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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Ree-O-Phone): 639.4175 Business Phone: 6394171
Inspection:
Footing Susp. Csiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg Unc'ers!ab Mech. Rouah-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-irr FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line insulation -Mech.
Jnderflr. Insul. Shear Wall f Gyp. Bd. -Elect.
Da!e Requested:_ -�/ /JS Time: AM PM
Address:_ c� ��/ L4 // LIL
BuilderL,22�s2. �,n�Cl� '�.(
Permit �j-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:w.�c Date:
_APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE �1;
---Call Fv Reinsp. 'I
ELECT R T CA1 F=,E:RIN I T
CITY OF TIGARD r TE ISSUED-11/03/95
COMMUNITY CI:VELOPMENT DEPARTMENT
13125 8W Hall Blvd.Tip-r.d,Oregon 97223*6199 (503)630-4171 PARCEL : 1 S 1 G4CH-1. `311110
I4 `.7W hill_L.VIE14 CT
SUBDIVISION. . . . : MILL.VIEW ZONING: R-•4. 5
t31-OCK. . . . . . . . . . . LOT., . . . . . . . . . . . . :29 !
C,ro.ject Descr-iption: Install for-anc,h c-irwuit
...--RESIDENT'IAL UNIT----- ----TEMP ERVC'/FFEDERr;--•--
1000 5F OR LESS. . . . 0 - 2,00 amp. . . . . . .. : 0 PUMP/T RR I GAT I(nN. . . . 0
EACH AT}D' L.. �isT2GF. . . : ;'01 - 400 amp. . . . . . . : 0 SIGN/GUT L-INE LTG. . : 0
I.iMT 1"I"D ENERGY. . . . . : 171 +101 -- 617I0 61np. . . . . . . : 0 SIGNAL./PANEL.. . . . . . . : 0
INANE=. HM/ 5VC/F'DR. . 10 601 +-amps-1000 volts. : 17.1 MINOR LABEL ( 10) . . . : 0
--- --"-SERVTCE./FEE DER -- . .....-.--LARANC-,11 CIRCUITS -___-_ _.. -_ADD' L. TNSP,FC"FIONG----•--
0 - ::'+71171 amp. . . . . . : 0 W/5E:RVICE OR FEEDER: 0 PIER TNE;F='EC:TION. . . . . .. 0
"'01 400 amp. . . . . . : 0 1st W/O SRV(, OR 1:DR. : 1 PIER HOUR. . . . . . . . . . . . 0
4101 - 6100 .amp. . . . , : 0 EA ADD' L SRNCH CIRC: 0 1;.1 E'LAN'f. . . . . . . . . . . .. 0
601 1000 IMp. . . . . : 0 ------._._._..______...__._.__._..-PILAN REVIEW SECTI0N
1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : ) 600 VOLT NOININAL. . :
Peconnect only. . . . . : 0 SVC/1"'DR ) = 225 AINF'r. . ; CLASS AREA/SPEC OCC. :
Owner,: _._._.----__._____. .___ _.__.___. ______ FEES
,.JOHN COO-; type amount by date r,er.pt
12314 SW MILI...VIEW COURT F'RMT 3i;j. 00 JSD 11/0,3/95 95---: 72501
5(''CT i 1. 75 ,JSD 11 /03/95 95--217 .501 1`
7IGARD OR 97223
L'h o n e #.- (503) 590--2352
Con . rac.tor.
CONTRACTOR NOT (IN FILE $ 36. 75 TOTAL
REQUIRED I Nc5P,E['.T IONS ------
Req fk. .
i
This permit is issued subject to the regulations contained in the ___._,__ •_______ - _
Tigard Municipal Code, State of Ore. Specialty Codes and all other F'e» ittee Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is rot started -
within 180 days of issuance, or if work is suspended for wore /__ �.''�'
than 180 days. slued -'Py
INSTALLATION ONLY
The installation is. t)einq made on pr-oprer•ty I own which is not intended for,
s a I c--, le,ast' . !)1., r.,er t. Mw
. �.
OWNS a' S SIGNATURE:
I NSTALL..AT I ON
SIGNATURE: OF' SUF='R. ELEC' N: _ ... . .. . DATE;
LICENSE 1\10
(':all for, inspection - 639--4175
------
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�.Yt'• -P� w"l" "ir"".".Y!,� " p" '.Ivo r 5.. I�Mra•r,,... R^n7 ri.i�., r, v�,e $ `#0FA q W
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. {
" • Tigard. OR 97223 Planck/Rec. #
F'erniit # ----1= 1. t" c;
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Phone (503) 639-4171 Bate !osued
FAX (503) 684-7297 FSf;uod by ,
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175 —
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Numi,or of Inspections per permit allowed
y ,� a
Address ���� 1 r��� ��l�f 1'�;j��L__ Service included: Items Cost(ea) Sure
4a. Residential- unit
City/State/Zip t f � f'°r
1000 M II or low $110 on
Name (or name of busine^S)_ ��� (CO
Each portion
l500 sq ft or --�
portion thereat $2500Limitt
Commercial❑ Residential Each
Energy $25Uo
ach Menul'd Homs or Modular �
Dwelling Service or Fnedei $88 00
2a. Contractor installation only: 4b.Services or Feeders
_ Installation,alteration,or relocation Q
r'lectrical Contractor G CL ' ,• 200 amps or less $0000
Address c L) J ✓ ' c �f` 201 amps 10 400 snipe $80 00
-�----7�-i-�- 401 amps to 800 ampe $12000 S
City Vd State_ Zip r 1 t>>j 601 amps to 1)00 snipe $18000 2
Phone N (c, f- (� / _ Over 1000 amps or voha $34000 2
Contractor's License No. 3 /94) l' _ Reconnect only $5000
Contractor's Board Reg. No. �' _
g 40. Temporary Services or Feeders
.t r" Inslellabon,alteration,or relxat.cn 2 'r
Signature of Supr. Elec'n 200 amps or loss $50 00 2
License No. Phone No. (� ;y (o r _ 201 amps to 400 amps $7500 _ 1
401 amps to 600 ampa $10000
Over 800 amps to 1000 Vohs
2b. For owner Installations: ase•h•above
4d.Branch Circuits
Print Owner's Name Naw alteration or extension por pants
Address a)The fee for branch arants uti(h
cityState Zippurchass of vwvkv or Wder Are.
`J - Fsr•h branch cirrdd $500
Phone No. _ b)The tea for branch arcus Mfhouf
The installation is being made on property I own which is purchase of servke or Aeedor Ase. c y
i� 2
not intended for sp ler lease r1f rent. First branch circuit $3500 !Each additional branch circuit 1500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each Pump or arionbnn arae $4000 2
Each sign or oulhne lighting $4001 _
Signal circuit(s)or a limited energy
Please check appropriate Item and enter fee in section SB. panel,aheration or extension _— $4000 T
or more residential units in one structurc, Minor I abals 110) $10000
Service and feeder 225 amps or more
4f. Each abl:lienal inapt ..ver
System over 600 volts nominal
_Classified area or structure containing .,tectal occupancy the allowable in any of he above
as described in N E C Chapter 5 Per inspection $35 00
our
Per hour $55 00
In Plnrtl $55 00 _
Submit 2 sets of olons with applicatio',l where any of the above
apply. Not required for temporary construction services. 5- Fees:
NOTICE
So Enter total of above fees $
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter evi line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Revieww if required(Sec 3) $
Su6fote;
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED ❑ Tnc;t Account tM $ —
Balance Uue �7
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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 I
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line Id w '
Plbg. Underiioor Rain Drain Framing l
Alarm Water Line Insulation ec
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Ita
Date Requested: Time: AM PM
i Address:
Builder: `j S JkkW, Permit
THE FOLLOWING COIRECTIONS ARE pr JUIRED: ;
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Inspector: Date: Q—'7
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1>'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: 63.-4171
Inspection:_
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlh
Foundation Plbg. Underslab Merl,. 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.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wal Gyp. Bd. ec1 ;
Date Requested: 6 Time: AM PN'
Address:
BuilderC�� . 70 7 ' I S� Permit #: x.1_4_ O_�v 7
THE FOLLOWING CORRECTIONURE REOU RED:
z
Inspector: Date:A52
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp. e5_
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Nd'"' r4,,�wrt•M'N'rk!'++ +fr [ ';tpr..- "p�yce r #'r'^" �'�n t i ,M4M '�h vrd�trK?r�tlr,M�gr!�','�`�N�b6M�"'�MI FI
CITY CSF TIGARD a
GLUMBING PERMIT
COMMUNITY DEVELOPMENT DEPARTMEi:T + •
13125 SW Hall Blvd.Tigard,Aragon 97223.8199 (503)839-4171 PERMIT #. . . . . , , : PLM95-0298
639-41.71 DATE ISSUED: 10/11/95
PARCEL: 1S 134CB--12903
SITE ADDRESS. . . : 12314 CW MILLVIEW CT
SUBDIVISION. . . . : MILLVIEW ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :29
-----•--------------------- ---------------------------------------._------------------_ ' r
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. . : MOBILE HOME SPACES. :
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . : TRAPS. . . . . . . . . . . . ., . .
STPRIES. . . . . . . . : 1 WATER 1-►EATERS. . . . . . : CATCH BASINS. . . . . .. . :
FIXTURES---------•-•----- LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . , . . :
SJNKS. . . . . . . . . . : JRINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . ,
LAVATORIES. . . . . : OTHER FIXTURES. . . . . :
TUB/SHOWERS. . . . : SEWER LINE (ft) . . . . :
WATER CLOSETS. . : WATER LINE (ft) . . . . :
DISHWASHERS. . . . RAIN DRAIN (ft) . . . . :
1i
Remarks: One reiJentiai backflow device.
Owner: -- ------------ ----- - --------------------- -------- FEES --------------
JOHN type amount by date reept
PRM - • 25. 00 CTS 10/11/95 95-271533
SPCT f 1. 25 CJS 10/11/95 95-271533
Phone #:
Contractor: -_____---•-------____------___--
CONTRACTOR NOT ON FILE
Phooe #: $ 26. 25 TOTAL
Reg #. . .
REQUIREn INSPECTIONS
Ibis permit is issced subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable ,aws. All Mork "ill be done in accordance with
approved plans. This permit will expire if work it not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signatkrre :
I s s i_i e d By: --�f.CJ �1n1
Call for inspect iun - 639--,175
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
'13125 SW Hall Blvd. Permit # iS-029?
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT PEE + ST. SURCHARGE r'
Nov Slnals Family Residences Ontv
Job AdWen U 1�7r 11I/I CW �t vt ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
❑ 3 BATH HOUSE$225.00
Addfess arw• ar Fee Includes a!I plumb!ng fixtures In the dwelling and the Mit 100 feet
of water service, sanitary sewer and storm sewer. See lees below.
FIXTURES
QTY PRICE AMT
-)Ys- Sink 9.00
man Ad"= ww. Lavatory 9.90
Owner Tub or Tub/Shower Comb. _ 9,00
CW~ no Shower Only 9,00
ct, -7 Water Closet 9,00
N" "'"""' jCA�t�/,��-, Dishwasher 9.00
/r,
i t� .�- �rg dkk � , Garbage Disposal 9.00
Occupant _ Washing Machine 9.00
Hour Urain 9,00
Water Heater 9,00
Laundry Room Tray 9,00
Urinsl 9.00
l(? Other Fixtures (Specify) 9.00
Contractor 9.00t
JdLn x) Cr- 61 vo( 9.00
Th" 9.00
I1G�' /c�c�lL' Sewer 1st 100' 30.00
"""Rftb"s"` O oft To N. Sewer-ea.Addit. 100' 25.00
0,J_/Y1 0 5 L 46-,) Water Service tet 100' _ 30.00
I hereby acknowledge that I have road this application, that the Water Service as. Addit. 100' 25.00
Information given Is correct, that I am the owner or authorized agent of ---the owner, that plans submitted are in compliance with ;tate laws, that Storm S Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm b Rain Drain AddlL 900' 25.00
number given Is correct. (If exempt from State reglstvation, please
g reason below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti-Pollution Device 9.00
Any Trap or Waste Not
_ Connected to a Fixture 9.00
Describe work new L) addition iteration repair Catch Basin 9.00
to be done residential 1P non-residential Insp of Exist- Plumbing 40.00/hr
Specialty Requested Inspections 40.00/hr
Exist!ng use of
Rain Drain, single family dwelling 30.00 1
building or property _ _ —
Reaidentlal backflow pre.eaflon
devices 15.00 )�
Proposed use of
building or property
®-� '(Except resident/al har.Mlow
prevenflon devices)
NOTICE •Mlnimurn Fee $25.00 E ISTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION —w
AUT11ORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 51; SURCHARGF.
CONFTRUCTION OR WORK IS SUSPENDED OR ABANDONED ! J
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25°,: OF SUBTOTAL I
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y TOTAL — r
Special Conditions
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O•Phone): 639-4175 Business Phone: 639-41 '1
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
i.
Pcsi/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Pust/Beam Mech. San. Sewer Gas Line -Bldg.
y
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wallyp Bd ' Elect.
Date Requested: 2K2 S 6 Time: AM PM
Address. 4 ,_4 �`7
Builder: �o — a Permit #: -� Z
THE FOLLOWING CORRECTIONS ARE REQUIRED:
x.91
4—
Inspector:
Inspector: Date: $
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` OVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
PPFj
Call
YFor Reinsp.
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CRY 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 rami -Plumb.
Alarm Water Lino Insula i -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
125-
Date Re nested: / � Time: AM PM
Address: 4L _ -
c�
Builder: a p Permit #;THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_ Date:
_APPROVED _DISAPPROVED 9APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
rte...
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Roc-O-Phone): 639-4175 Busin ss Phone: 639-4171
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Inspection: L t4- t,��_ �j 'iy/
Footing Susp. Coiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Outrt er, Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Instil. Shear Wall Gyp. Bd. -ElecVt.
Date Requested: c� - , _Time: AM 1\ PM
j - f 77
Address �� l� �Q_L��
Builder:h14_,�—�, 7 C� _ � ' [, Permit #:f::7� r, c 3,;2--7
THE FOLLOWING CORRECTIONS ARE REQUIRED:0) d.
� n
Inspector. x'11 1a7f' I f �y� Date
_APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Re;nsp. 1
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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 ec Rough-in Fireplace N
Post/Beam Struct. Top Elec. Rough-in FINAL:
!,Ira
Post/Beam Mech. San, Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Main ramin -Plumb.
Alarm Water Line Insulation -Mech.
Underfh. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ .Time; FSM PM k
n
Address:
SB�17er: { S Z. Permit#: Od 9.Z
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
4
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Inspector: Date:- 'v,j
_APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
E 9r�
_Call For Reinsp. Asn
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CITY OF TIGARD BUILDING INSPECTION NOTICE e
Inspection Line (Rec-O-Phone): 633-4175 Business Phone: 639.4171
Inspection:— I }---^v.
Footin Q qac'$ 11. Ceiling Sprink. Rough-in Appr,'Sdwlk
i dati i Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Un Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall Gyp. Bd. -Elect. ..-
Date Requested-- 5
quested: Tire: AM ' PM
Address:
Builder:_�0 Per its#: c�??r
THE FOLLO t�pCO CCTION 4Af REQUIRE
�{
Inspector: Date:
_APPROVED DISAPPROVED APPROVED SUBJECT TO ABGkiE 1
Call For Heinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec O-Phone): 639-4175 Business Picone: 639-4171
Inspection.
Footing Susp. Ceiling Sprink, Rough-in A r/Sdwlk
Foundation pp .,
Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct Plbg. Top Out Elec, Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line
Bldg,
Plby. UndeNloor Rain Drain
Framing -Plumb.
Alarm Water Line Insulation
-Mech.
Underllr Insul. Shear Wall
Gyp. Bd. -Elect.
Date Requested: q— \'�; _5
Time: AM K PM
Address: 1 2 j\ 1}� Y"
Builder: Gl —C1�, /,Permit u: "1S- U 2-9 L
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Insp -
Date:
,_ PROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
____Call For Reinsp.
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08/11%fly 09:05 'x'503 884 7297 CITY OF TIGARU IQJ002 UO2 " '
Community Development ELECTRICAL PERMIT APPLICATION
• 13125 SW Hall Blvd. '
Tigard, OR 97223 Planck/Rec. 0
Permit # Cl C q S D 3.:�I
Phone (503) 6394171 Date Issued
FAX (503) 684-7297
CITY Of TIGARD TDD No. (503) 684-2772 Issued by
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below: '■
Name of Development Number or InspseMona par permit Mlowed
Address 1 3 1 ,S w i II I V I car% C]- Serviep inck,drni Items Casljas) Sum �
City/State2ip lc' c'r. /�_U'\ 4a. Msldsntlal•per unit s
0 1000 an n 9,I.—
L\ i'k',i��Uv�c1L E'd ddthor'S°°`° It or
Name (or name of business)
porlron Mraol tt7G o0 1
Commercial[7 Residential Er+"oy � saF 00
Each Manurd Nome tar medtAor
p
nweio 3ehtroe ar Foo&t _ on pp
2a. Contractor Installation only: 4b.Services or Feeders
/�' �. � IMtallelron,Mleglron,n/ralerelbn 2
Electrical Contractor`�� � e C ;L l�(� 2a,wraps or Mss
sec 00 �
Address � l L1 zo+ moo.to.00 amps $00.00 2
40+emps to Wo err '
City Pyr an.c _, State�Zlp�`�7�I __.. act amps l0 loco an,pe $12000
Phone s ,t
Phone No. )�j 35 _ Ovr+omampsM.e>t. 934000 z
Contractor's License No. = .5 7(j L gecon»q only $6000
i Contractor's Board Rey, No (:; 5 4e.Temporary Bervlcae or readers
Instaa+gm 4tl.ra11W.tar r.tocalwn 2
Signature of Supra 'clec'n _ 200 arnp4 or we
License No. y11Q S P .� 2m amps to 400 ynps -- �pp 2
w h 00
� rrfie No.�SS ! 1
401 eTp.1e 900 er.pn f/VO 00
0.0,90o—go In IMM CAIR
2b. For owner installations: s«V above
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Print Owner's Name 4d.Branch Circuits
7+ New tll.ralron or exl.n n per panel
Address aj rM tee for branch arw4s meth
City —.-_ ____ State lip O+we►Isaa W a""im or etaol4r rte. 7
Phone No - E"b Arch nn,„1 Mon
--_- D)The b•lel March drah.mtheto _.._
The installation is being made on property I own which is vurrhose of so ries or bade'IIN, 2
not intended for sale, lease or rent. 's'brunch arars V"00
Leh aAlAbnal brand+argnl 95 00
Owner's Signatlnn 4e.Mlecellsneous 1
(ServRm or feeder rot included) .7
3. Plan Review section of required): FW1h Mo"p upalmn rir t. too on 2
Eich sign or ovilvw Ighhnp $40 CO
Phase check epprop►ieto item and enter two in section 5R. Cignal`moils)or a lenned orwirr -- 2
panty aMNVI,8n o/.Nenebn S4000
4 or more residential units in nno sMtrturo Mme't"We(+0) N0000
Swvtae and feeder 225 saps or more
Systqm over 600 voftb nominal 41 Each additional inspection over
_--------Classi6ed are■or stir-jcture mniaining spw..Iai occupancy the allowebts in any of the above
as described in N.E.0 Chapter 5 Per nspe000n —--
Pu hour SIM on
� tiSS 00 �r
Submit 2 sets of plans with application where any of the above in Ptpnl
apply. Not required for temporary construction services, ;
5. Fee4:
NOT ICF Sa Enter total of above fees = IS,DU j
5%Surcharge(TRS X total tee61 f '
(0 7 S
PERMITS BECOME V040 IF WORK OR CONSTRUCTION subtotal x _
AUTHOR17FD IS NOT COMMFNCFITHIN 180 DAYS,OR IF Sb.Fr mr 2�i of hna A fen
D W 1
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR flan Review it rewired(Sec 3) � I
A PERIOD OF 160 DAYS AT ANY TIME AFTER WORK IS Subtotal
MMMENCED. Trvst Accvvnt s
9elance It/Yc s )r O,
.a.lrr.n.rrr,pw.rop
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� � � 1�;•I. I r,'�' n� krt * �•!r ,e "+ "i'W{•x�'tu�N"" Q � �i�` 1'".M9•t^•r'tH. a4w"4!"^'+'u4k' X^'"vur�,v6''. ,M ..
«a �., + N tro.Lr r. ,.��j^'•K ''� trir �' 'R .:.a, r t ;.
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CITY of -rIOARD - WrE"Irt'r OF PAYtaf:ivT RErF.TPT NO. s9�!—P69PA9
CHrCK AMOUNT r 141. 7
WIMF CRAFT ELECTRIC, INC., CASH AMOUNT 1 41. Oki I
ODDRESS a PO PDX 1617/ PAYMENT DATE a II 81141 5 ( ;d
fa1_.18DIVIsION e r
PORTLAND, (3119'7C�'1 F,-- I ,
PURPOSE. OF PAYMENT AMOUNT VIA I D PURPOSr.. OF PAYMENT AMOUNT P-1 T D I
.......... __. ... _..... ..� ._._ _.._.... _...._...._._..4...........
E -E'CTRICAL PERMIT 135. 00 ST. BUILD PER 6. 75
i
SITE t 12314 SW M[I_L..vlr'ld rT I
F'LR9 y•-'Cdi;'•l
TOTAL AMr'tUN"CPA a D - — 1 41. 75
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�'��Nruar�"�.�, �Hr,1�a �k•490r°�*F+��pr'+t'�WMN''bNmr"
•
OF TIGARD PERMIT#. . PERM -
CITYMTER . . . .
COIIAMUNITV DEVELOPMENT DEPARTMENT DATE= TS5l1CD: 0,13/10/95 •
13126 8W Hall Blvd.Tigard,Oregon 97223 6199 (603)639.4171
PARCEL: 1G134CS-- i2'90W
wI rE ADDRE'33. . . : 12`314 SW MILLVIEW (:T
1UBDIVISION. . . . . MILLVIEW ZONING: R--4. 5 A
BLOCK. . . . . .. . . . . LOT. . . . . . . . . . . . . :, 0
BUILDING -_ ._._..._._.---------
REISSUE:
_-__-..,_.REISSUE:: DWELLING Utl'I'T73 &ASEME:N I . . . . . . . . :0 5 f
CLASS OF WORK. sADD BEDRMS:O BATWG:O GARAGE. . . . . . . . . . :O sf •
1'YF'E OF USE. — -31 FLOOR -REAS __...__ ._..__.._ REQUIRED
TYPE: OF CONST. :5N F1 R137. . 300 s f LEFT. . :43 ft RIGHT. 95 ft
OCCUPANCY GRP. -R3 51"_COND. . . :330 s.•F FRONT. ,10 f t RE.AR. . s 50 ft
STORTE:S. . . . . . . :2 FINBS11ENT:0 f REQUI(tED
HE 101•IT. . . . . . . . .22 ft TOTAL r 5110:!C DCTECTOR5. tY ,
FLOOR LOAD. . . . :40 psf VALUE. . . . . t; : 407..:,6+ PARKING lo-PACES. . : 1
RemctT'ic a : tc'AT'1-I I
PLUMBINC7
SINKS. . . . . . . . . . :0 FLOOR DRP ING. . . . :0 BACIA LOW fi'F'1F_.VNTRS. . :0
LAVATORIES. . . . . :0 WATER HLATCRS. . . :0 TRAPS. . . . . . . . . . . . . . :O
1'UI:If 3HOWE:R'S. . . . . 1 L0tJNDR'r' TRAYS. . . :k C;ATCI-i VAGINf3. . . . . . . :0
WATER CLOGETG. . :O SEWER LINO: (fit ) . -.0 GREASE: TRAPS. . . . . . . :0
0 WATER LINE "ft ) . :0 OTI••IER FIXTURES. . . . . .0
GORBAGE: D I SP. . . :0 FAIN DRAIN (fit) . :o '
W(,)SFI I NG MAOI 1. ,• . :0 SF RAIN DRAINS. . s 1
_ ..______...._......_..___.. MECHANICAL -._.. __.__._._._.__._..__.__..__.._ ._.__...-.______......_ FEE;
i UEL TYPE'S _.._ _ _._.. ...._...._ Ul-417 11TR3. . :0 type ilmot-stat 1,y cute r•ecpt
/BAS/ t / vEivr5 . . . . . :3 BPRT $ 242. 50 JD 08/10/97, 95--269073
MAX INPUT.0 SITU VENT FONS. -.0 B P L C $ 1.5.1. 1,3 BON 08/03/95 95--2&431.1:=-)0
FURN ( 100K —0 a 0 HOODS. . . , . . :0 BSPC $ 1.'. 13 JD 08/10/95 95-269073
F'URI`.i ) *.'1P.t0K . . .0 WOOD •rC:VES. .0 MPRT 1, CIO JI) 08/ 10/9',:5 95-..26907::3
FLOOR FURN. . . . :0 CLO DRYERS. s 0 013PC $ 1. 25 JLC 08/10/95 951-269073
DOIL/CMF .::J!( 0 OTI EV7. UhIIT.1 F"
4 PFl.T 4 x'3. 01 JD 0B/117./'3c 75 63073
C3Ati [3U'rLE:TG:0 P59,C $ 1. 95 JD 08110195 95-269073
Ot4ner- __..._ __....__._...._...__._..._.__.._.__....
JOHN COOK
i.�w314 5W MILLVIEW COURT
TIGARD Ori 972"23
Contractor: _....-_-.. ____... .__.__.....______._...--- ---_._....._____..__
Rf'AYBORN' '; Fs. UMBING1 Ir;
19990 SW CIPOLL ROAD
TUALATIN OR ':)706
F'Fione #k: 692-•41.323
8785.2
nH,
1 470. 46 TOTAL
This permit is issued subject to the regulations contained in the ---- - REPUIRE:D INSE)E:CTIQNS - - -- - -
Tigard Municipal Code, State of th-e. Specialty Codes and all other F'ootinrj Ir-rsp Framing Insp
applicable laws. All work will be dare in accordance with approved F o k_;rrnd mat i on Insp Insolation I rl s p
plans. This permit will expire if war' is not started within IN Post/Beam CArl.rct r3yp EAcar-cl Insp
days of issuance, or if work is suspe e., f s e than IN days. PCsst/Beaam Mec11a3r1 Rain ciraain Insp
Plm/urislab Insp Mectianicral r irl,ai
01^mitten ;;iyr}!At Ia,-c> : .... .___ . _ - _ __._ PI_M/Ur:derfIoarw P1s_rmk: Final
Mechanical Insp B,.iiIding Final
F=11 ,.imb Top 11i_rt (.r iar1 (:antro1
Call for• inspect; iori - 639-•4175
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Residential Building Permit Application
City of Tigard AU
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 •
Jobsite Address: /vZ3 I q M i
Subdivision: Lot # '1 Office Use Only
$ y 7 Contact Date _ I I Initials
Valuation: G �` Result
New Construction Only: (Square Footage)
Planck/Rec # _ �K
3L) s ; �-� Garage: Permit # Y i - Dox y
House: 9 Reissue of_
Map & TL# 12 9Uy
Corner Lot? Y 7 Flag Lot? Y 40 Zone _
Owner:
Plat#
S7�N,-> �� ��
i Approvals Required,
Address: � �--� �� II � << '��� �.r f
1 y r-Nr N 0 r Planning Setbacks _Solar
Engineering
Other
Phone: ( )
1 Items Required,
Co-.tractor: S CL 37ov— N(..
05 3 Subcontractors
Address: a
Truss Details
TV rQ_P 0113 O!L Coo Other_ ar
Notes
Phone.
Contractor's License # (7"
(attach copy of current Oregon license)
Contact Name:
Contact Phone: t
yrr
Subcontractors: Architect/Engineer: )LrJL1, xJ
Plumbing: Address: ,30d- f' ,41e f2V
Mechanical: �� _ ✓p,„ (' ,� ���t.►T� �-t�r+ �l..r'J�Je.� Or �, .
(attach copy of current OR Contractor's License)
Phone: if 3US ) ��� r U 1-3
JOB PTION: lf��?1°V►` ��� r .� Si`t-"� Y lei � II
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Applica 1 ig atura Applicant Phone number
Received by r� ' l (�tr�,t1�/t �' -- Date Received: _ ✓
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Permit# Account Description Amount Amt. Pd. Sal. Due
r /yJStL.1Z�1r z- Bldg. Permit (BUILD) 1, a _ i–i i, ��,
y _
Plumb. Permit (PLUMB) 3
I
Mach. Permit (MECH)
State Tax (TAX) / • 3 !S 3
Plumb:
Mech: Z
Plan Check (PLANCK) 1Y
Bldg: _LS7.G 3
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SININSP)
Parks Dev Charge (; 3DC) —
'2esidential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
I
Commercial TIF (TIF-C)
t
Industrial TIF (TIF-1)
I
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS) — —
i
Erosion Cntrl Permit (ERPRMT) _
Erosion Planck]USA (ERPLAN)
Erosinn Planck/COT (EROSN) —
YV, ... .. '�':..MPI�hM•{.n..u.yYtx...;.;y,.N
CITY OF TIGARD RRCE IFS" OF PAYMENT RECEIPT Ntl. :95-26912173
Ig NAME : 1S HOMES ( HECK AMOUNT
ADDRESS s 1-gy0BOX 129: CASH AMOUNT a 3 5099..0H76
TLILATIN OR PAYMENT CUTE 08/10/95
�
97068--
81~180 T V I S I ON o
PURPOSE OF PAYMENT 0MOL.INT PA't D PURPOSE.: OF PAYMENT AMOUNT Pr41.D
E+UILt►INE� E'EwRM MST9!�r-Q�r9�� i'4c'. N f,I.LlMHIN13 PERM
MECHAN I CAI_ PE 25. rho ST. BUILD PER 19. 33 '
FLAN CHECK FEr" 3S. 0,5
h
12'';314 SW MII_.LVIrW CT
TOTAL, AMOUNT PAID ;3259. 86
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C:I'TY OF T IC4ARF1 RECEIPT OF PAYMENT RECEIPT NO.
C.'HEE'li AMOUNT a 1 19. F10
NOME n S'L.s; CUSTOM WMES C'Or) •1 AMOUNT a 0. 0,o 1
AT)DRE"SS a VID Brix 1293 F� YME+NT DATE 1 08,103/911
T1..IAL_ATIN, OR ":091)IVISIOhl s
I y"7V►f.�...,
V.)URP(:ISE (.:IE F't1Y1d1=N T AMOUN I F1011-1 F'1_I F2F''C 517, Or. Pf O MF:N'T 0110UN T F)A I U
PI-AN L:HEC'K FEE 1 I C+. t,wr _. _..._..•_.
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1,•:•414 53W 111.1 1. VTFW I T. 8-4R
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AREA COCE - `
NUMBEq EXTEN9rpN` N"
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CAME To so vdu
l WILL CALL AMOY
WANTS Td BEE YOU AU --
RETURNEp YdUH CALL
SPECIAL ATTENTIdN
MESSAGE-Ud � g
SIGNED
L O F CE A DUCT roPS3002-S
and printers, Inc.
228-2395
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