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13721 SCJ J3NNA CT - i
CITYOF T I GA R DELECTRICAL PERMIT
PERMIT#: ELC2002-00256
DEVELOPMENT SERVICES DATE ISSUED: 310/02
' 13125 SW Hall Blvd., Tigard. OR 97223 (503)639-4171 PARCEL: 2S 104CA-10100
SITE ADDRESS: 13721 SW JENNA CT
SUBDIVISION: HILLSHIRE ZONING: R-7
BLOCK: LOT : 101 JURISDICTION: TIG
Proiect Description: Alterati,m to (2) branch circuits for basement remodel.
RESIDENTIAL. UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS _
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - JO amp: SIGN/OUT LINE LTG:
LI.MiT:D ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HDI/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERV,'CE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
RFEB, RAYMOND L - KRISTY A ELECTRICAL CONNECTIONS LLC
13721 SW JENNA CT PO BOX 875
1 IGARD, OR 97223 NEWBERG, OR 97132
Phone: Phone: 503-E-38-8033
Reg#:
FEES _ Required Inspections
Type By Date Amount Receipt Rough-in
PRMT CTR 6/10/02 $53.59 2.720020000( Elect'I Final
5PCT CTR 6/10!02 $4.28 2720020000(
Total $57.78
This Permit is issued subject to the regulations,;ontained in the Tigard Municipal Code, State of OR. Si)ecialty Codes and all other applicable
laws. All work will be done in accordance with approved plays. 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 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to
Permit Signature: � l4ed By:
_ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N:
L!r;ENSE NO: --
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
rt)-,te
te received: r_- Permit no.:��LC�•, t t.
City of Tigard jecdappl.no.: Expire date:
Ci►yuJTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223, issued: fay: Rccerpt no.:
Phone: (503) 639-4171 Fax: (503) 598-1960 se file no.: Payment type:
Land use approval-
& 2 family dwelling or accessory U Commercial/industrial U Mulli-fancily U Tenant improvement
U New construction U Addition/alteration/replacem,at U Jther: _ U Partial
.110111 SITE INFORMATION
Job address: 1312S- ;fin T Bldg. nn Suite no.: •fax map/lax louaccount no.:
Lot: Block: Subdivision: —
Project name: I Descrip ion and location of work on prernises:
Estimated date of'cornpletion/inspection:
CONTRAIC10111 APPLKATION 11--EE SCHEDULE
Job no: _, Fee Max
7 eL,���G'�N�fP�r.ONS' .��C Descripliun QI)'• (ca.) 7utnl no.incp
Business name: E''/�c rrc
New rrddential-single or multi-family per
Address: /'D &ox 87.5 dwellingunit.Includesattachedgarage.
City: ew !Lw Stale: 7_l P: 7/� Seniceh)cfuded:
PhoneSp3 _53 -&W Fax v3 I(x)0 sq.n.or less 4
Each additional 500 sq.ft.or portion thcroof
CCB no.: /y92 y (�.Irc�hus.tic.no: 36 - /02C Limited energy,resulemial 2
City/metro Ile.110.: Limitedenergy,non-residential 2
Each manufactured home or modular dwelling
signatuu,of'sup,ntsing electrician(requn,h I)ate Service anti/or feeder 2
su1, ch nnnnLicense nn. Services or feeders-Inclallatlon,
alteration or relocation:
PROPERTY1
200 amps or less 2
Name(print): 201 amps to 400 amps - 2
2
Mailing address: 4oi ampsm60oamps _
601 amps to 1000 amps 2
City: - - Stale: ZIP: Over I( x1 amps or volts 2
Phone: Fax: L-mail: Reconnect only i
Owner installation:The installation is being made on prop,!rty I own Temporary cenlces or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
ORS 447,455,479,670,701. 21x1 amps or less 2
201 amps to 41x)amps 2
Owner's sign iture: Date: 401 to 6W amps 2
NOLM Branch circuits-new,alteration,
or extension per panel:
Nance: _ A. Fee for branch circuits with purr-hase of
Address: service or feeder fee,each branch circuit 2
City: State 7� IP: B. Fee for branch cir•_uits without purchase
Phone, lax: E-mail:
of service or feeder fee,first branch circuit: 1 2
Each additional branch circuit:
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Hazardous location Fach sign or outline lighting _ 2
famifydwellings U Building over 10,010 square feet four or Signal circuits)or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration,or extension* _ 2
U Building over three stories U Feeders,400 amps or more "Description:_
U(kcupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
U F:gress/lightingplan U Other per inspection
submit___sets of plans with any orthe above. Investigation fee _
The above are not applicable to temporary construction service. Otter
Not nil jurisdiction%twcept credit cards,please call jurisdiction for more inhxmanoo) Notice Phis permit application Permit 1ec....... .............!1+
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
Credit card number: — --1_(� within 180 days after it has been State surcharge(8%) ....$ _
r:X ares accepted as complete. TOTAI. .
Name of ca of res shown on credit carU—
S _
Cardholder signature Amount
44o0,15th'tXltt'Uhtl
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
{� Restrictea Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per uilit
1000 sq it or less $145 15 _ 4 Audio and Stereo Systems
Each additional 500 sq If or
portion thereof $33.40 1 Burglar Alarm
Limited Energy $7500
Each Manufd Home or Modular ❑
Dwelling Service or Feeder $90.90 2 Garage C,)or Opener'
Services or Feeders F–] Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2
201 amps to 400 amps _ $10685 2 Vacuum Systems'
401 amps to 600 amps _ $160.60 2
601 amps to 1000 amps _ $24060 2 Other
Over 1000 amps or volts $45465 2
Reconnect only $6685 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system.......................................................... $75.00
2C0 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100,30 _ 2
401 amps to 600 amps $133 75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. Audio and Stereo Systems
Branch Circuits ❑
New,alteration or exter cion per panel Boiler Controls
a)The fee for branch circuits
with purchase oi'servlce or Clock Systems
feeder fee.
Each branch cirCr it $665 _ L-1 Data Telecommunication Installation
b)The fee for branch circuits
without purchar a of service Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $665 EjHVAC
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $5340 _
Each sign or outline lighting $53.40 _ Intercom and Paginq Systems
Signal circuit(s)or a limited energy
panel,alteration or extension $7500 _ Landscape Irrigation Control'
Minor Labels(10) $125,00
Each additional Inspection over ❑ Medical
the allowable In any of the above
Per inspection _ $6250 Nurse Calls
Per hour _ $6250 _
In Plant $73.75 v_ O,rtdoor Landscape Lighting'
Fees: Protective Signaling
Enter total of above fees $ _ _ F–] Other
8%State Surcharge $ _ Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses aro required licenses are required for all other installations
front of application —
Fees:
Total Balance Due $
-- ""� Enter total of above fees
Trust Ac.^unt# _ _ 8%State Surcharge $_ —
_-- — -_— --�"--- -- ---� Total Balance Due $
All New Commercial Buildings require 2 sets of p!ans.
41sta\fomLs\eIc-fees.doc 08/30/01
r.
V1_UMB I NG PERMIT
CITY OF TIGARD DATE I ISSUED: .
02/17/944 -9Qi2
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 972,JeF199 (503)839-4171 PARCEL: S 104CA--10.100
SSITE ADDRESS. . . . 1.37 :1 SW JENNA CT
SUBDIVISION. . . . : HILLSHIRE ZONING;: R•-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 101
CLASS OF WORK. . :NEW CIARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . el BHCKFLOW PREVNTRS. . :k+
OCCUPANCY GRP. . cR3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
F1XT'URES- --- ---___.___ LAUNDRY TRAYS. . . . . . : 1 5F RNIN DRAIN5. . . . . : I
SINKS. . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :5 OTHER FIXTURES. . . . . :0
TUB/SHOWEPS. . . . : SEWER LINE (ft) . . . . :0
WATER CLOSETS. . :3 WATER LINE (ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft) . . . . :0
Remarks : PATH I
OWNER: -------------------------------- --__-----------__FEES-__________._.___.
PAHLISCH HOMES INC TIF $ 1520. 00 JH 02/17/94 --
15100 SW KPLL PARKWAY BPRT f 550. 50 JH 02/17/94 -
SUITE E BPLC $ 357. 83 JLH 01/19/94 94--24 ibl'+
BEAVERTON OP ')7006 B5PC $ 27. 53 JH 02/17/94 -
Phone #: 643 SSDC f 280. 00 .JN 02/17/94 -
PARK f 500. 00 JH 02/17/94 -
Plumbing Contr•actor ---- ------- ---- MPRT $ 45. 00 JH 02/17/94 -
�i // MPLC $ 11. 25 JH 02/17/94 -
Names L� M5PC $ 2. 25 JH 02/17/94 -
Addres5 : _ b Il?. PPRT $ 162. 50 JH 02/17/94 -
C i t y : _.._.._.___St ae :,QP' - P5PC 6. 13 JH 02/17/94 -
Zips Phone4:.(0_,LV113_
Rey #:
------- REQUIRED INSPECTIONS -------
This permit is issued subject to the reg-
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insr)
Code, State of Ore. Specialty Codes and all r'ost/Beam Struct Water Line Insp
other applicable laws. All work will be done Post/Beam Mechan Appr/Sdwlk Insp
in accordance with approved pians. This Plm/undslab Insp Mechanica Final
permit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of issuance, or if work is Mechanical Insp Building Final
suspended for more than 180 days. Plumb Top Out Erosion Control
Framing Insp Crawl. Dv,ain
Fireplace Insp
�) Gas Line Insp
Insulation Insp
x Gyp Board Insp
Authorized Plumbing tontractor Signature
Call for inspection - 639-4173
Contractor Notes :
�aawraa�s.
CITY OF TIGARD MASTER PERMIT. :
��ERMI r #. . . . . . . 1+15T94-9025
COMMUNITY DEVELOPMENT DE*A'Ri'Ir ihT DATE ISSUED: 02/ 17/94
13125.Si 'Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171 PAPCE;_..: 2 104CA_.10100
SITE ADDRESS. . . : 13721 SW JENNA CT
SUBDIVISION. . . . : HILLSHIRE ZONING: R-7 PD
BLOCIJ.. . . . . . . . . . . LOT. . . . . . . . . . . . . : 101
-------------------------------- BUIL.DIN[a
NLISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . : 1092 sf
CLASS OF' WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . .
:7:_'3 s
YPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS------------
TYPE OF CONST. :5N FIRST. . . . : 1`76 s f LE:F•T. . :5 ft RIGHT. :6 ft
OCCUPANCY GRE''. : R3 SECOND. . . : 1352 5f FRONT. :21'0 ft REAR. . :36 ft
STORIES. . . . . . . :2 THIRD. . . . :0 s REQUIRED-- _-----_.______.__.__...
HEIGHT. . . . . . . . :28 ft TUTAL-- ----:2'6LB S SMOKE DETECTORS. :Y
FLOOR LOAD. . . . 140 psf VALUE. . . . . PARKING SPACES. . : 1
Remarks: PATH I
----------------------- PLUMBING
SINKS. . . . . . . . . . : 1 !=LOOR DRAINS. . . . . BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . ..0
•D/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0
'.R CLOSETS. . :3 SEWER LINE (ft) . :0 CREASE TRAP'S. . . . . . :0
D0 1WASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
6ARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
— MECHANICAL •________._._____.._.__._..---__ -___.___._. FEES
TYPES UNIT HTRS. . :O type amount by date r^ecpt
/GAS/ / / VENTS . . . . . :0 TIF f 1520. 00 JH 32,'17/94 —
MAX INPUT:O BTU VENT FANS. . :4 BPRT $ 550. 50 JH 02/ 17/94 —
1--URN ( 100K . . :0 HOODS. . . . . . : 1 BF-,LC $ 357. 83 JLH 01 /19/94 94-•247819
FURN ) =100K . . : I WOODSTOVES. :0 B5P(:.: 9, 27. 53 JH 02/17/94 --
FLOOR TURN. . . . :0 CLO DRYERS. : 1 SSDC $ 2:80. 00 JH 02/17/44 —
SOIL/CMP ( 3HP:0 OTHER UNITG: 1 PARI, $ 500. 00 JH 02:/ 17/94 -
GAS OUTLETS: 1 MPRT $ 45. 016 .J 11 02/17/94 —
Owner: $ 11. 215 JH 02/ 17/94 —
PAHLISCH�HOMES INCM5PC $ 2. E5 JH 02/17/94 -
1.5100 SW I'�'LL PARKWAY PPRT $ 162. 90 ,JFi 02117/94
'QUITE E P5PC $ 8. 13 .JH 02/17/94 -
BEAVE:RTON OR 97006
Phone #: b43
PAHLISCH HOMES INC.
15100 3W KOLL PKWY
'ITE E
,GAVERTON OR 97006
171hone #: 684--6453
Reg #. . : 42067 ---------------_..-...-_.... ... ...
f 3464. 99 TOTAL
This perait is issue subject to the regulations contained in the ------- REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applir.Able laws. Ail work will be done in accordance with approved Post/Beam Stt-uct Gas Line Insp
plans. This permit will expire if work is not started within 188 Post/Beam Meehan Insulation Insp
days of issuance, or if work is suspended for sore than 18111 days. Pim/undslab Insp Gyp Bnard Insp
PLM/Underfloor Rain drain Insp
>ermitte� Signatu- ,e : ._ _ . _P.)OPechanical Insp Water Line Insp
Plumb Top Out Appr/Sdwlk I-sp
Issue!j Pv : _ Framing Insp Mechanical Final
Call for inspection - 6:.?,9--4175
SEWER CONNECTION
PERM I T
CITY OF TIGARD PERMIT #. . . . . . . : SWR94-0027
COMMUNtTY DEVELOPMENT D&WOAMT DATE ISSUED: 02/17/94
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171
PARCEL.: 12S104CA-10100
SITE ADDRESS. . . : 13721 SW JENNA CT
SUBDIVISION. . . . : HILLSHIRE ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOT . . . . . . . . . . . . . : 101
------------------------------ --- ------------
TENANT NAME. . . . .
USA NO. . . . . . . . . . FIXTURE uw"rs. . . :
CLASE OF WORK. . . :NEW DWE LLI NO UN I T S. . : 1.
IYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
T NSTALL TYr". E. . . . -BUSWR 1.11PERV SURFACE. . f
Remar-ks : PATH I
Owner-.- --------- -
PAHLISCH HOMES INC type amol-Int by date recpt
15100 SW KPLL PARKWAY PRMT $ 2200. 00 JH 02/17/94
"U Il P
1-1 - E 1 NSP $ 35. 00 JH 02/17/94
BEAVERTON OR 97006
#: 643
Contractor:
CONTRACT':-,� NOT ON FILE
Pl-lurlp #: $ 2235. 00 TOTAL
R ey
------- REDUIRED INSPECTIONS
This Applicant agrees to comply with all the roiles and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires IN days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in ;111 directions from
the distance given. If not so located, thp install?r shall purchase
a "T.p and Side Sfwer" Permit and the Agency will install a lateral.
P I t t e e Lj T 1,3 e
Tssl-tecl By :
Call for- inspection 639--4175
Residential Building Permit Application
CA-
City of Tigard
13125 SW Hall BIV 1.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
only
Subdivision: y //s-4 ; Lot #
�I PLvWRec# °f
Valuation:
_1� � ���, y 5
Permit#
Owner: Reissue of
Address:
Approvals Required
Phone: Planning `
Engineedng
Contractor:
Address: i { /G o _s. k // p6 r t w��, S•,
Items Required
�Q�ycr^l cY0 G
Subcontractors
Phone:
Tvvss Details
Contractor's License # r
(attach copy of current Oregon license)
......:i...r ..: <a, ,..'•www—.�.•••• �,°
Subcontractors:
Plumbing:
Mechanical:
(attach copy of current OR Contractor's License)
Architect/Engineer:
Address: _4,;
97.2 j f
Phone: ti 1- 3 0/0
COMMENTS.
Applicant Signature & Phone number
Received by: _ Date Received:
i'
Permit # Account Description Amount Amt. Pd. Sal. Due
Bldg. Permit (BUILD) .53o,.�o 1) jo Sn
Plumb. Permit (PLUMB) ' Z•31 ,�Z,.5-2,
Mech. Permit (MECH) J vo
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) cue/.C� -�—r—,� �/ • v
Bldg:
Plumb: J
Mech:
d 2-7 Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Partes Dev Charge (PKSDC) G 0 c5!'iU
Storm Drainage Chg (SDSDC) �U /
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) 110
Comn;Qrcial TIF (TIF-C)
Industria:TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WaUAL)
i
Water Or-antity (WOUANT) r,
Fire District (FIRE) - '-- —
TOTALS:
%..o,ITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE OF
13125 SW Hall Blvd.Tigard,Oregon 97223e8199 (503)639-4171 OCCUPANCY
PERMIT #. . . . . . . . MGT94-902")
3'�-41 /I DA-rr-'. ISSUED: 09/1.4/94
PARCEL: 2SI04CA--10100
SITE ADDRESS. . . 1137021 SW JENNA CT
SUPID I V I S I ON. HILLSHIRE Z ONI NG: R--7 PID
"I LOT. . . . . . . . . . . . . a101
-OCK. . . . . . . . . . .
... ........
U'LASS Or:-- WORK. :Nr-.'.W
7 YPE Or USE. . . .BF
OCCUPANCY GRP. -R3
OCCUPANCY LOAD-228 4
rENANT NAME. . . :
Pemarkse PATH I
MHLISCH HOMES INC
15100 SW Ki,-L.L P'(-)RKWA'
!�-IJITE-. E
BEITIVERTON OR 97006
1+1hone #: 643
CUT)t I-aVt Dt-t
PAHLISCH HOMES INC.
15100 C3W KOLL PKWY
1`21 U T TE F
BEAVERTON OR 97006
f--1hune #. 604-6453
P-f., #. . - 42067
(Ic.c.,uparicy c;f the above r-eferellCed bUilding is hereby giveTi, and certifie
1.1w c.,ompliance with the State Of Orer
4ui, 16pecialty Codes for the group,
r�:C.I.(pl,�k tn.c y, and oAse undei- wh i ch the t-efer tanc ed per-m j t was i sued.
.11 DIN NSPECTOR
I'EJ
PQS'T 11\1 CONSPICUOUS PLACE
INSPECTION NOTICE
City of Tigard Buildiry Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-u-Phone: 639-4175 Business Phone: 63q-4171
Inspection•—__—______
Footing Plbg. Underelab Mech. Rough--in Appr/Sdwlk
found. Plbg. Top Out Gas Line FINAL
Post/Beam Strur_t. San. Sewer Framing
Poet/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd.
C--
Date Requested: —+�— -f--�--f— --Time: _---AM PN
Address:Z. 21 _ Permit 1s__J �
Builder:-
THE
uilder:THE FOLLOWING CORRECTIONS ARE REQUIRED:
CA A
Inspector: Date._
% APPROVED _-� DISAPPROVED APPROVED SUBJECT TO ABOVE
---Call For Reinsp.
r✓'
IT
CITY OF TIGARD PERMITU#. . . . . . :BING PLM96--i&:`13
COMMUNITY DEVELOPMENT oFPARTMENT DATE ISSUED: 07/24/96
13125 SW Hall Blvd.Tigard,Oregon 97223.9199 (503)639.4171
PPRCEL: .,'-'S 104CA•--11111.00
SITE ADDRESS. . . : 1371:'.1 SW JCNNA CT
SUBDIVISION. . . . : HILLSHIRE 7:CNING: R-7 PD
131._.00K. . . . . . . . . . . LOT. . . . . . . . . . . . . . 101.
CLASS OF WORK. .. :NF_W GARBAGE. DISPOSALS. : 0 MOBILE HOME SPACES. : 0
1'YPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . .. 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURF-c -- LAUNDRY I-RAYS. . . . . . 0 !:3F RAIN DRAINS. . . . . : 0
��INKS;. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
I.-AVATORIES. . . . . : 0 OTHER FIXI`URES. . . . : 0
TUB/SHOWERS",. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSE:1 S. . : 0 WATER I__lNE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : IT)Gtalliny a residential backflow device.
Uwrler : _____-..____________.__.__._______.-----__.__.__________._._. __ FEES --- --- -- _-__.-__
FRIG REF_.IH type amOUT)t by (fate recpt
.1.3721 SW JENNA CT PRMT $ 15. 00 CJS 07/24/96 96-282013
5P(::T $ lb. 75 CJS 07/24/96 96--2:82:013
TIGARD OR c)'7,.,-* 3
Phone #:
(-nntractor,: _...__._._......__._.---_-..._-•_--__--___-- __._--
PRO LANDSCAPE
PO BOX 5952
BE:AVERTON OR 97006 _.---•-------•----________.---.__---__.___..___.
P11-ione #: 504-642-5432: L 15. 75 TOTAL_
Rey #. . : 12174
REDUIRED INSV-"ECTiONS -
This permit is issued subject to the regulations contained in the RP/Backflow Flrev
Tigard Municipal Code, State of Ore. Specialty Codes and all othrr Final Inspection
applicable laws. A)1 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.
I ,er,mittee Signati-u,e : _ •
Call for inspection - 639-4175
City of Tigard - PLUMBING PERMIT APPLICATION Planck/Rec. # I-r-5. zz�?a c
13125 SVA/ Hall Blvd. Permit # fi,-m`7G-Oa4d
Tigard, OR 972231
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
New Sinale Family Residences Only
❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job � ��-��1C'� C —• ❑ 3 BATH HOUSE$225.00
Address Fee includes all plumbing fixtures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below,
"'""'"'"'•' ' FIXTURES QTY PRICE AMT
Sink 9.00
U. "A"1 """' Lavatory 9.00
- 1 .
Owner ( L Tub or Tub/Shower Comb. 9.00
Shower Only 9,00
O Cq I' z �? Water Closet 9,00 '—
""""' Dishwashei 9.00
Garbage Oiaoosal 9.00
Occupant MMM Ad*— Washing Machine 9,00
Floor Drain 9,00
"""" °► Water Heater 9,00
Laundry Room Tray 9.00
Urinal 9.00
Other Fixtures (Specify) 9.00
Contractor Ad*— 9.00
s.00
m 9.00
Sewer 1st 100' 30.00
1. Me. c °"'#&A.T.W Cower-ea. Addit. 10U' 25.00
-1 > Wattr Service 1st 100' 30.00
i hereby acknowledge that I ave read this application, tha the Water Service ea. Addle. 200' 25.00
information given is correct, that I am the owner or authorized agent of — —
th owner, that plans submitted are in compliance with State laws, that Slorm &Rain Drain 1st 10l)' 30.00
I am registered with the Construction Contractor's Board, that iie S'.onr &Rain Drain Ar dic 100' 25.00
number given is correct. (If exempt from State registration, illeaso
give reason below.) Ii i Home Space 25.00
( Baok Flow Prevention
SV �. . \V�� 'y�l C L Device or Anti-Pollution Device 9.00
S'°"" "'""" ' / 0ei Any Trap or Waste Not
I7 G ,JI ( _ Connected to a Fixture 9.00
Desc be work newaddition Q alteration C) repair Catch Basin_ 9.00
:)e done residentia Q non-residential Q Insp. of Exist. Plumbing 40.001hr
Spei.ially Requested Inspectiorc Z-00 h�
Existing use of
budding or property Rain Drain, single family dwelling 30.00
_
Residential backflow prevention
devices 15.00 ,
P-rr_osed use of
bi_oiding or property '(Except residential backflow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL
Pl:".'HITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF 5% SURCHARGE
CONSTRUCTION OR WCRK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL
Scecial Conditions -- —
-- —+— — --- Date issued �" �- `�F ;,y CTS
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line. 639-4171
�y BUP _
Date Requested_ u, G/ 0 AM PM BLD _
Locationl_>? ( I Y1�1 L_ Suite MEC
Contact Person Ph PLM _ 9[r_-' � ? S
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wa!I ELR
Footing A' --
Foundation NOT REQUESTED FPS —
Ftg rr FOU
Crawll Drain If
ND DURING RESEARCH SGN
Cr - —
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation , L '
Drywall Nailing
Firewali
Fire Sprinkler
Fire Alarm
Susp'd Ceilmq
Rcof
Misc: -
Final
PASS PART FAIL
,PtLjMBM-)
� L
os eam --
Under Slab
Top Out
Water Service
Sanitary Sewe
t�F�
Rain Drains
rm
A PART FAIL
- - -
HANICAL
Post&Beam - - ---- --
Rough In
Gas Line
Smoke Dampers
PASS PART FAIL
ELECTRICAL - - ___----- _.--_-
Service
Rough In
LIG/Slab
Law Voltage
Fire Alarm _--
Final
PASS PAR"i FAIL
SITE
Backfill/Grading -"
Sanitary Sewcr
Stor^1 Drain ( J Reinspection fee of$ required before next inapectlon. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin J Please call for reinspection RE: ( J Unable to Inspect-no access
Fire Supply LineADA
2
Approach/Sidewalk
Other Date _ Inspector Ext'
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.