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13195 SW ASF? URIVH
CITY OF 71GARD MFCHAN I CAL
PERMIT
DEVELOPMENT SEMCES FERMI #, . . . . . . : ME;'99-"0092
13125 SW Hall Blvd., Tigard,0R 97223(503)639-4171 DATE ISSUED: 03/04/99
PARCEL: ,w 102CA•-•00214 I
SITE: AT`^"<ESS. . . : 1.3195 SW ASH DR
SUBDIVISION. . . . : VIEWCREST -rFRRACE ZONING: R-4. 5
BLOCK. . . . . . . . , . . ?I LOT. . . . . . . . . . . . . :012 JURISD'CTION: T16
- -
CL�46SOF WORN . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE..",—SF UNIT HErATERS. . : 0 VENT FANS. . . : 0
t...",CUPANC^ ,' GRP. ., : R3 VENT. E W/O AP'PL: 0 VENT SYSTEMS: 0
STOE•;IES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
Q-3 HP. . . . : 0 DOMES. INCIN: 0
-15 HP. . . . : 0 COMML. I NC I N: 0
MA': INPUT: 0 PTU J5-30 1 IF-'. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 3(--130 HP'. . . . : 0 WOODSTOVES. . : 0
GAS PREF;,SURE. . . 51)+- HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UN I'l S----------- AIR HANDLING LIN I'T'.; O"'HER UNITS. : 0
FURN ( 11160K BTU: 1 (= 101100 cfm : 0 GAS OUTLETS. : 1
TURN ) -1Zt01', BTU: 0 > 10000 cfm : 0
Remarks : Install a new yas furnace and gas piping.
Owner: --- _____---_._-----------------.___....._._._...._.___.__-.___._______ FE=ES
JOSEPI- FORRETTE I-" pr amol-tnt by date recpt
' 2196 SW DASH DR PRMT L5. 00 13EO 0`,/04/99 99-313446
TIGARD OR 97223 SPCT ti J . 2G GEO 03/04/99 99•-313446
Phone #: 639--2465
Contractor: ------------------•-------- -..-
OWNER -•_-- ----__._____________.___.______._ _-_--
f 26. 25 TOTAL
Phone #',
Rey #. .
------ - REQUIRED INCPECTIONS
This permit is issued subject to the regulations contained in the Gas Line I n s p
ligard Nuaicipal Code, State of Ore. Spe6alty Codes and al' other Heating Unt Insp _—.—
applicable laws. All work will be lone in accordance with Final Inspection
Approved plans. This permit will exp.-e if work is not started
%;thin 180 days of issuance, or if work is suspended for sore _ � --
than 188 days. ATTENTION: Oregon law requires you to follow rule;
adopted by the Oregon Utility Notification Center. Those rules are —
set forth to OAR 952-881-8818 through OAR 952-801-8888. you may -
obtain copies of these rules or direct questions to (XK by calling
4
I <ss1.te By: PlPrmittee Si gnat i_tr e : G
r
+-++++++++++t+++A+++++++++++++++++}•+++++++++++++++t +++++++4-+•1•1••+++++++4•+++•4-+f 4t+
Call 639-4175 by 7 ,00 p. m. for inspections needed the next bi_tsiness day
L
v+++
Plan Check#
CITY OF TIGARD Mechanical Permit Application Rac'o By
1 v 125 SW HALL BLVD. Commercial and Residential Date Recd
T.GARD, OR 97223 Date to P E.
(503) 6394171, x304 Date to DST
Print or Type Permitni'�` -c''
Incomplete or illegible_applications will not be accepted Called
r i IJJame of Development/Pmied Description —�
1 J 5 VTable Table 1A Mechanical Code Jt Price Amt
Job Street Address A)[ Sunett A Permit Fee 10.00
Address 1) Furnace to 100,000 BTU —v
including ducts 8 vents see footnote 1,2 6.00
Bldg# C�YJState zip 2) Furnace 100,000 BTU+
including ducts&vents see footnote 1,2 7.50
Nen( ame of business 3) Floor Furnace
Owner A)yr� {� including vent see footnote 1,2 6.00
f -
Malling Address /1 — �) Suspended heater,wall healer
�� `� /1`S or floor mounted heater see footnote_1,2 _ 6.00
1 fiv/7 vl _ 5) Vent not included in appliance permit
Clj�/stete
Zi Phone 3.00
I ro/ 97a�3 C�3Check all that apply 'Boile,r Heat Air
Na (or name of laustFor Items 6.10,see or Pump Cond Oty Price Amt
footnotes 1,2 Comp
( 6)<3HP;absorb unit to
Occupant Malting Address 100K BTU 6.00
7)3-15 HP;ab,3orb unit
CnyiState zip Phone 100k to 500k BTU — 11.00
8)15-30 HP;absorb
unit.5-1 mil BTU 15.00 _
Contractor Name� �, 9)3.0-50 HP;absorb
( _ unit 1-1.75 mil BTU 22,50
Prior to permit Mailing Address 10)>50HP;ab.urb unit
issuance,a copy >1.75 mil BTU 37.50
of all licenses cnyistaie� —- zip Phone 11)Air handling unit to 10,000 CFM
are required If _ _ 4.50
expired in COT Oregon Const Cont Board Lk.# Exp Date 12)Ali,hanJling unit 10,000 CFM+^�
database !� _ 7.50
Architect Name r 13)Non-podable evaporate cooler
y° I 4.,,5
0
or Melling Address 1,#)Vent fan connected to a single duct
3.00
_ 15)Ventilation system not included in
Engineer Clty!Stme Zip Phone �plian __—_
® '--� —
--i
_ a tierce eby 4.50
16)Hood served by mechanical exhaust
Desa;be work to be done: 4.5_0
17)Domestic incinerators
New 0 Repair O Replace with like kind: Yes O No O _ _ ..50 _
Residential O Commercial O 18)Commercial or industrial type incinerator
30.0.0 _
Additional information ur de , ion of work: 19)Repair units
4.50 _
20)Wood stove
NOTE- For Commercial projects only,':rits over 400 lbs require _ _ _ 4 50
structural gas calcs. _ __ 21)Clothes dryer,etc +
Type of fuel: oll O natural gasK LPG O electric O _ _ 450
___ 22)Other units
I hereby acknowledge.that I have read this application,that the information _ _ 4.50
given Is correcJf that I am the 0 er o uthorized agent of 23)Gas piping one to four outlets
the owner, plans sub 9 mpliance with Or c ws _See footnote 1 200
__.-- q 24)More than 4-per outlet(each)
Signa of Ownef/Agent Date If
/ 50
`Minimum Permit Fee$25_.00 SUBTOTAL
Contact Qersan�lame Phone ——
(-,lJ /{'-
5%SURCHARGE
Ll�rI
_ _ PLAN REVIEW 25%OF SUBTOTAL ,
Foortintitils,lor commercial projects only: Required for ALL commercial permits only
1. Provide full schematic of existing and proposed gas line and pressure i TOTAL 4
2. Provide drawings to scale showing existing and proposed mechanical Gam.
•State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:lmechperm doc rev 02,4199
ELECTRICAL PERMIT
TY OF
T'G A R®
PERMIT#: EI_C1999-00523
DEVELOPMENT SERVICES DATE ISSUED: 8124199
13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 PARCEL. 2S102CA-00214
SITE ADDRESS: 13195 SW ASH DR
SUBDIVISION: VIEWCREST TERRACE ZONING: R 4 'i
BLOCK: 01 LQ%G1NA1-
JURISDICTION: TIG
Proiect Description: Installation of one branch circuit.
I _ RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'I- 500SF: 201 - 400 amp. SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS --__ _ ADD'L INSPECTIONS
0 200 amp: W/SERVICE OP. FEEDER. PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FnR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
_Reconnect only: SVC/FDR >= 225 AMPS_ CLASS AREA/SPEC OCC:
Owner: Contractor:
,JOSEPH FORRETTE OWNER
13195 SW ASH DR
TIGARD, OR 97223
Phone: 639-2465 Phone:
Reg#:
_ FEES _ Required Inspections
Type �ByJ Date _Amount Receipt Elect'I Service
PRMT DEB 8/24199 $37.50 99-317914 Elect'I Final
5PCT DEB 8124/99 $2.63 99-317914
Total $40.13
I
This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all othe. applicable laws
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 than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utilitv Nctification Center. Those
rules am set forth in OAR 952.001-0010 through OAR 952.001-0080 You may obtain obpies of these rulit.ordirect questions to OUNC at(503)
246-1987 /
ISSl3.D BY:
PERMITTEE'S SIGNATURV
_ OWNER INSTALLATION ONLY
The installation is being made on property I n which is n t intended for sale, lease, or rent.
. -.
OWNER'S SIGNATURE: �F v DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DAT'E:_
LICENSE NO: ,_----- ---------__—_.___.— --- --—
Call 639-4175 by 7:00pm for an inspection the next business day
CITY (''" TIGARDElectrical Permit Applicat'�n Pla�j' heck-tl�J� _
131'2.5 :,WW HALL BLVD. Recd ey
Date Recd 9-,-;) I-l/
TIGARD OR 97223 -
Date to P E.
Phone(503)639-4171, x304 Date to DST
Inspection (503)639-4175 Print of Type Permit u
Fax (503) 598-1960 Incomplete or illegible will not be accepted Caned
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development /�o ee Number of Inspections per permit allowed
Name(or name of business) _ t' '6? Service included: Items Cost Sum
Address_ .3 J J LLQ 4a. Residential-per unit
1000 sq h or less $ 1 1 7 75 _ 4
City/State/Zip_ 7_ � S _ .__ Each additional 500 sq.fl.or
1-� portion thereof $ 7675 _ 1
Commercial ❑ Residential lL Limited Energy — $ 6000 _
Each Manufd Home of Modular
?a. Contractor Installation only: Dwelling Service or Feeder $ 72.75 z
(Prior in permit issuance,applicants must provide contractor license 4b.Services or Feeders
information for COT data base). Installation,alteration,or relocation
Electrical Contractor 200 amps or less $ 84.25 2
Address 201 amps to 400 amps $ 85.50 2
Cit State--` 2i 401 amps to 600 amps $ 128.50 2
Y — --Zip �_--- 601 amps to 1000 amps $ 192.50 2
Phone No. Over 1000 amps or volts _ $ 363.75 2
Job No. Reconnect only _ $ 53.50 2
Elec. Cont. Lice. No. T Exp.Date 4c.Temporary Services or Feeders
OR State CCB Reg. No.—� Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No Exp.Date _ 200 amps or less $ 53.50 _ 2
201 amps to 400 amps $ 80.25 _ 2
Signature of Supr Elec'n 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
see"b"above.
License No _ _ _Exp.Date
Phone No 4d.Branch Circuits
--- --- New,alteration or extension per panel
a)The fee for branch circuits
25. For owner lnsta latlons: with purchase of service or
_ feeder fee.
Print Owner's NaTe 1'f Each branch circuit _ $ 5.35 z
Address b)The fee for branch circuits
without purchase of service
City e Stat Zip or feeder fee.
Phone First branch circuit $ 37.50
Each additional branch clrcuit $ 5.35
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease 7ren (Service or fPt:Jtrr not Included)
Each pump or irrigation circle $ 42 75
Owner's Signature._ r Each sign or outline lighting $ 42 75
Signal clrcult(s)or a limited energy
w Section f required):* Mipanel,alteration or extension $ 6000
3. Plan Revie
�. nor Labels(10) $ 10700
Please check appropriate item and enter fee in section 5B. 4f.Each additional Inspection over
_ 4 or more residential units in one structure the allowable In any of the above
— Service and feeder 225 amps or more Per inspection —�— $ 5000
--- --- Per hour J $ 5000
System over 600 volts nominal In Plant $ 5900
--Classified area or structure containing special occupancy as
described in N E C Chapter 5 5. Fees: ?_ j 0
Be.Enter total of above fees
* Submit 2 sets of plans with application where any of the above apply. -9'16 Surcharge(05 X total fees) $
Not required for temporary construction services. 741) Subtotal E
8b.Enter 25%of line go for
NOTICE Plan Review if re wired(Sec.3) $ _
PERMI' BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZFD Subtotal $ —
IS NO i ;;0MMENCED WITHIN 190 DAYS,OR IF CONSTRUCTION OR 11--11
WORK IS SUSPENDED nR ABANDONED FOR A PERIOD OF 180 DAYS LJ T,ust Account#
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ /
i:\dsts\firrms\cicctrfc.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Lime: 639-4175 Business Line: 639-4171 - -- —
BUP
Date Requested Requested " LAM PM _ BLD
Location �1CY C i/-L — Suite Suite MEC
Contact ��
ontact Person J Del Ph PLN'
Contractor Ph SWR
BUILDING Tenant/Owner _ ELC
Retaining Wall ELR
Focting Access:
Foundation FPS
Ftg Drain - SGN
Crawl Drain Inspection Notes:
Slab ��
_ .��5..� c
Post&Beam
BeamS - - - - -- -
Ext Sheath/Shear _
Int Sheath/Shear -
Framing --- -- ------ ---- —
Insulation
Drywall Nailing
Firewall - — -- --
Fire Sprinkler
Fire Alarm
SuSp'd Ceiling -
Roof
Misc: - ---- --- ----
Final
PASS PART FAIL ------------ - - -. _�_
PLUMBING
Post& Beam -
Under Slab
Top Out -
Water Service
Sanitary Sewer
Rain Drains
Final -
PASS PART FAIL
CHAN
Post R 96arn - ----- - - - - -- -
Rough In
Gas line - - - -
Smoke Dampers
PA5 PART FAIL
ELECTRICAL - - --- _
Service
Rough In -�
UG/Slab
1.ow Voltage _ -._ -------- - _ _-_ --------— — --
, ,.e Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading --� - - - - — -- -
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ _required befo,P next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE:_--�— ( J Unable to inspect- no access
ADA
Approach/Sidewa;kDate r� `�.� Itc t� Ext
Other _ - p
nR ec --------- --
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.