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9330 SW MILLEN DRIVE
CITY
^C �I^�r,R D ry ELECTRICAL PERMiT
�,i/r v PERMIT#: ELC2003-00559
DEVELOPMENT SERVICES DALE ISSUED: 9/8/03
13125 SW Hah Blvd., Tivard, OR 97223 1503) 639-4171 PARCEL: 2S114AB-04500
SITE ADDRESS: 99330 SW MILLEN DR
SUBDIVISION: KNEELAND ESTATES ZONING: R-4.5
BLOCK: LOT : 032 JURISDICTION: TIG
Project Description: (1)branch circuit for new a/c unit.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS_
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD't_ 500SF: 201 - 400 amp: SIr-N/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVCI FDR: 601+amps _ 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L'NSPECTIONS
0 200 amp: Wi3ERVICE OR FEEDER. PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FUR: 1 PER HOUR:
401 - 600 amo: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ _ _ PLAN REVIEW SECTION
1000+ amp/volt: > 4 RES U,JITS. >600 VOLT NOMINAL:
Reconnect only: SVC/FDR —225 AMPS: CLASS APEA/S C OCC:
Owner: Contractor:
HURLESS,BRYON OWrJER
9330 SW MILLER DR.
Phon 3: 503-684-8886 Phone:
Reg #:
FEES -�-
- Description Date T_ Amount
Required Inspections
I FLI RMT] I t C Permit v ti(1 t -- $46.85 —
ITAXJ 9%State I:iy ') iS 03 $3.75 Rough-in
Elect';Final
Total $50.60
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 expire if work is not started within 180 days of issuance,or 9 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
forft"i in OAR 952-001.0010 through OAR 952-001-C100. You may obtain copies of these rules or direct questions to OUNC at(503)2d9-6699 or
=80saved By: Permit Signature:0-332-2344.
.,+7�� ' t�ra ��� ti�,,Ll://
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�- .t� (!I '� � f_ ' n�, )j
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: �'1- DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _--.� _ DATE:___.—
LICENSE
Call 639-4175 by 7:00pm for an inspection tha next business day
Electrical Permit A ii�lication FOR '
_--- ----- ----�•iElectrical r
O�i Permit No.jrGC�-� vSS
CityCit of Tigard Planning Approval Sign
g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: I Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Internal: www.ci,tigard.or.us Date/By: Case No.:Contact See Page 2 for
24-hour Inspection Request: 503-639-4175 Nar.ie/Method: + Su lerhental information.
6 i" 'ORK .' r n
New constructlori _ Demolition Service over 225 amps- Health-care facility
-- commercial ❑Hazardous location
Addition/alteration/re lacer,ient Utht. ❑Service over 320 amps-rating of ❑Building over 10,000 square feet,
d , 1 &2 family dwellings four or more residential units in
i &_2-family dwellin CommerciaRridustrial ❑System over 600 volts nominal one structure
Accessory Building Multi-Famil ❑Building over three stories ❑Feeders,400 amps or more
So
� �_ - �_— ❑Occupant load over 99 persons ❑Manufactured structures or RV park
plaster iitoldcr [3Egress/lighting plan ElmOther-_
t ..
zJOBI ® 1191 >lli� t ,Gt)CA UN Submit —,sate of pla .vith any of the above.
The above are not applicable to temborar construction service
Job site address: `)?3U 171 i_ -- ,-
Suite#' Bldg./Apt.#: _ - Number of inspectiousper ermit allowed
Project Name: Description _ Qty Fee(ea.) Total
New residentlal-single or muiti-family per
Cross street/Drections toob site:
� dwelling unit.Includes attached ganga.
Le(A Ot, `-(Z nc� Iz V'-t 04\ ok"IlQ.s164 service included:
1000 sq.ft,or less 145.15 4
Each additional 500 sq.ft.or portion thereof 33.40 1
Subdivision: Lot#: Limited energy,residential _ '+5.00 _ 2
--- Limited energy,non residential 71.00 2
Cox nla / arcel#: Each manufactured hume or modular dwelling
Y..
„J service and or feeder 90.)0 2
tServices or feeders-Installation,
f i q,14E„J'1 1a��+ alteration or relocation:
200 amps or less 80.30 2
--- -- - — 201 ams to a00 amps __ 106.85 2
401 amps to 600 ams _ 160.60 2
'ROPE 601 amps to 1000 ams _ 240.60 2
`� �-•4
Nari1C: T )1� - Over IOUO amps or volts 454.65 2
'"� Reconnect only — 66.85 2
Address: �3c+ S'W y�l,1�e h_ tl+� Temporary services or feeders-installation,
alteration,'or relocation:
City/state/Zip: _r.` psi Ci c) Z-2 L-1 200 amps or less _ 66.85 1
Phone: ii(,'I Uo 41- b Fax: 201 amps to 400 amps - W —� _ IW 30 2
401 to 600 ams _ 133.75 2
^'' 1W C PERSON Branch circuits-new,alteration,or
Name: extension per panel:
— A.Fee for branch circuits with purchase of
Address: _ service or feeder fee,each branch circuit a 65 2
City/State/Zip: B.Fee for branch circuits without purchase of
--- --- ---- service or feeder fee flrst branch circuit r 46.85 2
Phone: Fax: _ Each additional branch circuit 6.65 2
E-mail: Misc.(Service or feeder not included):
r -- Each pump or irrigation circle 53.40 2
--- - Each sign or outline lighting 1 53.40 2
Job No: Signal circuit(s)or a limited energy panel, _
Business Name' alteration,or extension Pege 2 2
__ _ Description: --
Address:
City/State/Zip: -- Each additional Inspection over the allowable in an of the above:
—_, ---__,. Per inspection per hour min. I hour _ 62.50
Phone: Fax: Investigation fee:
CCB Lic.#: _ Lic. #:
—" - — Other:
Supervising electrician Subtotal S
3i ature required: _ _ Plan Review 2( 590 of Pem»t Fee) S e1,-',,
�
Print Name: Llc, #: State Surcharg, (8%of Permit Fee S 5 _
-- —�— — TOTALPE
Authorized - Notice: This permit application etpires if a permit is n6fol5tainee1n
L4Signature: '-�l Date: 190 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
- - (Please print name)
i:\DstsTermit FomisTlcPertnitApp.doc 01/03
Electrical Permit .Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEF
RESIDENTIAL WORK ONLY: _
Feefor 411 systems............................................................ $75.00
k'rype of Work Involved:
DAudw and Stereo Systems*
Burglar Alarm
Garage Door Opener*
Heating,Ventilation and Air Conditioning System*
Vacuum Systems*
Other
COMMERCIAL WORK ONLY:
Fee for each system.... .................................................... $75.00
(SEE OAR 910-260-260)
Check'rype of Work Involved:
Audio and Stereo Systems
Fj Boiler Controls
❑ Clock Systems
DData Telecommunication Installation
Fire Alarm Installation
HVAC
Instrumentation
n Intercom and Paging Systems
E] Ca.dscape Irrigation Control*
Medical
Nurse Calty
F1 Outdoor Landscape Lighting*
Protective Signaling
Other__
_Numberof'Systems
* No licenses are required. Licenses are required for all
other installations
i:\Dsts\Perm;t FormsiElePermitAppPg2.doc 01/03
loom
CITY OF irIGARD 24-Hour
BUILOiNG Inspection Lhie: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST -_
BUP -
Received to Requested AM �i_PM_ BUP
Location 5 W Suite MEC
Contact Person _ Ph�) — b�-�c ' r PLM
Contractor Ph swR
BUILDING Tenant/Owner - ELC
Footing -
Foundation Access: ELC
Ftg Drain EL.R
Crawl Drain _
Slab Inspection Notes: — - SIT
Post&Beare
Shear Ancf.yrs ------ -
Ext Sheath/Shear
Int Sheath/Shear
Framing - -- -- - -
Insulation
Drywall Nailing - — -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: - -
Final ---
PASS_ PART FAIL -----_-__.____-_---- -- —
PLUMBINQ
Post& Beam
Under Slab -
Rough-In
Water Service -
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - - - - -
Shower Pan
Other: - -- -
Final --------_�-.._.
-PAR FAIL
4116CHAt
Post&Beam ----.� ---�-- -
Rough-In
Gas Line
Smoke Dampeia ------ - ---- --
ftss PART FAIL -- ---------- -- ------ --- -
ELECTRICAL _
Service ---- -----___— - _-- — _--_—_ _-_
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of$-__ -required before nexf inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE [] Please call for reinspection RE:__. --_ _._.-. Unable to inspect-no access
Fire Supply Line - '
ADAd !�
Approach/Sidewalk Dat 7 7 -_ Inspector &1J-j:V ___- Ext__-_-
Other: ,
Fine! DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL_
CITY OF
T I AR D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00543
13125 SW Hall Blvd., Tigard, Oh 97223 503 639-4171 DATE ISSLFD: 9,5/03
9 ( PARCEL: 2S114AB-04500
SITE ADDRESS: 09330 SW MILLEN DR
SUBDIVISION: KNEELAND ESTATES ZONING: R-4.5
BLOCK: LOT: t132 JURISDICTION: TIG
CLASS OF WORK: OTR 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 0 3 HP: 1 DOMES. INCIN:
--- _ —�..�-------_—__-- 3 15 HP COMML INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODS'rOVE'a:
GAS PRESSURE: 50 + HP: CLU DRYERS:
FURN < 100K BTU. AIR_ HANDLING_ UNITS ___. OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OJTLETS:
> 10000 cfm:
Remarks: Install AC unit.
Owner: F ----- F'`E�► ---------
HURLESS, BRYON Description Date Amount
9330 SW MILLER DR. 1%11 t'I I 1 11rrniut I-cc 9/5/03 $72.50
StatcTar 9/5/03 $5.80
L_
Phone: 503-684-8996 Total $78.30
Contractor: _
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPLCTIONS
Cooling Unt Insp
Phone: 503-640-3607 Final Imipection
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the T+yard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All wo.k will be dune in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you ',o follow rules adopted in the Oregon
Utility Notification Center. Those rules ar-,� s,.t Forth in {OAR 952-001-.0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OU14C by calling
(503)246-6699.
Issued By: �',.Z� � Permittee Signatu, _�'����.� r ,1► yt
Call (503) 639-4175 by 7:00 P.M. for inspections needed ,lie next business day
�
?��ecanicfid Pr1R •cfon ' ' ' I'm
» ec
Received M«hxaical
Date/By! Permit No.: - �
C lty t if Tigard Planning Approval — Building
OatelB : Permit No,:
13 125 S W Hall Alvd. iii '` %� l�l� Flan Regie.. Other _.._.
Tillard,1 hegon 97223 Dat Permit No.:
Ph,)ne: 503.639.4171 Fax: SO3�gg 9cgp Post-Rovim I.And Use -
InOmet: www.ci.tigard,or.us CiTV9($ 1'TGAPI Date/By; Case No.:
24 hour Inspection Request. 9(�Il� �l'Y��I " Contact Jutts,; See Page,2 for
Name/Method- Supplemental(n(ormamio.
T'1'PE'O.F:WORR 'OG M1ERCtXL.FEE*SCHEDULE,-USE CHEC ISr...
Nem construction _ TE-Demolition Mechanical permit fees*are based on the total value ofthe work
)Add tion/alteration/replacement I Lj Other: performed. Indicate the value(rounded to the nearect dollar)of all
mechanical materials,equipment,labor,overhead and profit.
1 & 2-)gamily dwelling Commercial/Industrial Value: S See Page 2 for Fee Schedule
Act:�rs Buildi�_ a Multi-Family _
Maser Builder Other:
Description Fee ea. Total
vftttr�dvco ling
JOIE,S_ Ci"4R11CATiON-aYfNl)LOCAZmN'°'" --
Job site JO&S a. Furnace-ad -on air conditionin "" 14.00
(,;as heat pump 14.00
State#: _ B)d ./A t.#: 5uct work 14.00
Prc-)eat'dame: H droni,c hot water system 14.00
Cross st•eeVD1rections to job site: Residential boiler
for radiator or,t dronic s stem (4.00
Unit heaters((Lel,not electric)
(in Wall "r,;duct,suspended.etc. 14.00
Flue/vcnt for any of above 10.00
Sultdivic ion: Lot#: Repair units 12.15
Tal rnal/parnel # OftLE!!!jAEillarices
-'1GIbN:70F,, 09K t -r.• water heater 10.00
,,. .,
--- .` Gus fireplace_ 10-00
Fluc vent(water heated as fir lace) 10.00
Lo,I ightor(gay) _ I U.UU _
Wood/Pellct stove 10.00
-- — - Wood fire lace/tilsert 10.00
_ r_ C:hirtmn /liner/flue/vent »—_ 10.00
7 RQ ,dam•: ,, „ TENAN 1'r_fi�'. .�,;,,.�;.� rather _ 1 n.00
Naine: _ Eav(ronmental6lthauurk ventilation
Address. Range hood/other kitchen equipment 10.00
Cifr/Sts to/zl A' Clothes dryer exhaust 10.00
t r f_ Single duet exhaust
PII.C,ne: i 3 r •f_. Fax: (bathrooms.tail(:%compartMenk.
