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12957 SW 116TH PLACE N �D N V N C1 M ci n cD i k 12957 SW 116"" Phce MASTER PtRMITCi 1 OF TiGqRD 'ENT PERMIT#: MST20 01-00460DEVELOPNDATE ISSUED: 10!1/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12957 SW 116TH PL PARCEL: 2S103BD-09700 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 009 ;RISDICTION: TIG REMARKS: S./F PATH 1 BUILDING REISSUE: STORIES: 2 FLOUR AREAS k`.QUIRED SETBACKS REQUIRED CLAS90FWORK: NEW HEIGHT: 23 FIRST: 1,357 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: 5F FLOOR LOAD: 40 SECOND: 1..53 of GARAGE: 641 sf FRONT: 27 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 10 OCCUPANCY GRP: Fo BDRM: 4 BATH: 3 TOTAL: 2.610 00 st VALUE: E 252.504 20 REAR: 18 PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: i CATCH BASINS: 0 TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN<10014: a01LICMP<3HP: VENT FANS- 5 CLOTHES DRYER: 1 GAS FURN>00014: I UNIT HEATERS: HOODS: OTHER UNITS: t MAX INP. htu FLOOR FURNAN;ES: VENTS: 1 WOODSTOVE9 GAS OUTLETS: i ELECTRICAL RESIDENTIAL UNIT SERVIr,E FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOU! ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: W/SVC OR FOR, I PUMPIIRRIGATION, PER INSPECTION: EA ADD'L SOdSF: 5 201 •400 amp: 201 •4jO.,,;p lilt WIO SVCIFOR: 00 SIGN/OUT LIN LT PER HOUR: LI IITED ENERGY: 401 800 amp: 401 •800 amp: EA ADDL Cf CIR: SIGNALlPAi:cL: IN PLANT: MANU HWSVCIFDR: 601 • 1000 amp: 601+8mps•1000v: MINOR LABEL: 1000+amplvolt: Reconnect only: _AN REVIEW SECTION >•4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC —^— ELECTRICAL•RESTRICT'ED ENERGY A.SF RESIDENTIAL AUDIO 6 STEREO: B.COMMERCIAL VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPPARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDIr e.l.: OTHR: HVAC: DATA7TELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,274.10 RIVERSIDE HOMES RIVERSIDE HOMES This permit is subject to the regulations cotltained in the 15455 NW GREENBRIER PKWY#140 15455 NW GREENBRIER PKWY Tigard Municipal Code,State of OR. Specialty Codes and BEAVERTON,OR 97006 SUITE 140 all other applicable laws. All work will be done In BEAVERTON,OR 97006.2115 accordance with approved plans. This permit will expire If work is not started within 180 days of Issuance,or If the work Is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires 9 q you to follow rales adopted by the Oregon Utility Notification Center. Thr,se rules are set RupN; LIC 7oass forth in OAR 952-001-0010 through 9.12-001-0080. You may obtain copies of these ruies or iirect questions to REQUIRED INSPEr.TION3 OUNC by calling(503)246.198'. Erosion Control Insp 8, Wtr Proofing Bsm't Wa Footing/Foundation Dri Electrical Rough In Gas Line Insp Appr/Sdw;k;,,, Grading Inspection Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Sewer Inspection Post/Beam Mschanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Underfloor In-julation Plumb Top Out Exterior Sheathing Insi Rain draln Insp Plumb Final Foundation lg*—- Crawl Drain,Backwater Electrical Service Low Veltage Water Line Insp Final Inspection Issued t. >r Permittee Signature Call (503) 639-015 by 7:00 p.m. for an Inspection needed the next business y CITYOF TIGAR® _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-0025 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 10/1/01 SITE ADDRESS; 12957 SW 116-TH PL PARCEL.: 2S103BD-09700 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: L1 PSWR IMPE.<V SURFACE: Remarks: Sewer connection for new single family residence. Owner: —�! - -- _ FEES _ RIVERSIDE_ HOMES Type By Date _ Amount Receipt 5455 NW GREENBRIER PKWY #140 — — — BEAVERTON. OR 91006 PRM"r GTR 10/1/01 $2,300.00 27200100000 INSP CTR 10/1/01 $35.00 27200100000 Phone: 503-645-0986 Total $1,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. 1 ne permit expires 180 days from the date issued, The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer' Perm "Y Issu by: �_ C _ Permittee Signature: ✓'' % 1_ Call (503) 63U-4175 by 7:00 P M. for a,i laspection needed the next busines day 3S� Building Permit Applicafloo. "Daujeceivcd: p Permit no.; y , d City of Tigard ' t'loject/appl.no.: Expiredate: CilynlTignrd Address: 13125 SW hall Blvd,Tigard,OR 97223 - Rccci Phone: (503) 639-4171 Dateissticd: By p ono•: f ix: (503) J98-1960 ( Case file no.: Payment type: Land use approval: 18x2 family:Simple Complex _!_� U I &2 family dwelling or accessory U Cornmercial/indu�ti r.,I J Multi-family U New construction U Demolition D U Addition/^'teration/replacement U Tenant improvement U Fire sprinkler/alarm U Other. - jolt 1 Jobaddress: 110t95_2 Bldg.no.:0111 Suilc no.: Lot: Block; Subdivision: (' Tax map/tax Iot/ ccount no.: r 2 -Di�7Od 3ry Project name: 'I" Cr r 0. - Description and location of work on premises/special conditions:.— FIN onditions:_ 612 - - -- -- t It i Name:- C Ego Mailin address: k&2 fancily (11-Ililig: j ZIP: State, r � .52 City:" il ks�2 — _ — Pilone: ' - to Fax: I.-mail: No.of bedrooms/bath,........ ..................... y - Owner's rf-,presc itative: A 't _ Total number of floors............................ . - Fax 1 -mail: New dwelling area(sq.ft.) ....................... 7al Phone: I Garage/carport arca(sq.ft.)..............•.••....... Covered porch arca(sq. ft.) ......... ............... Name: ! t Dcck arca(sq.ft.) ......... Mailing address: Other slruclure.arca(sq. ft. 8 Stale; 7.11: City: CommerciallindustriallmultI-family: Phone: I ax E-mail: Valuation of work........................................ $ 1 o ' Existing bldg.arca(sq.fl. Bulginess name:` ) Z-Q'�_--- �1�..2.-�. New bldg.arca(sq,ft.)........ .. ......•...... .. —� Address: _ -- Number of stories............. .............. Cily: State: l.IP: Type of construction..... ...... Phone: Fa%• 1 mail: Occupancy group(s): Existing: CCB no.: 76 -- New: City/metro tic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon('Onstiuction Contractors Board under provisions of OILS 701 and may be required to be licensed in the Name: -- jurisdiction where work is being performed. If the applicant is Adds s:L7- _ exempt from licensing,the fallowing reason applies: Cu— ----Contact persPlan no.: ______Phone• Fox' Name: t ,I I•ICt person: Fees clue upon application ........................... Address: --- --� Datc received: -- --- - -- - — Amount received ....... f — City _- --- Phone: _ Fax: I:•nutil_ _-- -_- Please rel'cr to I'ce schedt'ic. _ hereby certify I have read and exnnhinrol IN,;application and Ute Nut all juneiiditute.cerci ciedn cards.pleuu call intialicnon fur mom inronnniitm attached checklist. All piovisions of laws and uhclinances govcrthinp this U visa U MaalerVard —.L— work will be complied with,whether Vecifted heretn4n nut. Iapltr'1 uthorircd sl .lure; curdhultkl as Shawn nn credo card x-_- e'nrdhoderNRnalwc�� Annnnt Print name: sC�G S� _._-� --- --- .. ---- Nttli:c 4404f,1 1 1 ri1001r't hhl 1 I his permit nplllicatitttl expires iI n penult is not olitnined within 180 days alter it has been accepted as complete. Mechanical Permit Application \ rDawreccived: /� b Permit na: ,cam � p City of Tigard ; Projecl/appl.no.; Expire date: C ity(4 Fgall Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt uo.: Fax: (503)598-1960 Case file no.: Payment type: Land use approval: _- Building permit no.: TYPE 1 U 1 &2 family dwelling or accessory U Commercial/industnal U Multi-family U Tenant improvement ' U New construction U Addition/alteration/replacemcnt U Other: .1011 SI 11.INWIRMAtION Job address: Indicate equipment quantities in Luxes below.Indicate the dollar Cldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax m_ap/tax lot/account no.: profit. Value$ . Lot: BIock: Subdivision: 'Sec checklist for important application information and Project name: jurisdit pun's lee ScI I Iu1e for residential permit fce. City/county: ZIP: 1 Description and location of work on premises: —_Y 1 1 1 1 —r` - Fee(ea.) 'Tota) Est.date cit completion/inspection: --v-- Deseliptlon 01y. Re .only t4",onl) Tenant improvement or change of use: Ti%AC: Is existing space heated or conditioned?U Yes U No Alt handling unit _ C.'I'M Airamr�itoonin site plant uired Is cxislin�spare insulall d?U Yes U No Alteration of existing IIVAC sytcm i PC%1 matIll7-ot,,J7. 1 of er compressors — -BusinessState holler perrmt no.. Address: v`t — N1 _--Tuns Hl ll/l I p _ �� lFi _ 1'Ir ,yrno C(-nll'.erg l ticssttlll eTt etC.lors State: Z11I �� Tfeni pun-i(s is pt ni rcqu rT u—) - Phone: 503.00q Fltx: yyj./(.j I mail: 1 nsla rep I ace fit rnace/huliter _-11" / CCB no; Including ductwork/vent liner U Yes U No "•�-��---- - 1,sta repacrel ca ICCaters-S►ispenlc , City/metro lic.no.: wall,or floor mounted Name(please print): �f L I cn { r t,l t ar a nce other ler 1 ran urnace 1 e gernt on: Ahsorption units If7l I/11 Name: Chillers_ _— _ IIP — Address: —v _a (.�t,lll IicssoI's_._� III, 14isironmenla ex Allil an vent at on: City; -- State: 7,II':! Appbancevent Phone: Fax: Ii-mail: Try'crex n—haust olds, Type I/ /rTi es,Fllclcnf iaziat -- hood fire suppression syslem Nance: I.xhaust fan with single duct(hath fans) Mailing address: xhatisr s tem a►nit front healing or AU City: - Starr 7II': uc piping x11 slr ull on(up it) out ccs) I 'type: LP(i _ NO oil Phone: I Fax: F mail: Tie pi pin_,el,icii al-TdTiona I over out cts — rocesxPiping(schemnl erequiret ) Number of outlets Name: t ler ,tijnpp ance or equ pmenl: Address: Decorative fireplace City: _� Stalk, _ 7..IP: —� nscr -type _ _ Phone: Fax: I L-snail: Woodslove/pellet clove �— -'— Applicant'sC)(ter:_signatme: Date: ------ Ot et: Name (ptiot): Nol all unaUct lt)nt 10re1111 tetlll t'lit tin,I,II'nN'call Int letic IItItI lot(note inlotmnlinn. I,l'Illtll It`e..................... Uvi• . UMnslei-CnitT nlicc Ibis permit npplicnTi"tl hlnnnnnn fee................$ ex piles it 11 permit is 111,1 41111ainIed - -- -'--" t'n•du cud nuud/rr �____� __ I P• I,ut te�icw(al `#') $ - Fq,ue, wilhul 190 days alter it Dae been State surcharge(11%) ....$ —� Nmnr or rnrt�iultkt ne thrum un rrcr II rmd accepled as colllplCtC. ----- ••— t'ludhnldet nlp,alote Auuntnl -- -- `."-"� .1 U141,11(MIOt,!xll .x4/211/01 12:59 FAX 1 3SO 254 7106 F.ARWI:SI F.1,BCTRIC, INC. 11.11141 Electrical Permit Application -`" -"-" Daterexeivexl: l-I x71 permit no.�►'xzn-e goy City of 11gard pro)ect/appL no^ Gxpire daw —_.__ Ciiyn/7logard Address: 13125 SW Flall Inlvd,Tigard,OR 9777..1 l)ateisrrred: _ Ily:R caiiltno,; Phone; (501)639-4171 —_..-_ -. _ fax: (503)598-19W) Cast:file no.. Payment type: Land use approval- ; pproval r U 1 R 2:atnily dwellinf,or acce.ruory U('torn„oc,.ixih,ub.,.r, •,I U Multi family U Tenant improvement U Net construction C)Adririr•rvu!tcu,min/rel la,ement U O)fher• U Partial 1 Job addreae; fild to.: Suite no.: Tax map/tnx lol/account moot � Lot: � Dlock � Subdivision:_ tk Project name: � scription and location of work Int premises: Fiolimtled date of comps+.:rtrdinspectlon: Job Mo. _ ' Business name: Fa r we S t 1-7,1 e c t r_1 c , Inc- 1/morc (aa) Total mono.I Address: 7402 NE 169t Ave Ne"r"'trerrMl-'i"pl°ernr.wtnAh per . AwelMsrtenk.IncladelMbrehcdt:antte. Com: Vancouver State: 7JP:_981582_ — srr.krlmtnded: I'Iwnc: t-ax; r 1' -,nail: t000ty.n urin► _ _ -" �--�- ---------L^ - -, — Each additional SW sq.It.or Imnlon thereof CCR no-62 350' I��Elec,bus.lie.no: 3'7: 2 T7_7(; Llmne4 enm�,rnidu,del z City/metro lit.no.: A _- V-T _ 4indredesf ,ted home 2 —�C7J �� 1!achmamrfaduredhomeormndutardwellinp BipnNureofluperyul�0"lliewnh Ired ..__ (yore r� StIvicosower feMrr � 2 Sup.ekes.name(print):A K W P Y U Fi _ - Ucerof no: 2 5 2 y J ntrH aY mors-In-� lnilon, dlenrlon er reloarinn� Jas amps of lege J -- -- -2oI"ops roe0oa_ - J Name(print): e eta!amps l0 00 amps Z Mailing address: 01e Claim amps J ZIP aver IOW ar's tap Phone: F'tx. E-tttail: hernnnectnnly t Owner Inttallndont The InsWladon is being made un property I own 1emponrytervkessrfredert- which is not intended for tale,leate,rent,or exchange according t0 ta`t'tlats""''tter'fH'"'orrrb"u,n 7 J00 amps tomo Ie�v _ ORS 447,455,479,670,101. lel amps l0 400 emirs owner's signature: Date: 40;11/600e 4 J ant clrtaNs-nen,aherallow, or esteaalon per psnal- Ntme: A.Pee for branch cheelu with purchase of /'.ddrst: - --- -- ___ �^ service or fbcder tee,each tKanch clrrolt J -s%: -- -` -_ p. Fee-farbonedd"iuwnhoelPWTbR e City: State ZIP: z of servke or fader fee,not Manch citoeil; - I'llonc Fat: Fantail: hachaddulonalbranehtkco�t, Mbs:(:4cr►tora a►net Imode ): Cr::rlVllr, Tri a,n{ninns"r,,,al U11e+dtl,mos.sec�ht� (unit pump oflnl�atlomdreM �- 1 loch ddn a oYthtM 1)p tlrr� J Gforiloeovet vielli n.nd,/raUnitortAl UttoudirWIHMaWr, _!:!S1_2 SInaleirtvnis)oratimiledentitypaw, lamilydwelllrspa d 1)olWinpovro IO,llOnpuarefeel lout nr t U System over 6011 volts nominal notice resid,ntia)emits In one suvoure sltssarlon,or ratenswrt• U nundint twrr slyer armlet O Feudcta,400 ampt tw atop •nescn On: -- - U Occupant load over 99 penotts 0 Manufactutrvl suanum or RV parts "Iola) loa ere►$be allowo►le In any of the U hprrrt/IipMiapplur U Unatr: BabroM_oeU or please v*k may e(tbe atone. In it atk+"let - `Ilse above more pet sippikeM tote core U W oa aemre. Other Nd an)wtisdlctloea atrapt Permit fee........ emW fudr,phare fall jull0ktlan Ge awn brrn rxorurn Rptlr ----- _. - . . . . .. S u This)rermil Application Flat review(M � 96) S •-- U vita U hlaturCod per Ifs permit is not ubta)ned within 1110 days alter it hu lien Sure sorrier...(11%) _ E Cndu tam number:... __-- -...."_._._.__�.._�_r- ._.. r ^' aceepted n complete TOTAII, ........... "`�1amr r o on t s i_ a+o.et,InmcvMl Plumbing Permit Application Date received: Permit no.: f�1 City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hail Blvd,Ti.vanl,OR 97' City ofTigardphone: (503) 639-4171 Project/apIlLno.: Expire date- Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: .. -_- _ Case file no.: Payment type: i 7LU I &2 family dwelling or accessory U Commercial/industi ial U Multi-family U Tenan;improvement U New construction U Addition/alu,ration/replacement i]Food service U Other- M 1,4111111t Job address: Descri tion Qh. Fee(ea.) l'otal Nev-I-rnd 2-family dwellings only: Bldg.no,: — Suite no.: (includes 100n.for each utilityconnection) Tax map/tax lot/account no.: — SFR(1)bath Sub Lot: Block: division: SFR(2)bath Project name: SFR(3)bath _— City/county: ZIP: Tach additional bath/kiwhgn Description and location of work on premises:_ _, siteutllitles: Catch hasinhuca drain Est.date of completion/inspection: Drywclls/leach line/trench drain Footing drain(no.lin,ft.) 1 Manufactured hnme utilities _ Businesa natne: H Alwil,"bAgr, 62#11RkIrimrS I/1C Manholes — Address_ y s IA45,raK Randrain connector _ City:a/Yy e 17 eo _ State: 0,C1 Zl P:C 70V-'> Sanitarysewer(no.lin.fl.)-- Phone: •(032 Fax: do: E-mail: m G Storm sewer(no.lin. ft.) Water service(no.lin ri.) Plumb,bus.reg.no; City/metro tic.no.: / ](p(/ Z Fixture or Item: Absorption valve _ Contractor's re rresentative signature: Back flow reventer — — Print name: r! r►1 ( cel Irlte: "" Backwater valve Basins/lavatory Name: Clothes washer ---_---- Dishwasher Address: Drinking fountains) -- City: -!_~— State: ZIP. Ejectors/sump J--� Photic: f,ax; E-mail Expansion tank _ Fixture/sewcr ca floor drain%thoor sinks/hub__ Namc(print): Garbage disposal Mailing address: �- -- — Hose bibh _ - City: — 5tatr; !II': Ice maker ----� --- Phone; Fax: [ mail: _ Intcrcepti�r/gmasc Uup Owner installation/residential maintenance only: The actual installal toll Primer(s) will he mode by me or the maintenance and repair nrnde by my regill,il RuOf drain(commercial) - empltry,re on the property I own as per ORS Chapter W. Sink(%),basin(s), WI) Owner's signature: 11;dc: swap — fuhs/showcr/shower tan Urinal Name: Water c o%ct Ad m -r. _ Watrr (cater _ city: Sher /II'' Other: Phone: Fax:` Ii•ntail Total Minimum fcc................ Nal all IuNuticaims accept credit oat i,pleas call lunefirlIM tat uuac Intiamatinn Notice:]Iii%permit appliCathnt Plan rCViCW(ill � U Visa U MauerCard expires if a pennll is not obtained —, �r) within 180 days tiller h has been ''l"'`'`L ....rge(8r.F) ....$ ► Ire. ' Name of cnidholck�tie �uwn oa cmll—'1 cZ- --- p necepted its conirlete. 1 O'I'A ................... _ S _ — i'nidhnl�lci signalwe -----— - �maani` 440 4616 tMYWOM) filVt •• ASS. INC. 10 O 20 •1 U 15455 '. i, GI1LCiZHlER PARKWAY t3UITi +! 40 / BFAVEHiC)N,OPE0"QN 97006 i 5CAL1_: 1" - ;I)' (�;p� ) G�15.0986 ,•�� ilii I 84-01, N iLlo 'o, s 130 r un t r w g I i ,.., r Ln 3'► ol IMV �, ► n 2 ol .� Ole r ♦ ' Ik- R1 50. .0• ! 1 / , 1• ol / .. NUN I R'S _..WOODLAND OAII 8p; t-1 _ IQAWN IirrI,1,r1Ki�� RIVLI-"r = - L LOI „9 ' -- 1 16111 F'I.�Cf -- ---- t ' .r I r I'•'. • �,IRt1'E1I�Jt' • 1'IANNIN(l ARFA -- :Il �i � i n i � C, 'nlih n,�Y. Su�Tc r•,n (Sfl',� nnr nn•" MACK ANI A ELECTRICAL PERMIT- / \ CITY O F T I G A R® RESTRICTED ENERGY DEVELOPMENT SERVICES � _—PERMIT #: ELR2001-00299 13125 SW HW: Blvd.. Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 11/26/01 SITE ADf1RESS: 12957 SW 116TH PL PARCEL: 2S 103 BD-09700 SUBDI'/ISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG Proiect. Description: All encompassing Low Voltage. A. RESIDENTIAL _ B. COMMERCIALT _` AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING BURGLfkR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL. # OF SYSTEMS: Owner: -- Contractor:----- RIVERSIDE HOMES GREENLINE INC 15455 NW GREENBRIER PKWY #140 PO BOX 230755 BEAVERTON, OR 97006 TIGARD, OR 97223 Phone: 503-645-0986 Phone: 968-1978 Roo #: LIC 103033 ELE 34.397CL SUP 3345JLE FEES Required Inspections _Type By Date__ Amount Receipt Lcw Voltage Inspection NRMT CTR 11/26/U1 $75.00 2720010000 Elect'I Final 5PCT CTR 11/26/01 $6.00 2.720010000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 dvys of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. Issued byIlex. �cci[tc r' G� Permittee Signature OWNER INSTALLATION ONLY The Installation is tieing made on property I own which is not intendcJ for sale. lease, or rent. OWNER'S SIGNATURE- DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N, DATE: LICENSE NO: ''IV f�.14-i- — Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application • — ---"- Date received:I I-ry(l' '�' Permit no.:',-I City of Tigard Project/appl.no.: Expire date: City(!f Tigard Addres,, 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By:/.. Receipt no.. Phone: (503) 639.4171 ( /; Fax: (503) 59$-1960 Case file no.: Payment type: Land use approval: _.I I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement .d New construction U Arlditi(mhdlerltion/replacement J Other: U Partial 1111 4111,1111MEMILIVIIII Job address: i 1 cj j 7 S W 11 6111 P Gidg.no.; Suite no.: ITax map/tax lot/account no.: LoU Block: Subdivision: I Ij^i rI,rt) w t aD, M^1D _ —_ Project name: Y �^ Description and location of work on premises: o w ENL%�r rj Estimated date of complelio"Al" a•'u'ur 1 , 1 ! Fee M1tax Job no: Descrip(loo _2!L (ea 'Total no.Ins Business name: 5 rbc C N I Aj L_ New residential-single or multi-famiiv per Address: u r3 e X e 1 $- _ dwelling,unit.Includessoat.hedgarage. Cil Stale: o I 'LIP: `1'72'5 Seniceincluded: Y' f 1 I(YX)sq.It �u Iv,,s 4 Phone: c ( Fax: Rb tj' j%3Y E-mail: — - —Each additional 51x1 sq.it.or ortiou there"' CCR no.: z ti _ Glee^hos. tic.no: C C.it Limited energy,residential 1S e 2 City/metro I' no.: _ Limited energy,non-residential 2 �+ ( ,^/ Each manufactured home or modular dwelling Service nnrUnr feeder Signature o su 'sin clectri.ial(required) - Date - Serrlcesorfeeden-hnslallalton, Sup.elect name(pliul): Ir) f IP. >,I ' I.Icenseno: alteration or relocation: 1 2(10 amps or less ` 201 amps to 4llt)amp 2 Nnnir (�Ir Int I 401 amps to 600 amps 2 Mailing address: _ 601 amps u)IW)amps 2 I Stale: ZIP: Over IWK)ant or volts 2 Phone: I ax: E-mail: Recotillect only I Tempnrorysrrvlces or feeders- Owner installation:The installation is he-in) made wl propeity I own installation,alteration,or relocation: which is not intended for stile,lease,rent,or exchange according to ta)amp,or le. 2 ORS 447,455,479,670,701. 201 am s to 41X)annps 2 Owner's signature: Date: _ 401 to 600 am s Branch circuits-new,alteration, or extension per panel: Name: _- A. Fee for branch circuits with purchase of Address: ,ervice or feede tee,each branch circuit 2 __ —"- SlalC: 'l I P: II. Fee for braneh circuits without purchase City: of service or feeder fee,firs)hranch circuit: 2 l'Itone: I at' 1i Ill:til: Loch additional branch circuil Mise.(Service or feeder not Included): IJ 11enllh carr I I.ih1 F.ach pum�itngutio1 circle _ 2 _ U Service over 225 amps-comrnercial finch signor outline lighting -- _ 2 JSrrvns•over 120artlps-rating of 1&2 UIhivirdousImatl.nl Fachsgnal rcwttslrnaightindenerg�pmleL I;oniln dwellings U Building over 10,M)squarr feet It-,aI fd 1 S%,u•nl over600 volts nominal more residential units in one slrucm,I• alteration.III extension* - - 2 J Ituddingoverthttestorics U Feeders.4t10annpsornam' "Urscn non __._ --- — U Occupant lond over 99 persons U Mnnufnelured structure,or Rt'park F'nch additional Invpectlon over the allowable In any of the atioye: _ i-)yiess/Iightingpinn U Other -_�- --------- Fre Inspection Submit_seta of plans whir any or the above. Invesugation to.- The above are not applicable to Temporary construction service. t+111cr -- — eaa call pPermit fee.....................$ l S o t Nia nil lud � µflctions trcept ordil rant,.piuistlirlion fill matt r fnforrnnlion. Notice:Ibis permit application l w ti _-. m) $ iel - U visa U MasterCard expires if a permit is not obtained plan revr y t within 18(1 day+after it has been State surcharge(KIT) ....$ _ Credit cud number _..-_. spires I U O _ accepted as complete. TOTAL .......................$ 8 �`-�Nnme crf-canlho�drr ss ehnwn on c It c� s udbol3.rr_�—.__.__ - Amount 44114615 1MXHr'OMI t' dttnatae ELECTRICAL PERIAT FEES: LIMITED ENERGY PERMIT FELL: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL_ONLY ---- -- -------- Number ct inspections per permit allowed Restricted Energy Fee...................................................... $75.00 (FOR ALL SYSTEMS) Service included: Items Cost Total Residential-per unit Check Type of Work Involved: 1000 sq,n or less _ $145 15 4Audio and Ststems' Each additional 500 sq.ft.or w — --- ❑ ereo S y portion thereof _ $33.40 ___ 1 Limited Energy $75.00 ❑ Burglar Alarm Each Manurd Home or Modular �— Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders Installation,alteration,or relocation ❑ Heating,Ventilation and Air Conditioning System' 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps _ $1,30.60 2 601 amps to 1000 amps $240.60 2 ❑ Other_/I Over 1000 amps or volts $454.65 2 7 Reconnect only _ $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system............................................. $75.00 200 amps or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ Boiler Controls a)The fee f•r branch circuits with purchase of service or feeder fee. ❑ Clock Systems Each branch circuit $6.65 2 b)The fee for branch circuits Data Telecommunicatlon Installation � -" ❑ without purchase of Service or fender lee. ❑ Fire Alarm Installation Firs(branch circuit $46.85 __ Each additional branch circuit - $6.65 Y ❑ HVAC Miscellaneous (Service or feeder not Included) ❑ instrumentation .Each pump or Irrigation circle $5340 Each sign or outline lighting $51 en ❑ Intercom and Paging Systems Signal circult(s)or a limited energy panel,alteration or extension $7500 Minor Labels(10) $12500 _ ElLandsce pe Irrigation Control' _ . Each additional Inspection over _ ❑ Medical the allowable in any of the above Per inspection $6250 _ ❑ Nurse Calls Per hour _ $62.50 In Plant — $73.75 w _ r7 Outdoor Landscape Lighting' Fees: j Protective Signaling Enter total of above fees $ - _ ❑ _ Other 13%State Surcharge g -- _ _ 25%Plan Review Fee __.______Number of Systems See"Plan Review"section on $ ' No licensor,are required Licenses are required for all other Installations front of application _ Total Balance Due Fees: ❑ Trust Account q Enter total of above fees -- - 8%State Surcharge $ Total Balance Pu,, i\dstsV'nma\cic4ers doc 06/07/01 SEP-02-1992 20:20 FROM TO 15035981960 P.02 T!Gz 2AR D, n-R Q7?t 2 3 1PAPORTANTPERMro NnT!C-F KAINIER FAGIFFG ELECTRIC ING 6916 Nk 90 1 H AVE PC) 60A 11; Jwo VANf.;UUVk:K -WA $�62 Electrical 14in.,nature Form peff-I-Q, t'p: 1-00140,0, L)CU,0, 11 g a L,,,,__aa jG;1' "1 ,,2,% '1r "I ww I 25- "Frk 0 C, Lw-" I Wei S 4 e A d 11200-9 tewv I 7nnin3. ' R-4 s; Remarks: SIF PAT14 I Your company has been indocalW w.the eieu&ffl,;a! contraclor for the permit indicatedabove Ir orde,r f r.,r me, electriml permit tn be v_911d. ttle Signature of the viper,. 6inq eWdemn is rewired r"J!v�sse have than tndkAdual from your company s& below and return this Electdwl S.ionatures lrmrrn Pdorto thci %tart qt thewoW t^ the wid resq above?, All N: BuIldina Deet. No olectriesl inspections VA If b,+ 9!Uth0t&ed until this f--f-,mp1M*d form is recelvetl %JI RIVERSIDE HOMES RAINIER PACIFIC FL FCr7!C* imr 15455 NW G39FFNRR1FRPKVV1t' t140 "40 NE qQTH AVF BF-AVEPTON, OR 97006 PO PDX R23070 VANCOUVERWA 9Al� C��(oo Phone N: 503 646-OPS hnrfp# SUP pipNIq AN INK .151rUNATURE 19 REOUIRC-n 04 TWO) r-ORM IT you neve any qi"Ions, pk"se"� 11 (503)(1139-4171. ext ft 31"1 rnnFh mm, vt An x.vv) TW CT!— 'TT CITY OF TIGARD 24-Hoar BUILDING Inspe^tion Line: (q03) 639-4175 MST INSPECTION DIVISION Business Line: (503) 539-4171 BUP Received -Date Requested ] -L Z AM— PM BLIP -- — Location �'I 5 11(.� Suite ._--- i MEC - - - -- Contact Pe,-son _-- Ph( .) Contra ,tor _ Ph( -) --- -- S% A -- — B_UILDING —, Tenant/Owner ___ ELC -- -- Footing ELC - Foundation Access: ELR Ftg Drain ".ravel Drain SIT Slab Inspection Motes. Post&P,-am - — - Shc,d, Anchors Ext Sheath/Shear Ir(Sheath/Shear Framing - Insulation Drywall Nailing Firewall Fire Sprinkler - —` Fire Alarm Susp'd Ceiling Root Oer: _ PM_AS PAP.T FAIL Post& Beam Under Slab Rough-In Water Service —� Sanitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain Shower Pan Other. - Final PASS PART FAIL MECHANICAL - Post&Beam Rough-In — — - - --- - - \ Gas Line �- Smoke Dampers -� ---- ' Final - PASS PART _FAIL ELECTRICAL Service _ Rough-In UGiSlab Low Voltage Fire Alarm Final Reinspection fee of g. required before next Inspection Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I-lease call for reinspection RE:__— _ Unable to inspect-no access Firs Supply Line ADA �"� "fes _ Inspector __ `�• vV _ Approach/Sidewalk Date __ -- Other: Final DO NOT REMOVE. this Inspection record from tho Job site. PASS PART FAIL AAAAAkAAAAAA/ AAAAAAAAAAAAAAA ,AAAAAAAAAAAAA, i �c o ► 44 — — \ — G ti ► � ID Ctoo- ► CD °~ ► H' ► s , Boo. p" a .. , ► ► CD114 ► 44 rD ► � O O ► rU44 rD G ► 44 44 pol.► t44 w ( `� ► ~ ► � ► t 4Q Ill.44 R � II ► irvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvlq ► CL a ,, � o C G� w a � o o C/) vj w �J ls�• = ry CL 0. n v o 0 ro t In r � ZI c a CITY OF Ti IGARG 24-Hour BUILDING Inspection Line: (503) 639-4!75 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP /C� � AM PM BLIP - - --- - Received . Date Requested_L_-�- " _ - t,` Suite MEC �. PhLocation (. -✓'=:� ) .�r'-f�� -��_ PLM Contact PersonSWR r- -- - - - --- r,ontractor �A-�C " r..�-1 _ I- - Ph( -) EL BUILDING TenanYOWner ----- �..._-------- .sem.. ELC Footing Foundation Access: ELR Ftg Drain S) Crawl Drain s Slab I >>pectian Note - - Post&Beam Shear Anchors - - - Ext heath/Shear Int Sheath/Shear Framing Insulation - - - - - Drywall Nailing Firewall Fire Sprinkler — Fire Alarm f-- Susp'd Ce,!ing ----- Root -- Other: Final -- -- PASS PART_ FAIL - PLUMBING Post a cream Under Slab Rough-In - - -- - — Water Service - �- _ Sanitary Sewer - Rain Drains Catch Basin/Manhole - - Storm Drain Shower Pan Other:r - --__------ Pinel - y�------ PASS-PART FAIL - MECHANICAL --- - — Post&Beam a-- -- -- ---. - Rough-In - Gas Line ---- Smoke Dampers -.----- Final '-- PASS PART FAIL -------- - - -._- - - -- - ECTRICAL -- Service - _ -___--- ---- --- Rough-In UG/Slab ___ ---- --" - Low Voltage -- ---- Fire Alarm Relnspecdon fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S�17Ir _] $_ -- PART FAIL - - Unable to inspect-no access � Please call for reinspection RE --- ----- Fire Supply Line =r/ ( Yom,,- 1 Inspector P L ADA Date / / �' � __.-� Approach/Sidewalk Other: _- -- DO NOT REMOVE this inepectlon record from the joky site. r,11al PASS PART FAIL CIT- _)F TIGARD BUILDING INSPECTION DIVISION MST 24-HGr ispection Line: 639-4175 Business Line: 639-4171 BLIP —� Date Requested AM PM _ BI.D _ Location -,7)- S_-7 Z / Suite MEC _ Contact Person Ph ��' 1_9 -2 PL.M -- — _ ��Ick Contractor r l� �.J �1>" �' ��.c;�j•��tr"tib- Ph �� -' SWR --- BUILDING Tenant/OwnerELC _ Retaining Wall — E L R �DD/ QG•� `� Footing Access: FPS Foundation - - Fig Drain SGN Crawl Drain Inspection Notes — Slab - ---- --- — -------._ —_ - SIl —.- -- Post& Beam Ext Sheath/Shear - - Int Sheath/Shear - ------ Insulation Drywall hailing -- -- -- -- - - -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof _ S Misc: Final PASS PART FAIL --- -- PLUMBING Post& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL _ MECHANICAL Post& Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL ----- tSI ART_ FAIL --.- - — SI Back filllGrading - - - - --- ---- --'—�---- ------� Sanitary Sewer Storm Drain [ Reinspection fee of$-_- required before next inspection. Pay at Clty Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: [ �Unable to Inspect-no acces ADA Approach/Sidewalk DateD,ij�--��Inspector,,,__� � Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. C% ''Y .7F TIGARD 24-Flour BUILDING Inspection Line: (503) 639.4175 INSPECTION DIVISION Business Line: (503) 639-4171 MSTU/ BUP Received ___.._----- Date Requested- l - Z'(!!!' AM _- PM BUP Location _--- " ` "> > ,�L -- Suite MEC Contact Person _ _ _ Ph( 2 q 76 PLM Contractor _ _ Ph( ) SWR BUILDING Tenant/Owner - ELC Footing - - -- — Foundation Access: ELC -_- -_- Ftg Drain -- Crawl Drain ELR Slab Inspection Notes: SIT Post& Beam Shear Anchors xt Sheath/Shear IN Sheath/Shear Framing Insulation - — - — Drywall Nailing Firewall Fire Sprinkler Fire �iarm '7 N•7 S T LI � 7 / �� [J Susp'd Ceiling - 07 Roof incl -- ASS PAR FAIL —1J— - PLUMBING Post& Beam v — — — Under Slab Rough-In � -- --Water m-- Water Service Sanitary Sewer — Rain Drains Catch Basin/Manhole Storm Drain Shower Pan -Other- Final P &--P* FAIL FAIL ---- ECHANICAL Pe1i1:�Feertf' — — Rough-In - Gas Line — Smoke Dampers _- `j — ',PASPART FAIL - — Service _ Rough-In UG/Slab _ Low Voltage Fire Alaim - - -- - — Final PASS PART FAIL Reinspection fee of$� _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE _ F_� Fire Supply Line Please call for reinspection RE:_ Unable to inspect-no access r ADA I ' Approach/Sidewalk Data —_�` �?- Inspector _C• 1 '✓ alt_ R' Other: `—�— Final DO NOT REMOVE this Inspection record from the job site. PASS PA7.T FAIL Gr i Y OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 10TV_�Go INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received J —Date Requested____ . /-/-S AM ---- - PM .. �' BUP Location �[ �`�-� Sriite MEC Contact Person ' - � Ph( ) _ -G PLM -.._ ( ) - Contractor Ph SWR � --- BUILD!S40 Tenant/Owner ELC - - Footir.g -J - ELC Foundation Access: E l-W Ftg Drain Crawl Drain -- SIT ` Slab Inspection Notes: Post& Beam Shear michors Ext Sheath/Shear - ---- Int Sheath/Shear _ Framing - --- - - Insulation - Drywall Nailing - Firewall -__- --_ Fire Sprinkler - Fire Aiarm - -- Susp'd Coiling Roof - Other: . -- - -- -- Final _ ------- PASS PART FAIL PLUMBING - - -- - -._- Post& Beam Under Slab Rougl--In f -- Water Service Sanitary Sewer _ Rain Drains Catch Basin I Manhole -- Storm Drain Shower Pan - -- Other; - - -- - jA PART FAIL HANICAL Post& Beam Rough-In Gas Line - Smoke Dampers Final -- PASS PART FAIL ECTFiICX_ - _ -- Service _ Rough-In - UG/Slab Low Voltage -- -- - �- ---- Fire Alarm Fina) Reinspuclion fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE PART FAIL. Please call for reinspection RE:__ -� Unable to inspect-no access � _ _.._ --- Fire Supply Line L� < - ADA I, I _- Ext 17_N� Approach/Sidewalk Daft ---- _ Inspector_ Other. Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL