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InitiallyGood c:v cn m c r 3 O c z D_ L O D v i 11560 SW BULL MOUNTAIN ROAD CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT PERMIT #: ELC97-0238 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 04/17/97 PARCEL: 2SIlOBD-02100 SITE ADDRESS. . . : 11550 SW BULL MOUNTAIN RD SUBDIVISION. . . . : ZONIN(3:'i-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG Pt,o.j ect Description: Reconnect only --RES I I'ENT I AL. UNIT----- ---TEMP S RVC/FEEDERS---- -----MISCELLANEOUS------ 1000 ----MISCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 - 200 anop. . . . . . . : 0 PUMP/I RR I CAT I i1N. . . . : 0 EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 ----SERVICE/FEEDER---- ----BRANCH CIRCLIITS--.---- ---ADD' L INSPECTIONS--- 0 - 200 amp. . . . . . : 0 W/SERVIC:E OR FEEDER: 0 PER INSPECTION. . . . . : 0 400 amp. . . . . . : 0 1rt W/0 SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . ; 0 401 - 600 amp. . . . . . : 0 Eil ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ---- -------------PLAN REVIEW SECTION----------------- t@00+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 1 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner-: ----___-- ------ -____-_- ---- ----------------- --- --- FEES ------------------ JACOUIE CHANDER type amol_Irit by date recpt 11550 SW BULL MT RD PRMT $ 50. 1210 B 04/1.7/97 97-293427 TIGARD OR 97224 5PCT $ 2. 50 B 04/17/97 97-2934P7 Phone #: ' 0•1t ract or^t -----------•-- _---------------------- ---------------------------.. OWNER b 52. 50 TOTAL -- - - - -- REQUIRED INSPECTIONS Elect' 1 Seruic., _ Phone #: Elect' 1 Final — Reg #. . : 999 ------..___ This oereit is issueo subject to the regulations contained in the te;.. Tigard Municipal Code, State of Ore. Specialty Codes ind all other PermO.tee Signature applicable laws. All work will be done in accordance with ipprov-d plans. This perait will exoire if work is not started within 188 days of issuance, or if worts A suspended for tore �.- than 188 days. Issued By - - -------------------OWNER INSTALLATION ONLY--------------------- ---- The installation is being made on property I own which is not intended for- sale, lease, or- rent / OWNER' S S I ONATIJRF• r, DATE t INSTALLATION ONLY--------------------------- SIGNATURE -------------------------SIGNATURE OF SLIP R. ELEC"V: _._ _.-------�___.__ DATF t i LIG-NSE NO: Call for- inspection - 639-4175 CITY OF TIGARD Electrical Permit Application Plan Check# 13125 SW HALL. BLVD. Recd By L TIGARD OR 97223 Date Recd 4-i Date to P.E. Phone(5031)639-4171 x304 Date!o DST Inspection (503) 639-4175 Print r,r Type permit Fax (503) 684-7297 Incomplete or illegible will not be accepted Permit _ 1. Job Address: 4. Complete Fee Schedule Below: Name Of Development Number of Inspections per permit allowed Name(or name of business)- Service incleded: Items Ccst Surn Address_.' y l L /:%cI L L /�/,t/1 _ _ 4a. Residential-per unit 1(00 sq.it,or less $110.00 City/State/Zip I /C _ %. Y, __ Each additional 500 sq,it or Commercial ❑ Residential portion thereof $25.00 Limited Energy $25.00 Each Manul'd Home or Modular Dwelling Service or Feeder $68.00 , 2a. Contractor installation only: (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor Installation,alteration,or relocation - 200 amps or less $60.00 2 Address 201 amps to 400 amps $80,00 2 City_ State Zip -_ 401 amps to 600 amps $120.00 2 Phone(`to. 601 amps to 1000 amps $180.00 2 Job NO. Over 1000 amps or volts $340.00 2 Elec.Cont. Lice. No. Exp.Date Reconnect only $50.00 - 2 OR State CCB Reg.NO. Exp.Date, 4c.Temporary Services or Feeders COT Business Tax or Metro No. ExpDate_-__ Installation,alteration,or r31ocatlon 200 amps or less $50.00 2 Signature of Supr. Elec'n _ -- 401 amps to 600 to 400 amps $100.00 Over 600 amps to 1000 volts, License Nr Fxp.Date see"b"above. Phone N, _. - 4d.Branch Circuits New,alteration or extension psr panel 2b. For ov.,ner installations: a)The fee for branch circuits with purchase of service or Print Owner's NameL)f ;' feeder tee. `-�`- Each branch circuit $5.00 Address / `) 5 <.. , e� i r/ b)The fee for branch circuits Q/ Y e." f' State c Zip i 1. �/ _ without purchase of Phone No. j%, �r V_i _ service or feeder W. First branch circuit $35.00 The installation is being made on property I own which is not Each additional branch circuit, $5.00 _ intended for sale,lease or rent. 4e.Miscellaneous Sorvice or feeder nrt Included) Owner's Signature _ Each pump or Irrigation circle $40.00 2 Each sign or outline lighting $40.00 __. 2 3. Plan Review section (if required):' Signal circuits)or a limited energy - panel,alteration or extension $40.00 2 Please check appropriate item and enter fee in section 5E. Minor labels(10) $100.00-_- 4 or more residential units in one structuie 4f.Each additional Inspection over Sgtvice and feeder 225 amps or more the allowable in any of the above cvstem over 600 volts nominal Per inspu.tion $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E C.Chapter r I In Plant $55.00 'Submit 2 soli pf plans with epplir oinn wheia any of the above appiV. 5. Fees: _ N..r required for temporary construction services. So.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ NOTICE subtotal $ - 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review It reauired(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,CIA IF CONSTRUCTION OR WORK Subtotal $ ---- IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account# Total balance Due I\DST StEI CN APV RM W96 CITY OF TIGAIRD BUILDING INSPECTION DIVISION MST 24-Flour Inspection Line: 639-4175 Business Line: 639-4171 _—Date Requested.___ Uj ` ;Z� ' � � AM PM BUP - -- I_ocation ( '?�L) ? Qf1 CG� Suite MEC _ Contact Person Ph _(2 _'� s� PLM Contractor _ Ph _ SWR BUILDING— Tenant/Owner ELL Retaining Wall ELR _ Footing Access: - Fcwndation FPS _ Ftg Drain SGN Crawl Drain Inspection Notes: - -- --- Slab ---- -- ----- SIT Post& Beam Ext Sheath/Shear _ Int Sheath/Shear Framing Insolation Drywall NailingS• ! _jY J� C'✓. 4 in Firewall -- Firewall �- Ala L Fire Sprinkler �K , e C� _ Qr L"'s f, �4 �L1`�- Fire Alarm Susp'd Ceiling __-_- Roof ,, n P Misc 4 .. Final 01 PASS PART FAIL PLUMBING Pos'& Eieam� -- Under Slab i op Out -- __ _... ------- ---------__Watet Service Service Sanitary Sewer _- Rain Drains Final PASS PART FAIL MECHANICAL ------�-- -v --------- Post& Beam _-_-- Rough In Gas Line - --- - .,.-- - ------ - -------- Smcke Dampers Ina PAS PART FAIL LECTIR Service Rough In UG/Slab Low Voltage �---- ---------_--_ � _ _— __ Fire Alarm -__—_-- - _�--_-- _--- - --___- ASS PART FAIL -_--_- --._ - _--- BackfillIGrading ��-— -_- ---- -- --� Sanitary Sewer Storm Drain ] ]Reinspection fee of$i-_ _ _required before next inspection Pay at City Nall, 13125 SW Hall Blvd Catch Basin Fire Supply line { ]Please call for reinspection RE _ [ J Unable to inspect-no access ADA Approach/Sidewalk O ! Other Date -D-- ------InsPecMr _ Ext - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. i CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --- Lje/t l? C' BUP _ Date Requested `� "Z ``�� AM PM --�C r3LD — Location I1=�� /.�L1-ne nst�-- Suite _ MEC Contact Person (. Ph (P g gy _ PLM _ Contractor —� Ph SWR BUILDING 1 Tenant/Owner _ ELC _ Retaining Wail '1 ELR Footino Access ----_._._-------.__--- _-- Foundation FPS Fig Di a;n ---- -- ------- Crawl Drain Inspection Notes: SGN Slab _ SIT Post& Beam --—- ---- - -- Ext Sheath/Shear Int Sheath/Sh, ar _- - - Framing Insulation _ Drywall Nailing --- — -- ---_ — — ._----- Firewall - - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc. __.-._.-- Final -- PASS PART FAIL -- __ __-____-___ PLUMBING Post& Beam Under Slab Top Out — -- — Water Service Sanitary Sewer --� Rain Drains Final --- P FAIL Post 8 Seam - -- - At Rough In r Gas Line -- Smoke Dampers -- BA99 PART FAIL 'ELECTRICAL -- Service Rough In — UG/Slab Low Voltage ,Fire Alarm Final PASS PART FAIL SITE Backfill/Grading _---- - -- -- -- Sanitary Sewer Storm Drain 1 ) Reinspection fee of$_ _required before next inspection Pay at City Hall, '3125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call iqr reinspection RE: [ ]Unable to inspect-no access ADA Approach/Sidewalk Date L C1 Other Inspector_ _ _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CiTY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line. 639-4171 --- - q (,. 12,61) BUP _ — _Date Requested t"I �- `1 C1 �AM - PM . BLD Location ( 1,�� C) x_`71 LJ i Suite _ MEC Contact Person Ph 10 3�/ PLM Contractor Ph SWR _ BUILDING Tenant/Owner 0f'�Y��U_ ' �.1� '!� !— ELC: F,etaining Wall ELR _ Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: --- Slab SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear _a - Framing Insulatioo Drywell Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -----. ---_--.-------..-._,_ __ —_.--_--- Roof - _--- -- - - Misc Final _ --- - -- - - PASS- PART FAIL_ Posl& Beam -- - --Under Slab Top Out - -- - --- Water Service _ Sanitary kav er Rain Drains _IKAS.a PART FAIL _ MECHANICAL V - Post& Beare .— Rough In Gas Line -- --- - - — -- Smoke Dampers i Final PASS PART FAIL ELECTRICAL -- Service Rough In UG/Slab L-ow Voltage Fire Alarm —�-_- ---�- --- Final PASS PART FAIL_ __- SITE Backfill/Grading - --- --- - - -- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection Pay at City Hall, 13115 SIN hill Alvd Catch Basin Fire Supply Line [ ]Please call for reinspection REE _ _ _ ( J Unable to insN^c' -no access ADA Approach/Sidewalk Other Date _ Inspector __— Ext _-- F inal ^ PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES rIRMIT #: ELr98-0561 13125 SW Hall Blvd.,Tigard,OR 97223(503)6394171 r)("a'TF ISSUED: 09/17/9R i I.E5Z, J_UL1, N"I J`4!-H- IN RIE, '1JT1DT')Tr"'T ON, Z(IN I N'' R--4. 