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11535 SW DURHAM ROAD STE C-2 J W CA v C X 2 3 O CA7 0 N 1 14 fI f 11535 SW DURHAM ROAD, SRC-2 CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 PFRhe TT #-. . . . . . , : Mc,C,' DhTC ISSUED: 08/1P1S P('RrEl, : "S1 191T)r_--00.40. tr . I'J t�f 4 r!M R.F, iW PARK C - L "..OT. . . . . . . . . .. 1r, Tt.IRT SD I CT I FiJinri F-111111141 0 r-VOF-' COOLER': ("(,M UNIT IHEATERS. . 0 VENT FANS- - I-r W/n 0 VENT I)Y'�14:Wq. . . . . . . . . .. DOTPS HOODS. . . . . . . . TYPE!3 - v) DOM1715, JNCTN: 0. 3-15 Hr`'. . . . : 1P COMML. INCIN: 21 .It Y I NF-*'U T. 0 I',T 1 .1 :30 14P. 0 REPAIR UNI'rs: v, I RI D A M PEFX', WOODSTOVES. . : 0 '104 HP 0 (,1.0 nF !.WITS._-.__ .. AIN HANDLING UNITS 0TWR UNITS. Q) URN ( 1001( nTU . "�l 0"A 0 4" rA 1i 1.r_ JIR N ) --100K DTU: _'I 10000 Cfm.- 0 RE6m,--w4s ., Deee existing HVAC equipment, replace W/new unit, associated ductwork, r-EES t y r.rw i.-I m a+t 11 t tj y dot L- v e"'j P n Y r, PRM7 79. 00 DRP 06/I / 37 '37- Pl 7:1 DR() Ob/ 12.197 r)7 5P7T 1 95 D RA 08/1 C"/17 2' tit 4 '50. 71T TC)T(l ,W6LkNi., Ulvi W21'+6 n,t. I 03948r-.,P R17-01JJI1171) 1NLor'r7C7Tr1NF, AS permit ;s issued su4_Jtect to the regulations contained in the GAi...iyre Tn%p yard Municipal Code, State of Ore. Specialty codes� . and �111 other MechAnic:al Ins p .pplicablp lows, P11 word kill be don= in ac-_ci W-lance wit.h Duc:'t T1)5'PPC1; icon ,ppt(,ved plans. This pevtkt will ewpi F if viork is not started r i nal I Ti,s;)Put i oii W days of issuance, or If work is suspended for more !'a, 1bt days, ATTEPTIMt Oregon low requires you to folloo rvles •"P'Fd by 0e Oreyvrt Utility Notificat;on Center, Those vulei are ,,', rv,th r, OPP W-811 0010 through MR 97-00l-W, You may btair copies of these rules or direct q4tstions is W by calling Plan Check s 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 t,DST Print cr Type Permit 0 ;J�.z>c J v � Incomplete or illegible applications will not be accepted Called Name of,DevetopmentlPropa J i Description L,;{r { �• ` Table 1A Mechanical Code OTY PRICE AMT .lob Street Address $uitsN A) Permit Fee -0- 0 10.00 Address 4'�I �•1 C Hldgr — CityiState Zip 1.; Furnace to 100,000 BTI 1 6.00 — ; including duds&ven.. _ Name(or name of businessl 2.) Furnace 100,000 BTU7.50 including duds&vents Z j b Owner � n nclud _ Maung Address 3) Floor Furnace 6.00 _ inc!udinn vent _ Cnyistate zip I Phone 4) Suspended heater,wall heater 6.()0 — or floor mounted heater Nome(or name of business) 5.) Vent not included in appliance permit 3.00 Occupant Mailing Address 6) Boiler or comp,heat pump,air Gond. 6.00 to 3 HP;absorb unit to 100K BUT- city/state zip Phone 7) Boder or Comp,heat pump,air Gond. 11.00 3-15 HP,absorb unit to 500K BTU" Contractor _ Nerne 8) Boder or comp,heat pump,air Gond 15.00 (Prior to { H n s 15-30 HP;absorb unit 5-1 mil BTU" issuance Ma,linpaldareu / 9) Boiler or comp,heat pump, nr cond. 22 50 applicant 30-50 HP;absorb unit 1-1 75(70 BTU— mast provide all citylstate Zip Phone 10) Boiler or comp,heat pump,air cond. 37.50 crontractor 1 (�� n' �t, 7,;�r )rx, >lir)HP;absorb unit 1 75 mil BTU" license Oregon Const Cont.Bond Lie.