Permit MASTE PERMIT
7/
CITY O TI PERM! #: MST2006 -00128
. 1A\ DEVELOPMENT SERVICES DATE ISSUED: 8/9/2006
_al Ali
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110AB - 01600
SITE ADDRESS: 14070 SW 114TH AVE ZONING: R -7
SUBDIVISION: COLE'S ACRES LOT: 002 JURISDICTION: TIG
Project Description: 400 sq foot addition.
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 14 FIRST: 400 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 30 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 10
VALUE: 46,200.00
OCCUPANCY GRP: R3 BORM: 1 BATH: 1 TOTAL: 400 sf REAR: 99
PLUMBING
SINKS: 1 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 1 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 2
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 W000STOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 *amps- 1000v: MINOR LABEL:
1000* amp /volt :
PLAN REVIEW SECTION
Reconnect only:
n=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 Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other
MICHAEL WAGNER OWNER applicable laws. All work will be done in accordance with approved
14070 SW 114TH AVE plans. This permit will expire if work is not started within 180 days
TIGARD, OR 97224 of issuance, or if the work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in
OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies
Phone: Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Reg #:
TOTAL FEES: $ 1,110.60
REQUIRED ITEMS AND REPORTS
Bolts in concrete
Issued By : Permittee Signature :
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.
c
� Fry- 7-" - : - 1012 •OF1' IC, 'USE ONLY • .
Building PermitrApp.lica`tion i [a
r 1(^ ^ J _ i Received `T.
City of Tigard Date/Br � g o r e Permit No.: )46 i w . 0 ., _ er ,g!
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
/�zr /' r + '\ • I Other Permit: Phone: 503.639.4171 Fax: 503.598I960- ` i ,, , Date/B . • t 1 •
Inspection Line: 503.639.4175 1� l L 1 2��6
Internet: www.tigard- or.gov Notifie /Mej Date Ready /By: ® See Attached Checklist for
a hod: 9 A I /e�� / Supplemental Information
� T Y 0i- t luF`>L_ �� , > rx 7` An w/ (.auk . .
I D t� r e a v, Y' V1 t P
, .� .. TYPE `OF WORK?�� • REQUIRED DATA: 'I- AND;-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. ( A � ' { (p 6, d
1
' \ - and 2-family dwelling Valuation: $
y g ❑Commercial /industrial )
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION . AND LOCATION , Total number of floors:
Job site address: t 4 0 1 0 51x., ` t ok." New dwelling area: square feet .
City /State /ZIP: 'T , 6f%e Garage /carport area: square feet
Suite/bldg. /apt. no.: Project na ‘,..teNtevr' Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
_____ '1Nr:21a' 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
` i, DESCRIPTION OF. WORK . ' work indicated on this application.
ea tliA C ) -f.. N G 6.0. mr, Valuation: $ p trelp
` SA/S`e'LA Existing building area: square feet
/ New building area: square feet
18.PROPERTY OWNER , ❑ TENANT Number of stories: •
Name: ! lot tio Q Type of construction:
Address: (3.1L e. Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax:( ) New: •
. ' APPLICANT ❑ CONTACT PERSON NOTICE •
Business name: (!43, i , Ipesstr, . All contractors and subcontractors are required to be
Contact name: � �S-�. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: t 3 l a ,r , v.7 jurisdiction in which work is being performed. If the
City /State /ZIP: ,�,�} -( �� A� R applicant is exempt from licensing, the following reasons
�" \ `1 � Q ck apply:
Phone: ( 2 ? 3 °6 Cif Fax: : (9E8 S et' I'o ^ Oltic- C
E -mail:
CONTRACTOR
Business name: BUILDING PERMIT •FEES* •
Address:
Please refer to fee schedule.
City /State /ZIP: r/„n a 6 9- •
Fees due upon application 4X j5
Phone: ( ) Fax: ( )
Amount received dl(j J • 5
CCB a , /�4 / J � /
tU
Date received:
Authorized signatur -..—.1 -..—.1 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
n
Print n c a.se Date: b( * Fee methodology set by Tri- County Building Industry ,
Service Board.
1:\ Building \Permits \BUP- PermitApp.doc 12/30/05 440461 3T(1I /02 /COM/WEB)
./A
One- and Two - Family Dwelling
•
Building Permit Application Checklist FOR OFFICE, USE ONLY
City of Tigard Received
Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960 4isr4
_Al. 1'J� ❑ Electrical ❑ Plumbing ❑ Mechanical
24- Hour Inspection Line: 503.639.4175 Al
Internet: www.tigard - or.gov ❑ Other.
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1' No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ 0.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district a 1 s royal re ' uired. Name of district: ❑ ❑ ❑w
•
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ : •
6 Sewer permit. - ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
basin protection, etc. .
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to'applicable local,and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. inteivals);;location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and
surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. .,
14 Cross section(s) and details. Show all framing- member sizes and spacing such.as floor beams, headers, joists, sub- ❑ ❑ ❑
•
floor, wall construction, roof construction. More than one cross section may be'required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building,envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ . ❑ ❑
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code 'design values'for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam /joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. .. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. 'A gas- piping schematic is required , ❑ ❑ ❑
for four or more appliances.
•
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ' ❑ ❑ ❑
architect licensed in Ore •on and shall be shown to be .. •licable 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 red lines or tape -ons. "Mirrored" building plans will not be accepted. , . . ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System DevelopmentFees 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 f 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.
` Building Fixtures
Plumbing Permit Application Gel -- � F012 OFFICE USE ONLY .,
Received Fi City of Tigard Date/By: .5 teU O L/ Permit No.: H5/ 75 6_651/gg"
111 U 1 3125 SW Hall Blvd., Tigard, OR 97223
Plan Review
l. C Phone: 503.639.4171 Fax: 503.598.1960 _ �oOS Da
Other Permit No.:
te /By.
Inspection Line: 503.639.4175 e,A p� T i GARD Date Ready/By: lulls: ® See Page 2 for
Internet: www.tigard- or.gov 1"tN \ •) Notified/Method: Supplemental Information
TYPE OF WORD` Of . �kr
OF, t 1 j ... 4'6if"16R n1., FEE* SCHEDULE
❑ New construction , t ]flemol rtton) ( t1 1,11 v For special in ormation use checklist
J a • . Description Qty. I Ea. I Total
,30 ddition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION , - SFR (1) bath 249.20
nd 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
.JOB SITE INFORMATION - AND LOCATION _ Site utilities
Job site address: t°14417 A a,1 (I k ‘ Catch basin or area drain 16.60
City /State /ZIP: �- '"� Drywell, leach line, or trench drain . 16.60
Suite/bldg. /apt. no.: I Project name: k00.tirvae. Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site:
e� Manholes 16.60
4 4M - NrXer Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) f Page 2 r •-s
Subdivision: I Lot no.: Water service (no. linear ft.: ) / Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
■OA 4 A ki'r<:NeAN Backwater valve i 16.60 ) (o• (a Q
ww _ \ Clothes washer 16.60
Dishwasher , 16.60 t � •
• 9 ROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Wtk 6 kklI Expansion tank 16.60
Address: Fixture /sewer cap 16.60
434 6- City /State /ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
X PPLICANT ❑ CONTACT PERSON Hose bib 16.60 Go
Ice maker ( 16.60 ((ey
•
Business name: (_[_S'.�c�� -. 6r Interceptor /grease trap • 16.60
Contact name: Q R,..,. ���'e.,, Medical gas (value: $ ) Page 2
Address: k "5 C o t■N43 v: Primer 16.60
City /State /ZIP: t >r e g 1 -1."&cl Roof drain (commercial) 16.60
Phone: (�� .t.. S+" Fax: : ( )
Sink/basin/lavatory 16.60 't3
Tub /shower /shower pan t 16.60 (b too
E -mail:
Urinal 16.60
CONTRACTOR Water closet t 16.60 (6‘
t
Business name:' ----- 6 - Water heater 16.60
•
Address: Other:
----- . - a- - Subtotal
City /State /ZIP:
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 1 7 ■ '
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized signat Allbk State surcharge (8% of permit fee) 13 j . ) C)
TOTAL PERMIT FEE
Print name: IW - j Date: •'�' �, This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
/`� *Fee methodology set by Tri- County Building Industry Service Board.
I:\ Building Wermits\PLMF- PermitApp.doc 04/06706" 440 -0616T00 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty Fee °yea) Total- Square' PermiiFee:
Footing drain - I 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00
Medical Gas Systems:
Water Service - each additional 100' 46.40 '
. Valuation: ` - Permit Fee: -
�
Storm & Rain Drain - 1st 100' 55.00 ' S 5 ,O D $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00`to $50;000.00• $379.50 for the.first.$25,000.00 and $1.45 for
each additional $100.00 or fraction thereof to
Inspection of existing plumbing or
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50,001.00 and up' $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building
•
Fixture Type: Replace ❑ Any new exterior'plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or moire new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi /Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor /Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA 13 - multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink - 2;:' Submit 2 sets of plans with any of the above.
3"
4 "
Car Wash Drain . Isometric or Riser Diagram
Garbage . - Domestic ❑ • Isometric or riser diagram is required for new buildings
' Disposal - Commercial three (3) or more stories in'height.
- Industrial.. r .
Ice Mach. /Refrig. Draitl$
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang ,
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial
•
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: 'plumbing permit can be issued. •
•
i:\ Building \Permits\PLM- PermitApp.doc 07/06/05
= V L \V f.
'Electrical P Application .' ' • ... F OR E
OFFICE U SE O N ° . ,
City of Tigard Date /B OIL) 610 . , • Permit No.: �"�y7 ._ QO / ,S
't 13125 SW Hall Blvd., Tigard, OR 97223 S 0 2006 Plan Review
- - I, Phone: 503.639.4171 Fax: 503.598.19¢0 Y\� — Date /B . Other Permit:
T I C A K D Inspection Line: 503.639.4175 at a . Date Ready/By: turfs: RI See Page 2 for
ATV �f
Internet: www.tigard or.gov ly �b- r Noti fted/Methed: Supplemental Information
� , �.� r
TYPE OF r WORK.., t G i''kt V PLAN REVIEW •
❑ New construction pdddition%alter / r Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current • ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
and 2-family dwelling less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
y g ❑ Commercial /industrial El building amps for all other installations. buildings.
u lti - family 0 Master builder ❑Other:
0 Fire pump.
0 Installation of 75 KVA or
` JOB. SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "I - ",
Job no.: Job site address: •1 /� t l C ` l 100HP or more occupancy.
❑
`T ❑ Six or more residential units. Recreational vehicle parks.
CitylStatelZlP: ❑ Health -care facilities. ❑ Supply voltage for more than
�� �0- ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE - •
Cross street/directions to job site: Description 1 Qty. I Fee. 1 Total 1
New residential single - or multi - family dwelling unit.
Includes attached garage.
Subdivision: L ot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK . (with above sq. ft.)
("AA ( s` Limited energy, multi - family 75.00 2
� � 9.ay. residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
ROPERTY OWNER - ❑ TENANT 201 amps to 400 amps 106.85 2
Name: th-zNeke- 401 amps to 600 amps 160.60 2 .
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 • •
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT • - ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fce for branch circuits
Contact name: without service or feeder fee, i 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular .
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2 •
/ t @ L- ) Signal circuit(s) or limited -
Business name: V v-'� ' w t �-� energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
` Per inspection 62.50
Phone: ( ) I Fax: ( )
Investigation per hour (1 hr min) 62.50 •
CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee):
Authorized sign., re: C TOTAL PERMIT FEE: •
i�`i� This permit application expires if a permit is not obtained within 180
Print name: i Date: A"Ical Vx n(0 days after it has been accepted as complete.
-
" Number of inspections allowed per permit.
t:\ Building \Pennits\ELC- PermitApp.doc 05/23/06 440- 4615T( I I /0S /COM /WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIALWORK
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
•
•
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems* •
❑ Other:
COMMERCIAL WORK ON LY: 7
Fee for each commercial $75.00 •
•
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 03/23/06
07/17/20%6 16.02 5036243601 TIGARD BUILDING DEPT rmIL o di V4
City of Tigard Revived OCIIIIIIIIIIIIIIIII
19175 SW Hall 131vd,. Tigard. OR 9,23 ,
to _
Pilo) e: $ J3.639.417t Pax; 3[13.598.1960 ) .: ,. s , t}p tit
bawd= Una 503.639,417 ,• .. rrr ±7 -
rneerneC w w,tijetd -rr.RN
T.?crr� l m . ��
+ t ,•.•� > .y ', y +1 'PY rrlf` r ,v-t; '` 3
txfe�l'��il'L�iG1��G.: �k� V.! 711 5i�' �" �; 1F�U11�� '�3',�A; r+ ++
,rmm�rY�hnn►d1 hn�rn• �s� ,r. n ' ; wA'� `.••�a 'ne.�••N+arn ,r . .,. f.!�.•d �.v +i
vacua
[] NEnY CAlts11'110d011 -i '4 : t1a0%It tlOttlflG111tict lCet Indicate th t lava ere Mated OS 9N vela, PM! work
Q DCSit0iltiatl D 4thCr: P��+t littlicais Wooded to the weal dollar} 0! all
nlechiniaal irately' 1aba. overhead. aid . • lit
' �y +n.r . j M 7' a.^'�^ -►yew 47:-Y;',";""":""7-7,771, , VaValue: S
ieti .` fl L vvi- s'k 1 • . . ,..,... ..: YS2l�`:1 Mcwh«/ , • ,.. �4.47,6 '"
„ yy tel 1 7 Icy y^ Y 74-2 , .,;. -:-. _:: - r.r.r �
'^A �
1 and 24ar ilidwelling 0 Ce nmt�relalnoirltleel9lli 0 Accessory building ,, .1•::. , :1 iO4- S�r m..x , '; ..r�. 'trr R l h e.ry3i. . :
Whmily Q Mager halo' we c1RecFiPiat
CI
MUIt
Ober Maori .:on eye►. IVO Total
T....r w.�� u
a a ; - .• ,e� ,�.• , s.x , -n ,_ rr. n»�� x vm!�!'• *^? -••••r ,.r- ?Armes;
RE .`� .ra:;: - y ,Ls= . ,,ggi:ki.;;'rr.. , .... ter iM ; .; _
/Ur Cat'''' • , .Rest ' pre,
, x shpain_ : , . 1111 1400
Fa tL: •.: a.r. 4 ,24. 1 BM . ., , i ME 17.90
Saitelbl ltdept. me.: « - c ` MININEETIMIIIIIII
Craaa Amt./directions to job pits; Dijs — 14.00
mimic reset otater NE 14.00
aid boiler (radiator or
. 14.00
IIIMIIMIIIIIIIIIMIIMIMIMIIIIIIIIIIIMII 1111 10 00 '
- ,eni g4r of above 11111 10
all moo INN
Tax map/parcel no- Chhar fad • ,, M,._
P; ,,,,,,,. 1=1 10.I a ME
'1nty r. wart heater org;
cc 1111 10.00 Ell
1,e :1 :, tat _ i0�0 L
w'•.., .ter a! Mil
Wind >. ...11 :, , 11111 moo OM
Sctz r• is, 's, r �,� krr` .rte
.. �., • M Y�1 !
]5 ,r4":taa,: rinwik 4 N *i..a ,44L :krfintr� der. IIIII 10.00
Nano;
Ease re e . l • a ;, : - ; . t : ve .. ..times
Addre sa: Flange baaVotherkitahara ry
. t n 10.00 O --
city/stamt�lp: - 1 ';, .. ¢mesh Mill 1000 — MO
Plum ( ) 1 sm,:e.dact inotl0,
wild .. $jt,,; C etl 111111 % 61+
. (, +, „. ?� e; ;;; i ' x l ,.: >�. vx ur > r� : y; {''� J teeferarki"' 19
t' r htr. . �•*�r�n , Nr +t:w7 T.aS•3��2AS�� r h he 7 r..:r iA , hlF�leN+w n w.�.wM4RN�Mah
Business Num Other; 10.00
mot name: ,, ,LI •,.. Et:,, four a1.d01b . It , , • ides :.
Address: Ter 6 do.
City/StatefZIP: c 1•1111111•11111
w
( . i , ., rs ; [teeter �
Phone: ( ) 1 ( ) w ��
s -many: Fir... low =UM
I IN
', M V w t ,t g A•fN @fCC7 ., :LY2h - , , cJn -,r g 8e ^
G
laikotecss I)e S: 1� dales dryer (
yjj�� 0th 11111111 AYSI[.e1V9S: , _ / — — � . 1. YY - y 4 w'i „'ryYSS -y .4
ft�, . ..M.', m, ti
9 ■btotal IIIIIIIIII
PbWK Minimum permit fee .`.,0) .. — O
CCR 1(0.: — '” Ph a _,_(2 %o! prrm� toe)
5tete s ($S6 o f permit ke) 1 , C)
Atith 17c4 signature; TOTAL p EPIVI1 u PES
�`rr '1' phial Ofraurlm wins Ir IP�lr'T;at.bialaed witai Ira
Print name: �� dam ale km > *employ.
�,�, Der AT, w . 1 m6X110dology sat AY 'Coemly Building indin (%y Sera ce 1l
I:iEaielb*Par IMIMINeillblpp,dot 01/06066 t 411002l004ay ,
Permit #: MST e Xob — 0.0/--i
Address: Igo-7o ) Iii-Fro
Issued by: 76 Date: TVC2-6
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
1 --- 1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure. must be
registered with the Construction Contractors Board.
OR
p 7.---
3B. I will be my own general contractor.
• If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
• Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
- _ • registered with the CCB and will immediately notify the office issuing this building permit of the •
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
�._e /_ /- L'(/ 10
lican Date
(Signature of permit a� D 9/0 (Date)
(White copy to issuing agency permit, file,
pink copy to applicant)
� ]
^ , �
information Notice to Property Owners
About Construction Responsibilities
Note: This Information information ME ice to Property Owners about Consoeuction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 70.055(5).
f you are acting as your own contractor to construct a new home or make a substantial improvement to an existing strucwre,
you can prevent many problems by being aware o f the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, be ruled. to be an employer and the people
you hire will he employees. As the employer, you must comply with the following:
Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages atthetiine employees
are paid. You will be liable for the tax payments even if you don't actually withhold the tax from.your employees. For more
information, call the Oregon Dept. o.f Revenue at 945-8091.
Unemployment insurance tax: As an employer, you arc required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Department at 378-3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. lfyou fail to obtain workers' compensation insurance, you may
be subject to penalties and will be liable for all claim costs if one of your employees is injured nntbcjob.Formuroinfbnnabon,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employee 'wugey. You will be
liable forthe tax payment even if you didn't actuall)' withhold the tax. For more information, call the internal Revenue Service
at 1'800'829'1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this p requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see ifyou have adequate insurance coverage fo
accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re-done,
Time to suervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have theexpertisetoactas yourown general contractor, to coordinate thework ofrough-in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you. have additional questions, write or call the Construction Contractors Board (PO Box l4|40, Salem, ORV7309'5O52,
503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. �
pmp'own,pn4
1/94
CleanWater Services
Our commitment is clear.
August 8, 2006
Case Design Group
1314 NW Irving St., Suite 203
Portland, OR 97204
RE: Addition to single family residence located at 14070 SW 114 Ave.,
Tigard, OR
CWS file 06- 001744 (Tax map 2S110AB, Tax lot 01600)
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 significantly impact the Potentially Sensitive
Area found, near the site. In light of this result, this document will serve as your
Service Provider letter as required by Resolution and Order 04 -9, Section 3.02.1.
All required permits and approvals must be obtained and completed under
applicable local, state, and federal law.
This letter does NOT eliminate the need to protect additional Sensitive Area s 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
Site plan attached .
•
2550 SW Hillsboro Highway • Hillsboro, Oregon 97123
Phone: (503) 681 -3600 • Fax: (503) 681 -3603 • www.CleanWaterServices.org
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: MST2006.00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 Iii II
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/26/2007 TIME: 7 :00AM PAGE: 69
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 060303 -01 503.639- 7349 h!
Corrections /Comments /Instructions:
/ = r�1 vt4- 1 g1 e - f� • we2ro,g`
613 IVO le"
[ASS ❑ PARTIAL APPROVAL n CANCEL I I NO ACCESS
I FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: 19/Z, 63/4 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006.0012Q
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639- 4171a�la�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/26/2007 TIME: 7:00AM PAGE: 69
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 050902 -01 503 -631 -7349 N
Corrections /Comments /Instructions:
/ _.3
PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS
—
❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: / t/ V Date: c IY 7 Phone #: (503) 718 - 21
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006 -00120
13125 SW Hall Blvd., Tigard, OR 97223. DATE ISSUED: 8/9/2008
Phone: (503) 639 -4171 , 04, y lu�A�
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' f I..
INSPECTION WORKSHEET FOR DATE: 9/12/2006 TIME: 7:01AM PAGE: 64
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 4(00 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9,112i2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 036340-01 803 - 544 -6620 N
Corrections /Comments /Instructions: /
OX ,
1
'11, ' SS n PARTIAL APPROVAL I I CANCEL I I NO ACCESS
• FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: IV Date: q ,)- V 6 Phone #: (503) 718-
._ r
CITY OF TIGARD -
g______
BUILDING DIVISION ' PERMIT #: MST2006 -00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: gigs ty06
Phone: (503) 639 -4171 , �m ' �l �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/&2006 TIME: 7 : 06AM PAGE: 35
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE 'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
. DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 036080 -01 503. 544.5620 N
Corrections /Comments /Instruction :
I ek—f
--
MAditt, w 1 v _—.
Ntet-64 i
4 1/4.a..tkr - o-cit-c- S
a J _ _ _ S .
V v.,/ V — 4-J---12-•24-5. +I) L-c____. --ceak---
- 11,...wr...6A..._ Nrov-P.. .
)V 4 7\4(iwil-a- VAAAft, •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` `' ° Date: I lfG / Phone #: (503) 2
P f � ) 718
CITY OF TIGARD ' ,.
BUILDING DIVISION PERMIT #: M ST200C 00120
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 MEIll I Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/21/2006 TIME: 6:58AM PAGE: 69 •
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
310 Crawl drain 035267 -01 503-544 -6620 N
Corrections /Comments /Instructions:
c- 7-ir-i -- 5 / Sa-e)7-- - -16-- J 's L 1
a- S' C ?
- 5 I ' cl,,,7 ..., .....,....__ .e„ 0.....e ---, - \ - -u --- V---ce.-- P.A.
L . , .-_ , 4 - 1- - -/v_-\ i , A *
ASS PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Dat e! Z` /6-62 Phone #: (503) 718L I
CITY OF TIGARD c
BUILDING DIVISION PERMIT #: MST2005- 00121:3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/113/2005 TIME: 7:03AM PAGE: 81
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLES ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 81/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
315 Post/beam plumbing 035190 -01 503 -644 -6620 ht
Corrections /Comments /Instructions: /
.PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL I I CALL FOR INSPECTION I ADDITIO AL FEES ASSESSED
I 2�.g
Inspector: t Date: • 0 I Phone #: (503) 718 -
I
CITY OF TIGARD •
BUILDING DIVISION . PERMIT #: MST200 0012B
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 13/W2006
Phone: (503) 639 -4171 / riµgi�� 1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/22'2006 TIME: 7 :O2AM PAGE: 30
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLES ACRES LOT #: 00) TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition. .
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 037035.01 503-544-6620 N
Corrections/Comments/Instructions:
CO 0iO FAN Qex.6 _
6 i►htG f Z 6Z- ' k,v14 1, 1 8a(L!■N kitiJ1`r v -
4 4 et.L`- o i 1,i5 vsh it co/1 W' W 2-1.. 6'2-- -
•
,
A PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
pector: Cr Date: 9 2 (1 Ph one #: (503) 718- �� -"
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2006.00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8l912005
Phone: (503) 639 -4171 i � ��l4,
Inspection Requests (24 Hrs.): (503) 639 -4175 ���
INSPECTION WORKSHEET FOR DATE: 10/512006 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 037758 -01 500 - 3644662 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: r Date: /G Phone #: (503) 718 - Z--- <r/
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MST2006-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639-4171 avetAi
Inspection Requests (24 Hrs.): (503) 639-4175 xt j.
INSPECTION WORKSHEET FOR DATE: 10/5/2006 TIME: 7 PAGE:
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 - TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: cmFR PHONE #:
Inspection Request Scheduled For: Date: 1 015/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 037758-02 500-354-4662
Corrections/Comments/Instructions:
( - ■11
I /'PASS fl PARTIAL APPROVAL CANCEL I I NO ACCESS .
I I FAIL EI ' ALL FOR INSPECTION LII ADDITIONAL FEES ASSESSED
AY
Inspector: Date: Phone #: (503) 718-
•
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MST2006-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/9/2005
Phone: (503) 639 -4171 / uiudph
Inspection Requests (24 Hrs.): (503) 639 -4175 W I �..
INSPECTION WORKSHEET FOR DATE: 3/28/2006 TIME: 7 :02AM PAGE: 18
SITE ADDRESS: 14070 SW 'S 14TH AVE CLASS OF WORK:
SUBDIVISION: COLES ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 0373/301 503.544 -6620 Y
Corrections /Comments/ Instructions:
ell �, s - - ��.t� 1 - • - : J A.t.; ie116,14'r�&.
%. -� ,, =/ , —Zf _ _ ( _ - =d/e.- A H
P SS n PARTIAL APPROVAL I I CANCEL H NO ACCESS
FAIL fl CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: ; Dater- 2 i ll' —4 6 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 u '4��ii�@ kkII
Inspection Requests (24 Hrs.): (503) 639 -4175 . ZIT/-
INSPECTION WORKSHEET FOR DATE: 9/27/2006 TIME: 7:07Am PAGE: 45
SITE ADDRESS: 14070 SW 114TH AVE . CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition. .
OWNER: WAGNER, tMMICHAEL PHONE #: .
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/2712006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 037208 -01 503. 6446620 N
Corrections /Comments /Instructions:
' 1 o.-v -r' .' iz eid ri4ui2. L /TOES
PASS PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9— —oe;• Phone #: (503) 718 - .
CITY OF TIGARD - ., . A
BUILDING DIVISION PERMIT #: MST2006- 00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2000
Phone: (503) 639 - 4171 ° u����l�
Inspection Requests (24 Hrs.): (503) 639 -4175 _�!�i
INSPECTION WORKSHEET FOR DATE: 9/22/2006 TIME: 7 :02A3vi PAGE: 29
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 480 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 037038-01 503 -5a4 -6620 N
Corrections /Comments /Instructions:
CI R te - - .6 4 N 6 v pet l iri V rit.4' CSC 4 lk 2 6v "
a M, e c o to m iv �•.4(Lite\�L. -
ID G.v , \ Ul 5 ��Qve •
-- tiiih b6 ®i, 1R F-N 5 �T k 11 a W AU.-,.
•,‘ V L'
14 e k 4Pt f4(L. V(tta (C 1'1 6066' .
u 11
S�' (i- . (N Ai Li o (t, 0 Ft� v coot.
1
PASS ,PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ° Ii \J 6 Date: It iii 0 Phone #: (503) 718- Ttit •
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: MST2006.00126
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 wq��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/1112006 TIME: 7 :00AM PAGE: 9
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNFR
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9111/2006 Pour Time: 10 : 00
Code # Inspection Description Confirm # Contact # Message
206 Footing 036322 -01 603.544 -6620 N
Corrections/Comments/Instructions:
i)- b1N5c)IJa ( --: CiA.44 4.4517n7r- — - j6 \ aL t, 6: - 0 i" . Vi ,----
/
❑ PASS FP / PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: l o to Phone #: (503) 718 4 - 4=6"
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Iv9Si 20QG£10 28
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 4 0041#
Inspection Inspection Requests (24 Hrs.): (503) 639 -4175 11.
INSPECTION WORKSHEET FOR DATE: 9/8/2006 TIME: 7 :00AM PAGE: 32
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER ,
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9 /8/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 036246-02 503 - 476 -7900 N
Corrections/Comments/Instructions:
•
1,--r PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ‘7 Date: Q-- 6-- Phone #: (503) 718- Z-4-‘1-3----
CITY OF TIGARD
BUILDING DIVISION PERMIT #: tviST2006-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/912006
Phone: (503) 639 -4171
AA 40A �°9 10� ili e
Inspection Requests (24 Hrs.): (503) 639 -4175 - :_..
INSPECTION WORKSHEET FOR DATE: 918/2006 TIME: 7.00AM PAGE: 33
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/8/2006 Pour Time: 9
Code # Inspection Description Confirm # Contact # Message
206 Footing 036246 -01 603.476-7900 N
Corrections /Comments /Instructions:
. K .. LL "Ni A. 4 s • i 2 Sc.) i:eS ,,..,_rte, Yti./0 .r rt
1 —1 5 1/4u.) / 7 „_ i U — ''--c: t ,:4..# p 07
1 tv
I PASS"" PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: / " Date: • g -- -- Phone #: (503) 718- -
18- S�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006- 00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 ,,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/8/2006 TIME: 7 :00AM PAGE: 31
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/&2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
230 Underfloor insulation 0366246 -03 503.476 -7900 N
Corrections /Comments/ Instructions:
SS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
9 4
Inspector: ' Date: 9- --.1- d d Phone, #: (503) 718 - g-1 -- /S'
L
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2006-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 819/2006
Phone: (503) 639 -4171 -40 ,00iiill
Inspection Requests (24 Hrs.): (503) 639 -4175 I
INSPECTION WORKSHEET FOR DATE: 9/6./2006 TIME: 7 : 06A PAGE: 33
SITE ADDRESS: 14070 SW 114TH AVE. CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot. addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/6/2006. Pour Time:
Code # Inspection Description Confirm # Contact # Message
230 Underfloor insulation 036.080 -03 503-544-6620 N
Corrections /Comments /Instructions:
•
ASS PARTIAL APPROVAL n CANCEL n NO ACCESS
I FAIL ) ALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: 9 ------/‘' Phone #: (503) 718 - Zc4-1-;-
CITY OF TIGARD ,.
1 BUILDING DIVISION PERMIT #: MST200 00128
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/9/2306
Phone: (503) 639 -4171 Alk hoodoo( I .
Inspection Requests (24 Hrs.): (503) 639 -4175 `'' ..
INSPECTION WORKSHEET FOR DATE: 9/6/2006 TIME: 7:06AM PAGE: 32
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 902006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 038080 -04 503 - 5446620 V
Corrections/Comments/Instructions:
/ st/4 /C ,- tom x0/f 4`-
US e g>' . - - AL \erA- ... c.a/ Z� A- 4- ( -- ; -2 - ) "Ue./ l7 Si (-C.--
PASS I I PARTIAL APPROVAL CANCEL n NO ACCESS
F it CAL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date:' -- O -- e Phone #: (503) 718 - 'Z
, CITY OF TIGARD ,. .
BUILDING DIVISION PERMIT #: iVi ST2006.00128
13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 8/9/2006 Phone: (503) 639 -4171 i67 �y�
Inspection Requests (24 Hrs.): (503) 639 -4175 .'''.�..
INSPECTION WORKSHEET FOR DATE: 9/6/2006 TIME: 7:06AM PAGE: 34
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
236 Shear walls/anchors 036080 -02 503- 514 -6620 N
Corrections /Comments /Instructions:
0 si 64
\
/.
.
ASS I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL I CA L FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 9 -'O - Phone #: (503) 718- f--4 -4.'V
r .
CITY OF TIGARD A .
BUILDING DIVISION PERMIT #: M ry'1t 206-00128
AR 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 gAii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/5/2006 TIME: 7:03AM PAGE:
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: g /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 035990-01 503 - 476 -7900 N
Corrections/Comments/Instructions:
4 /C v A t-' l, • ,p,o ) °mss,.,.;n
•
PAS- ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ��S`-�� Phone #: (503) 718 - �-'
_,..� _ ..
CITY OF TIGARD , •
BUILDING DIVISION PERMIT #: ST 006001 8 ,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 iufhp I ii�I
Inspection Requests (24 Hrs.): (503) 639 -4175 ;�' __..
INSPECTION WORKSHEET FOR DATE: 9/5/2006 TIME: 7 :03Am PAGE: 39
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COIFS ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 035909-01 503- 476 -7900 N
Corrections /Comments /Instructions: , -,4-..)
A C i l-- ;)-- ee ) \.e. 4 /0,=; Co " t----e,k.sit e,,,,, 5 i -;---- ( PAS ❑ PARTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: - Date: - - Phone #: (503) 718 - 2-
r r ,. -
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005 -00125
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/9/2006
Phone: (503) 639 - 4171 �✓fn��i 1 (
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 8/29/2006 TIME: 7:01AM PAGE: 37
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COL.E'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/29/2006 Pour Time: 2:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 035716 -01 503.544 -6620 N
Corrections /Comments /Instructions:
TWO I Set-iii i7 c.2,'s t� r�rzs -' -,— < - :"mss- r.t•,/-
-
PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
l' Date: , -- _r,c Phone #: (503) 718- 441
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST200& -00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: BFB /2006
,A
Phone: (503) 639 -4171 bigIgp a Ytv
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/21/2006 TIME: 6 :66AM PAGE: 513
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 4 00 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: W21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
226 Postlbeam structural 035267 -02 (3- 5446620 N
Corrections /Comments /Instructi ns:
.14/1 I ,Cv
UNA.J\Q
-e _(s)
74_)
o p PASS (l PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1/ Date: O/D Y Phone #: (503) 718 -2
CITY OF TIGARD .. ...
BUILDING DIVISION PERMIT #: MST2006-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2006
Phone: (503) 639-4171 i
0
Inspection Requests (24 Hrs.): (503) 639-4175 , „
INSPECTION WORKSHEET FOR DATE: 8/11/2006 TIME: 7 %Am PAGE: 11
SITE ADDRESS: 14070 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: COLE'S ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: WAGNER
DESCRIPTION: 400 sq foot addition.
OWNER: WAGNER, MICHAEL PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8111/2006 Pour Time: too
Code # Inspection Description Confirm # Contact # Message
205 Footing 034837-01 503-544-6620 N
:2/0 rr
Corrections/Comments/Instructions:
/2•
,.,
■
PASS 0 PARTIAL APPROVAL El CANCEL fl NO ACCESS
0 FAIL I I CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: ,-7 Date: -/,i Phone #: (503) 718-
•,.