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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 -;--
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslao Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech. ��
Underflr. Insul. Shear Wall Gyp. Bd. Elec t.� `
Date Requested: qjc-- /� �Time- AM � M�
Address: a �' IF
/? /�f _ —
Builder: �' U yyS _Permit N: �
THE FOLLOWING CORRECTIONS ARE REQUIRED.
17
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In pector. �z Date: % Z�, `7
PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp. 2—V A
WASHINGTON COUNTY �ortation
RESTRICTED
Department of Land rans
�� 155Nirtl l pe Section ELECTRICAL ENERGY
155 North ' s Avenue, #350-12
Hills Ore
Oon 97124 /��'
Information-;,.f. 3) 640-3470 Fax: (503)693-4412 A P LI C/`1 , I o N
PLEASE"PR
Please . _ sections, . . Permit No. &L1?
1. Location of instil lla_tionu/ Date
Addres��oZ �
City 2�,,- Zip Code 9 7,�-� 4. Type of work:
Ma N�
Map Tax LU RESIDENTIAL Restricted Energy Fee $407o
nccinas Map Book: Page (p_ Section (for all systems)
1Ct1%l� d/ ^ .�r� Check type of work involved:
AD' ections C f
Audio and Stereo Systems'
C m rcial ❑ Residential [ _ alar Alarm S Systems'
Tenant Name Garage Door Opener"
(it commercial) Fire Alarm
Heating,Ventilation and Air Conditioning Systems*
2. Contractor application: Vacuum Systems'
Other
Electrical Contractor
Address �' COMMERCIAL Fee for each system $40.00
City w State0le Zip -S;43 (see OAR 918-260-260)
Date — Job ut'nb r Check type of work involved:
Property Owner
Contractor's Licanse No.
Boiler Controls
Ciontra.7tor'S Board Reg Ni). Clock Systems
Phone NoC: _ Data Telecommunications Installations
Fire Alarm Installation
3. Owner application: HVAC
Instrumentation
Print Owner's Name Phone No. Intercom and Paging System
Landscape Irrigation Control*
Address Medical
Nurse Calls
C'Ity state _ Zip Outdoar Landscape Lighting*
This permit is issued under OAR 918.320.370. The applicant agrees Protective Signaling
to make only restricted energy installa.lons(100 volt amps or less) Other
under this permit and to do the following:
1. Only use electrical licensed persons to do installations where
-- required. (Certain residential and other transactions are exempt Number of Systems
from licensing. These have asterisks('q. All others need licens-
�n Ing.)
Call for an Inspection when all the installations under this permit No licenses are required. L'censes are required for all other installations.
We ready for inspection.
.- 3. purchase separate permits for all Installations that are not ready 5, Fees
—� for inspection when the Inspe,:tor Is out to inspect under this
permit. Entet fees $ �(J
4. Assume responsibility for assuming that all correctlons required
by the inspector are done,and
j 5. Assume responsibility for calling for a final Inspection when all of 5% Surcharge (.05 X total above) $ ic�• 106
the corrections are completed.
rhe person signing this permit must tfe1j re applicant or a person Trust Account $ ,
authoriz d the appllc f.
signature Total $
Authority if other than Hppliramt _ This permit becomes null and void It the work authorized by the
permit Is not commenc:o within 180 days from date of Issuance
For Inspections call of such permit or It the ivork authorized Is suspended or abandoned
640-3561 or 693-4415 at any time after work is commenced for a period of f eo days.
Electrical Permits are non refundable and non-transferable.
24-hour rocorder, one working day In advancQ of need BL24.114
CITY OF TIGARD
MASTER PERMIT
PERMIT #. . . . . . . : MST94-0 5:3
COMMUNITY DEVELOPMENT DEPAAT11 kff DATE ISSUED: 07/06/94
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PARCEL: 1S136CA-03100
SITL C)DDRLka;3. . . 11c:1`-j SW 79TH AVL
.SUBDIVISION. . . . . FRIENDLY ACRES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT'. . . . . . . . . . . , : 10
BUILDING --- -- --
REISSUE: DWELLING UNITS:0 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:O BATHS:O GARAjE. . . . . . . . . . :528 sf
TYPE OF USE. . . :8F q„•� f LOC7R (AREAS- ----__.______. Rf_G?UIkED SETBACKS--___.____.__
TYPE CIF CONST. :5N FIRST. . . . :0 Sf LEFT. . :50 ft RIGHT. ;5 ft
OCCUa'nNC;Y GRP. :M1 SECOND. . . :0 sf FRONT. :0 ft REAR. . .,5 ft
)TORIE;S. . . . . . . : 1 THIRD. . . . :0 sf REOUIRED-HEIGHT. . . . „ . . . - 12 ft TOTAL _.._..___.._.:0 5f SMOKE DETECTORS. ;
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 3200 PARKING SPACES. . :0
Remarks : BUILDING A POLE LEARN 528 SO FT
PLUMBING
INKS. . . . . . . . . . :0 FLOOR DRAINS.. . . . :0 BACI{FLOW PREVNTR;:.'�. . :0
LAVATORIES. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :0 LAUNDRY TRAYS. . . :0 CATCH BASING. . . . . . . :0
WATER CLOSETS. . :0 SEWER LIME (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATER LIME (ft ) . :QI OTHER FIXTURE5. . . . . :0
GARBAGE DIST'. . . :0 RAIN DRAIN (ft ) . :0
WASHING MACH. . . :0 5F RAIN DRAINS. . :O
MECHANICAL - - ------- FEES
FUEL TYPES---------_--- UNIT HTRS. . :0 type amor.lnt by date rer-I)I
VENTS . . . . . :0 BPRT $ 44. :;0 JG 07/06/94 -
141X INPUT:O BTU VENT FANS. . :0 HPLC $ 28. 93 JG 07/06/94
1=" -
. �I B 1 -'C $ 2. : 3 JG 07/06/94 -
FURN 100K . . :0 HOODS •, "'
FURN ) =-100111 . . :0 WOODSTOVES. : ?i
FLOOR FURN. . . . :0 CLC) DRYERS. : 0
BOIL/CMR < 31-11" '.0 OTI-ISR UNIT5;IZI
GAS OUTLETS:O
R CURVES
3737 SW BEARD
C'ORTLAND OR 97219
Ph on e #t : x`45-x='881
Cont Tactor•: -------.__.___----______--
H I NKLE. INVESTMENT
21181 S FERGUSON RL
BEAVERCREE::K OR 97004
Phone #; 7$6•-9689
Reg #. . . 99695 ------ -------------------------
$ 75. 66 TOTAL.
'hss permit is issued subject to the regulations contained in the ------- REUUIRED INSPECTIONS;
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/fol.trid Insp
rLD applicable laws. All work will be done in accordance with approved Post/Beam 5tr•l-ict y, _
-' plans. This permit will expire if work is not started within IM Fr,am i ng Ins p
days of issuance, or if work is suspended for more than 180 days. Rain drain Insp _
r Bo_lilding Final _
I' oi-mi.ttee Si gnat l.lre :, l LTosion Control— '---- -- __”
d By ;
Call for inspection - 639--4175
INSPECTION NOTICE
City of Tigard Building Deparfaaat
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4 75 Busi as Phones 639-4171
Inspectione
Footing bg. Underslab Meeh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Lina FINALS
Post/Beam Struct. San r Framing ^ ��Eld .
Post/Beam Mach. Rain 11ra�j Insulation -Plumb.
Plbg. Underfloor c�Water Line Gyp. Dd. -Mech.
Date Requestedds l� 1 Times AM pM
Address:L►? J _ Permit f s Mt7T
• � r
Builders_ \/\�. Z
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors Dates
./ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
w n Call For Reinsp.
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 215 5 W 7� l
Office Use Only
Subdivision: t 4-c*,,j Lot #_/
Valuation:
(/" (� L Planck/Rec #
�
Permit#/1,5 t i(l" o,-�S 3
Owner: (Y. h. �.�c c,-e S _ Reissue of
Address: 3 7 lel _ - ,� r a �r'a''`� Map&TL # U
o 'L", .G
Approvals Required
Phone:
\ Planning_
Contractor: e — Engineering
Add.ess- , �,-,, Other _
JQJCf0Q� �
Q , p Items Reguired
Phone: -7 � � / �`' o
Subcontractors_
Contractor's License #_
(attach copy of currentOregon license) Truss Details_
Contact name & phone: �u_�.c��� Y� [�b" I �'U(� Other _
Subcontractors:
Plumbing:_
Mechanical:
(attach copy of ct;n'ent OR Contractor's License)
Architect/Engineer:
Address,: __ I
1�
-+ Phone:
JOB DESCRIPTION: r �o1C �rtit �^ w o_a S�
Applicant Signature & Phone number -
Received by: Date Received:_ _
Permit # Account Description Amount Amt. Pd. Bal. Due
�f/lZy Bldg. Permit (BUILD) 4�i -
Plumb. Permit (PLUMES)
Mech. Permit (MECN) _
State Tax (TAX) �� 3 Zt 2'3
Bldg. �n 3
Plumb:
Mech:
Plan Check (PLANCK)
Bldg: •--�3, L/(J
Plumb:
Mech:
Sewer Connection (SWUSA) _._._.
Sewer Inspection (SWINSP) _
Partes Dev Charge (PKSD(;)
Storm Drainage Chg (SDSDC) -
Residential TIF (TIF R) _ _ --
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _.—
Office TIF (TIF-0)
Water Quality (WOUAL)
Water Quantity (WOUANT)
Fi niCtrk-.f (FIRE)
Erosion Cntrt Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN) .
TOTALS: ' 5-2,33 ,
31 :3 `�
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CORNER
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PRESSURE TREATED
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