10750 SW NORTH DAKOTA STREET IS VIONVU HIHON IFAS 0SL06
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10750 SW NORTH DAKOTA ST
_ MECHANICAL PERMIT
CITY OF T I GA R D
DEVELOPMENT SERVICES PERMIT*: MEC2000-00423
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/27/00
PARCEL: 1 S 134DA-02500
SITE ADDRESS: 10750 SW NORTH DAKOTA 31'
SUBDIVISION: ZONING: R-3.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APDL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
FUELTYPES _ Y 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT. BTU 15-30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30-50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO DRYERS:
FURN < 100K BTU: 1 _AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: �^ <= 10000 cfm: 0 GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas furnace
Owner: A FEES
Type By ~Date Amount Receipt
U PRM'r CTR 10/27/00 $72.50 2120000000
O �? ! -7 Z 5PCT CTR 10/27!00 $5.80 ?_720000000
r\ Total $78.30
Pho e:
Contractor:
REQUIRED INSPECTIONS
Gas Line Insp
Phone: Mechanical Insp
Reg#: Final Inspection
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JThis 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 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189.
Issue By: C.� _ Permittee Signaturl:-, *�—
Call (503) 39-4175 by 7:00 P.M.for Inspectlens needed the next business defy
10/24/00 TIIF 98:41 FAX 503 598 1960 CITY OF TICARD Q002
Mechanical Permit Application
rDa�tereceived:
City of Tigard :'txtject/appl.no.: p;nd.�;
City of Tigard Address: 13125 SW Hall Blvd,'figani,OR 97223 —
Phone: (503)639-4171 Dote issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no. Payment type:
Land use approval: BuildinRpermit no.:
I A 2 family dwelling or accessory ❑Commarcial/industrial U Multi-family U Tenant improvement
U New construction Addition/alteiation/mplacemen( U Other.
Job address: ' �3U ), Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labo,overftead.
Tax map/tax lottaccount no.: profit. Value S 150 C.)6`'
Lot: Block: Subdivision: "See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county:T �►: X17
pi
Description and location of work on premises: _
A�[_ /Al FQ(&JAce Ree(m) Toler
Est.date of cornpletiou/inapection: It-L ror 1Dewi y. Rn. Pis.osdy
Tenant improvement or change of use: Tling.n
Is existing space heated or conditioned7-4Yea O No it 1 _CFM 2ji,Q
v conditioning(site an rNu )
Is existing space insulated? Yes U No Alteration of existing system
er/rompressots
Business name: E State boiler permit no.:
Addre9s:
— HP Tons BTII/H
-- Firclamoke&mperplduct amp aetectors
City: _ Slate: ZIP: Ileetpurn s to an raga
Phone: — _— Fax: E-mail: nsta replace rnac urncr
CCR no.
Includin ductwork/vent liner 0 Yes O No
nsta rep arc re ocatc caters suspen
City/metro He.no.: wall,or Floor mounted
Name(please nl): -�� ent ora ranee t cr en mea -
Absorptionunits-__�_ BTIJ/H
Name: two t ,� Clmillers-- — HP _
Address: IO T5 ,v. /I cam;q Con realms HP
ros�ert eaexxhand vent t oat
Cfty: State:U 'LIP: 7 A lumce vent
Phone:.SPS-&Zo-%% Fax: E-mail:
)rye
Aust —
Hoods, ype rea. itC R n itt
hood fire suppression system --
Name: Ile-1. Exhaust(an with single duct(bath fans)
Mailing address:(o?SL� S t:", ti--�C x Ausf a stwu A An m Mating or AC
IL - - up to uu eb
City: Slate: ZIP:y7 Z Z Ty : — _LPC NO Oil
~ Phone:5v3 bt0- J Fax: F,mail: c piping eacha don over outlets
N
cess XW(ec tematicrequire
Name: Number of outlets
odw hided appliance of -
Address: _ Mcorativefireplace
(� City_ State: 7.1P: rtsert-ty e
W Phone: J Fax: I 5;mall: Waidstov pe et stove
Applicant's signature: (Atte:
Name(print):
Not on hmsdknons sceept credit endo,pWse mit iariodk jan kx rrrmr tarormadNm. Permit fee............... .$ _
OVies ❑MasterCard Notice:Thisemitfi application Minimum fee....... ........$
_
expires if a permit Isnot obtained
Credit card numbs:_— _ — _L- ,L Plan review(a1 %)
nxpirK within 180 days after it has been -
Name oic icer of s :,wn nn credit aW accepted As complete. State sttr:.ltarge(11%)....$
--- —
$ _ TOTAL ................... ;
Cardhdder tiguhrce A nt —
44M617(RxitlR`O?t)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST '
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -�
- BUP
Date RequestedZ, ? _ AM —PM SLD
Location U �U 5 w N1,vf5 P�kokt- -�� Suite _ _ MEC
Contact Person — ✓/ter+ Ph PLM
Contractor�_-- Ph SWR
BUILDING — Tenant/Owner ELC u��✓ ",�U 6�'�
Retaining Wall ELR
Footing Access: _
Foundation FPS
Fig Drain SGN
Crawl Drain Inspection Notes: —
Slab --- _--- SIT
Post 8 Beam --
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation —
Drywall Nailing o,
Firewall
Fire Sprinkler
Fhe Alarm —
Susp'd Ceiling
Roof
Misc: _ �L
Final —
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out ---"— — _
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post R Beam ----- — -- — —.—_
Rough In
Gas Line — - -
Smoke Dampers
Final -- --- -- - --
PASS PART FAIL
a Service — — -- -- - -- �'--- -----
Rough In
H UG/Slab
Low Voltage --
F-110 Alarm
,J 7inZi
_m A3 PART FAIL
UNITE
J Backfill;Grading --- - — —- --- -
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ _--required before next inspection. Pay at Caty Hall, 13125 SW Heli Byrd
Catch Basin
Fire Supply Line t ]Please call for reinspection RE: [ ] ble to Inspect-no access
ADA
ApprOtheoach/Sidewalk Uate /�-�' �_-G �� Inspectorxt _
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the fob sit*.
_
CITY ®� �I��R D - ELECTRICAL PERMIT
DEVELOPMENT SERVICES DATE ISSUED:PERMIT 10/27/1000-00805
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 PARCEL: 1S134DA-02500
SITE ADDRESS: 10750 SW NORTH DAKOTA ST
SUBDIVISION: ZONING: R-3.5
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of gas furnace
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 ams): PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUTLINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVG/FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER—� BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1 st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW_SECTION
1000+amo/volt: >=4 RES UNITS: a >600 VOLT NOMINAL:
Reconnect only: SVC/FDR%=225 AMPS: CLASS AREAISPEC OCC:
Owner: YY) Contractor:
107•x' 0
r� g 7-2-
Phone:
aPhone: Phone:
Reg#:
FEES Required Inspections
Type _ P.4 Dat,9 Amount Receipt Elect'I Final
SPCT -R 10/27/00 $3.75 2720000000(
PRMT L I-R 10/27/00 $46.85 2720000000(
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. 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 N work is
1 suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rukts adopted by the Oregon Utility Notification Center. Those
r rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain ooples of these rules ordKect questions to OUNC at(503)
J) 246-1987,
s~ i
J PERMITTEE'S SIGNATURE ISSUED BY:
a OWNER INSTALLATION ONLY
AliJ The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ DATE:
CONTRACTOR INSTALLATION Olat_Y
SIGNATURE OF SUPR. ELEC'N: r DATE:
LICENSE NO:
Call 639-4175 by 7:00pm for an Inspection the next business day
10/25/00 WED 10:04 FAX 5103 598 1900 CITY OF TICARD Q002
Electrical Perm#` Application_
Date received: �/ 7 tNmi
City of Tigard Project/appl.no.: Expire date:
City ofTiRard Address: 13125 SW Hall Blvd,Tigard.OR 97223
Phone: (503) 639-4171 Date issued: eY:_ Receipt aa.:
Fax: (503) 599-1960 Casef<lcno.: Payment type:
Land use approval:
bii•I cit 2 family dwelling or accesxory ❑Comm-rcial/industrial O Multi-family U Tenant improvement
LJ New consiniction ;iKAddititm/alteration/replacement U Other. U Partial
Job address:107- tccYr-A Bldg,no.: Suite no.: Tax me tax lot/arxount no.:
Lot: Block: Subdivision:
Project name: DescriF T and location of work on (rises: —
Estimated(late of com I ti rd' lection: ----
,lob no:
-- - - We IMax
Buxiness name: 111.) Total no.
Address: KVW1 Midw-daitberwilA.4bPr
dwell"Mall * , tilMeiatlgfrwp
City: T Slate: �ZlP: %Wvk*ftssfaded
Phone: -- Fax: I E-mail: 1000 s9.R.or leas 4
CCB no.: Elec.bus,lic.no: hwh additional 500 p.ft.or portion thereof
Limited etle�y,residential
City/metro lie,no.• �— z
I Jmited energy,non-residential 2
i�J� Each manufactured horse or modular dwelling
Signatureofsupery 4et quired) Date - Serviceendlorfeeder 2
Su elect.nenre(print): Licaueno: tienknerfee+ierrt-IartwBadear,
ahe"
tton""-'-''"tabs"::
20x1 unpn su lase 2
201 amps to 400 am --- —� - 2
Mailing address: 7 -o fl 401 a to 60x1 ams 2
601 amps to 1000 ams 2
City: State:Cl L 'LIP: 17 7. z Over 1000 amps at volu 2
Phone: Fai. E-mail: Reconnect Only - 1
Owner installation:T'he installation is being made on pmperty I own 9lsayionrywrrkesorfeeim
which is not intended for sale,lease,rent,or exchange according to hwall"Man+aNcratien,orrelecedOW.
