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Permit -• .r OF TIGARD MASTER PERMIT PERMIT #: MST2007 -00054 COMMUNITY DEVELOPMENT DATE ISSUED: 5/3/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S133DD -16500 SITE ADDRESS: 11994 SW 129TH PL ZONING: R -4.5 SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT: 201 JURISDICTION: TIG PROJECT: CHIN Project Description: 66 sf addition. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 65 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 66 sf 6,098.40 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: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: ELE FURN 0=100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 1 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: 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: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 • 1000 amp: 601t-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: WN�� o Municipal Code, State of OR. Specialty Codes and all other applicable LARRY & ELAINE CHIN laws. All work will be done in accordance with approved plans. This 11994 SW 129TH permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 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 Phone: 503 - 579 - 1994 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 449.37 REQUIRED ITEMS AND REPORTS Issued By : C ,// .././../d � ` ,� Permittee Signature : j� / � C - . Call 503.639.4175 by 7:00 a.m. for an inspection that • - Iness day. This permit card shall be kept in a conspicuous place on the job sit: til completion of the project. Approved plans are required on the job site at the time .f each inspection. 1uilding Permit Application ;. v .. Residential ± ` TOR OFFICE'USE CI RECEIVED Received �/{� y J r IIII ' a `J of Tigard b Date /BY :3// r� � � BP'S Permit No r • " Taec ( ... J3 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie ' Phone: 503.639.4171 Fax: 503.598.19 91AR 1 2 2007 Date/By: (.• Other Permit: T I G AR'D Inspection Line: 503.639.4175 Date Ready /By: Q rur ® See Page 2 for . Internet: www.tigard- or.gov ( TY OF fiGAR , ethod: /l/ /� /� Supplemental Information TYPE OF WORK / p ,_ IRED DATA : 1 - 'STD 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 v Iti dditio Iteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. ( <jC6. n CATEGORY OF CONSTRUCTION © 'i A i_ and 2- family dwelling ❑ Commercial /industrial Valuation: $ d� v ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: . JOB SITE INFORMATION' AND LOCATION. Total number of floors: Job site address: /I7 q f _ cJ ! 1 z r / pm E New dwelling area: ( ( square feet ` U City /State /ZIP: T� /' ,412,0 D. 0 / - 7 2. 2.. 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: C/,„ )4-/-7- E i z y v Covered porch area: square feet Cross street/directions to job site: / Deck area: square feet Other structure area: square feet 'REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: / mi / E Q4 1 2 /�4 Lot no.: 2_ / 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. Q h b / / 5 � /k / - - /P Valuation: $ , G/ �f(� Existing building area: square feet New building area: square feet ' %PROPERTY OWNER ❑ TENANT Number of stories: Name: /.41-4/2o- ,.-L a /■ CI-1»L/ Type of construction: Address: /) (_ y /21'1- 97 C5 Occupancy groups: City /State /ZIP: - 7 ! ,4 ( 2 ) /9 it "1 7 3 Existing: Phone: ( 5 7 _ .1 (9qV Fax: ( ) New: APPLICANT / / ❑ CONTACT PERSON - NOTICE Business name: J--pojl /A) oN g_ i ,)L/'/7 7 All contractors and subcontractors are required to be Contact name: �' yN t..,..; ��� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: / - T 5 - S // 7'L Al- jurisdiction in which work is being performed. If the City /State /ZIP: 7 / 7-L- 7 9 z92 Gj 7 2 _ ) / applicant is exempt from licensing, the following reasons < % z ° apply: t3 7Q2'D. Phone: ( r 5- _ 7 76‘ Fax: : ( ) _ r r•0 W E -mail: S of J . CONTRACTOR • 7 / 74/•..51z, Business name:773 D BUILDING PERMIT FEES* Address: �� (Please refer t fee schedule — City/State /ZIP: Structural plan review fee (or deposit): ' FLS plan review fee (if applicable): Phone: ( ) Fax: ( ) CCB lie.: Total fees due upon application: Amount received: ,s67 Authorized signat This permit application expires if a permit is not ob rued within 180 days after it has been accepted as complete. Print name: Date: L 2 11 l .//4/41. / 7 Fee methodology set by Tri -County Building Industry Service Board. I: \Building\Permits\BUP -RES PermitApp.doc 07 440- 4613T(11 /02 /COM /WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE US + Ci of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 • • . AssoBy: v Phone: 503.639.4171 Fax: 503.598.1960 1 Associated permits: TIGARD 24- Hour Inspection Line: 503.639.4175 CI Electrical ❑ Plumbing ❑ Mechanical x Internet: www.tigard - or.gov ❑ Other: . _ T FOLLOWING ITEMS AR D; FO E: REQUIRED, REVIEW , F HE' IEW , ' _ Y es No N/A 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 I i" ❑ ❑ 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 P--- ❑ ❑ 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 [f. ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, 0r ❑ ❑ 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. L� ❑ ❑ 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- lEr ❑ ❑ 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 p---; ❑ ❑ 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 Er ❑ ❑ 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 Oregon and shall be shown to be applicable to the project 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, I995. 1:\ Building \Permits\BUP- RES- PennitApp doe 03/21/06 440- 4613T(11/02 /COM/WEB) I ( ` l n ' 1 LSV', 1 ',� r� Mechanical Permit Application 7 w. z ` : • £ �p . EOROFFICE USE ONLY y t; City of Tigard �v SS\ Date/By: Permit No.: _ . • 13125 SW Hall Blvd., Tigard, S 722 gar �8� Q � Received Plan Review Phone: 503.639.4171 Fax ! " s. 60 Date/By: Other Permit: '� RD Inspection Line: 503.639.417 �, O Date Ready/By. B Internet. wwvv.ti ard -or. ov y Y' lo cis. See Page 2 for g g r A\ 5� ? ' O 0 Notified/Method: Supplemental Information TYPE OF 1' RI 7� \ " , „ COMMERCIAL FEE! SCHEDULE — USE CHECICLIST • ❑ New construction tgAddition/a t�'c onn/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 Al- � ❑ Multi- family ❑ Master builder For special information use checklist. ❑ Other: Description I Qty. Ea. Total . . - JOB SITE INFORMATION AND LOCATION ' . Heating/cooling Job site address: //// ^ Air conditioning or heat pump // �� 7 � , . L� (requires site plan showing placement) 14.00 City/State /ZIP: -774p ,p) l9/ . c9'7 Z 2 3 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: �� C co/c / co p2 / V ( E . Duct work 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 Subdivision: L//,4J, v7 (1/k 4. / k Lot no.: Z0 f Flue /vent for any of above 10.00 l J �� Other: 10.00 Tax map /parcel no.: Other fuel appliances . DESCRIPTION OF WORK Water heater 10.00 • a / / i� .� Gas fireplace 10.00 r C S FT 40 b/ r D� /c/ TGf�F/� Flue vent for water heater or gas ,vr + fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 ,J Wood fireplace /insert 10.00 • ' , : - J� PROPERTY OWNER , ; ❑ TENANT Chimney/liner /flue /vent 10.00 / Other: 10.00 Name: L ,4 / R L 2 , G /WO CH //I Environmental exhaust and ventilation Address: / / e L,_ / L el-11p /p LA L Range hood/other kitchen d / b 1 7 �/ ,t I ! equipment ment 10.00 City /State /ZIP: 776 4/j) t� k , 0 7 2.z3 Clothes dryer exhaust 10.00 / Single -duct exhaust (bathrooms, Phone: (50 5 -9 _ / t7q aL Fax: ( ) toilet compartments, utility rooms) I 6.80 g APPLICANT • T ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: S Q�/` //S/ 0A/6 4,11c/4/r/76 T Fuel piping Contact name: TO/1W l c) oiy / ' $5.40 for first four; $1.00 for each additional Address: V/ 7 5 - SO- / " / Z -!'�' � �l of& Gas h ea t etc. / Gas heat pump City /State /ZIP: p e AT L p,„ 0/2.. c(72,14 WalUsuspended/unit heater Phone: (5 0_ 4 2_55-77 Fax:: ( ) Water heater E -mail: Fireplace Range • , . CONTRACTOR Barbecue Business name: Clothes dryer (gas) Other: Address: - MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Minimum permit fee ($72.50) 7& .50 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lie.: State surcharge (8% of permit fee) , I■KV TOTAL PERMIT FEE Authorized Si Lure: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: j D ate: 5 '/Z - 6 7 • Fee method ology set by Tri -County Building Industry Service Board I.\Buildmg\Pe i s\MEC- PermaApp doc 04 /06/06 440 -46t7T (I I /02/C Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: , Permit $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. l Building \Permits\MEC- PermitApp.doc 12/30/05 2 - j s Plumbing Permit Applicati \ 1-01z 0 I' E ICI USF ON ' - 4 r nF ' 114 "> City Of Tigard n Received Permit No.: V 13125 SW Hall Blvd., Tigard, OR 97223 '\ 2 ' 24 Plan Review -- Phone: 503.639.4171 Fax: 503.59811 Other Permit No.: {,RQ Date/By. Inspection Line: 503.639.4175 il? .1I G A K U �-c`i 0° S ,Q � Date Ready/By. Juris: El See Page 2 for Internet: www.tigard -or.gov (Jt \ S { flwj Notified/Method Supplemental Information : ";^s. " -. r�im'+". ' =' -.. a _ -;;� It `f' . 'lG < _- '•,:-,•,i '1 ; . . ?: . ! - " ` e-r .d o " " S.wt ' ,�8; ': L, " ;e : TYPE`'OFVV� L- � " " .•i' ; ` 'l r �;; .r FEE .SCHEDULE' ' -` °,. ::r, �,... . •-',..� �r,� - �s ,.. ._... ^'.:r.3.,- z.�.: �._. <. .... ;'�_.. .,.r.x. -. *,•,r, For special information use checklist. ❑ New construction El Demolition ❑ " Ne 1 - t on Qty. I Ea. i Total Addition/alteration/replacement on/replacemen O ther: New 1- 2- family dwellings (includes 100 ft for each utility connection) tz a sk ,,,, a CATEGIORI' OF C . O I t .s SFR (1) bath • ' STRUGT OlV ' , .:' 3A'n,`, 249.20 " "sue- 'rt;5.. f ] I- and 2-family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building 1:1 Multi-family SFR (3) bath 399.00 ID Master builder Each additional bath/kitchen 45.00 ❑ Other: r a .., _ ;y ... .._ sa�Y �, a k =., _, Fire sprinkler ( sq. ft.) Page 2 ^ >`i.,f, n r ; , : :' ■JOB SI TE , INFOR AN ' '� " �,. ^ ; ? ,.4,„: - `' ��� I: ��, • Site utilities Job site address: // q 79._, 5h) /2 ,47-1.4 7 LA G.,..- Catch basin or area drain 16.60 City /State/ZIP: ! -r7 , A/1,6/ o� 77� 2-,; l' Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: t Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street /directions to job site: p4 /‘' 4„/ / /. ,i n fU !" Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 ( / /LC 4 � arg. A T $ U ( L /4(L t z6 Fixture or item Tax map/parcel no.: i . x£ , . a _ ... :,.. d w, .,.., r Absorption valve 16.60 y✓Y ,:' "', DESGR(PIIONrOF•'WORK <' (`.n .3 Y .,� 'i` ��aR � ^' �+��� � � �, ^� u" •° B ac kfl ow preventer Paget 6' i, __;p rf._, Z,Lj J)IT/O_A Backwater valve 16.60 Clothes washer 16.60 Dishwasher / 16.60 °4,ga �:.� . �1. .,; _r,:^' r t w • , . Drinking fountain 16.60 r *4 PROPERT1t? VYNERi' .; „ I, r.. 4. 4 "s °•;„•« t -1` t w_.., _ :�, •- ' -4" '1'- *' ❑'.TEN- -- -'-r '`'''''';., ( "" Ejectors/sump 16.60 Name: /. A ( R� / 4 06, 4.1N E C i i fJ'/ Expansion tank 16.60 Address: /l GT f 5 /2 J ' �jL,(.g Fixture/sewer cap 16.60 City /State/ZIP: ` 7 ,j v � e2 q 72 2 3 Floor drain/floor sink/hub 16.60 Phone: ( . o3) 5 7 g - / ai 9 Fax: ( ) Garbage disposal / 16.60 : : - . ,t ;5 94. '. y =" �APPLI6Aii 412'`; ZA 4z'.C:-' ON7`ACTPEiii1 ii 1V "�:"`.', '',' Hose bib 16.60 Ice rnakex 16.60 Business name: l�> O/NN'(; A-/LCh/( 7C7 Interceptor /grease trap 16.60 Contact name: _ 'TO L/,( / f � p N Medical gas (value: $ ) Page 2 Address: / g T 5 ^ 5 l / 7 � 7t� A� Primer 16.60 (commercial) / State/ZIP: l [ 7 / Roof d 16.60 City/State/ZIP: perL7 /A (7A 9 7Zlt4 ) Phone: (Ce3 ) 25-5 -_ /� 70 / Fax: : ( ) � 'asin/ lavatory ��tC / 16.60 0 Tub /shower / pan 16.60 E-mail: Urinal 16.60 r'. x� .V - k;c4. r . "CONTRA'CT'OR {a' .. si k' p,'. p .F¢'.- :4; ": .'``� _ ,-4 •c. _ a1,.., ..: m Water closet 16.60 Business name: Water heater 16.60 Address: Other: City / State/ZIP: Subtotal 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 si ture: TOTAL PERMIT FEE Print name: " Date: 3 -12. 07 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- PermitApp.doc 06/26/06 440- 4616TO0/02/COM(WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Sit *11-41, 0164:_ a F (ca) 3 T I 4 Square" FOOtage M Pei t_ ' eC ' r Y Footing drain - 1 100' 55.00 0 to 2,000 $1 15.00 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 - 1 st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 x, , ,r; }r. ,a - 4E:4 , 4" - on; : ' }Permit` : x€ ;k r* > 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 � 7 r . additional $100.00 or fraction thereof to and �yFixturc.Or � ;4 I ;?e QtY• F , Yee (ea), ' T � ' including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional SI00.00 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. $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof Fixture Work: 9w� xy, e ^- ° s ��...• fir; -t ss • s ,,..� Plan, Review� := fiiir�Piumbng:�Install "a, tions.�, Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and ,.; ,� greater, except systems designed and stamped by licensed u t mow$ t3) Quaotity (Fixttire)WoikPerfoemed,'` Fatare Type *"i ;/ Iteplaee engineer. ^, ifirped; . neded� rn Estating > ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub/Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic W4At • � �:,.a . : ... :, +mac sergr4PYS ,4,. An" Drinking Fountain ilia, +' 1wA, ; IsometncI'Or,R1 4" , Eye Wash • ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink -2" that meet the qualifications above. -3" -4" Car Wash Drain Comments regarding fixture work: Garbage - Domestic Disposal -Commercial - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang - Stall *Note: If the fixture work under this permit results in an Sink - Bar/Lavatory increase of sewer EDUs, a sewer permit will be issued and - Bradley fees assessed for the sewer increase must be aid before the - Commercial p Service plumbing permit can be issued. Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: is \Building\Pennits\PLM- PermitApp doc 09/22/06 Electrical Permit Application FoR OFFICE .1SL l�` . Received City of Tigard_ D aze/B Permit No.: n 13125 SW Hall Blvd., Tigard, lil' ' 73 q f ly- Plan Review la . 503.639.4171 Fax: 503.598.196Q Y t a0 Date/By. Other Permit: T 1 G A It D Inspection Line: 503.639.4175 �\�QN Date Ready/By: Juria: ® See Page 2 for Internet: www.tigard- or.gov `�,1 d( &° ,`1 V \C � Notified/Method: Supplemental Information TYPE OF WO 'C P PLAN REVIEW ❑ New c Addition /alterr Please check all that apply (submit 2 sets of plans w /items checked below): —_-.---, ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural and 2- family dwelling ❑ CommerciaVindustrial ❑ Accessory building amps for all other installations. buildings. Xl- Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION' ❑Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "l -3 ", Job no.: Job site address: // �'/� ) „ _ IOOHP or more. occupancy. -/ —� 7 r!i/ /2. G A C/ ❑ Six or more residential units. ❑ Recreational vehicle parks. City / State/ZIP: -- �+ aa /n� ice_ 9 7 2 2. 3 ❑ Health -care facilities. ❑ Supply voltage for more than �/d I L � 2 ! ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: F�(cd7 A /5/ p2) [J e Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: ./Z no 1,000 sq. ft. or less 145.15 4 U/G G . 4 G/z T S rrhi�Gr<t G Z o j Ea. add'I 500 sq. ft. or portion 33.40 l Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 6 SQ, r=l ,, A- n/-7-/o/ti ( /C /7-6H 0 residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 , )4 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: /4 � v 4 j G � � u � �+ fN 401 amps to 600 amps 160.60 2 �^t 601 amps to 1,000 amps 240.60 2 Address: // e:7 941. _ s &- /2 7* /G. t!E Over 1,000 amps or volts 454.65 2 City /State/ZIP: �'r6,,4/1,)) ,i� � 7 2 2, 3 Temporary services or feeders installation, alteration, and /or relocation Phone: -p_.?) 5 7? _ / q ci• Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with `. • )(APPLICANT ❑ CONTACT PERSON above service or feeder fee, X 6.65 2 each branch circuit Business name: 7- ,9h/� / G,� a. c_ r A /2-C � 7 C 7 B. Fee for branch circuits Contact name: C v �6/ / 1 7 n without t bran service or feeder fee, 1 46.85 2 /y / 6 C r ' first branch circuit Address: / 7 4 - _ s.- // 2-4A 1! Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: for2:7-- G vo/ e / a' 72 l !° / Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ('-0 ASS_ c 7D Fax: : ( ) Reconnect only 66.85 2 E -mail: / Pump or irrigation circle 53.40 2 CONTRACTOR . . Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited - energy panel, alteration, or Address: extension. Describe: Page 2 2 City /State/ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): Print name: Date: State surcharge (8% of permit fee): Authorized siAi re: vi 7 /)0I, ,—_ TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: j O�� (N v /' , 7r f�L / ///^^^ Date: (� 3 ' Number of inspections allowed per permit. I:1Building j' - PennitApp doe 05/23/06 440- 4615T(I 1/05 /COM/WEB Electrical Permit Application - City of Tigard . Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: (RE SID'ENTIAL WORK ONLY'7.__. _...___. rc ._._._ k Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Healing, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: r COMMERCIAL WORK3ONLY ,_- - „--77' _____ _ Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation El HVAC ❑ Instrumentation ❑ Intercom and Paging Systems • • ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC - PennitApp.doc 03/23/06 Construction Contractors Board Permit #:MST 2 6 o7 - 000 5 700 Summer St NE Suite 300 PO Box 14140 �� ,'•'.'!�• Address: / (. q g• �, S w `Zq p t Salem OR 97309 -5052 Issued by ..5//141/1/204 4 Date: Phone: 503- 378 -4621 ■//1-1.1 Web Address: www.ccb.state.or.us Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed 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 licensing 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: Er 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. f l 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR Er 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 5/5 - 7 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06 -01 -04 • Acting as Your Own eras Clntractor? • • INFORMATION NOTICE TO PROPERTY OWNERS ABOUT.CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. 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 concerns. Empl-yer Respousibilltes You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees".if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you 14 ust co t ply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold 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 Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you •are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.donstate.or.us/formspay.htrn11 for the appropriate forms. 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 could be subject to penalties and be liablefor all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their web site at www.irs.eov. • Other Resptnsibilities and Areas of Co; cerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. • • Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. • Property_owner.doc 06 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -0O0" 4 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502007 Phone: (503) 639 -4171 Jolt Inspection Requests (24 Hrs.): (503) 639 -4175 _ W INSPECTION WORKSHEET FOR DATE: 11/28 /2007 TIME: 7 :00AM PAGE: 39 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: ,VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: £C sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503 -579 -1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/28/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 060353-01 503.544 -3389 Y Corrections /Comments /Instructions: • r i 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED /2 S-p Inspector: Date: / 28 oT' Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: f 3Tii707 -000&4 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/: O7 Phone: (503) 639 -4171 ���4�m�ii Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/27/2007 TIME: 7 :01AM PAGE: 71 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 55 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503.57B-1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/27/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 060155-01 503 -544 -3389 Y Corrections /Comments /Instructions: n PASS PA RTIAL APPROVAL CA n n ii NO ACCESS n FAIL % CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: , / • Date: //r 2'--67 Phone #: (503) 718- "� � CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00054 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/23/2007 TIME: 7:00AM PAGE: 42 SITE ADDRESS: 1199,4 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 6 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503. 570.1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/23/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 05451001 503 -544 -3389 Y Corrections /Comments /Instructions: • • PASS n PARTIAL APPROVAL CANCEL n NO ACCESS FAIL , CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ° Phone #: (503) 718- 2.51 CITY" OF TIGARD ' BUILDING DIVISION PERMIT #: MST2007 -00054 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2007 Phone: (503) 639 -4171 /onmu�d9p Inspection Requests (24 Hrs.): (503) 639 -4175 J. IL, INSPECTION WORKSHEET FOR DATE: 8/17/2007 TIME: 7:01AM PAGE: 61 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503- 579.1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/17/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 054198 -01 503-544 -3389 Y • Corrections /Comments /Instructions: V Val * v • ❑ PA n PARTIAL APPROVAL El CANCEL 7 NO ACCESS FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: Date: 8- /7 — 7 Phone #: (503) 718- 'Zs�4'tS -. CITY O.F TIGARD . BUILDING DIVISION PERMIT #: MST2007 -00054 13125 SW Hall Blvd., Tigard, OR 97223 �� DATE ISSUED: 5/312007 Phone: (503) 639- 4171 ,, Inspection Requests (24 Hrs.): (503) 639 -4175 ��'- `:_.. INSPECTION WORKSHEET FOR DATE: 8/14/2007 -TIME: 7:00AM PAGE: 70 SITE ADDRESS: 11994 SW 129TH PL • CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN - - DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503 - 579 -1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 053911-01 503-544-3389 Y AiO q1 w' • Corrections /Comments /Instructions: (A, i N 0 644 fi j•A a () Z JA I/ h " A Li ' _ r li * Y ll I a_"5 !, I 1I . t'' 2 PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS IPAIL I I CA FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: ( - f Date: .1____7/ D Phone #: (503) 718- CITY OF TIGARD . , BUILDIN DIVISION PERMIT #: MST2007- 00054 13125 SW Hall Blvd., Tigard, OR 97223 h DATE ISSUED: 5/3/2007 ( . 0 Phone: (503) 639 -4171 , i * � i 1 v U Inspection Requests (24 Hrs.): (503) 639 -4175 ''I I.. v INSPECTION WORKSHEET FOR DATE: 8/7/2007 TIME: 7:03AM PAGE: 57 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503-579-1994 CONTRACTOR: OWNER PHONE #: 0 :A Inspection Request Scheduled For: Date: 8/7/2007 i {-- Pour Time: te ' Code # Inspection Description Confirm # Contact # Message , 240 Exterior sheathing 053499-01 5035443389 Y . 22) Vc nts/ nstructions: 22 orrections /Co 9 , 0 / _ .,-(--1 • r ( le ' ii. rkz-t--v% ie a ( n) 5 — - L P- . e . - GZ2 f i c fl ------ 4,L.-11 s, _ PASS 0,,,,I? PARTIAL APPROVAL n CANCEL n NO ACCESS .,11- I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED \& (11------ Inspector: Date: Zi Phone #: (503) 718- CITY OF TIGARD . A BUILDING DIVISION PERMIT #: MST2007 -00054 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/312007 Phone: (503) 639 - 41716 :. Inspection Requests (24 Hrs.): (503) 639 -4175 ' •II.. INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:02AM PAGE: 75 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503- 579 -1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/25/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 052649-01 15;997-678 Y Correc . ons /Comments /Instructions: 1 /-; r S -- 1 - 2. ❑ PA I PARTIAL APPROVAL Ti CANCEL NO ACCESS FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED 4 Inspector: ! Date: 2"-v 7 Phone #: (503) 718- 21 -9t,5� r CITY OF TIGARD • • BUILDING DIVISION PERMIT #: MST2007- 00051 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2007 Phone: (503) 639- 4171p Inspection Requests (24 Hrs.): (503) 639 -4175 ��� .. INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 57 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: • SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. • OWNER: CHIN, LARRY & ELAINE PHONE #: 503- 579.1994 CONTRACTOR: OWNER . PHONE #: Inspection Request Scheduled For: Date: 7/17/2007 Pour Time: 9:00 Coda # Inspection Description Confirm # Contact # Message 205 Footing 052127 -01 503 -544 -3389 Y 2 / © �a .nt ORS/ o'er Cor - ctions /Comments /Instructions: .i S k i-i.. — I - iv a Y 1Z:h :. c. 'N/6 . J !' Ne 7 —a 1 - C— G f'f L .C/. ��, e 1.// I/ PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS H FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ./ Date: 7 — / — e'7 Phone #: (503) 718- �`j'E- CITY OF TIGARD • - BUILDING DIVISION PERMIT #: MST 2007-00064 54 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5•/3/2007 Phone: (503) 639 -4171 i in�i; l I Inspection Requests (24 Hrs.): (503) 639 -4175, I I .. INSPECTION WORKSHEET FOR DATE: 12 TIME: 7 :00AM PAGE: 44 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 503. 679.1994 CONTRACTOR: OWNER PHONE #: Inspection Request. Scheduled For: Date: 12/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 050528 -01 503-544-3389 Y Corrections /Comments /Instructions: • PASS n PARTIAL APPROVAL 7 CANCEL _ NO ACCESS (l FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: - Date: / 2_ - . 3-- 67 Phone #: (503) 718- - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -0 0 4 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2007 Phone: (503) 639 -4171 jt Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/28/2007 TIME: 7 :00AM PAGE: 38 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: €5 s addition. OWNER: CHIN, LARRY & ELAINE_ PHONE #: 503-579-1994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/28/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 060354-01 5503 -544 -3389 Y Corrections /Comments /Instructions: Sgr PASS U PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL ( ] CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: CTd *A'J Date: I I 1241, 0 ) Phone #: (503) 718- CITY OF TIGARD r -.- .. .. - BUILDING DIVISION PERMIT #: MST2007 -00064 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 513/2007 Phone: (503) 639 -4171 A v4p Inspection Requests (24 Hrs.): (503) 639 -4175 •IL. INSPECTION WORKSHEET FOR DATE: 8/7/2007 TIME: 7:03AM PAGE: 56 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: • SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 6 LOT #: 201 TYPE OF USE: PROJECT NAME: CHIN '- DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE PHONE #: 603- 579.1994 CONTRACTOR: OWNER • PHONE #: Inspection Request Scheduled For: Date: 8/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 053503 -01 503 - 5443389 V 322-0 eL�,, (. V- - �, x �/ Corrections /Comments /Instructio 6 6.e, 60(t-G V2A- v %. 1(_ - 0 VIA Ca ' t 6-1( Zf i ''-' ( I s V 0 L PASS `PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS I I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �/' l.^ Date: S1 (° -) Phone #: (503) 718 ' V7 '• CITY ®.� �����® f `J5�Kwimv L►Zt�t�,t,.rri5 �� ( Z9��l+ ( BUILDING DIVISION PERMIT #: MST2007- 00064 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2007 Phone: (503) 639- 4171i + Inspection Requests (24 Hrs.): (503) 639 - 4175_!_ INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:00AM PAGE: 70 SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 • TYPE OF USE: PROJECT NAME: CHIN DESCRIPTION: 66 sf addition. OWNER: CHIN, LARRY & ELAINE, PHONE #: 503. 5791994 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8114/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 053911-01 503-544-3389 Y Akci44 (n d `9J W 'ti�^ Corrections /Comments /Instructions: ov � i i (e-?1-57) l r '!'" w A ot,5 iltralniftk. dal •._. 1111FIRMINEi 111MIONTEMIn minim p PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • FAIL n CA FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: If J o 7 p (. ( Date: / Phone #: (503) 718-