Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
V 1 / � ' e�I J3/oi CITY OF T I G A R D MASTER PERMIT PERMIT #: �,,, ,-.110 -00467 DEVELOPMENT SERVICES DATE ISSU s. 11/6/00 -1I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 ,- SITE ADDRESS: 12955 SW 113TH PL a iv ( .4, 7 1 �ARCEL: 2S103AC -07000 SUBDIVISION: FONNER WOODS ZONING: R -4.5 BLOCK: LO : 006 JURISDICTION: TIG REMARKS: Construction of new single family detached residence, Path 1. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,176 sf BASEMENT: sf LEFT: 9 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,204 sf GARAGE: 441 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5 'ALOE: $ 218,381.00 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,380.00 sf REAR: 37 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps•1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,573.31 This permit is subject to the regulations contained in the CROWN CONSTRUCTION LLC CROWN CONSTRUCTION LLC Tigard Municipal Code, State of OR. Specialty Codes and 8835 SW CANYON LANE #408 8835 SW CANYON LANE all other applicable laws. All work will be done in PORTLAND, OR 97335 SUITE 408 accordance with approved plans. This permit will expire if PORTLAND, OR 97225 work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: LIC 143308 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control Insp 8 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Plumb Top Out Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain /Backwater Electrical Service Exterior Sheathing Insl Rain drain Insp Plumb Final Foundation Insp Footing /Foundation Dr; Electrical Rough In Low Voltage Water Line Insp Final inspection Post/Beam Structural PLM /Underfloor Framing Insp Gas Line Insp Appr /Sdwlk Insp Building Final Issued By T1e Permittee Signature rx--s-- Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next buness day CI OF T I GA R D MASTER PERMIT PERMIT #: MST2000 -00467 A �i�; DEVELOPMENT SERVICES DATE ISSUED: 11/6/00 "� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12955 SW 113TH PL PARCEL: 2S103AC -07000 SUBDIVISION: FONNER WOODS ZONING: R -4.5 BLOCK: LOT: 006 JURISDICTION: TIG REMARKS: Construction of new single family detached residence, Path 1. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,176 sf BASEMENT: sf LEFT: 9 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 994 sf GARAGE: 441 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5 VALUE: $ 200,258.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,170.00 sf REAR: 37 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREAISPC 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: Owner: Contractor: TOTAL FEES: $ 6,435.00 This permit is subject to the regulations contained in the CROWN CONSTRUCTION LLC CROWN CONSTRUCTION LLC Tigard Municipal Code, State of OR. Specialty Codes and 8835 SW CANYON LANE #408 8835 SW CANYON LANE all other applicable laws. All work will be done in PORTLAND, OR 97335 SUITE 408 accordance with approved plans. This permit will expire if PORTLAND, OR 97225 work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: LIC 143308 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control lnsp 8 Post/Beam Mechanical Mechanical lnsp Low Voltage Water Line lnsp Final inspection Sewer Inspection Underfloor insulation Plumb Top Out Gas Line Insp Appr /Sdwlk Insp Building Final Footing Insp Crawl Drain /Backwater Framing lnsp Gas Fireplace Electrical Final Foundation Insp Footing /Foundation Dr Shear Wall lnsp Insulation lnsp Mechanical Final Post/Beam Structural PLM /Underfloor Exterior Sheathing Insl Rain drain lnsp Plumb Final Issued By : --�- Permittee Signature .c Q , ` 5 Le.ifA /. Call 03) 639 -4175 by 7 :00 p.m. for an inspection needed the next b siness day r)) J" /.o- t 7- '' d,. f B Permit Application Date received: /0"/6-00 Permit no.: /"�Sro�►pp0 -.q7 11 � ii City of Tigard - -.. Project/appl. no.: l� o Qe't000 -003490 City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 k Phone: (503) 639 -4171 Date issued: B Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: l &2 family: Simple Complex: TYPE OF PERMIT )] 1 & 2 family dwelling or accessory ❑ Commercial/industrial Cl Multi- family 0 New construction ❑ Demolition ❑ Addition/alteration/replacement 0 Tenant improvement ❑ Fire sprinkler /alarm 0 Other: JOB SITE INFORMATION Job address: 12 '55 Sly I l 3 PLac - Tt&lW. Ott 97213 Bldg. no.: Suite no.: Z Lot: ( I Block: (Subdivision: lFOYltl e trL LiJOot S I Tax map /tax lot/account no.: A 5/O3 0 7' - o Project name: 1 6. Description and location of work on premises/special conditions: ' f ')t7 � Wi-' OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: Ct/Z ∎ Cov, % u..cro v, LA-C. ( Floodplain, septic capacity, solar, etc.) N Mailing address: .■ L he, I.2j'F. j„0 (4.) I & 2 family dwelling: -C City: (State: (ZIP: Valuation of work $ i 20O ZS Y! Phone: — I Fax: I E -mail: No. of bedrooms/baths 3 2.5 O Owner's representative: Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) 2..11.0 APPLICANT Garage/carport area (sq. ft.) `f if f C Name: Ct2pw,� Cp -� ■ vim LL,L Covered porch area (sq. ft.) q�P Mailing address: Deck area (sq. ft.) `1 City: I State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial /industrial/multi - family: CONTRACTOR Valuation of work $ Business name: Existing bldg. area (sq. ft.) Crt��h Con.Sz 2v..f.T i t:A& L LC. New bldg. area (sq. ft.) Address:8S 35 Sup CAtn'0■1 Lcon.c y 0 $ Number of stories City:p0rsLFav\IN I State: 0qJ ZIP:qr]2 Phone:503-384 -/OS 4„I Fax:5e3 - 2824 I E - mail: " 9 r e Type of construction �' Occupancy group(s): Existing: CCB no.: 1,-(33 lAarw.a: -t . car.., • New: City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIIITECT/DESIGNER licensed with the Oregon Construction Contractors Board under Name: Ptt -fNl.l N - Cord provisions of ORS 701 and may be required to be licensed in the Address: 0,05 NIL,...) I P.�J jurisdiction where work is being performed. If the applicant is City �p2Tl A,�� OQ I ZIP: 912_0 9 exempt from licensing, the following reason applies: S tate: Contact person: M, 'sCt� Plan no.: a aq 1 - Phone:5b3-225 -1161 Fax:5,3.S. E-mail: rv ..COM ENGINEER Name: uueQ.R. C 6 Contact person: Fees due upon application $ Address:45 50 10 Date received: City: 1'O23-14,0 -x.17 IState:0e_ IZIP: q'7 to Amount received $ Phone:503 oz 5q 42_9z I Fax:503 Zgy 4,7 j E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard work will be complied with whethe pe ifie herein or not. Credit card number: I / Expires Authorized signature: -� lt-�.G Date: I0 2- Name of cardholder as shown on credit card Print name: IM o...Ic tie ll • Cardholder si $ Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (GroaCOM) fN i fry., V kl- ¢ten, r - TI�..�., 14 l�l a-t 0- 1 d.- - e�-`-t 1 c ,,/&, _0 . e A Plumbing Permit Application , A Date received: - Permit no.: ,. ;ti , <l�i�' e ia City of Tigard Sewer permit no.: Building permit no.: " Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 - 4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT I 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction 0 Addition/alteration /replacement 0 Food service 0 Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: I Z9 555 3 LD 1U3 ? cE 7 1 bF∎ 7 7123 Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: ( (Block: I Subdivision: Fovw‘er lsOotA.5 SFR (2) bath Project name: SFR (3) bath City /county` 'tbpoz RA ptsh I ZIP: 9'122_3 Each additional bath/kitchen Description and 1pcation of work on premises: Nell.....) Site utilities: C©v‘s7cu>re —T1 0 vN. Catch basin/area drain Est. date of completion/inspection: ` -0 ( Drywells/leach line/trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: R ,--jjP ,\ C'_ L,, \4.. Manholes Address:• Icop _S SFZi.∎ tY o1 Q SS Rain drain connector City: t 2u.∎p -ex I State° ZIP:g 32_ Sanitary sewer (no. lin. ft.) Phone: S o ' Fax: ' Storm sewer (no. lin. ft. 3.53$. Z 34 S, � a E -mail: ( ft.) CCB no.:f 7.4_, g'g a I Plumb. bus. reg. no: 3 6 -1 l ' B Water service (no. lin. ft.) City /metro lie, no.: Fixture or item: Contractor's representative signs /�'n Absorption valve Back flow preventer Print name: Pt j Sorvme,' 6- ll : 10 Backwater valve CONTACT PERSON Basins/lavatory Name: Clothes washer Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank OWNER Fixture/sewer cap Floor drains/floor sinks/hub Name (print): Garbage disposal Mailing address: Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENGINEER Tubs/shower /shower pan Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. MlRlmllm fee $ Notice: This permit application Plan review (at %) $ 0 Visa 0 MasterCard expires if a permit is not obtained Credit card number. I / State surcharge (8 %) .... $ Expires / within 180 days after it has been TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440 -4616 (M)0/COM) • • Electrical Permit Application . A Date received: Permit no.: 1 11 P V :j City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: I2q 56 £u3 l(3'. PLA -ce_ Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: ( I Block: 'Subdivision: F t _ Dvw‘e ,- WocD S Project name: I Description and location of work on premises: I•lew C..ovl ez Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name: l..�e, Re� G `ec_- �, _�, Description multi-family per Qty. (ea.) Total no. insp 1 1 • New residential - single or muhi- Address: 4 5 2 4 S W 0..c..v-� OV" rot K V t dwellingunit Includes attached garage. City: -7-i, b-u,. -.D I State: O e I ZIP: q - 7 2.2q Service included: Phone ED3.1. a, • l`l O ( I Fax:s33 /.2, (el I E - mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: y y (fig rj I Elec. bus. lic. no: 3 r{- 1 - 142.Q . Limited energy, residential GoH AP4 j1 j _ 2 City/metro lie. no.: r b$ _Limitedenergy,non- residential 2 v\ L Z J) t �� / 0 -I Z- 00 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 ices Sup. elect. name (print): YvvvA r ._... a �Q License no: L jo zg 5 �^tion or eders — installation, alteraation or relocation: PROPERTY OWNER 200 amps or less 2 _ 201 amps to 400 amps 2 Name (print): L'.�p W '� vv ,'TYL �0 vt LLL ■ 401 amps to 600 amps 2 Mailing address:g$ 3 S 5w CPro.`ttDv.. v`e_ 44 Lf tai 601 amps to 1000 amps 2 City: ?o 2Tl.Pe --c I StatePi I ZIP.(9 . a5 Over 1000 amps or volts 2 Phone6o3, 4 - 2, Be,2_I Fax5n .2.42. 6214 E - mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to llation, alteration, or relocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: ' . t , l Date: to — ID-- Crb 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 Cl Service over 320 amps -rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension' 2 ❑ Building over three stories Cl Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other. Per inspection Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card Cardholder signature Amount 440 -4615 (6/00/COM) Mechanical Permit Application . A , ,a Date received: Permit no.: � ' I City of Tigard �•� y g Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT Al & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: i) SS S(A_) 1 3 Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ • Lot: (p (Block: 1 Subdivision: Fvh.∎Aot lajJS *See checklist for important application information and _ Project name: jurisdiction's fee schedule for residential permit fee. City/county: 1 \ ( 5 pti, 2 p — w,erSH 1 ZIP:c', „)_a 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENTSCHEDULE Fee(ea.) Total Est. date of completion /inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM • Is existing space heated or conditioned? ❑ Yes 0 No space insulated? ❑ Yes ❑ N Air rati o e xi existing plan C Is existing system g P Alterati of existi HVAC system MECHANICAL CONTRACTOR Boiler /compressors State boiler permit no.: Business name u,,N �. HP Tons BTU/H Address: 1,,./ Z % f, i 0 sf %" Fire /smoke dampers/duct smoke detectors City: en tz k \ vAol 1 Stater i ZIP: '1 1 Z / c Heat pump (site plan required) Phone: 1Fax: (E Install/replace furnace/burner BTU /H Including ductwork/vent liner ❑ Yes ❑ No CCB no.: ' qj i 3 1 0 V Install/replace/relocate heaters —suspended, City /metro lic. no.: wall, or floor mounted Name (please print): Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: 1 State: 1 ZIP: Appliance vent Phone: Fax: E - mail: Dryer exhaust OWNER Hoods, Type l/ II/res. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart from heating or AC City: 'State: 1 ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: Fax: E - mail: Fuel piping each additional over 4 outlets ENGINEER Process piping (schematic required) Name: Number of outlets Other listed appliance or equipment: Address: . Decorative fireplace City: 1 State: 1 ZIP: Insert — type Phone: 1 Fax: 1 E -mail: Woodstove/pelletstove Other: Applicant's signature: 1 Date: Other. n Name (print): Not all jurisdictions accept credit cards, please call jurisdiction for more information_ Per it fee $ ❑ Visa ❑ MasterCard Not Th permit application Minimum fee $ expires if a permit is not obtained _ Credit card number: / / Plan review ( at %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. TOTAL $ Cardholder signature Amount 440-4617 (6100/COM) CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WEBBER ELECTRIC, INC 4524 SW CHARDONNY AVE TIGARD, OR 97224 Electrical Signature Form Permit #: MST2000 -00467 Date Issued: Parcel: 2S103AC -07000 Site Address: 12955 SW 113TH PL Subdivision: FONNER WOODS Block: Lot: 006 Jurisdiction: TIG Zoning: R Remarks: Construction of new single family detached residence, Path 1. 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 Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECT AL CONTRACTOR CROWN CONSTRUCTION LLC WEB R ELECTRIC, INC V■lIGber 8835 SW CANYON LANE #408 CHARDON Y AVE PORTLAND, OR 97335 IGARD, OR 97224 Phone #: 503 - 254 -6292 14 524 Phone #: Reg #: ELE 344 7 2C LIC 44087 AN INK SIGNATURE IS REQUIRED ON THIS FORM � Signature of Supervising Electrician If you have any questions, please call (503) 639 -4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BCS PLUMBING 17675 SW FARMINGTON RD. ALOHA, OR 97007 Plumbing Signature Form Permit #: MST2000 -00467 Date Issued: 11/6/00 Parcel: 2S103AC -07000 Site Address: 12955 SW 113TH PL Subdivision: FONNER WOODS Block: Lot: 006 Jurisdiction: TIG Zoning: R Remarks: Construction of new single family detached residence, Path 1. 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 Dept. No plumbing inspections will be authorized until this completed form is received po a )( 78 fit. � t7oo� OWNER: PLUMBING CONTRACTOR: 3 _ Z t CROWN CONSTRUCTION LLC BCS PLUMBING 5 - 932-- 8835 SW CANYON LANE #408 17675 SW FARMINGTON RD. PORTLAND, OR 97335 ALOHA, OR 97007 FAV SU 3 2. 4' Phone #: 503 - 254 - 6292 Phone #: 503 - 642 - 7922, 591 - 8842 Reg #: LIC 00094079 PLM 34 -259PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X2/1 Signature of Authorized Plumber If you have any questions, please call (503) 639 -4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECEIVED IMPORTANT PERMIT NOTICE jrA 2 4, 2001 RAJEN PLUMBING COWAN° DEVELOPMENT RAYMOND HENRY SONNTAG 1000 S SPRINGBROOK RD #55 NEWBERG, OR 97132 Plumbing Signature Form Permit #: MST2000 -00467 Date Issued: Parcel: 2S103AC -07000 Site Address: 12955 SW 113TH PL Subdivision: FONNER WOODS Block: Lot: 006 Jurisdiction: TIG Zoning: R - 4.5 Remarks: Construction of new single family detached residence, Path 1. 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 Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: CROWN CONSTRUCTION LLC RAJEN PLUMBING 8835 SW CANYON LANE #408 RAYMOND HENRY SONNTAG - _ C ® Z S OBROOK S^R:N RD " vi'. ���� . -- -- - --� - - -��rv3 iii i-�ii L.i ff:i.i NEWBERG, OR 97132 Phone #: 503 - 254 -6292 Phone #: 503 - 537 -6747 Reg #: LIC 126880 PI M 36 -78PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Sign /re of Aut orized ' ► •er If you have any questions, please call (503) 639 -4171, ext. # 310 CITY OF TIGARD BUILDING INSPECTION DIVISION MsT 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 7i ' 2- 3 AM PM BLD Location /2 /13 61 fre Suite MEC Contact Person Ph 51 Zf - Z3 Y Z PLM Contractor Ph SWR BUILDING Tenant/Owner /72/76 (.r-/t i -o ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab ~� Top Out 22 Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE ackfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call f r reinspe 'on RE: [ ] Unable to inspect - no access ADA eoach /Sidewalk Date 2.- ( Inspector r'' `' Extiffi Final PASS PART FAIL D NOT EMOVE this inspection record from the job site. 1/• Y 71 . CITY OF TIGARD BUILDING INSPECTION DIVISION MST .0 64 f • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location /Z- l3 > 3 `'' // 7( Suite MEC Contact Person Ph '/ 2-/ Z3' i PLM Contractor Ph SWR D�L.t- Tenant/Owner / ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain " 7 r 9 ( / � � Gvu. SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ai r ,PASS) PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final P��SS PART FAIL `MIECHANIG Post & Beam Rough In Gas Line S�I�e Dampers Fi nal PAS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date C-/ — / 3 --CS / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .CITY OF TIGARD BUILDING INSPECTION DIVISION MST ?U(,GUy 7 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 1 / 4 AM PM BLD Location /Zy 5C SW 7/3 vt ‘ Suite MEC Contact Person Ph q7-1- Z PLM Contractor Ph SWR UIL Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing '/ 5 ,4L �� c'Cu S) 6 . -c a3sAfix.. -X5 2 Insulation Drywall Nailing •C c7 i7 Firewall /� Fire Sprinkler ; 6 74 4 '771 SLR A ..- -- 7 () C (ZA cc./(. 57ZiC> Fire Alarm Susp'd Ceiling it& Ye) ' ' c; - s A/L5 ,� ( Su, /l 7 G rZT12' Roof ,, Misc:: -7 0 L.C.t b, c� [ (✓ GUS, S ASS PART FAIL / ` ' \c AP0 2 PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final . RASS T FAIL MECHANICA Post & Beam Rough In Gas Line Smoke Dampers inal') PASS PART FA ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date V / — " f Inspecto E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. L - • CITY OF TIGARD BUILDING INSPECTION DIVISION MST Z »' �� '�G 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ( BUP Date Requested 4 / -1 I AM PM BLD Location / 2 5 s w X17 moo / Suite MEC Contact Person Ph if- -3 S' PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation / / FPS Ftg Drain /Cl�j .•. y,�r✓ c�/L�a Crawl Drain Inspection Notes: f SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation �"� Drywall Nailing r'F'� c t_ "\Zoz ` /) .46 Y, ; J A : Firewall Fire Sprinkler �- Q 7,as'vltit l VDe ) IZA-9 " "744_4 Fire Alarm Susp'd Ceiling ( ) .Sdi/OlLT c2C G;A-4 ti -Lder Roof /� Mid O i/V57 JAC.0 anal ASS PART FAI v Z.ei" -F /7 ' Cic:4 4c-C.:55 - PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS_PART FAIL („MECHANIC Post & Beam e Dampers final PASS PART ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date ll / 0 / Inspector E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY,OF TIGARD BUILDING INSPECTION DIVISION MST , 5.&%6 -'06 4 24 - Hour Inspection Line: 639 - 4175 Business Line: 639 - 4171 BUP Date Requested 4 7 1 l AM PM BLD Location t�5� � �Q Suite MEC Contact Person ) Ph ��l — ! 42' PLM Contractor (A / e.,8 t3 €2 - l . Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: 1)/Z Slab Q �� 9, a SIT Post & Beam Ext Sheath /Shear r Int Sheath /Shear Framing A/C— / Ctij 7 (-74// Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm APP Susp'd Ceiling / f +, CC-e— / .1.112- .0�. d Misc: 7 r /NS ll o � Final PASS PART FAIL / 4 ( 7r i I , 7 n1c%S— (2/ — .6 - PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS 1 FAIL I Service Rough In UG /Slab CAffiae m PASS PART FAIL) SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ Unable to inspect - no access ADA Approach /Sidewalk l/ Other Date 7 — 9 `d / Inspe E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY } OF TIGARD BUILDING INSPECTION DIVISION FIST Z-c<D© 0467 24 -Hour Insprection Line: 639 -4175 Business Line: 639 -4171 ► SUP Date Requested `7 II ® k/ AM .) PM BLD Location / r? ? P7 Suite MEC Contact Person Ph // PLM Contractor �.r J -�* 2_. Ph �`--Z /7-23 8 v SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: A l Slab /7�G�s O��/„"1 72-) SIT Post & Beam /1y c-o � a /_� Ext Sheath /Shear T� Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PAS FAIL tL 4TRICAL Service Rough In UG /Slab Low Voltage Fire Alarm - ART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for r- inspection RE: Alb [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Dat /0 0 Ins .��� — — E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . . • CITY OF TIGARD BUILDING INSPECTION DIVISION -G 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 UP Date Requested i g AM PM BLD Location /c7/ - et) / / Ma Suite MEC Contact Person Ph SO/ 22,'Z-' PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Foundation cess: �( ^ i�(i �_r d 2 l FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS. 12.4RT FAIL 1 ‘Beam Under Slab Top Out Water Service Sanitary Sewer Rai Drains C a" PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call fo reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk (� Other Date r I nspector /�,,' i �� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site • . • . CITY AF TIGARD BUILDING INSPECTION DIVISgrisi pisr ""d 4bd ( " I t‘ 7 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested (2-6 - AM9/CPM BLD Location / 2, 9 5 5 // 3 cx Suite MEC Contact Person Ph OZt —2 - 31 Z PLM Contractor Ph SWR BUILDING Tenant/Owner 4 Retaining Wall V 141 /4, ELC ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath/Shear Int aming Sh ce j_ e i Fr 4-- Insulation Drywall Nailing 1 47/1/ (0 Firewall Fire Sprinkler 4 . Jj,v' Fire Alarm Susp'd Ceiling s Roof t( - ) V\Ad a Misc: Final FAIL 62/04 - e 1A-4 U • eBASS__gART Ji giaThia Post & Beam Under Slab < a—r Top Ou .„,,, Sani -wer 0;171 Rain Drains CA et f 4... in F' • PAS ' FAIL HA AI.. Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch upply Line Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire S ADA Approach/Sidewalk Date 7/19/ Inspector \ILL (3 Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. C!TY.O.F TIGARD BUILDING INSPECTION DIVISION M'sT 2a '� 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP • Date Requested Z-- 64- AM PM BLD Location /2-- y Sr 5 i 1/3e( Suite MEC Contact Person Ph Nu PLM Contractor Ph SWR ILDIN Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing tflsulatigtfl Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Fin. PART FAIL II BING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date 2-5 0/ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF.TIGARD BUILDING INSPECTION DIVISION MST * 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested c 9 --/ v / AM PM BLD Location / Z q }) //3 "'/" Suite MEC Contact Person Ph ,3 N- ? PLM Contractor Ph SWR �lllLCtaG• � Tenant/Owner A P` / n • 4i/ SL Zo 4 ELC Retaining Wall d tie ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Fina • SS : RT FAIL Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final P PART FAIL Post & Beam ou9 Gas Line Smoke Dampers Final AS jOART FAIL CTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date — ( Inspe E x t Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • CITY bI;.TIGARD BUILDING INSPECTION DIVISION MST 'c?•` YG 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / — - ? AM PM BLD Location / Z �l> >S c,i //3 a Suite MEC Contact Person Ph 5112 9'Z(- Z 37Z PLM Contractor Ph SWR BUI •_.:.= Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear rmin• nsulation Drywall Nailing " ) Sc , r v -'t ' cur wo es (`' C7-1/ r 677 /C Firewall / Fire Sprinkler � J 3 S t Li L1 iT'�7�U�Cif� Oi. S -/T: a /; L i,. �e S ,?ti�T C /h Sv Fire Alarm Susp'd Ceiling C /,4H -i4 Roof Misc: Final PASS PA FAI �.a i >�A �l cv C —��,� v „f-r X& —¢ - PLUMBING 44 Post & Beam Under Slab Top Out Water Service o ( S : e -�; _ z / 5 %y:: �c Sanitary Sewer Rain Drains /Y , „ C) rte- ¢/ 7b'4 Final PASS PART FAIL 4 ECI�,gL Post & Beam o • i�,' �u • i ii► �i:Giy' mo e !Pampers Fi AS PART FAIL TRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date / 7 G / Inspecto / E Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • * CITY OF TIGARD BUILDING INSPECTION DIVISION � °U -,e64,7 24- Hour.Inspesti Line: 639 -4175 Business Line: 639-4171 ��y BUP • Date Requested / — a-- G AM PM BLD Location / 2 9 5 "5 5 6 /(3 " . Suite MEC Contact Person Ph 4 7/ -Z 3 b L PLM Contractor Ph a c - OU 3 ZO BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: � / � Ft Foundation Drain /Cry ! S 4 GG, T"- c t / " v ar 2 1 ,4 / s f q c i y FPS g J SGN 0101/Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina mingth /Shear Co �_ Framing - Insulation Drywall Nailing Firewal Sp l (1 lki ' < J 9� ) � ��—r/ C1 �J Q / Fire S rinkler -4.9 `' ' I > � Fire Alarm ...,. Susp'd Ceiling Roof ( V# ) `r did( / Misc: �(f� ' ' �+ • Final ART AIL / �., p a PLUMBING ( `j 1, �ti.{ G�/� , U") ( et--A 0' m4 ! 4 4L(., ln/1 S2 <-( /k.5 - Water Service v 2 riz S f LI..r01 DL(/Sanitary Sewer (�1ry Rain Drains G� �YGW1/� Fin- -AS O' FA A L L -- eNe\:.‹ S - j S c k C Post & Beam 1 Rough In � /l t l 1 l IM_ 1. S \ - - s. Gas Line Smoke Dampers Final PASS PART FAI 1&15\&"IrNAJ Q_r /�- �/ �� ELECTRICAL p Service C -Q�/ k/L c.--- • Rough In UG /Slab Low A S Fire Alarm Final �� I p f (---1-4) � . PASS PART FAIL VW- S t � VI/Ns— 1 � S T'� SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA xx /� ^� Appoach /Sidewalk Date Ve U I Inspector v CJ� Ext J Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . C�1 OF TIGARD BUILDING INSPECTION DIVISION • MST ��� _ S/6 24 -Ho r Ins'Action Line: 639 -4175 Business Line: 639 -4171 • • • BUP Date Requested / ' 2- AM PM BLD Location /02.9') //36 Suite MEC Contact Person Ph �f Z� - Z3 � PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation // / ✓ yA FPS Ftg Drain i� .� � t 5 (U c u -t r /'►'+ r Crawl Drain Inspection otes: d � ' SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 2 Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL e rvice - l d ate-( • Rough In UG /Slab ow ge ire Alarm Fin PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / -- 3 ,6 - / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. _CITY OF TIGARD BUILDING INSPECTION DIVISION MsTGo -vo yG 7 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • �.. • BUP Date Requested /— 2 ) AM PM BLD Location f ZqS 5 c✓ //3 P( 1" ( Suite MEC Contact Person Ph 1,7( e 3 g PLM Contractor / /.�/ , f i'f 7Z S_ l / Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL DEL - EC' ICA Service lab Low Voltage Fire Alarm Fin �= 'c PART FAIL Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / -- 0/ Inspector _ _ ? Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. GIT OF TIGARD BUILDING INSPECTION DIVISION �-j ' �' MST 'rilJ'z��j 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested /---/ AM PM BLD Location / Z y 5 S L✓ X13 6 fAP Suite MEC Contact Person Ph 2 -1—Z- 3S' PLM Contractor Ph Sty SWR ILD Tenant/Owner _440,1 4/f 4.- //mot s � j � , ELC Ketaining Wall /.(G L cant ? ELR Footing Access! FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam ea /Shear Framing ( „ r / 7 S c r Z O iv I 7 • r9 - Insulation Drywall Nailing /— 4 —O/ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: , LZBIPPP PART FAIL • UMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / `/K - 6 l Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • • r :CITY :QF•TIGARD BUILDING INSPECTION DIVISION 04 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP Date Requested I 1 c, 1. 0 1 AM PM BLD Location 1'7,5 S S c lU 1.1 Pi, Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam t Int -a ear 1 \ er — / 57 Framing Insulation Drywall Nailing tlat 104 teJ n I v7,` Firewall Fire Sprinkler / - _ Q . / y I Fire Alarm .Z f� 1 _ / �P[ r 1./ / S 40 IN ST»t Susp'd Ceiling �.�J� Roof Misc: Final PASS PART 6 PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE • Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA I Approach /Sidewalk Date Oq (,P Jo / Inspector s Ext Other / Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • • .• CITF ■TIGARD BUILDING INSPECTION DIVISION • _ • • • ``/ • MST , e) —00.' Y 4 7 24 - Fldur Inspection Line: 639 -4175 Business Line: 639 -4171 BUP l; Date Requested /Z - ( AM PM BLD Location / 2 9 G 5) 5 w //3 & /21 Suite MEC Contact Perso �i'! Tk c�- Ph ‘) L Z PLM Contractor � Ph SWR (BUILDING 7 Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Oil Crawl Drain Inspection Notes: Slab SIT xt Sheath /Shear Int Sheath /Shear Framing U �✓U'� ,!� �0 Insulation Lv ∎5 Drywall Nailing 1 . Firewall Fire Sprinkler C■v\i-e_J Fire Alarm Susp'd Ceiling Roof Misc: 1 - 121 11° PART FAIL �"�� c - LU,r = "► C0 Post & Bea Under ab Top Out Water Service Sanitary Sewer M Rain Drains AqQrC _ � it-� `' ,, e J PART FAIL et. f MECHANICAL 49,AL ea ough In Gas Line Smoke Dampers Fin A S PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA }� ' "� ` Approach /Sidewalk Date 2// b ' I nspe ct or v (..� v ' ExtS `\ Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .• . OIT` OF TIGARD BUILDING INSPECTION DIVISION onST 2tr�� ov 24 -1-' ®ur Inspection'Line: 639 -4175 Business Line: 639 -4171 / 2-4 /, BUP ! Date Requested /— AM 64 /`ta PM BLD Location / 7 ? S w 11 < Suite MEC Contact Person Ph Pf I3 (v / PLM Contractor /3d(• Ph 'f k// 7 SWR 1JI D1Ne- Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN rawt - 13 * } Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Fi PART FAIL e Ie`tce • ost & Beam Under Slab Top Out Se (ain Drains • PART FAIL ANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk `�j/ Other Date A Inspector Ext� / - Final PASS PART FAIL DO NOT EMOVE this inspection record from the job site. CUT`i OF TIGARD BUILDING INSPECTION DIVISION • • `_ • ' MST p2e) -fY ( G 7 • 241iaui Inspection Line: 639 -4175 Business Line: 639 -4171 W - . , • BUP Date Requested // (( AM Cal `e PM BLD Location / Z � 575 5 tv 1/3t7,-, Suite MEC Contact Person Ph 7k f =G 3j9 O PLM Contractor Ph 3�`/ -/ G Z / /7 SWR BUI Tenant/Owner ELC Retai ' • Wall ELR • ooti , Access: • o lc- FPS / gDrain l Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: PART FAIL • e ' BING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for einspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk D a t e A l 1 Inspector Other Ext Final PASS PART FAIL DO N T R MOVE this inspection cord from the job site. • w y • • - —a s . • • • MST — Master Permit Inspection Description Date Passed By Notes Grading Footing /Setback r'i /j illiD Foundation walls f /IV /i i Slab Footing drain Waterproof basement walls .0■1110.11■ Plumbing underslab Crawl drain (7 /Vei Post/beam plumbing i 2ii\ v Wit Post/beam mechanical ► Z /./ . o Underfloor insulation Post/beam structural i 2-/%1/4.)c Shear walls /anchors I - i (_ p Exterior sheathing Plumbing top -out 1 /26 1 ' Ui — 274eA r 21 Gas line & test (- 2.9 - o ( K Mechanical rough -in 2- o i _ o i Electrical rough -in [ - o ( Electrical service / -2. f - o / Low voltage r -^ 267 C Sprinkler rough -in Backflow preventer Roof nailing giggiNNIONNINA Firewall Framing z- o r - o ( 0\ MFG -Home set -up Insulation - z - S- o r Drywall nailing L ..� Masonry /Reinforcement Rain drain 1 ..?((oI " WV Sanitary sewer V2/(1° �j Water service Pump /fill septic tank Approach /sidewalk Grading final .11111.0 Mechanical final 4 - 1 Plumbing final t../ ` C Electrical final /O 6 / G / Final inspection 4L1 1 o t / Special Reports SWR - Sewer Permit Inspection Description Date Passed By Notes Sanitary sewer Final inspection INSPECTION RECORD — MST (MASTER) PERMITS - r CITY OF T I A R A MASTER PERMIT PERMIT #: MST2000 -00467 .444 DEVELOPMENT O Blvd., SERVICES 639 -4171 DATE ISSUED: 11/6/00 SITE ADDRESS: 12955 SW 113TH PL PARCEL: 2S103AC -07000 SUBDIVISION: FONNER WOODS ZONING: R -4.5 BLOCK: LOT: 006 JURISDICTION: TIG REMARKS: Construction of new single family detached residence, Path 1. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,176 sf BASEMENT: sf LEFT: 9 SMOKE DETECTORS: . TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 994 sf GARAGE: 441 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: 5 VALUE: $ 200,258.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,170.00 sf REAR: 37 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP <311P: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS _ ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 • 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION: EA ADO'L 500SF: 4 201 • 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & 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: Contractor: TOTAL FEES: $ 6,435.00 Owner: This permit is subject to the regulations contained in the CROWN CONSTRUCTION LLC CROWN CONSTRUCTION LLC Tigard Municipal Code, State of OR. Specialty Codes and 8835 SW CANYON LANE #408 8835 SW CANYON LANE all other applicable laws. All work will be none in PORTLAND, OR 97335 SUITE 408 accordance with approved plans. This permit will expire if PORTLAND, OR 97225 work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: LIC 143308 forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control lnsp 8& Post/Beam Mechanical Mechanical Insp Low Voltage Water Line lnsp Final inspection $ Sewer Inspection Underfloor insulation Plumb Top Out Gas Line lnsp Appr /Sdwlk Insp Building Final Footing Insp Crawl Drain /Backwater Framing Insp Gas Fireplace Electrical Final Foundation Insp Footing /Foundation Dr Shear Wall Insp insulation Insp Mechanical Final Post/Beam Structural PLM /Underfloor Exterior Sheathing Insi Rain drain lnsp Plumb Final k ' Iss ued 6 1 Permittee Signature : t Q 2 -J °� i �� y : ti �_e , r x , � Call 03) 639 -4175 by 7:00 p.m. for an inspection needed th next b siness day NSIr