11680 SW 128TH AVENUE Ll i30 SW 128Td AVhNUL
CITY OF TIVA RD
CdMMUNrrY DEVELOPMENT DEPARTMENT
13126 SW HWI BW, P.O.Box MV,TigaM,Oregon 97223 (W)d38-4175
PLUMBING PERMIT
IDERMIT #. . . . . . . : PLIV192-01315
639-4171 DATE ISSUED: 279/03/92
SITE ADDRESS. . . : 11680 SW 126TH AVE PARCEL: IS133DD-08500
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. 122
------------------------------
CLASS OF WORK. . %."IDD GARBAGE DISPOSALS. . : MOBILE HOME SPACES. s .___
TYPE GF USE. . . . :SF WASHING MACH. . . . . . . : BACK-LOW PREVNTRS. . % 1
OCCUPANCY GRP. . sR3 FLOOR DRAINS. . . . . . . : TRAPS. . . . . . . . . . . . . .
STORIES. . . . . . . . ..2 WATER HZATERS. . . . . . % CATCH BPSINO. . . . . . .
F1 X LAUND"'. )'RAYS. . . . . . : SF RAIN DRAINS. . . . . c
SINKS. . . . . . . . . . : URI1*-iLS. . . . . . . . . . . . .* GREASE TRAPS. . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. . . . . 4
TUB/SHOWERS. . . . ; SEWER k-INE (ft) . . . . 1
WATER CLOCETS. . : WATER LINE (ft) . . . .
DISHWASHERS. . . . RAIN DRAIN
Remarks;: SPRINKLER SYESTEM
Owner: ------------------------------------ ------------------ FEES
DON MORISSETTE BUILDERS, INC. type amount by date reept
15555 SW RANGY RD. PRMT $ 15. 00 JH 09/03/9E
#201 15Pc r $ 0. 75 JH 09/03/9,2
LAKE OSWEGO OR 97035
Phone #s 620--7538
Contractors
SHOEMAKER' S PLUMBING
P 0 BOX 250
ESTACADA OR 97023
1-1hone #: 503--630- 772.8 $ 15. 75 TOTAL
Rep #. . g 56135
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Top--ol.tt Insp
Tigard Municipal Code, lzfatv of Ore. Specialty Codes and all other Final Inspect ion
applicable laws. All tork will be done in accordance with
approved plans. This permit will expire if work is not started
within 160 dr.fs of issuance, or if work is su,oindid for more
than 180 da s.
Vlermittee Signati.tre:
1queri By . -
Lall for inspection 639-4175
DEPARTMENT OF LAND USE&TRANSPORTATION
r ° WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY INSPECTONE 503 E LS: 3/640-3561/693-4415
OREGON Pacrt- 1 r,r
Date 05/04/94
Time 13 : 38
Permit Type Residential Electrical Permit Permit: # 05052814
Permit Status APPROVED Applied 05/04/94
Situs Address t 11680 SW 128TH AV TI lssued 05/04/94
Permit Title SFR - ELE.0/BURGLAR ALARM Completed
Permit Descr . To Expire 10/31/94
Project Titlk% : SFR - ELEC/BURGLAR ALARM Project # P0040176
Project Descr, * EROSION
Parcel Number 2:STI -- Land Use District
Valuation 0
Legal Descr .
Owner 10SPE;CTION - TIGARD Construction : OT
Applicant Name : PHILLIPS ELECTRONICS Classification : 900
Applicant Addr . : 11.10 NW FLANDERS Occuparic'y : R3
P'JRTLAND, OR 97209 Validated by : KF
Applicant Phan-,: 227-05'/1 Inspect-or Area
CONTRACTOR : PHILLIPS ELECTRONICS Lic , C 26-213C 227-0571
Fee description Units Fee/Unit Ext fee Data
-------------------------
Limited E;ntegy/Alter . /Exten:aion 1 40 . 00 40 . 00
Subtotal Electrical Pees : 40 , (.)0
:Mate Surcharge of 5% 2 . 00
'Total Electrical Fees :
*** Fees Requized * * ** * P'eg`s Collected S Credits * �. *
Method Check # Receipt No. Date Payment
CK 4598 05/04/94 42 , 00
TQI'AL THIS DATE 42 . 00
Feest 42 . 00
Adjustments : . 00 Total Credits : 00
Total Fees : 42 . 00 Total Payment: 4'2 . 00
Balance Due : . 0u
NOTICE: This permit becomes null and void It the work or construction for which It Is Issued Is not commenced within 160 days. Once construction hos started,
the permit becomes null and void It constructlon Is Intarnipled for a period of 160 days. I certify that the Information presented by the applicant and
his agent or agents In support of this permit Is true end correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will be compiled with whether or not specified on the plans or noted on the plans correction sheets. 1 acknowledge that
Ilia granting of a permit dors not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
Ilia structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval is given by the Building Offlr.'al. I further acknowledge that a Ilan may be placed on the title of the property upon which the permit Is Issued
specifying that the use or occupancy of fhe building or structure Is provisional and revocable until the satisfaction of all inspection requirements.
APPLICANT'S SK r'ATURE
WASHINGTON COUNTYRES RESTRICTED
Department of land Use & Transportation
..-� North
Electrical Inspection Section ELECTRICAL E N E R G Y
155 North First Avenue, #350-12
Hillsboro, Oregon 97124 APPLICATION
Information: (Sn3)3) 64 64U-347U FAX: (503) 693412
R.LWEPAT.
Please(complete aft se&t'1on"s,-.'1 through S. Project .Jo.__ Permit No,
1. ,Location of installation Label No._._—__^_ Date
,, Issued B� Office
Address��E�_)_— SCJ- 11 __6
City Te Zip Code ----
�( 9 7 ti L ?J 4. Type of work:
��r�
Directions
�� '� _, RESIDENTIAL Restricted Energy Fee � $40.00 ?
(tor all systems)
- -- ---- Check typo of work involved:
Commercial ] Residential Audio and Stereo Systems"
Tenant Name Burglar Aiarn
(if commercial)
This permit beromes null and void If the work author J by the Fire Alarm
Door Opener*
permit Is not con nenced within SBO days from date of issuance Fire A
of such permit or f the we rk authorized Is suspended or abandoned Heating,Ventilation and Air Conditioning Systems*
at any time attar� ork Is commenced for a period of 180 days. Vacuum Systems*
Electrical Permits are nun-refundable and non-transferable. i Other
2. Contractor appl" ationi
COMMERCIAL. Fee for each system $40.00
Electrical Contractor (see OAR 918 '60-280)
Address Q/ - 4 WNJ -
Date _ Job Number Check type of work involved:
Property Owner
Contractor's License No. Z�r 3 L C, (; BollerControla
Contractor's Board Reg. No. 5� Zj Clock Systems
_ 1�7�Q�7L _ Data Telecommunications Installations
Phone No.
Fire Alarm Installation
3. Owner application: HVAC
Instrumentation
Print Owner's Name Phone No Intercom.xnd Paging System
Landscape Irrigation Control"
Address Medical
Nurse Cella
C11i State Zip Outdoor Landscape Lighting'
Thls Irermlt is lesued under OAR 91A-320-370. The applicant agrees Protective Signaling
to make only restricted energy Installations(100 volt amps or less) Other
under this permit and to do the following:
1. only use electrical licensed persons to do installations where
required. (Certain residential and other transactions are exempt Number of Systems
from licensing. These have asterisks('). All others need licens-
lng)
2. Call for an Inspection when all the instaNadons under this permit 'No Iwenses are roqurrod. Licenses are required fbra0ofhsr(nsta!laUona.
sre ready for Inspection. C
3. Purchase separate permits for all installations that are not ready 5. Fees
for Inspectlwr when the Inspector Is out to Inspect under this Enter fees $ _
permit.
4. Assume responsibility forsesulning that allcurrections required
by the inspector are done,slid 5% Surcharge (.05 X total above) $
S. Assume responsibift for calling for a(trial Inspection when altof the corrections are completed ZLU
The person signing this permit must be the applicant or a person Total $
authorized to bind the ant.
Space below reserved for validation.
Authority it other than applicant _ _
For Inspe,:tions call
640-3561 or 693-4415
24•hour recorder, one working day In advance of need
10191