Permit \&pfiiY V
CITY OF TIGARD MASTER PERMIT
.71
• • ' COMMUNITY DEVELOPMENT Permit #: MST2008 -00055
T f G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/28/2008
Parcel: 1 S136CB02500
Jurisdiction: TIG
Site address: 11130 SW 82ND AVE
Subdivision: Lot:
Project: HEATH
Project Description: 1,558 sq ft addition, family room and shop.ADDED 100 amp panel 1/26/09. 2/9/10 ADDED (12)
branch circuits to permit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: First 528 sf Basement sf Left: Parking Spaces:
Height: 13 Bathrooms: 1 Second: sf Garage: 1030 sf Front Smoke
Dwelling Units: 1 Third: sf Right Detectors: Yes
Total: sf Value: $89,100.68 Rear:
PLUMBING
Sinks: Water Closets: 1 Washing Mach: Laundry Trays: Rain Drain: Catch Basins:
Lavatories: 1 Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures:
Tubs/Showers: 1 Garbage Disp: Water Heaters: Water Lines: Drains:
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Fum <100K: Vents: Woodstoves: Gas Outlets:
Fum > =100K:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 -200 amp: 1 0-200 amp: W/ Svc or Fdr:
Ea addi 500 sf: 20 1 -400 amp: 201 -400 amp: 1st W/O Svc/Fdr.
Limited Energy: 401 -600 amp: 401 -600 amp: Ea add'I Br Cir:
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
Owner: Contractor: Required Items and Reports (Conditions)
ROGER & DIANNE HEATH
9373 SW FAST PL.
TIGARD, OR 97223
PHONE: 503 -701 -3357 PHONE:
FAX:
Total Fees: $2,407.18
This permit is issued subject to the regulations contained In the Tigard Municipal Code, State of OR. Specialty Codes and all 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0010 through t OAR 95 2- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. n
Issued By: Permittee Signature: Q O ( \, ' fl a X
III C I TY O F TIGARD MASTER PERMIT
e PERMIT #: MST2008 -00055
COMMUNITY DEVELOPMENT DATE ISSUED: 5/28/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136CB-02500
SITE ADDRESS: 11130 SW 82ND AVE ZONING: R -4.5
SUBDIVISION: RANCH VALLEY LOT: 006 JURISDICTION: TIG
PROJECT: HEATH
Project Description: 1,558 sq ft addition, family room and shop.ADDED 100 amp panel 1/26/09.
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 13 FIRST: 528 of BASEMENT: of LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1,030 sl FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: of RIGHT:
VALUE: 89 10068
OCCUPANCY GRP: R3 BDRM: BATH: 1 - TOTAL: 528 sf 89,100.68 REAR:
PLUMBING
SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 1 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: 1 CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
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: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 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 & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL N 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
ROGER & DIANNE HEATH OWNER laws. All work will be done in accordance with approved plans. This
9373 SW FAST PL. 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 - 701 - 3357 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #:
TOTAL FEES: $ 2,307.46
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Issued By : � '
i1 4 A.' \ . ; , ' ! Permittee Signature
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.
1, • p CITY 1 � � _ MASTER PERMIT
PERMIT #: MST2008 -00055
COMMUNITY DEVELOPMENT DATE ISSUED: 5/28/2008
AtGAKD` 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
"` ' � PARCEL: 1S136CB - 02500
SITE ADDRESS: 11130 SW 82ND AVE ZONING: R -4.5 '
SUBDIVISION: RANCH VALLEY LOT: 006 JURISDICTION: TIG
PROJECT: HEATH
Project Description: 1,558 sq ft addition, family room and shop.
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 13 FIRST: 528 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1,030 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 P1160: s/ RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 528 sf 89,100.68 REAR:
PLUMBING
SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: • TRAPS:
LAVATORIES: 1 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: BOIL/CMP < 3HP: VENT FANS: 1 CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: • OTHER UNITS:
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: 0 - 200 amp: WISVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: ��,
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: �J )
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADOL BR CIR: 3 SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: O
1000+ amp /volt : v
PLAN REVIEW SECTION
Reconnect only: M
> =4 RES UNITS: SVC /FOR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: VV
ELECTRICAL - RESTRICTED ENERGY 1
A. SF RESIDENTIAL • B. COMMERCIAL 0
AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: . OUTDOOR LNDSC LT: 0
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: 0
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: (((�
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 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
ROGER & DIANNE HEATH OWNER laws. All work will be done in accordance with approved plans. This
9373 SW FAST PL. . 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 -701 -3357 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #:
TOTAL FEES: $ 2,217.52
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 - 4444
2
sued By : r
, ;
/;` / ,/ . Permittee Signature : , „Ai ��._ '
Call 503.639.4175 by 7:00 a.m. for an inspection that b - iness 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.
�>�>� Wcation � � �a — /l
$uildia>1Q a ><t
Residential +`- - " FOR.OFFICE'USE ONLY
.
City of Tigard 9 .
`J g Received
Date/By: • }7 { / / �.
may A I" Permit No.:).-/Sr�
13125 SW Hall Blvd., Tigard, OR 9722 DR P Plan Review, ^ Q
' C Phone: 503.639.4171 Fax: 503.598.1Ot ma 0 R Date/By: ' e . W Other Permit:
T I G A R D Inspection Line: 503.639 Date ReadyBy: v in /_ o cm J S See Page 2 for
Internet: www.tigard or.gov C`� ? 4 Notified/Method: lCf�
TYPE OF WORK R r ,�� SupplementalInformation
/I ;: N. a 1 -141 1 ) 7 ie < iE
E D 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 the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. j QQ •
❑ 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ f
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: I
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 7/ 3 O s It) g62 1-11) A u E New dwelling area: 17 square tee S
Garage/carport area: L s uare fee 3c)* City/State /ZIP:
Tr va4�u , 49 g_ �1 q
Suite/bldg. /apt. no.: Project name: lie / " ' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
ApOt 4low
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: go ?Fie lol F4 Type of construction: .
Address: 9 ; 73 S' cii f:f. s f y ,p i.A c_4 Occupancy groups:
City/State /ZIP: 17 4 12 D` o & '7 72-14 Existing:
Phone: ( ) 7o I— 3 3 5 7 Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON 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: BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State /ZIP: Structural plan review fee (or deposit): b . 3 . 5
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.:
Total fees due upon application: 7 D 9,. 3 3
Amount received:
Authorized signature: 4 44 7 _22 /
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: i e b gfr /4 A Date: 00„ * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -RES PermitApp.doc 11/6/07 440-4613T(1 I /02/COM/WEB)
Building Permit Application Checklist F
One- and Two- Family Dwelling FOR OFFICE USE ONLY City of Tigard Received
Date/By:
No.:
1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
C Phone: 503.639.4171 Fax: 503.598.1960
T I G A K D 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard - or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑
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 ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
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 ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑
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- ❑ ❑ ❑
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- ❑ ❑ ❑
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 ❑ ❑ ❑
locations. 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 ❑ ❑ ❑
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 four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon and shall be shown to be ap plicable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
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. ❑ ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
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.
1:\ Building \Permits\BUP- RES- PetmitApp.doc 03 /21/06 440- 4613T(11 /02 /COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard , DateBed
y Permit No.:
13125 SW Hall Blvd Ti OR 97223 4 j \'./' J Plan Review
' � C . Phon 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639 R c Date Ready/By: Juris: 0 See Page 2 for
3
Internet: www.tigard or.gov ��" 0 2E AP Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
•
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ AdditioTf /alteration/replacenient ' -'?
2. \. ❑ 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
❑ 1 - and 2- family dwelling ❑ CommerciaUindustrial ❑ 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. A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: ilk 0 3 s[� N h 4 u t or more. occupancy.
❑ Six Six o or r more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: �G, f �D a 472 Z 3 ❑ Health -care facilities. ❑ Supply voltage for more than
/ ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: It.l`H' ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
' Ea. add'( 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
r Limited energy, multi - family 75.00 2
A .1)122 t -It o. residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: /(m f�,� i4Q L 401 amps to 600 amps 160.60 2
7 601 amps to 1,000 amps 240.60 2
Address / I / 30 s w i/1.-- ''. Au i_ Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
� q 4, D . C�/L 9 72-2 3 relocation
Phone: (g')) ?o, , 3 3 .3 .- 7 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This ' r stallation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, leas or exchan: , accord' g to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
L / � D � Branch circuits — new, alteration, or extension, per panel
Owner signature: s _ _ Date: 6
D
— A. Fee for branch circuits with
❑ APPLIC 1 I ❑ CONTACT PERSO 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 tl 46.85 2
first branch circuit
Address: Each add'( branch circuit 3 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
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited- Ote)/ E /.-.— energy pa. Describe: alteration, or
Address: extension. Desccribibe: Page 2 2
E ach additional inspection over allowable in an
City/State /ZIP: P 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):
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440-4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
I RESIDENTIAL WORK ONLY: V f
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* •
O Vacuum- Systems*
0 Other:
COMMERCIAL WORK ONLY: — 1
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
O . 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 I ighting*
❑ Protective Signaling
❑ Other
Total.number of commercial systems: —
*No licenses are required. Licenses are required
. for all other installations
C\ Building \Permits\ELC- PermitApp.doc 03/23/06 - -
Plumbing Permit Application
. ti
Building Fixtures ki r .� 4/ Y 1. 4 - s r FOR OFFICE USE ONLY
ti.
