16120 SW 72ND AVENUE ADDRESS:
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CITY OF TIGARDELECTRICAL PERMIT
PERMIT#: ELC1999-00544
DEVELOPMENT SF.RVSCES ��IG11VAL SSUED: 9/8/99
13125 SW Hall Blvd.,Tigard, ,A' 97223 (503) 639-4 ARCEL: 2S113AA-00600
SITE ADDRESS: 16120 SW 72.ND AVE
SUBDIVISION: ROSEWOOD ACRE TRA( TS ZONING: I-L
BLOCK: LOT : 006 JURISDICTION: TIG
Proiect Description: Installation of one 200 amp service or feeder and 15 branch circuits. Job , 7732.
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: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL 110;:
SERVICE/FEEDER BRANCH CIRCUITS _-- ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: 15 PER INSPECTION:
201 - 400 amp: •:st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amid/volt: J >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC.
Owner: Contractor:
PACIFIC REAL-TY BRIDGETOWN ELECTRIC
15350 SW SEQUOIA PKWY STF_ENSLID + CO
SUITE 300 2230 NE THOMPSON
TIGARD, OR 97223 PORTLAND, OR 97212
Phone: Phone: 281-9397
Reg#: I IC 103824
SUr' 4177S
ELE 26-887C
FEES Required Inspections_____
Type By Date Amount Receipt
E,ect'I Service
PRMT DEB 9/8/99 $144.50 99-318170 Elect'I Final
5PC r DEB 9/8/99 $10.12 99-318170
Total $154.62
I
.J
This Permit is issued subfeut to the regulations contained.n the Tigard Municipal Code, State of OR Speaalty Codes and all other applicable law- �
All work will be done in accordance with 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 Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rulas are set forth in OAR 952-001-0010 through OAR 95.?-091-0080. You may obtain copies o>�se rules or direct questions to OL';JC at(503)
246-1987
J PERMITTEE'S SIGNATURE / - ` ISSUEI�BY: /
OWNER INSTALLATION ONLY
LL The installation is being made on properhr I own which is not intended for sale, lease, or rent.
J
OWNER'S SIGNATURE: _ DATE:
_ CONTRACTOR INSTALLATION ONLY
SIGNATURE OF VPR. ELEC'N t n �O v� _ DATE: 9-1"1g
LICENSE NO: 5 --
Call 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit ApplicatiftPlan cY
13125 SW HALL BLVD. EIVED Recd
TIGARD OR S7223 _ Date Recd 9 -7
Phone (E03)6,i9-4171, x30a SEP O 71999 Date to P.E. _
(503) 639-4175
Inspection Print Or Type COMMUNITY DEVELOPME14Date to DST _
P FGC l�99-coSS��/
Fax (503) 598-1960 Incomplete or illegible will not be accepted hermit#
Caned
1. Job Address: 4. Complete Fee Schedule Below:
Name of DevelopmentNumber of Inspections per permit allowed
//��''
Name(or name of business) Vy0r- C4) Service included: Items Cost Sum
Address___ �� -SW J,� 1` � 4a. Residential-per unit
L �r� 1000 sq.f1 of less $110.00 q
City/State/Zip C Each additional 500 sq.ft.or
portion thereof $25.00 _ t
Commercial0 Residential❑ Limited Energy $25,00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $88.00 2
(Attach copy of all cu enr II nses 4b.Services or Feeders
Electrical Contractor T f -t -E�t J�� L-1e�' - installation,alteration,or relocation—� 4�0�
i L z
AddrIe s_ �� 0 �t1 Se A 200 amps or less ��
201 amps to 400 amps _ $80.00 2
City State _Zip_ 401 amps to 600 amps $120.00 2
Phone No. " 1:3 q 1 601 amps to 1000 amps $180.00 2
Job No. 3 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec Cont. Lice. No.vn'b-Ss87 L- Exp.Date_ I D -V I —"
OR State CCD Reg, No. 0 Exp.Date Ji ' 0 U 4c.Temporary Services or Feeders
COT Business TF x or Metro No. Exp.Date -U Installation,alteration,or relocation
200 amps or less $50.00 _
fr/ -��- 201 amps to 400 amps $75.00 2
Signature of Supr EI@cn _7?l�.l-L�p-►���-.�i 401 amps to 600 amps $100.00 __ 2
1-7 s Exp.Date �0-(� �U l^ Over 600 amps 1000 volts,
License No. sae"b"above..
Phone No 34' 3/b'-• Wty lig LrP
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The lee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address '- Each branch circuit Sy�O _ 2
b)The fee for branch circuits 7
City _ _ State Zip 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
ii-,'ended for sale, lease or rent. 4e.Miscellaneous
(Service or feeder not included)
Owner's Signature___ _ Each pump or irrigation circle $4000 2
— - Each sign or outline lighting $40.00 2
3. Pian Review section (if required):*
t'
"' Please check appropriate item and enter fee in section 58. 4f.Each additional Inspection over
> 4 or mare residential units in one structure the allowable in any of the above
~ Service and feeder 225 amps or more Per inspection $.;5.00
-� System over 600 volts nominal Per hour $5500
Classified area or structure containing special occupancy In Plant $55,30
as described in N E C Chapter 5
U1 5. Fees:
J 'Submit 2 sets of plans v ith application where any of the above apply. 5a.Enter total of ahove fees r $
Not required for temporary constriction services. 5%Surcharge(05 X total fees) 7 �( $
Subtotal ,- $
NOTICE 5b.Enter 25%of line 5a for
Plan Review if required(Sec.3) $ —
PERMITS BECOOE VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCEL'WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR r�.BANDONED SOH A I-EMOD OF 180 DAYS AT ANY ❑ Trust Accoun!k
I IME AFTER WORK IS^,OMMENGED Total balance Due $
I:\DST\ELEC98.DOC R'.SV 4/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24•Hour InspLction Line: 639-4J75 Business Line: 639-4171
(�'_"BUP _ _
Date requested AMPM _ BLD
Location /�o P-0 .`_,> -Z� '-V( f4j 1 Suite MEC
Contact Person I fl n4_5�1 uyl t&c_, Ph _;14�/ '13 r7 7 PLM
Contractor Ph _ SWR
rBUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access.
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post&Beam
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling — 41
Root
Ksc _ _.-/"--—) Yl�
Final
PASS PART FAIL -- - ----•— -
Post& Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer ---- ---�-- �. -- --
Rain Drains
Final e
PASS PART FAIL
MECHANICAL
Post& Beam ----.. -- -- - -- -- ---- -- —
Rough In
Gas Line --
Smoke Dampers
Final ------------ --
PASS PART FAIL
ELECTRICAL — _------_-- -�_ ___
Rerviee — - ---- -_r----._ -.
Rough In
N UG/Slab _
> Low Voltage
Eico Alarm
PASS PART FAIL
rl:
-' Backfill/Grading -`--- -- '---- ' ` -
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ _ —_required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I J Please call for reinspection RE: [ j Unable to inspect-no access
ADA
Approach/Sidewalk V Q L /
Other Date ` L Inspector_ ,,yl I _ _ Ext _
Final
PASS PART FAIL. DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRTCAI... PERMIT
DEVELOPMENT SERVICES PERMIT #: F"LC98-0095
13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSuEn: 02127/98
PARCEL-: E:S113AA--00(500
E ADDRESS. . . : 16ld='1D SW '7 N1i AVE #B-01.
'RD I V I S I ON. . . . :RnsFWO0D A(�RE TRACTS 7 O IN 5: I
OCM. . . . . . . . . . . I._O'T . . . . . . .. . . . . . .00E) .JIJRICiD:L.C:'l"ILJhI: f]:G
Pr,a.j ect De seri.pt ion : Add a first branch circuit to an existing commercial bldg.
I DENT IAL t.JN I T-----. __---TEMP SRVC!FEEDERS_----•_
1.000 SF OR LE'S'S. . . . : 0 0 -- 200 amp. . . . . . . : 0 PL.IMP/IRRIGA'TION. . . . : 0
f_ACH ADD' L._ 5005F. „ . : 0 201 — 400 amp. . . . . . . : tA SIrN/O JT LINE LTG. . : 0
L_TIYIITED E'NERT7Y. . . . . : 0 401 _ 600 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps•-1000 volts. : 0 M NOR i_AE►F:I_ ( 10) . . . : 0
SERVIi"E/FEEDER --__...._ :)' L.. InIS{='1.. TT0N9)_-__
0 "- 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
1('01 — 4.00 amp. . . . . . : 0 i st W/O SRVC OR FDR. : I PER HOL)R. . . . . . . . . . . .. 0
401 - 600 amp. . . . . .. : 0 EA ( iDD' L BRNLI-I CIRC: 0 IN VII_-.ANI . . . . . . . . . . . : 0
1'711 _ 1000 amp. . . . . : 0 ___._______._.____._—PLAN NF'VIEW SECTION__._..___._____ ._.___...
