12360 SW CHANDLER DRIVE I
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12360 SW CHANDLER DR
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Ulvd., Tigard, 7R 97223 (503)639-4171 DERM77'
PERMTT FLP97-0087
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s aervit i� icsliod subject to the reglilations romfatro;J in khp
'Ird mipvirivaj rude, State of Ore. Specialty Codean-� W tither nj I. 4- Si
,licablp aws, All work will be doni in #crordancp wth
,roved glans. 'rhiS Dersit will expire if work is not carted
—lip 180 davs issuance, or if work is suspended 'or vore
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Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. PP
Tigard,OR 97223 # G�? �
Phone(503)639-4171
FAX(503)684-7297 DAIE ISSUED
TDD No. (503)684-2-172
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SFIETIONS
1. LOCAL ION OF INS FALLA FION 4. TYPE OF WORK
IZ 3La ll�[��er' {fir . l
Address RESIDENTIAL—Restricted Energy Fee. . . . . . $41.►0
�tAi-fit � CK�r� Q 7 2 Z1 (FOR ALL SYSTEMS)
City State Lip Check Type of Wurk Involved;
ISN STARTED W 17S ARE THIN 180 DAYS OF I SIIJJANCF OR IF WORKS SUSPEND)D FOR N-REFUNDAE AND EXPIRE IF WORK ❑ Audio and Stereo Systems*
180 DAYS. Burglar Alarm
❑ Garage Door Opener*
2. CC)N I RAC 1OR APPLICAT!:)N ❑
n Heating,Ventilation and Air Conditioning System*
Contractor t i PJl_�. c�.I yl,(-- �a� S L ❑ Vacuum Systems*
❑ nthvr
Address—11.11(, SIT V hl�C'22-v l — — ---
Date_ '2 �( _ MMMERCIAL—Fee for each system . . . . . . $40.00
(SEE OAR 918.260-2b0)
.'roperly Owner IA __ Atm Check Type of Work Involved:
Contractor's Board Reg. No. _�43 3 —....
_� ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone# - Z 7_0§7( ' ❑ Clot k Systems
,. 11 Data Telecom muni(at ion Installations
3. OWNER APPLICATION ❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ !nstrume=nlation
Address ❑ Intercom,(nd Paging Systems
❑ landscape Irrigation Control*
City State Zip ❑ Medical
This permit k issued tinder nAR n18-320.370.Thts applicant agrees to make only ❑ Nurse Calls
tesiricted energy installations(loo volt amps or less)iindw this lx rrnit and to do the ❑ Outdoor I andscape Lighting*
following:
Protective Signaling
1. Only use electrical licensee!persons to do Installations where required.(Certain
❑
residential and other transactions are exempt from licensing.These have El Other
asterisksl*l.All others need ficensingl. -
2. Call for an inspection when all of the installatlons under this permit are ready
for inspection at 103-611)-4171,
❑ _ Number of Systems
3. Purchase separ.uo Ianrrnih hir all umtadLunma:Ih,it,ire not really for inspection
when the inspe(for is out to Inspect urt(t(`r this pormil •No licenses ave required. I Iremm are required for all other installations,
4 Assume responsibility for assuring that all corrections mquinvl by the instovont
are dune,and
5. Assume respnosihility for calling fora final insjwctinn when all(it the corwrtions 5. FEES
are completed
The person signing for this permit must he the applicant or a person a. Enter Fees $ 4.4 t'c)
authorized to hind the applirinl.
h. 5% Surcharge(.05 x total above) $_7 (10
Signature t
TOTAL $ Z �'---
Authority if other than applicant
FNFRGAP.CHP
CITY OF TIGrARD CERTIFICATE C,:
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY
13125 SW Hall Blvd, rigard,Oregon 97223*8199 (503)639-4171 # S o
f)i.*J[*. ISSUED: 09/04/')6
11L ODDREGG. . . : 12360 SW CHANDLER DR
ORL.iticprm ZON IN(, R 5
.. . . . . . . . . . .I LO I . . . . . . . . . . . . . 14)6
IJ45ti OF WORK. -NEW
YPE Of 0nC.. sr
CLUF-v*ANCY
JPiNC f LOADS,:'
mArk. : PATH I
`Al HIM
"I") 10 5W CHAILOL.) LN
LuARU OR 97224
hune M CW-4235
hone 0:
4 P 4t. . : 000000
iris cev t i f iwotp grants ocrupancy of the above referenced building u, Irc)ri, r, a
iiereof and confirms that the hi-ij Iding has been inspected for compliance wits
he Mate of Oregon Specialty Codes for the grOLIFII o ' (-.'I p IB rl y, and use un,
" lah the referenced permil: wiAs isflied.
BUII-DING Of f' 1C
t . I 1r,1 I PLACE
(MITI( OF TIGARD J'31IOL'B- 0 )00
COMMUNITY DEVELOPMENT DEPARTME.NT1?
�( 13125 SW1"!1 Blvd.Tigard,Oregon 97223.8199 (503)839.4171 ZONING: f 3,
is+lei+_,r'•. . . . . . . . . . . . . . . . . . . . . . .1,6
---arks: PATH I
.__-----------------------------------------------------•------ BUILDING ----L_�_'_ _�__-----�a_2•�4�'��
',.EISSUE: STORIES.......: 2 FLOUR AREAS-_ - - BASEMENT...: 0 sf P.EGUIRED SETBACKS-..._ REQUIRED------_---
LASS OF WORK.-.NEW HEIGHT........s 30 FIRST.,..: 1854 sf GARAGE.....: 899 if LEFT..........: 12 SMOKE DETECTRS: i
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 1164 if FRONT.........: 2d .^ARKING SPACES:
fYPE OF CONST.-5N DWELLING UNITS: 1 FINBSMENT: 0 if RIGHT........ : i
uCCUPANZY GRP..,R3 .DRM: 3 BATH: 3 TOTAL------: 301r if vALUE..S: 210517 FEAR...........: 30
---------------------------------------------------------------- PLUMBINf
SINKS.........: 1 WATER CLOSETS., 3 WASHING MACH..: I LAUADRY TRAYS.: 0 RAIN DRAIN ft: 0 • RAFo.........
LAVATORIES....: 5 DISHWASHERS...: I FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: I CATCH BASINS.. :
TUB/SHOWERS...: -s GARBAGE DISP..s I WATER MATERS.: 1 WATER LINE ft: 100 BCKFLW PREVNTP: 1 GREASE TRAPS..:
OTHER FIXTURES:
---------------------- ------------ --- -- ---------—-- MECRANICAL
:�UEL TYPES----------- FURN ( ION ..: 0 BOIL/COP ( 3HPs 0 VENT FANS...... 4 CLOTHES DRYERS: 1
%GAS/ / / FURN )=100K ..: 1 UNIT IEA'TERS..: 0 HOODS.........: 1 OTHER UNITS...: 1
-AX INP,: 0 BTU FLOOR FURNACES: 0 VENTS. ........: 0 WOODSTOVES....s 0 GAS OUTLETS...; 1
-------
-------------------------------------------------------- ELECTRICAL ---------------
—RESIDENTIAL
---------------RESIDENTIAL UNIT--- ---SERVICE/FEEDER-- - --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLAKDJS---- --ADD'L INSPECT
1002, SF OR LESS: 1 0 - Z430 alp.. : 0 0 20C alp..: 0 W/SVC )R FDR.. : 0 P*/iRP.IGA?ION: 0 PER INSPECfiON:
EA ADD I, 500SF.1 5 c01 - 400 asp..: 0 201 - 400 alE—: 0 1st WO SVCIFDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......:
LIMITED ENERGY.: 0 401 - 600 asp..: sa 401 - 600 asp.. : 0 rA AD'A DR CIA: 0 SIGNAL/PANEL....- 0 1N RLW.T......:
MANF HM/SV^/rDR: 0 601 - 1000 asp: 0 601+asps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 _._____...__--.-------_..__----- PLAN PUIIIEW SECTION -- ----- .---..-._.-_____----_.
Reconnect only.: 0 s=4 RES UNITS..: SVC/FDR) -225 A.: > 600 V NOMINAL: CLS rMIA/SPC OLC:
--------—------------------------------------------- ELECTRICAL - RESTRICTED ENERGY
,i. 5F RLSIDENTIAL--------------------------- B. COMMERCIAL----------------------------------- ---- ------------------------
4UDIO 8 STEREO.: JACUUP SYSTEM..: AUDIO d STEREO.: FIRE ALARM.....: INTERCOM,'PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..s 0TH: :1 X BOILER.........: HVAC...........; LANDSCAPE/IR;IG: PROTECTIVE SIGNL:
'ARPGE OPENER..: ':LOCI............ INSTRUMENTATION: MEDICAL........: OTHR;
VAC...........; DATA,/TELE COMM,.- NURSE CALLS....: TOTAL A SvS10S;
wnei : _....___..-_-_--.--•------------------._.contractor+ --------------- TOTAL FEESO 43&'6
1AHONEY OWNER,
109:¢ 1'w CHATEAU LN
'IGARD OR 97224
-hone N: 62A-4235 Phone m:
Feg a..: 000000
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes vd ali o;
applicable laws. All work will he done in accordance with approved plans, This permit will expire 0' work is not started within tb%
.lays of issuance, or if stork is suspended for sore than 180 days.
--•.--..___..-_____�_ ..-------_-_---- -------.-•--------- REOUIP,ED INSPECTIONS _..--•.___-._._
Footing Insp PLM/Underfloor Low voltage Gyp Board Insp Electric' Final
Foundation Insp Mechanical lr.p rireplace Inip Rain drain Insp MechanlL Final
Post/Beas Struct Plumb Top Out Gas Line Insp Water Line Insp Plumb Firs! _
Post/Beam Meehan Electrical Servi Gas Fireplace Water Service In Buildirg Final
Crawl Drain Framing Insp In;ila✓tiioon�Insp Appr/SdMlk Insp Er son Contro„
1.-e v m i t; t,a t? 13 i q t i ai t 10 /:'
LLti i r ui irt, ec.j E its
F
1I T 4. sti0.
CITY OF TI LATE: IS0�''/07/9G
PARCEL_.: 25110PE3•-02900
„I.T COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 07223.8199 1503)639-4171
5UF�1:. . . , . . ZONING: R--3.
. . . . . . . . . . . . .
1-ENANT NAMU.. . . . .
USA NO. . . . . . . . . . : FIXTURE UNITS. . . . 0
CLAWS OF WORK. . . :NEW UWEL...ING UNITS. . : 1
TYPE: OF USE. . . . . :SF NO. OF BUILDINGS: 1
1NSTALL_ TYPE. . . . :BUGWR ?MPERV r-PRI-ACE: 1,71 sf
Rem�7rk 7 : f"='ATF•1 1
MAHONEY t y f) -km c, .int Icy fiat e I-ecpt
10':)10 SW CfIOTEf4U LN PRMT ,t L`.17'00. 00 P 021071_.c., 966-:75707
1N:�I-' 9• 31H. 00 D 111,;'/07
1 IGFaI D OR `)7Iz..24
Pfi on e #: 6204235
Cont I A..t far, _. .__..._.._ _._..___.__. ........
CONTRACTOR NOT ON FILE
IrElnc, I#• # �L'315. 0it) -10T0L
Reg
_._._.._.__. iE UU 1 F(LD J'Nbf-,E(,-r 1. .
This Applicant agr•ess to comply with all the rules and regulations Sewer Ir',pE f.,t ion
of the Unified Sewage Agenry, Th# permit expires 150 Jays fro%
the nate issued. Tne total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the ac_aracy 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 ____, .._._•__^____W—.-_-_.
a "Tar and Side Sewer" Pereit and th ency will install a lateral.
t . _ �j 1 p
in_SweC•t icon C-�39- 417Y,
`� � �' �
6o6T. I-
Residential Building Permit Application
City of Tigard
13125 SW Hal! Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 12 I)L"-D SwO Lha Did '-r6
-�1�, — Office Use Onl
�
Subdivision: � lir--� � Lot#
Contact Date / ! initials _
Valuation: � �'1� �r Result
New Construction Only: (Square Footage) Planck/Rec # f
^, Permit # 17137 -Uy
Ho�ise: �:)C) 1�J Garage: Reissue of_
Map & TL #
Corner Lot? Y � NFlag Lot? Y CN Zone 35
Plat # �
Owner: J )4 �� �
<' 1 Approva_Is Required
Address: J
IO.�G(,� C�1�� w`'��l Planning Setbacks '� Solar rd Eb
_ ' aOP, _t._' Engineering
,3 Other -- ------
Phone: –
r )IAMiL Ir �LL>I001 Items Required
Contractor: I I
Subcontractors
Address: — Truss Details
Other l _
Notes 61 �3 'Jc(�t^.Wf_
Phone: ( l
PUF VI
Contractor's License #
(attach copy of current Oregon license)
Contact Name:
Contact Phone: (_ l i�(;`W►1.�'`
Subcontractors: Architect/ r: StYtiCtPr
(3y-23� NVQu�,rstc�l
Plumbing: �r 0 _ Address: rh2V-:Su) 5 mak., t, .5il P_ 41"1
Mechanical: Ili
ro.
�r + L Q �� ; �0lat-c( OR cl1.701 —
(attach copy of current OR tractor's License)
Phone: ( SU3 1 2 Z`d-- 6,01
JOB DESCRIPTION: ---
s
Applicant Signature Applicant Phone number
i
Date Received:
Received by: _ -
H INWIMN N 00
Permit it Account Descriptlon Amount Amt. Pd. Bal Due
L� <- Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) C7
Mech. Permit (MECH)
r ,
25--- V,
Si ax +TAX)
Bldg:
Plumb:
Mech: 2 j� ✓
t[. n v v
Plan Check (PLANCK)
Bldq:
Plumb:
Mech: • L , f, L� --✓
-UO3v Sewer Connection (SWUSA) vv
Sewer inspection (SWINSP)
Parks Dev Charge (PK3DC) 560 ✓ '5e-v
Residential `rIF (TIF-R) 1 ?0
Mass Transit TIF (TIF-MT) �� '� �?e
Commercial TIF (TIF-C)
Industrial TIF (TIF 1)
Institutional TIF (TIF-IS)
Office TIF (TIF O)
Water Quality (WQUAL) _ / J
Water Quantity (WQUANT) `� —1cd
Fire Life Safety (FLS)
Erosion Cnt:l Permit (EP.PRNIT)
Erosion Planck/USA (ERPLAN) Lle 6 U T
Erosion PlanckJCOT (EROSN) D
TOTALS:
CHICAGO TITLE INSURANCE %NY OF OREGON
9'X)() S.W. GREENRUKG ROAD, POKI'IAND,OK O 9?2iJ (503) 684-8954
Date: September" , 1.995
To: City of Tigard Attn: JERREE rax #684-7297
From: Linda VanDyke-Chicago Title Insurance Company
Rot Arlimaton Rldgo Subdivision- Tigard,Oregon
Coot contribution for extenslon of S.W. Oaards '
Lot Number: Lot 6, Arlington Ridge
This Is to verify that for the above referenced lot, Bull Mountain Lend and Development Company
has paid the required $9,424.25 cost contribution lior the extenslon, of S.W. Oaarda At the dnrne
our office closed the above referenced lot sale, $1,424.25 was withheld from the sale proceeds
and is being held In escrow.
The escrow account is being maintained by First American Title Insurance, Tanesbourns office,
25-16 N.W. Town Centre Drive, Beaverton, Oregon 97006. For further Information, pleass contact
Jody Johnson at 646.0320.
r
a�� Dyke 1)6'jjye—z�
Lscrow omcer
Chicago Title Insurance Company
9900 S.W, Gresnburn Road
Portland, Oregon 97223
TOTAL P.02
TO' d 9ZO' oN ZZ: ZT S6, bT d3S : QI
Permit#: �`'1`'� 9&- 007-Y
Address: 1 Z3�O ho
N' Issuc•' by: w Date:
�8.K9 L --- - -
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, URS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following.statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 313:
ET1. 1 own, reside in, or will reside in the completed structure.
,0 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
D 3A. My general contractor is —
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct in(]that I have read and da understand the Information
Notice to Property Owners about Constr ction ResponNibilities on the reverse side of!his form.
t ZML-n
(Signature of permit applicant) (Date)
(White copy to issuing agencv permit file,
pink copy to applicant)
information Notice to property Owners
About Construction Responsibilities
Note: 'this Infinrtnation N,utr( , to Proper!) t/aanc rs about Construction Respon.%ihilities
was developed bY the Constrm tion Contractors Board in accordance with ORS 701.0.55(5).
If you are acting as your own contactor to construct a new [ionic or make it substantial improvement to an existing,'4170cture,
you can prevent many problems by bang aware of the fo,lowing responsibilities and areas of concur.
EMPLOYER RESPONSiBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing; or assisting•, in the
construction or improvement of a residential srr~actu►e, you will, in most instances,be ruled to be an employer and the people
you hire will be employees. As the.employer, you mint rornply with the following:
Oregon's withholding tix law: Asan emp'oycr,you mint withhold income taxes from employee wages at the torn-employees
are paid. "-m will be liable for the tax payments even if you don't actually withhold the tax from your emhh,yccs Fn more
informatio. the Oregon Dept. of Revenue at 945-8091
Unemployment insurance tax: A� an enaplover, vo.0 arc wqurred to pay a tax fur unemployment ansurancC purp„srs on the
wages of all employees. I`or more information,o all tl e Orcgon Employment Division at the Department of Human Resources
at 378-3524.
Workers'compensation insurance: Asan employer, ,uc subject to the Oregon Workers'Cor ",rnsahon Law,and must
obtain workers'compen s;utioil insurance fur your employee.. It you fail to(61anu workcrs'cotnpensaation insurance,you may
he suh.iect to penalties and will he liable(oral;claim costs if one of yourernplove,-s is injured on the jot,. F'r,r more information,
call the Workers'Compensatit,n I)i\inion at the Depart men( of('onsurrar-and litusiness Services at 9IS-7988.
U.S.Internal Revenue Service: Asan employer,you must withhold federal income tax from emplrwcrs'w,ag*es You will be
liable forthe tax payment even if vont didn't actually withhold the tax. I rnr more information,call the Intcrn;al iletcnue Ser icc
w 1-8(X)-929-1040.
OTHER ^=SPONSIBiLiTIES AND AREAS OF CONCERN:
Cotlecompliance: r.s the permit lruldcr for this hn,jert. i M;are resp(m.uhle 101 n•solvuug iii. IadUre to,neet code reyuircnucnts
that may be brought to sour attention through inspections,
Liability and proner lly damuke insurance: Contact your insurance age:it act Kee if you have adequate insurance coverage for
accidents and omissions such as falling triols,paint overspray,waster damage f•rotrr pipe punctures, fire,or work that must he
re-done.
Time to supervise employees: M ke sure you have srtfiicient tithe to suixrvice vour employees.
Fxperdse: Make sure your have.,.,, ::xpettise to act as yourown general contractor,to coordinate the work of rough-in and finish
trades, and to notify building? .ifficiaN at the appropriate times eo they can pet-form the required inspection.
I1 you have additional que,,tions, %,rite or call the Constntcticn Contractors Board(PO Box 14140,Sal,:m,01Z 97309-5052,
503/379-4621). The Board is located at 7M Summer St. Nla. Suite 3t)tl,in Salem.
prop-own.pm4
1/94
PE #. . . . . . . MST96
CITY OF T I GARD DATE
V ISSUED: 0.?./07/9E,
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL-. .7-'G 1114)B B &11)W 0
13125 SW Hall Blvd Tigard,Oregon 97223*8199 (503)639-4171
--ITE... I I Ili. 1-
SUBDIVISION. . . . : ARLINGTON RIDGE ZONING: R-3. 5
. . . . . . . . . . . LOT. . . . . . . . . . . . . :006
CI-ASS OF WORK. . GARBAGE 015P,090LS. . c I
TYV,L OF UISL. . . . :NEW WAG)HING MALH. . . . . . . : I BACKFLOW PREVNTRS. 1
OCCUP,ANCY GRP,. . :SF FLOOR DRAINS. . . . . . . : 0 T RAS 5. . . . . . . . . . . . . . 'if
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . . I CATCH BASINS. . . . . . . . 0
FIXTURES LAUNDRY TRAYS. . . . . . .�121 Sr RAIN DPAI14S. . . . . : 1
SINKS. . . . . . . . . . .. 1 GREASE TRAPI.Ej. . . . . . . :0
LAVATORIC'S. . . . . : 5 OTHER FIXTURES. . . . . : 0
TUB/SHOWERS. . .. . . 3 SEWER LINE (ft ) . . : 0
WAILR CLOS1.`.J5. 3 t4f4TER LTNE ( ft ) - - : 100
i,.'SHWASHERS. . . . s I RAIN DRAIN (ft ) . . ,. 0
kem;7.0-ks .- PATH I
OWNER:
mr-)HONEY "r I r-, 1, 1470. 00 D 0 7119 6 X36--07 57 V.,i
10910 SW CHATLAU LN TIFM $ 120. 00 B 02/07/96 96-215707
5W1,1 $ 160. 01b B OE/07/96 96-275707
1160RD OR 97,1,L4 5W111 .4, 10111. 00 b kr.::/07/96 96-E75'707
Plione #: 6204235 ELCF $ 2C;;,. 00 P OLV07/96 1.b -2757'
ELC5 $ 11. 75 B 0.:'/07/96 96-27570
rLRF-' $ 40. 00 123 0L/07/9F 1)G-,--'75707
ELR5 $ .2. 00 B 02/07/96 96--P-?-'m7
�I. 5L
Name : LAPH 1 $ IV A Iji 0LJ/07/96
AddressBVILL 1, 46 i. 13_� j D V11/ 2/96 L 96
CJ.ty ..JVeW6e_t_q 0 - S5PIC 1- 3 tj- 11mj 3 0 02,10/1196 96
lip: -. a r i e# V"Anil 501271. 00 B 02/07/96 96.-275707
Peq
Odditional. fi-es not shuwTi here. . . . . . . .
Ae b,, Y*139 REQUIRED INSr,ECTIONS
Thi-.if permit is issued subject to the reg
ttjatjorjs cont,.%ined in the Tigard Mun i c i pa I Footing Insp Gas Line Insp
Code, State of Ore. Specialty Codes and all. Foundat3un lnip Gas Fireplace
other- applicable laws. 011 wo,-k will be done Plost/Beam Struc-t Insulation I-
in accordance with approved plain s. This r-,cist /Be am Mechan Gyp Board Ii
permit will e>ipire if Work is not Started Crawl Drain Rain drain I, >y..
- thin IL30 L; ,aya of issuatnceq or if work is P'LII/Undei,flooi- Water Line Insp
.tspended for more than IBO day l- Mechanical Insp Water, Service T,
Plumb Top Out Hppi-,'!�dwik
Electrical Servi Electrical Fir)ak
Framing Insp Mechanical Flj-".Aj
2 Low Voltage P'lumb Final
Fireplace Ins p DuilLi�!C.j (-'iTlin.11
,that P'lumbing Con -actor Signature
Call f,)v inspection - 630 417T
mtrar.tot- Not Fs -
02121 96 11:22 $503 598 7745 CHEROKEE ELEC Z ool
Z 1 (9-` o
CITY OF TIGARD
13125 S.W. HAIL BLVD.
TIGARD, OR 97223or
'1
IMPORTANT PERMIT NOTICE `3 vie
't
CHEROKEE ELECTRIC CO r ��r
PO BOX '00230
TIGARD OR 97281
--
Electrical-Signature Form
Permit #. . . . . MST56-0024
Date Issued. : 02/15/96
parcel. . . . . . . : 2811OBB-02900
Site Address : 12360 EW CHANDLER DR
Subdivision. : ARLINGTON RIDGE
Block. . . . . . . : Lot : 006
Zoning. . . . . . . k-3 .5
Remarks :
PATH I
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 the supervising e!ec'crician
is required.
Please hava the appropriate individual from your company sign below and return this Electrical
Signature ror►n prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER : ETECTRTCAL CONTRACTOR:
MAHODrEY CHEROKEE ELECTRIC CO
10910 SW CHAMAU LIQ PO BOX 230230
TIGARD Ok 97224 TIGARD OR 97281.
Phone # : 620-4235 Phone # :
Rcq # . . : 3$681
X �
Signature o upervising Electrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have anv questions. please call 639 4171, ext #310
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639.4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling
Post/Seam Mecri. Sheai;3i;iath Framing ec
Plbg.Und/Flr/Slab Plbg, Top Ou' Insulation s
Post/Beam Struct. Mech, Hough-in Gyp, Bd.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _—_—
Date- —� -_ A.M. P.M.___- Entry:
Address:
3-L __
Tenant: _i Ste:_...___ MST: -�.
Con/ rw 1 C,.� _' — ----- MEC:
PLM
ELC:
THEE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
Ins,pa -r: Date: /�•��' b
-_4 APPROVED _,DISAPPROVED/CALL FOR REINSP. CF CO