City of �r Tigard
Sr(� 131 S �� D 20`8 Received
Date/By: Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223
: C Phone: 503.639.4171 Fax: 3.598.1960 Date/By: Review
� . , r P:' i ,,. ;� ateBy: Other Permit No.:
Inspection Line: 503.639.4175, , e % ' ",'• '
T I G A R D p Z, 1; ; Date Ready/By: Aids: ® See Page 2 for
Internet: www.tigard or.goV ;; " • , _r Notified/Method: Supplemental Information
TYPE OF WORK - FEE* SCHEDULE
❑ New construction ❑ Demolition For special injormalion use checklist
r Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- 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
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: // 3 5 O '11) A o E_ Catch basin or area drain 16.60
City /State /ZIP: 174 Xi).- q 7 Z Z, Z) Drywell, leach line, or trench drain 16.60
'
Suite/bldg. /apt. no.: I Project name: 14 g Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: 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
R bDi � t u N
Backwater valve 16.60 .
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: 4 Ee_ 14/4 A Expansion tank 16.60
Address: 43 7 � 5 L.) �� s f j7Z- Fixture /sewer cap 16.60
City /State /ZIP: / / e/4 p. 0 j Am_ f 7 yy Floor drain/floor sink/hub - 16.60
Phone: ( ) 7 0 1- 1.) §-7 Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
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
Phone: ( ) I F es:: ( ) Sink/basin/lavatory I 16.60
Tub /shower /shower pan 1 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 1 16.60
Business name: Water heater 16.60
Address: /JE 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)
Authorized signature: State surcharge (12% of permit fee)
# ��, _ / TOTAL PERMIT FEE
Print name: .1 Date: This permit application expires if a permit is not obtained within
ro 9�'f �'a r 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1: \Building\Pennits\PLMF- PermitApp.doc 12 /27/06 440- 4616T(l0 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
u . i
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1 100' 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
Valuation: 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
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
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
Mechanical Permit Application FOR OFFICE USE ONLY
- " -,, Received
City of Tigard Permit No.:
13125 SW Hall Blvd., Tigard, OR 972 - 23`' - = %' _ J Date/By: Plan Review
. G Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
APR T I G A R D Inspection Line: 503 Q P 1� ; Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ❑ Addition/alteration/replacement Mechanical permit fees" are based on the value of the 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
�D Air conditioning or heat pump
Job site address:
j�! ? B (,J o�^ ht cc (requires site plan showing placement) 14.00
City/State /ZIP: 776- A2 p / ep q 72....z 3 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: I1 f — Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
A Gas fireplace 10.00
M a1 t h 7.1 Flue vent for water heater or gas
fireplace 10.00
•
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
-
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: " q .,e,_ ii�� A Environmental exhaust and ventilation
9 373 .5&) f ' � Range hood /other kitchen
Address:
// �' ' . equipment 10.00
City/State /ZIP: —117 a , i t a , Da g72 -� 3 Clothes dryer exhaust 10.00
�� Single -duct exhaust (bathrooms,
Phone: ( ,1 ) 7Q 1 — 3�s� Fax: ( ) toilet compartments, utility rooms) 1 6.80
❑ ` APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CO OR Barbecue
Business name:
Clothes dryer (gas) 0
ZIL)A Other:
Address: MECHANICAL PERMIT 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. This permit application expires if a permit is not obtained within 180
d ays after it has been accepted as complete.
Print name: A ?Am_ '4 A Date: ,74,,,/,9 d °i
• Fee methodology set by Tri County Building Industry Service Board
iisi 1:\Building\Permits\MEC- PermitApp.doc 01/19/07 440-4617T (11 /02/COM/WEB)
Mechanical Permit Application - City "of Tigard _ P
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 o r
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00and
$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- PeimitApp.doc 01/19/07 2
CITY OF TIGARD - SITE PLAN REV y � I Designer:
"
40' j BUILDING PERMIT NO '' ' - &V—
I LANNING DIVISION:' Ryan Zink
■
Required 3et�cks: (� PP roved R
A ❑ Not Approved E CEE V E D 3111 Cottonwood Q Street Side: I S
From. 4...Q— Garage: 2r Rear: — L - : I West Linn, OR 97068
�. ) Visual Clearance: E Approved `` ```
PP 0 Approv
c c ) Maximum Building Height- feet I Ryantnzlnk�hotrnall.00m
c- CWS S ice Provider Letter Required: Yes e ON
❑ /� Cllent:
1 . ►-n. cw✓ Date: 5 / / A ved
ENGINEERIN DEPARTMENT: Roger &Dianne
_ Actual lope Approved ❑Not Approved Heath Addition Site P 15-Approved •
teij1 11130 SW 82nd Ave
Notes:
1 Portland, OR 97223
RANCH VALLEY,
j LOT 6, SLOO(
R #: 283623
w Tax Lot: 1S136C802500
o� Prop ID: R0283623
Q Map #:
° CITY OF TIGARD - SITE PLAN REVIEW
EXISTING HOUSE BUILDING PERMIT NO: / . r• a.� o / �. - PermltSet 04/24/08
LO
c 0) Trees:
A pproved 13 Not Approved
Protected. T Approved ,,_
o � ' � �/ ❑ , o Approved
B :
Date: 6 / vw I -
Notes: V
1 '_ l;' I el, tr ¢.t•e 4nci •f ) all 7117,
/
i r
F I
• Project No. 08 -11130
� ` f
ADDITION
— — — - — — =8
SITE PLAN
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—
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Y A 1
...._ IMI. 1/1 AM MK MI
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2008•00 0 &5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2000
Phone: (503) 639 -4171 av p 4 ' I
Inspection Requests (24 Hrs.): (503) 639 -4175 ' "'_
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: 9
SITE ADDRESS: 11130 SW 82ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1,558 sq ft addition, family room and shop.
OWNER: HEATH, ROGER & DIANNE PHONE #: 503.701 -3357
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 071737 -01 503- 701 -3357 N
Carrectiops /Comments /Instructions:
p6 ;ire -46 v i 2 a�u� A— IS \` c.� t/ d.J ✓a) ./ P I '� i'v. c t t) v
` V
[ C,C � �� t: '^ . - TO ✓ u e.,,T 13.mc k e v a, A RA0 ,
4-01, P (t ,_. ; L+� �t ✓V' 4 1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ✓ i ' L i Date: 123 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2008.0005E
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2003
Phone: (503) 639 - 4171"'( •
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 0/6/2008 TIME: 7 :OOAM PAGE: 9
SITE ADDRESS: 11130 SW 82ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 :;-TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1,558 sq ft addition, family room and shop.
OWNER: FIEATH, ROGER & DIANNE PHONE #: 503- 701 -3367
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 071421••02 503.701 -3357 N
Corrections /Comments/ Instructions:
•
g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Th nk_ \\ Date: to 1 k \o \mil Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: �r.,00 00055
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/200f't
Phone: (503) 639 -4171 4 4 1 1 ,.;, A
Inspection Requests (24 Hrs.): (503) 639 -4175 s.411-.
INSPECTION WORKSHEET FOR DATE: 10/6/2008 TIME: 7 :00AM PAGE: 15
SITE ADDRESS: 11130 SW 82ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1,65t3 sq ft addition, family roorn and .hop.
OWNER: HEATH, ROGER & DIANNE PHONE #: 503-701
CONTRACTOR: OM ER PHONE #:
Inspection Request Scheduled For: Date: 10/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
242 Interior shear wall; 076332 -01 503.701 -3357 N
Corrections /Comments/ Instructions:
° k- 'Co c'S vAas
.P4SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ZS Date: 640Croe Phone #: (503) 718- 24:2
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ;ST7008•Qi;055
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2000
Phone: (503) 639 -4171 .1-1-4v1144it
Inspection Requests (24 Hrs.): (503) 639-4175
WORKSHEET FOR DATE: 10/ 000 TIME: 7:0f�AM PAGE 16
SITE ADDRESS: 11130 SW 82ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 005 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1,5,f3 sq ft addition, family room and shop.
OWNER: HEATH, ROGER & DIANNE PHONE #: 503 - 701.3367
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10,6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 076331 -01 503- 701 -3357 N
Corrections /Comments /Instructions:
•
0 (`v -Je°
PASS 0 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 25 Date: Oc Phone #: (503) 718 - aca 3
, CITY OF TIGARD
BUILDING DIVISION PERMIT #: 7 �- �, 0
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: rd2S / `tlfifi
Phone: (503) 639- 4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 ,„ '. 1 ��
INSPECTION WORKSHEET FOR DATE: 9/29/2008 TIME 7: {t` AM PAGE: 10
SITE ADDRESS: 11130 ::lpd E3 NJD AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY 006
# 0 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1,:�;!_iki sc1 ft. addition, family room and shop.
OWNER: t IF :ATH, ROGER & DIANNE PHONE #: 50 :3
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/29/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 076056-01 503 -701 -3357 N
Corrections /Comments /Instructions:
_ _ . t .tea . ..o r OA"
/ / / L- )TlrJltit �jl�� /its. �, r> s� ✓_ 6 ��.���?? /e��.L��i� iC /jam
Ti PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: F-- 1 -- G'/ Phone #: (503) 718 - Z'! '
CITY OF TIGARD 1-
BUILDING DIVISION RMIT #: MST2008 -00055
13125 SW Hall Blvd., Tigard, OR 97223 I 013 - D E ISSUED: 5/28/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .�.__` 'fl.. S / j
INSPECTION WORKSHEET FOR DATE: &1712000 TIME: IMAM PAGE: 2
SITE ADDRESS: 11130 SW 82ND AVE. CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 TYPE OF USE:
PROJECT NAME: HE'AT'H
DESCRIPTION: 1,',68 sq ft addition, family room and shop.
OWNER: HEATH, ROGER & DIANNE PHONE #: 503-701-3357
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/1112008 Pour Time: 1:00
Code # Inspection Description Confirm # Contact # Mes g s /( e.....-----
205 Footing 071491 -01 503 - 701 - 3357 Y
C
Corrections /Comments /Instructi +ns: I , l
"1 :Aior 1 ..:■‘._ illdr- O 1 u
1 ' -, .r "—
,______ 401 :
,„ /
i 2 "' —k.
s , , I
t/L-Q4J—C - i / ,_-4- ---4----• "V CL--cLA , et..1_,
5 .
-ex -0 - �.e -w, �,,,, -- -- -- -
Q
c -ems -
U
❑ PASS / 7411 RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
U0, I ��l - �4z
4
Inspector: Date: `� � Phone #: (503) 718
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200E -O00 ►5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175' "'_�'
INSPECTION WORKSHEET FOR DATE: 6/16/2008 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 11130 SW 02ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1,558 sq ft addition, family loom and shop,
OWNER: HEATH, ROGER & DIANNE PHONE #: 503 -701 -3357
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/160008 Pour Time: 1:00
Code # Inspection Description Confirm # Contact # Message
X05 Footing 071421 -01 503- 701 - 3357 N
Corrections /Comments/ Instructions:
❑ PA ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: ‘--•--- Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION
A , PERMIT #: MST2008-00055
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2008
Phone: (503) 639-4171 7tf: lii
Inspection Requests (24 Hrs.): (503) 639-4175 A—, . - - ...
INSPECTION WORKSHEET FOR DATE: 2/23/2009 TIME: 7 PAGE: 5
SITE ADDRESS: 11130 SW 2ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: 1558 sd ft addition, family room and shop.ADDED 100 amp panel 112€403,
MI
OWNER: HEATH, ROGER & DIANNE PHONE #: 503,701-33W
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2J23/7009 Pour Time:
Code # Inspection Description / Contact # Message
115 Electrical service 08074a-01 \ 503-701-3357 Y
......___.
)
Corrections/Comments/Instructions:
c--
.„ al
PAS 0 PARTIAL APPROVAL El CANCEL El NO ACCESS
n FAIL fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED l
Inspector: (3 1\1661-E' Date: 3- 3 - Oi Phone #: (503) 718- 7114