5 JUPTSDICTMN: TIG Jerc.t De:;lIv. , ht: ion . Installation of 2 branch circuits. Job #2064-261. "73RVC /FrEPFRS- - MTSCELLANEOUS 000 sr OP LESS. . . . : 0 0 200 amp. . . . . . . : 0 PIUMP/IRRICATION. . . . nCH ADDIL SOOSr-. . . : 0 201 400 Limp. . . . . . . . 0 SIGN/OUT LINE LTG. . : 0 IMITET) ENERGY. . . . . : 0 401 Goo =kMFI. . . . . . . : 0 SIGNAL/rIANF1.. . . . . . . 0 nw-, HM/ SVC/FDR.: . : 0 G01-1-amps t000 volts. : 0 MTNOP LABEL ( 1.0) . . . 0 SFPVTCE/FEEDER------ ._.--...BRANCH CIRCUITS-------,- -----ADDIL- INSPECTIONS--- amp. . . . . . . 0 W/IDEPI ICI- OP FC:EDER: 0 PIER TPISPIECTION. . . .. . . 0 01 14q0 amp. . . . . . : 0 1st W/O SPVC OR FDR. - t PER HnUR. . . . . . . . . . . .. 0 tot 600 amp. . . . . . : 0 EA ADDIL PRNCH CIRC: I TN rLAwr. . . . . . .. . . . . : o 01 1000 amp. . . . . : 0 -----PLAN REVIEW SECT I rJN----------.--- L4004 amp/tpolt. . . . . : 0 =4 PEP) I jNT TS3. . . . . . . . eao vnt T NOMINAL. "„ connec_,t only. . . . . : 0 SVC/FD 1 22� nMPS. . CL-nqq r)REA/SPFC X I.,wnet,.” F-EES rnrKTF CHnNT)L.ER type CAM01.1.1t by date r-ecpt 780 SW INEZ PPMT 1 401. 071 DE-.R 09/17/98 98 30r7 TIGARD OR 9722/1 ')PCT $ 2. 00 DEB 09/17/98 r7ll-ionv #: ri1r3ENTX ELECTPM CO 42. 00 TOM 7?7') c!)W TECH CENTER DR. INSPF-r,77ONF� TMIAPD OR 97"_!'J'].3 Ce i ling covol- Elect' I SL-1- r`f�ionI, #n Wal ' r,fvr.,r- F1 vc,t:l I Final 4 1,. 17..100`1L" This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other -pplicable laws, All work will be done in accordance with approved plans, This persit will expire if work is not started within IN 13ts of issuance, or if worts is suspended for core than IN days. ATTENTION: Oregon law requires you to follow the rules adopted by 'he q-e;or, Ut0ity Notification Center. Tose rulet, are set forth in OAR 95CI-801-881e t 952-80I-1987. You isy obtain a - these rules or firtc'- qljestt6ns to OK b 11 (503)246-1967. I, v .0 ur mi. t tvv G)i.wnat i-ir-o r 18N.A. . A.4 T S tr,1;p d MY Mr --nwNFR TNc.;T0LL.n7'TON The irstallation is being nt�trlv o=r pv-upei,ty t ctw:, whiich is nob intended For -ales lease, or rent. WNFRI ES rIGNnT1JPF.- DATf I7ONTQr1CT(1P TN)TAL1nT1ON ONL', TGNATURE OF SUM EIECI N- DATES TCrN7,r Nn: ++4 +.++-&,4 +-+++4-++++*++4 4-+,+++-++++4++4++4+++-4--4,-+++++++4............... ++4-4....4++- Call 633-417n by 7.o00 p. m. for an inspection needed t,-ie next bosiness da 4.4-+-+-+44--#-+++4++++-+++++-+4-++-►4-4-+-f--I.44-+.4--t. SF'P-17-98 THU 03;46 PM PHOENIX ELECTRIC 00 FAX N0, 15036843611 P. 02 CITY OFTIGARD Electrical Permit Application Plan Ch 1, 13125 SW HALL BLVD. Recd t TIGARD OH 97223 Dale Recd--? Phone (503)639-4171, x304 Date to P.E. ' Print or Type Date to DST --- Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit It ALL Q� Fax(503) 684-7297 Called [Name . Job Address: 4. Complete Fee Schedule Below: of Development _ Number of Inspections per permit allowed Name(or name of business{ _ Y�t_t._ 'VIL, 1 Service Included: Items Cost Sum Address��) n3(.l� u��\`f\t?