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I .IMAGE IS NUT AS CLEAR AS THIS NOTICE Y 21 � � I � � 8 Il 4 7 11 12
IT I UE TO THE QUALITY OF THE ,
No.36
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13984 SW BLUESTEM LM
RESTRICTED
9
7',?,;23 " ELECTRICAL ENERGY
�. 3 c,-,- y17-r APPLICATION
PLEASE ..INT
Please cofnpletesections, , eh 5. Permit No. r
1. Location of;r.staal'lation Date
Address_ l�7 10 �L� I x' _
city— Zip Code_!J2.2� 4. Type Of work:
w
Map No. _ Tax Lot RESIDENTIAL Restricted Energy Fac $40.00
Thomas Map Book: Page Section (for all systems)
Check type of work Involved:
Directions ayj
Audio and Stereo Systema* a
Commercial ❑ Residential Burglar Alarm
Telephone Syster,is•
Tenant Name Garage Door Opener'
(if commercial) —__ — Fire Alarm
Heating,Ventilation and Air Conditioning Systems'
2. Contractor application: Vacuum Systems'
Other
Electrical Contractor r��// y �S OC[(��U _
Address - 1 / COMMERCIAL Fee for each system $40.00
City_&r �/in State Zips (see OAR 918-2642e0)
Date__ - Job Number Check type of work involved:
Property Owner Pa 'i r— c
Contractor's License No. C l- if ;4�2 13St
Contractor's Board Reg, No. //7 �c�'z Boiler Controls
Phone No. 7l5 .;20124 Clock Systems
Data Telecommunications Installations
Fire Alarm Installation
3. Owner application: HVAC
Instrumentation
Print Owner's Name Phone No. — Intercom and Paging System
Landscape Irrigation Control'
Address Medical
_ Nurse Calls
City State Zip — Outdoor Landscape Ughting'
This permit Is issued under OAR 918-320-370. The applicant agrees Protective Signaling
to make only res'ricted energy Installations(100 volt amps o,-IOPss) Other
under this permit and to do the following:
t. Only use electrical licensed persons to do Installations where
required. (Certain residential and other transactions are exempt Number of Systems
from licensing. These have asterisks('). All others need licens- -
Ing.)
2. Call for an Inspection when all the installations under this permit 'No licenses are required. Licenses aro required for all other installations.
are ready for inspection.
9. Purchase separate permits for all installations that are not ready 5. Fees
for inspection when the Inspector is out to inspect under this
permit. Enter fees $
4. Assume responsibility for assuming that alt corrections required
by the inspector are done,and
8. Assume responsibility for calling for a final inspection when sit of 5% Surcharge (.05 X total above) $
the corrections are completed.
The person signing this permit must he the applicant or a person Trust Account $
authorized to bind the eppllc r . tx;
_Z
Total $
Signature ________.__ __
Li��
Authority if other than applicant _ This permit becomes null and void If the work authorized by the
permit Is not commenced within Leo days from date of Issuance
For inspections call of such permit or If the work ruthorized is suspended or abandoned
any after work Is commenced for period of days.
640-3561 or 693-4415 Electrical
n
Permits ars non-refundable and non-transferable.ble.
24-hour recorder, one working day in advance of need BL24.114
AUG-17-1995 10:59 GARY'S VACUFLO, INC. P,02
RESTRICTED
ELECTRICAL ENERGY
(5b.3)& 39- 4/ 75' APPLICATION
PLEASE PRINT e e Permit No. �� "l J ' 0 V
1. Location of'i installation/ Date
Address /,-3 9�T
City zip Code 4. Type of work:
Map No._ _ Tax Lot _ RESIDENTIAL Restricted Energy Fee $40.00
(for all systems)
Thomas Map Book' Page — Section — Check type of work Involved:
Directions------- -- aW
Audlo and Stereo Systems'
– — Burglar Alarm
Commercial ❑ Residential Teleptrone Systems"
Garage Door Opener"
Tenant Name Fire Alarm
(ii commercial) ---- beating,Ventilation and Alt Conditioning Systems*
Vacuum Systems'
2. Contractor application: Oilier
Electrical Contractor.
Adc'ress �1<L�i:�,C'� - COMMERCIAL Fee for each system x.00
nty_�C� a2( . - State Zip (see0AR91s-Yb02ao)
Date �_1'7- ` Job Number —�_ Check type of work involved:
Property owner -
Contractor's License No. a roller c;onamlb
Contractor's Board Reg.-,No. -- Clock Systems
Phone No. :7_.1�-. =7�-- Data Telecommunkations Installations
Fire Alarm Installavon
3. Owner application: QAC
Inseumentedon
Phone No. Intercom and Paging System
Priv!Owner's Name Landscape!rrigatlnn Control'
--- �--- -- -- Medical
Address Nurse Calls
outdoor Landscape Ughting.
Pratertive Signaling
this permit Is issued under
OAR/lfdl6d70. The applicant agrees _ o +et
to make only restricted energy Inatallaflone(100 volt amps or lose)
under this permit and to do the following:
I Only use electrical licensed persons to do installations whore Number Of Systems
required. (Certain residential and other transactions We exempt y
rrem licensing. These have asterisks M. All others need flcens-
fog) •No liewrrsses are requlnd. (xenses am rogvired for all other installaffams.
2. call for an inspecpon when all rite Installations under this permit
are ready for Inspection. toady 5. Fees
2 purchase separate permits for all Installdtlons that are not
ter inspection when the inspector to out to Inspect under this Enter fees $ -- '
permit.
d Assume responsibility for assuming that dl corrections required tai
by the Inspector are done,and 5% Surcharge (05 X total above) $ �—
4. Assume responsibility ler calling for a final lnspecrion when sit of
the corrections are completed Trust Account $
The person signing this permit must be the applicant or a person
�
sudterlted to bind the app1I r �,� t�
• Total �—.---
AuNtotiN rt other then applleant _ _____�. - --.--- _ This permit becomes null and void If ate work authorized by the
permit Is not commented wlthln t s0 days from date of Issuance
of such permit or It the work authorized Is suspended or abandoned
For Inspections call
at any time after wort Ie commenced for a period of 1 e0 days.
640-3551 or 593-4415 Flectriesl psrmite are ton-refundable and non-transferable.
24•hour recordor, one working day In advance of need Pl2a•tta
TUTAL P.02
Community Development ELECTRICAL_ PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # EiC.
Phone (503) 639-4171 Date Issued
FAX (503) 684-7297
CITY OF TIGARI) TDD No. (503) 684-2772 Issued by _ (��1�(Alf
Inspection (503) 639-4175
1. Job Address: 9 4. Complete Fele Schedule Below:
Name of Development_!E0BLC 64EEe B-01✓ff 10fi Number of Inspections per permit allowed
Address1.37By SW QLU ESi-ri77 L-A). Service included. Items Cost(ea) Sum
City/State/Zip -if4o , Ott . 97 2-2-3 4s. Residential-per unit 4
1000 sq II or less $11000 //e•O✓
Name (or nam- of business) COf f� 6ftot i:., wol✓cf Each additional SOO aq It or 7S
portion thereof 3 $2500 G c 1
Commercial❑ Residential Limited Energy $2500
Each Manuld Home or Modular 2
Dwelling Service or Feeder $6800
2a. Contractor installation only:
4b.Services or Feeders
Installation alteration,or raincalion 2
Electrical Contractor_§ jj2 Le—c INC- 200 amps or less $6000 2
Address P- 0• 61IX-J-0 201 amps to 400 -v $8000 2
Cit Do -D State OR- Zip 9 pyp 401 amps to 600amps $12000 2
601 amps to 1000 amps __ $180 00 2
Phone No.
