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Permit e r;: • CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00242 ij DEVELOPMENT SERVICES DATE ISSUED: 8/12/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103CB -03700 SITE ADDRESS: 13215 SW 124TH AVE ZONING: R -4.5 SUBDIVISION: WILLAMETTE NO.2 LOT: 016 JURISDICTION: TIG Project Description: Remodel. Other mechanical is duct work. Other plumbing is ice maker. 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: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: VALUE: 80,000.00 OCCUPANCY GRP: R3 BDRM: BATH: - TOTAL: 0 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 2 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 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 FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 8 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: X 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 Munidpal Code, State of OR. Specialty Codes DEANGELO, STEPHEN T DANIEL L FORNEY CONSTRUCTION I and all other applicable laws. All work will be done in 14297 SW PACIFIC HWY PO BOX 118 accordance with approved plans. This permit will expire TIGARD, OR 97224 SHERWOOD, OR 97140 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: Phone: 503 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 #: LIC 79093 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 1,535.72 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS • Issued By : Permittee Signature • _I ..,imiLla. 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. , 11 Al Building Permit Application ' ` `. FOR OFFICE-USE ONLY v City of Tigard ECEDVED ft Date/By: : 7 / 7)� C Permit No. ;7 /0 -ad._ VI 13125 SW Hall Blvd., Tigard, OR 722 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /i. + II. . Date/B J Other Permit: I b - ,t l ` � � Inspection Line: 503.639.4175 JI + w 1 , J 1 4 200 -,'" ----- Date Ready/;y: ` 8 See Attached Checklist for Internet: www.ci.tigard.or.us � Notified/Method: / J 9) � �M1 Supplemental Information CITY OF TIGARD \ -t, )- V D i c, e. �,, A , n,.. -e„S,) ;�:�� �r, ur:; �`,w��:� °r;�,� =- :�` •^ °w� -e �"�n c,B -,�;:c,�� �=�#" �:'?�a- r: :;.t* �t � :�-7r _ - � v "t s > ;i{ �,t 9 a i fi Rsr'9 1. 1 ; ` . ia t t REQIJIRED e .....- ?.o-a. - AWVt air. z'' - ,.:,x. a_.,A;,: :EV v ,, , -,0: s,�>...= . ..z - ..Sw..e . =4 ..1 m,_ ..a:lal ., -.. x .: war x,,,i tt _ <;d' ,.. > ., - - . • ❑ 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 . -, �,;, � , g ., - . " ; '�" � CAtLEGO &Y O ^ a<?; ,<.K,;, • Qiff a. l :• * r•r ` ,,.;.t: PP work indicated on this application. a ' UCT ' )11- and 2- family dwelling ❑ Commercial /industrial Valuation: $ oho r ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: NA V' 'k$ 5;�92.a <':' ,�2*. .�z+ "'�� „a "�� `.;,,aW+,;M rm ., .. m c • ,,�a:: , .,;...:: PN, V 4 -� ` JOB SI '7E N ita larAND LO CATION IM, Total number of floors: ` mac;,. , � _ ,w* w�� °a, = ,: .., , - _ ., - . • > >., _ . . _ ' Job site address: (' . 2_a 5 5I . IZLi r.- S New dwelling area: square feet City /State /ZIP: 1 • R 9 ”] 2.23 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: c J I C'v D E/ - N. (ego Covered porch area: square feet Cross street/directions to job site: („AtiAft_b,F r 0raB (-cc Deck area: square feet o g■.) ("Ll Sr L..C—T (' ) /WV•vRA.Q.N fZ I CAW Other structure area: square feet ( '� "8 ; rt-S?3i.%�+t33fs.�:, k > -, ..:; " ,:va`'?�: �q�. �r:"': �s:` ",8ey*?:';�^it'. >. >,aca.!�=,,, ( 7-4 \U S E t MN\ l furl Y C'N le REQi`JII aili'A "G®M1a&AVA L;,CLlti E•CKL3S . „,,,, ,,,,. :b::" sn. nti sr :cry ^t3 ,,,,. .„,,,,,;:.,:' :e.,4,, 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 , . * ,t . , rwi4y, wz NNr6 , yy y RKr : „„ equipment, materials, labor, overhead, and the profit for the K 3“: � 1 DESC Tat kY WO t , i �' work indicated on this application. d Er/� we £a', : 7 ,at.., ., .gLm"'?.44 444 dAtq . . 0 AA"SJ, . a. T' LN .a , s , #MW, • r IC I t. RJA"1I"Sl IAUN Dtk y 2 DE_ i OP ea) U (7 Valuation: $ V.1 ALL 5 r ROO F' �� �� SCISSOR_ Tito 5 /� Existing building area: square feet ( x / New building area: square feet ;^, � vvv€v r t - h n,, a `r it "„r '' r b a +# i '' „y' ' g ,� . 47 , 0P1mit,TX r®WN�., Eit ,. , g u ` , TE1 T � Number of stories: Name: s •e: \I {J oI Type of construction: Address: (L, 2AS Sw z,t_t_ St Occupancy groups: City/State/ZIP: ” 7 G on._ Cf 7 23-' ' Existing: Phone: (56'2) 510' 6351 Fax: ( L -563 -'79 - s < - 1070 New: a.F ` ." . N yflna,. 2a " ',,':'�L `v.'s^'i'aa r r�^ -" ww; .:,.�' _ : i ;. - *.',,.,ew'{4:.:cy r;,l, :;.r t i F A`P =PI I w'� YFe '' }> a - -- ONrTA�G I4 e ' it N , l t ' ;r ,, �. �� s.� -: u•,, �;..... i��� o, _. ,'. ,.. ,ifs: ....,_ ss; ;+�,,,. <.;�a, � . - ,.. . ::: - €� - : I� OTIC�E ". „ • Business name: (et_ -L i FJ ?,r/ Co" .. s 7" Co All contractors and subcontractors are required to be Contact name: bk.,' � �� '� j licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: pO &:)x 1 C a jurisdiction in which work is being performed. If the City/State /ZIP: 5 p ' t 0 2 C "7( 4O applicant is exempt from licensing, the following reasons 2, �+ �7 apply: Phone: () b - l(q7 Fax: ( U S 3 [ fl E -mail: C�I�C L $o3 -3( 4 5 s;9't s ;�°' � , ��'. ' �. :a "�, `°�?"- a � '.e�'r�..�_,c�.�'ir_r�s��zF�:a h � . °c' �,:�.:� f � a a�i,� - +� sa, >;,..,, - . a x � e ,._.;.gym , ` ,• ,' i l 's'*Y•3 a;i4,..u•a ". 'CONTI,*,,, ,' ,4r ., ;, t.wa °'�„ = r;- .w -„� � � . s�are�'�� ",� .�; �rx R3411.3 ;� � . s-E�i. t . � � r . c�.`��� :�,...�.x� ..�»�: �"��a F�:,st Business name: ](� U U. 01 ` . c5,. co m ., ,, rp ,,, h- t <, w BUIIIDING. PER F -EES *- Address: CEO f X f ( Please refer to fee schedule. City/State /ZIP: f j(2� 97 ( � 6 C Fees due upon application Phone: (56.5) (, 5 --- 497 ' Fax: ( 53) 62 37Z� Q Amount received CCB Iic.: "-"/ q o _4•-, Date received: Authorized signature: This permit application expires if a permit is not obtained JJJ within 180 days after it has been accepted as complete. Print name: t-- iki\t' a..... . F--ificto Date: - i 4-155 * Fee methodology set by Tn - County Building Industry Service Board. i \Building\Permits \BUP- PermitApp doc 12/03 440- 4613T( I I /02 /COM/WEB) One- and Two - Family Dwelling i f Building Permit Application Checklist FOR OFFICE USE ONLY .- M ` ` City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 //H4r dl r 24- Hour Inspection Line: 503.639.4175 „AI.- � ���'ll� ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us ❑ Other: ' ; ,. THE FOLLOWING` ITEMS ARE FOR PLAN REVIEW , ,! `'V • a , t 'Yes `No .; ti N /Ax 1 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 approval required. 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. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. 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 ❑ ❑ Cl 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 maybe 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 .roject under review. ' JURISDICTIONAL SPECIFICS .. ' ' 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System 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. i:\Building\Permits \One - Two - FamilyChecklist.doc 12/03 3 Y`' , t�., h:f ; ' Electrical Permit Application . ,'FOR OFFICE USE ONLY .' ' y . i ' . City of Tigard Received Date/By: Permit ut No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 y / N Other Permit: . DDate/By: - Inspection Line: 503.639.4175 ';, - ` Date Ready/By: Jul is El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information aWl"r'`:^saa.` o?�t� /�° i'. gyp;.' =.fit, .A�4�„ "'�' a<;,;?er;t -. .:.;;,��r "�!`�H�.;�� ^Xib;. =- y *. V°w�8 ✓�„� m:t�:et� }:, ... : 44 ,la & <te . , �>. a a TYE,o,ii �U a ' . iAM .+. t ,. ' . : .s : _ .r rte: : 4- •AN.'R 1 ,. ; , -W ?, 4 'k , °:a�'xe�ck��;s�.�;;x�.H ,_ bw�+" "�'.N.'�'�."���i>, 9'iv�'ekr<o�� i53�v:- . r:�"ii's���ra.�w'. � :., n•..a ,ss_ 4::.z4e a<:.b,.�P _rte..,,.....,., a,.�.�..,f`,. - .., i .a. ,. ._ ,.. El New construction Addition /alteration /replacement Please check all that apply: !� �i EService over 225 amps, comm'l ❑Hazardous location ❑ Demolition ❑ Other: EService over 320 amps - rating ❑ Buildng over 10,000 sq. ft., z � i` ? �w. nL: 'S�tsC�`'C:S,na- ,.*- �!.,>c��w. -- T:...�*'»,�:- �;;T�;m`s"- �ed�x.: <zx ° -_ ';ss z8;° „r: -''I" - .�.� =x .w;•,*aW ' V f ; ,GAT � tatgor: NSTR +iJraON=."t of 1- and 2- family dwellings 4 or more new residential -49nd 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure El Multi - family El Master builder El Other: ❑Buildin over three stories [Weeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or k , . - JOB ST,I'E�,, INF0I MAPIN AND - mi: - : m` , *`ot ❑E /li plan RV park Job no.: Job site address: 1 ( s sw v 5 ❑Health - care facility ❑Other: Submit 2 sets of plans with any of the above. City /State /ZIP: 'Z G otz c{ 7 7'Z The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: g1l '1 ix s.l'FEEy ,SC -HEDUI E -ir ; j p Description Qty. Fee. Total Cross street/directions to job site: 42--t, 6- 2't -cam3 (7_,41 sr New residential single- or multi - family dwelling unit. e �- � ' I I Includes attached garage. LE "Fr F l //VV Z.-\1� (LT U C �- L tick) 5e alN � '1 - 1,000 sq. ft. or less 145.15 4 Subdivision: / r Lot no -: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ,. .. -,,.,_ *z , _ „,„ , , Limited energy, non- residential 75.00 2 l, , ,n ; t" � x DESCRTFTION; `Q,F, FORK t * a y k E ach manufactured or modular dwelling, service and /or feeder 90.90 2 N`P .y- f L1 /44-6 Y f" ? elfC ln,.t1T/� 16 I Services or feeders installation, alteration, and /or relocation At 1 _ �,, Let - 200 amps or less 80.30 2 �'' 'is���R„<;a! ( ;�.� "T e�: � r -,� �� L�- � � :,::> �'� � .,�.R;r . � :.,�;,� r�r �M <�;;p;..., ; 201 amps to 400 amps 106.85 2 K r.:,�P1�OEERpT,�'OWNE °., °;���",''� � .<,"�� =� � ®�:TE�'A�'NT�> ��5f� 401 amps to 600 amps 160.60 2 Name: S ( ey D ce-LO 601 amps to 1,000 amps 240.60 2 Address: '� Over 1,000 amps or volts 454.65 2 ��� "� s W � �� Reconnect only 66.85 2 1, City /State /ZIP: `R 0R . c l7 'Z. Temporary services or feeders installation, alteration, and /or l relocation Phone: (5 5 V 835-1 Fax: (Ce,) ,93 Z J 93 qo Zo 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 1 33.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel S Aug ,.. , , -. '- �2:` s 1 < a» ::: - 1 5 : AP PLIL T r ;- � : ,' `t - 9 ., O ° PERS ® N , i w,„i "' �45 - A. Fee for branch circuits with ** service or feeder fee, each - 6.65 2 Business name: DA-Nu . (. J t NT � �*�� 57..., Co branch circuit r � B. Fee for branch circuits Contact name: Ii1� eor . 1 +� each branch circuit without service or feeder fee, 46.85 Al i �2 ���+U, 0 Address: © C "re? + Each add'I branch circuit 8 6.65 53 ‘'&. 2 City /State /ZIP: S ( J NJ 1/4 O ft qt ' Z1 tj O Miscellaneous (service or feeder not included) t Pump or irrigation circle 53.40 2 ' Phone: ( bC. ) `� ! _ � 2 5.- co Fax: : (✓ / 0 2'37 Z7 Sign or outline lighting 53.40 2 E -mail: C„€'? & t!Y `'S( -5 Signal circuit(s) or limited - ��;� -;:; w' .r:� a�.•�"i3``,'��', ''; '>,��".:� . :fi" g 3 � x,�..., .�. ,.�.,, - ,,.�,,,�,,- .-�, •a,:��,. .,. . ,. �.,�,.- :.,.;,:�s}'.i..�. µ .to- � ' . WS° : - CON °T3RAG�' ENS, .,.,� 47p, p r r:h energy Panel, alteration, or Business name: r - ,� extension. Describe: Page 2 2 Address: � /� Each additional inspection over allowable in any of the above �� /V �� J1 / Per inspection 62.50 City /State /ZIP: ' / ; C l _ -/ i d 2 9 7 s7 / 1 4 Investigation per hour (1 hr min) 62.50 Phone: 63, 6, 2 _ i 9 Fax: (5r 3 6 z o _ e Q Industrial plant per hour 73.75 CCB Lic.:4qoy 7 Electrical Lie.:���11. _LAZ CSuprv. Lic.:4 2A, S Subtotal / gO. '� Suprv. Electrician signature, required: 7"7./ / l"i` w Plan review (25% of permit fee) , o ' 4 /.\\ surcharge (8% of permit fee) d Print name: ) e4.•�l rj b j Date: 7_)/ ...DS 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: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermilApp.doe 12/03 440- 4615T(10/02/C0M /WEB • Electrical Permit Application - City of Tigard ., Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDEiWaL.�?'®.RK ONLY ;.:..... .:. 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* n Vacuum Systems* ❑ Other: w O f RC AL WORKYO,;r,.�, .,.�.. » ».a. .«.a.rz... .»m.�K.A.'ze�»xn.... «..,� j d .. Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: Audio and Stereo Systems ❑ Boiler Controls n 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 is \BuildingPermits\ELC- PermitApp doc 04/03 1 • Mechanical Permit Application a:: . ' EOROFFICE USE ONLv. .. . , `4: City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /fj w � Other Permit: Inspection Line: 503.639.4175 ��� p_ 1 I' Date Date Re: C"7 'W Ready/By. Jwis: 8 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information ; Y i : * ` - TI 'P.E Q1 WOR r{ -, ¢ , . � � ��. ���:_ a �.:*r.,.°- , >x ...s,_ - m:=� .t<�i,��. r �.�,.s� ��'i E.... _ :�. F COI �YINI E,RGIt1L,•' EE,� __..� _ �� ::�_;:_.....,,� ���� _,r::,,�,,..::,,:�., , "1! S . EDULE� - . , USE"H� ❑ New construction 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. : ' %.. ;z titarN ..CATEGORY OF 661 UsC`I;ION ' �' „i Value: $ ,. E� :..,.._�a:,��� a:»�s.zxv�e�s=. .... :.,_..�- .a,,- _>'xz..v.o, :., -" ..m '.3f,.«a,tm�aa.� - w `.: ,' ^�s.. a ss asp =s, s RESIDEN /iA IPME SYSTEiVIS FEES *' '` ' ,- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: ,u t"ygyY Description Qty. Ea. Total ' t ' ' a =' JOB TI ∎fFA � ....: x a 'e .o,,.taar i;e ;;. .....&Z. ,rI,. RM9TI AN3) .I O;CAT'I 41) M : ;:i k; ;- Heating/cooling �. .M�, . :�.. ;.�� - -� „ ,ma y , � �-� i��x:�:,a -. Job site address: tt C (2 rh Air conditioning or heat pump � �1 c ?