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Permit C CITY OF TIGARD MASTER PERMIT PERMIT #: MST2006 -00046 ,1:ii/c DEVELOP SERVICES DATE ISSUED: 3/24/2006 Hall PARCEL: 1 S134C - 02400 SITE ADDRESS: 11965 SW 118TH AVE ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS NO.3 LOT: 053 JURISDICTION: TIG Project Description: Addition. BUILDING . REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 416 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 416 sf 38,438 40 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 4 MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FOR: a� PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /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 /FOR> =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 BRAD & PEN DIXON OWNER applicable laws. All work will be done in accordance with approved 11965 SW 118TH plans. This permit will expire if work is not started within 180 days TIGARD, OR 97223 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: 503 - 590 - 3607 Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1-800-332-2344. Reg #: TOTAL FEES: $ 1,032.83 REQUIRED ITEMS AND REPORTS Issued By : "2 �5^1 Permittee Signature : -e-, tr,e 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. ,1 Permit #: S1' -,26 ‘ — DD6 ej K Address: ( v:1 6,,- S ■ \) ( "' Issued by: L Z /j, Date: .5 j --66 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: A. I 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 ■ 11 ► 3B. I will be my own general contractor. r 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 Const ction Responsibilities on the reverse side of this form. . (Signature e permit app • ant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Enfoormaton Hot'ce tt Property Owners About Construcfion RespoU0sb^Nes Note: This Information Notice to Property Owners about Construction Responsibilities it'as de'cloj,ed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own 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. EMPL..)YER �ESPORISi 'MUTES: 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 be employees. As the employer, you must comply with the following: • Oregon's withholding tax law: As an employer, you must ‘,vithhold income taxes from employee wages at the time 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. of Revenue at 945-8091. 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 Depmboenrut 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. If you fail to obtain workers' compensation insurance, you may be subject tnpeouJtiosuodr/iUbc|iah|oforu||u|uimcosiuifmncofynuronup|oyeeuiai jured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal evenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable forthe tax payment even ifyou didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1-800'829'1040. OTHER RESPONSICLITUES AND .AREAS OF CONCERN: Code compliance: /\s the permit holder for this project, youurercsponsih|e for resolving any failureto meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see ifyou you have adequate insurance coverage for accidents and omissions udas fo||iog1o0|s,paintove,spruy,waterdannage froni pipe punctures. fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coord inate the work of rough-in and finish trades, and to noti' 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 |4\40, Salem, OK973O9'j052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300 in Salem. pmp'n"u.pm* i/V4 Build ng Pe rmit Apia l C, 1 Iv Etk FoR OFFICE USE ONLY City of Tigard DaceiBY - - Permit No.. 2®) 1,, OW ] 6 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re ew Phone: 503.639.4171 Fax: 503.598.1960 FEB ; 111/„. �'i t r,� +a 1 Daten3 . q kl 3 -) - d G Other Permit: 15 2006 Inspection Line: 503.639.4175 J ' Date Ready/By: H See Attached Checklist for Internet: www.ci.tigard.or.us y OF -t. A Notified/Method: i/ _ /1/4.Z..-- Supplemental Information REQUIRED DATA: I- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all " Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. - vi`i 3se .10 ln. 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ °` _ El Accessory building El Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: (la New 5 , l.J . (1 g'�` New dwelling area: qg square feet City /State /ZIP: f I (a A..e..70 O 12.-- q - 122: Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street /directions to job site: ( 2_( Si N l ' c t k ter t✓ }S U j ' Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK . work indicated on this application. 1 (0 ; 14 - n Pet 1�® 7 In - Valuation: $ Existing building area: square feet New building area: square feet )ROPERTY OWNER ❑ TENANT Number of stories: Name: -Jw - % I, e ) \ `&J) Type of construction: Address: (1 cik, 5 S t1/4...3 , \ \i-IA, Occupancy groups: City/State/ZIP:-11 V A- CO_ cZ't,Z 3 Existing: • Phone: (5.03 ) 5`10 - 7j b 6 Fax: (5=.',) 1-+S2.--- "l b New: . `a\APPLICA.NT ❑ CONTACT PERSON NOTICE Business name: e C f5 Ike, 9C All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board 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:( ) Fax::( ) E -mail: CONTRACTOR Business name: PriA C k5 4 -12. NE. BUILDING PERMIT FEES* Address: Please refer to fee schedule. City /State/ZIP: Fees due upon application 9 Phone: ( ) Fax: ( ) Amount received CCB lic.: , ,� Date received: Authorized signature: �..F'� `^^� (� ( This permit application expires if a permit is not obtained JJ �t� within 180 days after it has been accepted as complete. Print name: f ,12 - ) ' l X I. Date: 2. i - ob * Fee methodology set by Tri County Building Industry Service Board. i:\ Building \Permits\BUP- PernilApp.doc 12/03 440 .4613T(11 /02/COMIWEB) • One- and Two- Family Dwelling Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received Daze /By. Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598,1960 �� 24- Hour Inspection Line: 503.639.4175 ■ ; ,,I II ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us ❑ Other. THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW v« No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 ' Verification. of approved plat/lot. ❑ ❑ ❑ 4 Fire district a i i royal re f uired. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc., 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 1 I Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size 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 applicable to the project under review. JURISDICTIONAL PE :1 'l 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 Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. L\ Bui 'ding \Permits\B UP-RE S- PermitApp.doc 2 Electrical Permi; p i s 'f iOnI r- ki , FOR OFFICE USE ONLY - City of Tigard Date /Bed Permit No.. 13125 SW Hall Blvd., Tigard, OR 91_2 ;3 2006 Plan Review Phone: 503.639.4171 Fax: 503.59 -- /�'" ^ti�''�Nt �li +' Date/B . Other Permit: Inspection Line: 503.639.4175 r Date Ready/By: Juris: EI See Page 2 for Internet: www.ci.tigard.or.us CI OF I l j -a � Notified/Method: Supplemental Information PI M PibN1fOl' . vOit 0 ON PLAN REVIEW , ❑ New construction Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ❑Hazardous location ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder El Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑ Manufactured structures or, JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: t l`v1„, 5 , , 1! 1 S ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City / State/ZIP: -it coorc2_, c 9.- , The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE Description I Qty. I Fee. I Total I .• Cross street/directions to job site: l Z I' iJ Epc-rt_ tj k L 1 ,3 I ,,t,T New residential single or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 . . DESCRIPTION OF WORK Each manufactured or modular V--ea 1 n Ate- Ns) o al 0.,f-- dwelling, service and/or feeder 90.90 2 �✓ Services or feeders installation, alteration, and/or relocation 200 amps or less 1 80.3.0 2 'ROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 2 - o L�1,,s N A p 1 ' L j 601 amps to 1,000 amps 240.60 2 Address: l kct t 5 5 . t 1 - 3 . Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State/ZIP: 'n, L priii., ') , 0IZ G\ 2, 1 23 Temporary services or feeders installation, alteration, and/or relocation Phone: (s sc., J - - .4 ) ( 0 .1 Fax: (S •) 1 452. - 1316 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 exc ge, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2' • Owner signature: ti Date: 2 - IS `ab Branch circuits — new, alteration, or extension, per panel APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 3 Business name: I Q l s P3 -\) branch circuit 6.65 2 B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 Address: first branch circuit Each add'l branch circuit 6.65 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: Signal circuit(s) or limited- , CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 rn Business name: c f P 1,-\)‘...._,%-r. Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: Investigation per hour (I hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL .PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: X42) This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete Print name: \- -harm ) 1 Y...,1%.\ Date: - 2 - t S - o b * Fee methodology set by Tri- County Building Industry Service Board '• Number of inspections per permit allowed. 1:\ Building \Permits\ELC- PemitApp.doc 12103 440- 4615T(l 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 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ B oiler Controls ❑ C lock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ H VAC ❑ Instrumentation ❑ Intercom and Paging Systems Cl Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ P rotective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC- PermitApp.doc 04/03 Mechanical Permit A n ° c l o uv FOR OFFICE USE ONLY R eceived A City of Tigard y . Permit No.: ` 1 ei • —� ,, ' Date/B . {- � 13125 SW Hall Blvd., Tigard, OR 97223 FEB 15 ' 200 Phone: 503.639.4171 Fax: 503.598.1960 A i ti Ar o y ?, -I•, , Plan atte/RBY ew Othe Permit: Inspection Line: 503.639.4175 ' I Date Ready/By: Juris: El See Page 2 for err Internet: www.ci.tigard.or,us 'J OF 11': - tea,- Notified/Method: Supplemental Information 30e-10F T ZINC:IMATISION WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction ddition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ �,�'' RESIDENTIAL EQUIPMENT / SYSTEMS'FEES* - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi family ❑Master builder For special information use checklist. ❑ Other: Description I Qty. I Ea, I Total JOB SITE INFORMATION AND LOCATION Heating /cooling Job site address: 1 R b S 5 • k-,-) i cd t Air conditioning or heat pump ` t) (requires site plan showing placement) 14.00 City /State /ZIP: L )0' 0 b 9 "1 Zz.; Fumace 100,000 BTU (ducts/vents) 14.00 Fumace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street /directions to job site: ( 2,1 • N Ppot W yk �,1J Vl' 1-- Duct work I 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 1 i () (--:----).\ .T1 P' ... r.9 9 1.11 bN Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue/vent 10.00 PROPERTY OWNER ❑ TENANT Other: 10.00 Name: V i 7r�� D I Environmental exhaust and ventilation Range hood/other kitchen Address: \1000 S S • u3 , 0? . equipment I 10.00 City /State /ZIP: L, ' -(L o Yl._ s "I2Z 3 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( 5 S - 3k. .fl Fax: (Ss3) 1452- 71110 toilet compartments, utility rooms) 6.80 APPLICANT - ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Other: 10.00 Business name: 1 PjY` \T PIS AjJ i Fuel piping Contact name: • $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: C J firs(‘ \ c e l J\I - Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: 3 ./.S)...,_ ISM This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 9-,-) CK7 ty...z. Date: - 2- t S - O1„ • Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits\MEC- PermitApp.doc 12/03 440 -4617T (I I /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total_Valuation Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 Building Fixtures Plumbing Permit APO t fi "1. " \ a FOR OFFICE ICE use ONLY • Received A � /, co ^�� City of Tigard Permit No. Q V Date /By 13125 SW Hall Blvd., Tigard, OR 97223 FEB 15 2O,(1 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 r CD # e, »<r Y� NP '• Date /B Other Permit No.: 24- Hour Inspection Line: 503.639.4175 I_ y Internet: www.ci.tigard.or.us a ' - Date Ready/By: Jud:: ® See Page 2 for CITY .g 1' Notified/Method: Supplemental Information TM ) 1 f D��1IS`!4 FEE* SCHEDULE' CI New construction � ❑ Demolition For special information use checklist. Description I Qty. 1 Ea. I Total A ddition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 CI Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: 1 Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: i IC 5 _ L.) . l \I± Catch basin or area drain 16.60 7 T1 ,„ 1 012 �11ZZ City /State /ZIP: Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Cross street /directions to job site: (L SI ON-a_ Manufactured home utilities 110.00 L I, � ( Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 • 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 Back flow preventer Page 2 12--e? ` T\ ikt- P -O O ti-v6 y J Backwater valve 16.60 Clothes washer S 16.60 Dishwasher ` 16.60 Drinking fountain 16.60 .PROPERTY OWNER ❑ TENANT . . Ejectors/sump 16.60 Name: 12A ` peN)1J.k N...oti., Expansion tank 16.60 Address: k kc S . W • ((g' Fixture /sewer cap 16.60 . . City /State /ZIP: --n L -o 011_ crk12, Floor drain /floor sink/hub 16.60 Phone: (Sz S ' 3io Fax: (S >3 ) aS2- - Itlie • Garbage disposal ( 16.60 Hose bib 3 16.60 APPLICANT ❑ CONTACT PERSON Ice maker ( 16.60 Business name: ll\� P ,■ Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory ( 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: 5 nC AS j Water heater 16.60 Address: Other: Subtotal City /State /ZIP: Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 • CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: ?c2 - c) I y io Date: Z- 1S- ob 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. is \Building\ Permits\ PLMF- PermitApp.doc 06/05 440-4616T(10 /02/COMJWEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: T ° ' ' quar Site e Foota - Permit Fee: - av, U.t111t1eS � • �QtY, : • F e e { ea) Footing drain - 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 $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 Qt _ Fee (ea) Total additional $100.00 or fraction thereof, to and $10 Commercial Back Flow Prevention Device 46.40 $14 0 for r the first rst $ $10,001.00 to $25,000.00 $148.50 $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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. 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 more 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 Ice Mach./Refrig. Drains 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 p 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 „„ 4„,poit CITY OF TIGARD RESIDENTIAL PERMIT APPLICATION REVIEW ®iREG®N Permit Number joo( -e, Lot No. ---- Subdivision -- Address ! 1V-i Siel i ✓ejbt., . fit Contact Name ,/.} -0 Dlxo ei Business _ Street , q,,,.,6, 4K' 4-t2„'/' City -7•?6,A_T State KyA I Zip ? 7a? As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and plans have been reviewed to determine if it is complete and if the plans are deemed "simple” or "complex" as defined in ORS 455.467 and 455.469. kl The application is complete. The application is incomplete for the following reason: NF; D 1 €U5 D(1 �( The submitted plans will be reviewed; however, a penniit cannot be issued until the above information is reviewed and/or approved. The submitted plans cannot be reviewed until the above information has been submitted and/or approved. The plans are deemed "simple ". The plans are deemed "complex ". If you have any questions, please call Chad Williams at (503) 718 -2708. aj (/'■, ‘.g / 062 Name of Plans Reviewer Date 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772 ■ Feb.17. 2006 4:07PM CLEAN WATER SERVICES 503 6514439 No.1214 P. 1 I I)) Le' (1,c) FEB 1 5 20 � • File Number CeanWate \ Services C�� ,s Our commitment is clear, Sensitive Area Pre - Screening Site Assessment Jurisdiction TICS - A Date Map & Tax Lot LoT 53 , LE N4:1tatAT. 0 3 Owner B1 I: PO.) Kt pt x�rJ 1 • 1 3 c•0 02440. Applicant Site Address A_ tt„,5 s tJ�,1h Company E T1cl o-o c `•t 1Li Address 11%5 S - uJ • 118 Proposed Activity - � - �ioCr - 1.r - i pre' oL ru City State Zip Tte me-40 o Phone So 3 - Fax 5'03 - y °a4 Z By submitting this form the Owner, or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. Official use only below We Doe �rtlefa{ uce tardy below this line Y N NA Official use only bclow thla tine Y N NA Sensitive Area Composite Map P1,1 I Map # / IWD I I QS # wateinfrastructure maps n 7 Locally adopted studies or maps -- Other Specify • Specify 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: n 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. 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, • n The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. • • Reviewer Comments: • Reviewed By: G ' _ Date: Post -it ° Fax Note 7571 ,�, payee► DAfe 1 Waif i ffot / Official use only To 13.471 %x�h Fronk / d'V Returned to Applicant Co./nept. Co. (i Mail Fax Ot Counter Phone e # Phone n Date 2/� �/ B _ Q tom` So3.6 -5700 Fa x # 5 . 0 3 , T7r�' 78 � F oie # r• February 5, 2008 Brad & Penny Dixon 11965 SW 118th Ave Tigard OR 97223 RE: Permit MST2006 -00046 This letter is notification that the referenced permit for the work at the above address has not received a final inspection. Since more than six months has elapsed with no inspection activity, it is assumed that the work has either been suspended or abandoned and this permit will be expired by limitation as provided in Section R105.5 of the Oregon One & Two Family Dwelling Specialty Code. Please be advised that, in the event of a subsequent sale of your home, the lack of inspection approval for this permit could delay closing. The lending institution and /or the title company may require proof of a completed permit for such work prior to the sale of the property. We will allow thirty (30) days from the date of this letter to apply for reinstatement of this permit for the purpose of final inspection(s). Certain fees will be applicable at the time of reinstatement. A reinstated permit will be valid for 30 days. If the required inspection(s) fails, you will have an additional 30 days to make the necessary corrections. A minim fee of $70.00 will be assessed for additional inspection(s). If you fail to request these additional inspection(s), this permit will be expired without the opportunity for reinstatement. If you have any questions about the permit or its status, please call Jeanne Temple in our office at 503 - 718 -2433, Monday — Friday, 7:00 a.m. to 3:00 p.m. Sincerely, Darrel "Hap" Watkins Inspection Supervisor cc: Property File ___--. " . .----- ._ , ... _________________ • Alt . — _____ _ 'IV = 1 !, en& 1.1,p., : F ri-..4-1 ki - 4 _ ------ L i .._ I t i AppRz_e.;,-/..., , i 196:2 -- - • . I 11 - 7 , 0 i ,! 1 ' . .--1. 1 ,...__• • - • _ --_T- 7.7---------- - '.t - . . .:. 1 ';:::-:. - . :/r 1,, -:,.. ___ _ _ ..,..._ ......,..... ....41.::::, i •; 1 rporo.., ---- -, -- 1 • :.. -., -,-.., . .--., z-- • ..„--- - . ..., , .i., -, i . „ 4-pr110 Li L 1 ).:: '' ---,_: k: 1Z494 - - • j :.: 1 . . I ' • ,. , 1 .-------'...- :.. .' :. , . 1 "1 Ss . :.. ::... \ / qt, ._ r.[.. - ! - - , ,._ ,.•: K--, I : H i 1 '' & ' . 1 0 z 1 e? - -.1'.. 1-- ------ -----H 0 A PPITIO i . 1 Krz-g I '3' •_4 - -•-•-- ; • • 1 ••• „,-•-• . .;.:;-:, • -. . . - 1 -. • .: , .• .-rt. __ _ . _ _ _ 1 -'- 1 KFP:tr.a pt : :-.:•\-:... -. ' 4 7_ .'._._. 3-.6' -refrAL : 2I F ;) Q 2.146; - t. , - ..?...krio , • . „,... - I . .. .. _.:: ••:; -._,,..:.,,.. . I •, ... • 1 . , \ • •. .,. :., . • \s I i . H _ . • .1 . H • 0 u t) F . 1 I - , 4 L J I J t- F1240 P_ - 10 ise.le 1 1 I . , - - — — — --- — — -- — — — — — — — • A . ,EnEVFD U ' , -- 1 .-- 1 ' • - - .,. FEB 15 . 2006 __. I ! . • - y • A E I ' . Cil"Y' OF Duciiii) I BUTT:DING - DIVISION 1 1 • \-. / . . r , _ . q7.r,4-i 1 1 i I . ! ,/ . • . . , • F LAT e::-; rf ,_.__P CITY OF TIGARD - SITE PLAN REVIEW 1 1 __....- - . • . - BUILDING PERiVIIT NO.:/i 5r 20 - 000 i . i 06 1 L:L---------- '46 — I . . . • • PLANNING DIVISION: . . .. . Required Setbapics: f2rApproved..- 0 Not Aporc -... I i •; . , . . • I7N\/•ki,6■-( l . . Side: - 1 Street Side:•-t /• ' Front PLI Garage• <-0 Re::. IS 1 . ' - Visual Clearance: 2"/".‘p_proved .2 A,).• ' ' 2 4 ir _____ . __________ /., / Maximum Building I-leiilit:_. X feet 1 i . . . .. , CWS Service Provider Letter Required: ).- f . - . . „.: I B }.: dila Date: ./ liTh • 1 i - . • r _..4 „ ENGINEIERIN EPARTiVIENT: __. I ',1 I I 1 2 T14 . I io-': ri A ki j - Act D ual Slope:_% D Approved - I ' 0 Not Approved Site illv: 0 Approved 0 Not Approved 4 1; 10 -.4%i-j , ., • By: 1p Date: -- C- . 7 - 0_ i . •F f Iva. Notes: ., . _ v - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST a0 l 046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3!24/2006 Phone: (503) 639 - 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 L . INSPECTION WORKSHEET FOR DATE: 2/9/2007 • TIME: 7 :04AM PAGE: 75 SITE ADDRESS: 1196 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuit: for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 503-590.3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 219/2007 Pour Time: Code # e Inspection Description Confirm # Contact # Message p p 9 699 Mechanical final 043106-02 503. 590 -3607 N Corrections /Comments /Instructions: I .e I PARTIAL APPROVAL I I CANCEL I I NO ACCESS FAIL n CALL FOR INSPECTION Ti ADDITIONAL FEES ASSESSED Inspector: Date: 2 — 7 Phone #: (503) 718- —4(4-46--- CITY OF TIGARD BUILDING DIVISION . PERMIT #: MST2006-00046 13125 SW Hall Blvd., Tigard, OR 97223 411110 DATE ISSUED: 3/24/2006 Phone: (503) 639-4171 iozgoswiiif, Inspection Requests (24 Hrs.): (503) 639-4175 .-741J■ 41. INSPECTION WORKSHEET FOR DATE: 2/9/2007 TIME: 7:04AM PAGE: 76 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: 1 l SUBDIVISION: LERON HEIGHTS NO3 LOT #: 053 TYPE OF USE: . PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuit for total of 5, OWNER: DIXON, BRAD & PENNY PHONE #: 503-590-3607 .' CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 043106-01 503-590-3607 N Corrections/Comments/Instructions: it9 it,e.1- ---,..-.-- I I PA- PARTIAL APPROVAL fl CANCEL NO ACCESS AIL 1 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: / Date: 2-- 9 - 0 2 Phone #: (503) 718- Z_ft--.1---S-- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2006 Phone: (503) 639-4171 , - , Inspection Requests (24 Hrs.): (503) 639-4175 , INSPECTION WORKSHEET FOR '11965 SW 11 DATE: 7(17/2006 7 A ,._,„i TIME: , . :04Am PAGE: _ • 16 SITE ADDRESS: 8TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 503-590-3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough-in 033180-01 503-590-3607 N f Corrections/Comments/Instructions: ii 0:4 e--/ 1 /1 - e-- . 0 IV,, n PARTIAL APPROVAL 0 CANCEL n NO ACCESS I I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: at t- Date: 7 ls Phone #: (503) 718- . , CITY OF TIGARD BUILDING DIVISION A4- PERMIT #: MST?006 -00046 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2006 Phone: (503) 639 -4171 �Iuq ill Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/10/2006 TIME: 7:05AM PAGE: 21 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: • PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 503-590-3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 032861 -01 503-590-3607 N Corrections /Comments /Instructions: I&j aJc.4- C kJ 7 A 7 -e--.-.. ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 'FAI,L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \t; Inspector: Date:/ Phone #: (503) 718- 2:_l_____ CITY OF TIGARD BUILDING DIVISION #: 11+IS 20C) t r� ° 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2.005 Phone: (503) 639 -4171 /� 06111 I 5 . Inspection Requests (24 Hrs.): q ( ) : ( 503 Ins Re 639 -4175 �!�i 11. (503) INSPECTION WORKSHEET FOR DATE: 5/512006 TIME: 7 :10AM PAGE: 31 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. OWNER: DIXON, BRAD & PENNY PHONE #: 503 - 590 - 3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/92006 Pour Time: Code # Inspection Description Confirm # Contact # Message 31: Postlbe m plumbing 029373 -01 503. 590.3x07 N Corrections /Co merits /Instructions: , 1 4 k. V" 1,%, ■■/`,..---- - ( 2 1(3 -Q L.. V2 L.;;-,. — al- ,,ee,_k --4-1,\ r t.-■ - 0 --- ba-./ ..---,,,, *-- ,_,....„....., LI . ,,QQ ( V�' Li 0-4,t ; 'r/ (3 0 , J___ . - a 1 - ( - -..-- . ._.- . --c \ -c:. 6-45 . , PASS I I PARTIAL APPROVAL ❑ CANCEL NO ACCESS I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: V/t _ Date: / d Yc Phone #: (503) 718 - '.2->F2--1 CITY OF TIGARD r . BUILDING DIVISION .• PERMIT #: MST2006 -00046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2006 Phone: (503) 639- 4171��bN��@ Inspection Requests (24 Hrs.): (503) 639 -4175 4!i ° -•I L INSPECTION WORKSHEET FOR DATE: 7/10/2006 TIME: 7:06AM PAGE: 18 SITE ADDRESS: 11365 SW 110 TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 503-590 -3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation - 032861 -04 503 -690 -3607 N Corrections /Comments /Instructions: L;---e e'v [��^ ^��f5 C , - Dom.. .. ' ‘ - Z. 2- - "D 4 ..,e ReLik—k , c.A t--11: "6? -- 12 - U.--ii Ls), c) ) • e _ ` O .e �zs .4. .-- . s' ) --A" teN,...)2-- 1.- S - ii SS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS 1 FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED �0 b(n Z`� Inspector: 1 � � Date: ` Phone #: 503 718- �� CITY OF TIGARD BUILDING DIVISION PERMIT #: MSrla -00046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2006 Phone: (503) 639 -4171 W Inspection Requests (24 Hrs.): (503) 639 -4175 e'I �.. INSPECTION WORKSHEET FOR DATE: 7/1712006 TIME: 7:04AM PAGE: 15 SITE ADDRESS: 11865 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6.9.06 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 503. 590.3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 033180 -02 503-590-3607 N Corrections /Comments /Instructions: 4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: k'/(■ 1 Date: 2 / 2 /ie Phone #: (503) 718- 1 r CITY OF TIGARD BUILDING DIVISION - � ;° PERMIT #: MST200Ci 00046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24�)006 Phone: (503) 639- 4171 � pm lN u �u�y� r Inspection Requests (24 Hrs.): (503) 639 -4175 ,.. '■ L INSPECTION WORKSHEET FOR DATE: 7/10/2006 TIME: 7:06AM PAGE: 19 ,1 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 503 -530 -3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/10/2006 Pour Time: Code .# Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 032861 -03 503-590-3607 N Corrections/Comments/Instructions: e /� P i V . i 7 ° A . I 1 l • • _im (....j i .wk. r.2 .,A,, . IIMEMEMPIM % : 03 PARTIAL APPROVAL E CANCEL I I NO ACCESS I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED 1 1/4)) Inspector: \ C� `� Date: -771/0 0 Phone #: (503) 718- Hi-, CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2006 Phone: (503) 639 -4171 Aro ow I �I Inspection Requests (24 Hrs.): (503) 639 -4175 `'f L INSPECTION WORKSHEET FOR DATE: 7/10/2006 TIME: 7:05AM PAGE: 20 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERC>N HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6406 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 5035. 590 -3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 032861 -02 503 - 590 -3607 N Corrections /Comme is /Instru tions: _' _ -11 PASS ❑ PARTIAL APPROVAL ❑ CANCEL [ NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \c D ate: Phone #: (503) 718 l 2t 4.� ,14 e- 4.4.0w+.4 CITY OF TIGARD 4., < «-4 1 BUILDING DIVISION PERMIT #:1 �'f D(o'O 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 il Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: d TIME: PAGE: SITE ADDRESS: II 66 // O' CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #(51)3)5 0 —34,0 CONTRACTOR: PHONE #: Inspectio Request Scheduled For: Date: 0 '— -5 'f® Pour Time: Code � Inspection Description Contact p p Confirm # Contac # Message L,3�5 _ 0 Corrections /Comments /Instructions: 2'3 :- ' 52 24b = p • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL I I CALL FOR INSPECTION I ADDITIONAL FE S ASSESSE . , Inspector: f Date: Phone #: (503) 718 - ` . CITY OF ��nn n n��m nm�m��nu�p BUILDING DIVISION PERMIT #: MST2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3124/2006 Phone: (503) 639-4171 Inspection Requests (24Hro�:(503)G3Q'4175 ,..4101111 �� INSPECTION WORKSHEET FOR DATE: 6/16V2006 TIME: 7:0OAkI PAGE: 7B SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON L OT#� D6� TYPE � #: � PROJECT NAME: DIXON DESCRIPTION: Addition. 6-5-06 add 2 branch circuits for total of 5. OWNER: DIXON, BRAD & PENNY PHONE #: 603-5903807 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6116/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 031808-01 503-590.3607 Y Corrections/Comments/Instructions: ' . PASS EI PARTIAL APPROVAL ri CANCEL I I NO ACCESS | | FAIL I LL FOR INSPECTION ADDITIONAL FEES ASSESSED • Inspector: <-9 ` Date: Phone #: /503\ 718- 4`..L.4, CITY OF TIGARD BUILDING DIVISION - PERMIT Dcztk 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 1 °!t Inspection Requests (24 Hrs.): (503) 639 -4175 J ` I INSPECTION WORKSHEET FOR DATE: TI , MVP PAGE: SITE ADDRESS: 1 I CJ 42 1 /L7 Ave— CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: _ OWNER: PHONE 4 3) t�7o 533 2 CONTRACTOR: 1 � a / v._ PHONE #: Inspection Request Scheduled For: Date: 4 r 7 _ Oc Pour Time: Code # . Inspection Description Confirm # Contact # Message ,;2, --/k L S I L__ 6 Corre tions /Comments /Instructions: 4( 4v7 ,< 4;:. 4/4 - ter -r2s 4,7___. rev ; 2 c� / � he z a , .s., C.v..J • I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: -' Date: 4 —7 d f%' Phone #: (503) 718- ¢ 5/ CITY OF TIGARD ,. ' BUILDING DIVISION • . tr PERMIT #: MIST2006-00046 I 13125 SW Hall Blvd., OR 97223 ii ., DATE ISSUED: 3/24/2006 Phone: (503) 639-4171 immeo 6 Inspection Requests (24 Hrs.): (503) 639-4175 Awl ' IL. INSPECTION WORKSHEET FOR DATE: 'Si/ 13/2008 TIME: 7:02AM PAGE: 23 SITE ADDRESS: 11965 SW 110TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. 3/3108, PERMIT REINSTATED FOR 30 DAYS. OWNER: DIXON, BRAD & PENNY PHONE #: 50:590-3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/13/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 066654-01 503-590-3607 N Corrections/Comments/Instructions: - PL v y qk S lN)il ak-Z caK<71 1 • PASS . 7 PARTIAL APPROVAL III CANCEL I I NO ACCESS I FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: ''""...° NM LE' Date: 3 , I3 i'8 Phone #: (503) 718- 2_L0t) CITY OF TIGARD in ST BUILDING DIVISION PERMIT #Q006 OW L/ , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 1 h I�I Inspection Requests (24 Hrs.): (503) 639 -4175 ' F. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 1 `') Li f /) CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 6 ._ S_ p ( Pour Time: Code # Inspection Description Confirm # Contact # Message S>) cx z N Corrections/Comments/Instructions: r�. / . ■ - 3: v -z Rd cAL6 M y c .b AO' 2-16 . 6 up(Q Oto6a. R - \`T1c-ce,L, ctott.i N)1 6 K're In P - ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • N OELG Date: 0 0'6 Phone #: (503) 718- 211-14) CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006.00046 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2006 Phone: (503) 639-4171 .11 Inspection Requests (24 Hrs.): (503) 639-4175 v INSPECTION WORKSHEET FOR DATE: 3/13/20013 TIME: 7:02AM PAGE: 21 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. 3/3/08, PERMIT REINSTATED FOR 30 DAYS. OWNER: DIXON, BRAD & PENNY PHONE #: 503-690-3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 0666E4-03 503-590-3607 Corrections/Comments/Instructions: V A , PASS PARTIAL APPROVAL LII CANCEL LII NO ACCESS fl FAIL LI CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Cy--\ me!. Date: 3- 13 451 Phone #: (503) 718- 2-Lft& CITY OF TIGARD 0 • BUILDING DIVISION PERMIT #: tv1ST2006- 0063 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/200; Phone: (503) 639 -4171 u ll� f 1 f Insp Requests (24 Hrs.): (503) 639 -4175 _!J INSPECTION WORKSHEET FOR DATE: 3/13/2008 TIME: 7:02AM PAGE: 22 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 053 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Addition. 6-9-06 add 2 branch circuits for total of 5. 313.'O8, PERMIT REINSTATED FOR 30 DAYS. OWNER: DIXON, BRAD & PENNY PHONE #: 603-590 -3607 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 066654 -02 503 - 590.3607 N Corrections/Comments/Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0 k* J Date: 3' 3- 0a Phone #: (503) 718- cZy46