14145 SW HALL BLVD r
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1.4145 SW 'Ia11 Bl.wl —"—
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection tine: 639-4175 Business Line: 639-4171 ------- - ---
BUP—Date Requested Requested— AM PM BILD
t_ocation� A�IL iJ I V cl , SuiteMEC _
_
Contact Person _ Ph , PLM
Contractor //_ Ph SWR CC _
BUILDING -- Tenant/Owner [ L�=�-_
Ll c .�v ELu O 3 3
Retaining Wall ELR
Footing Access:
Foundation FPS
Fig Drain ---� --- �`-
Crawl Drain Inspection Notes SIGN ----- _ __-
Slab SIT
Post&beam / - -----
Ext Sheath/Shear S l�i !) " C'1'k ('C/ ( p`
Int Sheath/Shear -`- --
Framing - -----_..__�__�-_---
Insulation -
Drywall Nailing ----_.�_----__--- -��__�-_----
Firewall
Fire Sprinkler
Fire Alarm -_..__._-------------- -
Susp'd Ceiling --- --------- ._._,__... --- _- ._-... -- ----- - ----- - --
Roof
Mise.
Final
PASS PART FAIL --- _---- _________ --_.-------__--
PLUMBING _
Post& Beam
-- - -�
Under Slab
Top Out �,----
Water Service
Sanitary Sewer - -- -------
Rain Drains
Final _---
PASS PART FAIL
MECHANICAL
Post& Beam
Rough In Cas Line
Smoke Dampers
CSS--ZEAET FAIL
ELECTRICAL
Rough In
UG/Slab
Low Voltage
Fire Alarm
(PAS - PART FAIL ---
S
Backfiil/Grading - - ----- -----
Sanitary Sewer
Storm Drain i Reinspection fee of$ —�required before n,;xt inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch BasiPlease call for reinspection RE:
Fire Supplypply Line [ ] p _. _ - [ ]Unable to inspect-no access
ADA :� `7
Approach/Sidewalk
Other pate 3_3l)_ (? �____ Pector Ins /- _ � -.�•-'�—_� Ext —�_
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD EI F_rTRJM'lt. 'FRMTT
DEVELOPMENT SERVICES PERMIT #: ELr..99-0033
13125 SW Hall Blvd., Tigard.OR 97223(503)639.4171 DATE T SStJFD: 01 /14/99
PORCEI_.: 2 S 1. 1 1 AA-00401.
LTTE 1nDDRt=SS. . . : 1.41.4`J SW HPLl- B1_.VD
91,I13DIVIGT0N. ,. . . :FDGEWOGD Z.flNIN1a: R- 7
BLOCI!. . .. . . . . . . . . LOT. . . . „ . . . . . . . . . JURISDICTION: TIG
P'rn j er.-t De s rr i pt i on : Hall Blvd Baptist Church sign
-RESIDENTIAL.. UNIT-••----..- _..TEMP 3RVC:/FEEDER5.3---•_...- ___...-MISCE.I_..L_fnNEOUSi.-
i.Ooo S+Fr OR L_Eca . . . . : 0 - 200- am17. . . . . . . . 0 P'LIMP/IRRIGATION. . . . :
EACH ADD' L. 5009F. . . : 0 ;?01 400 amp. . . . . . . : 0 STGN/O+1T LINE LTG. . : t
LIMITED ENERGY. . . . . . Oi 401 - 600 amp. . . . . . . : 0 SIGNAL./P'ANF1_.. . . . . . . : 0
MANF. HM/ SV(-/FDR. . : 0 6011-amps-1000 vnit s. : 0 MINOR LABEL ( 10) . ., , : 0
........-_.._crf.:RVICE'/1=FEDER- _.-- ._.._.-_BRANt.,H r IRC,UITS__.__,.... _- --ADD' I_ INSP'F...CTTONS -..
0 2100 anrp. . . . . . : 0 W/SERVICE OR FEEDER- III PER INSP'EC'TION. . . . . : T
201 - 400 amp. . . . . . : 0 1st W/O riRV[: OR FDR. : 0 PVR HOUR. . . . . . . . . . . .. 0
401 600 amp. . . . . . : 0 EA ADD' I BRNCI-I (,TRC: 0 TN PI-.ANT. . . . . ,. . . . . . : 0
601 - 1.000 amp. . . . . : 0REVIEW SFCTION-__.____.__..__..__-.._...
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOI..T NOMINAL.. . :
Reronn er.t nn 1.y. . . „ . : 0 SVC,/FDR > 2'425 AMP'S;. . : CLASS ARFO/SP'E'r, 0(,r. :
Clwner..: _..._ . .__. .. . . _......._.._. .__.._ . 1-1 ..._...------_ _.-_..._ . __....... FENS
HALL. S1-.VD BAP'TT51 GHURM-1 type amoi.rnt by date recpt
14145 r3W HA1_I... BLVD P PMT 1 40. 00 .TSIn 01/14/99 99-312192
T T CARD OR 972'c.'4 5P'ET 2. 00 JSiD 01/14/99 99-312192
f I-,cines #:
INF.=R t 4,21. 0Q1 TOTAL
REOU T RE:.T) I N!3P'ECT T n,,sir -
Elect' l f='i.nal
o n r
e y t1. . .
This perrit is issued subject to the regulations contained in the Tigard Municipal Code, State of 0regon Specialty Codes and all othF
applicable laws. All wor4 will be done in accordance with approved plans. This persit will expire if work is not started within 180
days of issuance, or if woo i, suspended for sore than 188 days, ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon LRility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 958- _ 7, You say obk
of thesf rules or direct questions to OLNC by calling 15831246-1987. / )
I C;r 1_r e d By . �---_.
_._...._.. ...._.w___...__.___.-__ -__.._._..._.._.OWNFR 1NRTAt_t_AT TON ONt_Y _.-
e installation is being made CIT) I-rr-oper-t:y I av`'n whi.r_h is tint intended far,
I e I 1 ease, nr rent.
'JNER' S r T CNATURF.: DOTE:
cnNTRAC'TOP TNSTt,I.L_ATTON ONLY _. _ ...__._...._ __
'rNATURE OF Mfl-'F7. 1..A..I=C' N.- DATE:
++++44-4.4-4 1-4 + 44444 .,..F{...E.}.}..F+ 1 +++++f F +•+ i +hi i F^I-++•1-+i-+4.4-++4,4-+-t 4-+•4•+++++-+++•t+++4•4 }•+-f
rc';.II (-,73—41.75. try ",':00 p. m„ fnr an insppr_,ti,on nepded ttie next brrsi.nes1 d,a.y
.}-+4.4+. f..}+•F4-+i++++44--4-+444+4-++-+,4.4 .i.. •++++d•+•f•++•F.+.4 ,4- }.}-4-t-.4 1.4-4.t-1-4-4,4 + 4 4..4_ 4.4..1.1 .j_ t.
CITY OF TIGARD Electrical permit Application PlanChec�-
13125 SW HALL BLVD. Recd13 �,
TIGARD OR 97223 Date R9c'd_- � -��
Phone (503)639-4171, x304 Date to P.E.
Date to D
Inspection (503) 639-4175 Print or Type Permit u
Fax (503) 684-7297 Incomplete or illegible will not be accepted called-
1. Job Address: 4. Complete Fee Schedule Below:
Name of DevelopmentHNLIi y .i' r G-+{�:L'_i-t\. Number of Inspections per permit allowed
Name(or name of business) Service included: Items Cost Sum
Address_ 141 Wa 1-1 N I--1-•- t�J<� t-•l p�✓Lyrj __ aa. Residential-per unit
1000 sq fl.or loss $110.00 q
City/State/zip 1 \Z• ��1�.Z�� -- Each additional 500 sq.it.or
Commercial la Residential❑ portion thereof $25.00
Limited Energy ^_ $25.00
Each Manut'd Home or Modular
Dwelling Service or Feeder __- $68.00
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 $80.00 2
C11yState Zip 401 amps to 600 amps $120.00 2
Phone No. _ 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec.Cont. Lice. No. Exp.Date_OR State GCB Reg. No. -_Exp.Date__l_____ 4c.Temporary Services or Feeders
COT Business Tax or Metro No.,-----Exp.Date-_ Installation,alteration,or relocation
200 amps or less - $50.00 2
Signature of Supr. Elec'n -_ -- 201 401 amp to 600 amo 400 ps $100.00 __- z
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: s)The lee for branch circuits with
purchase of service or
Print Owner's Name 01WL ZA1AKlAN feeder lee.
Address tR101 SQ `=,"1- Each branch circuit $5.00
Cit '�1 C1 State Zi exl 7 Z Z,3 bl The fee for branch clr f
Y �� •�-�- P without purchase of
Phone No. C';031 7<44 -Ic i z"j _ service or feeder tae.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch cir;ult $5.00 2
intended for sale,
�lease
•�or rent. 4e.Miscellaneous
Owner's Signature t (Service or feeder not Included)
9 � _ Each pump or Irrigation circle $40.00
Each sign or outline lighting _� $40.00 - ---
3. Plan Review section(if required):* Signal circult(s)or a limited energy
panel,alteration o,extension $40.00
-
Please check appropriate item and enter fee in section 5B. Minor Labels(10) $100.00
4 or more residential units in one structure 4f.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection - $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C.Chapter 5 In Plant w $55.00
*Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5s.Enter total of above fees $
5%Surcharge(.05 X total fees) $ ��--
NOTICE Subtotal $ --
Sb.Enter 25%of line tis for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reguired(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 r
TIME AFTER WORK IS COMMENCED. ❑ Trust Account it - z
Total balance Due s
r1nSTSTLCH,Arl' nev 9/96