14888 SW 109TH AVENUE I :Y
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CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Half Blvd., TigardPERMIT #. . . . . . . : PLM97-001
,OR 97223 (503)639-4171 371
DATE ISPiJED: 01/4='1/97
PARCEL_ .'-SII.OAD-90029
SITE ADDRESI-" 1488kl SW 109TH AVE
SUBDIVISION. . . . : CANTERBURY WOODS CQNDOMINIUM Z(.-jNII\IG: RIc.
BLOCK. . . . . . . . . . . L.OT. . . . . . . . . . . . . :29
Ct-ASS OF WORK. . : PUP GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY Gf;P. . : R3 FLOOR DRAINS. . . . .. . : 0 TRAPS. . . . . . . . . . . . . . .. V,
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0
FIXTURES-------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. : 0
STNKS. . . .. . . . . . . : 0 URINALS. . . . . . . . . . . : 0 GREASF TRAP'S. . : 0
OTHER FIXTURES. . . . : 0
1 AVATORIES. . . . . .. ILA
TUB/SV,OWERS. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER UOSETS. . : 0 WATER LINE (ft ) . . . : 0
L)I SHWASHE RS. . . . : 0 RAIN DRAIN (ft ) . . . :
Remav,ks : REPi._ncEMENT OF WATER HEATER
Owner: FEES
1_'AROL._ WEIR type 'Amol_lnt by date v,ecpt
14888 SW 117.19TIA PRMT $ 25. 00 DRA 01/21/97 97-289205
1. ",5 DRA 01/2,1/97 97i::,692015*
TIGARD OR 9722�
Phone #: 684-9098
Contt'Ar-'tor':
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
*SEE ALSO MORLAN V,L,LIMBING*
PORTLAND OR 97206
mione. #.- 771 --1145 26. 25 TOTAL_
Reg #. . : 200734
RFOUTRED TN`7PECTIONS
This pet-pit is issued subject to the regulatio- -retained in Ue Water Line Insp
Tigard Municipal Code, State of Orp. Specialty Codes and all other Roi,igfi—in Insp
plirable laws. All work will be done in accordance with PLM/Un d e r-f.loon _
approved
oov-
approved plans. This permit will expire if work is not started Top—oi.tt Insp
within 180 days of issuance, or if work is suspended for sore Final Inspection
than 160 days. Final Inspection
Pet-mitte
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Is 1A e d D
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Call for- inspection 63,9-4175
CITY OF' 731GARD
DEVELOPMENT SERVICES PLUMBING PERMIT
".
13125 SW Hall Blvd., 77gard,0119;223 (503)63F4PERMIT 171 7S#. . . ' . . . : PILM97-00I..
1XITE
SUED: 01/21/97
PARCEL: '2S)- 10PD--900E'9
SITE ADDRESS. . . . 1.4888 SW 1091H AVE
SUBDIVISI.011. . . . - CANTERBURY WOODS CONDOMINIUM ZONING: R-Ic-
BLOCK. . .. . . . . . . . s LOT. . . . . . . . . . . . . :P9
CLASS OF WORV,. . -,REP GARBAGE DISPOSALS. t 0 MOBILE HOME SPACES. t A
TYPE:: OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY G141.). . :P3 FLOOR DRAINS. . . . . . . (b TRAPS.. . . . . . . . . . . . . . : 0
STORIES. . . . - - t- 0 WATER 1AEATERS. . . . . : I CATCH PAS I NS. . . . . . . : 0
F I XTURES--- LAI-INDR I TRAYS. . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . s 0 'J.' "NALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . . 0
I-AVATORIES. . . . . . 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . . .. 0 SEWER LINE ( ft ) . . . i 0
WATEP CLOSETS. . : 0 WATER LINE (ft ) . . . : 0
DISHWASHERF. . . . I el RAIN DRAIN ift) . . . c QA
,tempr-ks : REPLACEMENT OF WATER HEATER
f4iner,t
CAROL WEIR type aM01Ani-. by ciate i-ecpt
14888 13W IL719TIA P R MT $ 25. 00 DRA 01/21 /97 97-289209.
5pc"r* $ 1. 215 URA 01/2t"97 97-289205
TIGARD OR 972E4
Phone #-. 684--9098
Contrart;ot-r
13EORBE MORLAN PLOMBING
,3529 SE F. STER RD
o-13EF ALF33C, MORLAN PLUMPING*
' PORTLOND OR 97E,06
Phone #t 771 -I145 26. 25 TOTAI..
Reg #. . t 200734
REOUTRED INSPECI TONS
This permit is issued subject to the reyulatiot,. contained in the Water Line Insp
Tigard Municipal Code, Stati- af Cre. Specialty Codes and all other Rough--in Insp
applicable laws. All work will be done in accordance with PLM/Underfloor
approved plans. This permit will expire if work is not started TUP--ClUt ITIFp
within IN days of issualce, o if work is ittivendrd for more F' nal. inspection
than 180 days. Final Ivisper7tinn
i t t
CIO
`.i C:►ll for inspection 639-4175
CITY OF TIGARD Plumbing Application Recd By _
131.25 S* HALL BLVD. Commercial and Residential Cate Recd _
TIGARD, OR 97223 Date to P E.
1503) 639-4171 Cate to Pera sTt-P'T U'7/'t
Print or Type Related SWR x __
Incomplete or illegible applicotions will not be accepted caned-
Name of Cevelopment/Prolect FIXTURES (Individual) QTY PRICE AMT
Job Ern K; IA t"JA�e' Hre*' PC P;Otte Sink 9.00
Address Stre(et AGddressI tL Su to !zvatory 9.00
LI i 1
(5"j `U � Tub or Tub/Shower Comb.
9.00
t3ldg 0 Gtylstatr/ Zip Shower Only 9.00
t' („Y q V R "`�41 Water Closet
i
Name 9.00
G�YUl LA e1r, Dishwasher _
9.00
( owner Harling Address Swr.e Garbage nisposat
m j Washing rv,acrrn0 9.00
Crit'/Stat Zip Phone Floor Urain — 2. 9.000 3
9.00
Mame
(/1 Q 4 9.00
l oecup4ent Atwilliag Address r Suite Water Heater
9.00
Laundry Room ray 9.00
C+;v/Stste Zip Phone T Unna) DO
Hama
Other Fixt,.res(Specify) 9.00
/. 1
b✓I� 9.00
j Contractor Marling Adds � suite -90,(—) -_ .
i
�2 f(. J > ^.J Plll!!d >�1t'� 9.30
C.tyrState Zip Phone TOO
iu p' — n _ 9.00
O t on Const.Cont.Poart1 Lic. Exp.Date
AficA co"or CIL 3�� ��<{) 9.00
CuiwM Ptu-+►ting Lic.sExp.Date Sewer- 1st 100' 30.00
l lcert� U� 5 v yi Sewer-each additional 100' I 25.00 _ I
COT Business Tai or Metro s Ftp.Cate Water Service- ist 100' 3010
_ JI
Names ' Water Serwce-eaut additional 200' 25.00 j
Architect Storm s Rain Crain- 1st 100' 3000
Or Mailing Address '� Si ;e Storm d Rain Crain-each addrbonal 100'_ 25.00
Mobile Home Spar! 25 00
Englneer h'r - Zip Phone Commercial Back Flow Prevention Cevice dr anti- 25.00
_ I Pollution Cevice _
)escnCe worts New .:) Addition 0 Alteration 0 Repair 0 Residential Backflow Prevention Cevice' 15,00
o as dons: Residential O Von-residential O Any Trap or Waste Not Connected to a Fixture goo
kXtKkxul description of wont Catch Basin 9.00
insp.of Existing Plumbing 4000
verrhr
"S"use of — -- Sceaalty Requested Ins,ter-ions 40 00
Jding or property verrhr _
y Rain--•;rin singer family dwelliog 30.30
,000sed use of Grease Traps 900
building or propertyLD
_
t.0 QUANTITY TOTAL
'u Are you tipping. moving or replacing any fixtures? Yes C] No O I Iscmetnc or nser Jw9ram s reauinild J Cuanity Tctal u >9
ia.yas sit back of form) _ 'SUBTOTAL I j
I herebv acknowledge that i na,.e read this aeplication.that the information
liven.s :orect. ;rat I am the 3wner or authonzed agent of the owner.and 5% SURCHARGE r
71at clans-ibmitted are-n combliance with Oregon State Laws.
3ignaturs of OwneriAgent /J Daft@ / ] FLAN REVIEW 25% OF SUBTOTAL
°eau.ed on
M I-ba"41y tams>i TOTAL �
"CCoonI
Lwrt Person Name u( Phone ! L
'Minimum permit Ns is S25• 5%surcharge.except Residential Backflow,
Prevention Cevice,which is S 15 • 5%surcharge
%dsISNpimapp.doc 9/96
PLEASE COMPFL TE AS APPRIATE-LQ PROJECT:
Fixtures to be capped, moved or replaced Qty
Lavatory _
Tub or -Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3„
Water Heater
Laundry Room_ Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
;r
CITY OF TIGARD BUILDING M"PECTION NOTICE \
Inspection Line: 639-4175 Business Phone: 639-171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plu
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.!Ind/Flr/Slab Plbg. Top Out Insulation lec.
i
Post/Bearn Struct. Mech. Rough Gyp Su �>
San. Sewer Gaq Line A jpr/Sdwlk a n
i s.
Other: r 4l,Q &4 (.� 1 f" rL,
Date: AIM, P._M.__ Entry:
Address: �L — --� C� `. —✓ 1—+vt"�--
Tenant: f� G� Ste: _ MST:
I < BLIP:
Con/Own: � � rJ MEC:
PLM:
ELC: _
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELH:
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V)
m ----- -
LD
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Ins ctor. _( ___ ---�_ Date:�yL� /
APPROVED —DISAPPROVED/CALL FOR REIMSP. CF CO
CITY OF TIGARD BLILDING INSPECTION NOTICE
Inspection Line. 639-4175 Business Phone: 639 4171
Focting Rain Drain Cover/Service FINAL:
Foundation Water Line Ceilir P;urr,o.
Po,-�t/Beam Mech. Shear,Sheath Framing -Meeh.
PILq.Und/Flr/Slab Plbg. Tco, Insulation Elect.
Post/Beam Struct. Mecn. Rough in gypB -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Z
Date: A.M. P.M._ Entry:
Address:
Tenant: Ste:-__-_ MST:
SUP:
Con/Own- _ _-.. _ MEC:
PLM:
E LC: _
THE FOLLOWING CORRECTIONS ARE REQUIRED: - ELR:
L
7
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J
Inspector _. _ Date:y` 6
APPI OVED DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGAKD BUILDING INSPECTION NOTICE
It spection Line: 639-4175 Busir,esc Phone: 639-4171
Foot;ng Rain ;_rain Cover/Servica
FoundaJon Water Line ue!!ina umb.
Post/Beam Mech. Shear/Sheath ram" ech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation
Post/Beam Struct, Mech. Rough-in Gyp, Bd.
San. Sewer Gas Lined , r Appr/Sdwlk Bins.
Other: nl
Date: � A.M. �_P.M. E/ntry:
Address: `(_
Tenant;_ _ _ Ste: , MST
�b- ZZ , QIP.
�o -- —
Con/Own:_ �� -_ MEG:
_S-6 1(0 PLM:
ELC _
THE FOLLOWING CORRECTIONS ARE REO UIRED ELR:
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1
Inspector - - Date:y��'
-__ OVED DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING I0SPE,TION NOTICE
Iispection Lina: 639-4175 Busintss `hnn�e: 6,19-4171
Footing Rain Drain over/Sorvica� FINAL:
_--
Foundation Water Line Ceiling -Plumb.
Post/Bcam Mech. Shear/Sheath Framing -Mach.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mr,h. Rough-in Gyp. Bd. Bldg,
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: - -- - - - ---__--
Date: A.M._7_6RM� Entry:
Address: - --
Tenant:_ _ _ Ste: -__-- MST:
BUP:
Con/Own. MEC:
- --- - --- PLM:
EL.C: -THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
ef
rr (ILn
H
G]
�1
Inspector: n -
--- - - -- Date:
APPROVED —DISAPPROVED/CALL FOR REINSP. CF CO
Qs�
MASTER F,ERMIT
CITY OF TIGARD DATEIIS-,CUED: 03/27/96
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hah Blvd.Tigard,Oregon 97223.8199 (503)839-4171
,I Tf.F ADDRESS. . . : 1,413£38 SW i rT 9 TI( A)L
UDDIVISION. . . . : CANTERBURY WOODS CGNDOMINIUM ZONING;: R-1E:
'IuOCI: .---- -_-__-•-•_---- LOT.-- ----—•+---.- . . . :E9
_----- _•-----------------------------------_-----•-----
esarks: Colson garage re: pewits also for 14890, 14892, and 14894 sw 109th
BUILDING
-- STORIES.......: a POOR AREAS,-----_.._-_
...-, BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUI ----------
W01K. w HEIGHT........: Q r RST..,.: 0 s' GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS:
!SE...:MF FLOOR LOAD....: 2 °:FOND...: 0 sf FRONT.........: 0 PARKING SPACES: ,
-YPE OF CXT.:5N DWELLING UNITS: 0 FINDSMENT: 0 s; RICHT.........c 0
-CCUPANCY SRP.1R3 BDRM: 0 PATH: 0 TO'iAt--- --: 0 ;f VALUE..t: 3950 REAR..........1 0
--- -- -- --- ----------- - - ---------------•-- ------ PLUMBING --------------------------------------------------_--------------
-:NKS.........: 0 WATER CLOSETS.: 0 WN-' ING MACII..: 0 LAUNDRY TRAYS.: d PAN DRPIN' ft: 0 TRAPS.......... F
_aVATORIES....: A DI�)IWASHERS.... 2 FLOOR DRAINS..: 0 SEWER LINE ft. 0 SF RAIN DRAINS: 0 CATCH DA'INS..: 0
"1B/ i�iER 0 GARPAGE DISP..: 0 WPTER HEATERS.: 0 WATER LINE ft: 0 i,YrLW PREVNTR: 0 GREASE TRAPS..: 0
OTI4ER FIY.TURES: 0
-- ----- - ----.._. _ - _ .. ---_ ---- MECH4NICIV ---------- --- - -------------- ----- -- ...--- - .._.
-SEL TYPES----------- FURN ( 100K ..: 0 Ml',/C"'L' ( 3HP: 0 VENT FANS....,: 0 CLOTHES nRYERS: 0+
FL'RN )-I001( ..: 0 UNIT HLA rERS..: 0 HOODS... . .,. : 2 OTHER UNITS.. : 0
'AX INR.: 0 BTU FLOOR FURNACES: 0 ;rYTS........... 0 WGODSTnVF.S....: 0 GAS OUTLETS...: 0
-- ELECTRICAL -- -______.__..____________.____________________.._.._ __._• ,
RESI07NTIAL UNIT--- ---SERVICI'/FC SER---- --TEMP' SRVCIFEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS-- -ADD'L INSRfC'
:'-M SF OR LESS: 0 0 - 209 alp..: 0 0 202 alp... 0 WISVC OR FDR..: 0 PUMP/If' iGATION: 0 PER I145ECTIM;
:1 ADD'L 500r.,F.. 0 c61 400 asp..: 0 201 - 400 alp..: 0 1st W/O SVC/FDR: 0 SIGN/CLT LIN LT: 3 PER HOUR......: 2
IMITED ENERGY.: 0 421 - 603 a p..: 0 401 - 600 Sap..: 0 CA ADDL SR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......:
"INF HM/SVC/FDR: 0 601 - 1000 asp.: 0 601+asps-1000 V: 0 MINOR LABEL -10: 0
10004 asp/vo:`..: 0 ___________.._______.._...------.__. --_- PLAN REVIEW SECTION - --•_.__.__-_------_______..___...
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
--------_. EXTRIML - RESTRICTED ENERGY ----
SF
--SF RESIDENTIAL--------------------------- % COWRC.'AL---------------------------------------------------------------------------------
IJDlo i STEREO.: VAyINM SYTO..: AUDIO d STf.REO.: FIRE ALARM...,.-. INTERCOM/PAGING: ui1TCOOR UTSL LT:
"JRG.AR FARM..: OTH1 1: BOILER........., HVAC...........: LANDSCAPE/IRRIB: PROTECTIVE SIGN.:
-ARAGE OPENER..: CLOCK.. .......: INSTRUMENTATION: MEDICAL....,..., OTAR:
VAC.,.........: DATA/T'-'LE COMM.: NURSE CALLS....: TOTF # STEMS:
70TAL FEES:$ 0.02
-11 PROPERTY MANAGEMENT HORIZON RESTORATIM
-78 SW ARTHUR :6176 SW 72I'ID AVENUE
-ORTLAND CR 976101 TIGARD OR 911224
ire 0: 503-2cG-•229S Mcne #: `03-61-M1
Reg C., 46081
permit is issued subject to the regulations com;ained in the Tigard Municipal r•:e, State of are. Specialty Codes and all other
r,.:cable laws. All +orM rill be done in accordance with approved plp.ns. This p,n•sit will expire if worN is rot etarted within 180
lays of i,suar.:e, or if work is suspended for sore than 180 days,
RED1!Ikcu INS^ECTIONS
CO lectrica: hce:h Buildirg Pira? _
,`,' ,Ict�•icei Final -
;do' ng Insp -
��,`.atio* Insp —
:yp Board Insp
f
C39 4175 i
Residential Building Permit Application
City of Tigard
13125 SW Hall Bivd.
Tigard, OR 97223
(503) 639-4171/
Jobsite Addre s:
Subdivision: Lot# Office Use Only
.on: , no Contact Date / / Initials
Valua'_
Result
New Construction Only: (Square Footage) Oc
Planck/Rec #
Permit#_- /l `i! r - 0 o C�
House. Garage: Reissue of
Corner Lot? Y �' Fla Lot? Y N Map & TL# i�S/ ° - [ �< -
9 Zone
Owner: C
Plat '
y Address: r'� V
Approvals Required
ired
011 Planning Setbacks _ Solar
�1 Engineering
Phone: ( "� ) ZZ ^2ZQ�', Other
Contractor:
� Items Required
t'��
Address: I b C7 h � ��_111G1 Subcontractors _
Truss Details
a77-7—L( Other
Notes _1T 4 7
Phone ( �JU� 7�"`� �(`� 4 e1q
�
Contractor's License # �
(attach copy of currant Orego ► license)
Contact Name: .) — --�
Contact Phone:
Subcontractors: Architect/Engin,aer: -_
a
Plumbing: Address: _
v.
Me..h?nic;al:
�- (attach copy of current OR Contractor's License)
�= Phone:
JOB DESCR TON: a
Applicant Signature 11 Applicant ?hone number
Received by: _ Date 'received:
H vat,rr.v..rn
Permit S Account Description Amount Amt Pd, 1
Bal. Due
Bldg. Permit (BUILD) •
Plumb. Permit (PLUMB)
Meeh. Permit (MBC}!)
State Tax (TAX)
Bldg:
Pl1:mk:
Meer:
r
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWIfISF)
Parks Dev Charge (PKSOC)
Residential TIF Me-R)
Mass Transit TIF (TIF-MT)
Commercial T1F MF-C)
Industrial TIF MF4)
Institutional TIF (T1F4S)
Office TIF (T1F-0)
Water Quality (WQUA..)
h.' s
':Vater Quantity (WCUANT)
J Fire Life Safety ;)
c�
Erosion Cntri F ermit (ERPRMT)
J
Erosion Planck/JSA (ERPLAN)
?rasion Planck/CO T (EROSNI
TOTALS:
r
I
CITY OF TIGARD ELECTRPE RMITI#: ELCg6�0199
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: Oma:/08/96
13125 SW Hall Brvd.Tigard,Oregon 97223.8199 (503)639-4171
PARCEL: IM S 11 OAD--90029
SITE ADDRESS. . . : 14888 5W 109TH AVE
SUBDIVISION. . . . : CANTERBURY WOODS CONDOMINIUM ZONING: R--1:
BLOCK LOT. 9
Flt-o.ject Description : Install one branch circo_rit dr_re to storm damage.
---RESIDENTIAL UNIT---- --- TEMP SRVC/FEEDERS----- ------MISCELLANEOUS------
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 P'UMF'/i RR I GAT I ON. . . . : 0
EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
1_I Ih 1 TF_D ENERGY. . . . . : 0 401 600 amp. . . . . . . : 0 S I GNAL/F'ANEI.. . . . . . . : 0
MANE. HM/ SVC/,FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABE=L ( 10) . . . : 0
CIRCUITS ------ -----ADD' L INSF'ECTIONS_-
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEE')ER: 0 PIER INSPECTION. . . . . : 0
='01 - 400 imp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC- 0 IN F'LANT. . . . . . . . _ . : 0
601 - 1000 amp. . . . . : 0 _________.____--___---P'I_faN REVIEW SECT I ON
1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Uwner: ---- --- _-_._______.____._____._______________-----__.___-- FEES -------------- --
CMI PROPERTY MANAGEMENT type amol_tnt by date r^ecpt
7El SW ARTHUR F'RMT $ 0. 00 TMF' 04/08/96 STORM
5P'CT `h 0. 00 TMP' 04/08/96 STORIh
P,ORTI_AND OR 97201
Phone #: 503--2-24-2295
f_:o n t r-actor: ----_-.----------------_.--.--------...---------------------•---------------
ROSE CITY ELECTRIC CO $ 0. 00 TOTAL
4012 NE. CULLY BLVD
REQUIRED INSPECTIONS
-._._.._ ...
TIGARD OR 97 :13 Wall Cover, Elect' 1 Final
!-'hone #: 5503•-287-6164 Elect' 1 Service
Rey #. . . 3567
This penis is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other F'er,m i tt e e Si gnat sir-e
applicable laws. All work will be done in accordance with
approvers plans. This pervit will expire if work is not started
within 180 days of issuance, or if work is suspended for tore
than 188 days. Issued By
-
--------------------------OWNER JNSTALLATION ONLY-------------------- -__- -----
The installation is being madE on property 1 own which is not intended for
N sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
INSTALLATION ONLY-----------------------------
SIGNATURE
------------------•---------SIGNATURE Of: SUPR. ELFC' N: -��1 Gtt� ��f ._ _ _.. DATE: 1 �Q=��__�
L...J CENSE NO:
Call for- inspection ._ 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec.
r'armit # &AL 9
Phone (503) 6,'9-4171 Oate Issued 8- 46
CITY OF TIGARD FAX (503) 684-7297 Issued by Cfiar/er
TDD No_ (503) 684-2772 SLS'm' Zf
Inspection (503) 639-4175
1. Job Address: �� 4. Complete Fee Schedule Below:
Name Of Developmerlt�, n/ Number of Inspections per permit allowed
AUdress l qxa S ��SG `r-= Service includod: Items Cost(ea) Sum
City/State/zip �� _ 4s. Residential-per unit +
1000 eq it or lose $11000
Each additional 500&7 It or
Name (or name of business) portion thersof $2500
Commercial❑ Residential 2Limited Energy SL2500
Each Manurd Home or Modular 2
Dwelling Servica or Feeder $88 00
2a. Contractor Installation only:
46.Services or Feeders
Itr:tallalmn,alleration,or relocation 2
Electrical Colitractor 200 amps or loss $6000 2
Address Q Z 201 amps to 400 amps $8000 2
! Zip 401 amps to 000 amps $12000 2
City State
801 amps to 1000 arnps $18000 2
Phone No. _ Over 1000 Amps or volts $34000 2
Contractor's License No. Raconned only $1,000
Contractor's Board Reg. No_STG., 4c. Temporary Services or Feeders
hevlalInlron,alteration or relocation 2
Signature of Supr. Elegy.n 200 amps or nese $5000 2
License No. �. 75 _ Phone No. 201 amps to 400 amps $7500 2
401 amps to B00 amps ston 00 _
CTier 800 amps to 1007 volla
2b. For owner installations: 800W above
4d. Branch Circuits
Print Owner's Name New,alternbon or extension per panel
Address n)The fee for branch circuits with
purchase of serybe or Areder Are 2
City State Zlp, Each branch circuit $500
Phone No. _ b)The fan for branch circuits without
The installation is being made on property I own whicn is purchase or service or feeder Am. 2
Fust brarich orcurt $3500 .�-1 _
not intended for sale, lease or rent. Each additional branch urcu;t $500
Owner's Signature- _ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump nr irrigation circle $4000 2
Each sign or outline lighting $4000
Signal cimun(s)or a limned energy 2
Please check appropriate Item and enter fee Irl section 58. pnnel,aneratioo or extenvon $4000
_4 or more rasidential units in one structure Minor Labafs(101 Wo 00
Service and feeder 225 amps or more
N System over 600 volts nominal 4f. Each additional inspection s
ti Classified area or structure containing spocial occupancy the allowable in any of the above
F as described in N E C. Chapter 5 Per napar,t-, $35 00 _
_ Per hour $55 0n
—t In Plant $55 of
Submit 2 sets of plans with spplicacon where any of the aboveco
apply. Not required for temporary construction serulcee. Jr. Pees:
-' NOTICE 5a. Enter total of above fees $
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF Wvr,K OR CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review -quired(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account N
$
—
Balance_Que �_— s --
f�
. -oT.e
r CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 i
Footing Rain Drain Cover,/Service FINA .
Foundation Water Line Ceiling -Plumb.
Post'Beam Me& cheer/Sheath Framing -Meeh.
Plbo Und%FIr.-Slap Plbg. Top Out Insulation -Elect.
PostlBeam Struct Mech. Rough-in Gy -Bldg
San. Sewer Gas Line Appr'SdwlH. Reins.
Other
Date_ A.M ___P.M.__. Entry'
Address
Tenant: _ J �SL � 5te"�'� MST:(_�y1C-_'
BUP:
Con!Own: — MEC:_
PLM:
ELC:
THEFOLLOWING CORRECTIONS ARE REQUIRED ELR: !i
-v'--� �
}
J
� � n
—' Inspector Date. P
R70VED __DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
iiispectionn Line (Rec-O-Phone): 639-X4117.5 Business Phone: 639-4171
Inspection: SS
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL.:
Post/Beam Mech. San. Sewer Gas Line -Bidg.
Plbg. U,iderfloor Rain Drain Framinc -Plumb.
Alarm Water Line Insula- )n -Mech.
Underflr. Insul. Shear Wall Gyp. Bi- -Elect.
Date Requested: 17/� /S Tir AM p PM
Address: �� 1
Builder:_`� Q Zs JPermit --t��—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
c-'r-c-S,�
- 7--
1 �, A
� Inspector. Date: 1 -2-A
_APPROVED _DISAPPROVED —APPROVED SUBJECT TO ABOVE
w
J
Call For Reinsp.
Li
J
•
City of Tigard, Oregon Si000
g
Detailed Damage Assessment Form
BUILDING DESCRIPTION: OVERALL RAPING; (Check one)
INSPECTED(Green) ❑
Name: LIMITED ENTRY (Yellow) ❑
c 4, I C. — UNSAFE (Red)
es
Addrs: `o® S�*J cxo,�+ �_ -
4
No. )f Stories: DATE _ �1)�S TIME �` am6
Basement: Yes ❑ No-'J4' Unknown ❑
Approximate Age: years REPORTED BY
Approximate Area: square feet
INSPECTION TEAM MEMBERS
Structural System:
Wood Frame Unreinforced -nasonry ❑
Reinforced Masonry 0 Tilt-up O
Concrete Frame O Concrete Shear Wall ❑
Steel Frame ❑ Other
Primary Occupancy:
Dwelling ❑ Other Residential ❑ Commercial ❑ Notified occupants to vacate
Office Ll Industrial LJPublic Assembly L1pI'emis�s�'�
Occupants indicate temporary housing
School ❑ Government ❑ Emer.Serv. ❑ is required ❑
Hospital ❑ Other
Instructions: Complete building evaluation and checklist on next page and then summarize results below.
Posting Existing Recommended
None ❑ Posted at this Assessment:
Inspected(Green) ❑ 'Yes ❑ No
Limited Entry(Yellow) ❑ ❑ /Existing posting by:
Unsafe(Red) ❑ �
Area Unsafe ❑ ❑
'- Recommendations:
;= Cl No further action required
❑ Engineering Evaluation required (circle one) Structural Geotechnical Other _
Lo ❑ Barricades needed in the following areas:
l,
O Other(falling hazard removal,shoringlbracing required,etc.):
Comments (Why posted Unsafe,etc_.):
Tp _—�k_ 5Jt tpb9-"
Sheet of