Permit A ' MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2004 -00306
1y; DEVELOPMENT SERVICES DATE ISSUED: 2/17/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 07864 SW DUNE GRASS LN PARCEL: 2S112BA - 10200
SUBDIVISION: BONITA TOWNHOMES ZONING: R - 12
BLOCK: LOT: 038 JURISDICTION: TIG
REMARKS: New SFA
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 82 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 659 sf GARAGE: 570 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: 627 sf RIGHT:
VALUE: 142,644.60
OCCUPANCYGRP: R3 BDRM: 2 BATH: 3 TOTAL: 1,368 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
. MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: 0 GAS OUTLETS: 3
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1st 1N/0 SVCIFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNALJPANEL: 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: SVCIFDR> =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:
Owner: Contractor: TOTAL FEES: $ 6,591.49
JLS CUSTOM HOMES JLS CUSTOM HOMES This permit is subject to the regulations contained in the
Tigard Munidpal Code, State of OR. Specialty Codes
16280 NW BETHANY 16280 NW BETHANY and all other applicable laws. All work will be done in
BEAVERTON, OR 97006 BEAVERTON, OR 97006 accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 533 - 4006 Phone: 503 - 533 - 4006 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
'Reg #: LIC 139970 952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -6699.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
High- strength bolts
Structural welding
A
Issued By : J �1 / i • t �A Permittee Signature : 11 , 44 ,k _ ..,J
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
V • litt'IC
Building Permit Applicaii.on k noi ::....::..::,;: 0710 USE ON1.11(,
., , Ut, — • L
City of Tigard Received 0 4 4711r — dinp i .
nITY OF TIGARD
13125 SW Hall BI d . Tigard. OR 97223
Phone 503 639 4 l7i Fax 503 593.1960.--- - ' Plan Reiiiieli o 0 5 p
DaieBi. i
Inspection Lin , 6 ,-- tt fttc)..it BUILDING DIViSIOZ1/1
't irt-:t.:, Da:e Reaciy.B- Ji, ,„. 121 See Attached Checklist tor
ITtertlet" Ct itgard or us Non riediMelhod 1/4,0'. Supplemental Information
Qt_ rU 6
TYPE OF WORK .
I RE :RED DATA: - AND 2-FA.MILY DWELLING
I
construction Demolition he Permit fees' are based on the %alue of t work performed
KNew 0
-. indicate the \ aloe (rounded to the nearest dollar) of all
0 Addition alteration replacement ['Other 1 equiprnent. 1 labor oNerhead, and the profit for the
■ v. oik indicated on this application
CATEGORN' OF CONSTRUCTION t_ _
t
1 $ '4' -
1- arid 2- funiii. thi..elline XCornincrciak industrial H- \'aluatiou - 1 . .
'--
Number 01 bCdrOoms: .)--
Ei ACCCSS01:, 1:1111(3111g 0 :\11.1111-1:111111 ___
Master hider O
Number of bailnoorns 2. S -
El il 111 Other
Total rinintict of floors -5
.1013 SITE INFORMATION AND LOCATION
Joh site address fag . „ink, yit a-vasc) square leer
-----'
Cu Staic:711) • /IL CjL_- Oa! 5:0 'carpor t area: 570 square feet
111 i •
SUM laldt2..tapt no 1 ;roject name
C ( N k_VC-L■_ (._ ■..tt. ered rOlill area a...q
square feet
CT ()SS 511001 'directions to Joh sitc 7)CyCs Deck Llre;1
1...1-0 square feet
Othei slItICilile 2103 square feet
. ---
REQUIRED DATA: COMMERCIAL-USE CHECKLIS f
_
Subdivisto, \ -V s - A „ . iL 1 1 ,), Ho 55(
, 1,,,_,,-,,,-„, ,,,,„. :„::, i-„,,,,i on Mc \ :due of the \yolk performed
Indt,,lic the - ttiltte 'founded to the nearest dollar) of all
1 :IN /mil n;IrCel 110 a , ,,, c ).....„ \
N1111 111:)1:11,i15. I;11)01 0 \ CI head. and Mc profit lot the
DESCRIPTION OF \yowl< , Of 1 indlc:11Cd 011 this application
_i
Valtrition S il e ili 1 1 0 0
15]suiu2.1 area: square feet
—
N0 i). builihin; area 1( r square feet
----
--_
A pRopERT), OWNER
1 0 TENANT Number ot stoi c
i c ' _*_.3
_ -- -
:\ time- \,\ k-S --. \ AC Me L. I of construction:
Addi css Da.g° I\SITDt_Q_A-CM,---" Ot: clipany. :.:roups
,
(=it} Stait 71P .S20.....veyli (1?._ c t ti
— - -
Phone: 15bl/ Sb3- 1-1_03(:■&) Fax . cS e S'63 _ 1-13C)(0 Nett\
_
0 A P PLI CAN T 0< CONTACT PERSON
NOTICE
Business name _STVIE All contractors and subcontractors are required to he
Contac name liCellStd v. Ilh the Oieg01 Construction Contractors Board
under ORS - 01 and may be required to be licensed in the
.Address- --___1•Y\._Ei jurisdiction in s hich , .■.ork is bein2.p.erformed If the
applicant is t! frOITI ficensing, the f0110Willg reasons
City
:trot..
_
Phone (SOS.) ° I (09- 1 1- 1 S i Fax ( ) `Plille_,
E-mail
CONTRACTOR
13 usincss name
BUILDING PERMIT FEES*
Address
__-L Please refer to fee schedule.
Cit St:lie-ZIP
Fees due upon applIcation
i
Phone: t i Fax ( )
)
Amount received
CCB I ic. i SCI
Dr„, r ccti \ ed•
....-
Authorized signat e / This per mil application expires if 3 permit is not obtained
s, i i h in 180 da)s after it has been accepted as complete.
r
P rint " 1
1 1 name ells.s Date: i " Fes inethodoloc\ set by Tra-Couar: Building. lndastr?
Ser. ice Beard
Builc!,,r,',Permits ESUP P,rrnItArp .1, ,:' ';': .340.45131 COM WEB)
r-iet m m
at r et it "-Applic n atio
li OC -s; ' k
City of Tigard Received
,
DaterB:._ Perrni t N44.76 ....
e 13125 SW Hall Blvd.. Tigard, OR 97.72 j9 Plan Revie,
lh
Phone: 503 639.4171 Fax 503 598 1960 •
G1
Inspection Line. 503 639 4175 DIDaarteen3;: Oer Perrrut
ad JUI, 1 0 See Page 2 for
I , Axx-A.o tigard.or.Rpr
filrki Ell .
''...1
Notified:McOlod 1 Supplemental Information
.--
TYPE OF WORK PLAN REVIEW
. „...
El j\le construction 00 Addi3tortUla!tation'replacement Please meek all that apply
0:Ser. ice o. eT 225 2n-ps. cornm'l OHazardous location
E] Demolition El Other
fil cc. 220 amps - rating IliBuildn2, over 10,000 sq I
ci3DIPLORYng0Nks R u cm ON co 1- 211( 2-1:11111i% ilWel111125 d or more new residential
ES c.. 001) vohs nominal units In one SI
El 1 Lind 2-1 dv.elli2PMQ: industrial 0 Accessory building
DBuittnnE ci\ or three stones OFeeders. 400 amps or mo
11 11.1111-lamily 111 Nlaster buddel [II Other:
1110ccitpant lead c:-.0 99 pClsons ONIanufactured structures
JOB SITE INFORMATION AND LOCATION IllEgtess 111.21;t:n3 plan R\ pail(
00th&
Job no 1 ,, site q 5 bo 0iili,,,,f,,,ii,
-.. plz:ns 'xlili 2.n:. ot the abo\ e
C11:, 'St:itc Z I P ----[ i t C . !101 ::rphable to tempoian construction seri.ice
,,___ -----1. FEE* SCHEDULE
Suite b14 .117 no 1 Project 111_11 .1.0 ,......_
nt D,,,,,,,, ! QIN 1 Fee Total
_ —
Cross strecti directions (orb st ¥16,1. C , ,... V ......_ :\ cw residetinal stligle- Qr multi-family thselling 111111.
