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14511 SW 128TH PLACE 4 14511 SW 128'x' Place .'ITY OF TIGARD 24-Hour r BUIL^'""' Inspection Line: 0503) 63 -4175 MST INSPECTION G 'll:'ION Business Line: (503)6' -4171 qUP Received — Date Requested 5-/m- AM— ' °Mi �� BIIP 'Location __.—_-�"L.�1�--- --- _--Suite_ 1A!:C Contact Person Ph PLN; -- Contractor .____ Ph( ) SWR - BUILDING - Tenant/Owner -- �.�- ELC Footing ELC ---- _---- — Foundation AcGegs: , _ Q l ►:LFI -- Ft Drain /` i --� — C awl Drair, �` — — —� SIT - Slab Inspection-Note Past&Bea in -----_-_ Shear Anchors ^ Ext Sheath/Shear Int Sheath/Shear k f+ -1;Y-6-s Llt-/\ F ula ng Inssulatiti on —�,-,- Drywall Nailing Firewall a� Yl_��n,C _f� ',C � _1 S '�' S t_,��i�/\ ✓'� [-✓� - — Fire Sprinkler -- --� Fire Alarm Susp'd Ceiling - --�-` Root ----------- Other: ----- --- - Final -- �)ASS PART FAIL Fi.UMBING---- — -__—_-- - — Post& Beam _ Under Slab IRough-In Water Service Sanitary Sewer Rein Drains - --- -- ----� Catch Basin/Manhole _. Storm Drain Shower Pan Other:_ - Final PASS_ PART FAII MECHANIC_A_L Post&Beam Rough-In Gas Line Srr>nlce ZmsiinASFAIL E CTRICAL -- - -- - Service 4 0 Rough-In - UG/Slab 7 Low Voltage Fire Alarm Final Reinspection fee of$ required before next inspectlon. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE [� Please call for reinspection RE: Unable to Inspect-no access Fire Supply Lima �,. ,v n AA Approach/Sidewalk D� -� - Inspector Y t_.e� - F;A99 al — DO NOT REMOVE this I%spection record from the job site. PART AAAAAAAAAAAAr kAAAAAAAAA .*AAAA ` AAAAAAAAAAAAO,A � v ► t � ► ► -J ` ► U �; ► , o .a o � l ► l w w ► R • :- �" a o a R � � L y Q ► CA F- 01. R (n R 10. Q4 b �, R W4 -� 1.n c 44 -- �-- ► N J w ► . � A H V ► w � = y 7 fD 0 �• 0 s cp 06a a �04 -4t, . a N g � 0 J O ` V 7 � N 17 s � o � a 9 ti i CITY OF TIGARID 24-1iour BUILDING Inspection Line: (503)639-4175 fps INSPECTION DIVISION Business Line: (503) 639-4171 MST BUP Received _ Date Regoested Air! -_ -__ PM BLIP -- Location OL Suite_ MEC Contact Person � --QC _ ph( ) -7416 3 �� PLM _ Contractor Ph( ) -_- SWR BUILDING Tenant/Owner --_ ELC _-_ -- Footing Foundation ELC Ftg Drain AccesE: Crawl Drain ELR - - - - Slab Inspection Notes: SIT - Post&Beam _ Shear Anchors - - Ext Sheath/Shear Int Bath/Shear - - - - - - Framing — Insulation Drywall Nai!mg ---- - - -- - Firewall Fire Sprinkler - Fire Alarm Susp'd Coiling -- Roof Other: ----- ---- Final _PASS PART FAIL - - -- --- PLUMBING _.Post&Beam ----------- Under Slab Rough-In Water Service ----. -- - - - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain ----- -- — _� -- Shower Pan Oth ASjkI PART FAIL ANICAL Pest& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL _- ELECTR_ICAL _ Service _ -- Rough-In _ UG/Slab -----— Low Voltage / Fire Alarm --v Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Nell Blvd. PASS PART FAIL 31TE Please call for reinspection RE: _ _ F-1 Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date ut — Other: Final DO NOT REMOVE this Inspection record from the Joky site. PASS PART FAIL CITY OF l IGAIRD 24-Hour BUILDING Inspection Line: ( 03)639-4175 MST anon ) eoU 53q INSPECTION DIVISION Business Line: (503)6391)71 BUP Received Date Requested._ '' AM PM BLIP --_._------ Location �'�;L Kv-�- Suite MEC — Contact Person — _ Ph( ) 1C - PLM Contractor_—_ Ph( ) SWR BUILDING Tenan►/Owner --- _ ELC -- -- Footing - -- Foundation ACce55: Fig Drain Crawl Drain --- SIT Slab Inspecticn Notes: �l _- u Post&Beam - Shear Anchors Ext Sheath/Shear Int ShePth/Shear �---- Framing ---- T_ Insulation Drywall Nailing - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Root I -- Other: -----_-_ ZA ll PART FAIL kMBING ---- Post&Beam Under Slab Rough-In — Water Service Sanitary Sewer Rain Drains Catch Basin!Manhole Storm Drain Shower Pen - - Other: Final - - PASS PART FAIL — - -�------ ---- Post& Beam Rough-Ir -- ----- - ------- --- Cas Line Smoke Dampers ---- ---�-- `— inal AS PART FA_II__ —- —---- -- -- EL_ECTpICAL Service Rough-In _ — UG/Slab Low Voltage -- — Fire Alarm Final [] Reinspection fee of$ _required before next Inspection. Pay at City Hall, 13125 SW Hail Blvd. PASS PART_ FALL Please call for reinspection RE: Unable to Inspect-no access Fire Supply Line -11 ADA - Dawt. ' U /J L. Inspector `- "- - - --- ut Approach/Sidewalk Other: Tri-n7a " DO NOT MIME this Inspection record from the job site. X- '-PART FAIL CITYOF T IGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00300 13'25 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7!16101 PARCEL: 2S109AD-07800 SITE ADDRESS: 14511 SW 128TH PL SUBDIVISION: ELK HORN RIDGE ESTATES -ZONING: R-7 _ BLOCK: LOT: 004 _— _ JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: M02111-E HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY ORP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: —T SINKS: URINALS: GREASE TRAPS: LAVAfC'RIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: fi Rerrarks: Installation of back flow preventer. _-- _FEES__ - Owner: — -_—_ Type By Date Amount Receipt KEF- H BAKER INC PRMT CTR 7/16/01 $36.25 27200100000 14511 SW 129TH 5PCT" CTR 7/16/01 $2 90 27200100000 TIGARD, OR 972.23 — -- - --- Total $39.15 Phone 1' 503-524-6139 Contractor: — CLASSIC; GARDEN CREATION, INC. 16080 NW PARSON RD. FOREST GROVE, OR 97116 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 503-359-1823 Final Inspection Reg #: PLM 7204 This permit is i-.sued 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 days 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 OAFS 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 216-1987. Issued By; Permittee Signature: �,�,� �— -- �,—A ---- Call (503) 639-4175 by 7:00 P.M. for an inspection needs next business day Plunibing P'erndt Appy ' n City of Tigard Date.cceived: - �� Pernutno.. Address: 13125 SW Hall Blvd,Tigard,OR 97 S-Wer permit n).: Building permit no.: City of Tigard phone: (503) 639-41 i l Project/appl.no.: Expire date: Fax: (503)598-1960 Date issued: By Reccipt no..: Land use approval: case file no.: Payment type: U!/&2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement 13 New construction U Addition/alteration/replacement U Food service U Other: Job address: ('" ; (J Des tion _� k Qtv. (ca.) Total Bldg.no.: r-- Shite no.: - Nen 1-and 2-family dwellings only: (includes 100 R.for each utitit y connection) Tax map/tax wdaccor.t.no.. — SFR(1)bath Lot: Block: Subdi' ,'ion: SFR(2)bath —� Project name: _ SFR(3)bath City/county: ZIP: Each additional bat)dkitchen — Description and location of work on premises: Siteutilities: Catch basiniarea drain Est.date of completion/inspection: D wells/leach line/trench drain _ _ — 1 Footing drain(no.lin.ft.) Manufactured home utilities Business name: GC. Manholes — — Address: Fd) Rain drain connector City: State: ZIP: Sanitary sewer(no.lin.ft.) Phone: Fax E-mail: Storm sewer(no.lin.ft.) —_ CCB no.. '��p Plumb.bus.leg.no: Water service(no.lin.fL) -- City/metro lic.no.: ---�� Fixture or item: Contractor's representative signature: -- Absorption valve Print name: lv Back flow preventer Date: — Backwater vae _ -- Besins/lavatory — MM Name: -, ,_ - Clothes washer n,l Address: ( �� — Dishwasher — Cit : Drinkfn,fountains) Y J State-, ZIP: C'jectors/soT Phone: 0 W Fax: E-mail: Expansion t,;nk Fixture/sewer cap -- _Name(print): Floor drainsif,00r sink..-Jhub --- -- _Mailing address: -� Garbage disposal City: Slatr,: ZI : -- Hose bibb -_ __ _ Ice maker Phone: Fax: -mail: Interce tor/ reaae trap — Owner installation/res dential maintenance only: The actual installation Primer(s) _will be made by me or the maintenance and repair made by my regular Roof drain(commercial) - -- employee on the property I own as per ORS Chapter 447. Sink(s),hnsin(_s), lays(s) — Owner's si nature: Date: Sum -- - Tubs/shower/shower pan Name: Urinal Address: --- Water closet Water Ecater — — City: State: ZIP: Other: Phone: _ Fax: E-mail: o121 Na VI Jurisdictions accept credit crib,plea.callJurldkaon r«mon informMlon Minimum fee................ _ $(o•c�S O Visa U MasterCard expires Iltis permit application expires if a permit is not obtained Plan review(at — %) $ t audit,-vd number:_ within 180 days after it has been State surcharge(8%) ....$ t ap•ro� TOTAL �_ ....—_ accepted escom let ••••••••.••• ` :lune nr cerdholdeiaa�on coedit cei — p complete. ........... _ S Crdn der d are Amount - 4404616(600lt'l1M) PLUMBING PERMIT FEES: PRICE TOTAL New 1 grid 2-family dwelltngs only: - FIXTURES (individual) QTY ea AMOUNT (includes all plumbing fixtures!n PRICE TOTAL Sink 16.60 the dwelling and the flirst100 ft. QTY (ea) AMOUNT Lavatory - - 16.60 for each utility connection) _ Tb or—Tub/Shower Comb 16 60 -— One(1)hath _— $249.20 _ Two 2 bath $350.00 Shower Only - - 16.60 Three 3 bath _ $399.00 - Water Closet 16.60 VPLAN -16.60 SUBTOTAL 8°/s STIhTE SURCHARGkDishwasher 16.60 REVIEW^5_°.OF SUBTOTALGarbage Disposal 16.60 __- _ _TOTAL - Laundry Tray _ 16.60 — Washing Machine 16.60 Floor Drain/Floor Sink 2��- 16.60 3- -- 16.60 PLEASE COMPLETE: 4 -- - --- 60 Water Heater U conversion O like kind 16.60 Quantity b Work Performed e _ Gas piping re iuires a separate mechanical Fixture Type: New Moved Replaced Removed/ Ho _ _ me New Water Service Cao reed MFGG Nom 46.40 mink MFG Home New San/Storm Sewer 46.40 Lavatory - Hose Bibs 16.60 Tub or Tub/Shower - - --- Combination_ Root Drains 16.60 Shower Only -- Drinking Fountain 16.60 Water Closet - Other Fixtures(Spoctfy) - —16--60-- Urinal�- _ — -- - Dishwasher _ Garbage Disposal - _ Laundry Foorn Tra — - - Washing Machine _ -- Sewer-1s1_100' — 55.00 Floor Dra_in/Sink: 2" — Sewer-each additional 10^' ---- - 3 46.40 4„ -_ Water Service•1st 100' 55.00 V ater Heater Water Service-each additional 200' 46.40 i Other Fixtures --- - Slorm 8 Rain Drain-13t 100' - S erlf 5500 _ Storm 8 Rain Drain-each additional 100' 46.401 — -- Commercial Back Flow Preventlon Dnvico --'--" -- Residential Backflow Prev mien Device' Catch Basin -- - ---- -. - Inspection of Existing Plumbing or Specially . -- ---- -— - Re uested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling Grease Traps -�---- 16.60 - _ - - ------ -- ------ QUANTITY TOTAL Isometric or riser diagram is required If �— Ouantl�l_olal is_>9 -- 'SUBTOTAL -- --- ------- - - -- -----8%STATE SURCh.�RGE J_ ___""PLAN REVIEW 25%OF SUBTOTALRequired onl ly f fixtures ty total is>gTOTAL — E "Minimum permit lea is$72.50•6%state surrhan e,except Residential Backflow Prevention Device,w r>{9923 9%state surcharge All New Commerclni requlre pens with isometi is or dser diagrnrn and plan review IO I\dsts\forms\plm fees.doc 10/10/00 CITY DF TIGARD BUILDING INSPECTION DIVISION` , - 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST -- -- BLIP Date Requested AM PM Location /�� S'�� 5c-,) L -- BLD _— — -- -- � Suite MEC _ Contact Person `- -- Phi lrG c� S PLfy _�_C�N/ -Gy3 a C� Contractor--_ —_-- Ph _ SWR BUILDING — Tenant/Owner ELC Retaining Wall - - Footing - -- ELR _ Foundation ACCESS: ---- Fig Dram i FPS - _- Crawl Crain Inspection Notes: SGN Slab -- - Post&Beam ---_- __._— _-- -___- ------ - -- SIT Ext Sheath/Shear --�- Int Sheath/Shear -------__. ___ F,,aming Insulation - ---- ----------.._.—_ ------ T.- Drywall Nailing '-----`--- Firewall ---.._-�-- .-- _ -- ----- ------- - - - Fire Sprink;er Fire Alarrn ------ -- ---- __-- Susp'd Ceiling Roof Misc: _ Final --w-- -- -------- - ---- -- ---- PASS PART FAIL UMBI - Post& Beam - - - - ----- - - ---- Under Sla ` Top Out CI '7 L - - - - - - Water Service __. Sanitary Sewer -�,-'', ---- .- - _ -- '-- Rain Drains ASS PART FAIL MEI�ft ---------------- ----- Post& Bearn Rough In -- ------- ------_-- - -_�__ Gas Line Smoke Dampers _ - - Final -- ----- ----- --- - - - .._--- _ _ ___ PASS PART FAIL -- ELECTRICAL - --- _ _--- - -- Service � - -- - - - Rough In -- ----- --- --- UG/Slab Low Voltage -- "ire Alarm Final - --_ --- ----- --- -- --- -._----- PAS- S PART FAIL Backfill/Grading - ------- _-__-- Sanitary Sewer - Storm Drain )Reinspection fee of$ required before next inspe^tlon. Catch Basin Pay at City Hall, 13125 SW Hall filed Fire Supply Line [ ]Please call for reinspection RE: - [ )Unable to inspect-no access ADA Approach/Sidewalk Other Date _L ( Inspector__& Ext I Final PASS PART FAIL DO NOT REMOVE this inspe(-.tion record from the job site. i CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VAi ' _-Y HWY S ALOHA, OR 97006-1248 Electrical Signature Form Permit #.: MST2000-00534 Date Issued: 12121/00 Parcel: 2S109AD-07800 Site ,Address: 14511 SW 128TH PL Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 004 Jurisdiction: TIG Zoning: R-7 Remarks: Construct new single family residence Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN Building D-ept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: KEITH BAKER INC GARNER ELECTRIC 13037 SW ROCKINGHAM DR 21785 SW TUALATIN VALLEY HWY S TIGARD, OR 97223 ALOHA, OR 97006-1249 Phone #: 503-381-3765 Phone #: 591 •1320 Req #: LIC 121159 SUP 3707S ELE 34.305C AN INK SIGNATURE IS REQUIRED ON !HIS . �'RM i Signatur of upervising Electrician If you have any questions, pleGse call (503) 630-417 `, ext. # 310 1-04-2001 9:25AM FROM CRAFTWORK PLUMBING 503 h44 5989 P. 2 CITY OF TIGARD 1312.5 S.W. HALL BLVD. 'TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CRAFTWORK PLUMBING INC 7736 SW NIMBUS AVE BEAVERTON, OR 97008 Plumbing Signature Foi7n Permit#: MST2000-00534 Date Issi,Pd' 12/21100 Parcel: 2S 109AD-07300 Site Address. 14511 SW 128TH PL Subdivision: ELK HORN RIDGE ESTATES Black: I ot: 004 Jurisdiction. TIG Zoning,- R-7 Remarks: Construct new single family residence Your company has been indicated as thrs plumbing contractor for tho permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the Ftart of the work to the ad cress shove, ATTN- Building Dept. No plumbing inspections will b-?authorized untll this completed farm Is received OWNER PI UNIBING CON IRACTOK: KEITH BAKER INC CRJkFTWORK PLUMBING INC 13037 SW ROCKINGHAM DR 7715 SW NIMBUS AVE TIGARD, OR 97223 SE1,VERTON, OR 97008 Phone # 503-381-3765 Phrne #. 644-8698 Reg #: LIC 79666 P1 M 20-148PB AN INK SIGNATURE IS REQUIRED ON THI-S FORM yxvi - Signeture o1PAuthorized Plumber If you have a;iy questions, ploase call (503)639A171, Axt. # 310 �� TIGARD ��® � MASTER PERMIT PERMIT#: NIST2000-00534 DEVELOPMENT SERVICES DATE ISSUED: 12/21/00 43125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS. 14511 SW 1281 rl PL PARCEL: 23109AD-07800 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R•7 BLOCK: LOT: 004 JURISDICTION: TIG REMARKS: Construct new single family residence BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS, REOIIIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1.8_'1 sf BASEMENT: at LEFT: 7 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD. An SECOND: 1.159 rf GARAGE: 881 of FRONT: 21 PARKING SPACES •. TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 7 VALUE: $278,283.00 OCCUPANCY GRP: R3 BDRM. :1 PATH: 1 TOTAL: 21,990 n0 of REAR: 41 _ PLUMBING SINKS: I WA1ER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 1n0 TRAPS: LAVATORIES. DISHWASHERS: 1 FLOOR DRAINS, SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: TUBISHOWERS. 3 GARBAGE DISP: 1 WATER HEATERS: I WATER LINES: 100 BCKFI..W PREVNTR- 1 GREASE TRAPS: OTHER Flxl URES: MECHANICAL FUEL TYPES FURN<100K: BOIL+CMP<3HP: VENT FANS: 5 CLOTHES DRYER,. 1 GAS FI)RN»100K. 1 UNIT HEATERS, HOODS: I O'I HER UNITS: 1 MAX INP'. hhi FLOORFURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR: I PLIMPIIRRIGATION: PER INSPECTION: EA ADD't.500SF: 6 201 400 amp: 201 400 amp: 1st W/O SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR, LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADUL SR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 601+amps-1000v: MINOR LABEL: 1000+amp/volt PLAN REVIEW SECTION Reconnect only: >•4 RES UNITS: 9VCIFDR>-225 A.: >600 V NOMINAL CLS AREAISPC OCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B,COMMERCIAL _ AUDIO 6.STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM INTERCOMIPAGIC 3: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH. BOILER: HVAC: LANDSCAPE/IRRIG: PkOTECTIVE SIGNL: GARAGE OPENER: X CLOCK INSTRUMENTATION: MEDICAL: OTHR: HVAC: x DATAITELE COMM NURSE CALLS: TOTAL M SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,344.25 This permit Is subject to the regulations contained in the KEITH BAKER INC KEITH BAKER, INC Tigard Municipal Code,State of OR Specialty Codes and 13037 SW ROCKINGHAM DR 13037 SW ROCKINGHAM DR all other applicable laws All work will be done In TIGARD,OR 97223 TIGARD,OR 97223 acro;dance with approved plans. This permit will expire If work is not started v,;thIn 180 days of issuance,or if the work is suspended for more then 180 days ATTENTION Phone. Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rap N: LIC 92011 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp& Slab Insp Footing/Founds,,.:^Drl Mechanical Insp Framing Insp Gas Fireplace Grading Inspection Postloeam Structural Footing/Foundation Drl C'nchanical Insp Shear Wall Insp Insulation Insp Sewer Inspection Post/Beam Mechanica Pim/undslab Insp Plumb Top Out Exterior Sheathing Insl Gyp Board Insp Footing Insp Underfloor Insulation PLM/Undoiliaor Electrical Service Low Voltage Rain dr�ln Insp Foundation Insp Crawl Drain/Backwater Ftng Drain Bsm't Walls Electrical Rough In Gas Line Insp Wales Line Insp 1 )� �t Pcrmittee Si niture : Issued B g � )._..„.� Call (503) 639-4175 by 7:00 p m. for an inspection needed the neAt business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00381 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/21/00 SITE ADDRESS; 14511 SW 128TH PL PARCEL: 2S109AD-07800 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 _— BLOCK: LOT: 004 — jURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DJVELLING UNITS: 1 TYPE OF USE: SF IVO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF dwelling. Owner: — --- FEES KEITH BAKER INC - — - 13037 SW ROCKINGHAM D1Type By Date Amount Receipt TIGARD. OR 97223 PRM- CTR "2/2.1/00 $2,300.00 27200000000 INSP CTR 12/21/00 $35.00 27200000000 Phone: 503-381-3765 Total$2,335.00 Contmctor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued The total amount paid will be forfeited if the pennit expires. The Agency does riot guarantee the accuracy of the side se wer laterals If the sewp, it not located at the measurement given, the installer shall prospect 3 feet in all dirpcbons from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will instal a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-OJ1-0010 through OAR 952-001-0080 Yuu may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issuhd by: 4 f/�\ t� _ Permittee Signature: Call (503Y639-4175 by 7:00 P.M. for an inspection needed the next business day r Tn D5i Building Permit Application n� City of Tigard Date received:/2rf nn Permit no.: i Address: 13125 SW Hall Blvd,Tigard,trd,OR 97223 Project/appl.no.: Expire date: City of Tigard br � Phune: (503) 639-4171 Date is: J: Fax: (503) 598-1960 ��j — dY Receipt no.: r, / Case file no. Payment type: Land use approval: / 1&2 family:Simple Complex: &2 family dwelling or accessory U Conunercial/industrial U Multi-family r New construction U Demolition I` Addition/al teration/replacemeni U'Tcnanl improvenictit U hire srrinkler/alarni U Other: _ w 1 � Job address: 1-i Bldg. Bldg.no.: Suite no.: Lot: Block: Sutxlivision: �-- _ L I K r' Tax map/tax lot/account no.: FiG ect name: Description and location of work on premises/special conditions: Name: { Mailing address: I i 7 • I &2 fandly dwelling: City: State: ' Z(F: Valuation of work $�A' Phone: .. Fax _y E-mail: No. ..................................... - of hcdntums/halhs................................. Owner's representative: 'Total number of floors...... —�"t u U Phone: I ax: E-mail: New dwelling area(sqlux[ . ft.) . Garage/carport area(sq.ft.)................ ....... .. ............. Name: C - overed lxirch area(sq,ft.) ......................... Mailing address Deck area(sq. ft.) ......................... ............... --------- --- City: _ State: ZIP: Other structure area(sq.ft.)......................... Phone: Fax: E-mail: Commercial/h, Austrird/multi-family: — Valuationof work....................................... $ Business name; Existing bldg.area(sq,ft.) �h ... .. .,........ Address- r�t.� a r �r,�a New bldg.area(sq. ft.) ............ ........ ............... �� City: - 1 state: ZIP: Number of stories............ ........ .. .. Phone: Fax: — TYIx of construction..... ............................. E-mai I: CCB no.: r-17 .� I f r Occupancy group(s): Existing: Cily/metro lic.no.: New: Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under Name:AkA, i-1 A A provisions of ORS 701 and may be required to be licensed in the Address: c. •v,� , ,jurisdiction where work is being performed. If the applicant is Cit State: i ZIP: ) exempt from licensing,the tod!owing reason applies: Contact person: Plan no.: JL r f L Phone:2 2 Fax Name: il T onlaci person: hoes due upon application 1 Address: 5 ........................... $_ Date received- Cit state I7.IP:< 1 Amount received .... ...... ............................. $-- — Plxmc: c: Fez: Email: Pieria refer to fee schedule. I hereby certify I have read and exilliiined this application and the Not ell lunsdictions aceta credit cards,Please call iurivactiom for mn. ore infoxmatio attached chOcklist. All proVi lolls of laws and ordinances governitip this U visa U MasterCard work will be.. rb omplied it' hef•slIcifird herein or not, credit cardnumttn Authorized si nature: -----^" ):—IC: 7.7 -7 A Expires Print name: Namdodwmceditcar $ Cardho>I er tiRrumrr Amount Notice:This permit application expires if a permit is not obtained within IRO days after it has been accepted as cmnplete 410613(tilOaK'OM) One-and Two-Family Dwelling MM Building Permit Application Checklist rAssociatedpermils: no.: ,L:a of Tigard City of Tigard y " � Address: 13125 SW Hall Blvd,Tigard,OR97223 U Electrical U Plumbing U Mechanical U Other. Phone: (503) 639-4171 _ rax: (503) 598-1960 I Land use actions completed.See jurisdiction criteria for concuri•ent reviews. \ 2 Ferning.Flood plain,solar balance points,seismic soils designation,historic district,etc. — 3 Verification of approved plat/lot. — -- — — - — 4 Fire district---approval required. — — 5 Septic system_permit or authorization for remodel.Existing system capacity 6 Sewer permit. - — 7 Water district approval. 8 Soils report.Must carry original applicable stamp and signature on file or wi,�application. — 9 U•osion control U plan U permit required.Include drainage-way prote,,�ion,silt fence design and location of catch hasin protection,etc. 10 _ Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details.Plan review cannot he completed if co yright violations exist. 11 Sitelplo4 pian drawn to stale.The plan must show lot and building set back dimensions,property corner elevations(if there is mote than a Oft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems; Aity locations;directioo indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,conn^etion details,vent size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation tans,plumbing lixtures,balconies and decks 30 inches above grade,etc._ 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction. More than one cross section may be required to clearly portrav cc,struetion.Show details of all Nall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace e.^:rstruction, thermal insulation,etc. 15 Elevation view;.Provide elevations for new construction;minimum of two elevations f'or additions and remodels. Exterior rlevations must reflect the actual grade if the change in grade is greater Than four foot at building envelope:. Full-size sheer addendums showing foundation elevations_with cross references are acceptable. 16 Wall brueing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for -T noon scnptivc l.atlr analysis provide specilicauons and calculations to engineering standards. 17 Floorlroof framing,Provide plans for all floors/roof asserrrbhes,indicating member sizinl,,spacing,and bearing _ locations.Show_attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rcbar, For engineered systerns,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code,desig.i values for all beams and multiple joists over Ill feet long and/or any beani/joist carrying a non-uniform load. 20 _Manufactured floor/roof truss deal n details. _TF Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is requim,l � for four or more appliances. 27. Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall he shown to he applicable to the project under review. 23 Five(5)site plans are required for Item I I above. 24 - — - — — 25 — — 26 27 28 � — Checklist must be complet•d before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink. Red ink is reserved for department use only. 4404614tyana'0M) Mechanical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expiredate: / CN,.r(7irurd Address: 13125 SW Hall Blvd,'I'igard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 -- - Fax: (503) 598-1960 Case file no.: _ Payment type: Land use approval' —�_— _ Building permit no.: 161 1 &2 family dwelling or accessory U Commercial/industri:a U NIL11(i-f,11110}' 'J i'enant improvement Si New construction U Addition/alteratio,dreplaccment U 0dici:.1011 SITE INFORMATION COMMERCIAL1 Job address: 11611_ -�_ r, L. Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: Block: Subdivision: K h * e checklist for important application intormation and Project name: •lurisdretion's tee schedule for residential permit fee. City/county: i ZIP: crl '-7 LZ-3 _ Description and location of work on premises: Fee(ea.) Total Est.date of completion/inspection: v Dewri on "y. Rcs.only Res.only Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit --CFM--. Air txmditiuning(site plan regwretT)-- Is existing space insulated?U Yes U No I Alteration of existing HVAC system NIUCIIANICAL CONTRWFOR K0—Pr/—C-01—pressors -- - - -- Business name: State boiler permit mi.: HP Tons BTU/14 Address: 1 yy t;y w -e1-1W '11 Fire/smokc dampers smo c detectors!_ _ City: 'T, Statc k—1 ZIP: 'r %1 7 Heat pump(site pTn required-- _ Phone: Z . '•!2 Fax: E-mail: nsta rep ace fitrnac urns • iT ! TT— Including due I Yes U No CCB no.: 3`'3U C:Z ------ nstal tap ac re ocote eaters-suspen co, City/metro lic.no.: wall,or floor mounted Name(pleaseprint), Vent folappliance other than furnace I e gees on: EME[K)a Kilts liklil M111) Absorption units_ _-_ _ BTU/11 _ Name: Chiller,-- -- HP - --- Cum lessors Address: _ HI' - nv ronmenta ex mst an ventilation: City: State: ZIP: Appliancevent Phone: 1'ax C mail: )rycr�x-f•aust --- - 0o s, yp-pe!/res. itc a azmat hood fire suppression system Name: _ Exhaust fan with single duct(bath fans) _ _ — Moiling address: 31 'x iaust system a art from 1Tcm•n 7r AC Cit ' � State: ue piping and dist rut on(up to out etF) y: LPC; —� NC; Oil Phone: Fax:r I .1l E-mail; Fuel piping cacT note al over 4 outlets -- Process piping(schematicrequired) Number of outlets _ Name: 1 Other de appiiince or equipment: Address: _ Decorative fireplace City_ State: ZIPinsert- Iypc Phone: f L-111aiL oo stov pc ctstove (h et: Applicant's signature: A Jr Date: ' Other: Name (print): Ir No all Judshctioru accept credit cards,please cell Jurisdiction lot otore infomution. Permit fee.....................$ _ U Visa U MasterCard Notice:This permit application Minimum fee................$ _ expires if a permit is not obtnined flan review(at — %) $ r'iedii card number ��__ —— — 4a within 180 days after it has been --- — ar:ce ted as complete. ~talc surcharge(8%)....$ Name of cardholder u shown on credit cam— s p p TOTAL .......................$ -- Golder signature Amount 4444617(EMM IINt Commercial Schedule 1&2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE _ Description Table 1A Mechanical Code _ City Price Total_ Fwnace l0 100,000 BTU 1) rumacel01J 000BTU 955 ndudi duuis&vents - 11.00 - including ducts&vents z)Fum,fce 100,000 BTU. Furnace>100,000 BTU inaudi drds&vents 1,170 ') Floor Furnace 1400 including ducts&vents indudmg vent flOOf furnace 4) Suspended healer, all heat 14.00 955 or floor mounted healer _--_- _ __- including vent 6) Ven(nal included in applia� 6 so _ n_ rmil suspended heater,wall healer 12 u 9hJ 6) Repair units - or fluor mounted heater Check all mal owls Boller Heal Au Vent not included in appliance permit 445 for Kent;7.10,sec or Pump Co nd Qly 'rice Total footnotes 1,2 Comp _ Repair units 805 7)<3 11,absorb unit 10 10oK BTU 14.00 - <3 hp;absorb.unit &)3.15 HP,absorb unit 955 100k to 50%BTU 25.50 to 100k BTU _9_)I 5.30 HP,absorb 3-15 hp;absorb unit unit.5 1 mit BTU _ _ J5'� aduct --- 700 10)10-6 HP;BT, rb 52.20 101k to 500k BTU unit i-1.75 inti BTU - - 15-30 hp;absorb.unit11)>50In.absorb un&>t.75mll BTU $7.20 501k to 1 mil.BTU 12)!dr handling unit 10 10,000 GFM -- - +0.00 30-50 hp;absolb.Unit13)Air handling and 10-000CFM. 17.20 1-1.75 mil.BTU - - 1 p Non-portabb ewporale crokr 10-0-0- * 000 >50 hp;absorb.unit16)Vent ran ronneded to a aingk dud > 1.75 mil.BTIJ _ seo Air handling unit to t 0,000 10)Ve;Rstfon system not Included in -- 1000 applisnce n Air handling unit>10,000 0 i7)Hood served byto 00 Non-portable evaporate u6 1aj Lbmesllc In immtors t7.40 vent fan connected to a si6 19)Comrnerdal or Indualdaltypenc0995 Venr cyst.riot included in appliance permit 5 20)other unus,Including wood sloes 656 +000 --- Hood served by mechanical exhaust 2t)cgs piping one In lour outlets Domestic incinerator _1170 ._ 4 J90 22)More Than 4-per outlet(eaeh) I a; Commercial or industral i,dneralor _ Other unit,including woc d stoves,inserts,etc. 656 Inlmum ParmK F.e 7�.&0 BUF�TOTAL 360 8%suRC1/ARor. Gas piping 14 outlets _ PLAN r iEW 25%Or SUB AL Each additional oUCel 63 Required for ALL commercial permits only _ TOTAL _ Other InaperlWns and roes' t lnsfhedhons dude d--I twshs hours(M.-M Charge two hours) L72 5n flier than InslMclvv,s Id wlivh M leo is al-jfr-oih',rdrJled(rrxnitmmh Ch./rge lull hour) a i 2 ort IMI hrw, VOW _ ] Add,i,mai pan n!ww IeQuled try changes addd ons M revis"is to plain(rrvntmurn 7-uhtl Valuation - ----...- dWIVono no"I-)tt2SOr-1 1 'Slab•contractor Illalo,CMa,cafm 1--d a 1.00 to$5,000.00 ---- Minimum$72.50 _ ••neswlnMW AK:rertuoes ase Man showing p4o-n en1 of and SS,001.00 to$10,000.00 572.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof, to and including$10,000,00 S10,001.00 to$25,000.00 5148.50 for the first$10,000.00 and 51.54 for cacti additional$100.00 or fraction thereof,to and including$25,000.00 525,001.00 to 550,000.00 J $1,19 50 for the first$25,000.00 and S 1.45 for tach additional$100.00 or fraction thereof,to and including$50,000.00 $50,000.00 and up S742.00 for the first 550,000.00 and$1.20 for each additional$100.00 nr fraction thereof Plumbing Permit Application Tigard of Ti City b Date received: Permit no.: iT -Q7 C/ g "J Address: 13125 SW Sewer permit no.: Building permit no.:Hall Blvd,Tigard,OR 97223 - -- Ciryu(Tigard Phone: (503) 6394171 Projcct/appl.no.: __— Expire date: Fax: (503) 598-1960 Date issued__-- By: Receipt no.: Land use approval: Case file no.: Payment type: _j Art 1 RM IT U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family O Tenant improvement U New construction U Addition/ahcratiun/hrplacement U Food service U Other: l SITE INFORMATION' ME(for sp ecial information Job address: y 5 �1i� 1.2—� �J �— familyDescrdwellings Qt Y. Fee(ea.) 'Total Bldg.no.: _ �Suite no.: New i-and 2-family d��ellings only: (includes 100 fl.for each r:tim y connection) Tax map/tax lot/account no.: FR(1)bath Lot: Block: Subdivision:�1�� n 2)bath Project narne: SFR(3)bath City/county: ZIP tach additional badAitchen Description and location of work on premises: _ Siteutilities: Catch basin/arca drain _ Est.date of completion/inspection Drywells/leach line/trench drain CONTRACTORPLUMBING V Footing drain(no.lin.ft.) _ — Manufactured home utilities Business name: Q I IL-I N e- Manholes _ Address: 7_1t �!M ("Arvitlj, a. _Rain drain connector City: State: Zli': I t� _ Sanitary sewer(no.lin.ft.) Phone: - ,Z.( Fax: - - Y E-mail: Storm sewer(no,lin.ft.) CCB no.: k40115? Plumb.bus.reg.no: Fater service(no.lin.ft.) City/metro lic.no.: _ o Fixture or item: Absorption Contractor's representative signature: — ,;vc Back(low prntcr _ Print name: Date: U Backwater valve 1 i Basins/lavatory Narne: Clothes washer Dishwasher Address: Drinking fountain(s) _�— - -- — City: State: Tl.11': --�— Ejectors/sump Phone:' Z Fax: 1: mail: Expansion tank _ 1 Fixture/sewer cap _ Name(print): Floor drains/floor sinks/hub _ - - Garbage disposal Mailing address: o k Hose Bibb _ — City--( � State:0< ZIP.c 71 7_7__�_ Ice maker Phone: - Fax:, L - ' E-mail: Interceptor/grease trap _ Owner instal lation/residential maintenance only: Tile actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: _ Sum Tubs/shower/shower pan I tribal __— --- Name: _—.— Water closet Address: Water heater City: state: Zlr': Other: ------ — - -- - --- Phone: Fax: E-mail: Towl Not all Minimum fee........... ....$ ❑Visa ud�OlMasterCard` redil card+.yleaae call Jurisdiction for more Inlexnwti°n Nnticc:phis permit application � . I u plan review(at _ %) $ .,:ptres if a pelmet Is not obtained Slate,urr:hatge(896) ....$ credit card number ___. within 180 days after it has been :ap rca _ --. Name of colder ss drown on cre&cad accepted as complete. 'TOTAL .......................$ CU—dho'—fdet.I�tlalure AIII t 441)46 16 I��xlrt'�1M1 r PLEASE-QP-EUk: FIXTURES (individual) Qty Price Total Fixture Typequantt b work Performed Sink 16.60 New Moved_ Replaced I kemovedlCapped Lavatory -- 16.60 Sink _ -- Tub ur Tub/Shower Comb. 16.60 -C-vatory Tub or Tub/Shower Combination nly Shower O -_ - 16.60 Shower Only Water Closet ---- -- 16.60 Water Closet _ Urinal Urinal w 16.60 Dishwasher - Dishwasher 16.60 Garbage Disposal _ Lauf!jyRoom Tray Garbage Disposal - 16.60 Washinc�Machine Laundry Tray 16.60 Floor Drain/Floor Sink 2" - - '- 3" Washing Machine 16.60 4" - Floor Drain/Floor Sink 2" - 16.60 Water Heater - 3" 1 G.6U Other Fixtures(S cl 4" - i 6.60 --------- - Water Heater O conversion O like kind 16.60 -- --- ---- - -- - --- Gas piping requires a separate mechanical permit - MFG Home New Water Service 46.40 - "------ MFG Home New Sari/Storm Sewer 46.40 -_ COMMENTS REGARDING ABOVE: Hose Bibs 16.60 ..Roof Drains _ 16.60 -- Drinking Founlain - 16.60 --- Other Fixtures(Specify) 21.75 Sewer-tsl 100' 55.00 Sewer-each additional 100' 46.40 " " .Y•." Water Service-1 st 100' v 55.00 Water Service-cacti additional 200' 46.40 Storm R Rain Drain-Int 100' 55.00 Storm d Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' - 27.55 Catch Basin 16.60 Insp.of Existing Plumbing or Specially Requested 72.50 Inspection perthr Rain Drain,single family dwelling 65.25 Grease Traps - - 16.60 - QUANTITY TOTAL Isometric or riser diagram Is requ'ved M Quantity Total Is >9 'SUBTOTAL t 8%SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL kequkedonly Iffixture gty lolalis_9 J •�,`d'is• _.._ -- ---- - TOTAL 'ax 'Minimum permit fee is$72 50♦e%surcharge,except Pesidential Bar*rkhw Prevention Device,which is s:16 z5.8%surcharge -All New Cnmmerclal Buildings requke plans vAh Isometric o riser diagram and plan review Electrical Permit Application Date received: Permit no.: hJl Anfne '006 City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 9722? Date issued: By: Rccetptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TYPt'OF U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New cons(niction U Adrlilicat/:rltrratir)n/rel)lacentent U Other: U Partial JOB SITE INIPORMATION Job adcress: 1451 W - Suite no.: x map/tax lot/account no.: Lot: 1-- Block: Subdivision: Project name: Description and location of work on premises: Estimated date of com letion/ins ction: Job no: Fee Max Business name: r r ( /' 1 w resDescription Qtv. (ea.) Tolal no.dnsP New -single ar mull(-fandly per Address: /7 � _ f r duellingat,".Includes attached garage. City: fi. I State / I ZIP: Seniceincluded: Phone: Fax: I E-mail: 1000 sq It.or less - - - '—� I::ach additional 500 sq It.or portion thereof _ CCB no.: Glee.bus. lie.no: Limited energy,residential 2 City/metro lic.no.: Un iiedenergy,nonresidential 2� Poch manufactured home or modular dwelling Signature of supervising electrician(required) _ I lal, Service and/or feeder 2 Sup.elect,name(print). I,,,•„,,.,,,, Services or reeders-Installation, alteration or relocation: � " nnttll] 200 amps or less _ 2 Name(print): r�ct�� 1",1 I !401 01 amps to4tA)umpa amps to 600 amps 2 Mailing address:1�Q�j-7 W• t `^ n 01 amps to 1000 ampsCitya; Slate Qtp .P: Z Z ver 1000 amps or volts 2 Phoner3 - I .-ax:s -hE-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or re local ion: ORS 447.455,479, 0, 1. 2W amps or less _— 2 ' 201 amps to 400 amps 2 Owner's signature: f_ -_ Date: 401 to 61N)amps Hranch circuits•new,allerallon, or estenslon per panel: Nance: A fce for brunch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Slate: ZIP: i B. Fee far branch circuits without purchase -- --- of service or feeder fee,first branch circuit: 2 1'11411xI• ax: -- Hoch additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 nngls cormnercial U ldealth c:uelacility Each pump or irrigation circle 2 U Service over i 2n anips•rating of 1&2 LJ Hazardous location Each Sign or outline lighting 2 f unilydwellrnps U Building over IO.txx)squire feet four or Signal circuit(s)or a limited energy panel, U System over 61x1 volts nominal more residential units in one ar ucture alteration,or extension* 2 U Building over three stories U Feeders,4W art,-is or Haire •Descri lion: U Mcupam load over 99 persons U Manufactured structures or RV park FIch additional Inspection over the allowable In any of the above: U F:greWlightingplan U(thee _ --- perinspection F11--- Submlt_sets or plans with any of the above. Investigmi,m fee The above are not applicable to temporary construction service. Other Not all jurisdictions rcept credit cards.please call juriatictino tar name Information Notice:This permit application Penni(fee..................... U Visa U MasterCard expires if a permit is not obtained Plan n:view(fit _ %,) $ r Credit card number _._______--__ x __ i%ithin 180 days n11cr it has been State surcharge(896) .... ___laccepted as complete. TOTAL. .......................$ -- Warne of cardhoder as shown on credit cud --� cardholder signature Amount 4404615 trtnxl OW Electrical Permit Fees: Limited Energy Fees: -- _TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee .Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft or less $145.15 _ 4 ❑ Audio and Stereo Systems Each additional 500 sq ft.or portion thereof $33.40 _ 1 ❑ Burglar Alarm Limited Energy _ $75.00 _ Each Manurd Home or Modular 0 Garage Door Opener' Dwelling Service 0(Feeder $90.90 2 Services or Feeders E�O Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $8030 2Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps __ $160.60 _ 2 601 amps to 1000 amps $240.60 2 I 1 Other Over 1000 amps or volts $454 65 _ 7 ------ Reconnect only $66,35 _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocationFee for each system.......................................................... $75.00 200 amps or less $66.85 2 y_ _ _ 201 amps to 400 amps `— $100.30 _ 2 (SEE OAR 918-260-260) 401 amps to 600 amps $13375 —_ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Syslerns Branch Circuits New,alteration or extension per panel ❑ Boiler Controls a)The fee for branch circuits with purchase of service or feeder fee Clock Systems Each branch circuit __ $6 65 2 b)The fee for branch circuits ❑ Data Telecommunication Installation without purchase of service or feeder fee Fire Alarm Installation First branch circuit _ $4685 — Fach additional branch circ,0 _ $6,65 _ HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation Each pump or irrigation circle $5340 Each sign or outline lighting $5340 Intercom and Paging Systems Signal circuil(s)or a limited energy panel,alteration of extension ____ $75 00 -- Landscape Irrigation Control' Minor Labels(10) — _ $125 00 — Each additional inspection over Medical the allowable In any of the above Per inspection — $62.50_-- C� Nurse Calls Per hour $6250 In Plant — $7375 J Outdoor Landscape Lighting' Fees: Proleralve Signaling Enter total of above fees $ --__ nOther.---- --_— _--- --------- 8°/State Surcharge $ _ --Number of Systems 25%Plan Review Fee See"Plan Review"section on $ ' No licenses are required Licenses are required for all other insIdlations front of application Total Balance Due $ Fetes Enter total of above fees ElTrust Account#_ . e --_ 8%State Surcharge Total Balance Due $— -- r:Wsts\rurms\elc-feca.doc 111109/(X) u 0T.:' N 0'15'18"N E 68 00- 'n .......... MAIN FLOOR EL :488 0' IJ I GARAGE I/ i EL :478 0' .......... 4" CONC DRIVEWAY 11, J ———————U q-0 t U L S 0'15 3U W 8=0 0 87' PUE S Q A L E 0 0 AIAN SCOAD D(SION ASSOCIAM A 19 ITY OF TIGARD AeIE OR 14 ACCURACY OF f t W, 11 ts f4i soil An solut? 1wr ELKHORN RIDGE ESTATES 2228VC NUN D[R 10 VEMY ALL$111 C III 9'#YL L ANY fu PLACID 001 THF LOT 4 *NrPS 0�AN,001INIlAt fflU 0 A11045 BY KEITH BAKER LAN MASCOM CJS.M ASILWATIS 04C T( 6,02 SO, rN CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BUP — Received —_— Date Requested AM_ PM_-- 9UP — Location __ �� L _—_Suite _ MEC lontact Person ___._—� Ph t ' --Z-4 FILM — --- Contractor -__ _-. Ph( —) -- SWR _ BUILDING Tenant/Owner _ W_— ELC Footing -- — Foundation Access: ELC — Cr Drain ELR /� Crawl Drain Cr ---,�--- Stab Inspection Nates: SIT Post& Beam Shear Anchors -------------- - ---- ----------_.._--- ---- - Ext Sheath/Shear Int Sheath/Shear — ------ Framing Insulation - Drywall Nailing ---- --.-- ------- -- Firewall Fire Sprinkler Fire Alarm 1 Susp'd Ceiling Roof Cather. -- - - — Final - ---------- PASS PART FAIL --- — j— PLUMBING Pont+�Beam Under Slab Clough-In --- ---- -- - -- - Water Service --- —___-- _-- ,— :ianitary Sewer ------ - — ------ Rain Drains Catch Basin/Manhole — Storm Drain Shower Pan Other_ - - Final PASS PART FAIL - — -----_ MECHANICAL Post& Beam �— Ror-gh-In Gas Lino - —- - --_ - Smoke Dampers - - - - — ---- ------ — Final _PASS PART FAIL - - ELECTRICAL —+ Service --- - --.—__ Rough-In UG/Slab — -- ---- -- —-------- ---- Low'Voltaae - - - - --- - ire Alarm - PART FAIL Reinspection fee of re before next inspectior. Pay at City Hall, 13125 CW Hall Blvd. 81 I Please call for reinspection RE:._— _ unable to inspect- no access Fire Supply Line ADA Approach/Sidewalk Date�r`L�r `{,.�L Insp ---- �� 2� - Ext Other: Final DO NOT REMOVE this Inspection record from the Job site, PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST ' 3 V INSPECTION DIVISION Business Line: (503)639-4171 BUP z ,z c) —_ Received ,__ Dat@ Requested AM PM BUP — Location _ �_-�a 1r L — _ _ Suite—_ MEC — Contact PersonPh( j. ) � .3 - PLM - -) Contractor _. -- Ph — BUILDING Tenant/Owner __. _ ELC Footing Foundation ELG Access: ELR Ftg Drain Crawl Drain — Slab Inspection Notes: SIT Post& Beam - Shear Anchors -- - ---- Fxt Sheath/Shear Int Sheath/Shear Framing ----_---- ------—_-- _______ Insulation Drywall Nailing ►.�. �` ({�� — --------- ---------- Firewall -gyp U Qe' -- 0 GK M Fire Sprinkler T f- — — - — Fire Alarm Susp'd Ceiling - — - ----- - - -- -- v�� Roof Other. - Final PASS _PART FAIL_ ----- - - - -- ----� -- - -` PLUMBING -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 Hough-In - - - --- ias Line `smoke Dampers - I anal -PJ SS- FAIL f. CTRICA eti�Cr•'_._. Hough-In UG/Slab I ow Voltage _ --- FinaL) PASS PAR IL -� Reinspection fee of y_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE------ Please call for reinspectlon RE: _ U Unable to inspect--no access Fire Supply Line ADA n � ` _ 3 - � - ExtApproay.hlSidewalk Dats- � p Other: I-anal DO NOT REMOVE this Inspectlor; record from t10 job site. PASS PAR-r FAIL CITY OF 1-IGARD BU" .DINS ISPECTION DMS"I" IulsT 24-Hour Inspection Line: +175 Business Line: 63x-4 I BUP Date Requested. c- / f' AM PM _ BLD _ — Location r' �( �� l i s�� 2 t1 _ Suite _ MEC Contact Person Ph ,FV' j 7G 5 _ PLM — —r (L� Pi r SWR Contractor -f -- _ — - BUILDING Tenant/Owner ELC Retaining Wall— ELR _- Footing Access: FPS Foundation Ftg Drain SGN — -_— Crawl Drain Inspection Notes: Slab _— -- SIT Post& Beam I R r S Ext Sheath/Shear fjC. /1'1 r til j- 6e C Int Sheath/Shear Cr 7L to Z Framing _ --- - Insulation Drywall Nailing --__—.-- ---- ------_ -- Firewall --_—_ Fire Sprinkler -- —�- r F if e.Alarm — Susp'd Ceiling Roof _ Misc: -_.-- -_- - Final _ _ —_— PASS PART FAIL ---- PLUMBING — --- --- --- - ---- - I'nst& Beam Under Slab --- 1 op Cut Water Service --- _ --------.--- -_ - ~- Sanitary Sewer Rain Drains -- Fina' PASS Be PART FAIL -- MECHANICAL -- Rough In ---- Gas Line -- Smoke Dampers f rnal - - -- ---- - PASS PART FAIL --- -- -- - - --- - ------_____-- -- LE Service L1U Slab ----- Low Voltage _ Fire Alarm -------_._____ -------- -- Fin,L. ----- frASS 'PART FAIL- ---- --- - --------- - _- Backfill/Grading - ---- - — Sanitary Sewer Storm Drain Reinspection fee of$ required before next inspection ray at City Hall 13125 SW Hall Blvd [ ] _- -_ Catch Basin [ ] Please call for reinspection RE _ [ ]Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk nate _ c� Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site.