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14104 SW 121ST AVENUE l liff-04 SW I S7AV&jujr ' r I n k , t w r ••• •. • • c , • • • •• I J1 CITY OF TiGARD CLRFIGAJW L - OCCUPANCY COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . . MST95-034,7. 13125 SW Hall Blvd.Tigard,Ore,;-i io/223*8129 (503)630-4171 DATE ISSUED: 04/22/96 PARCEL- SITE ADDRESS. . . : 1.4104 1-W 121ST AVE !SUBDIVISION. . . . : ARLINGTON RIDGE ON I NG.-R_.3. 5 BLOCI... . . . . . . . . . : LUT. . . . . . . . . . . . . :029 CLASS3 OF WORK. :NEW TYPE OF USE. . . :SF OCCUPANCY GRN. ,;" K3 OCCUPAN'.."i' LOAD:2 lRemarks : PATH I uwner: PAUL DEAN 14694 SW GRANDVIEW L.N TIGARD OR '47224 Phone 590-510.5 Contractor: SCAN[?I NAV IAN GENERAL CONTRACTING(OVE PETERSEN, 7521 SW OAK ST PORTLAND OR 97223 Phone #. 452-9457 Reg #. . i 37046 This Cer-tificate grants OCCLIPaIICy of the above reFerr.,ncen building or portion thereof and uonfirms that the tildiny has been inspected for- rompliance with the State of Oregon Specialty des for the yrr,-ip, occupancy, gmc! use under shich the re fei-0=SSj.je44. B&I-L-D-1-N-G, -'I'NSPECTOR BUI'dDING OFFICIAL POST IN CONSPICUOUS PLACE CA� CITY OF T IG►ARDF°CRIhMASTAER P,ERMIT . . . . . . . : 1YIST95-OZ-46 COMMUNITY DEVELOPMENT DEBAR-VIONT DATq ISSUED: 09/25/95 13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)639-4171 r-,AR(,EL: 2S1101313-03J,00 3 F PiDDRESS. . . : 14104 SW 121ST AVE SUBDIVISION. . . . : ARLINGTON RIDGE ZONING: R-3. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . .02') BUILDING RE I SS(Jf--': DWELLING 1JNIT(;: 1 BASEMENI.. . . . . . . . :832 s f CLASS JF WORK. :NEW BEDRMS:4 BATHS:3 (.3 A R A G E. . . . . . . . . . :938 s f TYPE OF USE. . . :SF FLOOR REQUIRED SETBACKS­­­­­ T'Y'I-:,E OF CONST. :5N FIRST. ,, . . : 1600 s LEFT. . : 15 ft RIGHT. : 10 fl OCCUPANCY GRP,. :R3 SECOND. . . : 1123 s f FRONT. :2:10 ft REAR. . :50 ft: STORIES. . . . . . . :2 F I NBE)NENT:0 s f REQUIRED--------------------- HEIGHT. . . . . . — :29 ft TOTAL 2723 s f SMOKE DETECTORS. .Y FLOOR LOAD. . . . :40 psf VALUE. . . . . .01148 PARKING SPACES. . : 1 Remarks : PATH I -------I---- PILUMBING SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW P,REVNTRS. . : l LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 T R A f-',c... . . . . . . . . . . . . .. :0 TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft ) . :111 GREASE TRAV,S. . . . . . . :O DISHWASHERS. . . . : 1. WATER LINE (ft ) . : 10V OTHER FIXTURES. . . . . :0 GARBAGE DlSF,. . . : l RAIN DRAIN ( ft ) . :O WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 MECHANICAL FUEL TVPES---------- UNIT HTRS. . :O type amol.Int by date t-ecpt /GAS/ VENTS . . . . . :0 TIF $ 1390. 00 JSD 09/25/95 95-270928 MAX INP,UT :O BTU VENT FANS. . :4 SWM $ 130. 00 JSD 09/25/95 95-270926 FURN ( 100K . . :0 HOODS. . . . . . : 1 SWII $ 1121121. 00 JSD 09/25/95 95--270928 FUR14 ', =100K . . : I WOODSTOVES. rO BP'RT $ 688. 00 JSD 09/25/95 95-270928 FLOOR FURN. . . . :0 CLO DRYERS. : I BF,LC $ 447. 20 BON 09/12/95 95-270432 MOIL/CMP ( 3H, .0 OTHER UNITS: 1 135PC $ 24. 40 JSD 09/25/95 95-270928 GAS OUTLETS: 1 r ­RK 4, 500. 00 JSD 09/25/95 95-270928 Owner: $ 45. 00 JSD 09/25/95 95-270928 PAUL DEAN MP,LC $ 11. 25 JSD 09/25/95 95-270928 14694 SW GRANDV,:EW LN M5P,C 1, 2. 25 JSD 09/25/95 '-.)5 270928 38TH $ 225. 00 JSD 09/25/95 95-27121928 TIGARD OR 97224 P5PIC $ 11. :_0 JSD 09/25/95 95-270928 Plhune #: 590-E12'55 EROS $ 88. 00 JSD 09/25/95 95-270928 Contrar-tor: $ 28. 6.`l JSD 09/25/95 95-2709_6 SCANDINAVIAN CENEPAL ERP,C $ 2.8. 60 JSD 09/25/95 95-270928 CONT'RACTING (OVE P'E7ERSFN) 7521 SW OAF, ST PORTLAND OR 97223 CL P'hone 0: 452-9457 Reg #. . : 37046 ------------------------------------------- $ 3979. 50 TOTAL V) >_ This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Lire. Specialty Codes and all other Footing Insp r'11.tmb Top Okit applicable laws. All work will be done in accordance with approved Fo�.indation Insp Framing Insp plans. This permit will expire if work is not started within lee Plost/peam Str-l-ic-t Fireplace Insp days of issuance, or if work is suspended f t IPA days. Plost/Bit-ant Mectian Gas Line Insp Crawl Drain Insl.11at ion Insp Plermit � irl e , Sign At o9Z Pl /l.tridslab Insp Gyp )bard Insp --fILM/Undet-floor, Rain drain Insp Issued _4 Mechanic-al Insp Water Line Insp Call for inspection - 639--4175 SEWER CONNECTION -CITY OF TIGARD . . . I. PERMIT # ERMT SWR95--03'97 COMMUNITY DEVELOPMENT dI JifATHWI}NT DATE ISSUED: 09/25/95 13125 SW Hall Blvd.Tigard,Orapon 97223.8199 (503)830-4171 PARCEL: 2S 1 10BEI--05,x'00 .SITE ADDRESS. . . : 14104 SW 121ST AVE. SUPDIVISIC'N. . . . : ARLINGTON RIDGE ZONING: R--3. 5 BLOCK. . . . . . . . . , . LOT. . . . . . . . . . . . . .029 --------------------------------------------------------------------- TENANT NAME. . . . . : USA NO. . . . . . . . . . . FIXTURE UNITS. . . . CLASS 01= WORK. . . :NEW DWELLING UNITS. . : 1 TYPE OF USE. . . . . :SF NO. OF ESU I LD I NGS: 1 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : 5 Remarks : PATH I Owner,: _.__.____________.-________-•---.___.___ _.______.__..--____.______ FEES ---__.._--------.-•___- PAUL. DEAN type AM0Unt by date recpt 14694 SW GRANDVIEW LN ''RMT $ 2200. 00 ..TS" 09/25/95 95-270928 INSP $ 35. 00 JSL, 09/25/9 95-270928 T I GARD OR 97224 Phone #: 590-5125 Contractor: -.__.__._----------------.._---.__._ CONTRACTOR NOT ON FILE ---------------------------- 1"'1 one 4: f 2235. 00 TOTAL Rey it. ---- --- REQUIRED INSPECTIONS -----This Applicant agrees to comply with all the rules and r±yalat.iuns Sewer Inspection of the Unified Sewage Agency. The permit expires 180 days 1ror the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accilracy 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" Permit and the Age will 11 a lateral, t'ermittee �taiar : < c rr Call for inspection - 639- 4175 CL J t c.7 W _J ID JUL 27 '95 16 :29 No .052 P .01 CHICAGO TITLE INSURANCE COMPANY OF OREGON 9M S.W. GREENHURG ROAD, PORTLAND, ORBOON 97223 (503) 684.8954 Date: July cP71 1995 To:. City of Tigard ATTN: JERREL FAX #684-7297 From: Linda VanDyKe• Chicago Title(nsurionce Company Rot': Arlington Ridgu Subdivision-Y;;grd, Oregon Cost contribution for extension of S.:ti. Oaarde Lot Number: LOT 29, ARLINGTON PARK This is to verify that for the above referenoed lot, Bull Mountain Lend and Devolopmenf Company has paid the required $1,a24.25 cost conlrtbutlon for the extensipQ of S.W. Gaarde. At the time our office oloaed the above referenced lot sale, $1,424.25 was W thheld from the sale proceeas and is being held In escrow, The escrow account It, being maintained by First Americen Title Insurancs, Tenasbourne office, 2515 N,W, Town Centre Drive, Beaverton,Oregon 97005. For further Information, glees©contact Jody Johnson at 645.0320, eVanyke� Escrow om',er Chicago Title Insurenoe Company 99011 S.W. Greenbury Road Portend, Oregon 97223 Imo, U_ F� _1 W TOML, P.02 A3 PG-/= m src-re- L;r ICENLE US-A PLOT PA _3 Q LOT Zq rp I;,; S,To 9 1 i I Doc A A�AGN klD(:tE 3-7 374 o )Lj Ln 41 0 C: MFW'sihi� ri M St. W cn MOW ELGV F-F. 3735 i � a I � N p M: to 320 MAN LE4EL CAR 6At?A<.G Ln IF 3 'n'-* )Roti RcMONT u / �. — �ocu dns� I / 4JT"3 t4 rzot4 evD c.rr,j 5't4vjAW4 n�G, 'I v() 4 C. �P-4-" Reside itial Building Permit Application City or Tigard ` - 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobsite Address: C-c.�t Z4& -SW l ZI Subdivision: Lot # 7 Office Use Only �r �-/ Contact Date /—Initials - Valuation: -+— O Result New Construction Only: (Square Footage) Planck/Rec # 2-1) / Permit # Hous& Garageg4 Reissue of Corner Lot? Y ) Flag Lot? Y Map & 1"L # V Zone _ Owner: , Paw �-)�tn Plat # _ address: I Lj 40q1-/ _ CT-r-W-)CAu;eLu Approvals Required T r"a anti ` ) 7 ZZ L- Planning Setbacks Solar 1 Engineering Phone: ) �JO- /Z S—^— Other Items Required LContractor: _� P���Ser� Ymct��x C� Su�r�dlino.�J,ctn C 'F�t ubcontrac,ors Address -7Z2-1S.y (�X.�t . � n Truss DetailsPo(--t i , Qe �17Z.z3 Other - --- -- Phone: L 503 ) 9 SZ-T-45 -7 _ - Notes Contractor's License # -37 Q" 4�1 — (attach copy of current Oregon license) y* Y Contact Name �� 0 �, ' a.,,a.,, - +—IS2 4S7 - v Contact Phone �_ _ E-4 --52 '7 5 - M _ Subcontractors: Architect/Engineer: Iq M4S Plumbino �•W' r�►1umbt 1 Spec ' 4e& Address CL Mechanical: R( jd4xsk0t Aiv- 2yk,40 00— F ^ ,f (attach copy of current OR Contractors License) Phone L �— JOB DE IPT N� SIA44 + . 11"1, t.Le t -- — LD AA. ---- --_—_— (-S()3 ) H S 2---9 y i 7 __ -' Applicant Signat"re) Applicant Phone number l c Received by: �' 1. (� —__- Date Peceved. 12 A Permit i* Account Description Amount Amt. Pd. Bal'. Due . Bldg. Permit (BUILD) Plumb. Permit (PLUMB) Z). �' __ ZS Mach. Permit (MECH) r� �� S c n ✓ State Tax (TAX) 4� —�p Bldg: 13Y ''' G� I(Zos / , / � u Plumb: Z) ✓ __ �-/ f Mech: Pian Cho L'FC' (PLANCK) �S � Bldg: �r 1 Plumb: Mech: I 1 > �l,c,Q�i•��y Sewer Connection (SWUSA) "t1,v Sewer Inspection (SWINSP) .3 .> , L Parks Dev Charge (PKSOC) s U _ -S Dv Residential TIF (T1F-R) / U v / Mass Transit TIF (TIF-MT) Commercial TIF (TiF-Cl Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-0) Water Quality (WQUAL) Water Quantity (WQUANT) �' �� _ l�J cc Ln Fire Life Safety (FLS) C Eresion Cntrl Permit (ERPRMT) L/ L Erosion PlancklUSA (FRPLAN) L — w -' Erosion Planck]COT (EROSN) TOTALS: S -�- 1y I i i ' �; I t •I �f;1� 1'I I I 11 ' 1 (.11 1!f.iyMI NI 1't1 11 I , ' 1 11,11 1. t,111 1J h1141111111 7 i.'': lii, VIO 1 ': I I t .I 114 I I 1,1 1 .11 1 1 1111 11 111 1 I,1, 1411,1 IAII. II III 11, . I! 't11M)1.91.'l11?1'1 ,. Pt11A'I1A 111 1'blrr.1W1 11111111111 1'1110 1-'11111 '11;11 111 ►'111I'll 111 1Oft 1111"41 1'Is111 1.11 (IN a J 2 C7 W 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. ost'BeamMem Shear/Sheath Framing CMT_ Plbg.Und/Fir/Slab Plbg.Top Out Insulation Elect. H sUBeam Struc Mech. Rough-in Gyp. Bd. -B(d San. Sewer Gas Line Appr/Sdwlk'Yy1 eln Other: Date: L �, A.M. P.M. Entry: Address: Tenant: �.^ Ste:_ MST: O akc BUP: Con/Own: _^- _ MEC: PLM: .LC: �. THE FOLLOWING CORRECTIONS ARE REQUI L.R: a ri } — -- ---- t-- J 1 W Inspector _ ZL 04qQ_OVED 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 Mach. 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 Line Appr/Sdwik /f Other: — Date: A.M. P.M. Entry: -- — Addres Ste: MST: Tenant: - BLIP: �-Z-S L Con/Own:_ MEC:PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: J W -- - - J 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 Mach. Shear/Sheath Framing -Mach. Plbg,Und/Fir/Slab Ptbg. Top Out Insulation Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg. Z ' V San. Sewer Gas Line Appr/Sdwlk Reins. Other: Date: — _ A.M. P./M. Entry: Address: f' 0- Tenant: / Ste:,_ MST: G)/Own: "[U :2 �c SIR 0 �- MEC:_ PL M: ELC: ,g$'i-OL�� THE FOLLO'^IING CORRECTIONS ARE REQUIRED: ELR: _ a J -4 W J Inspector: Date: i Af*ArPPROVED —DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOTICE (AS Inspection Line: 639-4175 Business Phone: 639-4171 a/ b Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. st:/Bi m Me hear/Sheath Framing ec PIbg.Und/Flr/Slab �g.Top Out Insulation -Elect. ost/Beam Str Mach, Rough-in Gyp. Brl. San. Sewer Gas Line Appr/Sdwlk Reins. Other: Date: A.M. P.M.Y, Entry: c../_. Address: Tenant: _ _ Ste: MST: BUP: Con/Own:C MEC: PLM: ELC:THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: LAG 4 � 1p (J)p -TAxe -ve l c��¢, �� o�sr CD J !� Inspector: _ Date: _APPROVED ,DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-5171 Footing Rain Drain Cover/Service FINAL: Foundation Waier Line Ceiling -Plumb. Post/Beam Mach. Shear/Sheath Framing -Mach. Plbg.Llnd/Fir/Slab Plbg.Top Out Insulation -Elect. Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Apar/Sdwlk Reins. Other: Date: A.M. P.M. Entry: Address: Tenant: — — __ Ste: MST: BUP: Con/Own: _. MEC: PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: CL Cx r -- J Inspector: Date: (-I APPROVED 4USAPPROVED/CALL FOR 9EINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOT Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: , Foundation Water Line Ceiling -1u Mb Post/Beam Mech. Shear/Sheath Framing -Meth. 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: _ _ _K(_P A.M. - P.M._�. Entry: Address: — —fit _ Tenant: _-_ Ste:_- _ MST: d BLIP: Con/Own: i�-- — -- MEC:_. PLM: ELC: — --- - --- THE FOLLOWING CORRECTIONS ARE REQUIRED ELR: til F.. �n f-- J w Inspecto. _G Dater . UVED _-CISAPPROVED/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 -Plum . Post/Beam Mech, Shear/Sheath Framing -Mach, Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. Post/Seam Struct. Mech. ROugh-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: _ Iiij Date: A.M. P.M. Entry: ^. Ad Tress: Tenant: Ste: MST. BLIP: Con/Own: MEC: PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: G CL oe 7 6 f -- v � w Inspecto/�v Date: �APPROVED _DISAPPROVED/CALL FOR REINSP. CF CO I CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL.: Foundation Water Lina Ceiling <- lum . Post/Beam Mech. Shear/Sheath Framing -Mech. Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk 1Reins. Other: _— _ —_ !� Date: ` AN P.M. Entry:`��r2�yl� Address: (�-�[� _ 421 L dat:_ ,— Tenant: Ste: MST.c3.q J -7 ...7 Z Con,'Own 9q_5 MEC:_ PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: G7� L w Inspector:'`!'5 Date: _APPROVED —ILO APPROVED/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 Mech. Shear/Sheath Framing -Meeh. PIbg.Und/FlriSlab Plbg. Top Out Insulation leci� Post/Beam Struct. Mech. Rough-in Gyp Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins, Other: Date: W 15t 1 (�_- A.M, P.M. Ent . Address: �. Tenant: Ste: MST: S d 3 � Con/Own:d Z BLIP: MEC: PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: 4rAF'— 02-7S` r CL a ►— w - -- Inspector _� A j< Date. APPROVED _DISAPPROV /CALL FOR REINS . CF CO ILDIKra INSPECTION NOTICE Inspection Line: 639 4175 Business Phone: 639-4171 Footing Rain Drain over/Service FINAL: 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-in Gyp. Bd. -Bldg. San. Sewer Gas line 62;l Reins. Other: Date: _ A.M. P.M. Entry: Address: --- Tenant: Ste:_--- MST: 9-S--0-_34-Con/Own: _ MEC: PLM: --- - [--'LC: THE FOLLOWING CORRECTIONS ARE REQUIRED ELR: i J J Inspector: Date: PPROVED __ DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:_ Footing Susp. Ceiling Spiink, 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 -Bldg. Pibg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: ( l_ (^`Time:KAM PM Address: Builder. ��`��.5 j ,Z . Permit #:TEZ/Z 5=0-:)5( THE FOLLOWING CORRECTIONS ARE REQUIRED: TN- CL _ J W J Inspector,z G� �_� c_ Uate: APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE —Call For Reinsp. j j� CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-•1171- Business Phone: 639-4171 Inspection: Footing Susp. Ceiling Sprink. Hough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace PosttBeam Struct. Plbg, Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. P(bg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Undertlr. Insul. Shear Wall / gyp. Bd. -Elect. Date Requested:_ � Time AM PM Address: Ruilder. Permit #: �7 03 "l(2 THE FOLLOWING CORRECTIONS ARE REQUIRED: 4 � J L^ CJ Ud J Inspector: Date: Z _APPROVED _DISAPPROVED /--'APPROVED SUBJECT TO ABOVE Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 `\ Inspection: �J Footing Susp. Ceiling Sprink. Rough-in AppriSdwlk Foundation Plbg. UnderslabMech. Rough-in Fireplace Post/Be^iu Struct. Plbg. Top Out Elec. Rough-in FINAL: PU.Iftieam Meeh, San. Sewer Gas Line X� -Bldg. Plbg. Underfloor Rain Drain f�mg -Plumb. Alarm Water Line nsulation -Mech. Underflr. Insul. ShearWall Gyp. Bd. EJect. Date Requested: Z' Z�� Time: AM (J PM Address: 1 U 4 L.1 sa Builder: Permit #: (93467 THE FOLLOWING CORRECTIONS ARE REOUIRED: Zeit s _ ,� 4-t—� vi C Cl ---- Uj Inspector: Date: 2 4 _APPROVED _DISAPPROVED A OVED SUBJECT TO ABOVE �'7 —� _Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk Foundation Plbg. Underslab ec � Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-inkll FINAL: Post/Beam Mech. San Sewer as Line -Bldg. Plbg. Underfloor Rain Drain Framing: j -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: ­ / �_ I S! Time: AM, �PM Address: 1 L' f / - �. 4 7C 1--e Builder:_ !,Permit #: THE FOLLOWING CORRECTIONS ARE REQUIRED: Cz 1%11­z ,lZ �;� 4. � Q ��O- A,--* t­0 l Inspector: Date: APPROVED DISAPPROVED _APPRC':ED SUBJECT TO ABOVE Xall For Reinsp. t • . r CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171 Inspection: 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. Sari. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: Time: AM PM Address: -� Builder: Permit #: � `l4 (4� THE FOLLOWING CORRECTIONS ARE REQUIRED: ] 2-10� 3 (I � LLI S Inspector:, �o /�Y\,��------� Date Z �.-- -APPROVED DISAPPROVED APPROVED SUBJECT TO AROVF �� _Call For Reinsp. C./ CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: 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 -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul, Shear Wall Gyp. Bd. -Elect. Date Requested: Time: AM PM Address: E3uilder. Permit THE FOLLOWING CORRECTIONS ARE REQUIRED: CL Ln I 657 r�_��v� l.e. LA—A- Q, . �t L i . J � Inspector_ ( /y _ Date: ( 7 `APPROVED kDISAPPROVED APPROVED SUBJECT TO ABOVE /-R V`Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:_ Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Outlec. Rough-i ` FINAL: Post/Beam Mech. San. Sewer Gas Line Bldg, Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr, Insul. Shear Wall Gyp. Bd. -E!ect. Date Requested.__ L� I ime:_—AM __PM Address: � p r Builder:_ TZt,I� _L�.�� Z ��j�?, U Permit #: THE FOLLOWING CORRECTIONS ARE REQUIRED: .{ r Ln ja CDW J �� r / Inspector: �, �/ �-�c �l� Gate: / //—'�PPROVED ,DISAPPHOVFD ,APPROVED SUBJECT TO ABOVE Call For Reinsp. Tt-5 CITY OF TIGARD BUILDING INSPECTION NOTICE n Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 1�\J Inspection: Footing Susp. Ceiling Sprink. Rough-in Appr/Sdw!