7700 SW BONITA ROAD I I I
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7700 S14 BONI`l'A :LOAD
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND SERVICES DIVISION
155 NORTH FIRST,DEVELOPMENT
0
LSEORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON
NOTICE This permit becomes null and void If the work or construction for which it la Issued Is not commenced within 180 days. Once construction has started.
the permit becomes null and void If construction Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or agents in support of this permit is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Infe,mation may Invalidate this permit, All provisions of apnlicable laws and ordinances governing the construction and use
of this building or structure wO be compiled with whether or not specified on the plans or noted on the plans correction sheets. I acknov,muy:that
the granting of a permit does not grant authority to iccess private property or to use casements. I further acknowledge that the use or occupancy cf
the structure or building permitted depends upon n y calling for Inspections at various times during the process of construction and the building
Inapection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to app.uval by the
Building Department Is solely at the risk of the applicant and such use or occupancy is revocable until all Inspection requlremtnts are satleflei and
approval is given by the Building Official i further acknowledge that a Ilen may be placed on the title of the property upor.which the permit is issued
speclfying that the use or occupancy of the building or structure Is provisional and revocable until the"tlsfactlon of all Inspection requirements.
APPUCAN s sfONATUME
WASHINGTON COUNTY
Department of Land Use &Transportation E LECT R�
;CA L P E R M iT
\ak.a � Electrical Inspection Section'OfAPPLICATION 155 North First Avenue,11350-12
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412
•L-EASE PRINT Permit
Please complete a through Numbe, ¢' Date
1, Location of installation 4. Complete Fee Schedule below
Address : .', .i,u / s Number of inspections per permit allowed
Building Service included: Items Cost ea.
City�� � n Suite No. ^_ Cost(ea.) Sum
Tenant NarY1e A. Residential-per tanit
(if commercial) -__-_ __ 1000 5%ft,or less $110.00
Map No— Tax Lot Each additional 500 sq n
or portion thereof -- $25.00 ---
Thomas Map Book: Page: Section; Limited Energy $25.00
Each Manuf'd Home or Modular
Directions____
— Dwelling Service or Feeder $88,00 —____ 2
Commercial Residential
B. Services or Feeders
❑ Installation,alterations or relocation
200 amps or less _. $60.00 L2
G a. Contractor installation only: 201 amps to 400 amps _�. $80.00 _. _ __ 2
Electrical Contractor 401 amps to 600 amps $120.00 __ 2
-- - — 601 amps to 1000 amps $180.00 —------ 2
Address Over 1000 amps or volts _ $340.00 __ 2
City __ State _- ZIP Reconnect only -- $50.00 _._
Date___._— Job Number
Property Owner � _ C. Temporary Services or Feeders
Contractor's License No. Installation,alteration or relocation
Contractor's Board Reg. No, 200 amps or less _ $5000 z
201 amps to 400 amps $7500
Signature of Supr. Elec'n 401 amps to 600 amps __ $10000
Lirense No. Phone No. Ovrr 600 amps to 1000 volts see"B"above
D. Branch Circuits
2b. For owner installations: j J— New,alteration of extension per panel
a) The fee for branch circuits with
r)STnt-Owners a one purchase of service or feeder fee.
(� ,�7 g. $5.00
� _ �, (.LJ i,,�(J/t/i rte_ /��_ Each branch circuit _-
/ /� ��� e -7 Z w The fee for branch circuits without
_— _ — purchase of service or feeder fee.
pity State p First branch circuit $35.00
Each add'nl branch circuit $5.00
The installation is being made on property 1 own E. Miscellaneous(Service or Feeder not included)
which is not intended for sale lease or rent.
�� Eac'?pump or irrigation circle _ $40 00 _
�y� /, / Each sign or outline lighting $40.00
Owner's Signature f , _ ! r �� Signal circuits)or a limited
energy panel,alteration
3. Plan Review section (if required) or extension $4000
Please check appropriate Item and enter fee in section 58 F. Each additional Inspection over the allowable
4 or more residential units�o one structure in any of the above
Service and feeder, 800 elmhper insper:tion $3500
or more Per hour $55 co
___System over 600 volts nominal In Plant $55 00
__-Classified area or structure containing special
occupancy as described in N.E.C. Chapter 5 5. Fees
Submit 2 sets of plans with application where any of the A. Enter total of above fees $
above apply Not required for temporary construction 5% Surcharge (.05 X total fees) $ _ (j
11 services. Subtotal $
This permit becomes null and void if the work authorized by the permit is B. Enter 25% of line A for
not commenced within 180 days frorn date of issuance of such permit or Plan Review if required (Section 3) $
if the work authorized Is suspended or abandoned st anv time after work Subtotal $
Is commenced fir a period of 180 days. Electrical i rmits are non- $ --.—
refundable and non-transferable ❑ Trust Account
For inspections call
Balance Due $681-3699 or 681-3698
24-hour recorder, one working day In advance of need
BL28 • Bl95
CITY OF T I GARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PE RM 1. T
13125 SW Hall Blvd.Tigard,Oregon 97223 08199 (503)639-4171 PERM 1T #t. . . . . . .
DATE ISSUED: 10/19/94
PARCEL: 2SI12BD-00800
I Tt*:. ADDRESS. 0'7 700 SW BON T TA RD
iUBDIVISION. . . . : DURHAM ACRES ZONING.- R-12
ik..QCP*. . . . . . . . . . : LOI.. . . . . . . . . . . . . :66
TENANT NAME. . . . . .
USA NU. . . . . . . . . . F I xTURL UN ITS.
LASS OF WORK. . . :14EW DWELLING UNITS. . -. 1
iYPE OF USE:. . . . . :SF NO. OF BUILDINGS:
NSTALL TYPE. . . BUSWR IMPERV SURI-4ACE. . : : Sf
:remarks : GRANDFATHER CLAUSL. BONITO REIMBURSEMENT DIS7. --- $2808. 05
Owner, : FEES
11ARY ANN HULQUIST type aMOLint by date reept
-70.21 SW SONITA RD PIRM 1 $ 300- 00 JG 10/19/94
-
I NSF' $ 35. 00 JG 10/19/94
I IGARD OR 97224
J-)crlp #:
-UT)1.r actor—:__ —---————————————
�AVIN PPATT EXCAVCTING
r-t-11 '--
'E RANCHO ST
OR 9712Z-1-0000 --------------------
i1fione #. 503-649-7770 $ 335. 00 TOTAL-
P 33575
REQUIRED INSPECTIONS
11is Applicant agrees to Cmly with all the rules and regulations Sewer, Inspection
,)f the Unified Sewage Agency. The pervit expires 180 days fros
�^p date issued. The total asount paid will be forfeited if the
persit expires. the Agency dots not guarantee the accuracy of the
side sewer, laterals. :f the sewer is not located at the seasurevent
given, the installer shall prospect
pect 3 feet in all directions froi
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Perait and the Agency will install a lateral
Pei-mittee 8iqnati_tr,e : 4
Call For, insPectior, 639-4175
Residential Building Permit Application
City of Tigard
13125 SW gall Blvd.
T;gard, OR 97223
(503) 639-4171
Jobsite Address: 7-76 10 . u1 )bcw17-A p4P�
Subdivision: Lot 0 Office Use Only
PlancQRec #
Valuation: — --
�1 ---- `�u.� 4{ 1 f y- C.
Corner Lot? Y Permit #
Fla Lot? iN Reissue of_
Flag
Map & TL#
Owner: /" ,qN.(L /��'Li /ST Approvals Required
Address Planning
Engineering
Phone Other
C.)ntractor: ��-,4 V'/ Al 2 14 77+
lterns Required
Address: SUbcontractors
v
-- / -- Truss Details
Phone _ Other
Contractors License # 1
(attach copy of current Oregon license)
Contact Name & Phone --�
Subcontractors: Arctiitect/Engineer: W— _—
Plumbing: _ _ Address
Mechanical:
(attach copy of current OR Contractor's Licensd)
Phone:
JOB DESCRIPTION
Applicant Signature & Phone number
Received by: _ Date Received
N\WOROWCOMDEV�RF SAPP
CITY®F TI A R SEWER CONNECTION
CFTYOF TWA PE RM I T
COMMUNrrY DEVELOPMENT DEPARTMENT e>ReoonPE R M I T #. . . . . . . : SWR91--0167
L 13126 SW Hell Blvd. P.O.Box 23397,Tigard,Oregon 97223(15W)6394175
Ij--4 1. i I DATE I-SSUED: 07/131/91
SITL ADDRESS. . . : 07700 SW BONITA RD PARCEL : 2S112BD-1717-170j?j
SURD I V 15 1 ON. . . . : ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . .
CLASS CIF WORK. . . :ADD DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
IN TALL TYPE. . . . .I!U 7.)W P IMPERV SURFACE- : S f
Re m c.ark s . connect existing SFD to si ewer. Septic tank In Ll V t be PU M oed and filled.
Owner..: - -- ---- -—————--——————————--—-----————— FEES
MARY ANN HULQUIST type amol.tnt by date reept
16565 9W GREENLAND DR PRMT t 1500. 00 DCR 07/31/91 0
1HISP .4*- 3b. 00 BCR 07/31/91 0
l"ICARD OR 97224
Pflune #:
OWNER
Phone 1535. 00 TOTAL
Req
------ REQUIRED INSPECTION'S- ------
This Applicant agrees to comply with all the rules and regulations Sewer ln,;pectjon
of the Unified Sewage Agency. The permit expires & da,,,s from Septic Tank Fill
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee Ve accuract,, of the
side sewer iaterals. If the sewer is not located at the eeasuremen�
Oven, - installer shall prospect 3 feet in all directions from
the distance given. If not so located, the instiller shall purchase
a "Tap and Side Sewer" permit and the Agency will install a lateral.
'or
Permittee Siqnat:1.tre:
By :
Call for inspection 639-4175
A 33.5— (Lllte,
PILLJMB I NG VIE RM I T
CITY OF T I GARD DATE ERMIISSUED: 06/L4/96C,-01177
L4/966-0167
COMMUNITY DEVELOPMENT DEPARTMENT
S I I F13125 SW Hail Blvd.Tigard,Oregon 97223•x199 (503)639-4171 P'ARCEL: 2S112BD-00800
_ HDDR01100 SW BONITA R1
SUBDIVISION. . . . DURHAM ACRES ZONING: R-12
BLOCK.. . . . . . . . . . LOT. . . . . . . . . . . . :Cb
CLASS Calve WORK. AL T GARBAGE D1SP'O!7:)ALS. 0 MOBILE HOME—SPACES. : 0
f'eP'E OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PIREVNTRS. . : I
UCCUPIANCY GRP,. . : R3 FLOOR DRAINS. . . . . . . 0 TRAP'S. . . . . . . . . . . . . . 0
S r'ORIES. . . . . . . . .. 0 WATER HEATERS. . . . . . 0 CATCH BASINS. . . . . . . . 0
LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAIN). . . . . 0
SINKS. . . . . . . . . . . 0 URINALS. . . . . ., . . . . . : 0 GREASE FRAPIS. . . . . . . 0
LAVATORIES. , . . . . 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . , : 0 SEWER LINE (ft ) . . . : 0
WATER CL.OSEI'S. . : V, LINE ( ft ) . . . 0
DISHWASHERS— . - 0 RAIN DRAIN (ft ) . . . 0
lie in arks : I n st a I I v-es i d Jent i i.-A I back flow pr-event ion device.
Own e r-.
MARY ONIN HOLIJUIST type anal.trit Icy date recpt
77('x0 ':*:')W BONITA RD P,RMT $ 15- 00 JSD Ob/24/96 96-28093V
5PICT $ 0. 75 JSL 06/2-4/1)( 96-280930
TIGARD OR 97224
Phone #.
Lontv-actor,:
OWNER
P1h r)n e !0 5. 7t) TO AL
Req
REUUIRED INSPECTIONS
Th:s pernit is issued sub)ect to the regulations contained in the RPI/Bar-E(flow P—ev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved pians. This permit will expire if work is not started
withir 180 days of issuance, or if work is suspended for more
than 180 (Jays.
k-eir-mittee Siqnati.it-e .- 'evle
7 4-1
I S 15'..1 e d 4y f–
Call for inspection 639--4175
Address:
Issued by: Datc:
Statement: Information Notice to Property owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
fbIlowing statement belbre a building permit can be issued. This statement is required
fir residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt fi-om registration under ORS 701.010(7),
need not submit this statement. This statement wit/he_Jiled with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2,and either box 3A or 3B:
1. 1 own, reside in,or will reside in the completed structure.
I understand that 1 must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
F13A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
14 3B. I will be my own general contractor.
If i hire subcontractors. I ��i II hire only subcontractors registered with the Construction Contractors
Board. It'I change my mind and hire a general contractor. I will contract with a contractor who is
registered with the CCBand will immediately notify the office issuing this building permit of the
name of the contractor.
1 hereby certil'N that thc.►hove information is correct and that I hay c rv-ml.incl clo unclerctsu►cl the Infornurtion
Notice to Property thiner•s about L' struction Responsibilities on the reverse sidle of Ilii. form.
(Signature of pe it applicant) (Date)
(It>'hite cop►.to issuing agenr►.per►ttit fila,
pink copv to applicant)
,
I nformation Notice to Property Owners
About Construction Responsibilities
Sole: l in i,,lof matiun :v,olic:e to Prul►cW,I,Owners cibout ( ', nsn'ut'tu,u Res j►nu,ciGi/itfes
loos derelofird ti, the III 'oil vi►•urJiew t'ontruclors Board in uc c ordunce 11 ith ORS ,n/.0550).
Ifycxl are acting as lour o\\n contra,:Im to c , istruct a ne%%home or make a suh,tantial i►n11ru).vnient to an existing structure,
you can prevent mam problem,h\ beim;a\\arc ofthe Gallo\\inr It ,1,: n ,il,iliti. .,old alk a5 ofconccrn.
EMPLOYER RESPONSIBILITIES:
It•wou hire prr ons not registered a ith the Construction Contractors Board to do labor in constructim'! or assisting ill the
construction or improvement of a residential,triionre._;oll \will, in most instances,be ruled to he an employer and the people
YOU hire will he employees. As the employer,you nm,,l conipi. \\ith the following:
Oregon's withholding tax law: Asan employer,)roll Ill list withhold illconit;taw i I rom emplo\cc wag"Mille time eniploi,ces
are paid. You\\III-he liable for the lax paynler.t.s even if you don't actualiv\\ithholtl the tax from your employees. For more
infonnation,call the Oregon Dept.ol'Reyenuc at 4,115-801)1.
Uncmploy mens insurance(ax: As an employer,you are required to pay a tax for uneanploy meat insurance purpose,on the
"age,of all emploIk cc,, I or more inf01-11IR601i.call the Orcgon Employ►rlent Department,a 078 352.1.
Workers"compensation insurance: A,,an employer,you arc subject the Oregon Workers'Compensation I a\\,,and must
obtain\workers'compensation ill suraft c (or\our employees- If\ou f�ai,t\,oht,lin wurkers'cumpensatinn insurance,you nt'tiy
hc,uhiect Io penalties anti\\ill he liable for all claim Cost,ifonc of\ou ^mplt,�.cs i,injered on the job. For nu,rc intormatiun, .
coif the Worker,;'Com pen sat ion Division at the Depailmem nfCons, incr and Business Services at 945-7888,
U.S.InternalReventic Service: As all e•illployer.}ollill list\\ithholdfedeialinoImetax from ernplo\ces'\\ages ) ou\\illI,e
liable lilrthc tax pay meat G\era if v,lu dirin't t►cuclllw\\ithholtl the tax 1•or riots m(ornlatioti,call the Internal Rc%enuc Scr\its
at 1-900-829-10411.
OTHER RESPONSIBILIT ES AND AREAS OF CONCERN:
Codecomplionce: A thepermitholderforthisprolcct.�vuarcrerponsih(cli,lrc;ol\inganylailurct\,Intctcxldereyuircrntnis
that mol\ he hr.,,agl;t to your attention through inspections.
I-inhilih and pr-opert,l, damage in.ur•anee, It.
raltatt\o,lr insurance agent to ,cr il'\ou Ila\e adryuatc in,ur;uur cowerage�fi>r
accidents and onlis,lons such as falling tools,paint o\crspl.IN•\,Inter cianragc Iron, pipe punctures. tire,or\\ork that must be
re done.
Time lu euper�i.c emplca�er��: 1Lake ours\uu ha\e,utliricnt(lone to super\Ise your c°mplo�ces.
Fxpertive: '\lakc,ore\„uhiikethe experti,ctoactnr\,"ll'kMrluellet';rlcontra;I -r,locoordina(ethemirkofrouuh-in and fill ish
trades, mill to notify Imidding otllcinls Pt the mphrrpriate Iimeq.o the\ cnn perit,nn the required incpoetionc.
I1 ,,til ha\c ml&tlolml\lnc,ll„tls. \\file l\r Call the t „tis1r1101011( „111t lk:1ol'ti It-'all(N) llox 141-1(l• Smlelll,OR i0\) li`,'
X112 t'8 ?6211. The Board i., :.,rated at 70O SltlIIIjlet �.,t Ni�_ Mule 10O• ill �;ilcnl.
I ,,.t
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
15`125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name W Oevelupmenl Now Single Family Residences Only l
Ad*— ❑ 1 BATH HOUSE$140.00 F12 BATH HOUSE$195.00
Job -7•� C, i 7 3 BATH HOUSE$225.00
Address zip Fee includes all plumbi,no wtures in the dwelling and the first 100 feet
l 2 Z V of water service, sanitary sewer and storm sewer. See fees below.
Name is name of Bueanea.1 63K,_ FIXTURES QTY PRICE AMT
t
M � v 71i57 Sink 900
M.**Q Mt., P^°^^ Lavatory 9.00
Owner �' X11 / Tub or i ublShower Comb. 9.00
�"�s'■'° zo Shower Only 9.00
!" C J7� Vater Closet 9.00
)Hama Im .ni.of ru.�...i Dishwasher 9.00
�f(1'i y f Garbage Disposal — 9.00
Occupant 1A.0,0 Ame..a ph e
Washing Machine 9.00
t/
, I f1l ro $e Floor Drain 9.00
'Sts1^
zipWater Heater — 9.00
th Laundry Room Tray _ 9.00
N° Urinal 9.00
Other Fixtures (Specify) 9.00
M.de,u AAM... phone 9.00
Contractor _ _ 900
eYfs�.f, _ zr 9.00
Sewer 1st 100' 30.00
M■'°R^e"0^°-"^ ^r"• ' Sewer-ea. Addit. 100' 25.00 —
Water :service 1st 100' 3000
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200'— 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 3000
1 am regrstered with the Construction Contractor's Board, that the Storm &Rain Drain Addit 100' 25.00
number given is correct (If exempt from State registration, please -- —
give reason below.) Mobile Horne Space 2;.00
Back Flow Prevention —^
LIZx .. 4�ee y� _ �y+ /'�G'� Device or Anti-Pollution Device - 9.00
�,nef,,,e f^... .o°mi ` c•'° Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new a dition O alteration repair Q Catch Basin 9.00
to be done residentia) IN non-residential Insp of Exist. plumbing 40.00/hr
Snerially Requested Inspections 40.00/hr
Existing use of — -- —
building or property Rain Drain, single family dwelling 3000
Residential backflow prevention
devices 1500
Proposed use of —
building or property
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSI RUCTION OR WORK'S SUSPENDED OR ABANDONED --FOR A PERIOD OF 180 DAYS AT ANY TIME AFTEP.WORK IS
COMMENCED PLAN REVIEW 25% OF SUBTOTAL
TOTAL
Special Conditions
— Date issued