13714 SW HILLSHIRE DRIVE i
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13714 SW HILLSHIRE DR
CITY OF 71GARD RUILD!NG INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - - --
� r BUP
�
Date Requested - �-/- - 9r AMPM _ BLD
Location__13 71V -51—&) :�- Suite MEC
Contact Person — _ Ph — PLM
Contractor _ ��G LX7(I ttSWR _
BUILDIWG — Tenant/Owner —1_�1 !� C ?
Reta?ling Wall - -V 7—
Footing ELR
Foundation ACC_p SS"
FPS
Ftg Drain �—
Crawl Drain Inspection Notes: SVN
Slab ---- --------- --- --- - SIT
Post& Beam -
Ext Sheath/Shear
Int Sheath/Shear
Fi aming
Insulation
Drywall Nailing L)A) S1�1- ��T
—_—
Firewall --
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -_----- __ --__-- —
Roof �- 2
Final
PAS`i PART FAIL
PLUMBING
Post& Beanl — — - — — ---�
Under Slab
Top Out - -- - _--__ --- —
Water Service
Sanitary SewFr - ----- --- -- -
Rain Drains
Final —� �— -- — —
PASS PART FAIL.
ti1ECHANICAL - --_-�--
r'ost&Beam - - -- ---- ---- - ------- - -_
Rough li7 — -�--- ---
Gas Line ----__..__.—
Smoke Dampers
Final --- ----..._ ---- - -------
P %&--P*%l FAIL
cRIr.A� ---- --- -- --- -- ------------ ------ - --
e�
Rough In -------.___-------- ------_____.—
UG/
LowV
L ow Voltt age
F iLV'PJarnI
ASS,, PART FAIL ---------- - ------ -- ---- -- —
SITE
Backfi!I/Grading --
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ', PIr)se call for reinspection RE -,_ ( )Unable to inspect- no access
ADA
Approach/Sidewalk (2
other rate ' ! Inspector_ Ext
Final
PASS PART FAIL 00 NOT REMOVE thin Inspection record from the job site,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: �39-4171 ---
I 5� BUP
Dr:e Requested hj
AM-3PM _ BLD
Location z/y /J, S,aite MEC `J7 0C14'd'
Contact Person i Ph _ PLM _
Contractor — j 1 Ph SWR
BUILDING Tenant'Owner ���/�i; � ��Lr;-/ .�OQr� .57
ELG
Retaining Wall i ELR -
Footing Aca
Foundation NOT REQUESTED 1 FPS
Cr Drain awl Drain FOUND DURING RESEARCH SGN
Cr
Slab InsF NO INSPECTION(S) FOUND IN FILE SIT
Post A Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing - -.-..- -- -_-- --------
Insulation -- -- —-
Drywall Nailing
Firewall -
Fire Sprinkler
----------------------
Fire Alarm
Susp'd Ceiling --- ---------------_-_�._� __-_._----
Roof __._ ._.__--
_ —
Misc
Find --. __ ------ ---
PASS PART FAIL --------. ---- -- -__--- —
PLUMBING
Post 8. Besm
Under Slab
Top Out --- --- - -
Water Servi-e
Sanitary Sewer
Rain Drains
Final -- - -- -------_.Y
PASS FAIL
ECHANICA
Post&Eeam - - --- - - -
o�g
Smoke Dampers
S PART FAIL
EI- - TRICAL ------ --- - -- --- — - ---—-- -
Service
Rough In `
UG/Slab
Low Voltaar, .__-___-----------__--
Fire Alarm
------------------
Fina! ----------------_.. _.._---------
PASS PART FAIL
SITE
Backfill/Grading --------- ------ -------__._._--
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$—_--required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE -� __,__ _ [ ]Unable to inspect no access
ADA
Approach/SidewalN
Other Date Inspector
f J ti'�kf-- Ext f/T
Final
PASS PART FAIL] DO NOT REMOVE this Inspection record from the job site.
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CITE( OF TIG,ARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)6394171 n, 4'
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CITY OF TIGARD
DEVELOPMENT SERVICES
13125 S W Hall Blvd., Tigard,OR 97223 (503)639-4171 )A-rr
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Plan Check a
CITY OF TIGARD Mechanical Permit Application Recd By_
13125 $W HALL BLVD. Commercial and Residential Datc Recd
TIGARD, OFc 97223 Date to P E
(503) 639-4171, ;304 Date to DST
Print or Type Permit#
Incomplete or illegible applications will not be al:L;pied Called _
Name >f UeveiopmenVPro)ect Ccicription
Table to Mechanical Core On' PFdCE '>,MT
Jab -_vein Add„•a II II Sudeo A) Permit Fee 0_
a 10 00
Address
Elicge C4ytState Zip,. 8) Supplemental Permit 3.00
'k k L1 c (VI 2 '
Name for name of ousiness) , I
I ) Furnace to 100,000 BTU �6 00
OWr1P.t i (" k )
incl ducts 3 vents
Mailing Addresst 2) Furnace 100,000 BTU+ 7 50
V6 I !l-1 U) A(�I, 1inc! ducts&vents
city/state Zip Phone 3 1 Floo Furnace 600
CYA incl.vent
NaIpf name of twsin aa1 4) Suspended heater,wall heater
t L � _ _ or floor mounted healer
Occupant Mating Address 5) Vent not incl in 300
_ appliance permit _
Crtylstate ✓ t-11-- Zip Phone 6) Boiler or comp,heat pump,air Gond 600
to 3 HP,absorp unit to 100K BTU
Nina 7) Boder or comp,heat pimp,air cond. 11.00
I" i 3-15 HP,absom unit to:,02K BTU _
Contractor Mating Address 8) Bo;ler or comp,heat pump,air Gond 15 00
15-30 HP absorp unit 5-1 and BTU
(Prior to rG4y)stale Zip Phone _ 9) Boder or camp,heat pump,air cend. 22.50
issuance a copy t, Dt-L; (Y`j-) 30-50 HP,absorp unit•-1.75 mil BTU _
of aA licenses are Crag_Conn.Cont Board Lie a Exp. ate 10) Boder or comp,heat pump,air Gond. 37.50
required f I >', j �5' �� >50 HP,absorp unit 1 15 mil BTU _
expired in C O T COT eu"Wast ax Matro a Exp Date 11 ) Air handling unit to -4-5 0
data base)_ r ` �' - C/ r) 10.000 CFM
Architect Name 12) Air handling unit 750
10,000 CTM+ _
or Mailing Address 13) Non nortable 450
evaporate cooler _
Engineer Cdyistate p ancne - 14) Vent fan connected 3.00
_ _ to a single duct
Desenbe work New O Additio Alteraton 0 Repair O 15) Ventilation system not 450
b be done Resrdenti»L Noh- sidential O included in appliance permit
Additional Description ofwbrk aa-( 16) Hood served by mechanical exhaust 450
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;t `u. �)1k(;l,�L a ear . �!
17) Dcmeshc incinerators 750
Extsting use of 18) Commercial or industnalrype 3000
building or property. i (!� L- �_ incinerator
19 1 Repair units _ 450
Proposed use of 20) Woodstove 4 50
building or property 4_ -
_ _ 21) Clothes dryer,etc. _ 4 50
Type of fuel-oil 0 natural gas 13i LPG 0 electric C) 2_) Other units 430-
1
501 hereby acknowledge that I have read this application that the 23) Gas piping one to four outlets 200
information givens correct.that I am the owner or authonzed agent of
the owner,that plans submitted are in compliance with p on State 24) More than 4-per outlet (each)
laws
Signature of Owner/Agot Date CITY.SUBTOTAL
-SUBTOTAL
Contact Person Name Phone 5%SURCHARGE
PLAN REVIEW 25%OF SUBI OTAL ;2105
h jl
1 �
—_ - ---- ---1 OTAL '
)dstamechpmt doc irev 7)96) Minimum permit fees S25+5%surcharge
CITE( OF TIGARD
DEVELOPP"ENT SERVICES
13123 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
Community D)velopment ELEURICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # = ( 6 - C-
Phone (;,33) 639-4171 Date Issued
CITY OF TIGARDFAX (503; 684-7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete p=ee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address 1171 4-5 • w , _(-I i 1 1 s h i r e D r' , Service included items Cost(ea) Sum
City/State/Zip 7 U 4s. Assider+tia -per unit 4
1000 s9 ft or leas $11()00
)___ Each additional 500 aq 11 or
Name (or name of business
j�'� portion thereof $2b 00 t
Commercial❑ Residential,[]K x Limited Energy S2500 —
Each Manuld Home or Modular 2
C +IAng Service or Feeder _ $G8 00
2a. Contractor Installation only: 4b.Services or Feeders
Installation,alteration or�vtocation 2
Electrical Contractors c t:r i c a l Contractors 200 amps of lest $6000 2
Addre:'sj 5 0 N--V i c t o Y; S 1 i _A_ 201 amps to 400 amps $80 00 2
Citye s h a m State 0 r e • Zip 910 3 0 sol amps to 600 amps $12000 2
601 amps 10 1000 amps $18000 2
Phone Nu. 6 6 6_9 3 5 S Over 1000 amps Of vo%s $34000 2
�;nntractor's License No. 26-466__L_ t�eco^^pix only $50 00
' 'ractor's Board Reg. No. 47 7 1
l 4c. Temporary Services or Feeders
Installation dteration or relocation 2
Signature of Supr. Elec'n 200 amps or leas $5010
hone No 9 3 5 8 _ 201 amps l0 400 amps $ 00
License No. 18,;2 $ sot amps 10 600 amps ileo0000 _
Over 600 amps to 1000 volts —�-
2b. For owner installations: sea•b•Move
4d. Branch Circuits
Print Owner's Name__ �_ ,�_ New ai'nation or orteneron per p. of
Address a)The les for branch circuits Wlfh
City__ ^_ State Zip pureheee ul service or boder be.
Phone No. Each branch arcual _^ $5 00
b)The fop for branch cucuss wifhorr
The installation is being made on property I own which is purchau or service or beds roc
E;IS . G • +
not intended For sale, lease Or rent. First bramh cirard n0 3 5 0Each additional branch arcual Sit 00
Owner's Signature 4e. MiseellAneous
(Service or feeder not included) 2
?. Plan Review section (if required): Each pump or onriation orcie $4000 2
Each sign or outline lighl.ng $4000
Signal circuits)or a limited energy 2
Please check appropriate item and onto# fee irr section 58. panel alteration or amens on $4000
4 or more residential units in one structure Mmor Labels)lo) _` $too 00
Service and feeder 225 amps or,-noril,
_System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E C Chapter 5 Ppr'^spr..-i,w. —_ $'S 00
-'nr how _ $5500
i.t+iard � $55
Submit 2 sate of puns with application where any of the above DO
apply. Not required for tempv;.ry construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $
5%Surcharge(05 X total fees) $
PERMITS BEC')ME VOID IF WORK OR CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtoral $
COMMENCED ❑ Trust Account 0 $
Ralahce Due $ 36 . 75
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