Permit (199) CITY OF TIGARD MECHANICAL PERMIT
■ ` COMMUNITY DEVELOPMENT Permit#: MEC2018-00686
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2018
T t AI.t7 g Parcel: 2S110AC00200
Jurisdiction: Tigard
Site address: 11000 SW ANNAND HILL CT
Project: Annand Height,Lot 23 Subdivision: ANNAND HILL SUBDIVISION Lot:
Project Description: Adding NC unit. Placement of NC unit must comply with manufacturers requirements.
Contractor: WINDWOOD CONSTRUCTION INC Owner: ANNAND HILL LLC
12655 SW NORTH DAKOTA BY RICHARDS, M DALE
TIGARD, OR 97223 12655 SW NORTH DAKOTA ST
TIGARD, OR 97223
PHONE: 503-625-6526 PHONE: 503-768-4375
FAX: 590-7606
FEES
Specifics: Description Date Amount
Air Conditioning 08/29/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/29/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/29/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.2 .1987 or 1.800.332.2344.
Issued By: / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Applicatio .,` FOR OFFICE USE ONLY
City g DateofTigard ReceiBvey: PA
' A/ /f / , Perm& 0/•01E- `,
- a 13125 SW Hall Blvd.,Tigard,OR 97223 Q I t' 9 i Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ' a �° " Date/B : M. i IMS
Inspection Line: 503.639.4175 Ready Date/By: luris: Q See Page 2 for
TIGARD Internet: www.tigard-or.govI Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
KNew construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: ['Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
. - ,G /. / 0 Addition of new motor load of system
4
Job#: Job site address: AA ACil 4 100HP or more. ❑"A","E",°`1-2","1-3",
City/State/ZIP: / rd 3 ❑Six or more residential units. occupancy.
Qf ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: -4m Iv6/ 'L V 145 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
c'7/ f� FEE SCHEDULE
e vDescription I Qty. I Each I Total I *
ry New residential single-or multi-famil• dwelling unit.
Subdivision: ,/,1c ,t C�' //-1 L' Lot#: Includes attached garage.
�f 1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add•l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
/ (with above sq.fi.) 75.00 2
�/�f r/ /� Limited energy,multi-family f
75.00 2
residential(with above sq,ft.)
Renewable Energy 0 See Page 2
„a-PROPERTY OWNER 0 TENANT
Services or feeders installation,alteration,and/or relocation
Name: 6(/llvdittreodcl (-lft.s 6,116.44 1JAL/� 200 amps or less 100.70 2
Address: �(!Sv S' j[ ,- /! Pet,h/A s � 201 amps to 400 amps 133.56 2
T" 401 amps to 600 amps 200.34 2
City/State/ZIP: 70 turd t272,2.3 601 amps to 1,000 amps 301.04 2
Phone:( 1 •ii"7'brp_-L/3 7 Fax:( '3 ) 570 —7‘,‘,4 Over 1,000 amps or volts 552.26 2
` � � Temporary services or feeders installation,alteration,and/or
Email:it ti,d` d'v, (}�KYlveS ,4fl, 6It.(4 d ,((/A relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449.670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
ICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: , a, , above service or feeder fee,
lJ'' each branch circuit 7.42 2
Contact name: B Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: i Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: ( ) Fax: : ( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 4f-co -5C )k--I.t.)7/f C- Sign or outline lighting 67.84 2
// Signal circuit(s)or limited-energy
Address: �e '//ICI—) °OJ ri dca 2" panel,alteration,or extension. ❑ See Page 2 2
�� �ilJl`` Each additional inspection over allowable in any of the above
-
City/State/ZIP: ,- E 47'1)-43-'5
Additional inspection(1 hr min) 66.25/hr
Phone:,zj3) 57 q ...z....--2,ti Fax:((-(/ ) 4.Yb.9-97,3 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
Inspections for which no fee is 90.00/hr
CCB Lic.:/q1..,,2„2,6. Electrical Lic.: ,,--' Suprv.Lic.:Lf 5 specifically listed(V2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name A,ns 5 ih 4 A Date:6/ZE`/r(/ 0 Plan Review Required(25%of permit fee):
!/ State surcharge(12%of permit fee):
'— __ _ �•� TOTAL PERMIT FEE: ���"�
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: A 1r-1 q a /toe-4 Date/_ -t! `O days after it has been accepted as complete.
�/ * Number of inspections allowed per pennit.
1:\BuildingtPermits�ELC_PermitApp_ELR_ERE.doe Rev 06/17�'IS 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11000 SW ANNAND HILL CT, TIGARD, August 30, 2018 at
OR, 97224 12:31 :00 PM
Record Type: Record ID:
Residential - Mechanical MEC2018-00686
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor