13755 SW 116TH PLACE w
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13755 SVV 116" PI�c .
ELECTRICAL PERMIT
CITY OF T I G A R D PERMIT#: EI.-C2001-00363
DEVELOPMENT SERVICES DATE ISSUED: 7/16/01
.. 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S103CD-02400
SPE ADDRESS: 13755 SW 116TH PL
SUBUiV:SION: HOL_LYTREE ZONING: R-4.5
BLOCK: 01 LOT : 008 JURISDICTION: TIG
Proiect Description: Installation of one branch circuit for new a/c unit. Job No. R�J1170,
RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS 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 INSPECTIONS
0 200 amp: W/SERVICE OP FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADDT. BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amplvolt: >=4 RES UNITS: > 600 VOLT NOMINAL:
_Reconnect only: _ SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JAMES, JOHN R + JUDITH A SHARPE ELECTRIC INC
13755 SW 116TH PL 22605 SW RIGGS
FIGARD, OR 97223 BEAVERTON, OR 97007
Phone- Phone: 642-7937
Reg #: LIC 81518
SUP 3344S
ELE 34.217C
FEES Required Inspections
Type By Date _ Amount Receipt Rough in
PRMT CTR 7/16101 $46.85 2720010000( Elect'I Final
5PCT CTR 7/16/01 $3.75 2720010000(
Total ` $50.60
�J
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 a)tpire 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 by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952.001.0080. You may obtain copies of these rules s(direct questions to OUNC at(503)
246-6699 or 1-800-332-2344.
Permit Signature: Issued By:
OWNER INSTALLATION ONLY
The Installation Is being madE on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ DATLO._
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ._ DATE
LICENSE NO: _-------------------.--..____._.___._ _.___..._–_
Call 639-4175 by 7:001)m for an. i,ispection the next business day
Electrical Permit Application
-------- -- Datereceived: 7 /!e A/ Permit no,
Project/appl.no.: Expire date:
ejty of Tigard
Address: 1312y SW Hall Blvd,Tigard,OR 97223 Date issued: _ By: Recelptno.:
City of Tigard Phone: (503) 639-4171Pa Payment type:
Case fife no.: Y YP
Fax: (503) 598-1960
Land use approval: — —
TYPE 1
�1 &2 family dwelling or accessory L] mercial/industrial J Multi-family ❑Tenant improvement
❑New construction
Addition/alleration/replaceinent J other: ❑Partial
1 1
ej .S ' U Bldg.nu,: _ Suite no.: Tax map/tax lot/account no.:
Job address
Lot: Block: Subdivision:—
Project name. ,` 1�1�jO� 'Dk.A�.� Description and location of work on premises: G t.
41—
Estimated date of cornpletiun/inspection:
I
1 Max
Job
Fre
Job no: <i — (kseri tinn Qt} (cal Total no.ins
Business name: l' L G CS L� — Nrwresidentiat-singeormtdti•familvlwr
Address: dwellin unit.Include%attachedgarnge.
+ Service included: 4Cty
1000 sq ft.or less —
Phonc: C3 !r 9y�' Fax: Email:
Each additional 500 s .it,or portion thereof 2
CCB no.: " % 9 Elec.bus. lir.no: 3 a Limitedeneruv.msidential
r_
Limited energy,nonresidential
_City/metro lic.no.: 015 /
Each maruflar dwelling �
%I — service and/or feeder_
s uture of sit rvislhb cicctnrian Date(rc aired) 5ervicesorfeeden-Installation,
Sup.elect.name(print): License no. alteration or relocation:
2
1 200 am s or less ;
201 amps 111 Mn amps _ 2
Name(print): Y'lµ �_ _. 401 amps to boo amps 2
Mailing tdcres : 6�,I ant s to 1000 am s
2
City. ;J GG State IL ZIP: ( � ()ver 1010 amps or volts 1
E ail: Reconnect onl
Phony: Temporary
services or feeder-
Owner installation:Tl : installation is being matte out pror::cy I own Installation,alteration.or relocation:
which is not intended for sale,lease,rent,or exchange according to Zai amps of fess 2
ORS 447,455,479,670,701. 201 amps to 400 umpv.
Mile._
401 tit 61YI ur.t s
Owner's signature:
_ _ __—___ Branch�lrruits"new,alteratlnn,
or ester sion per panel:
Name: — A Fee for branch circuits with purchase of 2
—�— service or feeder fee,each branch circuit
Address: 13 Fee for hranrh circuits without purchase
City: Slate:_` Zip: _of service or feeder fee,first branch circuit: 2
I'ht,nr I'. nt,til:
I'ilx; Bach additional bra-ch
circuit
Mise.(service ur feeder not Included): 2
_Each pump or+organon c,rcle
J Ser:ice over 225 amps,,muoerMl J Heahh-:are lnctllty Eact. ,,n m out nene li t�h ting
J Service over 120 amps-,.notg of 1&2 J Building tover It locationsignalsquare feet foul or
Signal rircunt s i or a limited energy panel.
famtivdwellings dtrrmnni,or estensinn•
J System over 61x1 Volta nominal more residential units in one structure -
J Building over three stotles J Feeders,400 amps or more •llrsen?uoa --
J occupant load over'i'l persnns J Manufactured structures or BV park Vach additional Inspection mer the allowable in am of the alive:
J t:RresNUghtingplan J+nher Ir----. _ -- Penns ecuun
Submit _sell of pians with any of the above. Invesit.a0un lee
The above i nhrr are not applicable to temporary construction service. -- --��
_ ------ permit fee.....................3 Cy
\on ud rynaacuons accept credit cards.please call tunukimn tot m,nr eno+ntanun.
Notice: I hl;permit appllcallon plan review(al
Viso J MasterCard expires if a permit i;not uhlaineJ State surcharge(9%) g
within I$0 du)s eller it has been $ .2 r
Ired0 crud number__ — 'TOTAL .
_ ACCO led a4 complete.
14ame a e r as thuwn on credit rant�T
Ane .— .Wn•4A15 t6+1"larC0�11
CmSIM
L--er tle +un
-- _r
(JSi 6- >/ 6-)
CITY OF TIGARD BUILDING INSPECTION DIVISION � ��
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 `
A BUP _
Date Requested /1-1 / — AM _PM _ BLD
Location l 3 7 SS Sw /Al Z_e _ Suite MEC !41- o 4 G.6
ContL.ct Person _ Ph �J' - G�y'/� b PLM _
Contractor /Ph _�( Z-3,3 SWR
BUILDING Tenant/Owner �rkK C� JuJj 4A � �`��` ELC
Retaining Wall ELR _
Footing Access:
Fo ..dation FPS --
Ftg Drain — SGN
Crawl Drain Inspection Notes: -�
Slab --- - SIT _
Post&Beam
Ext Sheath/Shear --
Int Sheath/Shear
Framing _ --�_--
Insulation v
Drywall Nailing h— < A Citi 7 ` I .101ra /*00# "0C
T -
Firewall
Fire Sprinkler - —
Fire Alarm
Susp'd Ceiling
Roof
Misc: ---
Final
II, S__)PART FAIL
PLUMBING
Post&Beam -- - —
Under olab
Top Out --
Water Service
Sanitary Sewer
Rain Drains
Final
P SS-. PkRI FAIL
Rough In
Gas Line -- --- ------- _
Smoke Dampers
Final -- ---
i�AS6 PART FAIL
C _
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm -
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ j Reinspection fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( j Please call for reinspection RE: ( j Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 d Inspector�L �-� Ext J��S
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BLIP
Date Requested 7,1 y AM PM BLD _
Location /3 7s Y- si✓ 116 7 Suite MEC
Contact Person Ph PLM
Contractor k ct► ��^ _ Ph G Sc�_Il q o X l Z-53 SWR
BUILDING TenantlOwne '��/GS.( ccZG( �v S-t � T' _ "ELC '6O 3G3
Retaining Wall ELR _
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes-
Slab —_—, ___——.- SIT
Post&Beam
Ext Sheath/Shear —
Int Sheath/Shear
Framing ---_ — --
Insulation
Drywall Nailing — — --. ------- --
Firewall
Fire Sprinkler _ ---- ---
Fire Alarm
Susp'd Ceiling --- `-'�- - ---
Roof
Misc:_ --------_. —_-- - ---
Firal
PASS PART FAIL --------__ ----------- —
PLUMBING — `— --_
Post&Beam ,
Under Slab
Top Out
Water Service —_.--
Sanitary Sewer — -
Rain Drains —_ __—......
__ --
Final
PASS PART FAIL --_-
MECHANICAL
Post& Beam --- -- —_—_---- __.__--_
Rough In
Gas Line
Smoke Dampers
Final ----�-- � -- ____---------
PASS PART FAIL
R --
Service --
Rough In
UG/Slab ----
Low Voltage
Fire Alarm --_
tS ART FAIL _`--- —
Backfill/Grading --
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before neat Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Unable to in;nect-no access
Fire Supply Line ( J Please call for reinspection RE: ( 1
ADA �J
hlSidewalk
Other Date ! ` .._Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job *It*.
MECHANICAL PERMIT
CITY O F TIGARD
DEVELOPMENT SERVICES PERMIT#: MEC2001-00260
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/16/01
PARCEL: 2S103CD-02400
SITE ADDRESS: 13755 SW 116T1 i f'L
SUBDIVISION: HOLLYTREE ZONING. R-4.5
BLOCK: 01 LOT:008 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: /ENT FANS:
OCCUPANCY GRP: R3 VENTS WIO APDL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS.
