12260 SW NORTH DAKOTA STREET-1 1S V10)i1Ia HiHON MS 097,0
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12260 SW NORTH DAKOTA ST
CITY GF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hdl Blvd.,ilpe►d,OR 97223 (603)ON4171 PERMIT #. . . . . . . s MEC9 I-0129
LATE ISSUED: 10/20/T7
PARCEL: 1S134CH--34300
, SITE ADDRESS. . . : 12260 SW NORTH DAKOTA ST
SUBDIVISION. . . . : ANTON PARK ZONING: R-7
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :005 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . s 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . .. 0
FUEL TYPES------------ 0-3 HP. . . . -. 1 DOMES. INCIN: 0
:GAS 3--15 HP. . . . : 0 COMML. I NC I N: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DP.MPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . s 0
GAS PRESSURE. . . : 50-* HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 1 <= 10000 cfm: 0 GAS OUiLFTS. s 0
FURL ) =100K BTU: 0 > 10000 cfm: 0
Remarks : Wvis
Owner: --------------------------------------------------------- FEES - -- --------
A DAVIS type amount by date recpt
1260 SW NORTH DAKOTA PRMT f 25. 00 JSD 10/20/97 97-300191
TIGARD OR 5PCT $ 1. 25 JSD 10/20/97 97-300191
'hone #: 590-3656
Contractor: -- -----_.____------------.-----•__--
HOLL.AND' S HEATING
214201) NW NICHOLAS CT NO. 9 -----------------------------'---------
t 26. 25 TOTAL_
HILLSBORO OR 971224
Phone #: 645-8383
Reg #. . : 000752
--- - --- REQUIRED INSPECTIONS -- --This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp
applicable laws. All work will be done in accordance with Cooling Un t Insp
CL approved plafis. This permit will expire if work is not started Final Inspection
within IPO days of issuance, or if work is suspended for more
than 188 days. ATTENTION: Oregon law requires you to follow rules
} adopted by the Oregon Utility Notification Center. Those rules are
tl set forth in OAR 952-M-W8 through OAR 952-101-MM. You may
obtain copies of these rules or direct questions to OK by calling -
(581)246-9187.
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Issue By : Permittee Signature-
44++4..........4....
ignature:44++4+++++++++4t+++ ++++t+++++t+++++++++++++++++t++++i•+++++++++++++++++++1-t++....
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++t++4 +4+++++++++++++
CITY QF TIGARD Mechanical Permit A lication Par,cheek 0- -
PP Redd By
13125 3W HALL BLVD. Commercial and Residential Data R^_c'd
TIGARD, OR 97223 Data to P.E.
(503) 639-4171, x304 Date to DST_
Print or Type P«mt r�� `� of
Incomplete or Illegible a plications will not be accepted -
NWO of DawlopnunWro» Doscrbfim
Taf 1A Macharkal Coda QTY PRICE NMT
Job sa..k Daae.. A) Per., Fee -0• -0• tp.00
Address Sr!/.�(�v 7
° WeNk ZIP 1.) Furnace to 100,000 BTU e.00
ducts 6 vent
Nwre(or r'm of ) 2.) Fumaoa 100.000 BTU+ 750
Owner ff - s 4 ckfdkg duct d vent
/ "d';aa' 3.) Fk4rFumaa 6.00
inciiift on. vent
zio
c41,s2{) 4.) suep.ndad h..tor.w.0 heeler SAo
- or lkxtx mountad hestar
Name(a nem*a L 5.) Vint not kin appliance pemNt 3.00
Occupant w^a•�'• � - 6.) BoNar or corno,haat pump,air uond. 9.00
cam._ to 3 HP;absorb unk to 100K BUT-
PA01a 7.) Boller or camp,heat pump,air Gond. 11.00
_ 3-15 HP,abaft unit to 500K BTU"
Contractor . 6.) Boiler or aornp,haat pump,sk oxw. 15.00
/&i1A--S �f/f �,cl� 15-30 FP';absorb unk.5.1 nW a I U
Prior to permit *866 Addme �/ 9.) Bohr a
issuance,s copy ZN OV AAV�6&,,,M c--Ff- «Irnp.haat pump,.k donde 22.80
of all lioensss CMyl�Jbka 30-50 HP;sbsab unit 1-1.79mN BTU"
I' Phom 10.) BoRw or comp,haat pump,air pond. 37.50
are required N /)` J 'I �"� >50 HP,abeorb unit 1.75 mil BTU'-
ezpired In COT ! Caruq�WM.Board Lk.s - Fxp.Daft
q'6' 11.) Air har Jing unk to 10,000 M 4.50
se
databa4
Architect 'a"na 13.) ;rrh
or►poble evaporate 0001" 4.50
Or rNawny� � 14.) Vt;nt fan oonrwtded to a single duct 3.00
Engineer ciryrstra zip Phos. +5,) VerM U,-n syatam not krakfdad In 4.50
atoa pemW _
Desalbe work New O Addition O Alteration O Repair O 16.) I4000 served by nxKtuwdod azhnfat 4.50
to be done Residential/ Non-residential O
Additional Description of work, 17.) Domestic Rd,--mors
7.50
16.) Commercial or WxkiWW type 30.00
Inchwator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stow 4.50
Proposed use of 21.) Ck>thes dryer,etc. 4,50
building or property
O' � 22.) Other units 1.50
4' _
N Type of fuel-oil O natural ga LPG O ete�{c O 23.) (las pipkg one to fbur outI to 2,00
I hereby acknowledge that I have read this application,that the 24.) Mors than 4-par outb to(each) 50
J information given is correct,that I am the owner or authorized agent of
m the owner,that plans submitted are in compliance with Oregon Shta QTY.SUBTOTAL
laws.
W signature of nt Date "SUBTOTAL ,
2 /0/Zl 119 7 5%SURCHARGE
Cantodt Person Name Phone PLAN WEVM 25%OF SUBTOTAL
Don't dyr- �3g 3 - TOT 5
i:lrmechpmt.doc (rev 9
PSK flea is 325+
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CITY OF TIGARD ELECTRICAL_ PFRMTT
• DEVELOPMENT SERI,1 ICES PERMIT #: ELC97 -071 C
3125 SWHa11Bhd.,11pd,OR9rM2 ,$U)#301171 DATE ISSUED: 10/2-9/97
PARCEL: 1S134CD 04:300
SITE ADDRESS. . . : L22260 Sl-1 1,1rRT1 ! DAKOTA ST
SUr3DIVISION. . . . :ANTON rr1R1: iONING:R-7
!'.00K. . . . . . . . . . .. 1_.0T. � . . . . . . . . . . . ?7tl' JL.R:SDICTION: TT;;
Project Description : Install, aiteration or, relocation of a CEN AMP or less
service or feeder and add one (1) branch circuit far ar existing single family
dwellirg.
- RESIDENTIAL UNIT----- -----TEMP SRVC/FEEDERS------- -- ---MI9CEL.LANEOUS------
100w SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/I R R I GAT I ON. . . r. 0
EACH ADD' L. 500SF. . . s 0 201 - 400 amp. . . . . . . : 0 STGN/OUT LINE L_TG. . a 0
LIMITED ENERGY. . . . : 0 441 600 amp. . . . . . . : 0 SIGNAL../PANEL. . . . . . . : 0
MANE. HM/ SVC/FDR. . a 0 601+amps--1000 volts. : 0 MINOP LABEL ( 10) . . . : 0
- ---SERV I CE/FEEDER----- - —£RANCH C T RCU I TS------ - -ADD' L I NSP!:_CT I ONS--
i3 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 1 PER INSPECTION. . . . . : 0
2'01 - 400 amp. . . . . . 1 0 1st W,'O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . . 0
401 -- 600 amp. . . . . . 1 0 EA ADD' I_ BRNCH CIRC: 0 TN PLANT. . . . . . . . . . . ,. 0
601 - 1000 amp. . . . . 1 0 ------------------PLAN REVIEW SECTION-----------------
1000+ amp/volt. . . . . t f3 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOM I NA:_. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: __..__._____._.._.____.__...._______.__.---____.______________._._-- FEES
ART/GRACE DAVIS type amoo.rnt by date recpt
122260 SW NORTH DAKOTA. PRMT f 65. 00 GED 10/29/97 97--300501
TIGARD OR 972223 SPCT $ 3. 225 GED 10/29/97 97-300501
r7'hcne #:
Contractor:
JPC ELECTRICAL SERVICES INC f 68. 25 TOTAL
4120 SE INTERNATIONAL WY
STE A-107 ------- REDUIRED INSPECTIONS -
MILWAUKIE OR 97222: Undet-gr-or-end Cove Elect' 1 Final
Phone #: (7,54-3325
Reg #. . ! 097,774
oris permit is issued subject to the regulatiors in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in ac_crdance rf{tt app-oved plans. This permit will expire if work is not startid within 180
days of issuance, or if work is suspended for tore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. T'.n�e i-:les are set forth i-,i OAR 942-OOl 0010 through OAP 952401 1987. You say obtain , copy
QC
of these rules or direct qu.;tions to OWC by calling (58 246-1987.
H
Permittee Signature : Issi-ted lay :
eo
m __. ....._____—.___._.._._-----___..__...__._OWNER INSTALLATION
(D -'ie in!;tallation is being m.,de on property I own which is not intended fol-
LU ale, ) erase, or rent.
OWNER' S SIGNATURE: DATE:
INVALLATION
SIGNATURE OF SLIPR. F'LEC' N: � r r'aTF-
LICENSE NO:
+++++tt+• i-+++4++++++++*•tt++.++tt+t+t++t++++4.+ ++++t+t+fit +++ + ++ 4 ++
(''n1T. 63'. 4175 L. y ,00 p. m. for~ an inspection needed }hp next b'A1;inPss day,
+ + +,' F F+-I +++ 1 1-4-1 1.4. 1-4.4 4,4 4-4-4-14+44+4.4-+4-+++4 F++tk+.f++.+.+-1-+++++4-4........4-4+++++++.+
0ITY 0 TIGARD Electrical Permit Application PIanCheck 0
131k5 SW HALL F".VD. Recd By.
TIGARD OR 97223 Date Recd
Date to P.E. _
Phone(503)639-4171, x304 Print or Type Date to DS
Inspection (503)639-4175 Incomplete or illegible will not be accepted Permit 0
Fax(50)684-7297 Called
t. Job Address: 4. Complete Fee Schedule 8,91ow:
Name of Development _ Number of Inspections per permit allowed
Name(or name of business.) AKT r G?-IIC l DOV I Service lncludsd: Items Co.. Sum
Address Ir Uw '�'a 4a. Residential-per unh
Tj GC" IQ g7a '3 loco eq h.or lase $>>o.00 _ 4
City/State/Zip-
�,�_�_ Each additional 5Weq.ft.or
v
Commercial ❑ Residential portion thereof $25.00 �_ 1
Limited Energy $25.00
Each Manurd Home or Modular
Dwelling::ervlce or Feeder 588.00 � 2
2a. Contractor installation only:
(Attach copy of a c rent licenses) 4b.Services or Feeders
Installation,afleraliot,or relocation
Electrical Contractor I C-i-ir Loc. Installation,
Address ql� 5 E I'r a /orh� G I4/Q'7 200 amps or less J__ $80.00 IIL�_ 2
201 amps f-3 400 amps 580.00 _ 2
City_ "I' r X State U K Zip_ a 401 amps ,600 amps $120.90 2
Phone Nc - 33aY 601 amps to 1000 amps $180.00 2
;��� Over 1000 amps or volts $340.00 �, 2
Job No.
Elec.Cont No. 3 Exp.Date__ Raconnaa only $50.00 _ 2
OR State G. ,dg. No._142Exp.Date Y� 4c.Temporary Services or Feeders
COT Busir, _Tax or Metro No.__ Exp.Date Installation•alteration or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n _ 201 amps to 400 amps _ $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. I S Exp.Date see"h-above.
Phone --
4d.Branch Circuits
New,alteration or eMenslon per panel
2b. For owner installations: a)The tea for branch circuits with
purchase of service or
Print Owner's Name Wdor in.
Address Each branch circuit $5.00 2
b)The fee for branch circuits
city State Zip_ without purchase of
Phone No. _ service or feeder fee.
First branch circuit $35.00 c
The installation is being made on property I own which is not Each additional branch circuit Z $5.00 2
intended fo,sale,lease or rent. 4e.Misceliareous
(Service or feeder not Included)
Owner's Slgnatllr$ Each pump ur Irrigation circle $40.00 2
Each sign or outline lighting 540.00 2
L 3. Plan Review section(if requjred):' Signal circuit(s)or a limited energy
panel,alteration or extension _ $40.00 2
C Minor Labels(10; $100.00
I2 Please check appropriate Item and enter fee In section 58.
4 or more residential units in one structure 4f.Each additional Inspection over
` T Service and feeder 225 amps or more the allowable in any of the above
3 System over 600 volts nominal Per Inspection $35.00
Classified area or structure containing special occupancy Per hour $55.(!0
as described In N.E.C.Chapter 5 In Plant _ $55.00 -
Submit 2 sets of plans with application when any of the above apply. 5. Fa+es.
Not required for temporary construction services. So.Enter total of above fees $
LRLD
5%Surcharge(.05 X total fees) $
N-Q-1-10E Subtotal 5
5b.Enter 25%of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review yf M&W(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Strn'ohf $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY �(
❑ Trust Arxount
TIME AFTER WORK IS COMMENCED.
Total hatenCe Due s
I\ STSTLC0A APP Rm 9W
109 - -
x 1 1
CITY OF TIGARD BUILDING INSPECTI! DIVISION
24-Hoatr Inspection..Line:639-4175 Business Phone: 639-4171
Date Requested:
�_,�' n'�f' g 7 /� A.M. _ _ P.M. MST:
I,ocau-n:_LctS�12�. �1V
`— BUP: _
Tera it: Suite: Bldg: MEC:
Contractor: y l-� r7 WN Phone: 3 PLM:
Owner: LAI FA. Phone:
_ ELC: �
-- --- ---- — ELR:
SIT:
BUILDING BLDG(con't) PLUINBI NG � MECHANICAL L g�
Site Post/Beam Poat/Bewn Post/Beam o ce Sewer/Storm
Footi-Ig Roof UndFVSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UO Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
8311:tamp Drywall Storm Furnace
'ce MISC.
Maw Ceiling Rain Drain A/C G Slab
Shear/Sh,%th Fire Spklr/Alm Crawl/Found Dr Hent Pump Low Olt
IApproved Approved Approved Approved Approved
An!-.."ddwlk Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FIN FINAL
POWEL
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171 Call for reinspect p Reinspection fec of S_. required before next inspection C1 Unable to inspect
Inspector:__ ---- Date. 2 ' Page of
—
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CITY OF TIGARD BUILDING INSPLC j'iON DIVISION
24-Hour Inspection Line: 6394 173 Busit>m Phone:6394171
Date Requested: A.M. P.M.
_
Location:— _ l c � e_ BUP:
Tenant: Suite:__ BWg MEC:
Contractor: � yy__�� Phone: _ PLM:
� _ —
r: LdLLd.fle( � Phone: ��� _ ELC:
F.LR:
BUILDING BLDG(con't) PLUMBING btBCHAhi1CAL ELECTRICAL S1TE —
Sit- Post/Beam Post/Besm PR"- -� Cove/9er"ce Sew-jMtorm
Footing Roof UndFl/Slab Rough-In Ceiling Wats U..a
Slab Framing Top Out (las Line Rough-in i10 Sprinter
Foundation Insulation Sewer Ilood/Duct Reoorurert Vault
Bsmt Damp Drvwall Storm Fiance Tamp Service MISC.
Mationry Ceiling Rain Drain A/C UO Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr _N.et Pump Low Volt
Approved Approved Appr'ond Approved
LAppr/Sdwlk Not Approved Not Approval Nff Wi ved No(Approved Not Appiev_d
FINAL FINAL FINAL FINAL FINAL
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O Call ft rein tion > D Reinspection fee of 3 required before next WVecfm O Unable to Inspect
Inspector._ Date:_r J 1 --3.1_ I'tyC of