� Foundation Plbg. Underslab Mech Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech, San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. hear Wal Gyp. Bd. -Elect. Date Requested: 1c� ( TimeN.Y-,, AM PM Address: Builder: Permit aY: 25- C' 3 4 �p THE FOLLOWING CORRECTIONS ARE REQUIRED: N r_ C7 ry J Inspector: �TT � _APPROVED __DISAPPROVED APPROVED SUBJEO ABOVE Clc). _Call For Reitisp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639 4175 Business Phone: 639-4171 Inspection:_ 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 -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. sear Wall Gyp. 8d. -Elect. Date Requested: ��,Z �� �c Time:,KAM PM Address:—1 Builder: Permit q: THE FOLLOWING CORRECTIONS ARE REQUIRED: /74 CL w Inspector: _ Date: 2 / - -APPROVED --MW-P?ROVED APPROVED SUBJECT TO ABOVE _CaRR7r Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg, Underslab Mech. Rough-in Fireplace Post/Beam Struct. IbP g. Top O_ut Elec. Rough-in FINAL: Post/ earn Mech. Sari. Sewer Gas Line -Bldg. ( g. Undert�oorflain Drain Framing -Plumb. Alarm Water Line Insulation -Mach. Underilr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: Time: AM ___PM Address: Builder:T Pe'rmit 1!�` � – ()3 4 p THE FOLLOWING CORRECTIONS ARE REQUIRED: Com— a cc J 'L Q0 W J Inspector._ / i Date: �L � C' S ,APPROVED —DISAPPROVED% APPROVED SUBJECT 7-0 ABOVE _Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE c`> Inspection Line (Hec-O-Phone): 639-4175 Business Phone: 639-4171 {]/ Inspection: k 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 -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb, Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall// Gyp. Bd. -Elect. Date Requested: l 6 `] Time:XAM PM Address:�4 Builder: l tom` c� Permit #: ? 157 U 3 410 THE FOLLOWING CORRECTIONS ARE REQUIRED: 7i-� T s o✓.�- J c� W - Inspector ^_ Date: jl Z / �S APPROVED DISAPPROVED ROVED SUBJECT TO ABOVE Cali For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Roc-O-Phone): 635-4175 Business Phone: 639-4171 Inspection: � r�x_ �+,�['•--�a1`�,,..ti '!art. <J 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/BeanjX9ch. San. Sewer Gas Line -Bldg. (�PIbg. Underlloo Rain Drain Framing -Plurnb. Alarm Water Line Insulation -Meeh. Underflr. Insul. Shear Wal! Gyp. Bd. -Elect. Date Requested: Time: AM PM Address: �� y /z Builder: PQrmit e- -i THE FOLLOWING CORRECTIONS ARE REQUIRED: r r " J J Inspector: � ` _ Date:�� _APPROVED e-"DISAPPROVED _APPROVED SUBJECT TO ABOVE all For Reinsp. CITY OF"i IGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Footing Fireplace Foundation Plbg, Underslab Mech. Rough-in P Elec. Rough-in FINAL: Post/Beam Struct. Plbg. Top Out Bldg. Gas Line Post/Beam Mech. ��8� -Plumb. Rain Dr ih Framing Plbg. Undertloor -Mech. Water Li Insulation Alarm -Elect. Underilr. Insul. Shear Wall Gyp. Bd. Time: PM Date Requested: Address: r�g Permit #: � �� Builder: C THE FOLLOWING; CORRECTIONS ARE REQUIRED: ----------- a cc w J 17 �4 �_ Date. Inspect DISAPPROVED APPROVED SUBJE T ABOVE PROVED _DISAPPROVED For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Hough-in Fireplace Post/Beam Struct. Plbg. Ton Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. (flbq. Unde Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mach. Underflr. Insul. Shear Wall Gyp. Bd. -Elect.. Date Requested: 4(> Zj.2 I- /= Time: AM 4PM Address: I�1 (U11 &D 1 Builder: -7 S q — ,S,� n j0 V-1e _Permit #: 3 THE FOLLOWING COHRFCTIONS ARE REQUIRED: � — v v� F- J s C-0 W J In pector� _ _ _ _— Date: PPROVED DISAPPROVED APPROVED SUBJECT O ABOVE Call For Reirsp. CITY OF TIGARD BUILDING INSPECTION NOTICE r\ Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 inspection: (�C. Footing l0/0\ / Susp. Ceiling Sprink. Rough-in Appr/Sdwlk un�dati Plbg. Underslab Mech. Rough 'n Fireplace ostP /Beam Struct. Plbg. lop Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. ct. Date Requested: r & -5 — Ti,ZA PM Address L '7 l C� L( L2 ( C r/ Builder: _ Permit #• U 3'tY ( THE FOLLOWING CORRECTIONS ARE REQUIRED: _ J .'t L'1 - W Ing-sctor. APPROVED _DISAPPROVED APPROVED SUBJECr TO ABOVE _Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: _ ootin ) Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mach. Rough-in Fireplace Post/Beam Struct. Plbg, Top Out Elec. Rough-in FINAL: Post/Beare Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plurnb Alarm Water Line Insulation -Meeh. Underflr. Insul. Shear Wall Gyp. Bd. Date Requested) Time: 3 AM _ PM Address: Builder: Permit #: j s /THE FOLLOWING CORRECTIONS ARE REQUIRED: C � 7i'oy.✓J�. S�%i V� c YG '42 `fir J L L7 !aJ J Inspector:_ Date: !d / APPROVED DISAPPROVED —APPROVED SUBJECT TO ABOVE _Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: 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 -Bldg. Plbg. Underfloor ain Drain Framing -Plumb. Alarm Water I.ine Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: l 2. Time:4AM PM Address: / Z& y /_— Fluilder:_- ��L� a 9 Permit #: THE FOLLOWING CORRECTIONS ARE REQUIRED: d �1 1xi H 11 J C7 W J Inspector: Dater , �' _APPROVED _DISAPPROVED APPROVED SUBJECT O ABOVE 4-1—Call For Reinsp. L:.1 I Y (A I I tl H R I 141-A+- .1 P I OF Po-ly* 1141 PF tJ j I"1 1411. 9!..,1 ti 1114I.I.;k H11111,11,41 `0(1 141 [AAM) I.- V.01il1 rIMI-AINI 00 c1(11)Hu.fiH c DPA SGANDINOV 1(.111 (4:NVA041. ( 41111 141 f)(111 wi, ..I,lbcCl SW OAK !3f V 1,�t(IN POR ILANO OR 147H23- it 11*4 1 1'r 111, 1111.11-DINU PF,HM M,;1 4!-p -0,';,ltfn 68ti. 00 tF1O 1,11-1, 1 jAjq 1,1, ril. p,'. Ullil MNO PI. 4N (+0 (X� 19 7 'CIO MF.(JJf4NJ(',hl 111. 6il-I I Hl-l.1, WP USA M14145 .11139 1 00 1#0 IrWNL), 1AW: Lloo. 00 RU. DU 1.1 11 t 11 114111 1 1 t f F d 1 a i1n« 400 I RAN,=1 I I I I F f:V P. t O1h 1,lo.) Ul 4 Il I I Y I s 0. 11 .1 11' 11 1 . 1 otA. 014 Ot 11#4 1 j I y I fit A I I I Y I I I 11A0. 