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ELECTRICHt_ PERMIT
C04r'11TY OF TIGARD DATEIISSUED=596-0376 07/01/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall BNa.Tigard,Oregon 07223.8190 (5^3)839-4171 PARCEL,; 'ALS 124CA-05600
S1 Ir. "DURESS. . . : 11995 SW BU1RLPEIGHTS ST
'-�UBD I V I S I ON. . . . : BURLMOOD NO. 2 Z ON I N1=,:R-4. 5 I
BLLCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :c 9
Project Description: Installing two branch circuits.
RESIDEN?IAL UNIT----- ---TEMP S;RVC/FE.EDERS-___.-_ __.-.--MISCELLANEOUS----__
112100 ..i S F OR LESS— . : 0 0 - '"r_'1210 amp. . . . . . . : 10 PUMP/IRRIGATION. . . . : W
EACH ADDI L 5006F. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEI . . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
---- SE 9V ICE/FLcEDER---- ------BRANCH C I P.0 I TS--.----- •---ADD' L INSPECTIONS-
0
NSPECTIONS-0 - 29* amp. . . . . . a 0 W/SERVICE OR FEEDER: 0 F'ER INSPECTION. . . . . 1 0
201 - 40W .amp. . . . . . a 0 I st W/O SRVC OR FDR. . a FUER HOUR. . . . . . . . . . . . i/1
401 - 600 d m p- - , . . . 1 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : V.
601 1000 amp. . . . . : 0 -..-_ -.-_._____.__.____._FLAN REVIEW SECTION-------
1000+ Amp/volt. . . . . a 0 > =4 RES UNITS'. . . . . . . . : > 600 VOLT' NOMINAI . . :
Re onnert only. . . . . 1 0 SVC/FDR > _ 225 AMIDS. . t CLASS AREA/SPEC 01.C. a
Uwner: ------------------------- ________.__--•--__._________- FELS ------_-_-___._.--
BEVE RLY TOWNE type alna�yrt- by date recpt
11995 SW BURLHE I GHTS FIRMT f �40. 0 .75 06/13/96 96--280597
5PCT f 2-.-00 CJS 06/13/96 96'-X213059
T IGARD OR 97223 PRMT f (46. 005'CJS 07/1? 1/96 96-28) 194
Phone #: 5F'CT $ CJS 0.7.'01/96 96 28'i19
Contractor: ---____.____— _-- - _—•-__ .. __._._.____.._._---___..__.____.____.________. ..._._____.__._
BL-•".AVERTUN ELECTRIC f 84. 0171 TOTAL
Rl . 1 BOX 653
--_- --- REOU I RED INSPECTIONS -------
BLAVER101\1 OR 9700-i Wall Cover Elect' 1 Final
Phone #: :-,03•-524-4&i,44 Elect' 1 Service
(leg #. . : 50150
This ppreit is tented subject to the regulations contained in the
Tigard Municipal Cede, State of Ore. Specialty Codes and all other Permittee Si gnat Urex
applicable lams. All work will be done in accordance with
approved plans. This perBit will expire if work is not started
within 1811 days of issuance, or if work is suspended for Bore
than 189 days. I S S U ed By
----------.---OWNER INSTALLATION
The installation is being made on property I own which is not intended fr,r^
sale, lease, or^ rent.
f)WNE R' S SIGNATURE: _.__._. �. DAl E: _
_........__.__._____.------CONTRACTOR 1NS'TALLATION ONLY---
9
NLY--
S I GNPI URE OF SUPR. ELL-LIN: � DATE.-
i-
ATE:i-:CLNSL NU:
Call for inspection - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SVV Hall Bind.
Tigard, OR 97223 Permit # GLC4-,-0376
Date Issued - / 3 --4f,
Phone (503) 639-4171
IvARD FAX (503) 684-7297
CITY OF T
.. TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ Numt>•jr of Inspections per permit allowed
Address �' `% �J s Service included Items Cost(ea) Sam
City/State/Zip ! � v 4a. Residential -per unit
7 1000 sq, ft or less $11000 4
rune (or name of buslr•ess) Ul 2�`f '? 'w' W tj 2t•f Each additional 500 sq If or
portion thereof $25.00
Commercial ❑ Residential 1.united Enerp� $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only: 4b.Services or Feeders
Installation.alteration,or relocarion
Electrical Contractor /�l r �1 r r $80.00 2
200 amps or less
Addres �' r 't. 201 amps to 400 or ps $8000 2
$120 00 z
City �� ' r r State ('rZip _ 401 amps to 600 amps 2
601 amps to tom amps $180,00
Phone No. Over 1000 a rips or volts $340.00 7
Job NO. Reconnect o ily $5000 2
Contractor's license NO. 7 r9 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Installation,a"tration,or relocation
Signature- of Syupr. Elec'n _ . {'s• y• 200amps c less _� `
/ �' — 201 amps to 40u•mps $50.00 2
License No. .. Phone Nu_ 401 amps to 600 amps $7500 2
Over 600 amps to 10W vohe $too W
2b. For owner installations: %ee't.'above
4d. Branch Circuits
Print Owner's Name_ I New alteration or extension per pane
Address a)The fee for branch circuits with
purchase or service or feeds,fes. 7
City__ _ State Zlp Each branch circuit $500
Phone No. _ b)The fee for brarch circutts without
The installation is being made on property I own which is purchase of service or haler fee z
not Intended for sale, lease or rent rust blain nalbrcircuit _i_ $3500 J
Each additional branch clrcult _�_ $500
Owner Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Fah pump or Irrigation circle $40.00 2
Each sign or outline lighting 340 00
Signal clrcul(s)or s limited energy `
Please check appropriate Item and enter fee In section 58. panel,ane stion or extension __ $4000
4 or more residential units in one structure Minor Labels I10) $100.00
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 EC Chapter 5 per inspection $3500
Per hour _ $5500
In Plant $5500
Submit 2 sets of plans with application where ary of the above _
apph, Not required for temporary construction services, 5. Fees: 1'^
5a. Enter total of above fees $
NOTICE 5%Surcharge (05 X teal fees) $ .i
PERMITS BECOME VOID IF WORK OR CONSTRUCT!0'4 Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 Di',fS,OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR YVORK IS SUSPENDED OR.ABANDONED FOR Plan Review if required (Sec.3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTEF WORK IS Subtotal $
COMMENCED Trust Account alt
Balance Due a ' , "0
CITYO F TIG /\ R D _ MECHANICAL PERMIT
DEVELOPMENT SER/VVICESPERMIT #: ME,-2004-000091
13125 SW Hall Blvd., Tigard, OR 9722'1 '`733) 639-4171 DATE ISSUED: 1/9/04
" g ' PARCEL: 1 S134CA-05600
SITE ADDRESS: 1 X995 SW BURLHEIGHTS ST
SUBDIVISION: BURLWOOD NO.2 ZONING: R-4.5
BLOCK:
LOT: 029 AURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF U`'E: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS WIO APPL: VENT SYSTEMS:
STORIES: r4OILERSICOMPRESSORS HOODS:
FUEL TYPES_ _ 0 - 3 HP: DOMES. INCI'1:
I p( J 3 15 HP: COMML. INCIN.
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRZE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K 3TU: ? AIR_HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: I m Harr in,iall
Owner: _ _.,— -------- ----- FEES
TOWNE, TRENT THEODORE Description Date Amount
11995 SW BURLHEIGHTS ST IN114,111 1'cnnv Frr 1/9/04 $72.50
TIGARD, OR 97223 1 "X; tiralr 1/9/04 $5.80
Total $78.30
Phone: �-
Contractor:
SPECIALTY HEATING 8 COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: X03-040-'007 Final Inspection
Reg #: LIC 66578
This permit is issued subject to the regulations, contained in the Tigard Municipal Code, State of Ore
Specialty Codes and all other P'-plicsble laws. All work will be done in accorHance 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 in 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 by calling
(503)246-6699,.
Issued By: /r , Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. fo! inspections needed the next business dry
M e c h a a ermit A liRECre�ation eCety Mechanical
icst,
L IV D Dat" : l --9 -D Permit No.: C-C. - U 4
Ci Dl Il l,d Planning Approval 9uitdins
Date/By: Penmit No.:
131 $:W 1' I Blvd. Plan Review Other
Tiga #e**9)n 97223 JAN 0 9 n4 D.1 Permit No.:
Phone: 503-ii394171 Fax: 503.598-1960 Post-Review Land Use
Tntnrnrf WW w.ci.tigarr'.00.us CSN Date/By: Case No,
OF contact )writ.: Soo Page Z for
24-hour Insp�tction Pequest: 503.ODUMAINQ LJIVTDfkjrq NamelMttthod: --1161 1 Su lemental Information.
_�__' TYPE:OMORK. C011IIK R 'AZ]ME*•SCH£D'ULE-USE CRECKLIST
New cot stnlction Demolition Mechanical permit fees"are based on the total value of the work
Arlelitinr/alteration/re laeement Other: performed. Indicate the value(rounded to the nearest dollar)of all
GQRY.:,'OF CONSTRUCTION:., mechanical materials,equipment,labor,overhead and protit.
1 & 2-Fi.mily dwelling Commercial/Industrial Value: $
Sec Page 2 for Fee Schedule
Ac(1esso. 13uildin Multi-Famil PESP)!t 'i UIPMENIYSY.ST.ENfS FEE"SCHEDT.fL
Description ee ea.l eta
Magtet Iluilder r I Other: Heaun c 11no, --
_V ;' ORM�iTION' ' C1Qk�'IQ1V F m "
ace-add-on air conditionin • 14.00
Job site:add-esti: t' es Gas heat purnp 14,90
Suite#, Bld ./A t,#: Duct work 14.00
Project Nante: x ronio hot water syrtem 14.00
Cross:treet'DResidential boilerirccttons to fob site; for radiator or hydronic s stptn 1400
Unit beaters(fuel,not electric)
in wall in-duct,sns tided,etc. 14.00
luelvent or any of above 10.00
subdivision; Lot#: Repair units 12.15
Tax mel 1 a-cel 0: Other Pua�ApAt► ttanca3
�� Water heater 10.00
_ UCSCI7,>1M'101Y OF'VitC+RK Gas fire lace 10.00
p ` Flue vent water Ile-.teN as tl lace _ 10.00
_ Loulighter a%) I Q'00
Wood/Pellet stove 10,00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
PROPiBIR:i3l' Y'_—. A_N C ::i r` Otter: 10.00
NamC:-� Eaviroamental Exhaust&Ventilation�K Il�rl�` t 1 Range hood/other kitchen equipment 10.00
Address: �— S Clothes tyerex gust 10.(10
City/State/?'ip: _
— - -- Single duct exhaust
Phane1 Cf- �p( � _ r 1;1X: (bathrooms,toilet compartments,
PLI�'Ar,'T_ ' ,C1�.ACT'L'ffiL3Q.NIJ -- utillry rooms) 6.80
NameArticicrawl space fans 10.00
10.00
Address Oty Fuel Piping _
Clt /5"talC/71
**0S.40 Mr Asst 4 51.00 cacti additional
S. .� _.—
Phone: Fax: J
Furnace,etc.
Wall/suspendad/unit hcatct "•
ON'IRACCO Water heater ••
Busincs0 ane: r �, �.�c. }i � Fire lace ••
..
Addr ss: I d I r e.ef, _ B c e_ ea
City/ tatc/ZiR.. IJCE' CLL &, Clothes dryer(gas) "•
Phonc��{o ' C Ftut: �' t- p.} e13 Uthor.- '• _
CUB l..ic, 0: _.ito 6'C_ �;� � Total_
Authorlcted 7 1 Mechatileal Permit Fee"
Signrtwc: �t�- ti��- �1-k Date: Ile __ Subtotal S
Minitnti n Permit Fee$72.50 T
..'L�-L� (� l��'^ — Plan Review Fee '25%of Permit Fee) S _
(aerie print name) State Surchar 8%of Permit Fce S SC
TpTAL FEfL�11T FE6 $
Notice- rhls p•rmlt application expires It a permit is not oti5,ined within *Fee methodology set by Tri-County Auitdina Industry Service hoard.
180 days after t has been accepted as complete. "Site plan required for exterior A/C units.
i.\0atsT."YA1F wme%MecPermitAm.Anc 01101
Z 'd BtC.0 865 EOS sutoeaM R-41exQadS QBE160 *0 60 uer
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
OUP
Received � 21 16 �� Date Requested__ Z 3__(2 AMPM SUP _
'l7: 7
Location _ ` � �� �� —_�Suite E ac�a
Contact Person Ph(. _) PLM _
Contractor -� Ph( 1 —_ SWR
BUILDING Tenant/Owner ut/ISCI - ELC
Footing ELC
Foundation Access:
Ftg Drain ELR _
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Exi Sheath/Shear
Int Sheath/Shear
Framing / Ly!",4,iZ S19 k lc/
Insulation
Drywall Nailing
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling - - -- --`-
Roof
Other: -
=inal
PASS PART FAIL ----
PLUMBING -- _._- ----- - ---___-- -- - --
Post&Beam
Under Slab - -- --- -- — --
Rougi Ir
Water Service ---_. __-_-___—
Sanitary Sower
Rain Drains - --- ----
Catch Basin/Manhole
Storm Drain - ---- -- ----- -- -
Shower Pan
Other. ------- - ---- - --- —
Final ------- -- -
PASS PART FAIL -- -- _-- -_�---^----- J -
_
MECHANICAL
Post&Beam
Rough-In _ _-___-- --------_.__-�---
Gas line
Smol�e Dampers - - _ -- ---------- —-------- ---
gnal /
_ ART ---- - - --- -- --ELECTRICAL
Seivice
P^ugh-In -------- -- - ------- - -- ---- -- — _
UG/Slab
Low Voltage -
Fire Alarm
Final
lPAgT FAIL � Reinspection fee of$ required before next inspection. Pay 3125 SW Hall Blvd.
PASSSITE �, Please call for reinspection RE: J _ a e to inspect-no access
Fire Supply Line
ADA ` -Ext
ApproachJSidewalk Drib Z. _-._._, Infipoeto�__._'� `
Other: _
Final - DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line:639-4175 Business Phone:639-4171
•• ting Rain Drair, Cover/Service FINAL:
Foundation Water line Ceiling -Plumb.
Post/Bearr, Mach, Shear/Sheath Framing -Mach.
PIbg.Unc1/FIr/Slab Plbg. Top Out insulation -Elec.
Post/Beam Struct. Mach. Rough-in Gyp, Bd. -Bldg.
San. Sewer A-Gas Line Appr/Sdwlk Reins.
� ,� Q
Ot er:
Date: d _ A.M. P.M. _ Entry:
Address-
Tenant: Ste: ST7:
MEC:
LM:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
L ,r
Inspector;fDeter,
'APPROVED _DISAPPROVE D/CAL L FOR REINS P. F CO