The URL can be used to link to this page

Permit A, CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00130 101104 DEVELOPMENT SERVICES DATE ISSUED: 5/6/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S125DA-01001 SITE ADDRESS: 09095 SW 66TH AVE ZONING: R - 4.5 SUBDIVISION: LOT: JURISDICTION: TIG Project Description: 1200 sf. addition BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 28 FIRST: 571 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 758 sf GARAGE: 348 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 0 THRD: sf RIGHT: 5 VALUE: 131,256.00 OCCUPANCY GRP: R3 BDRM: 2 BATH: 1 TOTAL: 1,329 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: l VENT FANS: 1 CLOTHES DRYER: 1 FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: I W/SVC OR FDR: 3 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: 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: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes JOAN JOHNSON /SCOTT HALL OWNER and all other applicable laws. All work will be done in 9095 SW 66TH AVE accordance with approved plans. This permit will expire TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 Phone: 503 - 475 3180 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 -001 -0080. You may obtain copies of these rules or Reg #: direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 1,913.11 1- 800 - 332 -2344. REQUIRED ITEMS AND REPORTS Issu Permittee Signature : 6 ""a 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. v -, Building Permit Ap ke 1®E' V E FOR OFFICE USE ONLY J Ci}�� R Tigard Date/By: � of Ti and y : 1 / t cis /5� Permit No.: ST `i___0 � /3 • ` 13125 SW Hall Blvd., Tigard, OR 97223 A�3K 1 1. 2 oo� Plan Revt w ✓ Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 t'` - Date /By/v14.1/ 1 1 – .2 9 .r)S inspection Line: 503.639.4175 1 -Vi OF TIG -' r!, A I Date Ready /By: _ furls. E Sec Attached Checklist for Internet: www.ci.tigard.or.us C DI ONI w Notified/Method:� Q � r., • Supplemental Information TYPE OF WORK REWIRED DATA: 1 AND 2 FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ` Addi tion/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. cl xi. ; _ c ' ` ❑ 1- and 2- fancily dwelling ❑ Commercial /industrial Valuation: $ 91070 e Q 00 ❑ Accessory building ❑ Multi- family Number of bathrooms: Number of bedrooms: / ❑ Master builder ❑ Other: JOB SiTE INFORMATION AND LOCATION Total number of floors: Job site address: 90 9c 5 �J (Po AV New dwelling area: / t) \ square feet City/State/ZIP: rv1 y � , O/2 q7 2 .3 Ga ra g e /ca rport area: .Z-o S square feet Suite/bldg. /apt. no.: Project name: —.JO/11/6 pp) #6 f/ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet (?10 9 O lA h ei �y /0c i Other structure area: square feet � h /� & th' / ,T d, -rou � j7 � h 10 REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESSCRIPTION OF WORK LL work indicated on this application. ,S /.0,1 addaip,„) l ex/d7 h01�>� Valuation: $ Existing building area square feet New building area: square feet ,PROPERTY OWNER ❑ TENANT Number of stories: Name: (....0 A 14 S h n Sd v) Type of construction: Address: 70 4:7 3 w t j/ Occupancy groups: / City/State/ZIP: s R O l e_ Existing: ' 3J Phone: (03) of y j Fax: ( ) New: ,FKAPPLICANT ,CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: �a 0 �011 n ,Sd{' ey, Sfi A/4/� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax: : ( ) 261 . E -mail: I CONTRACTOR Business name: Oyvi e o W f e_r BUILDING PERMIT FEES* Address: /1-/ / Please refer to fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) Fax:( ) Amount received CCB lic.: Date received Authorized signature: join ...._� This pe rmit application expires if a permit is,,not obtained within 180 days after it has been accepted as complete. Print name: D y\ Date: 3//0/0_5°'' * Fee methodology set by Tri- County Building Industry / Service Board. t i:\Building \Permits \BUP- PermitApp.doc 12/03 440-46 13T( I I /02 /COM /WEB) One- and Two- Family Dwelling ' FOR�O Building Permit Application Checklist �` 4y r F FICE tUSE ON ,� � ,1 � ` ,gz.� City of Tigard Date /Bed Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 i Phone: 503.639.4171 Fax: 503.598.1960, I Associated p 24- Hour Inspection Line: 503.639.4175 i � Il ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us = ❑ Other: •TH E'FOLLOW IIst'G EMS ARE REQUIRED FOR EAN PREVIEW � r 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 comer elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be as slicable to the sro•ect under review. . , „JURISDICTIONAL 7� � �., 0.1 •', h .:. � 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2” x 11" or 11" x 17". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. , ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions 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:\Buildi*ig\Permits \One - Two - FamilyChecklist.doc 12/03 r Electrical Permit Application City Of Tigard FOR OFFICE USE ONLY c IV ED Date B y Permit No.G� _ ex) i �� 13125 SW !fall Blvd., Tigard g.G [� Plan Review '1 Phone: 503.639.4171 Fax: 0 )8.1960 l j Date /By: Other Permit: Inspection Line: 503.639.4175 O �- �'' Date Ready /By: Juris m See )'age 2 for Internet: www.ci.tigard.or.us p,pR 1 2005 Notified/Method: Supplemental Information GI '... (jij ag I ❑ PLAN REVIEW New construction d d i`bt t eJ �rer� o t n / n replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ❑ Hazardous location ❑Service over 320 amps — rating ❑ Buildn over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building System over 600 volts nominal units in one structure ❑Building over three stories ['Feeders, 400 amps or more ❑ Multi - family 0 Master builder 0 Other: ['Occupant load over 99 persons Manu factured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park � ll /� ,Q, G ❑Health -care facility ❑Other: Job no.: Job site address: 4JQ�� S ( / v (f/ [C� ! ` Submit 2 s ets of plans with any of the above. City /State /ZIP: / ( L ,- / � ''712- 3 The above are not applicable to temporary construction service. Suite /bldg. /apt. no.: Project name: FEE* SCHEDULE Description Qty. Fee. Totu1 Cross street/directions to job site: New residential single -or multi - family dwelling unit. Includes attached garage. l ,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add') 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular CO� / dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation e4( 5 �/n 5 / ' '� C is II 200 amps or less / 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: l oa v , 1- / y'qri f..-L. 601 amps to 1,000 amps 240.60 2 Address: 70,5 ' 1) 66 f1., Over 1,000 amps or volts 454.65 2 �/ �J 7 Reconnect only 66.85 2 — 774/7 Cit /ZIP: f /`'' l /�� Temporary services or feeders installation, alteration, and /or ( ) 6:?... C 6 r3 S / , `� ( ) 2000 0 amps relocation f Fax: Phone: mps or less g' 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 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'! branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal / Suprv. Electrician signature, required: Plan review (25% of permit fee) — State surcharge (8% of permit fee) Print name: J i � _ �� r Date: / �� l l v TOTAL PERMIT FEE This permit application Authorized signatu expires if a permit is not obtained within 180 / days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board " Number of inspections per pemit allowed. i:\ Building \Permits \ELC- PermitApp.doc 12/03 440- 4615T(10/02/CObt /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: CO i i RCIAL:WORK Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) 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 is\ Building \Permits\ELC- PemtitApp.doc 04/03 • Mechanica 0 EAM Cat10II FOR OFFICE USE ONLY City of Ti gard g � 200[ Received Permit N 13125 SW Hall Blvd., Ti ar 9 Phone: 503.639.4171 Fax: 0 3.598 r �� d Plan Review � Date/By: Other Permit: Inspection Line: 503.639.(i11f�� Or� v A �S R� ,cs lO .f � i ��{{ F W Date Ready/By: y: Juris: See Page 2 for Internet www.ci.tigard.o , p 1 Notified/Method: Supplemental Information { . ^ ,i ' , _TYPE OF WORK r ' , z .: . 'COMMERCIAL F SCHEDULE_ = 'USE CHECKLIST' ❑ N c o n struct i on ❑ Ad ditio n /alter a tion/rep l acem en t Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. ' `" , Y CATEGORY OF CONSTRUCTION N Value: $ El 1- and 2-family dwelling RES IDENTIAL EQUIPMENT / FEES* y g ❑ Commercial/industrial ❑Acc building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB S TCE I NFO Air conditioning or heat pump RMATION A1V 1 OCATION z Heating/cooling Job site address: ! D s— S C� 6. L / 1 ,.p / t Y (requires site plan showing placement) 14.00 City/State/ZIP: % 7 g - ! 0/2.... e7-7 "� Furnace 100,000 BTU (ducts /vents) ( 14.00 Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 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. 10.00 Subdivision: Lot no.: Flue/vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances ,� Water heater 10.00 ` DESCRIPTION OF WORK ;- ` z:_ . - d Gas fireplace 10.00 I /. L/? 0 I - _ d, I / tom 4_47_4 , Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 - Chimney/liner /flue /vent 10.00 ® PROPERTY OVPNEIt I _' ® TENANT :r Other: 10.00 Name: vi To ! h 11 S O Environmental exhaust and ventilation of Address: O l , W ; / " Range hood /other kitchen !/ ( ( 1 ; L f h, (O � equipment 10.00 City/State/ZIP: f/j " a r f OJ _ 2_3 Clothes dryer exhaust / 10.00 /% i Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) ( 6.80 `� .�1 APPLICANT x t , , ® CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: ova In ji3An s Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/ State/ZIP: Wall/suspended/unit heater Phone: ( ) I Fax: : ( ) Water heater Fireplace E -mail: Range a - i i CONTRACTOR F ... , _ Barbecue Business name: ' 0(44,1e4,— Clothes dryer (gas) Other: Address: 0.''',,,i: ....: MEC PE FEES City/State /ZIP: Subtotal 7 co Phone: ( ) I Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) 5•gc) 1111/ lip TOTAL PERMIT FEE Authorized Signature: This permit application expires if a permit is not obtained within � 180 --� days after it has been accepted as complete. Print name: T ,,../ V u OF s �rN Date: L l / /!/ j D� ' Fee methodology set by Tri- County Building Industry Service Board pp i:\Building\Permits \MEC- Permit pp doc 12/03 440- 46I7T(I1/ COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • Commercial Fee Schedule: Total Valuation T Pe niitFee;) tiog g . , a $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 12/03 2 • Building Fixtu CEIVED Plumbing Permll Ap licatio FOR OFFICE USE ONLY City of Tigard APR 1 1 UM Eew l Permit No.: 13125 SW Hall Blvd., Tigard, O T iCX' -_ 3 i7 Phone: 503.639.4171 Fax: 5 1 DIVISION / /elgi ill iA +h Date/By: Other PermitNo.: 24- Hour Inspection Line: 50t�t c LTIGARD „ ra Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information `° d TYPE OF W ORK t •I, .. y f a FEE `: SCHEDI)L E” ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) = r ' c 4 “ CATEGORY OF CONSTRUCTION r SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45 00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 s JOB SITE TPTFORMATION iAND LOCATION . ` 4-r ' :?;., -. , N. : $„ r : . - -...._ �., ._,- ... - ,_. _., ., . .. z. - .._.. ,,x .,_. -. _. Site utilities Job site address: 0 6/ 6' 12 4 ' Catch basin or area drain 16.60 City/State/ZIP: /q c7 Drywell, leach line, or trench drain 16.60 Ili r Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: job Gt (or S v-- � y Manufactured home utilities 110 00 Cross street/directions to ob site: /414e 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 . „ i ., , , t D OF�WORK ; 1 t4 ? „y r - a t Backflow preventer Page 2 / S A 4 j .r 0 Backwater valve 16.60 Clothes washer f 16.60 Dishwasher 1 16,60 ux ) • - Drinking fountain 16.60 s< z >:.' ® +•PROPERTY OWNER rr. r ,❑, TE t = ' .., Ejectors /sump 16.60 � ''_"�,� / Name: � a0 T10 /1hsoin Expansion tank 16.60 Address: D �� , Fixture /sewer cap 16.60 City/State/ZIP: 77q ur f/ ore_ /7�3 Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 n,� s Hose bib 16.60 < t .< ,, , 0 F AP P LICANT v ° D CONTACT PE re Ice maker 16.60 Business name: c c 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/b tn/lavatory) 16.60 Tub /show shower pan / 16.60 E -mail: Urinal 16.60 . u C CTOR ?`t a 'L � .,. �ts ; -.... �`' :� .. ,.-< - ., .a?` ..._.. . � si.. ..= 1” ,r ° ;" Water closet / 16.60 Business name: o w / e r Water heater 16.60 Address: Other: City/State /ZIP: Subtotal b3 4y?) Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: ■ Plumbing Lic. no.: Plan review (25% of permit fee) ,� / State surcharge (8% of permit fee) C .g Authorized signature: /f'!./� t / TOTAL PERMIT FEE 1 � A E�� Date: /MEM This permit application expires if a permit is not obtained within r 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Pemtits\PLMF- PermitApp.doc 12/03 440- 4616T(1O /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site .Utilities e;° Q Fee (eat-, Total Square-Footage , P ermit F ee Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Storm &Rain Drain - 1st 100' 55.00 Valuation ��, Permit Fee, :; $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 dr:Item s Qty.. Fee (ea) Total;:`. additional $100.00 or fraction thereof, to and ' � including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to 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. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . . Quantity by (Fixture) WorkPerformed Fixtuure Type - Replace • yew Moved _ Existing„ Capped Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" -3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach./Refrig. Drains p Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: is\ Building \Permits\PLM- PermitApp.doc 3/03 Permit #: MST S T O 5--cool Address: i 341 5 5 k.,e) ' Issu by: Date: 5 cY p Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: 5 A.4 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. f 1 441 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the .Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with-a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Proper Owners about Construction Responsibilities on the reverse side of this form. • ./% lif ' S li a5 (Signature of permit applicant) Date) (White copy to issuing agency permit file, - pink copy to applicant) - . Information-Notice te' ` '� _ About Construction Responsibilities • ' • ` ' ' • • �n Responsibilities the (Iin.■'nuiiox/CwitnuYo/�#oit,d/npcco/ohmcc with ORS 70/.Vjj(5). - -' you are acting as your own contractorto construct a new home or make a substantial improvement to an existing structure, you can prevent pa xyp/ub|cm�hybcin�o�m�o[\heG/Uu` ingrcsponsibi|kicsuodareas o[conccrn� ' ' ` ` • ''' EMP RRESPONSaLMES: i f you hire persons pot registered with the Cons,truction, contractors, Board to do labor in Constructing 0r assisting in the construction nrimproVcn\cn<'o[o residential srUc[onc will, in most inslunucs,hc ruled \obchneMp|uYo, and the people you hire vv0brom . As the cmn1ovc�. you mu�oomp|�\viUh thok`UO��ing: ' ' . Oregon's withholding tox|a‘V: /\/no employer, you muSt\v(thhoN(ocomctxxeS from' omp| cwageoat the time employees • are paid. You wiUbeUah/efor' thc•/ax 'payments cvenJ ynodon'tuc/uoUywiUhhoW[hcuz6on yu0remp|byces. For more • information, call the Oregon Dept. ofKcvunnucld94y-80Yi . • ' '' .'. . ' ` � �� • Unemployment insurance tax: As an employer, you are required to pay a tax for unemploy insurance purposes on tile wages oI all employees. For more information, call the Oregon Employment Dcpnrtmen1oi 78'3524. • Workers' compensation insurance: As an cmplover, oyer, youare,subjecttp the Oregon Vyork�dCompensation and must obtain workers' compensation insurance for your rm.|ovoe». |fyou fail noobixiu workers' compensation insurance, you may, bos � |t�ndviUbe|iuh|c[brxUdoimco�si[u si injured b For information, . ., �su ' , ' ``.. _ x�m�vu/ employees /Y Y U d�� /�,k�� z�� h�U� Div� � � �coo '/� of . 6 � �` �� ca n p� mn /amou|�b� . �m� o [ usomcrooJ8ium�si��p/i�csm94j�78O� '.� • //. ' • ' �`� `' • • 0.S. Internal Revenue Sorvicr: As an ernplover. von must vithhoid federal income tax froni eniployees wages. You villbe |iub|c[br the m \ actually . ywi�hho|d�hc\usFurmorciufbcnab U information, roa|FevcnoLSccr�co:: • oL\'8O0-8Z9 • _ -` • '. . . • ' ` • • • OTHER RESPONSIBILITIES AREAS .F:CONCERN:' • Code compliance: /\ydhe permit holder for this project, youorcrcyponsih\r5oroso|ringanyfbiiurcfomuucodcrcqxi,cme/to that niav be brought to vour attenton through nspections • . Liability and property damage insurance: Contact . your insurance agent to see iF!nu have adequate insurance coverage for accidents and omisdOns.00chus falling uvz\s, paint, ove/sp/ay, water damage from pipe punctures, fire. or work that rnust be re-done. ` � ' _ ` ~' � '' '' ' �� . �� , / � . Time Make �k�sur�,buho�csu0ic��!\ir� u �io� .iv��our unp}ov��s. - . mo Expertise: Make sure you have the expertise 10 act as vour own general contractor, 10 coordinate the work of rough-n and flnish {rudes.uodto notiyvhui|ding Officials utlhe'` inu'riunc s0lbe, can perform the required ihpuzhons. If you have uddi\iunu| i write urcall the Construction Contractors Board (PO Box t4\40, Salem, 0KY7S0n-505Z 503/378'462}). fte Board is located - u 700 Summei Si \1I Suite ]0V.inSalem. . � . �` � � . • ' pro y*uv.pm 1194 .�` . � ' '. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 110130 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/612005 Phone: (503) 639 -4171 �' Inspection Requests (24 Hrs.): (503) 639 - 4175:_ . INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7 :01AM PAGE: 77 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: • TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition, 717/05: Added (1) temp service. 1/19/06, adding a/c. OWNER: JOAN JOHNSONISCO1T HALL, PHONE #: 503-2469746 • CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 039237 -01 503 - 2463146 Y Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V 06 Date: li ' 3. 0 b Phone #: (503) 718- 4' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/612006 Phone: (503) 639 -4171 mow, ill Inspection Requests (24 Hrs.): (503) 639 -4175 ', INSPECTION WORKSHEET FOR DATE: 10/17 /2006 TIME: 7 :O4AM PAGE: 100 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. 1/19/06, adding a/c:. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503 - 246 -9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/17/2006 . Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 030249 -02 503 - 246-3146 `L Corrections /Comments /Instructions: RLY•lbe Vtikagt. okrn5zot. 1 a c. 6r d - p0.01 L se4aP0 La . t oi. 4 \ - --S< lam. wea_ vtsl . PA L... ,(,(0 s�c�v ►�� G2-� I CA 4)1 suve() (Ltsty, wq4- kagEt, N �-- Q�� J o a o ts& d-4 w L iki lL °T 1--- d o w4Ea tkolea._ w. 'rlk otsopiftes , roc 1. Y P-Jea.447 1 ■J 6F . Pik 1_ n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS A FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • NA A 6 a Date: 0 (1 1( 06 Phone #: (503) 718- 2.4410 CITY OFTIGARD BUILDING DIVISION PERMIT #: ivIST21 0500130 13125 SW Hall Blvd., Tigard, OR 97223 ;' DATE ISSUED: 5/8/2005 Phone: (503) 639-4171 Ali .�.�"r�if�� / Inspection Requests (24 Hrs.): (503) 639 -4175 F __ J INSPECTION WORKSHEET FOR DATE: 11/1/2006 TIME: 7:03AM PAGE: 113 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. 1/19/06, adding a/c. OWNER: JOAN JOHNSON/SCOTT HALL, PHONE #: 503 -246-974 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/1/2006 Pour Time: 0 Code # Inspection Description Confirm # Contact # .s- age : rt '799 Final insg�ection 033155 -01 503-246-3146 Y Al P Correctio s /Co ents /Instructiions: C -6 ) ." (..L.-."-jr, '‘. It, s".,_ --1„: --- 254/1----- r DIfi 1.q •5 I -6 ` • t■) 6 IQ 6 -- i 1 S -_C KI 6A-e , ikpb (1.5--c \k,5,e_ 1,,, p-- 3 7.:____ k-----v < \z_e____e ' i ❑ PASS 7 PARTIAL APPROVAL LI CANCEL n NO ACCESS FAIL 7 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Wzic C / /�/ Date: ii 1 O f Phone #: (503) 718- 2-(7/ - - -"- CITY OF TIGARD BUILDING DIVISION A PERMIT #: MS D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 5/6/2005 Phone: (503) 639-4171 Aiswit A, Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/17/2006 TIME: 7:04AM PAGE: 99 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK:. SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 717/05: Added (1) temp sentic:e. 1/19/06, adding aft. OWNER: JOAN JOHNSON/SCOTT HALL, PHONE #: 503-246,9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 038249-03 503-246-3146 - Y ' Corrections/Comments/Instructi ns: .ji. -- I?) bq ) . LI !. 4... .. /..„:„........ci V3 I 1 VIA 1-1- i ta v& ,j ----) Lke.„(2„,,_,Lp_____ 1,04.7k_ , N„),..AA . --C- V?„e_ C._ -; Le-I -e-rj• 1 C- 12_,Q_C) ‘---v■.. c r (DY•rxrk ---- ■ c.) Cd& S 6 S O PA 1 n PARTIAL APPROVAL ADDITIONAL FEES ASSESSED CANCEL • Li CALL FOR INSPECTION fl ADDITIONAL NO FAIL ACCESS I/6 (i Inspector: Date: 1 bil --2 Phone #: (503) 718- t i 2. 1 . . _ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200Fr00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2005 Phone: (503) 639 -4171 .16I��jll Inspection Requests (24 Hrs.): (503) 639 -4175 �_!+� I -_., INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: T:04AM PAGE: [3 SITE ADDRESS: 09095 SW 56TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 O. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503 - 246 -9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12116/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 02354601 503- 246 -3146 Y Corrections /Comments /Instructions: ft K\ • • PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: rir Date: !/ 15/6J Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/612005 Phone: (503) 639 -4171 ' , P;' A Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7:01AM PAGE: 76 SITE ADDRESS: 09095 SW 6tT €€ H AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp servic:e. 1/19/06, adding aft. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503 - 246 -974; CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 039239 -01 603 - 246 Y Corrections /Comments/ Instructions: VA) A PASS (l PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ ` FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N 08 Date: I I 3 • Ob Phone #: (503) 718 - 2 -44 k) CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2O05 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2005 Phone: (503) 639 -4171 ON � ' � l Inspection Requests (24 Hrs.): (503) 639 -4175 . ' °__.. INSPECTION WORKSHEET FOR DATE: 10117/2006 TIME: 7:04AM PAGE: 101 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7105: Added (1) temp service. 1/19/06, adding a/c. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503-2469746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10 /17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 038249-0/ 503. 246 -3146 Y Corrections /Comments/ Instructions: C7 i -%Y' — — ..- ■ k.M 11 -1-.._ 7 1. r /26 ^ 7\ 4 ri71 n i r Jr ! n`, -; PASS ►: ' 4 RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1 I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: l Date / /7 ! / C Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #:,T 2006 C;c9130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/200E, Phone: (503) 639 -4171 y , i Inspection Requests (24 Hrs.): (503) 639 -4175 . .. 1 4 "4 � INSPECTION WORKSHEET FOR DATE: 2/17/2006 TIME: /:06AM PAGE: 11 SITE ADDRESS: M095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOI-INsoN DESCRIPTION: 1200 sf. additi os7. 7/7/06: Added (1) temp service. 1/19/06. addirlg a#c. OWNER: JOAN JOHNSON/SCOTT HALL, PHONE #: 6o 46_97 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/1712006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final • 02,120 -01 603-246-.314 . a • Corrections /Comments /Instructions: • • El PASS II PA IAL APPROVAL • ❑ CANCEL ❑ NO ACCESS M FAIL % L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' Dat / Phone #: (503) 718- • CITY OF TIGARD 7a40 _ �� ' BUILDING DIVISION . PERMIT #: Mgt - 001: 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2005 Phone: (503) 639 -4171 4 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/6/2006 TIME: 7:00AM PAGE: 1 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp ..ervir:o. OWNER: JOAN JOHNSON/SCOTT HALL, PHONE #: 503- 2469146 • CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/5/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 024438 -01 603421-2617 N Corrections /Comments /Instructions: ( Vil )4 / �o�` PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ LL FO 1►'`- P TION ❑ADDITIONAL FEES ASSESSED Inspector: 1.444 — Date: Phone #: (503) 7 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 &00130 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/612005 Phone: (503) 639 -4171 �� Inspection Requests (24 Hrs.): (503) 639 -4175 .�� INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 7 :0 PAGE: 6 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7 /7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503-246 -9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 023550 -01 503-246-3146 Y Corrections /Comments /Instructions: Sc,45-7 l'i rti\ \IAN . 2 oLc s l el IA fRv• . v1 cam. a - o _ 6 ,∎ rrv\ 61 1 P kNCA ___ __, 7 1 1C 1 4PAD 'OM uNi3\utivik" i) 9A- )0,--N- a \ -q$ L. Mr c .c>N16 dos -- t (toky 4(4 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS A FAIL CALL FOR . NSP> ❑ ADDITIONAL FEES ASSESSED Inspector: Date: i I 6 Phone #: (503) 718- 24 ' , 1 I i - - 1 1 i i ... OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2005 Phone: (503) 639 -4171 .�!�! i�,ugn�,i l l l ; l � Inspection Requests (24 Hrs.): (503) 639 -4175 ,r- - __:; INSPECTION WORKSHEET FOR DATE: 7/1212005 TIME: 7:06AM PAGE: 21 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: '603 -246 -9746 CONTRACTOR: OWNER PHONE #: 503 - 4753180 Inspection Request Scheduled For: Date: 7/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 Temporary electrical service 011239 -01 503 -421 -2617 Y Corrections /Comments /Instructions: K PASS ❑ PARTIAL APPROVAL, ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cr % N 68 �t. Date: - 11 Phone #: (503) 718- 2-444) CITY OF TIGARD rTh BUILDING DIVISION PERMIT #: ivtsT2005 00 30 1 3125 SW�HaII Blvd., Tigard, OR 97223 DATE ISSUED: 5/612005 Phone: (503) 639 -4171 att■ 1 �4�i�I�II: Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/11/2005 TIME: 7:07AM - : PAGE: 7 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: : 1200 s'f. addition. 7/7/05: Added (1) temp service: �� OWNER: JOAN JOHNSON /SCOTT HALL, Ay -LO �� PHONE # :• 503- 246-9746 CONTRACTOR: OWNER PHONE #: 503- 475.3180 Inspection Request Scheduled For: Date: 7/11/2005 Pour Time: Code # Inspection Description C • • ' # Contact # Message 110 Temporary electrical service 0111159,01 503 - 246 -3146 N Corrections /Comments /Instructions: CD p . RA3v r E L C. (Z,4 CAL - P1=CZw►ti CARb 0s - rte L 'Re I cuL- i 0 6741 -4j0 on) c a v.)pf 1 �� W ,v■ C5 14411Z V\c'v ti e , ❑ PASS ❑ PARTIAL APPROVAL. ❑ CANCEL ❑ NO ACCESS *FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: R lv VsJ Date: 1 4 Phone #: (503) 718 - 2-9Ll CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/6/2005 . TIME: 7:12AM PAGE: 75 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: 'JOHNSON DESCRIPTION: 1200 sf. addition OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503246.9746 CONTRACTOR: OWNER PHONE #: 503-475-3180 Inspection Request Scheduled For: • Date: 7/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 Temporary electrical service 010765 -01 503-246 -3146 N Corrections /Comments/ Instructions: • ❑ PASS yg PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � � / 411/ _ _ Date: �` 5 Phone #: (503) 718 - I CITY OF TIGARD • BUILDING DIVISION I. PERMIT #:p 00 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: A:J-2 r1J Phone: (503) 639 -4171 ..�ttbv�a��1� Inspection Requests (24 Hrs.): (503) 639 -4175 :�'!+r` ''__.. INSPECTION WORKSHEET FOR DATE: • 7/ gl�1�Ci TIME: 7.(3>-AM PAGE: 10 SITE ADDRESS: 09096 SW GGTH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ,9i:31�h4;y�. t1 DESCRIPTION: 1:00 sf. addition. 7 /7 /OE: Added (1) temp service, 1/19/06, adding rz/c. OWNER: JOAN JOHNSON/SCOTT HALL, • PHONE #: r f2,2r1w)74# CONTRACTOR: O1/l'lER PHONE #: Inspection Request Scheduled For: Date: 2/170006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mech<a+ final 027120.02 fiO3•24G.3146 `t' Corrections/Comments/Instructions: P c 6 R/ 1W4 ' () ' 6 f-:12. q -i,G2. • • k/ ?goy/ b 01'1,C,. k 66 / s`Z .S 1I :k og .1 "1 PASS I P' IAL APPROVAL ❑CANCEL ❑ NO ACCESS n FAIL L FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: Date: 706 Phone #: (503) 718 . �• CITY OF TIGARD in sr BUILDING DIVISION PERMIT #:..20 66-0° ( ,3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 t Inspection Requests (24 Hrs.): (503) 639 -4175 ''I INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: G 6 95 66, CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: inspection Request Scheduled For: Date: /— /3 Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: Otee& y PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ! Date: 1 ' 0 Phone #: (503) 718- 27 1 " CITY OF TIGARD BUILDING DIVISION PERMIT #: ST2005-001:30 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: • 5/6/2006 Phone: (503) 639 -4171 Atoth rI Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/12/ 2008 TIME: 7:02AM PAGE: 19 SITE ADDRESS: 09095 SW 6Ef t H AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON/SCOTT HALL, PHONE #: 503 - 246 -3745 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/12/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 260 Insulation 024863-01 503 -421 -2617 i! Corrections /Comments / Instructions: • n PASS ❑ PARTIAL APPROVAL ❑ CANCEL k NO ACCESS FAIn 'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED - 0 1 a -� Inspector: Date: r Phone #: (503) 718- 0 6 7 L i CITY OF TIGARD BUILDING DIVISION PERMIT #: MSl2006-00l ins 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/200 Phone: (503) 639- 4171 {+ Inspection Requests (24 Hrs.): (503) 639 -4175 -. INSPECTION WORKSHEET FOR DATE: 12/30/2005 TIME: 6 :59AM PAGE: 21 SITE ADDRESS: 00096 SW 6Cq'I-I AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: "1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: f.:,;03 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/3(1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 024223-01 503.245.3146 N4 Corrections /Comments /Instructions: S ( tas �'c PRav !l `rl / &Lt7) (9V OcuLA. C t ►� • El PASS PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS (� FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- • CITY OFTIGARD BUILDING DIVISION PERMIT #: MST200F -00130 13125 SW Ha(I Blvd., Tigard, OR 97223 DATE ISSUED: 516/2005 Phone: (503) 639 -4171 • ICI Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/20/2005 TIME: 7 :3OAM PAGE: 27 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 S . addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, - PHONE #: 503 - 246.9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 023769 -01 503-639-4175 N Corrections /Comments /Instructions: • • i ■PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 'Y61 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200E -00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 516/2005 Phone: (503) 639 -4171 a:a Inspection Requests (24 Hrs.): (503) 639 -4175 "'I�.. INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 7:04AM PAGE: 7 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503 -246 -9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mecnanical rough -in • 023548 -01 503. 246.3146 Y Corrections /Comments/ Instructions: • 1 PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- • t( 3) CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 00130 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/6/2005 Phone: (503) 639 -4171 ., Inspection Requests (24 Hrs.): (503) 639 -4175 . �__.. INSPECTION WORKSHEET FOR DATE: 11/2212005 TIME: 7:02AM PAGE: 29 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: [1200. acidfiitrn 7/7/05: Added (1) tamp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503-246-9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 022256.01 603-421-2617 — ✓} M C l bi /OA (C n'l( 1 Corrections /Comments /Instructions: / ---a 7 -- 37D `-( c l j �✓ /../�12PJA . % , Q 6tZ / 2 Z( b- i l 5 /Y11.ey1'l l 0 g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAI ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 11 1/ Inspector: Date: 1 ( 2 J . / Phone #: (503) 718- Z 7 0 !b CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 00130 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/6/2005 Phone: (503) 639 -4171 Vit I nspection Requests (24 Hrs.): (503) 639 -4175 _.. -. / c,-- INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 2 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JAN JOHNSON /SCOTT HALL. PHONE #: 503 - 246 -9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10,113/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 11 " cxze:ior sheathing 018282 -01 503 -421 -2617 N C rrections /Comments /Instructions: -f-- kr/h( ) ZVI ( ) 0 --- 0 0 (,nom 'a V i- \ s (CAA a 4 -- C C . S c„_ T4_,+-,, 6\0-- I- g -e -,-----A e) e ( , cd 5 g_x_, , -,--,-,.„. r IA 4./ �) vk. k Imo. �..t,. s . 3) wl 1 sue- ,,L ._ 0 �,. cam. ✓-, , S . ,-,,,Q. & 0 C.9 E C `r\—cz--ettc_.,.,, ) — 0- - ,\CC L--- V, .-. Q 1 S O - '-�, -, " G ---,mac y_ , i - l_t _ r - e'_, - k C C 1 TR ",-‘(-- Sfe- — . Q AA , 3 -n r \c--4 2 - 7 -- L VI I L--( 6t--/ /-'‘,--(._ , 6 \ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS / ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED j Inspector: /t Date: 1 /( 3/ 0 . Phone #: (503) 718- / l l CITY OF TIGARD ' BUILDING DIVISION PERMIT #: MST2005 -00130 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/6/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ..._'. "'I_- . JdiS I INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7 :04AM PAGE: 101 SITE ADDRESS: 09096 SW 66TH AVE • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503 -246 -9746 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 018020 -01 503-246-3146 N Corrections /Comments /I structi ns: ,e_.7. VIIV\--et u- S • • I . I PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ►` CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED V"v y0 fr-/./0 Ins _ ector: Date: Phone #: (503) 718 P � ) . CITY OF TIGARD BUILDING DIVISION PERMIT #: 1445 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171 .1 A Ip�ii�l Inspection Requests (24 Hrs.): (503) 639 - 4175 ±x- INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 610 $ % lvW AVg • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message rocT7�61 bJZo3 -o/ ^� Corrections/Comments/Instructions: . a • Ai_ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: g 2 - z/4 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51612005 Phone: (503) 639 -4171 � "w°''� , 1�4'Iji ?� Inspection Requests (24 Hrs.): (503) 639 -4175 '_ INSPECTION WORKSHEET FOR DATE: 7/25/2005 TIME: 7:12AM PAGE: 59 SITE ADDRESS: 09095 SW 66TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: JOHNSON DESCRIPTION: 1200 sf. addition. 7/7/05: Added (1) temp service. OWNER: JOAN JOHNSON /SCOTT HALL, PHONE #: 503 -246 -9746 CONTRACTOR: OWNER PHONE #: 503 -475 -3180 Inspection Request Scheduled For: Date: 7/25/2005 Pour Time: 12:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 012039 -01 503 -421 -2617 Y 210 ii .7.n/ • Corrections/Comments/Instructions: ,,p jA 5co4 7(1A) • j LO I _ - , _ - - C-17/ O lJ 01 i/ _ M • Q C C AP �2 - ❑ PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL Q ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 7 2-5 Phone #: (503) 718-