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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
+ Footing Rain Drain Cover/Service FINAL:
x Foundation Water Line Ceiling Plumb.
Post/Beam Mach. Shear/Sheath Framing Mach. ,yA �r4 y
�,� It PIbg.Und/Fir/Slab Plbg.Top Out Insulation
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A: Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
`q San. Sewer Gas Line Appr/Sdwlk Reins.
r,yir 4 w• �i r t't `'' k Other:
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Date: A. --P.M. Entry:
Address:
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at Tenant: ._ -- Ste: MST:
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Con/Own: ��� MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspectorxli�;�_44_ R41�`c' Date:
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APPROVED --DISAPPROVED/CALL FOR REINSP. CF CO
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COF TIGARD PERMIT #. . . . . . . : MLC96-0200
DATE ISSUED: V16126/9f�
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.9199 (503)630-4171
PARCEL: 1 S 134AC-01300
SITE ADDRESS. . . : 1. 1409 :. W 1 F<ONWOOD LP
. : ENGLEWOOD ZONINU: R-4. 'L
SUBDIVISION
[?LOCK. . . . . . . . . . : 1_01 . . . . . . . . . . . . . :41. i
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
i . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
TYPE CiF USE.
OCCUPANCY GRP'. . : R3 'DENTS W/O APDL: 0 VENT SYSTEMS: VI
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES----------,---'- 0-3 HID. . . . : 1 DOMES. I NC I N: 10
: /GAS/ / / -15 HP'. . . . : IZI COMML. INCIN: 0
MAX INPUT: 0 BTU 1.5-30 HP'. . . . : 0 REI'A I R UN I T'S: 0
FIRE DAMPE:FRS?. . : 30-50 HP. . . . : 0 WOODS-I'UVES. . 0
GAS PRESSURE. . . : 50+ HP'. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS------------ ATR HANDLING UNITS OTHER UNITS. : 0 �
TURN ( 1.1110K BTU' 1 (= 10000 c^f m : 0 GAS OU1"l_E1 5. IZI
I FURN > =1OOK PTU: 0 > 10000 cfm : 0
Remav-ks : Repla.Cirig a gas fl_tr,nace and installing a A/C unit.
Owner,: ______.____._____.______._______-___._.___________.____.________
FEF_S __.____.__..___
LLOYD SELL_ type amol_int by date r-ecpt
11409 SW IRONWOOD LOOP' PRMT f 25. O0 TMP 06/26/96 96-281O25
SPCT E 1. 5 Iii.=' 06/26/96 96-281O2b
T IGARD OR 97223
Phone #: 620-321O
Contract or,:
FITZPATRICK HEATING
13900 SW BURNHAM RD
1IGARU OR 972'3
I Thione #- 245-3870 $ 26. 25 TOTAL_
Req #. . : 5335
REIDU I RED INSPECTIONS
This permit ;s issued subject to the regulations contained in the Gas I-ine InspTigard Municipal Code, State of Ore. Specialty Codes and all other, Mechian i ca 1. I n s p
applicable laws. All work will be done in accordance with Mi sc. Inspection
approved plans. This permit will expire if work is not started Final 1nspestion
within 188 days of issuance, or if work is suspended for more __-_._ -----•—
than 180 days.
P'a r,m i t t e e
T ss .ced
By:
C'aII for, inspection - 639-4175 1
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City of Tigard and MMECHANICAL PERMIT P�anck/Rec. # J
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13125 sw Hall Blvd. APPLICATION Permit # !EC96OdCU
Tigard, OR 97223
(503) 639-4171
.m.. .•..Pi•� rffe=sc7,p--ton
Table 3A Mechanical Code OTY PRICE AMT
Job 5 v/a 1) Permit Fee 0- 0- 10.00
Address
r> l2) Supplemental Permit 3.00
umaFe o
l,.m.. '•ne t �L 3^y 1) incl ducts &vents 6.00
Owner 0 /�Q�/�✓UaD CO's 2) incl. ducts &vents _ 7.50 ■
.. .w Floor urn,-ince >�
3) incl. vent 6.00
. . ,,,•..•. uspenc-ecF ea er, wall eater
(� 4) or floor mounted heater 6.00
----- ----Vent not inc. in
Occupant 5) appliance permit 3.00
— c7�pai�oFea ing, re rig.
6) cooling, absorption unit 6.00
�s'3? U of er Z-rcomp, heat pump, air cond.
•'e T P 7) to 3 HP, absorp unit to 100K BTU 6,00
u ••• - of er or comp, heat pump, air con .
8) 3-15 HP; absorp unit to 500K BTU 11.00
Contractor , h l LL� T- Boiler or com- p,'Feat pump, air ccn .
T7 9) 15-30 HP, absorp unit 5-1 mil BTU - 15.00
•a• •�� ^m^ of er or comp, heat pump, air con
10) 30-50 HP; absorp unit 1-1.75 mil BTU 22.50
hereby ac nm Ige ttfat I have read is app icathon,1 at t e Boiler or comp, hit pump, air cond
information given is correct, that I am the owner or a,ithorized 11) >50 HP, absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted arP ^ rnr#iarnce with Air handling unMo
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Beard, that the number given is correct, ,If exempt from State Air handling unit
registration, please give reason below) 13) 10,000 CTM + 7.50
Non portable
14)
orta lee14) evaporate r:nolei 4.50
Vent fan C� r
15) to a single duct 300
Ventilation system not
16) included in appliance permit 450
Hood served y
p/L 17) mechanical exhaust 450
escn a worn- new a3diition alteration 7 repair (_ Commercial or industrial
to be done residential nonresidential Q 18) type incinerator 30.00
xis ing use oOther re. woo stove, water
building or property _ 19) heater, solar, clothes drvers, etc 4.50
Proposed use of 20) Gas piping one to four outlets 200
building or property
21) More than 4-per outlet (each) 2,00
rype of fuel -oil O natural gas §D LPG Q electric O
NUTICE-
Minimum Fee $25.00 SUBTOTAL ZS
PERMITS BF OPAE VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL.
AFTER WORK 15 COMMENCED, - --
TOTAL
Special Conditions _
— Date issued 961 C' _by LZ
H 1LOWADSTSIVECHPIdT
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ELECTRICAL PERIh IT Ire
F'[:RIhIT #: ELC �6 IZ141�1 i
DATE T` SUED: 06/4/96
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 1 S 134AC-011*301b
S I TFt3,aSWKr�1�1�d.Tip�rd,Or�Qon o7 3.8100 {x503 63�-4171
f ) �.�. ,. . : i 1 r09 5W I RON�OO i_F'
SUBDIVISION. . . . : ENGL EWOOD ZON I NG: R-4.
BLOCK. . . . . . . . . . . 1_0 I.. . . . . . . . . . . . . :41
Project Description : Install two br^anch circuits. r'
.---.-RESIDENTIAL UNIT----- ----TEMP' SR.VC/FEEDERS---- ---._.--'MISCELLANEOUS----- A
1001' ,F OR LE13S. . . . : 0 0 -- '00 amp. . . . . . . : 0 F'UMIJ/IRRIGATION. . . . 0
EAC 41)D' L 500SF. . : 0 c01 - 400 amp. . . . . . . : 0 SIGN/OUT LINE: LTU. . : 0
LIhI.. IED ENERGY. . . . . s 0 41211 - 600 temp. . . . . . . : 0 SIl.3NAL/G='ANEL. . . . . . . : 121 r�
I"IAI\IF. HM/ SVC/FDR. . : VI 601+amps-1000 volts. : 0 MINI:;f< LABEL ( 10) . . . : 0
-- - 3Ef'tVICf_/FEE:DIFl-- _- CIRCUITS---- ----ADD' L INSPECTIONS -0.
0 200 ramp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSF'EC f ION. . . . . : 0
=1111 - 41210 amp. . . . . . : 0 . ..it W/O SRVC OR FDR. : 1 PIER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNC:IA CIRC: 1 IN P'LANT. . . . . . . . . . . . 111
61711 1000 ramp. . . . . : 0 _.-________.__..____..___--PL(4N RL.VIf.-:W SEC-1 IC1N--__-.______.-._._---..--- ■
1000+ amp/volt. . . . . : 0 ) =4 RETS UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Ret orinect only. . . . . S 0 SVC/FDR ) = '225 AMP'S. . : CLASS r2 '-A/5P'EC OCC. :
Owner: -- _.__..__._____-_.------ -___-..________. _.___._-------.____.._._.______._.._____ FEES
LLOYD SELL type amol_rnt by date r•ecpt
11409 SW IRUNWOOD LOOP' P'RMT $ 40. 00 JSD 06/24/96 96--1.:809::3
C7 $ '. 00 JSD 06/ 4/96 96-x:8093
T:IGARD OR 97c:23
phone #: 620-32.10
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Cont Tact or,:
I1T HOOD ELECTRIC INC 'b 42. 00 TOTAL i
139170 SW BURN 'AM #F-•'7
` ' -......_.-___. REQUIRE_D INSPECTIONS
1 :f.[iARU OR 97E23 Le i I ing Cover, E l ec:t' 1 Final
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P'h o n e #: Wall Cover,
Reg #. . : 113641
This permit is issued subject to the regulations contained in the __
Tigard Municipal Code, State of Ore. Specialty Codes and all other P Si gnature
applicable laws. All work will 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. 7`s lj e d by
INSTALLATION
The installation is being made on property T own which is not intended for-
sale, lease, or rent.
OWNER' S SIGNATURE: ._ __._ _..._..___...._..___�___...____.. DATE:
INSTALLATION ONLY-- ----- _----- ---- --- _._-..._.._.
SIGNATURE OFF SUP'R. ELEC9 N S .________.___ _ �__ DATE.:
I_i CENSL_ NO: ...._..__..
Call for- inspection - 639-41.•75
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Community Development ELECTRICAL PERMIT APPLICATION
,
13125 SW Hall Blvd. --y r, ?6 — (�L, "
Permit Tigard, OR 97223 errmlt # �-
Date Issued
Phone (503) 639-4171
FAX (503) 684-7297
{ CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
r1. Job Address: 4. ComplQte Fee S-hedule Below:
Na.- 3 of Development _ Number of Inspections per permit allowed
Address �LA) Service included: Items Cost(ea) Sum
City/State/ZipZ'`,L 4a, Residential -per unit
1000 sqft or less $11000 _ 4 i..
Name (or name of business)_ _ '^ Each additional 500 sq it or $25 o0
portion thereof I
F-17
Commercial ❑ Residential L�1 Energy $2500
Eachv _
\\ Each Menurd Home or Modular
Dwelling Service or Feeder $G6 OC 2 y
2a. Contractor installation only:
db. Services or Feeders
L� �-1 Installation,alteration,or relocation
Electrical Cont2ctort -T- J �k k:_ czT— 200 amps or less
$
60.00 Z
Address 7�._ RAJ�+��'� N-t tI � 4 V27 201 alnps to 400 amps $60.00 _ 2
401 amps l0 600 amps 5120 INj 2
City_— }iq ;s,� State(R Zip� �2 $leaoo _ 2
tj 601 amps to 1000 amps
Phone 0. �_ Over 1000 amps or Vohs _
$340.00 2
Job INC. Reconnect only $50.00 _ _ 2 I
contractor's license NO._�3 s 4c. Temporary Services or Feeders i
Contractor's Board Reg. N Installation,alteration,or relocation
Sigilature of Su r. Elec'n 200 amps or less _ 2
','01 amps to 400 awns $5��' 2
License No. Pho No._(_3 401 amps to 600 ampsg7 — 2
Over 600 amps to 1000 volts -
2b. For owner installations: see"b"above
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4d. Branch Circuits
Print Owner's Name New,alteration or extenslon per Fane
Address r, a)The fee for branch circuits with 2
City State Zip purchacoofservice orFeeder fen
y — --- Each branch circuit
Phone No. _ h)The fee for branch circuits without
o U
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit $35 00 �
Each additional branch circuit $500
Owner's Signature 4e. Miscellaneous ;
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4000 2
Each sign or outline lighting $4000 _
Signal clrcuh(s)or a limited energy 2
Please aleck appropriate Item and enter fee in section 5B. panel,alteration or extension $40.00
4 or more residential units in one structure Minor Labels(10) $10014)
_Service and feeder 225 amps or more
4f. Each additional Inspection over
System over 600 volts nominal
_Classified area or structure containing special occupancy the allowable In any of the above
as described in N E C. Chapter 5 per inspection $35.00
p Per hour $55.00
In Plant $55.00
Submit 2 sets of plan: with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $
NOTICE 5% Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOTCOMMENCED WITHIN 160 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec,3) $
A PERIOD OF 160 DAYS AT ANY TIME AFTER WORK IS Subtotal $ _
COMMENCED. Trust Account #
nl�inn $
Balance Due $ � '
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