Permit CITY OF TIGARD ELECTRICAL PERMIT
' • COMMUNITY DEVELOPMENT Permit#: ELC2018-00575
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2018
T t c.; I£Dg Parcel: 2S110AC00200
Jurisdiction: Tigard
Site address: 11000 SW ANNAND HILL CT
Project: Annand Height,Lot 23 Subdivision: ANNAND HILL SUBDIVISION Lot:
Project Description: Adding(1)branch circuit for A/C unit.
Contractor: DREAMHOUSE ELECTRIC LLC Owner: ANNAND HILL LLC
221 SW MOONRIDGE PL BY RICHARDS, M DALE
PORLAND, OR 97225 12655 SW NORTH DAKOTA ST
TIGARD, OR 97223
PHONE 503-648-5144 PHONE: 503-768-4375
FAX: 503-648-9723
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 08/29/2018 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/29/2018 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: • egon law requir-s you to ollow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throug'AR 95, '01-0090 ou may oo ain a c.'y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: A[/ .4��fL.J- Permittee Signature:
/ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONL1'
City of Tigard Received �
Fl , n q Date/By: a 7 (/ ,e4111111:1 „,
13125 SW Hall Blvd.,Tigard,OR 97223 F'.,,...`Ti 2 J c.0; Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: BJ See Page 2 for
Internet: www.tigard-or.gov -- Notified/Method: Supplemental Information
TYPE-0014 044 CS iVI1%IERt'IAL FEE*T$ <" t; " 'US1 E KL.IST f
Mechanical permit fees*are based on the value of the work
.E New construction El Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY, OF CONSTRUCTION RESIDENTIAL EQUU IN1NT/SYSTENIS FEES*
and 2-family dwelling El Commercial/industrial El Accessory building For special information use checklist.
❑Multi-family El Master builder ❑Other: Description Qty. Ea. Total
AI
Heating/cooling;SITE INFORNITOHtrip: CATi4N'
Air conditioning 46.75
Job site address: 1/�� Al J Q� A/ ,, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: /Ti c)V� ��, "` Furnace 100,000+BTU(ducts/vents) 54.91
/ Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32 ,
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: /24, /!X Lot no.._3 Other: 23.32
� 4
pn/-iOther fuel appliances:
Tax map/parcel no.: Water heater 23.32
'". Gas fir lace/insert 33.39
it
`.n. 0 'r - 's,> r x m - Flue vent for water heater or gas
/9,C fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
w :. a.; Other: 23.32
:.'1,-_,....,..4,... I.T.,:, PERT _flWNEIt A. * „
444 / /�•��r . _ Environmental exhaust and ventilation:
Name: �r,-.(/u9 (�,1 y"4- , Range hood/other kitchen
pcc-s- &-) !W equipment 33.39
/�
Address: [ �� Clothes dryer exhaust 33.39
City/State/ZIP: 7 d,?,/ t Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) b0--4/3 7 S" Fax:( ) Attic/crawispace fans 23.32
1 ."Al9- .r." r ®.a:, "i- ', r'. .0;CONTACT PER Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
1 ®,. . 0 : .. Clothes dryer(gas)
Business name: . Other:
lamr,/ kt., MECHANICAL :W 1
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 5—a/floor
' TOTAL PERMIT FEE too F()
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date/4//6
I:\Building\Penni C_PermitApp_040113.doc 440-4617F(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total.Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
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 12:32:15 PM
Record Type: Record ID:
Residential - Electrical ELC2018-00575
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor