10025 SW 70TH PLACE C)
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10025 SW '10'x' Place
CITY OF TIGARL 21-Hour
BUILDING Inspection Line- (503) 639-4175
INSPECTION DIVISION MST •- �� k `j�j
Business Line: (503)639-4.71 - -- --- ---- --
Received _ ��� Date Requested -2y
BLIP
Location M 19z 5 ll/ ?(�Y y1 AM-- -_ PM -
6UP - - -
suite--___--_- MEC
Contact Person -- -- - -
Ph(— ) -7 _�g�,S pt.M
- -
mtractor-- ._ -- - - -
-__- Psi(----) - -- -
- ---- -----
[Foundation
UILDING Tenant/Owner
cating ------ —
_Lr
tg Drain Access: ` ELC:rawl Drain ELR _
Slab I Inspection (Votes: SIT Post&Beam
Shear Anchors -
Ext Sheath/Shear --
Int Sheath/Shear _
Framing -- --
Insulation - - - ------
Drywa;;Nailing
Firewall ---
Fire Sprinkler
Fire Alarm - -- - --- --- --
Susp'd CeilingRoof
- --
Other: -
Final - -_--
PASS PART FAIL — - -
Post 8 Beam
Under Slab —Ho o V
Rough-In
Water Service -_ `Z L/
Sanitary Sewer
Rain Drains _
Catch Basin/Manhole --
Storm Drain ✓
Shower Pan
Other:
PASS PAF,T IL —
MECHANICAL
- - ___-- —
— -- - -
Post& Bean -
Rough-In —
Gas Line
Smoke Dampers — _ �—
Final
PASS PART FAIL
Service --�------ --- --
Rough-In --
UG/Slab
Low kVtage -
Fi Alai m
S PART FAIL 0 Reinspection fee of$.._-___ required before next Inspectlon. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspectlon RE:
Fire Supply Line --- _. Unable to inspect-no access
ADA er �L2- f �Ca ''
Otheoach/Sidewalk Daft �J_'._ Inspoctor _--
Final '--� DO NOT 11EMOVE this Inta,torrctlo" record from the job site.
PASS PAST FAIL
i
ELECTRICAL PERMIT-
CITY OF T I C A R D
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: Ei_R2003-00021
13125 SW Hall Blvd.,Tigard, OR 972.23 (503) 639-4171 DATE ISSUED: 1/29/03
SITE.ADDRESS: 10025 SW 70TH PL PARCEL: 1 S i 36AA-08400
SUBDIVISION: VENTURA ESTATES ZONING: R-4 .,
BLOCK: LOT: 006 JURISDICTION: TIC
Proiect Description: Install low voltage: All encompassing.
A.RESIDENTIAL _ B.COMMERCIAL
'AUDIO & STEREO: X AUDIO & STEREO: INTE!'COM & PAGING:
BI IRGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR L.ANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Ownpr. Contractor:
WINGATE CORP QUADRANT SYSTEMS
15840 S POPE LANE PO BOX 14833
OPEGON CITY, OR 97045 PORTLAND, OR 97293
Phone: 503-657-3300 Phone: 234-5558
Reg #: MET 00002466
SUP 1211 JLE
— ------- — ---------- LIC 96806
FEES ELE lg6gWi4itnspections
Description _Date _ Amount Low Voltage Inspection
(ELPRMTj ELR Permit 1/29/03 $7500 Elect's Final
[TAX] 8°4,Stale Tax 1/29/03 $6.00
Total $81.00
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 plans. This permit will expire if work is
not started within 180 d .ys 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 952 001-0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699. 1
Issued by i il ��_ Permittee Signature 7\ V
OWNER INSTALLATION ONLY
The installation is boing made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SI.JPR. FLEC'N _ DATE: _
LICENSE NO:
Call 039-4175 by 7:00 P.M. for an Inspection needed the next business day
1-03-2003 12:5'PM FROM OUADRANI SYSTEMS 503 236 2.322 P.
Electrical 'erar�litApplication
Datereccived; / '! c Permit no.:
ECH
City of Tigard Project/appl.no.: Expircdate:
CervofTigard Address: 13125 SW HAIL Blvd,Tiprd,
Phone: (503) 639.4171 J H►`t f i) 2OG3 -ate issuui: Hy I Receipt no.;
Fax: (503)598.1960CITY OF TIGAR D Case file no.: Payment type;
Land use approval: ;,cul DING' DIVISIC)hl �i
01' PERMIT
'61 l & 2.family dwelling or accessory C,C:ommerciaUindustrial U Multi-family ❑Tenant improvement
,61 New construction U,addittos/alteiatiirn/replacenient 0 Othcr. ❑Partial
1S IN170101ATION
Job address: 1 , 10`r- Tau 4 CA p( Bldg.no.: Suite no.: Tax map/tax lot/accountno,.
lot: _ 131crk Sumivision:_ r 41 J, ` - --1
Project name: Description and location of work on premises- U—Ci .Nk-sky—
Estimat xi date of completion/inspection: AA41A 3 AAA d o
1
Job no? FIT
Business rt neC. A.11ra-{� .� � ,� Description Qty..- Total no.in
- New rftidendal•dngk or multi•fandly per
Address: _ doctluigunit.Includes anachedgarage..
City: tierviechicluttedr
Phone: Faxlr\s4lf
-, E-mail: 1000 sq.ft.or less 4
Each additional$00 •ft,or onion thereof
CCB no.: �a bus.tic,no: j, C�S C Urnited energy,residential
Cit /metrolic,n _ ! mitedenertl ,non-residential
p laser:manufactured horse or modular dwelling—
Signature
wellingSi ature of su icing electric an(required) Date Service ancvor feeder
rio2
Sup.elect.narm t. Ci(AkfY)'Y)� Lfcert,enn:l7�1 iF/� Senicrsorfeeders-Iruhllatlorr,
alter alien er relocatlonr
1 1 200 amps or lent 2
MW
Name(print): i ! ✓ _ 201 imps to 400 amps - AA 2
Mailing address: 4m em to 600 smpc 2 1
601 amps to 1000 snips �
City: $tate: 7.Ip. _ F Over 1000 Amps or volts --
Phone' Fax: i E-mail: Aeoonnectonly ----� I
(weer installation:'Ihe installation is txing made on property I own TompararywriUmorfeeders-
which is not intended for sale,lease,mrit,or exchange according to hsehllrNon,riterrtlon,orrelotrtfon:
ORS 447,455,479,670,701. 200 stops or less 2
201"Vito 400 Unpi
2
D
Ownces signature! Date: 401 to 600 ams _ —T---
-_— Brstath eirmits-he-.I,allerrtion,
nrextea+lon per panel:
Name: - --- -- -- A Ffr,for branch cirrlrits with purehax of ^ ;
Addrm: service or fcedcr fee,each branch circuit _ 2
hitt. Slate ZIP' R. Fa for branch clralaits without purrhaxe r
—--- --- -- of cervix or fender tee,first branch circuit: 2
1'hnna. _ _ I;t�• Ii�mail•
Each additional branch circuit:
511W.(S i.l-e or fee errotincr d)t
O Srrvicrovrr275ampsazinmw.rual O Health-catc(aniily floh-+Um or rn stion Citel-Com- _ 2 '
0Smiceover 3T1amps-rating of 1&2 C3 liszardouslocarion c egnoroutlinelighting T'2
famiiydwellinri tU Ruilding over 10,000 squur feet tour or Signal circuit(s)or a limited energy panel.
O System over 6W volts nominal more residential units in wo structurr alteration,atertension* 2
UBuildingover our"stories ❑Feeders.400amps ormer. +j�sctipen:_T—_
U Occupant load over 99 persons U Manufacnired structures t r RV pan .ach-Milfi.nal h prrtixs over the allowable In any of the aWte:
U EsressAiShtingplan O Other- , _ _- per ins Linn
$ubmit—sats it f plaac with any of the shave. investigation fee --— -
TW above the not applleal le to tempor stry consuimilon service. Oma — -�
---— permit fee.....................$
Nd as jums7lctim axep asap cads,please call jwisdictim for more irrortoation. Notice;This permit application
vsa O Marr -0-rd expires if a Plan review at
a ' it SO r�F.3 CML "IAV accepted as
complete.erica as obtained 7tfs '01AL h..(.....8% ,.S AW �.
