Permit BuiJdin Permit ApplicatioD .EOR OFEICEUSEONLY s
r d RECEIVE' - D‘-/ _
City of Tigard Date/By: 40C— Perrut`�'� y a .
DalerB I , 1 ���YC./J
13125 Sw Hall Bkci., Tigard. OR 9 7223 Plan Review — "`
Phone 503.639 4171 Fax: 503.598 1960 ∎+hm% // A 9 5 . a 9 �Q/
0 1 b ,t �I t Da;e. l��� / �07�fiJ� Other Pern � % �J �� n ..11
Inspection Line. 503.639 41 5 Mfll' 0 I _ �p r � Date Ready;By Jr ` r 0 See Attached Checklist or
Internet w - ci Heard - us NoufiedNelhod- )V Supplemental Information 1
CITY OF TIGARD �t R ►r -�
TYP� �VOR�{ -�l` ISIV�y REQUIRED DATA: 1- AND 2- FAMILY DWELLING
New construction ❑ Demolition fees* are based on the value of the work performed -
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application- !8 / 3zo. 70
Valuation:
X 1- and 2- family dwelling XCornmercial /industnal O 1
❑ Accessory building ❑ - Multi- family Number of bedrooms:
❑ Master builder ❑ Other Number of bathrooms: 2 t
JOB SITE INFORMATION AND LOCATION Total number of floors, 3
Job site address: )141.10( v.\ y\ � .. 1-11/ ► , ` ` Ty-,, -' New dwelling area: 11 square feet
City /State /ZLP:.TroeY11 . ' C� � S v Garage /carport area 5- eb- 2 square feet
Suite/bldg. /apt. no.: `+ Project name: b � t � 1 M CI. Covered porch area. 32 square feet
Cross street/directions to Job site: `C\NToL c\ ��Y> e reeV re, Deck area: ` square feet
Other structure area: square feet
REQUIRED DATA:.COMMERCIAL -USE CHECKLIST '
Subdivision: Tnn L h� �m i !� Lot n Permit fees* are based on the value of the work performed.
Tax map /parcel no.: `���� -- `1 , 11 ?..,1 equip Indicate the value (rounded to the nearest dollar) of all
equipment. materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK . . work indicated on this application
Valuation: S
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑TENANT .: Number of stories: Of v
Name: OS C 5A� ' fri \Q 1 Type of construction: ��
Address: (oa$O TDe_ o�� _ Occupancy groups:
City /State /ZIP:. - 0 _ C � Existing
I
Phone: (sal) 533- L1I�n 6 Fax: (S 63 3 ' Lle7O(D New:
APPLICANT - ,; XCONTACT PERSON
usiness name: 5PME All contractors and subcontractors are required to be
, ntact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
dress: e is".IfAt..., jurisdiction in which work is being performed. If the
State /ZIP: applicant is exempt from licensing, the following reasons
apply:
e: (So3) ° lo l 3 Fax:: ( ) 1T-p ] lc _,
1:
x
CONTRACTO1
t
;name: 5 A m
- B1:1 LDING • PERMIT .F EES *
Please refe to fee schedule.
'ZIP:
Fees due upon applicat
) Fax: ( )
Amount received
139 q --fc. Date received:
gnat e:
This permit application expires if a permit is not obtained
-� _ within 180 days after it has been accepted as complete.
.ill CAS -- r&-k Date * Fee methodology set by Tri -County Building, Industry
Service Board.
•
PcrrnnApp dec 12!03 440 - 46131(11 /02'CONt/ \VEB)
Electrical Permit Application FO[toFFtcEUSEOiviv
City of Tigard Received
Date•Br Permit No.:
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Re"e•.v
Phone 503 639 4171 Fax. 503 598.1960 Gther Pernui.
■�
Inspection Line. 503 639 4175 r!"� 6. Date/By: r , Date Ready/By- fors 0 See Page 2 for
Internet. www ci.tigard-or us NotifiedRvleihod. Supplemental Informarion
. TYPE OF WORK PLAN REVIEW •
❑ New construction ❑ Addltionialteration /replacement Please check all that apply.
11 Demolition ❑ Other: ['Service over 225 amps, comm'I Hazardous location
❑Service os er 320 amps - rating ❑ Buildng over 10,000 sq ft .
