Permit MEC �~
O.FT � PERM 1,
COMMUNITY DEVELOPMENT DEpARTMENT PERMIT #.......: MEC95
m1usSW Hall Blvd. Tigard, Oregon m72u°o199-'6194n1 DATE ISCUEZ2 ZE/23�1'E
PARCEL: 1S134CD-04000
CI7.7 P.D7;TESC.... ;2051T Ct;:, 12iCT
• GUBDIVI3ICN....: LERON :-EIGHTS WO.3 ZONING: 9-4.5
~ .. ..,. . . L�7. .... .....".. c68
-------- -___ ----------------
CLA= OF WORR..:ADD FLOOR FUAN...~: EVAP COOLERS:
TYPE CF LJSE. '.. :SF UNIT HEATERS..: VENT FANS...:
OCCL:PANCY C0P..�R3 VENTO W/O APPL: VENT GYST[MO�
3TORIES........:2 BOILERS/COMPRESSORS HOODS.......:
FL;G:L TYPES- -'-'---- e'3 HP....t DOVES. IWCl%:
�/8AS/ / / 3-15 HP....: COMM!. INCIN:
MAX INPT: BTU, ;.5-30 REPAIR UNITS�
DAMPERS?..: 30-50 HP....: WOODSTOVEC..:
GAS PRESSURE...: 50+ HP....: CLO DRYERS...
NQ. OF UNITS ----- AIR HANDLING UNITS OTHER UK:72.a
r_]RN { :OCK DTU,:1 (= 10000 cfs:1 CAS OUTLETS. �
FLRN )=100K BTU: > 10000 cfm:
:Resas[ REPLACE AECGGB<TT7L GAS r°1;RMAC[ ADD 3 Trn AIR
O wmerI -- -------- -----_-- - FEEC --------
BLANC;XAR%} aunt y date
n2250 SW 121S_ AVE PRMT $ 25.eQ CTR 05/23/95 -
5PCT $ 1.25 CTR 05/23/95 -
7 OR c;7223
#:
Contractor: ------ ----------------
A-P.CC:..!RA7E OIL GC •
6732 NE 47TH
�CRTLAND CR 972�Z ----- ------------------------------
i7.:6 TC
e 5339t
------ RECUT RED IN3P[CTIONS ---
p*ra t is issad to the rey cootainyo: in the Gas Line :ns:D
Cud* of CpeziaIty Codes azd all sttar Insp
work bz ir acco:darca Inspection
appr:v26 nlans. T}iz expi/* if xat is not startee; _ , _____. _______
18C Jays i�suamce, or if work is suszendsd for oore
E in days. --- ---_-____-----
'__-_-_-
---' • - ----------------'---
_ -_ -_ -- __
Permi�te. 3imnatcre:
. - _- _-_. _ . -- _ -- -'. _---_' _-- _ -
- -------_-__ _ ________ . _--
- Cy: ___-_-____ — ' -
Call far inspect ior. - 639-4175
•
P,
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Bled. APPLICATION Permit #.. CA - 53
PO.Box. 22 -.. -
. i
Tigard, OR 9 %223
(503) 639 -4171 .
N.- of Dw. Description •
' u� j- 5-0 S t,f- I --t S54-- Table 3A Mechanical Code QTY PRICE AMT
Job 1) Permit Fee -0- -0- 10.00
Address mod zp
/ n 4''7 2) Supplemental Permit 3.00
Norm i« 4 » Furnace to 100,000 BTU
(. 4-- 2 1) incl. ducts & vents I 6.00
CO
�mm � Furnace 100,000 BTU +
Owner _.4,-$4---- e- S' 79- 0 2) incl. ducts & vents 7.50
o. - L a Floor Fumance
rj , I 1 7,))3 3) incl. vent 6.00
• <",.•. •^•, Suspended heater, wall heater
4) or floor mounted heater 6.00
ua.a Ada«. Phone W ent not i •. in
Occupant 5) appliance permit 3.00
(*rses. zp Repa of heating, refrig.
• 6) cooling. absorption unit 6.00
Name • Boiler or comp to 3 HP
Al.-- It 4. 7) absorp. unit to 100,000 BTU 6.00
Adf... Boiler or comp to 3 HP - 15 HP •
Contractor �;7 — fJG L f?d am ' l t ai` 8) absorp. r p 500,000 P moo to 15 - 30 e Q q `) a- a- 9) absorp. unit .5 - 1 million BTU 15:00'
d. a.P.•.:•„ N•.. CA) B.R. Tax N•. • Boiler or comp to 30 - 50 HP
5 3 9 / / J -70 10) • absorp. unit 1 - 1.75 million BTU 22.50
i hereby adatowl : • •e at nave read this application that the Boiler or comp to 50 HP .
information given is correct, that I am the owner or authorized agent • 11) absorp. unit 1.750,000 BTU • - • 31.50
of the owner, that plans submitted are in compliance with State • Air handling unit to i S /j�
laws, that I am registered with the State Builders' Board, that the • 12) 10,000 CFM . C 4.50
number given is correct (If exempt from State registration, please Air handling unit
give reason below.) n 13) 10,000 CTM + 7.
u.� Eck Non portable
f 4/t /l/VL4--C. . c 71Y1 . _ /9-' 14) evaporate cooler -, 4.50
Vent tan connected - .
- _ 15) to a single dud _ = 3.00 . -.
Ventilation system not
16) included in appliance permit 4.50
sw•I•, « 'r
••,t) Dar Hood served by
/t ( � d J f2-- -- 17) mechanical exhaust 4.50
Describe new Q add '. Q alteration 0 repair 0.- Domestic type
to be done residential -- non - residential 0 • .18) incinerator 7.50
Existing use of Commercial or industrial
building or property 19) type incinerator 30.00
. Other i.e., woodstove, water
Proposed use of • 20) heater, solar, clothes dryers, etc. 4.50
building or property
21) Gas piping one to four outlets 2.00
Type of fuel - oil 0 natural gas 0 LPG 0 electric 0
22) More than 4 -per outlet
NOTICE - c›5�
Minimum Fee' SUBTOTAL
PERMITS BECOME NULL AND VOID IF WORK OR 2
CONSTRUCTION AUTHORIZED IS NOT. COMMENCED 5% SURCHARGE I
WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 PLAN REVIEW -25% OF SUBTOTAL .
DAYS AT ANY TIME AFTER WORK IS COMMENCED. Z61
TOTAL - (o
Special Conditions ii ,� w () �
Date issued -. —)- ) a by �1llV Y Q 1� X A-
1 AECNPMT
CITY OF TIGARD BQILD INSPEC NOTICE /-�
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639/4 1
Inspection: ,1../1/14/Ce —
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab j'ough- Fireplace
Post /Beam Struct. Plbg. Top Out Elec. "ough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation
Underflr. Insul. Shear Wall Gyp. Bd. -Elect
Date Requested: 14 Time: AM PM
Address: / Zb �C� /2-/
Builder: Permit #; > "J c -.0 / 53
THE FOLLOWING CORRECTIONS ARE REQUIRED:
/
/mil/
wirr ArdP,'"A"
Ins ector: Datc Z.
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
• v` 155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, INSPECTION REQUESTS: 503 /640- 3561/693 -4415
lip OREGON XXXXXXXXX - -> 640 -3470
Page : 1 of 1
Date : 05/18/95
Time : 09:48
Permit Type : Residential Electrical Permit Permit # : 05067846
Permit Status : APPROVED Applied : 05/18/95
Situs Address : 12050 SW 121ST AV TI
•
Issued : 05/18/95
Permit Title : SFR - CIRCUIT Completed :
Permit Descr. To Expire : 11/14/95
Project Title : SFR - CIRCUIT Project # : P0050083
Project Descr. : * EROSION *
•
Parcel Num5er : 251'1'1 - Land Use District :
Valuation 0
•
Legal Descr. •
Owner : INSPECTION - TIGARD Construction : OTH
Applicant Name : ANDERSON'S INTEGRITY ELECTRIC Classification : 900
Applicant Addr.: 18345 SW PACIFIC HW Occupancy •
TUALATIN, OR 97062 Validated by : PH
Applicant Phone: 524 -4h81 inspector Area :
Fee description Units Fee /Unit Ext fee Data
1st Branch W /out Feeder [Enter #3 1 35.00 35.00
Subtotal Electrical Fees: 35.00
State Surcharge of 5`a 1.75
•
Total Electrical Fees: 36.75
* ** Fees Required •* ** * ** Fees Collected & Credits * **
Method Check # Receipt No. Date Payment
CR 1908 05/18/95 '36.75
TOTAL THIS DATE * * * * * * * ** 36.75
Fees: 3 6. '/ 5
Adjustments: .00 Total Credits: .00
Total Fees: 36.75 Total Payments: 36.75
Balance Due: .00
•
•
NOTICE: This permit becomes null and void if the work or construction for which it is Issued is not commenced within 180 days. Once construction has started,
the permit becomes null and void if construction is interrupted for a period of 180 days. I certify that the information presented by the applicant and
his agent or agents in support of this permit is true -and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading information may invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for inspections at various times during the process.of construction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure pr • itted prior to approval by the
Building Department is solely at the risk of the applicant and such use or occupancy is revocable until all ins ection requirements are satisfied and
approval is given by the Building Official. I further acknowledge that a lien may be placed on the title of the p . perty upon which the permit is issued
specifying that the use or occupancy of the building or structure is provisional and revocable until the satisfa tion of all inspection requirements.
4: F .A.
APPLICANT S - IGNATURE
1
• WASHINGTON COUNTY
de. �' 155 N Department of Land Use & Transportation ELECTRICAL PERMIT
-i Inspection Section
155 North APPLICATION
ortrt h First Avenue, #350 -12
Hillsboro, Oregon 97124
Information: (503) 640 -3470 Fax: (503) 693 -4412
Permit /
PLEASE PRINT Number e9elt Date .S / 1 AS-
Please complete all sections, 1 through 5. 4. Complete Fee Schedule below
Number of inspections per permit allowed
1: Location of installation
Address _I 2-) CD ( "9...0 j a (srt-- Service included: Items Cost(ea.) Sum
Building A. Residential - per unit
CitVI I ,, ( Suite No.
1000 sq. ft. or less $110.00 4
Tenant Name Each additional 500 sq. ft
(if commercial) or portion thereof $25.00
Limited Energy $25.00 1
Map No. Tax Lot Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
Thomas Map Book: Page: (a 5 s Section: 2- .
Directions B. Services or Feeders
• Installation, alterations or relocation
200 amps or less $60.00 2
Commercial ❑ Residential lb 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
•
2a. Contractor installation only: � ',�. ` -� cz* 601 amps to 1000 amps $180.00 2
Over 1000 amps or volts $340.00 2
Electrical Contractor f r c» - E., -k Reconnect only $50.00 2
Address I Pyl 3 5 St „) vtc. 1 Y
City`�J.ikL State Ow- ZIP 2_ C. Temporary Services or Feeders
Date • Job Number Installation, alteration or relocation
Property Owner 200 amps or less $50.00 2
Contractor's License No. Sy - 3 (o3 L 201 amps to 400 amps $75.00 2
Contractor's Board Reg. No. 401 amps to 600 amps $100.00 2 .
Over 600 amps to 1000 volts see 'B' above
Signature of Supr. Elec' e / - -- .I/... 0 Aso D. Branch Circuits
License No. r 5 - one No. 2 - foe / New, alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder fee.
Each branch circuit $5.00 2
Print Owner's Name Phone No.
b) The fee for branch circuits without
purchase of service or feedei fee.
Address First branch circuit $35.00 3S 2
. Each add'nl branch circuit $5.00 2
City State Zip E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle $40.00 2
The installation is being made on property I own Each sign or outline lighting $40.00 2
which is not intended for sale, lease or rent. Signal circuit(s) or a limited
energy panel, alteration
Owner's Signature or extension $40.00 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection $35.00
Per hour $55.00
Please check appropriate Item and enter fee In section 5B. In Plant $55.00
4 or more residential units in one structure 5. Fees
Service and feeder, 800 amps or more 3 5 cr
System over 600 volts nominal A. Enter total of above fees $
Classified area or structure containing special 5% Surcharge (.05 X total fees) $ f 175
occupancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $
above apply. Not required for temporary construction Subtotal $
services. ❑ Trust Account $
Balance Due $ "(0.75
For inspections call This permit becomes null and void if the work authorized by the permit Is not commenced
640 - 3561 or 693 -4415 within 180 days from date of issuance of such permit or if the work authorized is
suspended or abandoned at any time after work is commenced for a period of 180 days.
24 -hour recorder; one working day in advance of need Electrical Permits are non - refundable and non - transferable.
8/94
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350 -12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/640 -3470
OREGON INSPECTION REQUESTS (24 hours): 503/640 -3561 or 693 -4415
Permit #: 05067846 Project #: P0050083 Status . APPROVED Paige i oL" _
Applied . 05/18/95 I-suer3 : 05. /18 /9, Expire: : 11/14/95 OU5 /22/9:; 0'5:01
RESELEC
Permit. Title SFR ° CIRCUIT OTH
Description Begun:GS /18195
Job Address 12050 LW 121ST AV T i
Owner Name INSPECTION - TIG;ARD Regir,n :.
Applicant Name : ANDERSON'S INTEGRITY ELECTRIC
P1-one number 524-4681 Valuation: 0 Approved
Inspector Comments: Re ject.ea X____
IVP- RE2ULT;
REQUEST ERROR.
Plumbing
Mechanical:
Electrical:_
St.ructrual :
General
Inspected by : •. ' 4 ._., _ Date 'S
Inspect_ion Requested:
* Final Electrical 0499 E AP DN
05/22/95 RI SI EARLY AM PLS 13