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Permit q CITY OF TI "ARID MASTER PERMIT .: , : COMMUNITY DEV ,_LOPMENT PERMIT tt: MST2008 -00020 DATE ISSUED: 4/4/2008 TLG- AIt 13125 SW Hall Blvd., Tigard, OR .97223 503.639.4171 PARCEL: 2S 104DD - 09300 SITE ADDRESS: 13520 SW 129TH AVE ZONING: R - 4.5 SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT: 051 JURISDICTION: TIG PROJECT: PROVENCHER Project Description: Finish unfinished basement, 713 sq ft. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: 713 sf LEFT: SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: si RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: , BATH: 1 TOTAL: 0 sf 18,078.00 . REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3I-4P: VENT FANS: 1 CLOTHES DRYER: NAT FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ALKYL INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/0 SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: iti, ` LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC(FOR> =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: RIO ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL - • 8. COMMERCIAL - AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: 0 1 BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: 0 GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: f This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable LEO G. PROVENCHER OWNER laws. All work will be done in accordance with approved plans. This • 13520 SW 129TH AVE permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. These rules are set forth in OAR 952- 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 -553 -9562 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 809.71 REQUIRED ITEMS AND REPORTS Issued By �-, ...,..,.. > .- ... -- • .. �- - - -:, _ ; , ..:. Y � ._ - . .�- : -,. .. _. -. Permittee Signature : -c -� -' t. _ 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. q cry OF T I A MASTER PERMIT PERMIT #: MST2008 -00020 ° COMMUNITY DEVELOPMENT DATE ISSUED: 4/4/2008 T I G A R D; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104DD-09300 SITE ADDRESS: 13520 SW 129TH AVE ZONING: R -4.5 SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT: 051 JURISDICTION: TIG PROJECT: PROVENCHER Project Description: Finish unfinished basement, 713 sq ft. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: 713 sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 0 of 18,078.00 REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER UNES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER UNES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 1 CLOTHES DRYER: NAT FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER - TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 0 - 200 amp: WISVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNALJPANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000. amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable LEO G. PROVENCHER OWNER laws. All work will be done in accordance with approved plans. This 13520 SW 129TH AVE permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 -001 -0080. You may obtain copies of these rules or direct Phone: 503 - 553 - 9562 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 809.71 REQUIRED ITEMS AND REPORTS Issued By : �_� _ i Permittee Signature : O i°. - � " z �. -t-+c�� 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. CITY OF TIGARD I l i BUILDING DIVISION 9 PERMIT #: ms 1 13125 SW Hall Blvd., Tigard, OR 97223 • - DATE 4 4 Phone: (503) 639-4171 i#44 Inspection Requests (24 Hrs.): (503) 639-4175 .A.Inil■ AL 1 b INSPECTION WORKSHEET FOR DATE: 2123/2009 TIME: 7:00AM PAGE: 6 SITE ADDRESS: 13620 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish Onfinithed kige sq ft. OWNER: PROVENCHER, LEO PHONE #: 503-563-9662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/2312009 Pour Time: Code # Inspection Description Confirm # Contact # Message 0 , 299 Final inspection 08074501 503-653-9662 N Corrections/Comments/Instructions: 1 C 0 1 4;;=> n PARTIAL APPROVAL H CANCEL 1 ---- 1 NO ACCESS 0 FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED t iZ_____________ Inspector: Date: Phone #: (503) 718- CITY OF TIGARD ' BUILDING DIVISION - _ PERMIT #: S -i•.?B 00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639 -4171 v NN�pul.I(I�� '" Inspection Requests (24 Hrs.): (503) 639 -4175 -. '11... INSPECTION WORKSHEET FOR DATE: 7/75/2008 TIME: 7:00AM PAGE: 12 SITE ADDRESS: 13520 SW 129111 AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 0 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503-553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/2&2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final . - . 073224 -02 503 - 553.9562 N Corrections /Comments /Instructions: g PASS ❑ PARTIAL APPROVAL ❑ CANCEL Fl NO ACCESS FAIL CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: Cr Al ) Date: Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2008-00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: e114/20013 Phone: (503) 639-4171 A ,.„ 111 1, 1 1, Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/1/2008 TIME: 7:00AIVI PAGE: 89 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503,553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough-in 069135-03 503-553-9562 Corrections/Comments/Instructions: e k • ou , „ 6r 17.) Y UtLA—c-c,si P.43 1 -1 ki c, r it51 - 1 PASS PARTIAL APPROVAL El CANCEL NO ACCESS FAIL fl CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED 1 Inspector: (TDV11-4.../1 Date: / 6 q> Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41412008 Phone: (503) 639 -4171 es/4104 i i Inspection Requests (24 Hrs.): (503) 639 - 4175'' I .. INSPECTION WORKSHEET FOR DATE: 5/1/2008 TIME: 7:00AM PAGE: 92 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503- 563 -95562 CONTRACTOR: OWNER a PHONE #: Inspection Request Scheduled For: Date: 5/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 069135.01 503 - 553 -9562 N Corrections/Comments/Instructions: P ie) LA A c J-cc e fir/ 130.uVw l/6i v.(-- r J c- �.a,;(. X PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: CD \ v\ -- Date: Si 1 1 0.C Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -000 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4141/2008 Phone: (503) 639 -4171 � is � +�j�i f l ll Inspection Requests (24 Hrs.): (503) 639 -4175 !� - :_.. INSPECTION WORKSHEET FOR DATE: 7/25/2008 TIME: 7 :00AM PAGE: .13 SITE ADDRESS: 13520 sw 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT # 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCI -IER, LEO PHONE #: 50 - 553,05 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 71251 OS Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 0732" -01 503.653 -9562 N Corrections /Comments/ Instructions: PASS I 1 PARTIA APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑ C A CFO'. I ■ ' SEC • N ❑ ADDITION FEES ASSESSED Inspector: Date Phone #: (503) 718 CITY OF TIGARD BUILDING DIVISION PERMIT #: l�ST200 -00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639 -4171 Il Insp Requests (24 Hrs.): (503) 639 -4175 ,_/ r _.. INSPECTION WORKSHEET FOR DATE: 5/8/2008 TIME: 7 :01AM PAGE: 24 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503-553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/812008 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 069593 -01 603 -553 -9562 N Corrections /Comments/ Instructions: • X PASS pi PARTIAL APPROVAL El CANCEL El NO ACCESS ❑ FAIL ❑ CA I L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED h Inspector: 1 Date: C Phone #: (503) 718 - cbtb,a CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2008 -00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639- 4171*it Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:00AM PAGE: 55 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503 - 553 -9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/6/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 069372 -01 503-653-9562 N C • rrections /Comments/ Instructions: )V C A-74 " ki in+ --4 KICT rte' _ L c L'il: c Gi'1. n PASS /1 P' = ° : n CANCEL NO ACCESS FA 44 .. CALL FOR INSPE Ow. ADDITIONAL FEES ASSESSED ��11 g Inspector: Date: ‘-) Ob. Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION r PERMIT #: MST2008. 00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/412008 Phone: (503) 639 -4171 /ire Im�iiU" Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/6/2008 TIME: 7:OOAM PAGE: 54 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503-553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 516/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 069372-02 503 -563 -8562 N Corrections /Comments /Instructions: • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL _ CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED Inspector: Date: t . Phone #: (503) 718 - _Z6_4 i CITY OF TIGARD BUILDING DIVISION - PERMIT #: MST2008- 00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 414/2008 Phone: (503) 639 -4171 v' h�fli '�I� ` Inspection Requests (24 Hrs.): (503) 639 -4175 -;'+i INSPECTION WORKSHEET FOR DATE: 7/7512008 TIME: 7 :00AM PAGE: 11 SITE ADDRESS: 1°s520 SW 1 29TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT # 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503 - 5539562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 712.612008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 073224 -03 503- 553 -9 N Corrections /Comments /Instructions: ..CJ) -e Y `Tile ✓ 4 clo ba ezdaee) reFi��e �, b lea k) net i . PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ' Date:o 3vk y G$ Phone #: (503) 718 - .2/.23 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4M/2008 Phone: (503) 639 -4171 14i�i+ l @" 1 Il#� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/14/2008 TIME: 7:01AM PAGE: 15 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 603 -553 -9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5!14/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 616 Mechanical rough -in 069877 503 -653 -9562 N Corrections /Comments /Instructions: _ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS 1 1 FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 1 Q �- / Inspector: Date: 5 / —�� Phone #: (503) 718- [[[� BTTT��� f j�J CITY OF TIGARD -- BUILDING DIVISION PERMIT #: MST2008.00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/8/2008 Phone: (503) 639 -4171 n , mu , yu� ��I • Inspection Requests (24 Hrs.): (503) 639 -4175 L INSPECTION WORKSHEET FOR DATE: 5/13/2008 TIME: 7:02AM PAGE: 13 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503-553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 069806 -03 503-553-9562 N Corrections/Comments/Instructions: - 3._e..,e,5 sec- i -7!-e-- .:Cg -1 41 Z CO �/ CS ? M-L e V 5 _ Vv — 4�/LDS - � , zS / —<, /� / �4i.� ,;-_„ - -c PASS ❑ PARTIAL APPROVAL ❑ CANCEL (1 NO ACCESS AIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 5/3 — d Phone #: (503) 718 - "`ems# -c{�� | CITY OF ��nu m n�'n mmm�wm�uoa�� BUILDING DIVISION ' PERMIT #: &4ST2008-00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 414/2008 Phone: ( 5 O 3 ) 63 Q' 4171 A~� �� � Inspection Requests (24Hmj:(GU3)63Q'4175 �ar�' --� ' INSPECTION WORKSHEET FOR DATE: 6/13/2008 TIME: 7 PAGE: 14 | SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: / PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 oq�. ' OWNER: PROVENCHER, LEO PHONE #: 503.553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/13/2008 Pour Time: | Code # Inspection Description Confirm # Contact # Message 280 Insulation , 069806-02 503-553-9562 N Corrections/Comments/Instructions: | | G 0 PARTIAL APPROVAL El CANCEL ri NO ACCESS El FA|L CALL FOR INSPECT 1 ADDITIONAL FEES ASSESSED Inspector: |nopecto -�/�� Date: 5 �--^7a- . Phone #: /503\ 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 414/2008 Phone: (503) 639 -4171 pwill Inspection Requests (24 Hrs.): (503) 639 -4175 -4;i INSPECTION WORKSHEET FOR DATE: 5/13/2008 TIME: 7:O2AM PAGE: 15 SITE ADDRESS: 13520 SW 129TH AVE.. CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 05 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. • OWNER: PROVENCHER, LEO PHONE #: 503 -553 -9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 230 Underfloor insulation 069806-01 503-553-9562 N Corrections /Comments /Instructions: PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,./ Date: .5 Phone #: (503) 718- � }� 1. 4 ‘ .0 97 1 ? t...., . ._._ . . j f . . , CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2 008 -00020 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/1/20013 TIME: 7:00AM PAGE: 90 SITE ADDRESS: 13520 SW 129TH AVE CLASS OF WORK: SUBDIVISION: MOUNTAIN HIGHLANDS NO. 3 LOT #: 051 TYPE OF USE: PROJECT NAME: PROVENCHER DESCRIPTION: Finish unfinished basement, 713 sq ft. OWNER: PROVENCHER, LEO PHONE #: 503-553-9562 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 069135 -02 513 -553 -9562 N Corrections /Comments/ Instructions: (A L,.-1.16 -7v F A4 PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: / Date: 1 7 Phone #: (503) 718 - 'aQsb -6� Building Pe rn t4glic it-i" 1 A ResIdentlal ; WATFOR OFFICE USE ONLYi h . Y � , , i- si'-- - ' —y ? ECEV It d�, k , u , �F u ,, ,,,.:. 4-,d, " �'�,t _ '.„ ^'.. ,, x, s e- ,.- -I s, ..--...„, r City of Tigard Date/By: 3 7 Og , I Permit No.: )‘ (--e9611 13125 SW Hall Blvd.. Tigard, OR 97223 pp Plan Revie IN °� Phone: 503.639.4171 Fax: 503.598.1960 MAR 7 ( p ° U DateB /By y: 3 5 1 � Other Permit: T I G A R.6- D Inspection Line: 503.639.4175 Date Ready: ® See Page 2 for _ .. <, Internet: www.tigard - or.gov CITY ©FTICY Notified/Method: i I C Supplemental Information BUILDINCD TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING - ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ( Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application •y 2 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 18 ,5 ❑ Accessory building ❑ Multi- family Number of bedrooms: El Master builder ID Other: Number of bathrooms: f' _ JOB, SITE INFORMATION AND LOCATION Total number of floors: ' I : Job site address: / 3 5 O SW 12.9 T" A ye' New dwelling area: ` square feet City /State /ZIP: 77442.6 , 0 t2 4 7 22 Garage /carport area: / square feet Suite/bldg. /apt. no.: Project name: -.L,t ``� � �)..)0) (2--- Covered porch area: square feet Cross street/directions to job site: Deck area: square feet 6 AA2.D E fro /3 5 20 S Ii 7H Ave Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST. (1 Subdivision: MOO R; TA 10J N 1611144 *JO 5 No . 3 Lot no.: 5 I Permit fees* are based on the value of the work performed. i Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. • I Valuation: $ £1 e J i AL' . 1 - sa . I, II Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: LEO t: • &OVENGl - (ta2_ Type of construction: Address: J 35 2 0 S G4.1 ft 9 T6-4 A V E Occupancy groups: City /State /ZIP: -, 6PdLsD, 0 , 91 - 1, - CS Existing: r' Phone: (r p3) SS 3 95 6 2, Fax: ( ) New: '% _ . ❑ APPLICANT - ❑ CONTACT PERSON - \Q NOTICE G Business name: ^ All contractors and subcontractors are required to be Contact name: ,_ n j ( 1 C� �/) � licensed with the Oregon Construction Contractors Board / � r"t L ' / 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: / Jl I ,,F BUILDING PERMIT FEES* . Address: `/ (�1 ( Please refer to fee schedule 22, Structural plan review fee (or deposit): / (p() , .�c� City /State /ZIP: Phone: ( ) ( ) FLS plan review fee (if applicable): Fax: CCB lic.: Total fees due upon application: - Amount received: 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. I: \Building \Permits \BUP -RES PermitApp.doc 02/23/07 440- 4613T(11/02/COM/WEB) �% Building Permit Application Checklist One- and Two - Family Dwelling FFICE USEONL Pa rit ..., sc P, 5 n � �", k, r;i�� t..ty�''r^�_ 1f�.;> _ ... .f . ,__ _• .._., ..' City of Tigard Received Date /By: Permit No.: q 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: a Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 ❑ Electrical; ❑ Plumbing ❑ Mechanical TICARD,i Internet: www.tigard- or.gov -- . � , ❑ Other: #' ii' THE ARE RE UIRED FOR PLAN REVIEW �; Yes' ' No t N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size • sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. ' 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non - ❑ • • : ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. - 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22. "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the ,ro'ect under review. KIU RISD ICTI ONAL5 . 1) ( CI FIGS� #`. ' ' 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. 1 \ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(1 1/02 /COM/WEB) . . f !F ^ - ¢.wfit) ittFc >a� A r y' ; Electrical Permit Applicat„ '� ; FOROFFICE=USE ONLY4.- 4 F �. '' k i� ti fi °.it t?kr� f �ti4'A!'Eit°�R it+�e y .; e h Tigard 7.,._._ . Permit No DateBy p � City o 7 U � k laF/)�V�.te� ( ot a ° 13125 SW Hall Blvd., Tigard, OR ,9�2 e 7 ���� Pla Revie o � C 1'4 � Other Permit Ph one: 503 . 6 39.4171 Fax: 503. 0 Date/By: L.). 5- / S is i .- ' " Inspection Line: 503.639.4175 Date Read /B mds T1GARD Ins i Li p CITYQF- TIB PS1D y y / 0 See Page 2for caro'~ tr Internet: www.tigard or.gov Notified/Method: ( (i Supplemental Information TYPE or WOHK ' ` PLAN. REVIEW ' ❑ New construction 1 Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION - > _ • exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. 'JOB SITE 'INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "I - 3 ", Job no.: Job site address: 13 5 2 O S i , c ; 144 Six or or more residential R occupancy. Recreational t Z� � V C ❑ Six or more residential units. ❑Recreational vehicle parks. City /State /ZIP: — TI, &4 .D 0 Q_. q- Z'�3 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: Q(L E&v '7(E-e_ ❑ Service or feeder 600 amps or more. - FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 • • New residential single- or multi- family dwelling unit. G44206 /ro /342O S it,' /Zr/Tlt Includes attached garage. Subdivision: MO O/O'TA It► if 164 L.4,uAS' NO 3 Lot no.: 5 / 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ' DESCRIPTION OF WORK (with above sq. ft.) r Limited energy, multi - family 75.00 2 -6J N 15 /-J ON t I (S 1 $ A SE7K. -->K)T residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or Tess 80.30 2 ® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: Leo G - Pa_oVENGbtce 601 amps to 1,000 amps 240.60 2 Address: t 352_0 $ Lt.) IZ 4 T" k V E Over 1,000 amps or volts . 454.65 2 City/State /ZIP: �� O2 q7 1 2 . Z 3 Temporary services or feeders installation, alteration, and/or relocation Phone: (503 ) 55 3 Qs ib Z Fax: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'l branch circuit 3 ' 6.65. 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 . CONTRACTOR . Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited- energy panel, alteration, or Address: exte lion. escribe: 1 Page 2 76/ 2 O vil ' \ eP- tiv City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ' ELECTRICAL PERMIT FEES - • Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): Authorized signature: C Did 54 •'7;P/but TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. . Number of inspections allowed per permit. 1.\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05/COM/WEB • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: ! 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* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation H HVAC H Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical • Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\ Building \Permits\ELC- PermitApp.doc 03/23/06 Mechanical Permit Application , i Y o O FILE U S E ON Y' ' ' y}; � r g4 � C t i f , =r �!?r Rec eived ? C of Tigard r o r Date . 0 1 Ar dg M O Permit No.: Nro00S. a I3I25 SW Hall Blvd., Tigard, ORt �s b ' l r' .—� O(�C! - liii '''. F # e i , y f P lan Review C . ;, Phone: 503.639.4171 Fax: 503.:: .'.• t Other Permit: DateB ,1 I C A R i . Inspection Line: 503.639.4175 MAR - 7 ! U • Date Ready /By: �Jur � 0 See Page 2 for , ,,. ;;t ,F,. Internet: www.tigard - or.gov 1 , Notified/Method: - 11 & Supplemental Information CITY OF TI(PRF TYPE oatimiNG DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction Of Addition /alteration /replacement 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* t' 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 7 Air conditioning or heat pump 13 C.d S 1,2.9 1 V E.,- (requires site plan showing placement) 14.00 City /State /ZIP: ,- p l 0 (- c 2 . L Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Q Eij(4}„--v_ Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 / -,- Hydronic hot water system 1400 O logo sw la9 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: L ot no.: Flue/vent for any of above 6.80 �o�luTAtaU �/tc,N[�taos Na 3 5� Other: --- rt I rt "-(- - 3 1 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 1 10.00 Abb 6 A S fftg-pLACE Flue vent for water heater or gas �, ` fireplace 10.00 F/N IS /-1 U A IU t S H ED 6.4 - SeYt4 tJ IV T Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 pil PROPERTY OWNER ❑ TENANT Other 10.00 Name: Z E 0 G . p2o v N cf.( cQ Environmental exhaust and ventilation 20 rk nge hood/other kitchen Address: 135 .Sw /Z9 Ave /� equipment 10.00 City /State /ZIP: T642O, o4. q 7.. Z 3 Clothes dryer exhaust 10.00 _ Single -duct exhaust (bathrooms, Phone: (5'03) 5 53 QS ( � Z Fax: ( ) toilet compartments, utility rooms) 1 6.80 • ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Fax: ( ) Water heater Phone: ( ) Fireplace / E-mail: - Range CONTRACTOR ' Barbecue Business name: Clothes dryer (gas) OwNE Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Minimum permit fee ($72.50) Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: CJ� - �E� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: LE c G • 7 p.. 'j E KK HEI2-- Date: 03 * Fee methodology set by Tri- County Building Industry Service Board 1:\ Building \Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or _ fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\ Building \Permits\MEC - PermitApp.doc 01/19/07 2 Plumbing Permit Application Building Fixtures V-'� VED - 4 FORrOFFICE USE ? *" ; F , -. 5 " ,uu,,�t. p i ice `-% b ., ' , g r y i. s. , + xY ».'+ . . ' l :!+ + ,. t . ., *1?;: :� ... -C �„ S„ r . .. City of Tigard ^^ A ° ? U U Date /B 7 G g k . D Permit No.: M91 g, �� s a 13125 SW Hall Blvd., Tigard, OR 9722 y ,. :: Phone: 503.639.4171 Fax: 503.598 t� I (_� q Plan Review Date/By. Other Permit No.: i �� i�Ytft® Inspection Line: 503.639.4175 D ate Read r ® See Page 2 for I ��R� ; 6U1L®INGDIVISION /B y y a Internet: www.tigard or.gov Notified/Method: / /CO Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. I Ea. I Total ® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 IA I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 13 szp 5w I Z q r4- A V c Catch basin or area drain 16.60 /ZIP: Cit /State T Drywell, leach line, or trench drain 16.60 City/State/ZIP: - FL, el,_ v2 rt ZZZ3 Suite/bldg. /apt. no.: I Project name: pax, \EN clica Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 6 4 A P. D( / Tb / 5520 5tJ /2.5'm Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: (1 40 L 1N #i6 MLruNOS ,VO. 3 I Lot no.: 5-*/ Water service (no. linear ft.: _ ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 ' DESCRIPTION OF WORK Backflow preventer Page 2 f / N 15H U ‘OF /N ISI-f tD a A-S .7 Iv 1 Backwater valve . 16.60 Clothes washer 16.60 Dishwasher 16.60 PROPERTY OWNER ' I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: LEO C. , P a N C REP. Expansion tank 16.60 Address: (3 520 5 w t Z q - 4 lk v E. Fixture /sewer cap 16.60 City /State /ZIP: Tc z0 , t_) 2 q 72, _,3 Floor drain /floor sink/hub 16.60 Phone: (503 ) 55 3 q 5(c. "Z, Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 • Ice maker 16.60 Business name: Interceptor/grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory / 16.60 Phone: ( ) Fax::( ) Tub /shower /shower pan / 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 1 16.60 Business name: Water heater 16.60 Address: O V�J (, \ Q E p Other: City /State /ZIP: F Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: pe_Q_,D ad . TOTAL PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I: Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site` Utilities Qty. Fee (ea) Tour ';Square rootage;, Permit'-Fee: Footing drain - 1" 100' 55.00 0 to-2,000 - > -. $1.15.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: `Permit Fee: • Storm &Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each 'Fixture or Item ".' • Qty Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. e) Fixture Work: Plan Review for Plumbing'Installations. ' Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees ❑ Any new commercial building with water service 2" and • Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed • Fixture Type: . • Replace engineer. Previous Capped Added` 'Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower 1 ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser, Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -3" Car Wash Drain Garbage -Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink • -Bar/Lavatory i - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\ Building \Permits\PLM- PermitApp.doc 12/27/06 `= WV This permit does not authorize the violation of any MAR ` �Ud • rights of holders of private easements. The ap- CITY OF TIGARD - LIABILITY plicant is urged to contact any such parties and BUILDINGDIV!SION � I .., t1,i.ar niTrro,1l t arn•.. •• uinr4 TI la City -.--- J; T J cult.] it5 1 employees shall not be u responsible for discrepancies ` _ which may appear herein. _ -_ ,, m _ _Sy _ _ __ _ ___ _ i t r W w_. '- - f � 1V ` , --'it 1 ry 1 J j \ j / 1 ®I -, 1 ,1 , 7 c) i r -- 1 I 1 j 1 I _ 1 imam F� l II ® � — I ^ L i er ii i / G J j ' 1. i .. F 1 -1 —,,71,76--- 1 _ $ ...— �i B � L o ' I O P. I IP:E PCl PAIN ,� 1. — � L 6 7 GAS C Ar, r: A:; ( i A- (� ' l � 4 CP If } ;I � i �. . _. P i ' 21 IL h ' j ( I t 1 I I ' :::✓,,%1 II -Jig 1 + ) /'in'F't'1 /4 :. Ur 4;1 C CITY OF TIGARD r FLOOR PLAN Approved (?-.)= e,-a4.,, v:J„ = l -t_, 1 • Conditionally Approved . ( ): t b ! M5 'tT PERMIT NO. xis08- 60030 - See Letter to: Follow ( ): . Attach , ( )• Job3gdress: / 3Sa0 S /,* eve OFFICE COPY By: l •5._.7_,.w.__....__......_:_ r te. 77"114- . . 1 l0I 4-1,7..A.v, \z/../. .zreirati743 ,y, florro 01 •—• rn ' . fT-Oi nt9A7mi=1 f:4 11.)\ ViT _ mi P=00 ;L ,? .— t9 `1 4 - ,.\- - 1, 1 l am 1 i I I., !"..r.—=*---:r,I. 0 t' I I 1 .I 11 ,, SOUTH OATH ELEVATION WEST DATH ELEVATION NOrTH t3A1 ELEVA1 ikr = i-Gy , r4i:Alc: fk-1 --1-0 t-,:.--,o, Im — ----- ---- - (() ----- — w c 1 ___---_--=-_—_ _ 8 , Tc , L___ , I J - ,-, 171 -- -___ - -1 El x o 0 ____....._ / 7 - if_ I / . I clot.,,,,,a I 0 lc uior...0 t \ . .. ■____ , 4 1 ... ,,,,, ., I. 4.-- ____„ I • .c - -- — • :-:- kr _ --- .--A ---- • ., 0, t _ -- ' --- 4 -- . ----- vi, , . _ _ 4, _t Ot ...9._:11:-.— f • 1 A_I O oei \ - j____11 . - 1 LL L.I i — i o Iv I _ 1:-=_IS.C1 FICAL FLAN (0 II A 8 1 --- •■■.1 . do icavolp - 2:13i-O.NAOL:1 - _ 7 ,.L.00 0 1 1 V '=I 7 ,_. 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"I -,.'!" , q: :•;;'-', ...;) - "f %':- - ,,,e '.' . ., . .:' 4 -- `,', ,.. , ,)," .,,,,--".' :, ',..:;.',. ".:2&:f.' I" . ", Z'i. :v ' '+• 1/2 " Gypsum wall board (to finish ail walls) --,,,2, ywoo .. PI d decking (existing ,-:.....,, R fiu (path 1) - p( ---- I ri i in ch I Gams on 16 cic (existing i _,..,. Concrete Foundation wall (existing) .R5 5,.."-Wt`;''',10-itirk.§."4*00R-11.4- . — CROSS SECTION OF BACK EXTERIOR WALL Leo & Goy 113520 SW 1329th Ave) I Provencher !Tigard, Or 97223