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� ELECTRICAL PERMIT-
^` CITY OF TIGARD RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2004-00133
13125 SW Hall Blvd., Tlpard,OR 97223 (503)639-4171 DATE rSSUED: 5/24/2004
SITE ADDRLSS:09450£W MOUNTAIN VIEW LN PARCEL: 25111BA-11900
SUBDIVISION: BINGHAM PARTITION ZONING: R-4.5
BLOCK: LOT: 003 JURISDICTION: TIG
Prosect Description:All encompassing low voltage for new construction.
A.RESIDENTIAL B.COMMERCIAL _
AUDIO&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:
OTHER ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
- INSTRUMENTATION: _ OTHER:
TQIAL#OF SY TES M3:
Owner: Contractor:
WAYf - 'GHAM OWNER
14320 , A.RLOW COURT
BEAVF JN, OR 97008
Phone: 503-646-7999 Phone:
Reg#:
FEES Required Inspections
Description Date Amount Low Vcltage Inspection
JELPRMTj ELR Permit 5/24/2004 $75.00 Elect'l Final
[TAXI 9%State Surch-rl 5/24/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Muninipal 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 o work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to folio les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR n92-001-0010
CL throe AR 95 01-0100. You may obtain copies of these rules. or direct questions to OUNC at(503)246-6699.
re
/
t~/) Issu by Permittee Signature ,� ry
—� OWNER INSTALLATION ONLY
mThe Installation Is being made on roperty I ow9 which Is not tended for sale, lease, or rent.
W OWNER'S SIGNATURE: x ���,�u .. DATE: G
CONTRACTOR INSTALLATION ONLY M�
SIGNATURE OF SUPR. ELEC'N DATE:_ _
LICENSE NO:
Call 639-4175 by 7:00 P.M.for an Inspection needed the next buslnesa day
Electrical Permit A.pp otion
CityuPTigard p;�'' j p PetrtritNo
13125 SW Hall Blvd,Tigard,OR 97223 Plan Review/B
Phone: 503.639.4171 Fax: 503 598.1960 DateMy: Other Permit.
Inspection Line: 503.639.4175 Data Ready/By:— 1 gee Page 2 for
Internet. www.ci.figard.or.us NotltfedMati-od / / Supplemental Information
t
El New construction []Addition/alteration/replarement Please check all that apply,
❑Demolition ❑Other: ❑Service over 225 amps,cotnm'I ❑Hazardous location
[]Service over 320 amps -rating ❑Buildng over 10,000 sq.Ct.,
of 1-and 2-family dwellings 4 or more new residential
❑ i-and 2-family dwelling Commercial/induoulal ❑Aceeaaory building ❑System over 600 volts nominal units in one structure
❑Multi-family Master builds �� ❑Building over three stories ❑Feedtrs,400 amps or more
❑O,,cupant load over 99 persons ❑Manufactured structures or
// tr_�r�gresolighting plan RV park
.fob no: I Job site address: q�SQ 5'(d, � vied [�+e�< DHealth-care facility ❑Other
6ubnut_L sets of plans with any of the above.
Clty/StatdZlP: _�,P at AW Qre�eh 97 L z The above are not applicable to temporary construction service
SuiteP..Mg./apt.no.: )jectname: S�.i�Ql•. �rcL�eu.c� `' ..
Doovitur.n
Cross street/directions to job site: New resldzatial single-or multi-fatally dwelling unit.
-- _includes attached garage.
