14565 SW 87TH AVENUE ADDRESS:
.1-45...(OJ5 Sw '97r,4AVENUE
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone. 639-4171
Footing Rain Drain Cover/Service IN
Foundation Water Line CeilingPI:mr)
Post/Beam Mech. Shear/Sheath Framing $- ech)
Plbg.Und/Flr/Slab Plbg. Top Out Insulation `Elect.
Post/Beam Stnrct. Mech. Rough-in Gyp. Bd.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: A.M &P.M. , Entry:
Address:
Tenant: _` Ste:—_� MST: _41BUP !UV
i MEC
Con/ w} �,rn � 4 `„�_7 r� MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: .
Inspec _ _ Date:
PPROVED ___DISAPPROVED/CALL FOR HEINSP. CF CO
CITY OF T1 CARD MASTER PERMIT
COMMUNITY DEVELOPMENT DEP�JRTMENT PE R lyl IT #. . . . . . . : MST94- 0
086
13125 SW Hall Blv!;.Tigard,Oregon 97223*819V 16)139-4�71 DOTE ISSUED: 03/03/94
PARCEL: 2SI11AD-17.1100IZI
SITE ADDRESS. .. . : 1456' SW 87TH AVE
bUBDIVIGION. . . . PINELAROOK TERRACE ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .7
BUILDING
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :ADD BEDRMS:2 BATHS:2 GARAGE. . . . . . . . . . :84 Sf
TYPE OF USE. . . :SF FLOOR REQUIRED SE*TBACKS---------------
IYPE OF CONST. :5N FIRST. . . . :610 5f LEFT. . .-0 ft RIGHT. -3 ft
OCCUPANCY GRP. -R3 SECOND. . . -,902 '-,f FRONT. :30 ft REAR. . :25 ft
STORIES. . . . . . . :2 THIRD. . . . :0 ST REUUIRED----------------------
HEIfjHT. . . . . . . . :23 ft TOTAL----- : 1.798 Sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE— — $ : 71064 PARKING SPACES. . : 1
Remarks : r:,A'rH I
---------------- PLUMDING
SINKS. . . . . . . . . . .. I FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :3 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :O
TUB /SHCWERS. . . . .-3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :i,
tSATE R CLOSE I'S. :2 SE11, ER LINE (ft ) . :0 GREASE TRAPS. . . . . . _ :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . :0 OTHER F- IXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . !0 SF RAIN DRAINS. . : 1
MECHANICAL ------------------------------------ FEES
FUEL UNIT HTRS. . :0 type amount by date r-ecpt
/GP)S/ VENTS . . . . . :3 MPRT $ 31L. 00 JH 03/03/94 -
MAX INPUT:O BTU VENT FANS. . :2 Mv,LC $ 8. 50 JH 03/03/94 -
FURN ( 100K . . :0 HOODS. . . . . . : 1 M5PC $ 1. 70 JH 03/03/94 -
FURN ) =tl.00K . . :0 WOODSTOVES. :0 PPRT $ 97. 50 JH 03/03/94 -
FLOOR FURN. . . . -O CLO DRYERS. : 0 P5PC $ 4. 88 JH 03/03/94 -
BOIL/CMP ( 3HP:0 OTHER UNITS:O DFIRT $ 349. 00 J1A 03/03/94 -
GAS OUTLETS:O BPLC $ 226. 815 JH 03/03/94 -
Owner: t 1.7. 4°; JH 03/03/94 -
ADAM DROZDOWSK1
14565 SW 87TH AVE
TIGARD OR 97224
Phone ft: 684--8270
Contr-actor': ---------------------------------
OWNER
Phone
Reg -----------------------------------------
$ 739. 88 TOTAL
This persit is isFied sub'iect to the re,.-Iations contained in the --------- REQUIRED INSPECTIONS
Tigard Municipal Code, 'tate of Or-@. Specialty Codes and all other Foot/found insip Gyp Board Insp
applicable laws. All work will be done in accordance with approved POSt/Ilearl'! Strutt Rain dr-ain Insp
plans. This pervit will expire if work is not started within 188 Post/Beam Mechan Mechanical Final
days of issuance, or if wurk is suspended for more than 180 days. FILM/Under-f I oor- Plumb Final
Mechanical Insp Building Final
Plumb I-op Out Erosion Cuntt-cl
Framing Insp Cr-awl Drain
I 1-1 e d By: Insulation Insp
Call for insphetion b39-4175
Residential Buildinr,�_ermit AIl�atlon C��
City of Tigard _
13125 SW Hall Blvd. �I ► �2
Tigard, OR 9722-
(503) 639-4171 I ► p �D
Jobslte Address:_ 115(v�a S.�J, 7147 TI&ApD�2q
<' / Office Use On
Subdlvlsion:_/ I� + 6 •0/rI � '� Lot # 7
c� <� Pianckfflec# A ^
Valuation: 7 (�
Permit# M 5 I_N" 0 0 6
Owner: ADA + W LA_�y -),L AW h DRvZ.DD WSK; Reissue of
Address:_ 1456-rL
Approvals Required
T,&A Z ? (Al CI 7 --
Planning
Phone: `%o L814 - e-& 7O
Engineering
CoWractor: ADA-M Dko2 DoDjk N E L2) C�t►er_
Address: - A froy i✓ _.
Items Required
Subcontractors
Phone: 31 h 8 k- z 7 j _
Truss Details
Contractor's License #
(attach copy of cur.- Oregon license) Other
+rrii
Subcontractors:
Plumbing: _
Mechanical
(attach copy of current OR Contractor's License) 2
O .
Archlt.ect/Englneer:
a
F: Address: _
rn
J /
LL, COMMENTS: / 'f'7 Oh C ' /LL2t-S G - c��.r►� X. 7 YL/ ID �L = �
Applicant Signatuie Phone number
R,%ceived by:_; Date Received:
a'
Perms; 4 Accoun' Description Amour.. pmt. Pd. Bal. Due
c Bldg. Permit (BUILD) 3 at a
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) 2 S-,
Bldg: �� /- 105-
Plumb: _5-Plumb: _ (f
Mech: %,70
,7f
Zj
Pian Check (PLANCK)
Bldg: ..-�ti`✓ / . ��
Plumb: �P
Mech:
_ Sewer Connection (SWUSA) _
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
�► Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
H Office TIF (TIF-0) _ +�
J
a Water Quality (WQUAL) _
C.0
J Water Quantity (WQUANT) __ e
Fire District (FIRE) _
TOTALS: '00. C �L'
DEPARTMENT OF LAND USE 6 TRANSPORTATIt.'J
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON Axxxx„xxx--> 640-.14 /U
Page 1 of 1
Gate 11/22./94
Time 14; 42
Permit Type Residential Electrical Permit Permit # 05061099
Permit Status APPROVED Appli-I 11/22/94
Situs Address 14y65 5W 87`I'H AV T1 Issued 11/22/94
Permit Title Sr'R - SERIVCI CHANGE/'LU CIRCUI Completed
Permit Descr. To Expire 05/21/95
Project 'Title Sr'R - SERIVCI CHANGE/20 CIRCUI Project # P0045719
Project Descr . * EROSION
.1arcel Number 2S1'1'1 - Land Use District
Valuation U
Leual Descr.
Owner INSPECTION - TIGARD Construction O'TH
Applicant Name DROLDOWSKI , ADAM Classification 9UU
Applicant Addr. : 14565 SW 87TH AV Occupancy
TIGARD OR 97224 Validated by E13
Applicant Phone : 684-82'/0 inspector Area
r'ee description Units Fee/Unit Ext fee Dat,
------------------------------------------------------------------•--------
Service/r'eeder: LUU amps or less 1 60 . UO 60 . UO
Each Branch W/ r'eeder (Enter #) 20 5 . 00 100 . 00
Subtotal dlectrical r'ees : 160 . 00
State Surcharge of b% 8 . 00
Total Electrical r'ees : 168 , UO
*** rtes Required *** *** Fees Collected & Credits ***
-------------•--------------- --------------------------------------------
Method Check # Receipt No , Date Payment
CK 977 11/22/94 168. 00
TOTAL THIS DA'1-E ****kkr►** 168 , OU
r'ees : 168. UU
Adjustments : . 00 Total Credits : • 00
Total r'ees : 168 . 00 Total Payments : 168 . 00
Balance Due: . 00
d
J
CLI
NOTICE: This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 180 days. Once construction has started,
LO the permit becomes null and void If constructlor.Is Interrupted for a period of 180 days. I certify that the information presented by the applicant and
LL)
his agent or agents In support of this permit Is true and correct to the best of our knowledgs. I acknowledge that the Building Department's reliance
upon false and mislsadkig Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structum will be compiled with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant 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 lien may be placed on the title of the 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.
raV-06-If
APPLICANT'S SIGNATURE
WASHINGTON COUNTY
Department of Land Use & Transportstion ELECTRICAL PERMIT
Electrical Inspection Section
155 North First Avenue,
Hillsboro, Oregon 97124350-12 APPLICATION
Information: 503 640-3470 Fax: 503 693-4412
Project/P�rm'- �,_C'
Number _ (J�� _ Date —I
PLEASE PRINT //�/ q
Please coh7plete all sections, . •
1. Location of installation 4. Complete Fee Schedule below
Address_._ i - I1�A --5W 97 r y AY— Number of Inspections per permit allowed
Building Service included: Items Cost(ea.) Sum
City Y',.A A, Suite No.
Tenant Name A. Residential-per unit
(if commercial) — 1000 sq.ft.or less $110.00 1 4
2 S I l I h n-t�I QG CJ Each additional sq.ft
Map NO. or portion thereof
�faX Lot— of ��� $25.00 —�!
Limited Energy $25.00 1
Thomas Map Book: Page: <`' ' Section: f" Each Manuf'd Home or Modular
Directions— __ _—_ Dwelling Service or Feeder __— $68.00 2
B. Services or Feeders
Commercial Residential Installation,alterations or relocation
200 amps or less t $60.00 2
: 201 amps to 400 amps $80.00 2
2a. Contractor installation only: 401 amps to 600 amps $120.00 2
Electrical Contractor v"01 amps to 1000 amps $180.00 — 2
Address Over 1000 amps or volts _— $340.00 —�_— 2
Datc. .lob Number ._ � Reconnect only $50.00 — 2
Property Owner -- C. Temporary Services or Feeders
Contractor's License No. -
Contractor's Board Reg. Nn. _-- Installation,alteration or relocation
200 amps or le;s _____. $50.0C 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n ____ 401 amps to 600 amps $100.00 2
License No. Phone No. over 600 amps to 1000 volts see'B'above
2b. For owner Installations- D. Branch Citcvits
a����OLS/S h,/ NsE?/�_ 8Z 70 New,alteration or extension per panel
a) The fee for branch circuits with
Print Owner's Name hoe o.
��•� ,� r» purchase of ser s w feeder les.
ti W rQI V
��ess—' - — Each branch circw —!L055.
. � 00 1�y•�n2
T/(:•/f koO ✓%2?y b) The fee for branch circuits without
Ity tate Zip purchase of service or feeder lee
First branch circuit $35.00 2
The installation is being made on property l own Each add'ni branch circuit $5.00 _
which is not intended for sale lease or re t. E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle $40.00 2
Owner's Slgneaure _ _� � `�� _ Each sign or ou►lino lighting $40.00 _ 2
Signal circuits)or a limited
3. Plan Review section (if required) energy panel,alteration
Please check appropriate hem ae'enter fee In section 58. or extension —_ $4000 2
_ 1 & 2 family dwellings over 320 amps s/c meter F. Each ardditional inspection over the allowable
in any of the abcve
_ 4 or more residential units in one structure Per inspection $35.00Ln
Service over 225 amps; feeder 400 amps or more Per hour $55.00
System over 600 volts nominal In Plant $55.00
Building over 3 stories in height
Building over 10,000 sq. ft. 5• Fees c'. J
Occupant load over 99 persons A. Enter total of above fees $ L
'J' ! Manufactured Structures Park or Recreational 5% Surcharge (05 X total fres) $ roJ -9
Vehicle Park; new, addition or alteration Subtotal $
_ Classified area or structure containing special B. Enter 25% of line A for
occupancy as described in N.E.C. Chapter 5 Plan Review if required (Section 3
Subtotal $
Submit ;: sets of plans with application where any of the Less Bulk Label Fee $ 44 :7; ^ '
above E.pply. Not required for temporary construcflon
services, _ Balance Due $ , ?
For Inspections toll/� q i This permlf becomes null and vold N the work authorized by the peri" :e not oomrneneed
640.3561 or 693"FY 1 within 160 deyw from date or lesuance of eurh permll w fr the work outhmired Is
suspended ot abandoned at any time @Mer work b commenced for a perlod of 1.0 days,
24-hour recorder,one working day 1,i advance of need Electrical PermMe are non,efundable and non-tranarer@ble.
5/93