11172 SW 84TH AVENUE 1�-
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1 11?' SW 84"' Avenue
CITY OF TIGARD 24-Hour
BUILDING inspection Line: (503)639-4175 MST 01-n�
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received — Date Requested �l AM PM— BUP _
Location — Z 11 -7 3 �'`'� ..— `'�— --Suite -- _ MEC
Contact Person Ph( ) __— `( - PLM
Contactor__— -- Ph(—) SWR —
BUILDING Tenant/Cwner —,— — —__ _—.— ELC _
Fooring- ELC
Foundation Access:--� _—, — -
Ftg Drain / r� J ELR ---_
Crawl Drain
Slab Inspection Note,.Shear
SIT_
Post&Beam � 1.
Shear Anchors
Ext Shoath/Shear !
Int Sheath/Shear
Framing --
Insulation
Drywall Nailing --- ------- --_.-
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --— --- - ----- - ---
Roof
Other: �- ------- ------ -
Final
PASS PART FAIT.
PLUMBING
_ —__ ----- --- — -- — —
Post t'• Beam
Under Slab
Rough-In
Water Service -_—-__ -• -- --___ _- _
Sanitary Sower
Rain Drains -- ------ — - -- - - --
Catch Basin/Manhole
Storm Drain -- ---- ------ _-
Shower Pan
Other: -
ma
_50 _PART FAIL - -- ---- -
HANIC_AL _
Post&Beam —
Rough-In �_ —. -- --- -- ----
(Sas Line
Smoke Dampers
Final
PASS PART FAIL ------- - --- - -- --
EQ_dTRICAL —
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 _ �� Please call for reinspection RE:_- _—.— Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dstw � � __ Inspsotor-.-__- _ _--.-_ IExt
Other:-__ —
Final Do NO REMOVE this inspection r4cord from the lob site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MST _
INSPECTION DIVISION Business Line: (503)639-4171
Received -_ Date Re nested `� AM___ PM - —_ BUP ----
Location f 12 t r"�-� Suite —__— MEC _—
Contact Person h _) PLM
Cc;ntractor—` JY/vn�F ��lfCP1 r Ph SWR
BUILDING TenanUCwner ELC
Footing ELC
Founuation Access: �-�( ,t
Ftg Drain r '` /` C.. �✓ -r ELR --- ---- -
Crawl Drain
Slab Inspection Notes: SIT ------ -- -------__-
Pnst&Beam _.—
Shear Anchors - -
Ext Sheath/Shear
Int Sheath/Shear
Framing --- - --_ -- - -
Insulation
Drywall Nailing - ---- _ ----
Firewall
Fire Sprinkler -----
Fire Alarm
Susp'd Ceiling -- -
Roof
01her: —_-- -- -- -
Final
--PASS PART FAIL
PLUMBINGi 1__u ____ �l _ L i4��
Post&Beam
Under Slab - - — ---
Rough-In
Water Service
Sanitary Sewer
Rain Drains - - - - --- -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: --- - -- ---
Final
PASS PART FAIL
MECHANICAL
Post
—
Post&Beam -
Rough-In —_ -- --- ` _-- —.
Gas Line
Smoke Dampers — - — — ---
Final
PASS PART FAIL -- ---�— —� J" ---�
ELECTRICAL_
Service _
Rough-In
w lab
Low
Low Vc,tage
fj La .iaim
Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL.
SITE Please call for reinspect on RE: ___ -. lJnable to;nepect-no access
Fire Supply Line _
ADA t
Dae_ r� Inspector _- / 77 hv�
Approach/Sidewalk -+@-`-- �LC —` Ut-
Other: .__.______-___.
Final I DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
ELEVATION CERTIFICATION
PER SECTION 710.1 of the OSPSC (C'.'17YOF TIGARD
35 10.1 of the OTFDSC AEGON
THE UPSTREAM MANHOLE RIM APPEARS TO BE ABOVE SOME OR ALL.
