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Permit /d IS BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2003 -00115 v� lll'� - 13125 DEVE SERVICES 639 -4171 DATE ISSUED: 3/14/03 SITE ADDRESS: 7400 SW BULL MOUNTAIN RD PARCEL: 2S1106C -01000 SUBDIVISI : THORNWOOD) ZONING: R -7 BLO L (Q JURISDICTION: TIG REISSUE: AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: : sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 2,900.00 Remarks: Construction of 8' fence and retaining wall combination, located at the rear of Iote7, 8 & 9. Owner: Contractor: VENTURE PROPERTIES, INC DON MORISSETTE HOMES INC 4230 SW GALEWOOD ST., #100 4230 GALEWOOD ST, STE 100 LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 Phone: Phone: Reg #: 603- 387 - 755833 FEES REQUIRED INSPECTIONS Description Date Amount Foot/Found Insp [BUILD] Permit Fee 3/14/03 $72.10 Masonry Insp Final Inspection [TAX] 8% State Tax 3/14/03 $5.77 [BUPPLN] Pln Rv 3/14/03 $46.87 [BUPPLN] Addl Pln Rv 3/14/03 $62.50 Total $187.24 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Z ." a Issued By: V ' I Pe rm ittee Signature: Call 639 -4175 by 7 p.m. for an inspection the next business day Ao : c CITY OF TIGARD MASTER PERMIT PERMIT #: MST2003 -00480 4t DEVELOPMENT SERVICES DATE ISSUED: 11/24/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12395 SW WINTERVIEW DR PARCEL: 2S110BC -03500 SUBDIVISION: THORNWOOD ZONING: R - BLOCK: LOT: 006 JURISDICTION: TIG REMARKS: Construction of new SF detached residence. BUILDING REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 sf GARAGE: 408 sf FRONT: 15 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD sf RIGHT: 5 VALUE: 306,662 40 OCCUPANCY GRP: R3 BDRM: 4 BATH. 3 TOTAL: 3,190 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 6 201 - 400 amp: 201 • 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps -1000v MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,883.15 This permit DON MORISSETTE HOMES DON MORISSETTE HOMES INC Mu is Municipal Code, d State Specthe regulations ec Co i ode s and the 4230 GALE WOOD ST 4230 GALEWOOD ST, STE 100 a l l o t h e r ap a laws. All w work w ill be done Codes STE 100 LAKE OSWEGO, OR 97035 all other applicable tawok will i LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 387 - 7538 Phone: Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You 5o Reg #: LI& 387 may obtain copies of these rules or direct questions to S OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control Insp & Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation lnsp Water Service Insp Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insf Gyp Board lnsp Appr /Sdwlk lnsp Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final Footing lnsp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final Foundation Insp PLM /Underfloor Framing lnsp Gas Fireplace Water Line lnsp Plumb Final l Issued By : / ( .& '/92 J J Permittee Signature Call (503) 0 ' 639 -4175 by 7:00 p.m. for an inspection needed the next business day TO ( N l0" �D " /AA./ • czee 003 -00 3 SS A Building Permit Application ..... ' 4.,6 Cl Of Tigard Address: 13125 SW Hall B l � Date received: d„ �- a Pemut ito.: /)j� u y of �) l RE t d P1 Project/appl. no.: Expire date: CityojTgard Phone: (503) 639 -4171 Date issued: By6) Receipt no.: Fax: (503) 598 -1960 SEP 2 2 2003 Case file no.: Payment type: Land use approval: 1 &2 family: Simple Complex: • _es 1 _•l•,_. OF I'FRllII :'?e: - '• ,;..}:. . n ❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family , 'New construction 0 Demolition O Addition/alteration/replacement O Tenant improvement O Fire sprinkler /alarm ❑ Other. ry.,, .,. 't,''; . ,. . , f ': r r ,1,OB•SI fE IN1'.ORMA I ION 1I a te , f w 1 ', e - , r , ,,,:��' Fa K . Job address: 1 ,/ vviY l Bldg. no.: Suite no.: Lot: (• I Block: ISubdivision:'� - c r i l�a I Tax map/tax lot/account no.2.S/O -035 A Project name: ie- - Description and location of work on premises/special conditions: OWNER FOR SPECIAL 1NFOR1 USE CHECKLIST IM p ZNa' -lee (I loodplain,scpticcapacity solar,etc:)= 1,«_ Mailing address: 'e�i'mmn ' r I & 2 family dwelling: IlEanifir ) ZIP: . 30' Valuation of work $ Phone:. , r sJ Zripl , a No. of bedrooms/baths Owner's representative: L , i Total number of floors c� Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) __ ^'�i,t Covered porch area (sq. ft.) Mailing address: Deck area (sq. ft.) City: State: ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial /industrial/multi- family: CONTRACTOR RAC( OIt Valuation of work $ �- Z ria.L' Existing bldg. area (sq. ft.) New bldg. area (sq. ft.) Address: �jg W-4. itirir,fillENIIIIIIIIMI Number of stories City: State: ZIP: Phone: I Fax: I E -mail: Type of construction CCB no.: 7, c, Cj,j Occupancy group(s): Existing: City/metro lic. no.: New: Notice: All contractors and subcontractors are required to be 4 ;_. ti , i AIICI IITECTIDISIGINEll _ licensed with the Oregon Construction Contractors Board under Name: C- 4 , 4 provisions of ORS 701 and may be required to be licensed in the Address: --tip (L , -rs.P jurisdiction where work is being performed. If the applicant is City: State: I ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: (State: IZIP: Amount received $ Phone: I Fax: I E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information attached checklist. • , rovisions of 1 ws and o, dinances governing this 0 Visa 0 MasterCard work will be compl • wt • , , whether cified here 1 r�tot. / Credit card number: / / � Authorized si 14 atu . . / 1 A ( .:te: j J " I 1 0 Name of cardholder as shown on credit card Expires Print name: r L= _ 1 ' r.._ $ Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (butVCOM) One- and Two - Family Dwelling }� I Building Permit Application Checklist Reference no.: Associated permits: City of Tigard City of Tigaard Cl Electrical Cl Plumbing O Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 D Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 THE FOLLOWING ITEMS ARE REQUIRED.FOR•TPLA N. 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 4 3 Verification of approved plat/ot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. ;( 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control CI plan O permit required. Include drainage -way protection, silt fence design and location of ,/ catch -basin protection, etc. J� 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed r/ if copyright violations exist. , J� 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot x area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, X fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." • 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non - uniform load. X 20 Manufactured floor /roof truss design details. • y 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. • • JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". )( 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. 26 No rolled, reversed or mirrored building plans will be accepted. 27 28 Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614 (6,VOICOM) • ` Mechanical Permit Application ,. - C � Date received: Permit no.:�' i ,I , / 3 QOI Y'rY �'' • . G�,/EIV may,. '.1 City of Tigar Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Bb �ig3rd, OR 97223 Phone: (503) 639 -4171 2 V 4 Date issued: By: Receipt no.: Fax: (503) 598 - 1960 Case file no.: Payment type: CITY OF TIGARD Building permit no.: Land use approval: ausw iNerfninsit TYPE OF PERMIT . . 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement • X Vew construction 0 Addition/alteration /replacement 0 Other. JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE - - Job address: 0 4 A IM Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ • Lot: M' Block: Subdivision: l /M L i. a i Ny= 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: - &i2'FAMILY'DWVELLING: PERMIT FEE SCHEDULE'``',' Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPi1IENTSCI(IEDULE Fee(ea.) Total Est. date of completion /inspection: Description Qty. Res.only Res.only Tenant improvement or change of use: HVAC: Ill • - Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM g P Air conditioning (site plan required) I= Is existing space insulated? 0 Yes 0 No Alteration o existing HVAC system ii' NI' ..' Cl,Ii�NIC L' � CON•(R 1CT Boiler /compressors II �}� QR State boiler permit no.: ri, Ilstli� �I. J _ HP Tons BTU/H Address: trtf��aM Fire /smokedampers/duct smoke detectors _f Eiriairer9Ill Heat pump (site plan required) = Phone: � . ' Fax: E -mail: Install/replace ftirnace/burner BTU /H ■ -- Including ductwork/vent liner I] Yes 0 No CCB no.: • , — ' 'it InstalUreplace/relocateheaters— suspended, ■ -- City/metro lic. no.: N/A wall, or floor mounted Name (please print): *A Vent for appliance other than furnace MN Refrigeration: CONTACT CONTACT PERSON Abs units BTU/H III i , Chillers HP Com.ressors HP ME Address: �. ♦ Environmental exhaust and ventilation: ■ -- City: State: ZIP: Appliance vent Phone: Fax: E -mail: H I : =_ OWNER Hoodsoods, , Type U Wres. kitchen /hazmat hood fire suppression system � 11 ' .iu 1✓ q�, /a • Exhaust fan with single duct (bath fans) - __ 1 Exhaust system apart from heating or AC Mailing address: �'� / i_ r�� /• NM .� � Fuel piping and distribution (up to 4 outlets) ■ -- ��u���`�r� Type: LPG NG Oil Phone: z�i� Fax: E - mail: Fuel piping each additional over 4 outlets ENGINEER Process piping (schematic required) = Mil Name: Number of outlets Other ed appliance or equipment: 111 Address: Decorative fireplace City: State: ZIP: insert — type E �� Phone: IMMIIMIE E-mail: Woodstove/pellet stove - other. iii Applicant 's signatu" A A O: , r /- Date: 4P' Iii D Other. IIII Name (print): , t- v • 7 ME . Na all jurisdictions accept credit cards. please call jurisdiction for more information Permit fee $ Notice: This permit application Minimum fee $ 0 Visa c ard number 0 MasterCard expires if a permit is not obtained Credit card E / Expires w ithi n 180 d ay s a fter it has b een Plan review (at _ %) $ p State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ Cardholder signature Amount 440. -1617 (6A7 /COM) Plumbing Permit Application - - Datereceived: Permit no. tior ! 3 i pt' i fij City of Tigard Sewer permit no.: Building permit no.: C Address: 13125 SW 7223 City ojTi Phone: (503) 639-41r11 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: By: Receipt no.: Land use approval: SEP 2 2 2003 Case file no.: Payment type: . ; :: TYPE -OF PIItitillT . <,. 0 1 & 2 family dwelling or accessory • ,t o tn n i erc1 I i industrial 0 Multi- family 0 Tenant improvement b • New construction 0 Addition/alteration/replacement 0 Food service 0 Other. JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: Q0.., i =j ■1 \A-e Vj'eU\I D(' Description Qty. Fee(ea.) Total New 1- and 2- family dwellings only: Bldg. no.: Suite no.: . (includes 10011. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: (A [Block: 1 SubdivisiorilW JW SFR (2) bath Project name: SFR (3) bath City /county: ZIP: Each additional bath/kitchen _ Description and location of work on premises: Site utilities: Catch basin/area drain Est- date of completion/inspection: Drywells/leach line/trench drain Footing drain (no. lin. ft.) PLU\lRlNG CONTRACTOR Manufactured home utilities MN Business name: TS ` 1P L i Manholes ME Address: .��b�ira Rain drain connector M �'� ZIP: Sanitary sewer (no. lin. ft.) MI City t„ vim Storm sewer (no. lin. ft.) Phone: y - � Fax: E-mail: �, ip Water service (no. lin. ft.) CCB no.: [ I "7 L I Plumb. bus. reg. no: - - Fixture or item: City/metro lic. no.: N/A �/ / Absorption valve Contractor's representative signature �(/ t. Back flow preventer Print name: , • ' , IIM I U • "" 10 / Backwater valve CONTACT PERSON • Basins/lavatory 1.1.1 Clothes washer Name: P\■-- , - .- I1 Dishwasher Address: a aA 0 b 1c ,N - Dnnking fountain(s) City: State: Ejectors/sump Phone: Fax: Expansion tank ``= =4 - `: OWNER Fixture/sewer cap III Floor drains/floor sinks/hub Name (print): :1,1 .-it' l5 _ast ` `" Garbage disposal • Mailing address: ,, _ - • ^ • !JAL 1� Hose bibb III City: - ') ET( vaka�i�1 Ice maker _ Phone: j , - Fax: leIN E-mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Pnmen;s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s). lays(s) Owner's signature: Date: Sump • Tubs/shower /shower pan E NGINEER. Urinal = -- Name: Water closet Address: Water heater II City State: r ZIP: Other. Phone: Fax: E -mail: Total Minimum fee ................ $ Na art lunsucuons accept cretin cards. please call lunsdicuon for more mfomuuon Notice: This permit application %v $ �_ C Visa O MasterCard Plan review (at expires if a permit is not obtained _ ) C.edit card number. / / State surcharge (8%) .... $ �— Expires TOTAL $ __—___— accepted as complete. Name ol cardholder as shown on credit card S Cardholder signature Amount 440 -7616 (600WCOM) n, • ♦ • • t ,�9�� s ) y .1 s - Z 7 Y , sh s 3dK - s: C '` , El ectrical A l i c at i o n s: 1 ,t 0;1;-..•`-."--.).::.;.,---,...:;' . , • I V E D Date received: Permit no.: 0157,1 ' t /jka 1 s{ j ;}:•�iti City of Tigard pp Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 CITY OF TI N Case file no.: Payment type: BUILDING D V S O Land use approval: TYPE OF PERMIT 0 I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement I. New construction 0 Addition/alteration/replacement 0 Other. 0 Partial 1::^ : N-„ z- :. ,, . SITEINFORMATION - 2 -,, - = - Job address: �� .� ,_ 4 17 Bld.. no.: Suite no.: Tax map /tax lot/account no.: Lot: M' Block: Subdivision: V'ull I %1_41 Project name: Description and location of work on premises: Estimated date of completion/inspection: - _ . . .Q' A :.- n �' ,.,_ „ , R :; . FEE SCHEDULE . -- ...'� . _. <.(:UN`f) t'i \(r � � \1'1'1 I(, \ . :f lOV _ �.::� . . ., .,. r Job no: _ -AtJ Fee Descript Qt y. (n.) Total camomma Pigi - �I ' New residential - single or multi- family per Address: I/ • �� Etta: dwelling unit. lncludes attached garage. IESEIEZEIN112De Service included Phone. I I Fax: E -mail: loon sq. ft. or less 4 �" � lie. no : Each additional 500 sq. ft. or portion thereof __ CCB no.: Elec. bus. y ,�� � � �/ Limited energy, residential ___ 2 C' Limited energy, non - residenual ___ 2 II Each manufactured home or modular dwelling ■■. nature of suoervlsrng electrician (required) Date iiiit. Service and/or feeder 2 Errij= A'' License no 9 a Services or feeders — irulallation, A IL alteration or relocation: PROPERTY OWNER - ' 200 amps or less II 2 Name (print): ) : _ 2 • ` i '( . 1 �� . 201 amps to 400 amps ___ 2 401 amps to 600 amps __ _ Mailing address: � � - I r. #0,11) 5S'. • , 6 01 amps to 1 000 amps NEM� 2 City: .• �i= � ZIP: a ��� Over l000 amps orvolts ___ 2 Phone:, allogrz ossimmi■ Reconnect only ME__ 1 Owner installation: The installation is being made on property I gwn Temponry seni ati o ,orr feeders oc 11111 2 which is not intended for sale, lease, rent, or exchange according to tastallaha orrelontioo: 200 amps or less ORS 447, 455, 479, 670, 701. 201 amps to 400 amps __ 2 Owner's signature: Date: 401 to 600 amps 111111111111 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: •_ PLAN REVIEW (Please check all that apply) Misc. (Serviceorfeedernot included): ■■ O Service over 225 amps- commemal 0 Healthcare facility Each pump or imgation circle 2 n O Service over 320 amps - razing of 1&2 U Buildings location Each sign or outline lighting 2 g :■ 2 family dwellings 0 Building over 10,000 square feet four or Signal ctrcuit(s) or a limited energy panel. O System over 600 volts nominal more residential units in one structure alteration, or extension O Building over three stories 0 Feeders. 400 amps or more • Descri • tion• O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lighting plan 0 Other Per inspection __ Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information Notice: This permit application Permit fee $ O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number. / / within 180 days after it has been State surcharge (8%) .... $ Ee accepted as complete. TOTAL $ Name of cardholder as shown on credit card S Cardholder signature Amount 440 -4615 (6r000M) CITY OF TIGARD 24 -Hour - BUILDING Inspection Line: (503) 639 -4175 MST 3 —Oc INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested ,�'75 AM PM BUP Location IdA 3? Suite C‘ MEC Contact Person Ph ( ) 44W9 -9n7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fi - arm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. • SS PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA -('+(t NOB L { Approach/Sidewalk Date `) Inspector Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD '\ 24 -Hour BUILDING Inspection Line: (503) 639 -4175 goi 00 3 - OdW 7 00 INSPECTION DIVISION Business Line: (503) 639 -4171 // J BUP Received c- 3 27 6ate Requested /!(7 /0 9 AM PM BUP Location /2. 9 5 , i Suite MEC Contact Person Ph ( 5 oW 4 ? — 4/f37 PLM Contractor /0m Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing PI146- --bi ."5 Coy✓.tt'4Jo.., L. 31lCI t.l C r Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain S hear: ' Pan Other: anal PART FAIL ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE D Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 32) )1, I o (-( Inspector (1"0 1 - +r-- i R Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503 9 -4175 111 3 - DO 4((5 INSPECTION DIVISION f Business Line: (50 171 MST BUP Received Date Requested 3 — / 7 AM PM BUP Location / ° 3 , S leAL S u °.-3 A- MEC Contact Person I � Ph ( ) a v 9 - % .F-3 7 PLM Contractor �(// Q Ph ( ) 6 712-7 " 2407 SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Nt) ^ /� /� _ !L1 Framing Fiji ,6 0 —T — 0 Q ©g G Yl Q�`��' _ .r Insulation &w 62iy N.t3, ' Drywall Nailing Firewall ` Fire Sprinkler 4;1-1r I r Fire Alarm `rt - � _ 1 ' ( �� a Susp'd Ceiling y/ ,S 1 n Roof V A A- ot� :: - 5 7 \ k ,e_e- Cs PASS PART 400 PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Sm. a Dampers 4.167; PART FAIL - TRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA l p Approach/Sidewalk Date 3 / , ` / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARR 24 -Hour . BUILDING Inspection Line: (503) 639 -4175 3 — 00 T e� INSPECTION DIVISION • Business Line: (503) 639 -4171 M "/ BUP Received Date Reque ted ? / 7 AM PM BUP Location i z.-- 0 \ uite MEC Contact Person Ph ( ) PLM Contrac Ph ( ) SWR UILDIN Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: ..,T-r SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Ot PART FAIL I BING P /- ( .-- \ ost & Beam ,1 Under Slab u Rough -In 7 Water Service • Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain - Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART - FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final D Reinspection fee of $ required before next 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 ` ADA � c Approach/Sidewalk Date �/ I nspector , Other: Final DO NOT R MOVE this Inspection record from the Job site. PASS PART FAIL ti