13071 SW Tearose Way 13071 S.W. TEAROSE WAY 1 OF 1
ADDRESS:
13O'71 S L Ttsp,r _
I:\records\microfilm\target8\busIding.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION •
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
I)atc Rcyucstcd A.M. i I'M MST:
I,ocatIon
l ima i — - — Suite'- Nldp MFC:
Contractor Phone PLM:
— — _
-- -- (_
Ovvrtcr- — — - — — Phone ELC: 97 c,31_Z
.-...—_ , t .-i-- ELR:
SIT:
BUILDING BLDG(con's) PLUMBING MF('HANI(AL ELECTRIC SITE
Site Post/Ream Post/licam Post/Ream Z'bverf, ice Sewer/Storm
Footing Roof I JmIFl/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Lias Line Rough-In IJ(i Sprinl-ler
Iowxltd'ou Insulation Sewer Ilood/Ihict Reconnect Vault
It.mt I M np Drywall Storm Furnace Temp Service MISC.
Ma:.onin Ceiling Rani Drain A/C IJ(i Slab
Shear/Sh.avth Fire Spklr/Alm (',awl/Fa ind Ik Ifwt Pump I.ow Volt _
Approved Approvalrpnwc pro
pv. Approved I
Apps/Sd k Not Appnncd Not Approved No 7�ppi ed proved Not Approved
FINAL FINAL FINA1. (-MAL, FINAL
P7 Call tier relnspcctirm ri Rcinspcctrcm fee of I rcyuued hclore nc.1 nspectinn C7 linable to inspect
Inspector - I tate <- Z ,7_7 7 - Page__ __----of --
I .
CITY OF TIGARD MECHANIC.4L
DEVELOPMENT SERVICES FERMI-
44 PERMIT N • MEC97-0197
13125 SW Hall Blvd., Tl and OR 97223 0. 639-4171 o
,, � ,. g l� ') DATE IS:,JEu: 416/ 1 9/97
PARCEL: 2S1O5CB-04100
S I ' E ADDRESS. . . : 13071 SW TE66ROSE WY
SUBDIVISION • BULt MOUNTAIN MEHDOWS NO. 3 ZONING: R -25
BLOCK. • LOT JURISDICTION: URB
CLASS OF WORK. . :NEW FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS. . : 0 VENT FINS. . . : 0
OCCUPANCY GF.P. . :HE VENTS W/O APPI : 0 VENT SYTEMS: N
STORIES • 0 BOILERS/COMPRESSORS HOODS • 0
FUEL TYPES - 0-3 HP • 1 DOMES. INC IN: 0
3-15 HP : 0 COMML. INCIN: 0
MAX INPUT: 0 I3TU 15--30 HP • 0 REPAIR UNITS: 0
F-I RL DAMPERS' . . : 30-50 HP • 0 WOODST OVES. . : 0
GAS PRESSURE. . . : 50+ HP • 0 CLO DRYERS. . : 0
NO. OF IJN 1 TS- --- ---- AIR HANDL.I NG UNITS OTHER UNITS. : 0
FURN ( 100K RT;1: 0 <- 10000 c f m : 0 GAS OUTLETS. : 0
FURN ) �.1O0K BTU: 0 ) 10000 r f m : 0
Remarks : instl 1 boiler/heat pulp/a-c unit// air conditionin units 'annot be
placed inside setbacks
SHEAN/DEBT THOMPSON type amount by date recpt
13071 SW TEAROSE LN PRMT $ 25. 00 TAT 06/ 16/97 97-296OL:i
T IGgRD Of' 9 ='C SPCT S 1 . in TAT 06/ 19/97 97--296E170
'thcne Ns
errcontract o r' t J.1_!.:.`_.c*--1?..4 •
_
PIONEER OIL
' 270 NE GLISAN SAN ST -
S 26. 25 TOTAL.
1-'ORTL.AN1) OR 972:0
Phone! N: 254-9595
Reg N. . : 0005713
------•- PE OUT REI) I NSPECT I ONS ---- --
Th,s pernit is issued subject to the regulations contained in the Mechar i ca 1 Ins p ___ ____
Tigard Minicipal Code, State of Ore. Specialty Codes and all other Heat ing lint Irisp
applicable laws. All work will be done in accorannce with Cooling Unt Insp
app-oved plans. This permit will eroire if war! is not started F i nal Inspect ion ____ _ _.
within 1811 days of issuance, or if i iii is suspended for tore
than 181 t'ays. ATTENTION: Oreson ', iw requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules art
set forth n OAA 952-1S1-N11 through OAR 952-N1-1881. You say —_
obtain copies of these rules or direct questions to O11NC by calling _ ...
1513)?46-9187. -- -
T r ,i e BY : a
L -<__.eta_ .�_,J P e r•o i t t e e S i gnat la r e t,_ _ ___-
++++++++++l•- +++++++4++++41 +++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 p. m. for inspections needed the next business day
++++-$-++++-!+++++4+++++++++4+++++++++++++++++4+++++++++++++++++++++++++++++++++++ -
116 11 97 11 I.; %1503 684 7297 CIT\ OF TI6.AR1t 002 002
Pian Crede e
CITY OF TIGARD
Mechanical Permit Application Re d By�
13125 SW HALL BLVD. Commercial and Residential Date Rec d
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 Date to DST__
Print or Type Permit• f 1 C� ] 11
___ Incomplete or illegible applications will not be accepted
Called_
, a U•.Mown.nvPigoDescoOton 'T T-.�_____
Table 1A��al Code CITY PRICE M$T
Job 9a.w•eewa Suess A) Permit Fee 4 -0- 10 0
Address > re ' t
EI ar --— 1) Furnace to 100.000 RTU — 600
hUu3mg duals&vents
Nara NrMei t>,rwe1) 2) Fume®100.000 BTU* l 750 _y
Owner £-%4 1 S Jt P(111 ti\IZ111 w_,G'l`-- snctudng ducts I vents
mamaAe� 3► Floor Furnace 6 00 —J
13c, l 1 -) w `'elr Q ' L t1,_� mdudlnq vent
-_- j vote1 �� lip Petr. 4) Suspended beater, vat Mater 6 00
or floor moulded Matte
vers( Pi or• set 5.) Vert not Included in�'�anna permit 300
,� I
Occupants Ad.".
8.) Bohr or comp.heat pump.or cond Mill 600
to 3 HP:absorb unit to 100K BUT"
teestwo Be rhos V 7) Baler or=nip.heal pump,an cond — 11.00 -
3-15 HP.absorb unit to SOOK BTU"'
Contractor "'Pm , s) Boiler x comp.heat pvrr ,as 0cnd 15.00
issuance(Prior 10 1 1( LL j 1 (''1 ( (, C 15.30 HP,absorb unt.5.1 mil BTU"'
aarw 1\ 9) Baler or comp,neat pump.air cond. 22 50 i
applitant 3450 HP absorb unit 1-1.75md BTU"'
must prove aU ~
provide 10.) Boiler or comp,heat pump.air cord 37 SO
contractor 1• 1) "11 1(4, '150 P' :absorb unit 1.75 mid BTU" _
harnse argon one Caret use Fac OUN 11.) Au handling une to 10,000 CRN 4.50 -
informaeon • _) 1{ 1 . /
for COT COY assn frr.e/;4�4.i ' .- 12) Air handling unit 10,000 CFI 7 50
database). _tl() V 1.1 /- yir
A rC hitect N•me 13) Nan-portable evaporate cooler — 4 50
or meansbm.as 14.) Vent fan connected to a single dud 300
Engineer C Seu• - _no�`"mere 15.) Ventilation system not Included to 4,50
L appliance pemrl
Desalt.work New td Addition 0 Aiersdon 0 Repew 0 16 1 Food served by mechanical"must 4.50 -
to be done Residential 0 Nort-eacldpnf 0
Addbene Descllpoon of work 17) Domestic norlerstors -`
7.50
+' ) (A 1 to r- 4 CI 1 I te.) Commercial or ndusblal Noe 30.00
-__`__ InCr1lrsoor
Existing use of ~19) Repair units 4.50
building or property-_
--— 2a.) Wood stove IS 4.50
Proposed use of
21.) Cedes Unser, _elm 4.50
building or property--_ ______,
22) Other etas 4 50 -----
Type of fuel-oil 0 netumI gas 0 LPG 0 eieetn: • 23.) Gas point)9 ogle to four outlets al 200 —
I hereby acknowledge/tat 1 have read(Ns application 'hat the 24) Mors than 4-prr outlets(each) .SO
information given coat Nat I am the owner or authr,med agent of
the owner that peens submitted are in compliance.with Oregon State OTY SUBTOTAL
1112
laws
Signature of OwnerfAgent Data —v "SUBTOTAL
f; ( VA SURCt•IARGE
(r 11 LC-1 :1 GO
Co . - P "" Phone PLAN REVIEW 25%OF SUBTOTAL
TOTAL
t:ldstM+ec^hpmltdoc (rev 9 *Minimum per rift a is 525 4. summer5summer —MI lend- -
——y-Resdenbei A/C requires sae plan showing plectenerlt of unit )(•. •f)) \�
r
t )r ✓jc" `� �"
2 -
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.
CITY CF TIGARD ELECTRICAL FERMI
1
DEVELOPMENT SERVICES PERMIT N: EPERMIT 83
4611��, DATE ISSUED: 0E /18/97
..A 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171
PARCEL: 'S105C6-04100
SUE uiDDRE5S. . . : 12,071 SW TEAROSE WY
SUBDIVISION BULL MOUNTAIN MEAPO49 NO. 3 ZON I N( :R -25
BLOCK • LOT JURISDICTION: URB
Pro. ect De script ion : Install two branch circi,its
.-RESIDENTIAL UNIT------- ----TEMP 3RVC/FEEDERS--- -- --MISCELLANEOUS--
1000
---- M I SCELLANEOUS------
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 50051-. . . : 0 201 - 400 amp • 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY • 0 401 - 600 amp : 0 SIGNAL/PANEL - 0
MANE. HM/ SVC/FDR. . : 0 601+amp. -1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
----SERVICE/FEEDER---- -----BRANCH CIRCUITS----- ---ADD' L INSPECTIONS---
0 -- 200 amp • 0 W/SE=RVICE_ OR FEEDER: 0 PER INSPECTION • 0
201 -- 400 amp • 0 1st W/O SPVC OR FDR. : 1 PER HOUR • 0
401 - 600 amp • 0 EA ADD' L BRNCH CIRC: 1 IN PLANT • 0
601 - 1000 amp • 0 - ------PLAN REVIEW SECTION --
1000+ amp/volt • 0 ) =4 RES UNITS ) 600 VOLT NOMINAL. . :
Reconnect only • 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner : --- --- - . ._.-. ------------------------- _.--- - - -- - FEES ----------• - . ._ .-.
DEBBIE THOMPSON type amount by date recpt
13071 SW TEAROSE LN PRMT $ 40. 00 JSD 06/18/97 97 296115
TIGARD OR 97223 5PCT $ 2. 00 JSD 06/18/97 97-296115
Phone M:
Loot r act or: -- ------ -- __.__
ADAMS ELECTRIC CO INC $ 42. 00 TOTAL.
2340 SE CLATSOP
---- - --- REQUIRED RED I NSPECT I ONS - --
PORTLAND OR 97202 Rough- in Elect' 1 Final
Phone M: 234--9651 I_Jnde"g- ound Cove
Rea $f. . : 000005
'his pewit is issued subject to the r'gulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 188
days of issuance, or if work is suspended for sire than 181 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Not ifrat in Center. Those rules are set forth in OAR 952-011-♦111 through OFR 9S-e-1181-19(17. You lav obtain a ropy
of these rules or direct questions to OUfC by callin,AO31246-1987.
i / _
Permittee Sign3t'.n-et j t i e L Issued "gy:
-OWNER INSTALLATION ONLY -
lie 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 SUN?. ELEC' N: DATE:
LICENSE NO:
♦*+ ++++++++++++++++++++++++++++++++++ }++++ ++++++++++++++++++++++++++++++++++++ 4
Call 639-4175 by 6:00 p. m. for an inspection needed the next businses day
. 1++ r++++++1 ++++++++++++++++1++++++++++++++++++++++tiff♦++++++++++++++++++++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SVl Hall B'vd
.. , . Tigard, OR 97223 Permit # � 0Lc Ci — y
S
Date Issued 04°
•I SIA Phone (503) 639-4171
CITY OF TIGARD FAX (503) 684-7297
TDD No (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed 1
Address /.Jt 7/ :3. /{f, 7t H,(I.:. 1—i9i1/E 2ervice included items Costiea) Sum --
CityiState/Zip ' 1 ,2 el', ' ' ' 4a. Residential -per unit
1000 sq h less $110 00 '
Name (or name of business) Di Pea_/_ 7/ f///)-.rrr,'7 Lech additional l.00 sq It or
patron thereof $25 00 -- -_--
W525 00
Commercial I] Residential Lg limited Energy
Each Manurd Nome or Abdul:,
Dwelling Serene or Feeder Ma 00 2
2a. Contractor installation only:
4b. Services or Feeders
/� Installation afWatlon or relocation
Electrical Contractor 1_l9(�/9•/•>IJ G�f c' !7t'/ L_ _ _ 200 amps or less S50 00 2
Adthess -Q f'L) -z,.i,f- . £'4,I 7 442/' _-" 201 amps lc 400 amps s$80 120 00 22
_ r r 401 amps Ic hi00 amps
City r�iia r State �� Zip yl�rte, $150 00 2
Phone NoQ=i+ - f(, / 601 amps to 1000 amps a 5340 00 — 2
'7 _ Over 1000 amps Vons
Job NO _ s Z {, J A Pernno",tonly $5000 2
contractor's license NO rJ1 L :s-e 4c. Temporary Services or Foeders
.- '5:37‘
Contractor's Board Reg No _ - Installation alteration rrr miocatron
Signature of Supr Elect` [17s 200 amps or less 2
..2 SSC` 201 amps In 400 amps s50 00
L(cense No
Phone No ,.j � �✓ 401 amps In R00 amps $75 00 2
Over 600 amps In 1000 volts $'00 00
2b. For owner installations: tae'°' abOVe
4d Branch Circuits
Print Owners Name_ - - Nevi anerar on or',tension pm,,Me
Address aI The Ice for branch clrr.0 is with
City _ -—�_-- StateH Zip purchase of service. fowler lee f
Fall Manch rrcuf $6 00
Phone No Ti The lee for Ma.-h circuits without
The installation is being made on propely I own which is purchase of write et,'hock,M '
nott intended for sale, lease or rent tura,branch cIcc it 1_ $35 00
Each additional MMch circuit / $R 00 3"
Owner s Signature _ _ — 4e Miscellaneous
(Service or feeder not included) 2
3. Plan Review sectio'f (if required): 1 itch pump or rogation circle — $4000
E itch sign or outline II.IMmg $40 00
',oriel cNCuills)or e limited MMgy _-_-- 2
Please check aptlroprlate It.rm and enter fee In section SB panel alteration or extension $4000
4 or more residential unit in one structure Mine 10,141101 _ 5100 00 _—_
_
Seance and feeder 22°. amps or more
ystem over 600 volts nom nal 41 Each additional inspection over
i iassiflet' area or structure containing special occupancy the allowable in any of the above
as descnherl in N E C Chapter 5 "' s"' ' $75 op
I nr n., . -- -- ----....
$65 00
Ian. $ss 00
Submit 2 sets of plans with application where any of the above
apply Not required for temporary construction services. 5. Fees:
NOTICE Sa Fntr•r total of above 'les ! /4_____---
5"/ f
Surrharye I05 X totalees) $ _ .. . _.r
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal S _%_L
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF Sb. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec fl S
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal S
COMMENCED -•'n I 1 Trust Account a
S
ra.
Balance Due
$ 2 1