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8811 SW MAPLE COURT :pnoo eldoW MS 6488 t 0 U d a A cn eo 00 8811 SW MAPLE GT CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour inspection Line: 639-4175 Business Line: 639-4171 BUP _--_ Date Requested (E-/-716 AM PM �_ BLD Location 11 _ Suite��++ / MEC Contact Person _ Ph �/ '7 Q /,a 7�� PLM Contractor Ph SWR BUILDING Tenant/Owner ELC _ Retaining Wall ELR Footing Access: Foundation Q� FPS Ftg Drain " Crawl Drain Inspection Notes: SGN Slab _ Post&Beam — SIT Ext Sheath/Shear Int Sheath/Shear — Framing _ Insulation Drywall Nailing Firewall / Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final — PASS PART FAIL PLUMBING Post&Beam -- — Under Slab Top Out _ — Water Service Sanitary Sewer Rain Drains Final --- —�--- PASS PART FAIL — MECHANICAL Post&Beam — Rough In Gas line -- Smoke Dampers Final — -- PAqQ PAR'f FAIL EC L a ervice --- Rough In — F— UG/Slab _ U) Low Voltage ^ Fir rm -- J , m ASS ART FAIL W 13ack ill/Grading --- --- — ---_ Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ i Please call for reinspection RE:_-- [ J Unable to inspect-no access ADA Approach/Sidewalk heDate Inspector Ext Final PASS PART FAIL j DO NOT REMOVE this inspection record from the job site. `,�l LY OF TIGARD BUILDING INSPECTION DIVISION MST �4-Hour Inspection Line: 6394175 Business Line: 639-4171 p,rl c� BUP Date Requested / AM PM BLD Location S5 R I Suite MEC Contact Person Ph (�f -7 PLM Contractor Ph SWR —� BUILDING Tenant/Owner ELC _ Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: — -- Slab — SIT _ Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing -- _ Insulation Drywall Nailing Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling — Roof Misc.- ----- - — Final ---_�--- PASS PART FAIL �— — -- -- — PLUMBING Post&Beam — Under Slab -- Top Out Water Service Sanitary Sewer ^--_— Rair�Drains ZSS LICAL PART FAIL _—_.___�—` ------ - ---- --- -- Post& Beam -------- - Rough In Gas Line — --- -- --"- - Smoke Dampers Final - -- ----- ---- ------- PASS PART FAIL IL ELECTRICAL _-- R Service N Rough In UG/Slab — Low Voltage -� Fire Alarm -- m Final W PASS PART FAIL --- _j SITE Backfill/Grading — --- —� - Sanitary Sewer Storm Drain [ i Reinspection fFe of$ _— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call fo: reinspection RE: _ — [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date `�' ' _Inspector �(1�� ILI Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the Job site. . CITY OF TIGARD BUILDING INSPECTION DIVISION MST A26)0 1.-6f,c 14'-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested AM_ PM BLD Location I Suite MEC Contact Person ) (� Ph ef,)C�Z<-'PLM Contractor_ Ph SWR EUILDING Tenant/Owner ELC _ Retaining Wall ELR Foohng Access: Foundation 7Z— FPS - Ftg Drain SGN Crawl Drain Inspection Notes: - -- Slab _ - SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _ If4 AVAi MSSING PART FAIL - 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 i 1 - — ASS PART FAIL TRICAL & Service X Rough In u U) UG/Slab Low Voltage J Fire Alarm Final PASS PART FAIL — W SITE Backfill/Grading -�-- -- — —--- Sanitary Sewer Storm Drain [ )Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ )Please call for reinspeHion RE:_ ,^_ ( J Unable to inspect-no access ADA Approach/Sidewalk p Date ���o Inspector— Ext Other - Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. C 0+ O F3 vC U q O V 7 E u tl u u O _ a w v � G •PJ oc p� o � � b c � y 3 rN H v FROM., OWE WEST ELECTRIC FAX NO. 5032976375 Mar. 28 2001 10:17AM P1 CITY OF TIGARD . 1312£ S.W. HALL BLVD. TIGARD OR722 9 3 IMPORTANT PERMIT NOTICE OWEN WEST ELECTRIC 8310 NW REED DR PORTLAND, OR 97229 Electrical Signature Form Permit M MST2001-00007 Parcel: 1S13SAA-0590Q-Site Address: 08811 SW MAPLE CT Subdivision: MAPLE RIDGE ESTATES Block: Lot: 014 Jurisdiction: TIO Zoning: R-12 Remarks: New SF detached dwelling. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid,the signatures of the supervising electrician Is required. Please have the appropriate individual from your company sign below and retum this Electrical Signature Form prior to the start of the work to the address above, Al TN: Building Dept. No electrical Inspections will be authorized until this completed form Is received OWNER: ELECTRICAL CONTRACTOR: WINDWOOD HOMES INC OWEN WEST ELECTRIC 12656 SW NORTH DAKOTA 8310 NW REED DR TIGARD, OR 97223 PORTLAND, OR 97229 Phone #: 503-625-6526 Phone #: 297-6315 Req#: uc 22402 VE 20e5S sus 2e-32ec L AN INK SIGNATURE IS REQUIRED ON THIS FORM x -419 3 Signature of Supervlsl g ElecaHclan 0 9 U If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 1312: S.W. HALL BLVD. TIG,RD, OR 97223 IMPORTANT PERMIT NOTICE JIM'S PLUMBING PO BOX 7160 ALOHA, OR 97007 Plumbing Signature Form Permit #: MST2001-00087 Date Issued: 3/23/01 Parcel: 1 S135AA-05900 Site Address: 08811 SW MAPLE CT Subdivision: MAPLE RIDGE ESTATES Block: Lot: 014 Jurisdiction: TIG Zoning: R-12 Remarks: New SF detached dwelling. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form Is received OWNER: PLUMBING CONTRACTOR: WINDWOOD HOMES INC JIM'S PLUMBING 12655 SW NORTH DAKOTA PO BOX 7160 TIGARD, OR 97223 ALOHA, OR 97007 Phone #: 503-625-6526 Phone #: 649-1034 Reg #: 1 IC 71860 LL PI M 34-186ab H AN INK SIGNATURE IS REQUIRED ON THIS FORM , _J _m w X J _ Signature of Aut ed P ber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD MASTER PERMIT PERMIT#: MST2001-00087 DEVELOPMENT SERVICES DATE ISSUED: 3/23/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 SITE ADDRESS: 08811 SW MAPLE CT PARCEL: 1S135AA-05900 SUBDIVISION: MAPLE RIDGE ESTATES ZONING: R-12 BLOCK: LOT:014 JURISDICTION: TIG REMARKS: New SF detached dwelling. BUILDING REISSUE.: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED _ CLASS OF WORK: NEW HEIGHT: 20 FIRST: 688 of BASEMENT: of LEFT: 3 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 648 of GARAGE: 260 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: SN DWELLING UNITS: 1 FINSSMENT: of RIGHT: 0 VALUE: S 121,199.00 OCCUPANCY GRP: R,, BDRM: 2 BATH: 3 TOTAL: 1,336.00 of REAR: 10 PLUMBING i SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<10OK: 1 BOIL/CMP<3HP: VENT FANS: 4 CLOTHES r)RYER: 1 GAS FURN>•100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL _ RE5;:'FNTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amn: �WISVC OR FDR: 1 PUMPARRIGATtON: PER INSPECTION: EA ADD'L 500SF: 2 201 400 amp: 201 400 amp' lot WIO SVCIFf)R: 00 SIGNIOUT LIN LT: PFR HOUR: LIMITED ENERGY: 401 -$00 amp: 401 000 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVC/FDR: 601 - 1000 amp: 601-amps-1000V: MINOR LABEL- 1000+■mpfvoll: PLAN REVILW SECTION _ Reconnect bdlY: >-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 8 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA7TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,023.58 This permit is subject to the regulations contained in the WINDWOOD HOMES INC WINDWOOD HOMES INC Tigard Municipal Code,Stats of OR. Specialty Codes and 12655 SW NORTH DAKOTA 12655 SW NORTH DAKOTA all other applicable laws. All work will be done in TIGARD,OR 97223 TIGARD,OR 97223 accordance with approved plans. This permit will expire if L work is not started within 180 days of issuance,or if the C work is suspended for more than 180 days. ATTENTION: Phone: Phone: 780.4375(M) Oregon law requires you to follow rules adopted by the D Oregon Utility Notification Center. Those rules are set Rag#: LIC 50196 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to J OUNC by calling(503)246-1987. 0 REQUIRED INSPECTIONS 7 UErosion Control Insp 8, Post/Beam Mechanica' Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Gyp Board Insp �rlectri Fin Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Firewall Insp M , and nal Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Rain drain I p umb 1'11 Post/Beam StrLlctural PLM/Underfloor Framing Insp Gas Fireplace Wa Se Ic ns Fin ction Issued Permittee Signature Call(503)639-4175 by 7:00 p.m.for an Inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00054 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/23/01 SITE ADDRESS; 08811 SW MAPLE CT PARCEL: 1S135AA-05900 SUBDIVISION: MAPLE RIDGE ESTATES ZONING: R-12 BLOCK: LOT: 014 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: _ FEES WINDWOOD HOMES INC Type By Date Amount Receipt 12655 SW NORTH DAKOTA TIGARD, OR 97223 PRMT CTR 3/23/01 $2,300.00 27200100000 INSP CTR 3/23/01 $35.00 27200100000 Phone: 503-625-6526 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections 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 purc e "1 ap 10 Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to ow le dopted by the Ore on Utility Notification Center Those rules are set forth in OAR 952-001-0010 throu 52- 1-0080. You m obtain�sopies of these rules or direct questions to OUNC by calling(503) 24 19 j Issued "4q' Permittee Signature: C-77 Call (503) 639.4175 by 7:00 P.M.for an Inspection needed the next business day 30:09'00 MON 08:53 F.%X 503 598 1960 CITI OF TIGARD 10 Q003 • ��uJ/'=' - SID S� Building Permit Application i y Date received: _ 3 ,� Permitno.vr>��^ �7n City of Tigard Avject/appl.eo.: Expire date: City Address: 13125 SW Halt Blvd.Tigard.OR 97223 ryr Phone: (503)6394171 Date issued: By- Receipt no.: 1.1 Fax: (503)598-1960 Case lik no.: Payment type: Land use approval: . lea family:Simple Complex �— ,01 dt 2 family dwelling or accessory ❑Commiercial/industrial O Multi-family "ew construction O Demolition ❑Addition/alterationtreplacement ❑Tenant improvement 0 Fite sprinkledalarm O Other. Job address: 4- Bids.no.: Suite no.: Loc: Block: Su vision: l y� t e _C 4-,r CK.Z> Tax tnapltrut Gi-taccount no.: /s/ 3 5-4,9 Ptnjectmum: � it2f .yJZy Dom' _ .�S'T�9'?". d�.ao,Gin• Desi. I Iort and location of work on rses/spectal conditions: / -1 Name: ) /A,,_mcnalis J Mailing address: >I!2&way dwemoa: City: y +2 Ic lState:,,- Valuation of work............................... ...... -2�— PhonFax:,;',77- fi-mall: No.of bedroomsibaths... ,......... .�/2-... Owner's to tadve: /',( Total number of floors........... ................ Z Phone: Sa rrl 4f c- E-mail: New dwelling area(sq.fl.) .......... / 3 k Garage/carport area(sq.ft)....�..Q....... 2 Gy ra7m,,.: Covered porch area(sq.fL) address: Deco area(aq.ft.).............._..�............. City: /11.L� Other structure area(sq.R)....,r............. Phone: />ry Fax: Email: �tu�f�1: Valuation of work....................................... $ _ Existing bldg.area(sq.fL) ................. ..... Business risme: New bldg.area(sq.tL) .......... y dress: Sa lel r, Number of stories -- — City: State: ': Type of construction............... ... Phone: Fax: E mail: CCB no.: tE fL 4Occupancy group(s): Existing: — City/metro lic.no.: - New: _ Notkt:All contractors and subenntracton are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: e' r , jurisdiction wherr work is being performed.If the applicant is Ci : iCil Shta-rr Z1P: .-+ �,� exempt from licensing,the following reason applies: Contact person: / Plan no.: ,6 Phone: — Fax: E-mail: -- _— 1 Name: wL Contact person: /1tA Fees due upon application Address: $/j :, fate received: City: 1. JZIP: Amount received... S .........._.................... PArone: / Fax: )i E-mail: Please ref::r to fee schedule. I hereby certify I have read and examined this application and the Nei rt kn4awas WMV M6a cavi.pMye am Ji.actioe for ete�e�am:b. 1 attached checklist.All provisions of laws and ordinances governing this 0 visit O MasterCard work will be complied with,whether specified hetein or not cmat eird..oba. Authorized signature: - Y_ Bare: � �� r..ed ewdholths a*Awn its oieditad- - Pdnt name. S -- -- NtpvtOrae AVOW Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44o4617(61000r)W 10'09.'00 VON 08:54 FAX 503 598 1980 CITY OF TIGARD Q 004 Plumbing Permit Application Datereceivtd: Permitno.: �City of of Tigard sewer pertrdt no.: 8ui1din6 permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of7Fgard Phone: (503) 6394171 Project/appi.no.: Expire date: Fax:(503) 598-1960 Dateisstted: By: Receiptno.: Land use approval: Case 61e r1o.: payment type-- prf&2 family dwelling or accessory 0 Commercial/industrial 0 Muld-family v Team improvement 'Wew construction 0.e►ddidontaltemdodreplacemeat 0 Food service 0 Other: Job address: Fee say, Tabd Bldg.no.: Stutc no.: ttw 1-d a y: (fmLties IN Q.tlareach as111ty ) Tax tru�1/tax lot/ticoount no.: 3Y,!� d0 J T�h G SFR(1)bath Lot. IBlocL. I Subdivision: h)• bre -9 b --- Project mune: AL OL d",e 6: City/county: y' •yt CD C'lcr 7-H': jr�3 Exch addidonel tchen Description ttntl Location of work on premises: c,1-.42 60i-d lutea Catch basin/area drain Eu.date of completionrrupection: in c. 'n dmin(no. ' It) Business dame: lam 5 !vr'_Qf% Manufacu_ es home utilities hUart-holAddress: Gaconnector City:6LJO _ Staoo�/L_ ?_IP: Sanitary sewer(no.lin.IQ Phone: e Fax: A,V E-mall: Storm secret no.lin.tt.) — - CC'B no.: -7 Plumb.bus.reg.too: r /�•!/' stet service ta. ) City/metro 6c.no.: r) C7 6 S S" Fbdwe or Iteaa: Contractor's representative signature_ / - on valBack ve ^ W nt kwatervalve ow venter / Ry /L Date.!i Da ac Banrulfav a M ME M Hot Name: I r;, r 917 C ,'{ washer Address: d• rj� �vaalrer fountain(s) . City: yQ Stttt : ZIP UO G 0Dnn1kinx ors/eump Phone: 3 aaB-mail: .---- __ v�tank m/sewer caName(print): / ,.fit r..t; O �!La►'� 1r'vC. cors' ub O die Mailirtg stirrers: S:� /tX` ,tq posal Qty: 4.10 roe maker Phone: IFax:' " /,ut: &&nail: ne�p Owner mstallation/residemW mainunwice only: The acetal installation mer(s) d. will be made by tree or the maintenance and trimir made by my regular Roof drain(commercial) 0: employee on the property I Own asper ORS Chapter 447. Sink(s). in(s).lays(s) NOwnees si - -- Y Dace: Sum T1" - wedshower pan Urinal w closet m Address: aver - amt hearer (� (:ity: Istate W Phone: Fax: E-mail: �! 1 ttdsl J _ td as tadPMc lanr&= emsMt car&,ph*w na prbNetloe for from totl>ffrw&nNotiAe:This petmi.,spplicaticn Minimum fee........_......$ _ ❑Visa O MasterCard expires if a pmnit is not obtained Ilan review(&I --%) $ Cmen card Main" _- -- - within 180 days slier it has been State surcharge M)....$ n fete. TOTAL.......................S Name d eardnoW&as�an a"card accepted romp _ S Ca 4bolda dpurue Aaaaar 4"16(6AOCOM 10/09.00 MON 08:55 FAX 507 598 1960 CITY OF TiCARD IM005 Mechanical Permit Application Datereceived: Permitno.. '.�O 'd City of Tigard Projecdappl.no.: Expire date: Chyn/7igard Address: 13125 SW Nall Blvd.Tigard,OR 71223 Phone: (503)639-0171 Dateiaaued: By: Receipt no.: Fax: (503)595-1960 Cane file no.: Payment type: Land rise approval: — BuildinEperxttitno.: 01 R.2 family dwelling or accessory ❑ComnlMgAVuuhtatrial O Matti-family O Tench imptoventmt w construction U Addition/alterationtreplacwnent O Other. Job address: Indicate equiptneat quantities in boxes below.lndicam the dollar Bld .no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax lot/account no.: /.5 3._5-/qr4INV&Value$ Lot: Bloch: Subdivision: , P4.ClI;D'D(,,� •See checklist for important application information and Project name: 0 tjAtl " '.s-D L,[y CT 71}- jurisdiction's fes acbedule for residential permit fee. Citylcounty: ZIP.- Description IP:Description and location of work on premises: iWaa) Tow Est.date of letionthuTection: PUs 111,45. Tenant improvement or change of use: 1 In existing space heated or conditioned?D Yes p No Air a nk '?*0Q CFM Is existing space insulated'!O Yes .Et No Air sue V an A s neem Business name: (,V PW d 'tet'U ,�fd�Ys State boBa pelmh no.: HP Tone BTU/H Address: /Z" T:,+ !alt ^ / "�It_r uct sea tors city. .42 State:-i1, ZIP_: 7;r a eat aPIM --cs�--� Phone:L G Pax L-2,S "' -mail: Instalweplace tarnaeWburner I daetwort/vent Iftm U Yon O No CCB tto.__S�,lQ�_ e - Ci /metro lic.no.: _ wall,a floor mounted New(please print): L.� aB or oa �1 Abatreplaanits _BTU/H Name: �6- makes HP Address: / F4,l L,- E � City: Sf /r1 L State: ZIP Banoevent Phone: Fax: E-mail: Mxblustu—` Hooft Type at hood Me suppression system Name: !Fh/ G..;} / Atl�3 �IvL- Bxbauts fM whh tl duct(bath fans) Mailing address: SrS- d i' .+i�Q J'A`I` s or t pity: G C State•--i� ZIP• 1�k3 Fed PW"=1 MODWARAW upon oro — _ lir; Nr; ori phone• ��' r Fax•j E trail n n ova ou Natrhe Number of outlets EM eearvan \ rn Address: - - - - pewfteplace Ci State: Z>p - -Phone: Fax: I-mail: — 1eD1e Applicant's signature: Dave: Name(print): Permit fee.....................$ Nar iss FRisskibm,aep aemr end[pkae�i p.+.3ceon rnr mac iofarsrla�. Notice:This permit application Minimum .. fee........ ......S y O via D MamrC:vd expires If a permit is not obtained Ccud 11II1� /p„py within 180 days after it has been Plan review(at gyp_ %) !Sc _ --Nese d u m accepted m CAQlIp1EtC. Slate `V�)••..$ s TOTAL.......................S v A1omm 44"17(GONCOW 10/09'00 MON 08:56 FAX 505 598 1960 CITY OF TICARD 1 008 Electrical Permit Application Date received; Norton no.:If 11,-f City of Tiger PmjeWsppl.no.: Expire date. Cityef7igard Address: 1312"SW!tall Blvd,Tigard,OR 97223 Dote issued: By: ►tecelptno.: Phone: (503) 6394171 Fax. (503)598-1960 Caw fikno.: Payment type: Land use appmval: UrI&2 Gmily dwelling or accessary ❑Commercial/industrial O Multi-family O Taunt irnprovemet r Gll�ew construction O Additiodslteratitas/replatxtrlent O Other. _ ❑Partial Job address: Bldg.aro.: Suite oo.: Tan maphax lot/acoottot aro.: Int Block: Subdivision: ProJea tame: l.,d! !2j-VL a Description and location of work on ses: �— Fstinuted date of ledoMna 'on: Job sot l!V Has Burmese name: • _ /-^ y MyMy� a raw as / '�.. ��1.�. �1. v J ��%'{- Address: (3i 2 &-'v iwdiag..tfraelrtiessrasra.isrt's City: State_'' ZIP: q;rl 2, so sesbobise Phone:-„q-]_ „j-7 Fax: E-mail:-- 1000 IL or loo 4 CCB no.: a. Elrx.bus.lic.no: -� �3 - t�aidisioads00 R« maeor_ Wasslaissiffy.rsidsrttid 2 City/metrolit-no.: ^V}c"`!l'y 3 G — Lindedmerly.eoo-redtimaial a Bsdt msaoescltaad home or moftu dwelUry 8 o sou ervis doctricion rw.d W 9e:rioendkrleeder _ -- 2 6wVlasesr -IotsVtlM, Sup.s4atstame l.icetMeao:2g 40 6---') 2011 orlm 2 Name(print): /r rel l[) ✓-�C�r 1Q '� .�7ti�.� 1 b 10(1 2 1 to 600 amps 2 Matti address: / . ^ a7 NQ a 601 to 1000,SM! _ 2 City: 5 ZIP: r' Orar an or Vohs 2 Phone:44, (- .2,4 Fax: &mail: - - --- Raooa0W t Owner installation:The installation is being made on property I own Teupworysasvlceserkeders- whidl is not Intended for sole,lease,rent,or exchange acctxding to Osslalirtisa4tiswaslaaornlaatlsr ORS 447,455,479.670,701, wo er loo 2 tot a 40o Maps a Owner's a' Wre• Date: 401 to swamp 2 ln=&eMealtr-arw,slierwWe, er eaaaaslsa!a'�k Name: A-Fen Ile brooch dearita with ptrchm of servloe or feeds be.each brand dnatlt 2 (3 . State 73P:.` B. pee fbr hraerh oh, Its Wkhow porchse 2 Phone: Fax: 1Prfllall: of service a heeds fes`9m hraereI dnadt: Bach adA ic-ow ttrmchcircult O?ervkeover225smps al QHedthvefalty Each pumpawissikxdads 2 O Swine met 320 snips-tadrg of 1&2 O thewdrros!creno E.!Eb sip or 4mg 2 family dwelliW O Buildlnr ova 10MO square feet four or Signsl drouit(s)or s limited eneesy pace!, O SyMem over 600 volts rmmbW more residendal writs in ane anocmre dursdom a examdoo' 2 ❑Building over throe Mons O Feeds;400 amp or more • O Oaasam lad ave 99 pemns O Manufrcnasl stroenaa or RV perk Fm&s&Mdmd tsrgeetlaa aver do in my 41 do sAwss O EaressAirhthtrpiat v Oth-..__ . _—._-- -- Periaspecdoo S 1-_sels of plias whit soy of be aMVe faysdgadort fee -- Tie 068"etre ant applir WMe to tearwN y oosahsetlnM osa Vke. Odra — - Permit fee.....................S Not u .oe.pt nadir srdk P�dl l�s�o^�em�� Notice:Thie�bit application plan review ai_� Win O MstsCsd expires if t is am obtained ( ) S Cie&card within ISO drys after it has been State Wrell F(856)....S emu of 160 m—Cro&C-.Wd Upir" occeptedas complete. TOTAL.»_.................._ 3 —_— Ca,mddw sips re —�— 4404615MWOMIS) 6 7 ?S 65 Il_ Ali N o j, -7 M n -75- `J �0 AI(A ,, sKleJL A s AISA ,o qtr too 3, /2'7b S�l��w1��6'�� N1°P"J bbl �w/�I�oL�/ltDGL ftnAA��