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Case File 15. 00 fz. Lo qW ti 44 .01 �,+� 1''��M'iP• •';,'w;,1ty'�',''•1�" "�'�/ ����AZ v •fir yl •W YL ` I�i' .►�+ ' v `:i' . y 11 ,,•"`` ,`�;• 1^e,..�./:;. sem. '•♦ jMr��, kkK•� �f{1�1:�'�� lry •4�:' . - t :�• r,.;� •�''yf'a:�':,'� ,'. t ' , � � I,•• •/ . ' ..0.ii r,,` ~' c.,•r It -rj�,t,1. .>w�� 1'�, r 1• y i •r�r•l �'.!► a.l .'wk,'• 711, ' ,• J •�+ �,, "^'' �,/. .�F����' ♦,tet•Iyf, _ ,Y/ �• i . •',..: x�.11)w.. '.�'S ' 7i' 6/• �,iF. : I � �A .�. 'sem. •.�'/! ,rL'- I ,' �S� 'iv,��•,..1.>1�,aI••+ \• .'T.iti'?1�• / ,�N r .•.� r• •• ��'Jy '��r,:.T r'7 • - I ''i:{ :• y a•rl�� rl��• �� •rw••�• ••��•r r.�.r .���• �"t•,.��w• �'��••� t r♦•I•�•1 ��r��: • `I r LnI IAAICxl4� • ' 1 L;.Amo 16 ic Vt two �- i •' / r n \ J 15. 00' � l. • 1 Ld 9�xJf4L.csmeT C*1 s a •'im Uwoil 404"WrN ,�w � .r�� lM' ;ri�l �lyr ,t„y 7,1 �.a ,�1 j •�� r.I. AM \ NOTICE: IF THE PRINT OR TYPE ON ANY , III I _Ill I Ill 11Tf TTT ] p_I Ill Il _T _ I1I11 Jill 11 IMAGE IS NOT AS CLEAR A THIS NOTICEI ' l6 �tllllllllll_ 10 111111 III IIII __III1IIz IT IS DUE TO THE QUALITY OF THE II No-36A\'.; :-�... ORIGINAL. DOCUMENT E 6Z SZ LZ 8`L 4Z fiZ ��Z Z TZ I gt 9I 9T � St Zi IT i 6 8 L -r 9 S Z I OZ IIII II!I IIII IIII IIII III) IIII IIII ILII IIII Illi illi llll.11 ll 111 111 Ll. Illi illi Illi 6 i IIII IIII 11111,11 Illi IIII�IIII IIII Ifll � IIII IIII IIII ���� IIII illi l llll .11l llll�llli ���� 11.1.1 11.11.Lll ll>J 1111�1�k•II i f . r 150-00. SLP • � I ' I a L •r. ` , �. '•�•. ;'��Itj. yTF,, :, •16 1- :fir. �. �•' � {�q,ll,:;x.1a�. a At of tif Aj IN IF ,5"1r�a'• i'• jr ^� ..•1j,,� '', t{i'f� 1�� �r � F;•,; n,a�� + , t. • tr ,�• 1. �•,, w� ,M•.� .7•. •11�,✓..i q r' .'�+'4.`+.,) , ,i1•1 '�'�� ��`.%i4'f 'i�•,'I. ' tire, �r�rY;. ••, 1 .fir, .: •. .� �' '�~ 'w •t F'' '' +,r lir � t��'�:.., ��tt11((..., t ��./ ;�� a,•r•y�,At.• 1r. .44: ;� ; •)'.��,!�'���yyr�: •��'(� •�YZ/i •,� ,,. _ ..w 1� .�•4, •�._r`,,a..ww��•;:�' iwM'�'j t .l.C'`' 06i& ' � Y 1C • C�) vjcogs • �! ,, 7 •�.�� .•��r .r.�.wi� �r...rrr �... .�.�rr ..�•r.r�r �••••n•�wmr '. .'�.� ,t��-7t • •, ,� 1 , h '' 12 Ir '' f r . r •' ". ' ~7 r.�4 �, r ,«: t! �' ° • . O 15, 0©' � 1. . r 1 �T .YA.w X Yom.. I .� .. • •• ' �. , ..�. 31'•x. ..• .tt/ r.•sv ., � 1. j ,, r,�, 1.t'. t .►,•,:,.i �i :,'� • . i. ,• �, a� V L • •�1•r aw.. ••e.a•ter. a.r v m r w . • f.► � . .. a Now NOTICE: IF THE PRINT OR TYPE ON ANYl l-Itl l f 1 111111 I I I I I I I I I I I I I III III III III III III III I ( I 1 111111 III III 111 III III III III 111 1111111 III III III III III Ill IIIIIII III III 11111 l l 1 1 1 11 ! 1 I I II Ili 1 1 1 ! 1 11 S THIS NOTICE, � I I I ( I I I I 1 ! 111 11 IMAGE IS NOT AS CLEAR A Z I !r 2 � � � I6 I7 $ 10 9 - IT IS DUE TO THE QUALITY OF THE - - - --_-- -- ----------- -----____ __ ------_ -- _--------____---_- _ No.36 ORIGINAL DOCUMENT [nl•Y fpY1 1111:11116 II E I_II II6I-I IIII III II-I_I. II III! IIII IIII IIII IIII IIII IIII IIII Illl�llii,�!il. IIII IIII�IIII IIII II6II IIIII IIgII IIIII IILII T 11 -i I-I9T 11111 TI � TI I IET ZT TT TII1111 l6 llIIII ,ll.l lll 1111 JJ11 111 U 11Ll lllll4o a N O Cn C C X r 0 X m U) 0 X 11620 SW BURLCREST DRIVE 2�11�1 I CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 63 -4171 Date Requested: 2-3 G' Y A.M. .M. MS"C: Lorb(ion: ) I J4A) C BUPi-- Tenant:_ Suite:__ Bldg: MIiC: Contractor:������ �_ — Phore: PLM: _ Gruner: Phone: _ ELC _ t S_ bc(til_ �-j a _ 46 -,L r _ 24/0 BUILDING BLDG(con't) ,PLUMBING � CHANIC " ELECTRICAL SITE Site PosUlicam Post/Beam `Pdffft= ' Cover/Service Sewer/Storm Footing Roof UndIA/Slah (tough-hi Ceiling Water Line Sleh (gaming Top Out Cies Linc Rough-In (1(t Spritiklcr foundation Insulation Sewer Ilood/Duct Reconnect Vault lismt Damp Drywall Storm furnace Temp Service MISC. Masonry Ceiling Rain I)ram IVC UG Slab Shear/Sheath Fire Spklr/Alm Ciawi/found Ir Beat Pt I,ow Volt Approved Approved ppro+ed Approved Approved Appr/Sdwlk Not Approved Not Approved o proved Not Approved Not Approved FINAL FINAL INAL17 FINAL FINAL O Call for reinspectiFlo—? OR eifispection fee of S______`required beto next inspection D Unable to inspect Inspector: Date Page of_ _ I CITY OF TIGARD BUILDING IN ECTION DIVISION 24-Hour Inspection Line: 6394175 It4siness Phone: 6394171 11C Date Requested _ e ' C — /A M. _ MST: I owtion BIJP: Tenant:__ _ Suite _ _Bldg: _ MEC: Contractor:_ -'' - T��.�'�- —_Phone: 5 Y U 0,2-94L _ PLM- Owner: A A Phone. ELC: -- �-- T_ --- --- - II.R: _ VI'ltt" IL16-i &-C L4--&k- A4 IC S SIT: BUILDING I n'0 PLUMBING MECHANICAL ELOtTRICAL SITE Site osUBeam Post/Beam PosUl3cam Cover/Service Sewer/Stone Footing Roof Undl'USlab Rough-hi Ceiling Water Line Slab framing Top Out (ins bine Rough-In UG Sprinkler Found,alion Insulation Sewer Ilood/Ihut Reconnect Vault B."Int Dumb Drywall Stonn Furnace Temp Service MISC. Maunuy Ceiling Rain Ikam A/C IJG Slab Shear/Shealh Fire ' /Alm Crawl/l.ound Ih Ileat Pump I'm Volt Pprovex0 Approved Approved Approved Q Approved Appr/Sdwlk 4Y it ved Not ApprNot Approved '/y�' Not Appro� '.� -1 Not Approved 13 AL ove FINAL Z;/ FINAL f FINAL FINAL 411^^ - - -- - — i CI Call for reinspection /� O Reinspection fee of S_—__._—_—r uired before next inspection O Unable to inspect Inspector-- I✓�.-----_- Date -_-- Page_— of 1 CITU Or TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone- 639-4171 Date Requested: q _ M)___..__. '.M. . --- MST: --- ���'2 E') Ci(,�_ '�-�C� Location: — - — --- - - B(JP: Tenant: Suite: _Bldg: ! MFC: Contractor:.., { 4. 7jz —t, _A -- (honer: _ _ _ Phone. _ _ ELC:_ ELR:^ — _ ... SIT: BUILQ—IN G DG(coni) LUMBING MECHANICAL A ],L+�JL'AA. SITE Site Posl/Beam Post/Ilearn Post/Beam Cover/Service Sewer/Storm Footing Roof Ondl'I/Slab Rough-In Ceiling Water bine Slab Framing -fop Out Gas bine Rough-In l IG Sprinkler Foundation Insulation Sewer Ilood/Duct Reconnect Vault Flsmt Dump I)tywall Stonn Furnace Temp Service MISC. Masonry Ceiling Rain()rain QVC 1 KI Slab Shcar/Sheath fire.Spklr/Alm Crawl/l otmd 1_)r Ilent Pwnp I,ow Volt _ Approved Approved ApprovedI roved Approved Appr/Sdwlk Not Approved Not Approved Not Approved a pmvcd Not Approve) FINAL FINAL FINAL INAI., FINAL 0 Call for reinspection / Reinspection fee of S _required before next inspection d Unable to it►spect inspector — Date: —_ Page of CITY OF T I GARD COMMUNITY DEVELOPMENT DEPAIITMENT 13125 SW Hall Blvd.TiOud,Oregon 07223.6100 (503)630-4171 �.n�. nadltian 576 sq e.l, STORK:, .. 1 'LrLR AREAS---- __ PASW;T..,. D _. DF WCRK. ,ADD 4EIGHT......... 14 FIRST....: 576 sf GARAGE.....: 2 sf LEFT.,...,..,.: 2 SXX DETECTRS: Y OF JC!L.. :7 FLOOR LOAD....: 40 tr_C,X...: 0 0 rRONT.......... C "ARItI.4G SRIICEE: 0 E OF ^.ONST.,5N DWELLING UN17:t 1 FINKMENT. 0 of RIGhT.........: 7 -upwY GRF'.:R3 BDRM: 1 BATH; 1 TOTAL— -: 576 ,f VALUE-1; 37KE 'OR.. (a..... . WATER CLOSET . iAS8I iC MIaC'..: a LLnfaou� 7r k,u MIN .n,RAIN, f..., --'. ATQRIES....: 1 DISHi IERE...s 0 FLOOR DRAINS.. ; 0 CE;aCn '_INE ft; 0 OF RAIN DRAINS: 8 1 GARAGE DISP-.: 0 ATER HEATEIK.. 3 WATEr _114E ft: 0 BCKFI.W PREVNTR: 0 :'r ATK `."UPES: A NEC"iCAL -- . TYt'ES----------- FURN ( 10 ..t Q BOIL/CMP ( 31f: 0 W FANS.....: 1 CLOT)ES DRYER: 0 'URN .