10710 SW NAEVE STREET IS 3A3VN MS OILOT
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10710 SW NAIVE ST
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUIP
Date Requested 'AM —PM BLD
Location ��� ! /�(.� �� CSSuite _ MEC �����
Contact Person - Ph -_ PLM
Contractor Ph . SWR --
BUILDING Tenant/Owner _M �- �— ELC —
Retaining Wall ELR
Foo!`,ng
Foundation Fln
NOT REQUESTED FR 3 —
Ftg Drain FOUND DURING RESEARCH SGN —
Slab Crawl Drain NO INSPECTION(S) FOUND IN FILE SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing _-- - --
Insulation
Drywall Nailing --- - -
Freall If 1,7
Sp
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling d ---- --
Roof
Misc:_ -
Final
PASS T FAIL -- —
Post&BPam -�
Under Slab --
Top Out
Water Service _ —
Sanitary Sewer
Rain Drains - - ---
PART FAIL — - -- -
CHANICAL 67
—
Post&Beam '"-' --"•'— --�_�-- -�
Rough In _- —_ -- -
Gas Line -— -- --
Smoke Dampers
Final --
PASS PART FAIL
ELECTRICAL
Service — — ---
N Rough In
UG/Slab
Low Voltage --
Fire Alarm
m Final
PASS PART FAIL ---'
W SITE
Backfill/Grading ---�—
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin { ]Please call for reinspection RE:_ _ [ ]Unable to inspect-no access
Fire Supply Line
ADA I
Approach/Sidewalk Date _ Inspector (✓ / Ext
Other ^Q
Final
PASS PART FAIL NO REMOVE this Inspection record from the jobs site.
.CITY OF TIGARD DATEFtISSUED: 06/28/96
PERMIT #. . . . . . . s PLM96-0181
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 617223.0199 (503)839.4171 PARCEL: 2S 1 10DA-01400
SITE ADDRESS. . . : 10710 SW NAEVE ST
SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONING: R-3. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . ..005
--------------------------------------------------------------------------------------
::LASS OF WORK. . :ADD GARBAGE. DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . --SF WASHING MACH. . . . . . 1 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . 1 0 TRAPS. . . . . . . . . . . . . . s 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . : 0 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . s 0 `
LAVATORIES. . . . . : 0 OTHER FIXI-URES. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . 1 0
WATER CLOSETS. . : 0 WATER LINE (ft) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ftp . . . : 0
Remarks : Installing a residential backflow pevention device.
Owners ----- - ---- — ---_.___._.__----------------------------- FEES --.----_—_-----_
RENAISSANCE CUSTOM HOMES type amount by date recpt
1672 WILLAMETTE FALLS DR PRMT $ 15. 00 CJS 06/28/96 96-281104
5PCT $ 0. 75 CJS 06/28/96 96-281104
WEST LINN OR 97068
Phone #: 557-8000
Contractor-- -----------------------------
MOODY ENTERPRISE INC
FSO BOX 98
ESTACADA OR 97023 --------- ------------------------------
Phone #: t 15. 75 TOTAL
Reg #. . : 5973
-------- REQUIRED INSPECTIONS
-----This permit is issued subject to the regulations contained in th[ RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All Mork will be done in accordance with
approved plans. This permit will expire if work is not started
within 18A days of issuance, or if work is suspended for more
than 188 days. _
L!f, l:,e r m i t t e e Signature :
T 5 s _t e d B y
Call for inspection 639-4175
_m
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City of Tigard PLUMBING PERMIT APPL19A'tIDN Planck/Rec. # A0 V
13.125 SW Hall Blvd. Permit # 1
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE+ST. SURCHARGE
•ra•M*"w" Nov Sinpta FaniN Rooldepp" Onk
Q N 1 SSQNC .�U�r1M
Adswr CJ 1 BATH HOUSE$140.00 ❑2 BATH HOUSE$195.00
Job �� Q s w -eye O 3 BATH HOUSE$225.00
Addresscti+)r. ar Fee includes all pluryti rg fixtures in the dwelling and the first 100 feet
1 4 Ott 172-21 of water service, sankary sewer and stone sewer. See tees below.
77amoft ) FIXTURES QTY PRICE AMT
d I rfO#_�e fluvelae,1 " Sink 9.00
Me""""'-// �7 Lavatory 9.00
4N
Owner rb 7,2 r e 5� SOW Tub or Tuwshawer Comb. 9.00
A' Shower Only 9.00
f'(� II'NN ���� Water Closet 9.00
""^•,�^"^•M b.* ) Dishwasher 9.00
Garbage Disposal 9.00
Occupant N
•"^'"'••• ^'" Washing Machine 9.00
Floor Drain 9.00
d"'•
AID Water Heater 9.00
Laundry Room Tray 9.00
HIM / l Urinal - 8.00
A40a ,{/ e, 1;R` - I'V C• _ Other Fixtures (Specify) 9.00
Contractor 9.00
I)nX q G /��/_.� /� 9.00
/o b ZIP -------- 9A0
O n /Q 7O1' Sewer 1st 100 30.00
""•""0""1an No d I s" T.He Sewer-so. Addit. 100' 25.00
//T17 4j��3 water Service let 100'� 30.00
1 hereby acknowledge that I have read this application, that the Water Service es. Addle. 200' 28.00
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 Storrs tt,Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storrs 8 Rain Drain Addle. 100' 25.00
number given Is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti-Pollution Device 9.00
•^■•r•w^• a•w^n °"• Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new addition Q akerition 0 repair Catch Basin 9.00
to be done residential (S) non-residential O Insp. of Exist. Plumbing 40."r
Specially Requested Requested Inspections 40.Mhr
Existing use of
a building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
U)
devices 15.00
Proposed use of
J building or property _!_
� "(Except resfdar►Hal backflow
proventlon dlevlcsto
W
t NOTICE *Minimum Fee$26.00 SUBTOTAL I *Y
PERMITS BECOME VOID IF WORK OR CONSTRUCTION r
AUTHORIZED IS NOT COMMENCED WIIHIN 180 DAYS,OR IF 8%SURCHARGE 77
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25%OF SUBTOTAL
TOTAL
Special Conditions
`i _`_ Date issued 6` e_1 n 9K by �/>
CERTIFICATE OF
CITY OF TIGA RD OCCUPANCY
E='ERMIT N. . . . . . . s MST93-097
COMMUNITY DEVELOPMENT DEPARTMENT DATE I SSUEU s 02/1 2/rs
13126•W Hall Blvd.Tigard,Oregon 97223091" (593)6394171
PARCELt 29110[?A-01400
'PITC: ADDRE`(b. . .': 1V.ii 10 SW NAEVE ST
wUBD I V I S I ON. . . . r RENAISSANCE SUMM 1 7 Z ON I NG s R- .3. 5
'ILOCK. . . . . . . . . . n -OT. . . . . . . . . . . . . 1005
-----------------------------------------
C:LF 1S OF WORK. r NEW
TYPL OF USE. . . s SF
OCCUPANCY ORE'. rSN&r,S
OCCUPANCY LOAD r w
Remarks: PATH I
Owners
RENAISSANCE CUSTOM HOMES
1672 WILLAMETTE FALLS DR
WEST LINN ON 97068
Phone Ns 557--8000
C-ontrart or s ----------------------------------
RENAISSANCE CUSTOM HOMES INC
1672 SW WIL.LAME=TTE FALLS DR
WEST I..INN OR 97068
Phone #:
Reg #. . 1 97599
' hi ,; Certificate grants occupancy of the above referenced buildinb or portion
trei�f and confirms th*t the building has been inspe teci f'or compliance with
the ,tate of C)regon Spec_ial.ty Codes for the group, ol- uAnc And use under
Which the referenced permit was iesI.. 'd.
B-U LD I NO I NSPE� l) All I L C3 OF I I L_
POST IN CONSPICUOUS PLACF
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CITY OF TIGARD PERMITS#. . . . . . .
:TM ST95--0.-'137
COMMUNITY DEVELOPMENT UNNUM$NT DATE ISSUED: 08/30/95
13125 SW Hall Blvd.Tigard,Oregon 97223+8109 (503)639-1171
PARCEL: 2SI10DA-01400
SITE ADDRESS. . . : 10710 SW NAEVE GT
SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONING: R--3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :005
---------------------------------- BUILDING ------------------------------------ ----
REISSUE: DWELLING UNI'TS: !. BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. .-NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :440 sf
TYPE OF USE. . . :SF FLOOR AREAS------------ RF_ClU I RED SETBACKS-----------
TYPE OF CON ST. :5N FIRST. . . . : 1373 sf LEFT. . : 15 ft RIGH•f-. : 15 ft
OCCUPANCY GRP. :R3 SECOND. . . : 1173 sf FRONT. :20 ft REAR. . :24 ft
STORIES. . . . . . . :2 FINBSMENTiO sf REQUIRED---------------------
HEIGHT. . . . . . . . :28 ft TOTAL------:22546 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . f : :71783 PA.IKING SPACES. . : 1
Remarks : PATH I
-------------- PLUMBING
SINKS. . . . . . . . . . . I FLOOR DRAINS. . . . :0 BACKFLOW PRF-VNTRS. . : 1
LAVATORIES. . . . . ..5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . ..0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :@
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL - -____________ _______._.________.__ FEES
FUEL TYPES-- ------ UNIT HTRS. . :@ type amount by date recpt
;GHA/S / / VENTS . . . . . :0 TIF $ 1590. 00 B @8/30/95 95-269959
MAX INPUT:O BTU VENT FANS. . :4 SWM f 180. 00 B 08/30/95 95-269959
TURN ( 100K . . :0 HOODS. . . . . . : 1 SWM $ 100. 00 S 08/30/95 95-269959
FURN > -1001', . . : I WOODSTOVES. :@ BF-'RT $ 613. 00 B 06/3@/95 95-2269959
FLOOR FURN. . . . :0 CLO DRYERS. : i BPL C f 398. 45 DON 08/109/95 95-269044
BOIL/CMP < 3HP:O OTHER UNIT5: 1 B5PC: 9 30. 65 B 08/30/95 95--269959
GAS GUTLETS: 1 PARK f 500. 00 B 08/30/95 95-269959
Owner: --__._.__.___-------_..--_.-----_-_-----J_ MPRT f a-1. 00 B 08/30/95 95-2269959
RENAISSANCE CUSTOM HOMES MPLU f 11. 25 B 08/30/95 95-269959
1672 WILLAMETTE FALLS DR M5PC f 2. 25 B 08/30/95 95-269959
31ATH 1, 225. 00 B 08/30/95 95-269959
WEST LINN OR 97068 P5PC $ 11. 25 B 08/30/99 95-269959
Phone #: 557-8000 EROS 9 64. 00 B 08/30/95 95-269959
Contractor: - ----- --- __.________________ERP[ f 20. 80 B 08/30/95 95•-269959
RENAISSANCE CUSTOM HOMES INC ERPC t 20. 80 B 08/30/95 95-269959
1.672 SW WILLAMETTE FALLS DR
a
WEST LINN OR 97068
N Phone #:
Req #. . 97599 -------------------- ------ --
J f 3812. 45 TOTAL
m This pereit is issued subject to the regulations contained in the ------ - REQUIRED INSPECTIONS --_----
Tigard Municipal Code, State of Dre. Specialty Codes and all other Footing Insp Plumb Top Out
W applicable laws. All work will be done in accordance with approved Fok_tndat ion Insp Framing Insp
plans. This pereit will expire if work is not started within 18P Post/Ream Strutt Fireplace Insp
days of issuance, or if work is suspended for wore than 189 days. Post/Seam Mechan Gas Line Insp
Crawl Drain Instilatien Insp
Permittee S* atI.We : &_L4A.'
- Plm/�_tndslab Insp Gyp Board Insp
PLM/Underfloor Rain drain Insp
r .; .:, -ted Vy - M.1, ►., Mechanical Insp Water Line Insp
Call for inspection - 639-4175
SEWER CONNECITUN
Cirf OF TIG PERMIT
PERMIT #. . . . . . . s SWR95--035
COMMUNITY DEVELOPMENT NT DATE ISSUED: 08/30/95
13126 8W HeN Blvd.Tigard,Oregon 972234199 (683)939-4171
PARCEL: 2S110DA-01400
SITE ADDRE S::. . . : 10710 SW NAEVE ST
SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONING: R-3. 5
BL.00K. . . . . . . . . . . LO1 . . . . . . . . . . . . . r005
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF SUILDINGS: 1
TNSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : ,f
Remarks : PATH I
-----------------__-----_-------.__ -E ....__---_—_--_.
Owner-: ---__.____._______.__ F E5 --
RENAISSANCE CUSTOM HOMES type amolant by date recpt
1672 WILLAMETTE FALLS DR PRMT $ ,7_200. 00 B 06/30/95 95-69959
INSP 1 35. 00 B 08/30/95 95-269959
WEST LINN OR 97068
Phone #: 557-6000
Contrrac:tor: ------------------•-----------_.
CONT RAC TOR NOT ON FILE
--------------------
f'h o r e #: f 2235. 00 TOTAL
Req 0. . :
------- REQUIRED I ASPECT I ONS
This Ppplicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires IN days from
the date issued. The total amount paid wi'l 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 all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
Permittee S' ature :
Tse,i.i e d B y :IL
Call Ca11 for inspection — 639-4175
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S. W. N AEVE STREET
S 89'52'07" W 73.00'
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2.00'
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O 20.00' 11.00' �+ G
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89.00,g
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~ PRIVATE STORM DRAINAGE EASEMENT U
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N 89'52'07" E 73.00' I`r
W
_j --EIGHT FOOT PUBLIC AND PRIVATE UTILITY SCALE DRAWING LOT 5 RENAISSANCE SUMMIT
EASEMENT ALONG ALL FRONT AND REAR LOT LINES S.E.1,/4 SEC.10,T.2S.,R.1W.,W.M.
CITY OF TIGARD
fil
WASHINGTOM COUNTY, OREGON
AUGUST 2 1995 Centerline Concepts Inc.
DRAWN BY: BTA CHECKED BY: WGDIII 640 82nd Drive Gladstone, Oregon 97027
SCALE 1"=20' ACCOUNT 115 503 650-0188 fox 503 650-0189
Residential Build
City of Tigard JIB
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobslte Address: 0-110 WAVE
r' c_ Of o Use Qnly
Subdivision: _ _1'1Ql��Q1�k'1.,,u )t71111 l Lot X > _ �j
/� 3 PlancWRec
Valuation:, -
Comer Lot? Y CFO Permit
Flag Lot? Y
Reissue of
N -�-- ~�---
NMop& TL 1t
I _
Owner: 124 rl CLI`L xneL �us�om {-�0 rrl _
{I I I r ARRrov i,s wulred
Address: VOIJ; (1)I ll�Y�' k
, , I�(Ae) D _ Planning
WLT Lon, NZ TiI26FEngineering —.
Phone: �,p�z� �� �� ��-GSC
Other
Contractor: �l"I!�l�j(7 Yl(I✓ �l`.>�YI1 C'}1 _��
Address: Iu,' 7 2 ��11I�Yrll �� I��� •_ Subcontractors
Le_)� 1/lh �IL <��7��6 Truss Details
Phone: �c ��-7 Y)CO
q Other
Contractor's License 09 -75 q
(attach copy of current Oregon license)
Contact Name & Phone: _ 1 l l ren
a
Subcontractors: ArchitecttEnBineer:
N Plumbing: 1' Address: 1305 I Lo
Mechanical: I - l J i_ _ � r4[OTIj. or ��
(attach copy of current Off Contra tor's License) � `Cl 1 I
W Phone:
JOB DESCRIPTION:1 4�- A
Applicant Signature & Phone number
Received by. E� I Date Received:
N IWORWOMDEWtESAPP
PLUMBING PERMIT
CITY OF T DATEIISSUED: . 06/305955-0L97
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,OreW 972230100 (603)630-4171 PARCEL: 2 S 1 10DA-01400
SITE ADDREJS. . . : 10710 SW NAEVE ST
SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONING: R-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :0O15
_ -__---_--.----_-_-______---_ _--
CLAS S OF WORK. . :NEW GARBAGE DISPOSALS- 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES----------------- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE: TRAPS. . . . . . . :0
LAVATORIES. . . . . :5 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :3 WATER LINE
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : PATH I
OWNER:
RENAISSANCE CUSTOM HOMES TIF $ 1310. 00 B 08/30/95 95-269959
1672 WILLAMETTE' FALLS DR SWM t 180. 00 B 08/30/95 95-269959
SWM $ 100. 00 B 08/30/95 95-2269959
WEST L_INN OR 97060 BPRT $ 613. 00 B 08/30/95 95-269959
Phone #: 557-8000 BPL.0 t 398. 45 BON 08/09/95 95-269044
BSPC E 30. 65 S 08/30/95 95-264959
Plumbing Contractors ------ ---------- PARK $ 500. 0171 B 08/30/95 95--269959
MPRT 4 45. 00 B 08/30/95 95-269959
Name-_. ;• r ,,,�,� _..� MPLC E 11. r5 B 08/30/95 95-269959
Address:__ ?. .2 _ �pza MSPC $ 2. 25 B 08/30/95 95-269959
City :__e.�5•41!_.__�__. .—State.� --` 3BTH E 2:25. 00 S 08/32/95 95--269959
_�`Q P5F'C f 11. C-'S B 0A,'30/45 95-269959
Reg #: _ Additional fees not shown here. . . . . . . . .
------- REQUIRED INSPECTIONS -------
This permit is issued subject to the r-eg
ulations contained in -the Tigard Municipal Footing Insp Insulation Insp
Code, State of Ore. Specialty Codes and all Foi..lndation Insp Gyp Board Insp
othpr applicable laws. All work will be done Post/Beam Struct Rain drain Insp
in accordance with approved plans. This Post/Beam Mechan Water Line Insp
permit will expire if work is not started Crawl Drain Water Service In
within 180 days of issuance, or if work is Plm/undslab Insp Appr/Sdwlk Insp
suspended for more than 180 days. PLM/Underfloor Mechanical Final
a Mechanical Insp Plumb Final
NPlumb Top Out Building Final
Framing Insp Eros+ on Control.
/�� (� ��++ �� �� Fireplace Insp
-� x l.L.�.Li�d __Y_• Gas Line Ins p
W Authorized Plumbing Contractor Siglature
W Call for inspection - 639--4175
J Contractor Notes :
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # ---,171x,'or,
Permit
Phone (503) 639-4171 Date Issued to -17-ZC
CITY OF TIGARQ FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Pee Schedule Below:
Name of Development R. 6-4L.-kss ti . S� ► Number of Inspections per permit allowed
Address 1 n -7 I e Su- m 4- Q. s -f, Service included: Items Cosgoa) Sum
City/State/Zip 4�Residential It or lose
4
-per unit �_ $110 00 Ila. 0 0
Fads additional 600 aq h or
Name (or name of business) R- �-.��ss-v.c , a� portion thereof L_ $2500 Lna_, .� 1
Commercial El Residential I Fach Enerpy $1600
Each fvlanul'd Homs or Morhdar 2
Dwsfling Servics or Feeder $8000
2a. Contractor installation only:
4b.Services or Feeders
Installetron,alteration,or relocation 2
Electrical Contractor s,�.�l E ,,�# �•.�� 200 amps or leas sm00 2
201 ampa to 400 amps ti80 00 2
Address U • t�-icy _ —.
city. CA � � ���r.. ., State V� ZI �i 7 p t�' 401 amps to 900 wrmpa $12000 � 2
l. a_ �_ p 001 amps to 100 amps $18000
Phone No., _ 7 d 1 L-t -I— Over 100(1 amps or vohs $94000 2
Contractor's License No. ,'A til?-8 — C- Reconnect only sw00
Contractor's Board Req. N0. 3 LIQ 4 r-/ _ 4c.Temporary Services or Foodsrs
Installation,alteration,or relocation 2
Signature of Supr. Elec'n , ��� _ 200 amps or Was $6000 2
License No. G 1 = Phone No._L-:�-j-otL 201 amps to 400 amps $7600 2
401 ampr to 900 amps $10000
Over 900 amps to 1000 volts
2b. For owner Installations: see-b•above
P4d. Branch Cl suits
Print Owner's Name
Now,sheration u extension per panel
Address a)The Ise fir bench circuds w(th
ptwclose of servke a tiers►be. 2
City— _ State_ Zip Fach branch circuit $900 _
Phone No. b)The fee for branch dmiits wfthour
The installation is being made on property I own which is pumhose of pairyka or 0 -1 h.. 2
net intended for sale, lease or rent. First branch circuit $3600 2Each arldilional branch cormit $600
Owner's Signature_ 4e.Miscellaneous
(Service or foeder not Included) 2
3. Plan Review section (if required): Foch pimp or irrigation circle $4010 2
Each sign or outline lighting $4000 _
Signal circuit(s)or a limited ernrgy 2
please check appropriate Item and enter tee In section SB. panel,sheration or exionsion $4000
IL 4 or more residential units in one structure Minor I absla(10) $10000
Service and feeder 225 amps or more
0.' 4t.Each additional Ins ectbn over
System over 600�blts nominal p
NClassified area or structure containing special occupancy the allowable In any of the above
as described in N.E.C. Chnpter 5 Per inspection $3500
Per hour $66 00
In Pfanl 11155 00
-� Submit 2 sets of plans with application where any of the above
_m apply. Not required for temporary construction"Most. 5. Pees:
tL NOTICE
So, Enter total of above fees $
J 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCSubtotal $r10N Sb. Enter 2594,of ling A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if req for (Sec 3) $
_
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal E
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED El Trust Account 0 $
Balance Due t 2,10•_S b
CITY OF TIGARD
ELECTRICRL HERMIT -
RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: EL R95-0209
13126 SW Hnll 81vJ.Tigard,Orogon 97223.8199 (603)639-4171 DATE ISSUED: 11/14/95
PARCEL: 2S110DA-01400
::SITE ADDRESS. . . : 10710 SW NAEVE ST
SUBDIVISION. . . . : RENAISSANCE SUMMIT ZONINGeR-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :005
Project Description : Restricted Energy
A. RESIDENTIAL--------- B. COMMERCIAL----------------- ------•----------------
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : X BOILER. . . . . . . . . . e LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . : MEDICAL.. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: : e HVAC. . . . . . . . . . . . e PROTECTIVE SIGNAL. . s
INSTRUMENTATION. : OTHER. . : : :
TOTAL # OF SYSIEMSs 0
Al icant : --------------------------------------------------- FEES ------•---------•-
ACE SECURITY type amount by date recpt
3200 SW GREENWOOD CIRCLE PRMT $ 40. 00 TMP 11/14/95 95-27284'/
5PCT $ 2. 00 TMP 11/14/95 95-272847
TUALATIN OR 97062
Phone #: 224-9551
Contractor: --------------•------- --------------------------------------------
CONTRACTOR NOT ON FILE t 42. 00 TOTAL
-------- REQUIRED INSPECTIONS --- - --
Ceiling Cover Elec ' 1 Service
F"Tone it: Wall Cover E17 91 Final
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i tee Si gnat ure
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. is s y
------ ---.----.--•___---OWNER INSTALLATIONY_-.-_._.-_-.._.-__.--.-.----__._-__.-_.-.--. .____-.--
The installation is being made on property I ]Fn which is not ;-Mended for
sale, lease, or rent.
4. OWNER' S SIGNATURE- �- DATE e T
INSTALLATION ONLY----------------------------
SIGNATURE
----------------------.----SIGNATURE OF SUPR. ELEC' N e DATE:
J_
m LICENSE NO:
Call for inspection -- 6:39-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. I dd
Tigard,OR 97223 PERMIT#__
Phone(503)639-4171
FAX(503)684.7297 DATE ISSUED
TDD No. (503)684-2772
CITY OF TIOARD Inspection (503)639-4175 ISSUED BY
PILASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
107 (0 Sw A.,)`AEVE Address RESIDENTIAL RESIDENTIAL—Restricted Energy Fee. . . . . . 14d,QQ
(FOR ALL SYSTEMS)
City State Zip cTypt uf Werk Involved:
PERMITS ARE NON-TRANSFFRABLE AND NON-REFUNDABIf AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS Nor STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener"
El Heating,Ventilation and Air Conditioning System'
Contractor a SFC to IE Type_ to iV e 4- ❑ Vacuum Systems'
t
Address -2 0.0 5t, (i � �L r w e at0 C'!ez . El Other- --- -
Date / -�-7 _ `2 °d COMMERCIAL—Fee for each system . . . . . . . . .
(SEE OAR 918-260-260)
Property Owner 2` cklyne of Work Iny�1>cesi;
s. _�---
Contractor's Board Reg. No. C4 �� ❑ Audio and Stereo Systems
2 ^ G ❑ Boiler Controls
Phone . _ _ ❑ Clock Systems
3. OWNEk APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentatior.
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medical
This permit is issued under OAR 918-320-370.This applicant agrees to make only ❑ Nurse Calls
restricted energy Installations(100 volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
following:
1. Only use electrical licensed persons to do installations where required.(Certain El Protective Signaling
L residential and other transactions are exempt from licensing.These have ❑ Other _
asterisks(').All others need li(ensing).
2. Call for an inspection when all of the installations under this pe.mit are ready
for inspection at 503-639 4175.
r ❑ Number of Systeme
3 Purchase separate permits for all installations that are no;ready for inspection
when the inspector is out to inspect under this permit. •No lk-ences aro required. I-krnses are required for all other installations,
4. Assume responsibility for assuring that all corrections required by the inspector
are done,and
N ;. Assume responsibility for calling for a final insp-ction when all of the 5. FEES
J corrections are completed.
The person signing for this permit must he the applicant or a person a. Enter fees d r 00
aothoriMd to hind the apt,:`-ant.
h. 5% Surcharge(.0.5 x total above) $
Signature
TOTAL $ �`{2 t 9V
Authority if other than applicant i
ENERGAP.CHP