Permit CITY OF TIGARD MASTER PERMIT
IN s COMMUNITY DEVELOPMENT Permit#: MST2014-00092
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2014
T[v A R D 9 Parcel: 2S109AB03900
Jurisdiction: Tigard
Site address: 14310 SW 133RD AVE
Subdivision: THREE MOUNTAINS ESTATES Lot: 32
Project: Monoian
Project Description: Bedroom/dormer addition and remodel.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 150 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: Yes
Total: 150 sf Value: $30,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvaes Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum<100K: 0 Vents 0 Woodstoves: 0 Gas Outlets: 0
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Term)Srvc!Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 5
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All
Other N Other Description: Ecompasing N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ADD SF VB R-3 150
Owner: Contractor:
MONOIAN,BRIAN D A BRYSON CONSTRUCTION CO LLC Required Items and Reports(Conditions)
MONOIAN,CHRISTY 0 3029 NE 7TH ST
14310 SW 133RD AVE GRESHAM,OR 97030
TIGARD,OR 97224
PHONE: 503-896-8842 PHONE: 503-320-2720
FAX:
Total Fees: $1,273.98
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a c f Wasules littct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B • _ _____ _ _ �� Permittee Signature: et
•
C tf ir 5 by 7:00 a.m.for the next available inspec date.
This permit card sha I be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application RECEIVED
Residential FOR OFFICE USE ONE)
City of Tigard JUN 12 2014 Received ��� permit No.:rISTo�/4-U499.2,
13125 SW Hall Blvd.,Tigard,OR 97223�IT Plan Review��, �
' s Phone: 503.718.2439 Fax: 503.598.19 CITY OF TIGARD pa1e/g ; l a Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Read / Juris. El See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: �/ �i'( Supplemental Information
0 Sp,W.c w ; .
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit 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.
Valuation: $
1-and 2-family dwelling El Commercial/industrial 0 ) Ot)
El Accessory building E]Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 19-2.,‘10 SiA) 133 lid (Q, ',c, New dwelling area: square feet/gD_
City/State/ZIP: T(i Q ,A o2 }.a014l Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ���, _ !pit/— Covered porch area square feet
It Cross street/diredions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 11,rit rn't ff 1'l is lid-1z I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: < Indicate the value(rotnded 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
8e4 ror�/)A /J l` i17L,- £1 LII72YL bit -t!i-o-Kvt) 3pga_
!" Existing building area square feet
New building area: square feet
la PROPERTY OWNER I ❑ TENANT Number of stories:
Name: ('l6 4-`1 ,l tl_i` `A r, -- Type of construction:
Address: \LV \0 s‘,.) \ T ..0 Occupancy groups:
City/State/ZIP: Ltrt� n� ` ' � Existing:
Phone:( d')) O;,t b irk Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP: ..��((��
Amount received: yI X30,s g
Phone:( ) Fax: :( )
d PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: r Qn d fl t.,,CA r m Q l Commercial and residential prescriptive installation of
CONT CTOR 1 roof-top mounted PhotoVoltaic Solar Panel System.
Business name: //a Submit two(2)sets of roof plan with connection details
{y�r� l i r- S\{u `C and fire department access,along with the 2010 Oregon
Address: '�Oack N g 7 j� Solar Installation Specialty Code checklist.
City/State/ZIP:�'1/L6y1QI✓v t - e1 903 Permit Fee(includes plan review $180.00
- and administrative fees):
Phone:(569 0..1-)2/) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: OUi Total fee due upon appication: $201.60
Authorized .Movril This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: '• , Date: / *Fee methodology set by Tri-County Building Industry
Na�TIU /r/(J//0%t!/l_ �l�L`�y Service Board
I:\Building\Permits\BU¢RESPermitApp.doc 02/24/2011 440-46131(1 I/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received P
II 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By.
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T 1 G A R D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Ivtec�uur.
Internet: www.tigard-or.gov ❑ Other:
THE FOLLO\vIM; I"I F:\IN .1Rl I IQ IRFI) FOR I'I.A\ RI:\'II':W Yes No N./.
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: . ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. _ ❑ ❑ ❑
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ El
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
ull-size sheet addendums showing foundation elevations with cross references are acceptable.
(6 all bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
2 Manufactured floor/roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
for four or more appliances.
ngineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ CI architect licensed in Ore•on and shall be shown to be al 1 licable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑
5 Building plans shall not contain red lines or tape-ons. "Mirrored"building_plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building_plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9,1995.
I:\Build ng\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application EIVEh / l O12 014I( I 1 I.0\1.1
v Received ''
City of Tigard DateBy: t F�� Permit No.: MSrt�� _��Q�
;� • 13125 SW Hall Blvd.,Tigard,OR 97 23 Plan Review !!
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Date/By:
l l G li I) Inspection Line: 503.639.4175 JUN 1 2 Z 4 Date Ready/By: Juris See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF flI IS10N
TYPE OF ,�NC COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�yv 111, Mechanical permit fees are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 3'00.
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: `i-.\ \o SW V33 r-' PO Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: *-- ■ter•k e aaL\ Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: M p In e1 44 -t,ee ftU V Duct work i 23.32
Cross street/directions to job site: .\` 46,v Fdk_ Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: `V Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
1 p ^"" �',, Flue vent for water heater or gas
a0, .t4L.lAt-JZ-. -co �Ormix M) fireplace 23.32
(�{�n �',r Log lighter(gas) 23.32
( Oui __ "`j 9t-' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: l.d'l` I-Ze r14� 't''0 NCI1 Range hood/other kitchen
Address: \L% \0 Ca equipment 33.39
S� t Clothes dryer exhaust 33.39
/ City/State/ZIP: �� O ay Single-duct exhaust(bathrooms,
r / toilet compartments,utility rooms) , 23.32
Phone:(503) �1u Mick'c2 Fax:( ) Attic/crawlspace fans 23.32
E.APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
4 City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Cr\ 6,xui3 z.44 O 5 Y.4A -CO IYI Barbecue
CONTRACTOR (../.6-0 Clothes dryer(gas) _
Business name: r\ i)�SO l\ L'f15.Tt . L>(� Other:
MECHANICAL PERMIT FEES*
Address: 30 act NE 7 tJa S f- Subtotal
City/State/ZIP: C 1/GOIYz/k O2 T-9-630 Minimum permit fee($90.00) 610-U9
Plan review(25%of permit fee)
Phone:( ) -aD— U ZO Fax:( ) State surcharge(12%ofpermit fee) Ur •
CCB tic.:qio TOTAL PERMIT FEE(�1 :I
This permit application expires if a Pe rmit is not obtaided within 180
-7 days after it has been accepted as complete.
Authorized signature: (�� z. / * Fee methodology set by Tri-County Building Industry Service Board
Print name:(jn o o& Date: /u // If
t\Building\PermitsV�C_Permil pp_040113.doc `4'400-46177(I1I 1/02//COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$1 0,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Perrnits\MEC_PermitApp_040I I 3.doc 2
. . - Gresham Electric Inc. 5036679374 p.1
Electrical Permit ApipIgAtE FORCE! 1( 1 1:,0 O\t.\
City of Tigard CEIVEI)._
Received
Dateilly Li /2. i OA) Pcnnit N:
41 13125 SW Hall Blvd.,Tigard,OR 97227i
Ill Phone: 501713.2439 Fax: 503.593.J9i
7111 it,1 1. 2 2014 Plan Review
Datelldy: Reined Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Ions: Fa See Pahe 2 for
7 I(1.■.1:1'
: Internet: www.tigard-or.gov CITY OFTIGARD NotifiedRvIctliod: Supplemental information
i' '',; f''.-:1','-'l'S'i-'•-- .:f'f. !".:''''-'..-4:riAi'4'"';' : .k.1- -a'i !:IC.:.,I Li . .1 ; .,i':::-T.'-:i,'::::;;FF, :tif,'..(TA'NE‘tre.NY7t,-,-1.-.4::=;-:.54!.,:ii:..;`,W,;:.;V:
CI New construction . Fii •dditio alteration/replacement Please thee&ail that apply(submit I sets of pleas wiitenn checked):
0 Service or feeder 400 mop s or more 0 Balding over three stones.
IDDemolition ID Other: where the available fault current 0 Marinas and betty/ads
CATEGORY OF tioissirgiuorkit*.;?:,;i :-„..::::-.:=.....;.-. ... ;.:;..7: exceeds l0,000 amps at 150 volts or 0 Floating buildings.
and 2-family dwelling D Commerciallindustrial []Accessory building less to ground,ot exceeds 14,000 0 Commercial-nu agricultural
amps for an other installations headings.
Q Multi-family EJ Master builder El Other CI Fire pump. CI Installation of 150 KVA or
JOK.SITE:!INFORNIATIoN AND LOCATION ' '....,--:.-..-' '.-:-:,- 0 Emergency system. larger separately derived
0 Addition of aew motor load of 3)atm
Job II: j_Job site address: it/3i& ,S....) /33 rd/94. c_ 100ti?or more.
0 Six or MOM residential onies. occuancy.
City/State/ZIP: --TZ:frit..,-/L otz q7. ,_ 5/
CI tlealth-care facilities. 0 Recreational vehicle panics.
Suite/bldg./apt 4: Project name: plorisetzet Afr"Gs— 0 Hazardous locations, n
s, 0 Supply voltage for more the
0 Service or feeder 600 amps or more. 600 volts nomloal.
..__._.
Cross street/directions to job site / iill..r. le"(
Del eriplien 1 Qe. I Each 1 Treat 1 '
New residential single-or multi-family dwelling unit.
Subdivision: TA r-'...L friDa..9/Int. -4...icJI-4/3 [Lot 4: Includes attached garage.
, 1,000 sq,ft.Ode% 1 168.54 4
Tax map/parcel 4:
Ea add'I 500 sq ft.or portion 33.92 i
...:, :.. ..-
• -- " ,.1-,- .-...-,,.-...,-.:DESCRIPTPOri..0}".:NVORIcy:1-I1-::-:-..f•-- - • - •:::.'I- -, ' Limited energy,residential 75.00 2
Ad 4- 11516-S 44 Peek '‘.' Dankb5 At, CU rfs\•Lr' /'10 Alt) (with above sq.ft.)
Limited energy,mai-family . ,
7500 2
IviNe C■tr..44. PS PCOZ FPLAPti I;If& residential(win'abovesq.it.)
. Renewable Energy CI See Page 2
: • . OPR°Pf•Rlii-"'WM,":I., .•••••:-1 I=7 "1'.-- -::-.'ja.TINANT - '- .,- : Services or feeders installation,alteration,and/or relocation
Name: 0\f`i. Al j rflehnthir - 200 amps or less 100.70 2
, 201 amps to 400 amps 133.56 2
Address: #1,34 17 , i3,1)rj._ A)4._ -
401 amps to 600 amps 200.34 2
City/State/ZIP: T‘ira 17 L 0/2- 9-9, 611--1 601 amps to 1,000 amps 301.04 2
( Phone:(54-a)) gyy
Fax:( )
Email'(7/nytyaylotir;ar-metefingfidefri .
Owner installatifan:This installation is befrig made on property that I own which is not over 1,000 amps or volts _._ _ 552.26 _ 2
Temporary services or feeders installs tion,alteration,and/or
relocation
200 amps or less 5935 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670, Cl 701.. 201 amps to 400 arms 125.08 2
_
-Owner signature:_g160 Date: 401 am .ps to S9 amps 163.54 2
Branch circuits-new,alteration,or extension, r panel
gor.APPLICANT -_,-' s'.'.:- --..-0.corrrAcr PERSON . Br" • '
' A.Fee ror hraich circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit i 56.18 156a t 2
City/State/ZIP: Each midi branch circuit 4- 7.42 r i 2
Nliacellancous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: • -
Reconnect only 67.84 I 2
-
, -.•,.. -: - . .. .: . • ,, , : cONTRACP6R ,I• . .; .•.: .71... '.7; . - - .- Pump or irrigation circle
P
See 2 2
Business name: (.. ..12.ect54.444-A.4 ta....G. Tle_.)C.. 1,46
c
vi•
.1....1.. 11-111N 1 .. _ sign or outline Lighting 67.114 2
Signal circuit(s)or tin 1:1 ited-energy
pan ,alteration,or exten age sion. 67.84 2
iAddress: l . .r el
Each additional inspection over allowable in any of the above
City/State/ZIP: rnizz...51.40,...1 cric713.0
Additional inspection(I hr min) 66.25/hr
JPhone: y ) S'i 0...vi _h_
Fax:(503)tzle:ri_q37‘11.
Email:....9 Ir.e<s if?a pyi el e,cA-re c,......t5 yrrii L iv? ,Investigation(1 ht into)
Industrial plant(1 hr min)
Inspections for which no fee is 6615/hr
78.18/hr
90.00/hr '
CCB Lic./2?66.3 Electrical Lie.:2/ iCrACI Suprv.Lic.:447.9< s.Pe..cT..„ficalh:isud..cA.hr..), . , . .., .•
4ratiprv..Electrician signature,require.-
Print name: 407/ 1,4442... Id"
OM X., -....••••
..._ "e - „.e,C2
Date: ...
a' illIg '..- 1 .:..'-.' ...--,,.:f_!:-ELECTRICAL PERMIT FEES
Subtotal:
_1 _ 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized . 6 -
signature-(1 ,14 - TOTAL PERMIT FEE:
TlT permit application expires if a permit is net obtained within 180
Print name:0,,„--,,,,kkk tiktiketz.,_ Date: 6.114 j9 days aftex if has beat accepted 23 complete.
- • Number of inspections allowed per permit.
INHoitdiegsPerrnitst.ELC PennitApp_ELA_ERF..doc Rev 0401/2014 440-4615111V PS/COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14310 SW 133RD AVE, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
PASS
MST2014-00092
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14310 SW 133RD AVE, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2014-00092
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14310 SW 133RD AVE, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
FAIL
MST2014-00092
Herb Stabenow
Switch does not operate the light
Violation Summary:
Inspector Contractor