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11205 SV; BOXWOOD COURT
CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)631-4171 PERMIT #. . . . . . . .. MEC97-0 I
DATE ISSUED: 05/13/97
SITE ADDRESS. . . : 11205 9W BOXWOOD CT PARCEL: IS134AC-02621
SUBDIVISION. . . . : ENGLEWOOD N0. 3 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 178 JURISDICTION: TIG
CLASS OF WORV,. . :AI—T FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . : R3 VENTS W/o APPI-: I VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0-3 HP. . . . : 0 DOMES. INCIN: 0
:GAS 3-15 HP. . . . : et COMML. INCIN: 0
MAX INPUT: 0 STU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRF DAMPERS?. . : 30-50 0 WOODSTOVES. . : 0
GPS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF' UNITS----------- AIR HANDL..ING UNITS OTHER UNITS. : 0
TURN < 100V BTU: I <= 1,0000 cfm: 0 GAS OUTLETS. : I
FURN ) =100K BTUs 0 ) 10000 cfm: 0
Remarks i Installing a furnace, vent, and gas piping
Owner: ---------------------------------------------------------- FEES
DOUG GILLMAN type amaiint by date reept
11,205 SW BOXWOOD CT PRMT $ 25. 00 R V.15/13/97 97-294473
TIGARD OR 97223 5PCT $ 1 . 25 8 09/13/97 97-294473
Phone #: 590-5085
Cont ractcr:
ENERGY MASTERS HEATING & A/C
6470 SW 76TH
PORTLAND OR 97224
Phone #: f`=.44-8880 $ 26. 25 'TOTAL.
Reg #. . : 000585
RFOUIRED INSPECTIONS
This pervit is issued subject to the regulations contained in the Gas Line Ins
Tigard Municipal Code, State of Ore. Specialtv Codes and all other Mechanical Insp ........
applicable laws. All work will be done in accordance with Final Ins peat ion
approved plans. This pervit will expire if work is not started
within 10 days of issuance, or if mark is suspended for @are
than IN days.
Permittee 9 i at lit,e
Tssi.ied By .
Call for inspPetion 639-4175
CIT`( UP TIGARD Plan Checx
N!echanical Permit Application Recd By tyFJ
'13125 SW HALL BLVD. Commercial and Residential Date ROCA '3
TIGARD, OR 97223 Date to P E._
(503) 639-4171, x304 Date to DST
Print or Type Permit#
Incomplete or illegible applications will not be accepted Called
e of Deveb/gmenUProled Description _
'�9 ` f l Itntitil Table 1A Mechanical Code 0TY PRICE AfIT
Job StrsetAddress A) Permit Fee -0- 0 1 r.00
Address II.)L 5 -o !'ixi+ucrr4 Q-1. Suite* _
BiaGx
CRY/State Zip 8) Supplemental Permit 3,00 -'
- T le i,,c{, bIZ `1 721��
Name ro(name of business) 1.) Furnace to 100,000 BTU -
{ 6.00
Owner I-- C'l l� C'1 I 1 ��ya-b'1 incl.ducts 8 vents I
4ling Ada se i 2) Furnace 100,000 BTU «
l .2 C. rJ �11u �x u;(c_r{ �, incl ducts 8 vents 7.50
C. State I— Zip Phone 3) Floor Furnace -'
incl.vent 600
Name 16r name at business) 4) Suspended heater,wall heater 606
Sk t b ie- or floor mounted heater
Occupant Mailing Address — —
p I I - �- SCJ �(�Wl� �t� S y Vent not mCi m 3 00
1 t appliance permit
Cityi�Otrme I
ZIP phone6) Boder or Camp,heat pump,air Gond 6.10
�1 3 SIU ` �5 to 3 HP:absorp unit to 100K BTU
N 7) Boder or comp,heat pump,air Gond. 11,00
(.. %I, s r k 3 15 HP,absorp unit to 500K BTU _
ContraCtOr Maihnq A]d ss +t) 8) Boder or comp,heat pump,air Gond. 15.00
-7 -170 { U _l'� 15-30 HP;absorp unit 5.1 mil BTU
Attach copy of tyrStIme Zip Phone 9) Boder or comp,heat pump,air Gond, 22 50 !-
Curre (44 977 �. 30.50 HP;absorp unit 1-1 75 and BTU _
Oregon Const.Cont.Board Uc a Exp Patti 10) Boder or comp,heat pump,air Gond 37.50
C( c� e,-'r'L C ',/('9 ( I >50 HP;absorp unit 1 75 mil BTU
COT Business Tax or Metro N Exp Oct 11 Air handling unit to 450
_ CG0 f 1 It I ri 00 I `I 10.0CFM
4.50
NAfAe 12) Air handling unit 750
10,000 CTM_+
Or Mailing Address — 13) Non portable
450
evaporate cooler
Engineer Cdyistate --- zip Phone— 14) Vent fan connected _ 300
_Lo a single dud _
Descnbt:work New O Addition O Alteration(9 Repair O 15) Ventilation system riot 450
to be done Residential IQ Non-residential O included in appliance permit
Additicnal Description of work 16.) Hood served by mechanical exhaust 4 50
__ 1 7) Domestic incinerators 750
Existing use of 18) Commercial or ndustnaltype 3000
budding or property — _ epair units incinerator
19 1 R _ 4 50
Proposed use of 20) Woodstove 450
build,ng-property
21) Clothes dryer.etc _ -4 50
Type of fuel-oil O natural gas LPG O electric O 22) Other units — — 4 50 —
I hereby acknowledge that I have re:,d this application.that the 23) Gas Piorng one to four outlets I 200 �
information grven s red,that I art the owner or authorized agent of
the owner,that olan bmitted are in compliance with Oregon State 24) More than 4-per outlet (each) 50
law r {
Sign of Dwner gnt Data UTY.SUBTOTAL
Contact Persoh Name ~ Phone 5%SURCHARGE
I
7 A — PIAN REVIEW 25%OF SUBTCTAL
4-1
TOTAL
,,dstVnecttpmt doc (rev 7;'96) 'Minimum permit fee is S25+51%surcharge
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone: 6394171
I)ate Requested: I `� A.M. P.M. MST:
Location: c1eJ' y � BUR
Tenant: Suite: Bldg: MEC:
Contractor: ` PLM:
Owner: - - : p
C "_ ELC:
ELR:
_ SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam PostIl3vaun Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer liood/Nct Reconnect Vault
Bsmt Uamp I)rywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain INain A/C UG Slab
Shear/Sheath Fire Spklr/Ahn Crawl/Found Ur Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL, "M FINAL
moi, 7 rzz
f
zz
O Call for reinspection 0 kOnspection fee of S!_,_requited before next inspection nable to inspect
Inspector:2'1 Date: Patee__L_.of —
CITY 01"m TIG ARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.41-71 PERMIT #: El-C97-0281
DATE ISSUED: 05/13/97
STTE ADDRESS. . . : 11205 SW BOXWOOD CT PARCEL: 1!_-;i34AC-0262j
SUBDIVISION. . . . :ENGLEWOOD NO. 3 ZONING:R--,, 1-':
BLOCK. . .
LOT. . . . . . . . . . . . . : 178 JURISDICTION: TIG
Pro j e ut D e s cr i pt i o n v INSTL 2 BRANCH CIRCUITS
-
---------------------------------------------------- -------------------------- -
------RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---.-- ------MISCELLANEOUS------
1000 SF OR LESS- -- 0 0 - 200 amp. . . . . . . . 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' 1_. 500SF. . . .- 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT I- INELTG. . : Qb
LIMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . . . : o SIGNAL/PANEL. . . . . . . 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
------SERVICE/FEEDER---- ----BRANCH CIRCUITS------ ---ADD' L. INSPECTIONS--•-
0
NSPECTIONS——0 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . :
,"01 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : I PER HOUR. . . . . . . . . . . :
401 600 amp. . . . . . .. 0 EA ADDIL BRNCH CIRC: I IN PLANI.. . . . . . . . . . . 0
601 1000 amp. . . . . : 0 -----------.______-_PLAN REVIEW SECTION---------------
i000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . .. . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner. ------------------------------------------------------- FEES
DOUG GILLMAN type amol-trit by date recpt
1 120 5 SW BOXWOOD CT PRMT $ 4171. 00 TAT 09/ 13/97 97-294,+ 7.-,
TIGARD OR 97223 SPCT $ P- 00 TAT 05/13/97 9729447 '
Phone #: 590-5085
Contractors ------------
(GARY) COOPER ELECTRIC $ 41-7'.1. 00 TOTAL
11.845 SE 34TH ST
------- REQUIRED INSPECTIONS
MILWAUKIF OR 97222 Ceiling Cover Underground Cove
Phone #: 653-8803 Wall Cover Elect' I Servic(-,
Req ff. 000004
This pewit is issued subject to the regulations contained in the
Tigard Muniripal Code, State of Ore. Specialty Codes and all otht- Perme Signat' l.�.16
6
applicable laws. All Mork Mill be done in accordance with
approved plans. This persit will expire if work is not started lft�
within 180 days of issuance, or if work is suspended for sore
than IPA days. _FS'i U_—ed'
By —
_-_--_-_-----.----------_------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-----------------------------
9IGNATURE OF SUPR. ELEC' Ni DATE: cl-
LICENSE NO:
r,iii for inspection 639-4115
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # _—
Permit #
Phone (503) 639-4171
Uate Issued
CITY OF TIGARD FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: T :•5�0-,�a�' 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed ---
Addressrvn.rt incluckad Items Cost(ea) Sum
4s. Residential- unit ^
CitylState/Zip,/ 9�/r�_- �/Z• 9���_ P�
1000 w f1 or lees $11000
/
Ea
�' � ch addAional 500 sq II or
Name ( s) c' �' ��i. a- portionlliereol $2500 1
LimCommercial❑ Residential Each Energy $25 00
Each Manul'd Home or Modular 2
Dwelling Service or Feeder $66 00
2a. Contractor installation only:
� 4b. Services or Feeders
�/�"n_ �1� Inst00abon.alteralion,m relocation --` 2
2
Electrical Contractor r?'� -/�� 200 amps"or leen $6006 2
AddreSS�� S�S �3�7- r '/ ✓ 201 amps to 400 amps $8000 2
401 amps to 600 amps $12000
_ State Zi, -2 -- 2
City - _ x301 amps to 1000 amps $160 00
Phone No. _ r 3--SS _3 �� -// JC7 Over 1000 amps or volts $340 00 - 2
Contractor's License No.�3 Reconnect only $5000
Contractor's Board Reg Noy-?q i q 4c. Temporary Services or Feeders
Installation,alteration.or relocalion 2
Signature of Supr. Elec' / 200 amps or lees $50 00 2
License No. •� one No. 201 amps to 400 amps $7500
Ove401 rmps to 600 arrips 600 iloo 00
600 amps o 1000 volts -- --
2b. For owner Installations: ties above
4d. Branch Circuits
Print Owners Name New,sheratron or extension per penal
Address a)The lea lot branch circuits with
Purchase or service or Asci lee
(`illy State Lip___ 2
Each branch arcurt $500
Phone No. h)The ten for branch dreuds without
The installation is being made on property I own which is purchase of.«,rks or~polar Asp. �rz' `
First branch cuanl $3500 �- ��--`--
not intended for sale, lease or rent. Each additional branch circuit $600
Owner's Signature — 4e. Miscellaneous
(Serving or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation arde $4000
Fach sign or outline lighting $4000
Signal cimurt s)or it limited energy 2
Please check appropriate item and enter fee in section 5B. panel alteralron or extension �_ $40 00
4 or more residential units in one structure Minor l abets(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 net insperhon -� $'1500
Per hour $5`,Or)
In Plant
— $5,100
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. J. Fees:
s
NOTICE 5a. Enter total of above fees �
5%Surcharge(05 X total fees)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR flan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account K
Balance Due $
I
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