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Permit t . CITY OF T I G A R D MASTER PERMIT PERMIT #: MST2004 -00258 ^4 DEVELOPMENT SERVICES DATE ISSUED: 10/28/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10920 SW BRETTON CT PARCEL: 2S115AA -10000 SUBDIVISION: BRETTON WOODS ZONING: R - 4.5 BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: New SF BUILDING REISSUE: SSN2724 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,171 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,553 sf GARAGE: 486 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 264,553.20 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,724 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: 0 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: $ 8,288.79 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 #: 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 Insl Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing Insp 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 Post/Bear, - to • - Mechanical lnsp Shear Wall Insp Insulation lnsp Appr /Sdwlk lnsp ` L ' 1 . 0 Issuer By : —. ... I! /LA-4_t _ Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day {. Building Permit Application FOR OFFICE USE ONLY ■ City Of Tigard �� �� Date/By: it �� I - PernutNo.�� : 1 , %/y() UUL 13125 SW Hall Blvd., Tigard, OR - 97.223. Received Plan Review V c �!S�'(/k/ �/ Phone: 503.639.4171 Fax: 503.598.1960 ^ A :If ryJ � 1 Date/By! ( �V\ J 9 " 1 Other Permit: S'L�� t �-�7 it� 73, JICu Inspection Line: 503.639 4175 SC® 0 L � . al; . '�' I ! Date Ready/By: 6/ ' O t Juris - t See Attached Checklist for www.ci.tigard.or.us ��O lf Notified/M /0 6/ Supplemental Information Illrg y;., ,�R,�e L "�° 'tig ,' � '4d . r� arfr'tl <. ?;�;�'.: .'1�:.> . X53 M :� , �... „ - ;fsPit ..r=e .;rem . •iii .1 k " - ��.�. - -i<` ^. ;_ ';`:i..�, t, - t s '' a t , ` s . t #. 2 ... -,, P i • .: �.... ,P,E ,.,, a . w .— . z; T2E , D DATA_,1, d D't .. FAN l- `DW'ELLING -�" u,_�� c�x.M,.?: s , <.: c " _ � - .,..�,�.�7`."' . ^ r'z :Mti« ,b a.�.,� ��,���"r � �.-�s .�, _,, . if 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 y".t -:.:.� ¢- � �„'i� '.v ; n; e.�+'3' ?arc"w ��•r��a" >� �: •s» ?.»- -': k..• *winf '";•'.5 ;<4, ?':.,, �' : ':.aCATEGQRge.,.. v G,ONST12ilCTIONk- ,,x,, •,::5. '. ',' °- work indicated on this application. S'�L w,Rw ', n:.��:. + x,:`'s�'", , -i ? A. 3a2'. .:,. :� » :tS%�:v"�,'- 2- 'i^.,. !E rn:i g ,�€' : .. ...x��� „:5;,,,' ' . �.. . ����` � >� (1 1- and 2- family dwelling 1=1 Commercial /industrial Valuation: $ p � opa ❑ Accessory building ❑ Multi - family Number of bedrooms: 3 ❑ Master builder ❑Other: Number of bathrooms: 2 1 / Z ' i -.,7' p; -Ki -T ,x . ;;- n;3t .41 :3a aggi re�g; z °..�' : -^ ^s:; f's. ,r ;,ar': ;k[6-`'a° `. -; - Total number of floors: . : . . 1 , IFI TION :AND . LOCATION . , ^ . Job site address: /012 O /3`e f ./oh C { New dwelling area: 27 2 Lr square feet • City/State /ZIP: Garage /carport area: L/ 8'j square feet Suite/bldg. /apt. no.: Project name: Covered porch area: / square feet Cross street/directions to job site: Ob • / /17Y -- Deck area: square feet Other structure area: square feet _' ' REQUIRED DATAilCOMMEtte -W =.USE: GHEC'IQ:IST Subdivision: /5 L., / t 5' 1 Lot no.: Permit fees* are based on the value of the work performed. . Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all .�-, -, ,.:= ..`a" =. a ::s ,,iqf •l;, .nig, .c'r = °'t = .k, ; : '��° >Y.; "gg °r> ;cY: , j• a = :'.»i. " E'' i:.'' t •�.?'�: - e' equipment, materials, labor, overhead, and the profit for the ': �r m st: € 1� „- . V D RIP;I, -1YZN OF' WORTS P ? a } ,° � ,y ` , work indicated on this application. 4.1z - Valuation: . $ Existing building area: square feet • New building area: square feet � " t0. - - x�+,7Y.<<� :�zr<ax:�aus '�, '� . �s:r". p ?+rw;r� „��.. �!;;a.•`.s�'t�. P w i= • 1:- ER='I?SI„ O.W1`1EI': '. �.l,TFIYAN'r ate. �' % Number of stories: a%�,,:;,.,�x., »+`�: L , «.�„ �- 7�.'.�".�' `� ;ca=?� `��._' i� '���:,�ak+�a:- '�. e:.:.,.�v;« �,.,�;::,�.�n.;' - ,s " � ra Name: L. , C= LA gil) � ©I', e7 Type of construction: Address: 2 e e [- i . - f Sl. Occupancy groups: City/State/ZIP: `tom`— 't CS G 4O (2 - i � / ,(22_5' Existing: Phone: (5 7jj l> :s /j to Fax: ( ) $ -'' New: — :r:;:: , �s , as� # ; ��;;” ':'� :•;.;`+ ^.,i ,..' ^: i,* +a ?;•^ °v,;H, .� ::,.c ; ' fi r ': "?;i: F'�s' ? ,= a:t!,� ;k'i*s;. ;p� y�a APPII = , s .ER . t ��rfrti,.. C' ''' _` . ®rCONTA °�'T�` SO - ��. +Ito- �y�f` •. - - .••�ti't.u'.�Y - ..,.s. .t.. *:x:'iv.F "..... °' :'1' "x,5 �-` G:; .7. i:.:5'..'a :Tn t'¥. � ° '' '".'i. <. .':'fL:< i �., '.�+t' xv:4a - :,' s` 'i }:�M: � iv �`,r``:; -� ��,.,� - �` ��.�k:: � s . � - Business name: L � � _ t 4Afj2 Q/i 1 $ All contractors and subcontractors are required to be Contact name: t ,2 b rte, GP licensed with the Oregon Construction Contractors Board // under ORS 701 and may be required to be licensed in the Address: 2 ' . ' e c 1( t S it , jurisdiction in which work is being performed. If the City/State /ZIP: L a--4-i 05 it, ,9 (9� 'Y7e9.S,— applicant is exempt from licensing, the following reasons / / apply: Phone: (NCO) l9 5 — / C`3 : ( ) ` 7-7 E -mail: t : '�r- 41aeg°1: - °', s.;s`3 ;8w' `p C;. ^ " -3, .' __ w'' ia'y':: a:'?•<'M t ry : }`.;x�i ��,;€., Fgli -3;:k �s 2 .°' "F;;T; e t Atti l :; . OIVT -B�iG OR `� t ' ''"� ut A - =, ` •a n a .. • �� E g . � x+ z: ti is +a `"'�r�s 453= ��.w.= ,`'"�,.'v�i' ed..���'w,� �'�". -�` .:= ? ", kp+^"xs :'��..::.�2 ..�`uf'�r A :3ihi�"i'r`,' n .... , x.,'�`�!5�. ..� . �...: "�. Business name: ,� / / /A �all eg r -' r F-' / . r� ;x , ; , II� IIVG"PERIVIII'pFE�S . . Address: �j :� „,� .•...;T..„ ��»�;, b, . �. -... r.,, &` : : ,,; > > 2 / , , Please refer to fee schedule. �A L �' J� City/State /ZIP: L z i t . ? (9s .e' C eV? q)(2 Phone: L / F ax: Fees due upon application ( 5 ` t 9 2 5 0 1 t!3 ( ) ,t„�� CCB lie.: 4//5---2,5 — / ount received Date received: Authorized signature: j()_ / n This permit application expires if a permit is not obtained / /// c � L'�` � within 180 days after it has been accepted as complete. Print name: F0J . •it L, L �../__ . Date: ?? /7_ ©L( * Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \Permits \BUP- Per,nitApp.doc 12/03 440- 4613T(l 1 /02/COM/WEB) ', Aug 17 04 02: 07p 503 848 -6823 p. 1 1... 08/17/ 01:05 5036351343 ROBBIN•LEE PAGE 01. .Electrical :Permit Aj44ic.ataon f- ! ►. Orf ( NaO \Lt -��... - _ _ City of Tigard R!raC g V Re`4"°a .YettnitNo.: • 1 3-1 SW- Hen'Slvd • ., Ittard,.OR 97713 Date/By: Plea Rrvier Phony 503.639,4171 Fax: .503.598.1960 Aim trait - lrtepcotcn Title: 503.639.4175 . •e `- , i � { ' . D.r f + D.1, sediMerb lwif Set Page for .,'_ct.tlgard erica SEP 0 2 2 t1�1 Nx�irnd: tt plemeoteI tMa rmMoo `# t v:r .ii -..• 'i_L .w ''i 41: ",;i • -- •:433r FO . h�.Z'V'� i.or.ya�iFc:..3�Y:.• ' � _ = k- c Y: t r lt, i ,,� iIt T ` i ' New .consattuion t i t sr• w i• r i y . ❑ Atltlislont� ,._,t Pleax check all that apply 0 Demolition O o g e viLDING DIVV1 ISION 05erviee o er2`21 =Ms, comtn'1 G'ifnzardotis :F Ka +x rim m Bret rn r .r r , ( ieeover amps - ratios QSuiltfogover 10,000 s9. it., Af` ! 1 r�i i i T_ i a fi r-::... 1: 011.7•••T S. r of 1- uId 2- trimly durellitlgs d or crane now residential 1- and 2•family dwelling 0 Comtnercialfindustrial 0 Accessory building QSyedernover 609 nominal orals fc vac sm,cmtt ❑.Multi- fnlntly ❑ Master builder tea; °Buiiding over ttu4e stories OFeeders, 400 rasps or more _ N -r a _,. '�, M zs. _, r _ .rs 4 , , Qceuparlt load over 99 perso ❑ Manufactured = natures or % _ �� W .,I I a :. - , n; ' u - . i . r ., s'',1 .I1 IJE�IR[�ll plea RV park Job Go.: Job site tddst ss ® 2 (, QHxaltb taro facility DOS: r1-e On 6/ Subaru 2 sebafplans with any of she above City/State /ZIP: i app licable to The above are not temporary construction service SnitelbldgJapt, no.: Project.etartie �.i :Ws °' :: Drssrtiesee Qty. P r :.. 'retA I, • Cross streetiditections to job site: aArnr rs B /01 J' ew residential single - or matt - family dwelling unit / St Ienstaas imelsee gersge. 1;000 e 9 . ft.'' l e s s • 145 :15 s . Subdivisitm: /3/ ,,, /d J Lot n0.' Ea. add'1500 sq. fl• or portion 33.40 1 Tax mappareel rw : • Limited energ residential 75 2. ; ti r . . ...1_,-..7.,..T...-.::.:...1,,,;:...., Limited raee y, non- residential 75.00 2 ..I tl ....._ � d" r+i� , : 4 � t ....„, t .,.. : r I j l �,� al. r. .,,,l , r ..i. l .. tAj l 2 .j. � .a ; i Baths rt7eSlUfaeasted Or modular dwelling, acrvirc and/or feeder 90.90 2 ( Services or feeders iauteUulon, alteration, arid/or mimeation 200 =Mar less 80.30 2 :.m r •�q yr `I cr -C+ r '. :T T'E^tt.. 201 amps 1 ,,r �G ¢ , 0 400 crops 106.85 2 '11 1 1« . j Z- . h . . 6 , � . , 1 1 :1'. i : i t . _L.,. . t, am I, iw'La f hl l Ysirl?i S�Ef�q'I 401 amps l0 60� C ,/ /�.t taps attrpa _ 160.60 2 _ • NanIE: • iG J A• ? om .. $ 601 atrlpe • o I ,000 ammo . 240.60 ., .2 Address: A ire e, - 5 _ Over 1.000 amps or volts 454.6$ 2 t _ only Reconnect v , 66.85 2 Cit)' /States ( �s . ,.• #` - Temporary aeriice, or frodorS lonsUation, atteratlun, stadiar . Px • ( 9th .. ? S' f.7 1 13 fax: ( ) ,.-2•srl'f -e -` 200 amps or less _ ( '66 :85 1 • I Owner instigation: This installation is being tunic on that 1 own which is not 20i amps roe 400 amps r 400-30 2 i inrended for sale,,lease, rent, or exchange, according to ORS 447, 449, 670, and 70L X11 runes to 600 amps i 133.75 2 Owner &t oad:is c Date Branch eircettt - .alteration, or extension, per paael. 7F ` Y - 1 1 . ' r. . `T- ' ^ A. Fen for branch circuits •/rA a r- . f _ ,, .:a , .:. . ._....1 ... 1_ _. `. . b_ • , �nr.r " ,Brix or feeder fee, eac branch tarcuit 6.05 • '2 B. Fee for branch circuits ' Contact ' �, tQ-e. without service or feeder fee, 46.85 2 , t: Address: 2 a - I ec- ( S' . each branch circuit , each aid•s branch circuit 6:65 2' City/Stnte/Z.IP, 4 ( 4.-.9 7 1 _Ore. q 7 02f ^ At oceteneouf (service er feeder sot Included) Awe: ( t ) ) , 3.3 - 3 Faau:: t ) • YsamF irri atiatt circle ss.40 , a Sign or outing l(gltting 53,40 ' 2 E-mail: Yr "! 7 4 w . - a Signal clrcuit(s or linseed- I. t .x__ r ,,. - ri •1 _.i• `. -f'•••• I d • IL ,*k`" f : . , ' ✓1' . f '` . ' dri uli+ ••'''''• : exten D . os • extension. e: Page 2 2 Business nann: ei �, ,_ U /' C 1 1 O t , V . f rl 7 1. c ^i L ( EacEagle add itioeai' imp eceion.over ealowaWi in say oI rbr abeore /!)� Per inspeepou 62.50 � City/State/ZIP: a ., f r7 U /[.. invtstigation per hour (t trade) OM 62.50 - industrial plant hour MI 73 Phone: (SQa) co_ 12 Fax: (yo ) 5 -'` iw' i t.r {; ` ';,V _at ,s 1 CC�:I is : i 't '7! lr- lett:icaC Lac.: ` a Ll 7_, �uls�tal Suprv. Electrician signature, required: / „,,./ , wx Plan review (23% of permit the) Print name: j// ; f . t jl� [t/7 Date: SesurrSrarge (8 %.ofpc**�ut f ) . • A tltlt0tizest si tire: TOTAL PERMIT WEE t 'Ibis permit atryticatiOa if a permit is Tsai ebt +fined setr4io MO --r- • tiara idler it Lot Wrsx acct pd a eemytw Print mum Doti: ' Fee meroodolory wt by Tai - County Sadists Industry Seriee Board " NalobeI of iospeceow par 3cmo allowed crib d atvsnoit t.Gyfreonapme Ivor ++o -..al s'ItrOorsece -ose 1 Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard EC V LL�L��� �D Received Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1 ift i ) i DateB Other Permit: Inspection Line: 503.639.4175 yN� 0 2 2004 'pg f , \ I1 i y �, Date Ready/By: Juris: 8 See Page 2 for w Internet: ww.ci.tigard.or.us Notified/Method: Supplemental Information CITY OF TI(.ARn RIwRi�� ° ":f04 "`�'��''�_. , :). 4 " 'uCO'MMERCIAI;'FEE SCHEDiJLE,.._aU . gg New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition . ❑ Other: mechanical materials, equipment, labor, overhead, and profit. „t .n;a� :...:, :+ x.:,�., :, .:» :.., � � i' CATEGQRY. OF4CON fkIrGTION '"V W r s Value: $ :w1 BESIDENTIAIVIENT / MS YSTE FEES* IN 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ` ° "' L.EQUIP For special information use checklist. ❑ Multi - family . ❑ Master builder ❑ Other: Description Qty. Ea. Total Z _ ! ' > °.. �t�; p Ke ��: i i. �'' T.,-'.,_."^« r$e'&± x 'i -}Ye: �:�.;1= '?5.:�<�kr:. >.._+6^'�: «ap,.: P.��,i: J . A � = Y :� 4: - 'ks :: ,-:.:,_,•.;JO IT_E;",if: AND. =.I `O'CATIHIV''` ^' _ 4r , s =;`, ':,':P' ?; m ..xvh, : � �,c.,,vi.,� ,,,,, r..: >; s „,��.:.. ::,,,, ,L,, x-: ,. , n,a, a ..�. Heating/cooling Job site address: 0 '/ 2 a /3r� t19a Cr ir cond or heat pump �( tion (requires site plan showing placement) 14.00 City/State /ZIP: t ft/`-' /f 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: /..., f 0 y $ f✓LL)-�"! / /` j 4 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: 8 re: -0,„ I t2' Lot no.: Flue /vent for any of above 10.00 Other: 10.00 _ Tax map /parcel no.: Other fuel appliances ��c� bi=? .: j,•., Ft:^x:'i=W:0rdgfs';� a;. s ' s,y- «z+s.:= - .n.N�r j s' : 'S:H ; ""'s: "'r 4,.. t&r.:4v,',a ; r ;g ` Z' 4gatg„ * .-DESCRIPTION OF WORK v �l ' < c I( Water heater 10.00 �ia.xs�'v� � <, x;.�'::.�i_ -rrt:; .,<.;, .'�1. �., .�r�rr^ , '.s :.._,..� �. .,..,,: r .� nt �.., �';�ki, - ss. ,max a..� s :� �...�a:.,� .��.u." � 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 - :, <r; . � - �,7t,...:f x.,'�:_ ,t I s' .; ': °y.= `""41'..,,':..A:,,I :<, ;4 <y.,•4. :, :°r. Chimney /liner /flue /vent 10.00 �: � IPROPERTI�- ONERS �� �� �,;�� � � TENANT � � � :�� �: f i 7,^ - . m - . vnx , .rL . � � ,a� .4,.. ' ....� rt -c. ' �.._ _�. a.., „�......ax r...oe _ .. Y... ,3,.� =t�� _ _ � Other: 10.00 Name: L � e_ 4 //V I f/2/Ji /E5 Environmental exhaust and ventilation Address: 2 x B 5 (- , Range hood /other kitchen equipment 10.00 City/State/ZIP: 1, O, ( fie L , 0/7_ 6 Clothes dryer exhaust 10.00 • Single -duct exhaust (bathrooms, Phone: ( ) f ' 0 s_ /, i 4.(3 Fax: ( ) --. .e..- toilet compartments, utility rooms) 6.80 r is ci ^; s w; i: a:w :�x, r�.;, 3 c� ^ .a='w:�*r,:,';:- r.: '"' �; ;1 `-` .. ._ - ;- :. ,� :,., : i -Z. '`1- Vrf=!r ? , ,,"'AE PL IC,.. 5 . � ,e. „, ? t y 1 :4 4:41= CONTACT, r Attic /crawlspace fans 10.00 �'��x.`f � . ,., c .,a..v*_�..3r�rb .n �.°ss,. - ac.- „sv,�.���4 ..:,.,�. „,,.. ,= u.tU .f Business name: / � Q� s F uel 10.00 t _ T F/ 1;" Fuel piping Contact name: R��i, h Le_ I/ $5.40 for first four; $1.00 for, each additional Address: , 4 /3 G G IG G )1_ Furnace, etc. Gas heat pump _ City/State /ZIP: L „L n C , Oet q 7 9 .'s Wall /suspended /unit heater Phone: (03) ' C ? 5-__ / 7 111 Fax:: ( ) Water heater Fireplace E -mail: Range _ Barbecue 0 , ` « - x > = ..:, . . CO ,', 4 , . ��CTOR ;, _�a G.,4 , 1 , V4 . 'Y . n , ,'' .E�"P'.'; �5 .�°- ,and: {�R� '�.�.c. - ». 'y':- � ��:.h.z�� �. =ice'- " -.,. ..h...._�t -� .r.,..i�� > ag � ;y ^z�.r" t�s,=�,r_;,�:G Business name: /F J ` r� /' � � Clothes dryer (gas) IF t C� 7 �7 c� l ,'h� �CjQ� �"y Other: Address: , 70 S r • / / / ,. ; / Y,: >.: , ....... ,., ,.. ,. ,:.. , e ` Y. MECHA'NICAL .4 PER111Tf`FEES*: City/State /ZIP: CO-/7 / (P q 7 ©l3 .... Subtotal Phone: ( 5-0) 2 _- 12 (rfq Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: / 47 190 I State surcharge (8% of permit fee) 1._12 y 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: Po, K-, 2. 4 -e•.e.--- Date: ? _ / 7 , (9e ' L// * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (I t /02 /CO M/WEB) • Building Fixtures Plumbing Permit App l atio n VIED FOR OFFICE USE ONLY City of Tigard Received �[ Date/By: PermitNo.: 13125 SW Hall Blvd., Tigard, OR 97223'[r 0 2 2004 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /�_ A . � Other Permit No.: , I � 24- Hour Inspection Line: 503.639.41.7 OF A 1 D ate ReadyBy: Juris: F� See Page 2 for Internet: www:Ci.tigard.or.us ` �F r«i4R[D Notified/Method: Supplemental Information RI III nick.", ,.,.�, .y�ts -,, .n2"_ ..� =g,.., - - ��;. _ - ..F�x :sad .+ga :z �c �; - - -- R.. eXa> s1rt; ,_:�'^.�ea::a;. ^- �wr'c.az��.r;. sT., �.,,_: �..,; : ,az, ,a. 'a *sue z „ r -. rt±..a - r'sti �s .,. ' ;AT j �€ i�'°rii w . ,5 . }'=z:��':°:i;:%� <.•.. � -g ,a .,��x. ;,'� .:� �'��. - ,�.� ��.�; �. �..' = u� *� �t'r r.HEDUILE' - ;,f,,. t:WQRI , •rf. - -FEE SC . . Prt s s '3:,:a� -4E "• ..2 �a''1�1 ..� _ .�. .",:ygt...Fi:.� ... ... ,� _ ' lk�:. �- �' v€ h M�<.. e�'.- u�k,-. �' c.' ��e: ��.:..»;= iA� •:a,- `c`?.:i�.e�,, -, t ai ' . s-. , .,,- i`- '� ». ; >.:�.Y.�.,'F - ,., ,..- . �,..�...s, >... <,. ...- .... , .... . ..... ... .,.. „x.x:. I t New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) tt,.. ""'`�: >tc�r7- s'.::z :.��raa'�:<r;, -"Ar ;: y; � .; , : ��fi °+?t „��� >.•�rn€:;",'?�.v + =u `;4:Ft` ^�? �.I:+'- ..,;;:; z; � ' V Te 'I • CON STRallf N F ' { Y 249.20 �iWa � ::AA.WaWW4.*:, r. z fi i 9 ,, x.r-a _. ck a 4. w.'WK4: SFR (1) bath 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: • _, rt rr -t tbFg � 4 ry _ - _ Fire sprinkler ( sq. ft.) Page 2 ;, ;, , ,n , . ;mot gg N 'ORMA' A ND' I © Tl<QN ? , 1 , 6; u <'� X14 Et' s3 udt.`,, ;Ax 4.4hnt: ar. . . ai0i4. :r°4 -rw, a - .:.. u - ,._Ye .i,> 4 '... Site utilities Job site address: 1 0 q2 c a ✓e /10,-) C 1 Catch basin or area drain 16.60 City/State /ZIP: ` d�14 Q /..-' Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: o 4, / /0 2,� Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: /ST 7 yy - ivaaU_.j Lot no.: ic� Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: _..:r. °�, ,F, rt _ Absorption valve 16.60 .;� m 4174 `FDES' 11tIPTIaizi�jWaian„ ., °; r Pa ^k��� �: �'" R. ,,,,: �a -- ..�k`. � .� . , *.., � ?�.. �:�,��,:. , -� Page 2 . Backflow preventer g Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ,.: a , 4 , 1 i s c �: a g a: :4 -.. ,., 4: ; ., Drinking fountain 16.60 'i -t `'P EI - I'al WNLR, � .r: �, . EI�I` '' Ejectors /sump §;`a.z'�'_.'f e�:na:. °,. _: . ��z�sw ,e-� �. �, i� :�a�� • `_r`,,.�'� >.�t,,:�i 16.60 Name: L, E. �-L /T co l 1 L', /- Expansion tank 16.60 Address: 2 g P t.1C . t 6 {- , Fixture /sewer cap 16.60 City/State/ZIP: /� �ae , �Q � � L/SGr�. -� U Q/ q ?o3S Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) • Garbage disposal 16.60 ^- ,ywvr.. -. ta:,s .,r;:txx "" ;JPr .ti.' ,,._.: 1 .. „J�;rx;.'s�:;= :7.:a =:vi, r..., Hose bib 16.60 n..,.- 16.60 Business name: � Ice maker 4 �' 1..../0/ �j /�� _,E., � / Ld'i'7/i 5 Interceptor /grease trap 16.60 Contact name: / b 6 ,', Z ,� Medical gas (value: $ ) Page 2 Address: 2 0 ` ? I. „I. f 51. Primer 16.60 City/State/ZIP: i 0 L #/ q * /.J3. Roof drain (commercial) 16.60 Phone: (c"0.3) o ? 5 /24<? Fax: : ( ) Sq n,, l✓ Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: 16.60 Urinal zz.., ;x:01 , s� ;d"�; 'o�s"�.% t`7 'G"sfi11: .;5- t:�:'z*L'6' sr ;rr;° . eAg ,c,� : k` "'�i:: ' °. .. �r,. ,z ,` i = C ©l TI2P�CTOR fe ., P -', :s F ; IX '- < - Water closet 16.60 F� ...�.r x,.:,v.t�sx,.. £. E- :.1te_';4,_ r Sae, �a'S�� .. :rs -: ?�eaF r yak#, >..;� _ a..,..,...; . >. ���� � � R Business name: 5 /�, � �� Water heater 16.60 Address: / , 0, a / �q � I j2C q Other: City/ State/ZIP: i r / ' e• / I C q /Z j /, Z y Subtotal %(�/ ` Minimum permit fee: $72.50 Phone: (50 ) 6 q 2J/ I Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: / q q0 2 Plumbing Lic. no.: 4 -/if _ /05 Plan review (25% of permit fee) t � Authorized signature: / State surcharge (8% of permit fee) y TOTAL PERMIT FEE Print name: 4.:7/„. ,7 t e.�> Date: - ( 2 _( 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\PLMF- PermitApp.doc 12/03 440- 4616T(10/02/COM/WEB) kAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA ` r STREET TREE CERTIFICATION .. i .. i % .. .. 0 . N O a Lf- LA/ JI I, e ik/ C.. CO , wner /gent for (PLEASE PRINT) ,/F° e (PERMIT HOLDER) ° � ,� & ' ;, " . ...; • Do hereb at c y t h £ol g w i ng location 0. meets T �g r d %Washi# gton l and use and development standards for street tree installation. ADDRESS: �2. 0 S mil/ _ 4 i/:, T ` .. LOT: S UBDIVISION: �" BY: DATE: 0L / " 7 5� dr )/ 1 0. RECEIVED BY: DATE: , c CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00258 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •i0/281004 Phone: (503) 639 -4171 m��'�r'iiopi�Nlit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/6/2005 TIME: 7:02AM PAGE: 11 SITE ADDRBSS: 10920 SW BRETTON CT CLASS OF WORK: SUBDIVISION: BRtl ION WOODS LOT #: 008 TYPE OF USE: PROJECT NAME: BRE I I ON WOODS DESCRIPTION: New SF OWNER: LEE -LAND HOMES, PHONE #: 503••635 -1343 CONTRACYOR: LEE -LAND HOMES PHONE #: 635 - 1343 Inspection Request Scheduled For: Date: 8/50005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 012948 -02 603-789-6795 N Corrections /Comments /Instructions: - 0l - <o Si G +■I a S — - —r Tl _cr.E C - '7, .- s IJL or..l i C,.etiLGo ...► `i&' nt LZ F, ..1 647 se. m A 7 Le: L- P izav t J� C- -rZ 1 7 , , = ` - 1 - rd1° e L XT hez K ' _ x i ,TI� ' Lot/ ' . ��f/��t�.i,_ • ' �/ p1 Ai-K. - of ko • .-4.-- al. o r- ___ f■ , 4 PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ,, • ' L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED e'S -0 c Ins{�ector: L Date: Phone #: (503) 718- CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2004 -00258 1 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2014 Phone: (503) 639 -4171 i " i , Inspection Requests (24 Hrs.): (503) 639 -4175 ...,_All■ INSPECTION WORKSHEET FOR DATE: 8/3/2005 TIME: 7:06AM PAGE: 58 SITE ADDRESS: 10920 SW BRE I I ON CT CLASS OF WORK: SUBDIVISION: BRE I t ON WOODS LOT #: 005 TYPE OF USE: PROJECT NAME: BRETON WOODS DESCRIPTION: N SF OWNER: LEE-LAND HOMES, PHONE #: 503- 635 -1343 CONTRACTOR: LEE -LAND HOMES PHONE #: 635.1343 Inspection Request Scheduled For: Date: 8/3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 012702 -01 503.789 -6796 N Corrections/Comments/Instructions: 6 2 e - ii 4, C I - _ -:' :tA . . 7 4 _ 6 , - ...,, , - - -I &/, 4 e 7- - -I. . _ ., j. c - - - e 'ASS ❑ PA' IAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL • e ALL FO . I .PECTION ❑ ADDITIth AL FE S ASSESSED i ok, ...... Inspector: 4 ' ate: y o - r Phone #: (503) 711 CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2004-00258 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2004 Phone: (503) 639 -4171 7,/ IPtli Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 8d5l2005 7: 02AM 12 SITE ADDRESS: 10920 SW BREI ION CT CLASS OF WORK: SUBDIVISION: BRETTON WOODS LOT #: 006 TYPE OF USE: PROJECT NAME: BRt 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: 8/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 012948 -01 503 -789 -6795 N Corrections /Comments /Instructions: r- PASS ❑ ARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ' , L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED - ■fi11111111111W- 8 Pr. l e Inspector: Date: Phone #: (503) 718- . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00250 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: f0/2W2004 Phone: (503) 639 -4171 / '"��NU"NUi�ll6�t�1�'� Inspection Requests (24 Hrs.): (503) 639 -4175 `__.. INSPECTION WORKSHEET FOR DATE: 8/3/2006 TIME: 7:06AM PAGE: 54 SITE ADDRESS: 10920 SW BRETTON CT CLASS OF WORK: SUBDIVISION: BRETTON WOODS LOT #: 005 TYPE OF USE: PROJECT NAME: BREI ION WOODS DESCRIPTION: N SF OWNER: LEE-LAND HOMES, PHONE #: 603- 635..1343 CONTRACTOR: LEE -LAND HOMES PHONE #: 635-1343 Inspection Request Scheduled For: Date: 8/3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 012702 -02 503 - 789-6795 N Corrections/Comments/Instructions: • -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I Date: Phone #: (503) 718-