12408 SW DUCHILLY COURT-1 1 _W
12408 SW UUCHILLY COUk I"
/1
CITY O FTIGARD ELECTRICAL PERMIT
\ PERMIT M ELC1999-00630
DEVELOPMENT SERVICES DATE ISSUED: 10/22/1999
13125 SW Hall Blvd., Tigard, OR 97223 (5031639-4171 PARCEL: 2S110BB-01100
SITE ADDRESS: 12408 SW DUCHILLY UT
SUBDIVISION: AMES ORCHARD ZONING: R-1
BLOCK: LOT : W4 JUPISDICTION: TIG
Prosect Description: Install (1) 200 amps or less Service/Feeder.
_ RESIDENTIAL UNIT _ _ TEMP SRVC/FEEDERS _ _ ____ MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 arnp: SIGNAL/PANEL:
MANF HfAI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS AUU'L INSPECTIONS
0 200 amp: 1 W/SER.VICE OR FEEDER: PER INSPECTION:
201 400 amr): 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BP.NCH CIRC: IN PLANT:
601 - 1000 amp: _ PI__A_N REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: u > 600 VOLT NOMINAL.
Reconnect only; SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
REUDICKS, JEFFERY E i WILLAMETTE ELECTRIC INC
KATHY I_ PO BOX 230547
12408 SW DUCHILLY CT TIGARD, OR 97281
TIGARD, OR 97224
Phone: Phone: 624-3631
Reg#: LIC 000750 V R I G I n' nn L
SUP 19655 ' Y
ELE 34-283C
FEES Required_in_s_pections
Type By Date Amount Receipt
Elect'I Service
PRMT KJP 10/22/1999 $64.2.5 99-319286 Elect'I Final
SPCT KJP 10/22/1999 $5.14 99-319286
Total $69.39
Th's Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and all oiher applicx`.,re laws
All work will be done in acconiance with approved plans.. This permit will expire if 1vork is not started within 180 days of issuanoe,or�work is
suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by tt a Oregon Utility Notific,Gorl Center. Those
pules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these ru es or direct quest:ons to OUNC at(503)
246-1987.
� � /
F.-RMITTEE'S SIGNATURE �-�� �.�' ISSUED RY�r/
OWNER INSTALLATION ONLY
The Installation is being rT'.ide on property I own which is not intended for sal- , lease, or ren
OWNER'S SIGNATUR' ___ __—_—__ DATE:
CONTRACTOR INSTALLATION_ONLY
SIGNATURE OF SUPR. Et_EC'N: DATE:
LICENSE NO: ,J
Call 639-4175 by 7:00pm fog Fn inspection the next i-isiness day
i
CITY OF TIGARD Plan Check# _
13125 SW HALL BLVD. \1P',Electrical Permit Application Reed By
RECEI
TIGARD OR 97223 Date Recd
T 1999 . �\
Phone(503)639-4171, x304 (�(� C. Date to P EDate to DST_
Inspection (503)639-4175
( ) COMMUNIly lAVE.LUI'MLI'�I
503
Fax 598
Print of Type Permit# Ji_ly yy e c t 3�
-1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ I - --�- Number of Inspections per permit allowed
Name(or name of bu�}sines L c? ItICa•if S Service included: Items Cost Sum
Address ' 2S , l.. 1 �("A'iI h/I-/Y _�� � 4a Re`idential-per unit
CI /State/Zi / 1000 sq ft or less — $ 117.75 - 4
City/State/Zip p— ! e — -- Each additional 500 sq it or
portion thereof $ 2625 _ 1
Commercial ❑ Residential Limited Energy $ 6000 -
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72 75
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
Information for COT data base). Installation.alteration,or relocation
Electrical Contractor �!(�A>'11t' �/1�J fret-L&r, 200 amps or less $ 64.25 2
Address , 71L '2 q �, _ 201 amps to 400 amps $ 8550 2
Y
401 amps to 600 amps 128.50 2
cit _ i L•t L1�r State Zi $',_!__ � p l—s-�f 601 amps to 1000 amps E 192.50 2
Phone No._ _ �- - -=3 La 3/ _ Over 1000 amps or volts $ 363.75 2
Job No _S _ Reconnect only $ 53.50 2
Elec Cont. Lice. No.-7Ll- 3L Exp.Date /4' (JC 0 4c.Temporary Services or Feeders
OR State CCB Reg. No. "75 e) 1_Exp.Date Installation,alteration,or relocation
COT Business Tax or Metro No. xp.Date S' 200 200 amps or less $ 53.50 2
201 amps to 400 amps $ 8025 2
Signature of Su r. Elec'n 401 amps to 600 amps $ 10700 _ _� 2
g p Over 600 amps to 1000 volts,
License No. �� er `5Exp.Date see"b"above._���/ Ct/
Phone No (C 2 /!- .3 _-3/ 4d.Branch Circults
— New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's NameEach branch circuit $ 5.35 �^
Address _ b)The fee for branch circuits
- --- without purchase of service
City_ State Zip _ _ or feeder fee.
Phone NO First branch circus $ 3750
Each additional branch circuit $ 5 35
The installation is being made on property I own which is not 4e.Miscellaneous
intended for sale, lease or r(nt. (Service or reeler not included)
Each pump or irrigation circle $ 42.75
Owner's Signature. __- Each sign or outline lighting _ $ 42 75
Signal circuit(s)or a limited energy
(if required):* Mipanel,alteration or extension - S 6000
3. Plan Review section
1nor Labels i 10) $ 107.00
Please cheek appropriate item and enter fee in section 5B. 4f.Each additional Inspection over
_ 4 or r lore residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 5000
----. Per hour $ 5000
System over 600 volts nominal In Plant _ $ 5900
Classified area or structure containing special occupancy as T
described in N E C Chapter 5 5. Fees: /.
pa.Enter total of above fees $ lL' ?-
` Submit 2 sets of plans with applicrtion where any of the above apply. < (^ 'Surcharge 105 X total fees) $
Not reciui•ed for temporary construction services. Subtotal $
61b.Enter 25%of him 6a for
NOTICE Plan Revkw 4 iguired(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Accc,,nt# 3 7
AT ANY TIME AFTER WORK IS COMMENCED. 'rots/balance Duey a $
i'r1sWform.\electric doe
CITY OF TIGARD
1:3125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
TIGARD PLUMBING & HEATING
20205 SW CELEBRITY
ALOHA OR 97007
Plumbing Signature Ferre �
Permit # . . . . : MST98-050.1
Date issued. : 12/18/98
Parcel . . . . . . : 2S110BB-01100
Site Address : 12408 SW DUCHILLY CT
Subdivision . : AMES ORCHARD
Block. . . . . . . . Lot : 014
Zoni.ng. . . . . . . R-1
Remarks :
Interior alterations and enclosure of existing breezeway.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order
for the plumbing permit to be valid, please have the appropriate individual from your company sign
below and return this Plumbing Signature Form prior to the start of work.
No plumbing inspections will be authorized until thi, completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
PLTTMBING CONTR'AC:TOR:
r-'WHER ' TIGARD PLUMBING & HEATING
JEFF REDDICKS, KATHY 20205 SW CELEEITZITY
1.2408 SW DUCHILLY CT
TIGARD OR 97224 ALOHA OR 9700phone # :
Phone # : Reg # • • : 000374
Signature of A,.ithorized Plumber
Please return this completed form to the address above.
ATTN Building Dept.
If you have any questions, please call 639-4171 , ext. #310
CITY OF TIGARD MI- 5TF_R PERMIT
DEVELOPMENT SERVICESPERMIT #. . . . . . . : MST9fi-0 ;01.
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 ¢,,F�_ DfTF= ISSUED: 1. /1 El/'JH
y
f''pRCE'I_.; E'S 1 i.QrNI3-Qr 1 10iG
SITE ADDRESS. . :. 12409 SW DUC1-i T I_.L_Y CT �'� C',
'.rI.JBD I V I;I ON. . . . s AME S ORCHARD "q'!� ZON I N(.7: R- 1
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :014 0� JIJRIE3DICTION: TIGRemarks: Interior alterations and encicsure of existing breezeway.
-----------------•---------------------------------------------- BUILDING -------------------------—-----------------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...; 0 sf REOUTRCD SETBACKS---- REQUIRED-------------
CLASS OF WORK..-ALT HEIGHT.......,: 22 FIRST....: 0 sf GARAGE...... 0 sf LEFT..........: 0 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD..... 40 SECOND...: 0 sf FRONT.........: 0 PARING SPACES: 0
TYPE OF CONST.:SN DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT......... : 0
OCCUPANCY GRP.:R3 BDRM: 4 BATH: 3 TOTAL------: 0 sf VALUE..t: 67000 REAR..........: 0
--------------------------------------- PLUMBING ----------------------------------------------------------------
SINKS......... : 0 WATER CLOSETS.: 0 WASHING MACH.. 0 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES..... : 0 DISHWASHERS...: 0 FLOIR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WA'ER HEATERS.: 0 WATER LINE ft: 0 BCKFUW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
------- --------------------------•---------------------------- MECHANICAL -----------------------------------------------------------------
FUEL TYPES----.---- FURN ( ION ..: 0 BOIL/CMP ( 3HP: 0 VFNT FANS.....t 1 CLOTHES DRYERS: 0
GAS FURN )=ION ..: 0 UNIT HEATERS.. : 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.; 0 BTU FLOOR FURNACES: 0 VENTS.........: 3 WOODSTOVES....: 0 GAS OUTLETS...; 0
---------------------•--------------------- ---------------- ELECTRICAL ----•------------------------------------------------------------
--RESIDENTIAL UNIT--- ---SERVICF/FEFDFR--- --TFMP ERVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
I800 SF OR LESS: 0 0 - 200 amp..: 0 0 - 2200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
FA NDD'L 500SF.: 0 201 400 asp..: 0 201 - 400 amp..: Q 1st W;O SVC/FDR: 1 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.. 0 401 600 alp.. : 0 401 - 600 amp..: 0 EA ADDL BR CIR: 1 SIGt81L4*CL...: 0 IN PLANT......: 0
MANE HM/SVC/FDR: 0 601 1000 amp.: 0 601+amps-IMM v: 0 MINOR LABEL -10: 0
10004 amp/volt.: 0 --------- -----------------—-------- PLAN REVIEW SECTION -- -------------•-----------------
Reconnect only.: 0 )=4 RES UNITS..: SVU/FDRh225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
----------------------------------------------------- ELECTRICAL - RESIO1(fED ENERGY --------------------------------------------------
A. SF RES IDENT IB. COMMERCIAL----------------------- --------------------------------------------------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM,.: 01H: :: BOILER.........: NVAC...........; LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC.......... . DATA/TELE COMM.: NURSE CALLS ...: TOTAL R SYSTEMS: 0
Owner: - ---------- --- _--- --- ------Contractor: ----------------------------- TOTAL FEES:$ 693.80
JEFF REuDICKS, KATHY JACOBS CONSTRUCTION This permit is subject to the regulations contained in the
12408 SW DUCHILLY CT 16944 SW BEEF BEND RD Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97224 SHERWOOD OR 97140 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work :s
Phone A: Phone Il: 590-4769 not started within 180 days of issuance, or if the work is
Reg N..: 000838 Suspended for more than 180 days. ATTENTION: Oregon law
--------------------------------_.----------------------------- reo,n res you to fallow rules adopted by the Oregon Utilit,
Notification Center. Those rules are set forth in OAR 952-rA01-0010 through OAP 952-001-0080. You may obtain copieR of these rules or
direct questions to QUNC by calling (503)246-•1987.
------------------------------------------------------ RI:OL'IRFD INSPECTIONS ------ ------------------------------------------
Footing Insp Mechanical Insp Low Voltage Plumb Final _
Foundation Insp Plumb Top Out Insulation Insp Building Final
Post/Bea! Struct Electrical Servi Rain drain Insp _.
Post/Beam Mechan Electrical Rough Electrical Final
PLM/Underfloor Framing Ino" Mechanical Final
F'e r-m i t t e E S i n a t 1.t t-e
Tssi_tad By: _'� 9 —
i*.++++++.+ + +++ r ++ +.+4 4 + ++-++++ t + +++++•-+ 4 +++ ++++++++++-++++++-+++++,"+-++++f+++.+ + + 1
Call 6?.9-4175 iy 17:00 p. m. fctr, an inspection needed the next bl_tsiness day
CITY 01 TIGARD Residential Building Permit Application Plan Check 0 42-37K
13125 SW HALL BLVD. Alteration - Interior Remodel Only Recd By
Date Recd/«'
TIGARD, OR 97223 Single Family Detached or Attached (D;_tplex) Date to P.E.
V 503-639-4171 Date to DST Z-/
F 503-684-7297 (: Permit# IV-
Print or Type Called ,a
Incomplete or illegible applications will not be accepted LErr V61cf-
Name of Project Name
Job ( 91,11A E.
