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Permit
Fi ' � ' 'mr • , n ® ' MASTER PERMIT 41 . PERMIT #: MST2008 -00008 COMMUNITY DEVELOPMENT DATE ISSUED: 3/21/2008 T IGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134BD-07017 SITE ADDRESS: 10900 SW 115TH AVE ZONING: R -4.5 SUBDIVISION: ENGLEWOOD NO.3 • LOT: 206 JURISDICTION: TIG PROJECT: THOMAS Project Description: 200sf alteration above garage. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE SF FLOOR LOAD: 50 SECOND: 200 sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: SR3.3 BDRM: 1 BATH: TOTAL: 200 sf 20,000.00 REAR: PLUMBING SINKS: 0 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FOR: 3 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LP LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 • 1000 amp: 601.tamps- 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: C O ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL 8. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 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: This permit is subject to the regulations contained in the Tigard Ca Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable WAYNE & DONNA THOMAS OWNER laws. All work will be done in accordance with approved plans. This . 10900 SW 115TH permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952 -001 -0080. You may obtain copies of these rules or direct Phone: 503 -590 -2502 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: • TOTAL FEES: $ 730.35 • REQUIRED ITEMS AND REPORTS • Issued By Permittee Signature? . / 1 t Call 503.639.4175 by 7:00 a.m. for an inspection that business y. 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. ago 0 of Z ■ I %. 0* (�,� �DQ0 I I / DSO o 0 ©DU D DDD ` I I 0 UU 00 g I I I . a p �� �bpU 0 ' I I ✓� ,o ..I14° SV* ,,,,"'' 1 ..... . .. Em o .. /U /I I �E B ❑ p ce / 0 0\ 0 : : /(------- aider I. 6. 00 41. \ , \ B . 11 9' e °:' 1111. Iiirk \ VT N \ , cs ,, i ...060 ,.., 9 )7- < -.0- ': - / j ' \ \' , / game k 0-, , - -,,,...,, o9/ . \ / `zo 6 �i $ sp > ' / / Ch' OLL T � OD � T C'� / \ v \,- .- N II ion / .--, ' \,- \ SPRING MIMI •. Q �i<<� m\ 1 ■ ■ � Xe" _� ;I� W � o =NE co C J � O • cn lA l 03 - =BLACK — 1 i) / 1L . m li , 00 II L II \ i GENEVA ST 1 1 11 II 1 '; V i _ - I w -- TWANZANITA ST . / < 1 --- II lir i l 1 } u. ‹, 0\'' MANZANITA - � f �-- CT N` / TMOTH�P \ --9T C f \ ,- - NORTH -- IxIii DAKOT NORTH DAKOTA ST CT Ell L I i \ , BURLHEIGHTS \ DR — 1.- SW TORUND ST. . i ALP N \ Wz " \ V tL, 1 vol„ � �� 1 -_,' , -V s9 _------4 , _.„...,(\ , a w rx _ P� / , � / TIGARD — _ I U � I I7 \ - � MERESTONECT S ER 'E j �' \ ` \ ,,/'-- , CITY OF TIGARD BUILDING DIVISION PERMIT #: MS1'2008.00000 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: T21/2000 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/16/2009 . TIME: 7:01AM PAGE: 22 SITE ADDRESS: 10300 SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENGLBNOOD NO .3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS S DESCRIPTION: 200st alteration above garages. OWNER: 1 S, WAYNE & DONNA PHONE #: 503-590-1 CONTRACTOR: OWNER N Q D P U I A I\\' z SUS PHONE #: Inspection Request Scheduled For: Date: 1 /1CJ2009=; Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough - in 079735-02 971 N Corrections /Comments/ Instructions: - u� PASS ❑ PARTIAL APPROVAL CANCEL (l NO ACCESS n FAIL n CALL FOR INSPECTION. ❑ ADDITIONAL FEES ASSESSED Inspector: C'30 V bg Date: ' 1 6 • 01 Phone #: (503) 718- J'T°Gp CITY OF TIGARD - BUIL ®INGe DIVISION - PERMIT #: MST200B-00008 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 1 Inspection Requests (24 Hrs.): (503) 639 -4175 °`'.1 INSPECTION WORKSHEET FOR DATE: 7/20/2008 TIME:. •7 :03AM PAGE: 12 SITE ADDRESS: 10900 SW 115TH AVE _ _ CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO .3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS • DESCRIPTION: 200st alteration above garage. OWNER: THOMAS, & DONNA PHONE #: 503 - 590.2502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 7/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message /� 120 Electrical rough -in 073300 -02 971-222-4206 Y AO Corrections /Comments/ Instructions: 11 ... l_. _ . . i i A b AA .� ! - r it/ ::.I / / "Al— OW 6134-(11 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1 ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: 1 Date th _ I Phone #: (503) 718- G lJ CITY OF TIGARD _ v BUILDING DIVISION PERMIT #: MST200B•0000B 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3121/200t3 Phone: (503) 639 -4171 �, Inspection Requests (24 Hrs.): (503) 639- 4175 INSPECTION WORKSHEET FOR DATE: 6918/2008 TIME: 7:02AM PAGE: 63 SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: . SUBDIVISION: ENGLEWOOD NO3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200sf alteration above garage. OWNER: THOMAS, S, WAYNE & DONNA PHONE #: 503 -590 -2502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6118/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message ' IZ,Vi 115 Electrical service 071508-01 503.590.2502 Y ?iil Iry Corrections /Comments/ Instructions: r r / .