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CITY OF TIGARD BUILDING INSPECTION NOTICE
f, ,s li•spection Line: 639 4175 Business Phone: 639 4171
n
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb. t r zaff
Post/Beam Mech. SheariSheath Framing -Mach.
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Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. v� D
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Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Jne Appr/Sdwlk
Other:
,
Date: P.M. Entry:
J� _ a �A.M. _ nt�
Address: -- G�
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Tenant: _ _ Ste: MST:
BLIP:
Con/Own. _._ MEC:
PLM:
s� ` x"02 7lv 0 ELC:1,
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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k—*APPROVCD —DISAPPROVED/CALL FOR REINSP. f F CO
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CITY OF TIGARD BUILDING INSPECTION NOTICES
":� t11 ! f111 tf}11�1'r ,.yFj t
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL: ' 4w ,
Foundation Water Line Ceiling -Plumb. ��
t 1M Mr.S�yi�
y Post/Bearn Mech. Shear/Sheath Framing -Meeh, t �i;tl ti,w
Plbg.Und/Flr/Slab Plbg. Top Out Insulation ec
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
1 t a
Other: _ __ • �'
Date: 0 A.M. — P.M Entry: J 61K
Address: O / 6 _
Tenant: ^---------._.---�_.__._ Ste: _ MST ---
BUP _
` Con/Own: MEC:
£E PL.M !
ELC , ,
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
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ANNE
• CITY OF TIGARD
DEVELOPMEN f SERVICES ELECTRICAL DERMTT
P'- RM I T #. FILF,96-Oc.,4O
13125 SW Hell Blvd., Tigard,OR 97223 (603)639.4171 ?)A T E I S SUED: 10 109/96
PARCEL: 1,S135AD-01303
SITE ADDRESS. . . : 08900 SW OAK, ST
SUBDIVISION. . . . : ASHBROOK FARM 7.ONING:R-•4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 13
Project Description: Add 2' branch r.irci-tits w/oi_It service/1 eeder-
---RESIDENTIAL UNIT---------- - - -T EMF' S R VC/FEEDERS----- -----MISCELLANEOUS-------
1000 SF OR LESS. . . . : 0 0 - 1200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L_ 506SF. . . : 0 c'O1 - 400 amp. . . . . . . : Qi SIGN/OUT LINE LTG. . : 0
i t_1MITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL.../PANEL. . . . . . . : 0
1hIANF. HM/ SVC/FDP.. . : e. 601+amps,-•1O00 volts. : 0 MINOR LABEL ( 10) . . . : 0
- -SERV I CE/FEEDER-
S - -_ tiaRANCW CIRCUITS------- ----ADD' L I NSPECT T ONS---
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . .. 0
401 - 600 amp. . . . . . : 0 EA ADD' I•_ BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . : 0 ---- - _._____._F'L.AIu REVIEW SECT ION-
1000+ ;:mp/volt. . . . . : th ) =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect ovt l y. . . . . : 0 SVC/FDR ) = 225 AMPS_ : CI_.ASS AREA/SPEC: 01,C. :
Owner-,; ___.._.___.________.___._.______._..-. __..._______.________...--_-__-..._ FEES
JAMES EVERETT type amol-Int b/ date r^ecpt
8900 SW OAK ST FIRMT $ 40. 00 JDA 10/08/96 96--21-34887
PCT' $ 2. 00 JDA 1O/O8/96 96- A4887
TIGARD OR 97223--0000
Phone #: 206-245-2451
OMNI ELECTRIC OF OREGON $ 42. 00 TOTAL.
PO BOX 1788
REOU I RED INSPECTIONS
- ----
LAKE OSWEGO OR 97035 Wall Cover-
Phrrne #: 503--635--4306 Elect' 1 Final
Reg #. . : 41789This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all othor Pet-mitt a Signature
applicable laws. all work wiil be done in accordance with
approved plans. This permit will expire if work is not started �/
within IN days of issuance, or if work is suspended for more _ �[
than 180 days. I ai_Ied By� --
____._.____________.________.OWNER INS1"A-LATION ONLY--__./_______.___________________..
•The installation is tieing made on property I own which is not intended for-
sale,
orsale, leas:?, nr rent.
OWNER' S SIGNATURE: DATE
____..________.___..___..___________-CONTRAt_.TOR IhIS'fALL_ATION ONI_Y-----•---_.__________.._.__.______
5I GNATURE Or SUPR. ELEC' N: DATE-
LICENSE NO:
Call far inspection 639--4175
.. .,n.... .n_r,.h,.....a4A..41Ni4tp;.} (,'1,iC@BIW.—e.• ..•.•.w.y tA.R ..
A "140 F !9"r�.� �r. IPP'h1'it.
dry j♦$ .'��r�,�'�V;4t"pk`1Al 1�
r a.t: .,...,,.. • .,in..wiA"caone*�..,. - ,•:�cw.rr+sa+rc•.�+ewwl+rxie�wx«.n...«::.,.:...._ _...._
Community Development ELECTRICAL PERMIT APPLICATIO14
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Roc. #
Permit #
Phone (503) 639-4171 Date Issued
FAX (503) 684-7297 Issued by
i CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 'SOB NO. 68198 4. Complete Fee Schedule Below:
Number of Inapoctions per permit allowed
Name of Development A t n a Properties
Address 6900 S h Oak Serve included Items Cost(ea) Sum
1 . Residential- unit 4
City/State/Zip Tigard,_ OR a
_ _i
1000 sy 11 or lees $11000
$
Name (or name of business)"a vac=ant house" Eacfiadditional 500so It or -- 1
portion thereof $25 00
Limited Energy $2500 — A
Commercial Residential® Each Manurd Home or Modular
Dwelling Service or Feeder $66.00
2a. Contractor installation only: 4b.Services or Feeders
Installation,alteration,or relocation 2
Electrical Contractor Omni Electric of Oregon NOampeorless $6000 2
PO Box 201 amps to 400 amps -- 000 2
Address 401 am to 600 m $1212000 2
City Lake Oswego_ _ State 0R Zip 97035 601 amps a
to 1000 Pimps $18000 2
Phone No. 635-4306 _,__ Over 1000 amps or volts $340.00 _— 2
Contractor's License No ?6. 95C — _ Reconnarlonly 65000 —
Contractor's Board Reg. N 203 4c.Temporary Services or Feeders
Installation,alteration,or relocnbon 2
r
Signature of Supr. Elec' 2.00 amps or less $5000 2�'l�' — -- -- -- 2
201 amps to 400 amps $7500 I
License No. 23455 Phone o._ 635-4306 _ 401 amps 10600 am $10000 i
Over r300 amps to 1100 volts
2b. For owner Installations: """'b "'x " '
4d. Branch Clrr !
Print Owner's Name--.-- New,alleralion or extension per panel j
Address — ___—_
a)The tee for hrnnr.,circuits with
City _ State_ Zip—_ Each branch circuit $5 00 �--
Phone No. _ _ b)The tee for branch circuits without
purchase or swirks or Ilrodsr Ma. 2
The installation is being made on property I own which is First brnnch circv,4 1 $3500 35 .00
not intended for sale, lease or rent. Each addlioruwl bwxh circuit $500
Owner's Signature____ __ _ 4e. Miscallaneous
(Service or feeder not Included) 7
3. Plan Review section (if required): Farh Pump or angalion circle -- $4000 -
Each sign or outline lighting $4000
Signal clmuit(s)of a limited energy ?
Please check appropriate Item and enter fee in section 58. panel alteration or extension $4000
4 or more residential units in one structure Minor I abet"(10) $10000 _
_Service and feeder 225 amps or more 41. Each additional inspection over
System over 600 volts nominal
_ the allowable in any of the above
Classified area or structure containing spec al occupancy
as described in N E C Chaptar 5 Per hourintipl'°" $3500
—
Per hour $55 00 —
In Plant $5500
Submit 2 sets of plans with application where any of the above —
apply. Not required for temporary construction services. 5. Fees:
5p. Enter total of above fees $ 40.00
NOTICE 5%Surcharge(05 X total fees) $ 1r0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 4 •V 11
5b.
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Enter of tine A for
Review
CONSTRUCTION OR WORK IS SUSPENDED OR 03ANDONED FOR Plan Reeview if required(Sec 3) $
Subtotal $ —477UT
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS r
COMMENCED. S� `� `) - ' l� trust Account# $ (42 .00
r_5
2.>c
0,49-ice nue S —0—
OCT 01,611996
0—
OCT0; 1996
'Pages
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IT N' COV I TUAK) kE:[:LIP1 14, 1-14YP NI Wk-U Yltl NO. c96 !.,8 J S=?
NAME a OMNI t*1ECFR FC A ' UPW.-GON 1:;PSH AMULINi' x ill. vl.,o
AT)DRI-6W d Pf., BUX 1'r89 F=AYMEN'I DA'lE. Y t0 ? !`I6
Sl,)SOIVISlUN A
(.NKrt OR 9.703:si-
PIURPME Uw PAYME N1 PMOUNT PIPID D F'1 1RPIU.,)V I.If- WAYt+IOTI f-1MI IUM PO-110
i
40. X(A S I . R!111.0 I: I- R OID
OMNI ELECTRIC OF aF"3EGUN —4;-". 00
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ELECTRICAL PERMIT
CITY OF TIGARD
DEVELOPMENT SERV'IC'ES PERMIT #: r O
DATE ISSUED:
10/1O/0Q/98/9
6
13125 SIN Hall Blvd., Tigard,OR 97223 (503)1:39.4171
PARCEL: 1S135AD-01303
SITE ADDRESS. . . : 08900 SA OAK ST
SUBDIVISION. . . . : ASHBROOK FARM ZONING:R-4. 5 '
BLOCK. , . . . . . . . . . LOT. . . . . . . . . . . . . : 1 3
Pr-oject Description: Add 2 bt-anch circl.tits w/ol-tt service/feeder
-'-RESIDENTIAL UNIT---- - --'TEMP' SRVC/FEEDERS----- -----MISCELI r".`c1US---
1.000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/lRRIG,4T17N. . . . : 0 r'
FACIA ADD' L 5OO5F. . . : 0 201 400 amp. . . .. . . . : 0 SIGN/OUT LINE LTG. . : 0 r,
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . .. . : 0 SIGNAL/PANEL. . . . . . . : 0 �
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . , . : 0
-------SERVICE/FEEDER------ _.._.--BRANCII CIRCUITS-----___-- ---ADD' I_ INSP'EC'TIONS----
0 -' 200 ramp. . . . . . : 0 W/SERVICE OR FEEDER. 0 PER INSPECTION. , , . . : 0
201 400 .imp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER POUR. . . . . . . . . . . . 0
401 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PL.ANT. . . . . . . . . . . : 0
(SO1 - 1000 amp. . . . . : 0REVIEW SECTION--.-.------------------ j
1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 2,25 AMPS. . : CLASS AREA/SPEC OCC. i t'
Owner-; _.___._..___.___._..__..__._.___._______.___.__..___.____.._._..______._.._..______.___._ FEE'S
JAMES EVERETT EVF_RETT type amol_tnt by date r-ecpt
8900 SW OAK ST P'RMT 4 40. O0 JDA 10/08/96 96-284887
`,;PCT $ 00 ,JDA 10/08196 96-284887
TIGARD OR 972232-0000
Phone #: 206--2'45--2451
Cont,-actor:
OMNI ELECTRIC OF OREGON E 42. 00 TOTAL
PO BOX 1788
- -- -- REQUIRED INSPECTIONS
-AKE OSWEGO OR 9'7035 Wall Cover.
Phone #: 503-635-4306 Elect1. 1'lnal i
Reg #. . : 41789
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, btate of Ore, Specialty Codes and all other Perm i t t e e S i gnat Ltre
applicable laws. All work will be dr,ie in accordance with 1`
approved plans. This permit will expire if work is not started r ='
within 188 days of issuance, or if work is suspended for more
t than 188 days, Iss�.ted y, i
(7WNFF� I P
NSTAI_I_AT I ON
The installation is beingP made on ro ertY I own which is not intended for
r;al.e, lease, or rent.
'A', -{� 3
OWNER' S SIGNATURE : DATE:
__-_.-.-__-.-_.CONTRACT'OR INSTALLATION
+P SIGNATURE OF SUPP. ELLC' N: DATE: _
LICENSE N0:
Cali for inspection - 639-••4175 E �
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' }�"_r�'r{��`r�a. Y���p; �11, { i r • .; - d y,�tiA�a' . irf i'i� `.-:
FROM OMNI ELECTRIC PHONE NO. 503 635 1391 Oct, 07 1996 04:36F-M P1
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit #. �91a-0(0go
4 Phone (503j 639.4171 Ditto Issued S�
CITY OF TIGARD FAX (503) 584-729' Issued by
T t9D Na. (.503) 684-2. 72 ~- --
Inspection (503) 639-4175
1- slob Address JOB NO. 68198 4. Complete Fee Schedule Below:
Name of fieveiopment. Aetna Properties Number of(nspeciJonr per permit allowed
Address 8900 SW Oak Serviceilrluded: Items Ccsg0e) Sum
City/state2ip Tigard, OR an. Reeklential per unit - _ 4 am
1000 sq.Il.or leas $11000
Name(or name of business)"a vacant house", Eiedl addkiorvl 600 eq n.a,
porion iNreof VS 00 1
Commercial❑ Residential Urnhad Errerpr =25.00
Each MavRd Home or Modula :
Nvomrp 3snvlee or reader S9a 00
28. Contractor Installation only: 4b,services or Feeders ,
Irtrlaoatwn,a r knon,or relocator 2
Electrical Contractor
Omni Electric of Oregon 2oor,ap.ol.. 2 t
Address PO PoX— �— --------- 201 amm to 4M omps eco oo 2
Ci t> Luka Oswego State_ OR Zi9703`, 401an"10 no wore � $12000 2
p —.-- 601 amps to 1000 amps simoo 2
Phone No, 635-430§ ��_ Orer I aco amps or vohe $340.00 2
Contractor's License No, 2695C'nAmonnedor" W0.00
Contractor's Board Rep. N 103 . — y 4c,Temporary Services or Feeders
- �u J Inlallaan or Ins 2
Signature of Supr. Elec' a-' 200 amps or we: sSo.00 a.
LicengeNo.�45S — Phone o. 635-4306 2rlarnpaa,400amps 076 2
- 401 amps to WO ampa $10000
Over en>o amps to lobo Anse
2b. For owner Installations: saw IV al
Print Owner's Name f 44.aranoh Circuits
Now,albs-lorl or Atrlenaron per panel
Address __ a)IN fee for branch drWift Writ,f:ity - __.___ .____-_.- __-. State _ Zip_ r+mheaA of aww.a or headier Are, 2
Phone No. Each Branch ero,ll SE no
_ b)The fee lot branch ckwhe%firbocn
The Installation is being made on property I own which is� run Re"of xIce er hat do res. z
not intended for sale, lease rjr rent. First bisivi sharp 1 :35.00 3000 2
Each adelitional twon,+citcuit T_ sR 00
(Iwner's Sigrletura �— _ tie 111isoellaneous
(Services or feacior not included) :
3. plan ReWew section �if required): FAah purnp or irripatMn o•Ue W.Go Q
Fafi cion or oohs n I Ahtintl $4000
Spnei cimuh(e)rr a limped en,rrtry __ p
Plaste cheek ryrproWlale Item and enter tee In aeetbn 5Q. panel,attartalnnm.Menlo, WW
a or morn rt s4ential units in one structure M"r Lahce(10) $100 no
ServirA and feeder 725 amps of more �r
System ovw 600 volts nonliral 411.Esch add;tional inspection over
Classified arse or smicture containing spatial occupancy 'the allowable in any of the n',ove,
as dasctibed In N F.C Ch.tpler 5 Ptr igspaNren $3900
per hmn SAS.M
Dlarn af5.00
Submh 2 salts of plan with applic rtion where any of the above .n
apply. Not required for htmporary construction services. S. Fees:
NOT CE go. Erl total of above breis s 40.00
SBE.Surcharge((Y .' bpd loss) _
PERMrTS BECOME VOID IF WORK OR CONSTRUCTION suluora, -- f
AUTHORIZED IS NOT COMMFNCF.D WITHIN 190 DAYS,OR IF 5b. Enhtr 25%of line A for
CONSTRUCTION OR WORK IS SW-WENDED OR ARANDONFD FOR Plan Rw iow If required(Sec.3) Z
A PERIOD OF 160 DAYS AT ANY TIMF AFIEk WORK IS 9u6reral S
COMMENCED. Iq Trust Account A
081ance. Due
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8UB01VIS1UN n II
LARE OSWEGO, OR 4703b-,-
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F 1 !'yCTRICAL_ PlnkMI'r 40, 00 Sl . SOILV PILL 00
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CITY OF TIGARD BUILDING INSPECTION NOTIC2
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Founoation Plbg. Underslab Mech. Rough-in Fireplace
� r.
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor < /�t,� -Plumb.
;nrs
�Alarm Water Line �ulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: rr��
/
Time: AM PM
Address: oU
C-)
_!_�.J`�t — ^�
Builder: Z11" l � Permit #q=�S I +I:'
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r
Inspector: Date: , ^90_-5�_
o APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O Phone): 639-4175 Business Phone: 639 4171 / n f,1 �,! a r'•,
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor i ai Framing -Plumb.
Alarm Water Line Insulation -Mec
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. y
hate Requested: Time: AM PM
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Address: - cry'C`
Bui'der:., �'S ��c &--L. o t .Permit #:r}'i —�� IrJ
I THE FOLLOWING CORRECTIONS ARE REQUIRED:
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_APPROVED =MSAPPROVED _APPROVED SUBJECT TO ABOVE
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i CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171e<'
ry
° Inspection:
' Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Firepla%.-�
Post/Beam Struct. Plbg. Top Out Elec. Hough-in FINAL:
Post/Beam Mecth. San. Sewer Gas Line -Bldg. r'
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach. •
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Data Requested: (c� / ' _Time: AM PM
4MAddress: cl C`'<�
Builder: Permit#:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
A0.5 2-2 ��S�L1facC ✓C GGpF'N-rte iT � ^_ n"w':
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Inspector: Date:Zza/ f <<T
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE `��
_Call Foi Reinsp.
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CITY OF TIGARD
OREGON
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RE: SIIILD?NG PERMIT 4111 57-,q y G 3 7
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Inspections) have been conducted on this project . However, we
have no record of any subsequent or final. inspections within the
past 1.80 days .
Please note that permits become void if there has not been an
inspection performed for over 180 days . In that case, the Buil.ding
Division may require a new application and fees to continue work.
A notice of non- compliance against the property may also be
rec3rded by the City.
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Pl!a!3:� advise the Buildiacr Division, IN WRITING, within 15 days of
':his Letter, the status of this pr(-ject . You may request
additional time to complete the project .
Respond IN WRITING to : BuildingDivision 131 1
25 SW .gall Blvd. ,
Tigard OR 9722.3 . Be sure to include the following information:
1 . Building Permit # .
2 . Address o.t property .
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3 . Your name .
4 . Your phone number 8 : 00 a.m. - 4 : 00 o.m.
If ycu are ready to schedule your next inspection, please call our "
24-hour Inspection Recorder at 539-4175 .
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13121) SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 TDD (503) 684-2772 —
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City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Lire (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection• --- --
Footing Plbg. Underslab Meath. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer aurin` -Bldg.
Poet/Beam Meets. Rain Drain Ineulaticn -Plumb. _
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Plbq. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requested:_��(/ L� — Tei PM :
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-ICPermit f:
Address:
Builder:_ — —
THR FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector! Date:
APPrAMD DISAPPROVED APPROVED SUBJECT TO ABOVR pJ.
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Call For Reinsp. "
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INSPECTION NOTICE \�
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line jRec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
us1 r Footing Plbg. Underelab Mech. Rough-inX Appr/Sdalk
d I�
1r Found. Plbg. Top Out�11� Gere Line PINAL: �
Poet/Beam Structs! San. Sewer raining ../� -Bldg.
Poet/Beam MachIP( RaSn Drain Insulation -Plumb.
1
Plbg. Underfloor Water Line Gyp. Rd. -Hoch.
Deter Requested: 1612Time: _—AM PM
� Address: ( ��-� � Permit #: 7�1 �J_ /fj
M* Bullders
i' THE FOLLOWING OORRECTIONS ARE REQUIRED: �• l ,
—/,1-'�- --`-'tom--K_j-c_t cq Uv Q-,k-j
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Zen , i Inspector:_ �'` 'V` r-• - Date: /V -C
APPROVED VDISAFPROVBD APPROVED 6UBJErT TO ABOVE
For Reinep.
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rwaevc TION NOTICE J/
city of Tigard Baildiog D Part—t
1,3125 SW Ball Blvd. Tigard, Oregon 97223
r Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:_
plbg. Underelab Mach. Rough-in nppr/sdwlk
Footing
plbg. Top Out Gas Line FINAL:
,)und. s
Post/Beam Struct. 4an. Sewer
Framing -Bldg. i
n -Plumb.
lao
Post/Beam Much. Rain Drain InsuT �
Pl.bg. Underfloor Water Line Gyp. Bd.
-Mach. �
Time: AM PM
Date Requested: ------ k
Address: +
Builder: — —
THE FOLLOWING CORRECTIONS AAE REQUTRF.D:
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Data:
Inspector:__
APPROVED __1____DISAPPROV8D APPROVED SUBJECT TO AAOVE
Cell For Aeinep.
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. CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
13125 BW Hall Bbd.Tigard,Oregon 97223.6199 (503',639-4171 PERMIT #. . . . . . . : MST)4--0378'
DATE ISSUED: 10/05/94
PARCEL: 1 S 13 AD-01303
SITE ADDRESS. . . : 0890V.i SW OAK ;i`f
SUBDIVISION. . . . : ASHBROOK FARM ZONING: R-4. 5
SL.00U,» . . . . . . . . . . LOT. . . . . . . . . . . . . : 13
BUILDING
liEI` SUE: DWELLING UNITS:111 BASEMENT. . . . . . . . :0 Sf 1:
CLASS OF WORK. :ADD BE:DRMS:it BATHS:0 GARAGE. . . . . . . . _ . :0 S f
1-YPE OF USE. . . :SF FLOOR AREAS-- _-- - REQUIRED SETBACK a-- _._.________.__ ._.
a YPE: OF CONST. :5N FIRST. . . . :a6b sf LEFT. . :0 ft RIGHT. - Ib fit
OCCUPANCY [SRF'. :R3 SECOND. . . :0 sf FRONT. :0 ft REAR. . :0 ft
i
STORIf=S. . . . . . „ : 1 FINBSMENT:O sf RF.GlLIIRED
Hc.IGi+r. . . . . . . . : 1:3 ft T[)TAL-_ ----:cE-6 sf '.SMOKE-. DETECTORS. I
FLOOR LOAD. . . . .40 ps. 17 VALUE. . . . . s . 17200 PARKING SPACES. . :0 �
Remarks : ADDING SUN ROOM 266 SO FT PATH 1
_.._._.____._..___._.______._________.__._.-.-_-_•- PLUMBING
GTNKS. . . . . . . . . . :0 !=1_OOR DRAINS. . . . :0 BACKFLOW PRE::VNT'RS. . :0
LAVATORIES. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :0
TUU/SF{OWERG. . . . :0 LAUNDRY TRAY.5. . . :0 CATC14 BASINS. . . . . . . :0
WATER CLOSETS. . :it SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :Ili WATER INE ( ft ) . :'?i OTHER FIXTURES. . . . . :0
GARBAGE DIS . . . :ir HPIN D2AIN (ft ) . :0
WASHING MACH. . . :0 SFISA I N DRA I NS. . : 1
MECHANICAL __._____._________._._....____.____...__._.__....___.__._._ FEES - -_____.---------.__
FUEL. TYPES.-.----.____..__._ UNIT HTR7. . :0 type Amol_rnt by dat;v recpt
/GAS/ / / VENTS NPRT $ :126. 50 K-,-j 10/05/94 - "-
MAX I l`Jf'U T:h B E lJ VEh1'1' FANfi.
. :0 Ilf='L.C.1 $ 133. 5::3 JF 10/04/94 94--25746,--'
F•URN ( 100K . . :0 HOODS. . . . . . :0 B5r='C $ 6. 43 KS 10/05/94
TURN ) =100K . . :ail WOODSTOVES. :0
FLOOR FURN. . . . :0 CLQ DRYERS. : 0
BC)IL_/Clhf' ( ;,IIE'':0 O'T•HEWR UNITS:0
GAS OUTLETS-0
Owner: • __._.__._._.____._ _______--_-__.-____-_._. .._._ ._._.._.._. r
•TAME:S E.VERETT
8900 SW OAK S•;
TIGARD OR 97,223--0000
Phrjrne #z 2,0b--2-45-2451
Contractor:
CON'rRACTCIR NOT ON FILE
F'hnne #:
$ 218. 1+6 TOTAL.
This permit is issued subject to the regulations contained in the - - --- - REUUTRED INSPEC'T'IONt; -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Post/Beam Str I.rct bi-tilding Final
applicable laws. All Mork will be done in accordance with approved Post/Beam Meehan E:, osion Control
plans. This permit will expire if wa,4 is not started within Jae MeehaniceI Insp
days of issuance, or if work is suspended for nu,- than 180 days, Framing Insp
Insl.i).atian Insp •s_ ; ; ;
Gyp p B o a i d Insp
Rain drain Insp
�i i:)y �=�� -- Mechanical Final.
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Ca 11 for inspection _ 639--4175 '
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• Residential Building Permit Application
City of Tigard
13925 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Office Use Only
Subdivision: �4+�i�i-a.l( �C,-.r Lot
• Planck/Rec# �✓ ) -�
Valuation: _�7 Zc�n � se
Permit# t�51�,1�- 0,3 79
Corner Lot? Y
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Flag Lot? Y CN �►
Map & TL#IS 3.5.4 0- 013 n 3
Owner: c,�v� �s �r v Nct' /l
Approvals Required
Address: _ � e o Planning —
Engineering
Phone: 3 k ^ AIM Other
Contractor: Items Required
Address: Subcontractors
Truss Details
Phone: Other _
Contractor's License # _
(attach copy of current Oregon license)
Contact Name & Phone: ACM C a
Subcontractors: Arch ltsct/Engineer:
Plumbing: /`/0(((e _ Address:
Mechanical:
(attach copy of current OR Contractor's License)
Phone:
JOB DESCRIPTION:
Applicant Signature & PhorjWHUmber
Received by: _ ___ Date Received:
N IWORDICOMDE"ESAPP
.............
Permit# Accuunt Description Amount Amt. Pd. Bal. Due
IT -.v 3 Bldg. Permit (BUILD) P.3 a
Plumb. Permit (PLUMB) _
',iech. Permit (MECH) Y
State Tax (TAX) �3 _ _
Bldg:
Plumb:
Mech: _
Plan Check (PLANCK) 3 ;-3
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Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) _
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
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j Industrial TIF (TIF-1)
institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
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Fire District (FIRE) _
Ero:,ion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
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CaHECX AMC)UNi s 134. 443 I
EVF.F�tT'T, JAMES CASH AMOUNT' s N» 00
Flt.)1►FaF.:',i i r 0900 SW OAF( C?AYMk:CJ'C L)(il'F a i / `ii�14
T WARD, OW-TION 9-7;7!P3-- III
F'l.IF7T'osE OFPAYMrN T AMOUNT PA 1 t) F'URpLIl3F.., O] PHYML N t APICION 1 PPI C) I �
BIIIL_DYNU PERM M141914—0378 126.
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INSPECTION NOTICE �1
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection ___ -
Footing Plbg. Underslab Hach. Rough-in Appr/Edwlk
Found. Plbg. Top Out 5;as Line FINAL. y
Post/Beam Struct. San. Sewer Q Framing ,J -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plums.
Plbg. Underfloor Water JL1. a GYP. Bd. -Mach.
Date Requested: CJ Time: AH PM
Address: C> (� �2 - Permit #: [ 7�}� '09
Builders �3 n ¢�
ThE FOLLOWING CORRECTIONS ARE REQUIPED:
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Date:
Inspector:
APPROVED DISAPPROVED APPROVED SUBJECT 1O ABOVE
"''` -- Call For Reinap.
CITYOFTIGrARD CffTO tr4RD BUILDING PERMIT
COMMUNFTY DEVELOPMENT DEPARTMENT c,, , P111 T #. . . . . .
13126 SW HWI SW P.O.Box 2W97,T4W,OrWm 97223(603)630.4176
'TTE ADDRf r` &:_,`'V!Q, SW f1AK YT PAR,-,FI,. - 1a135AD-01303
�UBD I V 15 1 ON. . . . : ASHRROOK FARM ZONING. R--4. 5
5LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 1
IRE ISSUE : FLOOR AREAS--- -.-•.--T-_-- EXTERIOR WALL_ CONSTRUCIION—
' l_AcS OF WORK. :ADD FIRST. . . . e s f" N: S: F W
I.YPE OF USE. . . -SF SECOND. . . ; 5f PROTECT
I'YPE OFF DONS i". :5N TH I RD. . . . : s f N a S: E: W: aw
OCCUPANCY GRP. :R7 TOTAI-------: O 5f ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: BASEMENT. : 5f AREA SEP. RATED:
sTOR. : 1 HT. : 10 ft G A f"R A G E. :2,88 s F OCCU SEP. RATED:
HSMT?: ME:ZZ?: RECD SF-rBACKS---------- REQU.T.
F=LOOR LOAD. „ . . : ps f I_FFT: 1 Ft F?GHT: ft h I R SPKL r SMOIJ, DET. .
DWE_L_LING UNTTS: FRNT:20 ft RE=AR: ft FIR ALRM: HNDICP ACG:
BEDRMS: BATHS: IMF' SURFACE: PRO CORR: PWRIi1Nr::�:
VALUE. $: 2000
kemArks : CAR PORT
JAMES E•VERETT type amor_int by date t"PCr.t
8900 SW OAK ST PLCK $ 21. 13 JH 07/E3/9P
OPC r $ 1. 63 JH 0//23/9i- -
1'TtSAr,i) OR 9722•r_''3--0000 PRMT $ :3L. 50 JH 07/23/%_-
F'h o rr e #- it 06-245-2401
rWNE.R
t'hnnr� #a $ ��. c`t.a 1C11AL i
Rag #. . : 00000
RLUUIRED INSPECT 1ON5 ---•___._. _ ;', ,,,a:�a�.
Ih;s vermit is issued subject to the regulations contained in the Fr^aminq Insp
Tigard Municipal Code, State of Ore. 5oerialty Codes and all other Fi.na1 Insnec-t ion
applicable laws. All work will be dine it accordance with _.•___.___._ .� .._ __ _ _____._._.__.___ _ _._-....___
approved plans. This permit will expire if work is not startedi
_....
within 188 days of issuance, or if work is suspended for sore
than 188 days.
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T T 1312.5Sw11allBtvd. PLNCK/RECT #
CITY Or i TIGl RD PO Box 21397 h
PERMIT #
COMMUNITY DEVELOPMENT DEPARTMEN'C TogantOrcgon97121 .��P`�L-
(503)639-4171 DATE ISSUED
I
JOB ADDRESS: SGJ 0.4n TAX MAP/LOT
SUB: 6N,&00/ LOT: 43 LAND USE: I
i VALUATION: -:! 00�
OWNER SPECIAL NOTES
NAME: �M 4's �v��r� REISSUE OF: _.
A,IDRESS: 8 for _ 'c-1 D,4k T's a cr C�c e e LAST REISSUE: _
ct-p22 3 _ — FLOOD PLAIN/
PHONE: d Yf 4T6 3'3TDO m SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: PLANNING: _
ADDRESS: — —_ _ ENGINEERING:
FIRE DEPT: __—
PHONE: orHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS:
`r.
MECH: _ _ BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: _ _— OTHER:
AS: '
PROPOSED BLDG. USE:
COMMENTS: ';` °r '
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APPLICANT SIGNATURE �,t5
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Received By: _ _ Date Received: _
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PERMIT # ACCT # DESCRIPTION aaAMOUNT AMOUNT PD. BAL. DUE
$4 te',020y 10-432 00 Building Permit Fees ate' >"y
10-43' 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) _
Building
Plumbing
Mechanical
3
10-433 00 Plans Check Fee 27
Building
Plumbing
Mechanical
10-230 06 Fire -
30-202 00 Sewer Connection
30-444 00 Sewer Inspection _
} 25-448-0.2 Commercial TIF Fees __--
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
i 25-448-01 Residential Traffic Fees
2.5-448-05 Mass Transit TIF Fees _
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
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ZI-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL ^%S r Z
nm/3587P.WPF
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Permit No:
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Address: --
Issued by:___ Date:
•, ''•% —FOR OFFICE USE ONLY___— —
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, OP.S 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Cuntractors Board to
sign the following statement before the building permit can be issued.This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
under ORS 701.010(7), need not submit this statement. This statement mill be 4
filed with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313:
1 . l 1 own, reside in, or will reside in the completed structure.
2. 1 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.(;A '_1 My general contractor is
Contractor registration number- _-
I will inb ,,ict my general contractor that all subcontractors who work on the struc-
ture must be registered with the Constructior Contractors Board.
OR
3. B fi� 1l I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Co,tstruc- G
tion Contractors Board. If I change my mind and do hire a general contractor, I will I
contract with a contractor who is registered with the Construction Contractors Board i
znd I will immediately notify the office issuing this building permit of the name of
the contractor.
I hereby certify that the above Information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
k
SkIfi
ature of Permit Applicant Gate
f
CONsrRUCTION CONTRACTORS BOARD
0244J 8/91 I
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
:•.p dl� a 'a.:- N J E'
uS h�` fi' � "�t'
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INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES '
NOFfE: This Information Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the 1989 Oregon Legislature.
If you are acting as your own contractor to construct a new home or make U substantial improvement to an
existing structure, you can prevent many problems by being aware of the following responsibilities and areas
of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting
in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an
''employer" and the people you hire will ho "employees". As the employer, you must comply with the following:
u
Oregon's Withholding Tax Law: As an elnDloyer, you must withhold income taxes from employee wages at
the time employees are paid. You will be hole for the tax payments even if you don't actually withhold the
tax from your employees. For more information, call the Oregon Dep,7rtment of Revenue at 378-3390.
Unemployment InsuranceTax_: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of_all employees. For more info,,mation, call the Oregon Employment Division DHR t
at 378-3224.
Workers' Compensation Insurance_ As an employer, you are subject to the Oregon Workers' Compensa
Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers'
compensation insurance, you may be subject to penalties and will be liable for all claim costs If one of your
employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434.
U.S. Internal Revenue Service: As an employer, y0l must withhold federal it come tax from employees'wages.
Yo_u will be liable for the tax payment even if you didn't actually withhold the Lax. For more information, call
the Internai Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Codo Compliance: As the permit holder for this project, you are responsible for resolving any fai',ire to meet
code requirements that may be brought to your attention through inspections.
LiaLility and Property Damage Insurance: Cont;nct your insurance agent to see if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re-done.
Time to Supervise Employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work
of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform
the required inspections.
If you have additional questions. write to: Construction Contractors Board
700 Summer St, NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10/24/89
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CHECK AMOUNT : 55. 26
CASla AMOUNT s 0. 00
NAME. a EVEJ11TT, JAMES E.. PAYMENT DATE a 07,24/9e_
ADDRESS s 8900 SW OAK SUBD'i V I S I CJN
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