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Permit I 0 ® TIGARD MASTER PERMIT `� PERMIT #: MST2005 -00129 L , ,, , , DEVELOPMENT Tigard, 3 -639 -4171 DATE ISSUED: 4/25/2005 PARCEL: 1S133DC-05700 SITE ADDRESS: 13475 SW BRITTANY DR ZONING: R - 12 SUBDIVISION: BRITTANY SQUARE NO. 1 LOT: 015 JURISDICTION: TIG Project Description: Remodel: Attic to master bed. Other plumbing is capping off three fixtures. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: VALUE: 5.250.00 OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 3 MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES:. VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W /OSVC!FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 5.00 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: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: 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 Owner: Contractor: Tigard Munidpal Code, State of OR. Specialty Codes GREGG/1 CUNNINGHAM OWNER and all other applicable laws. All work will be done in 13475 SW BRITTANY DR. accordance with approved plans. This permit will expire TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 - 522 -1352 Phone: 503 475 - 3180 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 Reg #: direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 422.42 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Issued By : _ �d, ;.r z_ 2' i 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. • • M AST ER7'PERMIT I ■ F ! l ^ Y I ' PERMIT #: MST2005-001,29 �� . 'h DEVELO P ENT' SERVICES DATE ,IS 4/25/2005 �-" f3125 SW Hall Blvd. Ti and .OR 97223 503 - 639 -4171 • g PARCEL: .1 S13300-05700 SITEADDRESS: 1,3475 SW B.RITTANY.DR ZONING; R-12 SUBDIVISION: BRITTANY SQUARE NO,. 1 LOT:_ 015 JU,RISDICTION: TIG Project Description: Remodel: Attic to master bed. Other plumbing is capping off three fixtures. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES,: . TYPE OF CONST: 5N - DWELLING UNITS: - THIRD: sf RIGHT: _ VALUE: 5,250.00 OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:. LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS:, . CATCH BASINS: . TUB /SHOWERS: 3 GARBAGE DISP: WATER HEATERS: WATERLINES: BCKFLW PREVNTR:- GREASE TRAPS: OTHER FIXTURES: 3 . MECHANICAL FUEL TYPES FURN < BOIL /CMP < - .3HP: VENT FANS: CLOTHES DRYER: ' FURN > =100K: UNIT HEATERS: ' HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL . RESIDENTIAL UNIT SERVICE - FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 .- 200 amp: 0 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA-ADD'L 500SF: 201 - 400 amp:. ;201'' -.'400 amp: lst W/O SVC/FDR: 00. SIGN /OUT LIN LT: PER HOUR: .LIMITED,ENERGY: 401 -- 600 amp: 401 - 600 amp: EA ADDL BR CIR: 5.00 SIGNAL/PANEL: IN PLANT: MANU,HM/SVC /FDR: 601 - 1000 amp: 601 +amp- 1000v: MINOR LABEL: A, , r 1000+ amp /volt: ._ PLAN.REVIEW.SECTION Reconnect only: > =4 °RES UNITS: SVClFDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED.ENERGY A. SF RESIDENTIAL _ B. COMMERCIAL ®I AUDIO & STEREO: VACUUM:SYSTEM: :AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC.LT: o ` BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: - MEDICAL: OTHR: HVAC: - DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: 8 This permit is subject to the regulations contained in the Owner: . Contractor: Tigard Municipal Code, State of OR. Specialty Codes V GREGG/TERES CUNNINGHAM OWNER and all other applicable laws. All work will be done in 13475 SW BRITTANY DR. accordance with approved plans. This permit will expire TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the ' work is suspended for more than 180 days. ATTENTION: Oregon law - requires you to follow rules Phone: . 503 522- 1352 Phone: 503-475-3180 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 Reg #: direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 422.42 1- 800 -332 -2344. REQUIRED ITEMS AND REPORTS Issued By :. -' : .-C-d,;./',..e.--14 } Permittee Signature -- • �._. Call 503- 639 - 41,75 :by 7 :00 a.m.-for an inspection that businessday. "•� Thispermit;card.shall'be ;kept in a conspicuous place on the job site until completion of the project. 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'-' = '-'. •: ' ' - .- n' '3 01 01/2008..;CNI--.L. .. 06 li E 275 Fr-a;llirq • 01102/200a g•-'; • ,..,.. .,,,'„-,., .,. -, ., . , , ... ,,;- „ 03/ 2 , ? a J•1, ..:: - .. .:....; - I-- - 11,"-1 ;',--.,-;:-..„-:,.:;', ..i„,. • .. . . - • . : • . ), ' ',..'1, ',7 Rik-,--.. ' " 0 - 11 0.138FI-vIL ANN..!:., _ 06241,?;402. ' - :, J.' t'.•-.1 ! - , - ,,,, ••.- - ' 0 . I , .„..„... ,•'. -.. . . ' - - , 1 4,.".. ; • L j r -1 120 Etc• c .c?uilh-• in - 04/131 , 010 12:00 - Gar Ncble , . 04/1312010 •'F•;;-,. ...r...",,...,,,. LlpstairOaath',a,,,.. • 0 ,•'-.7f k,-..,.T wii.zw.sr.,:',....:•";;4:';..-t..,41t=1-ilMfr'r7','-Vt,...r:FkR".jf&I‘grWiterc,FiiRi140":444.04WAY.A 1 r ..A.f 'al 1...- •-. 61.-11 ,- --1,... '. '.. ' , - •-=. 4 * - - -, - - -- ,-..•'.- " '"--- ' --''''' '"'''" - 7,.,.;. : .. , ' . 77 5 1,t ::::,.., . 1 ‘--- ' •<;, .,,,:•: ,.• , ;,. .,,.. rn Reports ',- . .,,;,,-' _;,,..,' : • ,. . , . ' '- *''','irk : -,•-:1-.' e , 4.1.- - , - (-1t3. • ,,,tt.t..: ..-:... ., .- .-' . t' ':',,' -, t,...e , tt • , ---- - t, :.., „ . . , •” .. _ , , ,.. . , . I . • • - „ -. - , , , .. , >" My Reports " .. . • ..... _ .: . ' .. , • >Case Specific Permits . • . . . .. .. • .-.‘ _ • >Cashiet' ••,,.. . • ___ ._..,_ . . _ . - • ••-•- e, •----- = - • -- -- lat' '" at.: r-i. .-::,44-41:. - .. ,1 , ,41 . , itlitlki..-4. 3 .10' - "Tj'f - ii". - )-j"ti!j- . ; j., - . ''''t. '-'.•;,,P.'wagia-04,41-illitlx.talat-tinati..goomil.-4,...itt,P.4,t-hitLe 1"-. , - 1 * :1 - •1•'' , ! 1 .,..._.; • ''I - ' ,4- :;'' '-f t. :4 ,.., , L;•. , •- -1 : -. 4 - i.ruq0 ,- A„ , ii i1; • '1 -.4. 4 .•"..' - -iY - - - *•. --Y. tf.• - •-...N...-. 7 .---.:'-'. 17 ti'.•`,Ni.... - - - ..„..... - -: - .,....4-.'''''-- - -- - 1'..,.-.0i.4, - .-a,,t---• --- -- ., ::- — 1/23/2008 • Case Activity Listing 1 144:47AM EL - Case #: MST2005 -00129 1 . �. - : S l A nedt , Done U - „ " . e ^ - �:�..�: ,. Y'�- ,.,- «,tea.. � R. .. �.... .,. _ ., . t., ..�.z ..,. _. :- µ *?I ,. ^.- � ,,Dated _,, �.Date2 �..D t� ��Hol �<� ��; _ _: . ,a -� <_�, .�,Actt rt �De e �_ _.�. .,:.ate3. r d, ,. _�Dts :� To ....., ;.B �. Notes > MST2320 Plumbing rough -in 7/1/2005 7/5/2005 7/5/2005 None C I ' T fi t/ 2. / JW 7/5/2005 01068T -02 -- 503- 522- I352- VM STI N - =Igo MST I080 Revisions /Info routed 8/15/2005 None, DONE DER 8/15/2005 to PE DER MST1120 Revisions 8/18/2005 None APRV MAV 8/18/2005 apprvd /rooted to PT MAV MST2275 Framing 11/18/2005 11/21/2005 11/21/2005 None It ITT 1 / /o e HFY 11/21/2005 021930 -01 -- 503 - 522 - 13'51-- VM - STI Y - 140 MST2320 Plumbing rough -in 11/18/2005 11/21/2005 11/21/2005 None 4j y UM ( HFY 11/21/200 021930 -02 - 503 - 522 - 1352,- VM - HFY:: Y. MST2120 . Electrical rough -in 11/18/2005 11/21/2005 11/21/2005 None O <0/0 ‘s HFY 11/21/20 021971-01 -- 503 - 522 -1352 - VM - STI Y - 140 MST1540 Permit extension 5/2/2006 None DONE HAP 5/2/2006 180 day extension granted per owner granted HAP request. Exp date 11 - 2 - 0b MST2120 �Elel trtcal rd ugh ° i n 10/31/2006 1 1/1/2006 1 1/1/2006 None 1 P , / ItI , -. � CB 1 1/1/2006 039112 - 01 - 503 522 - 135 2 - V � STI Y - 180 MST2615 Mechanical rough -in : , 10/31/2006 11/1/2006 11/1/2006 None ART'" CB 11/1/2006 039112 -02 - 503 - 522 -13'52 - VM - STI Y --180 MST2320 Pluinbtngtough n i` • ,� 10/31/2006 11/1/2006 11/1/2006 None ART' CB 11/1/2006 039112 -03 - 503 - 522 -1352 - VM- STI Y -180 MST1730 Case update (see note) 11/28/2007 None DONE LS 11/28/2007 applicant called with an insulation LS question and will be calling in a framing inspection soon. told not to insulate until through framing approval. Page 2 of 3 CaseActivity_rpt :103/2008 Case Activ L 11a44:47AM CEL,/:. Case #: MST2005 -00129 Don date � �� a.; s .': � � Via. Actrvrtv Descri ton �,�,� � :_ , �'� . � ,,,.. ,,. -, . -,,,_ ,�._ ,:: � Date 3 � � Hold,,..,- ,. De ,� � , To � 4, .B � �, B :._Totes f. � � . MST2275 Framing 12/31/2007 1/2/2008 1/1 /2008 None CNCL STI 1/1/2008 0624 -01 -- 503 - 522 -13'52 -- VM - STI N MST2275 1/1/2008 1/3/2008 1/3/2008 None 'CFA RB 1/3/2008 062418 -02 — 503- 522 -1352 — VM - RB N • Page 3 of 3 CaseActivitv..rpt CITY OF TIQARD 0 . BuILDINO DIVISION PERMIT #: MST2005-00129 13125SW Hall Blvd., Tigard, OR 97223 TE ISSUED: 4/25/200S Phone: (503) 639-4171 I j rb ' ,azoipliii',1\ t Inspection Requests (24 Hrs.): (503) 639-4175 ,.._._,„ - -........ INSPECTION VVORKSHEET FOR DATE: 1/3/2003 TIME- PAGE: 66i SITE ADDRESS: 13475 sw BRITTANY DR CLASS OF WORK: ' SUBDIVISION: BRITTANY SQUARE NO. 1 LOT #.. TYPE OF USE PROJECT NAME: CUNNINGHAM DESCRIPTION: Remodel: Attic to master bed. Other plumbing is capping off three fixtures. , OWNER: CUNNINGHAtvl, GREGG/TERESA PHONE #: £O322-132. CONTRACTOR:- OWNER PHONE 4t: Inspection Request Scheduled For: ' Date: 1/3/2008 C Pour Time Code # Inspection Descript ,'• 4 # Contact # Message 276 Framing ° . 02410 503•522-'1362 N 3 Correctiens/Comm ts/Instructi ns: I , . Nritf 1 . , e4.■v?•• A '' (0 v - 4 . ) 0 ° C ‘AA0 ) ; :: - 76 : e ' - „, ,z4 t i r OA 0 VNACC/1 q-C.I1A *fL04 C.--eL. 4 , , , . ,0 , e -, Z. • f — 1 1 - 2–/ oro • WEEIERFNAIL A ir C 0 ‘, - I C 'eitt14.4. ..... • ' 5t2/6 7 N 0 -KArz,OLA 1,„ik ,,v‘ --(4) pe-ve---vv\-.Jck if o 1 ' . 1 ' , - 5. - ID k#erA" ___....... V(_J2 Ci•_' . 46 a__)2____ if " 1!) - - --.L• _ Af-__-____. . ao___ 61._ - 1/4 ,- , i c , o • ,40,,.. • 4 ---- - Air AP_ '...411i .._ Q...-0-.../L- it _.,,, ,„„, . __„.... _11 S).' iel/r/-', : ' V Le/NA ■r\ 0 \ . t5-- Q PASS n ' PARTIAL APPROVAL fl CANCEL 0 NO ACCESS a FAIL 1 I • CALL FOR INSPECTION, 0 ADDITIONAL FEES ASSESSED ... 1 Inspector: • Date: . '' - Phone #: (503) 718- . CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST200,6-'00129 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2005 • Phone: (503) 639-4171 kaiptiv . Inspection Requests (24 Hrs:): (503) 639-4175 Ali; 11: INSPECTION WORKSHEET FOR DATE: 11/112006 TIME: 7:03AM . PAGE: 51 - SITE ADDRESS: 13175 SW BRITTANY DR CLASS OF WORK: • SUBDIVISION: BRI1TANY SQUARE NO. 1 LOT. #: 015 TYPE OF USE: PROJECT NAME: CUNNINGHAM DESCRIPTION: Remodel: Attic to master bed. Other plumbing is capping off three fixtures. OWNER: CUNNINGHAM, GREGG/TERESA PHONE #: 503-622-1352 CONTRACTOR: OWNER PHONE #: • Inspection Request Scheduled For: Date: 11/1/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message • 120 Electrical rough-in 039112-01 503-522-1352 Y Corrections/Comments/InstrUctions: • any (( e_c • • tn/A.-cne----__ 4 ( TTT cct) • El PASS WI PARTIAL APPROVAL n CANCEL • I NO ACCESS FAIL •M ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED • Inspector: CPI • Date: I I / 6 6 6 Phone #: (503 z ) 718- • • CITY OF'TIGARD BUILDING DIVISION PERMIT # MST2005 -00129 13125 ` SW H all Blvd Tigard, OR 97223 DATE ISSUED: 4/26/2005 , Phone: `(503) 639 -4171 @ fl ` Inspection Requests (24 Hrs.): . (503)'639 =4175 ' :_.� • INSPECTION WORKSHEET FOR. DATE: 11/ TIME: 7:03AM'` PAGE: 49 SITE ADDRESS: 13476 SW BRI1TANY ITC. CLASS OF WORK` SUBDIVISION: BRITTANY SQUARE NO. 1 , LOT ##: 015 TYPE OF USE: PROJECT NAME :. CUNNINGHAM DESCRIPTION: Remodel` Attic to master bed. Other plumbing is, capping off three fixtures. OWNER: . CUNNINGHAM, GREfaG/TERES1 a PHONE #: . 503- 522 -1352 ' CONTRACTOR :, OWNER PHONE #: • Inspect Request Scheduled For: Date: 11/1/2006 Pour Time: Code # Inspection Description I Confirm # Contact# - se 320 Plumbing rough-in 039112 -03 503-522-1352 Corrections /Comments /Instructions: • • • • • PASS ,F2 'ARTIAL APPROVAL CANCEL n NO ACCESS . I ,;FAIL . n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED 1 6 Phone # (503) 718 -. _- , e:I�l� 'Inspector;:. Date; Z / . CITY OF T1GARD 410 „ BUILDING DIVISION PERMIT #: Iv1ST2006.00129 13125 SW Hall Blvd., Tigard, OR 97223 ”' DATE ISSUED: 4125/2005 ' Phone: ,(503) 639 - 4171 F 41 0 .Inspection Requests (24 Hrs.): (503) 639 - 4175' -' INSPECTION WORKSHEET FOR -DATE: 11/1/2006 TIME: .7 :03AM PAGE:. .50 S ITE ADDRESS: 13475: S BRITTANY DR `CLASS OF WORK: - SUBDIVISION: 8RITTANy SQUARE NO. '1 LOT #: 015 TYPE OF USE: PROJECT NAME: CUNNINGHAM DESCRIPTION: Remodel: Attic to master.bed. Other plumbing is capping off three fixture". OWNER: CUNNINGHAM, GREGG/TTERESA PHONE # 503- 522 - 1352 CONTRACTOR: OWNER PHONE #: - Inspection Request Scheduled For: Date: 11/1/2006 • Pour Time: Code. # • Inspection Description Confirm # Contact # M - - _ • - 615 Mechanical rough -in 03911.2 -02 503 -622 135 F/ Corrections /Comments /Instructions: • • • n PASS IMPARTIAL APPROVAL . n C A N C E L n NO'ACCESS V n FAIL 1 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: c Date 1. I ¢ Phone #: (503) 718- Z6 9r'' CITY O FTIGARD . 0 BUILDING DIVISION PERMIT #: MSf 0115 0012 131`25 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2006 Phone:: (503) - 4171 /O�iiii0111��,f i: Inspection Requests '(24.Hrs.): (503) 639 -4175 = ' INSPECTION.WORRSHEET FOR ' DATE:; 11/21/2005 TIME: 7;13AM PAGE: BO • SITE ADDRESS: • 13475 SW BRITTANY DR • CLASS OF WORK: ' SUBDIVISION 'BRITTANY 'SQUARE NO. 1 LOT #: 015 , TYPE OF USE: - PROJECT NAME: 1 G HAhfi DESCRIPTION: c '7/1iTit7 X ` `Attic\naster bed. Other plumbing is capping off three fixtures. OWNER: CUNNINGHAM. ,G GG/TERESA _ PHONE.# 503- 522 -1352 CONTRACTOR: OWNER � ti PHONE #: Inspection Request .Scheddled For: Date: 11/21/2005 Pour Time: Code # , 'Inspection Description Confirm' # Contact # Message - 120N Electrical rough -in ,021971 -01 .503. 522 -1352 ' Corrections /Comments /Instructions: • ❑, PASS PARTIAL APPROVAL n CANCEL - NO ACCESS FAIL 1: CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector. • (I- t --/ Date: � f /j» Phone '#: (503) 718 - CITY: OF TIGARD BUILDING ®IVO$ODN PERMIT #: IviST200S-00129 1:3125 SW Hall Blvd., Tigard, OR '97223 ' " DATE ISSUED: 4/255/2005 Phone: o section O Re 6 uests 7 24 Hrs.) :; (503) Inspection Requests I ( ) 639-4175 __.. , , INSPECTION WORKSHEET FOR DATE: ' • . 7/5/2005. TIME 7:12A1v4 PAGE: 64 • t\I wflo cic SITE ADDRESS 13476 SW BRITTANY DR CLASS OF ` WORK` SUBDIVISION :, BRITTANY .SQUARE NO. ,1 LOT #: 015 TYPE OF USE: PROJECT NAME: CUNNINGHAM DESCRIPTION': Remodel: 'Attic'.to,master bed. Otherplumbing is capping °off three fixtures. OWNER: ; CUNNINGHAM, GREGG/TERESA • • PHONE #: 503 -522 -1352 CONTRACTOR: OWNER PHONE # 503-475-3180 Inspection Request Scheduled For: Date: 7/5/2005 Pour Time: Code # Inspection' Description Confirm # Contact .# Message 120 Electrical rough -in 010681 -01 503 - 5211352 N Corrections /Comments /Instructions: f 6o warzV-,, up §T 1, ) k • • • )PASS : ❑ PARTIAL APPR OVAL ❑ CANCEL ❑ NO ACCESS FAIL .n ., L FOR INSPE ° TION ❑ ADDITIONAL FEES ASSESSED_ Date: • .' - Phone, #: (503) 718 - �Lnspector: ( ) CITY OF TIGARD 0 • BUILDING DIVISION A . . PERMIT # MST2005 -00129 13125. SW Ha ll Blvd., Tigard, OR `97223- • DATE ISSUED: 4/25/200 . Phone: (503) 639-4171 - v 1 . inspection Requests ,(24 Hrs.) (503) 639 - 41'75' ' .4414 A IL:: ' INSPECTION WORKSHEET FOR ` `DATE :, 11/21/2005 : , TIME: 7:13AM PAGE: 95 " • SITE ADDRESS: 13475 SW BRITTANY DR CLASS OF WORK: , SUBDIVISION: BRITTANY SQUARE NO; 1 LOT #: 015 TYPEOF USE: PROJECT NAME • .CUNNINGHAM - DESCRIPTION: trikemq;• I: Attic to master k ed.. Other plur Bing i"S dapping off throe futures. OWNER: CUNNINGHAM, GREGG/TERESA PHONE #: 503 - 522:1352 CONTRACTOR: OWNER - f PHONE #: Inspection -Request Scheduled! For: Date:.. 1.1/21/2005 Pour Time:; ' Code .#- Inspection Description Confirm # Contact . #'_ 'Message. . . 32N - - Plumbing rough -in 021930 -02 -, -503.522-1352 Corrections /Comments /Instructions ❑ PASS X PARTIAL APPROVAL ❑ . CANCEL ❑ NO ACCESS ❑ FAIL n- CALL FOR,INSP,ECTION n ADDITIONAL FEES ASSESSED • Inspector: X6 ` - - - _ Date: I/ a'1 Phone # :,'(503) 718- • CITY OF TIGARD ---_ BUILDING ,DIVISION PERMIT ,# IvMST2005 -00129 13125.SW Hall Blvd., Tigard;:OR 9 _ DATE ISSUED (4/2512005 • Phone: (503) •639 -41 //i mnr ;di �P „ ����jihl \ Inspection Requests (24 Hrs.): (503) ,639 -4175 INSPECTION WORKSHEET FOR ' - • DATE:;, 7/512005 TIME:. 7:12Aivi ' PAGE: • ' SITE ADDRESS': 13475 SW BRITTANY DR . CLASS OF WORK: SUBDIVISION: BRITTANY . SQUARE NO. .1 LOT #: 015 TYPE OF USE:: PROJECT NAME: CUNNINGHAM I : DESCRIPTION: Remodel: Attic to master bed: Other plumbing is capping off three fixtures. •owNER OWNER s GUNNING H'AM, .GREGG/TERESA PHONE #: 503 -522 -.1352 CONTRACTOR:- • • - PHONE #:. '503 - 475 -3180 Inspection Request Scheduled For: • Date: 7/5/2005. Pour Time: Code # • Inspectionbescription . Confirm # Contact # • ,. , Message 320 Plumbing rough -in 01.0681 -02 583522 -132 N Corrections /Comments /Instructions: 1•[ V) is- 0 - 1'1 1024,011. I z J �;✓� 14 vc' a f1 1°6 A S S1\ . L z '` -✓ >.l u • • o PASS [ PARTIAL APPROVAL 0 CANCEL ❑ NO ACCESS • 1 1 FAIL • n CALL FOR INSPECTION Q ADDITIONAL. FEES A .Inspector :�s Date:'O Phone # (503) 718- . 1 - C9TY OF TIGARD. 0 . 0 . . BUILDING DIVISION . . PERMIT # M.571 - .13125 SW Hall Blvd. Tigard,.OR 97223 �//�nil DATE ISSUED: 412512005 e :'(503) 639 -4171' i � ilii til , . ° Inspection Requests, (24 Hrs.): (503) 6397.4175 4 - - ' INSPECTION WORKSHEET FOR DATE: 11/21/2005 • TIME: 7:13AM - PAGE: ° ` 97 • • SITE ADDRESS: 13475 aSWBRITTANY DR CLASS OF WORK: • SUBDIVISION: BRITTANY SQUARE NO. 1 LOT #- 015 TYPE OF USE: • PROJECT NAME :',' CUNNINGHAM DESCRIPTION: .e o m dh Attic to master bed. Other plumbing is capping off threeiixturee. OWNER: CUNNINGHAM, GREGG/TF_'RESA PHONE #: 503 - 522 - 1352 CONTRACTOR: ' OWNER PHONE #: Inspection Request Scheduled For:. Date: /112112005 Pour Time: Code # - Inspection Description Confirm # Contact # Message 275Ny Framing 021930 -01 , 503-522 -1352 • Corrections /Comments /instructions: • • 'CN. S P:I'.: P Esc C3 -V l'- 3 t \Ai . .• . , , . _ PASS - 'PARTIAL APPROVAL fl CANCEL • . n ENO ACCESS ,I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED J . Inspector: �,_ � Date: Phone #: (503) 71,8; • • 4 _ .� _ ^ � � � :rte - '� - «��, » `� .. ^<�' f" _ ;� � -- � �«� ,��. .:- , -.. :,. :r -.� .., w te xr - a .�.,� �ffi x- .m V ' f:. © 1 � t�1to i,tlgC�ISI?.`t ��U :�'3 t[`Ilir {r C, .rtG" i r+i r f .,_Ct .E of ! =;'t � E'�. Ali ii i' ,�..G' —�,�i ..._� ! ' [ I'� - ] NZ — 1F ' ... Favorites �L - e Auton�atiori i Cite of Tigard, Oregon is e `i `' - u. Read ,Mail Print. f _' Harn� - rw �;3 13475 SW BRITTANY DR • r � r r u SHEJ FIELD CAR ,? C .<5 _ a=le e , rte- ..r al ,•!;,.. , 4 - , 1,4/4 A i - -;" P „1,„, , ''''f +- . -i ' ' n te I , : - ..,!: ! ,,,: - 0:: : d h ; r. ' 7 : J ?;'i x mi l...- -': WA 44, r r / -1.2,-.„-; - , . I. :� - FFithN3LN 4 - -i. C . , , ., i_AJ.-JRMc DR III ProRert ■i-Oti6cei Lifal . t ° .,,.. i h a" " 4r t +.#r , Tax ID- Nu 1S1330co57':o Tax Acccunt Number: Ri298777 Site .Addre =s: 13475 RITTANY DR Site City: Site ZIP 97223 Owner: CUNNINGHAM,. G4EGCRY&TERESA. Owner 2: 13 S'r'i 6RITTANY DR Owner 3: . r , - . Inspectian _ L ist „ . InbaA I 't�cros�ft „ -' . 14'rnh1l Building Per 11) 114 4 1 I,II I a lai ® `m ' � ��r, N 7 - i . ,. n;u ter it.. n,FORCOFFICE'UN� � 1. '. aft clp City of Tigard Received a O ! , y � a - 07 „ y Date /By: �D� 72 n � ^ 00[ B rJ Y��J PermitNo.• l.� 13125 SW Hall Blvd., Tigard, Q X0 2 �J Plan Review Phone: 503.639.4171 Fax: 503.598.19 r rn Date/By: 1 - e�' or MB./ Other Permit: Inspection Line: 503.639.4 OF 1 IGARD j j� • � ,� ' Date Ready /By: Juris: 0 See Attached Checklist for 4 Internet: ww w.ci.tigard.o fy • ILDIN DIVISION Notified/Method: �/ Supplemental Information '� tu TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING O ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. U 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. [� dwelling Valuation: $- ' , '._- .1 -and 2-family g ❑ Commercial/industrial ,- ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder 111 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ('N '' 5 Sim) E"( c +i n NI 'DO" New dwelling area: square feet City/State /ZIP: •--c- 0e 912 z, 3 Garage /carport area: square feet 4' Suite/bldg. /apt. no.: Project name: CAA I.i ,4'...5 I.A.C1 M Covered porch area: square feet Cross street/directions to job site: 15 s 4- ,.. 1 G'rS cC L 13x5 1- • Deck area: square feet Sb u.H.-. -5; d e Other structure area: square feet • - REQUIRED DATA: COMMERCIAL - USE CHECKLIS Subdivision: /3 - t` � - T Gw (� N Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. e . Ae_ Valuation: $ Z• M �. EI 1,, 3 r) kit CtS� L `(iS M e.,- i �;5.4 -r► tlx: o �.► , , C. (`U NSScise• c--1 - C% ICCA. - 'I�s'00!� +` Existing building area: square feet New building area: square feet 4ROPERTY OWNER ❑ TENANT Number of stories: t Name: Type of construction: -.re e_ceso. [.c4�� • yl' Address: 134- 5 . 5 i „ `, 6 fiA H z Occupancy groups: City/State /ZIP: -7-'6 d o(Z 1 Z-23 Existing: Phone: ()�3 52:z - 135 7 Fax: ( ) New: U - i PLICANT ❑ CONTACT PERSON NOTICE Business name: 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 applicant is exempt from licensor , the fol wing reasons City/State /ZIP: apply: PP Y: 66 ,'7 Phone: ( ) Fax::( ) E -mail: CONTRACTOR Business name: (`)1A 7T .N-j l BUILDING PERMIT FEES* Address: • Please refer to fee schedule. City/State /ZIP: Fees due upon application Phone: ( ) Fax:( ) Amount received CCB lic.: __ . _ _ --.2--------.....___ /� ✓�_._- Date received: _Authorized'signature: _� This permit application expires if a permit is not obtained - -_ `•" __ _ - - -' ...__ — -- /-_ -\',_ within 180 days after it has been accepted as complete. Print name C , , i Date: - 1 * Fee methodology set by Tri -County Building Industry u .) \ Service Board. i:` Building \Permits\BUP- PemitApp.doc 12/03 440 4613T(11 /02 /COM/WEB) One- and Two - Family Dwelling ' Building Permit Application Checklist r ''"�` m9,vro ' p;)N '�r' " �" I y FORfOFFICE•USE. ONLY l'r City of Tigard Received Permit No.: A 13125 SW Hall Blvd., Tigard, OR 97223 ' ' • Associated osociated pemvts: , Phone: 503.639.4171 Fax: 503.598.1960 ,' !"V 1:1 III ❑ Electrical ❑ Plumbing Mechanical 24 - Hour Inspection Line: 503.639.4175 AVIA VII Internet: www.ci.tigard.or.us ❑ Other: ' (. a r Y t. . ,, .- "�! NoN / `A t tr THE FOLIOOVIN TitEM -gR E REOUIRE.D F,�O aTa N iaV�IEW ` , : t :,� ,�, -6 7,N „7 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, ❑ ❑ ❑ furnacd, 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 applicable to the project under review. ,d N+" M1; a, Y i � 6. � '''�i` h 1'. , 7?g, n n 1 ir. a '* f . r �, tl . .. .. ,. ..r �p ° +N '7 + *�.}" rr! {'y ° V'>�F S:i ��� " i a r r 4 tso ) "?', ;. ✓ s s 9 N i . � .�.. I ._ 7 a ,t 41. $ �ri- �,idfi ,�-� f ., �?sz V - rl fh e wU„ 'r�t RISDICTIONAL SP »ECIFIGS + � 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. I:\Building\Permits\BUP -RES- PermitApp.doc 2 RECEi v E U dil'q "i ��„ t om . Plumbing Permit Application FO OFF US ON . " ' " � a Review / Re Plan City of Tigard DateB d J U'5 09 Permit No.: 44 r LI ow 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 CITY OF r I,m d'i ''a ,` Plan Re Date/By: Other Permit No.: V 24- Hour Inspection Line: 503.639.4175 7 I T LD INC C "!� ' " i , ` �' Internet: www.ci.ti ard.or.us Date Ready/By: �° 10 See Page 2 for g Notifieed/Metd /Met hod: Supplemental Information TYPE OF WORK FEE* S ❑ New construction Demolition For special information use checklist. Description I Qty. 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 249.20 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 111 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: (3L%1 5 3 ad 441,.N1 '--- e--, Catch basin or area drain 16.60 City/State /ZIP: • , �� CC. �', 7...1-3 Drywell, leach line, or trench drain 16.60 1 ^ Footing drain (no. linear ft.: ) Page 2 C Suite/bldg. /apt. no.: Project name: AA") ..i t Ay_ IAA Pi ` Manufactured home utilities 110.00 Cross street/directions to job site: IS S \'''- a 1 G u \ ,,,. . Manholes 16.60 > , S 1 a e- Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Lot no.: Water service (no. linear ft.: ) Page 2 Subdivision: (�J"si c Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 .a"4 Z vo _ J p 5e Backwater valve 16.60 _ \ 5 ii,e) Lam( i os . . i I4 / ._ f Q f .)-_e may -- Clothes washer 16.60 N � Dishwasher 16.60 ' r ` , ' ' ` CrA-7 � ∎ Drinking fountain 16.60 0-44OPERTY OWNER ❑ TENANT Ejectors /sump I 16.60 Name: �� e `Y eSc� � � CIA's.' yc,N.q_ Expansion tank 16.60 Address: t r 3 .5 ,5 . - 3>c - -1--can (Z, Fixture /sewer cap 16.60 City/State /ZIP: ', y.c r L Z Z3 Floor drain/floor sink/hub 16.60 Garbage disposal 16.60 Phone: ct3) SL L , L3 . 5 .2,_ Fax: ( ) PPLICANT CI PERSON Hose bib 16.60 0 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory I ' 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet t 16.60 Business name: t / , " f J Water heater 16.60 Address: C' Other: CQ(p•i Ns v b O�� 3 City/State /ZIP: US ..54A e.1` MGSt - c1 f r, Subtotal l Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) t, -.-,, __.. - -•-- State surcharge (8% of permit fee) Authorized.signature: „_ . C ,_ " "' - •-- -_-,C-._` TOTAL PERMIT FEE rY .. - � Print.name: --'�� \� a ' r � � � Date: This permit application expires if a permit is not obtained within y nA-C �.N a � � ( 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\BuildingWPermits\PLM- PermitApp.doc 12/03 440- 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 - 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 Valuation: Permit Fee: Storm &Rain Drain - 1st 100' 55.00 $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 and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by (Fixture) Work Performed Fixture Type: Replace New Moved Existing Capped Comments regarding fixture work: Baptistry/Font • • Bath - Tub /Shower - Jacuzzi /Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" -3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach./Refrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang , -Stall Sink - Bar/Lavatory Quantity Total -Bradley Isometric or riser diagram is required if fixture quantity - Commercial Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: • i:'Building\Permits\PLM- PermitApp.doc 3/03 Hall Blvd., Tigard, OR 97223 Plan Review 4+ .� 7++ ; t t f - ty .iizi titr �'. acdt, ' Js +' . . , Electrical Permit Al l• �, Y ' ' ' � r FORA i sE oURAT `!!: PAPU City of Tigaard E ) ). L Elk, r. )� Received 4/C6/05 b ! _ 1_ Date /By: Permit No.: C ° 012/4 13125 SW Phone: 503.639.4171 Fax: 503.598.1960 APR 0 ", �" / �,�,��,� , Date /By: Other Permit: Inspection Line: 503.639.4175 Date Ready /By: - 1 . ,,3 : ®See Page 2 for 8 �'� J- _�;- , Interne[: www.ci.tigard.or.us ' Notified/Method: Supplemental Information TVA WCFRITIGAR D PLAN REVIEW ❑ New construction UidtigOft, Please check all that apply: ❑Demolition ❑ Other. ❑Service over 225 amps, comm'I ❑Hazardous location ['Service over 320 amps - rating ❑ Buildn over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential g I and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Buildin over three stories ['Feeders, 400 amps or more ❑ Multi family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑ Egress /lighting plan RV park Job no.: Job site address: i r{ 1 S 5 U} , 3 f • -1-'-m",1/4( ❑Health -care facility ❑Other: 1 Submit 2 sets of plans with any of the above. City /State / "LIP: C Cg. 9/1 , l, Z The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg./apt. /a no.: 1 Project name: J N N t N~` l Description Qty. Fee. I Total `' Cross street/directions to job site: 1 3 5 + a l o -r s c. ..../ O ' New residential single- or multi - family dwelling unit. 11( Includes attached garage. Z-) ) s: Ue,.. . 1,000 sq. ft. or less 145.15 4 Subdivision: f sN Lot no Ea. add'I 500 sq. ft. or portion 33.40 I �r 5 are, 1 Limited energy, residential 75.00 7 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular / /J dwelling, service and/or feeder 90.90 2 .eM 0 �( Ze�CT A�1 a ca 4-t / 0(d � , 4SS Services or feeders installation, alteration, and /or relocation �/ = .5 tA.A 4 U-.e 5 x i e S [[[ 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 PROP RTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2 Name: U ( . C am : 4 , " ti % , 5 c , , C N pj',, kc:i. N 601 amps to 1,000 amps 240.60 2 Address: w F ; 4_ .}- 0, Over 1,000 amps or volts 454.65 2 «Z5 -S� Reconnect only 66.85 2 City /State /ZIP: 1 I dQ q1 Zl3 Temporary services or feeders installation, alteration, and /or /� relocation Phone: (5,3,52.2,_i35,.. Fax ( ) f� " 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, 1; change, acct • ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: . - 2� Date: O Branch circuits - new, alteration, or extension, per panel ❑/CPPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: • c without service or feeder fee, �.� t"Q �^ , ( � t �/ \ !/� ou se 46.85 2 each branch circuit � Address: \3 i S S LA) 3 c,' .-1,---V- (t. Each add'I branch circuit ,!� 6.65 2 � City /State /ZIP: {,� q 1 Z 3 Miscellaneous (service or feeder included) C, l Pump or irrigation circle 53.40 2 Phone: ( $2,7 Fax: : ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration- or extension. Describe: Page 2 2 Business name: ()IA LA 11A_O l Address: Each additional inspection over allowable in and of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) / Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: State surcharge (8% of permit fee) Date: �2 _`` `� - TOTAL PERMIT FEE �rAuthorized,signa t. / _ - -- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete - Print nam.ey - =, N j t ` . "A Dat i....6 % l QS Pe e methodology set by Tri- County Building Industry Service Board •' Number of inspections per permit allowed. ii. nuilditlePennits ,EI_C- PennrtAppioc 1210; 4 40 - 2515111) 02 CO,At /AEE 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 system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: n Audio and Stereo Systems n B oiler Controls ❑ Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation n Intercom and Paging Systems n L andscape Irrigation Control* n M edical • n Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i: Permits \ELC- PemitApp.doc 04,03