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12010 SW GARDEN PLACE N 0 S I � x � r i f f � 12010 SW GARDEN PL CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 InSta.l data '=lecoleat'i,:rt;f or systea WACIJ' 1 7Fft t Ittnr -,rid' , , .. . . , X90 life mplfInTY^ I'M too 1 1 ILSANT)-on �../ a o IFat_ i Ihd C7 h°' "1;`0ir," tit kt: ra" 40/{21LSA:! a f..tovt, r perait is issued su jrt to tie >-ejulatiors contay led :n "ie %gard Municip6l :ode, ';tate of Ore. Special,I 'wades a,' ',l cattle iBios, Ali ar;��, rk'.1 LE d65e fl.. acc;,dence filth app'':.',eei plans. ;': pet'eit Ns.11 eXplr" tf WV4 is Nt SJtA.t" rs of issuance, or i" wo,lm i4 vispegded `a+ sore tha^ IN dayn, arTEINT M 1,e;on lave requires you to follow rule adcF;a: paR �,. _ _•—�,, a P.lieS a;a sq� fv,.., lr, ORA '3�,,�'•Q Folt 1P t't�" h 34t �. 1 it;11 //- 7 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hall Blvd. �, K Tigard,OR 97223 PERMIT#— Phone(503)639-4171 FAX (503)684-7297 DATE ISSUED TDD No. (503)684-2772 CITY OF TIGARD Inspection (503)639-4175 ISSUED BY _ PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK 1"9 1)J D s C' . Aduress RESIDENTIAL—Restricted Energy Fee. . . . . . . . $40,90 (FOR ALL SYSTEMS) City State Zip Check Tyne of Work Involved: PFRMIIS ARE NON-TRANSFERABLE AND NON•RrrUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems' IS NOT STARTED WITHIN 180 DAYS Of MIIANCE OR IF WORK IS SUSPENDED FOR 1801)AY` ❑ Burglar Alarm El Garage Door Opener' 2. CONTRACTOR APPLICATION ❑ Heating,Ventilation and Air Conditioning System" Contractors ••(>j,_ __�Type_----_ ❑ Vacuum Systems* Address `2 te' �_-.\.��d X4_ l__�_�7! Other Date / IA7 _ _ COMMERCIAL•—Fee for each system . . . . . . . . . L40.()()L40.()() (SEE OAR 918-260-260) Property Owner /, Check Type of WorkInvolved: Contractor's Board Reg. No. Q d 7 Y'_ _, ❑ Audio and Stereo Sy lc,ms' ', L/ '/� ❑ Boiler Controls Phone# l�g =`�D .__ ❑ Clock Systems .B—Data Telecommlmit ation Installations 3. OWNER APPLICATION ❑ Fire Alarm Installation _ ❑ HVAC Print Owner's Name Phone No ❑ Instrumentation Address `— ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* City Stale zip ❑ Medical This Ixerntit Is issuer)under OAR 918.3211.370 ).tis applicant agrees to make only ❑ Nurse Calls restricterl energy installations(100 vole amps or less)under this nermit and kr do the ❑ Outdoor Landscape I ighling' following: ❑ Prolective Signaling 1, Only use electrical licensed persons to do installations where roqutred.(Certain residential and other transactions are exempt from licensing.These have ED-10lher_��G' 1 1`0 asterisksM All nihers need licensing). 2 Call for an inspection when all of the installations under this permit are ready for inspection at 503.639.4175 ❑ Number of Systems I Pmchase separate permits for all installations that are not ready for inspection when the inspector is out to inspect under this permit. •No lirenses,irr required. Licenses are required for all other installations. 4 Assume ro%po sihility for assuring that all rorrvoions required by the inspector are done.and 5. Assume responsibility for calling for a final Inspection when all of the corrections 55. FEES are completed. the}person signing for thi ermit must be the applicant or a person a. Enter Fees $ '60 authorized f6l#rn _ ap b. 5% Surcharge(.05 x total above) $_L4, co Si aU1re TOTAL $� Authority if other than applicant ENERGAP.CHP CITY OF TIGARD BUIL NG INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phorw.; 639-4171 Date Requested: ��—/Z — A.M. _ P.M. MST: Location: _ ✓_ BUR Tenant__ [ . Suite: Bldg: . MEC: Contractor.: ' Phone: Z .3 8 Z PLM: Ownera, Pi;ono: ELC: ELR: l :7O_31 S3 _ BUILDING BLDG(con't) PLUMBING M1CHANICAL ELECTRICAL SIT: SITE Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Stornt Footing Roof UndF1/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In I JG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Ihain A/C U I Shear/Sheath Fire Spklr/Ahn Crawl/Found Dr I Ieat Pump ow Vo. j( _ Approved Approved Approved rove Approved Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL F`N FINAL �L L-�5'7-Gp QOlv_,LRrA -'syyyL 0 Call for reinspection O Reinspection fee of S_ required before nexttiinnspection O Unable to insp ct Inspector: ----�_` Date:�z _ • 1 7 Page —of CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 639-4175 Business Phone. 639-4 i 71 011 Date Requested: �2 ,/ *5 1 1 _,9_ A M. �_ P.M. MST: Location: _ 0.12/d +? eel _ BLIP: Tenant: Suite: Bldg: �_ MEC: J//ees4.Contractor: 15z lQ fel "e ei Phone: a. r�(p/7 PLM: Owner: _ Phone: ELC: 4,4)17-0 L- cZAI - – ELR:!? SIT: BUILDING BLDG(con't) PLUMBING MECHANICAL - +I.ECXPACAL- SITE Site Post/Beam Post/13eam Post/Beam Cover/Service Sewer/Sturm Footing Roof UndFI/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In TJ(]Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsrnt Damp Drywall Storm Furnace Temp Service mise. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Ilent Pump Low Vo Approved Approved Approved Approved Approved AppriSdwlk Not Approved Not Approved Not Approved Not Awroved Not Approved FINAL FINAL FINAL FINAL J Call for reinspection einspection fee of S_ recmired before nest inspection O Unable to inspect Z_ Inspector:—.__-- JW. Date• ILS' _� Page of CITY OF TIGARD _7 DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 RESTRICTED ENERGY PERMIT #: ELR97-0353 DATE ISSUED: 12/15/97 PARCEL-: 2SI0IBB--00700 SITE ADDRE13S. . . : 1201.0 SW GARDEN P1_ #D#C-1 SUBDIVISION. . . . :TIGARD ROAD C.'ARDENS ZONING:C—G BLOCK. . . . . . . . . . : LOI.. . . . . . . . . . . . . :006 JURISDICTN: -, IG Project Description: Installation of protective signaling. ------------------------------------------- A. RES I DENT I B. COMME PC I AUDIO & STEREO. . . : AUDIO & STEREO. INTFRCOM & PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : L.ANDSCAPE/IRRIGAT. . : GARAGE GIPENER. . . . : CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . : HVAC . . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : VACI�UM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: HVAC.. . . . . . . . . . . . : PROTECTIVE S I UNAL. X INSTRUMENT'AlION. - OTHER. . : TOTAL. # OF SYSTEMS: I Owner: ---------------------------------------- FEES ACT type nmol-trit by date recpt 1201.0 SW GARDEN PL. PRM` $ 40. 00 1JH 121/15/97 97-301724 TIGARD OR 97223 5PCT $ 2. 00 TJH 12/15/97 97-301724 Phone #: Contracto: SON ITROL PACIFIC $ 4J'. 00 TOTAL. 1975 SW 6TH AVE ------ REQUIRED INSPECTIONS PORTLAND OR 97201 Ceiling Cover Low Voltage Insp Phone #: 223-5822 Wall Cover Elect' l Final Reg #. . : 000535 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 952-001-00I0 through OAR 952--N1-0080. You may obtain copies of these rules or direct questions to OUNC at (503)246-1967. I s s i-i Pd by-_.. Siqnat1.ire _ &,)n Z tzn�ll e INSTALLATION ONLY-------------------------------- The installation is being made on property I oven whirf, is net intended for sale, lease, or rent. OWNER' S SIGNATURE: DATE: ----------- INSTALLATION ONLY----------------------------- SIGNATURE OF SUPIR. ELECIN: DATE: LICENSE NO: + 4.................4-+++4.++4- F+4-4...... .............4......................... ('all 639---4175 by 7-00 P. M. for-, an inspection needed the next bi-tsiness day ........4........++++-1...............h++4.......4++4.........................444... Community Develohmenl RESTRICTED ENERGY ELECTRICAI APPLICATION 13125 SW Hall Blvd. Tigard,OR 97223 PERMIT# Phone(503)639-4171 d� FAX(503)684-7297 DATE ISSUED_— ;! TDD No. (503)684-2772 CITY OF TIGARD Inspection (503) 639-4175 ISSUED BY PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF VVORK PL, C4ARb5A( Ad �� RESIDENTIAL—Restricted Energgyy Fee. . . . . . . . 540.00 (FOR ALL SYSTEMS) City State Zip Check Type of ork Involved: PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK El Audio and Stereo S stems* IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR y 100 DAYS ❑ Burglar Alarm 2. CONTRACTOR APPLICATION ❑ Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* Contrac �_____Type _ ❑ Vacuum Systems* ./. Address El Other --- Date COMMERCIAL—Fee for each system . . . . . . . . . $4o.o0 (SEE OAR 918-260-260) Property Owner _ __ --_—_ Check Type of Work Involved: Contractor's Board Reg. No. S � 3 --- - ❑ Audio and Sterr,: Systems* ❑ Boiler Controls Phone# -" — --- ❑ Clock Systems 3. OWNER APPLICATION ❑ Data Telecommunication Installations ❑ Fire Alarm Installation ❑ HVAC Print Owner's Name Phone No ❑ Instrumentation Address ❑ Interunn and Paging Systems ❑ landscape Irrigation Control* City State Zip ❑ Medical This permit is Is.;wit under OAR 918.320.370.This applicant agrees to make only ❑ Nurse Calls restricted energy installations(100 volt amp%or Itss)under this permit and Indo the ❑ Outdoor Landscape Lighting* following: 1. Only use electrical licensed persons to do installations where required.(Certain .-t'rotective Signaling residential and other transactions are exempt from licensing.These have ❑ Other asterisks(*).All others need licensing). 2. Call for an inspection when all of the installations under this permit are ready for insp(v-tion al 503-639.4175. ❑ Number of Systems 3. Purchase separate permits for all installations that are not ready for inspection - when the inspector is nut to inspect under this permit, *No hrrnses are a quired. Licenses are required for all other installations. 4. Assume responsibility for assuring that all corrections required by the inspector _ are dont,and 5. Assume responsibility far.ailing for a final inspection when all of the corrections 5. FEES are completed. The person signing for this permit must he the applicant or a person a. Enter Fees $� authorized In bindt e applica h --"� ,-P . 5°rH Surcharge(.05 x total above) $ Signature TOTAL $ Authority if other than applicant ENERGAP.CHP RECEIVEP DEC 15 '1997 Cot,jMUrjjlY DEVELOPWINI CITY OF TIGARD DEVELOPML,IT SERVICES G'I.i)MR> Nr. PERMIT PERMIT #. . . . . . . . PLM97-0 , '-'171 ............Lk 13125 SW Hall Blvd.,`Tigard,OF. ^7223 (503)639-4171 DATE ISSUED: J0/21/97 ID4-6 Its PARCEL. 2S101r,13--00700 'LTTE ADDRESS. . .;;o, . - SW LaARDFN Pl_ `:SUBDIVISION. . . . : TIGARD RC)AP, G3 MEnNS IC7IVING: C,--G BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :17106 L)RISDTCTTOII1: TIC-; CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE_ HOME SPACES. : 0 TYPF=' OF USE. . . . :rOM Wf1SHTNG MACH. . . . . . : 0 RACKFI._OW PREVNTRS. . : 0 OCCI.PONCY GRP. . :B FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0 r,TOP I ES. . . . . . . . 0 Wf1TE R HEnTERS. . . . . : Q.1 CATCH BASINS. . . . . . . : 0 FIXTLIRfWS___.__._____.---.--- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 9)I NKS. . . . . . . . . . 1 UR I NALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 I.AVATC_IRIES. . . . : 0 OTHER FIXTURES. . . . : 1 TUR/SHOWERS. . . : 0 SEWER LINE= Ift ) . . . : 0 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : i i)ISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 -marks : P1r.rmbiny TT �C `E' .La_rZcS.._.'__ �..._.__.-----_.___- FEES 'IEKE:R PROPERTIES type amoi-int by date r•ecpt ;so SW MACADAM PRMT $ 25. 00 B 10/21/97 97-300,24,_.: 1E 100 SPCT $ 1. 25 P 10,121/97 97-30024'x' '1RTLnND OR 97501 one #: SOC I ATED PL.J_IMD T NG CO 0 BOX 301362 ')RT1_AND OR 971-3 one #: $ 26. LS TOTAL V'y #. . 000570 _------..— REQU T RED I NSPECT I ONS _..._.-- This permit is issued subject to the regulations contained in the Top•-ni-rt Insp ':gird Municipal Code, State of Ore. Specialty Codes and all other Final Inspection I)plicable laws. All work will be done in accordance with 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 Center. Those rules are set forth in OAR 952-MI-MIO through OAP 951-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling ] s s�.r e d $y: „� V ll�- ��- F'e t•m 1 t t e e S i y n a t r_r r-e:_� _,.__._________T___ +i ++-H+4•+++4-1-4+++i++++++++++-1-+++++++++++++-1-++++f-+++++++++++++++4 4++++++++++++ Call 639-41.75 by '7:00 p. m. for an i.nsper-t ion needed the nrxt bl.rsi.nes S day 4 i-i•++++-F 1-+++++++++i++++4-++++++++++++•r•++-1 ++++•++++++++++++++++++-4-+++++++++++++4 C TY• OF TIGARD Plumbing Application Rec'd By I 9 PP � 13125 SW HALL BLVD. Commercial and Residential nalARAcd�'I �— Date to P.E TIGARD, OR 97223 Date to DST (503) 63941171 Permit#�, 1'-020 '3 Print or Type Related SWR# f Incomplete o- illegible applications will not be accepted Called Name of Development/Project —� Job FIXTURES (Individual) QTY PRICE AMT 00 Address Street Address - Suite Sink — I 9. I�-(Ifil, "-V 6-o'-d to pit. Lavatory 9.00 Bldg# Cit ISlate Zip Tub or 1'ub/Shower Comb. 9.00 —� r c`tlt1 U k 97 J Z 3 Shower Only — - 900 Name (? --- Water Closet 9.00 Owner Mailing Address Suite Dishwasher 9.00 t}3 ti W ,N1 vii c\do'� Garbage Disposal 9.00 C nt /St tP f Zi Phone Washing Machine 9.00 -- 1'0•f It�•vl Ol� p Z°1 ,�Z( 5 ,OC Floor Drain 2' --— 9,00 vI Name !1 A( r. --- -- 3' 9.00 OCCupaftt Mailing Address , Suite 4' 9.00 1).0!1(,i S N1 L'4kPLN U- Water Heater O conversion O like kind 9.00 City/aia a D Zip Phone C A L'F i 3 Laundry Room Tray 9.00 Na Urinal 900 $50(10 rL M Other Fixtures(Specify) 9.00 Contractor Mailing Address �— — Suite D� ^ w `1 9.00 (Prior to issuance C t iSt tZip Phone -- applicant must 1� (,he '171-, iii f'Sti 1, — _ 9 00 provide all Oregon Const,Cont Board Lic il Exp.Dale 900 contractors 5 Will) 9.00 license Plumbing Lic.# Exp.Dale Sewer- 1st 100' 30.00 information ifA /� expired 4 1), 1' r Fewer-each additional 100' 25.00 in COT COT Business Tax or Metro# Exp.Date Water Service- 1st 100' 30.00 database) ►stir _ Water Service-each additional 200' 2500 Name Storm&Rain Drain- 1st 100' 3000 ArchiteLt _ Storni&Rain Drain-each additional 100' 2500 or Mailing Address Suite Mobile Home Space 2500 City/State Zip Phone Commercial Back Flow Prevention Device or Anti- 2500 Engineer Pollution Device _ Residential Backflow Prevention Device' i 5 00 Describe work New O Addition O Alteration Repair O — Any Trap or Waste Not Connected to a Fixture _ 9.00 to be done Residential O Non-residential —_ Additional description of work Catch Basin 9,00 Insp of Existing Plumbing d0 00 perthr j t,��try T r /s.r irt`' Specialty Requested Inspections 4000 Existing use of _ --_ per/hr i building or property U f. t iA _ Rain Drain,single family dwelling 30,00 Grease Traps 900 Proposed use of _ — building or property `orytr+^h-t '6�� _— QUANTITY TOTAL _ Isometric or user diagram is required d Quanrty Total is >9 Are you capping. moving or replacing any fixtures? Yes p No� - 'SUBTOTAL IY1 (If yes see back of form) I hereby acxnowledge that I have read this application.that the mfottnation — - 5%SURCHARGE given is correct.that I am the owner or authorized agent of the owner,and that plans submitted are.n compliance with Oregon State Laws. PLAN REVIEW 25°,6 OF SUBTOTAL Signatu of O er/Agent : Dato Regwred onN rt rodure qty total s,9 _ � TOTAL C 6k — IlzilttCit+v �J I� �� K; A Contact Person Nam Phone *Minimum permit fee s S25- 5%surcharge,except Residential Backflow l331 65 V Z Prevention Device.which is S 15. 5%surcharge .usisipimai»dot 597 PLEASE COMPA..ET-E-AS APPROPRIATE TOP OJECT: Fixtures to be capped, moved or replaced Qty Sink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal — Washing Machine _ Floor Drain 2"� 3" Water Heater Laundry Room Tray _^ Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: CITY OF TIGARD ELFCTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97--0706 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4111 7C1TE' IcSUED: 10/2-2/'17 PARCEL: _'�101)?A -007rT0 .. TT7 ADDRFS5. . . : 120.10 OW UARDEN F'L.. #LALD '-;I.JBD".VISION. . . . :TIG1")RD ROAD GARDENS ZONTNG:C -G BLOCA. . . . . . . . . . .. L.OT. . . . . . . . . . . . . .00C, JURISDICTION: TIG Pr-o,jer_t Descr~.i pt i on: Install four (4) service or, feeders 200 AMP6 or less and sixty-seven (67) branch circuits in an existing couercial building, RCSIDENTIAL UNIT-_..._.....__ -._--TEMP' SRVC/FEF"DER8---- - -- -MI5CEl-LANEOUS--- 1'100 7F OR LESS. . . „ : rZr 0 - ''00 amp. . . . . . . : 0 PUMP/IRRTGATION. . . . : 1Cf-I ADDI L 500SF. . . : 0 201 - 400 amr. . . . . . . : 0 eIIGN/CUT LINE LTG. . : 0 1 MITED ENERGY. . .. . . 0 401 600 Amp. . . . . . . : 0 SIGNAL/PANEI.. . . . . . ,. : 0 'INF. HM/ SVC/FDR. . : 0 601+amps--1000 volts. : 0 MINOR I-ABEL ( 10) . . . : 0 - -SERVICE;FEF"DER•---•---_ •------BRANCH CT.RCIJITS-__--._ __..ADP' I_ IN PECTIONS•- i-.'00 amp. . . . . . : 4 W/SERVIC•C OR FEEDER: 67 PER INSPECTION. . . . . . 1400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER IIOUR. . . . . . . . . . . C 01 --- 600 amp. . . . . . . 0 EA ADD' L. BRNCH CIRC: 0 TN PI-ANT. . . . . . . . . . . . 17' (;01 1000 amp. . . . . : 0 AN RFVTEW SECTION_....__.._.__....._.._._.___. 1000+ ramp/volt. . . . . : 0 ) =4 REG UNITS. . . . . . . . . ) 600 VOLT NOMINAL. . : Qeconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. : owner. _.____------- --..._______._-___._..__ __._--..._____._______. .....___.___.._ FEES ACT type Amol.trit by cat e rcrcpt 1 1,77,000 SW GP^"`FN PL. PRMT $ 575. 00 GEO 10/23/97 97--30032.3 I7GARP OR SPCT 28. 75 GEO 10/23/97 97-300;.x,23 I"hone #: rnPITOL. ELECTRIC CO INC $ 603. 75 TOTAL. 1 810 NE AIRPORT WAY UN ! ___.._...._._._ REQUIRED INSPECT TONS --- -._ P(3PTLAND OR 97230 Ceiling Cover Undergr^ol_tnd Co,.�, Phonp #: , 5r--748n Wall Covet- ETertI 1 Ser,vir_, PFrg it. . : 000487 This pewit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Speci-rlty Codes and all othp applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 18e Jays of issuance, or if work is suspended for rare than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by Oregon Utility Notification Center, Those rules are set forth in OAR 9°2 021-Q+O1O through OAR 952-0@1-1987, You may obtain a copy these rules or direct questions to OK by call-; 1503)246-1987. � rmittee 5ign<ztr_1r^e : I.Ss1.re(I B Y ' re-Z_ --_....._.._.....----- ...._._.__..._ ... .___._ .---___...OWNER INSTALLATION - r. installation is being made on proper,t°y I own which is not intended fc le, lease, or r-ent. 'NF"R' S S T GNATURF: DATE: TNSTALI_ )TION CNATURE OF rUPP. Fl.FC' N: —&A, DATE: � 5L__. . F.,ENSE Nn: 3/70 .� .{ ++++ }-f•+i++ E 4 +-1 -F r-++ +•++ ++ V+++-1+++++t++ F� i N++i{ F I F } F++i 4 4 F { +. ! + F � 4 4 4 4 1-+•h+i I + Call L32--4175 by ( '1or' A_n -iniiLieLtign }, la1ness day . +_r...+ +-1 1 1.+.{. r-_f.+.f.+++-1-1-i-+++4+4-++4+-f•+++ 1••1-+++•++t+++t-F++++•F-F++++.+•++++-1 -h++++.....+•F.. 1 CITY OF TIGARD Plan Check0 13125 SW HALL BLVD. ELECTRICAL PERMIT APPLICATION Redd By TIGARD, OR 97223 Date Redd Phone(503)639-4171,X304 Date to P.E. Inspection(503)6394175 Date to DST �y Fax(503)684-7297 PRINT OR TYPE Permit 6Z-0 {�, Q_,W06 INCOMPLETE OR ILLEGIBLE WILL NOT BE ACCEPTED Called . Job �dcress: 4. COMPLETE FEE SCHEDULE BELOW: Name of Development PARK 217 _ _ Number of Inspection or permit allowed Service Included: _ Items _ Cost_ Sum _ Name(or name of business) ACT---- 4a. Residential-per unit 1000 sq.ft.or less $110.00 4 ddress 12010 SW GARDEN PLACE_ Each Additional 500 sq.ft. fv or portion thereof _ $25.00 _-____ 1 City/State/Zip _TIGARD,OR 97223 Limited Energy $25.00__ __ Commercial X _ Residential Each Manufd Home or Modular Dwelling Service or Feeder �i $68 00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Service or Feeders Electrical Contractor CAPITOL ELECTRIC CO.,INC. Installation,alterations or relocation ddress 12810 NE AIRPORT WAY 200 amps or less 4_ $60.00 $240.00 2 City PORTLAND State OR Zip97s30.1029 201 amps to 400 amps $80.00 2 Phone No. '(503)255-9488 401 amps to 600 amps $120.00 2 Job No 97-741 _ 601 amps to 1000 amps _ $180.00 2 Elec.Contr Lic.No, 26-496C Exp.Date 10-1-98 Over 1000 amps or volts $34200 2 R State CCB Reg.No, 48748 Exp.Date 8-22-99 Reconnect only _ $5000 2 OT Business Tar.or Metro No. 00004542 Exp.Date 10.1-98 c. Temporary Services or Feeders Signature of Supr.Elec'n _ Installations,alterations or relocation 200 amps or less _ $50.00 s 2 License No. 3132-5 Exp.Date- 10/1198 201 amps to 400 amps $75.00 2 Phone No. (503) 25_5-9488 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts see"b"above, 2b. For owner installations: d. Branch Circuits Print Owner's Name New,alteration or extension per panel ddress a)The fee for branch circuits with City ;tate Zip purchase of service or feeder fee Phone No. Each branch circuit 67 $500 $33500 2 b) The fee for branch circuits without The installation is being made on property I own which is not purchase of service or feeder fee. intended for sale,lease or rent. First branch circuit $3500 2 Each add'nl branch circuit $500 2 wner's Signature e. Miscellaneous(Service or Feeder Not Included) Each pump or irrigation circle $4000 2 3. Plan Review section (if required): " Each sign or outline lighting _ $4000 2 Signal circult(s)or a limited energy Please check appropriate item and enter fee in section 5B. panel,alteration or extension $4000 2 4 or more residential units In one structure Minor Labels(10) $100 00 _Service&feeder 225 amps or more System over 600 volts nominal 4f. Each additional Inspection over _Classified area or structure containing special the allowable in any of the above occupancy as described in N.E.0 Chapter 5. Per inspection _ _ $3500 Per hour $55.00 Submit 2 sets of plans with application where any of the above apply. In Plant $55.00 Not required for temporary construction services. S. Fees: PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS 5a. Enter total of above fees $ _ $575.00 NOT COMMENCED WITHIN 1;0 DAYS,OR IF CONSTRUCTION OR WORK 5%Surcharge(.05 X total fees) $ $28.75 IS SUSPENDED OR ABONDONED FOR A PERIOD OF 180 DAYS AT ANY Subtotal $ _ $603.75_ TIME AFTER WORK IS COMMENCED 5b. Enter 25%of line 5a.for Plan Review if required(Sec.3) $ Subtotal $ _ $603 75 Trust Account# _ alai balance Due $ $603.75 RECE►VFr OCT 2 3 1991 COMMUNITY 0{VF.LOf t.'r CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 - - — BUP __Date Requested. �� AM _PM ._ BLD - — Location C lG Suite MEC Contact Person Ph PLM Contractor /—M�_ ^� - -- Ph j_ -j,� Z -z--- SWR --- BUILDING -- nant/Owner __ - ELC Retaining Wall ELR Footing Access: Foundation FPS _ Ftg Drain SGN Crawl Drain Inspection Notes: ------- Slay — Ie��i'/ �i►S,.y� / -�',��' SIT Post& Beam — - Ex;Sheath/Shear �'N Z- �-/ Int Sheath/Shear Framing ----- ---------- --- - Insulation Drywall Nailing Firewall Fire Sprinkler - --- - —----- -- - - --- - Fire Alarm Susp'd Ceiling Roof Misc: Final - PASS PART FAIL PL.UMBING Post& Beam ---- - ---- --- - Under Slab TopOut - -- - ----- --_--- ------ .------------ -- Water Service _ Sanitary Sewer - Rain Drains Final _ PASS PART FAIL MECHANICAL Post&Beam ___ -------- - _-.-- Rough In Gas Line ----- -- --- - - - - - -- - Smoke Dampers Final -- --- ------ - - - - -- 6ELFAIL EC ICAs_ ------ — — --- Service Rough In U6/Slab ow Voltage. - --- - - - - �'JiTerrn F , PASS,/ PART FAIL. T Backfill/Grading --- _ - - Sanitary Sewer Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd Catch Basin ire Supply Line ( ]Please call for reinspection RE: T_- _ ( ]Unable to inspect-no access ADA Approach/Sidewalk Other Date __ 4'� Inspector _—_ - Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the joh site,.