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Permit ,.,-• 49.,/a-alo .- e--0-, /e. .--o--e0 ki--40-4-6) 4 ('/A - . a CITY OF T GARD MASTER PERMIT , ": COMMUNITY DEVELOPMENT Permit #: MST200800136 T[GARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/16/2008 ,. Parcel: 2S103DB03700 Jurisdiction: TIG Site address: 11265 SW QUELLE PL Subdivision: Lot: Project: HIRTE Project Description: 136 sq foot addition and interior remodel. 2/3/09, ADDING SERVICE. 12/22/09, adding (14) additional branch circuits. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: First: 136 sf Basement: sf Left: Parking Spaces: Height: Bathrooms: Second: sf Garage: sf Front: Smoke Dwelling Units: 1 Third: sf Right: Detectors: Yes Total: sf Value: $13,168.88 Rear: PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: Laundry Trays: Rain Drain: Catch Basins: Lavatories: 1 Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures: Tubs /Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Bckflw Prevntr: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: ELE Heat Pump: N Hoods: 1 Other Units: 1 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: 20 Ea add'I 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) DARIN HIRTE MCCOY ELECTRIC CO INC 11265 SW QUELLE PL 2014 SE 9TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 PHONE: 503 - 849 -7573 PHONE: 503- 234 -7521 FAX: 503- 234 -9473 Total Fees: $935.06 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 -00 rough R 952 - 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. t Issue: r -` / 1 /� / / / Permittee Signature: 02 & /o 9 � T6 '" `e �T'� � v ` � A MASTER PERMIT i a ITY TIGARD PERMIT #: MST2008 -00136 ° COMMUNITY DEVELOPMENT DATE ISSUED: 9/16/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103D6 - 03700 SITE ADDRESS: 11265 SW QUELLE PL ZONING: R -4.5 SUBDIVISION: GENESIS NO. 2 LOT: 035 JURISDICTION: TIG PROJECT: HIRTE Project Description: 136 sq foot addition and interior remodel. 2/3/09, ADDING SERVICE. BUILDING • REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 136 N BASEMENT: N LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: N GARAGE: d FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELUNG UNITS: 1 T10M ar RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 136 ar 0.00 REAR: PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < SHP: VENT FANS: 1 CLOTHES DRYER: ELE FURN s<100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 anp: 1 0 - 200 airy: WBVC OR FOR 0 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 600SF: 201 - 400 amp 201 - 400 amps 1st WO SVCBOR 0 SIGN/OUT UN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 it EA ADDL BR CR 0 SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 - 1000 amp: 601nripa. 1000x. MINOR LABEL: 1000+ amp/vol : PLAN REVIEW SECOON Reconnect only: - sue RES UNITS: SVCIFDRs<226 A.: s 600 V NOMINAL: CL8 AREAISPC 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: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATARELE COMM: NURSE CALLS: TOTAL 0 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 DARIN HIRTE OWNER laws. All work will be done in accordance with approved plans. This 11265 SW QU ELLE 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- 849 -7573 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 818.71 REQUIRED ITEMS AND REPORTS r. Issued By : Permittee Signature : e 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. 4 �I�� ® ��® MASTER PERMIT . PERMIT #: MST2008 -00136 COMMUNITY DEVELOPMENT DATE ISSUED: 9/16/2008 TtGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 103DB - 03700 SITE ADDRESS: 11265 SW QUELLE PL ZONING: R -4.5 SUBDIVISION: GENESIS NO. 2 LOT: 035 JURISDICTION: T1G PROJECT: HIRTE Project Description: 136 sq foot addition and interior remodel. CA141(ki\C 0L: YIN C 00 al C_-. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 136 sf BASEMENT: st LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sl GARAGE: sr FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: st RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 136 sf 13,168.86 REAR: PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 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: ELE FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: W /SVC OR FOR: 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: 5 J 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 /FOR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: 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 a 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 DARIN HIRTE OWNER laws. All work will be done in accordance with approved plans. This 11265 SW QUELLE 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- 849 -7573 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 728,77 REQUIRED ITEMS AND REPORTS Issued y : LALL2i L f�i1 /ji7SPermittee Signature , f `. , .-, 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. MASTER PERMIT CITY OF TIGARD PERMIT #: MST2008 -00136 COMMUNITY DEVELOPMENT DATE ISSUED: 9/16/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 103DB -03700 SITE ADDRESS: 11265 SW QUELLE PL ZONING: R -4.5 SUBDIVISION: GENESIS NO. 2 LOT: 035 JURISDICTION: TIG PROJECT: HIRTE Project Description: 136 sq foot addition and interior remodel. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 136 at BASEMENT: sf LEFT: SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: of GARAGE: of FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: at RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 136 sf 13,168.88 REAR: PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER UNES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < BHP: VENT FANS: 1 CLOTHES DRYER: ELE FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: Mu 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: 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: 5 SIGNAUPANEL: IN PLANT: MANU HM/SVC/FDR: 601 - 1000 amp: 601+amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: »4 RES UNITS: SVC/FDR> =225 A.: > 800 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 0 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 DARIN HIRTE OWNER laws. All work will be done in accordance with approved plans. This 11265 SW QUELLE 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 -849 -7573 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 728.77 REQUIRED ITEMS AND REPORTS Issued y : , ... ■ �; - J 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. Jlectrical Permit Application Fofi OFFICE 11SE ONLY City of Tigard Received Date/ By: y: Permit No -: 2.0C �7D V LO ° 1312 1 - , 11B1 . ::rd, OR 223 M �� Ph Review Other Permit: Pho 1 .. 1 t 5 0 Pla Re T I : A R I) In • - n ine: 1 7 Date Ready/By: kris: I RI See Page 2 for , . t vw.t ' p� . Notified/Method: �y I Supplemental Information "pie- . *7 y } -_t E QF y, i ORK - _. x .� _: 4 r� REi ♦� PIE, _ i' rt ❑ New construction ® Addition /alteration/replacement r 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. � C OF TCONS'TRiICTIoN _ < < 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 ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or _ Emergency system. larger separately derived system. ' , JOB SLTE NFORAIATIOI I ND IAC,ATION,R _ - ❑ Addition of new motor load of 0"A", •'E ", 1 -2 ", ••1 -3 ", Job no.: I Job site address: 11265 Quelle PL IooHPormore.uWY ❑ Six or more residential units. ❑ Recreational vehicle parks, City /State /ZIP: Lake Oswego, OR ❑ Heahh -care facilities. ❑ Supply voltage for more than ['Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: I Project name: Hlrte ❑ Service or feeder 600 amps ormore. Cross street/directions to job site: ',emirate° 1 an. 1 Fee. 1 Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. R. or less 168.54 4 Ea. add'l 500 sq. R. or portion 33.92 1 Tax map/parcel no Limited energy, residential 67.84 2 DESCR,1`,PTJON ` OF VI'O tIC , __ (with above sq- R.) Add additional circuits to permit MST2008 -00136 Limited energy, tial ( thab -family 67.84 2 p residential (with above sq. R.) Services or feeders installation, a lteration, and/or relocation 200 amps or less 100.70 2 r _ _ 1:1_ P ,BOPERTY OWNER • _ T �� C ,TENANT. 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) 1 Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits wit with , ti- ;,.� D APP)<SIpANT , d C- -I--, AC `IrPERSUi4 above service or feeder fee, itt 7.42 2 Business name: - each branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 56.18 2 first branch circuit Address: Each addi branch circuit 7.42 _ 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 E- mail: Pump or irrigation circle 67.84 2 - = Cp 4T$ACTpii _ w Sign or outline lighting 67.84 2 Business name: McCoy Electric energy circuit(s) or limited - energy panel, alteration, or Address: 2014 SE 9 Ave extension. Describe: Page 2 2 City/State/ZIP: Portland, OR 97214 Each additional inspection over allowable in an Z• of the above Per inspection 66.25 Phone: (503) 234-7521 I Fax: (503) 234 -9473 Investigation per hour(1 hr min) 66.25 CCB Lic.: 8277 I Electrical Lic.: 26-82C I Suprv. Lic.: 2175S Industrial plant per hour 78.18 EI EC1BICAL _ ERi1i1:T . FEE S Suprv. Electrician signature, required: 2 Subtotal: Print name: James R. Hall I Date: 12/17/09 Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name I Date' : This permit application expires if a permit is not obtained within 180 days after It has been accepted as compMe. • Number of inspections allowed per penult. 1: PeemitApp.doc 10.01109 440.4615T(II/o5/COMJWEB . Feb. 3. 2009 7:47AM M • IctikiV Co. No. 0670 P. 1 Electrical rermit Appli cP : q r t FOR OFFICE .. It 1 ' = Cit of Tigard 3 2p09 Received Permit No.: ��QQ Date/13 : il$i i1. q 13125 SW HaII Blvd., Tigard, ORv9�E9 Plan Review It . Phone: 503.639.4171 Fax: 503.598 +60 . t Ne' 1 ‘ - Datdg : Other Permit: T I G A R D Inspection Line: 503.639.4175 1 ' T 0 . 1 Date Ready/9y: Emu 0 See Page 2 for ' Internet www.tigard•or.gov C tad I , Notified/Method: Supplemental Information . Atli _ 'moo - -. � m: - -^ _ ., - - J ' 7 ' � - '' . ' id= Fe r',�',+' - .74! - " -7 'xr . c " ? - . . 'L_^. T y',,5 i1 'h '''f w -_ ". .. ,, w : °.r - �' .. ... _ _ e : l _- 1.� 1+ . _. - ._. . C7 r i� rr.e '... r . ' - 3 ' �� ? ' � ❑ New construction ! Addition /alteration/replacement Phase check all that apply (submit a sets of plans w /items checked below): ❑ Send= or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other :C•' : :r- , -y..W r_- r_e+,:�•� - -.y-r� e . .. �ret,.ver:r T.`.rz_.�.mr boatyards. � rF:, 4 e ' e : 1 : , g ib llr� 4 1 1 -- r` '`="T °- "' exceeds 10,000 amps volts or 13 Ploaiin buildings. d agricultural ".�"-'�-��' '"� '� �'� '�"' • " - ' t less to ground, or exceeds 14,000 Q Commercial-use " - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family 0 Master builder 0 Other: 0 Fire PUp• ❑ Installation of 75 KVA on --- ._.. s: `3 � •- ..:br-- n +:,�•. ,• -1ti , ❑Emergency system. larger separately derived system. r. �114 �� , 't�V u F.�tl 6 ( I • c ' �6�•e. k•� A r . � �".c `�w'.e� •'� W 4: . r • ;:: � � > ' , . --_ (� Addition of new motor load of ❑ "A', "E ", "1.2 ", "1 -3 ", Job no.: Job site address: 1 looliP or more. occupancy. a t '`v -1 u et 1 `'l -P i ❑ Six or more residential units- ❑ Recreational vehicle parks, City / State/ZIP'" /1 / r - . ci op 1 Q Health-care facilities. ❑ Supply voltage for more an UUV// ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: _ i'roject name: C3tUd i i , pt 0 Service or feeder 600 amps or more. ` - c 7.1 �., X61 ilTilil E.= :- 741; -: street/directions site: -To = ir. ''''''Pee. ,: Cross street/dections to b i job Docriplion Qty. pea } total • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add 500 sq. ft. or portion 33.40 t Limited energy, residential Tax map /parcel no.: - ar n ari`�a u; r'nc 11sY o ?i ce - � � `� 75.00 2 �Eisi [� ., ,� �- �,� :.� �n asi�.� =. ,�.. -� . -. r- n�f�? -xa.�- = -� (with a6ovs aq. 5) ener , - ily 75.00 2 ` ma Limited residential (with above fam sq. fl.) Services or feeders installation alteration and/or r ocation MA 1 i _ _ IA .. 4 r " 601 0 200 amps or less 80.30 Llama k _ '�_' t�� ..�' � �,.; "; - _��:�_ =�� -� «.; - ti t ; -.-- �..,�.._,...,,W -�,� t_ �u .:- �,a..� �,- : =�;� °a ,:., .,_�.:t 3 f -�` p.at fl -_ "� - , - 201 amps to 400 amps 106.85 Name: 401 amps to 600 amps - 160.60 601 amps to 1,000 amps 240.60 Address: Over 1,000 amps or volts 454.65 2 City / State/ZIP: Temporary services or feeders installation, alteration, and/or relocation _ Phone: ( ) I Fax: ( ) 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 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits- new, alteration, or extension, per panel _ � A. Pee for branch circuits with -; c.^ ` Fu� Vii, e5;, t , .. .: ..,:w L '_ { [ -�Y� 6� If - '5: - 4-. t al above service or feeder fee, each branch circuit 6.65 2 Business name: McCoy Electric B. Pee for branch circuits Contact nrme: :Kalil without service or feeder fee, 46.85 2 fiat branch circuit Address: same Each add'I branch circuit 6.65 12 Miscellaneous (service or feeder not included) City/ State/ZIP: same Each manufactured or modular 90.90 2 Phone: (503) 234 - 7521 I Fax: : (503) 234 - 9473 Recon t on service and/or feeder Reconnect only 66.85 2 E mail: ksloper(amecoyelectric.com Pump or irrigation circle 53.40 2 r 15 ,.., _.:.7� r l�� ::�:�� _ x _.�; - - , . -'� � � ti �} c; :11 Sign or outline lighting 53.40 2 Business name: McCoy Electric Signal eircuit(s) or limited - energy panel, alteration, or Address: 2014 SE 9 Ave extension. Describe: Page 2 2 City/State/ZIP: Portland, Or 97214 Each additional inspection over allowable in any of the above Phone: (503) 234 - 7521 I Fax: (503) 234 -9473 Investigation s tigati gati o on 62. nvon per hour (1 Iv min) 62.50 CCB Lic.: 8277 I Electrical Lic.: 26.82C I Suprv. Lic.: 2175S Industrial plant per hour 73.75 Suprv. Electrician signature, required: 4Z k�(I�f I,. -. r I o' � � Subtotal: `L•� f Plan review` (25% of permit fee): Print name: James R. Hall Date: �� State surcharge (12% of permit fee): M' . te a rs? Authorized signature: 1 i I . Its / / TOTAL PERMIT PEE: , g 7 9 Print name: I z - w Date: This permit application expires If a pencil is pot obtained within 180 days after it bas been accepted as complete. • Number of inspections allowed per permit. IN Imidtng 'ermitsla1C•Pa,milApp.doe osr site 4404615r(11lu7!COMM'L"a ' uildin • P . rmit A l t lica ' s t Tkz .. esidential - J GEL VED FOR OFFICE USE ONLY N\ CI of Tigard SS Received r ��l Pernik Ny0 g .00/3 ..� 131 EP — SW Hall Tigard, OR 97223 2003 .-0:0 .-0:0 _� Plan Review ° � III • Phone: 503.639.4171 Fax: 503 Date/B : ■ 4 TIGARD Inspection Line: 503.639.4175 u iT ° OF TIGARD Date ReadyBy o 8 , Other Permit: Ell See Page 2 for I Internet: www.tigard- or.gov BUILDING DIVISION .tified/Me hod: // /O r • Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. DI ..}... 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. 1 -and 2- family dwelling ❑ Commercial industrial Valuation: $ / 7�0 f � El Accessory building 12 Multi-family Number of bedrooms: 4 Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 1 ON 4 S CA) l :! U e w f Pc- New dwelling area: 1 F. % square feet City/State /ZIP: T -., b R2n t 0(Z, Gil 1 1 -) Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 14= axe IGP, ; — .,(7e-4.-0L Covered porch area: square feet Cross street/directions to job site: 6. e,e, e 5 Z S L err 47 Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I 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. fZ e v D (j �� A T'ti 3 (3 q• rii 1 c7o r iz Gn Valuation: $ T G Yx,•'r rG u' Gn Existing building area: square feet ' AI New building area:, square feet --- . ER PROPERTY OWNER ❑ TENANT Number of stories: Name: f j p Q. . j"4".47.1—C. Type of construction: Address: 11 6 S Su) ( u e LL (�� r. `r t... Occupancy groups: City /State /ZIP: ----- 6 ,,.„. (1 ,,,.., I U (t co )3 Existing: Phone: (rjC ) 9 �. '� i5, Fa x: ( ) New: .i p �J APPLICANT CONTACT PERSON NOTICE Business nam ` All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board r- -cam �i 11-if v Pi • 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:: ( ) 1 4 E -mail: CONTRACTOR A Business name: D`fi 710 E BUILDING PERMIT FEES* Address: (Please refer to fee schedule) 00 City /State /ZIP: Structural plan review fee (or deposit): 4 /a5 . / FLS plan review fee (if applicable): n Phone: ( ) Fax: ( ) CCB tic.: Total fees due upon application: a Amount received: 1 S• 10 Authorized si ture: e.42._ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: i > T rE I Date>Sy / * Fee methodology set by Tri-County Building Industry Service Board. I: \Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(I1 /02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Received City of Tigard Date/13y: No.: 11 14 V 1 3125 S W Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 T I G A R D 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard- or.gov ❑ Other: 1 THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW I Yes I No I 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; dircction 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 • U ❑ ❑ locations. Show attic ventilation. • 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engiheered s ❑ ❑ ❑ 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 as Ilicable to the •ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) 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 must include 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(11 /02/COM/WEB) . Mecha.nical,Permit A -n Il_ ,,6 i tVED FOR OFFICE USE ONLY City Tigard Ti and Received ' Date/By: Q QQ O permit No . � r„,,„,,,,,,,,-_. oot / IN • 13125 SW Hall Blvd., Tigard, Oi7P23 2 C 3013 Plan Review C . Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit: TIGARD Inspection Line: 503.639.41J4ITY OF TIGARD Date Ready/By: pr la See Page 2 for Internet: www.tigard or.go DIVISION Notified/Method: / fQ.- Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction (� Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* Igj 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 Job site address: r� Air conditioning or heat pump 6 S t JP j ( A, V C► (requires site plan showing placement) 14.00 City /State /ZIP: •� Pt'rt.. O -1 ^ �� Furnace 100,000 BTU (ducts/vents) 14.00 1 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: ..-z vT Z p P nO E Gas heat pump 14.00 Cross street/directions to job site: (.7 P.n$ 5 a 5 L x0.67 Duct work 1 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 Gas fireplace 10.00 Ve,t,o ci p,,r .e, 0 7 rerf+ (Q1-4-2 (Q1-4-2 1 � 0 �` G ,. Flue vent for water heater or gas / fireplace 10.00 _- T w r.Ak-'P,.... .. 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: 0 A ✓ ti Environmental exhaust and ventilation Address: 11 , S S W 1 00 CAA e v Range hood/other kitchen I Pc- equipment 10.00 City/State /ZIP: `- f -r- 6, A_27 0 2 17 _2 .L 7 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (SO)) 1-- 9 73 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: % Gas h ea t p i � �'� (/ V � Gas heat pump City/State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CO7CTOR„ Barbecue Business name: v ) I /V Clothes dryer (gas) 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) Gv iAL- - TOTAL PERMIT FEE Authorized si This p ermit a expires if a permit is not obtained within 180 i� days after it has been accepted as complete. Print name: V er r2 _ 1 101.- Date: CI Id..10K • Fee methodology set by Tri -County Building Industry Service Board 1:\ Building \ Permits \MEC- PermitApp.doc 01/19/07 4404617T(II /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 . . Electrical Permit Applic , :"i ECEIVED Received FOR OFFICE USE ONLY 2 „ City of Tigard Date/By: Permit No.: N� 1 q 111 111 ' 13125 SW Hall Blvd., Tigard, OR 972 % - 2 20t, 3 Plan Review Phone: 503.639.4171 Fax: 503.598.1 0 Date/13y: Other Permit: TIGARD Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: Jun ® See Page 2 for Internet: www.tigard- or.gov ((�� DIVISION (� Notified/Method: I Supplemental Information TYPE NJI G DI `ISIO' • PLAN REVIEW ❑ New construction ® Addition/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 f 1- 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. El A Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ", Job no.: Job site address: I I )M 6 c �W a ,� P 100HP or more. occupancy. ❑ ` ❑ Six or more residential units. Recreational vehicle parks. City/State /ZIP: 1 Cr el et I ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 14 � fr A-.� Qesx C% C. E ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: 6G� S / ..X- s C.-C'o P Description I Qts. 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'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. II.) Limited energy, multi - family 75.00 2 V ,P. L O Gge 4 ( R-T' I + (41p Z 4-XC„ residential (with above sq. ft.) _ Services or feeders installation, alteration, and/or relocation — 1 - 0 vv .. - C ' TF4 &r\ 200 amps or less 80.30 2 r9i. PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 0 A't2S ZTfG 401 amps to 600 amps 160.60 2 \ 601 amps to 1,000 amps 240.60 2 Address: I I d. b 5 SW (Z 0 el i. e, PG . Over 1,000 amps or volts 454.65 2 City/State /ZIP: ` Temporary services or feeders installation, alteration, and/or.. �� ! > ✓ A 2 G 2 q relocation Phone: (SO.) 0 9 C. 7 5 7 3 Fax: ( ) 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 fors e, rent, or cc ge, ccording to ORS 447, 449, 670 and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner sigma ,,,f e Dat' 0 g" A. Fee for branch circuits with [ APPLICANT I t� 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, I 46.85 2 f first branch circuit Address: Each add'I branch circuit C, 6.65 2 G n'"C�' dV 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 CONTRAQ Sign or outline lighting 53.40 2 ^ 1 c Signal circuits) or in d- Business name: C. - 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): Authorized signa� State surcharge (12% of permit fee): TOTAL PERMIT FEE: Print name: Date: °I jaiker Tet application expires if a permit is not obtained within 180 V64.17,7- V64.17,7- ,�, t This his s 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(I1 /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:\ Building \Permits'ELC- PermitApp.doc 03/23/06 Plumbing Permit ApplicaRECEIVED , . Building Fixtures SEP - 2 2O FOR OFFICE USE ONLY City of Tigard Received Q 06 Permit No. W ' S OQ l3 ,� OF TIGARD Date/By: ' 1 131 SW Hall Blvd., Tig ard, O D an Review Phone: 503.639.4171 Fax: { � Date/By: Other Permit No.: Inspection Line: 503.639.417 DIVISION TIGARD Date Ready/By: Ju ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: . f/(, Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. ,�,� Description I Qty. I Ea. I Total t_y 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 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 1 1 6 5 Q Jew e p Catch basin or area drain 16.60 City/State /ZIP: I .1:9 A.4,9 iS � g -2 J-43 Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. name Footing drain (no. linear ft.: ) Page 2 no.: Project 1 i G.- (�/ A.STo7 Manufactured home utilities 110.00 Cross street/directions to job site: et'1 P' S Z S C/r,r> P 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 C e c, CJ (, pe're ( A - 1 - 4 A- n,r ,� Backwater valve 16.60 - 1--c' i-C e Clothes washer 16.60 Dishwasher 16.60 tip PROPERTY OWNER El TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: (7 el - ^ H-�- ti a.-- e Expansion tank 16.60 Address: 1 1 a ( , Le) Q V CSI✓ e 1 `, L Fixture/sewer cap 16.60 City/State/ZIP: -- 1 - - r - �� l�2 r 7 r C� ") ,(,,L' Floor drain/floor sink/hub 16.60 Phone: (7(j j) C ( -7 t')) V 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: ( ) Fax:: ( ) Sink/basin/lavatory ( ( - A 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONCTOR Water closet 16.60 Business name: tCp E/ Water heater 16.60 Address: Other: City/State /ZIP: Subtotal 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 signa State surcharge (12% of permit fee) TOTAL PERMIT FEE Print name: 0 g) et, x..- -rt. Date: 146 T his permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\ 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 (ea) Total Square Footage: Permit Fee: Footing drain - 1 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' A 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 Ins ection of existing lumbin or each additional $100.00 or fraction thereof, to P g P g and including $50,000.00. specially requested inspections - per hour 72.50 $50,001:00 and up ' $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Commercial 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 Quauti* 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 healtt}/care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. ff 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. 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 01/08/2009 07:18 5036565344 BROCKAMPJAEGER PAGE 01/01 l 4 CITY OF TiGARD ' r COMMUNITY DEVELOPMENT .. Ti G n I Z n 1 3126 SW Hall Blvd., Tigard, OR 97223 903.639.4171 BC EV\I ED 9 Electrical Signature Form �� o� 1 2 s IMPORTANT PERMIT NOTICE • MCCOY ELECTRIC CO INC L 2014 SE 9TH AVE • PORTLAND, OR 97214 Permit #: MST2008.00136 Date Issued: 9/1612006 Parcel: 2S103DB -03700 • Site Address: 11266 SW QUELLE PL Subdivision: GENESIS NO. Lot: 035 Jurisdiction: TlG Zoning: R.4,5 Project Name: HIRTE Description: 136 sq foot addition and interior remodel. 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 mall the form to: City of Tigard, Building Division, 13126 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3691. If you have any questions please call 603.718.2433. No electrical Inspections will be authorized until this completed form Is received OWNER: ELECTRICAL CONTRACTOR: DARiN HIRTE MCCOY ELECTRIC CO INC 11266 SW QUELLE PL 2014 SE 9TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone #: 503-849-7573 Phone #: 603-234-7521 Reg #: ELI? 26.82C LTC 8277 SUP 2175s AN INK SIGNATURE IS REQUIRED ON THIS FORM \ Sign. upe ing Electrician Name printed) SUP UC # • 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 A . r(11 I will be performing work on property I own, a residence that I reside in or a residence that I will , O reside in. If I hire subcontractors, 1 will hire only subcontractors licensed with the Construction Contractors Board. If I 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 t e information checked and completed above is correct and accurate. Print name of permit applicant Si ature of permit applicant 9 I oFs Dat Permit #: STaDOg "CO/3Co This form is supplied to building, permit offices by the Oregon ,,,�� , Address: L .44.) Q 6 ,�; � Construction Contractors Board, # 4,-;: N=,i as required by ORS 701.055 (6) w.i �,92b 02 97A Issued by: Date: This copy to issuing permit office CITY OF TIGARD -' 9. \ BUILDING DIVISION PERMIT #: Mm 2008 -00 r:35 13125 SW Hall Blvd., Tigard, OR 97223 1 DATE ISSUED: fttiv: i Phone: (503) 639 -4171 ,% 1/4 (, Inspection Requests (24 Hrs.): (503) 639 -4175 ' 0 6 Z INSPECTION WORKSHEET FOR DATE: 2/5/2009 TIME: 7 :00AM 1 AGE: 9 SITE ADDRESS: 11265 SW QUELLE Pt_ CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIRTE DESCRIPTION: 135 sq loot addition and interior remodel. 2/3/09, ADDING SERVICE. VII OWNER: HIRTE, DARIN .v PHONE #: 503419.7573 , CONTRACTOR: OWNER J PHONE #: . Inspection Request Scheduled For: Date: 2/5/2009 / P'''.° " . ` e:' , u Code # Inspection Description Confirm # Contact # Mes•" -. • 1,0✓ 280 Iris ulation 080320.01 ;t13 -N -757: `'( Corrections /Coma pts /Instructi ns: 7 0-7+ ..e _s riL--- . L-1-i&/ CLA / .°---f•V /,._ . I 4 \ 1: ) ASS ❑ PARTIAL APPROVAL , ❑ CANCEL (l NO ACCESS ❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ili ( ` l - Date: 2 ( Phone #: 503 718 )4 I nspector: / / ( ) CITY OF TIGARD BUILDING DIVISION PERMIT #: MsT2008 -001 6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/10.!20013 Phone: (503) 639 -4171 ICI Inspection Requests (24 Hrs.): (503) 639 -4175 ,— p -- INSPECTION WORKSHEET FOR DATE: 1/20/2003 TIME: 7:OOAM PAGE: 13 SITE ADDRESS: 11265 SW OUELLE PI_. CLASS OF WORK: SUBDIVISION: GENESIS NO 2 LOT #: 036 TYPE OF USE: PROJECT NAME: FORTE DESCRIPTION: 136:; sq toot addition and interior remodel. OWNER: HIF1TE, DARIN PHONE #: 5;03 - 849 - 7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/20/2003 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 079837.04 503.849 -7673 'r Corrections /Comments /Instructions: n ' . ► mg ®'I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL E❑ CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED � J Inspector, Al Date: ( Phone #: (503) 718- 1 • CITY OF TIGARD BUILDING DIVISION #: L,�sT2aras 0t),;i8 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: c ;tlet y(,y( }i; Phone: (503) 639 -4171 i +t�' t Inspection Requests (24 Hrs.): (503) 639- 4175' INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: '7:00AM PAGE: 22 SITE ADDRESS: 11265 SW QUEUE PL. CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIRTE DESCRIPTION: 130 sq foot addition and interior remodel. - OWNER: HIRTE, DARIN PHONE #: 503 - 819 - 7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/20/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message imCLieL 235 Shear wallah. nchors 079837 -01 603-849. 7573 t Corrections /Comments /Instructions: `P'I • -4. t Ki / PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI4NAL ES ASSESSED • Inspector: 'W M!4L Date: 20 IP Phone #: (503) 718 - �--3 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20013- 00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16/2008 Phone: (503) 639 -4171 r A Inspection Requests (24 Hrs.): (503) 639 - 4175:. INSPECTION WORKSHEET FOR DATE: 1/:0/2009 TIME: 7:OOAM PAGE: 21 SITE ADDRESS: 11266 SW OUELLE PL CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 036 TYPE OF USE: PROJECT NAME: HIRTE DESCRIPTION: 136 ,q toot addition and interior remodel. • OWNER: HIRTE, DARIN PHONE #: 603.849 -7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: Pour Time: P q �i /20 / ?flCl9 Code # Inspection Description Confirm # Contact # Message 605 PosUbeam mechanical 079t337 -02 503 -t3i3- 7573 Y Corrections /Comments /Instructions: A Al i a., w I art ir— PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL E CALL FOR INSPECTION ❑ ADDITI•NAL EES ASSESSED 41e Inspector: c j Date: a Phone #: (503) 718 - .0 CITY OF TIGARD BUILDING DIVISION PERMIT #: • MST'?0at 00i 36 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1612008 Phone: (503) 639 -4171 '�I Inspection Requests (24 Hrs.): (503) 639 -4175 . ':� '` INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 7:00AM PAGE: 20 SITE ADDRESS: 11266 SW QUELLS PI.. CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIPTE DESCRIPTION: 136 sq foot stcddition and interior remodel. OWNER: HIRTE, DARIN , PHONE #: 503 - 849.7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/20/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 6 • Mechanical rough -in 079837 -03 5034349 -7573 N Corrections /Comments /Instructions: 1 (..2-(-0 Pep_ 15i/uk) C .. 7 titm Na - Or--- 7 ---- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL---..... n CALL FOR INSPECTION ❑ ADDIT ONAL FEES ASSESSED c� Inspector: L Date: 2 0 � Phone #: (503) 718 - 2.-it-- CITY OF TIGARD C7- BUILDING DIVISION PERMIT #: MST2OO8 -00 i :36 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16/20013 Phone: (503) 639 -4171 atsiN f Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12J912008 TIME: 7:02AM PAGE: 3 SITE ADDRESS: 11265 SW OUFI LF PL. CLASS OF WORK: 4 ; 5 SUBDIVISION: GENESIS NO 0 LOT #: 03 6 TYPE OF USE: ` L PROJECT NAME: Hl F,-r DESCRIPTION: 136 sq f addition and interior remodel. OWNER: I'iIRTF, DARIN PHONE #• 603 - 7973 �a CONTRACTOR: s PHON OA , Inspection Request Scheduled For: Date: 1 19/`�0Q8 1 f ,«urTime: � D //Ile Code # Inspection Description Confirm # Co tact # Me (9 1 Exterior sheathing 07£3907 -01 603-849-7573 Y Corrections /Comments /Instructions: ) 2 ' . n -ASS U PARTIAL APPROVAL ❑ CANCEL i ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES SESSED v k Inspector: Date: i 4 6 Phone #: (503) 718- .,, ; CITY OF TIGARD BUILDING DIVISION #: MST2008- 00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: �t116/200t1 Phone: (503) 639 -4171 �a, ,, AL Inspection Requests (24 Hrs.): (503) 639 -4175 44. INSPECTION WORKSHEET FOR DATE: 11/14/2008 TIME: 7 PAGE: 7 SITE ADDRESS: 11265 SW QUELL E Pt CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 036 TYPE OF USE: PROJECT NAME: F IRTE DESCRIPTION: 136 sq foot addition and interior remodel. OWNER: HIRTE, DARIN PHONE #: 503-849_7 93 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11114/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 070099 -02 503.1349 -7573 Y Corrections /Comments/ Instructions: g S'.• L YI 1 "r •-/ fi`U a , - - Ls —.a 1 u_ . 1/ si Si .. Cn'Z v Ol (-l—`''{ 0/■ `YG 5-71- / p ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1/— /9- —erg Phone #: (503) 718 - "act-a-,7 CITY OF TIGARD BUILDING DIVISION - PERMIT #: h4ST2008.00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16r 1008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 - 4175!!x► INSPECTION WORKSHEET FOR DATE: 11/14/2008 TIME: 7 :00AM PAGE: SITE ADDRESS: 11265 SW QUEUE PL CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: O3r TYPE OF USE: PROJECT NAME: HIRTF_ DESCRIPTION: 136 sq foot addition and interior remodel. OWNER: HIRTE, DARIN PHONE #: 50341497673 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/14/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam stturtural 070099301 503 8437573 Y Corrections /Comments /Instructions: • 1 . 14/1/ bAxe '/I - f PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200B -00 i6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16J1009 Phone: (503) 639 - 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 .FA INSPECTION WORKSHEET FOR DATE: 11/3/2008 TIME: 7 :00AM PAGE: 1 2 SITE ADDRESS: 11265 SW OUFLLE ILL CLASS OF WORK: SUBDIVISION: GENESIS NO 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIUTE DESCRIPTION: 13(i so foot addition and interior remodel. OWNER: HIRTF, DARIN PHONE #: 5034349 -7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/3/2008 Pour Time: 1:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 077559 -01 503-8491573 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /1— ? 8 Phone #: (503) 718- t51-.4.- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- ooi36 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16/20013 Phone: (503) 639 -4171 *A Inspection Requests (24 Hrs.): (503) 639 -4175 1! INSPECTION WORKSHEET FOR DATE: 10/28/2008 TIME: 7:01AM PAGE: 10 SITE ADDRESS: 1'1266 SW QUE I_I. PL, CLASS OF WORK: SUBDIVISION: CFNESI y NO 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HI FF DESCRIPTION: 136 sq foot addition and interior remodel. OWNER: HIF2 i E_, DARIN PHONE #: 603 -849 -7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/28/2000 Pour Time: t00 Code # Inspection Description Confirm # Contact # Message 206 Footing 077267 -01 503.1348 -7573 Y Corrections /Comments /Instructions: • P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: Date: /0 —ZA -a� Phone #: (503) 718- "Z.._7-4.es- CITY OF TIGAR® BUILDING DIVISION PERMIT #:MS1200 0013 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: • Phone: (503) 639 -4171 Inspection Requests (24 HrS.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11 2...0 ( 3 "I TIME: PAGE: • SITE ADDRESS: } I \ 2 65 a OF PL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: • ' OWNER I QTY PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: ' 1(20 3 O1 Pour Time: Code ,# Inspection Description Confirm # Contact # Message �9 91.„ 31c I' , N A1._. Corrections /Comments /Instructions: '3 el Ns `1-\ c\c‘: CONEIZm F 2 •15 yip r Nobi °NAL- CZ.P■1\\)C-\\, CltQa \:\15 . - 9 • • ❑ PASS /:a PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �T • � Date: 1 ( 23JO 1 Phone #: (503) 718 - P �., _ _ CITY OF TIGARD BUILDING DIVISION PERMIT #: msT7000. 001: 5 13125 SW Hall Blvd., Tigard, OR 97223 A ititi DATE ISSUED: 9/16/2000 Phone: (503) 639 - 4171 f Inspection Requests (24 Hrs.): (503) 639 -4175 . - INSPECTION WORKSHEET FOR DATE: 1/15/2009 TIME: 7:02AM PAGE: 4 SITE ADDRESS: 1126E, SW QUELLF Pt, CLASS OF WORK: SUBDIVISION: GENESIS NO. :2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIRTE DESCRIPTION: 136 sq foot addition; and interior remodel. OWNER: HIRTE, DARIN PHONE #: 503 -049 -7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/15/2009 Pour ' Code # Inspection Description Confirm # Contact # Me sae 320 Plumbing rough - in 079741 - 01 503 - 849.7573 1` 1 °'.5 i Corrections /Comments/ Instructions: /b 3 r iek,1L— 0-k A ,fJ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- 1 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: EN:T20t1t3 001:36 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16/2008 Phone: (503) 639 - 4171 " ;I \III Inspection Requests (24 Hrs.): (503) 639 -4175 'LL. INSPECTION WORKSHEET FOR DATE: 11/7/2008 TIME: 7 :02AM PAGE: 2 SITE ADDRESS: 11265 SW QUELLE PL CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIRTE DESCRIPTION: 136 sq foot addition and interior remodel. OWNER: HIRTE, DARIN PHONE #: 503E 19.7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 077836 -01 503 -849 -7573 N Corrections /Comments/ Instructions: tgl, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL — CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED InspectorCt \ \‘\,' Date: I 1 ) Phone #: (503) 718- CITY OF TIGARD • _ BUILDING DIVISION PERMIT #: M Ot)136 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/18/2008. Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 .._' `'I INSPECTION WORKSHEET FOR DATE: 10/27/2008 TIME: 7:00 /0/1 PAGE: E SITE ADDRESS: 1126f SW OUELL.E PL CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 036 TYPE OF USE: PROJECT NAME: tiIRTE DESCRIPTION: 1 .sq foot addition and ulterior remodel. OWNER: HIRTF, DARIN PHONE #: 503849 -7573 CONTRACTOR: OWNER PHONE #: 1 Inspection Request Scheduled For: Date: 10/27/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 30( Plumbing underslab 077212 -01 503 -B49 -7573 Y Corrections /Comments /Instructions: VI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED I nspectorM -' 1 \ \ Date: 1 D \2'7 I OZ Phone #: (503) 718- , . ga Tidemark Advantage [Gary Noble - GN] Ell{1 M File Edit Options Window Help - ---- 21 in e ! 1, Exit New Open Task List OBE GIS X 9 . a ! j j Close View Add Delete Primary Print , . . . . .- • • . . - la , ,•„ ,yzai r _ 1 'i '',t, 1 ._, Eli '1,- - LI _ .... .... . . ., ... . _ . • . .. . , , . , : • - Name:DARIN HIRTE Updated: 9/10/2008 LS General • . • . - .. , . ,- • . . . - . . , „ .. • - • - - • - • .... . .... . Address:11265 SW OUELLE PL Jur friG „ , . •. „ " ." • lding - - . , - . , • , • - ; . - - - - ° Description: Master #.1MST2008-00136 Project: IHIRTE Bui • _ .... - s ' „ . - . ,. . _, __ ,,-, - . . . •• 136 sq foot addition and interior remodel. __________ ___ .. _ , . , _• . • _, -• • - _ . - Mechanical . .. . • • . - „ - - , - , ,. ..,_ .. .. , ,,,,,,, ..„.. PLumbing City Contact: 1LS ....- . • - ... ,_ • . , ... . , . . , .. . ., -.. Reissue: 'CUSTOM D ates Electrical "-, ' ' • - : . ' -• ' •• : - - -..-, _ • - . ,-. - , -:. - - --. Class of Work: RI— ., Received: id/2/2008 Type of Use: ig-- .. . , El ectrical • - - '- - '. --• - - - '' . ' -1 / 4 _ , -. - - ' '- ' ,, i: - -.;,„•,.,. : --- .• Target: I Type of Construction: $1■1 , -• - Issued: p/16/2008 Occupancy Group: 1R3 _ Restricted - , - .°. ' ' - - - --•• . - - - -. ..-. _. •.,' ' ' - ,..- - : •" ...4. Expired: piist2oce , Elecncal Total Valuation: i $13,168.88 Residentual Finaled: I Pa .4 r ir441■4 fil People Associated with MST2008-001 36 Role flame r 1 1 1 0 OWNER DARIN HIRTE . „ . - . • ..-, ... .. 11265 SW QUELLE PL TIGARD OR 97 ''• . , . . . - ., ,.• .. . _ _ . _ , ...• , BUILDER OWNER • • ' - • - -: ' MECHANICAL OWNER ' '''..' ° : . 1 ' • -- .- • ° -' :z PLUMBER OWNER - . .... . ' . ,,, . . • * - ' .. . - '•'- . • ; -.• ' ' . ' ELECTRICIAN MCCOY ELECTRIC CO INC 2014 SE 9TH AVE PORTLAND OR 97 , -. — ' ' ' . • , .-. .- - .' . . . , r • I, . ■ • ■. . 7 i z 3 (i Cl _ _ _ • . ..... .. .._.. . ... ... : . ... . 2. .2... . . . . . , _ - _ • . ,.. . . . , . .. . . .. ... ..... • . .. . . • , ... . 21 . ... . .. , . • • . .• ... • ., • View people information _ - . - - - - - i , r ) , i Inbox - Microsoft Out... 110 idem Irk Advanta_g_e - i - 1 ' P 4 -a i i.,, , , L . 4 ,-). . 7•37 AM CITY OF TIGARD BUILDING DIVISION PERMIT #:filiS1 ZO08 -00t3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 z .4.1s1 F111. INSPECTION WORKSHEET FOR DATE: *61 001 TIME: PAGE: SITE ADDRESS: 112,66- pL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: J (Kr I PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: r J 0p1 Pour Time: I Code # Inspection Description Confirm # Contact # Message 399 1D1,Al 2 Corrections /Comments / Instructions: 3 c c Pss,5 y 4 ,` 5 �,— ❑ PASS j A PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • b8 Date: 20 U1 Phone #: (503) 718- 2-41{' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2.006- 001.3; 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/16170011 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 :�'.� `�I �.. INSPECTION WORKSHEET FOR DATE: 2M/2009 TIME: 7 :00AM PAGE: 23 SITE ADDRESS: 11265 SW QUEUE P1.. CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 035 TYPE OF USE: PROJECT NAME: HIRTE DESCRIPTION: 116 sq foot addition and interior remodel: 2/3109, ADDING SERVICE, OWNER: HIRTE, LDARIN PHONE #: 5O3 -849 -7673 CONTRACTOR: (3 A {�R- " � i, A E .(thc, ZDi -EL l PHONE #: -"� J Inspection Request Scheduled For: Date: 2!4/2009 Pour Time: Code # Inspection Description 'Confirm -# Contact # Message 120 Electrical rough -in 000249 -01 503.730 -0273 Y Corrections /Comments /Instructions: �;, 1 m ri n ` 1 i () 41 O .`661, bF Ao . o Qua c Res _ m Pcxi ►e‹ Q 5"c i 4--IL P, a2s3m&t 0 1 . o » N. 11 L. , % tyt PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • G • Noe Lts Date: 2" L{ 1 Phone #: (503) 718- 1400 • City of Tigard, Oregon Page 1 of 2 a City of Tigard, C gon TIGARD it Place to Cull Home A .F 1 Search 1 Property 1 Planning 1 Crimes 1 Transportation 1 Utilities 1 Aerials 1 EOC 1 Street View 1 Print 1 1 Summary 1 Permit Summary 1 Community 1 Hazards 1 Explorer 1 11265 SW QUELLE PL Property Summary Genesis 13 yg - 0 6 m terrace Ruts ' ,. .r . .g. o a W H W S � O M Genesis N1 < u • (; a r = ip g G`G r 2 i i it , GAARDE 51. .__.._.....� P Q FAIRHAVEN ST Falai even Street FAIRHAVEN ST z 1 Nr FAIRHAVEN WAY Property Owner Info Tax ID Number: 2S1.031P13Q3700 Tax Account Number: R998184 Site Address: 11265 SW QUELLE PL Site City: Site ZIP: Owner: i SUSANNE E Owner 2: E PL Owner 3: Owner Address: Owner City: Fee. 5 Owner State: Owner ZIP: Acres: BI Ft: al b V C Bldg : Bldg Value: Land Value: Total Value: Taxable Ass'd Value: gil Sale Price: Sale Date: Year Built: District & Community Info Municipality: +1 Tigard Tigard Urban Sery Bndry: YES Tigard Neighborhoods: L Name Link to Website Area 10 Area 10 Neighborhood News School Attendance Areas: http: / /tiggisiw /mox52_multimap/ index. cfm? fuseaction = property. summary &CFID = 100746 &CFTOKEN =3... 2/3/2009 • CITY OF TIGARD BUILDING DIVISION PERMIT #: MS1 - 2008-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: }5'2000 Phone: (503) 639 -4171 (+� Inspection Requests (24 Hrs.): (503) 639 -4175 ': `- `�II INSPECTION WORKSHEET FOR DATE: 2/3/2009 TIME: 7100AM PAGE: 11 SITE ADDRESS: 11765 SW QUE L LE P1 CLASS OF WORK: SUBDIVISION: GENESIS NO. 2 LOT #: 035 TYPE OF USE: PROJECT NAME: H1RTE DESCRIPTION: 136 ; q foot addition and interior remodel. OWNER: HIRTE, DARIN PHONE #: 503-849-7573 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 713/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 060225-01 60'S.730.0273 Y Corrections /Comments /Instructions: • • ❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION AA - PERMIT #: NIST2008-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: T Phone: (503) 639-4171 . to:Nd!iiir Inspection Requests (24 Hrs.): (503) 639-4175 ..-0- IL. INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 7 PAGE: 16 SITE ADDRESS: 11266 SW QUEUE pl, CLASS OF WORK: SUBDIVISION: GENESIS No. 2 4 \ i 7 LOT #: 035 TYPE OF USE: PROJECT NAME: Ht•,TE DESCRIPTION: '1'36 sq foot a d d i t i o n and interior remodel, OWNER: HIRTE, DARIN PHONE #: 6034149-7513 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: .1/20/2009 Pour Time: Code # Inspection Description - e • - ; • .. . C ontact # Message 120 Elertrical rough-in 07984301 603-730-0273 411) tifv- Corrections/Comments/Instructions: ro-c.., 04.-1 %I 0 ■ I . . I• .,' ■ . IA .._ , 1 ( ( .. t r , Dcb ride Nu K44_ . , 444 41) fl PASS PARTIAL APPROVAL El CANCEL NO ACCESS fl FAIL LI CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED Inspector: G 1\1 U3 LC Date: i - 1-0 .. 1 Phone #: (503) 718- 7.4140