12655 SW 131ST AVENUE N
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12655 SW 131ST AVE
F CITY
OF TIGARD CERTIFICATE OF
COMMUNITY DEVELOPMENT DEPARTMENT ct:CUPI(-)NCY
1312b OW Hall•Nd,Tigard,Oregon 37233@$141 (W3)$39.4171 PERM i T #. . , . . . . : MGT'93. �LI1 Ou!
1-,,. ._.41 DATE ISSUED: Ot,/1 i/'i3
4'F�RCEL e 2r 104AC;-•10100
SITC` r�[11)f�[:.r,S. . . a 12655 SW 5.:315T AVE'
SUBDIVISION. . . . s MORNING HI1_L. #9 TONING.
BLOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . :244
CLASS OF WORK. :NEW
TYPE OF USE. . . r,F
OCCUPANCY GRP. :R3
OC:CUOONGV LOOD1226 4
ITENANT NOME. . .
Remarks s PATH 1
Owner: -.._.____._..__...,..._�. ._.-,_. ___ _._.... .._....__. ._.._......_ ._._.
JAY MILLER BL.DR. INC
p 0 BOX 236-2r)1
11GARD OR 97281
Phore #1 684-7543
1..crnt ract ora __.___. ...._.-.__...... ._..__.._.
JA" MILLER
PO BOX 23291
00RD OR 9 7281
i•4hone #r 684-•-7543
Ivey #. . : 430109
11cr,.upanc:y of the above i-eferenc2ed building is hereby given, on(I c:artifit.,
t-he compliance with theState Of Ur ^doo) Spec.iarlty Codes fat- thcp ul.oup,
')CrupmOrY, and k1sp? under whir..h the referenced permit Was Issued. f
FIRE DEPARTMENT
out (iVC3 I �hF'F.'C 7llR
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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST, HILLSBCRO,OR 97124
COON 1 i�-�/ INSPECTION REQUESTS: 503/640-3561/693-4415
t PHONE: 503/648-8761
OREGON Page 1 of 1
Date U3/25/93
Time 13 : 55
Permit 'Type il� siuential Electrical Permit Permit # : U5038772
Permit Status APPROVED Applied 03/25/93
Situs Address 12655 SW 131ST AV TI Issued 03/25/93
Permit 'Title SFR - ELEC/NEW HOUSE & L.V. Completed
Permit Descr. To Expire 09/21/93
Project 'Title SFR - ZLEC/NEW HOUSE & L.V. Project # P0029974
Project Descr. * EROSION
Parcel Number 2S1'TI - Land Use District
Valuation 0
Legal Descr.
Owner INSPECTION - 'TIGARD Construction OTH
Applicant Name T & M ELECTRIC Classification 9UU
Applicant Addr. : 833 NE BALDWIN ST Occupancy K3
HILLSBORO, OR 97124 Validated by KF
Applicant Phone: 250-1596 Inspector Area
CONTRACTOR : '1' & M ELECTRIC Lic. C 34-1480 648-6556
Fee description Units Fre/Unit Ext fee Data f
-----------------------------------------.---------- -
Square Footage [Enter Sq. Ft . ] 2500 130 OU
Limited Energy 1 20 . 00 20 . 00
Subtotal Electrical Fees : !; 150 . 00
State Surcharge of 5% U 7 . 50
Total Electrical Fees : U 157 . 50
** * Fees Required **,t *** Fees Collected & Credits ** *
-------
Receipt No. Date Payment
03/25/93 157 . 50
TOTAL THIS DATE ********* 157 . 50
Fees ., 157 . 50
Adjustments ; . UO 'Total Credits : UU
Total Fees : 157 . 5(' Total Payments : 157 . So
Balance Due : , 00
rIOTICE! This permit becomes null and vold If the work or construction for which If Is Issued Is not commenced within 190 days Once construction ha.t started,
the permit becomes n-dl and void It construction Is Interrupted for a period of 190 days. I codify that the Information presented by the applicant and
his agent or agents In support of thin permit Is true and correct to the beat of our knowledge I acknowledge that the Building Department's reliance
upon false and misleading Information may Invali.Rte this parm!I All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be compiled with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
Ilia granting of a permit does not grant authority to access pdvale property or to use easements. I further acknowiedye that the ties or occupancy of
the structure or building permitted.depends upon my calling for Inspncllons at various times during the process of const-uction and the building
Inspection stall verifying compllunce with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely of the risk of the appllcam and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval is given by the Building Official. I further acknowledge that a Iden may be placed on the title of vie property upon which the permit Is issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements
APPIICANT'S SIGNATURE —
� WASHINGTON COUNTY
PERMITDepartment of Land Use & 'Transportation ELECTRICAL
Electrical Inspection Section APPLICATION
1F5 North First Avenue, #350-1?.
Hillsboro, Oregon 97124
Information: (503)640-3470 Fax. (503) 693.4.112 Project/Permit
PRINTPLFASE Number �2-) DatePlehe
complete4, Complete Fee Schedule below
1. Location of installation1`1Number of Inspections per permit allowedy
Address !pelt 5 5 ; / 3 i �A Service included: `Items Cost(ea.) Sum
n Building y y /n A. Residential -per unit
City �/ r,�q nt� Suite No. 2 .�
Tenant Name 1000 sq.n.or lase $85.00 4
(if commercial) - Each additional 500 sq.ft
or portion thereof
Tax Lot Map No. Limited Energy $20,00
Each Manuf d Home or Modular
Thoma^Map Book: Page: Sectio
Dwelling Service or Feeder $40.00 2
__
Directions ��o yA y B. Services or Feeders
Installation,alterations or relocation
— 200 amps or less $50.00 2
Commercial i Residential 201 amps to 400 amps $60.00 _ 2
401 amps to 600 amps $10000
601 amps to 1000 amps $1,1000 2
2a. Contrnctor installation only: Jver 1000 amps or volts —� 1700.00 2
Electrical Contractor - �� wLE. LNc
Reconnect only $40 00 —_ _ 2
Address 'SInJ j3Ajjjwj&j _S _ ---
_ C. Temporary Services or Feeders
Date_ Job Number Installation,alteration or relocation
Property Owner T�a _) �tGiNl. r,� - 200 amps or less $4000 _
Contractor's License No, 3 4 /4�� 201 amps to 400 amps $5500
„ - -- 401 amps to 600 amps $80 00
B
Contractors Board Reg. No. E .3 V X53 —_ over 600 amps to loot volts see•B,aloe
Signature of Su r. Elec'n -_- _ D. Branch Circuits
License No. vl/ Phone rJo. New,alteration or ez!ension per panel
a) The foe for branch circuits with
purchase of service or feeder lee.
2b. For owner Installations: Each branch circuit $200
b) The fee for branch ci;;uits without
-- – - -- — purchaa of service or feeder fee.
isint Un ner'sNome---_- 'ioneTtn� First branch circuit _, $35.00
Each add'nl branch circuit $2.00 2
E. Miscellaneous (Service or Feeder not included)
Each pump or Irrigation circle — $40.00 2
Earth sign or outline lighting --_ $40,00 __ 2
The
Signal ara limited
installation is being made on property owo energy cane/,alteration
which is not intended for sale, lease or rent. or nxtension $40,00 2
Owner'sf3' inture _ F. Each additional Inspection over the allowabh
in any of the above, per inspection
3. Plan Review section (it requlied) $3500 --- -
5. Fees
A. Enter total of above fees $ / 5�
5% Surcharge (.05 X total feas) $
Subtotal $ _
B. Enter 25% of line A for
For InspectIT118 call Plan Review if required (Section 3) $
640-3561 or 693-4415 Subtotal $
24-hour recorder, Less Bulk Label Fee $
one working day In advance of need blalance Due $
ThIr permit becomes null and void If the work authorized by the permit Is not commenced within 160 days from date of Issuance
of such permlt or If the work authorized Is suspended or ahsadoned at any time after work Is commenced for a period of 160 days.
Electrical Permits ars non-refundable and non-transferable. 11192
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON 155
DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE, 503/640-3470
OREGON ii:SPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Permit #N : 050387'72 l�r.�,jw,:t # : PU02997d, 'J'Latliz ; VIP Page- 1 of 1
Applied : 03/25/93 l.S:.ued 03/25/9:3 Expires 09/, U4/11'/93 05 ' i2
RF, F1'E
Permit Title S.FR -- E:LEC../NrW HOUSE & t, V.
Description
Jib AdLirrss 1265! SW 131ST AV T1
fawner Name felt3PE(-'!T10N -- T'i!IARL r• -.3;,n l
Applicant Name T & M E.LECTRf(--
Phc,ne number 250- 1596
1nspe(7 s 12e
CITY OF TIGA RD ;Aj TW
WYOFTWARD
7
MAMUNITY DEVELOPMENT DEPARTMENT PrRiylli
13125 SW iimll BW. P.O.Box 23397,Tigaml,Oregon 97223 EO3)639-4176 I R IT!I T It. . . » . . „
03/j—
zji,TL ilUDIRESS. . . ; AL6.j,.� '0.-4
SURD #9
1iL()L1'K. . . . . . . . . . . L.0 1 . . . . . . . . . . . . . �1+4
LAU.1 I-DI HU
HE 1 SSW" DWELL.7146 UN.J.15t .1 f
OF WURK. 14EW b L'DRIYI:1.A. L44 H 4G 3 . . . . . . . . . . :48f'l S f
-'
-1 Y1-`E OP USE. 5F RV.QU I 1-.ELI SfIL io�4C' I
'I"'YPE OF CQf\IST. 51\1 F- I RS 1'. 1'A 38 FV. ft R1611'1'. - 1 1 ft
I"01\11). . . 0 I,L..: 9f F I�OW 1 0 tt REOR. 0 r t-
ULLOPPI10"Y GRV iR3 S E - I
SlIM I Es. . . . .. . .L 1-1-i I RD. Ft I I-4L D
HE I GH T. . . . . . . . ..LIS ft (J'f(41- SMOKL DE VEL TOIRS. eY
FLOOR LOAD. . . . 440 psf Q6 W 4 6 PHRKIINK"I GPOCE�'.;.
Pemarks: Pr4TI-1 I
SINKS. . . . . . . . . . . J, R-ncw DFRV)INS. . . . 1'441'11,1` LOW 1"REW4 I W"). 0
LF-4WITURIES. . . . . 15 WOTLN HEWFL.IRL). . . . J I' W
18/:.'HOWLIRS. . � . LOUNDRY C1'RHYS. . . .VA
WF4 I'E R CA-DEL-1,S. . ".31--wFN LINE (f-t ) . I;0 . . . . . . .Vj
D I 5HWM'*)'1-IER5. . . w A T'V,H Lf NE (f t ) . ; .1.0 0
G I',)R a F4 G V 15P. . . : Ri-)IN DRAIN ( ft ) . -0
...........
F.:L S
FOr"L HTR93. . oil type anlul.mt Icy date
li Ll V)S/ J J VI:,14 1'E.) ki" 6 l-, g. 1460 00 „IH 03 1
o-,I 44-L.". 00 JI-1
FORN 100K :0 1`10)LIE).. $ 267. 95 (-H Q42 16
1"URN :=I 00R WO()1.0 Ci I' V r..-:. 5 .IH 0..i) I
F-URN. I0
D10FRS. j -280. QIQ1 JHQ)3/1
0 ()'11 il-IR 1.11+11'7';;: 1 P 0 H K 8 500. 00 'J 1 1 Qf3/. 1.
00t) llt-'k r 015 JI-I
. .,k;; J11 0.?,
,JAY MILLFIR BLDR. J14('.
;.-5 MA 11i.3 j
0 BOX 23291 '5'7 1410 J 1 0,3
flIJORD OR 75 1)14 LA 3
:'hone it : (: 84 - 543
,.t:111trLRt.'t-rvv—.
Ii-0 I"ITI-I-ER
1-0 BOX
I" 100M) OR
i-lhrlrie
Iqe[.I #. 30109
355 TWAL.
This pewit is issued sub)tct to the regulations contained in the RL 00.1 RL D I IW14-i_t_. I J 01'4,.,
-
Tigard Municipal Code, r-fato of Ore. Specialty Codes and all other V 0 co t: f o it ri d I I-,r,t�) Fit,eplac.e
applicable laws. All work will be done In accvr,da;.,@ with approved 1- 0'3 t D P a on 15 t)-m C-t Gas 1- 3 tie lnst�
dans. This pervit will expire if work is not started within 160
lays of issuance, or if Nolk is sulptim-4 I 1A# .1
insiry C-/I-1 LAoaor`d n r"1.;
Yr,e i,m L L- L e e 13J.q I Ia. t ti I,e
,k qf tj I o1•1 1.1 ut'
1..a"I 1 v);A I11'.;. t
CIT1P'OFTIGrARD LSEWER COWNECI-ION
CnYOFTWARD
COMMUNFY DEVELOPMENT DEPARTMENT 01120MON PI In,R N I'I"
13125 W Holl Blvd. P.O.Box 21397,TIgRM,Oregon 97223(603)6304176
SITE ADDRESS— « 1.2655 SW J31S7* AVE
FO .-
1ILL. 49 ILS
BLOC14. . . . . . . . . . - . . . . . . . . . . . . . :244
I EW)N-1 NAML. . . . . ..
US" NO. . . . . . . . . . : F1 X"I'LJ k11 LJN I T5. .
CLASS OF WORK. NEW 1)W E'L L.11-4 G U N f r s. i
TYPE OF 5I NO. OV DUILDIN6isl
TNSTALL. I'YPE. ii Ufl�W R IMPLRV !aURF;44CL.
FE-L's
,JAY 1111L.L-FR BLDR. INC i:y We a a](.)1.(11 t t.)V date V-ec;pt
'
P 0 BOX 266:'91�91 PRIVII, b g?I kozi. oo JH QG/ i 5 9,5
INEWr. 00 JI IP 3/* 1.5./9.S
OR 9*7c.-81
684-7543
'010RA(' 10H ON
11.11)ne 1,0114L
REWIRED
This Applicant agrees to ciaply with all the rules and regulations
of the Unified Sewage Agency. The permit expires IN days from
she dAte issusd. The total amount paid will be forfeited if the
permit expires, The Agency does not guarantee the accunary of the
gide sewer laterals. if the sewer if, not located at the measurement
given, the installer shall prospect 3 feet in all directions trDe
the distance given, if not so located, the inial ler shall ourchase
a "Tap and bide Sewer' Permit and the Agency will install a iateraJ.
!. ssi.ted Bpi :
Lal I for, itisj.?er-t itin
r "PO
SW Iiall Blvd. PLNCK/RECT #e"
CITY OF
�. IGARD POIk)x23397 PERMIT # rns X93 /U U
COMMUNITY 1)EVELOPMEN'I'DEI'AR'I'MF,N•I' Tigard,Oregon 97M
(503)639-4171 DATE ISSUED
JOB ADURESS: I Z-(o 5 5 SyV 13IIt TAX MAP/LOT AS/0 4C -r'1 N 2 Y y
SUB: NlnMLXYG H4LEI Cl LOT: �`� M 1 __ LAND USE: _
VA: ::AT I ON: 103.0 41f, `
OWNER SPECIAL NOTES
;SAME: �,JQ-AA M.lLU,,-L, h • r)c- REISSUE OF: _
ADDRESS: �'-P-. b • �O� '2`��29 LAST REISSUE:
__ I I a r-crn,. C'�G'7 2-9 FLOOD PLAIN/
PHONE: (M4– 7J4-5 _ SENSITIVE LAND:
CONTRACTORpp APPROVALS RED IRED�/
NAME: n-A I'�L1 ILN i )ldh kly' � • _ PLANNING:
ADDRESS: r r�5 F� �� ENGINEERING: _
_ FIRE DEPT:
PHONE. OTHER:
CONTR. BOARD #: 5QICCA EXP DATE: l�-
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: -Y-,C-1'1 LIST/SUBC('NTRACTORS:
A MECH: _ )ae I l t-le�. BUS TAX: _
ARCH/ENGINEER CALCULATIONS:
NAME: _ TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: _
C(AMMI NT S:
APP(.iCANT' S GNATUP,F
Received By: _ [late Received: — _�
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. SAL. DUE
/A511j-d/oU 10-432 00 Building Permit Fees 443. ,-
10-431
3. `y10-431 00 Plumbing Permit Fees /,i3-
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building .IS //�
Plumbing 7, -7 ✓
Mechanical .Z
10-433 00 Plans Check Fee
Building , 9j
Plumbing
Mechanical /
10-230 06 Fire
:xwlP 3-0�
30-202 00 Sewer Connection, vU o2/oJ
30-444 00 Sewer Inspection •3 / 3 �"
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees _
25-448-06 Institutijnal TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees /3-50 13501-
25-448-05
3Su _2.5-448-05 Mass Transit TIF Fees //0 _ //0
52-449 00 Parks System Dev Charge (PDC) Su U
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of) _
TOTAL. ,j 3i sV 09 ,31
nm/3587P.WPF