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Permit ` CITY O F T I G A R D MASTER PERMIT PERMIT #: MST2004 -00256 , c �11 DEVELOPMENT SERVICES DATE ISSUED: 11/5/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10886 SW BRETTON CT PARCEL: 2S115AA -09800 SUBDIVISION: BRETTON WOODS ZONING: R -4.5 BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: SSN3128 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,292 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,836 sf GARAGE: 647 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 306,807.70 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 3,128 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: 1 VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: ' PER INSPECTION: . EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FOR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL /PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /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: Owner: Contractor: TOTAL FEES: $ 8,632.33 This permit is subject to the regulations contained in the LEE -LAND HOMES LEE -LAND HOMES Tigard Municipal Code, State of OR. Specialty Codes 28 BECKET ST 28 BECKET and all other applicable laws. All work will be done in LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 635 - 1343 Phone: 635 - 1343 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg 9: LIC 41535 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 PosUBeam Mechanical Plumb Top Out Exterior Sheathing Ins( Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing lnsp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line lnsp Plumb Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Po . :earn Stru . -I Mechanical lnsp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp Iss - d By : � � 4-! .iL . Permittee Signature : K - ,2 - & -- Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Aug 17 04 02:07p 503 - e48 -6823 p.1 C '' '" 08/1 08/17/2004 01: 05 5036351343 ROBBIN. LE PAGE 01. E1eet ical:Permft AppUication _ ..- cr;tflfF►r. f it ONI_t --' -__ - City of Tigard x.ed 14i25SK'llatl'B1vd Td OR 97223 1)atd8y: ptnrritNo.: Plat Review pim 503.639AI7t Eax: 503.598.:960 gY /By: Adel Permi • Inapt-en= -en= Line: 303.639.4179 .- 'i L. - cast Andy /wit See Pest 2 for - hltetnet: wu�w- cl.tigatder.ris NotiCed.k4eded: ... H 69plomeouti Mo. migloo ii' 14,1 �' a r`!ll �� f`ryTr"7.' -c i , r f - 1I,. J I � ,1''r i 11 ,g .s + y tJ" i .',i f�l Vir .� " �,_ �R. : .- .2.... 1 3---. �: '.k`tlp° c!.W ?.T � �_ 6.40, -G 6: ' a f t _ ..y ��j ,... .. -:.. New.constmctian ❑ Additionfalteradookeplacernent Please check all that apply ❑ I)emclttroa ❑ Other: DSetvice aver 225 amps, comet C'ilfasardouslocation F K r y + ,r,a� m '*T et - rx ✓ r r r, 0 Service over 320 amps - rating ❑Builda8 over 10,000 L'_.i s� , - - _",! 1 , t t .,4',2: ' 1 1 -, : ' 1 , + +, • • t:t ;:n3 � ' t. 1 ' of 1- cod 2 -family dwellings 4 or crime new rental I- and 2-family dwelling ❑ Cooenereialfindustrial ❑ Aoceasorybu3lding t7Syetentover 600 oohs non7ittal units in ooc structure ❑.Multi - family 0 Master builder ❑ Other: �y ❑B ufl4 r 'g pv three stories 0/Feeders, 400 is or more �[ I ki '' °s .?` t , - 5 , a Y w © Egress pz tJ owl 99 persons El l lu raged structures or 17. ". .r'.• ,.:i_r..'. „_n - r II - ' gp EV park Job Do.: Job site address: , , .1 G L ? - 0Hea tb•csre facility DOtfaa: Submit 3 sots of plans with any of the above CirylStace/ZIP: C2 The above are not applicable It) temporary construction service. 5orte/bldglalnt. no.: Project iii - a t 1 i1 ' ,. " ' ,i '• ,game: . , 4 ' ■ / ] Zap:rapt:6 . Qv. Pei . Tsai Cross street /directions to job site: +r i+o. 7 L Jp�7 :3� New residential single- or mWri- family dwelling wait S•' ranwise%acnededgerago. 1,000'sq.'R' test' 145.15 4 Subdivision: 15/j4•, , I 1 of n0.. 3 Ea, add'1500 sq. ft. or portion 33.40 1 Tax �: . .. Limited energy; residential 75.00 2 r,00.,-,c,7 'i � p •. 1 1 U fT „1 Limited ertergy, non-residential 75.00 2 J • ,. s ' .,...i, r ,._ -: ' .A., Lw�,� .t ,. ; T.4-----,- , r ..t .!. e s . . l ' • 1 '. ; 54 ! :; . _ 0' _.. " - -i ' $arch mntl9faco or rrlOdUleT {{ 1 • dweUtng,•sovice'and/orfootle? 1 90:90 2 Service. or feeders bowls/Ion, &iteration, aodlor rslocatio 200 atol s or less IIII 80:30 � I r T'a . r „ r' �-''! rs r 3G 1,411i"..1:_-.4V,,:,.' ' � ,7 T ! I L; I , ,0 20i amps to'400'araps 106.85 2 y S t ; ` ) I i : "' 401 amps w 600 aropa 160.60 2 Name, . J/ sr ! 5 601 an to 1,000 a+rp5 240.60 2 Address: 2 ' �. G .. • 5 Ova 1.000 . - or volts 4 54.65 2 r _ 1 l newt r.ect cute 66.85 2 City /State-) e: i ./... OP c e, . . r A0 f / 4 Temporary services or fealars lnstsUatioti, alletaaun, a.adror - Pbalole: (ca) ?5 /7q3 Fax ( ) -e"' 200 amps or less f 66 :85 I Owner installation: This installation is being made on property that 1 own which is not 201 3,o 4 00 t 1017 -311 z intended for sale, tease, rent, or exchange, according to ORS 447, 449, 670, and 701. amps amps 401 smog to 600 arils - 1/113 - 1111 Owner stingier= Date: Branch circatts. new alteration, or extension, per pearl � ° r ' A. Foe !or branch circuits �rA t L.:..� /�"' � scrrix or fecdot fee 6.65 B s1nees s ante: 14E _- P. D . . M f , _- 1 March citwit U B. Fee for branch circuits r Cont name: - L' La -e- without service or feeder fee, 46.85 J� 5 each branch circuit AddtrsS: e� ( I boon add'1 lowish circuit 6:65 -� City/Stoteiz P: L ( 4_. i) p f q) 02x- 1,14...e...... (terries or sot Included) - Pomp or itns&tien circle 53, , 12 P)tooe ( (J ) 3y Fax ( ) Sign or outline lighting 53.40 2 & masl _ _ Signal circuit(s) of lia>itod- ,3'.:•,...:."...:1-.1,1" �±n _ tM' " i1 . 1' ; :, ,_� P- • • , - : ,, 4.Ct -L anatCYl . altrrasion. es ca.tensioa. Describ Page 2 2 Business MOW: a . Address: - S e , -}. / k r� t 1 Each edditioaxt inspection over allowable in lay of The above V j.1 •L /i� Per inspection 62.50 City /State/ZIP; f 5 .49/a (A .. ~ investigation per hour (t1ssTO)_ 62.50 ( industrial plant hour 73.75 Thom: (T�) (a.. c El 1Z? Fax: ( a) 4 �, s � 1 rr � : Y . ", °t COB 'Lie.: ect icac. o Su Lis ns__ "a s' i "L� �{ Iti,� . - i _ t prv.. y/! , _ .� Subtotal . , Slimy. Electrician signature, required: ` L Plan review (23% of permit fee) Punt name: 7 Stu mm/reltarge (3%.ofperrrut foe) '• / s TOTAL PERMIT WEE A.utboiized si tore: .� Thin permt[ apLlicatioay,rptra iT a parotvt 6 not obc +incd MtAiO 7110 - dqa tiler it fat'Oceit accepted as comma. Print name: bats: • Fee r., by Tri- Coantr Buldimi l t atry Series Board ! •• Murobnof a allowed t18uldm6VcritstaII,GTorailApprios m os 440- a4i8ftiCr02/CAbe'w'F.1i Building Permit Application FOR OFFICE USE ONLY Eiew ived �/J City of-Tigard . Phone: 503.639.4171 Fax: 503.598.1960 .21614111N DateB : I) /0- �a - 6,1 Other Permit:'' it // -, 0 Cl Inspection Line: 503.639.4175 SEP 0 2004 e Date Ready/By: RI See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information $i7' ,..,, . ;� � . ,'..�:.� t -��> ..at' �:»..`s *1::.` ;:;.:"fir, ;�si� � � *�. �.. a�„: =',: °��r..' v:��...�;:i =.: ,, 4 : �,. t. g _ g 4 - ,9E I, ' N RI;.' iJIRE A'ItA e 5, I 1V1II 1' DWELLING - .�.=� o � �' �.. �� �.:« �= ��k4ts°�xL>��r`�,�i ; �.ai:. °.�°:.4.. ��=rn ., �, < =;'tm. mss_ :z'::c.:,, sa, -., -. ligg 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 INOV.1i : 4.4744 i - t: t . , #: :,,� =1' „ ft ,:g - .> .1r:-' work indicated on this application. $.k, a i , , � § CA, My,W W7 RoW'3TRUCTxI00 ~ k M PP Valuation: $ 1 - and 2-fa dwelling ❑ Commercial/industnal 3ca 1' aa 3 El Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: -2 !Z JOB SITE INr(JRli IAT 41APID� LOCATIOFt ,-- : :, % Total number of floors: • Job site address: L i C' LJioi / , � (1r New dwelling area: t 9/2 Q square feet City/State /ZIP: Garage/carport area: 6et? square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: 04 -a„' • '/o / (3y Deck area: square feet Other structure area: square feet ' tEQiI REDI DATA ,CElI *4 „IIJS Subdivision: 15 1- L /, s' Lot no.:3 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 p 4 , a r a �_ s $ equipment, materials, labor, overhead, and the profit for the - -' G u ' ` ” k s �`' ' z"`3 - xitm. - t -.. °° ,z r� K€ at a,. - - fi '�4-.4 :z �r- µ DL'SP TONOFOREw � work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet {' t. ' . � 5 =i4�,.�", ',rh`,,;a%`'..3$.. �w,.a;�' vh4 .., fir._ Y•, yr•;...{ ��? „.;, *3.�'r. -'. ; ; f RO Et2$' T4a ” t , ' t`' = 1, ? AN r -fi Number of stories: :a �,:� � r x..�. �Ja��.- �.e�x,�,� ,�,�.k; � �= _ _ ,�`», s.� �.�`ssi': , � x.�.��.., `� >.:�.:�.'�`I� . c. Name: L ,I (i L /�. /i t ,fl e, Type of construction: e Address: e � , �� -(- �' Occupancy groups: City/State /ZIP: C' 4 I - £s ' 5C O� ' 7e725 Existing: Phone: (c-.22 ('5 /j (� / Fax: ( ) 5 .L ;y,N; - � G � - �')•t New: - �::�•�:�a *.�':� _ ���::n:ha;b ^'� -�8c �,1*^�?;. �- ry4.,, , r.eb =` €;5: �.:e,:z." °a'�:.= '�' <:� cx�t; �A°..�t�.: r,- .7 , -:°1`_ 1 Q$PTvICAN§T, z ku , x .- , .5, . . f :GO1V1?AGT�P,ERS - ,,,,v. , 2 _ : 4 4 a?>•,taro•.rk� "' , - vim- -r ::m. w�" a�,;.4 .u° �... 'r s 3'.. i p :.it? .._,.. > w.zK:..,fc '' ., as s . - e3`a :_ , fg - ^' 'I �h',tk'i _.µ`:.Vi... Business name: L — l A/b 0/11 All contractors and subcontractors are required to be Contact name: 0 6 t ' t L /C e -Ei licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 2 a e L((-c - f S 1 . jurisdiction in which work is being performed. If the f , applicant is exempt from licensing, the following reasons City/State /ZIP: L t--K / .e, Us < a ,19/_ U?L9�S apply: Phone: ( 0) C> S- /3 c ' "x:: ( ) _Sot P7-7 . E -mail: t', � w 'W,; ,� G'ON1z. t; Vz Business name: L f- - L.. A i /p / C ,Of .,.., , h:; : , „ . . �! f S , v,B ,,,,„„ NG:?P�KM FE Address: E S* y Pte �'� �� .�. , .. 2 � I p �' "�� �� Please refer to fee schedule. City/State /ZIP: (� � / (93 `l/' .C! c �' CP,e (y )C��, Fees due upon application Phone: ( c?) 2 5 -_ / 2 3 ' Fax: ( ) t Amount received CCB lie.: Date received: Authorized signature: /) .... / ._, e ,„,... __ Thi permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Fo ; it L 4 yQ_,___ Date: K_ /7, c7'( *• Fee methodology set by Tri- County Building Industry Service Board. i'\ Building \Pemvu\BUP- PerrrutApp.doc 12/03 440- 4613T(I I /02 /COM/WEB) `nl Mechanical Permit Application FOR OFFICE USE ONLY Cl Of' T1 and u E� - I VI' D Received City g a Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 P 0 2 20 Aigm \ Da evtew Other Permit: Inspection Line: 503.639.4175 ch.) a �� , • ,11 1 y Internet: www.ci.tigard.or.us c-�'"1 �.. • Date Ready/By: Jura. 121 Page Notified/Met o Method: Supplemental for Information CITY OF TIGARD - :"`.:* :,= :;ate "RS'N .,« - t om • '' °r TsX ^*s ^ ^ �'iCa - . ?`A �_ , ': i e< ? _flizzi - fi - t S O t� 1 � N i`°g ` .' - .:. " `' , ' f. , CO`NIl -- -,- AL4'FEE* CHEDUI E = "TJSIOCHECIU IST Mechanical permit fees* are based on the value of the work • New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. P 4 * s1.ra P . `° ' ` Y:" UCT. ,4 - 1.2 -_-� , : --- -wt y EA%TEGORY OF ?.COINSTR, ION . ,1 r Value: $ , ..: . ,.,. ... s' ` ,... , - -1 . fRESIDENTI- AL,EQUWIENT I SYSTEMS: FEES* ite 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist. ; e g ' r Etx0:..x.:..:;�F,,: >:.::c k...� �,.sr.� _:,,�,.-:• - ...,,4 i,. Description Qty. Ea. Total LI .- ,1 ° ; . JO SI=TE,INFO RMi1TPk=,- 1VD LOCATION a ; Heating/cooling te - � . : � �z ;a,,z fl��va *�,� �,r�.: s Job site address: tO gc 8/€ ' Cr Air conditioning showing pump CJ / (requires site plan shong placement) 14.00 City/State /ZIP: J r S Cdt,` . /(9. Fumace 100,000 BTU (ducts /vents) 14.00 .0 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 / -f Cross street/directions to job site: rho, �U / j2 - 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: � e ai t9/A Lot no.: Flue /vent for any of above 10.00 c.. Other: 10.00 Tax map /parcel no.: Other fuel appliances � tx< t., ey: : - ) ,- ; - w„uvd -4 :t w.. ,-: -v,,w;: °ask; -, ..... v -z "grgr .: :ins :� �� l ' ' " � x ,3DE OF R WO, h , , Water heater 10.00 ¢e,,, ..;maw- k :;. �„ __.: .da v:x . ... � ,- stda•c -assa: _ 2 t..3u .� :"�'. . . Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 V'lii ; n, :n;. b . �,- , W s.:w., 'fl'- ; r t :1 , i= ' a:> ; 14. •, . >. f> Chimney/liner/flue/vent /liner /flue /vent 10.00 ,,,,....., � ERO;1'ER'FY= 4WNF.R SSA � � �„�' ®�= EL�1.�APIT" � � � � ��"� y s =. °a :• �f� r rsd;�.. -..a, k Other: 10.00 Name. 4., P t 1. /(/ ff a ys Environmental exhaust and ventilation Address: 2x £ �k,;I S /_ ` Range hood /other kitchen equipment 10.00 City/State /ZIP: Liz_ C (:)s _ g . L7 0 � �� J Clothes dryer exhaust 10.00 7 Single -duct exhaust (bathrooms, Phone: (50?) 05 /3 c(3 Fax: ( ) 5t-,, toilet compartments, utility rooms) 6.80 its..„ . p :... fi a.:::cs 3,-- ;; nc�: ii , .;f'. ..,. vx e:. :" 'r m- ,t • : -7 » c =�: ' ,r� *.: k ,,. r r AP.LTC ..,. ,M t„ t , � c;CON 7A kT 1I'ERS ON Attic /crawlspace fans 10.00 4,F 1 _ / 4 ev /I0 ' Fuel piping t to 10.00 Business name: i5 P�P� g Contact name: P„i -e $5.40 for first four; $1.00 for each additional Address: 2� /3 d ,...,/..., --(e )1._ Furnace, etc. � Gas heat pump City/State /ZIP: e d O�1 c q ?a ? Z. L � L Wall /suspended /unit heater Phone: (SO) ‘ ?5 1./ Fax:: ( ) 5a, � Water heater E -mail: Fireplace Range t ..VK 4' �.,� VCONIT CT()V l... "#.tr � ' y , F Barbecue Business name: r� � /4./ 1. 6 ,, Clothes dryer (gas) /�J q I /� Other: Address: col / ! 1 � ji ,e/- , .�." >_ . b . �; AN 1 H -x * Sr i „ <'; � � : t % •. - ]VIECH = FEES: City/State /ZIP: (b I 0 e q' 7 ©j 7 Subtotal Phone: (5-0.7) 2 6 I2 (/et Fax: ( ) Minimum permit fee ($72.50) 1 Plan review (25% of permit fee) CCB lic.: / Y''2 r State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: 2.7./..,,....... � This permit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. Print name: Po, S i 4rC.ei Date: 3 _ / 7 , az. ` Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (I 1 /02 /COM/WSB) Buildingjixtures Plumbing Permit Appl ii FOR OFFICE USE ONLY City of Tigard Received S EP 0 2 004 DDate/By: Per t No 2 13125 SW Hall Blvd., Tigard, OR 97223 L Plan Review , Phone: 503.639.4171 Fax: 503.598.1960 //q y/ ✓� I I , ; 1, Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 �. Juru: j Internet: www.ci.tigard.or.us CITY OF TIGARO --' Date ecVMet Supplemental y: See Page 2 for g Notitied/Method: S Information .� � " _ w _���> ^��_.,.� ��� r }� • -,• i.:.�: � = *.Qa'��.� .fi=t ,f, �.•: t <�,:,:-:, r�:a;�.: m: ,; < „E� - - .a° *- - -D , �,. ,v 11' : v - . „ '. :, :: I , EE* SGIIEDi3LE' .,4` :. -S _,.. .. rY <��$ `�- 3sf'"^.. s:.'; �nsa �_,_ - �� , n.�,. ,_. ..tt ..:, ..� ,., _ . `:. ,n .. __. ,..t a:: ...,,.,.... � . < _ ... r..�, s - _ e St 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) s r�ra+ai +, "s'&� ='i "'�; °;Y'� a% >,�::4��a ° °- -�sx. #§.+ :__.� ". -�'a« . ,; ;�:r,,.� _ -. r Ire .-" n `` G Yi ORY QFYCONSTRUCT�ON -�* e ;%. a ei _ y e %§ " SFR (1) bath 249.20 IN 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: Site utilities ., r r. xcs ,r ;gip > :, x.N a- Fire sprinkler ( sq. ft.) Page 2 . 14, ' *: ,: � s' .er g a rt #t�.0 3 ` 1,;1 . „;;, ; J , ,- STI IN) Q22MA T ION x1N „LO A xi( . a . ; v " ` nr�� «��a � �.,��. �.a��.�. �;,r�,. „� »,.,� ;; ..��:,�� >::,�.r: � 4�',_�" : .� Job site address: / ' 8C - ? /L�fnn ' / Catch basin or area drain 16.60 City/State /ZIP: , `` • „ / Drywell, leach line, or trench drain 16.60 l�y Suite/bldg. /apt. no,: '' I Project name: Footing drain (no. linear ft.: ) Page 2 /t) 6 Manufactured home utilities 110 Cross street/directions to job site: i�GLr h Q Q Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: 13e_442 It/r at/1S I Lot no.: 3 Water service (no. linear ft.: ) Page 2 Fixture or item . Tax map /parcel no.: .r,.;:: < .s =1 ; -, ;: r;,, u . ; . Abso sorption 16.60 �.:.,, zN. rp 1 ;: , r, ,s " r 1 ' ; - ' A W®12K , . , " r.,,,z ;t e r;' . , .w -:. , . , ,,o. a,_ Wiz_ - ...4. tr .. a Backflowpreventer Paget Backwater valve 16 60 Clothes washer 16.60 _ Dishwasher 16.60 „ts r'�. Y'.5, s . .S. 1 8ROB 'ItTiY 4 0,WNER „,., k' E 1 ,, ,Y . ` Drinking fountain 16.60 �s -'::. 4 ::�:`a�� ='#= #:+.�..5c =.�'ti"..� wa�i;. a;,e„ ..�, �, k.',:.`.. ..... ���a�E�� ' � _ � m � A �� ' � "� � `"" � "''�"�°�`'"''' '�''''' Ejectors /sump 16.60 Name: [, F C , L,t e 0 i- S Expansion tank 16.60 Address: 2 g .e v /. t 5I- , Fixture /sewer cap 16.60 City /State /ZIP: ,L ()/ '7G23S--- Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 as» s : s:r:'tr . r r t:MYr iAC r r` _ x} a t Hose bib 16.60 ; �xAPPLrI t t ;: CO ,A T 'ERS Ice maker 16.60 Business name: 4 4 �,./ /7 7/..; , Interceptor /grease trap 16.60 Contact name: R49 d b" ' ,- Medical gas (value: $ ) Page 2 Address: 2 e 6- k J. . ,5/. Primer 16.60 City/State /ZIP: Z- #1 q +13s Roof drain (commercial) 16.60 Phone: (co)) d 2 S- /2C /I Fax: : ( ) Sq �-C� T u b show /sho 16.60 Tub /shower /showee r pan 16.60 E -mail: Urinal 16.60 , z-vPi �. % .c.. ; �Ptila �'<; ;= ?i?;.it..u.'. :-:�. a;= ;.'�d.'r.:�*.x" v .s?e 1 1i . •: `:",: ,yr, ;xk'<' - _ , � 3 : 7 i 1 CONTRA,C OR Water closet 16.60 Business name: 6 9[_ B I kt M d ,'� Water heater 16.60 Address: O � � j2� q Other: City/State/ZIP: L-T ` / ' S b0 0 r � q? /2,j 12� Subtotal M inimum permit fee: $72.50 Phone: (50 ) 6 LI U �/ j Fax: ( ) residential backflow minimum permit fee: $36.25 CCB Lie.: / q ef j7 7 Plumbing Lic no.: 3 , L itt - P,6 `\ Plan review (25% of permit fee) ` / /�" ' '� State surcharge (8% of permit fee) Authorized signature /f Ja / TOTAL PERMIT FEE Print name: /: 015 L eJ„ •/7 . Date: L ' (7 _' 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 Tetmits\PLMF- PetmitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE G & B PLUMBING PO BOX 1269 HILLSBORO, OR 97123 -1269 Plumbing Signature Form Permit #: MST2004 -00256 Date Issued: ed: 1115/2094 GLIJ i ), Ul U. 1 IIJ L Parcel: 2S 115AA -09800 Site Address: 10886 SW BRETTON CT Subdivision: BRETTON WOODS Block: Lot: 003 Jurisdiction: TIG Zoning: R -4.5 Remarks: New SF. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN` Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: LEE -LAND HOMES G & B PLUMBING 28 BECKET ST PO BOX 1269 LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123 -1269 Phone #: 503 - 635 -1343 Phone #: 503 - 640 -2311 Reg #: LIC 19907 PLM 34 -44PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call 503.718.2433. kAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA -- 1 Pr STREET TREE C � . w L , � g G. ��- G- Aitt /IO I, 0. (,-, L L a ig ®caner / ent for (PLEASE PRINT) ' %, ,, (PERMIT HOLDER) 1 i -- - - - ''' _ art. ' , I Do here " � � ' ° �' ' � by =ffy tftatrhe following location meets ci Tigard / Wash ngton C ounty l and use and development standards for street tree installation. � s � ADDRESS: g � ‘r 1-3-47/19,.., 7, 0. 0. LOT: J SUBDIVISION: /3r /70/7 4/e2a) BY: DATE: 7- 2 5 pr 0> 1 RECEIVED BY: DATE: - 2' - /` E � 0. VVVV 4 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVN CITY OF TIGARD BUILDING DIVISION PERMIT #: ms-p00,4-00266 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/5/2004 Phone: (503) 639 -4171 A lm��mg Inspection Requests (24 Hrs.): (503) 639 -4175 ... z -_.. INSPECTION WORKSHEET FOR DATE: 7/29/20055 TIME: 7 :07AM PAGE: 44 SITE ADDRESS: 10886 SW BRE I ION CT CLASS OF WORK: SUBDIVISION: 'RE I 1 ON WOODS LOT #: 003 TYPE OF USE: PROJECT NAME: BREI ION WOODS DESCRIPTION: New SF, OWNER: LEE -LAND Ht MES, PHONE #: 5O3- 63&1343 CONTRACTOR: LEE -LAND HOMES PHONE #: 636 -1343 Inspection Request Scheduled For: Date: 7/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message a . 299 Final inspection 012451 -01 503- 789 -6795 N k.Corrections /Comments /Instructions: Ko Si off/ ' Iv 7 S' 4—a 7 Gerif— . C s F i r PASS F il "ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL 11 1_ FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: AAAIIIIII. Date: 7 � 7 CD S Phone #: (503) 718 - CITY OF TIGAR DIVI I N PERMIT #: BUILDING S O MST2004-00255 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/6/2004 Phone: (503) 639- 4171nH- a'gmypiipfi�l� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/25/2005 TIME: 7 :12AM PAGE: 10 SITE ADDRESS: 101386 SW BRL.I ION CT CLASS OF WORK: SUBDIVISION: BREI ION WOODS LOT #: 003 TYPE OF USE: PROJECT NAME: BRE I 1 ON WOODS DESCRIPTION: New SF OWNER: LEE -LAND HOMES, PHONE #: 603.635 -1343 CONTRACTOR: LEE -LAND HOMES PHONE #: 635 -1343 Inspection Request Scheduled For: Date: 7/25/2005 - Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 012063 -04 503 - 789.6795 N Corrections /Comments /Instructions: .INPME / ' / PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /711 ./✓ Date: 7 1 / T Phone #: (503) 718- i CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004-00256 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1.1/6/2004 Phone: (503) 639 -4171 � jrI%Etpiktiii Inspection Requests (24 Hrs.): (503) 639 -4175 •'__.. INSPECTION WORKSHEET FOR DATE: 7/2912005 TIME: 7:07AM PAGE: 42 SITE ADDRESS: 10886 SW BRiz. I ION CT CLASS OF WORK: SUBDIVISION: BREI I ON WOODS LOT #: 003 TYPE OF USE: PROJECT NAME: BRETTON WOODS New S F. OWNER: LEE -LAND HOMES, PHONE #: 603- 636.1343 CONTRACTOR: LEE -LAND HOMES PHONE #: 635 -1343 Inspection Request Scheduled For: Date: 7/29/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 012451 -03 503489 -6795 N Corr- tions /Comments /Instructions: • Igo - ASS % • RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL My INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector , •ate: Phone #: (503) 718- • I CITY-=OF TIGARD BUILDING DIVISION PERMIT #: MST2004-00256 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/512004 Phone: (503) 639 -4171 / , i tG lf jIll \ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/29/2005 TIME: 7:07AM PAGE: 43 SITE ADDRESS: 10805 SW BREFTON CT CLASS OF WORK: SUBDIVISION: BRETTON WOODS LOT #: 003 TYPE OF USE: PROJECT NAME: BREI ION WOODS DESCRIPTION: New SF. OWNER: LEE -LAND HOMES, PHONE #: 503. 635.1343' CONTRACTOR: LEE HOMES PHONE #: 635-1343 Inspection Request Scheduled For: Date: 7/29/20066 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 012451 -02 503 - 789 -6795 N Corrections /Comments/ Instructions: ? 6 `1. z s "0s 1 -P --_ss c c Cs ) cowl F'i--� I - A SS • .ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL Il C FOR INSPECTION n ADDITIONAL FEES ASSESSED / /" ? Z 2 er'S Inspector: A : Date: Phone #: (503) 718-