�,ii 4 ,•z./ jp pJe e edi t /I4V, 4t - i - 5v3 - 7/3",,A y416 rte= iniovvea4 b/. 3 ❑ PASS 7 PARTIAL APPROVAL (t CANCEL ❑ NO ACCESS 15 FAIL [ CAL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: if - Date: WRAg Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MS1•2008 -00018 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2000 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6117 /2008 TIME: 7:OOAM PAGE: 38 SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENGLEWOQD NO.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200sf alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 503 - 590.2602 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/17 /2008 Pour Time: Code # Inspection Description — Confirm • Contact # Message 115 Electrical service 071456-01 503 - 590.2502 N Corrections /Comments/ Instructions: n PASS 1 PARTIAL APPROVAL CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (16 Date: 61 1116% 0 Phone #: (503) 718- 26 CITY OF TIGARD • BUILDING DIVISION • PERMIT #: MST2000 -00008 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2000 Phone: (503) 639 -4171 � ,I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/10 /2008 TIME: 7:01AM PAGE: 28 SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 20 0W alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: ?303.590.2502 CONTRACTOR: OWNER ' PHONE #: Inspection Request Scheduled For: Date: 6/10/2008 Pour Time: Code # Inspection Description -C n iro f m #, Contact # Message 120 Electrical rough -in \ 07115101 `, \\ 503•x,90.2502 N 1i5' sn tvc . `, Corrections /Comments /Instructions: ) -- e@ILN, c 2- po 43 is. "A ,,,./tV A 2 e 3a ,,, „_ (x . ic4,\ vdy\, . (As 1. 5 v boa, W 3 i ;--- A rAQ - 1^) ka''( .13/' 1 L k . U ti■JI k . .0 )cR..8S LA c TT&c 1 v& w 1 ' . )11 ti.) ; c.,, N 6f J P 1✓ Ali i — o lc kNiqc cit. my o v.0 )6I -1-c---&N;-, Q,*, 1.- I\L_. c_totav 1,2ssAft.6 ity ti.#.Q - 1 wt - cy FEs-b i,.)-- c,Thict____ - ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS X FAIL e CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6— . N be, L.E' Date: 00 a Phone #: (503) 718- lift{ CITY ������N�������� ��mn m OF wm��w=��m�� BUILDING DIVISION ^ PERMIT #: k4sT2008'00008 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/21/2008 Phone: (503) 639-4171 Inspection Roque�a(24Hm.):(5U8)63Q-4176 ~J ^� INSPECTION WORKSHEET FOR DATE: 2y20/2003 TIME: 7:O0AM PAGE: 10 SITE ADDRESS: 1O90)[W115THAVE CLASS OF WORK: SUBDIVISION: ENGi[5WO0QNO.3 LOT #: 205 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 28Ust a lterati on a b o v e garaga OWNER: THOMAS, WAYNE & DONNA PHONE #: 503-590-2503 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/20/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 080673-03 971-222-4206 N Corrections/Comments/Instructions: . ~�~*� ^/ H PARTIAL APPROVAL 0 CANCEL ri NOACCESS | |FA|L CALL FOR INSPECTION 0 ADDITIONAL F ES ASSESSED � ^dp~ / Inspector: �~-- Phone #: �Q3\718' CITY OF TIGARD: C.- - BUILDING DIVISION if A Y r -1 PERMIT #: MST2001.O0008 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 d ILL I -- LI /+n' Inspection Requests (24 Hrs.): (503) 639 -4175 _� — f INSPECTION WORKSHEET FOR DATE: 1/1112009 TIME: 7 :01AMt PAGE: 20 SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO .3 LOT #: 06 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: ° . ) 0tisf alteration above garage. OWNER: 1 HOMA:a, WAYNE & DONNA PHONE #: € 0; 90 -7502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/10/2009 Pour Time: Code # Inspection Description Confirm # Contact # Me -sag: bat a S 616 Mechanical rough -in 079704 -01 971-2214206 Y & C-' VI t-e Corrections/Com ents /Inst .. U 1 Vl i \72,34,,, r� W, , --v, c, (--,---)--) -t-y-,,,- ,,,. / - cu:EE-i'--- 1,- 1) -F-,,.‹.,..6 -.1_,,,,i1- (47,, , Jt- 1?4cf- _, [ ,%.- . ii -,-.) r___4„-c., ,,,e u,7 ,Lix 1 1 3)11 3 VV H k-\-- i . L.) I-) V\ L PASS ,I0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED rrt�e '' ,,{{ Inspector: �` Date: Vi v Phone #: (503) 718 -9 3'4 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2003 0t100B 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 Inspection Inspection Requests (24 Hrs.): (503) 639 -4175 R -L. INSPECTION WORKSHEET FOR DATE: 9/10/2008 TIME: 7:00AM PAGE: 15 SITE ADDRESS: 10900 SW 1 um AVE CLASS OF WORK: SUBDIVISION: EN(3LENI )0D NO.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 20101st alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 603-590-2602 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/10/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message X36 Shear walls/anchors 075321 -01 971 - 222 -4206 N I Corrections /Comments/ Instructions: 0 �• i /. - r i Le "' .