� �� (requires site plan showing placement) 14.00 City/State /ZIP: Tit - , o(1 q - 7 ' Z23 Furnace 100,000 BTU (ducts /vents) 1 4.00 l7 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: 5 c \W\--N66 Gas heat pump 14.00 Cross street/directions to job site: f LD 16 (2 TO - 4d Duct work 1 14.00 II. / MARION a_1 iZ4 _ R eside r i hot water system 14.00 M r L t� C�1{'' F 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 .w�4,' ' ¢ +' -4 'ate- Ha l ni , i z /* a � _ , a DESC , ,,, , i, ® = WOR "h : , - : ` Water heater 10.00 i ;.:�, ,:"a;.�t'r«I'a.:.:ei'_ �%�<�.. a+.tizt -� ���aa _ . _ 1 _ _:a: , v-� t Gas fireplace 10.00 001---"T AA) Ci t ,�ej, j G L.1/U & /1 IL �> J' ° f i Flue vent for water heater or gas i 17-.11-A 'f� uc 4s' RAT I 7 tie-dull/0e fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 , ; PI2O k TY � WNEI2s' n` '1 l y TENANT , ,%„ Chimney /liner /flue /vent 10.00 Al..: t. . ..a �� .ie;, :a, iOsz& et * . _ ? 1 n `i Other: 10.00 Name: C+J;-E /E ( Ct Environmental exhaust and ventilation Address: i Z 7 J, S 56,1 (ZU th 57-- equipment hood /other kitchen euiment 1 10.00 City /State /ZIP: 11 6 dt, , co z Clothes dryer exhaust / 10.00 SIO- G-557 / Single-duct exhaust s (uathrorms, Phone: ( $03) "' ll Fa (C r�la 793' q ()�1 toilet compartments, utility rooms) 2. 6.80 <; . „� ;r,.a s': ,.. , . r."' _�_�: ; igip . il � ��;ii ,�3 Ni ace fans 10.00 , ",'140.4;a-A.;,:. Attic/crawlspace _ APPLI ' ..' t ; ,r � CONr T � P-ER..t- -14 .. 4 ;) P Other: 10.00 Business name: (EL L. f b fw .E / COP 5 �*©, F uel piping i 7 P g Contact name: r F $5.40 for first four; $1.00 for each additional Address: r y �/ Furnace, etc. v ` /` r ( Gas heat pump City /State/ZIP: c i - ct- I gQ Wall /suspended /unit heater Phone: ( 5 OS - V? 5 Fax: : ( 563) e'75 3 7 a7 Water heater Fireplace E -mail: CCLL563 -bl t,(- S""Z�� Range "`�.s :' �';:is���3�.. ,.. `� . };e; S .� ! R . y.�3 ",.S P'§'��'.. .�„ Kr,1..��cE =. 4 - n e a a � ._ .. s i C T. `",,. I4V 7 Barbecue y ;ar ,i: ?,...1,11xatxr. ,. kS.w `"' ae ,,,,U' 1 1:, 43. .m • Business name: e 71461,4 /� . ta r p Clothes dryer (gas) I °� Other: Address: ¢ I � `iVIE HAN' Wa'" ' . *;' �� ��� �`xr ICAT�,:2'KERIyITrrF- EES_. =_ ... City /State /Z1P: A r 6 7) Q O if,7/.3' Subtotal Phone: (503) QOM' - 4'313 Fax: ( ) 53 may, j Minimum permit fee ($72.5 ) i! ! 5'�" Plan review (25% of permit fee) CCB lic.: geo 013 State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signatu e: Date: This permit application expires if a permit is not obtained within ISO days after it has been as complete. * Fee method Print name: methodology set by Tri- County Building Industry Service Board 40144.7 i :\Building\Permits \MEC- PermitApp doc 12/03 440 -46177 (11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valaatu n ``, $permit,FeeN. % li v $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:\ BuildingPermits \MEC- PermitApp.doc 12/03 • 2 , w ' ,,, T +• h r+, i ,. N xt i ` pi t sie c... t Y d` s °�sv r z+. €qtr'-- Plumbing Permit Application " >I - . ;; ',•. t +FOR OFFICE *USE ONLY' yk •' `:" '-£' City of Tigard Received 13125 SW Hall Blvd., Tigard, OR 97223 DateBy: Permit No.: Phone: 503.639.4171 Fax: 503.598.1960 Plan Review t \ Date/By: Other Permit No.: 24 - Hour Inspection Line: 503.639.4175 �! ' p . Date Ready/By: y: Saris: See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information ::r. tr - -, ` - - - :?1-^::::' . -� :TYPErOE �vo RK�_ .. .. - - F E. S FI E . CI New construction_ • 111 Demolition Fo r special information use checklist.. . ` Addition/alteration/replacement ❑ Other: • Description • Qty. Ea. Total' - ,n _ d ;; ,_:e t . yi ^ ,..h New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATS f,: . fefl ,--, ri�K GORti ' F::z s;,.r ellla- .,l . *ct.,,. ,. z fi . -,, ,,- ..,.r.,, M,,,..:'O OIVSTRUGT'ION, > : �. , .., X k SFR (1) bath �u ..,. �-,..,. ��« �; t: ��.,� F °:=,'.�<::�::n:: > 249.20 IA 1- and 2- family dwelling . ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ID Master builder Each additional bath/kitchen 45.00 ❑ O ther: Y e a r °. :mod .° . F ', ;, - Fire sprinkler ( sq. ft.) Page 2 %'if " -`- g:=J ORV - ..,.�..�..... - �:.H: �:�- ta-r, r =w% ..... , - R E rIk IAT C AND. I e > O A v. l < , ,:, F , s'r -, >: ..�; ^. �€::r�;iu'e . "s�a*.:rr: ,a a: Ill._: r'�;s'" €;.r? >:�,� -.' " > : ;,3,} - ��`�- ° jam- � =' '•�: ° �� Site utilities Job site address: -7 + 11 " �� 4� s 5�� I �y Catch basin or area drain 16.60 l €. City/State /ZIP: I OR. 9-7 1.7-414- , Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: ". I Project name: c5 b Footing drain (no. linear ft.: ) Page 2 • Cross street/directions to job site: Sy Manufactured home utilities 110.00 Z ��__ /r 2T �� 2� / Manholes 16.60 - � R-T iZ� tk �v�J cm LO- Rain drain connector 16.60 I • 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 Tax map /parcel no.: • Fixture or item '. < €f a, : . .a . ; u r u,, , = = :;s r s :, - Absorption valve 16.60 • .t . ,•- �, gf.i ;W -P -sY t. ibl~✓S -YIP -T :{ - :.H. :1, , . ,. " =.s-.; : „ .x ,-. C TON.,OF �VORK ,, *;;' ; I., Backflow preventer • Page 2 • . , w.s: •. a .emse. _q _ _,�w :a� K�r ,. tF.,.,.< ,- . . _, ,...a,_,.- _. ,. ,. - g - ( \' /�� .�,.��+�, ,py-�`/�j' tom. p }��� 4 � ,. � : �y 1 I 5/4T-ti ..k.�'. �:��x: -..; .',. �. °.. 19 -et*AC / 1 ` . •.i�7 1\ VA VA LL- y � • • ' - _ 6 �( B va lve 16.60 Clothes washer 1 16.60 (6,13 Dishwasher ( 16.60 IC,,,e - 0 `'h1e* w a' - ,; ; ,w ,, #F; c ° { , a;;z: Stir, ;: ;: `' "` Drinking fountain 16.60 �- - " PROiikli tO i a , ' S t / ; ° TEI , R 1 n x `, c 3.,r`M..u�,- ,...... ws,°. ..,,.,f,•.„ . tai° x �is:3wdri,.ke - wac%. i .ei •.,a ,,>.aa. ' -9� EJeetomump 16.60 Name: S 1 E pf 'i EisZc`1 Expansion tank 16.60 Address: I�s-Lc S J l. ,3 i v_k i- 5r Fixture /sewer cap 16.60 City/State/ZIP: -' Gas y - '1,2. Floor drain /floor sink/hub 16.60 Phone: (smb) 4 b - • �^7 Fax: .n) �� • 3 _ Garbage disposal 1 16.60 6� . ' - 0 -nv " •114 �,.,; ily . i :: 11T ti {t ` } r. ,• I ; ma ail Hose bib 16 , s ,. , , _a, ; t '°: APPT IGAtVT � . : :: - `4 1,I ' * =l i . ' _ z . � ; C.. O i`I,H a i ; ,,. 60 ei:>.. 1 .. �;;`" �;- i�>:,:, �.•. �, �r�E�r,, c�,; zw:.' aµ,. ", �. .,;�� TACTrs,P,E �. ` }' ` ' "`" Ice maker 16.60 p Business name: N\ � ,RAN Cy 0 . eo 6 c Interceptor /grease trap 16.60 Contact name: 1-.. N �ue,/ Medical gas (value: $ • ) Page 2 Address: 1>O ,0 x l t (a Primer 16.60 City/State/ZIP: 4 5 V N d - q-/ (4 Roof drain (commercial) 16.60 Phone: ( ) C�ZS ,- (.�,q Z c ' I Fax: : (5-0) 2.7 Sink/basin /lavatory 5 16.60 $� . d - J14. ` -2 / 1 Urinal Tub/shower/shower pan --S 16.60 (,�q c� Urinal 16.60 ` - ,..,• =' - x :�- ° k- �= �" �- O CT <.,,� ,: <.:,,::�- �� - :. =._�., .. . - ._.. _ Water closet 'L_ 16.60 -53,20 Business name: 2. 51)1,_fi, - gAr Water heater 16.60 Address: V0 . , ( Other City /State /ZIP-.<wA ' 41c407.- Subtotal Minimum permit fee: $72.50 Phone: j ) it - ,t-Ic0 Fax: ( ) &A k._ l,329 Residential backflow minimum permit fee: $36.25 7,32 ,`' CCB Lic.: e��cZ Plumbing Lie. no.: 34-t � -3 Plan review (25% of permit fee) .1 6 Authorized signatur'� h State surcharge (8% of permit fee) j�. �'7 LL..rr [/G ZA TOTAL PERMIT FEE Print name: 04.4 ` yr¢-ti3 I Date:• -/ / T /0g� I This permit application expires if a permit is not obtained within T ` 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Pennits\PLM- PermitApp.doc 12/03 440.4616T( I O /02 /COMAVEB) - Plumbing Permit Application - City of Tigard - • Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: i- F ee ea -�n "'Total'`' '' . _. < � . ,x., � = �.. _ �;�.,..� .r = S `�u are Fo ` : : •rfi�..,.._ p : .q otage` Permit `Fee; Footing drain - 1" 100' 55.00 0 to 2,000 a $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer - 1st 100' 3,601 to 7,200 $220.00 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 - „; ,,., -;. ,.:.• Storm & Rain Drain - 1st 100' 55.00 Valuation < `: Per>11 t Fee: $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 �•" ; :<4i;� r;'�" t "`;;�r:�F`ee�,e H� �f: ,`.,�.''; additional $100.00 ,,F1Xture1or:.Iteiri =r =... n, '- Q Y (a) ,,Total';,'; on ,. frac tion thereof, to and • z .:��.:= ��c.;�ir��:�•�•;.� ��;�.:,s'�:� -:� :;::�«::,:;. including $10,000.000 . Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device - . each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) • 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for 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: Are you capping, moving or replacing existing fixtures? If ."yes", please indicate work performed by fixture. Failure to • . . • accurately report fixtures could result in increased sewer fees * . '2 r =� t ', `* f�t . IE1 O: anttt :14/015 00)'M rkPerfortned i; ei F xture Ty:pe '� � Ri r s %v x s aReplacU i , =t,P_ � °. ..• ., , Mop a x ,:... ca pp ed Comments regarding fixture work: Baptistry/Font CXA - SCIS1Y 1 'j)(lotto 4 r. - Bath - Tub /Shower as - Jacuzzi/Whirlpool I (V N IlZ1 - kmov ,S (> (Z, �-.Jh r . Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" • -3 " . Car Wash Drain . Garbage - Domestic 1 ' • • Disposal -Industrial -Commercial *Note: If the fixture work under this permit results in an Ice Mach./Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall e. r Sink - Bar /Lavatory - Bradley Quantity Total Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Urinal Closet - Toilet Z Plan review is required if fixture quantity total is. >9. Other Fixtures: is Building \Pertnits\PLM- PermitApp doc 3/03 . CITY OF TIGARD BUILDING DIVISION ,- / . PERMIT #: MST2005-00242 13125 SW Hall Blvd., Tigard, OR 97223 / „ - DATE ISSUED: 8 Phone: (503) 639-4171 earaiii#I ,■, Inspection Requests (24 Hrs.): (503) 639-4175 s-afg. AL INSPECTION WORKSHEET FOR DATE: 6/22/2006 TIME: 7:01A1v1 PAGE: 35 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE 140.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: rk%;11, 0+Liel lOther mechanical is duct work. Other plumbing is ice maker. 11/2105: Added low voltage WCi- audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6351 - CONTRACTOR: DINNtaapoRgiA'' Hr31*.k.*MRUCTI ON CO PHONE #: 503-625-4976 Inspection Request Scheduled For: Date: 6/22/2006 Po - i ,,. Code # Inspection Description Confirm # Contact # -ssage 299 Final Final inspection 032163-02 503-314-526°1 Y Corrections/Comments/Instructions: , . , r . .• / , .■ ) : : I ; ,- i ' • 1 Ck , i : , . ... . • 4 Al• W 1 f 1 1/4 ,:' -1 ,( e ra " t.SS I 1 PARTIAL APPROVAL 1 I CANCEL 0 NO ACCESS FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: ■ (fL/.. Date: ( P1 171V /C Phone #: (503) 718- ya_ x • CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST200S-00242 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 8/12/2005 Phone: (503) 639-4171 ... (if i Inspection Requests (24 Hrs.): (503) 639-4175 .41 INSPECTION WORKSHEET FOR DATE: 6/22/2006 TIME: 7:01AM PAGE: 36 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: r DEANGEL0 DESCRIPTION: L.fientiodek'Other mechanical is duct work. Other plumbing is ice maker. 11/2/05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 5 CONTRACTOR: MiNtaffi-Kat til'HIRDMTRUCTI ON CO PHONE #: 503 Inspection Request Scheduled For: Date: 6/22/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 032163-. 01 503-314-5261 Y Corrections/Comments/Instructions: - . 4 1 --- PASS I I PARTIAL APPROVAL EI CANCEL EI NO ACCESS EI FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED g\ Inspector: Date: `-' Phone #: (503) 718- . . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1212005 Phone: (503) 639-4171 A0,14 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/20/2006 TIME: 7:01AM PAGE: 22 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work Other plumbing is ice maker. 11/2/05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6351 CONTRACTOR: D fiLSORTERHZOMTRUCTI ON CO PHONE #: 503-625-4976 Inspection Request Scheduled For: Date: 6/2012006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 032005-01 503-3145261 Corrections/Comments/Instructions: • -3 q . \O \A'CP k i SO 104\ PASS fl PARTIAL APPROVAL r CANCEL fl NO ACCESS I I FAIL fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: Date: ‘' ' 06 Phone #: (503) 718- 2 -LA • CITY OF TIGARD BUILDING DIVISION PERMIT #: IvIST2005-002412 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/12/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/6/2006 TIME: 7:02AM PAGE: 19 17..1 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: Wil_LAMETI NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ice maker. 11/2/05: Added low for audiats,teleo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6361 CONTRACTOR: Die 1 CO PHONE #: 503 Inspection Request Scheduled For: Date: 6/6/2006 Pour Time: Code # Inspection Description Confirm # Contact # - 199 Electrical final 031178-02 503-3145261 ?f. to Corrections/Comments/Instructions: cprk c tK PrZo Zlic9 'Tc.t.t c-e) El PASS fl PARTIAL APPROVAL n CANCEL 0 NO ACCESS /PA FAIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: e.-141r Date: 6:_.6-o4 Phone #: (503) 718- g-Zi7/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00 2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639 -4171 " u4 1�t6�1" ' Inspection Requests (24 Hrs.): (503) 639 -4175 I L INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 80 • SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO • DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ice maker. 11/2/05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6351 CONTRACTOR: DQ It , pOM 1 TRUCTION CO PHONE #: 503- 625 -4975 Inspection- Request Scheduled For: Date: 11/4/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message / 120 Electrical rough -in V 020311 -01 503.314 -5261 N Corrections /Comments /Instructions: . tie pittiva a01 /OA -LI-Z p 0 a. -4e kt,(4,". 4.4 W. r WALK JAW 6 (0 en vet,e_ ( . A 5 i72 v�� j t 092 koled IbJ PASS PARTIAL APPROVAL n CANCEL NO ACCESS ❑ FAIL ❑ CA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: �4 o< Phone #: (503) 718- ` 4 i t/sr- 1,0,1 -, ,_ 17V CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00242 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639 -4171 , � ANq ������ f i Inspection Requests (24 Hrs.): (503) 639 -4175 ... • a INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 79 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAME I 1E1\10.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ice maker. 11/2/05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503 - 590 -6351 CONTRACTOR: 00110.ffl. t 1 TRUCTION CO PHONE #: 503- 625 -4975 Inspection Request Scheduled For: Date: 11/4/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 020311 -02 503-3145261 N Corrections /Comments /Instructions: • ( (44 1 • 1 CI PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS' FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: _ Phone #: (503) 718- CITY OF TIGARD 1 BUILDING DIVISION PERMIT #: MST2005-00242 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1212006 Phone: (503) 639-4171 ,,. Inspection Requests (24 Hrs.): (503) 639-4175 it INSPECTION WORKSHEET FOR DATE: 6/6/2006 TIME: 7:02Alvl PAGE: 20 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE 1\10,2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ice maker. 11/2J05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6351 CONTRACTOR: DiMirtriLiSMeil r TRUCTION CO PHONE #: 503 Inspection Request Scheduled For: • Date: 6/6/2006 Pour Time: Code # Inspection Description Confirm # Cs , . : Message 399 Plumbing final 031178.01 503-314-5261 Y r , Corrections/Comments/Instructions: V ji .2- ■ — IV Aloralowi -.IF„,, , I • I I7 ; -ASS El PARTIAL APPROVAL fl CANCEL 0 NO ACCESS • I I FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: hi / ke--- Date: ./ , I Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00242 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/12/2005 I Phone: (503) 639 -4171 JI 1 1 1111 Inspection Requests (24 Hrs.): (503) 639 -4175 _... INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 91 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMEI IE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: sm idef ther mechanical is duct work. Other plumbing is ice maker. 11/2/05: Added low voltage or audio /stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503 -590 -6351 CONTRACTOR: DIMISIJILD)1111ERHMMTRUCTI ON CO PHONE #: 503 -6 25 -4975 Inspection Request Scheduled For: Date: 1//222005 Pour Time: Code # Inspection Description Confirm # Contact # ssage 320 Plumbing rough -in 022211 -01 503 - 314 -5261 (� i ouLA Corrections /Comments /Instructions: ‘r-FF(')/(( CP") PASS I I PARTIAL APPROVAL ❑ CANCEL I NO ACCESS n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: \ v '�' Date: 1 / Phone #: (503) 718- CITY OF TIGARD MST200S 00242 BUILDING DIVISION PERMIT #: 8//2/2045 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 M ,eyim�W a, Inspection Requests (24 Hrs.): (503) 639 -4175 1 �.. 10124/2005 7:02AM 75 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 13215 SW 124TH AVE SITE ADDRESS: WILLAMETTE NO.2 016 CLASS OF WORK: SUBDIVISION: DEANGELO LOT #: TYPE OF USE: PROJECT NAME: Remodel. Other mechanical is duct work. Other plumbing is ice maker. DESCRIPTION: DEANGELO, STEPHEN T, 503 - 590 OWNER: DikiIt> L$OI I TRUCTION CO PHONE #: 503 - 6264975 CONTRACTOR: PHONE #: 10/24/2005 Inspection Request Scheduled For: Date: Pour Time: Cc ch # I Fad rD g c.r tion 0�3�1 600#1 58t139 McNage Corrections /Comments /Instructions: 1 2 2 7,:4/ 06 • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector. Date: • / -3-1 //b -1 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 76 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ice maker. OWNER: DEANGELO, STEPHEN T, PHONE #: 503 - 590.6351 CONTRACTOR: Dli l N, Lla)I "TRUCTION CO PHONE #: 503-625-4975 Inspection Request Scheduled For: Date: 10/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 018990-01 503-692-4139 N Corrections /Comments /Instructions: 1 1 • I PASS PARTIAL APPROVAL ❑ CANCEL I NO ACCESS . cy FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6-13\ -,,,_&_, \\ Date: 10 2') 'rp(c+ Phone #: (503) 718- CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2005.00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639 -4171 �r (� Inspection Requests (24 Hrs.): (503) 639 -4175 ..1,w- i L,. INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7 :09AM PAGE: 47 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbin is ice maker. 11/2/05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503 - 590.6351 CONTRACTOR: DIAINt .ELLSOIA TRUCTION CO PHONE #: 503 - 6254975 Inspection Request Scheduled For: Date: 11/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 020024-02 503- 3145261 N Corrections/Comments/Instructions: K PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION 1 I ADDITIONAL FEES ASSESSED i Inspector: / /' . Date: ii (• 61 Phone #: (503) 718 - ( CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639 -4171 N� i�ygi�l l Inspection Requests (24 Hrs.): (503) 639 -4175 `__.. INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 46 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbin is ice maker. 11/2/05: Added low voltage for audio /stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503 -590 -6351 CONTRACTOR: ORI# X H n TRUCTION CO PHONE #: 503 - 625 -4975 Inspection Request Scheduled For: Date: 11/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 210 Insulation 020824 -03 503 - 314-5261 N Corrections/Comments/Instructions: k i PASS ❑ PARTIAL APPROVAL ❑ CANCEL 1 I NO ACCESS FAIL n El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: / ( Date: a Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S -00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AMMf PAGE: 49 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 , TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ' e maker. 11/2105: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503- 590 -6351 CONTRACTOR: D ISTAL A L TRUCTION CO PHONE #: 503-625.4975 Inspection Request Scheduled For: Date: 11/9/2005 Pour Time: Code ## Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 020824 -01 503- 314 -5261 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: , ' Date: /1 • Phone #: (503) 718 - L' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 „ilir INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 52 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAME I 1E NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work Other plumbing is ice maker. 11/2/05: Added low voltage - for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6351 CONTRACTOR: DA141/131fILIKARERlittMTRUCTION CO PHONE #: 503-625-4975 Inspection Request Scheduled For: Date: 11/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough-in 020440-01 503-314-5261 Corrections/Comments/Instructions: .5 nig 4i z. n PASS FA;1 APPROVAL fl CANCEL El NO ACCESS n FAIL L CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED • Inspector: - Date: Phone #: (503) 718- - . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005 Phone: (503) 639- 4171 u 1 ,�,f�� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 51 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WILLAMETTE NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work Other plumbing is ice maker. 11/2/05: Added low voltage for audio/stereo. OWNER: DEANGELO, STEPHEN T, PHONE #: 503-590-6351 CONTRACTOR: [ AIIl l..k' )I IV TRUCTION CO PHONE #: 503 - 625 -4975 Inspection Request Scheduled For: Date: 11/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 020440-02 503 - 314 -5261 N Corrections/Comments/Instructions: i / _(J 'i v,ri,A5 �� Z �ca� 2� � 4 �cS�Y -� SrJ�°/�U�GZ -IBS �c%a Gv rr JOLS T I I PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . Date://7Q 1" Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S- 00242 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1212005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 „�' . 1 �.. INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 24 SITE ADDRESS: 13215 SW 124TH AVE CLASS OF WORK: SUBDIVISION: WiLLAML.I I E NO.2 LOT #: 016 TYPE OF USE: PROJECT NAME: DEANGELO DESCRIPTION: Remodel. Other mechanical is duct work. Other plumbing is ice maker. OWNER: DEANGELO, STEPHEN T, PHONE #: 503- 590 -6361 CONTRACTOR: DVDMILI3OfitlERHIMMTRUCTION CO PHONE #: 503 - 625 -4975 Inspection Request Scheduled For: Date: 10/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 019017 -01 503-314-5261 Y Corrections/Comments/Instructions: - / © / L'% -1 ✓-S c G " ',, O.!',. or 1 : ! L 'M-S — ° ,52-i c iGoi/ (9N 6:2_0.As -- K c ,ii1t .1./ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL ❑ ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED i Inspector: Date: i -2/— 'S Phone #: (503) 718 -