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Permit 1 1...? CITY OF TIGARD MASTER PERMIT 1 PERMIT #: MST2007 -00165 COMMUNITY DEVELOPMENT DATE ISSUED: 10/17/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112CC - GF031 SITE ADDRESS: 15767 SW 81ST AVE ZONING: R -12 SUBDIVISION: GAGE FOREST LOT: 031 JURISDICTION: TIG PROJECT: GAGE FOREST Project Description: New SF BUILDING REISSUE: MS1A -GR STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 895 sf BASEMENT: ' sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1,309 sf GARAGE: 469 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: St RIGHT: 5 VALUE: 226,668.75 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2204 sf REAR: 15 PLUMBING SINKS:. 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 NAT FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFOR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM /SVC/FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC/FDR> =225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC: ELECTRICAL - RESTRICTED ENERGY / A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL It 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 JT ROTH CONSTRUCTION, INC. JT ROTH CONSTRUCTION INC laws. All work will be done in accordance with approved plans. This 12600 SW 72ND AVE. 12600 SW 72ND AVE STE 200 permit will expire if work is not started within 180 days of issuance, or SUITE 200 TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: PORTLAND, OR 97223 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: 503 639 -2639 Contact #: PRI 503 639 - 2639 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 624 -0239 Reg #: LIC 31700 TOTAL FEES: $ 11,950.44 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 - 4444 Issued By • ` / � Perm ittee Signature •, • 1a/ /! 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 completi ' of the project. Approved plans are required on the job site at the time of each inspection. ! , Building Permit Application RECEIVED l�oR oil lcE usr: o\l.\ City of Tigard Dat /B d p� � • 13125 SW Hall Blvd., Ti OR 97223 0 L �� '� ' Tigard, A U G 2 8? U U Plan B R ov i ew ' C Phone: 503.639.4171 Fax: 503.598.1960 Date : • • • I p Permit I A k �� i , I / !L / — % I _ 1 FIG n I . D Inspection Line: 503.639.4175 CITY OF r Date ReadyBy ®See Attached Checklist for Internet: www.tigard-or.gov Notified/Method: Sup plemental Inf 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. ® 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ ❑ Accessory building ❑ Multi -family Number of bedrooms: f ❑ Master builder ❑ Other: Number of bathrooms: 2 yZ JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /--/..769 y Ai7� t�7 � /� New dwelling area: 2,..2, 0 square feet City/State/ZIP: Tigard, Oregon 6 Garage/carport area: If ' square feet Suite/bldg. /apt. no.: Project name: GAGE FOREST Covered porch area: c,, square feet Cross street/directions to job site: Hall Blvd and SW Langtree Street Deck area: ..,; square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: GAGE FOREST Lot no.: 2/ Permit fees* are based on the value of the work performed. l 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. / NEW SINGLE FAMILY DETACHED Valuation: S Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: J.T. ROTH CONSTRUCTION, INC. Type of construction: Address: 12600 SW 72 AVENUE, SUITE 200 Occupancy groups: City/ State/ZIP: PORTLAND, OR 97223 Existing: Phone: (503)639 -2639 Fax: (503)624-0239 New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: J.T. ROTH CONSTRUCTION, INC. All contractors and subcontractors are required to be Contact name: DAVID JENSEN licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 12600 SW 72 AVENUE, SUITE 200 jurisdiction in which work is being performed If the City/ State/ZIP: PORTLAND, OR 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 639 -2639 Fax: : (503) 624-0239 E -mail: DAVIDJ@JTROTHINC.COM CONTRACTOR Business name: J.T. ROTH CONSTRUCTION, INC. BUILDING PERMIT FEES* Address: 12600 SW 72 AVENUE, SUITE 200 (Please reJerto fee schedule, City/State/ZIP: PORTLAND, OR 97223 Structural plan review fee (or deposit): Phone: (503) 639 -2639 Fax: (503) 624 -0236 FLS plan review fee (if applicable): CCB lic.: 31700 Total fees due upon application: Amount received: Authorized signatur Thin permit application expires if a permit is not obtained �� J within 180 days after it has been accepted as complete. Print name: f �� , 2 . Date: l �f ** Fee methodology set by Tn-County Building Industry �✓ ''. / Service Board. I:\ Building \PermimaBUP- PeneitApp.doc /06 440- 4613T(I1/02/COM/WEB) 08/20/2007 06:39 5036489723 JERMOE ELECTRIC INC PAGE 06 Aug 17 07 10:06a jr Roth Construction, Inc (503) 624-0239 p.z • Electrical Permit Application FEULJVL e: 01 i is I. d) I of .I,1 City of Tigard ,r ,iv vesstit i� 13125 SW HMI Blvd, T d, OR 97223 7 U tit /a. Phwec 503.63R 41 pax: 503.598.1960A U U £ 0 ZOO ( � y 8 Review Other Pernik TIC, r, r, Iaep mina Line: 503.6]9 Vete ]to 111 See 3 kr CITY IRAN) Nod d '" Internee www.tigord.er.gov 9rvt�� Pgfer„a}Ips, TYPE OP W ,= j, :. - _ . PLAN REVIEW ® New cansenection ❑ Additicealeeration eploeement Please elseeh o,l teat aPpy (submit a sets anions oedemas clucked below): ❑ Service m fcedor 400 amps or more ❑ Building ova now nodes. ❑ Demolition ❑ Other Whmetheimitable Owls amen D bbniner and btstyarde. CATEGORY OF CONSTRUCTION exceeds 10,000 nom at I50 eofsor C Flouting buildings. ® I.- and 2-family dwelling ❑ Commercial/industrial ial�indusirial ❑ Acc anxy building lento ground or ooze ► woo 0 Conono eoMrae 0 Multi- family ❑ Master bolder GPs fie all niter iatttlktiott� bw tiffei Otltee: ❑ Fife poop. 0 taseset.gosar kVgor J OB S37$ INFORMAT[QN AND LOCAIIOPQ lu+roY'7s how separately derived 'petrel, G,,�_/ C� ❑� fa Addition 0 % "E". -1 -2". "t-3 Job no.. 11 J Job sire address: '�74r� v►w !� (` ) 100HP Or Mat neeupoocy. ❑ Six Of mom midendd sob. O lkwm0o sI'd 'dick Pada. City /St : Tigard, Oregon O Halle - are facilities ❑ Supply Wage for mole then CI Nnorldoon locutions. 600 wits now;nal. Suif dbldgltpt.no.: I Project name: GAGE FORM 0serwe fader 60 amps oreine Cross street/directions to job sits: HAII Blvd & SW Langtrec Street . Pei:!!: SCHEDULE ! �.1,. . pea eW New smldonnalsbeglo- or mob Wanly dwelling writ Include, a tnebed garage. . Subdivi t ion: CAGE FOREST . Lot no. : l ; 7.000 sq. ft cr less 145.15 4 Ea add'I 500 eq. R. or portion : " ' 33.40 0 Tax map/parcel no.: • tad ener(p, residential gi 73,00 Ell DESCRIPTION OF WORK J qtr above t! NEW SINGLE FA'VI LY DETACHED • Limited cony. m • • ly . 75.00 residential with 'bow . 0. Serious or feeders lest Wal ton. Alters and/or relocation • ® PROPERTY OWNER 20 amps or less ill 06.85 2 O TENANT 201 amps to coo ante 106.85 2 Name: J.T. ROTH CONSTRUCTION, INC. . 401 ramps to 600 amps III. 160,60 El 0, 1. 05 to I,t or amps 240.60 Ad:Address: 12600SW. 2600 SW. 72" AVENUE, SUITE 200 Outs 1.000 , , .. or volt s 454.66 ' City/State/ZIP: PORTLAND, OR 97223 Temporiny smiler or feeders irwtnlladon, ateesat1at . and/or relocation PbOrne: (503)639 -2639 1 Fax (503)614 - 0239 200 now or la s 66.85 1 Owner installation: This installation i9 bciTig mad* oa property that 1 own which :is not 201 ulfts to 400 naps 300.30 I 2 intended for salt, lease, mot, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 env* 333.75 _ • 2 Breech titettts - nee!, *erode ortexteosion, tar pand Owner signature: Date: A. Fad for btnaoh ctatita with is APPLICANT 1 ❑ (.II1Ylt ACT' PERSON above service et hula fee, each branch drank 6.65 2 Business nine: J.T. ROTH CONSTRUCTION, INC. B. Fez for breach circuits withorn service or f ester fee, Cortwa mart DAVID JENSEN 46.85 2 Got branch eireu n Address: 12600 SW 72 AVENUE, SUITE 200 Each addi branch circuit 6.65 Ei IdlexUaeeomr (service or feeder see included) City /State/ZIP: PORTLAND, OR 97223 Each mmnufectursd ca sooduler dwel 90.30 i 2 Phone; ('503) 639.2639 I Fats : (500) 674 -0239 ling. COQ and/or feeder R ump or irrigation only 56.85 II E DAVIDJ(c�Jl'QOTHINGCOM 7 irsigationoirele . 53.40 2 CONTRACTOR : or outline fighting 53.40 2 I Buaianaa name: JEROME ELECTRIC INC. Signal eiretit(s) a limited- energy panel, alteration or Address: PO BOX 751 extension. Describe: Page 2 2 City/State/ZIP: HILLSBORO, OR 97123 Emelt ddieioaal teapertfn oa'ar allowable is RA ease above Phone: (S03)648 I Fax: (503) 648 -9723 Per inspection - 62.50 laveetigtetigrtpetbtout (]]smelts) I 6250 CCB Lie.: 158119 I Electrical Lie.: 28775 I Suprv. Lie: 34119C Industrial per hour 73.75 EI:ECfRI Ax. PERMIT FEES Suprv. Electrician signature. required: Subtotal: Print name: DAVID A JEROME Dram r2,Q Plum review (25% of permit foe): • • 81ate msehmge (1394 of pe suit fee)! Authorized signature: / / TOTAx. PERMIT FEE: 7165 permit apparel eepliiose tr a tenure io suit nlrblod .stags IN Print nMmc: Date: days utter aim bean occupied eu complete. Numtxr of iaspecdoos allusive, per /emir l IMIIrge reolts5T.C.Paur' emirs arms No.lt rams .c .UWEB • Mechanical Permit ADD!•! EW ) p. r i l 1. t ( i I `I'' ' , ,.) City of Tigard Received tersditY Parted N64 d �I10 13125 SW Hell >31vi .. Tigard OR 9722 U G 2 8 2007 Plan Review Oil= Permit: O. Phone: 503.639.4171 Far: 503.5911.1 DMA,: bfapnaiee LA= 503.639.4175 CITY OF T16AiiD Date Re+drl8r: Nor: D Bee Pima <m Interact wKW.11gardbr.gpv N0o4adlMetwod: SapplerastadItfbreudea TYlE OF WORK COMMERCIAL FEE* SCHEDULE — I1SE CH6QQJST ® New ttststrtrtian ❑ Additian/elteradOefeplaceeseat Meehaea of permit fees• are based on the %else of the work perfumed. iodrnte the value (rmtdedto the newest doUar)otall ❑ DCmolitian ❑ Other. meebordeel materials, ogol aee1. labor. overhead, and proAt. CATEGORY OF CONSTRUCTION value f ® 1. and 2- family dwelling 0 Commercial/industrial 0 Accessory building RSA' EQUIPMENT > SYSTEMS FEES* lu ❑ Mph-family ❑ Mosier btnJder ❑ pd,a For epes�ar,e/br»,�toao dm-Ulm Description I (NY. 1 Ea I Tobel JOB SITE INFORMATION AND LOCATION Iiotlgdcao jab Silc tttatRa 17 6 7 .7) /5 /. d,. "ir !cedilie or beatpump teaaitea I4,00 City /SwtcIZXP: TIGARD, OREGON : Fnreaee 100.000 BN (elect eau) 14.00 Suite/bldg. /apt. no.: 7 Project name: GAGE FOREST Furnace 100.000 +BTU (ev aide) 17.90 Gas hod pump 14.00 Crass strset/ditections to job silk: Hall riled & SW Langteee Street Duct work 14.00 %Monis bot water syrtem , 14.00 _ Resider tin) boiler (radiator or hydroids) 14.00 Unit heaters (Siel•type, Dot electric), in -wall. uwluet s u s p e n d e d . etc. , 10.00 Subdivision: GAGE FOREST I tat so.: 3 Fludvart for of above 10.00 i on. 10.00 Tax map/meet no.: Other Rd Wailers DESCREFTION OF WORK Water baiter / 10.00 NEW SINGLE FAMILY DETACHED Gas fireplace _ 10.00 Floe vet for waver heater of gas firapleee _ 10,00 • Lee lilrpmr_IFoa), 10.00 Woodrpepd stove 10.00 Wood &eideeefmaett 10.00 21 PROPERTY OWN101 1 ❑ TENANT Cana rilina/Audvmx 10,00 Other 10.00 _ Name: J.T. ROTH CONSTRUCTION. INC. Environmental faint and venlpadon Address: 12400 SW V"' AVENUE, SUITE 200 Range hood/odor kitchen - e4tagment / 10.00 , City/Sew/ZIP: PORTLAND, OR 97723 Clothes dryer exhaust 10.00 . Singledlam exhaust (betlramns. Phone: (S03)6394639 Fax (503)6241.Z39 toilet eommaaents. util rooms) 6.10 ® APPLICANT ❑ CONTACT PERSON Attidcrawlepeeef2ns 10.00 Other. 10.00 Business name: J.T. ROTH CONSTRUCTION, INC. F el i4 t l Contact name: DAVID JENSEN I 3140 far Eras four, 51.00 for each addltlaasl Rome. etc. Address: 12600 SW 72 Ai/VI sum. IN tea that pump - £. CityfStMsrJZIP: PORTLAND, OR 972L3 WaWatspendedAtnit heater t Water hexer Phnsr. (503) 639.'2639 I Fat' : (S03) 62443239 - . _Fireplace E -mail: DA _ COM Rome CONTRACTOR Barbecue Clothes ebTer (gas) me se: TRERMALFLO,INC. Other Address: 7236 SW DURHAM ROAD 0100 MECHANICAL PERMIT FEES' City/Slsard Subtotal ZiP: TIGARD, OR badman permit fee (372.50) Perms (503) 6704143 I Fax: (503) 670.9864 Plan review (25% afpermit fee) CCS lie. 151547 State :runtime (E%ofmusk fee) , TOTAL PERMIT FEE 1 / T penal •pdal tea empire. if a Fermat. vet sbtied wain tae Authorized signore: i J . • '1 drys der 0 has aegis accq`i as mreplete I Pry tattle: W1 , --S I Date: 9 -67 I • Fix fiver web' Th -Cesay BefldNS ladueaM1 Sallee Bead evaveg1( nrWaC•l4rn onaig. amwee • 44O411Tt .GOWN) 08/17/2087 12:42 5036445989 CRAFTWORK PLUMBING PAGE 04/04 r+ui& t I U .1•c.•1ip JT Roth Construction, Inc (503) 624-0239 p.4 / Piumbin Permit A ii If E[) City of Tigard ' Rocivee .iI 13125 SW hall >, ragm� °R 2 8 2007 { r 503.33W Phew 503.639.4171 Face , I . „ lespe tion L 503.619.4175 ^ M��r ii yap T Internet www.qgmd.or.gov ONerFeneirNw: ; Lim TYPE qF '•- '`1 `i; _ ` i - - ttedlirdlMttGo/; 181 Nce►wa�u ❑ Demolition ' — .- ScBOCDUI.B ❑ Aas�eoemenc pt6er Per ..... , c,,,, _ Near 1- 2. 'd 6a Total OF CONSTRUCTION �°� � (iatahrda 100 R �r each 9.2 connooden) SFR (1) bath 249.10 ® 1 - sod 2 -f®oly dwelling ❑ Co Cnaneneiallmdastrial SFR (2) bah 0 Aooeeecny building ❑ Mohi-Emily SFR (3) bout 350.00 ❑ Mahhster Wilder _ 399.00 Other Each attritional bat/Watch= 43.00 E:=111/44WroVAII 40J1111,4 4 'Am. JOB S8$ INFORMATION AND LOCATION lime (- - sq. 8) _ pegs2 She cOlUdee City/5o1r1�: TICAMiU, OREGON Gbh been at ram dmic 16.60 Dr7well, teach lee. or trench coma Aria_ 16,60 Suitt/W.40am no.: Praieetamme: CicE FOREST Fuming drain (m. deed R: ell traAlehteetipns to job tats: ITa12 Blvd SW Street home utilities Page 2 110_00 Cross s Manhole' / 16.60 Rein drat mamma 16.60 9aedlar2 seeder (pa Ikea R: Page 2 Strum Berra (em. linear It: ___) Page 2 Stge ivition: GAGE FOREST f Laeao.; Water service (no, ear S.: ,_) / j • Page 2 Tax map/pared no.: Flatus wawa &d 'lyn DBSCR/PTION OF WORK lithe 1660 NEW SINGLE FAMILY DRTACBED Ow P r Page 2 Backwater valve 16.60 Clothes vosber 16.60 Dishwasher 16.60 ® PROPERTY OWNER p Making lberdain 16.60 TENAPrr Na J T. ROTS CONSTRUCTION. 16.60 Nam Address : 1�0 SW ri AVENUE, SUM 200 Evanston link 1660 F xestelrewer cep 16.60 City/State/ZIP: PORTLAND, OR 97?.23 Floor dreis ifloor sink /hub a �� 16.60 Pl Fax (�)6Z+�9 Garbage d•rPa+al 16.60 ® AP'DLICANt C] CONTACT PZRS 1N Rues i 16 60 tll BusineSS aame:.LT: LOTH CONSTRUCTION, INC 10e maker 1660 Casraaneme: DAVID JENSEN � 7° u a °V 1640 Address: 12600 SW 72" AVEPIUE. SUITE 200 Primer e al gm (lob= S � ) p 1 Pr><ner 1660 City/State/ZIP: PORTLAND, OR 97 3 Roof drain (eonemceetia4 16.60 Phone: (303) 639.2639 Far : ) 62 239 S ova y 16.60 Edna: DAVERW rROT> CCOIId T� Pm 16.60 CONTRACTOR — Odom 16.60 Wa t closet 16.60 Business emu CRAFTWORK PLUMBING. INC. Water beaux . 16.60 Address: 7'I?75W CIRRUS DRIVE Other: A!!! City/SlaterZ IP: BEAVERTON, OR 97018 Thom (503)6444698 Foie (9013) 644,4050 Ra lRadal baekllOW Uthlintrmr foe 3362 Oda Lic,: 79666 //�� Lim no.: 20-14EPH Plea review permit De) At: ori:PM sigma= /, /. %'.t-, /' �, / r State aadaerge (Oi olpaoiit the) TOTAL MOAT FEE / i M Date: ; 7 / / II* rem& applbMao expo II a parse es not ebtobed within 188 dlrys atbetr D he seen as aoe,rplare, tea maw 'Fee medtodi Ie y set by Tsi-C he y B thderg h Service Board. «a+srsnctato,coavrreer yi/t,V ,OX ?- 00 / City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 I1 July 2, 2008 • T I GARD J T Roth Construction, Inc. 12600 SW 72 " Ave., #200 Tigard, OR 97223 Re: Permit No. See "Notes" Below Dear Sir /Ms.: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: See "Notes" Below Project Name: Gage Forest Job No.: N/A Refund: ® Check #58047 in the amount of $1,200.00. ❑ Credit card "return" receipt in the amount of $ ❑ Trust account "deposit" receipt in the amount of $ Notes: Refund for overpayment of TIF -R fees due to calculation error at $240.00 for each of the following permits: MST2007-00163, 15731 SW 81 Ave., Gage Forest, Lot 29 MST2007- 00166, 15680 SW 81st Ave., Gage Forest, Lot 9 MST2007- 00165, 15767 SW 81St Ave., Gage Forest, Lot 31 MST2007- 00164, 15706 SW 81St Ave., Gage Forest, Lot 8 MST2007- 00162, 15672 SW 81st Ave., Gage Forest, Lot 10 If you have any questions please contact me at 503.718.2430. Sincerely, , 4 " WeriZ 77- e-- Dianna Howse Building Division Services Coordinator Enc. \ Building \ Refunds \ Administration \LuRefund- overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 III City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: J T Roth Construction INC DATE: 6/12/08 12600 SW 72n Ave #200 Tigard, OR 97223 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: Various — See Attached Case #: Various — See Attached Date: Various — See Receipts Attached Address /Parcel: Various Pay Method: Check Project Name: Gage Forest EXPLANATION: Refund overpayment of TIF -R fees REFUND INFORMATION: • • Fee Description From Receipt Revenue Account No Refund : Example: , [BUILD] Permit Fee Example: 245 - 0000- 432000 $ Amount [TIF - TIF Resident 210 - 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 (TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 [TIF-R1 TIF Resident 210 - 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 TOTAL REFUND: $1,200.00 APPROVALS: If under $500 Professional Staff ,22 If under $7,500 Division Manager /, f� y ‘' " `y 08 If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board / FOR TIDEMARK SYSTEMADMINISTRATION USE ONLY - ,/ Case Refund Processed: I Date: 1p12-5/0i" I By: I I:\ Building \Refunds \RefundRequest.doc 05/23/07 I STREET TREE CERTIFICATION 1 OWner/Agent for 07/7 -c7k ( (PLEASE PRINT) PERMIT HOLDER) -- - Do hereby certify that the following lOcation meets - City of Tiga-fd 'and Wahihgon (•ounty land use and del;eloprnefirstandardSzOi street tree installation. ,/,;\ IT • • ADDRESS: /5767 fi/ 6-7 M5 T2v1coi , SUBDIVISION: ita/frzt LOT: SIGNATURE: DATE: (0 AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) I.\ Building \ Forms \ Stree tTreeCerti ficate 01/19/07 CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 f INSPECTION WORKSHEET FOR DATE: 4/23/2008 TIME: 7:02A1v1 PAGE: 21 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF • OWNER: ,!T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639 -2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 4/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 209 Final inspection 068759 -04 503-806-0602 N Corrections/Comments/Instructions: GL6111.1 I a1' if- > • • U PAS rA /ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL gl CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Oc Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MS12007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 10/17/2007 Phone: (503) 639 -4171 -7v � hcil Inspection Requests (24 Hrs.): (503) 639 -4175 ..'4- `__.. INSPECTION WORKSHEET FOR DATE: 4/23/2008 TIME: 7:02AM PAGE: 22 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 603-639-2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 4/23/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical ical final 068759-03 503 -806 -0602 N Corrections/Comments/Instructions: l �4 I0_ PAS 1 IA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL rYCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ ` — Date: /p Phone #: (503) 718 - Z 6 VY • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1112007 Phone: (503) 639- 4171r� I t^ Inspection Requests (24 Hrs.): (503) 639 -4175 ....'..� IL. INSPECTION WORKSHEET FOR DATE: 4/22/200B TIME: 7:00AM PAGE:. 44 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503 - 630 -2639 CONTRACTOR: S IT ROTH CONSTRUCTION INC PHONE #: 503 - 639-2639 Inspection Request Scheduled For: Date: 4/22/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 068606.04 503-806-0602 N Corrections /Comments/ Instructions: PLP'( Zxrc:8 - °pl �� _ 1 7, � , j- • .- t- .r�,�s� - r7�t1 1 G -ASS r PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL r CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: • / Z U Phone #: (503) 718- — %1111■ , CITY QF..TIOARD , BUILDING DIVISION PERMIT #: MST2007.00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1 Phone: (503) 639 -4171 Aviitil# I nspection Requests (24 Hrs.): (503) 639 -4175 A 1. INSPECTION WORKSHEET FOR DATE: 12/7/2007 TIME: 7 : 00AM PAGE: 40 SITE ADDRESS: 15767 SW 81ST: AVE ' CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 03 TYPE OF USE: • PROJECT NAME: GAGE FOREST' • DESCRIPTION: New SF , . OWNER: JT ROTH.CONSTRUCTION, INC., • PHONE #: 603-639 -2E639 CONTRACTOR: JE ROTH CONSTRUCTION INC PHONE 503 - 2639 ' Inspection Request Scheduled For: Date: 12m2007 , Pour Time: 4 Code # Inspection Description Confirm # .. Contact # Message 320 Plumbing rough -in ' a 061050 -04 503-806.0602 N Corrections /Comments /Instructions: ' L i 3 ► 4-A,i ,r , ' ;i s let 7' F I Av\-t. 47A0 0- sd I`- Lo -r 3O IS Li 7. , Qe0o‘-T A-AA t;rr . u - 1 1 • ' / 1 • i , I 1 1 1 X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED , Inspector: YV 1V ..------ Date: (2-1 - 1) D Phone #: (503) 718- i 1 CITY OF TIGAR® . " BUILDING DIVISION PERMIT #: MST2007- 00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: W/17/2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/31/2007 TIME: 7 :00AM PAGE: 30 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 03.639 -2639 . CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503.639.2639 Inspection Request Scheduled For: Date: 10/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # • Message 315 Post/beam plumbing 058733 -10 503.806 -0602 N Corrections /Comments /Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 7 Inspector: (iL Date: Phone #: (503) 718- 1-J CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00 165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/ 17 / ?(Y) l Phone: (503) 639-4171 161Y 4114/ A Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/29/2007 TIME: 7 : 01AM PAGE: 6 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New f3F OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503- 639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 10/29/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 058543-14 503- 806 -0602 N Corrections /Comments /Instructions: 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: c 1 " - ti (f" Date: ►D `2A (,off Phone #: (503) 718 - CITY OF TIGARD - 1 BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: lQ /10/11000/ D AT Phone: (503) 639 -4171 q'�l Inspection Requests (24 Hrs.): (503) 639 -4175 ..:�� `__.. INSPECTION WORKSHEET FOR DATE: 10/26/2007 TIME: 7:00AM PAGE: 23 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jf' ROTH CONSTRUCTION, INC., PHONE #: 603-639-2639 CONTRACTOR: SF ROTH CONSTRUCTION INC PHONE #: 603-639.2639 Inspection Request Scheduled For: Date: 10/2612007 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 058447 -03 503- 8060602 N Corrections /Comments/ Instructions: X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6 1 l `l Date: 1- 12 C / c"? Phone #: (503) 718- CITY OF TIGARD 1 BUILDING DIVISION PERMIT #: MST2007-00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 ill Inspection Requests (24 Hrs.): (503) 639 -4175 �' F INSPECTION WORKSHEET FOR DATE: 10/26/2007 TIME: 7:00AM PAGE: 24 SITE ADDRESS: 16767 SW 81ST AVE_ CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New ;3F OWNER: sr ROTH CONSTRUCTION, INC., PHONE #: 503-639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503639 -2639 Inspection Request Scheduled For: Date: 10/26/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 068447 -02 503-806-0602 N Corrections /Comments/ Instructions: IX PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: d \A1...- ∎ %. \4\-...., Date: 10 (2 (O 1 - 2 Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: M ST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/200/ Phone: (503) 639 -4171 A ,t it Inspection Requests (24 Hrs.): (503) 639 -4175 '!!� INSPECTION WORKSHEET FOR DATE: 10/26/2007 TIME: 7:00AM PAGE: 25 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New :3F OWNER: ,!7' ROTH CONSTRUCTION, INC., PHONE #: 503 - 639 -2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 - 639-2639 Inspection Request Scheduled For: Date: 10/26/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 055447 -01 503.806 -0602 N Corrections/Comments/Instructions: X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: 1 t 1 ....r Date: (Q 1.2 1. / 0 7 Phone #: (503) 718 - CITY OF TIGARD 1 ._' BUILDING DIVISION PERMIT #: MST x007 Ota 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/ Phone: (503) 639 -4171 Ato � 1 1 Inspection Requests (24 Hrs.): (503) 639 -4175 _..'= '.. INSPECTION WORKSHEET FOR DATE: 3/20/2008 TIME: 7:02AM PAGE: 6 SITE ADDRESS: 15767 SW 61ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF • OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: Jr ROTFI CONSTRUCTION INC PHONE #: 503- 639 - 2639 Inspection Request Scheduled For: Date: 3/20/2008 Pour Time: Code # Inspection Description Confirm, # Contact # Message 199 Electrical final 06705(3.05 503 -006 -0602 N Corrections /Comments / Instructions: • II *- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Dater - Z cI Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST 2007 -00 X65 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10117/20Q7 Phone: (503) 639 -4171 4„u'd ty�ti y . I lii Inspection Requests (24 Hrs.): (503) 639 -4175 ` _ INSPECTION WORKSHEET FOR DATE: 17J7117007 TIME: 7 :03AM PAGE: 12 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 639 -2639 /?/,?. 7 Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 062041 -05 503 - 806-0602 N 01i-- !kl w V6rv`I A tXV F.i LS Corrections /Comments /Instructio j -ASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS II FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I Inspector: 1A.42) 1..S' Date: ‘10 ' Phone #: (503) 718-04 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 01)165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 tiaOltilit Inspection Requests (24 Hrs.): (503) 639 -4175 A_ .. INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7 :03AM PAGE: 11 SITE ADDRESS: 15167 SW 015T AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J1 ROTH CONSTRUCTION, INC., PHONE #: 503639.2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503- 639 -2639 Inspection Request Scheduled For: Date: 42/24ap07 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 062041 -06 503 -1106 -0602 N Corrections /Comments /Instructions: 4 P R aq % 0 Er k 't �p € 5 1 o S -'6431 Ma Ng \t Nd A ASS 1111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C7 NkSB L- Date: II /)4 * Phone #: (503) 718- 10411/0 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1 YAW Phone: (503) 639- 4171�� Inspection Requests (24 Hrs.): (503) 639 -4175 ":_.. INSPECTION WORKSHEET 1/14/2008 TIME: 7:04AM 7 SITE ADDRESS: 15767 SW 8151 AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 639 - 2639 Inspection Request Scheduled For: Date: 1/14/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 063170-01 503806-0602 N Corrections/Comments/Instructions: 6 7- 3 (/ _Z 6 9 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED Inspector: Dater —`�--0 r Phone #: (503) 718 - 2,1,< CITY OF TIGARD BUILDING DIVISION PERMIT #: MS T7007 165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1!;f17f2Gi7 -00 Phone: (503) 639 -4171 4Y141higit Inspection Requests (24 Hrs.): (503) 639 -4175 l'___. INSPECTION WORKSHEET FOR DATE: 1/11/2008 TIME: 7 :01AM PAGE: 5 1 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: Q3.1 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 503- 639 -2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 - 639 -2639 Inspection Request Scheduled For: Date: 1/11/2008 Pour Time: Code # Inspection Description Confirm # Contact # Mess • ■ - 280 Insulation 063090 -01 503 006.0602 Corrections /Com ents /Instructions: v ____ 1 kJ a ,,, : 0 ,„ \v „,,,,,„ ,,,. ,r,, 4-‘2.,. --- 1 A_ e . c.A.-t S— �� 4 2_ l L ivoLkii : P4_,ek__es (.T D e' s) 9-1 A ig ■rPriekl 1..vvec' ay c NI ' (44L.c,-(2_ 1 1 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONA FEES ASSESSED I a (1-Z________,--- A/A \ tt _0_ Inspector: Date: Phone #: (503) 718- p � ) CITY OF TIGARD BUILDING DIVISION 1 PERMIT #: MS12007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 k . INSPECTION WORKSHEET FOR DATE: 1/9/2008 TIME: 7 :01Ahlf PAGE: 5 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE= FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTFI CONSTRUCTION, INC., PHONE #: 603 - 639 -2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 - 639.2639 Inspection Request Scheduled For: Date: 1/9/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 062858.03 503 - 806.0602 N Corrections/Comments/Instructions: I 1 A- 4 fi�Ii1 1 IAA ° i J - 54,A---\ -- . 3 P ( *0 ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I 7)1 f A ,,,,,,.._ Inspector: Date: Z Phone #: (503) 718 - CITY OF TIGARD ' ` BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2007 Phone: (503) 639 -4171 Alt° Inspection Requests (24 Hrs.): (503) 639 -4175 . �:_— INSPECTION WORKSHEET FOR DATE: 1/9/2008 TIME: 7 :01AM PAGE: 6 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 081 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 5 -639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503- 639 -2633 Inspection Request Scheduled For: Date: 1/9/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 236 Shear walls/anchors 0628510 -02 503 8080602 N Corrections /Com ents /Instruct ns: -)I 1 VIA(6 1 C4 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS El FAIL El CALL FOR INSPECTION El ADDITIONAL FE ASSESSED 1 ( 14 . 7 Inspector: Date: I 1 i Phone #: (503) 718- A____ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST 2007- 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/111)00i Phone: (503) 639 -4171 eo Inspection Requests (24 Hrs.): (503) 639 -4175 _ .. INSPECTION WORKSHEET FOR DATE: 1/8/2000 TIME: 7:01AM PAGE: 4 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 503-639.2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639 -2639 Inspection Request Scheduled For: Date: 1/812008 Pour Time: Code # I}atpection Description Confirm # Contact # Message 275 Framing 062780.04 503-806-0602 N Co ections /Comments /Instructions: (r•r %/ ) — o - L ; LQ • c3 V 1 1` \ 4 vL,L7 V..„ '� - & //b6 4 :o8 e `:lv — =..%- — - , ...1_.. r VAV( \ V-. V 19:: r 'a "rte , .1 et 6,,,,s f■tb - kV\ 41 mot. S ` 0 S - Q PASS ❑ PARTIAL APPROVAL � ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v Date: 1 / � `' Phone #: (503) 718 -`30----(1 CITY OF TIGARD BUILDING DIVISION PERMIT #: n►1ST';t007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1712007 Phone: (503) 639 -4171 -,,, ` I I I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/8/2008 IME: 7:01AM PAGE: 6 SITE ADDRESS: 16767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503.639.2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 603639.2639 Inspection Request Scheduled For: Date: 1/8/2008 Pour Time: Code # Irrprection Description Confirm # Contact # Message 240 Exterior sheathing 062780 -02 503 806-0602 N Ctions /Comments /Instructions: \t& ‘ / -7/4) r (V1.4) . C �c �. Ow £ ifi ° - '�. e...-A- RCN-4-0-Q; NA 0 ...-- , 0 ❑ PASS PA • , RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL 111 CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Inspector: V [ is v Date: Ye/ Phone #: (503) 718- Z CITY OF TIGARD I � BUILDING DIVISION PERMIT #: MSI'200' 165 13125 SW Hall Blvd., Tigard, OR 97223 ISSU D: 10/17/2 wi g Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ''j (7/ INSPECTION WORKSHEET FOR DATE: 1/8/2008 TIME: 7 :01AM PAGE: 5 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: Q31 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New OF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503- 639-2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503.639-2639 Inspection Request Scheduled For: Date: 1/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 23f �, Shear walls/anchors 062780 -03 503 806 -0602 N Corrections /Commen : ctio /Instru f ze / o, ---- f . k,.-c 0 PASS ❑ PARTIAL APPROVAL [CANCEL ❑ NO ACCESS FAIL CA FOR INSPECTIO DDITION EES SESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2001 Phone: (503) 639- 4171u4��l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/7/2008 IME: 7:00AM PAGE: 20 I ADDRESS: CLASS OF SITE ADDRES 15767 SW 81ST AVE AVF CL SS O WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503-639.2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503-639 -2639 Inspection Request Scheduled For: Date: 1/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message i v 275 Framing 062689 -03 503 8060602 N Corrections /Comments/ nstructions: ',to...a 5s....,---<„, c ,.,4.e(2_,7,-, S (37 &P -- ., i L._ ti j i l ) .- 1\v /d /..., ) 0 ---. ❑ PASS ❑ PARTIAL APPROVAL i CANCEL ❑ NO ACCESS. ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- 1 CITY OF TIGARD BUILDING DIVISION ` PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 A . Inspection Requests (24 Hrs.): (503) 639 -4175 ` "I� INSPECTION WORKSHEET FOR DATE: 1/7/2008 T 7 :00AM PAGE: 21 SITE ADDRESS: 16767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: CAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jf ROTH CONSTRUCTION, INC., PHONE #: 503 - 6332639 CONTRACTOR: sr ROTH CONSTRUCTION INC PHONE #: 503 - 639-2639 Inspection Request Scheduled For: Date: 1/7/2008 Pour Time: Code # ) spection Description Confirm # Contact # Message 240 ' Exterior sheathing 062689-02 603-806-0602 N orrections /Comment /Instructions: 1 1 (eNe . t • /7-6 /6 -) (04) — vi( it r P ( 1 _S I .- Y\—i2.-tA.) (__ S el ❑ PASS PIA - ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Date: • v r Pho #: (503) 718� " Inspector: 1 ( ) 1 CITY OF TIGARD " BUILDING DIVISION PERMIT #: M5T2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/ 1 T/: ?007 Phone: (503) 639 -4171 l Inspection Requests (24 Hrs.): (503) 639 -4175 11- INSPECTION WORKSHEET FOR DATE: 1/7/2008 TIME: 7:00AM PAGE: 22 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: ONE #: 503 Jr �rr ROTH CONSTRUCTION, INC., CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 1/7/2008 Pour Time: Code # I< Description Confirm # Contact # Message 235 Shear walls/anchors 062689-01 503 - 806.0602 N I Corrections /C ments /Instructions: 6th.1 % / (C19 I 6 ❑ PASS ❑ PARTIAL APPROVAL IXCANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEE ASSESSED Inspector: AL_ ate: Phone #: (503) 718- VII CITY OF TIGARD ; BUILDING DIVISION PERMIT #: MST 2007-00i 65 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 4114 l Inspection Requests (24 Hrs.): (503) 639 -4175 . F ' L INSPECTION WORKSHEET FOR DATE: 1/4/2000 TIME: 7;01AM PAGE: 12 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503 - 639-2633 CONTRACTOR: 31 ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 1/4/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 062600 -01 503. 806.0602 N Corrections /Comments /Instructions: I I ❑ PASS ❑ PARTIAL APPROVAL `CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r: Date:' I 't i Phone #: 503 718 - Inspector: ( ) CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1W17/2007 Phone: (503) 639 -4171 Va Inspection Requests (24 Hrs.): (503) 639 -4175 ...°'III INSPECTION WORKSHEET FOR DATE: 1/4/2008 TIME: 7:01AM PAGE: 11 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE= FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New OF OWNER: rf ROTH CONSTRUCTION, INC., PHONE #: 503 - 639.2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 603- 639.2639 Inspection Request Scheduled For: Date: 1/4/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 236 Shear walls/anchors 06260002 503806 -0602 N Corrections /Comments /Instructions: • ❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: IN t)5 Phone #: (503) 718- . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST7007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2007 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ., .. :-.. INSPECTION WORKSHEET FOR DATE: 1/4/2009 TIME: 7 :0 PAGE: 10 SITE ADDRESS: 15767 SW 01ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: ,IT ROTH CONSTRUCTION, INC., PHONE #: 503- 639 -2639 CONTRACTOR: if ROTH CONSTRUCTION INC PHONE #: 503.539.2539 Inspection Request Scheduled For: Date: 1/4/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 062600 -03 503-1306-0602 N Corrections/Comments/Instructions: ❑ PASS ❑ PARTIAL APPROVAL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 4 Inspector: Date: ,� ; Phone #: (503) 718- I CITY OF TIGARD BUILDING DIVISION #: MST2007- 00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 / �a�'q Inspection Requests (24 Hrs.): (503) 639 -4175 P1 INSPECTION WORKSHEET FOR DATE: 11 ?12003 TIME: 7 :01AM PAGE: 8 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New OF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: . 603-639.2633 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503- 639 -2639 Inspection Request Scheduled For: Date: 112t2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 062423-04 503-806.0602 N • Corrections /Comments /Instructions: Cn2 C'� zr i io es. 0 /■ e___X/ 0 140 . 77_ , i Nio - n - i L! 'eRTIAL APP ❑ CANCEL ❑ NO ACCESS , fl FAIL j C' • - 1 PECTION ❑ ADDITIONAL FEES ASSESSED / Inspector: - Date: Phone #: (503) 718- 74 I CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639- 4171 1 Inspection Requests (24 Hrs.): (503) 639 -4175 ...'! `` INSPECTION WORKSHEET FOR DATE: 1/2/2009 TIME: 7 :01AM PAGE: 9 SITE ADDRESS: 15767 SW 01ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: (331 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Sf RUTH CONSTRUCTION, INC., PHONE #: 603.639.2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503- 639 -2639 Inspection Request Scheduled For: Date: 1/2/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 062423 -03 503 806.0602 N Corrections /Comments /Instructions: tZ GPO C-f 1 Z--in/07 ( ) r PASS ( C_K__c ,____ _ ❑ PASS r PARTIAL APPROVAL t0,► ► ❑ NO ACCESS ❑ FAIL Fa CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: _ _ Date: / 6 8 Phone #: (503) 718-Z 4/7 • CITY OF TIGARD ' - C/ ? F Lo BUILDING DIVISION ' /' t PERMIT #: IviST2007 -00 i65 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639- 4171vIp' Inspection Requests (24 Hrs.): (503) 639-4175 �IL. 1 INSPECTION WORKSHEET FOR DATE: 12/2.1/2007 TIME: 7:03AM PAGE: 9 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: (;AGF= FOREST LOT #: p31 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: ,IT ROTH CONSTRUCTION, INC., PHONE #: 503-639 -2639 CONTRACTOR: Sr ROTH CONSTRUCTION INC PHONE #: 503.639- 2639 Inspection Request Scheduled For: Date: 12/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 062041 -08 503 -806 -0602 N Corrections /Comments/ Instructions: ' 14 t t: • ,(- tc -.LJLe& , . aith .,„ 4 s e l cLiti- :Ai 0- 11 --, ° , -0 (4..fit-e-ek , Ti ° ' / . J. c.i.,,,-- c\.--f-56-e_....,,,a,s-- • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 "7/ Phone #: (503) 718- . ? l j • CITY OF TIGARD 1\16 1-\-Adk Co.r C-(. _ BUILDING DIVISION PERMIT #: MST2007 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17n007 Phone: (503) 639 -4171 :i2v it Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' . / INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7:03AM PAGE: 10 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 603.639 -2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 603-039 -2638 Inspection Request Scheduled For: Date: 12/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 062041 -07 503 -806 -0602 N Corrections/Comments/Instructions: ` 0 1b;3b --10 LfS I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED `" Phon #: 5 03 7 18- — ` 2 � Inspector: Date: ( ) 1 CITY OF TIGARD - BUILDING DIVISION PERMIT #: INST200i -00165 I 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/1711007 Phone: (503) 639 -4171 aI�l; Inspection Requests (24 Hrs.): (503) 639 -4175 _.' " L INSPECTION WORKSHEET FOR DATE: 11/20/2007 . TIME: 7:00AM PAGE: 8 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503- 639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503- 639.2639 Inspection Request Scheduled For: Date: 11/20/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 060019-04 503.806-0602 Y ' Corrections /Comments /Instructions: • 1 j2 0 v t :7)(m S i 2,�t� / I� 2 - i =t A I�- ❑ PASS 'J PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS r�0 J I n� CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED j Inspector: Date: / I .Z° 0 Phone #: (503) 718- 6 ` . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00165 13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 10117/2007 Phone: (503) 639- 4171�u�R��l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/20/2007 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 03.1 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF . • OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 603-639-2639 CONTRACTOR: Jr BOTH CONSTRUCTION INC PHONE #: 503 -639 -2639 • Inspection Request Scheduled For: Date: 11/20/2007 Pour Time: Code # Inspection Description Confirm # Contact # Me 236 Shear walls/anchors 060019 -03 503-806 -0602 Y Corrections/Comments/Instructions: • PAS 7 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL M . ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ Date: I '0,4 Phone #: (503) 718- Z14 CITY OF TIGARD BUILDING DIVISION PERMIT #: ST'2007 01)165 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 160 111 / Ai. ei Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10131/2007 TIME: 7:00AM PAGE: 28 1 SITE ADDRESS: 1967 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST' DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 503.639.2639 CONTRACTOR: ,.fr ROTH CONSTRUCTION INC PHONE #: 503- 639-2639 Inspection Request Scheduled For: Date: 1Q/31/ 2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 058733 -12 • 603806-0602 N Corrections /Com ents /Instructions: VX --/- 1 0___- V\ /--14--<_:-■-• tAr/?7 IA 1 6 --- c7/\r 0 4"ill/0-(---f • x Q l ^ vi 2__ • c-bt6_x_ ,,,,: , T . \Wis, , e AL 1 ./2d: i '--- - '"'" //Q `' \L\— i O \ 0L� 1 ci. u. 1 1 I�G- . • � . ..,61_,e_k _?/\ •gr 1 .._--_,-- ‘..)-12.Aipt...___8 ❑ PASS 1 P PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION , ❑ ADDITIONAL FEES ASSESSED Inspector: Date: q (1 ? Phone #: (503) 718 - Z4 f . / CITY OF TIGARD BUILDING DIVISION - - PERMIT #: M ST7007 -00 166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/7007 Phone: (503) 639 -4171 ytilli Inspection Requests (24 Hrs.): (503) 639 -4175 ... F_ INSPECTION WORKSHEET FOR DATE: 10/3112007 TIME :OOAM PAGE: 29 SITE ADDRESS: 15767 SW 01ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503.639 -2639 . CONTRACTOR: sr ROTH CONSTRUCTION INC PHONE #: 503 - 639 -2639 Inspection Request Scheduled For: Date: 10/31/'2007 Pour Time: Code # Inspection Description Ver Confirm # Contact # Message .6Th Mechanical rough -in / 058733-11 503 806 - 0602 N Cor /Co / ns ru t ic ons: - 7 . i ASS ❑ PARTIAL APPROVAL CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED I VA � ) C / b - Inspector: Date: ) b Phone #: (503) 718 • : ,t CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -0t166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 16/17/10:;7 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 II— INSPECTION WORKSHEET FOR DATE: 10/22/2007 TIME: 7:00AM PAGE: 2 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 031 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: JT ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: Sr ROTFI CONSTRUCTION INC PHONE #: 503639-2539 Inspection Request Scheduled For: Date: 10/22/2007 Pour Time: ;0:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 058050 -04 503806.0602 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /i— 7 Phone #: (503) 718- 'Zg� CITY OF TIGARD BUILDING DIVISION PERMIT #: m; T2007 00 66 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2007 Phone: (503) 639 -4171 A,ci + � Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/22/2007 TIME: 7:00AM PAGE: 4 SITE ADDRESS: 15767 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: U31 TYPE OF USE: PROJECT NAME: GAGE FOREST • DESCRIPTION: New SF OWNER: Jr ROTH CONSTRUCTION, INC., PHONE #: 503 -639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 639-2639 . Inspection Request Scheduled For: Date: 10/22/2007 Pour Time: 10 :00 Code # Inspection Description Confirm # Contact # Message 206 Footing 068050-03 603 - 806-0602 N Corrections /Comments /Instructions: • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: /6 -22. -07 Phone #: (503) 718- 2-4-q-S