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Permit
CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00310 ��I�+ DEVELOPMENT SERVICES DATE ISSUED: 9/30/2005 v Tigard, 13125 SW Hall Blvd., , g , OR 97223 503 - 639 -4171 PARCEL: 2S 114AC -00100 SITE ADDRESS: 16550 SW 93RD AVE ZONING: R - 4.5 SUBDIVISION: CAFFALLS CORNER LOT: 001 JURISDICTION: TIG Project Description: 556sf addition. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 14 FIRST: 508 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: 47,271.20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 508 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 0 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT " SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 • -200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 2 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: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes LENART, SI LVO + ADELL M COPASETIC CONSTRUCTION and all other applicable laws. All work will be done in 16550 SW 93RD AVE 3958 SE WAKE ST. accordance with approved plans. This permit will expire TIGARD, OR 97224 MI LWAUKIE, OR 97222 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 Phone: 503 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: LIC 90528 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 1,101.03 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 d B l / L � ' /�� ■ Permittee Signature ■ Issu y Call 503- 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. i i Building Permit Application r , ; ` , - FOR OFFICE USE ONLY :: ` " 4 City of Tigard CEIVE Rec eBy:I - 05 Permit No.: S�dt/(1.7 +Da3t0 13125 SW Hall Blvd., Tigard, OR 9122.1 Plan Revi: w Phone: 503.639.4171 Fax: 503.598.1960 AUG 2 2 20 11 h "y / � ' Date/By: /il.(11/ q - 2 7 - o5 Other Permit: • Inspection Line: 503.639.4175 ' . � � Date Ready /By: 0 See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: ME Supplemental Information CITY OF TIGARD ySs - A Ga `A * °, rr.,.a " ", ' €emu':. "m5. ^, "v"!&m<i �' i. ^...`.�.. 3, wry' " >,�:.r`.C" k ,ffa �' »:x"" '?i."=�"'c= _ ' <' '$ . & -`.- . =;: „t.. ;:mss -x :'�.,"; ” i-: i's; .' :l I . : fi r.,.,, „. S Vat y ;. €` ' , - � *z,'> t z 3 l 4 ” `'i2 �, ,#y,,,� G ila , ,: •. - Y, ; , ,, RED 'DATA :1 A ND,,= EAIVII LI'`DWL'LLING • • ;:� `" °�"'�, �.�'a"r'''- ,§��4° '' �, ° '..rz .�z= cS,T�� `WC:)KK� �' " "�''»x K ,. �.z• ��":, a � � �Q-..,' u:.,.; � .. , . ., . , _=a.':9E:. x. � � €� ati, ,:F'��w� .a, .. ;�' . r "d.&3':'..''a�� ".` ' :�... �...;!f.ir.,`k ,£�;�^ - ._ �C...�'�.a# ;3s::..,.�.::� �9; *�; : cS:. < : u� ❑ New construction ID Demolition Permit fees* K are based on the value of the work performed. ,,,,------ Indicate the value (rounded to the nearest dollar) of all • [ Addition/alteration/replacement ID equipment, materials, labor, overhead, and the profit for the Wftg ; : cY a , °...; ra :,:�' :.�z:<. ':, �;;a' „ > = < : „`. q;; ;` 1/ work indicated on this application. 'a ; w r - , CAT O : O U O ., d .. 3 ' :,, Valuation: $ ` PP � .. DD V } • L?� 1 - and 2- family dwelling ID Commercial /industrial % ' 11] Accessory building ❑ Multi - family Number of bedrooms: �/ 7` O- A° [I Master builder I=1 Other: Number of bathrooms: I 'i: > > <�'t- �'.' -.e H:.: isd;: '.>`- ' °�"o:if1«.``ri„k.A'°.'a*.. .;o�, °ry r•Sa�F Ja- _.i..R, > " ' ' Total number of floors: .* lin e; - r " ; S . Z . 4 : 4 N ..-4, , LO ATION` , , NA. _,' '.,..,s.•' _; Job site address: /. 5 ,.5 Gt..) '',.3"-',0 ,` ^`2� New dwelling area: $ O 5( square feet ` '� � City /State /ZIP: 7" 1s e.901e, Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet }z Other structure area: square feet 7 REQ.U'II2E`1 COI "Ci- AIAISE',C33ECKBIST, v Subdivision: e.--4 A, Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: +yt ry xd...- � <, n ,;.. % „- , equipment, materials, labor, overhead, and the profit for the �. , n e= ` $x+,5'"�.:r:'y<! ,e„`.t:.?e; rv 7;' An i�`.'^5� ?'; my ZIA FUi -' i f a „ ; ESCRIP�ION�O7 FORK l b work indicated on this application. y "a' � -�.; `* a �'."��.,... -,..� �,x ,. , .�.,� x �`i =..�.i�? -x _�<_, �t. - ... ELF x3`23<s`.,” - , �i �" ,SO , D Yy - .y, -PA, c� .64- � G. � �..r o Valuation: $ ` Existing building area: square feet ,--- i New building area: square feet . iP ROPERT� ,OWN ER ' "° e - ,t ®�'EN ANT ° 4 o -/' Number of stories: Name: ,71,t,,, d- 4 /e/'l iY 1 ---- Type of construction: Address: /6 5" � .,3 Ave____,, Occupancy groups: � City /State /Z1P• � /� , Q '97?'- Existing: Phone: (93 ) 5749 Fax: ( ) New: ,<,.,• - i r;.,Yf 'A:' ?r:.Y:2a , °E',: 'b 6 . L. att1:° SSr ,+ „r'% .; ; �N� '' .i � ..':: ';zY `''�`� ^,S *�§!'� ° >° % `" .;fi.3 ^s; '`::�: "s'�3iu�.- �:, .�t'�'£'n.'�:� �.: ^:re <<„�.....,; �> .;. _ CONTAGTTPER50P1.. r�_ ` ..�A'PPT;ICAN:T;;<�;,,.� -,` ., ,�. �rx, ,.... 'r e .. ..�5 • . .�._, ........,. ��p; :' .?...,. 'a� 'i;�� � . �'.; F.�: �'ti�' , sr�. »�� "���`'� ""`u�." >.�..�,'uie.....: � ^; � . .. Business name: 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: y: Phone: ( ) Fax: : ( ) 9o /0 if E- mail: / Business name: /� � ear -1`s ^ u � s 's. a �-.,.. ,..,,, .:., _..::w ».:�.�' N ` ;:;,'. P C t j s, ; `°°' "PEW,,,, ?.. , ,:7 "n • . g�. .e�., p E <FiES� a' i': � i',-`.' sr�?sx':::" ��iV, Ny. R° fJ] w. v'+ fs. "f'z`Y�.S4i''-:�i1°` ":. <.za;:.: i:,% «': ^� : .. Address: ,W5(55 SIB / , \ Please refer to fee schedule. City/State /ZIP:,. / / eJ � ,06 / Fees due upon application Phone: ( $Q3) 58 _q 93 — Fax: ( ) • Amount received CCB lic.: JQ 5 028 7/30/° Date received: Authorized signature: ABC // / yl. / --1- This permit application expires if a permit is not obtained � �,l °""'�+ -✓/ Q / / � within 180 days after it has been accepted as complete. Print name: L , "4� 'e7m.c � Date: / !/ ! 5 * Fee methodology set by Tri Building Industry Service Board. is \Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(I1 /02/COM/WEB) One- and Two - Family Dwelling �' Building Permit Application Checklist . . FOR OFFICE USE ONLY City Of Tigard • Re ceived permit No.: Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 O yew -NI 24- Hour Inspection Line: 503.639.4175 alill� ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us ❑ Other: THE FOLLOWINGITEMS ARE REQUIRED FOR PLAN REVIEW , ' ' " • Yes_ No: ,:. N /A "r I Land use actions completed. See jurisdiction criteria for concurrent reviews. • ❑ ❑ El 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 El 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 R. ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ . there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray • • construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. _ 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ 1 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. - 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or . ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS ._ + . .....I , .. 23 Five (5) site plans are required for Item I I above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". gi ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. C ❑ ❑ 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 ' ' ' �B Plumbing Permit Appl f V FOR OFFICE USE ONLY City of Tigard AUG 9 0 Received ®n� Date/By. Permit No.: /� -00 %� 13125 SW Hall Blvd., Tigard, OR 97223 V Plan Review *r Phone: 503.639.4171 Fax: 503.59ti1)1 }.0 I/�i ?ni�y0 �, I :\ Date /By. Other Permit No.: 24- Hour Inspection Line: 503.63 S rIGA j�d . .1� ^Al,,' Date Ready/By: Jung ® See Page 2 for Internet: vvvvw.ci.tigard.or.us / NG bN /SIniy J Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 R'1- and 2-family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 CI Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: /lr SSG 5 l'32--to Catch basin or area drain 16.60 City/State /ZIP: (( �4 l (X 7 7-.2-2--(1 Drywell, leach line, or trench drain 16.60 - Suite/bldg. /apt. no.: 1 I Project name: Footing drain (no. linear ft.: ) Page 2 S Manufactured home utilities 110.00 Cross street - i � T � / di to job site: ai�, / (d /0? ! 616 -6) Manholes 16.60 /ir j '7 /�� / 1 4 12 , ' i4 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: Page 2 r Storm sewer (no. linear ft.: ) Page 2 Subdivision: eA7rr /4, I Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: 1'i f,/1 -� --- - ©Qy�© Fixture or item - Absorption valve 16.60 . DESCRIPTION OF WORK Backflow preventer Page 2 Backwater valve 16.60 Clothes washer / 16.60 • P Dishwasher V 16.60 P ROPERTY OWNER I 0 TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: j/vc . - 4 -� & tY 1.,,z� Expansion tank 16.60 Address: / ., 53) 56,) . 13.-6-/ A Fixture /sewer cap 16.60 City /State /ZIP: 7;74i f� y, f C - L/ Floor drain/floor sink/hub 16.60 Phone: ( ) ,� (,? t.� l Fax: ( ) a Garbage disposal / 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker / 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 a Sink/basin/lavatory / 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 • CONTRACTOR Water closet 16.60 Business namc _ - j , y T � ° "" °-heater 16.60 Addres City /State /ZIP: -4. K--- Subtotal � n & Minimum permit fee: $72.50 Phone: / Y V , rax: t 1 ` 0e* Residential Backflow minimum permit fee: $36.25 CCB Lie.: ' 1 �./ '7 r Plumbing Lic. n - 4 3x/ Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: c - & - TOTAL PERMIT FEE Print name: 4CIPy/ �- ha_yee-7-1- Date: gj // _ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\PLM- PennitApp.doc 12/03 4404616T(10/02/COM/WEB) .V -7 % -O M "/L-. Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: .Site. Utilities_ Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture Or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof; to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof; to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: • Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by (Fixture) Work Performed Fixture Type: Replace New Moved Existing Capped Comments regarding fixture work: Baptistry /Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic ✓ Drinking Fountain Eye Wash Floor Drain/sink - 2" -3" -4" Car Wash Drain Garbage - Domestic \/ Disposal -Commercial *Note: If the fixture work under this permit results in an -Industrial 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 Bradley Quantity Total 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: i:\ Building \Pevnits\PLM- PermitApp.doc 3/03 'Mechanical Permit Kea- • F OR OFFICE USE ONLY' . . echan>! t �p >IEa US E° t Received City of Tigard Date/By. Permit No. f y\ rd. -00,5 00 31 v 13125 SW Hall Blvd., Tigard, OR 97223 t t Plan Review Phone: 503.639.4171 Fax: 503.598.19,¢�Q �j '1005 mi %r� Date/By. Other Permit: Inspection Line: 503.639.4175 . i" i Date Ready/By: iuris: Internet: www.citigard.or.us Supplemental See Pen l Information g CITY OF TIGARD Notified/Method: Supplemental Information . LtfLDfNG Diinkipil TYPE OF VVO COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of work 1:1 New construction D Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. /� CATEGORY OF CONSTRUCTION Value: $ L�'1 - and 2 - famil dwellin RESIDENTIAL EQUIPMENT / SYSTEMS FEES* y dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. [ Ea. I Total • JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: /4.5-15-62 �``� ' � Air conditioning or heat pump V f L) ,73/e0 v / (requires site plan showing placement) 14.00 City /State /ZIP: //16... � ; Furnace 100,000 BTU (ducts/vents) 14.00 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 a � ,9� Duct work ,/ 14.00 �{�+ Hydronic hot water system 14.00 (/t 6__r' / /-5) Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 /,,, // Flue /vent for any of above 10.00 Subdivision: fry/"`[.?, p �.e� L ot no.: Other: 10.00 Tax map /parcel no.: ,;257/ i j5 e - ,OD /pa Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 /' Gas fireplace ✓ 10.00 L / e 47 1 7l , / %/ De- ki. A,e -i'L . > Flue vent for water heater or gas fireplace . 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 ROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 10.00 Other: 10.00 Name: ci/ d__ /I La. 2_✓t' Environmental exhaust and ventilation Address: fZ 575 ' 6 cd /13r1 ✓ Range hood /other kitchen equipment 10.00 City /State /ZIP: / a d Ow e- 7 3..1'1 Clothes dryer exhaust 10.00 / / Single -duct exhaust (bathrooms, Phone: (3) s9, -6 7 y / Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Other: 10.00 Business name: - Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace ✓ E -mail: Range ✓ ' CONTRACTOR , Barbecue - . s bt ,61. _ . -_ Business namt Clothes dryer (gas) - i a Other: Address: I : MECHANICAL PERMIT FEES* City /State /ZIP: 1 _ Subtotal - Minimum permit fee ($72.50) Phone: (,. Fax: ( ) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: ( J� - 1 This permit application expires if a permit is not obtained within 180 c G L TtG%t/ _ _ days after it has been accepted as complete. Print name: 4•ic•fi /1 , �-, r Date: (// 7/05 * Fee methodology set by Tri- County Building Industry Service Board -7 i:\ Building \Permits\MEC- PennitApp.doc 12/03 440- 4617T(tt /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: - Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 Electrical-Permit Application ,FOR OFFICE USE ONLY City Of Tigard , • E1 Received Permit No q,� 13125 SW Hall Blvd., Ti ard, t►? Da? —00 0 g Plan n Review th eview Phone: 503.639.4171 Fax: 503.598.1960 byitfn °m�1 ' Alt Date/B : Other Permit: Inspection Line: 503,639.4175 9 � - i`1 W Date Ready/By: . Inns: H See Page 2 for Internet: www.ci.tigard.or.us AUG `� �0�� � Notified/Method: Supplemental Information - :3s.�t91:1,£ .. . .. h am :: G :i'FR-' Sa7 : 14.'sRr+:-'�: 5.'+L:: ° - : "t:. sk -y - _'k, t ri .1, f:. :11' s•� 7 1 "sA:Y^ ♦le b. t'.' s, i X` g t`S .s.. a G��`fie7 ,fir 5m' P" r. .. 2.. ,. "n A Vii° A�L`rLGaA k K''" t,..M i .�n;e , ' k r.. 2r , . r * .s St"� ° =tA :�m...ti 'i; e, , .y, L;. ..� s . >•_„4 .-,7, r _ :.>��� k� ,7��:±:�s- n<5n.,� S �a;,�@t, c � ������^� .� <'i�� . -. _ , a: �.. rsRC,., �r ,��r.r- +�°€.�.w.x.�,.- .��...fh. .r,,..,�.......< _ . �_ �k ,r _ . _ -.�__ . �: . P lease check all that apply: El New construction � L'7,1 �4g�or„}�, E:O$1/replacement PP Y' ❑ Demolition ❑Other: E] Service over 225 amps, comm'l ['Hazardous location RAW R = .:•- T h #may . b; art y << „ Y , , Yi ;* t . " ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq ft., r;,;»u;.d.� : rA rF� ri tf FgCONSfR f eiti 1 'A"�` n ' .4 of 1 -and 2- family dwellings 4 or more new residential i•`a. iipxd ",_ . `}.E"•,A: dif `k C 8u7v i: ..., xi ` wr .41-4 ,f ,,.aw::.: ,.1.. E ,igii: . 26.i -h4M.A: as - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master budder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons EManufactured structures or ' '' r .I � S1T' R 0 9 C CA` iii ' ; ?.' E ess%li htin plan RV. park ��' ; . ': � ��n �:nC€. y. ,.'r�.atc�>tr.'� .afv sr t�. RR �.° �`�s, ; - ?�u�,. z zs�a3-_ .:: f �'�,. "'s.`€�°�,�a�?;,ts�' - � ' P`> ❑ i�T g g P Job no.: Job site address: ❑ Health -care facility ['Other: Submit 2 sets of plans with any of the above. City /State /ZIP: M7 _5 tscAi 7 The above are not applicable to temporary construction service. �tgta, S END tM": ,e. Suite/bldg. /apt. no.: Project name: EE:,- .,',`;.:'_`.` S51. Description Qty. Fee. Total ** Cross street/directions to job site: i r / l ,,, tiU l ✓ vL 6 g, / 1 . New residential single- or multi- family dwelling unit. f/�� Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Si-e--12 � /-- Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 - I !/ir1Gt' C - S QC Limited energy, residential 75.00 2 Tax map /parcel no.: a..57/ .t /,,9- - QD /DO �: � � ; r} � � ;,t �� r �� �� „; _� t s ,, ,:� � - , � t „�, Limited energy, non - residential 75.00 2 ,`"�,1:�.�'`'� �;a� O ,z�WOJ2K' x �� °... >�:�'•�' ' ,,• Each manufactured or modular 1 —r'i D „ _ � I� � f - - S erv ic es service rs installation, feeder 90.90 2 /� /( Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 .a,> .,.p f �a �,;' _., .,, $ i.�; .. ..� ��. . ,r• -sr .- h ; �a . ,.. : •. - : y an amps to 400 amps 106.85 2 l . - _A.K. ` , � ,, E o ° r ; ° ,: , 9 $:„? ,4,- �' ��"� �� ” �'� � ` ^ � �`r�^�3 "' a• °` `ux4, 401 amps to 600 amps 160.60 2 Name: 6ilvo 0-Arie /l 4 Ke„-f 601 amps to 1,000 amps 240.60 2 Address: s3 l� : (� - r /f n / „ Z _ Over 1,000 amps or volts 454.65 2 �` Reconnect only 66,85 2 City /State /ZIP: `/ � f j 44/(7 , 7g�at J Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) 5,' 4 474 / Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 - 2 • Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ,�.,, . , ill i; ,, , t�m�- . , � `vp wk. ,.,_., ,:x sa ~ , : °= A. Fee for branch circuits with ' ” - ,. ' , "� .. _ ,.4r P,.PL�O'1st:T'� 'T; � - °, 4 ��: „._ �QN�L`ACTt�PE �• .�•. 's;... ' . �.-.F; �t aa -° .�` ast'` �. +� -'-�# a im-- �_ � -^ z service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, I each branch circuit 46.85 2 Address: Each add'l branch circuit X 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) S ign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - h r ` a ' l' ''�"� 0" a TI' �. `r=° °' ' Z t energy �.x�:s : ��:��s �a"��''' ... ' Ca0 CI'(�R; .: -.. �; �' �,ik� �"�, �'; • �t'� �*'� P anel, alteration, or Al /y / w _ (f!/ extension. Describe: Page 2 2 Business name: U I Cj j/( e ___I1 Address: Each additional inspection over allowable in any of the above /,,�/� Per inspection 62.50 City /State /ZIP: g /(./-O [N/5 6 J Cl Investigation per hour (1 hr min) 62.50 ((! ' "` �� Phone: Fax: ( ) `O Industrial plant per hour 73.75 t �: �•- �. � �. ��. EL��T, � .�R'L;C�T�`•�,ERNi�I7;")FE � .,. �.�;::s•`;:.:: CCB Lic. 92 w 5 sical Li -.37.30e.... Suprv. Lic.: Subtotal Suprv. Electrician signature, required: 7 -/---0# Plan review (25% of permit fee) State surcharge (8% of permit fee) Print name: Date: TOTAL PERMIT FEE Authorized signature: g dl' 007 ��_�.. This permit application expires if a permit is not obtained within 180 -,_ days after it has been accepted as complete Print name: A/w / ) Zp, ,,� D ate r / /7 / j * Fee methodology set by Tri- County Building Industry Service Board _ �j ** Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12103 - E /tG, r) � * 440- 4615T(10/02/C0M/wEB ,(yd�✓. Electrical Permit Application - City of Tigard - Page 2 Supplemental Information LIMITED ENERGY PERMIT FEES: ecF.ar';�•r- a-as„� ,.>.�;.•e: =� a. �ti �'6�.. s �k"t ' ,� +ar...�. x�;.x+ �;, RBTSI 4 x ' ' s �£ ,..,:r°s "' wss' D:E :. �p gip. 3 d� " ��. _.M � �> `�° s � `. Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ G arage Door Opener* ❑ H eating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: C>O'1VIEVIERCM ,.. W K `MIl Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication.Installation ❑ F ire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ M edical ❑ 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:\ Bui lding\Pemtiu\ELC- PermitApp.doc 04/03 ', CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE SCHLOTTMANN ELECTRIC 2459 SW TV HWY SUITE 445 HILLSBORO, OR 97123 Electrical Signature Form Permit #: MST2005 -00310 Date Issued: 9/30/2005 Parcel: 2S 114AC -00100 Site Address: 16550 SW 93RD AVE Subdivision: CAFFALLS CORNER Block: Lot: 001 Jurisdiction: TIG Zoning: R -4.5 Remarks: 556sf addition. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: LENART, SILVO + ADELL M SCHLOTTMANN ELECTRIC 16550 SW 93RD AVE 2459 SW TV HWY TIGARD, OR 97224 SUITE 445 HILLSBORO, OR 97123 Phone #: 503 - 598 -6741 Phone #: 628 -7225 Reg #: SUP 4055S LIC 93815 ELE 34 -373C AN INK SIGNATURE IS REQUIRED ON THIS FORM x er =A44. Signature f Supervising Electrician If you have any questions, please call 503.718.2433. Jan 18 06 09:31a p.1 ui/id/20115 u9:16 rAX 5u45981900 CITY OF TIGARD 1 0001 TiC2 3125 S.W. HALL iaLlit). iciARD, O wizk'3 610TiCiE FLUNZING PIECE/ VED STREET - ii0R11.A - Ni.), OR 97206 JAN 1 8 p CITY 2006 OF . . —U/LD rGARD 9 Form //vG OV/sio Permit NIST2005-00310 9r,30i2005 Parcei: 2S114AC-00100 bite l6556 SW 93RD AVE Sujuvjsiou: 4:.:AFFALLS CORNER Lot: 001 Jurisdiction: iiG Zoning: Remarks: 56tist addition. Yu u i ipfl ;las er ividicated as the piurribing contractor ior.the permit indicated above. in order tor me pionibiro permit to be valid, please have the appropriate indimigual from your company sign below n ri return this Plumbing Signature Form prior to the start ot the work 1,0 the add nbove. Pui!c'incr fl tIc pfumbing f.r.spectionz w01 be authorized LTail coriipk.qc,d form l 5 isecoiv OVvNL R. PLLMEiNG CONTRAe Ok: LLNART, aiLVta ± ADE iVi COLUiteit3iA PLUMBikG 16-553 S 'XITZE) AVE 6.626 SE HARNEY STREET IIGAR OR '7224 PORTLAND, OR 97206 q j Phone #: 503-T75-8481 Rog 4: Lie 1613i PLM 26-6U3P1. L SiGNATURE 15 REQUIREU ON TiliS FORM -• zjiglature oi-,-;utitorizeo riutnuer if you ve ny q SuU, please cali 503.718.2433. r - - 10 53 woo , ?,,-, :•• F , L Aug . • 01M� CLEAN SERVICES 503 6814439 No.8907 P 1 fi;i.‘ /�Jp �31 ., r � 2 05P �._Ald A � (�.. I , 1 .,..... ;ll ..... i - I•.��1 �r�v✓ t U u C[ I I iE { \ i SEA 2005 A UG 2g 2005 GO TIGARD r. File Nmnbc Bt31L r �ltal� ate S ervices . (D.r ,,,,,,,;,,,, „.,,, i, . cicsr. Sensitive Area Pre - Screening Site Assessment Jurisdiction ^1 I GA-0D_ Date d /!l /n Map & Tax Lot 2511 L} A c :0o, (D0 -- . - -. ._._ Owner ,Sr /va 4- . ,rte/ Site Address 1455C) log q3 R veL ` - r I 4 R. t7 D p_ 9722 / Contact /loss _ %9,�,( a ., Proposed Activity ,'v ie n_Alfaehpe Address -1'2 y �`` 556 51. �'- .d. :17,(-4 .2 kin_ Lf i,r -i . Phone g-511 - 4' 7q) Official use only below this line Y N NA Y N NA Ej n — Sensitive Area Composite Map - ❑ r i Stormwater Infrastructure maps Map # ),,,7_12,0A QS # 4112.0 -.] I l r Locally adopted studies or maps n 1 - I Other Specify Specify e2 (.1 Afe,ra Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resaution and Order No. 04 -9: u - Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM, A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. fa Sensitive areas do not appear to exist on site or within 200' of the site. This pre - screening site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subse•uentl discovered on your property. f- - _ = T -- ,. = _ - w ,- E The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Comments: L .s oh e eJi PvJ V T. Tic & :M. tla.., a14.1' Ao0 c t 4¢ri1a / r4 7 & o ". de/ wirer 4' /1 .. m Or _ x—�se er rz eF;lr:w��P,!is,•r: v J a.•V e•a Naar Tar's q,yr. Reviewed By: l .4 .- Date: 5' 3® Returned to Applicant Mail_" Fax Countaer_ Dille t/3 l of Bye... 2660 t>W HDlsboro H■ghway • Hillsrno, °rrrinn 97123 Phone: Fax: (SO3)1,31f14439• wwa.clr ;rux.ii(r;,,, I, Lc.cSz CITY OF TIGARD BUlLD►ING DIVISION PERMIT #: MST t7 5 00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005 Phone: (503) 639- 4171 �Q'�II Inspection Requests (24 Hrs.): (503) 639 -4175 ��' INSPECTION WORKSHEET FOR DATE: 10/2612006 TIME: 7:04AM PAGE: 57 'bv 2_ 64 I . /c 13 SITE ADDRESS: 16650 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 566sf addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 603-598-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503- 513.9435 Inspection Request Scheduled For: Date: 10/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 038799 -01 603 -598 -6741 N Corrections /Comments /Instructions: ( 1 rD r1, PASS ❑ PARTIAL APPROVAL ❑ CANCEL [ I NO ACCESS ❑ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Gtf?P Date: /0 Z 6 h � Z --(2 7 Phone #: (503) 718 - L/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005,00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005 Phone: (503) 639-4171 vote Inspection Requests (24 Hrs.): (503) 639-4175 JAW 1— INSPECTION WORKSHEET FOR DATE: 10/26/2006 TIME: 7:04AM PAGE: 56 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 556sf addition. • OWNER: LENART, SILVO ADELL M, PHONE #: 503-598-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503-513-9435 Inspection Request Scheduled For: Date: 10/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 038600-01 603-598-6741 Corrections/Comments/Instructions: pi PARTIAL APPROVAL CANCEL fl NO ACCESS FAIL pi CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: RA-6A Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION • PERMIT #: MST2005 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 913012005 Phone: (503) 639-4171 Aoidowt Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/26/2006 TIME: 7:04AM " PAGE: 54 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAITALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 556sf addition. OWNER: LENART, SILVO ADELL M, PHONE #: 503-598-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503-513-9435 Inspection Request Scheduled For: Date: 10/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 038800-03 503-598-6741 Corrections /Comments/ Instructions: 1fr; -ASS PARTIAL APPROVAL fl CANCEL LI NO ACCESS n FAIL fl CALL FOR INSPECTION f I ADDITIONAL FEES ASSESSED Inspector: C4-1 Date: Ar -6 Phone #: (503) 718- CITY OF TIGARD BUILDIITG DIVISION PERMIT #: MST2005 -00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) -4175 INSPECTION WORKSHEET FOR DATE: 10/26/200Ei TIME: 7:04AM PAGE: 55 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: - 556sf addition. OWNER: LENART. SILVO + ADELL M, PHONE #: 503-598-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503 - 513.9435 Inspection Request Scheduled For: Date: 10/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 038800-02 503 - 598 -6741 N Corrections/Comments/Instructions: FA PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / 2 0t. Phone #: (503) 718- ZcL/.C/ CITY OF TIGARD l I BUILDING DIVISION PERMIT #: MST 006.0 31Q 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: B130/2O06 Phone: (503) 639- 4171M Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1d19/2006 TIME: 7 :03AM PAGE: 21 - emu -zrt ' , 1 2 7 Mj g J ba- SITE ADDRESS: 15 550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAF FALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 556sf addition. • OWNER: LENART, SILVO + ADELL.. M, PHONE #: 503 - 590.6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503-613-9435 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: Code # nsp- - •escription Confirm # Contact # Message 120 I^`iectrical rough -in 02620 06 603. 780.7329 N Corrections /Commen s - • -. • PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: /"'* Date: !- f V" Phone #: (503) 718- 214 , CITY OF TIGARD .. . BUILDING DIVISION 44.,,,, PERMIT #: MST2.005.00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/200 ad 5 Phone: (503) 639-4171 ' e liii Inspection Requests (24 Hrs.): (503) 639-4175 4/- U., INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7:03AM PAGE: 2E; SITE ADDRESS: 1€650 SW 93RD AVE CLASS OF WORK: • SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: Gr addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503-69R-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 6O3-613.9435 Inspection Request Scheduled For: Date: 1/1W2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 31 Post/beam plumbing 026286-01 603-7a7329 N Corrections/Comments/Instructions: ., / / /42-7 4 1 -- - &,----0--- // I .1 ...PASS 1 1 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS n FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Orr" Inspector: Date: , i Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST200S -00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/)(106 Ittb Phone: (503) 639- 4171N�Kilm�ii�y��l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7 :03AM PAGE: 23 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 556s1 addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503- 598•674I CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503..513-9435 Inspection Request Scheduled For: Date: 1/19/ 00 ; Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 025285 -04 503-780-7329 N Corrections /Comments /Instructions: • - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: F Phone #: (503) 718- w s CITY OF TIGARD BUILDING DIVISION PERMIT #: /I) 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 sca / INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 3.Ad CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: / Pour Time(f i(r) c(7 # Inspection Description Confirm # Contact # Message f Corrections/Comments/Instructions: &ASS El PARTIAL APPROVAL fl CANCEL fl NO ACCESS Li FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED ut. Date: 1/V I nspector: Phone #: (503) 718- CITY OF TIGARD to Si BUILDING DIVISION PERMIT # 07>5 d 3I 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: Phone: (503) 639 -4171 AI\ ���� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 6,5 67341 11 e v CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: / — a - 3 °°O (P Pour Time: Code # Inspection Description Confirm # Contact # Message '/ o? 75 2 Z o aSSJ q�- .?.O _ 73a o re Comments /Instructions: C 6 5570 P t-' AAA .-4-t-4 " , \ ' L__ . / ' / I I 1 1? l 4 ' ansionmo /*grit ✓ va p a: / D-- ... th- v-e_J e, S : ?vc ',"---- ,0 0 / f ./ / %, i ' f j S II 5 ' i / ( -4 - ?..._e /..4._ c_ . <,-___,./( 7 / C ' ,vC 1___e C--(e,tc___ C...-- c CS' - -41/ 61-. / 7 D K) l S `i2eA1 / 0 2 - - rik . - 21.- - z&--. 19— z-fA-1 () o 67d4"5 s 6A° ■ .C.L...,4 Vec,tk_tfi -r- K.e.-:C.c.-L__ El PASS ARSL. ' P' iVAL (((,,, /// 1[ E ‘ ❑ NO ACCESS FAIL CALL FOR INSPECTION n ADDITION FEES ASSESSED r r _ Inspector: `� Date: V23 / Phone #: (503) 718- 2-Y2- CITY OF TIGARD A BUILDING DIVISION PERMIT #: MS I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/20'06 Phone: (503) 639-4171 „ ro llg l i i l t Inspection Requests (24 Hrs.): (503) 639-4175 ''--I I R INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7:03AM PAGE: 20 SITE ADDRESS: 16650 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 556sf addition. OWNER: LENART, S1LVO + ADELL M, PHONE #: 5035Ni-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503-51341436 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 025285-07 503-780-7329 N Corrections/Comments/Instructions: 1) VIA e cjkL.6,1-3 c---AJZ --(4 e t-ec. .-c, k a - S 1.3/ Le . i - 1 _ & ''. IIIII 1 / 2-) ikc - P-124--)I-C a e--1-1— %-s:Jt Z._ - 2.. . Vb , - Li 4 c.3- -.AM- \ le■02_ " ecFo‘ 2- • 1(5-L- +n• c%1^.5 LICITOC • l PASS PARTIAL APPROVAL I I CANCEL I NO ACCESS K AIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: 1/Z-: Date: 1- /t g Phone #: (503) 718- 7 Y 2—' CITY OFTIGARD BUILDING DIVISION PERMIT #: ST 00a 003111 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9i30/1005 Phone: (503) 639 -4171 -48P410111" I Inspection Requests (24 Hrs.): (503) 639 -4175 - 3 c c -- e4, ------ INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7 :03AM PAGE: 22 SITE ADDRESS: I6ao SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 666sf addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503.- 69th -67411 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: f3'13435 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: , Code # Inspection Description Confirm # Contact # Message 61 5 Mechanical rough -in 025285.05 603- 7t3W7329 N Corrections /Comments /I truction W CCA/U,6___.-52--- ,... OP k_A___, 1 I I PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �' `� Date: 1 / `c/3A" Phone #: (503) 718 - 2A I CITY OF TIGARD BUILDING DIVISION PERMIT #: IViST2.0015,00:110 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSU 9/30/200 Phone: (503) 639 -4171 Jirtmlt Inspection Requests (24 Hrs.): (503) 639 -4175 es - INSPECTION WORKSHEET FOR DATE: 1/19/2005 TIME: 7 :03AM PAGE: 25 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: L.ENART DESCRIPTION: 55Gsf addition. OWNER: LENART, S {LVO + ADELI. M, PHONE #: 503-598-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503. 13.9435 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 805 Positbegym mechanical 025285 -02 503.780-7329 N Corrections /Comments /Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS 1 1 FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 / - c / Phone #: (503) 718 - C/ (eZ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200:5.00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISS D: 9/300.005 Phone: (503) 639 -4171 itt Requests (24 Hrs.): (503) 639 -4175 • INSPECTION WORKSHEET FOR DATE: 1/1W2006 TIME: 7:03AM PAGE: 24 SITE ADDRESS: 1$60 SW 33RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 656sf addition. OWNER: LENART, SILVO a ADELL M, PHONE #: 503-596-6741 741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503.513.9435 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anch 025286 503 N Corrections/Comments/Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: L (° Phone #: (503) 718- 2--7 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -0031 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91301.x111' L Phone: (503) 639 -4171 'my Inspection Requests (24 Hrs.): (503) 639 -4175 i INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7 :03AM PAGE: 19 SITE ADDRESS: 16660 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 656sf addition. OWNER: LENART, SILVO + AMU_ M, PHONE #: 503-598 -6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503- 613.9435 Inspection Request Scheduled For: Date: 1/1912006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 026286 -08 503-7807329 N Corrections /Comments /Instructions: ----- PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED _ ____ OP • Inspector: Date: 0 1 4 6 Phone #: (503) 718 - Z )1-' CITY OF TIGARD BUILDING DIVISION PERMIT #: M ST2005 -00310 13125 SW Half Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2006 Phone: (503) 639- 4171 `■\ Inspection Requests (24 Hrs.): (503) 639 -4175 ' INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 31 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART • DESCRIPTION: 556sf addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503-598-6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503 -513 -435 Inspection Request Scheduled For: Date: 10/14/2005 Pour Time: 11 :00 Code # Inspection Descripti. Confirm # Contact # Message • 210 Foundation walls �/OD 018397 -01 503. 781 -6542 Y Corrections /Comments /Instructions: f acre: ! _ Sc dal l' in PASS r P ' TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL • ■I'L FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ,L ■ Date: /' r�S Phone #: (503) 718- . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005 Phone: (503) 639 -4171 / ��n Au ipmUlu�111� I � Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 656sf addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503- 598 -6741 CONTRACTOR: COPASE T I C CONSTRUCTION PHONE #: 503 - 55138435 Inspection Request Scheduled For: Date: 10/5/2005 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 017530 -01 503-781 -5542 Y Corrections /Comments /Instructions: • • i(JOT� n PAS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED :// Inspector: Date: /0— S OS Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7 :04AM PAGE: 9 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 666sf addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503-698 -6741 CONTRACTOR: COPASETIC CONSTRUCTION PHONE #: 503 - 513 -9435 Inspection Request Scheduled For: Date: 10/13/2005 Pour Time: 0 Code # Inspection Description Confirm # Contact # Me . •e 210 Foundation walls 018274 -01 503 -781 -5542 V Corrections/Comments/Instructions: PASS I I PARTIAL APPROVAL fI CANCEL ❑ NO ACCESS ( FAIL • k L FOR INSPECTION I _ ADDITIONAL FEES ASSESSED Inspector: �'-- Date: / 1 7 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: M;T2005 -00310 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005 Phone: (503) 639 -4171 J �"'a' �iiuiil�i 1 Inspection Requests (24 Hrs.): (503) 639 -4175 J INSPECTION WORKSHEET FOR DATE: 10/11/2005 TIME: 7:08AM PAGE: 31 i t ^"' 1 1..zc ¢N r >2 SITE ADDRESS: 16550 SW 93RD AVE CLASS OF WORK: SUBDIVISION: CAFFALLS CORNER LOT #: 001 TYPE OF USE: PROJECT NAME: LENART DESCRIPTION: 556sf addition. OWNER: LENART, SILVO + ADELL M, PHONE #: 503 - 598.6741 CONTRACTOR: COPASEI CONSTRUCTION PHONE #: 603- 513.9435 Inspection Request Scheduled For: Date: 10/11/2005 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 017978 -01 503- 781 -5542 Y ) 4Fr te l... LW. ctg Corrections /Comments/ Instructions: e . ... /1 6 F i z s V6 ri (74-4_7T Z kft4-7 H 0 c, /<- ) /4-5 P -. ?� S A PASS P TIAL APPROVAL ❑ CANCEL NO ACCESS FAIL I C r OR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ate: // #: (503) 718-