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ASTER
PERMIT
CITY OF TIGARD Mf�RMIT #. . . . . . . : MST96-017:-
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/1Eii96
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 F'ARCE:I_: 1 S1 34AD—V14000
�3ITL ADDRE5G. . . : 10870 SW 108"111 AVE
SUBDIVISION— _- BLACK BULL F'ARK ZOhl I NCi: R--4. L
BLOCK. . . . . .. . . . . . L. . . . . . . „ . . . . . . :b
Remarks: fire repair inspector will verify work in field
------- ----------------------------------------------------------- BUILDING ---------------------- ---------------------------•--------
REISSUE: STORIES.......: 1 FLOOR AREAS---------- BASEMENT...: 0 sf REDUIRED SETBACKS---- REGUiRED-------------
CLASS OF WORK.:REP HEIGHT........: 18 FIRST..,.: 1510 sf C•ARAGE..... 451 sf LEFT,.........: 0 SMOKE DETECTRS: Y
TYPE OF USE....-SF FLOOR LOAD....: 40 SECOND..,: 0 sf FRONT.,.......; 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSNENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP.:R2 BDRM: 3 BATH: 2 TOTAL------: 1510 sf VALUE..$: 57000 REAR..........: 0
-------------- ---------------------------------------------- PLUMBING ----------------------•-- --------------------------------------
SINKS.........: I WATER CLOSETS.: 2 WASHING MACH..: i LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAP'S.........: 0
LAVATORIES....; 2 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: o SF RAIFI DRAINS: I CATCH BASINS..: 0
TUB/SHOWERS...: 2 GARBAGE DISP..: 1 WATER HEATERS.: l WATER LINE ft: 0 BCKFLW PK VNTR: 0 GREAS" TRAPS..: 0
OTHER FIXTURES: 0
--------------------------------------------------------------- MECHANICAL --------------------------•-----------•--------------------------
FUEL TYPES----------- FURN ( I@& ..: i BOIL/CMP ( 3HP: 0 VENT FANS...,.: 3 CLOTHES DRYERS: 1
/GAS/ / / FURN )=100K ,,; 0 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........; 0 WOODSTOVES....: 0 GAS OUTLETS,..: 1
------------------------- ------------------------------------ ELECTRICAL -_--------------------------------------------------------------
--RESIDENTIAL UNIT--- •--SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- --- MISCELLANi0U5---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 1 0 - 200 amp.,: 0 0 - 209 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 2 201 - 400 amp..: 0 201 - 400 amp..- � Isi p m SGCt0R: 0 SIGN/OUT LIN LT: 0 PER HOUR..,...: 0
LIMITED ENERGY,: 0 401 - 600 amp.,: 0 401 - 600 amp..: 0 EA ADM. BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
10004 amp/volt.: 0 ---------------------------•--------- PLAN REVIEW SECTION -----------------•------------------
Reconnect only.: 0 )=4 AES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC':
-----------------------------------•---------------- ELECTRICAL - RESTRICTE.D ENERGY ------------------------------------------------
A.
----------------------------------------------A. SF RESIDENTIAL--------------------------- B. COMMERCIAL---------------------------------------------------------------------------
AUDIO It STEREO,: VACUUM SYSTEM..: AUDIO 6 STEREO,: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM.,: 0TH: :: k BOILER........,: HVAC...........: LANDSCAPE/IRR1G: PROTECTIVE SIGNL:
GARAGE OPENER.,: CLOCK....,,....: INSTRUMENTATION: MEDICAL..,.....: O1HR:
HVr'IC............ DATA/TELE COMM,; NURSE CALLS...,: TOTAL I SYSTEMS: 0
Owner: ------------------------ ---------Contractor: ----------------------------- TOTAL FEES:$ 984.21
NORTHRIDGE REMODELING NORTHRIDGE RE110DELING
c430 SW UMATILLA 2,430 SW UMATILLA
PORTLAND OR 97202 PORTLAND OR 97202
Phone N: 2324260 Phone M: 323-0260
Reg C.: 104738
(1: I
N This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plan. This permit will expire if work is not started within IB0
�- days of issuance, or if work is suspended for more than 180 days.
_J ----------------------------------------------- ------ REDUIRED INSPECTIONS ----------------------------------------------------------
Post/Bear Mechan Electrical Ser-vi Gas Fireplace Mechanical Final
Crawl Drain Framing Insp Insulation Insp Plumb Final
-� GLM/Undt.-floor Shear Wall Insp Gyp Board Insp Building Final
Mechanical Insp Low Voltage Rain dr in Inip Erosion Control
Plumb Top Out Gas Line Insp kI E(gctr al Final
tU ,
I ermittee Signati-t-,e: -- iss1.tarj Fly :
Cali for inspection -- 639--4173
Residential Building_Permit ,application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
' � 6_1k
Subdivision: P� t 4 �� Lot # (r Office Use Only
Contact Date I I Initials
Valuation: — 7 ( i7 • b Result
New Construction Only: (Square Footage) Planck/Rec # Unk" _
{ — Permit # ir5 f -
House: /, Gar& / Reis:;ue of
Map•& 'f # ISI 3y� - at p
Corner Lot? Y N Flag Lot? Y N Zone,
Plat #
Owner: "
Address:
��rovals Required
—
Planning Setbacks Solar
Engineering
Phone: ( cj03 ) _3 D 0 (4jD_ Other --
Contractor: YU-6 C`-11 t2-i /> C Items Required
Subcontractors ��d
Addre . 2 �/3 b S 4�. Vr�'I r r��r� Truss Det,3ils
,60- 7d 02-
Other — -- —
Phone Notes _—
L ) -
Contractor's License # 3
(attach copy of current Oregon license)
Contact Name: —/,P, e, 22 —. — -
Contact Phone: 03 D 0� cJ
Subcontractors: Architect/Engineer:
Plumbing pz)t/^0Address: ---- T---- --��--- --
Mechanical: _—
(attach copy of current OR Contractor's License)
ti Phone
JOB DESCRIPTION: 9�4 (,(itG+�
ApWnt Sianatwi Applicant Phone number
Received by: L (-iQ '/ —_ Date Rereiv�d: —
N Ilwla.nv....0
Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) LQ 3c
Plumb. Permit (PLUMB)
Mech. Perrr.it
(ME!'H)
L rL � / (j
c ( () 4 0 .
Bldg:
Plumb: 7
Mech: v2.o
L o
E L R.
Plan Check (PLANCK) / G 0
Bldg: Z�i,7 6, o_
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSOC)
Residential TIF MF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1) _
Institwional TIF (TIF-IS)
Office TIF (TiF-O)
Water Quality (WQUAL)
cti
unWater Quantity (WQUANT)
Fire Life Safety (FLS)
J
,-r
`' Er,—ion ;;ntrl Permit (ERPRMT)
–' Erosion Planck/USA (ERPLAN)
r
Erosion Planck/COT (EROSN)
TOTALS: . Z ` ��7 1d)
CITY UF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Semite FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd
San. Sewer Gas Line Appr/Sdwlk ems
Other: L
Date: �� A.M.—P.MM. Entry: Z)
Address: 4-2 �y D
C"16 D
Tenant: �1 p_ Ste:---- _ MST:
/�(.!X CJT � y`[� -- --
Con/Own: MEC:,
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
z
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1
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7 -
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Inspector: .__ Dite:
APPROVED —DISAPPROVED/CALL FOR REINSR CF CO
CITY OF TIGARD BUILDIN1 INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plurnb.
Post/Beam Mach. Shear/Sheath Framing
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd.
San. Sewer Gas
Gas Line Appr/Sdwlk Reins.
Other: 'r"���1�`" �t't' r� (c
Date: �(L—_3 & A.M. 1_P.M. Entry:
7066
Address: L) 9 17. 0 w l --
Tenant: Ze& A Ste: /J,�MSTI%`�� 7 Z--
Con/Own: ' / MEC:
Yl ELC:
THE FOLLOWING Ct1 R`CTIONS Aaa'�RREEE REQUIRED: ELR:
r
J
C
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--- — Date:�. Q"
Inspector: -
APPROVED �qAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
ins.93ction Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FIN .
Foundation Water Line Ceiling -rig ulb.
Post/Beam Mach. Shear/Sheath Framing ` .
Plbg.Und/Fir/Slab Pibg.Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd, CO.
San. Sewer Gas Line Appr/Sdwik Reins.
Other: _
Date: G _ A.M.—P.M. Entry:
Addrass:
Tenant: // Ste: MST:_"Z2
Con/OwnLSC
1-4*"' r?d Ne-7 MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
a
caF--
N
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W
OF
Inspector:_ Date:,[/Z 3
_APPROVED _r;°APPROVED/CALL FO INSP---N CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -PIL!mb.
Post/Beam Mech, Shear/Sheath Framing -Mecl,.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Lin Appr/Sdwlk Reins.
WW �)JU
Date: 7- 5- 74- A.M. P.M._ Entry:.
Tenant:_ �_ 0 0 7c) Ste: MST:`IG' 0/
BLIP.
Co wn: MEC:
Aa,4(A4-I-Y44w �ay-7��'6 � FSC:
TktE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
V
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Lo -�-SLct.'It
My
Tpc�'
or. _ _ _ Date: _
ROVED _ DISAPPROVED/CALL FOR REIN SID, CF CO
L!
A, c.'
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing / Mech.
Plbg.Und/Flr/Slab Plbg. Top Out sulatio ./ -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Heins.
Other: _
Date: _ A.M.—PM Entry:
Address: 0 8 21) /0 $
Tenant: Ste:____ MST: QI
Con/Own: BUP:MEC:
PLM: _
ELC:
T6EFOLLO WIG CORREC-IONS ARE REQUIRED: ELR:
I
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kl)� "-._._._ ��cd.
111
Inspector: � _ , Date:
APPROVED —DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam M,?ci). Shear/Sheath Framing -Mach.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas IL',iiee,, Appr/Sdwlk Reins.
Date: A.M.--P.M./
Address: LO C
Tenant:_ 0 �70 _ Ste:_� MST: -'4'(.
SUP: _
Con/Own: MEC:
-77 J~" 3 -75� ELC: C�+
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: T
r
Inspector: l"`�
APPROVED __DISAPPROVED/CALL FOR REINSP CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service V/k1 FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Fram -Mach.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: U -- A.M. _P.M. Entry:
Address: l D R zo o �---�
Tenant: Ste: ST:
BUP:
Con/Own: � _ MEC:
� PLM:
l�w��� l u¢5 _
Y
THE F LLOW� C R9 NS ARE REOUIRED: ELR:
[�� 2-1
- .�
u
----
Inspector: Date:
`APPROVED 15APPROVED/CALL FOR REINSP. CF CO
r
"*Y,
CITY OF TIGARD BUILDING INSPECTION NOTICE
' 4P Inspection line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.t)nd/Flr/Slab Plbg,Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: A.M. _ P.M.____ Entry:
Address: _ xx
Tenant: _ _ - _- - ----- — Ste:, U
BUP; _
Con/Own: MEC:
PLM:
ELC:
THE FOLLOWI G CO RECT NS ARE PEQUIR'D: AR:
--- f Q
r _
I `=rte Ak'o t 5 --
10
`C1p f'Q�NZ G�
(-J7 "lr�-amts
frn!!�-
Inspector: Date. 1p
_.APPROVED ISAPPROVED/CALL FOR REINSP. CF CO
w
V
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling Plumb.
Post/Beam Mach. Shear/Sheath Frrmi ) Mech.
Ib .Und/Flr/Slab Plb .To Out In�� -Elect.
P g 9 P
Post/Beam Struct. e'ch, Rough n gyp. Bd. -Bldg. �I
San. Sewer Gas Line Appr/Sdwlk
Other: I ——
Date: (yQ 2:�,�D A.M. _P.M. Entry:
Address: !d 74) QT
Tenant: - _ Ste: _ MSTY6 DZ 7 Z
BUP:
Con/Own: _ _ MEC:
PLM:
ELC:
HE FOLLOWING CORRECTIO S A E REOUJJ;tED: , ELR:
V �(r) 11iJ%In �
J
ca _ t
r.
LLJ e7
J --—�—
nspector. _ —_.___— Data:: u 7
4PPROVEU —Do SAPPROVED/CALL FOR REINSP. CF CO
C:TY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service 1 " FINAL:
FoundPtion Water Line Ceiling //F -Plumb.
Post/Beam Mach Shear/Sheath CjLmInV�" -Mech.
Plbg.Und/Flr/Slab Pibg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: _ A.M. P.M. Entry: — - —
Address: a
Tenant: Ste: MST:g a
BLIP: _
Con/Own: _ MEC: _
PLM: _
ELC: _
TAE FOLLOWING CORRECTION ARE REOUIRED: ELR:
_ � C3
XS
Inspector: Date: 0
APPROVED _DISAPPROVED/CALL FOR REINSP. CF CO
/ �C3
l y CITY_0_PTIGARD BUILDING INSPECTION NOTICE —`
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Y
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other. ---
Date: ZI 2-7c)
A.M. P.M, En`n,.
Address: !. o �1-7 a _ D '�''` _
Tenant: Ste: MST: O�"7
BLIP:
Con/Own: �� y�U -�3`jl� _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS,ARF REQUIRED: ELR:
1
r-
w
w�
i
C- `r
Det 7100 0
APPROVED -.-DISAPPROVED/CALL FOR RFINSP. CF CO
CITY OF TICARD BUILDING INSPECTION NOTICE
Inspection Line. 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service F
Foundation Water Line Ceiling -Plumb.
Post/Beain Mech. Shear/Sheath Framing -Meeh.
PIbg.Und/Flr/Slab Plbg. Top Out Insulation -t.-
PosUBeam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
i
Other: _ ----- — _--- ----
Date: M. _ P.M._—. Entry:_ - - --
Address: _�' - -- ---- — -- - —
Tenant: _ _ __ Ste:- - MST: --
��y wry 6 BLIP:
Con/Own /0o S LU O . -- MEC: - --
ELC
THE FOLLOWING CORRECTIONS ARE REQUIPED ELR. --
/._4i��`�
on
Inspector' Date
ROVED _DISAPPROVED/CALL FOR REINSP. CF CO
_J
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Ploj To Qi Insulation -Elect.
Post/Beam Struct. Mech, Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date. —/- _-- A.M. P.M. Entry:
Address: - _ 77 6_,___ 9. Y--A_ i_
Tenant: Ste:___ MST: _
BUP:
Con/Own i _ _ MEC: _
PLM:
'THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
n_
V)
G]
Uj
J
G
—� _ Dater
_
Ins
_DISAPPROVED/CALL FOR REINSP, CF CO
CITY OF TIGAR '1-1 DING INSPECTION NOTICE
j' Insijection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line ,,-Aeiling -Plumb.
PosUBeam Mach! hea Shear/ / Framing -Mech.
Plbg.Und/Flr/Slab✓ Plbg. Top Out-)/��
' �lnsulation -Elect.
osUBeam Struct. ech -i�� G . Bd, -Bldg.
San. Sewer as Lin I� r/Sdwlk Reins.
Other: —
Date: � A.M. _P.M. Entry:
Address:
Tenant: _ Ste:��MST:
�" BUP: --
Con/Own: MEC:
PLM:
ELC: _
THE OLLOWING CORRECTIONS AREEQUIRED: ELR: ___
��
�- - A
J _>
S _ Le,41.1"-vim-A
Inspector: _ _�� _ Date:
_APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
J
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Phear/Sheath Framing -Mech
PIbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: A.M P.M.— _ Entry: _ —
Address:
'Tenant: _ Ste: _ MST:96
Con/Own: _ _ MEC:
PLM: _
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
uv_" --
lJ C
7
l �
Inspector: _ Date:
_APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
L�
- - - --- _
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Date: ,c J A./M. _P. Entry: 0
Address: —
Tonant Ste: -__ MST:O
''II p BUP:
/Own: 'S7 / MEC:
PLM:
ELC: ._
THS F LLOWING CORRECTIONS ARE REQUIRED: ELR-,
_ -_12
M,
Ln J
F-
1-r
h-r '
G] ,
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S ctor: _�/*l
at8/G'APPROVEDSAPPR VED/C NLL FOR REINSP. CF CO II
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line. 639-4175 Business Phone: 639-4171,
Footing Rain Drain Cover/` ,-ice FINAL:
Foundation W,,ter Line Ceiling lu
Post/Beam Mech. F hear/Sheath Framing -Meeh.
PIbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdv.,ik Reins.
Other:
Date:
_J__ /.
_1�- A.M.—:P.
M.-- Etry:_Dj—f)_
6`
Address: c7' It —. _
Tenant: .- _-- See:_—_ MST: � C�
BLIP: `—
Con/Own: --,- __—_-- NEC:
1 11 M:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
to pector: Date
PPROVED DISAPPROVED/CALL FOR REINSP CF CO
ELECTRICAL PERMIT
1o, OF TIGARD DAE PERMIT I SSUED:C04/1x
8/966
COMMUNITY DEVELOPMENT DEPARTMENT
131:6 SW Hall Blvd.Tigard,Oregon 97223.81 gg (503)830-4171 PARCEL.: 1 S 134AD-04000
i3f 1,1E PDDRESS. . . : 108 7k� SW 108TH AVE
SUBDIVISION. . . . . BLACK BULL PARK ZONING: R-4. 5
BLiJC1, . . . . . . . . . . LO''... . . . . . . . . . . . . :6
Project Description : tempgrary service for 1-rse di.rring fire repair
----RESIDENTIAL UNIT------ -----TEMP SRVC/FELDERS----- -----MIS.ELL_ANEOUS-----
1.000 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 1 PUMP/IRRIGATION. . . . : 0
EACH ADD" L 500SF. . . : 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . g 0
LIMITED ENERGY. . . . . : 0 401. - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
HANF•. HM/ SVC/FUR. . : 0 601+amps-1.000 volts. : 0 MINOR LABEL ( 10) . . . 0
----SERVrCE/1=E1_DER---- _- ----BRANCH CIRCUITS-------- ---ADD' l_ INSPECTIONS--
0
0 -- 200 Imp. . . . . . : 0 W/SERVIC:E OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 •- 400 a.q. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 16 -----------------PLAN REVIEW SECTION-----------__._. .___-
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = E25 AMPS. . : CL 4SS AREA/SPEC OLC. :
Owner: -------------------------------------------------- f EES -------•-•-----..._.._._._
NORTHRIDGE [REMODELING type amol-tnt by date recpt
2430 SW UMATILLA PRMT $ 50. 00 J*H 04/18/96 96--278356
5PCT $ 2. 50 J*H 04/18/96 96--278356
PORTLAND OR 9`7;1ZQ!
Phone #: 2321-0260
Contractor: ------------.----•.-_---__-----_.---_.---_--.-.----___--------._.__.___---------_...__.
VIKING ELECTRIC INC t 52. 50 TOTAL
4326 FiE WOODSTOCK STE 518
-- - - _ REPUIRED INSPECTIONS
PORTLAND OR 97,206 E l ect' 1 Ser-vice
Phore #: 775-34/9 Elect' 1 Final.
Req #. . . 056527
t
This pvroit is issued subject to the regulations contained in the .
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee i gnat ure
applicable laws. All work will be done in accordance with
approved plans. This perait will expire if work is not started , J4�
within 180 days of issuance, or if work is susperi.0 `or aore (.�1�
than 180 days. I ued By
---------------------------OWNER INSTALLATION ONLY-•.__----__-__-.------.-,_-_-,-_._---
Fhe installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S Si GNAI UREr: DATE :
-----------------....___._._CONTRACTOR INSIALLATION ONLY--
'�1 UNATURE OF SUPR. ELEC' N: _ DATE: ,
JJL. L DENSE IVU: __.____ _. ___-.--. .._.__._---.-•---..`---- .._......._._._.___.______._.______._.._...._._____.__.__� ___���_.___..- ..
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Call for inspection - 639-4175
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd
Tigard, OR 97223 Permit #
Date Issued _
Phone (503) 639-4171
CITY OF TIOARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address I C 7 ' :S h/ BE Service includedItems Cost(ea) Sum
City/State/Zip 'Ti� 4
tA,R D� �� 4a. Residential -per unit
1000 sq. ft. or less $11000— _
Name (or name of business)_.____ Each lino Soo eq n or
$25 00
portion on thereof . 1
62500
Commercial ❑ Residential [� Limited Energy —
Each Manufd Home or Modular 2
Dwelling Service or Feeder $6800
2a. Contractor installation only:
4b. Services or Feeders
Inslallalion,alteration,or relocation
Electrical Contractor VI(L 0(T 20u amps or less 4ou 00 2
Address 201 amps to 400 amps $8000 2
401 amp:.lu 600 ainps $12000
City __ State Zip- 601 amps to 1000 amps $18000 _ 2
Phone No. Over 1000 amps or volts $340.00 _ 2
Reconnect only $5000 2
Job NO. _
contractor's license NO. 4c. Temporary Services or Feeders
Contractor's Board Reg. No._, Installation,alteration,or relocation /
Signature of Supr. Elec'n 200 amps or less
701 amps to 400 amps $5000 2
License No. _ Phone No. ._ __ 401 amps to 600 amps $7500 2
Over 600 amps to 1000 volts $10000
2b. For owner installations- see"b"above
4d. Branch Circuits
Print Owner's Name— New,alteration or extension per pane
Address a)The fee for branch circuits with
—_— — purchase of service or feeder fee. 2
City_ State_ Zip_ Each branch circuit $5 00
Phone No. _ — b)The fee for branch circuits without
purchase of service or feeder fee. 2
The Installation is being made on property I own which is 2
First branch circuit $3500 _
not intended for sale, lease or rent Each additional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
..,/ Each pump or Irrigation circle $4000 2
3, Plan Review section (if required): Each sign or outline lighting $4000
Signal circull(s)or a limited energy 2
Please check appropriate Item and enter fea In section 5B. panel,alteration or extension S4000 —
4 or more residential units in one structure Minor Labels(IM $10000
Service and feeder 225 amps or more
4f. Each additional Inspection over
System over 600 volts nominal
the allowable in any of the above
Classified area or structure containing special occupancy
_. Per inspection _ $3500 _
as described in N E C Chapter 5 per how $5500 _
In Plant $55 00
Submit 2 sets of plans with application where any of the above
apply Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees g
NOTICE 5% Surcharge (05 X total fees) $
5b. Enter Subtotal g
PERMITS BECOME VOID IF WORK OR CONSTRUCTION tat of line ! for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review irest red (Seca) g
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED Trust 'tccounl #
g
Balance Due a Z• U
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
VIKING ELECTRIC INC
4326 SE WOODSTOCK 3TE 518
PORTLAN'D OR 97206
Electrical Signature Form
Permit # • . . . : MST96-0172
Date Issued. : 04/18/96
Parcel . . . . . . : 1S134AD-04000
Site Address : 10870 SW 108TH AVE
Subdivision. : SLACK BULL PARK
Block. . . . . . . . Lot_ . 6
Zoning. . . . . . : R-4. 5
Rema} I-,s :
fire repair inspector will verify work in field
Your company has been indicated as the electrical contractor for the permit indicated above. In
(older 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. No electrical inspections will be a-athorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
NORTHRIDGE REMODELING VIKING ELECTRIC INC
2430 SW UMATILLA 4326 SE WOODSTOCK STE 518
rc
PORTLAND OR 97202 PORTLAND OR 97206
Phone # : 232-0260 Phone # :
Reg 0565 7
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�(� ,�0 88S
Signature of-Supervising ectrican
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310