Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00407
' .T1GARD 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171 Date Issued: 08/07/2009
Parcel: 2S114BA10600
Jurisdiction: Tigard
Site address: 16355 SW WOODCREST AVE
Subdivision: Lot: 0
Project: Sherwood
Project Description: 2 branch circuits
Owner: FEES
SHERWOOD, CHARLENE R Quantity Description Date Amount
3240 NW 112TH PL
PORTLAND, OR 97229 2 crt Branch Circuits 08/07/2009 $53.50
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/07/2009 $6 42
Electrical
Contractor:
CANBY ELECTRIC INC
790 S IVY ST
CANBY, OR 97013
PHONE: 503 - 266 -7878 •
FAX: 503 - 266 -5543
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION Oregon law - .uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 95 • -0 40. You may obtain a copy of the rules or direct questions to OUNC by calling.503 246 6699 or 1 800.332.2344
Issued By: Perrnittee Signature: —
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
• LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Aug 05 09 12:17p Columbia Heating /Cooling 503 - 598 -0270 p.2
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Mechanical Permit Applicatio r' I � :
Received • Permit Rs . i dr B / D4C:
City of Tigard atr/By.
jig a 13125 SW Hall Blvd., Tigard, OR 97223 AUG 0 5 2009 D Odra-Permit
a Phone: 503.639.1171 Fax. 503 598 1960 Date/By: O ur g See Page Z for
•
inspection Line: 503 639 4175 C �]F'�'�GARD Nou 6odlM lc h 1 supplemental lafot matioa i
rt�nttr Internet: www tidncd-or.gov BUILDING DIVISION •
TYPE
' C O)\ RC_iRL.. FEE' SCUEDU,4E , :- i1$E CFiECia•LST l
OF WORK - Mechanical permit fees' are basal on the value of the wort.
0 New construction Rndditionhtllcration /replacement performed Indicate the value (rounded to the nearest dolro� of all l
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and P
.. Vtiluc S
CATEGORY OF CO>•iSf RIJ�IION. :a0.'? - At : E (jfpNff,N'T / SY5TEri15,FEES`
ti: ,
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use check!isi.
❑ Multi-family ❑
Master builder ❑ Other. Description 1 Qty. Ea Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling
�1 J Air conditioning or heat pump 1 ) q,04
Job site address: /5335/5335 H t��l7�dlt! <<'vr.� ' (requires conditioning 1
Firm eec 100,000 BTU (ducts/vents) 14.00
CiglState2lP: 'i 7�r, Oil_ G7ZZ Cf Furnace 100,000+ BTU (ducts/vents) 17.90
�� �� JJ 14.00
Suite/bldg. /apt. no.. 1 Project name: Gas heat pump
Duct work 14 00 Cross street/directions to job site: Hydronic trot water system f 400
Residential boiler (radiator or 14.00
hydronic)
Unit heaters (fuel-type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.: Other: 1000
Tax map /parcel no.: Other fuel appliances
Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
r '' .f iY 4° Flue vent for water heater or gas 10.00 • rt•' f _�. - - - fireplace
-eLy 7 �i / J - Wood/pellet stove 10.00
V I, ' . � .: ..- -•_ - i � ..�. ' .. •.".. Wood fireplace/ insert 10 00
/ 10.00 10.00
e - . mutAinerlflue/vent
I ❑ TENANT Chi ey
Q] PROPERTY OWNER `il
Nam /� Environmental exhaust and ventilation
e ��� pow,.., Range hood/other kitchen
equipment 0 00
Address: I N 3 3f Sc. /f�I e �iaD G` - IU.o4
Clothes dryer exhaust
City/State/ZIP -- -1-;, a g7 z2 <-/ Single -duct exhaust (bathrooms, 6.80
- d F ame ( ) toilet compartments, utility rooms)
Phone: (J�j) ,SJ�� . 50. 5 c Attiderawlspace fans 10.00
❑ APPLIC4 NT ❑CONTACT' PERSON Other: 10 00
Business Warne: Fuel piping
C 1 / v $5.40 for first four, $1.00 for each additional
oct ame
n��� b I Furnace,
Address: Gas hen[ pum p
City /State/LIP. WalUsuspended/ttnit heater
' ! )..S-- c Water healer
Phone: 03 ) f.-)D•1 [ Fax..( f � Fireplace
E -mail. RanRo
CONTRA Barbecue
/� .� Clothes dryer (gas)
Busi nano : ( ? a I tom% b / w N i/t 4t (:.OV I rllQ Other
Address. 3 0 .0 „ 3 0 3 `, ( J/1 (/J[ MECHANICAL PERMIT FE ES' I
-\ 1
�D l Subtotal
City /State/ZIP: " ! / V e Z0 0 0_, 77 Z�/ Minimum permit fee ($72.50)
Phne: o (5 ) `r f L) Fox: (53-l) ) � ! _�0 Plan review (25% of permit fcc) H
5,-- State surcharge (12% of permit fee) I Si. CCB tic.: (v TOTAL PERMIT FEE 1 V t St
. This permit apptiadon expires if a permit is tmt obtained within 180
Authonzed signature: days after it has been accepted as complete.
1 Foe methodology eat by Tri County Budding Industry Service Boar
Print name: ' boil L � � 1 Date: �f , {lJ c�• I
a,•.r ft, rmirnunt•Fltt
Aug 059 12:17p Columbia Heating/Cooling 503-598-0270 p.3
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HEATING & COOLING, INC.
P 0. BOX 230397 TIGARD, OR 97281
(503)624-2704
SITE PLAN
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