10013 SW 70TH PLACE I
10013 SW 70'x' Place
CITY
oF TIGAR® MASTER PERMIT
PERMIT#: MST 2002-00312
DEVELOPMENT SERVIC S DATE ISSUED: 7/29/02
13125 SW Hall Blvd.,Tigard, OR 97223;6(503) 639-4171
SITE ADDRESS: 10013 SW 70TFI PI- PARCEL: 1S136AA-08300
SUBDIVISION: VENTURA ESTATES ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: TIG
REMARKS: New SF detached, Path 1
BUILDING
REISSUE. STORIES: 2 FLOOR AREAS _ RE(-U1RED SETBACKS REOUI"'_--D
CLASS OF WORK: NEW IIEIGHT: 24 FIRST: 1.641 sl BASEMENT: 28300 at LEFT, 16 SMOKE DETECTORS: Y
TYPE OF USE: SF I LOOR LOAD: 40 SECOND: 1 027 at GARAGE: 564 sf FRON''. 20 PARKING SPACES:
TYPE OF CONST: SN DWELLING UNITS: 1 FINBSMENT: at RIGHT: +
VALUE: $285,4760n
OCCUPANCY GRP: R3 BDRM. 3 BATH: 3 TOTAL: 2,060.00 at REAR, 11
PLUMBING
SINKS: 7 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1
rn5 FURN>••BOOK: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: OAS OUTLETS: I
_ ELECTRICAL
_ RFSIDENTIAL.UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD't.INSPECTIONS
1:11,15F OR LESS: 1 0 - 200 amp: 0 700 amp: WISVC OR FOR: 1 PUMPARRIGATION: PER INSPECTION:
EA ADC, 500SF 791 400 amp: 201 400 amp: tet W/O SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 800 amp: EA ADDL OR CIR: SIGNALIPANEL: IN PLANT:
MANU HM/SVC/FDR, 601 • 1000 amp: 6014amp9•1000v: MINOR LABEL:
1000.amplvoll
PLAN REVIEW SECTION _
Reconnect only:
>•1 RES UNITS: SVCIFbR>•225 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
_ ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDI')A STEREO: VACUUM SYSTEM: AUDIO A STEREO FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTW BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK- INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATARELE COMM: NURSE CALLS: ruTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,793.8,
INGATE COt2PORP",uN This permit is subject to the regulatlo%contained in the
WATE GOF'GKATION WING
ATE
S POPE LANE WING16840 S POPE LANE Tigard Municipal Code,State of OR. Specialty Codes and
OREGON CITY, OR 97045 OREGON CITY, OR 97045 all other applicable laws. All work will be done
accordance with approved plans. This permit will expire B
work is not started within 180 days of Issuance,or if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone. Oregon law requires you to followrules adorted by the
Oregon Utility Notification Cc iter. Those rubs are set
Reg N: LIC 34660 forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Froslon Control Insp 8, Wtr Proofing Bsm't Wa Fooling/Fou idation Dr; Electrical Rough In Gas Line Insp Appr/Sdwik Insp
Grading Inspection Post/Beam Structural PLMNnderflt it Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Footing Insp Underfloor Insulation Plumb Top Out Exterior Sheathlnn Insl Rain drain Insp Plumb Final
Foundation Insp _ Crawl Drain/Packwater Electrical Service Low Voltage Water Line Insp Final Inspection
Issued By : ` _,- Permittee Signature
Call (503) 639-4175 by 7:00 p m. for an inspection needed the nviftusirles*day
CITE( OF TIGARD SEWER CONNECTION PERMIT _
DEVELOPMENT SERVICES PERMIT#: SWR2002-00217
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/29/02
SITE ADDRESS; 10013 3W 70TH PL PARCEL: 1S136AA-08300
SUBDIVISION: VENTURA ESTATES ZONING: R-4.5
-- BLOCK:---- LOT: 005 — _ JURISDICTION: TIG _
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: Ll PSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF.
Owner:
---- --- ------� _._
WINGATE CORPORAI ION =_'--
7-D CuT
t oA-dc�a l
Bu ldiag Perin#Applies bion "MEMO
Date received: `)" i,'
City of � Permit no.1
Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Pkojecd
City of Tigardappl.no.: Ex " ate:
I'hon" (503) 6394171 Cate issues,: Rye,, _1 Receipt no.:
Fax: 503 -
Fax: (503) 5981960 JUN "? � f Case file no.; Payment type:
&2 familv:Simple Complex: �•
Land use approval:
0 1 &2 family dwelling or accessory 0 Commercial/industrial U Multi-family )9(New construction U 1 emolition
U Addition/altenaion/replaccment U Tenant improvement U Fire sprink!er/alarm U Other.
Job address: Bldg.no.: Suite no.: �-
Lot: I Block:— Subdivision: %qeA4 T-oQ lot/account no.:
Project name: _---
Description and location of work on premiscs/special conditions:, r_AE�
Name: ►t4( , S
Mailing address: I Q v — 1 &2 futily dwelling:
city: _ N Lt StateQ)� ZIP_q_aL9t .0 Valuation of work........................................ $ �$ y 7(
Phone: 1>5-t-IS00 Fax: E-mail: No.of bedrooms/baths.................................
Owncr's representative: Go _ bE_S t Total i rmber of floors.................................
Phone: 3 , Fax Email: New dwelling area ft �
Garage/carport area(sq.ft.).........................
Name: Covered porch area(sq.ft.) ......................... _
— -- Deck
Mailing address: area(sq.ft.)...............;..........�............
City: _ state: ZIP' — Other structure area(sq.ft.) �°n'..f!4....... Z _.
Phone: fax: CmercW/lndurU Wlmulti tamlly:
Valuation of work..... ....... . $
Business name: Existing bldg.area(sq.ft.) ..... ......... ........ _
•—--
Address: New bldg.area(sq.ft.)
_ _
City: talc- LIP: Number of stories................ ............... .`
. .. �_
Ptwne: Fax: Email: Type of construction..... .......................
�B Occupancy group(s): Existing:
New:
City/metro lie.no.: Nodee:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be requited to be licensed in the
Address: --��— jurisdiction where wort is being performed.If the applicant is
City: State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.: -
Phone: Pax: E-tttail: _--"
Name: Contactperson; Fees due upon application ........................... $
Address: !� Date receivers: _
City: _ State: _ ZIP: Amount received ......................................... $_
Phone: V _ Fax: E-mail: _ — _ Please refer to fee schedule.
hereby certify I have read and examined this application and the Na all ludo kdms accept end(MM.Pitsm can 111FIN10ion ra roam idurmatkat.
attached checklist.All provisions of laws aril ordinances governing;Utis Q visa U MasieK:ard
wort will be complied with,whet r specified herein or not, rpt cam oar; -- - n,
pim
Authori7A sigrtatum:t= - -Data: Nww urcanreoidst 0 at a«,_ aeait ZWJ --
$
Print name: is
— — cadtnra.t apwtae _
Notice:This permit application expires if pennit is not obtained within 180 days after it his been amepted as complete.
i1 Electrical Permit Application
v Dale received: Permit no.: - a a+?
i_igi City of Tigard Project/appl.no.: 1 Expire date:
City,,;Tigard Addiess: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Receipt no.:
Phone: (503)639-4171 a !) r ! I 1 (ase file no.: Payment type:
Land use approval: CL
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant impt.vement
)(New construction U Addi(ioNedtuauon;rrl;l,nu mrnt U Other: _ U Partial
JOB 4tUE IN FORMuriON
Job address: .� 'Y t__Sa - Bldg.no.: Suite no.: Tax map/tax tot/account no.:
Lot: iilt]C Subdivision: — S
Project nam,.;: Description and location of work on premises:
Estimated date of corn letion/inspection:
t
Fee Max
Job no:
-- (kscriptiun Qty. (ca.) 'total no.insp
Business name: 1 t:.. NewresideaBrnl-sltgleortnuui-family per
Address: 10fboo�- s� t _ dweWnBrnN.InchWesattached garaff.
City: r•1n St:.te:p ZIP: cj-4tzL. a�etttcluded
I3W sq.ft.or less _ _ 4
Phone:'I-'QL Each additional 500!3.ft.or partlon thereof
CCB no.: Lt3q 3S _ I Elec.bus.lic.no: 2AP Limited energy,residential __- 2
City/metro hc.no.: Limitedenergy,non-residential 2
Finch manufactured home or modular dwelling
Signature of supery i g electrician(required) 1— Service and/or feeder 2
I.iccntieno. Se{7lcHorfeeder%—Installation,
Sup.eled.name(print) i)gNC �C .(tet✓►' � �l'j`�'uc� dtentlonorrelocation:
200 amps or less 2
201 amps to 400 amps _ 2
Name(print): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 ams 2
City: State: ZIP: Over IOW amps or volts____ 2
I'lione: Fax: E-mail: Reconnectonly _ _ I
Temporary aervkss tx feeders;installation:The installation is being made on property I own Temporainstallatiry services
eedersorreiocation:
wt»ch is not intended for sale,lease,rent,or exchange according to 2W amps or less _ 2
ORS 447,455,479,670,701. 201 amps to ago amps 2
(),,knees signature - Dale: 401 to 600 ams 2
Bmnch circuits-new,Alteration,
or extension per panel:
Narne: _ A. Fee for branch circuits with purchase of
Address service or feeder fee,each branch circuit
B.
City: Stale: ZIP: Fee for brunch circuits without pure sae
� — of service or feeder fee,first branch circuit: 2
Phone: Lesch additional branch circuitam —
Misc•(Service or feeder not Included):
Each um or irrigation circle 2
O Service over 225 ampmnr
s-cotcrual U Health-care fnciln) h sign orou�"oe lighti� _2
0 Savior over 320 amps-rating of 1A2 U Harardouslt, ..ion Si nalcircull(s)o,alimi�edenergypanel,
familydwellings LlBuildingov 10,(1(x)square feel four or 8
O System over 600 volts nominal more residential units in one structure alteration,or extension*
O Building over three stories U Faders,4W amps or nmre *Description: —---
U Occupant load over 99 pemns; U Manufactured structures or Rv park Each additional inspection over the allowable In any of the above:
U EgressAigh6ngplan U ah'T -- — Per inspection
r—TTL
set=,,_arta or plans with any ortbe above. Investigation fee —
11te above are not applicable to temporary construction service. Other
Permit fee.......... ..........$
___---
rta all)urirdicuaro accept credit card,prear.call jurisdiction for m+xe informuion. Notice:This permit application Plan review(8l ,�96) $
_
o visa 0 MasterCard expires if a permit is not obtained
_^ —_—_—_ --. within 190 days atter it has been State surcharge(8%)....$
rred�n cad number: —.-_-
.pines_ accepted m complete. TOTAL .......................S
Nems cardholder—ar own an credl -ad
_ f
Crdhulder at are Amewn� 440-4615(N(xX'OM)
MechaWcai Pcrnit Application
Date received: If Permit no.:W-ogre c:-e-D
City of Tigard Pro,ect/appl.no.: Exatte date:
Cit ct 7'i urd Address: 1'3125 SW Hall Blvd,Tigard,OR 97223
> f 8 Date issued: Byl Receipt na:
Phone: (503) 639-4171 --
Fax: (503) 598-19(4) Case file no.: Payment type:
Land use approl,al: Building permit no.:
U I &2 family dwelling or accessory U Commercial/industrial LI Multi-family U Tenant improvement
4'New construction LI Addition/alteration/i-eplacernent U Other:
Jobaddress: {b P Indicate equipment quantifies in boxes below. Indicate thr do;❑s:
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,over lead,
Tax ma tax lot/account no.: profit. Value$ _
Lot: IIloek: Subdivision: 1ti ES See v:iecklist for important application, information and
Project name: jtsiisdiction's fee schedule for residential :permit fee.
City/county--M pcT I Zip: 4Z 3
Description and locatiod of work on promises:1.1 _
_ Fee(ea.) Tectal
Est.date of completioidinspection: ----- Description Qty. Res.only Res.only
Tenant improvement or r.hange of use: "
Air handling unit ---CFM—.
Is existing space heated or conditioned?U Yes U No At ondmuonin(sacplan requ ed)
Is existing space insulated?O Yes U No Alteration of exisun KEstem _
of er compressors
Business name: State boiler permit no.:
HP Tons BTU/H
Address:
Ei(> O S fe.�Et— IJ _ u smo a dampers/duct smoa detectors _
City: C_&.Ae_*_4- MA5 I State:_ ZIP: Ileat pump(sitepplan required)
Phone:(5e, pFax: E-mail: Instal Vreplace lurnacelburnir
CCB no.: — — Includingductwork/vent liner O Yes O No —_
_M-1 Instal Vreplacelrelocate heaters-suspen ,
City/metro(ic.no.: wall,or floor mounted
Name(please print): Ffii M_(' 1 ct4 V enc fora:p I iancc o er th—an—Vu—mace
ff Refrigeration:
Absorption units BTU/H _
Na[ Chillers HP _
— -- --
Compressors lip
Address:
Eaviromentsd exhaust and ventilation:
City: ^^_~ _— Slate.: ZIP: Appliance vent — —
Phone: —lI tx: 1•, mail ryer� exh gust _
oUs,Type t/lUres. tc c mmat
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mailing address: taus[system a an from heating or A
City: -- State; Z!p: plisift sad distribution up to 4 outlets)
_. l
pe: Ll'G —,_ NO Oil _
Phone: Fax: E-mail: d iia each additional over 4 outlets
ea pliNi7sMernatic required)
Name: Number of outlets
—_ Other listed appliance or equipment:
Address: Decorative fireplace
City: _ State: Zlp: inscn-type
Phone Faxw ail; stov-7e x etat�ave
cr!
Applicant's signature: -` _�, air.: (� Z. Cother.
Name(print): ��
Not W Ica WcOws a ce(r credit cards,plew call}uridictim for more Wmmoian. permit fee ................$
U Visa U MasterCard expires
This permit application Minimum feeee ...............$
expires if a permit is not obtained plan review at _ %
Credit cad somber --_-- __�1___ within 180 days after it has been ( $ —`
F.apirrs State surcharge(8%)....$
Nau�of�w ,,p a,cmhl card accepted as complete. TOTAL .......................S
—. CmdhoMta siptrrre Amawu 4404617(60O010^4
Plumbing Permit Application
Datereceived: Perrtut ao.:
City of Tigard Sewer permit no.: Building permit no.:
Address: "3125 SW Hall Blvd,Tigard,OR 97223
City ojTigard Phone: (503) 639-4171 Project/apps no.: kzpu-edate:
Fax: (503) 598-1960 Date issued: Bye
Land use approval: __— Case file no.: Paymen!type:
U 1 &2 family dwelling or accessory U Commercial/iudusuW U Multi-family U Tenant improvement
14New constrw.tion U Addition/altetation/n:pl:rcernent U Food service U Other:
�t
Description 7,ea. Total
Job address: '?t: :► ,;z yj - r. l_- ---- -
Bldg.no.: _ � Suite no.: -- New 1-tt'nd 2-liatlly drvcllirtp only:
Tax ma tart IoUarcount no.: (includes 1001t.f�)r catch utility connection)
a SER(I)bath
Lot: Block: Subdivision: e4LJ T FR(2')hath _----- -- _
Pm;ect name SFR(3)bath
City/county: g rui h additional bath/kitchen --
Description and lavation okor'k on premises:_.5�� r-� iteutilltier:
Catch basin/area drain
Est date of completion/inspection: --- - Drywells/leach line/trench drain
Footing drain(no. lin.ft.) —
Manitfactured home utilities
Business name: :r —�1Manholes -- -
Address: ( ' f4`I _ Rrin drain connector _ -
City; Stae.- a ZIP: q g616 Sanitary sewer(no.lin.ft.)
I'ttone: -E, C Fax; �E-mail: Storm sewer(no.lin.ft.) —
CCB no.: 5 2.(o _- Plumb.bus.reg.no:3"}35'�p� Water service(no. lin.ft.)
City/metro lic.no.: Fixture or Item:
Contractor's representative signature: Absojr rtion valve
Back flow reventer
Pont name: t Date: ICIL, Backwater valve
Basins/lavatory_
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s)City: Suite:Suite: _ ZIP: E'ectors/stun
Phone: Fax: E-mail: Ex tors/sum
tank
Fixturc/sewer cap —
Name(print): Floor drains/floor sinks/hub _
Mailing address:-- -- Garbage disposal
Hose bibb _
City: — State: ZIP: --- Ice maker
Phone: ---^ Fax: E:mril: —� Interco tor/ rease trap _
Owner installation/residential maintenance only: The actual institllatjon Primer(s)
wit!be made,by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the Ixoperty I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _
Owner's signature::_ _ Date: _ SumE_—�-
Tubs/shower/shower pan
Urinal
Name: --- -- --_—•— Water closet _
Address: _ Water heater
City: $talc: ZIP: OtneC �—
Phone: Fax: _ �E nutil: Total
------ -- Minimum fee................$
Na d1 Jurkawi4"&xxV aed t cant',plem call W@&',un for n"r wor"w'a'. Notice:ibis permit application —�
U Vias U Mrtercard expires if a mrni�is not obtained Plan review(at — %) $
Credl'can!sarrrber �____— _,L_1— within !80 day:.after it has been Stale surcharge(8%) ....S ____—
�'plm
:—_—_r _�_—.-- accepted as complete. TOTAL .......................$
Name d un1M'lrlrr r rJrowr m aadi'— cry— _..
_ S _
�Cwdhalder sipwiWe Amara 4104616(& MCOM)
N
70.95' ,.JN r
x
S
SCALE: 1" - 20° ��sJG ea
s'
> F6-
Z-Gs '
-
Z-Gs
' lY
Ii
i
BJ I
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Ste,
M
S.W. 70TH PLACE
WINGATE CORPORATION
15840 S. rl`bPE IANE
OREGON CITY OREGON 97045
500-657-3300
" COMPASS ENGINEERING LOT 5, 'VENTURA ESTATES"
-_-�-------- --�--�-���=
ENGINEERING SURVEVNG PLANNING CITY OFIAN;'1Y= 7k�NiD
a eese,,8,E LAKE ROAD G A6 COUNTY, OREGON
g MILWAUKIE,OREGON 9tM -----
ELECTRICAL
CITY OF TIGARD RESTRICTEDE ERG
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00060
13125 SW Hall Blvd., Ticiar(', OR 97223 (503) 639-4171 DATE ISSUED: 2/24!03
PARCEL: 1 S 136AA-08300
SITE ADDRESS: 10013 SW 70TI-I PL
SUBDIVISION: VENTURA ESTATES ZONING: R-4.5
BLOCK: LOT: 05 JURISDiCTION: TIC,
Proiect Description:l r�( 1y}1•, 1(ul� �`�(� " t�
A. RESIDENTIAL B COMMEERCIAL__ __—
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BLP GLAR ALARM: X BOILER: LANDSCAPEIIRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA!TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC. PROTECTIVE SIGNAL.
INSTRUMENTATION- OTHER:
L— TOTAL#OF SY1 EMS: —_-
Owner: Contractor:
WINGATE CORPORATION QUADRANT SYSTEMS
15840 S POPE LANE PO BOX 14833
OREGON CITY, OR 97045 PORTLAND,OR 97293
Phone: 503-657-3300 Phone: 234-5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES _ ELE 146g1i"Onspections
Description Date Amount Low Voltage Inspection
LLPRMT] ELR Permit ` 2/24/03 $75.00 Elect'/ Final
[TAY.] 8%State Tax 2/24/03 $6.00
Total $81.00
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 will be done in ar.cordance 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 by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699.
,�^-- 7 '
Issued by .
—�.r�L 12 1d
� Permittee Signature
OWNER INSTALLATION ONLY
1 he installation is being made on property I owr. which is not Intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ _ _ DA1 E:----
CONTRACTOR
: __CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N — �' ) l <t $LAaj ('-ZL 1, DATE:______________
LICENSE NO. ___ -- ---------- -- -- ----
Call 639-4,175 by 7:00 P.M. for an inspection needed the next business day
tl 2:00PF A FROM QUADRANT SYSTEMS S03 236 2322 P. 2
I
i
Fiectrical]Permit Application
` - „---" Datercccivcc'���{-��-�, Pemtit no.• .-Q Q
Lil
City of Tigardy of 'Tigard ProJect/appl.nov'_ Expiredate: _ j
Add+uss: 13125 SW Hall Blvd,Tigard.OP�2 1 Uateissued: B ,y Receiptno.: 1
,��11case
- '
Photic.: (503) 639-4171
Fax: (503) 598-1960 r ` Casr.filr.no.: — PAytneettype:
r
Land use approval:
1
1 &2 family dwr?Lng or accessory 0 commercial/industrial 0 Multt family I�T'enant improvement r
1l New ronruticcion U Addition/altstation/rcplacement IJ Other -- Gi Partial
ItINFORMATION
Job address:icX11 S tit 1b'K I�e�- ] of-� I Bldg,no.: Suite no.: -Tax reap/tax IuUaccount no..
�I1 SA_= 1-_ I
Wit: Block: _ Subdivision�T —�--�
Pmju:t nam_c: _ - Description and location of work on premia— eg�e�Yat ,1111.`kl-
Estimated date of co,npietion/inspection:
Fpr Max
Job no: — Description Qty. (ea.) Total no, ns
Business name. -A or multi-family per 1
New raldeofial-sitrgk !
Address: b,. 1 �� d.rtiftunit.includes at CWPrage.
�� State: 'J� �P��•Z`l� 5ctvitxinetnded:
a'
' &mail: t W0 ay rt..r less _ _
Phone: a3 F oW- —' -- - - -
P_srh arklitiorutl S00 aq.f1.or portion thereof
CCB no.: �l� Bloc.bus.lie.no: umltoderut�y,restdcndal- T---
City/metro tic, �. .1e2' .(fir Limitedcnergy,non-residential 2
Flch manufactured hone or(nodular dwelling 3
---- Date C;crvioe and/or feeder 2
Signature of au isle etextriolan(requireA -� -
Seryl cesorfccdcrs-fastallation,
sup.elect nam(print): (#{ 1 t r''oerue tw: " altersNou or relocation:
Lultif lull 200 amps or less _ 2
201 amps to 400 amps __ l
Name(print : --- --___ 401 amps to 600 amps ?1
Mailing address: 601 amps w IOW amps IF
City: over 1000 am or volts ---- —
fNionc:
l<maii: _Recemectonly __ �� I
Temporary servirea or frrdcrs
Owner installation:•ihc installation is being made on property I own �
Installation,alteration,ere relocatfun:
which is not intended for sale,lease,rent,or exchange according to 200 amps or less
ORS 447,455,479,670,701. 201 amps to aw stops � ?
Date: 401 to 600 ams 2 —j
Owner's signature: —
Branch rlrcaits-tie»,alteration, I
or extension per panel: r
Name: _
A. Fes for branch circuits with purchase of r
services or fa+dtr fee,each branch circuit
Cit _ ---- State: ZIP a. wee for brunch circuits without purchue —
nf service or feeder fee,Arst brvteh aeeuit: 2
Phone: lax: t,sdditionatbranchclrcuit:
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family dwellings U Rullding over 10,000 square feet four or Signal citeuit(g)or a limned energy pend,
O System over 600 volts nominal mom residential units in one structure alteration,of Mansion' _ )__'A
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O Feeders,400 amps or more •ryescA on: -
O Occupant load over 99 persons O Manufactured alruetums or RV park Ewch additional uLgPec lon"try t allowable le rosy of the-a-biovvee:
Q EirosAigMdngplan r-I('thar. ._.. Per indpmulan
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Permit foe.....................$ _
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U Vara Cl Maswcard expires if a pernlit is not obtained
within 160 days after it has been State surcharge(896)•...$ -_
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CITY OF TIGARD 24-Hour
BUILDING inspection Line: (503) 639-4175 -7
INSPECTION (DIVISION Business Line: (503)639-4 71
11) ,� --cl- ua BLIP -- ---- -—
Received _ _ _DaiA Requested— — AMPM_ +�'�_ BUP
Location ^� _ `
1 -- l --- �� Suite— — MEC --- ----- _
Contact Person _-- -- - — Ph(s� ) '7T3 - YO ?,5 PLM
Contractor_-- Ph (-;570i) /a S 7-3-3&Z) SWR ----.---------_--
B LDIN TenanUOwner _----- -- - ____-- ----—_ -- _ ELC --
---- -
Footing l
Foundation ELC _._....
Ftg Drain
Access: ELR
Crawl Drain -
------ --- -
Slab Inspection Notes: SIT - - - _
Post&Beam G�'� c= ..�ii� /¢P1
Shear Anchors -- - -- -- ----
Ext Sheath/Shear
Int Sheath/Shear
Framing ----_-
Insulation
Drywall Nailing -- ---- _
Firewall
Fire Sprinkler -- - - -----._.. --- - -- -- ----- --_
Fire Alarm
Susp'd Ceiling -- -- - - -- - - - -- -- -_
9oof
- r: -
nal -4e- ----
- - - - -
RT FAIL ---
NG
PL -- - -
Post _ -
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
anal
-P FAILPASS - - --- ------
_J NICAL - - ---- - --- -- - ---- _
os
Rough-In
Gas Line
Smo a Da2,�npers ----- — _. _ - --- - - -
in SIG?
ASS ' DART FAIL
RICAL
Service -- -._
Rough-In
UO/Slab
Low Voltage
Fire Aia m
Final Reinspection fee of$___ ._ __
PASS PART FAIL - required before next inspection. Pay at City Hall, 13125 SW Hell Blvd.
SME_—_ -_- U Please call for reinspection RE — _-- Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Z 10 Inspodor - _� Ext
Other:
Final - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF 71GARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
�----
BUP --- --
Received _-Date Requested._ - AM___-__ PM_. BUP
Location - _ -�� -7 0 1 -- PZ _--Suite MEC ___------
Contact Person -
Contractor - ___.-.. Ph (--) _-- -- -- SWR ---_-__-- -- -- -
BUILDING - Tenant/Owner __ _ _.— ELC
Foot!ri9
-- - - --- -
Foundation Access: ELC
FtgDrain —— ELR
Gr
Craw!Drain J
Slau Inspection Notes: SIT
Post&Beam ---__-_-- -__-----
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing -- - --
Insulation
Drywall Nailing --- - -- -
Firewall �y
Fire SprinklerFire Alarm
Alarm _
Susp'd Ceiling - I --
Root
Other: --
Final
ASS PART FAIL
PLUMBING_
Post&Beam _
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains -
Catch Basin/Manh,)le
Storm Drain
Shower Pan
Ther:
inal
PASS PART FAIL
MECHANICAL _
Post&Beam
Rough-In __ ......- --------
Gas
------Gas Line
Smoke Dampers -
Final
PASS PART FAIL —
ELECTRICAL _
Service - ---- ----- - ---
Rough-In
UG/Slab ----�- -------
Low VoltageO
Fire Alarm
aD ❑ Reinspection fee ^r$ required before next inspection. Pay at City Hall, 1,1125 SW Hall Blvd
_PART FAIL
F] Please call for reinspection RE,____ --_- Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date _03_ Inspector -�_ Ext
Other:_
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PARY FAIL