15905 SW OAK MEADOW LANE 15905 SW Oak Meadow Lane
_. ELECTRICAL PERMIT
CITY OF TIGARD
�\ PERMIT#: ELC2001-00622
DEVELOPMENT SERVICES DATE ISSUED: 12110/01
13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 f4ARCEL: 2S111DC-13300
SITE ADDRESS: 15905 SW OAK MEADOW LN
SUBDIVISION: SUMMERFIELD NO.11 ZONING: R-7
BLOCK: LOT : 629 JURISDICTION: TIG
Proiect Description: Install 5 branch circuits for remodel.
RESIDENTIAL UNIT TE:h1P SRVC/FEEDERS MISC.Fl -ANEOUS —
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION.
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED EtIERGY- 401 - 600 amu: SIGNAL/PANEL:
MANF NMI SVC/ FDF:: 601+arnps - 1000 volts: MINOR LABEL (10):
SERVICEIFEEDER _ _ BRANCH CIRCUITS ---ADD'L INSPECTIONS
0 - 200 amp:' W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st WiO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 !N PLANT:
601 - 1000 amp: PLAN REVIEW SECTION _
1000+ ampivolt: _ >=4 RES UNITS: ^� > 600 VOLT NOMINAL:
Reconnect only: _ SVC/FDR >= 22.5 AMPS: _ CLASS AREA/SPEC OIC:
Owner: Contractor.
GEISLER,WILLIAM PAUL TRUSTEE ME i ZGER ELECTRIC INC
GF_ISLER, BARBARA WILLIAMS TRUS 8780 SW LEHMAN ST
15905 SW OAK MEADOW LANE TIGARD, OR 97223
TIGARD, OR 97224
Phone: Phone: 244-9025
Reg#: LIC 96805
SUP 3130S
ELE 34-167C
FEES Required Inspections
Wall Cover
Type By Date Amount Receipt �1
Elect'I Final
PRMT CTR 12/10/01 $73.45 2720010000(
5PCT CTR 12/10/01 $5.88 2720010000(
Total $79.33
This Permit is issued subject to the regulations contained in the Tigard Munidpa!Code,State of OP Specialty Codes and all other 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification
Center. Those rules are set forth In OAR 952-001-On10 through OAR 952-001-008C. You may obtain copies of these rules or direct questions to
Permit Signature: ( Issued P-n —�
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
SIGNATURE OF SLIPR. ELEC'N: _-_ __.— DATE:—
LICENSE NO:
Call 639-4175 ny 7:00pm for an ii-spection the next business day
Electrical PermitApplication
`-�--- -� — 1�)atereceived:!MlPrmt no.cL ri
City of Tigard Project/appi.no.: Expire date:
Ciryo(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1966 ease file no.: Payment type:
Land use approval:
w'
JS"
1 &2 family dwelling or accessory U Commercial/industrial U Multi-f Itiily U Tenant improvement
U New construction W Add iIion/altortlion/re place metit U Other: _ J 1•,.rtial
'JOB SFFE INFORMATI 6"
Jobaddress: �) �' �'�i° lilrig. n„ ualr no.; Tex map/tax lot/account no.: —
Lot: Block: Subdi ision:
Plor-ct namc; I De,, " ,,-n and location of work on premises:
I •.tnn,alo•tl,lalr t,l run plru,n!hnsl. cline
OR AIIIPIACAT1115 - �,Z, IFE-St'llitDIULE
Job no: � err tax
Business namc: MP _ -- - Description try. (ea) Total nu.ins
6,----- New rexldrdial-single or multi ramilt let
Address: . i) I j dwelling unil.ani link r anartted garage.
City: Sale:Q ' ZIP: r 3 Service Included:
Phone �� �lhlour I(Nlt)sy (t ,n Ir•.•
Email:
Each;,adntonal 500 sq it or portion thereof
CCB no.: (� y p�; filec.bus. tic.no: 3 y-1(�7L' t.inotedenergy,residential 2
City/metro tic.no.: q Gr� ' 1 Lunitrdenerg,•,nou-rc.�nlcnnal 2
- — —_ '1 Foch manufactured home of modular dwelling
Signature of supervisin elecnired Unte 1 Service and/or feeder 2
Services or feeders-Installation,
Sup.elect.name(priv0: Ir I.tort%e no.i I71 1 ! alteration or relocation:
H 11121 two 1,11-1 AM 2(x1 amps or less ,
Name(print): 201 utnps to 4i10 amps -!
- - 401 amps to 6(x1 amps 2
Mailing address: — - T 601 am.s to 1000 nm s --'
City: State: ZIP: Oaer 1000 amps or volts — 2
Phone: Fax: E-mail: Reconnect tint I
Owner installation:The installation is being rnpde on property I own T'miw'aryservices orfeeders-
which is not intended for sale,lease,rent,or exchange according to �"f amp-or less or relocation:
ORS 447,455,479,670,701. 201 amps or Ie.s - - -- -
2a11 amps to 4041 at,tps _ 2
Owner's si nature: bate: 401 n,(,10 ams -� 2
8ronch circuits-new,alteration,
or extemlon per panel:
Name: -, _ A Fre for hranch circuits with purchase of
Address; service or feeder fee,each branch ci-cuit _ 2
Cily: Stale. ZIP: B. Fee for branch circaits without put hase
— of service or feeder fee•first branch circuit: 2
Phone: Fax: L-Iltail: Each addit,onal branch circuit:
Misc.(Service or feeder not Incladed):
U Service over 225 amps-conunerc•inl U Health c are f ecility F:ach pump or irrigation circle 2
U.Service over 320 amps-rating of 1&2 U Hazardous fixation Each sign or outline lighting 2
familydwelhngs U Building over 100K)square feet four of Signal circuit(.)or a limited energy panel,
U System over 6(x1 volts nominal more residential units in one structure alteration, qtr extension'
U Building over three stories U Feeders.410 amps on marc •lkscn ticu. _
U l kcupant load over 99 persons U Manufactured structures or RV park perch additional hlspection over the allowable In any of the above:
U I:guess/lightingplan U Other __ Per inspectionr--
Submit leis of plans with ani of the above. Investigation fee__
The alcove are not appllrsble to temporary construction service, other
-- --- $
Not all jurisdicnom accept crdlit cards please call jurisdiction for more Infonnaaon. Notice:This permit application Permit Tec........... .........
p $
U Viso U MastetCerd expires if n anti is not obtained Plan revieN(at ` %)
Credit card number _- _ ______._ 111within 190 days after it has been State surcharge(8%)....
--__ -- -- xM"' - accepted as complete. 'TOTAL .......................$ --
P:arne of c older u shown on ctedh cud
_ S _
----� Cardfiolder
Jputufe --- —�Amtwnt _ 440-46151tL4 'Ohl)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: - --- ---- — -- - -
RestricteJ Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: IterTIS Cost Total
Check Type of Work Involved:
Residential-per unit
I000 sq It.or less $145.15 _ 4 ❑ Audio and Stereo Systems`
Each additional 500 sq It or
portion thereof $33.40 _ 1 ❑ Burglar Alarm
Limited Energy $75.00 F _
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener'
Services or Feeders ❑ H,. �'inc„ --ation and Air Conditioning System'
Installation,alteration,or relocat: n
200 amps or less _ $8U 30_ 2
201 amps to 400 amps __ $106.85 2 ❑ nuuum Systems"
401 amps to 600 amps $160.60 2
601 amps to 1000 amps y240.60 __ 2 E] Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders — TYPE OF WORK INVOLVED • COMMERCIAL ONLY
Installation,alteration,or relocation Fee i`er each syatem.......................................................... $/t)00
200 amps or less __`_ $66.8:1 2 (SEE OAR 918.230.260)
201 amps to 400 amps $100.30 __ 2
401 amps to 600 amps $133.75 2 Check Typ,or Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits
New,alteration or extension per panel ❑ Boiler Controls
a)The fee for branch circuits
with purchase of service or ❑ C lock Systems
feeder lee.
Each branch circuit $665 _ _ 2 ❑ D iia Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑
or feeder fee. Fire Alarm Installation
First branch circuit _ $46.85 1(,
Each additional branch circuit $6.65 y ❑ HVAC
Miscellaneous I--I
(Service or feeder not included) I_J Instrumentation
Each pump or irrigation circle _ $53.40
Each sign�w outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circull(s)or a limited energy
panel,alteration or extension $75.00 _ D Landscape Irrigation C P
Minor Labels(10) $125.00
Each additional Inspection over ❑ Medical
the allowable In any of the above
Per inspection $6250 ❑ Nurse Calls
Per hour $62.50 _
In Plant $73.75 _ ❑ Outdoor Landscape Lighting'
Fees. ❑ Protactive Signaling
Enter total cf above fees $ ❑ Other_
8%State Surcharge $
--- —_—._,__Number of Systems
25%Plan Review Fe 1
See"Phn Review"3s1lon on $ ' No licenses are required Licenses are required for all other installations
front o4 application — _—
bees:
Total Balance Due $
Fnter total of above fees
trust Account#
~- 89b State Surcharge $
All New:ommerclal Buildings require 2 sets of plans. Tofa!H, „ tree Due $
i:\dsts\forms\eIc-f'ecs.doc 08/30/01
MECHANICAL PERMIT
CITY OF T I G A R D
DEVELOPMENT SERVICES PERMIT#: MEC2002-00074
17 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/19/02 0'111
PARCEL: 25111 DC-13300
SITE ADDRESS: 15905 SW OAK MEADOW LN
SUBDIVISION: SUMMERFIELD NO.11 ZONING: F-7
BLOCK: LOT: 1)"'9 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EV^.P COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUELTYPES _ _ 0 3 HP: i DOMES. INCiN:
LFIG ^ �^ —� -� 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 H;,.
FIRE DAMPERS?: 30 - 50 HP: OD*S UNITS:
WO005TOVES:
GAS PRESSURE: 504- HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS:
FURN >-100K BTU: 1 <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace existing gas furnace and add A/C. Property line adjusted per VAR2002-0006 J
Owner: — -- - _ FEES
Type By Date Amount Receipt
PRMT CTR 2/19/02 $72.50 2720020000
5PC T CTR 2/19!02 $5.80 272002000C
F hone:
Total $78.30
--------.._
Contractor:
COLUMBIA HEATING + COOLING INC
PO BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone:624-2704 Heating Unt Insp
Reg #:LIC 76359 Cooling Unt Insp
PLM 34-175 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if .vork is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law re wires you to follow rules adopted in the Oregon
Utility Notification Center. These rules are set forth in )AR 952-0_01-0010 through OAR
952001-0090. You may obtairi copies of these rules or .lire que § UNC by calling
Issue By: /, ; _��_ ! Permittee Signal,
-
C?II (503) ,s9-4175 by 7.00 P.M. for inspections needed th3 ne*t b siness day
Mechanical Permit Application
Dale received: Permuno.: + ,�
City of Tigard RojecUoppl.no.: Expire dart:
Of%,ofTigard Address. 1 1125 SW Hall Blvd.Tigard,OR 97223 pate issued: By: Recciptno..
Phone: (503) 639.4171
Fax: (503) 59$-1960 Case file no.: Payment type:
Land use approval: Building permit no..
1 &2 Family dwelling or accessory 0 Commercial/industrial U Multi-family -ii enant improvement
U New,construction .YAddition/alteration/replat.m- w J t)ther.
.1011 NITF INFORMATION 1 I
Job address; 9 ��o ,-/e,.;,1 , �Z . Indicate equipment quantities in boxes below. Indicate the di,ll.ir
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: profit, Value$
Lot: Block: Subdivision: *See checklist for important application whirmuu"n an l
Project name: jurisdiction's fee schedule for residentiu permit sec
City/county: ZIP: ,A
Description and rocs ion of work on premi es: _ t 111M I A FAI a MIR I WiJ I
Est.date of complet n/inspection: Description Qts.' Res only Rrw,out)
Tenant improvement or change of use: _ A
Is existing space heated or conditioned?U Yes U No Air handling unit ^—_CFNI
Air conditioning(site p an required)
Is existing space insulated?U Yes LJ No Alteration of existing HVAC system
of ear compressors
Business name: ,� ! �jyd ,. �� a �y
State boiler permit no.
�u'`Z12t - �� � HP Tons BTU/H
Address: del_) ej,, a it smo a dampers/duct smoke detectors
City: Staters 4-A ZIP: Heat pump(site plan required)
Phone: Fax: y E-mail: 1nsle rep ace urnac urner/_a_
CCB no.: d ti %c — Including ductwork/vent liner Yes U No
Hata rep ac're oe@:,;,,diel—su4pen e ,
Cit /metro lic.no.: wall,or floor moanted
Name(please print): V
ent foriarceot cr�i tTia�urnacc _
on:
a us BTU/FIName: /' q.t r a/C�Address: � is HPnta ex ust an vent at on:
City: State: ZIP: 77 ent
Phone: 00 '7U I Fax: E-mail I Dryerexhaust _
loods,Type /res.kitchenthitzmat
hood fire suppression system
Name: ( Exhaust fan with single duct(bath fans)
Mailing address: / > ;r/!' . ,i / It ti' s Du& Cil :x aust system apart from heating or AC
City: ,c-,eStatc:� ZIP: �� tie p p nR an st tit on up to outlets)
_ Type _ LPG NG (til
Phone; ' Gr Fax: E-mail: •tie t.in each as - nal uvei 4 ouTis—
Process piping(schematicrequire ) _
Name: Number of outlets
_ other IIA IIA- appliance or equipment:
Address: — !_ Decorativefireplace
City: State: ZIP: nsert-type
Phone: Fax: E-mail. oo stove/pel et stove��
ear:
Applicant's signature:,- G�,�'��u�y Date:��— `—
Name (print): r,
Not WI Jurisdictions srcepl cared;;curl,piece tali jurisdictionm
nn for ore lntcxrruum Permit fee........... . ... ...$ -2
O t all U MasterCard Notice:This permit application Minimum fee., $ _
`._._—__�_ expires if a permit is not obtained plan review(at %) $
Credit cud number
- FspJ within 180 days after it has been State surcharge(B%).,•.$
me —
aof cardholder a shown on credit cud accepted as complete.
S TOTAL, ......•................$
Cardholder signature Amount 44OA617 to WOMi
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CITY OF TIGARD
VA122002--00006 PLANNINGMNGINEtPlING
hAR.S'E1 SIDE ".ARIA MACK ArUM9TMNC
CITY OF TIGIARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
c �–�-�--— BLIP
Date Requesed - 3AM - - PM BLIP
� Re_f MEC --
�y
7.Location k �! �
Contact Person 7L-.—) — Ph 70 PLM
Contractor_ Ph( ) SWR
BUILDINU TenanUOwner _. c� Q- -__ ELC --
---- ! �' �� ELC
Footing _
Foundation Access:
Ftg Drain ELF{
Crawl Drain -- - SIT _
Slab Inspection Notes-- 3d -
Post&beam - t -- --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear i
Framing �' ��`�rT1iC'/.fL L�f�- ....cic. ii.QdF! __�-�� �.c:[-'. r 1�•�.3._3Q �/ _
Insulation
Drywall Nailing — - --- - - —._
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Root
Other:
Final ---
PASS PART FAIL —
PLUMBING_ - - - -
Post&Beam
Under Slab _-- - J-- --
Rough-In
Water Service
Sanitary Sewer _
Rain Drains -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In ------
Cas Line
Smoke Dampers
GnSs ART FAIL -- ^-- -" l—
CTRICAL
Service
Rough-In _
Ur/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PAR"C FAiL
SITE Please call for reinspection "f U Unable to inspect-no access
Fire Supply Line /
ADA ' Ins sctor /' �I /-
Approach/Sidewalk Det ��_ P -- -Ext
Other:
Final DO NOT REMOVE tkiis Inspection record from the Job site.
PASS PART ►*AIL
CITY OF TIGARD 24-Hour
• BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 Ms
p'
BLIP
Received ` _Date Requested_�___! 'l 0 AM _ PM -_ BLIP
Location L �511) 51- Suite____ _ MEC
Contact Person Ph( ) PLM -
-----------
Contractor_ � r'- �•,r_6% Ph s W F'
BUILDING Tenant/Owner _ _ __ _-_ ELC _
Footing ELC
Foundation ess'
Ftg Drain EI_R
Crawl Drain �- - - -
Slab Inspection Nate. : SIT
Post& Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -- - -- --
Firewall
Fire Sprinkler
Fire Alarm - JP- �i
Susp'd Ceiling -E�-G IPA- ��1
—
1
Roof
Other:
Final
PASS PART FAIL
PLUMBING_ _ —
Post&Beam
Under Slab -- --------._.— _ __
Rough-In
Water Service
Sanitary Sewer
Rain Drains ------ - —
Catch Basin/Manhole r-
Storm Drain --- -- -- —
Shower Pe,i
Other -- --
Final --
PASS PART FAIL — -- v—
_MECKNICAL
Post&Fieam
Rough-in
Cas Line
Smoke Dampers
Final
PASS PART FAIL -- — — -- —
ELFCTRICAL
Service —
gh-In
l a)
Low Voltage —
Fire Alarm
F-._ —4Reinspection fee of$ —required hetore next inspection. Pay at City Hall, 13125 SW Hall Blvd.
i
PART FAIL
SITE _ L Please call for reinspection RE:— _ lJ Unable to inspect-no access
Fire Supply Line
ADA
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Other:
Final DO NOT REMOVE thls Inspection record from the)alb site.
PASS PART FAIL