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InitiallyGood n 14265 SW 100'x' Avenue CITY OF TIGoARD 24-Hour BUILDING Inspection Line: (503)63:-4175 MST — — INSPECTION DIVISION Business Line: (503)639-4171 BUP _ Received _ _ —Date Requested—_—L— ----- AM---- PM—__—_ BUP Location Z Suite MEC -- ,l�- Contact Person rn Pi PLM — Contractor_— _ Ph( ) — —_— _ SWR — BUILDING Tenant/Owner _ _-- -_ ELC Footing ELC ^- Foundation Access: Ftg Drain E LR ---- Crawl Dain SIT Slab Inspection Notes: —� Post&Beam _ '-Top m"'S r s -NQ►�"Ct=4r' I `�M _ — Shear Anchors T ` Ext Sheath/Shear -- - --- Int Sheath/Shear Framing - — ---- ----- -- ----- -- Insulation r- 1 plAL_ ---- Drywall Nailing - Firewall --- Fire Sprinkler ---- --T-- - -- Fire Alarm Susp'd Ceiling Roof Other:-----_..___—_ _- Final -- PASS PART FAIL ----- PLUMBING_ - Post&Beam - Under Slab -- - - - -- - ---—— --- ------- - - Rough-In _ Water Service -- - --- — Sanitary Sawer — Rain Drag s ----- -- - Catch Bas n/Manhole _----— _--_.— Storm Drain ----_.__ _ -- -- -- - Shower Pan Other: ------_ . - _ ----- ---- - ---- ASS PART FAIL - - MECHANICAL ------ Post It Beam Rough-In Gas Line Smoke Dampers ---- -- - - — -- ---- --- Final PASS PART FALL -- _ --- --' - -_ ELECTRICAL ---- Service Rough-In --------- - --- -- ----- -- UG/Slab Low Voltage — ------- -- - ---- ------------- Fire Alarm Final Q Reinspection fee of$—_— required before next inspection. Pay At City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE:. -_--__ -___ 'J able to inspect-no access Fire Supply Line ADA We _ 6 Inspector --- --Ext --- Approach/Sidewalk Other: Final - DO NOT REMOVE this Inspectlop record from the job site. PASS PART FAIL. CITY GF'rIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST a ---- INSPECTION DIVISION Business -ine: (503)639-4171 BLIP Received ___ Date Requested— 3 -Aril PM _ BUP — Locatiol, Suite MEC _ Contact Person "-1/n — Ph(--) ��'"D PLM ContractorPh(--) - SWR — BUILDING Tenant/Owner __---._ _ --- ELC Footing ELC Foundation Access: ELR Ftg Drain Crawl Drain Slab Inspection Notes: SIT _ Post&Beam - -- _ Shear Anchors Ext Sheath/Shear ----- - Int Sheath/Shear Framing -- ---- - ------- - Insulation Drywall Nailing --L-- — - -- Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling Roof Other: --- ------- _ r Final (,f PASS PART FAIL , PLUMBING --_ _ 'le. — Post& Beam Under Slab --- — Rough-In Water Ser;ice ------ /t77'-- _ Sanitary Sever P Rain Drains — - - Ire Catch Basin i Manhole Storm Drain Shower Pan Other: Final -------- PASS PART FAIL MECHANICAL ---- Post&Beam Rough-In --- -- ----- - -- -- Gas Line Smoke Dampers -- - --- - Final PASS PART FAIL ELECTRICAL Service -�----- - Rough-In UG/Slab Low Voltage Fire Alarm na PART FAIL Reinspection fee of$_.__ __-_�required before next inspection. Pay at City Nall, 13125 SW hall Blvd. _fflTFSS - --- F] Please call for reinspection RE: [J Unable to inspect-no access Fire .upply Line ADA Dates /�r�✓�"fes G�� Inspaator �'"� fE1Ct Approach/Sidewalk - � '%a, DO NOT REMOVE this inspection record from the Job site. '94 PART FAIL J �\ CITY OF TIG /� R D ELECTRICAL PERMIT DEVELOP'vul,V _-SERVICES IS�UERVICES SSUFA): EL02003 00082 L/20/03 13125 L'W Nall Blvd., TiUard. OR 97223 (503) 639.4171 PARCEL: 2S111 BB-00800 SITE ADDRESS: 14265 SW 100TH f\VF= SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R-3.5 BLOCK: LOT : 016 JURISDICTION: IG Project Description: I RESIDENTIAL UNIT _ TEMP SRVC_IFFEUERS -- MISCELLANECrC5 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADDT 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 a-np: SIGNAL/PANEL: MANF HM/SVC/FDR: 60'+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS_ ADD'L INSPECTIO_N5 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FUR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECT-ION 1000+ amp/volt: -4 RES UN'—S: > 600 VOLT NOMINAL: Reconnoct only: _i__SVC/FDR—225 AMPS: CLAS_S_AREA/SPEC OCC:__ Owner- Contractor: MIKE KADERLIK EVERGREEN ELECTRICAL CONTRAUTO 14265 SW 100TH AVE 23861 SE 442ND TIGARD,OR 97223 SANDY,OR 97055 Phone: Phone: 503-668-4608 Reg#: LIC 130311 — --- —� 1:1.1. 3.4720 FEES Y 1' 45815 Description Date Amount Required Inspections 11,1K1 8'!i,Slaw I;it ?211/113 $5.34 � _ --�" -- II I.VRNi .1LL( I':rnut 2/2003 — 1W6.80— I Rough-In Elect'I Final Total $72.14 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,Sta'e of OR SpeValty Codes and all other applirtble laws All work will be done in accordance with approved plans This permit will expire i!work is rot started within ;q0 days of issuance,ore work 1s suspended.or more than 180 days ATTENT;ON Oregon law requires you to folic,;:rugs adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 though OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503) 246-6699 or 1.800-332-2344 Issued By: .�.�/AA)Z!4, , Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _— DATE: CONTRACTOR INSTALLATION ONLY SIGNA-URE OF SUPR. ELFC'N: _ Y _ DATE:_ LICEW c NO: ly,-)�� —_— Cal. 639-4175 by 7.00pm for an inspection the next business day 04/23/2002 15:21 FAX 5035981960 CITY OF TIGARD 07]00.' r Etractrical Permit Application -- -� _ — Datereceiveda _f 3 Perms• Ciity of Tigard �(��""'�� Noject/appl.no.: Expire date: City ojrgard Address; 131'25,!'1'-f FAa1RF.1 D223 Date issued: By: j Recxiptno.: Phone: (503) 6'.�- Fax: (503) 598.1960 Case file no.: Payment type: Land use approval: _ 1 &2 family dwelling or aeeebsory O Commercial/industrial O Multi-family J Tenant improvement u New construction 0 Addition/alteration/replacerrcnt J Other: Q I'antal r Job address: (�� 'k t`L Bldj. no.. jSuite no.. -Tax map/tax lot/account no.: Lot; _ 1?'.xlt, 9 Subdivision: Project name: Description told locution of work on remise(: •- >, ^ Oct Estimated date of com lation/inspecdon: a Job tido: For Mas• peycriirdon Qty. (ea) Total no,Fre Business cisme:l=dt'ri t'CCjs��cc-t r t t — noddmtw-dstirornadti•romih per Address: �, - adtletrmit lnetuda.n.�snisra�re, City: c 1 State:L,F� ZIP: C sJ�j SarVfeeisehtdesh Phone: - Fax: E•mttil: 1000 sq.rt.or fess _ 4 CB n0.: Elea.bus.lie.no: �,�� Each additional 300 sq.tt.or ion thereof t ?� Umitcdenergy,residtn;al 2 C' l�lic.no.: C--^, L tnitedener y,non residential 2 �J Each tounutamutcd holrtc or mudular dwelling - turt of supecvisi cleetrieian(required) Date 4 Service and/or feadcr _ Sop.elect.name(pr+^')C H VZ1` E r- License no: j 1:� ni eea or krdees- allatbn, ■Ileratlen ar reloesUan: 200 amps or lean 2 %tatr.e(print)' ,� t 201 a s to ams 2 401 afaps to&A mops i,'.lathn addlteas: -�M �(,� 1 amps to 1�— 1 __ +mP' Cit : Stat ZTP: Over 1000 amps of Volo Photte: rax! E-mail: Reeoctrre:tonly i Owner installation:The insmilation is being made an property I own Ta111'anrr aatx;ca°r rr:chess which is not intended for sale, lea3e,rcpt,or excbaugc according to hodis1Atiots,al erotion,erMutabon: ORS 447,455,479,610, 701. 200 amps of hese — 2 Ol amps to 400 amps _ 2 Qwnwees of ature: i?dte: 401 to 600 amps 2 Srnuheirealts efM,aherarta�.'-- ur rairrtaion par pial: Name: A Fee for branch,:itcolu with purchase or Addmss: service or tender fee,cath)!ranch circuit 2 City: Slate: LIP �_� Fee for branchcircuit&wi cit pufchuc - -- of service or feeder fes first branch circuit. ( t 2 FJoh�iiirmat txruuh dmslt Phofte: Fax. E mall f t lac.(Ser+iee er teerlar net luded): U Setneiae civet 11d ampseonrtr.u-1 O Health aanfseiho, Each pump or itsi ation circle ❑Service over 310 emps.e.ting of 1 k2 O Hatattivus Inea;lor, icTi 70,11M or outline lighting -- - fandlydtsellings QBuilding over 10.000sgweieet(out or SignadOra llndledenergvPanel, OSyssrmover ISM volts nonunal mom moidenrialunits inOn atn•aure alteration.oressenslon• - 1 2 O Building over three slants O Forder 400 amps at more sDestri tion: Miss U Oeeupont lam ova 99 petaous G Manufactured swnutw or RV park Each additional rryrAion over rhe allowable In arly of shoes: C]Egfae/lighdnp plan 0 Other - .� Pd ms calcis )< Subatsif--_an of NIW with My of the above. nveau sue-of e _ The above rue clot ispplltable to ttnteptratry cvaauoeH R- so"*-C. olhet - -- Na W)w:tdkuas setyt etadit cards.t�ecu)UVtadkxee for matte M►e,atnt►an Notice:This permit applicatiun Permit fee.....................$ O vivo O MasunCtud expires If a pexmil is rice obtained Plan review(at 96) S within 180 days after it has been Stale suldwse.(11%)....f _ n.prcr accepted w complctr TOTAL ................... S si/ante � wresm Y44e1S tM7YCOM1 CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00091 13125 SW Ball Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/17/03 SITE ADDRESS: 14265 SW 1GOTH AVE PARCEL: 25111 BB-00800 SUBDIVISION: TIGARDVILLE HEiCHTS ZONING: R-3 5 BLOCK: LOT: 016 .JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP. R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BAS!IgS: _ FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS_ _ URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN. ft Remarks: Replumb shower. FEES Owner: — Description Date Amount MIKE KADERLIK -- 14265 SW 100TH AVE I[,I,UM111 Fcrmit FCC 3/17/03 $72.50 TIGARD, OR 97223 ITA N1 8"i,titatc Tax 3/17/03 $5.80 Total $78.30 Phone Contractor: HALF MOON PLUMF31NG INC 11720 SW SUMMERCREST DR TIGARD, OR 97223 REQUIRED INSPECTIONS Phone : 701-7440 Top-out Insp _ Final Inspection Reg#: 1 I( 128288 III %1 34-3301313 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty kudos and all other applicable laws. All work will be dune ;o accordance with approved plans. This pF•rmit will expire if work is not started within 180 days of is,uance, or if work is suspended for more than i80 days. ATTENTION: Oregon law requires you to foilov rules adopted by the Oregon I � � I � ( r i. Issued By: ._ t.. l:�� i• i Permlttce Sigr►ature�. '��.�`�-.:� . -�•'� �-,- - Call (503)639.4175 by 7:00 P.M. for an Inspection needed the t3xt business day Building Fixtures Piu�>nb�n Permit Application ' OFFICE ° rateffly: eceived Plumbing -Il ate/B /% anning Approval Sewer City of Tigard Permit No.: 13125 SW Hall Blvd. an Review Other Tigard,Oregon 97223 ate/BY: Permit No. Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use Date/By: Case No.: Internet: www.ci.tigard.or.us Contact Juris. See Page 2 for 24-hour Inspection Request: 503-0394175 Narne/Method: _ supplemental Information. TYPE OF WORK FEE"SCHEDULE(for special information use checklist New construction Demolition Description Qty. Fcc(ca.) Total aAddition/alteratic'n/replacementEOther: New 1-&2-family dwellings Incl ides 100 ft.for each ut111ty connection CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 f 1 &2-F trnily dwelling Commercial/industrial SFR 2 bath 350.00 Acceyroty Building� Multi-Family SFR(3)bath _ 399.00 Master Build-r _ ❑Other: - Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCA_TIO Fires rinkler- ft M Pae 2 Job site address: 1 2_SAX Site Utilities Suite#: _ _ lig./Apt.#: Catch basin/arca drain 16,60 Dr ell/leach hnc'trcnch drain 16.60 Project Name: I Footing drain(nu. linear fl. Pae 2 Cross street/Direetio s to iob site: Manufactured home utilities 110.()0 fk Manholes 16.60 "7��-� � Rain drain connector - 16.60 Sanitary sewer no. linear 11,.� _ Pae 2 Subdivision: �►,ot#; _ Storm sewer no. linear R. Pae 2 Water service no, lineal 11. Pae 2 Tax ma / arcel #: _ Fixture or Item ]DESCRIPTION OF WORK Absorption valve 16.60 Backflow prcvcntcr Pae 2 Backwater valve 16.60 Clothes washer 16.60 1 -- ------ - Dishwasher _ 16.60 _ Drinking fountain I6i60 ROPERTY OWNER T NANT E cctors/swnp 16.60 Name: Expansion tank 16.60 - Address t ! / _I ___ Fixturc/sewer cup 16.60 Floor drain/floor sink/hub 16.60 City/State/Zip: Garbage disposal 16.00 _ Phone: Fax: _ Nose bib 16.6( APPLICANT El CONTACT PERSON Ice mnkcr 16.00 Narrle: ( ;,tom _ Intcrcc tor/ reasc trap16.60 Address: I" ) �aC �.+u�; Medical as value: 5 Pae 2_ Primer 16.60 Cit /State/Zi 04C- 22 3_ Roof drain(commercial) 16.60 Phone: ' - Fax: Sink/basinilavator 16.60 E-mail: Tub/shower/shower pan - 16.60 CON' TOR Urinal 16.60 _ Water closet 16.60 Business Name: �_ " _ Water heater 16.60 Address: i 1 _Gi P"IX r St- _ other: _ City/State/Zip: Z Other: * . Phone: {y?- - rax: Plumbing Permit Fees Subtotal S ('CB L1C. #: P 11b. LIC. ; 3 /j Minimum Permit Fee$72.50 S ,',uthorized Residential liackflow Ntfi .um Fee$36.25 SO lure: _ `�_ _ 11 ttc �.`.�"C� Plan Review 25%of Permit Fee) S State Surcharge 11%of Permit Fee S L_ .S _n----- _ __ TOTAL PI.RMIT FEE $ 11'Irase print rint nnn>r) --- Notice- This permit arplication etplres If a permit is not obtained within All new commercial buildinp,s requ re 2 sets of plans with Isometric or 1110 days after It has herr accepted as complete. riser diagram for plan revb w. *Fee methodology set by Tri-Cuunty Suilding Indu+try Ser0ce hoard. i:\Dsts\Pcrmit I'ornu\PlmPernitApp.doc 01103 Plumbing Permit Aaolication -City of Tigard Page 2- Supplemental Information Fee Schedule: Residential Fire Su ression S stems: Site Utilities Qty Fee(ca) Total Sq-!!are io0ta e: Permit Fee: . 55.00 0 to 2,000 $l 15.00 Footing drain- I°100' 2,001 to 3,600 _ $160.00 Footing drain-each additional 100' 46.4 3,601 to 7,200 $220.00 Sewer-l st 100' 55.00 7,201 and Greater _ $309.00 Sewer-each additional 100' 46.40 Water Serviec-1.. 55,00 Medical Gas Systems: Water Service-s_ additional 100' 46.40 Valuation: Permit Fee: °'.orm Rain Drain-Ist 100' 55.00 5I OD to$_ 52_000_(x1 Minimum fee$72.50 Storm&Rain[pain-each additional I(Y)' 4740 $5,001.00 to$10,000.00 $72.50 fa the first or fraction she thereof, t$1,52o for each additiun•�1$100.00 or fraction thcrcol',to and Fixture or Item Qty. Fee(ea) Total includin $10,000.00. Commercial Back flow Prevention Ik;vice 46.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for each additional$100.00 or fraction thereof,to Residential Backflow Prevention Device i _ and including$25,000.00. minimu-n:,; rmit fee$36.25) 27.55 Rain Draiingle family dwelling 1,s 25 $25,001(H)to$SO,o00.0U $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thewof,to Inspection existingplumbing or and includin $50,000.00.s ciall ested ins ections- r hour 72.50 $SO,INI l.00 and up $?42.00 for the first$504)(x)•00 and$1.20 for Subtotal: each additini r fraction thereo: _f Fixture Work: Are you capping,moving or replacing existing fixtures? If "Yes",please indicate work performed by fixture. Failure to accurptel 'report fixtures could result in increased sewer fees*. ( ornn)ents regarding fixture work: uantlt b, Flat re Work 1'crfnrmcd Fixture Tyre: Replace _ Ncw Moved Esletin�_ Car red Bo list /Font Both -TublShowcr -Jacurzi/Whirl pool ('or Hash -Each Stall -[hive Thru — -- Cus ldor/Watet Aspirator Dishwasher -Commercial -Domestic Urinkin Fountain k. Wash Floor Drain/sink 2" _ 4" ('.1r Wash Drain — *Note: If the fixture work under this permit results in an Garbage -DollicS11C Increase of sewer EUUs,a sewer permit will he Issued and Disposal -Cominercinl fees assessed for the sewer increase must he paid before the -Industrial plumbing permit can he Issued. Ice Much/Refri .Drains _ Oil Sepal aN r�00.%station)_ Rec.`'elmIc DUO SlaU011 _ Shower -(iollg -Stoll Sink -Ilarll avalory -[Bradley -Comilictool 'service _ --i—wimminz fool Filter — Washcr-t'lothes Water Extractor Watar Closet-Toilet Urinal Uther h'ixtures: is\Uses\permit Fonns\Plml1ermltAppPg2 div 01'03