Ct►mfit read eamu . within I BO daysafter Il has been State ( )••••a
_^['r_� O( p —11
rearm Of TY n 1 -�'��— I-
17�
Con orae?a Amin" e40461$(MI Cats,
p
CITYO F T I G A R D MASTER PERMIT
PERMIT#: MST2002-00299
DEVELOPMENT SERVICES DATE ISSUED: 7/29/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10025 SW 70TH PL PARCEL: 1S136AA-08100
SUBDIVISION: VENTURA ESTATES ZONINS: R-4.5
BLOCK: LO'r: 006 JURISDICTION: TIG
REMARKS- New SF detached.
BUILDING
REISSUE: STORIES. • FLOOR AREAS REQUIRED SETBACKS _ REQUIRED
CLASS OF WORK: NEW HEIGHT: 74 FIRST 1,261 at BASEMENT: 883.00 at LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: Sr F.OOR LOAD: 40 SECOND: 826 at GARAGE: 889 of FRONT: _f5 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: of RIGHT. H
OCCUPANCY ORP: RJ BDRM i BATH: 4 TOTAL: 2,08700 of VALUE: $288.903 00 REAR- 11
PLUMBING _
SINKS: 2 WATER CLOSETS: 4 WASHING MACH: I LAUNDRY TRAYS: t RAIN DRAIN: ion TRAPS-
LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS.
TUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTW I GREASE TRAPS:
MECHANICAL OTHER FIXTURES:
FUEL TYPES FLAN<100K: BOIUCMP<JHP: VENT FANS: 9 CLOTHES DRYER: I
GAS FURN>•100K: I UNIT HEATERS: HOODS: I OTHER UNITS: I
MAX INP: btu FLOOR FURNANCES: VENTS: I WOOOSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 9F OR LEI'$: 1 0 200 amp: 0 200 amp: W/SVC OR FOR: 1 PUMPIiRRIGATION: PER INSPECTION.
EA ADD'L 600$!: 6 201 400 amp: 201 - 400 an u: tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGI: 401 •600 amp: 401 600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR 601 • 1000 emp: 601+ampa-1000vMINOR LABEL:
1000+amplvolt:
Racannectonlr
PLAN REVIEW SECTION
—
>•4 RES UNITS: SVCIFDR»<225 A. >600 V NOMINAL: CLS AREAISPC OCC
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL _
AUDIO A STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIG- PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL OTHR:
HVAC DATAITELECOMM: NURSE CALLS TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,027.25
WINGATE CORP WINGATE CORPOPATION This permit is subject to the regulations contained in the
15840 S POPE LANE 15840 S POPE LANE
Tigard Municipal Code,State of OR. Specialty Codes and
OREGON CITY, OR 97045 OREGON CITY, OR 97045 all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire if
work is not started within 180 days of issuanoe,or if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
G igon Utility Notification Center. Those rules are set
Rey e: LIC 94660 forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)245-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Structural Plm/undslab Insp Electrical Rough In Gas line Insp Appr/Sdwik Insp
Grading Inspection Post/Beam Mechanica PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Underfloor Insulation Mechanical Insp Shear Wall Insp Insulatinn Insp Mechanical Final
Footing Insp Crawl Draln/Backwater Plumb Top Out Exterior Sheathing Insl Rain draln Insp Plumb Final
Foundatlorylnsp,\ Footing/Foundation Drl Electrical Service Low Voltage Water Line Insp Final inspection
IsaU By : Permittee Signature --
CI (503) 39.417'5 by 7:00 p.m for an inspection needed the next- slIPM-day
CITYOF TIGARD _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00205
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/29/02
SITE ADDRESS; 1002.5 SW 70TH PL PARCEL: 1 S136AA-08400
SUBDIVISION: VENTURA ESTATES ZONING: P-4.5
BLOCK: LOT: 006 _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: ?
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE.:
Remarks: Sewer connection for new SF
Owner:
WINGATE.CORP _FEES _
15840 ,13 POPE LANE Type By Date Amount Receipt
OREGON CITY, OR 97045 PRMT CTR 7/29/02 $2,300.00 2.7200200000
INSP CTR 7/29/02 $35.00 27200200000
Phone: 503.657-3300 — ----
Total $2,335.00
Contractor:
Phone:
Reg #:
`__Required Inspections
This Applicant agrees to comply with all the rues and regulations of the Unified Sewage ,Agency. The permit expires
180 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 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. ATTENTION: Oregon law requires you to follow rules adopted
by the 9m9on Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You ay obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987.
Iss d by: Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed d the next buslne ay
Building Fernut Application -_-�
Date received: 1 Permit no..
City of Tigard t'roaa Uappl.no.: Expire date:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
CityofTigard -
Phone: (503) 639-4171 Date issued: eyt Receipt no.: 1
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ — 1&2 family:Simple Complcx: l
S
U I &2 family dwelling or accessory U CommetciaUindustrial U Multi-farnily It New construction U Demolition
U AdditiotVz:itenttioti/replacement U Tenant improverrtent CJ Fire sprinkler/alarm U Other:
Job a.ldress ti C' Lc> ` c_ 7 — F- Bldg. no.: Suite no.:
Lot: I Block: subdivision_ V1�NTUF� •�j% Tax ma tax lot account no.:
Project name:
Description and location of work on pr;mises/special condi4cns: .S
Name: _ t NC�q'ff✓ Ort (''_
Mailing add! %LL.0 S, Rp (, 1 &2 family dwelllwg:
Stated "LIP•
City: ao t4 r.i . �-+0 Valuation of work........................................ 5 �
Phone: (651-7-110 Fax: Email: No.
_ of bedrooms/baths................................. ? __ 6.
Owner's representative: � �t.S ► Total number offlwrs................................. 3
Phone: IFax: E-mail: New dwelling area(Ser.ft.)
Garage/carport area(sq.ft.)......................... c*-1
_Name: Covered porch area(sq.ft.) ........................ _
Mailing address: Deck area(sq. ft.) ........................
City: Stme: ZIP: Odicr structure area(sq.ft.)..................�..
Phone: Fax: I;-rrrtil CommercW/InduatrW/multi-famUy: --- -
Valuation of work.................t.............. ......
� —
Business name: Existing bldg.arca(sq.fQ ................... ...... _
Address: -- New bldg.area(aq.ft.)....... .::.................. _^ -----
-- Number of stones.......................................
ZP.
Cit): _ stale: r . , Type of construcuoni......
Phone Faz: _ Email:
CCB no.; Occupancy group(s): Existing:
�
- Nc w: _
City/metro tic,no.: Nollce:Ali contractors and subcontractors ate required to be
li:a:naed with the Oregon Construction Contractors Board under
Nom; gtovisions of OR,701 and may be required to be licensed in the
Address: junsdiction where work is being,performed. If the applicant is
Cit State: Z111: exempt from licensing,the following renson applies:
Contact person: Plan no.:
Phone: Fax_ E-mail:
Name: Contact rwn: Fees due upon application ........................... $
Address: _ Date received:
(:Ity: _tate: ZIP: — Amount received ......................................... $
Phone: Fax. E-mail: _Please refer to fee schedule.
1 hereb) certify I have read and examined this applicabort and the Na rt jr ds6cuorm amW c"r Wim.pica cart iurWKyi„r►z tnm idtormenm
attached checklist.All pruvisions of laws and ordinances goveming this U vias U Mastercard
work will be complied with,whepw spradlaaherein or not.
Authorized signatum:� ' Ami_—" Date: '1`] U �_ —Nr'ee d crdroldot u shwa on nadYr crd
Print name:� �]Fr—p�� ___cultowee Iipwurr'_J ---- s AMC"
Notice:Thu permit application expi-es ifs permit is not obtained within 110 days after it has been accepted as wrtiplete. 440.4613 MMIMMd
Electrical Permit Application _
10atereceived: Permitno.:
City of Tigard Projczt/appl.no.: rBtk�,
te:
City ojTigard AddNss: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Receiptno.:
Phone: (503) 6394171 --
Fax: (503) 598-1960 Case the no.: Payment type:
Land use approval:
U I &2 family dwelling or accessory U Commer_•ial1industrial U Multi-family U Tenant improvement
)(New cunstniction U Addition/alteratirm/replacement U Other: U Partial
1uh address: I QU 7 ��. �}tp — I;I I�. nn.: Suite nu.. Tax rnap/tax lolls count no.:
ur �_ Block-'Subdivision- UE H-1U f./+ IIT ` 7-- --
Project name: —I Desrnption and ocation of-work on premises: 5��.,�E,yv
Estimated date of cornpletion/inspection:
CON1111ACroit APPLICATION 1.1111, SUI I L'Ilik'1.1"'9"
tee Mat
Business name: Peagk4gjm�fZ E „rel C.. 11,0121l no.In,
New residential-surkk urnvjhimuhl(amilr per
Address: dwrllingunit.Includes attached garaff.
City: State:C)JL4ZIP: LZ-Z, Servioeincluded:
Phone Fax: E-mail: 1000 sq.ft.or leas _ 4
Each additional 500 sq.tt.or pulion thereof
CCB no.: 5, Elec.bus. lic.no: fp Limited encrg ,residential 2
City/metro hc.no.: Limitedener ,non-residential
`._ 1 E:a,.h manufactured hom:or nodular dwelling
Signature of sLp-_rv&Tri electrician(re uired) Date service and/or feeder 2
Sup.elect.name(print): Dqyt-- bfvA f H ha License no 1.67j�L Settles orfeeders–h ddtstlon,
alteraHoe or relocallon
r 200 amps or less Z
Name(pfinl): 201 amps to 400 amps 2 _
401 amps to 600 amps
Mailing address: 601 ams to 1000 ams 2
City: – $late: ZIP: Over IOW amps or volts 2
Rione: Fax: Reconnecloniv I
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation:
200 amps or less 2
ORS 447,455,4*79,670,701. 201 amps to 400 amps r 2
Owner's signature: Date: 401 to 600 ams 2
Branch circ,rits-new,■leeratlou,
Of extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: State: ?IP: B. Fee for branch circuits without purchase
of service or feeder fee.,rttret branch circuit: 2
Phone.: Fax: E-mail: Each additional branch circuit:
MIK,.(Servke or feeder not included).
U Cemicr over 225 ampa-commercial ❑Health-care facility Bach pump or irri ation circle
U Service over 320 amps-rating of 1&2 U Hazardoua location Each sign or outline lighting 2
fandlydwelling. U Building over 10,000 syuam feel four or Signal circuit(s)or a limited energy panel,
U System over 6Cd volts nominal more residential units in one structure aiterntion,or extension" _ 2
U Building over three stories U Feeders,400 amps or more 'Descti tion: — ---
O Occupant load over 99 persons U Manufactured structures or RV park Fich additional Impectlon oyer the allocable in any of the above:
U F.gtessAightingplan U Odwr .� -•-- - -- Per ins ctiou
Submit_sets of plant pith any of the above. Investigation fee
The above are not applicable to temporary construction service. Other -
Na all jurfr.:hcum,accept cretin cant,please call jurisdiction rot nue information. Notice:This permit application Permit fee..................... _
U Viu U MuterCard expires if a permit is not obtained Plan review(al ._ %) $
Credit card numbtl: within 180 days alter it has been State surcharge(8%)....$
Expires accepted as complete. TOTAL $
_.gym d ar�i o–� own°a credit card
t
cardhower u Amount 4404611(69WOM)
Mechanical Permit Application NOW
r Qr Darerrccived: ;J/'-� Permit no.:/
City of Tigard Project/uppl.no.: rpt ate:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: Receiptoo.:
Fax: (503) 598.1960 Case file no.: Payment type:
Ladd use approval: , building peirnit no.:
U I &'2 family dwelling or accessory U CommerciaUindustrial U Multi-family — U Tenant improvement I
:New construction U Addition/alterttioiv.::placeinent U Gther:
Jul)address: i C>� - ` �, , j Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: � profit.Value S ._—
Lot to Block: subdivision _4,eT
,}See checklist for important application information and
Project name: jurisdiction's fee schedule for reside. al permit fee.
(city/county. p ZIP: Z,� 1011110111 OU'[11111111
Description and locadoff of work on premises:
Fee(ea.) ToW
Est.date of completion/inspection: 7h.ndlingunit
1)esrri ()t . Res.onl Res.otd
Tenant improvement or change of use:
-- i'FT1Is existing space heated or conditioned?U Yes U No Arrcoon-ci itiing(site pan-required)
Is existing space insulated?U Yes U No Alteration of existing AVAC system -"-
HLI[d 9111 or er cumpressors
Business name: �- (I Cho u State boiler permit no.:
HP TonsBTU/H
Address: j(ppp(�, S� F,��� Fire7smoke damper uctsmo a detectors —�—
City: C.�,Atm-plrt�Y),t�ij_ State:Q(t_ ZIP: _Reatpum (s`1tWe7tepanrequired) ---`
Phone:62p_-5gLq Fax: E-mail: Install/replace,—" furnace/but tier—, - --
CCB no.: Including ductwork/vent liner U Yes O No
-1 �--- Insta rep ac reocate eater er%-s_u_& n —
City/metro sic.no.: wall,or floor mounted
Nance(please print): EAQ-4 K.(]tt T=P-1 R l r_44 I Vent fora Lance of er than furnace - ��-
e
Absorption units BTU/11
Name: sofa Chillers — HP
Address: -- Comnressor. _ HI'
ray rotuoentisex ort and tent ton:
City: —� State: ZIP: Appliance vent
Phone: Fax. E-mail: I Dryerexhaust
Floods,Type UiUrn.kitchen/azmat -
hood fire suppression system _—
Name: _ Exhaust fan with single duct(bath fans)
Mailing address: - Exhaust system a an rom catin or AC —
City: - State: "LIP: V Fuel pipliq— tea up to 4 outlets)
Te: I.I'cl _ NU _ Oil _
Phone: }ax E-mail: y Fuelpiiiing each additional ver 4 outlets
trocw p1pliffild(schemaricreyut
Name- Number of outlets
--- - th ICstWipp Grace or equT-peal: —�
Address: — Decorativefire'llacc
City: --—_ - State: ZIP: in, i-ty
Phone: — Fax: E-mail: oo slov Ix fetstove
Applicant's
_ signature: Date: i �Tiec
fc` OL
Otbft
Name(print): —
Wit all Oddic-Ww 'e'Pt rtedit ewds.pkre call jurikkoon rut ruse info mationNoti
. Permit fee.....................$ -- —
U Visa ]MastaiCsrd tx:This permit application Minimum fee................$
expires if a permit la not obta;ncd
c•�d�t card dnrr,er:^_ --._ ^l 1_ Plan review(at __ `ib) $ _
Ella e. within Igo days after it has been State surcharge(8%)....$
Ntttpe nr e.&Rjei1�e orcirc„tua-` s accepted as complete. i u?TALs
.......................
CtrditoW tlprnre
410-4617(60W)M)
Plumbing Permit Application
Datcreceived: Permit no.:, _
"'lty of
l rl r igs1Cd Sewer pennu no.: i3ililding permit no.:- r
Address: 13125 SW Hall Blvd,Tigard,OR 97223 _
City of Tigard Phone: (503) 639.4171 Pr^ect/appL no.: dxpire dart:
Fax- (503) 598-1960 Date issued: Ry Receipt no.:
La:.d use approval: _ Case file no.: Payment type:
U I &2 farm.y dwelling or accessory Ll Commercial/industrial U Multi-family v Tenant improvement
QNew cc nstruction U Additiot>/alteration/replacement U Food service U Other.
1?escrlptlon (ttv. Fee ea. Total
LLAx:
address: New I ao�12-family dwellings only:
g.no.: __ Suite no.: (includes 100 ft.for Cath uhuty conm Wort)
map/tax lot/account no.: SFR(1)bath
Bloc:k: Subdivision: � FR(2)bath _
Project name: _ SFR(3)bath
Ct►y/countyfrf6� ZIP:�"ZZ Each additional bath/kitchen
Description and location or work on premises: 9= site utilities:
_ Catch basin/area drain
-- D wells/leach IinOtrench drain
Est.date of c ornplctionhnspection:
Footing drain(no.lin.ft.)
Manufactured home utilities
Business name. � �'_��S�s r. anhOles
Address: t _ E tn�N _ Rain drain connector
JA State. A ZIII:q Sanitarysewer(no.lin.ft.)
City:
Phone; {, Fax: Email: Storm sewer (no.lin.ft.)
_ Plumb.bus.re^ no Water service(no. in.ft.)
CCB no.: 2 -_ Fixture or Item:
City/metro lic.no.: Absorption valve
(:cauractoes representative signature: Back flow revenier
Print name c l Ery �y,ue z v Backwater valve
In Basins/lavatury
Clothes washer
Name: — _ - -- Dishwasher
AdiresF: -- Drinkin fountain(s)
Zip _ Ejectora/sum _
't
Plmne: — Fax: E-mail: Ex ars on tank _.
Pixture/sewer cap___
Floor drains/floor snksthub
Nwne(print):` Garbage disposal
Mailing address: — Hose Bibb
City: State: — ZIPS Ice m er _
Phone: Fax: E-mail: Interceptor/grease trap _
Owner it-'y:iA6olv`,csider.ial in,, ttenance only: The actual installation Primer(s) _
wit!:,e made by me or the maintemance and repair made by my regular Roof drain(commercial)
employee on tltc property I own as per ORS Chapter 447. Sin (s),basin(s), ays(s) _
Owner's signature: Date _ Sum
Tubsfshower/slower pan _
Urinal
_Nance: _ Water closet _ —
Address: - Water ater
City-- State: ZIP:_ ()ther.
Phone: Fax: &rtuil: 7 Total
Minimum fee................S —
Na all Iwidictkm WOW aedd crdi..PkW call JwikkUm fa ammion. Notice:This permit application Plan review(at — %) $
U via U MuterCard expires if x permit is not obtained
State surcharge(8q6) ....$ — —�—
cm&t,ml wnkbw __.�— — --�--_ within I60 days slier it has been
v� accepted as complete TOTAL .......................$
Naar of cxftuldr w rMwn m taadil ead
CNhdd,�upuuremarts - 401616(60a1C(MI)
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5/23/2002 TPW - -- S_Q A L E__—� • 2 0 ' ; 0_'
Ai FA wscgne u11sa10 uwtalnr,re s rot CITY OF TIGAND 21200 it
IlMIf FON f1(ACCUrACT V M TOSQdIo"
g011rA1D10'I m flq la11 etttrow�ily OF THE VENTURA ESTATES
/ MAUFA 10 vols.All Off C010104 WAUOsr6
iul.rut n�UO 011 flr Ott NO NOIs•IIf 1 OT 5
01m.t OF Ary 0011110f1µrE�0 01010 AflpllS
4
rrrr WASCOAD OwtUon furoa.nr.re By 'INGA IF HOMES
« ".." .`° ( 6,910 SO f r
..\' 101111 NII
CITY ®FTIG,ARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 6'•9-4171 MST
BUP
Received _ -
Datef�equested_— �S 'O 3 AM _ PM _ _ BUP
Location v oZ S �� L — ---- -- -- --
- _Suite MEC
Contact Person _--- �— Ph( ) _ PLM
Contractor s s�.l-�_�� r''. Ph ( `'—>) 6 — SWR - - --- --
BUILDING-- Tenant/owner __— ELC
Footing --- -
Foundation - '-'---- ELC
Ftg Drain Access: --
Crawl Drain LELR
_ ( � � 7 �_—_ -- - -- _
Slab Inspection Notes: =� SIT
- - - - -
Post 8 Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear - -
Framing
Insulation --
Drywall Nailing
Firewall 7
Fire Sprinkler ,.•� '� �- _---I v rvC.�tLQ�- ---- --- -- --- -
Fire Alarm
Susp'd Ceiling h
Roof
Other.
