InitiallyGood ADDRESS:
i.\records\microflm\targets\building.doc
DEPARTMENT OF LAND USE&TRANSPORTATION
/ WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
�/ 155 NORTH FIRST,HILLSBORO,OR 97124
COUNT I INSPECTION REQUESTS: 503/840-3561/-441
1
OREGON 9`9't
PHONE: 503/848-B
Pi.ge 1 of 1
Date 03/21/94
Time 14 : 39
Permit 'Type Residential Electrical Permit Permit- # 05051210
Permit Status, APPROVED Applied 03/21/94
Situs Address 10270 SW BROOKSIDE PL TI Issued 03/21/94
Permit 'Title SFR - ELEC/2 CIRCUITS Completed :
Permit Descr. To Expire 09/17/94
Project Title SFR - ELEC/2 CIRCUITS Project # : P0039035
Project Descr. * EROSION
Parcel Number 251'TI - Land Use District t
Valuation U
Legal Descr.
Owner INSPECTION - TIGARD Construction OTH
Applicant Name WEST SIDE;' ELECTRIC: Classification 900
Applicant Addr. : 7518 SW MACADAM AV Occupancy R3
PORTLAND, OR 97219 Validated by KF
Applicant Phone: 245-3385 Inspector Area I
CONTRACTOR : WESTSIDE ELECT. Lic. C 26-135C 245-3385
F'ee description Units Fee/Unit. Ext fee Data
------------------------------------------------------------------------------
1st Branch W/out Feeder [Enter #] 1 35 , 00 35 . 00
Addl, Branch W/out Feeder [Enter #] 1 5 , UU 5 . 00
Subtotal Electrical Fees : 40 . 00
State Surcharge of 5% 2 . 00
Total Electrical Fees : 42 . 00
*** Fees Required *** *** Fees Collected & Credits +�**
---------------------------- -----•----------------------------------------
Method Check # Receipt No. Date Payment
CK 14262 03/21/94 42 . 00
TOTAL THIS DATE ********rr 42 . 00
Fees : 42 . 00
Adjustments: . 00 Total Credits : . 00
Total Fees : 42 . 00 'Total Payments : 42 . 00
Balance Due: . 00
NOTICE: This perm"becomes null and void If the work or construction for which It Is Issued Is not commenced within 190 days. Once cons ruction has started,
the perm"becomes null and void If construction Is Interrupted for a period of 190 days. I certify that the Information presented by the applicant and
his agent or agents In support of this pernr"It true and correct to the best of our knowledge. I acknowledge that the Building bepar!ment's rellanr t
upon false and misleading Information may Invalidate this perm". All provisions of applicable lave and ordinances governing 111.0 construction and use
of this building or structure will be complied with whether or not specllled on the plans or noted on the plans correction sheets. 1 acknowledge that
the granting of a perm"dross not grant suthor"y to access private property or to use easements. I further aeknowliwiis that the use or Occupancy of
the structure or bulld!n;l permitted depends upon my calling for Inspections at various timet during the process of construction and the building
inspection staff verifying compliance w"h the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable untlt all Inspection requirements are satislled and
approval Is given by the Building Official. 1 further acknowledge that a lien may be placed on the I"le of the property upon which the permit Is Issued
specifying that the use of uecupancy of the building or structure Is provisional and revocable until the sallsfactlon of all Inspection requirements.
APPLICANT'S SIONATURIE
WASHINGTON COUNTY ELECTRICAL PERMIT
DepartmerK of Land Use & 'Transportation
Electrical Inspection Section
155 North First Avenue,#350-12 APPLICATION
Hillsb.fro, Oregon 97124
Information: (503; '40-3470 Fax: (503) 693-4412 Project/Permit
Number _ �-5/2�1 rate � 2- (
PLEASE . . _
Please complete all sections, I through 5.,
4. Complete Fee Schedule below
Number of Inspections per permit allowed
1. Location of Installatic,� � . -- --
Address 1���-
�1�� i5/ J/C Service included: Items Cost(ea.) Sum
Build' A. Residential-per unit
City /i C! Suite fJo. -- ---
1000 sq.ft.or less $110.00 4
Tenant Name Each additional 500 sq.ft
(it commercial) or portion thereof __ $25.00 _
Umited Energy $25.00 _ 1
Tax Lot _ Map No. --- Each Manuf'd Home or Modular
Dwelling Service or Feeder _ $68.00 2
Thomas Map Book: Page:_�._�_ Section:_ _
Directions_____._ __ -- B. Services or Feeders
-- Installation,alterations or relocation
Commercial ❑ Residential C- 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 — — 2
2a. Contractor instal a oq only, 801 amps l 1000 amps $180.00 2
i Over 1000 a amps or volts _ $340.00 _ 2
Electrical Contractor ( ��— Reconnect only ____ $50.00 — 2
Address l n�>" ��•
Date_ JoboNum� 1 In Temporary Services or Feeders
Property Owner _ _�ir� �3 �U U.vl >/Q Installation,alteration or relocation
Contractor's License No. G �/ 200 amps or lose $50.00 _ 2
Contractor's Board Reg. No. 201 amps to 400 amps $75.00 2
401 amps to 800 amp" $100.00 V _-._ 2
Signature of Supr. Elec'n -- Over 800 amps to 1000 volts see'B'above
License No._ 'S f S P one No. 2' D. Branch Circuits
New,alteration or extension per panel
2b. For owner Installations: a) The fee for branch circuits with
purchase of service or feeder fee.