Address Site Address Architect Mailing Address
- - —
Name City/State Zip 4 Phone
- X19
� ---
Owner Mailing Address I
Name
' Du C/f i L Engineer Mailing Address
/State Zip hone
Neme City/State Lip Phone
General -
Contractor Describe work New O Addition O Alteration Repair O
Mailing Address to be done:
Prior to permit y4 �, Additional Description of Work:
issuance,a copy City/State / Zi Phone i/�*fR/Ok' NC TZ�9770�l 6A/e �s2,k'f t X- ,f3/�ff "F
of all licenses �_ nr�.r top" �Y710 s pe '/16
are required If Oregon Const.Cont.board Exp.Dale PROJECT
expired in COT Lic,# yy VALUATION ter°
database
Mechanical Name — NEW CONSTRUCTION ONLY: _
Sub- J/>('p - "' ' Q / %" Sq. Ft. House: _ tiq. Ft.Garage
Contractor Mailing Address — --
// `�` '!s.t /%!F"Et f IL Indicate the restricted energy installation by the electrical
Prior to permit
issuance,a copy City/State Zip Phone subcontractor in the followin areas _
of all licenses OregonCuns /;'y Y 7E% Restricted Audio/Stereo
are required if t"Cont Boa,d Exp.Date Energy System Alarms
expired in COT Lic# ,. Installations Vacuum Irrigation
database ji' S stem System
I Plumbing Name _ M (check all that Other:
Sub- 7;9T m ti'` �!uAIY) -
Contractor Marling Address Comer Lot YES NO Flag Lot YES NO
(check one) check one)
e)r- ``qJ Cel` ,i4# Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City/State Zip Phone
issuance,a copy 9 a vr) - 2 Solar Compliance
of all licenses are Jregon Const.Cort Board Exp.Date (C3lculation Attached)
required if Lic.# -
expired In COT 374q ?, - 3� CO I hearby acknowledge that I have read this application,that the
database Plumbing Lic.# Exp Date information given is correct,that I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
Oregun State laws.
Name Si ure of Owner/Agent Date
Electrical CJ; „
Ptr/-F C/#,ir�f or -- -
Sub- Melling Address C ntact Person N me Phone#
4a., ," a ee b s
Contractor .73,2:5-4
C•� 7 _ FOR FFIC_E USE ONLY:
City/State Zio Phone Plat#: MaprrL#: _
Prior to permit 3i `
issuance,a co r Setbacks (/ Zone: Solar:
of all licenses are Oregon Const.Cont Board Exp. Date /►�—/�
required it Lic.#
expired in COT '7_" O- y Engineering Approval: Planning Approval: TIF:
database Electrical Llc.# Exp Date
�'J(4IV1 / I SFREM?DOC(DSl)8/11/98
-1Z 11
IBIS'
46
ba�
tul
V-.q
Poi
,fl
as
1
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WILLAMETTE ELECTRIC INC
F'O BOX 230547
TIGARD OR 97281
Electrical Signature Form
Permit # . . . . : MST98-0501
Date Issued. : 12/18/98
Parcel . . . . . . : 2S110BB-01100
Site Address : 12408 SW DUCHILLY CT ^
Subdivision. . AMES ORCHARD
Block. . . . . . . . 1Lot . 014
Jurisdiction: TIG
Zoning. . . . . . . R-1.
Remarks :
Interior alterations and enclosure of existing breezeway.
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNFR : ELECTRICAL CONTRACTOR :
JEFF REDDICKS, KATHY WILLAMETTE ELECTRIC INC
12408 FW DUCHILLY CT PO BOX 230547
TIGARD OR 97224
TIGARD OR 97281
Pile ri,, If : 624-2408 Phone # : 624-2938 FAX
Reg V . : 000750 /�
X
Signature of S rvrsing Electrician
If you have any questions, please call 539-4171 , ext. X1310
\ CITY OF TIGARD
_, PLUMBING PERMIT
DEVELOPMENT SERVIuES PERMIT#: FLM1999-00292
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED:
PARCEL: 2S110BB-01100
SITE ADDRESS: 12408 SW DUCHILLY CT
SUBDIVISION: AMES ORCHARD ZONING: R-1
__BLOCK: LOT: 014 __ —_— __ __ JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING; MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS-
_ FIXTURES LAUNDRY TRA1 S: 1 SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 0 RAIN DRAIN: ft
Remarks: Plumbing alteration
FEES
Owner: -
- Type By Date Amount Receipt
JEFF RIDDICKS 5PCT BON 09120/199E $3.50 99-318415
12408 SW DUCHILLY CT PRMT BON 09/20/199E $50.00 99-318415
TIGARD, OR 97223 — -- -
Total $53.50
Phone 1:
Contractor:
TIGARD PLUMBING + HEATING
20205 SW CELEBRITY
AI.OHA, OR 97007 REQUIRED INSPECTIONS
Insp
Phone 1: 642-7917 Top-out
Misc. Inspection
Reg #: LIC 00037443 Final Inspection
PLM 34-116PB
EXPIRED
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth it OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of nese rules or direct questions to OUNG by calling (503) 246-1987.
Issued By: �, �k" (� Permittee Signature:
Call (503.1639-4175 by 7.00 P M. for an inspection needed the next business day
CITY OF TIGARD Plumbing Permit Application Plan Check.$
13125 SW HALL BLVD. Commercial and Residential Rec'j By
TIGARD, OR 97223 Date Recd
(503) 639-4171 Date to P,E.
Print or Type Date to DS
Incomplete or illegible applications will not be accepted Permit* I Win'11
Related SWR# _
Celled
Name o1 Devreloomen Project
FIXTURES (individual) QTY PRICE AMT
Job _ �-\ .OIpU1/.V Sink 11.50
Address Street AddressSuite Lavatory 11.50
141.-1406 Sw ROLA'Alr- Tub or Tub/Shower Comb. 11.50
Bldg# City/State Zip Shower Only 11.50
r v 02 I L?j
1 Name Water Closet/Urinat (Specify) 11.50
?e'A ld - R � Dishwasher -- 11 50
Owner Mailing Address Suite Garbage Disposal 11.50
rI �t % kh P Washing Machine/Laundry Ru/ (Specify) 11.50 ,7
City/State Zip Phone Floor Drain/Floor Sink 2 11.50
Name 3" 11.50
4" 11.50
Occupant Mailing Address Suite Water Heater O conversion 011ke kind 11.50
Gas piping requires a separate mechaNcal permit. _
City/State Zip Phone MFG Home New Water Service 28.00
Name,- p, �1 MFG Home New San/Storm Sewer 28.00
G R� J u7G ((� Hose Bibs 11.50
Contractor Malting Address Syne Rein Drains 11.50
Zrr za; S.,) (p(ASrr} )if• Drinking Fountain 11.50
Prior to permit City/StateZi Phone Other Fixtures(Specify) 15.00
Issuance,a copy ILVIA Olt 91Uo 47-111 7
of all licenses are Oregon Const.Cont.Board Llc.# E pate
requ,.ad if 371 1- I 00 _
expired In COT PI mbing Lic.# Exp.Ua,
database 4 1/(,
Name Sewer-1 st 100' 3800
Architect _ Sewer-each additional 100' 32.00
Or Mailing Address Suite Water Service-1st 100' 38.00
Engineer Clty/State Zip h�jr `u Water Service-each additicnal 200' 32.00
Storm 6 Rain Drain-1 st 100' 3800
Describe work to be done: Storm&Rain Drain•each additional 100' 32.00
New R Repair O Replace with like kind. Yes O No O Commercial Back Flow Prevention Device 32.00
Residential tQ Commercial O Residential Backflow Prevention Device* 19.00
Additional description of wotk.
Catch Basin 11.50
Insp.of Existing Plumbing 50.00
Are you capping,movin r replacing any fixtures? per/hr
Yes P.No O Specially Requested Inspections 5000
If yes,see back of form to indicate work performed byper/hr
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling 4500
WORK COULD RESULT IN INCREASED StWER FEES. Grease Traps 11.50
I hereby acknowledge that I have read Ihis application,that the Information QUANTITY TOTAL
given Is correct,that I am the owner or authorized agent of the owner,and Isometric or riser u ay a r s required If quantity Total is >9
that plans submitted are In compliance with Oregon State Laws. 'SUBTOTAL -
SignatCV of Owl r/Agent D
7%SURCHARGE 2
Conta t Person Name i Phone
j
'"PLAN REVIEW 25%OF SUBTOTAL
1 BATH HOUSE 5178.on -Required only it fixture ifty total is>a
2 BATH HOUSE$250.00 TOTAL -,
1 BATH HOUSE$285.00
(This foe Includes all plumbing fixtures in tho dwelling and the first
100 fact of sanitary newer storm sewer and Water service) 'Minimum permit lee 15$50+ 7%surcharge,except Residential Backflow Prevention
Device,which is$25+70A surcharge
"AII New Commerrlal Buildings require plans won isometric or riser diagram and
plan review
I wittsVormslplumapp doc 815/99
PLEASE COMPLETE:
Fixture Type — Quantity by Work Performed
R
Moved
New eplaced Removed/dapped
Sink ------ --- -- __. � --- ._.— -
-- ------------
Lavatory
Tub or Tub/Shower Combination _
--------- — –
Shower Only _ _ ----
Water Closet
Dishwasher
Garbage Disposal
Washing Machine --
Floor Drain/Floor Sink 2" —
411
Water Heater —
Laundry Room Tray _
Uri,;al
Other Fixtures (Specify) --
COMMENTS REGARDING ABOVE:
I%d®ts%fonoeiplttjmspp dor.8/999
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUR _
----
Date Requested_ �'z �q(qAM PM __—_— BLD _
II
Location Suite MEG
-- -
Contact Person �—
� Ph PLM -
F' . SWR ------- _
Contractor _ --- - — —
—----
- ELC _
BUILDING Tenant/Owner _ —_
Retaining Wall ELR
Footing Access. FPS —
Foundation
Ftg Drain -------
SON ---- --- - ---
r,rawl Drain Inspection Notes:
SIT
Slab -----_ --- -----__------------ __---_ - -
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing - —
Insulation L�
Drywall Nailing ----
Firewall -
Fire Sprinkler __--
Fire Alarm
Susp'd Ceiling - ---- —
Roof — -
Misc - - � ..--- - —
t-inal — -
PASS PART FAIL - - —
PL JMBING - — -
Post& Beam
Under Slab -
I up Out
Water Service -
Sanitary Sewer
Rain Drains "—
Final -- -
PASS PART f-All.
MECHANICAL.
Post&Beam - -- --- -
IRough In -- _—
Gas Line -
,smoke Dampers — ---------
i incl
PASS PART FAIL_ — - -
Service - - -- - — - .---
Rough In
UG/Slab ------ - - _.—
Low Voltage
Fire Alarm �-
AAS3 �PART FAIL. -_-_------ ----------
Bar..kfill/Grading _.--^-�-- ---- - - -- -----
Sanitary Sewer required before Wert inspection Pay at City Hall, 13125 SW Hall Blvd
Storm Drain I I Reinspection fee of$ 4
Catch Basin _—,___ [ I Unable to inspect-no access
I Line ( Please call for re nspection RE'.__-
Frye Supply
ADA i
Approach/Sidewalk Inspector
Ext
Other J- Date =mow 9 — p
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
O / ? ELECTRICAL PERMIT e I'G"–'."A'Wb
PERMIT#: ELC2003-00019
t DEVELOPMENT SERVICES DATE ISSUED: 1/2.1/03
= 13125 SW Ball Blvd., Tigard. OR 97223 (503) 639-1171 PARCEL: 2S110BB-01100
SITE ADDRESS: 12408 SW DUCHILLY CT
SUBDIVISION. AMES ORCHARD ZONING: R-1
BLOCK: LOT : 014 JURISDICTION: TIG
Project Desc iption: I
_ _RESIDEN7IAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS
100(1 SF OR LESS: 0—!`00 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 4ud amp: SIGN/OU r LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECI IONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION:
201 • 400 amp: list W/O SRVC OR FDR: ii PER HOUR:
401 - 600 amp: EA ADD'L BRNCN CIRC: i IN PLANT-
601 - 1000 arnp: _ _ _PLAN REVIEW SLCTiON
1000 ::mp/volt: >__4 RES UNITS: > 600 VOLT NOMINAL.
Reconnect only: __ _SVC/FDR—225 AMPS: — T CLASS AREA/SPEC OCC:
Owner: Contractor:
REDDICKS,JEFFERY E a MID VALLEY ELECTRIC INC,
KATHY L PO BOX 655
12408 SW DUCHILLY CT WILSONVILLE,OR 97070
TIGARD,OR 97224
Phone Phone: 503-682-2955
Reg #: E1,E 3-5420
--- -- -- — LIC 151602
FEES SUP 34835
Description Date Amount
_ Required Inspections
11:1.PRMI-] ELC I'ermtt 1;2I nt $7345
I AX]8%State rax 1121 03 $5,88 Rough-in
I AX]8%State Tax 2/5/03 $3211 Elect'I Final
(additional fees not listed here)
Total $122.64 —� --- _
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 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 by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-00 - rough OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or
1-800-332-23
ISSU By: L�,� Permit Signature: it _ ----_�
OWNER INSTALLATION ONLY
The Instal a ion is being made on property I own which is not intended for sale, lease, or rent
OWNER'S SIGNATURE: —_ DATE:
CONTRACTOR INSTALLATION ONLY
S!GNATURE OF SUPR. ELEC'N:
LICENSE NO: — ----- --- -- ---- -- -
Call 639-4175 by 7:00pm for an inspection the next business day
20 03 01 : 16P Mid Valley Llectrin Inc. b0:3-692•7904 P. 1
Electrical Permit Application
�i- Datcreceived: i s i e` PerrNt no.;QZ�Wjr JOCI
City of Tigard Plnject/appl.no.: Expire date:
City g7igard Address: 13125 SW Hall Blvd,Tigard,OR 9? Dateissued: By.1` eceiptri-
Phone: (503) 639-4171
Pax: (503)598.1960 �'� Case file no.: Psyment type:
land use approval:
;(I &2 family dwelling or accessory ❑Cornmercial/industrial U kfulli-famfly U Tenant improvetocrit
D New construction Addition/alterafion/replamirient U Other:-__ U Partial
Job address: 1 4445 1l" Cildg.no.. 1 Swte no.: Tax rn tax lot/account no,:
LLL• -- Black: Subdivision: —
Project na!! I Dcacription and location of work on premises;Estimate(;ditr of corn mion/ins er.uon: _
Job_no: y 4 _ FeeMax
Business nAme-�1 E1� r;� - D01 00 !. e•l Tout aa.the
_ ww tial-dnla or nu ftf4amlly per
Address: — dwelling imit.inrludnavac+wigcrAge.
City: � state: zCP. lSerrltxinckritd
C'hotle: �,5�c� Fax: _ E-mail: I(YV w h nr ices 4
Foch additional 50(1 s .fL ar ruon thereof
CCB t10.: NS1 I E1ec,tals.lie.no: ��L Umiledeuei ,residential 1
Citylrne lie,no.: Urnhadenergy,non-residential 2
tt3 Each manufactured home at modular dwelling
et tune of au isin elect required) Dare Service and/or feeder 2
5rrr or ee n-Instaliati
Sap elect name(print). `J r )-' A — t.lceinbemo: a -- S altenti000rrelocation:
�
200 amps ni less 2
Name(Print): V ¢ -F �z 201 am to 400 amps — 2
401 amps to 600 amps 2
Mallitl eddree ' 1:7,A-(a G01 am a w I(100 amp+ 2
aria —
City: - State: ZIP: y'l/feZr Over 1000 arrp or vont - — 2
Phone: /cLj YCE Pax: E email: Recormxronly I
Owner insWlation:The installation is being made on property I own Temporary services or feeders-
wh:ch is not intended for sale,lease,rent,or exchange according to hsb0atinn,alteration,orrelocation,
ORS 447,455,479,670,701. 200 sine s or less _ 2
?01 amps to 400 ams 2
aWner'a SI t1atUle: milts: - 4nlrnhtlflampx 2
Willi 1111"10.11araoch circuits-aew,alteration.
or eMrrrloo per panels
Name: _ ___. A Fro u branch circuits with purchase of
4ddrtsaa: service or feeder file,each Ie anch elrcult 2
Cit Stele: -- H. Fee for tmnch cimria withrrut purchase
- of service or feeder fee,f,.brunch tlrcuit: l L 1 , 7
Phone: Fnx� F•mail• _--
Each additional branch drcuit. b
IL D
Mbe.(&r rice u feeder not Incladdr
0 Service over 2?5 amps-amartereial O Health carefaeility Fech pump or irrigation cirtle 2
J Service ov"320 amp+-rating,of I k2 ❑Huirdnus lmslion Each etgn or outline li hn j
familydMellingt U Buitdurg u+a 10,(100 syuars het four cr Signal eircult(s)or a limited etrergy panel,
❑System over 600+olla rromunal mare tesidr:uial units in one stricture attention,or extension* 2
❑Building over threestoria U Fecxien.400am�sormile a Ute.
U Occupant load over 94 penwm U Manufactured stru -t or RV pork Each dUtlonal ineperi[on over the allowable in any of the above.
U Hgrestnightingplan U Odrer ---_-- Per inspection --'
.4tsbmlt__arts of plass with any of ibe above. Inveati anon fa
The above ate not appllcable in temporary construction service. Other --
Nes all udKankwf kce r+edit reds, leave tall rtsdtcdan for mat Informadon. Notice:This
Permit fee..................... 7 .?
t M P F permit application
U vlsw ❑MeuorWaid expires If a permit I.t not obtained Ilan review(at
rtMi!card number �-_ within 110 days after it has been State surcharge(11%)....S
'"' secepted as complete. TOTAL .......................S 72f, 3 3.-
----Nnme c4 c older at Aown on cndlr exd-- --
S
t:ad da Ngaaraa Asacol— UO 4at5 t000�OM1
S,
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-1175 MST
INSPECTION DIVISION Business Line: (503) 171
2 L�f BUP - ------ - --
Received Pate Requested 3 ��' L__– AM __PM _- BUP
Location a - J Suite _ MEC
"
Contact Person ! Ph PLM —
Contractor Ph( ) __ - __ SWR _
BUILDING Tenant/Owner ____ _ ELC
Footing 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
Root - -- -
Other:--_
Final _ --
_PASS PART FAIL —
PLUMBING
Under Slab —
Rough-In -_-_-
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole —
Storm Drain
Shower Pan --
Other. --�
Final
PASS PART_ FAIL /
MECHANICAL
Post&Beam
-
Rough-In
Gas Line
Smoke Dampers --- ----
Final
PASS PARI FAIL — -�
ELECTRIdk
Service
Rough-In -
UG/Slab
Low Voltage -
Fire Alarm
Fina % Reinspection fee of$_ --.required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AW PART FAIL
E e-- [:] Please call for reirspection RE:—_ — - [] Unable to inspect-no access
Fire Supply Line
ADA Date - ��Inspector ry� Ext---
Approach/Sidewalk
Other:_
sinal DO NOT REMOVE this inspection record from the job site.
qS PART FAIL
U
CITY OF TIGARD 24-Hour
BUILDING Inspectio•i Line: (503)639-4175
INSPECTION DIVISION Business Line: (603) 639-4171 MST
BUP
Received _--__-. __Date Requested /_! AM---- PM BUP
Location __r ��'ill Suie----___ __- MEC _�__----
----- --
Contact Person __ ph �� PLMel- _
Contractor _Z � T Ph(__� ) 7 �� � SWR
BUILDING Tenant/Owne --_ ELC
Footing ELC
Foundation Access:
Fig Drain ELF!
Crawl Drain -�-
Slab Inspection Notes: SIT
Pos Beam
Shear Anchors - - --
Ext Sheath/Shear
Int Sheath/Shear
Framing - —---------- ------ ------ --- ..—
Insulation
Drywall Nailing -- - Ll-l L- - . .
Firewall
Fire Sprinkler
Fire Alarm _�1. i��_
Susp'd Ceiling C•c a goo it. -
Roof
Other -- -
Final
PASS PART FAIL L --
PLUMBING_
Post&Beam -- -- _
Under Slab
Rough-In
Water Service _
Sanitary Sewer
Rain Drains - - --
Catch Basin/Manhole
Storm Drain - -- --- - -
Shower Pan
Other:
Final
PASS PART FAIL - -
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers --
Final
PASS PART FAIL - -- - --- --- --
ELECTRICAL
Service
MU -t —_--
UG/Slab
Lr,w Voltage
Fire Alarm
gCM PART FAILReinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_
--SITE- _ n Please ce' reinspection RE: _ __ _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date jInspector Fitt
Other:
Final
--
DO NOT REMOVE this Inspection record from the)oke site.
PASS PART FAIL
1
CITY OF TIGARD 24-Hour
BUILDING Inspection Lite: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BUP
Received _ __ __�ateR ested___. �-- AM—__ PM -_ _ BUP
Location � ,. Cr —Suite - MEC
Contact Person Ph(x& D ) 794,
— PLM
Contractor
- _ Ph( ) SWR ---- — --
_BUILDING TenanUOwner �__. I: r ELC
Footing \- l
Foundation Flnsspectii'ionNotes:
cessELC
Ftg DrainCrawl Drain ELRSlab �� _ �Q _ SIT
Post 8 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
- - - -
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final -_-
_PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Damners
Final
BASS Pt.AY_FAIL_ - -
ELECTRICAL
Service
Ou
UG/Slab - - .
Low Voltage
Fire Alarm i—
Final Reins
PASS PART FAIL pectron fee of$_ required before next inspection. Pa
SITE F] Please call for reinspection nE Unable to inspect-no acres+
Fire Supply Line
.ADA �
Approach/Sidewalk Dato� j1?•�.td -4� L Inspoctor Ext
V
Other:
Final _ — DO NOT REMOVE this Inspection record from the Joh site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST -- ------
INSPECTION ':,'VISION Business Line: (503) 639-4171
BU? --- --
Received .___ Date Requested Z Z-AM___ PM — -- BUP _--_
oo
Location __.- -� D n^ / - _Suite _ MEC _
Contact Person __ Ph(—) �L/_/ PLM
Contractor _ 1 Ph( ) SWR
BUILDING Tenant/Owner - -- ELC
Footing -- - ELC _
Foundation Access:
Fig Drain ELR -
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam ---
Shear
--Shear Anchors _
Ext Sheath/Shear
- -----------
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - -- - - - - -—
Firewall _
Fire Sprinkler -
Fire Alarm _
Susp'd Ceiling
Root
Other:
Final
_PASS PART FAIL - -
--
Post& Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole _
Storm Drain
Shower Pan
Other._
Final
_PASS PART FAIL
MECHANICAL —
Post& Beam
Rough-In -
Gas Line
Smoke Dampers -- - ----
Final
PASS PART FAIL -- ------ ----
ELE_CTRICAL.0 __—
Serrice—�
Rough-In
UG/.flab
Low\Voltage ---- — ---- -
Fire Alarm
Final L] Reinspection fee of$ required before next inspection. Pay at City F,FtaLL,• aif Blvd.
PASS PART CAI «.,
SITE -_ _ ❑ Please call for reinspection RE: _.______ nable to inspect-no access
Fire Supply Line
ADA Approach/Sidewalk
Date �]i °`',;�Y - Iespe0or _ .-�� -- Ext - -
Other: ------_-- _
Final DO NOT REMOVE this Inspection record from the Joh site,
PASS PART FAIL