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Permit
i CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00186 - ll DEVELOPMENT SERVICES DATE ISSUED: 7/21/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14085 SW 89TH AVE PARCEL: 2S111AA -09400 SUBDIVISION: GREENSWARD PARK NO. 3 ZONING: R - 4.5 BLOCK: LOT: 078 JURISDICTION: TIG REMARKS: New SF detached BUILDING REISSUE: PH2154A STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,151 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,450 sf GARAGE: 676 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 257,340.20 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,601 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 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: 4 CLOTHES DRYER: 1 GAS 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FOR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: 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: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner Contractor TOTAL FEES: $ 7,867.96 FOUR D CONSTRUCTION CO FOUR D CONSTRUCTION Tigard permit is subject to the regulations contained in the FO R BOX CON FO FOUR BOX CON Tigard Municipal Code, State of OR. Specialty Codes BEAVERTON, OR 97075 BEAVERTON, OR 97075 and all cer applicable laws. Al. will done in accordance anrace with approved ed This p plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 - 590 - 0805 Phone: 720 - 7445 MOBL ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg 4: no805 / 1037 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Mechanical Electrical Rough In Gas Line Insp Storm drain lnsp Mechanical Final Sewer Inspection Underfloor insulation Framing Insp Gas Fireplace Water Line Insp Plumb Final Footing Insp Crawl Drain /Backwater Shear Wall Insp Insulation lnsp Water Service lnsp Building Final Foundation Insp PLM /Underfloor Exterior Sheathing Insl Gyp Board Insp Appr /Sdwlk Insp Post/Beam Structural Electrical Service Low Voltage Rain drain Insp Electrical Final , Iss -d By : . .. ! _! .IL ! ./,% Permittee Signature :. � ,..../- Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next • usiness day Building Permit Application I .D FOR OFFICE USE ONLY City Of Tigard ' Dat�Bed / A M Permit No.: r / .l8 13125 SW Hall Blvd., Tigard, OR 97223 y 8 11 A 1 Pl R eview Phone: 503.639.4171 Fax: 503.598.1960 1 ��em „ Other Permit: QQ��4 49 ����' 9/—l / O 0 N �hr i G I Inspection Line: 503.639.4175 F 11GN c 1� .1 I V DateB 2 Date Ready/By: ® See Attached Checklist for Internet: www.ci.tigard.or.us (' 1 (0 . \ !iC`• Notified/Method: 111 Supplemental Information . TYPE OF WORK REQUIRED DATA 1- AND 2- FAMILY DWELLING NIZ r New construction D 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 C CATEGORY OF CONSTRUCTION work indicated on this application. 1- and 2- family dwelling El Commercial /industrial Valuation: $ El Accessory building El Multi-family Number of bedrooms: T ❑ Master builder El Other: Number of bathrooms: 2 / /iy JOB SITE INFORMATION AND LOCATION Total number of floors: " --Ty, Job site address: j ( jorpct - S' (AL 9 7 g.-- p......./ New dwelling area: 2 /� n / square feet City/State /ZIP: r- / h A _ 9 7 er 2-V Garage/carport area: ` / 7 , square feet Suite/bldg. /apt. no.: Project name: Covered porch area: f _/s square feet Cross street/directions to job site: Deck area: — square feet Other structure area: square feet e----.. REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: !.... _ Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK A ,' work indicated on this application. Valuation: $ c 2 /.mac Ly,[ A,Q� / e_e .f —A-- Existing building area: square feet New building area: square feet gi PROPERTY OWNER , ❑ TENANT Number of stories: L/ !- T! (1 Name: '‘,.e (-2) ��4 S7-1,) _ .0 a.,__ Type of construction: Address: cr r S 7 7 Occupancy groups: City/State/ZIP: 4( , 707 S Existing: e Phone: ( ) ^ v — 40 O s Fax: ISO) 5 7 ) ---1 .S New: ' 441 h ' t a ;. .. i ;74. ❑ CONTACT PERSON NOTICE Business name: J 0 P` /lam / rs, /,6 a Li-e--- All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: _S "e/-ii, c tI L� ,,,L._.- BUILDING PERMIT FEES* Address: Please refer to fee schedule. City/State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) - 7/ /S S Amount received CCB lic.: Date 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: ,0,16_`� /// Apr, " Date: (, ,/Q * Fee methodology set by Tri- County Building Industry ^//l Service Board. i:\Building\Permits \BLIP- PermitApp.doe 12/03 440- 4613T(11 /02/COM/WEB) One- and Two - Family Dwelling Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 161 0 1 � ❑ Electrical ❑ Plumbing ❑ Mechanical 24- Hour Inspection Line: 503.639.4175 � ,• Internet: www.ci.tigard.or.us ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No 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 comer elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, 0 0 ❑ 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 0 ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore_•on and shall be shown to be ap.licable to the .ro under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". _ ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. . ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. i:\Building\Permits \One- Two- FamilyChecklist.doc 12/03 Electrical Permit Application_ FOR OFFICE USE ONLY City of Tigard �'rt \' Date/By: Pernrit No.: t � ,� ( ' i Y 13125 SW Hall Blvd., Tigard, OR 97223 J Plan Review Phone: 503.639.4171 Fax: 503.598.1960 1/61/1 �� " �"�'* 11 Date/By: Other Permit: Inspection Line: 503.639.4175 � g � Date ReadyBy: Juris ® See Page 2 for Internet: www.ci.tigard.or.us r. , p,D Notified/Method: Supplemental Information *. . `rt ;_ - -a± c. v ,, ,, _ a s 1 • a+ fib q § , +? s r '11 4 .,1"K,k > . 1.1 New construction ❑ Addition/alteration/replacement Please check all that apply: ID Service over 225 amps, comm'l ❑ Hazardous location ❑ Demolition ❑ Other: ❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., f k '' g ;' ` �, , .,. . 2 J ' M ?, � of 1- and 2- family dwellings 4 or more new residential 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure Multi family ❑ Master builder ❑ Other: Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ['Manufactured structures or P . r ..! : l t o ° n P ' ❑ Eg ress /lightingplan RV park Job no.: Job site address: , 4 *V:4 d� ❑Health -care facility ['Other: Submit 2 sets of plans with any of the above. City /State /ZIP: - / The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: r .. ., ?k Ala* Sttig ' - Description I Qty. Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: C u / ,,, , R , e Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax Limited energy, residential / 75.00 2 map /parcel no.: Limited energy, non - residential 75.00 2 Mt -, Each manufactured or modular dwelling, service and /or feeder 90.90 2 I I tEiw 6l0- 2 -/ Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 y a - a . t 201 amps to 400 amps 106.85 2 s aV . w :. EL , _ - _ ,.. • : - 401 amps to 600 amps 160.60 2 `� : 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 14 S `` Reconnect only 66.85 2 City/State /ZIP: : . A: U,t- C O `7 Temporary services or feeders installation, alteration, and /or relocation Fax: Phone: ( 6-76 — r f. 3 vr10 ' 1 7 (( 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel • °' A Fee for branch circuits with �' '� d service or feeder fee, each Business name: i s 4 „ V 0-‘2_,./ branch circuit 6.65 2 W, , B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - ' ` i ., .k o,3 �'"% e' , ener panel, alteration, or extension. Describe: Page 2 2 Business name: O ,1,,,..---- !C- t Address: .j S - • 'y � � Each additional inspection over allowable in any of the above '�T Per inspection 62.50 City/State /ZIP: 7,0 G .i /tom' O _ - Investigation per hour (1 hr min) 62.50 Phone: , ' — 2mirijagi Fax: ( ) Industrial plant per hour 73.75 '> ..' .` � 2 ^.* ' CCB Lic.:7g a D > Electrical Lic.04,4- 0_ Suprv. Lic.: ,i op - . Subtotal Suprv. Electrician signature, required: // y r� Plan review (25% of permit fee) Print name: - ,, . h ; - ` Date: _ /U' State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: ��� ' _� ./� • _ This • perm • appl • exp • if • a perm • i not obtained within 180 days after it has been accepted as complete Print name / _, r -.S i� / Date: t ,____ e i : � Fee methodology set by Tri- County Building Industry Service Board Number of inspections per permit allowed. i:\ Building \Permits'ELC- PemvtApp.doc 12/03 440- 4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: ___ Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems Ti Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC- PermitApp.doc 04/03 Building Fixtures i.--, r7 ''1/4. I ¶O PluMbing Permit Application „, FOR OFFICE USE ONLY City of Tigard Received ,... ,' Date/By: Permit NoMfrrdtz) - 0.- 13125 SW Hall Blvd., Tigard, OR 97223 1 \ 6 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 UV I \ni islO‘ kock# I '' Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.417 11 . 01 A.1. - A° Date Ready/By: Avis FO See Page 2 for Internet: www.ci.tigard.or.us '3U Notified/Method: Supplemental Information e gl . New construction 0 Demolition For special information use checldist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement E I Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 X 1- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00 0 Accessory building 0 Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 E 1 Master builder 0 Other: Fire sprinkler ( sq. ft.) Page 2 ''' ' -77 • 9 ". 7 47471Wrir 3 7 r ., yiF777,1„:,?, t Site utilities Job site address: /41( S Z,,, j ,..?7/ / 0-(...- Catch basin or area drain 16.60 City/State/ZIP: `-- 77,,4/,11 ( / 2)A .9 2.2-254 Drywell, leach line, or trench drain 16.60 Footing drain (no. linear ft.: ) Page 2 Suite/bldg./apt. no.: Project name: Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ____) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: __J Page 2 Subdivision: (._ -./. . I 4 A -3 1 Lot no.: 7? Fixture or item Tax map/parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 R2 -c-e-r14 /V,e..) ./6/ 64.1 ,.1 .. valve 16.60 Clothes washer 16.60 Dishwasher 16.60 D f oun t a i n 16.60 Ejectors/sump ,.a.,aii:-:-:.: ' N-4R - : - ..14,,: - ,-- . .4tar,.. ,,,,ten.... 4........42".:C. ' ,, .I.1.... . vh.,. •.,...4,...E., et...x ,. .. ,,,,,... -,.... 16.60 Name: c- a...) a L e C77 c_14 a-cf Expansion tank 16.60 Address: 0 "2 / r-77 Fixture/sewer cap 16.60 City/State/ZIP: , # o■<- 9 2 o 76 Floor drain/floor sink/hub 16.60 Garbage disposal 16.60 Phone: (5151) ,S CN;;1 1/4.S-- Fax: .(5J3).-.5:70 - t .,, `..-,.... 1::,,, Hose bib 16.60 Ice maker 16.60 Business name: ... 99:1- /XS ja.6 (') 0-e-/ 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 1 6.60 Phone: ( ) I Fax: : ( ) - Tub/shower/shower pan 16.60 E-mail: Urinal 16.60 '-. 4 - g.F.014 " ArfAailf..,,iTrirtaliTi r E . , n, - ' - . :.. Water closet 16.60 -,, •'*.i.i4 , ,....Eif.4..1re.", - ..!•;-,.....1:"'*.:- - - ...--v;r...,:, - -- , - _I , Business name: ‘--),_ 7? vriz 4 ,„:,, Water heater 16.60 Address: /5 72 g - c-/...12: A (i...e_i Other: Subtotal City/State/ZIP: il/Z,Z S i e,, (3x_ 7 1 2- 3 Minimum permit fee: $72.50 Phone:„(543) 41/0 .-- // Fax: ( ) at/ Residential backflow minimum permit fee: $36.25 Plan review (25% of permit fee) CCB Lic.: y9i Plumbing Lic. no...,_54 7x, State surcharge (8% of permit fee) Authorized signature: ,/,--„ 6 ,...,.„ 4 ,-- TOTAL PERMIT FEE Print name: i s 41 E j - - ()co l... A j - Date: 6..... 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. iABuildingTennits \PLMF-PermitApp.doc 12/03 440-4616T(i 0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suss ression S stems: 7 Z , .. 1. . :: )l ',. : q r As a 5N 6 ;, ' - :t e" �t Fee; Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Storm & Rain Drain - 1st 100' 55.00 $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 additional $100.00 or fraction thereof, to and t t _� ! Al . 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . k x s t n; i b 14 ' �6 ' : x i -; r . q ".;'.' ",,**ittyfr,c*C11 Comments regarding fixture work: • Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" - 3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: is\ Building \Permits\PLM- PermitApp.doc 3/03 Mechanical Permit Application FOR OFFICE USE ONLY Cl of Ti ark Received �J g DateBy: Permit No.. �' -� 13125 SW Hall Blvd., Tigard, OR 97223 �.� Plan Review moo 503.639.4171 Fax: 503.598.1960 - Aft. : Other Permit: Inspection Line: 503.639.4175 -( G � PQ `ON � .4 � 1 \ Date/By: Ready/By: Juris: H See Page 2 for Internet: www.ci.tigard.or.us G ` - ` `�( \✓' Q \v1,.. Notified/Method: Supplemental Information .alA_? 1'-';* 4 ( V"' -:.? - o w v - <;tersn:; 4 it&Ci't1)• 41*;`SFI)G+D`CFa == TTSE°OHECKLI3T pt New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. � ` ` ;.....� • i ' ,. t .+:::Ft.:l x.;i Value $ ' ' "' ,=RESI.UENTILL EQUTPMEN F / SYSTEMS FEES pil 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total Heating/cooling , x� s - '0 Hilt W i '''':'''V';' a I 0 A d ,e 'z g,/cooling � Air conditioning or heat pump Job site address: 4/ )4/ So L � J, (2t ' .0A O2 (requires site plan showing placement) 14.00 City/State /ZIP: ! _,, ,/T "ri9 f b c�2�/ Fumace 100,000 BTU (ducts /vents) 14.00 / T Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), Fl i e tic .3 in -wall, in -duct, suspended, etc. 10.00 Subdivision: �. (� . f , Lot no.: ` � Flue /vent for any of above 10.00 024. ' /.I / Other: 10.00 Tax map /parcel no.: Other fuel appliances Water heater 10.00 `A :% t ' .� . , k', ' f . p i a .- ° t _. s ,..,:>» .74. F .» :„ Gas fireplace 10.00 - J' Lt ,. f jN j/ c 1 ,37_9 �, Flue vent for water heater or gas 6 fireplace 10.00 hi iVio kJ (A - I L' Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 a ,, Chimney/liner /flue /vent 10.00 l` '''"-4---,-W, X 93 1 j : :. ,, , , � +��. Ii �- ° � Other: 10.00 Name: .c.-C- x-- < ALL q - ! 6 4 � � - Environmental exhaust and ventilation Address: cY 2 u -e Range hood /other kitchen O. C S equipment 10.00 City/State /ZIP: O V ,` 5. 5767.- Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (53) ,.5 _ 0 cpQ S Fax: (L-- ,... 0_ / 7 ( toilet compartments, utility rooms) 6.80 48 73 7 " m�' -` A tt i c /crawlspace fans 10.00 AZ p Other: 10.00 Business name: � 1� % / 9 . 10 L.42/ Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State /ZIP: Wall/suspended/unit heater Phone: ( ) I Fax: : ( ) Water heater Fireplace E -mail: Range .�. A t r ' ¢ , ° . , ; , .. i':,.4-5:,-,7,,-,-- Barbecue Business name: _ Clothes dryer (gas) ..2e4 2.-- 42. -i / / /� Other: Address: 1c / e , t 4 z 1 1 , , City/State /ZIP: / ' J h, a, b/� °! 71� Subtotal Minimum permit fee ($72.50) Phone: t �`7)� 9� s4 , y 3 Fax: ( ) Plan review (25% of permit fee) CCB lic.: 4 State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature:l4y-4-91&,-2 ��� This permit days afternit expires if a has been is not complete. within 180 Print name:)V Xiv /L'' u S Date: 6,-/ d .--6 * Fee methodology set by Tri- County Building Industry Service Board I:\Buitding \Permits \MEC- PermitApp.doc 12/03 !� 440- 4617T(I1 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: . t y al � 4`„ . 'b''t,�a` �.° ' � ,.. C sa r�`" $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 CITY OF TIGARD PERMIT #: BUILDING DIVISION DATE ISSUED: 13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 �I � -- INSPECTION WORKSHEET FOR DATE: Of — I'7— Cl0 TIME: l (; -3 PAGE: Q SITE ADDRESS: ( 4Dgts sq ++1 R02. CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: . e I_,., GJ l),.) 1 4k IkY) 1-'1 J OWNER: H D`(4 . PHONE #: 503 - 91•97 9‘ CONTRACTOR: LA m t1li k p le�l -r- ∎ @ PHONE #: 50 3_ 49_ 'i 3V Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections/Comments/Instructions: v o r La-be 1: E (_.- 9 .- 1 Sf ca 7A$, ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR REINSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Z —' N S �- 6 - 9 -- 1 Date: - • i()11 Phone #: (503) 718 -2 ti 11- J L i :\Building\IVR\IVR- InspWorksheet- BlankForm.doc 03/02/2005 CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 h '�'���O��,lp„il,,l, l , Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 1A O ts 1 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Ins��tion, Descri o Confirm # Contact # Message M9 / 1 Ilie 4 Corrections/Comments/Instructions: &, ` hV- Ca Ok .1A a rud ri nk 6 4) ■) f m ;19 0 k X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i _ Inspector: O Date: `"(' . Phone #: (503) 718- CITY OF TIGARD I I BUILDING DIVISION PERMIT #: MST2004 -00186 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/21/2004 � o Phone: (503) 639 -4171 ,0 0liypiq pl ii' Inspection Requests (24 Hrs.): (503) 639 -4175 ` __.. INSPECTION WORKSHEET FOR DATE: 4/4/2006 TIME: 7:11AM PAGE: 9 SITE ADDRESS: 14086 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 078 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO 3 DESCRIPTION: New SF detached OWNER: FOUR Ci CONSTRUCTION CO, PHONE #: 503 - 590 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 720.7445 MOBL Inspection Request Scheduled For: Date: 4/4/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 003648-03 603-720-7446 Y Corrections/Comments/Instructions: n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / Date: 4-4-- 0 '5 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -001$6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2112004 Phone: (503) 639 -4171 d o�� r � 1 1 � l l i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/15/2005 TIME: 7:13AM PAGE: 18 SITE ADDRESS: 14085 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 078 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503.590 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 720 -7445 MOBL Inspection Request Scheduled For: Date: 3/15/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 001763 -04 503 - 720.7445 N Corrections /Comments /Instructions: , i s.=" -44-71-47 5 x — 71, C - r te PASS -. 4 1--- PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS - R FAIL J ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED N I Date: 3 �,5� US Phone #: (503) 718- _asp I CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004-00186 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7121/2004 Phone: (503) 639 -4171 411 it Inspection Requests (24 Hrs.): (503) 639 -4175 ...�.� °__.. INSPECTION WORKSHEET FOR DATE: 3115/2006 TIME: 7:13AM PAGE: 19 SITE ADDRESS: 14086 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 078 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503. 5800805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 7207445 MOBL Inspection Request Scheduled For: Date: 3115/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 001763 -03 503. 72 Y Corrections /Comments /Instructions: i ��ST I St )A,4 770 A./ z J ,- L A _,..,,,_, 7,x,-4- - o' -- s ( QA r2P-S a u - G� A - v.ui. /zA.. -cam - • v Cc Q/ r/OS s� cv ���� c#9C Ki ( OA 4,.L T ( Nt f t "C ciw,o.e40-r) n PAS - E PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Inspector: , Date: 3 /S ci.S Phone #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ACV V —01-0 / a INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received /r7 Date Re•uested (1 1)-8 AM PM BUP Location / 0 , ter &Ve. Suite �- MEC Contact Person d' /`t./ Ph ( ) PLM Contractor n Ph ( ) SWR UIIDI Tenant/Owner ELC ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear ,mss t r nsu ati Nai 4757 191 all Nailing `�� Firewall Fire Sprinkler Fire Alarm R Ceiling Roof Other: Final P ART FAIL IT Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL ANIC Post & Beam Rou as Line Smo a Dampers Final PART FAIL ECTRICAL — Service Rough -In UG/Slab Low Voltage Fire Alarm Final J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date Q- Inspector ' Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST T �b INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested — a 7 AM PM I BUP Location . / Lf ' . 8 Ve Suite MEC Contact Person Ph ( ) 7 /9S PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shr heath/ E C ' Insulation Drywall Nailing '`•` o. is<Tv-th a A.. .v�c.�i��. ��c,�.�.�l2is Firewall Fire Sprinkler ��' �r�r��•�,�c% ��G �Eo2�..� E (4% c.: -kW A �JA =.��r TG Fire Alarm /WAY (" j42 (1 ) r i,VslJ ; .-<vLL 459 -y2A -a g 1 /1.4Ge -e Susp'd Ceiling Roof k Other: Final t� t�r� S TL/J Av ciicLs-7-4 .47 -$7%- -- - Y PASS PART PLUMBING Post & Beam Under Slab �B Rough -In Water Service / Sanitary Sewer Rain Drains Catch Basin / Manhole //11---( v4 Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam - S LI Smo a D -mpe F • - PASS PART E TRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 111 Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 9 �� — ©�-- Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour _ BUILDING Inspection Lin • (503) 639 -4175 MST ° L i r 60 / INSPECTION DIVISION Business Lin . (503) 639 -4171 BUP Received Date Requested 9 I( AM PM BUP Location / 1- /& g C Y Y Suite MEC Contact Person la .r )-2 Ph ( ) a. - '7 L igS PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Sheath/S ► - _1 Sheath/ e A - 0 - _ �.r /'� _ / 1 '_ E . @ rte Insulation ry --- Drywall Nailing - �� ` chi Firewall - Fire Sprinkl- a h - w- - S � a L.grot„ Fire Alan r. •_ • • -.,_ `_ li p Susp'. eiling �' r. F .�i PAS 19 FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final 4, k. -Tr) ^ PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE E Please call for reinspection RE: E Unable to inspect - no access Fire Supply Line / ,, ADA Approach/Sidewalk Date ' / 1.-- 7 Inspector Ext Other: Final DO NOT REMOVE this inspection recor , rom the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 MST 01 DO /A INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received (1 Date Requested $ ` AM PM BUP Location (v gs Suite MEC Contact Person Del Ph ( ) 7a3 - 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT ar Anchors Ext Sheath /Shear Int Sheath/Shear / // �+ Framing (/r- s�1 -�•� ¢L. f v zit 9/...r S ( a • s• e9 — 1 - 47 ' /`- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final .0 , PART FAIL NG Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Beam Gas Line Smoke Dampers Final PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date '�� ��'' Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST o2OOq-DOf 8� INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP g Location ��D c �� Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ?, S Insulation L4 � Drywall Nailing L� !•• Firewall • ye• /Z/i r S�a Fire Sprinkler Fire Alarm 4) Al2,;2 .5-rt, 11 — - - - V 5924, x.17,i,/�iL Susp'd Ceiling // Roof Cll,R Other: Final PASS PART PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL o t & Beam) Rough -In Gas Line Smoke Dampers Final PASS PART e m.. ELECTRICAL ', Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Ei Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA �-� d�— Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD - 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ac d4 1 7 1 "D 0/ 8 , INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received L Date Requested , 2 - 2 -4° _ - AM PM L- BUP , Location / `7 0 g� g ? X 7�-t�P - Suite MEC Contact Person FHA — L7 Ph ( ) 72.-0 7L/ % Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC tin• ELC ' � Access: • rain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing 64_1) UP- -10 C-r -S ti Insulation '' ll Drywall Nailing _ r - w - • ti 47 'Si �. .s /.0 /1S 5/ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PART FAIL - OLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date 2 - ' Z- Inspector - Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST `t —60 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested l AM PM BUP / 'f Location ! 0 J 5 7 Y 1-- Suite MEC Contact Person _.I) Q Ph ( ) 7 0 ' 7/ � f S PLM Contractor A ( SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain / /:2U?/ (t_ ELR Crawl Drain [� (�` t`- Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation ,- Drywall Nailing Firewall Fire Sprinkler ' `� Fire Alarm Susp'd Ceiling Roof Other: : j Final `'% �C5 PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Man le Storm Drain Shower Pan Other: PART FAIL ANICAL ost & B eam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: LI Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date / ��1 C Inspecto / � i/ Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour // BUILDING Inspection Line: (503) 639 -4175 MST ��// 'T'"� t10 INSPECTION DIVISION Business Line: (503) 639 -4171 G, BUP 1 Received Date Requested 2 ¥ AM i/ PM BUP Location / `ta S S c- 1 `— Suite MEC Contact Person ( Ph ( ) ( `10 _ 31 ( PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall IL t 1 / Fire Sprinkler � — Fire Alarm Susp'd Ceiling Roof a ' Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: F PAS PART FAIL CHAN Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Anal I I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: [ 1 Unable to inspect — no access Fire Supply Line ADA Date Inspector � j i �c Ext Approach /Sidewalk Other: Final DO NOT REMOVE this inspection record from the job site.. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ''' d c / - 0 0 / S/ INSPECTION DIVISION - Business Line: (503) 639 -4171 BUP Received Date Requested g /'- AM PM BUP Location / `1 6 5 5 F 7'x'"4 Suite MEC Contact Person _ Ph ( ) yd - 2 3/ / PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING mi Un e d rSTab Rough -In iiii r twa -e+r Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fin I PAS PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Anal I I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I ] Please call for reinspection RE: I I Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date ---‘2? / i7 Inspecto � Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested 7„f/ " v d �`- PM BUP Location / 1 /0 S �.v � �` � Suite MEC Contact Person Ph ( ) PLM Contra Ph ( ) SWR NG Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR - -w1 Dr- - S a• Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fi A mp 1, _ - T FAIL Pos :eam Under Slab Rough -In Wat -_ Fain D -' Catch Basin / Manhole Storm Drain Shower Pan Other: Final ) PART FAIL ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA h ,111 Approach/Sidewalk Date 7/ 2)t / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested .f --- AM %<-- PM BUP Location / I/ d S rc1 Suite MEC Contact Person Ph ( ) PLM Contra ,� Ph ( ) SWR k6 1LDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Slate Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall ailing / Fi rewal l " r Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fi , PART FAIL tPL U BING Pos :earn Under Slab Rough -In Wa,Service anita Sew- Ca ch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm • Final Reinspectiori fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I I Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA 3/1 I 1 ( !' Approach /Sidewalk Date -'` L ' Inspector 1 Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD r✓1 s i BUILDING DIVISION PERMIT #: e R 0 o q _ 661 31, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 - 4171 " " Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 3 _ TIME: PAGE: SITE ADDRESS: / L{ 0 8' 5 g `7 /-U--€ CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: V DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: 79.. d _74/4,5-- Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message • / //1)* E!f -±f!=l440ittzC_—, Lig 0( -z-- -S7- / ' Correctio& m nts /I structions: I ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS H FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: hone #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ,=•/) –GX)! e INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested /)--/O AM PM BUP Location / L D SS g GHQ - Suite MEC Contact Person 7)C — Ph ( )7 0 — 7 9 %'C PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ;�� ELC Ftg Drain Access: L ) /'� `/ ) ` � k ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing 3 1 1 r � (-)-p Insulation ��� � h (j �1 ' Drywall Nailing V 6 ' 1,\ Firewall t Q t\M S vt h ( OAR )k ri Fire Sprinkler �` C— Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In \t( Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In U Slab ow Volta Fire Alarm PART 1 L Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date / " 45) Inspector A Ext Other: Final DO NOT REMOVE this Inspection record f om the • ' site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST c ? l) O V-66/(?' —6 U/e ' INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received I Date Requested / ? 1 AM PM BUP Location ! U w.- E -ue Suite / / MEC Contact Person �� Ph ( ) �O� G 7 7" 5 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain / 0 �� f, )/ ELR Crawl Drain C.-/ l\ Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ��,\\ g 0 � \ Insulation • 3 wA SW 3 - �� fi� l�n. \N Drywall Nailing cc _ Firewall a, vlJ)�ol� , `,\ rl• �� 'P ` 'I`,� � G S 1.^Rtk Fire Sprinkler I Fire Alarm .S- Ohl �� � � �1 1 S )N4,) `0. �'� ` 1.co \ \ \ L Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service 1 111k Sanitary Sewer Rain Drains � Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fir- • rm ASS PARTS ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reins•ection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the ob site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST .b() -bD/ S INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested - ¥ AM- PM BUP Location / L i D S � � ' Suite c� MEC Contact Person Ph ( ) �° U — 74 �3 5 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL g - � a. Low Voltage Fire Alarm a Fi El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. rt PART FAIL El Please call for rei spection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST a7 60 60 l �� INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested _ a 3 AM PM BUP Location 1 S R Suite 1.497 78 MEC Contact Person Ph ( ) 7 a U - 7 Li PLM Contractor 4b7j67 -75 ez-e- C Ph ( ) 2 yc - 75 SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam lirei�' Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation 4, *Ali - j ® r SIP / , - L - b Drywall Nailing "t Firewall F" 2- in-6S C NEc. lie), 3) Fire Sprinkler ss�� ���ll w / D Fire Alarm j �K f om- COV tvic6r 73 6 F-/ L L ED jo Susp'd Ceiling Roof ter' 6 07SZ Pia 6 urn/45 3 E F' LE- 1✓r( 7 (46- Other: Final /1(£G 1/0,3 PASS PART FAIL PLUMBING '(,, A/ Ai s � Gi to A' 5 7b 56c-of-EP ( l41 W /71 Post & Bea Under Slab 1 if �✓� Pn- si (NFL 5 3 q, 3 0 ) Rough -In Water Service Sanitary Sewer n .c. -e /I� f} ry (p L.! I j s //I� /.Ufei�/v O7S Rain Drains - Catch Basin / Manhole C //D , 3 Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In (Fn Smoke Dampers (5c 3) 2 q- 0 5 - &06) Final PASS PART FAIL ELECTRICAL oug -In U N a. Low Voltage Fire Alarm \ Fi PAS PART Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line / /64,1 A Aoach/Sidewalk Date 23 — t) Inspector ( v 85 � Ext PP Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL (-941%,i3vr7 gour 7 ft-6 1 ( v/ 3A4 ' V■telnWA) -tea? / 91V X Li a 2y�f - o s6o Lh0 ',gam ■ eo rD y — 00l8P I 1 O- STREET TREE C .. ��'ai r . I, �) ■ - S d-i� �2 caner/ g ent for d l S' �� aitz�. o. A% (PLEASE PRINT) (PERMIT HOLDER) / , } /; s REcEivEr °� Do hereby y ` _ Y " ,3 0 ol location .. ® � RAE MAR 14 2005 meets k t. xof.� .' rd /Way on ounty l and use and development standards for street tree installation C ITY N OF G DIN: L� WILDING . ; - ! it- ' ADDRESS: 1 LI \ L , c <c 9 -1-1-3r 0. LOT: / 0 SUBDIVISION: 6 j ��s(�5rAl2 K- 0. 1 O- BY: ; DATE: —/ y -- U �� V 01 ® RECEIVED B o : _/' /_ _ DATE: i �y D 1 0. A ' VVVVVVVVVVVVVVVVVVVVVVVVTVVVVVVVVVVVVVVVVV7V7VV7VVVVVVVVVV1 1 FROM' : FOUR D CONSTRUCTION FAX NO. : 503 590 1751 Jul. 21 2004 03: 51PM P2 • "S I. CITY OF TIGARD Credit No.: 20ozi - 0001- Date Issued: Engineering �flll. Authorization `- Date: 3 -23 -04 TRAFFIC IMPACT FEE CREDIT VOUCHER Land Use Casefile No.: SUB2003 -00002 In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) Four D Construction Oevebpet) (name of is entitled to $ 4_44 194 in Traffic Impact Fee Credits that can be applied to TIF charges for development on lot(s) 1 -27 of the Greensward Park 3 Development. The use of TIF credits are subject to the rules and limitations of the TIF Ordinance which are listed on the back of this voucher. WARNING: This voucher must be presented at the time of issuance of the building permit, or if deferral was granted, issuance of an Occupancy Permit a P.... -___ DireetorQ Date Permit Numbers Lot Numbers Credit Used Balance Beginning Balance $ 44,194 5 - 1 gal `iI - 0003z. 30 253 0 06 5 --/2- obi_ 2d o v-0.0//62 8 3 2_ 0 & . -o4 ..7-O0 1 4 - oo/-.t g QV- sa'a -3(0 boy .,: Aiiii Balance carries = a nd t o TIF Credit No. • Ordinance 379 provides for an expiration 10 years from authorization. login \viola \tif09. S