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Permit CITY OF TIGARD MASTER PERMIT iiik PERMIT #: MST2005 -00370 lia li DEVELOPMENT SERVICES DATE ISSUED: 11/14/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136AB-05400 SITE ADDRESS: 10460 SW 72ND AVE ZONING: R - 4.5 SUBDIVISION: SKORO MLP93 -0008 LOT: 003 JURISDICTION: TIG Project Description: 682 sq foot addition to house. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 682 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THROE sf RIGHT: 5 VALUE: 69,225 OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 682 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 2 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: 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: 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 tit CIR: 7 SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amp3- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes JERRY OLNEY OWNER and all other applicable laws. All work will be done in 10460 SW 72ND 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: 971 221 - 2522 Phone: 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: $ 1,400.63 1- 800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : ,t.�l.� 6 a� Permittee Signature .. �� /7al -0 / Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business da f 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. Permit #: WaTapQS — ex) 3�0 Address: 104 to o w 70 A - 6 Issued by: Date: 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: 0 1. I own, reside in, or will reside in the completed structure. IX 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale I " I before or upon completion. 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 the 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 Property Owners about Construction esponsibilities on the reverse side of this form. "...././.. � /,7 /V--LS (Sig ; /re of permit applicant) / (Date) (White copy to issuing agency permit file, pink copy to applicant) information Notice to Property Owners About Construction Responsibilities Note: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance rrith ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas ofconcern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure. you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's with bolding tax law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your ernployees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your ernployees. ifyou fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one ofyour employees is injured on the job. For more information. call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even ifyou didn't actually withhold the tax. For more information, call the internal Revenue Service at I - 800 -829 -1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project. you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see ifyou have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire. or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work ofrough -in and finish trades, and to notify building officials at the appropriate tines so they can perform the required inspections. Jf you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052, 503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1/94 Building Permit Appli EIVED l O1z c)l:F1c is usr: t>Ni.v City of Tigard Received C/B 7 offer llin Permit No.: , _ -'0037O 13125 SW Hall Blvd., Tigard, OR 97223 OCT 2 5 2005 Plan Reviey._ ,1:.,41... ` VIII J J ,_ 9_oS. Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 , , • I ` Date/By Inspection Line: 503.639.4175 ( . l .j. -I I ■ Date Ready /By: nternet: www.ci.tigard.or.us Notified/MReady/By: //046-- � klist for I C ITY OF TIGA "" "' d / • I 3u / /AU-. 63 See Attached Checklist Supplemental Information BUILDING DIVISION / TYPE OF WORK rm W R UIRED DATA: 1- AND 2- FAMILY DELLING ❑ New construction ❑Demolition Pe fees• are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ® Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 69 , 125 El 1- and 2 -family dwelling ❑ Commercial /industrial Valuation: $ 30, 000 ❑ Accessory building El Multi-family Number of bedrooms: / ❑ Master builder XOther: �Wv/ f )72 Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: / Job site address: /0 I/6 0 S ?a h .2..... d New dwelling area: 6 S square feet City /State/ZIP: - j Q p _) U,c v � Garage /carport area square feet Suite/bldg. /apt. no.: I Project name: �e Covered porch aree °''? y square feet Cross street /directions to job site: Deck area: square feet � 'i Other structure area: square feet cp[ 1 1 Ll E / /7 n R EQUIRED 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 DESCRIPTIO OF WORK work indicated on this application. 