11025 SW SUMMER LAKE DRIVE i
11025 SW Slimmer Lake Urine
____ ELECTRICAL PERMIT%A oT�,�I° 1 OF T I GA R D PERMIT#: ELC2002-00652
DEVELOPMENT SERVICES DATE ISSUED: 12/20/02
13125 SW Hail Blvd.. Tiztard, OR 97223 1503) 639-4171 PARCEL: 1S133DA-06300
SITE ADDRESS: 11025 SW SUMMER LAKE DR ,ZONING: R-7
SUBDIVISION: AMART SUMMERLAKE
BLOCK: LOT : o85 JURISDICTION: 'rlG
Projact Description: Install 2 branch circuits: to AC and furnace.
_ RESIDENIi—L UNIT TEMP SRVCIFEE_DE_RS _ _MISCELLANEOU
'1000 SF OR LESS: 0 200 amp_ PUMP/IPRIGATION
EACH ADD'L. 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: bol+arr..s - 1000 volts: MINOR LABEL. (10):
SERVICE/FEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
2ri' 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
461 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
6011 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS >600 VOLT NOMINAL:
Rac:onnect only _ SVC/FDR>=225 AMPS: -_ CLASS AREA/SPEC OCC:
Owner: Contractor:
PADDACK,PYCHEN M + GRF ELECI RIC
A. LUELLA 15460 SE PARADISE LN
11025 EW S'UMMEF LAKE DR MULINO,OR 97042
TIGARD,OR 9722
Phone: Phone: 503-829-4146
Roy #: I-W 76751
Still 16555
_ FEES FLF 1-484('
Description Da`e _ Amount Required Inspections _
LI'l'ImI•j 1:1,(,Permit 12 20,02) $53.50 _
$4 28 Rough-in
[I AX j 80,(,State"f m I' 211"' F-lect'I Final
--- Total $57.78
This Permit is issued subject to the regulations contained in the 1 igard 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 if work is
suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center T Vse
rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these r!jle!.or direct questions to OUNC at(50�
218.6699 or 1.800-332,2344.
Issued By: r (,_.,�i A, I ;,�{, .� _ Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intend—ed for sale, lease, or rent.
OWNER'S SIGNATURE. _.— DATE:--
CONTRACTOR
ATE: _CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. EL.E(,'N: I ( Cc �_ DATE:
LICENSE NO: --
Call 639-4175 by 7:00pm for an inspection the next business day
Dec 20 02 06: 55a GRF Electric 5038235747
TA]Alectrieal Permit Application
`/ ` rcccivrd: Permit no.: 7 �-
City of Tigard C II.JtProject/appl.no.: Gxplre date:
City of7-Igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By rr, Kccefptno.:
Phone: (503) 639-4171 nn rr �� l�o� -- _--
Fax: (503) 5'98-1960 'JEI� Case file no.: 1 Payment type:
band use approval: _ CITY OF TIGARD
&2 family dwelling or accessory U Commercial/industrial OMulti-family J'I'enant improvement
U New cunslruction U Addition/alterittlon/replacement U Other:__ Cl Partial
11 SITEINFOIIMATION
Joh address: LI �_7 Bid g.'1 ?-, Suite no.: I'ax tors /tax iot/account no.
_ �w►.rt C,r LCA b P _
Lot: Block: Subdivision: �_
Project name: �kDescription and location of work on premises:
£=s,imet:rf da: of
Sob no: /1 L _-- ----- fir st,+.
Business name: G K.F �CC-'1'Y� Descril»lura llty. (ca i Total nn.ins,
Address: I5�-[L Ncvv vidmoial-sirgic err mulll-fandly
per
, divellingmdt.Includes anarnlgarage.
City:
So-vlcelncluded:
sly Phone: I ax_�Z t��_r,Jt,il: IW10sq.ft or les.:. 4 -
CCH no,: t1o:CICC,bug.lit !� Each additional 500 s .It.or ottiun thereof +
—. c �C- limited energy,residential 2
City/metro lic.no.: 7 Limited enerlov,non-residential 2
-Ott _ .Z Z C> l^ G-__- Bach manufactured home or modular dwelling
Signature of stioe, lec clan(rcyuir:d; Uat Service and/or feeder 2
Sup.elect.name(print): < _- L.k :n-,r no: i (o s-s Servicesorfeedera-Installallon,
altenllonorr iocallon:
11111OPERTY OWNER 200 amps or less 2
l � . M, �.� A d t (_C ,r _ 201 ampsl0400amps — -- - 2
Name(print): f/:
- 401 amps to 600amps 2
Mailing address: I ! Sto j• 601 nmpo to I000 amps - — - --2---
Cit State: ZIP: -, Over ltOl amps err volts
Pfione:�r) f Fax. E-mail: Hewnneuonly _ 1
Owner install.•tion:Thr,installation is being made on property 1 own Temporary services er feeders-
whir'.is not intended for sale,lease,rent,or exchange according to IR�llallotydteratlon,orreloation:
ORS 447,455,479,670,701. 201 amts or leis � 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 arra s - - -- - 2 -
Branch circuits-new,alteration,
or extension per panel:
Name. or
fee for biaiwh circuits with purchase ui
Address: _ - service or feeder fee,each branch circuit t g lo., _ 2
City: Slate: LIP: H. Fee for branch circuits without purchase
--
tuail Phone: lar, Email
of service ur feeder fee,first brtuich circuit: r L,5 2
�
Erich additional branrh circuit
1 Misc.(Service or feeder not included):
U service over 22-5 amps-ammnx:rciul U llealth-care facility Each pump or litigation circle _ 2
U Service over 320 amps-ratingof 1&2 U I-Imirdous location Each signor r nlinelighting 2
familydwelliugs U Building over 10,0(11 square feel fouror Signal circult(s)or a limited energy panel,
L3 System over 6nO volts nominal more residential units in nne structure alteration,arextension* 2
U Building overtlueestories O Feeders,400 amps or more 'Descri dun: _
Cl Occupani load over 99 prlsun: U Mwufactured structures or RV park Foch additional bsspectbn over the allowable In any of The above:
Q Egressnighungplan U 011ier: ._-- Perins cutin
r�
1�dbmll _-_ sets of plans with any nrlhe above. Investigationfee
The above are nc i applicable to temporary construction service. Other
--- ""
Permit fee........ .........$ -,
Nut all Jurisdictions accep credit canto.please coil Jusis./ictim fir orrice Inforinstlon. Notice:This permit application
U Visa Cl MasterCard expirrs if a permit is not obtained Plan review(at ,_, 91:) $ _
credo card number:_ / / _ within 190 days after it has been State surcharge(8%) ....$
fiapires accepted as complete. TOTAL .......................$
tine of cardbo a r own oo eredu cord--- r
— --C�tTib der siputure T Ameum 440-4611(frOatCOM)
/
CITY Y O F TIG ® R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00584
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/17/02
PARCEL: 1 S133DA-06300
SITE ADDRESS: 11025 SW SUMMER LAKE DR
SUBDIVISION: AMAR T SUMMERLAKE ZONING: R-7
BLOCK: LOT. 085 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE- SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VEN i SYSTEMS:
STORIES: BOILERSIC_OMPRESSORS_ _ HOODS:
FUEL TYPES _ 0 3 HP: 1 DOMES. INCIN:
I PG 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace gas furnace and exte,for A/C unit. Exterior A/C unit c:;nnot be placed within the required setbacks.
Owner: _ FEES
PADDACK, RYCHEN M + Description Date Amount
A. LLE LLA
11025 SW SUwiMERLAKE DR IMI,C'llI I'crmit Pcr 12/17/02 $72.50
TIGARD, OR 97223 11 AX 1 12/17/02 $5.80
Phone:
Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED INSPECTIONS
Phone- 538-2953 Machanicallnsp
Filial Inspection
Reg #. LIC 125815
This permit is issued subject to the regulations uvi tdilied 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 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set for in OAR 952-001-0010 through OAR
952-00 t-0100. You may obtain copies of these rues or direct questions to OUNC by calling
(503)246-6699.
Issued By: - A _ Permittee Signatm e:
Call (503) 639-4175 by 7:00 P.M. For inspections needed the next business day
Dec 16 O2 01 : 07p Oreean Heating and Air 503-531 ?172 p. 1
j (I0
Mechanical Permit Applicat.iolr
- - '- --- 11101
pate received: A1�) 6V Permit no.:H E( - 0
City of Tigard project/appl.no.: Expire date:
Address: 13125 5W Flan(Blvtl,'l'igard,Q;tV722-1 ��issuod: By: Rcceil ,u
City of Tigarr! / _ ---
Phone: (503) 639-4171
�lS payment t
Fax: (503) 59R-IhtiO ► Il
—_—-�
r4uildiug permit no.:
Land use approval: T• .•--
'V
,�,� ur.uial C:1 Multi lunti►y O'l'euantimprovement
7 1 &3 Ihmily dwelling or nccatiory ° cration/reE lacemrr,l U Qthcr.
U new construction __ --- -- ---
lob address: , „ Indicate cquipmeat iututtiUes in boxes below.Indicate the dollar
--_- —
r► e�l yY�.. value of all mcehr nical materials,equipment,labor,overhead,
Hldb_2a.: _ Surto nn
--� _-�� profit.Vnlue 3
_Tax nlap/tux lot/account no..
_ — 1
Hlock: Subtlivtaan:- 'See checklist for important applcation tnfomtation and
_ -- -- -- jurisdiction's fee schedule for residcnnial pertnn (c(
Project uome;
Cfly/cotut y T- ZIP:
ty. �._� 1
Description and toes ' nfwork on premises (la[fLJCZs 1-r.(Psa.) r„rat
LkwripHnn r kes.onl Ilei 'out
E .date of compie(on/inspection: _ Ai
Tenant improvement or change of use: Air handling unit _CFM
Is existing space heated or conditioned?13 Yes U No It"-O- t oning(y to p am tequ )
Is existing space insulated'?U Yes U No terauon o extshng VAC rystem _
�I B.7-1w—compressor
Slate boiler permit 110-:
11
name:—WIEGa-HEAT O _ ---_' HP 1"nc BTU/11
Address: p, OIR CMNDITIONIN r,INCr, uesmrTce rnpe tua smnTce electors _ Y
Gj,� _ LDi: eat pum f9itc �tequirec)
City: nit 347 Dundee, C)W ---- nsta rep ace urnacei:turner] Tf3197M
Picone: (503�fra3l3.2953 mra'i: ��- _ Including ductwork/vent lioer U Yes O No 1' 114-9c
CCH no.: __-. Gt9iaiTlrcp iceTre ocale en(ers-suspeet e -
City/metro lic.no.: 4�_ _
%k all,or Moor mounted _-
_ C� dont tier affiance o er t uao fumnce
Name lensc print): M' eiF germ oa: -- --
A.bearption units RTI t/H
Chillers _. --- ((p
Name: - ---- Corn ressme f1Y
Address: _--_ -.- nr ronmeeta ex stat ra res a on:
City:— ^�T Stale: LIP _ Appliance vena
—� - Ilr cr_ex tnusl
-- - Fax:
Phone: �I
hood 9.1y�x T!lT/IVB.FIICPCIYONtII�t — __
' fire suppression system
exhatut fan with stn le duct(both inns)
Name:
[x7iaust system n n�rt From nustiajor AC
Mniling address: � o,f�t1�1 sue p pink and dW1 n oa hap m a outlets)
C�CY State LIP: 1,;5__ T e: L.PG NG _ Oil
-_. �yp� - -
Ph�tuc E toad: uel i 'u1 r each udilitwnefover tleis _
_I rseftx p F ntt(sc ometic ;u 17 _ -
Number of outlets
Ncunc _._----_— -- -- — r flsZea oppilssce ore Patient. —
Arldress: Ckcrnmllve bre lelece-
- ---- - - -- • _
--- -- - Vfitsert- type
City: Slate: LIP: - ax stov Pe ct+love -� -
Nhorte
A licant's .si);naulrc_��►�1'�[�_ M- Dnte:-.�.1- �I+ (1 en
--- -- _
Name(ptint): +�e tCr->trc� V'4 fnp71- - -
- -^ Permi:fee.................... $ ---rld
NM rill rrrtadlulon+aaepr credit carts,plmxe.dl J.vl-Nc�km nn mwe mnnmeu--in Noike. This tlrrtnll apphcntlOn lV(inln!llm fee...............
U visa O tiloetert'.ad exp''e'r if n prmnit N not ubtaineri plan review(at %) S
Grana card number: _._ - - -- -•^-� --- wilhn I No days inner it has been Stale surcharge 8e/n S
_ -- csprtee g ( ).... 5 --
_ occa-31ed nit complete. f(1CAL 5 _ ..��.
_-"—_..Nam�oTcrrelFiifiT`na":FKrwn'rmerml• cairT--- . ..........
_ __ _ ' .......... t.ur.tat�tr,ivarc'otit►
_Y�__.-"�uTit-ei a ON lira -_, - moan
Dec 16 02 01 : 07p Oreton
won Heatint and Rir 503-537-2172 P. 3
Dec 16 02 12:38P 0HnC %.40P 503-537-9235 P. 1
Jog
OREGON HCATING & AIR CONOIJIDNING, INIC.
CCR #12981r
P.O. ROX 397 CALCI)LATEDOV-- UATF
DUNDEE,OREGON 97115
(503) 538-2953 Fax (503) 537 2172 DATE-
SCAIF a Air-
If
opt
II
mum 2c.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)638-4175
INSPECTION DIVISION Business Line: (503)638-4171 MST __—
BUP
Received __.—.— _ "---Date Requested_- �� "��' AM-----PM - _ BUP
Location _ __, Dom_ ynr uite_-_— — MEC _2i_- 0
Cintact Person __- � Ph(_—,) 5 3 _� 3 PLM —
Crntractor Ph(—) SWR _
BUILDING Tenant/Owner _____ _ �— C—F
Footing ELC _
Foundation -- ----
Ftg Drain ACCest4'
Crawl Drain } al ELR
Slab Inspection i4otes: SIT
Post& Beam -- ---- -------- -- - -
Shear Anchors -------------
Ext Sheath/Shear
Int Sheath/Shear -
Framing --- - _- --- ----- - -- --.^
Insulation
Drywall Nailing -- -.. - ---- - - - -------
Fi rewal I
Fire Sprinkler ------------ -__ _ _ -- _ _
Fire Alarm
Susp'd Ceiling --- ----- - --- --- --- --.r
Roof
Other
Final --
PASS_ PART FAIL
PLUMBING
Post 8 Beam -'- --------------__`.
Under Slab
Rough-In
Water Service -- --------- ----- - - -
Sanitary Sewer
Rain Drains ---- - -
Catch Basin/Manhole ,
Storm Drain — ---- - ---
Shc war Pan —-�
Oth,3r: -
Final
T FAIL — --- -- - --- � --
Postt-fm-
Rough-In
Gas Line
Smoke Dampers ------ - --
C.-
ASS ART FAIL ---—----- ---- -
rvlcp
Rough-In -
UG/Slab
Low Voltage
Fire Alarm
`` U Reinspection tee of$---_.___- _ required before next Inspection. Pay at City Haw, 13125 SW Hall Blvd.
SS )PART FAIL
M rz- Please call for reinspection RE: E1 Unable to Ins sect-no access
Fire Supply I inn
ADS ` Dsb 4�_ ilispoctor CL `� � Ext
Approach/ Idewalk
Other:
Final - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL