Permit ,
IT O OF TIGARD MASTER PERMIT
`� PERMIT #: MST2003 -00274
IIII. DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10965 SW 130TH AVE PARCEL: 1 S133AC -HB001
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 001 JURISDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 108 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 636 sf GARAGE: 536 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD. 709 sf RIGHT:
VALUE: 149 00840
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,453 sf . REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: 3
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 • 600 amp: 401 - 600 amp: EAADDL BR CIR: _ SIGNAL /PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVCIFDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,072.45
This permit is subject to the regulations contained in the
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES INTigard Municipal Code, State of OR. Specialty Codes and
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 all other applicable laws. All work will be done in
PORTLAND, OR 97219 PORTLAND, OR 97219 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 892 - 8758 Phone: 503 - 892 - 8758 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 58699 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
f ■
l,35 ill cod-tot-la 5-644-€5"9 REQUIRED INSPECTIONS
Erosion Control Insp 8 Plmfundslb Insp • Plumbing Top Out Shear Wall Insp Water Line Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insr Water Service Insp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab Insp Low Voltage Insulation Insp Rain Drain Insp Plumb Final
t
Issued : C\ a44 7 Permittee Signature : AR ,-o.
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
'Buiidin° Permit A P lica
*OII • FOR OFFICE USE ONLY
- p Received / g
RECEIVED
S��o• 7 � 7 4 1 -g c4 P No..
City Of Tigard D arning Approval Other
Date/By: Permit No- c I` � ` - 4) ' C - = -i - J
13125 SW Hall Blvd. JU N 2 7 2003 Plan Review Other
Tigard, Oregon 97223 Date/By: 1 ^dl /t3 s� Permit No.: QQ
Internet: w
Phone: 503 ww.ci.itig ar1 F SVILDING DIVIS D l:.14 - ° I l I Post-Review Date/By: Case No. � 6�0 � -Oee!' _�`
ww.ci.i dor Contact Juris.: El See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: 7 7 - Supplemental Information
TYPE OF WORK REQUIRE DATA:" '- :
' New construction [j] Demolition /q V . 1 &2 FAMILY DWELLING '_ = :
❑ Addition/alteration/replacement ❑ Other:
- *CATEGORY OF CONSTRUCTION - • . Note: Permit fees' are based on the total value of the work performed. Indicate
1 & 2- Family dwelling ❑ Corrlmercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application • ', �t O
❑ Accessory Building (i Multi - Family . I '}'' /
❑ Master Builder
❑ Other: Valuation - 1-- 008 '
:.:,10B SITE INFORMATION and LOCATION No. of bedrooms: 3 No. of baths: Z —
Job site address: 10q4,5 S W 1'5 r Total number of floors _
New dwelling area (sq. ft.) 14'SS
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) 4--_
Project Name: HAWKS 11C-AA .7-0•1148CfV1, a Covered porch area (sq. ft.)
Cress street/Directions Deck area (sq. ft.) P
to job site:
Sloi 13o TM /Naive 4.+ S.W. gAita EEAR- Other structure area (sq. ft.)
' - - .REQUIRED 'DATA:. '
COMMERCIAL - USE ('Hr.CKLIST
Subdivision: I-(4Wld %Elk "T77t uwEC _ Lot #: 1 -
Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
' . ` DESCRIPTION OF WORK :: - - the value (rounded to the nearest dollar) of all equipment, materials, labor,
eu t Sr �� T` r' , overhead and profit for the work indicated on this application.
Cr,�l,STlzuc�crL N o4ri
1P20JE1x ( I 4& 8 ) Valuation $
J Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
• PROPERTY OWNER'-. •(:D . TEN �" ANT - Type of construction V N
Name: A l�J/'P11.1 Ph 2K TOWPO Pv1,ES / L . L • G • Occupancy group(s): F
R-3
Address: gi5ao SW m & s? gu , CU Of 22.O
City /State /Zip: *Pognait3A. , Oa- q7 2-I9
Phone: 66i) SQ2 -$1sS Fax:6)1) eta-80,4( NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
51 APPLICANT "::-= : : ?❑ CONTACT PERSON_;;` :' provisions of ORS 701 and may be required to be licensed in the
Business Name: IF - 1..Br2004 c A cSMAte / 14.t , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: Mike K (4 k,J.SW c 214.1 PeA-oz from licensing, the following reason applies:
Address: g S r b SW f 2( 1l l SU (7.e 2lc •
City /State /Zip: kt2.rz4l OrZ Q'i u `I
Phone: o3)592 - ✓`t58 Fax:(S s°t2-6 ( :.:. :. s I NG, PERIIT'FEES * :
E- mail: ma/•K dlbr o t.dn ASSe)e.s C -)/ : :Pleasereferto :fee schedule. -
Business Name : 'bE L. .4.) 4 A5.kape v46, Fees due upon application $
Address: c 150C) Svd $AQ& ie. gL /b Sll o* 7.2,0 •
City /State /Zip: �(Zrjjt J o a. T1219 +9 Amount received $
Phone: D3\ 892 -5 ` 6 ( Fax: ( St93 2 -884 Date received:
CCB Lic. #: 58691
/ Z Fi 1
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: !� ,A
Dat / t 180 days after it has been accepted as complete.
it/tAe, (.1 144,J t' *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
- ∎Dsts\Permit Forms\BldgPermitApp.doc 01/03
° �� 999 ?
• : r� " ma y' ,- FOIZ [ISE " „ _f , ,
Electrical � at l ®� Received Electrical �/�%
• Date/B : Permit No.://r /O' - - OQ oz 7
City of Tigard v 7 2003 Planning Approval Sign
g JUN Date/B PermitNo.:
• 13125 SW Hall Blvd. Plan Review Other
OF
Tigard, Oregon 97223 `'QTY ... TIG in Date/B : Permit No.:
Phone: 503-639-4171 n S I19 Post - Review Land Use
+ Date/B : Case No.:
Internet: www.ci.tigard.or.us e i; Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Su lemental Information.
TYPE OF .WORK • - PLANREVIEW (Please check all that apply)
,' New construction ❑ Demolition El Service over 225 amps- ❑ Health -care facility
t, commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: 0 Service over 320 amps - rating of ❑ Building over 10,000 square feet,
. • CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in
jai & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egressilighting plan ❑ Other:
JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: (O9(6S SW 1 Al wine, FEE* SCHEDULE
Suite #: B14a. /Aptt. #: Number of inspections per permit allowed
Project Name: „1-1,41/04.S 166,.(1.. r LJP—J - »V E . Description I tv 1 Fee (ea.) Total l
New residential- single or multi- family per 0d- +
Cross street/Directions to job site: i � j dwelling unit Includes attached garage. 1
s� �) A v U - 5-14 - 1 N ll�` Service included: d
Y 1000 so. ft. or less 11 145.15 14 1 ' S 4
J r c.t /1 Each additional 500 so. ft. or portion thereof �„ 33.40 44_ _g 1
mug ' Limited energy, residential I, 1 75.00 '"l5 ,co 2
Subdivision: 1 ' i Lot #: Limited energy, non residential 75.00 2 ,
Tax map /parcel #: Each manufactured home or modular dwelling
DESCRIPTION,OF:'WQRK.
- service and/or feeder 90.90 2
" Services or feeder - installation,
C o r, 5'j"1t u-CT1 3 sr alteration or relocation:
� jj / 4� 011-166r 1 200 amps or less 80.30 2
�(.�Al. Vi 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
. , . 601 am 240.60 2 Li: - � TENANT , : ,,,
amps to 1000 amps
[PROP " TYOWN R = Over 1000 amps or volts
q 454.65 2
Tame: A.(JJkYl p K 170*Ni4 1" LL X, Reconnect only 1 66.85 2
Address: c1500 Sij &4e.gu - QL.N SUir(c. 22z Temporary services or feeders - installation,
Q 7 alteration, or relocation:
City/State /Zip 2rL}ir'� �
- - 7 c 2 ( 200 am's or less 66.85 1
Phone A
SOA) 4Z rr7 Fax:(�,)�J9 -e &- J 201 amps to 400 amps 100.30 2
. 401 to 600 amps 133.75 2
,� .. ; ,. CONT CT'PERSOI!f =. • APP ANT' :G:' - Branch circuits - new, alteration, or
Name:1EZE L. t �, ,��,, '�' AA t AS acifrES t �' extension per panel:
p � A. Fee for branch circuits with purchase of
p
Address: F5co &I-Am f.- ) S1l p ZZO service or feeder fee. each branch circuit 6.65 2
City/State /Zip: ; 1 , G� � ' 7 21 c1 B. Fee for branch circuits without purchase of
oC service or feeder fee. first branch circuit 46 2
Phone: (�p3) 7 S 15$ Fax: (S0.1) I q 2.. - e / _ Each additional branch circuit 6.65 2
E -mail: pslr, r CL d 1 trio,,Up)0.c'$oc , CO/1'1 Misc.(Service or feeder not included):
Each pump or irrigation circle _ 53.4
2
CONTRACTOR
r - 4TM Each sign or outline light 53.40 2
_Tnh Nn• !` e__A _ — Signal circuits) or a limited energy panel,
Electrum Inc alteration. or extension Page 2 2
Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) I 62.50
503 -361 -1256 Investigation fee: 1
CCB :116453/ELC:24- 353C/SUP:2919S Other I .
'''xElectrical:Pei iult Eees* "- $ -,.
Supervising electrician Subtotal $ _,
signature required: Plan Review (25% of Permit Fee) $ 0,_
Print Naraw Lic. #: State Surcharge (8% of Permit Fee) S
I cr TOTAL PERMIT FEE $
Authorized Bate: '1.0 Notice: This permit application expires if a permit is not obtained within
Signature: 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
iYl I C lv • AO Sefr
(Ple a print name)
` i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03
(i
.. ButMing r fixtures
Plumbfin P n FOR OFFICE USE ONLY
Received Plumbing �
Date/By: Permit No.: /S�� / v0O2 7
City of Tigard JUN 7 2003 Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
Phone: 503- 639 -4171 Fax8tflUISI i►', Post- Review Land Use
� a,; d�ji' � {�
Internet: www.ci.tigard.or.us a e . ' I Date/By: Case No.: Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 '-" Name/Method: Supplemental Information.
TYPE OF WORK FEE* SCHEDULE (for special information use checklist)
Nr
New construction E] Demolition Description 1 Qty. 1 Fee(ea.) I Total
] Addition/alteration/replacement ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
Z 1 & 2- Family dwelling ❑ Commercial/lndustrial SFR (2) bath _ 350.00 U•0, °p•
EAccessory Building ❑ Multi - Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
• . JOB SITE INFORMATION and LOCATION Fire sprinkler - sq. ft.: Page 2
Job site address: /c' //S SU/ f t 4vg_ Site Utilities
Bld /A t #: Catch basin/area drain 16.60
Suite #: g p Drywell/leach line/trench drain 16.60
Project Name: HAW k� �b TOUJrI L Wlg S Footing drain (no. linear ft.) Page 2
Cross street/Directions to job sit Manufactured home utilities 110.00
SLJ 130 k '` ,� 1 �r� S Manholes 16.60
3EA4) S Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: //,WK 11E4- J Lot #: I Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: _ Fixture or Item • . ..... . ._
DESCRIPTION OF WORK Absorption valve 16.60
orris - 22u.0 • Ct OF IV Si Backflow preventer Page 2
1-CANAJ f . P c , ( )l ( p & j - ) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
• ErPROPERTY'OWNER . 1 • ❑ TENANT Ejectors/sump 16.60
Name: AU'TU nJ PAQK T w!N AoWV1ES Lt-C Expansion tank 16.60
Address: g SOO 51W/ S4e.gj2 gok. / S Jt Z ZO Fixture/sewer cap 16.60
City/State/Zip: '-iz t 9 Floor drain/floor sink/hub 16.60
p' l2 ?? Q2 Garbage disposal 16.60
Phone.(54 9 (12- 07 50 I Fax: (5(3) 892- 0,541 Hose bib 16.60
' ; EAPPLICANT' -. - - _I :CONTACT PERSON, • Ice maker 16.60
Name: 1>lcli?E L. QP..Cju'i' S 4 OCUH' I _ti% Interceptor /grease trap 16.60
Address: 9560 S+J &t•e. Buie, Ki-111:., Su lit ZZc) Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: Poerti , Cl` ai'L 1 Roof drain (commercial) 16.60
Phone 3)892- 5758 Fax e.2. b &4/ Sink/basin/lavatory 16.60
E -mail: krA+r;lc. CI.iL1rrjf,Jhacce9G. Gdr,,.. Tub /shower /shower pan 16.60
' • • CONTRACTOR Urinal 16.60
Water closet 16.60
Plumbing Experts Inc Water heater 16.60
1 1925 SW Parkway Other:
Portland OR 97225 -5413 Other:
503 -469 -0443 . r; •• Plumbing Permit Fees* _• .-
Subtotal $ S 5 o . °,
C CB: 149035 PLM: 34-391PB Minimum Permit Fee 572.50 $
Authorized / /� Residential Backflow Minimum Fee $36.25 _
Signature: Date: Z� Plan Review (25% of Permit Fee) $ -
U L &Wi State Surcharge (8% of Permit Fee) $ 2 S • 0°
(Please print name) �
TOTAL PERMIT FEE $ Z _•
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans cu -
180 days after it has been accepted as complete. riser diagram for plan review.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\Dsts\Permit Forms\PlmPermitApp.doc 01/03
j ��� : ) ''�'� F.OR''OFEICE'.USE ONLY. . ; y 1 fi
Mechanical Permit Application Received , Mechanical ``,,�
® Date/B . Permit No.t'7.5 0 -/ . 79
I V
E I V Planning Approval Building
' City of Tigar Date/B . Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 JUN 7 2003 Date/Bv Permit No.:
p2 - 93 11 6 � Post- Review Land Use
Case No.:
.o
Phone: 503 - 63911171 Fra OF TiGA //_ tt Post - :
Internet www.ci.tigar ^�
t i � 'I r � L` �� Juris.: ® See Page 2 for
e3 T!9�t4'1v /D'aC� Contact
24 -hour IIISpection RequnW 9 Epiv/D' i `�' Name/Method: Su .lemental Information.
.TYPE OF' WORK, . ° >.
; r:., ,: COMMERCIAL FEE* SCHEDULE . USE CHECKLIST ,-
,'New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION: mechanical materials, equipment, labor, overhead and profit.
Hl & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
RESIDENTIAL EQUIPMENT /SYSTEMS. FEE
*
ril Accessory Building ❑ Multi- Family Description Qty Fee(ea.) Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 1 14.00 144
Job site address: (O9/ S 5u) ( � o t A-U Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work I 14.00 (i{."'
1/� KS 1K � � Hydronic hot water system 14.00
Project Name: TO W �01M +ES Residential boiler
Cross street/Directions to job sit (for radiator or hydronic system) 14.00
.SLO j'T 1 '` / 1-v (J � SW /4A'e Unit heaters (fuel, not electric)
`gehrzI s'7Y2f.41i (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10. '
� A r �
Subdivision: I< I 1✓�t �D Lot #: 1 Repair units 12.15
Fuel Appliances
Tax map/parcel #: Water heater 1 I 10.00 Io. `
DESCRIPTION OF WORK Gas fireplace 1 10.00 I0.'�`'
/ . � �--� Ln � 0 R /1(E IA ) , S Flue vent (water heater /gas fireplace) 2., 10.00 , 2f1. i .
(�C•�' - � t Log lighter (gas) 10.00
�( LJ� � OD J � � � � Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
. .
.'�PROPERTY :: .•� 0-T ENANT = ' :. - Other: 10.00
Name: tvi 4 K -1'o w4 I t►4 E s LLG Environmental Exhaust & Ventilation
AVIV ! v t'/ �` ) Range hood/other kitchen equipment I 10.00 10 . tu
Address: (36 Sh/ X26(/1? 0/4 / Sl/ l7 Z w Clothes dryer exhaust I 10.00 (p . °Q
City /State /Zip: Pa2TL 4'J die `
P� � 8 0-CONTACT 892,-884( Single duct exhaust n 4°
Phone: 503 Z- S Fax: (5.) S) (bathrooms, toilet compartments,
• ($'APPL CANT 6.80 �U •
CONTACT PERSON utility rooms) 3
� ,: � - � �
Name: 1> 4. &awt.) s /4-Siccm-+'C- i Jc • Attic/crawl space fans 10.00 .
Address: C( c 7/Va (Z Vick, ZZO Other. Fuel Piping
City /State /Zip: � / cot ,9-72-19 LC] * *($5.40 for first 4, S1.00 each additional) ,
Furnace, etc. I **
Phone:(So3) N2.-0150 Fax: �3�t�2-�Ge4( Gas heat pump ** ,
E -mail: y piz-1_ C d 1 brown0.S'SUC : C Wall /suspended/unit heater **
CONTRACTOR' :,;, Water heater 1 **
Smart Heating & Cooling LLC Fireplace I **
Range ;
ge 4.* 7616 NE Everett St Ran **
,
Portland OR 97213 -6347 Clothes dryer (gas) ** -
503- 254 -5096 Other: **
Total: 3 _ s+ gfl
C CB : 154133 Mechanical Permit Fees*
Authorized 7 I ( � /Z /01 Subtotal: $ 12. 3. 90
Signature: / Date: Minimum Permit Fee 572.50 $ -
13RuG & ( /)�, 1 r Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 3 4 40
TOTAL PERMIT FEE $ 4,
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i :\Dsts\Permit Forn s\tvlecPermitApp.doc 01/03
A
CIT TIGARD 24 -Hour
-BUILDING III Inspection Line: (50 . q 6 ., 75 • MST 3 "0'° D-7 Y
INSPECTION DIVISION Business Line: 5 " °- 1
(',"" BUP
Received Date Requested 6 - ' 7 AM PM / BUP
Location / 0 q 6,S / 3-4 �'L" �-u''e� Suite // MEC
Contact Person Ph ( ) 4%6 —`C 7 q 7 PLM
Contractor Ph ( ) SWR
a U e Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear '� /� c p 1 s Ly ,�,
Framing ; : V • `�•
Insulation < A . L 5 , z� Ste.. - y 1 L . re
Drywall Nailing •
Firewall . 9 0 ��
Fire Sprinkler v °
Fire Alarm
Susp'd Ceiling
Roof /
Other: P
411120 PART FAIL
• • , BING , c
• • st & Beam ekjtrt} j
Under Slab 1
Rough -In
Water Service
Sanitary Sewer
Rain Drains Catch Basin / Manhole (I/1
Storm Drain ' /
Shower Pan
Other:
Final
*ASS PART FAIL,
ANICAL _1 .. •
Poste:' j ` „ .,;,•;_f
Roug 4 /
Gas Line, j,rd''
•.. %-- mper
f. SS PART FAIL `
- LECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date e\ -7/3 Inspector Z” Ext
Other:
Final DO NOT. REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour { •
BUILDING Inspection Lin 639 -4175 •
INSPECTION DIVISION ` " Business Li - MST �� tea.
• -4171
BUP
Received Date Re nested VII AM PM BUP
Location /eM l Suite MEC
Contact Person 6/41.1 ( ) F66, _ 4 Fq —7 PLM
Contractor Ph ( ) SWR
CBUILDII Tenant/Owner ELC
Foot
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors ,
Ext Sheath/Shear
Int Sheath/Shear
Framing ' ` -L, m P -e.r/7 S�
Insulation / '
Drywall Nailing - . ∎ 4 �" j � '
Firewall / /
Fire Sprinkler "' ` `� 4# l a
Fire Alarm '33, C/ 1 ' / — e--------Q-- { _.Q_. G ' d ,
Susp'd Ceiling
O
Roof
Final
■
- PASS PART' AIL
PLUMBING '
Post & Beam
Under Slab
Rough -In
Water o, trZt )46
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
=VIOL
am
Rough -In
Gas Line
t Smoke Dampers PART
ie CTRICAL ‘ 11 . 1 ' l � 4 �//, . L-e- _ ki/Q Service /�
Rough -In ! S d. - t. - —
UG/Slab 0 I
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line 4?t'
ADA Approach/Sidewalk Date ' \ /U ' I nspector �� Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour -
BUILDING Inspection Line: (503) 639 -4175 MST 3 - 0 ?-74,4
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested �// AM PM BUP
Location /0 q/s /30 Suite MEC
Contact Person Ph ( ) 7b& — '/ ? '7'7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors ��-
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ��.p
Drywall Nailing ! i t (/ �` 'V
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ECTRICAL
Se
Rough -In
UG/Slab
Low Voltage
Fire • larm
4 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA .Date (� — 1‘ ✓ 0 (� Inspector / 1�- -t tiL.y Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour - , ,
BUILDING Inspection Line: (503) 639 -4175 MST ° �Gd3 —00 7 `(
INSPECTION DIVISION ' Business Line: (503) 639 -4171
BUP
Received Date Requested 6 - /0 AM PM BUP
Location / £ 96.5" Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing /
Firewall
Fire Sprinkler �_ __ ' -
%ii /
Fire Alarm /
Susp'd Ceiling
Roof
Other: j Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other
PASS PART FAIL
ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date
if '" Inspector )7rj Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
2050 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003 -00274
Date Issued: 11/3/03
Parcel: 1 S133AC -HB001
Site Address: 10965 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 001
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
Your company has been indicated as the electrical contractor for the permit indicated 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 to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC ELECTRUM INC
9500 SW BARBUR BLVD., STE 220 DBA SPECTRUM ELECTRIC
PORTLAND, OR 97219 2050 VISTA AVE #100
SALEM, OR 97302
Phone #: 503 - 892 -8758 Phone #: 503 - 361 -1256
Reg #: LIC 116453
SUP .a2 3 .S
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X ;'/—
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
PLUMBING EXPERTS INC
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
Plumbing Signature Form
Permit #: MST2003 -00274
Date Issued: 11/3/03
Parcel: 1 S133AC -HB001
Site Address: 10965 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 001
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC PLUMBING EXPERTS INC
9500 SW BARBUR BLVD., STE 220 11925 SW PARKWAY
PORTLAND, OR 97219 PORTLAND, OR 97225 -5413
Phone #: 503 - 892 -8758 Phone #: 503 -469 -0443
Reg #: LIC 149035
PLM 34-391PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X 7//,_ 7 .2 7 . ,"& 4 - e-
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
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