12465 SW 72ND AVENUE ADDRESS:
OD
n
L
1-
J
G7
J
is\records\microflm\targets\building.doc
E
%
2
� V)
\/ \_
e ; § §
2\ f
`
\{ 2
` f � )
z
[ ) a \ a a a a
� e a ~ * ¥ + a
7 z z O� z Ir Ix
7CO i i § § 2 § J
_
} \
C%4
co
to o g = m m m
C) $ o f = z m E
9 a $ ( ƒ ƒ ƒ 7 <
CD
0 /
U
-j /
, ]� c m = y i in § ]
� ] �
m f/ \
$ ) \
2 %
j \
. $ r4
o f
u
a a a a
k a a > a
§
§ § 7 e _ \ i 3
k \ ƒ ! c (
}
« / ° } I m w E e r
@ @ \ G R m / 8 \
\ \ ) ) \ \ \ \ \
« g u 2 w u m E
v
r
0
z
'o
� rn rn rn rn rn rn
a
a3 Cd rn
a
d G G O
V 00
M
v w
0w
TJ
co
UM
CL 0 En cn N in
4 0 a a a a a
I,,-
T c
U m
W o 0 0 o Z
*k c C o
0�
y a" rn
U
M CN � � �
w C
N N
Q
o � CN
i
o
N cl
L •S. a (i j
�.: u
JaIL
id
rn rn a LL U
C) ch n
J J
W W W LLl
Cc
c
c
ro
n.
0
p
N
P
Oyl �
O Q
92 U-
0 aro
M t7
c0
V
d
CL
v m
o w
=J
N
00
O
O d
N V)
9i D rai a
a
m
O c0 LoCDa
M c 0
p O
N R U)
� m
L a0 O
Q o N
() CJ
A
+r
U v
Q o
a
H
N
>
In is
.. m
LO n U
J a. ° a a
rn v
�. o 0
in N Q
0 O
3 &
0
L
%{ L
)% R
S )� \
= ae
2 w [ §
] a)
\ 0
\ k j k k k k k k
_ ¥ § ~ a + a a a 3 a
\ / { ƒ » § { § { \ (
CL = _ `
_
7\
CD
0
J o
CL§ ) \ \ \ \ \ } \
�
/
U �
� j § § \ §§ / / §
�
\ 0 \
m ,
$ \
CL
/ k k k k k k k k k
O ] 3 § ( a a a a a 3 a
$ ®
.± m
� o
.�
� - � �
@ a a a a a a a a
o § 3 3 \ § 5 § 3
�
@
/ 7
c f . / ( m E {
�
f ) { j ) \ \ \ \ { c
°
Cl.
I � \ V) \
EIL 9 < ) 4 2 ƒ / 0 2 E G
7 w c
f k k { ® \ ` N k k \
% w 2 ) § § Q� � § ) \ w
£
�\/
k0
b« a
ƒƒ%
»
Q)CL J \/ E
k H
. $ m # § $ § $ m
$� j \ \ j § § ) ) } § / k
�
�>
)\
C%j
T-
cL
�
CD j j } }} \} ( \\
m
_ = L � / / 9 )/ (
2m
� � 7
@
ID $ m $ S $ $ S t ¢ aS9 / a
\ § \ § § f § § §
$ 2
� o
:
Q �
0
3 k b
/ ) c \
« E 2 [
2 t ) f ; f
cz § 7 k \ I k a » k / 2
'oj ) § ( \ \ ƒ / c m ° ƒ
c ` '[ t c
k
a ° CL
/ f ) ) } ) LL � j E E
2 § § 2 ~ ° @ ® g 2 co 2 2 m
2 f k k@ k ) 2 N. § 2 k 2
a & 2 ( Y) G in Lo 2 q) in 2 rn 2 Y) in
� � � � � � � � ■ � � � ,
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-E1our Inspection Line: 639-4175 Business Phone: 6394171
lG_ G
Date Requested: �1 `/ , 7 A.M. P.M. MST:
Location: 2 BUR
Tenant: Suite: Bldg: _ MEC:
Contractor. ,a— � Phone: � '' �70 PLM:
_ _ `Z;Owner:— _ Ph e: '" ELC: 015 IF-71-,
. .
A 1/1 , SIT:
BUILDING BLDG(coni) PLITMING. MECHANIC ELECTRICAL SITE
Sate Post/Beam Pos;/ticam over,e • Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Linc ough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr --MeiaPurnp Low Volt
Approved Approved <4ve pproved \ Approved
Appr/Sdwlk Not Approved Not Approvedoved Not Approved
FINAL FINAL FIN L INAL FINAL
r
n:
1.
J
G7
C7
111
CI Call for reinspection qQnspection fee f S,6_ required before next inspection D Unable to i t
In4pector: )f-c�:Imemtc __ Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
C/
�
Date Requested: _ _ - — / A.M. _ P.M. MS'r:
Location: ��-� �S ��L(J a / _ BUR 2
Tenant: Suite:—
Bldg: MF.0 / 7-03 0
Contractor. 1 QLl!►�J-� Phone: c0 � PLM:
0%"icr.! _ QJ _ it _Phone:4,9, ;2-704
ELR:
srr:
BUILDI►4G BLDG(coni) PLUMBINGELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Watcr Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Ileat Pump Low Volt
Approved Approvedrov Approved Approved
Appi.S«wlk Not Approved Not Approved oved Not Approved Not Approved
FINAL FINAL. FINAL IINAL FINAL,
a --
Cr
H-
Ln
J
►r
cc
C7
LL) _
O Call for reinspection O Reinspection fee of S prequired before next inspection O Unable to inspect
Inspector: �_ mate: !" .S''r 7 Page of
CITY O TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: `LC97-0589
DATE ISSUED: 08/28/97
13125 SW Hall Blvd., Tigard, OR 97223 (503)639 4171
PARCEL: 2SIOIRB-01900
SITE ADDRESS. . . : 12465 SW 72ND AVE
SUBDIVISION. . . . :HERMOSJ PARK ZONING:MUE
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 15 JURISDICTION: TIG
P'r•oJect Descr-iption : Add two (2) branch circuits to existing single family
dwelling.
----------------------------------------------
---RESIDENTIAL UNIT----- ----TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-----
1000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/IPRIGAT ION. . . . : 0
EACH ADD' L 500SF. . - : 0 2't1 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0
MANF. HM/ SVC/FDP. . : 0 60i.+amps-1000 volts. : 0 MINOR 1-ABEL : 10) . . . : 0
----SEP''ii-:E/FEEDER---- -----BRANCH CIRCUITS----•----- ---ADD' L INSPECTIONS---
0 - 200 amp. . . . . . : W/SERVICE OR FEEDER: 0 F'ER INSFIECTIO14. . . . . : 0
x'01 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUP. . . . . . . . . . . : 0
401 - r,00 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION------------------
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMP'S. . : CLASS AREA/SPEC OCC. :
Owner: -------------------------------------------------------- FEES
GARY WOOD type amorint by date r-ecpt
12465 SW 72ND AVE F'RMT L 40. 00 GEO 08/=8/97 97-298745
TIGARD OR 97223 5PCT $ 2. 00 GEO 08/28/97 97-298745
Phone #:
Corr r-actor,: -__-__-_---------.__-------___-._
----.-------------------•-------.--------
WESTSIDE ELECTRIC 42. 00 TOTAL-
7518 SW MACADAM AVE
REQUIRED INSPECTIONS - --
POR71 AND OR 97:'19 Roi_igh-in Elect' 1 Service
Phone #: 245-3385 Undergror_md Cove Elect' l Final
Reg #. . : 000133
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work �s not started within 180
days of issuance, or if work is suspended for more than 199 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Tho,e rules are set forth in OAR 952-991-9919 through OAR 952-001-1987. you may obtain a copy
of these rules or direct questions to OUNC by cairing (593)246-1987.
JPer,mi.ttee Signat!rrP : ��l ___ Issr-red BY _-_
n•
v~ - ---------------------------OWNER I14STALLAT ION OK Y---------
Ine installation is being made on property I own which is not intended for,
sale, lease, or- rent.
=-' OWNER' S SIGNATURE: DATE:
-------------------------CONTRACTOR INSTALLATION ONLY--- --- ---------- - - -
SIGNATURE OF SUPR. ELEC' N: _ f Cr' DATE: ���! ...__. .z .._._....
LICENSE NO-
4--++++4............#-++++4 4.........................4............... ++4............4
O:+ ++++-F++++++++++-r•+++++++++t++++++++++++++++++++++++++++++++++++++++.++++++++++++
Call 639 -4175 by 6:00 P. m. for an inspect ion needed the next bl_rsiress da
+ � 1 + +++++++++++ +++++++++++++++++++++++++++++++;•4++++++++++++++++++++++++-r+++++
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd
Phone (503)639-4171, x304 Date to P.E.Date to DST
Inspection (503) 639-4175 Print or Type Permit#fGC 177 -O7F x9
Fax (503)684-7297 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
Name(or name of business) k22 ,�i,cr._ C nX 17Service Included: Items Cost Sum
Address
1,2 4a.S� �Gv/ 7� L ���7 4a. Residential-per unit
/ ; %� <!� [. %/ < < 3 1000 sq.ft.or loss $110.00
City/State/Zip 1
may-- Each additional 500 sq,ft.or
Commercial ❑ Residential El portion thereof $25.00 _ t
Limited Energy $25.00 _
Erich Manuf'd Home or Modular
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
(Attach copy of all curre i Iicpnse� J/� / C 4b.Services or Feeders
Electrical Cont actor 1 iC/ (e �rj �j Installation,alteration,or relocation
�T- j� 200 amps or loss $60.00
Address � _ v'/ ii7��< ��„ r•r' - 2
�--, 201 amps to 400 amps i $80.00 _
City ! ��ir( ` State L rE Zip 7cr/c� 401 amps to 600 amps $120.00 2
Phone No C C! 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00
Elec.Cont. Lice. No._. Y / Exp.C)ate - Reconnect only $50.00 2
OR State CCB Reg. No. <' Exp.
Date
J L �_Ex Date 4c.Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation,alteration,or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n ` ) 201 an ps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr / ( -1 Exp.Date see"b"above.
Phone N,
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch c!rcuits with
purchase of sonic@ or
Print Owner's Name _ feeder fee.
Address Each branch circuit $5.00 2
b)The fee for branch circuits
City State Zip without purchase of
Phone No. _ service or feeder fee.
First branch circuit / $35.00 3 2
The installation is being made on property I own which is not Each additional branch circuit $-oo 2
intended for sale, lease or rent. 4e.Miscellaneous
Owner's Signature---- (Service or feeder not Included)
g Each pump or Irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s)or a limited energy
panel,alteration or extension $40.00 2
Please check appropriate Item and enter fee in sec+ •n 58. Minor Labels(10) $100.00
4 or more resident'al units In one structure 4f.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
t- System over 600 volts nominal Per Inspection $3500
`n Classified area or structure containing special occupancy Per hour -- $55.00
as described in N.E.C.Chapter 5 In Plant $55.00 _
*Submit 2 sets of plans with appllcat!on where any of the above apply. 5. Fees:
cc Not required for temporary construction services. 5a.Enter total of above fees $
4 5%Surcharge(.05 X total teen) $
NOTICE Subtotal $
5b.Enter 25%of line So for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reaulred(Sec,3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Sub al $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. Trust Account#
Total balance Due t
VnsrsEWIC,Ailr new aw,
CITY O TIGARD MECHANiCAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
PERMIT #. . . . . . . : MEC97-0-09
DATE ISSUED: 08/15/97
PARCEL: 25.101 AR-01900
SITE ADDRESS. . . : 12465 SW 72ND AVE
SUBDIVISION. . . . : HERMOSO PARK ZONING: MUE
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1; JURISDICTION: TIG,
---------------------------------------------------------------------------------
CLASS OF WORK. . :OTR FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . - 0
OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOIL..ERS/COMP RESSORS HOODS. . . . . . . : 0
FUEL TYPES----------t 0-3 HP. . . . : 1 DOMES. INCIN: 0
-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: e B"fU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS---- ----- - AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 1O0K BTU: 1 (- 1.0000 cfm: 0 GAS OUTLETS. : 1
FURN > =1O0K BTU: 0 > 10000 cfm : 0
Remarks : replace existing gas furnace and add new a/c unit.
Ownev: ------------------------------------------- ---------- FEES
GARY WOOD type amot_int by date t-er-pt
12465 SW 72ND AVE PRMT $ E5. O0 GEO 08/15/97 97-29832'6
TIGARD OR 97223 5F!CT $ 1. 25 GEO O8/15/97 97-298326
Phone #:
Contractor': ---_----.-________--------------
COLUMBIA HEATING R COOLING INC
PO BOX 230397 __.__._.-_---_.-_-_____---_-_.
$ ;R6. 25 TOTAL
TIGARD OR 97223
["hone #: 624-2704
Reg #. . : 00076.3
---- --- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line I n s p
Tigard Municipal Code, State of Ore, Specialty Codes and all other Mechanical I n s p —_.__.__
applicable laws. All work will be done in accordance with Heating Unt Iinsp
approved plans. This permit will expire if work is not started Cooling Unt Insp
within 188 days of issuance, or if work is suspended for more Di_ict Inspection
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. Inspection
adopted by the Oregon Utility Notification Center. These rules are Final Inspection
set forth in OAR 9524,11-0810 through OAR 952-801-8080. you may
v- obtain copies of these rules or direct questions .:0 9UNC by calling
(583)246-9197.
el
J
Isso-(e By: Permittee Siynat�t�¢t
(
+++++++++++++++++++++•++++++++++++++++++++++++++++++++++. +++++++++++++++++++++
Call 639-4175 by 6:00 p. m. for inspections needed the next bi.tsiness day
++++++++++4++.+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++4+++
Plan CheCK#
CITY OF TIGARD Mechanical Permit Application Recd Ey
13125 SW.HALL BLVD. Commercial and Residential Date Rec d
TIGARD, OR. 97223 Date to P E
(503) 639-4171, x304 Date to DST
Print or Type Permit tt / E(f q-1-0 :50
Called
Incomplete or illegible applications will not be accepted
Namo O/evIeioprnent Projed Description
L u 1 \1
I Table to Mechanical Code QTY PRICE AMT
,lob Street Address I Suiten Al Permit Fee -0- -0- 1000
Address / 9 r7)
Bidge Cd state Zip 1 ) Furnace to 100.000 BTU ' 6,00
including ducts 3 vents
Name for name of business) 2.) Furnace 100.000 BTU* 750
Owner on including ducts&vents
Mailing Add ess � 3.) Floor Furnace 600
r^ including vent
CrState Zip I Phone 4) Suspended heater,wall heater 6.00
Qr• or floor mounted heater
Namd is name of business) 5) Vent not included in appliance permit 300
Occupant Mailing Address 6) Boiler or cornp.heat pump,air cond I 6.00
to 3 HP:absorb unit to 100K BUT" (O•��
yr5tate Z p Pnone 7) Boder or comp,heat pump,air cond. 11 00
3-15 HP,absorb unit to 500K B rU'•
Contractor N e 8) Boder or comp,heat pump air cond 1500
(Prior to I I(0 bI lcla+1 d L� 15-30 HP:absorb und.5-1 and "
BTU
issuance ding Address U 9.) Boder or comp,heat pump,air cond 22.50
applicant C9 30-50 HP absorb unit 1.1 75md BTU"
must provide all cityiistate Zip Phone 10.) Boder or comp,haat pump,air cond 3750
contractor (ii) ( >50 HP ahsorb unit 1 75 and BTU" _
license Oregdn Const.Cont.Board Lic 0 Exp Date 'i11.) Air handling unit to 10.000 CFM 450
information y J" /O.-.a_<
for COT C Tusiness Tax or Metro a Exp Date 12) Air handling unit 10.000 CFM 750
database) _ —(
Architect Name 13 ) Non-portable evaporate cooler 450
or Mailing Address 1 a I Vent fan connected to a single duct 300
Engineer Crtyrstate Zip'-
pPnone 15) Ventilation system not included n 4 50
202hance permit _
Describe work New O Adddion O Alteration O Repair O 1E.) Hood served by mechanical exhaust 450
'o be done Residential- Non-residential O___
Additional Description of work 17) Domestic incinerators 7 50
18) Commercial or industrial type 3000
Incinerator
Existing use of 19 1 Repair units 450
budding or property
20) Wood stove 4.50
Proposed use of 21 ) Clothes dryer.etc 450
budding or property _
22 1 Other units 450
Type of fuel•oil O natural gas.O LPG O electric O 23) Gas oiDing one to four outlets I 200 a0D
1-
v. I hereby acknowledge that I have read this application.that the 24) More than 4-per outlets(each) 50
information givens correct.that I am the owner or authonzed agent of
the owner.that plans submitted are in compliance with Oregon State QTY SUBTOTAL
J laws
Signet f Owns Date *SUBTOTAL
C-0
LLJ
J I 5%SURCHARGE
- l
C arson Name Phone PLAN REVIEW 25016 OF SUBTOTAL
' TOTAL
vii,J� r l r 1 ,
i dsttmechpmt doc irev 9 'Mlnim m permit fees 525-516 surcharge
—Residential A.0 requires site plan showing placement of unit
•
HEATING & COOLING, INC.
P.O. Box 230367 Tigard, OR 97281-0397
(503) 624-2704
i
I
i
i
p _ _
30'
a
35 '
F--
\ /
M.
LL)
o
(J-Joocl u) 7, 1 T,IQr-d. ars' 97a.a�
-- IYASTER P,EF2NIT
CITY OF TIGARD PIER11I1' #. . . . . . . : NST`)i.�-041E,
COMMUNITY DEVELOPMENT DEPARTMENT Df-)'FE ISSUED: 14-)9/18/96
13125 SW Hall Blvd,Tigard,Oregon 97223e8199 (503)839.4171 1f:lRCEI_..: 1:1:3 10 1(-113—Q)11)'A0
51-it— PDDRL.SE�. . . : 121465 SW '12N17 AVE
U14D 1 V 15 1 ON. . . . HE.RiYIOS 7 F'AFiK ZONING: R-3. 5
I.3LOU!. . . . . „ . . . . L-01 . . .. . . . . . . . . . . : 15
Remarks: Installing attached deck, and patio
---------------------------------------------------------------- BUILDING -------------
--------------------------------------------------
REISSUE: STORIES.......: 0 FLOOR AREAS---------- BASEMENT,,,: 0 sf REQUIRED SETBACKS---- REQUIRED-----------
CLASS OF WORK.-OTR HEIGHT........: 0 FIRST....: 0 sf GARAGE..... : 0 5f LEFT......,...: 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD....: 60 SECOND...: 0 sf FRONT.,.,.....; 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP,:R3 BDPM: 0 BATH: 0 TOTAL------: 0 sf VALUE..$: 4200 REAR..........: 0
PLUMBING ----------------------------------------------------------------
SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DPAIN ft: 0 TRAPS.........: 0
LAVATORIES..,.: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: Q
TUB/SHOWEPS...: 0 GARBAGE DISP,.: 0 WA,ER HEATERS. : 0 WATER LINE ft: 0 BWLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
-------------------------------------------------------------- MECHANICAL ------------
FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/CMP ( 3HP: 0 VENT FAN......: 0 CLOTHES DRYERS: 0
FURN )=I00M, ..: 0 UNIT HEATERS.. : 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...,. 0
------------------ ELECTRICAL -------------------------------------------.-..,------------
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- -••--MISCELLANEOUS---- --ADD"L INSPECTIONS--
1000 5F OF LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD`L 500SF.: 0 ZVI - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGNiOUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNALiPANEL...: 0 IN PLANT.....,: 0
MANF HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+a3ps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ---------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FD0=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
-- ELECTRICAL - RESTRICTED ENERGY ----------------------------------------------------
A. SF RECIDENTIAL--------------------------- B. COMMERCIAL-----------------------------------------------------------------------------
AUDIO I STERES.: VACUUM SYSTEM-: AUDIO I STEREO.: FIRE ALARM...,.: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER.........: HVAC....,...,..: LANDSCAPE/IRRIG: PROTEC'IVE SIGNL:
GARAGE OPENER..: CLOCK........,,; INSTRI'MENTATION: MEDICAL.,..,..,: OTHR: ::
HVAC.......,...: DATA/TELE COMM.: NURSE CALLS....: TOTAL A SYSTEMS: 0
Owner ----- -----------------------------Contractor: ----------------------------- TOWL FEES:$ 125.86
GARY WOOD OWNER
12465 SW 72ND AVE
H GARD OR 972233
Phone I: 207-5354 phone I:
Reg I..: OWNER
This permit is issued subject to the regulations contained in the Tigard Municipal Lode, State of Ore. Specialty CGuei and all nthe
CIL, applicable laws. All wirk will be done in accordance with approved plans. This permit will expire if work is not started within I
V days of issuance, or :f work is suspended for tore than 180 days.
- ----- REWIRED INSPECTIONS ---------------------------------------------------------
�~ FootingInsp
Framing Insp
=° Rain drain Insp '_—
L Building Final
osion Control
L:er,mitLee '.i4nC:tL .n
' \ 17 --
r inRp�rt: inrt h:,r:+--ft1"15
Plan
]TY OF TICARD Residential Building Permit Application Recd Byck# c
3125'SW HALL BLVD. New Construction Additions or Alterations Date Recd 12X
GARD, OR 97223 Single Family Detached or Attached Gate to P.E. ?_�-
03) 639-4171 Date to DSTPlermit
( i Print or Type Called #
Iricompf�te or illegible applications will not be accepted
_ ( I'd - 4 ��esaa l
Name of Subdivision Lot# Name
Job ( 10kIN"IP.Sn ��_k r I Architect Mailing Address
Address Site Address rl
� e
Name City/State Zip Phone
=� �1�— Name
Owner Mailing Address VO —
C,tylState Zip Phone g En ineer Mailing Address
q
1�1r
--- _-.- "f — 1 City/State Zip Phone
Name
General Describe work new O addition O alteration O repair O
..Ontractor Mailing Address to be done
Additional Description of Work:
City/State Zip Phone
i
Oregon Const. Cont. Board Lic# Exp. Date
\ttach Copy of Project
Current COT Business Tax or Metro# Exp Dale _ValuationO
Licenses
Name NEW CONSTRUCTION ONLY: _
Mechanical Sq.Ft. House Sq Ft.Garage:
Sub- Marling Address
ontractor Corner Lot Yes No Flag Lot Yes No
City/State ZIP Phone (check one) (Check one)
Restr;Cted Audio/Stereo Burglar
Oregon Const Cont. Board Lic# Exp Date Energy System Alarm
lttach Copy of
Current COT Business Tax or Metro# Exp Date Installation Garage Door HVAC
Licenses Opener Systems
I' Name (check all that Other
Plumbing apply)
Sub- Mailing Address Will the electrical subcontractor wire for all Yes No
restricted energy installations?
Contractor j
City/State Zip Phone Has th,� Subdivision Plat recorded? N/A Yes No
Oregon Const. Cont Board L r_# Exp Date Reissue of MST# Solar Compliance
Attach Copy of _ (Calculation Attached)_
Current Plumbing Lic # Exp. Date I hereby acknowledge that I have read this appl ration, that the
Licenses information givens correct. that I am the owner or authorized agent of
COT Business Tax or Metro# Exp. Date the owner. and that plans submitted are in compliance with Oregon
N State laws.
Name Signature of Owner/Agent Date
Electrical Contact Person Name Phone
Sub Mailing Address
;? Contractor FOR OFFICE USE ONLY:
-� City State Zip Phone Plat# Map LO:
Oregon Const Cont Boa d L c# Exp Date I Z I -- nt 1
Attar.h Copy of Setbacks Zone Solar:
Current Electrical Lic # Exp Data i/ C
Licenses
COT Business Tax or Metro# Exp Date Engineering Approval. Planning Approval: TIF:
istsVnstapp doc J r, I J
P�rmi # Account Desg Amount Amt. P 6W, Du
MST Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT)
State Tax (TAX)
Bldg: . .
Plumb:
Mech:
EL.0/ELR:
Plan Check
MST: (BUPPLN)
Plumb: (PL_MPL.N)
Mech: (MECPLN)
CDC Review (LANDUS) U U
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS: 01
a,4 y" Z
'•dststmstdpp doC
Rev %/96
Permit #i:
j issued by: Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, URS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt front registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 313:
El
1. I o,:vn, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
I
,V
?Ii. I \ill he my own general contractor.
It 1 hire subcontractors, 1 will hire only subcontractors registered with the Construction Contractors
cr
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
N registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
J
cc
1 hereby certify that the above information is correct and that I hui a read and do understand the Information
Notice to Property Lners about Construction Responsibilities on the reverse side of this form.
J �
(S' n Lure of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
o
v/
a
a
H-
N
Y
m
cD
i ICoI-G�1 _ I
�- �------ . «N���T�1�- -- ------ --�-____ {` 3„ -- - - -:�x�t ��K ��oar-- G_�,���o�►�� .
I IIs # MATCH HIPPVON6 MAE (liffP-1Z vl�-
eH
-- 2c& LAW-IEF: I FDF W TWD I�I^I�i
I_ LA<I Eovrr, 2-411 r_., ! 14A
t'--'
--- J�r- _ _ I �- �i/4,!1 .- I -� r'-I �+ ISN (- -I \ ►.Q.':�.'AGFi
IL
• - `., ! rte r.'; : ;,
121! 'p rr, ^iINCG e 1!r
I x Z
t•i�w 3° �
1/2-11 f7j.Wr2
&
RIO F C%1 Ef-
_Qtur-4 1
I � � Mr(Pr-E
-71
LD
FAII-0 -f
i
i
1
=I -0
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. ELCIj6-0582
'J
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)539-4171 DATE ISSUED: 09/06/96
PARCEL: :'SJ0JAB._0l')JZl0
SITE ADDRESS. . . : 1 _-'465 SW *72ND AVE
SUBDIVISIUN. . . . : HERMOSO PARK ZONING: R---,'3. 5
. . . . . . . . . . 1-01 . . . . . . . . . . . .
Project Deset-iption : One service or, feeder, to 200 amps and 11 br-anc:h cit,cktits
SRVC/FEEI)ERS------
amp. . . . . . . .. 0 FIUMP/IRRIGAT-ION. 0
1000 SF OR LESS. 0 11.11 _ 121127112
EACH ADDIL 5005F. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
1-11117ED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEI... . . . . . . : 0
lyIANF. HM/ SVC/FDR. . . 0 601+amps.-1000 volts. : 12) MINOR LABEL ( 10) . . . : 0
-1.------SERV ICE/FE'kyDER------ CIRCUITS---- I NSPECTI DIAS—----
0 200 artip. . . . . . : I W/SERVICE OR FEEDER: 11 PER INSPECTION. . . . . : 0
L"'V 1st W/O SRVC OR FDR. : 0
-11 400 amp. . . . . . :: 0 PER HOUR. . . . . . . . . . . .. 0
401 600 amp. . . . . . : 0 EA ADDIL DRNCH CIRCt 0 11\1 PLr4NT. .. . . . . . . . . . : 0
601 1000 ,:imp. . . . . : 1/1 Rl.' VIEW
I.Q101714- amp/volt.. . . . : 0 ) =4 RES UNITS. . . . . . . . ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > 2'25 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: FEES
GARY WOOD type amo+.lnt by date t'ecpt
1.2465 SW 72ND AVE P,R M T $ 115. 00 B 09/06/96 96--263666
SPCT $ 5. 75 13 09/06/96 96-283666
TIGARD OR 97223
Phone #: 201-5354
Contr-ac:tor:
GENIE ELECTRIC CONSTRUCTION $ 1C'0. 7'5 TOTAL
111395 SW AVERY CT
FSU LAOX 575 REOUIREI) INSPECTIONS
SHERWCOD OR j7140 Ceiling Cover- Elec-tl I Set-VICO)
Phone #: 503-631-6403 Wall Cover- Elect' I Final
Rey #. . - 056639
This permit is iss,.ed subject to the regulations contoined in the
Tigard Municipal Cooi, State of Ore. Specialty Coops and All other Per-mittee E)ignatt.ir-e
applicable laws. Ali work will be done in accordance with
approved plans. This permit will expire if work is not started B?'
/U
within 18@ days of issuance, or if work is suspended for more
than 180 days. I S S Lt e d Dy
OWNER INSTALLATION ONLY
The inst--.Al tat ion is being made on pt-epet-ty I own which s 11 ot intended fov^
sale, lease, or, t,ent.
OWIALHIS UIGNATURL: DATE
INSTALLATION
5113NA"TURE OF SUVIR. ELECIN: pk I�A4 DATE a
LICENSE NO,
Call for, inspection 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 972.23 Permit #
Date Issued
Phone (503) 639-4171
CITY OF TIGARD FAX (503) 664-7297
TDD No. (503) 664-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development _ Number of Inspections per permit allowed
AddressZL --/ (,Is— 1W ✓7� r /t V er Service Included Items Cost(ea) Sum
City/State/Zip //.1 o7A / `1 _ 4a. Residential •per unit
0, —r
1000 sq. ft. or Less $11000 4
Name (Or name of bLlslrless)_ _ Each additional 500 sq.ft.or
i� portion thereof $2500 _
Commercial ❑ Residential �1� Limited Energy $2500
Each Manurd 1- nna ur Modular
Dwelling Sery.a or Feeder $6900
2a. Contractor installation only: 4b. Services or Feeders
rInstallation,alteration,or relocation
Electrical Contractor=Cein e Cr' / hlv ns!/.�i�c, 200 amps or less � $6000
Address 201 amps to 400 amps $8000 z
401 amps to 600 amps $120 00 2
City Sie,- G di _ Stated_ Zip 171 yd 601 amps to 1000 amps $lBO 00 __ 2
Phone No. _ __ Over 1000 amps or volls $34000 2
Job NO. Reconnect only $5000 2
contractor's license NO. L - 4c. Temporary Services or Feeders
Contractor's Board Reg, No. 46 , ' Installation,alteration,or relocation
Signature of Supr. Elec'n200 amps or less 2
License No. J i S� Phone No.-!kye--S_ _ 201 ampto 405 amps $55.00 2
401 ampss to 800 amps $75,00
Over 100 amps to 100)volts $100.00
2b. For owner installations: see"b"above.
Print Owner's Name4d. Branch Circuits
__ New,alteration or extension per pane
Address a)The fee for branch circuits with
City State Zippurchase of service or feeder foe. 1
Each branch circuit �/ $500
Phone No. b)The fee for branch circuits without
The installation is being made on property I own which is purchase of ser ice or fil he.
not intended for sale, lease or rent. First branch 500
Each additional branch clrcuH $355.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump or Irrigation circle _, $40 00 2
Each sign or outline lighting $40 Oil
Signal circuit(s)or a limited enerpy
check appropriate Item and enter fee In section 5B. panel,atterstion or extension $4000
_4 or more iesidential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 411. Each able In al Inspection over
_Classified area or structure containing specla! occupancy the allowable in any of the above
as described In N E C Chapter 5 Per inspect""' $3500 —
I'm hour $5500
In Plant $55 00
Submit 2 sets of plans with application where any of the above
—j apply. Not required for temporary construction services. Jr. Fees:
5a. Enter tot31 of above fees
C-0 NOTICE 5%Surcharge (.05 X total fees) $
Il; $ -��
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT rOMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED rnP Plan Review if required (Sec.3) $ _
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED »•* re.... ❑ Trust Account K
wm.nr
6alaitce Due $ 7 s