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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Flour Inspect!-)n Line: 635-4175 Business Line: 639-4171
BUP _
Date Requested AM PM _ BLD
Location ��-tG �1 --8tiite r MEG
Contact Person Ph PLM
Contractor Ph _ SWR _
BUILDING Tenant/Owner ��' 2�>
Retaining Wall ELR _
Footing Acces q
Foundation 6V �� G Ili' ) ✓ . a'� FPS
Ftg Drain SGN
Crawl Drain Ir Not Requested
Slab - SIT
Post& Beam — Found DuringResearch —
—
Ext Sheath/Shear No lnsnectiern/st In File
Int Sheath/Shear —
Framing --- —_
Insulation
Drywall Nailing
Firewall
Fire SprinWer
Fire Alarm
Susp'd Ceiling —
Roof
Misc: ----. -.. -- --- - --
Final
PASS PART FAIL --- ----------- -------_ _
PLUMBING
Post& Beam ___.--.-------_.__ -
Under Slab
rop Out - ------- ----
Water Service
Sanitary Sewer
Rain Drains
Final —----------
PASS p R r FAIL.
MECWtNICAL -- - ---
Post& Boarn
Rough In
Gas Line - - --- - - ------ ------
Smoke Dampers
Final
PASS PART FAIL.
ELECTRICAL
Service
t� Rough In _ _---------
UG/Slab _._— _ —_—_ --_—__ ---------_---------_-- — —
Low Voltage
Fire Alarm
Final - -- - — -- ---- -- -----PASS, PART PART FAIL
SITE —
Backfill/Graoiily- — ----- ----- --- -- ---
Sanitary Sewer
Storm DrainI I J Reinspection fee of$— —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply line ( j Please call for reinspection RE: — _ ( t Unable to insper_t-no access
ADA
Approach/Sidewalk Date InspWor-- Ext
Other --- — —_
Final
PASS PART FAIT. 00 NST REMOVE this inspection record from the Job site.
ELECTRICAL_ PERMIT
CIP( OF TIGARD PERMIT #: EI_C960203
COMMUNITY DEVELOPMENT DEPARTMENT DATE 1SSUED: 04/08/96
13125 SW Hall Blvd,Tigard, Jrapon 97223.8199 (503)839.4171
SITE ADDPESS, . . : 148BIZ1 SW 109TH AVE PARCEL : 2S120AD-90025
SUBDIVISION. CANTERBURY WOODS CONDOMINIUM
ZONING; R i�_'
BLOCK. . . . . .
Pr�o•jectlDescription : -Install-one-branch. cii-cl.tit drip to storm danage.
----•---RESIDENTIAL UNIT---- --- TEMP.
SS SRVC/FEEDE:RS-•----- ---- �
1000 SF OR LCJJ . . . 0 0 _ `-MI�CEI .LANEOUS-----
200 am
p" " " • ; 0 PUMP/IRRIGATION. . . . : u
EACH ADD' L 500SF. . . : 0 `'01 - 400 amp. . . . . . . : 0 SIGN/OUT LIPIE LTG. . ; 0
LIMITED ENERGY. . . . ,
0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0
MANE, HM/ SVC/FDR. . : 0 601-�•amps-1004 volts. : 0 MINOR LABEL (10) . . . ; 0
--•---SF•f2V I CE FEEDER.----. - ---BRANCH CIRCUITS--.----•- ----ADD' L INSPECTIONS—-
0 200 amp. . . . . . : Q W/SERVICE= OR FEEDER: 0 PIER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . . 0 l s•t 11/0 SRVC OR FDP. : 1 PER HOUR. . . . . . . . . . . : IZI
401 - 600 amp. . . . . . : 4'I EA ADD' L BRNCH CIRC:: 0 IN PLANT. . . . . . . . . . . ; 0
601 - 1000 amp. . . . . : IJI _._.________.._.__ 'I__AhJ REV IEI!
10004- amp/volt. . . . . : IZI ) =4 RES UNITS. . . . . . . .
Re > 6'10 VOLT NOMINAL. ..Reconnect r n l y. . . . . ; q) SVC/FDR > = 225 AMPS. , : CL(, AREA/SPEC OCC. :
Owner-: - -_-___..__._---..___.___
CMI PROPERTY MANAGF�MEN1" FE_�:S
27P, SW ARTHUR type amol_tnt by date recpt
F'RMT $ 0. 00 CJS 04/08/96 STOR,1•1
PORTLAND OR 9720:
5F'L T $ 0. 00 CJS 04/08/96 STORM 1
Phone #: 224-2295
Contractor:
ROSE CITY ELECTRIC CC) $ 0. 01T TOTAL.
4012 NE CULLY BLVD I
---- --
TI(:�ARD OR 97213 REQU1RED INSPECTIONS -
Phone #: 503-ii� Wall Cover
87-6164 Elect' 1 Final
Reg it_ : 3567 Elect" 1 ,r service
This permit is issued subject to the regulations contained in the _ I
Tigard Municipal Code, State of Ore. Specialty Codes and all other F'c rm i t t e__e S i gnat_LI-Ve
applicable laws. All work will he done in accordance with
approved plans. This permit will expire if work is not ftarted
within 186 days of issuance, or if work is suspended for more
than 188 days. '' _--
Issued By
- 0!JNFR IHSTAL_LATION f.)NLY-----•---•- __
I The installation-is-being made on property I own which is not intended
sale, lease, or rent.
OWNER' S SIGNATURE.-
T _ DATF=a
�_.._ -
INSTAI_.I_ATION ONLY----------
_________________.
S I GNATUPF OF SUF'R. ELEC' N: _on
G DATE y�.�.__9C
rt
LICENSE NO;
Call for inspection - 639-4175
Community Development ELECTRICAL PERWIT APPLICATIUni
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # .S;�onr
Permit # l,-- 2a3 _
Phone (503) 639-4171 Date Issued zl- 8- 9�,
CITY O�TIGARD AM FAX (503) 684-7297 Issued by Chi,-&,i, <r-h w,cls
TDD No (503) 684-2772
Inspection (503) 639-4175
1. glob Address: 4. Comp►; to Fee Schedule Below:
Name of DevelopmenS Number of Inspections per permit allowed
Address__ !�_ROO :S(.,.) 14 Service included: Items Cost(ea) Sum
City/State,Zip Ir4y
4s. Residential-per unit 4
1000 sq 1' or less $11000
Name (or name of business) Each h nal 500 rq It or
portion
on Ihereol >;."�00 1
Commercial❑ Limned Energy $254 '
r Residential I z
tach Manul'd Home or Mcdul,•r
fhvr,t!,nq Servs.* r Feeder W 00
2a. Contractor installation only: 4b.Services or Feeders
G ' Irwtallation,alleration,or relocatio,t 2
EIE CtrlCdl ContractGr �./ 200 amps or lose _—_ $60 u0 _ 2
/ 201 amps to 400 a ps _ $8000 _ _ 2
AdGfDSS Z 401 amps to FAO amps $12000 2
Cil.- tate go'— Zip 601 amps 10 1000 amps $18000
Pt10r1No Over 1000 emps or vorls $34000 2
Contractor's License N0. _ Reconn3 a only $5000
Contractor's Board Reg. No. 4c.Temporary Services or Feeders
Installaltan,alteralion,or relocation 2
Signature of S pr. Elec'n 04 200 amps or less $5000 2
201 amps to 400 amps $7500
2
License No. � Phone No._Z� 40, amps to 600 amps $10000
Over 600 amps to 1000 volts
2b. For owner installations: W n"o
4d. Branch Circuits
Print Owner's NameNov,alteration or extension per panel
Address _ T a)The lee for branch circuits with
City State_! Zip _ purchase or servics or header his. 2
Each branch circuit _ $500
Phone No. h)The fee for branch circuits wffhouf
The installation is being made on property I own which is purchsrs of servles or hledler h».
First branch
not intended for sale, lease or rent.
Each additional branch
$3500 anch c�rcuil $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or it.gntion circle $40 0t. 2
Fach sign or outline lighting $4000
Signal circurf(s)or a limited ene,gy 2
Please check appropriate item and enter fee in section SB. panel,alteration or adensuon $4000
_4 or more residential units in one structula Minor Labors(10) $10000
Service and feeder 225 amps or more 41. Each additional inspection over
System over 600 volts nominal
un Classified area or structure containing special occupancy the allowable in any of ilia above
?- as described to N,EC C;.apler 5 Per inspection
Per hour $5500
.—, In Plant $5500
Submit 2 sets of plans with application where any of the above
il apply. Not -squired fur temporary construction services. 5. Fees:
5a. Enter total of above fees --
J NOTICE 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal E
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED Fon Plan Review if required(Ser.3) E
A PERIOD OF 180 DAYS AT A14Y TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account 0 $
Balance Due $
I - - Z)DD-/04 Ate+
eatramrlM�Mc v�acv
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 l
i
Footing Rain Drain Cover/Service FINA
Fourdation Water Line Ceiling -Plumb. �•'
PosL'Beam Mach. Shear/Sheath Framing -Meeh.
PIbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. B -Bldg.
San. Sewer Gas Line Appr/bulwlk Runs. I
Other:
Date: — �-� ` A.M. RM� Entry
Address:
Tenant: —_ Ste:_ MST: � p
BUP: /- en-�.
Con/Own. !71 �� �i.�/MEC: .i � I'
EI_C. _
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
rX
0
1L /
Inspector: Date: J/p
OVER __DISAPPROVED/CALL FOR REINSP. CF 2 C
MASTER PERMIT
CITY OF TIGARD DATCZIO�"UED: , ' ; '7/1)C, .00710
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.'rlgard,Oregon 97223.8199 (503)Big-4171 P'ARC'EL. 2'S 1 10ADI?A025
"' ADDRE.?S. . . ; 140130 OBJ 109T11 c)VE
JDDIVICI01\1. . . . : CANTERI.UFY' WOOD,' CONDOMII,IIUIQ 20NINIG. R-12'
LCi X. . . . . . . . . . . LOT. . . . . . . . . . . . r:,-
.t.J
narks: Coamon garage re: permits also for 14882+ 14M4, 14886 SW 109th
ISSI STORIES.......: 4 FLOOR AREAS---------- BASEMENT...; 0 sf REOUIRED SETBACKS---- REQUIRED--__-._----_
"._RSS OF ►'CRK.-,REP hTIGHT........: Z FI""....: 0 sf GARAGE.....: 0 s LLTT........... 0 SMOKE DETECTRS;
"(PE OF USE....MF FLOOR LOAD....: 0 SC 0 sf FRONT.........: 0 PARKING SPACES: 0
-"PE OF CONST,:5N W71-LING UN'TS; 0 F:':C-"' 0 sr RIGHT........... 0
''CUPANCY URA'.;"n3 BDRM: 0 BATH: 0 TOTAL-----: 0 sf VALUE..S: 4250 REi1R..........; 7,,
__.._..___-__ ...._._ .--•----------.___ ._._ ._-_-____..-----__—._.._ CLAING - -------------------------
"INKS.........: 0 WTER CLOr.;ETS.: 0 WASHING MACH..: 0 LAUNDRY T°AYS. ; 0 RAIN DRAIN ft; 0 TRAP,.........
_4VATORIES..... 0 DISHWASHERS...: 0 FLOOR DRAINS..; 0 SEWER LINE ft: 0 Sr RAIN DRAINS: 0 CATCH BA lt&.: 0
71B/SHOWERS...: 0 GARBAGE DISP..s 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLU PREVNTR: 0 f,REASE TRAPS,.: C
OTHER FIXTURES: f
_. ---------- - ----- --- -------- ----------------------- MECHANIC91- ---- ------------ --------------------------------------------
JEL TYLES ---- ----- FURN ( 10Q"' ..: 0 BORA MP ( 3HP: 0 VENT FANS.....: CLOTHES DRYERS; 0
FURN ;t'0. ..: 0 UNI1 J EATCRS..; 0 ru,ODS:......... e OTHER UNITS...: 0
,'Ax INP.: 0 BTU FLOOR r'JRNACES: 0 VENTS.........; C WOODSTOVE111..... 0 GAS OUTLETS...: 0
ELECTRICAL
-RESIDENTIAL LIKAT--- ---SERVICE/FEEDER---- --TCMP SRVC/FEEDERS-- ---BRANCH LOCUITS--- -----!SCELLANEOM---- --ADD'L INSPECTION:
'000 SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 asp..: 0 W/SVC OR FDR,.: 0 ^'!M- 1IRRIGATION: 0 PER INSPCCTION: 0
"A ADD'L SOASF.: 0 201 - 400 amp..; 0 201 400 amp..: 0 1st W/O SVC/FDF: 0 SIGN/OUT LIN LT: 0 PER HOUR.,..... 0
IM17T ENERGY.; 0 401 600 amp..: 0 401 600 imp.. .1 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN ry..W......; ^
'ANF 'N/SVC/FDR; 0 601 1000 alp.: 0 MINOR LABEL. -10: 0
1000+ amp/volt.: 0 - - --__._.._.__.._.__.....___.._ __--_-_-- PLAN REVIEW SECTION __--_-.----
Reconnect only.: )=4 RES UNITS..s SVC/FDR)=225 A.s 1 600 V NOMINAL: CLS AREA/SF'r OCC:
ELECTRICAL RESTRICTED EKM- Y
SFB. COWERCIAL..----------_-------------_------------_-------—_--_-----------------
JDIO i STEREO.: VACUUM SYSTEM..: AUDIO 1 STEREO.: rIRE u ARM.....; INTERCOMOACING: OUTDOOR LNDSC LT:
^(JRGLAR ALARM..: OTHI :: MILER.......... HVAC...........: LANDSCAPE/IRUG: PROTECTIVE SIGN',
'AM OPENER..: CLOCK..........: INSTRU!�.TJTATION; MEDICAL......... OTHR:
JAC...........I DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS;
--------- ..___..---..___.____._.___...._._ __- TOTAL 7ESA 0,00
-1I PROPERTY MANAGEMENT HORIZON RESTORATIONS
1P SW ARTMR ;U76 SW 72ND AVENUE
T'%PUVD OR !7201 TIGARD OR 91224
F #: 224-2295 ''hone #: 503-620-2121r
Reg C.1 46081
'his permit is issued subject t,, " regulations Contained it the Tigard Municipal Code, State of Ore. Specialty Codes and all other
pplicable laws. All work wil; he Tone in accordance with approved plans. ThiF permit will expire if work is nat started within 190
'ays of issuanv,, or if work is suspended fcr more than 180 days.
__.._ .__.. ._..--------_•---_--.__..__._. ---..______.._-_- PCOUIRED INSPECTIONS -
lectrical Rough Building Final
lectrical rinel
-..&ming Insp
'Isulation Ins;
.yp Board Insp
1`I n 7' _ _ i i{; . f l i I.�•'� C W�ii_��� ��H���
r� :11 far inspcctior - 639-4 7',
City of Tigard Rc-sidential Budding Permit Application1 � L
13125 SW Hall Blvd. 1 )ti
Tigard, OR 97223-
(503) 639-4 1
Jobsite Add ss: ZIM �o 100
Subdivision: Lot# Office Use Only
Valuationl�� �(rJL� Contact Date / / Initials
Result
New Construction Only: (Square Footage) C LSCC
Planck/Rec #
Permit # /h 5 i C.> T U
House: Garage: _ Reissue of
Corner Lot? Y N Fla LoYT Y N Map & TL# 0'0 >—fin F
Flag Zone
Owner: ,MMOM
(t �)w„���� d�x �5 Plat #
��,2i,j,' I ��� Y
Address: I'��t-�f � ' Approvals Required
-27b SIA31 ., - '' �,,Q Planning Setbacks Solar
',V` '( ��� ��1.,v` � � Engineering _
Other
Phone: ( C: � ) �N �C --
Contractor: Items Required
lr ' a) --720 Subcontractors
Address: f� � Truss Details
I" 6 7 2L Other
^
c L �t ,
L 7 -
Notes
Phone:
Contractor's License
att c co of current Oregon license)
Contact Name: �L1}'
4 r,tact Phone L 7i ) )�(�� r ( `) lei
Subcontractors: ArchitecUEngineer:
a
Plumbing: Address:
Mechanical
�- (attach copy of current OR Contractor's License)
_ Phone:
Ca ( )
JOB DES IP CN:
22jFj
Applicant ignature Applicant Phone number
CReceived by: _ Date 7Asei-nd:
ti'lnpn41.�. pp ..
Permit Account Description Amt, Pd. Ball. Duo
Bldg. Permit (BUILD)
a
Plumo. Permit (PLUMS)
Mech. Permit (NECK)
State Tax (TAX)
Bldg:
.-Ilumh:
Mech:
I
Plan Check (PLANCK)
Bldg:
Plumb:
n tech:
Sewer Connectiost (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSOC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C,)
Industrial TIF MF4)
Ins'itutional TIF (TIF4S) _
Office TIF (TIF-0)
Water Quality (WQUAL)
i--
"' Water Quantity (WCUANT)
moire Life :safety (FLS)
Erosion Cntri Permit (ERPRIVIT)
Erosion P!ancklUSA (ERPLAN)
E-csion PlanckICO i (EROSN) I
� v
TOTALS:
+�...r.rrrr..
CITY OF TIGARD BUILDING INSPECT0114 NOTICE
Inepecticw-bne (Rec-O-Phone). 639-4175 Bushness Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-r Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top nit Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. U,iderflor, Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wa'I Gyp. BJ. -Elect.
Date Requested: Z—�� / �1 Time: AM PM
Address:'\ ^46 4 6 L US
Builder: '-1 ` �D Permit tf:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
s 5- -c� f
c, A w - ,, -� - ---
Nf-
InspectorDate: 1L�l
_APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec O-Phone): 639-4175 Business phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundati^n Plbg. Unoerslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewor Gas Line -Bldg.
Plbg. Underflour Rain Drain Framing -Plumb.
Alarm Water Line Insula?ion -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address:
Builder: Permit #:
THE F-O-LL-O-WING CORRECTIONS ARE REQUIRED: -
J
J
1
Inspector — Date: L /
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
--Call For Reinsp.
N S�l000
City of Tigard, Oregon
Detailed Damage Assessment Form
BUILDING DESCRIPTION: OVERALL RATING: (Check one)
INSPECTED(Green) 0
Name — — LIMITED ENTRY (Yellow) U
UNSAFE (Red)
Addres..,,: ----
J�—�� DATE �� 13� TIME � a m
No.of Stories: -
Bas?ment: Yes ❑ No,�< Unknown ❑
Approximate Age: — years REPORTED BY. —
Approximate Area: square feet INSPECTION TEAM MEMBERS
Structural Syst,m:
Wood Framc 4 Unreinforced masonry ❑
Reinforced Masonry U Tilt-up ❑ — --
Concrete Frame U Concrete Shear Wall U T
Steel Frame U Other
Frlma.y Occupancy:
Dwelling ❑ Other Residential ❑ Commercial ❑ Notifiedcc apants to vacate
Office U Industrial ❑ Public Assembly U premises
Occupa s indicate temporary housing
School ❑ Government U Emer.Serv. U is required ❑
Hospital i] Other
Instructions: Complete building evaluation and checklist on next page and then summarize results below.
Posting Existing Reconmiended
None O ixisting
steel at this Assessment:
Inspected(Green) ❑ U Yes ❑ No
Limited Entry(Yellow) ❑ ❑ posting by:
Unsafe(Red) U --
v
Area Unsafe J U _
Recommendations:
U No further action required
❑ Engineering Evaluati n required (circle one) Struch ral Geotechnical Other
.`° O Barricades needed in tl a following areas: — T
LL:
U Other(fulling hazard removal,shoringlbraeing required,etc.):
Comments(Why posted Unsafe,etc.): C o l�oy fpd. 'rol
& OWN V
�eog�� �i��^^'^0�(� �►'►'a►r �P � �° / 0 Sheet