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Permit ' n0 ,. 4t q' MASTER PERMIT CITY I TY TIGARD PERMIT #: MST2007 -00169 __.... COMMUN DEVELOPMENT DATE ISSUED: 2/20/2008 : TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 -,,4t PARCEL: 2S 104AC -14300 SITE ADDRESS: 12976 SW HILLSIDE TERR ZONING: R - 4.5 SUBDIVISION: HILLSIDE ESTATES LOT: 008 JURISDICTION: T1G PROJECT: HILLSIDE ESTATES Project Description: New SF BUILDING REISSUE: MAS22122CA STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 28 FIRST: 1,371 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1,797 sf GARAGE: 632 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 1,120 sf RIGHT: 5 VALUE: 843,547.78 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 4 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 2 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 1 VENT FANS: 5 CLOTHES DRYER: 1 NAT FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 4 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 6 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 8 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVCIFDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: ALL -ENCOM BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable HAI NOOC PHAM ASCEND CONSTRUCTION laws. All work will be done in accordance with approved plans. This 14788 NW JEWELL LN 16142 SW POLLARD LN permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97229 TIGARD, OR 97224 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 614 - 9275 Contact #: PRI 503 - 484 - 8581 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 626 -2479 Reg #: LIC 164398 TOTAL FEES: $ 13,486.00 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 - 4444 Engineered soils Issued By • ( FOX10, 17171 _ P ermittee Signature : j Call 503.639.4175 by 7:00 a.m. for an inspection that busine s day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building .Permit Application_ Residential EC El l `tr- t�= - . - . a ��'1 r s FOR OF FI CE USE ON LY 3. i i.. i r" r t. City of Tigard (` DateB d g„9? 0' d Permit No.: t0/ edv6,9 ':111iirr,' V 13125 SW Hall Blvd., Tigard OR 9722 2 n 2001 Plan Review g �� M� C '' 1 Other Permit �j + Phone: 503.639.4171 Fax: 503.598�6� OF TIGARD Date / Ready/By� • 14 � • , lads ® See ) Page2 for vial Inspection Line: 503.639.4175 t TIGAILD p B D IVISION N otified/Method Supplemental Information - �= Internet www.tigard or.gov � Q .rWW i, ra • . TYPE OF WORK REQUIRED DATA: 1- - r 2- FAMILY D ' ' LLING IS New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the . CATEGORY OF CONSTRUCTION - . work indicated on this application. lJ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: 2_ JOB SITE INFORMATION AND LOCATION- . , Total number of floors: 3 Job site address: la / ? 0 OD AI /LL$, 7 -fiat_ • New dwelling area: 3 14 square feet City /State /ZIP: TIp.yi,ij ! 0,01.-.- cI7 Garage /carport area: 4,32_ square feet Suite/bldg. /apt. no.: Project name: ii }i ltd ,t 6.10iTE3 1.6 Covered porch area: 17 square feet Cross street/directions to job site: Deck area: 4I 0 square feet Einity,.0 WASI.N. -IT Other structure area: square feet tn/AL.A.iJiT -rb 133 ► c • REQUIRED DATA: COMMERCIAL- USE;CHECKLIST Subdivision: y CsIA i ES Lot no.: g Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK , . : work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet V) PROPERTY OWNER - ❑ TENANT . . Number of stories: Name: 1.4/a'! pJ e'Cc. pit/i.") Type of construction: Address: 147 9 ' 14- y ,J U Coe 1.,J .• Occupancy groups: City /State /ZIP: pDArlk4h1 J L j on, i/ 7141 Existing: Phone: ( t sZ;) (. set , y 2.75— Fax: ( ) New: P APPLICANT - ' : p' CONTACT PERSON- NOTICE Business name: All contractors and subcontractors are required to be Contact name: �pn/ licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: ! b 14j Sri pc L. IV , jurisdiction in which work is being performed. If the Ci[y /State /ZIP: fr'W' applicant is exempt from licensing, the following reasons ?fl - I e —' R 7 2 apply: Phone: (Si;3 ) 4 — s s - I I Fax:: (su ) s — 7i -+ E -mail: r ii/ t IN .1 Asce 1/J 0 co-ta4.- - 111 CONTRACTOR;. . Business name: /1st,avy cta'J J NI, _ BUILDING PERMIT FEES* 04- :.i i✓Rr Structural plan review fee (or deposit): (Please refer to fee s chedu l ) � , Address: J S I .7 City /State /Z IP: -n rprivj ; a1t ri 7 u 4 FLS plan review fee (if applicable): Phone: (Su3) Am - gy - I Fax: ( ,s"k3) ,,vj0 --7 6 i it CCB lic.: i6 139 'S (Vi Total fees due upon application: \ Amount received: ' 750 AO Authorized signature: ,. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 72# iil ',g-pd j }1/ Date: ? -1 -c * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building \ Permits \BUP -RES PermitApp.doc 02/23/07 440- 4613T(11/02/COM /WEB) Building Permit Application Checklist '�t a s I '` ` i : FORr OFFI I ' J ` ON LY u� F � One- and Two- Family Dwelling , City of Tigard Receive Permit No.: II Date/By: SW Hall Blvd., Tigard, OR 97223 Associated permits: g Phone: 503.639.4171 Fax: 503.598.1960 24 Hour Inspection Line: 503.639.4175 ❑Electrical ❑ Plumbing l I G A R IJ ❑ Mechanical Internet: www.tigard- or.gov ❑ Other. K i-trt LLOWING ITEMSAIikiiEQUIRED FO Pi ANREVIEWt ' t Yes>',T No ON /A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: • ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ - 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. _ 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. . 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray _ construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ .. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and /or any beam /joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be as .licable to the .roject under review. yr'`k !` i al . 1c r *i i r` if ,.. _ C . r . ` r* c ; . - i 1{146 ':..r a-. i t ,,tc _ V I \� -Ili l _ l�l �ri ��1._�`t_ , -Z-' . W :g # v k ' , At.?: », ,ST . _1 : . w 1 �,J. 1 _ t e : ; - 0 , 4 J" K:::na '� 6 ;: , , Y v w S - ^ .�I I . i =- _ � ... �{� , I t 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16. 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\ Building \Permits\BUP- RES- Permit App .doc 03/21/06 440- 4613T(11/02/COM/WEB) Electrical Permit Appl' , .. ri 4 ,� ' : _ ' F O FFI� F O L -Y , - ' 4 - ' ` • * FOR OFFICEtiUSE OIY ... 0" k e h � s i r u : kiftAC* 4�u5F}±ss�LL. � " T "f�',� `i2a',4 ,..x, ,,: C Received � 7- lt� • rq: 13125 of Tigard 1 rm 71 / /�/�/ 3: ' a `J ( Q 00 Date /By: 'i'i f, 13125 SW Hall Blvd., Tigard, OR 1 Plan Review p Other Permit: Phone: 503.639.4171 Fax: 503.5 1960 T `G�RD Date /By: Permit No.: T; I G K D Inspection Line: 503.639 ��' 'j Or l s\0` Date Ready /By: Juris: ® See Page 2 for ors: Internet: www.tigard or.gov , D 'V Notified/Method: Supplemental Information 1:51111 u „. TYPE OF WORK PLAN REVIEW . pzi New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural p i- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I 2 ", "I - ", Job no.: Job site address: I OOHP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: , ` ❑ Health -care facilities. ❑ Supply voltage for more than T� vITv ry i I� L ❑ Hazardous locations. 600 volts nominal. „ I O e C Ez r ❑ Service or feeder 600 amps or more. Suite /bldg. /apt. no.: Project name: /7+'w' �� t 4J .FEE SCHEDULE Cross street/directions to job site: cr itO y v..44.Nv-wr Description ( Qt 1 Fee. 1 Total 1 • New residential single- or multi- family dwelling unit. W J 7' h 133 LI Includes attached garage. Subdivision: Lot no 1,000 sq. ft. or less 1 145.15 4 �f t t 1.1 10 x.17 F� (�S l.t Ea. add'l 500 sq. ft. or portion 9.. 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 tj el%) CCwS J 1 6 LetT134 (44't,- residential (with above sq. 11.) Services or feeders installation, alteration, and/or relocation 200 amps or less' 80.30 2 p7PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: Witi hj b71G prrAvj 601 amps to 1,000 amps 240.60 2 Address: 147 'g N") 4 16 1A /a4„.. L Over 1,000 amps or volts 454.65 2 City/State /ZIP: .� by 11. f raty Temporary services or feeders installation, alteration, and/or relocation Phone: ( '- ) (9iQ - ,7J Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 grip, } � , �l 7 Branch circuits — new, alteration, or extension, per panel Owner signature: 0� ' Date: a A. Fee for branch circuits with Sl APPLICANT at CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: /IS ct�ivy) aligs7 444(,j %it1 110 0 , B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 1 41,,,' 77I,1W first branch circuit Address: l b /VI-- S7� Pakatitrar, i..-Al Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: 'Thr7 1 Each `T72;3 -¢ Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: (Sb) ) 48 —ecy J Fax: : (- ) J') -762.4 Reconnect only 66.85 2 E -mail: - 114 i4ry — AS GCN/ -a V L4e-t c rjr .Ne7 Pump or irrigation circle 53.40 2 •CONTRACTOR . Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: A'vLl-0 tLECri'u C - energy panel, alteration, or Address: extension. Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES :Ail Suprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): Print name: e M I Ll - Date: State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: \ This permit application expires if a permit is not obtained within 180' Print name: \ ' uilding \Permits\ELC- PermitApp.doc 05/23/06 Date: days after it has been accepted as complete. P ~ � /J/'J�J • Number of inspections allowed per permit. 1// / 440 -0615T(II /OS /COM/w'EB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: °RESIDENTIAL WORK ONLY: .. Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: ',: COMMERCIAL WORK ONLY:. . Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ A udio and Stereo Systems ❑ B oiler Controls n Clock Systems n D • ata Telecommunication Installation ❑ F ire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC - PermitApp.doc 03/23/06 , . A - 4 , 0. �3 ' Ssr^$3 F k � ? . N:s..i y4 " k F , .t f s. ,: a' c 4 . i t x' w;t Mechanical Permit Application }u . R o FO F�cE., �s. o..,.., - , , �s l , City of Tigard � Iv ' '3 ; ''yd Permit No.:, / , O —t) /�O 13125 SW Hall Blvd., Tigard, OR 97223 _ l C 5'" Phone: 503.639.4171 Fax: 503.598.1960 a , . ; Other Permit: `''•' Inspection Line: 503.639.4175 ' i C (� a t o Read /B El See Page 2 for • T IG`A'R'D UL3 2 2 y y : Juris g • Internet: www.tigard- or.gov Notified Method: Supplemental Information c1TY OF Tr `1 TYPE OF W ORK I3UILDIN DIV15jO COMMERCIAL- FEE* SCHEDULE - USE CHECKLIST - P. New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • . C OF CONSTRUCTION. Value: $ dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1 - and 2-family g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: Air conditioning or heat pump (requires site plan showing placement) 14.00 r , ,..„, a7� q 7 t "�} Cit y /State /ZIP: Furnace 100,000 BTU (ducts /vents) 1 14.00 Suite/bldg./apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90 Il4$ ioG a r"e. Gas heat pump 14.00 Cross street/directions to job site: i,. Ak/W c " 1j ■Arr Duct work 10.00 Hydronic hot water system 14.00 ivih ar Tb 13a 4 Residential boiler (radiator or hydronic) / 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Lot no.: Flue /vent for any of above ) 6.80 Subdivision: H. F l I.t i loc. Ls77`fiiJ g Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK _ Water heater i 10.00 Gas fireplace Z 10.00 i3 MC. Flue vent for water heater or gas �� fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 t PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: ('iii'1 Ai ro P erpy.i Environmental exhaust and ventilation Range hood/other kitchen Address: j47& N ,jE.uhLt, LA) " equipment ) 10.00 City /State /ZIP: n e 4.1) . P,t. 4'7224 Clothes dryer exhaust i 10.00 • Single -duct exhaust (bathrooms, Phone: (A ) 6 1 t+ - i Z 7,S- Fax: ( ) toilet compartments, utility rooms) 3 6.80 ' Attic/crawlspace fans 10.00 APPLICANT � CONTACT PERSON_ ... p Other: 10.00 Business name: wsG.l1 G yA) yhi L . Fuel piping Contact name: - TJfl $5.40 for first four; $1.00 for each additional Address: b 147— Furnace, etc. Sin) P rl' "av Gas heat pump City /State /ZIP: .111,773/440 d fi- y 7 114 Wall /suspended/unit heater Phone: ( ) _s-z...4 - 774-0 Fax: : (g ) St(C " 7671-f Water heater Fireplace E -mail: 1 W if*) • Asa i�.v 0 co— - W%T Range • ' CONTRACTOR Barbecue 1 Business name: � � G, Clothes dryer (gas) 1 BELL. F�6°Ir77r� Other Address: i$13 SE Pin:44 / vJ� MECHANICAL PERMITFEES* ' City /State /ZIP: L (.. J 0 17- 9 7 P 1 r Subtotal Minimum permit fee ($72.50) / Phone: ( � 3) - , l (�� Fax: ( 3 6 S6 ,71 i Plan review (25% of permit fee) CCB lic.: 44-7 State surcharge (8% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 / Authorized signature: days after it has been accepted as complete. Print name: Jot�/�' kys Date: * Fee methodology set by Tri- County Building Industry Service Board/ (:\Building \Permits \MEC- PermitApp.doc 01/19/07 440- 4617T(11/02/COA1/WEB) / Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: • Total Valuation: Permit Fee: , $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $1 00,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\ Building \Pemits \MEC- PennitApp.doc 01/19/07 2 Plumbing Permit Application fk x.xp � :� �`Ff 'p� k+s.` -<�' cr..b,� t; ��'E, ' * Y a §`�' ?4,�s Building Fixtures ; ? ti5 �+ �ss FOR ` OFFICE USE ONLY � a n ° „ • b i ttii i W. 1.4 ::1 - stAs,4't r , ,`w - <v; r , .e.'•17 .t.. , ;';'iz,r�+' k `.. `, ..:L� ^ "•c ?,uAV . " -f. ''';'!::.': - ,':, : ::.;, : . - :: : City of Tigard RECEIVE R eceived Permit No.: t 746 /(/J7/ II ° a 13125 SW Hall Blvd., Tigard, OR 97223 Date /By: ", Plan Review Phone: 503.639.4171 Fax: 503.598'1; 1 Date /B Other Permit No.: Inspection Line: 503.639.4175 '' "� y T l G A R D . :. r RD Date Ready /By: luris. 0 See Page 2 for cJ , r� r: Internet: www.tigard L1 f 1 " u Notified/Method: Supplemental Information TYPE OF ES1�{G DI' • V FEE* SCHEDULE Vi New construction ❑ Demolition For special information use checklist Description Qty. 1 Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF `CONSTRUCTION - SFR (1) bath 249.20 1 21 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath I 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 • JOB SITE INFORMATION AND LOCATION • Site utilities Job site address: Catch basin or area drain 16.60 City /State /ZIP: 71U'Al2-o Gt. y Ill Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: }N l.�SidiX �Jpf'i Footing drain (no. linear ft.: _) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 erf/i4a 'f0 UJA'WV 4 r Rain drain connector 16.60 jt,441.4.1:47- r t 133 / Sanitary sewer (no. linear ft.: _ ) Page 2 Storm sewer (no. linear 0 : ) Page 2 Subdivision: } !As i 6- I Lot no.: Water service (no. linear ft.: _) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 • DESCRIPTION OF WORK Backflow preventer Page 2 Pi444 gill/ i;' • Backwater valve . I 16.60 Clothes washer I 16.60 Dishwasher 1 16.60 . , p PROPERTY OWNER . . ❑ TENANT ' _ Drinking fountain 16.60 Ejectors /sump 16.60 Name: /.114 N 1 - D ( ii'fhf Expansion tank 16.60 Address: 147 5dj /v 1A ) ‘44 LA/ . Fixture /sewer cap 16.60 City /State /ZIP: Peylnvvynp i fit, 6124-9 Floor drain/floor sink/hub 16.60 Phone: (4513) 614 - 1271 Fax: ( ) Garbage disposal j 16.60 Hose bib 3 16.60 . i tij APPLICANT gi CONTACT. PERSON Ice maker I 16.60 Business name: /LtVj) co ,Ni 11■ L- • Interceptor /grease trap 16.60 Contact name: ¶j i / pai Medical gas (value: $ ) Page 2 Address: ) S)4 , L , ..J PCu,4,1 ,,r' Primer 16.60 City /State /ZIP: 17v7 i ofi- q72-.4 4- Roof drain (commercial) 16.60 Phone: ( .L;) -8;s31 Fax: : ( - ) ` 5 - q f p - 71024 Sink /basin/) /shows 16.60 "fay / f Tub /shower /shower pan 2 16.60 E -mail: ''Ttil IN/V.. PAS teenio ( CG j . NaT Urinal 1 16.60 CONTRACTOR Water closet 16.60 Business name: AEA M ecii IN L. Water heater 1 16.60 Address: Q &A) ('�/ ` ILO t Other: Subtotal City /State /ZIP: 1+1 1i,t.114) i Minimum permit fee: $72.50 Phone: (,s-63 ) 1 by a 4,2S Fax: (73 ) 6 fp .- et344 Residential backflow minimum permit fee: $36.25 CCB Lic.: 14, 4 - 7 Plumbing Lic. no.: Plan review (25% of permit fee) 8 State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: M) /t,6/4 Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building industry Service Board. 1:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty,.. Fee.(ea) Total Square Footage: Permit Fee: Footing drain - l t 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Storm &Rain Drain - 1st 100' 55.00 Valuation: 'Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture Or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. • Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing . ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918 780 - 0040. -Drive Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or -Riser Diagram - Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. - 3" -4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: is \Building \Permits \PLM- PermitApp.doc 12/27/06 II ME MORANDUM l' TO: Building Inspectors /7)57 00 i 6 FROM: Todd Prager RE: Hillside Estates Lots 1, 2, 3, 4, 6, 7, 8 DATE: September 17, 2007 Please do not sign off on final inspection until the tree remediation/mitigation plan is approved by me. My desk number is 503 718 -2700 and my cell number is 503 764 -6913 if you have any questions. Thanks, Todd FILE COPY l CITY OF TIGARD COMMUNITY DEVELOPMENT T %GAR,__ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Plumbing Signature Form IMPORTANT PERMIT NOTICE REA MECH INC 30330 SW GRABEL RD. HILLSBORO, OR 97124 Permit #: MST2007 -00169 Date Issued: 2/20/2008 Parcel: 2S104AC-14300 Site Address: 12976 SW HILLSIDE TERR Subdivision: HILLSIDE ESTATES Lot: 008 Jurisdiction: R -4.5 Zoning: TIG Project Name: HILLSIDE:. ESTATES • Description: New SF • Your company has been indicated as the plumbing contractor for the permit referenced 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. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: HAI NOOC PHAM REA MECH INC 14788 NW JEWELL LN 30330 SW GRABEL RD. PORTLAND, OR 97229 HILLSBORO, OR 97124 Phone #: 503 - 614 -9275 Phone #: 503 - 969 -6252 Reg #: LIC 164398 LIC 447 LIC 148437 PLM 34 -389PB LIC 35763 AN INK SIGNATURE IS REQUIRED ON THIS FORM X mied% yNc\-.<_\,\c,e,‘ Signature of Authorized Plumber Name (printed) 02/25/2008 11:08 5033579159 ARLOELECTRIC PAGE 01/01 r CITY '� F 11' , �� i" D COMMUNITY DEVELOPMENT 6-MAW 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form IMPORTANT PERMIT NOTICE ARLO ELECTRIC INC 50705 NW CLAPSHAW HILL RD FOREST GROVE, OR 97116 Permit #: MST2007 -00169 Date Issued: 2/20/2008 Parcel: 25104AC -14300 Site Address: 12976 SW HILLSIDE TERR Subdivision: HILLSIDE ESTATES Lot: 008 Jurisdiction: TIG Zoning: R -4.5 Project Name: HILLSIDE ESTATES Description: New SF Your company has been indicated as the electrical contractor for the permit referenced 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 below and return this Electrical Signature Form prior to the start of the work. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. if you have any questions please call 503.718.2433. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: HAI NOOC PHAM ARLO ELECTRIC INC 14788 NW JEWELL LN 50705 NW CLAPSHAW HILL RD PORTLAND, OR 97229 FOREST GROVE, OR 97116 Phone #: 503 -614 -9275 Phone #: 357 -2350 Reg #: F,.1..E 34-118c L1C 35763 SUP 3321S AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician Name (printed) SUP LIC City of Tigard, Oregon o 13125 SW Hall Blvd. 0 Tigard, OR 97223 WV 0 Gsr 'i� TrtGARD, July 2, 2008 Ascend Construction 16142 SW Pollard Ln. Tigard, OR 97224 Re: Permit No. MST2007 -00169 Dear Sir /Ms.: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 12976 SW Hillside Ter Project Name: Hillside Estates Job No.: N/A Refund: ® Check #58044 in the amount of $240.00. ❑ Credit card "return" receipt in the amount of $ n Trust account "deposit" receipt in the amount of $ Notes: Refund for overpayment of TIF -R fees due to calculation error. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I: \Building\ Refunds\ Administration \LtrRefund- overpay.doc 01/16/07 Phone: 503.639.4171 o Fax: 503.684.7297 o www.tigard- or.gov o TTY Relay: 503.684.2772 c } ' IAA City of Tigard r /dtlY Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Ascend Construction INC DATE: 6/12/08 16142 SW Pollard Ln Tigard, OR 97224 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: . Receipt #: 2007 -0540 Case #: MST2007 -00169 Date: 2/20/08 Address /Parcel: 12976 SW Hillside Terr Pay Method: Check Project Name: Hillside Estates EXPLANATION: Refund overpayment of TIF -R fees REFUND INFORMATION: Fee. Description From Receipt Revenue Account No. Refund Example': [BUILD] Permit Fee Example: 245 - 0000 - 432000 $ Amount [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 TOTAL REFUND: $240.00 APPROVALS: If under $500 Professional Staff j If under $7,500 Division Manager G<<) If under $22,500 Department Manager ` If under $50,000 City Manager If over $50,000 Local Contract Review Board / FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY ✓ Case Refund Processed: Date: 1 /z.,54 ? I By: i' I:\ Building \Refunds \RefundRequest.doc 05/23/07 `° ' CI TY OF TIGARD 6/I I /zoos p pt 7'. 1a 13125 SW 1_ :i).1 I1 M i Blvd. 7-'9 - , , ';x ..:t. -_ i,1. Tigard, OR 97223 303.639.4171 !t UGARD Receipt #: 27200800000000000540 Date: 02/20/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MS'l'2007 -00169 [CDCPLN] CDC Pin Rev 100- 0000 - 433060 46.00 MST2007 -00169 [LRPF] LR Planning Surcharge 100-0000-438050 6.00 MST2007 -00169 [BUPPLN] PIn Rv Balance 2 45- 0000 - 433000 151.33 MST2007 -00169 [BUILD] Bldg Permit 245- 0000 - 432000 ),?53.3? MST2007 -00169 [TAX] Build 8% State Surchrg 100- 0000 - 207020 180.27 MST2007 -00169 [METCET] Metro Const Excise Tx 245- 0000 - 229202 532.26 MST2007 -00169 [PLUMB] PLM Print 3Bth 245- 0000 - 431000 399.00 MST2007 -00169 [TAX] PLM 8% State Surcharge 100- 0000 - 207020 31.92 MST2007 -00169 [ELPRMT] ELC Permit 220- 0000 - 431510 412.35 MST2007 -00169 [TAX] ELC 8% State Surcharge 100 -0000- 207020 32.99 MST2007 -00169 [ELPRMT] ELR Permit 220 - 0000 - 431510 75.00 MST2007 -00169 [TAX] ELR 8% State Surcharge 100 -0000- 207020 6.00 MST2007 -00169 [PKSDC] SF Part: SDC 270- 0000 - 450000 4,812.00 MST2007-00 I 69 [TIF -R] TIF Resident 2 10- 0000 - 445001 3, MST2007 -00169 [TIF -MT] TIF Mass Tr 210-0000-448005 2 40.00 ` MST2007 -00169 [ERPRNIT] Erosion Control 100- 0000 - 207307 136.00 \. MST2007 -00169 [ERPLN] Erosn PIn Rv CWS 100- 0000 - 207305 44.20 �\ MST2007 -00169 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 44.20 MST2007 -00169 [MECH] MEC Permit 245- 0000 - 431010 123.30 1VIST2007 -00169 [TAX] MEC S% State Surcharge 100- 0000 - 207020 9.86 Line Item Total: S12,736.00 Payments: t �, Method Payer User ID Acct. /Check No. • Approval No. How Received Amount Paid w Check ASCEND CONSTRUCTION INC DEB 1304 In Person 12,736.00 Payment Total: 512,736.00 dtceopt vi Page 1 of I CITY OF TIGARD 0 • :,,, . - BUILDING DIVISION PERMIT #: MST2007069* 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/200f3 • I Phon9: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175' ..... -- INSPECTION WORKSHEET FOR DATE: 1/ 2n009 TIME: 7:00AM PAGE: 6 ' _ 1 _ ,.. SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: oos TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: New SF OWNER: PHAM, HAI NOOC PHONE #: 603-614-9775 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503,484-8581 Inspection Request Scheduled For: Date: 1/12/2009 Pour Time: Code # Inspection Description Confirm # Contact # Me 1 ::: 11 A, 299 Final inspection 079602-01 50: .)\ Corrections/Comments/Instructions: io &) A / <--TEc-______---1- -,--.2_-_-_ --, FA PAS • PARTIAL APPROVAL CANCEL 7 NO ACCESS . 111 FAIL /I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: . Date: / / Z.-- 0 Phone #: (503) 718- Z---6 ' 110 • CITY OF TIGARD a • _ _ __ BUILDING DIVISION w A _ 1--LHMI I _ #: : MST2007-00169 131225SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2120/2008 Phorie; (503) 639-4171 , Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/o/2009 TIME: 7:00AM PAGE: 20 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: , HILLSIDE ESTATES LOT #: 0.08 TYPE OF USE: ... PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: N SF OWNER: PHAM, HAI NOOC PHONE #: 503-6'149275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503-4811-0581 Inspection Request .Scheduled For: Date: •/13/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Elernical final ' 079505-01 503-448581 di Corrections/Comrnents/Instructions: R a) 12T i 2.- /30 /o & C...4 /L-) c_c, C /—J . _ ' - PARTIAL APPROVAL . . , / 7 CANCEL 0 NO ACCESS 0 FAIL / j CALL FOR INSPECTION 7 AD j_44 DITIONAL FEES, ASSESSED .._ Inspector: Date: , ' , ' Phone #: (503) 718_ „ . . CITY OF TIGARD • . PERMIT #: NIST2007.00"M ' 13.11,ILDIINQ EDIVISION 13125 SW Hall BlVd.-, Tigerd, OR 97223 - 'DATE ISSUED: 2/20/2000 Phone': (503) 6394171 1444118111t Inspection Requests (24 Hrs.): (503) 6394175 INSPECTION WORKSHEET FOR DATE: 12/30/2008 TIME: PAGE: 4 • 7:00AM SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES. 'LOT #: 008 TYPE OF USE: PROJECT NAME: t9lLLS1DE ESTATES DESCRIPTION: New SF OWNER: PHAtvl. FIAI NOOC PHONE #: 503-614-9275 CONTRACTOR: ASCEND (..',ONSTROCTI ON • PHONE #: 503-484-8581 Inspection Request Scheduled For: Date: 12/30/2008 Pour Time: Code # Inspection Description Confirm # Contact Message 199 Electrical final 079267-02 503-4844i581 Y Corrections/Comments/Instructions: %joa-t A - \ NO w GA.1 \4t- Y ti t45ii TO. 4■1 F ' A bE u‘yv G-i‘RisN'Elf , • 9 6 ( Z-ZAt - 1 7) # Ct1P4Z6t1. F P.P , .<fl) LL NLe . a:Ds F\)044 tisi4uc L. e PQ-0;si'isot 141_ Qcky-e9,6; fl , . • PASS n PARTIAL APPROVAL El CANCEL fl NO ACCESS FAIL - CALL FOR INSPECTION II ADDITIONAL, FEES' ASSESSED Inspector: va,w LT Date: 1. 1011 Phone #: (503) 718 City of Tigard, Oregon Page 1 of 2 . Alli:-. ,, ,,tio,, s a TT 11,,,, Is L. �� }Jyy 0 . r f � : r , s i q i t ,, { j i III - �. M11t / ! � ^ �1 �+ { / • y k ) � 39 � � £.- t r / Fl Ilt r . N a a ra Pia G' a' .4{ � ,.Y. %a M ri g '� ^. li Search 1 Property 1 F Planning 1 I Crimes 1 I Transportation 11 Utilities 111 Aerials 11 E JC- 11 1 Summary 1 Permit Summary 1 Community 1 Hazards 1 Explorer 1 ■ 12976 SW HILLSIDE TER Property Summary I FERN N S7 I a �E w WALNUT ST is �G., = :_. 1 _ - ... 31! 7V rq 1. 1 t ; I I _ M 0 tt 1 2 1 r Q Q i 1 � E - - 1 , _s t t I k{ E 1 f i t a as L 1 1 t ri o ..... j,, { - S , 4 � k 1 r i V t Property Owner Info Tax ID Number: 2S104AC14300 Tax Account Number: R2147322 Site Address: 12976 SW HILLSIDE TER Site City: Site ZIP: 97223 Owner: PHAN, HAI NGOC Owner 2: 14788 NW JEWELL LN Owner 3: Owner Address: Owner City: PORTLAND Owner State: OR Owner ZIP: 97229 Acres: 0.16 Sq Ft: 6,969.6 Bldg SF: 0.00 Bldg Value: $ 0 Land Value: $ 183,700 Total Value: $ 183,700 Taxable Ass'd Value: $ 102,740 Sale Price: $ 205,000 Sale Date: 11/15/06 Year Built: 0 District & Community Info Municipality: Tigard Tigard Urban Sery Bndry: YES http: / /tiggisiw /mox52_ multimap /index.cfm ?fuseact property. summary &CFID = 81722 &CFTOKEN =... 12/30/2008 CITY OF TIG�►RD 0, . BUILDONG` DIVISION F PERMIT, #: MST2007 -00169 13125 SW Hall Blvd. Tigard;, OR'97223 DATE ISSUED: 2120112000 Phone: (503) 639-4171 :'id I ,� ' Inspection' Requests (24 Hrs.): (503) 639. -4175 .. I .. INSPECTION WORKSHEET FOR DATE: 7/15/2008: . , TIME: 7 :00AM PAGE: 38 • SITE. ADDRESS: 12976 SW'.HILLSIDE. TERR - -CLASS OF`WORK: -SUBDIVISION: HILLSIDE ESTATES LOT #: 008 TYPE OF USE: PROJECT NAME :: HILLSIDE ESTATES •. DESCRIPTION: ;NeW SF •• OWNER: PHAM, HAI NOOC ` • PHONE #: 503,614926 CONTRACTOR :. ASCEND:CONSTRUCTION PHONE ii:: 503 - 4848581, . Inspection Request ,Scheduled'For: Date: 7115/2008 PourTime :. Code # Inspection Description .Confirm,, #`, Contact # Message 115 Elettrical service ` . 072634 -01 03- 357 :2350 N Corrections %Comments /Instructions,: - C ( jzzj 64 , �- cZ- � , .. • • 1-2-1' , - e r rte/ o� QLL v A— { — <Arr1<-__ ' F1 Pf - _ C_fi/ 1 �R-'/ A tic ( -C- • • LOA/ `' /PTIALAPPROAL ®CANCEL Q NO ACCESS n; FAIL /) P1 CALL FOR INSPECTION 0 ITIONAL FEES ASSESSED ' Inspector: Date : ADD 7 j,S� G��= Phone #: (503)` 718 - � CITY OFTIGARD , • BUILDING DIVISION PERMIT #: MST20 00169 13125 SW `Hall Bled,; Tigard, OR 97223 DAT ISSUED: 212012008 Phone: (503),639- 4171 @Ilil�. Inspection Requests (24 Hrs.): (503) '639 - 4175 `. INSPECTION WORKSHEET FOR DATE: &24/2008 TIME: 7 :03AM PAGE :. °18 „' SITE :ADDRESS: 12976 SW HILLSIDE: TERM' CLASS OFWORK: SUBDIVISION HILLSIDE ESTATES LOT #: 008. , TYPE OF USE: PROJECT NAME: HILLSIDE: ESTATES DESCRIPTION: New SF • OWNER: ;PHAM, HAI N.00 PHONE #s 603 -611- 9275 CONTRACTOR : ' . ASCEND CONSTRUCTION PHONE*: 603••484 - 8681 Inspection Request Scheduled Fora, Date: 6124/2008 • Pour Time: Code •# Inspection Description Confirm .# Contact # Message 135 Low voltage r 071'789 =02 503-484148581 ' hd Corrections /Comments %Instructions: • • • • • • PASS n PARTIAL APPROVAL ❑ :CANCEL ❑ NO ACCESS. n FAIL CALL FOR INSPECTION ❑ ADDITIONAL _FEES ASSESSED Inspector . ,. � t Date: C Z Phone #: (503) 718 - .: r t .; 1 CITY OF TIGA B(JI DIVISION PERMIT # MST 007 00169 .13125 •SW H all Blvd: Tigard OR 97223 ' DATE' ISSUED: -- 2.01200th Phone: (503) 639-4171 11411�ll Inspection Requests. (24 Hrs )? (503) 639 -4175 • • INSPECTION WORKSHEET FOR, DATE: 6/6/2008 TIME• 7:O0AIvi PAGE :, ' a; SITE ADDRESS: 12976 SW HILL.SIDE.TERR CLASS OF WORK: • SUBDIVISION: HIIL.LSIDE ESTATES • LOT #: 008 TYPE OF USE:; PROJECT NAME`. :HILLSIDE ESTATES • DESCRIPTION:: ' e,'SF OWNER: PHAM, HAI NOOC PHONE #. 503.6149276 • , CONTRACTOR :, ASCEND CONSTRUCTION RHONE #: 603-481- 8Sl3'1 Inspection Request;. Scheduled For :, Date: 6/6/2008 • . Pour Time: Code # . • Inspection Description Confirm• # Contact:# Message • 120 Elettric;ai cosh -in 070950.01 503- 936•235€3 N • Corrections %Comments %Instructions: • • n PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS n FAIL , ❑ CALL FOR INSPECTION E ADD % AL FEES ASSESSED • C am - • N Inspector: Date'- f 7 4 1 A, p U� 6' Phone: , #: (503) 718- CITY OF . RD BUILDING DIVISION' • PERMIT # MST2007 -09 69 13125 SW Hall Blvd.,• Tigard „OR 97223 DATE ISSUED': 2/20 2008 :Phone: (503) 639 -4171 vA4ln�ml9 "� Inspection Requests (24 Hrs;): (503), 639-4175 Agn • . INSPECTION WORKSHEET FOR DATE: 6/4/2008 TIME: 7:01AM PAGE: 62' • SITE ADDRESS: 12976 SVV ^HILLSIDE TERR CLASS OF WORK: SUBDIVISION:. HILLSIDE ESTATES LOT #: 008 TYPE OF USE:, PROJECT' NAME; HILLSIDE ESTATES • DESCRIPTION: . Nev SF OWNER: ,PHAM, HAI NOOC • PHONE #: 503614 -3275 ACTOR ASCEND CONSTRUCTION PHONE #: 503 - 484.8581 CONTR t..ab of 1 3 3 Inspection Request. Scheduled For: • Date: 6l4 /2008' Pour'Tirne: Code Ir}spectic Description Confirm # Contact # Message • 120 Elect lectrical. roug11 -ir! 070758.01 603-936-2358- . - N • Corrections /Comments/Instruction • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ No ACCESS ❑ FAIL n CALL. FOR INSPECTION ❑ ADDITIONAL FEES' ASSESSED Inspector: 002:0 S- Date: L f O Phone #: (503) 718 -. 1-17b , 4 . p ' ,- s r a !Ai ..:., . Rest t '{ ed ]Ene} ; � -��t J ectracal tll Log og -'f Tigard TIGARD Building Division 1 3125 SW Hall Blvd., Tigard, OR 97223 Phone:. 503.639:4171 Fax: 503.598.1960, Inspection Line: 5 Internet: ww■;tigard- or.gov PERMIT NO. :, { V \S p w / (cq ISSUED BY: DATE: 1,g_1,..2_0/e,/ w =� ti ` ' � , TO BEICOI r— *tllEDBY INSPECTING, L7RISIUICTI®� Z t ip T - - < .La.n z..r�,74 -,. ....�,.� sa ..,sxu..n r.,...,, s_ �, :� ,.�. n. z......- .,- -., .,......� N 5,u3tt -:�* .,, �fi,Y�� r CHECKTYPE OF WORK INVOLVED: • 1. &2- F.AMILY 'COMMERCIAL, .El Audio and Stereo Systems* . ❑ Audio-and Stereo 'Systems, El :Burglar Alarms '❑ Boiler. controls t1 Vacuum Systems ❑ Clock Systems ❑ Data Cabling , ❑ Data Communication Systems .other AL.- -1\ 0 OV.K7) f 1 I\ ( 0 Fire Alarms ' t, ❑ HVAC .. Intercom and pa systems 0 Landscape Irrigation Controls* f1 TIS MOS 1 .Bl, POSTED AT TI-IE JOB,SITE AT OR :NEAR,THE SERVICE ❑ Medical PANEL. TF TI IERE TS NO SERVICE PANEL, POST. ON OR NEt1R'TI -IL INSTALLED PRODUCT., AN INSPECTION SHALL BEREQUESTED ❑ Nurse Calls ONLY, A1IERALLOFTHEABOVE PERMITTED SYSTEMS 1-IAVE BEEN LI Outdoor Landscape Lighting *` •INS I•A7.1 ED, AND TT- IIS.LOG HAS BEEN STGNED BY TTNE SYSTEM Piotectve: signaling CONTRACTOR(S) OAR. 91S- 309 -04OQ. ' ❑ Other . i TOTAL NUMBER OF COMMERCIAL, SYSTEMS: *.Electrical licenses are nor required for these' items. Construccgon Contractors Board license is', required for installations.., : A r BE COMPLETE qj-W STA tSltq f ` " ' : x ;M .' ❑ System 0 System Company : .Q , "EA 4, ,,s.c_ Phone: 5'b,3 357 .. 3 _ G` tp \ ompany: Phone:: Address :SW ' /Jog) G t t 4 '-`CCB #y `''I 9' A. 1 SZ tjrr� e �] - 3 . Addr ess; CCB '# , ' Sig.: a..%_, yy . 6t et 111c. # `33 IS Sig: Lic.:, # ❑ System ❑ System . Company: Ph one: ' Coinpany:, Phone: Address: CCB Address: CCB -#' Sig:: C / Lie. Sig: Lc. # , , ❑. System. V C ati 1 ❑ Sys Company:: �__f A g - Phone: ' D- 3 ' Company Phone: / G� p # / 77 -)9 Address: CCB # , Sigdiess (GN • U►'� Lic. d .� � Sig: Lic., ❑ System ❑ System Company: - Phone: Company: Phone: Address: CCB #. Address: CCB'# ,Sig:: tic. # Sigc: Lie.. # ❑ System ❑ System . . _ _ - Company: Phone :, Company: Phone: Address: CCB # Address: CCB Sig.: Lic. # Sig Lic. # , - ❑ .System ❑ System , Company: Phone;: Company: Phone: Address: CCB ,# ' Address: CCB: # 'Sig.:. Lic.# Sig :, Lic. # 1 \Building Forms \ELC- RetnctedEnergyLog.doc 02/01/07, • 1 • ' '4110 • 918- 309 -0400 • Restricted E nergy Electrical Permit Application ,(1 A `separate Restricted Energy Electrical Permit Application Form;and Restricted Energy Electrical Installer Log, are created and .adopted. (2) The Restricted Energy Electrical Permit can be taken out by a general or subcontractor, limited energy installer or property owner for the fee set by 'the board in. OAR 91.8 - 309 -0030 for limited energy transactions . provided the, requirenients of this. rule are met. The person applying for the permit must: • (a) Assume responsibility to call for an inspection when. the permits are "signed by appropriate persons, installations are: completed and after all corrections are. made and comply with the requirements of the restricted energy electrical laws and the restricted energy electrical rules; • (b):Be responsible for all corrections required by the inspector under the permit, regardless of who performs the work; (e) Call for a final inspection when corrections are made and the work - is completed. (3) Options: The person obtaining: the permit may: (a) Limit the permit to only the work of the permittee,; or • (b) Include any and all limited energy installations including; those done by separate installers, but the installations must be ready for inspection' at the°first' call. When this _is • done, the permit inust be completed and separately signed by the person, also identifying the business responsible for each type of limited energy electrical: installation. (4) The restricted energy activities to 'be covered by the permit must be declared at the time of the purchase of the permit: • (a) I:t is not necessary' to identify the contractor at the time of permit issuance; • • (b) New permits must be purchased for all other restricted energy installations; (c) If a contractor is changed, the . contractor who completed the work must be identified. • (5) Regardless of what was initially intended the permit only covers those installations that, are in place'at,the time of the first call for limited energy electrical. inspection.. A:separate permit must be purchased for all other limited energy installations whether the installations become ready for inspection at a later date or are done•at a later date: (6) This •rule' does not apply to an industrial plant when ORS 479.560 is applicable. • (7) The Restricted Energy Electrical. Installer Log must, be posted at the job site for signing by appropriate; persons installing the separate electrical systems as shown on the form. A municipality may require more than of e log to. be •completed and 1'eft at the job site ifit ehooses;to. • • • ta\ Buildin \ Forms \ELC- Re5tictedl nergyl:ogdoc 02/01 /07 2 • • CITY OF TIGARD 40 BUILDING DIVISION P ERMIT #: . M ST2007 -00169 131 SW` Hall Blvd, Tigard, 'OR 97223; DATE ISSUED: 2/2012000 Phone: (503) 639-4171 ' '*$ . i Inspection Requests'(24 Hit.): (503) 639 - 4'•1.75' � I ., ' INSPECTION WORKSHEET FOR DATE: 5/22/2008 TIME: 6 :59AM PAGE: 9 SITE ADDRESS: 12976 SW HILLSIDE TERR "CLASS OF WORK: .,;SUBDIVISION: MILLSIO w ESTATES LOT #: 008• . ' TYPE OF USE: PROJECT. NAME: HILLSIDE ESTATES • - DE Now SF • . OWNER: PHAM, HAI NO:DC .- PHONE #: 503-6141-9275 CONTRACTOR ASCEND CONSTRUCTION PHONE #: 503 - 4848581 Inspection : Request Scheduled For, :. Date: .: 5122/2008 Pour "Time: .Code # Inspection Description; Confirm # Contact ,# Message 120 Electrical rough -in 070278 01' • 50` 357 -2350 •t Corrections /Comments /Instructions: - St O d` t -5'5 . r q\.t- V A «.r. 0 01.1b5 P% t4I NV C 'IV p N . P,a. R ` l _ -ti . ,. s e C17 CON- . . Pqa,, ik•o.'" ) .. - C k.4 catty r4 P i si1?� it Piw J bikaici,x x r. -.... b 00■20-- t ru... . , -cam, N 1 * Rizlinc irso1/44 NO coalOt .67L PLAK:' AetlaVf , % w 4. : ri t, . A'AL1- Clit 2 pl . • U�o I Pc o 1 '160 et4 . 4\poNs.oa_f a ook Amq _ ,t chcskTL:r idorz=v\fo - ,N)5.1t-i wiku.J6 Ata) uthal 1-. , . %-, Z ._ ". sys: co‘rcrk,L , Of' 7 7E:d - t oo (la' 4 Ofrit , . - V 0..:0 Q3 °1'. L%J OAS k., gbh A _._ _._. ---- vo..s.-..,..161% ao era r .; IV 0 it . PASS n PARTIAL APPROVAL • 1 I CANCEL n NO ACCESS iri FAIL • `11 CALL FOR INSPECTION A DDITIONAL FEES,ASSESSED - Inspector: . • N o6 t,, Date: _42 Phone #":' (503) 718- /Olio CITY OF TIGARD • B Iv UILDING' DIVISION, PERMIT MST2007- 40169 1'3125.SW`Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2008 . Phone: (503) 639 -4171 ! 1u ii II' � & • Inspection Requests (24 Hrs):,(503) 639 - _4175, II : INSPECTION WORKSHEET FOR'. DATE: ,5/2212008 TIME: 6:59AM PAGE: . 10 SITE ADDRESS: 12976 SW HILLSIDE TERR _ CLASS OF WORK:. • ' SUBDIVISIOK:� . HILLSIDE ESTATES LOT #: 008 TYPE OF USE: PROJECT NAME HILLSIDE ESTATES • DESCRIPTION: New SF • OWNER: PHAM, t °IAI NOOC PHONE # 503 -614 -9276 CONTRACTOR: ASCEND PHONE #: 503 - 484 -f36B 1 Inspection Request Scheduled For: ' . Date: 542212008' Pour Time: Code # Inspection Description Confirm # _ Contact # . .. Message 115 Electrical service 070277 -01 : 503. 367 -2350 N Corrections /Comments /instructions: % Tok,Ny TVr:-..: 2] -1 ' _ S VAce E" 1 ' • it ?) 4 ° N 6 -f. . ,' - K(rg 4 tipiq C _ __________C • • ❑ PASS - II PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS j FAIL ' '\CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G''' . IN 45 G Date: ) Phone # (503) 718 - dik)____: Said 1`,y'u. ta7ty . 1 3 P*r. jr4:s6INOR �;.., g® �� ' ® E M ORAN DUM i TO: Building Inspectors FROM: Todd Prager RE: Hillside Estates Lots 1, 2, 3, 4, 6, 7, 8 DA'Z'E: September 17, 2007 Please do not sign off on final inspection until the tree remediation/mitigation plan is approved by me. My desk number is 503 718 -2700 and my cell number is 503 764 -6913 if you have any questions. Thanks, Todd 4_ ® ME M O R A N D U M o f ; TO :- Building Inspectors oc\ FROM: Todd Prager RE: Hillside Estates Lots 1, 2, 3, 4, 6, 7, 8 DA'1E: September 17, 2007 Please do not sign off on final inspection until the tree remediation/mitigation plan is approved by me. My desk number is 503 718 -2700 and my cell number is 503 764 -6913 if you have any questions. Thanks, Todd fi f ' S f:' ' l''' ' . 1: ET T 1--: :., E _ • . __ , .. _i i .•_,, . ,, t.,..... t .�, t d N 20 ■ ti , X 4 ,. , 4 1 � r * . C I' N•� DIVISI 1 ' l r a ,1 '' -s a w e �- T�/fi'J �� " `�. `11 of �dC P Mil' iAl 1 U ! F Owner /'A it for. j : to ' i , , ,- (PERMIT HOLDE • (PLEASE PRINT) ry r lift N Do hereby 'certify t the ®llow � location meets City ®, z f l Ti B ard and e' asl ifn t Goun ty t g i 11 g, ty land use and devel' m s str tree installation. ,, "'p #' ," ' e*: i4"' ' ." ' � °'r v a . 4/19V- .1,9 'F `: . ;� ,� s° V €° , fi�x apaa � , , r p � � vim. °1 ' ' .� ,' v�/\�vv /� d' (-,Ali 'm Y h.h� �„ `v"e F P Sv� e T17� -�1: \ 0 ADDRESS: / 7 1 7 6 ,S (,,/ i- I IBS' 0-E C SUBDIVISION: H I LLS 10 66 LOT: S SIGNATURE: _ / DATE: / S ( OWivE RECF,IVED BY. DATE: - $ og (CITY OF TIGARD) I: \Building \ Forms \StreeffrceCcrtificate 01 /19/07 CITY OF TIGARD 410 BUILDING DIVISION PERMIT #: MST2007-00169 13125.5W Hail Blvd., Tigard, OR 97223 A DATE ISSUED: ma/200o Phone: (503)639-4171. / i tokAit Inspection Requests *(24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/912009 TIME: 7:01AM PAGE: 17 SITE ADDRESS: 12976 SW HI LLSI IDE TERR CLASS OF WORK: SUBDIVISION: FIII.L.SIDE ESTATES LOT #: 008 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCF1IPTION: N sF. OWNER: PHAM, HAI NQ 0C i /PHONE #: 603-614-9275 CONTRACTOR: ASCENDCONSTRUCTION 'PHONE #: 603-484-0681 Inspection Request Scheduled For:. Date: v9/2009 Pour Time: Code # Inspection Description, Confirm # Contact # Mes-.- 399 Plumbing final 079549-01 503-48443581 Corrections/Comments/Instruttions: • • • • • M1 1 ' El PARTIAL APPROVAL Eli CANCEL NO ACCESS n FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: _ - Date: 1 / 4 #: (503) • CITY OF TIGARD BUILDING DIVISION PERMIT . MS7.`�C1f}7 -C14� wC9 13,125ISWHall Blvd.,; Tigard, OR. 97223 DATE.lSSUED: 2/20/2000 Phone (503) 639 4171 Inspection Requests (24'Hrs.): (503) 639-4175 �I INSPECTION WORKSHEET FOR DATE: 1/8'2009 TIME: :t 0AM PAGE: 19 SITE ADDRESS: 1297$ SW HILLSIDE TERP CLASS OF WORK: SUBDIVISION: HILLSIDE s HILLSID!" ESTATES LOT #: 000 TYPE OF USE: - PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: „ • OWNER :. , PHAM ! , HAI NOOC. PHONE #: 603-6141.9275 CONTRACTOR: 'ASCEND CONSTRUCTION PHONE #: 60344M- 0501 Inspection .Request Scheduled` For: Date: 1/8/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 079606.02 663 -46486131 4 rectionsl .Comments %Instructions: v t\ 1. • _ —> C _ ;i to • • _ A ❑ 'PASS' ,PARTIAL APPROVAL ❑ CANCEL. fl NO ACCESS � FAI ' CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ; ...– Date: . 407_ Phone #: (503) 718- , 26 • CITY OF TIGARD • BULLDING, DIVISION PERMIT #: MST2007-00169 131'25 SW Hall Blvd., Tigard, 'OR 97223 m DATE ISSUED: 2.12W200 Phohe: (503) 639 -41;71 irnn�ui��i ' Inspection Requests (24 Hrs): (503) 639-4175 INSPECTION WORKSHEET FOR. DATE: • TIME: PAGE: 10/15/2008 7:Qt A 7 SITE C ADDRESS: CLASS OF WORK: '12976 SW 'I 11 i.I_SI E TERR SUBDIVISION: LOT #. TYPE OF USE: HILLSIDE . ESTATES' :PROJECT NAME: HILLSIDE EStATE DESCRIPTION: New SF OWNER: PHAMl, HAI NOOC PHONE #: 603 -614 -9275 CONTRACTOR., • ASCEND CONSTRUCTION PHONE #: 503-484-8581 Inspection Request Scheduled For: ' Date: 1QI1�i,2OoB Pour Time: Code # " Inspection Description Confirm # Contact # Message 322 Shower pan 076752-01 503 -484- 8581, N Corrections /Comments/ Instructions: • • E4 `PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector vY Date: 1'01 I S OC Phone #: (503) 718 - CITY OFTIGARD . BUILDING DIVISION PERMIT# IVIST2007400,169 13125 SW Hall Blvd. Tigard, 09 DATE"ISSUED: 2/2012608 — Phone: (503) 6394171 , Inspection Requests (24.Hrs.): (503) 63974175 INSPECTION WORKSHEET FOR ' DATE: TIME': 7:00Am , PAGE: 15 10/3/2008 ' ' SITE ADDRESS; LOT #: CLASS OFVVORK: 12976 TERR SUBDIVISION TYPE OF USE: HILLSIDE FSTATES • 000 PROJECT NAME: HILLSIDF ESTATES DESCRIPTION: New SF • OWNER: PH A M, AM HAI NO0C PHONE #: 503-614-9275 .CONTRACTOR: - PHONE #: 503 ASCEND CONSTRUCTIoN Inspection. Request Scheduled For: Date: Pour The: - 10/3/2008 Code # Inspection ,Descriptien COnfirm # Contact # - Message 330 Water, service 076280-01 503-484-881. N Correciions/CorrirneritsYlnstruttiOnsi' 1 r ob.,' CO, e- Jrtt 1 . e.44 (4 1" tV • • • • • -„ PASS El PARTIAL APPROVAL fl CANCEL El NO ACCESS FAIL LI CALL FOR INSPECTION. 7 ADDITIONAL FEES _ASSESSED • InSpector:Ca krvkiL; I \ \ Date 10 1,? 1 Phone #: (503) 718- Of TIGARD BUILDING DIVISION PERMIT # MST2007 -00169 13125 SW Hall Blvd., Tigard, OR 97223 'DATE ISSUED:' 2/20/2008 Phone: (503) 639-4171 'n4Nypl��l Inspection Requests (24 Hrs.): (503) 639 -4175 °+r` INSPECTION WORKSHEET FOR DATE: 5/8/2008 TIME: 7:01AM PAGE: 8 SITE ADDRESS: 12976 Sid HILLSIDE TERR, CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 008 TYPE. OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: New SF OWNER: PHAM, HAI NO00 PHONE #: 503 - 6149275 CONTRACTOR: ASCEND CONSTRUCTION _ PHONE #: 503.484 -8581 Inspection Request Scheduled For ' Date: 5/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 069603 -01 . 503-484-8581 N Corrections /Comments/Instructions: e � �� p'� `l% 1� - S Vii\ C 7/ • • ❑ PARTIAL APPROVAL 45 C_ ►' ❑ PASS ❑ NO ACCESS n FAIL 0 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date w > od ' Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION. '0_ PERMIT #: MST2007 -00i69 131,25 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 2/20/2000 Phone "(503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/7/2008 TIME , 7:00AM PAGE: 5 SITE ADDRESS: '12876 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION; HILLSIDE ESTATES • • LOT #: 008 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: N't SF OWNER: PHAM, HAI NOOC . • PHONE #: 503-6'i49275 CONTRACTOR:, ASCEND CONSTRUCTION PHONE #: 503.484 -0581 Inspection Request Scheduled For: Date 5/7/2008 Pour Time: Code # Inspection Description - Confirm # Contact # Message 320 Plumbing rough - in 069524-01 50 3-484-8581 N A1v Ci.J•./s Corrections /Comme /Instructions: are..! ' / Ay e sro,,,,A. if.- 1 k ; . '14 A Pi- , _ (A) ,t 4 et. r.- • ,, et, s' 8 • • • • 1 E' PASS n PARTIAL APPROVAL ❑ ' CANCEL ❑ NO ACCESS CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C,1% L` W\ \ \»'.wt. Date: c f7) 07, Phone #: (503) 718- 'CITY OF TIGARD 410 BUILDING; DIVISION PERMIT #: MST2007- 00169 SW 03 Hall Blvd., 71 Tigard, OR, 97223 DATE ISSUED: 1 ?OJ t1pl3 Phone: ( ) Inspection 'Requests (24 Hrs.): (503) 639 -4175 :- INSPECTION WORKSHEET FOR DATE: 31512006 TIME 7 :00AM PAGE: 11 SITE ADDRESS:. 12916 S HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 006 TYPE OF USE: PROJECT NAME HILL SIDE: ESTATES DESCRIPTION: New SF OWNER: PHAM, HAI NO00 • PHONE #: 50361'1 -9215 CONTRACTOR: ASOE.:ND CONSTRUCTION PHONE #: 5034184-8581 Inspection Request Scheduled For: Date: 3/5/2008 • ,Pour Time Code # Inspection Description Confirm If Contact # Message =0 6 f3anitaty; sewer : 066136 - 03' 503-4N-8581 Y Corrections /Comments /Instruction's: • • • • PASS PARTIAL APPROVAL 7 CANCEL n NO-ACCESS 1 FAIL n CALL FOR INSPECTION ❑ - ADDITIONAL FEES ASSESSED Inspector d l \ IN.-- Date: 3 1 '1 K3 Phone #: (503) 718- CITY OF TIGARD 0' BUILDING DIVISION' PERMIT #: MST2007 -00 i i9 13125 SW Hall Blvd:, Tigard, OR 97223 DATE ISSUED: 212912008 Phone: (503) 639 -4171 - Inspection Requests (24 Hrs.): (503) 639-4175 ; ' INSPECTION WORKSHEET FOR DATE: 3/5/2000 TIME: 7 :OOAItiil. PAGE: 12 SITE,ADDRESS 12976 SWHILLSIDE TERR CLASS OF WORK: SUBDIVISION: ' HILLSIDE ESTATES LOT #: 000 TYPE OF USE: PROJECT 'NAME: HILLSIDE ESTATES n DESCRIPTION: New SF OWNER: PHAM, HAI , 140,6C PHONE #: 503 CONTRACTOR: ASCEND CONSTRUCTI PHONE #: 503.184-8581 Inspection, Request Scheduled For: - Date: 3/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message. 340 Storms drain • 066136-02 503. 404 -0501 N Corrections /Comments /Instructions: • • • • PASS • ❑ ,PARTIAL, APPROVAL ❑ .CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector:: iAAS'�. -- Date: _ b `D 7 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: I ST2007 -00 169 13125 SW Hall Blvd., Tigard', OR 97223 DATE ISSUED: 2/201200€3 Phone: (503).639 -4171 Inspection Requests (24 Hrs.):. (503) 639-4175 . '' Is INSPECTION WORKSHEET FOR DATE: 3/3/2008 TIME: 7:0OAM PAGE: 21 • SITE ADDRESS: ° 12976 SW HILLSIDE TERR CLASS OF WORK: .SUBDIVISION: HILLSIDE ESTATES _ LOT # 008 TYPE OF USE: PFROJECT'NAME HILLSIDE !ESTATES' DESCRIPTION: New SF • , OWNER: PHAM, HAI NOOC PHONE #: 503-614-9275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503=484.95131 Inspection Request Scheduled For :' Date: " 3/3/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 0E'59t38 -01 503-484-8591 h! Corrections /Comments / Instructions: F ro ji G0 ti • Rec,/ R L, tp . ., s' P.61" • • • 1 I PASS X PARTIAL APPROVAL • ❑ CANCEL Li NO ACCESS n FAIL n CALL FOR INSPECTION I , ADDITIONAL FEES ASSESSED Inspector: - 0-- _ Date: 3 1 ,.31 ' Q Phone #: (503) 718- CITY OF TI GAR D BUILDING DIVISION - ' PERMIT M8T2007-00169 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2008 Phohe:(503) 639-4171 _ I Inspection Requests (24 Hrs.): (503) 63941,75 11 INSPECTION] WORKSHEET FOR DATE: 3/3/2008 TIME: 7:00AM PAGE: 20 . SITE ADDRESS: 12976 SW HILLSIDE TL. - 7 RR CLASS OF .WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 008 TYPE OF USE: PROJECT .NAME: HILLSIDE ESTATES DESCRIPTION: New SF • OWNER: PHAM, HAI NOOC PHONE #: 603-6149275 CONTRACTOR: ASCEI4D CONSTRUCTIQN PHONE #: 503-484-8581 Inspection RequeSt Scheduled For: Date: 3/3/2008 Pour time: Code # Inspection Description Confirm # Contact # Message 310 Crawl &sin •06988-02 503-484-13581 Corrections•/Comrnents/Instructions: , C■ra4-4 Qv 1/43■1:ki c414--6-ois GA-ti _ • 0 - 4 01— Nop vtivekit • • • I PASS IPARTIAL APPROVAL El CANCEL H NO ACCESS FAIL 111 'CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED I nspector: D ate: Phone #: (503) 718- • • 4 46001 y .. A ® MEMORANDUM it TO: Building Inspectors FROM: Todd Prager RE: Hillside Estates Lots 1, 2, 3, 4, 6, 7, 8 DA'1'L: September 17, 2007 Please do not sign off on final inspection until the tree remediation/mitigation plan is approved by me. My desk number is 503 718 -2700 and my cell number is 503 764 -6913 if you have any questions. Thanks, Todd CITY OF TI,GAR',D 11, f „�w • 1. • ILDIN DIVI I N PE RMIT: #: : 1 ti U G � S O B { �ST:�Otl7 a� �';9 13125SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2000008 Phone , (503) 639 - 4171 1 �� Inspection (24 Hrs.): (503) 639 - 41 :_2" " INSPECTION WORKSHEET FOR DATE: 12/30/2008 TIME.' 7:00Am PAGE: 5 SITE ADDRESS: 1 7 SW HILLSIDE { CLASS OF WORK: SUBDIU,ISION; ♦.HILLS "Il:}FFSfATEwti LOT #: 008 TYPE OF US PROJECT NAME: HILLC;IDE ESTATES y [ 1 DESCRIPTION: Nc *v HAI NOOC PHAM, P #: X03 -61�i 9 75 CONTRACTOR: ASCEND ., PHONE #: � ASCEND CONSTRUCT ION 563 -484 858;1 1 � ,■ S . Inspection Request Scheduled For: Date: 1261:72001 Pour Time: Code# Inspection 'Description Confirm # Contact . #. Me =g 699 Meckinical final 079267 -01 603 ' Y Corrections/Co ents /Instructions: 112(2c,4 • • �.1 RS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL - ❑ CALL FOR INSPECTION ,0 ADDITIONAL FEES ASSESSED � �� • Inspector; _ - .. Date: P hone #: (503) 718- CITY OF TIGARD n BUILDING DIVISION PERMIT #: MST2007-00169 13125 SW .Hall Blvd., 'Tigard, OR :97223 DATE ISSUED: 212.0/2008 Phone: (503) 639-4171 �ll , Inspection Requests (24 Hrs.): (503)639 - 41.75' _ .. . ' INSPECTION WORKSHEET FOR DATE: 10/21/2008 TIME: 7 :00Am PAGE: 31 SITE ADDRESS: 12976 SW HILLSIDE. TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES - LOT #: 003 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES • DESCRIPTION: New SF OWNER: PHAM, HAI 1400C PHONE #: 503 -514 -9275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503 Inspection Request Scheduled For: Date: 10121/2003 Pour Time: 10 :00 Code # Inspection Description Confirm # Contact # Message 220 Slab 07696E -01 503 - 484<8581 N Corrections /Comments /Instructions: X20 " , v, i L -, - r _ .: 4 - . 4,rr 0 Si.>v ( 7...., • ASS , PARTIAL APPROVAL. El CANCEL pi NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED' ii Inspector: Date: /D-7../ D 25 Phone #: (503) 718- } ¢1 CITY OF TIGARD , • BUILDING DIVISION PERMIT #: MS1.2007 -00 X69. 1'3125 SW Hall Blvd'., Tigard,; OR 97223 DATE ISSUED: /20/2001 Phone: (503) 639 = 4171 r i. . - Inspection' Requests (24 Hrs.): (503) 639 -4175 .1` •I �I INSPECTION WORKSHEET FOR . DATE:'; 7/2312008 TIME: 7 :02AM.. PAGE: - 3 SITEADDRESS: 12976 SW IllLLSiDE TERR' C O F WORK: _ SUBDIVISION: HILLSIDE ESTATES LOT #: 0 TYPE OF USE: PROJECT NAME HILLSIDE ESTATES DESCRIPTION: New SF OWNER: PHAM, HAII NOOC PHONE #: 503 -614 -9275 , CONTRACTOR` ASCEND CONSTRUCTION PHONE #: 503:.48A-8581 Inspection Request. Scheduled For: Date: 7/23/2009 Pour Time: • Code # Inspection Description ' Confirm # Contact i# Message 260 InfAllz4iOn 073058 -01 50-4. 84 -9581 N Corrections /Comrrmentstlnstructions: ...41) oe 44,„„ ?_ '2-: -4 . _ A. 2 : L -.c c.' L d L ,i s - ;a - reL..a. 4'r-, , , 5 -- Z e--j-;e ,�.iS7/4 l !//L1 -)7 `L // *T Z /9 C is6 i91---') - PASS • ❑ PARTIAL APPROVAL El CANCEL ' ❑ NO ACCESS n . FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED Inspector-: ' ' Date 7 -- 23 — Phone # (503) -. 24-4J = rr_ CITY •OF TIGARD ., . iii ir - BUILDING DIVISION , - PERMIT #: MST2007- 00169 1:3125 SW Hall Blvd.,; Tigard',, OR 97223 DATE ISSUED: 2/20/2008 ' 'Phone :: (503) I 639-4171 i� u i� 1 1ii�l i In Requests (24 Hrs.): (5b3) 639-4178 • INSPECTION, WORKSHEET FOR, DATE: ° 7108/2008 TIME: 7 :00AMv1: PAGE:' 17 SITE:.ADDRESS :, .12976 Sal HILLSIDE TERRR CLASS, OF'WORK: SUBDIVISION:; .HILLSIDE ESTATES, .LOT #: 008 TYPE OF USE: • PROJECT NAME: HILLSIDE ESTATES • DESCRIPTION: New SI•' ' • • OWNER: ' PHAM, HAI NODC PHONE #:. 603 -614 -9275 CONTRACTOR: :ASCEND CONSTRUCTION' PHONE #: 8034184 -8591 Inspection R Scheduled For: Date: 7/18/2008 Pour Time: Code # Inspection Description . Confirm # Cor tact Message • 280 In CMI ation 072872 -01 ' St03'4 48501 • N Corrections/Comments/Instructions: . • • tier Cowi ep/e4--..6) a) .. rrt e� - %19 5 . ,`e ,, n,. PASS " . 1 1, PARTIAL APPROVAL ❑ CANCEL . ..1 NO'ACCESS FAIL n CALL FOR INSPECTION n, ADDITIONAL FEES ASSESSED Inspector : ! • 5.. Date: = /8 duly o Phone # (503) 718 -. y . . .. . CITY OF TIGARD ; 6 . . IP BUILDING DIVISION - v , -- PERMIT #: MST2007-00169 13125 SW Hall BRidl, Tigard, OR 97223 ' DATE ISSUED: 21 . • Phone: (503) 639-4171 A vi fi a . 1 4 # 1 11110111 .., . Inspection Requests (24 Hrs.):, (503) 6394175 • INSPECTION WORKSHEET FOR • DATE: 7/16/2008 • TIME: 7:QOAM PAGE: • 9 SITE ADDRESS: i 2976 SW HILLSIDE TERR ' CLASS OF WORK: .. . • SUBDIVISION: HILLSIDE ESTATES LOT #: 008 TYPE OF USE: . PROJECT NAME: HILLSIDE ESTATES - DESCRIPTION: • New SF ' OWNER: PHAM, HAI NOOC • • PHONE #: 503-614-9275 , CONTRACTOR: ASCEND CONSTRUCTION • PHONE # • 503-48+8581 Inspection Request Scheduled For: Date: 7/16/2008 Pour Time: Code # Jr ctibn Desdiption , Confirm # Contact # , Message 9 276 , Framing 0 4 072727-02 • 6o3-484-8581 • Y , • Corrections/C' ' ments/Instructions: i ,, ' ./ 6- ,), • i4 1 Zei - (, --- ,---5 • irLG/fri.._ ificIAa/k. --n,fte,t, to A—, .(. j ,,..16,,e. r? . , m/ t/ s „‹,e_,,. 10..*(;,,,(2,AA r- 4V'c, ..kr - •Q • . C.- A ,.._.., ' ,...... , , , , ,„„I . • %...) • 1 -/e%. C - • C C__-/"A-' - 1/1 - ' ' - _ ----_ - t■-t . • , , \ 1 i f 4 ' \rt.- • G '' • - .1. ' I - , - - I ‘31- - - - V ' ' . 1 ' ■ it ■ amos■A • - •• ' A■ • - • / • • 1 /1Az,-tiL31-e-- A.,,,,J) -- (,,A . ‘ , . . 1 pAss • - I PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS 1 1. FAIL • 0 CALL FOR•INSPECTION • 0 ADDITIONAL:FEES ASSESSED v[ ( , Inspector: , bi Date -7- 1 -t,. I g Phone #: (503) 718 . . , CITY'F TIGARD • -al BUILDING DIVISION PERMIT # MS1 }007 -00169 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: N201200R Pl one: (503) 639 - 4171 'il i yiii ., Inspection- Requests: (24 Hrs.): (503) 639 -4175 .., INSPECTION WORKSHEET FOR DATE: 7/16!2008 TIME: ' '7: . 00AM PAGE: 10 , SITE ADDRESS: 12976 SW HILL."°.JDE TERR CLASS OF WORK: ' SUBDIVISION: HILLSIDE ESTATES LOT #:, 008 TYPE I OF USE: PROJECT NAME: ' HILLSIDE ESTATES DESCRIPTION: New'.SF " OWNER: FRAM, HAI NOOC _ PHONE #: 503 - 614 -8275 CONTRACTOR: ASCEND CONSTRUCTION PHONE # :: 503 -484 -8581 p q Inspection Request Scheduled For,: Date: 7116l2008 Pour Time: ` Code'.# Jpection 'Description Confirm # Contact, # Message 615 " . Mothanical _rouges -in 072727 -01 503-484-8581 Y . Corrections/Comments /Instructions; /A -° PASS- - =PARTIAL - APPROVAL Q CANCEL NO ACCESS n FAIL •. U CALL FOR INSPECTION. ADDITIONAL FEES ASSESSED Inspector: Date: )7 1 ?/ 4 ' Phone: (503) 718- Y2-1 CITY OF TIGARD � " .a. BUILDING ®IVISIO,IV - PERMIT # MST2007-00169 13125 SW Hall Blvd.., Tigard, OR 97223 � ATE ISSUED: 21.)W2008 Phone (503) 639 -4171 NPyp�61t I ! • I Inspection Requests .;(24 Hrs.): (503) 639-41'75 '7..-;..;'', INSPECTION'` WORKSHEET FOR DAT.E.. - 7/10/2006 TIME: 7 :00, M ,PAGE: - 17 SITE ADDRESS: 12976 SW HILLSIDE TERR `CLASS OF WORK: SUBDIVISION: HILLSIDfEESTATES LOT #: `908 TYPE OF USE PROJECT NAME. ll LLSIDE 'ESTATES DESCRIPTION: New' SF - ' OWNER; PI FIAT NOOC _ PHONE #: 503- 614 -9275 CONTRACTOR: ASCEND CONSTRUCTION . PHONE # 50 -4a1- 8581 ` Ins e • p q � - me: ction Request Scheduled For: Date: l /1f /2308 Pour Ti Code # " - . Inspection' Description Confirm # Contact # . Message 5 . Framing 072443-01 ' 50348443581 Y (ca( �o; , +- C r rections /Com /instructions 1 / r.�t(4 ` P ; 5 1. /c ,i " J lt-, K /d %2 ,R', S .yin =e. y )r,i'd iI - ) j K 1'., , /�l S uu Z �✓l- (v e D. n' - . k H 'r 4 /114 S4 f .' A-1- kR (6 v'I.V+V 1� Ia. r-vt.%L 'ltf/k .7 0I.1 1 4' "'l , f1 v Gv , `0 57:' cAlo w Ca r \Ok;'H iv.. ...4-.€.,,,-: m,' . 0 , Ipp . 6.) r \rov,c)Qi 5c -a w Lp e, ;.1 cri. .a4- r„,.n' /cei); n5 ') d;',.0 — 100,r/rac .;mac., " r . ``' ,/'o J ,Ft✓� . k � ri -.�' .. ,._, � �i ,.: • T' I C)O r' ; Qc.,�r■: �` el � • J 1 l 1 ` �. i t 4.4 ; 5� i}'��/\��' `J '"'� ne�� a'CU J� ) C/.G11: - 'L9'�"►� } CS � Piin °i Y�4 3; r)-e.- `�t�� \D. � J J J e Ar . q }.' G.. ,( G heiy1 i Civ � i „ Y 1e e . 5 '. b C:o"wt r . .e e hQ >~J' . 1 , .PASS' - • ` n ;PARTIAL APPROVAL n CANCEL El NO ACCESS 'FALL 1C. CALL FOR INSPECTION, ❑ ADDITIONAL FEES ASSESSED. Inspector` 1/ D ate :,, . k.1∎ /01:1 Phone #: (503) 718- d 23 CITY OF TIGARb • BUILDING DIVISION • PERMIT # MS 200 1 9 ,_ . .._ 1� f 00 6w 13125' SW Hall BIvd. :Tigard, OR 972231 DATE ISSUED: 2.00/20013 - Phone: (503) 639 -41.71 ,nroimyp Bltl�l� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/8/2008 TIME:. 700AM PAGE: . . 1.6 SITE ADDRESS: 12976 MA/ HILLSIDE TERR CLASS. OF WORK:. SUBDIVISION: HILLSIDE ESTATES' LOT #: 008 TYPE OF USE PROJECT NAME: ,HI LLSIDE ESTATE.; DESCRIPTION: New SF • 'OWNER: PHAM, HAI NOOC PHONE #: 503.614 -9275 CONTRACTOR: • ASCEND CONSTRI.JCTION, . _ . PHONE # 603.4134- 0601 Inspection' Request Scheduled For: Date: 7/8/200t3 . . Pour Time Code # Inspection Description Confirm # Contact # Message 610. Gas line 072323 -03 503-41 -0581 N Corrections /Comrnents /Jnstructions: ad' • • • • • • . PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL PI CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: / ;O Date: 7- . 8 ---e11 Phone #:, (503) 718- 'S-- CITY OF TIGARD • BUILDING DIVISION. PERMIT #",: MST2007- 00169 13125 SW Hall Blvd.,. Tigard, OR _97223 DATE ISSUED: 2/20/2008' Phone: (503) 639 -4171 / Cmvantlot@fjl l ' Inspection Requests (24 Hrs.): (503) 639 -4175 ■NSPECTIONWORKSHEET FOR. - DATE: 7/8/2008 TIME: 7 :QOAM • PAGE: 17 SITE ADDRESS:, 12976 SW HI.LSIDETERR CLASS OF WORK: SUBDIVISIONS' HILLSIDE ESTATES . LOT #° 008 TYPE OF USE: �" - PROJECT'NAME' HILLSIDE ESTATES DESCRIPTION:. New SF - OWNER : : PHAM, HAI NOOC' PHONE #: 50'3-614-9275 CONTRACTOR ASCEND CONSTRUCTION PHONE #: 503 -4B4 -8581 Inspection Request Scheduled For: Date: 702008 Pour Time: Code # , Inspection Description Confirm # Contact # Message Glf-i Mechanical. rough -in 072323-02 03:-484 -858.1 N Corrections /Comments /Instruction: �'. ,Pa % Elm' .TJZ� Y'4L• r'✓� = 7!v LL t 4e — w'Y•l , t2- pL/a=C.S —41.r-S _ 40 no-5 • • n PASS I 1 .PARTIAL•APPROVAL . [ CANCEL n NO ACCESS IL I I CALL, FOR INSPECTION [ ADDITI NAL EE S; ASSESSED Inspector:' _ Date: g' 2 -$ Phone #: (503) 718 -. 4 } _ CITY OF ji PERMIT #: IvIST2007-00169 BUILDING DIVISION 11 "' 13125, SVV Hall Blvd., Tigard, OR 97223 DATE ISSUED: W2002009 • , Phone: (503) 639-4171 I.ASP111,i0 Inspectibn Requests (24 Hrs.): (503), 639-4175 --44141■:111. • INSPECTION WORKSHEET FOR PP,■TE: 6/24/2008 TIME: 7:03AIA PAGE: 19 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: • SUBDIVISION: HILLSIDE ESTATES • LOT #: 008 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: ,New SF •OWNER: PHAM, HAI NOOC PHONE #: 503.-6149275 • CONTRACTOR: ASCEND CONSTRUCTION • PHONE #: 503-484-8581 • Inspection Request Scheduled For • Date: 6/24/2008 Pour Time: • Code # Inspection Description' Confirm # •Contact# Message 615 Mechanical rough-in 071789-01 , .503484-8581 • orre tions/Comments/Instructions: • Aiw ' /14se " 4 1D ) 6"'"" Zc•-7-/zi efi ao4V.,‹ • ail 3 -•• - _ , vr L." „ Ade u • Nsvx - - At ' • - &CI 77(-- fl • • • PAS— PARTIAL APPROVAL 1] CANCEL n NO ACCESS AIL. CALL FOR INSPECTION • ADDITIONAL FEES ASSESSED Inspector: ' Date: Phone #: (503) 718- CITY OF TI AR BUILDING DIVISION PERMIT # MST2007 -00 69 13125 SW Hall Blvd., Tigard, OR .97223 DATE ISSUED: 2t2+'2t108 Phone: (503) 639 -4171 44,90l'I Inspection Requests (24: Hrs.)::(503)'.639- 4`175: INSPECTION WORKSHEET FOR DATE: 06/2008 ' TIME: 7:00AM PAGE: 14 SITE 'ADDRESS: 12976 SW HILLSIDE TERR. CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOTS #: 008 ' TYPE - OF USE: PROJECT NAME: I•IILLSIDE ESTATES . DESCRIPTION:- New SF OWNER: PHAM, HAI NOM • PHONE #: '503 -614 -9275 CONTRACTOR: ASCEND, CONSTRUCTION PHONE #: 503- Inspection Request Scheduled For: Date: 4/16/2008 Pour Time: Code # Inspection Description Confirm # Contact 4. Me - ge 242 Interior :shear walls 068471-02 603A84-8581 Y Corrections %Comments /Instructions: • • • PASS n PARTIAL APPROVAL, ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION n.. ADDITIONAL FEES ASSESSED • Date: 9 ` / P hone #: (503) � '7` Inspector: • q/ (� / 718 � ,) CITY OF TIGARD up_ BUILDING DIVISIO.N PERMIT #: 10ST:2007-00169 131 SW Hall Blvd., Tigard, OR-97223 DATE1SSUED: 2120/2008 Phone: (503) 639-4171 hamitvO Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION'W9RKSHEET FOR DATE:, 4/16/2008 TIME:. 7:00AM PAGE: 15 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: 'SUBDIVISION: HILLSIDE ESTATES LOT #: 0013 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: New SF OWNER: PHAM, HAI NOOC PHONE #: 503-614-9275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503484-0581 Inspection Request Scheduled For: Date: 4/16/2008 Pour Time: Code .# 'Inspection -Descriptioh Confirm # Contact # Me ge 235 Shear walls/anchors 068471-01 '503484-8581. Cbrrections/Comments/Instructions: • • • • mi - K-ASS LI PARTIAL APPROVAL- 7 CANCEL NO ACCESS 1111 FAIL H CALL FOR, INSPECTION ADDITIONAL FEES ASSESSED Inspector: / Date: I la ( Phone #: (503) 718- . , . ., - i CITY OF TIGARD . ii Ili' • BUILDING DIVISION liFF • ,- PERMIT #: ,MST2007-00.169 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 2/2012008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 1 INSPECTION WORKSHEET FOR DATE: 479/2008 TIME: 7:OOAM PAGE: 3 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: , ,SUBDIVISION: HILLSIDE ESTATES LOT #: 000 TYPE OF USE: PROJECT NAME .filitSI DE , ESTATES . ' • DESCRIPTION: Nev,‘ SF . . OWNER: MAK, FiAl 6100C PHONE #: 603-614-92'75 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503-484-8681 Inspection Recfuest Scheduled For: Date: 479/2008 Pour Time: Code # Inspection Description Confirm # Contact # Mes z ....------ 242 Interior shear walls 068058-02 663-484-85t11 Y Corrections/Corm ents/Instruction : ... ''i . - - • DY-"- 9 ..,, __4,,..Q,,-, cc_esLiz._ -2:s-s) \r 5tvi . 1 55,A)a-___S ., • , .. . . • . . . . , . . . - - PA ._ . , , • Ft PAS PARTIAL,AF'PROVAL [E1 CANCEL E NO ACCESS FAIL — r7 CALL FOR INSPECTION , n ADDITIONAL FEES; ASSESSED t7(/1 I napector: ': - / /oe 2.4 2._ci Date: '6 Phone #: (503) 718- ' . _ CITY OF TIGARD ilb 111. BUILDING DIVISION 72.°P- MST2007-00169 13125S Hall Blvd., Tigard, OR 97223 i PERMIT 4t: ISSUED: 200/2000 • Phone: (503) 639-4171 _ . 1 40 41/ 1 0iiii , \ _..... InspectiOn Requests (24 Hrs.): (503) 639-4175 ,n,-,-VhIll": i lj..,' 1. INSPECTION WORKSHEET FOR ' DATE 4/8/2008 'ME: E: 7: 00AIVI PAGE: 2 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES ' LOT #: 008 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES • DESCRIPTION: New SF OWNER: PHAM, HAI NODC PHONE #: 503614-9276 CONTRACTOR: ASCEND ONSTRUCTI ON • PHONE #: 503-484-0581 Inspection Request Scheduled For: Date: 41812008 Pour Time: Code # Inspection Description Confirm # Contact # Mes- ...... 235 Shear walls/anchors 068051101 E,03-484850.1 Y - Correction ..mrnents/Instryctions: , / 4 . 4 !Old i A 40. - A - iii 1 I II I k yy) 1 ,_,Q _ - . CE/I/1 - , Z - a(i a ( 01.-e4 i / - - 1 --)--,(. , ) ft . . .---e■C j)e.AZ) , 1 7 1- b1S -la- i---(77,<..„,„‘____et_ft_ e c.._.e....r. . . ,....7. . . _ , ,„ i f d Ad/ ,y, , aims f r ..4....i_. 4 ' ; ' - - ----- -:" ' ° ' 1 _' _ L; ' vt, c........r of `4.-,-/ ' .-........ " V .-•-•"•-•' ----(2/KC ' .4 5 41 ei`f 64-,1N, r ,..,,e - • 1111 1,/iazre.,/ 16 - (54(2.1AA 3 . (rz I 1,--ep-D--(2_ /..' y v - (.1---Wa- - — CA.\_et-D / ‹___. Tfi , ' _ cz"e___ _ evi cA. (.4t - . 171CAS `, PARTIAL APPROVAL 0 CANCEL NO ACCESS • 1 1 FAIL n CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED • .k ------ inspector:: Z... (I C Date: - Phone #: (503) 718- ' • • CITY OF TIGARD 0 , BUILDING DIVISION 'PERMIT #: 1VIST2007 -00168 13t 5 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .2/7 Phone:. (503) 639-4171' :: L » 11 J11 Inspection Requests (24• Hrs.):, (503) 639 -4175 ' INSPECTION WORKSHEET FOR DATE: 4/7/2008 , TIME: 7:01AM - PAGE: 4 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISIONS HILLSIDE ESTATES LOT #: 008 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES • DESCRIPTION: New SF OWNER: PHAM, HAI NOOC-' PHONE #: 503 -614 -9275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503484858 "i Inspection' Request. Scheduled For: Date: 4/7/2008 Pour Time: . , Code # Inspection Description Confirm # Contact # Message. . 240 Exterior sheathing 067993 -01 503.484 -8581' N s /Comm nts /In tractions; orrection `� i . 1. --� � < 1 cal S ,, (.7-, C., --)=,:i . ,. ,...e.,_,,,,,k Q___I-A.,49 u...,,C,...sLic vv,_,,, . P • VIA-,' ; N,v -- evL,__ t . , • S 0 PARTIAL APPROVAL 0 CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION El ADDITIONAL FEES' ASSESSED J ,� Lr Inspector: Date: (1 /6,,r., Phone #: (503) 718; - • CITY OF TIG'AR,D BUILDING DIVISION .\ DATE PERMIT #: �MST2'007 -O °I69 13125 SW Nall Blvd,, Tigard, OR 97223 '' g �, E' ISSUED: 2/201 2008 Phone: (503)' .639 -41.71 ii�� Inspection Requests (24. Hrs..): (503) 639 -4175 NO V�f I INSPECTION WORKSHEET. FOR DATE 41712008 TIME: 7:01AM PAGE: 3 SITE ADDRESS: 125 TERR, CLASS OF WORK: SUBDIVISION: —HILLSIDE ESTATES LOT #: 001.3 TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES " DESCRIPTION: New SF OWNER: PRANI, HAI NOOC PHONE # . 03 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 504.4B4-B501 Inspection Request Scheduled For: Date :, 4/7/20X3 Pour Time : .. • Code: # Inspection Description Confirm # Contact, # Message 250 Roof nailing 067993 -02 603 -484- 8513.1• N Corrections /Comments / Instructions: • • PASS. n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ±: FAIL n .CALL FOR INSPECTION ' n ADDITIONAL FEES ASSESSED 6: e Inspector: Date: "[/ / Phone #: (503) 718-'x' l • CITY OF TIGARD BUILDING ,DIVISION PERMIT it: MST 007 -00369 1,3125 " SW Hall. Blvd., Tigard, OR . 97223, DATE ISSUED:. 2/20/20013 Phone: (503) 639 - 4171 • Inspection Requests (24 Hrs.): (503) 6394175' INSPECTION WORKSHEET FOR DATE:. 3/14/2008 TIME:, 7:00AM PAGE: 52 SITE' ADDRESS: 1297€ S"W HILLSIDE TERR CLASS OFWORK:. • SUBDIVISION: HILLSIDE ESTATES LOT #: 008 • • TYPE OF USE :' PROJECT NAME` HILLSIDE. ES PATES: . DESCRIPTION: New SF OWNER :. PHAM, HAI'NOOC PHONE #: 503 - 6149275 CONTRACTOR:. ASCEND CONSTRUCTION PHONE #: 603 - 484-0581 Inspection Request. Scheduled For: Date: 3/14/2008 Pour Time: Code'# Inspection Description # Contact. #` . Mess: - 225 Post/beam structural 06668701: 503.4048501 Corrections /Comments /instructions: - • 70-o)--) 7 7 / S C" G2J4 • • PASS :PARTIAL APPROVAL /0 CANCEL l NO ACCESS FAIL CALL FOR INSPECTION . ❑ ,ADDITIONAL, FEES ASSESSED Inspector. t Date Phone #: (503) 718- " 1 ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00169 - 13125 SW Hall Blvd., Tigard, OR 97223 , /' DATE ISSUED: 2/49068 ' Pho '(503) °639 -4171 44 4'ildilit 1. Inspection Requests (24 Hrs.):. (503) 639 -4175 r , INSPECTION WORKSHEET FOR DATE: . 3/7/20013. 1 E. 7 :00AM PAGE: 23 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORKS. SUBDIVISION: HILLSIDE ESTATES LOT #: 008 TYPE OF USE: . PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: New SF OWNER: PHAM1, HAI NOOC PHONE #: 503 -614- 9275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 503.484- 8611, -1 Ins pection Request Scheduled For,: -Bate: 3/7/2008 Po u r Ti : A Time: W Code # Inspection Description / Confirm # Contact # Mes : - jet 2 1 5 Post/beam structural 0662 '1 503.48 4 -858'1 Corrections /Comments /instructions: - .106'7" l'•••-d '. C . q-42..iz -- ' 1 V2 • ?6-s--------,___„--& ~--7 4\-- d_Q___-6\ , c &§ , n PASS f1ARTIAL APPROVAL ❑CANCEL .❑ NO ACCESS • FAIL ❑ CALL FOR INSPECTION ❑ .ADDITIONAL FEES ASSESSED Inspector: Date: / Phone #: (503) 718 - / CITY OF TI;G-ARD BUILDING DIVISION PERMIT #: MST1007 -O0 G9 13125' SW Hall Blvd, Tigard, OR 97223' ' DATE -ISSUED: 2{20,1200 �nm, "i ne: (503) 639 =4171 s liviiiiiII Inspection Requests: (24 Hrs.): (503) 639 - 4175. ' ,4 : INSPECTION WORKSHEET FOR .,DATE:, 3/5/ 2008 - TIME:: 7:004 /1 PAGE: 13 SITE ADDRESS: 12976 SW'HILL IDE tERR CLASS OF WORK: SUBDIVISION: - H1LLSIDE,ES11jTES • LOT #: LI00. TYPE OF USE: PROJECT NAME: HILLSIDE E. 'TAT.ES ' • DESCRIPTION: New 4:;'F ' OWNER: PHAM, HAI . PHONE #: 503. 6140275 CONTRACTOR: ASCEND CQt 1STRUCTi. "_ s. PHONE #: 504513t • Inspection- Request Scheduled For :. Date` ' 3/5/2001 PourTime: Code # Inspection Description Confirm # Contact # Message 2'66 :M,r pronging ha sern&a Walls 06613&.01 ' 50374848581 Y Corrections %Coninerits/ Instructions: 6 ;0 4...e i C 3- f e.. - - 57 1 - ,..e. . le 1 T. / (. Q CA le le e'i -- - -- - 1 0,- • 1 2 . , "' - . . I • • PASS PARTIAL APPR OVAL ❑ CANCEL , ❑ NO ACCESS vi/ I I FAIL CALL FOR .INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: Date: -3� Phone #.;. (503). 718- Z4" ■�, F TI�GARD' CITY _ • � , - _ BUILD'N:G DIVISION PERMIT # : 1MMST2007 -00169 13125: SW Hall Blvd. Tigard OR 97223 ,-) , TE I . D / 21 . 0 /2 0 08 Phone: (503) 639-4171 a /41011I / Inspection !Requests (24 Hrs.):, 503 639 -4175 . 1 ' INSPECTION WORKSHEET FOR DATE.;. 2d�. E>;a*2t�t.8 • TIME: 7:O0AM it PAGE: 18 SITE ADDRESS: 12976 SW°H(LLSIDE TERM . CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 008 TYPE OF USE: PROIECT NAME: HILLSIDE ESTATES' DESCRIPTION: New SF OWNER: PHAMM, HAI NOOC PHONE #: 503611 - 9275 CONTRACTOR: ASCEND CONSTRUCTION PHONE #: 50346$8581 Inspection Request Scheduled For: Date: 2126/2008 Pour Tim: 10 :00 Code # Inspection Description Confirm # Contact # Message 205 Footing 066652 -01 503,484-'8501 N . Corrections /Comments /Instructions: l.0 g VOC<L, 7 r a i PASS • ❑ PARTIAL APPROVAL U CANCEL : ❑ NO ACCESS [� FAIL n CALL, FOR INSPECTION LI ADDITIONAL FEES ASSESSED Inspector: r .V Date: / Phone #: 503 " �(503) 718- . • D. M. THOM SO , INC. 1080 SW Westwood Drive Engineer /Construction Management Portland, Oregon 97239 (503) 293-3811 February 22, 2008 Tuan Tran 16142 SW Pollard Lane Tigard, OR 97224 Re: New residence by Tuan Tran -- SW 133` & Walnut in Tigard, OR — Subject: Inspection of foundation bearing surfaces Dear Mr. Tran: On February 21, 2008, we visited your construction site in order to test and visually examine the bearing surfaces that were prepared to receive the proposed building foundations. When we arrived at the property, foundation forms were beginning to be placed on the perimeter of the home and indicated that the foundation would be constructed monolithically with a single, footing & wall pour. Our exploration was performed using a' /z steel rod and hand shovel. The rod was used to probe the soil in the footing areas to locate soft and yielding sub -grade and the shovel was used to identify the cause of the soft conditions. The assumption in this method is that stronger soils will resist penetration by the rod and will reflect the acceptability for supporting the building. We began on the right side of the excavation and continued, counter - clockwise, around the perimeter and finished with the interior footing lines. We marked the soft areas with orange paint and indicated the approximate depths of removal at the various locations. In general, we found soft soil along most of the rear wall, at footing steps on the left side, at the center of the front wall, at the step -down on the rear end of the center, interior footing and at the entire length of the right -to -left interior footing on the right side of the house. While we were present on the site, the concrete contractor had four workmen removing-the soft areas and had performed this work on the rear and left perimeter walls. With the corrections that we marked and within the limited depth of our examination, the bearing surfaces that were prepared can reasonably be deemed adequate to support design capacities of 1500 PSF. Very truly yours: ND PRO 0 0 i fip ill ik/ m lay Duane M. Thompson, PE G kloilkc' ct O regon # 6211 THO r CITY OF TIGARD 10 BUILDING DIVISION PERMIT #: MST2007- 00169 13125 SW Hall; Blvd., Tigard, OR 97223 BATE ISSUED: '2720f2008 Phone: (503) 639-4171 "Alt - Inspection Requests (24 Hrs.): (503):639 -4175 < ' INSPECTION'INORKSHEET FOR DATE: 2/2612008 TIM ' ": t AM PAGE: 17 SITE ADDRESS: 12976 SW HILLSIDE TERR CLASS OF WORK: SUBDIVISION: HILLSIDE ESTATES LOT #: 00B TYPE OF USE: PROJECT NAME: HILLSIDE ESTATES DESCRIPTION: New SF OWNER: PHAIVI, HAI NOOC PHONE #: 503-614:9275 CONTRACTOR: ASCEND 'CONSTRUCTION PHONE #: 503- 618'1 -85B 1 Inspection Request Scheduled. For: Date: 2/2612000 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 06555102 503.4841 -8581 N Corrections /Comments /Instructions: ?. a 4X V2--. Viz 2 ‘ 0 3 , (11Q S CIL,A__a_c__,res ). Wva „...,,j 7 ,_,,.._,._. t.- \17-,0„,c, v.,3 ------ C . .._e_.. --- c- - ,-,--,--: c__ vle__ c ',..,.._9--,- --k-A) LC. A.A.:-, 67 ---T" . -- C-- . 9-1 (- \3 1' I 4)7A C A - , '2,4 \ *. V CD Rt/N/ 06 ) AI:, . . _ ,_ . „ . , .. . . . , PASS ,. n PARTIAL APPROVAL 7 CANCEL n NO ACCESS FAIL I CALL FOR INSPECTION ❑' ADDITIONAL FEES ASSESSED Inspector: /�ZJ"' Date: / ( a ' J P hone #: (503) 718' Z Y LI t City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 UI • TIGARD July 2, 2008 Ascend Construction 16142 SW Pollard Ln. Tigard, OR 97224 Re: Permit No. MST2007 -00169 Dear Sir /Ms.: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 12976 SW Hillside Ter Project Name: Hillside Estates Job No.: N/A Refund: ® Check #58044 in the amount of $240.00. ❑ Credit card "return" receipt in the amount of $ ❑ Trust account "deposit" receipt in the amount of $ Notes: Refund for overpayment of TIF -R fees due to calculation error. If you have any questions please contact me at 503.718.2430. Sincerely, •6 Dianna Howse Building Division Services Coordinator Enc. I: \ Building\ Refunds\ Administration \LtrRefund- overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 I • a : City of Tigard T[GARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Ascend Construction INC DATE: 6/12/08 16142 SW Pollard Ln Tigard, OR 97224 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 2007 -0540 Case #: MST2007 -00169 Date: 2/20/08 Address /Parcel: 12976 SW Hillside Terr Pay Method: Check Project Name: Hillside Estates EXPLANATION: Refund overpayment of TIF -R fees REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: [BUILD] Permit Fee Example: 245 - 0000 - 432000 $ Amount [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 TOTAL REFUND: $240.00 APPROVALS: If under $500 Professional Staff �j n If under $7,500 Division Manager If under $22,500 Department Manager ,/ If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY ,� Case Refund Processed: I Date: I 6/40, By: I ��Cilr I: \Building \Refunds \RefundRequest.doc 05/23/07 .. . , � CITY O.F TIGARD 6/11/2008 13125 SW Hall Blvd. 12:39: 1 I PM Tigard, OR 97223 503.639.4171 • TIGARD Receipt #: 27200800000000000540 Date: 02 /20/2008 Line Items: Case No Trail Code Description Revenue Account No Amount Paid MST2007 -00169 [CDCPLN] CDC Pln Rev 100 - 0000 - 433060 46.00 . MST2007 -00169 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST2007 -00169 [BUPPLN] Phi Rv Balance 245- 0000 - 433000 151.33 MST2007 -00169 [BUILD] Bldg Permit 2 45 -0000- 432000 2 ,253.32 MST2007-00 I 69 [TAX] Build 8% State Surchrg 100- 0000 - 207020 180.27 MST2007 -00169 [METCET] Metro Const Excise Tx 245- 0000 - 229202 532.26 MST2007 -00169 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST2007 -00169 [TAX] PLM 8% State Surcharge 100- 0000 - 207020 31.92 MST2007 -00169 [ELPRMT] ELC Permit 220 -0000 - 431510 412.35 MST2007 -00169 [TAX] ELC 8% State Surcharge 100- 0000- 207020 32.99 MST2007 -00169 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST2007 -00169 [TAX] ELR 8% State Surcharge 100- 0000 - 207020 6.00 MST2007 -00169 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2007 -00169 [TIF -R] TIF Resident 210- 0000 - 448001 3,200.00 MST2007 -00169 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 240.00 MST2007 -00169 [ERPRMT] Erosion Control 100- 0000 - 207307 136.00 MST2007 -00169 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 44.20 MST2007 -00169 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 44.20 MST2007 -00169 [MECH] MEC Permit 245- 0000 - 431010 123.30 MST2007 -00169 [TAX] MEC 8% State Surcharge 100- 0000 - 207020 9.86 Line Item "total: $12,736.00 Payments: Method Paver User ID Acct. /Check No. • Approval No. flow Received Amount Paid Check ASCEND CONSTRUCTION INC DEB 1304 In Person 12,736.00 Payment Total: $12,736.00 cReceipl.rpl Page 1 oil