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Permit CITY TIGARD MASTER PERMIT PERMIT #: MST2005 -00217 c � l � i DEVELOPMENT SERVICES DATE ISSUED: 7/21/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S 135CC -02600 SITE ADDRESS: 10235 SW KATHERINE ST ZONING: R -4.5 SUBDIVISION: GREENBURG HEIGHTS ADDITION LOT: 011 JURISDICTION: TIG Project Description: Addition. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 11 FIRST: 512 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 47,308.80 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 512 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 2 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 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/O SVC!FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 6 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 & 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 # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes PATRICK, PAUL C OWNER and all other applicable laws. All work will be done in KATHLEEN A accordance with approved plans. This permit will expire 10235 SW KATHERINE ST if work is not started within 180 days of issuance, or if the TIGARD, OR 97223 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: Phone: 503 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: $ 1,158.99 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 i� >!� /' / Issued By : �. __ P %1 Permittee Signature : �i 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. i Building Permit Application FOR OFFICE USE ONLY _ • • . • City of Tigard Date - - • � .. �� Bed ``\` �� Permit N o. ^� j 9 o I ' 7 13125 SW Hall Blvd., Tigard, OR 97223 Y. ew U� g Plan Review Phone: 503.639.4171 Fax: 503.598.1960 tt / � p�ii 20 C "Olt i z Other Permit: 1 V� Q 'U 05 ��_1�'�II DateBY: MAsA 7 -�0 - � � Inspection Line: 503.639.4175 „I �► , • , Date ReadyBy: � Juris 6'I See Attached Checklist for Internet: www.ci.tigard.or.us OF TIGARD Notified/M V) -r- j ( Supplemental Information • CITY O ��- V a i cie. �\ ' -. -,. -¢ct {" r;= , > . ?b,t, +` :Z', ' s - x2. ",: '- ,+ <. ,,,, ..4:" =x :m, ,,.xam:• ., s' :, „ ' :: ' ° 's' i, "x ,c Y y r,' r �, i . 4 . 4- - _ a °� - -, , ;.3;"' . M$:� ^ S D ` 4 - � .; t � a° . , OF W® 7, :A -: °x '0 .a': =1tE ,ANDZ Fi °«�s�;s::'srta -;. i' �, 5�i.' ��a+ Yv:; t��.»_-,;. �; �= v. �- a�., �. �':. w. �...;" c� +"?;.�;�t'��'�- ,^'"y''',".,:., _....: az�� ,�-;,m�:'- <.`�._"�'�� 3�°:::€ arscr,,.<�:��5?�'.s; <�. -: �_�. �<..K .�... <. < .. .,... W :. ,.. , ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement • ❑ Other: equipment, materials, labor, overhead, and the profit for the V;F. =;�� �;z •� -r° � -` �° „�;�r�' -., �a a;�M r�,�; : :a;.r�at "� :��k -..�rr,,,,.„•..,:a;�,P: t � - �� f CATEGORX OF�CON TIZLIC'I'I®N` 4 ` p h work indicated on this application. ❑ 1- and 2- family dwelling ❑ Commercial/industrial Valuation: S 40 t coo ti i 3014k° 1:1 Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: t k� . ,; F ,< ,+:° <S :,: SIT I ; r . z',; ; iW # .: 4 ,' `_._� �. -,`. . : . Total number of floors �' JOB SITE INROR T ION AND LOC - s .b� n>f�,., .� -:_ -ter 1,_,;.�m �3�_, r,�as . � i .s���.:;m .�, �.•,_ .. ,- Job site address: /02,3 .5- w m�7 Ne a I , ou •� 5 r New dwelling area: square feet 5 2 City/State /ZIP: 7— t ' G A-.2 J 0 R E q 7'1-2- 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet • Other structure area: square feet ' a RU'IREED>-Dlk- A „COMIVJERCI #A USE:CHE;CKLIST. 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 „z,.:, ,.:, ;;, = x. € . ° , :s'r T: €'- :: € :° = :s , :..:.. r ; ; - . ^_ v .:1- :;. overhead, and the p equipment, materials, labor, overhe d a e ofit for the r ° . itll t <� _DESGRIPT ON OT WORK ` .., ' tt "t work indicated on this application. ell Valuation: $ R P 410 0 1. ,e, 1._ Existing building area: square feet New building area: square feet i. ; , , . L1P Y O ;G2 c , <F µ s TEN T 1A Number of stories: Name: P41 I / A-I R • A k Type of construction: ■ Address: / .1 .3 y cur A A ,14 ' e 5- Occupancy groups: � City/State /ZIP: 6 j_. E 9.7--x- 7? Existing: Phone: (5 03) 60)...a_ g ri t e Fax: ( ) New: . , Re - ; A „ > '. :iiN ;;: s. ti .:' s .', ,� :,:a.? >" re ';., 4 , " - : . (,, s ='.`,als i V '�w' °��:°�^h °.. -ac,: 1-,.'y �,��`�^�, "&a €. _s'. 2 '� �F�. : �, ':�`K ?•... >' .WS< xr" �-." Y,",�r1:�..�„�N k *'^:..i:�; €L"°$ri -:v:5s `.: tY,i'� , , - Ap PLI ANT:- 4, ., .® C 'PERSOlY:.,° . k„ _ <z < r:-4,,,.. , „,, v• °. i'> z.. a! .. �:�Zr.'�.. .t ^,€ ',3... ?- �.;,. `+�m.,a. ?<-..�. .a..za .: '.. 2 ' . --- ''''''''''-*---4 emu:. "sp:t zb ,5t '"�', `F ©T ' �..� s. r, t-�.,' y`,rxt�'�3.r+R °F.'�,��. .�'=�^,�ff�,:Yw�:,x�°rs: A.s= is.f i� ef" ... -. - 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 City/State /ZIP: applicant is exempt from licensing, the following reasons apply: . Phone: ( ) Fax: : ( ) . E -mail: ' ;-- .:; ». ^.^,'+, 2Rg{f _,.-41, '' gz�''go=' a , = fgep ,,,,;•-,^. «,; .d-^+ ;al r,':.r� :. :wc'-�s',�,`j" ,�°�.`._ -., ry `'r t _: s.. CONTnRACTOR J;: 1S , A, l �' " ' , Business name: - Ow E- /C/ - , r° , , " V. UILD, G ; ERMIT tF F Address: • Please refer to fee schedule. City/State /ZIP: • Fees due upon application Phone: ( ) Fax: ( ) • Amount received .CCB Iic.: - -- � - - - -- - - -- D ate received: Authorized signature: /f ,9�, This permit application expires if a permit is not obtained pa lt,� within 180 days after it has been accepted as complete. Print name: P / & Date: 5/ a 5 * Fee methodology set by Tri- County Building Industry '� C' pw • Service Board. i,\ Building \ Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02 /COM/WEB) One- and Two - Family Dwelling 0 , ' Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 iis i 1+ & i' ❑ Electrical ❑ Plumbing ❑ Mechanical 24- Hour Inspection Line: 503.639.4175 �I I� Internet: www.ci.tigard.or.us -� ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ El ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 ,Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. _ 15 Elevation views. Provide elevations for new construction;, minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must- reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive -path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ■ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured'floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the .roject under review. JURISDICTIONAL SPECIFICS 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 \One - Two - FamilyChecklist.doc 12/03 „ Building Fixtures Plumbing Permit Application at�` �� FOR OFFICE USE ONLY ' . City of Tigard 6 2005 Received 13125 SW Hall Blvd., Tigard, OR 97223 �' ,L 0 Date/By: Permit No.�3 .-.57 0,0 D2 ) 7 Phone: 503.639.4171 Fax: 503.598.1960 Plan Review OF TIGARDe + � Other Permit No.: 24- Hour Inspection Line: 503.639.4175� L D O DI VI6 , l oil' . • Date/By: Juris• Internet: www.ci.tigard.or.us BUILDING w Date edlMet y: I S See Page 2 for Notified/Method: Supplemental Information i . . : ; a t . 3 .Y,. P_ .. E OTC W0RI{ a 4 -. . i = .. Ti.EE CH EDIJLE �`".� -�,: a. ��� � T,: _. `�v<n�� °= 1���i. .. ._�. �.� 0 w,? 2 . .. �. � _ -i � r. is .. ; �.� ..:.., . ,.. a.,. ._. _n .,�r.� ,�:.. " .......?„,„a . . x r_ . ❑ New construction ['Demolition For special information use checklist. Description Qty. Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) '95;• +'•�'74. rw !;�• -u.: o7,4- x4.4 =v -y�;_s;. ;sz'i.,, -• vis A.,, ,tv .„•.,,, t `5;•?..., °`: ' }.- n.r.s x :; ✓ui i� ::. .`.E, ,.. ,�f2 ATEGORY" O) i-'e° I TR1JCT'ZOIY { * ,s ° .. SFR (1) bath 249.20 ❑ 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 J , ,,_ Fire sprinkler ( sq. ft.) Page 2 4 x JOB'S E INFO �Tti[ ii D L OC-A T Oil `' - et,' ...�, , ,v,,,,,,,,, . , ., ...... a6 , � � .LI , - .h l Site utilities Job site address: /.0 7..., 3 5' S g, sr Catch basin or area drain 16.60 City/State /ZIP: % 6 / OA T7) 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 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.: ) Page 2 Subdivision: 1 Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no � n � � � ' � t DESCRIP OF V " �!� � ^c � � � f � � F Absorption valve =r . 4 _ .. 'I _ � , , ..,,.,.J - _. r , e 44- t,x'24 .. _ Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 : we ..r`', ° °e:.:;,E , s , :.e:K3' Drinking fountain 1,6.60 ; .... ® PROP RTT ,OWN R . .. ~ TENA1siT "'� �.' 4 �'r ° �.eg "� Ejectors /sump 16.60 Name: 4 (I ,-- f) /�-T4 i k K Expansion tank 16.60 Address: , Fixture /sewer cap 16.60 City/State /ZIP: Floor drain/floor sink/hub 16.60 • Phone: ( • ) Fax: ( ) Garbage disposal 16.60 r r' s s ;� ,: r Hose bib 16.60 �' ari.,1APPLrc �T r im - i .�, .., . �, C.4ACTPERSQN t_s Ice maker 1 6.60 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 Phone: ( ) Fax:: ( ) . Sink/basin/lavatory et 16.60 Tub /shower /shower pan 4.. 16.60 E -mail: Urinal 16.60 J.l? �y,;.'r- #4 k:` „"`,`';,37W.', ' 7 %. ^ s3 :i , : •ct`#`? »'5 33'' 'tai' - "',%4 a , � 3 : C®N. l = :, g.< ` '�"�: � �.:;��•�,. ��. � � . � ���, �.;`^� �.' ... 1 ��'� >:.- gabz u `....< � ",�, a�r., Water close[ A. 16.60 Business name: O� /J L1` Water heater 16.60 Address: Other: Subtotal City/State /Z1P: 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) - State surcharge (8% of permit fee) Authorized signature: ' _ _ D 07:,„, TOTAL PERMIT FEE Print name: p� t_. ph -T A'' d 4 Date: 5/. 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- PemitApp.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: :.. ,. ` . : � � sgst ,, . ee , e - To£a ' e' w Site < utilities , .... w Q Y ._ �,? • Square 0 Footage . P t z ]Eee nr, . • Footing drain - 1s 100' X 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 w 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 E .'' = " -n '< sM^ ; •" > "'_ " �Valuat><on, ,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 °� ° , ... ;,; •,;; ,,...., :� ,,; :. e``ea ' additional $100.00 or fraction thereof, to and �1° .. ', 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for 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 * . 0 *1 re i a 4 ! Quani tj b ' ( Future Wo rkPe formec( Fixture /T ' - Replace O S41 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 2 Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:' Building \Permits\PLM- PemutApp.doc 3/03 Electrical Permit Applicatioj ' I E,D FOR OFFICE USE ONLY i ce+ �N Received • permit No.: ( � City of Tigard Date/By: I h3 ; co `004) . 13125 SW Hall Blvd., Tigard, OR 97223 t1(' Plan Review Phone: 503.639.4171 Fax: 503.598.1960 1■3• �ie�^9i : ii ° ,eA Date/ : Other Permit: Inspection Line: 503.639.4175 J ! r.\t Y �1 I' Date Ready/By: Iuris H See Page 2 for Internet: www.ci.tigard.or.us 0f _r-% %� ' -' " Notified/Method: Supplemental Information '.� ...; .. „�...� .: .�{ , � Y, x,-.. ;r^`. a' : `u�'' `?: y .... .a.T �g KaniV"t t •± _ - ' - : ^.= zi�sat' .r , ,: �x ,:-,.��xw i r.,a vc.vim"I."i: lt::. 4 , �: ry a' ..s ' $ ;."`fiir.#= u �z t= ,. ..,. a§ = :; *t , ,,. -. ..."°. 0 a. r ' tm : ; _ � , ;" u r P A, IZ: Yr 1�+ ' .. .,:,Y���nr �»� -nM� ��, �r-` A` ���n r,. x z. �:, a.- ...:;�� #�. ''�...��r�nta= ..��.�s.A�.�,�,.cs;_. �,N,� o,. . - -- _ .. ., -. .. _ ,—,,..:,,,,,,,P.—,-,',' - ❑ New construction Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location �.,. s , ; ❑Service over 320 amps — rating ❑ Buildng over 1'0,000 sq. ft., • ' ,:3�' ;T"^ °:?e,.. 4-i ; &{.w or more new residential �,�� � ,•= �.�fStE�OR���COh � , t = family dwellings 4 a 'f�;SZrr�*.:'.' _�, za'.'� � � 'r -m�•e .�:- :se�aaa.;t:�' kc.�' t�'� °s�. .r.«�^. ;9�'#`s:°xS.N'a Ya^,'i�Em.m:,^r of 1 -and 2- RI- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑Other: Building over three stories ❑Feeders, 400 amps or more , rY a DOccupant load over 99 persons ❑Manufactured structures or I t , • 3QB IT Fk FCi QN � 2 0 ' ; - ❑ Egress /lighting plan RV park Job no.: Job site address: � U�3�C $ tY k T7egitVe 57 . ❑ Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City/State /ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: rJ':= ` ; °SI31 DFL" :;. ., Description Qty. Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: . #•„ x Limited energy, non - residential 75.00 2 `� ' iii . .i ce ,, k� P m o . ,-. .a . , Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 *are m - wa.;,;,<, <_ ,. ;a0;41, 4: , : � - - 4,4 -< � % "• &. <" '. '.1 201 amps to 400 amps 106.85 2 §.' $��„`..< t •uxs'^3� f`:'.r . s«:,r:it`�.`�»S.',M""�'�a Z"Mt s'�.,":,x';:' 'A�r,SuS 401 amps to 600 amps 160.60 2 N Name: ,4_v L /71" / A 1 6 I ` 601 amps to 1,000 amps 240.60 2 4 L/�f1 Over 1,000 amps or volts 454.65 2 Address: /0 )-� / 5 w ' i � 5 r Reconnect only 66.85 2 City/State /ZIP: T 6412j-- d R �' Temporary services or feeders installation, alteration, and /or. / relocation Phone: ()3) 6 Xe-- cf 9l r/ 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,, nt, or exc ge,.acco ding to ORS 447, 449, 670, . d 701. 401 amps to 600 amps 133.75 2 Owner signature: C" / 0' 7;1 Date: d-t/ 8 Branch circuits — new, alteration, or extension, per panel N "'�' - "�"� `°� '�a"' ' ;- °' ` i-A :r '.� ` 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: without service or feeder fee, / each branch circuit 46.85 2 Address: Each add'1 branch circuit K 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- energy panel, alteration, or �/ 1 � '�'� extension. Describe: Page 2 2 Business name: `- "�'/�--' . i Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: • Investigation per hour (1 hr min) 62.50 Industrial plant per hour 73.75 Phone: ( ) Fax: ( ) _ • - . 5 CCB Lic.: Electrical Lic.: Suprv. Lie.: Subtotal ' Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. • is\ Building \Pernuts\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 1,0101 x. _ o f o t'LlESE Z zd` %Pa,- Fee for all residential systems combined $75.00 Check Type of Work Involved: n A udio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ V acuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n C lock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ P rotective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations : \ Building \Permits\ELC- PemntApp.doc 04/03 Mechanical Permit Application KtkidVED FOR OFFICE USE ONLY Received City of Tigard Date/13y: Permit N.N . 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ;go ' k el\ Date/By: Other Permit: Inspection Line: 503.639.4175 .i.- 0 6 2 Date Ready/By: Juris: EI See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGAriu Notified/Method: Supplemental Information nivIAION fiAtTvaivatiuwe4r-4--?, 4 . teczramE-,-4,azifivIdifib-hi, — : i r:: l y§ k 6j- EmoicusT , - 1.4 . 5vAVA:og3.11r.:.:::;- , AIRV:4.,;,..k....,-..3.4e.,1 , ..,,,,:,,,,gre , , :L:01',4z , :N',' , .'; ,,, ,. .,-,',:': ,.. . .„ -J '. - - – New construction ' Addition/alteration/replacement Mechanical permit fees* are based on the value of the work 0 R performed. Indicate the value (rounded to the nearest dollar) of all E Demolition D Other: ' mechanical materials, equipment, labor, overhead, and profit. P"lEl laVleialitailifrraFe&MedfroWil:Tgral-lllilll:ll.11arktl, „, Value: $ a i' p.,.,:37,,,,,i-em, EQUIPMENT , l , STFY I •SK S- F .- W.M,k.Frl.,,/l-' 0 1- and 2 dwelling 0 Commercial/industrial I: Accessory building l l: :.;, For special information use checklist. 0 multi-family 0 Master builder 0 Other: Description I Qty. Ea. Total l i rf Aiiiii Heatin N Air cond or pump Job site address: i v 2_ ) 5 v 1 - / r fie "e A I A. se- 5 7- (requires siitioning heat te plan showing placement) 14.00 City/State/ZIP: / / 6' k A 1 A 0 A j q 7 3 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 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. 10.00 Flue/vent for any of above 10.00 Subdivision: Lot no.: • Other: 10.00 Tax map/parcel no.: Other fuel appliances ze AV Water heater tvgrF 0 'l:,: " ;',"&l t,1%:11 ' „. .14,4 44 10.00 i,, , Gas fireplace 10.00 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 -tir l o iii ON} , rw . ' , cm,:.w , ..c.': ,, fyikTeriNANT , z ,,,- .4 : Chimney/liner/flue/vent 10.00 tc:L?%..swA l2 - , -.:w.,-. , ,...,7l0.... ., dite:llfmr.g'l,.... .19, -,,l-A- la.. ':til ill Other: 10.00 Name: p 4-(, I.- pi--7-0,i,:tA Environmental exhaust and ventilation - Range hood/other kitchen Address: equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 Single-duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 alfirtecliA4WitfitlAsileatigllgai ,P ,,::::•, Attic/crawlspace fans / 10.00 llele , tAll-' l :t.80..l4-W .....4.,; a, ; , m-Sommama Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Furnace, etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E-mail: Range '-'• EIRPSH't ikii.:. i „4, Barbecue Business name: 060 iu E_/2- Clothes dryer (gas) Other: Address: ittltEOTWitAt'OhWifgV: ' , ''''. ' City/State/ZIP: Subtotal Minimum permit fee ($72.50) Phone: ( ) Fax: ( _ ) - - Plan review (25% of permit fee) -- CCB lie.: State surcharge (8% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. . _ Print name: e vt f A ( ,f( Date: 57,,,,( 5 . Fee methodology set by Tri-County Building Industry Service Board i: \Building \Permits \MEC-PermitApp.doc 12/03 440-4617T 1 I/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: �., "`'� lea: § ; - °, ^'a".`L?t�I,�g<: : -,:" s.` " s "�;,- >.�.:,i,it�s�. .�.��. �:,Td ��''" ^ `", g „"� . ` i: ';�,,s' " liTotal aluati , , = x leerrn t Eee e .... : w. $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 12/03 2 Vfl SEP 2 8 2004 File Number q775 CleanV Ater Servic s Our commitment is -clear. By -' • :..1, ea Pre - Screening Site Assessment • Jurisdiction (I, O 644-� Date Map & Tax Lot I S 1 3�'CC, - OaIQOO Owner ` / Site Address t o a35 6.0 ke-nral E. 3 - - 1 - 1 - (0421 o0.. 979-9-6 Contact Proposed Activity ADVitvG env T t1-€ Address 7 6A-R , a/ZG- 97 Phone ( 3 62.0-87/F Official use only below this line Y N NA Y N NA s I�I S ensitive Area Composite Map �t Stormwater Infrastructure maps 1 Map # �S /c�/ 3 n I I ® QS # �f 2 9 n _ L oca ll y ad s tudies or maps n Other Specify Specify d%. a ..., Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No. 04 -9: n Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas • exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. P1 Sensitive areas do not appear, to exist on site or within 200' of the site. This pre- screening site assessment does NOT eliminate the need to evaluate and protect . water quality sensitive areas if they are subsequently discovered on your property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATER CONNECTION PERMIT. The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Comments: , &5S oti Yevi e ' d -le 2 Udi2 r1 e "i-el JDSed l o/o/ t.); /I M T filth • f QAw� / i bel / DROr ro ,2 /i-e.. t''/ !-p af. ".vet j�Oi h ti a r e_ Reviewed By: Date: /o /�*/ y Returned to Applicant Mail d( Fax Counter Date / / ?/a y By 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 Phone: (503) 681 -3605 • Fax: (503) 681 -4439 • www.cleanwaterservices.org , GARD 0 .- - �/ T , BUILDING DIVISION PERMIT #: tvMST2005- 002.17' 1-3125 S1N. Hall Blvd„ Tigard, OR 97223 DATE ISSUED: 7/21/21; 0, Phone: (503) 639 - 41 • 074/440/1t • Inspection Requests (24 Hrs.): (503) 639-4175 ' . INSPECTION WORKSHEET FOR DATE, 7/8/2008- • TIME: 7 :00AM PAGE: 33 SITE , ADDRESS :- 10235 SW KATHERINE ST CLASS OF`WORK: SUBDIVISION :: -' GREEN£URG HEIGHTS ADDITION LOT7# :; 011 TYPE OF USE: PROJECT NAME` PATRICK DESCRIPTION:' Addition.. OWNER: rPA'fRIGK, PAUL 0, ` PHONE # . CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled, For • Date: ' 7/W2008 ' , Pour Time: Code # • Inspection Description Confirm # Contact ,# Message 320 - , Plumbing rough -in 072316-01 . 503-620-8918 N . . Cor, rections /Comments /Instructions . • 'PASS n PARTIAL- APPROVAL ❑ CANCEL 7 NO ACCESS 1 I FAIL ❑ CALL FOR INSPECTION '❑ . ADDITIONAL FEES ASSESSED Inspector (Th J Date ) "an Phone #: (503) 718- , CITY OF TIGARD • BUILDING DIVISDON PERMIT# ii,1/44S1j608..00217 13125-SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2:1/2006' Phone: (503) 639-4171 _ Inspection Requests' (24 Hrs.): (503) 639-4175 li ■.= INSPECTION VVORKBHEET FOR DATE: 3/21/2008 TIME: 7:01AM RAGE:' 10 SITE ADDRESS: 16235 SW KATHERINE ST - OF WORK: SUBDIVISION: ORLENBURG HEIGHTS ADDITION LO. #': 011 , TYPE OF USE PROJECT NAME: PATRICK • . 'DESCRIPTION: Additton; OWNER: PATRICK,'PAUL .,-- = PHONE #:: • CONTRACTOR: OWNER , - • • • - • — Inspection . Request Scheduled For: Date: Si2..1/2 Pour Time: Code # Inspection 'Description CbnfirM Contct # Message 34) 'Plumbing rough ui r 06714102 503-520-8918 N Corrections/CommehtsilnWuctiohs: •c LJ(4 vz)\--, Rfq, d 5. 4- Lib '2,,p4- - A k1 t k./14,1/47V P' L( LAC. (••) Tv — VVA Df`c; e.,icuevx Pt 9v- Re 4,71 0rc-4 K7) j c tixLi Ti.e "I"' 14- tcb )• AVI€A 1 V.ei • 3: Alar c..(1 67 P 1 %43 f-fld'rAite..., lAkv Ft a 1 'Vyy Ct:;, czrb CL-V •-gtioio PR./ O c4 P 9,0k 0 Oo &vj O ■, Ope,LiV\il; CA,0,6c CA6r6V P A) fv\l'A Y-1 AAt., S (J buf otA-=.7 MA:J 645c1 t3 e2c1 /0,0 oRg - • . PASS J PARTIAL ,APPROVAL '0 CANCEL EJ NO ,ACCESS FAIL El CALL FOR INSPECTION ADDITIONAL FEES' ASSESSED Inpector: Date: .3 1-9 a7) Phone #: (503) 718 , • CITY OF TIGARD • _ BUILDING DIVISION PERMIT #: MST200 -00217 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ,7 /2112005 Phone: (503) 639- 41.71nii+d + . Inspection Requests (24 Hrs.): (503) 639 -4175 �±i ' I INSPECTION WORKSHEET FOR DATE: ' 'Ef1Eif2006 TIME: 7 :02AM1 PAGE: 18 SITE ADDRESS: 1023f, SW KATHERINE ST • CLASS OF WORK: SUBDIVISION: GREENEiURG HEIGHTS ADDITION LOT #: 011 TYPE OF USE: PROJECT NAME: PATRICK DESCRIPTION: Addition. OWNER: PATRICK, PAUL C, PHONE #: CONTRACTOR: ' OWNER PHONE #: Inspection Request Scheduled For: Date: 5/1612006 Pour Time: Code # Inspection' Description Confirm # Contact # Message • 306 Plttml7in underslab 029963 -01 593-620.8918 Corrections /Comments /Instructions /pi /x / 401'1.11.1 4°1 t3 ASS .0 PARTIAL APPROVAL ❑ 'CANCEL . ❑ NO ACCESS • FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: in/ Date: 0 ;, Phone #: (503) 718 - G CITY OF TIGARD 0 0 . BUILDING DIVISION PERMIT # %c�0 0 217 13125 SW Hall Blvd., Tigard, OR 97223 D ISSUED: � 112005 Phone: '(503) 639 -4171 v dg fi „ li ll t` Inspection Requests (24,Hrs.) (503) 639 -4175. Asli- 11. INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 7:00AM PAGE: 25 SITE ADDRESS: 10235 SW KATHF_RU'IE ST CLASS OF WORK:. SUBDIVISION: CREENt3URG HEIGHTS ADDITION LOT #: 01,1 TYPE OF USE: PROJECT NAME: PATRICK DESCRIPTION:. Addition. OWNER: PATRICK, PAUL C, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Daate: I120I20I13 Pour Time: Code # Inspection Description Confirm # Contact# Message 280 Insulation '079831 -01 503.620 -8918 N Corrections /Comments / Instructions: 111 - - -4,AIFT ( iYa' • -- `.,�, . iii.; - PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ Date ' a) Phone #: (503) 718 - b CITY OF T BUILDING DIVISION PERMIT #: MST2005-00217 G 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2112005 Phone: (503) 639- 4.171,udq�YI�E�il� Inspection Requests (24 Hrs.): (503),639 -4175 INSPECTION WORKSHEET FOR DATE: . 3/21/2008 TIME: 7:01AM PAGE:: 11 SITE ADDRESS: 10235 SW KATHERINE ST . CLASS OF WORK: SUBDIVISION: GRFENi3URG HEIGHTS ADDITION LOT #: 01 TYPE OF USE PROJECT NAME: F'AIRICK DESCRIPTION:.. Addition: ' OWNER PATRICK,, PAUL C, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For Date: 3/21/2008 Pour Time Code #- , Inspection Description Confirm # Contact# Message 615 Mechanii:a! rough -in 067142 -01. •503- 620 - 8918 Y. Corrections /Comments /Instructions: • ,, • • • V ss❑ PARTIAL. APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ Date: Phone. #: (503) 718- . CITY OF TIGARD BUILDING DIVISION 0 PERMIT #: MST2005.00217 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2005 Phone: (503) 639 =4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 2/6/2008 TIME: 7: 00AM PAGE: 22 SITE ADDRESS: 10235 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: GRCENF3URG'HEIGHTS ADDITION LOT #: 011 TYPE OF USE PROJECT NAME: PATRICK DESCRIPTION: Addition. OWNER: PATRICK, PAUL C, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 716f2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 064513-01 503 - 620.8918 \ 1` Corrections /Comments / Instructions: • • • PAS ❑ PARTIAL APPROVAL • ❑ CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 5 ' " V ( � Date: 2-41 Phone #: (503) 718- 2A • CITY OF TIGARD BUILDING DIVISION PERMIT #: IvIS12005-00217 13125 SW Hall E3lvd, Tigard, OR 97223 • - DATE ISSUED: mynas Phone: (503) 639-4171 44 I et\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/4n007 ME: 7:02AM PAGE: 26 SITE ADDRESS: 10235 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: OREENBURG HEIGHTs ADDrnow LOT # 011 TYPE OF USE PROJECT NAME: PATRICK DESCRIPTION: Addition. OWNER: PATRICK, PAUL PHONE CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For Date: 10M/2007 Pour Time: efde. die; v , Code # Inspection Description . Confirm # . Contact # 4 4; 240 Exterior sheathing 056972-01 503-620.8918 Corrections/Comments/Instructions: 93-692- 7e/ 7 N - V1/\-; • • • • PASS PARTIAL APPROVAL El CANCEL El NO ACCESS n FAIL CALL FOR INSPECTION. El ADDITIONAL FEES ASSESSED Inspector: Date! 6 4 7 6 Phone #: (503) 718- 6%/61 CITY OFTIGARD Agek BUILDING DIVISION PERMIT #: Iv1ST2005.00217 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2005 Phone: (503) 639 -4171 11-r• Inspection Requests (24 Hrs.): (503) 639 - 4175'!+ :_`' • INSPECTION WORKSHEET FOR DATE: 10/4/2007 TIME: 7 : 02AM PAGE: 25 SITE ADDRESS: 10235 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: GREENBURG HEIGHTS ADDITION LOT #: 01 TYPE OF USE: PROJECT NAME: PATRICK DESCRIPTION:- Addition. OWNER: PATRICK, PAUL C, PHONE #: • CONTRACTOR: OWNER PHONE #: • Inspection Request Scheduled For: Date: 10/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 056972 -02 5503 - 620 -8918 N Corrections /Comments /Instructions: 6 P� n PASS • ❑ PARTIAL APPROVAL $ICANCEL - n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED , Inspector: Date: bk 6 Phone #: (503) 718 - /II 2/4( CITY OF TIGARD • B 0 UILDING DIVISION PERMIT #: MST200E40217 13125 SW Hall Blvd., Tigard, OR 97223 DATE' ISSUED: 7/21/2005 Phone: (503) 639 -4171 A i���li* Inspection Requests (24 Hrs.): (503) 639 -4175 R:_.. INSPECTION WORKSHEET FOR DATE: 9 /11 /2006 -- 7 :00AM PAGE: 26 SITE ADDRESS: 10235 SW KATHERINE Eli CLASS. OF WORK: SUBDIVISI GREENBURG HEIGHTS ADDITION LOT #: 0.1 TYPE OF USE: PROJECT NAME: PATRICK DESCRIPTION: Addition. • OWNER: PATRICK, PAUL C, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/1112006 Pour Time: . 9 :00 Code # • Inspectio ri : scrip ' n Confirm # Contact # Message 205 Footing / 036312 -01 503 -62o -0 91 ; Y Corrections /Comments /Instr ctions: L.. A - _At All AIL \ 0 .., ' ±9 \fle 1 , ■ / 1 ® • . Cl_i 1127M • 1� • i iikl PASS ❑ P ARTIAL APPROVAL ❑ CA NCEL ❑ NO ACCESS ❑ AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 4A 2)//14 Inspector: Dater � �J Phone #: (503) 718 - • CITY OF TIGARD BUILDING DIVISION PERMIT'# MST2005-00217 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:' 7/210005 Phone: (503) 639 -4171 � A � voloo„ I ai Inspection Requests (24 Hrs.): (503) 639 -4175 .n- '+k' INSPECTION 'WORKSHEET FOR DATE: 9/7/2006 TIME: 7 j AM PAGE` ! 19 SITE ADDRESS: 10235 SW KATHERINE ST CLASS OF WORK'. SUBDIVISION: GREENBURG HEIGHTS ADDITION LOT #: 011 TYPE OF USE PROJECT NAME PATRICK DESCRIPTION: Addition. 1 OWNER: PATRICK, PAUL C, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Dater. 9/7/2006 Pour Time: 00 Code # Inspection Description Confirm # Contact # Message 205 Footing 036158-01 503-620-8918 N Corr ctions /Comments /Instructions: b 4..4:3 • PAS n PARTIAL APPROVAL n CANCEL - NO ACCESS AIL CALL FOR INSPECTION . n ADDITIONAL FEES ASSESSED Inspector: Date:9 - "2 ' -b Phone #: (503) 718- ` ,4 1/23/2008 Case Activity Listing 12:14; I7PM CEL Case #: MST2005 -00217 • .� .. , , Wit.. _ . w . ,.: �.. � , a�- .� . . R �. ��, E ,. � � °�.. � gar �,, -�_.�° �, ...., ,. _ ., a .. Assigr ed . tea... T -„ r >. - ,,, �„ U dated max.,_ . , . g P.. r . : x - :te f . afro' e. . ... a ', - . , . - -,: , - .. .m.'.. , x.Fe..,. 4 ,.. x • , +�. :.... : .c. a �' .1- - F' H .,.�° -a _ < x - t" 3 -: n. ..: ,, F - :. • 9 . ,.�. r'.'^ ., . as ,.. x. , a° -:� _a Atn� ,,,Desert hon, CPA � Date2 •. �. ��,Date�3� � •�Hoid . Des _t. To,•• "ui ..�:B :� B N" '` � � � .��.� _... F�...:�,��� ._e :� .�._....� ._.. >g � P °� Y�� � Y . - "�`.��.,� .� �� MST1010 Application received 7/6/2005 None RECD DER 7/6/2005 -- - - - -- DER MSTIO20 Permit created 7/6/2005 None DONE DER 7/6/2005 DER MSTI030 Check for parcel 7/6/2005 None DONE DER 7/6/2005 CWS site assessment provided. tags /CWS DER • MST1050 Site plan revwd /route 7/6/2005 None DONE DER 7/6/2005 to PT /PW DER MST1060 Building plans routed 7/6/2005 None DONE DER 7/6/2005 to PE DER MSTI 100 Building plans 7/20/2005 None APRV MAV 7/20/2005 approved by PE MAV MSTI 1 10 Approved plans 7/20/2005 None DONE MAV 7/20/2005 routed to PT MAV MSTI 8 I0 Ersn Cntrl 681 -4444 None 7/20/2005 MAV MST1240 Post - review 7/20/2005 None DONE DER 7/20/2005 completed DER MST1270 Ready to issue permit 7/20/2005 None REDY DER 7/20/2005 DER MST1280 Issue permit 7/21/2005 None DONE BB 7/21/2005 BLD Page 1 of 2 CaseActivity..rpt .1/23/2008 Case Activity Listing 12:14 - .17PM CEO.. Case #: MST2005 -00217 a �,.. ,_. ,. An ss ne z,...D , »one U dated.» u ice'.: ; ii ,...: rt z '� � *�'� �`° .tea vii_ .x,.::;.. > a �'�b ' .s Via' �, ra... g d ;Yt -: p '� ' � ' .., .., y.x, _ . ,. '- ,� ,..; � .: _4:.� 's.. ' ' .�... bP... ,. _, u " � .,: .- :£:. A-aAi w Des ton Date; -' .,, Date 2,,' t -- <.- d ,.. y ty, p „ -, Da e 3 . p� „Hold ; Dis To `�:• B B a\o MST! 120 Revisions 5/15/2006 None APRV MAV 5/15/2006 Revision - Reversed location of'W /C apprvd /routed to PT BLD and Lay. MST2305 Plumbing underslab 5/15/2006 5/16/2006 5/16/2006 None PASS MRS 5/16/2006 029963 -01 - 503- 620 - 8918,= VM - STI Y - 9 /L /g MST2205 Footing 9/6/2006 9/7/2006 9/7/2006 None g KBS 9/7/2006 036158 - 01 - 503 - V STI N - 150 MST2205 Footing 9/8/2006 9/11/2006 9/11/2006 None PASS RB 9/11/2006 036312 -01 - 503 - 620 -8918 - VM - RB Y MST22I0 Foundation walls 9/11/2006 None PASS RB 9/11/2006 RB MST2220 Slab 9/11/2006 None PASS RB 9/11/2006 RB MST2240 Exterior sheathing 10/3/2007 10/4/2007 10/4/2007 None PASS RB 10/4/2007 056972 -01 - 503 -620 -8918 VM - STI Y MST2275 Framing 10/3/2007 10/4/2007 10/4/2007 None CNCL RB 10/4/2007 056972 -02 -- 503- 620 -8918 - VI. STI N -150 Page 2 of 2 CaseActivitv..rpt