Permit 1
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2005 -00237
�i� DEVELOPMENT SERVICES DATE ISSUED: 7/12/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110BA 00390
SITE ADDRESS: 14040 SW 117TH AVE ZONING: R - 4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: 80 square foot kitchen addition and electrical upgrade.
BUILDING
REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 80 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: TURD: sf RIGHT: 5
VALUE: 7,392.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 80 sf REAR: 15
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 8 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: 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:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
JAMSHED, SINA OWNER and all other applicable laws. All work will be done in
14040 SW 117TH AVE accordance with approved plans. This permit will expire
TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: 503 - 590 - 6792 Phone: 503 475 - 3180 adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through
952 -001 -0080. You may obtain copies of these rules or
Reg #: direct questions to OUNC by calling 503 - 246 -6699 or
TOTAL FEES: $ 399.96 1 -800- 332 -2344.
REQUIRED ITEMS AND REPORTS
/ , i .i
Issued AIMP "0 '' l • Permittee Signature : i ll♦ / r iir
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that bus ness day. r jr,---;100,-
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.
,
Building Permit Application FOR OFFWL' USE ONLY
City of Tigard Received fillip 2
Date /B . ®Q .9 Permit No.: M5 , di 0� �0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review -
Phone: 503.639.4171 Fax: 503.598.1960 Alibb 1 �r „,,', . Date/B . CAA 1.1 7 j - OS Other Permit:
Inspection Line: 503.639.4175 � `!1. Date Ready/By: FM ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/method: _ Supplemental information
' TYPE OF WORK ., REQUIRED DATA: 1 AND 2 FAMILY DWELLING -
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
X Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ /` 3 :;?
1 -and 2- family dwelling ❑Commercial /industrial / �,
El 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: / 6/41.0 S bo j) 7 / lye p New dwelling area: square feet ' ' r
City /State /ZIP: —1-1 4 YG( , n►� � ?IL) r? J Garage /carport area: square feet
Suite/bldg. /apt. no.: t ,_ Project name: _ Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
C Oa rie ,S G✓ / � .c, �� ('
j Other structure area: square feet
e� / ” Q.v.< O , ,c 1..t./ /I7 4/ REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: ,._2 GG Permit fees* are based on the value of the work performed.
Tax map /parcel no.: S' �d Q� Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK 1_ , l(A 1 t work indicated on this application.
t � pr a rty � � irr�l� 2 � tu TPiAckc Valuation: $
VD ' Existing building area: square feet
New building area: square feet
PROPERTY OWNER I , • ❑ TENANT Number of stories:
Name: S Aa H AT € . i S Ile fit ' Type of construction:
Address: / 3 3/0 S 6 il n r i // 0 y Occupancy gr o ups:
City/State/ZIP: T / 1
e://ti q.7 2 ' / Existing:
Phone: ( 23) , 1 l Fax: ( SG') )) Si.
b 792 New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: /t// Al! contractors and subcontractors are required to be
` n •r, �- licensed with the Oregon Construction Contractors Board
Contact name: `
Saar e / G �c - under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) /l I Fax:: ( )
E -mail: S MA • d in,C441 ). Ci • l‘41--, .
.CONTRACTOR
Business name: t, BUILDING PERMIT FEES* " `
Address:
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
Phone:( ) Fax:( )
CCB lic.: Amount received
7 Date received:
Authorized signature:
/ / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: - �� Date: .. * Fee methodology set by Tri- County Building Industry
_ - •.i
Service Board.
i:\ Building \Permits\BUP- TI- PermitApp doe 12/03 440- 4613T(I I /02/COM/WEB)
i
Building Division
" �'` {{ Plan Submittal Requirement Matrix
_'' Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
. • Type .of Submittal # of Plans'
' (Includes new, additions and alterations.) Required at
Submittals
•
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 3**
Mechanical 2
Plumbing (building fixtures) • 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
•
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i: \ Building \Petmits\BUP- T1- PermitApp.doc 12/03 440-4613T(II /02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received �� A_ Permit No.: W 5 f; -' . Aii
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
/� /.�.�//1' ,�
Phone: 503.639.4171 Fax: 503.598.1960 f«i' I''�` Date/BY. Other Permit:
. Inspection Line: 503.639.4175 " I Date Ready/By: Ju ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: (cC2 Supplemental Information
• TYPE OF WORK PLAN REVIEW ' _
❑ New construction ❑ Addition/alteration/replacemcnt Please check all that apply:
El Demolition ❑ Other: 0 Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps - rating ['Bulldog over 10,000 sq. ft.,
. CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ l- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family El Master builder 0 Other:
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND ,LOCATION", ❑Egressflighting plan RV park
Job no.: Job site address: /.r0 ❑Health -care facility ❑Other:
4'7 .S Submit 2 sets of plans with any of the above.
. City / State/ZIP: 0 R y 7 3 (,t/ 1/ A Lie The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: u Project name: FEE* SCHEDULE _ ,
Description I Qty. I Fee. I Total I **
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
l3 ' <ruch., /�LL Al iie C N y,i'/ 4(1 C.,/e14.r.Z.) 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.:3 0 r l Ea. add'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 • 2
S Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
rf P 6- ra d G t7e rir I LG4 / /(44 / Services or feeders installation, alteration, and /or relocation
200 amps or less [/- 80.30 80 2
._4 PROPERTY OWNER I 201 amps to 400 amps 106.85 2
' t
❑ TENANT
401 amps to 600 amps 160.60 2
Name: S i Ia jr 601 amps to 1,000 amps 240.60 2
� S e
Address: l 3 31 -7 s. 1.4J ® ; � 0 Over 1,000 amps or volts 454.65 2
�? '✓ Reconnect only 66.85 2
City/State/ZIP: -7-:(414, lA P1 OR 9 7> Z 3 Temporary services or feeders installation, alteration, and /or
Phone: ( Fax: [� 510 - -�7 G relocation
5 �C{ - 6 77 I 6-o / . 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, re ,o' or exchange, accord g to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: a� , _ - I ` ./ _ � - Date: 6 027 Branch circuits - new, alteration, or extension, per panel
r
• ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
' service or feeder fee, each 6.65 2
• Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, , 46.85 2
Address: each branch circuit
Each add'! branch circuit 8 6.65 55. P'a 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax::( )
Pump or irrigation circle 53.40 2
-� Sign or outline lighting 53.40 2
E -mail: S �� . t 1� M s htd S . ( Signal circuit(s) or limited-
.
CONTR CTOR . energy panel, alteration, or
Business name: 06 eL s...(0.-- extension. Describe: Page 2 2
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) I Fax: ( )
Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic:: I Electrical Lic.: 1 Suprv. Lic.: Subtotal 43 5.1)
Suprv. Electrician signature, required: Plan review (25% of permit fee) ��""
• Print name: ate: State surcharge (8% of permit fee) /0 •ty;
TOTAL PERMIT FEE t i 51, ` 0
Authorized signature: Thi permit a pplication expires if a permit is not ob ained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
S /hl �'I sAe� 7 ( I) /0.5
••
Number of inspections per permit allowed.
1:\ Building \Permits\ELC -Penn itApp.doc 12/03 440-46 15T(1 0/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
:RESIDENTIAL WORK ONLY:- 7
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'ONLY:
Fee for each commercial system $75.00
(SEE OAR 9] 8- 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
i:\ Building \Pemiits\ELC- PeimitApp.doc 04/03
•
Permit #: 3 5 - 06 p 137
Address: D ik . // 7 71-£
Issued by: , _0 L £_�".. 4 / Date: /- /
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: re Oregon Law, ORS 701.055(4), requires residential construction permit appli-
g 9
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:
Or 1. I own, reside in, or will reside in the completed structure.
FAUFA
1 f 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
pm , 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/ wners about Construction Responsibilities on the reverse side of this form.
(S t o permit pplicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
~ -
Information Notice to Property Owners
About���o ��n Respons
•
Note: This Information Notice to Property Owners about Construction Responsibilities
was developed by the Construction Co traCrors Board in accordance with ORS 701.055(5).
•
If you are acting as your ow contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of 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 vill be employees. As the employer you must comply with the following:
• Oregon's withholding tax law: As anemployer, you must withhold income taxes from employee wages at thetirne employees
are paid. You will be littble for the tax payments even if you don't actually-withhold the tax from your employees. For more
information, call the Oregon Dept. n[ Revenue ut945-R09l.
Unemployment insurance tax: As an employer, you are 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 compeiusation insurance, you may
be subject Vo penalties and will he liable for all claim costs if one o[ your employees in injured ootbcjoh. For more information,
call the WOfkerS' 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 ncomc tax from employees wages. You will be
liable for the tax payment even ifyou didn't actuallywithhoid the tax. For more information, cal [the Internal Revenue Service
at 1'800-829'1040: "
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
• Code nce: As the permit holder for this p joct,yooxrnx:oponaih(cfhrrenohio&auyfbi{un:k`noectcodoncquiremen(s
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools, paint overspray, water damage from. pipe punctures, tire, or work that must be
re-done.
Time to supervise employees: Make sure you have sufflcient time to supervise your employees.
Expertise: Make sure you have the expertiseto act as your own general contractor, to coordinate the work of rough-i n and finish
trades, and to notify building officials at the approprite times so they can perform the requiied inspections.
•
if you have additional questions. write or call the Construction Contractors Board (P0 Box 14140, Salem, (}R973O9'5O52,
503/378-462)). The Board is located at 700 Summer St. NE Suite 200, in Salem.
pmy vwn.pmv
'
=
JUL 12 2005
. CITY OF TIGARD
- .k,,< File Nd ::tuber 13►'�(! 1N ' r;i1 / Oxti
Clean \Water Services - : ,
- -- = °=_ ii Fi re- Screening Site Assessment
01.11' CUITiiilillilelll IS CICFIr,
Jurisdiction C' t I Date ______61_a_11</S_____________
Map & Tax Lot "T'a . Ca l Owner Si ri a.. Yt e/ >'i Ow rt
'2-5\■013kc.3 Contact > t, Al 1
Site Address /2./)l/ r Iii 11 rill ABC, Company / 4 -
ri / �.
l! r�r� U ✓1- X17 z3 Address , : �r i fi
Proposed Activity City State Zip - L e, . I
Phone e •
Fax '.5 -3 - -- - < 7 `f' Z.
Officio, use only below thle line
Y N NA Y N NA
7.;a — Sensitive Area Composite Map . _ Li ® Stormwater Infrastructure maps
Map it S\tom., -O-- QS # _,5i: -
M Li a Locally adopted studies or maps n Other ,
Specify 7." I 1 Specify c 'a
- "- -1 MCr --
Based on a review of the above information and the requirements of Clean Water Services
Design and Construction Standards Resolution and Order No. 04 -9:
7 Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT
MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE
PROVIDER. If Sensitive Areas exist on the site or within 200 feet on adjacent
properties, a Natural Resources Assessment Report may also be required.
1>< Sensitive areas do not appear to exist on site or within 200' of the site. This pre-
screening site assessment does NOT eliminate the need to evaluate and protect
water quality sensitive areas if they are subsequently discovered. 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.
Li The proposed activity does not meet the definition of development. NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
Comments:
i tea. ed tv yt f - Z , :, e--(- C J- vii j ote rL % i_., j
.r. , - __:._ t C » '-\e1 ` ,d' "Fp S-41.(Mk. �' : ,C4-1 .-
Y, _i ._ ^ Eta .
'Reviewed By: , - j c `i S 1 - Date: -- ` ', -
.J
Returned to Applicant
Date
1Vdai! 1 '✓ t �.Y.
Fax Counter
2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 m en
Phone: (503) 681 -5100 • Fax: (503) 681 -4439 e wwwSiw_alors;.rvic_r�4
Mr
II
iii PI
V0 /T0 30Vd QEHSHVI'H S - 66 1 906960S 'S: S00Z /ZZ /90
T j
CIT, TI ' D illk ,
BUI ISION PERMIT #: MST :005. 00237
13125 SW HaII,.BIvd., Tigard, OR 97223 DATE ISSUED: 7/12./2005
Phone: (503) 639 -4171 I���yp I�
Inspection Requests (24 Hrs.): (503) 639 -4175 �,' W `:_.. II� ''-
INSPECTION WORKSHEET FOR DATE: 6126/2008 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 14O4() SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 - 590.6782
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/26+2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 071891-01 825 -878 -5723 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO. ACCESS
I FAIL • n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: C. � 6r 6 Phone #: (503) 718-
CITY OF TIGARD , t
BUILDING. DIVISION . I. PERMIT #: MST 00 00 37
13125 SW Hall Blvd.,,.Tigard, OR 97223 DATE ISSUED: 7/1;,00 -,
Phone: (503) "639 -4171
A-
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7 :00AM PAGE: 24
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 00 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA PHONE #: 503 - 590.0792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1119/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 059402 -01 925- 878.5723 N
Corrections/Comments/Instructions:
fr
/ j Li IA loc.. Al / Z'_ .. -. kilt seed -��/r
7). 7,14*A1i LI 14 A-twil/M .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
VI FAIL V CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / ®/ P hone #: (503) 718 - 1 % ) .
P )
CITY OF TIGARD
BUILDING DIVISION ,. PERMIT #: MST2005 -00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12 /2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: /0110/2006 TIME: 7:06AM PAGE: a
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503.580 -6792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 037860 -02 971 -732 -0712 N
Corrections /Comments /Instructions:
J/1/116 J/1 f
fl/OW
3) £I Jhu
)` PASS n PARTIAL APPROVAL
n CANCEL ❑ NO ACCESS
' l
..AIL CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Date: / `7 `° D A* Phone #: (503) 718 -Q '/V
CITY OF
��xn m m.�m TIGARD
. . '
BUILDING DIVISION ' ' PERMIT #: bAET2005-00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A- -UL
INSPECTION WORKSHEET FOR DATE: 10/10/2008 TIME: 7:06AM PAGE: 9
SITE ADDRESS: 14NDSW117T}fAVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED -
DESCRIPTION: SO square foot kitchen addition and electrical upgrade.
OWNER: JAASHED.ENN/\. PHONE #: 503-690-$792 r
CONTRACTOR: 0 wVE8 PHONE #:
Inspection Request Scheduled For: Date: 10110/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037960-01 971'732-0712 N
Corrections/Comments/Instructions:
�x ----'---� -- -- �r��
•
PASS | | PARTIAL APPROVAL CANCEL I NO ACCESS
`
ri FAIL I I CALL FOR INSPECTION | I ADDITIONAL FEES ASSESSED
�
Inspector: ��r . Date: Olt( 0�y Phone#� (5O3\718'
`
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00237
13125 SW Hall Blvd.,,Tigard, OR 97223 DATE ISSUED: 7/11!2005
Phone: (503)"639 -4171 � ll�.
Inspection Requests (24 Hrs.): (503) 639 -4175 J .
INSPECTION WORKSHEET FOR DATE: 10/25/2005 TIME: 7:10AM PAGE: 10
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA PHONE #: 503. 590.6792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: ' Date: 10/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 019282 -01 503 - 380 -3778 Y
■
Corrections /Comments /Instructions: VP' 1
•
V
•
S PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
*)1 6 Inspector: Date: / ,_ I Phone #: (503) 718-
CITY OF TIGARD • MST2005-00237
BUILDING DIVISION PERMIT #: 7/12/2005
13125 SW Hall Blvd.,,Tigard, OR 97223 DATE ISSUED:
Phone: (503) "639 -4171 w u�4p� 0iliI
Inspection Requests (24 Hrs.): (503) 639 -4175
10/24/2005 7:02AM 21
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
14040 SW 117TH AVE
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: JAMSHED LOT #: TYPE OF USE:
PROJECT NAME: 00 square foot kitchen addition and electrical upgrade.
DESCRIPTION:
JAMSHED, SINA, 503- 590.6792
OWNER: OWNER PHONE #:
CONTRACTOR: PHONE #:
10/24/2006
Inspection Request Scheduled For: I Date: Pour Time:
C °ich # I gc ritraproug c ption Rgt t7 "i S8 - ? X778 Mes age
Corrections/Comments/Instructions:
K 1 4 , A r 4 # . _Ad / Aid ° . ;A . ,, tb P/I4q " I ,
■
t
Ti �b PA A, t M // 1 1
41. I hit 1 / I 1 .... • h / f 0 A 1
l'
�J r
I I PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
K FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ke Date: 1 b R "I 0 hone #: (503) 718-
r .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200S-00237
13125 SW Hall Blvd.,,.Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) '639 -4171 v Ip11i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 19
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 - 590.6792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: / Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 019021 -01 503-590-6792 N
Corrections /Comments /Instructions:
�D 4
n PASS I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL A CA LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: t Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) 639 -4171 k ii "1
Inspection Requests (24 Hrs.): (503) 639 -4175 g. - ' I..
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 28
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 - 590 -6792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # - Contact # Message
115 Electrical service 018841 -01 503 -380 -3778 Y Pill
Corrections /Comments / Instructions:
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL =OR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD L,. Fl, x � 6�Ae�g
BUILDING DIVISION PERMIT #: MST2005 -00237
13125 SW Hall Blvd. Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) '639 -4171 : �"4pu�il I�I�i..
Inspection Requests (24 Hrs.): (503) 639 -4175 =� :_..
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 59
SITE ADDRESS: 14040 SW 117TH AVE ; CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical u grade.
OWNER: JAMSHED, SINA PHONE #: 503 - 580 -8792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message f j
280 Insulation 021140.01 503.380 -3778 Y Ck-P -Coti tm.odo l�m
rcetU fika
Corrections /Comments /Instructions: 3 r0 377 s(
)9EgAa ot.J rt7d /e- ?fi J 2 a 6
4.h.o 1./tc9,Q 3744.4 id,740-., be l 6 a4 0 4/7v1.-c -e U\e4--i i4....J
2) WV. -. D - 1_4.,,p a' t�.,01 4604 (Ai /} . e )epa.4, j7 doa y, 02 fAte —
�[i4.377
8) i210- a...g, Mt/Le /p' p. � 17.6z 24..e . p A/h,ee by /1014 t-aecife..0
4) /2.2cr - Iftelle / KAD-eA. etA I ,u 1/0 -1.t &1 .
5) ' T- 4 a4/1el d /L hf'e- aJ e1 z7
,
•
IV PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspect ! / Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00237
13125 SW Hall Blvd.,.Tigard, OR 97223 DATE ISSUED: 7/12/2005 .
Phone: (503)'639 -4171 A p�i ,
Inspection Requests (24 Hrs.): (503) 639 -4175 J
. INSPECTION WORKSHEET FOR DATE: 10/26/2006 TIME: 7:10AM PAGE: 9
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 6603- 690.6792
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message r
275 Framing c i 019282 -02 503 -380 -3770 V Celt at, 5414
!` m ",-
Corrections /Comments /Instructions:
I
5--e-e W
2 Z Z l76 /Z,i1
/
v e'.o )6
t t 1 i I / /,°‘
1,.. 9 '711)
11:0 yu0--o--e...
PASS KPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Mt Date: I Air I • one #: (503) 718-
CITY OF TIGARD " ,
MST2005-00237
l BUILDING DIVISION PERMIT #: 7//12/2005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503)' 639 -4171 k " ti Nitiii
Inspection Requests (24 Hrs.): (503) 639 -4175 #__..
10//24/2005 7:02AM 20
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
14040 SW 117TH AVE
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: JAMSHED LOT #: TYPE OF USE:
PROJECT NAME: 80 square foot I addition and electrical upgrade.
DESCRIPTION:
JAMSHED, SINA, 503
OWNER: OWNER PHONE #: -
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
Cg # InseQtion Description OpiIil7;� C 8pt Menage
•
r mmg
Corrections /Comments/ Instructions:
t J . 'IA -2 / A.c ' C 1 5/ /7,5= d- " •- •- /11 , ::'
ir 4gc ., -_` • Sao N/L 1 r7i- fld &1 ( ',4U2 -T'
A - r�A -C.1 - i ag. -. S 5 /7 -� A17, 9A.&c r ,44., L.
X /C4— � /° ,- TC9i rz U /1,Att
K r - i_e_____V_E, -- -, a44
n PASS H PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
AL-FATI. I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
I
Inspector: Date:/e #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200500237
13125 SW Hall Blvd.; Tigard, OR 97223 DATE ISSUED: 7!1'J2005
Phone: (503)639 -4171 4 N�'Ipu�i N'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 9/22/2005 TIME: 7 :12AM PAGE: 12
1
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHEU
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: PHONE #:
JAMSHED, SINA, 503
CONTRACTOR: OWNER PHONE # 5503 - 3180
Inspection Request Scheduled For: Date: 9/2212005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 016382 -01 503- -380 -3778 Y
Corrections /Comments /Instructions:
14/ flc * -�-\ -t /-41 , 7-TO-if el ,,,V y
'ASS I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL % ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector. _ _ late: 7ZZ S Phone #: (503) 718 -
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005,00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503)• 639 -4171 knoollill �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7:07AM PAGE: 42
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 59 6792
CONTRACTOR: OWNER PHONE #: 503
Inspection Request Scheduled For: Date: 9120/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
225 Post/beam structural 016152 -01 503- 380.3778 Y jOM#1
Corrections/Comments/Instructions:
( ) P /C-a v r br.5– -- ems; l0 u Wr Pt A--Ni j l4r �� A /G- -�
A aid — s Q■ - fr. J - �, 00 ® --- 'S
C S / poSi t 1 PA-)S T-C. '1 J 1r' o r%r
- iAi A.( - !. - A►-c� . A 'in 2 L
1114f, ` R r =�/ i S/ o ■.. dil
•
I PASS VPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL IN LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -- — Date: � Phone #: (503) 718-
%1111
CITY OF TIGARD .
BUILDING DIVISION #: MST2005.00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) 639 -4171 44 i1p i 0
Inspection Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7 :07AM PAGE: Al
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 - 590 -6792
CONTRACTOR: OWNER PHONE #: 503
Inspection Request Scheduled For: Date: 9/2012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
230 Underfloor insulation 016162-02 503-380 -3778 N
Corrections /Comments /Instructions:
PASS in PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL FA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ■ 4 _ -∎ Date: /26 C:7) Phone #: (503) 718-
_
I
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005-00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7112!2005
Phone: (503)' 639 -4171 4 'I140i�#
Inspection Requests (24 Hrs.): (503) 639 -4175 1.L.
INSPECTION WORKSHEET FOR DATE: 9/19/2005 TIME: 7 :06AM PAGE: 34
r -.,4 fI- z7G
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 -590 -6792
CONTRACTOR: OWNER PHONE #: 503.4755 -3180
Inspection Request Scheduled For: Date: 9/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 016024 -01 503. 380.3778 N
Corrections /Comments /Instructions:
�■
/0 471/t
1\607 : = F )/ 3 FU 77
Par 7A 77lIS 77t'9<
PASS • 'ARTIAL APPROVAL n CANCEL ❑ NO ACCESS
in FAIL IV FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ i _ Date: / 7. (D J Phone #: (503) 718 -
CITY OF TIGARD -
BUILDING DIVISION #: MST2005 -00237
13125 SW Hall Blvd.; Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) 639-4171 / o,e 1 +a A l l
Inspection Requests (24 Hrs.): (503) 639- 4175!�i ,...1..
INSPECTION WORKSHEET FOR DATE: 8/24/2005 TIME: 7:08AM PAGE: 23
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE: •
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SING, PHONE #: 503. 590 -6782
CONTRACTOR: Ol l ER PHONE #: 503 - 475 -3180
Inspection Request Scheduled For: Date: 8/24/2005 Pour Time: 11 :00
Code # , Inspection Description Confirm # Contact # Message
210 Foundation walls 014201 -01 503 - 380.3778 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
. 4 ,
Inspector: f Date: Z4 °S Phone #: (503) 718-
Y OF CIT O TIGARD .
BUILDING DIVISION PERMIT #: MST200S -00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005 .
Phone: (503) 639 -4171 Wit
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: (8/23/2005 TIME: 7:05AM PAGE: 10
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 603-590-6792
CONTRACTOR: OWNER PHONE #: 503 - 475 -3180
Inspection Request Scheduled For: Date: 8/23/2006 Pour Time: 1:00
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 014109.01 603-380-3778 Y
Co /Comments /Instructions: _ --
e_ii2c i r1 < C iA-$- y.) i )✓ .1 S o S i 25-
I I PASS I I PARTIAL APPROVAL I I CANCEL _ NO ACCESS
FAIL ri CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: 7 Z 3— o --- Phone #: (503) 718 -
CITY OF TIGARD .
BUILDING DIVISION .. PERMIT #: MST2005-00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503)639 -4171 k" 11 1P Ali
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8119/2005 TIME: 7 :07AM PAGE: 23
SITE ADDRESS: 14040 SW 117TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JAMSHED
DESCRIPTION: 80 square foot kitchen addition and electrical upgrade.
OWNER: JAMSHED, SINA, PHONE #: 503 - 690-6792
CONTRACTOR: OWNER PHONE #: 503- 475 -3180
Inspection Request Scheduled For: / Date: 8 /19/2005 Pour Time: 12 :00
Code # Inspection Description Confirm # Contact # Message
206 Footing 013926 -01 503. 380.3778 V
Corrections /C:' ments /Instructions:
∎'
�f
�� y •
A lr
MP
I) ,
e% �. / tea°" -�� % J�% 1L �J iL �� i ` Jt/L
) C4,1172 tit PgA
i IP r - I) A e
a / )S
( 1 6 tioi 01 .
PASS is PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL / I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 51/ one #: (503) 718-