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10220 SW CENTURY OAK DRIVE 0 N N O C� C n m z c 0 A C7 i 10220 SW CENTURY OAK DR CITY OF r T IV^ wH K^D ELECTRICAL PERMIT PERMIT#: ELC2004-00062 DEVELOPMENT SERVICES DATE ISSUED: 3/1/04 13125 SW Hall Blvd., Ticiard. OR 97223 (503) 639-4171 PARCEL: 2S111CC-03600 SITE ADDRESS: 10220 SW CENTURY OAK DR ZONING: R-7 SUBDIVISION: SUMMERFIELD BLOCK: LOT : 0,139 JURISDICTION: TIG Project Description: (3) ' jnzh circuits. RESIDENTIAL'UNIT TEMP_SRV_Cll-E_EDER_S_ MISCELLANEOUS — 1000 SF OR LESS: 0 - 200 amp. UMP/IRRIGATION: — EACH ADD'L 500SF: 201 - 400 amp: SIC V/OUT LINE LTG: LIMITED ENERGY- 401 - 600 amp. SIGNAL/PA,"'! MANF HM/SVC/FDR: 601+amps - 1000 volts MINOR LABEL. (10): SERVICE/FEEDER BRA 4CH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDFrt: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC �' FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SEC-,tZ)N 1000+ amp/volt: -4 RES UNITS: > 600 VOLT NOMINAL: Reconnect ons: — _SVC/FDR>--225 AMPS: _CLASS AREA/SPEC OCC: Owner: Contractor: EM WEST LLC DDA IN YOUR HOME BLESSING ELECTRIC, INC 16869 SW 69TH AVE. 4332 829 N RUSSELL ST LAKE OSWEGO,OR c 1035 PORTLAND,OR 97227 Phone: 503-443-2424 Phone: 503-284-1189 Reg #: 1.1( S7994 - -------- II.F 26-1510 FEES S1'1' 41991ti Description Date Amount— __ —_ Required Inspections 11.1.1)RMTI LL('Permil "�u_! $60.15 — --- 1 AXI 8 Surcharge ' '� n $4.82 Rough-in Elect'I Final Total $64.97 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or 4 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 952-001-0010 through OAR 952-001-0100. You may obtain cod t;of these rules or direct questions to OUN;at(503) 246.6699 or 1-800-332-2344. r ' Issued By: c t�� , , 11rc t Permit Signature: 71 CL#�fL� _ OWNER INSTALLATION ONLY The installat'on is being made on property I own which is not intended for sale, lease, or rent. OWNFR'S SIGNATURE: _ _ DATE: CONTRACTOR INSTALLATION ONLY \, 1 SIGNATURE OF SUPR. ELEC'N: X_�77) �\ I :47D 71 <�';!DATE:_ LICENSE NO: — Call 6"94175 by 7:00pm for an inspection the next b isiness day r Ee�TFral Permit AP049 Dv E[._ City Of'Tigard It"eiDatdB - ` 1-7.1/ Permit No�C,/{1��/_QOQ`•� 13123 SW Hall Blvd.,Tigard.OR 97223 �� C� ��' Plan Review - I'honc: 303.639.4171 Fax 50.3.598.1960 FEBf U lialeffl (Other Permit Inspecoon Linc: 503.639.4175 G'�Y Ur nate g torts T t(7 eady/By. 0 See Past 2 for Interact: www.ci.tigard.or.us pt iii n1l'.1r. DIVISIC'� Nottftlxl/Methodd V Supplemental Information T OF WORK PLAN REVIEW ❑New construction Addition/alteration/replacement Please check all that apply: ❑Demolition ❑Other: []Service over 225 amps,comm'I ❑I lazardous location ❑Service over 320 amps-rating ❑Buildng over 10.0(10 sq.ft., CATEGORY OF CONSTRUCTION of I-and 2-family dwellings 4 o, mo v new residential 11aT_and 2-I•ainily dwelling ❑('tanmere iat/industrial ❑Accessory building ❑Svstem over 600 volts nominal units in one structure ❑Multi-family ❑Master builder Other: ❑Building over three stories ❑Feeders.400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV p� Job no. __ I Jon site address: �(,�1. r w�� ❑I leelth care facility ❑()cher:—_ '� �/� z Submit I-sets of plans with am of the above. City/Stule/ZIP: / r OA t�'7 'rhe shove ere not applicable in tcmptuan construction service, Suite/bldg./apl.no.: Project name: FEE* SCHEDULE Desrrlptbn —F_Qq Pee. Tad •• Cross strcct/directions to job site: New residential single-or multi-family dwelling unit. Includes attached garage. n /C +_ 1,000 sq.11.or less 145.15 jT2 Subdivision: f,* p^yt � D&A-r Lot no.: 54 Ea.add'1300 sq.ft.or portion 33.40 Tax map/p::,ccl no.: �11L�s�� f,,)n� _ -_ Limited energy,residential 75.00- Limited energy,non-residential 75.00 DESCRIPTION OF 11'ORK 4 Each manufactured or modular dwellin ,service anti/or feeder 90.90 2 Services or feeders Installation,alteration,and/or relocation 200 amps or less 90.30 1 P i6P!ER OWNER -` ❑ 201 amps•o 4(N)amps 106.85 2 TENANT �� L L 401 amp to 600 amps - 160.60 z Name: We.5?- C �� Litor I amps to 1,000 amps 240.60 2 Address: 8G �� )vcr I.0(X)amps or volts 454.65 2 /e ---� � Reconnect onlyG6 R5 2 City/State/7,11): e " CA 7,0 3 Temporary services or feeders installation,alteration,and/or Phone:603) MV-4- 2-V Z l:ax:(5-0.3 S9 -729Q 2relocatlon 00 amps r Tess 66.85 1 Owner installation:This installatio-i is being made on property that I own which is not 201 amps to 400 amps I W,30 2 intended for rule.lease,rent,or exchange.according to ORS 447,449,670,and 701. 401 amps to 600 amps 130.75 2 Owner signature:_ Date: _ _ Branch circuity-new,alteration.or e:teaslon,per panel 0 APPLICANT --=-- oKrACT PERSON A.Fee for bnmc h circuits with service or fee der fee,each Business name: _ branch circuit 6.63 2 Contact name: �0�� --- B.Fee for Mach circuits f q;A '�� Pm & G7 7w eu without service or feeder fee, each branch circuit / 46.85 y , 2 Address: .,� — y d Each add'I branch circuit ;,I. _(r.63 2 City/State/ZIP: _ _ Miscellaneous(service or finder not Included) Phone:I sV' 1 S -O2! Fax::(S'j�3) ,Q f�'74 Pump or irrigation circle 53.40 2 I:-mail y�/ y5 r -�� Sign or outline lighting 53.40 2 Signal circuits)or limited-CONTRACTOR energy panel,alteration.or �`- Businesextension.Describe Page 2 s name: � J� � C Address: 7V. Each additional inspection over allowable in any or the above - Per inspection 62.50 City/State/?.IP: ��.r _ h,vestigation per hour t I M mini 62.50 - Phone: ► GJ. ��1� I F,,X:( )��y_ 1 -- Industrial plant per hour 71.75 -- CCR Lic.• 575►1�/ Elects teal Li c�* p __� ELECTRICAL PERMIT FEES* Su rv.I.ie.: . 1 Sublotai V Suprv.Electrician signature,required /V t/ -r"Y - V/ _ Plan review(25%of permit fee) Print namr: ate: n A ^n Slate surcharge(846 of permit fel y, Y TOTAL KRMII FEi. Authorized signal _ _ -- --_ ..1�: ihic hermit PPPli-tion eipir"Its permit is not obtained within 180 —'--� da*+Prier it has been"led a+complete Print Henle: Fcc nlethodolo-.y set by Tn-County Building Industry Service Hoard BLESSING ELECTRIC SOS 284 SS18 09/01/04 02s08pm P. 002 VUr vAr &-"I AY, AI AAA 1)VJJ0010V1A 4111 VI AIVAR0 4(JVUL CITY OF TIGARD 13125 S.W. HALL. BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BLESSING ELECTRIC, INC. 829 N. RUSSELL ST PORTLAND, OR 97227 Electrical Signature Form Permit #: ELC2004-00062 Date Issued: 3/1/04 Parcel- 2S111CC-03600 Site Address: 10220 SW CENTURY OAK DR Subdivision: SUMMERFIELD Block: Lot. 059 Jurisdiction: TIG Ztwi;rig: R-7 Remarks: (3) branch circuits. Your company has been indicated as the electrical contractor for the perm it indicated above. In order for the electrical permit to he valid,the signature of the supervising electrician is required. Please have the appropriate individual from your compai- sign below and return this Electrical Signature Form prior to the start of the work to the address above, A1TN Building Division. No electrical inspections will be authorized until this completed form is received OWNER ELECTRICAL CONTRACTOR, EM WEST LLC DBA IN YOUR HOME BLESSING ELECTRIC, INC. 16869 SW 69TH Au=. 032 829 N. RUSSELL ST LAKE OSWEGO, OR 9703.: PORTLAND, OR 97227 Phone #. 503.443.2424 Phone # 503.443-2424 503-284-1189 Req #: LIC 57994 ELF. 26-151C SCP 4199S AN INK SIGNATURE IS REQUIRED Ort THIS FORM Signature of Supervising Electrician If you have any questions, please call 503.710.2433. own CITYOF T I GA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT PLM2004-00055 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/1/04 SITE ADDRESS: 10220 S'JV CENTURY OAK DR PARCEL: 2S111 CC-03600 SUBDIVISION: SUMMERFIELD ZONING: R-7 BLOCK: LOT: 059 JURISDICTION- TIG LLASS OF WORK: ALT GARBAGE DISPO0'aLS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks. Fixture: (1) tub/shower. Owner: – �--_- _— FEES ^---- v EM WEST LLC DBA IN YOUR HOME Description Date Amount 16869 SW 69TH AVE #332 IPLt'Mill Permit Fee 2/9/04 $72.50 LAKE OSWEGO, OR 97035 I'I'AX1 8"„state 2/9/04 $5.80 Total $78.30 Phone : 503-443-2424 Contractor: WHITTINGTON PLUMBING 265 NW WILCOX HILLSBORO, OR 97124 REQUIRED INSPECTIONS Phone : 503-S40-93Top-out Insp,4 Final Inspection Reg #: III %1 34-3931'13 LI( 149483 This permit is issued subje^t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire it' 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 952-0001-0010 through OAR 952-0001-0100. You may obtair copies of these rules )r r.irect questions to OUNC by calling (503) 246-6699. Issued By: .%<<Lti< <f �i� 4_, _ Permittee Signature:; �1 CS C (�6LtL Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day RECEIVED Numbing Permit App iga>tiwn�l)QlIHamm EFEMMEKEXI City UI 1 rgard Rc.:cwLd „ I'cnnn No 13125 SW Hall Blvd., figard,OR ql2&Y OF TIGAR� uatdr+, -i l Phone: 503.639.4171 Fax: 503. DIVISION Plno kcvieµ ��e�ING fJam[JJ t:Aher Permit No 24-Hour Insp-etion Line: 503.639.4175 - ---- - I>atc Ready/By Jfor Internet: wis 0 ties Pane 2 Internet: www Cl.ligard or.Us NotifiLd/Mcthud Supplemental Information TYPE OF WORK _ _ FEE* SCHEDULE ❑New construction --�- ❑Demolition For specialin ormadonusechec•klisx - - Description 8a. I Total Addition/alteration/rvpfaccment ❑Other: New 1-2-family dwellings(includes 100 ft. for each utility connection) _CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00 ❑Accessory building -- ❑Multi-family A SFR(3)bath � 399.00 ❑Master builder Each additional'9th/kitchen 45.00 ❑Other: Fires sprinkler p (_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Jab site address: -10Z-.'Z-D P41 �-- D V ✓1� Catch basin or area drain 16.60 City/State/ZIP: _ -F'* -' ,CA 22 Drywell,leach line,or trench drain 16.60 Suite/bldg./apt.no.: Project mo: Ce yv t�a Footing drain(no.linear ft.:_) Page 2 Cross struet/dlrections W job site: Manut.1dured home utilities 110.00 � � �/ Manholes 16.60 c V 1--IL ''A~' �7 6 �pI`�e4 - A40y?% e i r Rain drain connector 16.60 &2A o yi_ N Ma�1._ b r Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.finest ft.:__) Page 2 Subdivision: _ I al t►o.: Water service(no.linear ft.:_� Page 2 C A O D� Fax map/parcel no.: Fixture or Item(� Absorption valve 16.60 , pp y,� DESCRIPTION OF WORK - Backflow preventer Page 2 r*4014'l0��l /"•s 0 Backwater valve 16.60 (4,J C4-viN-4 49 �Q,f -- ----- Clothes washer 16.60 �_ = Dishwasher 16.60 PROPER'L'Y OWNER ^T ❑ TENANT Drinking fountain 16.60 G -- Ejectors/sump 16.60 Nnmc: EPA ��T L L.e- J p& C_t✓r � - ^ �'L- Expansion tank 16.60 Address: r � S �� Fixture/sewer cap 16.60 City/SlatetZI )�sc/f �� 3 Floor drain/floor sink/hub 16.60 Phone: 3 - Z 7 L f_Fax:1,`si>�) �9�'" �J Da►bage disposal 16.60 --- ❑ APPLICANTCONTA( I' PERSON Hose bib 16 60 - y--� --- Ice maker 16.(r0 Business name: _ Interceptor/grease trop 16.60 Contact name: �Y/dN J J. V p��►�� Medical gas(value:S 1 Page 2 Addtt.s9: �A i-A, D Primer 16.60 City/State/LIP: Roof drain(commercial) 16.60 Sink/basiMavatory 1660 Phone:15(i�l '8l9 -0-30-1 2Fax::(Svc 53�V77y o -- Tub/shower/shower pan t6.60Y4-- _ �• Urinal _ 16.60 _CONTRACTOR Water cl'�aet _ 16.60 16.60 - Business name: ��/ /�j,(. wt` /(J� ) / x�r^ � Water iteaiP► Address: Other�L er rt C .r� ether. City/State/ZIP: /,�-t. L'(J -- r /'-' y - Subtotal Minimum permit fee: $72.50 Phone:(t I", 1. . 'I iG Fax:(� ?j),� y y. 7/ Vesidentia)backflow minimum permit fee: $36.25 %Z' t't'B I.ic.: I y�� /D/�i u'J Pltttnbinf,; na.:%?�- -?�•-J* _ Plan review (25%ofpermit fbe) A ,�-- 7 J. State surcharge(111%of permit fee) v// Authorized Aazure; -A` TOTAL PFRMI f FFI: Print nam Tb , Uele This permit applleadon expires if a permit is aM obUlned within 190 days after It has tom accepted as complete. CITY OF Tir-ARD 13125 S.W. HALL BLVD. TIGARD, OR 9722.3 IMPORTANT PERMIT NOTICE Wt:ITTING I ON PLUMBING 265 WeV WILCOX HILLSBORO, OR 97124 Plumbing Signature Form Permit #: PLM2004-00055 Date Issued: 311104 Parcel: 2S111 CC-03600 Site Address: 10220 SW CENTURY OAK DR Subdivision: SUMMERFIELD Block: Lot: 059 Jurisdiction: R-7 Zoning- TIG Remarks: Fixture: (1) tub/shower. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be va id, please have the appropriate individual from yr)ur company sign below and return this Plumbing Signature Form prior to the start of the work to the address above. ATTN: Building Division. No p'umbing inspections will be authorized until this completed form is received OWNER PLUMBING CONTRACTOR. EM WEST LLC DBA IN YOUR HO WHITTINGTON PLUMBING 16869 SW 69TH AVE. #332 265 NW WILCOX LAKE OSWEGO, OR 97035 HILLSBORO, OR 97124 Phone #:503-443-2424 Phone #: 503-846-9364 Req #: PI M 34-393PB I W (49485 AN INK SIGNATURE IS REQUIRED ON THIS FORM Xt Signature of Authorized Plumber If you have anv questions, please call 503.718.2433. IIs CITY OF TIGARD 13125 S W. HALL BLVD TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GLOBAL PLUMBING NEDJO MARKANOVICH 11077 SW 81 ST AVE TIGARD. OR 97223.8454 Plur;ibing Signature Form Permit f1` PLM2004.00055 Uate ISSUed: 311104 Parcel, 2S111CC-03600 Site Address: 10220 SW CENTURY OAK OR SuhdlviFlon: SUMMERFIELO Block. Lot 059 „unsdictlon: R-7 Zoning TIG Rr!marks Fixture: (1) tub/shower. Your company has been indicated as the plumarntjo contractor for the pelnui indicated above. In order for the plumbing perm;t to be valid, phase have the appropriate individual from your company sign below and return this Plumbing Signature Form prior tv the start of llhe work to the add mss above, ATTN. Building Division No plumbing inspec-tions will be authortxed until this completed form Is received OWNC.R PLUMBING CONTRACTOR, EM WEST LLC DP—,^%!N YOUR HO GLOBAL PLUMBING 16869 SW 69TH AVE. #332 NEDJO MARKANOVICH LAKE OSWEGO, OR 97735 11077 SW 81ST AVE TIGARD, OR 97223.8454 Phone # ,o -44+ "d�4 Phone 0: 503-620-b971 `1(0 `i 7 -�w D Re( LIC task i PLM 14 1:SFI1 AN INK SIGNATURE IS REQUIRED ON THIS FORM Slq;n -iurP of Authorized Plumber 11 yinij have anv uuestionn, please call 503.718.2433 r0"N QVV'Jll Au U i nHOtktlCruv VIVA Iu Ti toot 11 ru CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-%175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP Remivgd __ _ Date Ruested AM r_ PM — BUP - - - - Location z. �' � AuitMEC ----_�-_- Conta, Ph( ) 1 -G. PLM _ Contras- - - _ Ph( j SWR BUILDI_W, TenanUOwner __- - ELC Footing ELC Foundation -__- Ftg Drain h^Cess: ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam -- Shear Anchors Ext Sheath/Shear /- Int Sheath/Shear Framing — -- Insulation - Drywall Nailing Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling Roof Other:_ Final . PASS PART_FAIL --- PLUMBING— Post& Beam Under Slab Rough-In Water Service --- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - - - — ---- -- --- -- -- Shower Pan Other: PART FAIL --- --- �.--- -MECHANICAL — Post&Beam — Rougn-In ._._----_. GasLine _..-.._..-------------- ---- - ----- Smoke Dampers -- Final PASS PART FAIL ------ -- - -- —.. _.. ------ --- --- ELECTRICAL Service Rough-In --- ------ —- — — UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$_ required before next inspection. Pay at City Hall, 13123 SW Hall Blvd. PASS PART FAIL SITE — _ Please call for reinspection RE: --_ n Unable to insp act-no access Fire Supply LineADA / Approach/Sidewalk Dots -_ r ` linspeeer - '_-!v --___ Ext------- Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: /503)639-4171 MST BLIP Received _ // Date Requested 7_ AM .(QPM B11P _-- Location —___1_U aZ 0 1 Z Suite MEC _. Contact Person Ph L4 S— PLM Contractor—_— — Ph SWR AiPt — BUILDING Tenant/Owner _— ELC Footing ELC _ Foundation Access: Ftg Drain C-003 r ELR — Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear M_�T(L S`\W CL o�r�•� 2 6 Framing —.--- — ri Insulationt� C � S t Nv p,4 , Drywall Nailing 1--. _1 A -- Firewall Fire Sprinkler -- ---- — — Fire Alarm Susp'd Ceiling --- — —_ — Roof Other: — Final PASS PART FAIL — PLUMBING_ _ � __- _ CSaLID Post&Beam Under Slab Rough-In Water Service — --------� — Sanitary Sewer J� Rain Drains — - Catch Basin/Manhois Storm Drain — -- -- Shower Pan p -— --- 04C — ion PASS PART FAI� —7—, ,T — MECHANICAL _ L � Post&Beam Rough-In Gas Line r Smoke Dampers ---------- ---- — Final PASS PART FAIL -- - ELECTRICAL Service Rough-In UG/Slab Low Voltage _— Fire Alarm inaN Reinspection fee of$ —required before next insction. Pay at City Hall, 13125 SW Hall Blvd. ASSPAR ?e SIT F] Please call for reinspection RE: _—— Ej Unable to inspect—no access Fire Supply Line ADA �� Approach/Sidewalk Date `^7► 2— — Qq-- Inspector _NQjb � _Ext _ Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL