Loading...
8840 SW MAPLE COURT pnoo eldoW MS OV88 I t 0 0 L) m a iv 3c cn a� 8840 SW MAPLE CT CITY OF TIGARD BUILDING INSPECTION DIVISION ,�Q�} ���400 61.�- 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 BUP Date Requested�� /► AM BLD v Location � Suite ,1 // MEC Contact Person _ PhIS 0�'2Ja PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall 's ELR Footing ACCess: �\ FPS Foundation l Ftg Drain SGN Crawl Drain Inspection Notes. Slab — SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear gaming _ insulation Drywall Nailing Firewall Fire Sprinkler _ Fire Alarm Susp'd Ceiling _ Roof Misc: Final �v PASS PART FAIL - PLUMBING 42 Post&Beam Under Slab ! '- Top Out Water Service Sanitary Sewer Rain Drains _ Final PASS PART FAIL MECHANICAL ` Post&Beam -- Rough In Gas Line -- - - —� Smoke Dampers Final — PASS PACT FAIL a' Service _ _i— � Rough In N UG/Slab Low Voltage — J Firearm m WASS ART FAIL -- W SITE J /Grading --- Sanitary Sewer Storm Drain ( i Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ )Please call for reinspection RE: [ i Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Int pector ea4l Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST Q04 /� (. 6600 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 _ BUP Date Requested (o - AM PM BLD Location _Clk - Suite MEC Contact Person Ph �r7l_/ 06a PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation d0 FPS Ftg Drain Crawl Drain Inspection Notes: SGN _ Slab Post&Beam — Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation Drywall Nailing — Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling �. Roof Misc: Final PASS PART FAIL -- — — eam Under Slab Top Out Water Service Sanitary Sewer Rain rains AS PART FAIL _ AAL Post& Beam -- Rough In Gas Line Smoke Dampers Final — -- — -- PASS PART FAIL ELECTRICAL — -- a' ServiceIt _ Rough In N UG/Slab Low Voltage J Fire Alarm —� m Final PASS PART FAIL W SITE Backfill/Grading — Sanitary Sewer Storm Drain I I Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE —_� __ ( ]Unable to inspect-no access ADA r Approach/Sidewalk ��'� �Q '' I I / V Other Inspector Ct `t Dete Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST ��/-yyv�Z. 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 BUP Date Requested Co— AM PM _— BLD Location_ SrW %y n,A, Suite _ MFC Contact Person Ph / — U(, s PLM Contractor Ph SWR UIL Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation , FPS Fig Fig Drain - SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation - Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc: — ina ART FAIL — — P st 8 eam U Slab To )ut W t r Service ni ry Sewer — ain rains in R RT FAIL ECHA IC Post eam Rough In Gas Line - — Smoke Dampers tin-al -- PART FAIL E CTRICAL 0^ Service ix Rough In — U) UG/Slab — — –, Low Voltage Fire Alarm _ 'J Final PASS PART FAIL u�ir SITE Backfill/Grading -- Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Cath Basin Fire Supply Line [ 1 Please call for reinspection RE: 1A Unable to inspect-no access ADA /J Approach/Sidewalk other Date �— �,X Inspector Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. o� c _ o v � o O o w 3 U ti ¢ 0u n u cu V n •� � V o y� w y � O to y IMPORTANT PERMIT NOTICE OWEN WEST ELECTRIC 8310 NW REED DR PORTLAND, OR 97229 Electrical Signature Form Permit#: MST2001-00102 : . . ,Datil Issued 2126/01 .:.: Parcel: 1 S1 SBAA-6600.6 Site Address: 08840 SW MAPLE CT Subdivision: MAPLE RIDGE ESTATES Block: Lot: 024 Jurisdiction: TIG Zoning: R-12 Remarks: Construction of new single family residence, attached Path 1. Your company has been Indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of ti* supervising electrician is required. Please have the appropriate individual from your company sign below and return, this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL_ CONTRACTOR: WINDWOOD HOMES INC OWEN WEST ELECTRIC 12656 SW NORTH DAKOTA 8310 NW REED OR TIGARD, OR 97223 PORTLAND, OR 97229 Phone #: 503-625-6526 Phone #: 297-6375 Req #: uc 0002902 SUP 28858 EL! 28.328C AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature of Supe sing Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE JIM'S PLUMBING PO BOX 7160 ALOHA, OR 97007 Plumbing Signature Form Permit#: MST2001-00002 Date Issued: 2120101 Parcel: 1 S135AA-06900 Site Address: 08840 SW MAPLE CT Subdivision: MAPLE RIDGE ESTATES Block: Lot: 024 Jurisdiction: TIG Zoning: R-12 Remarks: Construction of new single family residence, attached Path 1. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: WINDWOOD HOMES INC JIM'S PLUMBING 12655 SW NORTH DAKOTA PO BOX 7160 TIGARD, OR 97223 ALOHA, OR 97007 Phone #: 503-625-6526 Phone #: 649-4034 ` Reg #: 60 p1 M 348 86ob C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD MASTER PERMIT PERMIT#: MST2001-00002 DEVELOPMENT SERVICES DATE ISSUED: 2/20/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 SITE ADDRESS: 08840 SW MAPLE CT PARCEL: 1S135AA-06900 SUBDIVISION: MAPLE RIDGE ESTATES ZONING: R-12 BLOCK: LOT:024 JURISDICTION: TIG REMARKS: Construction ['c� otionof new single family residence, attached Path 1. 6tM4r �T [� F3 ! (.�1 BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 13 FIRST: 956 of BASEMENT: of LEFT: � SMOKE DETECTORS: Y TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: of GARAGE: 228 of FRONT: 10 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 10 OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL: 958VALUE: S87,67900.00 of REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: rUBISHOWERS: T GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN<100K: 1 BOIL/CMP<3HP: VENT FANS: 2 C.OTHES DRYER 1 GAS FURN>-100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES. VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRR!GATION: PER INSPECTION: EA ADD'L 500SF: 1 201 400 amp: 201 - 400 amp: 1st WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 600 amp: EA ADDL OR CIR: 4!GNAUPANEI.: IN PLANT: MANU HM/SVCIFDR: 001 • 1000 amp: 401+amps-1000v: MINOR LABEL: 1000.amplvolt: Reconnect only: PLAN REVIEW SECTION --�-- >+4 RES UNITS: SVC/FDR-225 A.: >800 V NOMINAL: CLS AREArPC OCC: ELECTRICAL•RESTRICTED ENERGY _ A.SF RESIDENTIAL. B.COMMERCIAL AUDIO IL STEREO: VACUUM SYSTEM: AUDIO A STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGL AR ALARM: OTH: BOILER. HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE_OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: H11AC: DATAITELE COMM: NURSE CALLS: TOTAL A SYSTEMS: Owner: Contractor: TOTAL FEES: S 5,595.49 phis permit is subject to the regulations contained in the WINDWOOD HOMES INC WINDWOOD HOMES INC Tigard Municipal Code,State of OR. Specialty Codes and 12655 SW NORTH DAKOTA 12655 SW NORTH DAKOTA all other applicable laws All work will be done in TIGARD,OR 97223 TIGARD,OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or If the IL work is suspended for more than 180 days. ATTENTION: Phone: Phone: 7604375(M) Oregon law requires you to follow rules adopted by the H Oregon Utility Notification Center. Those rules are set (/) Rag M: I.IC 50196 forth in OAR 95:2-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. 'J REQUIRED INSPECTIONS m W Erosion Control Insp 8, Post/Beam Mechanica Mechanical Inso Framing Insp Rain drain Insp Plumb Final J Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Water Line Insp Final inspection Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insf Appr/Sdwik Insp Building Final Foundation Insp Fooling/Foundation Dr Electrical Service Low Voltage Electrical Final Post/Beam Structural PLM/Underfloor Electrical Rough In Insulation Insp Mechanical Final Issued By : '� Permittee SignaturQ Call(503) 639-4175 by 7:00 p.m.for an Inspection nee ed the next business day CITYOF TI GARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT 0: SWR2001-00003 La AMMIM 131253W Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/20101 SITE ADDRESS; 08840 SW MAPLE CT PARCEL: 1S135AA-06900 SUBDIVISION: MAPLE RIDGE ESTATES ZONING: R-12 BLOCK: LOT: 024 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit. Owner: — FEES WINDWOOD HOMES INC Type By Date Amount Receipt 12.655 SW NORTH DAKOTA TIGARD, OR 97223 PRMT CTR 2/20/01 $2,300.00 27200100000 INSP CTR 2/20/01 $35.00 27200100000 Phone: 503-625-6526 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections IL oc rn m This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not W guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Ciregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. Issued by: �, _ Permittee Signatu Call (503) 639-4175 by 7:00 P.M.for an Inspection nee ed the next business day '100 C0003 Building Permit Application City of Tigard Datereceived: �> n Permit Mi.:1�15r Ciry pard Address: 13125 SW hall Blvd Tigard,OR 97223 � 'AOt 11apired°°e Phone: (503)639-4171 Date issued: By: R,,eipt rho.: Fur:(503)599-1960 CAN ftSO..- Land use approval tors family:siaiphecomplex: ,al&2 family dwcWng or accessory O Commen ialVirdustrW ❑Multi-family A-PRew cow tructiou O Demolition O Addition/sherstlon/replacemew 0 Tenant improvement 0 Pire sprinkWalwat O Outer. Job address: f' ti/e o � 4 r C — B tto.: Smile aa: Lot: Bloch: SubdiviUoo: i}),1+ L It rCY;l' Tu erhth /tatt l(dacoount no.: /3/ Pltuled risme: "rl T r aT,; _ rfi p / fin Description and location of work on promisdspecis)conditions: Name: „�/ /� r /'•A .r "C Mailino address: r . r•- st y t 1.2 Swot!dwsal V City: :' ,} /t, Stare:.'•/ !�P 1 ' Valuation of work....................................... s 9 7(i 7 Phone: No.of brdroomW%du....;..........'i............ 2 � Ownees tive: / 7 - Total number of floors............. ................ Phone-. r New dwellin=area(eq.R) . . ................... __t7 G ('imp%arport area(q.R;.......... ....».. Z Z Name: S_Ain Covered h Brea R '— MaWn address: 3 Dark area(sq.fl.) ............ _.....:�....... .... Chy: .f;')1 LT State: ZIP: Other etntoxthte area(sq.R�....,,. ............. Phowe: /h!9 Fax: E-mail: ntW-Ilrimyt 1/aiustioR of work....................................»» _ Business name: Existing bldg.sma(sq.R) ............. ..«...« .`� �' — — New bldg.area( .R). Addms:--- 'Sad) G New bldg.ares(er of s. ...... . G ti• t,/n Stato 71P ............... Phone: Fsx: E mall: `— Type of rwrrsavctian ........... ............. Occupancy group(s):.. CCB no.: 5a, /3: New: City/metro 11L.no.: -- Ne6m All contractont and suboamttthetors we required to be licensed with the Orepn a astructlon Coat ukm Board ander Name: 3��N� /f 7 provisions of ORS 701 asd may be requited to be licensed in the Address: 3 U�� J i m t. ( jurisdiction W, re work is 1 Bing performed.If the applicant is OV: r / Stat elf—I ZIP y 7 / exempt ftom licensing,the Wowing reason applies: Contact penin:_— (,t,t�f Plan no.: `}- 4/ --- Phone• .i) E-ma": — --- Name_ Coouct person: '� s Pen due q=application Address: �/ 5 W Bate received: City: _2 /L'—1 t _ State! T1F: , C Amrwnt received........................................f Phone: ?�(1-'>L• 1� E-mail: — Please+-fer to flee schedule. I hereby certify 1 have toad and ex—ained this application and the No ri it I*" Worremot" attached checklist.All provisions of laws and ordinances governinit thio O Viae O MastwC•ard work will be complied with,whether specified herein or rote ase.+� +•.► _�_ _ Authorised sipthatute r,✓ "`� Dago: f - Nam of a.anoW.h;;"Q sae`s Print name :i Notice:This permit application expires if a permit r ant ohtained within 180 days ager it has been accepted as o:+mplete. 4"13(VWXYM 10,'09 '00 4011 08:54 F1.1 503 598 1960 CITY OF TIGARD 0004 Plumbing Permit Application City Ols lhteieceived: Permit no-: Tigard $ewerpettnft no.: Buildingpertnit no.: Cuyuf/Fgard Address: 13 125 SW Hall Blvd,Tigard,OR 97223 Mone: (503)639-4171 Projecttawl.no.: Expire date: Fax: (503) 598-1960 Dateiasued:� By: Receipt no.: L;utt1 use approval: Case file no.. Payment type:— Q f&2 family dwelling or arcessmy O Commereial/indu§trial Q Multi-family Q Tenant impovement Q Ncw construction O Addition/alteration/replacement Q Food service C]Other; J ob address: . Fee ea. ToW Bldg.no.: Suite no.: New Il-424 2—��dwiftr GWV; Tax ms tax lot/account no.: ! 3 / 4 .1", O (Iorinis tyINN.toreW&slayaoee8aar) -S"� '= SFR(1)bath L.ot: Block: Subdivision; �� Project name: ) :-!'� City/cotmty: lr;; 9-4e.) r+�ZIP.- Description IP:Description and locatirm of work on premises: 4/f 4 _ Sltettttfillfiw: ' Catch twin/area drain Est,date of com14 tio�nspection: we s/Ieach in nch 'n Midmill Fooling drain(no.ha k) Business name:_ , , Manufactured homeutilities dManholes Ar; _ sin drain tonne: or — City: &I V f-A _ Staot><W_ ZIP: ) l-r•G Sanitary iewer(no.lin.fQ Phone:G _LAO& Fax: n, tj E-mud: Storm sewer(no.lin.ft.) — - —' CCB no.: -11 5 i7_ Plumb.bus.reg.no: •j.�,;P Water service City/metro lic.no.: OV q �_1 v �S- orMm ' Contractor's representative sigaatttts: /L�/�� on valve Print natne: L Date: ack flow venter da Backwater valve Basinr✓Iav Name: ,(3/ 1i' 7• .4XM4 r1 Ulotheswasher_` — Adrlretts: Dishwasher city: 4.. 14-A _ State:`' Z lhinki fountains) Phone: _. E'ecto sump ` / 3 ax: E-mail: f -- Expansion n t ank vxtutdsewer Name(print): /� r, ) -r^ a; Floor tat oar sinks/hub Mailingaddress�.',2 vrF �` 5 �tJri d ,� L' _ — City: >(u — ~States~'�! 1 How bibb ,-- �� Ice maker Plume: r-_Z4 E-mail: Intcrceptor4mase trap Owner installation/residential maintmance only: The actual installationmer(§) — will he made,by me.or the maintenance and repair made by my regular Roof drain(commercial employee on the pto)etty I own as per ORS Chapter 447. Stnk(s),basin(s),lava(a) Owner's si nature: Dole: Sum Tubs/shower/shower pan • Name:-._, Urindl j -- ---- Address: Waterco§et Waterheater I (sty: r _ Phone: Nte as Wdkrtraa soeeI C°a'l'"&,r'►°"`cA*udkdna r4i Tm,,eW""'a"". Notice:This permit application Minimum fee................$ O Visa v masterr-ani Plan review(at __%) $ expires if a permit is not obtained Credit cart emmtar.- within I80 days after it hasas been State strrehaege(876),...$ _ N=r ct canthnidm u rMwn no cm'ir card accepted as complete. TOTAL.......................$ _ Crdholder ilpraluro _Anrwot 11n-11516(6AIdC1)Nt) 10.'09 00 40% 08:5.3 I.1.0 501 598 19110 CITY OF TICARD 2003 1Vlechanical Permit Application City of Tigard Datereceived: Pmnitno.: ti Project/appl.no.: Expiredate: CtryofTigord Address: 13125 SW llall Blvd.Tigard,OR 97223 - -- Phone:(503)639-4171 Date issued: — by: _TR eceiptno.: Fax: (503)598-1960 Case frleno.: Paymenttype: I-•trid use approval: Building permit no.: Q l 8t 2 family dwelling or accessory U CommesciaLindustrial U Multi-family 0 1'enant improvement ew umstruction U Addition/altetation/mplacement O other:. Job address: _ Indicate equipment quantities in boxes below.indicate tht:dollar BW&,no.: Suite no.: value of all rneehanical materials,equipment,labor,ova zW. T ax ma tart lot/nccount no.: /,j ?.. 1 j crG •� i Bt.Value S Lot: Block:_ Subdivision: Pc:Gr 2.�UGe *See checklist for important application information and Project name: / u�' t "(,� " rr5 jurlsdiction's fee schedule for tesidential permit fee. City/county: T,D;"4-, C ZIP: Description and location of work on premises: < pn�h 1111111MIEN E Eat.date of comple(iotYtnspection: � Ileataigaloet lAba(sa) Trial Tenant imptovemert or change of use: t Air httr+dlin " Is existing spas tented or conditioned?p Yes q Nounit CFM._co utmm (shte m reqs is existing space insulated?D Yea U No AlteraUnn of g H VAC system - oikr7—ecxnpn:saore Business name: J,t r�rf t� , J,t y� G State boiler permit no.: HP Tons__BTU/H Address: /_,k�. - �'" „... ,�•i/; r ite/ama uctx_=_Va cars Ciry: 7-17'64-4./ State:^ill ZIP i 7Z.2-3 eat ( te _qu Phone. ! c. Fax:%a S`i^ mail: na rep ace tuna urner- HTUJJI — CCB no.: Including ductwork/vent liner U Yes U No _ City/metro lic.no.. wall,or 7ounted�--W Name(please print): ) LY fVent -7FP&;RRiFF than ftirnice 1110111111 Reft`11111`011111111110: Abwrption units BT'U/H Name: 7, / /2,rC _//Ae Chillers _ _{_- HP Address: Z 22=ams HP City:� ✓��'fi I-- State: AA�liance. Ent Phone: 5/)-/n4— Fax: E-mail: Dryere�Fiit gust oods, ype a aranai flood fire suppression system Name: l,t j .v ( •• C, /"^, }f Ai C— Exhaust fan lvhh single duct(bath fans) Mailing address: r' ,t ,yf^ auu i tin or AC Cit $t � ZIP up tooutlets) Y L CG a Phone: _ .� r- fax:'J. i. E-mail LPO IYG cx[ el piping a over eta l.. (schematic required) U) Name- Number of outlets a Address: becoradve fireplace J_ City: State: Zip W�–type Phone: 1'ax: E-mail: tov e(stove W Applicant's signature: Date: - Name(print): '-- NPermit fee ............. NO(all lurl+�nim,aaep uedit nrd,,plr.ae nil jwtnfcaa�fnr mac infarraMi�n. •.-...$ _ U Visa Cl MarmrCvd Notice:Ibis permit application Minimum ice................$ _ ter giant r,aa,ta: / / expinro if a permit is not obtained Plan review(at _ %) S q,pat, within 180 days after it has leen State surcharge(89F ame d a.do"on rmt a nre - accepted as complete. ).... s TOTAL.......................$ nmoua-- +4o-ruts(sooa:oarh 10 '09'00 MON 08:56 f1C 50:1 598 1960 CITY OF TIGARD 11008 Electrical Permit Application Detemceived. Permit no.: City of Tigard Prajtxt/appl.no.: Ecpired,te: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 CAN the no.: Payme it type: Land use appmal: CYI A 2 fancily dwelling or act.-evstrry El Commerr:iel/indust»al U Multi-family O Tenant improvement U 1Gew construction U Addition/alteration/replacetnent U Other: U Partial Job address: U.: ITax map/tax lat/acaotmtno.:/61= 4 1.oC Block: Subdivision: A)1401 /1 d D!g r- za 1'to'cct time: ,rte'1.d Z'L t? Description and location of wtxic on premises: Fstimated date of letion/ina ction: Job no: Fera Ma Ruttiness name: Desty"on Q17. a�bass �,,�, • ,_ ,. ,�;:' �i':: A.f"fi s io:; Now -slimiglitioromillidand4pser Address: _ _ tweNYag tlr� City: _��_ _ State:;•'l 7n` +?'�j.2, >Ser.kelactVet Fax -- -. E-mail:---— 1000 R orless _ 4 Leh eddldond 500 a ft.of noon theemf CCB no.: / .. I Elec.hus.lic.no:_ j 7'..� --�I----°---. _ — 1 imitsd txerelp�rdidernial 2 City/metro lie.no.: y " �. _�Yi--- �_deaes non rdidrntial 2 numufactrre4 .K or modular dwelling Si of isekcuician(rcyuired) Data r ^ecu ce and/orfma 2 Sup.aim name(priat):j �.l` tri" tAcen'ooa!) 5-':5 Sonimarfeaitrn-hnft lmou, atlteraMor or releestba: 200 amp,a Ida _ 2 Name(pont): ;mac, t MIf E601 l to am am _ 2 Mailingtiddteas: / 1 to 600 amps 2 1� � '�'—� " t.J /l.'[;.2 to 1000 �— 2 City: T 7" /1- 51ffie; j! ZIP: j 7 ,3 Over 10101 amps to volts 2 Phone: ,:, /57 c.G 1 Fax:;., E-mail: Rowmmrtonly 1 Owner installation:The installation is being made on property 1 own Te"wwynrgcestrfeedeta- which ie not intended for sale,lease,rent,or exchange axtmiing to 11ast'S ooss, , of re, ORS 447,455,479,670,701. 2W amps or lea 2- 201 amps to 400 amps 2 Ownees si atone: Date:__ 401 to Ern amps 2 ■reach tic.silis-oew.alterdba, or exetmatoo per p000k Name: A. Fee tot bmmh cirvsita with ptrrhase of Addfvw. - ielae or Meder fee,each brooch cimalt 2 City: Stara: $Ip:-_ H. Fee for branch circuits without purchase - �- of service or feeder fee,first trench eimvit: 2 Phone: Fax: E-mail: Be&addtlanal- 'd waie Mee err aet►elatleJr a 0Setviceover22.5amp%tonmvicial QHealth(We facility Each puaV at itription circle 2 OSaviceover.320amp�-rstingcif 1&2 ❑Haimamlocation Eadtsign oroutline lighting — 2 N family dwellings U flui1tling over IO.O fe square n tour am Signal circuit(s)or a limited anergy panel. U) 0 System over 6W vol"nnminal more resident.81 emits in otter smiewn alteration,ov exieraiono 2 U Suildingoverthreestories U Frterlm,400amps ormore aDescri at. U Occttpent load over 99 persons U Manufactured structures or RV park Yeti oddh%Md IM tllowartile r m7 of tba ttllovaa U F4reu✓lipttungplan O Other__ -.. -- petirspection100 —� —i--- — Suba@_acts of plies wkh rev of the above- Investigation Poe � WIW above are rot appllcmble to temporary codtslosmics-s- Other —i Not as Jvtadieaem aocqu crowd arch,please nIt)wiaAeoae to nonce irrhvstinna. Notice:This permit application Permlt fee $ O vin O MabmCard expires if a permit is not obtulnM Plat)review(at�.%) S Credit Card—Am �_—_ Ewa within Igo days after it has been ;tate surge rcha (R%)--S accepted as complete. TOTAL.......................$ ems nr rkY r abewe ore cndh _ S J—CirdhM i slpuuat Amaat 410-4615 MCQCOMI l lbt 26. CaO No /4 a 10 0 r' c�p n r a ry �o /gU