Permit A .
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00310
_am. aili', DEVELOPMENT SERVICES DATE ISSUED: 3/7/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 12 BA -10600
SITE ADDRESS: 14475 SW PENNYWORT TERR ZONING: R - 12
SUBDIVISION: BONITA TOWNHOMES LOT: 042 JURISDICTION: TIG
REMARKS: New SFA
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 318 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 823 sf GARAGE: 480 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 TIOtD: 802 sf RIGHT:
VALUE: 194
OCCUPANCYGRP: R3 BDRM: 4 BATH: 3 TOTAL: 1,943 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 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: 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: 3 201 - 400 amp: 201 • 400 amp: 1st W/O SVC/FDR: SIGN /OUT UN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & 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: This permit is subject to the regulations contained in the
JLS CUSTOM HOMES JLS CUSTOM HOMES Tigard Muniapal 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.
ATTENTION: Oregon law requires you to follow rules
Phone: 503 - 533 - 4006 Phone: 503 - 533 - 4006 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
FOTAL FEES: $ 6,984.40 direct questions to OUNC by calling (503) 246 -6699.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
High - strength bolts
Structural welding
Issued : L6PAJ,04fig Permittee Signature
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day.
This permit cant 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.
Building Permit Application FOROFFICEUSEONLY
I
City o r ��� � Pernut N �
Tigard Received "I17/ v/ — x 3 /Q
1 3125 S5\ Hall Blvd . Tigard. OR 4722= rA I an IerP.Be ; ��rcn
Phone 502.6 =9 4171 Fax 503 598.19 CE� V Date:B j. /
, 7 _05 Ds p O rher P t ���i�
a
Inspection Line. 503 6.4 4 1 �• PlDa Date Read. A , I D See tries teed CheclJist for
Internet '.* °•s�s'.ct ugard.er us ;3 ��U Votified��•iet6cd Supplemental Information
_ Uhrt -
T Y P E T F f 1}_C�YRN(�p D r REQUIRED DATA: 1- AND 2-FAMILY DWELLING
\e.; conslrucl:on R 1!LtD , mlol titlbn �v I Permit fees" are based on the ‘•aInc of the '.sork performed -
1 Indicate the value (rounded to the nearest dollar of all
ID ,addition a,lteratton 1 El Other: 11 equipment_ materials, labor, o' cihead. and the profit for the
CATEGORY OF CONSTRUCTION
.ork indicated or, 1111S application_
Valuation_ s l q/ `1 � z _ yo
1- and 7- f;tmll■ chsellmf �Conunelcral'in urinal j Y/
Number of bedrooms
❑ Accessory building ❑ Multi- farrul_,
--
•umber of batluo 2
ill Master builder 1 ❑ Other: 1 1— •
-- - - --
JOB S1TE INFORMATION _AND LOCATION Total number of floors
3
(Ai � 1 � � v n
Job site address: LEE 1 r I _ Nev d.".c•ll;ng area (gt fj sy re f:1
Cyr)'StateiZ_IP: 1 -- Garacc carport are: Y ESO square feet
• Suite bldg 'apt. no : Project name - t - -- -- _ - f o'. ered porch area '3 41 square feel --
ddd���JJJ 4 --
Cross streeu'dircctions to job site Deck area quart fart
' QIhel S1lllrinr, 11rC.1 '(1L;iie Iret
_ RFQI'IIRFD DATA: ( Oy1 \1ERC1.AL - 1'SE ( 1lF( KLIy F
Suhdis'rslon I_t no 4 l''.:111111 fees' 111;: 1,;;,e11 nn ti:c - .;!u1 I 11D1,. \ l-eu e„
�� Q \ `-- Indio.lre the ',Au:: ilound:d to the nearest (Jolla t t r al :.
lax map parcel 110 a., L� I Q y t
e4Iulpnnnl. n).uCrtals latent 0.cihe3k1, :Hid the ph,■ • !Iti
DESCRIPTION OF WORK . -ilk ni,iis. on iliu of ncc_mon
—
, ulu::nmr. ti
CaD
- -- -- -- - - - - -- - - - -- - - -- - l.'•.tsur,gl square le,:
- Nev, huililnio._10.1 square leer
I'ROPERTY OWNER ❑ TEN:1Nl' 1 \'umber of •tone•
---------- --
NName. �.J � C
�� � �
— Oq�n - - C ----- - - - - -- i -1:T: et orn >Irucuc:n
C O � Q- l'rru,):mc. .,,,,,I,,_. ... -- -- -- _.
