Permit C ITY OF T IGARD MASTER PERMIT
PERMIT #: MST2004 -00308 A „,, DEVELOPMENT SERVICES DATE ISSUED: 3/7/2005
�` ” '= -� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S 112BA -10400
SITE ADDRESS: 14491 SW PENNYWORT TERR ZONING: R - 12
SUBDIVISION: BONITA TOWNHOMES LOT: 040 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:
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 823 sf GARAGE: 480 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: 802 sf RIGHT:
VALUE: 194
OCCUPANCY GRP: 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 r =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 LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps -1000v MINOR LABEL:
1000+ amp /volt :
PLAN REVIEWSECTION
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 Municipal 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
keg #: 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 B : Permittee Signature : ■
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next 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
p ". ris 4 "I)o oa" Ner...1--- 51.,17&- _7__
, .
it Building, Permit Appl.
ii'Ctirs:"°7-11VED „:„..,,.,:::::„.„.::-,:„.„.„,::,.--,,,:::::„:„..:FOR OFFICE' USE ONLY::':
r1 I.— %.4r ti...
City of Tigard
Dzite:B; 10 0401 Pe-- NW.,f,,-,,;,, -,0 50 ff
13125 SW H.till Blvd . Tigard, OR 97223 nr,-7 ''''. 2004 Plan Rei.ie_. .....K. /o f a 10
Oilier Pc. si.i., Zdeci
Phone 503.639 4171 F3X .503 598 19604'w ' Da te:13 , ..flii"
inspection Line' .5,F.13 639 -11
41 0 ,1i11. 11 '11 . ..., Dille Reaci:,B:. .„, ...., A _,...... J.,..iy c)._,ScipAttaches1 Checklist lor
InIeriCti .-.s, ci lig2rd cir us CITY OF TIGARD Notiired — / — Lk) "Trk --7 LC, • i ISiipplemenial Information
BUILDING DIVISION
r --- ?:2 u ri rt t,
TYPE OF WORK I REQUIRED DATA: I- A1ND 2-FAMILY DWELLING
Permit fees* are based on the i. alue of the work performed.
Ncii.v construction . 111 Demolon . -- ' 1 Indicate he i. able (rounded to the nearest dollar) of all
V
El A ddri ion. a Iteration replacement [7] Other. equipment. materials. labor. co erhead. and he profit for the
io.ork indIcated mililio application
CATEGORY OF CONSTRUCTION
Valuation_ S c ff 9 - 5 : 1 . ( 10
2-family dia.iellini.2. XCominercndustrtal
, NW tF.
El Accessory buildin4 0 NItilti-fam T:1:M Of 1:
il:. L_
3
N umber of bathrooms 2 •
D blaster builder D Other
— - - - 1
Total number of ;The 1
JOB SITE INFORMATION AND LOCATION .- 5
_ --,--------------
Joh s i t e address. 14 tii tzr l e i Nev. di.i.ail rm.: a r e a / e r g 3 sq f ee(
Cir 'State/ZIP: i.-.0S y_y__ CAZ ,..___
-.. To ts cs ...
„. , : L . I
Carafe carport :illn , 960 sqtiare feet
Suite bldi./..'apt. no I PI OICCI 11,111)( C OVered pOICII arca 3( s fe,,,
_
(Jioss streen'clireetions to lob site C ba •
t Y_\ OC17ReACI Deck „r,,,„ 1 5L square feet
- i
(2 SlitieliiRi .11:2,1 square feet
_ _ _ . _._
REQUIRED DATA: COMMERCIAL-USE CIIE( KLIS I
[ ubdivision __--, 1r'it vi t
0 \ _- \ e, ! ” 1 '
I or 1" L,16 P:111111 ii :ir i'.:','d ,11 ii:C '.::!;:c of thc"... oil; r crco:m
el e,1
Indicare the %.11!::: , IC , I,IT!,!;',■ Ille ',':1,
parc no . „ „ , ....., , (-_-, ,
1.11".i.f If' II - 1 1 d0113r I
Ck`.L'IlIC:Id. :1110 111C i' i01 Ilk'
DEScR 1 PTiON OF WORK. .`. Of k 111,11k .1;:t.! rili 'lir, .iiiiilli.:111iiiii
--- -____—__
----
\ Thl:ticill S q t, 000
ii.k.),,„,,, hurnirn:. ar....., - .(1rr.rre I ecr
, ..crnaic I0,..1
PROPERTY OWNER
1 " 111 !FENANT i . .\utilbci ,isu,r1L.:-. 3
N.Inic , „
as c,__5 _ __
Address (c)a.ao naT occup,,
.„...{„ps
.
1
City:S(2
t:n.2LP _S2c-xv.. 0 fe _ 9
1.„,„,,.-_,
1-1 1
phonc_ (561) sz3- LICZ(.0 Fax
0 A PPI..1CAiN'T Cit CONTACT PERSON ,
NOTICE
1311SIlleSS 11310e Alt contractors and :til tors al 0 required 10 he
Contact name: _ _ liccnsed ,.,. In} illc Or c..:.crt, or,suucnon Contracrors Board
—
under ORS 71. and ma:. be required to be licensed in the
.Address. 3 n,n1.-t- prisclic non in - .Ouch 9.0Ik is being pertormed If the
Crt 'StateZ1P applica m
nt is eNept fm ro Itcensint:t. the follosi.111C reasons
i apply
Plione: (SOS) 9 ( It-i. s [ Fax - : (
) II , 'CAM f r / / M 8 0
F-1 r
1 itev 72.ci .61 -ZS .-_-
CONTRACTOR
H8 70
13usiness name. 5 n in E
BUILDIN(.; PR:M
Eyr FEES
:\ ddress:
( •Slale.ZIP
I Phone: t ) Fax I
1
f . —
) ________
Fees due Lit?‘"o a r•f" 3411cdnie.
. 11
— A111011111 ICCTI % t'd
1 CCB lc. I sci q --
Daft rec
Aurhorized signat 1
t . L ._ 6,..,..7c
..
This permit application cspires if a pet mit is not obtained
,,ithin ISO dass alter it has been accepted as complete.
r 1
I Print narne• V 1 Dale
t - . Fee merhodoloFi. set 1-_, 1 n r:,1:,1 Btoldtn,! Indus S:fr:ce Boar,
Building Yvt , ,,r,c i 2 -,-..' ,.10.4! :=T I i ,:"_' CC.:
)L' 1CC11 Mal dui Milt i1}J}JlICIR1011 • ® i
' City' of Tigard Received
FermitNo ``,, ... .._ - / -
- - - lit r// �5V
�'
CIV ED DateB - �I6L66 I = ]?_ SW % Ha!1 Bls d . Tigard, OR 9'� * Plan Review
Phone: 503.6:` 4171 Fax: 50:. g 3 i Date.B: C'!.'ter Fermlt
Inspection Line t`03 639 -1171 - c. 0' :' Date Rcadp.B;•- 'ur` El See Page 2 for
Internet '.. .c heard eard or us oc 9 it 2004 Notified Method I Supplemental Information
TI-PE OF -- PLAN REVIEW
❑ New construction El . 4:1AIii ,''alb ra in�n lacement Please check all that appl_,
❑ EI piNG U VIbl ❑Ser n: er 225 amps. comet I ❑H azardo., location
Dernolitlon r
❑Scr. ce oi-er 320 amps - nucu ❑Bulldog r••. -e: IO.000 sd i
CATEGORY OF CONSTRUCTION of I- and '_ -far - ah. d.xclhnes ' or mote nevi resldcnital
❑ 1 - and 2-fan de',elling ❑ Commercial industrial ❑ Accessor'ybuilding
❑Systcrn 0101 500'.ol:s nor!tinal ::015 111 Inc snrcrare
❑Bur!d!ng ov c-r lhrre s ones ❑ Feeders. -100 arnp'_ or mot
❑ Multi - farm]\ ❑ \taster builder ❑ Other I q„ ❑).lar.uzclure.: sn!c :-
❑Jcc:n:,lll Inad c . - Cr persons
JO13 SITE INFORMATION AND LOCATION R\ nail;
t1.{� � rr�^ 9 �� ❑I?cr :.> L sht:ag On
,i 1 Job Site address -1 I LIC J fl/J VD �- I Health-C :iiC i;iili!;:. ❑01 C'I
)C1. n0.. -1 !! �r..�l r '
e ' se[. ti :.ns .'. L .:n'. nt the abo•, e
City Siatc'Z1P - Fr o , ,Ocir - c ,S t_r_O� -- — -- p, e ::r! a, ;'I r_ _ic 110 c■•n :;ul_I :c!; .<._ic
• EEL SCHEDULE
Suite•bide :apt. no Project naineT _ —
l neKnLli "n I Q8, re, - n,l:�t _
Cross street directions lo)Ob Site' y� ,^ ^ �i \r. +' residential'I r It•- or multi - (anvil. dwelling unit.
