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Permit f -, I MASTER PERMIT li '''. r CITY O F TIGARD PERMIT #: MST2008 -00016 COMMUNITY DEVELOPMENT DATE ISSUED: 5/8/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102DC -05300 SITE ADDRESS: 13812 SW HALCYON TER ZONING: R -4.5 SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT: 003 JURISDICTION: TIG PROJECT: GERTZ HOMES AT EDGEWOOD Project Description: New SF. BUILDING REISSUE: BLACKHAWK STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,194 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1,546 - sf GARAGE: 510 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD• sf RIGHT: 5 VALUE: 283,965,18 OCCUPANCY GRP: R3 BDRM: 4 . BATH: 3 TOTAL: 2,740 sf REAR: 15 PLUMBING SINKS: 2 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 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: 1 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA'ADD'L 500SF: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: 11 LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVCIFDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: I1 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: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable GERTZ CONSTRUCTION COMPANY, INC. GERTZ CONSTRUCTION CO INC laws. All work will be done in accordance with approved plans. This 19200 SW 46TH AVE 19200 SW 46TH permit will expire if work is not started within 180 days of issuance, or TUALATIN, OR 97062 TUALATIN, OR 97062 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503 692 - 3390 Contact #: PRI 503 692 - 3390 questions to OUNC by calling 503.246.6699 or 1.800.332.2344 FAX 503- 692 -5433 Reg #: LIC 34350 TOTAL FEES: $ 12,920.65 REQUIRED ITEMS AND REPORTS f&$h M) do/Jr eat- '/g4'4' Issued : A � - - / e A _/ / . Permittee Signature : Call 503.639.4175 by 7:00 a.m. for an inspection that busin s 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. 11-Z- f.r < 3 yid, / � �✓ Building Permit Application (.....Q_ Residential Q \J FOR OFFI 1 OFFICE USE ONLI' - • City of Tigard Received 't IJ ^ A III `J g • B � _ V Permit No. v � Qv() i , 13125 SW Hall Blvd., Tigard, OR 972 1 Pl an Rev iew Phone: 503.639.4171 Fax: 503.598.1960 E B % 9 � Date /B _ o Other erm: S F Date/B : %3. 3. Pit y_, T I GA R D Inspection Line: 503.639.4175 ` ca p Date Ready/By: luris: 64 See Page 2 for Internet: www.tigard - or.gov CA-Vi 0%. il +" ' Notified/Method: 14"( � Supplemental Information . ' `' @nv "r °' R "" + iz,,s,,:� ..;ac�. +�+x; 2,r'4 " " �.".�„ � �& 4 // ' {1 ,+. ` lk 1.-1 � ��a .%'Y `i,t . "",.iX, f , ,4 teia "x' ? a . 'i F b V44447,417:1$1:- A m N . E k w it e aY:9»: ti .:t. ' " . .r. '! , #. "4 - - w +.7k i c' d' w^a � , #s ' we.% z ',,,,.: c ' ., ,? 1.A u,,o),,,:T„.'pIr 011" W e ,. , _ : tt , ..„,„ +-,., Flf;'D � 2°' g i' , , �",c . s,,,�: �a. awe,.. .il,x�c^. P a, 3 # kc, e, ,. >Y fr._ . xiY.. ,Wi t. _, . ;.«� z� �. � ` ' t � �..�.:c- .,,.<ua* �rxc�t�m� z? °5t�.w•;✓nau _��.�"" "� ,� Z New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of alt the . ❑ Addition/alteration/replacement ❑Other: equipment, materials, labor, overhead, and the profit for 1 41 ;tr " -' < �" �` � c :ar` , ' • "wi,¢�`a . � a*s,:": €°�7�v : wA t, sr -'w6 ;;i � i�!arr• X t;.. �Xx# ti - Fx ; t'�s.< , rk , p oatve A rigtQ`T arim treff, jl P ;,ice" `' � o " " n «, l work indicated on this application. ,0 283 ® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ Z Or- Iti ❑ Accessory building ❑ Multi- family Number of bedrooms: y ❑ Master builder ❑ Other: Number of bathrooms: - 2--'€ 3 °w.t :. lxw° siw w z t a° .RS €r ire x xw ; s x , r � , •,, A 46 .. a ` ,, . "Q q 1 ; q : 1 t a +O CM VIOIY�' , , 43 *, `� Total number of floors: Job site address: 1 3 g /2,___ S to �4 is oyy 7hR2gce New dwelling area: 2 C 7 square feet a-490 City/State /ZIP: 'r, 6 q . I og G aAf t /722 3 Garage /carport area: 413 2 square feet37b Suite/bldg. /apt. no.: J Project name: Covered porch area: // (/ square feet Cross street/directions to job site: / i 4 `! $ f -4 - w Y e 4 QN Deck area: square feet 19 he 4. ,L. z lb 6 t Ct& C' b C l O th er structure area: square quare feet + ;4. _...., �., -, -., _.. .� ' ° -tt f�.a'�"'_ "ayaY�'L .,, ,..�., ika .,Ya �:.l.,,^. q a8' �stii:';ta��4"s %'�'f ✓PV{"4 °.,1�+ �:r RE � iTIftED DATA d �KL�tLST� /�// tf . ��tr+ :..�.�,rcc�.s+:,f+; <cs.2rt,� �mr, �&.:. m"£ m�> � E' �'. ��f4°.. >',�ta,-.n- s.� �tri�?s +?,. Subdivision: 6 eR f t / f r S t f c w a D GI Lot no.: 3 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2 $ w d Z D e_ 0 7� Q Indicate the value (rounded to the nearest dollar) of all t ,� J equipment, materials, labor, overhead, and the profit for the �� I� GT IONS® A # ' ` lr . ; � , 4 , work indicated on this application. � s...`_.rr ,n ,.,.. }�.,. - :.,�, ,ar4, =. R�S,.a� ?��.��ks� ., ,ei'.�. PP /Ve /-{a" Valuation: $ Existing building area: square feet - New building area: square feet �, ,gym*,. II" np, '+51 ti £u UinY' �� x+G A� ve �° a db� . sf'# �+'� " '�4 °,�++ 2.'i lIa R J>i>t Mfk i f. ; r g "5 i r 'w "; ; i t Number of stories: Name: Cep 37 k cfl ON ea Aoki) a N' y l461 Type of construction: Address: I? Z 6 0 Scd 1 1 / C Ay G. Occupancy groups: City/State /ZIP: ?k u ( 4 4;A' evz 9 7 Q c 2.-8? ? a Existing: Phone: (5'03) C. ? Z 3 3 ? c. Fax: 0 C ?Z— .5 3 New: s4i #,. ,,,. <,w.�..,m^ :.P'a} ;,,3 ae"�zn# 7.` ".• ",'% �ik`'FJs�.E °g`.AU VIVA" , � }ar :� „w:,�,' ;� -. '�'"6;�L+s,�- , -3:� �i`�e a P'' 4 '� , y. ,.� y �,,,,.,,�., � �, c z iA+� .Api$ C �% t,�•, € c ': x l.:, � R<a.. y. a '' '..” .w �..� -' � ,r£`� , A't. -t� �.% ''�' 1,� =A °.�T" 'H��,Q °:H+°`_13 „�: ^,N;;” e4�b� " s "�' ' F. �: e-.£ YS�ury. t._. �� "'�,: ".Z- "� „�a' `t ..,s. ` ,.' ',,,,, z- *zziami..^,akmiv,Y.lettt,t ., -.iii ,.., zu,.. .rc:.°,# + •s a �,d' t` •^ "4, ,r” « "�.�:; �.p�. �� ,,».+rr r �� qtr a �`�' �- # ��4,� ��'' sty ;�= `=tt+'�`�fi':�fit� p ^. a.N�t,: _ ,'�.,�.s�,�;'3, . ,; =.x� >�sa�w ,'F�`�7sxfC`� >:��n� " ". <x'i7rr�a;x:��` -�., �u.M`»Ti Business name: 4 rt c, CON size( c •1 am ( ii✓ G All contractors and subcontractors are required to be Contact name: �� E,�,r e f � licensed with the Oregon Construction Contractors Board , under ORS 701 and may be required to be licensed in the q Address: / ! Z D 0 j GJ DI vG ' ,4y,e _ jurisdiction in which work is being performed. If the City/State /ZIP: 1--e4 4 . v applicant is exempt from licensing, the following reasons • q /Y 0 ( Z `! 7 ' 0 G Z' 0 7 7 D app Phone: (5 .33) c ? 2._ 3 / 3 ? 0 Fax:: (S� 1 6/2— 5 3 3 3 Email: !<e/Y 6 a e27ez, C O �( a A�� ''‘,..4, Y* a n�*^ c�r�b�"�.6 �kS�sm'wa,,k� a#av �,� � ��r- r.�.:.° .� 1 ., z.+a, a,;44,, -,, ,,, po,z .* ,ak ti*...'"•u.� kax• ;$' �'tnkw?A4 ,a Business name: 6am.. - 62_ diA Sfi , _dt - a_. f[b Ai CO ZKC. ' 4PIVRA B, sI'1 I adal` °,a n 1 .;6 � ; _ , ` ltd "f� "' s� �`� �-� - a rS .,t k' � " i>� , "� Address: � � 400 S , �. �� e Structural plan review fee (or deposit): City/State /ZIP: 1.:t i l Q_ 14 ;At (SK 7• , p G Z - g 7 7D FLS plan review fee (if applicable): Phone: ( sa3) (o ! p Z# - 3 3'9- O Fax: (s 4. ?2 - s Y3 3 CCB lic.: 3 3 St� Total fees due upon application: Amount received: Authorized signature- This permit application expires ita permit is not obtained / within 180 days after it has been accepted as complete: Print name: 6(e 1 Date: Z= -D' uP' GIB` G Z- Dt & * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(l1/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling ' FOR O USE ONLY II4 City of Tigard , GRedei V 13125 SW Hall Blvd., Tigard, OR 97223 DateBy: Permit No.: Phone: 503.639.4171 Fax: 503.598.1960 t' Associated permits: TIGARD 24- Hour Inspection Line: 503.639.4175 „ p r Electri ❑ Plumbing El Mechanical Internet www.tigard- or.gov „.�, ' 4 ,t 4 - , 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ . . 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 . Fire district approval required. Name of district: • ❑ ❑ ❑ 5% Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ V1- basin protection, etc. 0 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state e ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if ,/ copyright violations exist. v 1 1 Site /plot planidrawn to scale. The plan must show lot and building setback dimensions; property corner elevations ( if there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements ❑ ❑ ❑ and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 - Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ - ❑ \ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 1,< Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ / systems, see item 22, "Engineer's calculations." K 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ \ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ l for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore ,ton and shall be shown to be applicable to the •ro'ect under review. JURISDICTIONAL SPECIFICS Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". .❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer-scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and accompanied by the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre- Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1 :\ Building \Permits\BUP- RES- PennitApp.doc 03/21/06 440- 4613T(11 /02JCOM/WEB) Mechan'cal Permit Application FOR OFFICE USE ONLY - , City of Tigard Received D G Permit No.: 7)757).606 �ClU(� II q 13125 SW Hall Blvd., Tigard, OR 97223 ,i� 0 .' Phone: 503.639.4171 Fax: 503.598.1960 Iate/B an Rev iew � o Other Permit: T I GA R D Inspection Line: 503.639 Date Read B Ju ris: ♦ ✓`� Internet: www.tigard - or.gov ¶1 ? 0� y o` Notified/Method: S S ee Pent upplemental l Information nr Q � � S . 1 afi t ,. S�a'''' l. p. q s d , 007W a 1: 45 ° .� f , ;;CO , . � -; v :. ., - K �ti`1?ta xr,.,., tee, zfL.: 1- ; X �:iaao „. ;,.3s?v 6` S •16 New construction ❑ Addition/alteration/repl. b oy' �� Mechanical permit fees* are based on the value of the work ❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead, and profit. �'�:`�;�' .�+,� ,�. {,�,- .+':ii ;^ =: az , � +i�x.s.e , xYAruc„�.,w.z� ? .a':�;e x r,s r , s � "�'� " alue: �'*��, ` ;� �`` aura- ^�:� �' +� '�:`� �� V Kr 41.1 641;14 *10 C±DN�t11! "INtig t ill a l $ _ a .. ��+1+° a x^.rxtsa5'c.. a,^� » !. .. „� +ac�.n�.r�1� -� ItFSTDIYPAl'Eg' M'`, ,(1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building '" i ��_ _ �� ❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist. ,.°'h . q"�t s b 1 r.,��rea�xutt� Description I Qty. I Ea. I Total P R > n.3�,,, ' ,: > ..1 0 s :: -, »,.eI i *A�Te� ), Ix , ax i "g Heating/cooling Job site address: J ? �'�� 5 co 11 !� O ? Air conditioning or heat pump PIS Y/ ,1sC (requires site plan showing placementr 14.00 City/State/ZIP: l y Q,/i,� 2 Z 7 L, 3 Furnace 100,000 BTU ( ducts/vents) f 14.00 Suite/bldg. /apt. no.: �/ I Project name: Furnace 100,000+ BTU (ducts/vents) 17.90 l/ / Gas heat pump 14.00 Cross street/directions to job site: /44 (' 5 w e s .f' a Ae Duct work 10.00 D 4 4 ..L- /� C Q s / Hydronic hot water system 14.00 / Ll it a Residential boiler (radiator or hydronic) 14.00 • Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: G e R. Flue /vent for any of above 1 6.80 Oise e s CN ECC e W O'eL4 L ot no. 3 Tax map /parcel no.: Z S 16 f Other: 10.00 ZdJ c D 5 3 at Other fuel appliances ,, ,1 .. °; a 0,t.N fAst is i ',. m E : ' Water heater I 10.00 A (/ c ca /1 o .e._ Gas fireplace 10.00 V 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 > 1. "� v` . .- Chimney /liner /flue /vent i.an 71001 ,. :'h B ga,a Y 10.00 � � � '' - � „ - ��s,'Q�N"N % <' �,� Other: 10.00 Name: G extr CK5 t6.4.. a 4.... c-- Environmental exhaust and ventilation Address: / L Q Q (� i' ` f,� Range hood/other kitchen t 1 v r equipment + 10.00 City/State /ZIP: 'r 4 Ida 1e d ` OR g 7.66 Z -. 8 7 7 6 Clothes dryer exhaust 1 10.00 ' Phone:'(] 63) ` f Z.- 3 3 Q O Fax: ( Sa3) G??...- Sy Single-duct comp rtm ents (bathrooms, rooms) s, Li . 3 toilet compartments, utility rooms) 6.80 :P��`�I�' e- ,�.a,' - ' ;:z .d%.s�r,�j: �aw+✓rc ` ,.,, ':�t'# { "�i ,L @ " a •:,.�.A'�r',.,,:. ��: >. . Attic /crawls . � `` ` p 1° CONT¢ c pERSb I"1`` € ' ace fans �� .: � , �s . „�� z,�a�� `,.�,�- a��u „�,aW�-,,�.`.::,� . �.�. � �.� ,�.;�� _ �. P 10.00 Business name: 4 e,� f 2_ Co f ,c 6- 4 o / Fuel 10.00 Fuel piping Contact name: `ee G t'•/C12. r $5.40 for first four; $1.00 for each additional Address: / ! ,Z p t7 s w Y L V ti Furnace, etc. j Gas heat pump City/State /ZIP: "T a. ( 'tom CA 7 CZ - g 7 70 Wall /suspended/unit heater Phone: ( 3 - 035 ` f z _ 7 3f O I Fax: : ( 5")) ( p Z_ 5- 3 3 Water- heater Fireplace E `Cek @ eAc c e , Co 147 Range ' ; , Kf,- . ;h % a Barbecue a ' ` :�, c �& 4 " - . , te r: Business name: Clothes dryer (gas) bA,�� °'K Other 4. ('`� r: Address: ip o / ! r Y 04 City/State /ZIP: E ,q, di l Cite e k 6 /Z 7 7 6 2. 2. Subtotal Phone: s0 3) `. 7 Minimum permit fee ($72.50) ( d z Z . Fa x: ($� 3 S ©� 2'773 Plan review (25% of permit fee) CCB lie.: it 2 .s-`- Ci, State surcharge (12% of permit fee) ! TOTAL PERMIT FEE Authorized signature: 4G4/... This permit application expires if a permit is not.obtained within 180 LA,. days after ithas.beeniaccepted as complete. Print name: r 5. . Date: Z - 2-?=- ff " Fee methodology set by Tri- County Building Industry Service Board I:\ Building\Permits\MEC- PermitApp. o c 01/19/07 440- 4617T (1I /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: • $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and - - $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC- PermitApp.doc 01/19/07 2 Ptumbing Permit Application Building Fixtures r Foli ' OFFICE USE ONLs' City of Tigard CEIVEt p� DReceiateB ved /�7- Permit No.: /��/� �p� 9 13125 SW Hall Blvd., Tigard, O 9 y` �� ✓ % �Vr./lt - Ca)/b Phone: 503.639.4171 Fax: 503.598ct Plan Review Inspection Line: 503.639.4175 T I GA R D r� L U U 6 Date/13y: Other Permit No.:� �- Ready/By: Juns Internet: www.tigard CITY (A- i 1U Date Ready/By: D Notified/Method: S See Page l Information � a� a q Y f: J` r _ - r { , v # Supplemental Information O g ' ri t, li f e, b ?,I a x : ..- '� - X .' 7' 0 o@ - t o t r " n �,, 4tb .�. t� .. Azs, nxz�Avi.l -a art,..- ....�. _ , . , xay ' .f:rn �,�, - 4 . . 3 � 'tt;�� ,, r$,b th0 a. .,,6 c. w.c.,, , "2a ' � &'Air . , ' 3 'New construction ❑ Demolition For special information use checklist. ❑ Addition/alteration/replacement 0 Description I Qty. j Ea. I Total eration/re New 1- 2- family dwellings (includes 100 ft. for each utility connection) 1 a n_ .p , v , ^ � O h � s 4.1.. u - i. ' _". ., GOBI' ©7 GO UC TOlY 1' ,, ; «t ls.� ' SFR (1) bath 24920 • j:Wf- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath t 350.00 • ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: w ^ x ,x � E. v .. x ,, Fire sprinkler ( sq. ft.) _ Page 2 I�.,#t..��'n a�,�'e.,Ua,.oa .. H � ,.u. . .<.�: ea Asa. r�<.�ax�v�t ; HS.a�,rz�v..x�:.��t,. a.- = a , .. s ; at? Site utilities Job site address: ` e/2_.. $ (J /4 1 y d /X /egg4t. e. Catch basin or area drain 16.60 City/State /ZIP: '�p y a ti,/ OA 7 7 2 2 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: J I Project name: Footing drain (no. linear ft.: ) Page 2 ,/ / Manufactured home utilities 110.00 Cross street/directions to job site: /Y4j1 sf 4_1 e s t 0,y r / Manholes 16.60 O Aft A 4 -7 C aC �y - al 4' D d Rain drain connector 16.60 r/ Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Water service (no. linear ft.: ). Page 2 Lot no .: 4 C/Z � � A�„5 4t E�r�„c 3 Fixture or item Tax map /parcel no.: Z S lb Z fJ C, 0 5 Absorption valve 16.60 .1,-, V, n n tx aa ,, T,. VT W in r t �a k� �o �� 4.4• Backflow preventer Page 2 Ate 4..$ /( /rr C Z- -i.. 43..q f---c Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Ik .3, riaiatrALVI a =4it � I ;: �z t.�4 , 7',Rit #WWen 3 Drinking fountain 16.60 ?, . ,,s. -" ,' I'SW" .FP.:. . 7;54 ifi'.Rg.Vi l fi,}. to t".lt",,, €;5 ;2"`IRe � ' Ejectors /sump 16.60 Name: G c d L . (J t VA- l a et 4 c 1 ... Expansion tank 16.60 Address: I 9 z O O S`' W /}/ (o `F /4 O e Fixture /sewer cap 16.60 City/State /ZIP: 'r4 a l.k. Z (, , 45X 12 ep4 Z - 23 7 ?e5 Floor drain/floor sink/hub 16.60 Phone: (3 -03) Gp Z_ ' 3 96 Fax: ( 3) 4f 2.- y 33 Garbage disposal 16.60 _p w-e ., a . + u t,. ; n .^ s ..� sstiru<x i , .t i ilc" _ Z �,,A, P %sgrl m . ®� O fA 1,' S ll ::: 16.60 Business name: a , e,>Lf� C 45 eii L.6 A live, Interceptor /grease trap 16.60 Contact name: k, N 6 •[A. j=_,� Medical gas (value: $ ) • Page 2 Address: /? Z D C,) Ye...) le C A V c Primer 16.60 City/State /ZIP: Ti 4 1„ 0/2_ Z!. 7 D t z _ g 2 2 0 Roof drain (commercial) 16.60 Phone: (36 ) 6, 4 1 Z - 3 3 g6 Fax:: (563) G4'2 _.�-`�i3 Sink /basin lavatory r 16.60 ii Tub /shower/shower pan 16.60 E-mail: 1C .eX G eK.fa co , Coa-. Urinal 16.60 ?i^ { 1wz1 ili �; a n r k�ry 4 ,� ' ¢s� m• I :�� >..... -6s�r�. `" � t,�r�r;�«t+:�'�PZ.. .t�r'�'a..r�.,��d�,��' s"',�.��f..��. ? .. -,+ ate Water closet 16.60 ' Business name: - riite .e. {cu t / lek Water heater 16.60 Address: fi d /3 e, x 2 2 y . Other: City/State /ZIP: 4_) .e.51--- 4 g ;Vat O 4 g• 7 O L s Subtotal $ C Minimum permit fee: $72.50 Phone: ( 3) 93 .- 2 3 gY Fax: (33_) CSCC- S z / z _ Residential backflow minimum permit fee: $36.25 CCB Lie.: / 03' 772 Plumbing Lic. no.: 3 -2 5-7 pe Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: 2 TOTAL PERMIT FEE Print name: /1, Date: ��,p �• Z-2.1: ere This permit;application expires if•a.permit is not obtained within- 180 days after it has been as- complete. *Fee - methodology set by Tri -County Building Industry Service Board. I: Building \Permits\PLMRPermitApp.doc 12/27/06 440- 4616T(10 /02/C0M/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information . - J , Fee Schedule: Residential Fire Suppression Systems: 1,7;:,;-pY ' Rity44',1, Irikriall/ grata* "j$FAWAR,VM Vt=t1VIVALF...'6, Sitattairett; 4 41 4, .i V4: - '4 7 4a1■„, :5 talWitritiM tr,jMrsolM9.0 #atUlt SIGRFIAA., 72.**' Footing drain - 100' 55.00 • to,2,000,„ $115.00 Footing drain - each additional 100' 46.40 .2;001.to.3;600 $160.00 ' 3;601 , tot7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 , 5/y/0 Water Service - 1st 100' 144 a41-50)-e-- 10 / 1,4 0 - ~"r Medical Gas Systems: Water Service - each addifiorial 100' 46.40 Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each mi,mv,...mr-iitytm, :3I11, f164,* WOW additional $100.00 or fraction thereof, to and KINA,W)1,11,±.4.VA.V4,14. arAkieg including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first$10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to - (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 - $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. - - Commercial Fixture Work: • Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. 1:1 accurately report fixtures could result in increased sewer fees*. Any new commercial building with water service 2" and it greater, except systems designed and stamped by licensed • r***;irw wages engineer. *Ni El New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918-780-0040. Bath -Tub/Shower 0 Medical gas and vacuum systems for health care facilities. -Jacuzzi/Whirlpool 0 Any multipurpose fire sprinkler system. Car Wash -Each Stall 0 Any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher -Commercial -Domestic r,WWW#Iptitil-g614111:1q2ifiiiVd.S245iWilr'24,1*, ,,AVIattg Drinking Fountain Si11*-Vite#11§..Q.W.V.M.KWELMLV...170MAgr4M1MMES-00 Eye Wash 0 Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. Car Wash Drain Garbage -Domestic Comments regarding fixture work: Disposal -Commercial -Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink -Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing.permit can issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i: \Building TermitsTLM-PermitApp.doc 12/27/06 4 Electrical Permit Application CI � ie x , } • , t „1; i ; : , h ” , I: Ott OF 1 1.0 I tl il Pr'O \l 1 ,t ;0 n, y ¢ City-of Tigard 1 11 Permit No.: . :� vs 4. t" 1 3125 SW Halt 61vd., Tigard, OR 972 \. \� �� .° ". •k Phone: 503.639 4171 Fax: 503.598.1960 J 4.-c*,, a _ Other Permit .''' Inspection Line: tion Li 503.639 - 4175 ` rIC; � � Date [read Y /B Y Sec Page z .. A Internet: www.tigard ar.gov �� \_ T WORK G. Notified/Method: Supplemental Information 'TYPE OF WORK �� PLAN REVIEW few construction ❑ Addition /alteration/rep CZnent : Please check all that apply (submit 2 sets of plans w /items checked below)[ : ❑ Service or feeder 400 amps or more 12 Building over three stones ❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑ Floating buildings. � - � less to ground, or exceeds 14,000 ❑ Commercial - use agricultural O.hl - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building snips for all other installations. buildings. ❑ Mulii- filmily ❑ Master builder ❑ Other: CI fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION El Emergency system. larger separately derived system ❑ Addition of new motor load of ❑ "A ", E'. "1 - ", "I - ", Job no.: Ls: ob site address: 3g 4 Z CJ “0,- � t00or more residential units_ or more. occupancy. I G lJ✓1 �et . ❑ Six or ❑ Recreational vehicle parks City /State /'LIP: ❑ Iieahh -cave facilities, 0 Supply voltage for more tI an ` ( �� U I � f `�" ❑ Hazardous locations. 600 volts nominal. Suite/btdg./apt. no.: Project name: ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to ob site: 1 D, estrintion I Qty. j Fee. l Total New residential single -or mufti- family dwelling writ. Includes attached garage. 1,000 sq. ft. or less r 145.15 (1 Subdivision: Lot no.: 3 ��S Tax map /parcel no.: Ea. add'1500 sq. ft. or portion iii 33.40 t1 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. R.) _ Limited energy, multi - family 75.00 2 J residential (with above sq. A.) Services or feeders installation, alteration, and/or relocati 200 amps or less 80.30 2 PROPERTY OWNER ❑ TENANT 201 amps w 400 amps I 106.85 2 Name: , e� f ' = A _ 11 �s 401 amps to 600 amps J 160.60 2 T - J°� 601 amps to 1,000 amps 240.60 2 Address: 1 q 1- I-LA...) t. I Over 1,000 amps or volts 454.65 2 City /State /ZIP: ' 7, ,. ' . - l - R C 7o & •- Temporary services or feeders installation, alteration, and /or . relocation Phone: (9)3) (q "3 3G} U Fax: (563 )69 Z — S3g 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits— new. alteration. or extension, per panel A. Fee for branch circuits trill, 0 APPLICANT ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: first branch circuit Address: Each add'/ branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular ' 90.90 2 Phone: — dwelling, service and /or feeder ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 • ' 2 CONTRACTOR Sign or outline lighting 53.40 . 2 [[�� ti , , Signal circuit(s) or limited- I Business name: l/ - EI -e t r l !.— � , energy panel. alteration, or Address: ( FU e 23 3 extension. Describe: Page 2 2 CityJStateIZlP: �(t w(z i,. 1 6 O k 9 77 7 _ Each additional inspection over allowable in any of the above f/ !� Per inspection i 62.50 Phone: (511p s tic . 7 a p Fax: ( 51-19 - 7 e- 13' Investigation per hour (t hr min) 62.50 _ CCB Lie.: x _ Electrical Lic.: - { L cj. Suprv. Lie -: Li / „/ 75 Industrial plant hour 73.75 1 t re y ELECTRICA P FEES Suprv. Electrician signature, required: Subtotal: 2. —75 St Plan review (25% of permit fee): Print name: f , ` / G +Fie r f� 7 (� 2 State surcharge. (12% of permit fee): 33 r Lf S Authorized signature: TOTAL PERMIT FEE: '/Z 7 Print name: Date: This permit application expires if a permit is not obtained within ISO days after it bus been accepted as complete- ' Nmnher of inspections allowed per permit I ' d/ Uihtingtl 'crmitellIL('- t'crenitApi, du.: 05 /21 /00 440 - 161'0(11 /05/C'OM/wGn Z.d E 2L61791.179 01210213 N21H0I2I9 BZC L L 90 LZ unr Electrical Permit Application FOR OFFICE USE ONLY City of Tigard En Received e DateB / mos Permit No.: "—CAA) kz) • q 13125 SW Hall Blvd., Tigard, OR 97223 ®e+ Plan Rev • ' 4 M : Phone: 503.639.4171 Fax: 503.5' :11 � Date/B 4...4 �� r Other Permit: _emu �; . T I GA R D Internet: www.ti Inspection Line: 503.639.41 a '"-- — - \ 6 D ate Re adyBy: Juris: ardor. o U Supplemental See Page for g g � Notrfied/Method: fd In . r p :.:: ` :Vit�igl"". . w 4i MU ``l', : 'DkK� t k ,,? 