Q
L>.IStln
Phone. (5b3) S$3 L 1 _ t 1/4 . 0 Fax. 1.S b3) 3 1 -164( 0
❑ APPLICANT [ CONTACT PERSON —.
NOTICE
Business name. S T- ) —
All conuaclors and subcontractors are rcquned'o be
Contact name. j l licensed 's uh the Oregon Construction Contractors Board
� �� under ORS 701 and may be requited to be licensed in the
.Address I J unsdtctron m ..Inch ". ork is being performed 1f the 1
Clh'Stare. %ZIP. apphc.lnt Is exempt from licensing_ the following - reasons
2 —J appl:•
p.
Phone: (SOS) 1 (4,9_ ILIS J 1 l Fax - ( ) �p 1 7— �
E-mail -
y 1..... CONTRACT_ OR - -- — -
—
Business nam 5R ► ' 1 e:
C 1 BU'ILDIN'G PERMIT FEES'
Address - --
-- — 1 PL ^ace refry r°-11" schedule. Cits •Slale:ZIP- -
- - Fees due upon appltcal!on
Phone - ( )
Fax. I 1 -
• 9 l �� - j :amount recet.ed 111
CCB tic: i 3
Date received
Authorized signatt This permit application expires If a permit is not obtained tithin ISO class after it has been accepted as complete.
Fnnt e1 G am
me: � - Fate - -. ' Fee melhodo':oa', set n\ Tn- (. Budding lnd.tsr::
S!i Board
1 RuSldeigPermas dr•c 12 ^? 4.1l I."r, 1 i v: CCM -.',-CN1
N., L:1C.LI 1 . 11 1 CI will :it.1J1111:dL1011 1 1 1 • '
City Of Tigard Received
Permit No III 0, ....06 / 0
By
Date..
,i 13125 SW Hall Blvd.. Tigard, OR 9 7223 -
Plan ReYlca.
Phone. 503_659.4171 Fax 503 -593 1960 Da ;e :T, 0l..1er F
Inspection Line: 503 639 4175 EIVE . 1(.. Date ReadY.To. '.r' RI See Page z for
Internet wv.,,, ci ligard.or.us REC Nonnedi4elhod 1 Supplemental Information
TIgrEE OF R }4 R' PLAN REVIEW
❑ New construction Z~ Please check all that applj
❑ :h]dillon.alierahon, replacement
❑SenICC o :er 225 an-ps. Comm 1 ❑ Hazardous loc;nlon
❑ Demolition ❑ OtheY:
,�-�• ❑ .- cr. o'.cr 320 amps ralme ❑B :aldnr-, over 10.61:0 sq f
C.aTEGt`1RlF -G) S t,F� R ,L��' TION 01 I - and 2 - far. •d•oeiI1nos or mole nee. residential
31 ❑S:.slcrn o• cr 600'.olts nominal ;1:1!15 in one s:rucr_ne
❑ 1- and - family dwelling 0 ,.ornmercod.rndustnnl ❑ Accessory building
❑Burldms 0x e1 three str•ne5 ❑Feeders. 400 amps OF rnci
❑ hlu]ti famil.x ❑ \taster builder ❑ Other.
❑ J: cup.anl 164d C''..21 nI, perSnn. ❑ .larn.:f::cwre ac
;;r.1c. :, r
JOB SITE .INFORMATION AND LOCATION ❑ ress 10 plan R-� !
Job no lob site address J-1 'I Q �� - -
J�`� CS I � : ' sets of ply n s . � l ll; : of t he ate' e
Cll :"'State'ZIP- I ► 4111/10._ � { l i r i , _ _ ale not ;�hhc : :blr 16 lempc�,a1 . :.•nsl... :l: ; - -
scr. - ice
I SCIIEDULE
Suitc bldg apt. Project nan,eTsxmn, i,,_ - - - --
Cross Street directions 10 Job site \ { n Q — c_ 1 l nc J residential 5inale- ur mu Iii- fa mil, dl [ling 'mil.
