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CITY OF TIGARD
DEVELOPMENT SERVICE'S 1YASTER PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639•�t 1 TERM(T #d•. . . . , . . : MET96-11151 E,171 DATE ISSUED: 11/1fl/9E,
PAF',C:EL. : 2: 31030(:-11Ov-j'7Q10
SITE ADDRESS— . : 1.3720 SW 115TH AVE
aLJBI)M S I ON. . . . : V I EWMOUNT Z 5N f N 77: R--4. 3
BL.00K. . . . . , . . . . . L.01.. . . . . . . .. . . . . . :4`,i
Remarks: Fire damage repair - structural only
--------------- ------------------------------------------------ BUILDING -------------------------------------------------------------------
REISSUE:
--------------.----- ---
REISSUE: STORIES.......: 0 FLOOR AREAS---------- BASEMENT...: 0 sf REVA RED SETDACKS---- RE4UIRED------------
CLAS,"• OF WORK.:REP HEIGHT........: 0 FIRST....: 0 sf GARAGE.....: 0 sf LEFT..........: 0 SMrKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 0 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 0
TYPE OF CON5T.:5N DWELLING UNITS: 0 FINBSMENT: 0 Sf RIGHT..........: 0
OCCUPANCY Gp. :R3 BDRM: 0 BATH: 0 TOTAL-------: 0 sf VALUE..f: 15000 REAR..........: 0
----------------------------------------
SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LrUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
------------------------—------------------------------ - -- - MECHANICAL ------------------------------------------------------- -
FUEL TYPES-------- FURN . 00K ..: 0 BOIL/CMP ( 314): 0 I.JJT FANS.....: 0 CLOTHES DRYERS: 0
FURN )=.00K ..: 0 UNIT HEATERS.. : 0 H"ODS......... : 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
.._-------------------------------------------------------------- ELECTRICAL ----------------------------------------------___._--.---------
--RESIDENTIAL Uh:T--- -- 4FRVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ----BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LESS: 0 0 - 200 amp..: 0 0 200 arip..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp.. : 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN Lf: 0 PEP. HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL 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
1000+ amp/volt.: 0 ------------------------------------- PLAN REVIEW SECTION -------------------------------
Reconnect only.: 0 )=4 RES Uf"TS..: SVC/FDR)=225 A.: ) 600 V �'AINAL: CLS AREA/SFC OCC:
---------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY -----------------------------
A.
-------------------A. SF RESIDENTIAL-- -------------------------- B. COMMERCIAL-----------------------------------------------------------------------------
AUDIO t STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER.........: HVAC...........: I-ANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER—: CLOCK..........: INSTRUMEN'ATION: MEDICAL........: OTHR:
'"'AC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS: 0
Owner: ---- _.._.__-.------.--__-----.-._--Contractor: ------------------------------ TOTAL FEES:$ 187.86
JANET YOCUM OREGON HOME IMPROVEMENT GO INC
13720 SP 115TH 17('55 SW PILKINGTON RD
TIGARD Ott 97223 LAKE OS'WEGO OR 97035
Chane A: Phone b: 635-6248
Reg N..: 34908
This permit ;s issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work w:11 be done in accordance with approved plans. This permit wi'.1 expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days.
------------------------------- ------------------ REOUIRED INSPECTIONS -------------------------------------------------- ---
Framing Insp
Insulation lnsp _
Gyp Board Insp —
Building Final
Erosion Control
F e v m i t t e e S i g n a t rar•e : vft�� � �__. I s s r..r e d By
0711
fav inspection - G39--4175
CITY OF•TrGARD Residential Building Permit Applico tion Rec t By
13125 SW HALL BLVD. New Construction Additions or Alterations Claw Recd
-IGARD, O)R 97223 Single Family Detached/Attached ( 1 or 2 units) Date to P E / "
,503) 639-4171 cart!to Dsr - -'Z - f;
Print or Type Permit# l►t 57
Incomplete or illegible applications will not t accepted
(,'Iya. ( ��^��
Name of Prolec; Name /
Job Colin
Architect wlao,ng Address
Address S%%Jdress
t) 37ao
Name C ty,Stat,t o Phone
. \M I 1 (2 J✓tom_ -
Name
Owner h ading Address
U Engineer Mailing address
c r t,�ee
Z10 Phone 9
GdyrStatte To
Name j Phone —
General �,� MV1iL Describe work New O Addition Alteration C Repa r
Contractor Mahn Address to be done
S-S S40 C r let Type of Use
(fdyrSta,e Z!p Ph ne 4111,1
�) 17 X)�� -�-zi(P T Re of Co structton
pre9, `1(�n }est Can Board L.c s E,x ate, � �• L' �+
Attach Copy of f j p -� r-A Occupancy Class
- —
CurrS
ent OT Business Tax or�Ltetro x Exp Date o&-vl C. L
L censes (7CX))C 0 � C 7 V Al it be 4pnnklered, Yes[] No&�'—
Name If Ye separate FLS plans and
Mechanical application to be subrr
Number of Stones
I Sub- Mailing address
Contractor r� Proposed L'se
C.ty,State Z p Phone
Previouti Use
Oregon Const Cont Board L.c x Exp Date , C— —
Anact,Copy of faluaticn $
Current COT Business Tax or Metro a Eco Date
Licenses NEW CONS%KUCTION ONLY:
:
- I .came -- Building ID
Plumbing — —
Sub_ Mailing Aacress Unit Types squareIt a of snits
A.)
Contractor
C ty,State Z o Phone B )
cl I i
Attach Copy of Oregan Canso Cant Board L,:a i Exp Date I D.)
Current Plumping uc a ',Jill the e!erncai succcrr•actor wire rer ail restrved Yes l No-
I i ExD Ddte Ener ntstailations7
Lice Has the Sucdrv's-on Plat recorcea'l N/A Yes I No
I COT Bus,ness Tax or Metro s E.xp Date
ereov acx ,c-.vieage:hat : nave 'eaa'his aimicaticn tnat;ne
F- ; dame rn`crmatiun given s :orrect nat I an owner or authorized agent cf
,n cle 'he owner and.hat plans sueminet. are:n comoliarce .vith Oreccn
�- Sub- Mailing Address State:aws _
ture of OwnfiAgen I Date
J Contractor � ��
Gry,Slate Zip I Phone nAct erson Nam', I Phone
Oregcn Cons; Cont Eoard L,ca � Exp Date FOR OFFICE USE ONLY
Att2Ch Copy Of
Current I E ectncai L: s Exp Cate slat# MaprrLtt Zone
Licenses I //? t
i CJT 6usrness Tax or Me:,,:)x I Exp Date Engineering Approval Planning TIF
Approval
.sts•.resa:: :cc N
Permit# c4un D a�r!��ti n Am n �,rnt Pd
MST Permit (BUILD)
Plumb Permit (PLUMB) i
klech. Permit (NIECHi
E`C/ELR Permit (`LPRrV1T)
State Tax (TAX) 5. 5-3 -- 5
._
Bldg:
PILIHib:
fvlech.
ELC/ELt':
Plan Check
MST: (BUPPLN) /
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review - planning (CDCPLN)
CDC Review - bldg (CDCBLD)
Sewer Connection (SWUS.A)
Sewer Inspection (SWiNSP)
Parks Dev Charge (I 'KSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quanmy (WQUANT)
Erosion Control Permit (ERPRMT)
J
Erosion Planck/USA (ERPLAN)
Erasion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS:
j ds;s esaoo �!ac rev =3
CITY OF I IGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech, Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg. Top Out Insulation -Eley,
Post/Bearn Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlkeii
Other:
Date: �� A.M. _—P.M.
Entry:
Address: '51 r `_
Tenant: _ _ Ste: MST:
BUP:
Con/Own: `7 MEC:_
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUinED: ELR:
00
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C.7
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Inspector/ c- 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/Serviceice:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-ir Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Rains.
Other ———-- -- --
Date: M. P.M.�7� Ent
Address: 12277 Z d T� �t'�/�
Tenant: _ Ste:__ MST: ._
BUP:
Con/Own: L�� MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELF: _
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,CL �
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Inspector:/A(41—�_ Date: )12—w"
APPROVED —DISAPPROVED/CALL.FOR REINSP. (:!!F) CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain toyaOService FINX.:
Foundation Water Line Ceiling -Plumb. 11
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg, Top Out Insulation -Elect
Pos,t/Beam SIruct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: , A.M. P.M._`—' 'Entry:_
Address: _3 i U -1 T� _
Tenant: _ Ste: _ MST:
-� BUP:
Con/Own: !� �-��1,�, �C MEC:
PLM:
`/ ELC: 1
THE FOLLOWING CORRECTIO14S ARE REQUIRED: ELR:
J
C7
J
Inspector:i M l bate:
,APPROVED —DISAPPROVEDICALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE 1
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water line Ceiling -Plumb.
Post/Beam Mech Shear/Sheath rammg) -Mech.
Plbg.Und/Fir/Slab Plbg. Top Out ttlscrfation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: —
Date: �-7' _ A.M._ -P.M.--- Entry:.
