12761 SW 133RD AVENUE C
tD
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12761 S1N 133"' Avenue
CITYOF TIGARD _ MECI.IANICALPERMIT
DEVELOPMENT SERVICES E ISSUED:
#: M28/03 -00081
DATE ISSUED: 2!28/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104AC-04500
SITE ADDRESS: 12761 SW 133RD AVE
SUBDIVISION: MORNING HILL 8 ZONING: F2-25
BLOCK: LOT: 189 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYNE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FULL i YPES _ 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GA-- PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: A AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm.
Ramarks: Installation of A/C unit. Unit cannot be placed«itlun the required setbacks.
Owner: FEES
SIRRINE,JON R Description Date Amount
118 PLYMOUTH CV �MF(1II 1'ennit Fcc 2128/03 $72.50
SAN RAFAEL, CA 94901 ITA x) -„titatc'I, : 2/28/03 $5.80
Total $78.30
Phone:
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED INSPECTIONS _
Mechanical Insp
Phone: 948-3838 Final Inspection
Reg # LIC 43124
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work Is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-66
Issued 9y: —f-�- Permittee Signature: %'70 g _
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
02/25/2003 12:11 5033569002 GAROKEN PAGE 01
03 21 01 aEl) 12 33 FAX 503 598 mo CITY OF TIGARD
o3a
Mechanical Permit kpiplication
---_-_ Pate recelred.�y��7- 71
t no'z.- �pL7R
City' of Tigard -
ProjecVepphno,: e due.
Giq of T.Rorrr Address 13125 SW Hall Dkri 'I gar I OR 97221 ---
Dere issued:
Phone: (S03) 639-417x1 ReccIpt no
Fax (503) 598-1960 /� Cnsefileno.: �. ent type:
Land use approval; I`_ Building permit n
tI Nil
*- & 2 (smlly dwelling or accessory J Coir,rn trciaUmdustnal J Muln•famity D Tenant Ilnp-o%emem
New construction 7 Additir n/alteration/replacemem a 6.'her:
lob adutess 1�� � Std 1 Indicate equipment r„antiues in boxes below. Indican the dollar
i Bldg no. Suite no.: value of+ill mechanical materials,equipment,labor,overhead.
t Tax mAp/tar lot/account no.: profit. Value$
Lot Block: Subdivision: � •See checklist for ,•portent application information and
project name: jurisdiction's fcc tiL!�c&,lc f,�r residential permit far
Cttyi:ount):�'y,,,_rr.rJa�1,. ZIP. ___-�
I ""cnpi nand Ic;2 tion of``worL;on premises;._
�t� _ 1•ec(ra) Total
Est date of completlon/inspecuon 3_t�� _^ 7Adlma
►e.(,ijoinn Pas.onl Ras,util,
Tenant impro%ement or change of use, CFM
Is existing space heated or conditlaned?G Yei Z No Air conditioning(sne fin ieWu rad
Is existing space lnsulated7 O Yes O No cerIlion oexisting MVAC system
s a er compressor
Business name. State bolter permit no
C1QrG1✓ t'1 - t� _ HP Ton& BTUM
Addre%s (r,5
irc smo a darnpers/cluct smoke doteclats
City ,� State i lP: p eat pump
Phan 6U -;-M23 Far;' -1ODo� E-mail: n+t�furep acau-�rnaee/bumer— -
CCB ria '—" Includin ductwork/vent liner 0 Yes O No
Cityltnetru llc. no ♦j�l S y nreps relocate eetere-suspen e
wait,or fluor mounted I
Name(please print): o en: ora acigarn�e �m ornate --+--i
1jkj MI r gars, otTn;
_ _ Absorption uruts BTVK
Name; Chiller HP
Address, tom lessen _ HP
nr roomea�exTiautitind vert at ort �r""`�
C►ty Stare ..IP: Ap Uence vent -`
Phone Fax: f•rnad ryere ausi ---
ooas, ype / tes tc a azmat
hood fire suppression sy&tem
Name. e��'r- �( �( >, � exhaust fan with stn ie duct(bath fens)
'
Marling address awl a Stam a art om atin or
- -`.
City. State. ;;1'p; '� piping an ssr u on up to out eta
LPG NG Oil
Pitons. Fax E•msJI: uel piping each add itionol over 4 outlets
rocesap p nR(ic,emahe require )
gameNumber of outlets
ter a app ancr or rq�Ttnrnt. '
Address _ Decorwvefire lace
City. Stale :'.IP '^ Tnecit-t
^PhonyFex E-maila slot pe eistove
jp;licenfs Si net a �'r DAIe, a other
a� U
Name
'-r.�.� r„�ruLcuonr stceoi cred,i cvdi plesce V1 lut+idleunn for mart Inc++»uon Permit �-
,'sa ]M Notice This permit application 'Minimum fee.. S _
exrlre+if a permit i►nal attained Plan review(it '$r) $
within 180 days after it has been -�
r i• urine ndu<Y _ �s
accepted u complete. TtpTAL ate huge (89i+) 5
lu holder u�uurt �..yni
02/25/2003 12:11 5033569002
GARUKEN PAGE 02
--7
IGARCKEN ENERGY C[] . ING .
