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14188 SW MISTLETOE DRIVE NAIHU 301371SIW MS PPT'•T 1 W H ce G W O H W a H U) H ` r 3 0 I OD I 14188 SW MISTLETOE DR Page No. 1 CASH HISTORY FOR CABG No.: V11497—i2i9 WINDWOOD HOMES 14198 SW MIST:ATOR DR 0.:/17/9/ Action Description Req/ achd/ Bred/ Action Notes Diep By update W4 Code Sent Dana Dona Date W? ------- ------'----------------------- -------- -------- ----- -- -------------------------------------- ---- --- -------- --- PIMA003 Application received / / / / 07/09/97 VBCD B 07/09/97 JON PIMAOOS Create Permit / / / / 07/09/97 PASS B 07/09/97 WN PIMA050 (F) Issue permit / / / / 07/17/97 PAGE B 07/17/97 SKM PIMM7S0 RP/Backflow Preventer 07/09/97 / / 02/24/99 PASS RB 02/75/99 RD P[MA799 Final Inspection / / / / 02/24/99 PASS RD 02/25/99 RB PIMA900 Case Finaled / / / / 03/23/99 03/23/99 JT d R ,r. V 14 Page No. 4 CAGY HISTORY FOR CABS NO.: MST96-0540 NINDNOOD HOMYB 14198 BN MIRTUMOY DR 06/17/99 Action Description Req/ 9chd/ End/ Action Notes Disp By Update Upd Code Yav+t Dane Dane Data By ----—- ------------------------------ -------- -------- -------- ----------------------------- ---- ---- --- --------- --- MOTA799 Building Final / / / / 09/23/97 1. Gas line not connected at cook top. FAIL EA 09/25/97 J*H 2. Real joints at firebox if applicable, provide installation manual. 3. Beal/i;sulate door jamb at upper storage. 4. Provide insulation shield at b-vent storage area. S. Insulate return air supply (others). 6. Real joint behind fnmace at ceiling. 7. support gas piping at furnace and rater boater. e. Vertical spacing not to exceed four inches. 9. Return handrails to post at garage, also at front entry. 10. Ritchen cook tap not vented. 11. Heat ducts disconnected also needs support. 12. Support under floor insulation (voids). 13. Support gas piping. 14. Recover vapor barrier no needed. 15. Remove wood debris at crawl. CALL FOR RRINRFRCTION, MECHANTCAL & BLDG FINAL CORRECTIONS ABOVE. MBTA799 Building Final / / / / 12/16/97 see mach final this date FAIL RB 12/16/97 J*H MSTA799 Building Final 02/25/98 / / 02/23/99 Can't find plumb/elect final approvals. FAIL RV 02/25/98 J•H MSTA799 Building Final / / ( / 02/25/98 el.ec FAIL RC 02/25/99 ROC Q not approved NMSTA799 Auilding Final / / / / 02/26/99 PASS RC 02/26/99 J'H MSTA960 (F) Issue Cert. of Occupancy / / / / 03/25/9R MATLSD 6/12/99 MAIL VN 06/12/99 Viii V W J Page No. 3 CASE HISTORY FOR 009 110.: N"PS-0540 MINDMOOD h..AES 14166 SM MISTLWPOa Da 06/17/96 Action Description Req/ achd/ End/ Action MOtee Disp Vy Vpdato VPA Code Sent Dene Done Oath/ my '------ ------------------ -------- -------- -------- -------------------------------------- .... ... ........ ... MSTA790 Electrical Final / / / / 09/1.2/97 Chip tile at countertop recept. to allow FAIL DRP 09/16/97 J•H plate to fit flat on wall,ART360-9. Recpt. in livinq roam needs boat extender, ART370-20. Reept. at desk in kitchen not contacting wall surface. Plate does not cover opening - 410-56(s). Plate an island recpt, not flat on surface, ART410-56(e). Jet tub motor,, w^cesa7 MOTA'790 Electrical Final 02/25/96 / / 02/26/96 PASS BRP 02/26/96 A•P MSTA790 Electrical Final. / / , / 02/25/.96 Previous correc_ticn• have not been done. FAIL ARP 02/25/96 J•H PWA790 Electrical Final / / / / 03/06/96 Panel signed. PASS UP 03/09/96 J*H M9TA795 Mechanical Final / / / / 09/23/97 SEE BLDG FINAL THIS DATE. FAIL KS 09/75/97 J*H MSTA795 Mechanical Final / / / / 12/15/97 Mechanical i Bldg Final notes: FAIL KS 12/16/97 J*H 1. Insulate (void) at header and around jamb at upper storage. 2. Support under floor insulation at heat duc* (booRa). :1. Heat ducts (disconnected at crawl. 4. Kitchen range not vented to exterior. 5. Recover vapor barrier as needed. Also remove wood/debris at crawl. S. Vertical spacing at guardrail (garage) not to exceed four inches oc. Also handrails/guardrail need to and is newer post or return to wall. section 315.1 CARO CODE. I MSTA795 Mechanical Final 02/25/99 / / 0:;/24/96 PASS RC 02/25/96 ROC U) MSTA797 Plumb Final / j / / 02/24/911 PMTMa- GROUT CRACKM- CAULK AS NRW3= PASS RH 02/25/96 RA AT JACUZZI. W J Page No. 2 CABS HISTORY MR CABS NO.: MST96-1,1.40 MINDNOOD 1100SS 14188 SN MISTLYTOB DR 06/17/9• Action Description Req/ Schd/ Rnd/ Action Notes Disp By Update upd Code Sent Done Done Data By ------- ------------------------------ -------- -------- -------- --------------------------------------- ----- --- -------- --- MBTA720 Mechanical Insp / / / / C2/25/90 fireplace to be installed at a later FAIL RC 02/25/90 ROC date MSTA722 Plumb Top Out / / / / 04/03/97 PASS MS 04/04/97 MRS MATA723 Electrical Service / / / / 04/23/97 APP GB 04/23/97 ans M9TA724 RI.otrical Rough In / / / / 04/23/97 APF GA 04/23/97 OHS MSTA72S Framing Insp / / / / 04/24/97 such issues; 2x10 in garajw- averspwm-id FAIL RB 04/23/97 RB for floor joists; collar tie garage fwd gable; fam. rm.