14050 SW FERN STREET 1
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14050 SW FERN STREET ''
CITY' OF TIGARD EL.ErTPICrIL. PERM'""
DEVELOPMENT SERVICES 17-11-P41ITT #-. r_('99-0071
13125 SW Hall Blvd,, Tigard,OR 97223(503)639-4171 DAI'F 11;r,3UET)-. QIP/ 10/99
TF ADDP :SO. » » » I 4i-V-M 'c,W
IBDIVIFITON, -HANDY ACRr,.6 70NIN04R-7
LOT. . . . . . . JUP I S o;:!., DICT'TON: iMP
i on: First branch circuit
-RESTIDENITPL, UNIT - - -. - Tr7MP L3PVr,'r'r--J--Dr--Pr3 MT3CPl-1-nNEOU'
'00 OF OR LFS5. — 0 0 200 ..amp. » . , . » . : 0 PUMP/T RR 1 GAT I ON. .
-0 1 - - 'N/f
,CH ADD' L Fj00f3r,. 0 400 amp. .. , . . , . . 0 S T(I -HJT L TNr...* I TG. .
' MTTf,--D ENERGY, . . 0 401. C.00 amp. » . » . . . 0 S I GiNni-/Pr-INEL.. . . . . . 0
V% IAM/ GVC/F'Dr. . 0 r,.01.famps 1000 voltn. 0 MTNOR LABrL 0
TW;PECTIONIS-- -
317 r.
.2.00 4mp. . . . . . . 0 OR r'rEDEP: 0 PUP TNe. :17TTON. -- 11,
4910 amp. . . . » » : 0 17,t W/D SRvr r]R FDR. z 1 Pr-`R HnUR. . . . . . . . . . . 1 0
r7,00 amp. , . . 0 r'n 1,)Dy., i. r,,wr,ji r1l?r: 0 T19 PLANT.
100v� amp. . . . » : 0 Pl..nN 91:7 V T.F W SrrTTON--------- -
1100-f AMP/V0lt— . -, Vt Rr'r') Ul"ITI'S. . . . . . . . ) (',00 VOLT NOMTNAL.
c-onner-t only. rl-PSE31 AREPI/S017(, Orr.
Inp"Y': *1 * I - * . rr"r. r,
INDY T!ANrtWTRTH y I.:)c, a m n I I I I t by date
W FERN !�',T -
01�o@ r PrMT t 7 151 10 0 T,
C-11PRD !w,r7, s 79 n OF'., 1 C,
'Nj)Y JUNFW'TrT11 ~r- 75, T(ITaal .
050 OW rFRN
PrPUT111711
,Gnpl) OR 97223 in
orle 4f: 232--99" ,
s 1-�ecsit is issued subject to the regulations criltAined in the Tigard Punicipal Code, State of Oregon Spec;al-'i
;ilirablp laws. All work will be done it Accordance with approved plans. This pewit will expire if work is rel started witt,in W
,s of i4suancf, or if work is suspended for tore than IN days, ATTENTION! Oregon law requires you to follow the -ales adopted by
Oregon 4"ility Notification Cotter. Tlra4e rules ?rr W fortl} ir. OAR I5e-01-We thni,igh MR "2441-1987, yr : NAy obtain a copi
lt.7se rUlps or direct questions to nLW g (5031846-tW-
T
n W N F P T N r,T 1 1 F'Yr T 0 N n N I Y
r, fl tl o 1.0-1 4 rtl 4
CITY OF TIGARD Electrical Permit Application Plar Check
13126 SW HALL BLVD. Recd By
TIGARD OR 97223 Date to P.Ec'd C
Date to P.E.
Phone(503)639.4171,x304 Cate to DST
Inspection(503)639-4175 Print or Type ?errNte
Fax(503)684.7297 Incomplete or Illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ Number of Inspections per permit allowed
Name(or name of business)k4717,0 k �� I Service Included: Items cost sum
Address �i�J-5o 1/ r �'� 4a. Reaiderttial•per unit
it —� '000 sq.a.or leas 51 tO.00 a
City/State/Zp .f,�i,� J/1 UI _ Each addhloral so0 ca.h.or
❑ Flesidential.� portion thereof $25.00 1
Commercial Uml;eo Energy 528.0C
Each Manurd some or Modular
2e. Contractor Installation only: Dwel'inp Service or Feeds* — $88.00 2
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Ccntractor _ _ Instal stion,alteration,or reloceuor
200 amps or less $80.00 2
Address_ 201 amps to 400 amps 580,00 2
City State Zio 401 amps to 800 amps _ $120.00 z
Phone No _ 801 amps to 1000 amp& $180.00 2
Over'000 amps o•volts _ 1340.00 2
Jeb No
Elec.Cont. Lice.No. Exp.Date Reconnect only _ 1150-M 2
OR State CCB Reg.No. _F_xp.Dale .—. 4c.Temporary Servlen or Feeders
COT Business Toy cr Metro No. Exp.Date Installation,alteration,or relocat on
200 amps or lase 15000 z
Slgrature of Supr. Eler.'n 201 amps to 00 amps — 3 Oc z
401 off"to 000 $13100
1
00 amps $t»oo z
Over 800 amps;o 1000 volts.
License No. Exp.Dale see"b^above.
Phone No. 4d,Branch Circuits
Nen,alteration or extension per panel
2b. For owner installations: a)The fee for braich circuits with
purchase of service or
Print Owner's Name �/'C , U� _ feeder les.
Address—Z fJSU I t.✓ w/ _ Eac,r brash circuit 35.)0 2
City� 2 Stat® r� b)TVs'so'cr trrsnc 1 circuits
�_ P without purchase of
Pho'te N0. AZT service or 11"0er fop,
First branch clrcift $3500 — 2
The installaton is being made on properly I own which is not Each additional orencr circus: $500 2
Intended for sale,lease or ren 4e,Miscellaneous
((Service or fe9der 101 hcir,ced)
COwner's Signature i�r-- L �— Each pump or trrpatbn creta _ i4D i
Each sign or outline ighnng
3. Plan Review aa (I/required):s Sipral clm:lb,$)or a Imlted energy14000 2
=
panel,alierallol or extenslon
Minor Labels(1 D) $10000
Please check appropriate Item,and enter fee In section 5B.
4 or rnore residential units In ore stricture 4f.Each additional Inspection over
Service and feeder 225 anus or more the allowable In any of the above
Sys,ern over 600 volts nominal Ps•inspectbn 535.00
Classified ere&nr ser,ucture containing soenlal occupancy PSI hour $55.00
as described in N.'..C.Ciapter 5 it PAN $5S.00
'Submit 2 sets of plans with application what@ any of the above appty. 5. Fees:
Not required for temporary onnstructlon aerWoes. 6s.Enter ictal of above fees $
6%St rcharge;.06 X total fees; 1
NOT ICE Subtotal 1
Sb.Enter 25%of IIns So'or
PERMITS BECOME VOID IF WORK OR CONS—SUCTION AUTHOa12ED 13 Olan Review iL-soul L1S1(9ec 3) $
NOT CCMMENCED WITHIN 150 DAYS.OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED On ABANDONED FOR A PERIOD OF 180 DAYS AT AW r
TIME&.r_TEa A'O/RrK IS COMMENCED. ❑ Trust Ao,tnt a
i� (J t!�ti„Lf/�•w JW jYMr 14 ' bl�1� oc
V 's . Total bls►ance Out
r'OBrSYcLOi&.AFP �.,&1C
zoom aevgi1 Ao .uia 098T 969 C09 TPA 51 :80 03.11 88,01, ZO
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to"P'ITY OF TIGARD
M�P'r:'RMTTUI
DEVELOPMENT SERVICES P,F.RMIT #. . . , . . . : MEC990051
13125 V Hall Blv,I., Tigard,OR 97223(503)639.4171 DATE. 16GL)ED.-
rE ADD RF:]"',5
r,D,f%)i S I(I h�l. . . . HWIDY ACPFri Z0N_*l`J[3: P-7
LAIT. . . . . . . . . . . . . :022 TURIt3l)TCTT0N- !]RD
_.____F 00P r,"LJRN. 0 F_VArJ 1'�OOLFRGJ' 0
i OF WORK,, :OTR
'r-Ir OF' LIP3177. . . FSF- (.JNTT HEATEW3, 0 VENT PANS— : 0
CUr,ANCY GRP,. . : R3 VFNT�3 W/n AP'PI 0 VENT SYSTFMS: 0
nRTI-9. . . . . . . . 0 HOnDq. . . . . . . : 0
DOMF.L). INCTN: 0
'EL TYP[7r) - Pt...71, 1 1p, COMMI. . INrTN-. 0
1 A 5 3- IF, Hr,,. . . 0
iY TWDIff. IZA STIJ 15- .3171 3171 lAr'. - - - - A I)IF,44:11P ONT'IT11 14A
RE' Din.MP'F RR) 30--50 HF. - - - 0 W0nT)5T0VE4ri. 0
'7) F''R E 5 P I I'V- !;0+ Hr'. . . 0 r-1,0 DRYERFi, (I
. nF UNTT"3 AIR HONDI ING I)NITS 0_tHFR t.!NTTF1. 0
!RN ( 11211211-', RTIJ: 0 f`-1
!Rlq TIT11: 0 > 1.0000 rfm: 0
in Ar k s - Installation of 22 ton gas pacil.
JrIer'."
iNDY X.INGWIRTH t J P$7, "A In 0 1.111 f 1)� i.i t;e P 1.
02108
1050 SW F'ERN �TT 1,RMT 5. 0 0 D EB - /9") 99-31
immr)
E33TEPN HFPTTNr3 R A/r
3 14 SW C-11) 1. FN 111,VD
E ;7,00 'n5 TOTPL
AVFRTnm nR 9700�.
'tone # f.,4t) 5 110 ri
R r q it V1 110 7 F-9
RF IN I I R1:�D I N l3f. .C7*I OW,
TL,is pereit is Issued subject to the regulations contained in the t 11-1 s r 1
gard Municipal Code, State of Ore. Specialt,,! Cores and all other mprtlarlic-Al Trisp
plirable law., All worts will be done in a�rordancp with JAP�t; itig Lh)f Ttisp
,-proved plans. This peroit will expiri, if wiirN is not started r1c,n I i ii q t lyi-W I ri s p
thin JP# 1`13ys of iss,iancia, m if wort- is slitperided for 80VP Misr. 7nsl�)Prf inn
3n 180 days. ATTENTION: Oregon law require you to fallow rules Final 1t1SPrrf;i0n
1:ipted by the Gregor Utility Notification Center, Thnge rules are
:, forte it OAR 9`2-001--R10 through OPP. 952 001 NPBfI. You IIIA11
`4,ain copies of these r.les or direct q,r,i r r to OIJKr by calling
� 'f
eb I-M t t
T) IFIP
F++++++++4-4-+4 +++++4-++4+4++ +•+++++++•++-++•+••+-'#-++++++++f-+ _++ + i f + 4
A
17' f:iy 7-40
11mr
+++++f-•-F+++ 4+++++++++•++++++++4 +.+++++-+++4-++ �+4-++4-4++++-t-+++•+++E++4-++4
Plan Ch k# _-
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Rec.'d Zz-
TIGARD, OR 97223 Date:o P.E."
(503) 639-4171, x304 Date to DST_
Print or Type Permit#
Incomplete or illegible_applications will not be accepted called -�
Name of Development/Project Description -
�� t�; I f Table 1A Mechanical Code _ Q: Price Amt
Job sire Address tT- snae# A) Permit Fee 10.00
Address U Q -S W F 1) Furnace to 0 BTU
including ducctsls&8 vents see footnote 1,2 6.00
dg# Utyistate ZIP 2) Furnace 100,000 BTU+
J r Z 1 3 including ducts&vents see footnote 1,2 7.50
Name(or name of business.) 3) Floor Furnace
Owner
Z7 includink vent __ see footnote 1,2 _ 6.0_0
MallinAddrosa�' ✓u!��/Z jet --- 4) Suspended heater,wall heater
Fl---A,,-
or floor mounted heater see footnote 1,2 _ 6.00
/-
0 r p s b--- /_A, 1 r 5) Vent not included in appliance permit -
CdylState Zip Phone 3.00
�� Check all that apply 'Boiler Heat Air
-------— Name(--�+�=-y-LLQ For Items 6-10,see or Pump Cond Qty Price Amt
Name(c-name of business)
footnotes 1,2 _ Comp
6)<3HP;absorb unit to j
Occupant Mailing Address IOOKBTU _ j _�- —I _ 6.00 -_
7)3-15 HP;absorb unit
City/State Zip Phone 100k to 500k BTU - 11.00
B)15-30 HP;absorb
unit.5-1 mil BTU _ _ 15.00
Contractor Name 9)30-50 HP;absorb
t i ;�L�✓ }fr f „/� unit 1-1 75 mil BTU _ 22.50
Prior to perrn t Mailing Address 10)>50HP;absorb unit
issuance,a copy 1 `' 51��/�L- ��� ��! !� _ >1.75 mil BTU _�� 37.50
of all licenses ny/Stald Zip Phone 11)Air handling unit to 10,000 CFM
are required if JjE,, V Q/Z Oc ,c J_�vP �— 450
expired in COT Oregon Conal Cont Board Lie# Exp Date 12)Air handling unit 10,000 CFM+
database_ �7 fj -s' " o-" 7 50
Architect erne --' 13)Non-portable evaporate cooler
4.50
or Mailing Address _ 14)Vent fan connected to a single duct 3.00
15)Ventilation system not included in_
Engineer CnyrSlate Zip Phone appliance permit 4.50
16)Hood served by mechanical exhaust
Describe work to be done _—_ 450 -
17)Domestic incinerators
New V Repair O Replace with like kindYes O No O _ _ 7.50
Residential Ol- Commercial O 19)Commercial or industrial type incinerator
30.00 _
Additional information or description of work 19)Repair units _
4.50_
20)Wood stove
NOTE: For Commercial projects only;Units over 400 lbs require _ _— 4_50
structural gas talcs. 21)Clothes dryer,etc
Type of fuel oil O natural gas electric, 22)
O electric4$0
22)Uther units
I hereby acknowledge that I have read this application,that the information ,____ 450
given is correct,that I am the owner or authorized agent of 23)Gas piping one to four outlets
the owner,that plans submitted are in compliance with Oregon State laws. See footnote 1 _ 1 1 200
24)More than 4-per outlet(each)
Signature of Owner/Agent Date 50
/ j7 - jar _ Minimum Permit Fee$25.00 SUBTOTAL S
Contact Per$drx arae Phone
___ __ _ 5%SURCHA_RG
7 -f 0� PLAN REVIEW 25%OF SUBTOTAI
Foonotes for commercial projects only: Required for ALL commercial permits onlyi
1 Provide full schematic of existing and proposed gas line and pressure. TOTAL S
2 Provide drawings to scale showing existing and proposed mechanical
units _ 'State Contractor Boiler Certification reouired
---` "Residential A/C requires site plan showing placement of unit
14nechperm doc rev 02/4199
CITY OF TIGARD BUILDING INSPE; 'ION DIVISION
M,iT
24-Hour Inspection Line: 639-4175 B.Isiness Line: 639-4171 ----
HUP
Date Requestedr- < < AM PM BLD
Location / y S`L) `4e I'I't Suite MEC
Contact Person .���— �f�I.a PLM -
T—
Contractor _ h ` f Yh (� ��n1/ SWR
BU!LDING Tenant/Owner ELC < ""L
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes- /-P /,1/.' / '
Slab I �.—IL 4, 0 �k- SIT
Post& Beam 1
Ext Sheath/Shear tiLZ_ ► Z —
Int Sheath/Shear
Framing --
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: - -- -- - -
Final
PASS PART FAIL_ - -- ------- ---- - -- --- - -- -
PLUM9ING
Post&Beam - ------- --
Under Slab
lop Out -
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL _
MECHANICAL
Post& Beam —
Rough In
Gas Line ---- --._ - ---- -
Smoke Dampers
Final - - - -
PASS PART FAIL
ELECTRICAL - - - - - ---
Service
Rough In
UG/Slab
Low Voltage
larm -------- -- -- - _ --- ------
Fina
ASS PART FAIL _ —_—_ _.— ------ -
SI
Backfill/Grading - T
Sanitary Sewer
Storm Drain f j Reinspection fee of$ _— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line , l )Please call for reinspection RE, -_-_ ___-- ( )Unable to inspect-no access
ADA O
Approach/Sidewalk Date Inspector d Ext
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 -�
BUP
Date Requested_ I AM PM BLID
Location ` U J rJ `� Yl � Suite MEC ` CJS
Contact Person _ c f- Ic k:�Y�. Ph t�� � �"�Ocy' PLM
Contractor Ph SWR
BUILDING - Tenant/Owner ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS
Fig 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 ----- --- --- - ----- -.. -- ----
Final
PASS PART FAILWING
Post
Post R Hearn ----------- ------------ ----
Under Sla'b
Top Out
Water Service _
Sanitary Sewer -
Rain Drains
Final
PASS PART FAIL
MI~CHANICAL
I lost&Beam
Rough
- --- -- -- ------ .- -" - ------"-- --
Rough In
Smoke Dampers
Irma> - - - -- - - —
ASS PART FAIL
tLECTRICAL ---- - - - -- -- - ---
Service
Rough In _ --
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading - -- -- ----- - - - --
Sanitary Sewer
Storm Drain I 1 Reinspection fee of$ required before next inspection flay at City Hall, ';1125 SVV I lah I11vd
Catch Basin
Fire Supply Line [ 1 !'lease II for reinspection '?E I Unable to inspect r o acres
ADA
ALF'J't'n
proach/Sidewalk r
er Date ------- 1'. --- Inspector -----s--- .------Ext
al
ASS PART FAIL DO NOT REMOVE this inspection record from the job site.