InitiallyGood � 1
\ V • 1 a / \
l
INN
\0 _
4oMX-
�
J
\ 1
� V ♦ r� rp ! e _,
\
\• ti � ( M fel� `\ ` lV 1
LLQ s 1
its, ern a1
JK
1 D 0
( a1
1
1 CJI
x n
1A > /
/ 4
OF
9 yj
ict
..' nw3't....w'W.�rixvAl•IkL:.'.'��,4ro-. ;. ,:,„.m„ ,...K,...:,.:,....�... �',(! „�'�T ��1�� �. 1� r"�M'f4.!
NOTICE: IF THE PRINT OR TYPE ON ANY r�IIrlI I I1 IIIIIII �I III I I IIII IlI+I I►�►III►I��tlrlr�r IIIIIIt IIIb 11111111 1111111 IIIIfIt VIII t tllllt llltllll Iltitll111111111 (Jil(Ill
-f(Ilf(I ((f�lT 1(11111 SII IIS � I�I �
� L 1- _—_4 I I I I 6 ! L I I I IMAGE IS NOT AS CLEAR AS THIS NOTICE, ' ` $ lO 11 ( 1�L_ � -
IT IS DUE TO THE QUALITY F _ � �
O THE IIII IIIIIIIII IIII � I
. No 38ORIGINAL DOCUMENT
ll71111311azi
£ 8 _ iZ 0G9
llll�ll� III�II1II8Illilllll I� i
r
l �
A
p
A
l
l
i
t
P
13851 Sit ALPINE VIEW CT
f��I�►`� CITY OF TIGARD BUILDING INSPECTICN DIVISION MST _--
"� 24-Hour Inspection Line: 639-4175 Business Line: 639-4171
I� BUP
lDate Requested AM PM _ BLD
Location �� / Suite MEC '7
Contact Person Ph fLM� / G�
Contractor _ Ph SWR
BUILDING Tenant/Owner 'SLC Y
Retaining Wall —__ P-LR/
Footing
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH SGN
Crawl Drain NO INSPE(TION(s) IN FILE
Slab - SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing - ---_-_-- -------�._ __��— ------____--
Insulation
Drywall Nailing - -_�. .- - �_--------- --- -- __-�_
Firewall
Fire Sprinkler _.-.....
------------ --_-- -- ----..._._—
Fire Alarm
Susp'd Ceiling ----- - _- --- -- ---- --------
Roof
Misc: _ _ - .-.- --- -- -- - --- ----- ------— - ------
Final
PASS PART FAIL - - - - - - --- ---------L.UMEJNGG
os,&Beam
Under Slab
Top Out V
Water Service
Raillery na r � �j
Rain Drains s �'" 2-+/41
17n al'
SS PART FAIL
MECHANICAL
Post&Beam ------ - _ -- -- -- ------- _—
Rough In
Gas Line -- ---
Smoke Dampers
Final ---
PAS PART FAIL
CT AL __ ---- --- — -
Service --_-_- - -_-.. --
Rough In _
UG/Slab _-
Low Voltage,
Fire Alarm —
inal
ASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm uraii [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: [ ]Unable to Inspect-no access
ADA
Approach/Sidewalk Date InspectorExt
Other — - — __ - -- ---
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD PERMIT
DEVELOPMENT SERVICES PLUMBING
PERMIT #. . . . . . . : PI_M97-0186
13125 SW Hall Blvd„ Tigard,OR y7223 (503)639.4171 DATE ISSUED: 05/23/97
PARCEL: 12IS 109BA--02700
r�1 TE ADDRESS. . . : 13851 SW ALPINE VIEW CT
SUBDIVISION. . . . : HTLLSHIRE SUMMIT ZONING: R-7 PD
BLOC:K. . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG - -- ---
CLASS OF-WORK.. :ADD- -� --GARBAGE DISPOSALS. : T 0- MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFL.OW PREVNTRS. . : I
OCCUPANCY GRP. . :H2. FLOOR DRAINS. . . . . . : 0 TRAP'S. . . . . . . . . . . . .
STORIF_S. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS 0 GREASE "TRAPS. . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . :
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
1�15HWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Ilpmarks : INSTL 1 RE.SIDENTAIL BACKFLOW PREVE=NTION DEVICE
- FEES ____------- - ----_
IERULLI type amoi_tnt by date recpt
13851 SW ALPINE VIEW PRMT f 25. 00 TAT 05/23/97 97-259051
TIGARD OR 97223 5PCT $ 1. 25 TAT 05/23/97 97--295051.
Phone #:
Contract or-----~-•-------__"_-------------------
CEDAR LANDSCAPE
14:375 SW P" I RICIA AVE
IHILLSBORO Of"t 97123 ---- - -
----------
r1h on e #: 50,33-628-3411 f 26. 25 TOTAL
Reg it. . : 000058 - - ---- -____--_ .
- REQUIRED INSPECTIONS
This permit is issued subjert to the regulations contained in the Misc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other RP/Backflow Pr-ev
applicable laws. All work will be done in accordancE with Final Inspect ion _
approved plans. This permit will expire if work is not started --
within IN days of issuance, or if work is suspended for morethan 190 days. --- --- —T
i ot-mittee Si gnat1_ire :
I ,cue d R y • --__ _��—_
Call for inspection - 639--4175
J
CITY OF TIGARD Plumbing Application Recd By
Date Recd
13125 SW HALL BLVD. Commercial and Residential Date to P E.
TIGARD, OR 97223 Date to DST
(503) 639-4171 Permit 0
Print or Type Related SWR# _
Incomplete or illegible applications will not be accepted Called
-- Name of Development/ProjectFIXTURES (Individual) QTY PRICE AMT
Sink 9.00
Job (W- /C — Lavatory 9.00
Address Street Address Suite
Tub or Tub/Shower Comb. 9.00
1 s _/ Shu A inti:
Bldg 0 City/State lip Shower['oly 9.00
Wdter Closet 9.00
Name Dishwasher 900
Garbage Disposal 9.00
Owner Mailing Address Suite
— —
Washing Machine 9.00
City/State Zip Phone Floor Drain 2' 9.00
3• 9.00
Name V 900
Malin Address Suite
laundry
Heater 9.00
Occupant 9
laundry Room Tray 9.00
City/State Zip
Phone Urinal 9.00
Other Fixtures(Specify) 9.00
Name 9.00
ClDr?� n)JSC'sC iAX 900
Contractor Mailing Address Sude — _
1 .S tu.i rR�clA i;Ie 9 00
City/State Zip Phone -- 900
1111s A_,Qe iii- ;0 7/.13 /JN 3-111 -- ---- 9.00
Oregon Const.Cont Board Lic.0 Ftp.Dale — —
9.00
Attach Copy of _ S !?,I J _ (v "q –
Current Plumh,nq Lic.0 Exp.Date Sewer-1 st 100' --- —_ 3000
t-icenses sewer-encn addlllunal 100' .1L 00
Bu
COT siness Tax tr Metro• Exp Date – Water Service- 1st 100' 30.00
Water Service-each addition it 200' 25.00
Name —
Storm&Ram Drain- 1 st 100 3000
Architect _ _ — -
Mailing Address SuiteStorm 8 Ram Dram-each ao�lilional 100' 25 00
Of Mobile Home Space 2500
Engineer �,State_=`P Phone Commercial Back Flow prevention Device or Anh- 25 00
Pollution Device
Residential Sackflow Prevention Device' I 15.00 �S _
Describe work New O Addition O Alteration O Repair O _
to be done Residential O Non-residential O Any Trap or Waste No!Connected to a Fixture 9.00
Additional descnption of work f Catch Basin 9 00
Inv of Fxistmg Plumbing 4000
_ per/hr
—_ — -- Specially Requested Inspections 4000
Ex,stmq use of I ^_ permr
building or property------- Pain Dram,single family dwelling 3000
Proposed use of Grease Traps 900
budding or property_------------ --
QUANTITY TOTAL
Are you napping. .noving or replacing any fixtures? Yes C) NO p Isometric or user diagram s required A Duanrty Total u >9
(If yes see back of form) 'SUBTOTAL ���x
I hereby acknowledge that I have read this application,that the information — 5% SURCHARGE
given,s correct.that!am the owner or authorized agent of the owner.and
that plans submitted are in compliance with Oregon State Laws PLAN REVIEW 25%OF SUBTOTAL
Slgr1ature of Owner/Agent Date Requved onry I rywre ary iota,, >9
IQ
Contact Person Name Phone
•minimum permit fees S25-7%surcharge.except Residential Backflow
/� j 9;j• Prevention')evice.which,s S15- 5%surcharge
,.ldststplmapp doc 8/96
PLEASE
COMPLETE AS APPROPRIATE TO PROJECTi
Fixtures to be lapped, moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
411
Water H,, ater
Laundry_Room Tray
urinal _
Other Fixtures (Specify)
:OMMENTS REGARDING ABOVE:
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL. PERMIT -
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 RESTRICTED ENERGY
PERMIT #: ELR97--0153
DATE ISSUED: 05/23/97
PARCEL: 2S109BA-02700
SITE ADDRESS. . . : 13851 SW ALPINE VIEW CT
SUBDIVISION. . . . :HILLSHIRE SUMMIT ZONING: R-7 PD
BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . ..012 JURISDICTN: TIG
Pro J ect De s c r i pt i on: INSTL 1 IRRIGATION CONTROLLER
1=I. — -----
RESIDENTIAL—_-------- 8. COMMERCIAL--------------------------------- ----
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : I-ANDSCAF'E/IRRIGAT. . :
GARAGE OPENER. . . . . CLOCK. . .. . . . . . . . . . MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE CIMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR L.ANDSC L_T TF :
OTHER: . . HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :
1NSTRIT IENTAT I ON. : OTHER. . : I RRGTN CNT: :
TOTAL # OF SYSTEMS: 0
Owner: __ --- -- FEES -----------------
TERULLI type amoUnt by date recpt
13851. SW ALPINE VIEW PRMT $ 40. 00 TAT 05/23/97 97-295051
r ICARD OR 97223 SPCT $ 2. 00 TAT 05/23/97 97-29505
1.
Phone #:
Contractor: --______--------------------------•-------------------._....
CEDAR LANDSCAPE $ 42. 00 TOTAL_
14375 SW PATRICIA
--------- REQUIRED INSPECTIONS
-----
HILLSBORO OR 971123 Ceiling Cover Elect' l Service
( Phone #: Wall Cover Elect' l Final
Reg #. . : 000058
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t e e S i gnat ttre
applicable lams. All Mork will be done in accordance with
approved plans. This permit will expire if mark is not started
within 180 days of issuance, or if work is suspended for more —•---than 180 days. I s s i-ted By
OWNER INSTALLATION ONLY---------------------------
rheinstallation is being m.-ade on property I own which is not intended for
;ales lease, or rent.
f 1WNF R' 5 )T GNATURE: DATE: _
---CONTRACTOR INSTALLATION ONLY---------------------.- —"
S I GNPTURE OF SUPR. EL.EC' N: DATE:
LICENSE NO:
Call for inspection — 639-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT#
Phone(503) 639-4171
FAX (503)W-7297 DATE ISSUED
TDD No. (503)684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY
PLE4SE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
1.385/ 5W ���or�v� VrEuJ
Addrgss RESIDENTIAL—Restricted Energy Fee . . . . . . . . . 1410.00
-_(�dRv 10 (FOR ALL SYSTEMS)
City State Zip Check Tyne of Work Involved:
PERMITS ARE NONTRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK [� Audio and Stereo Svstems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
/ ❑ Heating,Ventilation and Air Conditioning System*
Contractor C,6'b0 �AN�SCr Type 1,AM►5CA� ❑ Vacuum Systems'
Address 5.40 Arwi64 AGE Other -ro-Meitf rt l .' Cc,AJ-404Ge4
Date 7 _ COMMERCIAL—Fee for each system . . . . . . . . . $40.00
(SEE OAR 918-260-260)
Property Owner _ reR a LL/ Check Type of Work Involved:
Contractor's Board Reg. No. 3`r3'1�3 _ ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone# to•zs' i� /� , ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
u Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medical
This permit Is issued under OAR 918.320.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(too volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
following:
1. Only use electrical licensed persons to do Installations where required.(Certain U Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
asterisksi').All others need Ilcensing).
2. Call for an inspection when all of the installatio 1s under this permit are ready
for Inspection at 503.639.4175.
❑ Number of Systems
3. Purchase separate permits for all Installations that are not ready for Inspection
when the inspector Is out to Inspect under this permit. •No ikemes are required. Licenxs are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done,and
5. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
1 he person signing for this permit must be the applicant-)r a person a. Fnter Fees $ 4�
authorized hind the applicant.
m%
L� b. 5% Surcharge(.05 X total above) $
i
Signature
TOTAL_ $ � a _0V
"
Authority if other than applicant
FNERGAP.CHP
RECEIVED
MAY 2 3 1997
COMMUNITY DFVFIOPMFNT
CERTIFICATE UF
OCCUPANCY
CITY OF TIGARD PERMIT #. . . . . . . : MST95-0098
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 01- /15/915'
IV25 SW Hall Blvd.Tigard,Orogon 97223981[12 (503)639-4171
ADDRESS. . . p 13051 SW ALP1114E VIEW CT PARCEL: 25109SAH5012
lm:(JBD I V I S I ON. . . . t HILLSHIRE SUMMIT' ZONINGeR--7 PD
31-OCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . .012
CLASS OF WOPK. :14EW
r-Y P E 0 F, USE. . . FSF
occuPANCY (3PP. R3
i)(.J.AlPAWCY LOADrr?11� 4
! 1 Ni iN I NAME.. . . .
i�pmavks .. r-,A*m i
jwr)el-: - __-_ -----------
.11L CONSTRUCTION
" t10 T-.)W FIR LOOP
ITGARD OR 9722.3
01unp #: 6C-1 4-7714
: ontr-actov-: - - ----...
;_'HI. CONGTRUCTION INC
'110 SW FIR LOOP
I IGARD OR WsR23
'hone #t 6i-.,4-7714
1'eu "53769
0-lis Cet-tificate certifiez, that the -Sbove cefevenced building or- por-txon
1,hpv�euf ha% been insoacted for, compliance with the Tigat-d Building Code
for, the 9�-oup arid divit;ion of occupenry and use For which the above
-efevenced pei-mit was iSSI.Aed, and occupancy i s het�ehy vp-ant ed.
I N OFF I C I ril
BUILDING INSPECTOR
POST IN CONSPICUOUS PLACE
CITY OF TIGARD IH., IF I� 1 'tMIrII
COMMUNITY DEVELOPMENT DEPARTMENT . . . . . . .
13125 SW Hpill Blvd.Tigard,Oregon 97223.8199 (503)639.4171 DATE ISEUED:
Pf-4 R C E L S 1.0'-.0 B A H!3 14)1.,
V1(.. L i
HILL5HIRE U)MMT1
... . . . . . . . . . .. . . . . . . . .
BUILL)INC-)
Jk DWELT—I NL-.7 U1,4 1-1 '�-. i i . . . . . . . . Ic+ S r
NLW BEDHMS.0 LA AT HE; UPRAGL.. . . . . . . . . . :a 16 S f
t. L) F L'lilu' s
it.
_J I
Y,I-,!- (DF CONE)% :5N F I RSI. . . . : 1515 E F,r*. 6 ft RIGHT. : 10 ft
L3 LUJ4-'(-1HLr 1_0 . 1`RON I f t Rr R. . 0 f t
1U1
l\JBS01[_Jq 1'-3 RLL
I L 10 1 1 41_. I)LILLIURS. : Y
:'w F)St VHLAR.. . . . .
------ PLUMBING
FLOOP DRAIN5. . - - :41
1. P(_K I L.OW PP F-:V N 1 R G. . , I
•1v 41 Ll R 1 L.5. . . . . WAr-ER HEAH:.W'.). : 1 R"Ps. . . . . . . . . . . . . . :0
1 101WI-1 r [JiUNDRY 1 . 1 1-(11-1—H BIAS I N5. . . . . . . :V1
Fi L I-U EJ L 1 h6. . c>LWLR LJ.NL ( ft ) . -.0 L2kErISL (RHPLj. . . . . . . :0
W01EH Lll,'!. tft ' . : 100 U I HEP F I X MIREI-3. . . . . .0
RAIN DRAIN f t VA
t-I-
Mi-C-HANI CAL. FEES3
1 yPF!__) UNIT- I AT :0 t y p -1 1!1()U T I t 1_1y hate T Hc:
VEN (Li -.0 FIF it 1':15111. 00 JDA 0�/lb/9b
i NiL) I .kA 124 J U VLJ\1 i I- AW_i. - 4 'DWH it 1 60. 0 lip .3 L)" 111.5/ I
W < 100K 0 HUOU:_•. . . . . . : I L,Wm 11 100. 00 J110 03/ 15
�N =100K I WUUl.)':_) I UvEb. : '.;I L%Ptl 0 lit j A.;14 W. t7i
L-JUH. 1-URN. . . . :0 ,"LA) DRYERJ. : I BILL 95 B 141 03/03/'.).j ')Lj- -b
:0 3 1)0 J Ll A 0:11
J i..E I k 500. 00 JDA 0--,"1'—,
4—j. 0111 Jul-) O3/ 1,J
I eOJIL I I UN MPL.0 4 .1 1 . -1b J D" 03" I
k:j :;W F I I. ..:.',,-j J LH I
.5. 00 1 On 03/15/9:..'
ill.1 uk, I.. L15 .:00 0
4 4 4� -t I_R 0 (14. 00 1 D0A 0.3 3 15
1.
"j_ ERV - 2,121. 60
_W
Aj
14
is Issuld stjuiect to the regulations centained in tme R E 0 U I R L D 1NGPEC.. F I 01N5
m.^icipal Lode. State of Ore. SpPciaity Codes and all other F oat iny Insp P 1 t.tm b I ci P Ll..A
.Pc.Iret'e laws. Aij work will be done in accordance witm approved F n 1.jndat j OT 1 n S P F-r,aming Insp
This peril* will expire it work is not started within IN Post/beam 1_,f'v-LtCt- Fireplace Ineq?
^f lsj,.;an.ce, Dr if work is suspendea for ave tl-an 180 days. P,ost/BeLqm McGhan Las Linc 111SP,
1't-.Awl Lwaiii 111 S-A I At 10',' IP
m/1-md ri I ab Insp Uyp Doar-O 1.nsp
i.<aiti ot-air) Inc
M P(-.,I I'A n).).r-a I 1 1'.s P W t e I-
Lai 1 f :-. .. i ri s e L t j.o n - 6 9-417`i
_dLWER CONNECTION
P,E RM I T
CITY OF T I OAR P,ERMII #. . . . . . . . SWR95009b
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED:
13125 SW Hall Blvd,Tigard,Oregon 9722306199 (503)639-417, P,F)RCEL:
I 11:: (_4 D j iLW Ll
. . . : J.�btji t)w PL.PINL. LC)NllqC.-.): R-7 �11_)
A)bDiVISION— �- HILLIEMIRL SUMMi'l
.�L.QLK. . . . . . . . . . LOI . . . . . . . . . . . . . 'Z'-1
1NAh4l NAME.. . . . . : FIX-TURF ur4i T S.
A NO. . . . . . . . . : D L. L.1 1\1 b U N 11 3 1
,x.1.1;;'.:; (j�. W 0 13 rl,. . . :NC-_W NO. OF L BUILDINGS: 1
YI-IF UF UC,5E. . . . . :SF IMP'ERV 50RFkCE- -
TYPE. 'f3USWR
t'k S
w ri e r',:
I 1L CONSTRUCTION type ain a -in t b y (J—,t e
F.,RMT 2200. 00 JDA03/15/K.
/13.0 5W FIR LOOP'
I NbP' 3 5. 011, J DI) 01/15/9�)
ilLiHlrKL)
NO] ON 1- 11—L
Ione All 00 10 1 HL
R e U *1. .
RLUU IRE D I NSFIECI I OW
Applicant agrees to comply with all the r,',Ps and regulations bK wwr inspection
the Unified Sewage Agency. The permit expires IN days from
P date issued. The total amount paid wiIi De forfeited if the
-sit expires. The Agency does not guarantee the accuracy of the
I sewer laterals. If the sewer is not located at the measurement
,en, the inctaiier snail prospect 3 feet in all directions from
e distance yIyen- It not so located, the installer shall purchase
iap and Side newer Pei-sit and the Agency will ii--tall a lateral.
..........
Liv
ball for insirteCtiot, 639--4175
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: v I `.—Ti
/� II_
z Office Use Only
Subdivision: A l kkmce �)Ll LtI&—, Lot#
Planck/Rec # _+;1
Valuation: .�
Permit #
Corner Lot? r l N
Reissue of
Flag Lot? Y N
Map & TL #
Owner: �/ /(J l�l�'(„� c i l 10 __ Approvals Required
Address. L. .` !J ' -� c ' ---- Planning �_--
Engineering — ----
Phone: _ — Other
Contractor: Items Required
Address: Subcontractors
Truss Details
Phone Other IS' f FJC 6cmA Ld L iyam_
, r
Contractors License # --S 1 7K�Z tiPOE r `
(attach copy of current Oregon license) D d ;5/6ps
Contact Name & Phone-
Subcontractors: Architect/Engineer:
Plumbing: _f�1 Address
�Mec
PniI - - t .. _
(attach copy of cu rent OR Contractor's License) -
Phone.
� f
JOB DESCRIPTION
r ` '
Applicant Signature & Ohone numb2r
n� I�
Received by'. ^ t+yLy W 1"1,A, Date Received:
Permit # Account Description Amount Amt. Pd. Bal. Due -
/p5t!e,�O !Lr Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech: Z �/
Plan Check (PLANCK)
Bldg: "o , a
Plumb:
Mech: • 1
j--GU Sewer Connection (SWUSA) Z Z L v
Sewer Inspection (SWINSP) � 3J
�i
Parks Dev Charge (PKSDC) -5yy S c J
Residential TIF (TIF-R) h" o
Mass Transit TIF (TIF-MT)CommercialTIFTIF (TIF-C) --
Industrial TIF (TIF-1) --
Instituticnal TIF (TIF-IS)
Office TIF (TIF O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPR.MT) ---3--�'
Erosion Planck/USA (ERPLAN) - V47
Erosion PlancklCOT (EROSN) 0 '.7-V /
TOTALS:
1
DEPARTMENT OF LAND USE 6 TRANSPORTATION
WASHINGTON LAND 155 NORTH FIRST,H LDIVISION
LSBORO ORNT SERVICES
COUNTY, INSPECTION REOUESIS: 503/640-3561/693-4415
NOTICE This permit becomes null and void If the work or construction for width It Is Issued Is i commenced within 180 days Once construction hes started.
the permit becomes null and void If construction is interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or ag.nts in support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this bulldir.g or structure will be compiled with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit d,as not grant authority to access private property or to use easements, I further acknowledge that the use or occupancy of
the structure or building permitted depends upor my tailing for Inspections at various times during the process of construction and the
u,, ing
�spectlon staff v�rifying compliance with the variaf by codes. Use or occupancy of the building or structure permitted prior to app y te
Buildirg Mpartment Is solely at the risk of the applicant and such use or occupancy is revocable until all inspection requirements are satisfied and
approval is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit Is Issued
sr+scifying that the use or occupancy of the biliding or structure Is provisional and revocable until the satisfaction of all inspection requirements
APPIJCANT'S SIGNATURE
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of !_and Use & Transport?:ton
Electrical Inspection e, ^n APPLICATION
155 North First Avenue, #350-1[
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412
Pro ecUPermtt tr
� ,�
PLEASE PRINT Number _-_-- 5�
, nate
. . : through 4. Complete Fee Schedule belov.
1. Location of inst,all's,�ion _ Number of inspections per permit all,)wod
Address� ��L__J`IL rIG Ui�u�G�' Service included: Items Cost(ea.) Sum
wilding A. Residential - per unit
City Suite No,-- -_— --
---,---�--- --------— I000 sq.ft.or less i $11000
Tenant Name Each additional 500 sq ft
(if commercial) _ —_— _ __—_..- or portion thereof _._3 $25.00 —
Tax Lot ,��� Tt/I p Limited Energy _—1-- $25 00 — — 1
a No. Each Marut'd Home or Modular
Dwelling Service or Feeder $68 OC _ ---
Thomas Wisp 00 Page- _Page:_ Section-_.___
Direction _CL -- - B. Services or Feeders
Installation,alterations or relocation
200 amps or less _ $60.00 .--
Commercial Residential 201 amps to 400 amps $80.00 _ _ .-
401 amps to 600 amps _— $120.00
2a. Contractor instal/ tion on l ; ' 601 amps to 1000 amps $180.00 -- — --
Over 1000 amps or volts $340.00
Electrical Contrac or - Reconnect only -- $5000 ----- -- .
Addre �l
Date�_ Job Npmber 14 14 u i 2- C. Temporary Services or Feeders
Property Owne. _. LCt�Std-rKC i7 Inatallet�.,n,alteration or relocation
Contractor's License No. 3V- _ 200 amps or less $50.00
Contractor's Board Reg. No. 201 amps to 400 amps $75.00 --
401 amps to 600 amps __ $100.00 _
Over 600 amps to 1000 volts see"B"above
Signature of Su r. Elec'n .
License No,_M`�_.S Ph ne At-, C'2_ D. Branch Circuits
510 7 S',3 New,alteration or extension per panel
2b. For owner installations: F19X 9.2 9- :19 5",3 a) The fee for branch circuits with
purche e7 or service or feeder lee.
Print War's— ado Phone No. Each branch circuit $5.00
h) The fee for branch circuits without
purchase of service or feeder fee.
First branch circult $35.00 2
b State Zip Each add'nl branch circuit $5.00 2
E. Miscellaneous (Service or Feed^r not included
The installation is being made on property I own Each pump or irrigation circle $40.00
which is not intended for sale, lease or rant. Each sign or outline lighting $40.00
Signal circuit(s)or a limited
Owner's Signature ____- --- energy panel,alteration
or extension $40.00 —_--_
F. Each additional inspection over the allowable
In any of the above
3. Plan Review section (if required) Per inspection $35 00
Please check appropriate hem and enter fee In section 58 Per hour __ $55.00In Plant $55.00
_4 or more residential units in one structure
_Service over 800 amps; feeder 800 amps or more 5. Fees
_System over 600 volts nominal A. Enter total of above fees
Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
5ubn11t 2 sets of plans with application where an/ of the Plan Review If re fired (Section 3) $
above apply. Not required for temporary construction Subtotal $ --
services $
Less Bulk Label Fee — —_--
Balance Due $
For inspections call This permit becomes null and void if the worts authorized by the peimn is not commenced
640-3561 or 693-4416 within ISO days from date of Issuance of such permit or It the work authorized is
suspended or abandoned at any time after work Is commenced for a period of ISO days.
24-hour recorder, one working day in advance of need Electriealpermits are non-refundable and non-transferobfe
Asa
J
SEE 35MM
ROLL# 22
FOR
LARGE
DOCUI�✓IE1� T
CITY OF TIGARD BUILDING INSPECTION NOTICE } )
Inspection Line (Rec-O-Phone). 6394175 B-isiness Phone: 639-4171 U
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec, Rough-in FINAL: (}
Post/Beam Mech. San. Sewer Gas Line fd) `/•
Plbg. Underfloor Rain Drain Framing .
Alaim Water Line Insulation
Underflr. Insul. Shear Wall Gyp. Bd �'I• Elect.
Date Requested- '/
`x.� Time _AM PM
Address:—_Z
72- r} 5 K-C' 1L�`t��.,c�
Builder. J Permit # �
THE FOLLOWING CORRECTIONS ARE REQUIR -
— '
U fI
Inspector:_ �• "�/ Date
)-ArmOVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
l, _Call For ReinsF.