$ tap Dole 11.) Air handling unit to 10,000 CFM 450 irfomtation ✓r i `% r-! I tr/111 for COT COT Butrwas Tax or Moro a Exp,Dare 12-) Air handling and 10 000 Cf M 7 50 _ database)._ „J I j 11 _ Architect Ner"e 13) Non-portable evaporate cooler 450 Or Mailing Address 14.) Vent fan connected to a single dud 300 Engineer Crtyistate Tp Prime 15.) Ventilation system not included in __ appliance permit _ Descnbe work New O Addition O Alteration 0 Repair O 16.) hood,irved by mechanical exhaust 4.50 to be doneResidential O_Non-residential O Additional Description of work ——� '— t 17) Domestic incinerators 750 i ;�t r ("t rr•_L- ' ��tG.•Cc. i /�i�c� ia.+�.1 , --- — d 18) Cornmeicial or industrial type 30.00 Incinerator _ Existing use of 19.) Repair units 4 5G building or property 201 Wood stove 450 Proposed uv. ,f 21 ) Clothes dryer,etc. a 50 building or pin i-erty 22.) Other units � 450 Type of fuel-oil O natural gas 4 LPG O electric O 23) Gas piping one t0 four oiaets lJ 200 I hereby acknowledge that I have read this application,that the 24.) More'h;n 4-per:,utlets(each) .50 information given is correct.that I am the owner or authonzed agent of the owner,that plans submitted are in compliance with Oregon State CITY SUBTOTAL laws Signature of OwnerlAgent Date I —� — 'SUBTOTAL — 5%SURCHARGE Contact Person Name Phone °LAN REVIEW 25%OF SUBTOTAL TOTAL 1dstlmechpmt doc (rev 9 *Minimum permit fee is S25+5%surcharge - -Residential A/C requires site plan showing placement of unit. �G�c�l G•—� Honeywell THE T7300 IS A PROGRAMMABLE PROGRAMMABLE - THERMOSTAT FOR COMMERCIAL SINGLE ZONE HEATING, VENTILATING, AND AIR CONDITIONING (HVAC) EQUIPMENT. THE COMMERCIAL T7300 DIRECTLY REPLACES MOST SINGLE STAGE AND MULTISTAGE THERMOSTATS TO THERMOSTAT IMPROVE CONTROL, PROVIDE SIGNIFICANT ENERGY SAVINGS AND INCREASE USER CONVENIENCE. ❑ Sevon-day flexible programming a �* """'^-' ► ❑ Full feature Liquid Crystal Display ❑ Proportional plus Integral (P+I) control r �� } ❑ Intelligent Re,;overyTM' ❑ Intelligent Fan rm ❑ Concealed keyboard lockout switch and locking cover 0 .......................... ❑ Automatic heat/cool changeover ❑ 07300 switching subbases ❑ Built-in HVAC equipment prate tion (with minimum on and off times) 'r. ❑ Thrje hour override at unoccupied program ❑ Continuous unoccupied key ❑ Comfort adjust feature i 4W ❑ Battery backup ❑ Optional remote sensor and override T7300 capability (with remote annunciation) ❑ 24 Vac, 50/60 Hz power supply AND (1,73,00 VNF9L8 Form Number SS40M4 11/09 O Horwyweil 19!10 P 1 The T7300 Programmable Commercial Thermostat system controls comrworclal single zone !-NAC equipment. It consists of two components, the T7300 thermostat and a 07300 subbase. The T7300 thermostat contains a keyboard for entering the tim and temperatures, along with an LCD (L.Iquki Crystal Display) for reading back Information, The ihem)os?at also contains a microprocessor, which performs the calculations required to control the single zone system. fwo models of the 77300 are available, the T7300A and the T7300B. The T7300A cannot be overridden with the co°.,er locked down. When the lover is io;*ed down, the programming and override keys cannot be reachod by the ocr,,upants, providing complete securtty. The T7300B contains a 3 HOUR OCCUPIE') button on the cover, enabling programmed temperatures to be overridden without opening the mover. This button allows the occupants to temporarily adjust the temperature while avoiding unnecessary tampering. NOTE: Honeywell offers a simplified model of the T7300, called the 77200 Programmable Commercial Thermostat. This thermostat can be used on 1 heat - 1 cool HVAC units that do not require all of the T7300's capabilities. Refer to form number 63-5056-1 for details on the T7200 One of the 07300 ±arnity of subbases is needed in order to complete the control system (see figure 1). There are seven different subbase applications; however, there are eleven 1';300 and x7300 combinations. Following are the seven subbase applications. • 07300A ­ Provides conventional control (gas and electric systems) without system or fan switching. • 07300B — Provides conventional xnlrol with system and fan switching. • G7300C -- Provides heat pump control with system and fan switching. Includes provisions for auxiliary and emergency heat. • 07300D Provides heat pump control with system and fan switching but uses conventional terminal designations. Compressor changeover is corrtmiled internal to the heat pump equipmem. Irdudes provisions for auxiliary and emergency heat. • 07300E — Providers coaventionai r:ontrol with fan switching. • 0730OF --- Provides heat pump conte it without system and fan wwiiching. Includes provisions for auxiliary heat. • 0730OG --Provides conv9ntional control with system switching (3 stage cooling, 1 stage heatlog). 7 77= Q7310 , FIG. 1--T7300/07300 THERWSTAT CONTROL SYSTEM CONNECTED M A SINGLE ZONE ROOFTOP. 3 63-403" Was MODELS. Thermostat- _ T7300A1005 Fully configurable programnwble commercial thermostat. T73D:A1'354 Fully conflgtirable programmable commerrlai thermostat with international face Fiats. T730QA1088 Fully configurable programmable commercial thermoistat with spanlah lace plate, instruction oral nncking label(International Market Only). T7300e1DW Fully configurable programmable commercial thermostat with 3 Hour Occup'ed button In cover. NOTE. T7200 :herrnostat with limited configurability is alr., available - see lorm 63-60661. Subbases- _ Q73OUA1000 1•Hest 1 Cool, non-switching 07300A1018 1-Heat I-Cool to 2-Heat 2-Cool configurable, non-switching, auxiliary relay output. t0731*91006 1-Heat 1-Cool to 2-Hest 2-Cool configurable, r stem and fan switching,suxi!lary relay output. w' 1-compressor host pump, auxiliary heat,emergency neat, system and Ian switching, 07300C1006 auxiliary relay output,emergency heat and auxiliary LEDs. 0'73 OC1014 ?-compressor heat pump, auxillary heat,emergency heat, s stem and fan switching, auxlllary relay output,emergeicy heat and auxiliary haat LEDs. 0730OD1038 2-compressor heat pump utilizing conventional terminal designations. Auxiliary heat,emergency heat, system and fan switching, auxiliary relay output, emergency heat and auxiliary heat LEDs. _ 0730OD108.9 1-compressor heat pump utilizing conventional terminal designations. Auxiliary heat,emergency heat, system and fan switching,auxiliary relay output, emergency heat and auxiliary heat LEDs. 07300E1001 1•liest 1-Cool to 2-Heat 2-Cocl configurable, fan switching only, auxiliary relay output. �— 0730OF 1009 1 compressor heat pump,non-switching,auxiliary heat, auxlllary relay output and auxiliary neat LED. Q730OF1017 2-compressor heat pump, non-switching, auxiliary teat, auxiliary relay output, and auxiliary heat LED. _ 0730061007 1-Neat 3-Cool, system switching, auxiliary relay