Case File ca
Ul
n
a
N
m
(D
9750 SW Pihas Street
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 630-4175 MST Zi, Z-40 - V6
INSPECTION DIVISION Business Line: (503) 630-4171 BLIP
Received _- _,_Date Requested -1 - AM--- W -__-_ BLIP
Location --E--2 Sw l �7a. _J Suite_ - _ MEC -__-
Contact Person — Ph( ) 6-V Z L._w- PLM -_ --- -_
Contractor__ _ —_T-- Ph(____—) SWR ----- - --
_BUILDING TO rant/Owner .—
ELC
Footing ---- ELC
Foundation Access: .Q,2iJ J t' ELR
Ftp,Drain -
C:awl Drain _ -
Slab Inspection Nates: SIT -
Post& Beam _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler - -
Fire Alarm
Susp'd Ceiling - ----_ --
Roof
Other.
Final
PASS r.,NT FAIL
PLU_MBING ---
Post&Beam
Under Slab -- ------ - - - -- --_.- -
Rough-In
Water Service
Sanitary Sewer
Rain Drains ---- -
Catch Basin/Manhole
Storm Drain -- -
Shower Pen
Other: --�---
Final _
PASS _PART_ _FAIL - - -
MEC_HANICAL --
Posi&Beam--
Rough-In -- ----- - --._ -- - .^_.
Gas Lir,;
Smoke Dampers - --- --
Final
RMS PART_ FAIL -- ---__,.__ --------- --- - ---
ELECT --- - --------._----_..- -- -- -.�_-
-service
Rough-In ---
UG/Slab
Low Voltage -------- --- -- --- --- ---
Fire Alarm
Ro,nspecfion fee of$—___._. _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
u Please call for reinspection RE:____ _. —_ rF-1u Unable to inspect- no access
Fire Supply Line
AICA D� V L� Inspector -- Ext --
Approach/Sidewalk
Other:
Final -- DUB NOT REMOV=. this Inspection record from the job site,
PASS PART FAIL
CITY OF TiCAIRD 24-Hour
LIJi;�DING Inspection Line: (5031639-4175 JCJ ` �
MST
INSPEC*FON DIVISION Business Line: (503)639-4171 T
BLIP - —
Received Date Requested_ �v AM PM BUP
Location 1715-6 � i.�L Suite _ _ MEC _
Contact Person �: '-!��____— Ph(--) _G PLM
Contractor _ _ Ph( )
BUILDII_J_G Tenant/Owner _ — _—_ --__ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam —
Shear Anchors
Ext Sheath/Shear e._.._._. .
Int Sheath/Shear
Framing
Insulation
Drywall Nailing '
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING — ------------ ----- ,---- --
Post&Beam r
Under Slab -- -----------_ — -----Rough-In
Water Service _--- — ____ ----,___-- ----- ----
Sanitary Sewer
Rain Drains -- — ------ --- ---- ---
Catch Basin/Manhole
Storm Drain --- ----- —_ -- _ --.__--__—__
Shower Pan
Other• -----__—.�------ ------------- ----------- — - —
fQPA-F� PART FAIL --------_._... -------- ------ ---------------- ---
- -----
_CHANICAL -
Post& Beam — ---
Rough-In ------ - —..-- ---- —__ —- -- ------------
Gas Lina
Smoke Dampers ---- --- ------- ---- --Final
-
PASS PART FAIL —— __.... ---- ---- --- ----------- —
ELECTRICAL
Service --
Rough-In --_
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E] Please call for reinspection RE: — n Unable to inspect-no access
Rie Supply Line V
ADA Date %_ Inupoct�or'_/ / ,(� Ext
Approach/Sidewalk --
Other:
Final OO NOT REMOVE this Inspection record from than job site.
PASS PART FAIL
cl Fl
CD
ry O ^
7
� fl �►.1
3
U \�
f -
O O
Q
�0
S
C
4
s
Z
>c
CITY OF 1''IGARD 24-Hour
BUILDING MST
Line: (503)539-4175 MST •�Z
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received Date Requested_ ' _ AM.----_'M ----. BUP
Location r-'' �- Suite-- __. MEC __-_- --
__ Ph -- --)
Contact Person - l -- PLM _
contractor _ --__-- _-- Ph(-- ) — _ SWR --
Tenant/Owner ____._.-__ _-. _ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain SIT
Slab InF jection Notes: -
Post R_Beam --_-
Shear Anchors
Ext Sheath/Shear -�--� -
--
IntSheath/Shear _ Z
Framing
Insulation
Drywall Nailing -- ��-
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --
Roof
Other: - _-. ----- --- -
aj%ART FAIL — -- ----
PLUMBING -
Post& Beam _
Under Slab --- --
Rough-In �-
A--
Water Service --------
Sanitary Sewer
Rain Drains
C:etch Basin/Manhole
Storm Drain --- -__- - 711
Shower Pan
Other. - -- - --- /
Final
_PASS PART FAIL -- - - --- ---_ -- ---
MECHANICAL_- -------_-__ _._—_ ---
Post& Beam -
Rough-In --- -- - --
Gas Line
Smoke Dampers ----------- _----- ----- -- - -
Final
PASS PARTFAIL
RI
ELECTGAL_, -.-_.�_.- . ------- -- - -- - -- --- -
Service
Hough-In -- _-. ..--- - _ ------__- -
UG/Slab
Low Voltage ------- ---- -- ___- -- -
Fire Alarm
Final L Reinspection fee of$_.. -N required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Data.-._ �/1- � z Inspector
Other:
Final DO NOT REMOVE this Inspection record from they; Joh site.
PASS PART FAIL
hk,AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
. pop
. ►
4d i
4 \ ►
44 ►
4 c ►
4 �' ►
4 or ° loo.
4 l0 ►
i
►
4 O �. rD .
r , Al ►
.�
4 ►
Yr1 I
444
� ►
ti� ►
ct
a, II ,� � � O � ►
44 `'� ►
IN.
414pollx
r ►
�..y ►
Z4
41 1
f a
nloLj �tttti�tt �a .tyt:, 0901p6scog IVA sect ZOO rt. or
�
CITY �� T I���� ELECTRICAL PERMIT
PERMIT#: ELC2002-00232
DEVELOPMENT SERVICES DATE ISSUED: 5/23/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135CD-NP010
SITE ADDRESS: 09750 SW PIHAS ST
SUBDIVISION: NACIRA PARK ZONING: R-4.5
BLOCK: LOT : 010 JURISDICTION: TIG
Proiect Description: Temporary service for job shack at Nacira Park Subdivision
RESIDENTIAL UNIT _ TEMP SRdC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amn: 1 PUMP/IRRIGATION:
EACH ADD'!. 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 (101-
SERVICE/,FEEDER Y BRANCFI CIRCUITS __ _ ADD'L INSPECTIONS
_
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: "'st W10 SRVC, OR FDR: PER HOUR:
401 - 600 amp: LA ADD'L BRNCH CIRC: IN PLANT:
601 - ,ODU amp: __ PLAN REVI_E_WSECTION___
1000+ arnp/volt: >=4 RES UNITS: _ > 600 VOLT NOMINAL.:
Reconnect only: SVC/FDR >= 225 AMPS: CLASS ARTA/SPEC OCC:_
Owner: Contractor:
JLS CUSTOM HOMES ROSS ELECTRIC
17201 NW CORRIDOR CT#110 23810 SW DRAKE LN
BEAVERTON, OR 97006 HILLSBORO, OR 97123
Phone: Phone: 642-2800
Reg#: ELE 34-436C
LIC 118821
SUP 4232s
FEES _�----- __ Required Inspections v _
Type By Date Amount Receipt Elect'I Service
5PCT CTR 5/23/02 $5.35 2720020000( Elect'I Final
PRMT CTR 5/23/02 $66.85 2720020000(
Total $72.20
I
This Permit is Issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes ar,d all other applicable
laws. All work will be done in accordance with approved plans. 1"his 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 U'Ility Notification
Center. Those rules are et forth in OAR 952-001-00io through OAR 952.001-0080. You may obtain copies of these rules or direct questions to
i
Permit Signature:( C; (rl, «( Issued By: � '. / 6z
-
OWNER INSTALLATION ONLY --.
The installation is being made on property I own which is not intended for lease, or rent
OWNER'S SIGNATURE: DATE:.______.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:—
LICENSE NO: —
Call 639•4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
-- - —!—' - --- Date received:5 1 Pe _ •-�Q'(,
City of Tigard Project/appl.no.: Expire date:
City q-Tteard Address: 13125 SW Hall Blvd, Tigard,OR 97223 Date issued: I3y: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 1Case file no. Payment type:
Land use approval:
=New
mily dwelling or accessory O Commercial/industrial J Multi-family U Tenant improvement
nstruction 0 Addition/alteration/replacement -.A Other: --t1-PP —U Partial
t t
Job address: -7 p S w �l a S �f Bldg. no.: Suite no.: ITax map/tax lot/account no.:
Lot: Block: Subdivision: '► ala Q.tr oL o-r I), _
—Project name: Description and location of work on premises 5 if r t.►,('< r• ,�> `ham_
Fitimated date of completioniinspectinnv
Job n<►: Fee Max
_us� E le e�'r'i L _ bessriptlrm _ ea) foul no,Jna
Biuesl ttamc: - -
� �`�� Newresidenlial single tants per
Addres. Ss_�ti 5 L U �rt7� L t 1 dwtllingunll.Ineludesattasbedgxrage.
City: 0. 1 State:(;(-? ZIP: 9ervicelf rluded:
Phone: - $cto Max:Same L-mail: IWO .0.or less 4
C tach additional 5W sq.0,or portion thereof
CCB no.: $Qj a Klee.bus.lie.no:, Limited energy, residential 2
City/ et o II( C.no.; — - Limited energy, non•msidor m Z
V�"" y77��.--�-�.�_
Each manufactured home or modular dwelling
Signature of s�rvising electrician uired) Date Service and/or feeder 2
Sup.eect. name Iprintl License nu: a� 7 9ervleesorfeeders-Itntullnlon,
alterallon or relocation:
,1 L 200 amps or less 2
Name(print): J L Vl-�Sl a M rn�' 2011 amps to 4X1 amps 2
4111 amps to 61x1 amps __ _ 2
Mailing address: �CUC1 J w �urr�c�o. C�>t bol amps to Ifx,Oamps 2
c* • r - c,; State: Z1P: over IOW amps or volts _2
Phone., ` y0(,w rax:C 33 y3e C••mail: Reconnait onl,
Owner installation: The installation is being made on property I own InstTectponry se, rati or fo rr err
hich is not intended for sale,Lase,rent,or exchange according to 200 alas r leleratlon,arrclocatlnu:
2l)(l�or less _j � 2
,)[)S 447,455,479,670,701. 201 amps o 40(t ams 2
Owner's cij n.ilur_ Date: 401 In 600 ams _
Branch circuits-new,dterstion,
or extenrlon per panel:
"cl,3 _ A. Fce lin branch:ircuits with purchase of
Ati'IrC99: service or feeder fee,eacl,branch circuit 2
City Slate: Zip- - B. Fee for branch circuits widaxn purchase
------ I;tr I' mail of service or feeder fee,Tirol branch circuit: _ 2
Phone. Bach additional branch circuit
Mise.(Service or feeder not Included):
U Service over 225 antps•commet, _1 I lealth-cam Iacili[N Fach pump or imgation circle _ 2
U Service over 320 amps-mttng of I&2 U Hazardous locution Each sign or outline lighting
family dwellings U Building over lo,(xx1 square feet four or Signal circuit(%)or a limited energy panel,
f]system over(Ol)volts nominal more residential units m one smtcture alteration,or extension* 2
U Building over three stories U Fecdcm,4X1 amps or more •Descri tit n _ —
U Occupant load over 99 perm U Manufactured vnictures or RV nmk Each additional Impection over the allowable in un)oftheabove:
U F.gress/lighting plan U Other: Per impelium — ( —l- —
Submit_bets of plans with any of the above. Invest�9-a-fion fen
The above are not applicable to temporary construction service. other _
—_-- Permit fee ......................S _lok. 8
Not all j nirdmions accept credit cards,please call junsdlctum For more information Notice' Phis permit application °
U Visa U Mastercard expires if a permit x not obtained Plan review(at — /o) S
Credo card number. ___._ _ �.L—L— within IRO days after it has been -State surcharge(9°/a).... $
Expires accepted as complete. TOTAL.
Name of carJholde, ns shown on n find carr---
_ S
Amount 440-
(:ardholder st{nature —�— ��
MASTER PERMIT
TY OF
T I G A R D
PERMIT#: MST2002-00246
- -�� DEVELOPMENTSERVICES DATE ISSUED: 5/24/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 09750 SW PIHAS ST PARCEL: 1S135CD-NP010
SUBDIVISION: NACIRA PARK ZONING: R-4.5
BLOCK: LOT: 010 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence. Path 1
BUILDING
REISSUE STORIES: 2 FLOOR AREAS REQUIREU SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT 25 FIRST: 1402 of BASEMENT: of LEFT: 15 SMOKE DETECTORS. Y
TYPE OF USE: Sr FLOOR LOAD. 40 SECOND: 1,600 of GARAGE: 402 sf FRONT: 44 PARKING SPACES: 2
TYPE OF CONST 5N DWELLING UNITS: I FINIuM_:NT: of RIGHT.
VALUE: 5 265,002.00
OCCUPANCY GW R3 BDRM• 4 BATH: 3 TOTAL: 3.00200 of REAR.
_ PLUMBING
SINKS. 1 WATER CLOSETS. I WASHING MACH: I LAUNDRY TRAYS. I RAIN DRAIN: 100 TRAPS:
LAVAI DRIES: 5 DISHWASHERS. I FLOOR DRAINS: SEWER LINES 100 SF RAIN DRAINS: I CATCH RASINS.
rUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATERLINES 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
'AECHANICAL
FUEL TYPES FURN c 100K: SOIL/CMP a 3HP: VENT FANS: 5 CLOTH13 LRYER: I
GAS FURN>000K: I UNI I4EATERS: HOODS: 1 OTiERUNITS 1
MAX INP btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I
ELFCTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 0 200 amp: 0 ^00 amp: W/SVC OR FDR: I PLIMP/IRRIGATION: PER INSPECTION.
EA ADD'L 5003F: 201 400 amp: 201 400 amp: lot WIO SVC/FDR 011 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 500 amp: EA ADDL OR CIR: SIGNA'/PANEL: IN PLANT.
MANU HM/SVCIFDR: 501 t0 1 amp: 601-amps-1000V MINOR LA'jEL:
1000♦ampv•o11
PLAN REVIEW SEl:T10N _
Reconnect only:
>•4 RES UNITS: SVCMOR>•225 A >600 V NOMINAL, CLS AREA/SPC OCr.
ELECTRICAL•RESTRICTED ENERGY
A.SP RESIDENTIAL B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC L'r.
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL,
UARAGE OPENER: CLOCK: INSTLUMENTATION: MEDICAL.: OTHR:
HVAC: DATA/TFLE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,532.80
WhIITFURD/SCGTT LLC. JLS CUSTOM HOMES This permit is subject to the regulations contained in the
Tigard Municipal Code,State of OR. Specialty Codes and
4888 NW BETHANY K5#381 17200 NW CORRIDOR CT.#1 10 all other applicable laws. All work will be done in
POP- \ND,OR 972.29 BEAVERTON,OR 97006 acrordance with approved plans. This permit will expire if
wvi k Is not started within 180 days of Issuance,or If the
work is suspended for more than 180 days. ATTENTION
Phone: Phone. Oragon law equires you to follow rules adop' d by the
Oregnn UtPly Notification Center. Those rules are set
Rag#: LIC 139970 forth In OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling 246-1987.
REQUIRED INSPECTIONS
Erosion Contrcl Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final
Fooling Insp Crawl Drain/Backwator Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas LI,a Insp Appr/Sdwik Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical FI I
Issued By Permittee Signature
Call (5 3) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITE' OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: S -00162
DATE ISSUED: 5/[24/024iU2
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135CD-NP010
SITE ADDRESS; 09750 SW PIHAS ST ZONING: R-4.5
SUBDIVISION: NACIRA PARK
LOT: 01:) JURISDICTION: TIG
-- --- -
TENANT NAME:
FIXTURE UNITS:USA NO:
CLAS` OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new SF detached residency:.
Owner: — FEES
WHITFORD/SCOTT LLC. Type By Date Amount Receipt
4888 NW BETHANY K5#381
PORTLAND, OR 97229 PRMT CTR 5124102 $2,300.00 27200200000
INSP CTR 5/24/02 $35.00 27200200000
Phone: 503-533-2255 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applialr,t agrees to comply with all the rules and regulations of the Unified Sewage Agency. The per lit expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so locat;d,the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: �i�YY ! _
Permittee Signature:
Call (5 31) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
—
[).lie received: Permit no.:
City of Tigard 1'mjccUappl.no.c Expire e.
I rn��/fr,crl„I Address 13125 SW Ball Bkd I ward,OR 97221
I'honr (503) 639.4171 Dale Issued: fly:', +( ecelpt nu.
kl\ (01) 598-1960 Case file no Payment type
Landuseapproval: _ lK2fannh 111 l - Complex:
1 1.
J 1 ,C .' 1.1111115'dwelling of accessory U Comme,rl,1!n d-111,11 J .\111111 1.111111•, -ANL-\\ Wll.(I-Wion U Demolition
_I r1d 11111,11/ala rnhun/rrpl:,ccmm�t U'1'cnanl inillimr111.111 1110 X1,111 1.1,
JOB SITE INFORMAT1 '..n
oh address: � _ w Bldg. no.: Suite no.: W
l.ot:�(� — 13mck: Suhdivision: � )` - I I,Ir Wrap/tax lot/account nn.
0
U� Project name:
l�15I0 Desctiption and Irxation of work on premises/spccial conditions:
1 ' 1 �J
1111 » ,ar
Narnc: �� r- _ i\ —
� L1._ ti.�- +
K1•lil11u' :Id lits,. L ( ) f 7�1 1 X 2 Guuil\ dt,tllin,: o
�'� — ' r�J 2 AS o 81,
('n\ 7.
State C, /.II . �',Ilu,uion 11! ', 0
I'Lun, 1 11: li-mail: ut hrdlu„nlsr'h rth♦ AA
LU- tj
Owner's leprrsentau%c „lal ❑urllhrt o1 13(1111•. !.
PhOI1C: `. I'd �.�j �-L,C -r1H111: Nr\t'd\\r11111":11 .1 � 1 111
1 / I ��vrlrllpu�l1 ur, 1 'i II i
Name:
Mailing address:
-- ------ State: 7.1 P: Olhrr>Iruiluri•ar''a I�t3 tLl - --
City: -- --
I'honc; hax; G ntaiL ('ornmrrciallindustriel/multi famih:
Valuation of work... . .. /
r Existinr hldg.arca(stl. I't
Business name: tl `' (I_.i�r��- r l.�x- '._)_�_ _. ..
_ Nc�', hide arra(s5'. 11.)
Address: -- Numhrr
titalt 12 711 ,
I ti lir of runtitrut 111111. .
Occupancy Lroup(s). 111
CC11 no.: -L-5 7 - New:
City/metro tic. no.: Notice:All contractors ants suhcontraclors are reyutrcd 111 he
licensed with the Oregon Construction Contractors hoard under
pm\r,unry of ORS 701 and may he rryuired to he licensed in(he
Name: C� ), _-_ -- jurisdiction where work is being 1wilormed. Il the applicant 1,
Addres���
1 ��� � ? ,_,� ' exrnlpl from licensing,the following reason apphrs
1 Sta %II'. `{) -
Contact person:3� flan nu_:--6—r-)(
_�' ---- - -- ---- -- - -
1'hor.r ?,'7 Z _ I; =-- E-mail:
Nam ( 1 111ac1 person Does due upon application
Addtcss L '
ylt
{ T f Sia Antolini it —I _. $ _ I
( rly . t ��l'l_ _ _ s
I'hon I a _I'Icasc retro to Inc schedule -
1 hrtt'h) er1111 v l have fe'ld and("alllllll•II IIII.,apphl all,Irl mid Ihr tirA iII I111wh•hnm a trill emm t v i plrav,;,II pnlvlrrhnn f1,r 111"1'1 1'1
nitaohrll chrckllst, All pn,\Isn� y of I,I\\'.and olduonit rs r1 \1'oun�Ihl, J v1,., J Mastt'It'ard
- 1 .Ii wl 11111111♦.,
work \%Ill he tontplird 'A' it Iclhcr Ill Wk IIIOd IIt-IL-I11 Ill 11rll
Authurvrd sit!nalurr Zee,
l� (Num-r 1111,(Irnn11 appl11,IL 111 c\11111 •11 e prnnll r.nut uhl, "J,\1111111 1 NO khl ,,11101 It 11.1.11"1211 ntteplcd X,w1111,1rt1:
Mechanical Permit Applicatia>11 Permit no.:
Dale received:
City of Tigard t'rojecVappL no.: Expire date:
1 - Address: 13125 SW hall Blvd,Tigard,OR 97223 pate issued: By: Receipt ro.:
01),o) 11garlt Phone: (501) 639-4171Pa mentiYP c
Case file no.: Y : _
Fax: (503) 598.1960 Building permitno.:
Land use approval:
7-kNew
amily dwelling or accessory U r' 11111urrcialnndu,ulal
U Multi-farnils ❑Tenant improvement
l_l ,� 111inut/allrration/rcplaccntcnt
O C)ther. _
onstruction t9,11t x
Indicate eyuipntent quantities in loxes hcluw. Indicair Illy Bullar
Job address' 41-4 � J W _ r S s value of all mechanical materials,equipment,labor,overhead,
Suite n- o..: - profit.Value 5
Bldg.no.: � � •
Tax ntap/tsar lot/account no.: rj , vSee checklist for important application information and
Lot: Block: Subdivision_ - jurisdiction's fee schedule for residential pennil fel-
1 Ill A
Project name: J I wit 104 t
s ZIP: I r1 Fill 1
City/county' t
�Lk Total
Description and Ir tion of work on premises:. FCC: '' - -1--��
---- scription may. Itcs.onl)
UcItrs.nnly
{ist,
(late III completion/Inslu-t nill - t I t ,I I
i oming unit - ( I M - -
'tenant Llltprt)%rlurrlt rtr chalwe rel u,x: _ _ ------- _ -
Air conditioning(Site pl:ui ieyulrcdl
Is r.vi,i nu p:1i r hcaled ur cnrtdllloncd I U l es U No - - - -
Alteralion of existieg IIVAC systcnl
Is r•1.Iln, 'I,�, ul ,1 ,1 J 1'cs U N" toper/compresors --
t r Slate boiler permit nn
Ions
Business nanir: t th,.l.cu ti l
---- - -- - -
I . r t Isc/smokc antper�./J�e�et tsnnike erectors
AddresI � a,c]_L._.-A- 1 -Wea�pump(silcpTnreyuircd)
titat l.II : _
Oily: 1�' '" recta 1 rep ace furnaccllrurnc-r -
1 l:Mail: Including ductwork/vent liner U Yes U No
r .7_2 _ nsta replace/relt)cateheaters-suspende
CCB no-' j}2 wall,or floor mounted
� 7 ' :-----
City/metra tic.no.: -��r'= •_-- ? Vcm fur ap liance of er than furnace
Name(please print}: L- 1 of gest on:
1 Absor uonUnits,_ -- Ill,ll/H
Chillers- -------- Ill,
Name:
If[,Colrcssors _-_-
m
- ?rev ronmenla ex ausl an vent at on:
Address:
7.11' APItbatic eve11t
__________--•
City_ - _. )ryerexhaust
P. retail: o s.'i yp�l
I'honc: e /111r" talenTfia7iliz _
1 hood fire suppression systcnl
Exhaust fan with single duct(hath fans) --
Name: '1 Lv ` -- ix Jost syste.nt a tart roan catin or AC
I �, = :ue p p ng an str t on(up to out els) -U(I-
Mailing addres>, seal ZIP. Z rYI'< _LI'(i NG _- 011
• SL -- —
(Ily_ i Z�d+� i m:sil ucl ti in.ac t a itiona over out els -
{'hune;` 1•',x'. 'rocessppng(schematicrrqulrcd) _
-----
1 I er it app ante or r equipment: C -
Naltte'_ t„C-J�t,c� - Decorative fireplace --—
Address: L .I - ` ' : Fnvitvi -- - =— —
!.I
_('ll Still` '` '-1 _-3-- on clove/pe e'slove `--- - -
Y
Phos _' Ut cr.
L�F'f��-- of ter:_----------- _J-
Nanitiraltl' siltnaUnr-` �' ,
(prntU ._�-.Z-F-r l —------ - Tenial fee
- - Nnurc I hr,pernul alglbcalt 111 Minimum let'
N,t,d1 puiWll,uun,.urpl,u•du ivd,.pl••ac urn luny wm Int uun'•inbnnrluun
J`,..1 U Md 1CICJIII c dun•.1t i l,Q"Illt is nut nhi,nnc`I plat) review(,It Q
1,rL1 aid nitrulrl , / „1111111 190 dal,it lie( II lla.heed dale,tire hat"VC I'"%I r
jL1 'pled ilk 0111111lete ''O AI•
Nantr of tLJllllrl)<1:1,1rInM'n 1111,ICIIII Jud .
..._...._- ............
s AR
Electrical Permit Application
_---- - t,,,tr n•celscol i'c1 rtit nu.
City of Figard I'1„Irrl/:1111,I.Ito: Expire date: -
t Addle.- I;I tiN' ILMI 111td.'1'i):ud,O1i ')7221 1)MI,Issued. - 11y: licet'y,tnu
I'bl,nr 15111) (11O•J 171 Case Ills no.. Payment type:
F.1, 15114) SIN 1900
;Intl rest• approval: _--
1
U I ,� .' I:uulls loss(Ilu1t;In .trrrssuly U l'uninlercial/industrial U A1ulu I,uniiy U•I•en;uu inlpruvrnlrnl
U Nrts rum.uu,ul„t U MI'111iunlallxi,lunn/rrpla.rnlrl,t U 0111x1 _— U Pattlal
olid;. nu,: Sunr nu 'Iax ntap/tax lot/account no 1s1 1
Jul,addles'; S� �.�l�t� 1L�l.S- - - -
I.al: ----
11)escription and location of wink on ptunlsxs
I'rujccl niultc
listinctlyd d;ux I,I lnnlllxlhuthn,la',rinn
1aiV417=41
1'a• Met
.lob no: /• ------ De'tliptiol• Qly. (ea.) 1'otnl nu.int 1
Ilu.utr•.• n,unr Ro�^s G crC _-_.-_- --- Nrn resldtvdi:d tlnnlrorrnn111-fnnlily,ler
\dJn •', �3�{�V is L4) V L41ducillo(;unit.luclollesanaclrrlgarage.
Sl,tlt'or 1/11' q 7t�3 sk•nIce im1udrd' '
I•tl•, 1`hl,lSloorO .1
l nal .t ll III..
11' mall -- - --- ..
_
I r II LLhu ud 5(Nlsy It t poluonlhucol -
�1s��1 UX111', Ines IIx 1111. 3y-Y3r� -- , --
t't'li n„ -
l'II,/nlrnn Ir tel, f.��(�_/ _ _ I Inut•Jcnul, nnn resldenhnl _ ___ --- -
I J I.al.h m:,n J1.1,I mea nnup rn mo,lulal lluclll Ig - -
_- I Lor spy�Ir
1,"1 lecll•zI _ _ _. -..
N'I\ �IIII' Clh ti l Cin Urlullr�l
Slp.n:,lule of sol set tit csurfeeders-{nst:dlalioo.
Sill, ch"t u•,mell'lll', al,erarlotorrelocalion:
kill 1 ' 1 2110,mills nr less -
?nl
N,ullrlptlnll 4��r 1111vnp.Il,6fN)nngn ------- - - - -
Is1I' lila ,nq,s u,IlHlnanq,+ 2 —
(II State 1 -(leer ltNHlatupxur vuilt - _ -- - -._ -Z
.1111:111: Itccounccl only
'Iroyulrary tersicr+or frrdrn- I
Uss'ncl inaallulil+n:l'Irc InsU,lla11 n Is hcln) 0111111 (tn property I own in,l:dlnllon,oileraliou,orrrlocaNnu:
salnxll I•;nal nurn.lyd fin sal• ase,n•nl,lu (,xthan);e according to
(Iktidl1,•155,•Vh) 0N),
11.IIr .� 1,1111 amps — — -
(h%necs 51'llatutc. -
Ilranch dreulh•nett,aUcralion,
I
or etlention per panel:
Name - �V L � ' -- -- } A I-rr 1`111 1)1,uldl Urtw.,.
—n ' Wlvlu•ul Icedcl It( c.leh htan(h uleult -
- I1 I cr fur branch cittu s ssnhoul purcha-w Z
( Its �1 � �� ,�-�i — '- -- (scaleeorfeederter•tirollranchcirculi --- --------
V`C� 11 A 1 all addlliuualt'tanchur,wl — — -
ILII
Mier.(Sertice nr leedcr nol Included):
I II loll I l hpunlpnrnllgauuucncic ___.—_- -- - - - -- 1 _
I , 11 sign or outline{iglmng
1J .loll 111
Ilmldmg•,Isrr In IH,II sya:ur(rel lll,ll lit 1 nal t ucwgsl or a hllutrll rn"rKy panel. z
Lnmlydwrltll,Ke .dnlation,nrcxlcnsum - ._---_
u,lnc Icsidrnunl wow w(1111.%11110111C
U lw,a-mm'et('011volts umnunal ._.
Ulerders,4lHlau,psulnane I,, •snlun _.-
J RulbhnK u,cr Ihlce Hlnm•hMollie: -
1 1 k l❑ll,ll11 IUad
lit 4-1,Il!pl'IH 1 hlanllt'loofell%oto tures ut kV Pat A I:1('II Addll{Opal{11(1Mt1{oll m1P1 Ihr a1lnNahle III alit rlf IIII' - -
1 I Idu•1 - I' I nr.l r.um � � I -
_I I I�n••,UhK,htulKpl.cl ----- -..._ - {
tiubmll tett nl pl:un ttltb xny(11 life>t we. In r.npamll,ll•I•
l III 'i
1114,allure at a fill,:rpplit:rhle to Iem potart I,ookif Il lion sertice. i
I'l 11011 II r
I , ..dl I le l.••..l�.......
l.a u,1`.., nal NuU(.c I In,Ilrunll aplll,l alma,
l.ul el........ .Mill-llnJll. o I. 1" 1"I" I'IIL\'ll'N' illi 1
rspuc�It a II•luno , mil nhl.nrr:ll
J\ .I _l�t.ralll alio /
sslllln, IXII LI• Ilirt Il 11.1'.to;rll
,XVIII ul udnll.l 1 'I'^ .1,l(pwd 1 lnll'lll,,1. 1111 \1.
..1� nlh•dJ.,.,. I,... „bl n.l
I1 ,:n,,ISI„ ,� ����• •ll,
k
11Ut3-7-2001 07:09(1 FIROPI:EDWnRL) I•IULI.LI1 ,'LUMBI 503 628 1633 TD:5035334306 l': 1' 1
,ruy. U 10 1. tu; r l FAX p. 2
1'luintung Permit Application
I)alemedved: Pwvwtno.:
City of Tigard Sewer permit Go.: butIdlna perndt no -
AJdteas: 11125 SW hell Hlvd,Tlgvd,OIL 97221 ito I/a (no., Bxpiredate:
0gvI 9dami I'hotte: (501)619-4171 pp'
7
Fax:(50.1) 598.1960 Ualelsaunl - By: -- ltecelpinn
Lured 11sC approvAl Cuefiler .: i'eyn,rntrY1K:
-
C6t 2 family dwelling or accesemy U Commemia irwlusrrinl Q mwirrmni)y Q Tenant tmpmvernent
New calstrueyical U Additiun/th ,retion/teplacentent U F(MA service U Other:
W11111.11 I MIELmmugm 111111110111 mill
Job address: lhxaII[kin 1j" tee ra, 7au1
Suite nn. -` Nan -anrf 1•G,mlly do I rrRa only, -
Bid .no.: _ _ _. (1nct dntoo n.rbrt' thtd1111yco-1too)
Tax tnap/lax Ioy—Unt"U,: _ S17t(1) all, -
1 Subdivision: f -1 -_ :IFN(J)GetII - -
rmJcct Horne: - -- _ — ---_ S ' (3)
City/cu un( 1 - ?.Ip: : ch t diU'un a elle ten
Description am)localinn r wd on prentiw-u _
•i Catch besir,/eren drain
17h,date of e•anpletioneinspection: Ll! ; i.r; i Urywells/Icacr��ldlrcnch dralu _ _ __
-man crelnQto__in. t.)
�nnurat,•tutetl home utl)iu_e_s _ __
I)uxinoes name: C:s1.1ur1.ti(.J �L��IxI_-- -t'(�IM�1.V1r• man o es
Adtimm: 2. Qvij j, n7n�tuin ctinnectur i •:t -_
State_ar ZII' `llDlnsewer(no. in,ft.) ? ,
�,� ���.,�j Stunit Bract(no.lin IC) -
rhone: Fnx: a�K:7[n s Cs—mall; ----
CCH no.: r" r Plumb.bus.re;O.no: sten is 1vr co no. In. .)
1 -i---•-- ---'� Nxtvre or Ileac
Cit hnedv lie nU.: [� _
_--� - Ablorption calve
Contractot's re{t�rext,tslive algnatttre: ( tq v +'� K low watrr
F'rint name C- 1 11 v gtlC' ackwtttt varve
ttl- rMury -
C ea wallr _
Nance: -_-_
T1is vvtis rr
Address:
ifzhim/lewer
log Fountn n(s)tor s f?tt>iil: llm I leu ca
Name(print): ��L� f Lv % our tTralu loot
_ UutubaRe _sposal
Mn11in add,ess: ' aL_ ow b1�h --
aty: +4 ry Stater:' 7 P.Jj_._. ice'nilk" - -
1'twnc:.� --male telt
Owner installati(Wresidcntial mal tenanae only: The actual irtMallatkm �JmeRs)
will Ire,trade by me or the mai Ince acrd tepair made b) my rogUlm -an�cumme�nlj i
engitoyeo arI lir P."Pr ry 1 n r ORS(41apwr 447. �'in j r1 yt(n(a},Sava(e) _-
tivvna's si nature; � Irau-
u vwed ower pan
-
Nemc: �. E. _ _ -Vtrntu c(rnet
Addreaa:-��r?l X5. 1- W�ta
Cit 1' r Sure: ZIP � ^ I lhhtr:
-.._.
7'altt
Nra as Inrb4 Uvr arrep r;;i.raa.eleaw cant I.W6-rrn Sa mae� Minimum fee.......
Noti.e Thls permit applleatlon plan review(at -_- 'IU) S
O M" O SIASINCud aspire,11 a permit is not obtained ---�-
tW',r.a mmt r. J—_ . __ .- . l widiin 180 days after it W leen Stalc surcharge(1191.)....S
Pj '10TA1. ,....... ._. S
ecceptulasmrnplete --'-
__ S
2 a311rr ilpr+re ----_�arnru` as 4616 twnatvStl
1
�4Q
i
a
QQ
atV"an
I
Gclr ge
V/
Main Floor
0
CL
t
i
59
N P-
60
SW Nacira LN
Scale 1 rr ?01 (Trach B Private ST.)
9750 SW Pihas ST Applicant;
Whitford/Scott
Tigard, OR 4888 NW Bethany Blvd K5 381
Lot 10 Nacira Pari. Subdivision Portland, OR 972z-9