11435 SW 90TH AVENUE i
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ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BUP _
Date Requested .��5 % 'A N1 PM _ BLD
Location_ _ Suite MEC
Contact Person Ph PLM ����
Contractor Ph 771—�yy� SWR
BUILDING Tenant/Owner �aiELC
c U� _
Retaining Wall ELR _
Footing Access: /
Foundation FNS
Ftg Drain
Grawl Drain Inspection Notes: SGN --
Slab _ _ SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkle
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final -
PASS PART FAIL - -- --
LUMBI
Post& Beam
Under Slab
Top Out
Water Service—,.)
Sanitary ewer
Rai Drains
W-6 PART FAIL _
MECRANICAL.
Post& Beam _ _-.-.- ----
Rough In
Gas Line -- ----- -----
Smoke Dampers
Final - — ----- - --._._
PASS PARI FAIT_
a
ELECTRICAL ---- - -- --- - - -----------
Service
� Rough In --------------
`� UG/Slab
Low Voltage
Fire Mimi —
Final _ --------
- -- ---------- -----
PASS PART FAIL
SITE
Backfill/Grading - --
Sanitary Sewer
Storm Drain ( J Relospection fee of$ __required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
r7ire Supply Line ( )Please call for reinspection RE: —, [ I Unable to inspect no access
ADA �. `
ApproachlSidewalk Rate ' � Z �InspeCtOr (�
Other _ Ext
Final
PI►,oS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW.Hall Blvd., Tigard,OR 97,czd(5,03)639-4171 PERMIT #. . . . . . . : FILM99-0071
DATE -SSUED: 03/12/99
PARCEL: 19135D8--02602
SITE ADDRESS. . . : 1. 1435 SW 90TH AVE
SUBDIVISION. . . . : TIGARDVILLE PARK ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :004 JURISDICTION: TIG
----------------- ----------
CLASS OF WORT,. . :OTR GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
' TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BnCKFLOW PREVNTRS. . : 0
OCCUPANCY GRP'. . :R3 FLOOR T)R,7iINS. . . . . . . 0 TRAP'S. . . . . . . . . . . . . . . 0
STORIES. . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES------------- LAUNDR%1 TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . . 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 ETHER FIXTURE3. _ . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . _ : 40
DISHWASHEPE'. . . . : 0 RAIN DRAIN (ft ) . . : 0
Renarks : Installation of approximDtely 4.0 feet of water service.
Owner: --------------------------- FEES ------.-----__
FAULK,
---------
FAULK, JEFF & DOROTHY type amount by date reept
11435 SW 90TH PRMT $ 30. 00 DEB 03/12/99 99-313643
TIGARD OR 97223 5PCT $ 1. 50 DEB 03/12/99 99-313643
Phone #:
Contractor-------------------- ----__---_.
CROWN PLUMBING
2*3172 SW STAFFORD RD
TUALATIN OR 97062
Phone #: 771-9449 $ 31. 50 TOTAI_
Reg #. . - 1000042 REQUIRED INSPECTIONS
This permit is issued subject to the regilations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Co�-t and all other Water Set-vice In
applicable laws. All work will be done in accordance with Final Inspection
approved Glans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for scre
than 188 days. ATTENTION: Oregon law requires you tc fullow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-90014010 through OAR 952-4%1-M. You may
obtain copies of these rules or direct questions to OUNC by calling
C-1 (503)246-1987.
L
Permittee Si qnatt.W
T
V+++4.................................4.............4.............................
Call 639--4175 by 7:00 p. M- for An inspection nPeded the next bus i Tie es:i U4 M,y
..................4....................4................... ..........4'+-4-+++4-++4
i
CITY OF TIGARD Plumbing Permit Application Plan crrecks
13125 SW HALL BLVD. Commercial and Residential Recd By ,--- _
TIGARD, OR 97223 Date Recd
(503) 639-4171 Date to F.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#�
Related SWR#
Called
Name of Development/Project FIXTURES (Individual) QTY PRICE AM7
Job '/y`35" -; - , �� t '� Sink s.00
Address Street Address Suite Lavatory 9.00
Tub or l ub/Shower Comb. 9.00
Bldg# Cite/State Zip Shower Only 9.00
Water C,oset 9.00
e'4�( j<u:i (� Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal —9.00-
1/935
.00IIy3s S c*196 Washing Machine 9.00
City/State Zip Phone ---
/1 0 R 97 Floor Drain/Floe Sink 2" 9.00
Na 3" 900
9.01
Occupant Mailing Address Suite Water Heater O conversion O like kind 9.00
Gas piping requires a se aiat_e mechanical armit.
City/Stale Zip Phone Laundry Room Tray 9.00
—
Narpp Urinal 9.00
L y C'L J,V f�ht vim- 6, W-3 Other Fixtures(Specify) 9.01)
Contractor Mailing Address Suite 9.00
r oC 9.00
Prior to perndt Cf /State Zip Phone
I _ Sewer-1st 100' 30.00
issuance,a copy - Uct a�t� 0 R Ui, 7?)-9 y4
Sewer-each additional 100' 25.00
of all licenses are Oregon Const.Cont.Board Llai Exp.Date
requ,red If CL C r.'0 Water Service-1 st 100' r ! 30.00 c '
expired in COT Plumbing Lic.# Exp Date Water Service-each additional 200' 25.00
database - v U F a c` -
_ 3 1- � C Storm 6 Rain Drain-1st 100' 30.00
Name Storm S Rain Drain-eanh additional 100' 15.00
Architect _ Mobile Home Space — 25.00
or Mailing Address 8 Commercial Back Flow Prevention Device or Anti- 25.00
P(Ilutlon Device _
Engineer City/Stale ZIP Phone Residential Backflow Prevention Devine* 15.00
(Irriget?on timing devices require a separate
Describe work to be done restricted energy permit.) _
New (� Repair O Replace wur+like kind: Yes O No O Any'trap or Waste Not Connected to a Fixture 9.00
Residential 71 Commerclat O Catch Basin 9.00
Additional de.criplion of work: —
Insp.of Existing Plumbing 40.00
per/hr
1 ' Specially Requested Inspections 40.00
error
Rain Drain,single family dwelling 30.00
Are you capping, moving or replacing any fixtures?
Grease Tr ps g,p0
Yes O No O
If yes, see back of form to indicate work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isome Yk or riser diagram Is required H t]uanlRy Total Is >s _
WORK COULD RESULT IN INCREASED SEWER FEES. "SUBTOTtA
I hereby acknowledge that I have read this application,that the Information
LD given Is correct,that I am the owner or authorized agent of the owner,and 6°h SURCHARGE 5 r.
that plans submitted are in compliance with Oregon Slate Laws.
Signature of Owner/Agent Date —"PLAN REVIEW 26%OF SUBTOTAL_
Rbc ulred unl}K fixture gt�otal Is>9 _
�.. ��)�zti�J Ci'„L � �- s�
Contact Person Name Phone TOTAL
/ cy y y cy *Minimum permit fee Is$25+ 5%surcharge,except Residential Backflow
L Prevention Device,which is$15+5%surcharge
**All Now Commercial Buildings require plans with Isometric or riser diagram
and plan review
I%dstslpksnopr doc 712M
PLEASE COMPLETE:
Fixture Type R Quantity by Work Performed
_ Neter iMoved Replaced Removed/Capped
Lavatory -�-
Tub or Tub/Shower Combination _
Shower Only _
Water Closet
Dishwasher -
Garbage Disposal -
Washing Machine _ -
F-oor Drain/Floor Sink 2" ,
Water Heater - - -
Laundry Room Tray -�
Urinal - -
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
LL,
CITY OF TIGARD BUILDING IN% PECTION DIVISION MST
24-Hour Inspection Line: 6?.9-4175 �Business Line: 639-4171
� Blip
U Date Requested �" O AM PM _ BLD —
'
I l� �� Suite MEC
Location - - -
Contact Person / �^ 1 Ph PLM
O
Contractor Ph 5 7)-J.D-J SWR
BUIL DING_ Tenant/Owner t,(-�A-� ELC
Retaining Wall ELR _
Fooling Access:
Foundation FPS
Fto Drain SGN
Crawl Drain Inspection Notes:
Slab _ u'� SIT
Post&Beam lJ
Ext Sheath/Shear
In.Sheath/Shear / `�-CAV Le-
Framing 1 �'L G.!�f2�r�t ��
Insulation
Drywali Nailing tYt (c' Q --
Firewall � - { IJ U_L�
Fire Sprinkler A2 �-h_ /
Fire Alarm - / 7���1 YU r rye C-Dm
Susp'd Ceiling
Roof - AQvt �( r
Misc: -------- ---
Final
PASS PART FAIL - -- ------ - ---
PLUMBING io,' 10 e C1 _ _
Post& Beam
�.:'5-111�—T f? CQ�1
Under Slab
Top Out - — - ---.-_� ------
Water Service
Sanitary Sewer
Rain Drains
Final
PASS P 1RT FAIL
MECHANICAL
Post& beam ---
Rough In
Gas Line -- --
Smoke Dampers
Final -- ---- -T_ - _ - -
PASS PART FAIL
ELECTRI9AL - ---___ -- -- — --- ----
Service _-
iRough In
un n I�n UG/Slab �V r• —
Low Voltage
Fines'`
PASS PART FAIL. -
(zS
Ul
J Backfill/Grading -- --
Sanitary Sewer
Storm Drain I [ ]Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall blvd
Catch Basin [ ] Please call for reinspection RE: [ ]Unable to inspect- no access
Fire Supply Line
ADA /
Approach/Sidewalk Date 10 4` 9161;- Inspectors _ 14 6AEXt'¢L��
Other --�-
Final Y
PASS PART FAIL J DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD ELECTRICAL PERMIT
-ERMIT kt: ELC98--05,,1
• DEVELOPMENT SERVICES DATE ISSUED: 09/34/98
13125 SW Hall Blvd„ Tigard,OR 97223(503)639.4171
PARCEL: i S 1.?,51)FJ—O2602
SITE ADDRESS. . . : 114,,5 SW 9OTH AVE
SUBDIVISION. . . . :TIGPPRVIL.I._E PARK ZONING: R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :004 JURISDICTION: TIG
Project Description, ; repair an existing electrical system.
-__-._RESIDENTIAL_ UNIT------ -.---.TEMP SRVC/FEF-DERS-------- -----MISCELLANEOUS-------
1000 SF OR LESS. . . . : 0 0 — 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADu' L 512)0SF„ ,. „ : 0 201 — 4.00 amp. . . . . . . : 0 SIGN/eUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . : 0 SIGNAL/PANEL... . . . . . . . 17,
MiANF. HM/ SVC/F"DR. . : 0 601+amps--1000 volts, : 0 MINOR LABEL ( 10) . ., . : 0
----SERVICE/FEEDER---- ----BRANCH CIPCUITS----- ---ADD' L INSPE'CTInNS-- --
0 — 200 amp. . . . . . : t W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 171
201 — 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
4.01 -- 600 amp. . . . . . : 0 FA (ADD' L-. BRNCH CIRC: 0 IN P=LANT. . . . . . . . . . . : 0
601 -. 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION----------------
tOOO+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOI...."f NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > _ 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner,: -------------------------------------------------- FEES ----------------- ---
7AU1_..K, :TEFF & DOROTHY type amount by date recpt
11.435 SW 90TH PRMT $ 60. 00 GEO 09/04/91 98-:30888_'
TIGARD OR 97223 SFICT $ 3. 00 GEC] 09/O4/98
Phone #:
Contractor: -------•---__.--_---.__.-__.-----_--
AMERTCAN ELECTRICAL SERVICE $ 6:3. 00 TOTAL_
PO 'PDX 1057
------- RECU I KED INSPECTIONS
----
SHERWOOD OR 97140 Elect' 1 Service
Phone #: 204--9864 PAGE F 1 e ct' 1 Final --
Reg #. . : 001.01'
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of 01•egon 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 the rules adopted by
the Oregon Utility Notification Center. Those rues are set forth in DAR 952-0.01-0010 through OAR 95'_-001-1987. ',ou may obtain a copy
of these ruleF or direct questions to OUNC by 1' g t 1246-1987.
Permittee Signature : _ _ _ Issued By '
NE'R INTALL.ATION ONLY--._----.-----------_..._----____-..____.
"The installation is being made on property 1 own which is not inte+ided for
sale, leas?, or, rpnt.
OWNER' S SIGNATURE: -- DATE:
CONTR►AGT NS'TAL_LATION
5 T GNATURE OF SUP'R. ELECT' N. ' _—. DATE:
I..I CENSE NO:
+.1•... -F++-h+ h++++-Fa..+..........................................................
Call 639-41.75 by 7:00 p. m. for an inspection needed the next business day
................ ++++++++++++++++++++++++++++++++++++++++.++++++++++++++++++++-+
CITY-OF TIGARD Electrical Permit Application Plan Check a
Recd By
13125 SW HALL BLVD. Date Recd
TIGARD OR 97223 Date to P.E.
Phone (503)639-4171, x304Te Date to DST
Inspection (503) 639-417Print Ory�1
5 Permit»�
Incomplete or illegible will not be accepted Called_
Fay (503) 684-7297 -
1. Job Address: 4. Complete Fee Schedule Below:
Number of Inspections per permit allowed
Name of Developmen- �fG�
Name(or name of business) Service included: Items Cost Sum
4a. Residential-per unit
Address1000 sq.fl.or less $1111.00 __ 4
City/State/Zip ' -tet Each additional 500 sq.ft.or --
r� portion thereof $25.00 1
Commercial F-1Residential,Y.J Limited Energy
Each ManuPd Home or Modular
Dwelling Service or Feeder $68.00 ?
2a. Contractor installation only: 4b.Services or Feeders
(Attach copy of all current licenses) Installation,alteration,or relocation
Electrical Cgrttractor �' � - i-' =-- 200 amps or less L $so.00 _ 2
Address �t' ' 20' ,imps to 400 amps $80.00 2
t -�' r State_ Zip 401 amps to 600 amps $120.00 2
Ci
Y 601 amps to 1000 amps $180.00 2
Phone No. - Over loon amps or voltr, _- $340.00 2
Job No. -- Reconnect only $50.00 2
Elec.Cont. Lice. No. Exp.Date� -_
OR State CCB Reg. No. D Exp.Da6nV- 4c.Temporary Services or Feeders
COT Business Tax or Metro o. -Exp.Date- _ Installation,alteration,or relocation - -
200 amps or less $50.00
201 amps to 400 amps $75.00 -
Signature of Supr. Elec'n - 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License No. S�fr7-'^�Ex .Date I- T _- see"b"above.
Phone No. /y rl, ��,z( �- - 4d.Branch circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name__-- leader lee. $5.00
-- Each branch circuit
Address - b)The fee for branch circuits
City _ `- State Z;p without purchase of
Phone No. _ service or feeder lee. __ $35.00 2
Firot branch circuit 2
Each additional branch circuit_ $5.00
The installation is being made on property I own which is not
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not Included) $40.60 _ 2
Owner's Signature. _ Each pump or irrigation circle $4000 2
Each sig;i or outline lighting
Signal circuit(s)or a limited energyr
3. PI an Review section (if required): $40.00 I panel,alteration or extension $100.00
r- Minor Labels(1',
`n Please check aprropriate Itern and enter fee In section 51B.
4f.Each additional Inspection over
I.- -_`_4 or more residential units In one structure the allowable in any of the above
5erviee and feeder 225 amps or more Per inspection $35.00
-j _System over 600 volts nominal $55.00 - -
c� Classified area or structure containing special occupancy Per hour $55.00
In Plant ---
_ as described in N.E.C.Chapter 5
5. Fees: U
Submit 2 sets of plans with application where any of the above apply. 5a.Enter total of above fees $
Not required for temporary construction services.
5°I°Surcharge(.05 X total fees) �
Subtotal
NQTICE
5b.Enter 25%of line Se for $
PERMITS BECOME.VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Rerlew if reaulrg�(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY El Trust Account S
TIME AFTER WORK IS COMMENCED. Total balance Due
I MATMELC98 APP Par 9198