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14335 SW MCFARLAND BLVD
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#- MEC2003-00577
13125 SW Hall Blvd.,Tigard, OR 97223 (50:.) 5394171 DATE ISSt'2:D: 9/25/03
PARCEL: 2511 O BA-04500
SITE ADDRESS: 14335 SW MCFARLAND BLVD
SUBDIVISION: SHADOW HILLS ZONING: R-2
BLOCK: LOT: 020 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR BURN: LVAP 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: DOMES. INCIN:
? - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -3n HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN —100K BTU: <= 10000 cfm:
a GAS OUTLETS:
10000 cfm:
Remarks: Replace furnace with like kind.
Owner: _ FEES
FUJITANI, KIYOSHI F ANC Description Date Amount
JANET T IMFCIII Pcr►nit Fee 9/25/03 $72.50
14335 SW MCFARLAND BLVD ITAX] 8%StateTax 9/25/03 $5.80
TIGARD, OR 97223
Phone: Total _ $78.30
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 503-234 7331 Heating Lint Insp
Final Inspection
Reg #: LIC 1441
IL
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WThis 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 !.aw requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)/7, 6-6699. _
Issued,By: � I� " -L_.A Permittee Signature:_ 9 t , .
Call (503) 639-4175 by 7:00 P.M.for Inspections needed the next business day
Sep-24-03 08:05A R.02
Mechanical FermAj A Dm*A16n_ 1 � ,
Do 41 -1,7
Planning Appmvel HuRd:nj
City of Tigard N Uate/H — PertnitNo,'
13125 SW Hall Blvd. Plan Review
Tigard,UrcKou 97Z2:i Sp r �jQZ ll.�ny �r��--� No.:
1; 7f1 � puol•Review Land Use
Phone: 503-639.4171 Fax: 50 til rtlVl DaWH : Cue No,:
Internet: www.ci.tigard.or.us Contact lar Sec Palke 2 for
24-hour Inspection Request: 503-639.4175 N■rndMeUtoA: _ Supplemental Information.
'I YPF OF WORK" O`MMERCIAL FEE&ACHEDULE J U9F CHECKLIST
New construction _ L)CtttQliliOn� Mechanical pernut fees"are based on the local value of the work
Addition/aIIcration/re 11/rep]acemcnt QlhcI" icetfnnned. Indicaterial the value(roun,ledabor to the nearest dollar)of all
_ CA1'EGOitY OF.CONSTttUCTION � mct:hantcal rnatcnals,ec)ulpmrat,labor,uvenc�nd and profit.
Value- $ _ See Pare 2 for Fee Schedule
& 2 hamily dwelli� Colnmercial/industrial _ -- —
— RESII)F.NTIAL F.QUIYMFNT/SYSTEMS FEE'SCIIFDULE
Accessor i3uilding, _ Multi-1:amilY
Description Qf7 ie ea. Totals
(] Master D ilder Other: -
- JOB SiTE INF0101ATION and LOCATION Furnace-aid-tin air condition!_
Job site address. " tr"1l_ q� U Gas heat pump_ _ !4 Qp
Suite#: A1�JA t.#: Duct work ___ _ 14.0C)
t Iiydronic hot water system ` 14.00
Project Name: 'r -ice_- t=om — Residential boticr
Cross street/Directi es to job site: for radiator or hydronic systern)_ 14.00
Unit heaters(fuel,not electric)
In walllin-duct,sug n ed etc. 14,00
Fluc/vent for any of aboveL10.00
Kepair unit■ 12.15
Subdivision: - __ Lot#:~ c;,ther>rracetA X10,00
'Tax ma / arce) #: _ Water heater — _i
1PSTI N'OF� b>RK• )j{, ,;+,..,,1, Gas fire lace—
Flue vent(vaster healer/gss rireplaceLo li hter asZ___Womwellet stove Wood flrTjoa elmsert Chimne /Hoer/Oue/vent 13!N Other:
Environmental Eiheust&Ventilation
1e: tA1-1 Q c' Range hoaVothcr kitchen equipment 10.00
Address: qi e A Clothcr dryer exhaust 10.00
Clt /State/Zip: � ��^ _ Single duct exhaust ~'
*"_0'P',_,r!
Fax: (bathrourrtc,toilet compartments,C 9 i + CONTA-E ('L+g utility toonms� fi.80
Altic/crawlvacc fans 1000
Ni : �,,`_5 �- 1c� "� Ocher:
Address: c ,y �_ _ ___ Fuel Piping
.r• ( �� �" 5.40 far Drst a,51 00 each a
tt /% edilional
Cll +'$ aeI ,•
y --�- ��" — - Furnace,etc,
Phone: _ j' = _. 42s heat pump •' _ _
E-mail: Well/suspendcd/unIt heatcr�_ '—'
t �R' >:;;. °f.. ,., Water heater ..
Husiness Name: Fireplace i—� •• _ _
Range •'
Address: `--1-1 4 ,`Z 1,, `Jr"A V,_. IL :•
ED r.��/State/7.ij�: ;�^�11c �.� _S )
t IC Clothes d r gaq •"
Phone:.D?� L. .._ Fax__ .5' Other.
W _ _ Total:
J CCH LiC. 1y: ` L Mechanical Permit Fees•
4uthorized U fq Subtotal: S
Signature ���JJJ���tttcl I_--1 Minimum Permit Foe$72.50 S
Plan Review ree 25%of Permit Fee S
` --- (Please print name) _- _ State Surcharge B%of V� S —
_TOTAL]PERMIT FEE $
expires _
Notice.- This permil appltratlon If•permit is nM ohtalned within "Pee met6odalo� set by Tri-CeuAty Building industry. ee Ao►rd,
i so days after It has been accepted as complete. ••Site plan reQulred for er;lerlor AK,■alls-
I\DetsNPemrit FomrtMecPerrnitApp.dm 01101
CITY OF TIGARD 24-Hour
BUILDING 6` Inspeotiop kine: (503)61"175 . —MST
—
INSPECTION DIVISION Business LIA: 1903)6394 i71
BUP _—
Received _-- __—_Date Requested__ _� _PM BUP
Location ___ /W� �._ �� Suite _ MEC,
Contact Person 1 Ph Z0 PLM
Contractor___ _ __ Ph(-) SWR
BUILDING _ Tenant/Owner -- ELC _
Footing ELC
Foundation Access:
Ftg Drain �-* `� �'�'°' ELR _
Crawl Drain
Slab Inspection Notes: srr -
Post b Beam
Shear Anchors
F)d Sheath/Shear _
Int Sheath/Shear —
Framing - — --
Insulation
Drywall
Drywall Nailing ---
Firewall
Fire Sprinkler ---
Fire Alarm
Susp'd Ceiling
Hoof
Other: _ —
Final
PASS PART_FAIL
PLUMBING
Post Beam
Under
Slab -- - ----
Rough-In
Water Service --- - -- - ---
Sanitary Sewer
Rain Drains ---- - --- — - -- -
Catch Basin/Manhole
Storm Drain ---ShowerPan
Other:
Final
FAIL — ----- --- ---
MECHANICAL --
PEsam
Rough-In - ---- -- —
Gas Line
EPT
pers -
FAIL
(1ELEMIC L
3 Service
0 Rough-in
UG/Slab
U
LowLow Voltage
ri Alarm
Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS PART FAIL _
S Please call for reinspection RE: _____ Unable to inspect -no access
Fire Supply Lines
ADA
Approach/Sidewalk Dab Ingor
Other: _
Final DO NOT REMOVE this Inspection record from the 166 site.
PASS PART FAIL
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC9i•-0348
131253WHall Blvd.,l7gard,OR 97223 (503)639.4171 DATE ISSUED: 06/11/97
PARCEL: 2S110BA-04500
SITE ADDRESS. . . : 14335 SW MC FARLAND BL.VD
SUBDIVISION. . . . :SHADOW HILLS ZONlNG:R-2
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :20 :iURISDICTION: TIG
Fero j ec Pe svv i pt i on: instl 5 branch circuits // job ii ?
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- ------MISC:ELL.ANEOUS------
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/I RR I GAT I ON. . . . : 0
EACH ADD' L. 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0
MANE. HA/ SVC/FDR. . : 0 801+amps--1000 volts. : 0 AINOR LABEL ( 10) . . . : 0
--- -13ERVICE/FEEDER---- -----BRANCH CIRCUITS------ ----ADD' L INSPECTIONS----
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 4 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : QI -____-__-____._.__._PL AN REVIEW SECTION------------------
1000+ amp/volt. . . . . : 0 > -4 RES UNITS. . . . . . . . : > 600 VOLT NOMI4AL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner-: -------------------------------------------------------- FEES
KIYOSHI FUJITANI type amount by date recpt
14.335 SW MCFARLAND PRMT f 55. 00 TAT 06/11/97 97-295649
T I GARD OR 97223 SPCT $ 2. 75 TAT Q16/11/97 97-295649
Phone #:
Contractor: ------------------_---------------------------..-------------.--.--.--
FARWELI. PERRY ELECTRIC $ 57. 75 TOTAL
1607 NE 32ND AVE
-------- REQUIRED INSPECTIONS - ----
PORTLAND OR 97232 Ceiling Cover- Under'gr'ound Cove
Phone #: 239-0078 Wall Cover- Elect' l Service
Reg #. . : 091733
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance ;.ith approved plans. This permit will expire if Mork is not started within 188
days of issuance, or if work is suspended for more than 188 days. ATTENTION: Rregon law requires you to follow the rules adopt4ed by
the Oregon Utility Notifi :on Center. a rules are set forth in OAR �2-9R1-*le through OAR 952-881-1987. You may obtain a copy
of these rules or dire�t q stions to/J#C y calling (583)246-1987.
K Issued By :—�A/L z&ZIA ,-1"d Permittee Signature : J41
INSTALLATION ONLY-- -- -- --- ---- --- ---- -- --- -
0 The installation is being made on property I own which is not intended for
9 sale, lease, or- rent.
OWNE=R' S SIGNATURE- _ DATE:
``InnNSTALLATION ONLY------------------------___--
SIGNATURE OF SUPR. ELEC' N: L U`ii� � DATE: _� /Zi 7
LICENSE NO: S
* Call 639-4175 by 6:00 p. m. for an inspection needed the next business day**
IN
CITY 4 TIGARD Electrical Permit Application Plan Check 0
13125 SW HALL BLVD. Recd By_
TIGARD OR 97223 Date Recd_
Date to P.E.-
Phone (503)639-4171, x304 Date to DST
Print or Type
Inspection (503)639-4175 incomplete or Illegible will not be accepted Permit it
Fax (503)684-7297 Called
1. Job Address: �, 4. Complete Fee Schedule Below:
Name of Development_41A r - - Number of Inspections per permit allowed
Name(or name of business's)_ Service included: Items Cost Sum
Address _- �T 7 Jf "4 �'4 4e. Residential-per unit
CI /State/ZI ( a-+L� 1000 sq.0.or less $110.00 4
ry E poi additional 500 sq.IL or
Commercial ❑ Resid.)ntxal portion l $25.00 1
Limited Energy
$25.00
Each Manut'd Horne or Modular
2a. Contractor installation only: Dwelling Service or Feeder $88.00 � p
(Attach copy of all all cur gqp Services or Feeders
Ins
Electrical Contractor �/ Installation,alteration,or relocation
200 amps or less $60.00 2
Address ti Z 201 amps to 400 amps $80.00 2
City A State Zip 2 401 amps to 600 amps $120.00 �- 2
Phone No. Z 3 1 ci b') ?f 601 amps to 1000 amps $180.00 2
Job No. - Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. _`Exp.DateReconnect only $50.00 2
OR State CCB Reg. N^13110W Exp.Date---k_ - 4c.Temporary Services or Foods,a
COT BuFiness Tax or Metro No._} Ij-Exp.D / installation,alteration,or relocation
200 amps or less $50.00 2
Signature of Su r. Elec'n 201 snips to 400 amps $75.00 2
g p -- 401 amps to 600 amps $100.00 2
L Over 600 amps to 1000 volts,
License Nr IfObx-s Date� see"b"above.
Phone N
4d.Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase or service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 �= 2
b)The fee for branch circuits
City State_ Zip without purchase of
Phone No. _ service or feeder fee.
First branch circuit 'J.../$35.00 �'� 2
The installation is being made on property I own which is not Fach additional branch circuit_ $5.00 _ 2
intended for sale,lease or ront. 4e.Miscellaneous
(Servire or feeder not included)
Owner's Signature- --! Each pump or irrigation circle $40.00 -��_- 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuits)cr a limited energy CLpanel,alteration or extension $40.00 _ 2
Minor Labels(10) � $100.00 -._--
Please check appropriate Item and enter fee in section 5B.
(- 4 or more residential units in one structure 4f.Each additional Inspection over
_Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00 _
as described in N.E.C.Chapter 5 In Plant $55.00 -
W *Submit 2 sets of pians with application whore any of the above apply. 5. Fees: r
-j Not required for temporary construction services. 59.Enter total of above Fees $
5%Surcharge(.05 Y total fees) $ --�-
NOTICE Subtotal $ -
5b.Enter 25%of line 59 it
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reaVit (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Suhlotal $ -IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. El Trust Account ft_________ :
Total balance Due
L_
I inti?SAF I C:`lf�1'I' nt`V!�/�r1
CITY OF I IGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
�' /(G �
le—
Date
Dete Requcstel: ! 7 A.M.�,� P.M. MST:
Location. �-� 3 �S.S�L ' l c ` ��P�•� a(. = Ae&'_Z;L BUP:
Tenant: Suite: Bldg: MEC:
Contractor:_ 1 c_ T,�( � i'_ Phone: PLM: _
Owner: �4 >>> t'"�Q C. Phone: & - vZ ELC: 'I
t) ELR:_
�_._ �/.�-- '�Z-l'Z�.L i..-�-`l Q-G�•L'�_ tC�-CCfc�Q�1.'SiI':
BUILDING BLDG(con't) PLUMBING MECHANICAL i CTRIC . sffy
Site Post/Beam Post/Beam Post/Beam over,ervi"ae Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In IIG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Tamp Ihywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Ileat Pump Sec It
Approved Approved Approved ysd ) Approval
Appr/Sdwlk Not Approved Not Approved Not Appmved Not Approved Not Approved
FINAL FINAL FINAL Z1 N_ FINAL
z C'
On
0 Call for reinspection O Reinspection fee of li required before next inspection C]Unable to inspect
Inspector:2Z4I � Ihetc: � Page of