-IW ..; 0 UNIT HEATERS..; 2 iiOOIIS.........; Q OTHCR ",,,5,,.: 0 0 BTU t1.DOR a a i ENTS..... s' XODSTOVES....: 0 GAS CL''. 0 _..__ .___...._..._..__...__._._--- -.........._.. =TM Ai. iiAL UNIT - ---SERVICE/FEEDER---- --TEW SRVC/FEEDERS-- ---3RANCH CIRCUIT: 41:CILANEOIB;---- --AOI'. SF CR .0:S: ti 0 200 arp.. ; 0 0 c00 aep.. : 0 W/SVC OR FDR..: 0 PtWIRRIGATION: 0 PER INSPECTION: +DD'. 3W7.: E+ 1C: 4H amp..., 0 201 - 4@0 amp..: 0 1st WIO SVC/FDR: i SIGN'QUT LIN LT. 0 PER HOUR....... 0, ?rn- ENERGY,: 0 401 600 alp..: 2 401 - GM amp,, : `t EA ADDL AR CIR: 0 SI.NPLINWEL...: 2 ANT.... 0 601 - 1000 amp.: 0 60! alp lue V. 2 MMR LABE1. 10. 0 PLAN REV.EW SCWTION Reconnect only.1 2 )=4 ME- :1:TS.. ; S7C/FDRI-z" A. ) 600 V NOMINAL: CLS AREA, CL[:TfilwA, - RESTRICTED DERSY D. COMMERCIAL mr,Ppo „ycTIM. AMID 6 CTEiIEC.: NIKE ALARM.....: I14TEPCON/P#imi Ci1TLC011 Or-S, BOILE?.........; ti'"AC........... : LANDSCA /IRRIS: PROTEC'IVE •^SIGNS. CLOCY..........; INS T-JVTr1ATION: M UCAL......... OTHF: : DATA/TELE C1l,MM.: VJrX CALLS, TOTAL a SYSTENS: Untral-Ur; TOTAL FEES:1 5215.13 VICR phone C Res 0... ONNIC. S Ne'b:: .: lanuriu i,Avjk,A iL ii.p ii]dlatiz-s c.ntalned ;r t``e TijarC Munic:pal CDCei State of Lire. Specialty Codes aii0 c :viii u 'lane in aC.7rdiitcf hitt 2pfr-oved pl IB. T}is permit will typire if iia+'k is r."t st2"ted h., L ce : s avicej c't if a„rk :b Su;F.eao2d f01' 171'8 tl.dli 10 days, Erosin Cent::rel Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4971 1 .,lobsite Address: XC' �'-������ r���r ��� IWO Subdivision: &u, f � Office Use Qnly -/ Contact Date -z/ I' Initials +r Valuation: _ / L_L—_ —. Result y '7 i 4 /I !7 t New Construction Only: (Square Footage) Planck./Rec # Permit # ilhty -CLy u House: __._. Garage Reissue of Map & TL # 1-5 C Corner Lot? Y (N Flag Lot? t, (N Zone W �I Plat # _ Owner: Approvals Required Address. t Planning Setbacks _(_ Solar li,� nn Engineering Phone: f � ) ) :5't o �- Other Items Required Contractor: _ Subcontractors Address Truss Details _ Other Notes Phone ontractor's License # � (attach copy of current Oregon license) Contact Name —__-- �_ - -- ,)ntact Phone ` Whcontractors: Arch itecVEngineer: Plumbing _ Address: 1% - 1i; Mechanical - _— ------- ����n WL (attach copy t)f current OR Contractors License) Phone. LS(J 9L - JL SV JOB D S( TION: A U FW n Applica t Jignature Applicant Phone number Received by Date Received. t.�� ny,nu,.,ay Permit# Account Description Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD). -.,� ` Plumb. Permit (PLUMB) Mach. Permit (MECH) Bldg: Plumb: [Mach: Plan Check (PLANCK) Bldg. Plumb: Mach: Sewer Connection (SWUSA) , Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-0) Water Quality (W©UAL) Water Quantity (WQUANT) _ Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) i Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) TOTALS: �r, Permit #: .> ... Address: :I0 . ISSUed by: Date: 12-- Statement: ZStatement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 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: /"I own, reside in,or will reside in the completed structure. (� 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. L J 3A. My general contractor is L J (Name) Contractor regis. # 1 will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR M,/'IB. I will be my own general contractor. If I hire subcontractors, 1 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 and that I have read and do understand the Information Nolice to I'ro erty owners abou (onstruction Responsibilities on the reverse side of this form. k.0 I (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) information Notice Property Owners Aboux Construction Responsibilities Note: This InjW—Inution N Sri; e to Property Owners about Construction Responsibilities was developed fav the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to cons'.ruct a new home or make a substantial improvement to an existing structure, you can p.-event many problems by being aware;of the following responsibilities and areas of concern, 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 structure,you will, in most instances,he ruled to be an employer and the people you hire will he employees. As the employer,you must comply with the following: Oregon's withholding tax law: As an employer,you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information,call the Oregon Dept.of Revenue at 945-9091. Unemployment insurance tax: As an employer,you are required to pay a tax for unemployment insurance purposes on th- wages of all employees, For more information,call the Oregon Employment Division at the Department of Human Resources at 378-3524. Workers'compensation insurance: As an employer,you are subject to the Orrgon Workers'Compensation Law,and must obtain workers'compensation insurance for your employees. If you fail to obtain %+orkers'compensation insurance,you may he subject to penalties and will be liable for;al claim costs if one of your employees is injured on the joh. For more information, call the. Workers'Compensation Division at the Department of Consumer and BUsinCGs Services at 945-7898. U.S.internal Revenue Service: As an employer,you must withhold federal income tax from employees'wages You will be liable Im the tax payment even if you didn't actually withhold the tax. For more information,call the Internal Revenue Service at 1-8(f)-829.1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder I Or this ProJec t,you are responsible for resolving any failure to meet coxae requirements that Inay he brought to your attention through inspections. Liability and property damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for ;accidents and omissions such as falling;tools,paint overspray, water damage from pipe punctures,fire,or work that roust he re-clone. 'Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expert i se to act as your own general contractor,to coordinate the work of rough-in and finish trades, and to notify building officials at the appropriate times in they can perform the required inspections. If you have additional questions,write or call the Construction Contractors Board(PO Box 141411,Salem,OR 97309-5052, 503/378-4621). The Board is located at 71X)Summer St. NV, Suite 3(x), in Salem. prep-own.p1114 1194 PM SSE 35MM ROLL# 22 FOIA L..,-kRGE DOCUMENT CITY OF TIGARD VERTICAL NETWORK INDEX NO. 30 L. 188 .79 AGENCY: CITY OF TIGARD DATE DESCRIPTION: BRASS DISC SET IN THE CURB ON THE SOUTHEAST CORNER OF S .W. 95TH AVENUE AND NORTH DAKOTA STREET. INDEX NO. 34 EL. 19 . 33'1VN AGENCY: CITY OF TIGARD DATE DESCRIPTION: BRASS DISC SET IN THE CURB ON THE SOUTHWEST CORNER OF S.W. DURHAM ROAD AND 92ND AVENUE. INDEX NO. 36 EL. 229.75TVN AGENCY: CITY OF TIGARD DATE DESCRIPTION: BRASS DISC SET IN THE CURB ON THE NORTHEAST CORNER OF S.W. 78TH AVENUE AND PFAFFLE STREET. INDEX NO. 3'1 EL. 2.28 . 27TVN AGENCY : CITY OF TIGARD DATE DESCRIPTION: BRASS DISC SET IN THE CURB ON THE NORTHEAST CORNER OF S .W. NORTH DAKOTA AND S .W. 115TH AVENUE . INDEX NO. 41 EL. 176 . 38 AGENCY : CITY OF TIGARD DATE DESCRIPTION: BRASS DISC SET IN MONUMENT BOX 19 FEET WEST OF CENTERLINE OF SOUTHERN PACIFIC R .R. TIAC'PS, 2 FEET SOUTH OF THE CENTERLINE OF NORTH DAKOTA STREET . STAMPED "DLC 52 DI.0 54 1981" 3 SEE 35MlyI ROLL# 22 FOR LARGE DOCUMENT I CITY OF TIGARD DEVELOPMENT SERVICES ELECTPICAL PERMIT 13125 SW Hall 6,wd., Tigard,OR 97223 (503)639-4171 PERM IT #: EL.C96-0661 DATE ISSUED: 10/16/96 PARCEL-: 1S1:-'1-CA-07400 SITE ADDRESS. . . : 11620 13W BURLCREST Dlq SUBDIVISION. . . . : BURLWOOD NO. -!. 7ONING:R---4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . : 14 Project Description: --- RESIDENTIAL UNIT------ ------TEMP SRVC/FEEDERS---- -----M I SCELLANEOUS——-- 1000 ----MISCELLANEOUS——- 1000 Sr OR LESS. . . . : 0 0 200 amp. . . ., . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADDIL 500SF. . . - 0 201, 400 amp. . .. . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 SIGNAL/PANEL.......: 0 MANF. HM/ SVC/FDR. . : 0 601-i-amps-1000 voltt;. *. 0 MINOR LABEL ( 10) . . . : 0 ----ziERVICE/FEEDER----- ----BRANCH CIRCUIT'S -.---ADD' ;- INSPECTIONS--- 0 - W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 200 amp. . . . . . . 2 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . : 0 EA ADDIL BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ---------------_-_PLAN REVIEW SECTION-­­­­­­­ 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL . : Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. z Owner: FEES KEITH SLOAN type amount by date recpt 11620 SW BURLCREST DR PRMT $ 120. 00 DRA 10/16/96 96-285272 5PCT $ 6. 00 DRA 10/16/96, 96-2B527E, TIGARD OR 97223 Phone #: 590-0256 Contractor: ALLIANCE ELECTRIC INC $ 126. 00 TOTAL 19590 SW 51ST ------- REQUIRED INSPECTIONS TUALAIIN OR 97062 Elect91 Set-vice Phone #: 691-2222. Elect9l Final Reg #. . : 000787 7 This permit is issued subject to the regulations contained in the Tigard lunicipal Code, State of Ore. Specialty Codes and all ,ether Perm it-A-ee Signat care applicable laws. All work wi;l 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 than 18@ days. ,sued By INSTALLATTON The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER' S SIGNATURE: DATE: -._---------------------_-CONTRACTOR INSTALLATION ONLY---------- SIGNATURE OF SUPR. ELECIN: DATE-. I-ICENSE NO: Call for inspection - 639-4175 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # _ Permit # Phone (503) 639-4171 Date Issued ---,14- FAX (503) 684-7297 Issued by CITY OF TIGARD TDD No. (503) 684-2772 _ - Inspection (503) 639-4175 r I. Job Address: �"T l� 4. Complete Fee Schedule Qe/ow: Name of Development Number of inspections per permk allowed — Address 11620 SW Bu r 1 c res L Dr Service included Items Cost(ea) Sum City/State/Zip T i g a r d 4a. Residential• per unit 4 1000 eq it of lana $11000 Name (or name of business) Keith Sloan rack additional 500 sci It or �p-J`� portion thereof $25 00 1_ 1 Commercial❑ Residential ltraded Fnergy $2500 Fach Manuf d Noma or Modular f>,valAng Servta r Feeder W00 �. Contractor installation only: 4b.Services nr Feeders Insla9stion alternhon or relocalion 7 Electrical Contractor Alliance Electric 200 amps or Ions 2 $w,on 120 . 00 Address ,, t19590 -W 71st 201 amps to 400 ampr. '— $8000 City t u U U 1. 111 Jtat _ ZI 401 amps to 600 amps $120 00 2 p__. 601 amps to 1000 amps $16000 2 Phone No. 691 -2222 Over 1000 amps or volts $34000 Contractor's License No. 3-310 C Reconnect only $50 00 `- Contractor's Board Reg. No, 787 1 3 _ 4c.Temporary Services or Feeders Installation affaration.or relocation 2 Signature of Supr. Elects_. _.�, ,�ZL-f1! 