27e:.169 �
;:PCT• $ 1. .25 D 10/26/95 95---2•721.69
TIGARD OR 97i=:r_"4
Phone #:
Corrtr"actor,•
R--•:)CCURA-Ts OIl- CO
6�732 NE 47TH
"ORTL_AND OR 97218
$ 26 5 Tam-
it'. . %
O'TAI_it. . . 53391
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REQUIRED INSPECTIONS
This permit is issued subject to the regulations contaired in ter Mechanir_al Insp
Tigard Municipal Code, State of lyre. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance wish
approved plans. This permit will expi°e if work is not started
r,ithi 180 days of issuance, or if work is suspended for more
than 190 days.
P a r-m i t t e e S i g ri a t+r-e :
i 7 c; -(ed By
Call for i n,pect i on — 639---4175
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City of Tigard MECHANICAL PERM!T Planck/Rec.' # _
13125 SW x'211 Blvd. APPLICATIC Permit # :6!T--C
PCS Box _
Tigard, Oh b i 223
(503) 639-4171 _
DQscripbon
Table 3A Mechanical Code QTY PRICE AMT
Job f `w���(_1 s"�J "i l F; - iJ � j 1) Permit Fee -0- -0- 10.00
A
Cf 7J a� 2) Supplemental Permit 3.00 �
.T..�•• "—I Furnace to 100,000 BTU �{+
tLA ;.� f_tC _ L T. 1) ind,ducts b vents 6.00
wa«+ umace Ioo,000 +
Owner2) Ind.duds&vents 7.50
... Floor Furnance
3) Ind.vent 6.00
�» Suspended heater,walk►eater
4) or floor mounted heater 6.00
Vent not ind.to
Occupant 5) apprianca permit 3..00
.rRepair of hoating,re ng.
6) cooling,absorption unit 6.00
_ Boder or mnp to 3 HP
7) absorp.unit to 100,000 BTU 6.00
ku" w "or or comp to 3 HP- 16 HP
�� 8) absW.unit to 500,000 BTU 11.00
Contradof
eY or comp to 15 30 14V
-
_ r /vii ] i 9) absorp unit.5- 1 -nillion BTU 15.00'
w r....No r,.r( er or Comp to 30•50
•3c7� 10) absorp.unit 1 - 1.75 million BTI; 22..50
hereby aeftlowledge that I have read t}iis Appheation that OW Bodw or comp to 50 HP
information given is correct,that I am the owner or authorized agent 11) absorp.unit 1,750,000 BTU 31.50
of the owner,that plans submitted are in compliance with State 1 � Air handing unit to
laws,that I am registered with the State Builders' Board,that tie 12) 10,000 CFM 4.50
nUmbor given is correct. (If exempt from State registration, please Air handling unit —
give reason below.) 13) 10,000 CTM 7.50
Non portabFG
14) evaporate coolor 4.50
ent fan con
15) to a single dud 3.00
Ventilation system not
16) included in appliance permit 4.50
_ 17) mechanical exhaust 4.50
sen new 0 addition() a�bon 5_,epau be type
to be done residenfial)o non-residential Q 18) inc�mrator 7.50
Existing use of Commercial or to st•
b0t,ling or proporty_ , 19; typ9 incinerator 30.00
er i.e..woodstove,water
Pr,
use of 9)) heater,solclothes dryers,etc. 4.50
building
Type of fuel-oil() natural gas)6 LPG Q electric 21) Gas piping one to four outlets 2.00
�_— 22) More than 4-per outlet
O CE � ,•
Minimum Fee' SUBTOTAL
f'Epmm BECOME NULL AND VOID IF WORK OR
CONSTRUCTION AUTHORIZED IS NOT COMMENCED 5%SURCHARGE
WRHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 PLAN REVIEW 25%OF SUBTOTAL
DAYS AT ANY TIME AFTER WORK IS COMMENCED.
TOTAL
qpocial Condions l—
D?re issued _,- ----by_
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # F(
Phone (503) 639-4171 Date Issued_ 10
CITY OF TI�3ARD FAX (503) 684-7297 Issued by 47• K�l^- °^
TUD No. (503) 684-2772
Inspection (503) 639-4175
4. Complete Fee Schedule :Below:
1. Job Address: P
Name of Development Number of inspections per permit allowed
y" AddressJ�-�7 cJ U v'� H(6H L A-y�%/_� Service included: Items Cost(ea) r Sum
7 4
City/State/Zip t� C) /�- �1 7 �Z ��y 4s. Residential•per unit
r 1000 sq If or 1688 $11000
Name (or name of business) Q �f jl 1 ►C- F 1 6 t— Each addilinrwl 500 aft ft or I N
portion thereof $2500
E
Commercial❑ Residential LEI ach Energy $2500
Each Manu1'd Homs or Modeler 2
Dwelling Service or Feeder $6800
2a. Contractor Installation only: 4b.Services or Feeders
/ Installation,alteration or relocation 2
Electrical Contractor /� /� �L'�° ��T <'!�i E d �i n/ 200 amps or lees $60 00 2
r Addre^s_ ��} N / /�� _ 201 amps to 400 amps $8000
401 amps to 600 amps $12000 2
Cityt_ _ State C 2 Zip *� 601 amps l0 1000 amps $leo 00 2
Phone No. �, o C--f �:— _ Over 1000 amps or volts $34000 2
Contractor's License No. /� ? U _ __ Reconnect only $5000
_
Contractor's Board Reg. No. ei 4c.Temporary Services or Feeders
Installation,alteration,or relocation 2
Signature of Supr. Elec'n _ 200 amps or less $5000
201 amps to 400 amps $1500 2
License No. one N0. �� �� F t�id 401 amps to 600 amps $10000
Over 600 amps to 1000 volts 1
f 2b. For owner Installations: see•b'above
1
4d.Branch Circuits
1 Print Owner's Name !_ New,alteration or extension par panel
Address e)The lee for branch circuits Mth
City__ State Lip` purchase of eervks or Aseder Ars. 2
Facf.brench circuit $5 00
Phone No. _ b)The fee for branch circuits wlf lortl
The installation is being made on property I own which is purchase of seryke or Aseder Me. cry 2
not intended for sale, lease or rent.
First addsbranch cil br / $$5 00 _.�.2_ 2
Each additional branch circuit $500
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Owner's Signature4a. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4000 `� 2
Each sign or outline lighting $4000
Signal cimuit(s)or limded energy 2
Please check appropriate Item and enter fee in sscth.)n 5B. panel,alteration or extension $4000
_ 4 or more residential Unite in one strict,ire Minor Labels(10) $10000
Service and feeder 225 amps or more
System ove-600 volts nominal 41. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $3500
Per ban _ $5500 � +
In Plant r $55 00
Submit 2 sets of plans with application whore any of the above
apply. Not required for temporary construction oervices. 5• Fees:
NOTICE 5a. Enter total of above fees $
5%Surcharge(05 X total fees) $ / >>
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Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25%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 ABANDONEv AOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED, I ❑ Trust Account N r
Balance Due $ 7-5
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