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Permit ® i� `R�"�'�� , r, � MASTER PERMIT , „! t/ (( CIT O TIGARD «(JJJ I ' PERMIT #: MST2008 -00074 ` , ° : COMMUNITY DEVELOPMENT DATE ISSUED: 6/27/2008 'TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DD SITE ADDRESS: 11774 SW 125TH CT ZONING: R -4.5 SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 137 JURISDICTION: TIG PROJECT: GARSTECK Project Description: 560 sf. addition.MEC other -duct work. PLM other- ice maker. 8/6/08 add range vent, gas to fireplace, range, barbecue.11 /19/08, adding elc service. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 11 FIRST: 560 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 560 sf 61,700.36 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 3 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: WISVC OR FDR: 3 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st WIO SVC /FDR: 0 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 0 SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 6014-amps-1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVCIFDR > =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & 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 0 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CHRIS GARSTECK OWNER laws. All work will be done in accordance with approved plans. This 11774 SW 125TH CT permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503 -524 -4979 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 2,192.14 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 • ' � Iss ed By : �� _ �j` _, L`,,,,,� Permittee ignature : :_"" • C A �_A— Call 503.639.4175 by 7:00 a.m. for an inspect) . usine s day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. il 7,C a CITY OF TIGARD MASTER PERMIT PERMIT #: MST2008 -00074 ° COMMUNITY DEVELOPMENT DATE ISSUED: 6/27/2008 ,-TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DD-10000 SITE ADDRESS: 11774 SW 125TH CT ZONING: R -4.5 SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 137 JURISDICTION: TIG PROJECT: GARSTECK Project Description: 560_sf_addition ■ I - • - a - • • - - , • . ' lumbing other- ice maker. 8/6/08 add range (vent/duct to range, gas to fireplace, range, barbecue .1 ILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 11 FIRST: 560 s1 BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 560 sf 61,700.36 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS 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 WIO SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAUPANEL: 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 /I SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CHRIS GARSTECK OWNER laws. All work will be done in accordance with approved plans. This 11774 SW 125TH CT permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 524 - 4979 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 2,154.67 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : -t-- 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. n C ITY OF TIOe4RD _ MASTER PERMIT � i ® COMMUNITY DEVELOPMENT D PERMIT #: 6/27/2008 MST2008 00074 ATE ISSUED: TaGARD; 13 125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 - PARCEL: 1S133DD -10000 SITE ADDRESS: 11774 SW 125TH CT ZONING: R -4.5 SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 137 JURISDICTION: TIG PROJECT: GARSTECK Project Description: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED . CLASS OF WORK: ADD HEIGHT! 11 FIRST: 560 s/ BASEMENT. sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 560 sf 61.700.36 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN >=100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADM_ 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/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAUPANEL: IN PLANT: MANU HM /SVC /FOR: 601 - 1000 amp: 601.amps- 1000v: MINOR LABEL: 0 1000. amp /volt : / PLAN REVIEW SECTION W Reconnect only: 1 > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREAJSPC OCC: ELECTRICAL - RESTRICTED ENERGY ` A. SF RESIDENTIAL B. COMMERCIAL V AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: V BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL s SYSTEMS: . This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CHRIS GARSTECK OWNER laws. All work will be done in accordance with approved plans. This 11774 SW 125TH CT permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 -524 -4979 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 2,073.47 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 i "--Th if ,// ff.." Issued By -. 1 / jf Permittee Signature : /%"" Call 0 9.4175 by 7:00 a.m. for an inspection that busi K s .ay. This permit card shall be kept in a conspicuous place on the job site unt$ co pletion of the project. Approved plans are required on the job site at the time of etch inspection. Electrical Permit p19Ca�lo r 'i,- `a ' g €.1, l ()It50li �A''.i;t('±r, 1 F �s , ; ��iw) r ECEI�IED •.: v b ` * " - i t ,q . >. r « . Received City of Tigard Date Permit No.: w (, , at7 a 13125 SW Hall Blvd., Tigard, OR 9722 s V 19 2008 Plan Review Date/By: Other Pen .`. - f_ l ®. Phone: 503.639.4171 Fax: 503.598.1.: Permit: a `= -t" 4 ^ . Inspection Line: 503.639.4175 G Date Ready/By: 1u 63 See Page 2 for 'A R ^D t t I,l ( Internet: www.tigard-or.gov � Q F 11 Notified/Method: 1* Supplemental Information TYPE OF >11G DIVISION PLAN REVIEW ❑ New construction X Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 11 �J 5w Six or or more. occupancy. f 7 �-�t ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: ❑ Healthcare facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 0I71c —Ire. CI) ❑ Service or feeder600 amps or more. FEE SCHEDULE Cross street/directions to job site: Dese iptioo I Qty. 1 Fee. 1 Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family e M C�y� f �3 -,-- L. 4' _ residential (with above sq. ft.) 75.00 2 Services or feeders installation, alt ation, and/or relocation 13 ' - 200 amps or Tess 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 10 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: k Fee for branch circuits with • ❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 3 6.65 2 each branch circuit • Business name: B. Fee for branch circuits Contact name: without service or feeder fee, - 46.85 2 first branch circuit Address: Each add'I branch circuit • • 6.6 5 2 Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: �1J J �`.- rej' iz G , Signal panel, alteration, or circuit(s) or limited - q / energy panel Address: L S 6 e 0 y .T1 r extension. Describe: Paget 2 City/State /ZIP: / OA T L 4•ffi V, y7 2 � '. Each additional inspection over allowable in any of the above 9 Per inspection 62.50 Phone: ( 5 J ) 4 j 7 '% C Fax: (Gl 69 77/ 9-"`"0,5"--- Investigation per hour (t hr min) 62.50 CCB Lic.: / " 7(i4 Electrical Lic.: 2, C —/O% b ' Suprv. Lic.: L f 3 0 5 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Print name: S / ,, ff ` Date: Plan review (25% of permit fee): V "' 18 - State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. ■ 8/4/200S 4:56 PM FROM: Perfect , 3 . N e Perfect Climate TO: 503-59R-1960 PAGE: 003 OF 004 • /A. MerimtAPetlppnit Application , 0 Oct) . , , , 13125 sw i-wil filvd„ Ticltd. OR 972 • II City of Tigard tio . • ar.... --- , Kevin.: ' mime: 503.39,417I Fax: 503.59a. l' 6) ON et scAr" c_ ' aicony: % P. 1";;: ; •! , 13 ...." ;: i rc" i 1 No. s-ra boa' -- 00(5 7 Othcr Nret if: : . titeCtiOn I ,ine ;103.639.417f '''N4. e. N.- t..tri T I GA R D IS ' fo Nriticd: N - ,$)\■ Date Rtraty.Sy: E4 See Pa or Iternee: ge : t n www,tigard-or.gov o14:113..,N1 Skipplcrntntai I aro r o matip I *\k'\9‘ - ..... ......... , - ...... - v pc t» WORK t _ !, COM_NtrAtClAt FEE' SC.:HEDULE - USE (.111:11(1.IST i - - _......_ --; .. - Mtchartie.al pcmit fee,' are based ontlitt valise nf the worl; 0 New conmrc.ction XAdditiory'alteratioliimlloei:men1 re-formed. ludic:at,: the s,alue .t W. 2i3■; Ova rc ij.:11,31 1 Of ,N11 0 DemolitiOn 0 othir . ineehanical. matcstills, cttuipitittll. tatior, averhead, and il'orit CAIEGORY Of CONS"! RUCTION - ,.- --- '" Rf.SIDEN'TIAL 1.01.111 NI CNT 1 S1STENIS P EfS," INf 1- and 2-family dwellin g 0 Om merciarindtistria 0 Ai.ce_:,,sry buildint, mufti- famil 31; _....... 0 i'vlu'..4P:r builder [3 Other: JOB SEI. F. ()R111ArtION AND LOCA'I1C)N -------- , 1-- - . i oticcipri..7a " fr:r :Mum' :qic■rinarrcin VA,' . licititleiCjill k a - — Ai: 4,, htat pump 7 .-- „1 - .------ Osy I Li_ 1 oat - — Jab te --''L- 1 1 -- 1 2- -'!..6 C 1 si address: 1/3 :1 _/„.„., . ,,,,/,__ ' .:tc. , k.ttvA ..1:Cp . sh.v.v . .r.:: v I I - . . 1,.. : City!State,./11": . 0,, -. C.: - -- -2 --7 .' 1 o 7 C73 roll e Suilek.114 RI.: (...., .... ., .„.-_. 1 PP; IJ Oa 11:11110: ■ .....-. _,.„,„..„,.., - , Ftgrtn;:t 160 1:00 ‘ 1311)1.1.1 tl ..T,',..c.64.1 .,..,_ '4, G..s year runp . '14 1.4.1 • :. . ....._ i C.11 sirectidirect ions to loh 3ite. 1)11....t wcYfk, ' 1 1: I !J,0k; . / l . c L,.... to.t - - -1 I 1 tit hal .....a.tr.r . I i ,-",----77— 14 00 c,.,. 1h ; .1 ....--.1 ..ol_er ,ra -IN it kyr 1 . .......... .... 1 1 h'sxlcont4.1 i - 14 I.!11 Unit heater iftict-ryp. not elm-Alio. " I 1 w111,iti.duct sucpendd, en:. i I.1 00 I i 1 F I deiVil i t for .....n of ishoYe 1 ....— Subdivision: I LA'n no.: --- .' - Other „... - 'i ax. f713pipanvt hp,: , ,. 01tier Did applianceN _ _ i . .— . .. ' ; I Water lwater I. ,:, _.' i ' 1 1 I) EscRirrioN OF WORI: z f- 0— ' F / C I ' Cias fir;p1= „, I I 0 o'.1 . Ine star! i if r hk cT or as _ ,1 '..‘ vs. 1-2-, "4 ci,,L) // i,,6><D____ j - 1 ',. ', a%., ...-.. . 1 I I fin_..Tiace I _, --- I al; ii- itcr1cast . ; Yfc.3144.'lfetSlttve , . _ , 1 1p 00 ' 1 , _ --,- - --- i t Wkh.ld fp1ilIn5ett t 1 10 00 1 1 ----- ‘• .--- - - --' I , r;11111fluVliine.:ifitte,:Vertt - - 1 1 I t",,, IP; 1 ---1 1 rRorRrY OWNER 1 0 TENA"I ; ()titer - 0 10 0 1 - ._. .... - .. • . .. _______. Envirimm_i_rit_al_e and vvntilatiari . _. . . 1 cityis.,,,...,: Ckdhes drvcr CNil;iti‘l 1 1 ti.1,1t) I -r• — S.nsIc-diii uxhaust fharhmom5, ■., 1 . Phone: tfir3I ,pc—..5 VD ! ra.,, ( ) . icik.t ..,.Inimiuratti....11,],!;. yrnsi ! 4...so El .1PPI -WAY!' I_ 0 CONT,VC I' PERS()N i AttsefelaiM5pacc. niroi 111011. : CAtter: All3ilICSS name: . Fuel piping C.,...mact name: _ SS.-*; ror fir..t four: S1.0 For each additional ... . -- -. . - _ ...„ „. : 1 rlimace. el, - Addis: -1.- — t. Gas li pump ! . 1 City/St:ft/LIP : V;a1P..,tripenAcd.'unn nc:iter ._ ( ) atr ._ .:. .. 1 -. . ixe hea,.e.r • )on e:. 1 . . 1 :11,e. lace r _ , 7H 11 ial E-mai1, , l, ! i I , P4ime - --- 1 CONTRAE:TOR ' narbo:IP: .__:_l ' Liusine's virile -" Hi_ ) CL__k_C_/ l'E Ad .).4--i,e - , ctutht, dr,..er f F5131 I ..1 - dress: -PO - NJVCIttNICAl. PERMI I l...S h • -4,-- -, "'"--- — . -..... C 'N ''ll'' /1 '.— : if... " , .111. tate", . c ..... ) , „.. ...44.....3.,, - r fir -. / 7-6,-) O , P1al1t _ = - I — Minimum norms re,.' I'S'id .3 il •! i : (57 9/ F av, ( FSe C Plan revie%% 125?..4 of nenn i r. . ., -, __ ., ') ..- . _ C(....13 ke,: / "---,4 . ) .----..- C..' _,, _ :joie sulcharts 1, I 2'.!•,,, ,71" rern tit fz t - , • - ToiA I , PI:RS{1T 'FEE - .. . / --7 -,-,- ,,21 Th;, prrinit aTip ,, rn tinh k'spire if a perma i no ofitainqd ',kith,. lfh, Ani1lori7A Ala tnr,!: / ..._„,_ - , , .., .." . ..- c_ --.---:,._. 41.1., A tier it has htchl,c,:etited As ow - - "t----E] [Prinz narne : v.!) / .e", -- • ... I , ...p..„___5.2.1_, 4 ,40.' _ ..-. , i.,,,, ,,I. (1,, .....1 t..... 1,;..c.. . Stail r t .: h. 1, si Stirs i: rc ,-,-, 1 '; Ddte. .... -- CI , ) ,. -- - 1 .- 1 '.1111:16nETcrr Os; Qi[o.“1:f7 N.... *"......,„ . 1.1 , : s 14:, I 'M kt o.:::CtAIIVI. hi ) >' Zplaon ue ' "� G Building Pe t �n ��tn��7i1 — Residential e� -r�£�3FOR`OFF CE'U SEON � �w: A � '`N 4r ` .: ,. ° ..,. . . :r, . yr , 4.�0 '_, r rc` .j ;, y �; Received a City of'd'igard �C, �� Date/By : � Permit No .:�'/1 9' 13125 SW Hall Blvd., Tigard, OR 97223 � Y/ Plan DateB y: .�j- ,.?6 K y � r 0 Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 p, �,0 1 G A R I Inspection Line: 503.639 �j i 1 Date Ready /By: � Juris: ® See Page 2 for Internet: www.tigard - or.gov �\� (, t' , led/Method: J Supplemental Information �.� 1* � /y iL- • • . TYPE OF ,WORK C,1 *�1� REQUIREDDATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ DemoliiQDl Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of �c+ ist Addition/alteration /replacement ❑ Other: equipment, materials, labor, overld, and the profs tile- CATEGORY OF CONSTRUCTION w ork indicated on this applicatip 6/ - 700 , 36 Valuation: $ e I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 I -•i —I z4 Go i z S-Nei ..,-r . New dwelling area: . 5 - 4 0 square feet City /State /ZIP: --r. 15 A Cam, ei-, Z2 3 Garage /carport area: square feet Suite/bldg. /apt. no.: I Project name: 6 4 l3.4 CG Covered porch area: „,29.K. square feet Cross street/directions to job site: s Deck area: 4,/ g square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 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. Valuation: $ i t 3 SS TOtP (264;Pt 4. ' d N - Existing building area: square feet New building area: square feet PROPERTY OWNER - ❑ TENANT Number of stories: Name: C L 0-t s , c R C' &. Type of construction: Address: 1 1 - 7 ' - 1 2 s A (7r Occupancy groups: City /State /ZIP: -,r-15 a-FA D e C l/ 2-7-- • Existing: Phone: (5 5 2 4- 44-7 [? Fax: ( ) New: ❑ APPLICANT . ❑ CONTACT PERSON. NOTICE Business name: All contractors and subcontractors are required to be Contact name: / 1 A R licensed with the Oregon Construction Contractors Board l3 under ORS 701 and may be required to be licensed in the Address: I 17 4 �.-r� 12 jurisdiction in which work is being performed. If the � ' applicant is exempt from licensing, the following reasons City /State /ZIP: �i ri'� e e, 1 2.2 3 apply: Phone: (503) 34 7 " 9 g 41 Fax: : ( ) V �*, W iv f E- mail: Rg.64 1. msg. oz." M . CONTRACTOR Business name: oU) N Q e BUILDING PERMIT FEES* . Address: . (Pl refer to fee schedule) Structural plan review fee (or deposit): . . City /State /ZIP: Phone: ( ) ( ) FLS plan review fee (if applicable): s Fax: Total fees due upon application: 1s-3 . 38-- CCB lic.: / Amount received: Authorized signature: This permit application expires if a permit is not obtained /,` �-"�, 2_ within 180 days after it has been accepted as complete. * Print name: / 1� l�� Date: Fee methodology set by Tri -County Building Industry Service Board. I:\Building \Petmits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11 /02 /COM/WEB) Building Permit Application Checklist , �` 7 w i t s,v,sr •,- 7„,: 70.,, x . ,.: One- and Two- Family Dwelling f. `;r } FOR r 0FFICE *US ONL n� ts - ', " City of Tigard Received Permit No.: Date/By: Ln v 131 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 0 Electrical El Plumbing 0 Mechanical TIGX Internet: www.tigard- or.gov ❑ Other: t` ' JTHE FOLLOWING ITEM AREaREQUIRED FOR +� A NT'R E VIEW �� , �. e s : No N/A • I 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- ❑ ❑ ❑ bass rotection, etc. 3 C plete sets.of legible plans. Must be drawn to scale, showing conformance to applicable local and state C ..„ ❑ ❑ ❑ bui ' g 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 copyrt vis 1 l Site /plot lan olations drawn exi to t scale. The plan must show lot and building setback dimensions: property corner elevations (if ❑ ❑ ❑ �Jhere i ore than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings '. and foundation, stairs, fireplace construction. thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. I 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- 0 ❑ ❑ 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. `,, ... S PE'CIF1C5 . , , 4 �i6- r �' y .. s,. 7 ` a .. . . 7 , - . k" r w I 23 Five (5) si - plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x ". ❑ ❑ ❑ Two (2)=• s 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 trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and accompanied by the project arborist's signature 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- PemritApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB) a7� ( , 11 Co mmunity Development tV Request for Pe.rrnit Action . qS# TOE CITY OF TIGARD ' GO v vy_ S% Building Division Sevices Coordinator 4:5125 8 NV Hatt 3311d, l'i OR 97223 13 1)IW Pherk.c.: 50,3.7182100 .F.ax; 503.598.190 . c.v7„.r...v.tigard-or,vv . 0 ....., FROM u t.,/wricT 0 A.ppl.ican.t 'Contractor Li City SrAff REFUND OR. N-Arrke: INVOICE TO ": ''''' i.A.,,e .-7\ ,...L.c -r e-i...1 H4. r /0(1, ' ,....... mailin A dat.c23-.., 1 ibc,..,4' ../ i - 7 4.4; cii715t1telZip', a t Of, F1 C")P C 7 - 7 C:') .X:.). — PLEASE T,kKE ACTION FOR - 71-tE ITENI(S) CHECKED (I): [11 CANCEL PET APPLICATION. E3 REFUND P.E.P2Vill' FEEDS ( receipt., if f.: 0 INVOICE FOR FEES DUE Cattach case fee geht-elliJe and 1 beigt..v). 5? REMOVE 10k FROM PERMIT (...i, not crincei peric), _-...., Permit 4.. ;;QPc-.... -:., . - ... 7 - r 7 '7 `7,7: !: "7,7”7: 1, . , ....... . . Sirs: A•dicsi or IA el. ;A:.: / t 7- 7/1 195 - e_,T7 ------- - Ptoje-ct Natne; Lo,tia..i,T1.(i Iii- . -. frz:tftsdivision, 1" a rn.:_ :Nif 4 Lt #: ... EXPLANATION: 4HoOt,_, cA.‘,2 A L,:ik..1-14 r,.. (' 41::: 4,wki..,.1 ',,.. , V :171:1- t -- fit 11 E Etil A 1.014 L e4 sro.,./Y.e.rort, e- ....... ...... „_,!..„ c e ' 1' ) ' -( '7177,t "ii■.:!, ./'...si,"':::,01..., ,..,.. .......,.. L , :, 33ii;YJA10.1.C . . ....._ • • • 1. M.-:: Diro:.tor II/ liuiliiiN ..C4fi Tnr.. !v. 44 •1.".. 0:1 4.-4 M.: • . A. 'in. iv. whlth ',..: nol.rtM;; :::i "Orr ,..of tkc '. rise 1p7,:!iLat.icir. e.r.',7: r.:1:4r. v:L 4 3plicalicy:: 'p v. jt.INit;!.:,....1.. r i.4.;;;Ltt :my :c., c-_ Ilia .bc,.:0111:1:4i;47.44:1j. F ; !.107 rl.Xe e.r.ir: 1 r c:i.f 11..c. '..i.Lrid 'TT Z.:791.K747447, fr,- f:•, k.5lued 7cfirdi F, ktt Ini 11 aln 50 ‘..';.? '1;C" ! 7P f" ulhe.ri .....n.nr.rd..‹ar ;I:. 0. li" oe,v v ,r..!, , ,, r r 1 ■,47c.,1 c ,.. 7 ,/,,, , ...-jo ..;:: ne) e. 'er', ,2F thc. trAtiktir;;:rent fi. ..‘at-1.17•..!piar... 0:7...k.; Iv mr.::irippi7,7 !'.:T. ke„ 45.74.4: 4ifrgpilt: p: ir. er.,r, 11m7 crw.lhee , r....Y. , :lic.11 paFcrtm: v- rcavo :.=.1p54, .%;:vrir (-7 TsztckF ecf KaCtiMrle till't;.04.1 FOP, 01 USI 0 N tx f0 Syt ,141fttio.. 0111, / .-1111%,,i1 Rte. ki- 1de .ArircLiii: rz.o, to/A/2 , AINEEZr'' 1r.el. Ane.1 Proccw7. '. plit Al /, 5-: !; ' I ProcesEtd-; Date 1 ...iP.Y._.............___i E1 1:scrstic Can..-„eitzi I Due:. ,v / 11„iry 1 ....pac-_.L .... rari± , :isc1. , r .... . .E3v ii ;Rr.,cciv, -#.. 1 .6.9.tc. 1 34.ei..tRul l'ahaYtIgiE . . . R,....,: ri,IZA'.,;(i7 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST 2008-00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2008 Phone: (503) 639 -4171 4,',�,� Inspection Requests (24 Hrs.): (503) 639 -4175 '=. "_.. INSPECTION WORKSHEET FOR DATE: 7/25/2008 TIME: 7:00AM PAGE: _. 33 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT # 137 TYPE OF USE: PROJECT NAME: GAR STECK DESCRIPTION: 560 sf addition.Mechanical other - duct work. Plumbing other ice maker. OWNER: GARSTECK, CHRIS PHONE #: 603 - 524.4970 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/2 &2008 Pour Time: Code # Inspection Description Confirm # Contact # - Message 310 Crawl drain 073201-01 503-933-2557 Y Corrections /Comments/ Instructions: E ac , k.f; L., r. SA/ Vi c., v , t V&A Ov- { vim-- e o ' et % %A S'vr of u .-.Iv c--t.0„/ PASS ❑ PARTIAL APPROVAL ❑ CANCEL Li NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: cbV+ - _41 A \,'^�'- Date: 7 /24OTI Phone #: (503) 718- ,.,,,. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20 0 f 00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 607 /2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 s' 1 .. INSPECTION WORKSHEET FOR DATE: 7/2512008 TIME: 7:OOAM PAGE: 32 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. OWNER: GARSTECK, CHRIS - PHONE #: 503 -524 -4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 7/25/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 073201 -02 503- 933 -2557 Y Corrections /Comments/ Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 1 Inspector: i h^'� Date: — 7 )9 s l 11Q1 Phone #: (503) 718- This form is recognized by most t3uilding Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. ih BUILDING DIVISION - CA' Ro / 'TIC MITT L LETTER • TO: _,A: , . / ,. / , .! 5. DATE RECEIVED: DEPT: BUI • ING DIVIS' ON RECEIVED NOV 19 2008 FROM: CAS fr. nFr - 1•j'D W-owJEK CITY OF I IS ON _ T�`u, BUILD COMPANY: p1Qd14 j_t K &AA- eZV S'ru �� . - PHONE: 5b3-- P -44-SS- (1___3 RE: I t 77 `t. S w 1 Gl2 f r L o— c)c)(xZ ( ite Address) (Permit/Case Number) (Project name or s name and lot number) • ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: �' °SS wu< (s ) p �d/ rt d6 U.,".1hcwS Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: /,<J S j'E c; E..,( J- ck) t-tEs7 <SWSI't.1 SS l aJ eg= &i...A ss llL...oc<<. kfl Aida to p1e,4 w f,.c�s la ge J c ,� n -( C tI L- 1. i-c Pc-A041 FOR OFFICE USE ONLY Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes ❑ No Fee Description: Amount Due: $ $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: \uildingWons\Transmina1LetterRevisions.doc 4/4/07 CITY OF TIGARD ' - _. BUILDING DIVISION PERMIT #: MSI200B -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2001 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 m °'I �.� INSPECTION WORKSHEET FOR DATE: 1/14/2o09 TIME: 7:01AM PAGE: Q4 SITE ADDRESS: 11774 SW 126TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 660 sf. additian.MEC other -duct work. PLM other- ice maker. 8/6/08 add range vent., gas to fireplace, range, barhecue.11 /19/013, adding elc service. OWNER: GARSTECK, CHRIS PHONE #: 503 -524 -4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/14/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 079612 -01 971- 219 -3803 N Corrections /Comme� /Instr�nl (1 1 1 (-- )(1 )21._p_Ass ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION i PERMIT #: MST2008-00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2711008 Phone: (503) 639-4171 Atm,Ai et, Inspection Requests (24 Hrs.): (503) 639-4175 _.:.14.77411 INSPECTION WORKSHEET FOR DATE: 1/8/2009 TIME: 7 PAGE: 23 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 M. addition.iviEC other-duct work. PLM other- ice maker. 8/6/08 add range vent, gas to fireplace., range, barbecue.11/19/08, adding elc service. OWNER: GARSTECK, CHRIS I ‘ PHONE #: 50:3-624-4979 CONTRACTOR: OWNER / PHONE #: t•-- . ?-r-a•r Ca Inspection Request Scheduled For: Date: 1/8/2009 Pour Time: cc e_.e.55-- Code # Inspection Description Confirm # . Contact # Mes 610 Gas line 07949501 971-219-3803 ...._.---------) / 6° Corrections/Comments/Instructions: er(i. z JO .N-kk 1 PAS ------ 1 PARTIAL APPROVAL E CANCEL 0 NO ACCESS ry: FAIL 1:11 CALL FOR INSPECTION Ei ADDITIONAL FEES ASSESSED Inspector: LId/14).? — Date: 1; 0 Phone #: (503) 718- CITY OFTIGARD -- BUILDING DIVISION PERMIT #: c• (vial2t00 -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2008 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . ': 6 INSPECTION WORKSHEET FOR DATE: 1/8/2009 T :00AM PAGE: 24 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.MEC other- duct work. PLM other- ice maker. 8/6/08 add range vent, gas to fireplace, range, barbecue.11 /19/08, adding elc service. OWNER: GARSTECK, CHRIS , Q PHONE #: 503- 524 -4979 CONTRACTOR: OWNER f� > PHONE #: IIIJJJ//"' fit I -- 0-1r. Lr-t al/ Inspection Request Scheduled For: Date: 118/2009 ` Pour Time: -e5 — Code # , Inspection Description Confirm # Contact # Me g 275 Framing 079494-01 971-219,-3803 Y kr t a d Corrections /C ments /Instructions:rf" \CI ' 5 LA) SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Ins ector: Vicii. V u Date: , �I b � P Phone #: (503) 718 - CITY OF TIGARD - BUILDING DIVISION - PERMIT #:'TZ0s ogor4 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 81;171 � Phone: (503) 639 -4171 A, Inspection Requests (24 Hrs.): (503) 639-4175 „rill, INSPECTION WORKSHEET FOR DATE: 1/8/2OO9 TIME: 7:OOAm PAGE: 22 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: r;€;o sf. addition.MFC other -duct work. PI..M other- ice maker. 8/6/08 add range vent., gas to fireplace, range, barbecue.11 /19/OB, adding elc service. OWNER: GARSTECK, CHRIS PHONE #: 503.524 -4979 CONTRACTOR: OWNER PHONE #: 1 I il ?Ni t IV c Inspection Request Scheduled For: Date: 1/812009 Pour Ti e: a',LL.es 5 --- Code # Inspection Description Confirm # Contact # Mes:..: 20O Insulation 079497 -01 971 -219 -3803 ...________- --- e TA Corrections /Comments /Instructions: 0°4° A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED WI Inspector: Date: ' 00 Phone #: (503) 718 CITY OF TIGARD All BUILDING DIVISION ' #: MS[20013 -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27 /2000 Phone: (503) 639 -4171 A. 1 rl 1 Inspection Requests (24 Hrs.): (503) 639-4175 �__ INSPECTION WORKSHEET FOR DATE: 12/30/2008 TIME: 7:00AM PAGE: 19 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 1 TYPE OF USE: • PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.MEC other -duct work. PLM other- ice maker. 8/6108 add range vent, ga to fireplace, range, barhecue.1 1/19/08, adding olc service. OWNER: GARSTECK, CHRIS PHONE #: x53..574- 4979 CONTRACTOR: OWNER . PHONE #: Inspec ,*,,u,1 Regygst Scheduled For: Date: •12/30/2000 Pour Time: Code # nspection Description Confirm # Contact # Mes-x ge A/ - M " 276 Framing 0 /13.01 971.219 -3803 Y Corrections /Comments/ Instructions: 0 q S c)- Af d r-, s - ci-t_e__S u_fL, L.-1,- Se-e_, - ,f 1,6,7.. /0c f s -1`z `- ` e , f p 9- " 6, Liz-R-4f (_,t. W I i ,-- s t, 0 ind-eje-0--- (...4 ,c -N pre_ iz c-a , ., a „, c„.:.- —A„.. _, . ” 'i ' .T c (,<1LQ 1 . • 7 4. 7 , L ` 0 __,,,._ -,s Ci t , L_d-- 41124 ,, Q i '' \ k i______ ) ' S s - A 171 A . CEv y(I- - vim. (1 c e ) . n PASS ❑ PARTIAL APPROVAL ❑ CANCEL r: 0 ACCESS L LQALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED // Inspector: � Date: , .W 3 a `� a P #: (503) 718- — r P CITY OF TIGARD ' BUILDING DIVISION - PERMIT #: MST200R -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27 /2OOB Phone: (503) 639 -4171 'lift Inspection Requests (24 Hrs.): (503) 639 -4175 °__ INSPECTION WORKSHEET FOR DATE: 12/30/2008 TIME: 7 :fj0AM PAGE: 15 • SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: l;,G() si. addition.Mf =C other-duct work. PLM other- ice maker. 8 /6/08 add range vent, gas to fireplace, range, barbec:ue.11 /19108, adding elc service. OWNER: GARSTECK, CHRIS PHONE #: 50.> 524 -4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/30/2008 Pour T e: Code # Inspection Description Confirm # Contact # Mes ge 699 Mechanical final 079252 -01 503 -491 -4848 Y Corrections /Comments/ Instructions: 0 q - ,mo D o ( A -0- __ ' t- f `'-.(---f ("Jot- lam► 5 R- 1 1 A V/ AL V A- /_) fiLK ki CV 06.,,,,, prri2.47 .QN' ( ta. c_e_ etti 4) - V r . ti U Ti ' 4 1 PASS PARTIAL APPROVAL 61 CANCEL r NO ACCESS li AIL A.CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: \le" G v Date: 1 ?I 6 6' Phone #: (503) 718 - 9) " / may CITY OF TIGARD "' 1 BUILDING DIVISION PERMIT #: MST200B -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/20013 Phone: (503) 639 -4171 I�L� Inspection Requests (24 Hrs.): (503) 639 -4175 '� -_.. INSPECTION WORKSHEET FOR DATE: 11/17/2008 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 1,60 sf. addition.Mechanic::sl other -duct work. Plumbing other- ice maker. 0/6/00 add range vent /duct 1 to range, gas to fireplace, range, barbecue 1 OWNER: GARSTECK, CHRIS PHONE #: 503 -524 -4970 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Sh WIC walls/anchors 078016-01 503 -7813 -4455 N Corrections /Comments / Instructions: r ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS . ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /) 17 - Phone #: (503) 718 - __. . , • , CITY OF TIGARD --- ,, BUILDING DIVISION - PERMIT #: MST2008.00014 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 60712008 Phone: (503) 639-4171 .1 Inspection Requests (24 Hrs.): (503) 639-4175 „......... 1!. INSPECTION WORKSHEET FOR DATE: 11/17/2008 TIME: 7 PAGE: 28 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT _ _ #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sr. additionlvlechanica/ other-duct work. Plumbing other- ice maker, 8/6)08 add rangelrentidud to range:, gas to fireplace, range, barbecue OWNER: GARSTECK, CHRIS PHONE #: 603-524-4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 078015-01 503-788-4455 N Corrections/Comments/Instructions: laP 4_ _ - .2r i . --4 f --_ ,- p 5:7 _A- 04d 1440 (-4-/Ye.A94. ( ----2e4-c-l-t -"'',: ei':- y e) ''RstC i yel cer5 49L1-rt..45 -71 - - • ..„5 . . : 5 ri PASS --- D PARTIAL APPROVAL 0 CANCEL 111 NO ACCESS FAIL E CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inepector /. _1 Date: // — 0 a Phone #: (503) 718- CITY OF TIGARD _ ' BUILDING DIVISION PERMIT #: Sr2pa 00074 13125 SW Hall Blvd., Tigard, OR 97223 al, DATE ISSUED: 6/27/200t1 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 '_ F''I.1 INSPECTION WORKSHEET FOR DATE: 10/7/2008 TIME: •�. PAGE: 31 SITE ADDRESS: CLASS OF WORK: SUBDIVISION: 11774 SW 125TH t i' LOT #: TYPE OF USE: PROJECT NAME: VILLAGE AT SUMMER LAKE PARK 4 137 DESCRIPTION: GARSTECK 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. 8/6908 add range vent/duct to range, gas, to fireplace, range., barbecue OWNER: GARS'f ECK, CHRIS PHONE #: 503.524 - 4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/7/2408 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 g 8- Framing 076339.02 503. 960 -9477 N Corrections /Comments /Instructions: .See Per J4 9 - .2 - oc, (2 r) ,() © ��r , A' c) c7 - o g ( e lec4 ∎�,.1 iRovck 1?-e� e. 'crc c/ 2). Sl'iec:, )(A y r vcic.I 4 1 .) Veit •,1 tiev1.1-',1a 1 3 Z. kr, '� e -, 7 Jo #k %; J £-S 01 e. ( ir&n' H J4 0.0 PkH - � /06,40... : - � e , elna� :<< (.1 ( 5k � gu � ; .rec) ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS. n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED v Inspector: Date: 1 oG'rOd Phone #: (503) 718- 2 J CITY OF TIGARD ' BUILDING DIVISION PERMIT #: c .. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 000 OnOl4 6/ f . Phone: (503) 639 -4171 " f�� 612712 ?08 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/6/2008 TIME: 7:0QA PAGE: 1 • SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.lvlechanic,el other - duct work. Plumbing ether ice rnaker. 816108 add range vent/duct to range, gas to fireplace, range, barbecue OWNER: GAR )TECK CHRIS PHONE #: 503 -524 -4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1016/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 236 Shear vvalls/anchors 076339.01 503 - 960 -9477 Y Corrections / Instructions: J/ 4/• 4-+ Di✓ _ IV l] PASS ❑ PARTIAL APPROVAL El CANCEL O ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector:. Date: /6-6. r-e, v Phone #: (503) 718- <'4 • CITY OF TIGARD BUILDING DIVISION PERMIT #: Iv9S1200t3 00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/20911 Phone: (503) 639 -4171 i , Inspection Requests (24 Hrs.): (503) 639 -4175 7� INSPECTION WORKSHEET FOR DATE: 9/76/ ?008 TIME: 7 PAGE: 7 SITE ADDRESS: 11774 Emf 1251 CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: . 137 TYPE OF USE: PROJECT NAME: t;ARSTECK DESCRIPTION: s sf. addition.Moc:hanical other -duct. work. Plumbing other- ice maker. W6108 add range vent/duct to range, gas to fireplace, range, barbecue OWNER: GARSTECI{ CHRIS PHONE #: 503 -574 -4979. CONTRACTOR: OWNER #: Inspection Request Scheduled For: Date: 9/26/2008 Pour Time: Code # inspection Description Confirm # Contact # Message 275 Framing 075986.01 503960 9477 N Corrections /Comm nts /Instructions: 0 N o-4 : . �k �� . g/A 0/6 (YA9 - ;c (LO 1v-- (Ze,..,0„ ‘& 5 1,.\.. . . .-(c -k.zo.,/e.,ep r bLit t*-- . 671) U C.v ; 4-ri ,9-,". A v .Q.,,,.t 4'. r-k...-0-e„s-c- ' z) kj o-0 g, ikes n:o -.> (d 0'42, OA (iv% • Lo 3 I Q ' ) 2 - ant - - - 2 f \ `J�v ,�,;,.. 64E___. 0 6-1--Lo_r LA„itt vv,, c-0(3.___ a &&,. -- L,,,,, a.. N.,e_e-r-c .A---23 \-2-e___ --../.._ ..g32AietiL,c_A---- c .. r. - ----7 )--( 4 0 &A/1..., , Kit,k 6, -JA , L.0-1A 1- 4- , c 0 ASS ❑ L'12-- PARTIAL APPROVAI ❑ CANCEL ❑ NO ACCESS $2 FA CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED / V 0 Inspector: i4c 4111 v Date: / r Phone #: (503) 718 - 74 Zfilf CITY OF TIGARD ' _ BUILDING DIVISION PERMIT #: t isT2oOt 00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6127/2000 Phone: (503) 639 - 4171 lisa " , i , i Inspection Requests (24 Hrs.): (503) 639 -4175 ell' 0, INSPECTION WORKSHEET FOR DATE: 9/26/2000 TI • 7 :00AM PAGE: 6 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: r 6O sf addition.Mechanical other -duct work. Plumbing other- ice maker. 816/08 add range vent/duct to range, gas to fireplace, range, barbecue OWNER: GARSTECK, CHRIS PHONE #: 503 - 524 -4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/26/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 23 €, Shear walls/anchors 075986 02 503 961)-9477 N Corrections /Comments /I str.. ctions: � 11,.. ) RAO I II --- .. I /A ■ a .1 . ..4 . tGA 4 14 ) ' a q , ❑ PASS a P' - IAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL vj CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 0 �lX I Phone #: 503 718- 2i I Inspector: Date: ( ) CITY OF TIGARD BUILDING DIVISION . #: MST2008- 00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2712008 Phone: (503) 639 -4171 A , Inspection Requests (24 Hrs.): (503) 639 -4175 s' '` _._.. INSPECTION WORKSHEET FOR DATE: 9/10 /2008 TIME: 7:U0AM PAGE: 1 SITE ADDRESS: 11174 SW 125111 CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. 8/6/08 add range vent/duct to range, as to fireplace, range, barbecue OWNER: GARSTECK, CHRIS PHONE #: 503 - 524-4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/1012008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 075330.01 603.933-0407 N Corrections /Comments /Instructions: Al , FLfc� i.¢L / (iLP r°) = 2 N-L-L i ti Sri A.a-u. 4,,,,C/ -..4- ri 2 ♦ o F (may ,/u L . ,4 , / - w,,/ _i'"_. o.1 ,' .T • ❑ PA ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: D ate: . / - -p Phone #: 503 718- ,c4.Ei-�f ' p - 1 • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200R.00074 13125 SW Hall Blvd., Tigard, OR 97223 411110 DATE ISSUED: 6/27/2001) Phone: (503) 639 -4171 111 Inspection Requests (24 Hrs.): (503) 639 -4175 .�' e 7 INSPECTION WORKSHEET FOR DATE: 8/20/2008 TIME: 7:02AM PAGE: 7 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical . other -duct work. Plumbing other- ice maker. 8/6/08 add range vent/duct to range, gas to fireplace, range, barbecue OWNER: GARSTECK, CHRIS PHONE #: 503..524 -4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/20/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 074414-01 503-933-0407 N Corrections /Comments/ Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: c9-- 26-0-6 Phone #: (503) 718- CITY OF TIGARD y_. BUILDING DIVISION PERMIT #: MST2008.00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/ 27/2008 Phone: (503) 639 - 4171 " , , p0' Inspection Requests (24 Hrs.): (503) 639 -4175 ':� $1.. `'I I.. INSPECTION WORKSHEET FOR DATE: 8/7/2008 TIME: 7:01AM PAGE: 25 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: (ARC TECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing othe,- ice maker. M/08 add range vent/duct to range, gas to fireplace, range, barbecue OWNER: GARSTECK, CHRIS PHONE #: 503 - 5244979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 8/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post /beam structural 073881 -01 503. 933 -2557 N Corrections /Comments /Instructions: ) "5 b1 )cct i - \ \\ OM Yta l 1 ,l1C4e.i G �,a" CI> �■ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 2•S Date: 77i9v Of Phone #: (503) 718- 2/.-r CITY OF TIGARD BUILDING DIVISION PERMIT #: MSr200 -00074 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/27/2008 Phone: (503) 639 -4171 A It Inspection Requests (24 Hrs.): (503) 639 -4175 .... INSPECTION WORKSHEET FOR DATE: 817/2008 TIME 7:O1AM PAGE: 24 SITE ADDRESS: 11774 SW 125TH i CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT # 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. 8/6l08 add range ventlduct to range, gas to fireplace, range, barbecue OWNER: PHONE #: F (3ARSTECK, CHRIS ,03 - 52.4 - 4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/7 /7008 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 073882 -01 503.933 -2557 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 7s Date: ? "Vv 0e Phone #: (503) 718- - ya CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2008 Phone: (503) 639 -4171 � 1 Inspection Requests (24 Hrs.): (503) 639 -4175 ,_ I.. INSPECTION WORKSHEET FOR DATE: 8/7/2008 TIME: 7 :01AM PAGE: 23 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: .137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanic l other - duct work. Plumbing other- ice maker. 8/6/08 add range vent /duct . to range, gas to fireplace, range, barbecue OWNER: GARSTECK, CHRIS PHONE #: 503- 524 -4373 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 8/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 073882 -02 503 -833 -2557 N Corrections/Comments/Instructions: J C GAivC 12.1 11m�Q, 0. --eir� ka *. 1 , . fie) / , , , ,c,-- _ tom ❑ PASS ❑ PARTIAL APPROVAL c CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: f S Date: - 94. Phone #: (503) 718- 24U3 CITY OF TIGARD r BUILDING DIVISION PERMIT #: MST2008.00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6127/2008 Phone: (503) 639 -4171 AA , Inspection Requests (24 Hrs.): (503) 639 -4175 '.: `'I f .. INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 32 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. OWNER: GARSTECK, CHRIS PHONE #: 503. 524 - 4978 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7117/2008 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 072808 -02 503-933-2557 N Corrections /Comments/ Instructions: v t t d zse1 i,2- .` 51 Z1.5 , . i ., ,. h - , w P ASS • ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . / Date: 7---/7-0 Phone #: (503) 718 - -4-5— CITY OF TIGARD BUILDING DIVISION \ PERMIT #: MST2008 -00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2008 Phone: (503) 639 - 4171 " 't' l Inspect Requests (24 Hrs.): (503) 639 -4175 I 1 .. INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:OOAM PAGE: 33 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. OWNER: GARSTECK, CHRIS PHONE #: 503 -524- 4979- CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/17/2008 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 072808 -01 503.933 -2557 N Corrections /Comments/ Instructions: /n4 Sjt-e- 5 Y.= "-z o2 C414.4.0 1 om -- e;. y‘r- • PASS ❑ PARTIAL APPROVAL CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: - 7- / 7 -z Phone #: (503) 718- -2-CAZ. • CITY OF TIGARD BUILDING DIVISION PERMIT #: M;3T2008.00074 13125 SW Hall. Blvd., Tigard, OR 97223 DATE ISSUED: 6127/200E3 Phone: (503) 639 -4171 AA, ; p�'I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:00AM PAGE: 28 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct. work. Plumbing other- ice maker. OWNER: GARSTECK, CHRIS PHONE #: 503 -524 -48"/3 - CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For:. Date: 7/16/2008 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 072716-01 503833.2557 N • Corrections /Comments / Instructions: (Ji O—i6 &Ai • ❑ PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 746 —d 8 Phone #: (503) 718- _23. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00014 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 560 sf. addition.Mechanical other -duct work. Plumbing other- ice maker. OWNER: GARSTECK, CHRIS PHONE #: 603-624-4979 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/16/2008 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 072716-02 503-933-2557 N Corrections /Comments/ Instructions: ititk O Gi✓ $' 7 ; ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- _Mc,-FZ. City of Tigard, Oregon Page 1 of 2 City of Tigard ,iregon �=; , Q „, , tit_ ?•, ti ll% /bell Bird • Ifgarrd, (1IZ )',.. ?,t W t? 4 C P j.cjj1 .� I 4 a r �- S : .in i 6 5 9 - II - / .: \ 01' 1 ' 1 - i ' ' . .:.„ . . : ,[ r Hi " AllacetoCallHome” I Search 1 Property ft — Planning 11 Crimes I Transportation lir Utilities 1 Aerials I EOC 1 1 1 Summary 1 Permit Summary 1 Community 1 Hazards 1 Explorer 1 11774 SW 125TH CT Property Summary 5umnrettake Pare • S emmer Hats Park Q 0 411 411 V. N • J Gj Caps tune . OP��.. WINTERLAKE DR - .— - _ ' Metes ton ' 1s. - — FALCON RISE DR - _ ,._- C - ' . z 1— . tN - - - N �.. .. C.7 4yoo dward ES , ... - r . - 1 Wind,niY W \le.y Yiaxttr:r £ r rr._•r, > , --- _- •_. -- -J • C N KATHERINE ST,..._ _. ' _ Property Owner Info Tax ID Number: 1S133DD10000 Tax Account Number: R2010622 Site Address: 11774 SW 125TH CT Site City: Site ZIP: 97223 Owner: GARSTECK, CHRISTINE Owner 2: 11774 SW 125TH CT Owner 3: Owner Address: Owner City: TIGARD Owner State: OR Owner ZIP: 97223 Acres: 0.16 Sq Ft: 6,969.6 Bldg SF: 1,877.00 Bldg Value: $ 139,800 Land Value: $ 178,000 Total Value: $ 317,800 Taxable Ass'd Value: $ 187,680 Sale Price: $ 121,635 Sale Date: 08/07/91 Year Built: 1991 District & Community Info Municipality: Tigard . Tigard Urban Sery Bndry: YES http: / /tiggisiw /mox52_multimap/ index. cfm? fuseaction= property.summary &CFID = 67848 &CFTOKEN =... 12/11/2008 CITY OF TIGARD - - BUILDING DIVISION PERMIT #: MST2008.00074 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2008 Phone: (503) 639 -4171 V Inspection Requests (24 Hrs.): (503) 639 -4175 °'I INSPECTION WORKSHEET FOR DATE: 12/11/2008 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 11714 SW 125TH CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE: PROJECT NAME: GARSTECK DESCRIPTION: 56 0 sf. addition.MEC other - duct work PLM other- ice maker. 8/6/08 add range vent, gas to fireplace, range, barhecue.11 /18108, adding elc service. OWNER: GARSTECK, CHRIS PHONE #: 503 -524 -4979 CONTRACTOR: O% ER S I L' f n N C n' , „, Wey: Inspection Request Scheduled For: Date: 12/11/2008 Pour Time: Code # - Inspection Description on it Contact # Message 120 Electrical rou h -in 078885 -01 971 - 219 -3803 N Corrections /Comments/ Instructions: )1\f© 06 1 b6 • - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ F' IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6g L Date: i �[ t J '$ Phone #: (503) 718- p kj MapOptix 5.2 Interface Page 1 of 1 • Tools - li City of Tigard MAPOLATER BETA n Meadows P W - N Dm Kiteo alk C OHV, . a I n h - -HAWKS 8EA — m _ � L J t e _ C L -1 J �—j Guay /li RD ST �^m t j do `• • L~l �� , � ' ` ..� i O t — } � _ CestPZ at Brittany f )!------- ' \ ,th ' - _ t ? r-1 E /) \� ;_,� , t� W inter Lake OMe' - _ I a. a 135th Ave `-' -' -'• - -- _ - /j Summer Lake" --'- --- u+ — " S W 135th and $clioas ft ! � � ' • O r" :*- ' �° V. - 0 6-7 4 { — a . j � �� 1 r — w� ir,......_„,_ , _.„, % —" 1 S umnrertake Park I Jf ,r ut Selection O u -I) ,f j - \�— ( - .. 4 0 p- !. , .,,,,___ ; ( o „s - cci' ls ‘ °... 0 I.. , it ;,'''' i =° = I q n ,,,,t-sm.,,t , , g r) i --I-1 7 so,, • do 0 I a ,``fi l Y i ; s, / / �, ` l' I 1 rO6A �df \ ` C ....../r----\\ � Q _ �� / Summer hLGS PerA • M ,; ∎t�tl r . S u R i �wINTEaLAKE * A I i • - �.0 r Capstone „ - :u.cit © r.. Wiz 8 ti � t' 'a ; � Woodward E5, e W -- LAURLtcm r DR _�' E. j �_° 1 r� —s _ N I r .1 : 1 ,I 1 ' -d. C It f T r Mmmtiiii3f a Open Space :_ - RtS6 , 1\ 1l r 7 9 I i I ; l I' fiti System Tabular Results Query Results , '`, [ I '-P f I Address 1 1 L Address Search (1 - 1 of 1 Record) Address Street City ZIP Code State Tax Account Number Tax Lot ID Situs '' c 11774 SW 125TH CTi 125TH TIGARD 97223 OR R2010622 1S133DD10000 0 i http: / /tiggisiw /mox52 /staff.cfm ?action= mox52_if tigard &screenHeight= 840 &screen Width... 6/5/2008 Electrical Permit Application P , . 4„,t. ` > � FOR ;OFFICE USE ONL 4 _ < 'a - Received r I e - City of Tigard DateB : )-0 ! A / Permit No.i �Lr�4j p — e�7T'v 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review 11 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: - ) � r i Inspection Line: 503.639.4175 Date Ready /By: J Juris: RI See Page 2 for F T I C. . . Internet: www.tigard - or.gov Notified/Method: A - ( //O • "' Supplemental Information TYPE OF WORK ,. "PLAN: REVIEW ❑ New construction K1 Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. ' CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB' SITE' INFORMATION. AND LOCATION ' . ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "I - ", • Job no.: Job site address: //77V 5-Gt.) Gr 1 OOHP or more. occupancy. ❑ Recreational vehicle parks. ❑ Six or more residential units. P City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than 77 i ] � n / \ / 7 z T ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE - Cross street/directions to job site: Descriptio 1 Qty. I Fee. 1 Total 1 • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 < Limited energy, multi - family / X % r /Ve‘c2 / / l/4"✓ residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER . .. ❑: TENANT . 201 amps to 400 amps 106.85 2 egg/ .5 t4 , ��L 401 amps to 600 amps 160.60 2 • Name: G l 1 5 601 amps to 1,000 amps 240.60 2 Address: // 7 7g/ Sw /,01.5- _ " Over 1,000 amps or volts 454.65 2 City /State /ZIP: f y N /l� �7 Temporary services or feeders installation, alteration, and/or /Tic relocation Phone:- ) , 5,,w— 99 % Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑. : APPLICANT. . ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: l � c // wishut service or feeder fee, , 46.85 2 1 4 `/5 2t-FL first branch circuit L Each add'I branch circuit 6.65 2 Address: / l .77y s. /,2c� C� Miscellaneous (service or feeder t included) City/State /ZIP: -7 ski` 9 7 z� Each manufactured or modular 90.90 2 / dwelling, service and/or feeder Phone: ) . 3 y 7 - ' , . 5 - 1 , / / Fax: : ( ) Reconnect only 66.85 2 E -mail: C. 17 r.4 C! 095,0- ( '-7 Pump or irrigation circle 53.40 2 / 'CONTRACTOR ( ,, L � Sign or outline lighting 53.40 2 Business name: 1 } ` r g /( / p G Signal circuit(s) or limited - ? - energy panel, alteration, or Address: S/ 7/ S ((r ' A 4 \ & extension. Describe: Page 2 2 City/State /ZIP: A.L d(iv((/ Of- q'7 Each additional inspection over allowable in any of the above r . � Per inspection 62.50 Phone: Yom) )C-3t�_ �l >/.29 Fax: ( ) Investigation per hour (I hr min) 62.50 CCB Lic.: l ( �� ' / Electrical Lic.:a,Lj. �C(UG Suprv. Lic.: t�� Industrial plant per hour 73.75 t ELECTRICAL PERMIT FEES Suprv. Elec s ign ure, required: lU /� �J Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized i signature: __ TOTAL PERMIT FEE: � j Date./f;,... This permit application expires if a permit is not obtained within 180 Print name' /./ v / Z3 days after it has been accepted as complete. * Number of inspections allowed per permit. 11Building\ Permits \ELC- PermitApp.doc 05/23 /06 440 -46 t5T(11 /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: "` Fee for Al residential systems combined ... $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* H Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC H Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 4.' a r1' tv " , .r R -a , ^r ai ° .: ?:_ � o Mechanical Permit Application r n ? _-FOR OFFIC ONLY , aa:P x 'fi :: R eceived City of Tigard Permit No.: 131 Hall lvd., Tigard, OR 97223 Plan Re : '. /. rem Iiw ^ ,a_ 8� r' P� � 'S , "' ' Phone: 503.639.4171 Fax: 503.598.1960 Plan Review DateB Other Permit: , f I .TIGAI I� Date Read Inspection Line: 503.639.4175 NM HI S Page e t Ready/By: Y Interne: www.tigard- or.gov Notified/Method: r1` 7 Qt� 4 4 Supplemental Information TYPE OF WORK , • COMMERCIAL: FEE* . SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction I fk Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION., .. .. Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Air conditioning or heat pump Job site address: //77y S�■ /��j�' t ?tom (requires site plan showing placement) 14.00 City /State /ZIP: �j r1 71 `7i="z 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 ( 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Flue /vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances ' DESCRIPTION` OF WORK . . Water heater 10.00 Gas fireplace 10.00 /9X 3.- i /54:1 c I. 71---+ 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 PROPERTY OWNER Chimney /liner /flue /vent 10.00 ❑ TENANT= Other 10.00 Name: C c is %4 Environmental exhaust and ventilation 7 -/ `�� Range hood/other kitchen Address: //7l7 S(.,GJ / C equipment 1 I 10.00 City /State /ZIP: e .,/ Q� 97:20-' Clothes dryer exhaust 10.00 //� Single -duct exhaust (bathrooms, Phone: •3) .2 '7 7 � Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON • Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: Gr e, Pp $5.40 for first four; 51.00 for each additional Address: //77/ J? /-7-c--.±:(--- zxt- Furnace, etc. Gas heat pump City /State /ZIP: -/.j, o e f�� -z5 Wall /suspended/unit heater Phone: ' 3.� 4, Fax: : ( ) Water heater ��) ,13417._ Fireplace E- mail:e �- /t�e gy5; . ,Cary.--7 Range - CONTRACTOR Barbecue / G ot c / - _ / - . Clothes dryer (gas) Business name: T[ ,(,� Other: Address: /7 . � ,,,,k y ) 1,60 7 <0 � j �j MECHANICAL PERMIT FEES* City /State /ZIP: 6 `te r "az� f /01 /1 / Subtotal Minimum permit fee ($72.50) Phone: (9)3) L 9/ - C Yr Fax: ( ) Plan review (25% of permit fee) CCB lic.: if gLf State surcharge (12% of permit fee) / TOTAL PERMIT FEE Authorized signatur This permit application expires if a permit is not obtained within 180 ��i!�� ^�� days after it hss been accepted as complete Print name: Date: 0O * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 440 -46171' (1 I/02 /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 $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or • fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $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: \Building\Permits\MEC- PermitApp.doc 01/19/07 2 Plumbing Permit Application Building Fixtures � "* FOR,OFFICE' USEONLYiwt x ' 't r „ City of Tigard Deceived Permit No.' io, - - V , "a 13125 SW Hall Blvd., Tigard, OR 97223 y 5 1I " �, Plan Review II Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No.: Date/By: 4. 1. _ Tw a ICA'RDi Ready /By: Inspection Line: 503.639.4175 D ate Read /B y +c ris el See Page 2 for �y . r I nternet: www.tigard or.gov Notified/Method: 0 ®p III ,1` Supplemental Information - TYPE OF WORK : • FEE* SCHEDULE . ❑ New construction ❑ Demolition For special information use checklist Description Qty. 1 Ea. 1 Total i Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) - CATEGORY OF CONSTRUCTION . SFR (1) bath 249.20 ep 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 • ' :JOB ' SIT I AND L Site utilities • Job site address: " // /y �f /2' _ Catch basin or area drain 16.60 / City /State /ZIP: / / G /9�G 62 c�3 Drywell, leach line, or trench drain I 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: iUU) ( Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 D ESCRIPTION OF WORK / . Backflow preventer Page 2 /y[ v 3 /. iJ 4 , . �, 4"). -=-. Backwater valve 16.60 Clothes washer 16.60 Dishwasher ( 16.60 0 " PROPERTY OWNER . I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 /,/ Name: ! !O/D� f t '- i( Expansion tank 16.60 Address: / 7 7 1,4.d. /° t C-1 = Fixture /sewer cap 16.60 City /State /ZIP:7 / f.. Oie y,.7�'2.-3 Floor drain/floor sink/hub 16.60 c Fax: Phone: (� ) ( ) Garbage disposal 16.60 Hose bib 16.60 • ' ❑ APPLICANT ❑ CONTACT PERSON• . Ice maker ( 16.60 Business name: Interceptor /grease trap 16.60 Contact name: t�)rL( Medical gas (value: $ ) Page 2 Address: /7774/ !'‘,‘,> /7 Primer 16.60 City /State /ZIP: �`. ,� ehe 9.7223 Roof drain (commercial) 16.60 Phone: (s3) _5:2 -y y, y I Fax: : ( ) Sink/basin/lavatory �, 16.60 Tub /shower /shower pan 16.60 �g�5 E -mail: ��ft�l� / � /1'f/'fJ- r`GiV' Urinal 16.60 . • CONTRACTOR .. Water closet 16.60 Business name: _=�r t o. ,f Water heater 16.60 p Other: Address: / a / AE / �� iiijjjjj / City /State /ZIP: lX �s Q v/\ -,7- 3'd Subtotal Minimum permit fee: $72.50 Phone: ( / ) ••••• Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: 4 0/ 4 000 1 .01: 97 g l Lic. no.: Plan review (25% of permit fee) Ail / State surcharge (12% of permit fee) Authorized signature: P/ TOTAL PERMIT FEE Print name: �� Adirj119)2ITSMEIM Date:�tis%/�I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I: \ Building \Permits\PLMF•PermitApp.doc 12/27/06 440- 4616T(I0/02 /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 - 1' 100' j 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer - 1st 100' 1 55.00 3,601 to 7,200 $220.00 ( 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Storm &Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Ram 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 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" -4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink -Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\ Building \Permits\PLM- PermitApp.doc 12/27/06 Age Mar 03 08 12:23p Port Peninsula 360 665 6563 p. 1 o� RECEWED • e•ill • MAY 2 9 2008 :i l CITY OF GARD �� UA.R I I DIVISIO C1eanWat Services - ' 08 BU Our tun) mitment i% clear. i,- f CWS Fie Number Sensitiv Area Pre- Screening f o � - oao $�6 Site Assessment Jurisdiction: Property Information: (example 1S234AB01400) Owner Information: / Taxiot ID(s): 1 C ",1 I 3PD —j 0 O b Name: ('1,£ S (� A24 e0�* Company: Address: (1 - 7 if 6. (.4) . 12. $' 0 T Site Address: 1 17---7/4 .• L) t Zs-44 (•-1 -. T RAad Oz. Gf' 223 `1 1:5A R 3 R_cr / c e - 27 Phone /Fax: J / Nearest Cross Street: .`') i,; wi niee 1 q -{c.,_ De . E-mail: PC k' R nn6 )4. ( 6 in Development Activity: Check all that apply Applicant Information: Addition to Single Family Residence (Cit. deck garage) ❑ Name: (' h 12:t. or. FL i ..5i_ e de. Lot Line Adjustment ❑ Minor and Partition ❑ Company: Residential Condominium ❑ Commercial Condominium ❑ Address: 1 1 1 1 0) t 2 S'' C.- Residential Subdivision ❑ Commercial Subdivision ❑ - r o ed J O q 7 22 3 Single Lot Commercial ID Multi Lot Commercial ❑ Phone /Fax: ', / Other 'Z DO mS (c.0 S .1 E -mail: 0..- qP 5--ec k (Z fyIs�1.f' `De( . k 2 i - 5 Will the project involve any o ff -site work: YES n NO Unknown n Location and description of off-site work: Additional comments or information that may be needed to understand your project This application does NOT replace the need for Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ 1200 -C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document, and to the best of my knowledge and belief, this information is true, complete, and accurate. Print/Type Name: - "� _ Pr int/Type Title: _ , ArammArtmew Signature: // '(� RMei Date: ®t7 FOR DISTRICT USE ONLY n Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. n Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre- Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. t x Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s) are attached. • n The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT SERVIC ROVIDER LETTER IS REQUIRED. Reviewed By: ls!�'� Date: 3//0 8 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 , 4/ L Phone: (503) 681 -5100 • Fax: (503) 681 -4439 • www.cicsnwarerservices org Revised: May 5. 2007 VLl��2 � 7kt Information Notice to Property Owners About Construction Responsibilities Statement Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. [ORS 701.055 (4)] This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box and complete the following statement: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or 1 will be performing work on property I own, a residence that I reside in or a residence that 1 will reside in. If I hire subcontractors, 1 will hire only subcontractors licensed with the Construction Contractors Board. If'. change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I have read and understand the Information Notice to Property Owners about Construction Responsibilities contained on these two pages and I hereby certify that the information checked and completed above is correct and accurate. L/ d -/JS 6V-.57 K at, Al sir Print name of permit applicant Signature of permit applicant '7c '//g Date Permit #: . CC( )7y This form is supplied to building of permit offices by the Oregon 24., Address: l� 7�y �u� �� C Construction Contractors Board, a 7;y-01( r//' 1 ? 7)d-3 s required by ORS 701.055 (6) •.• Issued by: / - Date: r p2,% l/ p This copy to issuing permit office . . . . • „ . . RECEIVED MAY 2 9 2008 CITY OFT1GARD _ ' 3 : 1 P BUILDING DIVISION 6 .. , ...... _ . . 1 , it, --- • . 1" ; .,..' :7 t ,,!), ,, ,0 , , , ,i ; • . . II . . - • ' : , I .. WC'S " (e;' d4.4'• O spy...,,L __ 006 t-I e)Olg S we -C -- ‘ - L'r -- - _/..1. ., : ,._ :-..;.(::..... . `` ■ . • ' L . I I . ....di ' ' . - . . . ,,i'. ? 14 ; AI f '.. !. : "' : ■ _ : . ..- ' i 54 4 `' .'': . . - 7.6 ' I 1 .6 , ■ ' ' 3V1 .. .. . _ .. , . . . agilo" — , ; ,.:: 9S Comrnents: I • , . . . CIT OF . PERMIT NO.: :aczy=az:2 SIT PLAN REVIEW 1 B ?cit)Ft—tioCy7ef 477- PLANNING DIVISION: Required Setbasks Approved_ El Not Approved 1 Side: 'D Street Side: is --- — 77 Front. _.z.t'.— Gaxage: _412 Rear: i- A Li, -,-- 1 Visual Clearance: Q Approved 0 Not Approved 'Maximum Building Height. -_22... feet C WS Service Provider Letter Required: 0 Yes 0 No C3 Received I. ..,Rat,A ditto Date: 513o/Or ENGINEERING DEPARTMENT: Actual Slope:2:-_ .% 15 Approved 0 Not Approved Site PI : El CI NO Approved e._ 5" ° '• — _ . Notes: CITY OF TIGANW SITF P " faulLorNG PERMIT NO: tdrAw-m■-•,_-_,:" ''''''REVIEW Tree 0 d i AppTov::edte:CI5N;ArIPPIrrvPPr°7edelj 81—a°74.1 '.77-- / PfetededThes. it APProved 0 N A Naar Cf- ° 0 _ .