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Permit • CITY O F TIGARD MASTER PERMIT Er R® PERMIT #: MST2005 -00153 ATi DEVELOPMENT SERVICES DATE ISSUED: 5/3/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S134CD 01700 SITE ADDRESS: 11970 SW 118TH AVE ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS NO.3 LOT: 047 JURISDICTION: TIG Project Description: Kitchen & family room remodel. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 2,500.00 REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: 1 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: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: 1 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: 0 - 200 amp: W /SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EAADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/0 SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: 9 SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: , VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other LANGLOIS, J R + E JANE COMSTOCK DEVELOPMENT LLC applicable laws. All work will be done in accordance with approved 11970 SW 118TH 12020 SW 118TH plans. This permit will expire if work is not started within 180 days TIGARD, OR 97223 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 of these rules or direct questions to OUNC by calling 503 - 246 -6699 Phone: Phone: 503 -579 -5772 or 1- 800 - 332 -2344. Reg #: LIC 124376 TOTAL FEES: $ 407.92 REQUIRED ITEMS AND REPORTS :��� Issued By : , / 4f�r 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. e. • Bu Permit App >! FOR OFFICE USE ONLY City of Tigard vi m 3 2 005 A Date /B : y �7 �'�— Permit No. S'� 9O5 ab /53 ii i 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Recei Phone: 503.639.4171 Fax: 503.598.1960 Other Permit. Inspection Line: 503.639.4175 Gn'y GF 7I GAR D 1$101 � Date Re ,� `> 71� `` DI VISI /�_I,,, r Date Ready /By: Juris ® See Attached Checklist for Internet: www.ci.tigard.or.us BUILDING Notified/Method: --1 Supplemental Information ti.;"'„ r - gi r , ;iii ' . TYPE; < <QI ..WORK-:: ° - .;" , :ik ., REQUIRED DATA:;( = AND 2� FA MILY DWELLING A�.:- , ;.. -„ :�. • tea,• �- .� -_�.w .., ...�_ - .,T , .., � ,,,, _ , . �. �, . _- ._ '- __ ._ . , , , „ ❑ 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 4 ' P"' '" ? ' "' '''' , �. ��= . °`: '``" � °� " °'° " ? `�" work indicated on this application. :tom, , �<::, - -- ? : -: , :.:•; "' „. .CAT'EGQRY OF "C QNSTRUCTION , ' -' '° '' 'Z � pp i• 1- and 2- family dwelling El Commercial /industrial Valuation: $ So ❑ Accessory building Ill Multi-family Number of bedrooms: 3 1=1 Master builder CI Other: Number of bathrooms: , f: r. I I,- , Total number 'i: ' JOB ' SITE; INFORMATION AND;- 'LOC4TION, °''' , =, ,,i of Floors: Job site address: i i n ' 0 S\,.- k1Q►•L, New dwelling area: square feet City /State /ZIP: 'r 1ci.„.,D o x q 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job se: lc Deck area: s �'i'4it pit �� P.►tJ square feet q Other structure area: square feet AREQUIRED;- DATA: ,c- 0)1MERCIAC_USE CHECICL^IST, 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 ,'.: ., ,,, ,;:, and the profit for the equipment, materials, labor, overhead, a e o r ''S • =- D ESCRIPTI ON ,O F i WORIK -° ` ry work indicated on this application t `, "k. 0�C�� 1 cS , � Valuation: $ Existing building area: square feet New building area: square feet •::PRO ERTY. ,ti` , "� ,, ' ... ' $ - ® , TENANT ' - Number of stories: Name: L r S s�M; f.(awli O, g Type of construction: Address: ikeil6 Ste, i \% .\_ • Occupancy groups: City /State /ZIP: %, cep \t.O 04 C,i1 Z,Z3 , Existing: Phone: (,cZ1) g9 O9 C ca , Fax: ( ) New .vy} ., ❑, APPLICANT . ' ;;; ,.,.,, ::� CONTAGT''PERSON • ;; ,`,.-,•• _.: ..:; - " : ,.:," � ;a "`NONCE- �... • - _ name: 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:: ( ) \ J E -mail: r m . ?` ; ,�, CONTRACOTOR '; ; ,,'e,,, -. • . %. _a., . - . ., - , - d„ � -_ ,. . ; _. e3��rz;L ,. - . _ _. Business name: Ztsrt i 1� � :�. , .,, - t�Y. � HtYh C. f '" }.;;, ' , ; * :1• ,aI itNif FEES*' - Address: it-01A S' IN %I Please refer to fee schedule. City /St` ee /ZIP: •�, (a1 9 -� 71, � Fees due upon application Phone: (gam( _ -Z , Fax: (SOS ) S - 5 .; Z tj . CCB lie.: Z ?.� /10 Amount received 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: —alC (vr.-,"s V- Date: „ Z._ %5' * Fee methodology set by Tri- County Building Industry Service Board. i \Building \ Permits \BUP- PermitApp doc 12/03 440- 4613T( I 1 /02 /COM /WEB) Electrical Permit AppR NED FOR OFFICE USE ONLY r� City of Tigard MAY Received _ MAY 20 DateBy: Permit No. S'� A5 c4f/S 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.196„ ■ �A �I �' Date/By: Other Permit: Inspection Line: 503.639.4175 �F rr�aRO ^^' GPI I� D ate Ready /By: Juris' 0 See Page 2 for Internet: www.ci.tigard.or.us a. TYPE.O .WORK B1 11L ®rn�o O " " °� rsrory �� °„ ,,�� P - Notified/Method: Supplemental Information > Fi ` ��:> a ,., � = gym . ❑ New construction '. Addition /alteration /replacement Please check all that apply: ❑ Demolition El Other: Service over 225 amps, comm' l Hazardous location �, r , ,, ,,. _ „” .rz - - ,, , Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION';, °`I : of I- and 2-family dwellings 4 or more new residential I - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure CI Building over three stories ❑Feeders, 400 amps or more El Multi - family 111 Master builder 111 Other: _ Wit_ , TE IN �" - Occupant load over 99 persons ❑Manufactured structures or _ JOB S FORIVIATIOND- LO N1 ' #iON' f ,, s„:.„„:,„4' ''•, ;; : ❑Egress /lighting plan RV park r , CI Health-care facility ['Other: Job no.: Job site address: �1 1 S 5,1rt Submit 2 sets of plans with any of the above. City /State /ZiP: 'ri(, ° o ei Z.1.3 . The above are not applicable to temporary construction service. 1 , ;;: ' - ° .^' ,;• • :. ' ,,, ,,',!° F EE °SCHE' -;; a te~- . Suite /bldg. /apt. no.: Project name: - EDU7•` ,, �_ ' ** Description Qty. Fee. Total Cross street /directions to job site: 1.. p o � � �� ; , � New residential single - or multi - family dwelling unit. !� IN includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'1 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: , ,,.,, Limited energy, non - residential 75.00 2 SCRIPTION'FR,WORIC s ' „ , ,, ,*,m7 ,,, , ,- ,,, "' g, ` DE - , it' Each manufactured or modular , dwelling, service and /or feeder 90.90 2 Ir I 1 SA Lj 1 r� . ■K(`ce'`� - Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 „4^,,.,. ,,......._ ;. "v;-. .,, 4 -, , •:.- 201 amps to 400 amps 106.85 2 , ' rte. ER9T,W4Y'O, • .1.4,',,m..;-42.; t 1 ., `;, TEtVANT " ,w,. ,� . �:, ” ,,.:, ; <,m , -- ,y .,_ _ � ., •: �� °.��• ...> , > " , ' 401 am to 600 amps 160.60 2 � Name: j� r ) P ' j C. (-�N 9 r'0 i i 601 amps to 1,000 amps 240.60 2 Address. ' l I c i . 11a Sir k% , -,- Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: �" i I 9 v„ix, may, 91 2.13 _ Temporary services or feeders installation, alteration, and /or Phone: ( ya ) ss - 050z.. Fax: ( ) 2 200 00 amps or less 66.85 I 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 600 amps 133.75 2 Owner signature: Date: Branch circuits- new, alteration, or extension, per panel ❑ i ; ; ° , a ., ' _ ®° NTAGT PER �) A. Fee for branch circuits with _ ° ; fir`` , - °_' . �::.-,: �:., ��- m .: �: �-", xt ,�:;: � � i ': ::. ;:�. .a ,.- ' : . ' CO ,.,...,°° ,4.� .- ,:.�.. „;;';'r . ` % .:, service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, e !t„ 46.85 y(., , Address: each branch circuit 63' 2 Each add'l branch circuit 4 6.65 59 .6. 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- ` ` r z CONTRAGTOR '' , i `4 W / energy panel, alteration, or extension. Describe: Page 2 2 Business name: 5 _/) r - 6 C am, Address: /2.e,7.2 3" //re Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZiP: ! /G/9-,e%, © - 9 7 - Z3 g per ( ) Investi anon er hour t hr min 62.50 Phone: (57j ) F ax: Industrial plant per hour 73.75 52y - 33 1 ( v ) 5 8 772 � ., , ,;,, *7.1,; :;; EL 0TRICAti PER1VIhT,FES *.. ,. ; - CCB Lie.: /sec 7. Electrical Lie.: 3V-72c Suprv. Lie.: ,�Z/S Subtotal iOk, Suprv. Electrician signature, required: r �� %�1� Plan review (25% of permit fee) 2 b) • D ate: State surcharge (8% of permit fee) i -1 Print name: /...8_6_7, t Ct y>J 1 i/ _ 6 7 5 — _ TOTAL PERMIT FEE 111 , el t„4 Authorized signature: This permit application expires if a permit is not obtained within 180 � /j /j' days after it has been accepted as complete Print name: / / L ✓ r i Date: S - 4 • `N---C * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i.\ Building \Pennns \ELC- PermitApp.doe 12/03 440- 4615T(10/02/COM /WEB Mechanical Permit A t st.. - , II FOR OFFICE USE ONLY .- ... R eceived City of Tigard Date /By: Permit No\ 40J = � / 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 ' 3 y i p" 200 ' "91i 1, Plan Review ,��� � ' "91 ,$ Date /By: Other Permit: Inspection Line: 503.639.4175 rAir ?'I I ( Date Ready /By: kris El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information BUILDING D 1VtS rp N,. , -, I„ .. ,. 4 . ,,, TYPE:,_OF,.WORK ,> <,,, ,COM_MERCIAL ° FEE „,§giEpm.i„, g.,v. s H ❑ New construction ig Addition /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 ` `? "- *; � 4it ;. .. Value: 'CATEGORY OF ONSTRUCTION - RESIDENTIAL EQUIPMENT / SYSTEMS FEES * � cly I_ and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building Multi M builder For special information use checklist. 111 y ❑ ❑Ot her: Description Qty. Ea. Total JOB.SITE" INFORMATION' AND' LOCATION "' "_';' ° =.1' °` sS Heating/cooling . , t Job site address: Air conditioning or heat pump f i + �(� S v� % rL (requires site plan showing placement) 14.00 City /State /ZIP: + °iAitD ©t \_ 91 2.1..., Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 i C1,,,ALI.4 1 , 1 L , I Ntr' Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances ' ' `6E'`'" '" Water heater 10.00 � ' : '. �� "� ;"" , :�, UESCRIPTION�O ?. . 3 =- �. _ _ �.' =��. ��,> � ; . � a�;�ti , • ._ : _ � :.... -. � _ems Gas fireplace 10.00 k . i4 e,,., t;,., I r,w, L., it,..:._ 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 ,v Chimney/liner/flue/vent 10.00 ® :;PROPERT,Y QWNERTEN W. � d_ : . Other 10.00 Name: ..r 11. as,y,t� (..,®w i 01) Environmental exhaust and ventilation Address: Range hood /other kitchen 19 "� S. r- t1 V i v.- equipment s 10.00 City /State /ZIP: 1 ,, bll 9') C. l_ i - Clothes dryer exhaust / 10.00 Single -duct exhaust (bathrooms, Phone: ( ) ,_ 0(4 b f t . Fax: ( ) toilet compartments, utility rooms) ) 6.80 ,., 3,,,,, : , - n ,,.,,,- -, Attic /crawlspace fans 10.00 'Ilii '`M"_ 11 APPLI(ANti :3 : [ :,' P W)N, Other: 10.00 Business name: 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 d ;�, y , lam" rk, "' ': a` , °` 'h'``' CONTRACTOR''` > Barbecue ` � Clothes dryer (gas) Business name: cw A. ,k. i-Ior -5 t S_ Other: Address: i Zv , 4.,,, 1% ¶'11\ 1--r6- t '''''V „� �//';'' MECHANICAL, P RMTTfFEES * ':K '':;£ City/State/ZIP: Subtotal cs ike N M ) _ °) si - S ZS Fax: ((s-0). (s-0). J 1, Minimum permit fee ($72.50) Phone: ( S 5 Plan review (25% of permit fee) CCB lie.: / 7 — `' State surcharge (8% of permit fee) • - �, TOTAL PERMIT FEE Authorized signature: , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ---"No� C0tN, £ rvk Date: 5- z•- e�J * Fee methodology set by Tri- County Building Industry Service Board - is \Buildmg \ Permits \MEC- PermitApp doe 12/03 440 -4617T (II /02 /COM /WEB) fz. i ` t• Plumbing Permit Ap it` : CEIVED FOR OFFICE USE ONLY Cit of Ti and R eceived '> y g MAY 200[ Date/By: Permit No. 6S )� 13125 SW Hall Blvd., Tigard, OR 97223 � Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /may I �\ Other Permit No.: I 24- Hour Inspection Line: 503.639.4175CITY OF TIGAR * ' L I Date/By: Date Ready /By: Juris ® See Page 2 for Internet: www.ci.tigard.or.us BUILDING Notified/Method: Supplemental Information � G " TaY W PE OF ORCC- -� r =� ' F SCtl DU E ),i °� : ❑ New construction ❑ Demolition For special information use checklist. ¢�, Description Qty. Ea. Total Li. Addition /alteration /replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) 4`IS • ` , ,' ,_ t: CATEGORY OF CDNSTRUCTION . 4 �, ° .... ....:.: .v, , .. ,, _._ - ..�:�:m.,,. . - ,, �� : � : :_ F SFR(I)bath 249.20 ‘ 1,1' I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 III Accessory building III Multi-family SFR (3) bath 399.00 III Master builder Each additional bath /kitchen 45.00 :. '' .,.:..,, .,;.�.;.,�, �,;,.�.<._., >: .,�... O ;.,,.. Ot Fire sprinkler( sq. ft.) Paget .,f : , : .,.__. i JOB SITE INFORMATI < N' `AND;, -%9GA„ TIO ` ::,. ., Site utties Job site address: k i CI '1 s; i 1 %as.. • Catch basin or area drain 16.60 City /State /ZIP: -T.; c,;,p.c, cit. q • Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities - 110.00 Cross street/directions to job site: •i2 i .31 • • ` . K a. m +.. 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.: n .•., - . , .:.. :... Absorption valve 16.60 ' '° ;' , ' f< DESCRIPTIOSI OF,,W,,,ORK ` -: ' ',; 1,1,' .:� _„ w _ , W •. _- ,. , •, d Backflow preventer P y� �. :, Page 2 1`LMtA 0... 4C V-,AAN tC++' Backwater valve 16.60 Clothes washer I 16.60 `c, • �o Dishwasher j 16.60 ik. Ir,e s * TEN $`x ` ; ;� ,�: R'OPERTY' O ' �• ; ., °`; :gi � , Drinking fountain 16.60 , °, ®�PVYNER : : �: =�;;� ' Electors /sump 16.60 Name: , %k $ y:: e, i± N,,,,,. Ions • Expansion tank 16.60 Address: I E(10 :ii.• ;01, i,t. . Fixture /sewer cap 16.60 City /State /ZIP: "1 ciy1,�LD C!4t en 1.1-3 - Floor drain /floor sink/hub 16.60 Phone: (s S'cip , cro Fax: ( ) Garbage disposal 1 16.60 �. . < ',.:: ', p , ;; ..,:; , a ;. ∎11,: .,. ;. ,..a{„> ;,•:.,.,� . Hose bib 16.60 9'9 � 4 - 4 ';',..,h;.,,, P C , ..0, -, ...:',, 's ; - ,4`O PER , Ice maker j 16.60 Ic• 1 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: Sink/basin /lavatory 16.60 ( ) Fax: ( ) Tub /shower /shower pan 16.60 E-mail: Urinal 16.60 ,. , ;,� ', . . C O . NT RAG s . . TOI2,•, - .. ,:,- 3 ; .,:, : ��, ,,,. , � .. , 16.60 i':�? . ; ;:� > . ,. � -, ..,. . f.;.,._w�..., s. , = :n:: °` <��� Wat clos Business name: atn4 1~ NaMC S Water heater 16.60 Address: iZ,.0 5 ii p Irk- Other: City /State /ZiP: - y , o k 9-) ti.1 Subtotal fj i t., .'j p 7 Minimum permit fee: $72.50 Phone: ( may) s--,9 .. ,s'.a z.c1- Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: j 2_ Li 3i c., _ Plumbing Lic. no.: i Ts e, Plan review (25% of permit fee) •LI.Off' Q e State surcharge (8% of permit fee) • L S Authorized signature: N �, i �J� \ ,�f �� /� J TOTAL PERMIT FEE • Print name: 30��1 �� Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete, *Fee methodology set by Tri- County Building Industry Service Board. i \ Building \Permits \PLM- PermnApp doc 12/03 440- 4616T( I 0 /02 /C0M /WEB) CITY OF TIGARD • . A. BUILDING DIVISION { ♦ PERMIT #: MST200 &00153 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005 Phone: (503) 639 -4171 A til yp h Inspection Requests (24 Hrs.): (503) 639 -4175 W INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 58 !Z./ , ((47lcts t#$ SITE ADDRESS: 11970 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 047 TYPE OF USE: PROJECT NAME: LANGLOIS DESCRIPTION: Kitchen & family room remodel. . OWNER: LANGLOIS, J R + E JANE, PHONE #: CONTRACTOR: COMSTOCK DEVELOPMENT LLC PHONE #: 503-679-5772 Inspection Request Scheduled For: Date: 7/1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 010629 -04 503 -318 -8307 N Corrections /Comments /Instructions: 011°' , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL // C' FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . Inspector: Date: 7 d (503) 718 - • CITY OF TIGARD BUILDING DIVISION f PERMIT #: MST2005 -00153 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005 Phone: (503) 639 -4171 „'i 1 ‘�� � Inspection Requests (24 Hrs.): (503) 639 -4175 . ..� INSPECTION WORKSHEET FOR DATE: 7/112005 TIME: 7:14AM PAGE: 69 SITE ADDRESS: 11970 SW 116TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 047 TYPE OF USE: PROJECT NAME: LANGLOIS DESCRIPTION: Kitchen & family room remodel. OWNER: LANGLOIS, J R + E JANE, PHONE #: CONTRACTOR: COMSTOCK DEVELOPMENT LLG PHONE #: 503 -579 -5772 Inspection Request Scheduled For: Date: 7/1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 010629 -03 503 -318 -8307 N Corrections /Comments / Instructions: • • g PASS • -ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / Inspector: Date: " Phone #: (503) 718- CITY F CI O TIGARD 1 BUILDING DIVISION PERMIT #: MST2A0500153 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/3/2005 Phone: (503) 639 -4171 4 % Alii,, 9 lm1 @t4G ' ; Inspect Requests (24 Hrs.): (503) 639 -4175 '. INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 61 SITE ADDRESS: 11970 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO3 LOT #: 047 TYPE OF USE: PROJECT NAME: LANGLOIS DESCRIPTION: Kitchen & family room remodel. OWNER: LANGLOIS, J R + E JANE, PHONE #: CONTRACTOR: COMSTOCK DEVELOPMENT LLC PHONE #: 503-579-5772 Inspection Request Scheduled For: Date: 7/1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 010629-01 503-318 -8307 Y Corrections /Comments /Instructions: l►4 PASS 2 - ARTIAL APPROVAL ❑ CANCEL n NO ACCESS fl FAIL - FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -.......... 7 / Inspector: Date: �� Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION ..._ - •,- PERMIT #: MST2005-00153 13125 SW Hall Blvd., Tigard, OR 97223 A, DATE ISSUED: 6/3/2005 vit Phone: (503) 639-4171 :o btilIT Inspection Requests (24 Hrs.): (503) 639-4175 ,JA- -J— INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM . PAGE: 60 SITE ADDRESS: 11970 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 047 TYPE OF USE: PROJECT NAME: LANGLOIS DESCRIPTION: Kitchen & family room remodel. I OWNER: LANGLOIS, J R + E JANE, PHONE #: CONTRACTOR: COMSTOCK DEVELOPMENT LLC CONT PHONE #: 503-579-5772 Inspection Request Scheduled For: Date: 7/1/2006 Pour Time: I Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 010629-02 503-318-8307 N Corrections/Comments/Instructions: VPASS 0 PARTIAL APPROVAL lij CANCEL 0 NO ACCESS 0 FAIL 111 CALL FOR INSPECTION [1] ADDITIONAL FEES ASSESSED Inspector: /1 7 / kA Date: & Phone #: (503) 718-