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Permit ?` CITY OF TIGARD �, MASTER PERMIT PERMIT #: MST2004 -00254 O lt DEVELOPMENT SERVICES DATE ISSUED: 12/7/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10860 SW BRETTON CT PARCEL: 2S115AA - 09600 SUBDIVISION: BRETTON WOODS ZONING: R -4.5 BLOCK: LOT: 001 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: SSN2697 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,171 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,526 sf GARAGE: 486 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT: 5 VALUE: 257 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2.697 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: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 5 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 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: $ 8,242.18 LEE-LAND HOMES LEE -LAND HOMES This permit is subject to the regulations contained in the L 28 LEE-LAND Tigard Municipal Code, State of OR. Specialty Codes 28 E -LAND HOMES and all applicable ed p. Al. This permit 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 #: 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 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insj Rain drain lnsp 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 lnsp Water Line Insp Plumb Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service lnsp Building Final Post/Bea uctural Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk lnsp Iss ed By : Permittee Signature : L. Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Rug 17 04 02:07p 503 - 848 -6823 p.1 08/17/2004 01:05 5836351343 . ROERIN.LEE PAGE. 81. ...Electrical Application , ---,,,,,,, m..._. , i�c :tflFfit -, t ,>: ¢tilt Ts_ City of Tigard Raceised PcrraitTli.: 1 ?125 SW gat1'B1vd., Ti 7 , patr . • - asrd,OR S'7� Pisa Rrveew Ptroaa 303.639A171 Fax: $03.S91.15450 . - , , , Other Pere Lind: 303.639.4175 . - All li� rvB ,.. . paxBeady/By: mix H Sot Pap 2fir bitdatcc .Wcva'.CI•tlgardurma Notified/Method: S • •lemeautl taloea,atloa ;:� i �.i1`C t y ,■)TT' � / .- ,. F*,.",7.'_ _i- J.I .g�, "Z. t ,- G] Mr i''a'� ,,, R„'".. t, r_ - - +�41...!.:- `5- 'r_,. _FIT,,,tw.. , .r.,, � ' 'll�,e?i 2• < ,W t'' �kaii". ll '2 . .�.�` x�a5:15E:...a�Y.Y• • -n: New.consauuicn 0 Addititsr/altee:ationheplece mess ?least cheek all that apply= 1:1 Demolition ❑Other °Service wer223 saps, comm'l Clfarardous'loradcn F �cr i ?.:a. , . *lei n r r li� °service over 320 amps - rating °Bunting over 10,000 sq. ft., w 1 , 1 ~ , - T e i -rz ; .tom - t ,.n. ) r • i of 1 - l'id 2 - rrnly dwtttitlgs 4 o m ine new residential 1- and 2-fau i1y dwelling ❑ Con>rnereial/industrial 0 Accessory buildiug 0501cmover 600 mils it,oae srrucurre ❑.Multi- family D Master builder ❑ Otllex: °Building over ttuee Bullies °Feeders, 400 Mpg or mare y-. ! F L i - v � �t 'r,c� QOccupantload over 99 persons ❑Manufactured revenues or :a. � , i I ' : 0E81ts041:tins liv' Job So.: Job site sddres O76 O a xe. a 7 0 . [SHwkb -care facility QOM: Suhrrt4 2 sets <Apia= with any at the eborz • City/State/ZIP: i LlG� The abort are not tpplicable to temporary construction service Stute/bldgiapt. no.: J Project r : .', 1 ' .L �S. t 4L 1 :1 ?l• j ..... �'a!:ae-, p • / � / bexrietive Qtr. Po- 1 Total. Cross strset/directioi s to job sits: a„, /, /Og New residential single or maid family dwelling unit. tacWdee itraebed garage - 1,0011 ag: ft.'to ten 7 14535 . -S 4 Subdivision: 13/ Tom /.0'0,1)- Lot n0.: I Ea, add'I 500 sq. 0. or portion 33.40 1 Tax map/pared no: Limited energy, residential 75.00 2 Limited rainy, lap- residential 15.00 2 1 ' •1...,: ,.y . .:_ ti, ` '! r',•jt. . w? ' . t- •'l.. ' � r + • •�. t i ::111%;; . i-,:.,_-K, . r_'_ s A ,T.,;',..,.. . . , -. _. 1,. $ eat' s _ l ... . .a ._ a , " • ,. , 1,... left rmnut'scwred or rteodulet j � :, dwelling, service and/or feeder 90.90 2 service; or feeders iosta iafioa, alteretien,.and/or reloeation 1 I 200 soil's or less 80.30 2 _7.'7 r . -5R ` L3` ' , �� � .' cys u i r i V . :,- . e dTT ' : �.i :.0 201 atrtps to 400 amps 106.85 2 1 It,''I;all 401 ern ra 600 aw 160.60 2 , / l 601 ,ones m 1,000 soaps 240.60 2 ` Ova 1.000 .,- orvoha - e54.65 _ Reconnect only 66.M 2 City/State/ = je c e , X ( # j) r • - Temporary strike, or feeders tnstabation, alter titan, and/or veraeation Pte: ( ?,s - J3 ((3 Fat- ( ) .51(...41.4,.....- 200 sups or less I 66 =85 J Owner insttllatioo: This installation is being made on property iliac I own which it not 20i suip5 W 400 imp, -- 10.0.317 Ill 1 intended for sale, lease, rent, or ezchangc, according to ORS 447, 449, 670, and 701. 441 a .. to 600 aargsa 133.75 • [ Owns= sigisetu?= . Date :. Broocheiratks - new alteration, orexteosine, per pacer r .. s' 1 ' - , ' K r • 7 ? , � 9 ' .T 1. _ L._ ' r_ �•_ ■ T t. r P, A. Fe e for branch circuit one .__. se rioe or feeder fee each 6.05 !twinge; name: 4 4: p of . G. S branch iarwit tr Contact throe: p .� . La-e- B. w'i for branch circuit; fee, 46. Y _^' withoYt Setvicc or ' Ads: 2: d ec - i 7 S . each bfawch 4, circuit Each add'1 rettch circuit C 6:65 2' F' 161isearnslops (mice er feeder eof 010101• • • Thom n 3) 6 3.s /3 3 Fax' : ( ) Si or outline 1 Tut= tTut= w il7igatscircle 53.40 � 53A0 2 E - mail: r WC Sissat citcait(s) or lia i utod- :r ? ; • 7"" 3,:i i---..':::7-1, tf 1 n ab 1 ,. t I . ,. ti'u eSYPatw1 Mter2tion, os ++ �_ K s in 1t: . r . i t • extension. Describe: rage 2 2 Business nauu , �} /9 [,'1 l.�ILS/1 /t 'e.... r'1 C r Address: f i V r 7s- t_ Each additiaeui teat • cation. ever allowateeinsoy at rue above j 4 J /t� If.•• ~ Per in:peclron 02.50 City /Stattr�P: f r'S tP a L 7. 23. Inv,itigatioa per how j: pin) . . 62.50 : Industrial Obit hour 73.75 I . Phone ( , ) 6 - f I .- . CC Fax:( 'ca) st, u I- • ;s 4a r . i "`'. .. , :: I ' v .i:_ ;[rued`. .� a elaWM ar v 4 .Subtotal signature, `� J ` Finn review (25% of permit tae) - 1 • required: Svsiesurc1i rge (S;a.4fpermit.fee) J Print fume: dl" S. TOTAL PERMIT WE Authorized Signature: This permit apylieedoo eapt es Et a puma a rot a stefined MtAio tae - hays filer a'>,as tern aeceptsd as eorapat• Print name Dete: • Fee methodology ogy s.t by TO- Coorty Swldiaa l duntry Ser ,ce Sous r " Wmaber ofinsysctiior lett puma allowed turoretwalrtr evatLGreasi ,sprier Ia/cs &re .% 3T1icro2now:van • Building 1P ermit Application 'FOR OFFICE USE ONLY City of Tigard • R EC E '10 � Received /}j , Permit No.: iO c� -27d ' 13125 SW Hall Blvd., Tigard, OR 97223 p lan n Review : / f Ix Plan OHe, Phone: 503.639.4171 Fax: 503.598.1960 �(� + Ih DateBy: 0 2 Other Permit: _ 1 , w r ` Inspection Line: 503.639.4175 "�. Date Rea.yB O y. ® See Attached Checklist for Internet: www.ci.tigard.or.us SEP w1.1 1 Notified/Method: Supplemental Information r'It I ,rr c .� , >.t ';,,. _ice' '°.` ts " .�i vs> T:y OE' ' :'�� � UI � w D . `� � :ARE RE ATA.1 = � . ' 'F �� " A N D:2 AIVIII�:: .�; * � � ..� s_,£ , a ��:3,. ;a.,:. °st.� .nr .�_, .* ��t'� , rya` " +�. ��iz''' xa, N` 4•.., :,'r,�z1�Q*o-x- ,:;;V ,. , _ -. 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 �:rux Ot" "''`', �?;d;+''�`.'`= sr¢'�;";<;.•s a;°e'?'.;s�F ;thy'.: „ r.<:e:°:.��r.'3s�r.'.Lf',.,i;, - °.z:.�. ^;c: _- - "° t r g' 1 t « t " work indicated on this application. s tCATEGORY OR COSTRI3C IO,- PP a..- a',•x.$„3e. +n: re,z'£w . ems=" e61 i ^a`'+9i s -"`,"e 3' ^.:a.`SF..,€a34'..33r "n. ; :`2• - � , ✓- s'a,;d.5.§ »+S, . a . ��i, �.„ " y . .x . Valuation: $ ( r 1- and 2- family dwelling ❑ Commercial /industrial �� 0 Accessory building Number of bedrooms: ❑ ry g ❑ Multi - family ❑ Master builder ❑ Other: Number of bathrooms: 2 / / � zµ > ', z . `' JOB SITEl'INilORIV1"ATIq ,,AN LOCATION '' ' Total number of floors: Job site address: / C U re-/ /o/2 r.,(-, New dwelling area: . 2‘zr7 square feet City/State /ZIP: / / /� Garage /carport area: !- /y6- square feet Suite/bldg. /apt. no.: - / Project name: Covered porch area: square feet Cross street/directions to job site: 0/ -/e2 -/e2 / Oy Deck area: square feet Other structure area: square feet &EQUIR D DA_; COIGIIVIEI2CIA = USE'GHECKLIST / ' /C9, -ED :A AT Subdivision: 1��e't -10,, t ,r - 5' Lot no.: f Permit fees* are based on the value of the work performed. Tax map/parcel no.: f Indicate the value (rounded to the nearest dollar) of all F . r , `rvr _ t^ „r Its equipment, materials, labor, overhead, and the profit for the . $ ' t`v. Y` �' > l R '-Y`r . '9 u- 24 - finis ' . q i i* �'DLSCR ,,- OE �012I� t work indicated on this application. .a.. . _ -w -��e sa ���� ...,..s�..:�'`l.u_a.. -�_ n s , . =r.t.a_ . Y_. >.�°1 „fir - ,��`"iS�� .. �..., . n} Valuation: $ Existing building area: square feet New building area: square feet ;tea -.I '�° "K -a a �, t- ... .: : <.s4:` i)- =?r,�r; - +.�,4`ar.:.; n..a ;` #:,�' ";`� i k r'"-"�« =:; n: . • PRUP. RT,tY WN Rt s. : _ P `' t - , ' „:, g �+�� (O ,�E � ,,, „�. .rk - �TEi\t'A _ 1�r�� "- ��: �i. Number of stories: ;`;`�,T:34F�':s� :. <...,t-,;" a� i%'”, 3'', d5. � r�h ' i;,° Y' ru�, �3: �':::. G:•,.i'.;aa��' .` , 'N . �u .wc . • i? a- �# �^3irs �'tt', Name: L F e- —_ L4 #' I 6 1 �� � Type of construction: Address: 2 e a �(( sl Occupancy groups: City/State /ZIP: 4-l.l(, J CS ' -e 072 / 7 7 f Existing: Phone: (5 2j < :5 Li L I 2 Fax: ( ) jer-- ill .L— New: -`c, j.<c.'.:° ' ' S: ::a -G"M ^::;:: ',.':x.2 .��rf ^ s`.rt's := na: 3,�,• .[?.,: ':, ".wr „ z:., `;.- '?sir"c''^. - •::.;:a'^i... :': ,�,3?�?•ak,-, Viz. t %, s,, ,: ,,; iV^a t; r; =tom , :t:,,,:# ' }' ,' -: ,' uy .. .. i Al p- BUIC -ANTif r ',. - ,`'v`. a, 3n„° : CONY T :E ya_ : t ' :' ,, ten; ,;,,, x?- :'; t i. + x t �-� °�vs.» ' °si�,s;� Qom.. tv' �� €,� „�:r;C AC P. RSO . .�- = �i:c•- r:�.�., �;.�� . � >., "s'i., &ii.R ».r.,- "b..�t,� r i?irt -. . T= l, ,. i.;.,° s4 :'a , +.G,"a"- .�s:�. =a'+., , :. s�.:w. .k ., fi,, .^' +: A' 4 �� _ ,� .�';r:�,z� . ,- ,:��`o: , ,:.s ��;� "' = ;tt�.•_ ��` �""." ?= a��� y � : 1 $:�NOTIC,E ��� ,. a�nf;'':, • <� ; � All contractors and subcontractors are required t E � AM ���� .....,- � �;;��r�:- ���,. ,.-�,'�.:,.. ..- _ Business name: � to be Contact name: h' ' t licensed with the Oregon Construction Contractors Board . f c e �' under ORS 701 and may be required to be licensed in the Address: 2 X e L (.�. f S I • jurisdiction in which work is being performed. If the City/State /ZIP: L a--K.i O S It./ , = a (9'C 17('-i t applicant is exempt from licensing, the following reasons /' / apply: Phone: ( 5' 0 C3 5 — 1 / 3 (/3 ax:: ( ) . _ 5 7 1. -ei ,e--- E -mail: r a' :%^�;i & :v: , :�;; "''r ;x r . rA :.�x�.''`:t _x,:f, >a_ .; °;. c i - , .7..'S "� _ ,.,.,- ;'.'ar 7", e w �"ri �ES + k �,'rVM eONTRA Z . 7 .e f r ` ..1.1. T A� , al p ' . ....:tr; ,. z.b..* ,i ,s -u t as�: „., 4"Aw y �.. 4 ., . w 4,A ' Business name: L. /� E _ ,; .. .., e: l� /t �p /C ©�� �= S t , _ ,, '{ „.„ „, TTTLDING P R ,. FEHS,4; Address: 2 g GlC�dit 5/ ._.. » -� ;:z- ,c = =.�.. a,::, .tti :,E ^4 =i.,,,,K•_`::... - . Please refer to fee schedule. City/State /ZIP: 2_ ? (9s � ,L/ c /9 1�e q 2t'�3/ } Fees due upon application Phone: (5'U ' I L`3 F ax: ( ) t M .t.� CCB lic.: - mount received � _ / ~1 Date received: Authorized signature: This permit application expires if a permit is not obtained / J within 180 days after it has been accepted as complete. Print name: /l of , ./t L, 4 _e-e__ - Date: F<77, d 1 ( * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \BUP- PernitApp.doc 12/03 440- 4613T( I1 /02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY C City Of'Tigard Received Permit No.: l ,9J U Y 13125 SW Hall Blvd., Tigard, OR 97223 r Plan R eview Phone: 503.639.4171 Fax: 503.598.1960 Gtsa;K; • "• i\ D Other Permit Inspection Line: 503.639.4175'III Y Date Ready/By: Jw Internet: www.ci.tigard.or.us �.. is. 8 See Page 2 for g SEP 0 2 200k Notified/Method: Supplemental Information • A,; , ;.,.'.,, 1 ; ' : •.Jegig'�'kti5,,Y ,- sR -ir*'° , �, ., ...... ,. ,, ` .;:t C O �, -_,,�� x 3 VIlVI.E RCIAL .ESE* °SCHEDUL-E. -sUSE�'CHECI<L IST J New construction ❑ AdditionlalteitahotSrEjilg et1101 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. KI-fig ' . - -w ; �.�r. = oli --:, :.: t. ,�:-- �: ,:; ; Value: $ ..: . - _,. �st ATEGORY OF.CONSTRUCTION ,, ,' . `,. :., ... ,, ' TIi , E; ULPMEN S YSTEMSsFEES* ' Ill <r• 1- and 2- family dwelling ❑ Commercial /industrial Accessory building = RE SI DEN; ;Q"" � For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total war. ��- ;: �_. T�.�: ,- 3:,��„;« � °c�; F ; , OB S t AND LOCATION y ,, £ ,y ? % , f, , , ; ; : Job siie address: > `t '; Heating/cooling ' / 3,-1-1 � ! O 6,1 � � Air conditioning or heat pump (requires site plan showing placement) 14.00 City/State /ZIP: � 1 01./c /9, Furnace 100,000 BTU (ducts /vents) 14.00 / Fumace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas hea pump 14.00 Cross street/directions to job site: k/ i_he that ?to / 7 4. ....‘ , / , ` [ j - 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: erQ "li til Lot no.: / Flue /vent for any of above • 10.00 Other: • 10.00 Tax map /parcel no.: Other fuel appliances '4. ,, * , , .., „ � . t � - w - Water heater 10.00 t r " x ,., #. , :. n'il # _ ; A.. V ' SC PTION ,OF WORK .. ,;V S `` i', W.. sz., 1 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 ,; :� ., -r te ,: a s. ,- i > y r := r ,.. - , z--:-; r a,1 >; ` ` A , . Chimney /liner /flue /vent 10.00 s .. - rEROPERTY UWN s0 ®� TEN - , � , .a te , 1` _...:- Other: 10.00 Name: t r f� 1.,1/b oi` i 1 s Environmental exhaust and ventilation Address: 2 X ,O c '•� S , Range hood /other kitchen equipment 10.00 City/State /ZIP: L(L < O S (,// /it 0/F- g)0 0.� j r� Clothes dryer exhaust 10.00 ( ) . J S- / Single-duct exhaust (bathrooms, rooms) 6.80 ooms, Phone: S© 7 Fax: ( .) S ra toilet compartments, utility $} * x m z ts: TM:i4 hy$a` :iw-s.Y.ov:.�%# •. <• :cW:" '::Y'` =. » ` s '.'¢," ;i4 ' }'.w.^ x i 3y ; ? - ..?r.. :u: ' �.� �;� � t �r , �;, . `r` ; °�" ' Attic/crawlspace fans 10.00 -` . t .,<, t 1 TG %_ - , ';''f § `..; : C ONT �`' -' P a. x.x:,�� ..': , :�` e.'�:k s�`.�:'n;��re :r::�,,�r:ik:�� .:?„;..4s,...:, „� -;;u.: x,:`M�`x;�.;��_ ..::�'si.-a�;k2 *1`:;.��':; ` l /10416:- Other: 10.00 Business name: L E f ' 4 il 5 Fuel piping Contact name: f„i, pi Le- .i $5.40 for first four; $1.00 for additional Address: 2 /3 4 (G � � �1 Furnace, etc. �c� Gas heat pump • City/State/ZIP: L �i� n Gv eyd 0g o �(.;9.5)..5---- Wall/suspended /unit heater Phone: (50) ‘ ? J /? L/ 1 Fax: : ( ) ��(.w ._ r Water heater ` Fireplace E -mail: Range - e p, n ' > ^r. ;--: ',;.' r - »*; -',a ;;'6:-. -..a .c�•.ee^,,. €., .. - ° 4 : , ?e= ^ y;v u �� r�CONT CTOR,�`= ,a , � _ 'r�'y Barbecue � " ��r....Rz .. g�: ,e� t t t Business name: J `� ( r Clothes dryer (gas) � �� e���� /- Other: Address: c / r /`/ 2.1 ,,,, . A. z` C, " s' ... G- / Q S 5 rym MECHAIVICAI EEIZMI kFEES • . City/State /ZIP: �b / 0 f. q' 2 012 �.