CATEGORY OF. CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential 1
. - I
❑ 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stones ❑Feeders, 400 amps or more
❑ Multi ❑ Master builder ❑ Other:
❑Occupant load over 99 persons
Manufactured structures or
,JOB SITE INFORMATION AND LOCATION - ['Egress/lighting plan RV park
Job no.: Job site address: lc ` yo ❑Health -care facility ❑Other:
� 1`e Submit 2 sets of plans with any of the above.
City /State /ZIP: r-C O_ • (_ The above are not applicable to temporary construction service
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: 1 �.�+ �� Il )._ E,„„‘,„.. eE,„„‘,„.. Qry,. 1 Fee. Tout .,
Cross street/directions to job site: 9�J�� YN't��� T�nYtio l teeV- N ess residential single - or multi - family dwelling unit.
includes attached garage.•• ,
1.000 sq. 0. or less 145.15 4
Subdivision 0.x\ l Lot no :& Ea add'1 500 sq. ft. or portion 33.40 1
\_{,), �� L Limited energy, residential 75.00
Tax map /parcel no.: ( )S I , a sil,1 Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30
• $t PROPERTY . i . ❑'TENANT 201 amps to 400 amps 106.85 2
- , 401 amps to 600 amps 160.60 2
Name. S C�C\ TY\ \ 601 amps to 1.000 amps 240 60 2
00 a
Address: 1‘k, V, _ Over 1,000 amps or volts 454.65 2
• 1., �a� a Reconnect only 66.85 2
smolt li � V Q .- �
City /State /ZIP: , a N " - Temporary services or feeders installation, alteration, and /or
Phone: (66 53 r// AJ
3 Z'L Fax: ( S) 53 "A � 71 0 2mps
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
❑ :: ;. • . .-: °' y CONTCT A PERSON'.
A Fee for branch circuits w'rrh
service or feeder fee, each
Business name: c branch circuit 6.65 2
�
-- �^'' B. Fee for branch circuits
Contact name: io - without service or feeder fee,
46.85 2
�t ``-- C each branch circuit 6
Address: I 1 � Each add'I branch circuit 6.65 2
City /State /ZIP: J Miscellaneous (service or feeder not included)
(,j 2 )et� { ' 1 l 3S ( ) 5 " ME Pump or irrigation circle 53.40 2
hone: Fax:: r .- f
Sign or outline lighting 53 40 2
- mail
Signal circuit(s) or limited-
. ,, .,,
- . ',CONTRACTOR '•'" energy panel alteration, o r
- r extension. Describe. Page 2 2
Mess name: I, rt
ess: &S w 1 O 3 �.t _ \ U �c C ' 1[t l C {/. E 1 +�
l _ Each additional inspection over allowable in any of the above
• 1
` Per inspection 62.50
W; \
;tale /ZIP: % CC r O e Q (t . 1z 2 Investigation per hour hr min) 62.50
( S O3) 1D 42 - cx Fax: ) (L42_ 5RkS Industrial plant per hour 73.75
fr �� v • ELEC'FRIC•'AI. P,ERNITF FEES '
c.: l ($g2 Electrical c.: q - Suprv. Lic.: Subtotal
'ectrician signature, required: i I Plan review (25% of permit fee)
Sf � _ V t. • 6 , Dates State surcharge (8% of permit fee)
`
-- -- TOTAL PERMIT FEE
sig�iature:
L _ _ `� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
I; CL V. e ' goA-es Date: Fee methodology set by Tri- County Building industry Service Board
`" Number of inspections per permit allowed.
C- PermitApp -doc 12/03 440.4615T(10!02!COM/WEB
Mechanical Permit Application FoROFFICEUSEON Y . >. ..
City of Tigard Received
DateBy_ Permit No
13125 SW Hall Blvd., Tigard OR 97223
Plan Review
Phone: 503 639.4171 Fax: 503.598 1960 Other Permit
�' /A/ � � DateBy'
Inspection Line: 503 639.4175 �(L.�1�
z s �� • Date Ready By Jura 0 See Page 2 for
Internet: www.CI tigard.or us Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
X New construction [11 Addition /alteration/replacement Mechanical permit tees* are based on the value of the work
performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit- ,
- ' CATEGORY OF- CONSTRUCTION • Value- $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
fr 1 - and 2 family dwelling Commercial /Industrial 111 Accessory building
For special rnformarion use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. Ea Total
JOB SITE INFORMATION ;AND LOCATION Heating/cooling
Air conditiontne or heat pump
Job site address: 1 q (�/� r J
'1`) sL �P v v\ r cr- (requires site plan showing placement) 14 00
City /State/ZIP: ��; � O Z Cf Furnace 100,000 BTU (ducts /vents) 14.00
1 Furnace 100,000+ BTU (ducts /vents) 17 90
Suite /bldg. /apt. no.: Project name 1
�
i v�1 } Gas heat pump 14.00
Cross street/directions to job slteey-\ ` IFN. S Z(.. & �Q l Duct work 14 -00
Hydromc hot water system 14.00
��� Residential boiler (radiator or
hydronlc) 14.00
Unit heaters (fuel -hype, not electric), 1
in -wall. in -duct, suspended, etc 10 00
Subdivision: 1 _ T Lot no : Flue/vent for any of above 10.00
� h\ 1 5 �� Other: 10 00
Tax map /parcel no.: 025 1 w 1 a c6 1 Other fuel appliances
'DESCRIPTION OF :WORK ,{. water heater 10.00
Gas fireplace 10 00
Flue vent for water heater or eas
fireplace 10 00
Log lighter (gas) 10 00
Wood /pellet stove 10 -00
Wood fireplace. /insert 10 00
. 'I'�; PROPERTY, OWNER . . Chimney/liner/flue/vent 10 00
T Other. 10 -00
❑ TENANT
, Name: U LS Ct tnT p 1 Environmental exhaust and ventilation
Address: �aa� �� ' a6c,, � Rane hood /other kitchen
equipement I 0 -00
City /State/Z1I'Q 'V r C3( Q� . Clothes dryer exhaust 10.00
��'` n 1 � Single -duct exhaust (bathrooms,
(5
'hone: 3 )51:2 IM( Fax: (50 3 ) 536 [ 36
l 6 toilet compartments, utility rooms) 6.80
i `' + �]' AFYLI CONTACT PE RSO N Attic /crawlspace fans 10.00
Other: 10.00
, siness name:
SE\ Fuel piping
tact n ame: cc- l 55.40 for first four; 81.00 for each additional
Furnace, etc
ress:
B M ` Gas heat pump
itate/ZIP: Wall /suspended /unit heater
(563) 9(09_ `({ Fax: : ( ) S F J Water heater
` ` Fireplace
Range
44 C : A Barbecue
Clothes dryer (gas)
tame: • -e •• ` 111...... 6 •.r Other:
// _
- 0 • lO 5 b3 ;, , MECHANICAL PERMIT FEES*
P: X10 � 0 9I CY>' Subtotal
l 1LSi �� Minimum permit fee ($72.50)
591 -9P Fax: (Romig_ -� Plan review (25% of permit fee)
I _ U V State surcharge (8% of permit fee)
TOTAL PERMIT FEE
tune- • . This permit application expires if a permit is not obtained within ISO 111 _ _ Jib days after it has been accepted as complete.
-� `�+ Date: • Fee methodology set by Tri- County Building Industry Service Board
-nnitApp doe 12/03 440-4617T (11 /02 /COM/WEB)
Building Fixtures
Plunabirig Permit Application :•- FOR OFFICE USE ONLY .,..•:.-...-,,::,' -'''.
City of Tigard Received
Perrrut No
13125 SW SW Hall Blvd.. Tigard. OR 97223
Plan Review
Phone 503 639 4171 Fax. 503_598.1960 _ 1611 . 4 .W . i '.1 Date/By: Other Permit No
24 Hour Inspection Line 503.639 4175 dUL-AV. ioris
--,,....... Date Ready/By El See Page 2 for
Internet NVWW C i . t 2, a r d _ or us NottfiedfMethod Supplemental Information
: TYPE .of,:wi0ii_ic. :,::;,.. _' •:i - _.l.i. - 'il:, . : ' :' ' _ FEE' SCHEDULE
N ew consmuction Demolition
For special information use checklist.
g D
Descnption Qty 1 Ea I To;a1
EI Addition/alteration/replacement Eli Other. Nev.. 1- 2-family dwellings (includes 100 0 _ for each utiliry connection)
?::."CATEGORY. OF CONSTRUCTION - -:- - i'i ,-,- -, - , i . - SFR (1) bath 249 20
XI - and 2-family dwelling XCommercial/industnal SFR (2) bath 350 00
SFR (3) bath ><.... 399 00
D Accessory building 0 Multi-family
Each additional bath/kitchen 45.00
III Master builder D Other:
_ ., ., Fire spnnkler ( sq. ft ) Page 2
., q. - 70B i .".'ANDl LOCATION
ii-',`:siii'i=-7-lii: c - - ■ t e ut i -
, ;,; : iii , ,,'-iii 7 .. - i,;-ll.„,-..r.i.: -, -i4i;ii:ii'i:ii'aiii,iiii,i-" , .-,,-,---,i•i-,,::^,-*,,,, '.',,,,,.!.,,, :::"• .- - .-: k. V. , -1' ' '' - ^."':2 r.. :' a ll I3es
e - 7 ----.
Job site address: P r kvu - r Catch basin or area dram 16_60
City/State/ZIP: 1 1 cer Pri-- Drywell, leach line, or trench drain 16.60
) Footing dram (no linear ft. ) Page 2
Suite/bldg./apt. no.: j Project name:rs?....) Nlanufactured home utilities 110 00
Cross street/directions to job sitr tr •%jOrc\r'i CP e V..._
Manholes 16 60
Rain dram connector 16.60
Sanitary sewer (no linear 0.- ) Page 2
Storm se v er (no linear ft.. ) Page 2
. . .
Lot Water serv ice (no linear n_. ) Page 2
Subdivisiona
- Crs_ - 1 - &)---nV‘M . Vke _S no.:0Vaf,
xtu
Fire item
Tax map/parcel no.: 1 ,,, w? .. :A .
.....,.., Absorption valve 16 60
Vbi ik..-1::;‘:_ • '::, ,, :
,..-5- ..: .:`;:.,.-I-,s- -... .:*'.1::...,,:;„ -, .;.;=:1-'.:1'.:.;' ::. ', -, ' ,- -_'-:.:',II-::.: - ...-:-.. , ]-;'• - • backflow preventer Page 2
Backwater valve 16 60
Clothes washer 16 60
Dishwasher 1 16 60
F.„ Drinking fountain 16_60
Ejectors/sump 16 60
Name: LS CA J.4 . ‘CM . Y . Y'S Expansion tank 16.60
Address: 1 to aBc ., , ) ( ..A. ,
Fixture/sewer cap 16 60
City/State/ZIP: 00 r (4„ s-- l ko
, Floor dram/floor sink/hub 16_60 ,
Phone: (553) timu, Fax (5ps)5s3 .. e./306 Garbage disposal I 16.60
-0 7-
usiness name:
Interceptor/ease trap 16 60
I ; I
mtact name: - - tCli-il-, Medical gas (value: $ ) Page 2
dress: 31; NtE J Pnmer 16 60
/State/ZIP: Roof drain (commercial) 16.60
ie: (66S) 4 .1,7_ i4153 Fax: : ( ) (.. TY \Ed Sink/basin/lavatory
Tub/shower/shower pan 16 60
II:
... Urinal 16_60
''P.:
Water closet 16.60
za name: (--- \ c t.i.....\. \ \ tjL3v\ ___, Water heater 16 60
• ,2 6 t.). R_O:In\OZOJ 1 ,. 6 6 Other: _.
Subtotal
'jZ2: 1,-1; kAnNooiro ,
( - 9 Tiezi. Minimum permit fee: $72.50
63 6,2.8 - 1(0302 Fax: (5153) tdag _ ti33 Residential backflow minimum permit fee: $36 25
c ia, lo A9 Plumbing Lic. no.:311 --ca(gt Plan review (25% of permit fee)
,*" State surcharge (8% of permit fee)
ignature:- . -
a_ Ilk -. -._ 3---..„ TOTAL PERMIT FEE
T r—lAci -, Elada,), Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted a complete.
*Fee methodology set by Tri-County Building Industry Service Board.
,MY-PermitApp_ dot 12/03 440-4616T (10/02/C OM/WEE)
C UILDING - ITY OF TIGARD
B DIVISION PERMIT #: MST2004 -00330
1 3 125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2004
Phone: (503) 639 -4171 i Requests (24 Hrs.): (503) 639 -4175 !
INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 64
SITE ADDRESS: 14406 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 026 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES, PHONE #: 503 -533 -4006
CONTRACTOR: . JLS CUSTOM HOMES PHONE #: 503 - 533 -4006
Inspection Request Scheduled For: Date: 4/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005267 -01 503 -642 -2800 N
Corrections / /Instructions:
V i
p4 d 2 -94 4 .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . / Date: O Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2004 -00330
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/'004
Phone: (503) 639 -4171 /,,,, � �U � �Ipullf'11��li ?
Inspection Requests (24 Hrs.): (503) 639 -4175 ' -_...
INSPECTION WORKSHEET FOR DATE: PAGE:
5/10/2005 TIME: 7 :16AM 27
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 14406 SW PENNYWORT TERR LOT #: TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES 026
DESCRIPTION: BONITA TOWNHOMES
New SFA.
OWNER: PHONE #: 503 - 5334006
CONTRACTOR: JLS CUSTOM HOMES PHONE #:
JLS CUSTOM HOMES 503-533-4006
Inspection Request Scheduled For: Date: 5!1012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006505.02 503-209-2005 N
Corrections /Comments /Instructions:
.- i
i --- dr '
lir
,Z"--' " I `
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO ' L F S ASSESSED
Inspector: iljOr Date: _ 0 Phone #: (503) 718-
CITY OF TIGARD .,
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MST2004 -00330
Phone: (503) 639 - 4171 ° "�' " "����lypiill6l�li�l 1129!2004
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: PAGE:
5/10/2005 TIME: 7,16AM 28
SITE ADDRESS: 14406 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: LOT #: BONITA TOWNHOMES 026 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA. I, -< 14 3 � / 1
OWNER: JLS CUSTOM HOMES, ri 0 J/ ))1al(ire
PHONE # : 503 -533 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE # . 503- 533-4006
Inspection Request Scheduled For: Date: 5/10!2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 006505 -01 503-209 -2005 Y
Corrections /Comments /Instructions:
f j — / 4./. .
}fRASS ❑ PARTIAL APPROVAL ❑ CANCEL
// FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED,
Inspector: /i��' / Date:-- Phone #: (50�
Y
A , CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00330
llii DEVELOPMENT SERVICES DATE ISSUED: 11/29/2004
`1.�! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14406 SW PENNYWORT TERR PARCEL: 2S112BA -BT026
SUBDIVISION: BONITA TOWNHOMES ZONING: R - 12
BLOCK: LOT: 026 JURISDICTION: TIG
REMARKS: New SFA.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 167 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 820 sf GARAGE: 585 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 TNRD: 787 sf RIGHT:
VALUE: 181
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,774 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 31
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEWSECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,890.70
This permit is subject to the regulations contained in the
JLS CUSTOM HOMES JLS CUSTOM HOMES Tigard Municipal Code, State of OR. Specialty Codes
16280 NW BETHANY 16280 NW BETHANY and all other applicable laws. All work will be done in
BEAVERTON, OR 97006 BEAVERTON, OR 97006 accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 533 - 4006 Phone: 503 - 533 - 4006 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 139970 rules are set forth in OAR 952 - 001 -0010 through
952- 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Ftg Drain Bsm't Walls Mechanical Insp Gas Fireplace Structural welding final Water Service Insp
Sewer Inspection Slab Insp Plumbing Top Out Insulation Insp High strength bolts fina Smoke Detector
Footing Insp Plm /undslb lnsp Framing Insp Shear Wall Insp Rain Drain Insp Electrical Final
Foundation Insp Electrical Service Roof Nailing Exterior Sheathing Insr Storm drain insp Plumb Final
Wtr Proofing Bsm't Wa Electrical Rough -in Gas Line lnsp Firewall Insp Water Line Insp Mechanical Final
Issued y : ■>` • • / - 4 , ' : .. Permittee Signature : G
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day