- _Lt ��- ��J -` �QQ Includes attached ;VI :l,,v.• — I — -
V t—
�� ct �y .� a Lrtl no La add 1 : :�_rl s:! it r.l pert ,�n :If
��� �- + v`l � —
subdivision
1 � 1 1m11cd cncr, .. res . ;cnllai d
Tax map parcel no - 1 La i { j
1 u'nued C ncr_'.. nc-n- rr' :,1 5 Or)
DESCRIPTION OF Lad 'r.rer i 'am. ,i i
-- ul.!,
d'scll'�nc� ° •cr , oe de t ! 9''irl t
-- _ _ _ -- -- -- - -- _ _ —� ticrwitc> or Iced, lost alto u, u l allrrat and. ur relocation 1 1 -I! -,: !1,t or — — f \ti
- — i I -Iii , : -. I - _:!' ait!,�'5 ,i I
IR PROPERTY O V ER ❑ 'I EN.A 1 — �
��p I
\ddress- Ig , \\ t - — -
City Slater ZIP: L m n T - ^ n I \ �, (� j l clnpulan +cr i,1 fcrdcn lri'IaIl.tiio n. , a It1'raiirr it-. .l ll l! Or
Phone i ‘1R, g _ �L. (5 `\.." ) 53 4 3J _ �r clllcatiun
" at
— I 1
proper --
Owner installation: This installation is beet', made on n, cin Ihai 1 o•en eehich 15 nut nl alni ��r,.I .I .'!'
intended for sale. lease. rent. or cvch :urge_ accoidinc to ORS a-1 - - - 1 - 1 9 5 i, and - II! r _
1 — - -- -- Branch circuits nits J111q•,
rcll llA Ill' +. Ill1'I :1111 `--- - - - - -- — = --
(1e' -'n l'r Si s_i�alute. Date - - - -_ n. or e.tenvo n. her hand
Ill AfI'L1Co N'I CON "I 1C'f PERSON I e. ;,a h!arnit rr.. i �
— — j 5(1 , 10 ;1 oI :0•,10• :Ct'. e'Ch
BlIS111CSS name I hr..nc'rl,0 :1 -- hr :u; _
- 0 Pee for h!anrh , '� I+ uu� j
Contact name_ �� - - --
L� r 4. I !il;Orr: qtr', ICC r.r roc :Jet ■;'C'. -16
A
L
ddress. J M 4 eacl� ch t rant
Si'.
E ach acid 1 Mooch , :tc', :II o 05 1 i
Cttv, j !Miscellaneous (sera lee or feeder nut included)
q(,, el [� Rlln ?p Of ItrIL'a!Ir n ilirlC 1 G; ,1 0 n
Phone ��c 3 l `� I _ I �� P ay . (' j � � - _ I
$Iii, a null nr hei!u n !
E-mail —I
:,na! rr,nnu >I •r I ^hued
CONTRACTOR ! clita !_-. panel- alterat!,m- p1
f - .!c t. n 1 , n ibe Page 2
Business name
I , s
O C \ , — 1 � r F uh additional inc oaer able in any of t he al ci e
Address: • n 1 . J l , � / - —
Cit. State/ZIP: u t' C\^ V.J�IL�_ V Q .,r _ I }' CI IP_ :Ili`ll l n'1 5,1.. 1:RYSh C: :1 R pt; hC cl :1 ^r milli 52 'li I
i I — = - i j
Phone- ( (� / , I �7 1 ndtaa,al giant per haul I
503) (p t{'Z -�C?pc I F a. ) tDy C- 1S I I
ELECTRICAL PER'•11T FEES'
CC Llc. l aR2 I Electrical 1 .c y_ Sur Lie
t .._.\ p' j Subtotal I
Sups. Electrician signature. required ,,,,� r j 1-'::,r, cr
:. , ,‘. '.35` permit pent feel
I 1 b'a e so ;c haree i5 "o of remit fe 1
Print name - 5-v Eve ��, D are -
TOTAL PEK ?I1 T FEE I
Authorized signature: - - - This per not :Tolleauon expires if a permit is not obtained within Ibt
_ -" da■s atter It has been accepted as complete
Print name Date: - Fee e;lredc•,:e, set b_. - :-, Building Indu<n_: Service Board
it Qt. m -nCoup .. bumbrr ^i Ins-,,irons DDe• pemul also -.ed
: - Bmld,ng ?rccas'•.EI-C- PerulA.rr;cc I2 -- 0•.85,5 T110'"',..7J'.1 ",•TB
1 ■112L11dllll -d1 1 C1111l1. .ii1Jl5lllilllllll
•
Recel y, r / / _
City of Tigard Re cis PennitNo i /0 � 55'1
./ 13125 SW Hall Blvd -, Tigard OR 9
Phone: x+03 639 - 1171 Fax 503 5985 196,0 Plan Re le • .r
:,lr it Dale:B_•: Other Permit'
Line 503.639 4175 1
.i Date Fead•:By. lul ti 8 See Page 2 for
Internet \su ss ci.tsgard onus
NotiTed'?`9ethod. Supplemental information
--
®lew 111....r% R1
• R.
T Fit 6, ��' 7 ZI C V
V COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
X New 1 \lechpen cal pen fees' are based on the ii. of the - .t -orlc
Ne.. construction [I] Additionialteralton.'re ment
❑ Demolition ❑ Other. OCT performed Indlca;c the salue (rounded to the nearest dollar) of a
' acr tt echan:cal malerials, eauIprn•ent, labor, o'encead, and profit
CATEGORY OF CONST 21 4 T.l tt 2,11 attic $
GiTY OF �•} • RESIDENTIAL EQUIPMENT / SYSTEMS FEES
$(1- and 2- family dv'.elling N ComLvdturlisIbttATOISIMAcccssor .' building — — -- —
—
=ur v:crici :r. o rise chcckl!.
❑ multi- tamely ❑ Master builder El Other — — —,—
Dc;crlpn; r! I Qt,,' l L -- Th lal
,JOB SITE INFORMATION AND LOCATION Ileaun!ir coulin!O
lob stle address 1 Litigi P/ no , �� �� An cCnrllu��nme or heat pump
1 ( I I e ;Imes ae plan , lly)s nls placement: Id (..)0
____/
Gp.'
' 'Stale:Z1P i1 � 1 C) i;?_ • 1 Furnace i1Jrl- rli .irt B1 I.' )duce: ,ergs) 4 / -1 00 0 --
1 unracc 1')) (10(.,_- BTU tdne:s seats) 1 90
Sulte.bldir]apt no.. Pro(ecl 113111C y\ A - - -�-
�+LL r Gas lief:) pump 1.1 ncl
Goss slrecL'dtrcclions to wb site , �/� ��� Duct .'n_Ih 1-1 00
1 lJ.
EU I1'.dlon:c hot •iater_.,stem
H a 1)0 y
I 1 csltiennal boiler t rall,lau,r nr
h■ihonicl 1-1.00 I -
Unit tie pi. (luei- I.pe - n01 electncr.
Ill ___ I I_I_il,:il_SIll:p Cl Id L/J_ CO:: II" 50
!,, I
{— f Lel LTC)
Flue .Gill 1,11 all of ::1,,,,c.
S Ir
uhdicISir,n bLTC?T ' p I n„ --
T— ,NR!35 — — — i() , —
Tax m :10 0 no,. 5j ( A 1Wi711) ) - - Othtr furl ❑ flianrc5 - - - --
D1-S( RIPTION OF WORK , •'•.:1 ;1 11c':. ( : - - - -- l lii09
t tT
- I.IS I,Ii cc
li
-- - - -- l 11 ;: sent 1 ,...I 1 gas
:Iterld. r I 101,i
- !! I ). ilt cI 12.,:- i - n
r• 1(11),
_ . - h ' t ` - -- � I
II illepl_" ,nse t -� l0 I1ri
1 I it ,e:rl
ra --- -- - , n,- - . c, t - _ - I - - PROPERTY OWN it) , , , t) EK
❑ TEN
- - I t ;ll•,_I � ill 01) Na i
me: 3 L C (
z - FAIN eshausT and sentilatiun
Address: f I f�� ti \ S1 -�s ���� - — f ?:,n!_e Iii_ nNitunmrntit i I:iichen ) —
C il),Slate.'ZII z �� f Icihcs (11,„ c i �(1
1 Sn:cic -.tut! co::„, Ihathiooms. � 1
f hone l 1 Fax f
S03 533 LI�n�o Sdg) 53 - toile( compaitmenls. utilu: rooms) ..3 0 S0
❑ APPLICANT - X CONTACT PERSON I lute era Is'ace I_nl, Ill_
Buslnessname _1:-`1(') L Other Fu -_ 10 00
Fut.! P'J5[P f
C
•
ontact name. c_ 1�n S5.40 for first four; 51 -00 for each additional
Address e� M� Furnace. etc f -
Gas hest pump
GIV'Stale.ZLP Wall suspended unit healer
Phone: O Q 3 Fax l ) -
9k9 1 (45 5 . S S E, later healer /
)
Fireplace_ _ i
E -mail.
Range j CONTRACTOR Barhecue
Business name Cinches diner t�_ast
Address- ■`
(Q 5 53 MECHANICAL PERMIT FEES`
C1tc.State.'ZIP
Subtotal
q I �. 7 14 p(� �. 2
Plan re vie'.‘. r-
Phone, (5p) 591 p L `4 Fax: (563) (Y) �Iimmur.I [re ($72
fe es
'. 15eb of permit feel
-
y 13 - --
CCD lfc : I State surha: gz Br o of permit fee)
i L TOTA PERMIT FEE
Authonzed sigrature
- . — / - This permit application espires if a permit Is not obtained „ ilhin ISO
1 ' .� Jass alter it has been accepted as complete
Print name: W. 15 t 4- T ax. Dale- 1 " Fee :rcihode!or'. set b T: count; Building Indinair: Serr,ce Board
t :Bu'ding'Pcrrngs " \tE(-PernnApp doe !2'05 .saS._. :17T tai „i"r0`.LWEB)
r uilulllg r I ALUI CJ
a
t:
Plumbing Permit ap • OF FIC E US • L Y , - :,
Citrof Ti Datered n
REC I Y EV Received PemulN• j ., -' jj
13125 SW Hall Bl+d ,'Tigard, OR 9%223 (/ �( —
Phone 503 639 4171 Fax 503 598 1960 fi e' Plan Re+ie x
Dale:By Other Perrrut No
Inspection . 24 Hour Line. 503 - 639 4173 OC
P ��+ � sJ LtJo b Dale Ready/Di,' ' "" 0 See Page :tor
Internet' ‘.l h
- .v' ci.gard.or us '�
Notified. ":lelhed Supplemental Information
' .- - T\ 1 ' 13 JO t\Y.-Xa' GIARD - - - FEE* SCHEDULE
f lANcls construction BUILD114 Eil" ; l uron For special information use checblisr.
— -- • — Deser.ption 1 Qty. Ea Tr a!
Li ; ldduion'alteratronreplacement ❑ O her ' 1e+ +' 1- 2- Tamil s• d + +'ellings (Includes IGO 0 for each utility conneu:en
- ' C;\TEGORY OF CONSTRUCTION.. , SFR i 1) bath 2 =9 20 - -.
X I- and 2 -family dwelling Colninercralimdustnal SFR (-) bath 35000
❑ - lccessor, building El Multi-faint,. SFR. (3) bath ' 3 nn-
Each additional bath(kitchen 45 00
❑ Master builder ❑ Oiher, - --
Fire sprinkler ( sq ft) Page 2
J013 SITE L \FORNIAT10N AN'f), LOCATION Citeuti]iues —
Job site a ddr ess- �/.,, , • / Catch basin or area dram
6 60
Cit }'State -ZIP r ` • • - -- Dr'.'ell, leach line. or trench drain 16 60
Suuc.hldg rapt no Pro)______,,,..,
tect name Footing drain (nn linear ft • , i Pare 2
� t — Manufactured home utilities 110 (
Cross street, dlrecllonPk s 10 l Si IC!---11/,\'‘ rLJLI a U - � V ,.. ! r-n r -- —
Planholcs ir; 60
-__ -- — Ram drain connector i 6 6(:
— —
Sanitar, _c�'.rr (nc llncar 11 ) l'agc 2
— -- — -- -_ . -- — — S;rru se :p er Inc linear It 1 face —� —
uhdl'.'I :inn Lo t n(, at"r scr. +cc (I10 llncar 0. 1 Pape _�
S
AlssorptIon ...live - ns . c o. 1 - _ ' ____ �U — —
Fixture or item
F:o. ncrp parcel no
16 6(1
DESCRII''I1ON OF WORK -
• - --- - - -_ -- - --"— -- -- I' , i „,.. Il r r ., p r e: e n t e r Pace.
ack :.atcr oaf :c rn
It E
----- " --- I'It.i hie ++a5her 166(?
- - - - - -- -- ----- - - '-- - - - - - - -- - — -- — I?I_h_' :1:: ` Ir,c'1
PROP OWNER Ihm }Ir��li iunt;n 16x
3L i cctodru
rsup 16 60
nl
N:Ic t C �/�
- —_ --- k — ( ,�.1_.>S MeS Expansion tank 10 60
- Address — � �
a�� 1 n ._ Fl.xturc :sc'c r cap 16 00
Cit•,. State /71 ` 1-1cair drain; floor sink.hub 16 60
Phone ( 583 ) 5213_ l inao I Fax: (5O3 )53_ CO '(O Oar bare disposal I 16 c0
" Huse bib � 16 60
❑'APPI IC�N.T .CONTK PERSON
: [ Ice maker 16 f,0
Business name' rn G -
Inicrccptc- rigreasc u 16 GO
Contact name - - gib • - r •ledlcal gas (. attic' 8 ) Page 2
Address. (-1A-E_ j Primer 16 60
CInn State, ZIP. Roof drain (commercial) 16.60
Phone 15 ,g ! 11153 Fax:. ( L Sink lasrnila atory 16 60
Tubishower'sho'.+er pan 16 60
E-mail
. .._. CONTRACTOR - L nal 16 i0
r
er close! 16 6Q
Busin n;:mc (,n
— 11 v( 1�` < .Iter hewer h- , —
Addlcss: 02_417(_____ \, 1),.. k lia \ ] Q TO _ � —
Minimum permit fee: $72
Ulber
Cr; Stale 215. k:-.1; \,1c5bQ i rp _ l_) e._ / .) subtotal 50
Phone. (563 /„Zg _ i (43_ - � Fax (a,3) 6 ] ' _ Residential backllo minimum permit fee $36 25
CCB Lc. r � a � � Plumbing Lic no :3 -;,,a)() Plan re,iely (25 %ofpe nnrt tee;
` State surcharge (8% of permit fee)
Authorized signature
. �� a- -- — TOTAL PERMIT FEE
Print naine', _ �� Date • This permit application expires if a permit is not obtained +.ithir
C am— 180 days after it has been accepted as complete.
"Fee methodology set by Tri- Counts Building Industry Service Boar(
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CITY OF TIGARD
BUILDING DIVISION . ' PERMIT #: ELR2005 -00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639- 4171�� �Ji��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 829/2005 TIME: 7: 13AM PAGE: 76
SITE ADDRESS: 14491 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 040 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
• DESCRIPTION: Security.
OWNER: JLS CUSTOM HOMES, PHONE #: 503.533 -4006
CONTRACTOR: AZIMUTH COMMUNICATIONS INC PHONE #: 503- 638.0110
Inspection Request Scheduled For: Date: 8/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 014465"01 503 - 209.6038 Y
Corrections /Comments /Instructions:
/C ,
1
1
I&1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
l
Inspector: f'/ Date: g � Phone #: (503) 718-
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00308
13125 SW Hall Blvd., Tigard, OR 97223 4111111,A,„\ DATE ISSUED: 3/7/2005
Phone: (503) 639 -4171 �riiNl���yi4l 1 i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 57
SITE ADDRESS: 14491 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 040 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES, PHONE #: 503.533 -4006
CONTRACTOR: 1S CUSTOM HOMES PHONE #: 503-533-4006
Inspection Request Scheduled For: Date: 8/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final V 014473-01 503 -642 -2800 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I nspector: P`1 Date: ���� Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: MST2004- 0030th
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2005
Phone: (503) 639 -4171 au4lovilii
Inspection Requests (24 Hrs.): (503) 639 -4175 „Jai- -.
INSPECTION WORKSHEET FOR DATE: 0/30/2005 TIME: 7:11AM PAGE: 61
SITE ADDRESS: 14491 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 040 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES. PHONE #: 503 - 533.4006
CONTRACTOR: ,LS CUSTOM HOMES PHONE #: 503.5334006
Inspection Request Scheduled For: Date: 8/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 014677 -02 503 - 209-6038 Y
Corrections /Comments /Instructions:
lix PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: '1 s Ill A-- Date: P ]3131bc r, Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00308
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2005
Phone: (503) 639 -4171 /oimiu lVul��i r+�
Inspection Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 75
SITE ADDRESS: 14491 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 040 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA
OWNER: JLS CUSTOM HOMES. PHONE #: 5035334006
CONTRACTOR: IS CUSTOM HOMES PHONE #: 503 - 533-4006
Inspection Request Scheduled For: Date: 8/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 014465-02 503-209-6038 N
Corrections /Comments/ Instructions:
. Itl
fA ,,....,,,, ( ...____ ( „,,,,,,, : _,,, ii „.._,
SASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ��ALL 0R INSPECTION [1] ADDITI NAL F ES ASSESSED
A O / jZ1/Phone ( Inspector: �, Date: #: (503) 718 -
CITY OE TIGARD
BUILDING DIVISION - ."-- PERMIT #: MST2004 -00308
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2005 �� jJ
Phone: (503) 639 -4171
A,,,, 4N��
I Requests (24 Hrs.): (503) 639 -4175 "_I_.
INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7 :11AM PAGE: 60
SITE ADDRESS: 14491 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 040 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: 8/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 014577 -03 503-209-6038 Y FM Corrections /Comments /Instructions:
i ti '
II
F (/ /
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI•NAL FEES ASSESSED
Inspector: 0 Date: 40 • 0 Phone #: (503) 718-