outout. NOTE:All subbases Include two annunciation LEDs and r9mote sensor capability. MOUNTING: ELECTRICAL RATINGS: 07300 subbase - two No. 6x32 screws Supply voltage - 20 to ' n Vac, 50/60 Hz (provioed). Temperature offset per 50L ft 1157 m) of 2-wire DIMENSIONS: cable (1000 ft [305 mJ totill length) for remote sensor wires. TEMPERATURE OFFSET FOR REMOTE SE?"S R WIRING: _ 1�--�t■��� Temperature - �— ��'� Monitored 18 AWG 2Q AWG 22 AWG I _ ,yt.q 50-90OF -0.40F -0.70F 1.0°F ! o o 10•'32°CL -0`30C -0.40C -0.60C _ SYSTEM CURRENT DRAW: T73W/Gnoo T7300 therrmstat and Q7'310u Subbase: 6 VA maximum at 30 Vac:, 50 )r 60 Hz. I, 67 A�r10M�4 CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PUF17 r--0 7,+ DATE I S SJE D: 08/11/97 PPRCFL: '5110DC—OO40e, 'T,TEw ADDRESS. . . s 1153"j aW D1JRf4AM RD #C, -i=' IJBDIVIGION. . . . : WILLOW BROOK PARI' 1.17NTr+Iti:C:- :l 11.-f.3CK. . . . . . . . . . LOT. . . . . . . . . . . . . : i(:, JURT9iDICTTON:T1G 'ZF--ISSLJF_: FL,r)oR ARf-As; .. E"XTE'RIOR WALL CONSTRUC T ,L-Ari C2mmerc al 6uilding_Permit AupliQation eb/� C,rV o/Tigard i3i:s Sw Karl sivd. Tigard.OR 97'.22 Jobsite Address: 1/; �`=> 5J a GI-A HAI OFFICE 115E ONLY Suite � C ' 2- -�,- I�_ -74 _ Planck/Rec. # Valuation: Permits Map&TL* Jwner: LLvl KFlrr q`� =�55UC- Aggrovals au— Address: � 3 � C 'S -qT t{ fPlanning Engineering_ Telephone: ZZ-2 Other ontractor: tqos?� N �i ry1y , eta �— ; � .���•_ �� ddress: P c) (�t�ESr �r✓r✓ f 0,e Type of constr:MM'� elephone: `�3 5 Z,, - 1� S `/ Occupancy Class:__ _ contractor's license if ,? � �� Sprinkler? Yes �J (attach copy of current Orn lie e) j , r� t � � tq. FL Of Project: �IOc� 'ofitact name & telephone: ,�Mi Story• (1st, 2od, etc.): / .5 architect b Engineer: /14 i�-ORA,,,v C„�J I Proposed Use: � I address: 3C--) :5. �-tj �Y2/ f L-,/Ly Previous vise: Note: Plumbing g mechanical plans must elephone: Z�,4 _ C� S be submitted at time of building permit application. � n 'OB DESCF.IPTICN: �k-P� � � 7 _�V5•S-e s � �f���`1(E' LJr4oYlrl�.r, pplica t Signature 8� elephone Number) Received byy,:-,-_,:�e cr Date Received: �� 7 'ERMITS Account Oescnption Amount Amt fid. Balance Our Building PermiC (BUILD) - r�`�r — —"� Plumbing Permit (PLUMB) Mechanical Permit i State Tax , (TAX) Bldg. Plumb. Mosch. Plan Cheek (PLANCK) ! , ' 3:3 Bldg. Plumb. _ Mech. Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSOC) Residential TIF (TIF-R) Mass Transit TIF (TIF.&IT11 Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TI F-p) Water Quality (WOUAL) Water Quanity (WQUANT) Fire Life Safety (FLS) Erosion Cn,rl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) TOTALS: .CCMTT CCC tCS7, lc/% CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIP BLIP — --_ � � ��y/ U / — y .3k + Date Requested _ AM PM _ BLD Location S " ��> ��" ,��, k-h c=� � _ Suite MEC c/ —Oo?rL Contact Person Ph ` �� d PLM Z 4 Gv Contractor �„� kid Ii \bo Pah _ SWIR BUILDING Tenant/OwneJW hOOQ 40 ELC Retaining Wall s�v�> r" ELR Footing Access Foundation FPS Ftg Drain SGN Crawl Drain Inspection otes - Slab ----___._ ' ���----- -------------- ---______._ SIT Post& Beam ----- - - -- Ext Sheath hear - -_- Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler - ---- - -- -- -- -- -- Fire Alarm Susp'd Ceiling -_--- -------------- ---- Root Misc _ Final --- -- PASS PART FAIL - - Post&Beam - Under Slab ''op Out --- ---- -------------- Water Service ` a Sewer ins PART FAIL CHANICAL Post& Beam - Rough In Gas Line - Smoke Damper-, Final - ---- --- - P PART FAIL Ser i _ -- — — R�u i In ------ --------------- LLab �Itage 7FF re Aidrm inal PASS PART FAIL --- ....