Includes 31.111C11 el] liar :loy -•
j ,1412..) sy I1 0l ':_5s t r I i . I
- i —
Subdn'ISlon: Lol no �� I Ea add'I 1':�0 su n rr p+'rtioa 1 �U -
as, �, a�i I,t „Icedene :g�- reSl „cnilal f,1,,
Tax map /parc no. — - - - - -- _
DESCRIPTION 01 WORE -- ,---- -- - =- �-- - - - --
Pa -11.01 llaclur 1 0 1, 1 m 111
�•sC11 : ^C. F.01 :CC ail :! ;1c,i_'r n
•
_ -_ ----- _-- _ -- __ ___ ____ ___ ti c l s ices o r I e c d . c r m , r a l l a l i u n . a l l c l a i i o i , a n d . or rrloertion
'lit .:Inr. ,sr ic. _ .. 1
PROPERTY 011.--NEE ( - - -- - j, 1 . i ! ,'. 317,n, ; `
—
C-
\ ddlcss. �� �sdIM 4s-L- ,,, ( � - - 1 -- . ”- -- ! -1' -1 n
x- a .1
0110 Sr11e' %1 j`1 � c
Icplat, yerslccsrlrlecllerpi11 tall. ii,i alter' :Ilion.aud.ur
`LJ � t �'4 3- - -- reloc.rtiun
Phone Faa I � 3a,_ l
( �a3 fi - S 5 n�, or :� t l I
Owner installalion: This installation Is being male 00 pit' pertv that 100,n «Mill Is not ,, 1 x010, 10 -''”) lop j i' i' 11 1
Intended for sale, lease- rent. or cxrh:lnee. lccordmg to ORS 44 1 49 r,-ll- and - ill - - -- . - - - - l-
-'I ai - ,00 amt's j I I :-
(hvric'r signature • Date - -- 11101111 circuits- Hess. alteration. or c0tr11s101I. per panel
- - -- -- -- - - i ', cc n 1 Pl,m�h c nzln:: �,, - --I - 1 -
❑ APPLICANT CONTACT PERSON I I
SCI ICC 01 1 101 :00 03ch
tf
BUS111eSS name U - -- -_ - -_� _ 6 1
branch l irl "1
-- - B lieu f , r blanch , ucu11s 1 — C —
Contact name — � I „:,0011; scr, Ice f,'1 1eCder ice. 46 g;
Sib each Lt,lch circuit Address: ui
_ -- � F ach a LF] blanch eacnit 6 65
City /State.-ZIP: J I Pump (a rrr�1,, / I lliocellaneous (sersice or fe•eder not included)
Phone: ( � L TQ) Q r� 1 `J „ 9' - 1 £.; 2 Fa Y . ( ) n E irrigation clrcie -- --- i _ :i t 1 Sl,n, or utltf nc h E -matt c....1 i I - I
_IL 10.11111.1''4 11101100- 1
CONTRACTOR cnei!_ panel- a!lerauvn. or i
f C` I0e:•c1'be I
1
Pane name I l
I • trl
Business name
1
r -- - - -- I I
•
Address: 1 r 1 O Each additional inspection o xer a llos,able in all of the abose
A d 1,._.._ -
L �01 nlsncCh.n �. 62 sC'
Cris State. ZIP. k_u ,, c ,, , S O t T Q` _ t Z _ I I :r.rsu ; :or p;; 'rct :r'l ;11 11 6= 50 ` ` ( l l[ - � i -
((�� Li•Jcsrtai cant per hilrl
I 7; .
Phone: 663)(o 1 Fax: ) 6 /42' k pi ,
ELECTRICAL PERMIT FEES*
CCB Lc - 1 +gR Electrical Lc : q _ \ Sups Lic. Subtotal 1
Supra. Electrician signature, required - r � � P: a Ic., ', � :. of p ermit tee?
—..•r_
I �
I , Male 5_::;!large (S °e 0) penl,lt feel 1
Print name: 5A- Cv . e... ir I Dare: l --
i / - I TOTAL PERMIT FEE �
Authorized Si P[3ture' ! / -,L This p ermit application expires If a permit is not obtained within 121
/f / disc after II has been accepted as complete
Print name �Q -c...1 Dale: , - Freme'hed, set b_. Tn m
- County Bullde!ndLls Ser.iceBonrd
i a c_, ' N31112e3 CI ms: ecuons per pearat all•ci:: ed
1 Bu-lc1ng -Pcrin lArp r1cc 12 -- a 5 010 `-' ro'd ",:Gil
1!tC1..iId1114A1 L C111111. 1- ]IJtJ11lt1LIt ll
City of Tigard L '°� Received N/� //],�
] 3125 S��' Hall IIh d., Tigard. o 9 • 3� ``
{ J D. ateB Permrt%�'°/t% - 00to
q EI�
Him Retie's'
Phone: :n03 - 639 a 171 Fax: 50 ' Other Pernur
y ^,Jqr r Dale - B - ; -
t nspection Line 50=.6:9.4175 V.; \t � � I Date Read_..8. l'ei El See Page 2 for
Internet: « ci.titzard.or - us i .. J`S ��'
Q Notified /Method. Supplemental Information
T f"P6 CIV(9�]tt N1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
r nI �Irchamcal pennn fees' are based en INC value of the .
v
Ne, construction �}l .r
pencirmed I-rdtca :e the value (rounded to the nearest dollar) of a
❑ Demolition ❑ Other. • rnechan: cal materials, equipment. labor, o• erhead. and p1otit
CATEGORY OF CONSTRUCTION aloe g
RESIDENTIAL EQUIPi•IEN'T! SYSTEMS FEES-
[ and 2- family dwelling ,<Commercial: industrial ❑ Accessor•. building I — --
fyr .',CC i : rfo' •yr : :: on arse e;: rC-:::
❑ Nlulit -famil y • ❑ Master builder [1] Other — , —
1 )escrlpt.r Ot, I Pa TnIa1
JOB SITE INFORM: ION AND LOCATION Heating cooling
r '' .fr ' :1!- ;or.d;ur.mtn�• or neat p:unp -
Job site address_ I ��! o:ginies site plan ..h.. .,in pin(emeni, I I -t 1,4t
Crr' :iStaIGZIP 1' c _ .. O E. C , Furnace �10.17'nl!ill.' ducts : tins) 1 1arr(, I —
1 t- una !0
ce I.(t0 BTU t;uca it
.ce; I 1 - ;t , i
Surlea Idg apt no.. U Project name �� ]
Ga< heat rump I" '..
L Cross sircct`drreciions I(1 lob sic: . t` P Duct '
11_.dran,c hit '.airr .,■stem - - I u i
Residential boiler ',radiator OF
hrdroo e 1_1 00
1 -hit h :•at•e flu.! - r.pe, riot .kennel.
ur.'.r 211. tit- ,!'ucl. su;rttidcd.cic iii
1 '� •
[� Flue ,. cut !oran_ of ::Hove I 11.. ,
-
ubdi\.i',ionr 1CA��1�A Lot no.- c ?. _ -- -- - - - -- -- 1
Tax mil )r parcel no . _51 � pl C , 1 Other fu
_ - --- -- ' — - —
map /parcel � el
r
I�
— DESCRIPTION OF WORK ncctrr
---- -_ - --- -- --- -- 1 u ----- - --
•
1.1'n Ili- _-i:, In;e;t - - -- --- 1 1, •,r
I --- - --
J n
M, PROPERTY OWNER ❑ TENANT h,nn'= lt::_r '•c; " - - -- I' - ' _
Utl,:t I iii;
Name: TL` %rn 11._ F. n anti p r'n1i111itrn
lddtcss: (^ 1 < :!1 i L I�r.,',! !!ii k i, 2!
W a .� —�� L/ . e,11 ipmeil! j I r0 0 11
CiL State'ZI- r ( I� then dr-.La _sh ust 1_ _ 1'-■ C'il
'r --- l � Smelyduc! cshaL,;,t thathronms.
Phone: (503 )533_ cipp _ Fax (5e3 ) 533 - 41346 1 t,llrt comparimen ! c- utility 1001051 , 0 SO _
❑ APPLICANT • CONTACT PERSON ante era :'.Isoac Lms I 1 10 0) --
Business name. Other I 10 00 ,
Bus
� l i - -L� t Fuelpilting
Contact name i S5.40 for first four. 31.00 for each additional
:address_ M e Furnace. etc
3P\ ` , F. o a. heat pump
City •State: :ZIP. —
':'.'all 'suspended. unit heater
Phone' (5(3) 9b9_ 114,5? - Fax
l ) (�(� `�� atcr heater
+ ) ` l Fireplace
E -mail
Ran c
CONTRACTOR- . Barbecue
3 �] 1 \ \,`� ,., C l,- .I!ies elite tr�as'1
T usness name 1 � Y U� �� k. i s
O'•7:-., gk %• � .
address: f7 4 — , )C �tECll.�vlc :u PEri�ln FEES
CIt r'State:'ZTP' 11 )Y Y. 1. 0 ` — • . 1 1- - 7
jv [ Subtotal l
q q p( � 1 Minimum permit fre'(S72 50,' 1
Phone. I
5 3 5 1 - 1 2 14 _ Fax (5 3) 8gii_ U � QZ �) I Plan re :re., t 25'1 of permit reel
CCB lrc )L-1 131 Li
_— plate surcha:ee (S", ofpermit fee)
--------- TOTAL PERMIT FEE
Authorized sizti tune _ ' 7 hiy permit application expires it a permit is not obtained „rlhin 130
_ _ - daps after it has been accepted as complete
Pnnt name W 1 C t TC z D 1 • Fee :ncth d;r,oe': set h. Tr.- Count', Building !nd:sn_. Sri ice Bcaid
i'. Bu •id,nG'7Pcrrnns;MEC- PenrulApp doe 1 203 440 -46177 L II■22 C0'.L WEE',
ullulllg r IALUI CS
Plumbing Permit Application FOR x# '
OFFICE ■
No
City of Hall v d ®g DaKecei'•ed �/�f j�II - c 3�b ED V 1erBy Penral c/
13125 SW Ha 9�2 - -
Phone 503 659 -4171 Fax 503 59S 1960 Plan Re,
Date.By Other Perrrut No
24 Hour Inspection Line 503 639O1P �: 'f�
,r, ' 20 1 C,. D a l e R ea d y : El S ee P age 2
Internet: , .\--, , ,-.v CI tigard.or us
Netified'' Supplemental Information
F'r}Kn - : FEE* SC}IEDULE •
gN.' construction gV,LDI D ��� 1 NG It D i etnolrnen For special information use checklist
-- Descnphnn Qty Ea Tc
❑ Addition alteration replacement ❑ Other. New 1- 2- famil dwellings (includes 100 ft for each unlit:, connect
CATEGOR'Y OF CONSTRLtCT1ON. SFR (I) bath I 249 20
K I - and 2- fariiil_, d's elline XCornnrcrcialiindustrial SFR t,2 i bath 350 00
❑ Accesson El Multi-family ulti- famil} SFR 3 bath 399 00
Each additional halh 45 00
❑ \lasic, builder ❑ Other -
Fite sprinklci ( 59 it) I Page 2
.. LW -75' S]TE INFOR'\11TION_ r\2'J), LOCATION,: ._. - Site utilities
Job site address - 75 w -1/ r ', Catch 11 area drain 16 60
Cit:'Siat ` LIP cr O En; : leach line. or trench dram 16 Eli --
1 111
Suin.bldt apt. no-- Protect name ^ Footing drain (no. linear ft- ) Par. 2 .
Manufactured home utilities 110 00
Cross :tree directions to tub site G r
�1 tl+
-_ 1 %lanholes 16 60
- -- --- • —
Rain drain connector 6 -Ct
— — --- i Sanitar, cc. +'cr (no linear it ) Pape
Storm scV:rr (no linear ft ) Pace 2 �—
T-- . lcr s cr• ice (r.o hncar 0 ,
�Suhdnilnn Lot no _
�n s o �-� e� 1 — � Pa
1 I _ }w�A Fixture or item
— lhsoihhoi 'rake l c, 01,
DESCR "PION, OF R'OI2K -- -— -
- -- - - - -- — — - I ;,1; l:ilu pre'. enlcr Pape .2
f,':,ck alvc 16 , 0
--- he _____
_ ____. .._ _ ____.. _____ ____ - . _ _________ _ _
Pii,h l 6 - 6 1 ' --
Tzt PROPERTY OWNER - Di inking fountain 16 /:0
❑ ' FENANT.;`- -- - --
— -- - <_ Ficcinrs:surnp 1660
Name ` C ' C --
me B LS C .lA[_l � � Expansion tank 16.60
_\ddi - 1(,0 $� 3� I —
/ � i Fixwrer'se c ap 16 bC)
0 1t'•.5latc i.IP � �- -L e. q Floor draiir'lloor stnkhuh (6 60
Phone. ( Fax Garbage ,503 5 �- y� (� ( x63 ) 533 y30(O e disposal 16 u0
p
Huse bib I 16 60
Business name.
❑ . r 1PF i IC: T cONT. &CT PERSON : ;
�^ -L _,.,. _.. ,_ lccmakc•r 16_60 ` r `
g ease trap 16 60
-
Contact name �� lnicrceptor /
Medical gas (value. 8 ) Page 2
' Address- 3� = Primer 16 60
L State,ZIP- +� (commercial) Lit;, Roof dram (cmmercial) 16 60
Sinlubasutla.'ato 16 6C1
Phone' I sc&4 9 11153 - Fax : ( ) (1� D
` Tuhrsho'•ser.'sho pan 16 60
E -mail, i
Lrnal 1660
CONT R , �C 1 TOR �- y� titer close! 16 60
B ss usine name. � 1
.0:\ei � rx _. Water heater _ 16.6
eother --
Cif,- ,State'IP: \ \1\)( ' � 1 C _?_ 9 T10R
Subtotal
4 •Minimum permit fee. $72 50
Phone' (563) (.02 - 1 6,32_ Fax (033) ( - y Residential backllo-v minimum permit fee $36 25
ZI O 1'Ian res iem (25% of permit fee)
CCF3 Lie: ��a�o �9 _ I Plumbing Lic. no :3y
. Stare surcharge (8% of permit feel .
Authorized siLmalure: i ,3�
. TOTAL PERMIT FEE
Print name: Date This permit application expires if a permit is not obtained , sithir.
180 days after it has been accepted as complete.
'Fee methodology set by Tri- County Building Industry Service Boarc
Puildh:c'Pc:r,ns tLh1F- Pennn \rp dcc 12 :03 aa0- 46161310 /C_'COMr.VEH1
CITY OF TIGARD - • •
BUILDING DIVISION PERMIT #: MST2004 -00310
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2005
Phone: (503) 639 -4171 �iugnn j
-
Inspection Requests (24 Hrs.): (503) 639 -4175 AA
INSPECTION WORKSHEET FOR DATE: 8/24/2005 TIME: 7:08AM PAGE: 25
SITE ADDRESS: 14475 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 042 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 503.53:4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503 - 533.4006
Inspection Request Scheduled For: Date: 8/24/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final , / 014200-03 503 -642 -2800 N
Corrections /Comments /Instructions: �
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If PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2004-00310
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 31712005
Phone: (503) 639 -4171 �iigffil
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 69
SITE ADDRESS: 14475 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 042 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: N SFA
OWNER: JLS CUSTOM HOMES. PHONE #: 503 -533 -4006
CONTRACTOR: IS CUSTOM HOMES PHONE #: 503 -533 -4006
Inspection Request Scheduled For: Date: 8/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 014472 -01 503 - 209 -6038 Y
Corrections /Comments /Instructions:
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XI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
] FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CT° 1) '`' 414 - 7 :i )1) b- - Date: I )2-a 1""' • Phone #: (503) 718-
CITY OF TIGARD - -
BUILDING DIVISION PERMIT #: MST2004 -00310
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2005
Phone: (503) 639 - 4171 °��n��Nl���
Inspection Requests (24 Hrs.): (503) 639 -4175 °'
INSPECTION WORKSHEET FOR DATE: 8/26/2005 TIME: 7:06AM PAGE: 77
SITE ADDRESS: 14475 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 042 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: 8/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 014349-06 503209-6038 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: Date: hone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004-00310
13125 SW Hall Blvd., Tigard, OR 97223 DA TE ISSUED: 3/7/ ?005
Phone: (503) 639 -4171 �II� //i l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 68
SITE ADDRESS: 14475 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 042 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 503- 533 -41106
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503- 533 -4006
Inspection Request Scheduled For: Date: 8/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 014472 -02 503 - 209-6038 N
Corrections /Comments/ Instructions:
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL II C L FO' INSPECTION ❑ ADDITIO AL FE`S ASSESSED
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Inspector: i ,_ Date: Phone #: (503) 718-