14882 SW 109TH AVENUE i
ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour InsN-3ction Line: 639-4175 Business Line: 639-4171
BUP
Date Requested AM--- PM BLD
Location—� Suite _ MEC
Contact Person Ph PLM _
Contractor _ Ph SWR
BUILDING Tenant/Owner — ELC
Retaining Wall _ ELR _-
Frating
Foundation A,cess: d In 1n I�� y� ?t 7 � FPS
Ftg Drain 1 SGN
Crawl Drain T Not Requested
Slab SIT
Post& Beam hound Haring Research - —
Ext Sheath/Shear L No Insnertion(c) In File
Int Sheath/Shear
Framing �. - -- --- ---- -
Insulation
Drywall wailing
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling _--_-_-
Roof
Mise. ----------------------__..-- - ---------
Final ---------
PASS PART FAIL --
PLUMBING - ------- --- --- -- - ----- -_
Post& Beam
Under Slab
I op Out
Watcr Service
�'anitary Sewer - - ---- - - ------..-- �- � —
Rain Drains
Final --- --- - -- - ----
PASS PART FAIL - _ _--
MECHANICAL - ------------ ----------_-.
Post & Beam -- ------ -- --- --- - -- --- -
Rough In
Gas Line ---------- __ -. _ _
Smoke Dampers
Final -- - - ------ ------ --- - - ----
PASS PART FAIT_
� ELECTRICAL ------ ---_----- -- m --- — ---
Service - -- - ----- -....__ -- -----
Rouge In
UG/Slab - _�_._------_,-__----- -- -- -
F' Low Voltage
' Fire Alarm -- --------. _.--.----- - -
c� Final
PASS PART _ FAIL —
'�' 5ITE
J
Backfill/Grading
Sanite.; Sewer
Storm Draw ( ) Reinspection fee of$- _required before next inspection. Pay at City Hall, 1312.5 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RF _ _ . _ -_ [ ] Unable to inspect-no access
Fire Supply Line
ADA
Approac?i/Sidewalk Date In-spector Ext
Other --
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
— CITY OF TIGARD BUILDING INSPECTION NOTICE �lr,
Inspection Line: 639.4175 Business Phone: 635-!171
Footing Fain Dmin Cover/Service FIN, �I
Foundation Water Line Ceili.ig -Plumb.
Post/Beam Mech. Shear'Sneath Framing -Mech. `
1 Plbg.Ur;I/Flr/Slab Ploo lop Out Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp B -Bldg,
San. Sewer Gas Line Apor/Sr.wlk Reins.
t
Other:
Date: Z A,M. F.M. Entry: _
r1 i
Address:
Tei.ant:�_ Ste:_ MST: �t'`�
/
con/Own. ,Lf7 U Szlj j ig MEC:
PLM:
FLC:
THE FOLLOWING CORRECTIONS ARE REOUIRED: ELR:
Inspector: —.__---- Da
ROVED _._._.DISAPF ROVED%CALL FOR REINSR CF CO
DERMIT
LFiL
CITY QF Ti GARD IDERMITI#: ELC96—OL _15
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/08/96
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
P-ARCEL.: 215110'aD q0026
SITE ADDRESS. . . . 14B8C_' SW 1091"H AVE
SUBDIVISION. . . . : CANTERBURY WOODS CONDOM I N I PJM Z OIV I NG: R--1
rBLOCK. _._Y �_pr
P' ei , ,
r- ect Descr^iption : Install one-branch-cir`cl�iit�dl^re-to�s+.ari,_damage.
�---��_.__._ --
--•-R'ESJDENTIAL UNIT---- ----TEMP' SRVC/;EFDERS-----. -----.MISCELLANEOUS---._._.
1000 SF OR LESS. . . . ! 0 0 - 200 amp. . . . 0 P'UMP'/I RRIGAI' ION. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 ramp, . . , . , . 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY.. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . 0
MANF. HM/ SIIC/FDR. . : 0 601+amps-1000 volts 0 MINOR LAPEL ( 10) . . . : 0
.....---BRANCH CIRCUITS--__-___ -_-ADD' L INSPECTIONS-.--
0 -- 200 AMD. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSP'ECTION. . . . . 0
201 - 400 am[). . . . . . : 0 1st W/O SRVC OR SDR. : 1 ':'ER 1-40UFR. . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 EA HD D' L BRNCH CIRC: 0 II! PILANT. . . . . . . . . . . 0
61711 - 1000 amp, . . . . : 0 -____._-.__-. ----. .. -.--_PILAN REVIEW
1000+ amp.'vol t. . . . . : 0 ) =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Rer.onnecb only. . . , : 0 SVC/FDR > x:'25 AMP'S. . : CLASS AREA/SPEC: OCC.
Owner- : - - ---.--------._...___.._.__.__.____.___._._______.____ _ r.-'-c
CMI P'ROPER'TY MANAGEMEN-I type <a.na1-tnt by date recpt
278 SW ARTHUR F'RMT $ 0. 00 CJS 04/08/96 STORM
P'ORl L.AiVD OR 97201 SPCT $ 0. 00 CJS 04/08/96 STORM
Phone #^ 224-2295
Contractor:
i.
ROSE. CITY ELECTRIC C:0 $ 0. 00 TOTAL
401e' NE CULLY BLVD
---- - REQUIRED J NSPIH CT I ONS --- -
TIGARD OR 97213 Wall Cover- Elect' 1 Final
Phone #: 50:3-287 -6164 Elect' 1 Service
Reg #. . , ;3567
This pereit is iss^ed subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other F'er^mittee�Si nnattlr^e
applicable laws. all work will be done in accordance with
approved plane. This pereit will expire if work is not started
within 180 days of issuance, or if work is suspended for Borer� �__�__-.
`han 180 days. Iss1_red By
INSTALLATION ONLY------.----------_---_-._ ry-__
The installation is being made on pr^open^ty 1 own which is not intended far^
sale, lease, or^ rent.
`n OWNcR' S S I GNAT URL: DATE:
INSTALLATION
LL SIGNATURE OF c3UPIR. ELEC' N : —QnL L[.. Trt�!G��! DATE: g-do-
I
L I CENSE^ NO:
Call for inspection - 639-41.75
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hal! Blvd.
Tigard, OR 91'223 Planck/R 3c. #
Permit # ��ao r _
Pl�lone (503) F39-4171 Date ISSubd V- S'- S�6 _
CITY OF TIGARD
FAX (5P3) 684-,'297' Issued by ChU /Pr S/,
TDO No. (503) 684-27772 —
Inspection (503) 639-4175
I. Job Address: 4. Complete Fee SchedWe Below:
Name of Development 6a' d zz—dovaa} Number of Inspectiois pe-permit allowed
Address &982, f�-w f09& _ Service included: Items Cost(ea) Sum
City/State/Zipj (�� -- 4a. Residential-r:., unit 4
t 1000 sq II or lege __ $110 00
Name (or name of business) Each additional 500 sq It or -
portion thereof $2500 1
Commercial ❑ Residentialpi Limned Energy -- $2500
Each Manul'd Home or Modular 2
Dwelling Service or Feeder woo
2a. Contractor installation only: 4b.Services or Fcedere
r
Electrical Contractor E� ,( Installation,allembon,or relocation 2
rf - 200 amps to Ins $ 0 00 - 2
Address_ __ � 201 amps to 4t)0 amps $8000 2
a� 401 amps to 800 amps $120 f10 2
Ph0 801 amps to 1000 amps $18000 _ 2
PhOn No. `1 Over 1000 amps or volts $34000 2
Contractor's License No. Reconnect only $5000 _
Contractor's Board Reg, No._?15�f0_ 4c, Temporary Services or Feeders
Installation,alteration,or relocation 2
Signature of Supr. Elec'n, LSC: a444 200 amps or lees $50002
_
201 amps to 400 amps $/5 00 2
License NO. ���_— Phone NO.,__ 401 amps lu 600 amps --" $10000
I
re 300 amps to 1000 volts
2b. For owner installations: am•b•above
4d. Branch Circuits
Print Owner's Name __ New,alteration or extension per panel
s
Addres -__ _ n)rhe lee for branch circuits with
City_ _ State Zip purchase of aervice or Aeeder nit.. 2
-- — Each branch orcun $500
Phone No. b)The fee for branch circuits without
The installation is being made on property I own which is purchan,of eervke or Rieder fej. 2
not intended for sale, lease cr relit. First branch circuit $3500 �1' t 2
Each additional brand.circuit $500
Owner's Signature _ _v_ 4e. Miscellaneous
(Service or feeder not ine ided) 2
3. Plrn Review section (if required): Each pump or irrigation circle $4000 2
Each sign or outline lighting $40 00 _
Signal circuil(s)or a limned energy 2
Please check,appropriate Item and enter fee in section SB. panel alteration or extension $4000
4 or more rosidential units in one structure Minor Labels(10) $1000r)
!_Service and feeder 225 amps or more
n. System over 600 volts nominal al. Each additional inspection over
v1 Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 ",',rte-oon $3500
~
F- ni holo —_- $5500
Pinot $55 00 .
Submit 2 sets of plans with application where any of the above —--
G� apply. Not required for temoorary construction services. 5. Fees:
U-1 NOTICE 5a. Enter total of above fees $
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subforal $
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 if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account N $
Balance Dilip are ?S
�Mr'(a1WNWf¢T�
CITY OF TIGAFD VU:LDING INSPECTION NOTICE
Inspection Line: 639 4175 Business Phone: 639-4171
Footing Rein Drain Cover/Service FINAL:
Foundation Water Line ailing -Plumb.
Post/Beam Mach. Shear/Shead Framing -Mach.
Plbg.Und/Flr/Slab Plbg. Top Oui Insulation -Elect.
Post/Beam Struct, Mech. Rouo!rin Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwik Reins.
Other: I--t
Date: _ A.M._P.M. Entry:
Address:
Tenant: Ste:___ MST
BUh; _ _
Con/Own: MEC:- ------ -..-_--
PLM:
ELC.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
L
IH
r-r
CA
111
J
Inspector: — Date:���
APPROVED —DISAPPROVE D/C ALL FOR REIN SP CF CO
MASTER PERMIT
61"Y OF BARD DATir ISSUED: 03,27,1�6
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 9722'3.8199 (503)8/3''91-4171 PARCr-.L..:
'_ W i 01 1 fiE) �l C G
i O:l i{fl A V IE
:LJl3DIVISIOIV. . . . : CANrORDURY WOODS 'CONDOMINIUM �ONIt`IG; R -lu
._^CI'. . e . . . . . . . I_OTw . . . . . . . . . . . e ..'.C.
corks: Como garage re: persits also for 14888, 14884, 14866 SW :09th I ,
___ - -------_-- _ ---_----
---------—------------
LISSUE: STORIES.......: 0 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-----------
-LASS OF WORK.;REP HEIGHT........: 0 FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS:
'YPE OF USE...:MF FLOOR LOAD..... 0 SECOND...: 0 sf FRONT.........: 0 PARING SPACES. 0
-TE O' `ONST..SN DWELLING UNITS: 0 FINOSMENT: 0 sf RIGHT.........: 0
_LTANCY GRP..-R3 BDRJM: 0 BATH: 0 TOTAL------: 0 sf VALUE..t: 41150 REAR..........: 0
---.--_....___-_.__...._._----------------. ._ ------.____.._..__..-_- PLM, INr
........ 0 WATER CLOSETS.: 0 WASHING MACH..; 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
iFATORIES...... 0 DISHWASHERS...: 0 FLOOR ORRTN£..: 0 SEWER LIME ft: 0 7, RAIN DRAINS: 0 CATCH OASINS..: 0
B/SHOWERS... : 0 GARBAGF CTSP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS... 0
OTHER FIXTURES: 0
MECI4ANI:AL _.._ _---•-------._....._.___. ---.___.._.._..___..___..----------._-_._.
-_L TY;CS------------ FURN ( le0K ..: 0 BOIL/CMP ( 3HP: 8 VENT FANS ....: 0 CLOTHES DRYERS: 0
FURN )=INK ..: 0 UNIT HEATERS..: 0 HOODS.........: 2 OT'rEP i1RITS...: 0
4% INr.: 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 INSPECT:'
'M SF OR LESS: 0 0 - 2% alp.. : 0 0 - 200 alp..: 0 W/SVC CR FDR... 0 PUMP/IRRIGNIION: a PER iNSPCCTION:
ADD'L `Off.. 0 201 400 air .: 0 201 - 400 asp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR,......: r
LIMITED ENERGY.; Ti 4eI 600 avp_ a 01 -- 600 aRp..: 0 CA ADDL OR CTR: 2 SIGNA:-!(•' WL...: 0 IN PLANT,,.,,.
'NF !I+t;'SVC/FDR: 0 601 Ie08 asp.: 8 601+asps-1000 v: 0 MINOR LABEL -10: 0
1000* asp/volt.: 0 __..._.__._____.__.____..__._____._____ PLAN REVIEW SECTIOW
Reconnect only.: 6 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: r" 4XA/S;^C G;:_
------__------------------- ELECTRICAL - RESTRICTED E1-RGY -------__
A. SF D. COMMERCIAL---------------------------------------,--•---------------------_.._______..____
'CIC t 5TCKO.: VACU`JM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....; INTERCOM;PAGING: OUTDOOR LNDSC L'
1GLAR ALARM..: OTH: 10ILER........... HVAC...........: LANDSCAPE/IRRIC: PROTECT;VE SM4.
,ZAGE OPENER..: CLOCK..........: INSTRLMTATION: MEDICAL......... OTHAt
1C...........: DATA/TELE COMM.: NURC: CALLS....: TOTAL 1 SYSTEMS: e
;ier: -- _ _.----_______--,__....-_ -__._Contractcr, ._______.__________._ _.._-.__.. TOTAL FEES:1 0.00
PROPERTY MANAGEMENT HORIZON RESTORATIONS
SW PRn1UR 16176 SW 7LV AVENUE
ITLM1 OA 97201 TICARD OR 97224
ne 1: 224-2t5 Phone t: 503 620 2215
Rep C.: 46081
N _. pt,ait is issued ,abject to the -epulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all tther
-lic,64 lags. 411 work will be done in accordance with approved plant. This pereit will expire if work is not started within 180
;s of issuance, or if wol-k is suspended for sore than 189 days.
RCOUIRED INSPECTIONS
c� !ctrical Rogg Building Fir•al
ctrical Final
sing Insp
ulat i or. Imp - -__---- _----_
Board Nip - -- - ----- �. —
Call f.ov inspection - 6:39 417',
I t d.bt t' 'i • .t}lir -' �.Y
Residential Building Rermi6 oolication
City of Tigrrd v,; Ya
13925 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jabsite Address: qpa I X U
w
Subdivision:— Lot# A.
t�
daluatio Contact Date `'`` f ! Initials —�
Result
New Construction Only: (Square Footage) # /d�
House: . — Garage: it#
Reissue of
Gomer Lot? Y N Flag Lot? Y N r V&TL# L��'f t t o
n Zone
PI
Owner: fia�
Address Approvals Required
1
Planning Setbacks Solar _
—�` Engineering
Phone: L1_��q 2—::2—C;j — Other
Contractor: -� ItemA Required
Address: r
220 Trim Subcontra�-tors-- _
Truss Deta,.a
f 1�45�1 A q7�iL` �otf r
Phone: Notes
Contractor's Licens
of currentOregon license)
Contact Name. 6,)rttMcqp -- —
Contact Phone: 62- r2-;—;, 15-
Subcontractors:
Subcontractors: Architect/Engineer:—
o Plumbing: lddress:
rt: --
W
N Mechanical:
(attach copy of current OR Contractors License)
�^ Pne:
JOEL DE ,ION: ho(
Applicant tignature Applicant Phone number
Received by: Date Received:
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City of Tigard, Oregon k�a� bpk
Detailed Damage Assessment Form
BUILDING DESCRIPTION: OVERALL RATING: (Check one)
INSPECTED(Green) ❑
Name: LIMITED ENTRY (Yellow) ❑
UNSAFE (Red)
Address: --
- DATE 1� 1315
No. of Stories: TIME _ �� any
Basement: Yes ❑ No Unknown ❑
Approximate Age: _ years REPORTED BY
Approximate Area: square feet INSPECTION TEAM MEMBERS
Structural System:
Wood Frame Unreinforced masonry ❑
Reinforced Masonry ❑ Tilt-up ❑ ---- - -
Concrete Frame ❑ Concrete Shear Wall ❑ —
Steel Frame ❑ Other
Primary Occupancy:
1hvelling U Other Residential ❑ Commercial ❑ Notified9ccupants to vacate
Office ❑ Industrial ❑ Public Assembly ❑ premises
Occupy is indicate temporary housing
School ❑ Government ❑ Emer.Serv. ❑ is required ❑
Hospital ❑ Other
Instructions: Complete building evaluation and checklist on next page and then summarize results below.
Poc:::g Existing Recommended
None ❑ Posted at this Assessment:
Inspected (Green) D El Yes Ll No
Limited Entry(Yeclow) ❑ 13xisting posting by:
Unsafe(Red) ❑ /Area Umsafe ❑ ❑
Recommendations:
U No further act;on required
J
Ll Engineering Evaluation required (c:iide one) Structural Geotechnical Other
LL U Barricades needed in the following areas:
J
U Other(falling hazard removal,shoringlbracing required,etc.): --_
Comments Myported Unsafe,etc.): -- o 1 �St'obi mol` CAI ollp–
ul __ j
P\mac. � ► ' � Sheet _of
—..