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11565 SW 66TH AVENUE ADDRESS: Ln J G] W i\records\microflm\targets\buiIding.doc ± \i § Ei §/ }a i22\ LL( 24 (n /? \§ ) \\ (( $ 7 \_ i / \ \ \ 00 \ \ C) § @ 0 0 2 E ƒ K _ _ _ > ) W � C'4 04 CL � } \ 0 2 / < � 2 M a) CO k \ ƒ co � 7 \ @ f� — # k n i ƒ i 7 i ® I k § \ k [ C3 k k k ) § � .§ ® > j u 2 � � m / k k m G ®-6 P i 07 / \ } LLJ \ \ \ / & R & e a d J J \ 9 f g m ( 8 (L I Co CO & « 3 )3 ]mco i C N 0 E i N E m = C � O C N a O nL n N V)D D C O)N C M C CJ N a) C N N O c� v E u O C N 2 N 7TJ N T C E °� L z num oo co co co co ,� oy D d rn rn m rn rn c rn Crn m rn rn m id d N r- N N D a0 co 00 63 66 O O O O O C O D Q D m O p p p p U -) d D y O S � J Q Val p W W to w O O Q I o cl�. ❑ p a 00 O) > J o w w w p W O p p p u c O � 0 N O � Q O oo cn co c U m co m m a L d r O N a 0) oD N 4" aD f� 00 O O O O O W _W N .1.jco co 01 4-1 Q O Q1 O O d Ci H lr I-- �-,. L7 J Q� G7 U p r� C N N v O CN N w N c9 W d O (D C Q C C U) W LL LL a N a € N 7t Q Q S W LL1 L LLl U 0) M O O) U U O M cm 0 J U � U LO U w .amQ J J -j J J J U LL1 W W W W IL W - CITY O " TIGARD BUILDING COMMUNITY P`IELOPMENT DEPARTMENT IDERMIT #. . . . . . . : LlUi--194­0227 13125 SW Hall Ellvcl d,Oregon 97223.8199 (503)639-4111 DATE 'ISSUED: 08/10/94 PPRCEL: 1SI36DD-0010111 Si I L ClDUHLa3h. . . 1ib6'1:j 5W 66TH AVE SUBD I*V IS 1 ON. . . . WEST PORTLAND HEIGHTS ZONING: C-,_ BLOCK. . . . . . . . . . .. LO*i.. . . . . . . . . . . . . .4 RE ISSUE: FLOOR A PEAS—— EXTERIOR WAI-L CONSTRUCTION— CLASS OF WORK. :DEjv1 FIRST. . . . .- 5f N.- S: E. W.- TYV`E OF' UTIE. . . GF SECOND. . . : Sf PROTECT OPENINGS?---­ TYPE OF CJNST. :5N THIRD. . . . : s`' N: S: E: W: OCCUP(INC" (3RP. :R3 0 5 f ROOF CONST: FIRE PET? : OCCUPAf'.:Y LOAD: BASEMENT. : sf AREA SEP. RATED, ST 0 R. : HT. : ft GCR0GL. . . : Sf OCCU SEP. RATED- BSMT':1 : MEZZ,.) : REDD SETBACKS----------- REUUI FLOOR LOAD. . . . : psf LEFT: ft RG1+T - ft FIR F3110K DEET. . DWELLING UNTTS: F*RN7 : ft REAR: ft FIR ALRM: HNDICP ACC: B E 1.)RM S BATHS. IMP, SURFACE: PRO CORR: PORR I NG. VALUE. 0 Remarks : SEPTIC TANK MUST BE PUMPED, FILLED, AND INSPECTED. ALL DEBRIS MUST K"I RLMIOVE71). Owner: FEES FRED JENSEN type amal.tnt by date -- __recce_.._ D1131 SE MILL P R MT $ 25. 00 JG 08/10/94 5PET 1i 1. 25 JG 08/ 1.0/94 PORTLAND OR Vlhonp #. 230-9575 LontTact or: -------------------------------- OWNER Phone #: $ 2 6. 25 TOTAL R e rl #. REQUIRED INSPECTIONS This permIA iy 'Issued sub,qct to the regulations contained in the Pi-imp/Fill Septic Tigard Municipal Code, State cf Ore. Specialty Codes and all other FiTlal Inspect ion applicable laws. All work will be done in accordance with approved plan;. This permit will expire if WVP IS not Started ....... within 180 days of issuance. qr if work is suspended for more than 180 days. IsEued By : Call for inspect iori 639--4175 . M Residential Building Permit ,!k lication ,,ify of Tigard 13125 SW►Mall Blvd. Tigard, OR 97223 (503) 639-4171 Jabsite Address: Subdivision: Trot tt Office Use Oniv Valuation: Planck/Rec# Permit Comer Lot? Y N Reissue of Flag Lot? Y N Map & TL# Owner., _ Approvals Required Address: %D � sr rylL�-C�/ Planning _ ------– =11� — Engineering Phone: 5715 _ Other Contractor: Items Required Address: _ Subcontra+aors — -- — Truss Details Phone: __ - Other Contractor's License # (attach copy of current Oregon License) Contact Name & Phone: r Subcontractors: ArchitectiEngineer: a a Plumbing: — _ _ Address: — v; Mechanical: '– (attach copy of current Crl Contractcr's License) Phone: co J JOB DESCRIPTION: Applicant Signature & Phone number Received by: �r Date Received: N MIpFiDCOMOEVIRFS�PP Permit# Account Description Amount Amt Pd. fiat. Due BIJg. Permit (BUILD) _ Plumb. Permit (PLUMB) Mech. Permit (MECH) — State Tax (TAX) Bldg: _ Plumb: Mech: Plan Check (PLANCK) _ Bldg: Plumb: Mach: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) _ Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSDC) Residential TIF (TIF-R) Hiss Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Offs, TIF (TIF-O) _ Water Quality (WQIJAL) Water Quantity (WOUANT) Fire District (FIRE) Erosion Cnt'! Permit (ERPRMT) _ _y J Eros;on PlanckJUSA (ERPLAN) Erosion Planck/COT (EROSN) _ TOTALS: CITE' OF TIGARD EL.ECTRICAL PERMIT -!iF PERMIT #: ELC98-104 , DEVEWPMENT SERVICES DATE ISSUED: 08/19/98 13125 SW Nil/Blvd., Tigard,OR 97223 (503)639.4171 PARCEL: I.SI36DD-00100 SITE ADDRESS. . . . 11.565 SW 66TH AVE SUBDIVISION. . . . .WEST POPT[_AND HEIGHTS ZONING:MIJE BL.00K. . . . . . . . . . : i-oT. . . . . . . . . . " " " :004 JT ,JURISDICTION: IG Pi­o.ject Descr-iption : Installation of 100 amp service for ODOT camera station. To be located approximately 51 east of east property line. -REGI DENT I AL. UNIT---- SRUC/FEEDERS———— —.----MISCELLANEOUS--------- 1000 SF OR LESS. . . . : 0 1") EOO amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADWL_ 5009F. . . : 0 201 /AOO amp. . . . . . . : 0 SIGN/OUT LINE L.TG. . : 111 I-IMITFT) ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL-/P,nNEL.. . . . . . . : 0 MAKIF. HM/ SVC/FDR. . : 0 6014-amp:5-1000 volts. : 0 MINOR I-ABEL. ( 10) . . . : 0 ------4;EFVJCF/FEEDER---- ----BRANCH CIRCUITS------ -----ADD' [- INSPECTIONS--- 0 NSPECTIONS—0 — .200 amp. . . . . . : 1. W/SERVICE OR FEEDER: I PER INSPECT*101',1. . . . . : 0 201 — 1100 amp. . . . . . : 0 Ist WIO SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . : 0 401 600 -.Amp. . . . . . : 0 EA ADD' [- BRNCH CIRC: 0 11\1 PL..ANT. . . . . . . . . . . : 0 601 1000 amp. . . . . : 0 R E.V I EW SECTION------------------ 1.000-! amp/volt.....: 10 ) =4 RES UNI-S. . . . . . . . : ) 600 VOLT NOMINAL_. . : Reconnect only . . . . . : 0 SVC/FDR ) = 225 AMPS_ : CLASS AREA/SPEC OCC. : Owner-: FEES E I-E C TR I CA L INNOVPTIONSJFNSEN type amOUnt by date rerpt 3021 SE 129TH FIRMT $ 65. 00 DEB 1718/1.9/98 98-308319 PO BOX 435 5PCT t 3. 25 DEB 08/119/98 98-308319 PORTLAND OR 97c'36 Phone #: Contractor,: -------------------------- ELECTRICAL- INNOVATIONS $ 68. 25 TOTAL. 3021 SE 129TH AVENUE REC!UJRED INSPECTIONS rup'l-l-AND OR 97236 Elect' l Service Phone 760-7267 Elect' l Final ........... Reg #. 000664. This permit is issued subject to th, regulations contained in the Tigard Municipal Code, State of Oregon Specialty Caries and all other applicable laws. Ail work will be dor.r in arcordancP with approved plans. This permit will expire if wov+ is not started within 180 days of issuance, or if work is suspended tar more than 180 days, ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 952-001-00I0 through OAR 952-001-1967. You may obtain a copy of these rules or direct questions to OUNC by calling 15031246-1987. Permittee Signati.li-P : 'ADD A IsSi-ted By(Z INSTAIA-Al ION F)WY----- The installation is beinq made on pr-ope,-ty I own which is not intended for, sale, leaser ar rent. OWNFRIS SIGNATURE: DATE: ........ INS TALI-ATION A SIGNATURE OF SUPR. EI-ECIN: W&�L f- � DATE: --/f LICENSE NO:+++++++++4•+++•F+.....4-4-++++,+-++++4-++-+-4-+4+++4++4--+-+-(-+4.........4++4................... Call 639-4179 by 7:00 p. m. for an inspection needed the next bi.tsiness day ++++++•++++i•++•+•++++++++++++4•++ '-........A........4•......4.....4..++++++++-4-+4•........4-+ L A CITY OF TIGARD Electrical Permit Application PlanCheok-#, _ 13125 SW HALL BLVD. Recd BSS Date Recd TIGARD OR 97223 --- Date to P.E._ _- Phone (503) 639-4171, x304 Date•o DST _ Print or Type - Inspection (503) 639-4175 Pe,mit 0 C� e76-- Fax (503) 684-7297 Incomplete or illegible will not be accepted Called_ r1 Job Address: 4. Complete Fee Schedule Below: Name of Developmeni II Numbor of Inspections per permit allowed Name(or Warne of business).//66"' usiness)��5 6' Service included: Items Cost Sum Address- 6/3G'T '"nC'�GD $�C2o �i45f 4a. Residential• per unit QOP�Q ry /�L 1000 sq.ft.or loss $110.00 4 City/StatE/Zip _ _ Each additional 500 sq.ft.or portion thereof $25.00 1 Gomm9rcial ❑ Residential ❑ Limited Energy $25.00 _ Eich Manut'd Home or Modular Dwelling Service or Feeder $68.00 , 2a. Contractor installation only: (Attach copy of all rcurrent licenses) 40.`L'e:vices or Feeders Electrical Qontr ctor /=le . \( q/ ,X�� `' `'' t d N Insta'Iatlon,alteration,or relocation Address �l�0 -X 200 amps or less 1 $60.00 �_� 2 201 amps to 400 amps __ ;080.00 2 City_Pc A.T bA ti d- State O n Zip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 - Exp.Date /a Reconnect only $50.00 Eh_ Cont. Lice. No. OR Staia CCB Reg. No., 4 6 y i Exp.Dat _ 4c.Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date_ Installation,alteration,or relocation ~ 200 amps or loss $50.00 Signature of Su r. Elec'_c/r �j�����u 201 amps to 400 amps $75.00 _ g p r1L 401 amps to 600 amps $100.00 Over 600 amps to 1000 volts, License No. Exp.Date see"b"above. Phone No.- ' -- 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of ser vice or Print Owner's Name - feeder tee. C,C) Address_ Each branch circuit l $5.00 _ - b)The foo for branch circuits City State______ Zip__._-__ _- without purchase of Phone No. --_ service or feeder fee. First branch circuit $35.00 The installation is being made on property I own which is not Each addfli net branch circuit- $5.00 Intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature Each pump or Irrlaatlon circle $40.00 Each sign or outline lighting $40.00 3. Plan Review section (if required):' Signal circuit(s)or a limited energy panel,alteration or extension $40.00 Minor Labels(10) $100.00 --- Please check appropriate item and enter fee in section 5B. 4 or more residential units In one structure 4f.Each additional Inspection over Servicu and feeder 225 amps or more the allowable In any of the above r Systbm over 600 volts nominal Perm $35.00 Clnssltled area or structure containing special occupancy Per hour $5!;nr --_ as described In N.E.C.Chapter 5 In Plant _ $`" - - - J ' Submit 2 sets of plans with application where any of the above apply. Jam. Fees: Not required for temporary construction services. 5a.Enter total of above tees $ �` �:� - 541.Surcharge(.05 X total fees) $ NOTICE Subtotal $ - 5b.Enter 2F%of line 3o for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan R.,view If reauired(Sec.3) $ - -- i JOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK subtotal -_ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ❑ Trust Account 0 ~ TIME AFTEr1 WORK IS COMMENCED. --- $ Total balance Due I\DS1S\ELC".APP nn. ^•''-- CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24--Hour inspection Line: 639-4175 Business Line: 639-4171 — BUP �I Date Requested/1 f S� 7 I" HMPM BLD Location �� l�s �' Suite MEC Contact Person Ph SL'�c '� PLM Contractor Ph SWR _ BUILDING Tenant/Owner be- ELC Retaining Wall ELR Footing Foundation Access: FPS _ Ftg Drain _ Crawl Drain IIispec io 'No _ r SGN Slab t IIEGVYu.S �a� S QGc SIT _ Post& Beam Ext Sheath/Shear /r.,r� lIT (NT^ �1Ci.•-�'�S /�C' Int Sheath/Shear Framing Insulation / � Drywall Nailing1YJs�–y` � L11.LrL_-- !��' L— c rj� Firewall Fire Sprinkler le �1L �Z�P�l1�C��2_s__Co 4L Fire Alarm Susp'd Ceiling 41%- Roof _�'I , v ------- --- - Misc: -- — J — --— Final PASS PART FAIL PLUMBING Post&Beam — Under Slab _� �� �.ti-D c4ge � Top Out �_ Water Service Sanitary Sewer Rain Drains Final — PASS PART FAIL _—�_�Q — :sS MECHANICAL Post& Beam --- — -- --- — Rough In Gas Line — --- ---- Smoke Dampers Final -- -- P T FAIL EL ECTRICA3�- 5f?rvlc oug In I �— UG/Slab I- Low Volta;e Pire Alarm ASS ART FAIL —. Backfill/Grading Sanitary Sewer J Storm Drain [ J Reinspection fee of$ _required before next inspection. Pay at City Hall, 1312E SW Hall Blvd Catch Basin Please call for reinspection RE: Fire Supply Line p I J Unable to inspect-no access ADA / �� Approach/Sidewalk / Other Date t_ Inspector y �- Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the lob site. CITY O� �I���D ^ ELECTRICAL PERMIT PERMIT#: ELC1999-00674 ' DEVELOPMENT SERVI;vES DATE ISSUED: 11/10/1999 13125 SW Hall Blvd., Tivard, OR 97223 (503) 639-4171 PARCEL: 1S136DD-00100 SITE ADDRESS: 11565 SVS'66TH AVE SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT : 004 JURISC:CTION: TIG Proiect Description: Installation of a 200 AMF service/feeder. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS _ 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGAT!ON: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 451 • 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS - ADD'L INSPECTIONS 0 - 200 amp: 1 WISF_RVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st V410 SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: ' 601 - 1000 amp: _ PLAN REVIEW SEC)' 'N _ 1000+amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: : VC/FDR >=225 AMPS: CLASS AREA/SPEC OCC Owner: Contractor: ODOT ELECTRICAL INNOVATIONS 11565 SW ATLANTA :021 SE 129TH AVENUE TIGARD, OR 97223 PORTLAND, OR 97236 Phone: Ph•..ne: 760-7267 Reg M ELE 26-699C LIC 00096412 SUP 3621S FEES Required Inspections Type By Date Amount Receipt _ _ � Eact'I Service PRMT DST 11/10/199 $64.25 99-319683 Elect'I f=inal 5PCT DST 11/10/199 $5.14 99-319683 Total $69.39 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved oians This permit will expire if work is not started within 180 days of issuance,or.t work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adc, ;ed by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through GAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE -, ISSUED BY: Lar f - OWNER INSTALLATION ONL4 The installation ir; being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNAI URE: _ DATE: CONTRACTOR INS1 ALLATIG N ONLY SIGNATURE OF SUPR. ELEC'N: � { ____�.-- . DATE: LICENSE NO: ,all 639-417° by 7:00pm for an inspection the next business day CITY OF TIGARQ Plan Check# Electrical Permit Application 1312tir SW 'BALL BLVD. Recd By Date Recd TIGARD OR 97223 Date to P.E. Phone (503)639-4171, x304 Date to DST _ Inspection (503)639-4175 Print of Type Permit#F C/rrp C�LYi�� Fax (503) 598-1960 Incomplete or illegible will not be accepted Called_ ?. Job Address: 4. Complete Fee Schedule Below: Name of Developme ot lV ONo _ Number of Inspections per permit allowed Name(or name of business) (�Q D Service included: Items Cost Sum Address �tw/ Ar/-A//t r1 4a. Residential-per unit 1000 sq ft or less $ 117.75 _! 4 CityState/Zip rI G(L rt � _C7 1�+t-rte_ _- Each additional 500 sq ft or portion thereof _ $ 2675 1 Commercial © Residential ❑ Limited Energy ^ $ 6000 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.7.5 2 (Prior to permi,issuance,applicants n.ust provide contractor license 4b.Services or Feeders information for COT data base). Installation,alteration,or relocation Electrical Contractor G &-c-TA.4 n I L r✓Nc✓A f i e^ 200 amps or less _ $ 64.25 ( f.3„� 2 Address ¢ wQ t 1 ref \ 201 amps to 400 amps _ $ 65.50 M 2 ,n 401 amps to 600 amps $ 126.50 2 City U ._k oAAir%jC(w,State�_Llp 51 601 amps to 1000 amps $ 192.50 2 Phone No. / s' - S4 V.� U Over 1000 amps or volts $ 363.75 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. Aet� Exp.Date_ 4c.Temporary Services or Feeders OR State CCB Reg. No. CX `r/:3 Exp.Date Installation,alteration,or relocation COT Business Tax or Metro No. _Exp.Date 200 amps or less $ 53.50 _ 2 201 amps to 400 amps $ 80.25 401 amps to 600 amps $ 100.00 2 Signature of Supr. Elec'n over 600 amps to 1000 volts, see"b"above. License No. 3 C_-2 / Exp.D:to _ L 4d.Branch Circuits Phone NO. i .7 3 7� T_ New,alteration or extension per panel a)The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit _ $ 5.35 Addressh)The fee for branch circuits without purchase of service City ^_State _Zip or feeder fee. Phone No. First branch circuit $ 37.50 ---- -"�- _ Inch additional branch circuit $ 5,35 The installation is being made on property I own which is not 4o.MisceOa .)us intended for sale, lease or rent. (Service.•ree•..r not Inclur;ed) Each puma nr irrigation circle $ 4275 - Owner's Signature Each sign or wrline lighting $ 42 75 - - Signal cIrcuit(s)or a limited energy panel,alteration or extension $ 60.00 _ 3. Plan Review section (if required): 14inor Labels(10) $ 100.00 Please cherk appropriate item and enter fee in section 5B. 4f.Each additional Inspection over 4 or more residential units in one stnl:.ture the allowable In any of the above r - Per Inspection _ $ 50.00 Service and feeder 225 amps or more Per hour $ 50.00 _ System over 600 volts nomina, In Plant $ 59.00 Classified area or structure containing opecia!occupancy as described In N.E.C.Chapter 5 Jr. Fees: 5a.Enter total of above fees $ Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(.08 X total fees) $ __f. y Not requirca for temporary construction services. Subtotal $ 6b.Enter Y5%of line 6s for NOTICE Plan Review if re uq Ired(Sec 3) $_ PERMiTS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 GAYS ❑ Trust Account It _ AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ 1•,gyp I:\dsts\fiirms\cicctric doc