6 R f Q i i Valuation: $ 6vS 9 �1 ii 0 Existing building area: square feet New building area: square feet PROPERTY OWNER I ❑ TENANT Number of stories: Name: \J e)Q ),e U id e // Type of construction: Address: i �O Occupancy groups: City / State/ZIP: 4/�: C-L 7 . Existing: Phone: c 6/) 0 /..... ' , Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be � Contact name: l-AJ licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City / State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone:( ) Fax::( ) E -mail: / CONTRACTOR Business name: / ( a `;�/ /!�� BUILDING PERMIT FEES* Address: Please refer to fee sched e City / State/ZIP: ` f � f ( • 6,1 Fees due upon application Phone:( ) Fax:( ) Amount received CCB Iic.: Date received: — Authorized signature ."7 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: , // 01 , 7vey I Date: /d 0 o.1 * Fee methodology set by Tri- County Building Industry/ / Service Board. i:\ Building \Pennits\BUP- PetmitApp.doc 12./03 440 -4613 I /02/COM/WEB) One- and Two - Family Dwelling ` Building Permit Application Checklist FOR ol• icii usi; ON1.Y 'City of Tigard a lik ce xei�e Re eive Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 . y "" •' �° 0 Electrical 0 Plumbing 0 Mechanical ,24- Hour inspection Line: 503.639:4175: • ; . —I J Internet: www.ci.tigard.or.us 0 Other. t 11-11 FOL.LO\VING ITEMS ARE IZEOUIRi l) I'OIZ PLAN RZEVIi::\V les No N/A 1 Land use actio : s completed. See jurisdiction criteria for concurrent reviews. ■ ❑ III 2 Zoning. Flood p .'n, solar balance points, seismic soils designation, historic district, etc. ❑ 0 ❑ 3 Verification of ap . roved plat/lot. ❑ ❑ 0 4' Fire district appro : I required. Name of district: . ❑ 0 ❑ 5 Septic system permi or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approva . ❑ ❑ ❑ 8 Soils report. Must carry o • anal applicable stamp and signature on file or with applicatio ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ : ermit required. Include drainage -way protection, silt fen' design and location of catch- ❑ 0 0 basin protection, etc. 10 3 Complete sets of legible pia 1 .. Must be drawn to scale, showing conforman > 'o applicable local and state ❑ ❑ ❑ building codes. Lateral design detat . and connections must be incorporated into e plans or on a separate full -size sheet attached to the plans with cross r. erences between plan location and de s. Plan review cannot be completed if copyright violations exist. 1 1 Site /plot plan drawn to scale. The plan m , .t show lot and building set ck dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4-ft. elevation differential, •Ian must show conto ines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including d- ; s); location of 1s/septic systems; utility locations; direction indicator; lot area building coverage area; percenta_ - of covera • : , impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any h 1 • owns and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identificatio indo • ize, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconie • and decks 3 t • ches above grade, etc. 14 Cross section(s) and details. Show all framing- ber sizes and sp. 'ng such as floor beams, headers, joists, sub- 0 ❑ 0 floor, wall construction, roof construction. Mor han one cross section : be required to clearly portray construction. Show details of all wall and r • sheathing, roofing, roof slope, - iling height, siding material, footings and foundation, stairs, fireplace constructio• , thermal insulation, etc. 15 Elevation views. Provide elevations for ew construction; minimum of two elevatio for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the ac .1 grade if the change in grade is greater than fou oot at building envelope. Full -size sheet addendums showin • oundation elevations with cross references are acceptab 16 Wall bracing (prescriptive pat 1 and /or lateral analysis plans. Must indicate details and loca • •ns; for non- ❑ ❑ ❑ prescriptive path analysis prov'. a specifications and calculations to engineering standards. 17 Floor /roof framing. Provi • plans for all floors/roof assemblies, indicating member sizing; spacing, an • ' ng ❑ - ❑ ❑ locations. Show attic ve ation. 18 Basement and retaini 1 1 walls. Provide cross sections and details showing placement of rebar. For engineered . ❑ ❑ ❑ systems, see item 22, ngineer's calculations." 19 Beam calculation Provide two sets of calculations using current code design values for all beams and multip 'oists C. ❑ ❑ over 10 feet Ion d/or any beam/joist carrying a non - uniform load. 20 Manufactu :, floor /roof truss design details. 12 ❑ 21 Energy C pc e compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for fou or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ ,a licensed in Ore on and shall be shown to be licable to the project • under review. 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. ❑ ❑ 0 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. 0 ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre- Screening Site Assessment form is required for all building additions, 0 ❑ ❑ 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. L I:\ Building \Pernits\BUP- RES- PermitApp.doc 2 Electrical Permit Applicit:ton1 EIVEz I (Ii OFFICE t sl ()NI City of Tigard Received g DateB . Permit No.: t lord • _ -- 70 13125 SW Hall Blvd., Tigard, OR 97223 ( Plan Review OCT 2 5 2 . Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 ` t = s' r i ' D a t e B . Inspection Line: 503.639.4175 4•, } ! � „ Date Ready/13y: Juds: ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental information TYPEtWlki UIVISIUN PLAN REVIEW ❑ New construction - %12(Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location ❑Service over 320 amps — rating ['Bulldog 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 buildi ❑System over 600 volts nominal units in one structure Other: dQ ❑ Multi - family 0 Master builder 11 / ['Building over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION gh g plan RV ❑Egress /li tin lan park . Job no.: Job site address: f 0�(O n yG `� ❑Health -care facility ['Other: 7°?Tf�i Submit 2 sets of plans with any of the above. City/State/ZIP: 7 _ l 9 4, n $ ®� ' ? 9 7 2V The above are not applicable to temporary construction service. , Suite/bldg. /apt. no.: Project name: a e FEE* SCHEDULE Description I Qty. I Fee. I Total 1 ** Cross street/directions to job site: New residential single - or multi - family dwelling unit �a� c� Includes attached garage. lZ �p? �� 1,000 sq. R or less ( 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: / , / 36, B - O o5 C� t�� Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular ((�� n, t dwelling, service and/or feeder 90.90 2 6, J1 O ` 2 1 k r2 y 1� wiv) Services or feeders installation, alteration, and/or relocation add/ k) 4?) t 200 amps or less 80.30 2 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: , 1e t . 601 amps to 1,000 amps 240.60 2 itq Address: Jo 6 4)01., Over 1,000 amps or volts 454.65 2 G� c:, �� Reconnect only 66.85 2 City/ State/ZIP l ? a i l 0 Q � Temporary services or feeders installation, alteration, and/or ( 974 2� o„ relocation Phone: / , Fax: ( ) 200 amps or less 66.85 1 Owner installation: 'nstallation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, t, or exch. ge, • . • „ din t S 447, 449, 670 �d70 . 401 amps to 600 amps 133.75 2 Owner signature r «, // Date: / j ,� d Branch circuits — new, alteration, or extension, per panel ❑ • T I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each o fp Business name: branch circuit �/ 6.65 2 B. Fee for branch circuits Contact name: �� without service or feeder fee, f 46.85 2 Ch Address: each branch circuit Each add'I branch circuit 6.65 2 City/ State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax ( ) Pump or irrigation circle 53.40 2 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: �f / �� Address: C_w )/‘(,11 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.: I Electrical Lic.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name Date: State surcharge (8% of permit fee) 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: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. is\ Building \Pennits\ELC- PumitApp.doc 12/03 4404615T(10/02/COM/WEB /, lectrical Permit Application - City of Tigard ' . ge 2 - Supplemental Information LI ITED ENERGY PERMIT FEES: RES i, ENTIAL WORK ONLY: Fee for !II residential systems combined $75.00 Check Ty e of Work Involved: ❑ Audi, and Stereo Systems* ❑ Burglar .larm ❑ Garage Do • Opener* ❑ Heating, Vent! tion and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system. $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Syste s ❑ Boiler Controls ❑ Clock Syst- s ❑ Da elecommunication Installation • II ire 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 \Pennits\ELC- PamitApp.doc 04/03 1 Mechanical Permit Al4tetv ED ruR OI Ficl.. HSI'. ONLY City of Tigard Received /44'r Date/By. J ., 370 13125 SW Hall Blvd., Tigard, OR 97223 2 00 5 Date/By. Plan Review Permit No.: Phone: 503.639.4171 Fax: 503.598.1960 oC I J i i A , ; ,, . Other Permit: Inspection Line: 503.639.4175 1. l /, ='I Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information TIGAR ON TYYC%CITY WlOF 4F pNLCI RK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction Addition/alteration /replacement Mechanical permit fees* are based on the value of the work !ll�� performed. Indicate the value (rounded to the nearest dollar) of all • ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory b it g , I For special information use checklist. ❑ Multi - family ❑ Master builder Other: / tYtn Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling • Job site address: / /f) �J Air conditioning or heat pump /Q 7 f � / 6(/ ! /7 (requires site plan showing placement) 14.00 City / State/ZIP: 0 47 r 9 ER Furnace 100,000 BTU (ducts/vents) 14.00 / Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Q Gas heat pump 14.00 Cross street /directions t job site: Duct work 7,, 14.00 . - 5-J4?) 7 1 , /)� _ Residential 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 DESCRIPTION OF WORK Water heater 10.00 t�� Gas fireplace 10.00 QG D1 / ''1� Mej �) Flue vent for water heater or gas �d ,P, C G '1 ([l ) �i l /)� r ✓06 fireplace l t 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 .EROPERTY OWNER 1 ❑ TENANT Chimney /liner /flue/vent 10.00 // Other: 10.00 Name: v - j 0 Environmental exhaust and ventilation Address: � \..// � r � / n Range hood /other kitchen P � l a ° / equipment 10.00 City /State/ZIP: / / q �� -7 (d Clothes dryer exhaust 10.00 / Single -duct exhaust (bathrooms, Phone: (97/) •— . Fax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Business name: Other: 10.00 Fuel piping Contact name: :a/y /)✓, % $5.40 for first four; 51.00 for each a dditional Address: Furnace, etc. Gas heat pump City /State/ZIP: Wall /suspended/unit heater Phone: ( ) I Fax: : ( ) Water heater Fireplace E-mail: Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State/ZIP: Subtotal Minimum permit fee ($72.50) Phone: ( ) I Fax: ( ) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) d / / - TOTAL PERMIT FEE Authorized signatur . / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: iy t o ei f ��JI), Date: ��f . ,.& • Fee methodology set by Tri- County Building Industry Service Board i :\Building\PermitVMEC- PemitAppLc 12/03 440- 4617T((I /02/COM/WFB) Mechanical Permit Application - City of Tigard Page Information Commer Fee Schedule: Total Valu: tion: Permit Fee: $1.00 to $2,001 10 Minimum fee $72.50 $2,001.00 to $5,1 i 0.00 $72.50 for the first $2,000.00 and $ . 0 for each additional $100.00 or fra ion thereof, to and including $5,000 00. $5,001.00 to $10,000.0 $141.50 for the first $5,000.0 and $1.80 for each additional $ 10.00 or fraction thereof, to and i uding $10,000.00. $ 10,001.00 to $50,000.00 31.50 for the first ': 0,000.00 and $1: for each ads • ional $100.00 or fracti. 1 thereof, -• and including , $50,000.!0. $50,001.00 to $100,000.00 $771.50 fo . e first $50,000.00 and $1.25 for > . ch ditional $100.00 or fraction • ereof, t... d including $100'1!0.00. $100,000.01 and up $1 • '6.50 for the first $10 ! 000.00 and .10 for each additional $11 110 or fraction thereof. Note: All new . 1 mmercial buildings require 2 sets of plans. • • i:\ BuildingTermits \MEC- PermitApp.doc 12/03 2 Building Fixtures Plumbing Permit AgetWE.D rc►lt c►rrlcl: I 111.1 City of Tigard Received Date/By Permit No.: 14.1 Sraxs Cdr 37t) 13125 SW Hall Blvd, Tigard, OR 97223 5 005 pan Review Phone: 503.639.4171 Fax: 503.598.1��1 /. rr.,, >. p g y Other Pet No.: 24- Hour Inspection Line: 503.639.4175 I Date Ready/By. • turis El See Page 2 for Internet: www.ci.tigard.or.us CITY ( W T I G ARG Notified/Method Information Inforation I � 11S" FEE* SCHEDULE 1 � ► � ❑ New construction ❑ Demolition For spedal information use checklist. Description 1 Qty. 1 Ea. 1 Total )ddition/alterationheplacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ I- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder 0 other: /90E7 7'1 Each additional bath/kitchen 45.00 Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION \ AND LOCATION Site utilities /e) Job site address: / ii .� J 74 /711- Catch basin or area drain 16.60 City /State/ZIP:�9& e1 9 70/ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.. ) Page 2 Manufactured home utilities 110.00 Cross street/dtrections to job site: o �k C Manholes 16.60 C f-i) 77 77 t 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 D TN OF WORK T � IO 1 Backtlow preventer Page 2 �� /Y � � f� 77 ■-2/ Backwater valve 16.60 '' I ))9 (--)M ))7L 1 y /1 Clothes washer 16.60 � Dishwasher • 16.60 RO OWNER I ❑ TENANT Drinking fountain 16.60 - Ejectors/sump 16.60 Name: l - E7 a��l Expansion tank 16.60 Address: /c) 6e, n v n� Fixture/sewer cap 16.60 City / State/ZIP: 79 /1 ) At 9 7 _, Floor drain/floor sink/hub 16.60 Phone: (97/) j ., . Fax: ( ) Garbage disposal 16.60 7 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: �. Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60 Tub/shower/shower pan 16.60 E-mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: / Water heater 16.60 Address: /�'" • eC Yy� ./� Other: I - 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 %ofpermit fee) Authorized signs State surcharge (8% of permit fee) Z-17 TOTAL PERMIT FEE Print name: Spica zi,4, pzfi4 / I Date: // 4 61 This 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:\& tildineermia\PIMF- PermitApp.doc 06/05 440-4616T(10/02/COM/WEB) Plumbin ' Permit Application - City of Tigard Page 2 - Sup lemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: _ Permit Fee: Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additio :1 100' 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 $309.11 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100 46.40 Valuation: Pe :1 it Fee: Storm &Rain Drain - 1st 100' a 55.00 $1.00 to $5,000.00 Mi . mum fee $72.50 Storm & Rain Drain - each additional 10 ' 46.40 $5,001.00 to $10,000.00 2.50 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 $25,001 0 $148.50 for the first $10,000.00 and $1.54 for Residential Back flow 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 0,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,00 .10 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: 45. each additional $100.00 or fraction thereof Fixture Work: Plan Review for Complex Structures Are you capping, adding or replacing fixtures? If "ye , A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure system that meets any of the following criteria. accurately report fixtures could result in increase sewer fees *. Please check all that apply. Quantity by (Fixture) Wo • • Performed ❑ Any new commercial building. Future Type: Replace ❑ Any new exterior plumbing site utilities. Previous Capped • ded Existing • A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ edical gas and vacuum systems for health care facilities - Jacuzzi/Whirlpool p i viding services to human beings. Car Wash - Each Stall ❑ Plu bing installations, alterations or additions to food service - Drive Thru facilit where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are bein • 'nstalled for the food service area. • Dishwasher - Commercial ❑ Any new r idential building containing three (3) or more - Domestic dwelling unit Drinking Fountain ❑ Any NFPA 13 ► multipurpose fire sprinkler system. Eye Wash Floor Drain /sink 2" Submit 2 sets tans with any of the above. -3" -4" Car Wash Drain Isometric or ' 'ser Diagram Garbage - Domestic in Isometric or riser diagram i equired for new buildings Disposal - Commercial three (3) or more stories in het = t t. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture wo Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: _ plumbing permit can be issued. i:\ Building \Pennits\PLM- PennitApp.doc 07/06/05 CITY OPII6ARD BUILDING DIVISION PERMIT #: i 1ST20p5 pp370 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/20007 TIME: 7:00AM PAGE: 65 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/2/2U07 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 044222 -01 971 -221 -2522 N Corrections /Comments/ Instructions: e PASS ❑ PARTIAL APPROVAL 11] CANCEL ❑ NO ACCESS ❑ FAIL d CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 47 7 Phone #: (503) 718- Z-4-r CITY OF TIGARD - ' BUILDING DIVISION PERMIT #: MST200F 00370 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 A 1 1 • Inspection Requests (24 Hrs.): (503) 639 -4175 _� ..„ 1 L. INSPECTION WORKSHEET FOR DATE: 3/1 /2007 TIME: 7 :00AM PAGE: 5 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/1/2007 Pour Time: Code # Inspection Description - • • •• # Contact # Message 199 Electrical final 044177 -01 971- 221 -252 Y 7----- Corrections /Comments /Instructions: i P PkASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �" toe?) Ls Date: 3 1 " 1 Phone #: (503) 718- *a) CITY OF TIGARD - r BUILDING DIVISION PERMIT #: MSt'2005 00370 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 itiMt.. INSPECTION WORKSHEET FOR DATE: 7/23/2007 TIME: 7 :01AM PAGE: 13 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: Q03 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 - 221.2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/23/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 043808 -03 971 -221 -2522 N Corrections /Comments /Instructions: 1 0101 -6 : • A Li- _ ■ so V . 1 S tia Map 0 1/41' l,E sir. ARC, F oa PIK`f i l" : E'SY T M ► M 4 ��c ( -j Poe, �, ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 7 (1.FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: -"---, 1 08 t Date: Z't3- O') Phone #: (503) 718 - 10'14 CITY OF TIGARD - .,'n ST BUILDING DIVISION PERMIT #: 200,C pOs -- 60 3-76 13125 SW Hall Blvd., Tigard, OR 97223 DA TE ISSUED: Phone: (503) 639 -4171 A .. 11 '� Inspection Requests (24 Hrs.): (503) 639 -4175 ,_ -_ "'I INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / D C/6 Q A1 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3- /6 -0 Pour Time: Code # Inspecti. • • - . • • 4 Confirm # Contact # Message E 2e, , R ii. / 7 _ --2. - 2s - Z Z Correctionsf-OoThments /Ins • • : PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G---Aa ` / Phone #: (503) 718- 240 t �� Date: 3 Vold 6 CITY OF TIGARD 01 St BUILDING DIVISION PERMIT #:,;pf 5 D 03 76 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Ay Inspection Requests (24 Hrs.): (503) 639 -4175 � ,Az !i " �.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: /G (4 7 a CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Descrip on Confirm # Contact # Message z _ as aa- Corrections /Comments /Instruct ns: YYst ` v 1 L a f L-7,14% o CLE`N(L 6 t:.au S (N PALL l r 6 �. LA yrcr cAN o■i . Et ► L cwt, 1. -''�'i o t\ W Ate. (ka 1' KEN 2)4 " \\\ - rAt Rd)C N N ∎17- 0 ..40 M (Z Bbilik \'2x • S m0 C:r V %QS FE& c0 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 12 .-8. NO8 Le. Date: 3- 3 - Phone #: (503) 718 - 2 itiD • CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2005-00370 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 .,, 11 .II Inspection Requests (24 Hrs.): (503) 639 -4175 __ `_ _.. INSPECTION WORKSHEET FOR DATE: 2123/2007 TIME: 7 :01AM PAGE: 14 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -000i3 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. • OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/23/ ?007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 043808 -02 971- 221 -2522 N Corrections /Comments/ Instructions: \ igl i DASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (71 l./ Dated Phone #: (503) 718 - CITY OFTIGARD - BUILDING DIVISION PERMIT #: f ;,{ 2005•f3f�37 i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/:.05 Phone: (503) 639 -4171 Avo Inspection Requests (24 Hrs.): (503) 639 -4175 ,�- INSPECTION WORKSHEET FOR DATE: 1/27/2006 TIME: 7:0OAlv1 PAGE: 49 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 871 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/27/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 026879-01 503 - 329.9633 N Corrections /Comments /Instructions: / -� ii. . /L1 / (j 2 ;/( .-td& (, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector. 1 & Date: 1/72 2 - 1 Phone #: (503) 718- _3(1t/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S.00370 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 A 1 �� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 2/23/2007 TIME: 7:01AM PAGE: 15 SITE ADDRESS: 10460 SW 72140 AVE CLASS OF WORK: SUBDIVISION: SKORO MLP83.0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2123/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 043808 - 01 971 N Corrections /Comments/ Instructions: A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: "2--- 2 3 -0 7 Phone #: (503) 718- 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: Ms -00370 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 �&J' Il .. INSPECTION WORKSHEET FOR DATE: 212312007 TIME: 7:01AM PAGE: 12 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/23/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 043808 -04 971- 221 -2522 N Corrections /Comments /Instructions: AJ EG- P eq/a - C t C-Adt. . tC'► i t vkc_ Al s v g -4 rnv� S's1a - 2: ❑ P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED %) . Date: Z -- ZS -0 7 Inspector. Date. Phone #: (503) 718 - 72'1 6/4-t_ CITY OF TIGARD j S BUILDING DIVISION PERMIT #: an s--__06 3 'c) 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: / Phone: (503) 639 -4171 tbt eilij Vie_ Q,tv n/ Inspection Requests (24 Hrs.): (503) 639 -4175 q INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 0 t (P (a 7 a /Pat CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 - 15-0 Pour Time: Code # Inspection Description Confirm # Contact # Message 4- - 3.2_q-5633 Corrections /Comments/ Instructions: ___ L)___? • ?-PlOal e.2-G4 c c%i5 . a/ p), I2 D Ll. 1Za- PO- --3--/ 7 6 Cc cJ ed>ul COM p4 I44 7 z3 , 9 ""di/ 72,r0 = / /9/ o giA2el (1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / cam ,I Inspecto • / Date: V I a4 Phone #: (503) 718- 2 -- /lik CITY OF TIGARD ill 5T" BUILDING DIVISION PERMIT #: 07,0O5-_, ex 376 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 ov i Inspection Requests (24 Hrs.): (503) 639 -4175 :� .4%m y - INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 0 `t eav 76). - id CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 --/ (( —04. Pour Time: Code # Inspection Description Confirm # Contact # Message s Corrections/Comments/Instructions: -'• F 1 z-e iki.,L_ to--41 L.- - .1-oz-te,.5 Ito 4 z_...,- eLtP --- i w (Ar�-L_-- -- ss l P r kfiS- C( c CS IL ..._ . 5 r\-- .-- le- ( ii.ye,--- — 04 (DE_ — k EAR MU -0rt__- DO 1 I 1 &J7LC / ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i _ a rk Inspector: Date: 4 #: (503) 718 - -2.- CITY OF TIGARD - BUILDING DIVISION PERMIT #: M; 1200fJ 003 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 .�'!! "_.. INSPECTION WORKSHEET FOR DATE: 1/31/2006 TIME: 7:01AM PAGE: 34 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93-0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 871 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/31/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 026022 -01 503-329-9633 N Corrections /Comments/ Instructions: RCjrn 1.2?-age &-S . t, R�-0-z— z�/ J Cot'ieC..: PASS (1 P' - TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL . c L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' Date: Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2o05_00370 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2M6 Phone: (503) 639- 4171H `__�il Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 1/27/2006 TIME: 7:00AM PAGE: Eta SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93-000B LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 6132 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971- 221 - 2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/27/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 025876 -01 503 - 329-%33 N Corrections /Comments/ Instructions: el) - „� - - - - i • / ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: Date: /-= 2,7--06 Phone #: (503) 718- -`1-"-' CITY OF TIGARD . BUILDING DIVISION PERMIT #: MS12005-0 0370 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 i,11 y ,t�l�l� Inspection Requests (24 Hrs.): (503) 639 -4175 !�i :_,. INSPECTION WORKSHEET FOR DATE: 1/9/2006 TIME: 7:01AM PAGE: 14 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO INMLP93000B LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 6132 sq foot addition to house. OWNER: OLNEY. JERRY PHONE #: 971-221-2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/9/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 606 Post/boam mechanical 024593 -01 971 - 221.2622 N Corrections /Comments /Instructions: �, ��--- • G -6) , C-0 ._i : t‘ 'ASS 4 •ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL /41/A LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED s Inspector: Date: . Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2O05- 00370 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639 - 4171 Ab ro Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/6/2006 TIME: 7:OOAM PAGE: EA SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO ML.P93 - 0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/6/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 024490 -01 603 -329 -9633 N Corrections/Comments/Instructions: �►� ° (��Gtsll� l h S • ❑ PASS PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS ❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: MP/ , _ ` _ Date: Phone #: (503) 718 - C. CITY OF TIGARD -- BUILDING DIVISION PERMIT #: M ST7..006 00370 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/7005 Phone: (503) 639 -4171 '�g9 �� Inspection Requests (24 Hrs.): (503) 639 -4175 . `'' I.. INSPECTION WORKSHEET FOR DATE: 1/4/2006 TIME: 6 :59AM PAGE: 30 SITE ADDRESS: 10/160 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKOFtO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 -721 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/4!2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 024349-03 503- 329 -9633 N Corrections /Comments/ Instructions: I) p Kov i e.,- 11--1 (-7 Le_ i=e / Sf ot..ln -1 o/(' IPLi S P'th Z 20vi(Jc= a1-v/'Sf — 5 r i<i." w 7 4 /1 t'E /Z LA— % id dl_ -- 'Ni' q- ' o -1 - : 6 - c,/ 4 CJ.S C CL- - L / C C L 6/ (JS' �` /Ss / "/ -y/ — o 'ova( 1/ Q n1 -( /G `1 0C //4 /L /", 6 NC 6 iVi ----/OT R 6,7 -i S Kti c4 h e 7?(____ ' ---- Afor ---- iz_ci-(»y ❑ PASS W•ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 17 FAIL ■ ' A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / P 1 Inspector: _ Date: Phone #: (503) 718 - %b CITY OF TIGARD ' - BUILDING DIVISION PERMIT #: MST200 -00370 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 II Inspection Requests (24 Hrs.): (503)639 -4175 .�' F:- INSPECTION WORKSHEET FOR DATE: 1/4/2006 TIME: 6 :59AM PAGE: 31 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO Mt.P93.00013 LOT #: 003 TYPE OF USE: PROJECT NAME: OLINEY DESCRIPTION: 6132 sq foot addition to house. OWNER: OL.NEY, JERRY PHONE #: 971 - 221- 2622 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/heam mechanical 024349-02 503. 329.9633 N Corrections/Comments/Instructions: f l eD ece T S — 1 — C-7 , b()e. Alo Y THIS Pee__ MA-n! y r a 1 S L r ' - r Q C� . 4.0" (i - v 6%r 1•.10 2. K_ i-f / /o (z7:1-6 V 1 2 . t' Sc-s----c___— v,-4 ( 7 - 7 S 7TH' ( ❑ PASS ! "ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS k FAIL % . L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: —■ 111111 . 11 ► Date: / - I �hone #: (503) 718 - CITY OF TIGARD ' - BUILDING DIVISION PERMIT #: MS 2006 -00370 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 Vil Ins pection Requests (24 Hrs.): (503) 639 -4175 — INSPECTION WORKSHEET FOR DATE: 1/4/2006 TIME: 6:59AM PAGE: 33 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO iv1LP930006 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 6132 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 - 221 -1522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/4/2.006 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 024349 -01 503- 329 9633 N Corrections /Comments/ Instructions: S () rt-N FD PUvt/1.1 PASS 5 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ' FOR INSPECTION ❑ADDITIONAL FEES ASSESSED ry c---- Inspector: A _ Date: Phone #: (503) 718- \ CITY OF TIGARD - - BUILDING DIVISION #: MST20ur.00370 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/:)(;05 Phone: (503) 639 -4171 / �a , ��' Inspection Requests (24 Hrs.): (503) 639 -4175 �' _ �! INSPECTION WORKSHEET FOR DATE: 1/4/2006 TIME: 6:59AM PAGE: 7 9? — 7i - •4K SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 - 0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNE DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971 - 221 -25)2 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 024357 -01 971 - 221 -2522 N Corrections /Comments/ Instructions: leai F_0 ❑ PASS 6 P TI PPROVAL ❑ CANCEL ❑ NO ACCESS AIL C ' OR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I - - - -- --: 05e------- Phone #: (503) 718- - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00370 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/2005 Phone: (503) 639 -4171 w � � l� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/13/2005 TIME: 7 :02AM PAGE: 6 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 • LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: 682 sq foot addition to house. OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/13/2005 Pour Time: 12:00 Code # Inspection Description Confirm # Contact # Message 210 r , Foundation walls 023391 -01 503-932 -49448 N Corrections /Comments/ Instructions: f - G - O1 ,4-j ? S / oL A- ei C-5 ....-" 4- 1. v'�LS'!Jl i 6d 7-7c. o. ICLZ / Lv4 -- "ra : i7A-/C- [ iC 4 JZ- /1.i" -7�-i �[ � - i itizagoc Ch m- 4c , / 1...4S7-4---4-4_, AZLtJ! 170 w/(-S /4--, smUe✓4 /- 30 /AG , r - 4 c , x- 4o — _ ' „ , , . 2 >1 ...■•"-------- ( C ,1 e. ai pis ,a0c i -,,,-- 7,---,--2--,A, -T A- rime,) -3 L07---p m PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / -- U Phone #: (503) 718-