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9285 SW EDGEWOOD S!'REM'
CITY OF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES DATE
#. . . . . . . : MST97--0513
ISATE ISSUED: 11 /26/97
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
i
PARCEL: 2S10DC-00404
I T E ODDHESS. . .. :0"i Hl- SW U=Dbl:-W001) � .i
SUBDIVISION. . . . :EDGEWOOD ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :0l E:, JURISDICTION: T16
Remarks: Addition and alteration to an existing single family dwelling.
.._---------------------------------------------------------------- BUILDING ------------------------------------------------------
RFISSUIE: STORIES........ 1 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED---------------
CLASS OF WORK.:ADD HEIGH'........: 15 FIRST....: 370 s.7 GARAGE.....: 0 sf LEFT..........: 5 SMOKE DETECTRS: Y
TYPE OF USE...:5F FLOOR LOAD....: 40 SECOND...: d sf FRONT.........: 0 PARKING SPACES: 2
TYPE OF CONSf.:5N DW(.LLING UNITS: I FINBSMENT: 0 sf RIGHT.........: 5
OCCLPANCY GRP.:R3 BURT. 0 BATH: 0 TOTAL-------: 370 sf VALUE..S: 52000 REAR..........: 20
---------------------------------------------------------------- PLUMBING ------------------------------- --
SINKS.........: I WATER CLOSETS.! 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS..,......: 0
LAVATORIES....: 0 DISHWf;SHERS...; I FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 0 GARBAGE DISP..: I WATER HEATERS.: 0 WATER LINE ft: 2 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
------- MECHANIMI -------------------------------_���---------------- -
FUEL TYPES------.--- FURN ( 100K ..: 0 BOIL/CMG ( 3HP: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0
GAS FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS.........: 1 OT;F R UNITS...: A
MAX INP.: 50000 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: I
--------------------------------------------------------------- ELECTRICAL ------------------------
--RESIDENTIAL UNIT---- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MiSCFLLANEOUS------ --ADD'L INSPECTIONS---
1000 SF OR LESS: 1 0 - 200 alp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION- o PER INSPECTION: 0
EA ADD'L 5WT,: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 Ist W/0 SVC/FDA: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 600 amp. .: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAU-/PANEL...: 9 IN PLANT...... : 0
W. HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 -------------------._.------------------- PLAN REVIEW SECTION --------------------------------- -
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPL" OCC:
----------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ------------- -------------------------------
A. SF RESIDENTIAL-------------------------- B. COMIIERCIAL-----------------------------------------------------------------------------
AUD1O d STEREO.: VACUUM SYSTEM..: AUDIO 6 aiFREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDMR LNDSC LT:
BURGLAR ALARM..: 0TH: ;: BOILER.......... HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK............ INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NUIRSE CALLS....: TOTAL A SYSTEMS: 0
Owner: -------- --------------------------Contractor: ----------------------- ----- TOTAL FEES;$ 552.15
LOUIS ; WNCH5MUTH .1LM SERVICES INC This permit is subject to the regulations contained in the
9285 SW EOGEWDOD STREET 12535 SW StWRCREST OR Tigard Municipal Code, State of Dre. Specialty Codes and all
TIGARD OR 97223 TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phnne A: Phone A; 590-2451 not started within 180 days of issuance, or if the work is
Reg C.- 000700 suspended for more than 180 days. ATTENTION: Oregon law
..__---.----__---_----------._------------------------------..__....._. requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952.001-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1987.
------------------------------------------------------------ REQUIRED INSPECTIONS --------------------------------------------- --
Footing Insp Mechanical Insp Fireplace Insp Water Line Insp
Fnundation Insp Plumb Top Out Gas Line Insp Electrical Final
Rost/Beam Struct Electrical Rough Insulation Insp Mechanical Final
Lravel Drain Framing Insp Gyp Board Insp Plumb Final _
PLM/Underfla r Shear WapInsp Rain drain Insp Building Final
/
Issl_led y1a"'4'_1Jv ,_-- F'er•mittee Signat i.ty-e
+++++++++ ++++++++++++++++4--f-++++++++++++++++++++++++ ++++++i-+++*4.4-++++++++++++
Call E39-417`', by 7:00 p. m. for an inspection needed the next bi_:siness day
Plan Check# 2
CIT'i OF fIGARD Residential Building Permit Application Recd By
13125 SW HALL BLVD. New Construction Add''.ionS or Alterations Date Recd- "3 .
TIGARD, OR 97223 Single Family Detached or A;►ached (Duplex) Date to P E._
V 503-639-4171 Date to DST
F 503-684-7297 Permit# 7-�
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Project — Name
Job —--------
$ite Address Architect Mailing Address
Address
City/State Zip Phone
N#me ��
.1;ye"+ Name
Owner Mailing Address
V'06-3'-V, Engineer Mailing Address
City/State �i'Zi P one g
��f`/J 5 � p X ��' ��y city/State Zip Phone
—General Name _
Contractor ✓ 4 !" `.���✓/O f I'k- Describe work New O Addition Alteration O Repan O
Mailing Address to be done:
Prior to permit j y��(V�s*rt /r C C' Additional Description of Work:
issuance, a copy City/State Zip Phone
of all licenses
are required if Oregon Const.Cont.Board Exp.Date PROJECT ! �s
expired in COT Lic,# (� VALUATION I $ C3i ',O OQ
database / UG� �
Z- / �✓ —
Mechanical Name _ NEW CONSTRUCTION ONLY:
Sub-, �� S �� "` Sq. Ft. House: Sq, Ft. Gurage
Contractor Mailing Address
D� ADn
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance,a copy City/State Zip Phone (check one) _ (check one)
of all;icenses Restricted Audio/Stereo Buralar
are required if Oregon Const.Cort. Board Exp. Gate Energy I _ System Alarm
expired in COT Lic -
_ database Irtstallatior Garage Door HVAC
Plumbing Name f� _ — clnPner_ Systems
Suh- r tl�E'�/S w���d/R14 (check all that nthpr
Contractor ailing Adeik)ss apply) -_r wire
i�U �D �� Will the electrical subcontractor wire for all YES NO
restricted energy installations? _
Prior tz)permit City/State Zi Phone — 7
issuance, a copy Has the Subdivision Plat recorded? NIA YES NO
of all licenses are Oregon Const.Cont.Board Exp. Date — -
r;quired if Lic# Reissue of MST#. Solar Compliance
exl•ired in CUT �?� C'
(Calculation Attached)_
I :atabase Plumbing Lia# Exp. Date I haerby acknowledge that I have read this application, that the
-( ( ''I information given is correct, that I am the owner or authorized
Name agent of the owner, and that plans submitted are in compliance
with Ore on State laws. _
Electrical DMC1'__ /Lc ,c oc T,�' r c y" S is of OwnerCA"nt, �—J Date
Sub- M.cling Address
Contact P on hone#
Contractor Name /
City/Slate Zip Phone
Prior to permit /' ? o FOR OFFICE USE ONLY:
issuance, a copyL ' Plat !(MOPP Map
of all licenses are Oregon Const. Cont. Board Exp. Date � - /6
required if Lic# ' Setbacks ,—RP -F-F— i. e Solar/
expired m COT i � -c� �, � _ � c,
database Electrical Lic # Exp Dete —
y, Engineerir Approval: Plannir)g Approval TIF:
- FT L-. t c'.�•+Jt I SFREM DOC (DST) 4107
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CITY OF TIGARD Electrical Permit Application Plan Check N
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd-
Phone(503) 639-4171, x304 Date to P E.-
Print or Type Dale to DST,_
Inspection (503) 639-4175 Permit uT
Fax (503) 684-7297 lncorr�pietn or illegible will not b' accepted Called----
1.
alled ___1. Job Address: 4. Complete r ae Schedule Below:
Name of Development_______ / __-_`^_- Number of Inspections per permit allowed -
Name(or name
yof-business)e(--06/.,j- y/��3A9U i� - Service included: Items Cost Sum
Address�/�00� J rt'/�ji! 7-P a ki1&0 V 4a. Residential-per unit
/State/ZI i,(�& yr'7y Z.. 1000 sq. t or less $110.00
Ci ,
P� � _ Each additional 5U0 sq.It.or
Commercial ❑ Residential portion thereof $25.00 _---------
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00
2a. Contractor installation only: --�
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor--W-IL;�..,.i V►"a �c l G'1�(2 , c_ Installation,alteration,or relocation
200 amps or less $60.00 2
Address Y.:� -_ 201 amps to 400 amps $80.00
City ,i 1 State v _Zip ri7, 2 v 401 amps to 600 amps $120.00 -�- 2
2
Phone No, 3 S�3;i- / 601 amps to 1000 amps
$18000 2
Job No. _ - Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. --3 1Exp ate Reconnect only - $50.00 2
OR State CCB Reg. No._7 " "2 p Da z !7z 4c.Temporary Services or Feeders
COT Business Tax or Me 0. p.Date 3- -•�S' Inst illation,alteration,or relocation
i` 200 amps or less $50.00 2
Signature .upr. EI n 201 amps to 400 amps $75.00 2
-- 401 amps to 600 amps _ $10.00 2
nvr,,r 600 amps to 1000 volts,
License ,l`' 3�_Exp.Dat z It-L. see"b•'above.
Phone Nr _ 3 j� j
4d.Branch Circuits
Now,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
• �;; __ feeder lee.
r iiiri is^C...
Address Each branch circuit _ fir,on 2
-- b)The fee for branch circuits
City _ State - Zip without purchase of
Phone No. service or feeder fee.
First branch circuit _ $35.00 __. 2
The Installation is being made on property I own which Is not Each additional branch circuit _ $5.00 2
intended for sale,lease or rent. 4o.Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40 00 _ 2
Each sign or outline lighting $40.00 _ 2
3. Plan Review section (if required):+ Signal circult(s)or a limited energy
panel,alteration or extension $40.00
_
Please check appropriate Item and enter tee in section 58. Minor Labels(10) $100.0-`-
____4 or more residential units In one structure 4f.Each additional Inspection over
Eervice and feede-225 amps or more the allowable in any of the above
System over 600 v ,Its nominal Per inspection $3500
Classified area er structure containing special occupancy Per hour $55.00
as described in N.E.C.Chapter 5 In Plant $55.0
Submit 2 seta of plans with application where any of the above apply, S. Fees:
Not required for temporary construction ser:Ices. 5a.Enter total of above fees $ --
5%Surcharge(.05 X total fees) $ --------
NOTICE Subtotal $ -------
5b.Enter 25%of line Se for
PERMITS BECOME VOID IF WORK OR CCNSTRUC N AUTHORIZED IS Plan Review It reauirA(Sec.3) $ -NOT COMMENCED WITHIN 180 DAYS,OR IF CONS rHUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS AT ANY
TIME AFTER WORK IS COMMENCED L7 Trust Account M.
Total balance Due s
l _
t OSTSIEIC96 APP Rev rLNe
CI'T'Y OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc 639-4175 Business Phonc: 639-4171
Date Requested: �lt!0 19A.M. � .,_ I'm.— MST.
Lavation: S ' DUP:
Tenant 67Suite:-Bldg: MEC:
Contractor: Phone: y —� PLM:
Owner: Phone: ELC:
----- — ELR:
SIT:
BUILDING BLDG(con't) MB MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof tJndFVSlab Rough-In Ceiling Water line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt
Approved rov Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL CAW FINAL FINAL FINAL
O Call for reins Reinspection fee of S _ ' d ubefore next inspection O IJnable to inspect
Inspector: Date: -__ W_� _ Page— of,_�
CITY OF TICARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone: 6394171
Date Requested: ZLL _ A.M. P.M. ____ MST: 2:7 0Q Y 3
Locution: — !�� Z+X0,O U BUR
'i'enant:_ _ _ Suite: Bldg: __- MEC:
Contractor Phone: � �� PLM:
Owiur Phone: ELC:
ELR:
SIT:
BUILDING LD (can°t) PLUMBING r M4ECHANJCAj ELECTRICAL SITE
Site ost/Beam PosUBumiPost/Beam Cover/Servicz Sewer/Storm
Footing Roof UndFl/Slah Rough-In Ceiling Water Line
Slab Framing Top Out Lias Line Rough-In Uta Sprinkler
Foundation Insulation Sewer Ilood/Dact Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C LIG Slab
Shear/Shcadi Fire Spklr/Alm Crawl/Found IN Heat Pump Low Volt
prove Approved App��, Approved Approved
Appr/tidwlk of Anprovcd Not Approved _' oA t proved Not Approved Not Approved
tNAV FINAL FINAL, FINAL FINAL
`T"�s �.�.�:c>f �✓?1� GvDr�r�t S:�1a LGA i� -crV1
oNea S Exp SIA!le-to
0 Call for reinspectiogl C1 Reinspection fee of Srequired before next inspection 0 Unable to inspect
Inspector: _ Date ._ Page— __of----
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-H2our Inspection Linc: 639-4175 Business Phone: 639-4171
Date Requested -7I!(,i I7� A.M. P.M. MST: 77 e- _O
Location: C 13UP:
I'enant:_� Suite: Bldg: MEC:
Contractor:_ t11 Phone: —5— PLM: _
Owner. " Phone:
_ � ELC:
------- - ELR:
BUILDING BLDG(con't)- PLUMBING- MECHANICAL -TRIC srr: SITE
Site Post/Beam Post/Bewn Post/Beam ervtce Sewer/Storm
Footing Roof Undl I/Slab Rough-fn Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Me:+onry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt
/wproved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approval Not Approved Not Approved Not Approved
FINAL FINAL FINAL. FINAL
Aa R
O Call for reinspection C1 Remspedion f:e of S. required before next inspection (7 unable to inspect
Inspector:- �� -- Datc: 3 91 9_2 Page-----of..— --