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If this notice appears clearer than the
document, the document is of marginal qu,,jiity. 3/4/97
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CERTIFICATE OF
OCCUAOF TIGARD P RMIT #. .. . .. . *. M91-94--0d,30 �1
+! COMMUNITY DEVELOPMENT DEPARTMENT 1)A TF I i�SUF_D a 06/01/95
13125 8W Hall Blvd.Tigard,Oregon 0722390 1 N (603)$30.4171
i' PARCEL: " 1 k'►4C�D-�1�2 011
iITE ADDRESS. . . : 13714 SW tt1LLSMIRE GR �
SUBDIVISION r HILLSHIRt. ESTATES ZONING:R-•-7 tin �
L�LOCH,. , . . . . , . . . x LOT
. . r . • . • . r . • . ► i 6.1.
CLASS OF WOPK. -NEW
TYNE OF USE— :SF
OCCUPANCY GRP. i R3 �
OCCUPANCY LOAD: 12171 4
TENANT NAME. . . :
ftealark f'ATH I
Owner,;
CURTIS LOOP
9322 SW MAPLEWOOD ISR
V__228
'f I CARD OR 9722;
["hone #:
!:nn•h� actor,a -- - ._.....___.._.___...__,_ _._.___.-.__.-._......___r. i
R BRADBURN C ONGT
9675 SW 75 AVE'
I-)ORTLAND nR 1472,23
V>hone #i 2415-9905
Reg #. . : 54590 C
Chis Certificate :_er^tif'ies that th above refel`enced building or portion
1:heireof hats been inspacted for- compliance with the Tigard Building Code
fc►r the groi_1p and div. sion of ocCUPSnVy and use for which the above
r eferencvd permit was isiued, and occupancy is her^seby grantea",
BUILDING INSPECTOR
''OST IN CONSP I CUOIJS FAL ACE
� ��;�� '; ����� �,��ro�1 .'�° 7� a• .d a i ..r �� a°
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• CITY OF TMARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 63S4175 Business Phone: 639-4171 r,
{ Inspection_ _
I
Footing Susp. Ceiling Sprink Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San, Sewer Gas Line _B�J . C e!
Pibg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line InsulationMock. .
Underflr. Insul. Shear Wall Gyp. Bd. -Elei,t.
Date Requested:_ _ 1 `Tlma:,_AM --
Address: �—
Builder: — Permit #: /
THE FOLLOWING CORRECTION' .-i F. RE'�UIRED:
- I
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Inspect--or: -�� Date:
r6PPRU�ED DISAPPROVED
Call For P,einsp.
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� TOTAL OFrICt%RODU�.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone):639-4175 Business Phone: 639-4171 `
Inspecti.:n:—
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam oJech. San. Sewer Gas Line -Bldg.
PILg. Underfloor Rain Drain Framing
i , g -Plumb.
` Alarm Water Line InSL lation -Mech.
Underflr. Insul. Shear Wall Gyp. 13d•
Date Requested:__ - j l `7 Time: AMPM
Address:___
Builder: �ermit #:111 `�1!—64 3f„;y
THE FOLLOWING CORRECTIONS ARE REQUIRED: ��~� ?3 0
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Inspector `J r -- -� �I� Dater
4APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE •, -
Inspection Line (Rac-O-Phone): 639.4175 Business Phone: 639-4171 Y
Inspection:__
Footing Susp. Ceiling Sprink. Rough-in AFpr/Sdwlk x
Foundation Plbg. Underslab Mech, Rough-in Fireplace
Post/Beam Strutt. Plbg. Top Out Elec. Rough-in FINAL:
Post/Bear,ri Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain FramingiUr 7) Zq�
Alarm Water Line Insulation Medi.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: _ _Time: AM PM
Address:_
Builder:_ Permit #:
THE FOLI..OWING CORRECTIONS ARE REQUIRED:
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Inspecto/? Date:
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�APPROVFD DISAPPROVED
VVVVVV _Call For Reinsp.
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CITY ()F TIGARD BUILDING INSPECTION NO i i vE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-4171 f
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Inspection:
Footing Susp. Ceiling Sprink. Rough-in �r/S Zk
9
Foundation ^Ibg. Underslab Mech. Rcugh in Firepla e
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAW:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb. r
Insu!ation Mech.
Alarm Water Line
Underllr. Insul. Shear Wall Gyp Bd.
Elect.
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Date Requested: PM/ ��
Address:_ /
Builder.
Permit #: '
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Date: ����
Inspect'r. —�
gAPP:FRjOVE _DISAPPROVED CT TO ABOVE
,..
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 ;
i
Inspection:
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough in FINAL:
Post/Beam Mech. San. Sew.:r Gas Line BId9
r,
Plbg. Underfloor Rain Drain Framing
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall H Gyp. bd. -Elect.
Date Requested. 'Ci _ Time:_____AM PM
1 w
Address: ` � kA- \ �j —
Builder: _Permit #: 1 V
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectorf
_APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
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Call For Reinsp.
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�' } D nr•n CITY OF TIGARD"BUILDING INSPECTION NOTICE
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Inspection Line (Rec•O-Phone): 639-4175 business Phone: 639-4171
iry i
Inspection..:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
st/Beam
/�Ib3. Top Out Elec. Rough-in FINAL: j
+I' e ost/ eam Me . San. Sewer Gas Line ���Id ,Y
k Plbg. Underfloor Rain Drain Framing
Alarm Water Line Insulation
„ Underflr. Insul, Shear Wall Gyp, Bd. 7 -Elect.
Date Requested: " 1 Time: AM PM
�h Address:
a Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUI,,ED: �_ Z
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1, Inst,actor: Date:
_APPROVED XVISAPPROVED ,APPROVED SUBJECT TO ABOVE ;
Call For Reinsp. Iy�
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CITY OF TIGARD WJILDING IN.S;;CTION NOTICE {'•
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Insvection" — '
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace 1
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San Sewer Gas Line -Bldg. t
Plbg. Underfloor Rain Dra.., Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp, Bd. -Elect.
Date Requested: Time: AM PM
Address:_
Builder:
_Permit #Cie,
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Ck,
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Inspector: yl-A, ti _ Date: _3
_APPROVED ISAPP.-aOVED —APPROVED SUBJECT"�TO ABOVE
11�
—`� Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-4
Inspection:_ _—
Fcohu .- Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Fcundation Plbg. Underslab Mach. Rough-in Fireplace
Post,7leam Struct. Plbg. Top Out Elec. Rough-in AL:
Post/Beam Mech. San. Sewer Gas Ling -
BidPlbg. Underfloor Rain Drain Framing b. 4
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: 07` 2% _-'I ' Time: AM PM
Address:_�7 � I �1�\4NkVV-e _
Builder:�C V_ per,,, g;
PM �Y t
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector. Dater /
VED DISAPPROVED _APPROVED SUBJECT TO ABOVE
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_Call For Reinsp. '
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone):639-4175 Businass Phonti• 639-4171
a k� L Inspection:_
Footing Susp. Ceiling Sprink. Rough in ApprlSdwlk ��� '
Foundation Plbg. Underslah Mach. Rough-in Fireplace
post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: } d
Post/Beam Mach, San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm -Mach.Line Insulation -Mach,
4 ,
Underflr. Ir.sul. Shear Wall Gyp. Bd. lect J
Date Requested: j c�- `I `1 Time: PM `
Address:--t
Builder:_ �ermit#: jYj ST-7 —L "i:-' a
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THE FOLLOWING CORRECTIONS ARE REQUIRED: -~a ?3 0
2-7
4e go _ C
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Inspector Date: •_7�
%APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp,
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O Phone): 639-4175 Business Phone: 639-41'1
}
Inspection:
ting Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
,nidation albg. Under s•?
' b Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg. 11,
Plbg. Underfloor Rain Drain Framing !"fib,:
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -L-lect.
Date Requested: 1 ri S
Time: AM X, PM
Address:
Builder:
Permit #:_� =i`- � � •�� u�r�fi " � ='s,
I I ,� i r'] 6 f{1
THE FOLLOWING CORRECTIONS ARE REQUIRED: rd M , , , + " ���J�Is(���.
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Inspector:?L/—
Date:
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_AI''^ROVED _DISAPPHOVED `APPROVED SUBJECT TO ABOVE
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Call For Reinsp. "
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: I) tuso
Z) �
Footing . Ceiling Sprink. Rough in
9 '4�pNSdwlk �/ )
Foundation Plb UnderslabRough-
9• Mer.h. in {rep ace
Post/Beam St.uct. Plbg. Top Out Elec. Rough-in FINAL:
POst/Beam Mech. San. Sewer Gas Line Bldg,
Plbg Underfloor Rain Drain Framing -Plumb. �
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd.
•Elect.
Date Requested: I G •
IC—Timc: AM PM
Address: ---,! t ✓✓'i" �, �i � C�
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Builder Permit #: CX o
THE FOLLOWING CORRECTIONS AHE REQUIRED:
-5 Sze
Inspector 4
Date:
`APPROVEDDISAPPROVEDAPPROVED SUBJECT TO ABOVE
—Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phcne: 639-4171
Inspection- a
Footing Susp. Ceiling Sprink. Rough-inAppr/Sdwlk a `�
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Bearn Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -!Bldg
Plbg. Underfloor Rain Drain Framing 'lumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested:
`/S-9,j Time: AM
PM
Address: j V �� CU J YF rd� yes
Builder:yCcGC G7 Lc. t-yt. yXj Permit #:&57
THE FOLLOWING CORRECTIONS ,RE REQUIRED:
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1 Z7 C JG I � y��pf rk f ti a a<v d �,rh'
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Inspector.
I—.1�'"vI v Date:
APPROVED DISAPPROVED _APPROVED SUBJECT rO ABOVE
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 g
Inspection,:
Footing Susp. Ceiling Sprink Rough-in APP r/Sdwll<
Foundation Plbq, Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
-Bldg.
Plbg. Underfloor Rain Drain ranfi �P/
� -plumb 4
Alarm Water Line nsul'at fo �
•Mer.., .
Underflr. Insul. Shear t Vall
Gyp. Bd. -Elect.
Date Requested: 5/ j Time: AM
-� PM
Address: / / //
Builder: •• _ Permit#: C� 3
U
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
or:
—' Date:
;7PROVED
_DISAPPROVED APPROVED SUBJE 7 TO A90VE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
_
_ Pcti
on:
Footing Sus Ceiling 9 Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslabech. Roughs Fireplace
PostiBeam Struct, Plbg. Top Out Elec. Rough-in FINAL:
4.
Post/Beam Mech. San. Sewer as L' -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �
---l� �5 � Time: AM PM
Address: _ �/ C/ � ,
Builder Permit #: rX
THE FOLLOWING CORRECTIONS ARE REQUIRED:
In,
— - Dater
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
-__Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. Elects
Date Requested: `)
Time: AM PM
Address: '
Builder._ _ Permit #: C' '
THE FOLLOWING CORRECTIONS ARE RE ., 'IRED:
\'_LL- Sc./�c?(��A�r'� L1..i.�.•+ ��!!•.� �` L 9;�L2/L-S�-Y�-r 7r./1 I i:�,. -
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Inspector:_I i
Date:
_APPROVED _DISAPPROVED C-ABPROVFD SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
'. Foundation Plbg. Urderslab Mech. Rough-in Fireplace
Post/Beam Struct. Ib ..To Elec. Rough-in FINAL: tr
} Post/Beam Mech. San. Sewer Gas Line -Bldg. .
Plbg. Underiloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Undertlr. Insul. Shear Wa!1 Gyp. Bd. -Elect.
Date Requested: S/iC' � 5` n_Time: AM PM
Address:
—. _3c�
Builder: Permit k: � �7
i
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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In$pector. ,,Z bate:
APPROVED _DISAPPROVED _APPROVED SUBJ CT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
1
Insper tion:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Ibg. Top O Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line
a -Bldg, i
Plbg. Underfloor Rain Drain Framing Plumb.
Alarm Water Line Insulation -Mech I
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
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Date Requested:- �D % j`j Time: AM PM
Address: –7 J y �� C. ' a n d `V i
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Build(r: Permit #: 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date: - f
_APPROVED — ISAPPROVED APPROVED SUBJECT TO ABOVE
`Z'alT�r Reinsp.
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DEPARTMENT OF LAND USE 6 TRANSPORTATION
WASHINGTON LAND bEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON
XX}(XXXXXX--> 640--3470
Page 1 of 1
�.° Date 05/04/95
Time 15 : 48
Permit 'Type Residential Electrical Permit hermit # ; 0506'1313
Permit Status APPROVED Applied U5/04/95
Situs Address 13'/14 SW HILLSHiRE DR '1'1 issued U5/U4/95
Permit 'Title : SFR - ELEC/NEW HOUSE Completed r
Permit Descr. To Expire 10/" -/95
Project Title SFR - ELEC/NEW HOUSE Project # P0049699 �
Project Descr . * EROSION * m
J � 6
Parcel Number 2S1'Tl - Land Use District
Valuation t 0
Legal Descr ,
uwrter INSPECTION - 'TIGARD Construction OTI,
as Applicant Name FRONTIER ELEC'riiiC Classification 900
Applicant Addr . : PU BOX 15'/E3 Occupancy R3
ti GRESHAM, OR 9'/U3U I,alidated by KKP
Applicant Phone : '/'/1-4146 Irspect.or Area
k ' F'ee description Units Fee/Unit Ext fee Data "
----________- --_----
Square Footage LEnter Sq. Ft . ] :3000 210 . UO
Subtotal Electrical Fees , 210 . UU
State Surcharge of b% 10. 50
Total Electrical Nees : 22U . 50
** Fees Required Fees Collected & Credits
--------------- -----_----_----------------:_.---_--.----.-----_.--
Method Check # Receipt No . Date Payment
CK 1'/121 05/04/95 220 . 50
TOTAL 'THIS DA'Z'E, ********* 220 . 50 �
Nees : 220 . 50
Adjustments : U Total Credits : UU
Total Fees : 220 . 50 'Total Payments : 220 , 50
S
balance Due : . 00
s
NOTICE: This permit becomes null and void N the work or construction for which It Is Issued Is not commenced within 11110 days. Once construction ties started,
the permit becomes null and void If constructlor.Is Interrupted for a period of 180 days. 1 certify that the Information presented by the applicant and
his agent or agents In Pupport of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's iellance
upon false and misleading Information may Invalidate this permit. All pru:lelons of applicable laws end ordinances governing the construction and use
of this building or structure will be compiled with whether or not specified on the pu,:ar r—ted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of,-nnstructlon and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspectlon requirements are satisfied end
approval Is given by the Building Official. I further acknowledge that a Ilan may be placed on the tale of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable untli the satisfaction of all Inspection requirements.
APPLICANT'S sh]NATURE
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WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue,#350-12 APPLICATION
Hillsboro, Oregon 97124
Information: 503 640.3470 Fax; 503 693-4412 Project/Permit f ,
PLEASE Number >�Kf_44 ) -_- Date
Please c6fnpletesections, . •
i. Location of ln4. Complete Fee Schedule below
sal/atlon /f
Address 1371V 5W HA72b& -'1 Number of Inspections per permit allowed
Buildingg Service Included: Items Cost(ea.) Sum
city � 1 GRre� Suite No._
A. Residential-per unit
Tenant Name
(if commercial) _ 1000 sq.ft.or less 111_ $110.00 O, 00 4
Each additional 500 sq.ft Al
Tax Lot Map No. or portion thereof `I $25,00 !e 0 -0 U
Limited Energy $25.00 1
Thomas Map Book: Page: Section:_ Each Manufd Home or Modular
Directions Dwelling Service or Feeder $68.00 2
B. Services or Feeders
Commercial Residential IT Installation,alterations or relocation
200 amps or less $60.00 2
2a. Contractor v1stallationY�onl 201 amps to 400 amps $80.00 ___ 2
401 amps to 600 a $12mps 0.00 2
Electrical ContractorNjvir,< E CT9 t C 601 amps to 1000 amps $180.00 2
r Address y0 eog /S`7g ,ESN/FrVI, a/�`f?o.3U Over 1000 amps or volts $340.00 _ 2
Date S-Z-1S .lob Number Reconnect only -- $50.00 _ 2
Property Owner
Contractor's License No. 3-62�- _ - C. Temporary Services or Feeders
Contractor's Board Reg. No. j $Zt�G , Installation,alteration or relocation
�- 200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Suer. Elec'n ^,77� 401 amps to 60C amps $100.00 _ _ 2
License No.� , �r' Phone No. 77 i- `��7y Over 600 amps to 1000 volts see'B'above
2b. For owner Installations: D. b"anch Circuits
New,Coration or exto,ision per panel
a) Thb tLe for branch circuits with
ring War's-Remoie --- purchase of service or feeder les.
AWF-AT - Each bran-,h circuit $5.00 2
b) The fee for branch circuits without
Z`iry State Zip - purchase of service or feeder fee.
First bran-h circuit $35.00 -_._ 2
The installation is being made on property / own Each add'lil branch circuit_- $5.00 __ _ 2
which is not intended for sale, lease or rent. E. Miscellaneous (Service or Feeder not included)
Each pump or inrOstlon circle $40.00 2
Owner's Signature _. Each sign or outline iighting $40.00 2
Signal circuit(s)or a limited
3, Plan Review section (if required) energy panel,alteration
Please check appropriate hem and enter fPe In section 58. or extension $40.00 2
_y 1 & 2 family dwellings over 320 amps s/c meter F. Each additional inspection over the allowable
4 or more residential units in one structure In any of the above
Per inspection $35.00
Service over 225 amps; feeder 400 amps or more Per hour $55.00
System over 600 volts nominal In Plant $55.00
_ Building over 3 stories in height
_ Building over 10,000 sq, ft. 5. Fees
_ Occupant load over 99 persons A. Enter total of above fees $ Z 10 .00
Manufactured Structures Park or Recreational 5% Surcharge (.05 X total fees) $ 10. 5D
Vehicle Park; new, a, clition or alteration Subtotal $ _
_A Classified area or structure containing special B. Enter 25% of line A for
occupancy as described in N.E.C. Chapter 5 Plan Review if required (Section 3) $ -
Submit 2 seta of plana with application where any of the Subtotal $Less Bulk Label Fee $
above ripply. Not required for temporary construction 2 20.5
services. Balance Due $
For Inspections coli This perm"become•null and void if the work euthorlsod by the Fern it is nal commenced
rrUhin tw days from date of he,uance of such permit or a the work r,uthorlzed Is
640-3561 or 693-4415
suspended or abandoned of any time after work is commenced for a period of V day.
24-hour recorder,one working day In advance of need Eledrical Permits are non-rafundable and non-transferable
5/93
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DEPARTMENT OF LAND USE 6 TRANSPORTATION �
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION �
111//`1 155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
OREGON
XXXXXXXXX---> 640-34'iU
Mage i of 1
Date 05/04/95
Time 15 : 44
' Permit 'Type Residential Electrical Permit Permit # 05067311
Permit Status APPROVED Applied 05/04/95
Situs Address i 15935 SSW t)'/'1'H AV 7.'1 Issued 05/04/95
Permit Title Sk'R - ELEC/ONL C'JA%CUIT Completed �
a . Permit Descr. i'o Expire c 10/31/95
Project Title Sk'k - E;LEC/ONE CiRCU11' Project # P0049697
Project Uescr . k EROSION
Parcel Number 2S111UU-Uy300 Land Use District Mall
Valuation U
y
s. Legal Uescr. C:HEbbMAN DOWNS, LOT 19 ( FROM A&T: 04/08/94)
M` Owner LUANGRATH, KHAMPHET AND Construc.-ion O'TH
Applicant Nacre W-W ELECTRIC Classification 900
Applicant Addr, : 15460 S PARADISE LN Occupancy kt3
MULINO, OR 9'/042 Validated by : KKP
Applicant Phones 829--4146 Inspector Area
k'ee description Units F'ee/Unit. Ext fee Data
1st Branch W/out k'eeder [Erit.er # 1 1 35 . UU 35 . 00
Subtotal Electrical Fees : 35, 00
State Surcharge of 51 1 .75
Total Electrical Fees - 36 . 75
k** Fees Required *** *** k'ees Collected & Credits
F
•'... --__�.�....�....—.�.-..�—_�-......_�.�._.—�--...... --- ---._..-_.._—«.--f:.`o....-...-..��.-..�.---�...`a.�_..—�.�.-�..�-.ter.
Method Check # Receipt No Date Payment -
.; CK 2409 U5/04/95 36 . 75
T(.) 'AL 'PHIS DATE ********* 36 , 75
Fees : 36 , 75
w Adjustments : , UU 1'otal Credits. . 00
Total k'ees : 36 . /t, 'Total Payments t 36. 75
Balance Due: . 00
X
NOTICE, This permit beeonm null and void N the work or construction for which it Is Issued I-not commenced within 180 days. Once construction has started,
the permit becomes null and void If construction Is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or agents in support of this jermh Is true and correct to the test of our knowledge. I acknowledge that the Building Department's reliance
t upon false and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will bo complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. 1 further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections tat various times during the process of construction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval to given by the Bullding Official. I further acknowledge that a Ilan may be placed on the title of the property upon which the permit Is Issued
specifying that the use or occupanct,of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements.
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APPLICANT'S SIGNATURE £
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6A WYK I Q4
WASHINGTON COUNTY ELECTRICAL PERMIT
:.apartment of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, 4350-12 APPLICATION
Hillsboro, Oregon 97124
Information: (503)6404470 Fsx: (503) 6934412
Permit
4lease
. - Numbek � Date e -te all sections, 4. Complete Fee Schedule below
jJ 8 7 to Lf r Number of Inspections per permit allowed
1. Locationof Installation
Address Pi o_110 In e 1 ,Lae -iA _ Service included: Items Cost(ea.) Sum
City }'�j(,., Suitelnt�l0. A. Residential-per unit
1000 sq.ft.or less $110.00 4
Tenant Name Each additional 500 sq ft n I
(if commercial) or portion thereof $25,00 r
C `
NO.� �(�� �, JV Limited Energy $25,00 � 1
Map Tax Lot _�— Each Manuf'd Home or Modular
i Dwelling Service or Feeder $68.00 2
Thomas Map Book: Page:_ Section:
Directions B. Services or Feeders
Installation,alterations or relocation
�
—7 200 amps or less __ $60.00 2
C:nmrnRrr`IAI I I Ra.Cilit?ntial 201 amps to 400 amps $90.00 2
.iI;F SLCI_Tf .i I. 401 amps to 600 amps $120.00 ___ — 2
154GO 9 PAF:F1D 1 SES Li NI.l 601 amps to 1000 amps -- $180.00 — 2
MUL I NO, OF: 1971=14: Over 1000 amps or volts $340.00 _ 2
yO „ED__,4 14 E Reconnect only $50.00 —. 2
9 C. Temporary Services or Feeders
C ON'T-RAt::TORS L-I C:CNGE ft 26-e78C Installation,alteration or relocation
I: ONTRACTORS BnAF'n 171713. 41 101543 20Camps orless $50.00 2
aUF'EF:V T SOF' if 30003-S 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100,00 2
Over 600 amps to 1000 volts see'B'above
Signature of Su r. Elec'n l D. Branch Circuits
License No. 20435 Pho No. g
I New,alteration or extension per panel q
a) The fee for branch circuits with
2b. For owner Installations: purchase of service or feeder lee.
Each branct circuit �_ $5.00 2
Print nets ams one o. — b) The fee for branch circuits without
purchase of service or feeder e. 22 L -
Address First branch circuit $35.003 > 2
Each add'nl branch circuit $5.00 2
city State zip E. Miscellaneous (Service or Feeder not included)
Each pump or Irrigation circle $40.00 2
The installation is being made on property I own Each sign or outline lighting $40,00 2
which is not intended for sale, lease or rent. signal circuit(s)or a limited
energy panel,alteration
Owner's Signature or extension $40,00 2
F. Each additiottal Inspection over the allowable
In any of the above
3. Plan Review section (if required) Per inspection __ $35.00
Per hour $55.00
Please check appropriate Rem and enterfee In section 58. In Plant $55.00 _
_4 or more residential units in one structure
_Service and feeder, 800 amps or more �. Fees
_System over 600 volts nominal A. Enter total of above fees $
_Classified area or structure containing special 5% Surcharge (05 X total fees) $ x_15
occupancy as described in N,E.0 Chapter 5 Subtotal $ _
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $
above apply. Not required for temporary construction Subtotal $
services. El
Trust Account $
Balance Due $ _,_2
For Inspections call This permit becomes null and void If the work authorized by the permit Is not commenced
640-3561 or 693-4415 within 180 days from date of Issuance of such permit or 11 the work authorized le
suspended or abandoned at any time after work Is eommenend for a parted of 1b days.
24-hour recorder, one working day in advance of need Electrical Permits are non-refundable end non transferable.
8/94
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DEPARTMENT Or LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/540-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
i Permit . 06731 ., Project # P0049699 Statue F,F'r,Rova,., Page 1 of I
Applied 05/C4/95 Isruecl 05/04/95 Expires 1 (1/31/95 05/11/95 C18 : OF1
RE6ELF��
PF.-rnit Title SFR - ELEJ/NLW HOUSE OTH
Descriptx.)n Hegti), 05/(14/95
.:: Job Addr&Es 13714 "W HILLSHIRE DR TI �
Owner Name INSPECTION - TICARD Region �
r'. Appl i rant. Name FRONTIER ELE(:'TR I C
Phone number 7"71-4146 Valuation : 0 Apprc,;�c'd^_ .
inspector (!ornrr,ents Rejcected_
_ IVR- .REStJL'ra
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REQUEST ERROR!
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Plumbing
E
' MecIla%ItI
Electrical
,h.
Genera I
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Inspected by . _-_ Data
Cover & 5erl.: ; p403 E AF DN IVA
' . -
05/11/95 Pi .JF
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
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Inspection:
Footing " Susp. Cei ing Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mech, Rough-in Fireplace
Post/Beam Struct, Plbg, Top Out Elec. Rough-in FINAL:
Post/Beam Nlech, Sari. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech. I
Under(Ir. Insul. Shear Wall Gyp. Bd. -Elect. ,
Date Requested: _S/ �it -S Time: AM PM
/ c
Address:
Builder:- �{ S j O f Permit #:
THE FOLLOWING CORRFCTIONS ARE REQUIRED:
Inspector: Date: .S
APPROVED DISAPPROVED •/- PPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing G/ Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation _ Plbg. Underslab Fireplace
I Post/Beam Struct. `+ Elec. Rough-in FINAL:
ti Post/Beam Men. Sewer Bldg.
Plbg. Underfloor Drain (Fir a—mi n -�Zj n -Plumt).
Alarm Water Line , sulat' n p z -Mach.
Underflr. Insul. Shear Wall Bd. -Elect.
I
Date Requested: _ > A Time: AM PM
Address: 12 / L� � G't.liL 6-� 7 L—
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Builder. � `� ' J ���S Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED: J
�1,11J.�t.►n^..I.���L 1'���.'t� trT� �1��-c' r? tilt ti,,.�,A� ,lr�il.NI..CU��i
�SJr1/V� C�.l�e'LJIrC� Z•1_�S �M•G�/�, r
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Inspector: /,/ •J' Date:
_APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
I
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
1
Foundation
Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
�---' Gas Line -Bldg.
Post/Beam Mech. San. Sewer
Framing
-Plumb.
Plbg. Underfloor Rain Drain g
Alarm
Water Line Insulation -Mech. d
I
Underflr. Insul. Shear Wall Gyp. Bd.
-Elect.
Time: AM PM
� . Date Requested: _, �
Address: �///
Builder: Permit #: Q
THE FOLLOWING CORRECTIONS ARE REQUIRED:
74
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Inspector: ` Date:
APPROVED /'DISAPPROVED _APPROVED SUBJECT TO ABOVE
-Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639.4171
*� Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
` ost/Beam Str Plbg. Top Out Elec. Rough in FINAL:
/B ame
st Mec . San. Sewer Gas Line
-Bldg. �.
Plbg. Underfloor Rain Drain Framing Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall Gyp. Bd. -Elect. 41
Date Requested:_ ) (���/�J� Time: AM PM
Address:-/3 -7L� / 7'-C,�Qr.y��n > Z. Z
Builder: (2 5 � Q Permit #: 9y-G T 3
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J' I
Inspector: -
_APPROVED e---6ISAPPF 7VFD APPROVED SUBJECT TO ABOVE
r—
—Call For Reinsp
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i
Inspection:
ooting� 'A0,1 Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
ounda?ion Plbg. Underslab Mech. Rough-in Fireplace
Post/Beim Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. !Nr:—.:�Sewer Gas Line -Bldg.
Plbg. Underfloor Rai, Framing -Plumb,
Alarm ater L n Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: 3// /J S Time: AM PM
Address:
Builder Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
it
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Inspectod Date:
APPROVED DISAPPROVEDPPROVED SUBJECT TO ABOVE
— _ I .
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 ( r
Inspection:
Sprink. Hu;:3h-in Appr/Sdwlk
Footing Susp. Ceiling ;SI
Foundatio Plbg. Underslab Mech, Rough-in Firep ace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: ■
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm
Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: -� /3 5 _5 Time: AM PM
Address:_ I3 2L-q-
2
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Builder. 1�G - ` c U�� Permit #: 7 36
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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' �i ��� �i,.� �'�' -� " .Sig-v p Tc.L,.: s �' f�7Ci%•.�o--' e
S/ 7,.:- op• C/> A/41
•`�' �! � v/� /� / may/ /C L/`��!•/ 7 L L 1-f J���
Inspector:_ Dater BSc
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsu.
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02-24-95 10; IMAM FROM SUNTEL DESIGN S j.9 `/- `ASO PO1
-WNTEL IPENIGN, NoN'Ment',lr, �1V �•1�A,�� t'(
weer inv Nueniosion. mice sell
Tlqurel. 4119 WSW
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02-24-90 10; 17AM FROM SUNTEL DESIGNF��02
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:
ootin Susp. Coiling Sprink. Rough-in Appr/Sdwlk '
r=oundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb. T
*. ,•_ I
Alarm Water Line Insulation -Mech.
Undedir. Insul. Shear Wall I Gyp. Bd. -Elect.
Date Requested: l I r�� /y- 1 5�5�� Time: AM PM
Address:�,� ,7 7 /�—C. �lJ '= � Z-z--
Builder: Permit #:
:l
THE FOLLOWING CORRECTIONS ARE REQUIRED:
A
Inspector: Date: zs "s
�--APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
d Call For Reinsp.
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• f i d 4 1 8rry �,•„ 't4 1 i) 1J •€ s4 �i y M
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CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER F'ER0.1 7
13125 SW Hall Blvd.Tigard,Oregon 979.23.6106 (503)630-4171 PERMIT #. . . . . . . : MST94-04,� '{
631)--4+.1 "1 DATE ISSUED: 01/12/95
I PARCEL: 25104CD-02200
S1 TI'S: ADDRESS. . . : 13714 SW HIl_LSHIRF_ DR
S0130IVISION. . . . s HILLSHIRE ESTATES 'ZONING: R--7 PD
BLOCK . . : LOT. . . . . . . . . . . . . :02iii:
--------------- BUILDING ___________._____----.__.-_---____.__ ..--- -_.__.._---•._--
F4E I SSUL: DWELLING UNITS-. 1 BASEMf=Nl•. . . . . . . . :0 s f
CLAS:i ►.IF- WORK. -NEW HEDRMS::3 BATHS:3 GARAGE. . . . . . . . . . :492 sf
TYPE OF USE. . . :SF FLOOR AREAS _--- _- -- REOU I RED SE TBACI•(S------------
I YPE OF: CONSI . :5N FIRST. : 1600 sf LEFT. . :5 ft FifGHT. :5 ft
OCCUPANCY GRP. : R'3 SECOND. . . :990 Sf FRONT. :20 ft REAR. . :50 ft e
STORIES. . . . . . . . I FINSSMENT:O sf REQUIRED--------
HEIGHT. . . . . . . . :
EQUIRED-________-_._____-____HEIGHT. . . . . . . . :L-'0 ft TOTAL.- -------:2590 s f SMOKE: DE:TECTORS. :Y
FLOOR LOAD. . . . :40 ps f VAL.UE. . . . . 175474 PARKING SPACES. . : 1
Remarks : PATH 1
PLUMBING
131NKS. . . . . . . . . . : I FLOOR DRAINS. . . . :0 LAACKFLOW P'REVN'FR'.3. . : I
i_.PVHTORIES. . . . . :4+ WATER HEATERS. . . : 1 TRAP'S. . . . . . . . . . . . . . :0
IUB/SHOWERS. . . . :3 LAUNDRY TRAYS 1 CATCH BASINS. . . . . . . :0 r
WATER CLOSETS. . :3 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . .0 f `
1.)1 SHWASHERS. . . . : 1 WATER LINE (ft) . : 100 OTHER FIXTURES. . . . . ..0
ljHHbHbF_ DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASH I NG MACH. . . : 1 SF- FRA I N DRAINS. . : 1
.-_____________-. MECHANICAL ___________..__ .._.._..__..__ _..__._..________.._..__ FEES
FUEL TYPES- __________.__ UNIT HTRS. . :0 type amount by date recpt
iWAS/ / / VENTS . . . . . :0 TIF f 1550. 00 JF 01/.12/95 -
MAX INPUT:O LTU VENT FANS. . :4 BPR T E 623. 00 JF* 01/1a/95 -
FURN ( 100K . . :0 HOODS. . . . . . : 1 SPLC $ 404. 95 KAR 11/14/94 94-258653
F=URN ) -100K 100K . . : 1. WOODSTOVEiS. :O B5PC $ 31 . 15 JF 01/12/95 -
j FLUOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JF 01/12/95 -
BOIL/CMP ( :3HP:0 OTHER UNITS: 1 PARK. $ 500. 00 JF 01/12/95 -
GAS OUTLETS: 1 MP'RT $ 45. 00 JF 01/12/95 -
Owner: ---____..._...__-.._._-_____.________.___._____.____MP'LC s 11. 25 JF 01/12/95 -
CURTIS LOOP M5PC $ 2. 25 JF 01/12/95 -
j
13322 SW MAP''LF=WOOD DR 3BTH $ 225. 00 JF 01/12/95 -
V-2E9 P5RG $ 11, 25 JF 01/12/95 -
TIGARD OR 97223 EROS $ 64. 00 JF 01/12/95 -
i P";)one #: Ey'RPC $ 20. 80 JF 01/12/95 -
jContract or: - -_________.__.._________._.----_.__ERP'C $ 20. 130 JF 01/12/95 - '
H bRADL;UHN CONST
8675 SW 75 FIVE t :.
F'OFl-I LF1tJD OR 97223
j Phone #-, .45-9905 �.
j Reg #. . . :x4590 '
� ._-_.__...__ _ 33789. 45 TOTAL_____________.___
f .
This perait is issued subject to the regulations contained in the ------- REQUIRED INSPECTIONS' ------- i
Tigard Municipal CAP, State of Ore. Specialty Codes and all other Font/founid Insp Fireplace Insp
applicable laws. AE work will be done in accordance with approved Post/Beam 5tr^r_►ct Gas; Line Insp
plans, This oervit will expire if Mork is not started within 100 Post/Beam Mechan Insulation Insp
days of issl_dnce, or if Mork is suspended or wore th80 P'
an IN Insp Gyp Board InEp
PLM/Underfloor- Rain drain Insp
I-'er,m11, 1, 5iynature n � /, Mechanical Insp Water Line Insp
Plumb Top Out Ap►pr/Sdwlk Insp
tss _rkci i y : F=raming Insp Mechanical Final
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CITY OF TIGARD
I
COMMUNITY DEVELOPMENT DEPARTMENT aE WE R CONNECTIONR
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ti126 8W Hall Blvd.Tigard,Oregon 9'1223 6199 (603)636-4171 F'lr T
4 PERMIT #. . . . . . . SWR94--021,61
639-4171 DAT!=: I laSUEU,: 01! 12/'35
PARCEL: 2SJ.04CD02%*=_ 00j
SITE ADDRL`.i 3. . . : 1:x714 5W HILLSHIRE IrR 1
SUBDIVISION. . . . : HILLSHIRE ESTATES ZONING: R-7 PI)
BLOCK. . . . . . . . . . . LO T. . . . . . . . :171 '2
uSH NO. . . . . . . . . . . FIXTURE UNI'FS. . . :
Ll_f-GS OF WORK. . . :NEW DWELL 1N6 UNII :J. . : I
iYl�-L OF USE. . . . . .SF NO. OF' ESUILDINGS: 1
INSTALL TYPE. . . . :F3USWR IMFIE:R°J SURF=ACE'. . : : ,f= �
Remc-►rka: PATH I
Owner.: ___---...--.--_.._._______.. ....__._____.__._________ _. __.___..._.._._.__..-.- FEES
,.,IJRT'IS LOOP type 4amol..►nt by d_at:e 1 ecpt
9,3"-`'21 5W MAPLEWOOD Ilk PRMT $ 2200. 00 ,JF" 01/12/95
j V_2128 INSF' $ :35. 1110 J1: 01/1�1'/95 ...
IIGARU OR 97223
i ! 'honky #:
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CONTRACTOR NOT ON FILE
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-- —_—-- REQUIRED I NSK'LCT•I CINE - — --This Applicant agrees to -omp)y with all the riles and regulations Sewer- 1 ni.;pect i on
of the Unified Sewage Agency. The permit expires 180 days from
the dato issued. The total amount paid will be forfeited if the
J permit expires, The Agency does not guarantee the accuracy of the
a side sewer laterals. if the sewer ►s not located at the measurement
given, the installer shall prospect 3 feet in ?11 directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a 1 rel.
Perm itL•ee> 511.111 ,kt f> _
I for inspec-tion — 639-4175
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1a V1 ASW-,
Residential Building Permit application '
City of Tigard
13125 .SIN Hall Blvd. �L,r,.
Tigard, OR 97223 (�
(503) 639-4171
�
Jobsite Address: / -� / ! c1J / f/_cX lr r ►"-
// �71 Office Use Ong
Subdivision:tri%�r�i i+e C'S t L;�t# d e
Planck/Rec
Valuation: / 75 V 7V-
r Permit# �' 4 3 U
Corner Lot? Y -N_1
Flag Lot? Y Reissue of
Map &TL#
7
Owner: 1 h / i t ��Q h o �. L�
Aaarvvals Required
Address: f U''d
GV .4q�,n <c�� Planning ) .f i � L Ic
L A /
I :s_ -ti Engineering
Phone: _ Other
Contractor:
Items Required
Address:
Subcontra--tam - k
1-17►^7La N `.I Truss De ails
Phone: ` ` . a C7 Jtkut -�G�'i! '✓`/..�rlj E
Contractor's License #
(attach copy of current Oregon license)
Contact Name & Phone: `� O 9 rrZ (,� h /�/ -j�� 9Cf NC SI
Subcontractors: I Arch itectlEngineer: %/
Plumbing (� Address: 3 //
Mechanical
(attach copy of c went OR Contra rs License 111
Phone: U 'i:2_ .3 0 f .S
JOB DESCRIPTION:
ApIKEant Signature & Phone number
Received by: :i Date Received:
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41
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Permit# Account Description Amount Amt. Pd. Bel. Due
Ms6V3 Bldg. Permit (BUILD) 3 ;
Plumb. Permit (PLUMB)
_ Mech. Permit (MECH) `��� j�
State Tax (TAX)
Bldg:
Plumb: I Z>
✓ ■
Mech: -�.?�� ✓ f
e
Plan Check (PLANCK) U
Bldg: v�l, yS ✓
Plumb:
Mech: 1!• Z 5 ✓
SW �O,LY' Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) u J viJ
Storm Drainage Chg (SDSDC) _
)' Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) / Zll Zd
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) 1p
Erosion Planck/COT (EROSN) Ztj•�� O2p ray
TOTALS: y
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FROM :.DIAMONND REALTY Inc. PHONE N0. 503 646 6507 Jan. 12 1995 10:36AM P1 �.
0 Rea
ianwn nc.
Fax Cover Sheet
Fa .
j Transmitting Cover Sheet plus
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TEL: (503) 524-7960 FAX (503) 646-6507
1
To: C,
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Company: T ,_�I
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Fac Number: C$4q-- 72 9 7
From:
Comments:
This Vc,,�,
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12274 SW ALLEN BLVD, SUITE 103
BEAVERTON, OR. 97005
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FROM UIHMONNU REHLTY Inc. PHONE NO. 503 646 6507 .Tan. 12 1995 10:36HM P2
S
Ol•'12-`A3 09:38 0503 274 0324 W.A•E.C• Z00:
01i1ti99 09:02 a802 246 2174 FTDELITY TITLE »•• W.A.E.C. Qduu3i0u2
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u. jJr sl the w"derel faad,of IoW D1 mrs of remid of the properW dosaibad&W
1 w n!
� � L4t M�S p�� � �tbdlt►iai0n ` , frr �fi
TuW AA&V91 :SC/ ,f(! sti;rs- O r Ub 14raw toe sor redo
Tse Mai aed Lot Nivabie ASI D y C,0 -� FCoffM&deft Ono�a.,,ar h r,.
-Q NXIM" AS I OII k SIA
rc�m(ned a to td eaJavlicn a u*:..
de hW 9UY r%14 W tbt propat�'a M@n 4f&Qaoplt Lot 0�1 +b eMecf upon ins
BtsDdss#idoaL alae lettowa as T1RV4 add117!�:
I les� Dr.
and u Tae Ma«sad Let NumWa25 9 dXUG 6,Asn mmplylas,rr+tls
Oa�un1 y�evslo�muat Code 8osdaa 110!8,030.0 mum gt�ada cine 7'S�Ri�deeeeCi�
GOA aeras that the Rt motum miy bene a shade paint hddht 41:54 feet~ ther9j,'r allow*,&bade
j oa&A area othemse p%"-e4ry Codi 6eotdon 18.88.010.7.
In addida,m, Uwe also soleus the City of Tigard from ttabWtp for daeatdvt SICWdq QM tbie
ad�uetcaorlt. ,
1 Alcgr Recording Return To: .y ;
D U1M01M UAI Y iAete
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letvarror QT 91005
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CITY C?F" T I GARD RFC,'F_I F>•f OF PAYMENT RECF I FlT NO. :95 26 04`"f 7
CHECK AMOUNT : 57'74. 4' '
NAMF' s RK BRADNURN 0014 TRUCT ION CASH AMOUNT a 0. 0121
ADDRESS
. 0121
ADDRESS PAYMENT DATF= :01./1�'/9!-;
SUBDIVTSION
PURPOSE OF PAYMEN I AMOUNT PAID F.'URPOSiE OF PAYMENT AMOUNT PAID
BUILDING PERM _...._ _._ .6P � ON PL.UMDING PERM __ ....;2c=____..
1, _ e�c,.7. 00
,�. MECHANICAL. PE: 45. 00 ST. k.UI l._D PER 44.. 65
E'I_AN CHECK FE 166. ;::0 SF:Wr:.R USA 22100. 00
SEWER INSPECT 35. 00 PARKS SDC 5(110. 00
RESIDENTIAL TRAFFIC FI=FS 1430. 00 MGaSS TRANSIT T'I F FEES 120. 00
H2O QUAL I-F Y FAC:11.I TY FEE 180.1 00 H20 P.l1ANTI'CY F AC I L-I TY FEE 10111. 00
E-ROSION CONTROL P RMITFE'E: 64. 00 EROSION C;17NTROL PLAN CK i":0. 80
=.,
EROSION CONTROL. c_'0. so
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MST94 ...04;,111
13714 SW Hl.1.1._RHTRF- DR L 01 - I
T'UTAC- AMOUNT 1 l(i T L7
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