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7275 SW HE,RMOSO WAY
ELECTRICAL PERMIT
CITY OF TIG�ARa —
PERMIT#: ELC2004-00519
DEVELOPMENT SE^VICES DATE ISSUED: 8/17/2004
13125 SW Flail Blvd..Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S101AB-01200
SITE ADDRESS: 07275 SW HERMO)SO WAY
SUBDIVISION: HERMOSO PARK ZONING: �AUE
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Add A/C circuit and 120v cir.
RESIDENTIAL UNIT_ TEMP SRVC/FEEDERS MISCELLANEOUS�
1000 SF OR LESS: ~� 0 - 200 amp: Y PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 4L"O amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALWANEI_:
MANF HMI SVC/FDR: 6nl+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: WiSERVICE OR FEEDER: I PER INS.'ECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
101 - 600 amp: EA ADD'L BRNCH CIR,,: IN PLANT:
601 - ;000 amp: _ PLAN REVIEW SECTION
100C amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL_
Reconnect on � SVC/FDR>=225 AMPS: _ CLASS AREA/SPEC OCC:
Owner: Contractor:
KEYWAY CCRP BEAR ELECTRIC
14820 SE JOHNSON#101 P 0 BOX 389
PORTLAND, OR 97267 DONALD,OR 97020
Phone: 503-654-6223 Phone: 503-678-1355
Reg #: LIC 20919
--— — — ELE 24-107C
FEES _ SUP 3162-S
Description Date T Amount Required Inspections
[EL.PRMT] ELC Permit 8/17/2004 — $53.50 —� —
[TAX]8%State Surcharge `;/17/2004 $4.28 Rough-in
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codbc end all other applicable laws.
All work w0l be done in accordance with approved plans This per mit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-01 U0 You may obtain ropies cf these rules or direct questions to OUNC at(503)
2466699 or 1-800-332-2344
Issued :- � �QyL��=�� --- Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE
CONTRACTOR INSTALLATION ONLY
SI•_,NATURE OF SUPR. ELEC'N: _ DATE:
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
17, 2004 11 : 25AM BEAR ELECTRIC, INC _ z; NO hlii—
EIe, rival Peplication f E
RccereJ �, Elzrmcal / G „ .
City of Tigard l>JC� rX EE iEl
13125 SW ball Blvd, Plan Review other
Tigard, Oregon 97223 ,i i Permit Na.: _
Phone: 503-6394171 Fax: 503-598.1960Pdst- evie�v land Lse
t)ate/By: __ Case No.:
Internet: wwwxi.tigard.onuz conteet J 's See Page 2 for
24-hour Inspection Request: 503.63YA175 illi l)It\i0 a . ,i� ia� fethod: Supplemental Information,
�y.'�• n4T,i i i..�r� ,",`L iF,R',.�OriG: ��11 V~.LRr �'hF• N.� �alr- ,'„�, }d'� 7 tri , 'y.1. 'Ly L,
k-ddition/alteration/rSpleoeTnent
ew construction Dernolition Ser•.•ice over 22$amps Health-eare ttrcility
commer ,,i ❑Hazardous lotation
❑ Other: ❑Service over 320 amps-rating of Buildtng over 10,000 square feet,
'A1z 11 l., s '1'l� �';G1CJ ` +1_.`?, l&2 family dwel&go four pr more residential units fn
1 &2-Fanuly dwellin _ Commer_ciaUlndust ial ❑System over 600 volts nominal one savcwrc
Building over three stories Feeders,400 amps or more
Accessoyy Builditi Multi-Fainfly Occupant load o�er 99 persons Manufactured srructums or RV park
Nfaster Builder Other: Egress/lighting plan (J Other:
f• Pl<1V �>ES�iCIt7� l�d. aQ> tri Submit^silts of plans with any of the above.
The above are not applicable toem ra const.uction service.
Job site addi6ss: GSA?CJ ,,, y s
Suite#: Bldg./Apt.#: Number of ins ections per permit allowed
ProjeotName: Description Qty Fee(fin') Total
Cross StTeetrolta0ti0n9 to 017 Site: New residential-single or multi-fe.m(ly per
J dwellieg unit Includes attached garsoo.
Service iucludcd:
1000 s .ft or less S ! a
Eac additional500 sic-1,i or portio thereof 3311+.
Subdivision' Lut#f: Limited"VM,residrntisl 75-00 2
Limited energy,non residents 75.00
Tax ilia / arcel#; ach tnanutkcnued home or modular dwelling
�, — r: i1 +x�G;d s service and/or feeder 9090 2
__�+— s ''_` Service!or feeders :istal4tt,t, —�
Cy46�`V -0--12,0V_ tt Its alteration or relocation:
200 amn or less WIN 2
-- ---- 201 amen to 400 amp;
401 amps to 6N?taps 1 2
1 60 t amps to 1000 an _ 240,60 2
0va 1000 ataRor volts 454.66
Name; _ Reconnect enl�_ ,85 2
\
Temporary serviens or readers-installation,
Address: /y x,4 S�. 1„(f 4 U -`1 _ �/ 1 alteration )r relocation:
City/State/&D: 200 amps or less --- 66.35 1
Phone: Fay: 201 amps to 400 gimps 170.30 2
401 cc 600 amps 133.75 2
- r - - - -t Branch circuits new,alteration,or
Name: extension per panel-
A.Fee for branch circuits.with purchaseof
Address' _ or feeder fee,ea4h branch circuit 6.65 2
city/state/zip: B.Fee for service branch circuits without purchase of
PhoIle• ~ ---�-- service or feeder ft, stanch oi, ' � 46.85 � 2
Fax:
Fax. _ Each additionel branch cireur. 6.65 2
NUK(itivice o•.Swaet no:.mzIr.dedl: _.
e seh pump or ItTl Ion circle3.40 2
. _- s....._s 1 - Fach si or oa Una h—ht�n___ - __ s .40 � z_
J0b No: rt?,-#.- Signal circuit(s)or a limind energy panel,
Busixiess Name: rr!5.Azn!�C- ZU'r— - altemdon or extension Page 2 2
bescription:
Address: &A
Each additional lus ectlon over the allow le in-toy of the above:
City/State/Ziw � p� p • z n �-------
�_ _I,e:S� _ Per cue hou-(mire,1 hour) �—62.50
Phone: -G7�-/_ SS I Fax: /08 trots_ _ -- --- -
CCF Lic.#: �q/� Lic #: ,a 10-71,C other;
X 0001_ MMMMW
Supervising electrician subtotali
signature re ed: - 1 — Plan Review(Z5%of Permit i±eel IS Ez—
Priht Name: v% Lic. #: It 21 State Su_rt harize(8 1`%of PerC'dt'i ee) 1
TOTAL PERMIT ME I 5 "7,
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date' 180 days after It has been aceepted as complete.
'Fee methodology set by Tri-County Ruildin`lnr uttry Servica Board.
(Please print name)
\Dsts\Perrnit Forrna\E1cPermitApp doe 01103
a
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00574
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/24/2004
PARCEL: 2S 101 AB-01200
SITE ADDRESS: 07275 SW HERMOSO WAY
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT I1FA'rFRS: VENT FANS:
OCCUPANCY GRP: R:i VENTS W, ' ;P _: VENT SYSTEMS:
STORIES: _ BOILER" PRESSORS _ HOODS:
FUEL TYPES 0 1 ;P: 1 i DOMES. INCIN:
LP_G 3 - t., HP: COMML. INCIN:
MAY. INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 _ AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replace oil furnace with gas f irnac:. Add AC. Vah c: $2,000.00
rner: —FEES
..A
KEYWAY CORP Description Date Amount
148:0 SE JOHNSON # 101 [MECH] Pen-nit Fee 8!24/20Uz $72.50
PORTLAND, OR 97267 [TANI :: State Surchart 8/24/200,, $5.80
Phone: 503-654-6223 Total $78.30
—
Contractor:
BELL HEATING
15550 SE PIAZZA AVE
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503-656-1184 Cooling Unt Insp
Heating Unt Insp
Reg#: LIC 447 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municip it 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 3atk 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
(503)246-6699.
Issued By:�� t�t-�. ,;. �, Permittee Signature:
Call (503) 6394175 by 7:00 P.M. for inspections needed the next business day
,chanical Permit Application F011tOPFil Et]SE' ONLV
f)' of Tigard Received q Pc mit N, n
(, nit-�GC+_ -DO5>
13123 SW Hall'dlvd.,Tigard,OR 97223 Date/By: --- -
Phone: 503.639.4171 Fax: 503.598.1960 Dan Ravi"'
a " Othe,Permit:
Inspection Line: 503.639.4175 Date Ready/By lu - ® See nage 2 for
into,,:-t: www,ci.tii;ard.or.us Notified/Method: ;/ Su lementat Information
WWI!I � e. r , C' D--�UL'E - 119PCHECKLIST
❑New construction Q'Addition/alteration/repiacement Mechanical permit fees•are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,oventead,and root.
e: ; :: t Value:5
brTRtn'lt)N
_ tQMENT/SYSTEMS FEES"
�1-and 2-family dwelling •❑Commercial/industrial ❑Accessory building
❑Multi-family ❑Master builderOther: Oestri + For special information use checklist.
❑ ion
p. Qty I 8a. I Total
BE.LP
t.«:." r. +,. Hearin cooling
Job sit!address: -� �- a Air conditioning or heat pump
re tyres site lan showie lacemant 14.00 1 tV
City/State/ZIP: Furnace 100,000 BTU(ducts/vents) 14,00 Urc
Furnace 100,000+BTU ductsivents) 1790
Suite/bldg./apt.no.: Project name: Gas heat pump 1400
Cross street/directions to job site: -� 1_ r„ Duct work — ; 14.00 -
�ts.a �-- H dronic hot waters stem 14.00
�'`1�— t• Residential boiler(radiator or
h dronic 14.00
-- -- nit heaters(fuel-type,not electric),
to-wall,in-duct,suspended,etc 10.00
Subdivision: i.ot no.: Fiue/vent for any of above 10.00
Other: 10.00
Tax map/parcel no.: _ Other fuel appliances
INS
�: y Water heater __A 10.00
Gas fire lar^ 10.00
P,. r l - it -cis.C _ Flue vent for water heater or gas
�v A IL fireplace 10.00
Log lighter(pass 10.00 _
Wood/pellet stove 10.00
Wood fit lace/insert 1u.00 _
Chi mne /liner/tlue/vent 10.00 +_
Other: 10_00y .
Name: C.Fi P Environmental exhaust and ventllptlon
Address: Range hood/other kitchen
�0k O equipment 10.00
City/State/ZIP: � [:�� 3 Clothes dryer exhaust 10.00
Phone:( ) 4�- (0, ;,L, Fax:( ) _ --�I toilet
exhaust(bethroroot
_ toilet co artments,utilityrooms) 6.80
, Eqli' t .. — CON-l',It I T Pi-160N +�Yt,i" Attic/crawls ece fans 10.00
Business name: r- r - Other: 10.00
Tucl piping _
Contact name: (t lG� ��� $5.40 for first four;$1.00 for each additional
Address: 5�. '�=A22l�k (�j� Furnace etc
City/State/ZIP Gas heat u
mp
�.�►51— — -_ 'Jf Wall/suspended/unit ended/unit heater
Phone:( w;16 rl 1$'-k� Fax: 1q,3 ) �tc"� 5 t` Water heater--
E-mail: - Fireplace
Range _
Barbecue
Business name: `e - Clothes d er as
�^a ���t— l
Address: Other_._ __S�53 �s�—__—? 2?�
City/State/ZiP C" k.& ess Coe 000 t Subtotal
Phone:( �j(p �� Fax: Minimum permit tee($72.50)
CCB lie.
-1—Fax: ___�. Plan review(25%of permit fee)
State surcharge(?".v afitcrmi:far'
TOTAL PERMIT FEE
Authorized s' at e. 1>4 it 5 L Th' permit application expires If a permit Is not obtained s%lthin 180
days atter It list been accepted as complete.
Print nam — — Fee methodnlogv set bo Tri-Counh Puildinp Industry Se,,ice Bnard
tlaulkin�tPerrtual.lLCI'ernuu�ur:c, I['c� .ten.�it'*.('i•i1�r'^M�a'ttA
t
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule: _
$1.60 to$2,000.00 Minimum fee$72.50
$2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30
for each additioual$100.00 or fraction
thereof,to and includuig$5,000.00.
$5,001.00 to$10,000.00 $141.50 for the first$5,000.00 and
$1.80 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and
$1.31 for each additional$100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and
$1.25 for each additional$100.00 or
fraction thereof, to and including
s100,000.00, _
$100,000.01 end up $1,396.50 for the first$100,000.00 and
$1.10 for eac,t additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i`Ruild,ngV'umits\MFC-r•-rmitApp doc 12'03 2
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BELL HEATtN(�
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CITY OF TIGARD 24-11c.ur
BUILDING Inspectinn Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 -----._-_�-
BUP __-----------J_____-_
Received Date Requested___ �� 5-_ AM_ PM--______ BLIP
Suite MEC
Location - _____ � Y1.�4�- -_.____.__
__..._.�_ _-__- --_--
Contact Person __ _-- Ph(-_ -__-) PLM _-----_._-_--
Contractor _— Ph(_______) iJ _� SWR
BUILDING _ Tenant/Owner ELC o20G�f-Oc�SI
Footing ELC
Foundation Access:
Ftg Drain Em _
Crawl Drain _-
Slab inspection Notes: SIT
Post&Beam
Shear Anchors oe
Ext Sheath/Shear I _
Int Sheath/Shear
Framing _10— -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ---- -
Fire Alarm
Susp'd Ceiling ------
Roof
Other: _—� -- __ _ -_ -_ -�._._--- _ --_------- --__ - ---------- -----
Final ----
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab -- - -- - _ __ - - ------- ------------ ---
Rough-In
Water Service - - - -- --------
Sanitary
-Sanitary Sewer
Rain Drains - - - --- - - ---- ----- -- — --
Catch Basin/Manhole
Storm Drain - - _- - -- - -- --- --- --
Shower Pan
Other:
Final _
PASS PART FAIL - - _ -,----- -- - -
_MECH_ANICAL
Post& Beam - �_--- ------- ---
Rough-In -_-_•-__ _--____ --- __----
Gas Line
Smoke Dampers --- -- - -- - - - -
Final
PASS PART FAIL - - _ - -- --- -- --_—
ELECTRICAL
Service
Rough-In -
UG/Slab
Low Voltage
Fire Alarm
PAR_TFAIL L Reinspection fee of$ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
r-ftgtii---
-- Piease call for reinspection RE: Unable to inspect-no access
Fire Supply Line
i
ADA �''- DCI � 44_-,g��aApproach/Sidewalk Date bb�� Inspector Bfit _
Other:
Final -- DO NOT REMOVE this Inlspec+ton record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hcur
BUILDING Inspection Line: (503)639-4175
MST
INSPECTRUN DIVISION Business Line: (503) 6394171
BLIP _ —
Received -_________ Date Rested ested r-7 + 3 AM_ PM -- BUP
Locaiion ___L ,_._ L�-L Suite __ MEC
Contact Person Ph PLM
Contractor
_-- — Ph( ) - -- - – SWR _ --
BUILDING__ Tenant/Owner ___, - ELC
Footing ELC
Foundation Access: -^—
Ftg Drain I ELR
Crawl Drain
Slab I Inspection Notes SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - ---- AA .-
--- -
Firewall
Fire Sprinkler ----------- ��_.-.._..—
FireAlarm _— t`�a (PJ�� �� kpJ _
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 --
PASS PART FAIL ---- -_ ----- - - -- --------��--
MECHANICAL
Post&Beam -------- ---_ ---Tl
Ro ---- - -- - _
ICKS-
Sino, Dampers -- ------- - - --- ---- ----
AS PART FAIL — - -- -- ---
RICAL--—
Service
Rough-In
UG/Slab — ---- ------__.-----------...----------
Low Voltage _ _ -------------___- - _ _-.--
Fire Alarm
Final Reinspection fee of$_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ - Please call for reinspection RE: _ ❑ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 111stractor Ext _
Other:
Final —^� DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL J