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12220 SW JAMES COURT ,f I i I /I 1 c I 122_',G SVA, ,JAMES STREET CITYOF TIGARD _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00141 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/8/02 PARCEL: 2S 103CB-07.000 SITE ADDRESS: 12220 SW JAMES ST SUBDIVISION: WILLAMETTE ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: CTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 BOILERS/COMPRESSORS _ HOODS: _FUEL TYPES 0 - 3 HP-— DOMES. INCIN: — — — 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS ----- OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Replace existing furnace witli like kind. Owner: FEES_ LARRY IVERSON Type By Date Amount Receipt 12220 SIN JAMES ST PRMT CTR 4/8/,)2 $72.50 272002000C TIGARD, OR 97223 5PCT CTR 443/02 $5.80 272.002000C Phone: Total $78 30 •------- -- ---- Contractor: FITZ ENTERPRISES INC 232 NE MIDDLE FIELD RD PORTLAND, OR 97211-1238 _ REQUIRED INSPE_CTIONS____ (; Heating Unt Insp N Phone:503-283-1256 Final Inspection Reg #:LIC 33512 This permit is issued sub,ect to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notific ition Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calving 1Fn-AY?AA-Q1 RIC) - T i ► Issue By: wC�fR'��(11 Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day \ Mechanical Permit Application "Datereceived: Q7- Permit no.:�j2-pD1�/ City of Tigard ProjNct/appl,no.: .xpiFcctat Address: 13125 SW Hall Blvd.Tigard,OIL 9722; -- Phone: (503) 639-4171 Date issued By Receipt no.:� Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: — v- BuildingPermitno.: &2family dwelling or accessory U C'onrtnerci�,dindustnal :1 Multi family U Tenant improvenicnt U Nr„w construction ❑Addition/alteration/replacement U Other: .10111 SITE INFORMATION (10NIMEIRCIAL VALUATION S('111:1)[11,E Job address: 11R cquiPmcnt quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.. value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: _ profit. Value$ Lot: Block: Subdivision: — 'See checklist for important application infiirmation and Project name: — — v jurisdiction's fee schedule for residential permit fee. City/county: v JIP: - Descri tliion-and location of work on premises: 1 t t `��`.- TAJ AS ------- -e(e. Total Est.date of completion/inspection: Desai ion Qty. Res.only Res.only Tenant improvement or change of use: HVXC' Is existing space heated or conditioned'?UkYes U Noinditioning(site plan required)Air handling unit —_ CFM Is existing space insulated'? Yes U No Alteration of existing AC system Boiler/compressors -- _ - Business name: 1T2 }tF< <\yC. t F�;k-v tE' •0\tk (7-c”, late boiler permit no.: HP Tons B rum Address: "7i2 �f VVI\ L-WA V> Fire/smoke amper, uct smo a detectors - -" _. City: Statc: ZIP:e Tz k eat pump(site plan require ) Phone:2 12A Fax:2'63 (�� E-mail: nsta 6:ep ace urnac .urner___� - Including ductwork/vent liner W-es U No _ CCB no.: i - Install rep ace re oc-teh aters_suspended, City/metro tic.no.: tL( wall.or floor mounred Name(please print): Vem for a, fiance of er t an furnace Refrigeration: Absorption units __ BTU/li Name: Chillers ______ IiF' Address.- - ----- Compressors -- - -- - - Environments ."_.ter ,t and vent lalion: City, _ _-- State: ZIP: Appliancevent Phone: I E-mail: Dryerexdaust --- --_- --- --- t FToons,Type res. itchen/hazmat hood fire suppression system Name: 1.V •- : �ti �� Exhaust fan with single duct(bath fans) Mailing address: 27-0 v) 1 Fn VC-S S Exhaust system aart from heating or AC City: TStattx-,*? ZIP:r Fuelpiping andistribution up to outlets) Z Z''� T _.� Oil l Phone:S 2- .(�" Fax: E-mail: y�1e -- each ad Na I'uc�i in�each additional over 4 outlets 'rocescpiping(sc ematicrequirc ) _ Name: Number of outlels Address: --- t ier_Hf�pp mnce or equ pment: Decorative fireplace City: State: 7_1P: nser-type �-V Phone: F x: TE-mail: oo stovcTpciietstove — --- �- A licant's si nature: Other: _PP g c( Date: ( II Z- ter: Name (print): w�\ G �'t: t'T Z - Not ell jurisdictions accept credit cards,please call Jurisdiction for more;nformatinn Permit fee.....................$ `Z•r' _ U visa U Mastercard Notice:'Phis permit not sin"tion Minimum fee................$ t•n•dit cmd mmnhec _ _L�,- expires if a permit is not ob:aincd Plan review(at _ %) $ Expires within 180 days alio it has Leet State surcharge(8%)....$ 5 �' Name or cardholder as shown on credit card accepted as complete. — � $ TOTAL .......................$ aaaafd�tr,rotdicoMl ciudholder signature Amount MECHANICAL PERMIT FEES ' COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: Table 1A Mechanical Code Dry (Eaa))_ PERMIT FEE: - Description: p►iTotal $1.00 to$5,000.00 Minimum fee$72.50 Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000,00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or ncluding ducts F.vents _ 14.00 fraction thereof,in and including 2) Furnace 100,000 BTU+ $10.000,00. including ducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or includingvent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000 00 and 5) Vent not included In appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units $50,000. 0. 12.15 $50,001.00 and up $742.00 for the first$50,C00.00 and Check all that apply: Boiler Heat Air $1,20 for each additional$100.00 or For Items 7-11,see or Pump Cond _ fraction thereof. footnotes below. Comp Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<3HP;absorb unit to 100K BTU 14.00 8•/.State Surcharge $ 8)3-15 HP;absorb 25.60 unit 100k to 500k BTU 25% Ian Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00 Required for ALL commercial permitsoni unit.5-1 mil BTU TOTAL COMMERCIAL PERMIT FEE: $ unit 30-50 Flt';absorb unit 1-1.75 mil BTU 52.20 - --- - - -- __.- 11)>50HP;absorb unit>1.75 mil BTU 67.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00 _ Value Total i 3)Air handling unit 10,000 CFM+ Description: _ Q Ea Amount V 17 20 Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU including 1,170 15)Vent tan connected to a single duct ducts&vents 6.80 Floor furnace including vent 955 _ 16)Ventilation system not Included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted heater ----- -- 17)Hood served by mechanical exhaust Vent not Included in appliance 445 111.00 permit - 18)Domestic Incinerators Repair units _ 805 17.40 <3 hp;absorb.unit, 955 19)Commercial or industrial type Incinerator to 100k BTU 69.95 _ 3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves 101k to 500k BTU 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU _ 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1."/5 mil.BTU _ Air handling unit to 10,000 cfm 656 - 8%State Surcharge $ Air handling unit:10,000 cfm 1,170 Non-portable evaporate cooler- - 656 - TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a slqgle duct 446 Vent system not Included in 656 Appliance Permit Hood serve(Lb mechanical exhaust 656 Urher Insaecdons and Fees: 1 Inspec.:nns outside of normal business hours(minimum charge-two hours) Domestic Incinerator 1,170 $62 50 pb•hour Commercial or Industrial Incinerator 4,590 2 Inspections'or which no fee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves 656 $62 50 per h tur Inserts,etc. 3 Additional pl:in review required by changes,additions or revisions to plans(minimum Gas pin 1-4 Outlets 380 charge-on@44f hour)$62.50 per hour Each additional outlet _ 63 "State Conlrector Boller Certification required for units>200k BTU. "Resldemial A/C requl,es site plan showing placement of unit. TOTAL COMMERCIAL $ VALUATION: All New Commercial Bub'dings require 2 sets of plans. I:\dsts\forn s\rnech-fees.dnc 02/11/02 Construction Contractors Board >> License Details Page 1 of 1 OREGON CONSTRUCTION CONTRACTORS BOARD License Details as of April 8, 2002 1:58 PM LICENSE NUMBER: 33512 NAME: FITZ ENTERPRISES INC ADDRESS: 232 NE MIDDLEFIELD RD PORTLAND OR 97211-1238 WORK PHONE NUMBER: 503.293-1256 LICENSF. STATUS: Active ENTITY TYPE: Corporation EXPIRATION DATE: 6/9/2003 LICENSE CATEGORY: Specialty Contractor/Res DATE FIRST LICENSED: 7/25/1980 EMPLOYER STATUS: NON-EXEMPT BOND COMPANY: TRAVELERS CASUALTY INSURANCE COMPANY: WESTPORT INS P,, SURETY CO OF AMER CORPORA TION BOND AMOUNT: $ 10000 INSURANCE AMOUNT: $ 1000000 BOND EFFECTIVE:TO: 6/9/2003 INSURANCE EFFECTIVE 6/30i2002 TO: View Fond History View Insurance History View Claims Histtq View X-Reference Licenses View Associated Names View SIC Codes View B5.i*ng_Codes.Division License Details Print this Page QUERY MENU CCB HOME Send mail to Web Administrator with questions or comments about this web site. Pane Lest modified Fahruary 2.2,2002 'QUERY COMPONENTS REND LIVE DATA ��t��IIL�IIC 8. $tare of Oregon Liability StotQment littp://ccbed.ceb.state.or.Lis/Bill/regiio222.,isp 4/8/02 CITY OF TIGARL 24•-Hour BUILDINGInspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST ______.._� BUP Received Date Requested 7 its___ __ PM BUP Location —___ --Jt Suite MEC _2 Contact Person — Ph(—) PLM Contractor --- - -__-. . ---- ---- - -- Ph( ) SWR -- — ---- BUILDING TenanU�vfsEc��- � 'y�-� ELC _ Footing - --- - V _ ELC - Foundation Access, Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam — Shear Anchors Ext Sheath/Shear -- Int Sheath/Shear FramingA d_-, _ c7 a �. cW r ACt, -- - - Insulation Drywall Nailing -- — Firewall Fire Sprinkler - - ---- Fi•o- Alarm Susp'd Ceiling — Roof Other: ---- Final PASS PART FAIL PLUMBING ---- -- Post&Beam Under Slab - - Rough-In Water Service - - -' Sanitary Sewer Rain Drains - f Catch Basin/Manhole Storm Drain -- Shower Pan Other. ------ — --_ Final PART FAIL 'Zg`�-- AI MECHANICAL _ -- --- - — Post&Beam Rough-In -- --- --- Gas Line S ,g_k e Dampers s - al ASS, PART FAIL - - ELECTRICAL Service --- Rough-In ----- ------ — --- UG/Slab Low Voltage - -- -- Fire Alarm Final Fj Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL -- - Please cell for reinspection RE:— Unable to inspect-no access_-- _�_ Fire Supply Line ADA Approach/Sidewalk Date Inspector_ _._ -- _ - - Ext - Other:.__- Final DQ NGT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST q-7 . O'�< 24-Hour Inspection line: 639-4175 Business Line: 639-4171 a C� BUP Date Requested Lf 64 "C( / AM P10 _ BLD Location Suite MEC Contact Person _ l•'�R° _ Ph _ PLM _— Conti-actor Ph _ SWR _ ILD Tenant/Owner ELC_ Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: ---- Slab - __�.`-- -----,-_.-- --- __.-�_ SIT Post& Beam - Ext Sheath/SF ear _ Int Sheath/Shear — Framing Insulation — Drywall Nailing _ Firewall Fire Sprinkler - -- ------- ----------- -------------------- Fire Alarm Susp'c. Ceiling Roof -------__..._---- - - - ---- fim� 11 PART FAIL -------- ---- ----... ----- ------- ----- PRIMING Post&Beam - - — -- ----- - --- - Under Slab lop Out ------- -------------- Water Service Sanitary Sewer -- Rain Grains Final -' PASS PART FAIL. MECHANICAL Post& Beam - — -- Rough In Gas Line Smoke Dampers F inal PASS PART FAIL ELECTRICAL.�� Service Rough li, -- -- UG/Slab --- ----- ------- -- ' ow Voltage Fire Alarm - - ------------ ---------- — — Final i PASS PART FAIL SITE Backfill/Grading --- ------- —------ -- -- ---- Sanitary Sewer Storm Drain ( ] Reinspection fee of$`_ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please cal for reinspection RE V_ _- [ ]Unable to inspect no access ADA /G, e_-� Approach/Sidewalk Other Date J Inspector _ —Ext _— Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD MASTER PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : M �ST97 0355,c'� DATE ISSUED- 08/27/97 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PARCEL: L'S 103CB--0E 000 SITE. ADDRESS. . . : 12220 SW JAMES ST SUBDIVISION. . . . : ZONING: R-4. 5 BLOCK. . . . . . . . . . L01 . . . . . . . . . . . . . JURISDICTION: URB Remarks: Converting an existing garage to livable space and the aadiiion of zn attached garage. --------------------------------------- -- ------------- BUILDING -__..— _ ------- _ _------------------------------------- REISSUE: STORIES.......: 1 FLOOR AREAE--------- BASEMENT...: q sf REQUIRED SETBACKS---- REQUIRED--------__.._ CLASS OF WORK. :ADD HEIGHT........: 12 FIRST....: 480 sf GARAGE.,.,.•. 400 sf LEFT..........: 24 SMOKE DETECTRS: TYPE OF USE...-.SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 2 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBXNT: 0 sf RIGHT.........: 0 OCCUPANCY GRP.:R3 BORN: 0 BATH: 1 TOTAL------: 480 sf VALUE..4: 30598 REAR..........: 99 ------ --------_--__---------------------------------------- PLUMBING -- --- - --- - SINKS.........: 0 WATER CLOSETS.: 1 WASHING MACH..: 1 LAUNDRY TRAM,.: I PAIN DRAIN ft: 0 TRAPS.........: 0 LAVATORIES....: 2 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LING tt: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB/SHOWERS...: 1 GARBAGE DISP..: 0 WATER HEATERS.: 1 WATER LINE f'.: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 ------------------ ------------___—_------ --------- MECHANICAL ---------------------------------------------------- FUEL -•----------------------•-----FUEL TYPES----------- TURN l 101K ..: 1 BOIL/CMP i 3HP: 0 VENT FANS.....: 2 CLOTHES DRYERS: I GAS FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: I MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 1 ---------•------------------------------------------------ ELFCTRICAL _ _------------ ___------------ ----------------------_- --RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- -- -MISCELLANEOUS- -- --ADD'L INSPECTIONS-- 1000 SF OR LESS: 0 0 - 200 amp..: 0 0 - 209 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADD,L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 9 1st W/O SVC/FDA: 1 SIGN/OUT LIN LT: 0 PER HUUR......: 0 LIMITED ENERGY.: 0 481 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BP CiR: I SIGNAL/PANEL...: 0 IN PLANT......: 0 MANE HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0 i000+ amp/volt.: 0 ------------------------------------- PLAN REVIEW SECTION ------------------------------------- Reconnect —------------------------------- Reconnect only,: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: -------..-------------.---____. ELECTRICAL - RESTRICTED ENERGY - A. SF RESIDENTIAL------ - ------- ---- ---- B. COMMERCIAL-----------—------------------------------------------------------------------ AUDIO I STEREO.: VACUIP SYSTEM... AUDIO I SIEREO.: FIRE AU1RM.....: INTERCOM/PAGING: OUTDOOR LNDSG 13: BURGLAR ALARM..: OTH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR: HVAC...........: DATA/TELE COMM.: NURSE CALL:....: TOTAL I SYSTEMS: 0 Owner: --------------------------------------Contractor: ------------------------------- TOTAL FEES:$ 486.81 CROUCH, FRED I KAREN OWNER This permit is subject to the regulations contained in the 12220 SW JAMES ST Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARO OR 97223 other applicable laws. 1111 Mork will be done in accordance with approved plans. This Nirmit will expire if work is Phone N: 579--7763 Phone 0: not starte) within 180 days of issuance, or if the work is Reg C.: 000010 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-Oei-0180, You may obtain copies of these rules or direct questions to OLNC by calling (503)246-1987. --------------------------------------------------------- REQUIRED IN!9PECTIONS -------------------------------------- Erosion ------------------------------------Erosion Control Crawl Drain Electrical Rough Insolation Insp Plush Final Footing Insp PLM/Underfloor Framing Insp Gyp Board Insp Building Final Foundation Insp Mechanical Insp Shear Wall Insp Rain drain Insp Erosion Control Post/Deas Struct Plumb Top Out Low Voltage Electrical Final M _ Post/Beal MechanElectric 1 Servi Gas Line Insp Mechanical Fina'_ ISS1.Ied By :- , _ Permitter: Si gnati.tt,e - .a F 1 +++ -+++++.}++++++++++++++++++.4.+•++++++++++++•4-++++4-++++4-++ A +4 4+++++•4 ++++4+4 1 Call 639-4170 by 6:00 p. m. for- an inspection needed the next bi_isiness day Plan Check CITY OF TIGARD Residential Building Permit Application Recd By 13125 SW HALL BLVD. New Ccnstruction Additions or Alterations Date Recd TIGARD, OR 97273 Sinole Family Detached or Attached (Duplex) Date to P E. '1 '1503-939-4171 Date to DST .2 (� 7 F 503-684-7297 Permit#hl`:;)( i' )r) Print or Type Called - _- Incomplete or illegible applications will not be accepted Name of Project Name Job 4..-1d,f " Address Site Address _ Architect Marling Address Name ti ZG` S W \ cry/ Q_ J t`- City/Slate Zip Phone r/-eA (-r•o veal., Owner Mailing Ac dress _ Name City/Stater Zip S�". "} • En ineer Mailing Address Phone u U Q.• %:+J,) +'/`7�F Cit (State iNa Y Zip Phone l General Describe work New O Addition Alteration Repair O Contractor Mailing Address — to be done Additional Description of Work: yy3fr'� City/State Zip Phone /ci /r nIw eA Un v Oregon Const.Cont. Board Lic# Exp. Date !, r n` Attach Copy of Current COT Business Tax or Metro# Exp Date PROJECT -Licenses - �V VALUATION $ Name Mechanical NEW CONSTRUCTION ONLY: Sub- Mailing Address -- Sq. Ft. House: J;-4 J;i Sq. Ft. Garage Contractor OZM, Corner Lot YES NO Flag Lot YES NO City/State Zip — Phone (check one) _ (check one) Oregon Const. Cont Board Lic# Exp. Date — Restricted Audio/Stereo Burglar Attach Copy of _ _ Energy System Alarm Current COT Business Tax or Metro# Fxp. Date Installation Garage Door HVAC Lrcynses ( Name - --- ___ Opener Syst'ms I (check all that tither. Plumbing _ apply) Maii` Address Sub.- g Will the electrical subcontractor wire for all YES NO Contractor restricted energy installations C ty/State Zip Phone Has the Subdivision Plat recorded? N/A YES SIO Oregon Const.Cont Board Lia# Exp. Date - Reissue of MST#7 -- Solar Compliance Attach Copy or Current Plumbing Lic.# Exp Date _ __ (Calculation Attached) Licenses I hereby acknowledge that I have read this application, that the COT Business Tax or Metro# Er.p. Uate information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance Name — _with Oregon State laws Si na a of Owner/ I - Da t Electrical v c,�� e r• .---•• �. Sub- Mail ng Address �- -----Co ct Person a # Contractor _ --- : F �_ t r0;X.-l1' -- �i��763 C•ityvState _Zip Phone FOR OFFICE USE ONLY: aqo 8 �� , _ Plat t —�—_— Map/TL#: Oregon Const. Cont Board Lie# Exp.Date i �( wf• �-j l %X Attach Copy or ___ Setbacks: Zone Solar: Current Electr cal Lie #— F cp Date I � I,, /- -- f i Licenses Enging�Ong Approval: Plannin Tax or Metrg Approval: TIF CO"r 3usiness o# Exo I 01 - I Date r SFAPP DOC (DST) 4197 r Permit # Acct. Descritpion COT VVACO Amount Amt. Pd. Bal. Quo ----__= MST. Permit (BUILD) (L)BUILD) Plumb. Permit (PLUMB) ( ) (UPLUMB) Mech. Permit (MECH) (UMECH) WO ELC/ELR Permit (ELPRMT) (UELPMT) State Tax (TAX) (UTAX) /ice, �`k -- . BLDG: 'f yJIi, c _— PLUMB: / MECH: E.0/ELR: Plan Check IVIaT (BUPPLN) (UBUPLN) 3 Y _ , ► �� z�'„ Plumb: (PLUMB) (UPLUMB) Mech r' (MECPLN) (UMEPLN) CDC Review (GUILD) (CDCBLD) (UCDC) CDC Review (PLN) (CDCPLN) N/A Sewer Connon (SWUSA) (USWUSA) Reimbur. District ( ) ( ) Sewer Inspection (SWINSP) (USWINS) Parks Dev Charge (PKSDC) N/A Residential TIF (TIF-R) (UTIF-R) Mass Transit TIF (TIF-MT) (UTIF-M) Water Quality (WQUAL) (UWQUAI_) Water Quantity (WQUANT) MWIDANT) Erosion Control Prmt (ERPRMT) (UERPMT) Erosion Planck/USA (ERPLN) (UERPLN) Erosion Planck/COT (EROSN) (UEROSN) Fire Life Safety (FLS) (UFLS) TOTALS: _ -------- � % 1 (J J . + � = I Sr APP DOC (DST) 4197 AFTER RECORDING RETURN TO: M & T MORTGAGE CORPORATION 5285 SW MEADOWS RD. , STE. 290 LAKE OSWEGO, OR 97035 DEED OF TRUST 'I'IIIS DEED OF TRUST ("Security Instrument") is made on July 14 ,1997 The grantor is FRED L CROUCH and KARIN M CROUCH ("Borrower"). The trustee is CHICAGO TITLE 99005W GREENBURO RO. , PORTLAND, OR 97223 ("Trustee"). The heneficiary is M &T MORTGAGE CORPORATION which is organized and existing under the law,'of THE STATE OF NEW YORK and whose address is ONE M &T PLAZA, BUFFALO, NY 14203 ("Lender"). Borrower owes Lender the principal suns of One Hundred Eleven Thousand Five Hundred and no/100 Dollars (U.S. $ 111,500.00 ), This debt is evidenced by Borrower's note dated the same late as this Security Instrument ("Note"), which providers for monthly payments, with the full debt, if not paid earlier, due and I)ayablc on August 1 , 2027 This Security Instruill tit secures to Lender: (a) the repayment of the debt evidenced by the Note, with interest, and all renewals, extensions and modillcations of the Note; (b) the payment of all other sums, with interest, advanced tinder paragraph 7 to protect the security of this Security Instrument; and (c) the performance of Borrower's covenants and agreements under this St:curity Instrument and the Note. For this purpose, Borrower irrevocably grants and conveys to TAislee, in trust, with power of sale, the following described property Ilocated in WASHINGTON County, Oregon: SEE EXI-IIBIT 'A' ATTACHED HERETO AND BY REFERENCE MADE A PART [HEREOF. TIGARD which has the address of 12220 sw JAMES STREET [street,Cityl, Oregon 97223 IZipCcnlel ("Properly All hcss"1' LN 4235958 OREGON-Single Famllyy FNMA/FHLM� UNIFORM INSTRUMENT Form 3038 9/90 -OR(OR)194121.01 Amended 5191 Peg" ®il fi VMP I�IORT6AGE FORMS-18001621 L1291 Tis. _ I ILII I III [III IIIIII III[III[III re C,�vv�Gl� hone'. 579�77.6CO ,j hkrb� � /v�ac�-o s,W• 3/9MeS sf • - __-- Dal 0 'Lr ` Willa mei/e {SLAT �- -- c�d° �Sr_03� LOT a000 r - Z o n7/n(- 9 - 4,5' i'' = ao ' -- V�,r r tfc. 3C) I LyYCisE� L7�04I/P—L Y. I • � ' . .' � ' vim . � . �.�.Qssory � 5� � N I � �� a e►o _ i SafQ�k I 111 I 4�d '� .l� " J• � '�� 3 -g,-6 L I jb' Drab' I �J rb 1 n r n9D f AIN I I EL _...._ ... .. .._. ��. zee ,_ ._...... ro.� �... ... c�..�.;,o PVA. f}cc.eJSory 21. �111hIMU dH `SCG Flpr-�-/(YJl n D S,d,P_ • � I <v oTt(. I I AFL,;7�/ V I / 5u,5rtNb f�O ISLE' I o I Q�Moa eL oL • , 1 � I I 5 E�. 7L -- CITE( OF TIGARD MASTER PERMIT �-� DEVELOPMENT SERVICES P, RMIT ##. . . . . . . : MST97-►��;. 13125 S W Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 09/02/97 PIARCEL: 2SI03CB-0200o SITE ADDRESS. . . : 12220 SW JAMES ST SUBDIVISION. . . . : ZONING: UBDIVISION. . . . : ZONING: R-4. 5 BL-OCK. . . . . . . . . . L.OT. . . . . . . . . . . . . JURISDICTION: URB Remarks: 528 Sq. ft. accessory building ----------- ---------------- ----------------------- -- BUILDING ---------------- REISSUE: STORIES.......: t FLOUR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED------------- CLASS OF WOW.:ACS HEIGHT........: 12 FIRST....: 0 S GARASE.....: 528 sf LEFT..........: 5 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD....: 50 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 0 TYPE OF CONST,:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIM„ 5 'A CLMCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE..$: 9335 REAR..........: 15 - ----------------- PLUMBING ---------------- - ------------- -- ------------------------ SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: a LAVATORIES.... : 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATC)l BASINS..: 0 TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 - - - ---•..--------------------- FUEL TYPES---------- FURN ( 100K ..: 0 BOIL/CMP ( 31P: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0 FURN )=100K ..: b UNIT HEATERS..: 0 HOODS.........: 0 OTHER 1141TS...: 0 MAX INP 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....; 0 GAS OUTLETS...: 0 --------------------------------------------- _ _ --RESIDENTIAL UNIT---- ---SERVICE/FEEDER----- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ---MISCELLANEOUS--- --ADD'L INSPECTIONS-- '000 SF- OR LESS: 0 0 - 200 amp..: 0 0 - 200 asp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 50A9.: 0 201 - 400 amp..: 0 201 - 400 asp..: 0 1st W/O SVC/FDR: 1 SIGN/OUT LIN LT: 0 PER F!OUR......: 0 LIMITED ENERGY.: 0 401 - 600 asp..: 0 401 - 600 amp..: 0 EA ADDL 6R CIR: 0 SIGNAL/PANEL...: 0 IN ?CANT......: 0 MAh'F HM/SVC/FDR: 0 501 - to" amp.: 0 601+asp.-iow 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/SPC OCC: _____..-----.-_-----.------_____-----------_--__------ ELECTRICAL - RESTRICTED ENFRGY ------------ ;�. SF RESIDENTIAL_----- -------------------- B. COMMERCIAL------------------------------------------------------ AUDI0 I STEREO.: VACUUM SYS,E4..: AUDIO 6 STEREO.: FIRE A09H.....: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURR AP. ALARM..: 0TH: :. BOILER.........: HVAC...........: LAWSCAPE/IRR1G: PROTECTIVE SIGNL: GARA9 OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR: HVAC...........: RATA/TELE COMM.: NURSE CALLS....: TOTAL I SYSTEMS: 0 Owner: -----------------------------------Contractor: ---------------------------_-- TOTAL FEES:$ 136.86 CROUCH, FRED I KAREN OWNER This permit is subject to the regulations contained in th,� 12220 SW JAMES 5T Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARD OR 97223 other applicable laws. All Mork will be done in accordance with approved plans. This permit will expire if work is Phone I: 579-7763 Phone I: not started within 180 day: of issuance, or if the work is Reg I••: 000008 suspended for more than 180 days. ATTENTION: Oregon law ��—_----- -------------------------------------- requires you to follow rule; adopted by the Oregon Utility Notification Center. ?hole rules are set forth in DAR 952-001-0010 through DAR '52-MI-W. You may obtain copies of these rules or direct questions to MK by calling (503)246-1987. -- -_----- ---- -------- ------ REQUIRED INSPECTIONS ------------------------------- 111"u-0 vvw Footing Insp ---- --- — — Framing Insp Rain drain Insp — — -- — — Final inspecti 15 S llCd B : �!L �_ _ G'er-mittse Signature tt+}t++++ i+++1++++++++++++++++++++i-+}}+{.} ;-+••+++++{+�+ ++++++1-+++++++t+• . Call 639-4175 by 6:00 p. m. fur, an inspection needed thext bL;siness day :I`TY OF T,.lGARD Plan ChechN• Residential Building Permit Application Recd By �j 3125 SW HALL BLVD. New Construction Additions or Alterations Date Recd �- _IGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 2- ! 503-639-4171 Date to DST -Z 503-6$4-7297 Permit# V' � `,' > Print or Type Called - _ Incomplete or illegible applications will not be accepted Name of Project Name Job Address Site Address Architect Mailing Address Nam>� t City/State Zip I Phone ' A C. r o J<JA_, I Owner Mailing Adtlress Name _Qdy/State!/�I Zip _ Phone Engineer Mailing Address Natne Gty/State T_ Pho.i General -- Describe work New Addition O Alteration O RepaO Contractor Mailing Address — to be done:_ Ir City/State _ Additional Description of Work. Zip Phone Oregon Canst.Cont. Board Lic# Exp. Date `, 4 -- i Attach Copy of Current COT Business Tax or Metro# Exp. Date PROJECT n Llcenves VALUATION $ '�`-` / -33 Name - Mechanical 0/1-/C NEW CONSTRUCTION ONLY: Sub- Marling Address , --- Sq. Ft. House. Sq. Ft. Ga ra e Contractor City/state Zip Phone Corner Lot YES NO Flag Lot YES NU (check one) (check one) Oregon Const. ant. Board LIC# Attach copy of Fxp. Date Restricted Audio/Stereo Burglar Energy System Alarm Current COT Business Taz or Metro# — Fzp. DDate Licenses Installation Garage Door HVAC -� Name - — Opener Systems (check all that Other: Plumbing apply) Sub- Mailing Address Will the electrical subcontractor wire for all YES NO Contractor restricted energy instal;ations? l C ty/State Zip Phone Has the Subdivision Plat rerorded? NIA YES NO Oregon Const.Cont Board Lc# Attach Copy of Exp. DaDate Reissue of MST#: Solar Compliance Current Plumbing Lic # Expte (Calculation Attached) Licenses I hereby acknowledge that I have read this application, that the COT Business Tax or Metro# Exp Dale information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance Name — -- with Oregon State laws. Electrical , ,.��_� Sign of oy D t Sub- Mailing Address Cont t Persso{ arm)e / one# Contractor = _✓y„r�� 7 CityiState Zip Phone FOR OFFICEUSEONLY: Plat jf: '�a n �Q Map fL#: r.iregon Const Cdnt Buard Lir.# Fxo Date ) \trach Copy of _ , _ Setback Current Flectncal Lit #! Exp Date �,A ) Zone %; Solar: I_ tenses 1` I KPlannij,4;pval. TIF6C6T Business Tax or Metro Exp Date � Ir I:SFAPP DOC (DST) 4/97 Permit# Acct. Descritpion COT WACO Amount Amt. Pd, Bal. Due 6J% (- MST. Permit (BUILD) (UBUILD) 8o 5o Plumb. Permit (PLUMB) (UPLUMB) Mech. Permit (MECH) (UMECH) ELC/ELR Permit (ELPRMT) (UELPMT) State Tax (TAX) (UTAX) BLDG: PLUMB: MECH: ELC/ELR: Plan Check MST: (BUPPLN; (UBUPLN) Z. j y�l'► �� p Plumb: (PLUMB) (UPLUMB) Mech: (MECPLN) (UMEPI-N) CDC Review (BUILD) (CDCBLD) (UCDC) CDC Review (PLN) (CDCPLN) N/A. Sewer Connon (SWUSA) (USWUSA) Reimbur District ( ) ( ) Sewer Inspection (SWINSP) (USWINS) Parks Dev Charge (PKSDC) N/A Residential TIF (TI IF-R) (UTIF-R) Mass Transit TIF (TIF-MT) (UTIF-M) Water Quality (WQUAL) (UWQUAL) Water Quantity (WQUANT) (UWQANT) Erosion Control Prmt (ERPRMT) (UERPMT) Erosion Planck/USA (ERPLN) (UERPLN) Erosion Planck/COT (EROSN) (UEROSN) Fire Life Safety (FLS) (UFLS) TOTALS: _ r� —J ~3 3 I I SFAPP DOC (DST) 4/97 Permit #: . �,�,: • M Address: Issued b L� Dsrte: 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 building permit can he issued. This statement is required far residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), treed not submit tltis statement. This statement wilt be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and ?, and eithcr'iox 3A or 3B: El1. I own, reside in, or will reside in the completed structure. � 1. i understand that I must reeister as a construction contractor if the structure is sold or offered for sale before or upon completion. LJ 3A. My general contractor is LJ (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. 1 will be my own general contractor. if i hire subcontractors, I will hire only subcontractors registered w th 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 Informs+'::nr Notice to Property Owners about Constyastion Responsibilities on the reverse gide of this S'orm. i (Signature of permit applicant) (Date) (White copy to issuing agency per►nit file. pink copy to applicant) r tntorrnation Notice to Property Owners About Construction Responsibilities ;'Vol r11 If PI0'-wtit olt r:, r, ai;vw Lund`iructtcln Responsibilities n,. 4< +r:I)ii ;ins Braid in u(cmdanc'e with ORS 70/.055(5), j111prciveivient to flit existing smic'ture, ui ill .:?tiU1'.=i111t t�;'+tIlls It,Ititlt:;,1110 We;t`. UI Lulwal'. EPAVLOYIEP gF.SPONSIBILITIES: nt, 1sir 'a I., I: tllil l'"i l =1111 th,' 1;: ull,r.1,11 Buoi t to l;U lahulfit or rissklina in the. .. r,•,1,;, .:IIT '.It-III ki :III ,'III, ill imr:,,t ifisi:111t,cl,, ht' rtil..'(I i�,Iv, ;ill L'mplo�x, ;If111 the people. lit l l l !);ri,l i ttlllili\; lLlth thl.' 11,11hL1111`'' I. " .� �. , ," •.lrnr tn+cr�frc?rtY 1•tttf7lhci�r tVtl r',iltihc lien. r,htployms i. I I ,;,.:,ri,-•it' t ijr,�i t it Ills ,1111111.011 ttl(•.lill( tr11111`1ftl lr'r_�ltlpl'.l\1'1'x. For!lu)rc. •�f�nul� 11 ;r. I,.' 1, 101 ;It),tllill.aril u'1!t m-oirance pial'Itis(`k oit the ,1011 ill thu I)cpll)tlru nt of 11u111all Rcsilrlrcas a ,11 i qii; I t. ;1,.' i a\'l:.Ill \.1'tIIR:.'r,' i';,n it 'n.,lt�ur I ,11• ;n!Il 111UIt 16I.6il W1 01lNl IIIsk I r:illt'+', l,mf(hely 1 1 1i. t t 1y,'!il 1" 11A I1 vII111 Vol Iflti"Ililtilltllt, R: .11 !i l'.:f'1'in'tll l i till'.t:In1.I .Ji,� Flo,III,— �Illhol(1 the Li', flit 111t1rt' ild -rill II IttIL 1.',ii) 111!' h11 ril;t) Il,"t:,.. OTHER RESPONSiBILITiES AND AREAS CSE CONCERN: t761R'<'111!)'1{It111fY'.: �15LH' i�' I',1`11hIIiII�_'IIU' IIIt�l1t111,'� t 11111.,i:''.`it`:'.i,l'll'�j17�.'tlrirt'<111\'lilt:"illy failill-i'itlllh.'t'1�: 1'Ih"1't'tlliUl'1I1.'lIl'� 01�11 IliaA II'." "I,ili�llll ° 1111' t!t�t'tltlt"1 lhrtllil'll 1115111'•;1t1r11. wi)1111y an(i l ilf I1t: llilhi.0;lgelll to see Ii V(ill llal ;' adcquati 111AIMIC1' r:t!+r-' 101 It Slit l 1• t8111l11 (l?lil:., I illnt t. :.'! ('Illi, L\ III'I I1i1111ail_1C 11-0111 pll)C l)1111CtUlCS, l"'t'. UI 14'lll-K 111111 11111"1 lit' Time to supvtIke 1'rn,llnti4'.':c; Nfid)c i,ill ]Milt- I„ r �OCI'li',1" �.1'?ht• PYY�Jt)IMG:'+'tIIFPIrt't?iEr`ti, Irthsytlur;l?t,nl"(11r'r;l�rrRfr;lCtIN.1Or'1)nr+1 1 'i1i I 1 .;, ll Illrlil(lt' It0do, an(I m tr+tii'v htlild nc rlt'FlcialQ alt thl' ;lrhrnitri 1tc tihu`� So tht'y cart Perform the rv,r1,t..,l it, inlnti. 11 Noll ha\1' uldillUnal 41W,01,Ill". writt`of 1.,111 the(.onstt'U01till t 141 lli, , aAeul,(111 ') ' (l(>-'�II"�•'. .(13/378 16'11. The Aa,u'cl i,, I,Icalcll ;it "no Stimm,r St. NF .�ilite 3W, in Salem, IIItyI.iv II tnnl I 1:1 r■ .r August 25, 1997 Cin( OF TIGARD OREGON Fred and Karin Crouch 12220 SW James Street Tigard, OR 97223 Re: MIS 97-0015/Accessory Structure Dear Mr. and Mrs. Crouch: This letter is in response to your request for approval of a 528 square foot, 13-foot-tall Accessory Structure/Garage. The Director has approved this structure finding that it meets the approval standards of Section 18.144 of the Tigard Community Development Code. The structure is on a parcel of land that is smaller than 2.5 acres and zoned R-4.5. The structure, as proposed, does not encroach into the five (5)-foo+ side yard and rear yard setbacks required for accEssory structures in residential districts. The structure also dces not exceed 15 feet in height or 528 square feet in size. There are no identified sensitive lands. Therefore, the structure meets the requirements of the applicable development code sections for this type of use. This Accessory Structure approval allows the structure in the location proposed, however, you are required to obtain building permits prior to construction. Please submit a copy of this letter of approve with your request for building permits. Please feel free to contact me concerning this information if you have any questions. Sincerely, Julia Powell Hajduk Associate Planner r\curpinljuliMm Mcrouch.acc c: MIS 97-0015 land use file Development Services Technicians 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 ra51 dO wiI/gnref{e X51-03c- LoT ..ao0o - e j. t oO ;qD /•Avr�. I : aaka� � I,vp ory —5z}.b��n 2Z (uin�Mu _ �' � SSD /' �,.I�• � '� i 2 o n r riff ACL rAO I Q I ` of // ( •M �h I •cru� � , (Ali J [7A(AV 1 r ., m oc� c L l� J loo a.2$0 . •• �a�� ani tF14t ' zz Su M ` 5Qr I Sw rb� I y elP )y sorrT(c. Ib 6r*,r CL I I �tMOG yk 9i -7Z. —let- Sa+2,,q virclt CITY 4F TIGARD DEVELOPMENT SERVICES ELECTRICAL FERMI-f 13125 SW Hall Blvd., Tigard,OR 97223 (503)839.4171 PERMIT #: ELC98-0274 DATE ISSUED: 05/26/98 SITE ADDRESS. . . : ] 1:'220 SW ,JAMES STPARCEL.: 2E 103CB--02000 Q1 Jpr.VIS:OhI, , , . :W1L_LAMETTE 101\1ING.R--4. 5 BLOCK. . . . . . . . . . LOT'. . . . . . . . JURISDICTION: IJRB P"ro.)ect De scr i pt i on; Add 2NW or less service/feeder and two branch circuits. ---RESIDENT IAL UNIT---- -TEMP'-SRVC/FEEDERS---- ------MISCELLANEOUS- --- ].000 SF OR L ESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/I RR I GAT I ON. . . . : 0 EACH ADD' L. 500SF. . • : 0 201 - 400 amp. . . . . , . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 11ANF. HM/ SVC/FUR. . : 0 601+amus--1000 volts. � 0 MINOR LABEL ( 10) . . . : 0 _-SERVICE/FEEDER------- -----BRANCH CIRCUITS• ----- --.. -ADD' L INSPECTIONS--— 0 - 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 2 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . , 401 - 600 am . . . . ° 0 P• • • • • • : 0 EA ADD' I_ BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . ; 0 601 - 1000 amp. . . . . : 0 ------_-----------FLAN REVIEW SECTION---------- • ------- 1000+ amp/volt. . . . . : 0 ) =4 RES Uh'I TS. . . . . . . . : > 600 VOLT NOMINAL. . Reconnect only, . . . . ; 0 SVC/FDR ) = 225 AMPS_ : CLASS AREA/SPEC OCC. : Owner: ___-_--.-__-.--•---.___..._____________.__---•----_-•_ -- - FEES ----.___.__________...-__-•-- UPOUCH, FRED & KAREN type amoo.int by date recpt i 20 SW JAMES ST PRM'T $ 70. 00 GEO 05/26/98 98--305977 L') GARD OR 97223 5PCT $ 3. 50 GEO 05/06/98 98-305977 Phone #: �.CTltractor`: ---•--------------- OWNER - -----_--- $ 73. `' 0 TOTAL. REQUIRED INSPECTIONS ----- Elect' l ServicePhone #: Elect' 1 Final Reg #. . : 000000 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. 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 than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0018 through OAR 952-001-1You may obtain a copy of these rules or direct questions to Ol1NC by calling (503) 1987. ' I '+ r mittpe Signat I� s i_:a r1 R y; -- ---------------------------OWNER INSTALLATION C►NL Y- --- -- --The installation is being made on proy I own which is not intended for - 1 e, lease, or rent. �� CIWN 'R' S SIGNATURE' �s --''"r �! DATE: INSTAI_.L_ATION ONLY-----..._-_.__...._____._.__.__.._...._. _.__ .__.__.._ SIGNATURE OF SUPR. FL.EC' N: _ _ DPTE: LICENSE NO: ++++++}+•}++++•}++i+++•++++•1.+++++++++++•}+++4++++++-+++4+++++++4 1 +++++++++++}+++++++ Call 639--4175 by 7:00 p. m. for an inspection needed the next business day +{.+.1..+++++++++++•++4-++•}+f++++++•}++++++i•+++++++•}++++++i+4-++ }+++•.E.++++++++}•}++++++++ r Permit#: b (��5-IP — 'ti) Address: IRR;?6 issued by: Date: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.05.5(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. 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. # 1 will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR �13. 1 will be my own general contractor. if I hire subcontractors, 1 will hire only Subcontractors registered with the Construction Contractors Board. if 1 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 du understand the information Notice to Property Owners aboutCJo}�S[I7uction Responsibilities on the reverse side of this form. `.1 � �� _ --- -- -------- --- -- ---S f 2 G' ay (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) 01 Information Notl6e to Property Owners /about Construction Responsibilities !,��rc, ;�:; ,n,;�i,,n ,ti'•�ttt t (,).l'1vPlst7p (f ti'lli: ab va Garn trtwtiort Re.sponsih)b, . ;l r(ri�'i: Irl r.' _' ('.',Irr•„ilr, /kill rhrtfYrlLYn)'s Boardin occookinc'e tt di OR, 704 `il ,Ir ilits^ lr;i'(1 ,;t1;'1'ilirllr too ill cotroriv-1 (I lim ht111'e UI make it 511174ti11it1Jl Illl{)rOV1011I 'I11(U iln f AlSting '.ItII III (rt'r rl .`lila i) l :iiln 1W i1 (114 4� Qmlw Clglj �(►Iai�l�{ ''9 ti Jti {� my •"`,.;. 5 d A t r. n;W EMPLOYER RESPONSIBILITIES: '! I,I lit I'1'1'i( 1..• t),ll 'l' �`•.. �t;tl t`Its. li i I IT 111,101d 141 drt 111111W I L1'l1>L;U,I1I'16 UI 13's11St111): 11' 111(' I( ;�1ifl!I it ,11 f.1'-1(Irt it t Ill, Ifl lit,?:t ittSt;inc,",, be rlllt'(1 i(r ill_' d11 l 111 ll(?yr'r illlll the pci)h1C uil Illrt;: A(114 ;11; t.. 't !ii'. n(,1„' _ �11 I1 r11'i, .,if11 i}I ' t(?(1tr`.•.In 1.)('t` 1111rt ev itilirllYl7!{'ti 1. %1.'1 A- A" Irl -Ill 11)(1 tr t:'f it; r)1l tc( ;r,'1t11I1r11(!II'”tltilt:'t21X"ifrrtn('111p1t)}'fe VViw("<.Yt lhl' lIrlh't 11'i 1'1I0Yml \�111 )'1 11 1,fE for 111- t,v f!,rritlt",)I "V1'11 if 1,oli don't wiilally ibithhold Ihr tax ftnm Vrllrr rrtlrlt l�t'C'•. + Ilft)rin,►linti. c,111 111•' 1 tn'Iinn i )j—(f Revenut' ,t 114".8ol)l w,nii11111merir Iriarriiricel',;1A" A ,ill t'1 pt, 1111:1r",nil !ll 1,1 (' all; Iit)lcrl r:• 1(1r n)!)l !111(1p;rtidtifill,call tlw-, ;)rcgonl.r;tnlr ;ir,--ilt Liiv000ii Ill Ihr: I)upai I 11lent cat i Itil Ila II lit llrl4E.`!'!,r a'gtrtpr'rltilitil)li itttitt"`:frit"(." �),all 4'1'.11+InVCr,. }'tru 11r(` �Uh�t'(I 1:,Ill(' O1'C tln W', u111plil+,lll�.11I I::Iv II1Ll'il �:IilUl t':1!11.,C('ti�("t111111r"tl.ti.1111`�+ 1'1',l.IfL�1C+: it1l '>,trtirClil(11uVCt:a_ 11 y^l-til 11111 Li11,11'!til!Il Wr.lr{�CI',4�C(71'1?�t;il�t.ltli111 IIiSIIriJi7CP,� 1 � Ili:Ij utIIct i +, (,, 11;111ic rind Vl Ii' Ii 17'w 1111 , !:1:ill c if crrlr(it'yr_iurenlpi,n,e s 1%itij`ure:d on the j4, T�-)r tir rom infra, 1 I ,��. ,i �, (z. ,t1��•Ir.al�"JI (1, I ill (�;1 th;' I�)r1 ,rtlurnt r.f r'tru.umcr an 1.ul;irfElieIs �etVtcC,g -r • • S. Ildl-rllal Revell toc su virt,: A .111 cclIIpiln'cr, vt111 11141st N,v1t[4111)Id f4trleral inc,ttlie IaA trt*1 i0ThpIb.* est— vA�f!�. Yrin vwr! 1111c for th ,ON Iti,lvrtWl`tl"(' �. ,t i ,lI Jilin t;'L iu;111y N,it11hold tile:t:o i 1t ln(trr int';it n llirtn.c;til lh,,Tw r lr:,i P, i wit c: , OTHER RESPONSIBILITIES AND AREAS OF CONCERN. i•totevoiritliarlr•e: •\`;thc1),-m jlhctlderforilw pop'(t .ti,rIr rt111ntt�lnyI�ailun in ntc'C.trudc'rcytli: Illnl r11ati' hL. Ilrnuhhito pcait.Wtintioll through in,ix'olon". i:cbiiil� .Irid 1/rlryu:rly Osla+.Ii,�it ittwtrlstltt�:.C;R1n(;tc(i'nw ul�uranc(�1t��ltt ic.t;eG i1'you I1,i�c:uiJt:�ltiatc. nl;,ur,incc rr 1,cr,lA'(` ft,l Il r 1tJont!,,Intl oml•,:,Iolls much .r fallul};tool .11an1: v.u:1;I(ly. \Aalvi tlailiilgt: lion) pipe pllnclurr: firr.. or tnu'',l 1 tllalc. i'it►u� to cupc'r•�i,c rrltph►]�ec'.�: Ma4,t� .�irrc ynt.l have :,nllit:irnt tinic n, �I11+t•rvi„' �;sur �',u1)i1r,;'I` ►'.�C�c�T�lifie! M1�1'�{Sti1�1`”.t•.n 1r • 'rH�'Ci��nr't?ih't'ti,�t.'I;,` ',�Nir tt'1t,�,^nCr:,1 iY nirar'tltr.Its t tlrl?bili.Ift'tilt'lt't`1'iC ri(IYnl�+,h-Iit F111(I11t11St1) IJI_it"i. (rfl(1 Irr11I7fIfV�tltllllil'11` .ifirj ll., tt '111' : ttrltnhri llr'iitiv- k iAeyCiltt 1`erfot`m flit,r'Prittirod Itignet tionq If yclitltaYc aildiNhnlil quc�atiuny, wrltc 4�rciill the r I'I:' Iru,fl, n ('unll,n.lt�r� {;tr:rd INO I;n� 141-i0 .Salem,OR 973Ot)-505' (Ul't;5 dh211 1'he Hhlitd is luculcrsi ,rt ?t 1t) 51n1u1r:I ti! ^�I `uit,! i(N1, m SRIvIll, pt1q1 t11LIr pin-1. i"ri CITY OF TIGARD Electrical Permit Application Plan Check# 13125 SW HALL BLVD. Recd By - TIGARD OR 31223 Date Recd_ Date to P.E. Phone (503)639-4171, x304 Print or Type Date to DST_ � Inspection (503) 639-4175 Permit# C r Fax (503) 684-7297 Incomplete or illegible will not be accepted called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name(or name of business)__ Service Included: Items Cost Slim Addrr)ss /2 2. O ; G,i �',�,w { j� 4a. Rasldentlat-per unit - 10(X)sq.ft.or less - $110.00 _ 4 City/Sia+' Zip �° !� �r� I 7� Each additional 500 sq.ft.or Commercial ❑ Residentiali portion thereof $25.00 _ 1 Limited Energy -. $25.00 Each Manuf'd Home it Modular 2a. Contractor installation only: Dwelling Service or Feeder $68.00 _-- 2 (Attach copy of all current licenses) 4b.Services or Feeders Hectrical Contractor Installation,alteration,or relocation Address200 amps or less $60.00 2 ---- - 201 amps to 400 amps $80.00 2 City State_ _Zip 401 amps to 600 amps $120.00 2 Phone No. 601 amps to 1000 amps - $180.00 2 Job Na. Over 100n aReconnect only amps or volts $340.00$50.00 2 _ 2 _ � Elec. Cont. Lice. No _Exp.Date_OR State CCB Reg. No. -Exp.Date_ 4c.Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date_-_ Installation,alteration,or relocation 200 amps nr less -. $50.00 2 Signature of Su)f. Elec'n_-_ 201 amps to 400 amps - $75.00 2 -- ------ 401 amps to t;00 amps $100.00 2 Over 600 amps to 1000 volts, License Nr _ ____Exp Date_ see"b"above. Phone N --- 4d.Branch Circuits Now,alteration or extension per panel 2b. For owner installations: ,i)The fee for branch circuits with 7 purchase of service or ----- Print Owner's Name_1 eE ��c�r- /� feeder fee Address /L Each branch crrcul $5.00 /07- 2 b)The fen for branch circuits Citv i -r- r State_ izrZ._ Zip `7 7� � without purchase o► ----- Phone No. �Y -2 `.a -? 7�•3 - - _ service or feeder lee. First branch circuit $35.00 _ 2 rhe installation is being made on property I own which is not Each additional branch circuit_ $5.00 2 intended for sale, lease or rent. �� 4e.Miscellaneous (Service or feeder not included) Owner's Signature t/ Each pump or irrigation circle - $40.00 2 Each sign or outline lighting $40.00 2 33. Plan Review section (if required):* signal circulf(s)or a limited energy . alteration or extension _ _ $40.00 _ 2 Minor Labels(10) _ $100.00 w_ Please check appropriate Item and enter fee in section 5B. - _4 or more residential units in one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per Inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C.Chapter 5 In Plant _ $55.00 *Submit 2 setr of plans with application where any of the above apply. Jam. Fees: r Not required for temporary construction services. 5a.Enter total of above lees $ 516 Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If re to tired(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONE=D FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED ❑ Tiost Arcount 0 �. Total balance Due $ I VATS\ELCAO APS' -RM 91911 -z7 2037 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 6394171 Date Requested: ' / A,M, P.M. MST: � Location: — ---- — 9�a� MFC _ Tenant: _ _ _— Suite: ^7 Bldg: MEC: Contractor: 1 — Phone: ( 7 — — PLM: (honer: -- ----- --- Phone: ELC: — ELR: — f --- BUILDING �BLDG ) LUMBING ME ANICA� ELECTRICAL . SITESrie Posvikam Posl/73eam Cover/Service Sewer/Storm Footing Roof I1ndFl/Slab Rough-In Slab Ceiling Water Line Framing Top Chit (ias bine Rough-In 110 Sprinkler Foundation Insulation Sewer Ilood/1)uct Reconnect Vault D3sint Damp Drywall Storm Furnace Temp Service M[SC. Masonry Ceiling Rain Thain A/C U(j Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Float if) Low Volt _ Approved Approved Approved Approved - F11pr /Sdwlk ved Not Approved Not Approved Not Approved Not Approved ZIAL FINAL FINAL FINAL FINAL t 11 Call tbi remspec ' . Il Reinspection fee of S _ required beiirre next inspection O f lnahle to inslxxt Inspector, . j - 9- �� C) -_ Ditte: hat;e__—_ of .� i CITY OF TIGARD BUILDING INSPECTION DIVISION )4-Hour Inspection Line: 639-4175 Business Line: 639-4171 V' p p BUP l 72 -3 Date Requested 70 AM PM BLD Location / Z I'W Suite MEC Contact Person Ph _5776 _ PLM — Contractor Ph IM 20 SWR BUILDING Tenant/Owner (T� ELC _ Retaining Wall ELR _ Footing Access: - - FOUndation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab _-- SIT Post& Beam Ext Sheath/Shear _ Int Sheath/Shear Framing — Insulation Drywall Nailing A _ - Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling - _-_-- - - _-.--__--- Roof M i c -- ------ - -- Final PASS PART FAIL -- ---- ------ - _ -.--_- _- PLUMBING Post& Beam _:----------- ------. ------ -- - -- - Under Slab TopOut ---- - ----- --------- - - .-_-------- ----- Water Service Sanitary .ewer ---- - ------ -------- - -Rain Drains Drains Final PASS PART FAIL MECHANICAL - --- ---_ --- ---- ---- __-.__- - Post& Beam - - --- - --- ------------. - ----__--____ Rough In Gas Line -. -.- _ — - ----- - ------- Smoke Dampers Final -- ----- - --- ------ PA=�&- -PAIN FAIL ELECTRICAL - ------'" - - Service ��.._.-.__-------- ------------- /! ------ -- --- -- -._r-.-- -- Rough In l� ------- ---- UG/Slab --- --- -- --------- -- -- ----- --- Low Voltage .ice Alarm f ----- -- --- ---- — -.- F- 11 ASS,,' PART FAIL_ 1TE Backfill/Grading - - --- -- ------ -- Sanitary Sewer Storm Drain [ ] Reinspection fee of$ - _ --_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Sr,pply Line [ ]Please call for reinspection RE:_ __--_ - { ] Unable to inspect- no acre« ADA Approach/Sidewalk Date � Inspector Ext -- Final PASS PART FAIL DO/NOT REMOVE this inspection record from the job site. 1 �~ S ' r � i A t �• CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT 4: ELC99-0119 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED: 03/01/99 PARCEL: 2S103CB-02000 SITE ADDRESS. . . : 122'20 SW JAMES ST SUBDIVISION. . . . :WILLAMETTE ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . . JURISDICTION: URB Project Description- Electrical addition --RESIDENTIAL. UNIT---- ---TEMP' 3RVC/FEEDERS----•- -----MISCELLANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 BLIMP/IRRIGATION. . . . : 0 E01,,H ADD' t_ 500SF. . . : 0 201 - 4!_0 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amFs-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 ---- -SERVICE/FEEDER------- ----BRANCH CIRCUITS------ ----ADD' L INSPECTIONS---- rh - 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 40.1 - 600 amp. . . . . . : 0 EA ADD' L. BRNCH CIRC: 0 IN PL.ANT. . . . . . . . . . . . 0 601 - 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION----------------- 1000+ ECTION---_-_--__--__-_- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR > - 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: _..___----- --- --------- ---___ _ ----- ----------- -- FEES CROUCH, FRED & KAREN type amol.rnt by date recpt 12220 SW JAMES ST PRMT f 610. 00 B 03/01/99 99--313.345 TIG,ARD OR 97223 5PCT $ 3. 00 B 03/01/99 99-313345 Phone #: Contractor; FRED CROUCH $ 63. 00 TOTAL. 1:'220 SW JAMES ST REDUI RED INSPECTIONS -- - - - TIGARD OP 972.23 Romgh—in Elect' 1 Final Phone #: Elect' 1 Service Reg #. . : This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by flip Oregon Utility Notification Center. Those rules are set forth in OAR 952-M1-0010 thrcugh OAR 952-NI-1987. You may oatain a c,lpy of these rules or direct questions tF�:�c by call' 4� /J n s _ied �By -y_- - -------- C . ----_---OWNER / INSTALLATION I"hp installation is being made on prop ty I own which is not intended for gale, lease, or rent. / Ol-INF_R' S S I G N A T L J R E: -_lir-''�--� _._ _ DATE: INSTALLATION S T GNATURE: OF SUPP. ELEC' N: DATE: LICENSE N0: + F 4++++++++++++++++++i•+-F+++.++++++++4•+++++++++•+++++4•+++++++++++++++++•4++++++4++ Call 639-4175 by 7:00 p. m. for an inspection needed the next business day ►-4-4 4+++++++++++++++++++++++++++++++++++f.++++++++++•f•++++a-++4•+++++++-f+++++f++++4+ CITY OF TIGARD Electrical Permit Application Plan Check a 13125 SW HALL BLVD. Recd By - TIGARD OR 97223 Date Recd Date to P.E.3. I-` ? Phone(503)639-4171, x304 Date to DST Inspection (503) 639-417' Print or Type - Incomplete or illegible will not be accepted Permit a FLC 0111 Fax (503)684-72.97 `t Called r- - 1 1. Job Address: 4. Complete Fee Schedule Below: Name of Development_- Zt/i 114 710_ Number of Inspections per permit allowed Name(or name of business) - Service included: Items Cost Sum Address 0( d L) J,r!✓ ,7/,t/rt elr 34- - -- 4a. Residential-per unit City/State/Zip-- b i1�.�-- t C1 �7,/�a? 1000 sq.ft.or less $110.00 _ -- 4 _� Each additional 500 sq.It.or Commercial ❑ Residential pQ portion thereof $25.00 1 / t Imited Energy $25.00 Each Manul'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: -- (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor. Installation,alteration,or relocation , Address 200 amps or less $60.00 � 2 201 amps to 400 amps $80.00 2 City_ State_ Zip. 401 amps to 600 amps $120,00 2 Phone No.. 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 2 Elec.Cont. Lice. No. Exp.Date_ Reconnect only $50.00 - 2 OR State CCB Reg. No. Exp.Date 4c.Temporary Services or Feeders COT Business Tax or Metro No. --Exp.Date_ Installation,alteration,or relocation ,00 amps or less $50.00 2 Signature of Supr. Elec'n 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1006 volts, License No. -Exp.Date_,� see"b"above. Phone No._ _ _ 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: al The Ino for branch circuits with C purchase of service or Print Owner's Name / (/7 yCk _ feeder roe. P ddress_ V a p f 'G Each branch circuit $5.00 2 City_7=i� , State 1110- Zip_127a�-_ h)The lee for branch circuits �. wfthout purchase of Phone No. 7 i 7 7�• - service or feeder lee. First branch circuit $35.00 The installation is being made on property I own which is not i-ar:n additional branch circuit_ $5.00 _ 2 intended for sale, lease or rent. 4e.Miscellaneous (Service or feeder not included) Owner's Signature_ zv _l� _ Each pump or Irrigation circle _ $40.00 _ 2 Y - Each sign or outline lighting $40.00 2 3. Plan Review section (if required):' Signal circuits)or a limited energy- panel,alteration or extension $40.00 2 Please check appropriate item and enter fee In section 5B. Minor Labels(10) $100.00 4 or more residential units in one structure 4f.Each additional Inspection over Sarvlce and feeder 225 amps at more the allowable In any of the above System over 600 volts nominal Per inspection _ $35.00 Classified area or structure containing spot!.;occupancy Por hour $55.00 _ as described in N.E.C.Chapter 5 In Plant --- $55.00 Submit 2 sets of plans with application where any of the above apply. Jr. Fees: . Not required for temporary construction services. Se.Enter total of above fees $ l l 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if re utred(Sec.3) $ - - t1()T COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ I`;SUSPENDED OR ABANDONED FOH A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED ❑ Trust Account 0__ 3 Total balance Due $ I qn`•1 r0Fl C.Mi Arm nry(11)1. CITY OF TIGARD BUILDING INSPECTION DIVISION MST -2 - 03SS 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested �� ' "�� AM L PM BLD Location I Z?�"�-'� CSS . Suite MEC Contact Person, Ph PLM Contractor Ph SWR BUILDING Tenant/Owner — ELC _ Retaining Wall ELR _ Footing Access- Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab _ _. _- SIT Post A ram — — Ext Sheath/Shear _ Int Sheath/Shear — Framing — Insulation Drywall Nailing Firewall Fire Sprinkler __-_-- -- ----- — -----__—_— Fire Alarm Susp'd Ceiling _— Roof Misc: Final PASS PART FAIL -- ---- -- — PLUMBING Post& Beam — -- -- — — --— ------ Under Slab Top Out ----- —_ —.— ��— --- Water Service Sanitary Sewer --- Rain Drains Final ..- -- -- - ---- - -- PASS PART FAIL Post 9 Searn -- - ----- --_-- ---- -- — --- - Rough In Gas Line -- --- -- - --- ke Dampers I --— r---- -- PASS PART FAIL ILInfiCTRICAL ;ervtce Rough In -- 1 lr,/Slab ow Voltage ---.__—.------ — --- — -- — I ire Alarm --- --- — ---- -_— —--- f incl PASS PART FAIL.SITE Backfill/Grading -- ---- — — — -- Sanitary Sewer Storm[train [ ] Reinspection fee of$ _ _—_—required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ) Please call for reinspection RE: —__ — _ [ Unable t,,inspec(- no access ADA Z, nate OtnerJ Inspector Approach/Sidewalk Ins J4r------- p -— Ext — - Final PASS P�.RT FAIL— DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 MS i _ / BUP _ 7 16 Date Requested_ AM X PM BLD Location Suite - MEC Contact Person _ 1'/L �( Phi '�� ll( PLM _ Contractor Ph SWR. BUILDING Tenant/Owner ELC Retaining Wall _ ELR Footing - Foundation Access: S r FPS Fig Drain All-/' o e Crawl Drain Inspection Notes: SGN Slab SIT Post& Beam - IExt Sheath/Shear Int Sheath/Shear --- -- Framing _- --_ Insulation ---- Drywall Nailing I r ewall ---- --'- Fire Sprinkler Fire Alarm - -- ---"-- Susp'd Ceiling -- Roof - Misc: Final - - ------ - - PASS ART FAIL P BI Post& Beam Under Slab Top Out ----- - ---- -- -------- Water Service Sanitary Sewer ---- ----- - - _ _--_ -_ Rain Drains S PART FAIL MECHANICAL Post& Beam ------------- -_ --- _--_ -- -___ Rough In Gas Line - - --- --- ---- --- - --- - -- Smoke Dampers Final ----------- �- ----- --- —- PASS PART FAIL Cr ELECTRICAL -- - ------- --- - — Service Rough In --_-------- _---- --- UG/Slab Low Voltaae -- -- Fire Alarm Final -_ ------- -- - -- - - PASS PART FAIL SITE Backfill/Grading - --- --- - --- --- Sanitary Sewer Storm Drain ( J Reinspection fee of$ -- required before next inspection. Pay at City Hall, 1:1125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please call fm-reinspection RE:_- - --Y [ ]Unahle to inspect-no access ADA Approach/Sidewalk Date - �y - Other Inspector_ �. --_- Ext Final -PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUII .DING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- BuP Date Requested `r-�� Am PM BLD ��Zlv115 a Location 11 Suite MEC Contact Person r >; -- _ Ph S Z PLM Contractor_ _ Ph SWR _ BUILDING — Tenant/Owner ELC Retaining Wall ELR _ Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post& Beam - - Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing - -_ Firewall _ -�----- --•• ------ Fire Sprinkler Fire Alarm Susp'd Ceiling - - --_-- -� Rnof ---- Mise:_ __ -- ------- - - - Final PASS PART FAIL _- PLUMBING Post&Beam ------- Under Slab -rop Out ------- --- ------- ------ Water Service Sanitary Sewer -- - ----`--`---- -- -- -� Rain Drains _ Final - - - PASS PART FAIL - MECHANICAL Post& Bearn - - -- ---- -- _ _ Rough In Gas Line - -- ----- ----- Smoke Dampers Final - - --- ---- -- --- -- -. PASS PART FAIT_ UG/Slab -_ _- - -- I_ow Voltage FireAlarm _ .._PAS PART FAIL --- -- --- - -----` - Backfill/Grading ------ - - ---- - ---- Sanitary Sewer Storm Drain I J Reinspection fee of$- required before next inspection. Pay tit City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I ]Please call for reinspection RF. _-_--- ]Unable to inspect-no access ADA Approach/Sidewalk other _ -- Date _` f —_ Inspector_ , c, Ext —_— Final PASS PART - FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT M PLM2003-00305 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/26/03 SITE ADDRESS: 12220 SW JAMES ST PARCEL: 2S103CB-02000 SUBDIVISION: WILLAMETTE ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIYTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 30 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install 30 ft. water service. FEES Owner: Description Date Amount IVERSON, LARRY 12220 SW JAMES ST II'LUM111 Permit Ice 6/26/03 $72.50 TIGARD, OR 97223 [TAX I t{" Statc'kix 6;26/03 $5.80 Total $78.30 Phone : 503-521-0921 Contractor: WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 REQUIRED INSPECTIONS Phone : 607-1781 Water Line Insp Final Inspection Reg#: LI(' 23847 I'I.M 26-2081113 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work wi!I be dune in accordance with approved plans. This permit will expire if worK is not started within 180 days of issuance, or if work is suspende,a for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the 0 -pon By: J'L ILC, 1�f j� T 7(( _ Permittee Signature- Issued Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 1� Plumbing Permit Appticadon Datereceivod• - Permit no.: X,1)? -0-9� City Of Tigud Sewer permit no.: Building permit no.: City gfTigard Address: 13125 SW Hail Blvd,Tigard,OR 97223 ,hoot: (303) 639-4171 PreJerdeppl.no.: Expire date: rex: (503) 598.1966 1 Dote Issued; dy , Rocciptno.: Land use approval: Case filo no.: _ I Payment type. 1 &.2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family 0 Tenant;mprovement O Now construction 3 Additiodslteration/replacement U rood service Ll Other: 11111111111azill Am Job address: Dwerl e i o.: t . Fee ea. oral Bldg.no.: SuitNew 1--*'Q � Y dwellblio only: (Includlss 109 0.br each utlUly connection) Tax map/tax lot/account no.: SFR(1)bath. Wt: Block: Subdivision: S R 2)ba a Project name: f t _ (3)Rffi Cit /count , 1_ c a on at tc en Description and1 of vyork on premises: Site vtwtla:: -Catch haain/area drain Est.date of con letion/inB don: we sac trent n ng drain(no, Manufactured me utilities - i9uainoae name: I,n) LAC— (� i . �` — _ t.7— .- 1 an1101ea Address; 1% /yu) ain rain connectorZIP: snits sewer no, in.ft.) Phone:al�c- off rax: -� P-mall _% I r�"+ Storm sewer(no,lin. CCB no.: ,� � -- 1 P_ t�mb.bus.reg.no t alar ably ce no.hn.,. City/metro Hc.no.: � Fixture or Iteau Absu Jon valve Contractor's t!prea Uve Signature: ac ow preventer _ Print name: ` 0 N Date: _a Backwater valve B asins/lavatory avato ^6� othes w r Name: .:2�P�'//S�_ shwas ger Address; N n�n-bunt n 's City: State: fit' 1ctors/sum Phone: r )s'7 rax: I_a 3 -null: ans on __. sewer ca _ Name(print): Floor ra ns floor s nk�h al Mlilling address: Garbage Bs Hose ib C.ity� _ s Swto: ZIP tem ai w — -�- -- Phone: — ��Fa>t: E-mail: Interco or grease trap Owner installation/residential maintenarce only: The actual installadun me s) will be made by me or the maintenance and repair mace by my regular Roof drain(commerc ac employee on the property I own as per ORS Chapter 447. Sink(s), as n(s , av&_5 Owner's signature: Date: ,um Tuba/shower/shower an _ Name: star closet Address: ater heater City: — State: _ ZIP: ter: P one: Total N all iudulktloru accepteccept l prem Owl 0800 ion fm mon idbno saa. Notice:This permit applloaUon Minimum fee................ Visa OMss of et r'5 expires if s permit is notobWned Plan review(m %) $ acdtl cud 1 ` b _ State surcharge(8%) ....$ �� a within 180 days after it boa been 1, u11e cu or on card secepledd ss complete. TOTAL ....................... Y v r Hare orerm aJ0 4616 tR.:a/COMI CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4117MST --_ BUP Deceived ___ Date Requested _. 7 AM_ — PM___—_. BUP Location -- ______!._Z Z Z 0 _ �� -----Suite----- MEC — --- Contact Person .—_ _ Ph ) S a 1—0 9 PLM -3 — 00 .30-5 Contractor__. _ Ph( ) --�_ SWR — -- WILDING _ Tenant/Owner — —_ ELC Feting ELC Foundation Access: —^- -� - Ftg Drain ELR — Crawl Drain — - Slab Inspection Notes: SIT Post& Beam Shear Anchors ---- -- __ ----- - - ---- Ext Sheath/Shear Int Sheath/Shear — Framing Insulation — - — Drywall Nailing --- —_ —_ — -_----- Firewall Fire Sprinkler ----- --- _ _- __- Fire Alarm Susp'd Ceiling ---- - --- - _ _—�_ Roof Other. -- - _ Final _PASS PART_ FAIL �-- ---_—� -- ------ PLUMBING --------- -- -------- — --- -- — Post&Beam Under Slab - Rough-In Sarn'iary 5uwer (lain Drains --- --- ---- ------_ _ -__ _ Catch Basin/Manhole Storm Drain -- - -- --- -- --- ---- Shower Pan Other: - Fi WHAA_PART FAILNICA_L_ Post&Beam Rough-In ras Line Smoke Dampers _ - - -- ---- - --- - --------- Final PASS PART FAIL. --- - --- ------ - --- -------- - - ELECTRICAL Service --- -------------._..._-- --------..�------------w_____ Rough-In UG/Slab - ----- - --- --------- Low Voltage Fire Alarm Final Reinspection fee of$___ _ required before next inspection. Pay at City Hall, 13125 SW Nall Blvd. PASS PART FAIL SITE [] Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date -?/ // I _ Inspector ) Ext Other: Final DO NOT REMOVE this Inspectlo-i record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)6'39-4•',. 1 MST BLIP Received . _Date Requested AM PM— BUP —_— LocationSuite _—._ MEC Contact Person Ph( ) )) PLM Contractor ..__._ _—_, — Ph( ) o� 3 S- 7 SWR - BUILDING ----_ Tenant/Owner .. _ .__ - ELC Footing ELC Foundation Access: ,• ✓„ ELR Ftg Drain i' - Crawl Drain Slab Inspec tes: SIT Post&Beam --------- ----- - _��- -- Shear Anchors ✓ Ext Sheath/Shear - --- Int Sheath/Shear Framing - - --- -- - - -- --- -- Insulation Drywall Nailing ---- - - ---- -"-- Firewall Fire Sprinkler ------ -------------- �� - --- Fire Alarm Susp'd Ceiling -- Roof Other: ----- -__ Final PASS PART FAIL - PLUMBING ____ ---- - -- ---- -- -- Post&Beam _ Under Slab - -- - --- /' — Rough-In ,yjLTqt_&rvice Sanitary Sewer _ Rain Drains Catch Basin/Manhole Storm Drain - - - ShowerPan Other: -- AR FAIL Post&Beam Rough-In ---- -- - -- - - - -__- Gas Line Smoke Dampers -- - - -- - ----- ---- ------- --....--- Fcial PASS PART FAIL - -- - ---- - -- - -- Service Rough-In UG/Slab ---- Low Voltage -- ------- ---- -- ---- Fire Alarm Final Reinspection fee of$- _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS_ PART FAIL SITE [1 Pleaso call for reinspection RE: ---_ Unable to inspect-no access Fire Supply ADA Date � ._ Inspector__GLL^' -- - -- Approach/Sidewalk -J - --- - - Other: Final DO NOT REMOVE this Inspection record from the)oh site. PASS PART FAIL