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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124 }
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COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Perma , P0041300 Sta"Uer t
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INSPBCTION WIO
City of Tigard Building Depsrtw t
13125 SM Ball Blvd. Tigard. Oregon 97223
Inspection Line (Dec-O•-Phone): 639-4175 Business Phones 639-4171
Inepections_�^__
Footing Plbc,. Underelab Mach. Rough-in Appr/Sdwlk
Pound. Plbq. Top Out as Lln, FINJ1Lt
Post/Roam struct. Sen. Sewer Fraeleq -Bldg.
Post/Boom Koch. Rain Drain Insulation -Plumb.
Plby. Under!loor Water Line fo
y so
gyp. Rd. -Nh.
DAts Poquestedt_ Tle PM
Address: 16 2 1Mi22e1�/ 0& � Pelws.t ��/�� —e)�x I,
Builders l
THE FOLLOWING CORRacTIONS IIRE RXUUIR1.U2
Inspectors
note
V___APPROVMD DISAPPROVED
APPROVED SUBJECT TO ABOVE -_
_ Call Por Relnep.
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DEPARTMENT
DEPARTMENT OF LAND USE 6 TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION X3.50-12
155 NORTH FIRST, HILL 30ORO, OR 97124
.•� COUNTY, PHONE: 503/640-3470
OREGGN INSPECTION REQUESTS (4-14 hours): 503/640-3561 or 693.4415
Psrwit # . 0505747" Prcijec't # P0043300 S+.atu- APPROVEE f'.xIA 1 of 1 #
Appliad 08/24/94 Issued, 08/x4/94 Exp.irou 02/20/ j OR/30/94. 05 : 31
Permit Title F n - AIR HEAT 0TH
DoacripLion Aequn OR/24/94
Job Address Ift"?Hr SW SUMMERLAXE .,p 'r
Own*r Nama IN PFCTION TIGARr., Rook, n I-
App i i anti t Nanro ji,'. F Y F, ROSIN F
Phone numbp_r �a �r.4"� - x64 Valuation
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Inspe.:tion
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08/3(l/94 RI F•; 4`(� -()A j 4 4 ENTRY iii 141 j
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C11Y OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MECHANICALPERMIT
13125 SW Hall Blvd.Tlnvd,Oregon 97223.8199 (503)639.4171 PERMIT #. . . . . . . . MEC94-0236
G39--41 71. DATE ISSUED: 08/24/94 �
E IARCEL: 1513..AD 0760►i1
SITE: ADDRESS. . . : 1.07635 SW ial.1MMER LAKa Ew DR
SUBDIVISION. . . . : AMART SUMMERLAKE ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 120
------------------------
CLASS OF WORK. . :NEW FLOOR FURN. . . . : EVAP COOLERS: .1
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FENS. . . :
OCCUPANCY GRP. . :R3 VENTS W/O APP:-.: VENT SYS'TE MS:
STORIES. . . . . . . . : 1 BOILERS/COMPRESSORS HOODS. . . . . . . :
FUEL TYPES-------------- 0-.3 HP. . . . : 1 DOMES. I IVC I N:
: /GAS/ELE/ / 3-15 HP. . . . : FOMML. INCIN:
MAX INPUT: BTU 15-.30 HP. . . . : REPAIR UNITS:
T IRE DAMPERS?. . : 30-50 HP. . . . : WOODSTOVES. . :
CARS PRESSURE. . . : 50+ HF,. . . . : CLU DRYERS. . :
NO. OF UNITS----------- A I R HANDL 1 NO UN 1 Tw OTHER UNITS. :
t URN k 100K BTU: 1 <= 10000 1:f m: CAS OUTLETS. : 1 1
FUPN > =100K PTU: > 10000 cfm :
Remarks : GAS FURNACE/ELECTRIC AIR CONDITIONER
Owner: --------------------------------------------------------- FEES ---_-----------
ROBIN HOEYE type amolAnt by date recpt
1.0785 SW SUMMERLAKE DRIVE PRMT f 25. 00 JF 08/24/94 -
5PCT f 1. 25 JF 08/24/94 --
TIGARD OR �
Phone #: i
1
Contractor:
ANCTIL SHEET METAL. CO.
4320 N WILLIAMS AVE
PORTLAND OR 97217 --_--___-__-_.___-_--_ _-__-_.-------_.----
Phone #: 2.81--0752 $ `E. 25 TOTAL
Req #. . 08897
-------- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and al l other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspect i on
approved plant, This permit will expire if world is not started
within 18111 days of issuance, or if work is suspended for more
than 18@ days.
1 k+
Permittee Si�nat�.lr e .
( Call far inspection _ 639-4175
I,,
00/20/93 07547 0303 084 7297 CITY OF TIGARD Q001/001
City of Tigard G� MECHANICAL PERMIT Pte wRuc. #����-(A1
13126 SW Hall Blvd. , rL, APPLICATION perm" n
Tigard. On 97223 ��w\r
303 639 4171 I
W 111 Nis
Table AA 141= val Code CITY PRK)Ut AMT
Job :s & m te,
lA K� +� Pomrit T«o r a o to.00
Address .M ---s ------
110AP'D OP. c`7 Z!Z 3 2) gc"*ntwvw F'anM 9.00
0 1) inat•docs A wum 6,00
Owner C' S -0 2) MA duan&vraux 7,30
6ARD Ft--"
1 -
U G 72 3) Ind own s.�a
4) of poor rrtotrnMd hoawr 6.00
t7CGJDAci1 Aw
5) • wo ptlrmit 3.00
o r -
_ 6) vmkv.ahsonAW un#t Con
c'' r. pu p
� &E7 ME7A 1 (O, 7) to 30W ebswp unit to l tlOK BTU 6.00 L)(.�
"' w or CompF�w pump,air colky -
('.�nhtlCtO U N �II! tAm S S29�: i 6) 9.1R NP abswp unit to sooK BTU 11.00
sp Wow Of attnp,FwaTpump,Sur co
Ok'7W C) ?7023 9) 15.30 HP ebswrp un&.8 1 me BTU 155.00
uw IW M Mier or cw v,rold PUMP.av
10) 3450 HP abwp unit 1-1.75 mil®1U 22"
t a von ISS Sapp i. of or onaw. pump.air ---
Inlbrtearien 91ven Is co"cl.Ihet 1 an tho awr+er or atfib artnd avant 11) >So HP&Amp" 1.75 ml)BTU x1.60
of tl4 owtwt,tMt ptwe wrt"ltted Bra in oompAetda w 1h$tatob -
itw i,that I w"rtplOwed with ftConstruction Ceftacwes posh, 12) 10,000 crm 4.50
"I go number gtvan is coned. (It exempt Ir"State ragistn1110t, — --
plaass 9�teason below.) 't unit
13) 10.000 CTM+ 7 SCI
14) uvapa its doctor 4.50
it&icon w'I;r
111 toedno duct 9.00
an arstam not --
_,, 16) kckx%dIn appliom pwo 4.50
to be done trnow r Q) mort-nsldet11a1 -�� 1 cert o f l u 4.30
!e) type 1,xi"M*bt Woo
rip twee of Mer 0,0,wens ;wr1G.- - - -
INA ffing w property 19) hoatse,snlar.elol"driers,e(a. 11.60
Repos use of 20) am pol one to bur outlets _ 2,00
T7pe of h-,l-oll21) More then 4-w curet
f7 ntotunl get� l-PO Q elerArlC -
PERMITS BECOME VOID fF WC)RK On CONSTRUCTION Minimum FN li26.o0 SUBTOTAL-" ---
AUT1K nlZeD 19 NOT COMMENCED VATMN 160 DAYS.on F%SURCHARGE
IF CONSTRUCTION On WOFIK 19 SUSPENDED OR - -
ABANDONFh ran A PERIOD OF 160 DAYS AT ANY TIME P1�y fIEViEVY 29%Ot:SUBTOTAL
Ar'TEn WORK I9 Cc WENCEO. —
TOTALZr rjQ
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DEPARTMENT OF LAND LSE 6 TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/840-3G8'1/693-4415
PHONE: 903J64&X?fi1X--> b4U-34'/0
OREGON Page 1 i of 1 •
Date 1 08/24/94
Time 1 12 : 54
Permit 'Type Residential Electrical Permit Permit # 1 0505'1477
Permit Status APPVL)VE:D Applied 1 08/24/94 �
Situs Address 10'/85 3W SUMMERLAKE DR I'1 issued 1 08/24/94
Permit 'Title : SFR - AIR CUNDIT10NER & HEAT Completed :
Permit Descr, To Expire 1 02/20/95
Project 'Title : SFH - AIR CONI:.I T I ONE R & HEAT Project # P0043300 •
Project Uest-r.. : * EROSION
Parcel Number, 2S1'1'1 •- Land Use District 1
Valuation 0
Legal Descr.
Owner 1NSPECIJON - 'TiGNRD Construction : O'TH
Applicant Name 1 HUE.YE;, Ho IN E' Classification 900
Applicar, .: Add>: , : 10'/8b SW SUMMERLAKE; Dat Occupancy R3
TIGARD OR 97213 Validated by 1 CS
Applicant Phone: 524-U364 Inspector Area :
Fee description Units Fee/Unit Ext. tee Data
--- ------------------------_-----�-------------------_-----_-__-.---.--------------
-1st---
-Branch W/out Feeder ( Enter #] 1 35 . 00 35 , 00
Addl . Brunch W/out Feeder LEntex #] 1 5 , 00 5 . 00
Subtotal Electrical. lees :
40 . 00
State Su: charge of 5% 2 . 00
Tonal Electrical lees : 42 , 00
**It lees Required * * ** Fees Colley-ted & Credits ** +�
------------------- ------------
Method Check # Receipt No. Date Payment
CK 2246 08/l_4/94 42 . 00
TOTAL THIS DA'Z'E: ********* 42 . 00
?' bees : 42 . 00
Adjustments : . 00 Total Credits : , UO
'Total lees : 42 . 00 'Total Payments : 42 . 00
Balance Duel . 00
NOTICE- This permit becomes null and void If the work or constriction for which It Is Issued Is not commenced within 190 days. Once construction hes%tade!I,
the permit becomes null and void If constriction Is Interrupted for•period of Iso days. 1 certify that the Information presented by the applicant and
his agent or agent,.in support of this permit Is into and corrom to she best of our knowledge. I acknowledge thmi the Building Department's reliance
upon friss and misleading Information may Invalidate this permit. All prrrle)ons of applicable laws and ordinances governing the construction and use
of this bullding or structure will be co.nplled With whether or not specified on We plans or noted on the plana coirection sheets. 1 acknowledge that
the granting of a permit doas not grant authority to access private property or to use easements. I further acknowledge that the use or occup ty of
the structure or building permitted depends upon my calling for Inspectlons at various times during the process cor"truc►lon and the ul cg
Inspection ata"verifying compllenca With'_is various codes. Use or oceupsney of the bullding w structure
edr to app sl re
Building Department Is solely at the risk of the applicant and such use m occupancy Is revocable until all I Ion Ireme ■ Idled and
approval Is given by the 1lullding Official. I further acknowledge that a lien may be placed on the title of a ropal pon wh) nth rmll Is Issued
specifylig that the use or ocewancy of the building or structure Is provisional and revocable until I factl f all Ins tlo quiraments.
CANT'S SI AT
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WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation «e�
Electrical Inspection Section APPLICATION
155 North f first Avenue, #350-122
Hillsboro, Oregon 97124
•
Information: (503)640.3470 Fax: (503) 6934412
Permit �
PRINT
h!umber `?-`� �..� DatePLEASE `
Please complete all ' 4. Complete Fee Schedule br:low •
1. Location of Installation Number of Inspectlon#,per permit allowed
Address 10 76 s v k^.a^ .-e-la)" .D Service included: !terns Cost(ea.) Sum
Building A. Residential-per unit ,
City - -I a( Suite o.
- __._ 1000 eq,tt.or less $110.00 4
Tenant Name Each additional 500 sq.ft
(if commercial) _ or portion thereof $25.00 -
Limited Energy $25.00 I
Map No, Tax Lot Each Manifd Homo or Modular
Dwelling Service or Feeder __.__ $68.00 2
Thomas Map Book: Page; Section:_
Directions _ --- --- B. Services or Feeders
Installation,alterations or relocation
200 amps or less $60.00 2
Commercial ❑ Residential 201 amps to 400 amps $80.00 2
4C1 amps to 600 amps -- $120.00 _ 2
2a. Contractor installation onl : 601 amps to 1000 amps $140.00 2
Y Over 1000 amps or volts $340.00 2
Electrical Contractor -__ Roconnect only $50.00 _ 2
Address
Date Job Number C. Temporary Services or Feeders
Property Owner Installation,alteration or relocation
Contractor's License No. 200 amps or less $50.00 ____ 2
Contractor's Board Reg No. _ 201 amps to 400 amps $7500 _. 2
401 amps to 600 amps $100.00 2
Signature of Supr. Elec'n
Over 600 amps to 1000 volts see W above
`__ -_ �__ �
License No. -.__ Phone No. D. Branch Circuits
Now,alteration or e:dension per panel
2b. For owner Installat!ons: The fee for branch circuits with
b ' to F 1-}n a v L 5 L_y_-_0_3 L� puichaso of service or feeder fee.
PrintOwner's Name T'h-o a No. Each branch circuit $5.00 2 f
107 S e w SS J M eIt Lp b) The fen for branch circuits without
r� �r -- purchase of service or feeder06.
Z-3 First branch circuit /�-_ $35.00 2.
City Slate Zip Each add'nl branch circuit ` $5.00 2
E. Miscellaneous (Service or FeEder not included
The installation is g �dee, perty i own Each pump or irrigation circle $40.00 _ 2which is not int �' d f saor runt. Each sign or outline lighting $40.00 _ _ 2
Signal circuit(s)or a limited
Owners Signature -__. enei9l panel,alteration
or extension y_ $40.00 2 + I
F, Each additional inspection over the allowable
in any of the above
3. flan Review section (if required) Per inspection $35.00
Please check appropriate hem and enter fee in section 5B. Per hour $55.00 _.
_ . - _
_4 or more residential units in one structure In Plant $.55 00
Service and feeder, 800 amps or more 5. Fees
_.System over 600 volts nominal A. Enter total of above fens $ _
__Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
Submit 2 sets of plana with appi{catlon where any of theB. Enter 25% of line A for
Review if required (Section 3) $ --
above apply. Not required for temporary construction $UPlan Plan R $
services. $ ---
Less Bulk Label Fee
Balance Due
For Inspections This permit becomes m It end void K the work suthw1rod by the Permit Is not uommancad
640-3561 or 693 415 within 190 days from date of Issuance ol such permt,w it the work sttttwttyed is
24-hour retarder, one working day in advance of need E
suspended or abandoned at anytime atter work is commeneed fm•Period of 190 days.
lectrical Permits ars non-rsfundeble and non transferable.
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