_ FUEL TYPES _ M 0 - 3 HP: 1 DOMES. INCIN:
3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
GAF ,RESSURE: 50 + HP: WOODSTOVES:
DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS S:
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfrn:
Remarks: Replace gas furnace and add a/c unit. Placement of a/c unit must comply with standard setbacks.
Owner: FEES
JAMES,JOHN R+ JUDITH A Type By Date Amount Receipt
13'755 SW 116TH PL PRMT CTR 7/16/01 $72.50 272001000C
TIGARD, OR 97223 5PCT CTR 7/16/01 $5.80 2720010000
Phone: Total $78.30
Contractor:
SPECIALTY HEATING &COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Heating Unt Insp
Phone:629-5643 Cooling Unt Insp
Reg#:LIC 66578 Final Inspection
This permit is issued subject to the regulations cr.,ntained in the Tigard Municipal Code, State of Ore
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is itch started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You y obtain copied of hese rules or direct questions to OUNC by calling (503)246-9189.
Issue y: Permittee Signature: y��'Ca,j `�
Call (503)639-4175 by 7:00 P.M. for Inspections needed the next brisiness day
Mechanical Perinilr;Application
City of Tigard Date received: /l/ o! Permit no.:Nf t: /.e."
Cityf Tigard
Address: 13125 S W Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
o
Phone: (503)639-4171 Date issued: By Receiptno.:
Fax: (503)598-1960 Case rile no.:
Payment type:
Land use approval: Building permit no.:
Will
)KI &2 family dwelling or accessory Cl Comm ercial/industrial ❑Multi-famil
❑New construction AAd �on/alteration/replaccmellt U Other: Y D Tenant improvement
Job address: )! t5 -qc � Indicate equipment quantiti.s in boxes below.Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.. profit.Value$ _
Lot: Block: Subdivision: *See checklist for important application information and
Project name: X14-vvt.o S (t,y!, jurisdiction's fee schedule for residential permit fee.
City/county: 7 Gvt CO / S >< ZIP: 7,)-1
Des ription and ocntion o ork on p este: qcl. Di
t t t
Est.date of com),letion/inspection: Uee(ej•) Coral
Description Q Res.onl Res.ottly
Tenant improvement or change of use: / . C:
Is existing space heated or cogditi,.ned?C Yes ❑No Air handling unu CFM
Is existing space insulated? mos U No Air eon it onjng(site pian require )
terat'on o existing AL system -
lA N` compressors
Business nam ( Q State boiler permit no.:
Address G6HP Tons BTU/H
City: 1 Q� State: air smoke amper, uctsmo a etc
ctors
O ZIP.4 7 3 eat ump(site p an requ re ) -
Phone• . 4.,A jy Ey f ax�r96-t-4I E-mail: nsta rep aceurnac!/burr:e /
CCD no.: Z,65 7 8' _ Including ductwork/vent liner 0 Yes VNo
City/metro lie.no.: lie Q(- Insialureplacetrelocate heaters-suspen suspended,
__ wall,or floor mounted
Name(please print): rN14 t-f(�IS
entforappianccot er an furnact.—
t t e gent not
Absorption units—_ BTU/H
Chillers _ — lip
Address: $,�q .5C4J 3 ST CentressorsHP
City: T St<n c:Q _ ZIP. C) �d,a,a nr tronmenta e. must mn vent mt a;
� Appliance
cevent
r:
Phone: Fax:J $ /� r-ttnll: 7ryerexUU;t —
a s, ype res, itc eN trzmat
Name: - �7h,u J'/4�1�VLE<9 hood Fire suppression system
H.luiling address: Exhaust fan with single duct(bath fans)
__ / 6( �
_____�_,��_ _ G:..E..�• x must systema art from eaun or AC
City: '� /� Ls ICP Stalc:(}k ZIP: C? = 2.3 Ue P P ng an st ut on(up to out cls)
Phone: - J ' Fur_._. If maul --- TYPe _ LPG _ _ NG Oil
tic piping eac a ltluna over out ets
rProcess piping(schematic required)
Nam,,: Number of,outlets
Address: — "- — -- t ter [ app mace or equ pment
Decorative fireplace
Ciry: — State: ZIP: -w- - 'insert-ty !
Phone: ax: — F'.-mail -- - oo stove/pe etT1 stove -
Applicant's signature: 6aefr4lei t, 41111 Date; 7 // br other:
Name 04t t't ri ter:
Not All)uriWlctlonr accept credit cards,please call jurisdiction for rnorr infom idon.
Permit fee.....................$
U Visa U MasterCard Notice: This permit application
Credit card number r / expires if a permit is not obtained Minimum fee................$
Plan review(at
Expires within 180 days after it has been r c?r) $
Rom of t rrrdhulckr ns.sawn nn credit caM nCClpled 0.S complete,
State surcharge(9%) ....$
$ TOTAL $
Cant older sianarure —
_ Amount
4404617 Omwom)
r
Commercial Schedule 1&2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE Oesct prion -
Furnace to 100,000 BTU Table to Mechanical code oty Price Total
955 1) Furnace to 100,000 OTu
including ducts 8 vents inclumn ducts 6 vents 1^00
Furnace� 100,000 BTU 2) Furnace 1 ducts
&vents
inGudm ducts 6 vents 17.40
ncluding ducts&vents 1,170 3) Floor Furnace --
inGud-n vent 1400
floor furnace - 4) suspended heater,wall heater
including vent 955 or floor mounted healer 11 00
suspended heater,wall heater 5) Vent rat md_±d in nppl ance permit 8.80
or floor mounted heater 9556) Repair units 12.15
Check all that apply 'Boller Heal Air
Vent riot included in appliance permit 445 For Items 1.10,see or Pump Gond oly Price Total
Repair units 605 footnote`1,2 comp r' -
7)c3HP.absorb unit to
3 hp;absorb.unit 100K BTu 14,00
6,3.15 HP,absorb unit
to 100k BTU 955 100k to 500k BTU 25.60
3.15 hp;absorb.unit 9)155.0 HP:absorb
unit 5.1 mil BTU _ 35.00
101k to 500k BTU 1700 10)30.50 HP,absorb
unit 1.1 7$mil nTU52.20
15-30 hp;absorb.unit 11)>50HP.absorb unit>1 75 mil BTU
67.20
501k to 1 mil.BTU 2310 t 2)Air handling unit to 10,000 CFM
-- 10.00
30-50 hp;absorb.unit 13)Air handling unH 0.000 CFM
1-1.75 mil.BTU 3400 (7,20
14)Nor evworate cooler
10,00
>50 hp; .unit 15)NorVent fan coningle dud
> 1.75 mil.l.BTU 5725 ) ceded to'asingle 6.80
Air handling unit to 10,000 ,fm 656 16)Verhiabun system not included in
ai.phance permit 10,00
Air handling unit>10,000 cfm 117017)NWd served by mechanic l exhaust
10.00 _
Non- ortable evaporate colter 656 1s)Domestic incinerators
vent fan connected to a single duct 446 19) _ 17.40
Comtnereal 5.r Industrial type indnerator
Vent cyst.not Included in appliance permit 656 89.95
20j Other units,Including wood stoves
Hood Served b mechanical exhaust 656 10 00
Domestic incinerator 1170 21)Gas piping one to bur outlets
540
Commercial or industral Incinerator 4590 22)Mo-e Ihen 4-por outlet(each)
1.00
Other unit,including wood stoves,Inserts,etc. 656 Minimum Parmll Fea 72.60 SUBTOTAL
6.4 SURCHAPGE
Gas piping 1-4 Cutlets 360 --,
PUN REVIEW 25%OF SUBTOTAL
Each additional outlet 63 Required for ALL commercial permits only
TOTAL
Other InsWcuons and regia
1 k,y.ectidns ranside of nomvi Duy,ness guns Irtan-rdurge twit hw,sl
%72 50 per hour
2 inwiti tions'a whk11 M lee n spear.1py nti"ted(--rn ehupe hae t.")
112 5.o per Min
n'Dation _ 4" 1 Addeiurw pun rev» mw d by manges eddd-W'"-%lu MuleTotal ,m nnnu�
-----_ - ---- rsurgeanahae neon)$12 sit per hour
•state centroclar Brawn Cntir"t-rr.quirm
$I.00 t0$5,000.00 --` „--- Minimum$72.50 _ _-•---r----1 ••nH,denhal AA IMunes site plan tn.w,rq unit
pueene•r•i w
S5,001.00 to 510,000.00 �^ -J $72.50 for the first$5,000,00 and 51.52 for
each additional S 100,00 or fraction thereof,
to and including$10,000.00
510,001.00 to S25-00-0--00 41d$.SO for the fir.,510,000.00 and S 1.54
for each additional S 100.00 or fraction
thereof,to and including$25,000.00
$25,001.00 to$50,000.03T9.50 far the tits($15,000.00 and$11745-1
for cacti additional S 100 00 or fraction
thereof,to and including$50,000.00
$50,000.00 and up S742.00 for the first S50,000.00 and S1.20
for each additional S 100.00 or fraction.
thereof
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