16565 SW MATADOR LANE i
surf JOPIRNN MS 99996
I
d
c
cv
0
v
a �
oc �
F-
N
m �
t9 �
J
16565 SW MATADOR LN
CITY O F TIGARD
I ARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00195
0610612001
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 2S116AD-
D-
PARCEL: 2S 1112200
SITE ADDRESS: 16565 SW MATADOR LN
SUBDIVISION: KING CITY NO.15 ZONING:
BLOCK: 22 L07: 004 JURISDICTION: KIN
CLASS CF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERSICOMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15-30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO DRYERS:
!-URN < 100K BTU: _ AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BfU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of PJC. KC does all pian review.
Owner: FEES _
CATHERINE ANGSTEA) Type By Date: Amount Receipt
16565 SW MATADOR LN. PRMT BB 06/06/20( $72.50 KING CITY
KING CITY, OR 97223 5PCT BB 06/06120( $5.80 KING CITY
Total $78.30
Fhone: _—�_.__��
Contractor:
SPcCIALTY HEATING 8 COOLING
9528 SW TIGARD ST"
TIGARD, OR 97223 REQUIRED INSPECTIONS �!
Mechanical Insp
Phone:620.5643 Final Inspection
Reg#:[,:C 66578
a
oe
F5 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
to
uu Specialty Codes and all other applicable laws. All work will be done in accordance with approved
a
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952.001-0080.
You may obtain copies of thes rules or direct questions to OUNC by calling (503)246-9189,
Issue By: Permittee Signature:_fin �� i�Yt.,
Call(503)6394175 by 7:00 P.M. for Inspections needed the next business day
01-/05/2001 12:51 5036393771 CITY OF KING CITY PAGE 02/02
Mechanical Peradt Application
Date tecelved: -g-61 permit no.:n1 ryj! r�j
City of Tigard
CuvofTignrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Ptc3acyappl.no.: Expire date,
Phone: (503) 639-4171 Date Issued; Reeclpt no.:
Fax- (501) 598-1960 l
( � � Cass file no.: Payment ype:_
Land use approval: Building permit no.:
,V'I &2 family dwelling or accessory ❑Commercial/industrial C3 Multi-family 0 Tenant improvement
U New construction Addition/altemtion/replacement O Other:
.1011 SITIE INFORM%I ION I-
Job nddress: (�J r_ Indicate equipment quantities in boxes below.Indicate the dollar
Bldg. no.: _ Su(te no. value of all mechanical materials,equipment,labor,ovettued,
TAX map/tax lot/account no.: profit.Value$
Lot: Block Subdivision: _ 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential armit fee.
City/county: �� ZIP' v
Description and 1 cetlo6 of work on premises:
Fer(ert-) 'ibtal
Est,date of cotupledon/InUrction� oa Rea.od Ra.only
Tenant improvement or change of use: A '
Is existing space heated or conditioned?Qves O No Air handlin unit _ .CF'M
Is existing apace insulatedl.12"es O No r conditioning fe an roc l )
iteration o existing , stem
o ler compressor
Business nam, yQ L ¢ State Witt permit no.:
4SLa� 7 S rHP ran, TjT[I/N
Adr mLas: 71rre7tmo a amper uct,reo a detectors
City: I Q�1 d State: Heat urnp ,to Tan ne u re ) —
Phone• ap;sFax.--98r 0)/ E-mail: nus repCace r:mec mmrner -_ 1/ "
Includin duetwotir/vent liner U Yes 0 No
CCR nn.; nets /rep aci reTocate eater,—suepcn e ,
City/metro lic,no.: _ wall,or floor mounted
Name(plcase tint): ei5 `- Vent ora anceo er an lmsce
a Ion 8111 e era osu
a WON Absorption unlu_ _, B f UM
Name: (�� P/t; Chillers__ _� w Hp
Address: ga �_�/ ?` THP
o ree,ora
1 S
City: eJ Sta ohviroenneeta ci ra and ewoillsi o"[ u.-'
G
A Iiance vent
Phone6:53 4.RO- Pax:5.7rcrJI E- "l: a cx Bust
Hoods, ypeV res, tc a &timet
hood fire suppression system
Name: Exhaust fan with single duct(bath fans
Mailing ddress: � _ 0 au,t s stem& art rom heattn or
City: Stare: Zip: art up to outlets)
Q. Phone Pte. _.. B truth: —�rLPG ;--r NC3 OU
Fuel I fn oath 34dit(oral over 4 outlets
� cesfep(p (sc emat ctequ rc )
U) Neme: Number of Uatiets
t ek d epJ p— aT[ace o`e aetwT�eaTt "
Decorstivefin lave
J City: State: ZIP': nsert-v
_m Phetne: Tax: E mom: uov etetove
er:
C7 Applicant's signature: Date: � �y
tl! Name (print): A
r
Not all judkilcmiosu Wespp est:.cards.plwe Bali hrritdk on for moss Inowmulem Permit fee................ ..$
O Vlea O MuurCar" Notice:This permit application. Minimum fee................$
expires If a permit is net obtained
C+edi.cud namMl._ Plan tL'VIEW(at v 96) s
t=.. n, within 180 days atter it has been Stabs surcharge 8%
.me of c ohms u s�ilrw)it cwd accepted as complete.
s TOTAL .......................S
r,ipmalYta � Amoan•�
410+1617(6 rocom)
C —_ ELECTRICAL PERMIT
CITY OF TIGAR®
PERMIT M ELC2001-00294
DEVELOPMENT SERVICES DATE ISSUED: 6/6/01
13125 SW Hall Blvd.,Tipard,OR 97223 (503)639-4171 PARCEL: 2S116AD-12200
SITE ADDRESS: 16565 SW MATADOR LN
SUBDIVISION. KING CITY NO.15 ZONING:
BLOCK: 22 LOT : 004 JURISDICTION: KIN
Prosect Description: Installation of(1)branch to A/C.
RESIDENTIAL UNIT TEMP SRVC/FEL JERS 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 HMI SVC/FDR: 601+amps-1000 volts. MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 - 200 amp: WISERVICE 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
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CATHERINE ANGSTEAD SHARPE ELECTRIC INC
16565 SW MATADOR LN. 22605 SW RIGGS
KING CITY, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 642-7937
Reg#: LIC 81518
SUP 33445
ELE 34-217C
FEESRequired Inspections
Type By Date Amount Receipt ^ Rough-in
5PCT CTR 6/6/01 $3.75 2720010000( Elect'l Final
PRMT CTR 6/6/01 $46.85 2720010000(
Total $50.60
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 wigs approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is
IL 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 ONR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these ru!es ordkect questions to OUNC at(503)
246-6699 or 1-800-332-7344
N
Permit Signature: 2 Issued By:
r
1
0 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 INTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: -L t';da r 0— DATE:
LICENSE NO: -
Call 639-4175 by 7:00pm for an Inspect!on the next business day
Electrical Permit Application
Datereceived Petrnitno.:f_ I-coyly
City Or A 'Tigard Pmject/appl.no.: Expitedatc:
CitvojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no
Phone: (503) 639-4171 ,
Fax: (503) 598-1960 ✓ l Case file no.: Payment type:
Land use approval'
.&I &2 family dwelling or accessory U Commerciat/industrial U Multi-family U Tenant improvement
U New construction 4Addition/alteration/replacenient U Other: _ U Partial
Job address: r Bldg. no.: Suite no.: Tax map/tax lot/account no.: _
Lot: Block: Subdivision:
Project name: I Description and location of work on premises: C-Kj,,jJW
Estimated date of completion/inspection: o Q
,fob no: S,611 'A Fee Max
Business name: /` a FT-- ode:- Description Qty. (ea) foul no.lis
New residential-single or multi-family per
Address: "-X.,L r dwelling omit.Includes attachedgarage.
City: _ tate:e< ZIP: o p y Service included:
Phone: 3 4- /-4 I Fax: I E-mail: 1000 sq.ft.or less 4
Each additional 500 sq.ft.or portion thereof
CCB no.: FS/ Elec.bus. he.no: 3qa
17 C
Limited energy,residential 2
City/metro Iic.no.: vA5 3/ Limited energy,port-residential 2
/ Each manufactured home or modular dwelling
Signature of supervisifig electrician(required) _Date w Service and/or feeder 2
Sup.elect.name(print): L-i Accuse no: s Ser0cesorfeeders-installation,
alteration or relocation:
200 amps or less 2
Name(print): ( 5 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: I&S&5 SW 6111 amps to 1000 amps 2
City: Cj State:Q e ZIP: L-j;., Over 1000 amps or volts 2
Phonc:(0cgo 3 Fax: E-mail: Reconnectonly I
Owner installation:The installation is being made on property I own Temporaryn,altecwurfeereoc
which is not intended for sale, lease,rent,or exchange according to Insta amps
or 1 alteration,on,orreloratrlon:
ORS 447,455,479,670,701. 201 amps to 400 2
201 amps m 4110 amps 2
Owner's signature: Date: 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: p Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
` City: SIaIe: ZIF: B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: t 2
C Phone: {,tx E-mail: Each additional branch circuit:
PLAN* REVIEW(Please check all that aPplil Mise.(Service or feeder not included):
r JServiceover _tiango-cnmmercmi UHealth-care facility Each pump oritrigationcircle 2
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
familydweltings 13 Building over I0.(Xx)square feet four or Signal ctrcuit(s)oralimited energy panel.
C.System over6lx)volts norrunal more residential units in one structure alteration.or extension" 2
J Bwldme over three stones U Feeders,4(x1 amps or more •Desert don: _
Occupant load over 99 persons U Manufactured structures or RV park F,ch additional Inspection over the allowable In any of the above:
J Egresstligh agplan U Other -- _—_---__-- Perinspection
Submit___.sets of plans with anv of the above. Invetuganon fee
lite above are not applicable to temporary construction service. Other
Not all pinsdicnons accept credit cards.please call junulicuon for more information, Notice: l'bis permit application
Permit fee.....................
U visa 13 MasterCard expires if a permit is not obtained Plan review(at — %) $ _
credo cud number L1—_ within 180 days atter it has been State surcharge(9%) ....$
Name of cardholder as shown an credit card Z5
Expires accepted as complete. TOTAI. ....................... leo
_ a
Cardholder signature Amount 4.10-4615((WIXY170M)
KING Cixi
IMO O SAV 1160 Aenue,ling Citi•,Oregon 97=4 '593
Phone:(503)6314.40$°•FAX w03)639-37 71
Notice To Cc:-.tractors Working 1n King City
Due to an intergovernmental agreement with the Cin of Tigard. man, building related permits
for projects in Ding Cite are issued and inspected b% the Cit,• of Tigard.
If your permit application DOES NOT REQUIRE PLA` REVIENN', simply complete the
appropriate application legibly and submit it to the King Cite staff. The King Cin staff will
collect all fees and `w. the application :o the City of Tigard. Cit, of Tigard staff,.;ll then create
the permit. issue the permit. and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
vvheth:r''ou prefer it to be mailed wkhout an- notification. Any incomplete or illegible
application will be returned to King Cin staff for correction and no processing will occur t; .til a
complete. legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW. this form must be sinned by a.
?.Ing Ciry staff person. King C in star a ill simple sien :Kia form indicati ?g land use approval.
Tcke this signed form to the Cin of Tigard Development Services Counter located at 1312-5 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
avail.lble at 639-4171 Ext. 304 should you have am questions concerning submittal
requirL.nents. .all permit fees will be :assessed and collected at the City of Tigard.
The Cit, of Ding Citv hereby authorizes applicant to pursue permits at the Cit% of TiPard
Building D,_-partmen, for the following project: d, t _
located at: M5(a5 Jw 4,4 A ior
A �
King Cin Repr en'ative
1 nsrs;,C1\iT c o,
4
COY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639.4171 —
BUP
—Date Requested_
/ _AM PM BLD
Location. 1 G 1 6 S /��Tq G r G r-- (j_L Suite _ MEC Z� as 19JJ
Contact Person _— Ph -5�3 G f�`'�3 PLM
Contractor Ph SWR — —
BUILDING Tenant/Owner _ _ ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain
In Notes:
Slab �— SIT
Post&Beam
Ext Sheath/Shear _
Int Sheath/Sh :ark
Framing
Insulation
Drywall Nailing .�a _
Firewall
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling --- -- -
Roof
Misc: —
Fina;
PASS PART FAIL - —
PLUMBING _
Post& Beam �—
Under Slab
Top Out
Water Service
Sanitary Sewer —
Rain Drains
Final
PASS T FAIL
VHA L
r6s'TA Beam -- —�
Rough In CAA-e--
Gas Line
S� Dampers AW A FAIL
TRI AL --
a Service —
OC Rough In
F' UG/Slab
W Low Voltage —
Fire Alarm — --- -
Final
m PASS PART FAIL
W
SITE
J Backfill/Grading -�
Sanitary Sewer
Storm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE [ j Unable to inspect-no access
Fire Supply Line -- --
ADA
Approach/Sidewalk r 5
Other Date 4. -- �' �/ Inspector _ Ext —_
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
1�
CIW OF TIGARD BUILDING INSPECTION DIVISION J� k..1ST
24-Hour Inspection Line: 639-4175 Business Line: 639.4174 -- - ! —
aUP
Date Requested f --,.-AM `PM BLD _
Locationf�i�<i S� �� 5 GAG v Suite _ MEC _
Contact Person Ph 6i w 5-Z c(3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC —
Retaining Wall ELR
Footing Access:
Foundation FPS
Fig Drain SGN
Crawl Drain Inspection Notes:
Slab _— — — SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing — — --
Insulation _ �f--
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc —
Final
PASS PART FAIL —PLUMBING
Post
Post& Beam ---
Under Slab _
I op Out —
Water Service
Sa+iitary Sewer
Rain Drains
Final PASS PART PART FAIL
MECHANICAL
Post K [learn — — --- — - —--
Rough In
Gas Line -- ---- —
Smoke Dampers
Final -- — — --
PASS PART FAIL
d ervice
Rough In
H UG/Slab _ —
j' Low Voltage
Fi larm
m ASS ART FAIL.
t9
W Backfill/Grading --- '-`--
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$_—__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: n _ [ ]Unable to Inspect-no access
Fire Supply Line
ADA _ 1/
Approach/Sidewalk Date Inspecto ✓ � Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site.