- ceiling /floor joists- overspanned....if doorway-floor jrists over spanned---if access cl ,ing-ceiling joists-ok; 27;g railing joist aver-spanned- upstairs bedrm; 4'skylight framing needs to be doubledl strap plate at master bedrm. MSTA72S Framing Insp / / / / 04/25/97 mach issues; arnrer-spanned floor joists FAIL RB 04/20/97 RB MSTA725 Framing Insp / / / / 04/30/97 mach issues FUND RB 04/30/97 RB MRIA725 Framing Insp / / / / 02/25/95 PASS RC 02/2S/90 ROC NST4725 Shear Mall Insp / / / / 03/21/97 pending- drywall shear PASS RD 03/21/97 RB MST,727 Low Voltage / / / / 04/23/97 l,Vr_A Qq 04/23/97 GRS MSTA73S Gas Line Insp / / / / 04/22/97 gas pressure dropped. FAIL. RB 04/22/91 RA MSTA735 Gas Line Insp / / / / 04/24/97 PASS FM 14/2S/97 RB MSTA740 Insulation Insp / / / / 04/30/97 mach issues; batt master bedrm i fwd FAIL RB 04/3'197 RB hedrm gable ceilinga; Insulate drop ceiling at master bedrm east wall 4 aft bedrm west wall; drop corner insulation dorm to warn side; firestop all thru penetrat i one. H N MSTA740 Insulation Insp / / / / OS/01/97 PASS RB 05/01/97 RD MSTA745 Gyp Board Insp / / / / 05/06/97 PASS Al. 05/00/97 RAA ..� MSTA755 Rain drain Insp / / / / 02/13/97 PASS MS 02/14/97 Mn m MSTA760 Water Line Insp / / / / 02/13/97 PAPS MS 02/14/97 MB MBTA765 Appr/Sdwlk IneF / / / / 09/23/97 PASS MH 09/24/97 f*N Uj J MSTA770 Miec. Inspection / / / / 07/1S/97 need access to house PAIL RAR 07/10/97 :AFI MSTA770 Misc. Inspection 07/20/97 / / 07/17/97 shower pan approved PASS MS 07/20/97 J*H r Page No. 1 CASH HISTORY FOR CABS NO.: PST96-0540 NINDNOOi) HOPffiS 14198 SW MISTL MN DR 06/37/9• Action Description Req/ echd/ End/ Action Notes Disp By Update Upd Cade Sent Dene Done Date By ML5TA005 Applicati�- +ceived / / / / 11/26/96 PASS DOW 12/03/96 JD MSTA000 Permit Created ! / / / 12/03/96 PASS JSD 12/03/96 JD MSTA010 Check for prel. restrict. / / / / 1.2/03/96 PASS JSD 12/03/96 JD MSTA012 Plans routed to Plans Examiner / / / ! 12/03/96 PABA JSD 12/03/96 JD M.9TA026 Plans approved by Plans Exetr / / % / 12/04/96 PASS RT 12/04/95 BT2 MSTA030 Reviewed plans roasted to PSTS / / / / 12/09/96 PASS RT 12/10/96 PITH MSTA090 (P) Ready to issue / % / / 1:/10/96 PASS ARA 12/10/96 PHN MOTA092 (F) Issue combination permit / / / / 01/09/97 PASS JSD 01/09/97 JD MSTA095 Issue plumbing signature fora / / / / 01/17/97 RRCD JM'r 01/17/97 JT MSTA097 Issue electric signature form / / / / 01/31/97 "CD JSD 04/01/99 JT MBTA'105 Footing Insp / / / / 01/22/97 special inspection needed- unstable FAIL RB 01/23/97 RB fill. use 1-9-97 MSTA705 Footing Insp / / / / 01/23/97 received into record Carlson Testing PASS RB 01/23/97 HAB Report MOTA706 Foundation Insp / / / 02/06/97 pending- vent in front wall....along the PASS RB 02/07/97 RB front porch. MSTA710 Post/Beam Structural / / / / 02/19/97 no plans on site PAIL AS 02/19/97 BB MOTA710 Post/Beam Structural / / / / 02/20/97 posting missed; girders missed; header FAIL RB 02/20/97 RB needed behind furnace; gusset posting- plumbing nail plates NSTA710 Post/Beam Structural / / / / 82/24/97 PASS RB 02/24/97 RB NSTA711 Post/Beam Mechanical / / / / 02/19/97 PASS RB 02/20/97 RB MSTA711 Post/Beam Mechanical / / / / 02/20/97 PA98 RB 02/20/97 RB MOTA713 Crawl Drain / / / / 02/13/97 PASA MS 02/14/97 MRS MSTA717 PLM/Underfloor / / / / 02/19/97 PASS M8 02/19/97 MRS IL MSTA720 Mechanical Insp / / / / 04/22/97 gas line test failed; soffit ductwork in FAIL RB 04/22/97 RB garage; exhaust venting disconnected; seal thru penetrations w/in return air plenum; in.eulate/flame spread fireplace cavities; insulate wyes of flex duct w/in attic. crimp ends of rectangular duct MSTA720 Mechanical Insp / / / / 04/24/97 incompleted FAIL RB 04/25/97 RB MSTA720 Mechanical Insp / / / / 04/20/97 to be completed at insulation FAIL RB 04/29/97 RB MSTA720 Mechanical Insp / / / / 04/30/97 pending- return air seal; flame spread PRM RB 04/30/97 RB fireplace cavities CITY OF TIGARD 46 DEVELOPMENT SERVICES MUM 13125 SW Hall Blvd.,Tlgard,OR 97223 (50,9)839171 CERTIFICATE OF OCCUPANCY PERMIT 11. . . . . . . a MST96-0540 DATE ISSUf`Da 0+3/2"5/98 r3TTE ADDRESS. . . ; 14168 SW MISTLETOE DR PARCEL a 29104CC--01400 GUBDIVISION. . . . a HILL.SHIRE: ESTATES NO. 2 ZONINQaR-7 Pr) 81_OCK. . . . . . . . . . a LOT. . . . . . . . . . . . . 111.9 JURISDICTION aT10 -------------- CLF#SS OF WORK. aNEW TYPE OF USE. . . tBF 'TYPE OF CONSTR a 5N OCCUPANCY ORP. aR3 OCCUPANCY LOADa2 fj e m a r k s : Neva SFQ FQTM I fawnera _.__.__.--___-_..---_-___-__-_.._--_--_-- WINDWUOD HOMES 14076 SW BENCHVIEW TERR T IGARD OR 91224 Phone ila 590-4700 Contractors __.------------------------------ WINDWOOD HOMES 1407E SW BENCHVIEW TERRACE (FAX M 590-7606) TIOARD OR 97224 Phone M: 390-4700 Reg #. . : 50196 Thi% Certificate grants oceupakncy of the mbove refe►,enc,ed building or portion thereof and confirms that the bi-iilding has been i.r.;ipeated for compliance with the St Ate of Oregon Specialty Codes for the group, ocCupancyr and usw under• which thy+ referenced permit was isst-ted. a n ; BUILDING INSPECTOR S /INSPECT 91 jPv RI' I )CIR J m POST .N CONSPICUOUS PLACE W J ve CI'T'Y OF TIGARD BUILDING INSPECTION DIVISION 4-Hour Inspection Linc: 639-4175 Business Phone: 639-4171 .. Vt Tete Requested: _ — A.M. P.M. M3T: V Location: 1) — _ 01 IT: Tenant: Suite Bldg: — NEC: Contractor:--- _Phone: PLM Owner: Phone: WG SIT: _ BUILDING BLDG(can't) PLUMBING MECHANICALSITE Site Post/Beam Pod/Beam Pogt/Bemn Cover/'eivicx Sewer/Storm Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Framing Top()ut ('m Line Rough-In UG Sprinkler Foundation Insulation Sewer llmxVDuct Reconnect Vault Bsmt Drunp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm CrawVFound Dr Heat Pump Lew Volt Approved Approved Approved ppxrr' Approvexl -- Appr/Sdwlk Not Approved Not Approval Not Approved eel Not Approved FINAL FINAL FINAL � FIN4L A-1 As /till A 61 .r D ' o � A-_7 � — 4 a-A AmAIJ _ IL Xw rn m W J O Call for reinspection O Reinspection fec of S— —_requited before next inspection C)I.Triable to inspect Inspector: Date:_� .� — Page__---of -- CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW HSI!Blvd.,Tiyrrd,OR 97223 (503)M4RESTRICTED ENERGY PERMIT 141 f=LR9P-0070 DATE ISSUED: 03/09/9P PnRCEL_: 2S 104CC-01400 SITE" ADDRESS. . . : 14188 S1tI MISTI_.ETOF- DR SU13DIVISION. . . . :HILLSHIRE ESTATES NO. 2 7ONINGaR-7 PD PLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 11.9 JURTSDICTN: TIG r'ro,ject Desc�ri pt i an: Installing burglar alae Ai.ID I n & r)TFRFn. . . : At In T 0 R STF Rf Q. . : I NTF ROOM & PPG T NG. . : BURGLAR ALARM. . . . : X BOILER I..ANDSCAPE/T RR T rAT. - • anpnQE OPENER. . . . : CLnCK. . . . . . . . . . . .I MEDICAL. . . . . . . . . . . . : 14VAC. . . . . . . . . . . . . . DOTA/TELE' r.OMM. . . NURSE CALLS. . . . . . . . .. VACUUM gYC;TFM. .. . . : F T RF ALnRM. . . . . . : OUTDOOR LANDSC LITE! OTHER: c : HVAC. . . . . . . . . . . . : PROTECTIVE S10NAL_. .. INSTRUMENTATION. : OTHER— : . : . . TOTAI.. # Or SY STEMS: 0 Clwner: _____.___...___._.__.________..______._.____..______....____..____._ FEES MARK IRBY type amol_int by dat0 recpt 141fit3 EDW MISTI._FTOE. DR PPMT t 40. 00 8 03/09/'98 98--3039;'9 TTGARD OR 97224 5;7,r T ! P. 00 A 03/09/98 98-303339 Phone #: AL ITEC: Tr.r.LIR T TY $ 42. 00 TnTAt PO Sny rrl t R ------ REn,(.II RFD I NSF,EC T I ON5 PORTLAND OR 97;38 5310 Ceiling Cover Low Voltage Insp Phune 0 : 3,31--2.F,20 Wall Cover El err-' 1 Rei; #. . : 001188 This posit is issued subject to the regulations contained in the Tigard Municipal Coder State of Ore. Specialty Codes and all other applicable lAws. All work will be done in accordanre with approved ;,lays. This pereit will expire if Murk is not started within IN lays of issuance, or if work i5 susnended for wore than 190 days. ATTENTION: Oregon law regeires vnu to follow rule adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-M-0010 through !X14 You Nay obtain copies of these rules or d*fct ques'.' r; to WC at (5031216-1987. L ,5r.Ipc1 M; ----- FnrmittAe $f cln,-rturn vl s.. l _' . - —OWNCR INSTAL L PT ION 'he installation is being made on pr--open-ty I own which is not intended for 1 ea r, or rant_ _ _ dN^R+ S r,IfWnTIIRE: DATE-• INSTP1.1 n'TT'lf\' nNt."Ui •. C7 � T rNnTUPE OF CUPR. ELEC+ N: �1'r DATE: 1 T C N!7r NO t +++++++++++++++++++•f•f++++++++F++4-+++++•+-++i++..+f.F+•{ }.4-++++++++++-f 4-++,+ Call E-39 -417"5 by 7:00+ P. M, for- an inspection needed the next blasiness day '-+•++•++++++++++•F++++4•++++++++.+++++++++++++++•f++++++++++++++++-r+++++++++ + 1 r•, ., Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION e 13125 SW Hall Blvd. PERMIT# Tigard, OR 97223 --- Phone(503)639-4171 DATE ISSUED FAX(503)684-7297 - TDD No. (503)684-2772 CITY OF TIGARD Inspection (503)639-4175 ISSUED BY PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK I q/ __,5 W .s�I e ri ve__ A ssRESIDENTIAL—Restricted Energy Fee . • S9tLQIl � '?2 y (FOR ALL SYSTEMS) City �( State Zip 0Ijw L Type of Work ImLad' PERMITS ARE NON TRANSTERAME AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems IS NOT STARTLD WITHIN 180 DM'S OT ISSUANCE OR IF WORK IS SUSPENDED FCIR Er Burglar Alarm 180 PAYS. ❑ Garage Door Opener' 2. CONTRACTOR APPLICATION ❑ Heating,Ventilation and Air Conditioning System' Contractor All Lec S eC tl KJI Type__—. ❑ Vacuum Syste:ns' ❑ Other Address PO Dox 55310 =Portland. 0R .L7Qa-1UQ Date �bj _ — COMMERCIAL—Fee for each system . . . . . . . . . 1L44.f1S1 (SEE OAR 91 q-260.260) Propert) Owner Watt._._ J�k�' —- - QjukIype of Work Involved.; Contractor's Board Reg. No. 118839 ❑ Audio and Stereo Systems ❑ Boiler Contrnls Phone # 331-2620 ❑ Clock Systems ❑ Data Telecommunication installations 3. OWNER APPLICATION ❑ Fire Alarm Installation _ ❑ MVAC Print Owner's Name Phone No ❑ Instrumentation ❑ Intercom and Paging Systems Address ❑ Landscape Irrigation Control' _------State Zip ❑ Medical Clly ❑ Hurse Calls This permit is issurd under OAR 918-120.370.This applicant agrees to make only (� Outdoor landscape Lighting' restricted energy installations(too volt amps or less)under this permit and to do the following: ❑ Protective Signaling IL 1. Only use electrical licensed persons to do installations where required.(Certain ElOther ------- IL residt- -al and other transactions are exempt from licensing.They.have asterisks(').All others need licensing). U) 2. Call for an inspection when all of the installations under this permit are ready for Inspection at 503.639.4175. ❑ Number of Systems 3. Purchase separate permits for all installations that are not ready for inspection ,Vo lirenxs are required. licenses are required for ell other installations. J when the inspector is out 10 inspect under this permit. — m 4. Assume responsibility for assuring that all corrections re auired by the inspector -- —-- -- 0 are done,and J5. Assume responsibility for(ailing for a final inspection when all of the 5. FEES corrections are completed. /IO �1 The person signing for this t .the applicant or a person a. Enter Fees $v L V authorized to bind fi t L�rt)ff) b. 5%Surcharge(.05 x focal above) $ Signature TOTAL_ Authority if other than Applicant fNTRGAP.CHP CITY CF TIGARD MASTER PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . . MST96-0540 13125 S W HSH Blvd., Tlgsrd,OR 97223 (5W)6394171 DATE ISSUED: 01 /09/97 PARCEL: 2S104CC-0.'2400 S T TF' ADDRE ISS. . . : 14188 SW MISTLETOE DR S1;BD T J I S T 0N. . . . : H I LLSH I RE ESTATES NO. 2 ZONING: R-7 PA HLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 119 Remarks: New SFD PATH I ------_-- --- ---- --------�—______ — BUILDING ----------------------- --------- REISSUE: STORIES.......: 2 FLOUP AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACR5---- REQUIRED--- -- CLASS OF WORK.:NEW HEIGHT........: 25 FIRST....: 1280 sf GAMGE...... ?00 sf LEFT..........: 6 SMOKE DETECTRS: Y TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 1339 sf FRONT.........: 28 PARKING SPACES: 1 TYPE OF CONST.-5N DWELLING UNITS: I FINBSMENT: 0 sf RIGHT.........: 5 OCCUPANCY GRP.:R3 BDRM: 5 BATH: 3 TOTAL------: 2539 sf VALUE..f: 10649 REAR..........: 08 SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 8 TRAPS.........: 8 LAVATORIES....: 5 DISHWASHERS...: 1 FLOOR DRAINS..: 8 SEWER LINE ft; 8 SF RAIN DRAINS: 1 CATCH BASINS..: 0 Tl1P/SHOWERS...: 3 GARBAGE DISP..: 1 WATER HEATERS.: I WATER LINE ft: 180 BCKFL.W PREM r. I GREASE TRAPS..: 0 OTHER F1XTLNF9.- 6 ----—-----—-------------------------------------------------- MECHANICAL. ---------------- FLEL TYPES---------- FURN ( 108K .,; 8 BOIL/CMP ( 3HP: 6 VENT FANS.....: 4 CLOTHES DRYERS: 1 /GAS/ / / FURN )=180K .,: 1 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: 1 MAX INP.: 0 BTU FLOOR FURNACES: 8 VENTS.........: 0 WOODSTOVES....: 0 BAS OUTLETS...: 1 -------------------------------------------------------------- ELECTRICAL -_------------------------------------------------------------ —RESIDENTIAL LIMIT-- ----SERVICE/FEEDER----- --TEMP SRVC/FEEDERS--• ---BRANCH CIRCUITS---- --MISCELLANEOUS---- --ADD'L INSPE07IONS-- 1000 SF OR LFSS: 1 0 - 2200 amp..: 0 0 -- ;.Wasp..: 0 W/5VC OR FDP,..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 8 EA ADD'L 508SF.: 5 201 - 400 amp..: 0 201 480 asp..: 0 Iit W/0 SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER Ham......: 8 LIMITED ENERGY.: 0 401 - 600 amp..: 8 401 - 1.00 amp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0 MANE HM/SVC/FDR: 0 601 - 1008 asp.: 0 601+amps-1808 v: 0 MINOR L.ABE1 -18r 0 1800+ amp/volt.: 0 ----------------------------------- Pl_AN REVIEW SECTION ---------------------------------- Reconnect only.: 0 )=4 RES UNITS..: 9VC/FDR)=225 A.: ) 600 V NOMINAL: CLS AhEA/SPC OCC: ------------------- ELECTRICAL - RFSTRICTED ENERGY -------------_.._M ----_-----.---_--- A. SF RESIDENTIAL——— B. COMMERCIAL------------------------------- ---- - - ---- ------------- ---- AUDIO 4 STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OIJTDODR LNDSC IT: BURGLAR ALARM..: 0TH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK..........: 'NSTRU£NTATION: MEDICAL........: OTHR: HVAC............ DATA/TELE COMM.: NURSE CALLS....: TOTAL R SYSTEMS: 8 Owner : - -- ---- ------------------------rantractor- ------------------------------- TOTAL FEES:$ 4662.20 WiNDWOOD HOMES WINDWOOD HCLMES 14076 SW BENCHVIEW TERR 14076 SW SENCHVIEW TERRACE 4 TIGPRD OR 97224 TIGARD OR 97224 Phone A: 590-4700 Phone A: 590-4700 N Reg C.: 050196 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Dre. Specialty Codes and all other m applicable laws. All work will be done in accordance with approved plans. This permit will expire if worN is not started within 108 days of issuance, or if work is suspended for more than 108 days. LU J - --------------- REQUIRED INSPECTIONS Footing Insp PLN/Underfloor Framing Insp Gas Fireplace Water Service In Building Final Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp Post/Beam 5truct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final Post/Beam Meehan Electrical Servi Fireplace Insp Rain drain Insp Me^hanical Final _.- Crawl Drain Electrical Rough Gas Line Insp Water Line Insp Plumb Ft PPr,mi.i-tee Siynatur,F!: Call far in pection 639--4175 CITY OF T SEWER CONNECTION DEVELOPMENT SERVICES PERMIT PERMIT #. . . . . . . : SWR96-0551 AILISM 13125 SW Hall Blvd.,Tigard,OR 57223 (50,.9)6*4171 DATE ISSUED c 01/09/97 PARCEL: 2S104CC-01400 SITE ADDRESS. . . : 14188 SW MISTLETOE DR SUBDIVISION. . . . : HILLSHIRE ESTATES NO. 2 ZONING: R-7 PD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 119 ---------------------------------------------------------------------------------- TENANT NAME. . . . . :WINDWOOD HOMES USA NO. . . . . . . . . . : FIXTURE UNITS. . . s 0 CLASS OF WORK. . . c NEW ►rriw.r sl w+ur hx,- DWELLING UNITS. . : 1 T1 PE OF USE. . . . . :SF NO. OF BUILDINGS e 1 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE_: 0 sf Remarks: New SFD ------- -----------—----- WINDWOOD HOMES type amount by date recpt 14076 SW BENCHVIEW TERR PRMT f 2200. 00 JSD 01/09/97 97-268713 INSP $ 35. 00 JSD 151/09/97 97--2-88713 T I GA =D OP 97224 Phone #: 590-4700 Contractor: ----------------.------------_ CONTRACTOR NOT ON FILE ------------------------------------- Phone #: f 2235. 00 TOTAL Reg #. . : yvsa.+�rwys —------ REQU I RED I NSPECT I ONS ------- This Applicant agrees to comply with all the rules and regulations :w Sewer Inrspect ion of the Unified Sewage Agency. The perait expires 189 days free the d'te issued, The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not lecated at the measurement given, the installer shall prospect 3 feet in all directions frog the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" perr4t and the Agency will install a lateral. f'a r,m i.t t e e S i g n e t�►�e^r -: _ _ —i __ N ` Call for inspection — 639-4175 m W J Plan chock r :TY OF TtGaRD Residential Building Permit Application RecJBr 1125•SW FALL BLVD. New Construction Additions or Alterations oats Recd JL ,GARD,.OR 97223 Single Family Detached/Attached (1 or 2 units) oats to P E X03 :03) 639-4171 Date to UST !A• Print or Type Permit a ST -05 Casted Incomplete or illegible applications will not to accepted Called Name of Project �— Name Job /! t?' Architect Mailing Address Address Sde� dress b e 3 o S �, 1 T'N iJ e CA rState Zip Phone Name wv � I� 0 Co Nvr..c r D , 13 IL q� 72-04 Zzs- lit,(. Name Owner Mailing Address 9 U _ �� N evyx- )k e S w Qc�^.iC N i t rw T��rt.2. En ineer Mailing Address G�tyistate zip Phone g.2 -01 A-Vi 3 I 1 c. Ski l�-A © OS tL ?"ay ' 4 - ?U- AUL' tyN ate Zlp ?hone Nems FV'T-L-10 , y 2 r r -23 oloK b. General Sim c N U ^r t�yt Describe work New$Y Addition O Alteratwn O Repair O Contractor Mailing Address to be done. Type of Use Cdy►Srate Lip Phone SFA . Type of Construction Oregon Const.Cont. Board Lac M Exp Dat _ J / b Attach Copy of St 96 - 9- Occupancy Class Current COT Business Tax or Metro a Exp,Date - Licenses ?b q wM it be spnnklered? Yof L! Name If Yes.separate FLS plans and .Mechanical LOVA J(.-tro J+,`,A-t1 N application to be submitted Number of Stones Sub_ Mailing Address a Contractor (o`i 1 d St= t f T)' Proposed Use CitylState Zip P one P-FL 0 , 3 .O 4-U 1 I. Previous Use Oregon Const.Cont. Board Lac to Exp. D to ------ --- Attach copy or - 2s �+ Valuation $ 93 S�, �.-- Current COT Business Tax or Metro a Ex Date ---a- Licenses ski._ -7 • z-� S�� 4�. NEW CONST' 'f)N ONLY: Name Building ID S. Plumbing -a t yr t S Lk r>.d o tib* l — Unit Types `square rt. r or units Sub_ Mailing Address _ Contractor tS- Q. 8cx r(oo B ) �M 3 C.ty/State Zip Phone _ NLr OIL 9�0 Ia`(9--Gtv3Y. C.) Oregon Const Cont. Board Lic s Exp. 0e D ) Attach Copy of t 21 2 it Weill the etectr>Cal subcon[•actor wire for all restricted Yes NO Current Plumomg Lic.aX Ex .Dat ? IL Licenses 3 y__ �B / 31 9 ane ostallsitions Has the SuMivrsion Plat recorded? N/A Yes. Na COT Business Tax or Metro tt ExD to N .�b � I hereby acknowledge that I have read this application that the Name information given is correct.that I am the owner or authorized agent of Cr Electrical fvN-1 1-1,c D CLU; (-,fl (C the owner, and that plans submitted are in compliance with Oregon d State laws. m Sub_ Mailing Address ' Q Signrtu O h� Contractor ��� S��I L A N H A n 1 JC,tyiStste Zip Phone Co non Rome Phone )Lr'"-0 , rT Z i 3 f. 3 - s r 3 3. = 2 L c l+AV?--0 S K '70 --,-1 Oregon Const.Cont. Board Lie.# I Ex D to FOR FICE USE ONLY: attach Copy of -?--? 4`t -;- 3 } Current Elecsncal Lac.# Exp. Date Mlsn�RCtCM �I Licenses I r q� Zone c, COT Business Tax or Metro s Eate Engin"firq vol tanning TIF `l b S r v I x 3 . q -e ra K( L 0r3 P.�Iptoval itstresacp doc t P rmi # Account Descrigtign 6MgWpj Amt_ Pd. Bal.Due ' /►a5'►9� NIST Permit (BUILD) 64 3 40 6-4 Plumb. Permit (PLUMB) ?25. Nlech. Permit (MECH) _ f�:- , .q S, ELC/ELR Permit (ELPZMT) 2 7S, _ 2 7� tate Tax (TAX) ,��4� � Sy", V0 � Bldg: .3-l•LS umb: Me 3,Z� ELVEL 13. Plan Check MST: (BUPPLN) q/ - X7. Plumb: (PLMPLN) Mech: (MECPLN) CDC Review - planning CDCPLN) �--- CDC Review - bldg (C BLC, — IV r �.. Sewer Connection (SVWS .4;zl&0 Sewer Inspection (SWINSP) :3 Parks Dev Charge (PKSDC) /d Residential TIF (TIF-R) 1570 /S-o Mass Transit TIF (TIF-MT) a. Water Quality (WOUAL) oc N U) Water Quantity (WOUANT) -' Erosion Control Permit (ERPRMT) 1 �— m W Erosion Planck/USA (ERPLAN) _ ��,� _ e�•�t! t Erosion Planck/COT (EROSN) a7ir• __ moi• Fire Life -,ety (FLS) TOTALS: �eZ 25cUl,t�► i dsts%resapp doc rev. 10/48 � 1 1� •- Solar Balance Point Standard Worksheet Address Box A calculations: North-South dimension for the lot. Box A.- This :This dimension is determined by finding the midpoint of the North lot line and drawing an intersecting line perpendicular to that point. First, determine which property line is the North lot line. The North lot line is the line with the smallest angle from a line drawn east-west and interjecting the northern most point of the lot. 4V-+ t � North-South Dimension for lot: Measure the distance from the midpoint of the North lot line to the South lot line along the described line. ��feet t N EF 40 M tMlMon Box B calculations: Shade point height for your residence. Box B: 1. Determine whether measurements will be based on the peak or save of your Which describes stnx=re. The e-i ation of the ridge is Aso important. your residence? 1a: If the roof lin( .ms North-South, measurements will .... 5 AVI.- (erode one) be based on the peak of the roof. T55-5-5-57 W 1A is H1 b: If the roof line runs East-West and the roof pitch is less than 5/12, measurements will be based on the eave. 3 w J 1c: If the roof line runs East-West and the roof pitch is 3/12 or steeper, measurements will be based on the peak. Box B. continued Box B; 2. Measure change in elevation from front property line to finished floor elevation. If the lot slopes up from the front lot line to the foundation, the figure is positive. If �3 ft the lot slopes down from the front lot line to the foundation, the figure is negative. 3. Measure distance from finished floor elevation to the affected peakleave. + .._ n It 4. If the roof line runs North-South,deduct three feet. If the roof line runs East-West, -- -- It deduct nothing. 5. Subtra , one foot for each foot of difference in elevation from the front property line to the rear property fine, if the lot slopes up from the front to the rear. If the lot has no slope or slopes up from the rear to the front,deduct nothing. G 6. Total figure for box B: 2 It Brox C Distance to the shade reduction line. Box C: 1. Measure the distance from the North property line to the foundation near the 32 R affected peak/eave. 2. Measure the distance from the foundation to the affected peak or eave. + 310` R 3. Total figure for box C: (10 ft It is nitst unful m draw a venial line to mWesent dw appropriate App a formol in bac•l1'and a' n lan line to repo the aptmpriate Rpm found in box'C'.The intersecdon of the verdcal and Irorittorcd Rums determines the value focard in bat*W.The value in box')'should be compared to the value in boot W;if die value In bac'8'is less dean or equal oo the value found In boa'O',then the buildin6 is in compliance with the solar balance aode. If you have any quesiav,please aontaa us at 639-4171,x304 or at the Community Oevelopmecrt Counter. MAMMUM PERMITTED SHADE POINT HEIGHT a Fes! MOW*to North-south lot dlncenston on feed shade 100+ 95 90 8S 80 7s 70 65 60 SS SO 45 40 Bne from nardwirn Int tine rte fKt1 70 40 40 40 41 42 43 44 63 38 36 38 39 40 41 42 43 60 (-oG 36 36 37 38 39 40 41 42 s3 34 34 34 35 36 37 38 39 40 41 s0 32 32 32 33 34 35 36 37 38 39 40 R 4S 30 30 30 31 32 33 34 35 36 37 38 39 f. 40 28 28 28 29 30 31 32 33 34 33 36 37 36 W 35 26 26 26 27 28 29 30 31 32 33 34 3s 36 30 24 24 24 25 26 27 28 29 30 31 32 33 34 25 22 22 22 23 24 2S 26 27 28 29 30 31 32 t7 20 20 20 20 21 22 23 24 25 26 27 28 I9 30 J 15 18 18 18 19 20 21 22 23 24 2S 26 27 28 10 16 16 16 17 18 19 20 21 22 23 24 2S 26 S 14 14 14 IS 16 17 18 19 20 21 22 23 24 Box D. Maximum allowed shade point height: 3(► feet W ' lsotn.chp Revised:12696 c5HrcA h:slarhr 1!' _Lon icy /2-7 60 fi[ 1�r�ycc N �. q)(f 7:40 Alm C 1 r 1� 7 1 o--,o A li `.. - All CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT 18125 SW Holt Md.,11pi1ld,OR 97223 (503)69lZ4 171 PERMIT #. . . . . . . : PLM97-0268 y DATE ISSUED: 07/17/97 SITE ADDRESS. . . : 14188 SW MISTLETOE DR PARCEL: 2S104CC-01400 SUBDIVISION. . . . : HILLSHIRE ESTATES NO. 2 ZONING: R-7 PO BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 119 JURISDICTION: TIG -------------------------------•------------------------------------------------ CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1 OCCUPANCY GRP. . aR3 FLOOR DRAINS. . . . . . ., 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . 1 0 CATCH BASINS. . . . . . . : 0 FIXTURES------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . ., 0 SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . ., 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . ., 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . a 0 WATER CLOSETS. : 0 WATER LINE (ft) . . . s 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . . : 0 Remarks ., Installing residential backflow prevention device Owner: ---------------------------------------•------------ FEES -------------- WINDWOOD HOMES type amount by date recpt 14076 SW BENCHVIEW TERR PRMT f 15. 00 B 07/09/97 97-296910 TIGARD OR 97224 SPCT f 0. 75 B 07/09/97 97-296910 Phone #: Contractor--------------------------------- CEDAR LANDSCAPE 14375 SW PATRICIA AVE ))I1-LSBORO OR 97123 -_.---------------------------------- Phone #: 503-628-3411 1 15. 75 TOTAL Reg #. . : 000058 ------- REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the RP/Backflow Prey 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 188 days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow rules _ adopted by the Oregon Utility Notification Center. Those rules arq set forth in OAR 952-8881. 818 through OAR 952- 88 -M. You may obtain copies of these rules or direct questions to OUNC by calling (583)246-1987. '— Issued By: 1J_ ''� Permittep Signature :_ 04 / ++++++++++++....4-++++++4.....+++++t++++.+++++++.........++++t++t++++4.....+++++ Call 639-4175 by 6:00 p. m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++4+++++i•+++++++++++++.....+t+++t......4t+++t++ City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 13125 SW Hall Blvd. Permit # RMI - Tigard, OR 97223 {503) 639-4171 MINIMUM $25.00 PERMIT FEE+ ST. SURCHARGE rVir/s AREr,4;V_5 New Single Family Reelter>caa Only ""••• ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00 Job /.f/B me ow, ❑3 BATH HOUSE$225.00 Address 0"" Zb Fee Includes aq plumbing fixtures in the dwelling and the first 100 feet r1AAD of water service, sanitary sewer end storm sewer. See fees below. "'"'+'""""'•"""� FIXTURES CITY PRICE AMT Sink 9.00 UMbv Aa••• ^'•^• Lavatory 9.00 Owner Tub or Tub/Shower Comb. 9.00 cowsh" rp Shower Only 9.00 Water closet 9.00 "."N„"MM«ow"", Dishwasher 9.00 Occupant Garbage Disposal 9.00 ma"Adit" Phu" Wishing Machine 9.00 Floor Drain 9.00 �""'• Zb Water Hester 9.00 Laundry Room Tray 9.00 "'^• Urinal 9.00 CEDgR 44AIAPSc E xiuL'. Other Fixtures (Specify) 9.00 °#&q"°"" ph" 9.00 Contractor /9375 SW PMXr 64 19vE X,9 ill 9.00 cows"' �,e Zb 9.00 //i11SA44o GIr. 97/.,?3 Sewer 1st 100' 30.00 s"•"•9et•tl01"• co►".To"' Sewer-ea. Addit. 100' 25.00 584-3 Water Service lot 100' 30.00 1 hereby acknowledge that I have read this application, that the Water Service ea. Addfl. 200' 25.00 information given is correct, that I am the owner or authorized agent of the owner, that plans submitted are In compliance with State laws, that Storm&Rain Drain lot 100' 30.00 1 am registered with the Construction Contractor's Board, that the Storm b Rain Drain Addit. 100' 25.00 number given is correct. (If exempt from State registration, please give reason below.) Mobile Home Space 25.00 d Baric Flow Prevention 7- ! -97 Deice or Anti-Pollution Device 9.00 °�•"•• °•^�° •M"� c"• Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new addition 0 afleraGon 0 repair 0 Catch Basin 9.00 to be done residential 0 non-residential 0 Insp. of Exist. Plumbing 40.001hr 4. Specially Requested Inspections 40.001hr Existing use o/ Rain Drain, single family dwelling 30.00 F•, building or property Residential backflow prevention devices 15.00 Proposed use of J building or property m '(Except residential backflow prevention devices) W J NOTICE *Minimum Fee$25.00 SUBTOTAL �SJ PERMITS BECOME VOID IF WORK OR CONSTRUCTION 7� AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 6%SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - -FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PLAN REVIEW 25% OF SUBTOTAL TOTAL Special Conditions Date Issued by CITY OF TIGARD DEVELOPMENT SERVICES 19126 SWHSUBlvd.,Tiped,OR97223 (609)OX4111 ELECTRICAL PERMIT - RESTRICTED ENERGY PERMIT #: ELR97-0190 DATE ISSUED: 07/17/97 PARCEL: 2SI04CC-01400 SITE ADDRESS. . . : 14188 SW MISTLETOE DR SUBDIVISION. . . . :HILLSHIRE ESTATES NO. 2 ZONINGsR-7 PD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . : 119 JURISDICTN: TIG Pro j ect Descr i pt i un s Installing residential backflow prevention device ---------------------------------------------- ---------------------------------- A. RESIDENTIAL--------- B. COMMERCIAL-------------------------------------- AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . : GARAGEOPENER. . . . : CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . : HVAC. . . . . . . . . . . . . .. DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: IRRIGATION: :X HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : INSTRUMENTATION. : OTHER. . : : : TOTAL # OF SYSTEMS: 0 Owner: ----------------------------------------------------- FEES ---------------- WINDWOOD HOMES t-7-pe amount by date recpt 14076 SW BENCHVIEW TERR PRMT ! 40. 00 n 07/09/97 97-2296910 TIGARD OR 97224 5PCT f 2. 00 B 07/09/97 97-296910 Phone #: 590-4700 Contractor,: -------------------------------------------------------------------- CEDAR LANDSCAPE $ 42. 00 TOTAL 14375 SW PATRICIA ------ REQUIRED INSPECTIONS ------- HILLSBORO OR 97123 Elect' 1 Service Phone #: 628-3411 Elect' 1 Final Reg #. . : 000058 This permit is issued subject to the regulations contained in the Tigard Municipal Code, Btate of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance With approved plans. This permit will empire if work is not started Within 181 day; �f issuance, or if work is suspended for @ore than 181 days. ATTENTION: Oregon Is requires you to follow rule adopted by the Oreyon Utility Notification Center. Those rules are set forth in OAR 952-111-111 through OAR 952-"l-1181. You may obtain copies of these rules o- dir-4 questions to OUNC at (5131246-1987. 0� IssUed by ("'�� Permittee Signature. ,_ y _-OWNER INSTALLATION ONLY------------------------------- The installation is being made on property I own which is not intended for J sale, lease, or rent. m OWNER' S SIGNATURE: _ DATE: C9 J --------------------------CONTRACTOR INSTALLATION ONLY---------------------------- SIGNATURE OF SUPR. ELEC' N: DATE: I._I CENSE NO: +++++++++++++++++++++++++++++++++++++++•+++++4+++++++++++++++++++++++4•+++++++++++ Call 639-4175 by 6:00 P. M. for an inspection needed the next business day ++++++++.+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++♦ CITY OF TIGARD Electrical Permit Application Plan check a 13125 SW HALL BLVD. Rec'd By D TIGARD OR 97223 Date Recd Date to P.E. Phone(503)639-4171,x304 Print or Type Date to DST Inspection(503)639-4175 Incomplete or illegible will not be accepted Permit a_ Fax(503)684-7297 Called 1. Job Address: / 4. Complete Fee Schedule Below: Name of Development ��hiRE �.S rif7ES Number of inspections par permit allowed Name(or name of business) Service Included: Items Cost sum Address_ ?8 5W /Ri ST-tETaE' Z;W. 4a. Residential-per unit City/State/Zip �Q'Aw �� 1000 aq.ft.it or lass $110.00 4 Each additional 500 eq.ft.or Commercial❑ Residential IJ Uportion thereof _ $25.00 _, 1 mited Energy $25.00 Each Manuf'd Home or Modular 2a. Contractor Installation only: Dwelling Service or Feeder 189.00 p (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor Ce-iMig 19ND5C t!W Installation,aherallon,or relocation Address /4 37 3 5W rATR/c/A yE. 200 amps or less S80.00 2 T !9 201 amps to 400 amps $90.00 2 City HiW56ago State CW Z!p 4'7/•79 401 amps to 600 amps _ $120.00 2 Phone No. i2,y 34// 801 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Elec.Cont.Lice. No. Exp.Date Reconnect only $50.00 2 OR State CCB Reg. No. _Exp.Date 4c.Temporary Services or Feedere COT Business Tax or Metro No. Exp.Date_ _ Installation,alteration,or relocation l 200 amps or less $50.00 2 Signature of Supr. Elac'n ��tu�_�4 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 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 purchase of service or Print Owners Name- fsedsr he. AddressEach branch circuit $5.00 2 b)The fee for branch circuits City State Zip without purchase of Phone No. service or feeder Me. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature Each pump or Irrigation circle _ $x•00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required): Signal circult(s)or a limited energy- IL nergy d panel,alteration or extension _ 140.00 2 Minor Labels(10) $100.00 Please check appropriate Item and enter fee In section 58. -� 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 t _ System over 600 volts nominal Per Inspection $35.00 J Classifled area or structure containing special occupancy Per hour $55.00 m as described In N.E.C.Chapter 5 In Plant $55.00 J Submit 2 sets of plans with application where any of the above apply. 5• Feels: f7 ma Not required for temporary construction services. 9a.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review d Ijg Id(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« Total balance Dura IADSTSIELC96.APP Rev 9198