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14886 SW 109TH AVENUE
ADDRESS: Svc 109 ;rjyAvoj4uk Un J Q7 C� W J i:VOw(-(ls\micro(Irr,\targetslbuiiding.doc L 0 y QI N N 7 a � �rn m ~O N a z C = (p O7 Q1 O� mCL 07 O V V' T V S V ,y a y a a a a (I M v L7 y O O > 7- z� z° N O N G of °z vi z 4 0 a CO M m U J o cr, 4 ul 0 •y H r � Q 1� O Oi pi d N 4-1 d 1�0 •� C V Q r 'm C` d d V f� F-- N F-- J G7 � J C UJ j Q J CD > v U LL D yNU a N N n 77a a 3 w w LL F ,n a O o 0 0 �i g o 0 M M > C14 rio m m m m m m U �() U U U U U U U U Q W W w W U w W W � 2 & �oe= \ /k \ » £e cT CL, k / )§ ` m 0 {L a= _ z £_ & ac I m $ @ 7 m m $ $ m m a % $ d \ % co \ ) 04 § \ \ k k § § 7 \£ g R ) R ) 2 / § R § R Q ( \ � �— 0 � ; _ 0 � � 0 $ q § G § $ / / � o J ƒ ƒ ƒ ƒ 7 7 to cn \ \ / / \ \ c % $ �0 ® 2 7 § 69 % 7 \ cn § § $ .� ® > / � m � 2 \ m / k ul/ k 2 � 2 0 K / � \ 5 C: 2 2 � f 7 R ) 2 / k \ EL ) \ \ \ 7 $ \ \ $ \ 7 k 7 � ) . � � _ [ r _ A t f r a s / \ A } f � k \ ) S 3 E a ) � E a g ° ° ° © 2 m A 8 / :! r R@ G A w E \ \ k § / m § / § k ) | � w m « « r@@ m m m m m CITY OF TIGARD BUILDING INSPECTION DIVISION y(oG 24-Hour Inspection Line: 639-4,175 Bosiness Line: 639-4171 BUP Date Requested _ AM PM BLD _ Location MEC _ Contact Person Ph PLM Contractor Ph _ SWR BUILDING' Tenant/Owner LC nataining Wall ELR Footing [77eSS' Q Four 'alion OVA- JrjnCA G 12�1�(I f) �'A �- FPS Fig Dra.n Crawl Draii Not Requested SCAN Slab Found During Research - SIT Post& Beam Ext Sheath/Shear No Insnecfimi(c) In File Ini Sheath/Shear Framing Insulation Jrywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final — PASS PART FAIL --------- --- -- ---_— e—_� PLUMBING Po,t&Beam --- Under Slab Top Out Water Service Sanitary Sewer --------- _--_—__—_�—_ _—. Pain Drains Final -PASS PART FAIL NIECHANICAL _ Past& Bean-. ---- ---- ------ --------- Rough In GasLine - -- ----- - - --- - e —----- -_.---- Smoke Dampers Final - --- ---------- _..._ - PASS PART FAIL ELECTRICAL Service Rough In UG/Slab -- Low Voltage Fire Alarm Final - -- -------- --------- -- -- — .—T PASS PART FAk. 31TE Backfill/Grading --- -- - ---._-- -`-- ------ Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please c;A for reinspection RE _ —^_ ( (Unahle to insper;-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector— _ Ext Other — - -- --— Final PASS PART FAIL rjO NOT REMOVL this inspection record from the job site. CITY CSF TIGARD PERMITI#Hi_ELC9GI.111202 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/08/9 . 13125 SW Hall Blvd.Tigard,Oregon 97223.819Q (503)839-4171 PARCEL. 51 10E;�-90V_1.'8 SII L ADDRESS. . . : 14886 SW 1.0')TH AVE SUi+DIVISION. . . . : CANTERPU�tY WOODS CONDOMINIUM ZONING:R-i:_. BLOCK. . . . . . . . . . . '_:.)T. . . . . . . . . . . . . :28 Project Description : Install one branch circi.lit cane to storm damage. RESIDENTIAL UNIT----- -----TEMP SRVC/FEEDERS-•---- -------MISCELLANEOUS------ - 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/I RR I GAT I ON. . . . : 171 EACH ADD' L 500SF. . . : (a 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . .i 0 I__IMITED ENERGY. . . . . . 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+ampIi 1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 ---•--SERVICE/FEEDER•----- • --.-----BRANCH CIRCUITS------•-•- -- ADD' L INSPECTIONS------ 0 - 200 amp. . . . . . : 0 W,/SERVICE OR FEEDER: 0 PE:R INSPECTION. . . . . : 0 201 - 400 amp. . . . . . . 0 1 st W/O SRVC. OR FDR. . 1 PER HOUR. . . . . . . . . . . . 171 401 - 600 amp. . . . . . : 0 Ewe ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . , . . . : 0 601 - 1000 amp. . . . . : 0 -...-_.._______.__-_-__---FLAN REVIEW SECTION-----__ 1000-F amp/volt. . . . . : 0 ) :=4 RES UNITS. . . . . . . . : ) 600 VOLT NOM aL. . Reconnec-; only. . . . . : 0 SVC/FDR > = 225 AMPS— : CLASS AREA/SrEC OCC. : Owner: ___.______.____._____..___._..__..._..,_______.__._______,___.____.___-.__ FEES CMI PROPERTY MANAGEMi=NT type amot.int by date recpt 278 SW ARTHUR PRMT $ 0. 0-71 CJS 04/08/96 STORM 5PCT $ 0. 0111 CJS 04/08/96 Sl-ORII PORTLAND OR 97201 (-'hone #: 224-•2295 Contractor: -- ----- - - ----- ------ __._._..----_.------•----____.__________._____._._.__----___.__--- ROSE CITY ELECTRIC CO 0. 00 TOTAL 4012 NE CULLY BLVD - ---- REQUIRED INSPECTIONS ---- TIGARD OR 97213 Wall Cover Elect' ]. Final Phone #: 503-287-6164 Elect' I �aervir_e Rey #. . : 3567 —�W- This permit is '.ssued subject to the regulations contained in the Tigard Municipa, Code, State of Ore. Specialty Codes and all other Permittee S i gnat i.1re applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started /- within 180 ►.ays of issuance, or if work is suspended `. more L4.4.z__ than 180 days. Issued By ---------------OWNER INSTALLATION - 1he = nstallation is being made on propert / I ovn which is not intended for _-Alp, lease, or rent. OWNERI S SIGNATURE: DATE: I NSTALLAT I n.,1 LLIGNATURE OF' SUF'R. ELEC' N: _.JC2_n Qp,0/164--�.._...._..___.__ DATE: if�_. LICENSE NO: CMI for inspection - 639--4175 Community Development ELECTRICAL PERMIT APPLICATION 13125 S`li '-lall Blvd. Tigard, OR 97221 Planck/Rec. # -�7 tal-;" Permit # Ez--�L -03rd a_---_� Phone (503) 639-4171 Date Issued 4/- e- o/- CITY OF TIOARD FAX (503) 684-7297 Issued by l"/�c lel �C A�./�_ TDD No. (503) 684-277'L Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Sc.!iedule Below: Name of Development' __ Number of Inspections per permit allowed Address_ ,q Ill J �� _ Service included Items Cost(ea) Sum City/State/Zip —77,6 Q,/ _ 4a Residential•alar unit 4 1000 aq It or lase $11000 Name (or name of business) Each adds ionai Soo rAj it or portion thereof $25.00 I Commercial❑ .1t sidential Limited Energy $2507 Each Manufd 1,ome or Modular 2 Dwelling Peri-n,or Fees r _ $fW 00 I 2a. Contractor installation only: 4b.Services or Feeders Inetallatinn,alteration,or relocation 2 Electrical Contractor 200 amps or lees $6000 2 Address 201 amps to 400 amps _— $817 00 _ 2 C Ity Sate _. Z_lp _ 401 amps to 100 amps $12000 2 801 amps to 10J0 amps _ $1 to 00 2 Photle No. �,� _ _ Over 1000 ampe or volts $34000 2 r Contractor's License No. D462, Reconned only $5000 — I Contractor's Board Reg. No. 7—__ _ 4c.It m porary Services cr Fer;ders Installation alleratior.,or relORatlarl 2 Signature of Su r. Elec'n _ 200 amp6 or loan $5000 License No. �_ Phone No. G 201 amps to 400 amps 00 -• 40' amps M 800 am Pe f100100 00 _ Over 800 amps to 1000 voila 2b. For owner installations: aw<•b•above 4d. Branch Circuits Print Owner's Name._ Naw,alteration or extension per panel Address � a)The tee for branch circuits with City _ Stai°__ 'Zip pumhe"of Nrv(ce Of bmNr Ase. 2 Phone N0. Each branch circuit _— Sri 00 — b)The lee for branch circuds without The installation is being made on property I own which is p rchase of seryke or foodtr W. 2 not intended for sale, lease or rent. Firal branch circuit $35 00 2 Each additional branch cnrcud $500 Owner's Signature _ 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each Pump or irrigation circle $4000 _ 2 Fach sign or outline lighting $4000 Signal cimurf(s)or a limided energy 2 Please check appropriate Item and enter fee In section 5B. panel,aheration oi exlenaron $4000 4 or more residential units in one structure Minor fatnle(10) $100 00 _ Service and feeder 225 amps or more System over 600 volts nominal 41. Each additional inspection over un v�Classified area or structure c.ntaining special occupancy the allowable in any of the above as described in N E C. Chapter 5 Par inspection $3500 Per hour $5500 J Submit 2 sets of plans with application where any of the above In Plant $55 co apply. Not required for temporary const►uc!ion services. $. Fees: tai NOTICE 5a Enter total of above tees $ � —.1 — 5%Surcharge(.05 X total fees) $ T TIT _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 1.80 DAYS,OR IF 5b. Fnter 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 k Balance Dye � S 36 e 7S` w�wlrnn4�aW¢m�i �� ,IC ';MIT C-111y OF TIGARD DATE: 1E3SLJcn: 02/217/96 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oreg— 97223*8199 (503)639-4171 L - 10"'Tij I T[ C1 El-w Z R 2, CLJBDIVI'.13101N. . . . . L400DS) C0�11)0i,11"4'ILJM zCJP4Il1T*: R12 SL0 'C1- ,. . . . . . . . . L.OT. . . .. . . . . . . . . . ,23 Remarks: Ca3mon gar-ige re: permits also for 14888, 14882, 14884 S 109th —---—---------------------------------------- BUILDING __1________..___—---------------------------------------- -- RE!SSUE: STORIES.......: 0 FLOOR AREAS---------- PASEKNT... 0 if REQUIRED SETBACKS—- REOUIRED-_---- CLASS Cr, WORK.:REP MIGHT........: OL FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS: TYPE OF FLOOR LOAD..... P SEGO...: 0 sf FRONT.........: 3 PARKING SPACES: 0 TYPE OF CXI-'T.:SN DWELLING UNITS: 0 FINDSMENT: 0 --f RIGHT.........: 0 OCCUPPNCY GRP—,R3 DDRIM: 9 BATH: 0 TOTAL------: t sf VALUE.A; 4250 REAR..........: 0 ____-...__----------- ----------- PLUMBING SINKS.....,...: 0 WATER C1LZL`1 S.: I WASHING MACH..: t LAUNDRY **IAYS.: Z PAIN DRAIN ft: 0 TRAPS.........: 21 10'.'ATOR16'S...... 0 DI'0"SHEhS...: ? FLOOR DAMNS..: 0 SEWER LINE ft. 0 Sr RAIN DRAINS: 2 CATCH BASINS—: 0 T 'lo'NTR: 0 GREASE TRAPS—: UB/SHOWE'ri...: q GARBAGE DISP..: 0 WATER HEATERS. t WATER LINE ft. 2 BCKFLW PRE OTHER FIXTOEr.'; FUEL TYPES- PJ RN ( IW} .. : 0 2101LIMP ( 3H',r, e VENT FANS.....: I CLODV) DRYERS: 0 FURN )=100K 0 UNIT HCATERS.. 0 POODS.......... 0 ^"Jcp UNITS...: 2 MAX INP. 0 BTU FLOOR PURNAMS, 1 VENTS......... 0 6=TOVES....: 0 GAS OLI(L�TS.... 0 ELECTRIL-k -A[SIDEITIAL UNIT--- ---SERVICE/FCZDER---- --TM SRVC/FEECERS-- ---?Rk ., CIRCUITS--- ----KISCELLANE' --ADDL INSPECTIONS- 100(t 17 OR LMS: 0 0 - 'W alp,,: 0 ? - 200 amp..: 0 WJ'SVC CR F'rr...: 0 PUMA/IRRIGATION: C PCR INSPECTI'CIN; 0 EP 431 L S&V.: 0 Let - Ito alp..: 2 211 - 409 amp..: 0 lit W/O SVC1FDR: 0 SIGNI,"I'dT LIN LT: I PER HOOP,......: 0 Llr?!TI:D ENERGY.- 0 401 - 600 asp..: 0 401 - 600 asp..; 0 EA AUDI. OR CIR: I SIGNAL/PANEL...: 0 IN PLANT......: 0 KW %N/SVC/FDR: 0 601 - AM alp.; e 601+85ps-I000 v: a MINOR LABEL -Ill, 0 .ON+ asp/volt.: 0 PLAN REVIC14 CECTION Reconnect only.: 0 )=4 RES UNITS..: SVCIFDR)-Ze^.S A.., ) 600 V NONINi'L; CLS --------- %ECTRICAL RESTRICTED ENERGY -------- n. Sr RES 4124T I AL- --- D. --------------------------- '41CUUM SYSTI?... AUDIO 9 STIPEO.: FIRE ALARM.....: INTERCOM/PAGING., OUTDOOR LNDSC LT, GLRR AOILEP.......... ALAK. CTP, HVAC..........,: LANDSCAPE/IRRIG: PROTECTIVE SIONLi GARAGE OPENr.P.. LOCH..........: iNSTRUM.DiTATION: MEMCAL........ OTHR: 4VAC.......... DATA/TELE COMM.. NURSE CALLS....: TOTAL # SYSTEMS, I Cart+actor; - TCTAL MEE':$ 0.00 HORIZON RESTORATIONS "i'6 SW "ND AVEIIAX TIGARD OR 97ZL^4 J Chane It 51'-ELN L 2^1'1� Reg I—" 46a1 s permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other 1:i:able laws. All wor�.� will be done in accordance with approved plans. This pe-mit will expi-i-i if work is not started within 180 iays of issuance, or if work is suspended for more thr IN days. REWIRED INSPECTIONS --------- ------------ cc Building Final LAI !nsp Gyp Bud (2, .. .....------- 9aft C Al� tj Residential Buildit�RRlicafionT' City of Tigard r t r 13125 SW Nall Blvd. Tigard, OR 97223 .Rt i a',° /. ;"� (503) 639-4171 \ , Jobsite Address: Subdivision: Lot# OA cytkiF 0 ; r1. I(r ContactDate f ! Valuatio Initials -- ReWV' New Construction Only: (bgtlare Footage) Pianr-VRec Perml:V. -souse: '� _._ G3rage: ----------- Reissue cf` Cnrner Lot? Y N Flag Lot? Y N Zone Owner: Address: Ida. Ff" '"n{orcn kq Fmgutred ,1^1 �'/ �"'n` Pianrnng Se,hac.f:s Solar 275 N 1� l�YJ Engineerog --- Phone: ub ' �( ;` - Other—, e"`.'�y' -—2��moi 1 - - 'j I +ems:�egirf,rctci Contactor: Address: r (f7 1'_7 Ufw� '7 _ SUbconbractors ---— Tnrss Details _ Gthey Phone: j t L Notes - Contractor's License4_Qqb®�5 ' att-c copy of current Oregon license) ► "` Contact Name: Cont;:ct Phone.- Subcontractors: hone:Subcontractors: Architecui7ngineer- ' Plumbing: _ - Address: N Mechanical: (attach copy of current OR Cor,tractor's license) Phone: f JOB DE/9P1,� ON: - N� A;W ,r j A,F r- V7*9 1 cz Applicantignature Applicant Phone number received by: _ Date Received— 4 r M t • u� ` w Y CL I J U n l .� 'J > f (n N ij s I �` n a < =E < LL LL !n a W 1J \ Fp- C2 ) 1 w Oc �/ c Za ►- .5 cc o c o, o r W � c tCI- J c m CD C uiEv ` l 7 am a a d a �) CL Z^ 0 W D LL - CJS Vr J C r ^ < a Cc ❑ MCl 6- " W LL mas° vcy pQ cn oc � v ~ > o O oa ; c i aWC <o U U. (n C a. cn 5 3: U) \ O y r 0 z LU _ a a .t y > c p E E a' c O d CVV N mo C NL Q d O CL �� °o '0 0 o g' °c E z a < `jl C LL LL a s a < < cc h > u l /'1 O m �o E¢ vi EC=i $ d Z v a• rn < iL u Cn a cn w U Q Q \ Ll1 w o c Oz Uo' °' v) E -� w F- .c Q Q� ' O ~ F c > 0 CC W c s rn T m a a C_ _ a:a m d ro N r I Q 2 a CL W LL C < C: - r` z� ` . LU LL N I < mM � �, > "I � c p LL cr Q a U $ v a -, LLQ 0 c F :3 d W 1 l G ){ (n U- cn' a s Cn Q ¢ o O I >- C: r� _ p 2 8 j N y I f ui c c E E " c -� -� O (� o \ _ c c �; N p v!� o a C ti 07 m E a d LL a CL 0 : in in � T7 N v W d < C t° u ao 0. a Q � n < m F=- , 2 — Ln .. N Ss� 000 City of Tigard, Oregon Detailed Damage Assessment Form BUILDING DESCRIPTION: C VERALL RATING: (Check one) INSPECTED(Green) ❑ Name: _ — _ -- LIMITED ENTRY (Yellow) UNSAFF (Red) Address. -- -,-- DATE '�X11'- 1�S "'IME _ .2 a me No.of Stories: Basement: Yes ❑ Nat< Unknown ❑ Approximate Age: years REPORTED BY _ — Approximate Area: :;quare feet INSPEtr PION TEAM MEMBERS Structural System: Wood Frame Unreinforced masonry ❑ — _ — Reinforced Masonry ❑ Ti!t-up ❑ ------ Concrete Frame ❑ Concrete Shear Wall ❑ Steel Frame ❑ Other Primary Occupancy: Dwelling ❑ Other Residential ❑ Commercial ❑ Notified Qccupants to v, tate premises Office ❑ Industrial ❑ Public Assembly ❑ Occupar<ts indicate temporary housing School ❑ Government ❑ Emer.Serv. ❑ is required U Hospital ❑ Other� `�.�� instructions. Complete building evaluation and checklist on next page ar.I then summarize results below. Posting Existing Recommended None ❑ sted at this Assessment: Inspected (Green) ❑ ❑ _ Yes ❑ No Limited Entry(Yellow) u ❑ \xisting posting by: Unsafe(Red) ❑ Area Unsafe ❑ ❑ Recommendations: ❑ No further action required �? ❑ Engineering Evaluation required (circt.one) Structural Geetechnical Other LL; ❑ Barricades needed in the following areas: ❑ Other(falling hazard rentoml,shoringlhrac ing required,etc.): — le Comments Mhy(posted Unsafe,etc.): Q�'- 01� St' ol" c� C ��1� �5� ' �• Q'9�. �c�,�,;, \ �' �;�r �� �Sheet�_of