=A-W ;�,•�;11,;, _ , ,AGI'�P /' utility rooms) 6.11
Nat ne: _ 0
.� A�.tic/crawl space fans10.W
Address: _ Cther: - 10.00
Feel PintCity/5ta:_
.(SSAO for first
41,$J. each additional
Phone: _-- , Fax: R_v Furnace,etc. — ••
1r-lttttil� rns he+a_pum_p ••
ON71R G"!C_OI c,� '',:.� '(y,.: Wall/su!Rended/unit heater
er
••
Water heat "•
Businest Name: a C• {-t ��,(G.}-1 r Ftrepluce ••
Address I (r 01 �" p eP Range
Cid''/eta e/Zi (S c BBV •" __ -
T Clothes dyer(R") •"
Phone tfo s�� Ftuc (e, i_ e;fi IJ Mai: — "• -
CC_N Lic. Total:
Auth)rued Meehatdcal Permit Fees,
Signrture: �G�t1La...� _ .�a:_,_ Date: _ _ Subtotal 3 -
Minimum Permit Fee$72.50 f -
q �"l ✓�•` I �`"� Malt Rcvicw Fee Z5%of Permit Fcc S
(Please print name) State Surchuze 8° of Permit Fee C O
TOTAL.PERMIT FEE S3 2 p
Not(cc: Thi permit application&*Ire#if a permit is not obtained within •qac mnthodology set by Tri-County Building Indust ervice hoard.
180 days aft it It has Men accepted as complete. "Site plan required for exterior A/C.Alta.
i:\Dsts%Permi;FomuNecPernitAliptim 41mt
2 .d BILL) 86S COS Zu t zeal-I F;'AI e t oaaig e l i :80 CO b0 dos
SITE PLAN
FL
PL PL
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STREET
Specialty Heating & Cooling, 111c
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
1 fillsboro Phone 503 .6403607 Fax 503 .681 .0793
B 1 L 13 a G C. p-0 q sut2vatl R141elvaC113 ell :80 ED *0 dos
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
q BUP .
Received ___ Date Requested._ / �( AM_ PM BUP
Location ___ 3c.) '�VXc,� Suite _ _ EC 3'rJ'' _
Contact Person —_ Ph(_ _) . D '?�o�. PLM
Contractor _ plt W
BUILDING Tenant/Owner
Footing
Foundation ELC
Ftg Drain Access: 1
ELR
Crawl Drain - �--
Slab Inspection Notes: SIT —
Post& Beam
Shear Anchors - — ----- --
Ext Sheath/Shear J
Int Sheath/Shear -- —`—
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling � ---- -- _—
Roof
Other: _ _ --
Final -----�-
PASS PART FAIL ----
P_LUM_BING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer — —
Rain Drains ----- --------- ___,— —___�
Catch Basin/Manhole
Storm Drain
Shower Pan —
Other:
Final
PASS PAJIT FAIL `� --.— --- -
Post&Beam
Rough-In
Gas Line
5 e Dampers
in
PASS PART IL n ----------- -
ELECTRICAL / - c�^ �
Service -1 77
�. ✓ -
UG/Slab
Low Voltage
Fi larm
r
SS SART FAIL F] Reinspection Ise of$— required before noxt inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE_ — _ [-] Please call for reinspection RE: _ F-] Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk 111118ft Aft-0 Inspector 14r''
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL