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11165 SW HALL BLVD I ~ i rn o� I f __ 'PATS T M Me 99TTT — CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . , : PILM9'.3-0003 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED: 01/06/99 PPRCELz IS135DA-CAHNI SITE ADDRESS. . . : 11165 SW HALL. BLVD SUBDIVISION. . . . : MLP97--0013 PILAT#1998-038 ZONING: R-12 BLOCK.. . . . . . . . . . . LOT. . . . . . . . . . . . . :001 JURISDICTION: TIG -1------------------------------------------------------------I------------------------- CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . - 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0 FIXTURES-------------- LAUNDRY FRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0. TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 76 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . . : 0 Remarks : Add sewer line for and existing residence. Own.?r: FEES MARVIN CAHN type amount by date recpt 5795 SW CRANBERRY CT PRMT $ 30. 00 GEn 01/06/99 99-311954 BEAVERTON OR 97223 5PCT $ 1. 50 GEO 01/06/99 99-311954 Phone #: Contractor__________________________-.--__ ED ontractor-------------------------------- ED WYANT EXCAVATING INC PO BOX 1.242 SHERWOOD OR 97140 Phone #e 625-9294 S 31. 50 TOTAL Reg #. . : 111263 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Sewer Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection 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. Tilose rules are set forth in OAR 952-000I-0010 through OAR 952-000I-0080. You may ------ obtain copies of these rules or direct questions to OUNC by calling (503)246-1987. d P,: Pet-mittee Signati-I +++++4•................................4•....................................... Call 639-4:175 by 7:00 p. m. for an inspection needed the next business day .......4.......................4............44-1......I........... ...........4-+ CiiT 07 TIGARD Plumbing Permit Application Plan Check# 3125 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 9723 Date Recd <<_ (503) 639-4171 Date to P.E. — Print or Type Date to DST Incomplete or illegible applications will no P accepted Permits moi►+ -�scr�3_ Related SWR 9 cso_©3 Called Namo of Development/Project FIXTURES (individual) CITY PRICE AMY .lob -- Sink 9.00 Address Street Address 5ulte Lavatory _ 9.00 Tub or Tub/Shower Comb. 900 Bldg# I W,Slate� Lip Shower Only 9.00 ((- R;q b 0 72-Z 3 N � Water Closet — 9.00 �. R�i t 10 Dishwasher 9.00 Owner Mailing Addressuite Garbage Disposal — 9.00 '71` ` (YA6 D( l _ Washing Machine — —�— — 9.00— C l8tatey Zip Phone — /QA 7- �5 2 Floor Drain/Floor Sink 2" 9.00 -- V6 J 3' 9.00 1)E P -5 4• — 9.00 Occupant Mailing Address >� Suite Water Heater O conversion O like kind 9.00 ``. (L- U LVj, Gas piping requires a separate mechanical permit. City/State Zin Phone Laundry Room Tray 9.00 o) 7772 J 6.2 • -22 L Urinal 9.00 Name Other Fixtures(Specify) r 9.00 '�A) — — Contractor Mailing Address Suite 9'0° q 2 9.00 Prior to permit Cd /State Zip Phone p Sewer-let 100' 30.00 ?/S Issuacce,a copy ` (('�• i�{ ` (C' ��-�a I _ Sewer-each additional 100 25.00 of all licenses aro Oregon Const.Cont.Board Lie.# Exp.Dale — required If j (,,; -� �p C,C) Water Service-1st 100' 30.00 ._ expired In COT PITxp bing LIc.0 E .Date Water Service-each additional 200' 25.00 database (l r r C� Storm&Rain Drain-1 st 100' 30.00 Name Storm&Rain Drain-each additional 100' 25 fit-' Architect Moblle F1ome Space 25.00 or Mailing Address We Commercial Back Flow Prevention Device or Anti- 25,00 Pollution Device Engineer City/State Zip—� Phone Residential Backflow Prevention Device' 15.00 (Irrigation timing devices require n separate Describe work tr be done restricted energy penult.) New O Repair O Replace with like kind: Yes O No U Any TrRF `,taste Not Connected to R Fixture 9.00 Residential O Commercial O Catch Be 9.00 Additional description of work Insp.of Exlat:rig Plumbing 10.00 ,er/hr _ Specially Requested Inspectons 40.00 er/hr Are you capping,moving or replacing any fixtures?— Rain Drain,single family dwelling — 30.00 Yes O No O Grease Traps 7100 If yes,see back of forth to indicate work performed by -- QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser dlagram Is required If Quantity Total Is >9 WORK COULD RESULT IN INCREASED SEWER FEES. •SUBTOTAL I hereby that I have read this application,that the Information given Is�omact,that I am the owner or authorized agent of the owner,and 6%SURCHARGE that lap hs� sub ed ereInm Ilance wit Oregon State Laws. Slgr atum of Ohlrner/Agentl r1 Data — **PLAN REVIEW 26%OF SUBTOTAL R ulred only N fixture".total Is>g -- -- TOTAL (fair,itoct Person Name Phone 'Minimum permlt fee is$25+5%surcharge,except Residential Backflow _ Prevention Device,which Is$15+5%surcharge **All Now Commercial Buildings require plans with Isometric or riser diagram and plan review I tdststphmarq doe TOM PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink Lavatory Tub or Tub/Shower Combination Shower Only _-_—_-_--i — ------ – Water - Dishwasher --- Garbage Disposal — Washing Machine -- — - - -- Floor Drain/Floor Sink 2" Water Heater~ ---- Laundry Room Other Fixtures (Specify) ---- COMMENTS REGARDING ABOVE: I IM01ph mhiH,Aix 7f."", CITY CF TIGARD DEVELOPMENT SERVICES SEWER CONNECTION 13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 r--1E RM I T PERMIT #. . . . . . . . 9WR99 -0iri;t� DATE ISSUED: 01/06/99 PARCEL: 1 G 133DA--CAHN 1 `SITE ADDRESS. — : 1 1 165 SW I-IAL_L_ BI...VD SLIBDIVI S ION. . . . :ML_P97-001;3 PLAT#1998--038 ZOI\IING: R--ice' BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :001 JURISDICTION: TIG TENANT NAME. . . . . :BOWERS, DEBBIE !SSA NO. . . . . „ . . . . . FIXTURE UNITS. . . 0 CI_..A9113 OF WORT!. . . -ADD DWE I.. L.I NG Uhl I TES. . : 1 T1e'l-'E OF UCC., . ,. . . :rF Nf7„ nF R1-)T!.DTNrrC: 1 T N;CTAL L TYPE. . . . :L.TPS)WR I MPERV SURFACE: 0 s f Remarks : Add sewer- line c.onner_tinn for' and existing r-esidence. Ilwner: _._____________.___.._._____.__...._._.____._____---____.___.___._____-• FEES 1y1ARVII,1 CAI-IN type amol.rnt by date r^ecpt 5795 SW CRANBERRY CT PRMT $ ;1?,00. 00 CECI 01/06/99 99•-3119'55 BEAVFRTON OR 9-7223 IN'3F' $ 35. 00 GEO 01./06/99 99--311:355 Phone #: Contractor,: OWNER Phone #: $ 2335. 00 T(-,TAL. F�eg #. . , ---_-- - RE QU I RF...D INSPECTIONS -- - This Applicant agrees to comply with all the rules a,d regulations of the Unified Sewage Aoency, The permit expires 180 days fromthe 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. 1f 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 o "Tan and Side Sewer,” hermit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set fn-th in OAF 95E 001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct gdestions to OUNC by calling (5031246-1987. \ L � Isst.red by : �- Permittee 9itgnat�_rre � F I i + ++-+ +-++++++4+++++f-+++++-+-+-4-+4-+++4++++++++++++++++++++-+++ ++4++++++++++++-F+-+-+ + ++ Cal 1 639-4175 by 7 :00 pr. m, for^ an insper2tion needed the next business day ++++i+++++4 4+++++++++4•+•f•+•++++++++-+++++-h++++++•+++++•++++4-+++'+++++++'++++++....f'+++i •*+' i CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 6394 i 75 Business Phone: 6394171 Date Requested: �// � elf A.M. P.M. MST: Location: 1 I I G .� !i C% x JIL �. L, PUP: Tenant:— Suitt: Bldg: MEC: Contractor:--�} ( ��'�,.? Phone. �l d "5 PLM: 4 (honer: Phone: ELC: ELR: SIT: _ BUILDING BLDG(con's) LUMBING ,; MECHANICAL ELECTRICAL. SITE Site Post/Den Post/f3cam Post/Bcam Cover/Service Sewer/Storm Footing Roof UndFI/Slab Rough-In Ceiling Water Line Slab Framing Top Out (las Line Rough-In UO Sprinkler Foundation Insulation Sewer IIood/Duct Reconnect II—If Bsrnt Damp Drywall Storm Furnace Temp Service M6N—n-- Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Ifeat Pump Low Volt jApproved rov Approved Approved AAppr/Sdwlk Not Approved of uvu Not Approved Not App-ovedFINAL FINAL FINAL FINAL FI ts4 O Call for reins n Reinspection fee of:_. required before nest inspection O 1Innble to inspect Inspector: / --- Dae: Page_ _ __of__�_. CITY OF TIGARD -, DEVELOPMENT SERVICES PLUMBING PERMIT 13125 SW Hall Blvd., Tigard,OR 37223 (503)639.4171 Pr.:RM I T #. . . . . . . . PL_M97-0533 DATA=_ ISSUED: 12/19/97 PARCEL: 1S135DA-02300 SITE: ADDRESS. . . : 1116:=: SW HALL BLVD SUE{DIVISION. . . . : METZGER ACRE TRACTS ZONING: R-12 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..011 JURISDICTION: TIG CLASS OF WORK. . :AL.T GARBAGE DISPOSAL.S. : 0 MOBILE HOME SPACES. : 0 'TYPE OF' USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0 STORIES. . . . . . . . r 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0 FIXTURES—----------- L_AUNDRY TRAYS. . . . . : 0 SF RAIIV DRAINS. . . . . : 0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE ( ft ) . . . : 0 WATER Cl-OSE'TS. : 0 WATER L-INE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Installinq residential bar.kfl.ow preVenti.0T1 device Owner— ________—•---_—_.._.-------_______._______________._______ FEES --__----------- MARVIN CAHN type amol.int by date recpt 5795 SW CRANBERRY CT PRMT $ 15. 00 B 12/19/97 97-301921 RF_AVERTON OR 97007 5PCT $ 0. 75 B 12/ 19/97 97-3019c1 Phone #: Cant Tact .JONES SPRINKLER REPAIR & I NSTA 4070 SW 192ND ALOHA OR 97006 Phone #: 649-6093 f 15. 75 TOTAL Rpq #. . : 6958 ---- -- - PEOU T RED INSPECTIONS -— - This permit is issued subject to the regulations contained in the RP/Back f 1 ow Prev Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All More will be done in accordance with approved plans. This permit will expire if worN is not started within 1A0 days of issuanre, or if wnrl is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rales adapted by the Oregon Utility Notification Center. Those rnlec arm _ set forth in DAR 952-MI-010 through OAR 952-AQ►81 988H. you may obtain copies of these rules or direct questions to OUNC by calling (503)246-1,J87. ISS1.1ed By: ��_ !rf '�`� Permittee Signatl_ire : + +++++++++++++i•+++++++++++++i.+++++++++++++++++++++++++++++++++++++++++++++++++ Call 639-4175 by 7:00 p. m. far an inspection needed the next bi.isiness day *+++.+++++++++4•+++++++++.++++++++++.F -++++++++++++++++.++•6+++++i•+++++++4-F+-+++++i+ 7 CITY OF TIGARD Plumbing Application Recd By� 13125 SW HALL BLVD. Commercial and Residential Date Recd Z , TIGARD, OR 97223 Date to P.E. (503) 639-4171 Date to n r Permit 0 C T ?J Print or Type Related SWR# Incomplete or illegible applications will not be accepted Called Name of Development/Project On back indicate work Purformod by Sxture. Job / /� —S. zu ff l FIXTURES (Individual) -` QTY PRICE AMT Address Street Address Suite Sink _� — --j Lavatory 900 Bldg# City/State Zip — -- _ f f D Tub or Tub/Shower Comb. 9.00 Name Shower Only 9.00 L Ali— r v c/7�l C_S r; Water Gloset �- 9.00 Owner Mailing Address Si,lte Dishwasher 9.00 S7S ti Garbage Disposal �- 9.00 City/State Zip Phone d'� f -, "170x, 6d G/s Washing Machine 9.00 Name Floor Drain 2" — 9.00 3" _— 9.00 —.— Occupant Mailing Address Suite 4"� 8.00 Water Heater O conversion O like kind 9.00 Y City/State — Zip Phone ___ I-3undry Room Tray 9.00 Name L �j ---- Urinal9.00 /lrG l q�7 a _ Other Fixtures(Specify) — � � j 9.00 Contractor Mailing Address Suite —V -- — 9.00 Prior to permit City/State Zip Ph ne 9.00 issuance,a copy /U/ , J, L c �u r' �y q- Ge 9 3 9.00 of all licenses are Oregon Const,Contcard I_Ic.# Exp.Date -- g qq required If S 6��•/f Sewer-1 st 100"-- ----- 30.00 expired in COT Plumbing Li # Exp.Dale database -Sewer each additional 100' A— 25.00 _ Noma �- Water Service 7j Iory — 30.00 Architect Water Service-each additional 200' 25.00 Or Mailing Address Suite Storm&Rain Drain-1st loo' 30.00 Storm&Rain Drain-each additional 100' 25.00 Engineer City/Slate Zip Phone Mobile Home Space 2500 Commercial Back Flow Prevention Device or Anti- 25.0/1 Describe work New O Addition O AlterallolRepair O Pollution Device to be donai Residential O Non-residential d Residential Backflow Prevention Device' 15.00 rim L7� Additional description of work: Any Trap or Waste Not Connected to a Fixture � 9.00 / Catch Basin goo 7, 1 171 L7 / insp.of Existing Plumbing 40.00 �') _ __ __ __ per/hr — Existing use of Specially Requested Inspections 40.00 building or property _ __ _ er/hr Rain Drain,single family dwelling 3000 Proposed use of Gease Traps goo building or property.______ OUANTITY TOTAL I hereby acknowledge that I have read this application,that the Informelion Isometric or riser diagram is required A Uuarnty rctal is >9 given is correct,that I am the owner or authorized agent of the owner,and •SUBTOTAL O that plans submitted are in compliance with Oregon State Laws. Signature ofO 'wner/Agent Date 5%SURCHARGE -1 42 C Crn �f �'��7�`�f' —" PlJ`N REVIEW 25% OF SUBTOTAL Contact Person Name Phone Requlied only d fixture yty.total is>9 --TOTAL Minimum permit fee is$25+5%surcharge,except Residential Backflow Prevention Uevice,which is S15+5%surcharge i ixislpimapp doe 5517 PLEAS.-COMP L IFTIL — Fixture Type —�--- Quantity by Work Performed New Moved Replaced Removed/Capped Sink — � ----^-- _ -- Lavatory �— Tub or Tub/Shower Combination _ Shower Only __— Water Closet Dishwasher Garbage Disposal — _Washing Machine Floor Drain 2" _Water Heater - Laundry Room Tray Urinal_ Other Fixtures (Specify) COMMENTS REGARDING ,ABOVE: 1ldsls�lm lCO dnG`+, CITY OF TELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: EL.C97-0599 10 13125 SW Hall Blvd., Tigard,OR 9720 (503)639.9171 DATE ISSUED: 09/03/97 PARCEL: 1 S 1.35DA-0 '300 917E ADDRESL. . . - I 1 165 SW HALL BLVD SUBDIVISION. . . .. :METZGER ACRE TRACTS ZONING:R--12 BLOCK. . . . . . . . . . . L0T. . . . . . . . . . . . . : 11 JURISDICTION: TIG FIro.j ec-t De scr i pt i on I. Installation of 2 branch circuits. --------------------------- - -RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS--•-- ---•--MISCELLANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 ,_.IMITED ENERGY. . . . . : 0 401. -- 600 amp. . . . . . . : 0 SIGNAL/r'ANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps- 1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 --,_--SERVICE/FEEDER-- -----BRANCH CIRCUITS------- -_ ADD' 1.. INSPECTIONS___._ 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : a EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 - _____-----.-__-----PLAN REVIEW SECTION------- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: ------------------------•---•------------------------ FEES ------------------ MARVIN CAHN type amount by oat- recpt 5795 SW CRANBERRY CT PRMT `F 40. 00 URA 09/03/97 97-298900 BEAVERTON OR 97007 ;PCT $ 2. 00 DRA 09/03/97 97-298900 Phone #: Contractor: ---------------------------_--.--___-------•------ __---------------.- OWNER $ 42. 00 TOTAL ------- REQUIRED INSPECTIONS --- Rokrgh-in Elect' 1 Final Phone #: Elect' l Service Reg #. . : 999999 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will be done in accordance with apprcved plans. This permit will expire if work is not started within 180 day., of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires ynu to follow the rults adopt^d by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-801-MIO threugh,OAR 952-001-1987, you may obtain a copy of these rules or direct questions to OLK by calling (1 46 1987. ['�rmrt4;ee Sigr)at1_rre : x X�.. �- Issued�y: INSTALLATION ONLY--------__-.---.------------_. . The installation is being made on per rty own which is not intended for sale, lease, or rent. /� k 7 �.y OWNER' S SIGNATURE: / �. - DATE: 9` -� �-__. TNSTALL.ATION ONLY------- ______---___-----.--_-._-.. S I BNATURE OF SUPR. ELEC' N: W_. DATE: _ LICENSE NO: —_ ____ _-----_-�.__. _� ---•-_--_ --__ ++++++++++++++++++++++++4.++4 ++++++++i-+++++++++++++++++++4-++ f+++++++++++++++++i Call 639-4175 by 6:00 p. m. for an inspection needed the next bi-rsiness day 4•++++++++++++++++++4,++++4•++++++++++++I++++++++•+f +++++++++4+++++•++++++++++++++4-+ CITY OF T'IGARD Electrical Permit Application Plan CheckA., _ 13125 SW HALL BLVD. Recd By cd TIGARD OR 97223 Date Re Date to P.E. ---- Phone (503) 639-4171, <304 Print or Type, Date to DST Inspection (503) 639-4175 Permit#9-LC-222=0 Fax (503) 684-7297 Incomplete or illegible will not be accepted called__ 1. Job Address: w 4. Complete Fee Schedule Below: Name of Development___ //_ll Number of Inspections per permit allowed Name(or name of business) 't��r\U� �( 11C_A� ��I_ Service included: Items Cost Sum Address 11 ( 6 r S L0 NR�^ V 4a. Residential-per unit City/State/Zip -Ti'� h L�� Each a additional 500 sq.ft.or ft.or less $110.00 ____A_, q Commercial ❑ Residential ❑ portion thereof $25.00 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $88.00 2a. Contractor installation, only: (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor Installation,alteration,or relocation 200 amps or less $60.00 __ 2 Address _ 201 amps to 400 amps Y $80.00 _ 2 City_ State -7_ip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1001,amps $180.00 2 v Over 1000 amps or volts $340.00 2 Job No. Elec.Cont. Lice. No. Exp.Dale Reconnect only $50.00 2 OR State CCB Reg. No. Exp.Date ,_. 4c.Temporary Services or Feeders COT Business Tax or Metro No.__ __Exp.Date_-.____. Installation,alteration,or relocation 200 amps or less $50.00 201 s to 400 Signature of Supr. Elec'n 401 amps to 600 amps - $100.00 Over 600 amps to 1000 volts, License No., ___Exp.Date see"b"above. Phone No.__- _. ---_--- --- - 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with 1`n J purchase of service or Print Owner's N v I feeder fee. Address -� �� -L 1V Each branch circuit $5.00 _ N Zt - b)The fee for branch circuits City_�� State p without purchase of r Phone No. (D t J2 - ___ service or feeder fee. ✓J ow 2 First branch circuit 4L $35.00 The Installation is being made on prop In, I o n which is not Each additional branch circuit 1 $5.00 intended for sale,lease r nt. n j 4e,Miscellaneous (Service or feeder not included) Owner's Signature ___ Each pump or irrigation circle $40.00 2 Each sign or outline lighting _- $,30.00 2 3. Plan Review section (if required):* Signal clrcult(s)or a limited energy panel,alteration or extension $40.00 _ 2 Please check appropriate item and enter fee in section 5e. Minor Labels(10) $100.00 _ 4 or more residential units In one structure 4f.Each additional Inspectlun over Service and feeder 225 amps or more the allowable Iii any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $5500 _ as described In N.E.C.Chapter 5 In Plant $5500 Submit 2 sets of plans with application where any of the above apply. 5. Fees: Not required for temporary construction services. ba.Enter total of above fees $ 5%S,,rcherge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line 6s for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If required(Sec.3) --NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account M_ s Total balance Due \DsrsiELcss APP nm wse CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Lina: 639-4171 -- p BUP _ ------__Date Requested i AM ��PM BLD Requested_ Location � I I(r k �%�iy Suite _ MEC Contact Person i c Ph '� PLM Contractor Ph _ SWR BUILDING Tenant/Owner _ ELC --1�, Retaining Wali ELR Footing Access: Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: ----- — Slab _---- ------ -----_ ------- SIT Post& Beam --- Ext Sheath/Shear Int Sheath/Shear Framing --- -----------�.�_— - -- - ---Insulation Drywall Drywall Nailing _ Firewall Fire Sprinkler `l�j Fire Alarm Susp'd Ceiling ---- - - - - - - - Roof Misc: Final PASS PART FAIL PLUMBING Post R Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Bost& Beane Rough In Gas Line Smoke Dampers Final PASS PART FAIL LECT , Services Rough In UG/Slab Low Voltage Fir _ larm —_ -- — I PA'§S PART FAIL_ OV Backfill/Grading ----' -- - Sanitary Sewer Storm Drain ( j Reinspection fee of$ —required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( j Please call for reinspection RE: _ ( j Unable to inspect-no access Fire Supply Line ---------- -- _ ADA Approach/Sidewalk �l,,`, __ Date =�. __— Inspector .y1__- _�-� _ y�_ - Ext LFinal PASS PART FAIL DO NOT REMOVE this inspection record from the job site.