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CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL_ PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #: EL_C96-0707
DATE ISSUED: 11.'04/96
PARCEL: iS13 3DD-0-3900
SITE. ADDRESS. . . : 12:542 SW BRIDGEVIEW CT
SUBDIVISION. . . . : VILLAGE A T SLIMMER I-AKE PAF(K 3 ZONING-. R-4. ')
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :i8
Pr�o.ject De-cription: adding limited erreryy panel or, extension
RE:S I DENT I AL UNIT----- ---TEIMP SRVC/FEED~RS- ---- --•----M I SCELL.ANEOUS---_--_..
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 5005F. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401. - 600 amp. . . . . . . : d SIGNAL/P'AHEL. . . . . . . : i
MANF. HM/ SVC/FDR. . : 0 601+amps•-1000 volts. : 0 MINOR (_..ABEL ( 10) . . . : 0
--.__-_.SERVICE/FE:EDER•--_..__ _.... BRANCH CIRCUITS----- -....___ADD' L. INSP'E'CTIONS------
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
. 0i. 400 amp. . . . . . : 0 1st W/0 SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH r1RC: 0 IN PLANT. . . . . . . _ . . . : 0
GO 1. - 1000 amp. . . . . . 0 ___._______.____._--_FLAN REVIEW SECTION-•-----._-__--._____.
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : > 600 VOLT NOMINOL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner-.- _________._._______.___-_.._______--------._._____----._--- FEES
-----------------
ANTHONY NATONIEWSKI tyr,,(. amoi.rnt by date t-ecpt
12542' SW BRIDGEVIEW CT PRMT $ 40. 00 TAT 11 /04/96 96-286065
5F"CT $ 2. 00 TAT 1 1 /04/".'6. 9C •286065
1IGARD OR 97223
!hone #:
Contractor;
HONEYWELL_ $ 42. 00 TOTAL
15495 SW SEQUOIA SUITE 100
REQUIRED INSPECTIONS - ---- --
PORTLAND OR 97224 I.eiling Cover Elect' 1 service
Phone #: 03--968--3333 Wall Cover Elect' 1 Final
Reg #, . : 57824
This permit is issued subject to the rogulacions contained in the
Tigard Municipal Code, State of Ore. Sp cialty Codei and al l other Per m i t t e� S i gnat
applicable lar+s. All work will be done in accordance with /
approved plans. This permit will expire if work is not started __ i�
within 190 days of issuance, or if work is suspended for more I
than 88 day':. ssr.red Py
-OWNER INSTALLATION ONLY----- _-_•_-----_______.__..--_-.-_
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S F I GNATURE : _ .� DATE r
.___.__--(7ONTRACTOR INSTALI_.ATION
SIGNATURE OF SUPR. ELEC' N: _ DATE:
LICENSE NO:
Call for inspection -- 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # _Z-0 C/
Date Issued
Phone (503) 639--4171 — -- — -
CITY OF TIGARDFAX (503) 684-7297
TDD No (503) 684-2772
r Inspection (503) 639-4175
1. Jots Address: 4. Complete Fee Schedule Below:
Name of Development Number o;Inspections per permit allowed
Address_',' -5S 2 J Ir j e4,-,e_ V t eL> 0 _. Service included Items Cost(ea) Sum
City/State/Zip—Tag d! -JC ?Z;2;Z " 4a. Residential -per unit
-J , 1000 sq f', (,I less 511000
Name (or name of business) Na_Lnlu.).5 k l Each additional 500 sq ft ir
portion thereof $25 no
Commercial ❑ Residential ® Limited Energy $25 oo I
Each Manufd Home or Modular
Dwelling Service or Feeder $680 � 2
2a. Contractor installation only:
4b. Services or Feeders
nstallation,alteration or relocation
Electrical Contractor 200 amps or less 56o 00 2
Address 5` ` C_�j .r, rte;", ItI— r 201 amps to 400 amps �— $8000 2
City r o ate C, Zip P/] 401 amps to 600 amps $120 00 — _ 2
T—� 601 amps to 1000 amps $18000 2
.
Phone No. ' ��� v Over 1000 amps or volts $34000 2
., .
Job NO. Reconnect only $5000
contractor's license O L a D 1 C.L E ___ 4c. Temporary Services or Feeders
Contractor's Board Reg No4 ] 9 2 Y Installation,alteration,or.elocatlon —
Signature of Supr. Elec'n 4 200 amps or less 2
License No.q 7 yJ/_L- P1,4 NJ�4'_��_1 d 201 amps to 400 amps $5000 2
401 amps to 600 amps $75 00
Over 600 amps to 1000 volts $10000 -- -
2b. For owner ;frstallations: see"b"above
4d. Branch Circuits
Print Owner's Nam _ _ New alteration or extension per pane 1
Address r.�'he fee for branch circuits with
City State Zip purchase or service or feeder toe
Each branch circuit $500
Phone No. _ b)The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder foe 2,
First branch cacult $3500
i,ot intended for sale, lease or rent. Each additional branch c-rcuit S500
Own1+r's Signature 4e. Miscellaneous
(Service or feeder not included) 2
mgavon circle $4000 2
3. Man Review section (11s Each pump or Irequired): Each sign or outline lighting $4000
Signal circult(s)or a limited energy -- 2
Please check appropriate Item arid enter fee in section 5B panel,alteration or extension $4000
4 or more residential units 1 one structure Minor Labels(10) _ sloo on
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional Inspection over
Classified area or structure containing special occupancy the allowable In any of the above
as described in N E C Chapter 5 Per inspecl'rn $3500
Per hour $5500
In Plant $5500
Submit 2 sets of plan= with application where any of the above e-
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $
5% Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR plan Review if required (Sec 3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. .m�mv.aw< �_� Trust Account 4
$
�O—
Balance Due
1 ---- 7
FCE-W If ILWLC0 OAN
CITY OF T I GARD PERMI1 #. . . .
c-CUPe. . . . M03 Tj 3 9 5 9
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED' 07/26/94
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)639-4171
PARCEL s 15 133DI).-03900
ATL 1100RESS. 1��542 SW URIDGEVIEW (.T
SUBDIVISION. . . .. t VILA !'*'jE Al SUMMER LAVE- PARK ZONING:R-4. 5
f;Loct<. . . . . . . . . . : LOT. . . . . . . . . . . . . 178
CLASS OF WORI',. .NL-:W
TYPE OF' USE'. . . .-SF
0('.l.'.UF1ANCY GPP. -.R3
OCCUPANCY LOAD:228
I 1-1-JANT 111AME. . . :
P-marks - PATH I
PON MORISSETIEF fit-IMES
1 `1555 SW BANGY RD
1-0i(L' OGWEGO OR
phone #- 620- 1538
Contracture
C'ONTRACTOR NO*T ON FILE
Reg
Occupancy of thp above reference0 building is here-by given, ar-.cj certifies
the complianc-e with the Statp Of Oregon Spectelty Code-, f(--,i the group,
or-cupoincy, and use under which the refer eiiced permit was i4sued.
0 BU L r)
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POST IN CON SiPICLJOUS PL14CE
NI SPECj1gN NOTICE �-
city of Tigard Building Department
13125 SII Ball Blvd. Tig-_'d, Oregon 97223
Inspection Line (ROC-O-Phone)t 639-4175 Business Phone: 639-4171
Inspections --
Footing Plbg. Underelab Mech. Rough-in hppt/8dwlk
:mound. Plbg. Top out Gas Line t_z
JPoet/Beam Struct. San. Sewer Framing d
Post/Beam Mech. Rain Drain Insulation -plumb.
Plby. Underfloor Nater Line /
Gyp.
Bd � �
Date Requesl.edt C�C TimetM
Address t v 1�� Pe tit
Builder: \I VNOIN
Y a
THE FO:.inNlNli CORRECTIONS ARE REQUIREDt
A,
J —
Inspector: Date:
� v `c " --�'"�`--- —�
APPIfOVab DISAPPROVED APPROVED SUBJECT TO ABOVS
�`� _—Call For Reinap.
CITY OF TIG;ARD MASTER P'E.RMIT
PERMIT #. . . . . . . . MST93-959`
COMMUNITY DEVELOPMENT DF:P..q,RT,IVIFMT DATE ISSUED: 01/26/94
1312 SW Hell Blvd,Tigard,Oregon 97273.8199 (503)839-4171
SITE' ADDRESS. . . : 1;.'542 SW BFt I DGF".V I[:.W CT PARCEL: 1 133DD-0: 900
SUBDIVISION. . . . : VILLAGE AT SLIMMER LAKE P'ARK 3 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :78
BUILDING -______..___.__.______.____---------------
REISSUE: DWELLING UNI TS: 1. BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:5 BATHS:3 GARAGE. . . . . . . . . . :679 sf
TYPE OF USE. . . :SF FLOOR AREAS-------- --- REQUIRED SETBACKS--------------•
TYPL OF CONST. .-5N FIRST. . . . : 1580 sf LEFT. . :29 ft RIGHT. :5 ft
OCCUP'AI\ICY GRP'. :R3 SECOND. . . : 1515), sf FRONT. :21Z ft REAR. . : 19 ft
STORIES. . . . . . . :_ 'THIRD. . . . :0 sf REQUIRED---- _.____._________.__
HEIGHT. . . . . . . . :. a Ft TOTAL.--_---:,309': sf SMOKE DFTEC•TORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 154592 PARKING SPACES. . : 1
Remarks : PATH I
PLUMBIN(.3
OINKS. . . . . . . . . . : 1 FLOOR DRAINS,. . . . :0 BACKFLOW P'REVNTRS. . :0 -
t_AVHTORIES. . . . . :3 WATER HEATERS. . . : 1 TRAP'S. . . . . . . . . . . . . . :0
TUB/SHOWE:R5. . . . : 4 I._(aUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSE-i S. . :3 SEWER LINE (ft ) . :0 CREASE TRAP'S. . . . . . . :0
1)IfaHWASHER'S. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SF RAIN DRP I NS. . : 1
---------------- MECHANICAL ------------------------------------ FEES
FUEL fYP'FS-- -- - --- - UNIT HTR5. . :0 type amoi_int by date r^ecpt
/GAS/ / / VENTS . . . . . :0 TIF `E 1520. 00 JH 01/26/94 -
MAX TNr'U' :0 LA! IJ VENT F"ANS. . - 4 BP'RT t 370. 50 JH 01.!2:6/94 -
FURN < 100K . . :0 HOODS. . . . . . : 1 BPLC `F 370. 83 JLH 12/03/93 93 ;74 6if•
F URN ! =100K — . 1 WOODST11VES. :0 B5P'1: 1; 28. 53 JH 01/26/94
FLOOR F'URN. . . . :0 CLO DRYERS.. : 1 SSDC f 280. 00 JH 01/26/94 -
i F30IL /CMF' < :,FIP':0 OTHER UNITS: 1 PARI-/, t 250. 00 JH 01/26/94 -
GAS OUILETS: 1 MP'RT $ 45. 00 JH 01 /26/94 -
Owner : _MP'LC $ 11. 2:5 JH 01 /26/94
DUN MURI.9SETTE Hf'F'S NiElP,C i 5 JH 01/26/94 -
15555 SW BANDY RD P'PRT $ 147. 50 JH 01/26/94 -
P15P'C: 4 7. 36 JH 01/26/94 -
L.141',L OSWE(30 OR
Phone #: 620-7538
Contractor^: _____._..__...._.___.___..__....._-•---....._.____
DON MORISSF_TTE BUILDERS, INC.
`aN00 SW MEADOWS RD
!)UIIi_: 151
LAKE OSWE GO OR 97035
Phone #: 620 -7538
Reg #. . . 35533 !.__..___________._______________._._.
7 3233. 24 TOTAL �
This persit is issued sub.iect to the regulations contained in the ------- REOUTRED INSP'ECTTONS -- -- -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fir-eplace Insp
applicable laws. All work will be done in accordance Hath approved F'ost/Beam Str1.lct Gas Line Insp
plans. This permit will expire if k isnot started within 168 Post /Beam Mechan 111SLtIati0n Insp
days of issuance, or if work is suskended 6r eortth4n 0 days. P111111/1-mdSlab Insp Gyp Board Insp
IJ F'LM/Underfloor Rain drain Insp
er^mittee 5ignat)i1^e ; _ iAI : �Ll �1h' Mechanical Insp Water Line Insp
Plumb Top Out Appr/Sdwlk Insp
I s s 1-i e d Fay : �._..__ Framing Insp Mechanical Final l
Call for^ inspection - 639-4175
CITY CF TIGARD SEWER PERMIT CONNECTION -
��RMIr
COMMUNITY DEVELOPMENT DMP.>�RIMIDIT FERMI r SUED: . . 0,,10
DATE ISSUED: 01/26/94
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PARCEL: 1S133DD-03900
5111- WDDRESS. . . : 12542 5W BR I DGE V I E::W CT
SUBD I V 1:S I ON. . . . : VILLAGE AT' SUMMER LAKE PARK 3 ZONING: R-4. 5
DLOCR. . . . . . . . . . . LOT. . . . . . . . . . . . . :78
------------
TE:NANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . . :
CLASS OF WORI!. . . :NEW DWELL.ING UNITS. . : 1
TYPE: OF USE. . . . . :SF NO. OF BU I LD I NGS: 1
IN!3TALL TYPE. . . . :BUSWR IMPERV SURFACE. . : - Sf
Remarks : PATH I
Owner: -______._._._.___.____.____.___._____ .____.__.__.__...________- FEES
DON MORISSETTE HOMES type amount by date recpt
15575 SW RANGY RD PRMT $ 2200. 00 JH 01/26/94 --.
IN13P $ 35. 00 JH 01/26/94 -
LAKE_ OSWEGO OR
Phone #: 620-•7538
Contractor:
CONTRACTOR NOT ON FILE
--
I fh o n e #: $ 2235. 00 TOTAL
Reg #. . .
REQUIRED I NSPEC-r I ONS -__._._._
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
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 Agency does not guarantee the accuracy of theV�!
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions frac
the distance given. If not so loced, the ' staller shall purchase
a "Tap and Side Sewer" Permit andlthe Agency will ins 11 a lateral.
Prarrnittee SI gnat Lire : u ,
I s s 1.r ed N y
Cal I for inspection 639--4175
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P.O.Boot 19524
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l ,OR 9'1219
( 03)244-9314
The Foundation ForARordable Homes
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Residential euildin Permit Application
9 �¢
City of Tigard `
13125 SW Hall Blvd.
i Igard, OR 97223
(503) 639-4171
�S133 03you
Jobslte Address: %�;1.r�� .>�� ��'t.Lt t u r c'w L
� t
ca use tint
Subrlvlsbn:` 'Z 7,L.x,"• C_ Lot! 6 ,� y
Rec#
Valuation: -
etmit .r _
Owner: �3ue of �
s
Address: 16-,55Ss
Amd
i
Phone:
a
ng;nePrir+g . .....::.: ..,.
Cuntractrr: >fi �5 �' y Other
Address:
Items Fier uired
Subcontractors
Phone: F*) 3� _
Truss Details
Contractor's License M a
(attach copy of current Oregon license) ~r
Subcontractors:
�
Plumbing: E)h G= m R se p,-S
Mechanical: Tj—u 2 0LE P.
(attach copy of current OR Contactors Uce,r.;e)
Amhitect/Englneer:
Address:
Phone: 690 _
COMMENTS: _
WA Applicant Signature ! Phone number
Received by:rt - __ _ __—__-- batA Received: �'�
Community Development ELECTRICAL PERMIT APPLICATION
15125 SW Hall Blvd
Tigard, OR 97223 Planck/Rec. #
Permit #
Phone (503) 639.4171 Date Issued `7
CITU OF TIGARD FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639-4175
1 Job Address: 4. Complete Fee Schedule Below:
Name of Development-2 �UI�'�5�.� Number of Inspections per permit allowed
Address r 5� U� Vie. C E'ul_ Service included. Items Cost(ea) Sum
City/State/Zip �('
-� t ��� ( (�)r\�� �!� _ 4a. Residential-per unit 4
to00 rml It Orions $11000
Name (or name of business) Each a ) fi or
portion n therehereof $2500
1
Commercial❑ Residential® Limited Energy $2500
Each Manufd Home or Modular 2
Dwelling Sarv,cs or Feeder W 00
2a. Contractor installation only: 4b.Services or Feeders
br:lallalion,alle,ahon,or relocation 2
Electrical Contractors L� t�_h:� fc►L Stn )t- or lens $150 no 2
Address1 201 amps to 400 amps $8000 2
�ySySlts"- — 401 Amon to 600 amps $12000 2
Ciity_z(J�k�A' (\ Stata�_ Zip� � got Amps to 1000 amps x180 00 2
Phone No.� (c�� "L'�O� _ _ aAr 1000 amps or volts $34000 2
Contractor's License No. -.3 1-3L C- _ Reconnect only $1000 _
Contractor's Board Reg. No. -1 j -7q 7 4c.Temporary Services or Feeders
Installation allarelion or relocation 2
Signature of Supr. Elec'n rI. AM,,.
200 amps or less $5000 2
License No. Phone No. ,- ' I(' _ ,GY ro, amps l0 400 Amps $7500 2
— � --- 401 amps to goo amps $10000
Over 600 amps to 1000 volts
2b. For owner installations: nee'b•Above
4d. Branch Circuits
Print Owner's Name_ _ New,alteration or extension per panni
Address n)The fee lot brant i cacudr with
City' State _ ZipPf 71`11e3e of service or feeder W. 2
Each branch circuit $500
Phone No. _ b)The tee lot branch circuits wifhouf
The installation is being made on property I own which is purchea of somke or Iseder lee 2
not intended for sale, lease or rent. First branch circuit �_ $3500 2
Each aoddional branch circu l $500
Owner's Signature___ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (%1 required): Fnchpump orirrigation circle $4000 2
Each sign o,outli,,e lighting $40 00
Signpi on-A(s)or a t-mded energy 2
Please check appropriate item and enter tee in section 58. panel,t IarAhnn or edension $4000
_4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps of more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E C Chapter 5 tom"" %35 On
xi5 00
Submit 2 sets of plans with application where any of the above --
00
apply. Not required for temporary construction services. 5, Fees:
NOTICE 5a. Entet total of above fees $
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ _
COMMENCED ❑ TruSt Account N
Balance Due $