-G lyrics 4 • - PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / Date: 9'% Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2000- 000013 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 312//2008 Phone: (503) 639 -4171 t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/10/2008 TIME: 7:0OAM PAGE: 13 SITE ADDRESS: 1090() SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200sf ;alteration above garage. OWNER: THOMA S, WAYNE & DONNA PHONE #: 503-590-2502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/10/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 075321 -03 971-222-4206 Y Corrections /Comments /Instructions: / !LJ =G- • _ *Ayr Asir mi l✓ la)Sd �T. Kea ❑ PASS El-PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ?iF'AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / / /--r- Phone #: (503) 718- —1°12. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200B- 000013 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2•1 /2008 Phone: (503) 639- 4171 '"a�ONI +� Inspection Requests (24 Hrs.): (503) 639- 4175 !�i:-'' I.. INSPECTION WORKSHEET FOR DATE: 9/10/2006 TIME: 7:0OAM PAGE: 14 SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENGI.EWOOD NO.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200d alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 503 - 590.2502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 075321 -02 971.222. -4206 N Corrections /Comments/ Instructions: • e �' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718 - 2.5V- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00008 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/200fi Phone: (503) 639 -4171 At Inspection Requests (24 Hrs.): (503) 639 -4175 . ' ' --.. INSPECTION WORKSHEET FOR DATE: 8/12/2008 TIME: 7:00AM PAGE: 2 SITE ADDRESS: 10900 SW 115TH I AVE CLASS OF WORK: SUBDIVISION: 1= NGLF` {){�q N+J 3 LOT #: 205 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200sf alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 503 f i90 -2602 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 81.12/7008 Pour Time: ?:(lf) Code # Inspection Description Confirm # Contact # Message 2i0 Foundation walls 074081 -02 971 -222 -4206 Y Corrections /Comments /Instructions: P ASS .n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL I n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I Inspector: Date: 15 --/ `L �Ge) Phone #: (503) 718- Z CITY OF TIGARD BUILDING DIVISION PERMIT #: r2ant3 00008 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2000 Phone: (503) 639 -4171 a Inspection Requests (24 Hrs.): (503) 639 -4175 il INSPECTION WORKSHEET FOR DATE: 8/12/2008 TIME: 7:O0AM PAGE: SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: SUBDIVISION ENGI EWOOD NO .3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200sf alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 503 - 590 -2502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 8/12/2008 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 074081 -01 971222 -4206 N Corrections /Comments /Instructions: 0 1 • PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: g -it — 5 Phone #: (503) 718- 9-4V CITY OF TIGARD BUILDING DIVISION PERMIT #: IMST1000 -0000$ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2000 Phone: (503) 639 -4171 41111 Inspection Requests (24 Hrs.): (503) 639 -4175 . ' -._.. . INSPECTION WORKSHEET FOR DATE: 7/28/2008 TIME 7 :03AM PAGE 13 SITE ADDRESS: 10900 SW 115TN AVE CLASS OF WORK: SUBDIVISION: ENCI EYVt,OD NO 3 LOT #: - 106 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 200d alteration above garage. OWNER: PHONE #: 503 -590 -2502 CONTRACTOR: THOMAS, WAYNE & DONNA OWNER PHONE #: Inspection Request Scheduled For: • Date: 7/28/2000 Pour Time: 11:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 073300.01 971 -222 -4206 Y Corrections /Comments/ Instructions: • • ❑ PASS ❑ PARTIAL APPROVAL CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 2s? „N oB Inspector: 3 Date: 1?” , Phone #: (503) 718- 2 y 7 • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 i )':;)8 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3121/2001 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 - 4175 INSPECTION WORKSHEET FOR DATE: 4/2212008 TIME: 7:OOAM PAGE: 37 SITE ADDRESS: 10900 SW 1151H AVE CLASS OF WORK: SUBDIVISION: ENGL_EWOOD.D NO.3 LOT #: 20E; TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 20 )sf alteration on above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 603 - S90 - 2502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 4/2212008 Pour Time: 11:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 060709 - 01 503.690.2502. `1 Corrections /Comments/ Instructions: ,cob /Paz a4 ✓ h ',4 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1— 2:7--a0 Phone #: (503) 718 - �¢� Case Activity Listing 1/16/2009 CCEL 7:58:56AM Case #: MST2008 -00008 Assigned Done Updated ,, Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes MSTI010 Application received 2/6/2008 None RECD BB 2/6/2008 BLD MST1020 Permit created 2/6/2008 None DONE BB 2/6/2008 BLD MST2205 Footing 8/12/2008 8/12/2008 8/12/2008 None PASS KBS 8/12/2008 074081 - 01 - 971 222 - 4206 VM - STI N r MST2210 Foundation walls 8/12/2008 8/12/2008 8/12/2008 None PASS KBS 8/12/2008 074081 - 02 - 971 - 222 - 4206 - VM - STI Y MST1080 Revisions /Info routed 9/4/2008 None APRV BLS 9/4/2008 E - mail from Engineer with revised to PE BLS hold down (second to first floor) second floor over hang. MST1120 Revisions 9/5/2008 None APRV LS 9/5/2008 apprvd/routed to PT LS MST2235 Shear walls /anchors 9/9/2008 9/10/2008 9/10/2008 None PASS KBS 9/10/2008 075321 - 01 - 971 222 - 4206 - VM - STI N MST2240 Exterior sheathing 9/9/2008 9/10/2008 9/10/2008 None PASS KBS 9/10/2008 075321 - 02 - 971 222 - 4206 - VI' " STI N MST2275 Framing 9/9/2008 9/10/2008 9/10/2008 None F KBS 9/10/2008 075321 - 03 - 971 222 - 4206 - VM - �' � / STI Y 150 MST2320 Plumbing rough - 1/14/2009 1/16/2009 None ( j 6 STI 1/14/2009 079735 -01 - 971- 222 -4206 - VM - �/ STI Y MST2120 Electrical rough - in 1/14/2009 1/16/2009 r f{j None Q STI 1/14/2009 079735 - 02 - 971 222 - 4206 - VM - /2J 1-1144 STI N Page 1 of 4 CaseActivity ..rpt Case Activity Listing 1/16/2009 CCEL Case # : MST2008 -00008 7:58:56AM Assigned Done Updated Activity Description Date 1 Date 2 Date 3 Hold Dis To By By Notes MST2615 Mechanical rough -in 1/15/2009 1/16/2009 None STI 1/15/2009 079764 -01 — 971 - 222 -4206 — VM - STI Y MST1030 Check for parcel 2/6/2008 None DONE BB 2/6/2008 Not required. tags/CWS BLD MST1060 Building plans routed 2/6/2008 None DONE BB 2/6/2008 to PE BLD MST1041 Site plan routed to 2/6/2008 None DONE BB 2/6/2008 None required, within existing Pln/Eng PT BB foundation. MST1065 Begin plan review 2/7/2008 None DONE BLS 2/8/2008 BLS MST1080 Revisions /Info routed 2/15/2008 None DONE BB 2/15/2008 Trusses calcs. to PE BB MST1070 Revisions /Info 2/15/2008 None DONE BLS 2/25/2008 requested BLS MST1080 Revisions /Info routed 2/25/2008 None DONE BLS 2/25/2008 Revised trusses to PE BLS MST1070 Revisions /Info 2/25/2008 None DONE BLS 2/25/2008 New truss doesn't carry existing roof requested BLS load (rafters /ceiling joists) MST1720 Misc. activity (see 2/26/2008 None DONE BLS 3/13/2008 Met with appl., waiting for new note) BLS engineering on connection from grider truss to framing. MSTI080 Revisions /Info routed 3/19/2008 None DONE DEB 3/19/2008 2 sets of revised calcs. to PE BLD Page 2 of 4 CaseActivity..rpt Case Activity Listing 1/16/2009 CCELI Case #: MST2008 -00008 7:58:56AM Assigned Done Updated Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes MST1100 Building plans 3/20/2008 None APRV BLS 3/20/2008 approved by PE BLS MSTI 1 10 Approved plans 3/20/2008 None DONE BLS 3/20/2008 routed to PT BLS MST1240 Post - review 3/21/2008 None DONE BTT 3/21/2008 completed BTT MST1270 Ready to issue permit 3/21/2008 None REDY BTT 3/21/2008 Mechanical contractor information BTT must be provided prior to issuance. MST1250 ELC signature on 3/21/2008 None DONE DEB 3/21/2008 application BLD MSTI260 PLM signature on 3/21/2008 None DEB 3/21/2008 application BLD MST1280 Issue permit 3/21/2008 None DONE DEB 3/21/2008 BLD MST2205 Footing 4/21/2008 4/22/2008 4/22/2008 None PASS KBS 4/22/2008 068709 -01 - 503 -590 -2502 - VD' STI Y MST2120 Electrical rough -in 6/9/2008 6/10/2008 6/10/2008 None ago -7 / zi I GN 6/10/2008 071152 -01 - 503 -590 -2502 - VM - STI N -180 MST1300 Issue ELC signature 6/16/2008 None RECD BTT 6/16/2008 form BLD MST1290 Reprint permit 6/13/2008 None DONE BTT 6/13/2008 BLD Page 3 of 4 CaseActivity..rpt Case Activity Listing 1/16/2009 CCEL/- Case #: MST2008 -00008 7:58:56AM Assigned Done Updated v Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes MST2I15 Electrical service 6/17/2008 6/18/2008 6/18/2008 None FAIL HAP 6/18/2008 071508 -01 — 503 -590 -2502 VM - HAP Y MST2205 Footing 7/27/2008 7/28/2008 7/28/2008 None CNCL BLS BLS 7/28/2008 073300 -01 — 971- 222 -4206 -- VM - BLS Y MST2120 Electrical rough -in 7/27/2008 7/28/2008 7/28/2008 None PASS HAP 7/28/2008 073300 -02 -- 971- 222 -4206 VM - STI Y Page 4 of 4 CaseActivity..rpt CITY OF TIGARD BUILDING DIVISION PERMIT #: Ms1000l3.00008 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 2720/2009 TIME: 7:00AM PAGE: 11 SITE ADDRESS: 10900 SW 11511 AVE CLASS OF WORK: . SUBDIVISION: ENGLFWOOD190.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 209sf alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 503-590-2602 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 212012009 Pour Time: Code # Inspection Description Confirm # Contact # Message 322 Shower pan 080673-01 97 - 222 - 4 206 Corrections/Comments/ Instructions: - 0 PARTIAL APPROVAL CANCEL n NO ACCESS 0 FAIL FA CALL FOR INSPECTION ADDITIONAL FEES ASSESSED AMP 6 Inspector: / Date: 7 - - t—C Phone #: (503) 718- Z l v% CITY OF TIGARD . j � BUILDING DIVISION � / 0 , � " PERMIT #: MST' ;0013 -00000 13125 SW Hall Blvd., Tigard, OR 97223 DAT ISSUED: 3,1l2StQii Phone: (503) 639 -4171 !g )g — U y b A — Inspection Requests (24 Hrs.): (503) 639 -4175 z "'' INSPECTION WORKSHEET FOR DATE: 1116/2009 TIME: 7:01APM1 PAGE: 23 SITE ADDRESS: 10900 SW 115TH AVE CLASS OF WORK: SUBDIVISION: ENiGi EWOOD NO.3 LOT #: 206 TYPE OF USE: PROJECT NAME: THOMAS DESCRIPTION: 2001 alteration above garage. OWNER: THOMAS, WAYNE & DONNA PHONE #: 503-590-2.502 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/1612009 VI Pour Time: E% ' Of-2r '. 0 O ,I W" Code # Inspection Description Confirm # Contact # Mes ge 320 Plumbing rough - in 079736 - 01 971 Y Corrections /Comments /Instructions: ' iji _U ' \)Q ( g iiii U l i 4/ -2- s,,,,, Qi.,._ ,.''' PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED HY' 'PI\ "< Inspector: `j P Date: 1 J � b') Phone #: (503) 718 - '' IW "� CITY �I MASTER PER 7 PERMIT #: MST2008 -00008 ' 'L. ' , - . COMMUNITY DEVELOPMENT DATE ISSUED: 3/21/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134BD-07017 SITE ADDRESS: 10900 SW 115TH AVE ZONING: R -4.5 SUBDIVISION: ENGLEWOOD NO.3 LOT: 206 JURISDICTION: TIG PROJECT: THOMAS Project Description: 200sf alteration above garage. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 200 sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: SR3.3 BDRM: 1 BATH: TOTAL: 200 sf 20,000.00 REAR: PLUMBING SINKS: 0 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: WISVC OR FDR: 3 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: SIGN /OUT LIN LT: PER HOUR: LIMI1 ED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVCIFDR: 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 8 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: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable WAYNE & DONNA THOMAS OWNER laws. All work will be done in accordance with approved plans. This 10900 SW 115TH permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 590 -2502 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 730.35 REQUIRED ITEMS AND REPORTS Issued By OIRIP dl Permittee Signature . 1 - Al t Call 503.639.4175 by 7:00 a.m. for an inspection that business • =y. 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. Building Permit Application �� 4 , .94 ,,E �S xr ",,„, r r7mr,ry } fi 0. k n E r.a�` , Residential : t .f �4stitle � FOR OFF ICF ; USE ON : ` ' r.� t" 4 y1 3 ie , "�� 1 Date /B RECEIVED Received I .- / City of Tigard / 1 r Permit Nol ,., j� ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie 0 2008 Date/By: + . S. /°/�11a Other Permit: Phone: 503.639.4171 Fax: 5035 9¢0 f0� T Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for �IGAFD � Ti'• H , °rcd' Internet: www.tigard - or.gov Notified/Method: :5/39/41.' ✓'/ Supplemental Information CITY OF TIGARD Kacfue t,,,, (AkAyAre_ . ®U' VISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition 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. 0 _ and 2- family dwelling ❑ Commercial /industrial Valuation: $ 2a G p e..) ❑ Accessory building ❑ Multi - family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB`. SITE INFORMATION AND LOCATION Total number of floors: Job site address: 0 &c2 • 5-' A , / l J 1 1 � / 4 vQ New dwelling area: 200 square feet kg,,,, City /State /ZIP: 17 G`4'K 0 o t ! 7 2-2-3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: , 1 i+f 5,4,,,„1/4._ 4/w Covered porch area: square feet Cross street/directions to job site: 7-2 — // 5— / a5/ Deck area: square feet 44 A.. l — .- pas a/1/0.— Li/ay./ Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: ,k 4,,,,, Lot no.:; 0‘ Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no./ equipment, materials, labor, overhead, and the profit for the r ' DESCRIPTION OF WORK work indicated on this application. LN14l / kf !3r kt 6a L d v-v E'Y/3 / / / Valuation: $ 6 � Existing building area: square feet New building area: square feet ROPERTY OWNER ❑ TENANT Number of stories: Name: & L bl II , A 1 & o 5 Type of construction: Address: )v � (;O Y 5 / /, Occupancy groups: City /State /ZIP: -- i t /� — �'k Z 33 Existing: Phone: (�3 5 - [i l 5z) 2- " (r urn �( 7/ J , Z I/ Z .0,6 New: ❑ APPLICANT ❑ 'CONTACT. . " NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board 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: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: lA r"), J BUILDING PERMIT FEES* Address: (Please refer to fee schedule) Structural plan review fee (or deposit): City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: 1 0 4._ Amount received: 4. - 1 1.i► set Authorized signature: 13, This permit application expires if a permit is not ooeained within 180 days after it has been accepted as complete. W �l )1 / F u w D *Fee is exempt frFeb set by Tri- County Building Industry y Print name: Service Board. 1: \Building \Permits\BUP -RES PermitApp.doc 11/6/07 440-4613 T( 1 1 /02/COM/WEB) Building Permit Application Checklist .. r.Vr tiT^ brow ,K r t,� e : tf M ; �S ,t7i G I One- and Two - Family Dwelling 1 ' 1 f FORIOFFICE USE ONLY! g 1t 1 re'I Cl of Ti and Received permit No.: Date/By i' V 131 SW Hall Blvd., Tigard, OR 97223 Assoated permits: C Phone: 503.639.4171 Fax: 503 598.1960 ' � ` 24- Hour Inspection Line: 503.639.4175 ❑Electrical ❑ Plumbing El Mechanical T I G A R D Internet: www.t or.gov ❑ Other: ,; ?A+THE;FOLLOWING,ITEMS ARE RE Q UIREDTOR PEAN REVIEW x � ` 4 W0--ii es No Ni - 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ IT 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ (g 3 Verification of approved plat/lot. ❑ ❑ ®' 4 Fire district approval required. Name of district: . ❑ ❑ ' 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ EY N.. 6 Sewer permit. i, • ❑ ❑ a 7 Water district approval. ❑ ❑ Q 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ Er 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ Er basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ®' ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area;. building coverage area: percentage of coverage; impervious area; existing structures on site; and surface drainage. —. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size Ir ❑ - - and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, i' ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub - Nr ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ®' ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- Ear ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing 5d ❑ ❑ lo Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ®" ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists f ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for f6ur or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or j ir ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the •roject under review. - ^ 4 ' IURI,SD J ONAL SPI I CS ex r ,1 w 'h k 4 . 1'4 "r .: ` I 1 t{. a.... .,. . . r �,� �' nr.-.. � 4 .. -r.Z,. r; � ,.. f zJ - - �..�s,_.. i X i.. -, I .,,q �.,.... , � ) M4t �.,. 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 1 or 1 x 17 ". 2 ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. 2 ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ® ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ RI • 27 "Drawn to scale" indicates standard architect or engineer scale. 0 ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ . and protection measures must be drawn to scale and accompanied by the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. . I:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(1 I /02/COM/WEB) Mechanical Permit A licatl ► � 1 .: � pp r , »� , .,4 ., ,FOR OEF IC E'�USE' ONL�I a �� ` t � d VW 1 i C I V . Received arrr� r t e ' , City of Ti and Date/By: ggT t 9, t g y Permit No. ie 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review . Phone: 503.639.4171 Fax: 503.598.1960 FEB - 6 2008 Date/By: Other Permit: 111r°11�P '^ Inspection Line: 503.639.4175 §T I G A R D Date Ready/By: luris: ® See Page 2 for rdu n.narr Internet: www.tigazd- or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION . TYPE•.OF WORK • ` • •::: COMMERCIAL FEE *;'SCHEDULE — USE CHECKLIST ❑ New construction Addition /alteration/replacement Mechanical permit fees* are based on the value !Attie work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • CATEGORY OF CONSTRUCTION Value: $ C„ 1'26 r - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building : RES I DENTIAL EQUIPMENT /SYSTEMS FEES ❑ Multi- family ❑ Master builder For special information use checklist. ❑ Other: Description p Qty. Ea. Total . . JOB. SITE .INFO RMATIONAND LOCATION Heating/cooling Job site address: /O7 o 5 , / / c-- / V Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State /ZIP: 7 7 ,4 b 0 k- 7Z 2 5 Furnace 100,000 BTU (ducts /vents) 14.00 Suite/bldg. /apt. no.: Project name: 4,Q , a ,,t,. /16/(4V-"-- Furnace 100,000+ BTU (ducts /vents) 17.90 Gas heat pump 14.00 Cross street/directions to job site: Duct work �- 10.00 / �e t /v.r A l L p 4 s w -d � Hydronic hot water system 14.00 P1t^ t /t/ t/l ![ Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 l Flue /vent for any of above 6.80 Subdivision: N, h l�/Ga Lot no.: G Other: 10.00 Tax map /parcel n .: Other fuel appliances • DESCRIPTION OF WORK • Water heater 10.00 Ey l AC S ` b r & t i a �� Gas fireplace water heater or gas e 10.00 ��zt y` /�^ Flue vent fo e > i S, // � � l -47.2 Log lighter (gas) fireplace 1 0.00 ` 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent / 1134ROPERTY OWNER . ❑ ` TENANT • Other: 10.00 Name: &k yr p f pet, „ ix 797i of Environmental exhaust and ventilation Address: l o -e)" 5 (/ f / 5 � Range hood/other kitchen / equipment ment 10.00 City /State /ZIP: T „, 0, 9-7723 Clothes dryer exhaust 10.00 ` Single -duct exhaust (bathrooms, , , Phone: (5p 3) 0 D Z . fCPit 9 2 / ,., 2 Z Z- 4 � toilet compartments, utility rooms) �'^ 6.80 ❑ APPLICANT - ,❑ CONTACT PERSON Attic /crawlspace fans 10.00 Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; 51.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater E -mail: Fireplace _ Range CONTRACTOR Barbecue Business name: a (,(� N E I� Clothes dryer (gas) Other: Address: MECHANICAL PERM IT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: Th perm application expires if a permit is not obtained within 180 _ days after it has been accepted as complete. Print name: �/` C9 1/ - O' yl e t yr ,, t (/ Date: F �/ `1, 0 Fee methodology set by Tri- County Building Industry Service Board 1: \ Building \Permits\[vIEC- PermiitApp.doc 01/19/07 440 -4617T (11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2. Supplemental Information Commercial Fee Schedule: Total Valuation:. Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC- PermitApp.doc 01/19/07 2 Plumbing Permit Application Building Fixtures -0�, ..,v � FOR�OFFICI US Q NLY� ' ,m.- `� °]d r .. k Jtkb 4 ',Ntk a d if t. r,,,- 1, oll . r ...a... rrd' �� �Y tOr i, 7 n City of Tigard COVED Plan Rea Permit Nop y ��_ c0-c.�� " yr a 13125 SW Hall Blvd., Tigard, G t t Plan Review „a,,,.a,, t; G Phone: 503.639.4171 Fax: 5 t . e . _ Date/By: Permit No.: DI Inspection Line: 503.639.4175 Date Ready /By: Juris: 0 See Page 2 for +T I G ►t ►�' Internet: www.tigard- or.gov nn u,,tlia��n�;s�,, - ..: FER - � ' 2000 Notified/Method: Supplemental Information • .TYPE OF WORK ! TT FEE* SCHEDULE ❑ New construction 1JerAdtid4ttGa�� For special information use checklist %Addition/alteration/re lacement 13( h G 0tViSI ®N Description Qty. Ea. Total p New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 /Si- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 - 1 .JOB SITE INFORMATION AND LOCATION Site utilities Job site address: / //.5M-- /G7 �UU �; vl r xi✓e Catch basin or area drain 16.60 City /State /ZIP: / ' �J v y/ c' k 9 7 2- Z3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: ./ 1 Project name: w]A5 f c det ,c_ /,j�4d� Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: PA Manholes 16.60 i ji/ee' /1/ Ire '►`et 4t s �v' , Rain drain connector 16.60 / Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: r„, / ,;,(„/ I Lot no. Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 . DESCRIPTION OF WORK Backflow preventer Page 2 1 / e)"- - / /./ 5Y / ' B jt'ri`a- `` i i h Ri ... C Backwater valve 16.60 - 7/-Q f'XI 5 7��/ C/j w Clothes washer 16.60 D f� Dishwasher 16.60 Drinking fountain 16.60 PROPERTY OWNER . I ❑ TENANT Ejectors /sump 16.60 Name: W..i ` i # J s . - 72 e) Expansion tank 16.60 Address: /I// 9'6./e2 . 5 - fit/, 7 / S' /..1-,/ Fixture /sewer cap 16.60 City /State /ZIP: -re. N`� P l 77 Z 3 Floor drain/floor sink/hub 16.60 Phone: ( ) i- l 5 2 C,°/ 1) f 7 t- Zit-4,206 Garbage disposal 16.60 ❑'APPLICANT . Hose bib 16.60 ` ❑ CONTACT PERSON' Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 .lavatory • f 16.60 Phone: ( ) Fax: : ( ) /shower /s ower pan /m 16.60 E -mail: Uri """7 16.60 CONTRA OR Water closet tg i 16.60 Business flamer/37 ((jai Water heater 16.60 Address: Other: Subtotal City /State /ZIP: Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: 7///,..t / � TOTAL PERMIT FEE Print name: vtr =t l a 7 j) 7 ' ii'} Date f ' , , Thi permit application expires if a permit is not obtained within y 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. 1:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information . Fee Schedule: Residential Fire Suppression Systems: Site Utilities ,. .Qty• ' Fee (e0 Total - Square. Footage: Permit Fee: , Footing drain - 1s 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Val11at10I1'. Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee "$72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. Fee (ea). Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential' Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Plumbing Installations - ' Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed . Fixture Type: : Replace • engineer. Previous Capped . Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial- - - Domestic , , I or Riser Diagram Drinking Fountain g Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial // - Industrial / �/V4-5 c j� �`1 / v�yo/C L4„, i / Ice Mach. /Refrig. Drains SGtict p /✓ ('a T[vr�s' - c�: P y Oil Separator (Gas Station) 5> -k i:„.-,1) 6 e f r'w_rr•• --,/ c i-i-vi Rec. Vehicle. Dump Station ri � 4f3 ekl� K il-p aelf4 4 0 Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\ Building \Permits\PLM- PermitApp.doc 12/27/06 Electrical Permit Applic I,t .' trP^ ) V 1.012 OF I IGE USh I ', < I k � .v,• ` t ,,l' ,, .'RG ,. Rat '' ,,, . *k ' 14 C V Received { City of Tigard DateB : Permit N. ✓,�; �Gb i n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C .z. 9[ Phone: 503.639.4171 Fax: 503.5 0— 6 2008 Date/By: Other Permit. If," RII01 Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for «raisirxl Internet: www.tigard- or.gov CITY ()F TIGARD Notified/Method: Supplemental Information TYPai911 'MIS DIVISION PLAN REVIEW ❑ New construction A ddition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. . ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 7 700 $ d� / / -----ii- g 100 ee more. c ❑ Six o or r more oo re a rreesidential units. ❑ R ecreational vehicle parks. City/State /ZIP: �C ❑ Health -care facilities. ❑ Supply voltage for more than r j ��� ['Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 4/413 i ,,. ,44/4.,...._ 4.,.. ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 // y� t New residential single- or multi- family dwelling unit. 6-A--,_ �` /,,,,t �' /" � � 1 £ Includes attached garage. Subdivision: -,, �Ori�/ Lot n / o.:Z c2c 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) � /� v' / / "/ 2-- residential (with above sq. ft.) 75.00 2 L energy, multi - family y,or/t� / /4 ,1 5 7 � B v- y]d c C �// 5 1 �� V Services or feeders installation, alteration, and/or relocation � 200 amps or less 5 80.30 2 . �D r / OPERTY OWNER . ❑ TENANT 201 amps to 400 amps 106.85 2 Name: ��t lt,.to Parni�l � J f 401 amps to 600 amps 160.60 2 t 601 amps to 1,000 amps 240.60 2 Address: /62' 9 acj S (,-V / / 1 j -� Ave Over 1,000 amps or volts 454.65 2 City/State /ZIP: / ' ,. .Z� (2 4 C 2 z.$ Temporary services or feeders installation, alteration, and/or ! relocation Phone: (5 5 , - 5-'z F " �/ � ' � f{ ` 7 / — Z 1 - /ZU 6 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and ‘2-60.5?". 701. 401 amps to 599 amps 133.75 2 h , ii--.12� Date: e, Branch circuits — new, alteration, or extension, per panel Owner signature: ��iiy� / A. Fee for branch circuits with . ❑ APPLI C ANT ' ❑ CONTACT' PERSON above service or feeder fee, 6.65 2 • each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 //yy �� t CONTRACTOR • Sign or outline lighting 53.40 2 Business name: / 4 1 Signal circuit(s) or limited - (� � d` ) E� energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (i hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ' ELECTRICAL PERMIT FEES . Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): Y �/ State surcharge (12% of permit fee): Authorized signature: : / ' A t r4 TOTAL PERMIT FEE: ., This permit application expires if a permit is not obtained within 180 Print name: I a i _ p , i e g i S D ate: Z� days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 I /05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: • Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \BuildingWermits\ELC- PermitApp.doc 03/23/06 • Information Notice to Property Owners About Construction Responsibilities Statement Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. [ORS 701.055 (4)] This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box and complete the following statement: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or 1 will be performing work on property I own, a residence that 1 reside in or a residence that I will reside in. If I hire subcontractors, 1 will hire only subcontractors licensed with the Construction Contractors Board. HI change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I have read and understand the Information Notice to Property Owners about Construction Responsibilities contained on these two pages and I hereby certify that the information checked and completed above is correct and accurate. Wet ti 71 af Print flame of permit applicant Signat a of permit applicant /Wav 2/ 0 Date Permit #: M�i Q - ( "YY This form is supplied to building f �� �09oa 560 l/ 5 � permit offices by the OregonF. Address: A = -- Construction Contractors Board, N:_ a =i 2 02 as required by ORS 701.055 (6) 97'i2 3 Issued \-- te: 3 ar This copy to issuing permit office CITY OF TIGARD COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form REG° ED JUN 162-NS IMPORTANT PERMIT NOTICE or( �� N BEAVERTON ELECTRIC BOOM 15865 SW NORA RD BEAVERTON, OR 97007 Permit #: MST2008 -00008 Date Issued: 3/21/2008 Parcel: 1 S134BD -07017 Site Address: 10900 SW 115TH AVE Subdivision: ENGLEWOOD NO.3 Lot: 206 Jurisdiction: TIG Zoning: R -4.5 Project Name: THOMAS Description: 200sf alteration above garage. Your company has been indicated as the electrical contractor for the permit referenced above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: WAYNE & DONNA THOMAS BEAVERTON ELECTRIC 10900 SW 115TH 15865 SW NORA RD TIGARD, OR 97223 BEAVERTON, OR 97007 Phone #: 503 - 590 -2502 Phone #: 524 -4444 Reg #: ELE 34 -194C LIC 50150 SUP 1635S AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician Name (printed) SUP LIC #