Permit CITY OF TIGARD MASTED PERMIT
PERMIT #: MST2004 -00364
� 'aa t DEVELOPMENT SERVICES DATE ISSUED: 3/24/2005
„� I " 13125 SW Hall Blvd., Tig rd,� n223 503 - 639 -4171
l ( f�c weca PARCEL: 2S112BA-11300
SITE ADDRESS: 07917 SW LN ZONING: R -12
SUBDIVISION: BONITA TOWNHOMES LOT: 049 JURISDICTION: TIG
Project Description: New SFA.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 682 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 1,003 sf GARAGE: 440 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 TARO sf RIGHT:
VALUE: 166,884.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,685 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: 3 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: 4 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 2 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 /OSVC!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 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 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
JLS CUSTOM HOMES JLS CUSTOM HOMES and all other applicable laws. All work will be done in
16280 NW BETHANY 16280 NW BETHANY accordance with approved plans. This permit will expire
BEAVERTON, OR 97006 BEAVERTON, OR 97006 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
952 - 001 -0080. You may obtain copies of these rules or
Reg #: LIC 139970 direct questions to OUNC by calling 503 -246 -6699 or
TOTAL FEES: $ 6,895.49 1- 800 - 332 -2344.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
High- strength bolts
Structural welding
Issue By : 31:100 44�.tq 4 Permittee Signat
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• . q CITY OF TIGARD MASTER PERMIT
' ' -- 2 COMMUNITY DEVELOPMENT Permit #: MST2004 -00364
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/24/2005
Parcel: 2S112BA11300
Jurisdiction: TIG
Site address: 7917 SW PICKLEWEED LN
Subdivision: Lot:
Project: BONITA TOWNHOMES
Project Description: New SFA. 12/9/10, Reprint to correct street name spelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 682 sf Basement: sf Left: Parking Spaces:
Height: 25 Bathrooms: 3 Second: 1003 sf Garage: 440 sf Front Smoke
Dwelling Units: 1 Third: sf Right:
Detectors: Yes
Total: sf Value: $166,884.00 Rear:
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: Rain Drain: 100 Urinals:
Lavatories: 4 Dishwashers: 1 Floor Drains: Sewer Lines: 100 SF Rain Storm Sewer:
1 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins:
Bckflw Prevntr:
Footing Drain: Ice Maker: Hose Bib: Backwater Value:
Other Fixtures:
Drywell- Trench Drain:
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1
GAS Heat Pump: N Hoods: Other Units:
Furn<100K: 1 Vents: 2 Woodstoves: Gas Outlets: 3
Furn > =100K:
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 -200 amp: W/ Svc or Fdr:
Ea add'l 500 sf: 3 201 -400 amp: 201 -400 amp: W/O Svc /Fdr:
Mfd Home /Feeder /Svc: 401 -600 amp: 401 -600 amp:
601 -1000 amp: 601 +amp- 1000v:
1000 +amp /volt:
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA 5N R3
Owner: Contractor:
JLS CUSTOM HOMES JLS CUSTOM HOMES Required Items and Reports (Conditions)
16280 NW BETHANY 16280 NW BETHANY
BEAVERTON, OR 97006 BEAVERTON, OR 97006
PHONE: 503 - 533 -4006 PHONE: 503 - 533 -4006
FAX:
Total Fees: $6,895.49
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and at other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. A - • • '. •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -06 -0010 through OA' 95 1090. You may obtain a copy of the rules or direct questions to OUNC by callin• • . • :7 or 1.800.332.2344.
.
Issue. :y: V l �� 1 Permittee Signat o- ,1i'gr . c- 1 /—
Call 503.639.4175 by 7:00 a.m. for the next available inspecti. date.
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.
DomiTil
f Building Permit Application i � ' . FOR OFFICE'USEONLY _ .
°�' qtr Received 1 H of T
� gard Date/By/ 1 /} ,�G — (i `/ , ,'''''r•---- Permit No - � T[lV !f/� u
7/)/1 y -riil�i(y
13125 SW Hall Blvd , Tigard, OR 97 , n Revie.v
Phone. 503 - 639.4171 Fax: 503.598-18 CE E •� 44, Pla /C -irk- 6S OtherPermicSW e(r/ 36 Inspection Line: 503 639.4175 ,;„ -. Date Ready/13y l❑ * ( / RI See Attached Checldist for
Internet www.ci.tigard.or.us
Notified /Method 1 A Supplemental Information
DEC 0. 2004
- ' . ,. .. l e :1 -,AND 2 A1�IIL ' DWELLING
[2
New construction 3iiPLi)11fi �>l Romt'}irtld�g h Permit fees* are based on the value of the work performed.
indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials. labor, overhead, and the profit for the
. . CATEGORY - OF' CONSTRUCTION - work indicated on this application /(C
X 1- and 2- family dwelling Commercial /industrial Valuation: $ PaO/,
❑ Accessory building ❑ Multi- fam)ly Number of bedrooms
❑ Master builder ❑ Other: Number of bathrooms - '.
