9350 SW 70TH AVENUE l
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CITY OF TIGAiRD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BLIP
—Date Requested / `� AM __ _PIVD — BLD –
Location__ Suite MEC ----- — —
Contact Person __ Ph PLM
Contractor Ph _ SWR
BUILDING _ Tenant/Owner _ ELC C
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain -- -- SGN
Crawl Drain Inspection Notes: ---------
Slab -- —�- SIT
Post&Beam ---
Ext Sheath/Shear
Int Sheath/Shear
Framing �—
Insulation ---
Drywall Nailing
Firewall
Fire Sprinkler _
Fire Alarm
Susp'd Ceiling
Roof ---
Misc: - --
Final
PASS PART FAIL. - --- --- -- - _ --- ---- -- - --
PLUMBING
Post&Beam - - -- - - -
Under Slab
Top Out --
Water Service
Sanitary Sewer - --
Rain Drains
— --------------------—
Final
PASS PART FAIL
MECHANICAL
Post&Beam - - - --
Rough In
Gas Line
Smoke Dampers
Final ---- -----
PASS _PAR FAIL
�KEETRI --- --
Service
Rough In -
_ UG/Slab
Low Voltage -- _--
a:
F- ..ire Alarm
—
F_ PASS PART FAIL
c. Backfill/Grading —
Sanitary Sewer
111 Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
J
Catch Basin i
ll f
Fieuse call reinspection RE:
Fire Supply Line [ J p — ( J Unable to Inspect no access
ADA
Approach/Sidewalk Date
Other .S Inspector _Ext
Fina
PASS PART FAILJ DO NCT REMOVE this inspection record) fr,,)m the job site.
---
ELECTRICAL_
-- ELECTRICAL PEPI',IIT
PE'RMIT #: ELC96-0551
.
CITY OF TIGARD DATE 15SUED: 08/22/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171 A R C I`*.A_: 1 S 125 DA-Q)81)0 3
IT E i-i D D I:R E 5 S 0 93 b 0 SW -101 H 0 V F.
,)JBDIVISION. KINGS VIEW Z ON I NG:R-4. 5
,-0 C:K. I . . . . . . . . LCAT. . . . . . . . . „ . . . :63
noject Description : NEW DIRCINCI-A CIRCUIT AND ONE ADDITIONAL
UNIT------ -•---TEMP' SRVC/FEEDERS---- --------MISCELL.ANEOUS-------
iOOO SF OR LESS. » . . : 0 0 200 amp. . . . . . . : 0 PUOP/IRRIGATION. . . . 1 0
EACH ADDIL 500SF. . . : 0 201 40171 amp. . . . . . . : 0 SI(7N1/OUT LINE LTG. . - 0
LIMITIED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . " Q,
MANF. HMI SVL:/F-DR. . - 0 601+amps-1000 volts. : 0 MINOR LABEL. ( 10) . . . C 0
----SERVICE/FEEDER---- -- ------BRANCH CIRCUITS----- ---ADU' L INSPECTIONS—-
200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . % 121
AIDUR. . . . . . . . . . . .* 14
0 PIE R I
L I s t W/0 5 R V C 0 R 1:�'D R. : 1
401 - 600 `imp. . . . . . : 0 EA ADD' L BRNCH CIRC: I IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTIOV------.-.._..__..__._._-_.-._.
1000+
-----------------
1000+ amp/volt. . . . . : 0, > =4 RES UNITS. . . . . » . . : ) 600 VOLT NOMINAL. . :
keconnect only. . . . . : 0 SVC/FDR ) - 225 AMPS. . : CLAGS AREA/SPEC DLC. !
Owner... FEES
Ci. I-,, HI:LI_ type AIR01.111t Ly date recpt
1350 SW 70TFI f-*,RMI* $ 40. 00 it',11H 08/2E:/96 96-283184
5 P C T 2. 00 jIyIH 9628316,1
J:GAPI) OR 072,23
none #:
ontractorm ------------------------------------------------------------------------------
KLLIAM OYALA $ 4a. 00 TOTAL
j')47.-:,) YARMER LANE
------- REQUIRED INSPEC-rIONS
5T 1AELENS ROAD OR 97051 Ceiling Cover Elect' l Service
"hone 8: 503-366-0521 Wall Cover Elect' l Final
1ierj
This permit is issued sub)ect to the regulations contained in the
Tigara Municipai Code, State of Ore, Specialty Codes and all other Permitted- Signat Ltre
applicable laws. All work will be done in accordance witn
approved plans. This permit will expire if work is not started
within 16@ days of issuance, or if work is ispendpa for more C'.4414.1-
than 180 days. sued By
-------- -.-.__..___--___..-.-__.._..__..OWNER
no installation is being made an property I own which is not intended for
i,A 3.e. I o a s(?, or, rent.
-WNERIS SIGNATURE: -------- DATE:
CONTRACTOR INSTALLATION ONLY----------
&NATURE E
OF SUPR. LL1101 N: DA f'E
I CENSE NO:
Call for inspection -- 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued
Phone (503) 639-4171
CITY OF TIOARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-0175
1. Job Address: V 4. Complete Fee Schedule Below:
/ 1
Name of Development �'�. �7{r Number of Inspections per permit allowed
Address y3 '�� Service included: Items Cost(ea) Sum
City/State/Zips d ��d� 9 X� 4a. Residrntr,d -per unit
1000 sq, ft or bss $110 G0 4
Name (or dame of business)__ Each on tIhee 590 sq.N.of —
portion rnof $25,00
Limited Energy $25.00 1
Commercial ❑ Residential Each Manufc H)me or Modular
Dwelling Si Rice or Feeder $68 Q0 2
2a. Contractor installation only:
4b. Servicr s or Feeders
� Installation,alteration,or relocation
Electrical Contractor �/u " a ��v// 200 amps or leas $80.00 2
Address 7 r,r,r r i-I 201 amps to 400 amps 120:20.0000 2
,
City C r, �State C: r Zip C L 401 amps to 800 amps 601 amps to 1000 amps $also 00 2
Phone No. 0 3 - Vit! -�� Over 1000 amps or volts $340.00 _ 2
9 Reconnect only $5000
2
Job NO. --1 ��--
contractor's license NO. --I 4c. Temporary Services or Feeders
Contractor's Board Reg. No. - � Installation,alteration,or relocation 2
Signature of Supr. Elec'n 2U0 amps or less 2
201 amps to 400 amps $50.00
License No. 77S one N .5a3 364'-��.Z 4G1 ampa,osoGamps :7500 2
Over 800 amps to 1000 volts $10000
2b. For owner installations: see„b„above.
4d. Branch Circuits
Print Owner's Name New,alteration or extension per pane
Address a)The fee for branch circuits with 2
City State Zip
purchase or service or feeder fee.
Each branch circuit _ $5,00
Phone No. b)The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee.
First branch circuit $3500 ,O
not intended for sale, lease or rent. Each additional branch circuli $5.00 S_ a G'
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or IrrigatioEach-Ign or outline liglig circle :40.00 _
hting ,_ $4000 2
Signal circud(s)or a limited energy
Please check appropriate itemand enter fee in section 5B. panel,alteration or extension $4000
4 or more residential units in one structure Minor Labels(10) :100 00
_Service and feeder 225 amps or more 4f. Each additional Inspection over
System over 800 volts nominal the allowable In any of the above
Classified area or structure conWiting special occupancy per Inspection $3500
as described in N.E C Chapte 'i Per hour $5500
In Plant $5500
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary co latruction services. 5. Fees:
5a. Enter total of above fees E � ATO
NOTICE 5%Surcharge (.05 X total fees) 3
L) Subtotal $
J PERMITS BECOME VOID IF WORK OR CONSTRUCTION Fb. Enter 25%of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review If required (Sec.3) $ •�'�V
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. ❑ Trust Account R g
mm /
Balance Due
MASTER PERMIT
CITY Cali T I CA RD PERMIT a#. . . . . . . : rl T94-030!i
COMMUNITY DEVELOPMENT DbPWR_flthT DATE ISSUED: 08,104/94
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL: IS125DA-08903
':-ITE ADDREGS. . . - 09-150 SW 70TH AVE
SUBDIVISION. . . . : KINGS VIEW ZONING: R-4. 5
BLOCK. . . „ . . . . . . : LOT. . . . . . . . . . . . . :6,3
BUILDING
REISSUE: DWELLING UNITG:O BASEMENT. . .. . . . . . :0 Sf
;.LASS OF WORK. -ADI) BEDRMS:O SATHS:0 GARAGE. . . . . . . . . . .0 S f
TYPL OF USE. . . :5F FLOOR REQUIRED SLTBACIAS-
TYPE OP." CONST. :5N FIRST. . . . :320 5f LEFT. . :9 ft RIGHT. :0 ft
OCCUPANCY bRP. :R3 SECOND. . . :0 r5 f FRONT. :50 ft REAR. . :0 ft
STORIES. . . . . . . :0 THIRD. . . . :0 S f REQUIRED-_-______.___________..
HEIGHT. . . . . . . . - 0 ft s SMOKE DETECTGRS.
FLOOR LOAD. . . . :60 ps-F VALUE. . . . . 1500 PARK 1 NG SPACES. . 0
Reinarks : ADDITION OF A DECK 3L0O GO FT
PLUMBING
S I NKS . . . . . . . . . :0 FLOOR DR(IINS. . . . :0 BACKFLOW PREVNTRS. . :O
LPVATORIES. . . . . :O WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :0 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WOTE'i CLOSETS. . :0 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
D IS';WASHERS. . . . :0 WATE*R LINE (ft ) . :0 OTHER FIXTURES. . . . . :0
GAROAGE DISP. . . -0 RAIN DRAIN (ft ) . :0
WASHING MACH. . . :0 SF RAIN DRAINS— :0
MLCHANICAL FEES ---
FUEL. UNIT 1—IT—RS.. :0 type a rn 0 1.(n t by (late recpt
VENTS . . . . . :0 BPRT $ 2'5. 00 JG 08/04/94
—
MAX INPUT:0 BTU VLNT FANS. . :0 BIDL.G $ 16. 25 JF 08/01/94 94-25507(,
TURN < 100K . . :0 HOODS. . . . . . :0 B5PC $ 1. 25 JG 08/04/94
FURN ) =1001-, . . :0 WOODSTOVLS. :0
FLOOR FURN. . . . :0 CLO DRYERS. : 121
BOIL/CMP ( 3HP:0 OTHER UNIT':'):Vl
GAG OUTLETS:0
Owner, :
RICHARD & JANA PATTERSON
SW '701-1-1
TIGARD OR 97223
[-",hone #. 5914383
CONTRACTOR NOT ON FILE
':,hone #.-
Reg #. .
$ 42. 50 TOTAL
Ln This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all other- Foot/fol_tnd Insp
applicable laws. All work will be done in accordance with, approved Post/Beam Strl.lct
vians. This permit will expire if work is not started within 180 Framing Insp
days of issuance, or if work is suspended for more than 180 days. Bi.tildinq Final
Erosion Control
d D <,S
Call for inspection 639- 4175
_J
A
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 634-4171
Jobsite Address:
Office Use Only
Subdivision: Xlt-i Lot# _
Planck/Rec # -t
Valuation: ���_�� ✓
Permit # &5f 3 G
Cosner Lot? Y
Reissue of
Flag Lot? Y IJ
Map & TL #
Owner: � n����t�VSI�— A i rovals Required
Address: 5� Planning
fes_
677-73 — Engineering
Phone: Z`12 k a -- O,her
Contractor: Items Reguired
Address: Subcontractors
Truss Details
Fhone: —.. Other
Contractor's License # _
(attach copy of current Gi egon 4cense)
Contact Name & Phone:
Subcontractors: Architect/Engineer:
i lambing _ Address:
Mechanical: —
"' (attach copy of curant OR Contractor's License)
Phone: — _ -_--
JOB DESCRIPTION:
J
Applicant Signature & Phone number /
Received bj;,.,,i/? __ Date Received: 4 ``�7 _
N WORMCOMOEMESAPP
Permit# Account Description Amount .pmt. Pd. Pw. Due
tL L) Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) _
Mech. Permit (MECN)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
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)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O) _
Water Quality (WQUAI_)
Water Quantity (WQUANT)
Firf. District (FIRE)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN) _
TOTALS: �� '
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