16727 SW MONTEREY LANE V
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16727 SW Monterey Lane
ELECTRICAL PERMIT
TY OF
T I GA R®
PERMIT#: ELC2002-00304
DEVELOPMENT SERVICES DATE ISSUED: 7/9/02
13125 SW Hall Blvd., Ticiard. OR 97223 (503) 639-4171 PARCEL: 2S116AD-07300
SITE ADDRESS: 16727 SW MONTEREY LN
SUBDIVISION: KING CITY NO" 12 ZONING:
BLOCK: '18 LOT : 005 JURISDICTION: KIN
Project Description- ImMallation of(2) branch circuits.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS — MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIG!" ')UT 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 OR FEEDEI:: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA AGD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ _ PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: — > 600 VOLT NOMINAL.
Reconnect only: —SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
DANIEL-LE JOHNSTONE ALL-WAYS ELECTRICAL
16727 SW MONTEREY 6032 SE BREWSTER PL.
KING CITY, OR 97224 PO BOX 68456
MII_WAUKIE, OR 97267
Phone: Phone: 513-6614
Reg#: SUP 1287S
1.Ir 49032
FIE 3-229c
FEES Required Inspections
Type By Date Amount Receipt Rough-in
5PCT CTR 7/9/02 $4.28 27200200001 Elect'l Final
PRMT CTR 7/5/02 $53.50 2720020000(
Totai $57.78 i
This Permit is issued subject to the regulations contained in the Tigard Muniape.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 if
work is suspended for more than 180 days. AT"ENTION: 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 or direct questions to
Permit Signature: y. Issued By:
OWNER INSTALLATION ONI_v
The installation is being made on property I own which is riot intended for sale, lease, or rent.
OWNER'S SIGNAI URF: -- DATE:—
CONTRACTOR
ATE:CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: __, l ----"__— DATE:
LICENSE NO: ._ ---- — ------ ------ -- —
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
-- vats received: Permit no.:
City of Tigard Projecl/appl.no.: !-- Expiredate:
Cloy of Tigard Address: 13125 SW Wall Blvd, I irard,OR 117223 [late issued: h+: Rcceiplno.:
Phone: (503) 639-4171 --
Fax: (503) 598-1960 ase file no.: Payment type
Land use approval:
-�jTIIPE OF PERMIT1Q'I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvemew
/U New construction U Addition/alteration/repiacem(!nt U Other. U Partial
INFORMATION
Job address: /'7;'77", Bldg.no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivisio
06 A
Project name: Description and location of work on premises: 74 ZLI�-'
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE i
Job no: ver Max
Business napl: - --- Descriplion Qty. (ea.) 7ulal 2o-in,
New residential-single or nedti-family per
Address: dwelling unit.Includes nllached gnrsq e.
Clly: I Sial ZIP: Serdeeincluded:
Phone• ? —.S/ Z. Faxt 3- rt 1 E-mail: IOW 5q.ft.or less 4
^ Each additional 500 sq.ft.or portion thereof
CCB no.: 21— Elec.bus.tic.no: -� Limited energy,residential 2
City/metroJic.no,: Limited energy,non-residential 2
Each manufactured home or modular dwelling
e of sit ervismg c Ctrici (re air ) bate Service and/or feeder 2
sup.elect.name(pri ��� License no. ? ''7 Services orfeeden-inslallallon,
alteration or relocation:
200 amps or less _ _ 2
Nnmc(print): 201 amps to 4W amps 2
401 amps to 600 amps 2
Mailing address: 601 mops fo 1000 amps _ 2
City: $tale: 71P: —_ Over 1000 amps or volts _ 2
Phone: Falx: E-mail: Reconnect only I
Owner installation:The installation is being made on property I own Temporaryservices orfeeders-
which Is not intended for sale,lease,relit,titexchange according to Installation,a I leral Ion,or relocation:
2amps or less 2
ORS 447,455,479,670,701. 211011 — _amps l0 4(x1 amps _ 2
Owner's si naturt;: Date: 401 to 600 ams 2
Branch clrculI new,alteration,
ENGINEERor extension per panel:
Nanle:_ A. Fee for branch circuits with purchase of
Address: service or feeder fee each branch circuit 2
State: 71P: _ B. Fee for branch circuits withuut purchase
y - of service or feeder fee,first branch circuit: 2
Phone: I ax F.-mail: I:achadditional branch circuit
.
PLAN REVII-11111lease Cl*ck 811 flint apply) Mlsc.(Service or feeder not Included):
U Service over 22raps-conunercial U Itealth-cafe facility F:aeh pump or irrigation circle 2_
5 w
U Service over 320 amps-rating of 1&2 U Ilazmdouslocation Each sign or outline lighting 2
,amilydwellings U Buildinp-•ver 10,(xx)square feet fouror Signal circuit(s)or a limited energy panel.
U System over 600 volts nominul more resid mtial units in one structure alteration,or ex tension" 2
U Building over three stories U Feeders 1',3 amps or more *Lcscrition.
U occupant load over 91 persons U Maouiactured structures or RV park tach additional Inspection over the allowable In any of the above:
U Egrem/lightingplan U t)thrr __— 11'r inspection
Submit—sets otplans with any of the above. Invcstigotionfce —
The above are not applicable to temporary construction service. Other
Not all jurisdiction"accept credit cant",please call jurisdiction for utr infonnatiao Notice: Ibis permit application
Permit fee..............I......$
m `—
U Visa U MasterCard expires il'a pennit is not obtained Plan review(at _ %) $
Credit cord number: _-_1_.-L_- within 180 days after it has been State surcharge(8%)....$
accepted as complete.
TOTAL .......................$ �
Nath!of e I r as shown nn cit It cud
S
........-C roller sigrralwt - Amount 440.1615(6MWCOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEL'S:
Com tete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
P Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 Sq ft or less $145 15 _ 4 Audio and Stereo Systems`
Each additional 500 sq.ft.or
portion thereof $33.40 _ 1 Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder _ $90,90 2 Garage Door Opener`
Services or Feeders Heating,Ventilation and Air Conditioning System
Installation,alteration,or relocation
200 amps or less $80.30_ 2
201 amps to 400 amps _ $10685 2 I r_1 Vucuurrr,Systems'
401 amps to 600 amps _ $16060 2 �I
601 amps to 1000 amps $240.60 2 L_I Other
Over 1000 amps or volts $454,65 2
Reconnect only $66.95 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system......................................................... $75.00
200 amps or less $66.85 _ 2 (SEE OAR 918.260-260)
201 amps to 400 amps $100.30
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts.,
as"b"above. Audio and Stereo Systems
❑
s
Branch Circuits
New,alteration or extension per panel Boiler Controls
a)The fee for branch circuits
with purchase of service or U Clock Systems
feeder fee.
Fach branch circuit $6.65!_--- Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder foo.
First branch circuit $4685 _
Each additional branch circuit Z $665_ __. HVAC
Miscellaneous [] Instrumentation
(Service or feeder not Included)
Each pump or Irrigation circleI _ _ $53 43 Fach sign or outline lighting $53.40 _ El Intercom and Paging Systems
Signal circuits)or a limited energy
panel,alteration or extension _ _ $75 00 __ Landscape Irrigation Control'
Minor Labels(10) _ $125.00
Eac'r additional Inspection over J U Medical
the allowable In any of the above
Per Inspection _. $62.50 � �� Nurse Curls
Per hour $62.50 ___
In Plant $73.75 Outdoor Landscape Lighting'
Fees: ❑ Protective G,gnaling
Enter total of above fees $_� - n Other
8%State Surcharge $ Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required Licenses are required for all other installations
front of application. —
Fees:
Total Balance Due $
----�"- Enter total of shove fool $
❑ Trust Account p 8%State Surcharge $
Total Balance Due $.—_ --
All New Commercial Buildings require 2 sets of plans.
0dstslf3rmslcic-fces.doc 08/30/01
CITYOF T I GA R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MECR 002-00436
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 1
PARCEL: 2SIS116_
16AD-07300
SITE ADDRESS: 16727 SW MONTEREY LN
SUBDIVISION: KING CITY NO. 12 ZONING:
BLOCK: 18 LOT: 00.5 JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNiT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL_TYPES i 0 - 3 HP: DOMES. INCIN:
- 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSI OVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITSOTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm: GAS OUTLET'
> 10000 cfm:
Remarks: Installation of furnace ant heat pump.
Owner: FEES _
DANIELLE JOHNSTONE Description Date Amount
16727 SW MONTEREY IMIJ 111 I'crnut Fee 10/4/02 $72.50
KING CITY, OR 97224
1MF.C'HI I'crnut Fee 10/4/02 $0.00
jTAX] 8 StateTax 10/4/02 x5.80
Phone: 10/4/02 $0,00
Contractor: Total $78.30
TRI-TECH HEATING
6603 NE 137TH AVE
VANCOUVER, WA 98682 REQUIRED INSPECTIONS
Phone: 360-891-2002 Mechanical Insp
Final Inspection
Reg #: 101873
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 clays. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. "Fhose rules are set forth in OAR 952-001-0010 through OAP.
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699.
Issued By: �e�_ _ Permittee Signature: /,-A/
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
10/03/2002 10:44 5036393771 CITY OF KING CITY PAGE A-2
09/26/2002 09:20 5036393 71 CITY OF KING CITY 1AGF e2
1RI-COUNTY
sravici.aNTIR Mechanical Pe >ltApplicatio1n
• Ch �L King City — - Date receivixt: -
1. 13125 SW Holl Blvd, PMjWt/eppl.tic Expire dace:
�> Ttgard,OR 97223 '*� ` Data Issued: By: Receipt nail;
Clar{camas Phone:(503)639-417i'.)'
39-4 1 7i„F7CFile
MUltnot"llah asa a no., Payment type: _—
Washington Building permit no
1
Land use approval: ,... ---..-• --
1 J 2 family dwelling or accessory *mMerciatindustrial 0 Multi tarrtily rl Tr•,nAnt iroprovenitant
U New construetton dltian/eltetpltion/replacement ❑Qther. ,- _ —__.. _ __- ____ .�
Job addressl ,.2A V-2 JLA J _ MQV 1_�, Indan
Indicate equipment qutitles in N)Xes below tndirnre the duller
Bldg. nom _ —=IAM 0.: � _ � value otAll tnQcha.n,cnl matennJs,equfpmrn[,latktr,averhrAd,
MR /tax lot/aruount no.. _ _ prol9t.Value-lax
Lot; Block: Subdivision: _ *See C1w,_klisr for important vpplirarion information rinif
Pio act name: y /urudicrton'r fee sclmdula for residennnl 1mr ruf e.
City/count - t'I r ZIF:
[ ,rcripi nand ocaNtm of wsr on,p see:_ t
�F- f Fn:tea.) 1•ma1
Eat.data of com ledott/intion: kes only kas on�.�
'I anent improvement or change oP u»e: AC
Air'iandlln8 unit — — CPNi
Is existing spare hearAd or conditioned ❑Yes No r conditiantnj(Pita P an rept )
Is existing 9par�e insttlatcil7 1 Y,", -) teratintl of extstinit HVArr eyseem I v v
Br,filer/compressors
State boiler permit no.:
Business tame: ! f`, �l I r� __._ HP 'oro 13T1.M
-TvAddr -- eramn a ampere/ ucr smoke etec,ror:
gta Z
At un (site an rh uiredl _ o
City: (_ _ — ,�.
E'hcrne' �' - alt; -l`f rnall:� � Insra rep acn rrnse ua/h trter__.�%Fr
dLir� zl _e��Yj�d — trcludin ductwork/vent Ilnar G]yea O No
CCB tim; C 3 —_ nstalt/rep acdre ocatt eaters-suspen
city/11180M tic.no.: watt,or(loop mounted _
Nitrite lease .'nt): — YvN (1 ant fora fiwce other tTiaan-_0 a
Brat n:
010 Absorption units BTUM
Chillers _ HP
Name: Chillers
ressors pip
Address: —� roementir'lt, ep and veo�t ser
City: _ State ZIP: A liance vent
E'honr: Fax: email: Urycrex 4utt -�
t� ype ITsTcitc�nat
_ hood rut suppreeslon aygtem
Nam Pxhaust fops with sin I_g e duct(bruh fade) _
rMailtng Address: "���_�1� rte, (may v-7v
pi ng Ra anal rte_bOt c—Fid(n or
Fue piping an tt oa ftp ro o4rlefl)
City: -.J l _.._ Stat _ :lp .. T'y LPG NO Oil
one: 3 r. 1.•twill. - Fud piping aec p anal over 4 outlets
aerapiping sc terns(c rrtqutrad)
Number of oatiets
Na mrper Il;�vil np�n`tw er equipment, 11
City:
Phone: insert-ryps —
_ as all:µ Woo-rove ps as stove
t _
p pplieant's.atg Others
Nam -e(PNnt). �[, - -
_.,,,,, Pctmit
,4,"hJl)urlydklbm aem mdlt cad(,P1#04 00101114WOO per Ile Inrbrnwton lvotice: This prrmir ewpficatilon Minimum f#* ...... —
v1w O MasterCak �xpGds Ifa permir is not obtained Plan review fat %) --
;.evil owed numea. -- w1diin t90 days after U has been State surcharge ,-
- deecpted as compkif
Noma br�tdhnId a sh w 4 o— s m+cd—'t r-4(T TOTAL . _. ... .........
d had tllrla11p1 r.ep-Ial7 ttirflOrCt?Mi
i
10/03/2002 10:44 5036393771 CITY OF KING CIT`/ PAGE 03
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Sr 3 g 4rY0A-
a�G
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639-417
BLIP _
Received __.__ Date Requested yN__ BUP
Location ? Suite__ . 3~Ot1y3 .
Contact Person _ _ Ph( ) _ _—_ PLM _
Contractor___ _ — Ph(_ ) .,r; SWR
BUILDING Tenant/Ownerrlti _ �� � a`---�-_ C
------ - - -
Footing LC _
Foundation Access: V
Ftg Drain ELR
Crawl Drain - - - --
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Sheaf
-
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - -------Firewall
Fire Sprinkler --- -- - -- -- ----
Fire Alai
Susp'd Ceiling —W------ --- - -_
Roof
Other: __ ---- ---- -- ---
Final
PASS_PAST FAIL —
PLUMBING
Post&Beam
Under Slab _--- ----_-___.-- -- --- -- —
Rough-In
Water Service
- --- --- — - -----
Sanitary Sewer
Rain Drains -- ------ — —--
Catch Basin/Manhole
S'orm Drain — -- —- - — -- --
Shower Pan
Other:
Final
PAS SRT_ FAIL --
Post8 Beam .._ -- -----------------.-- -- --- --_--_---__
Rough-In ---- ------ --_—.-- --
Gas Line
Smoke Dampers _--
nal
ASS PART FAIL ---
_
Rough-In
UG/Slab
Low Voltage
Fir larm
ur [-I Reinspection fee of$—� required before next inspection. Pay at City Hall, 13125 S1M Hall Blvd.
PART FAIL
SITE _ _—_ [� Please call for reinspection RE: — —_ _ Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1 Z d- - Inspector--
Other:
nspector-__.-Other:
Final — 90 NOT REMOVE this Inspes Mon record from the Job site.
PASS PART FAIL