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9305 SW COMMERCIAL STREET
CITY OF TIGARD ILDING INSPECTIO14 DIVISIOr4/
24-Hour Inspection Linc: 6394175 Business Phone- 6394171
Date Requested: .?-/i - — A.M. _ P.M. _ MST:
Location: _ B'JP:—
Tenant _ Suite:__ Bldg: _.mc:
Convector: _ Phone: J5rc+c_
Owner Phone: --- _—• Y ELC:
SIT: _
BUILDING BLDG(con't) PLUMBIN . MECHANICAL ELECTRICAL SITE -
Site I'osUlieam c, -P'ns mda n I'ost/lleam Cover/Service Sewer/Ston
Footing R(X)t, I)ndl-1/Slab Rough-In Ceiling Water Line
Slab I ramicig Cop Gas Lime Rough-In UG Sprinkler
Foundldion Insulation Sewer . 'Ihmd/l)uct Rccotmect Vault
l)snit Damp Drywall 3tottti- Fumilce Temp Service MISC.
Masonry Ceiling Rain Drain A/C I IG Slab
Shear/Sheath Fire Spklr/Alm CrawlXound Dr I leat 1'111111) Low Volt _ —
Approved < ovc Approved Approved Approved
Appr/SdNlk Not Approved �NoL&Droved Not Approved Not Approved Not Approved
FINAL FINAL FINAL, FINAL FINAL,
Cl Call for reins ion/— Reinspection fee of S._ _ _ _tequlted betilrr. next inspection C7 I Inable to inspect
Inspector_ / I ate /� - Page____of
l� ELECTRICAL PERMIT
CITY OF T I G A R
PERMIT#: ELC2000-00443
' DEVELOPMENT SERVICES DATE ISSUED: 08/02/2000
13125 SW Hall Blvd.,Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S102AB-01200
SITE ADDRESS: 09305 SW COMMERCIAL ST 05
SUBDIVISION: NO, TIGARDVILLE ADDITION AMEND ZONING: R-25
BLOCK: LOT : 064 JURISDICTION: TIG
Prolect Description: Reconnect Only, Apartment#5
RESIDENTIAL UNIT TEMP SR1fCIFEEDERS MISCELLANEOUS
1000 SF OR LESS: i 0 LCC amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
nAANF HMI SVC/ FDR' 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER — BRANCH CIRCUITS ADD'L INSPECTIONS_
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION _
1000+amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVCIFDR>=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
COOPER DEVELOPMENT CO
c/o SUNNARBORG, MARSHALL H
AND JOANNE E
TIGARD, OR 97223
Phene: Phone:
Reg#:
FEES _ Required Inspections
Type By Date Amount Receipt
—�. Elect'I Service
PRMT JMT 08/02/200( $53.50 0004182
5PCT JMT 08/02/200C $4.28 0004182
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 160 days of issuance,or work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copie,of these ruIr s or direct questions to OUNC at(503)
2.46 1987
PER.MITTEE'S$j_G A,TURE ,i / t ISSUED BY:�l
OWNER INSTALL TION ONLY
The installation is being made on property I own which is riot intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ DATE:
LICENSE NO
( Call 6394175 b47:00pm for an inspection the next business day
r
CITY OF TIGARD Plan Check#
13125 SW HALL BLVD. Electrical Permit Application _—
Recd By
TIGARD OR 97223 Date R e c'Cr —Z— _
Date to P E
Phone (503)639-4171, x304 Date to DST
Inspection (503)639-4175 Print of Type Permit
Fax (503) 598-1960 Incomolete 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(Ur name of business)_ r �I�—n Service included: Items Cost Sum
01
Address_ CJ 5 S . C ] _ r� ►t -5�,/� 4a. Residential-per unit
Cit /State/Zi T.Q (t C"7 1000 sq ft or less _ $ 117 75 __ 4
y p -- -� � - - - Each additional 500 sq ft of
portion thereof _ _ $ 2675 1
Commercial ❑ Residential Limited Energy $ 6000
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 7275 -__ 2
(Prior to pennit issuance,applicants must provide contractor license 4b.Services or Feeders
Information for COT data base). Installation,alteration,or relocation
Electri sal Contractor200 amps or less $ 64 25 _ 2
Address _ 201 amps to 400 amps _ $ 8550 2
City State _ ZI w 401 amps to 600 amps $ 12850 _ _ 2
y-- -- __---- p --- 601 amps to 1000 amps $ 192 50 2
Phone No ._._ --- — Over 1000 amps or volts $ 363 75 iu 2
.lob N0 -- ---- Reconnect only _-T-- $ 53.50 - 2
Elec. Cont. Lice No Exp.Date—_ _ 4c.Temporary Services or Feeders
OR State CCB Reg No Exp.Date—�_ Installation,alteration,or relocator
COT Business Ta-or Metro No Exp.Date � 2C0 amps or less $ 53.50 2
201 amps to 400 imos $ 8025 2
Signature of Supr. Elec'n _ _ 401 amps to 600 amps $ 10000 _ 2
Over 600 amps to 117,00 volts.
$
ne"b"above.
License No _Exp Date
Phone No 4d.Branch Circuits
-------- - --------- ------------ New,aiteration jr extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name jQ�..11 t rl tia Each branch circuit _ $ 5:55 2
,V7` i— b)The fee for branch circuits
Address —] _ Ir - - without purchase of service
City i " , rc' State 0Pzip.27LZ 13 or feeder fee.
Phone No �P First branch circud _ $ 37 50
Each additional branch circuit $ 5 35
The installation is being mac,, C.•1 property I own which is not 4e.Miscellaneous
intended for sale, lease or rent (Service ot feeder not included)
Each pump or irrigation circle -_ $ 42.75
Owner's Signature.1C f/ Gc.h rcGt�� Each siren or outline lighting _— v $ 42 75
Signal circuits)or a limited energy
panel,a.te•alion or extension $ 60.00
3. Plan Review section (if required):* Minor Labels(10) — $ 10000 --
Please check arpropriate iters and enter fee in section 58. 4f.Each additional Inspectior over
_4 or mora residential units in one structure the allowable in any of the above
Service and foeder 225 amps or more Per inspection __ _ $ 5000
-- Per hour � $ 5000
System over 600 volts nominal In Plant $ 59 00
Classified area or structure containing special occupancy as
described in N E C Chapter 5 5. Fees:
Sa.Enter total of above fees $
+ Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(08 X total fees) $
Not required for temporary construction services. Subtotal $ _
5b.Enter 25%of line 6a for i
NOTICE Plan Review if required;Sec 31 $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account#
AT ANYTIME AFTER WORK IS COMMENCED Total balance Due
I:\dsts\rnnns\cicctric doc
CITY Or TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection line: 339-4175 BLrsiness Line: 639-4171 -
BLIP
Date Requested AM V PM BLD
L-ocation � ez-iC�c Suitey , c MEC _
Contact Person Ph (e - /.mss l lr PLM
Contra-.tor Ph SWR _
BUILDING Tenant/Owner `'z nl L=t. ELC 2 GUd " ii 4t y 3
Retaining Wall ELR
Fuoting Access- w
Foundation FPS _
Fig Drain SGN
Crawl Drain Inspection Nutes: —
Slab — — ----- ------ — SIT
Post& Beam ---
Ext Sheath/Shear _
Int Sheath/Shear
Framing ---- ----.__—__ — --- --- ---_..
Insulation
Drywall Nailing — — --- ------- --- — — --
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceif,�
Roof _-----— ------ —
Misc: ------------------ --
Final
PASS PART FAIL _--
PLUMBING
Post& Beam ---— --- --- - — - _.
Under Slab
Top Out -- ---- -- — - - ----------
Water Service
Sanitary Sewer ---—— —---- --- ---------
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough In
Gas Line - - ----—-- _ ---_
Smoke Campers
Final ----
PASS _PART FAIL
LECTRICA 0 ----_- --------_.._ ___
Service ff Carl', 0,
Rough In
UG/Slab
Low Voltage
Fire Alarm ------- _.._.-----_ ---- --------- — — —-
F
rl,ASV PART FAIL
Backfill/Grading --- ------ ---
Sanitary Sewer
Storm Diain ( ]Reinspection fee of$-^ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ]Please tali for re/ins RE. _ ( J Unable to inspect-no access
Fire Supply Line —
ADA o
Approach/Sidewalk Date Inspector Ext
Other __ _ n -- Y13-
P
LFinal ---- --——--- —
PASS PART - FAIL DO NO REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRICAL PERMIT _
PERMIT#: ELC2003-00196
DEVELOPMENT SERVICES DATE ISSUED: 4/4/03
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102AB-01200
SITE ADDRESS: 09305 SW COMMERCIAL ST 18
70NING: R-25
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND
BLOCK: LOT : 064 JURISDICTION: TIG
Project Description: Electrical reconnection.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS_
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVCi FDR: 601+,imps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER --__,BRANCH CIRCUITS — ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/0 SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT-
601
LANT601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES 10",fS: >600 VOLT NOMINAL:
Reconnect only: 1 — _SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Cantractor:
MARSHALL SUNNARBORG
7670 SW YARNS ST
TIGARD.OR 97223
Phone: 503-639-1396 Phone:
Reg If:
FEES
Descri con Date Amount.
p _ Required Inspections
ELPRM II FLU 11cmut 4/4/03 $66.85 - -- -�-
I1 AX)k%State Tax 414/03 $5.35 Elect'I Service
Elect'I Final
Total $72.20
- —�
I his Permit is issued subjec! 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 perinit will-xpire 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 8154-00.1-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or
1-8032-2344
Issu By.
Permit Signature: /
OWNER INSTALLATION ONLY `
The installation is being made on property I own which is no± intk+nded for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:----
CONTRACTOR
ATE:---_CONTR CT R INSTALLATION ONLY
SIGNATURE OF SUPR. ELE(7,'N: _ — DATE:___----. _
LICENSE NO: -
Call 639-4175 by 7:00pm for an inspection the next business day
1 1 1
Electrical I�y eI'IIP11 Application Received L•lectrical
Date/By: Permit No.:
CitOf Tigard Planning Approval Sign —
Y g Date/By: Permit No.: _
13125 SW Hall Blvd. Plan Rcvi�:., - Other —
Tigard,Oregon 97223 Date/By: Permit No.: _
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
,711 Date/By: Case No.:
Internet: www.ci.tigard.or.us Contact luris.: Sec I'a(;e 2 fur
24-hour inspection Request: 503-639-4175 Name/Method: I - _suirlemental Information.
_TYPE OF WORK - PLAN REVIEW Please check all that apply)
New construction _ L] Demolition Service over 225 amps- Ll I lealth care facility
-- commercial ❑I lazardous location
Addition/alteration/replacement I ❑Other: _ ❑Service over 320 amps-rating of ❑Building over 10,000 square feel,
CATEGORY OF CONSTRUCTION I &2 family dwellings tour or more residential units in
1 &2-Family d%-ellin!L Commercial/Industrial ❑System over 600 volts nominal one stmc,ure
❑Building over three stories ❑Feeders,400 amps or mora
Accessory Building Multi-Family [J occupant load over 99 persons ❑Manufactured structures or RV park
_❑ Master Builder ❑Other: ❑Fgress/lighung plan ❑Other:_
JOii SITE INF9R 'fi N and LOCATION Submit_sets of plans with any of the above.
-lbs$ The above are not applicable to temporary construction service.
Job site address: '"f / ` q,��$ �,W.Cenraer,crel FEE*SCHEDULE
Suite #: _ Bldg./Apt.#: - number of it ections per pcrmit allowed
Project Name: rsAiw.// �5c it r beQ _ _ Description _-- - llq Fee(ca.) �o,i
oss street/Directions to job site: ,/ New residentialnunit.Includes
or tacheunultgaro' per
� dwelling unit.Includes attached RaraAe.
Service Included:
1000 sq Il or less—__ 145.15 4
Each additional 500 sqn.m jmriion thereof_ 33.40 — 1
Subdivision: _ Lot#: t-imited energy,residential 75.00 2
Limited energy,non residential 75.00 2
Tax ma / arcel M Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
-- Services or feeders-Installation,
alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps - 106.85 2-
401
401 am s to 600 am 160.60 2
Plt�r'ERTY OWNER __ TENANT 601 amps to 1000 amps 240.60 z
Over 1000 amps or volts 454.65 2
N'.me: Q r-5 ''// .S to/9/14rw0 Reconnect only 66.85 2
GLrr►S 'Fznrporary services or feeders-installation,
Address: 7/070 S, W
alteration,or relocation:
City/State/Zip: IG d OR 72-2-3� 200 amps or lass 66.85 _- 1
Phone:(5.,)3&�- - 3 —w Fax: i01 amps t"400 amps 100.30 2.
APPLICANTCONTACT PERSON 401 to 600 ams 133.75 2
�- — Branch circeits-new.alteration,or
Nae:m
extension per panel:
A.Fee for branch circuits with purchase of
Address: - _- _ service or feeder fee,each branch circuit 6.65 2
Ctty/State/Zi _ _ B.Fee for branch circuits withoia purchase of
-- ---------- - service or feeder fee,first b anch circuit 46.85 2
- ------ ---- --Phone: -----
Fax: Each additional branch circuit 6.65 2
E-mail: - - —_ ----- "- -- Misc(Service or feeder not included):
CONTRACTOR - c�um�2tr irrigation circle 53.40 2
Ea
-- F.ch signm outline lighting_ __ 53.40 2
Job No: T Signal cimidt(s)or a limited energy panel•
allerati•,n,or extension _ Pae
Business Name: 2 2
_ �- _ ascription: -
Address: � �. � J----
Cit /State/Zi Fach additional inspeclion over the all_o_wahle in an)of the above:
_ Per inspection per hour min. I hour) 62.50
Phone: '
_ ax: Investigation fee.
CCB Lic. #: y Lic. t, Other: -_ —
—--------- Electrical Permit Fees*
Supervising electrician _ _ subtotal S _
Signature required: Plan Review(25%of Permit Fee) $
Print Name: _ Lic.M State Surcharge(8%of Permit Fee) S 5 " ri
TOTAL PERMIT FEE S 2_, q
Authorized Notice: This permit application expires if a permit Is not obtained within
Signature: / Date:-Y/,-Y/ 3 190 days after 11 has been accepted as complete.
/ *Fee methodology set by Tri-County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit FormslElcPernntApp.doc 01!03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for sill systems............................................................ $75.00
Check Type of Work Involved:
LI Audio and Stereo Systems*
Iturglar Alarm
Garage Dooi Opener*
I leating,Ventilation and Air Conditioning System*
C] Vacuum Systems*
Other
COMMERCIAL WORK ONLY:
Feefor each system.......................................................... $75.00
(SEF OAR 918-260-260)
Check T)pe of Work Involved:
L] Audio and.Stereo Systems
Boiler Crntrols
C7 Clock Systems
Ueta Telecommunication histallation
Fire Alarm Installation
HVAU
u Instrumentation
Intercom and Paging Systems
Landscape Irrigation Control*
Medical
Nurse Calls
e
! 1 Outdoor landscape Lighting*
n Protective Signaling
C� Other_ ------ --
______Number of Systems
* No licenses are required. Licenses are required for all
other Installations
i\I)sts\I'ermit Fonns\lilcPermitAppPg2.doc 01103
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
!NSPECTION DIVISION Business Line: (503)639-4171 MST
BUP ------- -
Received _____ Date Reques d__ _ AM PM ___ BUP
r
Location _0� _Suite_ ' MEC
Contact Person ____ .__ 1�- -4 -___ Ph (—) �_-��_`1�_ PLM
Contractor — -- ---- -- Ph(.... . — —) ----- - --_ SWR
BUILDING— - —' Tenant/Owner &17
— ELC _
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: St f
Post&Beam
Shear Anchors ----� ----
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall ✓Fire Sprinkler - --- - ---------------- ------ ---
Fire Alarm
Susp'dCeiling ----- --- ---
Roof
Final
PASS PART FAIL —
PLUM_BIN_G_ -
Post& Beam -
Under Slab - ------ -
Rough-In ---------- --- - -- ---_—._------
Water Service - -- -
Sanitary Sewir
Rain Drains
Catch Basin/Manhole
Storm Drain - -- ------ -- - ------ __
Shower Pan
Other: -- - - - ---
Final
PASS_ PART FAIL -- -- ------
MECHdNICAL
Post 8 Beam ----� - v-- - - ---
Rough-In ------
Gas
___---Gas Line
Smoke Dampers - -- -. - ---- - -- ---
Final
PASS PART FAIL - ---- -----
ELECTRICAL
r
Rough !n
UG/Slab
------------
Low Voltage
Fire Alarm
Final - ❑ Reinspection fee of$__ -__ _.._ required beiore next inspection. Pay at City Hall. 13135 SW Hall Blvd.
PART FAIL
$ _ _ Please call f� reinapection RE: _._._.-__-- [] Unable to inspect--no access
Fire Supply Line
ADA
Approach/Sidewalk Date / = - Insp r
Other: -_
f
Ficial DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD
DEVELOPMENT SERVICE; P"-uPERMIT
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 DARM I T #SU. .ED . . . . : PLM98-00 c
DA-f E: ISSUED: 02/06/98
PARCEL: .:'S 102AB-01 x='00
5ITE ADDRESS. . . r 09303 .SW COMMEHCIAi_ ST
SLJBDIVISION. . . : N0. TIGARDVI( LE ADDITION AMEND. ZONING: R-25
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :064 JLIRISDICTION: TIG
,LASS OF WORK. . :AL._T GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF IJSE. . . . -MF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES-------------- L..ALJNDRY TRAYS. . . . . : 0 5F RAIN DRAINS. . . . . : 0
SINES. . . . . . . . . . r. !JR INAI_S. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . . 0 OTHER FIXTURLi. . . . : 0
TUBI6HOWCRS. . . : 0 SEWER LINE (ft ) . . . : 100
WATER CLOSETS. : 0 WATER L.-INC' (ft ) . . . : 1.00
DISHWAcHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remar-ks : Water- service and sanitary sewer repair. No work il, the right—of• way.
Repairing bi.rilding lateralF, only.
Owner-: -- -- --__—_.____________._.___.__..__.._._.__..._..._-------.___.._----.---__-_-- FEES
MARSHA L_ SLINNARDORG type amU'.u,i, 1by LJALe r•eL:1JL
7570 EW VARNS PRMT $ 60. 00 B 01 /27/98 98-3028,_8
TIGARD OR 97223 5PCT $ :•,. 00 B 01/117/98 98-302828
Phone S:
LARSEN 8. SONS, PLLJMB I NG CO.
7000 SW 36TH AVE..
PORTLAND OR 97219
F''hone # .. f46-7004 $ 63. 00 TOTAL
Rey #. . - 000676
- ---- — RE0t.J I RFD I NSPFCT I ONS — —This permit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Coue, State of Ore. Specialty Codes and all other Water Set-vire In
applicable laws. All North will be acne in accordance with Final Inspection
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 Ccater. Those rules are
set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may
obtain copies of these rules or direct questions to OLINC by calling
(503)246-1967.
Issi_red By , '
w' � %/�/l Lt f='e r m i t t e e S i g n a t i_r r-e : �`�"�— �'t-C- _n-�t
4•++++++•++++++++-.4-+++++++•++++++++++++++++++++++++++++++++++..V+4+++++++i-++++++++
Call 63'9- 4175 by 7:00 p. m. for an inspiection needed the next b�rsiness day
L++++•r+++++++++-++-+++-►+++++++ -++++++++++++++++++++++•a++++++++++++++++4-++++_+++++
CITY
OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PL.M98-00`5
DATE ISSUED: 01/:'7/98
PARCEL: 2S102AB-01200
SIFT: ADDRESS. . . : 09305 SW COMMERCIAL ST
SURD I V I S I ON. . . . : NO. T I GARDV I I._LE ADDITION AMEND. ZONING: R-25
BLOCK. . . . . . . . . . . L_OT. . . . . . . . . . . . . :064 JURISDICTION: TIG
-----------------
-
CLASS OF WORK. . :ALT GARBAGE_ DISPOSALS. : 0 MOBILE. HOMESPACE S. :-0 _ Y
TYPE OF USE. . . . :MF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRE'. . : R3 FLOOR DRFIINS. . . ,: . . : 0 TRAPS. . . . 0
S'TORIE'S. . . . . . . . : 0 WATFR HEATFRS. . . . . . 0 CATCH BASINS. . . . . . . : 0
FIXTURES----------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
I-.AVATORTES. . . . : 0 OTHER FIXTURES. . . . : 0
TU11/9HOWERS. . . : 0 SEWER LINE (ft ) . . . 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 100
D I riHWASHE RS. . . . : 0 RAIN DRAIN (ft ) . . . 100
Remarks : Water service and rain drains
Owner: -- --- - ---_.____.__---•_________________ ________. ___--._.-- FEES ----------_-__--
IKAFSHA L SUNNARDORG type amo�int by date rerpt
7670 SW VARNS PRMT f 60- 00 Ei 01/27/98 96-302829
TIGARD OR 97223 SPCT $ :.?,. 00 B 01/27/98 9(3--302828
Phone #:
Contractor- -_________._____..--•-_-___.__.___..___-__
LARSEN & SONS PLUMBING, CO.
'7800 SW ;;6TH AVE.
PORTLAND OR 97,',t'3
Ph on e #: 246-700L: $ 63. 00 TOTA'_
Reg #. . : 000376
.----.---_- - _ ------- ,I
This permit is issued subiect to the regulations contained in the REQUIRED INSPECTIONS
Water Service In
Tigard Municipal Code, State of Ore. Sperialty Codes and all other Rain Drn i n I n a p -
applicable laws. All Mork will be done in accordance with Final - ,ispect ion
approved plans. This permit will expire if work is not start PH
within 19Q days of issuance, or i, work is suspended for eorr -�—
than 198 days. ATTENTION: Oregon law requires you to follr,w rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-MI-Ole through OAR 952-Wl-#W. You may
obtain copies of these rules or direct questions to OMC by calling
(5@3)216-1997.
By-_, _.L' _.ti� '!'�.!'u _._.._------- P e r m i t t e e Signa`u r e:
s
4'++4.................4..++++++++4+++++++h+++++++++++++++++-++++++++++ +++++++
Call 639-4175 by 7:00 p. m. for an inspect ion needF i the next bUs4 ness clay
+++++t++++++++f+++++++++++++-+-F++ h++-F•4-++++++++++++t++1-+++++++++++++++++++-1-+++++-
CITY OF TIGARD Plumbing Application Recd By.
13125 SW HALL BLVD. Commercial and Residential Date Recd - -
TIGARD, OR 97223 Date to RE
1503) 639-4171 Date to Dr
Permit# y
Print or Type Related SWR
Incomplete of ;Ileo;ble applications will not be accepted Called -
a of DevelopmentiProiect On back Indicate Work Perlormbd by fixture.
Job Na�� _a Al,� i ry i(v FIXTURES (Individual) QTY PRICE AMT
Address StreetAddresW `S,..Ite Sink 9.00
Lavatory 9.00
Bldgs City/State ZIP Tub or Tub/Shower Comb. 9.00
Name — Shower Only 9 0Q
Water Closet 9.00
Owner M_r�iling Address Suite Dishwasher e.00
(` Garbage Disposal 9.00
C;ty/State Zip Prone Washing Machine 9.00
\' �- '3
Name Floor Drain 2" 9.00
3" 9.00
Occupant Mailing Address suite 4' 9.00
City/State Zip Phone Water Heater O conversion O like kind 9.00
Laundry Room Tray 9.00
i �Name Urinal 9.00
S
L /ky v-l;.y�.�-�(% L ';1j _ Other Fixtures(Specify) 9.00
Contractor I g Addresp Suite 9.00
Prior to,qr p Ci /St to Zip Pho e/ 9.00
issuance,a copy
p
of all licenses are Or%Wn Con,tt.Cont.Board Li—c.# Exp. .Vle 9.00
required if T Sewer-1st 700" 30.00
expired in COT Plumbing Ur_* xp.Dale --
> �r., > Sewer-each ndditlonal'0'
� database r�" s; + f�,>f - �(/ 25.00
Name, Water Service-1 st 100' 30.00
Architect Water Service-each additional 200' 25.00
Of Mailing Address Suite Storm&Rain Drain-1st 100' 30.00
Storm&Rain Drain—each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 2500
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New O Addition O Alteration O Repair O Pollution Device
to be done: Residential O Non-residential O — — --a
_ Residential Backflow Prevention Device' 15.00
Additional description of work: Any Trap or Waste Not ConnEeed to a Fixture 9.00
Catch Basin 9.00
Insp.of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections, 40,00
building or property______ _+ er/hr
Rain Drain,single family dwellir; 30.00
Proposed use of Grease Traps � �� 9.00
budding or property
QUANTITY TOTAL
I hereby acknowledge that I have read this application,that the information Isometric or riser diagram Is required it Quanity Total is >9
given is correct,that I am the owner or authorized agent of tho owner,and —— 'SUBTOTAL
that plans submitted are in compliance with Oregon State Laws.
Slg ore of Own@ gent Date _ 5%SURCHARGE
— --I PLAN z,o�
dhtabt P rit&n Name 1 hone
PLAN REVIEW 25%OF SUBTOTAL
Required only if Ilxture qty total is>9
TOTAL
f 'Minimum permit fee is S25+5%surcharge,except Residential Backflow
,._ f : Prevention Device,which to i surcharge
0,1,1 161 14
I tdsta�pimapv net sm"
1
PLEA COMPLETE:
Fixture Type Quantity by Work Performed
New Movea Replaced RemovedlCapped
Sink __
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal —
Washing Machine_
Floor Drain 2"
4"
'Nater Heater _
Laundry Room Tray —
Urinal _ —
Other, Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I)osb`ylmapp doc 597
A^WkCITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PFRMIT #: ELC97-0712
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 10/24/97
PARCEL: 2S 102AB-01`00
'E ADDRESS. . . :09305 SW COMMERC;I AI._ CT
';3DTVISION. . . . N0. TIGARDVII_LE ADDITION AMEND. 7.ONING:R—"
OCN.. . . . . . . . . . . LOT. . . . . . . . . . . . . :064 JURISDICTION: TIG
o j ect Descr-i pt i on: Reconnection only.
RESIDENTIAL_ UNIT-_....._. ._ -TEMP SRVC/FEEDERS---_ ____.__MISCEL_LANEf7l.1C -
' MOO SF OR LESS. . . . : 0 0 _.• 000 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
-i^..H ADD' L 500SF. . . : 0 201 400 amp. . . . . . . . 0 SIGN/OUT LINE LTG. . : 0
"MITFD ENERGY. . . . . : 0 401 -- E00 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
'I-NF. HM/ SVC/FDR. . : 0 601 +-amps. 1000 volts. : 0 MINOR I.-ABEL ( 10) . . . : V
--SERV I CE/FEEDER-----— -•---BRANCH CIRCUITS------- ---••-ADD' L INSPECTIONS—-
-
NSPECTIONS—-
-- 000 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
''1 _. 400 arnp. . . . . . .. 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401. - 600 a.mp. . , . , . : 0 EA ADD' L BRNCH CIRC: 0 IN PL.ANT. . . . . . . . . . . .. C
E',01 — 1000 �Xmp. . . . . . 0 ___________.__. ..__PL_AN REYIE:W SECTIQN___.__.__----.____._.
1.000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) E00 VOLT NOMINAI-. . :
Reconnect only. . . . . : 1 SVC/FDR > 2:25 AMPS. . : CLASS AREA/SPEC OCC. :
FEES
VIKING WARTMF_'NTS type amol_Irlt by date r•,ecpt
1..0`, Cly! CQMMrRClfll... "1T F'RMT $ 50. 00 DRA 10/2:4/97 97-310w
(f1ARD OR W.-I'? 5PCT $ 2. 50 DRA 10/24/97 97-300
iNER r 50. '0 TOTAL
RE01_"IREL) INC)FI CTIiON7
Elf�ct' I Service
'lone #: Eler-t' 1 Final
g #. . . 9:9999
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 W
'4ys of issuance, or if work is suspended for more than 18N days. ATTENTION: Oregon law requires you to follow the rules adopted by
Oregon Utility Notification Center. Those rules are set fcrth ii OAR 95Z Nl- th' R 9°.,2-@01-1987. You may obtain a cop;
these rules or direct questions to OX by calling 31246•-1987.
r'm i t t e!?
y '
PVE �o ISG (Zk" tA1JI3EC� �u �,1VtJn�VKE REQ
— --- -- — - - - - - ... -- —OWNER INSTf1LL_ATION —
le installation is being made on pr-opprty I own whirh is not intenders For-
lle, lease, or- rent.
INFR' S 7I GNATURE., � DAVE: 14-
I
4r
-_.----._._._.. __-_... ..-... ....._._.CI7hJTRACtQR INSTALLATION ONLY---
'GNATURE Or GUC'R. El_EC' N: DATE:
'CENSE NO:
++++++f+-FA ++-a r t+++4 4 1 F F++++++++ L+++•-!-+++++++++++-F++++-++++-F+•++++++++++++++++•+++
Call 639- 4175 by 7:00 p. m. for an inspection needed the next t,usinpss day
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By .r i
TIGARD OR 97223 Date Recd I,'
Phone (503)639-4171, x304 Dale to P.E.
Inspection 503 639 4175 Print or Type Date to DST
Ins
p ( ) Incomplete or illegible will not be accepted Permit# L G t _ t
Fax (503)684-7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ II 11 Number of Inr pectione pur permit allowed
Name(or name of business) I kIn _ k14)Ke- I� Service Included: Items Cost Sum
Address O rn w err IecS ( 4a. Residential-per unit
.- 1000 sq it,or less $110.00 4
City/State/Zip Each additional 500 sq.fi.ur
Commercial ❑ Residential portion thereof $2.5.00 1
Limited Energy $25.00
Each Manuf'd Hrrm•it Modular
Dwelling Service or Feeder __ $6800 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical ContractorInstallation,alteration,or relocation
200 amps or less $60.00 2
Address - 201 amps to 400 amps $80.00 2
City _ __State -Zip 401 amps to 600 amps $120.00 2
Phone No. __- - 601 amps to 1000 amps $180.00 2
Job No._ Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. Exp.Date Reconnect only $50.00 •! 2
OR State CCB Reg No. Exp.Date_ 4c.Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation,alteration,or relocation
200 amps or less $50.00 _ 2
Signature of Supr. Elec'n 201 amps to 400 amps _-_ $75.00 _ 2
-- 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr -- _,Exp I te__ see"b"above.
Phone N
--- - - 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
/)^ / � / purchase of service or
Print Owner's amp-Ad a irS` Lk I I n CL rLo� feeder fee.
LZ_UiEach branch circuit $5.00 2
Address -7 U S s f �-Z-- b)The fon for branch circuits
City__ Slate Zip�E L. 3- without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 _ 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e.Miscellaneous
J (Service or feeder not included)
Owner's Signature s/�Qs Each pump or irrigation circle -- $40.00 _ 2
Each sign or outline lighting $40.00 2
3. Plan Review s etion (if required):* Signal eircuit(s)or a limited one,gy
panel,alteration or extension $40.00 2
Please check appropriate item and enter fee In section 5B. Minor Labors(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 _
as 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:
Not required for temporary construction services. 59.Enter total of above fees $ L, _„
511.Surcharge(.05 X total fees) $ LA.`} �`l �
NOTICE Subtotal $
5b.Enter 25%of line 5a for
PEf�, 'S BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review it required(Sec.3) $
NO, i.vMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Jr
TIME AFTER WORK IS COMMENCED. ❑ Trust Account It I ,
Total balance Due s
IWSTSAELC96.APP nev 91516