1,000 sq.ft.or less 145.15 4
Subdivision: Lot no.: Ea.add']500 sq.R.or portion 33.40 1
Tax map/parcel no.: - Urnitet energy,residential 75.00 2
Limited energy,atm-residential_ 75.00 2
Each manufactured or modular
dwelling,service and/or Ceeder _ 90.90 _ 2
/Ow VD 'y L �✓!� '7f Services or feeders Installation,alteration,and/or relocation
200 amps or less 80.30 2
20' amps to 400 amps _ 106.85 2
401 amps to 600 strips 160.60 2
Name: Wa,j K-&, L. $i&I't 601 amps to 1,000 amps 240-60 2
Address: 9 $(� S,(,,) /fist a t I�, ICit7 L K� _ Over 1,000 amps or volts 454.65 2
— Reconnect only 66.85 2
City/State/ZIP: T .R •-W, . 0,kG o�, 47 ZZ '14_ Temporary services or feeders Installation,alteration,and/or
Phone:(5",Oy 6 y6- 78q Fax:( �) relocation
200 strips or Ir-s ! 66.85 _ I
Owner installation:This installation is being(Wade on property that I own which is not 201 amps to 400 amps 100.30 2
or m
i-itended for sale,lease,r nt,or exchang accg to ORS 447,449,670,and 701 401 amps to 600 amps 133.75 2
Owner signature: i2 �^ Date: ;'IZ11111,0V Branch circuits-new,alteration,or extension,per panel
A-Fee for branch circuits with
,mice or feeder fee,each 6.65 2
Business name- branch circuit
-- —' B.Fee for branch circuits
Contact name: without service t-f ' , fee,
each branch r 46.85 2
Address: _ Each add']bran _ 6.65 _ 2
City/°:dte/ZIP: Miscellaneous(. ,ceder not Included)
O. Phone:( ) —�� Fax: :( ) Pumpirri
or gation^-ircle 53.40 2
Sign or outline lighting 53.40 2
'�.. E-mail: Signal circuit(s)or limited-
energy panel,alteration,or
:9'A'+F N . - extension.Describe: Page 2 I
Business name:
.J Address: Each additional Inspection over allowable In any of the above
m ----- Per inspection61.50
JCity/State/ZIP: _ _ Investigation per hour(t hr ruin) 62.50
•"1 Phone:( ) Fax:( ) Industrial viant o Thour 73.75
CCB Lic.: Electrical Lie.: Suprv.Lica Subtotal
Suprv.Electrician signature,required: Plan review(25%of permit Cee)
Print naine: I Date: _ State surcharge(8%of permit fee) ,�--
__L TOTAL.PERMIT FEE Alp.d
Authorized signature: This permit application expires If a permit la not obtained within 180
days after It Aar been scceptee as complete
Print name: Date: • Fee methodology act by Tri-County Building lndttstryService Board
••Number of inspections per permit
i\BuildtigTermi1tTLC.Pemwl.vvdoc 120.1 e40-461Fr(10/OVCOWWHB
Electrical Permit City of Tigard
Page 2 -Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined......,. $75.00
Check Type of Work Involved:
Audio and'.�weo Systems*
El/Burglar Alarm
l�
�, g Door Opener*
ener*
[�Heating, Ventilation and Air ditioning
System*
ER/Vacuum Systems*
Other:
Fee for each commercial system....................... $75.0
(SEE OAR 918-260-260)
Check Type of Work Involved:
❑ Audio and Stereo Syste:,is
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Inst ation
❑ Fire Alarm Installation
❑ HVAC
❑ vmentation /
0. ❑ Intercom and'Pag:ng Systems
N ❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Out,'.00r Landscape Lighting*
❑ Protective Signaling
L] Other_
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i lPoildin&ernwsOFLC-Pm kApp dm(0410]
CITY OF TIGARD 24-Hour
BUILDING � Inspection Line: (503)639-4175 � MST a bb - 6O5
INSPECTION DIVISION Business Line: (503)639-4171 OUPRRceived Date Requested - 3-6 AM---PM _—
Location __�1 Z_ mt, _Suite__ MEC _
Contact Person �_ �� _ Ph(__-,) 49 PLM
Contractor Ph(jEg- _aq_�e4- � SWR _
BUILDING _ Tenant/Ov-ner _ ELC _
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain --y
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear
Framing
InsulationAl A
Drywall Nailing —
Firewall
Fire Sprinkler
Fire Alarm 4---�'�
Susp'd Calling - —T—T----
Root
Other:
Final
PASS PART FAIL -
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer I
Rain Drains
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other:
._1 ---
PART FAIL
CH_ANICAL _
Post A Beam �-
Rough-in
(L Gas Line
HSmoke Dampers -- ----- �_��
N Final
PASS PART FAIL — -
ELECTRICAL
ED Service ----
j5 Rough-In
W UG/Slab
_j Low Voltage
Fire Alarm
Final Reinsper:tion fee of$-� required before next inspection. Pay at City Mall, 13125 SW Nail Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE: Unable to Inspect.-no access
Fire Supply Line f'
ADA
Approach/Sidewalk �� �- I� � - — — ffxt
Other:_
Final DO NOT REMOVE this InspoWen rmmrd from tha,fob alb.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST D 3_
INSPECTION DIVISION Business Line: (503)639-4171
OUP
Received . Date Requested r AM _PM _ OUP
Location —_—L1 6 —7)qj L I .,L- J-4) *Aq Suite MEC
Contact Person Ph(--) &(h1, r;�--1� PLM
Contractor. Ph SWR
BUILDING Tenant/Owner _ ELC _
Footing
FoundationAmess: ELC
Flo 0;ain ELR
crawl Drain
Slab Inspection Notes: _ SIT
Post&'Beam _
Shear Anchors --- ---
Ext Sheath/Shear
Int Sheath/Shear _--- -
FramingInsulation
Drywall
Drywall Nailing -_-
Firewall
Fire Sprinkler - ---- ---- - --- -- ------
Fire Alarm
S,ap'd Ceiling - - - - - - -- -
Roof
Other:
Fina!
PASS PART FAIL __-
PLUMBING
Post&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 --------------_ __-__- _
Fid
':SSS PART FAIL � - --_ ------ --- -__ --
_ELECTRICAL
Service-__.._______.
Rough-In
UG/Slab -
Low Voltage e�}�` !_..�' ---
Fire Alarm C-F
S PART FAIL LI Reinspection fee of$__ -required before next inspection. Pay at City Hell, 13125 SW Hall Blvd.
SITE _ Please call for reins tion RE:- Unable to Inspect-no amass
Fire Supply Line
ADA A9 6/-,"'Approach/Sidewalk - 1plLe_U_
Kit
-
Other:
Final _ DO NOT REMOV►;this Inspeafto rowrd�6/m the1"s .
PASS PART FAS.
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received ------Date Requested—&) AM PM— BUP
Location - � a&—�*. L1 —Suite— MEC
Contact Person Ph(—) ��'G — q PLM _
Contractor_ _-- Ph( ) __ SWR _ --
r DING Tenant/Owner At ELC —.
"ng ELC
Foundati,)n Access:
Ftg Drain ELR
Crawl Drain --- SIT
Slab Inspection Notes:
Post&Beam --- --- _
Shear Anchors
Ext She Sheath/Shear Int Sheaih/Shearar0e-1 (<M�) "-'
Framing _
Insulation /��j�P L
Drywall Nailing
Firewall
Fire Sprinkler -- —
Fire Alarm
Susp'd Ceiling
Roof
Other: ----- ----- ----
n _
PART FAIL
BIND _ _ --
�.. Post&Beam
Under Slab — - — ---
Rough-In
Water Service - -- --
Sanitary Sewer '
Rain Drains -- -
Catch Basin/Manhole
Storm Drain
Shower Pen
Other:
Final
PASS PART FAIL
MECHANICAL — —
Post&Beam
Rough-In - — --
a Gas Line -
rx Dampers - - — -
i _
N S PART FAILkloff — —
RICAL -
-� Service
m Rough-In ---- — --- --_ - —
UG/Slab —
_j Low Voltage --- -- -- --- --- - - —
Fire Alarm
Final Q Reinspection fee of$ _required before neid inspection. Pay at City 14811, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ____ n Unable to Inspect-no access
Fire Supply Line
ADA Data IMpeaw pct
-
Approach/Sidewalk —
Other:_ —
Final DO NOT REMOVE thle Inspection r,3eon4m the fob she.
PASS PART FAIL
�►RD MASTER PERMIT
CITY OF TIG
PERMIT#: MST2003-00356
DEVELOPMENT SERVICES DATE ISSUED: 10/2/03
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171
SITE ADDRESS: 09450 SW MOUNTAIN VIEW LN PARCEL: 2S111BA-11900
SUBDIVISION: BINGHAM PART/MLP2001-00013 ZONING: R4.5
BLOCK: LOT: 003 JURISDICTION: TIG
REMARKS: Const. new SF detached residence.
BUILDING _
REISSUE: CUSTOM Sl ORIFS: 1 FLOOR ARE'S ____ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 13 FIRST: 2.310 of BASEMENT: ofv LEFT: 5 SMOKE DETECTORS: Y
TYPE cF USE: SF FLOOR LOAD: 40 SECOND: 240 of GARAGE: 576 of FRONT: 70 PAP.KING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD. of RIGHT: 5
VALUE: 692.00
OCCUPANCY GAP: RJ aDRM: 3 BATH: 2 TOTAL: 2.550 of 254, REAR: 16
PLUMBING _
SINKS: t" WATER CLOSETS:` 2 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS:
LAVATORIES: 2 DISHWASHERS: I FLOOR DRAINS: SEWER I INES. 100 SF RAIN CRAWS: i CATCH BASINS:
TUB/SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER I INFS: Ino BCKFLW PREVNTR. GREASE TRAPS:
OTHER FIXTURr.S:
MECHANICAL
FUEL TYPESFURN<100K: BOIL/CMP<SHP: VENT FANS: 2 CLOTHES DRYER: 1
GAS FURN>000K: 1 UNIT HEATERS: HOODS: t OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER _ IEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 O -200 arrr•. 0 -200 amp: WISVC OR FD R: PUMPORRInATION: PER INSPECTION:
EA ADO'L SOOSF: 5 201 - 400 omp: 201 - 400 amp: tat WIO SVCIF DR: SIGNIOUT L;N LT: PER HOUR-
LIMITED ENERGY: 401 - 600 ama: 401 000 amp: EAADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVCIFDR: $01 1000 amp: 601+amps-1000 v: MINOR LABEL:
1000•amolvolt
_ PLM!REVIEW SECTION
Racnnnect nnly•
>•1 RFS UNI"f S: BVCIFOR>e225 A.: >600 V NCMINAL- CLS AREAISPC OC
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMMAGING: OUTDOOR LN9Sr:LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIC: PROTECTIVE SIGNL'
GARAGE OPENER: CLOCK: WSIPUMFNTATION: MEDICAL: OTHR:
HVAC DATAITELE COMM: NURSE.CAI LS: TOTAL 0 SYSTEMS:
Owner: Contractor. TOTAL FEES: S 8,093.36
This permit is subject tc the regulations contained in the
WAYNE BINGHAM HOME BUILDERS SERVICE CENTERTIgard Municipal Code,State of OR. Specialty Codes and
14320 SW BARLOW COURT 8435 SE 17TH AVENUE all other applicable laws. All work will be done In
BEAVERTON,OR 97008 PCRTLAND,OR 97202 acoorr+ance wl h approved plans. This permit will expire 4
w-: Is not started within 180 days of Issuance,or if the
work Is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503-646-7899 Phone: 503-2334841 Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through 952-001-0080. You
Rep�: LIC 1588 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Plm/undslab Insp Framing Insp Gas Fireplace Watar Service Insp Building Final
Sewer Inspection Mechanical Insp Shear Wall Insp insulation Insp Appr/Sdwlk Insp
Footing Insp Plumb Top Out Exterior Sheathing insl Rain drain Insp Electrical Final
Foundation Insp Electrical Service Low Voltage Storm drain Insp Mechanical Final
Slab Insp Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Issued By : - !�!� s� f Permittee Signatur _
Call (503) 639.4175 by 7:00 p.m.for an inspection needed t 9 next business da
CITY OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00285
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 10/2/03
PARCEL: 2S111 BA-11900
SITE ADDRESS; 09450 SW MOUNTAIN VIEW LN
SUBDIVISION: BINGHAM PART/M1.1`2001-00013 ZONING: R-4.5
BLOCK: LOT: 003 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached residence.
Owner: _ FEES
BINGHAM WAYNE Description Date Amount
14320 SW BARLOW COURT - —
BEAVERTON, OR 97008 [SWUSA]Swr Connect 10/2/03 $2,400.00
[SWUSA]Swr Connect 1012/03 $0.00
Phone: 503-646-7899 ISWINSP]Swr Inspect 10/2/03 $35.00
[SWINSP]Swr Inspect 10/2/03 $0.00
Contractor: -
- Total $2,435.00
Phone:
Reg#:
Required Inspections _
i
This Applicant agrees to comply with all the rules and regulations of the Clean Watei Services. The permit expires 100
days from the date issued. The total amount paid will be forfeited if the permit expires. !,4 Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement giveo, the Installer shall prospect
3 feet in all directions from the distance given. If not so located,the installer shall purchase s"Tap and Side Sewer' Perm
tee,
r'
Issued by:� ')e, �c � Permittee Sig natu :l Y
Call (503)839-4175 by 7:00 P.M.for an Inspection needed t next business day
06.27;2002 11:46 Z:AI 5095981960 CITY OF TIGM 11002
Ih�l?aOo ►-C,0013 'fa ps 7_ �s s� ►,�,►�
Buildingtatiom
Date received,r - �U .t, Pa mit ne.:r�r,,i �• ;,
City sof Tigard''''II Rojeet/apgl•no,:
Adam", 13125 SW Hall`bid,tl�4& 97223 ��e1�°
City oJ77�aid Phone: (503) 639.41711 1,x OF TIGARD Daty bsuod: H1r' Receipt no.:
Fax: (503)598.19NUIL NQ DIVISION Case fueno Paytoanttype:
Land use approval: lam_ 1&2 family:Simple complex:
r
U 1 &2 family dwelling or accessory ❑Cimmercial industrial O Multi-family )4-New corotruedon O Demolition
Cl Addiuon/alteradon/nJplacement 0 Tenant improvement U Fire sprinkledalum O Other:
Jobaddress: 9L-50 S.W. MOUNTAIW •VIEW L Rf~ I BMS.no.: Snipe no.:
uoc 3 3 Block: ' `e 3ubdiridoa: 'Ti' my A s e tAci4WV5 I Tax ma tax lot/account no.: a I !1 BA 0 12D1
Pro ect name: 13 N G H A M P!✓S I P!~N F 'LC�C�2, C
Description mud to aUon of work on tetnistss/special conditions: i v1 e S o
•..id�.t.�ce oc '4- cY• �-tf-a '�
Name: 5 i'\ k a vr,
Mailing address:14.3 Z O S.W. Bav o'U COEA_r4 1 ltt>esiy dwallYBt
City: 6'al e;l- GN SIM:O FZ TJP: 9 7 00$ Valu on of work.._....».....».................. S.�5� fi
Phone: W46-6. 7$`l Fix:43 Q-0201 &MzU: i7t3i' ha; C No.of bedroomeybatlu.......................
..,.... 2_
Owner's resentative: 5 a N%e. c e, TOW number of floors................. _ 1
Phone: Pu: &Mall: New dwelling area(sq,ft.) .,rZ .r,U...•......
Garage/carport stem(aq.R.)...........•...•......... 5 Z�
Name. W. 15 I V\ 1A a VA' Covered porch area(sq.ft.)..........•.............. 370 0
Mailin address: 13 2 O S. W. 1 COLAY Deck area(sq.ft.) .......................................
City:0&4x V t r' y1 Stale:b R M'* 9700.8 Otter structure area(sq.
Phone:E,4 Ea ''��F CI I'tut:43 t?- �701 E-ttlall: ComseerclttlllsdartsinUArultl-is►etily!
ValuMou Of work....................................
Existing bldg.area(sq.f /
Businessnatto., hte 1. •Ild�iti Service Ce eV ,rr�,_.
Adder a: 4 3 5 S• E. !7 v c t1`t tr- New bldg.arra(sq.ft.)...........
City: V' l n State: o h M. `17 Z C 2 Number of storlea............. ................
Type of oonsuw-don.. .............................:. ._
Phone: 23 -4 41 Fax:Z30.0a9t li-mdl: Occuputey gr ;;r Eriedng
CCB no.: 1 E 8 I I t Ne
City/metro bc.no.: A 7 f ? F,� NeOce:All contmctnra and subcontractors are required to be
licensed wits the Oregon Conwmctlon Contractors Board under
I v. l V1 e��,v provisions of 0125 7111 and may be required to be licensed in dee
Address: 4� G` S. W. Cis r 1�w Coil r l jtnisdtctl where work is being pert4tmed.If the applicant is
yyrn Ci 6aVe.t CVA state:OR ZIP: �-t( C Ell exempt from licensing,the following reason applies:
I,- Cnnraet S��G Piga no.: -- --
-r
Phone: Fax: t)1 -mail:
1�1L~I G�•, t1a�,,t�? �.
co
W
"C: K' v. Coatssx G Fees due upon application ...-....................... S1� i'
Address: 319 .LJ. Wes t, o v\ Date received:
ci : f' N a►ti A Amount reoeived $
_Phone: ^ "t- If-43 Fax:2 73-5G`1G &nUI1: Plesse Mader to fire s&,du*
I hereby cettify I have read and examined dais application and the Noe W wow M&evil•d...4n labdte ba tar nye.ba�rian
attached circUst.Ali provisions of laws and ordinances governing this 0 via 0 w•terCm
work will be complied with,,-- -- beton ar not. hair end Mwkw.
Authorized &IVWure
Nodoe-This perrait application apim if a pwmh Is not obtalm d*thin 110 nays Aw It ho bene,soospled w eoumicts. 440.611 Isesseroatl
08/27/2002 11:47 FAX 5035981960 CITY OF TIGARD IM005
Plmbing Permit Application
City o la lgiu u `r Date ttuelved: Yumit no.:(V 4' ' �' `-L
l i� Sewer permit no.; Building petmitno.•
Ct. ?f7't urd Address. 13125 SW ball Blvei,Tigaid,OR 97223 ---
y d Phone (503) 639-4171 Rolect/appl.ao.: ti><plccdate:
Fax: (503)598-1960 JUL 1 0 2003 Date issued: By: R=4xno.:
CITY OF TIGARD Case ale no,: Payment
Land use approval. type:
O 1 &2 family dwelling or accessory ❑Coinme.MM/industrial O Multi4mnily 13 Tenant improvement
❑New construction ❑Addition/sitcration/neplacement D Food service 0 Other
IJ6buddrcsir; i/� jj / l l 1%J LI_•1, ! T_ Fee ea. Total
Bldg.no.: S;11-m- no.: ew cm .
Tax map/ma lot/eccountno.: (iacLsdeal00R.6orraadaaltllityeessacetbta)
— _ SFR(1)tarn
Lot: Block: Subdivision: 2)bath
Project name: NFR )bath
City/county: Each 0dititmal ba
Description and location of work on premises:_ _ 9h'etatllitieol
Catch basin/ama dentin
each ' n —
Est.date of com lction/ins •tion: —
n drain no.Ito.NT 180
Manufactured hoLie utilities -
Business Sam -T Y, an o ea --
Address: b,) < 3 Cingrain connector _ I —
City: State: 1z1P: of 17 3- Sanitu sewer(no.ITn.k)
Phom,pj - Fax E-mail; Stoat sewer no.L D.ft.) -
CCB no.: y 2- �- Plumb.bus.reg.no: - /" ater service no.