�`v��t°4\\Y\ �Lt` 4a. Residential-per unit City/State/Zip_�,L�1�1� , C'N1- ��}' tWO sq.n.or lass $110,00 4 Each additional 500 sq.It.or 525,00 1 Commercial ❑ Residential portion thereof Limited Energy $25.00 Each Manul'd Home or Modular Dwalling Service or Feeder SGG.00 2 2a. Contractor installation t6n1y. (Attach copy 1 current Iloens s) 4b.Services or Feeders Electrical Contractor- Installation,alteration,or relocation Addressn' n200 amps or less $50.00 201 amps to 400 amps $80,00 2 City ' ' State rp 401 amps to 600 amps $120.00 2 Phone)f 601 amps to 1000 amps — $180,00 2 Job No., 7 - L Over 1000 amps or volts __ $ 40,00 2 Elec. �x — Reconnect only — $50.00 2 Cont. Lice. No. _ — � p,Date OR State CCB Reg. No. Exp.Date 4e,Temporary Service*or Feeders COT Duefness Tax or Metro No, Exp,Date Installation,alteration,or relocation j--� 200 amps or less S50,00 2 Signature o.5upr. EI®c'n��– _ 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 g Over 600 amps to 1 GOO volts, i_icense Nr I Or-1 -Exp.Datesae"b•'above. Phone Nr -211f N 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The roe for branch circuits with Purchase or service or Print Owner's Name feeder fee. ` Address Each branch circuit $5.00 _ _ 2 b)The too for branch circuits City State Zip without purchase of Phone No, _ service or feeder fee. ►�,�tV) First branch circuli $35,00 J 2 The installation Is being made on property I own which is not Each additional branch circuit s9,00 `K3— 2 intended for sale,lease or rent. 4o.Mlscellanoous (Service or leader not Included) C'Wnef'S Signature Earh pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required).* Signal circuil(s)or a limited energy panel,alle►atlon or extension $40.00 2 Please check appropriate item and enter tee In section 58Minor l.abols(10) 5100.00. 4 or more residential units in one structure 4f.Each additional Inspection over Service and leader 225 amps or more the allowebla In any of the above System over 600 volts nominal Per inspection $35.00 Classitled area or structure containing speclel occupancy Per hour $55.00 _ as desce.bed In N.E.C.Chapter 5 In Plant $55.00 Submit 2 sots of plans with application where any of the above apply. Jam. Fees: Not required for temporary construction services. ea.Enter total of above fees $ W-c �J�,c 5%Surcharge(.n5 X total fees) $ noligg Pvbtoral $ 5b.Enter 25%of line 5a for PERMITS P.ECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Revlew j=j j((Sec.3) $ NOT COMMENCED WITHIN 100 DAYS,OR IF CONSTRUCTION OR WORK Subtotal S IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. Trust Account Total balance Due j i.�DSTS\ELu00 APP %� *90 CIT' OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT DEVELOPMENT #. . . . . . . : MEG98-0?F-1 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE 15SUED: 08/20/98 PAPCEL: ;-7'Sl10BD-02100 SITE ADDRESS. . . : 11550 SW BULL MOUNTAIN RD SUBDIVISION. . . . : ZONING: R-4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTION: TIG ------------------------ CLASS OF WORK. . :OTR FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES-------------- 0-3 HP. . . . -. 1 DOMES. INCIN: 0 :GAS 3-15 HP. . . . : 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. . . . - (11 WOODSTOVES. . : 0 GAS PRESSURE. . . 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF AIR HANDLING UNITS OTHER UNITS. : 2 FURN ( 100K BTU: 1 10000 cfm : 0 GAS OUTLETS. : 5 FURN ) =100K BTI,-!- 0 > 10000 cfm: 0 Remarks : Installation of furnace, 2 gas inserts, gas piping for 5 outlets and a/c unit. A/C unit must comply with setbacks. Owner: FEES JACKIE CHANDLER type 8MOLInt by date recpt 9780 SW INE?_ PRMT $ 33. 50 DEB 03/20/98 98-3084t)9 TIGARD OR 97224 '55FICT $ 1. 67 DEB 08/20/98 98-3084.7q Phone #c Contractor: FIRESIDE DISTRiBTRS CF ORE INC 13893 SW BOONES FERRY RD $ 35. 1 7 T 0 T A I.. PORTLAND OR 97224 Phone #: 503-684-8535 Reg #. . : 000409 ------- REQUTRED INSPECTIONS This permit is issued subject to the regulations contained in the Gas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp applicable laws. All work will be done in accordance with Heating Unt Insp approved plans. This permit will expire if work is not started Cooling Unt Insp within 189 days of issuance, or if work is suspended for more Misc. Inspection than 188 days. AT1TEPTION: Oregon law requires you to follow rules Final Inspection adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-01-NIO through OAR 952-00I-0180. You may obtain copies of these rules or direct questions to OUNC by calling (513)246-9187. 13� K4 Permittee Signature: f++4.........4-++4-1............................................................... Call 639-4171 by 7:00 p. m. for inspections needed the next business day � ++4...................4...4.....................4-++++4............................ 08/07/88 I-RI 15:5.1 FAX 503 598 1960 CITY Of•'TIGARD [tool Plan Chuck d CITY OF TIGARD Mechaiical Permit Application Rec'dBy 13125 SW HALL BLVD. Commercial and Residential RECEIVEDDale Recd r TIGARD, OR 97223 iar�,. :ate to P.E `503) 639-4171, x304 Uale to Us r Print or Type AUG 1. _ 1991 Pem,ltp Al tCy'k— 5(</ Incomlplote or illegible a plications will not be acceptsd alied — r Name U Devecpment/Prolel Description C, Table 1A tMechanical Code = Q1 � Pnce _Amt t Address.'ob Street BUK*N A PermilFee� W —� 10.OU p��t ' 1) Furnace to 100,000 BTU j Address E -S U (Yl' «_ inc;uding ducts 8 vents Bldg# ce.yrstete zip 2) Furnace 100.000 BTUs _ Cj C'" �� h�Includduds d vents _ _750 _ Name(or name of business) 3) Floor Furnace p��r ' \ n �Y =�, includingvent nt _� 0 00- ^ MWIngAdarecc 4) Suspended heater,wall heater or floor mounted hezto, 6 00 &C LVY-,R.,.�—_ 5) Vent not Included in applw ; nce perm; city/statezipPhone _ 3.00 CHECK ALL `Boller Heat Alr Name,or name o}bus noni THAT APPLY. cr Pump Cond Qty Prt.:e Amt _C _ Com<3HP;abeorb u,lt to OLCUPd�(tt MoilingAdarsss 1000,BTU 5.00 7)3-15 HP absorb colt Cltyl9uu Ip ne IWit to 50%BTU 11.00 N)15-30 HP;absorb ___ unit.5.1 mil BTIJ 15.00 Contractor N'e'e '1n\ I _ B)30-50 HP;absorb — ru's(( U 1 Ls' IULL unit 1.1 75 mil BTU _ 22.60 Prior to permd Melling Address 10)>50HP absorb unit issuance a copy l �' t ,N Lu_6� 4 V >1.76 milBTU - 37.50 of a l licenses byr8uu ZIP 11)Air handling unit to 10,000 CFM i ' are required f l _ 450 expired in COT Oregon Const Cont ecsrd Llo.e exp Dim 12)At handling unit 10,000 CFM+ databese � � — 750- Architect Nen1tl 13)Non-potable evaporate cooler 4.50 or raedtng AddrM 14)Vent fen connected to a singe duct 300 _ 15)Ventilation system not Included In Engineer Cnyrststa _ _—_+ tip Phone ® liance permit 4 50 18)Hood-Arved by medlanioal elrhouet Ds irtibe work to be done 450 17)Domestic Incinerators New O Repai, O Replace vith like kind Yes• No 0 18)Comme150 Residential 0 Commercial U Commercial(v indualna"yps incinerator 30.00 _ Adddlonai infonnallion or descnptlon of work y� 19)Repalt units 4 50 v 20j Wood stove V4 ado Y Pr L "' n QA �-^�1 t r t: — ---- -- -450 `� 21)Clothes dryer etc. Type of fuel ell C natural gas• LPO O elect&O 22)Other Its i —--- 450 o ��- - 50 - I hereoy acknowledge that I have reed this application,that the Information 23)Gas piping are to bur outlet given is correct,that I am the cwner or authorized anent of _ j._ 2.00 12 0 the owner.that plans submitted are In comp)ance wltn Oregon State laws 24)More than4-uar outlet(each) 50 r S Slpnaturs of Owner/Agent —-- ---- Dab MIInimum Permit Fee$26 00 SUBTOTAL r QJ _ _ __..._ . G !� ��.� _ — V'1. i 5%SURCHARGE Contact Person Flame Phone PLAN REVIEW 25%OF SUBTOTAL Re ulred for ALL commercial errnlA onl TOTAL 'State Ccntracter Boiler Certl5c6cn regwred - -Residential AC relul es site plan stowing pincement of unlit 1 Vnectnperm doc rev 07/70198 FIRESIDE DISTRIBUTORS HEATING, AIR CONDITIONING AND FIREPLACE SPECIALISTS A �5, i L ! I r � I Sob in��e� �--E ��. It, d re-s S �1 �p . V'W "T'I 18399 S.W. HOONF9 FERRY RD. • PORTLAND, OREGON 97224 • 503-8R4-8535 a (FAX) 503-820 5609 CITY OIF TIGARD _4PLUMBINr! PERMIT DEVELOPMENT SERVICES PER 1312MIT 5 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: " 0" 6* /20/98LM98-02,90 SITE ADDRESS. . . : 11'J50 SW BULL MOU1�4TI-)IN RD PARCEL: 2s110BD___02100 SUBDIVISION. . . . : ZONING: R--4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTION: TIG ------------------------------------------ ------ ---- -------- — CLASS OF WORK. . :OTR GARBAGE DISPOSALS. : OME SPACES. :—0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY BRP. . :R3 FLOOR DRAINS. . . . . . :: 0 TRAPS. . . . . . . . . . . . . . STORIES. . . . , . . , ; 0 : 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0 FIXTURES—--_____ LAUNDRY FRAYS_ . .. ., : 0 SF RAIN DRAINS. . . . . : SINKS. . . . . . . . . 0 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . 0 LAVATORIES. . . . . o OTHER FIXTURES. . . . 0 TUB/SHOWERS...: 0 SEWER I- INE0 WATER CLOSETS. : 0 WATER LINE (ft ) . . . 0 1.)1 SHWASHERS. . .. . : @ RAIN DRAIN (ft ) . . . : 0 Remar!<s : Installation Of water- heater-, corver-sion to gas. f)wner: --------------------------------------------------------- FEES -------------- TACKIE CHANDLER type amoi.int by date 1780 SW INEZ reept PRMT $ 25- 00 DEB 08/20/96 98-308459 1IGARD OR 97224 5PCT $ 1- 25 DEB 08/20/98 98--308459 V"hone #: 1IRESIDE DISTRIBUTERS 18389 SW BOONES FERRY RD PORTLAND OR 97224 Phone #: 684-6535 $ 26. 25 TOTAL. Reg #. . : 40979 This pervit is issued subject to the regulations contained in the REQUIRED INSPECTIONS ----- Tigard inspection Tigard Municipal Code, State of Ore. SPecialty Codes and all other Final Inspection aPPlicable laws. All work wid be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issuance, or if worth is suspended for more than l8edays. ATTENTION: Oregon law requires you tL follow rules adopted by the Gregor, Utility Notification Cente-. Thisr rules are set forth in OAR 952-888I-0010 through OAR 95C-8881-0060. You say obtain copies of these rules or direct questions to OLINC by calling (583)246-1987. Issued Permittee Signati.tre: ................................................4................./ ............. Call 639-4175 by 7:00 p. m. for an inspection needed the next business day ++++++++++•F++++++++++++++++•++++++.}}{ }+++++++...................4.................. GITY OF TIGARD Plumbing Permit Application Plan Check# 13125 S'.V HALL BLVD. Commercial and Residential Recd By _ TIGARD, OR 97223 Date Recd (501) 639-4171 Date to P.E. Print or Type Date to DST/ Incompkate or illegible applications will not be accepted Permit# t' o Related SWR# Called_ Name of Development/Project FIXTURES (individual) + -- PRICE AMT Sink !~ +-- 9.00 Job G Q_ Y' e --- --- - Address Street Address Suite Lavatory 9.00 e)U_ -- a Tub or TublShowrr Comb 9.00 i� Bldg# Cit /Skate ZIP Shower Only 9.00 Na — ( Water Closet 9.00 _Q-ip � &v- Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 rlvl� Washing Machine 9.00 City/Slate Zip Phone — Floor Draln!Floor Sink 2" 9.00 Nome _ 3"! 9.00 Till 4" 9.00 Ocouupant f•iailing Address Suite Water Heater a conversion O like kind tt 9.00 Gas piping requires a separate mechanical permit. 1 ,� City/Slate Zip Phone Laundry Room Tray 9.00 -- — _ Urinal 9.00 me � t ye->I t ` u '7-N5 Other Fixtures(Specify) Contractor Mailing AddressI�7C p� Suite 9.00 Y r 9.00 Prior to permit lty/StateP n Sewer-1 a 10U' 30.00 issuance,a copy 1p Cj 5 Se ver-each additional 100' 25.00 of all licenses are Oregon Const.Cont.Bard Lic.# Exp. al�j /� _ required if ��l -- ��O u J Water Service 1st 100' 30.00 expired in COT Plum ng Lic.# Exp Da WAter Service•each adds, net 200' 25.00 database I 2-"K LO tj d0 Storm&Rein Drain-1st 100' 30.00 Name Storm 6 Rain Drain•each additional 100' 25.00 ArchitectMobile Home Space 25.00 or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 _ _Poilutir-i Device _ Engineer Clty/State ZipPhone Residential 690flow Prevention Device' 1500 I _ (Irrigation timing devices require a separate Describe work to be done: restricted energy permit.) New O Repair O Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00 Residential O Commercial O Catch Basin 9.00 Additional description of work Insp.of Existing Plumbing 40.00 per/hr Specially Requested Inspections 40.00 _ per/hr Are you capping,moving or replacing any fixtures? Rain Drain,single fandly dwelling 3000 Yes 0 No 0 Grease Traps 9-00 If yes,see back of form to Indicate work performed by fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TL WORK COULD RESULT IN INCREASED SEWER FEES. Isometric w riser diagram is required ri Quantity BT Is Ts >9 >9 'SUBTOTAL I hereby ackn Nwledge th.it I have read thls application,that the information given is cared,that I am the owner or authorl-ej agent of the owner,and 6%SURCHARGE that plans submitted are in compliance with Oregon State Laws _ Signature of Owner/Agent Date **PLAN REVIEW 26%OF SUBTOTAL 'J„ Required only K fixture qty totalis_>9 Contact person Name � Phone TOTAL 'Minimum permit fee Is$25+5%surcharge,except Residential Backflow Prevention Device,which is S15+5%surcharge -All New Commercial Buildings require plans with isometric or riser diagram and plan review I ldslsl{il,,ma[r da 7r21W PLEASE COMPLETE: � Fixture Type �-- ^ Quantity by Work Performed F -__—^—� —` _- New Moved Replaced Removed/Capped Sink Lavatory -- Tub or Tub/Shower Combination Shower Only _ _— Water Closet Dishwasher _Garbage Disposal — — Washing Machine Floor Drain/Floor Sink 2" Y — Water Heater ---^----- V--- - -- -��- Laundry_Room_ Tray _ _Urinal - — Other Fixtures (Specify) - — COMMENTS REGARDING ABOVE: J I kd%ts'4dvmap(.do 70M