11980 SW NORTH DAKOTA STREET-2 is diO)idO HibON MS 06661
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1 I Vii SW NUF DAKOTA ST
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: EL.C97-+0299
13125 SWHAHBlvd.,llp rd,OR 97223 (501)M4171 DATE ISSUEDs 05/23/9.
PARCEL: 1S134CA-03000
SITE ADDRESS. . . : 11980 SW NORTH DAKOTA ST
SUBDIVISION. . . . :BURLWOOD NO. 2 ZONING:R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :3 JURISDICTION: 710
Project Description: 11GTL 1 bWIC CIAWIT // J01 1 ?
-----------------•-----
---RESIDENTIAL UNIT---- ----TEMP ERVC/FEEDERS---- -----MISCELLAN70US-----
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . a 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 CIRCUITS------ ---ADD'L INSPECTIONS---
@ - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : 0 1st W/O ERVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . - 1 a iv EA ADD' L BRNCH CIRC: 0 IN PL.ANT. . . . . . . . . . . 1 0
601 - 1000 amp. . . . . : 0 ----- -------PLAN REVIEW SECTION----------------
1000+
ECTION----------------
1000+ amp/volt. . . . . : 0 ) =4 FEES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR )= 225 AMPS. . : CLASS AREA/uPEC OCC. :
Owner: ------------ -------------------------------------- FEES -----------------
JOAN K ARRINGTON type amount by date recpt
11980 SW NORTH DAKOTA ST PRMT $ 35. 00 TAT 05/23/97 97-295046
TIGARD OR 97223 5PCT f 1. 75 TAT 05/23/97 97-295046
Phone #:
Contractor: ----------------------------------------------------------------
GRF ELECTRIC 1 36. 73 TOTAL
15460 SE PARADISE LN
------- REQUIRED INSPECTIONS -----
MULINO OR 97042 Ceiling Cover Underground Cove
Phone #: 503-829-4146 Wall Cover Elect' 1 Service
Reg #. . : 001015
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and ell other Perm i S i gnat u
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
LL within 181 days of issuance, or if work is suspended for more
than 181 days. I Stitt ed By
�N -----------------------------OWNER INSTALLATION ONLY----- ------------------------
The installation is being made on property I own which is not intended for
sale, lease, or rent.
_m OWNER' S SIGNATURE: _ DATE:
a
J ---- ------------ --------CONTRACTOR INSTALLATION ONLY------------------•--------___
SIGNATURE OF 5Ui=R. ELEC' Na ___ DATE: 5-21
LICENSE NO: _
Call for inspection - 639-4175
CITY OF TIGARD Electrical Permit Application Plan Check»_
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone(503)639-4171,x304 Date to DST_
Inspection (503)639-4175 Print or Type Pem11t N
Fax(503)684-7297 Incomplete or illegible will not be accepted Called��
1. Job Address: 4. Complete Fee Schedule Below:
Name of Developments Number of Inspections per permit allowed
Name(c r name of business)_�Q G1 Y1 1�11� Yi'43!;I_",`�_ r Service Included: Items Cost Sum
Address_ ty S Lu N U Y 4 1'1 bc4 fc Ct 4s. Residential-per unit
1000 sq.ft.or less $110.00 4
City/State/Zip �I 4A L 0 ir- �� Each additional 500 sq.ft.or
Commercial❑ Residential LT Llportion thereof $25.00 1
mlted Energy $25.00
Each Manurd Home or Modular
DwelNng Service or Feeder $88.00 2
2a. Contractor Installation only:
(Attach copy of ell c m t licenses) 4b.Services or Feeders
Electrical C ntr Or Installation,alteration,or rekcatlon
Address "' 200 amps or less $80-00 2
201 amps to 400 amps -_ $1180.00 2
City Sthte _Zip --2 0- 1 401 amps to 600 amps $120.00 _ 2
Phone No. _ C - 601 amps to 1000 amps $180.00 2
.lob No. Over loon amps or volts $340.00 2
Reconnect only $50,00 2
Elec.Cont. Lice. No. _ 1',C_. Up.Date
OR State CCB Reg. No. /01SZ/ --�,-Exp.Date 4c.Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date__ Installation,alteration,or relocation
200 amps or less $50.00 2
Signature of Supr. Flec'n 201 amps to 400 amps $75.00 _ __ 2
g - - 401 amps to 600 amps $1$X).00 2
( Over 600 amps to 1000 volts,
License No.- > _Exp.Date._ _„_ see"b^above.
Phone No._ is v" ' -4 /`j_- 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner Installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name` leader W.
Address Each branch circuli $5.00 _ 2
b)The fee for branch circuits
City State Zlp without purchase of
Phone No._ service or feeder fee. �{
First branch circuit $35.00 l 2
The installation is being made on property I own which Is not Each additional branch circuit_ $5.00 2
Intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not 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 circult(s)or a limited energy'
ISL panel,alteration or extension $40.00 2
Minor'abets(10) _ $10o.00
Please check appropriate Item and enter fee In section 58.
N 4 or more residential units in one struch.lre 411.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
5 System over 600 volts nominal Pe Inspection x•00
_Classified area or stricture containing special occupancy Per hour $55.00
m as described in N.E.C.Chapter 5 in Plant $55.60 _
W "Submit 2 sets of plans with application where any of the above apply. 5. Fees:
.J
Not raqulred for temporary construction services. 5a.Enter total of above tees $
5%Surcharge(.05 X total fees) $ [_S
NOTICE Subtotal $
5b.Enter 25%of line 5s for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review 1fM41f@d(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY r,
TIME AFTER WORK IS COMMENCED. Trust court N-
Total balance Due
I TSTSTLC99.APP na 9w
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hmr Inspection Lino:639-4173 Business:''bone:639-4171
Date Reqursted: M. P.M. MST:
1) 3 Location:—_L_L_Zj )i� BUp:
Tenant:_ P State: /BWS MEC:: 17 7- 613
Contractor_ . ''� �t --- _Pfwtt°: , ltr� n.M: _
Owner: EM 7
ELR:-+-
SM
BUE NG BLDG(eoa't) PLUMBING CAL RLRCTOCAL -SITR
Site Post/Beam Post/Beam PosilBeim Cover/Service Sewer/Slarm
Footing Roof UndFI/Slab Rayh-In COW" WdW I,I
Slab Framing Top Out Gas Line Roul" UO Sprhow
Foundation Ins dation Sewer Hood/Duct Reconnect Vault
Bent Damp Drywall Storm Fwwqe Temp Service hFM
t Masonry Ceiling Rain Drain C A/C UO Slab
Shear/Sheath Fine Spklr/Alm Ctawl/Found Dr tDIM I.ow WIL mama=
Approved Approved Approved Apptov od
Appr/Sdwlk Not Approved Not Approved vedNa m
FINAL FINAL AL FINAL
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O Call for rein. M Reinspwhon fee of snext hupectimt 0 Unabk to�d
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Inspector: - Date: Page o[— —
t '`• � o ��� II Ili! ,, �. �
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Insom ion Linc:6394175 Businras Phocw;: 639-4171
Date Requested: C�//���� _ M. P.M. ?AT:
T- 1
Location:_ BUP: _
Tenant:_ _ Suite: Bldg: MEC:
Contractor: Phone: _ PLM:
Owner:— Phone: ELC:
ELR:
SR: _
BUILDING BLDG(con't) PLUMBING ECHANICAL� EL19CIMCAL SITE
:,lie Post/Beam Post/Beam Pa esm Cover/Service Sewer/Storm
Footing Roof UndFVSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bamt Damp Drywall Storm FUENO Temp Service MISC.
Masonry Ceiling Rain'Drain A/C UO Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr ent PUMP Low Volt
Approved Approved MIvved Approved Approved
Appr/Sdwlk Not Approved Nct Approved ved Not Approved Not Approved
FINAL FINALAL FINAL FINAL
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Inspector: Date: --j � __ Page of _
CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT N. . . . . . . s MEC97-0135
13125 SW HBO Blvd.,Tigard,OR 87223 (503)OX4171 DATE I SSUED s 05/15/97
PARCEL: 1S134CA-03000
SITE ADDRESS. . . : 11980 SW NORTH DAKOTA ST
SUBDIVISION. . . . a BURLWOOD NO. 2 Z ON I NO s R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :3 JURISDICTION: TIO
-----------------.-----------------------•---------------------------------------
CLASS OF WORK. . sADD FLOOR FURW . . . : 0 EVAP COOLERSi 0
TYPE OF USE. . . . sSF UNIT HEATERS. . : 0 VENT FANS. . . s 0
OCCUPANC*ir ORP. . sR3 VENTS W/O APPLs 0 VENT SYSTEMSs 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES------------ 0-3 HP. . . . a 1 DOMES. INCINt 0
a 3-15 HP. . . . s 0 COMML. I NC I N t 0
MAX I NPUT S 0 BTU 15-30 HP. . . . t 0 REPAIR UN I'T'S t 0
FIRE DAMPERS?. . t 30-50 HP. . . . : 0 WOODSTOVES. . e 0
OAS PRESSURE. . . s 50+ HP. . . . t 0 CLO DRYERS. . s 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 0 (A 10000 cfsw: 0 GAS OUTLETS. t 0
FURN )-100K BTUs 0 ? 10@@@ cfms 0
RemiarN . IMM 1 BOILER/RIR COIF/NEAT MIP // W/AIR CONDITIONINS UMTS CAM BE
PLACED W TTIACKS
Owner ---------------------------------------------------- FEES --------------
JOAN r il ..RINGTON type amount by date recpt
11980 —W NORTH DAKOTA ST PRMT $ 25. 00 TAT 05/l5/97 97-294647
TIGARD OR 97223 5PCT • 1. 25 TAT 05/15/97 97-294647
Phone #t
Contractor: ---•--------------__.-_____-•----
—•-------------------------------------
Ph o n e #v $ 26. 25 TOTAL
Reg #. . :
------- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Post/Beam Insp
RTigard Municipal Code, State of Ore. Specialty Cedes and all other Mechanical I n s N _
CO) applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 181 days of issuance, or if work is suspended for more
m than 181 days.
J ..'
Permittee Si at9 _
Issued By:
Call for inspection — 639-4175
City of Tigard MECHANICAL PERMIT PlancWRec. #
13125 SW Hall Blvd. APPLICATION Permit # -6
Tigard, OR 97223
(503) 639-4171
e... esrnpnon
Table 3A Mechanical Code QTY PRICE AMT
Job j c%';�G j rilz)(`w� Da ) Permit Fee -0- -0- 10.00
Address
2) Supplemental Permit 3.00
.,...,. Furnace b
c, 1) incl.duds a vents 6.00
Furnace 1 00,UQU is I U +
Owner ( 1CNO S``� �'`�'�'` pi's"'' 2) Ind.duds a vents 7.50
,... Flour Fumance
\ 02 `-i�aa3 3) incl vent 6.00
spe seater,w eater ,
4) or floor mounted heater 6.00
... Vent rat inci.in
Occupant 5) appliance permit 3.00
.,. — epav of hoating.r rg.
6) cooling,absorption unit 6.00
i er or comp.heat pump,air co . _
7) to 3 HP absorp unit to 1100K BTU 6.00 Lam'
.,s . er or comp,heat pump•air co
nT
(_j ��` - �a�1 -�t3N- 1 8) 3-15 HP absorp unit to 500K BTU 11.00
Contractor i er or comp,host pump,air cond.
�1V O� 7 a1.aZ 9) 15-30 HP absorp unit.5.1 ml BTU 15.00
w ,. u 1 er or Comp. at pump,air co;a.
`�l'� 10) 30.50 HP absorp unit 1-1.75 ml BTU 22.50
rye a Sgo at have res x is app atioc, t e er or comp, at pump,au co
Information given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner,that plans submitted are in compliance with State ' r ing unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 rFM 4.50
that the number given is correct (If exempt from State registration, r ing ural
please give reason below.) 13) 10,000 CTM. 7.50
Ton porta
14) evaporate cooler 4.50
Vent tan connectod
15) to a single dud 3.00
I
Ventilation^ system not
/fin16) iricludedin appliance permit 4.50
., Hood Wrvod 67y
1� mecluv*ol axhtiust 450
scr new. a rtwn -alteration Q repair Q Commercialor ittlustrial
to be done resider al non residential Q 18) type incinerator 30.00
17-xisting-usw of Otior i.e., stove,wag;
building or property 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property
21) More than 4-per outlet
Type of fuel-of 0 natural gas O LPG 0 electric O
NOTICE
Minimum Fee$25.00 SUBTOTAL b
PERMITS BFCOMF.VOID IF WORK OR CONS"MUCTION a
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 25X OF SUBTOTAL
AFTER WORK IS COMMENCED.
Q TOTAL
Special Conditions
a\ Q51110 Date issued` by
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