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12961 SW 116TH PLACE N N .J J ..i 7 ro �o 12961 `;w 116"' Mnce w CITY OF TIGAR .♦ MASTER PERMIT PERMIT#: MST2001-00459 DEVELOPMENT SERVICES DATE ISSUED: 10/1/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12961 SW 116TH PL PARCEL: 2S10313D-09600 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG REMARKS: Construct new single family detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS __3EOUIRFD CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,233 at BASEMENT: at LEFT: 5 SMOKE DCTECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,189 of GARAGE: 497 at FRONT: 20 PARKINi SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: at RIGHT: 5 VALUE: $233.087 40 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2.422 00 at REAR: 26 PLUMBING SINKS: 1 WATER CLOSErs: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS; 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1C0 BCKFLW PREVNTR: 1 GREASE TRAPS: MECHANICAL OTHER FIXTURES. FUEL TYPES FURN 4 100K: BOIL/CMP i 3HP: VENT FANS: 5 CLOTHES DRYER: I GAS FURN>00OK: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: hh1 FLOOR FURNANCES: VENTS. 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEOERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 •200 amr: 0 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 •400 emu: 201 -400 amp: til W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 •600 amp: 401 -600 amp: EA ADDL OR CIR: SIGNAUPAI.EL: IN PLANT- MANU HM/SVCIFDR: 601 • 1000 amp: 601+ampb1000V MINOR LABEL: 1000♦amplyolt: PLAN REVIEW SECTION Reconnect only. >•4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM. INTERCOMIPAGINO: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,110.00 This permit is s..aject to the regulations contained in the RIVERSIDE HOMES RIVERSIDE HOMES Tigard Municipal Code,State of OR. Spe^ialtvCodes and 15455 NW GREENBRIAR PKWY#140 15455 NW GREENBRIER PKWY all other applicable I jws. All work will be dc.mr in BEAVERTON.OR 97006 SUITE 140 accordance with appru,ed plans. This pi rmit will expire H BEAVERTON,OR 97006-2115 work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rip N: LIC 70065 forth in OAR 952.001-0010 through 952-001.0080. You may obtain copies of these rules or direct questions Ir, OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural PLM/UnderflLor Framing Insp Gas Fireplace Electrical Final Grading Inspection PosVBeam Meehanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor Insulation Plumb Top OL t Exterior Sheathing Insl Rain drain Insp Fin3I Inspection Footing Insp Crawl Drain/Backwater Electrical Se-vice Low Voltage Water Line Iwr Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp AppriSewik Insp Issued By : .4— Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00234 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/1/01 SITE ADDRESS; 12961 SW 116TH PL 1ARCEL: 2S10313D 09600 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS Ck-= WORK: NEW DWELLING UNITS: 1 TYPE CF USE: SF NO. OF BUILDINGS? 1 IN,-:M'.LL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new single family residence. Owner: � -- - FEES RIVERSIDE HOMES 15455 NW GREENBRIAR PKWY #140 Type _ By Date Amount Receipt BEAVERTON, OR 97006 PRMT CTR 10/1/01 $2,300.00 27200100000 INSP CTR 10/1/01 $35.00 27200100000 Phone: 503-645-0986 Total $2,335.00 Contractor: Phone: Rey#: Requrrda ii;spections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm Issued by: ��= ,li? Permittee Signature:_?fz Call(503)639.4173 by 7:00 P.M. for an Inspection needed the next busines ay Building Permit.Appiic:atio ll City Of Tigard Datcrecei-cd: ft, /7 O Permit Address: 13125 SW Hall Bl-d,'I i g lyd,OR 97223 Project/appl.no.: Expire date: City of Tigard b� y` Phone: (503) 639-4171 Bate issued: By: Receipt no.: b Fax: (503)598-1^60 Case file no.: Payment type: Land tISC approval: _ I&2 fat.ily:Simple Complex: � - - - ---- C Aft OF PERMI'T U I &2 family dwelling or accessory U Commercial/industrial U Multi-family 4'New constmclion U.Demolition > U Addition/alicratiolt/replacement U'renant impntvcnlcnt U Fite ;prinklcrhilarnl U Other: JOB 91TE INFORMATION Job address: W E31dg.no.: Suite no.: L-ot: Block:_Subdiv�iston- ,� -- I'ax map/tax IoUaccount no.: Project name: t� v ' - i_ Description and location of work on premises/special conditions: 0 711 Fill 1,41 T 111 IN 111 Name: �VPi.itC�C Mailin_ address:/��t/ (' J -r .i -- I & 1 Iaulilj drrelliltt City: Slate 7.IP: r Valuat n of work._ ........ $ oZ3,3 of'7• Phone: - _ !,o rax: E-mail: No.of bedrooms/haths................................. Owner's represcmativc:' -:i-- 11bt Total number of floors Phone: I;tc >,' li-mail: New dwelling area(sq. ft.) G _ - Garage/carport area(sq.ft.)..........y..y..a., Name: L -`t") t��e`�lt C Covered porch arca(sq, ft.) ......................... t L ailing ad�dress: C. heck area(sq. fl,) ........................................ City: State: GIP: Other sIr•uctwr arra(sq. fl.)......................... Phone. l'ax: F 11mif Commerclal/IndustriallnmltI-family: t t Valuation of work................... .................... $ Ihrsincss nanit: Exisling bldg.area(sc. Q) ................. _ a_, , Y2 1 Address: New bldg.arca(sq. 1't.).......... Number of stories Cit ., — ......................... ..... .... Y� .,talc: l.II': �••••• ----.- Phone: ha., E-mail: I'ype of construction......� CCB no.: _ - ---`-- Occupancy group(s): FxisliIIg: City/metro lie.no.: — New: Notice:Ail contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under Name: pr)visions of URS 701 and may be required to be licensed in the Address: �- -- - - Julisdi -Iiun where work is being l erformed. 11'(lie anplicat is Cil : uc: 7..IP: exempt front licensing,the following reason applies: Contact person: Ilan no.: -- -_-�-- Phonr,: raw: f: mail --- _. --- Name: „ tees due upon application $ ........................... Address: —_- -----_ hate received: - Cily: --�5lacIP: Amount received Phone: Dux: k, m;hit: I'lease relcr to fee schedule. _ I herchy certify I have read and examilletl 1111"application all([Ihr Not nal iuti.dicrt,ntq merry credo rmda,plea.."roll iutia"11on far more Infimttnhnn attached checklist. All provisions of laws and ordinalles rin't•rnnir lfu'. Uv,a UMasterCard work will he complied with,whetht i In•t'ifir(l lleleill of not, t'rcdil uud nundrr C._. _ Alllhorb-ed singlurez �� Y� �tr� );htv: _t7, �1�''/ - Nem"of rmdhnl r as rhnwn nn rredh rand Print name: Zk-CT LA%�/ ) --- --- 7-- M _ Amnant Nu(ice:This pemlit application expires ifa permit is nol uhtained within 180'lit)s aller it haw been accepted as comple(e. 440 anh r(FjAXV(oRh Mechanical Permit Application '- ------____,----- Datercceivcd: D op Permit no.: � 0 e,>,cy of Tigard Projecdappl.no.: Expire date. Citygffigard Address: 13125 SW hall blvd,Tigard,OR 97223 Date Issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 1 Case file no.: Paymenttype: Land use approval: _ I Building permit no.: 'I 1TV OF PERM IT- U I &2 family dwelling or accessory U Colnmercial/industrial U Multi-family a,tenant improvement r I<Vew construction U Addition/alteration/replacement U Ocher: JOB SITF,IN FORMATION Job address. f� Indicate equipment quantities in boxes below.Indicate the dollar value of all mechanical materials,equipment,labor,overhead, Bldg.no.: Suite no.: rax map/tax lot/account no.: prolil.Value$ LoC 131ock: Subdivision: "See checklist For important application information and d�u — jurisdiction's fee schedule for residential permit fee Project Warne: Wt[r . City/cot,nty:-2 tt'A a r ZIP: — I & 2 FAMILY DIVELLING PERMIT FEE SCHEDULE Description and location of work on premises: Est.date of completionlinspection: IIVAD"Criptlott Qty. Res.only RO-•s.only 1'cnant improvement or change of use: �' space ficated or conditioned'!U Yes U Nu _Airhandiing unit ----CFM---- Is existing _ g•p Air cont ilioning(rile p an reriuire� Is existing spare insul ded'?U Yrs U Nc, A teras ono ex sling AC sy,S em 1 1 of erkonsprtasars — Stale hoilei permit no.. A f Irl *5. �nL III' 'Eons ii'fU/H Address:_ 02Z.Alf AiGn ff. ✓r iresalu ecOut pers uctsmo eieteclors — City: e♦ !O nd Stater '1.IP: 72/2 eat pump(sae plan rcquirep Plume: — y •/`j _ nsla rep ace funlnce/turner_--- / ,�j p3- * fax: fi ,nail' Including ductwork/vent liner U Yes U No CCB no... 7y(Q & - _ nsta /rep acrTrclocate ficaters-suspended, City/metto lic.no.: wall,or floor mounted _ Natnc(please print): _ �t —�U u N N Vent 101 a )lance of ser than urnacc Refrigeration: Absorption units-_____ Name: Chiller, -- Co'"' om nr•sun _ __ III' Address: _ nv ronmrula rx east an vent lotion: City: _— — Slate: ZII'------ Arrli,nlrevent Phone: G-mail: hyercx n- 1 7oats, y`I pTV res. -ii Ti ell 17f niinat hood fire suppression system Name: Nxlusust fan Willi single duct(hath fans) Mailing address: x toast s stem n uu1 lam.1�1:11111ix ur piping an sir rut on lap to (miler;) City: _ — Stale: ZIP: Typc: _ LPs; NO t hI Phone: FIX: L'-mail Uc nining-actind onal over 4 ou—tic—is roceits piping(w enultic required) Number of outlels Name: _ _ —� er st appifaince or equ pmenl: Address: _ DecnraliveI[replace _ ('fly: Stutc: zIC': nsell lypr :- �aa slave(pr et slave Phunc; � fax; [: Arl'lic;ult's. 1'n:;tlnr, Inde: _ _ _�_ —._..--- ----...--- ----- ter: — run - Nut n11 iwiwllrrinn+rccryn r,rdil raid+,plrn+r roll pniwdi,noa In,oust iulnnnalun, I'ctlllil It's ... ...._.........$ .-_ �_— NuUcr 11th pernlil upplicalion Nlininunn Icc. ._ .. U vita U Mn.lelt'n"I cvpires 11,41 pelsnil is not nhlained $ -- d'tedir rmd numle•, I Idl)Il•\ 1-w I al 1 $ �sithin IRo days after it hay;been Slaw surcharge(ti":) . ..$ _- -, cont accepted as lett. ams a Tar n,Rr a�shown m nnnr cmd r r - —�- i'mdbnlder ilµn�Uur -A,nnwi' ) 44046111(wrM)KINI �I_lr>r U4/20/U1 12:59 VAX 1 360 254 7106 FAIMST ELF( l'Itic. INC. oo) F, Electrical Permit Application Date►eceived: ( C Dertnitno �' 0 ��'lej City of Tigard Roject/appl no.: Expiredatc: lett Cirvn/yjgrorJ Address: 13125 SWliallILd.Tigattl,M 97723 Uatelssried: _ BY. Receiptno.: Phone; (303)639-4171 Pax; (503)598.1460 Cast file no.: Payrner type: Land use approval: O 1 &2 family dwelling or accessary U Commercialfindustrial Ll Multi.family U Tenant improvement q New con!nn,-tion O AdditioNelteranon/trplacemerit U Other: l l Partial 1 Rldg�n0.: Suile no.: Tax map/tax lot/nccLet: eUnf no.' Dltxk.- Suhdivisia): e,�. I'ry eel name: "' _ ;!�3.�---.-- --------------»--------_._ scription and location of work on protases: Estimated date of completion/inspec,too I Jloh no: Re INan llusinessss"AMC: F a r w e s t I:1 P e t t i t` I it C. • Ian (ea) Total no.Inip Address: 7402 N 1 th Ave- 'aayw"W` °r""'mPer r,n c o u v e r d"`�'K`"h.1nc�af•�RWW. -City: State: ZJP; &rrkefnebrkd! 1'Ixmn i^ Tax:2.111- maih _ _ Itwo sy n ur lar A CCR no,fi 2 3 S U tiler-,bus.lit.nD. -3'7-2 7 7 C •�hlonol 100 rq,ft.or portion theacof - Umrled enm((y,rerklenns, 2 Citylie.nu.: limheAr rr -readeabal� r 7 Nath ramwfaclur.d horse or modular dwelling Signature o1 suptrvkService t c�kcieian( ulrnd eense nor � Zaee Z _'zup elect none(prmices or feeder+-In4w6don, -- _ allerslloo or relocatlanr 2120 amp+or icer 2 Name(print): 201 1#T to 400 amps 2 Mailing address: �� '"'".�-- -- sol ampsa tloo un�s '" 2 601 o e 10 1000 am i itY: _ r State ZIP: — Over 1000 M -�--— ---- _ ()ren 10(10 amp+or vola 2 Phone; Fax: E-mail: Iteamnertnnly Owner Inslallotion:The installation is being made on property I own Tr'n('er+�racrvknerree4ta Which is not intended for sale,lease,rent,or exchange according to hataHstlen,auaratlea,arrebcatlam! QRS 447,455,479,670,701. 2W amps or Ica; 2 10 00 2 serge+ — Owner's signature: 201 Ames Date: 401 10 WO arripq 2 Much circaNs-nen,skera les, Name or extenalan per Penal! A. fee far bunch mala veldt purchiu of _Addrtas: _� __ service or facder Or&,call braneh circWt 2 City: Sta(Ct~ ZIP: H. I'�r!for brunch chmitc whhoal pwrh+e Y^~ of servkr or fonder ftx,nro branch cirah: 2 Plfine: '� _ Fax: &mail: cgoddtuonalbtrrchcirculc Mhc,(dcrrkaor rnwYaladed): 0Servioeover 223undrnennrtnr;al UHalth-uusfaciny -13webruMurlnt lundrele 2 tlServlopnvernaanq)ttmh,Noflit 1 0HwardotrrkearionEachalenorWni Uir� 2 famnydwelkng, L1boikiMaovrrin,000square feet rm,rtx Signal circuiUr)oraUmlledmetLYputel, U Synrm over wo vola nrmm,si neer-rraldentla)anin In our-ttrurtute dleention,of rxtenelo ior___ I I- -.,A_-a U nuadinp over Wtee"ArsU Feeder.400 amps tN store ♦Ikrcn don --- 11 Occoparrt load over 99 pen„L 0 Maulkluml euartuesr ut RV pmt, Mach walvall C=160 aver e►e/Uattahle W any of We slave. U hyrriellxhtiegplan r3 vers:.-�---� _-� - Pet inspection Submil.-.-_sets of phew whh My of the oMve. InvesugNion far- ^_ The above are fast Myrtlteable to ItKlorffy eaisstrrc1lou orrHre,e tAitet _.�__ �_ Na rt1 Jsitrlkrtoat aeeep c,sdrr rargk,plena rril lwkrreoerr fm awar kAern.rltr Not" This pasnrll application Permit tee........-.......... U Visa U MasteiCard expires If a permit it not obtained Tice+)tevlew(al -._ %) s __.... within too days after it has been State surcharlte(11%)....S _ �fa`mr�`r eTieen en s accepted as completr TOTAL, Ie0 MY Ieal01 UM) Plumbin go, Pcr>init Apploeatimn �Datercccivcd:: 17 el Permitno.: —C04'S� Cit of Tigard City � Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 — — City ofTigard Phone: (503) 639-4171 Projccl/appl.no_ — Expiredate: Fax: (503) 598-1960 Date issued: By: cipt no.: Land use approval: Case rile no.: Payment type: 1 ' U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement ,4Ncw ronstnlrtion U Addition/allerdion/replacement U Food service U Other-. rol 11M Ida Rif 713' Y4`r 5 � !�J Description dwel Qtv. Fcc(ca.) Total Job nddre%:-: GL- (<' C Bldg.no.: Suite no.: New 1-and 2-faroGy dwellings only: (includes 10011.for each utility connect ion) Tax map/tax lodaccount no.: — SFR(1)bath _ Lot: Block: Subdivision: &,, ey5 a SFR(2)bath Project name: _ _ SFR(3)bad' — City/county: -71—G,+4.p 'LIP: 2 S Each additionalballi/kitchgn Description and location of work on premises: Slieutilltles: �FooliFgdrain h bin/area drain _ Est.date of completion/in.l t u. n Ieach line/trench drain (no.lin.ft.) PLUMBING1 1 Manufactured home utilities Business name: C, Manho es — -- Address: W �Va� Rain drainconnector ily:a/'e•o/t lA : 7.IP:- Z — Sani'nry sewer(no.lin. It.) — Phone: _&S7Z Fax: (032-— E-niai� C p Storm sewer(no.lin. ft.) GCB no.: Plumb.bus.reg.no:PA I o 3 Water service(no.fin. Il.) Fixture or Item: City/metrolic.no.: !! 7'&/ (/ Z ./� — -- Absorption valve Contractor's representative signature: _ track flow rcventer Print name: „% N1 Date: /7-" I Backwater valve Basills/lavalory Clothes washer Name: _ -- Dis wa _ s t�er Address. 5-tri-n kg fountain(s) City: ��5late: GII': _ Ejector- sum —+ Phone: Fax: L-mail Expansion tank rixture/sewer ca _ loop rains/flcxir%inks/hub Name(print): Car age is oaal Mailing address: __— I lose hibh City: — --S(ate: ZIP: _ lee maker — Phone: I�ax: E-mail: Interceptor/grease tap Owner installation/residential maintenance only: The actual installation Primer(s) will he made by me or the maintenance and repair made by my regular Rc)of drain(commercial) _ employee on die property I rsvn as per ORS Civipter 447. Sink(%),basin(s),Iays(s) Owner's si nature: Date: Sulci— — l'u %/s:howcr/s ower pan Urinal - Namr.: --•--- rWnCity: State: LII': Other ---� — Plurnc: �Fax: E-mail: oral --- -_ 1lnntiutin Ice ............... — Not all IuN«rllclinn«xceln crerlll cant«,please call ptd«rlicarrtt for mole IIlIn1111at1m1 U Vlan O Ma Notice:'1111%permit,tlgtlicnllun , alcrCnrd I all ries frits(,!I _ 7F) $ -__-- rxpires if a pennit i�not obtnined Stale stilt 1wrge(11%) ....$ C1edu cold naml*r:_.— __ ____ ____ c«•ilhin 1 Nd days alter it has been Narvit of Ctt�r hn r r a«elmwn on crier .rl caret accepted as complete. _ S (Ort ltpl�t Cr 11`nalatC _`Amount,_.__ 1.11146161(OVIN OM) 10 ' 0 2() Rj\/r-nSQE HOMES,INC- WRIER PARKWAY ........... ........ 15455 UjjNAN.VIEF- #140 B,,,Xvcj4TC)N.OREGON 97006 - '1066 - 1-o 4 1 10 1 mo ti 2y C 1V IT, 0, 30 -- ou <<13 0 1< o I�j <<, Lp 0 U) 0) (j) 0.9 tp -4- A s 1-1 U N F E R'S WOODLAND OAT[ /�ti - . III WESTLAKE JQMES NAWN Ili CONSULTANIq Ito- RIVERSIDL I ---. ---_1m )ILCKED BY LOT "8" -- 116-m 'LACE —. .- EN G I 1Y Ir Ef?I N G' •6 SOUVI-AING •6 M AREA -- 6,15465 f- VA(IFIC )Iflj(Tl�AJF (JVNIKbjllAy NI) ';v S%I 101A 'Alt rlIITF I5n F I[I A C K A R A - 3,653 1) , AN 30G L I WAIT 114(;1M 97;!;!t I ELECTRICAL - CITY OF TIGARD RESTRICTED ENERIGY DEVELOPMENT SERVICES PERMIT#: ELR200 i00300 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/26/01 SITE ADDRESS: 12961 SW 116TH PL PARCEL: 23103BD-09600 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG Proiect Description: Low voltage: all encompassing. A. RE"IDENTIAL B.CLAMERCIAI.___ 4UD!O & STEREO: AUDIO & STEREO INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: I OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL: LINSTRUMENTATION: OTHER: - ------.--____—_ S_�_— Owner: Contractor: TOTAL #OF SYSTEM RIVERSIDE HOMES GREENLINE INC 15455 NW GREENBRIAR PKWY#140 PO BOX 230755 BEAVERTON, OR 97006 TIGARD, OR 97223 Phone: 503-645-0986 Phone: 968-1978 Reg #: LIC 103033 ELE 34-397CL SUP 3345JLF FEES _ Required Inspections i'ype By Date Amount Receipt Low Voltage Inspection PRMT GTR 11/26/01 $75.00 2720010000 Elect'I Final 5PCT CTR 11/26/01 $6.00 2720010000 Total $81.00 This Permit is issu — `---- ed subject to the regulations contained in the Tigard f 1unicipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done In accordance with approved plans. This permit will expire if work is not started withir, 180 days of issuance, or if work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. Issued by r� /{C)/ZL permittee Signature OWNER INSTALLATION ONLY _ The Installation is being made on property I own which is riot intended for sale. lease, or rent OWNER'S SIGNATURE: DATE: ___.___` CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: t' ) id lcyf �..,__ DATE: LICENSE NO' ---- :5 �` _15 L<- `— Call 639-1175 by 7:00 P.M. for an Inspection needed the next business day V__ I Electrical Permit Application '� _—_-- --- - '— Uatereceived t'crmu y city Of 1�111'(� Project/appl nu.: —_ Expire date: Address: 13125 SW Hall Blvd,'I igard,OR 97223 Date issued. By Receiptno.: �'("'�r(�`(r`l Phone: (503) 639-4171 Payment e Case file no.: Y YP Fax: (503) 599-1960 Land use approval: _ eMM U Multi-family U Tenant improvement 2! 1 &2 family dwelling or accessory U Commercial/indusu Lal U Partial l>{I Nr.w construction U Addition/alteration/replacement U Other: t tAA R, 11 Job address: L "I b I J w rib r It PL Bldg.no.. Suite no.: Tax map/tax lot/account no.: _ Lot: $ Block: 5uhdivision: N u N r b et S — Description and location of work on premises: t_ tL___ Proiect name: — — I?sfimatc(I date of compietion/insprrti in t 1 FK *lax Job no: — -- nescri til on Qt • (ea) rolal no.ins It Businessname: y' ,e�E� r E ' �" Ne"residential-singleormulti-famiiyper Address: 7 J r: 7?S dwellingunh.Includes attached garage. Slate:U It IIP: ! tieniceinciuMI: q City: I C a I(xx)sq.rt.or Irss -- Phone: e l Fax: `I b f? 0 E-mail: Fath additional SW sq.ft.or salon(hereof Elec.F. tic.no: 34 -3` «• Limited energy,residential I 1 T, 0 2 CCB no._�, ; 0 3 2 City/metro tic.no.: Limitedenergy,nonresidential � F.uch manufactured home or modular dwelling = Oale service and/or feeder Signature or supervising electrician(required)- Servlcesorfeeders-Installation, 1'v License no: alteration or relocation: u�, rl,c1 aortae(print): J A 2 201)amps or less 2 201 amps to 400 amp+ 2 Name(print): 401 amps to 600 amps _ -- 2 Mailing address: — 6uf amps io 10(x)amps 2 SlalC:! Z;P: over 1000 amps or volts — _ I City: Rearttncctonl Phone: Fax: Email: Temporary scrvlces or feeders- 0%ner inF.ullatiou:The installation is being made on properly I own Installation,Alteration,orrelocation: 2 which is riot intended for sale,lease,rent,or exchange according to .w amps,or fess _— 2 ORS 447.455,479,670,701 2if maps to 41x)amps _ 2 Dale: ^ 401 to 6(:'a am s Owner's sf nature: Branch nccu*.new.aheralion. ore litemlon ps-panel: Name: _ A. Fee for branch:ircui,4 with purchase of 2 --' service of fl'ed:r fee,each branch circuit — Address: - — B. I;ec for branrh circuits without purchase -- City; State: ZIP: B. of service m feeder fee,first hrnnch circuit: 2 Phone: I':tr F-mail: Fuchadditional branch circuit: Mixc.(Service or feeder not included): 2 1:ach pump or,rng_uion circle 2 U service over 225amps-conunercinl U ilenhh•carelycility N,uchs+gnoroudmcfighting — U service liver 320 anips•ruling of I&' U Haaardous location si nal circuits)or u limited energy panel. 2 fnmilvdwellings UBuildingoverl0,t100squarc feet four, alteration.U system over 611(1 volts nomirml more tesideolial units in tine structure - V U Buttding over three stories U Feeders,4110 amps or snore olk%cri tion: U lkrupanl load over 49 pcnnns ❑Mnnufucturcd structures or kV; ark tAch additlonvl inspeclion Over the allowable in any of the above: U Fgtcss/IlghtingIII oil U other ______- Ver inspection Submit seta of plans with any of the shore. ( Investigauun fee f '1 he above are not applicable to temporary construction 01-1 vice. Other S r Permit fee.....................$ — Not toll)unsdicmmn Accept creditrazrt+,please tall JuNsdirtloa feN m,to mhxuuuu+rr Notice: chis permit application Plan review(at _ `g') $ --- expires ira pennit is tool obtained V o v U visa U MasterCard within 180 days oiler it has been State surcharge(99f) ••••$ Credit card n mitmc u �— 'Tam ...... i{I �o ----------_ F?sptre' accepted as complete. ..�.............$ .----- -`-Name of rinTTrFer�s�F'own nn err n e - s -- — ---..--.—_ - Annum. 4M)-1615 16xxIlCOMI —`"J C'ardh'older slgnmure ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: - --� P Restricted Energy Fee..................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total I Check Type of Work Involved: Residential-per unit 1000 sq ft.or less $145.15 4 ❑ Audio and Stereo Systems" Each additional 500 sq.ft.or portion thereof $33.40 _ 1 ❑ Burglar Alarm Limited Energy $75.00---- Each 75.00--__Each Manufd Home or I lodular ❑ Dwelling Service or Feeder $90.90 2 Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alleration,or relocation 200 amps or less $80.30_ 2 EJ201 amps to 400 amps _ $106.85 2 Vacuum Systems 401 amps to 600 amps $160.60 2 r 601 amps to 1000 amps _ $240.60 2 17, Other A L,L �II/ Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each s/stem..................................... .................... $75.00 200 amps or less $66.85_ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ _ $100.30 2 401 amps to 600 amps __— $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 _ 2 C-] Data Telecommunication Installation b)1 he fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit _ _ $4685 ❑ Each additional branch circuit $665 HVAC r"scellaneous ❑ Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circult(s)or a limited energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) $12500 Each additional Inspection over ❑ Medical the allowable In any of the above Per Inspection $62.50_ ❑ Nurse Calls Per hour $b2.50 _ In Plant $73.75 _ ❑ Outdoor Landscape Lighting' Fees: L] Protector paling Enter total of above fees Other 8%State Surcharge $ -_ .--,-----Number of Systems 25%Plan Review Fee See"Plan Review'section on No licenses are required. Licenses are required for all other installations front of application _ - vFees: Total Balance Due $ – I Enter total of above fees $ ❑ Trust Account# _J 80/.State Surcharge i Total Balance Due i Wsts\fomukic-rees.doc 06/07/01 CIT'( OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspersion Line: 639-4175 Business Line: 639-4171 PUP 3 --------_- -- Date Requested—_ AN'- � —,.-- PM BLD `- _ 10L4L '� Suite MEC -�_�_--- Location --.L.L -- _ 9 -7 PLM Contact Person .7✓ .L SWR _ Ph Contractor a_ �r1 - f- ELC BUILDING Tenart/Owner ELRRetaining 771 Wall Footing Access. FPS Foundation SGN Ftg Drain Crawl rrain Inspection Notes: «C�� SIT Sipli - -- V Post&Beam --- - J — Ext Sheath/Shear Int Sheath!Shear e Framing ---- -- --- Insulation - Drywall Nailing --- -�-�-- Firewall Fire Sprinkier _ Fire Alarm - Susp'd Ceiling - --- --T— _ 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 --"- - Final PASS PART FAIL ELECTRICAL — Service ]FA - Rough In _ UG/Slab - ---- -- Lbw Voltno (rrnPAR ----- _ '� SITE - Backfill/Grading Sanitary Sewer required before next inspection. Pay at City Hell, 13125 5W Hall Blvd Storm Drain ( ]Reinspection fee of$.— 4 .Catch Basin ( J Unable to inspect-no access• ( J Please call for reinspection RE: Fiie Supply Line ADA Ext Approach/Sldw ,.alk Date / "� I►tS(7PC10tr Other Final pp NOT REMOi/E this inspection record from the job site. PASS PART FAIL 24-Hour CITY or- TIGARD ;nspection Line: (503) 639-4175 MST BUILDING Business Line: (503) 639-4171 BUP _ INSPECTION D!1fIStUN - - - -- e-- PM BUP -- ---- Date Requested j_--J--- AM _ - - _ Received , — MEC - ---_- ' ^L Suite Location PLM PLM _ -------- - Contact Person --'�'dt -- Ph( ) - --- --- Ph SWR Contractor ELC - TenanUOwner ----"- ELC. r--� BUILDING j Footing ' _4z)t-tr I Foundation F�nec ss: ELR Fig Drain SIT ---- Crawl Drain tion Notes:SlabPost&Beam Shear Anchors Ext Sheath/Shear ---- 1, t Sheath/Shear Framing - - insulation - - Drywall Nailing - -- Firewall , Fire Sprinkler ^" Fire Alarm -- Susp'd Ceiling --- - -- ------. Roof - - - Other: - - Final PJLSrf3 '_PA R FAIL �L.UMfS _ est&Beam- 't lJricTer Slab Rough-In _ Water Service -— Sat otary Sewer Rain Drains i Catch b.:gln I Manhole --t Storm Drair, / Shower Pan ASS PAF FAIL _ CHANICAL_ ----- Post& Beam Rough-in ------- Gas Line _ — Smoke Dampers - --- Final - - - PASS PART FAIL - ELECTRIICL— Service Rough-Ir, — UG/Slab __----- - t ow Voltage I ire Alarm required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. F' Reinspection fee of$ E] Unable to inspect-no access PART FAIL J l__r� Please call for reinspection RE: 10.1Ext Line Fire Supply l c.,-V 1►' Inspector - ADA Dater Approach/Sidewalk Other: DO NOT REMOVE this Inspection record from the job site. Final ppSS PART FAIL CITY 4F TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST Z"I INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received ____ _--__ Date Reauested '__ AM _ PM BUP Location /�� G / ,l1' 1 , L __ _._ -__ Suite MEC J ., - Ph 72, 7 �G X_. PLM Contact Person __ _ Contractor __ Ph( _ ) _ _ _ SWR - LDI G TenanUOwner -- --- ------ -- ELC --- - - - - F- o ing ELC Foundation Access: Ftg Drain ELR _----_ Crawl Drain Slab Inspection Notes: SIT -_- -_ Post& Beam -- ---- - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - - - -- ---- _ Insulation Drywall Nailing ---- -- -- - --. - --Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling - -- - --- .._--- - Root S PART FAIL PLUMBING -- ..Post 8 Beam Under Slab _ Rough-In Water Service --- Sanitary Sewer Rain Drains -- -- Catch Basin/Manhole Storm Drain - Shower Pan Other Final PASS PART FAIL MECHANICAL —� Post& Beam-- - Rough-In — — -- -- - Gas Line Smoke Dampers -- -- Final _ PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Volta;le - Fire Alarm Final Reinspszbon fee of$ -_required before next inspection. Pay at City Hall. 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for ri pectio RE:_ __�_ ,_,G'�� Unable to Inspect-no access Firu Supply Line ADA "7 Approach/Sidewalk Date ` Inspsctar i Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL. a AAAAAAAAAAAAA &AAAAAAAAAAAAAA. ♦A`AAAAAAAAAi� .'� d i Prri a. rD ► a- r ► A-F CCD ,r1i ► rP Fri 4�i `�I f•'} � � ,y.'I' O ► '.() F-, ► ° ° ► NJ ► oil ► g 0 n c O o � � e I � 6 � a ^ 0 0 � I O v; C 4 J ,e ti 0 2 S,