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CITY OF TIGARD BU,LDING INSPECTION DIVISION MST
24•-Hour Inspection Line: 639.4175 Business Line: 639-4171
13UP
Date Requested "! "6 'L79 _AM PM _ BLD
Location f Suite MEC
Contact Person _ );I a4✓1 50k� _ ( Q C• Ph _ r `/ < "ice PLM _
Contractor Ph SWR n
BUILDING -�- Tenant/Owner ELC C79 :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 PART FAIL
P_CTRIC
---------
Rough In
a UG/Slab
CC Low Voltage
Fire Alarm '
PART FAIL �T -
E
Backfill/Grading '-
w Sanitary Sewer
'J Storm Drain ( ]Reinspection fee of$_ required before next InspeLlIon. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin i
ll f
Please call rens ectlon RE:
Fire Supply Line ! p [ ]Unable to inspect-no access
ADA
Approach/Sidewalk Data
Other '�" -�' ,��� Inspector s. -,.c.�.�' Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
ELECTRICAL PERMIT
PERMIT#: ELC1999-00194
DATE ISSUED: 4/6/99
PARCEL: 1 S136AD-02501
SATE ADDRESS: 10570 SW 71ST
SUBDIVISION: VILLA I•7GE ZONING: R-4.5
BLOCK: LOT : 004 JURISDICTION: TIG
Proiect Description: Installation of 1 200 amp or less service or feeder.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS_ _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 600 amp: SIGNA'_IPANEL:
MANF HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LAEEL (10):
SERVICE/FEEDER BRANC'-I CIRCUITS _ ADD'L INSPECTIONS
0 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION —
1000+ amp/volt: — >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect oniy: SVC/FDR >= 225 AMPS_ CLASS AREr JSPEC OCU:
Owner: k-JALLPr(`-`, �-10Rt ti Contractor. r i S L r C7 g, C_
1c15-7o b,-, 71Stc- t
�44 � �w �,A2P���2 &J'�:)
TCcRR�i C-'f- P6P-TLAN� c,2 97;;Lr7
Phone: Phone:
Reg #:
_ FEESRequired Inspections
Type By Date Amount Receipt Rough-in
—I
Service
PRMT DRA 4/6/99 $60.00 99-314270 Elect'I Final
5PCT DRA 4/6/99 $3.00 99-314270
Total ^$63.00 _
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 days of issuanoe,or if work is
suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility N tification Center. Those
rules ar> set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503)
?46-1987
Permit Signature: �, Issued By: y l
OWNER INSTALLATION ONLY
,_- I he installation is being made on property I own which is not intended for sale, lease, or rent.
w OWNER'S SIGNATURE: __. DATE:
CONTRACTOR INS>I ALLATION ONLY
SIGNATURE OF SUPR. ELF_C'N: _� = _ DATE:
LICENSE NO: — --
Calll 639-4175 by 7:00pm for an inspection the next L rsiness day
CITY OF TIGARD Electrical Permit Application Plan ChQdCW--1N z-
'13125 SW HALL BLVD. Recd B
Date Recd
TIGARD OR 97223 _
Date to P.E.
Phone (503)639-4171, x304 Date to DST
Inspection (503)639-4175 Print or Type permit# F L� /y s 9-
Fax(503) 598-1960 Incomplete or illegible will not be accepted Called _
1. Job Address: 4 Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
N,-me(or name of business) L1-1 L'I-0 r` _. ' Service included: Items Cost Sum
Address4a, Residential-per unit
_ 1000 sq.fl.or less $110.00 4
City/State/Zip Each additional 500 sq,ft.or
portion thereof _ $25.00 _ 1
Commercial ❑ Residential❑ Limited Energy $25.00
Each Manufd Home or Modular
Dwelling 3ervIGe or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b.Services or Feeders
`,, installation,alteration,or relocation c?e9
Electrical Contractor /c .Ye S c2r s ___ 2.00 amps or less $60.00 '/2
Address 4 ` - T 201 amps to 400 amps $80.00 2
City State / _Zip r� 2 !� 401 amps to 800 amps __ $120.00 2
Phone No. �� ' }" c� 601 amps to 1000 amps $180.00 2
.lob No. Over 1000 amps or volts $340.00
Elec. Cont. Lice. No. , 'G ��f�'C Exp.Dat@ l-'GJ Reconnect only - $50.00
OR State CCB Reg. No. F>5 S3 ! Exp.Date '!LL,62t 4c.Temporary Services or Feeders
COT Business Tax or Metro No49 pZExp.Date Installation,alteration,or relocation
200 amps or less $50.002
�r 201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n ": z t -� 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. %' S Exp.DateZ _ - L,/ sae11b"above.
Phone No. 4d.Branch Circuits
New,alteration or extenslon per panel
2b. For owner Installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name, feeder fee.
----- Each branch circuit
_ $5.00 2
Address b)The fee for branch circuits
City_ State 7_ip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit- $5,00 2
intended for sale, lease or rent. 4e.Miscellaneous
(Service or feeder not Included)
Owners Signature _ Each pump or irrigation circle $40.00
Each sign or outline lighting $40.00
3. Plan Review section (if required):'
Please check appropriate item and enter fee in section 5B. 4f.Each additional Inspection over
n_ 4 or mure residential units in one stru-ture the allowable In any of the above
r Service and feeder 225 amps or more Per Inspection $35.00
rn --
System over 600 volts nominal Per hour $55.00
_Classified area or structure containing special occupancy In Plant $55.00
J as described in N.E C Chapter 5
5. Fees:
r Submit 2 sets of plana with application where any of the above apply. 5a.Enter total of above fees $
LLC Not required for temporary constnrction services. 5%Surcharge(05 X total fees) $ f
Subtotal $
NOTICE 5b.Enter 25%of line 5a for
Plan Review if required(Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account# r`.• C
TIME AFTER WORK IS COMMENCED Total balance Due $
I:\DST\F.LEC98.D0C REV 4/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
_ BLIP Requested_ ��4'1 - - �l h AM �'� _PM BLD
Location �Vj 7Ll S�/`-t Up Suite MEC J n
Contact Person Ph PLM 1--l"ai '��1 S
Contractor Ph!- SWR
BUILDING Tenari/?v�nel
t � In�l��G'[x'_ ✓ >l��-- ELC
Retaining Wall ELR
Footing Access:
Foundation FPS _
Ftg Drain I SGN
Crawl Drain I inspection Notes:
Slab __ __ SIT _
Post&Beam ��—
Ext Sheath/Shear _
Int Sneath/Shear
Framing _
Insulation
Drywall Nailing
Firewal!
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: ---- -
Final
PASS PART_ F-AIL — ---------- ------ -_.-_-
-UM
Post&Beam
Under Slab
Top Out
vualer-S.�tYi�
Sanitary Sgw-r ---
r s
PART FAIL
E HANICAL _
Post&Beam -
Rough In
Gas Line
Smoke Dampers R
Final __- _______
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of$ _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ I Please call for reinspection RE: [ ]Unable to Inspect-no access
'vire Supply Line
ADA
Approach/Sidewalk Date Z12 Inspector— Ext
,Other
Final
PASS PART FAIL 00 NOT REMO this inspection record from tttie job site.
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125SNall RI- Tigard,OR 97223(503)639-4171 PERMIT #. . . . . . . : PLM99--0095
DATE ISSUED: 03/31/99
PARCEL: 15136AD.-012,501
SITE ADDRESS. . . . 10570 SW 71ST AVE
SUBDIVISION. . . . : VILLA RIDGE ZON f NG: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :004 JURISDICTION: TIG
CLASS OF WORK. . :AL.T GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . - 0
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 I-RAPS. . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES----------------- LAUNDRY TRAYS. . . . ., : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . - I
TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 100
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . , : 0
PpmArl-(s : Alteration to water service.
Owner: FEES
WALLACE MARTINI type amoLint by date recpt
10570 SW 71ST PRMT $ 39. 00 DLH 03/31/99 99-314128
TIGARD OR 97223 5PCT $ 1 . 95 DI-H 03/31/99 99-314128
Phone #: 1245-9157
CROUCHLEY PLUMBING
8717 N LOMBARD ST
PORTLAND OR 97217 -----------------------------------------
Phone #e 503-286-4431 $ 40. 95 TOTAL
Reg 0000 t I
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Get-vice In
Tigard Municipal Cnde, State of Ore. Specialty Codes and all other Top.--ol-it Insp
applicable 13"s. All work will be done in accordance with Final Inspection
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. ATTENTION: 'Iregon law requires ynu to follow rules
adopted by the Oregon Ut,lity Notification Center. Those rules are
set forth in OPR 952-00b1-00I0 through OAR 952-0001-0080. You may
obtain copies of these rules or direct questions to OIJNC by calling
(503)2,46-1387.
4
I s s i-t P d By : Permittee Si gnat urO4-7::!:Vr-
0
4..........+++++4+++-4-++-#-+++4.++++++•..+++++f-++++++++++++++++++++++.1++++++++++
Call 6313-4.175 by 7:00 p. m. for an inspection needed the next bi-Isiness day
++++++++++++++++++++++•++++++++++++++++++--+++++++++++-+-+-4-++-f-+-4-++-h+++++++++++++++
,/98 TUE 15:06 FAX 503 51.8 1960 c I'I'1' (11" 'f I c.',RD Z002
OF TIGARD Plumbing Permit Application Plan Check It
25 SW HALL BLVD. Commercial and Residential Reed 0y__���
iGARD, OR 97223 Date Recd
(503) 639-4171G� Da'e to P.E.to
-- --
Print or Type I / emDate nit#
DST _
Incomplete or illegible applications will not be ac',epted R
Related SWR#
Called
Nemo of DevelopmenUProjed FIXTURES,.(ipdiYtdual)'� ?rk QTY { 1t?RICE ;AMT
Job Sink 9.00
Address Street Address Suite Lavatory _ 9.00
b S' 7 O S w y Tub or Tub/Shower Comb. 9.00
Btdg# City/State Zip 9.00
Shower Only
ri a r2J 5 7'2 •.,3' ___�_..
-- ---- - -Z Water Closet 9.00
Name
Vet L Z-a G e 7-/ A; Dishwasher _ 9.01
Owner Mailing Address Suite Garbage Disposal 9.01,
- Washing Machine 9.00
City/State ip Phone Fluor Drain/Floor Sink 2" 9.0u
3" 9.00
Name .?y5- 91-5 -
� 4" 9.00
Occupant Mailing Addrriss Suite Water Healer O conversion 0 like kind 9.00
_ Gas pipin2 requires a separate mechanical peimil.
City/State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Name t/G �1• P L13 � U Other Fixtures(Specify) 9.00
9.00
Contractor MellintrAddress Suite
? �Z N, ►�. t J 9.00
Prior to permit City/State Zip Phone So_T sower-t sl 100' 30.00
issuance,a copy 37-1_0 C 2 ?'710 Op6-V T 1 Sewer-each additional 100' 25.00
of all licenses are Oregon Cry.Cont.Board Lic.• Exp.Date
, O
reqult.ed if - - / Water Service-1st 100' 30.00
expired In COT Plu In LIC.0 Exp.Dale Water Service-each additional 200' 25.00
database Storm 8 Rain Drain-1 at 100' 30.00
Name Storm 8 Rain Drain-each additional 100' 25.00
Architect _ Mobile Home Space 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollullon Device
Engineer City/State Zip Phone TT Residential Backflow Prevention Device' 15.00
llrrigabon timing devices require a separate
Describe work to be done: restricted energy peermIt.)
New O Re alr)O Replacewith like kind: Yes 0 No Any Trap or Waste I. 'onnected to a Fixture 9.00
Residential Commercial O _ _ Catch Bann J 9.00
Additional description of work:nI,sp.of Existing Plumbing 40.00
i cpGact_
wa. 7� • t G 2 v. e- t_ er/hr
r r r W W °"4 e- `''Z 4k 719/LT Specially Requested Inspections 40.00
r -r/,!- V e `✓4- perll,r
Rain Drain,single faotlly dwelling 30.00
Are you capping,moving or re lacing any fixtures? Grease Traps 9.00
Yes O No
If yes,see back of form to incl ate work perfonned by QUANTITY TOTAL ! "
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is mquired I QuantAy Totalis >o
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL
I heroby acknowledge that I have read this application,thet the information
given is correct,that I am the owner or authorized agent of the owner,and 5%SURCHARGEp�
that plans submitted are In compliance with Oregon Slate Laws. /
_ " `' "
9lgnaturd of Owner/Agent Date "PLAN REVIEW 26'x6 OF SUBTOTAL
Required only w Gdurc qty.tocol I.>D �F
TOTAL }:, � :r•.
Contact Person Name Phone
•Minimum permit too is$25+5%surcharge,except Residential P_ackliow
Prevention Uevlce,which is S15 f 5%surcharge
"All Now Commercial Buildings require plans with isometric or riser diagrar
and plan review
l%dstslplumapp.doc?nM