Loading...
13398 SW 136TH PLACE ADDRESS: i Q. AeX r ti r J - - L i:lrcootdslmicro(Imuargels\buiiding.doc w J } 2 2 g m GTLO ) & _ § 6 a � § § / § d $co ) ) § F- >_> \ C CD c0 / m 9 } / § } co !X) CY) >1 � m V k } k � { � ¢ 7/ / 2 ) \ k � k k Q & E & C4� � . N E � u < G a CL / % % / $ 7 l £ ) b ƒ m $ k k / \ $ ) ) / j ( 2 d d m m , }f= /§ \� \(3t *oE ` / k« @ § & . \) j2/ a - Egw 2 2\Gj \ 2 ° $ § ° _ ° OD@m \ \ @§) ( 2 \� co§ { \ \ { _ ' _� � �> 2� � � p ) § \ \ ( \ \ \ 6 af o a = a 00 a m W a m m m m m m § c \m Tj c� � � 7 U L- Cl) 0 3 § § a a $ \ � 2 � � Q - $ 0 � 2 � / / ) 7 S _ 2 LLJ .0 kLl- k !\ / \ © f LM \q \ \ I) CL) w E a mo R $ ° f \ < \L) uR k § ) 2 j ) w m j j) CY) C C p _ 7 J NU 'X 'C fa f9 "0 o c y o o c_ 3 N C N N fU C .N Ct77 n .- C O O C fUal U E fV N > 4 D'5 N ai I c 0 3' a`) ac C: in0 0 , _Q N t p .73 T] a) C `O T�) .V) N C C € a a Ci U p m cr3 N n E m z it a' m o00ori 00 co OD n 00m `° io co o ao r- cP o rl 3 G m N N m N N fD (D h �3 c 00 V �d t0 T = _ CL O O Y � CO ❑ Y Y 7 O > S � M M CN C) CLO W N N Z U) _j N to to w O 1 Q a• Q p Q Q of C) n. a LL a a a CIO m cW 0 W O Y Y Y O Y Y 1 C 'D r" c p O N H r W a �, M f0 COR a00 rn � rn rn rn T n M/ N m co co coV a' c3 a, 0 m - OL tY F- r J N CCD a c a€ c u C7 O € cU a` 01 CD a C c cl c C LL v� t co y Cl- y N f0 _y 9 f9 o O U C7 ii LL ii U i`n r un trn (n o un v, o LO Q Q Q Q r- Q Q r- a(qC Q w w w w w w w w W (D -J F- W p -j z U N O W❑p o l'-0awzQ W J LLJ OpwO�uwiwa0z0 aw z °a wa7Um0�3�=wF- pF- aw n = c�° o o V)z cn LL m w o Z�LL -'F-` W=ZwF-rj �p E y oo �oos@�w'QZo crw U°° w-1 U W z>gWoZwmJpbm2 °Z J❑g Nrn aroi om �� (.D a. a_ w om Z C c- C- 2iQZ QF- Z WO DT- ztn°i Qom? M M M M M M M M M M Cl) M M M M M M Y1 m o1 Q T T :h OM7 0 m � O O � Q T Q1 � T v ao v v a D 3_ M cl FI 00 o o o a1 0`1 in G N N N N C N N N N N CJ N N N N N r co m o-i m 'n c3 cD i3 c3 co ^ v v m Q1 01 a M r 1 a v F- F- F- W (n V) (1) V) (f) m (n cn N (n U) m A >` m J J J w w � Of Of X w Of m m w w m lY m w = T w a m a m m m 0 C7 z 2 0 2i m cr o p a 2 a 7 v w o y x � ti C cn cn V) cn a m V cn z z a n, cn a z a V a 9i o aQ a a a Q ° LL LL a a ❑ a a a Q Q a w a Q a Q M a m cn c -j _ o F- I- cn V) fn N N (n N 0 :) LO to to m U) m <n cn q Ir T U 0 2 d 2 2 (7 2 w c U (7 a' 2 Y (D v o rn o N Q Ury M M M M M M Cl)r,. M Cl)M M M M coM Cl)M M M M Cl)M Cl)M M M M IL rn rn rn rn o Q, rn Q, a1 m rn o1 rn o, rn rn rn a, 01 rn rn rn rn N v V N N is r` o a3 r o o M o rn u� 10 r N C N r N N N N N N . N y- C N it c%1 ('1 to N N G) O r� V Q r OM1 d O � t,. fL F ~ o N T roY al, C J n c L° c _> V'1 N yy N i a (1 V T N C n Q N Q vl C_ 01 10 N p a ro o vai C c C w c c n E c W - c n o E E ti a c c m iL E g ro '�` o c c y c J .? Gi o N Q�1 c H tp C O 0 N J c lL p, ° n CL H riS cr3 S m m .0 c 7 im v y n c N j c c 5 E _v 3 u w a a 2 1 a (7 s (D 3 2 n. co L t` O O O O � fO N r 0 O rn rn O 0 r O NMO N V d 0 to 0 Q7 Q1 o 0 o r- r r, r� r r r rr- oo r- LO > Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q m Q Q Q to N V) 0 fn F- (F- V Q !n to to /? (n N N � N (n N fn N (n Vw 7 cn fn cn cn cn § 2\wE2 / k .® I k ci & / 2 CD E M- § \ 2 \\\}\ \ \ \ ° 2o o ) ; /0 \ \{'t- \ �. � � u� %%z ( ) Ge ) w7)22 $ & k 7 $ 2 G 7 \ § CL \ § \ 2 mm = u u u u a = o e � G _ }\ � to Ir— q 2 6 f « < E ƒ ƒ A £ m L 2 ~ C14 2 � \ U CL G § G G § § § � m § i;5 ( Q \ d � @ w > j 2 Q - � � CK: [ c % § � cl° a 2 i f \ ƒ } w f k f F ) § § @ o \ ) d / � f \ R o § ° / Lr) / § $ e e w e e r � k � � f § § N ra _ U Iv rn mom- E � me c d N O C O N O N (Er CI P m B (a.•_ 'm—2 (>) 2 Iy c �y�oor � E g 3 m � s m c ° n CD c o N >" r E C N �. c r �tk c W- a) a� v Nuc > =? Cl. a O a• m dr `- a> N Oy [ t o o rn E °Y ar E (h cpo CL uEi 'c 'o O N.o O x O. 0) LID LO to U O� O7 CA U7 1T O) a T N O LO O1 CA C11 CA w LO LOLO to Lo Ln 'D (U (O N 33 � � Ca � m . zb (a O a0 tKS o0 aCl n M d' a Q7 rn Cl O D r ♦✓ h- h- H (n (nN In U) N U) U) J 1 J (y m m m m CC mm 0 W F m CL m ro m m Y Y. Y Y -' 0 -' X D v m o y N M (n (0 (n In In (n J (n rn (n A d (n cn cn z z (� a a (n n. a¢, N a C N H m m C im o 0 0 0 0 (n cn m (n N (n O (r, Q (n N (n Y m - Y V OIC O � � r N � a � V ''' rn ori rn p ori _) N In In O O Ca aj 1` r r (�' 4 V 25 a, 03 O n WN U) y •� m U� V a CL cc o .1 Cl T; c Q� C y �+ y >. .7 Q N N E 01 OI W p.fLC a la a o N c (�_p m a E o a c_ J c d O O C P !Y C lL T E LL C C' d u E E 5 E v crE N q 0 0� Q a a ct� a LL c a ' m' Ln Nn _O O O N In O In In I O N n < pp n O .. O N M N N V It w 0 0 N Ctl T n (n n n n n n O O Op n n n Q� h 0 N H 0 w N (n Q (/) N N N VJ N N to N (� N (/J N N In In (n v 0 z °' rn rnCL rn rn A N N N V U) U) a CO CL CD 0 0 D v y o >> 2� c T- C) Q a a N a �I a a a a M m w Q. 0 C7 C7 v r � � O (D Lm 0 M Q o o m o a �• °' �'! U) O v` N r r r N N Q a y `v A O i n v c L C O O J OCL W Il 2 N m N p (D D c d LL m C iI w U In N Q� O 0 Q a a Q a �' it d 0 z °1 m rn rn rn rn rn m V N N N N N N U .D .� J W = W CX m m m m 7 -D N O > =J T- Va N d V C a Q a M o 0) T m o it ccn7 c`n7 Q oQ) # rnO r CD V) a ro U mm o `Q n a 04 a N o C a N N A �. O V Q •- th d � � N O r� L1 T h V U W a7 O o n O a N N W .0 OCL ll J u a p0 OOOy a v LL vU ll7 N t. 0 0 LO 0 CITY OF TIGARD ELEr.TRTCPL PERMIT DEVELOPMENT SERVICES PERMIT #: FLJ'08­03417, 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 D n T E I q f 73 LJ r-..1): CSE;/2*..3 138 V r,T V %i 10 PT I 11`0i�l'Ll,,;(.3., P 7 r,";) 'T T G 0,135 J I R T!- C TTO N t L i FSI; i .art Electrical addition 0q: !7rOR I.-Frr. . . 0?00 amp. . . . . . . . r,UMP/I RRTCPTI(3N. th ­1GN/01..JT LINE I_TG, 0)r1H L 1,3009F. 0 $0 1. 4 4 M I--%. . . . . . . . 6210 4mp. . . . . . . : 0 -,nNFI-,. . . . . . . . 0 IVITTED ENERGY. . . . . 0 401 simr :iINJF. HM/ SVr�/FY)R. . 0 %,01 t limp; 000 1 s. ; IVH t-10IR I.1')r1F!, f 10) , 1`R's)I rE/FEErFR-.­--­- nT)r,) INSPECT I(It'Z-3 2100 4MO -.kmp. 0 1 St W 0 R V C El 13 F-DR, 1 1 . . . . . . . . . . 600 rimp. . . . . . Vi C0 I. DRNCII C I RC. F' it,I Pt ni,.i-r. 1000 amp. . I Rr.V T FW '01714 zmp/vclt. . . . 0 -4 REQ; UN'T'n). 1W0191INPI.. Lj ri T C:,,t 17T Svr/7DR P25 PIVIPS. C'Lr'49,R nRF.:0/r3F,F_c, ncl, y pt, ik in 0 y Ll il P SW -(_,Tl--1 P1,!4Y 4 0,: D 112 7 9r3.. '2",0 7 Trin- RV nq 97FZ ;25 LA 0,C./279 t) ;R--,70 77 UTrR(­7) 7NGPEr_T1DN,5 F CsC-t 1 s P I-vi(7.e. pet-sit is iss%.,Fd s,�hject to Che vej,j.lations contained in the Tigard Municipal Code, State Cf Oregon Specialty Codes and all', other laws. "11 W+)rk Wil'I bf done it accordance with approved plans, This perait will expire if worli it not !tvted %ithil, 1V s of isv.-Ancej i+ if kcr� is s,sppndtd for more than 1,7! days. ATTENTION: Orogon law requires you to follow the rules adopted tv Iv;vr, i'lilit,., *1 ,';I:Atior reti:er. '1110sf rQ#5 are 5f-" fc1th in DAR 9"12-"* 'r- ftA'."Frv- v,,f say obtair, rll*. 1.1)ota ntlpS nr '-,ro-t q,ifsti.tint fn O!W:' by ral,I inj (F P4; 98 -t 7 vi LAJ CITY OF TIGARD Electrical Permit Application Plan Check# 13125 SW HALL BLVD. Rec'd By %71 - i TIGARD OR 97223 JUN 2 I� Dateraec'd � --Z , Date to P.E. Phone. (503)639-4171, x304 ( °1'+'!TY ll,Ufl01"'I rJ! Date to DST Inspection (503) 639-4175 K'rint or Type permit#_��C � - •�i�lu Fax (503) 684-7297 Incomplete or illegible will not be accepted CalledG�z 1. Job Address: G ee 4. Complete Fee Schedule Below: Name of Development H) ✓�A CJ _ Number of Inspections per permit allowed - Name(or narne of business) -`1 ti�rCUS b Service included: Items Cost Sum Address f� 3 -S �� J 4a. nesldential-per unit 1000 sq.ft.or less $110.00 4 City/State/Zip- Each additional 500 sq.ft.or Commercial ❑ Residential portion thereof $25.00 _ 1 Limited Energy $25.00 _ Each Manuf'd Home or Modular Dwelling Service or Feder $68.00 ; 2a. Contractor i?stallation only: (Attach copy of all current licenses) 4b.Services or Feed ms Electrical Contractor 1 i - „�, . . ,L_ Installation,alteration,ar relocation Addr ss��.-� � k.i e= /��'�"�"�'- 200 amps or less $60.00 2 u��u 201 amps to 400 amps $80.00 2 City State 19 i2- Zip 2 2, iQ�2 401 amps to 600 amps $120.00 2 Phone No. >G T < < 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts $340.00 _ 2 Reconnect only $50.00 2 Elec. Cont. ice. No. `ice Exp.Date - OR State CCB Reg. No. y 3B S/ Exp.Date _ 4c.Temporary Services or Feeders COT Business Tax or Metro No. /,9 7Z- Exp.D a Installation,alteration,or relocation 200 amps or less $50.00 _ 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 1000 volts, License No.av�-S Exp.Date see"b"above. Phone No. 7- Z f �-2!~ - 4d.Branch Circuits Nc,v,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 2 - ------ -- - ---- - - - b)The fee for branch circuits City -_ Slate___ Zip _ without purchase of Phone No. service or feeder fee. _ First branch circuit ' $35.00 2 The installation is being made on property I own which is not Each additional branch circuit_� $5.00 72 _ intended for sale,lease or rent. 4e.Miscellaneous (Service Owner's Signature Eachpump or Irrigation circle lle $40.00 2 Each sign or outline lighting _ $40.00 2 3. Plan Review section (if required):* Signal cirruit(s)or a limited energy panel,alteration or extension $40.00 - 2 Please check appropriate Item and enter fee in section 513. Minor Labels(10) $100.00-- _ _4 or more residential uniis In one structure 4f.Each additional Inspection over s Service and feeder 225 amps or more the allowable In any of the-ibove System over 600 volts nominal Per Inspection _ $35.00 _Classified area or structure containing special occupancy Per hoar $55.00 ►- as described In N.E.C.Chapter 5 In Plant $55.00 J L A Submit 2 sets of plans with application where any of the above apply. 5. Fees: Not required for temporary construction services. 5a.Enter total of above fees $ W 5%Surcharge(.05 X total fees) $ Z J NOTICE Subtotal $ Sb.Enter 2591u of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If required(Sec.3) $ -NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ -IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account# S �7 Z� Total balance Due I InSTSTI.C99 APP Rev WN CITY OF TIGARD BUILDING INSPECTION DIVISION ��j� ST ;24-Haar Inspection Line: 639-4175 Business Line: 539-4171 p fBUP Date Requested �" � � / ✓ (�-'�-416M)� XPM BLD Location Suite MEC Contact Person Ph PLM _ Contractor a.� 'u_ _ Ph L7. SWP, BUILDING Tenant/OwnerELC Retaining Wall a ELR Footing Access'. Foundation FPS — Ftg Drain SGN Crawl Drain Inspection Notes: Slab —_— SIT Post& Beam — - Ext Sheath/Shear I Int Sheath/Shear _ FramingZ<<� < �-- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof Misc: _ -- FiUaL` PASS -)PART FAIL ---- -- — — PLUMBING Post& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains F,nal PAS FAIL #ECHANLCU Post& Beam --- - -- ---- - ------- Rough In Gas Line -- -- - - ---- - - SDam ers nal � ---- ---- `PASS PART FAIL ELECTRICAL - - - - - Service — Rough In UG/Slab - - --- — s Low Voltage Fire Alarm Final PASS PART FAIL SITE wc backfill/Grading w Sanitary Sewer -' Storm Drain [ j Re.inapection fee of$. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line f ] Please call for reinspection RE: [ ]Unable to inspect no access ADA Approach/Sidewalk OcherDate " -16 - � Inspector Er,t --------- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARDM'7r,Hf1NICAI_. DEVELOPMENT SERVICES r-ER011 T 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 r'F RM I T #1. . . . . . . DATE ISSUED: 06/16/98 F'nRCEL: 2S 104CA--08500 ITE ADDRESS. . . 13398 SW 136TH PL_ 'UBDTVTSION. . . . : HILI._SHIRE ZONING: R--7 F'l) LACI:. . . . . . . . . . . I._.OT. . . . . . . . . . . . . :085 .JURISDTCTION: TIG CLASS OF WORV,. . :ALT FLOOR V-URN. . . . : 0 EVAF' COOLERS: 0 TYRE: OF USE. . . . SF UNIT HE=ATF=RS. . : 0 VENT FAN,. . . : 0 (77CUF'ANCY GRP. . :193 VENTS W/O AF'P1_: 0 VENT SYSTEMS: 0 7URIES. . . . . . . . : 0 BOIL.ERS/COMPRE=SSORS HOODS. . . . . . . : 0 IJE:I_ TY'''ES-___ ___________ 0_..3 14F'. . . . : 1 llC1I4F5. IIVCIN: 0 3--1.5 HF'. . . . : 0 CCIMML... INCIN: 0 MAX T NRUT: 0 BTU 1 8•.;30 HF'. . . ,• : 0 REPAIR UNITS: 10 F IRE DAMPERS?. . : 70-50 HP. . . . : 0 WOODSTOVES. . : 0 SAS F''RESSURE. . . : 50+ I-',F'. . . . : CIJI DRYERS. . : 0 NO. OF UMI T TS----------_--. AIR HANDL INC LPN I TS OTHER UNITS. : 0 FURN ( 100K BTU: 1. C= 100iM0 c f m: 0 GAS OL.ITI._ETS. : ?' FURN )=100K BTU: 0 > 10000 r.fm : 0 Rr:mat-k s : Replace existing furnace add A/C unit and gas piping. A/C units cannot be placed within the required set bask areas. DIANA 1_. ANDREAS, type .imol-int Iny date r`er:Pt 1:3398 SW 136TH F'1_.WY PRMT $ ?Ci. Qr0 GEO QAC./1 E,/98 98--306581 TIGARD OR 972E'3 SPOT $ 1. 25 GE_O 06/16/98 98-- 3(A6r1-J B I F''hc)ne #k: 524-.478 3 ,JACOBS HFnT I NG & A/C 4474 SE MILWIaL)KIEt AVE ------------------------------------- - $ 26. Z=5 TOTAL, " IRTL.ANO OR 97202 'ronh +t: 5flr:�,--234-7731 g . . : (/~0001 4 -- --- -- REOL)T REI) I Nc-3PECT 1'nt\IS -_.. _..... is permit is issued subject to the regulations contained in the Gas L_irie Insp - lard Municipal Code, State of Etre. Sperialty Codes and all other Machan i ca l T r)s p J icable laws. All work will be done in accordance with Heating Un t Insp proved plans. This permit will expire if work is not stArted Cnnl ing Lint Insp .thin 180 days of issuance, or if worm is suspended for more Misr. Insver..t i on ar 182 days. P70TION: Oregon law requires you to follow rules Final insper_t i on ipted by the Dregon Utility Notification Center. Those rules are '" } forth in ~JAR 9521VI-0010 through OA4 952-8A1-0AA0, You may F= ain copies of these rules or direct questions to OUNC by calling +++++++++++-++,4.... ...4{ r..{-+4-4+4+4-++++.4--1--1-+•f-4-+++-1-+++-+-4-4+i- .I f i i-.+ r.4 .+ ++.-4 gall 63171--4175 by 7:00 p. m. fnr, in ypectiuns npr�rleri the noxa bl..)si.nrss rJray p..}..+++.1....,..+.-P 44...1_4..4 4 ' ++4++-+++++++4-+-1•#+f..........i•....°F++4•►+.+-h...4•...i-++++-t•++.r.+..l..4.-)..4 Plan Check# CITY Gf TIGARD Mechanical Permit Application Re:j By_ 13125 SW HALL BLVD. Commerc;al and Residential Date Recd TIGARD, OR 97223 ;/ Date to P.E. (iO3) 639-4171, :304 � Daie to DST Permit# 33 Print or Type caned Incomplete or illegible applications will not F)j accepted TYof Deveiopment/Proiect -{. Descnption G t-,�l`f7�� � � Table 1A Mechanical Code CITY PRICE AMT Job street Address Suites A) Permit Fee -0- -0- 10.00 Address Bidga CyrStau Zlp 1.) Furnace to 100,000 BTU 6.00 l including duds&vents Name(or narne of business) j 2.) Furnace 100,000 BTU+ 7.50 Owner � � : /1WY1 f"LG including duds&vents °f 3,) Floor Furnace 6.00 I including vent citylstate R bane o 4.) Suspended heater,wall heater 6.00 �1 v / V4_ J or floor mounted heater Nwm(&nantili of business) 5.) Vent not included in appliance permit 3.00 Occupant M°i( A qtr � `' ' n 6.) Boiler or comp,heat pump,air Gond. 6.00 / to 3 HP;absorb unit to WOK BUT" _ CnyrSZip Phone 7) Boder or comp,heat pump,air cond. 11.00 L 2-Z4 i, 3-;5 HP,absorb unit to 500K BTU" _ Contractor Norm �,�% 8.) Boder or comp,heat pump,air Gond. 15.00 (Prior to i� 7 'r 15-30 HP;absorb und.5-1 mil BTU- issuance marl Address 9.) Boiler or comp,heat pump,air gond 22.50 applic"r, 30-30 HP;absorb unit 1-1 75mil BTU" must;:,rovde all Cirvistate ZIP Phone 10.) Bc•ler or comp,heat pump,air Gond. 3750 contractor ; - i� 17�/{-7 >50 HP;absorb and 1.75_mil BTU" license Oregon Const.Cont. Lto.N Ex 0 a �r 11.) Air handling unit to 10,000 CFM 4.50 information 44 / f for COT COT susrnessTax orMeW Exp Date 12.) Air handling unit 10,000 r:FM 7.50 dataoase). I !2 Ui Architect Name 13.) Non-portable evaporate cooler 450 Or Mating Address �Lj ) f �M. VC.it fan connected to a single duct 3.00 Engineer tyi'1Ot° Zip Phone Ventilation system not included in 4.50 appliance permit Describe work New O Addition O Alteration 0 Repair O r16.) Hood served by mechanical exhaust 4 50 to be done Residential 0 Non-residential O Additional Description of work 17) Domestic incinerators t 7.50 AW 18.) Commercial or industrial type 30.00 _ Incinerator Existing use of 19.) Repair unds 4.50 building or property � ,' ��(, 20.) Wood stove 450 Proposed use of 21.) Clothes dryer,etc. 4.50 budding or property 22.) Other unit-. 450 Tyne of fuel-oil O natural gas O LPG�i electnc O 23) Gas piping one to four outlets 200 7-hereby acknowledge that I have read this application,thrtt the 24) More than 4-per outlets(each) 50 F. information given is correct,that I am the owner or authorized agent of I the owner,that plans submitted are in compliance with Oregon State CITY SUBTOTAL laws Signature of Owner/Agent Date _ 'SUBTOTAL v W _ 5%SURCHARGE coillitact Person ante l Phone PLAN REVIEW 25%OF SUBTOTAL TOTE i ndstVnechpmt.doc (rev 9 'Minimum permit tea is 525+5%surcharge "Residential A1C requires site plan showing placement of unit. 7-1 5 � (�oLGQiC 'a�Jll , �oy�T L/1�7 dt2 9-7 2. -32 D�(1 T 07 I i M4 1V �2vPCa;v J ' N� r(7 A � r a Lo W 2 MER PERMIT CITY OF TIGARD PE P 111 ATS:T4. . . . . . . : MST95 -0372C, COMMUNITY DEVELOPMENT COARTMtNT DATE ISSUEr 09/06/95 13125 SW Hall Blvd.Tigard,Oregon 97223o$199 (503)839-4171 PARCEL. 25104CA-It)0500 SITIE ADDRESS. . . : 13398 SW 1-"GTH r-'!I- SUBDIVISION. . . . : HILLISHI RE ZONINC,: R-7 PD . . . . . . . . . : LOT,. . . . . . . . Oe'5 BUILDING RCI SSUE: D-Wrl-LT.NG UNITS.0 n-ASEMENT. . . . . . . . :0 sf LLASS OF WORK. :Prt� BEDRMS: 1 BATHS: I GARAGE. . . . . . . . . . : 195 sf T Y r-,rz" . OF USE. . . :SF FLOOR REQUIRED T Y PE OF CONST. :5N FI.RSI . . . . :0 sf LEFT. . :0 ft P I 0h,J. 0 ft OCCUPANCY GRP. ,R3 SECOKL 0 sf rRONT. :0 ft REA R. . 0 ft: STORIES. . . . . . . :0 FINIDGMENT;972 sf REQUIRED---._._.._____._..__.....__..__._._. HE I SHT. . . . . . . . .. 0 ft TOTAL--- ------- :972 sf SMOKEE DETECTORS. :Y FLOOR LOAD. . . . -ti 0 psf VALUE. . . . . $ : 66023 PARKING SPACES. . :0 Remarks : Addition - completi.yin basement, appr-ox. 972 sq. ft. of habitable space --------- PLUMBING', TAKE:. . . . . . . . . . . 1 n-oon Dpnlris. . . . -iz, BACKFLOW PREVNTRS. . -.0 LAVATORIES. . . . . .. I WATER HEATERS. . . :0 TRAPS. :0 TUB/SHOWERS. . . . - 1 LAUNDRY TrAYS. . . :0 CATCH �A' G—IN' S* * * *. ' zo WATER CLOSET S. . : 1 SEWER LINE ( ft ) . :O GREASE TRAPS. . . . . . . ..0 DlG1AWnS31iEP.S. . . . : 1 WnTEP LINE (ft ) . :0 OTHER FIXTURES. . . . . .r1j GARBAGE D1SP. . . : 1 PAIN DRAIN (ft ) . :O 14PSHING MACH. . . :O GF RAIN DRAING-0 MECHANICAL FFES FUEL UNIT HTRS. . :0 t y p IP a m 0 1-k n t by date I-'ecpt ,"GAS/ VENTS . . . . . :5 BPRT $ 3-34. 00 JSD 09/06/95 95-;=:70.::0`..', MAX INPUT:el BTU VENT F(IN5. . - 1 13PI-C $ -,1.7. 1.0 1301,1 0,11/J=1/135 9"i••-2,69613 FURN ( 100K . . :121 HOCJ�1'3. . . . . . . I BSPC T, .16. 70 J IS D 09/06/95 95-270205 r-URN ) =10171K . . OZI WOODGTOVES.- 10 MPPT 40. 0,71 ..TSD 09/06/r35 05-27020"1 rLOOR FURN. . . . :0 CLO DRYERS. : 1T MPLC 10. Oft) J �D 09/06/95 95--2:70;::05Soll-/Cmp < OTHER M 115 r.,C . x'10 JS0 00/06/15 15 -21 7 02 01,2 GAO OUTLETS;0 r-,P,R'r s 54. 00 J51) 09/06/95 95-27020!J 2. 70 .Y")[- 09/06/1)5 95-i '7 0 2 CA!15 i"IARK LIECHTY 1.3398 SW 136TIA PLWY TIGARD OR 972;�.13 01-lane #. 579 2923 OWNER Reg 00017100 676. 50 TOTAL This poreit is issued subject to the regulatiors cvitained in the REOUIRED INSPECTIONS) Tigard Municipal Code, Stitt of Dro. Specialty Codes and all ether mecll-)atlil_al I n s p -ipplic&blit laws, All workwill be done in accordance with approved Plumb Top Out This perait will expire if work is net started within 180 rt-am _4 - plans. Inr p -Pys of Issuance, or If work is sucof"ded fir Imp tan IPe d Imsulation InEip Gyp Soar,d I n s p flpchanic,al Final Plumb Final s S u d Ta tDuilding Final Call foo, irSPOLtion 639- 4175 Residential Building Permit application City of Tigard 13125 SW Hall filvd. Tigard, OR 97223 (503) 639-4171 I Jobsite Address: j J 9 S L'-� ! f�+tN PC 11 `` Subdivision: ll�•� "�Z Lot # _- Office Use Only ri�. .� Valuation: ���. ;�- _ Result tDate / / Initials Planck/Rec # I ' New Construction Only: (Square Footage) Permit # >>Sir; D 3Z G• House: 77- Garage: /S Reissue of Map & TL# 2510t/CAi —O J Zone Corner Lot? Y' —N Flag Lot? Y N Plat # Owner: (✓`/��'- i (FL � � A�1�rovals Required red ( � Address: �C Sc.� ' f Planning Setbacks Solar !P� Engineering Other Items Required Phone: Subcontractors _ Contractor: ���� L' ,J t>�' Truss Details Address: Other Notes Phone: Contractor's License # (attach copy of current Oregon license) Contact Name: Contact Phone: L ) _ Subcontractors: Arch itecUEngineer: Fr Plumbing: L> c��^i�c. !' Address. Mechanical: 0(,t)7\/ L (attach copy of current OR Contractor's License) .J� Phone: -_ IT— JOB T —JOB DESCRIPTION: S03 579 _ ;rcl a S6l App' ant Signature Applicant Phone number y: Received b _� ` _ V Date Received: 1"I `l 5 H uo�hn�nae Permit # Account Description Amount Amt. Pd. Bal. Due" Ix,10-oR 6 Bldg. Permit (BUILD) - Plumb. Permit (PLUMB) r �v s � ' Mech. Permit (MECH) State Tax (TAX) Bldg: �� Plumb: c� v Mech: Plan Check (PLANCK) Bldg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-O) Water Quality (WQUAL) Water Quantity (WQUANT) F- v, Fire Life Safety (FLS) _ Erosion Cntrl Permit (ERPRMT) L w Erosion Planck/USA (ERPLAN) J Erosion Planck/COT (EROSN) TOTALS: Permit#: Add.,ess: Issued by: Date: l 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 buildin o 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 3B: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I roust 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. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR �Uz 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors LL Board. If I change my mind and hire a general contractor, I will contract with a contractor who is Ce registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. r H- I hereby certify that the above information is correct and that I have read and do understand the Information _L Notice toPropert Owners about/JJ onstruVt Responsibilities on the reverse side oft s f m(.. V W � (Signature of pe it plicant) (Date) (6 to copy to issuing agency permit file, pink copy to applicant) C11YOF TI FARD 1WRD RD COMMUNITY DEVELOPMENT DEPARTMENT 01� 15125 SW HWI Bkod P.O.Bac 23397,TlpW,OrWo 97 (503)639-4176 MASTER PERMIT RM11 #. . . . . . . . MST93 12!16 DATE ISSUED: 03/29/93 SITE ADDRESS. 13,3-98 SW 136TH PL PARCE1-: 2SI040'Z'-,HSi)81 i71UBDIVISION. . . . HILLSHIRE ZONING: R-7 Pr) UL . . . . . . . . . . . L0'r.. . . . . . . . . . . . . 0815 ------ BUILDING DWELLING UIQ iTS: i BAGEMEN'T.. . . . . . . . !0 5f 'l.t4bF OF WORK. N E W BEDRMSt4 BATHS:3 GARAGE. . . . . . . . . . :484 f or11 USE-. Fl...UOR AREAS-------------- ------- REQUIRED `-'F'E:: OF CONST. .50 FI RST. . . . ; 1210 s f L E . :8 ft RIGHT. :5 ft '(:.IJPANCY GRP. :R3 (,3 E C 0 114 D. . . . 11 33 s f F R 0 1144. -.20 ft REAR. . -39 f t F'I ES. . . . . . . :2 THIRD. . . . :0 s f R E 0 U I REI)__.....__.__ - 3HT. . . . . . . . :3 1 ft- TLjl'f4L-- :,R343 5 .Y DEI ECTORS. JOR LOAD. . . . :40 psf VALUE- - $ .- 116490 PARKING SPACES— : 1 riarks : PA1'H I PLUMB i NG -- NKS. . . . . . . . . . . I FLOOR DRAINS. . . . Q, LAAGK�FLOW PREMM-3. . :0 1YATORIE5. . . . . ..5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . ..0 ,)B/SIIIOWERS. . . . .3 LAUNDRY TkAYS. . . . 1 CATCH BASINS. . . . . . . :0 1 ER GLUSE-I'S. . :3 SEWLR LINL (ft) . .0 GREASE TRAPS. . . . . . . ..0 -A j - rURLS. . . 0 L, AWAI�Ail""Rs. . . . . 1 W�)TER LINE kft ) . - 100 OTHER F- -I X' ,jORS"GE DISP. . . % I RAIN DRAIN (ft) . ;0 i5HING MACH, . . : 1 5F RAIN DRA I N5. . : 1 MECHANICAL FEES )I'--L TYPES- u4i'r HTRS. . :0 type ant(junt by d At P rflopt IASI VENTS TIF $ 1460. 00 JH 03/29/93 - ! '+)A: INPUT:0 13T U VENT FANS. . :4 BPR V * 475. 50 J11 OW/29/1)3 - iJHN < 100K . . :ILI HOODS. . . . . . : 1 BPLC $ 309. 08 JLH 02/10/93 93--23655if UNN . . : I WOUDIS 1"0 YES. :0 Mjpc $ 23. 76 J1i V',:;/L:1)/93 LOOP FURN. . . . -.0 CLO DRYERS. : 1 'GSDC $ 280. 00 JH 03/29/93 OIL/ClYIP 31AP.-0 .iTHE-ii UNIT',:-): I PARK 1 500. 00 JI; 03/29/9; GAS OUTLETS: 1 MPRT $ 45. 00 JH 03/29/93 1 1 . cl!:i JH 03/213/9"3 A FULLERI'ON 1'45PC $ 2. 25 JH 03/29/93 10�21 SW CAPITOL 11WY PPRI * 162. 50 JH 0:3/`13!93 ).JJTE # 275 P5PC $ 8. 13 JH 03/29/93 JPTLAND OR ')'7Z'11) '. W, FIT-LERTON SW CA4'110L HWY U I TE # E'7 -; ")RILAND OR '37219 :wf)e #: L'_J F'Ll 41716 i J $ 3277. 49 T*UrPL finis pit-sit is Issued subject to the regulations contained in the REQUIRED INSPECTIC)ivS - igard Municipal Code, State of Ore. Spmalty Codes and all other Footifoi_md Insp Fireplace Insp appikabItlaws. All work mill be dwip 1haccorde Aithapproved P. st/Eleam Stv".wt Gas Line Insp plans, This permit wil; emp:re if w Ft ithin 160 Pest/Seam Mectian Insulation Insp nays of issuance, or if nark is suspense 0 day Plm/undslab Insp Gyp Board Insp m��z FILM/Untier floor Rain di-sin Insp 'I'Mittee, Mechanical IT-)SP Water Line 1n,..-,p Piumt, "fop out Appr/Sdwlk Insp L Fi-aming Insp lyl&cfianical Final t: �;,.!eLt1UT1 (2.39-4175 SEWER CONNECTION CITY OF TIFARD PERMIT 4001D COMMUNITY DEVELOPMENT DEPARTMENT one*016 PERMIT #. . . . . . . : 5WR93-0150 19126 BW HO Blvd P.O.B=23307,Tipid,Or@W vi (603)639-4175 T5`1Jr7.I7,— 03/29/93 SITE ADDRESS. ., . : 1LiW t:3'LJH PIL f r1FtC'LL: iR510400—FiSJOBb T)UBD I V I S I ON. . . . : H I LLS31 i I[RE ZONING. R-- 7 PC BLOCK. . . . . . . . . . .. LUT. . . . . . . . . . . . . :065 TENANT NAME:. . . . . . USA NO. . . . . . . . . . . F I X TURC UN ITS. . . - CLASS 01 WORK. . . -NEW DWELL I NU UN I TS. . . I 'TYPE OF USE— . . . -.SF NO. OF' 'BUILDINGS. 1 iNSTALL TYP11-:. ., . SU5WIR IMPLRV SURFACE. -., sf ?Om�:.Ar,ks : PATH I FEES R W FULLERTON type amui.knt by date i-'r-Cpt 9700 SW LAP110L HWY PIRMT $ 2100. 00 JH 03/29/93 S31JITE # '"273 IN SFJ 1; 3 5. Oka JI-1 03/29/93 PORTLAND OR (737219 r''Ii,i,ic #-. 29,'3'--E'277 CONTRACTOP NOF ON f77ILE lur-e 0: 2135. 00 TOTAL R E Q U I RLE INSPECTIONS cIs A,,pljcant agues to comply with all the rules and regulations :fewer, Inspection of the Unified Sewage Agency. The permit expires 186 days fro& t',e date iisfied. The tots; alount paid will be forfeited if the permit expi"s. The Agency does not guarantee the accuracy of the side sewer laterals. if the sewer is not located at the measurement given, the installer shall prospect 3 f t I I 1r,cti T tin n a, ire ha:on, from e I poll h .L:e given. If not trio disto a �r "st a 'Tap and Side Sewer' Pore:: .1::attf,:" e Cyinsta I all a 7111rsall, is-il.ted By : Lull fur, illspectiori 6,39-4175 rX r`-1- Ln CITY OF TIGARD 13175 sw mail 814 PLNCK/RECT CGMMUNM n-EvELOPMENT DEPARTMENT rWrd,ofn-107M PERMIT 0 -1115 f�• - o plc 7 __ (5W)E3"171 DATE ISSUED JOB ADDRESS: x'33�/�' S cti��3 � TAX MAP/LOT 2,S 10(10P- �- SUB: LOT: e—f ILAND USE: _ VALUATION: OWNER SPECIAL,NOTES NAME: REISSUE OF: AUURESS: NwY ` "2-45 LAST REISSUE: >-., %.- .s._. FLOOD PLAIN/ PHONE: 7-93 - 7-Z--+--j SENSITIVE LANG: CQNTRAC M � APPROVALS REOUIREO NAME: 7j2 W 17, .L-r..�� PIANNING: ADDRESS: LA '1 2 ENGINEERING: �-� CX;' 942\`7 FIRE DEPT: PHONE: 293 - 7--C-`q OTHER: ?11P CONTR. BOARD #: AOU-41 EXP DATE: 11 ob 9 ITEMS REQUIRED SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS: MECH: BUS TAX: ARCHIENGINEER CALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: \lo�71-G1 ���1 Frcr-�v�� u� •C Q►) �yZ OTHER: PHONE: ti PROPOSED BLDG. USE: F" COMMENTS: ;�1J �1� u�i./L �l(4-X0 rkx/ CL,, 17�e US 'E SATs SY9'! A J •C W J APPLICANT SIGNATURE Received By: Date Received: EXEMPTION FROM MAXIMUM SHADE POINT HEIGHT STANDARD I/We, the undersigned, as legal owners of record of the property descibed as: Lot NeA- of �����s►��rzC —Subdivision Tigard Address kl'; 12 2- Tax Map and Lot Number do hereby release the property owners of adjacent Lot N �� of ��w`�����2� _Subdivison, also known as Tigard address ����� '`• � \�(c-r�1 �Ac and as Tax Map and Lot Number from complying with Community Development Code Section 18.88.050.G (Maximum Shade Point Height Standard) ; and agree that the structure may have a shade point height of feet, thereby allowing shade on an area otherwise protected by Code Section 18.88.050.D. In addition, I/we also release the City of Tigard from liability for damages resulting from this adjustment. 0<11 S nature Signature State of Oregon ) County of ) ss This instrument was signed or attested to before me by Jol p-1 c'h l ekL and on x/13 , 1993. 0 v7 h Signature of Notarial Officer J My commission expires: (Notary Seal) UJ i D• THS br/rlt/Exempt Mst . My CITY OF TIGA RD CMOF461D COMMUNITY DEVELOPMENT DEPARTMENT 7 13126 BIN HWI Blvd P.O.em 23W.TOW,Orepn q=(603)M4176 PLUMBING P'ERMIT R DATE ISSUED: 03/L9/93 FE ADDRES,3. SW 136TH PARCEL: 2S104-00..-HGO. SUBDIVISION. . . . : HILLISHIRE ZONING: R­7 PD . . . . . . . .. . . : LOT. . . . . . . . . . . . . :065 ------------------------- GLASS OF WORK. NEW GARBAGE VISP,MnLo. . : 1 ('YiJE OF USE. . . . iSF WASHING MACH. . . . . . . : 1 BACKFLOW P'REVNTRS. . z0 OCCUPANCY GRP,. . :R2 FLOOR DRAING. . . . . . . :0 TRAP's. . . . . . . . . . . . . . . . STORIES. . . . . . . . 9 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0 1.,:,1 XTURES L(iUNDIRY TRAYS— . ' I SF* RAIP4 DRAINS. . . . . .. i 9 1 NKS. . . . . . . . . . .. i GREASE TRAPS. . . . . . . :0 Lf4VPIUHILS. . . . . :5 OTI IER FIXTURES. . :0 TUBiSHOWERS. . . . : SEWER LINE (ft) . . . . :O WA'11F'R, :3 WA LR LINE (ft) . . . . . 100 I RAIN DRAIN (ft ) . . . . :0 P'I;T H I OWNER: R W F*ULLLRI'Olq TIF $ 1.460. 00 J11 03/29/93 1700 SW CAV'ITO(_ HWY BPRT $ 475. 50 JH 03/29/93 .lii.JIVE # vz7,J $ 3 V)- 0 6 JLH IZI 10/9 93­2365�, DURTLF)ND OR 978119 L3. 78 JH 03/.129/93 293--'IR277 SSMC $ ii60. OVI JV4 O.V;::9/133 IDARK $ 500. 00 JH 03/29/93 1.un)b i t $ 45. 00 JH 03/a-1/913 MPLC $ 11. c:5 JH 103/29/113 LI INC, M5P'C $ 2. 2:5 JH 03/29/93 wi r PRI 160. 50 JH 03/, V -At r SA pbp,c, 8. 13 JH ITIS/x9/93 u n e# 4r 2 7 REQUIRED INSPECTIONS flii% Permlt is issued sl.;hject to the uiations contained in the 'Tigard Municipal Foot/found Ensp Rain drain InsE_, L~ou'e, State of (]I-e. Spc,-Li�aj,ty Codes and all Fust/Beam !--)eruct Water Line Inst. ol-ohel- applicable laws. All work will be done �Plost/Ueam Plechan APPYI/Sdwlk Ins4.. in nccordanc:e with appruved plans. This P'lM/I..(nJSl.'_Ab 111SP (yjef_jja'1jQal F'jr.,_ 0- J)er'Mit Will eX;)1rL- if WW-k is not started PLM/Underfloor (:Ilijmb Final witi,in 160 diiys of issuances, or if work is Mechanical Insp Suildinu r'inatl CC —ispended for more than 180 days. F-111.imb Top Out Erosion Contr,ol V) Cr,-Awl Drain Fireplaue Insp ua,., Line nsp Tt)sulatiotl 11-15P Lyp Board ITISP A L I oUlz Od "'A 01 ,jntrautor Signature for inspectiort 639. 41 i,"; Notes : ----------- ........... CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223e8199 (503)639-4171 PLUMbINU PERMI T' PE FRM I T #. . . . .. . . . PLM93 -0,.6j 639-4171 DATE ISSUED: 09/14/93 PARCEL. '.::5104C(i -08500 5 ADLRESS. . . 13 3 9 0 S14 136T1-I PL !':)JBDIVISION. . . . HILLSHIRE ZONING- R-7 PI) .PLOCP. . . . . . . . . . L01.. . . . . . . . . . . . .085 OF WURl-;. U-f:lRBAUE MODILF.-- V(OML SPACLS. T YPL-- OF USE. . . WASHING MACH. . . . . . . : rAACKFLOW PREVNTRS. . . 1 OCCUPANCY GRP— :R3 FLOOR DRA11\1r.4. . . . . . . : TRAPS.. . . . . . . . . . . . . . . STORIES. . . . . . . . .. WATER HEATERS. . . . . . . CATCH BASINS. . . . . . . : FIMURES - — LAUNDRY TROYS. . . . . . : SF RPIN DRAING. . . . . : SINKS. . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . . t-AVATURIE5. . . . . OTHER FIXTURES. . . . . . (UO/SHOWERS. . . . 'c;EWER LINE (ft ) . . . . : WA'!EN t;l-C)'---! WATEY LINU ( ft ) . . . . ')I,'.)'-iWASH[:RS- .. . , RAIN DROAN (ft ) . . . . SPP (NKLER ',Dr-Rly11T FEES R. li. F1JLLr-RT10,*,J type amai.Ant by date r-ecr ')700 SW CAP fTUL- HWS' PRMT $ 15. 00 JH 09/14/93 4- ZZ75 5PCT S 0. 75 JH 0',/14/x)3 P,cwrLAND OR CJ7219 z'J 'H COAST HIUMWAY 14 9 7439 $ 1J. 75 TOTAL. REQUIRED INSPIL.,.1 IUNG TF is persit is ivs.uea subject to the regulations contained in the I.-It-ev Tigard humnu! Code, Statv of (ire. Specielty Ccles and all other- f71 ri a I Iri�ipect s.art arplicable laws. P)l work will be done in accordance with &::rovec play,-. This persit will expire if mark is not started 189 days Of issuance, cr if work is suspended for sort .0 ...... LAJ CITY OF TIGARD DEVrLOPMENT SERVICES 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 CERTIFICATE OF" OCCUPANCY PERMIT #. . . . . . . : MST93-0167 DATE ISSUED: 09/21/93 MORCEL : 2S l04CA-06500 131 TE ADDRESS. . . : 13396 SW 1.361*11 PSI_ SUBDIVISION. . . . : HILLSHIRE ZONING-R--7 PD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . aO85 JURISDICTION:TIR CLASS OF WORK. :NEW TYPE OF USE. . . :5F TYPE OF CONST R:SN OCCUPANCY GRP. :R3 OCCUPANCY LOWD:2 Remarks t MH 1 Owners ---_--_-----..----------------------.- R W FULLERTON 9700 SW CAF,i T0L HWY SU17E # 275 PORTLAND OR 97219 Phone #: 293•-22*77 Contractors THE R. W. FULLERTON COMPANY 9700 `7W CAPITOL HWY SUITE # 275 PORTLAND OR 97219 Phone i1: 293-2277 Pecs #. . : 40671 This Certificate grants occupancy of the above referenced br.tilding or- port; ior, thereof and confirms that the building his been inspected for r-ompl. ianrp with the State of lregan Specialty Lodes for- the grog_ occupaff-y, and use r.tnder. which the rp 'erenc:ad permit was issl.ied. �,�/ r. .x 66ILDINO iNSPECTtaR rW� y_ -~-�� A TL iNO OFF L iAL �4 r' ti FROST IN CONSPICUOUS PLACE t w ll v Community Development ELECTRICAL PERMIT APPLICATION i 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # ( LC Phone (503) 639-4171 Date Issued-I Ck FAX (503) 684-7297 Issued by CITY OF TIGARD TDD No. (503) 684-2772 Inspection (503) 639-41.15 _ 1. Job Address: 4. Complete Fee Schedule Below: Name of Development till /2-C Number of Inspections per permit allowed i 1 Address x 3 3 9 9 S w A L Service included: Items Cost(ea) Sum 1 City/State/Zi l J/L 4a. Residential-per unit % 4 '�/ 1000 sq It or Ives $11000 //� Name (or name of business) ����� f— �� J Each additional 500 sq It or portion thereof $2500 1 Commercial ❑ Residential' Limited Energy $2500 2 II Each Manurd Home m Modular Dwelling Service or Feeder W8 GO 2a. Contractor installation only: 4b.Services or Feeders Installation,alteration.or relocation 2 Electrical Contractor_ 200 amps or last $6000 2 Address 201 amps to 400 amps $8000 2 401amps to 600 am Ps $12000 2 City State Zip 601 amps Io 1000 amps $160 00 2 Phone N0. Over 1000 amps or volts $34000 2 Contractor's License Nc. Reconnect only $5000 _ Contractor's Board Reg. No. 4c.Temporary Services or Feeders Installation,alteration,or relocation 2 Signature of Supr. Elec'n 2n0 amps or lass $5000 2 License No. Phone No. 201 ampr,to 400 amps $7500 2 • 401 amps to 600 amps $10000 Ovaf 600 nmps 10 1000 volts 2b. 'or owner installations: see W above Print Owner's Nam - 4 if--e-HaNo Branch Circuits HI New,alleralwn or extension per papal Address ��� (I? L a)The tae for branch circuits with City /( State-f_ Zip 7 E ch b«u�arcurt or Nedar be. $500 Phone No. h)The lee for branch circuits without 1 tie installation is being made on property I own which is purchase of aawos or Molar fee. 2 riot intended for sale, lease or rent. Fest b'anch circuit $3500 ,/ Q�(� Each additional branch arcud $500 _ ()wner's Signature /L-- '' 4e. Miscellaneous T � (Service or feeder not included) 2 3. Plan Revi w section (if required): Each pump or irrigation circle $40 00 —_ 2 Each sign or outline lighting $40 00 Signal circud(s)or a limited energy 2 Please check appropriate item and enter fee In section 58. panel,alteration or extension $4000 4 or more residential units in one structure Minor Labels(10) $10000 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N.E C. Chapter 5 Per inspertion $3500 Per hour $5500 In Plant $5500 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: ' So. Enter total of above fees $ NOTICE 5%Surcharge(.05 X total fees) $ i PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ' AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 250 of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review it required(Sec 3) $ _ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. ❑ Trust Account N $ Balance Due $ r� ` rasl'nimrMYMrcirm SO `\ L/ /1\J '-�✓� \� /