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14028 SW HLUESTEM LN
C �� of Tic acrd
`� MGTON RESTRICTED
Brpercrr►ent�n ra partatle�
i� 155s � ELECTRICAL ENERGY
Information: 5D3,-6t46-� Fa>;-{6061 -683-412 APPLICATION
PLEASE PRIN_(
• . • sections, • • Permit No. e L tL q S— D7 5
1. Location of Installation Date
Address L40�225 <,L� &LS ,tuv4:!L 1L
City_ wast Zip Code 97,VV 97,V4. Type of work:
Map No. Tax Lot _ RESIDENTIAL Restricted Energy Fee $40.00
(for ali systems)
Thomas Map Book: Page Section
Chick type of work Involved:
Directions
Audio and Stereo Systems* U
Commercial ❑ Residential Burglar Alarm
Telephone Systems*
Tenant Name Garage Door Opener'
(if commercial) _ �__ Fire Alarm
Heating,Ventilation and Air Conditioning Systems*
2. Contractor application: Vacuum Systems'
Other
Electrical Contractor
COMMERCIAL Fee for each system $40.00
(see OAR 918-280-260)
Check type of work involved:
U 1A
I I1 ; �
I i i 7 f}' ,1 l I (I _ Boller Controls
Clock Systems
Phone No. ___— —._.. Data Telecommunications Installations
Fire Alarm Installation
3. owner application: HVAC
'nstrumentation
Print Owner's Name Phone No. Intercom and Faging System
Landscape hu;ation Control*
Address Mediccl
_ _ Nurse Call.
I71ty State 71p Outdoor Landscape Lighting*
This permit Is Issued under OAR 918-920-370. The applicant agrees PtoteJive Signaling
to make only restricted energy Installations(100 volt amps or less) Other
under this permit and to do the following:
1. Only use elertrical licensed persons to do Installations where
required. (Certain residential and other transactions are exer sat _ Number of Systems
from licensing. These have asterisks(°). All others need licens-
ing.)
2. Cali for an Inspection when all the Installations under this pe'rnli 'No licenses are required Licenses are required for all other installations.
are ready for Inspection.
3. Purchase separate permits for all Installations that are not wady 5. Fees /7 ,
Permit.
for inspection when the Inspector Is out to Inspect under Uda Enter fees $ 1�
permit.
4. Assume responsibility for assuming that all corrections required
by the Inspector are done.and 5% Surcharge .05 X total above $
s. Assume responsibility for calling for a final Inspection when all'cf 9
the corrections are completed.
The person signing this permit must be the applicant or a person Trust Account $ (p
authorized to bind the app�(gp
Signature Total{ g
Authority if other than applicant .._—_- ____________ __ This permit becomes null end void If the work authorized by the
permit Is not commenced within 1 so days from date of Issuance
For Inspections call of such permit or If the work authorized Is suspended or abandoned
a tr time crier work as commenced fore period oft 6o days.
640-3561 or 693-4415 Electrical Permits are non-refundable and non-transferable,
24411our recorder, one working day in advance of need RI_24-114
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CITY GF TIGARDr' RMI.Ir .PERMIT #. . . . . .
SWP95-0,108
COMMUNITY DEVELOPMENT DEPARTMENT DATE I S SUED I;
13125 SW Hall Blvd.Tigard,Oregon 47223.8109 (503)030.4171
PARCEL » 1 S 13__MD—PR I I:3::
�. ADDREG`.3. . . a 1400�8 SW SLUE";STEM LN
"IUSD I U;S T ON. . . . : PE BBLECREEyK 11
ON T Nr;
—Oct,, _ . . . . . . . .. , 1..OT. . . . . . . . . . . . .
TENANT NAME. . . . . :
,JOA NCJ. . . . . . . . . . : FIXTURE UNIT`:.. . .
':LA20 OF WC RK. . . ;NEW DWELL_INC UNITS. . . i
TYPE= Or USE':, . . . . 9SF NO. OF SIJILDINGS: 1
INSTALL TYPE. . . . :L)L1SWR It1GEf;u C31.JRrACE. . : '-if
Remar-ks: PATH I
E
-LOSTF', PAC ICIC IIOML71 I"� 4;.r: di"i ,.lnt. by date r Nl pt
14700 SW OSPREY DR .,RMT t x.:200. 00 SW 05/30/9
GUTTY 7 .tl 27`y 1111 P $ 3'.). 00 SW 05/30 5
BE~AVERTON OR 97007
^hos,e ti . 64C., ..0000
Cvntv,actor. : ._...__.......,...-_ _-.__---_._....._ _._-- -
CONTr'ACTOR Nf)T (IN riLr"
u! 3. 00 TOTAL..
R #. .
REQUIRED I NSr'rLT I DNS
?his Applicant ;frees to comply with all the rllE and regulations
of the Unified Sewage Agency. The posit expires JU drive fron _____ ._-......_..._...
the date issued. The total asount paid rill be forfeited if the
eo#it expires. the !igen y does 00 guarantee the ac,.uracy of the _.. ..._ _ ..._..._.__..__.._..
I
sewer iateras. It the sewer is ao: lac+ted at t •eas.��-eon.
:en, the installer shall prospect 3 feet in all directions from _... . .__._ - _. .. ._ .....__
distirce given. If not 50 1Ci:-�nd, the installer "uurchase
'AA -nd Side Sewer" RF':it ar Awry will
i eteral.
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Residential -BuildingPermit App igation (�
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 14028 SW Bluestem Lane
Subdivision: Pebble Creek #2 Lot# 32
Office Use Only
Valuation:
� )35 , �= Contact Date / Initials
Result
Planck/Rec #
New Construction Only: (Square Footage) Permit # n -D.,
House: _18 2 1 Garage: 520 Reissue of M51 '1
Map & TL#
Zone r
Corner Lot? Y N Flag Lot? Y N Plat #
R
Owner: Costa t'acific liorne�, Approvals e uired
Planning Setbacks f I Solar r,)(('-
Address: 8625 SW Cascade Blvd. #606 Engineering
Beaverton, OR 97008 Other - ----
Phone: ( 503 ) 646-8888 Items Required
Contractor: SAME SubcontractorsTruss Details l
Address Other _ v
Notes r��rc.� 4 `-.:)t_�CA._t�� 0 K.
Phone: ( ) --II• �---� !!RTA'
Contractor's License # 65157
4 tJ� R Qan V't(' -(J�AOL�
(attach copy of current Oregon license) rut::
Contact Name: Marci Weber
Contact Phone: ( 503 ) 646-8888
Subcontractors: Arch ite t/Engineer: Iverson Associates
Plumbing: _Wolcott Plumbing Address: 151 SW Kalmus Drive C. 140
Mechanical: Arco Installations Costa Mesa, CA 92626
(attach copy of current OR Contractor's License)
Phone: ( 714 ) 549-3479
JOB DESCRIPTION: Resubmit of Permit MST 94-9103
Applicant Signatur9 Applicant Phore number
I "1 Received by: � .�, I,IA_� kc,�, ��- Date Received:
H%WW%dMv...er
i
Permit # Account Description Amount Amt. Pd. Bal. Due
rp YtiL Bldg. Permit (BUILD) _JQU. U 560�SJ /
Plumb. Permit (PLUMB) ��� 2 ZS,
Mech. Permit (MECH) _ J Y �Z
State Tax (TAX) '�, Z y3 ZL
Bldg: _ 5 3
Plumb: Z
Mech: , y
Pian Check (PLANCK)
Bldg:
Plumb:
Mech: _
.SL✓�y�'0��1Y Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R) Z.11-3 J 3 ✓
Mass Transit TIF (TIF-MT) 12-0
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL) 4-1
Water Quantity (WQUANT) 00
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT) _ (, y
Erosion Planck/USA (ERPLAN) 6, ,�4
Erosion PlanckiCOT (EROSN) _ �-v
TOTALS:
1
P`EMIT
BIPEMIT
CITY OF TIGARD FUMM I T NG#. . . R. . . . MST
COMMUNITY DEVELOPMENT DEPARTMENT DATE TSSUCV: 05/30/9�
13126 SW Hall Blvd.Tigard,Oregon 97223o8199 (503)039.4171 P Ark CE,1-: 17 1"71,73U,-Pp,
1406'21", '.')W Bi.AJE1,;'rEW, i-,N
PEBBLE -
-CREEK II ZONING:
LOT. . . . . . . . . . . . . .3L.
'LAGS Or WURK. i ;N'"W GAIRSAGE Dispoopl..S. : 1
TYPO OF USE* * . p .-SF WASHING MACH. . . . . . . 31 SACKFLOW PPEVN'rRS. .
'XICUPANCY GRP. . :R.", FLOOR DRAINS. . . . . . . 0 TRAr*113. . . . . I . . . . . . . ,
71'n R I E 5. . . . . . . . ..2 WATL-:R HEATERS. . - 1 CATCH SASINF . . . . . . . iO
X 11)RE. 1.1,UNDRY Sr' RVIIN DRAIN(, I
GRU.AISE TRAPS. . . . . . . .0
OT I 1ER f-IXTURES. . . . . .0
TU0,1SHOWERS. . . . . SEWER LINE (ft) . . . . .0
A T 113 0 0 r I 14ATrR LINE (ft ) . . . . j 1V-4`a
PAIN DRAIN (ft) . . . . :0
-
--ks: PATH I
47ES11—
PACTr'7'r.' IT)Mr—
T I r-7 1 0. 00 711A 0`5/30/0'
SWM T 1010. 1210 0)w 05/30/9
14730 SW n-"7rN' n7'
-dt.J I TE" # 100. 00 7W 0"?/,71011
T $ 500. 5171 S W 05/30 1.)F,
BPr
r.,4(-, PIP 1-c I Ij 0. 00 nON 0J/1
sr';-.C:
t 5)0. 1210 1w
PARK 11500. 00 sw 01L/31211
"
W""Kh-4it9 1 -8. 4 0 5
VJOL�WLW
Mr 1-c 14. 63 SW 05/30,
61�%/'370/
3 wr;i t 2iE.5. 00 3W 01/30
f)ddkLiorial Fi?pt-, m cj 1; o,
Y
Li 1,at i oris cjrnt ai n ed i r-4 1-1 a T i Cj8V'L(J ML,j:i C.I q I Footi" 111sp
t3tof,* of tL- t 1 W5 1-) 1 T1-7 Cyp
other sppliC014 �.Iw All worl., will, be clone Post,'DvalTl St)"UCt Ra i 1-1 j
in 6� il F-*Qst/VeAill HC�,��-hAt, W,A t Ll I
.p ,w i t�� a p p t-o v ed p I A Ti T- I �4
0*1-illif,t wJ11 i.f work is not started Ciawl Drain wat Pr
Vii► A F r"11 m J z- I a 13 1 T, 0 p.i--,,I
n t:t r rl i'
t-p thali 11-0 days. PLM/U-iderFlcioi m f,c I r i
01 L4 A T o p C11.11
t3 r 1-1
[",All For i.nspecti on
o',
�f ry
pWASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, #350-12 APPLICATION
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412
Permit
Number 'PLEASE PRINT L:,LLL `) t� 1`� Date (a
completePlease 4. Complete Fee Schedule below
1. Location of installation
Number of Inspections per permit allowed
----
Address L(0.)V 51&/ 1265rE111`1 LN. Service included: Items Cost(ea.) Sum
Building A. Residential-per unit
City _r 1 G q/LU Suite No.
_— 1000 aq,n.or lase $110.00 �.v� a
Tenant Name Each additional 500 sq,ft
(if commercial) __. or portion thereof 3 _ $45,00 7 S Oo
L'mited Energy $25.00 t
Map No.— Tax Lot Each Manuf'd Home or Modular
Dw.Iling Service or Feeder $68.00 2
Thomas Map Book: Page:� Section:
Direelions GsCEEK Su B Dr yr f ro N B. Services or Feeders
---- Installation,alterations or relocation
200 amps or less $60.00 — 2
commercial ❑ Residential 201 amps to 400 amps $80.00 2
401 amps to 600 amps _ $120.00 2
2a. Contractor installation onl 601 amps to 1000 amps $180.00 2
Over 1000 amps or volts $340.00 2
Electrical Contractor YCAd. eL.Ecj-tGf L /NL . Reconnect only $50.00 2
Address or
City State_all- ZIP 97e Zo C. Temporary Services or Feeders
Date -20 - 75' Job Number Inslalla,ion,alteration or relocation
Property Owner G• s 0 6c,i idpG 200 amps or less $50.00 __ 2
Contractor's License No. _ 251-to 201 amps to 400 amps $75.00 ___ 2
Contractor's Board Reg. No. 9 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts see V above
Signature of Supr. Elec' -D. Branch Circuits
License No. 2 73 yS hone No. , �i 9d / SS New,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder fee.
Each branch circuit $5.00 _____ 2
-------— -or°No ------ -- b) The fee for branch circuits without
Print Owner's ems Ghonpurchase of service or feeder fee.
- - - - First branch circuit $35.00 2
Address —
Each add'nl branch circuit $5.00 2
Its 9tate —Zip-- ---- --- -- E. Miscellaneous (Service or Feeder not included
Each pump or irrigation circle__ $40.00 2
The installation is being made on property I own Each sign or outline lighting $40.00 _ 2
which is not intended for sale, lease or rent. Signal circult(s)or a limited
energy panel,alteration
Owner's Signature _ _ 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
Per hour $55.00 —
Please check appropriate hem and enter fee In section 513. In Plant $55.00
4 or more residential units in one structure
Service and 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
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $
above apply. Not required for temporary construction subtotal $ / fy Z-S
services, ❑ Trust Account $ A
Balance Due $ Ij-Y—, �Y
For Inspections call This permit becomes null and void If the work authorized by the permit Is not oommenced
640-3561 or 693-4415 within t60 daya from dated Issuance of such permit or N the work authorized Is
suspended or abandoned at any time after work Is commenced for a period of ta0 days,
24-hour recorder, one working day In advance of need Electrical Permits u•non-refundable and non-transferable.
8194
I it IL�-i I L Uf:
OCUPANCY
CITY OF T I GARD PERMITLLR#. . .C. . . . : MST95--0268
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 09/13/95
13125 SW Hall Blvd.Tigard,Oregon 972234199 (503)639-4171
PARCEL: 15133CDPSII38
5I TE ADDRESS. . . : 14028 SW BLUESTEM L.N
SUBDIVISION. . . . : PEFIBLECREEK 11 ZONINGtR;r-Z
BLOC14. . . . . . . . . . c LOT. . . . . . . . . . . . . ::32
CLASS OF WORK. sNEW
r'YPE OF USE. . . :SF
OCCUPANCY GRP. rO9-
OCCUPANCY LOADs226 4
rENAN1 NAME. . . s
Remarks : PATH I
Owner:
COSTA PACIFIC HOMES
t478O SW OSPREY DR
SUITE # 275
BEAVERTON OR 97007
Phone #s 646--88813
contractors
COSTAPACIFICHOMES
8625 SW CASCADE AVE STE. 606
13EAVL.(2TON OR 971211215
Phone *s 503-646.--0888
Reg #. . t 65157
This Certificate cert if ies that the above referenced building or portion
thereof has been dnspected for compliance with the Tigard Building Code
for the Ilt-oup and division of occupanc�y and use for whi, the above
V 4
ll a
�ferencod pe mit, issued, and occ
rupany is herob ;Lhtod
UILDING INSPECTOR BUILDING OFFICIAL
POGI IN CONSPICUOUS PLACE
WON
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phorie: 639-4171
Inspection:
Footing qusp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg.Top Out
Elec. Rough-in AL:
Post/Beam Mech. San. Sewer Gas Line Idg
Framing
Plumb
Plbg. Underfloor Rain Drain g L _
Alarm
Water Line Insulation Mech.
Undedir. Insul. Shear Wall Gyp. Bd.
-Elect.
Date Requested:
—\'> —r1 Time: AM PM
Address. � „
Permit q: U Z O
Builder: — pq
THE FOLLOWING CORRECTIONS ARE REQUIRED: 4
Date: 1 3
CIspector:
PR
ED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call FoReinsp.n