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Permit 4 i ' CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00390 Alai SERVICES DATE ISSUED: 12/6/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S115AD 00600 SITE ADDRESS: 16740 SW 108TH AVE ZONING: R - 4.5 SUBDIVISION: WILLOW BROOK FARM LOT: 030 JURISDICTION: TIG Project Description: 816 sq foot garage attached to residence with breezeway. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ACS HEIGHT: FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 12 SECOND: sf GARAGE: 616 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: TURD: sf RIGHT: 5 VALUE: 20,155.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 2 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 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: 1 0 - 200 amp: W /SVC OR FDR: 2 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVOFDR: 0 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 0 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 MARTA MAY BLACK DIAMOND CONSTRUCTION 0 and all other applicable laws. All work will be done in 16740 SW 1058TH AVE. 16280 SE TIMBERDARK LN accordance with approved plans. This permit will expire TIGARD, OR 97223 OREGON CITY, OR 97045 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- 350 -2700 Contact #: FAX 503 -631 -4428 adopted by the Oregon Utility Notification Center. Those PRI 503- 793 -1564 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: LIC 113538 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 710.93 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : __ % _ __ Permittee Signature : P IKI 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. • 115r - °6o3 0 Building Permit Application FOR OFFICI: USE ONLY: City of Tigard Received �n permit No. g RECEIVED � � � (� �� Date /By: II/ 3/01 QJ (9069,j 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 t / ,,,, i ; Ai li' + Date/By. ( v1A V / / /'J Other Permit: Inspection Line: 503.639.4175 NOV 2� c_ u' Date Ready/By: L 1m " � , ' t ® See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: 4 �7 Supplemental Information �(O� (:ITV CIF TI(;ARf) c -: - . btu / U Ta!1W9R1VISION R IR DATA: 1- AND 2- FAMILY DWELLING New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El I- and 2- family dwelling El Commercial /industrial Valuation: $ ZO t i' ° O El Accessory building El Multi-family Number of bedrooms: El Master builder CI Other: Number of bathrooms: . JOB SITE INFORMATION AND LOCATION Total number of floors: • Job site address: 1( 4D St,....1 \Di T )4,.:'�. New dwelling area: • square feet City /State /ZIP: 't t&AQ.y .D a¢ . Garage /carport area: alt ., square feet Suite/bldg. /apt. no.: Project name: H Covered porch area: square feet Cross street /directions to job site: IDLIR 4/4 t l 230 I. paU4 AA,* Deck area: square feet mk- P-& Rr 12-01.-L.oa,,., (U&tit to , (0" -40. . Other structure area: square feet 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- work indicated on this application. Valuation: $ CIA-I ¢£ Existing building area: square feet New building area: square feet fti' PROPERTY OWNER ❑ TENANT Number of stories: Name: A- M,A.1 . Type of construction: Address: \ (, -1 - ' .-ki4 icePt h V Occupancy groups: City /State /ZIP: rycrit-o e2- Existing: Phone: 03),350 Z. 7 oe) Fax: ( ) New: AR • ❑ CONTACT PERSON NOTICE Betsities ame:.3 t t4)(A -aD �o*. Go. All contractors and subcontractors are required to be Contact name: 41... �� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 1 102 . _.;,(.. ,* . L.1....), jurisdiction in which work is being performed. If the City /State /ZIP: n .. _� .9-1 applicant is exempt from licensing, the following reasons apply: Phone: ( • /� / 7 (C;(73) 0 Fax: ( E -mail: CONTRACTOR Business name:TL `0 t AwCoND C....t.1 s C--o . BUILDING PERMIT FEES* Address: \ 402 S- 11 f _ L Please refer to fee schedule. City /State /ZIP: rttaec ext_ g Fees due upon application Phone: ( D3 19 , < c L i- Fax: ( ) / Amount received • CCB lie.: � t -� g 7 I 0 Date received: Authorized signature: This m 8 i a permit is not obtained within per 180 it days applica after on it expires has been if accepted as complete. Print name: atj5 -rta H. N fit. Date: \ l l o 5 (2dD4 * Fee methodology set by Tri- County Building Industry Service Board. i \ Building \ Permits \BUP- PemiitApp.doc 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 g Daze /By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 - �� " * ❑Electrical ❑ Plumbing ❑ Mechanical • ' 24- Hour Inspection Line: 503.639.4175 y, 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 Ve 'fication of approved plat/lot. ❑ ❑ ❑ 4 Fire • istrict approval required. Name of district: • ❑ ❑ ❑ 5 Septic • stem permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer pe it. ❑ ❑ ❑ 7 Water dist ' t approval. ❑ ❑ ❑ 8 Soils report. lust carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control • plan ❑ permit required. Include drainage -way protection, silt fence desi u and location of catch- ❑ ❑ ❑ basin protection, et 10 3 Complete sets o • gible plans. Must be drawn to scale, showing conformance to appf able local and state ❑ ❑ ❑ building codes. Lateral . -sign details and connections must be incorporated into the plan or on a separate full -size sheet attached to the plans •th cross references between plan location and details. Pla review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. 'e plan must show lot and building setback dimen• oris; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation .' ' erential, plan must show contour lines at 2- intervals); location of easements and driveway; footprint of structure (in. uding decks); location of wells /septic s tems; utility locations; direction indicator; lot area; building coverage area, sercentage of coverage; imperviou area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bo , any hold -downs and r: nforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identificatio , window size, .cation of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies an. 'ecks 30 ches above grade, etc. 14 Cross section(s) and details. Show all framing- member size .no pacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross '- ction may be required to clearly portray construction. Show details of all wall and roof sheathing, roof g, r. •f slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulaf on, etc. 15 Elevation views. Provide elevations for new construction- inimum of two elevations for additions and remodels. ❑ ❑• ❑ Exterior elevations must reflect the actual grade if the c . ge in grade is great- than four foot at building envelope. Full -size sheet addendums showing foundation' elevati s s with cross references ar: .cceptable. 16 Wall bracing (prescriptive path) and /or lateral a • . lysis plans. Must indicate detat . and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications • , ■ calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floor: roof assemblies, indicating member sizing, s.: ing, and bearing ❑ ❑ , ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide c'.ss sections and details showing placement of rebar. For en: • -red ❑; -- ❑ ❑ systems, see item 22, "Engineer's calcul tons." 19 Beam calculations. Provide two sets fcalculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam /j_ st 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 Ore•on and shall be shown to be applicable to the .ro'ect 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 redlines 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 11/22/2005 TUE 11:03 FAX 503 557 1059 Parkin Electric -• -- • City of Tigard /1001 /002 • Electrical Perm Application FOR OFFICE USE ONLY �jEVV r City of Tigard o�` Received Permit No. 13125 SW Hall Blvd., Tigard, OR 9722 -- Plan Review MST3Gn T - air 3 9D ^ , 7n T Pn Re Phone: 503.639.4I71 Fax: 503.598.1960 n: J: p'� I c\ DatrlBy: Other Permit: Inspection Line: 503.639.4175 10V 2 2005 Date Ready/By: _Tunis: Ei See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental information • ;Myti•7,M?.' " *Q t r' `�'' '• 3 �• - +t-: i ^a �.-�- .c.W,,:f'". �'� , itV ,.1. ,tr-W I .P' r ; } •t'Z'V e+; : #.,ct,e q .ua - wr s, 4;. • -- r -f -naa, ? �, , t - 1 3 .� .fn t :1 r �, ;w- TL_ L n t e ._ 4 t: . ��.izs�• • �. �'�' 5 - m,.- ?yF^e.fi� ?� ��.. f fi m. '� -3x. y �'�, -- ��,4� .� -( cy.V J 'y� @ ro<:9:.4,_.�9:d; ..: - 0 New construction 15 t& Jditicdn/ eration/replacement Please check all that apply: ❑ Demolition ❑Other ❑Service over 225 amps, comrn'l ['Hazardous location tr r , sm cf �, - , i rte � 2 ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., 7WA _ 7 . _ j „„ „.__� : f T t _ .9 .kig` j_ 00e4 IV. I ra : of 1- and 2-farra dwellings 4 or more new residential L"! 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ' ❑ Multi fatally ❑ Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more r�i , r � � F F ,3 c a n w tfs _ ['Occupant load over 99 persons DManufactured structures or 1i- !: e "' ,,, t kj i 4 ak , .1.i't , t ` ^`(`5,:;tR 7,s r1' ❑Egress/lighting Plan RV. park Job no.: ` (493103 Job site address: 1 (A' 0 i/v I ViDE 1 1 i �_, n ❑Health -care facility ❑Other: T1/'C� Submit 2 sets of plans with any of the above. City/StateJZIP: c\---41 _l p , / //tr/t The above are not applicable to temporary construction service. • c.e /V /• -'I � G •' G l - o- )Y), -�"'Yi"n.''.}.`� -7" s'd` :: ?i ?.?:.W.. /' t.(iI � �7.;ador BJIr�;�- r. - .,i,i - -.. ect name: —. --- �- ��_ ---� • -• -�=., - . ^. Suite/bldg. /apt. no.: Project Description Qty. Fee. Total • Cross street/directions to job site: 7 . $ l am a u't CL . 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 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy', non - residential 75.00 • 2 'r' R =� s : i <F . . c I ,Q is 4, " A t�� 4 . ; : iil'i'� l ,74 �'` � ; rw ct if ,'k.1.; &.4. :k:., ._..' ,._ :1....._ 1 1'.T_.,r i_...z._. r . ", , i:. _..o.s ,,:ML"_. Each manufactured or modular r.Z' t S L ! 9 dwelling, service and/or feeder 90.90 2 ww Services or feeders installation, alteration, and/or relocation 200 amps or less / 80.30 gO. 50 2 4i � " 9 j ti t 7 4 ` 's '` ' rtk , �e e ,� v,si 7' " F 201 amps to 400 amps 106.85 2 "4 1 . 4 .: ,a; 1 r'. � 4 { S t' L y R ' �_...z k'W'''I leg,+ 1 1G4C.; 1 ' -' �.s, 4 ^` � , o 401 amps to 600 amps 160.60 Z Name: M (,1/4'Yi} c. 4 601 amps to 1,000 amps 240.60 2 Address: I Over 1,000 amps or volts 454.65 2 Reconnect only • 66.85 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or Phone: (95 ) . IA yt,( - 1 Fax: ( ) relocation t 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 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 ; y;3.. , i -.17— 5 �f••',RfP n -c :. 'a .4'. -, ., a1�." U, Y ck S ? < ,�- Y .1-1 :s• 4 "7 i�� S: 1 ... ;3^31- . ... .: t a Y e y46 . 4 °2 4� t'�=l- h� r A. Fee ice or circuits each -'". "" . " `.' - "'- ". "".` " 1,- y ` " : c '"'"� " - ` service or feeder fee, each Business name: branch circuit 6.65 2 Contact name: B. Fee for branch circuits • without service or feeder fee, - .. 46.85 > 2 Address: each branch c ircuit • • • • • - —• Each add'l branch circuit A 6.65 /3. 50 ; City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax : : ( ) Pump or irrigation circle 53.40 2 E-mail: Sign or outline lighting 53.40 2 Signal circuit(s) or limited - 7 t 7.sa '_ r :._,.N. -,4:tall . ., :: ,• i , _ ?•I: a Rx,.� a. � . energy panel, alteration, or Farfcul .t✓lecttlC;Znc. 1 -.. t - extension. Describe: Page 2 2 Oregon City, OR 97045 503 - 657 -4958 fax: 557 -1059 - Contractors License #: 34-4C exp. 07 -01 -06 Each additional inspection over allowable in any of the above Supervisor: 4241 -S exp. 07 -01 -06 Per inspection 62.50 Contractors Board Reg #: 35151 exp. 10 -12 -08 Investigation per hour (1 hr min) 62.50 Metro # 2416 exp 11 -01 -05 industrial plant per hour 73.75 Owner: ri, ;, 4' l;L - >= Subtotal 9 5 Z. 6,e Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) 1• T ? ag/ TOTAL PERMIT FEE /el. Q Authorized signature: This permit application expires if a permit is nut obtained within a. /� days after it has been accepted as complete Print name: ©gciD ,B./ Date: • Fee methodology set by Tri -County Building Industry Service Board ** Number of inspections per permit allowed. is\ Building \Petmits\BLC-PermitApp.doc 12103 440 46irr(10 /02/COM/wE8 Building Fixtures ,. Plumbing Permit Application FOR `OFFICE USE ONLY City of Tigard Received Permit N 13125 SW Hall Blvd., Tigard, OR 97223 y o.' ST J�� 400)16 Plan Review / /..y Phone: 503.639.4171 Fax: 503.598.1960 h:ry)NGI , w{t Date/By. Other Permit No.: Plan R 24 Hour Inspection Line: 503.639.4175 °• I Date Ready/By: ions: RI See Page 2 for Internet: www.ci.tigard.or.us 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: ' -• ;.1 New 1 swellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 2 - 1 1- an - - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 building SFR (3) bath 399.00 ❑ Accessory g ❑ Multi- family ❑ 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: 1 go SW 1 b 0 %I Catch basin or area drain 16.60 City /State /ZIP: `ti( D/L Drywell, leach line, or trench drain 16.60 . Suite/bldg. /apt. no.: f Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street /directions to job site: Manholes 16.60 ®ePi. L Uwe (2f1r ell do Rain drain connector A. 16.60 33 - ,2 0 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.1I C ) Page 2 5 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 (J n DESCRIPTION OF WORK ° Backflow preventer Page 2 Chia Di444.4s Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER 0 TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State/ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 '❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone:( ) Fax::( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: B14(44 PI 4 tO --. i Q Cb....)Cr. Co Water heater 16.60 Address: 62te,0 c. - riM6egAvi L (4 Other: AD City /State /ZIP: Ivi*3. Ctrfl,, pi,` Subtotal 71c. t Minimum permit fee: $72.50 Phone: (S/)3 ) Q31, 4.4. ( •=f- Fax: (9 *IA if. /,8 Residential backflow minimum permit fee: $36.25 CCB Lic.: t 1 Plumbing Lic. no.: Plan review (25% of permit fee) , � State surcharge (8% of permit fee) 7 06 Authorized signature: l _ - ( l/`. / I TOTAL PERMIT FEE Print name: r DPr 12 k�� Date: ttr Zj• 0 4 5 .-- This permit application expires if a permit is not obtained within / 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. ilBui !ding \Pennits\PLMF- PermitApp doe 06/05 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard ' Page 2 - Supplemental Information Fee`'Scli$if'u �� ' Residential Fire Suppression Systems: Site U tilities -- - 90.-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 - lit 100' 55.00 7,201 and greater $309.00 Sewer - each : dditional 100' 46.40 Water Service - st 100' / 55.00 S"s Medical Gas Sys ems: Water Service - h 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 - - h additional 100' 46.40 $5,001.00 to $10,000. t 0 $72.50 for the first $5,000.00 and $1.52 for each Fixture o r I tem' ' • , ' Qty. . Fee,(ea) Total additional $100.00 or fraction thereol to and including $10,000.00. Commercial Back Flow Prey- • tion Device 46.40 $10,001.00 to $2 ,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Back flow Prevention Device each additional $100.00 or fraction thereof to (minimum permit fee $36.25) 27.55 jj. • K :and including $25,00O0D, Rain Drain, single family dwelling 65.25 $25,001.00 tr $'5d;000.00 •`$379:50 for the first $25;000.00 and $1.45 for Inspection of existing plumbing or '� = each adtitional $ t00 (i(Mfili tion thereof, to and including X50,000.00. specially requested inspections - per hour 72.50 $50,001 0 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: f. each additional $100.00 or fraction thereof. • t .�' r Fixture Work: • Plan Revi for Comple S • - Are you capping, adding or replacing fixtures? If"' •s", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria accurately report fixtures could result in increased sew • • es *. Please check all that apply. rx Quantity by (Fixture) Work Perfo ed • El Any new commercial building. %•.01-•!! ":t., q tir - .i Fixture Type:, eplace ❑ Any new exterior plumbing site utilities. . Previous Capped, Added Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower Medical gas and vacuum systems for health care facilities - Jacuzzi/Whirlpool roviding services to human beings. Car Wash - Each Stall ❑ P robing installations, alterations or additions to food service - Drive Thru facil 'es where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator / are bein_ installed for the food service area. Dishwasher - Commercial / ❑ Any new r- •dential building containing three (3) or more - Domestic / dwelling units. Drinking Fountain ❑ Any NFPA 13 -D ltipurpose fire sprinkler system. Eye Wash / / Floor Drain /sink i/ 2" Submit 2 sets of p is with any of the above. 4 ,> Car Wash Drains' ` Isometric or Riser . . ' ram-r• Garbage - Domestic / ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall . . .. . . _ • Sink - Bar/Lavatory a , '' 1 - i ' • it: ' `., ? ' - Bradley :A , . • ;%C.1%.4 I - °' :. :n - Commercial - Service ,Ca •t.. ; .`•! , - ,' Swimming Pool Filter ` - - ',:t.\ s; , �• ; Washer - Clothes *Note: If the fixture work under this permitiresults in an Water Extractor (Water Closet - Toilet increase of sewer EDUs, a sewer permit will be is s ued and • 'Urinal ,fees assessed for the sewer in m ust be paid before the Other Fixtures: ^t plumbing permit can be issued) i i:\ Building \Permits\PLM- PermitApp•doc 07/06/05 CleanWater Services Our commitment is clear. DEC 0 6 2005 November 22, 2005 CITY OF TIGARD BUILDING DIVISION Melinda Smith Development Services Review 13131 SE 125 Ave. Clackamas, OR 97015 RE: Garage addition located at 16740 SW 108 Ave., Tigard, OR CWS file 05- 004857 (Tax map 2S115AD Tax lot 00600) Clean Water Services has received your Sensitive Area Certification for the above referenced site. District staff has reviewed the submitted materials including site conditions and the description of your project. Staff concurs that the above referenced project will not significartly impact the existing Sensitive Areas found near the site. In light of this result, this document will serve as your Service Provider letter as required by Resolution and Order 049, Section 3.02.1. All required permits and approvals must be obtained aid completed under applicable local, state, and federal law. This letter does NOT eliminate the need to protect Sensitive Areas if they are subsequently identified on your site. If you have any questions, please feel free to call me at(503) 681 -3605. Sincerely, Chuck Buckallew Environmental Plan Review 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 Phone: (503) 681 -3600 • Fax: (503) 681 -3603 • www.CleanWaterServices.org CITY OF TIGARD , / A iv.. s > BUILDING DIVISION PERMIT #: r6 r ` Q 639 c 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 44, yl� (���I1 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: .1 T L 0 ` b t CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: --. )c3 _ ‘,S ( y Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: . PASS I I PARTIAL APPROVAL I I CANCEL I I NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: - Phone #: (503) 718- CITY OF T'IGD BUILDING DIVISION PERMIT #: ms-1-2005„ r�t�i30 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/6/200.5 Phone: (503) 639- 4171�� �l�i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 2/1612006 TIME: 7:07AM PAGE: 60 SITE ADDRESS: 16740 SW 108 - 11~1 AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MAR TA PHONE #: € 03.360 2 00 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CC) PHONE #: 603-793-156'4 ;t'4 Inspection Request Scheduled For: Date: 2/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 026997-01 EiO3 -6E7 -4950 N Corrections /Comments /Instructions: cis4,66 .. tk LC 7._ 0®6 0®I 1 2%. (14 F i ( 32dos 1) uOtkaLt es Pv-vh41 Ft& > v) (i 7 C C gl,.... 2. oo,5 - GO Vc4 \ S - II -- = 1 1•PA) . 'to citii-e 53.cze t/.1', Ka) fl L:0\\V i t 6\ R N I I PASS 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL "�! ALL FOR I. ' - _ • ❑ ADDITIONAL FEES ASSESSED n �nI Inspector: , _!/',,,c - -- Li..,, _ Date: ,L 1 l74 Phone #: (503) 718- 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006- 003;10 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/a;;J2006 Phone: (503) 639 -4171 Inspection, Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR • DATE: 7/7/3()()6 TIME: 7 PAGE: 67 SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: ()3Q TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: G03.360.2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: :03793.1564 Inspection Request Scheduled For: Date: 2/77210 Pour Time: Code # Inspection Description Confirm # Contact # Message 420 " %NA :w.9 � . 026371 -01 503 'r %O5 uN bun, € Corrections/Comments/Instructions: • VI PASS f I PARTIAL APPROVAL • IP1 CANCEL I I NO ACCESS FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 1k) Date: 11 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: iVIST2006-00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12161200h Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 A-A,411 INSPECTION WORKSHEET FOR DATE: 2/1/2006 TIME: 7:02AM PAGE: t>u SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: 5n3642700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503-793-1564 Inspection Request Scheduled For: Date: 21112006 Pour Time: Code # Inspection Description Confirm # Contact # 120 Electrical rough-in 026099-01 503-657-4958 Y Corrections/Comments/Instructions: &7 T'75LI S7 / //' 1 -1131 m KJ4-y' • • j PASS 1--1 A' AL APPROVAL fl CANCEL n NO ACCESS 1 FAIL ALL FOR INSPECTION H ADDITIONAL FEES ASSESSED 1° Inspector: Date: Phone #: (503) 718- — – "CITY OF TIGARD BUILDING DIVISION PERMIT #: tvis2005.00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/200b Phone: (503) 639-4171 --dhlwil. Inspection Requests (24 Hrs.): (503) 639-4175 AA 'Al. INSPECTION WORKSHEET FOR DATE: 1/31/2006 TIME: 7:01AM PAGE: 54 SITE ADDRESS: 16740 SW 1017111:1 AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: 503-350.2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503-793-1564 Inspection Request Scheduled For: Date: 1/31/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 026011-01 503-657-4958 V Corrections/Comments/Instructions: C.,0\.r cr 1 I PASS Ei PARTIAL APPROVAL E CANCEL 0 NO ACCESS N AIL E CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: C7iNak\--- N Date: lc -b nib Phone #: (503) 718-2NAL • 7 CITY OF TIGARD BUILDING DIVISION PERMIT #: MS #2006.00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7:03AMMf PAGE: lx' I4i4 SITE ADDRESS: 16740 SW103TH AVE CLASS OF WORK: SUBDIVISION: WILL OW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 6'16 sq foot garage attached to residence with breezeway. OWNER: MAY, Iv€ARTA PHONE #: 503- 350.2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503.793 -1 664 Inspection Request Scheduled For: Date: 1/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 025272 -01 503.657 -4959 N 12 p (� o v t Q IA p lA6N t- Corrections /Comments /Instructions: IL49 6 q6 \"):.r P4ac.A" c Nil w (-03 - 94998 3e1 • N1 Cz Ct.NN i.-\(k'\ cf 3( I tflb 01 A SS n PARTIAL APPROVAL ❑ CANCEL 11 NO ACCESS a FAIL ❑ !ALL FOR INSP TION ❑ ADDITIONAL FEES ASSESSED Inspector: % f Date: I' 6 7 6 Phone #: (503) 718- ?i e' ' CITY OF TIGAFD , ( ( d �` AN S i BUILDING DIVISION b PERMI # c d 63 S d 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 odiir+�NOu�iglkl ��I� Inspection Requests (24 Hrs.): (503) 639 -4175 `'__.. 1 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: , , "] L 0 ■ t' CLASS OF WORK: , SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: -- 63 k S j ki 1 Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: :�� Date:ti Phone #: (503) 718- . 4 • CITY OF TIGARD `'- 2eaS- ve39•0 BUILDING DIVISION 62 A PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171�� dip Inspection Requests (24 Hrs.): (503) 639 -4175 _ ' l l .. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: I (0 L k 6 0 p CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: _ CONTRACTOR: PHONE #: ') �' `� r 1 J y Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message C Cv —1 — . s-e) Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - Date: Y - 3/ ---- ° =7 Phone #: 503 p � ) 718 - ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MsT ftt)5 r 03 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i17}6/2l0 Phone: (503) 639 -4171 ass A u ,� 1 Inspection Requests (24 Hrs.): (503) 639 -4175 1L INSPECTION WORKSHEET FOR DATE: 1/24/2006 TIME: 6:58AM PAGE: 51 SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WLLOW BROOK FARM LOT #: Q3O TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: 503 -360 -2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503 - 793 -15CA Inspection Request Scheduled For: Date: 1/24/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 02568401 503-793-1564 N Corrections /Comments /Instructions: Aar W • n PASS ❑ ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION I _ ADDITIONAL FEES ASSESSED IN, A Inspector: ; Date: L ! L' Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: IMST2005•00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121E12005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/18/2006 TIME: 7:01Aivl PAGE: SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY MARTA PHONE #: 603.350•2100 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503-M3-154 Inspection Request Scheduled For: Date: 1/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 236 Shear wallstanchors 026095-02 503-793-164 Corrections/Comments/Instructions: AA /IV 411,11. 11W IV I I I PASS ARTIAL APPROVAL pi CANCEL fl NO ACCESS FAIL I I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: ilk Date: ( 0 (,/, - Phone #: (503) 718- r CITY OF TIGARD 1 BUILDING DIVISION PERMIT #: MST2006- 00390 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/60006 Phone: (503) 639-4171 .Ab .,110 Inspection Requests (24 Hrs.): (503) 639-4175 J Jalr AJ... INSPECTION WORKSHEET FOR DATE: 1/18/2006 TIME: 7:01AM PAGE: 94 SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway, OWNER: MAY, MARTA PHONE #: 603-30-2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 603-793-1664 Inspection Request Scheduled For: Date: 1/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 026096-01 603-793-1664 N Corrections/Comments/Instructions: it AVIV _____Aiw 1 - H r Aal."Iir r Il■ Nila VLAII■ lib VW •\--r ...., 1.-- PASS PARTIAL APPROVAL D CANCEL 0 NO ACCESS n FAIL C LL F. - INSPECTION El ADDITIONAL FEES ASSESSED - i Inspector: OP/ 1 Date: [ Dat Phone #: (503) 718- ——„e CITY OF TIGARD BUILDING DIVISION #: MST2006 -00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2005 Phone: (503) 639 -4171 *11 u10 Inspection Requests (24 Hrs.): (503) 639 -4175 J 'I I.. INSPECTION WORKSHEET FOR DATE: 12/15/2006 TIME: 7:04AM PAGE: 39 SITE ADDRESS: 16740 SW 100TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: 503 - 350 -2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503-793-1564 Inspection Request Scheduled For: / Date: 12/16/2005 Pour Time: 11 :00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls ,I 02353E -02 503-793-1564 N Corrections /Comments/ Instructions: c ► A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ':r U� Dater 14 0 !) Phone #: (503) 718- L! v CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/512006 Phone: (503) 639 -4171 / emus �16H i j��� Inspection Requests (24 Hrs.): (503) 639 -4175 �� ' INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 1:04AM PAGE: 40 SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: 503 - 350 -2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503-793-1564 Inspection Request Scheduled For: , Date: 12/15/2005 Pour Time: 11:00 Code # Inspection Description Confirm # Contact # Message • 205 Footing V 023538 -01 503 - 793 -1564 N Corrections /Comments/ Instructions: N i l PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED � I 1 Inspector:` ��,L Date:Date:' �'" i j Phone #: (503) 718 - i CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S -00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2005 Phone: (503) 639 -4171 : "�� A 1 @i�� ) Inspection Requests (24 Hrs.): (503) 639 -4175 �� _ LL :_.. INSPECTION WORKSHEET FOR DATE: 12114/2005 TIME: 7 :01AM PAGE: 32 SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeway. OWNER: MAY, MARTA PHONE #: 503-350-2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503 - 793 -1564 Inspection Request Scheduled For: Date: 12/14/2005 Pour Time: 2 :00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 023464 -01 503- 7931564 Y 26 S v - . c S- Corrections /Comments /Instructions: 69 `Ul- - , r,7 , -- ( • • • PASS -- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL JCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ( Date: / ___.. /4-• z',1 Phone #: (503) 718- CITY OF TIGARD A . BUILDING DIVISION PERMIT #: MST2005-00390 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/200f, Phone: (503) 639-4171 akoppiVii Inspection Requests (24 Hrs.): (503) 639-4175 s ag INSPECTION WORKSHEET FOR DATE: 2/7/2006 TIME: 7:02AM PAGE: 60 SITE ADDRESS: 16740 SW 108T1-1 AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 3f TYPE OF USE: PROJECT NAME: MAY DESCRIPTION: 016 sq foot garage attached to residence with breezeww. OWNER: MAY, MARTA PHONE #: 503-350-2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503-793-1564 Inspection Request Scheduled For: Date: 2/712006 Pour Time: Code # Inssection Description Confirm # Contact # Message 336 Rai t: ain 026343-01 503-793-1564 Corrections/Comments/Instructions: • PASS PARTIAL APPROVAL 7 CANCEL 7 NO ACCESS • FAIL 7 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: '1 LE Date: / 66 Phone #: (503) 718- -2_4 Ivo CITY OF TIGARD BUILDING DIVISION PERMIT #: MS 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6I2(fl) Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 211/2006 TIME: 7:02Ai Vi PAGE: 33 SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 03() TYPE OF USE: • PROJECT NAME: MAY DESCRIPTION: 816 sq foot garage attached to residence with breezeww. OWNER: MAY, MARTA PHONE #: 60:3-3%2700 CONTRACTOR: BLACK DIAMOND CONSTRUCTION CO PHONE #: 503493.1564 Inspection Request Scheduled For: Date: 2/1/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 336 Rain drain 026096-01 603-793-1564 Corrections /Comments/ Instructions: f\1 er I I PASS P TIAL APPROVAL CANCEL NO ACCESS FAIL 7 IN ALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED 2. ro Inspector: . Date: • Phone #: (503) 718- Case Activity Listing 12/1/8AM �' g 11:05:38AM TIDEMARK Case #: MST2005 -00390 COMPUTER SYSTEMS, INC. Assigned Done Updated Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes MST1010 Application received 11/3/2005 None RECD BB 11/22/2005 DEB MST1020 Permit created 11/22/2005 None DONE DEB 11/22/2005 To replace BUP2005 -00591 DEB MST1030 Check for parcel 11/3/2005 None DONE BB 11/22/2005 Customer informed that CWS tags/CWS DEB provider letter required. MST1060 Building plans routed 11/3/2005 None DONE BB 11/22/2005 to PE DEB MST1065 Begin plan review 11/15/2005 None DONE MAV 11/22/2005 DEB MST1070 Revisions/Info 11/15/2005 None DONE MAV 11/22/2005 requested DEB MST1100 Building plans 11/28/2005 None APRV MAV 11/28/2005 approved by PE MAV MST1110 Approved plans 11/28/2005 None DONE MAV 11/28/2005 routed to PT MAV MST1810 Ersn Cntrl 681 -4444 None 11/28/2005 MAV MST1240 Post - review 11/28/2005 None DONE DEB 11/28/2005 completed DEB 1 MST1250 ELC signature on 11/28/2005 None DONE DEB 11/28/2005 application DEB Page 1 of 2 CaseActivity..rpt Case Activity Listin g 12/1/2005 11:05:38AM 8AM TIDEMARK Case #: MST2005 -00390 COMPUTER SYSTEMS, INC. Assigned Done Updated Activity Description Date l Date 2 Date 3 Hold Disp To By By Notes MST1260 PLM signature on 11/28/2005 None DONE DEB 11/28/2005 application DEB MST1270 Ready to issue permit 11/28/2005 None REDY DEB 11/28 /2005 Need CWS service provider letter. DEB Page 2 of 2 CaseActivity..rpt