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Permit JP MASTER PERMIT d C ITY F TIGARD 117 " COMMUNITY DEVELOPMENT PERMIT #: MST2006= 00257 , ,4 , DATE ISSUED: 1/12/2007 1 T1 RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 112BD - 01600 SITE ADDRESS: 15030 SW 79TH AVE • ZONING: R-4.5 SUBDIVISION: DURHAM ACRES LOT: 038 JURISDICTION: TIG Project Description: 760 sq ft addition , BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 760 sf BASEMENT: 51 LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sI FRONT: 20 PARKING SPACES : • TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 10 VALUE: OCCUPANCY GRP: R3 BORM: 1 BATH: 1 TOTAL: 760 sf 70,224.00 REAR: 15 • �� PLUMBING SINKS: WATER CLOSETS : (1 '/ WASHING MACH: LAUNDRY TRAYS: RAIN. DRAIN: TRAPS: LAVATORIES: DISHWASHERS: �� FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: • TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: 'GREASE TRAPS: OTHER FIXTURES: ' MECHANICAL FUEL TYPES FURN < 100K: 801UCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 3 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: ,0 - 200 amp: WISVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:. EA ADM. 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FOR: 1 SIGN /OUT UN LT: PER HOUR: UMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAUPANEL: IN PLANT: MANU HM/SVCIFDR: 601 - 1000 amp: 601•amps- 1000v: MINOR LABEL: 1000. amp/volt : PLAN REVIEW SECTION Reconnect only: >=4, RES UNITS: SVC/FDR> =225 k: ? 600 V NOMINAL CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY ■ 1 A. SF RESIDENTIAL B. COMMERCIAL AUDIO it 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: s 01. HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 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 JEFF CAMPBELL OWNER laws. All work will be done in accordance with approved plans. This 15300 SW 133RD 'AVE permit will expire`if work is not started within 180 days of issuance, or TIGARD, OR 97224 . if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted bythe Oregon' Utility Notification Center. Those rules -are set forth in OAR952 -001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct' Phone: 503-620-7517 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 1,321.49 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 A ;1 . ! ; r-' .4 1 ' I Issued By : %' i /,).; J o Permittee Signatur k • A I Call 503.639.4175 by 7 :00 a.m. for an inspection that b 1-1 4 - ay. This permit card shall be' kept in a conspicuous place on the job site until o • pletio - of the project. Approved plans are required on the job site at the time of each inspection. 0 Ank. atoltimi to ®® MASTER PERMIT Ilh T PERMIT #: MST2006 -00257 rt 1' COMMUNITY MUNITY DEVELOPMENT DATE ISSUED: 1/12/2007 ;TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 rr, ` 9 PARCEL: 2S 112BD -01600 SITE ADDRESS: 15030 SW 79TH AVE ZONING: R - 4.5 SUBDIVISION: DURHAM ACRES LOT: 038, JURISDICTION: TIG Project Description: 760 sq ft addition BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12: FIRST: 760 sf BASEMENT: sf LEFT: 10 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: 10 VALUE: OCCUPANCY GRP: R3 BORM: 1 BATH: 1 TOTAL: 760 st 70,224.00 REAR: 15 PLUMBING SINKS: WATER CLOSETS: 1 WASHING, MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 , DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: • TUB/SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER UNES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: • BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 3 MAX INP: btu FLOOR FURNANCES: VENTS: 1 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:. PUMPI1RRIGATION: PER INSPECTION: EA AMYL 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: t SIGNIOUT LIN LT: PER HOUR: UMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT: MANU HM/SVCIFDR: 601 - 1000 amp: - 601 +amps•1000v: MINOR LABEL: 1000* amp/volt : PLAN REVIEW SECTION Reconnect only: -- s=4 RES UNITS: SVC/FDR> =225 A.: - > 600 V NOMINAL: CLS ARENSPC OCC: ELECTRICAL - RESTRICTED ENERGY 1 A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State.of OR. Specialty Codes and all other applicable JEFF CAMPBELL OWNER • laws. All work will be done in accordance with approved plans. This 15300 SW 133RD AVE permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center: Those rules are set forth in OAR 952 -001 -0010 through 952 -001- 0080. You may obtain copies of these rules or direct Phone: 503 620 -7517 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332 2344. Reg #: TOTAL FEES: $ 1,321.49 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 '" ' f r)c e a Permittee Signature!: l_ A ■ Issued By : - /� r . ,.�:.�.- _ // I r Call 503.639:4175 by 7:00 a.m. for an inspection that b i i - 1 day. i This permit car d shall be kept in a conspicuous place on the job site until o • pletio - of the project. Approved plans are required on the job site at the time of each inspection. • Building Permit Application FOR OFFICE USE ONLY City of Tigard Received il�E® f / PermitNo.: II Hall Blvd., Tigard, • '?�l ? '° " Date /By: 1/ D � J� Gtw ° 13125 SW g y � Plan Review '• Phone: 503.639.4171 Fax: 51 . ' . 9.0 Date /By: Other Permit: TIGARD Inspection Line: 503.639.4175 NOV 4 2 00 6 Date Ready /By: j 1 0 See Attached Checklist for Internet: www.tigard- or.gov V Notified /Method: /0/1/9 oG / `d Supplemental Information CITY OF TIGARD 4ipket_ w/ +^ * ©IVISiOM • • w ; � �� TYPE t it 1 E UIRED DA TA: 1 AND ,i2 FAMI�I Y DWELLING" ❑ New construction ❑ Demolition rmit 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 F =, °� 4 4 z s CATEGORY OI' iCONSTRUCTION ,�f n F" 3 f work indicated on this application. 70 t4 • 00 )4.1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: L- ❑ Master builder ❑ Other: Number of bathrooms: 0 f x 1 Total number of floors: � %, � � JOB SITE INFORM AND LOCATION r d r Job site address: Isr C --741-- 4/\ New dwelling area: 1 t square feet City /State /ZIP: -11r' �T X "' ✓✓ QA) 012_ 1 1 2,, Garage /carport area: square feet Suite/bldg. /apt. no.: ` Project name: 1 Covered porch area: square feet Cross street/directions to job site: a0-11,\ O" 5 Y Deck area: square feet 1 i -1, \ C �,IJ 1� l ' �° Other structure area: square feet REQUIRED +DATA COMMERCIAL -USE CHECKLIS .-' Subdivision: I 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 r r, $ s DESC OI• WORK l t �� work indicated on this application. P,A1 � �RIPTION w : J� –70i0 p �� �. A•-t t� {-p t / 1 t r1 M� Valuation: $ ( l J 6 Iv I V OJT �1 (� t'lVlt V Existing building area: square feet New building area: square feet *# ' PROPER i OWNER TENANT' Number of stories: Name: ` ( Type of construction: Address: �T�K31 -1� �L.� Occupancy groups: City /State /ZIP: 0 C122,' Existing: Phone: ( �1'S Fax: ( ) '- 1�!) — 1 tom., New: A#AMSitt:P'Vtfit#9ANI:om i e � ❑ CONTACT PERSON x ._ _ k p' "� "` Np' E ) e,? r fi , ,, �f' < Business name: All contractors and subcontractors are required to be Contact name: j — CAW? licensed with the Oregon Construction Contractors Board ..�� under ORS 701 and may be required to be licensed in the Address: f ' ...4*- jurisdiction in which work is being performed. If the v City/State /ZIP: -. N . 11641->44 1 "0 t 0 � o — ` /' , applicant is exempt from licensing, the following reasons apply: Phone: %) 0/;,=�5\'1 I Fax: : ( ) E-mail: \t \i aor e_ 17 a Vejs 1Y j f t ' 'CONTRACTOR r „ �' Business name: o s t BUIEDING PPERMIT FEE ° S* ' a Address: �! .4%.r ' � -r ii t' (elea e,r f er to feese/iedti .„ ,, .. Cit Y /State /ZIP: l� Structural plan review fee (or deposit): FLS plan review fee (if applicable): Phone: ( ) Fax: ( ) CCB lie.: Total fees due upon application: 1 3 y Amount received: Authorized signature. 1 This permit application expires if a permit is not obtained I �p • 10 within 180 days after it has been accepted as complete. 3t Print name: 4 0 1 Date: \'n \J * Fee methodology set by Tri- County Building Industry Service Board. 1:\ Building \ Permits \BUP- PermitApp.doc 03/21/06 440- 46t3T(11/02 /COM/WEB) 'Mechanical Permit Application ,: FOR OFFICE USE OnCY • ^ ECEI � Received City of Tigard �F�i R Received y. t/ y ,0 it_.) Permit No.;�l� 2✓I /_- 6 70 4 2 j 7 v 13125 SW Hall Blvd., Tigard, OR 97223 - r Plan Review ✓L"w ' ® t 4 Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit: T I G A D Inspection Line: 503.639 NO V 4 20 Date Ready/By: Mil H See Page 2 for Internet: www.tigard- or.gov Notified/Method Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. . CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 4],1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating /cooling Job site address: 6.1N ` ` p� Air conditioning or heat pump Sw l rn — (requires site plan showing placement) 14.00 City /State /ZIP: — O&OL , 0 © Q 1 I .2k.) Furnace 100,000 BTU (ducts/vents) 14.00 G�� M� Furnace 100,000+ BTU (ducts/vents) 17.90 C�VI Suite/bldg. /apt. no.: Project name: 1r �i Gas heat pump 14.00 Cross street /directions to job site: v l r\ or., O.I C Duct work 14.00 42..00 e Hydronic hot water system 14.00 0 t.,J/ a . �� � I \ c 0 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 DESCRIPTION OF WORK Water heater 10.00 � �) Gas fireplace 10.00 t V9 t N (� � JJt1 Y/1F Flue vent for water heater or gas fireplace 1--tv.vd- 40''0' Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 , • %PROPERTY OWNER ❑ TENANT Chimney /liner /flue vent 10.00 Other: 10.00 Name: \YEA'fr Environmental exhaust and ventilation _ Address: IS).)- G •C Range hood /other kitchen equipment 10.00 City /State /ZIP ML Q CA- c )_i\ Clothes dryer exhaust 10.00 L � , Single -duct exhaust (bathrooms, • Phone: (tA ) (, Fax: 6) )` 2, – -�'V 5i toilet compartments, utility rooms) k 6.80 (43. $0' ilt APPLICANT , ❑ CONTACT PERSON • Attic/crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name OVS. $5.40 for first four; $1.00 for each additional Address: 1 St/) — 1 Ai Fumace, etc. Gas heat pump City /State /ZIP v �� O Wall /suspended/unit heater ' Phone: 6\1 y j\ Fax: : ) – 1 . 2:6 - 5 1 6 \ Water heater Fireplace E -mail: v \ \CI t,'' �Q AC E. v (\ - 1\9_, Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) Other: Address: MECHANICAL.PERM IT FEES* City /State /ZIP: Subtotal 52,0v Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) . Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized si ature: This permit application expires if a permit is not obtained within 180 >'� days after it has been accepted as complete. ll Print name: V ` r f 1 f - 1 , `y re ` Date: \ ) 0)0 • Fee methodology set by Tri- County Building Industry Service Board I:\ Building 'Pennits\MEC- PermitApp.doc 04/06/06 440 -4617T(11 /07JCOM/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 12/30/05 2 06/06/2007 02:23 5036406221 APGAJDTQJTMAGMG PAGE 01 CITY OF e i--1 ',, i.a, COMMUNITY DEVELOPMENT §174..; ;!wh' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Plumbing Signature Form IMPORTANT PERMIT NOTICE CRICKET'S PLUMBING 480 NW BROOKWOOD AVE HILLSBORO, OR 97124 Permit #: MST2006 - 00257 Date Issued: 1/12/2007 Parcel: 25112BD -01600 Site Address: 15030 SW 79TH AVE Subdivision: DURHAM ACRES Lot: 038 Jurisdiction: R - 4.5 Zoning: TIG Project Name: CAMPBELL Description: 760 sq ft addition Your company has been indicated as the plumbing contractor for the permit referenced above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: • JEFF CAMPBELL CRICKET'S PLUMBING 15300 SW 133RD AVE 480 NW BROOKWOOD AVE TIGARD, OR 97224 HILLSBORO, OR 97124 Phone #: 503 - 620 -7517 Phone #: 503 -846 -0134 Reg #: L1C 154438 LIC 124236 PLM 34 -315PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X � ►�. 244.'2,1 OR K K// Signa :re of Authorized Plumber Name (printed) . Electrical Permit Application FOR o rrrci si ONLY ' c Received . . City of Tigard ! ECEWWE �; DateB . // a eir M Permit No.: M'zo—et955 ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review CI "' Phone: 503.639.4171 Fax: 503.598.19 2 006 D . Other Permit: T I G A`IZ D Inspection Line: 503.639.4175 Date Ready/By: IIMII El See Page 2 for Internet: www.tigard - or.gov CFrY OF TIGARD Notified/Method Supplemental Information TYPE OF A Wi ®flvG DIVISION PLAN REVIEW ❑ New construction CeAddition/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 (g.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 N AND LOCATION ❑Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ", I00HHP or more. occupancy. Job no.: Job site address: , ,��' ❑Six or more residential units. ❑ Recreational vehicle parks. Clty/State /ZIP 711(A&•() 0.9,_ ok,22■4 ❑ Health -care facilities. ❑Hazardous locations. ❑ Supply voltage for more than 600 volts nominal. Suite/bldg. /apt. no.: Project name: Cokablak cietts ❑ Service or feeder 600 amps or more. � , � _ � I FEE SCHEDULE . • Cross street/directions to job site: Vi)..‘ C....1 ev� �--r {1 � n "47 Description I Qty. 1 Fee. 1 Total 1 • Vn Qr� t j I _._. _ New Includes atta e single- or garage. multi-family dwelling unit. 1 . ` V N ��� Cludes attached arage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 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 ADD - 1U0 e-:11- Limited energy, multi- family 75.00 2 • . Olv 9 3 " \) ( ®f residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name:�j� �+ �,� _ 401 amps to 600 amps 160.60 2 °JE ' '' , ` 601 amps to 1,000 amps 240.60 2 • Address: r `j ( 4\. Over 1,000 amps or volts 454.65 2 City/State/ZIP:-V\ 6\ ''O a ;Zkik Temporary services or feeders installation, alteration, and /or relocation Phone: (Stb ) kxrt, "Th\, Fax: (9h ) - 72,s-5 - ;\ 200 amps or less 66.85 1 Owner installation: Th nstallation is be 'g made on property that I own which is not 201 amps to 400 amp t 00.30 2 . intended for sale, I -. `e, :, t, or exc g',, a to ORS 447, 449, 670 an 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: .�g I A o i.J Date: 11 V Q 4 A. Fee for branch circuits with , w AP ' 1 t / ❑ CONTACT PE SON above service or feeder fee, 6.65 2 each branch circuit Business name: 4 B. Fee for branch circuits Contact name: without st bran service or feeder fee, 46.85 2 • ��� 1` N ���1�� first branch circuit Address: t j -- cJ \,+_ ..44.c., Each add'I branch circuit ` 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: 6,-k\--v..-.0 . o.Q_ O 7 }J Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: (�jv` ) t)-1'\ I Fax: : )12) S' Reconnect only 66.85 2 E -mail: , 1 (, ` k E . \*.,,, 1 4\ . 1 �,� Pump or irrigation circle 53.40 2 . V (' CONTRACTOR Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited - • energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State/ZIP: _ ' Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: \ I Electrical Lic.: I Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Print name: / I Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: • This permit application expires if a permit is not obtained within 180 Print name: `1 Date: 11 1 days after it has been accepted as complete. ' Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PertnitApp.doc 05/23/06 440-4615T(11/05/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: [ WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) . • Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ 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 1:\ Building \Permits\ELC- PermitApp.doc 03/23/06 Plumbing Permit Application Building Fixtures FOR OFFICE USL ONLY �������® R e ce ived q_ City of Tigard Date/B // V 040 .�J Permit No.: l`P ,0 ( -' �2 7 . q 13125 SW HaII Blvd., Tigard, OR 97223N 0 V 4 , 4 Plan Review 1 o ; • Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.: T9 G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: J�u ®See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method:7 rte• Suppl emental Info rmation TYPE OF WORK FEE* SCHEDULE El New construction ❑Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ` Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 V I- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 . El Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 1EO r l v∎ i Catch basin or area drain 16.60 '� C� City /State /ZIP: � ,02._ or1'2,?i q Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: \tt -5 VOU5VV- Footing drain (no. linear ft.: ) Page 2 ` � A Manufactured home utilities 110.00 Cross street/directions to job site: I ► r ` dN f ■ .j °lCrt.lNC Manholes 16.60 , NN '3 V`1 cjo ) S 17 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 • Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Back flow preventer Page 2 ADO O ( fl' 0 - ts -Ae311 0 U k-Ntimt Backwater valve 16.60 • Clothes washer 16.60 Dishwasher 16.60 �� Drinking fountain 16.60 �j PROPERTY OWNER ❑ TENANT • � / Ejectors/sump • 16.60 Name: 3 ('t`n' 'v1_. Expansion tank 16.60 Address:icjV? '\ - M ,` Fixture /sewer cap 16.60 City /State /ZIP: "' i �� L"L �' Floor drain/floor sink/hub 16.60 Phone: 2) ) (a, 1 Fax: 32 r123 -•51S) Garbage disposal 16.60 APPLICANT ❑ CONTACT PERSON , Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 . Contact name: C,L.„ Medical gas (value: $ ) Page 2 Address: '6i' Si,/\) •1e'M J-tJT Primer 16.60 City /State /ZIP: -\\L, .-o C,. 1122,9 Roof drain (commercial) 16.60 ( f 1� x: , 6\ 1 Sink /basin lavatory 16.60 �C1 -�`0 ) ._ Phone: Fa y ,/� �y Tub /shower /shower pan 16.60 .k2 E -mail: ��nr (30 vi../01(\ _' Vim Urinal 16.60 CONTRACTOR Water closet ( 16.60 Business name: Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 . Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: I Pl b g Lic. no.: Plan review (25% of permit fee) / State surcharge (8% of permit fee) Authorized signature: J A. , TOTAL PERMIT FEE Print name: 1 .�ti� l Date: kk a� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1:\ Building \Permits\PLMF- PermitApp.doc 04 /06/06 440- 4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qtr. Fee (ea) ' Total Square Footage: Permit Fee: • Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' • 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. Fee (ea) Total - additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for • Residential Back flow Prevention Device each additional $100.00 or fraction thereof to • (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. . please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. El 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 ❑ Any new exterior plumbing site utilities. Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities. . Bath - Tub /Shower ❑ Any multipurpose fire sprinkler system. - Jacuzzi /Whirlpool ❑ Any complex structure as defined in OAR918- 780 -0040. Car Wash -Each Stall - Drive Thru Submit 2 sets of plans with any of the above. Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Isometric or Riser Diagram . Drinking Fountain ❑ Isometric or riser diagram is required for new buildings • Eye Wash that meet the qualifications above. Floor Drain /sink - 2" -3 „ -4" Car Wash Drain Comments regarding fixture work: Garbage - Domestic Disposal - Commercial - Industrial -. • Ice Mach. /Refrig. Drains - Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall ' Sink - Bar/Lavatory *Note: If the fixture work under this permit results in an • - Bradley increase of sewer EDUs, a sewer permit will be issued and - Commercial fees assessed for the sewer increase must be paid before the - Service plumbing permit can be issued. Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: is \Building\ Permits \PLM- PennitApp.doc 09/22/06 Permit #: 'To& Q — 00a57 Address: 150 'a-0 4 Issued by: e1 6J ,&_ Date: / /, -O 1 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: !On 1. I own, reside in, or will reside in the completed structure. Y MI t ,-J 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby cert fy that the above inform . on is correct and that I have read and do understand the Information _ Notice t rtp arty 0 i ers a lout o '�struction Responsibilities on the reverse side of this form. ,' r p 1 ) A C.) j\ 6 ( .gn o f p ermit applicant) (D te) L (White copy to issuing agency permit file, pink copy to applicant) . ` • • Information- Noti.cfato Property Owners A�out����nst��c���� Responsibilities • �������^�- ` ' ''--. '_-_ Note: This Information Noiice 10 Pro Owners about Construction Responsibilities was developed by the {'onstr,/o/io// Contractors Board in accordance with ORS 70/.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, youounprevertnuuoyprob|nmsbybcioga*arcofdhefb|}owingocmponsihUdiexondureuoofcouccru. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people you hire wili be einployees Astheeiiiptoyer. you rnust comp!y with the following: Oregon's withholding tax law: As an employer, you must withhold income taxesfrom employee wages atthn time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. o[ Revenue uz445-809|. Unemployment insurance tax: As an employer, you are. requ ired to pay a tax for unemployment insurance purposes on the. wages of all ernpoyees. For more information, call the Oregon Employment Department al 378-3524. Workcrs' compensat insurance: &sun,emp!uyer, you are subjectto the Oregon Workers Compensation Law, and rnust obtain workers' compensation insurance for your employees. Ifyou fail to obtain whrker5 compensation insurance, yOu may be subject to penalties and will be liable for all claim costs if one of your employees is injured onihc'nb.Formorciofhrmu1ion, call the Workers' Compensation Division at the Department of Consumer and Business Sery ices at 945-7888. U.S. InternalRevenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at }-800'829-}040. OTHER RESPONSIBILITIES AND AREAS .OF CONCERN: Code compliance: As the permit holder for this project, youurerusponsih|nfbrreanlviugunyfuUure to meet code requirements that niay be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agentto see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire. or work thai must be re-done. Time tosupen/ise employees: Make sure you have sufficienttirne to supervise youreinployees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work ofrough- in and fiuinh trades, and to notify building officials at the appropriate times sothey can perform the required inspections. ][ you have additional questions, write orcall the Construction Contractors Board (PO Box |4l40, Salem, OK.o7JDY-5O52, 503/378'462)). ThO Board is located at 700 Summer St. NE Suite 300, in Salem. • • prop-ownpm4 \/94 CITY OF TIGAFID 410 . Aiii BUILDING DIVISION PERMIT #: M; T fltl& Qt 2F,7 13125- Blvd., Tigard, OR 97223 DATE 'ISSUED: 1/12!2007 Phone: (503) 639-4171 to opt@ill • Inspection Requests (24 Hrs.): (503)'639-4175 ' 503) 639.4175 - INSPECTION WORKSHEET FOR DATE:' 1014/2007 TIME: 7 :Q3 M PAGE: E5 SITE ADDRESS 1ft'i301: 79TH AVE • • CLASS OF WORK: SUBDIVISION :. DURHAM • " IN ACRES LOT #: 036 - TYPE OF USE ' ,,PROJECT NAME: CAMPBELL DESCRIPTION: 760 sq ft addition . OWNER: CAMPBELL, JEFI~ • PHONE #: 503 -G2( -7517 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/4/07 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 lnsulatiOn 056924 -02 503-620.7517 - N Corrections/Comments/Instructions: • • , -., VeAeki., A-ez_ ,- pcoo-7-r-c___%, W.24_,IAleci.elage,a/ . k 40 ' •17' - / sy IZEA #° gle, ' GI-- Vi d / ' 1 1('-e------ - °r417 - - j4 • • • • F PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS . FAIL • , °' ALL , 4 IN , '- ECTION. _ ADDITIONA _ EES A SSESSED 4/ Inspector / A /A/ ∎,' Date � — P hone #: "(503) 71 e CITY OF TI,GARD 0 B 0 UILDING DIVISION PERMIT #:, Iii ST2O06:LU267 13125 SW Hall Blvd., Tigard, 'OR 97223 Phone: (503) 639-4171 u�iitdltp i . DATE ISSUED: -0120007 ' , t Inspection Requests (24 Hrs.): (503) 639- 4.175 1I INSPECTION WORKSHEET FOR 'DATE: '10/4/2007 TIME; 7 :O i�i><i . PAGE: 66 SITE ADDRESS:, 15030's y79TH AVE CLASS OF WORK: • SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: ' PROJECT NAME: CrAMPBI"LL DESCRIPTION: 760 fig ft addition • - OWNER: CAMPBELL, JEFF., PHONE #; 503- 620.7617 CONTRACTOR: OWNER PHONE #: ,. Inspection. Request Scheduled For: Date: 1t u4 /2oo7 • Pour Time: Code # InspectionDescription „: Confirm # Contact # Message • 276 Framing ' 056924- 1 603- 62017617 N • , Corrections /Comments/ Instructions: i . ;..i -a / it L mi , � �i� � � Y MI • - -ASS PA °. 1 IAL APPROVAL ' ' ® CANCEL' n NO ACCESS IIII FAIL. p • LL FOR l ■ PE ION ❑ ADDITION E S ASSESSED 7 Of Inspector Date:, - t/ - Phone # (503) 714 ' ' 1 . . CITY OF TIGA ' DIVISION PERMIT # . MST200G-00257 13125 SW Hall'Blvd., Tigard, OR 97223 DATE ISSUED: ,Phones(5Q3)'639 X4174 1/1212007 Inspection Requests Hrs.): (503) 639 -4175 iNSPECTION WORKSHEET FOR DATE: 911412007 TIME: 7 :00AM PAGE: 19 SITE ,ADDRESS: 15030 SW 79TH AVE ,CLASS.OF WORK: . SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: PROJECT NAME: CAMPBELL • ,DESCRIPTION: 760 sq ft addition -. OWNER: GAMPBELL, JEFF PHONE #: 503-620-7517 CONTRACTOR: OWNER PHONE Inspection Request Scheduled For: Date: 9/ 1412007 Pour Time: Code #i Inspection Description Confirm # Contact # Message • 235 Shear avolls/enchors 055741 -01 503-620-7517 N Corrections /Comments /Instructions: G' 4)-117- ( !-1 -9, C.4471, �. • • • • I PASS I1 PARTIAL APPROVAL CANCEL 17 NO ACCESS. • 1. 1' FAIL CALL FOR INSPECTION , (l ADDITIONAL FEES ASSESSED Inspector: , . Date: q —__o, 7 Phone #: (503) 718- 7n 4'J • CITY OF TIGARD 9 . • BUILDING DIVISION PERMIT #: MST2006 -00267 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12/2007 Phone: (503) 639 -4171 u �afp9 i Ft1 Inspection Requests (24 Hrs.): (503) 639 -4175 °'f I INSPECTION WORKSHEET FOR DATE: 9/14/2007 TIME: 7:OOAM PAGE: 18 • SITE ADDRESS: 15030 SW 79TH AVE CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE, OF USE: PROJECT NAME: CAMPBELL • DESCRIPTION: 760 sq ft addition . OWNER: CAMPBELL, JEFF PHONE #: 503-62.0.7517 CONTRACTOR: OWNER PHONE. #: Inspection Request Scheduled. For: Date: 9/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message '240 Exterior sheathing 055741 -02 503. 6207517 . • N Corrections /Comments /Instructions; , • PASS ❑ PARTIAL APPROVAL I CANCEL n NO ACCESS n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED • Inspector: - Date: — L4--o 7 Phone #: (503) 718 - 2 ;+4 �� c_(: tti . CITY OFTIGARD 410 "BUILDING DIVISION • PERMIT #: MST2006- 00257' • 13125 SW Hall Blvd., Tigard, OR 97223 , µ DATE ISSUED: 1/ Phone:, (503) 639-4171 ��wdliphii 'ICI Inspection Requests (24 Hrs.): (503) 639-4175 41 ' INSPECTION. WORKSHEET FOR . DATE: 9/14/2007 TIME:, 7 00AM PAGE: 17 SITE ADDRESS: 15030 SW 79TH AVE CLASS OF WORK: • SUBDIVISION: DURHAM ACRES LOT #: 03B TYPE OF USE: PROJECT NAME: CAMPBELL • • DESCRIPTION: 760 sq ft addition OWNER: CAMPBELL,, JEFF PHONE #: 603.620 -7517 CONTRACTOR; OWNER PHONE #: Inspection Request Scheduled For: Date: 9/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message • 242 Interior shear walls 055741_03 503. 62(1.7517 N - • • Corrections/comments/Instructions: • • • • • • ASP SS 1 1 PARTIAL. APPROVAL n CANCEL NO ACCESS 1 FAIL CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED (nsp,ector: Date l-j° /4- - 7° Phone #° (503) 718- • 'CITY. O . • BUILDING DIVISION •`. ' PERMIT # :, MST200Fr00257 13125,SW''Hall Blvd., Tigard, OR 97223 DATE. ISSUED: 1/12/2007 Phone: (503) 639-4171 *iii#00 Inspection Requests (24 Hrs.): (503) 6394175 INSPECTION WORKSHEET FOR DATE: 6/28/2007 TIME 7 :01'AM PAGE: 74 • SITE ADDRESS: 15030'SW 79TH AVE CLASS OF WORK;' - SUBDIVISION:: DURHAM 'ACRES LOT # :: 038 TYPE OF 'USE: PROJECT NAME: CAMPBELL • DESCRIPTION:. 7E0 Eq "ft addition OWNER: CAMPE3ELL, JEFF PHONE • #: 503-620-7517 CONTRACTOR: OWNER PHONE #: • Inspection Request Scheduled For Date: 6/28 /2007 r Pour Time: • p p Contact; # . Message Code # Inspection Description Confirm # 225 :Post/beern structural . 051100 -01 503620.7517 N . Corrections /Comments /Instructions:. _ �'C • • • • • • • • • • • PASS ❑ PARTIAL APPROVAL ❑ . CANCEL NO ACCESS FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: . Date:. --f' : • Phone #: (503) 718 - CITY OF TIGARD 0 , • BUILDING ' PERMIT #: MST200&00267 13125, SW Hall Blvd:, Tigard,'01:1'97223 • , D ATE,ISSUED 1/1211007 . Phone: (503) 639 -4171 /iii Pi Inspection Requests ..(24 Hrs .): (503) 639-4175 _-. , • • ' r INSPECTION WORKSHEET,FOR DATE „ &28/2007 TIME: 7 :01AM PAGE: 73 SITE ADDRESS: 15030 SW 79TH AVE CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 038 - TYPE OF USE: PROJECT NAME: CAMPBELL DESCRIPTION: 760 sq. addition ' OWNER: CAMPBELL, JEFF PHONE #: 603.620.7517 CONTRACTOR: - OWNER PHONE #: Inspection Request Scheduled For: Date 6/28/2007 Pour Time: - • Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 051100-02 . 603. 620.7517 N Corrections'' /Corrments /Instructions: • , PASS • ❑ PARTIAL APPROVAL • n CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED =Inspector ' Date: 6- Phone #: (503) 718 - "•'Z i 'i , ! ti r • , • CITY OF T1•GARD lb A • BUILDING .011/110N „ PERMIT #: MST2006- 002'57 . 13125 'SW' Hall Blvd., Tigard OR 97223 DATE ISSUED 1/12/2007 Phone ; (503) 639- 4 4�10iil 1`71 Inspection Requests (24 Hrs.) • (503) 639 -4,175 INSPECTION ;WORKSHEET FOR ..DATE: 616/2007 • TIME: 7`02AM PAGE: . 47 SITE, ADDRESS: 15030 SW 79TH AVE • CLASS OF WORK:' • • 'SUBDIVISION: DURH'AIVi ACRES`” LOT #: 038 TYPE. OF USE: PROJECT NAME CAMPBELL DESCRIPTION: 760 sq ft addition • . OWNER: CAMPBELL. JEFF. PHONE # 503- 620.751 7 CONTRACTOR: OWNER PHONE # Inspection Request Scheduled For:, . Date: 6/16/2007 Pour Time: Code # Inspection Description . ` - Confirm `# Contact # Message • • 226 •Post/beam structural - 060302 -03 603 - 620.7517 N Corrections /Comments /instructions: . 210 _ - f %�.. r n (/L c ' 1 S ' " eL' •L��S }C�i j o- - • • • • • • • `PASS; PARTIAL APPROVAL I1 CANCEL n NO ACCESS` ';AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: • i' Date:= ( ) ' �7rS � Phone # 503 718- - 2-1 - W) • CITY OF TIGARD 0 3 - BUILDING ' 'DIVISION • • PERMIT ; #: , $T20o 0 5% 13125_ SW' Hall' Blvd., Tigard OR 97223 DATE ISSUED:,: 1/12/2007 Phone (503) 639 -4171 &Iau NIi l " . ' Inspection Requests (24 Hrs.): (503) 639 -4175 1 'III L. INSPECTION WORKSHEET FOR DATE: 6/15/2007 TIME: 7:02AM PAGE: 48 SITE ADDRESS: 16030 SW 79TH AVE CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: - PROJECT NAME`. ' CAMPBELL • DESCRIPTION:. 760 sq ft - OWNER: CAMPBELL, JEFF PHONE #: 503-620-7517 CONTRACTOR: ,OWNER PHONE #: Inspection Request,' Scheduled For: Date: 6/15/2007 Pour Time': Code # Inspection Description Confirm # • Contact # Message 605, ' Post/beam :mechanical 050302 -02 503- 62(1.751 N Corrections /Comments /Instructions: • - PA PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL CALL'FO ;INSPECTION ❑ -ADDITIONAL FEES ASSESSED Inspector: - Date: rL gS — 0 ? Phone #: (503) 718- 72... ,CITY OF TIGARD 0 o , 'BUILDING DIVISION PERMIT # M x1200 00257 13.1'25 SW' Hall Blvd., Tigard', OR 97223 DATE ISSUED: 1/12/2007 Phone:, (503)' 639-4171' emit iii lIt .' Inspection Requests (24 Hrs.): (503) 6394175 ,' __.. , INSPECTION `WORKSHEET'FOR DATE: , 3/29/2007 TIME: ' 7 :00AM PAGE: 12 SITE ADDRESS: 15030 SW 79TH AVE - CLASS OF WORK: ' ' , SUBDIVISION: DURHAM ACRES LOT #: 038` TYPE"OF USE: PROJECT NAME: CAMPBELL DESCRIPTION: 760 sq ft addition . OWNER: CAMPBELL, JEFF PHONE #: • 503-6207517 • . CONTRACTOR: OWNER ' - PHONE #: •Inspection, Request Scheduled For: Date: 3/29/2007 • Pour Time: 10:00 Code # Inspection Descriptibn Confirm ';# Contact # Message , 210 Foundation walls 0.45689 -01 . 583.667 -3938 N Corrections /Comments /Instructions; / 2Li cy-s4 z LL I (, /2' JOh9 ' S/ Z 7/ j' -f /4 " Or eve / • • 1 - PASS 1 " 1 PARTIAL, APPROVAL ❑ CANCEL 0. NO ACCESS n FAIL • n CALL FOR INSPECTION. D . ADDITIONAL FEES ASSESSED - Inspector: • ./` r • „ Date. =�Z<1 --- ' • Phone #: (503) 718- Z.:I -ice -CITY OF TIG R'D . buiLDONG D VISIO . • PERMIT #: . I ST2006 00257 13125 SW Hall Blvd., Tigard; OR 97223 - DATE ISSUED: 1/12/2007 Phone: (503) 639-4171 4 • a iritipp � i I , Inspection Requests. (24 Hrs.): (503) 639 = ,4175. F AIL, 'INSPECTION WORKSHEET FOR • DATE :. 3128/2007 TIME: 7 :00AM PAGE: SITE ADDRESS: 15030'SW'79TH AVE , CLASS OF WORK: 'SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: ' PROJECT NAME: CAMPBELL DESCRIPTION: 760, sq`ft additwi OWNER: CAMPBELL, JEFF PHONE #: 503-620-7517 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: .3/28/:007 Pour Time: 2:00 Code #' / Inspection Description Confirm ; #: • Contact # . Message e ' 210 • Foundation walls 045584 -01 503- 667 -3938 N . Corrections/comments/Instructions: • ❑ PASS, PARTIAL APPROVAL ('.CANCEL ❑ NO ACCESS `. AIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED . Inspector: Date: .?-= 28-0 ? Phone #: (503) 718- CITY OF TIGARD 0 BUILDING DIVISION PERMIT #. MST200G- 002E+57 13.1'25 SW Hall Blvd., Tigard, :OR 97223 , _ 'DATE ISSUED: 1/12/2007 _ Phone: (503) 639-4171 , nundpN • Inspection Requests (24 Hrs.): (503) 639 -4175 ' ,INSPECTION; WORKSHEET'FOR DATE: • 3/26/2007' TIME: 7:00A M: PAGE: 24 SITE ADDRESS: 15030 SW 79T1-1 AVE CLASS. OF WORK: SUBDIVISION: DURHAM "'ACRES' •LOT #: 038 TYPE, O F USE: PROJECT NAME: CAMPBELL DESCRIPTION: 760 sq ft addition y • • ., •OWNER: ,CAMPBELL, JEFF • - . PHONE #: 503-620.7517 CONTRACTOR: OWNER PHONE #: • Inspection Request Scheduled For: • Date: 3i26/2:007 Pour. ime: 1 :0 Code # .Inspection 'Description Confirm # Contact :;# Message ' 205 , Footing . 045391 -01 503 -667- 3938 N • Corrections /Comments / /Instructions: • V . _ ' , h l • • .,,.PASS ❑ - PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ 'FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ° ASSESSED - • Inspector: Date: 3‘d 0 1' Phone. #: (503) 71'8 - 'V ' 1 'CITY F . BUILDING DIVISION (L q PERMIT # K h1I;,1"2fl05- 0412.x7 13125 SW Hall Blvd., Tigard, OR 97223 F,,,,i DATE ISSUED: .111212007 Phone` (503) 639-4171 '1101 i A : ' Inspection Requests. (24 Hrs.):. (503) 639 -4175 �I I � INSPECTION WORKSHEET FOR DATE: 10/1/2007 TIME: 700AM PAGE: 27 SITE ADDRESS: 15030: SW 79TH AVE • CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 038,. TYPE OF USE: PROJECT NAME CAMPBELL _ DES 760 sq ft. addition. O WNER : CAMPBELL, JEFF PHONE #: 503- 620.751T CONTRACTOR: C:)w .ILR PHONE #: Inspection Request - Scheduled For: - Date: 1 QJ1f2U07 Pour Time:, Code # inspection Description Confirm # ' Contact # Message . 120 Electrical rough -in 066648-01 503 - •620.7517 N ' Corrections /Comments /Instructions: . A / ' Z ). 4 57/NI& Lidebit4.45 . 0 ,b _ r= / , Mj.cat .4., , , _ 'II. _ 6.,A, A , ., .1 , . , . , , . . . . . , , . , , . . , • . . . .. . ,, .. . . , . 1 �`!► g (; t . : . . IASS I PARTIAL APPROVAL . ❑ CANCEL n NO ACCESS l FAIL 'I I CALL FOR INSPECTION • ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 0 ( / /O7 Phone #: (503) 718- CITY , OFTIGARD" • BUILDING DIVISION , PERMIT #: MST2006.00257 1325 SW' Hall Blvd, .DATE Ti Tigard, OR 97223 E ISSUED: 1/12/2007 Phone: (503) 639-4171 %.1 0 0p0iI Inspection Requests (24. Hrs.): (503) 639-4175 AL. INSPECTION WORKSHEET FOR DATE:. - 1213122007 TIME 7: ogi PAGE 21 - - SITE ADDRESS: 15030 SW 79TH AVE CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: PROJECT NAME: CAMPBELL DESCRIPTioN: 760 sq ft addition OWNER: CAWBE- JEFF ' PHONE #: 503-620-7517 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/31/2007 Pour Time: Code # Inspection' Description Confirm # Contact # Message • 322 Shower pan 062362-01 503-6201517 Corrections/Commente/Instructions: L- of t Li kg e- • PASS I 1 PARTIAL APPROVAL 1 CANCEL NO ACCESS fl FAIL fl CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector:M Date': V2,1 7? ),D Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION : • PERMIT .MST200S -00757 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1217007 Phone: '(503) 639 -4171 ied4luwi fl I nspection Requests (24 Hrs.): (503) 639 =4175 INSPECTION WORKSHEET FOR DATE: 9/28/2007 TIME: 7:00AM •PAGE; 32 SITE ADDRESS: 16030 SW 79TH AVE CLASS OF WORK:. SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: PROJECT NAME: CAMPBELL. DESCRIPTION: 760 sq addition • OWNER: CAMPBELL, JEFF PHONE #: 503 -620- 7517 CONTRACTOR` OWNER PHONE #: Inspection Request Scheduled For: Date: 9/28/2007 Pour Time: • Code # Inspection Description Confirm # . Contact # Message 320 Plumbing rough m 06'6673 -01 503.620 -7617 N Corrections /Comments / Instructions: • • • • g PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED p L J.CI:t- --1- -- X1 �) Phone #: (503) 718- Inspector: r Date: ` CITY OF TIGARD 110 410 BUILDING DIVISION PERMIT #: MST2006 -00257 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12/2007 Phone: (503) 639 -4171 invti lI Inspection Requests (24 Hrs.): (503) 6394175 ..._' '` :_.. INSPECTION WORKSHEET FOR DATE: 6115/2007 TIME: 7:02AM PAGE: 49 SITE ADDRESS: 15030 SW 79TH AVE CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 038 TYPE OF USE: PROJECT' NAME: CAMPBELL DESCRIPTION: 760 sq ft addition - _ OWNER: CAMPBELL, JEFF PHONE #: 503620.7517 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 611512007 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post /beam plumbing 060302 -01 503 -620 -7517 N Corrections /Comments /In ructions: , 5 , /A-4--f c-"Le II . 17 LC-LQ.5 ` \'d . 1 ... x k.A /\Air t J 2(4r _ c2, \--) eiA■ • . • .,\ i e . _ /Th . . , PASS 01 APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ C ALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED • Ins ectori D a t e: P hone #: (503) 718 ! v