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11190 SW 109TH AVENUE ADDRESS: 11190 0(PTO AVANUE J O� w.. C,7 W J i:\records\micro(Im\targets'd)uiiding.doc CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 6394171 Date Requested: — _ I A.M. r ! P.M. 1AST: Location: , ► 4�F } (.7 _ BUR Tenant:_ _ Suite: _Bldg: MEC: Contractor: Phone: q �y PLM: _ Owner: /--�-- Phone: (Q ( a D Z 2- ELC:_ - ELR: -61 — - SIT: BUILDING BLDG(con't) PI.UMEINC MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Post/Beam Cover/Service .fewer/Stour: Footing Roof UndFI/Slab Rough-In Ceiling Water Line Slab Framing Top Out )4� Gas Line Rough-In UG Sprinkler Foundation Insulation Sewern� HoodlDuct Reconnect Vault Bsmt Damp Drywall Storm t'�"`� Furnace Temp Service misc. Masonry Ceiling Rain Drain A/C UG Slab Shear/Shcath Fire Spklr/Alm Crawl/Found D- Heat Pump Low Volt Approved eA-pprovApproved Approved Approved Appr/Sdwlk Not Approved oved Not Approvcd Not Approved Not Approved FINAL INAI,,, FINAL FINAL FINAL CL f CY cat- N _ J C' W J 0 Call for specti O Reinspec4on f of S _ required before next inspection O Unable to inspect Inspector: Date: "- _ Page_ of MEMO CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 6394171 Date Requested:P (�' `7 `/ / I/�/yam, A.M. P.M. MST: _ Location: ! `10 ,�G1!i [t / / / ( _ BUR_ Tenant: _ _ Suite: Bldg: MF;C: Contractor: Phone: Owner: Phone: FLC: ELR: - _ SIT: BUILDING BLDG(con't) / PLUMBIr1 MECHANICAL. ELECTRICAL SITE Site Post/13eam L—fNnt/f Gam Post/Beam Cover/Service Sewer/Stomr Footing Roof WOFI/Slab Roagh-hr Ceiling Water Line Slab Framing i'o, -,rt Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer Ilood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Frain A/C UG Slab Shcar/Sheath Fire Spklr/Alm Crawl/Found Dr I Teat Pump Low Volt Approved roved Approved Approved Approved Appr/Sdwlk Not Approved ed Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL i- V; c^ _J Fall ibr r tion C7 Re' s ion fee of S iryAircd 1 ore nem inspection O 1 Jnable to inspect hisliccto� Dale: _J Page of- Z4 f_ c I CITY OF TIC A Qn DEVELOPMENT SERVICI MB. . . PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639• ,� #• • • • • LM 7–k�15 = P SUED: 05/01/97 �� ^11!`'� L: 1 S i.34nA-00302 SITE AD?)RF_5S. . , : 11190 SW 106TH AVE SUBDIVTSION. . . . : NORTHERN PINE1 J1(3.- R--4. 5 BLOCK. . . . . . . . . . . L_C]T. . . . . . . . . . It �DTCTIC N: TIC ---------------------------------------------------------- CI._.ASS OF WORK. . :ALT GARBAGE DISF'O! HOME SPACES. : 0 TYPE OF USE. . . . :SF WAS147 4C:) MACH. , � W PREVNTRS. . : 0 OCCUPANCY GRP. . : R3 FLOOR DRAINS. . � � d STORIES. . . . . . . . a 0 WATER HEATERS ! �� ASINS. . . . . . . : 0 --- –_-- LAUNDRY TRAYS, za�j-Ey�� 1 DRAINS. . . . . : 0 FIXTURES---_--- SINKS. . . . . . . . . . 0 (JRINALS. . . . . . . - �� / 11 0 TRAPS. . . . . . . . 'ALAVATORT.ES. . . . : 0 OTHER FIXTURE! TUB/SHOWERS. . . : 12) SEWER LINE (f• WATER CLOSETS. : 171 WATER I_i NE (f' DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . . : 0 RemaY'ks : replace water- heal-'et, F)wn er: __.---------------__.________.__.__._.___.____________.___ FEES --------__- -.--- JOLENE BRACKEY type amoitr.t by date recpt 1 1 190 SW 106TH AYE PRMT $ 29- 00 .TSD Q17-5/01 /97 97--294009 TIGARD OR 97223 SPCT $ 1. 25 JSD 05/01/97 97-294009 Phone #: GEORGE MORL.AN PLUMBING 55:9 SE FOSTER RD PORTLAND OR 97206 ------------------------------------- Phone #: 771-1145 f 26. 25 TOTAL.. Reg #. . : 0051027 ----- -- RFDIJIRED INSPECTIONS -- --_-- This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipai Code. State of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 190 days of issuance, or if work is suspended for more = than 190 days. m Permittee Signa 'LD f7al l for inspect ioi, – 639-4175 CITY OF TIC ® pn DEVELOPMENT SERVIC UMBING PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639, M. • . • • . • : P1 M97-0153 'esl-)ED: 05/01/97 i: ISI.34DA-00302 e SITE ADDRESS. . . : 11190 SW 106TH AVE uO SUBDIVISION. NORTHERN PINE IG: R--4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . 3DICTION: TIG -------------------------------------I-------------- ------------ CLASS OF WORK. . :ALT GARBAGE DISPuSALS. - 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . - 0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : ) TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . s 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0 IrIXTURES-------.------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : '0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 I-AVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . . 0 SEWER LINE ( ft ) . . . : 0 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Replace water heater F)Wfier: ----------------------------------------------------- FEES -------------- JOLENE BRACKEY type amoLtnt by date reept 11190 SW 106TH AVE PRMT JSD 05/01/1.9-/ 97-294009 TIGARD OR 972r,13 5PCT 1. 25 JSD 05/01/97 97-294009 Plione #: Contract ot----------------------------------- GEORGE MORLAN PLUMBING 9SP9 SE FOSTER RD PORTLAND OR 97206 ____-------------------------_.--_..___-____ Phone #: 771-1147) 26. 25 TOTAL Reg #. 00"-27 REQUIRED INSPECTIONcm This pervit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, Stafe of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with approved plans. This persit will expire if worN is not started within 188 days of issuance, or if work is suspended for sore rL, than 188 days. e r m i t t e e S 1 lsslleri ..................... Call for insmertion 639-4175 z� :ITY bF TIGARD Plumbing Application Recd 8i 13125 SW HALL BLVD. Commercial and Resir'enti3l Cate R(ic'd TIGARD, V.7 97223 Dale to P E. 503) 639-4171 Dace to DST Permits Print or Type Related SWR• Incomplete or illegible applications will not be accepted ci,ed Name of DeveiopmenuProject FIXTURES (Individual) QTY PRICE AMT Sola Q-u Sink 9.00 Slreet Address �` Surto Lavatory 9.00 Address n Tub or Tub/Shower Comn j C RVQ Bldg s (/$18te Zip Shower Only 9.00 j I Water Closet 9.00 —JI Dishwasher ! 9.00 I Ownrar NUBrp Address Suite Garbage Oisposal --I 900 i I1 o 01i Washing Machine CI X1State 21p Phone i Floor Dram 2' :.00 3- 9.00-_ 4 goo Occupant Muiartg Address Suite Water heater 9,00 Laundry Rcom Tray g 00 ( U City/State Tip Phone Unnal - _ 9.00 Name Other Fixtures(Specify) 9.00 t , -- 9.00 t Contractor Mailing Address Suite 9.00 '1 c - G /State Zip Phone 9.00 i r ( 9.00 OV000 Const.Cont.Board Uc.9 Exp.Dale s 900 AMeM Copy o1 9.00 t,urrentt Plumbing Ur-0 Exp.Date Sewer-1st too' 3000 I.)-c-, ^ LicNreae G'J P Q _ Sewer-each additional 100' I OT Business Tax or Metros Exp.Date CWater Service• 1st 1o0' —1 ---130 00 Nemo Water Senesce-each additional 200' 25.00 Archlitect Storm S Rain Drain- 1st 100' 30.00 --7 or Mailing,Address g, ;e Storm S Rain Crain-each additional 100' 25 00 Mobile Home pa Sce 25 00 EngineerI C,ty/State Zip Phone Commercial Back Flow Prevei,mn Cevrce or Anil- 25.00 Pollution Cevtce _ >esatbi•work Vew 0 Addition G Alteration O Reoa r Residential Backflow Prevention Device* �— 15 CO o be done: Residential O von-residential O Any Tap or Waste Not Connected to a Fixture 9 00 I %d&bor4M desrrnpuon of worts -- J ` Catch Basin Too I Insp, of-ExistingP!umbing 4U 00 J i � I oenhr ~_ —rs.ong use of Scec;aily Requested Inspections 40.00 xaldtnq a property_ I I oenhr Rain Crain.single family dwelling I 3000 -Imposed use ofGrease Trap- 9.00 t� *udding or property —' QUANTITY TOTAL Are you app". moving or replacing any fixtures? Yes p No,] Isametnc x reser aupram s reausec if Cuanay toui w >9 (if yes see back of form) 'SUBTOTAL I hereby acknowledge that I have read this applicaticn. hat the information riven.s correct.'hat I am the owner or authorized agent of the owner.and 5% SURCHARGE hat clans submitted are in compliance with Oregon State Laws. ;i nature of Own•riAg• t paw PLAN REVIEW 25% OF SUBTOTAL C& � �)eou+tw only R'6nure m 'ctal's�_ _ `um - TOTAL 'n ct anon eine Phone �`' i Minimum permit fee is S25- 5%surcharge.except Residential Backflow QC Svc Q A 1 . Prevention Cavite.which is 515• 516 surrnarge taststplmapp doc 9/98 PLEASE COMPLETE AS AP�'FZOPRIATE TO PROJECs: t r=ixures to be capped,__ pp moved or replaced Qty Sink Lavatory _ Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine ^�— Floor Drain 2" 3" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: G_ n: — H J L..l .J CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service INA Foundation Water Line Ceiling -Plumb. Post/Beam Mach. Shear/Sheath Framing -Mech. Plbg.Und/Flr/Slab Plbg.Top Out Insulation C�L�,e`L1��, Post/Beam Struct. Mech. Rough-in Gyp. Bd. ��-Bldg. San. Sewer Gas Line Appr/Sdwlk J�–-O-"ins. Date: .— _1 A, -- nom: Address: Tenant: `'' ll —_ Ste: MST. XH d 6Esc:FOLLOWING CORRECTIONS ARE REQUIRED: ELR: Of — ok co C7 W Inspector:!' i �'!d Date: APPROVED _ DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPEr TION NOTICE Inspection Line: 639-4175 Business P-ione. 639-4171 Footing Rain Drain Cover/Service INA t Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing -Mech. Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. Bldg. Ran. Sewer Gas Line Appr/Sdwlk Reins. A, Other. �� " Date: _/ - p A.M. Ptry• Address: �l ! Q 61 _/U� G Tenant: 3te: MST: T 5 _!�4_7 Con/Own:45� a MEC: PLM• ELC. - --_ THE FOLLOWING c6hRECTIONS ARE REQUIRED EI.R: F— J G7 C-0 Inspector: Date: _ `"1rP15'ROVED DISAPPROVED/CALL FOH REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing -Meeh. Plbg.Und/Flr/Slab Pibg.Top Out Insulation Elect. Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: --- -- Date: 7 �Z `�� A�.M�_P.M, Entry: Address: Tenant: _ Ste: T: MS BLIP: Con/Own: MEC: PLM: i4•cQ - U -t�o � bZ ELC: � j THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: J _ Inspector: eir 11111i Date:,L—j— APPROVED _.DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Busines,, Phone: 639-4171 Footing Rain Drain Cover/Service f INA Foundation Water Line CeilingPlum Po;;t/Beam Mech. Shear/Sheath �--- aa�i[�g,�% -Mech. Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: a) -- Date: 77— 1/-- 1(u A.M. —P.I.".. Entry: _ Address: —. -2U 5 CC.) 16 6 ==p Tenant: Ste:_-- MST: TS�o-3-70 BLIP: Con/Own:_4 �t%L _ MEC: PLM: -------- ELC: _ THE FOLLOWING CORRECTIONS ARE REQUIRED. ELR: rK Ln H C] C.7 lil Inspector _-_ Date: 7 41 _APPROVED __ DISAPPROVED/CALL FOR REINSP, CF CO MASTER PiERMIT CITY OF TIGARD DATEIIS#ilEDe . 11/17/95 COMMUNITY DEVELOPMENT DEPARTMENT PARCEL_: 1 S 1 4DA -00 302 13126 SW Ha11 Blvd.Tigard,Oregon 97223.6199 (5.03)639-4171 ..SITE ADDREa15. . . i. .L )1Ci T.W LiL",i. 11i 1-1VI:_. SUBDIVISION. . . . : NORTHERN FINE ZONING: R--4. 5 BLO(_-K. . . . . . . . . . . LOT'. . . . . . . . . . . . . I'--- Remarks: ADDING 1 BED ROOM PATH I --- —--------------------------------------------------------- BUILDING ---------------------------------------------------------------- REISSUE: STORIES......, : 1 FLOOR AREAS---------- BASEMENT... : 0 sf REQUIRED SETBACha---- REQUIRED-•------------ CLASS OF WORK.:ADD HEIGHT........: 15 FIRST....: 165 sf GARAGE.....: 0 sf LEFT.........,: 5 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD,.,. : 40 SECOND...: 0 sf FRONT....,....: co PARKING SPALES: 0 TYPE OF COPaT.:5N DWELLINb UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 5 P_CUPANC/ GRP.:R3 BDRM: 1 BATH: 0 TOTAL------: 165 sf JALUE..f: 10669 REAR..........: 1. -------------------------------------------------------------- PLUMBiNb ---------------------------------------- ----------------------- - SINKS.........: 0 WATER LLOSETS.: 0 WASHING MACH,.: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS......... : 0 LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS_: 0 TUBiSHOWERS...: 0 GARBAGE DISP.. : 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 MECHANICAL --------------------------------------------------------------- FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/CMG ( 3HP' 0 VENT FANS.....: 0 CLOTHES DRYERS: 0 FURN )=100K ..: 0 UNIT HEATERS.. : 0 HOODS.........: 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 0 ----------------------------------------------------------•----- ELECTRICAL ------------------ --RESIDENTIAL UNIT--- ---SERVICE/FEEDER- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS---• ----MISCELLANEOUS---- --ADD'L INSPECTIONS— 1000 5F OR LESS: 0 0 - 2,00 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADU'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0 LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp.. : 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT...,.. : k� MANF HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 0 MINOR LABEL -10: 0 1000+ amp/volt.: 0 -------------------------------•--- PLAN REVIEW SECTION ------------- ----------------... Reconnect only.: 0 )=4 RES LWITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC: ------------------------------------------------------ ELECTRICAL - RESTRICTED ENERGY --------- A. SF RESIDENTIAL--------------------------- B. COMMERCIAL---------------------------------------------------------------------------- AUDIO 6 STEREO.: VACUUM SYSTEM_: AUDIO 6 STEREO.: FIRE ALARM...... INTERCOM/PAGING: OU'iDOOR LNDSC LT: BURGLAR ALARM..: DTH: :: BOILEH.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENFR..: CLOCK..........: 11151RUMENTATION: MEDICAL........: OTHR: HVAC...........: DATAJELE COMM.: NURSE CALLS....: TOTAL. N SYSTEMS: 0 Owner: -----------------------------------Contractors ------------- ---- --- TOTAL FEES:$ 147,06 JOHN VENABLES OWNER 7120 SW 60TH PORTLAND OR 97219 Prone N: 246-7544 Phone 11: Reg 11..: x00000 This permit is issued subject to the regulatio,s contained in the Tirard Municipal Code, State of Ore. 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 th; 140 days. - ------------------- rEOUIRED INSPECTIONS ---------------------------------------- Footing Insp Framing Insp ie ;rival Final _ Foundation Insp Low Voltaqe Building Final post/Beam 5truct Insulation Insp Erosion Control Electrical Servi Gyp Board Insp Electrical Rough RainFn e r M it t e e ':.>i ra n cl t i�'(�'f Y. - I s s -1ed D yr inspection — 639--4175 ELECTRICAL PERMIT ATEII IE11/17/ 9CITY OF TIGARD DISSUED: 5 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)830.4171 PARCEL: 1 S l 34DA-00,__1—0 SITE ADDRESS. . . : 1 1 1'34ti SW 1 Vii_ i-I 1 AVEC SUBDIVISION. . . . : NnRTHERN PINE ZONING:R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1 Project Des;- Aption : AD9ING 1 BED ROOM PATH I ---RESIDEN)'IAL UNIT---- --- TEMP SRVC/FEEDERS----- -•----MISCELL_ANEOUS----•----- 1.000 GF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/ IRRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 201 - 400 vamp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL-/PANT?_L. . . . . . . : 0 MANE. HM/ SVC/FUR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 __SERVICE/FGEDLR - --- _.___BRANCH (.-,IRCUITS----_.- ---ADD' L INSPECTIONS—- 01 400 amp. . . . . . : 0 W/SERVICE OR F=EEDER: 0 PER INSPECTION. . . . . : 0 E01 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1. PER HOUR. . . . . . . . . . . : 0 40:1 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0 601. _ 1000 amp. . . . . : 0 __.--_._.__._----__.__._PLAN REVIEW SECT ION-•-______________ . ..___ 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 ;QVC/FDR i = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: ---___- ---_--._________._____..___-----___.__________.______-- FEES ------_.---_-__.___. JOHN VF_NnBLF S type amount by date T^ecpt 7120 SW 60TH PRMT $ 40. 00 JSD 11 /17/95 95-273050 5PC1 4 .2. 00 JSD 11/17/95 93--2700''_,1, PORTLAND OR 97219 Phone #: 2'46--7544 OWNER f 42. 00 TOTAL ---- REQUIRED INSPECTIONS Wall Cover Elect' l Final Elect' 1 Service ;41q 011.10000 This permit is issued subiect to the regulations cuntained in the Tigar' Municipal Code, State of Ore. Specialty Codes and all other Permittee Si gnat ore 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. I s s ed y __.-.-.-__.-.OWNER I NSTALLAT ION ONI_-Y---_-___-___________.._____ _ The installation is being a on r perty I own which is not intended fot- ;_ sale. lease, or^ re t. ,/`A OWNER' S S I GNAI URE: �rC/ N. DATE e 'r _---_.-CONTRACTOR INSTALLATION J ra SIGNATURE OF SUPR. ELEC' N: DATE- LICENSE ATE:LICENSE NO" _..__............. ... Call for- inspection - 639-4175 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. _ Tigard, OR 97223 Planck/Rec. #Ilk "ermit # ,LC —OSS Phone (503) 639-4171 Date Issued CITY OF TIOARD FAX (503) 684-7297 Issued by TDD No. (503) 684-2772 Inspection (503) 639 4175 1. Job Address:,�(( 4. Complete Fee Schedule Below: Name of Development I' , t ►//Gk► VeNumber of Inapections per permit allowed — Address �� J!�/ ' l,� �� _ _ Service included Items Cost(ea) Sum n City/State/Zip ��J c per_ 2 4a. Residential-per unit 4 1000 sq II or lest $11000 Name (or name of business) Each additional 500 sq It or portion thereof $25 or Commercial❑ Residential Limited Energy -- $2500 _ Each Manul'd Horne or Modular 2 to Dwelling Servmoo or Fender $A19 00 2a. Contractor installation only: 4b.Services or Feeders Installation,alteration,or ielorahon 2 Electrical Contractor 200 amps or lets $so 00 2 Address 201 amps to 400 amps $90 00 2 401 amps to 800 amps $12000 2 City State Zip 801 amps to 1000 snipe $18000 2 Phone No. over 1000 amps or vohe $:140 00 2 Contractor's Livens No. _ Reconnect only $so 00 Contractor's Boa Reg. No. 4c. Temporary Services or Feeders Installation,afteralion or reli,�cntion 2 Signature of Supr. Elec'n_ 200 amps or leas __ $5� _— License No. Phone No. 201 amps to 400 amps $7500 -- 401 amp@ to 800 amps $1(in 00 cNor Wo amps to 10170 Vohs - -- 2b. For owner installations: see•b•above r + 4d. Branch Circuits Print OWn S Na/my a TU N i G En/I/te t+' _ New,allnration or extension Par panol Address (I S a)The foo for branch circuits with ��-- � purchom of"mks or boder too,City=1 l6A-r20 State e zip�j� Each branch circuit $500 Phone No. 03 /N b)The lee for bra x h circuits without The installation is being made on property I own which is purrhoso of service or beds Ibo. First branch circuit $3500 not intended for sale, leant. Each additional branch proud $500 Owner's Slgnatu 4e. Miscellaneous (Service or leader not included) 3. Plan evilew section (if required): Fart'pump or irrigation circle $4000 _ t Each sign or outline lighting $4000 Signal umud(s)or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel alteration or nxlen@ion $4000 _ 4 or more residential units In one structure Minor I abels(10) $10000 _ Service and feeder 225 amps or more System over 600 volts nominal 4f. Each addilional irspeclion over Classified area or structure containing special occupancy the allowable in any of the above as described in N E C Chapter 5 For inspection $35 00 _ Per hour $5500 ' Submit 2 sets of plans with application where any of the above In Plant f55 00-- apply. Not required for temporary construction services. S. Fees: Cry NOTICE 5a. Enter total of above fees $ 5%Surcharge 105 X total fees) $ PERMITS BECOME VOID IF WCf'I OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review it wired(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED ❑ Trust Account N $ Balance Due $ L -- —i r.,w1-11.M4YC pT 40 City of Tigard Residential Building Permit Application 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobsite Address: Subdivision: � GI fh t�� n /, _ Lot # Office Use Only ' Valuation: e EL 1,4— Contact Date _/ / Initials T Result New Construction Only: (Square Footage) Planck/Rec # / - C c 6� House: ��.a Garage. Permit #Al sfq)-- D 3 Reissue of 1 Corner Lott Y N Flag Lot? Y N Map & TL �1 L(r�A — Zone _ � .c,' Owner: U-U11A/ P V I C1LIWA&a Plat # ; / `3 Address: �> j W L-,e�t�,� — Approvals Reciulred ^ ry '� Planning Setbacks N Solar 9 N �7 Engineering Phone: � !LP 3- ) � Other_ Contractor: Items Required Address -� � c �� .� Subcontractors 1. �� Truss Details _ — PV Y V!A ,. p In C "1 a) Other i Phone: �,� —t �� / N y Notes Contractor's License # -— ( ch copy of current uregon license) Contact Name — — Contact Phore — ) Subcontrar..tc s: Architect/Engineer: Plumbing ,�//� v Address: _ Mecnanical: /44 J (attach ropy of current OR Contractor's License) C.3 Phone: ( ) LL JC8 DESCRIPTION GSI Applicant Signature l Applicant Phone number Received by _ / Date Received: ( - ` Ii Permit;* Account Descripdon Amount Amt. Pd. Bal. Dui �5t 7 Bldg. Permit (BUILD) , jZ Q�, y Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) 3 3 Bldg: Plumb: Mech: >/ 13 Plan Check (PLANCK) S�-Z 3 �•� t7 Bldg: S6, 7"3 Plumb: Mech: Sewer Connection (SWUSA) Sewer inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Instiftitional TIF (TIF-IS) Office TIF (TIF-O) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) _ m Erosion Cntrl Permit (ERPRMT) _ J Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) TOTALS: w7= E .4 i N - I T I)r 4 ro T7 ------------ W N Ln 2 co F . C7 liJ J /l/v /7iyylo� S�- f• F tit ' First American Title Insurance Company of Oregon an uaume0 business name of TITLE INSURANCE COMPANY OF OREGON s 1700 S.W. FOURTH AVE., PORTLAND, OR 97201-5512 (503) 222-3651 NORTHERN PINE IMP 1S-1, 34DA J 1/4 6EC'r10N CORNER\ S 170' 10390 67.60 N119°4S'W ez.12, VI —� t0 w 134.29 INITIAL PT, S e9eeo''.N'W 103.9 1905 1800 "�*50 51" /� W 900 INfTWL PT. 3800 .23Ac. 96AC. 45 At: 7 LLl r 9TA� 100 6.38AC. 0 Z TRACT 1B+ (,,j 800 PURPOSES; FOR STORM DRAIN 6 PURPOSES ei` v67.60 70093 �SW3216E I 600169.99 LL' 6200 -� ^ S.18 Ar- 1400 a 10 3 33 0 4& N : 5 �D - 01 n N a w ., O 500 03 0 4 5 a 60 11 ° _ - - 2 zn 0 m 1500 6 as �� za 3s9e �..1 N -1 • o 33 95 Tz.99 u 1— e 4 .477-- 400 I a 60 w WOAr- 1600 12 � N 3600 N a 1c— 4200� ! L-L 7 0oa .37Ac. ! it: =a : . 134.26 _ Q u0 o 300 _ 3500 ►�-� 4300 M 3: - - 13- ry- , c ry ~ I (n 302 1 I Cr e 8 55.1 n 3DA6 154.36O 113.26 17.99 2t 73 1 ^ T t- 7-----r--LN O R I H�TC.R. NO. 45X12-"3'X- � �dO � ' ' oI ------NORTH G- Lot 13, NORTHERN PINE, IN THE CITY OF TIGARD, COUNTY OF WASHINGTON AND STATE OF OREGON: EXCEPTING THEREFROM THE FOLLOWING DESCRIBED PORTION: 00 > Beginning at the Southwest corner of Lot 13 of NORTHERN PINE ADDITION, a duly recorded 4C. 1— plat on file in Plat Book 42, page 13, in the Records of the County Clerk's Office of Washington County, Oregon, and running thence along the Westerly boundary line of said CC" Lot 13, North 0°31'0011 East for 46.00 feet; thence South 89038'10" East for 115.28 feet; CThence South 0°31'00" Wgst for 46 feet to a point on the Southerly boundary line of said Lot 13; thence North 89 .3 IWI West for 115.28 feet along the Southerly boundary line of said Lot 13 to the point of beginning of this description; u ' ti 1 I r I CUUU N •e' N n ll.:J. I 'i' ('1rl- f I UAW) Pl- Ll IP) Ol Pi I YI*A:-N I Irk l l J 1'I 0(l, '� fAit i,l, iolt A fl, NOME t-11,111111,11 V.1. I I J SO 106111 AVE F rlrhll 111 Ol 4 1 1. s ol.' ,14!15);' *1 1 Ot.40) OR ',I HAI)I V I!i 1.1 AA 9'1. ,k-- CL P 1: 111 I,flYIvW NI A1,1111.1N7 Pf-i'l D (it Iff y IVII. I'll 1 W11111111,11 11fl.11) 1.1 JF.t�p, l7f V) IN 3 _j 11--11 On LLA I (A I k1 It�I1II L;J I Y (!i 'I I 0AND W (-F I PT Of— POYMENT PF-CIV.11- 1 NII. a 14h. 111.,0ij I;HF*,(",K f-11110111' , '-),i IMF k)I.l.N()JAA.,�-f-.), J V CASH fINIAINI s VI.- LAO Vlh No I]il A V I(T,1, J V-10110'MF,141 ImIll M-le, `;w (:orl-I f I V E J131)1 V I !:,)I I jtA l-'I 111 I I N 1141) t I R 9'!;`'19— I I f 1 Ifl- P64Y1I1-A1 fAIVI'llip'll Polo PIMPOW-., 10. PAY MF-1.1( HVII JUN I Ppi 11) -1111 01NI'i t-11-44M Ki I"Pti-ABS7 t 86. 05111 -14. 1-3 I I�l NO Pi NPI I 111 1 1, 35. 1(A CO LD ICON. I-IlvllltlN'f NND 9 (if I I l if•lfil1 HF. I P I LIF L 101 Mf-N I PF(.1- I I'I 11(.1, t ti+`'1 1'I.•;V1 1u1 1.;11l.1 ;H; f1hl1UINI 'w'. 1/11�1 NfIMF o VE14Wq..FC.)9 J V 0. 00 W)DP'F ISS t VI:.NO-1OI. LE.111 V 11.;1:1 ,1 t v lYr!! N I J)H I H o 1 1/ 1, //4,13 7120 ON 60411 f1Vl:'. 11 IlllltUI!yI(A t PICA 11,34N1'1 Ok 4/.A 9.. I 1 ti; P(111NUk", OF, PHYN-M rf 1111.11 IN I 1 4l I,U t"OHPOSU.. OF h'f 1Y'hi!.fJ I t 1Mtll lh1 I 14.110 CL F=1. F1"TR11.141 l'1 PlylI I Bbl. li1V) 1yI . BLII1_II r+,H v f-- rr J 4] C•7 11; J 1 l►I tal.. Llf*!UI N•�i l I-'l f l I+ � - 1 h l'. 1.�1.'I S 4 Q � q � Illy "J.Dlu R° i N ^ I^ s Its 1 Ii 1 .I 1/1j � U � �Al 4 K � S � Lb� �l- vZ o c VI) t?D i � u IN, OE 0 ILA v► ` c M � • CL� � ANSIdERS! Li "1wZS '!aKENERGT EFFICIENT? Yes. This home is fully insulated with R-19 fiberglass insu- lation under t}efloor, R-11 filter;lass in all exterior walls, and R-30 insulation in the ceiling. The space heaters add efficiency by allowing separate room heating, and fans to cir- culate the heat. IS T'TERE A COMMON BALL MrWEEN THE HOMES? No. This hone is attached by exterior siding and roof--there is NO COM14ON WALL. Each home has an exterior 2 x, 4 wall on its own property, fully insulated and sheathed on both sides fro■ foun- dation to roof wit's thick fire-rated sheetrock. DIAGRAM OF NOISE A�1D FIRE BARRIER BET'.AfEEN VIE TWO HOMES: ' 2x y I Oxy 'S WD6ro AYE W ALL +� WALL i L19� SW t Ofd ANE FIR$,RATE.O SHF�eT` FiR�-R�1TE.0 SHEErRocK COMMON PROPERTY L i NE IS T."RE A ,OMMON AREA. No. Tkere are no common areas; sack hone is on its own lot. A simple agreement in the dead states the owners' willingness to share a joint access and maintain the consistency of exterior paint an,' roofing. IS THZRE A WAR3ANTT? This home is fully covsred by the one-year Ore.*nn State Stat- utory Warrantv on new hones. MOW ARE THE LOTS DIVIDED? DIAG2A.kt OF PLOT 'LAN: 13 .3' b � N U Y � o rz r m O O rt 5 W. ►JO►2TN AKCf N r � v � (ID a x � M� � T s ,-SZ" � o° � a � � b 2 r J Cal M � LL: J A qj �1 r o � L s 6 V a rt: C47J J Permit#: Address: 90 .--[A,) JIssued by: _ _ Date: �IS Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement 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), need not submit this statement. This statement will be filed with the permit. Dill in the appropriate blanks and initial boxes I and 2, and either box 3A or 313: L I own, reside in, or will reside in the completed structure. 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is — (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR i 3B. 1 will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with (tic Construction Contractors Board. If I change Illy mind 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. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Pro pe s out Con, r clion Responsibilities on the reverse side of this form. (/ / (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant)