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CITYOF TIGARD _ ` ELECTRICAL PERMIT
CITY
�J TIG
PERMIT#: ELC2004-00209
DEVELOPMENT SERVICES DATE ISSUED: 4/23/2004
13'125 SW Hall Blvd„Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104AC-02000
SITE ADDRESS: 13075 SW HAMPTON C-i
SUBDIVISION: PP1990-043
ZONING: R-4.5
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: (2)branch circults.
_ Job No.2613
kESIDENTiAL UNIT YY TEMP SRVC/FEEDERS _ MISCELLANEOUS
1G00 SF OR LESS: _0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'I_500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps -100J volts: MINOR I ABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER- PER INSPECTION:
201 - 400 amn: 10 W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BR.'ICH CIRC: 1 IN PLANT:
01 - 1000 amp: _ _ PLAN REVIEW SECTION
1000+ amplvolt: --4
4 RES UNITS: > 600 VOLT NOMINAL.
Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OAC:
Owner: Contractor:
VOELLER, NATHAN HILLSBORO ELECTRIC
13075 SW HAMPTON CT 21185 NW EVERGREEN PARKWAY
TIGARD,OR 97223 HILLS' ORO OR 97124
Phone: 503-526-0463 Phone: 503-439-9666
Reg #: I LE 34-43990
- -- —_- I W 134481
-_ —^ FEES `l ,I'1) 4941S
Description Date Amount
:;squired Inspections
J! I ['RMT] El_CPenial 4/23/21104 $53.50 --� --
I A t j 8%State Surcharge 4/23/2004 $4.28 Rough-in
Elec;1 Final
Total $57.78
L
This Permit is issued subject to the regulations contained in tho Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws.
All work will be done in accordance with approved olens. 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 yuu to follow rules adopted by the Oregon Utility Notification Center Those
rules are set in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)
246-66 or 1$00- -2344.
Issue y: Q o c��, Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ DATE:-
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: N"`--' DATE:
LICENSE NO:
Call 639-4175 by 7.00pm for an inspection the next business day
From:HILLSBORO ELECTRIC LLC. 5036013680 04/21/2004 16:13 #594 P.002
EtecUtyat Permit Av Aicution
City of Tigard D "°�'
13125 SW Nall$Ivd,Tigard,OR 9723) Pimm Raview Permit N
Phone, 503.639 4171 Fox- 503,598.1960 Dora!® ; Other Permit,
Insprellon Line 503.639.4175 xe Ready/ey, 0 See Page 2 for
Internet, www,ci.tiprd.or,us Nodfled/Msthod, Supplemental Infurmstion�
TYPE OF WORK PLAN REViE,W
❑New construction Additienlalteratiun/replacement Please check all that apply,
❑Demolition ❑Other: ❑Service over 225 amps,comm'I [INUArdous location
QService over 320 amps-rating 08uildng over 10,00()sq,ft,
t ATfaGURY OF CONSTRUCTION _ of i-and 2-fbmi(v dwellings 4 or more new residential
1-and 2•family dwelling El Commercial/industrial ❑Accesson•building QSystem over 600 volts nominal units in one structure
Multifamily Q Master builder []Other: QBulldtnp over thrix stories Ll Feeders,400 amps or mare
JOB SITE tN.FOR11fATtON AND.t.00A'TInN 00ceupant load over 99 persons ❑Manufactured structures or
UEgress/lighttng plan RV park
Job no.: 7 I _IOb site address^.��n ��t n, � []Health-care facility [Other: i
_�(� { Submit•L sets of plans with any of the above.
City/State/zlp: 11 J ' __ The above are not upplirable to temporary construction eorvice.
$uitdbld ./a t•no. Project name: Ed tfv Total
F@E6 SCHEDULE.
Cross street/directiors to job site. New residential mingle-or multi-Osmlly dwelling un'a
- Includes attached ra �
_ 1,000 .R.orlesi_ 145.15 _ 4
Subdivision Lot no. Ec add'1500 sy_k or portion 33.40 1
— Limited energy.rreidential 75.00 2
Tax trap/parcel no.: Lirnited energy,run-residential 75.00 2
JESCRIPTiON 0!r WORK Each manuflctured or modular
dwelling.service and/or feeder 90.90 2
Services or feeders inatallaNso,alteration,and/or relocation
200 amps or less 80.30 2
Q PR PERTYBR �] TIiN:�INT 201 amps to 400 amps 106.85 2
401Q-W to 600 amps 160.6_0 2
Name: V106_01 amps to 1,000 amps 240.60 2
Address- Ov-r i•n00 amps or volts 1 434.65 2
- RecLonect only 66.85 2
City/State/zIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Pae ( ) rel )m _
_ 10U ampr or less E1
Owner Installation.This installation is being trade on property that I own which is not 201 amps;o 400 amps 1:11:3M751
2
intended for sale.,lease,rent,or exchange,according to ORS 44'1,449,670,and 701, 401 amps to 600 amps 2
Owner sit►nsture: _ _ date r Branch circa Its-now,alteration,or teriAlon,perponell
— U APPLI NT' L] CONTACT PERSON A.For orrano epi ircuits,valt
' — - -— service or feeder fee,eam
Business name: branch circuit 6.65 1
- - -- 13.Fee for branch circuits
Contact name: _ withow service or ffieder fee, i 46.85 rS 1
Address: each branch c�rcuit
Bach add'i branch circuit 6.65 _•4 2
City/state/ZIP; Miscellaneous(service or feeder mot included)
Pump or irrigation circle _ 53.40 2
Phone( ) fax: ( ) $ign or outline lighting 33.40 2
E-tnall. _ _ Signal circuit(s)orlimited-
CONTRACTOR energy panel,alteration,or
Businessname:Hillsboro Elecextension.Describe: Page 2 3
tric L
Address: Each additional Inspection over allowable Ia an of th+above
21 1 8 NW EyeraI'een PKWY ELL 41 1 0 Per inspection I 62,so
C'Ity/St.ate/ZIP� Hillsboro, OR- 97124 Inve-olgation pethour(Ihrmin) 1 62.50
Phone.(5 0 3) 439-9666 Fax:l5 0 3 )(01 3 8 0 Industrial plant per hour 73.75
-•36 - ELECTRICAL. PERMIT FEES,
CCR Lic.:1 3 4 4 81 Electri Lic.;3 4-4 9 C Suprv.Lit.: 4 9 41 S SubtcU_ t 5
Suprv.Efeevician signature,required. Plea review(25616 of permit fee)
Print name:joay V i tame Date:
State surchnrge(11%orperm t feel
TOTAL PERMIT FEE •1
Authorized signature: This
perell moF, Hoe esph•es If a perm.Is net obulaed wltAie Ia0
d ya attar h has been seceptad as complete
Print name: Pee methedotor set by TNrovnry Buildrny hdustty Service Bard
•�Number of inspsetiems per permit allowed.
1.1a„ilduy+Pcrmns\BL.C-.pmm7Ugf.dos *07 eMMn)KT�IWJK'OtitM1VBa
h
7 CITY O F T I G A R D _vMECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00201
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4120104
PARCEL: 2S 104AC-02000
SITE ADDRESS: ?
NJ[ec hanical Perplitn licatio>« e • o
Re. cd MOchanical
Da; IJ Permit No,-
'City of Tigard PlanningApprovat g.;lding
13125 SIV Hall Blvd. Date//a : Permit No.-.
Tigard,Oregon 97223 Platin Review other
241Cf"� Permit No.:
Phone: !03-6394171 Fax: 503.595-I960 Post•RcvicW Land Use
Internet: www,cl.tigard.or.us1y°� Case No.:
24-hour I nspcctio.,Request: 503-639-4175 Contact lures„ qee Page 3 for
Narne/Mtthod! Sti le ental information.
TYPE QF WORk _ CONINI(E<et�►L»>ie-5 Du -vsE CHiCKLIST
YeW:onstruCtiOn Demolitl0n� Mechanical permit fet,s"are based on t c to v
4r-1
AM ion/alteratian/re lace j r t _ oChec: p h tat slue of the work
D crformed. Indicate the value(rounded to the nearest dollar)of all
_�.ATEGORY(1F CONSTRUCTION mechanical materials,equipment, lubur,overhead and protit.
rpt 2:Fantil dwellin Commercial/Industrial value: S Sec Page 2 for Fee Schedule
Accd:;sory Buildilt Multi-Famil RESIDENTIAL.E VIPMENT/SYSTEMS FEE•SCAEriULE
Masts r Builder Othcr: Desert Hott tv Nee ea.) Total
_JOB SITE INFORMATION And'LOC TION �bt Coolino
lob site iddress: Furnace-add. air conditionin * 14 00
' Gas hear pum t a.00
Suit's TF: _ Bld -/A tA. uct work 14,00
Pr0''sct Name: K dronic hot waters stem 14,00
Cross strt et(Dir -----7 s to job site: Residential boiler
for radiator or h dronic system) 14.00
Unit heaters(tLel,not electric)
in wall,in-duct,sus snded,etc.) 14.00
Fluea/vent for an of above 10,00
�ubdlvisi m: Lot# PL-,air units I 12.15
Tax tE�L!arcel#: �~ Other Fuel A tiorices
rifi5C72t. ITION OF�VOR1( Water hoate 10.00
Gas Fre lace 10.00
FIwe vent(water heater/ as fire lace) 10,00
Lo li hter as) 0.00
Wood/i•'ciler stove ,10.00
Wood frecnSett 10,00
ROPEI.CY Chimnev/liner/tludvent 10,00
lva�rr Other: o. o
Narri,�L'���-•� ' ti�� C LQ.Sr t;nvironmental Fathaust tai V rntilation
Address: '.tom — Range hood/other kitchen cquipmcnt 10.00
Cit /;�tatc/Zip: Clothe0 dryer exhaust — 10-.00
Phon; 1 . V- 1,", Fax: Single duct exhaust
AP.PLI�.UVT (bathrooms,toilet compartments,
CON CC PERS N nrili rooms 6.3U
NB& Attic/crawl ace fans 10 UO
Address: Other:
City/State': _ Fuel Pi ip nq
""SS,40 for first 4,S1,00 each additionFI
Phont;: Fax: Furnace etc. .;
E-[tial l: Cas heat um —
�_��ONT C.TOIt 1Valbsua cndtd/unit hrarer� ••
Business name: S t-t F l Water heater ..
Fire lace ..
Address: U I �,-
Cit /5tate/Zi A(i _�� C
Phone:--LICT Clorhes d er as)
Fax: (vk I- o 'T i•7
CCD Lic, rt_ r1` Total:
Authori::cd Mechanical Permlt Fees'
Dnte:��tf Subtotal: S
�J t��t( •_�"� L� t �.r..� Minlrnum Pemuc 2. I) '\b
--LFee S Plan Rcview Fee 2 of Permit Fee) S
(Please print name) Statc Surchar a 8%of Permit Fee) I S > u
Neticet This permir application expires If a permit Is not obtained within TOTAL,t 'RMyTr
180 dans after l has been accepted as complete. "Fee mtthodaingy set by Tri-County Building Industry Service Board.
\Dstt\Pe mit rt MUVecPemiiU\pp dot 01/03 Slte plan required for exterior A/C units.
2 •d HtLo 8139 Eos 21I12WOH 92ta10adS dE9tbo io at Jdd
iN
SITE PLAN
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Specialty Heatinc & Cooling, Inc.
9528 Sw Tigrard Street
rI'ivard, OR 9722'-)
Phone 503 .620.5643 Fax 503 .598.071 8
Hillsboro Phone 503 .640-3607 Fax 503 .6$ 1 .0793
E -d 9LLO HBG EOS ZutzeaH R2ietoad5 d*q :*o it] 61 .+dH
CITY OF TIGARD 24-Hour
BUILD;NG Inspection . (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 6394171
- --- - — -----
``qBUP -- --- --
Received Date Requested A — PM BLIP
Location -)v,6 � Suite MEC - —
Contact Person , (1 Ph PLM --- ---
Contractor_ __ Ph( ) SWR
BUILDING TenanVOwner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Insp Ion Notes: / SIT
Pos!&Beam _, �d3� L. �✓y --- ,�;
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall flailing
Firewall
Fire SprinklerR�/E� --
Fire Alarm
Susp'd Ceiling - - --- --- ----.---� _._-- __--
Roof
Other. --------_ __- -- -----_ -�__�--- -- -__
Final -
PASS PART FAIL
PLUMBING i--- -_- _-
Post&Beam
Under Slab --
Rough-In
Water Service
Sanitary Sewer
Rain Drains -- - -- ---- -
Catch Basin i Manhole
Storm Drain -
Shower Pan
Final
_PASS PART_ FAIL_
MECHANICAL
Poet&Beam
Rough-In
Gas Line
1E noke Dampers —--- -- -. -- —
Final
PASS PART FAIL --- - -- — —
SLECeTR-IG — ---- -- - —
Rough-In
UG/Slab
Low Voltage
foe Alarm
FinaU
❑ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
S [� Please call for reinspection RE: _—_ Unable to inspect-no access
Fire Supply Line
ADA nate � Inspector
I''t M LL
Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING ( Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received Date Re uested AM PM__— BUPA
Location 7 Suite #EC
Cortact Person d Ph V& 3PLM
Contractor Ph( ) SWR
BUILDING lenant/Owner _ ELC _
Footing
Foundation Access: ELC
Fill Drain ELR
Crawl Drain —
Slab Inspection Notes: SIT
Past& Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear G - M/� 2L-
Framing VV
_k..�J`�-
Insulation
Drywall Nailing -- — _
Firewall
Fire Sprinkler — —
Fire Alam
Susp'd Ceiling — — — —
Roof
Other:_ —
Fnal -------._ �
PASS PART FAIL -
PLUMBING
Post& Beam —
Under Slab —
P ough-In
Water Serviue -- —
Sanitary Sewer
Plain Drains
Catch Basin/Manhole
Storm Drain — - ---
Shower Pan
Other:
Final
P S PART FAIL -
FCHANICAL '
Post—& Beam —
Rough-In
Gas Lioe
Smoke Dampers - --- — —
a
PART FAILICAL
-- --- - --
Rough-In _
UG/Slab
Low Voltag
Fire Alarm
Final Reinspection fee of$ before next ins required
PASS PAR_ T FAIL ❑ 4 pection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: _ Unable to inspect-no access
Fire Supply Lhrs
ADA
Approach/Sidewalk Date - Inspector Ext
Other:
Fina! _ DO NOT REMOVE this Inspection record from the Job sito.
PASS PART FAIL