_JOB SITE INFORMATION AND LOCATION Total number of floors- 2
Job site address "7 % pi �w I V l Nev dwelling area - WAS square feet
Cin %State /ZIP: `Tn _ [ x 1 O� • Garage/carport area: � square feet
Suite/bldg. /apt. no -: "X Project name_ , ( �
N- Covered porch area: t iZ,� square feet
Cross street/directions to job site: .41 , 4. ` ' 4_ ' �` a 'Q , '"Oz Deck area `J square feet
Other structure area square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdnislon. n1 � Lot no : Permit fees* are based on the clue of the work perform
�� � indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.' IX equipment, materials. labor, o erhead, and the profit fof the
DESCRIPTION OF WOR work indicated on this application_
Valuation $
Existing building area: square feet
New building area: square feet
PROPERTY OWNER -- - - ❑ TENANT Number of stories:
Name: M-S C AAc. / M C �lYP Type of construction.
Address: V (499 CD 1\k ��-}-�/1 � Occupancy groups.
Ctn;State.ZIP:� ''`` Q
I V l� . 4 2 r� Existing.
Phone (583) 5 — LII\n Fax: (Sb ) sz ' J ' L()r W New:
APPLICANT _ CONTACT PERSON .
NOTICE
Business name: P r All contractors and subcontractors are required to be
Contact name: • 1(j) licensed with the Oregon Construction Contractors Board
�+ under ORS 701 and may be required to be licensed in the
• Address: 3 noL jurisdiction in which w ork is being performed. if the
applicant is exempt from licensing the following reasons
Cit} /State /ZIP:
t c apply:
Phone: ($b3) °t (.9_ `- I f Li'S 3 Fax: : ( ) 5n `' y� e_,
E -mail:
. ::
- CONTRACTOR- - -
Business name: 5 in G
- 'BUILDING PERMIT FEES"
Address:
Please refer ro fee schedule -
City/State/ZIP:
Fees due upon application
•
Phone: ( ) I Fax: ( )
CCB he.: i39 9 �/ , Amount received l
1 1 n l r'—' Date received:
Authorized signal e: , \ ' A#-T . This permit application expires if a permit is not obtained
��V11 u/ � within 180 days after it has been accepted as complete.
Print name C2 Date: • Fee methodology set by Tn -County Building Industry
Service Board.
F ParmirApp doc 12/03 440- 4613T11 I /02 /C01V'aEB)
1
LICCL111 ill 1 0111111 .I pJ./ilLitLIV11 a o
City Tigard Received Permit No
Y Ol la g Date/By:
13(125 SW Hall Blvd, Tigard, OR 97223 Plan Review
• f • Phone: 501:639.4171 Fax: 503598.1960
tittirti it Date/By- Other ur
er Per
Inspection Line: 503.639.4175 Al _ Date Ready/By: Jaris El See Page 2 for
Internet: wws .ci.tigard - or.us Notified/Method: Supplemental Information
'. : - .a.7': _ T WORK PLAN REVIEW
•
❑ New construction ❑ Addition/alteration /replacement Please check all that apply-
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. f
' ' CATE OF. CONSTRUCTION._ of 1- and 2- fancily dxvellings 4 or more new residential
El 1- and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or moi
❑ Multi- family ❑ Iv'laster builder ❑ Other' ❑ Ianufactured structwes c
Occupant load over 99 persons
- - JOB SITE - INFORMATION AND LOCATION: , ❑Eeressdightingplan RV park
1 /,� 17 6 � e ) ci ❑Health -care facility ❑Other'
lob no.: '� ✓t Job site address: / / �
/ �� Subrut 2 sets of plans with any of the above.
City /State /ZIP: r6 The above are not applicable to temporary construction service-
' -
Suite /bldg /apt. no.: ' Project name 1-C FEE* SCHEDULE
Description 1 Qtr. I Fee. l Tout
Cross street/directions to Job site: Y1 ,1 a_ h- c� C ree� New residential single- or multi - family dwelling unit.
l Includes attached garage.
1,000 sq. ft. or less ' I 145.15
SubdivisionT t ke� I� t o� Lot no Ea add'1 500 sq. (t. or portion 3 33.40
Limited energy, residential 75.00
Tax map /parcel no.: S 1 a Fj} Limited energy. non - residential 75.00
_ DESCRIPTION OF WORK . ' - Each manufactured or modular
dwelling, sen and / or feeder I 90 90
Services or feeders installation. alteration, andior relocation
. 200 amps or less I 80 30
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85
401 amps to 600 amps 160 60
Name: " LS Ct ,C11Y1 \, � , 601 amps to 1,000 amps 240.60
Address: Up Wl� \ ���\ C i . Over 1,000 amps or .oils 154 -65
n� sV`t �l Reconnect onh 66.85
Cite Stale /ZIP:
Sib �• • 41,.• " . Temporary' services or feeders installation, alteration, and /or
-��//� ^' — relocation
Phone (�'L Fax: (S) S3(,' `T 200 amps or less I 66 85
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps i 100.30
intended for sale lease, rent, of exchange, according to ORS 447, 449, 670. and 701. 401 amps to 600 amps 1 133 -75
Owner signature: Date: Branch circuits - new. alteration, or extension, per panel
_ ❑ APPLICANT - • ,CONTACT PERSON' A Fee for branch circuits t yrth I
service or feeder fee, each
Business name: n branch circuit 6 65
Contact name , B- Fee for branch circuits
r without service or feeder fee. 46.85
,address: each branch circuit
( AK r l lJ Ea ch add'l branch circuit 6.65
City /Slate /ZIP: Miscellaneous (service or feeder not included)
( hs) .1� 1 I ! (4 3-s ( ) 5 �� Pump or irrigation circle 53.40
Phone: Fax:: r -i
1 Sign or outline lighting 53.40
E -mail: - Signal circuit(s) or limited-
CON - energy panel, alteration, or
extension Describe: Page 2
Business name: r- ��5 E t C_ r C I
Address: aSg 1 e �l - )' ��Y 1_ J �) - Each additional inspection over allowable in any of the above
U Per inspection 62.50
City /State /ZIP: v,] t y ��\ cc , O e ci'l. 12 S Investigation per hour (1 hr min) 62.50
Phone: (SD3) h q2 _ a�OC 1 Fax: ( ) 6 /4'L_ 1 J[ At ]ndustrial plant per hour 73.75
1l V ELECTRICAL PERMIT' FEES*
CCB Lic l gaz Electrical ,c : q - Suprv. Lic.: Subtotal
Suprv. Electrician signature, required: ' = 1 , At-. Plan review (25% of permit fee)
_ • D - State surcharge (8% of permit fee)
_
Print name: 5A v�
_ �� TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 18
\\ VI r days after it has been accepted as complete
Print name: ' � 1 , / C L a Le � Date: • Fee methodology set by Tn -Cowry Building Industry Service Board
/ �/ " Number of inspections per permit allowed.
