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CITY OF TIGARD BUILDING INSPECTION DIVISION (
MST �6 , 3 41
24-Hour Inspection Line: 639-4175 Business Line: 639-071
BUP _-
Date Requested AM PM .—,-- BLJ —
LocationM C C` �1��1 & Suite MCC
Contact Person Ph PLM
Contractor Ph 'SWR —,•�__
BUILDING Tenant/Owner _ EL(;
Reta`.:;rq Wail FLR
Footing Access: �„� FPS
Fou.idation I �1 rJy- ��,�j Q _-
Ftg Drain --- SGN
Crawl [Drain I In- =
Not ot Requested — SIT
Post& Beam Fouhd During Research
Ext Sheath/Shear No lnsnertinnlcl In File -- — --
Int Sheath/Shear
Fr ming -------- ---- - — ----------- --
Insulation
Drywall Nailing --__-_._ - _ -- ----------- -----
Firewall
(Fire Sprinkles ----- --- -- --- -- ----- _-
Fire Alarm
Susp'd Ceiling _--.--- - ---- - ----- - -- -- ----
Roof
Misc._ ........-- —_.. _ ---- - ------ --------- -
Final ----_-_—
PASS _PART FAIL ----- __. . ------.__-- _-- ------__._
PLUMBING
Post& Beam --- -----___-- ------------__--_ - - ----- --
Under Slab
Top Out
Water Service
----------------------------- — --- ------
Sanitary Sewer
Rain Drains - -- --------____-- _----_ —
Final
PASS PART FAIL
MECHANICAL
Post& Beam --- -------- -- --
Rough In
Gas Line --- --- -- - - - _— -_
Smoke Dampers
FinalF 'S
l ----- --------------- --- ----- -------- - -
PASS PART FAIL _��
ELECTRICAL_ � --- _ _ ---- ------_.---- _--_
Service
N Rough In
vi UG/Slab -------- - ----... -- --- --- - —-
Low Voltage
Fire Alarm I -------------- -------- -- --- _ —. --— -
C Final
BASS PART FAIL -- — -- -- --- - - ---- — --
u, SITE
Backfill/Gradino
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$- — required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ] Please call for reinspection RE' I 1 P
Fire Supply Lire ----__.� Unable to inspect-no access
ADA
Approach/Sidewalk
Date ]nQnecto, Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
MOSTER c,FRMIT
CITY OF TIGARD Df I*E I�iSUED: 02/27 9E
COMMUNITY DEVELU"`MENT' DEPARTMENT
13125 SW Hall Blvd.Tigird.Oregon 97223.8199 (503)839-4171 F'At'RCEEL: -51 L OAD-9k9074
SUBDIVISION. . . . : C•ANTERLAURY WJJDS CONDOMINIUM ZONING: R--12
131-OCK. . . . . . . . . . . I.0T. . . . . . . I . . . . . : 74
Remarks: Repair due to store damage. No fee as_essed.
PATH I
--------- BJILDING -------------•------------------- ---------•-----------�__
REISSUE: SYORii.S..•....: c FLOOR AREAS-------- - BASEMENT...: 0 s; REQUIRED SETBACKS---- REUUIRED-------------
CLASS Or WORK.:REP HEIGHT........: 0 FIRST....: 0 sf ;ARAGE.....: 0 sf LEFT..........1 0 SMOKE DOECTRSr
TYPE OF USE....SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.........: 0 PARK.. : SPACES: 0
TYPE OF C(1NSi.:5N DWELLING U41TS: 0 F(NBSMENT. 0 sf RIGHT....... .: 0
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL-..- 0 sf VALUE..1: 58000 REAR..., .....: I
PLUMBING ---------------------------------------------------------------
SiNKS.........: 0 WATER �LOSETS.: 0 WASHiK MACH..: 0 LAUNDRY TRAYb.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 Sf RAIN DRAINS: 0 01CH BASINS..: 0
TUB/SHGWERS...: 0 GARAAGE DISP..: 0 WATER HEATERS.: 0 WA70 LINE ft: 0 Btd'PLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER F19% t::• 0
-------------------- -----•-----•------------------------------ MECAANIU
FUEL TYPES----------- FURN ( 1009 ,.; 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 0 CLOYHES DRYERS: 0
/GAS/ ! / FURN )=10N ..: 1 UNI1 HEATERS..: 0 HOCDS.........: 0 OTHER UNITS. .: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........1 0 WOOLSTOVES....: 0 GAS OUTLETS. .: 0
-------------------------------------------------------------- ELECTRICAL -------------------------------------••--- --------------
--RESIV.NT1AL UNIT--- ---5EAVICE/FEEDER----- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOU3---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 0 0 200 amp..: 0 0 -• 200 amp..: 0 W/SVC UR FDR.. : 0 PUMP/IRRIGATIDN: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 2201 - 400 asp... 0 201 - 4oJ amp..: 0 1st W'J SVC/K'R: 0 SIGN/OUT LIN LT: 0 PER HOUR......: B
LIMITED ENERGf.: 0 401 600 amp..: 0 401 - ;40 asp.,; 0 EA PDDL BR CIR: 0 SIGNAL/PANEL...: .� IN PLANT......: 0
MW HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+a1ps-1000 v: 0 MINOR LABEL -18: 0
10G as ivait. 0 -- PLAN REVIEW SECTION -----_-------_________________...
Reconrect only.1 0 )=4 RES UNITS..: SVC/FDR)a225 A.: r 600 V NOMINAL: CLS AREA/SPC OCC:
----—---.-_-____.____------------_.------------------- ELECTRICAL - gESTRICTED ENERGY
A. SF RESIDENTIAL---------------------------- B. COMMERCIAL----------------•------------------•---------------------------------------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR I_NDSC LT:
BURGLAR ALARM..: OTH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTI'E 51GNL:
GARAGE OPENER..: CLOCK..........s INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATNTELE COMM.: NURSE CALLS....: TOTAL II SYSTEMS:
Gnne►--- .._-----------------------------------Contractor: ----------------------------- TCTAL FEES:1 0.0Q
1ARJORIE MILLER HORIZON RESTORATIONS
14990 SW 109TH 16176 SW 72ND AVENUE
TIGARD OR TIGARD OR 97224
Phone N: Phone A: 503-62'@-22^15
Reg C.: 46081
This permit is issued yubjeci to the regulations contained in the Tigard Municipal Lole, State of Ore. Speciaity Codes aria all other
appilcabie lams. Ali work will be Done in ALCordance with approved plana. This permit viii expire if work :s not star•teo within 160
days of issuance, or if Run• is suspended for more than 180 days.
-----.. ------------------------------- REQUIRED INSPECTIONS
Mechanical Insp Insulation Insp Plumb Final
Plumb Top Out Gyp Bnard Insp Buiiding Final
Electrical S^rvi Rain drain Insp
Framing Insp Electlical Final
Low Voltage Mechanical F:
r _
of'1-Mi.ftae 5 iyl:zt1_:I•-e 155 .ecl Cly :
G�11 fur in�p >c:tion - .39--4175
Residertial Builciing permit Applicatior
City of Tigard
13125 SW Haid Blvd.
Tigard, OR 97,2123
(503) 639-4171
Jobsite Address: _•. i—1 � !1-�.5�__-�L=�
Subdivision: _ Lot# Office Use Only_ _
_T ���_ Contact Date �k/�l / �.' Initials
Valuation: Result
New Construction Only: (Square Footage) Planck/Rec #
House: _ Garage: Permit #
Reissue of N 14
�/ z
;orner Lot? Y N Flag Lot? /o ID,
1 II Y N Zone Map & TL#
��11 Pla #
Owner: '�---'
Address: 10,1 4 ! gpLoMals Reqs "fired
Planning Setbacks 1 f0 Solar
l Engineering rJ/t�
Other
Contractor: �
� r76 _ rte/ C 4 Items Required
�?,r' -t,�(� t'[_
Address: � H � SIJ , Subconua,.tors
�1 Truss Details
Other -- ---
Notes
Phone: _ (`
cJ/„�Q
Contractor's License # (6OF)L
(attaFh copy of current Oregon license)
Contact Name: _ ok)
Contact Phone: `�—
Subcontractors: QQ Architect/Engineer:
R r`' Plumbing: SU C ,L 11Lw 'ty I Address:
N
Mechanical:
(attach copy of current OR Contractor's License)
f a Pl �� ` j i i Phone: ( )
cc ----
JOB DESCRIPTION: L-
Y c-y 05� 1CQ (Y2:2�'
Applic nt Signature 1 Applicant Phone number
Received by: """ Date Received:
Permit S A."aunt Description Amount Amt Pd. BaL. Due
r
Bldg. Permit (Rutu)
Plumb. Permit (PI.'?As) C)
m4ch. Permit (N,ECH) U
State Tax (TA X)
Bldg: 0( ,(,-,/
,(, ,�
Plumb: U 0
Mach: U � r B
I
Plan Check (Pt.4NCK)
Bldg: U '
Plumb:
Much:
Saw-or Connection (SVIUSA)
Sewer Inspection (SWINSP) _
Parks Dev Charge (PKuDC)
Residential OF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (T1F4)
histitutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
'erosion Cntrl Permit (ERPRNVIT)
Erosion Planck/USA (ERPLAN)
rosion Planck/COT (EF(ISN)
r � /
TOTALS: �; C'�r �•?r �, Civ
..moo
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it
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Ap
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64
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CITY OFTIGARD BUILDING INSPECTION NOTICE
ktspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Coilirl Sprink. ?nugh-in Ap; Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas L no -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulati n -Meeh.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: _ _ _Time:---AM PM
Address: Ct V U �`
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED: �
�.,� 7
Inspector:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Iof Call Fr r Reinsp.
I
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phony: 639-4/175 Business Phone: 639-4171
•Inspection:_ �-'1�1/� CIrC : �r
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplacb
Pos(/Beam Struct. Plbg. Top Out Elec. Ror,;" FINAL:
Post/Beam Mech. San. Sewer Gas line -Bldg.
Plbg. Underfloor Rain Drain Framing -Pll;rnb.
Alarm Water Line Insulation -Mech.
+t
Jnderflr. Insul. Shea: Wall Gyp. Bd. -Elect
Date Requested: _i Time:_ AM PM
Address:_ 1
Builder: Permit #:
THE FOLLOWING CORRECTIO14S ARE REQUIRED:
`T �e.
00
LA
a ./ltitti. 71-�v-
04
In—spactoror. `-�J _ - Date: Z 1
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
�"7 ' Call For Reinsp.
K l C)Z
tj
X50 laao
City of Tigard, Oregon ,,
Detailed Damage Assessment Form
BUILDING DESCRIPTION: OVERALL,RATING: (Check one)
INSPECTED(Green) ❑
Name: _ LIMITED ENTRY (Yellow)
J
_ UNSAFE (Red) ❑
Address: 1 "�°l0 6"A `Q
No.of Stories: _ — DATE 1:1ti3 aS _TIME 3'tS am �m
Basement: Yes ❑ No ❑ Unknow-i ❑
Approxima',e Age: _ years REPORTED BY
Approximate Area: . square feet INSPECTION TEAM MEMBERS
Structural System:
Wood Frame ❑ Unreinforced inasonry U —
Reinforced Masonry ❑ Tilt-up ❑
Concrete Frame U Concrete Shear Wall ❑
Steel Frame ❑ Other _
Primary Occupancy:
Dwelling ❑ Other Residential ❑ Commercial ❑ Notified occupants to vacate
Office ❑ Industrial U Public Assembly 0 premises ❑
Occupants indicate temporary housing
School ❑ Go emment L] Emer.Serv. ❑ I is required ❑
Hospital U 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) ❑ ❑ 2sting
es Ll No
Limited Entry(Yellow) ❑ ��! posting by:
Unsafe(Red) ❑ L1
Area Unsafe U U
Recommendations:
❑ No further action required
Engineering Evaluation required (circle onStrul,f,,, C:;eotechnlcal Other
❑ Barricades needed in the following areas:
U Other(falling hazard removal,shoring/bracing required,etc.):
Comme 4(Whyposied Unsafe,etc.): _ Awv 2,j AIA Ali 11Uv Q►� ►U
- — -
q&-44- I S . -CUT
"N , ? `�c ��.� Sheet of
�CO.v►.��� ��t�-5����M�l `� ��ea�� ��� �.J���� c� �`►�2c.M.�c�v�o�1 ���(���ra�) `'!\`^J1\t��
COIN A ELECTRICAL PERMIT
®FT
I� RD DATEJISSUEDI:CO2�/09//96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orapcn 97223.8199 (503)639-4171 PARCEL: 2S 1 10AD-90074
1 11_ :�01)itL' o. 1'+`�`J0 :w! 10`-)1 i i 1-IVL
.,J'uDIVISION. . . . : CANTS'RBURY WOOLS CONDOMINIUM ZONING: R-10.
'_ -UCK. . . . . . . . . . . I_01`. „ . . . . . . . . . . . .7ir
roJect Description: ins' i11 two branch curcLtits.
RESIDE?;TIAL UNIT----- ---TEMP SRVC/FEEDERS---_ -._---MISCEL..LANEO1JS------
000 SF OR LL-.i3. . . . : 0 0 - 200 <amp. . . . . . . . it PUMP/IRRIC=aTION. . . . : 121
;AC H ADD' I. 5'?1OSF. . . : 0 x.:01 -- 40VI amp. . . . . . . : 0 SIGN/OUT LINE” LTG. . : 0
_IMITED ENERG �. . . . . : 0 401 --• 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
,IANF. HM,, SVC/FDR. . : 0 601+amps;--1000 volts. : 0 MINOR t_AB�:L._ ( 10) . . . : 0
-----SE:RVICE/FEEDER ----- CIRCUITS--____ -.__._..ADD' L 1NGFECT ION;'
1 -- 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
.7:01 - 400 amp. . . . . . : 0 1st W/O ERVC OR FDR. : 1 PER (JOUR. . . . . . . . . . . : iii
r01 - 600 arcip. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
1000 amp. . . . . : 10 -..__._.__._._._.____.__.__.._FLAN 13EVIEW SECTION------__.-__-..._.-._..--
' 000+. amp. Volt. . . . . : lb ) =4 RES UMTS. . . . . . . . : ) 600 VOLT NOMINAL. . :
'teconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CI.ASS i-1RE A/5PL_C UCC. :
:Jwner,. _____..._.__ _____.___._______....__._.__-_.__.___.______ _________ FEES
'_'ANTERBURY WOODS type a.mol.lnt by date r-ecpt
4990 SW 109TH PRMT $ 40. 00 CJS 02/09/96 9E-275798
SF-*,CT $ x. 00 CJS 02/09/96 96-2757'")0
16NR1) 0R 1)722:s
,hon-? It:
,ontr"actor• --_-_.-....._,......_.....---._.._._----._._..-.-.---__._.________.___.
/ ;OSE CITY L_.L1=CTR I C CO INC $ 42. 00 TOTAL
11 NE CULLY BLVD
REQUIRED INSPECTIONS
ui� ILPND OR X3'7,_13 Elect' I. Service
'hone #: Elect' I Final
his peratt is issued subject to the regulations contained in the _
-igard Municipal Code, State of Ore. Specialty Codes and all other r,er•m i tt ee Si gnat Lire
applicable laws. All work will be done in accordance with
,pproved plans. This permit will expiry if work is not started
,ithin 180 days of issuance, or if work is suspended far• more
nan 180 days. I s s Lted by
INSTALLATION ONLY-
'Fie
NL_'Y'Fie installt:ttion is tieing mAde on property I own which is not intended for
ale, if ease, or rent.
iWNE R' S SIGNATURE: _ �_ ___. _ DATE t
--- -L"ONTRACTOR I PJ5TALLF T I011
J
a� IGNATURL OF SU;--R. ELLC' N: DATE e
_I UFNSE NU:
Call for inspection - 639--41.75
i.
1. + I 1 11! I ' 1,111;11 111 � I il ' I lil 1 � 1 .1•II %il I.I 1 I- il ' I I'd11. �e.•
� i !I 1 ,I. I n'll Il!i•I I 11 I
�,1, � � t1,1ri111 1111 I '+ 1-11 1'11 1'11'rhli III 11i-111 ,_ 1-1, ; 1,1 „ �.�
1'(AYIvlf.N'f (OR 10;41 It.011 X10141101.1 1.11 1 111,011,14 1 c11,11AIN I I'1111t
A11T1. y11j4 S t. !"11_!1 1.i/ 1-'f ht
161,l
I (11f1f 1111111011 1'11111 7 U1M�1
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # .9G- .2 -7579,-P
i
Permit # iF4C ; oop_3
' Phone (503) 639-4171 Date Issued L;l - 96
CITU'OF TIGARDFAX (503) 684-7297 Issued by /c-r Sc Ar""dl _
TDD No. (503) i.,84-2772
Inspection (503) 639-4175
1. .lob Address: ( UX01 4. Complete Fee Schedule BE hcw:
Name of Development ' 1 1 l �� L L, Numb(w of Inspections per permit allowed
Address Service included: Items Cost(ea) Sum
City/.(.')tate/Zi 4s. Residential-per unit 4
1000 sq It or Wes $11000
Name (or n me,of busi SS)^ Each additional 500 att If or 1
portion thereof $2500
Comrnercial Residential ❑ Limited Energy $2500 __�__
Each Manu1'd Home or Modular 2
Dwelling Servioa or Feeder $6800
2a. l^ontractor tallati n only:
4b.Services or Feeders
Install lion,alleraf on,or relocrdion 2
Electrical Ca ntractor zoo amps or lees $6000 2
AddrPS3 201 amps to 400 amps _ $8000 2
Cti — 401 amps l0 600 amps $12000 2
y D AA State Ip 601 amps to 1000 amps $18000 2
Phone No. Q I Co Nor 1000 amps or volts $34000 2
Contractor's License No. �,1_(� Reconnect only $5000
Contractor's Board Reg. No. 4c.Temporary Services or Feeders
Ins latnon,afteratior,or relocation 2
Signature of Supr. Elec'n f- 200 amps or less $5000 _ 2
` 201 amps to 400 amps $7500 2
Licen_,e N� one NO ) 401 amps to 800 amps $10000
Over 600 amps to 1000 volts
2b. For owner installations: an*•I)'above
4d.Branch Circuits
Print Owner's NameNew,alteration or extension per panel
Address a)The lea for branch circuits with
Cihr State Zip purchase of service or Assder Are. 2
I�hOnla N0. Each branch circuit $500
_ _ b)The tee tot branch ctttuda wffhoct
Fhe installation is being made on property I own vol „I I Is purchase of service or Areder he. 2
Fimt branch circuit $3500 3 S, 2
not inl,ended for sale, lease, or rent. Each additional branch circuit �_ $500
,)wner's Signature_ 4e.Miscellaneous
(Sorvic9 or feeder not included) 2
3- Plan Review section (it required): Each pump or itngahon circle $4000 2
Each sign or oulline lighting $4000
Signal circuit(s)or a limited energy 2
Pltwee check appropriate item and enter fee In section 5B. panel,alteration or extension $4000
a 4 or more residential units iti one structure Minor Labela(10) $10000
Service and feeder 225 amps o:more
System over 600 volts nominal Q. Each additional inspection over
N Classified area or structure containing special occupancy the allowable in any of the above
as described in N E.0 Chapter 5 Per inspection _ $3500
t— Par hour $55 on
$55
–� Submit 2 sets of plans with application where any of the above In PlantDD"——
apply. Not required for temporary construction services, $. Fees:
LL 5s. Enter total of above fees $
NOTICE 5%Surcharge t 05 X total fees
PERMITS PECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ^
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b.Enter 25%of line A for
CONSI RUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Pl;n Review it required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust A,count>r
$
Balance Due s 6.
.oRrm,b.n.«gym