DarViVi 1 '<-1C----- 111CI rides all:it:lied mra■,..-e.••
-
, : r■ ei c c. li_ ■.1 1353 145 Id
Ea .1,1 sq it oi portion I 33 dili
Subd i \ isioniznai_kcx.._ ocr\.,_\AliwsLI Lut 110.: _
res,„„„31 T5 00
1 a: map/piitcel no . c .)S 1 ( ...i. Lai2
1- I in ,111t11,1'. 11 C.111. 1 :::.1LIC1111111 75
DESCRIPTION OE WORK [T 11 rrr:rnrr, 1fl:.'■1 14 111( I 1 I
t.1% :1,: :Ind c feeder ; 90 90
, :er Res (.t leerier installation. alteration and;or relocation
Su
- g. pRpERTy owNER 1 0 .1-EN.ANT . ._i .,:r;r, -1i. anss
1 1(
— ' S.
o
'
tH .::■;or io o .imrs It0 60
N:1111e __Lk..1-LLQTYA_ -S1--0 t- 1 .tdItt it i .tt .tuint; , 2 - (i t
-
AcId1"." i
‘ \ 6 a.Fs, kiu,. c- LiR___Y■ CA— 2 , ,,; 1 ,, , , ,.mr , tit
Itti rt.:mt.-0 c.it. - ttt •.4 rill.
-i - -
Cri v ■ a I c. 711 - ,..k n Q .._____ --- ..3
I ,,, serc ices or feeders imoallation. alteration. and; or
1-- 1 arc:Ilion
Phone 16 ,1 S C/O() ( 1
! Li\ (',5tn 5,3-10 _
.i,„ ...!:-111 = ,, ],..,:, 60 85 1
Owner Inst:111:mon: I his 1m:1:111m:on is 1 intit.le on prupeit:, 11131 1 own which Is nut 17' - ,11::, , ,, 0•10 :Imps KO "_
iilICn(iCd 101 511C. 0 c,1: Tent, 1)1 1:31:11;inyc_ -- .1ccoldin!.z ler URS 44 4-19. 57Ci. and - 0 i ,-
I I H3 7 5 I
.
Oi.vner sn,mattire. - . Date Itt.liall 01-0iits - 110y. alter:lin e■tension. per panel
.._
0 Arpt1cANT 1 LcONT.Acr PERSON A 1 lc.) 1 11 circtills
— ,c:, I, 01 tenter :CC. ncil
665
BlISilleSS n:11113 6ra1 :.. c11x.:111
- --
— 1 Fee !or branch cucurts
COI T-IltIllt: W- - L. . ■ 11 U);1.1,.. Ser ;CC or feeder tee.
-16
--- E
Address: TY1-F btant_hurcon
ach aLtil 1 cIrCUlt 6 65
City /Stale ZIP i Miscellaneous (sers ice or teeth.' not included)
Phone (2 Ct _ 1 (-13 1 F:r; . ( 1 SR rYt & 1 p,..fii, ,..r imgation circle
1 Sism ot °ohne light
53.40
E-mail: I 615121(11(011131 1.4 hurled-
CONTRACTOR c!
' e'per:. Innel, .)11er 3)100. 31
I ' ,- ,
e\ 11 e Cli
IC11:10 li Page 2 ,
Business name.
Address a I C...:) nk_k k\ 1 E201 arlditronal inspection r,ser alio able in any of he abovr
r
, PC1 1115.1 1 62 50
City State /1 1' R., ,-, 0, . 9,- i u s
131 11 !1(q11 i 1 31 131(11 1 6
Phonc (53i t in _‘.6..- 1 F:1N (ziStt) _ 5RIS
111,111Stilal 91211i per hour I 73_75 .
ELECTRICAL PERMIT FEES*
CCB Lit:: I 8R 1 Electrical 1 c _ 1 4 - . . Supry. Lic..
Subtotal
i d _7-----
Supra Electrician sit:nature. required A hp. a re. ieA 1 25' , ; , of permit fee)
-.0 1 ra :-.
Print name. 5 E V ..- I a W 1 Si:aft. s1.7ch;:Tge (S'/, of permit lee)
_ i Dare:.
_.
TOTAL PERMIT FEE
i , - ------• ,
., E -
Authorized sist • Tture. This permit applicanon espires if 2 permit is not obtained within 18
' - clays alter it has been accepted as complete
Print name: c 11 -
E cA__-_ __, j Dale - Fee me:hc.cloc :: b:. Tri-Counr, Buildme !ndustiy Ser.ice Board
-- Num'oei el m5pec:ions per pe1 2110wed
i'.13.1dIng•I', dr; 00 22v.2 6 IfT(ID.OTC01.1',,TO
; 1�lecnanical rermli Pt ppiicanon FOROFFICE_USE.ONLY:
City of Tigard Received
Date.13: Perrrn Ij r 0
N. o' ,
t 13125 S. Hall Blvd Tigard, OR 97223 Plan Re•.re• /( �(�
Phone_ 503 639_4171 Fax 503 598 1960 1 r� i� Date B. Other Permu
lnspectIon Line 503.639 41 7 C ��� ED I +1 .-. Date Read. By lu,a 0 See Page 2 for
\ Internet\ .l el h r u
gard os NOW Supplemental Information
n(q)rPE bF ARK COMMERCIAL FEE* SCHEDULE - USE C13ECKLIS7
New construction ❑ Addll;on'altej It n replacement Mechanical permit tees' are based on the value of the , .pork
� ! per,cm
red Indicate the , alue (rounded to the nearest co!lar) of a
❑ Demolition Q F ��� � HK S ION rnechan:cal n; eputnment. lal`cr, oxerhead. and profit
r
CA a -&i Y OF CONSTRUCTION value g
T
RESIDENTIAL EQUIPMENT r SYSTEMS FEES`
I- and 2- faith dhelllnp XCnrnmerci :il.mduotnal ❑ Accessor, building 1 -- — —
I f ur rec .01 lr_ , "7{:i:0t 010 chr`c L. r
El fltatl- farntly ❑ 51:inter builder ❑ Other r,
�
...., r ,. t.i,; t -. Ea , Total
JOB SITE INFORMATiO,N AND LOCATION I Heating, (moll
iob Site address Nat l .+i- �c:'Jluontne or heat Trump
j �
Ireque < - s site pl.;n shn' ,r.e oho r.,l ! 4 "''0
i ;0il':00 814 (d . 1400
Llt`.'Sta lc; L1P. _ � O Y . q3 id (ducts _ nvs� � _
1`
I — - �J — T - 1 Funace ',„ r:(!( GTU : .enc.: I - 90
uc.ld
'h�� -'apt no Pi name
Su —
h 1 O s : i p "' 11 00
irceL'dircchons to lob site �D'Lic : -rnl. 14 C.0 !
X11 }
Cross s � �c�. � �� i -- � - —
K 1 11 drr"_ic hul':';uer s_ � a 00
Rc>ieenloil hot!et iruhator o1
h.dr,�nr. ■ 14 00
— -- — brut In':ae'-: duet - type, net elecnie:.
111 :1!I_ in- ,!.:a- 5!. '1uded, et( 1', c:!;,
Fluff en! "1 :n,. a ' _ i I
`ulhdr.lsio1 Tin i no --- 1 = — —r::, - --
S— (,Mitt U
Tax Mar parcel no fhIi hid r r liances
i
a�� ate 1f
DESCRIPTION OF WORK Hs\ :uer he = -`:r — 1 n:,
• 51•.:r :::, 1 ,s,li i 1u':1I,1 I
— — — J ,1 p_Ik� t . 1 - - -- - - 1l
`,1, ,,,-,`lice msen Ili rav
M, PROPERTY OWNER ❑ 'CENAN'T
— — — — 1 71: . I o Cs
Name �L� ` 1 a / . Q \M j F.initonmental esh:tust and senlilatIM)
-
�._V 1 LiA 1! r! ' - R:r !": Billet kit, he:1
Address (ID Q
Cli r'State Zlf ��p � t -- ‘ --) i� F !nthes dl rt e`.h_usl i Ct 00
Stncic_,lust eshautit i•ath,cuns,
Phone - 3 ) 513 - clOun Fa -,- s, 533 4 ( 6 . l
1,,,k comp rlmcnts uhIll ,00msl 6 80
. ❑ APPLICANT I CONTACT PERSON Niue cre0 Ispace !;ins 1 0 00
Business name. £h M F Other } 1000
F, Fuel d in g
Contact name $5.40 for first four; 51.00 tor each additional
Address' '�A M E 1 1 urn::ce. co_
�!� 1 (;as heat pump
Cits !State'ZJP
\\ all. sutpended 01111 lietrr 1
Phone (5 ) 10 - 14,5' Fax . l ) 5t c•(\-, `,rater heated 1
u F;, epla ce
E -mail — I
1 Rance
CONTRACTOR Barbecue
Bt151ne5S name \!_ec C ies dr. er ( !
--
v� 1111CC� -��
4 "
Address 5�`� MECHANICAL PERMIT FEES'
Cir Sl ate,'ZIP - --
(V ` _ Subtotal
Phone (52) 591 -cip fax 1563.18 _ 89 nlimmum permitfee e
Flan re.ie•'. °'e of permit tee)
iee)
CCB hc_ 1 L{ 131 � 1 State surcharse (S ° of permit fee
TOTAL PERMIT FEE
�_ r ` his pet mn apphcau ,s
on expires if a permit ,s not obtained ilh,n 194
Authorized sieptature- '
. _ _ ...a. Bass atter i1 has been accepted as complete-
1 Pnnl name ' 4 c t Date i ' Fee methcde,!o_•;. se, h. Tr".-Count". Budding Indust Sen. ice Board
, '',Budrm€ Penrr, App doe !2 arC 451:1 I I I ` ,,,5'l
y tsuildtng fixtures
Plumbing Permit Application FO OFFI USE ONL ,�`,
t
City of Tigard Received ,��
Date'9�- I Petn"at N,_ / i - //�� I�j
1:125 SW Hall Bl . Tigard, OR 97223 .0. r
d -
Flan Re�re�z "
Phone 503 6 9 41 i I Far SG. 598 1966 Curer Perron No
p � i1,� ,� Dat
2a Hour Inspection Line 50 ='639 = 1y,�'�i i� ,.. - -
��j E ��C " Dale Read: B 0 See Page : for
Hemel_ -5, cr - ligard Dr US Notifedl•lethod Supplemental Information
1'YPEr0 WO}t7C - " t0 FEE` SCHEDULE
Nc; \C construction rrllClrOn yY ❑ °_rj ���� tl On For special information 115e checklist ■
�r l l�+ � -- Dcsc u — 1 Q_'� i Ea 1 To ;al
❑ Addition alter ation'Ieplacemenl GI, I 1 Q� 10 Ne.\ 1- 2- (amity dwellings 11nclu•.ies 100 ft fnr each u11111 conneCi Oi
- CATEGORY II STR[ CTION,• SFR (1) b _ � ar, _1 r- —
I- and 2 2- lamil_' J's aim! onuncrcral'indtislrral SFR ( =) bad: 350 ". :('
[11 SFR i3., �1 99 C,0
Accessory building 1 ❑ 1%1ul6- fannly
- -- - Each additional balhAuchen 1 15 00
❑ Master hutldcl 1 ❑ C'Ihcr. — — — —
F:re spnriMc, I sa 1t) 1 Par._ 2. 1
JOB SITE INFORMATION _A-ND LOCATION :.f <. Site utilities
site address �1 1 _ , / . �S -0 Catch ha'.
m ur area dram b ill
Cil'1'Stare ZIP ,-----_,--- 7c, ` P 9 Dr. yell. le „,:h brie, 01 trench digs 10 t -i
- -- �- } Foniir drain (no linear ft- I 1 Page _�”
Suitc.bldg,apt. no V Protect name� V 4...0......_ - - --
-- " " "`� — (.lanufacu:led horse utilities 1 it" (1 I
Cross street. JlreClions to job site - ` �,, r . - I -- --
— - - - - - -- -- - "--- " - - - - -- _ - - fCn.iraln connec. 100 Ir' 1)'
- - — — nntan _c_r (no linear 11 1 - -- I : - - -I --
5: I
rn , ,. :'.'cr (no Inca, It t I'a - ■
-- —�� — — 1 - — I -
$ubd ;ISfo :r 1 - Of no . -tir sc'.:cc (n, 1,,,,,T fl t I 1 l.e, _ J
-- - /� )_^ — — Fixture l l l l l e l l l
Tax map p;acrl no _L��/1L �I�/D — - - - - --
h; . ;Tt t o ,,:I .,• I I(. 0
DESCRIPTION OF WORK . - - - - J — —
H,i, l.;1, v pit'•. enter P.
— — —
- lt.Ilr:.5 °slier i I ,."
— — - -- - - - -- -- - - - - - -- -- - - " - -- - -- - -' I t ; .. nip
rzi I lD as PROPERTY 0 INinl:un
n f :,n!, U
1VNER - -- - -- I -- l-
❑ TEV :� \T' f rr:
'
- -- 1-re c 1l 1 - alms 1 1 ( , nU
N.imc- 1 - ( .UPS SL S F ,
" - - .. -_. - 1-
.r,anslr�n tank i 1 (, 00
1Add,,,„ o, Fn.;ure SL:'. rr cap G (.',■
Cif:, Slate ZIP ? :Kl 1 1 N 1 V1 drain' floor sink. 16 iii I
- - -- � try x 1L � ? 1-1— ��� F1
� r- - - - -
Phone_ ( a 1 533_ LiOcAL, Fa). 1 563)5$ 4� 110 b e drspioil 1 ;1 1.‘
w � � - Hcse bib � 1 :i 00
❑ 1PPLICANT K.CONTACT PERSONA -
1 lee maker 10 69
Business name { rn - --
- - "__- t.'
- - - -- Interceptor'eicase trap 1 660 I
Contact name
I lb • _ ;`ledi g as (value 3 ) Pa ce < • - _ _I
Address- 3_ J E Primer 10 60
j
CIh',5latcrZIP_ Roof dram (commercial) 16 60
Phone I5 ) cia.- y/53 Fax _( )_ fV1� Sink. basinda 1h GO
E-mail l Tuh,sho,�rr.atc,�erpan 1r,6,rj
Uri 1 h -
CONTRACTOR
er closet i !, 1,( '
Bnsrness 11::111C �`� ¶"\ I '\ \ e _ I_ - 16
- - --
: ate, heaver 1 6 60
Address c 2 1- J� _ � � • Other —
b — r
Cif $tale.7_1P _�� *�l�Sb� Y� ' -- 93_
— Subtotal J
1
-
/ NI:nlmum permit fee 5 5i '
+'' l
Phone- (5631 /„Zes - 1 l0 `za_ Fax: (6A31 1 6 ] B _ y Res :dentlal backflow minimum pemut ice 536 1
CCB Lic - /� C'' + l� QC i1 - Plumbing L .. ,,
rc. no ..3q .) L -- Plan review (2559 of permit fee)
V QL C J v State surcharge' R.d of pc in n feel
Authorized signature; �.
L� - TOTAL. PERMIT FEE
Pnnt name _ Date_ This permit application expires if a permit is not obtained within
I aka 0 — ■
180 da }s after it has been accepted as complete.
'Fee methodology set by Tri- Count}' Building Industry Ser vice Boar(
BaildmePerm:t. FLP.1F retmitApp due 12.11 110- 00767110 /l,✓COM-O.F.B1
CITY .OF TIGARD
BUILDING DIVISION PERMIT #: MST2004-00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2f17/2006
Phone: (503) 639 -4171 Aki, �l �
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' -_—
INSPECTION WORKSHEET FOR DATE: 7/26/2005 TIME: 7:07AM PAGE: 42
SITE ADDRESS: 07864 SW DUNE GRASS LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 038 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 503 -533 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503 -533 -4006
Inspection Request Scheduled For: Date: 7/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012157 -01 503 -642 -2800 N
Corrections /Comments/ Instructions:
1 6 h og- ` 1_, `l I! , a � .
I ,, e _
asp P . - y • /r l - a. -1I' 2.4.......___ Imo»
I I
7 4ASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CA / OR - Er IIN ❑ ADDITIONAL FEES ASSESSED
Inspector: /L_ /I Date: No P Phone #: (503) 7182
CITY OF TIGARD -
BUILDING DIVISION J PERMIT #: MST2004 -00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1 7/2005
Phone: (503) 639 -4171 %/ /f / " /pI P�41fl1�ill
Inspection Requests (24 Hrs.): (503) 639 -4175 ._'!� `: -..
INSPECTION WORKSHEET FOR DATE: 8/9/2005 TIME: 7:05AM PAGE: 59
SITE ADDRESS: 07864 SW DUNE GRASS LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 038 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 5503.633 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503 -533 -4006
Inspection Request Scheduled For: Date: 8/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 013155.02 503-209-6824 N
Corrections/Comments/Instructions:
l
`'
A I -41/V
PAIINAVEffil;
• .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR SPECTION ❑ ADDITI NA EES ASSESSED
Inspector: r \ Date: ICY
Phone #: (503) 718-
CITY OF TIGARD ' N
BUILDING DIVISION PERMIT #: MST2004 -00306
13125 SW Hall Blvd., Tigard, OR 97223 �� DATE ISSUED: 2
Phone: (503) 639 -4171 "' " "
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' ! `__—
INSPECTION WORKSHEET FOR DATE: 8/1/2005 TIME: 7:05AM PAGE: 6
SITE ADDRESS: 07864 SW DUNE GRASS LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 038 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 503 -533 -4006
CONTRACTOR: AILS CUSTOM HOMES PHONE #: 503.533 -4006
Inspection Request Scheduled For: Date: 8/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012557 -01 503 - 209-6824 N
Corrections/Comments/Instructions:
/ � 41
c.------ 4 di k
p
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL MI CALL FOR INSPECTION ❑ ADDITI • AL EES ASSESSED
Inspector: Date: v 615-- Phone #: (503) 718 -
\
CITY OF TIGARD
BUILDING DIVISION ' . PERMIT #: MST2004-00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/2005
Phone: (503) 639 -4171 46, i, gp
Inspection Requests (24 Hrs.): (503) 639 -4175 -__—
INSPECTION WORKSHEET FOR DATE: 8/4/2005 TIME: 7:08AM PAGE: 32
SITE ADDRESS: 07864 SW DUNE GRASS LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 038 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 503-533 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503-533-4006
Inspection Request Scheduled For: Date: 814/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 012828 -01 503209-6824 Y
Corrections /Comments/ Instructions:
1.; • • SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4 fr
Inspector: Date: Phone #: (503) 718-