Permit k M(
e. Li-
r . MASTER PE
CITY OF TIGARD PERMIT #: MST2006 -10070
,' i
- DEVELOPMENT SERVICES DATE ISSUED: 6/30/2006 F. J I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133DD-16400
SITE ADDRESS: 11989 SW 129TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT: 200 JURISDICTION: TIG
Project Description: 2nd story addition.
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 21 FIRST: 322 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 226 of GARAGE: sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE:
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 548 sf 50,727.60 REAR: 20
PLUMBING
SINKS: A WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: \ \ DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: BOILICMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN , +100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX I NP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR 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: 2 SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
, -+-4 RES UNITS: SVC /FDR> =225 A.: + 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 4 SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other
JIM HARBOLT ROYAL REMODELING RESOURCES INC applicable laws. All work will be done in accordance with approved
11989 SW 129TH PL PO BOX 230805 plans. This permit will expire if work is not started within 180 days
TIGARD, OR 97223 TIGARD, OR 97281 -0805 of issuance, or if the work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in
OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies
Phone: Contact #: pRI 684 - 7873 of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Reg #: LIC 90746
TOTAL FEES: $ 1,111.51
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Issu /I , , r1,t _4.1,' Permit Si gnature : ■ ∎ . j _ -/
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.
Building Permit Application, g F1, FOR OFFICE USE ONLY
j
City of Tigard I Date By ��/ 4K . Permit Nom -Sz ( %O0 7 D
13125 SW Hall Blvd., Tigard, OR 97223 c Plan Review ' \ a •. -"
Phone: 503.639.4171 Fax: 503.598.1960 1 (16 if �'' Date /By. W Q . D • 3t. Other Permit: •
Inspection Line: 503.639.4175 10" 1 kJ,- -A 1' Date Ready l 6y: ���l . BI See Attached Checklist for
a
Internet: www.ci.tigard.or.us a Notified/Method: A I' ,/,, � ' } I Supplemental Information
m ;fiats '., ..v 4- + i a „ n # t s, K k .,, - i .,» „;
_, - , , 7 �, ,„, OR < -'k- � E I DA -",,,,,,-,t,,,,,'--... A: I ' AND., N1ILY D .-
+ x�.,�-•'�S =�.z,m.� ��x -'7�.- - fi_°1°1rT:f�1 , '� _�..� .� -_x ..__ ._ � � *_ ,....�_ - � .�-�- _ e ,r - 1. • _ .� ��a - �� ° .+..; . �4_� , �.. - x - ,,
❑ New construction I I'I ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
i g Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
µ* x 7 ; z CATEGORY ,, OF C ONSTRUCIO
TN - K t work indicated on this application. 5 0 - 7 a 7 _ (
I c .)(i
gl- and 2- family dwelling ❑ Commercial /industrial Valuation: $ --.411-7651=5)6—.
❑ Accessory building ❑ Multi - family Number of bedrooms: 1
❑ Master builder ❑ Other: Number of bathrooms:
t5 2 . �. ;s i JOB SITE `INFORMATION AND - LOCATION r Total number of floors: 2.
Job site address: I I 0/8 9 S �t t2..1 Tb Ft- New dwelling area: S yl square feet5 I4
City /State /ZIP: 'ia 'I -a O , 01 1 273 Garage /carport area: SI square feet
Suite/bldg. /apt. no.: Project name: .4. 2.ec,, --i Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: "c square feet WI
R EQ U IR E D DA TA :ICOM = C
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
fi t- . . y . i .`rq 1 r ,� . -, 's-
DESCRIPTION OF WORK �c ° , < r work indicated on this application.
;
.,, .� ,• �•1 -i;�� arm. �,-.ye. ta ��m��, -,ry. . ro . �,ix.. ,_�.- S2`ts. ..Sr't� ..- �-. � k�`:, -., _ . > .. , ro w. -5i:-.
Valuation: $
Z - STC.2`i 4..pD lT I ON)
Existing building area: square feet
New building area: square feet
, x a - PROPERTY OWNER k r . ` ®TENA t _ . F� Number of stories:
Name: ,1 /v\ (40.21x, L"'r Type of construction:
Address: Lt'*•-•"*,x - (p9f . 6Li- Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
.
'5'4 ' d - 4 A S 47.%W . - d ® . PERSON .' . * I S `4 .j " NO t = - � ., `a ;
,..:•:' , Z du ,t 4 .� , � __ ,,, - . � _ SCI ,: _,c _. ;
Business name: i2O e T 6 L( / All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E -mail:
,,, „y_ z x _,. _�, _r ' ., -A CONTRACTOR c .�_s , .`, : A
Business name: O
� YAK (ZL�p� 4 � ��,
Address: P
� g �� SQ �� �, s , B U I L,DIN(.� PE'RM F EE S � � � w
X C ; Please refer to fee schedule.
City/State /ZIP: c�,, nn QQ
T•1 �� �''f""'`�" �2 � 7, V ( Fees due upon application �0
( 5D3) — �� _
Phone: Fax: ( )
CCB lic.: F G�(' I � D Amount received c725--6%
Date received: - �� a6 Authorized signature: ' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Wr....p1,.-(��y7 CC..4 Date: 4. —(5 - O.f * Fee methodology set by Tri- County Building Industry
Service Board.
i \Building\ Permits \BUP-PermitApp.doc 12/03 440- 4613T(11/02 /COM/WEB)
Mechaical . _ ..,, ri ,)
n Permit_Apphcation ._ _ __
FOR OFFICFUSE ONLY
City of Tigard 1.- \t \.--'''. " Received
Date/By: Permit No --- 6 C- id 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 , , V' r )pq, A. ' 0
Date/By: Other Permit:
0, 1 J L
Inspection Line: 503.639.4175 - ..---1 81.!-' Date Ready/By. Juns: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
AU i'i. •
$
SlC ' O'
, i'ar ; .,1, , , : r .i. f:, = e , N,,, , ,L` , p - A - 9 7 , :, .7, , :;1'1 , ! :n ;:;::;:$:1 7 : . :••I'l;l : '„D i jiy , ' , .e: ; **14:0 liii1,•1,,p*70*:*#**7
0 New construction dition/alteration/replacement
Mechanical permit fees* are based on the value of the work
lid
performed. Indicate the value (rounded to the nearest dollar) of all
CI Demolition El Other: mechanical materials, equipment, labor, overhead, and profit.
,=::44.tX.IEaritilriWebiiittiiisi:ZWI6';,;qiV,„4,,,..k.7:il Value $
. ',..,„,.,„,„. ,,.4.4 44V ' 4 414 ,:4 44, ,, ,, --"a , ,,,:i tj4Z. :r
trAq„13-PPKNPAV.49-14TAIPM„,SY.g.,?F) ,( V '
' and 2 dwelling III Commercial/industrial CI Accessory building
For special information use checklist.
CI Multi-family CI Master builder CI Other:
Description Qty. Ea Total
.;--,;,_w; ,,...;„., ,
;f,z. .ol
IPP'71-.-tii-7-r - -. , ,..nkvi:,.. ,, t-,:v-:-::, Heating/cooling
Job site address: I. 1.9 8 9 1---1 l2_°1 - n- , ft
• Air conditioning or heat pump
(requires site plan showing placement) , 14.00
City/State/ZIP: - 17,--,,R_Tz, , eye . 911:13 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 1 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
A"tSdifPiiON45t::WoltkfR*ejitrrVg;;iZfq-e,I,,,A;'4:P.4: Water heater 10.00
-e '';kk . ' , - e,g,..xlswt '.4
Gas fireplace 10.00
- 2 - Z - . 1::y2. - ) - A.]:= % I 0k) Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
tbfwomt *:•,, Chimney/liner/flue/vent 10.00
Other: • , t4 , - f.r - .1-= , rcili-111,14 , -4-x. , 5 , ,c,--,xv,,
10.00
Name: i NA 1'-k41.2 , ;:zi (-7 Environmental exhaust and ventilation
Range hood/other kitchen
Address: ('''Slf::YVN €_■) equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) -- )9 -1.5 cl Fax: ( ) toilet compartments, utility rooms) 6.80
i4AvtaN, 4 3$5,12a."Iiiiran - s - WArKWiiW1 :„24.,,VARI if VAaarifi 'W,,a,':-F: Attic/crawlspace fans 10.00
t1 , - , , ,, , m,7,,,,„ , ,'..„..,,,,,-,„.,. , , , ,,,,..,.,„,„4.1 . „4:1, - ,,,,y-tvo.
Other: 10.00
Business name: ( 2,,,,--,,_ raer,0c.)(......1,....161 Fuel piping
Contact name: 4-c PLA',...7 $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: Po ax - 7:3 , ==. Eb Gas heat pump
City/State/ZIP: -neAssz/m„ ° I 12-8 1 Wall/suspended/unit heater
Phone: ( ) es%. 8 .ck Fax: : ( ) Water heater
Fireplace
E-mail: Range
--,-.. ,, - z- , :,,:,., ,,,,„,..,,: ...,-g!,--
!V ''7V;(4 . S T"CjPti'X''''?'Tq '":''i1P'i4 Barbecue
Business name: Clo
4
Address: l'o. i( i
't) thes dryer (gas)
Other:
City/State/ZIP: Q p itay Ok._ ( 70/ 5 Subtotal
Minimum permit fee ($72.50)
Phone: (i0 9 --, 1 9 ,ii 9 Fax: ( )
Plan review (25% of permit fee)
CCB lie.: /1100 ( 6, State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board
i: \BuildingTermits\MEC-PermitApp.doc 12/03 440-4617T (11/02/COM/WEB)
. - ( ' ‘'d Fr)
Plumbing Permit Application- FOR OFFICE USE ONLY
City of Tigard 1 ^oo� A EE'iew Permit No m 0 % -% QO 7 13125 SW HaBlvd., Tigard, OR 97223 I � ; L D���JJJJJJ ��)
Phone: 503.639.4171 Fax: 503.598.1960 / i,g '(IP ` + � Date /By: Other Permit No..
24- Hour Inspection Line: 503.639.4175 t, T lv =,l L Date Ready/By: ions: 0 See Page 2 for
Internet: www.ci.tigard.or.us +, i� 1- 1 . `-, s -Yi l 1 S 1 ' j1 Notified/Method. Supplemental Information
'TlrS �`OF WORh _ . x r a - . , o- y _ , SCHEDULE
�..�.._M -. ':�'�> - �-�.5, _..:,iat s .,... �i ... �- x m..a l _ rt `�c °
�'�� �_, a- o-s._"a s� .., w. � i � .._ ma= ._ '�"� - :Pi, a _..�:q -�' °: �.�- �;-;..� , z+ a. -m . � .d a_. , ,: ^�FS:v
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. I Ea. I Total
Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
", t.:44 tS &TEdOR% OF ° CONSTRUCTIONI F - { r i SFR (1) bath 249.20
(g 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
: JOB SITE; I NFORMA T IO N „AND L OCATION h y 4 , ; Site utilities
Job site address: 1 1 C18 5 W i't - 744 FL. . Catch basin or area drain 16.60
City/State /ZIP: - FL 4 „�Z, i> <=,e . 1 " `"t„'Z'> Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: �p(,_-� ` Footing drain (no. linear ft.: 13) Page 2 S . G3
Manufactured home utilities 110.00
Cross street/directions to job site:
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
Fixture or item
Tax map /parcel no
Absorption valve 16.60
. " ,-, DESCRIPT O F'+WORK V . a
° ti � - � . � �?, x��"3 Backflow preventer Page 2
2 ' Tb 2r A.i c. 17 on Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
- t , eF i , or . It Drinking fountain 16.60
"` V d w11PROPERT O�'YNER .>r , ` _ , ,. k i ® "" .. ,A,
° Ejectors /sump 16.60
Name: , I ,".■ o L. Expansion tank 16.60
Address: C fy a , • �3. g C ) . mi l J Fixture /sewer cap 16.60
City /State /Z1P: \ Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
v ` tAPPL'ICNT ?�`N ` , ®'CONTACTRSO
PEN ° _' Hose bib 16.60
E g, �M, P__ - j.�_s:_ _.> a<. - i maker 16.60
Business name: 12 orA,L 1 0 p 6 Li iJ 4
Interceptor /grease trap 16.60
Contact name: "j «7 7 PL-"zT Medical gas (value: $ ) Page 2
Address: pp le 'Z3Q goy Primer 16.60
City /State /ZIP: 7-1 ct ,ty2 D cs>2, 9 ") 2. ( Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (-S" ) _8 Lt -1813 Fax: : ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
- CONTRACTO :; -_ - _ `_ 4,,e:1'
t , w-w ,_ , emu... Water closet 16.60
Business name: (4 � � P ,,> ( 6 _ Water heater 16.60
Address: .>t 1 r / Other: . �L k ,� Q 701P9+ Subtotal
City/State /ZIP
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 7 g--52-- Plumbing Lic. no.: o31/44/6- Pb Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:
TOTAL PERMIT FEE
Print name: Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i \Building\Permits\PLM- PermitApp doe 06/05 440 -4616T(I0 /02 /COM/WEB)
Electrical Permit Ap plic a ti n FOR OFFICE USE ONLY -
City g of Tigard , t-. 2006 Received
Date /B Permit No 3 Id ---70 7 0
`J 1 ''
13125 SW Hall Blvd., Tigard, OR 972231\ 11 � ° Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1 '�"t H �"' i4p t1IM " 1 Date/Bv Other Permit:
Inspection Line: 503.639.4175 & 1' UV - il J _'' . Date Ready /By kris' 1Z1 See Page 2 for
Internet: www.ci.tigard.or.us d. , T r, DIV ') i'U - Notified/Method Supplemental Information
2. x... &B. - < , -. '�= ;4 ° 1
r - LrC:.. 1 '; zu�' ice'' 3 - ,- - z,.,7 'q i ?' ° i ;-. i"
,, .._a A .,.-v °°1 . 4 - % _ � zAa T w OF WORK <. :p .z� g,_ S. ? „ .t , : , ` -,.. a _. .''-,::',Z.,-" LA ;=1" REiEW
' - wF, ,, .,
` E ' >., , .,
..-
❑ New construction ,Addition /alteration /replacement Please check all that apply:
❑ Demolition 1=1 Other: ['Service over 225 amps, comm'l ['Hazardous location
_ ['Service over 320 amps - rating ❑ Buildn over 10,000 sq. ft.,
_- - ,A -1 01 ,,,4 CATEGORY CONSTRUCTION .;s
:,:i.8,4 4..,.� r of I- and 2- family dwellings 4 or more new residential
I1 and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
III Multi- family 0 Master builder 1=I Other:
['Occupant load over 99 persons ['Manufactured structures or
E . - r x _ -JOB SITE ]INFORMATION AND. LOCATION, 3 - t ❑Egress /lighting plan RV park
Job no.: Job site address: i 19 6 oi .41--( (t 1 'I . ❑Heit 2 of plans above . .
City/State /ZIP: '"7. /. -AL QQ, 9 7 .2...-z The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: `T Project name: (y�gp��' -w a ` ` i ; F,EE*;wSCHEDULE _' ,'` y .,
Description I Qty. I Fee Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
' t _ 4 s, �- s , DESCRIPTIONt OF )VOR. li '` , 3 p ,9 ,, c Each manufactured or modular
T
dwelling, service and/or feeder 90.90 2
Z_ 47-02.--i-- A.�� 1 \ I oN Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
n ' � ERT Y OWNERr W 1 t
.64 R �: , ®f,TENANT qt M , ' , A . 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: , 1 1 `-� 4 �L e01-7 601 amps to 1,000 amps 240.60 2
Address: C ('e,, J ��-- f\ Over 1,000 amps or volts 454.65 2
J Reconnect only 66.85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: (Sb ) 5- 151--) 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
4. y - ' ,, `APPL,ICANT4?`' `' l k V 0 CONTA PERSON it ' A. Fee for branch circuits ii ith 4. service or feeder fee, each 6.65 2
Business name: 2o,,--p.. L. (26,✓lpp.0 .. branch circuit
Contact name: • Cc, f - 4-- � `�T \l B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: Po P Z30 V a Each branch circuit
Each add'l branch circuit V--• 6.65 2
City/State /ZIP: - 1 -- ; Ct. .a.RD 91 1 Miscellaneous (service or feeder not included)
6 Pump or irrigation circle 53.40 2
Phone: ( ) & O*‘k --1 613 Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
a , W; t ' , / ' .- a ,CONTRACTOR - 5V. _ . K, nz'Ald _ < energy panel. alteration, or
Business name: l� 6 -02- ( € C-- L C,� • �` - extension. Describe: Page 2 2
Address: Po ( '-:7-)1 1 Tf� Each additional inspection over allowable in any of the above
Pan/ 7 Per inspection 62.50
City/State /ZIP: --'rt &12_ 0e._ 9 / Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
r,,_ : 'n,,' E P_ E RMTT>FEES* ? , iF,_
T
CCB Lie.: 0 S-7 Electrical Lic.: Jtt/- 2/t Suprv. Lie.: 1/oa8 5 Subtotal l9 6' , --
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) L , 1
Print name: Date:
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 Tn- County Building Industry Service Board
* Number of inspections per permit allowed.
i:\Buildmg\Permits\ELC- PermitApp.doc 12/03 440- 4615T(I0 /02 /COM/WEB
- Jun. 9. 2006 2 :42PM CLEAN WATER SERVICES 503 6814439 o L, -- P. _
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ill JUN O 2 2aa6 k"� l � d ii-, < .. ,may r � C le Number 0 � � ��� r�Y �Tl.ltn t lean ater \ ervic `
011{ commitment is elc:ir, D Area Pre - Screening Site Assessment
Jurisdiction T __ _n _ _ Date Z - Z-- -zoo....
Tax Map & Tax Lot /� . ) Owner S +•.., 1,44.. t5eat,--
Applicant t o r r c ; • : , . 5 . 4 : 3 1 , , , _ )
Site Address 1 t`I -•21-‘..1 1Z°% ?" Company - -
' --,. •e 2v., o rr. 1 - LI Address 4th _3t. _
Proposed Activity City State Zip poL7. R • °t -, r Z.
i-tC _ A-./;:e i 4 IQw Phone s 440_ 93I3
Fax 440. 73 41
By submitting this form the Owner, or Owner's authorized agent or representative, acknowledges
and agrees that employees of Clean Water Services have authority to enter the project site at all
reasonable times for the purpose of inspecting project site conditions and gathering Information -
related to the project site.
oflldel use only below Ws lino
oow
Official use only y below this line Official use only bmbM
V N NA Y N NA
Sensitive Area Composite Map Stormwater Infrastructure maps
® ❑ ❑ map # __. /(i't�. ❑ ❑ t CIS # 4.z1_ .
❑ I__ I T Sped y adopted studies or maps ®❑ ❑ i Other
ces have tom40 -�
Based on a review of the above information and the requirements of Clean Water Services
Design and Construction Standards Resolution and Order No. 04.9:
❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST
PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER. If
Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural
Resources Assessment Report may also be required.
® Sensitive areas do not appear to exist on site or within 200' of the site. This pre - screening
site assessment does NOT eliminate the need to evaluate and protect water quality
sensitive areas if they are subsequently discovered. This document will serve as your
Service Provider letter as required by Resolution and Order 04-9, Section 3.02.1. Ali
required permits and approvals must be obtained and completed under applicable local,
state, and federal law.
n The proposed activity does not meet the definition of development. NO SITE ASSESSMENT
OR SERVICE PROVIDER LETTER IS REQUIRED.
Reviewer Comments:
tee/ on it e vte.) d yX.0 nt vM I elvvr•rt ,pm1 4i PP / ..w . A o pPaloSea1
C ' 4fat uur .f f�aaar t ?aers'7Er / _rewf7'+s/ I �.4'v ve °W u+r
Reviewed By: Date: 6Mie of
Post -it" Fax Note 7871 Dare 6 / G I • 1 ag°cs� /
A/W e‘ use only 1 II
To From / Returned to Applicant II
e �ve / / Mail _ Fax ,.L C'ouni r
_ "I
Co.ioept pb+ / ✓e9�fr Co. i[, _ ate _1/ 9/O -V .._ l+y .:.
Phone # Fhnne n r
t S Ij
Fax # ve3• gm • l'3t7 Fax #
CITY OF TIGARD , BUILDING DIVISION PERMIT #: MST2006.10070
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/30/2006
Phone: (503) 639 -4171
A v, gNWpWIII�
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' ' I
INSPECTION WORKSHEET FOR DATE: 4/20/2007 TIME: 7:00AM PAGE: 46
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6847673
Inspection Request Scheduled For: Date: 4/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 046878 -01 603. 209.2292 Y
Corrections /Comments /Instructions:
1%4A;c PARTIAL APPROVAL C
❑ n ❑ NO ACCESS
I I FAIL I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: Date: ¢ 2a — 7 Phone #: (503) 718- ,-4-41-5
. .
CITY OF TIGARD
Is
BUILDING DIVISION PERMIT #: MST2006- 10070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/3012006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7 :01AM PAGE: 613
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/6/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6847873
Inspection Request Scheduled For: Date: 4119/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 046720 -04 503- 209 -2292 Y
Corrections /Comments /Instructions:
4 41 0 EcEar/L' a - - f7' /0 v .,r .6 i-ws /% ,,r44.. r ',t , p) -6
d
I I PASS H"PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 - 9c-oN—
•
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200&.10070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/3012006
Phone: (503) 639-4171 .eAlk
mro
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4119/2007 TIME: 7:01AM PAGE: 71
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9113/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 046720-01 503- 209 -2292 Y
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: ¢ 2-f--eff7 • Phone #: (503) 718 '—v
. to
CITY OF TIGARD
to
BUILDING DIVISION PERMIT #: IVIST2006-10070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2006
Phone: (503) 639-4171 A
„A
Inspection Requests (24 Hrs.): (503) 639-4175 ft
INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7:01AIVI PAGE: 20
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6844073
Inspection Request Scheduled For: Date: EV20/2005 Pour Time:
Code # Inspection Description , Confirm # Contact # Message
280 Insulation 036871-01 503-209-2292 Y
Corrections/Comments/Instructions:
•
PASS PARTIAL APPROVAL El CANCEL Li NO ACCESS
I FAIL C L FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: , —7,7, Date:q Phone #: (503) 718-
CITY OF TIGARD • • ,
BUILDING DIVISION PERMIT #: MST2006.10070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5138(2006
Phone: (503) 639 -4171 f ur u�ii
Inspection Requests (24 Hrs.): (503) 639 -4175 'I� ..
INSPECTION WORKSHEET FOR DATE: 9/19/2006 TIME: 7 : 05AM PAGE: 27
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
•
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 58$7873
Inspection Request Scheduled For: Date: 9/19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 036787 -01 503-209 -2292 Y
/C�orrrrections /Comments /Instructions: � �J
iLfd 'u2 N./ ,d� or--/ . r, G //+ ar-4-) CJNE' /A1edi
ki i )'-' L lJ z.'1 /,f37V �r .T/ - :r12; y 1hC y
ei/ - c. /AksoA,c-ge,A.3
PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL I "I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Q- Phone #: (503) 718- 24
. .
CITY OF TIGARD
BUILDING DIVISION A. ,
PERMIT #: MST2006-10070
13125 SW Hall Blvd., Tigard, OR 97223
A
DATE ISSUED: 6d30/2006
Phone: (503) 639-4171 bovivoi# /
Inspection Requests (24 Hrs.): (503) 639-4175 M' 11.
---
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7:06AM PAGE: 82 .
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARI3OLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 664-7873
Inspection Request Scheduled For: Date: 9115/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 036687-01 503-209-2292 N
Corrections/Comments/Instructions: 1:1,.. j
4
i
• f 4 0
\/ \rt-u ■ Q ,AA) s_, c<-.....,- 6P---&---e-v\.-cly
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0 PA' S I PARTIAL APPROVAL n CANCEL n NO ACCESS
VI FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: , 1(1 - (_■ ---- Date: 9 /t\1 6 ,e, Phone #: (503) 718:2-- 2 1 /
i
. -
CITY OF TIGARD
. . . ,
, . BUILDING DIVISION A , .
PERMIT #: Ni "i 0070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 61
Phone: (503) 639-4171 ' th msdlApitti l II
Inspection Request rs.): (503) 639-4175 1.1.. —
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7: 86A1v1 PAGE: 133
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK: '
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
• . PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration: W13/06: Added (2) 'Links.
OWNER: HARBOLT, JIM . PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 68471373
2
Inspection Request Scheduled For: Date: 9/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 036586-02 503-209-2292 N
Corrections/Comments/Instructions:
, .
---------,
•
. ASS Ei PARTIAL APPROVAL n CANCEL El NO ACCESS
I I FAIL . El CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: V6C J Date: /
q (3( Phone #: (503)
CITY OF TIGARD .
BUILDING DIVISION #: MST2006 10070
13125 SW Hall Blvd., Tigard, OR 97223 /f<e0° DATE ISSUED: 6/30/2006
Phone: (503) 639 -4171 �0"�u�l�� °� Inspection Requests (24 Hrs.): (503) 639 -4175 �_' `1L. •
INSPECTION WORKSHEET FOR DATE: 9/16/2006 TIME: 7:06AM PAGE: 64
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 6 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM 64 I PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873
Inspection Request Scheduled For: Date: 9/16/2006 Pour Time: 90 ,
Code # Inspection Description Confirm # Contact # M ssage
235 Shear walls/anchors 036685 -01 603- 209 -2292 V AI? 0
c
Corrections /Comments /I uctions: 0 15
0 --4- . A+c) 0-.A..11/4.---9--2.Q .
•
j 6A SS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL I I CALL FOR INSPECTION 11 ADDITIONAL FEES ASSESSED
Inspector: �� - Date: /' / (D Phone #: (503) 718 - �t" Z Li
, ._... _4. . _.
. /
. ..
CITY OF TIGARD
.,.
BUILDING DIVISION PERMIT #: MST200€-10070
13125 SW Hall Blvd., Tigard, OR 97223
IA i, DATE ISSUED: 6130/2006
Phone: (503) 639-4171 :yoll 14
Inspection Requests (24 Hrs.): (503) 639-4175 ,_:,,W %.1..
y
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TI ■ : ' : PAGE: 81
SITE ADDRESS: 11989 SW 129TH PL. CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUIVIIVIER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added c_ work alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM 5 4C/ Pr PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684-7873
Inspection Request Scheduled For: Date: 9/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 036587-02 503-209-2292 Y
Corrections/Comments/Instructions: __---
---- D 6 . J 1-6--- T --- 9
Tv\ pi-5-1 6-p-l_r-L
e
c
1 drifs n PARTIAL APPROVAL n CANCEL I I NO ACCESS
fl FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
O ( --
Inspector: A Date: / ‘ /I C / #: (503)
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: h:15T200610070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6f3012006
Phone: (503) 639-4171 7
Inspection Requests (24 Hrs.): (503) 639-4175 L. am a.•
INSPECTION WORKSHEET FOR DATE: 7/20/2006 TIME: 7 : 04 AM PAGE: 30
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6
Inspection Request Scheduled For: Date: 7/20/2006 Pour Time: 1:00
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 033399-01 503-209-5391
Corrections/Comments/Instructions:
4-5
•
ASS PARTIAL APPROVAL fl CANCEL NO ACCESS
I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: / Date: 7-2o-7-, Phone #: (503) 718- 721 N
•• ,
-■
V,r otl mot, v.1 on t .7_4( 4 4. '
CITY OF TIGARD -6 2is-
BUILDING DIVISION "ra « 4 PERMIT #: MST2006 -10070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6130/2006
Phone: (503) 639 -4171 tilt'
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 7114/2006 TIME: 7:16AM PAGE: 17
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 • T #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6847873
Inspection Request Scheduled For: Date: 7/14/2006 Pour Time: 12:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 033125 -01 503-209-5391 N
Corrections /Comments /Instructions:
( P..>z.30-vt. Je -1., d .► poi o. e.c.e : __ -S
a
A/64--C.: 1 2 ,fy IT `� ci
�- 51e--A h ez.( dry - -rer&
. 3 `?e , , 1 r_ ,: /,, -aka . , orb t/
a4- d o t_e -/ 'V- h ,.// L G t- o 1
C 2 e ..Q ote G /h 2 f < /--mo t A -�
a/ 9 4/14-
4 PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
.►;; AIL r= 2 ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 74/ ft 076 Phone #: (503) 718- 7 0 C.a
t
CITY OF TIGARD
,„
BUILDING DIVISION PERMIT #: Iv1ST2006 1gfl70
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/30120U6
Phone: (503) 639 -4171 /u � eppa�pv� ,)
Inspection Requests (24 Hrs.): (503) 639 -4175 :�' - I ..
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7:01AM PAGE: 70
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 046720 -02 503-209-2292 Y
Corrections /Comments/ Instructions:
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL fl CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 4 1."^4-■ Date: gir i Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
MST200 -10070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &,30/2006
Phone: (503) 639 -4171 Ave
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7 :06AM PAGE: 87
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Addeoi alteration. 9/13/06: Added (2) sinks.
Gge - Pr
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873
Inspection Request Scheduled For: Date: 9/15!2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 036577 -01 503- 692 -4139 N
Corrections/Comments/Instructions: ,
'' k6 5 .LAL....„_P \ 12_e_'- c----
- L-I.„° (--f c3Q1,AA v t
1 L/e_t_ P---..„ -
\j■J`C --- ( C--eA/V71 .e----0 e_3 4
(2_,.._A__ c-t--1___„; ) — K5
N0 6, c4.i-A. 02____ f 6 s7 &--A--..-1.,&._,
1 k."-.- ,r,,,.. L-2 \---\- C l
6 s `4) 1(/'€ itz-v---e_
iiigt b
ASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
V AIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED •
Ins ector: 4/1--- Date: l d / Phone #: 503 718 - 7 �' p � ( )
OA At
CITY OF TIGARD
BUILDING DIVISION t - it i , fir ,Q PERMIT #: MST2006- 101)70 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/30/2006
Phone: (503) 639 -4171 1 Z q' 4 i a I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7:01AM PAGE: 69
SITE ADDRESS: 11989 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8/06: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046720-03 503- 209 -2292 Y p
Corrections /Comments /Instructions: so� CAI 0 �M�r
PASS - PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . 4
Inspector; PI Date: II/ ` l0 � Phone #: (503) 718 -2‘. Vi
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MST2005- 101170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/30/2006
Phone: (503) 639- 4171 w a �ii����
Inspection Requests (24 Hrs.): (503) 639 -4175 �'
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7:06AM PAGE: 80
SITE ADDRESS: 11989 SW 129TH P1., CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: . 200 TYPE OF USE:
PROJECT NAME: HARBOLT
DESCRIPTION: 2nd story addition. 9/8106: Added ductwork alteration. 9/13/06: Added (2) sinks.
OWNER: HARBOLT, JIM PHONE #:
CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 584.7873
Inspection Request Scheduled For: Date: 9/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 036587 -03 503 - 209"2292 N
Corrections /Comments/ Instructions:
FAN R) 1 160-'6 M
•
I; PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V OG L, Date: I& Phone #: (503) 718- 1411L