Address: 'Z O 1 / I S
Tenant: Ste: MST: L 6 d
BUP:
Con/ewn )o lq� MEC:
LM: _—
THI. FOLLOW114G COR ONS ARE REQUIRE ELR:
Ce
w
Inspecto . — _ Date: n
VED —DISAPPROVE D/CALL FOR REINSR CF CO
C'I'TY C)F I I t�0P Vi 01- PAYM041 REA1.1VI N(j, 1)
%,HFC,K PMOLINC
fAifCt-j COWITRUCTTON Co• -,,H PMOUNT n 13. Vi"A
17c,",3t) ',?W f'IL.KTNL-,TLN HD PAYMNI UAIL
9081)1 v t 6 ION
OP 9
OF I-AYMN I PlIOUNI 1,AIL) PUPI-ILKA:, Ul PAYMLNI AMLIMIT PAIL)
PLAN (.14H K
cn
37;?0 SW i i m PLAN CWt.",li 411 J - I-4,R
V-11fAl. AMC.UN7 PAID A-A
f_;J I OF l Il"ARD •- IaE.Iwk II-''T Cit PlOYMI.NI 141-IL-Al" N(l. :'-:;h-
C,HF.("K AMULNI'
NOME a 0141CO O r ONS3 1"R O T I UN ( WA I HMLIUN f
fllliIRIi .S's x 1`7;x:;`.:, SW toILKINu Cliff RV I'"'YMI N'l DA-1F,.. z 1 I1lVit,"tk:
LAM' tISMW-'GO OR W01) e
97 0
Pl.tl'IPOC— 7. UP PAYI -Ji I All(OUN I PAID U. I IANA1, N 1 {)h! )C.IN I PI[l)
IHIIILC TM6 I+44MI I 1 i0, r.0 'it . BUILD f14P `, . ',,Jk
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ot
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N its employees,sha!I not be responsibfi
discrepancies which may Appear hermrl.
APPROVED FOR CONSTRUCTION
CITY OF "FIG ARD
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PERMIT NO,LL0jjf0SJ I1-E ADDRE SS.J�Zo
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CITY OF TIGARD ELECTRICAL PERMIT
SERVICES P,ERMIT #: ELC96-0751
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED, J.2/03/96
P,ARCEL: 2S10.31)C05700
SITE ADDRESS. . . : 13720 SW 115TH AVE
SUBDIVISION. . . . : VIEWMOUNT Z ON I NG; R-A.. 5
BLOCK * . . . : LOT. . . .. . . . . .. . . . . :45
h-It-o.iect Desctiption : ADD 12 BRANCH CIRCUITS
UNIT---- ---TEMPI SRVC/FEEDERS----
1.000 SF OR LESS. . . .. : 0 0 '200 AMP. . . . . . . : 0 PUMP/IRRIGATION. , . „ 0
EACH ADD' L 500SF. . 0 201 400 Amp. . . . . . . : 0 SIGN/OUT LINE L*TG. . : 0
LIMITED ENERGY. . . . 0 401 600 amp. . . . . . . : 1A SIGNAL./PANEL.. . . . . . . : 0
MANF. HM/ SVC/FDR 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
-------5ER V I CE/FEEDE R• ----BRANCH CIRCUITS------. --.---ADC' I_ IN9PECTI0NS----
- 200 amp. . . . . . .. 0 W/SERVICE OR FEEDER: 0 PIER IN-9P,ECTION. . . . . : 0
201 400 amp. . . . . . : 0 Ist W/O SRVC OR FDR. : I PIER 1-40UR. . . . . . . . . . . . 0
401 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRC: 11 IN PLANT. . . . . . . . . . . : 0
(Sol. 1000 amp. . . . . ! REVIEW SECTION----- - _.___._____.._.__..
1.000+
ECTION-----
J.000+ Amp/volt'. . . . . : 0 > =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMP,S. . CLASS AREA/SPEC OCC. :
Ownet,: FEES
JANET YOCUM type amoi-tnt by date t-er-pt
1.3720 SW 115TH PRMT $ 90. 00 TAT 12/03/96 96-287171
5PICT $ 4. 50 TAT 12/03/96 96-287171
ITCARD OR 9722-31
Plhone #:
Contr-actor-:
FRIBERG ELECTRTC CO 94. 50 T0-AL
4633 N WILLIAMS AVE
REQUIRED 't'WEC'fIONS
PIORTLAND OR 97217 Ceiling Covet-, Jer,gv,oi_(nd Cove
"'gone #: 503-288-5161 Wall Covet- E , ect I I Set-v i ce
Reg #. . : 000013
This permit is issued subject to the regulatinns contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other F1er•m t.tJ r- S i 11
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work :, suspended for more
than IN days. Isadied By
-.OWNER INSTALLATION ONLN'-----
The installation is being made an property I own which is not intended fog
iale, lease, or- rent.
OWNFRI 9 SIGNATURE: DATE:
TNF3TALLrrTON ONLY-----------------------------
7TGNATURE OF SUPIR. FI-ECIN: DATE:
IJ
I.-ICENSE NO:
Call for inspection - 639--4175
G,l '1 Y OF' i I UARD RF-CE I F''.i OF F PYMEN'I REC L- 10 NO. "3 E, t. ►
CHECK AMOUN('
NAME j-{'PI BERG F.J..t-CTRIC: C0 CASH AMOUNT
f1U1)F2E:!, , e 46'',ti N WIL.LIOMS AV PAYMl.N"1 DA'TL !c '4�'•; '�f
SUIOTVISION
pokwow-), lip
C'l►T0,►:► ,L CIF l' AYMLN i OMUUNT Pf11 D I LJRI,01: E:. fit I lA v MI=NT FIMUUN'T PA 10
i I. F C r Fr T C Gil.. I I_.i�M T 1 '? . IZI►7+ �: ► . } I.I ► r, , C N 4. ;,,o
F'(1I7 13720 yW I t5IH
ICITAL AMOUNT PAID 94.50
Community Development ELECTRICAL PERMIT APPLICATION
f 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # L _4
' Phone (503) 639-4171 Date Issued
CITY OF TIG�►RD FAX (503) 684-7297 Issued bit _
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Comi7lete Fee Schedule Below:
Name of Development OCU n.) Number of(Inspections per permit allowed
Address '3 7-• 3: w. I L TT Service included. Items Cost(ea) Sum
-- i
l City/State/Zip7LGU Q ti _ 4a. Residential- per unit 4
1000 aq It or lets $11000
Name (or name of business) EPS additional 500 sq II or
tthereof $25110 1
Commercial❑ Residential Limited Energy $2500
Each Manul'd Home or Modo r 2
Dwelling Servbm or r x $6800
2a. Contractor Installation only: 4b.Services or Feeders
Installation,alley'ion,or relocation 2
Flectrical Contractor Flt 13 f-QA �L t�{� 200 amps or lose $80 00 2
Address Y(o 3(-e' Ar• !.V r L'L[ H'1 S 201 amps to 400 amps $8000 2
401 amps to 600 amps $120 DO 2
City j:C A+-�,<t Stated j_ Zip���i 601 amps to 1000 amps _^ $180 00 7
Phone N0. Over 1000 amps or volts _— $34000 _
�"�'nl
Contractor's License No. ala 5
- I Reconnect only $5000
Contractor's BoarC Reg. NO I A 11`1?CR C, 4c.Temporary Services or Feoders
Installation,aflerelion,or relocation 2
Signature of Supr. Elec'n 200 amps or lase __ $5000
License No. /�S_; Phone No. I& �� 2r,1 amps to 400 amps _-_ $7500 2
101 amps 10 600 amps $10000
Over 600 amps to 1000 volts
2b. For owner installations: see•h•above
4d. Brench Circuits
Print Owner's Narr'? _ New atteration oi extension per panel
Address a)The lee for brenrh circuits with
City_ State_ ZipPurchase of smvks or hoder bit. ?
�- Each branch circuit $500
Phone No. _ b)The fee for tranch circuits without
The installation is being made on property I own which i� putt bran or scuit or hyaW hti. cy� 2
Fact branch circuit branch
(_ $35 00
not intended for sale, lease or rent. Tach addniowl branch arwi; ..La� $500 r -
Owner's Signature_ 4e.Miscellantwus
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation code $4000 2
Each sign or outline fighting i_ $4000
Signal circurt(s)or a limited energy 2
Please check appf opriale item and enter fee in section 5B. panel,alteration or extension $4000
4 or more residtmtial units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 60(l volts nominal 41. Each additional inspection over
a Classified area or structure containing special occupancy the allowable ii any of the above
as described it N E C Chapter 5 Per Inspection _ $3500
Per hour +— S5500
� In Pant T $55 00
Submit 2 sets of plans with application where any of the above
apply. Nor required for temporary construction services.
Fees:
So
.� 5a. Enter total o'at ova fees $ �Y
i NOTICE 5%,Surcharge(05 X total feet;) $ -�'SC-7Tj
PERMITS BECOME VOID IF'NORK OR CONSTRUCTION Subtotal $
w
� AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF tib.Enter 25°i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Revievt if required(,Sec 3) $
I A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
f COMMENCED ❑ Trust Account A $
Balance Due $