00 t_k(li-)j A lt4 1 4 11'4 1(it'll 114 O 1 11 1 88. 011A (,()NlRW F-'1 .FIN 1,14 C'.8. 61A F: 1410N I 1.4,11WI ;-,H. 60 LU 1 ', I 1,1,t A4 I ".1-1r i ()Vl-,. wliIi. 11110ON4 P(Aill CITY OF TIGARD PERMIT SUED . . . . MST95-0346 DATE ISSUED: 0915/95 COMMUNITY DEVELOPMENT DEPARTMENT • PARCEL: 2S110BB-05200 13125 SW Hall Blvd.Tigard,OrogQon 07223.8199 (503)839-4171 SITE ADDRESS. . . : 14104 SW 121ST AVE SUBDIVISION. . . . : ARLINGTON RIDGE ZONING: R-3. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :029 CLAS6 OF WORK. . :NEW GARBAGE_ DISPOSALS. . : 1 TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : 1 OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0 FIXTURES--------•------ LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1 SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . :0 LAVATORIES. . . . . :5 OTHER FIXTURES. . . . . :0 TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0 WATER CLOSETS. . : ?, WATER LINE (ft ) . . . . : 1.00 DISHWASHERS. . . . : 1 RAIN DRAIN ( ft ) . . . . :0 Remarks : PATH I OWNER: ____._.___.__.__.._.---------------__-.-- --____-__-•--___.___FEES-------.-------- PALIL DEAN TIF f 1590. 00 .JSD 09/25/95 95-270928 14694 SW GRANDVIEW LN SWM $ 180. 00 JSD 09/25/95 95•-270928 SWM f 100. 00 JSD 09/25/95 ^5-270928 TIGARD OR 97224 BPRT $ 688. 00 JSD 09/25/95 95-2.70926 Phone #: 590--5125 BPLC $ 447. 20 BON 09/12/95 95--270432: B5PC $ 34. 40 JSD 09/25/95 95-270928 Plumbing Contractor: _.._._..-------.-----.___.__.._ PARK $ 500. 00 JSD 09/25/95 95-270928 MPRT $ 45. 00 JSD 09/25/95 95--270928 Name : _hl.,-F]_� Plum _Snec�,s�lties, Inc .__ IhPI_C 11. 25 JSD 09/25/95 95-x_709:=8 Address : P.O. Box 606 _ _ M5PC $ 2. 25 JSD 09/25/95 95-270928 City:. Gresham ---State : OR 3BTH $ 225. 00 JSD 09/25/95 95-270928 Zip: 97030 Phone#: 663-9066 F15F'C $ 11. 20 JSD 09/2:5/95 95-270928 Reg #:26-5.12P�_.` Additional fees not shown here. . . . . . . . . -- ---- - REQUIRED INSPECTIONS ------- This permit is issued subject to the reg-- ulations contained in the Tigard Municipal Footing Insp InsUlation Insp Code, State of Ore. Specialty Codes and all Foundation Insp Gyp Board Insp other applicable laws. All work will be done Post/Beam Struct Rain drain Insp in accordance with approved plans. This Post/Beam Mechan Water Line Insp permit will Pxpire if work is not started Crawl Drain Water Service In Ljithin 180 days of issuance, or if work is Plm/undslab Insp Appr/Sdwlk Insp ,:Uspended for more than 180 days. PLM/Underfloor Mechanical Final Mechanical Insp Plumb Final Plumb Top Clut Building Final d Framing Insp Erosion Control Fireplace Insp _ > Gas Line Insp _!Chor"i zed Plumbing ontra for Signature -'_ Call for inspection - 6.39-4175 l*ontractor Notes: CITY OF TIGARD PERMIT#: PERMIT PERMIT #: f_'LG95-0644 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 1L/21/95 13125 SW Mall Blvd.Tigard,Oregon 07223.9109 (503)630.4171 SITE_ ADDREf:S. . . : 14104 SW 1219T AVI SUBDI V I S ION. . . . : ARLINGTON RIDGE Z.ON I NG: R-3. 5 BLOCK. . L O T. . . . . . . . . . . . . :02,1) Project Description : ___._REazDE_NTIAL UNIT------ ----TEMP SRVC/FEF_DERa----- -----MISCELLANEOUS----- 1000 GF OR LESS. . . . : 1 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 5005E. . . : G 201 - 400 amp. . . . . . . : 0 STEN/OUT LINE L'T C3. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : Q, SIGNAL/PANEL. . . . . . . : 0 MANF=. HM/ SVC/FDR. . : 0 601+amps•-•1000 volts;. : V_l MINOR LABEL Qi -. SERVICE/FEEDER---- -----BRANCH CIRCUITS----- ---ADD' L INSPECTION{;-.-_. 0 - 200 amp. . . . . . : V7 W/SERVICE OR FEEDER: 0 PER INSPE'C:TION. . . . . : 17, 201 - 40Z amp. . . . . . 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EA ADD' L. D RNCH CIRC: 0 11\1 PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION___-_--- -__----. 1006+ amp/volt. . . . . : 0 > -4 RES UNITS. . . . . . . . : ) 6170 VOLT NOMINAL— - Recurinect only. . . . . : 0 SVC/FDR ) = 225 AMPS— : CLASS AREA/SPEC OCC. Owner: ---------------------------- ---------------------- FEES SCANDINAVIAN HOMES type amount by date recpt 14104 SW 12131— PRMT $ 310. 00 0 12/,-:1 /1)5 95-27416E, OPCT $ 15. 50 D 12/21/95 95-•274166 r'I CIARD OR 97i.2,23 Phone #: ContrAct or: ----------------.-__.__-_______._--_.._-_.__-.__.-_._-----_.-.-_.--_------..__ F7AITH ELECTRIC INC 32'5. 50 TOTAL. PO BOX 20476+ ------ REQUIRED INSPECTIONS --- I1,E:I ZER OR 97307 Phone #a This Perot is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 5oecialty Codes and all other !-ger m t t.et? EairarIEi euf-, avolicable laws. All work will be done in accordance with approved plans. This pertit will expire if work is not started within 180 days c issuance, or if work is suspended for tore '06tvVV"kX 1"V'cVIY� '/ than 180 days. Isnued By -------------------------- -OWNFR INSTALLATION The installation is being made on Property I own which is not intended for sale, lease, or rent. 9WNERT S SIGNATURE: _ _.._.._... _..__..._.. DATE: _ -----------------------CONTRACTOR INSTALLATION ONLY--------____.-_-_.__--_- ---__ i 1 UNATURE OF SUPR. ELECT N: __.___..._..._._._�.__._.._...- DATE: L ICENSE NO: -J Call for inspection - 639-4175 LIIY (4 1 1 c:iui I m Rl rl JPI I'I P(-4YlvR 1\1 I I'l � l JPI Nil. I I F:L P, 'r R I f 1 NC 14.1 X RIA47b 'I-Mvil NJ DAIF OR t 1) C-i it)N PIMI'Ll'o'V. I it tlf't Mi.N I OHAD P1,1141,01itft Ut- I-111Y1,11 .10 HOHIIIPJ I 1'W)II I- I 1 I T R 11,.(it r,f ISMvl I IA. VtO I I 1 14- 14 n. ct Ln C-0 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # C YU IV Date Issued tl - i Phone (503) 639-4171 FAX (503) 684-7297 ITY OF TIGQRD TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development ��l(�r uyd&yl�1 ��Ghu� Number of Inspections per permit allowed Address[�O y 3W 111 s r ,rt✓e- Service included Items Cost(ea) Sum City/StatelZip_II_t 4a. Residential -per unit 00 1000 Sq. ft or less �_ $110.00 Q 4 Name (or name Of business)_ Each additional 500 scl ft or V ( ��/ portion thereof $25 00 �C V Commercial L_� Residential to Limited Energy $2500 1 Each Manurd Home or Modular Dwelling Service or Feeder $6800 _ 2 2a. Contractor installation only: 4b. Services or Feeders ♦n Installation,alteration,or relocation EIS CtrlCal OntraCtOr l�}] � 'C L /'1 e Zn t� 200 amps or less $60 00 2 Address (' &K 9LO lif 7 201 amps to 400 amps i $8000 2 City_ State Zip_ ) 401 amps to 600 amps $12000 2 $18000 2 n 601 amps to 1000 amps Phone o.� 1 /�� _ Over 1000 amps or volts _� $340.00 _ 2 NO. Reconnect only $5000 _ 2 ,ontractor's license NO. Z4 - X — 4c. Temporary Services or Feeders Contractor's Board Reg. No. C) Installation,alteration,or relocation Signature of Supr. Elec'n 200 amps or less — 2 License No.-3, L 5 Phone No. zo1 amps to 400 amps $50 00 ------ �--- 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 Owners Name New,alteration or extenston per pone Address a)The fee for branch circuits with purchase of service or feeder fee. r City StateZip _ Each branch circuit $500 Phone No. b)The fee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 Eaacch additionnalalbbranch circuli not intended for sale, lease or rent. Ebranch &$500 rSS DO Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or Irrigation circle $40 00 _ 2 Each sign or outline lighting _ $4000 Signal circuit(&)or a limited energy 2 Please check appropriate Item and enter fee In section 5B. panel,alteration or extension $4000 4 or more residential units in one structure Minor Labels(10) $10000 Service and feeder 225 amps or more ��- System over 600 volts nominal 41. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above f- as described In N E C Chapter 5 perhour Per hour tion $3500 4 -n p __ $55.00 _ In Plant $5500 F- Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: NOTICE 5a. Enter total of above fees $ 11 c 5%Surcharge (05 X total fees) $ L' PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 5bEnter AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF . CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reevivieww if required (Sec 3) line A for $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED Trust Account # $ _ Balance Due $ 'A p CITY OF TIGARD ELECTRICAL PERIT RESTRICTED ENERGY _ COMMUNITY DEVELOPMENT DEPARTMENT F'E:RMI T #: EL.R95--0251 13125 SW Hall Blvd.Tigard,Oregon 07223.8189 (503)639.4171 DATE ISSUED: 12 /95 PARCEL. 2S 1 1 w DL'.--05200 ;ITE ADDRESS. . . : 14104 SW 121ST AVE..: GUBD I V I S I ON. . . . . ARLINGTON RIDGE 2 O I NG: R-3. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :IT='9 Project De_cri.cotion : All Encompassing restricted eler�tr^ical permit. RESIDENTIAL---------- D. COMMERCIAL----__.___---_______________________---__. AUDIO & C:TEREO. . . : X AUDIO & STEREO. . : I LvT'ERCOM & PAGING. . .. BURGLAR ALARM. . . . : X BOILER. . . . . . . . . . : LONDSCAPE/I RRIGAT. . : GARAGE OPENER. . . . : X CLOCK. . . . . . . . . . . . MEDICAL-. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . : X DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : Vnf-1 IUM c]YSTEM. .. . . : X F I RE Al. AP11. - . . . .. r. OL)TDOOR I._ANDSC !1 Tr C)TL IF R:ALL : : X HVAC. . . . . . . . . . . . : D ROTE.CT I VE= SIGNAL. . - INSTRUMENTATION. : IGNAL. .INSTRUMENTATION. : I.,THER. TCS FAL # OF_ SYSTEMS: 0 anpl icant : __.__.__.__._____._.____._-• FEES , - CANDINAVIAN GENERAL CONTRACTI tvpe amoLrnt by date recot 75211 SW OAK 5T PR11T $ 40. 00 .TSD 1j,/2c)/9 5 5PCT 4; 17. JSD 12/29/917) 95-274454 �'Or TLAND OR 97223 �'h on e #: 452-9457 L,on t;Tact or: 3CAND I NAV I AN GENE rml-- _ $ 4..'. 00 TOTAL_ ,ONTRACTING (OVE PETERSEN) 7521 SW OAK ST ------- REOU T REI) INSPECTIONS ------- .PORTLAND OR 9721r_'3 ceiling Cover Fl er_t' i Service 'hone #: 45E'-•9457 Wall ,V n—r #. . . 3704E L This oereit is issued subject to the regulations contained in the ..._ .. - Tioard Municioal Code. State of Ore. Soecialty Codes and all other F'ermitee Signat�lre aoolicable laws. All work will be done in accordance with iooroved olans. This oereit will expire if work is not started within 180 days of issuance. or if work is susoended for tore than 188 days. Is t.red By INSTALLATION rhe installation is being mr7de on property I own which is not intended for ,ale. lease. or rent. OWNE Ft' S SIGNATURE- _.. _ _. _ _. _ DATE INSTAU__A-EmN 9T(NATURE: OF SUPR. ELEC' N: _-- --_.__.. DATE .� .-ICENSE! NO: J Call for inspection - 639--4175 Q0 W w,w f.1 t .1 1{•''I Nil. (imillfwl M-IMN. Icill 1,41,1111.)rIll AD D HE"is c DHO ISUONDINf-Wis-41\1 l4hlf.14.4 (AINW NI Difit 9 �,,p 13W 11,41t." ., I I,WlIILPNO Ilk 4 1', 'c', t I 110 't IY, - NI III PH4 MP N 1 IOU it It I I I't 1114 It III lityl.1 1 .40. t+0 1 it C.0 141,04 RM t -101141. f4m(AINI 11#4.11) • Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hall Blvd. �/ /� (l( /; Tigard, OR 97223 PERMIT# C `� %7 V G Phone(503)639-4171J FAX(503) 684-7297 DATE ISSUED �` SA4 s TDD No. (503)684-2772 CITY OF TIGARD Inspection (503)639-4175 ISSUED BY PLEASE COMPLETE ALL SECTIONS 1. LOCATION Or INSTALLATION 4. TYPE OF WORK )41,01.4 Suk) f -9:2-/ Address Q RESIDENTIAL—Restricted Energy Fee. . . . . . . . . 140.00 f` k p CA.� 0 Ic 17 Z Z' �' (FOR ALL SYSTEMS) City State Zip Check Tyne of Work Involved: PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK [] Audio and Stereo Systems IS NOT STARTED W'',1119 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. ❑ Burglar Alarm 2. CONTRACTOR APPLICATION ❑ Garage Door Opener* ��**'� I G V,4 t @j e. A4,%,11.4�1 ��, ❑ Heating,Ventilation and Air Conditioning System' Contractor�-'t AJ I r'0 0t 4 'IN Type t' ❑ Vacuum Systems' Address r5� S i.,J d°` k t�"` Other_ Date 2-I Z-"1 I COMMERCIAL—Fee for each system . . . . . . . . . )40.00 + — (SEE OAR 918-260-260) Property Owner �a �^i �a Q V1 ChUl Type of Work Involved: Contractor's Board Reg. No. 3 4' ❑ Audio and Stereo Systems �'2- I qS ❑ Boiler Controls Phone#f ❑ Clock Systems 3>�OWNER APPLICATION ❑ Data Telecommunication Installations ❑ Fire Alarm Installation 1> A 1) -- ❑ HVAC Print Owner's Na Phone No ❑ Instrumentation ress '-- ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* City Sta!e Zip ❑ Medical This permit is issued under OAR 918.320-370.This applicant Agrees to make only ❑ Nurse Calls restricted energy installations 1100 volt amps or less)under this!nrmit and to do the ❑ Outdoor Landscape Lighting' following: 1. Only use electrical licensed persons to do installations where required.(Certain ❑ Protective Signaling residential and other transactions are exempt from licensing.These have ❑ Other asterisksM.All others need licensing), CL 2. Call for an inspection when all of the installations under this permit are ready for Inspection at 503-639.4175. � ❑ Number of Systems 3. Purchase separate permits for all installations that are not ready for inspection >- when the inspector is out to Inspect under this permit. •No licenses are required. Licenses are required for all other installations. t.— 4. Assume responsibility for assunnh that all corrections required by the inspector are done,and 5. Assume responsibility,for calling for a final inspection when All of the 5. FEES corrections are completed. /1 L7 C The perso ning for this permit must be the applicant or a person a. Enter Fees $ authori7 t th plicant. b. 5% Surcharge(.05 x total above) $ Sign, tffp Com' TOTAL $ Authority if other than applicant ENERGAP.CHP CITY OF TI GAR® ELECTRICAL PERMIT-/96 �-- PERMIT #: EI_C9G-0042 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 01/22 13125 SW Hall Blvd.Tigard,Oregon 97223.9199 (503)830-4971 PARCEL: 2S 1 10131;•-052 00 SITC ADDRESS. . . : 141.04 SW 121ST AVE SUBDIVISION. . . . : ARLINGTON RIDGE ZONING:R-3. 5 BLOCK. . . . . . ,. ,. . . ., 1-01 . . . . . . . . . . . . :021) project Descriptio. : ------------------------------------------------------------------------------------------- -- -RESIDENTIAL UNIT---- ----TEMP SRVC/F SEDERS------ ------M I SCELL.ANEOUS------- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 201. _ 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . : 1 MANE. HM/ SVC/FUR. . : 0 601+amps--1007+ volts. : 0 ih•IIJR LABEL ( 10) . . . +;`+ ----SERVICE/FEEDER---- ----BRANCH CIRCUITS----- ---ADD' L INSPECTIONS------ 0 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 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. . . . . : 0REVIEW SECTION-------- 1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . ;• > 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR > = 2:25 AMPS. . : CLASS AREA/SPEC OCC. : Owner: -_._____.---_.__. .__-------_.__.------_____-_-__.- -__.__._____.-_-.___ FEES --------------__._ F'AUL DEAN type amol-int by date recpt 14104 SW 121 ';T AVE PRMT $ 40. 00 CJS 01/22/96 96-2751 4 5PCT $ 2. 00 CJS 01/22/96 96-275154 TIGARD OR 97223 Phone #: ('0r)tractor: I JONEYWELL f 42. 00 TOTAL 1.5x_+95 SW SEQUOIA SUITE 100 REQUIRED INSPECTIONS PORTLAND OR 972:24 E1 ect' 1 Set-vice Phone #: Elect' l Final Rug #. . . This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signat+.lre -.`icable laws. All work will be done in accordance with approved plans. This permit will empire if work is not started /. within 188 days of issuance, or if xork is suspended for sore than 188 days. Issued By -----------------._-------_-----OWNER INSTALLATION The installation is tieing made Ln property I own which is riot intended for- 'Ale, lease, or� rent. 11WNER' S SIGNATURE : __ -- _-_ DAIL: c� +- _-----------------___-—CONTRACTOR INSTALLATION ONLY- -------_ -_--- ---------- �- SIGNATURE OF SUPR. ELEC' N: fIIGi� DATEe /-a :A . 96 = LICENSE NO: w Call for insp c} ion - 639-4175 I it I f Y Ut 11 14-11111 - 10 t I J I I I It 14 4 r PlI 14 1 fli i k i I ' I Ni 3 11 .(-,K OCA-1 III t 1540-) o SW bbid(IIII.J.H-4 I.-ItIMY PiOtll NI Oto lIr-. 1 0 1 I.-IONILMD UH A JIM 1 9 1!31 ON 1 9 1 4 ML IN)I fOlf.)UN I PI-IJ 1) V wmv N I f4ftll)l IN I PH 11) 1 A• LO 40. 00 '. 1 !1 1 1 It P 00 V) F- 7J LU 0 IF 111W 1;�-'I ST VA 1`11 .4-00i'll-, 4i-'. 00 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # . fZC/Vr, 00-/2 il Date Issued 1=y6 Phone (503) 639-4171 TTY------- CITY OF TIOARD FAX (503) 684-7297 TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Narne of Development /� _ Number of Inspections per permit allowed Address /4 1 L1���� S/q +iHUL' Service included Items Cost(ea) Sum City/State/Zip %/��f�f�U L�/� l 7 ��� 4a. Residential -per unit ///1 1000 sq. ft or less $11000 4 Name (or name of business) / l7L( �. /f rT V Each additional 500 sq n or $2500 — portion thereof 1 x Llmlted Energy $25,00 Commercial ❑ Residential L1�' Each Manurd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: 4b. Services or Feeders Installation,alteration,or relocation Electrical Contractor L t`I coe 1�C— 200 amps or less $60.00 2 Add re s �� c Gds /C 201 amps to 400 amps $ato 0000 2 L S xLi ,�r LCG fl _ / _ 2 77 401 amps to 600 amps 2 City r'` t >n,11i State!' Zip ( g $160.00 601 amps l0 1000 amps 2 Phone No.�' �'�S 5 J — Over 1000 amps or volts $34000 Reconnect only $50.00 Job NO. r3 4 -=•tel contractor's license NO. 4c. Temporary Services or Feeders Contractor's Board Reg. No. - Installation,alteration,or relocation 2 ianature of Supr. Elec'n ✓ 200 amps or less 201 2 * , amps to 400 amps $50.00 2 License No.C3� JlC _ h fSo (� S'-. 5 3 401 arrpsto600amps $7500 -- - Over 600 amps to 1000 volts $10000 2b. For owner installations: gee"b"above 4d. Branch Circuits Print Owner's Name_ ____ New,alteration or extension per pane Address a)The fee for branch circuits with 2 —-- purchase of service or feeder fee. City _ State_ _ Zip Each branch circuit $5 D0 Phone No. __ _ b)The fee for branch circuits without 2 a purchase of service or feeder lee. The Installation is being made on property I own which is !_ 2 First branch circuli $35 00 a not intended for sale, lease or rent Each additional branch circuit $5.00 _ Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Platz Review section (if required): Each pump or Irrige circle $40 00 Each sign or outtlra lig lighting $4000 Signal clrcult(s)or a limited energy Please check appropriate Item and enter fee in section 5B. panel,alteration or extension �_ 1114000 4(j ,t�' 4 or more residential units in one structure Mlnnr t abets(10) 0 00 o Service and feeder 225 amps or more 4f. Each additional Inspection over System over 600 volts nominal Classified area or structure containing special occupancy the allowable in any of the above _ Per Inspection $3500 as described in N E C Cnapter 5 Per hoar $5500 ?' In Plant $5500 Submit 2 sets of clans with application where any of the above apply. Not required for temporary construction services. PI y 4 P ry 5. Fees: �° 5a. Enter total of above fees $ NOTICE 5% Surcharge (05 X total fees) $LU r(JU J Su PF_RMITS BECOME VOID IF WORK OR CONSTRUCTION $ 5b. Esterer 25 25�/o of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec 3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS - -- C:OMMENCED ❑ Trust Account # Balance Due $ _ . ELCTRICn1_ PERMIT CITY OF T I GARD RESETRTCTF--*D fz-NF-RrY Ll COMMUNITY DEVELOPMENT DEPARTMENT PERMIT # , ELR96--111027 13126 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 DATE ISSUED: 01/19/96 PARCEL: 2,S110BD--05-200 ETE ADDRESS. . . : 14104 SW 1L'1GT AVE SUBDIVISION. . . . : ARLINGTON RIDGE ZONING: R-3. 5 LiI_Ocv. . . . . . . . . . .I LOT. . . . . . . . . . . . . 0 C29 Project Description: install fire alarm. A,. RESIDENTIAL---------- B. COMMERCIAL-­­­­ AUDTn & STEREO. . . . AUDIO & CTERFO. . : INTERCOM & PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . . LANDSCAPE/IRRIGrT. . ; GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . I IIIED I CAI... .. . . . . . . . . . . : HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . : TIRE ALARM. . . . . . X OUTDOOR (._ANDSC L. ITEC:: nTHER.- HVAC. . . . . . . . . . . . . PRnTFCTIVF qTSNAI_.. . .- INSTRUMENTATION. : OTHER— : TOTAL- # OF Sys"rEms: 1 ,I).licant : r- EEG `1UL DEAN type am,- Lint by date r,ecot 14104 SW 121ST AVE PRMT s W. 00 CJS 01/ 19/96 96--1.75067 `;PCT $ 2. 00 CJS 01 /19/q6 96--27506'7 TIGARD OR 1)7223 Phone #: CP Pt;T- $ 42. 00 TOTAI... A0 0!_9 we /.G*qq'9 AL-) REQUIRED INSPECTIONS 0/'. 9 Ceiling Covet- Elect' l Set-vice Phone 4t. Wall Covet- Elect' I Final Ren #. . , This aervit is issued subject to the reaulations contained in the Tigard Municipal Code. State of Ore. qoecialty Codes and all other Pei-mitee Siuriati-tr-e acolicable laws. All work will be done in accordance with aoaroved plans. This permit will exoire if work is not started within 18@ days of issuance, or if work is susvended for mare C-1 _1C than 180 days. lss,_tecf By INSTAL!. ATION The installation is beinq made on proper-ty I own which is not intended fat- s AIe, le,.Asp. or- rent. OWNER' S SIGNATURE: DATE: INSTALLATION 96- I GNATURE ELECI N: a,le. OF SUPP. DATE i L I CENSE Nn Call for- in-,nection — 6:3q---41I7F, C) I y Ut- I I('41 .) HP f*11,1 (if f-'tlymt:191 F?I-Cu- II I NII, 196- /1,110(, SH 01401141 0. 00 lo'KIA10.10 Pt"WY PAYMFIS11 1114117 " IA 1 9(. JOVA V l'i U JN I-'1_I1� 1111M1I11 Cl 11 4 11.11'1'C1;1 111 I'iI`rIY11rNI 1-4111.111141 14411) P[JfW(,IbL. lit PHYME141 1.011111141 WI-I'llp .............. 1 10 13-11.. Pl1-11.1 1 40. VIO !i I « W 1.11 11 1 It H 101 Community Development RESTRICTED ENERGY FLECTRICAL APPLICATION 13!25 SW Hall Blvd. Tigard, OR 97223 PERMIT#_EL/�966 Bo Q 7 _ Phone(503)639-4171 DATE ISSUED FAX (503) 684-7297 —_— TDD No. (503) 684-2772 CITY OF TIGARD Inspection (503) 639-4175 ISSUED BY PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK dor RESIDENTIAL —Restricted Energy Fee. . $40.00 y� 9 �-a (FOR ALL SYSTEMS) Gty —L� State Zip Check Type of Work Involved: I PERMITS ARE NON-TRANSFERABLE AND NON-l-EFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems' IS NOT STARTED WITHIN 1110 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. ❑ Burglar Alarm 2. CONTRACTOR APPLICATION El Garage Door Opener' o ❑ Iseating,Ventilation and Air Condilioning System` Contractor -�Z)/Uyh� _-- _(_ _ ❑ Vacuum Systems' Address_/` f S ` O/ W-P— -'lc0/A i�u /f /v d ❑1 Other — Date COMMERCIAL— Fee for each system . . . $40.00 -- ----- -- (M F()AR 91(1-260-260) Property Owner` _ _ _ Chec oe of rklnyolved: Contractor's Board Rog. No . _ _---- ❑ Audio and Stereo Systems" ❑ Boiler Controls Phone# __gi�� tS a ❑ Clock Systems 3. OWNER APPLICATION ❑ Data Telecominunic;)lion Installations Fire Alarm Installation ❑ HVAC Print Owner's Name Phone No ❑ Instrumenlation Address ❑ Inlercom and Paging Systems ❑ landscape Irrigation Control* City State Zip ❑ Medical This permit is issued under OAR 918-320-370.Thk applicant agrees to make only ❑ Nurse Calls restricted energy installations(100 volt amps or less)under this permit and to do the ❑ ()utdoor Landscape Lighting' following: 1. Only use electrical licensed persons to do installations where required.(Certain L-1 Proh,ctive Signaling residential and other transactions are exempt from licensing.These have ❑ Other asterisks(').All others need licensing). "- 2. Call(or an Inspection when all of the installations under this permit are ready for inspection at 503-639-4175. ❑ Number of Systems 3. Purchase separate permits for all installations that are not ready for Inspection cc l'- when the inspector is out to inspect under this permit. •No licenses are required. Licenses are required for all other installations. `n 4. Assume responsibility for assuring that all corrections required by the inspector > arc done,and F- 5. Assume responsibility for calling for a final Inspection when all of the corrections 5. F E FS are completed. The person signing for this permit must be the applicant or a person a. Enter Fees $ ' authorized to hii t w ,1h cant. -- t,' _ — /% o. 5% Surcharge(.05 x total above) $ Signa e TOTAL $-4-106 Authority if other than applicant ENERGAP.CHP