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10670 SW DERRY DELL COURT I �i i i i i 10670 Derry Dell Ct. CITY OF TIGARDELECTRICAL PERMIT DEVELOPMENT SERVICES FIERMIT #: ELC98-0246 JAM13125 5W Hall Blvd., Tigard,OR 97223 (503)539-4171 DATE ISSUED: 05/11/98 PARCEL: 2S103DA-02900 sITE ADDRESS. . . : 10670 SW DEFRY DELL CT SUBDIVISION. . . . :DERRY DELL FLAT 2 ZON I NG r R-3. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :0;51 JURISDICTION: T I G F'ro.j ect De ser i pt i on: Relocation of 288 amp or less service, and 15 branch circuits. -- -TEMP, SHVC/FEEDERS----- ------MISCELLANEOUS----- 1,000 -----MISCE_•LLANEOUS----- 1.000 SF OR LESS. . , . : 0 0 _ '200 amp. . . . . . . : 0 PUMP,/T RR T GAT I ON. . . . r 0 EACH ADD' L 500SF. . . : 0 201 -- 40th amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANE. HM/ SVC/FDR. . : 0 601+81ps-1000 volts. : 0 MINOR LABEL ( 10) . _ : 0 -- -SERVICEi �'EDER---- ------BRANCH Ctki;UITS---- - ---ADD' L INSF,f.:CTIONS--- 2,00 amp. . . . . . : 1 W/SLRVICE OR FEEDER: 15 PIER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 FIER HOUR. . . . . . . . . . . : 0 401. - 600 amp. . . . . . : ill EA ADD' L- BRNCH CIRC- 0 IN F'LANT. . . . . . . . . . . 0 601 - t000 amp. . . . . : 0 ------------------FLAN REVIEW SECTION----------------- 1000+ amp/vol.t:. . . . . : 0 ) =4 RES UNITS. . . . . . . . : i 600 VOLT NOMINAL. . : Reronnect only. . . . . : 0 SVC/FDR ? = 225 AMF,S. . : CLASS AREA/SPEC OCC. -. Owner: -_____.---------________----_____ -------_._.__--•___-- FEES RONALD l_ AND TAMMY G GUSTIN type amoi-int by date reel t 10670 SW DERRY DELL CT F'RMT $ 135. 00 DEB 05/ 11/98 98-305637 T IGARD OR 97223 5F'CT $ 6. 75 DEB 05/11 /98 98-305637 Phone #: Contractor: -------__.__.__.---------._._____-- OK BROTHERS ELECTRICAL. $ 141. 75 "'OTAL. CONSTRUCTION PO BOX 231 133 -------- REQUIRED I NSF'ECT I ONS --- TIGARD OR 97281 Rol.igh-in Elect' 1 Final FIhone #: 697-487:', Fleet' ] Service Reg #. . . 123430 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State cf 0•egon Specialty Codes and all other applicable laws. All we,!, will be den@ in accordance with approved plans. This persit will expire if work is not started within 188 days of issuance, or if work is .ospended for sore than 198 days. ATTENTION: Oregon 1Am_requires you to follow the rules adopted by the Oregon M ility Notification Lcnter. lh se rules ar t forth in BAR 952-88! 8 through•.rAN 952-881-1987. You may obtain a copy of these rules or direct questions to by ca 11 ( 1246j§N7.P e r m i t t e e fignati-ir'e : x � -- I s s"'e i -------------------------------OWNER INSTALLATION ONLY ------------- -- -- _.___ _ The installation is being made on property T own whi-; is nit intended for Sale, lease, or rent. OWNER' S SIGNATURE: -__ __— DATE: 1 ---- ---------- ------- -CONTR7TOr' Ll_ TION ONLY---------------------_ _.. S T GNATURE OF SUFIR. ELEC' N: DATE: I_. I CENSE NO- ...............4....... ..........#-+4-4.......................4.......4++++++++-++4++ O:+++++++++++++++++++++-F+++++++++•t+i-i.+++++.+++++++++++++++++.++++++++++++++++++++ ra11 639--4175 by 7:00 p. in. for an inspection needed the next bt-isiness clay +++++++++++++i-+-1 +t++++++4+++++-++ a++++++ +4-+-++++4+++++i+++++++++++++++++++++++++++ i CITY OF TIGARD Electrical Permit Application ,Y PlanCheck 13125 SW HALL BLVD. (�j Rec'd By\�-- TIGARD OR 97223 ��, , i� Data Recd--5-// -9P I ( Phone (533)639-4171,x304 J Date to P.E.�� � Date to DST Inspection (503) F39-4175 Print or Type � IX Date Permit ll CL Cr -���j0 Fax (503) 684-7297 Incomplete: or illegible will not be accepted Called__ 1. Job Address: rr 4. Complete Fee Schedule Below: Name of Development_ C�V� ja Q�L� _ Number of In:pectlons per permit al►oweo Name(or name of business) _ Service included. Items Cost Sum Address I O l('j D_ S,_�_br,.ZN t L `_ 4a. Residential-per unit 10(x)sq.ft.or less $110.00 q City/State/Zip 2.Z _ Each additional 500 sq.ft.or -�- Commercial El Residential portion thereof $25.00 __ 1 Limited Energy $25.00 Each Manuf'd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $68.00-- (Attach copy of all current licenses) 4b.Services or Feeders Electrical�yntraCtof f�K f S Installation,alteration,orggipCauen �w- Address �"�' 2-�11�i - 200 amps or less t $60,00 City G r _ State ►� Zj r^ 201 amps to 400 amps $e0,00 p j�Z 5t�3 L 401 amps to 600 amps $120.00 Phone No. 1 -4fa 1 3 _ 601 amps to 1000 amps a $160.00 --.-_ 2 Over 1000 amps or volts 2 Job No. $340 c0 Elec.Cont. Lice. No. 3 C_ Exp.Date ►� �, Reconnect only _._ $50.00 2 OR State CCB Reg. No. 12 1JJQ _Exp.Date /�_�- 4c.Temporary Services or Feeders COT Business Tax or Metro No. _,51L, Exp.Date 1J� Installatlor,alteration,or relocation 200 amps or less $50.00 Signature of Supr. Elec'n 201 amps to 400 amps $75.00 i - - 401 amps to 600 amps $100.00 Over 600 amps to 1000 volts, License Nr _Exp.Date _ see"b"above. Phone Nr -X3_%!1�G:, ----- 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_ _ leederfee. Address - 5ach branch circuit $5.00 ----- h1 The fee for branch circuits City _ _ Sfafr Zip -- without purchase of Phone No. - service or feeder fee. First branch circuit $35.00 The installation is being made on property I own which is not Each additional branch circuit- $5.00 intended for sale,lease or rent. 4e.Miscellaneous Owner's Signature____ _ _ � (Service Each ordirrigation er not circled ) - $40.00 Each sign or outline lighting $40.00 3. Plan Review section (if required):* Signal circuit(s)or a limited energy panel,alteration or extension _- $40.00 _ 2 Please check appropriate item and enter fee in section 58. Minor Labels(10) $100.00 4 or more residential units in one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Por inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 __ M as described in N.E.C.Chapter 5 In Plant $55.00 "Submit 2 sets of plans with application where any of the above apply. 5. Fees: / Z S � Not required for temporary construction services. > ba.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ - NOTICE Subtotal $ -- ------ Sb.Enter 25%of line Ss for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reguired(Sec.3) $ -NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ 7- - IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account it Total balance Due s l%03TS%ELC96 APP nm.!V% t CITY a F TI GA R D MECHANICAL DEVELOPMENT SERVICES PERMIT PERMIT #, . . . . . . : MEC97-0347 13125 SW Hall Blvd., Tigard,OR 977.23 ('503)639-4171 DATE ISSUED: 09/16/97 PARCEL: 2Sj.J3DA--02900 SITE ADDRESS. . . : 10E70 SW DERRY DELL CT SUBDIVTSION. . . . : DERRY DELL PLAT 2 ZONING: R-3. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3.1 JURISDICTION: TIG CLASS OF WORK. . :ALT FLOOR FUPN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :9F UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . -R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES-------------- 0-3 HP. . . . : 0 DOMES. INCIN: 0 3-15 HP. . . . : 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR 'JNITS: 0 F IRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 OPS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 141 NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 121 FURN ( 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS. : I TURN ) =100K BTU: 0 10000 cfm: 0 Remarks : Add natural gas furnace and gas outlet to existing single family dwelling. Owner-: FEES RONALD L AND TAMMY G DUSTIN type amot.trit by date recpt 10670 SW DERRY DELL CT PIRMT $ 25. 00 GEO 09/16/97 97-299268 TIGARD OR 97223 5PCT $ 1. 25 GEO 09/16/97 97--299268 Phone #: Contractor-: ----------------------------- OWNER ----------------------------- --------- $ 26. 25 TOTAL Phone #: Reg #. . : 999999 REQUIRED INSPECTIONS This permit is i.;supud subject to the regulations contained in the Gas Line Insp Tigard Municipal Code, State of Grp, Specialty Codes and all other Mechanical Insp applicable laws. All work will be done in accordance with Heating Unt Insp approved plans. This permit will expire if work is not started Misc. I!i5pection within 186 days of issuance, nr if work is suspended for more Final Inspection 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 9521-301-0616 through OAR 952 AN1 488. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9187. Issi-le By : Permittee Sign e: 4..................... -4.............4+++4+4-4++4.+++4.+-4.........+++++4......4 4 Call 639-,4175 by 6:00 p. m. for inspection-, needed the next bi.isiness day ++++++++++++.1-+++++++++++++.4-+++++++++++++++++++++-+•++•+++++++++++++•i-+•++++++++ F++++ Plan Check M CITY OF TIGARD Mechanical Permit Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 97223 Date to P E. (503) 639-4171, x304 Date to DST Print or Type Permit called Incomplete or illegible applications will not be accepted ( Name of O svatopmenl/Proiect Description Table 1A Mechanical Code CITY PRICE AMT job Street Address Suesr A) PNrrnd Fee -0- -0- 10.00 Address � ` L � l � _ Baps [S s ZIA 1.) Furoate to 100.000 BTU 6.00 G �o� � inclu_dinduds C vents Name(or name of business) 2.) Furnace 100,000 BTU+ 750 i - including ducts&vents Owner . i:' � _ Y �1� inc � l Y _ _ e uq Addis 3.) Floor Furnace 6.00 l r l C including vent cltyrsuft Pp Phans 4) SusDbnded heater,wall heater 6.00 >s( �r SLC or floor mounted heater N (ori d business) 5.) Vent not included in appliance permit 3.00 , Occupant etlina Address 6) Boiler or comp,heat pump,air Gond. 6.00 Address ( � ( to 3 HP;absorb unit to t00K BUT- 'Cifyistate zap Phone 7.) Boiler or comp,heat pump,air cond. 11.00 3-15 HP:absorb unit to 500K BTU" Contractor Nar11e 8.) Boiler or romp,heat pump,air Gond. 1500 (Prior to '.5-30 HP,absorb und.5-1 mil BTU" issuance Mailing Address 9.) Boiler or comp,heat pump,air Gond. 22.50 applicant _ _ 30-50 HP;_absorb unit 1-1.75mil BTU"_ must provide all cilprstate Zip Phone 10.) Boiler or comp,heat pump,air cond. 3750 contractor _ >50 HP;absorb unit 1.75 mil BTU" _ license Oregon Const Cont Board t.ic is Exp Oise 11.) Air handling unit to 10,000 CFM 4 50 information if expired in COT GOT B .nest Tax or Metro K Eap Oslo 12) Air handling unit 10,000 CFM 7 50 database) Architect Na'"a 13.) Non-portable evaporate cooler 4.50 or Mailing Address 14) Vent tan connected to a single duct 3.00 Engineer cityistate �- Zip Phone 15.) Ventilation system not included in 4 50 _ _ appliance permit _ Desaibe work New O Addition O AReratton ip Repair O 16.) Hood served by mechanical exhaust 4.50 to be done Residential 0 Non-residential 0 Additional Description of work 17.) Domesh:incinerators 7.50 18) Ctxnme,cial or industrial type 30.00 Incinerator Existing use of 19) Repair units 4 50 huilding or property _-- 20) Wood stove 4.50 Proposed use of ( 21 ) Clothes dryer,etc -` 4 50 building or property �.1(�� 22.) Othe,unite 4.50 Type of fuel-oil O natural gas LPG O electric O 23.) Gas piping one to four outlets 2.00 I hereby acknowledge that I have read this application,that the F4) More than 4-per outlets(each) 50 information given is correct.that I am the owner or authorized agent o.' the owner.that plans submitted are in compliance with Oregon State QTY SUBTOTAL _ laws Signature of OwnertAgent Date *SUBTOTAL 5°'o SURCHARGE - � - Contact Person Name Phone PLAN REVIEW 25%-0 F SUBTOTAL --- - TOTAL r� i dstVrte<hpmt dot (rev 9 'Minimum permit fee is$25 *5%surcharge "Residential AIC requires site plan showing placement of unit.