(P 70 _ Over 1000 amps or volts $34000 2
Contractor's License No. �Z-y /07 L Reconnect only $5000
Contractor's Board Reg. No. 'Lo 717 _ 4c. Temporary Services or Feeders
Installation alteration,or relocation 2
Signature of Supr. EleC'n JC fy�l,.yc s< /moi,-,.f�,�1 200 amps or leas $5000 _ 2
License No..—, j(,Z,� Phone No. 1 B-/3 _ ?01 amps to 400 amp, $7500 _ 2
401 amps to MO amds $10000
Over 600 amps to .000 volts
2b. For owner installations: see•b'above
Print Owner's Name 4d. Branch Circui s
�— New,alteration or extension per panel
Address _ a)The fee for branch circuits with
City State Zip purche"of service or Water W. 2
— Each branch circuit $500
Phone No. h)The fee lot branch circuits wtfhouf
T he installation is being made on property I own which is purchase of servke or boder W. 2
First branch circuit $3500 2
not intended for sale, lease or rent. Each additional branch circa 1 $Soo
Owner's Signature _ _ _ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (it required): Each pump at irrigation circle $4000 2
Each sign or outline fighting $4000
Signal circuit(s)at a limited energy 2
Please check appropriate item and enter fee in section 5B. panel,alteration or extension $4000
4 or more residential units in one structure Minor I shale(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E C Chapter 5 l'nr ur.pociwn __— $35 00
P',how $5500
Submit 2 sets of plans with application where any of the above In nly,i --- $55 00
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ ��o
NOTICE 5910 Surcharge(05 X total fees)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5bSub l taof line A for $
.
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if required(Sec 3) $ X
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ I qv-2.E
COMMENCED ❑ Trust Account k
Balance Due $ y, 5
SEE 35MM
ROLL# 22
FOR
LARGE
DOCUMENT
'��
CITY OF TIGARD _Pf.- MIT MASTER P�7RPIIT
' #. . . 11S
COMMUNITY DEVELOPMENT DEPARTMENT DATETSSUE . . . . .D: 05/30/95
T137
13123 SW Hall Blvd.Tigard,Oregon 97223@8199 (503)639-4171
0 R E.1:3;i. . 3904 SW SLUESTrMf L.I.
L,'I ON.
ZONING: P-25
LCT. . . . . . . . . . . . .
......---- SUILDING
T 7 1 J!-.;M7 T"i 4 011 .; OWELLING UNIT";.- 1 BAICIEMENT. 0
Or WGRI/. :NEW BEDRMS: S A T HS 3 GARAGE— ,
'OF US[7. . f7jr- 171-00p PC.OU I RE 11
CONST. 5N P I RST. . . . : 1410 a-r LEFT. 35
X.,ANCY GRP,. R5 SE"COND. 442 MINT, ft RF-Ar. .
FTNDSMEN':0 is f PEM-
TOTAL
cc,1. OMnKrcrro
: DET —1.
MR LOnD. . . . ;40 p s f VAL UC. . . . . $ : .) 'ACE S.
ks . r"ATH
U!M n I N G
S. . . . . . . . . . .. j r-LOOR DRAING. . . IA MCtiF-LCW ::'REVNIvu
)ATORICS. . . . . ..4 WATER HEATERS. . . . I TRAP,S
Trmy-:,..
CATCH C40 I NS. .
TER CLOSETS. . c3 SEWER LTNE -:ft ) . .vi GRUA0C TRAPS. . . .
-1.314WA7i . . . . I Wf,)TrP LINr (ft ) . 100 lJT1 ir r, f"I X'rIL!r'[-",. .
RBAGE DISP. RAIN 0RnIN (ft ) . :0
311ING Mn'.T.l. MITN DROV,171. ,
MECHANICAL F E"C
t t
VENTE3 . :0 TIF" 1550. 00 Low orj/-�o,
P T!j VrNTU`n7 t �17n mo
;J P N 40ODS. . I SP!-r
.. 00 Jrj
403ODS TO V rl, q
'w 0
M-0 DRYEn". P A p K t 50�
OTHER
"Ir^T 1 T W 03/1
GAG OLJTL.ETr,,. I MP L C, 10. 8p, SW 111:7) 30
00 W 0,
P"1%,7' t.
err 1164. 00 T,W
nIpl 60 cw
30 raw
50. 00 1�w 1) '30
SWM 3 0
w r I
L
SEWER CONNECTION
CITY OF TIGARD PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT ;:'ERMIT #" . " " " " "
. . . . . . .
13125 SW Hall Blvd.Tigard,Oregon 97223*810 (503)639-4171 DATE ItSGUED;
PARCEL: IS133CD-PST '
1 '.- 17-11,04 SSW M-kJESOTEM i-N 3o
In',)I V TSj I ON. PEBBLECREEK I I ZONING: R-25
. . . . . . . . . .
LISC1 NCM. . . . . . . . . . . r-I X TURE UN I TO.
NEW D14C.LLING UNITS.
Tyl,"T: rr" USE. :SF NO. OF BUILDINGS. 1
rk L j W(i SLJRFACr.'.
PATH I
Ownew—.- F CE S
COST, I1CIr1C tjoM--
t by date i-ecr)t
1-4730 3W OSPqEY DR PRMT t 7,C--00. 00 rj'W 0S/;50/95
BEAVERTON OR 97007 00 ow 01511310/115
14 ; 1-146
rr
—INTTrV-TOR 119T .),,4 rTl-r7
# 0171 TOTM,
REQUI ixC:11 I NSr*'C'V'T I OW
This 4plicamt agree: to f-'Wj with all tht rules and regulations Suw�— Inspect ior,
of the Unified Sewage kjoricy. The Pervit Wires 180 days from .......
the date issued. The total allount Paid 411 be forfeited if the
persit expires. The Agency dcts not guarantee the ACC41-iicy of the
side sower laterals. If the seat,,- ii not located at the istalul,listrt
livon, the installer shall prospect 3 feet in all directions front
the distavt giver.. If not sq 1000M, thp Irstaller shill p�!rr�;tr
a "Tap a!-d Side Sower' Petail lilt irstai:
C)
1
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 13984 SW Bluestein Lane
v
Subdivision: Pebble CreeLot# 30 Office Use Ong
« - Contact Date / / _Initials
Valuation: /zZQ.3U S- — Result
Planck/Rec # Lr-I ,
New Construction Only: (Square Footage) Permit J71 ?6,0 .`
Housa: 18 61 Garage: ___q90 Reissue of
Map & TL# _33 C t2- 13
Zane
Plat #
Corner Lot? Y N Flag Lot? Y N
Owner: Costa Pacific Homes Approvals Required
_
Address: 8625 SW Cascade #606 Planning Setbacks _ SolarEngineering _
Other
Beaverton, OR 97008 —
Phone: (503 ) 646-8868 Items Required
Contractor: Same Subcontractors
Truss Details _
Other
Address. -- — -'�
Notes
Phone: ( ) _' a�
Contractor's License # 6 515 7 0 4t
(attach copy of current Oregon license)
Contact Name: Marci Wpber %h7 r,os reeore4,eE c�eI Cr;
Contact Phone: j 503 ) 646-8888 dog" ox.- #e&A,(Subcontractors: ArchitecVEngineer: Iverson Associate_
Plumbing: 4 Address: 151 Kalmus Drive C. 140 _
Mechsnical: Arco Installations Costa Mesa, CA 92626
(attach copy of current OR Contractor's License)
Phone: (7 14 ) 549-3479
JOB DESCRIPTION: Resubmit of Permit #MST 94-01q4
(IL)-f G,2C4V
plicant Signature Applicant Phone number
Received by: __ 4, Date Received:
Permit# Account Description Amount Amt. Pd. Bal. Due-
fi �i 1 U Z""Bldg. Permit (BUILD) -3OS,ry-
Plumb. Permit (PLUMB) ,(,J Z ZS-1,11
Mech. Permit (MECH) duy
State Tax (TAX) 31r,71 C _
Bldg: d-S,ZY
Plumb: /1 ,
Z
Mach: �2.1 Y
Plan Check ✓(PLANCK) }�
Bldg: 5-J tSv did
Plumb:
Mech: /D-YY
Sewer Connection (SWUSA) &u a224y
Sewer Inspection (SWINSP) 3 j 3 v
Parks Dev Charge (PKSDC) sub S 'd
Residential TIF (TIF-R) 3 �
Mass Transit TIF (TIF-MT) / Z o J�v
Commercial 'TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WOUAL) /� l ✓
Water Quantity (WOUANT) (10 —'�
Fire Life Safety (FLS)
Eroslon Cntrl Permit (ERPRMT) �
Erosion Planck/USA (ERPLAN) ►�U �1�!'�
Erosion Planck/COT (EROSN)
TOTALS: <-,Z vc, S
...�rrrr.u.i.
I
Solar Balance Worksheet
Address �� �b(F��P� k iIf
Box A calculations : North-South dimension for the lot . Box A:
This dimension is determined by finding the midpoint of the
North lot line and drawing an intersecting line perpendicular y
to that point . Measure the distance from the midpoint of the
North lot line to the South lot line along the described line . ft
Box B calculations : Shade point height from your structure . Box B:
1 . Determine whether measurements will be based on the peak
or eave u.f your structure . The orientation of the ridge
is also important . Which
la: If the roof line runs North-South, measurements will be describes
based on the peak of the roof . y
our lot?
1b: If the roof line .runs East-West and the roof pitch is less (Circle one)
than 5/12, measurements will be based on the eave .
lc : If the roof line runs East-West and the roof pitch is 5/12 la 1b lc
or steeper, measurements will be based on the peak.
2 . Measure change in elevation from front property line to ft
finished floor elevation.
3 . Measure distance from finished floor elevation to the
affected peak/eave . + ft
4 . If the roof line runs North-South, deduct three feet .
If the roof line runs East-West, deduct nothing.
— ft
5 . Subtract one foot for each foot of difference in elevation
from the front property line to the rear property line, if
the lot slopes up from the front to the rear. If the lot — ft
has no slope or slopes up from the rear to the front,
deduct nothing.
6 . Total figure for box B : ft
Box C. Distance to the shade reduction line . Box C:
1 . Measure the distance from the North property line to the ft
foundation. --
2 . Measure the distance from the foundation to the affected + ft
peak or eave .
3 . Total figure for box C:
ft
in(i�R'Fff-f&WE OF
OCCUPANCY
PERMIT #. . . . . . . s MST95. 0200
CITY OF TIGARD DATE ISSUEDc 11/06/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171 PARCEL: 1 S 133CD—PB I 130
l 1 I OUlPubL'.)tj. . . . aW DL JLw j 11.1'1 U-4
3UBrIVISION. . . . i GEBBLE:CREEK II ZONING:R-25
BLFICK. . . . . . . . . . t LOT. . . . . . . . . . . . . 130
CI_NSS OF WORK. s NEWY.________..-_____.__._._ -.--.._--
TYPE OF USE:. . . s SF
OCCUPANCY GRP. r%04p�
OCCUPANCY LOAD:2
Remarks s
F'AIH I
Owner:
COSTA PACIFIC HOMES
14780 SW OSPREY DR
# 275
BE.AVE:RTON OR 97007
Phone Ms 646-A888
Contr,actor: _._._..__..........—__._-.._.___._ .-___....._.._. _._...._.____ _
cOSTN--PACIFIC 1-10MES
8625 SW CASCADE AVE. STE. 606
EWAVERTON OR 97005
Phone M s 51213..-646-•8668
Reg #. . s 65157
i'his Certificate grants occupancy of +',ea above rpfer-enced building or portion
thereof and confirms that the building has been inspected for compliance with
the state of Oregon Cpec_ialty Codes for the group, 0cC-u1JwnC..y and use under-
which the referenced permit was issued.
��.I 1 I LD I NI3 INSPECTOR BU I LD IZ�74'��I AI...
G06"1- IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION NOTICE
.,�Pection Line (Rec-O Pnone): 639-4175 Business Phone: 639-4171 l
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mach. Rough-in Fireplace
9 �-
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Lii.e �
Plb . Underfloor Rain Drain Framing h
9 g -Plum ,.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �� Time: AM PM
Address: �.Zi 911_��,/p/� p�yy�
Builder: Permit#:
THE FOLLOWING :ORRECTIONS ARE REQUIRED:
17
Inspector: Date:
t
_APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
t1 j Call For Reinsp.
K` -