8065 SW CAROL ANN COURT r
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.9rrE E!JM
LOT: 4 BLOCK: N/A SUBDIVISION: DURI" SCHOOL PARK
SECnON: Sal 1/4 12 T-2S R-1 W W.M. CITY: TIGAM
COUNTY: WASHINGTON STATE: OREGON SCALE: 1'= 10'
WE
TAX MAP AND TAX LOT No.: TAX MAP 2S1--12CD
SITE ADDRESS: 8065 CARCA ANN COURT
ZONING: R e 12 S
OWNER: HERB HOFF'ART & Co.
4632 S.W. VERMONT
PORTLAND, OREGON 97219
TEIEPHONE: 244-01876
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8065 SW Carol Ann Court
CITY OF TIGARD _ MASTER PERMIT
PERMIT#: MST2001-00293
DEVELOPMENT SERVICES DATE ISSUED: 5/31/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 08065 SW CAROL ANN CT PARCEL: 2S112CC-14200
SUBDIVISION: DURHAM SCHOOL PARK ZONING: R-12
BLOCK: LOT:004 JURISDICTION: TIG
REMARKS: S/F Path 1
BUILDING
REISSUE: STORIES. FLOOR AREAS REQUIRED SETBACKSv� REQUIRED
';LASS OF WORK: NFW HEIGHT. J7 A FIRST: C36 at BASEMENT- of LEFT: 5 SMOKE DETECTORS:
TYPE OF USE: til FLOOR LOAD. an SECOND: 923 of GARAGE: 300 of FRONT: r 1 PARKING SPACES: 2
IYPE OF CONST. 5N DWELLING UNITS. 1 FINBSMENT: el RIGHT r;
VALUE. S 14 A,505 SU
OCCUPANCY GRP: N3 BDRM'. 4 RATH. "1 TOTAL: 1,56500 or REAR: 17
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS RAIN DRAIN: 100 TRAPS'.
LAVATORIES: 3 DISHWASHERS: I FLOOR DRAINS'. SEWER LINES ilii. SF RAIN DRAINS: 1 CATCH BASINS:
1URISIIOWFRS. GARBAGE DISP I WATER HEATERS. I WATER LINES. I1,iBCKFLW PREVNTR: I GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL.
FUEL TYPES FURN<100K: I BOIL/CMP c DHP. VENT FANS 4 CLOTHES DRYER:
(!A!; FURN>=TOOK: UNIT HEATERS. HOODS: I OTHER UNITS: I
MAX INP btu FLOOR FURNANCES: VENTS I WOODSTOVES: GAS OUTLETS.
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS 1 0 - 200 amp 0 200 amp WISVC OR FDR. 1 PUMPIIRRIGA11ON. PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp. 201 - 400 amp tet WIO SVCIFDR. l SIGNIOUT L'N LT: PER HOUR:
LIMITED ENERGY 401 600 amp 401 600 amp: EA ADDL SR Clk SIGNAL/PANEL: IN PLANT:
MANII HMISVCIFDR: 601 - 1000 amp: 601-amps-1000v. MINOR LABEL:
1000+amp/volt
PLAN REVIEW SECTION
Reconnect only:
>-4 RES UNITS: SVCIF0R1=225 A.: 600 V NOMINAL. CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
_ A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 6 STEREO. VACUUM SYSTEM: AUDIO&STEREO- FIRE ALARM INTERroMIPAGING: OUTDOOR LNDSC L'.
BURGLAR ALARM: OTH: BOILER: HVAC. LANDSCAPEAPRIG: PROTECTIVE SIGNL.
GARAGE OPENER. CLOCK INSTRUMENTATION: MEDICAL: OTHR:
HVAC. DATA/TELE COMM. NURSE CALLS. TOTAL 0 SYSTEMS
Owner: Contractor: TOTAL FEES: $ 6,160.01
This permit is subject to the regulations contained in the
HERB HOFFART HERB HOFFART T!gard Municipal Code,State of OR Specialty Codes and
4632 SW VERMONT STREET 4632 SW VERMONT all other applicable laws All work will he done in
PORTLAND,OR 97219 acoo,dance with approved plans This permit will expire if
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENI ION
Phone. Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Cente• Those rules are set
Reg# 1 I 'I.I' forth in OAR 952-001-0010 through 952 001.00PO You
may obtain copies of these rules or direct questions to
CLINIC by calling(503)246-1987
REQUIRED INSPECTIONS
Crosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation tosp Mechanical Final
Sewer Inspectinn Underfloor insulation Plumb Top Out Exterior Sheathing Insl Rair drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Watt:r Line Insp Final inspection
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr,Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By : °1<`_ _ Permittee Signature : - �
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT _
DEVELOPME14T SERVICES PERMIT#: S I OU166
.13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/331/011/01
SITE ADDRESS; 08065 SW CAROL_ANN CT PARCEL: 2S112CC-14200
SUBDIVISION: DURHAM SCHOOL PARK ZONING: R-12
BLOCK: —_ LOT: 004 + ! JURISDICTION: TIG _
TENANT NAME:
USA NO: FIXTURE UNITS: 0
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner: ---
- FEES _
HERB HOFFART Type By Date —Amount Receipt
4632 SW VERMONT STREET --
PRMT CTR 5/31/01 $2,300.00 27200100000
INSP CTR 5/31/01 $35.00 27200100000
Phone: 503-244-0876 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires
180 days from the date issued The total amount paid will be forfeited if the permit expires The Agenc/ does not
guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given If riot so located, the installer shall purchase a"Tap and
Side Sewer' Permit and the Agency will install a lateral 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 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987
Issued by: Permittee Signature:
- t
_< _ g
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
S �cJ 6Z 2 U c'l — J U ( lo
Building Permit Application
Datereceived: - _pl Peti»itn3Ol-Cpa1 j ,,
City of 'Tigard
Add..-ess; 13125 SW Ilall Blvd,Tigard.OR 97223 ProJcct/eppl.no.: Expire date:
City of Tigard �
Phone: (503)639-4171 Dale issued: By. __ Receipt no. `
Fax: (503)598-1960 r Case file no.: Payment type: �L
Land use approval: - 1&2 family:Simple Complex: ✓`
XI &2 farnily dwelling or accessory U Conunercialiindustrial U Multi-fannly U New construction U Dernolition
UU Additiui/alteration/repiacemcnt U Tenant improvement U Fire sprinkler/alarm U Other: _
INFORMATION
Job address: $cJ G'T Bldg.no.: Suite no.:
Lot: IBlock: SubdivisiL)n:,-(Dqd&,aA4 4Lr6626` Tiax map/tax lot/account no.: 41/sed _ /VZrvo.
Project name. ,L AlgA4 S dA,;COe. /O,ri_g
Description and location of work on premises/special conditions: A,,,J �i --.-
132 -- lz13 -- - -
OWNERtCHECKLIST
Name: ' '
Mailing address: 1 &2 family dwelling:
City: State: ZIP: Q 7 Valuation of work........U. w!G........ $ AZ3M5
..............
Phone: _p Fax .o! E-mail: No.of bedrooms/baths................................. 6
Owner's representative: Total number of floors................................. 2
Phone: JFax: n o F.-mail: New dwelling area(sq.P.) .......................... _/b fo 5-
APPLICANT
Garage/carport area(sq.ft.)
Name: Covered porch area(sq.ft.) .........................
---------- ---
Mailing address: Deckarea(sq. t.) ........................................
Other structure area(s , ft.).........................
City: stale:p Z.IP: , .L —
Phone: ?.Al- Cr7f. I Fax: 0d7 E-rrlail: - Commercial/industrial/multi-family:
r Valuation of work........................................ $
.AIN itill
Business name: ,C,Z, 6K " (�/ a Existing bldg.area(sq.ft.) ..........................
Address: yL� `z' New bldg.area(sq.ft.)................................
Numberof stories........................................
City; N T/ State: ,Q ZIP: 7a i
Phone:�y�l•o f�� Fax:a�yi oJL E-mail: Type of construction....................................
Occupancy
no.; 3 y!a? 7 :cupancy group(s): Existing:
`� New:
City/metro lic.no.: Notice:All contractors and subcontractors are required to be A
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: 11,j/ vim) � .,/�' jurisdiction where work is being performed.If the applicant is
City: State: V - ZIP: 7,7 _ exempt from licensing,the following reason applies:
r
Contact person: q c, e.JI Plan no.: --
Phone: _6 Fax: Se dr E-mail: - - —
Name: ,„,, �.,� -a , 1 Contact person: Fees due upon application ........................... $_
Address: J Date received:
City: State: ZIP: Amount received ......................................... $ _
Phone: Fax: E-mail: Please refer to f e schedule.
1 hereby certify I have read and examined this application and the Nat as j aisdicaons accept mat cards,pleae call jurisdiction for more InfonmWon
attached checklist. All provisions of laws and ordinances governing this U Visa U MasterCard
work will be complied witJT,whs ler specified herein or not. Credit card number:
ExpiresAuthorized signal Date: _ //Jy Name of cardholder as shown on create card
Print mune: - ---- Cardholder sitmarure - s Antowrt
Notice:This permit application expires if a peimi!is not obtained within 180 days alter it has been accepted as complete. 4404613(ryoercOM)
Electrical Permit Application
'— _-- Date received: Permit no-
Cit of Tigard ---
y � I'rojccUappl.no.: Expire date:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By:
Phone:Phone: (503) 639-4171
Fax: (503)598-1960 Case file no. Payment type:
Land use approval:
XI &2 Tamil) dwelling or accessory U Commercial/industrial U Melti-family U Tenant improvement
New construction U A(Idiurni/altcralinn/rchla can nl U Other: U Partial
1 : SITE INFORMATION
Job address: fQ(.s ��. } e 1 Suite no.: ITax map/tax IoUaccount ri
Lot: Block: Subdivision: ,Q q S OOc. Aooeo< e7 ( CC Ly
3omD
p,uject nam , 4ery �, sea ,oma, Description and Irx-ahon of work on premiseti_ A -
Estimated(late of complclitm/inspection: Q , ap.,� Or
C'ONTRAC70111 APPLICATIONI
.lob no: f ee M,rx
Business name: Description Qty. (es.) Total no.fn%p
Address: rye, - New residential-dngkor multi tamih per
/y/O A145 � - �J � d"IlIntunit.Inelutlesattached gar mg,
Cit): _ State: ,C ZIP: 9?Ag o Service included:
Phonc:Ay-a_rdy.o rax: y E-mail: INH)sq n.or less __ ___.1
CCB no.: g , Elec.hos,lie,no: a re _j�/� Each additional 5('t)a ft.or portion thereof ,
Limited energy,residential
City/metro lie.no.: Lintitedenergy,ono-residenhol ---
�— sr-- Bach manufactured home or modular dwelling
ore of supervisinelectrician(required) flare f Service and/or feeder 2
Sup.elect.name(print): p,y- A4. I License nn: services or feeders-Installation,
alteration or relocation:
-PROPERTY 200 amps nr less 2
Name(print): E, �rgW,e?-- 201 snips to 400 amps 2
— 401 naps to 600 amps
Mailing address: ,16 3 A s U-) 1AF e ,J 60I,lops to iW)amps
City: o ,anJp Slate:p,Q zlP: 97a,5; overl(x>nampsorvolts
Phone:a -Ce 21k I Fax: E-mail: itrc(imn:ionl I
Owner installation:The installation is being made on property I own IemporatyseryIces orfeeders-
which is not intended for sale,Ieasc,rent,or exchange according to Indallallon,alteration,orrelocation:
ORS 447,455,479,670,701. 2(x)imps or less 2
201 amps w 4(x)amps 2
W
ier's Si mature: Date: _ 401 to WK)ams 2
Branch ch,cults-new,alteration,
or extension per panel:
Nan1C: _ A Fcc for blanch circuits with purchase.,(
Ad(lress: service or feeder kr,each branch circuit 2
City: State: 7.11' B Fre for branch circuits w-thout purchase
nl service or feeder fee,first branch circuit: 2
Phone: Fax: Email —
Fachadditional branch circuit
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2
0 Service over 320 amps-rating of 1 k2 U Hazardous location Each sign or outline lighting, _ 2
familydwellings U Building over I0.(x)0 square feet fnur or Signal circuit(s)or a limited enerl,y panel.
U System over 600 volts nominal more residential units in one structure alteration,or extension* 2
O Building over three stories U Feeders,400 amps or marc •Ik wri pion.
❑Occupant load over 99 persons O Manufactured structures or RV park finch additional Impectlon over the allowable In any of the above:
U Egreswlighdngplan U other- __- Pennspcction
Submit—sets of plans with any of the shote. Investigation fee
T'he above are not applicable to temporary construction service. other
Nd all)udsdictions accept credit cards,please call luris.lich(st for nwwe information Notice:This lvmtit application Permit fee.....................$ _
U Viso U MasterCard expires if a permit is not obtained Plan review(at _ %) S __—
credit cud number widtin IRO days allcr it has been State surcharge(9%)....$
t'xplre' accepted as complete. TOTA I,
Name of cardholder u s own nn credit cor.1 --
Cardholder signature Amount 410-461%MCK rant)
Plumbing Permit Application
Date received: Pennit no.:
City of Tigard l sewer cnnit no. Building Address: 13125 SW Hall Blvd,Tipard,OR c�' P pcnait no.:
City of Tigard Phone: (503) 639-4171 1'rojcct/appl.no.- Expiredatc:
Fax: (503) 598-1960 Date issued: By: Receipt no.
Land use approval: Case file no.: Payment type
TVPE 00 PERMIT
1 &.2 family dwelling or nccessnry U Commercial/indusinal U Multi-family U Tenant improvement
,XNew construction U Addition/alteration/replacement '-J Food service U Other:
11 SITEll N FORMATION
.(For special luforan.
t .a 1lPtifri IYI1111
Job address: p I rYl�r� - -- - Orly. hre(ea.) ltolsYl
-�---- Ne" t-Alld Z-Ialllll'1 dNc`Ilin{s only:
Bldg.no.; Suite no.: �
-- (lneludr�10111t.fillr•>lthulilil�rriturccYi,n)
Tax map/tax lot/account no.: S// -/V.9-00
--_ 1
1 I hull j
Lot: Blcxk: Subdivision. —WAM R Sf,,lt 1SII. (7t
Project name. 6 ZIP:,04 HA2 K I I
City/county:-7 q y'7a a Loch additional bath/kitchen - --
Description and location of wor on premises: _—_ Site utilities:
_6/.1 r �/�w _ Catch basin/area drain
Est.date of complete n/inspection p To _,� a Drywells/leach line/tri-1ch drain
I'o,t ting drain(no.lin.. ft.)�
Business name: �, Mae:ufactured home utilities _—
A T �� yLy�fi�1G�t Manholes _
Address: 773 S`4). it/� Rain drain connector
City: State:p ZIP: Sanitary sewer(no.lin.ft.) - -- --
Phone: r: _ Fax: yy, E-mail: Storm sewer(no.lin.ft.)
CCB no.: 7q _-_ Plumb.bus.reg,no:,9 0-Z ly Water service(no, lin.ft.)
City/metro lie.no.: to Fixture or item:
Contractor's representative signature: '. - Ahso tion valve Printname: -- ack flow reverter
r� �. a Date' a Backwater valve
CONTACT1 Basin.0avatory
Name: Clothes washer
Address: a Dishwasher
-- -T-
`J Drinkin fountain(s)
City: State:OR 71 P: �j 7�,y lijectors/ sump
Phone:a. _off Fax:�� - I?-mail: Expansion tank ---
Fixture/sewer cap —
Name(print): fs,/G --�/�F F�,e7 Floor drai:Y•dl sinks/hub
Mailing address: -- -- Garharc dis sal
City: State: �e 71P: 5;,7.R/ Hose hihh
— ---
_—�___ Ice maker
Phone: I7ax: -pr E-mail: Interceptor/grease trap
(honer installation/residential maintenance only: The actual inslallatinn Primer(s)
will he made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property 1 own as per ORS Chapter 447. Sin (s),basin(s),lays(s)
Owncr's si nature: Date: Sump _
Tubs/showcr/shower pan
Urinal _
Name: /�o,yeF � ,�„-D _ _ Water closet
Address: —
Water heater
City: State: 7.1 P: Other:
Phonc: haz: E-mail Total
Sim all jurisdiclimu accept credit cards,plea+e cell Jurisdiction far more inrnrmahnn Minimum fee................$ _
Notice: this pcnnit application
U Visa A MasterCard expires if a pem it is not obtained Plan review(at _ %) $ _,_.
Credit card oumtrer: -._.--_----_-.__.__ _ ,- 1. /-- ,%,Thin 1 R0 clays alter it has been State surcharge(9%) ....$
r:�plre. -
-- accc ted ascrnn Ictc. TOTAL .......................$
Maine nr cat�rnlder u shown nn credit cent—V— p p —
S
CrdlWder tigmlure ---— —Amount LIO It lh lMlglt'r rpt
Mechanical Permit Application
v� Datereceived: Permit no.:
City of Tigard Project/appl.no. Expiredatc
Add13125 SW liall Blvd,Tigard,OR 97223 -
CiryaJTigurd Address: Date issued: By: Receipt no..
Phone: (503) 639-4171 — --
Fax: (503) 598-1960 Case file no.: Payment type:
Land use onproval: Building permit no.
TVPE OF PERMIT
1 &2 family dwelling or accessory U Conuncn:ial/Indutitnal U Molti family U Tenant improvement
New construction U Addition/,tltcration/replacement U t ulrr�
00111 SITE INFORMATION1 tSCHEDULE
Job address: e7 Indicate equipment quantities in boxes b0ow. Indicate the dollar
Bldg,no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: 17SI _1y-2 po profit.Value$
Lot: Block: Suhdivision r "See checklist for important application information and
Project name: 4S jurisdiction's fee schedule for residential permit fee.
City/county: 11 P: 97aSCHEDULE
Desc �ition and atio of wo k on premises: t t 1 d
Pee(en.) Total
Est.date of comp) on/inspection: Drw•ription Q1y.1 Res.only Res.onh
Tenant improvement or change of use: Air handling unit
Is existing space heated or conditioned)U Yes U No
Air conditioning(site plan require )
Is existing space insulated"U Yes U No I Alterationo existing system _
CONTRACTOR rn er/compressors
Business name: State boiler permit no.:
�c.�.r— HP Tons BT(I/H
Address: it smo c ampers/ uct smoEc etectors
Statc:p e ZIP: 9qp cat pump(site plan required)
Phone: fa_ I'ax o� G snail: Install/replace urnac urner i
TUIH
Including ductwork/vent liner U Yes U No
CCB no.: a/19_2 nsta rep ac rz ocate eaters-suspended,
City/metro lic.no.; _ wall,or floor mounted
Name(please print):,e&!!�t. - ent for^gip iance of er t an furnace
of geration:
Absorption units BTU/H
Name: ___.__ _ Chillers
Com ressors _ Hl
Address: 8a ScJ d -- nv ronmenta exhaust an ventilation:
City: , State:Ce ZIP: 91.6t i Appliance vent
Phonc:a y Fax:-7,/v-o L'-mail: )ryercx;oust
Hoods,Type res. nc a darmat
hood fire suppression system
Name: / Exhaust fan with single duct(bath fans)
Mailing address: �,� ' :x roust systema art mm estilit or
AC
Fuel piping a»r str ur on(up to 4 out cls)
City: btCYoy.aL state:p,e 7.1P: , NO Oil
Y(1e ---
Phone: .p Fax:.7,/4/-o1- 1?-tnaiL Fuel piping each a Itiunal over 4 outlets
Process piping(schematic require )
Number of outlets
Name: `J9a�+-v t er ste appliance or equ pment:
Address: Decorative fireplace
City: State: ZIP: Inscrt-type
Phone: E-mail. oo stov pe et stove
Other:
Applicant's signatur: u00a'5 I Date: 6 r of ter:
Name (print):
Not all Judns ardictloccep credit cards,plraa call luriuhctlon for mere Infwmtlan Permit fee.....................$ `
❑Visa UmseMasterCard Notice-1-his permit application Minimum fee................$
expires if a permit is not obtained Plan review(at ._ 9i.) $
Crrdit card numher: - 1--� within I RI)Jays after it has been
Pspirea State surcharge(8%)....$
game or cwdholdrt u shown on credit card accepted as complete.
— Cardholder signature_ — Amnum 4444617(60YCOM
SE-- E 35MM
ROLL #20
FOR
OVERSIZED
DOCUMENT
�;ITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CRAFTWORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
Plumbing Signature Form
Permit #: MST2001-00293
Date Issued: 5131101
Parcel: 2S1 12CC-1 4200
Site Address: 08065 SVV CAROL ANN CT
Subdivision: DURHAM SCHOOL PARK
Block: Lot: 004
Jurisdiction: TIG
Zoning: R-12
Remarks: SIF Path 1
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
HERB HOFFART CRAFTWORK PLUMBING INC
4632 SW VERMONT STREET 7736 SW NIMBUS AVE
BEAVERTON, OR 97. ?8
Phone #: 503-244-0876 Phone #. 644-8698
Req # i ir. 79666
FSI M 20-148PB
AN INF( SIGNATURE IS REQUIRED ON THIS FORM
X
Signatufe of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
i
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
EASTGATE ELECTRICAL INC
1410 NE 106TH
SUIT.: 206
PORTLAND, OR 97220
Electrical Signature Form
Permit #: MST2001-00293
Date I:,sued: 5/31/01
Parcel: 2S112CC-14200
Site Address: 08065 SW CAROL ANN CT
Subdivision: DURHAM SCHOOL PARK
Block: Lot: 004
Jurisdiction: TIG
Zoning: R-12
Remarks: S/F Path 1
Your company has been indicated as the electrical contractor for the permit 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 company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR-
HERB HOFFART EASTGATE ELECTRICAL INC
4632 SW VERMONT !)TREET 1410 NE 106TH
SUITE 206
PORTAND, OR 97220
Phone #: 503-244-0876 Phone
Req #: uc 43701
ELE 26-340c
SUP 1512S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
--
Sig ture of upervisii Electrician
If you have �,iny questions, please call (503) 639-4171, ext. # 310
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CITY OFTIGARD 24-Hour
BUILDING inspection Line: (503) 539-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 —
BUP
Received Date Reqursted _ AM - PM _ BLIP
Location - Suite— _ _ _ _
-- --� MEC - - - --
Con',act Person Ph � ` PLM -
Contractor--- - , Ph( -) --- _ -- - SWR --
rBUILDING Tenant/Owner _ _ ELC
Footing — ----- — -------
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain -
Slab Inspection Notcs: SIT _
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing Insulation
DrywallDrywall Nailing
Firewall
Fire Sprinkler -- ---
Fire Alarm
Susp'd Ceiling
R-)of
Other: -
Final
_PASS PART _FAIL —�.-
PLUMBING
Post& Beam --
Under Slab --
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Dain - -
ShowerPan
Other:
Final —
PASS PART_ FALL
MECHANICAL _
-- ------ ------------
Post 8 Beam --- ----- -------------- ------------
Rough-In --- ----- —_- --- -- --------- -- - ---- - --
Gas Line
Smoke Dampers __--
Final
T FAIL ------ --- -------- - ----- - --
Service
Rough In
LIG/Slab -
Low Voltage
Fire Alarm
i -� Reinspection fee of$ required before next inspection. Pay at City Hal:, 13125 SW Hall Blvd
PA PART FAiL
S TE Please call for reinspection RE:__ _____ l� Unable to inspect-no access
-------
Fire Supply Line
ADA
Approach/Sidewalk Date / Z Inspector -�_- 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 MST
INSPECTION DIVISION Business Line. (503)639-4171
BUP —_
Heceived _-_ _ Date Requested_ -/z AM — PM ____. BUP - -_
Location C� � -� L�/j? Suite MEC
Contact Person ,Y' .L/i�'y Ph(_ ) PLM
Contractor _ Ph( )
--- ---- SWR
BUILDING Tenant/Owner —_ ELC
--oot—
Fing
Foundation Access: ELC
Ftg Drain
Crawl Drain ELR -- - -- ---- -
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 - - --
Root - - ----
Other: - - -
Pinal
PASS PART FAIL ---- - -- -- ___---- -w._.--- - --- -
_PLUMBING-
Post&Beam-- -._ ---------- - - ------- ------- -.._____
Undf�r Slab --_- -- ---- --- - - -- --- -- --- --- ---
Hough-In
Water Service ----- -- -- --- - ----- - - _------------- --
Sanitary Sewer
Rain Diains -- ---- ----- - - -- - - ----- -----
Catch Basin/Manhole
Storm Drain -------—-
Shower Pan -_--
Other. -- -- - -- - - -- - --- -- -
flfial
_ SS PART FA_I_L --- - - ---- ___..._� - -- -___.----------------
NICAL - -
Post& BeamRough-in
Gas
Gas Line
Smoke Dampers ------ -- --- -- --- - ---
Final
PASS PART FAIL -- ----- ---- -- ----
ELECTRICAL
Service - ----- ----- -- - - - — — -
Rough-In
UG/Slab - ----- ------ - ------ - --
Low Voltage --- -- ------- ------ -- --
Fire Alarm -- -
Final El Reinspection fee of$ -.-_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
3JTE [] Please call for reinspection RE: __- Unable to inspect- no access
Fire Supply Line
ADA
Approach/Sidewalk pats ���� Q Z Inspector �� � Ext
Other:_
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
Gf I'Y OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-1175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received -_ _____Date Requested 'Z AM PM -__ _ BLIP
Location LA Suite—____.. MEC _
Contact Person ��- _ Ph(_ ) ZG 7 7�1-y PLM
Contractor _ Ph( ) __ SWR --
BUILDING__ Tenant/Owner _ _ _- _ _- ELC
Footing ELC
Foundation Access:
Ftg Drain 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 ---- -
Root
Other:
AS _ PART FAIL
PLUMBINf3 -__ -
Post&Beam
Under Slab - - - -
Rough-In
Water Service -
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - --
Shower Pan _
Other:
Final
PASS PART FAIL_ - — —
MECHANICAL
Post&Beam
Rough-In --- - -------
Gas Line
Smoke Dampers -
1
S PART FAIL
ELECTRICAL
Service -_---- —
Rough-In _
UG/Slab
Low Voltage —
Fire Alarm
Final u Reinspection ho,- of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE u Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Onto. 7-711- .Q_' Inspector _ Ext—�—_
Other:_—_--
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL.