Case File l
l
"" 13955 SW 104TH AVENUE
CITY OF TIGARD BUILDING INSPECTION DI"1SION
24-Hour InspCction Line: 639-4175 Business Phone: 6394171
Date Requested: 15 _ A.M. P.M. _ MST: d .
Location:_ % L j` BUP;
Tenant:
— Suite: Bldg: _ �4EC:
Contractor: Phone: -S�G '— G( U .7 PLM:
Owner: Phone: _ r✓ ( — Z- ELC: —
ELR:
BUILDING BLDG(con't) PLUMBING — Ste'
MECHAN[CAL �� SITE
Site Pest/Beam Post/Beam Post/Beam Cover/Service Sewer/Stone
Footing Roc,f UndFUSlab
Slab Rough-In Ceiling Water Line
Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fin:Spklr/Alto Crawl/round Dr Ileat Pump Low Volt
Approved Approved Approved A ov Approved
Appr/Sdwlk Not Approves'. Not Approved Not Approved o roved Not Approved
FINAL FINAL FINALFINAL
M Call for reinspsxtion 0 Reinspection fee of S--.—required before next inspection O Unahle to inspect
Inspector: .
, _
— late:— 1. ! `_ Page
CITY OF HGARD iWILDING INSPECTION DIVISION
24-Hour I tspection Line: 6394175 Business Phone: 639-4171
I)ate Requested: �l�eI l9 7 A.M. P.M. MST:-I( ,` 051 QL_
I.ocaticn: i '.-)9 5 5 1 f �._ BUR —
Tenant:_ _ Suite: Bldg: NEC:
Contractor: Scil a lt Phone: 510 -61 7 PLM:
Owner: Phone: Kjd_ 2Z I- -r' ELC:
-1�A k_,C� 0._' CiD�I.� C� jJ ELR:
SIT:
BUILDING BLDG(con's) PLUMBING MECHANICAL ELECTRICAL SITE
Site PostMeam Post/Beam PosU13eam Cover/Service Sewer/Storm
Footing Roof tJndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer flood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masoru), Ceiling Rain Drain A/C UG Slab
Shear/Sheath fire Spkir/Alm CrawVFound Ih I feat Pump Low Volt
roved Approved Approved Approved Approved
At,pr/ti l,vl1 ted Not;approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
0 Call for c ' 0 Reinspection fee of Sr fired before next inspection 0 Unable:to inspect
Inspector: Date J Page of_
CITY CF TIGARD
hIASI ER F'E.RMI7
DEVELOPMENT SERVICES PFRr1I7' #. . . . . . . : MST96--07512
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.1171 DATE. I SSIJET): 12/ 17/96
! I T(_. ADDRF_ S. . . 13195 -i 5W 1 041"H F=IVE.
')IgDIVIGION. . . . : MI._P96- 0008 7LINING: W--1
UGI'. . . . . . . . . . 1_07. . . . , .. . . . . . . . :IT02
Remarks: Path 1
----------------------------------------------------------- BUILDING ----------------------------------------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 ;f REQUIRED SETBACKS---- REQUIRED--------------
CLASS OF WORK.:NEW HEIGHT........: 22 FIRST....: 600 sf GARAGE.....: 300 sf LEFT........... 12 SMOKE DETECTRS: Y
TYPE OF USE...-SF FLOOR LOAD....: W SECOND... : 784 sf FRONT.........: 20 PARKING SPACES: i
TYPE OF CONST..-5N DWELLING UNITS: 1 FINBSNENT: 0 sf RIGHT.........: 6
OCCUPANC' GRP.:R3 BDRM: 3 BATH: 3 TOTAL------: 1384 :f VALUE,.f: 97894 REAR..........: 15
--------------------------------------------------------------- PLUMBING ---------------------------------------------------------------
SINKS.........: 1 ,JHIER CLOSETS.: 3 WASHING M4CH..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: ? DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWED...: 2 GARBAGE DISP..: 1 WATER HEATERS.: I WATER LINE ft: 100 8CKFLW PREVNTR: I GREASE TRAPS.. : 0
OTHER FIXTURES: 0
-------------------------------------------------------------- MECHANICAL ---- _..------------_---------------------------------------
FUEL TYPES------------ FURN 1100K ..: 1 BOIL/CMP ! 3HP: 0 VENT Fh!IS.....: 3 CLOTHES DRYERS: 1
/GAS/ / / FURN i=106K ..: 0 UNIT HEATERS..: 0 HOODS......,.. : 1 OTHER UNITS.,.; l
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 1
-------------------------------------------------------- — ELECTRICAL ---------------------------------------------------------...
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDEP.S.-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 1 0 - 200 amp..: P N - 280 alp.. : 0 W/SVC OR FDP..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 580SF.: c 201 - 400 amp..: 0 201 - 480 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN L1: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 600 amp..: 0 401 - 60e amp..: 0 EA ADDL BR CIR: 0 SIGW'PANEL...: P IN PLANT......: 0
MANF HM/SVC/FOR: 0 601 - 1000 amp.: 0 601+81ps-1000 v: 0 MINOR LABEL -10: 0
ION' amp/volt.: 0 ---------------------_____----- PIAN REVIEW SECTION --------------•------------
Reconnect only.: 6 )=4 RFS UNITS.,: SVC/FDR)=225 A.: ) 60N V NOMINAL: CLS AREA/SPC DCC:
- ----------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY -_--------------.---_---------------------------------
A. SF RESIDENTIAL--------------------------- B. COMMERCIAL--------------------------------------------------------------------------.
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO 8 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC I '!
BURGLAR ALARM..: 0TH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL.
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL.........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS..... (OTA' k SYSTEMS: 0
Owner: _--.. ------------- --- --- -- -Cant ract or: ----------------------------- TOTAL If[S:1 4350.81
RONALD BOHART WILDFLOWER PROPE
15491 SW PEACHTREE DR WILDFLOWER PROPERTIES INC
14180 SW 162ND AVE
TIGARO OR 97224 TIGARD OR 972241000.
Pinne A: 590-0107 Phone il: 503-620-3180
Reg li... 205048
This permit is issued sub)ect to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable lays. All work will be done :n 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.
-- ------- — - REQUIRED INSPECTIONS __ ------ ---_ _----------------------- ----._....__..
Footing Insp PLM/Underfloor Framing lnsp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Will Insp Insulation Insp Appr/Sdwlk Insp Erosion Control
Post/Deal Struct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final
Post/Beam Mechan Electrical Serwi Fireplace Insp Rain. drain Insp Mechanical Ci4al
Crawl Drain Klectrical Rough ,Water Lice Insp Plumb Final
- r ,
Pet-mittep 5ignat u : _ l:sSued Py : �
C;a. I for inSpectiorl 639--4175
ATY ® F TIGARD 3EWE-R CONNECTION
DEVELOPMENT SERVICES PERMT"r
PERMIT #. . . . . . . : SWR96-0X14
13125 SW Half Blvd., Tigard,OR 97223 (503)635.4171 DATE ISSUED: 1.2"/17/96
PARCEL- 2S 1027C--08800
;ITE ADDRESS. . . : 13955 51-1 104TH AVE_
SUBDIV"ISION. . . . : ML.!=196•-0008 ZONINI3: R-1'c'
BLOCK. . . . . . . . . . . L o 1-. . . . . . . . . . . . . :002
TENANT NAME. . . . „ :130HART, RONALD
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :NEW DWE.I.L_1 NG UN I TS. . I
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUSWN IMPERV SURFACE: 0 f
Remarks: l='at:h 1.
Ownet-: --__._.________ __._______.______-_.__._.__----._..__...__._______._. FEES
PONALD BOHART type amoi.rnt by date r•ecpt
1.5491 SW PEACHTREE DR PRMT $ c00. 00 JSD 12:/17/96 96-'87818
INSP $ 35. 00 J51) 1.2/17/96 96-='8781(3
TICARD OR 97224
Phone #: 590-0107
f:ontr-actor,: --__----____.__..__._-___.w_
CONTRACTOR NOT ON FILE
'1 2235. 00 TOTAL.
Reil M. . :
_- ---- REOU I RED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer 111spect i on
of the Unified Sewage Agency. The permit expires 180 days from
thn date issued. The total amount paid will he forfe..cu if the
permit expires. The Agency does not guarantee the a-,curacy of the
side sewer laterals, if the sewer is not located tit the measurement
g,ven, 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" Permit and the Aqency will lateral.
t e r m i.t t e e
1.s s u e cl 8 Y ti r- ..._ _ _
r
Call for- insper.tion - 639-"4175
Pla,
"ITY OF TIGARD Residential Building Permit Application Rec'dJByck# I �
'13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd V _
TIGARD, OR 97223 Single Family Detached or Attached Date to P E. I-&--
(503) 639-4171 c�.z�� Date to DST ff G
Print or Type Peru"t#1Y1 q
Incomplete or illegible applications will not be accepted Called ec c 53LUWA �G4%
Z-5 ((?-CC- ys�
Name of Subdivision Lot# Name
Job
Address Site Add 10_31 SLI
Architect Mail ng Address
tvame LA up o M T- C,ty!State Zip Phone
v>i Ekx&kqe .--JArw-uF&111 — Name -�--
Owner Marling Address Na
/5 eer tH 60
City/State/State Zip Phone Engin Mailing Address
r
to Name City/St;.,- Zip TPh,,T
_ Po2rUAlUD 709 2761 -6Y76
General uvfcor"cceO _ /9"eOp 2.T7ts, /luc. Describe work newX addition O alteration O repair O
Contractor Ma lin Address to be done
1 S Qr %.Cv. HTOW 1 Additional Description of Work
City/State Zip Phone
OR ' 1 9- -ora �
Oregon Const. Cont Board Lic# Exp. Date
Attach Copy of U _ Project
�J r
Current COT Business Tax or Metro# Exp Date Valuation $
Licenses
Name -- NEW CONSTRUCTION ONLY:
Mechanical Cger-leot•) (-twMtr1 Sq.Ft. House: Sq.Ft.Garage:
Sub- Mailing Address
Contractor ✓•C'• emr 355- Corner Lot Ye No Flag Lct Yes ND
City/State ZIP Phone (check one) (check one)
fA�riFrk�F r z z. 1.5,5-'e,z Restrlcied Audio/Stereo Burglar
Oregrn Const.Cont Board Lic.# exp.Date Energy System Alarm
Attach Copy of '- . 1 _e, _e?
Current COT Business Tax or Metro# Exp.Date Installation Garage Door HVAC
Licenses r('t1/ 1I J q _( q Opener k Systems
_ Name (check all that Other:
Plumbing !'` 1Ar;W a pl )
Sub- Marling Address — Will the electrical subcontractor wire for all Yes N
Contractor /112 r- 'w )C IjDt\Grestricted energy installations? ►�'
r;tyiState zip Phone Has the Subdivision Plat recorded? N/A Yes Nr,
it) C/1 ") / X p L 4Z_ ,/,,
Ore�on Cont Cont Board Lic.# Exp.Date Reissue of MST# Solar Compliance
Attach Copy of [" %(")z- -'rp Calculation Attached)
Current Plumbing Lic.# p Exp Date I hereby acknowledge that I have read this application, that the
Licenses 3 C/ Z'i F , !7-5f information given is correct, that I am the owner or authorized agent of
COT Business Tex or Metro# Exp.Date the owner, and that plans submitted are in compliance with Oregon
State laws
Name Signatu t Date
Electrical e'�V(oj Z' 6:;A)T-, _` t( 3 6
- Con o M
Sub- Mailing Address me Phone
� ��
Contractor I n "• /t, -fFOR OFFICE USE ONLY: _
x City/State n Zip Phone Plat# Map(TL#.
tmftfo
Oregpon Const.Cont Board Lic.# Exp Date I I r py of 5- i5 r-Z-P,%a -- —
Setbacks Zone Solar
Current Electrical l.lc # Exp. Date
Licenses 2 71'r' G t^- / ' + t ..
COT Business Tax or Metro# Exp Date Engineering Approval Planning Approval: TIF:
Fes' p
AstsImstapp doc il, j��t{ rj
1
PBal, Due
ermit .6cco4�Q�Llp im Amour
+ Amt. Pd.
M —f Dos Il MST. Permit (BUILD) 2 7
Plumb. Permit (PLUMB)
Mech. Permit (MECH) qsy _ �/���)v
ELC/ELR Permit (ELPRMT) 0-400 v
State Tax (TAX) 3 U q, 3
Bldg: .11..3 i
Plumb: // Z )' V
Mech: 2,,&3 V
ELC/ELR: / U
Plan Check
MST: (BUPPLN) �?�S �� V
Plumb: (PLMPI-N) _
Mech: (MECPLN) /c.� , J o ,/ 3
CDC Review r .r (LANDUS)
to CSewer Connection (SWUSA) �?..2 u u
Sewer Inspection (SWINSP) 3 2�
Parks Dev Charge (PKSDC) U 51) [ v SZ
Residential TIF JIF-R) _/1-7 0
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT) _��J ' /L 0__—
Erosion Control Permit (ERPRMT) _�� U
Erosion ;-Ilanck/USA (ERPLAN) 1__1' >'
Erosion Planck/COT (EROSN) [ V
Fire Life Safety (FLS)
TOTALS: 6 g • —4 >j 5, 1
i WsWmstapp doc �—
Rev 7198
Solar Balance Point Standard Worksheet
.Address _
Box A calculations: North-South dimension for the lot. Box A:
This dimension is determined by finding the midp,.)int of the North lot line and drawing
an intersecting line perpendicular to that point.
First, determine which 'oroyerty line is the North lot line. The North lot line is the line
with the smallest angle from a line drawn east-west and intersecting the northern most
point of the lot.
T45°—►
1 �°�`�
N North-South
Dimension for Lot:
Measure the distance from the midpoint of the North lot lire to the South lot line along;
the described line.
1
NOgM•SOU1N DIMENSION trey
Box B calculations: Shade point height for your residence, I Box H.
1. Determine whether measurements will be based on the peak or eave of your %Vhirh describes I
structure. The orientation of the ridge is also important. -our residence?
�
1 a: it the roof line runs North-South, measurements will .� circle one)
be based on the peak of the roof. OU
1 b: If the roof line rung East-West and the roof pitch is
less than 5/12, measurements will be based on the I
eave. L—
1 c: If the roof line runs East-West and the roof pitch is
5/12 or steeper, measurements will be based on the
peak. Aoa PAA M.4
Box B. continued Box 8:
2. Measure change in elevation from front property line to finished Floor elevation. If
the lot slopes up from the front lot line to the foundation, the figure is positive. If it
the lot slopes down from the front lot line to the foundation, the figure is negative.
3. Measure distance from finished floor elevation to the affected peak/eave.
4. If the roof line runs North-South, deduct three feet. If the roof line runs East-West,
dedur:t nothing.
5. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property line, if the lot slopes up from the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing.
6. Total figure for box B:
Box C. Distance to the shade reduction line. I3ox C:
1. Measure the distance from the North property line to the foundation n_ar the II
affected peak/eave.
2. Measure the distance from the foundation to the affected peak or eave.
3. Total figure for box C: �� f
It is most useful to draw a vertical line to represent the appropriate figure found in box"A"and a horizontal line to represent the
appropriate figure found in box"C".The intersection of the vertical and horizontal lines determines''--value found in box"D". Thi-value
in box"D"should be compared to the value in box''B"; if the value in box"B"is less than or equal w the value found in hox"D", 1111en
the building is in compliance with the solar balance code. If you have any questions, please contact us at 639-4171,x304 or at the
Community Development Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT (In Fcet)
Distance to North south lot dimension(in feet)
shade 1()0+ 95 90 85 80 75 70 65 60 53 50 45 -air
reduction line
from northern
Int line lin feetl —
70 40 40 40 41 42 43 44
65 38 38 38 39 40 41 42 43
60 36 36 36 37 38 39 40 41 42
55 34 14 34 35 36 37 38 39 40 41
50 32 32 32 33 34 35 36 37 38 39 40
45 30 30 30 31 32 33 34 35 36 37 38 39
,11l 28 28 28 29 30 31 32 33 34 35 36 37 3b
35 26 26 26 27 18 29 30 :31 32 33 34 35 3
10 24 24 24 25 26 27 28 19 30 31 32 33 31
' 30 31 ip
.i 22 22 22 23 24 25 26 27 28 29
20 20 20 20 21 22 23 24 25 26 27 28 29 3
1 S_�_- fig_.-�lfl --18 19--3@ -2t- �?--s�3 --24--�6•--2� _4 ,
10 16 16 16 17 18 19 10 11 2e 23 24 25 2�
14 14 14 15 16 17 18 19 20 21 22 23 2
[Box D. Maximum allowed shade point height: fC! feet
hMocs\nancy\ventura\solar chp
Revised 2/26/96
211.4 30bi'N 02d 10'30' r= 2115
MA IT, u' p-
frT �
D rn to rn 211
U�, Z
N �� I - __
TP
�O N �C
1-
70 qh 3 D
2103 76A N71 'b' 0'E 2"70
U QZ n 7
r- -�r�
tD n ()
i
1 210tp
�O u
N
0
210 Gl -s r-
X69 n I° eL' �qV)
66A7'N and p 269.15 U� N t-
F ---- - -- 6
269 2 �_—__�-__
9 ,� 0 L n
�lJ fi �q N A
AN
4
r
i
FD 5/8' IR (R 1)
S 89'49'30" E
FD 5/8" IR (R 1)-- 0.65'
S 807-53-17" E
0.22' _
\v FD 5/8" IR
LOT 2 oU n S 8T49't"" E
FD 5/8" IR (R 1)---, C o � t,� 0.31'
S 87-53'17" E
0.15' "� t
j 0 50'
LOT 1 �_
V. Lo00
'� k6 0
FD 2" IP INJT'4L POINT `V a
(HELD ,4S INITIAL "JO SQUARE" (iii)
POINT, RI))
1) N 89'24'31" W 131.43' (M; 131.3R' (R 1
I 50.05'
'"""4 81.38'
� 40
PARCEL 3
f
.9402,3549'3 3,508 sq•ft' h
+0, 1994 o w
2 42.64' Lu tp
N 89'24'31' W �1J
o 0 7.5' I Q
h d
h 4a
z M.74'
iPARCEL 1 W S BT25'21" E d-
cr, o 8,280 sq.ft. --- -- a O
N 15' ACCESS �--
n til EASEMENT o
h
a
42.59' � �
S B9'25'21 I (n
�u
3 �
5' PUBLIC UNDER- PARCEL 2
ry 31988 sq.ft.
GROUND U77LI Y
1* EASEMENT ^�
o
49.9 7' = 57.99'
S 89'25'21 E 107.96' (M)
\ 131.29'
\ ADDITIONAL DEDIC.A 110N
+3\ 11 — 878. 18'S. W. MCDONAL D ST.
FO 2" BRASS DISC C.R. 430 N
IN MONUMENT BOX
l/SRT BK 3
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GOIN ELECTRIC ENTERPRISES
12207 SE 1.67TH
CLACKAMAS OR 97015
Electrical Signati re Form
Permit # . . . . : MST96 -0512
Date issued . : 7.2/17/96
Parcel . . . . . . : :S102CC-08800
Site Address: 13955 SW 104TH AVE
Subdivision. • MLP96-0008
Block. . . . . . . 1,„1 . 002
Zoning. . . . . . : R-12
Remarks :
Path 1
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the e!ectrica; permit to be wflid, the signature of the supervising electrician
is required.
Pleaae have the appropriate indivic'ual from your company sign below and return this Electrical
Signature Forni prior to the start of work. No electrical inspections will be authorised until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR.
RONALD BOHART GOIN ELECTRIC ENTERPRISES
15491 SW PEACHTREE DR 12207 SE 167TH
�
�, ,1 C)/ Sim /�•,�
TIGARD OR 97224 CLACV.� S OR 5^ 115
Phone V : 59;)-010'7 Phc oe it :
Reg # . . : 005318
X S�e
*��
Sign ureo��uerr ci len
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
CITY OF 'rIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN OR 97062
Plumbing Signature Form
Permit # . • . . : riST96-0512
Date Issued. : 12,117/96
Parcel . . . . . . : 2S102CC-08800
Site Address : 13955 SW 104TH A'1E
Subdivision. : MLP96-0008
Block. . . . . . . . Lot : 002
Zoning. . . . . . . R-12
Remarks :
Path 1
Your company has been indicated as the plumbing contractor for the permit indicated above. In order
for the plumbing permit to be valid, please have the appropriate individual from your company sign
below and return this Plumbing Signature Form prior to the start of work. No plumbing inspections
will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: PLUMBING CONTRACTOR:
RONALD BOHART MODERN PLUMBING
15491 OW PEACHTREE DR 11120 SW INDUSTRIAL WAY
TIGARD OR 97224 TUALATIN OR 97062
Phone # : 590-0107 Phone # :
Reg # . • : 87906
x
Signaturk df Authorized Plumber
Please return this completed form to the address above.
ATTN: Building Dept.
if you have any questions, please call 639-4171 , ext. #310
W,
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT it: ELC97--0003
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01/06/97
PARCEL: 2SI02CC-08800
qITE ADDRESS— : 13955 SW 104TH AVE ZONING: P-12
SUBDIVISION. . . . : MLP96-0008
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . .
Project Description: Installing temporary service
-------------------------
------------------------------------ --------- -----
MISCELLANEOUS-----
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS-
0 200 1 P,UMP/ IRRIGATION. . . .
1000 SF OR LESS. . . . : 0 201. 400 amp. . . . . . .
• : 0 SIGN/OUT LINE LTG. . : 0
EACH ADDIL 500SF. . . : 0 tel
600 amp. . . . . . .. : 0 SIGNAL/PANEl. . . . . . . . : 0
LIMITED ENERGY. . . . . : 0 601+amps-1000 volts. : 0 MINOR LABEL (10) . . . : 0
MANF. HM/ SVC/FDR. . : 0 GTRCLJITS------- ----ADP..' L INSPECTIONS--
----SERVICE/FEEDER------ W/SERVTCE OR FEEDER: 0 PIER INSPECTION. . . . . 0
0 - 200 amp. . . . . . 0 0
201 - 4.00 amp. . . . . . : 0 1st t4/0 13RVC OR FDR. : 0 PER 0
EA ADDIL BRNCH CIRC: 0 IN PLANT . . . . . . . . . . . :
401 - 600 amp. . . . . . 0 -----___--PLAN REVIEW SECTION---------------
601, - 1000 amp. . . . . : --------
0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL— :
1.000+ amp/volt. . . . . : 0 SVC/FDR )= 225 AMPS- 2 Ci. ASS AREA/SPEC OCC. :
Reconnect only. . . . . : 0 ........................... FEES -----------------
Owneri ----------------- --------- type amount by date recpt
RONALD BOHART PRMT $ 50. 00 B 01/06/97 97-288446
15491 SW PEACHTREE DR 5PCT $ 2. 30 8 01./06/97 9'7-2,8844f,
'TIGARD OR 97224
Phone #: 590-0107
Contracto"' --------__.._________________________.__$__-_5F`.
$ 52. 30 TOTAL
OWNER
REGUIRED INSPECTIONS -------
Flect' 1 Service
Phone #: Elect' l Final
Reg
This it is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicablp laws, Pil work will be done in acrordar.-P with
approved plans. This persit will expire if work is not started
"Ithin 160 days of issuance, or if work is suspended for sort
Issued ;�y
than 181 days,
INSTALLATION ONLY----._------
The
NLY------------The installation is being mndc an property I own which is not intended fat-
. leg l.pass, at- rent. DATE:
'1WNER' S S I GNAT L I RE
INSTALLATION ONLY---._
OF SUPR. ELEC' No DATE:
ICENSE NO:
Call fat- inspection - 639-41.75
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Perrnit # F-VA-1-cir-33
Date Issued i -(y-
Phone (503) 639-4171
CITY OF TIC3ARD
FAX (503) 684.7297
TDD No (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address I .i,t s 1. 16( ( (t Service included Items Cost(ea) Sum
City/State/Zip /�a ot�t2l� r;lc 7 r 4a. Residential -per unit
1000 sq ft or less $11000 4
Name (or name of business)-LLs.Lp!`!ntairry, �/1 , )�I Each addltional500 sq h or —
����77 portion thereof $2500
Commercial ❑ Residential Limited Energy 52000 1
Each filanurd Home or Modular
d
Dwelling Service or Feeder 168 00 2
2a. Contractor installation only: --
4b. Services or Feeders
Electrical Contractor Instpllalion alteration or relocation
Address -__ ___._:._ 200 amps or less ,_ S60 00 2
_ 201 amps to 400 amps _ $8000
City State _�__ Zlp _�__ 401 amps to 600 amps — $12000 2
Phone N0. 601 amps to 1000 amps $18000 2
Job NO �----- Over 1000 amps or volts _— $340 00 2
_ Reconnect only $5000 2
rontractor's license NO. _ -- --
Contractor's Board Reg No. 4c. Temporary Services or Feeders
Installation,alteration,or relocation
Signature of Supr. Elec'n 200 amps or loss 2
License No. Phone No. 201 amps to 400 amps $5000 -- 2
401 amps to 600 amps $7500 2
Over Boo amps to t0oo volts $10000
2b. For owner installations: see„b„above
Print Owner's Names , 4d. Branch Circuits
" New alteration or extension per pane
Address__Lit r_ r (• a)The fee for branch circuits WithCity_ .//G f,,,' --LL_ Stated_ Zip--- purchase or set vice or hada M. 2
Phone No. y; Each branch circuit $5.00
b)The fee for branch circuits Wt out
The installation is being made on property I own which Is purchase Ofservice orhedrt 1". 2
not intended for sale, lease or rent First branch circuit138 00 2
Each additional branch circt It 15.00
(lwncr. ';ignaturo_ 4e. Miscellaneous
(Service or feeder r.,_ uded) 2
3. Plan Review section (if required): Fach pump or irrigation circleleo 00 2
Signal circurfs)or a limited energy
Each sign or outline lighting 14000
2
Please check appropriate Item and enter fee in section 58. panel,alteration or extension fao 00
4 or mole residential units in one structure Minor labels alteration
:100 00
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inspection over
Classified area or structure containing special occupancy , the allowable In any of the above
as described In N E C Chapter 5 Per in%pertion $3500
per rr,,i $115 00
Submit 2 sets of plans with application where any of the above Mani Ess no
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees
NOTICE $
5% Surcharge (05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS, OR IF Sb, Enter 25%of line A for `�—
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Ser,3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. •� -m,+. .. _I Trust Account 0
mm app
$
Balance Due $
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone. 639-4171
Footing Rain Drain Cover/Service FINAL
Foundation Water Line Ceiling „m
Post/Beam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. r=-Bld�
San Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: 5 1lr � A M. b ..� Entry:
Address: .
Tenant: _ _—_.___—__ — _ Ste: MSTb 5
BLIP:
Con/Own: _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
N Ql2l
Gt s _�1 �11^ —
v# elo't _ . <�
/0-71.1
_ fX7 Tt7
ZL
--_
Inspector: . ._ __—_ Date:
—APPROVED , DISAPPROVED/CALL FOR REINSP CF CO