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Permit i CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00343 � IIII DEVELOPMENT SERVICES DATE ISSUED: 10/18/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BB 07000 SITE ADDRESS: 16185 SW 104TH AVE ZONING: R -12 SUBDIVISION: SWANSONS GLEN LOT: 011 JURISDICTION: TIG Project Description: Addition. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 22 FIRST: 252 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 446 sf GARAGE: sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: 5 VALUE: 107,000.00 OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 698 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:. LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: . MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS • MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 • 200 amp: 0 - 200 amp: . W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st WIO SVC /FOR: I SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 6 SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEWSECTION 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 Munidpal Code, State of OR. Specialty Codes -RENEE BARNES LAY'S CONSTRUCTION CO and all other applicable laws. All work will be done in 16185 SW 104TH AVE 7400 SE MILWAUKIE AVE accordance with approved plans. This permit will expire TIGARD, OR 97202 PORTLAND, OR 97 202-61 97 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 4017 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 1,554.86 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Bolts in concrete Structural _welding._ _ -- Special inspection (see plans) - Issued By : % . 25-4 - 14 - Permittee Signature : ilk ! 1 y Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business • - This permit card shall be kept in a conspicuous place on the job site until co ;1 on of the project. Approved plans are required on the job site at the time of each inspection. Buildin Permit A lication ` FOR USE ONLY City of Tigard oate/Br /Q_ J GS . '2 Permit Notes �1D05 --^GV3y3 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ! /o /�'I,rvigAl ^^ ' , Date /By� /0 - 4 —6S Other Permit: Inspection Line: 503.639.4175 OCT ' 3 2005 _ -„, { l Date Ready/By: 1uris: ' ® See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Meth.d: /Q- 1?'6 Kr Supplemental Information e::::;/; % , , Via, /e/`t/ .- T + e • REQUIRED DATA: 1- AND 2- FAMILY DWELLING .. r i. ' . — Ili ii, /�` .I �.r ❑ New construction ❑ Demolition i Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all . 0 /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valu ation: $ gl - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms. JOB ,SITE INFORMATION AND LOCATION Total number of floors: Job site address: I (4 ( S' IAJ / 0 4 New dwelling area: square feet City /State /ZIP: -T-) (o /1-42.-b 04- q7 (9-0- Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 8,0 1;e14 e 5 Covered porch area: square feet . Cross street /directions to job site: b i.Lie.4 Deck area: square feet Other structure area: square feet REQUIRED.DATA: COMMERCIAL - USE CHECKLIST . Subdivision: . I Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. .&,0v Co e�Q1C. 4T -0, IOU fi 4 o0/I17 roau tb 75 , Valuation: $ I Existing building area: square feet te�rr'' New building area: square feet . ( .PROPERTY OWNER ' • , - ❑ TENANT . ' Number of stories: Name: ieeA►E�. r3A,a. S Type of construction: • Address: [ L ( % S S LA./ ( 0 f 4 e Occupancy groups: City /State /ZIP: - T't ly i4-lizab C9 ye._ q 72 02- Existing: . Phone: (SO) C.&O- /DD i Fax: ( ) New: g APPLICANT ❑ CONTACT PERSON NOTICE Business name: eevecNm 7 All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: /V 6 LC' under•ORS 701 and may be required to be licensed in the Address: - 71-14.0 S '' m ii. /.tau (e 41/ jurisdiction in which work is being performed. If the City /State /ZIP: P - 2i A 3 L '°7 7 l .,, C61 q? applicant is exempt from licensing, the following reasons apply: Phone: (Sb ?) a • i-(-41 j � � 1 Fax:: ( ) � 3 ,j - /9 70 E -mail: / v�� / oxy - +- r. q ` S e.9 °V S iz v G T71 A . CONTRACTOR Business name: jr 7 g 4 BUILDING PERMIT FEES* " Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application C°'� `' 2 2 A . Phone:( ) Fax:( ) Amount received CCB lic.: t. 0 /7 e Date received: Authorized signatur /' �� / This permit application expires if a permit is not obtained 6---)a within 180 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri County Building Industry . Service Board. is \Buitding\Permits\BUP- PermitApp dec 12/03 440.4613T( 11/02/COIN/WEB) One- and Two - Family Dwelling K g Building Permit Application Checklist FOR OFFICE USE ONLY • City of Tigard Received g Date /By Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: Hour Inspection Fax: 503.5 Line: 503.639.4175 960 ^- LI � il -� 4111‘,\ ❑ Electrical ❑ Plumbin ❑ Mechanical 2-Hor Ipetion 503.639.4175 --- 11- -+y�i� .I , g Internet: www.ci.tigard:or.us ❑Other. • • THE. FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/. 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing - member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full size - • • • o - •. . _ _ . . '.. . • .n elevatin S with erns references areacceptabl_e- 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. 1 7 Floor /roof framing: all - floors /roof assemblies; indicating member sizing, spacing, and ❑- ❑ - -- ❑- - 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., shearwall, roof truss) shall be stamped by an engineer or. ❑ ❑ ❑ architect licensed in Ore•on and shall be shown to be .. Ilicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 1 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 \BUP -RES- PermitApp.doc 2 Mechanical Per I, ;' :( �,v ` i " FOR OFFICE 'USE ONLY ' 1 7 i- - ' - Received !fq City Of Tigard Date /By:�/ 1? /,( Permit NA V\ + 137.' 13125 SW Hall Blvd., Tigard, OR 97223 2005 Plan Revie JJ Phone: 503 - 639.4171 Fax: 503 -59 /r» ¢ .. paze/g Other Permit: a 0� C I `� Date/By: Line: 503.639.4175 -j,/, Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us f ARD Notified/Method: Supplemental Information OF " BUI C WORK COMMERCIAL FEE *. SCHEDULE USE CHECKLIST ❑ New construction raAddition /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. CATEGORY OF CONSTRUCTION Value: $ k l- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT I SYSTEMS FEES* 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/ 85- s y ! Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State /Z[P: 77 i., Ala &V q "2 X)3-- Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Dy,,l/5 Gas heat pump 14.00 Cross street /directions to job site: r Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or • hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 • Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances • DESCRIPTION OF WORK ' Water heater 10.00 dl - • .' n Gas fireplace 10.00 1//1' •Z d XJN: Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 • Wood fireplace /insert n 10.00 ❑ OWNER ❑ TENANT Chimney /liner /flue/vent 10.00 • Other: 10.00 Name: Environmental exhaust and ventilation • Address: Range hood/other kitchen equipment 10.00 . City /State /ZIP: Clothes dryer exhaust • 10.00 Single -duct exhaust (bathrooms, Phone: ( ' ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT . ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Business name: /�. r/M Other: 10.00 t5 - " -C7 ` Fuel piping Contact name: krivo,t 6 6140 !4,-G . $5.40 for first four; $1.00 for each additional Address: 7q DJ s /y1 /44irki A-Ur Furnace, etc. Gas heat pump City /State /ZIP: 025—(,, Q d 7P. 7__ Wall /suspended/unit heater Phone: ( 553 3 Li% I Fax: : ( s c 33 — /936 Water heater • Fireplace E -mail: 42/fg g Z -o'9 /`�+ ( 7 O S%JQILG7i Je ea Range � - J/ CONTRACTOR' Barbecue Clothes dryer (gas) Business name: C(� Other: Address: ?0,1\C(' n � " MECHANICAL PERMIT FEES *F City /State /ZIP: V �� (j" Subtotal Phone: ( ) Fax ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: go / 2 l £ r 00 State surcharge (8% of permit fee) ed` "`t TOTAL PERMIT FEE Authorized signature:ga,yL ed This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ate: • Fee methodology set by Tri- County Building Industry Service Board i:Building \PermitsMEC- PennitApp.doc 12/03 \ \ 440-46I7T(11 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total= Valuation: Permit Fee:` _ $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including • $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 Oct. 18. 2005 2:56PM No. 6114 P. 1 4 ., El ctrital Permit A A,!. ,: � i.o i E' ,()‚ ■ OFF ICE I `1: ON I.1 tt_: - City of Tigard Received Permit No.: Lj e0� ` I° 13125 SW Hall Blvd Tigard, OR 97223 OGT 1 8 ' 2; � 0 � Plan Review Phone: 503.639.4171 Pax 503.598.19611 1 /',- !' I DateB . . Other Penult! 1 Date Ready/By: A See Page 2 for Inspection Line: 503.639.4175 -r- :.. Internet: www.ci.tigard.or.us y OF T1G '�• i . Noti tied/Method: iii Supplemental Information � t _ yt^ c e, '. ^,,�!i;.'oa:..�, :�,�, r•6y' -' ::J .tY.'', l..iC::'� ( �er, ; ,p_�n� , - ..,:... r; _ • ; ; . ,, 4 ,, 1 ,: ;^ -, � "i, , ;Y, ti ...fq)ki •,.s: l r.'I7j,y,.."& c '. i t:: ti ,; ,.�,.:t „s;; a4.03 a4,. �. F" +V a , " . i _ c : n,. C S...- 0 ; ?..vs,i 0 .2: ` �'ht;:lsks , , ;a .. . � a •r-, a�, L. , .... ° •ra?c. ,,.:4 x... , s Yl �, +: '' .�.-w „,'.,;;14.':•:- :•.•�rss:�:1:t,� _. . �} la''. . r,:, �`.. r.: c. o. ._� ?;.....:,..,,- � >.•,.•:._ ,.. ❑ New construction ,ii''' f • • .dil-ion/alteration/replacement Please check all that apply: 0 ❑ Demolition El Other , s . ,.,! °G* V. 4 . V. wak: yt ,-. , - . t . ,,, �'''∎ .:•: � r. w.: ,:,• . . '.r y . 0 . , } , Service over 225 amps, coming Hazardous location � ,N h . orb: R!r ^'; •t� f „�. ❑Servi ov 320 am � ratin ❑Hu •]dug over 10,000 sq R w 1 r • '' Z,, . �J•; 4.0, .,.L'�* y, � 4' N Ur1 •:'Y '3"''z; �' -' it s °� „ �.e . ' : : :; of I. and 2- family dwellings 4 or more new residential ( s , rq,,.. lei.,..,. �� {!� .... � . l�t,�: f+ l - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure [Buildin over three stories ['Feeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other: [) Oc cupant load over 99 persons ❑ Manufactured structures or • r�'•� ;;t•:, °� �' `i• ^ "��V= +7"^'F7 ,�,.ti.o.} <,n.• ;- ..��,..., ,:hs!.:,•:..+:a�ry =t•' d�= ..;4�" i;;.�.�':'x�: ` +��'�;:: 1W park t:,x't ''j. x t:.��) yf•!;<:•7.��T,QI� ?g,:4i :, +„'., :i 'it*4..:01,j :a ,P;,,tr".xT Fl `'1; 4::, ❑ 1 1 plan . ` ', Job no.: J Job site address: ; U I`g5 S is) L t I I V ` ... ❑lfealth -care facility ❑Other: Submit 2 sets of plans with any of the about. City /State/ZIP: -1-\ c (� -� e The above are not applicable to temporary construction service, v `• - F,h =w'� . -,i +� � x- , . �,..r • L0,i.r 4 x-t a ,tJS . •EFL - ,•, Suite/bldg. /apt no.: 1 Project name: ? ' "�* ^ ' u"; ' �+ ° , Sr;? ' . ✓1 � a1. 7 :Ta,� De"u•Iplbo Qty. trN, r Total - - I - Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes attached garage. . 1,000 sq. R. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft or portion 33A0 1 ' - Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 e:s L .. W M ,, r .„ a7" , tT �, M'' i ` '' o a t�"s ra• �t Ai* , 3 'r L ,a+i4M �r .. Each manufactured or modular / QOt t .- dvGelling,setvibo'ari 'feeder 90 2 Services or feeders Installation, alteration, and/or relocation 200 amps or less 80.30 2 re wane , n., ,r ) p r t�'`�� f t, %s' _'" "v ,, 201 amps to 400 amps 106.85 2 • + �'� g ,c• .,1 r .� s . raa i4.+�ra,;#.t•f �lu.t...m °. �. %. -_ 401 amps to 600 amps L60.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 am or volts 454,65 2 Reconnect only 66.85 2 City /State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less I 66.85 f 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 s Date: Branch circuits- new, alteration, or extension, per panel ,.rr Z ' '" n 7 v ?: Ari. -; :? . . hI •;15,S., t A. Pee for branch circuits with F „• ,�},� Ji'i Ct; :� �:w }'''•'•- n ° � , t ;i r `� ` , ` ,j' a < � a sr1 _ A:;a; ..A "'r:°,.: 1 ' . . , < -• : . , X41 , ? '� ' ' service or feeder fee, each 6.65 2 Business name: a branch `` o_. 1 a, VI B. Fee for branch circuits Contact name: _ without service or feeder fee. i r! each branch circuit 46.85 `f , 2 Address. Each add'l branch circuit C 6.65 t. 79 , 56 2 City /State/ZIP! Miscellaneous (service or feeder not Included) Phone: ( ) p ( ) - Pump or irrigation circle _ 53.40 2 S ign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- ?� H tt �� 'C: 7h i w �.� ;s r� '�;yr xLe�. , .t t: � ' �'''t''? " :PE ° energy panel, alteration, %�t ,u`�'ru�ev"�1:,%r .. • .r.5 -� A '"L?.sk�'�ltf�� ^''nh4�7r,'.. '• . ,f3,:. •;y >!': , ' ?Q`�ct:.4 ?;a, •t or 2 extension. Describe: ' Page 2 Bushiest Red's Electric Company - • Address 2002 SE Clinton _ Each additional inspection over allowable in any of the above Portland, OR 97202 Per inspection 62,50 City /Sta (503)233-8487 Fax (503)233 -1281 Investigation per hour (1 hr min) 6230 CCB# 4443 Elec. Lla# 28 -152C Supry Lic.# 5010 -S Industrial plant per hour _ 73,75 Phone, ( n Yu t' . 0. 0` t MEE i "r #rii'a CCB Ian - Subtotal g', ,x5 Supry . Electrician signature,required: '� Plan review (25% of permit fee) Print name- � -- Date: • State surcharge (8% of permit fee) , 94 • V (/)) / PJ'I is /,/ TOTAL PERMff 1FEE i a / 0 Authorized signature: This permit application expires itrt permit isnot obtained within :0 days after it tuna been accepted as complete Print name: Date: • ' Pee methodology set by Tri- County Building Industry Service Board - - " Number of inspections per permit allowed. ;4n.au,..,,n..... :,.,c, r v-...;,".....,..- 1,1111 .14o- 4615T110/02/COM/Wr1B CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 ® y RECEIVED IMPORTANT PERMIT NOTICE JAN 1 2 2006 JOE PETRO PLUMBING CITY OF TIGARD PO BOX 98 BUILDING DIVISION WILSONVILLE, OR 97070 -0098 Plumbing Signature Form Permit #: MST2005 -00343 Date Issued: 10/18/2005 Parcel: 2S114BB -07000 Site Address: 16185 SW 104TH AVE Subdivision: SWANSONS GLEN Block: Lot: 011 Jurisdiction: TIG Zoning: R -12 Remarks: Addition. 1/12/06, adding (1) lay. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: RENEE BARNES JOE PETRO PLUMBING 16185 SW 104TH AVE PO BOX 98 TIGARD, OR 97202 WILSONVILLE, OR 97070 -0098 Phone #: 503 - 620 -1005 Phone #: 503 - 625 -1986 Reg #: LIC 91524 PLM 3 -469PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X It — Sig of Authorized Plumber If you have any questions, please call 503.718.2433. p A-4441 k 10 CITY OF TIGARD '� 5 7 BUILDING DIVISION PERMIT #:4WOS - 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ^ , r , , Phone: (503) 639-4171 : ��� '4��vlli 5i' Cl - Inspection Requests (24 Hrs.): (503) 639 -4175 �..PI .4 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: l C / g l6 LI A- CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: f ' f/ OWNER: , PHONE #: CONTRACTOR: ° • PHONE #: Inspection Request Scheduled For: Date: 3 - a �.0 ` P Pour Time: Code # Inspection Description Confirm # Contact # Message -- D rivfrid (a a- -lads orrections Comments /Instr uctions: 8 0 _ -7 g F( / 6l ri: ie 6/ . ---- ? I? .". AY/2-41/4e, PASS i PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS 1 I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: L/ ' Date: 2 .6 6 Phone #: (503) 718- 27 47M CITY OF TIGARD /05-7 BUILDING DIVISION PERMIT �a�p QD3l�� 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 uamgm�i Alk, Inspection Requests (24 Hrs.): (503) 639 -4175 I1. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / Lei 8 /O1f /3" CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: C Q, PHONE #:5 3D 6v /' RS CONTRACTOR: O V\VL( PHONE #: Inspection Request Scheduled For: Date: 3 -24-0 p Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: itz PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i,, , Inspector: 1'/i Date: A ,- 6 one #: (503) 718- I CITY OF TIGARD BUILDING DIVISION PERMIT #: MS 2006-00343 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/181201)!; Phone: (503) 639 -4171 111011hl Inspection Requests (24 Hrs.): (503) 639 -4175 ....4._,W u' 1_— INSPECTION WORKSHEET FOR DATE: 1/4/2006 TIME: 6,59AM PAGE: 35 1 SITE ADDRESS: 16186 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN LOT #: 011 TYPE OF USE: PROJECT NAME: BARNES DESCRIPTION: Addition. OWNER: BARNES, RENEE PHONE #: 501620- 1005 CONTRACTOR: LAY'S CONSTRUCT1ON CO PHONE #: 50:3 23;3 4900 Inspection Request Scheduled For: Date: 1/4 /2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 121' Electrical rough -in 024343 -01 503 - 2316467 e N Corrections /Comments /Instructions: • IsJ v 1/4imwy) LLm3b , u/ 5. W Katfro A S P\ S (Atc,.v \ ' v °X ' �( � \ PASS I PARTIAL APPROVAL n CANCEL I I NO ACCESS � FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: !lL' ' -'�'' V ; Date: /`1 Phone #: (503) 718 -cZy4( CITY OF TIGARD i) S Y BUILDING DIVISION PERMIT 003 b 0 3 (I3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 ��' ° ��� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / / /6 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3- 15 667 Pour Time: Code # Inspection Description J Confirm # Contact # Message 21-f ' ' ( - lads Corre on Comments /Instructions: ' ASS SI PAR ^ PPROVAL ❑ CANCEL ❑ NO ACCESS II FAIL n 'BALL •R INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date (C 196 Phone #: (503) 718- CITY OF TIGARD rt/1Sr BUILDING DIVISION PERMIT #: „200 _ 'ad 34( 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection' Requests (24 Hrs.): (503) 639 -4175 „._: &W INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: gc l s 41 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: /— / 3 - Pour Time: Code # Inspection Description • Con rm # Contact # Message 5 310 3 3 3 3 2 6 l'''` ,6 �.* 2.; � �P � i c orrections /Commen`rs /Instructions: e-ov' L$ � � AKA. . �� ! .ems ���_ .1 .2&/(,/ittat__ ■•• oz-.•,.- ►:Al 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ' 0 Date: a Phone #: (503) 718- November 9, 2005 I was called by the job site framer on this date at 1:09 PM with a concern RE: the Post /Beam Structural inspection. It appears that the Construction Supervisor (Randy) has ordered the framers to deck the post /beam structural elements (consisting of Special Inspection) without COT inspection. The framer called me to see if I could do an inspection prior to them decking. This is the second (2 time an incident of this nature has happened at this site. The first, being that the footing was poured without inspection, which was "ordered" by Randy on 10- 28 -05. As a concern, I traveled to the 16185 SW 104 site address and again expressed the importance of following the guidelines for the required inspections and using the IVR system to call in the inspections) of request. I explained that, "if, the contractor isn't willing to work with us than the COT will not work with the contractor any further." If there is any covering or concealment of any kind or progression of work done without inspection or approval, then a STOP WORK ORDER shall be placed to cease the project of potential hazards or Code violations. As the Inspector, please note the above issues and be very careful of remarks stated by the site workers. Also, be very observant of what . is happening at this addition project and if you suspect any concealment or wrong- doing- shut it down. If there is a need to do this, inform either Hap or myself. Rick D to 4.44.A- i 5 0 1 CITY OF TIGARD .. .. . BUILDING DIVISION A PERMIT #: MST2005.-00313 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 10/18/2005 Phone: (503) 639-4171 j114,1110 II\ Inspection Requests (24 Hrs.): (503) 639-4175 Awl 11. INSPECTION WORKSHEET FOR DATE: 1/26/2006 TIME: 7:0:3AM PAGE: SO SITE ADDRESS: 15185 SW 104111 AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN LOT #: oil TYPE OF USE: PROJECT NAME: BARNES DESCRIPTION: Addition. 1112/06, adding (1) lay. ..---- OWNER: BARNES, RENEE .,/-- PHONE #: S03-620-1005 CONTRACTOR: LAYS CONSTRUCTION CO PHONE #. 51)733499 . Inspection Request Scheduled For: Date: 1/2E42006 Pour Time: Code # Inssection Description Confirm # Contact # Message 201) Insulation 02574a-01 603-347-3609 N Corrections/Cornments/Instructions: 0 d fe44--e - 7 6 'e-k- .Zif - ile) cileri 17Y /( tei&) RI 6O '2_ - 73 / PeW, , all' ithOte, lel PASS fl PARTIAL APPROVAL III CANCEL fl NO ACCESS FAIL fl CALL FOR INSPECTION 0 ADDITI NAL F ES ASSESSED 94 IN1 Inspector: t/ Date: 1 if / Phone #: (503) • CITY OF TIGARD r. BUILDING DIVISION PERMIT #: iv1;_;T005 0113 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10M/2006 Phone: (503) 639 -4171 ..A 11 �fl Inspection Requests (24 Hrs.): (503) 639 -4175 .'!+� `'l l .. INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7:03AM PAGE: a SITE ADDRESS: 16111.5 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN LOT #: 011 TYPE OF USE: PROJECT NAME: BARNES DESCRIPTION: Addition. 1/12/06, adding (1) lay. OWNER: BARNES, RENEE PHONE #: 503-620-1006 006 CONTRACTOR: LAY'S CONSTRUCTION GO PHONE #: 503 - 233.4969 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 025293 -01 503- 2502531 N Corrections /Comments /Instructions: C , (uJ —Ay — BA N\ f fo {- 1 kS ID nt; i f V 1 - PASS ❑ PARTIAL APPROVAL I ( CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Date: O Phone #: (503) 718 _45t,,.,,.____ CITY OF TIGARD • BUILDING DIVISION PERMIT #: PAST2006.003 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/ Phone: (503) 639 - 4171 ■ 40 ,- 0�ii���� il' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/18/2006 TIME: 7 :01AM PAGE: 1 SITE ADDRESS: 16186 SW 104TH AVE / CLASS OF WORK: SUBDIVISION: `SWAWSONS GLEN LOT #: 011 TYPE OF USE: ' PROJECT NAME: BARNES DESCRIPTION: Addition. 1/12/05, adding (1) ay. 9( ) l. OWNER: BARNES, RENEE PHONE #: !. CONTRACTOR: LAYS CONSTRUCTION CO PHONE #: 603-233-4989 Inspection Request Scheduled For: Date: 111 8/2005 Pour Time: Code '# Inspection Description Confirm # Contact # Message /_ _ , 0_ 276 Framing 025190 -01 • 603 - 2502531 t Corrections/Comments/Instructions: • clt f, ...t. I L['__i 4.Ad / / °' ''. Ce �/ cep/94o /&/ fh f7/ /�� . . 1�� 6 -c Jo . e,. /6 c-c/t_ /rn. �4.6(c. /Z txr ( pt oz - 6O ., .2) /?.,, o �/,, s.�� ce a -/-� P -- �% � o 4e.i ri -:ia L�)C � 1 .. ! Al 5) pe*oz/rde ar et..- /ad -,ti._ A,...,2A_, Z 0 I" _.,.., 6z,-, .. i . 0 -2 _ a-,::0 .o 76 --/-v J P - a : 6 6 . - - e 1 2 4 4 0 - 4 1.4.01-74 / eiu.v /d.0 �.z , c'J (‘a Z .6./ 3:2 1 c A-0A» t/ein 1 f_lett6i a ; (4 - g glY6 - / 0 / /?--' 'I de 5(4, -4..0-'1 /1'1 -C. itt 0 S .a c Z.,_ .L /Lc di, 71- 45-71. . ,z� ,.L_ C 6® PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS 4 FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED q�/ x 27©4 Inspector: / ,V� �° D ate: C / Phone #: (503) 718- CITY OF TIGARD _ N" IMS i BUILDING DIVISION •- 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED#: do - : Phone: (503) 639 -4171 � v�wlflh litii Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: I A's /O (p TIME: PAGE: SITE ADDRESS: i L 10' ' - Al-R, CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: ] PHONE #: i CONTRACTOR: 6„..„1 O PHONE #: Z s_o - Zs 3 1 Inspection Request Scheduled For: Date: Pour Time: Code # nspection Description Conf L 2 Contact # Message .. _ q G • "2`--t D Ex-4. ‹ G--,2 I . &QL-e • i % or -ctions/ r e - s/ ?;tr 'c ions: ' . - ,` -/ 1.O -1 Sim V -- Ple,W7 (./.0_11 , ._ 17 W (5 k , T2, dean-M 0(1, Ga(4 /,�7. d UP c)4. 5Ac.,I coa i /2t 4 r pi h-,groti,- a g.)„, s ,,z,A_A_.,,Z ,A,- -.,2, c 2 t - 1_, e f ___i gi, , v ,,, r 3) c. ke G4_ a4 e.fi 2-k ? 45oe fits 7- -r. JP,e- c -J e-on • /i PASS *PARTIAL APPROVAL fl CANCEL ❑ NO ACCESS ❑ FAIL 1 I CALL FOR INSPECTION 1 f ADDITIONAL FEES ASSESSED Inspector: - " Date: i 13 , et Phone #: (503) 718- Z166 CHI OF TIGARD 0 te ASi BUILDING DIVISION PERMIT #: 2 � d�j ° O ��y3 . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 ./ Inspection Requests (24 Hrs.): (503) 639 -4175 9 I S 0 tj INSPECTION WORKSHEET FOR DATE: l k /r h<; TIME: - PAGE: SITE ADDRESS: j (2 I' 6 6 L &) I ©y' ' : CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: {�c'� /� OWNER: `� Y 25 PHONE #: CONTRACTOR: ' A :..i S C N4-12 c M7\ PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 12'S cO � , / 6 ( rrii1 juv2 L Correcti ns /Comments /Instructions: ) IA/ ttY) 5 - , cLiz_ ,i_i,..\-s • p _e___,..J--- 4 L / ( l 5 4.....,, s ,L - ‘ 7 .c.t)L...) ,_ ve,,,, i X+'•) i`^ CO l IBC. ` __,( C�'� \ SQa c-2 .) 1 <:__ U) CC- 6 ` . P b 4-e. ' Le s s ` c..____ t ' (0,-- k_st_a-g_.-(2,-_, . 6 - vyv cSLic-4.--Q ( 042- ) 6 U-k-1,,A_ C `‘ . L P.--ct- S, •,2_,P,-N2..-e___-- ( m-<____ c v\S ---e--vt-,\-- (^- 5 Q ,e__. ?cr'S--e_Ss . t i t . . . .i e --b v? — c .. .. 1:.,. , Lzc . 3—,(-e___ . '2.e. c ,, . kl■) : n PASS X PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \4, kk )ate Inspector: Date: Phone #: (503) 718- - i CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S -00343 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10l1B/2005 Phone: (503) 639 -4171 At ��ii� ii4 Inspection Requests (24 Hrs.): (503) 639 -4175 .-_ -_, / / 7 INSPECTION WORKSHEET FOR DATE: 11/2!2005 TIME: 7:04AM PAGE: 65 SITE ADDRESS: 16185 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN LOT #: 011 TYPE OF USE: PROJECT NAME: BARNES DESCRIPTION: Addition. OWNER: BARNES, RENEE PHONE #: 503- 620 -1005 CONTRACTOR: LAYS CONSTRUCTION CO PHONE #: 503- 233 -4989 Inspection Request Scheduled For: Date: 11/2/2005 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 020097 -01 503.250 -2531 N Corre tions /Comments /Instructions: 1 - 2-titill/vi 5r-e_,:. CAJL_ .T--t■- V62_ \ O• , ( . 2.5s -- & - Z) -4,(5+t-'A I -rte ° w 6 k-A r ,2--. -�- _c-- '0 z dg) \JO-Ar ..- 7Liki \r(2_,\,,,,ALc 6,, # , $ LI/ c_q_e_i, - ---k -e,,, 5 / g- L,k,,. rc.J .e1,5c 2-‹se.3 . z...t.,,A----2... \t-- v.v.3 0 k oviLicce-A-p L . l‘li 0 U t'4L1 .(' (2.5� `1 , • .,,,u, c4-- V L `-e_ r.r--3.-4__.,..Th e 6) 1 ( jIgt/_z_e17./0__(LJ 2e, u(\ l.1' () a tO v1/\ `e,L4 A \A-7 (,&_)( \r(f2_62‘ ,..r y.:L.,,,,...c__ . , a 'Q/ i'ci-e—`UL. 14_35 • ` _ /___ rS' ! 111, .-04 �� ? 1 � V 1 • , \ T `/ s�— ili • • cAr , -wk c,,,.. 1-1A c A--�. , ti Li 1,01-60A ❑ PASS Igt PARTIAL APPROVAL n CANCEL NO ACCE i °• FAIL % ❑ CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Ins e ctor: c I/LV' Date: `/ 718- Date. Phone #: 503 p � ) 718 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S-00343 13125 SW Hall Blvd., Tigard, OR 97223 d____________. DATE ISSUED: 10/18/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 Jah91111\ �f Cr- INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 4:11PM PAGE: 81 SITE ADDRESS: 16185 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN LOT #: 011 TYPE OF USE: PROJECT NAME: BARNES DESCRIPTION: Addition. OWNER: BARNES, RENEE PHONE #: 503. 620.1005 CONTRACTOR: LAY'S CONSTRUCTION CO PHONE #: 503-233-4989 Inspection Request Scheduled For: Date: 10/28/2005 Pour Time 1:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 019441 -01 503 - 307 -0781 N Correc ions /Comments /Instructions: `l • 4aptF SLY I PASS ❑ PARTIAL APPROVAL El CANCEL [l NO ACCESS FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASS SSED Inspector: Date: 10/ D - Phone #: (503) 718-