tint ner'e f3ame one o. Each branch circuit �_ $500 2
b) The fee for branch circuits without
Address -—-- purchase of s rrvks or feeder fes.
First branch circuit ,_ $35.On — _ _ 2
city State Zip Each add'ni branch cilcult $5.00 2
E. Miscellaneous (Service or Feeder not Included)
The installation is bein� made on property I own Each pump or Irrigation circle_ $40.00 2
which is not intended Tor sale, lease or rent. Each sign or outline lighting __ $40.00
Signal circuit(s)or a limited
Owner's Signature energy panel,alteration
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
Please check appropriate Item and enter fee In section Gt3. Per hour �— $55.00
In Plant $55.00
_4 or more residential units in one structure
_Service over 800 amps; feeder 800 amps or more 5, Fees
___System over 600 volts nominal A. Enter total of above fees $
_ _ClassNied area or structure containing special 5% Surcharge (.05 X total tees) $ _ �-
occupancy as described In N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with appllr:ation where any of the pian Review if required (Section 3) $
above apply. Not required for temporary construction Subtotal $
sprvlces. -
Less Bulk Label Fee $
Balance Due $
For inspections tali
Thla permM beeomaa null and vnld M Iha work aulhorlrsd by the permM la not txrmmencetl
640-3561 or 693-4415 whhln ISO days from data of laausnca of auch pormll r H the work eutherleed Is
awp'nded m abandoned al any tlm�o"w work locotnmeneed for•parbd oftso dnya.
24-hour recorder, one working day In advance of need EleMrloal psrmlts ate non-rofundabls and non traneforehle.
1,'s<
INSPNGTION NOTICE
City of Tigard Building Departasnt
13125 611 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree--O-Phone)s 639-4175 Business Phono: 639-4171
Inspections_ �Aa��N
Footing P1bq. Underalab Hoch. Rough-in Appr/&Wlk
Found. Plbg. Top out Gas Line FINALS
Post/Ream Struct. San. Sower Framing _81419,
Post/Beam Hoch. Rain Drain Insulation _F1usab,
Flb9. Underfloor Nater Line G
ff QI/ yp. Bd. -Koch.
Date Requesteds �V�' Tines 11M ,_FN
Address, (62-20 1�1V(J()i-�� I trrit #e MC-_70 �rY-m 73
Builder, _ l o Z(�" 2-76Y
THEFOLLOWINGcOkRECTI()NS ARE PEpUIREDi
Inspectors— Date,
__, APPROVED --` DISAPPROVED `/ APPROVED SUBJECT To ABOVE
__call For Relnnp.
MECHONICAL.
PERMIT
CITY OF TIGARD PERMIT #. . . . . . .. : MEC94-0073
COMMUNITY DEVELOPMEN DATE ISSUED: 03/15/94
.3125 SW Hall 814.Tigard,Orogon 97223e8199 (503)839-4171
PARCEL: 25102BB-00811
SIYE ADDRESS. . . i 10270 SW BROOKS ICE PIL
SUBDIVISION. . . . : BROOKSIDE PARK ZONING: P-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5
CLASS OF WORK. . :NEW FLOOR FURN. . . . EVAP COOLERS:
TYPE OF USE. . . . :SF L1N1T HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . :R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES. . . . . . . . %2 BOILERS/COMPRESS09S HOODS. . . . . . . :
[--_UEL 0-3 HP. DOMES. INCIN:
: /VAS/ 3-15 HP. COMML. INCIN:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. . . . : WOODSTOVES. . :
GAS PRESSURE_ - 50+ HP. . . . : CLO DRYERS— :
NO. OF AIR HANDLING UNITS OTHER UNITS. : 1
F=URN ( 100K BT*U: l <= 10000 c f m: GAS OUTLETS. :
FURN ) =100K BTU: 10000 cem :
Remarks : INSTALLING F 7U RNANCE ANL"` WATER HEATER
Owner: FEES _._-------_--._
LANDERS type 3MCIAnt by date recpt
I.0r-'70 SW BROOKSIDE PL PRMT $ 25. 00 BLT 03/1.5/94
5PCT $ 1. 25 BLT 03/15/94
IIGARD OR 97223
Phone #:
Contractor: ---------------------------------
COLUMBIA HEATING
8900 SW BURNHAM
SPACE E-11121
TIGARD OR 972;-,3
Phone #: 624—.._'..'704 $ 26. 25 TOTAL
Reg #. . .- 76359
------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
Tioard Municipal Code, State of Ore. Specielty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This 'permit will expiry if stork is not started
within 180 days of issuance. or if stork is suspended fey, more
than IPA days.
Permittee Signatures
Tssued By:
Call for inspection 639--4175
City of Tigard MECHANICAL PERMIT Planck/Rec. # —
13125 sw Hall Blvd. APPLICATION Permit # _
Tigard, OR,97223 —
(503) 639-4171 ry G2'r213-c'06,
-— scnpbon
j Table 3A Mechanical Coda - CITY PRICE AMT
Job 1) Permit Fee 0 0- 10.00
Address stA--- np -
7T� f�JJ 2) Supplemental Permit 3.00
^�^•auma o 1 '000 Blu
,Ct-�J Zcl 1) incl,duds h vents / 6.00
-�a..•. -�� -
Furnace , -13T3TCT+
Owner 2) incl.ducts&vents 7.50
BP F urnaance II
3) incl veru 6.00 I
healer,ovaallheator v --
,yjt�_ 4, or floor mounted heater 6.00
Occupant en not'r�on—�`
5) appliance permit 3.00
-r-Tynsw— epair o eatin,rein-g. -- ----
6) doling,absorption unit 6.00
I .7 WTOr-or cornp�aTpwnp-gv d - -
�L 7) to 3 HP absorp unit to 1004 BTU 6.00
-� ••�, �"( �" Eleder orcomp-wit air corK --
Contractor • 8) 3.15 HP absorp unit to 500K BTU - 11.00
or comp,hoot pump,Para .
9) 15.30 HP absorp unit.51 mil BT1J 15.00
-t T�
Boiler or compTieat pump,air coif ---
10) 30-50 HP absorp unit 1-1.75 mil BTU 2.2.50
-7-R—or-05—yacknowleage that I have read as ap rca an, is e - boiler or comp, a pump,air Zo-M. -- --- ��
information given is correct,that I am the owner or authorized agent 1 1) >50 HP absorp unit 1,75 mil BTU 37.50
of the owner,that plans submitted are in compliance with State — r handling 5nd te - -� --
laws,that I am registered with the Construction Contractor's Boanl, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, r handing unci -- -
please give reason below.) 13) 10,000 CTM+ 7.50
Non portable
14 evaporate cooler 4.50
lVent Ian connected
15) M a single dud 3.00
Vonfilation system not
16) Included in appliance permit 4.50
served
17) mechanical exhaust 4.50
srn w new a a►on a n repair L� mmeraa or mdustrialto b e done residenbal,®' non-r"clential Q 18) type incirwalor 30.00
t.%sTn use o �`- - ier r.e—woo stove,water---
building or property � 19) heatar,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to fair outlets 2.00
building or property ---
Type
Type of fuel-oil 0 natural gasg LPG Q electric O 21)-More than 4-per outlet.,-_--
NOTICE
Minimum Fee$25.00 SUBTOTAL 01
PERMITS BECOME VOID IF WORK OR CONSTRUCTION -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCMARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY`TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED. - -
TOTAL
Special Caid6ons
Data issued by
wd*1
►.x'r',r lJF TXI'li?h17 - ti;F::C:[ +1'T' l.,i F!AYMF.NT' FtF;'(:E IF''T NO.' v 94-.PTAMY4
CHECK AMOUNT 4 52.;A
AIMF a COLUMBIA 111,,�:ATIN(:3iTOCII. N(3 C:A9H AMOUNT a pi.00
I71)Ctih'�a4 a
8906 SW PURNHAII ST PAYr!F;MT DATE, 3i 1ti/94
I TOARI), ORF:I UN SU13DIVISICTN u
`a7c'P3...
UF:PCTW CTP" P(IYMk.:N'T RAMCCINT P0.r.0 PRlRPOLSF: UF' PAYW;'N7 AMOUNT PAJ 1)
'C, 134h1AN C CAI.. F'I" 1 6 C'M Pl0 Sl .. F11.17 1 1) VIE 1< 1
F'C:HAMICAI... WF' 10P70 70 SM P P5.it 0 ISI BI1 111) ►'F.R
1'V I A1. AMCII.IN T Poll) 50