__._. ------------------- -- -----_.- - -—---- -SITE Backfill/Grading ---- - _ ----------_ __----------------- _�-..___----------- Sanitary Sewer Storm Drain j J Reinspection fee ni $- -required before nest inspection Pay at City Hall, 13125 S'dV Hall Blvd Catch Basin i J Please call for reinspection RE _ _ -^_ [ ]Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Other _ _ Data /__ _ Inspector� � L{ ny s F xt Final PASS PART FAIL DO NOT REMOVE thi► inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 1)394175 Business Phone: 6394171 Date Requested: 9 -q- ! / A.M. P.M. MST: 1.ocation: /1,� �� J BUR —-- Tenant: --S//u��ite: Bldg: MEC: Contractor: ���� � �' Phone: !71 Owner: — i,ione: i ELC: ELR: SIT: BUILDING BLDG(coni) PLUMBING MECHANICA:. ELECTRI Site Post/Beam Post/Beam Post/Beam over ce Sewer/Storm Footing Roof UndFI/Slab Rough-In Ceiling Water line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C U'.l Slab Shear/Sheath Fire Spklr/Alm Cra%%Wound Dr Heat Pump 1 e9G Volt __ Approved Approved Approved Approved --- Appr/Sdwlk Not Approved Not Approved Not Approved ved Not Approved FINAL FINAL FINAL FINAL FINAL Cy e GL 2- -7 D Call for rcinspection 0 Reinspection fee of 3 required before next inspection O linable to inspect Inspector`v�� �" ��:�� L4 Date:1---- Date: 1 -C7 --y---� — P°gt--�—of—� CITY OF TIGARD BUh DING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phonc. 639-4171 Date Requested: . cl .- '7`" A.M. P.M. MST: Location: a 1 -- BUR Tenant:_ _ Suit : Bldg: NEC: Contractor l C% /lc _ Phone: ;? PLM: _ Owner: n Phone: ELC: ELR: tm BUILDING BLDG(coni) PLUMBING — MECHANIC y ELECTRICAL SITE Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm Footing Roof UndFl/Slab Rough-hi Ceiling Water line Slab Framing Top Out Gas Line Rough-In I JG Sprinkler Foundation Insulation Sewer Ilood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace 'Temp Service: MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I teat Pump Low Volt Approved Approved (&EPEOR> Approved Approved Appr/Sdwlk Not Approved Not Approved fDlel ,roved Not Approved Not Approved FINAL. FINAL !*NA FINAL FINAL O Call for reinspectiioon�� D Reinspection fee of S_ ueeluired betore next inspection C]l lnable to inspect Inspector:�_y�C _ _ Date:_ _� Page_---_of__ _ CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 6394171 Date Requested: `rj •qL_w _q 7 A.M. J _ P.M.______� NIST. Location: _5 J . __L kA_1 t �'� -' -- --- ---- BiJP: 7-03 7� Tenant:_ Suite:_ Bldg: MEC: r Contractor: 1 �. Phone: / Ct 5 ' 2-310 PLM: Phone: ELC: L 0 GK 130 1( : I 1 M— _ ELR: SPI': BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Bcam Post/Beam Post/Beam Cover/Service Sewer/Storrs Footing Roof UndFUSlab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer flood/Duct Reconnect Vault Bsmt Damp Di wall Storm Furnace •temp Service MISC. Masonry et ins &1 L( Rain Drain �b t JG Slab Shear/Sheath Tire Spklr/Al Crawl/Found Dr I teat Pump Low Volt C- pinov Approved Approved Approved Approved Appr/Sdwlk 1q:01pproved ::.A Approved Not Approved Not Approved Not