Permit CITY OF TIGARD PERMIT #. MST2006 -00081
MASTER PERMIT
4 adj, DEVELOPMENT SERVICES DATE ISSUED 6/21/2006
Ip— 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL" 2S103BD - 11500
SITE ADDRESS- 11716 SW ERROL ST ZONING: R -4 5
SUBDIVISION CAPPOEN ESTATES LOT. 006 JURISDICTION TIG
Project Description New SF
BUILDING
REISSUE STORIES 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK NEW HEIGHT 26 FIRST 1216 st BASEMENT sf LEFT 5 SMOKE DETECTORS Y
TYPE OF USE SF FLOOR LOAD 50 SECOND 1 390 sf GARAGE 552 sf FRONT 20 PARKING SPACES
TYPE OF CONST 5N DWELLING UNITS I THIRD at RIGHT 5
VALUE 25503900
OCCUPANCY GRP R3 BORM 4 BATH 3 TOTAL 2606 st 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 4 CATCH BASINS
TUB /SHOWERS 3 GARBAGE OISP I WATER HEATERS I WATER LINES 100 BCKFLW PREVNTR GREASE TRAPS
OTHER FIXTURES
MECHANICAL
FUEL TYPES FURN 4100K BOIL/CMP < 3HP l VENT FANS 5 CLOTHES DRYER 1
NAT FURN >=100K 1 UNIT HEATERS HOODS 1 OTHER UNITS 2
MAX INP Mu FLOOR FURNANCES VENTS WOODSTOVES GAS OUTLETS 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD L INSPECTIONS
1000 Sr OR LESS 1 0 - 200 amp 0 • 200 amp W /SVC OR FOR PUMP /IRRIGATION PER INSPECTION
EA ADD L 500SF 5 201 - 400 amp 201 - 400 amp 1st W/O SVC /FOR SIGN /OUT LIN LT PER HOUR
LIMITED ENERGY 401 - 600 amp 401 • 600 amp EA ADDL BR CIR SIGNAL/PANEL IN PLANT
MANU HM /SVC /FDR 601 • 1000 amp 601+empa 1000v MINOR LABEL
1000+ amp/volt
PLAN REVIEW SECTION
Reconnect only
> =4 RES UNITS SVC /FDR> -225 A > 600 V NOMINAL CLS ARENSPC 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 0TH BOILER HVAC LANDSCAPE/IRRIG PROTECTIVE SIGNL
GARAGE OPENER CLOCK INSTRUMENTATION MEDICAL OTHR
HVAC DATA/TELE COMM NURSE CALLS TOTAL # SYSTEMS
This permit Is subject to the regulations contained In the Tigard
Owner Contractor Municipal Code, State of OR Specialty Codes and all other
FOUR D CONSTRUCTION CO FOUR D CONSTRUCTION applicable laws All work will be done in accordance with approved
PO BOX 1577 PO BOX 1577 plans This permit will expire if work is not started within 180 days
BEAVERTON, OR 97075 BEAVERTON, OR 97075 of issuance, or 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
Phone Contact # PRI 503 - 590 - 0805 of these rules or direct questions to OUNC by calling 503 -246 -6699
FAX 503 - 1751 on -800- 332 -2344
Reg # LIC 71037
TOTAL FEES $ 10,279.97
REQUIRED ITEMS AND REPORTS
Issued By G a , Permittee Signature
Call 503 - 639 -4175 by 7.00 a m for an inspection that business 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.
_ - 3 - ti L 4 / 0 5 -
B Permit APnf &jE V EL FOR OFFICE USE ONLY•
City of Tigard Received / 471 —6
13125 SW Hall Blvd , Tigard, OR 97223 A pp n q Plan Review / � , f / ±,
Phone 503 639 4171 Fax 503 598 1960 ryf l\ 14 LOO'� / '46 <r l� , Date/B ,S'21 ' i 5 a alien Permit s il l 1 , i j t r
Inspection Line 503 639 4175 _ ' . • �, Date Ready/By f tuns ® See Attached Checklist for
Internet www al ngard or us ell Uk. �LuFa Notified/Method,_) 25 yClilt r) Supplemental Information
���'(� rT TC: rMFITSTON 1 V-.17 V-.17 .3
''j 5 J
—'AVIJOF WORK REQU EDDATA: I- AND 2- FAMILY DWELLING
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
a l I- and 2 -family dwelling ❑ Commercial /industrial Valuation $ Z, (f,Sj V ,3 8
❑ Accessory building 0 Multi-family Number of bedrooms , /
LA Master builder ❑ Other Number of bathrooms ![ --
JOB SITE INFORMATION AND LOCATION Total number of floors "1 O
Job site address 1 17/4 a 4.,j R NC � .. Z. New dwelling area ,26 O b square feet
City /State /ZIP '773 p R i l ?4,,c_ . 9722 Garage /carport area 2. square feet
Suite/bldg /apt no Project name Covered porch area _E 13 square feet
Cross street /directions to job site //4 7:, 'L- //0/9-244...-7 Deck area -- square feet
Other structure area — square feel
' REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision 61.910 N TS/�7T -e of Lot no 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
24- 1-161 4 ,14 Valuation $
/� Le
Existing building area . square feet
New budding area square feet
PROPERTY OWNER ❑ TENANT Number of stories -
Name cc ,c `)) ( 74 ,Clti a A) as— Type of construction ��
Address ' ?Qe Z sy Ls -7 7 Occupancy groups
City /State /ZIP 4. 07, 97 0 -75- Existing
(
Phone 03) S2 S O- ocPC Fax (5-I] d s S/0 -/ 7S( New
APPLICANT ❑ CONTACT PERSON NOTICE
Business name 4-91-9-[ ,, Aid h i. 4 a U,,,--/ All contractors and subcontractors are required to be
Contact name licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address jurisdiction in which work is being performed If the
City/State/ZIP applicant is exempt from licensing, the following reasons
apply
Phone ( ) Fax ( )
E -mail
CONTRACTOR
Business name S - Ji.-c� � 4 h 00— BUILDING PERMIT FEES*
Address Please refer so fee schedule.
City/State/ZIP
Fees due upon application (7,2 r® dry
Phone ( ) Fax ( ) 9
Amount received dZC-1 O
CCB he 7/ 0 7 V -"d /,/
Date received V
Authorized signature ���� /% /_ / - This permit application expires if a permit is not obtained
L1l��G / ✓/y within 180 days after It has been accepted as complete.
Print name (,�J�4?,4 /. /mile -, Date „Z-AS---6 . / • Fee methodology set by Tn- County Building Industry
Service Board
11Bui Idmg \Permus\BiJP- 31- PenniApp doc 12/03 940- 4613T(11 /02/COMRWEB)
r
Building Division
Plan Submittal Requirement Matrix
Commercial & Multi- Family - New, Additions or Alterations
Co of regard
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building I*
Fire Protection System 3 **
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
\BmldingW.mitLs\BUPgi- PamnApp doc I2/01 440- 4611T(11 /O2JCOM/WFB)
Building Fixtures
Plumbing Permit Appli'
ca�tinn & � FOR OFFICE USE ONLY
City of Tigard u u Received Pe Permit No
13125 SW Hall Blvd, Tigard, OR 97223 Date/By
Plan Review
Phone 503 639 4171 Fax 503 598 1960 APR 1 4 2 .."?', j�ittYllitq Dye Other Permit No
24 -Hour Inspection Line 503 6394175 JJ{• ' Date Ready/By runs E1 See Page2 for
Intel net www ci tigard or us d ' IT V OF f1 � 1 Notified/Method Supplemental Information
TY K FEE* SCHEDULE
I i t cv
New construction ❑ Demolition For spend information use checklist.
Description I Q I Ea I Total
❑ Addition /alteration /replacement ❑ Other New 1 -2 -family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 24920
0 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi -family SFR (3) bath 399 00
Master builder Each additional bath/kitchen 45 00
❑ Other
Fire sprinkler ( sq ft ) Page 2
JOB SITE INFORMATION AND LOCATION
Site utilities
Job site address 1/ 7A S /N• c_..,1,/ 0/ Sr Catch basin or area drain 16 60
City /State /ZIP /7,#)2./ d t 2 3 Drywell, leach line, or trench drain 16 60
Suite/bldg /apt no �Pro)ect name Footing drain (no linear ft ) Page 2
Cross street /directions to Job site Manufactured home utilities 110 00
Manholes 16 60
Ram drain connector 16 60
Sanitary sewer (no linear ft ) Page 2
Storm sewer (no linear ft ) Page 2
Subdivision (''� /, 0. -.rye -5 I Lot no C, Water service (no linear ft ) Page 2
Fixture or item
Tax map /parcel no
Absorption valve 16 60
DESCRIPTION OF WORK Back flow preventer Page 2
Backwater valve 16 60
Clothes washer 16 60
Dishwasher 16 60
jgi PROPERTY OWNER I ❑ TENANT Drinking fountain 16 60
� (ft-
Ejectors/sump 16 60
r
Name LA /t. , ai y S72 erne A) Expansion tank 1660
Address Q 2,ry / L�� ] Fixture /sewer cap 16 60
City /State/ZIP,�j� _ / [J� r � . D / X- Floor drain/floor sink/hub 1660
Phone 5 3 ) _9O —0C ( � OV Fax (S 57O—/757 Garbage disposal 16 60
IX APPLICANT ❑ CONTACT PERSON Hose bib 1660
A / Ice maker 16 60
Business name J t L E _ / / 6 0 Q ' Interceptor /grease trap 16 60
Contact name Medical gas (value $ ) Page 2
Address Primer 16 60
City/State/ZIP' Roof drain (commercial) 1660
Phone ( ) I Fax ( ) Sink /basin/lavatory 1660
Tub /shower /shower pan 16 60
E -mad
Urinal 16 60
CONTRACTOR Water closet 16 60
Business name r • 7 ��6h+z ,4/k9 Water heater 16 60
Address ,/ ...S /_"' l -C Au -2--, Other
City /State /ZIP // /I £.S 6 a ,2, n 1 72 3 Subtotal
// J Minimum permit fee $72 50
Phone �oJ) �d -.3l Fax ( ) Residential back flow minimum permit fee $3625
CCB Lic / 2 2 7 3 / Plumbing Lic no 44--47(../p4 Plan review (25% of permit fee)
Authorized signature / 9-t / e �J- State surcharge (8% of permit fee)
°-vcss� . Gs, TOTAL PERMIT FEE
Print name O ' t .1k'e. (�, -- Date S "I.5.7--c), This permit application expires if a permit is not obtained within
ISO days after it has been accepted as complete.
*Fee methodology set by Tn -County Building Industry Service Boar
1 \Buiidmg\Penmu\PLMF- PenmiApp doe 06/05 4404616T( IO/OLCOMRVEB)
•
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 - I" 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' 4640
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 Backfow Prevention Device each additional $100 00 or fraction thereof, to
(minimum peanut 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: each 00 and up $742 00 for the e fi first rst $50,000 00 and $1 20 for
each additional $100 00 or fraction thereof
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity_by (Fixture) Work Performed
❑ Any new commercial building.
Fixture Type:
armed ❑ Any new exterior plumbing site utilities
Previous Capped Added Existing ❑ A commercial building with installation. alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor /Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ My new residential building containing three (3) or more
- Domestic dwelling units
Drinking Fountain ❑ My NFPA I3 -D multipurpose fire spnnkler system.
Eye Wash
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
-3"
-4
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach /Re &ig Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water or increase of sewer EDUs, a sewer permit will be issued and
Closet rode
Closet - rod p
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures plumbing permit can be issued.
1 \umldina \Pem,ns\pLM PemwApp doe 07/06/05
Electrical Permit Applicatidc NE FOR OFFICE/USE ONLY' r
Received
City of Tigar Date/0 Pem,d No
13125 SW Hall Blvd, Tigard, OR 97223
1 4 , 1 2Q0 Plan Review
Phone 503 639 4171 Fax 503 598 1960 pPR M.�0Wili Date/13 Other Permit
Inspection Line 503 639 4175 J i b V .• • Date Ready/By tuns EJ See Page 2 for
Internet www ci tigard or us t t' S (y tf 11 *riTni Nonfied/Method Supplemental Information
TYPE b WQMR Intl 61 t--f ‘ ' - PLAN REVIEW
Lyi New construction ❑ Agin n /aa1 e at ration/replacement Please check all that apply
❑ Demolition ❑Other ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps – rating ❑ Buildng over 10,000 sq R,
CATEGORY OF CONSTRUCTION of I- and 2 -family dwellings 4 or more new residential
I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family W Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park
Job no : Job site address- / r /7 ❑Health -care facility ❑Other
/7/ �') � r` �L� S-7- Submit 2 sets of plans with any of the above
City /State/ZIP''77 ✓ G / 0 972.7=3 The above are not applicable to temporary construction service
Suite/bldgiapt. no. Project name FEE• SCHEDULE .
Description I Qty I Fee. I Total
Cross street/directions to job site: New residential single - or multi-family dwelling unit.
Includes attached garage.
1,000 sq R or less 145 15 4
Subdivision- ,Afint Lot no.: Ea add'I 500 sq ft or portion 33 40 1
�F-Y / Limited energy, residential 75 00 2
Tax map /parcel no
Limited energy, non- residential 75 00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90 90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
201 amps to 400 amps 106 85 2
4°d PROPERTY OWNER ❑ TENANT
�t)u / n 401 amps to 600 amps 160 60 2
Name:
.--
l S7/2 c c GTIC [_'sue 601 amps to 1,000 amps 240 60 2
Address' (D 207 /S '7 Over 1,000 amps or volts 45465 2
/ / Reconnect only 66 85 2
City / State/ZIP' lfO_Ay er-J.,`! ,, 97 a 7J Temporary services or feeders installation, alteration, and /or
Phone j 3j) SSo — s od I Fax:SD3 ) Cfc\ -17J_ relocat am
200 amps or less 66 85 I
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 600 amps 133 75 2
Owner signature: Date- Branch circuits – new, alteration, or extension, per panel
1APPLTCANT ❑ CONTACT PERSON A Fee for branch circuits with
� � / service or feeder fee, each 6 65 2
Business name: S?r/ � h 0 a - e_ branch circuit
Contact name B Fee for branch circuits
without service or feeder fee,
46 85 2
Address• each branch circuit
Each add'I branch circuit 6 65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) - Fax : ( ) Pump or irrigation circle 53 40 2
Sign or outline lighting 53 40 2
E -mail Signal circuitis) or limited -
CONTRACTOR energy panel, alteration, or
` � � C extension Describe Paget 2
name [�
Business nam
Address- 7_S7 S. wJ 42 i/--2-, Each additional inspection over allowable in any of the above
Per inspection 62 50
City / State/ZIP C j ,TG ,( / 6 X_ 2 z 22 / Investigation per hour (1 hr mm) 62 50
Phone (52t ) V�_ 77 Ls rc i ." Fax ( ) Industrial plant per hour 73 75
Y" p � / ELECTRICAL PERMIT FEES*
CCB Lic.: 93�p Electncal Lic. 3/Y) _2_2 C Suprv. Lic.: 3 b C Subtotal
i! -
Supry Electncian signature, required. 0 - _ /271 (4� Plan review (25% of permit fee)
i ��� -L ^ n State surcharge (8 % of permit fee)
Print name. Na 4 .� 4T /t4, 0 tihti Date 3 /- OA
/'� / TOTAL PERMIT FEE.
Authorized signature: �j� `/ / This permit application expires a permit is not obtained within within ISO
� �G�111111 days after it b has been accepted as complete
Print name.�4l� r J}�il �� Date 3 2� p-..c • Fee methodology set by Tn -County Building Industry Service Board
C� /� •• Number of inspections per peon' allowed
i \ Building \Penmu\ELC.Perm,tApp doe 12/03 440- 015T1I t/0LCOM/WEB
Electrical Permit Application - City of Tigard •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
l RESIDENTIAL WORK ONLY
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Bur Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
El Vacuum Systems*
rl Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
n Boller Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\Bwld.ng\Perm,SELC -Perms pp doc 04/03
Mechanical PermPAQJ it ttion �� FOR OFFICE,US ,O_ ' ,
Received
City of Tigard 14 TO Date/By d
Receive Permit No
13125 SW Hall Blvd , Tigard, OR 97223 nP Plan Review
Phone 503 639 4171 Fax 503 598 1960° kw. o ,1 to Da/ Other Permit
Inspection Line 503 639 4175 ' `t. 1 E' Al. a I Datl Ready/By Ready /By Jvns ® See Paget for
Internet www CI tigard or us t `1 ,N y � . 1 N r1 Notified/Method Supplemental Information
` aft f)% V
'1 " TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CIIECKLIST
K ] 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
CATEGORY OF CONSTRUCTION Value $
I - and 2 -family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Multi -family p-Master builder ❑ Other: hor special information use checklist
Description Qty I Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address /7 '7 7
Air conditioning or heat pump
// / /� S. t2 &.... 2 -1 / (requires site plan showing placement) 1400
City /State /ZIP 771 / 2 /i U/_ 7 9 . - Furnace 100,000 BTU (ducts/vents) 14 00
Furnace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg /apt no Project name Gas heat pump 14 00
Cross street /directions to job site Duct work 14 00
Hydromc hot water system 14 00
Residential boiler (radiator or
hvdronic) 14 00
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc 10 00
/
Other 10 00
Subdivision ���(� ,�L Lat no yp Flue/vent for any of above
Other 10 00
Tax map /parcel no Other fuel appliances
DESCRIPTION OF WORK Water heater 1000
qj Gas fireplace 10 00
JS �(/ �rYlcA 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
r? PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 1000
(PROPERTY 10 00
Name D) �j �._,S7- £a r Environmental exhaust and ventilation
Address P c (' ' 2 /.....5-7 7 Range hood/other kitchen
equipment 10 00
City /State /ZIP EQ ---„.wi 9' '7 a d 7 Clothes dryer exhaust 10 00
q — / / 7.5-1 Single -duct exhaust (bathrooms,
Phone
(-.AZ) S 0 - O ?a Fax (SO. C 9v " / toilet compartments, utility rooms) 6 80
lg APPLICANT ❑ CONTACT PERSON Attic/crawlspacefans 1000
Business name fL, �� / Other 10 00
n """ �L v u Fuel piping
Contact name $5 40 for first four; $1.00 for each additional
Address Furnace, etc
Gas heat pump
City /State /ZIP Wall /suspended/unit heater
Phone ( ) Fax ( ) Water heater
Fireplace
E -mad
Range
CONTRACTOR Barbecue
Business name�f, nr_ /ZJ Clothes dryer (gas)
Y / , /1 c� Other
Address
a S. w ! , 0 e _,, 7. � , MECHANICAL PERMIT FEES*
City /State/ZIP '7'/ t/ JAI ' c7 7 2-2- Subtotal
Phone .(SL ?) t a _ 5C4, Fax ( ) Minimum permit fee ($72 )
/ k` / Plan review (25% of permit feeee)
CCB he C� S State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature s � / This permit application expires if a permit is not obtained within 180
� /r/ / days after it has been accepted as complete
( � /t
Print name D' l'7:-�'/el ! /C Y
Date 3 - -- 7-6 • Fee methodology set by To-County Building Industry Service Board
i \Budding/Pennits\ MCC-Perm iuApp doe 11/03 440-4617T(I I /01/COM/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
$135 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 $100,000 00 and
$1 10 for each additional $100 00 or
fraction thereof
Note: All new commercial buildings require 2 sets of plans.
i \Bmldmg\Permos\MEC- PermfApp doc 12/03 2
. CITY OF TIGARD
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
IMPORTANT PERMIT NOTICE
3S7 -
S.
Electrical Signature Form ��V X006
Permit #: rvl ��(6O 6 -O cc) c ' :.` A PO
Date ( Parcel: / O G� NGO \�
Site A dd res s: / l - 7 / ( s U/ -� t sO w
Block. Lot.
Jurisdiction.
Zoning
Remarks:
Your company has been indicated as the electrical contractor for the permit indicated above In order for the electrical
permit to be valid, the signature of the supervising electrician is required Please have the appropriate individual from
your company sign below and return this Electrical Signature Form prior to the start of the work to the address above,
ATTN Building Division
No electrical inspections will be authorized until this completed form is received
OWNER' join D £L aiteo,t, ELECTRICAL CONTRACTOR
Pd aoy IS 71 Q— E02-" '""' 911e 1 �p
,� (Z p7S So 7OS IV W a- -d" PA
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Phone #* Phone # 3793— 3s a3.5
Reg #.
33 ?/S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
nature of Supervising Electrician
If you have any questions, please call 503.718.2433.
Please return this form by mail, or you may fax it to 503.624.3681.
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STREET TREE CERTIFICATION `®
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CITY OF TIGA'RD ,
BUILDING DIVISION - ' PERMIT # MST2C36 -00091
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. 4 6/21/2006
Phone. (503) 639 - 4171 , 1 „IC
Inspection Requests (24 Hrs) (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 2/1/2007 TIME 7:01AM PAGE 71
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION. CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF. 1/9/07: Added NC unit.
OWNER PHONE #.
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For Date. 2/1 /2.007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 042797-02 503-720 -0012 Y
Corrections /Comments /Instructions:
Q PASS ❑ PARTIAL APPROVAL I I CANCEL NO ACCESS
I I FAIL (/ /((' CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: i % " Date: 7 —i o 7 Phone #: (503) 718- _ 1
A
CITY OF TIGARD ( , - • " .
BUILDING DIVISION PERMIT# MSr2006e0081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 612112006
Phone (503) 639- 4171I'II
Inspection Requests (24 Hrs ). (503) 639 -4175 , .._ ^
INSPECTION WORKSHEET FOR DATE 1/2512007 TIME 7 :03AM PAGE 15
SITE ADDRESS. 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF. 1/9107: Added NC unit.
OWNER PHONE #
CONTRACTOR. FOUR D CONSTRUCTION PHONE # 503.590 -0805
Inspection Request Scheduled For: Date 1/25/2007 Pour Time
Code # Inspection Description Confirm # Contact # Message
293 Final inspection 042519 -03 503- 720-0012 N
Corrections/Comments/Instructions:
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aIl�f � �. l � /�! I I PARTIAL APPROVAL ❑CANCEL n NO ACCESS
I�!l FAIL ❑ CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector GlflP Date: 4 ��o Phone # (503) 718- 7
CITY OF TIGARD i
• ' . . , ,,
. . •
BUILDING DIVISION PERMIT # MST2006.000B1
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6/21 /2006
Phone (503) 639 - 4171 , 1 A
Inspection Requests (24 Hrs) (503) 639 -4175 �Y- °'I J..
INSPECTION WORKSHEET FOR DATE 1/25/2007 TIME 7:03AM PAGE 16
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME. CAPPOEN ESTATES
DESCRIPTION' New SF. 119/07 Added NC unit.
OWNER PHONE #
CONTRACTOR. FOUR D CONSTRUCTION PHONE # 503- 590 -0805
Inspection Request Scheduled For: Date. 1/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 042519-02 503 - 720-0012 Y
Corrections /Comments /Instructions
p PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
• • IL 1 I CALL FOR INSPECTION i ( ADDITIONAL FEES ASSESSED
Inspector: [---4717 � Date: / /Z�/ Phone #: (503) 718- Z��j
CITY OF TIGARD r .
BUILDING DIVISION PERMIT # MST2006-00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone: (503) 639 -4171 t\
Inspection Requests (24 Hrs )• (503) 639 -4175 44- 1!.L
INSPECTION WORKSHEET FOR DATE. 1f412007 TIME 7:00AM PAGE 8
SITE ADDRESS* 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE#
CONTRACTOR FOUR D CONSTRUCTION PHONE #. 503.590_0BQ5
Inspection Request Scheduled For Date: 1/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 041811 -02 503-720-0012 Y
Corrections /Comments /Instructions
146t,Se— - R --v-tr IC c f
1 V d
Za..c
!'0 C s r2,A( k( r,—R_s .
/C!of"U .
il. Pt - n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I i FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: e--/-/--t Date I it °I? Phone #: (503) 718- 7. G dir-
CITY OF TIGARD
A A
BUILDING DIVISION PERMIT # MST2006,00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6121/2006
Phone (503) 639 -4171 'iI�
Inspection Requests (24 Hrs) (503) 639 -4175 s _
INSPECTION WORKSHEET FOR DATE. 10/6/2006 TIME 7 :03AM PAGE 19
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE #:
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For. Date: 10 /6/2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 037813-03 503-720.7445 N
Corrections /Comments/ Instructions -
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL l I I CALL / FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED /
Inspector: " ✓ —" D ate: t / Or Ph one #. (503) 718- � ✓
CITY OF TIGARD . ' - •
BUILDING DIVISION PERMIT #. MST2006.00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21/21706
Phone (503) 639 - 4171 1 1
Inspection Requests (24 Hrs) (503) 639 -4175 y ''fil'
INSPECTION WORKSHEET FOR DATE. 6/4/2006 TIME 7:04AM PAGE 20
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT #' 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION. New SF.
OWNER PHONE #
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503- 590 -060G
Inspection Request Scheduled For Date. 8/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
315 Posllbeam plumbing 034405-03 503-720-7445 N
Corrections/Comments/Instructions
PASS n PARTIAL APPROVAL CANCEL I I NO ACCESS
n FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 7 �/
Inspector. `�'` �/v V Date: r5 Phone # (503) 718 vV
CITY OF TIGARD . •
BUILDING DIVISION PERMIT # MST2006 -00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 6(21/2006
Phone (503) 639 -4171 Ill
Inspection Requests (24 Hrs) (503) 639 -4175 _ _..
INSPECTION WORKSHEET FOR DATE: 7/6/2006 TIME 7.03AM PAGE. 43
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK.
SUBDIVISION CAPPOEN ESTATES LOT #. 006 TYPE OF USE:
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION Now SF
OWNER PHONE #
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503 -590 -0805
Inspection Request Scheduled For: Date: 7/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
•
310 Crawl drain 032731 -01 503-969-4631 N
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL l NO ACCESS
FAIL �^ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / r �/ /^� L\ & Date ,/ a / Phone #• (503) 718-
■
. CITY OF TIGARD • A BUILDING DIVISION • PERMIT# MST?006 -00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6/21/2006
Phone (503) 639 - 4171 , 1 ,1 �
Inspection Requests (24 Hrs.): (503) 639 - 4175 „! — ^:_'_..
INSPECTION WORKSHEET FOR DATE 7/6/2006 TIME. 7:03AM PAGE 41
SITE ADDRESS: 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT #. 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER FOUR D CONSTRUCTION PHONE #• 503-590.0805
CONTRACTOR PHONE #
Inspection Request Scheduled For Date: 7/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 032731 -03 503-969 -4631 N
Corrections /Comments /Instructions:
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ 7 Date 2/ f Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST2006- 00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6121/2006
Phone (503) 639 -4171 ' XIt
Inspection Requests (24 Hrs.) (503) 639 -4175 s_
INSPECTION WORKSHEET FOR DATE 7/6/2006 TIME 7:03AM PAGE. 40
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK:
SUBDIVISION. CAPPOEN ESTATES LOT # 006 TYPE OF USE:
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION' New SF.
OWNER PHONE #.
CONTRACTOR' FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For: Date: 7/6/2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 032731 -04 503-969 -4631 N
Corrections /Comments /Instructions
SS I I PARTIAL APPROVAL ❑ CANCEL [ I NO ACCESS
77 FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector M,• NJ(/'
Date: • / Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST2006-00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6/21/2006
Phone (503) 639 - 4171 A �
Inspection Requests (24 Hrs) (503) 639 -4175 rWr 1 .,
INSPECTION WORKSHEET FOR DATE 7/6/2006 TIME. 7:03AM PAGE' 39
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT #. 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF
OWNER: PHONE #
FOUR D CONSTRUCTION 503. 590.0805
CONTRACTOR PHONE #
Inspection Request Scheduled For Date: 7/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitaiy sewer 032731 -05 503-969.4631 N
Corrections/Comments/Instructions
I XL PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector 9 fq6 i 4 Date: ./ Phone #: (503) 718 - �"r°r
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2006-00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED' 6/21/2006
Phone, (503) 639 -4171 I
Inspection Requests (24 Hrs.) (503) 639 -4175 h'ii.
INSPECTION WORKSHEET FOR DATE 1/25/2007 TIME 7:03AM PAGE 17
SITE ADDRESS. 11716 SW ERROL Si CLASS OF WORK
SUBDIVISION: CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME. CAPPOEN ESTATES
DESCRIPTION' New SF. 1/W07' Added NC unit.
OWNER PHONE #
CONTRACTOR' FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For Date: 1/2512007 Pour Time:
Code # Inspection Description Confirm # Contact # MMee
199 Electrical final 042519-01 503-720 -0012 / Y S'K
Corrections /Comments /Instructions. ��
Tr 1/ ` 7
r- - Se c o22 iJZ e 1- o.LS —
PASS PARTIAL APPROVAL CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: CY/P Date: C / Phone #: (503) 718- Zrcy7
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST2006.00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6/21/2006
Phone: (503) 639 -4171 maliAle
Inspection Requests (24 Hrs) (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 1/412007 TIME 7:00AM PAGE 7
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 4Q6 TYPE OF USE.
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE #
CONTRACTOR, FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For Date' 1/4/2007 Pour Time
Code # Inspection Description Confirm # Contact # Mess.. -
i
�
199 Electrical final 041811 -03 603- 720 -0012 Ste__(
Corrections/Comments/Instructions:
5-
/ - �.-- is fp i M-_-_71' M r i e THY S Tl ✓LI t �
,i .. N 1 . . _ - A r rltu
_ ei_t S =T JJ
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3 ci> - l ' vJ ilk _ 1 1 ?k? "7
LO L - C �i -4C 1 steak S' r -- 4 Z!
I I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED / /
Inspector c-itie Date / /y� 7 Phone #: (503) 718- Z6" 7y
CITY OF TIGARD .
BUILDING DIVISION PERMIT #• MST2006 -00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 6721/2006
Phone (503) 639 -4171 ��'',' ' � I �^
Inspection Requests (24 Hrs) (503) 639 -4175 " __..
INSPECTION WORKSHEET FOR DATE: 10/9/2006 TIME 7 :01AM PAGE 6
SITE ADDRESS. 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION- New SF.
OWNER PHONE#
CONTRACTOR FOUR D CONSTRUCTION PHONE #- 503. 590-0605
Inspection Request Scheduled For: Date: 10/W2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
135 Low voltage V 037874 -03 503-59(1.0805 N
Corrections/Comments/Instructions:
r
la 1 if '/ / a- id, ti 1 ,, 1
L l
A & s,>j,, /9 --)- gi
dui `j
PASS \PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
VO
Inspector lifitir Date. / q G 0 4 Phone # (503) 7182 V
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST200600081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone (503) 639 - 4171
Inspection Requests (24 Hrs ). (503) 639 -4175 N ,.
INSPECTION WORKSHEET FOR DATE 10/6/2006 TIME 7 : 03AM PAGE 21
SITE ADDRESS 11716 SWERROL ST CLASS OF WORK
SUBDIVISION. CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME. CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE #.
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503550 -0805
•
Inspection Request Scheduled For Date: 10/6/2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 037813-01 503-720.7445 N
Corrections /Comments /Instructions
1 •&i t 0 1,&-‘41
PASS I PARTIAL APPROVAL CANCEL ❑ NO ACCESS
I I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector t/" `r"� Date: ( Phone #' (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST2006 -00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. U21/2006
Phone. (503) 639 -4171 j. 1
Inspection Requests (24 Hrs) (503) 639 -4175 jai'
^'IL
INSPECTION WORKSHEET FOR DATE 10/6/2006 TIME 7:03AM PAGE 20
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT #. 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION• New SF.
OWNER PHONE#
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503-690 -0805
Inspection Request Scheduled For: Date 10/&2006 Pour Time 1
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 037813-02 503-720.7445 N
Corrections /Comments /Instructions:
I
I
r
A i PASS I I PARTIAL APPROVAL CANCEL NO ACCESS
FAIL n C L FOR INSPECTION I I ADDITIONAL F / E , S ASSESSED
Inspector: I Date: � l
(76/ FEES
Phone # (503) 718-
CITY OF TIGARD ' .
BUILDING DIVISION PERMIT# MST200600081
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED W21/
Phone (503) 639 -4171
Inspection Requests (24 Hrs.)• (503) 639 -4175 Jilt ..
INSPECTION WORKSHEET FOR DATE 10/19/2006 TIME 7:02AM PAGE 32
SITE ADDRESS: 11716 SW ERROL ST CLASS OF WORK.
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER. PHONE #
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503. 590.0805
Inspection Request Scheduled For Date. 10/19/2006 Pour Time.
Code # Inspection Description Confirm # Contact # Message
280 Insulation 038497 -02 503 - 720 -7445 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL I I CANCEL NO ACCESS
I I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,� Date 70 15 -06 Phone #: (503) 718- Zt`ti
CITY OF TIGARD . -
BUILDING DIVISION PERMIT # MST2006-00081
13125 SW Hall Blvd , Tigard, OR 97223 D ATE ISSUED. FJ2112006
Phone• (503) 639 -4171 tI
Inspection Requests (24 Hrs ): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 10/19/2006 TIME 7:02AM PAGE 34
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF
OWNER PHONE #
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For Date: 10/19/2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
242 Interior shear walls 038497 -01 503 - 720-7445 N
Corrections/Comments/Instructions:
. 1atec 57L .fz/ GLA.e -S �G�t, «• = �� �7s• r �,
I I PASS- I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector. Date: /d —19 — Phone # (503) 718- ?q
CITY OF TIGARD .
BUILDING DIVISION PERMIT #. MST200G -00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21 /2006
Phone (503) 639 -4171 k
Inspection Requests (24 Hrs ). (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 10/17/2006 TIME 7 :Q44M PAGE 74
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION' CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME. CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE #
CONTRACTOR FOUR D CONSTRUCTION PHONE #V 503-590-0805
Inspection Request Scheduled For: Date: 10/17 /2006 Pour Time.
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 038305 -02 503-720-0012 N
Corrections/Comments/Instructions:
PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS
— FAIL I I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector �� Date: /6 r- / 7 —do Phone #. (503) 718 - _.q'-q_'_
CITY OF TIGARD • A
BUILDING DIVISION PERMIT # MST200 6-0t308i
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21 /2006
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs) (503) 639 -4175 '__
INSPECTION WORKSHEET FOR DATE 1 011 7/200 6 TIME 7 :04AM PAGE 76
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK*
SUBDIVISION* CAPPOEN ESTATES LOT #• 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION. New SF.
OWNER PHONE #.
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503.5.10 -0805
Inspection Request Scheduled For: Date: 10/17/2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
275 Framing 038305-01 503-720-0012 N
Corrections /Comments /Instructions:
PASS I I PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
I I FAIL dk I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date a1 / 7--h- Phone # (503) 718- Z ----
CITY OF TIGARD • . `
BUILDING DIVISION PERMIT # MST2006•00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6/21/2006 '
Phone (503) 639 -4171 "Wilt
Inspection Requests (24 Hrs ): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 10/9/2006 TIME 7:01AM PAGE 8
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER
•
PHONE #.
CONTRACTOR FOUR D CONSTRUCTION PHONE #. 503.590.0905
Inspection Request Scheduled For. Date: 10/9/2006 Pour Time
Code # Inspection Description Confirm # Contact # Message
6ID Gas line 037874 -01 503-590-0805 N
Corrections/Comments/Instructions:
j�� 4MS '.-Finel "2 i —7— s — Z6 '/ Ci ,- /tit. s nl -
Ri I I PARTIAL APPROVAL I CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: %1` Date: ki- Is'6 Phone # (503) 718 - 7¢141---
CITY OF TIGARD -
BUILDING DIVISION PERMIT # MST2006.00081
13125 SW Hall Blvd , Tigard, OR 97223 D ATE ISSUED ed21/2006
Phone (503) 639 -4171 e '11 1
Inspection Requests (24 Hrs) (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE 10/9/2006 TIME 7.01AM PAGE 7
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME: CAPPOEN ESTATES
DESCRIPTION. New SF.
OWNER PHONE#
CONTRACTOR FOUR D CONSTRUCTION PHONE #. 503- 590.0805
Inspection Request Scheduled For: Date' 10/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 037874 -02 503-590 -0805 N
Corrections/Comments/Instructions
up Srcu," Z cnctC Gp' I& , T wn , 4,e ei- t
i / -S 144/0 -r --I-3 - '.C6.L / Veal a4 Ci dti i -
/
c7
I I PA 7 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: / /�% Date le —Gj F6 Phone #: (503) 718- ±-4-474C
CITY OF TIGARD .
BUILDING DIVISION . A 0
PERMIT # Msr200600081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone (503) 639 - 4171 tilt
Inspection Requests (24 Hrs) (503) 639 -4175 ; . ''
INSPECTION WORKSHEET FOR DATE 10/9/2006 TIME 7:01AM PAGE 3
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION. CAPPOEN ESTATES LOT #- 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE#
CONTRACTOR FOUR D CONSTRUCTION PHONE #. 503-690.0805
Inspection Request Scheduled For: Date: 10!912006 Pour Time
Code # Inspection Description Confirm # Contact # Message
275 Framing 037874 -06 503-590-0805 N
Corrections/Comments/Instructions:
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Inspector 7,I/ Date /� — y — CO Phone # (503) 718-
CITY OF TIGARD , . .
BUILDING DIVISION PERMIT # MST2006 -00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone (503) 639-4171 A
Inspection Requests (24 Hrs) (503) 639 -4175 � .;. "II :.
INSPECTION WORKSHEET FOR DATE 10/9/2006 TIME 7:01AM PAGE 6
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION- CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE #
CONTRACTOR. FOUR D CONSTRUCTION PHONE # 503 - 690-0805
Inspection Request Scheduled For: Date. 10/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
235 Shear walls/anchors 037874 -04 603. 590.0805 N
Corrections/Comments/Instructions
PAS SS ❑ PARTIAL APPROVAL ❑ CANCEL pi NO ACCESS
I I FAIL (/ //I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector /). A Date: 1P — –0409 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST200S00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED: 6/21/2006
Phone (503) 639 -4171 yew IIIi
Inspection Requests (24 Hrs) (503) 639 -4175
INSPECTION WORKSHEET FOR DATE' 10/9/7006 TIME 7.01AM PAGE 4
SITE ADDRESS. 11716 SW ERROL ST CLASS OF WORK.
SUBDIVISION: CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME. CAPPOEN ESTATES
DESCRIPTION' New SF.
OWNER PHONE #.
CONTRACTOR. FOUR D CONSTRUCTION PHONE #- 503-590-0805
Inspection Request Scheduled For Date 10/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
242 Interior shear walls 037874 -05 503-590-0805 N
Corrections/Comments/Instructions.
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PASS I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED
Inspector: MA Date:/9 Phone # (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT # MST2008.00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6(21(2006
Phone. (503) 639 -4171
Inspection Requests (24 Hrs ). (503) 639 -4175 Agar 1...
INSPECTION WORKSHEET FOR DATE 9/1912006 TIME 7 :05AM PAGE 6
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION' CAPPOEN ESTATES LOT #. 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION Nev SF.
OWNER PHONE #
CONTRACTOR' FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For Date: 9/19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 036808.04 503 -720 -7445 N
Corrections /Comments /Instructions: •
PASS I 1 PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
I I FAIL . I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i/7' Date: Q— /l —afo` Phone #: (503) 718- nfir
CITY OF TIGARD -
BUILDING DIVISION - PERMIT # MST2006-00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone (503) 639 -4171 l �*
Inspection Requests (24 Hrs) (503) 639 -4175 ''II..
INSPECTION WORKSHEET FOR DATE 9/19/2006 TIME 7:05AM PAGE 5
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOF_N ESTATES
DESCRIPTION. Now SF.
OWNER. PHONE #.
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503-590.0805
Inspection Request Scheduled For Date: 9/1W2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
235 Shear wallJanchors 036808-05 503.720-7445 N
Corrections /Comments /Instructions: ��yyA� /
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I I PASS ARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL ���_ I I CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED
Inspector !1'�rl �/ Date: 9 n---ak+ Phone # (503) 718 - 4
CITY OF TIGARD
•
BUILDING DIVISION PERMIT # MST2006 0000B1
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone (503) 639 -4171 il
Inspection Requests (24 Hrs) (503) 639 -4175 nti� _ .
INSPECTION WORKSHEET FOR DATE. 9)19/2006 TIME 7 :05AM PAGE 7
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # p06 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION New SF.
OWNER PHONE #
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503- 590.0805
Inspection Request Scheduled For: Date: 911912006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
242 Interior shear walls 036808 -03 603-720 -7445 N
Corrections /Comments / Instructions
/
O�PA S' ---' I I PARTIAL APPROVAL ❑ CANCEL (7 NO ACCESS
FAIL p CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
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Inspector: . �LJ� Date: 9-19 -o4 Phone #: (503) 718 - 24-4-c
CITY OF TIGARD - -
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BUILDING DIVISION PERMIT # MST2006 -00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 6/21/2006
Phone (503) 639 - 4171 atilt
Inspection Requests (24 Hrs) (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 8/4/2006 TIME 7:04Am PAGE 22
SITE ADDRESS 1 SW ERROL ST CLASS OF WORK
SUBDIVISION- CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION• New SF.
OWNER. PHONE #.
CONTRACTOR. FOUR D CONSTRUCTION PHONE a 503 - 590.0805
Inspection Request Scheduled For: Date 8!4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
225 Post/beam structural 03440501 503 -720 -7445 N
Cans /Commelnstrions jp
d i r L'iC' y „ j `7 C74L,2 4h/trier
PASS PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: 4 CC_ Date: 7 q (0 `-C Phone # (503) 718 - v ` v 1
CITY OF TIGARD a -
•
BUILDING DIVISION PERMIT# MST2006.00081
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 6/21/2006
Phone (503) 639 - 4171 , 1�jl�l
Inspection Requests (24 Hrs) (503) 639 -4175 ,•�i
INSPECTION WORKSHEET FOR DATE 8/4/2006 TI . 7 04AM PAGE: 21
SITE ADDRESS. 11716 SW ERROL ST CLASS OF WORK.
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION' New SF.
OWNER PHONE #-
CONTRACTOR FOUR D CONSTRUCTION PHONE # 503-590-0805
Inspection Request Scheduled For: Date: 8/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
605 Post/beam mechanical 034405.02 503-720-7445 N
Corrections /Comments / Instructions
PASS I I PARTIAL APPROVAL fl CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
VO Inspector: Date. d / Phone #: (503) 718- VitL
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CITY OF TIGARD _ l►'l ST
BUILDING DIVISION PERMIT #: o_o% -co�/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED
Phone (503) 639 - 4171 4 , 1 yq( I A
Inspection Requests (24 Hrs.). (503) 639 -4175 ..L- IL
INSPECTION WORKSHEET FOR DATE TIME PAGE
SITE ADDRESS / ( / (P E/ v l CLASS OF WORK
SUBDIVISION. LOT # TYPE OF USE
PROJECT NAME
DESCRIPTION.
•
OWNER PHONE #•
CONTRACTOR PHONE#
Inspection Request Scheduled For: Date: 6 -9_9 — 'our Ti ✓ / / b O a
Code Inspection Description Confirm # Co # Message
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orrec i /Comments /Instruc ions: •
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n FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED \\
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Inspector: Date —zs -- Phone #: (503) 718 - ¢G /
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2oo6-0o081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 612112006
Phone: (503) 639 -4171 Ake
Inspection Requests (24 Hrs.): (503) 639 -4175 ... I ! '' _ I — l ' `
INSPECTION WORKSHEET FOR DATE: 7/5/2006 TIME: 7:03AM PAGE: 42
SITE ADDRESS: 11 716 SW ERROL ST CLASS OF WORK:
SUBDIVISION: CAPPOEN ESTATES LOT #: 006 TYPE OF USE:
PROJECT NAME: CAPPOEN ESTATES
DESCRIPTION: Now SF.
OWNER: PHONE #:
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503.590
Inspection Request Scheduled For: Date: 7/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 032731 -02 503. 969 -4631 N
Corrections /Comments/ Instructions:
n ' ASS PARTIAL APPROVAL _ CANCEL El NO ACCESS
n FAIL 1 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ar7i Date: 7 6 1 0,2 Phone #: (503) 718-