Final
PASS PART_ FAIL
PLUMBING _—
Post 8
Under Slab
Rough-In — -- — —
Water Service _
Sanitary Sewer
R
Rainin Drains - .r___�✓_�_� r7 _�� `� C./
Catch Basin/Manhole --- --- - -
Storm Drain ---— - - _
Shower Pan - - — --- --
Other:..._ - - ---- —
Final
PASS_ PART FAIL ------ -
MECHANICAL --
Post&Beam ---- -—-------- - -
Rough-In
as Line --- --
Smoke Dampers -.-_ -__-.
Final _ ----- - --
jjKPASS T FAIL - ------ - -- -- _RIC ____
Rough-In - -
L:G/Slab --- -- - - -----._—
Lcw Voltage
Fire Alarm —._--_ _---_----- ---- --
�n [� Rein:apection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
SITE F] Please call for reinspectlon RE:---. _ [ Unable to Inspect -no access
--- -
Fire Supply Line -
ADA
Approach/Sidewalk Insp•ator
Other:
Final DO NOT REMOVE this Inspection record teom the Job site.
PASS PART FAIL
$ 5 0
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CITY OF TIGARD 24-Hour
BUILDING Inspection. Line: (502)639-4175 MST
INSPECTION DIVISION Business Line: (5n3)639-4171
BUP ------ --
Received --Dale Requested — AM_ PM_—___— BUP —_—_--
Location Suite --- MEC
Contact Parson ----_--- - —__ Ph PLM
— Ph(— ) SWR
UILDIN_G� Tenant/Owner ELC
ooELC --------- --
Foun ion Access: _
Ftg Dram Crawl
. ?) ELR --- -- -_
Crawl Drain LJ SIT
Slab Inspection Notes-.
&Beam --------- - - ---- -- — — ---
Shear Anchors
Ext Sheath/Shear -- -
Int Sheath/Shear
Framing -- - - ------ - --- - - -- ---
Insulation
Drywall Nailing -- -----
Firewall
Fire Sprinkler -----------
Fire Alarm
Susp'd Ceiling -- ---
Root
inel —
PA9T FAIL
Post&Beam -- --
Under Slab -
Hough-In
Water Service --- ------ �_
Sanitary Sewer
Rain Drains — `— -
Catch Basin/Manhole
Storm Drain --- -_--- `- 01 � ------—
Shower Pan
Oth - - — -----------
=11-
-- --
1`inal _-_-- --
T FAIL -- - -- --- .-
;
NIC414 - _—_ -----— — _ — --- —
Rough-In - - - _T_ ------ -
Gas Line _
c_:moke Dampers _--
RT FAIL_ - - --- - ----------------- --
r
.l
ROU -I ----- --
1.1G/SI --
Low �`� ------
f it rm --
`� Reinspection fee of$___-- _required before next inspection. Pay at City Hall, 13125 SW Hell Blvd.
ASS PART FAIL i } Unable to inspect - no access
SITE n� Please call for reinspe tion RE'
Fire ADA Date
Line --- I � O `� ;.�
Apr roach/Sidewalk
Date.__ �__ _ Inspector 1 _ Ext
O ls,YZI N(\ t.
in aV DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL