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11060 SW 106TH AVENUE ADDRESS: W SW o& AI � cn F� J FH cm V J isVecordslni,crotlmltargetsllwilding.doc CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Une: 639-4175 Business Line: 639-4171 MST — BUP 1 Date Requested" 0-2 —AM PM BLD _ Location ' 77-1 t% Suite l � ( p (#)C Contact Person L� a c,�.�z. Ph C' �"- kI,)-0 PLM Contractor Ph i f�� ' SJR 7 / SWR BUILDiiJV Tenant/Owner EL Retaining Wall ELR Footing Access: Foundation ��� p�-�' / n Ftg Drain `��►Ef�«� -� � � iC &� J-,SP FPS - Crawl Drain Inspection Notes: SIGN Slab Post BeiH'4-V& SIT Be--m ���� Ext Sheath/Shear �i r Int Sheath/Shear Framing Insulation A I /-} _ �- - Drywall Nailing Iv QrE•r V / P�)M( SED 6/UE /NS PEC T7UJ Firewall ` - Fir: Sprinkler _ Fire Alarm O Susp'd Ceiling _ Roof Misc: Final PASS PART FAIL PLUMBING — — Post& Beam -- -' ------- - Under Slab Top Out -- -- ------- -- -- -- - - - Water Service Sanitary Sewer - �- -- - -- Rain Drains Final ----- -----_ --- --- - — - P _- FAIL Pos±& Beam - --------_ _�_. -- _-- _ Rough In ,jas Line Smoke Dampers — in ,-)Q., -- --- - ---- - _ _ PASS ART FAIL - - Service Rough In - - v, UG/Slab _ Low Voltage - -------- - _--- - ------ '- arm ' Fin ---- ---- -- ----.— PASS PART AIL SITE -- ----- ---- -- --- - Bac krill/Gradingg - - -- - - --- — ------ -- Saoitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line l ]Please call for reinspection RE _ - - ( ]Unable to inspect- no access ADA AppOtheroach/Sidewalk Date - _ Inspector- _-- Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - — p U p Blip Date Requested ��"��-0 - /c7 AM_ PM BLD V - Location-----/,, JLC ��r/Cli Suite __ MEC Contact Person /1�f y7�l� /c RAS Ph —J?0Z _ PLM Contractor Ph SWIR G B1111-DING Tenant/Owner ELC Retaining Wall EL12 Footing Access: Foundation FPS Ftg Drain -- SGN Crawl Drain I Inspection dotes: — — Slab SIT Post F.Beam — Ext Sheath/Shear Int Sheath/Shear / Framing __. -f���1 �� •• �c c�t ;�t_. Insulation Drywall Nailing Firewall Fire Sprinkler _— Fire Alarm Susp'd Ceiling Roof Misc: --- Final — PASO PART FAIL - PLUMBING Post& Ceam - —� Under Slab Top Out �_----------- Water Service Sanitary Sewer ---_ --- J --�-- Fain Drains sinal ----------------- ---- - F�1&!s --PART FAIL ----____- —___--- -- - A ------' Post& Beam RoU h I asLind --------- -____-- --- -- -- - — Smo cV'_Dampers PA .S- _PART c FAIL Seivice ------ ---- --- -- - - Rough In N UG/Slab —_.------- -------- -- — - Low Voltage Fire Alarm PASS PART FAILSITE -� Backfill/Grading Sanitary Sewer Storm Drain ] ]Reins action fat of$ _ — required before vert inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line lease cell for reinspection RE:_ _ ; J Unable to inspe;:t-no access ADA Approach/Sidewalk Other Date /Q- 7 ''� Inspector Ext Final PASS PART FAIL 00 NOT REMOVE this Inspection record fv,m the job site. CIT"! OF TIGARD 13UILDING INSPECTION DIVISION 24-Hour Inspection Line: 63 -4175 Business Line: 639-4.171 ®1 - 27- q�--� 1 E%UP - - e. _Date Requested �!` 7 - �� AM PM — BLD _ Location ji�—S�� 1Q lUL SuiteMEC CM- 0305 Contact Person _rnaA ,9&DA-k,5 Ph _ — PLM Contractor�� � C14 Ph _ SWR BUILDING Tenan�owner ELC Retaining WAI ELR Footing Access: Foundation �� Aj C � OA 11 /�- � FPSFtg Drain vvl_ SGN Crawl Drain Inspection Notes: - - — Slab — SIT Post . Beam Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nai in9 Firewall / Fire Sprinkler .: -�G1.1��, � � � ✓� r _ �,��/a�/_�r��c; _ _ __ Fire Alarm Susp J Ceiling Roof Misc: — -- — — Final _ SS PART —---- — -- ,PLUMBING Post& Beam — — Under Slab Top Out — Water Service Sanitary Sewer _ �- Rain Drains Final — PASS PA FAIL MEMANICA Pnst& Beam -- ---- —_ — — ---- Smoke Dampers ( If ASS PART f J41L ELECTRICAL — --` — Service Rough In — N UG/Slab ---- -- --- -- - — -- -- -- — — Low Voltage Fire Alarm ---_ � Final PASS PART FAIL �; SITE Backfill/Grading —'— J Sanitary Sewer Storm Drain I (Reinspection fee of$—_` required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin f Please call for reinspection RE'. ' ( j Unable to inspect-no access Fire Supt-ly Line ADA Approach/Sidewalk Other Date c_ 7�,_ _Inspector — Ext Final � — PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY O F T I G A R D MECHANICAL DEVELOPMENT SERVICES PERMIT Ak 13125 SW Hall Blvd, Tlgard,OR 977223 (503)639-4171 PERM JT #. . . . . . . : MEC98-0305 DATE ISSUED: 07/31/98 PARCEL: IS134DA-00700 SITE ADDRESS. . . : 11060 SW 106TH AVE SUBDIVISION. . . . : NORTHERN PINE ZONING. R-4. 5 BLOCK— . . . . . . . . : LOT. . . . . . . . . . . . . :009 JURISDICTION: TIG -------------------------------------------- CLASS OF WORK. . :OTR FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . : R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES---------.---- 0-3 HP. . . . :: I DOMES. INCIN- 0 :GAS 3-15 HP. . . . . 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 1`,-:30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS'.'. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UN I TS------------ AIR HANDLING UNITS OTHER JNITS. : 0 FURN ( 100K BTU: I (= 10000 c'1m: 0 GAS OUTLETS. : i FURN ) =100K BTU: 0 > 10000 cfm: 0 Rem-Arks -. Installation u� gas furnace, a/c unit I gas piping. Placement of a/c unit must comply with standard setbacks. Owner: ---------------------------------------------------------- FEES MARTIN RAMOS type amount by date rec,3t 11060 SW 106TH AVE PRMI $ 25. 00 DEB 07/ 31/9B 913-30786E TIGARD OR 97223 `:,PCT $ 1. 2E DEB 07/31/98 98-307862 F--Ihont- #: 684--8020 Contv -Actor: ------------------------------- N G HEATING & COOLING/GRITEA 5541 NW DEERFIELD WAY ---------------------------------------- $ 26. 25 TOTAL PORTLAND OR 97229 Phone #: fleg #. . : 0009"08 REQUIRED INSPECTIONS TWs permit is issued subject to the regulations contained in the Gas Line Insp T;gard Municipal Code, State of Cre. Speciilty Codes .-nd all other Heating Unt Insp applicable laws. All work Nil! be dorin accordance with Cooling �Jnt Insp approved plans. This permit will expire if work is not started Misc. I n s p e cion within 100 days of issuance, or if work is suspended ftr more Final Inspection !7 than 180 dal,,s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9552-00IAM16 through OAR 952-00I-O080. You may obtain copies of these rules or direct questions to O(K by calling I ,;-, is By , Permittee cSignati-ire -AtP- ++++++++++ .++++++++++++++++++-++++++++++•++++•+++++++.F+++ +++++++++++++++++++•++•+++ Call 639-4175 by 7-00 p. m. for, inspections needed the next business day -4-+-+-+-1-+++4......4-++++4-+4.++++++++++++i•++++++++++++++.+++•...I.+++++++++++++++.++++++ CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171MST _ tom' BUP _ 1 , 6Y Date Requested PM BLD LocationSuite p _ MEC Contact Person10 /M )S Ph Qc�-D Q J _ PLM Contractor _ Ph SWR rB—UILDING Tenan caner ELC —_ Retaining Wall ELR _ Footing Access: LL n n _ �7-� Q ,r Ft Foundation n �F- V) Do Re t DA y 1� - ► OO 6USki/j/ FPS -- g SGN Slab Crawl Drain Inspection Notes: M (�( S / /� p SIT _ Post&Beam L�� ���Mpr n Ie 0�, TI� Ext Sheath/Shear _ Int Sheath/Shear i Framing �7� r Insulation Drywall Nailing _ Firewall Q, (/ Fire Sprinkler — Fire Alarm y Susp'd Ceiling Roof Misc: _ _ — Final PASS PART FAIL -- — PLUMBING Post&Beam --- — Under Slab Top Out -- Water Service Sanitary Sewer -' — —^—— Rain Drains Final --------,. —.—. _ P FAIL �. MECHANICA _--"-- ----_--. ___ — Post& Beam Rough --- -------- ------ — Rough In (? Q1caJce�ampers Fin ---- - — --- — ASS. PART FAIL (ZirtrCTRICAL - ----------- ---- — Servi-,e Rough In — "' Ur/Slab Low Voltage — -_- --— ---�— - - -- J Fire Alarm ---------- ----------------- Final — --- --- --- �� PASS PART FAIL UJ SITE J Backfill/Grading - — Sanitary Sewer Storm Drain j j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Olvd Catch Basin j j Please call for reinspection RE: [ j Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk Other Date I I _ (� Inspector 1� ��___._ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MsT 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- — G BLIP _ Date Requested - �� AM PM BLD Location IOh� ?n- / � _ Suite MEC Contact Person Ph to ^ XO a--O -LM Contractor /--1 /'✓J Ph Z"ZZ- /�,y I _ SWR 54?ID -EE�tLfC� VG Tenant/Owner Z-UL Footing etaining Wall r ()[U 7 Foundation Access: FPS Ftg Drain SGN Crawl Drain Inspection Notes: - — Slab — C /Cc SIT Post& Beam / —— Ext Sheath/Shear Int Sheath/Shear _ ---� Framing - — L� 9 '- _ -_ - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- — _ _ Roof Misc: Final PASS PAF'T FAIL -- _ PLUMBING Post&Beam -- Under Slab Top Out Water Service _ Sanitary Sewer - Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam -- - ----- --- — - Rough In Gas Line - --- - - Smoke Dampers Final --- --- - PA FAIL _. _ LECTRIC _ ~- - Service N Rough In --- ----_— - _— -- _— UG/Slab ---- --- -- -- --- - --- �- Low Voltage Fi_r_eLk"arm — -- ------_ — --------- c� Fi SS PART FAIL - il r J Backfill/Grading --_—� -- -- -- Sanitary Sewer Storm Drain [ J Reinspection iee of$_ required before next inspection. Pay at City Hall, 13175 SW Hall B;vd Catch Basin Fire Supply Line [ ]Please call for reinspection RE:`_ —____ _ [ ]Unable to inspect-no access ADA f,pproach/Sidewalk Other Da. & Inspector Ext _ Final PASS PART FAIL 00 NOT REMOVE this inspecti3n record from the job site. Plan CheckA CITY OF TIGARD IViczhanicai Permit Application Recd By 13125 SW NAL! BLVD. Commercial and Residential Date Recd TIGARD, OR 9t.-13 Date to P.E. (503) 639-4171, x304 Date to DST Print or Type rermit n I {7 C -Q.205- Incomplete or illegible applications will not be accepted Called Name of 0evobpment/Prole(W17 1 rJl Description Table 1A Mechanical Code OTY PRICE AMT Job Strom Address Sure# A) Permit Fee •0- -0- 10.00 Address 1 0(o p eldga Citylstate Zip1.)7 1.) Furnace to 100.000 BTU ) 6.00 c _ including ducts&vents Name(or name of business) 2.) Furnace 100,000 BTU+ T 7.50 Owner I�,p ✓t�v, 6- u S including ducts&vents (illi Address ^w f � _ �l^ 3) Floor Furnace 6.00 5 1 _including vent _ City/State g Zlp Phons 4.) Suspended heater,wall heater 6.00 C J 4 00 DC?3 or floor mounted heater _ Nano(a name of business) 5.) Vent riot included in appliance permit 3.00 .,`dw _ C\S 0 Vvh�Or Occupant Mailln{,Address 6.) Boiler or comp,heat pump,air Gond. 6.00 _ to 3 HP;absorb unit to 100K BUT" CHyrStaa Zip I Phone 7.) Bo,ijr or comp,heat pump,air cond. 11.00 _ 3-15 HP;absorb unit to 500K BTU" v Contractor Nome 8) Boiler or comp,heat pump,air cond. 15.00 15-30 HP;absorb unit.5-1 mil BTU- Prior to permit Mailing ddrew; Q l� 9) Boiler or comp,heat pump,air Gond. 22.50 issuance,a copy 30-50 HP:absorb unit 1-1.75mil BTU" of all licenses C /State Zip Phone 10.) Boiler or comp,heat pump,air cond. 37,50 are required if r� lAfl r d i� .3 >50 HP;absorb unit 1.75 mil BTU" exp'red in COT Oregon Const.Cont.Board LIc.0 Exp.Date 11 ) Air handling unit tc 10,000 CFM 4.50 database `� I �j 1 �YArchitect Name 12.) Air handling unit 7.50 10,000 CTM+ Or Mailing Address 13.) Non-portable evaporate cooler 150 Engineer CHy/Btate Zip Panne 14) Vent fan connected to a single dud _ 3.00 Describe work New O Addlilond Alteration O Repair O 15.) Ventilation system not included 4.50 to be done Residential-6 Non-residential O in appliance permit Additional Description of work: 16.) Hood served by mechanical exhaust 4.50 4- 17.) Domestic incinerators 7.50 Existing use of l 18) Commercial or industrial 30.00 building or property type incinerator 19.) Repair unit! 4.50 L Proposed use of 20.) Wood stove 4.50 building or property ` 21.) Clothes dryer,etc. 450 n Type of fuel-oil 0 natural gas e LPG O electric O 22.) Cther units 4.50 r I hereby acknowledge that I have read this application,that the information 23.) Gas piping one to four outlets / 2 00 r, o given is correct,that I am the owner or authorized agent of _ the owner,that plans submitted are in compliance with Oregon State laws. 24,) More than 4-per outlet(each) 50 J Signature of OwnerfAgent Date •SUBTOTAL j 5%SURCHARGE Contact Perso Name Phone PLAN REVIEW 25%OF SUBTOTAL L•�c r" Required for all commercial permits only. TOTAL jmff8t�< 'Minimum permit fee is$25+5%surcharge "Residential AIC requires site plan showing placement of unit. 1:lmechprmt.doc rev 4/15/98 ll�o ew r067 n J it .J CITY OF TIGARD ELECTRICAL_ PERMIT DEVELOPMENT SERVICES PERMIT #- El._C98-0588 13125 SW Nall Blvd., Tigard,OF 97223(503)639-4171 DATE I RCUE'D: 09/23/98 PARCEL; 1 S 134DA--0+0700 SITE ADDRESS, . . : 110GO SW 106TH AVE SUSDTVTSI0N. . . . :NORTHERN FINE ZONING— R ..4.. 5 DL_.00i;. . . . . . . . . . . LOT. . . . . . . . . . . . . :OO9 JURTSDICTION: TIG r_'r,o jest Description : Add electrical - --._ _.RESIDENTIAL. UhlIT_.._-..-_ __.._TE!'+!F' SRVC/FEE'DERS---._._. 1000 SF OR LESS. 0 0 200 r,In p., . . . . . , : 0 PUMP!I RR I SAT I ON. . . . : 0 TACH ADD' L 5O0SF. . . : 0 1301 - 400 amp. . . . . . . .. 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENEROV. . . . . : 0 401 - 600 amp. . . . . . . : 0 STGNA1_/PANE I.... . . . . . » : 0 MANE. HM/ Sb'C!f"DR. . : 0 E,01 +amps 1000 vo It S. : 0 MINOR LADEL ( 10) . . . : 0 -------SERVICE/FEEDER- _-F+RANCH CIRCUITS----- _____ADL)' L INSPECTIONS--.-._ T - 2017.1 amp. . . . . . :d W!SERVICE ON FEEDER: 0 PE"R 1lNNlS'E(WT',0N. . . I, . : Oi 201. - 400 amp. . . . . . : 0 1<st W/O ERVC OR E=AR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EO Alyn" l_ PRNCH CIRC. rD IN PLANT,. . . . . . . . . . . : 601 - 1000 amp. . . . . . 0 ____..____.______.____FLAN REVIE=W ';EE.CTTON__-_-_--_ .____. ._... 10!0@+ a m p!v o l t. . . . . : 0 ) =-4 RES Uhl I TS. . . . . . . . : ) sewt !rnL"f NC1M I NAL. . Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPE=r: OCC. (7wneI : _._ .........__.._.....__._......._._._ .. ._._._.._. FEES MARTIN RAMOS -�"'� type amai.rnt by date .^ecpt 1. 1060 SW 106TH AVE �'� PRMT s _05. 00 UE(l O'•3/23'106 98 :,0�.34O8 TIGARD OR 972r'_.3SPCT' $ 1. 75 GECI O9/ ,3/98 98--309AVIS Phone ##• E,134­8012117i i rontr,actor: OWNER �.' S .36. 75 ` nTAL / _.._.. .._._,._.._ REQU I RF.D T RISPr"f'T I nN5 ._..__ [:1.r^c t' 1 Service Phone #: Elect' ]. Final Rei #. . : 00000 r This pertit is issued sub,l.ct to_.the-Ke ulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issuance, or if work is suspended for core than 180 days. ATTENTION: Oregon iaw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9520-001-9010 through OAR 952-00)-1991, Yc.r y obtain a copy J these rubs or direct questions to OUNC by calling/(503)246-1997. :Iv) mi.ttee `i-i Qr•:sI ,ire • 7Git 9i(/+— Is':r.rari (' /(�J ,�5, l �-✓ > ___G4NF'R INSTALLATION 1- �, Thr in%tallation is lbr - i, made rnperty I own which is not intended fcr ;alej lease, nr^ Tent:,, w `IWNE'R' S S TGNATI." .__ � DATE - 1 - °�• C1 I ATT ON ONLY--- .____._._.._.._.__._.____..... � ( N(2TURE' OF I'Uf'F;. I:�_L.:. i..' ISI: DATE: -jr-ENSE NO: + 4 4-+++ 4 ++ 4•+i 1..4.+4•++4 4- f+-!-4....++•44•+-f•+ f+•{•+••h++.++•!+++++4•-F++-h+-4+++i•+++4+4.4..F4.+.+•++4-+F- ! Cal. 1 X37?''-- 1175 by 7:00 p. m. for- an insper-t ion nee_PLI the next husine5s day ++++++++4+++4.4 .1-4•-+-+++++i-+-++++4-++++-1-+++4,,+-4-+-1 +++++-►++++++++f+++++++++++4 09/22/A8 TUE 10:35 FAX 503 598 1980 Cl'i'1 OF 'I'IGARD 0002 CITY OF TIGARD Electrical Permit Application Plan Check 0 13125 SON HALL BLVD. Recd By--- Date y __Date Rec'd TIGARD OR 97223 Date to P E. Phone(503) 639-4171, x304Print or Type �� Dateto DST-� Inspection (503) 639-4175 Incomplete or illegible will not be accepted permit ftLI-(` 4r"? Fax (503) 684-7207 � _ � Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development pj Number of Inspections per permit atlowad - Name(or narno of ba lsiness)_M jN t N 1\ r R n^ti c: Service included: Items ccit Sum Address ' 0�' C) S w U�1 4a. Residential-per unit lutru sq.it.or less _ $110.00 _ 4 City/State/Zip_I Z > Each additional 500 sq.h.or portion thomof 325.0u 1 Cnmmerrial ❑ Residential Limited Energy — $25.00 Earh ManuPd Hmmn or Modular Dwolling Service or Feeder sss no 2 Contractor installation only: (Attach copy of all current licenses) 4b.Services or Feeders EI8G1rjC OnlraOtOr _ Installation,alteration,or relocalion 200 amps or less $60.00 2 Address_ _ 201 amps to 400 amps $80.00 2 Cjry Stttte_ 7i)1 -_ 401 amps l0 600 amps ..___ 4120.00 2 Phone No. `� 001 amps to 1000 amps � 31110.cx1 --- 2 Ovor 1000 ompt:or volts $340.00 2 Job No. J -- -- Reconnect only $50.00 _ 2 Elec. Cont Lice.No. _Exp.Dato _. OR State CCB Reg. No. —EXp.Da31E 4c.Temporary Services or Feeders COT Business Tax or Me o. _Exp.Date ",_ Installation,alteration.or relocation / 900 amps or lass $50.00 _ 2 201 amps to 400 amps $75 00 2 Signature of^up erlar.'n _ -- 401 amps to 600 ompa $100.00 2 Ovor 600 amps to 1000 vollE, I icnnsr. —_ Exp.Date__­_ .__ see"b"above. rho . No. 4d.Uranch Circuits Now,alteration or extension per panel 2b. For owner installations: A)The fee for hrannh cirr.ults with � " �� U purchaso of eorvlro or Print Owner's Name, �w J feeder fee. �r Address— U L �a l� v�-� Ench branch circuit $5.00 ----- b)l lie fee for branch circuits City_Z 1 c �� State Q,/ 23 1 without purchase of . Phone No. f c'I t,I1 $C a L, L Ic) J c 3 u S '!t first bre h header lea. ,00 " First branch circuit � $35.00 _-.._ 2 The installation Is being marip nn property I own which is not Each addillonal branch Orrult^^ $5 intended for sale,lease or rent. 4e.Miscellaneous (Service or leerier not Included) r Owner's Signa.ttlre ���y Each pump or Irrigation circle $4°°° 2 Farh slUn or nulllne lighting _ 440.(x) 2 an Review section (If required):''" Signal circuit(e)or a limhod nnnrgy panol,altoratlon o,oxtonelon $40.(x) 9 Mirror 1_ahsls(10) $1°°°° Please eh appropriate ile d enter fee In section 50. 2 _4 or rnnra r ntial uNfs in one structure 41.Each eddRlonal Inspection over {j _ Sendce and lead rrtr,ps nr mem tte allowable In any of the above - -,System over volts n, I Pa+ a+pnrdnn __ S.�S.OU r lasslA res or strucU,rr ca Iny spcc lal occupancy Per hour $55.00 ----- as _rrihed in N.F.C.Chapter 5 In Plant $.55.00 _ Sub 2 SE.s of pines with ap,3llcetlon where any- the above apply. Jam. Fees: 5��. Not required for temporary constructlon services. Ss.unmr tai of above fees t 1 5%Sulchnrge(.05 X total fees) $ - NOTICE Subtotal $ 5b.Enter 25%of lino 5a for EFlMITS BECOME VOID IF WORK Of r CONSTRUCTION AUTHORIZED IS Plnn Review 11je%ilrnrd(Sar.:1) 3 NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subto!'., $ IS SUSPENDED OR ABANDONED rOR A PERIOD OF ISU DAYS Al ANY Trus,Acrnunt N!_- TIME AFTER WORK IC r`.nmMFNCED. Total balonce Due I qwP I YCLC96 APP nr 9MFi Permit #: j�F4,C�b C(07-- 05-'j5- g �1 Address: N'• z) Issued by _ Date: 3_ Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires resid,ntial construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following,;tatentent before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), nee 'not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 313: 1. 1 own, reside in, or will reside in the completed structure. 2. 1 understand that I must register as a const;uction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is I�J (Name) Contractor regis. # I will instruct my general contractor that all subcontrac.r.rs who work on the structure must be registered with the Construction Contractors Board. OR 313. 1 will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my inind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. LO M w I hereby certify ihat 1 he above information is correct and that I have read and do understand the Information Notice to Pi oherty Owners about Construction Responsibilities on the reverse side of th - form. CI (Signature of permit applicaat) (Date) 1 (White copy to issuing agency permit file, pink --opy to applicant) CITY OF TIGARD ELECTRIcnt-. PERMIT ' r I T #: F 0617DEVELOPMENT SERVICES DATE ISSLED: 10/09/9 8 13125 SW Hall Blvd., Tigard, OR 97223(503)639.8171 PARCEL: 1 S 1.,4DA--00700 SITE_ ADDRESS. . . : 11.O6O SW 106TH AVE SUBDIVISION. . . . :NORTHERN PINE ZONING: R--4. 5 '3L_OCK. . . LOT. . . . . . . . . . . . . :rl09 JURISDICTION: TIG ' Pro j er_.t Description. Installation of 2 branch circuits. -- -RESIDENTIAL UNIT---- ---TEMP SRVC/FE':DERS---- -----MISCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . .. . : 0 EACH ADD' L 5005F. . . : 0 201 _ 400 amp. . . . . . . : 0 SIGN/OUT LINE LTC,. . : 0 LIMITED ENERGY. . . . . : 0 401. - 600 amp. . . . . . . : 0 SIGIVAI._/PANEL. . . . . . . . 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR L.PBEL_ ( 10) . . . : 0 __SERVICE/FEEDER- - _.__.__BRANCH CIRCUITS-__._-__ ---ADDIL INSPECTIONS-.-- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INt_;PECTION. . . . . : 0 ;?01 - 400 amp. . . . . . : 0 I st W/O ERVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 600 amp. . . . . . . 0 EA ADD' L BRNCH CIRC,- 1 1 N PI._ANT.. . . . . . . . . . . .. 0 601 - 1000 amp. . . . . . 0 --- - --- ---- -PLAhI REVIEW SECTION-- 10004- amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : ) 600 VOLT NOM I NAL... . Reconnect only. . . . . : 0 SVC/FDR > = 2275 AMPS. . : CLASS AREA/SPEC OCC. . rlwner.: ____.___.___.__._........__.__....___._..____-__-__._._.-__ -------.---._.___-___ FEES MARTIN RAMOS type amot.int by date reept 11060 SW 106TH AVE PRMT $ 40. 00 DEB 1O/09/96 98-309885 TIGARD OR 97223 SPCT $ ;x. 00 DEB 10/09/98 98-3O9885 Phone #: 684-8020 Contractor: AMP ELECTRIC $ 4i?. 00 TOTAL.. 11400 NE 4TH PLAIN RD ------- REOU I RED INSPECTIONS VANCOUVER WA 98662= Elect' l Service Phone #: 222-1647 Elect' 1 Final Peg #. . : 000781. This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if krork is not started within 180 days of issuance, or if work is suspended for anre than 180 days. ATTENTi"JN: Oregon law squires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are sei forth iA DAR 952401-0010 t OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-1987. rlermittee Signat+.rre : // ��� 7 Tssi_red TNSTALLATION The installation is being made on ,property I own which is not intended for sale, lease, or rent. OWNE:R' S SIGNATURE: DATE: -------------Cr]NTRACTOR INSTAL-�LA�TIOON- ONLY---------------------------- SIGNATURE OF SUPR. ELEC' N: (,- � Le��`� �~'� DATE: "9-�� 1_ I CENSE NO: + 4.++++•� +++++++++++•++++++++ f +i++++ +++++++++++++++++++...F++f++++++++++.f-+++++•++++4 Call 639-4175 by 7:00 p. m. for an inspection needed the next bl_rsiness day ++++++++++++++++++++++++++++4.+++++++++++++++4•.+++••F++++++4-+++4-+4•++++•1•++++4+++•�+ + rat•tER. PAC. SPAiAQUA INTER. '3032_533144 P. 01 01�1b-9i 1R; 12 $LU3 064 7297 CIT! OF TI(.AU Z010 ,01r 1 CITY OF TIGARU RECEIVE i glectrloel Permit Appi!Cetion Plan C" j 13125 SW HALL BLVD, TIGARD OR 97223 OCT (I r, 199 �G, Data Ryo'd Phone ('50)0.19.4171, x304 Date to P.E,_ InSpaction (503) 639.417g'C"MUNITY fl'_VE!.l!F yr w Print or Type Date to DST Fax (503) 694.72+ 7 Incomplete or Illegible Wlll not be accepted Pe;mit ll�� e i8 r _ _ ^l. Job Address: l i (00 4. Complete Fee Schedule Below: �Y~' Name of Development Numbet of Inspe,:tlans par permll Allowed — Name (or name of business) ��✓ �t��� S ,Service included.— Items Cost Slim w 411. Ftesidentl3l•par unit -.---�•.••`..—.�..__.�•.... 1000 11.It or lose $110.00 ;,Ity;st�►P,zip_,___ << a✓ C r_ Z .� --- E.on utldillollal 50o eq n or CgrnmQrrlai J Rosidentlc. pon.an thereol 325.00 Llrih sh Erargy S25 09 Each Msnu('d Mor or Mod_tsr Dwelling Service or Faador X68 00 .2a, Contractor installatlon only: (Attach Copy Of all current licensee) 4b.Seryloca&F�,edera Elecfrlcrai Cotttrrlctor _ty� � C e,C InSta\IIallon,altvenor„nr wl%at on Address /.�,Z cc C /,_�., 1�.� L 100 laps or leis ,_ SFJ 00 ---- i 241 1110 100 amps Stale _Zlp 4�t anise to 600 sapsW� s12a(+0 Phone No. 'X "2 —1b Y 7 601 amps 10 1000 snipe _„— ste7.00 Joh No �{ _ -- — ©ver 1069 ATPS or voile L=. �7... F!pr. Lon! I loe. No 7 l� Exp,lJatA/ - / ` Asccnnec;orty OR Stave CCS RegNo. -7--k-73 �2 Exp.Dat9 _ 4c.Temporary ServItos or Fooders COT Bus'ness Tax or Metro NQybOici436'ID Exp,Dtate 0 r y 7 In-Ma!latloo,alle•a:-on,or relocation - ^-- I200 Amps or IASs „�, S`C•00 576 W Signature of 5upr. Elacn I'L_,–L201 r+mpS to 4Q0 gfrpl— — 401*mph's too amps $too 00 / 0.9r 60011'nr5 to 1000-Jlts. Licerse No _ L/ Exp,Date Date— sae°a"aenve. dor - — ed.drench Circuits New,altaraGon or o4ar%3,on('9r pan:rl 2b. For owner instahko4tlons: al The leo(or branch circ0i; with ___ __.__ —._ I purchase of or Paw Print OnOr'r1 Name reader lee.. Add•essY~ Each bear&Circuit ----- b)Tr.s los for ur,ncn crrcurls C!ty 3tdle_„_ Zip, without purchase of Phone No,---.- service crreactor lee 435.00 F+:et brach 0co.11 -The Irr9tallATiGn is beim mads on property I own which Is n0! Each edditlonal,)ranch circuit Intended for solie, lease or rent. 4e.Miscellaneous (Fetiiow or leader not included) UNner'3 SignalvrN _ _ Each pump cr Irrpation 0cle $4nu,00 Each sign or outline lighting y 54:1.00 3. plan Review see�)Gt7 (ll req►.lhred):' Signal cR liers1 cr a lx1onlrniM eneryy� —✓ panel, ellsrsricn ore eenalon __ s40� fvtlnar Letrrla(10) $100-Mi riepso check appropriate{tem and antst fee In section 63. _ 4 er mora res 1111111,11 ur+it! n Ca O SNucturn 41.Each aAdlt'Onal Int ihil on orer Sery CA ri'd Nil U5 amps or More the allowable in uny of the above _9y3tom over G00 volt!nominal Per in5pec'on S�S.GO - C+assMlod 8104 or Ift,-VO rx+ta ring jottlgl a;oupttncy Per hour aI d0eorlbed In N.E.C,Chapter S In Plant S3500 Submit 2 ace of plool with opplloetion where any of the ebovo apply. I 5. Fees: r� �L Not required for temporary eenstructlen aa► tie.Ental tote+of era�o tees $rkes L 5!G Bureharga(OS 1 total feast sb.Friar 250:of line Sa(qr BZCG`Al!VC+D IF WOQK 04 CC'NSTrl1lCr'01`411 AUTHORIZED IS Plan RevreNf It..IEq'j"40(1eC 3) $ t,OT COMMK`CFD W-Tf•rIN t?J DAYS,Oil IF CONSTRUCT'ON OR WORK StMor•r s IS Ct!9PFN l!!D Oq AAANDONED FOR A PERIC 0 OF 111111)DAYS AT ANY [] Trust Account K TIME•AP194 WORK IS COMMENCED Tc+tnf balance Dt1e