14892 SW 109TH AVENUE r
ADDRESS:
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ICY
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 (Business Line: 639-4171
BUP _
Date Requested —AM--PM BLD
Location A?-- Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner 2
Retaining Wall ELR
Footing �-
Foundation AcCeS,�n �� �`r� �. FPS _
Ftg Drain 1 �Lt
Crawl Drain SGN -
Slab Net Requested
Found Durin ► Research SIT
Post 8 Beam �+
Ex!Sheath/Shear No Insnection(s) In rile
Int Sheath'Shear
F aming
Insulation
Drywali Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —��—
Roof
Misc: ------- ---- -- -- - - -
Final -
PASS PART FAIL ------__---------.__-- ---__-_.—_ -_-- - --
PLUMBING
Post 3 Beam ---____---------------- ------------- --- -
Under Slab
Top Out
Wa'er Service
Service
Sanitary Sewer
Rain Drains
----. _----- ----------------------Final
PASS
-
PASS PART FAIL
MECHANICAL
Post& Beam - -- - -- -- ------ --- --
Rough In �►
Gas Line - - --- - - - --. --
Smoke Dampers M
Final -. - -- ---- ---- --- --. - _ —
PASS PART FAIL
ELECTRICAL _- - ---- - -- - _----------- ----__
n_ Service
V) Rough In
UG/Slab
Low Voltage -----�-_
Fire Alarrn - --- — -- ---- ---- -- ------ -----
r. Final
PASS PART FAIL.
SITE
bockfill/Grading
Sanitar;Sewer
Storm Dra n ( j Reinspection tee of$ required before next inspection. Pay at City Hall, 13,25 SW Hal Blvd
Catch Bas n [ ] Please call for reinspection RE: _ _,. [ j Unable to inspect-no access
Fire Surply Line
ADA
Appraach/Sidewalk Date _ Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
PERM
CAL
.-CITY OF TIGARD F ERMI`T1#: ELC96�02,01
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/08/96
13125 CW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
'ARLE?..: i=S110AD-90031
SITE ADDRESS. . . : 14892 SW 109TH AVE
SUBDIVISION. . . . : CANTERBUURY WOODS CONDOMINIUM ZONING: R--12
BLOCV. . . . . . . . . . . :_OT. . . . . . . . . . . . . :31
Pr-oject Description : Insta:. 1 one branch circuit &ie to storm damag-,
---RESIDENTIAL Uh1IT --_ -----TEMP ,ERVC/FEEDERS--_- ------MISCELLANEOUS--.____
1000 S1=' CR LESS . . . : 0 0 2,00 'amp,, . . . . . . : 0 PU,;F'/I RR I GA-' ION. . . . : 0
EA('-'H ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTC. . : 0
LI'MITED ENEPGY. . . _ g 0 401 - 600 <amp. . . . . . . . 0 SIGNAL/PANEL. . . . . . . : 0
MANr. HM/ ;VC/FLR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
__.---SERVICE/FC-EDER----.-__ ---.._LiRAIvCI1 CIRCUITS -_.____. —_..-ADD' L INSPECT IUNS,-
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 -- 400 amp. . . . . . .. 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . : 0 - Fr-VIEW _--
1000+ amp/volt. . . . . : 0 >=4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > := a-25 AMOS— : CLASS AREA/SPEC OCC. :
Owner; _.___---•------_._______ __________._.__-__..._.___._._.___ ___.._.______ FEES
�.,MI PROPERTY MANAGE=MENT type ainoont by date recpt
L78 SW ARTHUR PRMT $ 0. 00 CJS 04/09/96 STROM
5PC"i `6 0. 00 CJS 04/08/96 STRGM
PORTLAND OR 9 201
Phone #: 503-224-2295
Cuntractor: -._._____--•---____._______.__._____.___.__._____________..__.__._.__.__..----._.._.___.___ ._..__ _. _ _
ROSE CITY ELECTRIC CO E 0. 00 TOTAL
4012 NE CULI_Y BLVD
------ REQUIRED I N SPECT I ON6 ----
TIGARD OR 97i213 Wall Cover Elect ' 1 Final
Phone #: 503-•287•-6164 Elect' 1 Service
Reg #. . . 3567
This persit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee SignmAture
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 -suance, or if work is suspended for sore
than 180 days. Issi-ted By
INSTALLATION
The installation is being made on property I cioin which is not intended frr
Nsale, lease, or rent.
OWNF.RIS SIGNATURE: DATE:
INSTALLATION ONLY----------..___----.._ ...___-..
SIGNATURE UF" SVF'R. ELEr' N s �1,� /111RJ>�t�n••_ DATE: ry Qb --
.J T
L I CE14SE NO:
Call. for inspection - 639-4175
.� Community Development ELECTRICAL PERMIT" APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Flanck,'Rec. # &1-z2,
Frermit 9 EXL 4-;5
Phone (503) 639-4171 gate Issued 5/- R- 9,1--
FAX (503) 684-7297
CIIssued b
TY OF TIGARD 7 jD No. (503) 684-2772 y G�
Inspection (503) 639-4175
r 1. .lob Address: 14. Complete Fee Sc;iedule Below:
Name of DevelopmecSw lU"Ir Number of Inspection*per permit allowed
Address Service included Items Cost(ea) Sum
City/State/Zip_ "�-� T� 4a. Rea ,ential-p4f unit 4
1COO sq II or!"so $11000
Name (or name of business)_ _ Each additional 500 eq it or
portion;hereof $2500 1
Commercial❑ Residential Lii-ided Energy $2500
Erxh Manufd Home or Modular 2
N-Ilmg Service or Feeder _ ! o 00
2a. Contractor installation only:
1 4b.Services or Feeders
Installation,alteration,or relocation 2
cfactrical Contr%cto! ✓ oe 200 amps or les $80 00 2
Address s2 I-VE7 AW419 201 amps to 41 0 amps _ _ $8000 2
City St401 amp,;to W 0 amps $12000 2
at Zip_ sot ampu to IOoO amps $18000 2
Pho` a No. 2— Over 1000 amps or volts $34000 2
Contractof's License N0. Reconnect only $5000
Contractor's Board Reg No. It 7v � 4c.Temporary Services or Feeders
r Installation,alteration,or relocation 2
Signature of Supra Elec'n__ _ 200 ampe or leas $5000 2
License No. P-447.S Phone No. 201 amps to 400 amps 2 t
401 amps l0 800 amps $100100 Oc OC
Over 80O amps to 1000 volts
2b. For owner Installations: see•b-aW,@
4d. Branch Circuits
Print Owner's Nam@Naw,alteration or extension per pnnnl
A..ddress n!rhe fee lot branch circuds with
City _ State Zlp
purchase of aervke or leader W. 9
Each branch circuit $500
Phone NO. _ b) The fee for branch circuds without
The installation is ueing made on propert.r I owls which is pushs"or somke or leader tie. e 2
not intended for sale, lease or reEac
nt. branch $3500 2
ach additionalal br-4nch ararlt $500
Owner's Signature _ ^_ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Fach pump or irrigation circle $40 OG 2
Faph sign or outlaw tiphting _ $4000
S Anal cimuil(e)or a hinted energy ?
Please check appropriate item and enter fee in sect;on 58. panel,alteration or rldension _ $4000
d 4 or more residential units in one structure Minor Labels(10) $10!100
Service and feeder 225 amps or more
N _Sy.tem over 600 volts nominal 4t. Each additional inspection over
Classified area or structure containing special occupancy the allowat It. in any of the above
insp
as dasctibed in N E C Chapter 5 Par par hour hour son $35 00
$5;00
Subm0 2 sets of plans with application where any of the above in Plant $ss 00
apply. Not required for temporary construction services. 5. Fess:
W So. Enter iota)of above tees $ _ S
ly;
NOTICE 5% Surcharge(05 X total fees) $ �•
PERMITS BECOME VOID IF WORK 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 required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account 0 $
Balance ire
wartbwd�r4wcgr^1{p
r— CITY OF TIGARD BUILDING INSPECTION NOTICE !
Inspection Line: 639-4175 Business Phone: 639-4171 ( \)
Footing Rain Drain Cover/Service FIDE,, /
Foundation Water Line Ceiling -P,umb. �-
Post'Beam Mach. Shear/Sheath Framing -Meth.
Plbg.Und/Flr/Slab Plbg, Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-inGyp. B P.idg.
San Sewer Gas App,'Sdwik Reins
Other: _ Y
Dat? -4 �_ A.M. —_P M(.(.�Entry:
Address: _
Tenant: � 1 �-- BUT. c00
—Q- -
Con/Own: ME(,. I
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
!T 7
a
a:
V)
I11
—� Inspector — Date: �Z
ROVED _DISAPPROVED/GALL FOR REINSP. 'CF
�CITY
MR STE T
r,'rrMIT #. . . . . . . . MCTOS _00
643
r
COMMUNITY DEVELOPMFNT DEPARTMENT
13125 SIN Hall Blvd.Tigard,Oregon i7223981S9 (503)439-4171 F'Ar^F�L,. c�•1 1 SAD-'!� L:,i
`TC f-DI)FRESS. . . : 1,430'` CW 10')Tl i A'1C
SUBDIVISION. . . . : CANTt-RDUURY WOODS CONDOMINIUM Z.ONINO: F'.- 12
Dl_Gr1-1. . . . . . . . . . . LOT. . . . . . . . . . . . . ..11
Remdrk5: Corson garage rc; permits als. for 14888, 14890, and A894 sw 109th
R+EISSUC: STORIES.......: 0 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- F=JIF�D---------_
CLASS OF WORY..:REP HEIGHT........; 0 FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMOKE TTECTRS:
TYPE 07 USE...:MF FLOOR LOAD....: 0 SECOND...: 0 sf FRONT.........: 0 PARKINS SPACE :
TYPE OF CONST.;5N DWEL1"+13 UNITS: 0 FINPSMENT: 0 sf RICHT.........: 0
OCCUPANCY GRP. ,P7 BDRM: 0 BATH. 0 TOTAL------: 0 sf VALUE..4: 3950 REAR........1.1. 0
PLUMBING -------------------------._----------------------._-----------
SIh'(5.........: 0 WATER CLOSETS.; 0 WASHING MACH..: 0 LAUNDRY TRAYS.s 0 RAIN' DRAIN ft: 0 TRAPS.........: 0
LAVI;TORIES....: 0 DISHWASH7'S.. : 0 FLOOR DRAINS... 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS,.: 0
TLIB/SHOWERS...: 0 GARBAGE D1 SP.,: 0 WATER HEATERS.: 0 WATER LINE ft: ? &Imil PR.EVNTA: 0 GREASE TRAPS..: 0
OTPE9 FIXTURES: 0
----------------------- M,ECHANICr4 -_-_-.-.---.--.____-_-.------------------------..__-__..�.._____--
FJrE. TYPES----------- FUP,N ( 1009 ..: 0 COIL/CMP ( 39,: 0 iL1,T FANS.....: 0 CLOTHES DRYERS; 0
rUr.N )=100K ..: C 'UNIT HEATERS,.: 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 3 BT'J FLOOR FURNACE'.'. 0 Vl:ri:;,.........; 0 WOODSTOVES....: 0 GAS OUTLETS...: g
ELECTRICAL
--RES,'DENTIAL UNIT--- _-..SERVICE/rEE1)ER-- - --TEMP SRVC/FEET-RS-- ---BRANCF- CIRCUITS--- ----MISCELLANEOUS----- --ADr'L INSPECTIONS-
OR LESS: 0 Q' - fl-H amp..: 0 0 - "N amr..; 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER '.NSPECTION: 0
EA ADD'L NOV.: 0 201 - 480 alp..: 0 V1 - 400 asp..; 0 1st W/O SVC;FDR: 0 SIGNMUT LIN LT: 0 PER rIOUR. .....1 0
LIMITED ENEF'CY.: 0 401 - 600 amp..: 0 401 600 amp..: 0 EA ADDL BP CIr: 0 SIGNAL/PHI-I...: 0 IN PLANT...... :
NANF 6*q/SVC/FDR: 0 601 - 1000 a-p.: 0 601+amos-1000 vs 0 MINOR LABEL -10: 0
12$0r ampPLAN REVIEW SLCTION
Rec�nnect only.: C )=4 RES UNITS..: SVC/FDR)=225 A.. > 600 V NOMINAL; CLS AREA/SPC ^CC:
ELMTRICAL - RESTRICTED ENERGY -._.----..___...._....-
A. SF RiSIDENTIAL--- _____..__..---- -----.._ B. COMMERCIfL--------------------------_-----------------------------------.._-----__--..
AUtIO a STEREO.: VACUUM iYSTEM..: AUDIO I STLREO.: FIRE ALARM.....: INTERCMM/PACING: OUTDOOR LNDSC LT:
BURGLAR ALARM.,; 0TH: :: BOILER.......,.: HVAC..........:: LANDSCAPE/IRRIG: PROTECTIVE SIGNLi
GARAGE OPENER..: CLOCK........... INSTRUMENTATION, MEDICAL.........: OTHRs :s
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL 1 SYSTEMS: P
Owner; __ .._..._-----.._- _----Contractor: .-__ _.__..__._ TO':A! ''ECS:f 0.00
CMI 'R7.TM ;ANAGEMEN'T HORIZON RESIuAATIONS
278 GW ARTHUR 16175 SW 72ND AVENUE
( TRTLAN'D OR 97201 TIGAan OR 97?24
'hone 0., 50-2N-2^"9! Phone A: S03420-2215
Reg R..: 46091
This permit is ;Issred subject to the regulal.ons contained in the Tigard Municipal Code, State of Ore. Specialty Codes and al: .:, _.
- applicable Iasrs. All pork Kill be done in accordance with approve! plans. This permit will espirl if work is not started withi-
- days of iss,;an,ce, or if work is suspended for more than 18f days.
------ ___ _ REWIRED ;' :JNe
Buiiling rival
r ± : 7 ..
i
L Jyy ! 1
lel � I(f , 2� �{ I��.. l .fir % � I��V{.•II! Ir1' 1��,•�� 1 �.i old'-1 J � �1f
. Residential' Building Permit Apo icatio�r r ;`
City of Tigard �.• '{
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4971
Jobsite Address: - � �-q;_*qd0*T,0ad
Subdivision: Lot# Office Use Only
Contact Date / / Initials
Valuation: 5no -- Result
New Construction Only: (Square Footage) Planck/Rec#
House: _ Garage: _ — Permit# �% 7 �. (, '
Reissue of
Map &TL# c"ill('A 5/
Corner Lot? Y N Flag Lot? Y N . Zone
I Plat#
Owner. 5
&"
Address: Agwrovals Required
`2 (uU1 Planning Setbacks Solar�•�
�( J!.(lJ Engineering
L - --Z � � Other
e
Phon167
Contractor, Items Required
r _ 16 t7 h SZ� Truss Details _
Address: �}7�7 Truss Details
` L"ll.CllS_�Llz�( Other
Notes ' '} �
Phone: T03_ -
.f - Vii"►�' --
Contractor's License # . Oq609� 1 _
ipttach copy of currant Oregon license)
Contact Name:
Contact Phone: 620 221
Subcontractcrs: Architect/Eng'neer.
.y Plumbing: Address: _
(.L
Mechanical:
!Z (attach copy of current OR Contractors License)
Phone:
Ca
�= 4
JOB L`ES R T�JN: l 11' d
Applicant Signature 1 Applicant Phone number
Received by: _ Date Received: Q
ZF_0
�s
CITY OF TIGARD BUILDING INSPE"TION NOTICE
inspection Line (Rec-O-Phone): 639.417E Business Phone: 639.4171
Inspection:_ 7L G— ii
Footing Susp. Ceiling Sprink. Rough-in Appr.'Sdwlk
Foundation Plbg. Underslsd, Mech. Rough-in Fireplace
Post/Beam Struct. Plb,-i. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. ,ewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plu;nb.
Alarm Water Line Insulation %j.,H
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested \ �� > � Time: AM °M
Address:___L�
BuiiJer '3Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r
Inspector �' i_ Jate:
�- APPROVED DISAPPROVED SUBJECT TO ABOVE
_J
—Call For Reinsp.
J
• City of Tigard, Oregon
g g �p
Detailed Damage Assessment 'Form, '
BUILDING DESCRIPTION: OVERALL RATING: (Check one)
INSPECTED(Green) ❑
Name: _ LIMITED ENTRY (Yeltow) ❑
UNSAFE (Red)
Address: i',�S W c C\Naxx
" �� °IS TIME am6
ri
No. of Stoes: � l DATE 1
Basement: Yes ❑ Nom' Unknown ❑
Approximate Age: _years REPORTED BY_
Approximate Area: _ square feet INSPECTION TEAM MEMBERS
Structural System:
Wood Frame Uareinforced masonry ❑ — _ —
Reinforced Masonry ❑ Tilt-up ❑ --
Concrete Frame ❑ Concrete Shear Wall ❑
Steel Frame ❑ Other v 1
Primary Occupancy:
Dwelling LJOther Residential ❑ Commercial ❑ Notified occupants to vacate
premis-ds
Office Ll Industrial El Public Assembly Ll Occupants indicate temporary housing
Schcnl ❑ Government U Emer. Serv. ❑ is required L]
Hospital ❑ Oth "`P•�
Instructions: Complete building evaluation and checklist on next page and then summarize results below.
Posting— Existing Recommended
Name ❑ Posted at this Assessment:
Inspected (Green) ❑ ❑ / Yes ❑ No
Limited Entry(Yellow) ❑ ❑ Existing pc sting by:
Un_Fafe(Red) ❑ --
Area Unsafe ❑ ❑
y
Recommendations:
~ ❑ No further action required
J
❑ Engineering Evaluatiot,required (circle one) Structural Geoteclinical Other
LL ❑ Barricades needed in the following areas:
❑ Other(/ailing hazard removal,shoringlbraci,(,ic_,,ui�ed,etc.):
Cornrnents WY po-,ted Unsafe,etc.): �`�„� � ��I rQ-i
�,-T' Q��l �'�'�1 ��a.w tr \►r5�1�.��^i\ C . l� �l l Sheet