OF THE FIXTURE; SPILL RIMS IN THIS STRUCTURE. INFORMATION IS
NEEDED ON THE ELEVATION DIFFERENCE FROM THE MAAHOLE TO
THE LOWEST FLOOR CONTE, `KING PLUMBING FIXTURES TO
ESTABLISH THE NEED FOR A BACKWATER VALVE(S) AND TO
DETERMINE WHICH FIXTURES NEED TO BE PROTECTED FROM
BACKFLOW. OBTAIN AND SUBMIT WRITTEN DOCUMENTATION TO THE
CITY OF TIGARD BUILDING DEPAkTMENT WITH THE FOLLOWING
INFORNIA71ION:
LOT NUMBER t O
SUBDIVISION Ask �IiC,p.,LL /tAea s
ADDRESS-LU-1 Z eU) 2q t'- At/v-
PERMIT# /BAST 2 o 2- bo153
A TRANSIT SHOT ON(DATE)
a?. _ _ •iE1S VERIFIED THAT THE FIRST
UPSTREAM r'ANHOLE SPILLRIM IS_4,0' " Hl:;!) OR LOWER(CIRCLE
ONE)THAN THL LOWEST FINISH FLOOR ELEVATION.
70�� ` —_ ------DATE 3/zo 0 t
I'LUMBEIt
64j/ t. 'l DATE 3�z0�z
JOB SUPERIN TF DANT
I ABOVE INFORMATION ACCEPTED AND APPROVED BY:
INSPECTOR— . 6, ---------DATE
13125 SW Hall Blvd., llgard, OR 97223 (503) 639-4171 TDD (503)(584-2772 --
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)63q-4171 BUIP
�M
Fleceived Date RequestedAM ._PM BLIP - - - -
Location —_._ -L-2 S'(4 MEC - -- - -
Contact Person Ph(—) �i LPLM -- -
Contractor — _ Ph( ) • -- -
StivR
BUILDING Tenant/Ownei _— ELC
Footing ELC --.
Foundation .�,
Access: ELR
Ftg Drain -
Cra:vl Drain SIT
Slab Inspection Notes: -
Post&Beam —
Shear Anchors
Ext Sheath/Shear / - `• -_i ✓ - —� —
IntSheath/Shear
Framing
Insulation
Drywall Nailing
Firewall _ -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ---- -- —
Roof
, Fir�l-� -- - -_ --
p .S RT FAIL
PLUM ING
Pc st&Bean, _
Under Slab ---- ---
Rough-In _
Water Service ----------
Sanitary Sewer
Rain Drains --� - —-"�—
Catch Basin/Manhole
Storm Drain -- — "'--��----
Shower Pan
Other:_---- - _ _—
Final _—_— ------ — -- - - -- ——
PASS PART FAIL
-----------
MEC_H_AN_I_C_AL --
Post ft,Beam
Rough-In - -- - ------ _. —
Gas Line
Smoke Dampers
_fAPART FAIL
TRICAL
Service ----- .—_—.-__
Rough-In
UG/Slab
Low Voltage --
Fire Alarm
Final u Reinspection fee of$ 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 L Ins
ADA pati ti — 7 D Inspector Ext
Approach/Sidewalk
Other: _
Final DO NOT REMOVE this lnspectlon retord from the Job sl#e.
PASS PART FAIL
\ CIT" OF TIGARD �, _ MASTERPERMIT
'�+ PLiMIT#: MST2002-00153
DEVELOPMENT SERVICES DATE ISSUED: 3/6102.
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 11172 SW 84TH AVE PARCEL: 1S136CB-10600
SUBDIVISION: ASH CREEK MEADOWS ZONING: R-7
BLOCK: LOT: 010 JURISDICTION: TIG
REMARKS: SF Path 1
BUILDING
REISSUE STORIES: FLOOR AREAS _ REQUIRED SETBALKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRSI: 036 Sr BASEMENT. of LEFT. 7 SMOKE DETECTORS.
TYPE^�:USE: SF FLOOR LOAD: I ;,ECOND: 1 113 sf GARAGE: 460 at FRONT 38 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: SO RIGHT.
VALUE, S 187.43580
OCCUPANCY GRP: R3 BDRM: .1 BATH: + TOTAL: 1.948.00 of REAR,
_ PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DR^"IS: 1 CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP• I WATER HLATERS: t WATER LINES. 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHEr,FIXTURES
MECHANICAL
FUEL TYPES FURN c 100KI BOILICMP<3HP. VENT FANS: 5 CLOTHES DRYER. I
GAS FURN 1=100K: UNIT HEATERS: HOODS: I OTHER UNITS I
M.AX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: OAS OUTLETS:
_ ELECTRICAL
T RESIDENTIAL UNIT SERVICE FEEUER TEMP SPVC,FEEDERS_ BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 imp: 0 200 amp- WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'I.500SF: 3 201 •400 AMD: 201 •400 amp: tet W/O SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITEn ENERGY: 401 •600 amp: 401 •600 amp: EA ADDL SR CIA: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFOR: 601 • 1000 amD: 6011ampS-1000v: MINOR LABEL:
1000.amolv011
PLAN REVIEW SECTION
Rerormecl only:
>•1 RES UNITS: SVC1FDR>•225 A.: 600 V NOMINAL CLS AREA/Sf C OCC:
ELECTRICAL•RESTRICTED ENERGY _
A.SF RESIDENTIAL _ B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM. AUDIO A STEREO: FIRE ALARM: INTERCOWP.AGING: OUTDOOR LNDSC LT
BURGLAR ALARM: OTH 901,EER: HVAC: LANDSCAPEIIRR1G: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK. INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAlTELE COMM: NURSE CALLS TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,759.30
ESUNGER BUILDERS INC ESLINGFR BUILDERS This permit Is subject to the regulations contained in the
11575 5'.N PACIFIC►i IN 11575 SW PACIFIC S INCIN Tigard Municipal Code,State of OR. Specialty Codes and
115 1S 11575TIGAS,OR IFIL all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire If
TIG WD,OR 97223 work Is not started within 180 days of Issuance,or if the
work is suspended for more than 180 days. ATTENTION:
Phono: Phone: Oregon law requires you to follnw rules adopted by the
Oregon Utility Notification Center. Those rules are set
Req 0: LIC 6236' forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 81 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspectiun Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection
Foundation Insp Footing/Foundation Dr, Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
(t_ 49 14 r
Issued By : __— Permittee Signature :
Call (;0 ) 639-4175 by 7:00 p.m. for an inspection needed the next buslnes Iday
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00109
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DA r E ISSUED: 3/6102
SITE ADDRESS; 11172 SW 84TH AVE -
PARCEL: 1 S136CB-1060J
SUBDIVISiO'J: ASH CREEK MEADOWS ZONING: R-7
6LO-X _ — LOT:_ 010 _ _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK- NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF
Owner:
ESLINGER BUILDERS INC FEESES –
11575 SW PACIFIC HWY Type By Date Amount Receipt
PMB 160 P RMT CTR 3/6/02 $2,300.00 27200200000
TIGARD, OR 97223 INSP CTR 3/6/02 $35.00 27200200000
Phone: 503-620-9515 Total i $2,335.00
Contractor:
Phone:
Rea #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180
days from the date issued. The total amount paid wil' 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 located,the installer shall purchase a"Tap and Side Sewer' Perm
Issued by: _ _ Permittee Signature:
Call (;63) 6394175 by 7:00 P.M. for an inspection needed the next bus ess ay
Building Permit Application
('Illy of r� igai'l� halt ru:civtd: i'• Pcrnul Ito.:MJr�p�,� OWE
' rI I'mject/nppl.no.: Expire dart::
Crryuf'1'ignrtl Alldlcss: 13125 SW Ilall lilvd,'I'i a EGE�>)/ .� --- - ______^
I'liswo: (503) 639-4171 IVED Ualcissued: 11y; Iteceiptnu•:
Fax: (503) 598-1960 Case ldc no.^ - I'aynlcnitype:
L:uul use uprrawlL __ .1itom I&zfamily:Sil»ptc Complex: �/ rn
U 1 &2 family dwelling or accessory U Commercial/indusoial U Mulli-Llnlily New ctmslruction U Demolition
r-I Addition/nilernlion/replacement U•Tenant improvell)CM U Fire sllnnklerinli ri III U Other:
Intl addnas I I( 1L S W 9AvC Bldg.no.: Soilc no.:
Loc 10 __. I I11uCk:M Suhdivisiun -�a ptU� Tax neap/Inx lot/account no.: 134,0', /�b� J
I'r<r!ject name: � yp� - :/ _ y �
Description and location of work un prcmiscs/slx viol cnntliliuns: �YY!e,.
6WNER FOR SPECIAL INFORMATION, USE ('14TRUST
(t loodplain,sel)fIc capacity,solar,etc.)
Moiling address:�/, l) �u a If �ll'1 p►1� l dL� 1 dt 2 family dr ,ing: ooL/ Q�
City: -0 SUuc: LIP. Valunlionol'w.alt......•...1R..?.7v?.G:.......... $ `c
I'hone: - �/ I'vux: 17S :-mail: No.orbedrnunts/I)aths................................. LA ? _
Owael's cerlescntalive: Wahm4m —' t �. {?Ir 'Total uunlber of hoot:~..............
Thune: I"it x: r mail: New dwelling arca(sq. I'l.) ................•..•..•.., Iy _
-•�.r Garage/carport mea(sq. ft.).........................
Name: - a �1.11CC' J L le�L_> CovcIed poltll vca(sq. fl.) ......................... A
Mailing addl(w, ( ) 1 Dcrk ;urea(SII. II ) ....•.............. . •................ -
I �1� __ -..-__ Other strucIme arca(m I1. .......... .
City: A Stale: GIP : I )
Phone: IrW MIX: E-mail: -� /'rllluncreiulliuduslriallnudli-family:
Valuation of work................................ ...... .
I?xisling bldg.urea(sq. fl.) . ........... ...........
Business unntc: .•--.c ' . �n - .� I�,,• --------
�..� 1t11� C- 1'- ✓ - IAC-_- New bldg.arca(sq. fl,) .....•.... .. . ...............
Address: mom►- J '' Number of stories............
_ _
Illy: SIi11C: !II': --
--- -- --- 'I YPr of construclion....... ................ ........
I'11unc: I ilx: I?-nuul:
Occupancy group(s): Ixisl I
— -- ---
�G_�-
/j) -fill . . New:
----
Notice:All conunclors and subcontractors me Irllimed to be
licensed with the Oregon Construction Cominciors Bo:ud moci
Niune: �-r fie. �,lC"1l .rr>< 1 provisions of OILS 701 and cony Iw required to be licensed In lllr
Address: z� �G t, `t jurisdiction where work is Icing performed. II'llic r,ppllcant is
Cil : r1 . Y" StVif1, 7.IP: "�,� - exelttpt front licensing,the following reason npplics:
Ctlltlata per.oI Fr& p., -.?[I flan_ It _ - -----
Ilex:
Name: ft1ft-t-110o f y Conlnd pelsmi BYlap — FCC.%dile 111)nll ilpplicalloll ...................•.... ---
/�d111t.5V-._.�"�1:1..Yr1 p.�—.GZ, __.:.? t�L► a Dine leceived: ---_-_-_i -_
I'uy ~tall /II': Amount occelvcd ...................................... 1 _...-_.�-.___..
I'lunlr �14u: II' orad. 1'll•n•:c 11�Ic1 In I11• •,1111•IIIdI�
I livirby Iclllly I have tvall alld I1ulmilled Illi~ applicatioll Illld 1111' 10 all IluhJitlimis 1lcccl4,ud11[sults,pkat hall IIIIINI11111 NI Iul 11101,.11111NIIINII m
allacbcd t bct Hill, All provc;mm of laws and oldiliances govelnhlg this U VIUI U MAYIe1C•ald
wok 1v01 he kilmlilit•tl 1 W 1 r W11 bvicm or not. Cletilltmdouudwr. -_— _1
Aulliori/ed Signalive: ''— hi11C: ,y_ZY/OL. '� NenK d un'tlwTilct ai i<Iwwn an clef 11 call _
$
III iIII name 1.1 t r ►►■t__.4�-�, L•/��`�/,��! .Z.. -. 777^zzz _ Crr holt rNtnoUwd ✓__Anwmu
Nulim-I Itis pemiii opplicallon expilcs it n Ilcrniwd 11411 obtallied N am 1 MII trays liner it 1111M lcell loccepled its complele. 414)4h 11(601111W MI
i'itiitibiiig Pcriuil Api)licat:ion
Dalcrcc eive�!: Permit no.:
City of Tigard Sewer ►cnnit no.: Building Address: 13125 SW flail Blvd,'Tigard,OR 97221 I g permit no.:
City of Tigard phone: (503) 639-4171 Project/appl.no•: Ltxpiredatc:
rax: (.503) 598-1960 Date;ssued: By: Receipt nn.:
Lard use approval: _—__ case Me no.: Payment type:
1
U I &2 family dwelling or accessory U conullercial/industrial U Mulli-fal:.iiy U 1,011ant improvement
ANew construction U Adclitioti/alteratioit/replacennent U rood scrvicc U Other: _
1 1 1 1 ► .
Job address: 7Z 5W tbtJ4:? Descri Nlon ()( . s rc(ca.) 1'01a1
Illd_g. no.: Suilc on.: New 1-rind 2-family dwellhq;s only: -
(Includes 1001t.for excrtolllilyconned loll)
Tax mnp/I�vont no.: 15 I ���_+ Srlt(1)bath
LAW to Block: Subdivi-iio":A;h (ftek Meadow) SFR(2)balh -
Projec.nanto: Crttn4ts SFM(3)bath -- - -
City/cou-9y: A cj \_/ zrp:87223 I�,c t additional a dkitchen --
Description and I anion of world on premises: Sileulilillea:
New 5 � i I LA H 1.+1 L Catch basin/arca drain
Lst.date of utmpletion/inspeclion: _ _01, Drywclistleach linddench drainPLURIIIIIING�CONTRACT —
1II Fooling drain(no. lin.fl.)
Manufactured home utilities _ -Business name: LAC -- Manholes - ---
Address: l Tz 1`1 !,D- GJ Ec t,, 128 U Rain drain connector
City: IStatc:L ORCI-hely Sanitary sewer(no.linn.)
Prate:(o(S•Iq`7 Fax:b ; 14-Z I E-mail: S101111 sewer(no.lin.fl.) T
CCB nn.: �j(�'t (( Plumb.bus.reg.no: ?7Ci - Gt: ( 2 Wnler scrvicc(no.Irl.ft.) -
Cily/luc:m Iic.no.: O(j�j(j Mature or item:
��
Cnntrnclor's representative signature: Absor Ilion valve_
Back flow preventer
Priol tante.: -C)6,-JL Unlc.110 •'Z"7j I-)1
Iinckwnlcr valve
Uasins/lavnlory
Name: Clothes washer
Address: - -' Gliltwulicr
City: SIaIC; xlp; Drinking founts n(sf )
_� Gjeclor swap _
Phone: Fax: Gmail: -Iixpmision tank
1'ix1U sewer cAr
Name(print): Edi-1, .9 r c1 r r y .,c. -1 oor drains floor s- ink4/lmb
Mailing address: r Garbage disposal
Hwm 1 lose bib t
City: Slalc: 'LII': 72L) Ice maker
Phone: _q 5 15 1I-nx:C,2 0-T1 751 F,111Ail: nlcrccptor/gtertsc imp
Owner Installatiorl/residential mninlcnance only: 11nr Aclual Installation -11ttimer(s) _
will be made by me or the maintenance and repair made by my regular Itoof drain(commercial)
employee on die pml►ctly 1 own as per ORS Chapter 447. Sin (s),basin(s), nvs(s) - —
Owner's si nature: Dale: Sump_ -
liXtA 101 ill
1'u►. s urwr.r/showcrd►An -- --�-
_Name: N
Address:
_ -WrUcr tenter
__
frond: -- I--nx: 1i-mail: _ Total
Nan all)UdItUcaau*wW venal c",pleats call Jwidkllon rat mac InrotaWlao Notice:11tis pclolil application Ivl lrlirnlitll fee................$ -�_---
U Nu U MasletCad expires if a permit is not obtained 1 Inn rrvicw(nt — 76) S
Credh crd number: within 1#0 days alter It Inns been State surcharge(876) ....$
Ir te` 1'O'1'AI
as complete. -
�une eu .w r a Chown on cte�ll e�vecce lete. ' .......................$ted�-- _ r p
CuJlioiikr tllmrure _ - mea nu 1 410161M1 mu"M)
li'lechanical Permit Application
1)ntc received: I'ermil no.:
City of Tigard I'l iccl/appl.no.: Lxpirc(laic: -
C'iryn/Tigard Address: 13125 SW Ilall I1lvtl,'I•If,aid,Olt 97223 Dalk:issucd: Ily: Rcccipinu.
Phone: (503) 619.4171
Fax: (50a) 598-1900 Case Iilc no.: f I'nylocnl type
l.allyl Ilse approval: �—---_ -- -— Iluildirtf!permit li: ----ADETTriv
U I & 2 Gamily dwelling,of accessory U contmercial/indusl iat U Mulli•I'tmnily U TC1111nl hollim engem
New conslim Ii n U Mldilioo/71Ccrnlionhcpinrcmcnl U Otho:
308 SITE INFORMATION1YALUAVONlitCHEDULE
tub addrerts: (� -12. $v1 Qjy4=t' �. IIIl11Ci11C equipment tlutlttllllCS 113 hOXCS I,cIuW. Indlctilt IIIC doll;n
111dg. no.: —^—�Sidle nu,: vnluc of an met.0;mical I1 aiwinls,equipment,lahut,ovclhead,
Tax nanp/lax lot/account profil. Valuc S _
I.ut: Itlock: Subdivision• -1 C,1FM L i�[fP0V!nQj "See checklist (tar impurinnl applicolion Infurmmlino and
I'nljecl ntunc: -� jurisdiclion'.: tl t• II.-dole foI residanU:ll perntil I";c.
C'lly/cnunly: "rc;av-.' _ : 'llf': W d-3` _ -F 1
I ll!sc 1►lion and 11114{lion I I work on prentjses: t 1 1 1 1
1_ t r(c'1 a t 114_14E y 15
Fst.dale of arntplrliun incl/ tcclir►It-mea�lemlQ� 7-1-6'L -- AC: - Deutipllon F0 !y. 11mouly lics.ouly
Tennnl implovc1m.111 m chaltgr of tisc: Air haudimg unll _ CFM
Is exisltog Space hrnled ur condilionrd?U Yes U No nit cantTiion 1,1 ��(site plan required)
Is cxasling!spat r insulated?l]Yrs U N" Alleinhon nlt xis ing 1 Cf C system -CONTRACTOR -
MECHANICAL IioiletWo pli-Nsotc �—
liuslr _ (alc I' 1cf 114.1 1 o.:
suIIl'
Tons 11'1' 1/11
Addiess:
1110-In 111 - —
t
if Y: ) Slnle�- %II': III,ll llunlll(silr pini lulo toil)-`-- — — —
1'I�,;me:a��_1. , __ rax: Lt•nmil; � _iiatil,llillh(aceTilrnocc�ilirnrr Tl'i'[7/lT-_____...__r_.
Including dodwork/venl liner U Yes U No
-lit-lil rc( roTocntciicnlrrs-
sa--isliciacloiT
t itrinntt lIn , .';_J. _ wall,or floormouNed
Naloc (please prod) C �- � l f•r p — col rofn,j�ITatccml toI tan urnnceCONTACT -
PERSON
c r gcrnllon:
Absorption omits__ _ B1'll/I
tJann r✓ C'hillcls_---- _____`_. III'
Coma oessul s
Addicss: , .r
--•--fid � �'-- - �� ---- '.ur ronmcmla exhaust nor rcnlat nu:
Clly: _— -- Slnl1: ZIP:_ - Appliance vent — —
('hour: fax. L's-mail: 1)lyele:,hnust-
1To`ods,TypeDli/re'.i. itulicn umoal
hood lire suppression syMcill _
Name: � L' t s Exhaust fan will)silt.le duct(bnlh falls)
r lailin nddlr.ss - 'T xTintisl s stent n i it roalil ur, U
pilling
11111 , � t � rte mil rlymenl sull on(tilt to uul cls)
,
yllc: I.I G NU Oil
I'I one (tax(, <)- ? ntaiL - vac Tmj1 ra Ti art 1 ounTove-1-l ow eIT-s---
roccsSp p ng(sc aenanl cn:quircd) .
lJ.unl --
Nomber of om lets
11 ac�iis v .11111 asci--e ar egil purer-I- iii- -
illlllr�,ss: I tccnnnlvl•I u rpincc
City Slate: _ '4.11': used=lyjm --- _
I'In ull t i r l
it 11;
---—� wrnnl!t 41u v 1ltc cl --
hrr:
�I'I'In.ult', •,II•.natutt ,tale: �- Itrt't
Iffly
Nln all pull h 111411 w trld rlettll tMdt,Rheas!call)mimlicli i I'm Inme Intd111a1a1N1 I'ct tail fee.....................
UVisa UhlnsrelCald Nulice This pcoatit npplicnlit'm Min.nuull fee................S
rlldu card nnndKl - -{/ cxpilcs if n prrnit is nut nbinine1l Plan review(at _._ 'AI) `.
w•ilhin Igo dnys alter it has beem Slate smchmge (819I11 ....S ._
- "mile t A flki:i� awii nn cret'Tsid ncccpled as complete.
1•miifinllvt—1lsnatmt AinnwH d111401116AX ON!i
r
Electrical Permit Appl ication
- 1)nlereceived: Permit no.:
City of Tigard Project/appl •w.: Gxpired.11c:
Cirye%/'ignrd Adthcss: 13125 SW ILMI mwi,'rignrd,OI2 97223 Doleissucd:— Hy: Rccetpino.:
Mimic: (503) 639-4171
Vast: (503) 598-1960 Case file no.: Payment lypc:
Land lose ;11)1)1 Oval: ___--_ --_----.`_--
TYPE OF PERMIT
U I & 2 family dwelling or accessory U C:onunercial/indum ial U Multi-family l: Tcnan( improvement
ANew construction ❑Adtlitioit/al(eration/replacement U Oder: U Pallial
1 INFORMATION luh gddIC55�1 I -7 -1, SW 9�1i>" A-t�• Illrlg. no.: Suilc no.: Tnx Innphax IoUaccount no.:
_Lot: (p lllock:- Sul►division: �S�S�s3KMcckdnw1__��— -` --- _---
Project nnme: 6 CreRK Description and location of work ort premises S, I9_I{ EaI!,iI
F.stinr•'red dale of completion/inspeclioll: y
i 1 CI
Job Ito: 1 Mar
never 11'11"" Qly.
1lllSlllex5 Ilallle: D . A . J c r O 111 o G].c c L r i c (en. TolAl 110.Inc r
New rcsbkttlial-slogle or nadll-fandly per
Addi-ess: PO Box 751 _ dwelling unh.Includesallaclirdproge.
City: Hillsboro S(alC0 RLIP: 97M 3 Servicebtclutled:
Phnnt•,
648-514411 I-Ax: _ :-I»oil: 1000 sq.ft.ur Icss n
1 .t
'It no.: 3 6 0 51 I3Icc.bas. lie.no: 3�_1���-- Bach additional 5011 sq.n.or portion Ihcrcof
--
United energy,residential 2
t rIWinetroI1c. no.: 1063 Limited ertergy,rwn-tell dential 2
i tach Insists foci Ili elf hove or orodult r tl&cllhtg - -----
Sierra re of sultcrvi•ing a eel-I licien(required) Dole — Service antUor feeder
Stip,elect.name(print): License on; 2 Services or feeders-installation,
919 Al iil alteration or relocation:
200 stops or Ica% 2
Pl,trw 'print): IJ-tri I•hC 201 ampslu40flampt _ 2
p,, 401 snips to 600 amps 2
P•Lnlnt),nddfC9s: � � 1 l 1 r��CaSj - 6014111111 to IOWslops 2--
City: �1'1 G t d State: ZIP:l 7 x 0 over 100(1 snips or volts 7
I rax:(' 2 1 -911751 fs ntniL Itecun,cclordy I
Owner Instillation: he installation is being made nn property 1 own Temporary rervlc"or feeders-
which is not intended for sale,lease,fent,or exchange according to I.00s rtlfoo lealteration,sorrelocallon:
OILS 447,455,479,670,701. 21x►awls ar less ? _
201 21nps to 400 amps
lAvIlet'S sil!nalnlc: I)ntt: 401 infrfxlnnpe -- 2—
Branch circuits-oew,alteration,
/� or extension per panel:
1 x
t I;t1n" I�____ �_ _ _ A. Pee for brut..lr cinAls with purchnse of
Address: service or feeder ree,each branch clIcklir
It. Fee for branch clrcuna without putchose
City: Stale: 7,11':
-- — -- . -- of service or feeder fee,first brnmch circuit: 2
I'hone: I nx: F mail:PLAN REVIE"W(Pleble A-"' .11 41-6 wipph)
-- -
liach uldillmut bnncheircah:
Are.(Serslee or feeder viol Included):
U Srrvirrovet 215 amps-cnmmminl l Ilrallh cmrfacihly f!eh unlpof litigation circle - 2
U Sri vire over 310 snips-paling or 1&2 U I latatdous location I'sach sign or outline llgldblg 2
(amilydwellings U Iluilding over 10,(x)0 square feel four or Signal circuil(s)or a Ilmiled energy panel,
ill system over 600 voles nnndnnl stole residential units in note allucnnc allegation,nr extrminn• 2 _
U 1111lldimgliver 1111remanic% U feeders,41x1211111%oroene 4111seripiun'
U Mcupmn load over 99 persons U Marttlraclureil a1luclurej or ItV 11altt F'Acls additional Inspection over lite allowable lit any of the mlrrrve:
U ligrc%s/lighiuogpinn U Olhrr. _ Per Inspection
N111nn11__sell of plans hill any of file above. Invesliealfunfee [---i --r!--
The al►oye are not applicable to lenlporary c-nsfrurllon service. Otter
Nor oil)udullelionr arceltt credit cardr,please call Itrdrlkllun for more Inrannallrnt Nn1ICe:111113 penttll applicallon Pettilil fee.....................S
U visa U Mastetcud expires if n penttil is nal olunincil 1'1111 review(til _ %)
t'redu eml number: IJ ii/ within 1 R0 days eller it Ions her 11 S(nle st►nchalge(11%) ....S
rIrCA:lttelt 114 Ct11t1111e1C. I/)I A I1 ........................
____il�nre of ariJlio714"ii ih`nwn etairelliFii7-_._'
1
-— —1'ar�i iiet�i�r��1(nalute iUlinnnr + 4411 4611 t6411A't►All
RECEIVED
ITT Ino
alu t"D111Q j1b��itA
Ale
I I
I I
POOkk710
f` IiO(,1SE 5i
m 7=r zoa.s
7.9D Fih�E �
'PI: 203.0
63i h
PRIVFW,Akly,
I N
N
1 0Alp
ITA-L PWAA 3YRKET" TREE a"
r IL7 F-I f-s
q•• • ;�� pL.'S
�� '37.02' 'S'SIDEW/�LK
1 1172 S.W 3A A'\A=.
LOT 10 ASI I C:RVVK MI ADOWS
WASI11N0'i'ON COUNTl
MAI'13116('11-1000
XONIN(t K7 LOT SQ.N'r,5000
11172 SW 84.111 AM
•r1UARD,OR
1151.IN(11;R BUILDERS,INC'. (503.620.9511)
11575 SW IIAC'I{-'tC I1WY,PMIII 160
TIOARD,Oh 97223
P:II(►SION('ON•1'111011.PLAN
I Sill Imre to be inslallcd.i,low side ol"lot
2 Ihiveways&sidewalks to be grnvcl«I