15769 SW 82ND AVENUE I
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15769 tiVV 82Ild Ave
__ ELECTRICAL PERMIT
Y OF
TI CARD PERMIT#: ELC2003-00334
DEVELOPMENT SERVICES GATE ISSUED: 6/9/03
13125 SW Hall Blvd.,Tioard, OR 97223 (503) 6394171 PARCEL: 2S112CC-07300
SITE ADDRESS: 15769 SW 82ND AVE
ZONING: R-12
SUBDIVISION: LANGTREE ESTATES
BLOCK: LOT : 005 JURISDICTION: TIG
Project Descriptinn: Install hot tub circuit.
RESIDENTIAL. UN_I_T_ TEMP SRVCIFEEDERS_ _ MISCELLANEOUS
1000 SF OR LESS: _ 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L rOOSF• 201 - 400 amp: SIGN/OUTLINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps -1000 volts: MINOR LABEL ('10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION•.
201 - 400 amp: 1st W/O SR,'!. OR FUR: 1 PEP HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: 4 RES UNITS: ,> 600 VOLT NOMINAL:
Reconnect cnl SVGiFUR—225 AMPS: CLASS AREAISPEC OCC:
Owner: Contractor:
BONNIE DYE OLIVER'S PRCISION ELEC.
15769 SW 82ND AVE 17035 SW HIGH HILL LANE
TIGARD,OR 97224 BEAVERTON,OR 97007
Phone: 503-639-2841 Phone: 503-579-7747
Reg 1t: ELE 34-521C
------ LIC 41435
FEES SUP 25395
Description Date Amount
Required Inspections
JELPRMTI 1-1 r Permit r 'tri; $46.85 ----
11.\]8"',Stat" la" o v n l $3.75 Rovjh-in
Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All
work wN 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 rules are set
forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)2466699 or
1-800-332-2344.
Issued By: Permit Signature:_�l
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intender) for sale, lease, or rent.
OWNER'S SIGNATURE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE.. OF SUPR. ELEC'N: `t >? _ _----------- --- ---_-- DATE:------.____________
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
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06/06/2003 09:47 2035795907 REVILO SAINTS PAGE ial
lde�.b icai Permit Applicatyon
Date trceived: Permit no_
City Of Tigard Project/appl.no.. Expirodate: `T
City njTigard Address: 13125 SW tiall Blvd,Tigard,OR 97223 Date i95ued:—_ By:. j Receipt no. --
Phone: (503) 639.4171
Fax,. (503) 598-1960 Case file to.. Payment type
Land use approval:
M
tri 1 dk 2 family dwelling or accessory O Commercial/industrial J Multi-fanti',y Cl Tenant improvement
U New construction U Addition/alteration/replace mens J Other: . J Partial
lil,lg m__ - Suite no.: ITax m tax lot/account no.:
Lut: Block: Subdivision:
Project nam : Description and location of work on premises:
Estimated date of com letion/i'n ctlon:
Job oo: -M- Maw
-CTS —� Dew ri tion t -, (r� Total no.1.5p
Business name�� ,5 `�tL /raG;�- New mirimtlal•AWIr w mrrM hinigy per
Address: dwrlWytunN.InckaYnenaitvd�ruge.
City: Stat ZIP: %rr lcrkar de&
Phone; _7 %f Fa 5 --mall: IOW sq.ft.or las 4
Each additional SW sq.ft.or portion thereof
CCB no-:41 Elec.bus.lie.no: 3 Y—S-A4 a.... U titerl energy,residential 2
City/metrollc.no.; 3-a5.65 4 Or G Limitelenergy,non•residential 2
�, Each manufactured home or modular dwelling
nattier of supervrsm�el�ec►trician to uiredL_ -Date D-/-C Service arA'or feeder 2
Sup.elect name(print) yr/►1. �� License no: 3 ^icaorfreAet+-taahllatkm,
allervilon or relocation:
1W amps or less r 2
Name(print)' -201 snips to 4W ams 2
Mailill address: y -.G 401 amps to ti00 amps� 2
—. 601 amps to 1000 s 2
Cit ; r T y 1 State: ZIP: Over 1000 am s or volts 2
Phone:— I Fax; IE mall Reconriectonly I
Owner installation:The installation is bring made on properly I own Tetarornrys0rvkeeoe n-
which is not intended for We,lease,rent,or exchange according to imiliallsillor"aher+tkm,ormkwatton-
ORS 447,455,479,670,701. 200 amps to seas _ 2
201 amps to 400 ams _ 1
owner's sigmtore: nate: 401 to two amps 2
)stanch clrcwNa-staler,aketilloa,
or extses"per reel:
Name; �! AFee for branch circuits with putrhase of
Addrnas: - service or feeder fee,each branch circuit 2
City: State, xIP: A.Pee b'LAh ciwift purchase
of service c feeder fee,first branch circuit: _2
Phone: v Fax: �ttlaVl: Bachditiotulbranchcimrrait
Mlac.(50^1100 or feestat Inc uded)r
D%rvier over 22S strips-commen•ral U Health•careforility EscA ump or irrigation circlr_ 2
Q Service over 320 amps-rating of 1 Act ❑Humdous lotalion Bach sign or outtine lighting _ 2
family dwelling i7 Building over 10,000 square feet four or Signal cirtull(s)of a limited rnrrRv psnrl,
0 System over 600 volts nominal more residential units in one stmetute alierstion,or eaxenslona 2
O Building over three stories ❑Feeders,400 amps or snore Inescrl tion.
O flexupont load over 99 persons U Manufactured structures or RV park DichaddMenallyps,pr over the ailw.bMImy o(tite above:
i U Egtees/lighnngplan O otherPetirupection _
1Wsbmft nob of plass rNth soy of the above. tnvewp000 fes _
710 above are not applilicable to ilemporsiry cvlsstrucill p tknlca. other
orntPermit,fee...................
se
Nor d1)tvialkoora accris,crrdlt coni..pleatali Ndlc
riorm to mere infarlon. Notice:This epplIention
t]Visa
review(at 96) S
a O Maeterc_ard expires if a permit is not obtained -
criabi card member; within 180 devs after it hasbeen State surchaMe WFH....S
— plm accepted err,complele TOTAL .......................$ O �
'�aTe r sAoe+n oe endir caw �— ----
s
attars _j wo461+rtt�0on�oMt
CITY OF TIG/ARD 24-Hour
BUILDING Inspection Line: (503)635-4175
INSPECTION DIVISION Business line: (503)639-4171 MST
BUP
Received __ Date Requested AM L'— PM BLIP
Location =Suite MEC
Contact Person _— Ph( ) c 9'7 y-0y3(,e I? PLM
Contractor _— Ph(- ) _ SWR
BUILDING Tenant/Owner _ - _ ELC _ d O 3
Footing ... -_'
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 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 PART FAIL
- - - —
PLUMBING
Post&Beam--
Under Slab __—
Rough-In --.-__�_ - ------- —
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other.
Final V- Y—
PASS PART FAIL -
MECHANICAL
Post& Beam
Rough-In
Gas Line _ _ __.--
Smoke Dampers
Final
PASS PART FAIL --- -------
ELECTRICAL —
Service
Rough-In
UG/Slab '(
Low Voltage
Fire Alarm - - --�
ASS PART FAIL Reinspection fee of$_ _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI _ ,_ [7 Please call for reinspection RE:.-- Unable to inspect-no access
Fire Supply Line _ Jam'%� �-+
f. a
ADA Date C� � �
Approach/Sidewalk — Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record fror>Ita the job site.
PASS PART FAIL.
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2002-00017
13125 SW H'.il Blvd., Tigard, OR 97223 (503) 6 iJ-4171 DATE ISSUED: 1/18/02
PARCEL: 2S 112CC-07300
SITE ADDRESS: 15769 SW 82ND AVE
SUBDIVISION: LANGTREE ESTATES ZONING: R-12
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHIN,; MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ _FIXTURES LokUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: tt
WATER CLOSETS: WATER L.iNE: a') ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Run new 40'water service, _—
____
Owner: FEES
Type _ By Date Amount Receipt
COX, FRED B + CLARE C PRMT CTR 1/18/02 $72.50 27200200000
TIGARD, ORR 9
15769 SW 91/'?24 AVE 5PCT CTR 1/18102 $5.80 272002 J0000
-
Total $78.30
Phone 1:
Contractor: _
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED INSP7C IONS
Phone 1: 503-771-9449 Final InsF,ection
Reg#: LIC 42671
PLM 34-70PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done In accordance with approved plans.
This permit will expire if work is not started within 180 days of 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 rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
Yali may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
k
Issued By: Signature.—
,�: >n.� _ Permittee _.
Call (303) 39.4175 by 7:00 P.M. for an Inspection needed the next business day
Plumbing Permit Application
Date received: - $-b2 Pemrit no.((/yl i5c,a Opo
City 4 Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 9'7223
Cary ojTigard phone: (503) 639-4171 Projcct'appl.no.: Expire date:
Fax: (503)598-1960 Date issued: _ ty: Receipt no.:
Land use approval: case rte no.: payment type:
JIQ f e 2 family dwelling or accessary Cl Crnnmcrciaf/in�lusu ial U Multi-family U Tenant improvement
t1�New construction U Adtlition/alteraticm/rcptaccmene 7 Food service U Other:
lob address: ��� Description Qtv. Fee(ea.) Total
Nen'1-and 2-family dncllings only:
FS�i 7w nBldg.no.: (Includes 100 A.for each utility connection)
Tax map/tax lot/account no.: _ SFR(1)bath
Lot: Block: Subdivision: _ SFR(2)bath
Project name: SFR(3)bath ---
City/county: ZIP: 2t? Y l=.ach additional batlt/kitchen
Description an ation of work on premises: _ Niteutilitles:
qQ , (.J-tj— .Sev UICs _ Catch basin/area drain
Est. date of completion/inspcction: / .29--c',Z Drywells/Icach line/trench drain
Footing drain(no.lin.ft.)
Mant.factured home utilities
Business name: (v c w .jluvvt(j1Mg• _ _ Manholes
Address: 2 ,3'c=' fvao.c;s Rain drain connector
City: State:C, ZIP: 7,)i Sanitary sewer
Phone: 77b-9 Y( Fax: 7/i-9•ys' E-mail: Water
(n.lin.R.)
Plumb.bus.reg.no: Water service(no. lin.ft.) 5 `
CCB no.: g• 3 y�7o P Fixture or Item:
City/metro lic.no.: / /_ Absorption valve
Contractor's representative signatui 9�kr.-nte v. Back flow reventer
Print name: + r tit a,i i r,� )ate: -/6 -U Backwater valve _ -
Basins/lavatory _
Clothes washer
Name: _S �G Dishwasher _
Address: Drinkin fountain(s)
City: State: ZI,': Ejectors/sun
Phone: i'ax: E-mail: Expansion tatik _
Fixture/sewer cap
Floor drains/fI r sinks/hub
Name(print): ��r e C(�! Garbage dis sal
Mailing address: G 9 S cv F-;.z-a Hosc hihh
City: - ' StateC�j ZIP: y Ice maker —
Phone: (, •L)9(f q Fax: E-mail: Interce.tor/ rease trap _
Owncr instaVation/residential maintcttancc only: The actual installation Primers) _
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sin (s),basin(s), ays(s)
Owner's si nature: Date: Sum
- Tubs/shower/s ower pan
Urinal
Name: _ Watrrcloset
Address: Water heater
City: ` Other:
Phone: Fax: E-mail: Total _
Minimum fee................$ S"S . u c7
Not nit Jurisdictions accept credit cards,ptase cdt iurirdktlon rot more inronrtatioe. Notice:This permit application plan review e.. ___ 96)
U visa U MasterCard expires if a permit is not obtained --�— '
Credit card number within ISO des atter it has been State surcharge(8%)....$
shown on credit cab accepted as complete. """"""' """"' �y y
:spires - Y T9)TA.I, $
_
Name of ctudltol r u
Cardhdder dputure s Amount W-46161&OWOMI
PLUMBING PERMIT FEES:
PRICE TOTAL N we 1 and 2-family dwellings only:
FIXTUR•_ES (indivldual - QTY eat AMOUNT_ (includes all plumbing fixtures In PRICE TOTAL 1
Sink 16.60 the dwe!Iing and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.80 f.r each utility connection)
One(1) ath _ $249.20
Tub or Tub/Shower Comb. 16.60 Two 2 bath _ $350.00
Shower Only 16.60 Three(3)bath —_ _ $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16 60 8%STA'i_E SURCHARGE _
Dishwasher 16.6 0 L!�CANIkEVIEW 25s/o OUBTOTAL
TOTAL
Garbage Disposal 1F 50
Laundry Tray 16.60
Washing Machine 1660
Floor Drain/Floor Sink 2~ 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60
Water Healer O conversion O like kind 1 _ t�uantit
6.60 b Work Performed
Fixture Type: — New Moved Replaced Removed/-
Gas piping requires a separate mechanical
Capped
omit. — ---- —
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatq!y—_— __
Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drair-3 16.60 Shower On! _
Drinking Fountain 16.60 Water Closet
—. Urinal
Other Fixtures(Specify) 16.60 _Dishwasher _
Garbs a Dis osal
Laundry Room Tray
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st 100' 55.00 3" _
Sewer-each additional 100 46.40 4"
Water Service-1st 100' x5.00 7 5 Water Heater
Water Service-each additional 200' 46.40 Other Fixtures
_ (Specify)
Stoma&Rain Drain-1st 100' 5500 —�
Storm&Rain Drain-each additional 100' 4640
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 — —
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50 —
Requested Inspections _ per/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 —
Grease Traps 16.60
QUANTITY TOTAL
Isometric or riser diagram Is required If v __
Quantity Total Is >9 _
'SUBTOTAL
-72 -- ---
8%STATE SURCHARGE - -
"PLAN REVIEW 25%OF SUBTOTAL
_ -_ Re uved only If flit ore qty total I6�9 _
TOTAL
Minimum permit fee Is$72 50+e%stale surcharge,except Residential Backflow
Preventon Device,which Is Sae 25+e%state surcharge
"All New Commercial Buildings require plans wrh Isometric or riser diagram and
plan reviow
I:\dsts\forms\plm-',ee9 doc 10/10/00
(;ITY OF TIG ARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION 9usiness Line: (503) 639-4171 MST _-
IUP --- --
Received Date Requested_ _ Z Z,—AM__ PM __.-- BUP
Location _ l i �, -2 Fq✓!k]L V Suite _ MEC
Contect Person _ Ph (_ ) PLM d coZ Od 6
Contractor_ _ /1�ct1Yl.-/ —_ Ph(- _-) '17 SWR _
BUILDING� TenanUUwner -_- ELS.
Footing
Foundation Access: '--'—" ELC _- --
Ftg Drain pv-�,..� K✓ .4Crawl Drain .��t z4t,s 11 .lc 2 — 1�.s <<' ELR
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors -
Ext Sheath/Shear
Int heath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - -------- _--
Fire Alarm
Susp'd Ceiling - --
Roof ,
Other: --- -- ,
Final
PASS PART FAIL - -- - -
PLUMBING—
Post&Beam
Under Slab
Rough-In
Er Serves --
Sanitary Sewer
Rain Drains -- - -.---�---_-.----_-._-__...---
Catch Basin/Manhole
Storm Drain - -
Shnh9r Pan
Other: - -- --- -- __r
PASS PART FAIL _ - —
_ HANICAL
Post&Beam --___---------.-�-�-- ----
Rough-In _- —_--- -
Gas Line
Smoke Dumpers
Final
PASS PART FAIL_
ELECTRICAL
Service --
Rough-In
UG/Slab --_—
Low Voltage
Fire Alarm ---- �--� --i -
Final Rein. wdlon fee of$.__— —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE_ LJ Please call for reinspection RE:_ _ —___- Unable to inspect-no access
Fire Supply LineADA
/
Approach/Sidewalk Date _ (_ 2- ____ Inspector _1�l ( _� __-KXt__--
Other:
Final �- DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL