Permit RECE1VU)
From.Erik Nicholson Fax 41(503)343-4696 To: Fax: +1(603)6961900 P .2 of 2 052112014 7:13
Electrical Permit Annlicattpn I i n:,0 t i, r I .1 ' .1 ,
City of Tigard AUG 212014 ae"i"d ,'/Arj ,;-0 Peewit �/
IA .- 13125 SW I fall Bled.,Tigard,OR 97223 Wta'B. //r At S♦.�1 /lim
( It mrs llrstew
Phone:303.71!!2339 F..:563'5 I Y OFTIGARI �'` Parma..
I;�..�. t1 Tnspeclion Line:503.639.4175 k...,117: lurk 8 Sae Page afar
/Mantel;+vsvw.tigard-oceux ohaaMaacthad I Sgrr4rnglfaRrsaaoa
w
;;.N i/ .,;' ' ri53'';!„s^Y ',:fi 7 i°,t-e '?S ��: 17:','?''. r qrir 77r,i r'4;? u f
❑New constluelirn .Additionlalteration/repiacrmcnt Plow chak all On WAIF(s002l feis al pions.Nlenn dtxted below):.
❑Unice or freN 400 ammo lours ❑Bmrlim otw throe va.ib.
❑Demolition ❑Other Mint the available fall mono 0 Macias out hmryllds
r ........,z'F..,;Z3 , .>,, �t k,!,:i_,e ! c.l,+ .;..:';.:'v Pffrobr, eserala lO,mOsmpa at ltO watsor ❑Flmtia2busWmp.
at \-aril 2-farnil y dwelling am to pv®0..1 neordr 11,000 1]l xitha t aF»e sa vIt ud
y ns �❑cett„r,`RialrndnsirlHt 0 r„prmrarleil,niwalrnao< at�mn�
0 Multi-family ❑Master builder ❑Other: DFae pump. 01mrallation of ISO KVAor
-;oa�i ,q• •••�jny7v'+��gwq rlrn c�9Jy4'�jR qy 01 memory system layw servsxkty desired system.• .�,. ,tr X'>:-fi DAlfdiiran or etn moll load of D"A',"6",'1.2'.'1.1'.
loh tt0: lob site address! 5.+ IWFWP or mat Kooky.
1,s-co (.er...., L
0 Sic or more read:mist te2.: 0 Rarrastrpnal WWI peaks
City/State/ZIP; T,',14_,$) ea. y -...4..3 ❑ltelaaearc routine; ❑Sappb lea s.,a rare'Mm.
CI Ifazardon lamina. 660 oks oomwsl
SuiterbWJgfapt no.: j Project name: ❑scone 4,reade 66U442samerre.
Crap alreet/direakons to jut,site. 9 r(-s. A." .;. r ri `-".,.c-.f .. net i'3® ':?:,
New residential single•or multi-family dwelling unit.
1� Includes attached garage. r
Subdivision: {csle•e'S /1'/.)s4ss., . (ZrezA 3,urq,Tiot no_: i[fCit sq.R.or ku 162 24 4
a fi adi'1500 m.ft.or potion 33.92 1
Tam reap/parcel no.: 1,S t3 S C
a......� 2 S0�_v
- Lmnaleney
.seiae
naa! 75.00 2
:.✓ w4.' aXrr s ill7i k tI .7 :. :::` .e4 eb.:"..q R)
it m TW
retry.2242 4-64201y 7500 2
t(3 k4c.ns, OrV snr.t -- -fsu-.n Wsli. -- it:Mental(wilhabon9.11)
-Rerewa wietp <.-1--,.
.,---- -------- --- ---- -- -------------------------------------------
t '.. .O Qnktt -
el.dG L1.*C $ervicesorfeeders laflana lion,alteration,and/or relwntiem
% %;7 (`;�7 l.,✓ j� r �` '�Ss '�rf: a .Mg �� es 200arlipsatecs 100.70 v-Z.
.'::>.__: .,ei::.:. �5.._.r . :,,0 fl' :,A4cAEa,: "':
Y '.++ee- 201 soya ro 400 amps 133.36 2
Name:
4,ka. 1.,..1;a,JIS]A 401 amps to 600 amps 20034 2
Address: °MSc, S w (-2-.4..6 ,w 601 area to 0000mp6_ 301.0* 2
CitylStatd/.I I`; Os'a 1,033 amp&a*Olt, 552.26 2
T. j -s?. r$ et' - Temporary arnica or'(mien lamella lion,alteration,audfoc
Phone:(Lilt) 3o 114 8 S`1 t I Fax:( ) Mon Gan -
200araps or Ilse 39.36 1 1
Owner installation:This innallation is being made on property that I own which is not 201 amts to 4-03 amps 125.08 '2
intended for sale,1.-•a rent.or--• annge,accordi •to ORS 447,449,670,and 701. 401 mops to599 amps 168.St 2
Owner signaluI _ Lad IJate• gaol!1 y Branch circuits-new.altenln or extension,per panel
x:.; .s lKli:1 r Tarr: d r-c s r A.Foefabraochcuantswir:
. . ":',arci ahasrscnioeorfawleree 742 2
lusiieSS nsmc: r ,►t cwt.branch circuit
1$y r i���! G 1i( . B rec for branch cinasits*ohm
ConNctname: 'J- Wrslk 1/ tani`eto feeder feefirst 56.16 2
R 310 S w i c,1,,r_ 1x11 brand ibrvit
Address: Each add'I booth cite l 7.42 2
4 _MtisruNaaeons(aerlice IF feeder sat included
City7State/ZtP: ( �4/1') i q Fad.arawfacNta4or noSata.
!
6784 2 rcrc:a br feeder(ref )9.gq-({Zzq Fax::( )
nail: a 1lemnmet only 67.83 2
1:- . , r 1N C . t
l't8....ti.dig tiq 67.24 III
:.'.:.%. '',_r r �G .� /j.%'':.7!t!.ef'A.�°�x .'n+ $iylarauilinelin circle
67.24
.. ....: .tL�;.. .. .1..'.6`:ia.. u!%5 ,.,��`. .,� icYd'YL.w.::.. __
Business name: gg/�ii,-fe/ e.f`Ec-O?-LC si,aaleinym.)arr,>nnm<n.tpy See
p t,alteratiat a Men a Paga 2
Address: y1 3!0 ( Each add(dooal fmpctioa aver attowable is any)oflle above
261iLeral msj 1ien(Ikr rain) 6625/h4 ■Cii)JS1atez2W: 4 V I r'' 104
itemisation(1 hr min) 0625/hr ■
Fhortr(503)TSt j24 I Fax:(' ) IOdusLill plea(l hr min) 7216'hr
nrnpertions for attar*fee it 9000r Tr
CCR LTC.: 29 2..W4J3ieeiaical l_ie.:� erg 7 suprv.Lie.:6)_01 5 _freeirlratt)'iisted h ht min
( .i,U,(..... .H7�•t Y:F; 7•.4:%t:,5>:.,.l'm7/J/TS?r
Suprv.Electriciansignantre,required: !� /(r] 9._.. 11 :.< t.
/� ! W Subtotal:
Print name: ?,aC, -A D pf, Wile Ptm review(25%of permit fee):_
L• �'-I /f./}� -. State wroharge 02%of pcmtit fee):
Authorized Signature: ))61-1.44 l..rr-s-�f f)- TOT Al.K RM I f FNF:
r�� �^a�,y�(�
TIM penult amitotic"eLpires:f a per..ii o.et oloei.ed eight.;110
Punt name: D `i2i r I Date' d.l.ark.,:tlw lam aacykdosTemplet,
14 srobrr of mnatiaas elbxai per peroiL
Iw.4.*Po.Txetc P. 4,,_LJ:rsec an-osavnat 471*I I irctroliVOttUl.
a CITY OF TIGARD ( MECHANICAL PERMIT
1111 s COMMUNITY DEVELOPMENT ryirjy T Permit#: MST2014-00109
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/17/2014
Parcel: 1S135CD02800
Jurisdiction: Tigard
Site address: 9550 SW LEWIS LN
Project: NICHOLSON Subdivision::HERS ADDITION TO GREENBURG HE Lot: 6
Project Description: Second story addition of 604 sq ft. Consisting of master bedroom,master bath and office. 10/8/2014: Reprinted
permit to include ductless mini split system.
Contractor: BUILT IN OREGON Owner: NICHOLSON, JADE M
530 6TH STREET 9550 SW LEWIS LN
LAKE OSWEGO, OR 97034 TIGARD, OR 97223
PHONE: 503-928-1352 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Building Permit-Additions,Alterations, 07/17/2014 $857.46
Type of Use: SF Demolition
Class of Work: ADD Type of Const: VB Plan Review 07/08/2014 $402.51
Occupancy Grp: R-3 12%State Surcharge-Building 07/17/2014 $102.90
Stories: 2 Misc Administration Fee 07/17/2014 $4.25
Info Process/Archiving-Lg$2.00(over 07/17/2014 $30.00
11x17)
Info Process/Archiving-Sm$0.50(up to 07/17/2014 $12.50
11x17)
Tig-Tual School CET-Residential 07/17/2014 $688.56
Fuel Plan Review 07/17/2014 $154.84
Fuel Types. Lavatories 07/17/2014 $50.04
Gas Pressure: Tub/Shower/Shower Pan 07/17/2014 $12.51
Water Closet 07/17/2014 $25.02
12%State Surcharge-Plumbing 07/17/2014 $10.51
Services or Feeders-200 amps or less 07/17/2014 $100.70
Branch Circuits w/Purchase Service or 07/17/2014 $74.20
Feeder
12%State Surcharge-Electrical 07/17/2014 $20.99
DC Provision Review,SF-Ping 07/17/2014 $75.00
Total $2,753.61
Required Items and Reports(Conditions)
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 the 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 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 • .•I I. . - •
Issued By: �� t Permittee Signature:
�I
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.Mechanical Permit Application I OR OI t 1( 1 I •.l Ov I 1
City of Tigard Received J
DateRy: Permit No: j` 4,T t -er)/109
13125 S W Hall Blvd.,Tigard,OR 972223: r�`
• Phone: 503.718.2439 Fax 503.5911 Q s", t 5 joy' tkhc7 Permit.
1!t i,�It l i Inspection line. 503.639,4175 5 3 Date Ready/By. 1u„s Ql Sec Page 2 for
Internet: www.Itgard-or.gov NotitiedMetlux! Su
pptemeatal!prorogation
.n
rips OF wokivt or i 1 017 • COMMLRCIIAI. F18*SoI DVIR-USE CHECKLIST '
,t Mechanical permit foes*are based on the value of the work
❑Ness construction ,/Addition/altcrati�� t performed_Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: 4 r mechanical materials,equipment,labor,overhead,and profit.
GAT GOaY OI►t~ON8TRI3t'TItNI
I. . ' ! Value:S
��i allgi ULhtl'IAL SQuintrItrr!S'Y'*.tl'ITMSt 1RE
Et 1-and 2-family dwelling ❑Commcrciallindu_atrial 0Acoesso • • - For sperial information use checklist
❑Multi-family ❑Master builder ❑Other Description I Qty. I Ea. I Total
108 STTE INFORMATION AND LOCATION Hcaoat:/eooiiag: ,
Job site address: 9550 .s, Le-4-.4 15 GSI Air conditioning 46.75
City/State/ZIP: !G A a D ()ate 4 0^4 9722-3 Furnace 100,000 BTU tdactstvants) , 46.75 ,
Suite/bldg./apt.no. Project name: 1,\,, ,,,i,,,,, Furnace 100,000+13T11(ducwvents) 54.91
Cross street/directions to job site (t mS r 4 N ) G_42.6—E-,,..4 " 9 // Ly
Heal pump , 1 61.06 (,vs�
Duct work t 23.32
Hydronic hot water system 23.32
, Residential boiler(radiator or
Subdivision: Lot no.: hydronic) 23.32
Tax map/parcel txi.: Unit heaters(fuel-type,not electric),
in-wall,in-duet,suspended,etc. 46.75
DESCRIPTION OF WOE
Flue/vent for any of above 23.32
rv."7" Smvv. A 'D1 'TICS,J Other 23.32
r` SC-E 2. 'S , r- Other fuel appliances:
CWa-4�V� cif- S /'I 1181, / 1/J ytsq/r Water heater 23.32
/ ) -qtr S-1-. � rD /Q4r
; ^PROPERTY OWI R A T Gas v n vent f for water 33..39
Flue vent for wafer heater or gas
Name: k\ fireplace 23.32
ER_ 4 75 A>Jr 3chct.Vu4
Address: 01 550 4.-Eu.iv 1-NJ Log lighter(gas) 23.32
City/State/ZIP: / r 4 f42 v 0 4 C‘...7 Zz 1 Wood/pellet stove 33.39
Phone:( A l---; ) 3c,r:i 1 t Fax:( ) Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
e1
Ocher: 23.32
" l aviroemental exhaust and ventilation:
Range hood/other kitchen
equipment 33.39
City/State/ZIP. (-A lee- Oo4 0 z.,,1 ct 7 c-3 4
Phone:( 5..5 ) ''r1 6-Q 7 Z c l TFax::( l Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
toilet compartments,utility moms) k 23.32
E-mail: , t. - irk . 02E14 t.,,,d Gj C MA ,L. Cc`"�
�AC"Ieit I 9 AHic/crawLspace fans 23.32
Business name: 44 t`1
(it.„ .f�� Other: _ 23.32
Address: j ' cs
Feel piping: ,
' 1.15 tor first bar$4.03 br each additional
City/State/LIP: 1� as Lti e �k, 9''�(j 1s1 '
[ q t Furnace,etc.
Phone:( 3 ) [ •—/, Fax:( )
CCI3 lie.. Izt;i} Gas heat pomp ,
5 nJ 1 Walbsuspendcd/una heater
Authotiretl signature: ;.
Print name: ■.. 1144.11111.11. Date.
Water heater
I'Ituitd'mg`P ,eiu,MF.0 PanasApp MO113 du. 440-4617T(11102('0114'WFti) 1- f 1 `i
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2014-00109
T I G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/17/2014
Parcel: 1 S135CD02800
Jurisdiction: Tigard
Site address: 9550 SW LEWIS LN
Subdivision: BOETCHERS ADDITION TO GREENBURG I Lot: 6
Project: NICHOLSON
Project Description: Second story addition of 604 sq ft. Consisting of master bedroom,master bath and office.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces. 0
Height: 19.5 Bathrooms: 1 Second: 604 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 604 sf Value: $66,615.16 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr 10
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ADD SF VB R-3 604
Owner: Contractor:
NICHOLSON,JADE M BUILT IN OREGON Required Items and Reports(Conditions)
9550 SW LEWIS LN 530 6TH STREET
TIGARD,OR 97223 LAKE OSWEGO,OR 97034
PHONE: PHONE: 503-928-1352
FAX:
Total Fees: $2,733.79
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a••py of the • -=or direct questions to OUNC by calling 503.2 87 or 1.800.332.2344.
Issued By �� ��/� Permi e= '• •: ure: --Jr.- r
.83, •175 by 7:00 a.m.for the next available ins lion date.
This permit card shall be kept in a conspicuous place on the job site until mpretion of the proj 1.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR OFFICE IISE ONI.1
City of Tigard ,. Datee/Be: • A. Permit No.:A ' . _•. .
4 13125 SW Hall Blvd.,Tigard,OR 97223 -
g Plan Review Other Permit:
= Phone: 503.718.2439 Fax: 503.59 �'�� Date/B : Yi��a ..
T I G A R D Inspection Line: 503.639.4175 % iikS) Date Ready :y: ��' nY//� Supplemental See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 'rte rCI Supplemental Information
TYPE OF WORK .t.--6.$-°00Qa
REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demo• G, Permit fees*are based on the value of thework performed.
Indicate the value(rotnded to the nearest dollar)of all
.Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the
f` CATEGORY OF CONSTRUCTION work indi• ed on this application.
l-and 2-family dwelling Valuation: �fi•,e $ I 7`Ic
y g ❑Commercial/industrial Gh I Irby
❑Accessory building ❑Multi-family Number of bedrooms:
1:1 Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 95 5o fkAi \---C vki t S t_ New dwelling area: square feet
City/State/ZIP: F( 6A'�p 0 i2- 1-1 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: g cvt bel T� °E- (--1 jam" t_ Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(roulded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
2- r411 C� 1 v cz �1-` GV, nv C,✓ Valuation: $
Q(A.✓k 0. 1 'C✓�. l l r1. .Old S t' Existing building area square feet
11 New building area: square feet
.PROPERTY OWNER ❑ TENANT Number of stories:
Name: 1*-i F--- ; A- p``S b�-1 I - Type of construction:
Address: 1550 5 L.e v Is L-&v Q_ Occupancy groups:
City/State/ZIP: T-7-1 0.r d 12- 9 12 2 3 Existing:
Phone:(1 t g 3b 9) s3-1 ( Fax:( ) New:
APPLICANT JSZ CONTACT PERSON BUILDING PERMIT FEES*
^ (Please refer to fee schedule)
A
Business name: t` l C.a I l t)C 5- Structural plan review fee(or deposit):
Contact name: 6 'v\ I . D p
Address: '"` t'1� FLS plan review fee(if applicable):
f [7 �{ Total fees due upon application: L1
City/State/ZIP: b ys-.-l0.1,,,A V t� - l 1 2 32 %�f 0� •��
r�., Amount received:
Phone: y3) 6 <t) `t{ \ O Fax::( )
E-mail: kot11 cull des►3v1 `�L` L-b�, PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
0. Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: ?AAA v:‘ (� e� l� Submit two(2)sets of roof plan with connection details
Address: �3U � �-- , and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP: / U SuV%� ) OP- 9'-1 63 and administrative fees): $180.00
Phone:(5-f3) qag- f 35"P-. `J Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.: , Ct 2_395 f'/4 f Total fee due upon appication: $201.60
Authorized signature: This permit application expires if a permit is not obtained
r within 180 days after it has been accepted as complete.
Print name: ` t b 1,-� Dater *Fee methodology set by Tri-County Building Industry
11 WW li i 1 / Service Board
1:1BuildinglPermits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLI ,
Received
IN City of Tigard DateBy:
+ 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing 0 Mechanical
TICARD
Internet: www.tigard-or.gov 1:1 (hhen
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )es `° `/`
I Land use actions completed. See jurisdiction criteria for concurrent reviews. _ ❑ • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district.etc _ ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ 0
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 a.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 if
copyright violations exist.
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 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,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.
20 Manufactured floor/roof truss design details. 0 ❑ ❑
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 Ore on and shall be shown to be licable to the ro'ect under review.
23 Three(3)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 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingplans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440 4613T(11/02/COM/WEB)
.Mechanical Permit Application FOR OFFI( I I sF ONLY
Received Q
City of Tigard Date/By: Permit No.: KGJTp�I -�/ F.
-'I 13125 SW Hall Blvd.,Tigard,OR 97 1 Han Review
Phone: 503.718.2439 Fax: 503.59 Date/By: Other Permit:
Inspection Line: 503.639.4175
T I G A R D Internet: www.tigard or.gov $ ` \k c Ready/By: 1��s Q! See Page 2 for
,`� Notified/Meihod: Supplemental Information
t
TYPE OF WO' '',AI COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction jz Addition/altera"s . performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
PI 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. ( Total
JOB SITE INFORMATION AND LOCATION Heating/maw
Job site address: 9550 c.,,, („,.,,,s LtJ Air conditioning 46.75
City/State/ZIP: -7 1 4 A Q-i. L (Z 4 C,v 97 2 2-3 Furnace 100,000 BTU(ducts/vents) 46.75
Suite/bldg./apt.no.: Project name: !V t f 1,4n4 4 v�1
Furnace 100,000+BTU(duets/vents) 54.91
Cross street/directions to job site t �T H 4 N'a G-12E6—E 1 X11
t Heat pump 61.06
Duct work i k 23'.32
Hydronic hot water system 23.32 ,
Residential boiler(radiator or
Subdivision: Lot no.: hydronic) 23.32
Unit heaters(fuel-type,not electric),
Tax map/parcel no.: in-wall,in-duct,suspended,etc. 46.75 ,
DESCRIPTION OF WORK Flue/vent for any of above 23.32
2- 5rbC'k A'v 't 110 Ai Other: 23.32
•4k S rE Q S:.:v. TE- Other fuel appliances:
Water heater 23.32
Gas fireplace/insert 33.39
PROPERTY OWNER I ❑ TENANT Flue vent for water heater or gas
Name: N\ fireplace 23.32
EQk11c 4 "3A E- tC.Nat.'Da4
Address: `1'550 1 LEN.,t S L,..1 Log lighter(gas) 23.32
City/State/ZIP:-7--.7 4 " p oQ 4,v c% 7 Lz '3 Wood/pellet stove 33.39
Phone:( A 1.5 ) 30'\ e -'% Fax:( ) Wood fireplace/insert 2332
a-APPLICANT ❑ CONTACT PERSON
Chimney/liner/flue/vent 23.32
Business name: +? c `L'T `e4 O irLet.c,,j L.1.. c
Other: 23.32
Contact name: . 7„E a ')t,S tit-foes Environmental exhaust and ventilation: _
Address: '5 3c 6.rH s Range hood/other kitchen
Jj � �,p equipment 33.39
City/State/ZIP: Lek - Cx,,f-•rts`4 0 ve-CZLf..1 cc-7 C 34
Phone:( 5G-3 ) 3�6_a 7 Z Ct Fax::( ) Single-duct es dryer exhaust 3339
Singl exhaust(bathrooms, i ,
E-mail: ` L T . 1 N - U�--�E.,u y M A t L. C ca'A
toilet compartments,utility rooms) \ 23.32
CONTRACTOR 115'0 Attic/crawlspace fans 23.32
Business name: : Other: 23.32
Address: S j [�tC Fuel piping:
114.15 for first four;$4.03 for each additional
City/State/ZIP: j_a_k OL L(x t b L)2 9 76
) Fax:( ) Furnace,etc.
Phone:(
3 1� — 3
CCB lic.: /4,3 Gas heat pump
Wall/suspended/unit heater
Authorized signature:
Print name: c
;� Date:--- Water heater
I:\Building\Pamits\MEC_PamitApp_040113 doc 440-461 Tr(11/02/COM/WEB)
• Plumbing Permit Application
. Building Fixtures FOR OFFICE USE ONLY
` Received ��//��
City of Tigard . Permit No.. .L / --c) %Q
Q Date/By: �'(>I
114
• 13125 SW Hall Blvd.,Tigard,OR D `1�1� Plan Review
i Phone: 503.718.2439 Fax: 503. 8.196 \` n Date/By:
Other Permit No.:
I C A R D Inspection Line: 503.639.4175 Jv I �V ` Date ReadyBy: lurir fd See Page 2 for
Internet: www.tigard-or.gov �+ �� Notified/Method: Supplemental Information
TYPE OF WORK..�,V```,,1:r4"3°
P � ' FEE* SCHEDULE
❑New construction ❑al ition For special information use checklist
Description I Qty. 1 Ea. 1 Total
A'Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
jg 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: (155 ' S,,,, C. S L.,_,...; Catch basin or area drain 18.76
City/State/ZIP: 1 4 A a'D G Ca v J 4-7 2Z 3 F owing drain line,linear ne trench drain 18.76
e
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: N,(4 c I. f u>rJ Manufactured home utilities 50.03
Cross street/directions to job site: y 51 H A A . e y 3yG3 4 Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
IClothes washer 25.02
L/ '"`v S Th¢•'t ,AVV D$110'i Dishwasher 25.02
L i .AA.gki r e. 5"v t-VC Drinking fountain 25.02
Ejectors/sump 25.02
'PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: EQx'c 4- tT�p F N .c. L IT,A
Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
550 5.. E,C'^r% f Lts► Garbage disposal 25.02
City/State/ZIP: -r, c A 4 9 UQ Gr., co'L 2 3 Hose bib 25.02
Phone:( 4 y 5 ) ) _ 5 7 t Fax:( ) Ice maker 12.51
IR APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: 5V 1L"r (N 0 eZr.04 LLL
Primer 12.51
Contact name: V EN Bent,46-4eS Roof drain(commercial) 12.51
Address: 5 30 6 r ST Sink/basin/lavatory c/a(r "7---- 25.02
City/State/ZIP: LA. 'cc' dSwL--4 fj 0 06-z C..J at-70-s-4 Solar units(potable water) 62.54
Phone: )•p 5) 3Ci G-q 7 Z c j Fax: :( ) Tub/shower/shower pan ( 12.51
E-mail: by.1.-r. I N . o G� e C-•-+v►a 1 L , 4c. Urinal 25.02
CONTRACTOR Water closet t 25.02
Business name: N Water heater 37.52
lN'�ii(0 �L�M6l Water P�P �1 in WV 56.29
Address: 70 31 Al Bea Q.L t,4 6 TO t,/ tik V£ Other: 25.02
City/State/ZIP: 'pd l'?T 4.it", (9Qg�crJ cal 12 0 3 Subtotal
Phone:( '503 ) C16 2_ `I 9 7 Fax:( ) Minimum permit fee: $72.50
Vbs. s6 1�1 g Plan review (25%of permit fee)
CCB Lic.: VC7"i Plumbing Lic.no.: State surcharge(12%of permit fee)
Authorized signatyre: c -- '`=__ 111117 TOTAL PERMIT FEE
Print name: g; - This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Bui ldinglPamits\PLMU-PermitApp.doc 10/01/09 44046I6T(10/07/COM/WFB)
Electrical Permit Application FOR OFFICE USE O\L.1
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Permit yr /��
Phone: 503.718.2439 Fax: 503.598.1 � �"" Date/B : Other Permit:
I lc \1'11
Inspection Line: 503.639.4175 Date Ready/By: heir B See Page 2 for
Internet: www.tigard-or.gov Q ll° Notified/Method: SupplemeatalInformation
TYPE OF WORK ,•' PLAN REVIEW
❑New construction Or Addition/alteration/replacement r't Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSfAktiON exceeds 10,000 amps at 150 volts or ❑floating buildings.
gi 1-and 2-family dwelling less to ground,or exceeds 14,000 ❑Commercial-use agricultural
y g ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A "E","l-2""I-3"
Job no.: Job site address: Ct j 0 5 W L Six or or more more. occupancy.
S ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than
ty , t 4,pia 0 Q 6-c4.0 t.1 q('7 7-2 3 ❑Hazardous locations. 600 volts nominal.
Suite/bldgJapt.no.: Project name: N A C tits L 5 0.1 ❑Service or feeder 600 amps or more.
Cross street/directions to job site' f H • FEE SCHEDULE I . I Fee
�`'�'1! ��`� �t—�L1.1 3S�4 I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.) --
Limited energy,multi-family
2_
I . ' 5 reo(t y A Pp,i O 1`i residential(with above sq.ft) 75.00 2
Renewable Energy ❑ See Page 2
NY-E-1". (■-kA 5 T' Su vr'E Services or feeders installation,alteration,and/or relocation
ja'PROPERTY OWNER I 0 TENANT 200 amps or less i 100.70 2
201 amps to 400 amps 133.56 2
Name: EQ-1 k 4 S AT)E ■C.Ho t.. c�'J 401 amps to 600 amps 200.34 2
Address: ct 55 0 5w (....Ew+ S L.,4 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 i 2
City/State/ZIP:' 'T 4 A2 ) 0 --tic, ct Z 2 Z 3 Temporary services or feeders installation,alteration,and/or
Phone:( 4 i 5 )?,[+t.. -S-1 >i Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
Vir APPLICANT 1 0 SAC. A.Fee for branch circuits with PERSON 1 above service or feeder fee,
(0 7.42 2
Business name: 15 : L T r.1 ►G L. C each branch circuit
B.Fee for branch circuits without
Contact name: liSFa .i ,C7S t-h-- Q-5 service or feeder fee,first
56.18 2
branch circuit
Address: '5'30 T1- c r Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: LA v,6- O5,,,'t---&e, Q(€t o,., oil o 1 4 Each manufactured or modular
Phone:( '5O ) 3 C{ 6, q 7-2_q Fax::( ) dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: ;,i e LT• \N. OE'4461'/ Q CxMA la- • c t:.y Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal circuit(s)or limited-energy See
d`� l7j1. C C� (� 6 N E C T l C- panel,alteration,or extension. Page 2 2
Address: C(cs 35 5'-. 7E ee,4 ( 1"�x 1 R y Each additional inspection over allowable in any of the above
Additional inspection(l hr min) 66.25/hr
City/State/ZIP: --r-"1 4 A Q O 02€4a r3 (-VI Z 2 q
Phone:( 5a' ) 7 4 7 - ,55 4 ( I Fax:( / ) /o// //i
Investigation(1 hr min) 66.25/hr
If �/ Industrial plant(1 hr min) 78.18/hr
CCB Lic.: Ct' �(9 7 Electrical Lic.: 6�2 �Suprv. ic.: r,"Q3 S P
7/a7 / � Inspections for which no fee is �/hr
Suprv.Electrician signature,required: IN/ specifically listed('/:hr min)
ELECTRICAL PERMIT FEES
Print name: /nXi/e ,/Ac Date: 7.-7-/(f Subtotal:
Authorized signature: ` a If/"/ Plan review(25%of permit fee):
�i State surcharge(12%of permit fee):
Print name: /1ip11ti,7 Oa/ . Date: 7-7-/q TOTAL PERMIT FEE:
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05212013 440-461ST(11/05/COM/WEB
OP
• City of Tigard
•
■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: mj702p/1/- do/o�l
Site Address: 95SO SW Les Ln.
Project Name: N;c)n nl son Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Se c-ona s orN) acld kiion TO SF h0rop_,
Verify site address/suite #exists and active in permit system.
Si Plan Elements:
ee (3)copies of site plan xisting structures on site
ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure (including decks)with finished
r wn to scale (standard architect or engineer scale) floor elevations
CMorth arrow
—P-Utility locations(required for new,may apply for additions)
( address,project or subdivision n m n to number ! _: anon of wells/septic to ad p l name and lot e s/septic systems
plicant information (name and phone number) r. osion control(including drainage-way protection,silt fence
of dimensions and building setback dimensions design,location of catch basin,etc.)
,--etnt area,building coverage area,percentage of coverage and -iflSireet names
impervious area(applicable if R-7,R-12,R-25&R-40) CZ rreet tree size,type and location
._Q4.reperty corner elevations(2 foot contour lines if more than -enlisting trees to be retained with drip line,and tree
4 foot differential) protection measures
Clean Water Services—S rvice Provider Letter: (lot platted prior to 9/10/1995):
Required: ❑ Yes No Received: ❑ Yes ❑ No
—E1--)Land Use Case#:
Crf Zoning: R-Li,S
itir Setbacks: Front I ' Rear 1 S Side 5 t Street Side 1 01 Garage 20
rj
❑ Landscape Requirement:
mot Coverage Maximum:
❑ uilding Height: Maximum Height 30 Actual Height 19 $t 1
isual Clearance
—easements
HE—Sensitive Lands: ❑ Yes ❑ No Type
— Urban Forestry Plan
--Conditions Met
Notes: see sekbac n Ct5 meascA reJ in 977 w i+h approved perm I.+
-Fd,r neAki con s1'r'I4c4 i 0 ,-
Approved By Planning: 1 /,/ /'/j///j,/ Date: 1 1,3) J q
aiyirr
Revisions (after Building Submittal on y) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1 dgPerm itRvw_RES_042914.docx
. I
•
Building Permit Submittal
Original Submittal Date: /111
Site Plans: #
Building Plans: # 'Z
Building Permit#: Lam}?nter building permit#above.
Workflow Routing: ❑ ning Ltd-Engtneering ErretTinit Coordinator L'�—Building
Workflow Sign-off: [�Si 9ff for Planning(include notes from planning review)
Route Application Documents: nigtneering: (1) copy of permit application, (1) site plan, (1) building plan and
on Ian review routing form.
uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 6 j Date: -7/ri>i,
Engineering Review
❑ Actual Slope: _
❑ Conditions Met
Notes:
Approved by Engineering: Date: 7 • $
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions Met- Prior to Issuance of Building Permit
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
K to Issue Permit
Approved by Permit Coordinator: �� r/ Date: if
1:\l3 u i l d i ng\Forms\B I dgPerm itRvw_RES_042914.docx
I
CITY TI6ARD DATE L�Zr]—:% .14 ��.9 J
BUILDING PERMIT APPLICATION of ? R
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED R'1 �— I `T
. OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER
OWNER Nati C9'th JOB ADDRESS 4550 1L.: Lii.ti Lathe HOME APAIREI-IIYECT ;
5630 SE MOrrisan ENGINEER IC
BUILDER
(S IF•'+ ADDRE9B DESIGNER
• STRUCTURE XE]NEW ❑REMODEL .°ADDITION Cl REPAIR ❑RENEWAL OF IRE DAMAGE ❑DEMOLITION
w1g RESIDENCE ❑COMM ❑EDUCATIONAL OGOV•T ❑RELIGIOUS❑PATIO OCAR PORT ❑GARAGE ❑STORAGE°SLAB ['FENCE,
OBONO ❑MOVING OCONOITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED DEIGNS i
a:-7 5r; 3 aEl
OCCUPANCY_.Y LAND USE ZONE BLDG.TYPE FIRE ZONE— PLAN CHECK BY BUJ HEATS
:unat_ st%IG ?Ashy 4:Watling u/Rt'Arhari varacke--.3 tiitd'rDOma 2. 13.th
•
OCC LOAD FLOOR LOAD 40 HEIGHT 20 NO.STORIES I AREA 1 .2C NO.BEDROOMS 3 VALUE 17*AO.
BU ILDIING DEPARTMENT SET BACKS FRONT "U REAR 16 LEFT SIDE 2- RIGHT SIDE I2+ j
1 3
Permit I 141.VC `
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE.ZONING
Plan Check 61.SG REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE I
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE i
State Tax �.45 LICENSE.SEEP RAT PERMITS REOUIMED FOR sE SUB CONTRACTORS TO
�� NG AND HE;TGURRENT CITY BUSINESS
Total Idb.95 ���Y/ L 610 L L,I
By , ANT OR AGENT
Approved —(t'l Receipt No
•
,.
NICHOLSON RESIDENCE
. -D .,7,
(..„ ...._.
" " `-I - - - - - 124' — — — — — f
o I r 1
V F I -
o.
N1 ` --11'-101/2"
0 WI — —
l' ro v . _.. --_ —,
•Ei) K .,:::c. di NEE: on [IIRe'rci
N 1m Cr
N
vm
o
CITY OF TIGAR D
I
Approved by Plann n1. , LL— — — — i,..".
Q 20'-0 112" t 40'-2 1/2' e
Date: !-7 g I -II b0'-3" a 19'-4"
ir Initials: ..0 i' € • ) )
1 0 3
m lJ f tom;
I E3
cri •
D
CSW Lewis Lr
0----C SITE PLAN
.3 V- 1 15'-O"
0 t i
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9550 SW LEWIS LN, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2014-00109
Jeff Grove
Violation Summary:
Inspector Contractor