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12X64 SW ASCENSION DR
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
�?I 24-Hour Inspection Line: 639-4175 Fusiness Line: 632-4171 -
I -� BIP
,�' c. 1 _Date Requested AM__ PM -- — BLD —_
Location 1 2--1 L 466 F t,� 1 C2t-� Suite — /MEC-� l�"
Contact Person Ph �LM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Fooling NOT REQUESTED
Foundation FOUND DURING RESEARCH FPS
Fig Drain NO INSPF.CTION(s) IN FILE SGN
Crawl Drain ---
Slab _ -.-- SIT
Post& Beam ---- -----
Ext Sheath/Shear
Int Sheath/Shear — - —
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - -- —---- -- ------- -----.
Fire Alarm
Susp'd Ceiling ---
Roof
Mise ---- - --- --
Final ---...--.__-_ �Z ---
PASS PART FAIL - --- /' ---- ------ - - -
PLUMBING
Post& Beam _—._—
Under Slab
Top Out --_--- — -- —Water Service
Service _
Sanitary Sewer — --
Rain Drains
Final
PASS PART FAIL
E�CHr;�N 'AL
I'Ost�S Beam -- -- --- - — -
Rough In
GasLine �. ------- ----- ------ -- —- . -�.----------
Srnn�e Dar, Pers
final
PASS
- - - --- ---- - ---..- -
ASS PART FAIL
ELFr.TRICAt. ---
Service _
Rough In
----__----- ----.-__. ._ ----- __-._-----------------
UG/Slab
Low Voitage
Fire Alarm _
Final
PASS PART FAIL --___.--_-----_--_ -. - _--
SITE
Backfill/Grading -- - -�-- - -- ----� —
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection Pay at City Hall, 1312.5 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE __ __.__._�_— [ J Unable to inspect- no access
ADA
Approach/Sidewalk
Other Date _-- _— Inspector V Ext
Final
L PASS PART FAIL DO NOT REMOVE this inspection record from the job Site.
MT
CAL
CITY OF TIGARD PERMITI#: EL-'CR8I0410
DEVELOPMENT SERVICES DATE ISSUED: 07/21 /98
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
PARCEL: ,J i 1.04BC-44900
SITE ADDRESS. . . : 12764 SW ASCENSION DR
SUBDIVISION. . . . :HILLSHIRE WOODS ZONIr4G:R--7 PD
BLCICK. . . . . . . . . . . LOT. . . . . . . . . . . . . :060 JUR 1 E;h 1(: I"TON: T I G
Pro J ect De scr i pt i on : Installation of one branch circuit.
-
---RESIDENTIAL UNIT---- ---TEMP ERVC/FEEDERS---- -----MISCELLANEOUS-------
1000 SF OR LESS. . . . : 0 0 - 00 amp. . . . . . . : 0 PUMP/ IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL-/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR I-ABEL ( 10) . . . : 0
-----SERVICE/FEEDER----- - -----BRANCH CIRCUITS------- ---ADD' L INSPECTIONS—-
0
NSPECTIONS--••-
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 F'ER INSPECTION. . . . . : 0
201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 — 600 amp. . . . . . : 0 EA ADD' L BRNC;H CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 — 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION-------------__._.-
1000+ amp/vo:lt.. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FAR )- 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: --- ---------- FEES ------------------
GERG S!gBATAK — — — -- type amoi.int by date recpt
12764 SW ASCENSION PRMT $ 35. 00 DEB 0-7/21/98 98-307517
T 1 CARD OR 97224 5PCT $ l.. 7S DEB 07121198 `38--;507517
Phone #:
Contractor: -------------------------
TRI—CITY ELECTRIC $ 36. 75 TOTAL
PO PDX 68797
--------- REDU I RED INSPECTIONS - -- i
AILWAUKIE OR 97267 Roi-rgh--in Elect' 1 Final
Phone #: 659-8222 Elect' 1 Service
Reg #. . : 50888
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 188
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law require, you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules arp set forth in DAR 952-001-0010 thR 952-001-1397. You may obtain a copy
of these rubq Y
s or direct questions to DIMC b calling 15031246-1987.
Iss�.red B • _ --
l e r mi t t _e S i g n a t; . - %_- ' _-�
--OWNER INSTALLATION ONLY - -- ------------- "-------__
The installation is being made on property I own which is not intended forsale, lease, or rent.
OWNER' S SIGNATURE: _--__ DATE: -------_-__
-------CONTRACTOR INSTALLATION ONLY----------------- - - -
SIGNATURE OF SUPR. ELEC' N: i d--�^ _ DATE: 7'
LICENSE NO: __ ------ ------- -- --- - - -
++++++++++++++++++++++++4-++++++++++++++++++++++++i+++++++++++++++++t+++-++++++++
Call 639•-4175 by 7:00 p. m. for an inspection needed the next bl.rsiness day
++++++++++++++++++++++++++++++.+++4-++++.....+++++++++-F+++++++++++++++++++++.4-++++f-+-
CITY OFTIGARD Electrical Permit Application PlanChecc -
13125 SW HALL BLVD. Recd B _•
TIGARD OR 97223 Date Recd_ 7 a f r
Date to P.E.
Phone(503)639-4171, x304 Date to DST
Inspection (503)639-4175 Print or Type Permit# &ICC77 le-_0q/Q
Fax (503)684-7297 Incomplete or illegible will not be accepted Called-
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed -
Name(or name of business)GE. Qa SA Q3 -rA I,,-' Service included: Items Cost Sum
Address /D-75 1�U • A nl s 4a. Residential..per unit +
City/State/Zip�a A R d R y 7 D 1.3 1000 sq•ft.or less - $110.00
Each additional 500 sq.ft.or
r,1 tCt portion thereof $25.00
El
Commercial Residential ISI Limited Energy $25.00
1 Each Manut'd Home or Modular
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
(Attach copy of all�current�Ilcgnses) 4b.Services or Feeders
Electrical C,Qntractor l'• I �- F--� `-o Installation,alteration,or relocation
AddrQss_ Y 0 X �,S'7 ri 201 amps or less $60.00 2
20I amps to 400 amps $80.00 2
City 1-uJ F}as K 1 f, State OL Zip_ 1 7,) 4'7 401 amps to 600 amps $120.00 _ 2
Phone No. LSM 1) c.� d- 8- ; 1 601 amps to 1000 amps $180.00 2
Job No. J Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. - '�-114 Exp.Date fc-1 - WJ Reconnect only - $50.00 _ 2
OR State CCB Reg. No. S Exp.Date 6• `9 1 4c.Temporary Services or Feeders
COT Business Tax or Metro NocWb A 1163 Exp.Date 9-1- 5,1 Installation,alteration,or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n --� J 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 _
Over 600 amps to 1000 volts,
License No. a`4-U5 S Exp.Date /0 - I- Y b' see"b"above.
Phone No. <,s`7- S 1 1
-- 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The too for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circu!t $5.00
b)The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 S 0 Z' 2
The installation is being made on property I awn which is not Each additional branch circuit $5.00 _ 2
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not Included)
Owner's Signature Each pump or irrigation circle $40.00 Each sign or outline lighting $40.00 _
3. Plan Review section (if required):* Signal circult(s)or a limited energy
panel,alteration or extension $40.00
Please check appropriate item and enter fee In section 5B. Minor 1.abela(10) `_ $100.00
4 or more residential units in one structure 4f.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection _ $35.00 _-
Classified area or structure containing special occupancy Per hour $55.00
es described In N.E.C.Chapter 5 In Plant $55.00
+Submit 2 sets of plans with application where any of the above apply. S. Fees:
C C
Not required for temporary construction services. Ss.Enter total of above fees $
5%Surcharge 105 X total fees) $ -
NQjLU Subtotal $ --
5b.Enter 25%of line 5s for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Reviewfi raoui►ed(Sec.3) $ ---
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. 11 Trust Account#._ S 7J-
Total balance nue
!
11,05TSTI-C96 APP Rm 9/96
MECHANICAL
CITY OF TIGARD MEPERMITAL
DEVELOPMENT SERVICES PERMIT #. . . . . . . . MEC98-0384
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISStJED: 0'9/08/98
PARCEL: 2St04BC--04900
i 1 1 L ADDRESS. . . : 12'( 64 13W OSULN:') LON DR
(s')JJBD I V I S I ON. . . . : HILLSHIRE WOODS ZONING: R 7 PD
BLOCK. . . . . . . . . . : LO'l.. . . . . . . . . . . . . :060 JURISDICTION: TIG
1:',LASS OF WURK. . ALT FLOOR FL-IRN. . . 0 EVAP COOLERS: 0
TYPE OF lJSE. . . . SF LJNIr HEATERS. . : 0 VENT FANS. . . : 0
()CClJPANCY GRP. . : R3, VENTS W/O APPL.: 0 VENT SYSTEMS: Vi
BOILERS/COMPRESSORS HOODS. . . . . . . : 0
-
1AJEL TYPES-.__.__._.-.._..._.__.._._-TYPES-.__.__._.-.._..._.__.._._ 0-3 HP. . . . : 0 DOMES. INC IN: 0
')TORIES. . . . . . . . 0:ELC 3-15 HP. . . . : I COMMI_... INCIN: 0
MAX INPUT: LA BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
F71 RE DAMPERS?. 30-50 HP. . . . : 0 WOODSTOVES. . : 0
IiAS PRESSURE. . . : 50+ [-I P. . - 1A CLO DRYERS. . : 0
NO. OF LIN TTS----------- AIR HANDLING LJNITS OTHER UNITS. : 0
FIJRN ( 100K DTIJ: 0 10000 cfm : 0 GAS OUTLETS. : 0
FURN ) =,100K BTt.J: 0 > 10000 cfm: 0
Re mar-k s : Sabatak - install A/C unit must comply with standard setbicks
Owner: FEES --------------
GR'E'G SABATAK type amoi.int by date r-ecpt
112-764 SW ASCENSION PRMT $ 25. 00 JSD 09/08/98 98-308904
TIGARD OR 97223 5)P C T $ 1. 25 JSD 09/08/98 96-308904
1 ,hone #- 524-6016
Eoritt-actav-:
()BSOLUTE COMFORT HEATING
R COOLING ----------------
L7:,305 PRINGLE RD SE #C >t 26. 25 TOTAL
13ALEM OR 97302
Phone #. 503-391 -081.9
Reg #. . : 841.04
-------- REOUIRED INSPECTIONS'
This permit is issued subject to the regulations contained in the Cooling 1Jnt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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, Those rules are
set forth in OAR 952401-0010 thtnugh ORA 95E-00I-0080, You may
obtain ropies of these rules Pi. direc, questions to OIJK by calling
(503)246-9187.
