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13473 SW CHELSEA '_P
CITYO F TI GA R D __MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ME02003-00649
13125 SW Hall Blvd., Tigard. OR 97223 (503) 6394171 DATE ISSUED: 1/10/03
SITE ADDRESS: 13473 SW CHELSEA LP PARCEL: 2S102DB-038UC
SUBDIVISION. CHELSEA HILL ZONING: R-12
BLOCK: LOT: 01:> JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: Y EVAP COOLEF.S:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/U 11PPL: VENT SYSTEMS:
STORIES: _ BO_ILERS/COMPRESSORS _ HOODS:
FUEL. TYPES _ 0 3 HP: DOMES. INCIN:
l_F'G 3 15 HP: COMML. INCIN:
MAX INPUTS BTU 15 - 30 HI: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: �'OODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN >=100K CTU• <= 10000 cfn: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Iw tall orfrc( ,tanding gas stove,hipim,and I outlet
Owner: F�rC _
�S
FORBES, MAR FIN T. Description �i Datia Amount
13473 SW CHELSEA LOOP ---
TIGARD, OR 97223 1MF('II] Permit Fee 11/10/03 $72.50
TAX I Y, State Surchart 11/1 J/03 $5.80
Phono: 503-639-3560 __ Total $7R 30
Contractor:
T& K MECHANICAL
11525 SW CANYON ROAD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Phone: S03-626-4652 Gas Line Insp
Heating Unt Insp
Ron #: LIC 121165 Final Inspection
Th s permit is issued subject to the requlations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all )ther applicable laws. All work will bq done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to folitrw rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
�✓
Issued 9y: < < _ �. ct Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanicil termit A,wlication
Dntereceivril:'I/lc;icy Permitno.• ) ? ; V3 -vv
City of Tigar Projectlappl.no.: _ Expire date:
C'ityoffigard Address: 13125 SW H Ivd,'Tigard,OR 97223
Phone: (503) 639-4171_ Date issued: By.t'$ Receipt no.:
Fox (503) 598-1960LIIY OF TIUf%RU Case file no.: Payment type_
RI III SING DIVISION
Land use approval Building permit no.:
TYWOF PERMIT
0 1 &2 family dwelling or accessory U Conunercrtl/indusilial U Muhl linin" U Tenant improvement
U New construction U Add ition/alterationlreplacement J Odwl
ITE 1R / $CIIIEDULE
Job address: 3 Lf 7 Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Suit no.: _ value of all mechanical materials,equipment,labor,overhead,
'fax map/tax lodaccovnt it().: *See
Value$
Tat: Block: Subdivision: 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit tee.
City/county: cs, ' 7.1P: 1�.TFANIIIIIIN DINE -1-1-RA FEE
Description and location of Aik on premises: A-CX-2 e
(4 a! r -- l(IC(esr,) Ajdal
Est.date of completion/inspe—ct on: L -5 �' peecri inn^ (XY. Res.only '.(I-s.ort�,
Tenant improvement or change of usc:
Air handling unit _ _ _______�•f�M_�___ - �__
Is existing space heated or conditioned'? Yes U No it con it on ng(aite plan required) _
Is existing space insulated?4Xes U Na I Alletaticn of caist ng C system __
ppl"Km Ica] of er compressors
State boiler permit no.:
Business name:
x i HP Tons BTU/H
Addren+. �Cl Fire/smoke amper, uct sato a etectors
City: State. r" ZIP: Heat pump(site pan required) ,
Fax: Install/replace urnac urner_—BTUIN
i`hone
�;. / , E-mail: Including ductwork/vent liner U Yes U No
CCB no.: Install/replace/relocateheaters-suspended,
City/metro lic.no.: cj (4, wall,or floor mounted
Name(please V 21forappliance of er t an furnace
t e gest on:
Absorption units BTU/H
Name: n 6'4t n -e,,- t Chillers Hi'
Compressors lin'
Address: 13 4 7 3 S L,, C lc(Sc "lcif nv rotunenta ex ust an v4+rt ar ou:
City: State: (�,I ZIP: '17 L Z. 3 Appliance vent
Phone:(,3 Fax: E-mail: Dryer exhaust
Hoods,Type res.kilt en/har.mut
_ hood fire suppression system
Name: ti►� ( �J Exhaust fan with single duct(bath fans)
Mailing addreF3: (. 7 3 5��t �' e Sr— K'�d7 x aunt s stem a art rom eat n or C
�--- l piping andistribution up to outlet
City: c State: ZIP: c?7 l Z- Fuel LPC; NO Oil
YIx� -.----
Phone: Fax: E-mail: -��'xs M( i in eat a t ons over autTets
Process piping(sc em'ucrequtrc
Number of outlets
Name: ter1Fde4l app ane^nr eLquTnent:
Address: Decorative fireplac!:
State: ZIP: Insert-type !— —
Phone: Fax: Email: oo stov pe et stove
Ot to v
Applicant's signature: Da1e: 1(- I L' ter;
Name 1ptinq: -� _ ts•--. 7�"t' ,��
Na all jurisdictions accept credit cads,please call jurisdiction for more information. Permit fee.....................$ 0
U visa U Master('a,l Notice:This permit application Minimum fee................$
expires it a permit is not obtained Plan review(al _ %) $
ExpiresCredit tea number. —_ � within ISO days after it has been
ted complete. surcharge(896). ..$ - u
--Ramof cadhohkr es shown one II c accepted as p TOTAL .......................$
S
Cadholder d#aume i Atnount 440.4617(600WOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMIL`r DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Tablo 1A MechFnical Code Qty (Fa) Arnt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to .00,000 BTU
$1.52 for each additional$100.00 or Including dt cts&vents _ 1400
fraction thereof,to and Including 2) Furnace 103,000 BTU+
$10,000.00. Including ducts&vents 17.40 _
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Flo,)r Furnace
$1.54 for each additional$100.00 or including vent 14.00
fraction thereof,to and Including 4) Suspended heater,wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 a,Id 5) Vent not Included In appliance permit
$1.45 for each additional$100.170 or 6.80
fraction thereof,to and including 6) Repair units
$50,000.00, 12.15 _
$50,001.00 and up $74.2.00 fo:the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for ea(,h additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp '
Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit
$ to 100K BTU _ 14.00
8%State Surcharge , $ 0) 15 absorb
unit 100kk to 500k BTU 25.60
-J t t
25%Plan Review Fso(of subtotal) $ 9) HP;absorb 35.00
Required for ALL commercial Pernits onl unit
.5-1.5-1 mil BTU
TOTAL. COMMERCIAL PERMIT FEE: s 10)30 52.20
,1,,,1 t-11.7.75 mil BTU absorb
F11)>50HP;absorb
--- -_-- unit>1.75 mll BTU87.20
ASSUMED VALUATIONS PEP.APPLIANCE: 12)Air handling unit to 10,000 CFM� 10.00
Value Total 13)Air handling unit 10,000 CFM+
Desai tion: Ol LEa Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-port!jble evaporate cooler
ducts&vents 10.00
Furnace>100,000 BTU including 1,70 15)Vent fan connected to a single duct
ducts&vents _ 6.80
Floor furnace Including vent 1 955 16)Ventilation sys,,m not Included In
Suspended heater,wall heater or 955 appliance permit 10.00
floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included in appliance 445 10.00 _
permit 805 18)Domestic incinerators 17.40 _J 1
Repair units _
<3 hp;absorb.unit, 955 19)Commercial or industrial type Incinerator
to 100k BTU 69.95
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101 k to 500k BTU 10.00
15.30 hp;absorb.emit,501k to 1 2,310 21)Gas piping one to four outlets
mIt.BTU _ 5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1.1.75 mil.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU _
Air handlin unit to 10 000 cfm 656 8%State Surcharge $
Air handling unit>10,000 cfm ---1,170
Non-portable evaporate cooler _656 _ TOTAL RESIDENTIAL PERMIT FEE: 3
Vent fan connected to a single duct 446
Vent system not Included In 856 -
appliance permit
Hood served b t Inspections mechanical exhaust 656 Other po and Fees:
ectionoutside of normal business hours(minimum charge-two hours)
Domestic incinerator 1,170 $62 50 per hour
Commercial or Industrial incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
Other unit,Including wood stoves, 656 $62.50 per hour
Inserts,etc. 3 Additional plan review required by Jianges,additions or revisions to plans(minimum
Gas I in
e 1-4 outlets 380 charge-one-half hnur)$62.50 per hour
ach additional outlet _ 63 'State Contractor Boiler Certification required for units>200k BTU.
TOTAL COMMERCIAL $ "Residential A/C requires site plan showing placement of unit
VALUATION: All New Commercial Bu0ings require 2 sets of plans.
I:WstsVormMmech-fees.doc 02/11/02
C1
1 Y OF T'GAR„ ELECTRICAL PERMIT
PERMIT#: ELC2003-00715 i
DEVELOPMENT SERVICES DATE ISSUED: 12/11/u3
13125 SW Hall Blvd.. Tigard, OR 97223 (50?1 639-4171 PARCEL. 2S102DB-03800
SITE ADDRESS: 13473 SW CHELSEA LP
ZONING: R-12
4'UBDIVISION: CPELSEA HILL
BLOCK: LOT: 015 JURISDICTION, TiG
Project Description: I istall 2 branch circuits. Wire for stove and kiln in garage.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: ^� 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL:
MANF HM/SVC/FDR: 60++amps-1000 volts: MINOR LABEL. (10):
SERVICE/FEE[ER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: i PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
FORBES, MARTIN T. DEKORTE ELECTRIC
13473 SW CHELSEA LOOP PO BOX 12379
TIGARD,OR 97223 PORTLAND,OR 97212-0379
Phone: 503.639-3560 Phone: 503-740-9769
Reg#: ELE 34-5410
LIC 143114
FEES stiP 41175S
Description Date Amount
Required Inspections
Iia.l'RMTj ELC I'crnut 1' 11 W $53.50
IAXjh 8 State Surcharge 1' 1 1 n,� $4.28 Rough-In
Elect'l Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All
workwill 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 follov rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952.001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at 1503)246-6699 or
1-800-332-2344.
Issued By: 1UG Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sa;'�, lease, or rent
OWNEWS SIGNATURE: _ _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: -/
Call 639-4175 by 7:00pm for an inspection the next business day
nEKORTE ELECTRIC LLC 5032882291 12/09/09 12192em P. 001
Electrical Permit ADDlicationFOR,OFFICE USE ONLY
— --- - Received nn Electrical r� V 71�
Drte/B :�O �r Permit No
City of Tigard(� PlamingA ro i Sign
is Dale/Fly: Permit No.:
13'25 SW Hall Blvd. Plan Raviev, Other
Tigard,Oregon 97223 DatrJB : Permit No.
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Internet: www.ci.tigard.or.us Date/By; Case No.:Contact 7 's See Page 2 for
24-hour Inspection Request: 503-639-4175 Namr.Vethod: f Supplemental Information.
y New construction Demolition Service over 225 amps. L I Health-care facility 1
cotntrarcial ❑Hasardous locatio,i
Addition/alteration/relacement I El Other: C1Service over 320 amps-rating of C]Building over 10,000 square feet,
. y, ..,:t. y' Vilit1 R 2 fanilly:wellings four or more residential units in
1 & 2-Fatnil dwellingLJ Commercial/Industrial D System over 600 volts nominal one structure
Acl Csso Building Multi-Family ❑Building over three stories ❑Feeders,400 amps or more
Occupant load over 99 persons ❑Manufactured structures or R"perk
Master Builder Other: 1]Hgress/lighting plan 0 Other: _-
4 ( �` Submit sets of pians with any of the above.
`�,� The above are not applicable to temporary construction service.
Job o site address _ y J�_ E t ,
r x.
7-2—
Suite #; $ldg./Apt.#: Number otias actions ter omit allowed
Project Narne: _ �- Description f Qty Pee(e■.) T„tat
Naw residential-single or multi-family per
Cross street/Directions to job site: dwelling unit.Indudl's attache,)garage.
�p►�r/h/��J A
Service Lvcludes
1000 so.ft.or less 145.15 4
Each addic ons $00 sg,A.or portion thereof 33.40 1
Subdivision: -� Lot#:_ Limited energy,residential 15.00 —_ 2
Limited enerxy,non residential 75.00 2
Tax map/parcel#: Each manufactured home or modular dwelling
a4, L. twI2I8 ►, " ' servfee anlUor feeder 11.90 2
Services or feeders-Installation,
—� OI alterarlon•tr relocation:
200 amps or'ess _ 80.30 2
r�-'--��-- 201 amps to 400 amps 106.85 2
401 amps to 600 Amps 160.60 2
r. 601 amps to It00 amps 240.60 2
Over 1000 amps tonits 434.63 2
Name: y __ _ _ ,_ Reconnect only - 66.83 - 2
Address: Temporary services or feeders-Installation,
C�/State/Zlp� _ T
alteration, le relocation: _
_ 20D amps
less t 66.85 1
Phonn: Fax: 201 amps to 400 am _ 100.30 2
1p ,' 401 to 600 amps _ 133.15 2
.c t?171d�F11%r41,N! it ' 11 y"y'y�'-` t Branch circuits-naw,alteration,or
Name: extension per panel:
Address: A.Fee for branch circuits with purchase of
service or feeder Ice each branch circuit 6.65 2
Cit /5 tate/K-ip_ B.Fee for branch circuits without purchase of
— -- -- scrAce or feeder fee,rust branch circuit Y 46.85 2
Phone, _ —, 1 ax: - _ Each additional bench circuit 6.65 2
E-mail- MIsc.(Service or feeder -•' eluded):
'�A T 4i,q cU+ft7�,�� � 'rte, t, i, �j.i �lAk Each um or Irrigation..tele 53.40 2
'a NS'. r jG Fach Iign of outline li sting 53.40 - 2
Job No: 0 3. Signal circuit(s)or a limited energy panel,
AUS1neSS Name: alteration or extension Pa e 2 _ 2
��- Description:
_Address: ok /t rq
Cit /State/Zi 7-" /lEL c�.�,7 Z Each additional Inspection over the allowable In anyof the above:
Per inspection r hour min.1 hour 62.50
Phonw 7,er 6 Fax W-Z 2.-3/ Investigation fee:
CCB Lic. #; Lie. #: 3 f— �{c- ~� other: — — 4$ !-.
—
Supervising clectriei rm" - -
/ _Subtotal o
Signati.tre required C Plaa Review(25%of Permit Fee $ _
Print I18me: Lic. #: S State Surcharge 8%of Permit Fee S LJr
_ TOTAL PEkMIT FEE S
Authorized Notice: This permit application expires If a permit Is no obi Ined within
Signature: G� Date: /g' a 3 180 days after It Mas been accepted as complete.
J. 'Fee methn0alogy set by Tri-County Building Industry Serviee Board.
(Pleup'C name)
4�i.lDstsV'etTtutF0rms\ElcPemdtApp r :Voc 011O3 „//)!���4/
r t �
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP
Received _ Date Requested_ AM is M BLIP _
Location f 3 4y 7 3— � -�-�__ —Suite —_ MEC 3 �
Contact Person — _ Ph PLM --
Contractor Ph( —) SWR — —
BUILDING Tenant/Owner -3, _ ELC -3—DO -7
Footing ELC _
Foundation Access: CC)
Ftg Drain M �3 (D ELR
Crawl Drain
Slab Inspection Notes: ` U�t_�>r,,l ,Lt� SIT
Post& Beam
Shear Anchors --
Ezt Sheath/Shear
Int Sheath/Shcar
Framing
Insulation
Drywall Nailing ------ — -
Firewall
Fire Surinkler - - -- — --- --
Fire
Ssup'd Ceiling - ----
Roof
Other:
Final
PASS PART _-.FAIL
PLUMBING
Post 8 Beam- --- -------T-_-._____-_-- — ---
Under Slab -- ---___----__---- _-- __
Rough-In
Water Service - -- ---- --- -
Sanitary Sewer
Rain Drains - - --
Catch Basin/Manhole
Storm Drain -------- -____ _
'shower Pan
G her: — - --- --
Finw
PASS PART FAIL ---- -- -- _-- - -'
_MECHANICAL
Post& Peam
Rough-In
aC—Line
Smo a ampera -� ------- -- — - ---- ---- - —
PART FAIL
ELECTRICAL_ _
Service-
ou
Low Vo Cage
re Alarm
c �P/tSS _PART FAIL Reinspection fee of$__ _-required before naxt inspection. Pay at City Hall, 13125 SW Hall Bird.
_ Please call forleinspection RE: Unable to inspect-no access
Fire Supply Line
ADA ,—
Approach/SidewalkDate-/ `>- lespoctor
Other:
Final DO NOT REMOVE this Inspection record frothe site.
PASS PART FAIL