1001- amp/volt. . . . . : 0 ) -4 RES UNITS. . , . . . . . : ) 600 VC1L..T NnMTNAL_. . :
,,connect only. . . . . . 0 SVC/FDR > - 4E5 AMPS. . . CLt•'lI3S AREA/SPEC OCC.. :
_ FEET)
"`CTRIJST type amnitnt by date rer_pt
16140 SW '7 NL) AVE: PIRMT `w 35;. 00 (CEO 0.2/27/98 98-3033 .r-
( TGARD CIR 97223-0000 5PCT $ 1. 75 CFO 1712/27/98 98-30 36,
Phone #:
PHOENIX rLrrTR I C CO 4 3G. 75 TOTAL-.
737`y SW TECH CE=NTER DR.
_..____.__... RFnI. T RFn T NrF'FrT T nNS
'T'IGARI) OR 972-23 E lent' l Ser-vice
Phone it: 684--3600 E.1er_t' l Final
. 000`1;c
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 is not started within 18P
days o� issuance, or if work is suspended for tore than 180 days. PTTENTION: Oregon law reouires you to follow the rules adopted be
the Oregon Utility Nctificaticn Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987, You may obtain a epee
of these rules or direct questions to OUNC by callin (503)246-1987.
ri Per m i t t e e S i.rl n a t i.r r e : _. .__..._....__._,.... _- _._.._....__...___. ... T s s e d By " __.___ _.__.` •►
A ....__._.._�_...._...._._.._
a
N
--------------OWNFR INc3TA1.l_A7Tf1N
The installation is being made on pr,oper^ty I own which is not intended far
sale, 1 ease, at-, merit:.
E' "rWNFR' S STGNATIJRP: DATE;
_.
lLLJ
—1
--------------CONTRACTOR TN19TAL..1 ()TTQINI nNl-Y__... .__........_-._.-.__.....__.__.__...
wIGNAT1.1RE. OF SI.JPP. FL.EC' N: _ _�� �— _ DATE::
r17—
++4-+4-+4-4-+++4-4,+--H++4-+4--4-++i-++++4-++-4- F•+++++•++++++f+++.}+ !-++4-+i•+++++++++-#•+-h-F-h++-i-+++4++
(,all 63'3-4175 by 7:00 p. m. for an inrpection needed the next b�.rsiness day
+++++++++-hi•+++++++++i-+++++++++•++++4.4++++-h+++++++•t+-h++1-+++.4 t 4 1 1..4 -1 1 A f_4 1 .1_ 1
Fra-24-98 TUE 08:21 RM PHOENIX ELECTRIC FAX NO, 503 684 3611 P, 02/02
CITY OF TIGARD Electrical Permit Application Plan Check a
Rei d By
13125 SW HALL BLVD. Data Recd
TIGARD OR 97223 Date to P.E.
Phone(503)639-4171,x304Date to DS
%
Print or Type Permit 4 �c S
Inspection (503) 639-4175 Incomplete or illegible will not be accepted
Fax(503)684-7297 _ Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development � Number of Inspections per permit allowed
Name(or lname of business - Service included: Items Cost Sum
Address �f!`• �>(. � Q- 4a. Residential-per unit
1000 sq.ft,or less �_ $110.00 0
City/State/Zip ` Each additional 500 sq,h.or
IT portion thereof S25.00 t
CommercialAll Residential❑ Limited Energy S.15.00
Euch Manuf'd Home or Modular
Dwelling Service or Feeder $68,00 2
2a. Contractor installation onlY., 4b.Services or Feeders
(Attach copyI current licenses) Installation,anemoon,or relocation
Electrical Contractor 200 amps or less $60.00 2
A dress c • _ I `- r `� 2ol amps to 400 amps $80.00 2
City �^_Stategl TJp 401 amps to 600 amps - $120.00 2
Phone N 601 amps to 1000 amps 5180.00 2
Job No.,��J\c'� 1 O Over 1000 amps ur volts $340.00 2
Reconnect only $50.00 2
Elec.Cont.Lice. No.-. Exp.DP..te
OR State CCS Reg. No. Ex .Date 1 4c.Temporary Services or Feeders
COT Business Tax or Metro No - �Exp.Date Installation,alteration,or relocation
200 amps or less 550.00 2
201 amps to 400 amps _, $15.00 7
Signature of Supr. Elec'n - a--- 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 411 4oS Exp.Date see"b"above_
Phone No. 1 �y c t•''i? 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name
feeder branch
fee.
Each branch Cirowt � $5.00 2
Address b)The fee for branch circuits
City State 2.lp without purchase of
Phone No. service or feeder fee. 2 ,
First branch circuit $35.00 �C 2
The installation is being made on property I own which is not Each additional branch circuit S5.00 2
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not included)
Owners Signature Each pump or irrigation circle $40.o0 -- 2
CL Each tign or outline lighting 2
3. Plan Review section (if required):' S+pane circuitor
orlimited energy`
panel,alteration r extension S40.00 2
~ Minor Labels(10) $100.00
rn
II'lesse check appropriate item and enter fete in section 58.
►-- 4 or mcre residential units in one structure 4f.Each additional inspection over
Service and feeder 225 amps or more the allowable In any of the above $35.00
System over 600 volts nominal Per Inspection $55.00
an Per hour
Classified area or structure containing speci,il occupancy $55.00
LL
as described in N.E.C.Chapter 5 In Plant
J
'Submit 2 sets of plans with application where any of the above apply. Jr. Fees.
Not required for temporary construction services. So.Enter total of above fees $ c
5`b Surcharge(.05 X total teas) S -7111
NOTICE Subtotal t
Sb.Enter 25%of line So for
PERMIT::BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review tfre�jLW(Sec-3) $
NOT COMMENCFD WITHIN 160 DAYS,OR IF CONSTRUCTION OR WORK ubtotal S -"
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 1000 DAYS AT ANY Trust Account A �r
TIME AFTER WORK IS COMMENCED. s
oil balance Due
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: A.M. P.M. MST:
Location: /c C.0.' 74�/l�_ ('�t 't BUP:
Tenant Suite: Bldg: �_ MEC:
Contractor: /2 r -L Phone: PLM:
Owner: ' Phone: C �� 75- ELC:
At ELR:
�_ C i •� U _ ( [ [ �� �,t' ILL. C�� J L j i Ti.E f�.-u`L'ti�.�- G. � �•
BUILDING BLDG BLDG(con't) PLUMBING MECHANICAL CLLECTRI SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Iiood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spk1r/Alm Crawl/Found Dr Beat Pump Low Volt
Approved Approved Approvedpprov Apprcved
Appr/Sdwlk Not Approved Not Approved Not Approved -WM-A oved Not Approved
FINAL FINAL FINAL FINAL FINAL
R"
N
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U Call for reinspection --3 Reinspection fee of S required before nextinspectionO Unable to inspect
Inspector: _ Date: `7 ' N-70 Pabc of
SIGN PERMIT
PERMIT #: SGN92-0119 DATE ISSUED. . .. : 07/24/92
EXPIRATION DATE: 09 /.2¢/91-
PARCEL. . . . . . . . .: 2S113AA-00600
ZONE. . . . . . . . . . . : I-L
BUSINESS NAME. . : KIRK PAPER
SIGN LOCATION. . : 16120 SW 72ND AVE
APPLICANT/AGENT: C BREIDENBACH
BUSINESS TAX NO:
SIGN:
PERMANENT (X) FREESTANDING ( ) FREEWAY ( )
TEMPORARY ( ) WALL (X) ELECTRONIC ( j
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS. . . . . . : 10" X 8'
TOTAL SIGN AREA. . . . . . . 7 sq.ft.
WALL AREA. . . . . . . .. . . . . 384 eq.ft.
WALL. FACE (DIRECTION) : W
SIGN HEIGHT. . . . . . . . . . . 16 ft.
PROJECTION FROM WALL. : 2 in.
ILLUMINATION. . . . . . . . . : NON
DESCRIPTION OF SIGN:
PERMANENT WALL SIGN. 10" X 8' = 7 SQ.FT
MATERIALS. . . . . . . . . . . . : STYROFOAM
EXISTING SIGNS. . . . . . . : 0
ELECTRICAL PERMIT REQUIRED: NO
BUILDING PERMIT REQUIRED. _ : NO
ADMINISTRATIVE EXCEPTIONS. : N/A
PERMIT FEE: $ 10.00
_ r
APPROVED BY:
DATE: 07/24/^2
PPzmi t No_ SGt!9'�- I
CTTX OF TIGARD
SIGN PE7d-aT APPLICATION
The applicant hereby applies for a permit for the work irniicated or as s4iown in the
aoeanPwVing plans'and specifications_
SIGN LOCATION ADORE-13S: _^16180 SW ?2ND AVENUE
NAME OF BUST14ESS: KIRK PAPER
C-Sreidenbach Signs In Depth Tn
ApPtscArrr/t�rrr: ------ ax��rrx: _ � pHor,rr:: 503 635 3390
The City of Tigard iUPOsee✓-• an arunsal Business Tax which heist be kept current on all
pex-sons doing business in tl,+-- City- rx) you presently have a a=-ent bisuwss tax?
YTS ( X) NO ( ) License r Metro # 1946 OCB # 66735
PROPOSTD SIGN: (Chexyk as ra,ny as apply)
1 ees
PERtWENr ( X) 1'REESTANDEW, A ) 0 - 10 S q. F t.$10.0 0
1EKR)RARY ( ) w1r, (x ) E1,97f 20N-IC ( )24-100 s q.F t. $75.00
(MiER ( ) BI)TfXC]ARf) ( ) EftUCON ( ) 100
SIGN DIMENSIONS: 10" HIGH X 8' WIDE = 7 SA.FT. E MIRATIDN azd F:
TCVML S GN XZFA (S4- Ft-) : —7
wALL AREA (sq- Ft-): �16' HIGH X 74' wim = 384 SA.FT. Fees
WALL FACES Dirccti.on�_ WEST _
marr (Ft) : ilial 16'
IIIJMCITION: YES ( ) NO ( X) TYPE: Raiser] _j&tt•_rs
COPY: KIRK PAPER
MATFRIMS: ST-YRGcnwnv _
EXISTING, SIGNS:
AUMINISIRAIIW EXCEPTION: N/A ( ) APPI M-D ( ) HOW M1KH
AREA ( ) HELCI[r ( )
CL2R'lFNL5:
N ---
PfANTdUJG DEPARnMENr All. sign permits mist be ao-.Ag3ani:ed by a ,calf,
w Permit Fee: Q " drawing and plot plan_ 11 work authorized trr>dE
c� Rei No: 9Y-� 7-'L� `�� a sign permit Sias not been r-copleteri within ninety
Apo:aved By:� days after the issuance of the permit, the rermit
ate" -L, - shall become null and void-
E7.E=C AL PERI-IT I CERTIFY 13W I AM M E RDODRDED CX44ER OF TM
REDUIRED: YES ( ) NO ( .) PROPERTY OR AN AG-21r AUITfORIZED BY WE: OWNER.
BUITDING pOZUT Y =C- Breidenbach
RE7?(fIRIS: YES ( ) " NO (�) Applicant's SiCqjIrvalur��
Signs• In c3lepth,Inc.
17150 SW Pilkington,Lake Oswego,Or.97035 (503)635 3390
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BUILDING PERMIT APPLICATION "OF
TIGARD DATE 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE_
OR AS SHOWN AND APPROVED IN THE ACCLIUA44YING PLANS AND SPECIFICATIONS. OWNER PHONIC
REry LOT NO.
OWNER i�•�• .ni�lr��D6J. JOBAD �L . i ItIIDl "U �["�rjMETA�ORESS
ARCHITECT
ENGINEER
BUILDER _ �r.16(1,�3 :�L i:it.• ADDRESS I E.':�';�9LI2 ,t I1LA1 (3 r"I0 1 DESIGNER
STRUCTURE ❑NEW ,URI MnDEL El ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ NESIDENCE ;Qr,OMM ❑EDUCATIONAL ❑GOV'T ORE LIGIOUS[:]PATIO ❑CAR PORT ❑GARAGE [:]STORAGE❑SLAB []FENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY--,� 'l..LAND USE ZONE_ BLDG.TYPE _jrJ FIRE ZONE PLAN CHECK BY 9tIJ HEAT
,;i"diij li(.l' of Liiturior tenant separation WallI, construct o.' of nk w tullellt
4 ;i rcit:iort wall, new 83x100 upsri:.ng in wall at grid lino The
J
QCC, LQAp________FL9CC{_LOAD.__._.----.►:IE1.G�lI_-- -__,NQ_ LQFllE9 AREA 1�I .-RMMMS VALUE ------
BUILDING DEPARTMENT SET BACKS FROI REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SOBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULA'IONS AND ALL C�IPLICABLF CODES AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
WORK V11LL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES HND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES Nr.r WAIVE
RESTRICIIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BinINESS
State Tax fil.) LICENSE. SEPARATE PERMITS aEOUIRED FOR SEWER, PLUMBING AND HEATING.
Total :I
BY
APPLICANT OR AGENT
Approved k3 Receipt No
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
— —
w Contractor _
Permit No. -
�' Rough-in
Fixture
FlnRI
,1 - -
/ 77
HEATING 7T C
i
Contractor
Permit No.
Gas or Oil
Rough•In
Final
SEWER
Final
DRIVEWAY
J
Final
D
p Storan Drainage
J
J (RRin Drain)Final
S Idewal k
Curb dt Street Final
Approach _
g,DG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY --
;' Landscaping
��/ �/ Zoning Final
BUILDING PERMIT APPLICATION 11T TIGARD DATEOF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF'
LOT NO. —
bruet i 1 �fi ^,I 1 7" ridA� t
OWNER JOB ADDRESS HOME ADDRESS —�
ARCHITECT
li,tj. Rare, ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTU.'r _❑NE_W El REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL OF IRE DAMAGE ❑DEMOLITIDN
❑ RESIDENCE ❑COMM ❑EDUCATIONA' ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE [:]STORAGE❑SLAB ❑FENCE
[:]BOND ❑MOVING ❑CONDITIONAL USE ❑DES!GN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE_-- BLDG.TYPE FIRE ZONE___ PLAN CHECK BY ___ -__ HEAT___
:J_]. I 1 1. � Or AlLruilEiu eny.Llleored 'ildu i ol.111datiorl fu
N
H
J
�= Qom, LOAD FLOOR LOAD HEIGHT __ Q.U_QR __, AREA NO.BEDROOMS VALUE _
LD BUILDING DEPARt EN1
LL! SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
J Permit - -- - - _
-- - THIS PERMIT iS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE LODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
— WORK WILL BE DON' IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AN,)IN COMPLIANCE WITH
Sub-total d. ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRFNr CITY BUSINESS
State. Tax LICENSE SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING
Total
BV nPf&nNt OR AGENT
Approved Rer.elhl No
--- - ---- _-r.�------
nitltRf'`+ PN(]Nf
F7-
ATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
� Contractor
Permit No.
Rough-in
Fixture
Fire+
HEATING
Contractor
Permit No.
Gas or Oil
^_ Rough-vi
M, Final
SEWER
Final _
m
DRIVEWAY
CD Final
LQ
J
_ Storm Drainage
Rain Drain) Final
Sidewalk
Curb&Street Final
A roach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final i
1, BUILDING PERMIT APPLICATION "FY TIGARD DATE 1-
TILE UNDERSIGNED HEREBY APPLIES ! OR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE
LOT NO._
OWNER U4-ig E7arltrUu^It JOB ADDRESS ,id(;. ,I, JW 7iend HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER _ ulLLJtIF] L UCIaf:. ADDRESS 1fjC-;(';f1ZiL V-1 DESIGNER
STRUCTURE ❑NEW 11 REMODEL ❑ADDITION CREPAIR ❑RENEWAL ❑FIRE DAMAGE [:]DEMOLITION
❑ RESIDENCE CICOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORt OGARAGE ❑STORAGE OSI AB GFENCE
❑BOND ❑MOVING []CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCI IPANCY__ -_LAND USE ZONE BLDG,TYPE_ FIRE ZONE PLAN CHECK BY HEAT,_.._
Tur'. ..jt1 w intt'j wr Ut'f'icu apartition wabis t. utorufrunt. wall ,JILL,
a
.J. 1:ailet 1"L`LJ►l nocure plumbing permit
-
i--
J _
OCC,LOAD 3 FLWR Logo, __.HEIGHT 22 NO. TD_Fj D_0 ES VALUE r
BUILDING DEPARTMENT
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit - —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
—" WORK WILL BE DONE IN ACCORDANCF WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS_ CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY RUSINFS,
State Tax LICENSE. SFP.ARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total �I
BV
nn cANt OR AGENT
Approved Receipt No.
A00Pf SS -- - - P E ,�
REMARKS PLUMBING DATE
DATE INSP. TYPE INSPECTION
Contractor
Permit Na
ti't
Rough-in
Fixture
Final
htATING
Contractor
Permit No.
Gas or Oil
Rough-in
a
►- Final
cr _
N SEWER
Final
DRIVEWAY
m
.• Final
c�
W
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
. Landscaping •
• Zoning Final
CITY TIG oA RD DATE_— —. 19 —. NA
Uli-DING PERMIT APPLICATION OF
r UNDE RE"IGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED SUILDERPHONF - —_
AS SHAWN' AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PhoNF —
LOT NO
94 —
T� JOB ADDRESS V[�/ / '^ HOME ADDRESS
ARCHITECT
ENGINEER
C ADDRESS _ -- DESIGNER Z07 -
"JRE Q%EW _❑REMO_DEL_ ED ADDITION ❑FREPAIR _❑RENEWAL ❑FIREDAMAG ❑DEM ITION
I NCE ❑COMM_❑EDUCATIONAL ❑GOVT ORELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGEOSLAB ❑FENCE
H'.'ND OMOVING OCONDITIONAL USE ODLSIGN REVIEW ❑COUNCIL APPROVED OSIGNS
CL'PaNCY _y�__LAND USE 2CNE—_—__SLLDGGTYPE--__ __—. _FIRE ZONE_ PLAN CHECK BY _.
—_ HEAT_---
✓� -
4.C9a.___._-- FLflQf9-1.4BLL____—_ HH _—___---.
E NQ.-. RIE --------�R —_—___�YS�@EDROOMS VALUE^-----
BUILD_ING (APARTMENT SET BACKS FRONT REAR W —LEFT SIDE RIGHT SIDE'J—oyi
-
----- — THIS PERMIT 15 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check e REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
--�— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub 10181 ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- -- -- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
,tate Tax LICENSE SEPARATE PF RMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
T01a1
Eiy ...LLL --- _— ----- —
�� APPI I C A N I OR AGE N1
Approved .. — 4Recelpt No. ---- ----
____ __-_ _ - AD[iRE55�-~ PHONE.
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a DATE 7 MACKENZIE ENGINEERING INCORPORATED
CHKD. ®YrRM DATE( "i CONSULTING ENGINEERS
Jpp0 7��� SHEET
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f3UILt >INC� '14 0. 1 No. 2 '
SIN FLF ,,
UNIFIED SEWERAGE AGENCY �drn LU/7Z4 r
FIXTURE UNIT VALUES �aS, SC�3S
FIXTURE >n FIXTURE JNIT VALUE.
Toilet 8ld I �e�sp .•- I 6 .044 MIN 1 15"
Urinal 9 5 1 -�
Sinks : aY
Lavatory 3o 2 1b41 Il}lIJ - /S'
Bar Sink (Commercial) 3
Soda Fountain 3
Pot, Scullery etc. 4
Service (2" outlet 3
(3" outlet 4
Hoer? Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (11" outlet) 2
Bedpan Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain 1 U 2
L.',jndry Tray 2
Shower (each head) 2
Food Waste Grinder (dwelling u's)15
Clothes Washer
12 lb. washer 12 I
20 lb. washer 20
30 lb. washer 30
Extractor 6
N
Each 16 Fixture Unit values :-4 dual one dwelling unit.
J
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UNIFIED SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTURE FIXTURE JNIT VALUE
I �
Toilet 6
Urinal 5 /
Sinks:
Lavatory �' 2
Bar Sink (Commercial) 3
Soda Fountain 3
Pot, Scullery etc. 4
Service 2" outlet / 3
�311 outlet; 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (12" outlet) 2
Bedpan Washer 5
Dental. Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain 1 11 �-
2
Laundry Tray 2 11
Shower (each head) 2
Food Waste Grinder (dwelling u' s)15
Clothes Washer
12 lb. washer 12
20 lb. washer y 20
30 lb. washer 30
a
R Extractor 6
Each 16 Fixture Unit values equal one dwelling unit.
LO
m �h-
7 �
r%
UNIFIED SEWERAGE AGENCY
FInTURE UNIT VALUES
FIXTURE �� FIXIURE JNIT VALUE
Toilet 6
Urinal 5
Sinks :
Lava tory 2 !
Bar Sink (Commercial) 3
Soda Fountain 3
Pot , Scullery etc. 4 _
Service (2" outlet 3
(3" outlet 4 _
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (11" outlet) 2
Bedpan Washer 5
Dental Cuspidcr 1
Dishwasher (Commercial) 4
Drinkinq Fuuntain 1 1
Laundry Tray 2
Shower (each head) 2
Food Waste Grinder. (dwelling u ' s)15
Clothes Washer
12 lb. washer 12
20 lb. washer 20
30 lb. washer 30
Extractor 6
~ Each 16 Fixture Unit values equal one dwelling unit.
UNIFIED SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTURE 41 FIXTURE JNIT VALUE
Toilet 6 1TN1
Urinal 5
1
Sinks :
Lavatory 2
Bar Sink (Commercial) 3
Soda Fountain 3
Pot , Scullery etc. 4
Service (2" outlet 3
(3" outlet 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (12" outlet) 2
Bedpan Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain 1
Laundry bray 2
Shower (each [lead) 2
Food Waste Grinder (dwelling u' s)15
Clothes Washer
12. 1b. washer 12
20 lb. washer 20
30 lb. washer ',0
Extractor 6
Each 16 Fixture Unit values equal one dwolliiig emit.
LL�
�/
UNIFICD SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTURE FIXTURE JNIT VALUE
Toilet �� 1 �r 6 H4 111Y
Urinal 5 Z
Sinks :
..'-
Lavatory __ 9 2
Bar Sink (Commercial) 7 ;t 3
Soda Fountain 3
Pot , Scullery etc. 4
Service (2" outlet 3
(3" outlet 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (12" outlet) 2
Bedpan Washer5
Dental Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain 1
Laundry Tray 2
Shower (each head) 2
Food Waste Grinder (dwelling u1s)15
Clothes Washer
12 lb. washer 12 _
20 lb. washer 20
30 lb. washer 30
Extractor 6
Each 16 Fixture Unit values equal one dwelling unit.
J
CO
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UNIFIED SEWERAGE AGENCY
FIXTURE UNIT VALUES �
FIXTURE S FIXTURE JNIT UALE!F
Toilet 6 ��
Urinal 5
Sinks :
Lavatory 2
Bar Sink (Commercial) 3
Soda Fountain 3
Pot, Scullery etc. 4
Service (2" outlet 3
(3" outlet 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (l1" outlet) 2 ..
0edpan Washer 5 /
De,ital Cuspidor 1 �p
Dishwasher (Commercial) 4
I
Drinking Fountain 1 _
Laundry Tray 2
Shower (each head) 2
Food Waste Grinder (dwelling u1s)15
I
"lothes Washer
12 lb. washer 12
20 lb. washer 20
30 lb. washer 30
R Extractor 6
F-
Un
~ Eacri 16 Fixture Unit values equal one dwelling unit.
J
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111 r^-
J
UNIFIED SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTURE FIXTURE MIT VALUE
Toilet 6 _ U
Urinal 5
Sinks :
Lavatory 2
Bar Sink (Commercial) 3
Soda Fountain 3 _
Pot , Scullery etc. 4
Service (211 outlet 3
(311 outlet 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub ( 12" outlet) 2
Bedpan Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) G
Drinking Fountain 1
Laundry Tray 2
Shnwer (each head) 2
Food Waste Grinder (dwelling u1s)15 �-f Z-
Clothes Washer
12 .lb. washer 12
20 lb. washer 20
30 ib. washer 30
Fxt.ractor 6
Each 16 Fixture Unit values equal one dwelling unit.
J
02 C/
It1 .r
J
r
UNIFIED SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTURE FIXTURE JNIT VALUE
Toilet 6r1 1' 11 4 fir'
Urinal 5
Sinks :
Lavatory 2 J 14o
Bar Sink (Commercial) 3
Soda Fountain 3
Pot , Scullery etc. 4 �.�--
Service (2" outlet) 3
(3" outlet) 4
Hose Bibs
Bradley Sink 5 J
Floor Drain 2
Bathtub (12" outlet) 2 _
Bedpan Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain I
Laundry Tray 2
Shower (each head) 2
Food Waste Grinder (dwelling uts)15 _
Clothes Washer
1.2 lb. washer 12
20 lb. washer 20
30 lb. washer 30
Extractor 6
Ln
~ Each 16 Fixture Unit values equal one dwelling unit.
J
Ll t
UNIFIED SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTUREq FIXTURF JNIT VAIUE
Toilet �1� 6 L
JJ
Urinal \ 5
> ,
Sinks: -Lti
Lavatory 2 �
Bar Sink (Commercial) 3
Soda Fountain 3
Pot, Scullery etc. 4
Service (2" outlet 3
(3" outlet 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (1?" outlet) 2 _
Bedpan Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) 4 _
Drinking Fountain 1 I
Laundry Tray 2 _
Shower (each head) 2
Food Waste Grinder (dwelling u1s)15
Clothes Washer
12 lb. washer 12
20 lb. washer 20
30 lb. washer 30
Extractor 6 _
v;
y
`- Each 16 Fixture Unit values equal one dwelling unit.
UNIFILD SEWERAGE AGENCY
FIXTURE UNIT VALUES
FIXTURE FIXTURE_ ,JNIT VALUE
Toilet 6 r,44 I)l 'f
Urinal 5
Sinks :
Lavatory 2
Bar Sink (Commercial) 3
Soda Fountain 3
Pot , Scullery etc. 4
Service (2" outlet) 3
(3" outlet) 4
Hose Bihs
Bradley Sink 5
Floor Drain 2
Bathtub ( l2" outlet) 2
Bi,dp. i Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain 1
Laundry Troy 2
Shower (each head) 2 r 2
Food Waste Grinder (dwelling u1s)15
Clothes Washer
12 l.b. washer 12
20 lb. washer 20
30 1b. washer 30
a
Extrai.:tor. 6
f- _
Ln
~ Each 16 Fixture Unit values equal. one dwelling unit.
m
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J
UNIFIED SEWERAGE AGENCY
F-1"T UNIT VALUES
FIXTURE f + FIXTURE JNIT VALUE
Toilet 6 ?j U
o-
Urinal 5
Sinks :
Lavatory 2 _ � U
Bar Sink (Commercial) 3
Soda Fountain 3
Pot , Scullery etc. 4
Service (2" outlet) 3
(3" outlet) 4
Hose Bibs
Bradley Sink 5
Floor Drain 2
Bathtub (12" outlet) 2
Bedpan Washer 5
Dental Cuspidor 1
Dishwasher (Commercial) 4
Drinking Fountain 1 �
Laundry Tray 2
Shower (each head) 2
;ood Waste Grinder (dwelling u1s)15
Clothes Washer
12 lb. washer 12 !
20 lb. washer 20
30 lb. washer 30
a
c� Extractor 6
Ln
Each 16 Fixture Unit values equal one dwelling unit.
m
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