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16925 SW MONTEREY LANE eue-, Ae:,%iuoW PAS 9711^96 m c ev J LD S c L O k � 3 N U J 16925 SW MONTEREY LN l� • CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT N: MEC2002-00213 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 5/23/02 PARCEL: 2S 116AD-09800 SITE ADDRESS: 16925 SW MONTEREY LN SUBDIVISION: KING CITY NO.13 ZONING. BLOCK: 19 LOT:002 JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: S1 UNIT HEATERS: VEN T FANS: OCC.PANCY GRP: VENTS'NIO APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INC' 1: MAX INPUT: BTU 15 -30 HN: FIRE DAMPERS?: 30-80 HP: REPAIR UNITS: GAS PRESSURE: 50+ HP: C O CRYERS: S: FURN < 100K BTU: AIR HANDLING UNITS CLO CR FURN >=100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 1000x1 cfm: GAS OUTLETS: Remarks: Exterior A/C unit Owner: — _ FEES _ WILBUR RASMUSSEN Type By pate Amount Receipt 16925 SW MONTERY LN PRMT JMT 5/23/02 $72.50 KING CITY KING CITY, OR 9722.4 5PCT JMT 5/23/02 $5.60 KING CITY Phone:503-624-7776 Total $78.30 Contractor: ROTH HEAL ING 6.COOLING 6990 ANDERSON ROAD CANBY, OR 97013 REQUIRED INSPECTIONS _ Final Inspection Phone:503-206-1249 Reg#:LIC 14008 a H m This permit ir- issued subject to the regulations contained in the Tigard Municipal Code, Stat, of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with appro ad plans. This permit will expire if wort: is not started within 180 days of issuance, or if work is suspended for.-:-arc t"an 180 days. ATTENTION: Oregon law requires you to follow rules adapted in the Oregon Utility Notif%ation Center. Those rules are set forth in OAR 952-001-00 '0 through OAR 952-001-0080. You may obtain copies of these rules or direct questions ''o OUNC by calling Issue By: Permittee Signature: Cali;503)639-4175 by 7:00 P.M.'or Inspections needed the next u iness day 05/20/2002 12:26 5036393771 CITY OF KING CITY PAGE 02/02 SERv a R Mechanical Permit Applicationnumm r City of King City Date received: - _ Permit no �? 1!3 13125 SW Hell Blvd. GEIV Iv�act/appl.no.: Etpire dstte: lckamas Tigard, OR 97223 Date issued By: Receipt no. „lultno„fah Phone: (303)639-4171. FAX (303)684-7297 Case file no.: Payment type: Washington Case l,l.i Y Ui� ��rili.l`_' Land use approval: Building permit no. MIN �I g nas— & 2 latnlly dwelling or accessory O Commercial/indltstrial Q Multi-family O Tenant IM 0 New construction O Additionlm]tCfatiott/rtplacement ElOthm Provememt "AWY01 Joh address: /o��J'� �W _2V l7r!2 Indicate equipment quantities in boxes below.Indicate the dollar Bldg. no Suite no value of all mechanical materials,equipment,labor,overhead. Tax map/tax lot/account no_: �SaS -�� profit. Value S -- I,ot: Block.' 9 Subdivision: ] /`3 •.See checklIff forimportanrappticx1on informtufon cwtd Project name: Jutrfsdicrtort's fee schedule for rrikienital rmtt Jiee. Citl�y/co-unty: j!!�IA/! el, 1 -- ZIP: Description and locationnoo work on premises:INST�4L� c �Ld LLT . CW yi7� -. Est.date of completionrnspe.don: Description F«(ea.) Tatal __ K+uE 7.� �D i De s r ip ion 1Rw eel Rea,oat Tcnant improvement or change of use: ` Is existing space heated or conditiontd70 Yes 0 No Air handling unit CFM Is existing space insulated?XYes Q No h'tend on trig(s te�requ Aleradon of exictin InVA syZ stem o er/compressors - Business tutme:xow /of�'4 /U4 GD /it16 State boiler permit no.: �S; P972ti — — HP Tons BTU/lt __ uWsmo edam�e pct smoke tors __ state:U� /j4 eat um (siu p an requ - - -- F'rane aO(p- /�,r/!� Fax: _�- Email64 replace rna umer__ CCA nop�� — cludin du�ctwork/vent liner O Y m O No - — - n Tf/rep mplenesters- suspen e City/ntetm lic. no.: wall,or floor mounted Name(please print): Jj^/ ent tar a fiance o-Tt er-t tF-an ace : erat o: Absorption units B'I'I)/H Name. ,fJ y—A� J D Aa 1011�e chillers _ _ -- — Address: oRiV Hp - ---_ ^,y LsD 3� 6 r a'9 tom rt sora KP - Ci[y: State: ZIP: a anent A leat acrd vent a: iana vent Phone. Fax: E-mall: r ex aunt s. ype U rtes. itches, azmat hood fire suppression system dame: /,rr. �j -/J��sSC�tJ Exhaust fan with sin8le duct(bath fans) a �4rriling address:/�p "_� �) 17 w Ar t- �AI,- _x aunts stem art nom eat or `ix it-— ��-4a� -- ue a ae u t- Y' /Col” C/Tr Ls-to—te; p P 9-m d i �o(up re outlets) rn 'hone a7�- 7;�y Fax; Email: nuc tt i�ea o^s ovear out etsotl t'rocsss piping(�maTrequ J lame Nurr her of outlets C ddress: �— -~- — --- eC t ace or equipment: Decorative fireplace Wity: _ tate: ZIP: nsert-—type hone: a E-mail: woonstoVelpellet stove np cant's sign��afrrrrr -C(print) ATL � �• .e blSS�x1 dL_ Other:.._. - _.,Itulsdictioas soeept credit rards,pleat call jurisdiotlen for more lafermatioa. Permit fee.......... ...........s _ -ism a MasterCard Notfta:TVs permit gpplkadon Mlalmum fee ................$ — rt card number: L� expires if a permit lr not obtained Plan review(at �) s _ _61, o widllin 180 days after it has been State surcharge(89Fi).....S - — Name of cardholder as show.ascredit card accepted as complete. _ __ S TOTAL. ............... . ......S Cudholdv s aaa[ure -� �- Amount 440-4617(MrdCOM) 05/20/2002 12:26 5036393771 CITY OF KING CITY PAGE 81/02 RECEIVED MAY P LtI x ut tlu, D BUILDING DNIBION KING CITY � 13:f()n::.'�%. ;i•3cn.�•:�nua.n:nq�:c;•.On;on 9'^'.'J Ptior,�;iJ9•;u$'_' FAX COVE: SHE:ST DATE ' - TO ATTIf FROM � T�:s transmittal ansmittal containspages , acluding this Caves Sheet . If you experience any problems , Llease contact : Cit-y of King City (503) 639-4062 Fax Number (503 ) 639-3771 CITY OF TIGARD 24-Hour BUILDING 4 Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Datc, Requested AM PM _ BUP -,, Location _ —Suite _ MECc?` yU Al 3 Contact Person 27`a'v�— ___._^_ Ph(_ ) � ' - f� PIM Contractor Ph(_ _) swerve. BUILDING Tenant/Owner ELC Footing ELC F>r�ndattoo Acces Drain s/ ELR -- Crawl r)rain 16n407 ��4 Slab Inspection Nates: SIT Post& Beam —— —_-- _-- Shear Anchors — Ext Sheath/Shear _ Int Sheath/Shear Framing ---- — ----— — Insulation Drywall Nailing — - — -- Firewall Fire Sprinkler - ------ — -- Fire Alarm Susp'd Ceiling — _—_-- 00, --- —-- Roof s Other: -- Final PASS PART FAIL `-------- - ------____.___--- ------__--- _ PLUMBING Post&Beam Under Slab -- -- -- Rough-In Water Service -- _----- — Sanitary Sewor Rain Drains --- Catch Basin/Manhole Storni Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL_ Post!f, Beam Rough-In — — Gas Line d S ke Dampers N S PART FAIL _ CTRICAL J Service m Rough-In __ ----- — — — --- - UG/Slab WLow Voltage Fire Alarm Final El Reinspection fee of� _ —_required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE — F] Please call for reinspection RE: Unable to inspect -no access Fire Supply Line ADA Date �' I�eepectRor -- �t Approach/Sidewalk Other: Final NOT REMOVE this Inspection record hom the job sib. F"S FART FAIL �, �I TY O F T I�A R® ELECTRICAL PERMIT PERMIT#: ELC2002-00248 DEVELOPMENT SERVICES DATE ISSUED: 6/6/02 A4 13125 SW Hall Blvd.. Tigard, OR 97223 (503)639-4171 PARCEL: 2S116AD-09800 SITE ADDRESS: 16925 SW MONTEREY LN SUBDIVISION: KING CITY NO.13 ZONING: BLOCK: 19 LOT: 002 JURISDICTION: KIN Prolect Description: Installation of(1)branch circuit for new a/c unit. RESIDENTIAL UNIT TEMP SRVC/FEEDERS 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: W/SERVICE 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: SNYDER CANBY ELECTRIC INC 16925 SW MONTEREY LN 790 S IVY KING CITY, OR 97224 CANBY. OR 97013 Phone: Phone: 266-7878 Reg#: LIC 26071 SUP 21235 ELE 3-112C FEES Required Inspections Type By Date Amount Receipt _ Rough-in PRMT CTR 6/6/02 $46.85 2720020000( Elect'I Final 5PCT CTR 6/6/02 $3.75 2720020000( Total $50.60 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specially Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if vrork 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 Cente. Those r;:'es are set forth in OAR 952-001-0010 through OAR 9C2-001-0080. 1' y obtain s of these rules or direct questions to Permit Signature: .L4(0�h� ( - Issu d By: 1 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 INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _,, , _' DATE: LICENSE NO: Call 639-4175 by 7:00pm for an Inspection the next business day 11ecttritcal Permit Application �etefeCelVed: 5 pennitao.: City Of Tlgsw4 r— � Projeot/appl.no.t SW adata CfryofTisard Addrecs: 1;4125 11100 'pi Datelss"cl: y Rccelptoo.: Phone, (503) 639-4111 Fax: (503) `+98.1960 Caw the no.: Paymcnl type: MAY I I LAnd use approval: zaaz {X1 tit 2 fautiiy dwelling or acaeasory O CommtxQielMdneuiel O Mdd•hSnlly O Teat►nt improvement ❑New construction J11 Addititan/allia atkm/replaoeuseut O Othem. 0 Partial Job address: Big no,; Sults no.: Tax ma tux imlaccount no.: Lot: Block: Subdivision: Protect ilamo: Description and location of tyotk on yremieiss; t r� �,.i _ Bstimatod date of corn iction/ins er_dow Job no: lrbe Mat Business name: .,�� total no. ft a per Addtws: dwelbt�mk,AlNeMtamadee�g�rya Cit : � _Mate: 2IP: t �errioelodasidr I Phone: yS -mail: 1000 a lase 4 Lh CCB no.; 'Z to o-i t Elec,bus.uc.no: - % a G it am_ , „t;,t 2 /metre lic.n 1 uo.: 9'11 le ,non""-��aenTu S&chmat erred hoiw to u1u dwelling 31 attae of Superyfi.0 elecvicion(required) µ Datt $0p.elecL name(phntA t•t4 711, 014i,naW ILO:Z.t 2'3 S elM Or —vera telioa, alfettades ert'el0eattaai 100 WP or lac _ 2 =�a1Op` ._----_—_ Mailing Rddress, c15 S• tr3 i"�t+^` am a to am City: State: ZIP; e t or rolls Phone: Fax: E-mail: Ownx installation:Thc installation is bring made on property I own Tr*>7 or bestsiMtSaeet eit!!atlollt orrelocetlon: Which is riot iownded f-,r salt,kase,rent.or exchange according to 200 mp of tea ORS 447,455,479,6 70,701. 201 tun s to 40(t Ownel's si re: tO "° ' 2 jWWR draft-gem,Alterative, or 61"Um der 0"eb N*m,:: __ A. Pit for brRMh alNUM Wlth purcttar•of Addre.AS: servies or fender fa%each branch circuit 2 Clry_ _—- - Stat4: ZIP; pyeuy�a�i circuit.wl out pvmhwc of earvloe or Eader fea.Am watch eiro,li t•, 16 4U 2 Phono: Fax, &mail: ortreMt notine u e i P�4h a or Irdaadgn circler _ 2 O Strvlotovcr227 emps<omrocrcial Q ifcalth-cmaleeillty Bach noroetline — 2 Q Service over 320 amps-rating of 1 dn2 CJ Huardrius locadon n t e are Iirnited rpt incl. — fsmilydwellinga aRuudingover IO.00gluar'efeel foorM > gyp L 2 O System over 600 volts nontrial mote tetldeitJal r 'ts in enc raua re aleltedon,or/xtentlen� 0HuUdngover threestorim UPeadets,400%A4%jrrtinro • on; 0 occwpont load onu 99 pencils O 14anAknured strgcntMri at RV park bell addluonal IrUPK"ever the aUorrebk til any e t r re &dwdlighdnet.lun D fhi+er --- per action — --- $ubndt—sets of Visas with any of the aber•o. tovwtigeuott ee The above are,not applierble to tonepo►ary cogiet IKdOn service. Odwr Permit fee 5 ._`4 �__ yet rap dotice:TWs permit appHcatlon Plan review'(at ey) S t]Vise x: explre s if a jennit 11 not obtalntd - - r 4� withtn Igo days aAcr it has been State fur.•I„lye(8°k; c t Ew qva b TOTAL L ,j L+i a n i Bina accepted as complete. C oma• e 'al cbu.�c S 0 16 .. \ _ Cw hr+lder st j,m me A,naam �%/;.Yf 1 i 16c00/COM) I d Wtib2:130 E00F l2 'h EW 217SS99F20S 'ON 9N0HcJ --*41 31810919 ABNHJ WONJ CITY OF TIGARD 24-Hour (BUILDING � Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP Received — Date Requested_— AM �PM — OUP Location _ C02 Suiie p� MEC Contac' Person .� , 0-, h PLM __— Contractor_ �77-7V, a _ Ph( ) SWR BUILDING Tenant/Owner __ ELCQ. Footing FoundationELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam _ — Shear Anchors Ext Sheath/Shear Int Shoath/Shear Framing _ Insulation Drywall Nailing --- - Firewall Fire Sprinkler --- Fire Alarm G _ Susp'd Ceiling --- Roof Other: _ — ------- -- - -1t1c� .� Final PASS PART FAIL - — PLUMBING Post&Beam � v Under Slab Rough-In Water Service — Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain Shower Pan Other: -- Final _ W� PASS PART FAIL �- MECHANICAL Post&Beam _-- Rough-In -- --- ---- ---- -- ____._ Gar.Line Smoke Dampers - - --.--.-. Final PASS 1ART FAIL — - — - ELECTRICAL _ Service 'T- Rough In _- UG/Slat, Low Voltage Fire Alarm 44EQ' PART FAIL I] Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. ell=bWS E r� _ Please call for reinspection RE,-- Unable to Inspect-no access Fire Supply Line _ ADA /����} Approach/Sidewalk Date `- - �----- Inspector _Y z -- Ext Other: _ v Final T DO NOT REMOVE this Inspection record tram the job*No. PASS PART FAIL MECHANICAL PERMIT CITY OF T I G A R D DEVELOPMENT SERVICES PERMIT#: MEC2001-00383 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 10/31/01 PARCEL: 2S 116AD-09800 SITE ADDRESS: 16925 SW MONTEREY LN SUBDIVISION: KING CITY NO.13 ZONING: BLOCK: 19 LOT:002 JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRESSORS HOODS: FUEL TYPE'S _ 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30-50 HP: OD GAS PRESSURE: 50+ HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS C OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Installation of gas furnace, duct work and gas piping. Owner: FEES JOAN SNYDER Type - By Date Amount Receipt 12365 SW MARION PRMT DLH 10/31/01 $72.50 KING CITY TIGARD, OR 97223 5PCT DLH 10/31/01 $5.80 KING CITY Total $78.30 Phone:503-655-4829 - -- Contractor: ROTH HEATING ROTH ZACHERY HEATING INC PO BOX 1265 REQUIRED INSPECTIONS CANBY, OR 97013 Gas Line Insp Phone:503-266-1249 Mechanical Insp R:zg#:LIC 14008 Final Inspection This 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 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 these rules or di;ect questions to OUNC by calling (503)246-9189. Issue 8y: ? �'a ( Permittee Signature: Gam/ Call(50)/639-411175 by 7:00 P.M.for Inspections needed the next business day 10,'30/7001 15:54 5035393771 CITY nF KING CITY PAGE 02/02 na0%11FyU A A/Ci Pogo 1 ✓ 10%29/2001 14:36 5036393771 �a .CITY OF KING CITY TRI-COUNTY PAGE 01/02 SERviam-1 R Mechanical Permit Application City of King City ate received; �10 Pamit no.;MSC 13125 SW Hall Blvd. Project/appl,no-.: Sxpim am: Clackamas Tigard,OR 97223 Dan issued: Iiy Raa.ipt no.: Multnomah Phone; (503)639-1171,FAX:(.503)684_7297 �Q - Case Ale r1o.: Payment type Washington , . sand use approval: _ Building permit no.: 1 do 2 family dwelling 4r accessary O CominerciaUindustrial ❑Multi-family U Tenant Impfovetnent U New consauction ❑AddidoWallamtion/roplaeennent a odic: lob address: r- k :?,� ideate-Auipfnaftt quantities in boxes below.tndicate the dollar SWB no: _ . Sulie no.; +slue of All M&CMnied matorlaI&equipmertt,labor,overf,ead, Tax map/tax lot/accoutx no.; - profit.Value S _ I,ot' block Subdivision: •See AN't 111t for impoftw appllcallon Wlvrtrttutoa asid Project name: urtrdicriaw't a whedule for ret1Qemial permit e. City/County: ZiP: 1111 SNERENT Description id 1 son of wtxlc nn,pmnlises:. Y G at. daft of ci (w) TMW �letlott/inapecizon: _ -�"- ha a . )Aar6 tis.ey Teiuu:t improvement or change of tet; - —� : is exiadng space heated or conditioned?U Yes a No Air howlins unit CFM - .. ll:enisttlnK Insulated?J4 Yea 0 No +t_0a— A tendon of eld sfatsm cornpreitsors B.lainess nettle: Stale boiler permit no.. Ate. ,L�. _ __..-_----.-�.....____ HP Tans , Dili o o� rWWAm0k& Rqo e n am let _Clty: Stns Z1P: p sae wME _E'btlnc:��. Fsx• R„rneit: lfiseaUlneptlae ur,w_ � 1If" . Inchldina duotwort.ivent 14W■yes l]No �yQ� City/rnrmrno" nsal cs/e -0mVe WON,or floor ntor•r W Name(please tuj: vent ft`e Absorption unite BIUdi Name � /�►.,�' Chillers , HP —' Address.G�36.5 S., � _ compressors HP City: cacap ZIPM. ..a • rata. WOM : imme rent E-mail:E-•trail i al -- _Nance: hood tiro supptsrsion aysesm Exhaust fan with sl le duct fans) ta. NtaiYtag address: --- -____ x un aystyti !M or AC City: f p : ZIP: s piping as w to to e"wr arra)) Phone: Fax: -troll: LP© No t?il r 44lipi ing e a oven punTeis _ -1 Name: Number u of outlets piplasat r,cq _ m Address: - — — �t4er a a e:r pr PP wrens--� W City: --- Decorative" - - - - State: zIP:� Phone: FI E-mail: qo trove Aa,rt's ritnarsrre: !d all}vlaAki;m Strop!erelk cards.pinga all jnriseicybp ter n wr in(ornrr�lerl, Permit fEt......................$ _ l Villa JRMsn p. n IVVdcc:7ALe penatt Appik4wew M►:urnutn fee......- .......s r.di!'MH 1. rwsar• - OD - [6d 3 3� sepb+re jlrperaelfisnotrhshwd Paan review .t ..— ` EaplrM sr/s3�/ani deys g0ty k Ates been ) f -- Name°� Aol�r y Nerq e.rretfu cfrd —- eecrpted a aswrplet� State atftharse clear d amen �talav TOTA1.L..... .. ................s HOrsh laleelCOMI 011i rA CITY OF TIGA RD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 I / BUP Date Requested__ 11- 6 AM PM BLD Location ' Suite �'1 • 3 Contact Person ` Ph PLM Contractor Ph SWR _ BUILDING Tenant/ �� '`-�` _ ELC ' O Retaining WallELR Footing Foundation FPS Ftg Drain SGN Crawl Drain 71nspectio tes: Slab '��' SIT Post& Beam - r~ Ext Sheath/Shear 1 11 -0— ' '' ''" Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- Roof S' Misc: — Final PASS PART FAIL — --- — —---- _ PLUMBING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PAR.Z FAIL _ — HANI eam Rough In _ Gas Line _ Smo Dampers S PART FAIL _ KECT111CA61 �—� a Service — - Rough In ~ UG/Slab N - — Law Voltage Fire A m m ISS PART FAIL ----- — -- ---- W owl I& 'a Backfill/Grading - - - — Sanitary Sewer Storm Drain [ ]Reinspertiori fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please cal;for reinspection RE: [ ]Unable to inspect-no access Fire Supply Line - ADA / (C Approach/Sidewalk Date / / _ U / Inspector 1 Ext Other — t'— Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. ' CITY OF T I G A R DELECTRICAL PERMIT PERMIT tlx: ELC2001-00529 �^ DEVELC MENT SERVICES DATE ISSUED: 10/31/01 13125 SW Hall Blvd.. Tigard.OR 97223 (503)639-4171 PARCEL: 2S116AD-09800 SITE ADDRESS: 16925 SW MONTEREY LN SUBDIVISION: KING CITY NO.13 ZONING: BLOCK: 19 LOT : 002 JURISDICTION: KIN Prolect Description: Installation of 2 branch circuits for gas furnace and A/C unit. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS _ 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MANF HMI SVC/FDR: 601+amps- 1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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: JOAN SNYDER CANBY ELECTRIC INC 12365 SW MARION 790 S ;VY TIGARD, OR 97223 ,ANBY, OR 97013 Phone: 503-655-4829 Phone: 266-7878 Reg#: LIC 26071 SUP 2123S ELE 3-112C FEES _y Required Ins_pectlo^. Type By Date Amount Receipt Rough-in PRMT DLH '10/31/01 $53.50 KING CITY Elect'I Final 5PCT DLH 10/31/01 $4.28 KING CITY Total $57.78 This Permit is issued subject to the regulations contained in the Ti and Municipal Code,State of OR. 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 by the Oregon Utility Notification Center Those rubs are set forth in OAR 952-001-0010 through OAR 952-001-0080. YOU may obtain copies of these rules or direct questions to OUNC at(503) 246-6699 or 1-800-332-2344. / Permit Signature: (')V14 IPG -9 7-7,11 Issued By: 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 INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: �� /f/'Li e 9�Q _ DATE: — LICENSE NO: Call 639-4175 by 7:00pm for an Inspection the next business day Electrical Permit fl.tenatvaA: !p vrrtntrne. City of Tigard proeet/ (.no•t rixpiyuto C1ry).Mgar4 Address' 1'41)5 SW Ha)l Blvd,Tigard,OR 97223 Dateie9004: 13y Receipt oo.: Phone (503) 0539-4171 Fax: (503) 596.1960 Cast,file no.. Payment type. Land use approval: 191 tit 2 family dwelling or accessory C]Commcrula1/indurtdal O Muld-family ❑Tenant improvement 0 New constriction O AdditlorValteradon/MPlAcement O Other: _ (]pardal Job address: 4 n do Bld .eo.: Suits no.: Tax rna ax lot/account no,: L.ot--— slack Subdivision: _ Project name: " I Deseription end location of work on pramisea. Estimated date of eorripietion/ins ction: eo; IAta Ma>t Wo Business mortes: d roast no. er per Address: Cay - ST a�aul�tattt.olaa.aaa�et,wpr.o. city-! h State:tyz ZIP: 41114 t Sa vitutsic.da* Phone: g Fax fl_"-S_S45 Email: 1000.$4,ft,or lea -4 —�— —" - e sdd denul SUU c ,ft.orrtlo I thereof CCB no.: "2.Lo 91W-"t t Enbus. Ijc.no: 12 c --4--_�- United anetYy,residential2 ity/lnetro Hc.no.: 1 �i q^- --M /OP d 7l- Limlted .mat,-taei 40" O (5-k-.4 aschmae CWredhamemmodulardwelling Signature oftjjjosiadIMtritien(requirod) Dots U.L.L larvlttan&arfeader ( 2 ucenn not 2123 S er -w allraon, Step.sines,ttnrne(print): ��r4 .-- rnitemtsQoe ett�sloestitmt 100 limps or love 3 Wale(print): t m_4 amps _. - 4011fag"todODUWA 2 Mallin address: 601 am Sam S to WOO amps ��— " 2 City, u--- Stat: 211': _ t 1000 amps or vo is 2 Phone: M Fax: E-tna11; zxtnoao 1 Owner installption:T}tc installation is tx.ing made on pcoperry 1 own Temporary ea ar which is not intunded for sale,lease,teat,of exchange according to btetallallon'alhtsttloe.urrobestl°"' ORS 447,455,479,670,701. 200 iintor lets 2 XIi sm a to 400 tutr Owner's ill re: Date: 49 fa sm _ 2 Drent -sew, 14hoton, or extension pet bgaelt Name: _ A. Fcs for prMM circuity with purchuse of Address: service or fetrdw fee.each branch circuit " 2 Ci State: ZIP: A Fes roe brcntts:viU,out pur�httse — -- of Tyles mds. fcar fee,Ant branch cir�u,t 2 Phone: FAX: E meil: aIflonnI braneh Film" MW,(Ser""or Willie not e a ). Servicenvcr22S imps-corrwrr iol O Hcdlh-carrfacility Bachpomperinlyat3oncir0le 2 Cl O Sender ova 320 amps-rating of t&2 O Hrsardrntatneadon Bach si Or outline lit __-- w v 3 family dwaltingA O Rodding over r0,t ,squart feet kuror gran)a rev t')or a Ilmitad anergy panel. O System over fm volts nonunal mote Midendal units in one sncwfo altenlu0n,or extensian• j _ 2 0 guUdinitoverthrct'stories O Pctieem.40n amps or more O oempant load over 99,)mons Q Manutactu•ed umotura or PV parkdddhlmnl In. over the allowable In arty of ft re: F,grcadhghdntr'a•, O Chher _-- T— Perinspection Subnut sets of ptltae with emty of Iltr•above. invesu !tion fec The above are..net applicable to icon ports"con+4rucdon service. other Permit fcc. . ... ....• •.. _�� n yet n1i jtgtrdict vn wceM crrdo v vd4.ptaau call jutisdicucn far mon infotmnuoa Jotjce:This permit applicsUon plan rviev lel mmxMueete:ca expires if a ptrmll is not obtained S y'T j SILL_3 Lr{0 i`i�/ 0' vrithIn t8o days after It has been State sun ltargr IM S ' 't card qumbrr_ rt.r rc. TOTAL 4� t ( �1 r ucoepted as complete. ' 5(aAdGOMI nmouat aan.%r t Td Wd2-T :F T T 002 02 '13C) E VSS99Z 'ON 3NOHd DNI D I MID313 AHNbO W06A "U 16/30/2001 10:06 5036393771 ._ KING CITY 153008,W 110th Avenue,Kin`City,Opr h WW4- $ Phone:(603)988-4082•FAX(608)8899.8111 Notice To Contractors Working In hang City Due to an intergovernmental agreement with the City of Tigard, many boding related permits for projects in Kang City are issued and inspected by the City of Tigard. If your pernit application DOES YO r REQUIRE PLAN REVIEW, sirrlply cornpiew the appropriate application legibly and submit it to the King City staff. The King Cit,,- staff will collect all fees and fax the application to the City o`Tigard. City of Tigard staff wIII then create the permit, issue the permit,.and.perforin in3pectfons. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any Incomplete or illegible application will be retumed to King City staff for correction snd no processing will occur until a complete, legible application is received. If your permit application DOES REQUIRE PLAY REVIEW,this form must be signed by a King City staff}person. King City staff will simply sign this forth Indicating land use approval. Take this signed form to the City of Tigard Development Services Counter loca,ed at 13125 SW Hall Blvd, Tigard, to submit applieatione and plans. Development Services Technicians are available at 639-4171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits et the City of Tigard Building Department for the fo!loving project: locar,-d at:. !k-.NC u_ Z1 -O! King City Rep1•esentative da.4t utf-tut £d Wd8T:Z'; 1003 0£ '130 £bSS99Z : 'ON 34OHd OriI 0I810313 AHNUO WOad