�-- S,t�cc 1 979 / ! l
3Sb5 5W� 662rvo AVE •
r-- BE^v_BEaVFF70N, Op 97007 TEL 1
L (.503t 1348-3838 FAX 15031 356-90037
43 124
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O A �I G
CITY ,I"aR® ELECTRICAL PERMIT
\ PERMIT#: ELC2003-Ou 105
DEVELOPMENT SERVICES DATE ISSUED: 3/4/03
13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639-4171 PARCEL: 2S104AC-04500
SITE ADDRESS: 12761 SW 133RD AVE ZONING: R-25
SUBDIVISION: MORNING HILL 8
BLOCK: LOT . 184 JURISDICTION: TIG
Project Description: Install (1)branch circuit to AC unit.
RESIDENTIAL UNIT TEMr !,kV7/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPEC I IONS
0 200 imp_ W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: i PER HOUR:
401 600 amp: EA ADD1 BRNC1t CIRC: IN PLAN'.
601 - 1000 amp: i _ PLAN REVIEW SECTION
10u0l amplvolt: —4 RES UNITS: >600 VOLT NOMINAL.:
_ Reconnect only: _ SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC:____
Owner: Contractor:
SIRRINE,JON R HESE..RLE ELECTRIC
118 PLYMOUTH CV 19680 SW NEUGEBAUER RD
SAN RAFAEL,CA 94901 HILLSBORO,OR 97123
Phone: Phone: 503-628-2.095
Reg #: SUP 3053S
�__-- ------ LIC 152114.'
FEES EI.1 34-1olit
Description Data Amount Required Inspections —
JELPkM I I I{l t' I'rrmrt -1-110 $46.85
4 $3.75 FRough-in
(TAX)8%Stare 1- 1 — ct'I Final
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 it work is
suspended for more than 180 days ATTENTION Oregon law requites you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503)
246.6699 or 1.800-332-2344.
Issued By: i_(A cz i cr i ,_ll Permit Signature: ) I t_ i 1_d ze r -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N: _ DATE:
LICENSE NO: ---- -- —
Call 639-4175 by 7:00pn, for an inspection the next business day
Eledrical Permit /application
I)aterrceivcd sf Permitno.:�l�)LJ,)r!'"(,f
r-� -
City of Tigard '- ' Project/appl.no.: Bxriredale:
City ufTigard Address: 13125 SW flall Blvd,`Tigard,Olt 97223 Dale issued: ---- 13y: i li Receiptno.:
Phone: (503) 639-4171
Fax: (503)595-1960 Case file no.: Payment type:
Laud use approval: _
1
01 &2 family dwelling of accessory �U/Conunelcial/industrial U Multi•fanlily U'I'eoant improvement
U New construction Aq AddllInn/;dterdiunhcplacenlenl U Other: _ U Partial
Joh;oldies: Z 7 ( J� Suite no.: [a.e ntn,/l;lx Inlhtcrount no.:
Lul: II lock: ! Subdivision:
1114jecl name: Description and location of work on premises:
Estimated(late of completion/inspection: JJ-f?Glt Z-o0
1
Juhno: 1iEDE11LE--ELEC- RJG---- I1C Mn9
Ilushtess name: - Uesrllp0un Illy, (ea.) final
_ no.ln,ll .
— 19680!;W_�leugel� aver Road Nest iesidential-91nCknrronilllnruiiylwr
Ad(Itcss: illlsbD Oregan 97123.9446 doellingurdt,Includesallncheilgrrnge.
r'ily: Stale: I'I.IP• Seniceincluded:
I'lione: 628-2095 1-ax: 628--30 '3 , 7 ( ,c IW)stl.ft.ollc59
r.11ch addniunnl SITU sq.1c of portion lhcteof _
2 8 I [:ICC,hU9. IIC.Ilrt; 34--160 ( Lindled enclgy_residemial 2 l
t liti/III' ILIIC,no.; 072 Limnedeneigy,non residential 2-
O -Ilnch alnnufnctuted home ur uatdulurtlwclliu
•iS cnalum VWI.41' Dale Set vice and/m feedet 2
e ti�clall(1^.tui _
Slip.elecl.1101 . inn' 1 o r r i-P y 1,. p r Crease 1111:3 0 5 -S- Setrlcrs or feeden-InarAllnllnn,
Alltndlon or relucMlun:
1 l 2W amps of less 2
Ni1111C(plil ): Jif ! 201 amps to 4W amps _ 2
Alaiilug ttdttcs 5 401 at1111910OWalurs 2�
6U)antis to IW)amps 2
t'ily: Stale: 1.11': Overlm"llipsnrvulu _ 2-
1'hluht
IT mail; Itrconnrclonl l�.
l)55'ner instal lilt ion:The installation is living(trade on plopefly I own 7'empoi-mywrflcesorfeeders- i
ssilich is not intended fur sale,lease,tell(,or exchange according to InslAllallnn,Aht►Allnn,orrelatAllon:
ORS 441,455,479,67(1,701. NN)11111111;or less
201 amps to 400 nulls 1
(Ilvtict's SIIIL'lhllc; Dale: 401lit RK)limps 2_
Branch circuits-lith,dlefnliun,
or eUrnslon per panel:
N;11111•: A. lice fut branch circuits with purchase of
1tIIC35: service or feeder fee,each blanch clicult 2
Stale: 7,11': It. lire for btanch chcolln wa chase
- —` — - �- of service tit fecdrl frr,fit 114 111111101 clr(uil' 'I 2
I'llultr: I':1 r• I' 111:111' I nett ulitlhlollal h11111t'II clic((((.
Mkr.(rferHceorftedernntincluded):
U Servireove1215nm1••,1,nmur1rinl U IlvPhh(air facility I a0hpunlporhllgalloncilcle 2
U Srtvkeovrr 120any, ruUognf IR2 U lla mdouslocalinin I ncllslgnutoulliuelighting 2
1`1111111Y dwellings U nulhhng over 10,11x)aqume feel four lir Signal chrultla)at a linvied rlleigy -
USyatc11luvrlatxlvollinondrinl nxlletesidr•ltinlunits Int/uentructure nlleratioo,ofcxtelmlon" 2
1 U nbhne over(leer slotira U I'vedets.41x)tams of umne •I O kaTii1rilon:
i I,..d 111:1 l Duel 1191w•Isn11a U nufncuurd thuclmra o1 RV pink riddillunal Inspertlon user Ilse Ilion able In Any of life Abose:
I I �, vlyhnnr!ph111 U Other --.• P r I LI'!Jnl�l irlu _ I'��—`r—"—�
Snhot II—set of plan,Ivith oily of the ahove. Invea0gn0on ire ��
f-he above Are not applicable to fent iorary construction service, either -
-
NM all pais(k'thtns ttOelA rtes(((rants,please rldl)udedklttxl rix mixt InfanlaalM Notice:'I his pernlil application PClllltl fee.....................
U visa taA1rICAn1 c expires if n pennll Is not obtained Plan review(at _,_ %) $
t'Irtllt clod nuu11WI: Ulet't -.3 ?c'r•�+y1f Z ' SUlll•Altfchnf e
__ within IRU days Alter It line hero B ( "A1) ERE
_� _.
f fa''tr`j� �, '= it�"� apt a aCCCpleda1Ct1111pIr1C, II1hAI $
-- . .......................
( Kan1r nT cittpwl. 1 u i own on rlr i ems
X= Tivrltit-il`nmut "- S Amount
% 44W6t3(60NCUM)
l` I-ti, 'A r FAX PERMIT #/RECEIPT TO 503-•628-3076 ASAP. THANKYOU.
CITY OF TIGARD 24-Hour
bUILLING Inspection Line: (503)639-4175 MST — —
INSPECTION DIVISION Business Line: (503)639-4171
BUP —
Received _ 1 —Date Requested_J3_ — AM PM —__ BUP
Location __ 1 oZ -7 �2 L_— , Suite_ _ MEC
Contact Person __ —_. Ph ( ) PLM
Contractor_ __ — Ph(_ ) SWR —
BUILDING_ Tenant/Owner ___ S7 d? � ' - � - ELC
Footing
Foundatioi• Accass: i FSI 7 ` b ELR
Ftg Drain J
Crawl Drain — SIT
Slab InspeCion Notes: �h N- i �� , -
Post&Beam
Shear Anchors
Ext Sheath/Shear - ------ -
Int Sheath/Shear
Framing ----_-------_ - �__ --------------- ------____—___--- --
Insulation
Drywall Nailing --�� -�- �----- - —Firewall
Fire Sprinkler -----
Fire Alarm
Susp'd Ceiling ---
Root
Other. --
Final
PASS PART FAIL
PC&IBING
Post&Beam
Under Slab --
Rough-Ir _—
Water Sorvice -
Sanitary Sewe
Flain Grains - ---- ------- --- --_.—_� _.—
Catch Basin/N anhole
Storm Grain —
Shower Pan
Other:
Final _
PASS PART FAIL
AMENANIC --- ----- - ----- - --
Post& ea
Rough-In / •� -- - --- . ---- - -- -
Gas Line
-Smoke Dampersf------
T FAIL ---e_-- - - -- -�—
TRIC
Rough-In --
UG/Slab
Low Voltage
AASlar,
arm
Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
S -� Please call for reinspection RE:__ ___ -- ----_ F] Unable to inspect--no access
Fire Supply Line l
.SDA �/ l Q I U � -�'` Ext
Approach/Sidewalk Dab _ Inspector ---
Other: �-
Final DO NOT REMOVE this Inspoction record from the Job site.
PASS PART FAIL