i \BuitdingiPermits \ELC- PemviApp doe 12'03
440- 4615T(10102'CO!W� +'EB
ivtecnaulcal rermit /Application e
City of Tigard Received
Date/By, Permit No
l 13125 SW Hall Blvd., Tigard, OR 97223
All, Plan Review
503.6s? - 4171 Fax: 503.598.1960 Other Permit:
t
Inspection Line: 503.639.41 75 y J Date.By Date Readv:B runs-
InterneInternet: www.ci.ti ardor us See Pent for
g otified/1\4etho d : S Supplemental l Information
TYPE :OF �A ORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
X New construction ❑ Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of a
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profi t
CA TEGORY ._OF- _CONS_ TRUC_ TION - Value- 5
RESIDENTIAL EQUIPMENT / SYSTEMS FEES`
Irl- and 2- family dwelling XCommercial /industrial ❑ .Accessory building
For special rniorma; ton use checkhsr
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea I Total
. ' . JOB SITE INFORMATION "AND LOCATION Heating cooling
� 7 /m f r q p/ � ... Q d r Air conditioning or heat pump
Job site address: v� 7 U (��,� i
(requires site plan showing placement) 14.00
State /ZIP: _i Furnace 100.000 BTU (ducis'vents) / 14 -00
City
1i �(�. q�
Furnace 100,000+ BTU tducis.'ventsj 17 90
Suite/bldg. /apt. no.: Project name
vt1 }ems Gas heat pump 11.00
Cross street/directions to job site t/'\ ` � �- c Duct \.ork 14.00
�'� 1 �� �► Hydromc hot water system 14.00
���i Residential boiler (radiator or
hvdronic) 14 00
• Unit heaters (fuel -type, not electric),
in -wall, to -duct. suspended, etc 10.00
S: `- �}�� Lot no.:
Flue/ vent for any of above 10 00
Subdivision: Other 10 00
Tax map /parcel no.: L J ^ 5 1 � 1 � 1 Other fuel appliances ■
DESCRIPTION. l O WORK Water heater / 10 00
Gas fireplace / 10,00
' Flue vent for water heater or gas
fireplace 10 00
Log lighter (gas) 10,00
\ \'ood•pellet stove 10 -00
Wood fireplacelmsert 1000
t, PROPERTY OWNER Chmvie_v %liner:'(lue' vent 10 00
❑ TEN Other-
1000
Name: V -' ,C'1 ', liai Environmental exhaust and ventilation
/ 1 ` J Range hoodiother kitchen
Address:
l0t� O �� t CA 10.00
City/State/ZIT 1021 --h�� c +� . ��`������JJJ Clothes dryer exhaust f 10 00
I Single -duct exhaust (bathrooms, !�
Phone: (5 )5.. L`O�� Fax: (56 g) 533- x{366 toilet compartments, utility rooms) I 6.80
APPLI ANT:; CONTACT PERSON Atttcicrawlspace fans 10 -
Business name: (\(\ E Other: 10.00
Fuel piping
Contact name: _ $5.40 for first four; 51.00 for each additional
Address: _ t: , Furnace. etc. 1
B �J Gas heat pump
Cih•'State /ZIP: Wall /suspended /unit heater
Phone: (543)9669_ 1q Fax: ) S `
� � Water heater i
1 Fireplace 1
E -mail:
Range
CONTRACTOR = ":_ Barbecue
Business name: fi ��� ) � dr C.06 l�(' Clothes dryer (gas)
Oth
Address: `r ��1, l+ Co 5 5 . . . - . - 1‘ . 1ECBANICAL PERMIT FEES*
CitviState.!ZIP: \ c ■l b O 91-N1); � Subtotal
, Minimum permit fee ($72 50)
Phone: (5:, ) 591 -9tiz 14 Fax: ( 503) 8 q _ OY Plan review (25% of permit fee)
CCB lic.: I -1 1 31 z...) State surcharge (8% of permit fee)
/
1.1 — % �� TOTAL PERMIT FEE
Authorized si w Lure:
/ This permit application expires if a permit is not obtained within 181
days after it has been accepted 25 complete.
Print name: a / ' Date: i
J • Fee methodology set by Tri-County Building Industry Service Board
i'\Buflding \MEC PPermi � pp doc 12/03 440 - 461 =T (I li02!COMJ\VEB)
tsuhturg rilxtures .
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Perrrut No--
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503. 598.1960 ds� /fi yY F ) �'� Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639 4175 _:.
°_ -��, - Date Ready/By s 8 See Page 2 for
Internet: www ci.tigard - or.us Notified/Method- Supplemental information
_ - TYPE OF ; WORK r - .F "SCHEDULE
New construction ❑ Demolition For special information use checklis —
Descnption Qty 1 Ea- I To,al
❑ Addition •'alteration /replacement ❑ Other. New 1- 2- family dwellings (includes 100 0 for each utility connecuor
-- CATEGORY. OF CON S FR (I) ba 249,20
x1- and 2- family dwelling XCommercial/industrial SFR (2) bath 350.00
ill Accessory building 111 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
O
; _ "' FOi•1ATI7�l� AND L L OCATIOI�? 'ggi:,=
-.,•_ 5 JOB - STYE L R
,.- - .....- x ,-' +`W Site utilities
Job site address: L IT 1 . Su 1 G c( rfij Catch basin or area dram 16 60
CityiState!ZlP: ` �� O l -} Drywell, leach tine, or trench drain 16_60
)
Suite/bldg. /apt. no.: I Project name: Footing dram (no- linear ft.: ) Page 2
��A \
Manufactured home utilities 110 00
Cross street/directions to job site �-�j o h
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
StorTn sewer (no linear 0.. ) Page 2
_ ` �o�Jtl MPS f J' Water service (no linear R :
Fixture or item ) Page 2
Subdivision: ` Lot no.: " 1
Tax ma arccl no.. a 1 � 0 l w ? „
PP
,. . ,<. _ . ,;:.. , - - -, _ . � - . , - - . . . . . .. . . ..... - - �. Absorption gal
A orpt e 16.60
�.
DESGRI} TION'OF - �VORIC Backflow preventer Page 2
Backwater valve 16 60
Clothes washer 16 60
Dishwasher 16 60
r -- Y Dr nkin fountain 16 -60
1 . PROPERTY O VER ❑ r TENAN ,- ;' ;-
t Ejectorstsump 16 -60
1
Name: `
V J ( ,t AEA \ACYYV5 Expansion tank 16.60
Address: i(0 ago � 5 ,,.._, �' Fixrurelsewer cap 16 60
City /State /ZIP.' r . � l C , ,�. 4.- , _ Floor drain/floor smk/hub 16.60
Phone: �3) 522 ? ` � �� Fax: (M3) .3
_ e/ 0 Garbage disposal 16.60
? : r t. ,,,, p„ ..:;s=°tx; : >� `` z -r rmil - _ Hose bib 1 16.60
,, ti i APPI.IC - £ y - k a _ - M, EON7A,C>r`
ice maker 16.60
Business name: i porn E, ' Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: 3Pif__, Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: (566) 4 may_ 1 y53 I Fax:: ( ) (A L u asrn/lavatory 16 -60
Tub/shower/shower ,• ` Tub /shower /shower pan 16.60
E -mail. Urinal 16 -60
_ €ONTRAC OR r
n .
s c. = sU ':e, Water close! 16.60
Business name: M � 1` e L n \b. \C'`Y\ Water heater 16 60
Address: ) 'lily `31_,,,.. z� - 1 �. - Other -
City /State'ZIP: -, e \ /pit qi S Subtotal
`\ j 1
1 l s. Minimum permit fee. $72.50
Phone: (563) (021s _ 1 t P _ Fax: (5/53) ( R _ 1 4683 Residential backflow minimum permit fee: $36 25
CCB Lic.: Dqa ( _ Plumbing Lic. no.: 3q a60As Plan review (25% of permit fee)
r- t State surcharge (8% of permit fee)
Authorized signature. 9 / a TOTAL PERMIT FEE
"' N II� 1 I / / ll l
I Print name: J Li I permit application expires if a permit is not obtained within
C Date: This per 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Boar(
RuildinglPcmuts'YLMF.PmnitApp doc 12/03 440 4616T /02/COM/WEB)
CITY OF TIGARD .
BUILDING DIVISION
PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2005
Phone: (503) 639 -4171 �o� v ,��gl1°yl °1VPi
Inspection Requests (24 Hrs.): (503) 639 -4175 U
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 24
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 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: 10/7/2005 Pour Time:
Codee # Inspection Description Confirm # Contact # Message
19 Electrical final 017748 -03 503 - 642 -2800 N
Corrections /Comments /Instructions:
i' Dc Vi(di ?\_-,, N\t,(,s\K(sz ‘‘\ Lt\ka ')I., ti)l
•
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: AA ..c.. Date:/ / / Phone #: (503) 718-
/
CITY OF TIGARD
BUILDING DIVISION • -
PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2005
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AM PAGE: 8a
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 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: 10/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 017862 -03 503-209-6038 N
Corrections /Comments/ Instructions:
AMMO' �.
v Fir
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDIT ONAL FEES ASSESSED
Inspector: t 410 Date: (' Phone #: (503) 718-
. ;. ,.
CITY OF TIGARD _ .
BUILDING DIVISION PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2005
Phone: (503) 639 -4171 � i�h�
Inspection Requests (24 Hrs.): (503) 639 -4175 !J
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 39
SITE ADDRESS: 07917 SW PICT <ELINEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 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: 10/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 018250 -01 503 - 209-6038 'f
Corrections/Comments/Instructions:
{)
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: J2 Date: /67/ Phone #: (503) 718 -
CITY OF TIGARD . .