ORS 447,455,479,670.701. 200 amps or leas 2
201 amp to 400 amp 2
Owner's si natum: Datc: 401 to 600 amps — 2
Dtw"Meru---mew,altenHen,
Name'
of extenaloa per p ml:
-__ A Fee for hranch circuits with purchase of
Address:` _ service or feeder fee,each branch eirealt 2
CL City: Slate: ZIP: B. ree for branch circuits without purchase
Phone: has' E-mail: of service or feeder fee,first branch circuit: 2
Exh additional branch circuit:
1- Mbc.(&;ries orkedernet hcltded):
U) ❑Service over 225 amps-commercial ❑Health-caro facility Euir pump or imation circle 2
U Service ova 320 amps-rating of 1 R2 U Haurdttus location Each sign or outline lighting
2
J farm ydwellings U Building over 10,0110rquam feet four nr Signal circuills)nr a limited Pimp panel,
mUSyrtemover MUvoltsnominal more residential urtts in one structure alteration,or extension* 2
U Building over three stories U I�ers,4(ltlampsarmnre *Description:
W 13Occupant loud over 99 persons O Miffla W ured structures or RV park FNjpmv Insped-hise ever
J U Fgressflightlnsplan U(Aker: 11111!a sews ! tarYoftMaYove
Perinaprxtion _
Subm"_T We of phos(Mth any of the Move. - Investigation fee - r-T-�-
IMe above are not appfemble to temporary cowdredlou atxvke. Other -
No all)urisdictinr accept credit rinds,Me—call loriwficrion for esus infannsti; Noticer This permit application Permit fee.....................$ _
O Visa U MasterCnrtl expires if a permit is not obtained Plan review(at _ %) $
Credit card nrmher: __- _L_! within ISO days after it has boon State surcharge(9%)....$
Exprrea accepted as complete. TOTAL
�irneof cardholder as s s�envn tin ratxllt cord �.._
-- S
_— Cardholder dputare Artrxrat
440-615(6MWOM)
10/25/00 WED 10:05 FAX 503 598 1980 CrTY OF TIGARD Q003
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
Restricted Energy Fee...................................................... $75.00
Number of Ine lona r It showed (FOR ALL SYSTEMS)
Service Included: Items Cost Total
Check Type of Work Involv9tl:
Residential-per unit
1000 sq.ft,or less _T $146.15__— 4 ❑ Audio and Stereo Systems
Each additional 500 sq.R.or
portion thereol _ 533 40_ 1 ❑ Burglar Alarm
Limited Energy — $75.00
Each Manurd Horne or Mrdulor ❑
Dwriling Servu;n or Feeder _ $90.90--- 2 Garage Door Opener-
Services or Feeders F Heating,Ventiiabon and Air Conditioning System,
Installation,alteration,or mlocetion
200 amps or lees _ $80.30 2 r�
201 arr;)s to 4W amps _ $106.85 -_____—_ 2 0 Vacuum SyrtPmss
401 amps to 600 amps5100.80 2
ps
601 amto 1000 amps — —_ $240.60— 2 ❑ Other
Ove-1000 amps or Yoke $454.65 2
Reartvwct only $66.65— 2
Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY
InsteAatlon,akemtbn,or relocation Fee for each system..........................................................
200 amps or less _ _ $88.85 2 (SEE OAR 8111-280-280)
201 amps to 400 amps $100.30 _ 2
401 amps to 600 amps _ $133.75 2 Check Type of Work Involved:
Over 800 amps to 1000 volts,
see"b"shore. [� Audlo and Stereo Systems
Branch Circuits ❑
Now,alteration or extension per panel Boiler Controls
a)The lea for tmanch dreuks
with punchase of service or ❑ Clock Systems
redder hs.
Each branch circuit f $6115` 2 ❑ Data Telecommunication Installatkm
b)The fee for branch circults
Without purchoes,ofswtce ❑ Floe Alarm Installation
or feeder fee.
First branch circuit ---L- s4e.e5
Each additional branch circuM $8.65 HVAC
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or Irrigation circle $5340
Each sign or"Ina IlghLng S53 40 ❑ Intercom end!aging 3yslem9
Signal cirwlt(s)or a limited energy
panel,alteration or extension $75.00 ❑ I_andsrape Irrlgatirm Control'
Mlnnr Labels(10) _ $125.00 —
Each additional Inatlectlon over F1 Medical
the allowable in any of the above
Per Inspection $62.50 ❑ Nurse Calls
Per hour _ $82.50
In Plant _ $73.75 -- ❑ Outdoor Landscape Lighting'
a Fees: ❑ Protective Signaling
Enter total of above foes $` I 1 mer
8%State Surcharge $ — _Number of Systems
25%Plan Review Fee
See"flan Revir W'section on $ No licenses we required. Licensee em required for all other hrotgll.tions
front of application --- --
// Fees
W
—a Total Relence Due $y,V &0
ryry Enter total of shove face $
Elrrust Account R -- 8%State Surcharge E
- Total&WArrce Dun t _,
i:klsts\fortneklc-fees.drr 10/09/00