�. Subtotal Phone: (5-0) 2 �� /2 4/( Fax: ( ) Minimum (25% fee permit fee) l Plan review (25% of permit fee) CCB lie.: (./(2(..2 t State surcharge (8% of permit fee) Y TOTAL PERMIT FEE Authorized signature: ' This permit application expires if a permit t is is not obtained within 130 days after it has been accepted as complete. Print name: Po n 2.- 4-1,--- Date: ? _ / 7 , t'/ zy * Fee methodology set by Tn -County Building Industry Service Board i :\Boilding\Permits \MEC- PermitApp doc 12/03 440 -4617T (11 /02 /COM/WEB) • B Fixtures Plurlhbing Permit Application, p� FOR OFFICE USE ONLY , City of Tigard « E i V Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: r Phone: 503.639.4171 Fax: 503.598.1960 SEP 2 2P u xn p i �piNP4 f ,•' Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 -. I Its: Plan Review Date Ready/By: El See Page 2 for Internet: www.Ci.tigard.or.us Notified/Method: Supplemental Information ntTAr r�C TIh ..:.5^.. _' „ ck = :v.... �m+,3'�r :.� 3!:; !; � m r` rHR+ �:T.F.'rYm wi a:i;k �:3,a' ;." o °` •r `;:.`" t "w , t: ,'` .�x,.'.'z;a.•;5, wg , _ . :ma x, . ,s' ?a : ^; .. „ : ? -..,.; , � . ; .. 4 .t -: ' ti- i i . , ; ` T, Y P E ° p ` < te sir` .. , . + , 1 t . r �. R AC: .', t,. FEE. SCAEDi7 ` �� X x35 <���'� � -�-`,a �h' � >���': r��3�,',�: ��,,', *,.., 9°s'�. °t.'��;; 'err �. �'.�," 3 �'; s..s, ;:,,..<e ,..., ...... .,. ,�.. ... ,... E . <.,,.. a ,��'��`..�.C4..a.-- .,� -i �.. .. ms`s �` �.,..a. ~.rya .. ,,, � s I P New construction ❑ Demolition For special information use checklist. Description Qty. Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) + ° :,, `" - `3s?s ,i'drs ! .'xY ` ; r'^ti . nr?�;, -e. °S =:t; -i ' k4 3C ? °:Ar' ;4: ? -m =,.; �5;e3 - r.;t' _--"; n :.. * R .. it 4 ; z � CP. G ORY,. £ ,,,„ 4 , TR L' G I , x' ; . , , ' • , ..,,, ., SFR (1) bath 249.20 IN 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 CD Accessory building ❑ Multi - family SFR (3) bath 399.00 • Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: a, ts: ®asr ° _ rwx - >: rte <Iu,� Fire sprinkler ( sq. ft.) Page 2 n Ntitx'x . =t.WW,.. 4*., ' = sue° a „r,4:r*�,a. , :- .1e^.`r y,... .,, .''°,ac. .. >�. a:'_�. c-_: Site Utilities Job site address: 0 6 ® •v / , r Catch basin or area drain 16.60 City/State /ZIP: j e /, Dg Drywell, leach line, or trench drain . 16.60 Suite/bldg. /apt. no.: J I Project name: Footing drain (no. linear ft.: ) Page 2 job site: / Manufactured home utilities 110.00 Cross street/directions to I 0" 4 '�� G3 / 0 � '� Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Lot no.: r Water service (no. linear ft.: ) Page 2 Subdivision: 8 �t7� 5 I Fixture or item 'Tax map /parcel no.: .� w a< : ::!r' :?q% „ , ; . �; �:'s �ro «`&::- :- = r ^.,,.. C„a['S>wa6 «t:r,- of = ,' ?'� s,.° .y,r�,,..,.,,.'-r•-, Absorption valve 16.60 t 'DES "GRIP�TION OF WWiii °�s "a r xa ��+�. x�:�.�. ,x �.v .. .mot; :r?�°' �i�ti�:? �= rx:nszr`� �- 's,.5.«. r.r,,..,�.� .,, � �?: .0 n.o-.a. Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Expansion tank 16.60 e , ,� ,�µy,„'., m ,. ;,.. > t s - f ik ;N : .a <" � stg c a: ,- r - n ,a - ; =K:t , , �..tas i Y t ' ; Drinking fountain 16.60 a ° ,C -- 'y! YI L - , "O RO::e F. \I'+ 'ov s. .. , i~'t: R' X -sr-`' . . tis 1 .L,.j F •= -• • + {' , . . � // :�u.�.,.���!,�: .�:r.: _ :�'�:b,: ' ism° x� , .��:., rn"h�:��: Ejectors /sump 16.60 Name: C, f 6 , _z_ /4 r'U Om IL- Address: 2 D 4 - e - t $ T , Fixture /sewer cap . 16.60 City/State/ZIP: 5 6 7 20 3- ty L �� � �} Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ') Garbage disposal 16.60 'lx ">�''"r3+°... .".., �- :e2w,J` .:,ir,e: *� a�'.k �t;;'rx;,•r:- ,a' Hose bib 16.60 'xF 4 , �' f i o °- G AC PERs xt 243.1r � � .° r *. :1- : ,n - - ` ,. • l,i,P� , . ` �w,s, $ 16.60 ` ~' Ice maker Business name: 4.F:.1:-._ - LA/V #(4/g Interceptor /grease trap 16.60 Contact name: r 44 .' -. / ,� Medical gas (value: $ ) Page 2 Address: 2 e G- 0 , L 5 , Primer 16.60 City/State/ZIP: 0 >! t/ e W Roof drain (commercial) 16.60 Phone: Sink/basin/lavatory 16.60 ( Q'j S_ 24/ Fax:: ( ) Sy v Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 ... °. ; a° r.,, - ;%,..' ^:::,, 'yak ei:. m- fe::^ i, , ,"4- wt. :,0:':. :7„�: : ;., :;1 A:t # .t s� b s � x� 4 „ sG�i� l e; W�TWrk,t� m � :tg � Water closet 16.60 Business name: G o1- rr a - h /p2_,7 Water heater 16.60 Address: /9 0 , i ? / 0 / 2 q Other: City/State /ZIP: t / Subtotal t ! 4 ��`� ` L ? � � ` / Minimum permit fee: $72.50 Phone: (5)) L / e' -2_2/ , Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: / q 1 I 1 7 Plumbing Lic. no.: 3(1_ 4 /Lf _ re Plan review (25% of permit fee) l State surcharge (8% of permit fee) Authorized signature: L.26> TOTAL PERMIT FEE Print name: go,CS , L e Da te: / 7 _ a This permit application expires if a permit is not obtained within C 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board is'. Building \Permits\PLMF- PermitApp.doc 12/03 440- 4616T( I 0/02/C0 M/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 -00254 Date Issued: 1217/204 Parcel: 2S115AA -09600 Site Address: 10860 SW BRETTON CT Subdivision: BRETTON WOODS Block: Lot: 001 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 ',4J J( //I l J Signature of Authorized Plumber If you have any questions, please call 503.718.2433. STREET T CE TIFICATION R .. .. ��, � ,: I, PO ‘,'"? Z • Z .L I , Owner /Agent for Lie Zdee / (PLEASE PRINT) (PERMIT HOLDER) A \ Do herebyrce rty th fall location meets cit of T:i a / " o n " County land use and development standards for street tree installation. ADDRESS: /a F ( � 0 --C: 4/ , a-e 66/-7 0. / 0- SUBDIVISION: gre 7 / Dr? lit/ v� LOT: D d S BY: id;• DATE: q `2 - (25--- RECEIVED BY: DATE: 7Z o A CITY OF TIGARD ' A . BUILDING DIVISION PERMIT #: MST2004 -00254 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /2/712004 Phone: (503) 639 -4171 :r� lury�ii�p6l�I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/12/2005 TIME: 7 :04AM PAGE: 55 SITE ADDRESS: 10860 SW BRE( ION CT CLASS OF WORK: SUBDIVISION: BRETTON WOODS LOT #: 001 TYPE OF USE: PROJECT NAME: BRL I ION WOODS DESCRIPTION: New SF OWNER: LEE -LAND HOMES, PHONE #: 503- 6351343 CONTRACTOR: LEE -LAND HOMES PHONE #: 635.1343 Inspection Request Scheduled For: Date: 9/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 015400.02 503- 789 -6795 N Corrections /Comments / Instructions: t 'paspo /4 c Lrivcs' ci L- .4--t9 , s. 411) k ►� PASS II P TIAL APPROVAL n CANCEL ❑ NO ACCESS n FAIL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /7 #: (503) 718- CITY OF TIGARD . . 1 BUILDING DIVISION PERMIT #: MST2004 -00254 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2004 Phone: (503) 639 -4171 /oo�ir ,r ( I Inspection Requests (24 Hrs.): (503) 639 -4175 ''f — INSPECTION WORKSHEET FOR DATE: 9/12/2005 TIME: 7:04AM PAGE: 56 SITE ADDRESS: 101360 SW BRE I I ON CT CLASS OF WORK: SUBDIVISION: BRETTON WOODS LOT #: 001 TYPE OF USE: PROJECT NAME: BRE I i ON WOODS DESCRIPTION: New SF OWNER: LEE -LAND HOMES, PHONE #: 503.635.1343 CONTRACTOR: LEE - LAND HOMES PHONE #: 635..1343 Inspection Request Scheduled For: Date: 9/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 015400-01 503-789-6795 N Corrections /Comments/ Instructions: • ` ►4 PASS 2 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I l FAIL It ' LL FOR INSPECTION El ADDITIONAL FEES ASSESSED : �f f �d Inspector: _ � gate. Phone #: (503) 718 - 411 CITY OF TIGARD ) BUILDING DIVISION PERMIT #: MST2004- 00254 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2004 Phone: (503) 639 -4171 : emu ° u �H����l Inspection Requests (24 Hrs.): (503) 639 -4175 �_.. . INSPECTION WORKSHEET FOR DATE: 9/9/2005 TIME: 7:07AM PAGE: 24 SITE ADDRESS: 10860 SW BRE I I ON CT CLASS OF WORK: SUBDIVISION: BRETTON WOODS LOT #: 0p1 TYPE OF USE: PROJECT NAME: BRETTON WOODS DESCRIPTION: New SF. OWNER: LEE -LAND HOMES, PHONE #: 503-635-1343 CONTRACTOR: LEE -LAND HOMES PHONE #: 635 -1343 Inspection Request Scheduled For: Date: 9/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 015303 -01 503-789-6795 N Corrections /Comments/ Instructions: `RASS _ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r -. 7 -. Date: or ,: 6 Phone #: (503) 718- CITY OF TIGARD A , BUILDING DIVISION PERMIT #: MST2004-00254 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/71204 Phone: (503) 639-4171 ?Tip Inspection Requests (24 Hrs.): (503) 639-4175 .-_-_-- ....... INSPECTION WORKSHEET FOR DATE: 8/3/2005 TIME: 7:06AM PAGE: 24 SITE ADDRESS: 10860 SW BRETTON CT CLASS OF WORK: SUBDIVISION: BRt. i I ON WOODS LOT #: ��I TYPE OF USE: PROJECT NAME: BRETON WOODS DESCRIPTION: New SF. OWNER: LEE-LAND HOMES, PHONE #: 503-636-1343 CONTRACTOR: LEE-LAND HOMES PHONE #: 635-1343 Inspection Request Scheduled For: Date: 8/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 012719-01 603-789-6795 N Corrections/Comments/Instructions: / , 12 PASS 0 P'tTIAL APP A 0 CANCEL E] NO ACCESS n FAIL i e r 0, • A L L F SP- TION El ADDITION, ES ASSESSED y Al Inspector: A , Date: ; 3 0S Phone #: (503) 7-180