BUILDING DIVISION PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2005
Phone: (503) 639 -4171 / # , h , ll/ 11 J��pIi pillllfill i
Inspection Requests (24 Hrs.): (503) 639 -4175 .� J! `__—
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7 :02AM PAGE: 34
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA,
OWNER: JLS CUSTOM HOMES, PHONE #: 503533 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503-533-4006
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 018392 -01 503 -209 -6038 N
Corrections /Comments/ Instructions:
0 1V1 /., h/
.
a
i
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
❑ FAIL CAL JNSPECTION ❑ ADDITIO AL F- S ASSESSED
)
Inspector: Date: � l .
P Phone #: (503) 718 -
T t 1a
DONITA
Building Permit Application �� FOR OFFICE USE ONL Y.- V
"p l Receved r
I ' O SW r M ani • Re e ive -a .)- Permit No. S r f� (/ /I 7 IAI
?
Th 91
13125 S Hall Blvd., Tigard, OR 9 Plan Review // C T
Phone: 503.639.4171 Fax: 503.59 1 E .let�d�.,. 11 Date/By: --- b " 6 5 Other Petmri. - r 2"d y A, 36
Inspection Line: 503.639 4175 AJ, Il Date ReadviBv 1 9 See Attached Checklist for
Internet: wutiv.ci.ligard.or . us DEC 0 2004 ?rotificd'Method: 1 l� Supplemental Information
- ..'. Gal CIF 1� G/ � RD .. .,e 1 11 - - , : 1- AND 2- FAMILY DWELLING
KNew construction Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment materials. labor, overhead, and the profit for the
work indicated on this application. / 8pcp
. CATEGORY OF 2ONSTRUCTION ! 1
I- and 2- family dwelling Valuation: $ 'go,
XCorrunercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms
ry
❑ ',taster builder ❑ Other: Number of bathrooms: L .5
• JOB SITE. INFORMATION AND LOCATION Total number of floors 2
lob site address`-riq/ l SA) Pi tew te( N New dwelling area:` .1 1 6 S square feet
Cit)iState /ZIP: T �` 1e Q�� ■ I Garage /carport area: lima square feet
Suite/bldg. /apt. no.: v Project name: - {' a Cornered porch area: - : 50 square feet
C� �- ICJ
Cross street/directions to job site: a_c\--- cQ r ..112.9.1__:.0e.. Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: ( le \\ p j�� Lot no.: q Pcrmit fees' are based on the value of the
the n work perform
L1 + Indicate the value (rounded to the dollar) of all
Tax map/parcel no.: aS 1 �' (� T GY �1 ------ -.._.. -._. equipment, materials. labor. overhead. and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New budding area: square feet
PROPERTY OWNER - [ • • ❑ TENANT Number of stories:
Name: S -r L.___ A Type of ronstr n ctro
Address: : fl (DQRQ n4WrQ Occupancy groups:
. (`
Cit :State -i_IP: t _ cl 6 el
�
V . Existing:
Phone: (563) S c1ox1k, Fax: (sc)3) 3 - is 0 New:
❑ .1P1'LIC.UVT• -... •• • 1,K CONTACT PERSON •
NOTICE
Business name: th r l t r All contractors and subcontractors are required to be
Contact name: N \ um. n licensed with the Oregon Construction Contractors Board • v under ORS 701 and may be required to be licensed in the
Address: _ jurisdiction in which work is being performed. If the
City/State/ZIP: �+ •► � applicant is exempt from licensing, the following. reasons
apply':
Phone: (SOS) ° t (ta9- 1 LIS 3 Fax:: ( ) 131 )
E -mail:
CONTRAC:COR'.. _:.,•
Business name: 5A
F RUI DJNC; 'PERMIT FEES* •
Address:
Please refer to fee schedule -
City/State/ZIP:
Fees due upon
application
Phone:( ) Fax:( )
CCB lie : i39 1 �t� I i Amount received
1 ` — I Date received:
Authorized si rat c: ' A
______I'V
g T his permit application expires if a permit is not obtained
v within 180 days after it has been accepted as complete.
r Print name: � C)t 4e f, Date: _ I • Fee methodology set by Tr- County Building Industry
l! =L � Service Board.
: doe 12/03 440.a613T(1i c. — cone .vm :u)
L
t.ICI'll mat I C1111111. i '
•
City of Tigard Received Penrtit No.:
1 3 Plan Rev
1125 SW Hall Blvd Tigard, OR 97223
Plan Review
• . • ' Phone: 503':639.4171 Fax: 503.598.1960 Gam . 4r t� Da1e1B,.• Other Permit:
Inspection Line: 503.639.4175 4 I� Date Ready/By • turn 0 See Page 2 for
Internet: u-ti v.ci.tigard.or.us NotifredR.Iethod• I Supplemental Information
- • TY14_ :' OF WORK PLAN REVIEW •
❑ New construction ❑ Addition /alteration /replacement Please check all that apply
III Demolition ❑ Other: ❑Service over 225 amps. comrn'1 ❑llazardous location
❑Service over 320 amps - rating ❑ Buildng over 10.000 sq f
CATEGORY OF - CONSTRUC rION, of I - and 2- family dv 4 or more new residential
❑ I - and 2- family dwelling 111 Commercial/industrial 111 Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders. 400 amps or mot
❑ Mull /- family ❑ Master builder ❑ Other: ❑ 1anufactured structures t
, ['Occupant load over 99 persons
. • JOB SITE, INFORMATION ANT) LOCA'T'ION . ❑Egressiltghting plan RV park
Job no.: L a Job site address: 7 1a) f� � 01-care facility ❑Other'
JJ 1 Submit 2 sets of plans with any of the above
City/State/ZIP: The above are not applicable to temporary construction service
1 10.Q��J t O � • .
0 FEE* SCHEDULE
Suite'blde apt. no.: Project nam Zn.^
l� AA llrs
y , , /� ] Description l) I r y Fee. I Tout
Cr oss Street d1rectror15 to job Site S�w 1 re�� New residential single- or multi - family dwelling unit.
499444 ......JJl��......JJl�������� \` yl� ` Includes attached gangue.••
1,000 sq. ft. or less f I 145 IS
Subdivision: ' - -- , Lot no : Ea. add l 500 sq ft. or portwri j 33 40
` Limited energy, residential :5.00
vl - ax map/parcel no.: a I a 1 Limited energy. non-residential 75.00
DESCRIPTION OF WORK Each manufactured or modular
• dwelling, service and/or feeder I 90 90 _
_ Services or feeders installation. alteration, acid /or relocation
200 amps or less 80 30
PROPERTY OWNER ❑ TENA \'f
201 amps to 400 amps f I 106 85
401 amps to 000 amps 160 60
Name: —31 -'S C--i _ 1 601 amps to 1,000 amps 2-10 60
Q
Address: kto k �J�..f/ ' \ � „ \C ] Over 1,000 amps or volts -154 65
Llti . Reconnect only 66 8:
C II \ %SIatC /7_IP: ` t o ^ Q�� `1 (f / _ icmporrn services or feeders instillation, alteration. and!or
��GL��I ` 1 - a relocation
Phone: (663 ) tea i I Fax: ( s 53 — 200 amps or less i 66.35
(Tyner installation: This installation is being made on properly that I own which is not 201 amps to 400 amps I 100 30
intended for sale, lease, rent, or' exchange, according to ORS 447, 449, 670. and 701. 401 amps to 600 amps I 133 75
Owner signature: - Date: Branch circuits - new. alteration, or extension. per panel
❑ APPLICANT I • - g.CON'1ACT PERSON A Fee for branch circuits tech
service or feeder tee, each
Business name: , c._J branch circuit 6 65
• B. Fee for branch circuits
Contact name: , II 0 I without service or feeder fee. .16.85
Address: £ WIC each branch circuit
Each add'I branch circuit 6.65
City /Slate /ZIP: Miscellaneous (service or feeder not included)
Phone: `
( 6fl3 ) 1 I - ^ i - 1 /4 3 - s I Fax:: ( ) r - { 5 n E , Pump or irrigation circle 53.40
— - -
/ ! Sign or outline lighting 53 40
E-mail: Signal circuit(s) or limited-
” .. . : - CONTRACTOR • energy panel, alteration. or
r extension Describe Page 2
Business name: (1 :1- ., r%
Address: C7�SS 1 Q �V ` 1 _ \ Q ��F I
� Each additional inspection over allowable in any of the above
LJ�_ra Per Inspection 62.50
City /State /ZiP: v] iA L C � Q � O _ f'� u � 1 '72 Investigation per hour it ht nun) 62.50
Phone 6563) h 4 7 Z _d80C r Fax: kat ) 64 5 B S I ndustrial plant per hour 73.75
c • ELECTRICAL PERMIT FEES*
CCB Lic.: ` ($pz Electrical 1.1c.: q - Supra. Lic.: Subtotal
Suprv. Electrician signature, required: 4 All Plan review (25% of permit fee)
State surcharee (8 °i of perntt fee)
Print name: a- -v€. 1 DatC—
TOTAL PERMIT FEE
Authorized sil?pature: _ Ui f ( 1G� / t 4 This permit application expires if a permit is not obtained within IS
_ AA - I days after it has been accepted as complete
Print name: ',1 N / / ul Q , j 1 '/ L A yi S . , 4 Date: • Fee methodology set b.: ; ri- Count.; Building Indusny Service Board
(1 •' Number of inspections per permit allowed
i' tBuitding•.Pemuts'F-LC•PemuiArp doc 1 440 461.T( 10,02 :CO.M /Vv'EB
J.viecnanicai rennet. Application .
Received
City of Tigard Date/By: Permit No
e 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re::e'.
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit
II Date Be:
Inspection Line: 503.639.4175
Date Readv.`By: lures p See Page 2 for
Internet: www.ci.tigard.or us �, Notified/Method: Supplemental Information
TYPE OF .WORK" " - COl1;MERCiAL FEE' SCHEDULE - USE CHECKLIST
r'N New construction ❑ Addition/alteration/replacement Mechanical permit fees' are based on the value of the +ork
performed indicate the value (rounded to the nearest dollar) of a
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
- • CATECOiEY OF CONSTRUCTION • Value $
RESIDENTiAL EQUIPMENT / SYSTEMS FEES'
i$ZI and 2 family dwelling Al Commercial /industrial ❑ Accessory building
For special information use checklist
❑ Multi family ❑ >\•lastet builder ❑ Other:
Description Qty. I Ea I Total
JOB SITE INFORMATION AND LOCATION Heating
Job site address: J • v /L ® Air condtuomne or heat pump
r w�lll..�����` �__ (requires site plan �showing placement) 14 00
(duct
----- 'r Q Furnace 100,000 BTU s'',enra) / Id 00 I
CityrState /ZIP: 'i L O �� / / t
1- Furnace 100.000+ BTU tducts. vents) 17 90
Suite/bldg./apt. no.: Project na me: �1
��LL(is Gas heat pump l a 00
Cross street /directions to job site: ���{Y � �- Duct w ork 14 00
�+ Hydronic hot water system 14 00
�� Residential boiler (radiator or
hvdronie) 14 00
Unit heaters (fuel -type, not electric), i
in- wall. in -duct. suspended, etc 10 00 ,
�� Fluc.+'ent for any of abo +c 10.00
SubdiV1Si011 `_ T ►�•� Lot no.: gq
I' - other: 10 00
Tax map /parcel no.: a � 'm 1 Other fuel appliances
(/ \
DESCRIPTION. OF WORK Water heater / 1000 r
Gas fireplace 1 10 00 l_
• Flue vent for water heater or gas
fireplace 10 00
1 Lon lighter (gas) 10 00
\\ ood pellet stove 10 00
Wood fneplace / uuert 10 00
Chimney liner ilue vent 10 00
r. PROPERTY OWNER ❑ TENANT ( Other 10.00
Name: TLS C_� *-Qt-(� a/ Environmental exhaust and +entilalinn
v vV�-+ 1 \ f _ � C� Range hood.other kitchen t
Address: '� t equipment 10 00
CilyrSlatel7_11 ^` r tT I . e 6 , • r _ Clothes deer exhaust / 10 00
�.l�CS� tJ �(! Single -duct exhaust (bathrooms, L.�
Phone: (563 )513— C"(QQ(o Fax: (563)53s- q366 toilet compartments, unhty MOT s) 1 6 80
❑•'APPLICANT: fa CONTACT PERSON Attic /crawlspace fans 10.00
Business name: h E., Other:
Fuel IO.GO
ripen
Contact name: 1 I ( $5.40 for first four: $1.00 for each additional
Address: c:\ M E Furnace, etc.
Gas heat pump
City /State /ZIP: - / r � 7 Wall /suspended /unit heater
Phone: (5p3) 9669- 1 Qs '7 Fax: ( ) 5 wat heater _L_ _
� 1 ( ` ` Fireplace (f
E-mail:
Range
CONTRACTOR : •. ° ' Barbecue
� ] ` '`n Clothes dryer (gas)
Business name: \ \ 1 _ _ el-q l _ — LC ^ O 1
.` _ G1 CO ��C�] , Other:
Address: 0 6 v MECHANICAL PERMIT FEES*
City/State/ZIP: %4:: ^ O 91�/'� Subtotal
( 50 , ) 591 - 9a 2 ( 8�f® ( }�
Minimum permit fee permit fee)
Phone: Fax: '
Plan review (25% of permit fee)
CCB lie.: ' 4 l I State surcharge (8% of permit fee)
a ( j �' TOTAL PERMIT FEE
: Authorized si lure:
I 1 � • - This permit application expires it a permit is not obtained "ithin 131
I _ r days after it has been accepted as complete.
• I v
I Pnnt name: N / - � • Date: 1 • Fee methodology set by in-County Building Industry Service Board
,\nuilding+Pcm;its +MFC.PemutApp dec 12/03 440 - 46157111 /02 /COM/+EB)
Dunning r ixtures
Plumbing Permit Application r :.' FOR OFFICEUSE ONLY
Cit of Tigard Received
D eceve
Plan Review Per
nut No
•
13125 SW Hall Blvd.. 'Tigard, OR 97223
Phone: 503.639.4171 Fax 50 3.598.1960 �u Other Perrrut No
24- Hour Inspection Line: 503.639411 75 �y D cei atd B :. y — —
„ -. Date Ready/13y: !um El See Page 2 for
Internet www.ci.tigard.or.us
Noti(edlP1cthod' Supplemental Information
.,.. ,. .., :
..; : OF ,•:�1`O.I 21C.: :`; . c
:;;:;���: -. C!!E J F )IJ
_ _- F E
g New construction Ili Demolition For special information use checklist.
Description Q I Ea j To,al
❑ Addition /alteration•`replacemera El Other: New I- 2- family dwellings (includes 100 ft. for each utility connectior
CATEGORY. OF`.'CONSTRUCTION : _ SFR (I ) bath 2-19 20
XI- and 2- family dwelling (ZQ Cornmcrcialiindustrial SFR (2) bath 350 00
El Accessory building [j] Multi - family SFR (3) bath 399.00
Each additional bathikitchien 45 00
❑ Master builder El Other:
Fire sprinkler L_ sq. ft) Page 2
. Si -TE L N l.. l)R∎p t i r l oy_'AI Yll'..1,0( ATI ,,A.y :,:.
�• _ - � site u iii ilics •
Job site address: L � � Catch basin or area drain 16 60
City /State /ZIP: ` • 9 Drywell, leach line, or trench drain 16 60
Suite/bldg. /apt. no.: L Project name• Footing drain (no linear 11.. ) Page 2
-- - Manufactured borne utilities 11000
Cross street/directions to Job site ri n_ ,4-- � --
U, —y Manholes 1 6.60
Rain drain connector 16.60
Sanitary sewer (no linear ft.: ) Page 2
Storm sewer (no. linear ft . ) Page 2
•-- _
Subdivision: Lot rro.: rr� Water service (no linear fl ) Page I
- t — � ` �vJYl \-b!MQS t
Tax nrap'pareel no ' .\ Fixtur or item
Wri:) l Absorption valve 1660
1)F,SCltfl' PION OF WORK B:tektlo I,rc. erlrcr Page
Backwater valve 16 60
Clothes `a ashen 16 60
Dishwasher — 1 ■ 16 60
.• 2:..., r•::,�; _ r.. Drinking fountain 16 60
Vt. PIKO1'FR•I - 6 — N6 .6 R. - - - ,:: ❑: J NA1V.1tix `P: —
'`< E jectors. surrrp 16 60
Nance: as. C �cS _ — Q �S .__ Expansion tank 16 60
Address: l to aso 3� — �' Fixture /sewer cap 16 60
City /State%7_1P: x �(� • C:1._ � 1 , Floor drain /floor sinlohuh 16 60
n�� y�(Q Fax: (5 )5 ��J--�O y � Garbage disposal 1660
Phone: f93)5
• -. F : •, .• . ,. ..
.. : , .. _ .r ::- :a., .• :, r
a' : • Q'_ AI'. 1' 1. ICIN: F: >'` ^.' ^`.�!:`. - ` Hose bib 16.60
F
j l •, A • . E ON7 :G4_-YEI2 S O I V ; ! • '
' , . ... f . ... F., , t ',..... _ r... ,_.. -. ;_ ......... _, .. _.r ::.4,L'^ :r Ice maker
16.60
Business name:
t if , R k 1 1 \ • Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: 3fA Primer 16.60
City /Stale) %IP: Roof drain (commercial) 16.60
Phone:
( ) 4 c t,9- /11 Fax: 53 ( ) ( SinkPoasin / lavatory 16 60
Tub/shower/shower pan 16.60
E -mail:
Urinal 16.60
;CONFR.•1CI;OR's: :< _;::,:,�:::`' t: Water � ... ::.::'� , ...- �. ._, = ...... -:: ji •: ''�: •.<•:�.,, -, �.aterclesct 16.xr
0
Business name: E ��A o N1 e h ( �\ � � Water heater 16 60
Address: O 4 J� �VJ 3 1._. 1C ` �� Other:
7'7 Subtotal
City /State,ZIP: `A iA1tS �— /'\ � '1
/ �— V-i� -� �sa...i' Minimum permit fee: $ 72.50
Phone: (653) tp28 _ ) �CZ Fax: (6-53) 1. J,, .3 Residential backflow minimum permit fee: $36.25
CCB Lie.: c w 9 _ Plumbing Lic. no.:3� - Rt,./..1 Plan review (25% of permit fee)
e tt y n ' ; • '/ 1 State surcharge (8% of permit fee)
Authorized signature; 'AVl 1 '' J � �6 TOTAL PERMIT FEE
I Print name: (/v ,� IIL•�y� I Date: 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 Boar(
Building \Pr,mirs`.PLMF- t'errniiApp doe 12/03 340.4016T( I OI07JCON.tWEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/24/2005
Phone: (503) 639 -4171 �n
Inspection Requests (24 Hrs.): (503) 639 -4175 s_' ^'' �..
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 24
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: LS CUSTOM HOMES. PHONE #: 503 533 - 4006
CONTRACTOR: IS CUSTOM HOMES PHONE #: 503-533-4006
Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code � # Inspection Description Confirm # Contact # Message
199 Electrical final 017748.03 503 - 642 -2800 N
Corrections /Comments /Instructions: \ I s i ' IA
I. - 1D \11(i T \ ic\ NW S \ \ \ \\S LW, •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:) •=c—. p Date: Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSU 3/29 /2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I I..
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AM PAGE: 88
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES, PHONE #: 503- 5334006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503- 533.4006
Inspection Request Scheduled For: Date: 10/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 017862 -03 503- 209 -6038 N
Corrections/Comments/Instructions:
4111
iL . ' iir Lyzmafirmim
f y I/ J
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I/ CALL FOR INSPECTION ❑ ADDIT ONAL FEES ASSESSED
Inspector: r � Date: ( (& ` " Phone #: (503) 718 -
CITY OF TIGARD .. .
BUILDING DIVISION PERMIT #: MST2004-00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2005
Phone: (503) 639 -4171 .."11g l
Inspection Requests (24 Hrs.): (503) 639 -4175 .._......i
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 39
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES, PHONE #: 503-533-4006
CONTRACTOR: IS CUSTOM HOMES PHONE #: 503 - 533 -4006
I nspection Request Scheduled For: Date: 10/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 018250 -01 503 -209 -6038 Y
Corrections /Comments/ Instructions:
{) g
pASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: IAA Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00364
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/24 /2006
Phone: (503) 639 -4171 I i i
Inspection Requests (24 Hrs.): (503) 639 -4175 ^_
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 34
SITE ADDRESS: 07917 SW PICKELWEED LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 049 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES, PHONE #: 503- 5334006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503.533.4006
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 018392 -01 503-209-6038 N
Corrections /Comments/ Instructions:
ii
4
1 (i. r
i
1 ,
1/7 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CAL FO INSPECTION ❑ ADDITIO AL F. S ASSESSED
Inspector: i F Date: D 4 r Phone #: (503) 718 -