Approved r FINAL FINAL FINAL FINAL C]Call for reinspection 13 Reinspection lee of S _required before next inspection O Unable to mspcct Inspector _�� -- Da9— l�_� Date: _- 7 Page-- nl CITY OF 1IGARD 1: 125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE PORTLAND STATE ELECTRIC PO BOX 14646 PORTLAND OR 97214 Electrical Signature Form Permit # . . . . : EI,C97-0596 Date Issued. : 09/02/97 Parcel . . . . . . : 2S110DC-00400 Site Address : 11535 SW DURHAM RD #C-2 Subdivision. : WILLOW BROOK PARK Block. . . . . . . . I )t . 16 .71ii indiction: TIG Zoning. . . . . . . C-G Remarks : Installing first branch circuit and 4 add' 1 branch circuits Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of work. No electrical inspections will be authorized until this completed form is received. AN INK SIGNATURE IS REQUIRED ON THIS FORM aNI;E< : ELECTRTCAL CONTRACTOR : NORTH RIM DEVELOPMENT PORTLAND STATE ELECTRIC PO BOX 6 PO BOX 14646 WEST LINN OR 97068 PORTLAND OR 97214 Phone # : Reg # . . : 000966 X Signature Of S dervlsirig Electrici�an Please return this completed form to the address above. AI-TN: Building Dept. If you have any questions, please call 639-417 1 , ext. #310 CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES DATE T #: D: 09/0296 DATE ISSUED: 0'3/02/97 13125 SW Hall Blvd., Tigard,Oh 97223 (503)639.4171 PPRCEL: 2S110DC--00400 ';1 TE ADDRESS. . . : 11535 SW DURHAM RD #C-2 1_AJBDIVISTON. . . . :WILLOW BROOK PARK ZONING:C- G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 16 JURISDICTION: TIG ("ro J ect De scr i pt i cin: Installing first branch circuit and 4 add'1 branch circuits ---RESIDENTIAL UNIT----- ---TEMP' SRVC/FEEDERS---•— ------MISCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 — 600 ramp. . . . . . . : I SIGNAL_/PANEL. . . . . . . : 0 MANE. HM/ SU[,/FDR. . : 0 601+amps-1000 volts. . 0 MINOR LABEL ( 10) . . . : 0 ------SERVICE/FEEDER----- ----BRANCH CIRCUITS- ---- -----ADD' L INSPECTIONS----- 0 — 200 amp. . . . . . : 0 W/SERVICE OR '=rEuE,-, 0 PER INSPECTION. . . . . : 0 2'01 — 400 amp. . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . . 0 401 — 600 amp. . . . . . : 0 EA ADD' L- BRNCH CIRC: 4 IN PLANT. . . . . . . . . . . : 0 601 — 1000 amp. . . . . : 0 -------------------FLAN REVIEW SECTION---------------- 1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS (AREA/SPEC OCC. : Owner: ---- — --____-------- _-------------- — -- —__—_ ____ FEES --•---•---------- -- NORTH ---- -- NORTH RIM DEVELOPMENT type amor.int by date rer.pt PO BOX 6 F'RMT $ 55. 00 B 09/02/97 97-298823 WEST LINN OR 97068 SPCT $ 2. 75 B 09/02/97 97-298823 Phone #: Contractor: PORTLAND STAIE ELECTRIC $ 97. 75 TOTAL PO BOX 14646 - ---- -- REQUIRED INSPECTIONS -- P(IRTLAND OR 97214 Ceiling Cover Elect' 1 Service Phone #: 233--8030 Wall Cover Elect:' 1 Final Reg #. . : 000966 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 952-081-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to (XK by calling (503)246-1987. [-'er mittee Signatl-rr~e : 'Yss�_ied By : �-- -.OWNER INSTALLATION OhJL_Y--------- ----____--._----.-..--___--- The installation is being made on property I own which is not intended for sale, lease, nr rent. OWNER' S SIGNATURE: — _—� _---- —_ __,—_. DATE- INSTALLATION ATE:INSTALLATION QNLY--- -- --------------- --- -__-_ SIGNATURE OF SUPR. ELEC' N:,�,�- yCe DATE: ----.------- LICENSE N O: T(k(,t(A q l -9� _.. --- --------- ------- -_ ++++-t+++++++++++++++++++++++++#+++++++++++++++++++++++++++-F+i-+++++++++++++'-F++++ Call 639-4175 by 6:00 p. m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++++++++4•1.+++++++++++++++++++••1 ++ Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Bled. Tigard, OR 977?3 Permit # Date Issued Phone (503) 639-4171 1 1 1 L,CATV OF TIGARD FAX (503) 684-7297 TDD No (503) 684-2772 Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development 1 i�/1t"J fJ�C�(� �`– Number of Inspections per pnrrnit allowed AddressAL15-.`Y5- )cService included Items Cost(eal Sum C;lty/State/Zip--T—�k (4, ©�� _ 4a. Residential -per unit 4 1000 s0 it or less $11000 Name (or name Of business)_ Eaportion Thereof ch additional f sq fl or $2500 Commercial Residential ❑ Limited Energy 52500 Each Manurd Harris or Modular Dwelling Service or Feeder $6800 2a. Contractor installation only: 4b. Services or Feeders w( ,.j� c:j,t T 1 e r r Inslallebon..or la t% at relocation $60 00 � Electrical Contrac or / ll C jt 206 amps or lesn --- Address4 LIG'-4(/1 G 1_ 201 amps 400 amps $8000 Cit i�t� _ State_C V _ zip 172 I t 401 amps to 600 amps $120 00 _ z y—L.7� 601 amps to 1000 amps 5160 00 Phone No..�2.�3 yC.S0 Over 1000 snips or volts $340 00 Job NO. Reconnect only _- $5000 _ contractor's license NO. . G �( � 4c. Temporary Services or Feeders Contractor's Board Reg No Installation,aiteratio,or relocation Signature of Supr. Elec'n C-)(� M I Y 1 _. 200 amps or less 201 amps to 400 amps $5000 I_icerise No ��_ � Phone No-A2,. U �(-i 401 amps to 600 amps -- $7500 — --- z Over 600 amps to 1000 volts S10000 — 2b. For owner, installations: see"b"above 4d. Branch Circuits Print Owner's Name_ New,alterat on or extension per pane Address a)The fee for branch circuits with --- purchase of service or feeder fee City State__ — Zip Each branch circuit $500 Phone No. __-_ b)The fee for branch circuits without The installation is being made on property I own which is purchase of service or/seder fee First branch circuit _ $35 00 not intended for sale, lease or rent Each additional N -anch clrcu0 _ $500 i Owner's Signature -_ _ _ _ ___ 4e. Miscellaneous (Service or feeder not included) 3. Plan Review section (If required): Each pump or itingle $4000 Each sign or outtlinnee lighting E40 00 Signal circull(s)or a limited energy ` Please check appropriate item and enter tee in section 5B. panel,aneration or extension $4000 _ 4 or more residential units in one structure Minor Labels t10) $10000 Service and feeder 225 amps nr more _ 4f. Each additional inspection over System over 600 volts nominal the allowable in any of the above Classified area or structure containing special occupancy $3500 as described in N E C Chapter 5 Per h inspection __ Per hour $55 CO In plan' `_ S5500 s-- Submit 2 sets of plans with application where any of the above apply Not required for temporary construction services. 5. Fees: So. Enter total of above fees NOTICE 5%Surcharge 105 X total fees) Subtotal _ PERMITS BECOME VOID IF WORK OR C)INSTRUCTION 3 5b. Enter for tal of ins A STRUCTION for AUTHORIZED IS NOT COMMENCED WITI IIN 180 DAYS, OR IF Plan Review e r (Sec $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. «,�,,,,,�•.•. Trust Account # P,�,.or / Balance Due $ �