Issl.ke By :
...... Pet,mittee Signature:_
1-++4•...................4.......................4...............................4-+++ -
Call 639-4175 by 7:00 p. m. for inspertions needed the next bl-isiness day
............................................4........................#-++++.......4++4
(17r29/98 WED 16:38 FAX 509 Sea 1960 CITY OF TIGARD fh002
. R EQEIVFD Piancoock r '
CITY OF TIGARD Mechanical Permit Application
Reed ay- "
13125 SW HALL BLVD. Commercial and Residential . _ 81998 Dato fted�ff_ 0W>
TIGARD, OR 97223 Date to P,E.
(503) 639-4171, x304 UEVELON,"�Nt Date to DST
Permits �I 1Z:
Print Or Type �_��
Incomplete or illegible applications will not be accepted called - —
Nameofof 0evelopmenit Pioled Ikrgcrip110n
Table 1A Mechanical Code oty Price m
Job Simi Address Su IIM A Permit Fee 10.0
1) furnace to 100,000 BTU
Address >(oY jh/ SCC/7fY . Including ducts d vents 6.00
Bldgs GMyrsiNe Zip 2) Furnace 100,000 BTU+
Q�J G Z d 3 including ducts&vents 7,50
Node(ornamo of business) ✓ V— 3j Floor Furnace
Owner K. /� itiAud n vent 6.00
Me1Nnry rue 4) Suspended healer,wall heater
or floor mounted heale• 6.00 _
/ / S�✓ o4Se ewsla^, 5) Vent not included in appliance permit
ceyrstNe rp 'rPhon�-NU 3 00
y-7.).) Sal CHECK ALL *Boiler Heat Air
-
Nw6e;m neme of business) i HAT APPLY. or Pump Cond Qty Price Abnt
Comp •• _ _
6)<3NP,abserb unit to
Occupant MauugAddreaa - 100K BTU 6.00 —
7`3.15 HP.abaorb unit
eBiNSnwe Zip Phone 1f^k to 500k BTU 11.00
sir 15-30 HP.absorb
_ t 5-1 mil BTU 15,00
Contractor Name /96solwM y)10.50 HP:absorb
1-114 unit 1.1.75 mil BTU 2_2.50
Prior to permit Moping AddressSS G `10)>50HP,absorb unit
laewnae,a copy J /, ]1.75 and BTU 31.50
of all licenses cnyrstNa rip 11)Air handling unit to 10,000 CFM
are required If ��301 rj[-,�,q _ 4.50
expied in COT Oregon Consr Coni Board Lk M Cxy Dai 12)Air handling unh 10,000 CFM+
database Fyi -y9 _ 7.50
Architect Nara 13)Non portable evaporate cooler
_ a.50
or Maiing AdMeas 14)Vent fan connected to a single duct 300
15)Ventilation system not included In
Engineer cnvIstaie GipPhone _ appliance permit 4.50
16)Hood served by mechanical lzhgust
_ _ 4.50
Describe work to be done+-'-- 17►Domestic incinerators
New O Repair O Replace with like kind Yes O No O - 7'50
ResidenUeA Commercial O 18)Commercial or industrial type incinerator 30.00
i —
AddRbnai informstion or description of wort: _ 1 g)Repair units
4/G - - - 4.50
3 -
i �1 tot wood stove
4;50
i 21)Clothes dryer,etc
4.50
rype of fue ollU natural gas O LPG O eled 22)Other units
4 5U
I hereby acknowledge that i have brad ttua application,that the inlortnatbn 23)On piping one to lour outlets
00
gfven Is cord.that I am the owner or authorized agent of 2
the ower,that piens submitted are in compliance with Oregon Stele laws 24)More Ilion 4•per outlet(each) .50
9101rature of Owner/Agent Date
Minimum Permit Fee$25.00 _ _ SUBTOTAL
IM - 5%SURCHARGE d�
Contact Person Name! Phone PLAN RE EW 25%OF SU.STOTAL
(-ro 3J Required for ALL commercial permets only
TOTAL
�'i1,� /�.�.,.Sia/fit'•-tom�o�Lf__ _— -- a�°::-�-=;•.
'State Boiler Cerliflcation required \
"Residential A!C requires she plan showing placement of unk
I%mechperm dor. rev 07/20!98
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
pBLIP Date Requested �' c�Ci 0 —AMM _� BLD A-----
7 / . (� Sic, - -
Location �r �� ..�i�1�1 �d?Z.-' Suite //�� / MEC
Contact Person t - Ph ��� �� �%C I& PLM
Contractor )lel _ PhSWR
BUILDING_ TenanVOwner ELC
Retaining Wall ELR
Footing Access:
Fr ���� j/rit
Foundation FPS
Ftg Drain SGN
Crawl Drain inspection Notes:
Slab _ _ _ SIT
Post&Beam -' -
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ___
Fire Alarm
Susp'd Ceiling
Roof /��---
Final
PASS PART FAIL ------------- ----. -.-
PLUMBING
Post&Beam ----
Under Slab ---
Top Out - - -- ------ ------___
Water Service
Sanitary Sewer -v-�--- -�-- - - - —
Rain Drains
Final -----___.___------_--- .--- _
PASS PART FAIL _ _ --
MECHANICAL
Post&Beane ------ -- -- ----- - ----
Rough In
Gas Line — -- -- - -- — --
Smoke Dampers
Final
PASS PART FAIL
ELECTRICA -------------_—__--- _-___
Service
Rough In
UG/Slab
Low Voltage -
Fire Alarm
PART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ J Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ J Please call fo reinspection RE:
Fire Supply Line [ J Unable to inspect-no access
ADA
Approach/Sidewalk Date 24 `/1 Inspector _ '�-+' � Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour lnsN^ction Linc: 639-4175 Business Phone: 6394171
Date Requested: I .�� l I _- A. I'.M. _ MST: _
Location: a- �i �� . ;(r l..:L-L,tj� �L�� ---- BLIP:
Tenant:— Suite: _13ldg MEC:
Contractor: c 1 Phone: _ PLM: ) Z�
Oweer: .�'C Phone: ELC: -- .
SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/I3eam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storni Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spk!r/Alm Crawl/Found Dr I feat Pump Low Volt
Approved Approved v Approved
Appr/Sdwlk Not Approved ed Not Approved No Not Approved
FINAL F'1lVAt;, FINAL _UNA,L, FINAL
— ------ ---- --
ZP
0 Call for reins n Reinspection fee of S_ required.before next'nspection O Unable to vispect
Inspector—,— — — _-- Date: �� page _of�,-
CITY OF TIGARD PLUMBING PFRMYT
DEVELOPMENT SERVICES PERMIT #. . . . . . . :
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 0441.8/97
PARCEL.: 2SI04BC-04900
c;ITE ADDRESS. . . : 12764 SW ASCENSION DR ZONING: R-7 PD
SUBDIVISION. . . . : HILLSHIRE WOODS
LOT' 60 -JURISDICTION:
BLOCK. . . . . . . . . . . ---------------------------
-------------------------------------------------------
("I—ASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 3
CY GRP. . : Fl.-OOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
oCCUPAN0 CATCH BASTNS. . . . . . . . 0
0 WATER HEATERS. . . . . :STORKS. . . . . . . . :
FIXTURES----__._____-- 1_.AUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . 0 0
- : :
SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . 0 GREASE TRAPS. . . - .
.
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . ' 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 171
WATER CLOSETS. : 0 WATER LINF (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Tnstallinq residential backflow prevention vention device
-------------------------------- FEES ---------------
Owner- type amotint by date recpt
RICK ROORDA PRMT $ 15. 00 B 04/1.8/97 97-293461
t2764 SW ASCENSION DR 5PC1 $ 0. 79 B 04/18/97 97-2934AI
TIGARD OR 97224
Phone #:
Contractor--_---------___.____
--------------
OWNER
r------ ---------------------------
OWNER
------------------------------------ -
$ 15. 75 TOTP.,.
Phone
Reg #. . : 99999 ------- REOUTREr INSPECTIONS
This permit is isvik subject to the regulations contained in the RP/Backflow Prev
Tigard Municioal Code, State of Ore. Speci-I
.t, Loes and all other Final inspection
applicable lasts. All way+ still be done in accordance with
approved plans, This nervi- will pynirr if world is not started
within jej days of issuance, or if oork is suspended far @are
than 180 days.
Permittee S i]In a t r e
Call for inspection 639-4175
'!TY OF TIGARD Plumbing Application Recd By• 6
'125 SWHALL BLVD. Commercial and Residential Date Recd— -� -c
GARD, OR 97223 Date to P E.
Date to DST
=03) 639-4171
'ermit aO 1� -1
Print or Type Related SWR 0
Incomplete or illegible applications will not be accepted called _
-- - —
Name of DevelopmenUPrtFIXTURES (Individual) QTY PRICE AMT
,lect _
Sink 9A0
Job > 1 G,,C � Lavaton 900
Address Street Address Suite
�- � Tub or rubiShower Comb 9.00
Si
Bldg 0 City/StateF �/t:-7 Zip Shower Only 110
— (f i0C, Z-)!_ Water Closet 9.00
Name 1172 —
Dishwasher 900
I G.. —
Owner Mailing Address Suite Garbage Disposal 900
,�C VY11 Washmy MAchme 900
City/State— Zip Phone Floor Drain 2- 9.00
Name 4- 900
--
Occupant Mailing Address Suite Water Healer 9 U0
Laundry Room Tray 900
CityiState Zip `Phone Urinal 900
Name
-- 57,-1'��� Other Fixtures!Sper.,ty) 9.00
----- ---.
o u- — 900
Contractor Mailing Address ��ude 9.00
L 71"y nA--i.) .4,sc�15 nett — — 900 --
Prior to issuance City/State ' Zip Phone — — 900
applicant must
rd C. , - - -L 7 — 9,00
provide all uraon Const Cont Board Lic 0 Exp.Date _
contractors 900
license Plumbing Lic.s Exp Date Sewer-tsl 100 3000
information Sewer-each additional 1002500
for COT COT Business Tax or Metro 0 Exp.Date Water Service- 1st 100' 3000
database) _— —
Name Water Service•each additional 200' 2500
Architect Storm&Rain Dram- 1st 100' 3000
Or Mailing Address
Storm&Rain Drain-each adoitional 100' 2500
Sude _
Mobile Home Space 2500
Engineer CitylState Zip Phone Commercial Back Flow Prevention Device or Anil- 2500
Pollution Device
"�escnbe work New O Addition O Alterati Repair D Residential Backflow Prevention Device' 1500
)De done Residential O Nonresidential Any Trap or Waste Not Connected to a Fixture 900
.1edinonal description of work Catch Basin 900 --j
Insp of Existing Plumbing 40.00
77 per/hr
__.1 /'✓'!'� 5I� � F�'�` ;peuaily Requested InspecLons — 40.00
sting use of
,ding or property_ 6 ��� _ 3000
Ram Dram,single family dwelling 30,00
'•oposed use of Greases a Traps 900
')wilding or property_ —__— --. QUANTITY TOTAL
:re lou capping. moving or replacing any fixtijres) Yes C, No Ou Isorr'etm or nser a agram,s-equ,red t Quanity Totat s >9
(It yes see back of form) ___ 'SUBTOTAL IS G�
I hereby acknowledge that I have read this application,that the ieformation ----
given is correct,that I am the owner or authorized agent of the owner and 5% SURCHARGE
'hat plans submitted are in compliance with Oregon Stale Laws
Signature of O,ynai'VAgent — -Date — PLAN REVIEW 25% ^F SUBTOTAL
--eq,j,red onty.f 5r-.,re Qty total s_3 -- i
� TOTAL I, 7
Contact Person Narr e — Phone
'Minimum permit fee,s 525- 5'6 surcharge.except Residential Backflow
Prevention Device,which is S15 • 5%surcharge
I: plmapp.duc 12 96 (dst)
PLEA,FC E AS APPROPRIATE_Tn1r! OJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
_
Dishwasher
Garbage Disposal
Washing Machine__
Floor Drain 2"
3"
Water Heater
Laun_d_ry_—Room Tray_ — .
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I: plmapp.doc 12/96 (dst)
' ITY OF
DEVELr PrAIENT SERVICES ELECTRICAL PERMIT
.r...,
- 131.:5 SW,lall Blvd. 3rd,OR 97223 (503)639.4171 RESTRICTED ENERGY
PERMIT #: El_R97-01.2
DATE ISSUED: 04/18/97
PARCEL: 2SI04BC--04900
vT'I'l AT:')RE9S. . . : 127,=.4 SW fl3CENSION DR
r.1'; V TSP' iN. . . . :HILLSHI RE WOODS ZUNINr:R-7 RD
. . . . . : LOT. . . . . . . . . . . . . ..60 .7URISDICTN:
Irte: , r ect f'+ pt , 01' ` it;stalling residential backflow prevention device
A. .. :�a IDENT 1 ' -- __-- .._-R.. COMMERCIAL----------------- ------------- --
' "! DR S "EREO. . . AUDIO (1 STEREO. . : INTERCOM & PAGING. . :
f� ',tCiL'1R ALH�14. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. .
CiARAGE OPENE1(. . . . : CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . :
HVAC. . . . . . . . . . . . . : DA"iA/TELE COMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR L_ANDSr I.. ITF:
OTHER: IRRIGATION: :X HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :
INSTRUMENTATION. : OTHER. . :
TOTAL. # OF SYE TEM S: 0
Owner: --__-_----------- ------- --
--_________-__------•------ FEES ----------------
RICK ROORDA type amot.111t by date recpt
t2764 SW ASCENSION UR PRMT $ 40. 00 B 04/18/97 97-293484
TIGARD 0'R 97224 5PCT 4 c":. 00 B 04/1.A/97 97-2934A
Phone #: 579-1857
contract or:
OWNER $ 42. 00 TOTAL.
--- - -- RFQU I RED INSPECTIONS
- -
-_ E 1 ect' 1 Service
Phone #: Elect' 1 Final
Reg #. . : 999
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other per-mi.tee Sigrati.tre
applicable laws. All work will be done in accordance with
aporoved plans. This permit will expire if work is not started
within 190 days of issuance, or if work is suspended for more
than 180 days. I s s�a e d B y
-------_•-_-_._______.___-_---OWNER INSTALLATION ONLY----- ------------------ --_-- -
ThP installation is being made on property I own -,-shish �.s not intender] for'
:,ale, lease, Lir rens. - DATE: �
OWNER' S S'r;NATUnE: --
----CONTRACTOR INSTALLrTION ONLY------------------------- -
G T SNATURE OF SUPR. FLEC' N: _ . . n^TE:
T r_FNSE NO,
Call for inspection 639-4175
Rec'
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Dat d byi _t
13125 SW HALL BLVD PRINT OR TYPE
TIGARD OR 97223 Permit#:J-�LL.J ,t� z z
V- 503-639-4171 X304
F - 5Q3-6134-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
11VILL NOT BE ACCEPTED
lame of�D Development Project TYPE OF WORK INVOLVED -RESIDENTIAL _
Restricted Energy Foe....................................... E40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste# Check Type of Work Involved
ADDRESS 11-) 4 v r--�
City/State Zip Phone t LJ Audio and Stereo Systems
-
i ''rte7��� L �
( r, -
N ie Burglar Alarm
i2Garage Door Opener'
OWNER Mailing Address C
Heating,Ventilation and Air Conditioning System'
City/State - Zip � Phone#
vacuum Systems'
Name �,,
z Other. �_ /re lJ l h�rG N ! —
CONTRACTOR Mailing Address TYPE OF WORK INVOLVED -COMMERCIAL
TFee for each system................................... .. $40.00
(Prior to issuance a City/State Zip Phone# .........
(SEE OAR 918.260-260)
copy of all licenses Exp Cate
are required if Oregon Contr Brd Lic # Check Type of Work Involved
expired in C O T Exp Date
data base) Electrical—Co ntr 1 # Audio and Stereo Systems
COT or Metro Lic # Exp:D.te
Boiler Controls
owner s Name Clock Systems
C
OWNER - Mailing Address r,
lJ Cala Telecommunication Installation
APPLICANT 67 Lam-City-tate Z.ip Phone# f-1 Fire Alarm Installation
This permit is issued under OAE 918-320-370 1 his applicant agrees to lrJ� HVAC
make only restricted energy installations(100 vnit amps or less)under this I_
permit and to do the following C7 Instrumentation
1 Only use electrcal licensed persons to do installations where required Interrom and Paging Systems
Certain re!�idential and other transactions are exempt from licensing
These have asterisks(') All others need licensing, Landscape Irrigation Control' - GtjF`>
2 Call for inspections when installation under this permit are ready for L
inspection at 503.639-4175; L Medical
3 Purchase separate permits for all installations that are not ready for an Nurse Calls
inspection when the inspector is out to inspect under this permit.
Outdoor Landscape Lighting'
4 Assume responsibility for assuring that cit corrections required by the
inspector are done, and, LJ Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the Other -
corrections are completed
Permits are non-transferable and non-refunHable and expire if work is not Numoer of Systems
started within 160 days of issuance or if work is suspended for 180 days
The person Signing for this permit must be the applicant or a person
No licenses are required Licenses are required for ail other installations
authorized to bind the applicant --
. FEES:
ENTER FEES s
SignatureC ^ —
5'%SURCHARGE(.05 X TOTAL ABOVE) :._
7U1AL
: 1-12 00
_ --
Authority if other than Applicant --
i vesele dor.12/96
CITY OF TIGARD CERTIFICATE OF*
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY
13125 SW Hall Blvd.Tigard,Orogon 97223e8199 (503)639-4171 PERMIT #. . . . . . . i MST'95
DATE ItS'SAJED: Or)/06/96
PARCEL.. : 29,1001(" V*4060
1.T E ADDHL.S5. 12764 SW ASLENG 1014 DR
`31JBDI V IS 1 ON. . . . : HILA_ 411FIC WOODS ZONING: R 7 1:11)
BLOCK. . . . . . . . . . : L.01 . . . . . . . . . . . . . .60
SS OF WORV. .-NEW
TYPE OF USE. . . 15F
I)('XUPANCY GRP.
OUC-UPANCY
,marks :marks A
141 NDWOOD HOMES
1 1,q76 SW SENCHVIEW TERFOICE
+•,iWD OR 17224
#1 590-470121
1.11 NDWOOD HOMES
iW76 SW BENCHVILW TERRACE
-
TWORD OR 9722di
Phune #c 590- 4700
Reg C . , 05011A,
JjjjS Certificate grants OCCUPWILY of the obovp refcArenc 41 building cir portion
thereof and ronfirms that the building has been insfE)tctp for compliance with
r:"p�
the aa
tp of Oregon Spec Codes for the W.�+qpl o c: q) )cy, and osp uncler
which the referenced pet-mit was issued.
/*Di
-DIN INSPE R S I ril L. FICIAL_
P050 IN CON5PICUOLIE; PLACE
.J .
I--7 #. . . . . . . MST95 -•0449
CITY OF TI GAR® DATE ISSUED: 01/17/96
COMMUNITY DEVELOPMENT DEPARTMENT F,ARCEI_: '�'104E{C -HWOGIT
13126 SW Hall Blvd.Tigard,Oregon 9722398199 (503)630-4171
A-1BO I V I S I C)N. . . . a H 1 L.L-SH I RF=: 4JGGU a 7 Clly I N[i; R-7 FAD
+I-.UCK. . . . . . . . . . . L.fJT. . . . . . I . . . . . . ..60
iemarksl
--------------------.-------------------------------------- BUILDING --------------------------------------------------------__..
;TISStE: STORIES...,...: 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS—- RFOUIPED----------
"LASS OF WORK.:NEW AE1%'T........ : 26 FIRST....: 931 sf GARAGE.....: 440 sf LEFT..........: 6 SMOKE DETECTRS:
r FRONT.........: c0 PPAKING SPACES:
TYG� OF 'JSE...:SF FLOOR DAO....: 4A SECOND...: 13C sf
''IPE OF CONST.:;NN DWELLING UNITS: 1 FINBS14ENT: 0 sf RIGHT.........: 12
iCCUPANCY GRR.:R3 DORM: BATH: 3 TOTFU----- . 0 sf VAI-UE..4: 114689 REpR.......,... :�5
---------------------------------------------------
PLUMBING ------------------------------------------------------------
-----------
SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: 0 RAIN nPAIN ft: 0 TRAPS......... '
LAVATORIES....: 4 DI944SHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS.. :
EJB/SHOWERS... : E GARBAGE DISP..: 1 WATER hEATERS.: 1 WATER LINE ft: 0 BCKFLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIXTURES: 0
-- MErHANICAL ----- ----------------------------------------------------------
FUEL TYPES----------- FURN H INK .. : i BOIL/CMP ( 3HP: 0 VENT FANS.....1 4 CLOTHFS DRYERS: 1
!GAS! / / r1JRN )-IM ..: 0 UNIT HEATERS..: 0 FOODS.,.......: 1 OTHER UNITS...I 1
MAX INP. : 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: l
-------------------.--------------------------•---------------- ELECTRICAL - - --- ---- ---- ----- ----------- -------- ---- --.....__...
--PESIDENTIAL UNIT-- ---SERVICE/FEEDER---- --TEMP SRVCIFEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 5F DR ESS. 1 A - '00 amp..: 0 0 - ;00 amp..: 0 WISVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 945F.: 2 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUIT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY. : 0 401 - (,00 8110..: 0 401 - 600 ame.. : 0 EA ADDL BP CIR: 0 SIGNAL./PANEL...: 0 IN PLANT......: P
MW NM/SVC/FDR: 0 601 - 1000 ago.: 0 601*amps-1000 v: 0 MINOR LABEL. -10: 0
1000+ alo/volt.: 0 ------------—--•------ ----- --- - PLAN RF:tEW SECTION ---------__--_---------_--------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)-225 A. ) 600 V NOMINAL: CLS AREAISPC OCC:
------------------------- ELECTRICAL - RESTRICTED ENERGY ------------------------------------------------•-----
A. 8F RESIDENTIAL--------------------------- B. COMMERCIAL-----------------------------------------------------------------------j-------
AUDIO b STEREO. : VACUUM SYSTEM..: AUDIO 6 STEREO.: FIPF ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT;
BURGLAR ALARM..: OTH: X B0i1.ER.........: HVAC...........: LANDSCAPF/TRRIG: PROTECTIVE. SIGNL:
GARAGE OPENER..: CLOCK........... INSTRUMENTATION: MEDICAL........: OTHRI ::
HVAC. DATA/TELE COMM.: NURSE CALLS....: TOTAL R SYSTEMS: 0
Owner: -------------Contractor: ----------------------------- TOTAL FEES:f 3778.27
WINDWOOD-HOMES WINDWOOD HOMES
14076 SW roCHVIEW TERRACE 14076 SW BENCHVIEW TERRACE
ARD OR 97224 TIGARD OR 97224
ne t: 590-4780 Phone 0: 590-4700
Reg N..: 05019E
s oermlt is issued subject to the regulations contained in the Tigard Municioal Code, Stato of Ope. Soecialty Codes and all other
,.Aicable iaws. All Mork will be don._ in accordance with avor'oved clans. This permit will expire if work is not started within 180
Avg of issuance, or if work is susoended for more than 180 days.
REQUIRED INSPECTIONS ------------ - --..-__- __-. -
:oting Insp PLM/Underfloor Framing Insp Gvo Board Insp Electrical Final
nidation Insp Mechanical Ingo Lcw Valtaoe Rain drain Insp Mechanical Final
st/Beam Struct Plumb Too Out Firpolace Insp Watpr Line Into Plumb Final
st/Beal Mecran Electrical Servi Gas line Ipso Water Service In Building riral
awl Drain Elec+.rical Rouch s'41#tl Aoor1Sdwlk Into Erns' n Control
M �
r-m i is t 4?e `3 i ca n at �v� y s1_1 E l.i Sy 4--••
Call for inspection 639--417`G
I.
P'I_RMIT
CITY OF TIGARD E;ArMI 1 a3SU D: . 01/17/965 014
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223@8199 (503)839-4171 F''F•1RCE.L: 2S 10r4F1C--HW0(,0
!USD I V 16 1 ON. . . . : H I LL SM I RE WOODS 70N I NC: FR-7 F'D
NL..00K. . . . .. . . . . . . L.-OT. . . . . . . . . . . . . ..60
TENANT NAML . . . . .
J.J8A NO. . . . . . . . . . . FIXTURE UNITS. . . : 0
CLASS OF WORIi. . . :14EW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF NU I L D I NGS: 1
TNSTAI_.L TYpr. . . . :SUSWR IMF,ERV SURFACE: 0 s f
Remarks :
Owns / ____-___..---._...._...--- __-- FEE,
III I1\11)W A ;1011L5 type A M0Unt by c.1ate recpt
14076 '•W BENCHVIEW TERRACE F'RMT $ 2200. 00 P 01/17/96 96-274' _+
INSP $ 315. 00 S 01/17/96 '?G--274()()"
TICARD 0R '37`1:4
1-.,hone #: 590--4700
antr-actor:
:ONTRACTOR NOT ON r1LF
!''Bone #: 35. 00 TOTAL
RPy #. .
-- --- - REOU I RED I NSF'ECT I ONS -
'his Applicant agrees to comply with all the rules and regulations Sewer In-,pect i.oT
if the Unified Sewage Agency. The permit expires IN days from
the date issued. The total aeount paid will be forfeited if the
Gerrit eroires. The Agency does not guarantee the accuracv of the
gide sewer laterals. if the sewer is not located at the measurement
liven. the installer shall prosoect 3 feet in all directions from
the distance given. If not so lorated. the installer shall ourchase
a "Tao and Side Sewer" Permit and the Agency will install a lateral.
='ermittee � t' _. .. .. _...
+ +ext l lr ,.
T 5 st i.1 e d D y :..� 1 'LVl�„ Q�
Call for inspection - 639--4175
.l t f'S •�
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: X�&!qs4
Subdivision:
Alk-4-'r r �e,►rij.� Lot# 41. G Office Use Only
/ l� ���, Contact Date I / Initials
Valuation: 'z l`,( _- Result
Planck/Rec #New Construction Only: (Square Footage) Permit #
House: , _ Garage. — Reissue of
Map & TL #. ?S161I/C
Zone
�-��- Plat #
Corner Lot?C_%-> N Flag Lot? Y N
Owner: 6�0,4`UApprovals Required
Q C1Q-`4) 1*/443 —
At./
/ Planning Setbacks Solar
Address: /YU 2r. S c%cam _ Engineering
Other
�G Items Required
Phone: j, 5"zJ:3 ) 0 -�`!O X17
Subcontractors _T _
Contractor: _ Sca/II Y — Truss Details
S�nVc Other
Address
Notes ------ ,--- ----_--
Phone ( ) SU P--r ---- ----- —
Contractor's License #
( ttach copy of c rrent Ofegon license)
Contact Named �u_-___ -
Contact Phone'
Subcontractors: Architect/Engineer: 4�► ���lcSY�-�+ __
Plumbing _ V l/n-S /U 6.p� i/ 311`t(c Address _ /I ti lei
Mechanical: 19/��1 ��5 7 /� 0-c 97-zj 9
(attach copy of current OR Contractor's Lice se) r
14 i ;X9Phone: ( S � ) •�f�, �-�S 9��/
JOB DESCRIPTION:
� i ____ - ( ► =;roc%• Yeo 0
A_" nat i ant SI - -----
p g�ure Applicant Phone number
Received by: �.~� >`t� e,�/` Date Received ��S
H j"M1d.nvw6W
1
s
Permit # Account Description Amount Amt. Pd. Bal. Due
UV y Bldg. Permit (BUILD) L/ �Z-
Plumb. Permit (PLUMB) 2.L
Mech. Permit (MECH) q ,3,fV
State Tax (TAX) U. (-U
Bldg:
Plumb: Z
Mech: . /
Plan Check (PLANCK)
Bldg: a b'
Plumb:
Mech:
114 i d f l Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) 3s' p-1
Parks Dev Charge (PKSDC) 50v SOS C?Z'
Residential TiF (TIF-R) ��� _ �l-7 U ,
Mass Transit TIF (TIF-MT) ' L, Zv , (7t
Commercial TIF (TIF-C) _Y
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL) OT)
Water Quantity (WQUANT) / vti' _7)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT) G •� _ LIZ)
��. Erosion Planck/USA (ERPLAN) w"-�Uo.�t
Erosion PlanckiCOT (EROSN)
l "
1} `�� TOTALS: (t%® :2 I'T _ '3 2 , .
wQv�s ter^/ (9 ls�e f5x , qj �ft
33
Sw f2N 5.r
1
f
lf�O.r7rd ��iR r'
i y
If t-
�
--L t
III .Q �LLLI.____
Iv U
irem
�
r---^ CITY OF TIGARU BUILDINGINSPECTION NOTICEv-
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL.
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech, Shear/Sheath Framing -Me
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech Rough-in Gyp. Bd, Id
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: �� A.M. M. _ Entry:
Address:
Te t: _ Ste:_ MST:
I ` BLIP:
on Own: U `�L ��.`� MEC:- -.-
PLM: ---
FLC
THE FOLLOWI COR CTIONS ARE REQUIRED ELR:
Inspector:ctor. — - — Date:
—APPROVED _--DISAPPROVED/CALL FOR REINSP. CF CO
a
r
I