200 amps or leas $5000 7 201 ampe to 400 amps $15�0 2 I icense No _Q -� _ _ Phone No. 401 arapa 10 600 amps S10000 _ Over 600 amps to 1000 volts 2b. For owner Installations: see•b*above 4d. Branch Circuits Print Owner's Name _ New attcrshon or extension per panel Address n)Tha fee for branch areata with City_ State Z.ip purchmse of swvks or tial r I». Each branch circuit $5 00 Phone No. b) The lea for branch circuits without The insta!I6f.on is being made on property I own which is pr.-h4"of"ryke or Nader Am. 2 not intended for sale, lease or refit. First brarr,h circuit $35 00 Each additional branch circuit $1.00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (i/ required): I aclt primp or litigation cure $4000 _ Fnr-1,sign or oulhne lighting _ $4000 Signal cirrud(s)or a limned energy Please chock appropriate item ani enter fee in section 5B. panel alteration or edmston _ S4000 4 or more residential units in one structure Minor minis,1 0) $10000 _ _ Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing spEr;ial occupancy the allowable in any of the above as described in N E C Chapter 5 "'^ter M-I,�r, s35 00 ___ i'rr hour $55 o0 Submit 2 sets of plans with application where any of the above — apply Not required for temporary construction services. 5. Fees: NOTICE 5s. Enter total of above fees $ 5%Surcharge( 05 X total fees) $ d PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Sh. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FON Plan Review if required(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED ❑ Trust Accountill! $ - Balance Due $ .126 ",OQ rtwdcn.Mw�Wc ym app CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 6394171 A.M. D-te Requested: v.3 _�// P.�Mp._ MST: Location: BUR tenant: l- Suite:_ Bldg: MEC: Contractor: .l 1 Phone: J/te0 -OZ) J L PLM: (rev: --Phone: ELC: — � ELR: SIT: �- 4 -" BUILDING BLDG(coni) LiJMBIN MECHANICAL ELECTRICAL SITE Site Post/Begun t'e5df am Post/Beam Cover/Service Sewer/Storni I"ooting Roof l)ndll/Slah Rough-In Ceiling Water LineSlah Framing Tori Out Ga.y Lute Rough-In UG Sprinkler Poun(h+tion lunula:ion Sewer IloodA)uct Reconnect Vault HSmI l ramp D"all Storni Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C I IG Slab Shear/Shcalit Fire Spklr/Alm Crawl/Found Dr I leal Pnath Low Volt _ Approved Approv A i proved PI' Approved A>tt/tidwll. -�'� I! Approved I I Not Approved oaf/T1'�'roved Not Approved Not ApI roved Not Apl,roved FINAL = 'ItINAL FINAL FINAL, FINAL C3 Call for reinspection Cl Reinspection fir of S required before next inspection O Unable to inspect Inspector — �] - Ib►tc: Page of 1 CITY OF TIGARD DEVELOPMENT SERVICES 11ASTUR F'E.RMT1- F'ERM I T #. . . . . . . . 1 ..iT96- :x.'040 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01 /10/97 PIARC:EL.: 1 S 134CA-0740171 SITE* (-iDD14ESS. . . : 1. 161*'0 SW 6URI..CRE51 ISR (3UJAD T V I S I ON. . . . : SURI-WOOT) NO. 2 ZONING: R­-4. 5 F L-OCK. . . . . . . . . . I 1 (11.. . . . . . . . . . . . . : I �r Remarks: addition 576 sq feet PATH I -------•------------------------------------------------------- BUILDING REISSUE: STORIES.......: i FLOOR AREAS -------- BASEMENT,,,; 0 sf REQUIRED FETBACKS---- REQUIRED------------ CLASS OF WORK.-,ADD HEIGHT........: 14 FIR£T....: 576 3f GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS: Y TYPE OF USE... :SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT......,,.; 0 PARKING SPACES: 0 TYP,: OF CONST.:5N DWELLING UNITS: I FINBSMFNT: 0 sf RIGHT.........: 7 OCCUPANCY GRP.:R3 BDRM: 1 BATH: I TOTAL-------: 576 sf VALUE—$: 37826 REAR..........: 36 ------------------------------------------------------------ PLUMBING —----------------------------------------------- SINKS.........: 0 WATER CLOSETS.: I WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0 LAVATORIES....: I DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft; 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB/SHOWERS...: 1 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 MECHANICAL ---------------------------------------------- - ---- -- FUEL TYPES -------- FURN ( 108K ..; 0 BOIL/CMP ( 3HP: 0 VENT FANS..... : 1 CLOTHES DRYERS: 0 /ELF/ / / FURN )=IW, ..: 0 UNIT HEATERS..: 0 H90N......... : 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 3 WOODSTOVES....: 0 GAS OUTLETS...: 0 __ ___.------------------------------------------------ ELECTRICAL- -- —_-------.__.----------------------_—..._---------- UNIT--- ------UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L 1NbpECTIONS-- 1000 SF OR LESS. 0 0 - 200 asp..: 0 0 - 200 asp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION; 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR; 1 SIGN/OUT LIN LT: 0 PER HOUR.....,: 0 LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 asp..: 0 EA ADDL BR CIR: 7 SIGNAL/PANEL...: 0 IN PLANT......: 0 WMF HM/SVC/FDR; 0 501 -- 1000 amp.: 0 601+asps-lm v: 0 MINOR LNca -10: 0 1000+ asp/volt.: 0 ----------------------------- - - PLAN REVIEW SECTION --------------_�___— _�w..----- Reconnect only.: 0 1=4 RES UNITS..: SVC/FDR)=2225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC: ------- ELECTRICAL - RESTRICTED ENERGY ------------—.-------------------------------------- A. SF RESIDENTIAL----------------...------ B. COMMERCIAL---------------------------- -- ----------------------------------------- AI!DIO A STEREO.: VACUUM SYSTE:M..: AUDIO Il STEREO.: FIRE ALARM.....: INTERCOM/PAGII,c: OUTDOOR LNDSC LT: BURGLAR ALARM—: 0TH: .. BOILER....,..... HVAC............ LANDSCAPE/IRRIEI: PROTECTIVE SIGNL: 3ARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL......... OTHR: HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL A SYSTEMS: 0 Owncr; -- ---- - --- -- --- - ----- -----Contractor- ----------------------------- TOTAL FEES:$ 561.88 KEITH SLOAN OWNER IIE20 SW BURLCREST DR TIGARD OR 97;23 Phone t; 590-0256 Phone A: Reg M.. : 000000 This permit is issued subject to the regulations contained in the Tigard Muni-ipal Code, State or nre. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work not started within IBP days of issuance, or if work is suspended for more than 180 days. -_-•_----------------------------------------------------- REQl1ERED INSPECTIONS -------------------------------------------------------- Footing Insp Mechanical Insp Electrical Rough Gyp Board Insp Building Final Foundation Insp Plamb Top Out Electrical Rough Rain drain Insp Erosion Control ` post/Beam Struct Plumb Top Out Framing Insp Electrical Final PLM/UPdPrfloor Electrical Servi Fireplace Insp Mechanical Final RLM/Underflner Electrical Rough Insulation �Sp Plum► Final n / , F'er•mitt; ee ';igna+t.bre : _ •-- --�-Ssr.red By C:a: 1 for in5pec,tion — 639-4175 C 1 i Y O F T I G A R D MECHANICAL " DEVELOPMENT SERVICES PPERMIT E R tl I T #. . . . . . . : MEC97-000L 13125 SW Hall Bivr:., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 01 /10/97 PARCEL: I8134CA-07400 . ITE ADDRESS. . . :: I SW BURLCREST DP S SURD I V I S I ON. . . . : BUHL.WOOD NO. 2 ZONING: R-4. 5 T11-OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. 14 ( I-ASS OF WORK. . :A[.T FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : QA OCCLIPHNCY GRP. . .-R3 VENTS W/O APDL: 'A VENT SYSTEMS: 0 STORIES. . . . . . . . : I BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL 0-3 HP. . . . . 0 DOMES. INCIN: b : /WOD/ 3-15 HP. . . . , 0 COMML. INCIN: 0 MAX INPUT: 0 5TL1 15-30 HP. — 0 REPAIR UNITS: 0 FIRE DAMPENS?. . : Y 30-50 HP. . . . 0 WOODSTOVE-` . : I GAS PRESSURE. . . 1 50+ HP. . . . .- 0 CLO DRYERS— : 0 NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 0 FURN ( 100K BTU- 0 10000 r:fm: 0 GAS OUTLETS. : 0 FURN ) =100K BTU: 0 > 10000 cfmc 0 Remarks : WOOD STOVE BY OWNER (EARTH STOVE SPECS ON JOB SITE) Owners FEES KEITH SLOAN type amol-mt by date rept 11620 SW BURL-CREST DR PRMT $ 25. 00 JMH 01/10/97 97-288739 5PCT $ 1. 25 JMH 01/1271/97 97-2887,39 TIGARD OR 97223 Phone #: 590-0256 ONTRACTOR NOT ON FILE �iune #: $ 26. 25 TOTAL. REQUIRED INSPECTTON17 This pervit is issued subject to the regulations contained in the W o o d s t o v e I n s p Tigard Municipal C,,,de, State of Ore. Specialty Codes and all other Final Inspection applicable laws. A:l work will be done in accordance with approved plans. This pervit will vxpi�e if work is not started within 188 days of issuance, or if work is suspended for more than 188 days. Permittee Issi-ted By : Call for inspection 639-4175 Pcrnfit #: Address: Issued by. Date: 1859 Statement: information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 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 btuilclirng hermit c•ctn be issued. This,statement i s required for residential building, electrical, inec•hanical, 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 i and 2, and either box 3A or 313: . I own, reside in, or will reside in the completed structure. . 1 understand that i must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 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 B. 1 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 and that I has v read and do understand the Information Notice to 1'rKt�vners about Con ucti ltesponsihi{itics u►n the reverse side of this form. nature of permit applicant)Pp (Date) (White copy to issuing agene'v per►nit file, pink copy to applicant) Information Notice to Property Owners About Construction responsibilities 01i'11, ry tlhc,lrl t',1.!vi1*1r+-v.w 1',` ',;a 11Yr� :/r 'r'r,�14'+' !•1 ll!r ( 1?'(i/'ih !Ire!! ?'•'71r1r':rlri?t r?'t,lrrl 11, 1A'. ,,.„�'tr;� .r ,I. ') 0550). 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I!'( •I11J!' - i1 'l1:' 11 1,'1! ,!1 !:',. t... ••Y1'L OTHER RESPONSiBILiTIES AND AREAS OF CONCERN; 1 +01 _ritllphalli•a'; '1+,. p 11111' h..'• I;_'i1.+111111`-I11rlIC_1 �!l,il:'I"�i��_';L11'11.:ll`IR'­I,llt.' 1.111",.'I'.:111.'.t'1 Ili 11. pit , h:• hl'111a' I rl 111n,tir'11 in�hct tune, ialbilil, and jimpertt, dunlaltce insurance: C ollt.It.:t yOUl lilsuratK::,ilt;rnl to�.0 1l WU h,l\r iaJrtluat,. 111"IlI►10 "•' l WI 1''; 1 ;11• il+'I 111111~}irr11`, 1.n.'li a`, Lalling look, pillill t''+l'I'Splal), "illy[dI lllliigk11V11+1111 C i)!1111i1.11ti`., till.' 'I '. ,Ii'k iii it ril'! I I ilnc to stl1wr1isc vIllI ttil vs: \l l6(' Mill- Full have tiulficu'nl hila(' II, "((lief,i,\:' \+,llr i'llipt r,.•1': Ux1fiertise. \4 A(r.tJIvYIt (I linvetile exptIli se 1(1,1 ttit,\'('IirIJec*neralcc•ntrictlir,tocoordimlmthew( rkofruuIt!h ill;Intltill;,1, .1?1t1 to ilotifv Ili l i ldi?lp?Official at the apprclmrWe limet;gotheroni perform the re(loirod morecticn tz 111 ; '1t h;lVC Aduitilm2i yucstiow" �k6W of call the Ctmi;tru(lion Contractors t3c,yont Wo Bity 1;31.10. Salein.C)R ();0 I's -162 1) Thr Board k Ilrcat;d at 'illi)tiumiller tit. NF Slate M), Ill'Get 1. I �+a