15985 Queen Victoria Place 15985 QUEEN VICTORIA PL 1 OF 1 FILMED 2004
15975 SW Queen Victoria Piece
CITY OF TI 24-Hour
BUILDING :nspection Line; (503) 639-4175
INSPECTION DIVISION Business Line: 503 639J 171 MST
( ) BUP ______
Received Date R nested _JP f AM / M 131:PI:P
Location ._1 1.... lc
3 w t L,s4--01 C f:-r �!`t_'. Suite MEC %2IIoz- 3 / 7
Contact Person ___ __4Q J �__ r'- 4kt iii! Ph(__—) 23t/ 7_, 31 PLM
Contractor �— Ph( ) SWR
BUILDING Tenant/Owner - __ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab inspection Notes. SIT _ ___
Post 8 Beam
Shear Anchors
Ext Sheath/Shear , , �. _
Int Sheath/Shearr( n ` I I
Framing 0•. 1 ( 4 ��..I -7ARZ C✓ 11 _ 1 I T
Insulation "��
Drywall Nailing 1i-� v
Firewall
Fire Sprinkler
Fire Alarm 1'�_ w� . 55 1"*"W"%* 14-r*.. ..--(:4.---,,Susp'd Ceding 1 ,Root y5W trvr.-.71 G.Celr �Q 6,16 �V II
Cher __ _ ,, r1' {
Final ► EL V21 .c.t.cUL-k ....• •
PASS PART FAIL
PLUMBING
—
Post 8 Beam -
Under Slab
Rough In
W__D__fAu; (19"Y'JS
Wo-4-1.
Water Service ; �
N
1 Sanitary viewer / 1C 4//
Rain Drama Vim-
Catch Basin i Manhole
Storm DiainShow - - r-T) ` •% t 6
Other Pan - - _.� d �j P 1 • • '4...4. tom. - -
Fin: V\504k1--- W` A Log: ..+
PASS PART FAIL
Post& Beam
Rough In 0`L ___14 ---
S,noke Da
irt-j‘
oma, CA,. c -0%..f r )
mpifir
Final j
PANS 4149 FAIL • V - — -
ELEC - -
Service -
Rough-In
Ufa/Slab
Low Voltage
Fire Alarm
Final 0 Reinepection le1e of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART MIL
grrt - n Please call for reinspection RE in Unable to inspect --no access
Fire Supply Line + �j
ADA Date l iJ, 1 b2- Inspector (._.A_(X
__sit
Approach/Sidewalk
Other.
F nal DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
I I
i i /.� J /(" -) - E r r . r � 1 ' n -t-1 ! Ti _j „ A � ' r� te
CITY OF TIGARD MECHANIC l PERM
IT
DEVELOPMENT SERVICES PERMIT#: MEC2002
-
00517
DATE ISSUED11/18/02
ay ., ga , PARCEL:
2S110CC-12300
SITE ADDRESS: 15975 SW QUEEN VICTORIA PL
SUBDIVISION: KING CITY NO 3 ZONING:
BLOCK: LOT: 036 JURISDICTION: KIN
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: RI VENTS MO APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUFLTYPES0 - 3 HP: 1 DOMES. INCIN:
[Pc, _ 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: t AIR HANDLING UNITS _ OTHER UNITS
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS. 1
> 10000 cfm:
Remarks: Conversion to gas furnace, venting and gas piping 11-21-02 AC unit added to permit
owner.. FEES
—
ALLAN HOVDE Description Date Amount
15975 SW QUEEN VICTORIA X11 C 11I Penult !•ee 11/18/02 $72.50
KING C11 Y, OR 97224 SMI( III Permit Fee 11/18/02 $0.00
(TAXI ii"..State-1 ax 11/18/02 $5 80
Phone: 11 A XI V ~Este f aN 11/18/02 $0 00
Contractor: _ _ ( Total $78.30
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND OR 97202 REQUIRED INSPECTIONS
Gas Line Insp
Phony: 503.234.-111
Heating Unt !nap
Reg I: 1441 Cooling Unt Insp
Misc Inspection
Final Inspection
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 days ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100 You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699. - /. , (-r-t
Issued By: , 2. 1[ 1i t:. 17 Permittee Signature _ J
Call (5031 639-4175 by 7:00 P M. for inspections needed the next business day
_-
Nov-20-02 10 : 45A Jacobs Heat. inch 81 3y258 p 0l
I
Nov 18 02 11 : 37A Jacobs Heating 8139258 P . 01
(t )
A ,lk Mechanical Permit Application
Date reoei.ed:
)14. ..1 of Tigard RECEIVED '"°'n"' _ _�`�1'n
J
i ProlecVappl.no.. I.'.aptre date !�. ' I
Lay„f I'RarJ Address 11125 5W Hall Blvd.Tigard, OR 9722: r- ----- T-_ - _
Phone r Sri 1) ('i9-4171 Dare tqued Br f Receipt no
pax (501) 59R 1960 NO 20 2002 rase file to.. Payme••t type
Land use approval: �,17Y CIF TIGAHU Huddiiigpermit no —'— — --'
1.111.11.11111111111111111110Miattrin=11111WAIMIIIIIIIMIIII
57J.JE 2 family dwelling in accessory JCommcrcial/industnal U Multi-family
U New constrvaion ...1Addition/alteration/replacemenOtherreplacement U( Tenant tmprovertxnt
1011 NI Ii I\1411(111%101\ I()NIA iv) \J \ \I I \I If1\ ♦t III 1)1 I I
Job ad'M ,' L-'" • _<_1(5)TS ',r k., .`4' . Indicate.equipment quantities in homes below.Indicate the dollar
elan. S. tine no• w value of all mechanical materials,equipment.labor.overread•
rTait mnp/ta■los/aoruunt n0.. profit. Value S
Lot: Block: Subdivision' _-- •See cf eeklutt for mportavtl tlpplicat.nn nfrxmaluin and
Project ria 'r• ,/' -- - unsdiaiort's fee schedule for residential
•�-_._ permit fee
I City/county: 1 t r Ct l.IPlIP - ;�I 1• A 2 I %Ill 1 Mil I f I\ . PI Utt11.11 I tt 111 I►1 l 1
' Description and location of'work un p rune _ _ _-- \\1111)\1%11 It II %I:I\1)1 \ III\I I oil II'l
-
11 \1 ( IIIII111
Fai date of compleuot✓inspct ton t . . Feake.)
P111.....„
Ng!
"Tenant improvement or change cal use HVAC: -
Is existing space baled or conditioned,J Yc% -1 ILt Air handless rule CON
Is existing spue)(Isolated',U Yes .1 No Air sotsdiitrrrtin4 a IesaT�raq�u j /ri
terithrnofesisting system
'II ( III \It \I I11\(p \I Hitt linTer?.pnpressors
Business Warne �7 �c_,.%_ .
State mule permit no.•
Address: � ._. � Ln^ 1 - ,_ - - F;r.Jt Ndam t detectors .
City + ptln/duet smoke
S ZIP.C1 •:atpump(site plan required) OE
Phone. • Fas•�l J. E-mail •+wlU'eplaceFurnace/burnei : e
CCII no IF, -- - Ini.luding_drr_tworktvent liner Yet,]Ni,
:;.!y/rnelro bc.no.. nst Urep acJrelocstrhurers-sdspenrrd —
- - se' wall,or nom mounted
Y„tne(•It►ase • t :~a• ' C •- rut txa;•fianceoiilerthanfurnace __" • --
....41111Chum units FM 44 11111
Name.
Chillers _
Ai
Q i e C
f Address-- - - 1 -"a--- - Co .ressors HP =
L'i1y. � r ..^-
-S'li`t: ■
None: f-asE-Mall b ere' sou ----- - —
CM NI It '. •t Yaw des-Tittclrer�r lutetal—
Nameaa,,,. : • ' / hoed fire supl mics.system ---
V F.sh,ns fan with sing k duct(bath fang)
Marling res,. c. s ,a _
--- � • �i � ,�. -4 •. at s steer. from hunk
4. Jt iw / P `, a /.711.- *pin out col
Phone: F s T . : LPt1ta ! NG _ Oil
E-mail. ere •I in eta ovov
e er putt e."---\4.1\1 IN recess lac made requires` 11.11111.111111111111.11.111
Namt' 'Humber of ourkH
Address slier listed*lime*ow
NulrAwM:
arativefireplace
r City. --- lc_'T'SI it -- lDecutea-1ffx -- - -- —
L I. • x 12E111 `i dillW datov eTpe et -
',_V11's Sirit IMOIR1111111
�Ti --,26 Cr,lMil
_
-- _t w
tw■as fuesae+ias tar mil rink*Ye tail melee lee r..a..«ntwr.` flus fee 5 WP
I
.]Visa UJMute,Cry home I his{►cern t auphcrtton Minimum lee 5 _
rRa.r,rd Ames / caplets.1•pr r+tN.5 not Atoned man maw,revteM Isi 41 5Ltd
- - rpiai ever
I 80 dao,atter N has bee.d cal -ir ii r:i me~Mir- Acceptedlas r memo% Sire tWtliarRr fM41 5
_ - ctaNw s ---__.__. S ariiiti (- ( 1 mTAL 1 f �-i
•6c ?.13 l� l.Pas t G�
r .41
Nov-20 02 10 . 45A Jacobs Heating 813925}3 P . 02
•
7J
bleatiaJ
NauSE
/Rohr
rr
fob NSE ^ N 0 u n e--
7C
7C Cw ot/` /ax'A Po
rno0 /3030
MAKE
�f eD 35 C_
14/ 2.1 3. . N0L6i47E
Pc'itr. o/i . 97402.
503 - 23/- 733/
rgx 3'03- 234- 6415Z
ACITY OF TIGARD ELECTRICAL PERMIT
PERMIT It: ELC2002-00613
DEVELOPMENT SERVICES DATE ISSUED: 11/22/02
13125 SW Hall Blvd.. Tiaard. OR 97223 (503) 639-4171
PARCEL: 2S110CC-12300
SITE ADDRESS: 15975 SW QUEEN VICTORIA Pt CONING
SUBDIVISION:
BLOCK: LOT : 036 JURISDICTION. .IN
Project Description: 2 branch iircuits to AC and furnace
_
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY 401 • 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FOR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION.
201 • 400 amp: 1st W/O SRVC OR FDR. 1 PER HOUR:
401 • 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >=4 RFS UNITS: >600 VOLT NOMINAL:
— Reconnect only: SVC/FDIC>r 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ALLAN HOVDE WEST SIDE ELECTRIC CO INC
15975 SW QUEEN VICTORIA 1834 SE 8TH AVE
KING CITY. OR 97224 PORTLAND OR 97214
Phone: Phone. 231-1548
Reg#: I i t 'r,
FEES
Description Date Amount
Required Inspections
(TAXI ti".State fax I I/22 02 $4.28
)EI.PRMT)ELI'Permit II/22'02 $53.50 Rough-in
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations c. ntained 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 rf work is
suspended for more than 180 days ATTENTION Oregon law requires ycu to follow rules adopted by the Oregon Utility Notification Center Those
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 at 1503
246-6699 or 1-800-3X-2344
Issued By: i
� LL � f : ill L Y Permit Signature:
x. L
OWNER INSTALLATION ONLY
The installation is being madr on property I own which is not 'Wooded for sale lease, or rent
OWNER'S SIGNATURE: _ _ DATE:_ _
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ _ DATE:
LICENSE NO: _ -- - - —
Call 639-4175 by ' U3pm for an inspection the next business day
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT 0: ELC2002-00613
DEVELOPMENT SERVICES DATE ISSUED: 11/22/02
L 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171
PARCEL: 2S 110CC-12300
SITE ADDRESS: 15975 SW QUEEN VICTORIA PL ZONING:
SUBDIVISION:
BLOCK: LOT : 036 JURISDICTICN: KIN
Project Description: 2 branch circuits to AC and furnace
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS. 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY 401 - 600 amp: SIGNAL/PANEL.
ma'IF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp. 1st W/O SRVC OR FDR. 1 i'ER HOUR:
401 - 600 amp. EA ADD'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:
ALLAN HOVDE WEST SIDE ELECTRIC CO INC
15975 SW QUEEN VICTORIA 1834 SE 8TH AVE
KING Cif" OR 97224 PORTLAND.OR 97214
Phone: Phone: 231-1548
Reg*: El.l: 26-I35c
FEES
Description Date Amount Re•ulred Inspections
(TAXI M.State Tax 11/22/02 $4 'l8
II I I'KMTJ ELC Permit 11/22/02 $53 50 Rough-in
_ _ ____ Elect')Final
Total $57.78
This Permit is issued subject to the regula'ons contained in the Tigard Muniapal Code,State of OR Sraaalty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work:s 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 Ly the Oregon Utility Notification Center Those
rules are set forth in OAR 952.001.0010 through OAR 952.001-0100 You may obtain copies of These rules or direct questions to OUNC at(503)
246-6699 or 1.800.32 2344 l . •
Issued By: L�i� /r c tc <<i , �1��l4.. _ Permit Signature: a.44 p1, GC/-► _,_
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELFC'N. _ DATE:
LICENSE NO. ( c J - --
Call 639-4175 by 7.00pm for an inspection the next business day
I il
Electrical Permit Application OFFICE ISE OLI'
Data received (; Permit no k/
.011• -1-:. City of Toga � /��1 Prosed/opp1. no.. _ 1111 i•apira date _ _
Addreai: 13IT5 SW I ErCI µIV)RJIIl�23 D I
Cttyu/Tr)wrJ Dr10 tweed! By u^cclrt um
I'hono: ('03) 639.4171 �—
Fax' (503) 59S-1960 Care file no. Payment type
Nov 2 0 100;
Land us approval; _
If I .1 t.'
I 1 'EVE PERN1I r
1 & 2 family dwelling or accessory O Commercial/industrial -t Multi-family J Tcnnnt rrnpnlvcrncnt
ZI cw construction U Addition/oltcrationlrcplaccment _(111.e. --_J Part W t
.108 SITE 1NFO/t'IA'1'ION
lob address, 1.54.7.5. 5...J.(r;),,44),._,l '('1t/_gt. Bldg. no.. Suite no.. Ten map/tux 1othtecourrt n1,- _.
Lot; Dluv ; F Subdivision: _
Project nrttlett. v, / __ „_,.1 y Description and location of work on premises.. w,te{ A(___/.1 Cr-„t /rl q c('
I:stunated date ol completion/Inspection..
(O;NIItt( 10k AI'PLI( tlltl\ FLU SCIfLOLLE
Jab Do: � 1• Mee Ma%
Beanies)name. C„ L L.e.t-i4tL __1111 _1111 n,•oos riplir.a Qtv.• (tel Tmel_ an.m�
• .0
a�_ N.'yr Jock. ra uttl Noah per
Andra*): -71.7 1j/-1 ! Lti A
�_- dweainNgg,t.lq War•etre.bed cany.r.
City. p r T 1 f,.., ' State:Q 2 ZIP. ('It 71 i U yeryiaesnt baled;
_
Phone;t31...-1 rs�l Fula.1'b .fX 77 E-marl IINNI�� 0 or I... J
_1111-- -.+—
t.:n.h hilduumril 51111 wl, ll,rr pr,rigm 1111.4,1,44,1
CCB no.. t Z,30(c. Elea bus.he.no. It t 1. C' i - ,
.. _
- 1 N.,1 errcrye3s, ra.Nk„l.al -_
('ll /m n Inc.1M.: 1 unilul •-.m Y. ,wi•n,akl
,l,al 2
__�_
y1.1/2 d./O L Loh manufactured home or modal:a Jwelling
),1;ra11M.' or sell'•S...51-2--....._..
',+My C .ecineran Ircgarocd) slate %,•rvae and/or Wilt!
r _
Sup. eke,name OWN) c'.r L•»s.o'w, ac. Lk(Ino: ZL{, h(Intirevarfeeders-inaleNafiaar
PRO PERI V OWNER Ulla fs.iss ter'cleanness
rill imp...,Ie..
1111 amp,.l Jlgt atop.. � �-- —_ - '
Name r9u •
�A v� 1111
7 401 amps to(Jq Ilnl('y 2
MailuiE atkiress: 14(17< (7(,.1 .M' , ` r c
? �� �,/>� .., _L M l amps M 111011 amps . 2
(.fly• �; .(... 4-. _ .. .- . imp. 1
Phone.!�41,..3_ ei1rIIQ- Nw
Fax IE•mall' . n .co
al nly — 1 I
OWTMt instillation Inc Installation is being made on properly I own Tralponnrcnlrr,orfrrdcry
which is nut intended tot sale, lease,tent,tit exchange according to I .iI,liun,alleraliun,w rrlw sour.
OkS 447,455, 479,n'n, 1(11 -ia1 amp.or le.. _ .. 1
2ii1 unpv Io can onn o, , — _
I Owner's immature _ Date. 401 144 5.00i. * 1
cls virtu*. new,sItrrailmn,
N enlemaiva per pawl.
Name:
an
_ A I ec foe Irthmrt.sawit,patralr.tra' of
Addresa' wrv,cu or Nutlet Wu,each Marg h.,marl ,, _
('lav' 'State. 17.1P. 11 i(a tog ar:uah,.vraulta wthaa tantalum I �/ yp`r
r -_ .dvrwrur»a+t.R•tir'finsMiwht,nru1 1(�5-,�.•. T) l
i hale' Fax I. Ins.' Lao oidoionial bea io unto, -�r* �,L 1
PI 5'5 RI%Iktt (Please check all lhatappi ) Mtae.I%eryIt*arf.edaraMleeladed)v
J.ervµc Iver 115 ampsu,r.mr+..,d .1 Healhamr lac,My Lull pump ra 141414!1_11011arch t 2
J Sayler..ver 120 amps r1Im11•r1 I..2 U Hazardous locatamEach ri5n M outline lignin I _ 2
an
family dwdIings J Wilding m 10.000 quare feel four or ~swill(stwryrl of a tainted mew,panel, 1 [ 1
U Svuem over it(S)volts nominal ra,n 11,41411.141,41 .m.l%u,uo. .tn,.lua .Alualnw, ,w c.la,a(.a• _— i I 2
J Pudding met threr a((x(ea J r«Jera 400 antra or more •(ktcnpuan 1
J I kcep►al 1,11,1.wn tW la•,wa,r J Mrwlactund.t(aAwn Si, kV wit Lath addltl.Ylhiprewes etre the ailewshk in as,oftile abaft;
1'...r ,n,pc,non L
L__ Submit tel.of plan,with tiny of the ago,.•. Indy5
vcal„a,-I.c 11__...
TAI•above arc nal applicabk lu le.prntiry ctv
cunnitmeliun aice. ether
-_� Permit fee S —i';'1.
;Al•real.4w,;V cad(r canI. Marr cab s 51 1.t.I.•..sat adaaa,Nrarl Notice' Thlt pttfn11i ipttti.Jtton
ACV.., U aroort
st t ' F,t'ard eltplres if a permit i}mt ohquKd Plan review lar %) $
(u•dn two...atm 13 •'Lb'3 y C3A-r sic. . '. i 3i Ibj I **tin ($0(tare atter it fear fetes state rurch4r?tu(It%) ... I L • ,
Q
_ -.c� t.
� s
!1 . a.
('alh
nddernrnaw�u t.
_im(wn( J
secopto4 as cumplck.. TOTAL .. _ sa(f/(.14(MU(uVl
1 'III LL90-9CLICOG I 'v0 otJ22aTI aP',g osa? V !CIBO an 02 "ow