Ci /metm lie.no.: Ftatm�or 1tes:
Contractor's representative signamm: Absorption valve
err_. ow preventer
Print Weare: Date. Ba'ckwa=—ave -
a _
Name: C o nos washer _ I
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City:
Address: DriVn f WWI)
City: State ZIP: tunPhone: Fat: B-mail: (ank
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Phone:
e(print): 1 n r)r( Door ai u ng address• ie 1
Hose ib
City:—_ State: 2lPIce maker 1
Fix: &mail: late, m ase Mp —
Owner installation residential maintenance only: The actual installation s
will be made by roe or the maintenance and repair made by my regular RooUdMn(commemal)
employee on the pmpetiy I own as per ORS Chapter 447. Sink(s), basin(s), ays s ¢
Owner's signature: StvnR
TubstshowedIt war pan
Udnal
Name: _ - alit closet
a
Address: waterheat"
Ci State: [23P: per`"_._ —
Phone: Fax: 8 mail:
Not sit ILmisacdom omW m&emM.plea"will jarMkdoe rat mm wamnits Notioe:This permit application Minimum Fee................$ _
U Visa ❑M6stetcud expires i r a permit is not obtained Plan review(at-- %) S _—
Cmdit=moi numtxr --- ---�-Tpi1-- within 160 days atter it bas been State surcharge(8%)....S
sena or on accepted as complete. T6T4L .......................S
s
AMMM 1/64616(e4dCOM)
06/27/20,02 11:47 FAX 5095981960 CITY OF TIGARD 14006
Mecbw,da lPerWtApplication
Date meelved:
City of Tlg� t V G�J P,,,jeW,ppl.no.: H:phe date:
Ckyofn�eard •lddtess: 13125 SW Hall Blvd,T�Atd.QR 972 iswod Er Reneipttw.:
Phone: (503) 639.4171 �p� I2003 Duc
Fax: (503) 599-1960 (;ITY OF TIGARU CasetileGa. Payment-MM:
Land use approval: ;111L D I NG Q I�((,�gn__ Buildingpermit no.:
0;NLwo;vn lling or accessory O Comumvial Industrial O Muld•family 0 Tcrant imptavetnent
L construction O Additlonlalteradon/teplaccment O Other
Jo �(` ('/i /4�' I i ',7jurwisdic=ction's
Indicate equiprnetu quantities in boxes below.Indicate the dollar
Brno.: Suite no_ value f ell mechanical materials,equipment,labor,ov�edwad,
Tax rax lot/accuunt no.: profit.Value S
I.at Block— Subdivision: --� 'Sclist far important application information and
Pts ect name: fee schedule for residential permit fee.
CiD!�ottttty: Tile:
Description and location of work on premises:
Fse(ea.) Tod
Eat_date of completion/inspection: KVAQ R• Rw*miy
Tenant impraventent or change of use:
Is existing space heated or conditioned?U Yes U No Airbsndli unit CTM _
Is existing space insulated?O Yea O No AMIt con non n to ■n C UnM
Bttsittt;is ttetne' StAte boiler permk no.:
Fir' Tons BTUM
Addtaaa: t a O stao c eo
City - Statu:pi Id ZIP:9-u- 8to Insauvrepmeturnownuner
--
PIIQD<is:IJ'J ! I'ii 13-mail: I -
GCB no.:: :��/,r�- 3 --- r►cladht ductetetdt/veot deter�Instaivrepi �a No
c ityMteiro lic.no.: A won,or floor m000tod
Nates law ): V4Mt iumece
Absorpiion units BTUM
Name: man —lip
Audit: HP
advaWWOm
City: Appliamwent
Phone: Fa:: &mail: -- i — —
HOW Type U 11thn.
heod fire wpptasion system serous i —
NantG: r i 1 f �/t- Iixbaeestruwith aunt t5tts 2
Mailing address: err I
ply sate: IMP "WPOWCOMOMWmaw.LPG Ivo ou Z
Phone: I&mere aI OMMMM over
retmmok(mac
Name: Number of outlets _kA_
Address: Decorative
ity: I State: IMM—
Pbone, Fc
99"stove
A plicant's signature: Date:
Name t):
No an*bdleaor roto ON&Calk obum CA ao n IN mr Yrbnmsd Notice-This permit sppliCatlon ftanit fee........ .......S
13Visa o ot ms"Wrtd 6gdm if a permit Is nobtainedMinimuta fe+e................S
On&sad"caber: --�— %idem 1110 days aft it has beat Plan review(at
Nie d r ae _ aooeI a complete. stow wM'tome(M....S
CITY OF TIGARD RECEIVED
13125 S.W. HALL BLVD.
• TIGARD, OR 97223 MAY 2004
CITY OF TIGARD
IMPORTANT PERMIT NOTICE BUILDING DIVISION
GREENWAY ELECTRIC COMPANY1
1w5�1 SW qIJILL PR gq(O0 s()j 7(1 CxA-11-1J 5-17- t STI:7 10 �I
AVERN, 97007 � �7��3
�3-/20 -662,0
Electrical Signature Form
Permit #: MST2003-00356
Date Issued: 10/2/2003 '
Parcel: 25111 BA-11900
Site Address: 09450 SW MOUNTAIN VIEW LN (/Vyf
Subdivision: BINGHAM PARTITIONBlock: Lot: 003 Ak ^'
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Const. new SF dotached residence.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for
the electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign telow and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL. CONTRACTOR:
WAYNE BINGHAM T/V
WAY E CTRIC COMPANY
14320 SW BARLOW COURT L ll ��105ttq X N�-�
7008 T 9j�0U7BEAVERTON, OR 9 .n 6,A4-? Q/V2Z3
Phone V 503-646-7899 Phone #: 603-679- 064 1 50 S&)ZO.602 9
Reg #: LIC 153421
ELE 34-617C
SLIT 50255
a
F
AN INK SIGNATURE IS REQUIRED ON THIS FORM
r
x1 _
Jg ature of Supervisinglectrician
If you have any questions, please call 503.718.2433.
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IE In(S)• 24680
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EL.2604. _ {�'�' ` S'('0'
I I Err , II
TRAGI A Ph�EL 3mv I
� p€p�l � � ✓ / \� � I `�-'h.756'
t
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20 rL
EL.264y I t
50W sq.R *3 - '
I �
IMI till(i I. 14P 110 11,11fiqN. AIM.
IL
— — I 42' 0' 4'-0' _ — _ II6'-0_ _ I _ _ EL.260'
EL.263'
- -- - - - -
I EL.263' EL.
m I d I Street eler!%D Haftood AT 40 FEET O/C
a MH.Y 0 AT 4' ABM CROWD
w CENTERED H 4' SWARE PLANTER
J ADJACENT 10 SIDEUTAI K
��1C�HAM VTE PLAN
NORTH
SCALE LOT AREA • nA42 sq.rL
o i0 W 30 i0 ISLDG.MIRAGE 2,150 6q.rt-
10, COVERAGE 211
SCALE_ 1' = 30'-0' It•PERVIOW MEA 3,430•q.rL
C ITV OF TIGARD- SITF PVN ItEVIF W
1S1111.F LIXfi PFkMIT NO.:
PLANNIN tV►tilt)N</Po Required Saha . S.
Q No!
Side: �� StrF=ront• _.___Visual Clearance: ❑ Nor
Maximum Rudline IOvs,Service Prov' er I ;, Yet
F-.NGINLER c. DFI'AR'hM[:Nf:
Actual � Date:
[3Approved ( of Appri kv.
Site Pla G Approved [INt ppro�rJ
[IV!
Ne►1
('I ry OF TIGARD- SITE PIAN RFVIFW
BUILDINGPERMITNO.: 54
pa,_r r1
PLANNING DIVISION: R q .S
Required Setbacks: Approved [] Nw Ahrrudco
Side: _rte+-.-., Street Side:
From. A$.Q_ Garage: -giq— Re"Is JA'.
Visual Clearance- Approved 0 Not Approved
Maximum 1311ildinu Ileight zo- feet
CWS Service Provider Letter Required: ❑ Yes 4"o
[] Received
BN: yt Date: V-/L
FNGIN 4. ING IM-PARTMENT:
Actual Slope: % Approved ❑ Not Approved
Site Ilia , / Approved ❑ jNoVApproved
Fav: Date: 7 03 I` ,E�
Notes: V
°' JUL 10 1003
ai CITY OF TIGARD
BUILDING DIVISION
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