117 i 7 <:.m.« a °�'ya, 7 , tea, '`(� � ;y' I am , .r t _. . !" , F .., ,, a *k h "_ . ; a "' .auk _x � . < ' 4 . 117 New construction ❑ Addition/alteratt. i` - o,11, 1 Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑ Marinas and boatyards. � � mil ;�� ,a�yv >, �r �� "�� "" '� ��' , s a[ 150 volts or yE �: sI ;t � IN "( tlVO _ �I- ,S '`' 1® y ° " P ❑ Floating buildings. ��.. . ,,.��tk�xu� wt . A�i� .. �� exceeds 10000 amps to ground, d or exceeds 14,000 dwelling ❑Commercial -use agricultural 1- and 2-family g ❑C /industrial 0 building amps for all other installations. buildings. Multi- family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or ' �� P�" t z .v w ,: " t" "' , ❑ Em rge system. larger separately derived system. a " '}`,' a�.fi`i�t r lt` a'.� t �kJ013' SO �: '�... " ® ..` ttaV 'fit z* ,., 4, erg; a ��tx� w�:F.�r sti ="<rj atr, ❑Ad d e ition o ncy f new motor load of ❑ "A" "E" "1 - 2" "1 - 3" Job no.: (Job site address: / 3 I -S'4.) A/ 04J Teo< ❑ 100HP or more. occupancy. Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 7 Q �," 6A- 7 2 2 Z,3 ❑ Health -care facilities. ❑ Supply voltage for more than J ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more. Cross street/directions to job site:// 4, L6 5 �• C s-'� Q'�/ Description I Qty. � Fee. I Total I ` New residential single- or multi - family dwelling unit. 15/«, t R e t '.O 6",( 0 4.1 * eC Includes attached garage. t /4 074 rc( c�/ l Lot no.: 3 1,000 sq. ft. or less 145.15 4 Subdivision: Gri Tax map /parcel no.: a S / p z 0 C. 0 S3 7 Ea. add' 1 500 sq, ft. or portion 33.40 1 Limited energy, residential �„ � �� .,,�.,�„ � 75.00 2 rar� w i ESCAOvOiY1'O o *, . g5 (with above sq. ft.) ..!'3 .r.,.�4..n.t`.• .r. r,. �s�w k + D «4'tra,wcin. .+w,r .,"r . i .. ort U u.. ''' ;, ,t'.. Z AAi, ,(�a -L.- Limited energy, multi- family ` i residential (with above sq. ft.) 75,00 2 Services or feeders installation, alteration, and /or relocation t t �,,� � � .� 200 amps or less 80.30 2 a � , . ��.,,� ,,,Y•a�.•.�«v .�. � lx ;�f�,.1�s / ;..' �....�.� ` � 201 amps to 400 amps 106.85 2 Name: G ex fz edAt `/A rs C l eAl �j live 401 amps to 600 amps 160.60 2 Address: / 7 Z Q 0 s w 4/ 6 -t- Over 1,000 amps mps amps 240.60 2 Over 1,000 amps or volts 454.65 2 City/State /ZIP: r 4 j lir y OR 7 7 Q C z _- 87 2 0 Temporary services or feeders installation, alteration, and /or / relocation Phone: (51S 3) 6 g 2 -- 3 3 ? 6 I Fax: (S 6.7 2 -5'13 3 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel t A. Fee for branch circuits with I ' tea. ` K E' Y ' ;1 + ' , ,. 0 © e * above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular Phone: ( ) I Fax : : ( ) dwelling, service and/or feeder 90.90 2 Reconnect only • 66.85 2 E-mail: Pump or irrigation circle 53.40 2 : .. �; a., u rv, ' a, ; `. P',_ I Via; ;: zsi ' ` l > s Sign or outline lighting 53.40 2 Business name: Dec e / Signal circuit(s) or limited - t)C . /h•e� elec- it t L IN C.. energy panel, alteration, or Address: / O G 3 7 S 6 fi /l extension. Describe: Page 2 2 City /State /ZIP: / A'l .. ,,K� Q X ? 2 Z z• _, Each additional inspection over allowable in an of the above p pp Per inspection t Phone: (Y3) 7 8 G- V O®4 Fax: (S703) 784.- Z6i/� G Investigation per hour (1 hr min) 62.50 CCB Lie.: Y3 q3 5""' Electrical Lie.: 24 3 z (c Suprv. Lie.: Z$./ ys- Industrial plant per hour '"1 €M�`: �+'.:1'u�"L^t L.".`_ a° ' u:. ,U s G,.,. ri �EIt�{ v <ti ? :. ; Suprv. Electrician signature, required: goi.e. . _ Subtotal: Print name: to D Z Q Plan review (25% of permit fee): 4 V G / N +G K e mac State surcharge (12% of permit fee): Authorized signature: / TOTAL PERMIT FEE: «< This permit application expires if a permit is not obtained within -180 Print name: /r, , ��?�Z -- Date: Z " - Z_7: e) cf days after it has been accepted as complete * - Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information ' LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check T e of Work Involved: A udio and Stereo Systems* Q Burglar Alarm Gara Door Opener* 'Heating, Ventilation and Air Conditioning System* Er Vacuum Systems* Other: Ate f4., 0q.k_ ez • Fee for each commercial $75.00 system _. (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical . ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all.other installations 1:\ Building \Permits\ELC- PermitApp.doc 03/23/06 t i City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 IlL .. • PI 11111 i IY S v I .1 .„ Nay :„. f, „ ,,,,G June 16, 2008 Gertz Construction Co., Inc. 19200 SW 46 Ave. Tualatin ,OR 97062 Attn: Ken Gertz Re: Permit No. MST2008 -00016 Dear Mr. Gertz: The City of Tigard has processed a refund for overpayment of permit fees on the above - referenced permit for the following: Site Address: 13812 SW Halcyon Ct. Project Name: Gertz Homes at Edgewood, Lot 3 Job No.: N/A Refund: ❑ Check # in the amount of $ . ® Credit card "return" receipt in the amount of $167.00. ❑ Trust account "deposit" receipt in the amount of $ . Notes: Refund overpayment of plan review fees $750.00, less additional SDC fees due for Parks $403.00, TIF- Resident $160.00 and TIF -Mass Transit $20.00, = total refund $167.00. If you have any questions please contact me at 503.718.2430. Sincerely, ./d Dianna Howse Building Division Services Coordinator Enc. I: \Building\ Refunds\ Administration \LtrRefund- Overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 11114 . City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Gertz Construction Co., Inc. DATE: 6/13/08 19200 SW 46 Ave. Tualatin, OR 97062 REQUESTED BY: Dianna Howse Attn: Ken Gertz TRANSACTION INFORMATION: Receipt #: 2008 -746 Case #: MST2008 -00016 Date: 3/7/08 Address /Parcel: 13812 SW Halcyon Ct. Pay Method: CreditCard Project Name: Gertz Homes at Edgewood, • Lot 3 EXPLANATION: Refund overpayment of plan review deposit, less additional SDC fees due. v. - =.i. : "fi.€; ,':.';Fkr:�:; .�::?f_'4:,roc�y;.,ssz's �:�,�.: : > "s } ":'...eY:�Y:.ri:;i '.."s,.' _ " `1 - ;:= '.°- ,P'•a, �REFUNDnIN�FO :RMAT.ION::,�_.::>:.,. �:.,: ,.� �:,. �ir. ��. �',::. _ . La..Fsn`:�r_ .z- - r.s€`,- .=_ta,�_ ia: �z<. m: �, i_ �ra�a�?` �' � "'l�`.Z,,,;ti�::ti;i�a�- .:Y�s:;:; _ .,....., - a � .. ., .. ' " . Fee'D escnptio n F rom R ece i pt Revenue A ccount N o Refund a Exa mple : [BUILD Permit Fee p [BUPPLN] Pln Rv Deposit 245 - 0000 - 433000 $167.00 TOTAL REFUND: $167.00 APPROVALS: If under $500 Professional Staff ° / 1 y; If under $7,500 Division Manager If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board F OR TIDEMARK' Y :j -- >.°:: <:,.._.t _ _......, ry:a ...... . .... . . . S S,T:ElVI�,AD1VhIN'ISTR'ATION .USE`bN'LYa�`.:,.. _ Case Refund Processed: Date: 5 v; . - B /' _ 1: \ Budding \ Refunds \RefundRequest.doc 05 /23/07 rilNa CITY OF TIGARD 6/13/2008 A 13125 SW' Hall Blvd. 4:5 3:29PIM Tigard, OR 97223 503.639.4171 'TIG ,! -?1-;1‘;:i.45. F. Receipt #: 27200800000000002068 ` / -.� t4 Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00016 [PKSDC] SF Park SDC .270- 0000 - 450000 403.00 MST2008 -00016 [TIF -R] TIF Resident 210- 0000 - 448001 160.00 MST2008 -00016 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 20.00 Line Item Total: 5583.00 Payments: N'lethod Payer User ID Acct./Check No. Approval No. How Received Amount Paid CreditCard GERTZ CONSTRUCTION DLH 02445B In Person 583.00 Payment Total: $583.00 v 1 o o W . a, � ., 0 i4 ; eel p 4 L a� . d o cn w a s �+ .. To. 4.) V d 5 v . ~ A+ ,9 E E ti c, d U O x ;`A p4 O p, O J v .-� � q H w a c ..,r I MS CITY OF TOGARD 6/13/2008 1 q y 13121 SW Hall Blvd. 4:53:1 1 PM ' Tigard, OR 97223 503.639.4171 Refund Receipt #: 27200800000000002067 ,..- / ., Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 - 00016 Reversal - [BUPPLN] Pln Rv Dep 245 0000 - 433000 (583.00) Line Item Total: ($583.00) Refund: Method Payer User ID Acct. /Check No. Approval No. I - low Received Amount Paid Credit Reversal GERTZ CONSTRUCTION 02445B In Person (583.00) Refund Total: ($583.00) • cKrr, l I' I ul I €i �k= CITY OF TIGARD 6/5/2008 h � 11 1 3t215W Hall 131\d. 8 • :05:SOAM , Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000000746 Op sc,,, F A/,/ . 4-4,__ Date: 03/07/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00013 [BUPPLN] Pin Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00014 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00015 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00016 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00017 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00018 [BUPPLN] Pin Rv Deposit 245- 0000 - 433000 750.00 Line Item Total: $4,500.00 Payments: Method Payer User ID Acct. /Check No. Approval No. . How Received Amount Paid CreditCard KEN / GERTZ CONSTRUCTION BTT 02445B In Person 4,500.00 Payment Total: $4,500.00 ,Rerey,i.cp1 I' I oI I `` CITY OF EGAR® 6/13/2008 �� 4.50:30PM si,,:„17.4:- '. � 2 i t 13125 Han Bl d. • � ' Tigard, OR 97223 503.639.4171 tT D Refund Receipt #: 27200800000000002066 f � ,. ."v 'iy �' -S '' i :- Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 - 00016 Reversal - [BUPPLN] Pln Rv Dep 245 0000 - 433000 (167.00) Line Item Total: ($167.00) Refund: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid Credit Reversal GERTZ CONSTRUCTION 024458 In Person (167.00) Refund Total: ($167.00) o, N O 0 s b - O W v ai Q, 4 .. . 0 r . .0 e 1, n " `:„ �v p C ^ w v 0 (.1._ ..... t o 5 . � :� v W o m :~ k a NI «S '"' E v v 4 4J ., : � >~ w 5 r ,.z a! 2 € o 14 G o . ', -a ca IX J Q E-1 w r=4 P. .. F c K ,,,,, r 1 1 e I or' CITY OF TIGARD 6/5/2008 1 4 , 1312; SW 11x11 131 d. 8:05:50AM • j "Tigard, OR 97773 5113.639.4171 MAW Receipt #: 27200800000000000746 Date: 03/07/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -0001 3 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00014 [BUPPLN] Phi Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00015 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00016 [BUPPLN] Phi Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00017 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00018 [BUPPLN] Phi Rv Deposit 245- 0000 - 433000 750.00 Line Item Total: $4,500.00 Payments: Nlethod Paver User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard KEN / GERTZ CONSTRUCTION BTT 02445B In Person 4,500.00 Payment Total: $4,500.00 • • R.rin.ru face I or I CITY OF TIGARD 5/28/2008 Fees Associ With 9:53:04AM • 13125 SW Hall Blvd. TIGARD Tigard, OR 97223 503.639 Case #: MST2008 -00016 2 is- 074(v 1X54 Fee Start End Revenue Created Type Date Date Dept Description Account Number By Date Amount Due BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 BTT 3/3/2008 Aff,itap 75 0.00 CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pln Rev 100 - 0000 - 433060 BLS 3/18/2008 46.00 0.00 LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100- 0000 - 438050 BLS 3/18/2008 6.00 0.00 BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 BLS 3/18/2008 11 03 _ 0.00 BPRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245- 0000 - 432000 BLS 3/18/2008 1,586.12 0.00 SURI 12/31/2007 12/31/2020 [TAX] Build 12% State Surchrge 100- 0000 - 207020 BLS 3/18/2008 190.33 0.00 MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245- 0000 - 229202 BLS 3/18/2008 340.75 0.00 MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245- 0000 - 431010 BLS 3/18/2008 134.10 0.00 SUR2 12/31/2007 12/31/2020 [TAX] MEC 12% State Surcharge 100 - 0000 - 207020 BLS 3/18/2008 16.09 0.00 PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 BLS 3/18/2008 399.00 0.00 SUR3 12/31/2007 12/31/2020 [TAX] PLM 12% State Surcharge 100- 0000 - 207020 BLS 3/18/2008 47.88 0.00 ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220- 0000 - 431510 BLS 3/18/2008 278.75 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 BLS 3/18/2008 33.45 0.00 ELRP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220 - 0000 - 431510 BLS 3/18/2008 75.00 0.00 SUR5 12/31/2007 12/31/2020 [TAX] ELR 12% State Surchrge 100- 0000 - 207020 BLS 3/18/2008 9.00 S 0.00 PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270 - 0000 - 450000 BLS 3/18/2008 4,812.00 0.00 -1103 TIFR 7/1/2002 12/31/2020 [TIF -R] TIF Resident 210 - 0000 - 448001 BLS 3/18/2008 94, 0 2H__, r9- 0.00 I TIFM 7/1/2002 12/31/2020 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 BLS 3/18/2008 22_ 9.110 0.00 - 20 EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100- 0000 - 207307 BLS 3/18/2008 88.00 0.00 ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100 - 0000 - 207308 BLS 3/18/2008 28.60 0.00 ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 BLS 3/18/2008 28.60 0.00 Total Due: $0.00 - 73 /6. 0 c2 go _ �','-3 - /67 A � Page 1 of 1 CaseFees rpt � CITY OF TIGARD 6/5/2008 13125 SW Flail Blvd. 8:06:06AM Tigard, OR 97223 503.639.4171 . TIGARD Receipt #: 27200800000000001554 Date: 05/08/2008 Line Items: Case No Trail Code Description Revenue Account No Amount Paid MST200S -00016 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 46.00 MST200S -00016 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST200S -00016 [BUPPLN] Pln Re Balance 245 -0000- 433000 1,030.9$ MST200$ -00016 [BUILD] Bldg Permit 245- 0000 - 432000 1,586.12 MST200$ -00016 [TAX] Build 12% State Surchrge 100- 0000 - 207020 190.33 MST200S -00016 [METCET] Metro Const Excise Tx 245- 0000 - 229202 340.75 MST200S -00016 [MECH] MEC Permit 245- 0000 - 431010 134.10 MST200S -00016 [TAX] MEC 12 %, State Surcharge 100- 0000 - 207020 16.09 MST200S -00016 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST200S -00016 [TAY] PLM 12% State Surcharge 100- 0000 - 207020 47.88 MST200$ -00016 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2008 -00016 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 33.45 MST200$ -00016 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST200S -00016 [TAY] ELR I 2 State Surchrge 100- 0000 - 207020 9.00 MST2008 -00016 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST200S -00016 [TIF -R] TIE Resident 210- 0000 - 448001 2.800.00 MST2008 -00016 [TIE-MT] TIE Mass Tr 210- 0000 - 448005 720.00 MST2008 -00016 [ ERPRMT] Erosion Control 100- 0000 - 207307 88.00 MST200S -00016 [ERPLN] Erosn Pin Re CWS 100- 0000 - 207308 28.60 MST2008 -00016 [EROSN] Erosn Pln Re COT 245- 0000 - 433010 28.60 Line Item Total: S 12,170.65 Payments: Method Paver User ID Acct. /Check No. Approval No. l Received Amount Paid Check GERTZ CONSTRUCTION CO DEB 2885 In Person 12,170.65 Payment Total: $12,170.65 ckeceipt.rpI Page I of I rn ... r t .. -.r_ .r,a.,. .......... ..._..:...i. ...-. �: .c.,.._��..r - ....e......�. -. .._ .:..:....».�...,..�. «: .......v...« ....c+.x._- a...... d.v.u..�.n..+.«.. -v» . w... x....... c... v..... o.« ._......... �....,_«..ss.. ..... .- ..... < ,a_.....- ,....._.. ...,:.._...a- x.� —.w_ .ev..n.. __... e____..va+...w�. -- — _.«aa.:... ST ? . ri —.— :',4 ST!1:::,...:, . �} .. _. , .. .... • . ....... .. :,•.,. •.•.• .... .. . . s.,,, ..•..•. ... ....:., , ._ _ r! .. . . . . . .... _ . .. .. .,.... I, is - � 1. , JuL - e---- • � j�� - z , , ®w er /A eot.f . (PLEASE PRINT) ) ' : (PERMTI' HOLDER) '' : rya Do hereby certify that the f o lowing location meets City of Tigard land nse and devel®pp ent standards .. street tree istallatl ®n. ADDRESS: /3 y / Z' cS-1-0 ,' —e. .v 7-z. SUBDIVISION: XfiG1.-citeAtAO LOT: / . . SIGNATURE: gp / , DATE: / i 5 (o IR /AGENT) — RECEIVED BY: DATE: (CITI' OF TIGAIZD) v!: Jr ..y,, 1:\ Building \ Forms \StrcctCrccCcrtificate 01 /19/07 Elev 214 \ Elev 214 Sil -, . riv iii , . ' ' .... . _, N LOT 3 co 5.00 7 607 SQFT 5.00 MM � ;0= - - TREE PLANTING SCHEDULE W ly �� d ' Na.r r..rw.r arwN .Y I ' UI Cr) CO N ..-�W.INrM. LC N Wu b M Y C�- r u -- aw � _ .r e.. gar 0.0. N Elev 216.5 �� ® P 16.14 0.. 2464/04 Matt r M w...elm r. p..yMyn... 5.17 �� : 5- ...... r � .w 1.7[31111111111111 ■411041/4. 0.44101 44 ham • ' ,.h„ 100.4141 YAM 15 5 3= 40 10040 Elev 216 ..... , sawn r*" -- ill , ,.... a Gravel Drive a for Erosion 9e o WARNING: O OBTAIN LOCATES PRIOR TO ANY g46( .�� ' EXCAVATION C �1\ ;•IiI rA � �ip Elev 216 56.00 LL1 Elev 216 SW HALCyOr' TE R RACE GERTz CONSTRUCTI NC. ON HOME SQUARE FOOTAGE ' C OM P N Y A MAIN FLOOR =1162 SQ.FT. BUILDING UPPER FLOOR = 1503 SQ. FT. /'�` CUSTOM HOMES SINCE 1977 �111, TOTAL = 2665 SQ. FT. (503) 692 -3390 GARAGE = 437 SQ.FT. 13812 SW Halcyon Terrace Lot 3 Gertz Homes at Edgewood SCALE 1' = 20' GERTZ CONSTRUCTION COMPANY INC. PLOT PLAN 4/8/08 /3e/2 50-) )-ict I c j oy Terr . , CITY OF TICARD - SITE PLAN REVIEW BUILDING PERMIT NO.: 'YI'?$T 2o0S • poo /ti PLANNING DIVISION: Required Setcks: [a Approved ❑ Not Approved Side: Street Side: IS Front. Garage: L Rear: (S Visual Clearance: [Approved ❑ Not Approved Maximum Building Height feet CWS Service Provider Letter Required: ❑ Yes ❑ No ❑ Received , By : tku-r Date: 4 /}4,0 Jl ENGINEERIN DEPARTMENT: Actual Slope: _% LEI Approved ❑ Not Approved Site PI,pn: / ["Approved of ' pproved B : 4 i s, Date: 4 5` 60 NotCs: ` s • /'2 4 dL_ni tn- • • - CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: Street Trees: /Approved ❑ Not Approved Protected 7-2//)44 Trees: �9 Approved No Approved BY: Pr Date` d dp Notes: / CITY OF �� mn m n��m mnn�w�mmm�� BUILDING DIVISION PERMIT #: M8T2O08'00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: :3/8/3008 Phone: (503) 639-4171 ANAP94 VIA Inspection : 175 A0� -*�J� INSPECTION WORKSHEET FOR DATE: 12/17/2008 TIME: 7 PAGE: � • SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERlZ HOMES AJEDGEWO{)Q LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES ATEQG[WOOD DESCRIPTION: NewGF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 5n682-339O CONTRACTOR: {9ERT2 CONSTRUCTION COINC PHONE #: 5O3'692-335O Inspection Request Scheduled For: Date: 12K17/2OD@ Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 079091-02 60a-7m Corrections/Comments/Instructions: '1F1 �� CANCEL LII NO ACCESS F FAIL 11 CALL FOR INSPECTION | | ADDITIONAL FEES ASSESSED ■11. Inspector. [)ate: ^^b Phone #: /5O3>718' iltra ' ` ' CITY OF TIGARD BUILDING DIVISION 44 PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: , 5,410008 Phone: (503) 639-4171 an oll i tyliit Inspection Requesth(24 Hrs.): (503) 639-4175 AA '.--.. INSPECTION WORKSHEET FOR DATE: 12/17/2008 TIME: 7•00AM PAGE: 10 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: N SF OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 12/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 079091-01 503-780-7793 N Corrections /Comments/ Instructions: PARTIAL APPROVAL pi CANCEL 0 NO ACCESS fl FAIL I CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: ------ , C----:'' ‘ Date:. f 1 ' Phone #: (503) 718 CITY OF TIGARD BUILDING DIVISION Ai & , PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/812008 Phone: (503) 639-4171 *84/111IlltI lli. Inspection Requests (24 Hrs.): (503) 639-4175 -A. - IL. INSPECTION WORKSHEET FOR DATE: 1211'1/2008 TIME: 7:00AM PAGE: 6 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT FDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 1 2ir iii2008 Pour Time: Code # • Inspection Description Confirm # Contact # Message 199 Electrical final 078981-01 503-780-7793 N Corrections/Comments/Instructions: • - • i p PAS PARTIAL APPROVAL I I CANCEL . I NO ACCESS / III FAIL CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED Inspector: 4/111 Date: [Z- // 0 5 Phone #: (503) 718- c . ‘'.:- 4 CITY OF TIGARD : . BUILDING DIVISION PERMIT #: MST2008.00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 518/2008 Phone: (503) 639-4171 Ai : .:11114114 411\ Inspection Requests (24 Hrs.): (503) 639-4175 ,.._._W ---. INSPECTION WORKSHEET FOR DATE: 12/10/2008 TIME: 7:01AM PAGE: 6 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDG :FliVOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: Ki sF, OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: W3.692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 121100000 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 078947-02 503-780-7793 N Corrections/Comments/Instructions: 1 IQ '-e„ --__ - 7-7 ei4 IZ 1 Cu f Jo f z f:'&(_5: ITSAf00 S11-1 -. Ftel-vti / c.--:7%. , , - 1 1 4,1" ---- i 14 Is.! C) 01 I-L-1 Z._ i .S' S 4. e Ii ii PARTIAL APPROVAL 0 CANCEL pi NO ACCESS FAIL 7 CALL FOR INSPECTION 11] ADDITIONAL FEES ASSESSED 74111111■- Inspector: ::::::=:=. Date: 12 - b 0 Phone #: (503) 718- Z-6 _ . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200B-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2008 Phone: (503) 639-4171 -40 10i ir,‘ Inspection' RequeSts 639-4175 11. INSPECTION WORKSHEET FOR DATE: 7/8/2000 TIME: 7:00AM PAGE: 19 SITE ADDRESS: 13012 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: NeAt SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/8/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 072322-03 603-780-7793 Corrections/Comments/Instructions: • PARTIAL APPROVAL CANCEL n NO ACCESS I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED __17z Phone #: (503) 718- e Date: g 4 _..2_6V Inspector: CITY OF TIGARD BUILDING DIVISION ' PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502008 Phone: (503) 639-4171 Inspection Requests (24. 639-4175 INSPECTION WORKSHEET FOR DATE: 7/8/2008 TIME: 7:00AM PAGE: 30 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: • PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 072318-03 503-780-7793 Corrections/Comments/Instructions: • 7: 4 1 \-1 to Q6S Wir-p ( 1 ge (1 PARTIAL APPROVAL CANCEL 7 NO ACCESS IN FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: Date: 7 Phone #: (503) 718-it gy) CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502008 Phone: (503) 639-4171 Inspection Jitlil Requests (24 HrS 639-4175 INSPECTION WORKSHEET FOR DATE: 702008 TIME: 7:00,04 PAGE: 29 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 718/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 072318-04 603-780-7793 N Corrections /Comments/ Instructions: • • 1110 fl 1 1 PARTIAL APPROVAL El CANCEL fl NO ACCESS 4 . " --- I I FAIL gh CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: 0 °'- Phone #: (503) 718- 2-6 W - ■.... . . • CITY OF TIGARD , BUILDING DIVISION ., ,ER MIT #: msT2008-000.16 13125 SW Hall Blvd., Tigard, OR 97223 A.,, , ? 7 ,.._ :., E ISSUED: 5/l3/20(8 Phone: (503) 639-4171 oval /W I T, 7 A Inspection Requests (24 Hrs.): (503) 639-4175 A' :7 - -- / / ----- INSPECTION WORKSHEET FOR DATE: 12/15/2008 TIME: : II Am - PAGE: 2 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: ao3 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 6036913390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-592-3390 Inspection Request Scheduled For: Date: 12/15/2000 Pour Time: foo tPr Code # ›/ Inspection Description Confirm # Contact # Mes(g) 11) 1 (11- 399 Plumbing finaI 079055-01 .503-1W7793 y , A li \ Corrections/Comments/Instructions: , / 'Iv • 40 .._ 0 PASS El PARTIAL APPROVAL 0 CANCEL E] NO ACCESS VILFAIL XCALL FOR INSPECTION I] ADDITIONAL FEES ASSESSED Inspector:, . . . Date:1 VI (kV Phone #: (503) 718-( s , CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200R-00016 13125 SW Hall Blvd., Tigard, OR 97223 A i CKL DATE ISSUED: 502008 Phone: (503) 639-4171 a,„„iiiillt‘' Inspection Requests (24 Hrs.): (503) 639-4175 seasi '-'-.... ''' INSPECTION WORKSHEET FOR DATE: 1211212008 TIME: ee :00AM PAGE: 29 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 603-692-3390 tr Inspection Request Scheduled For: Date: •2/12/2008 Pour Time: Code # Inspection Description Confirm # Contact # Mes. . g 399 Plumbing final 078981-02 503-780-7793 V Corrections /Comments / Instructions: ,..._ V- r I) I- (- 47) - CA/CYS--i- +0 . 16l)( 4 dre—' 6 Cj t L--(Z 4 // /, 6-1 ) s --- , 7' 0 , 3 PASS 7 PARTIAL APPROVAL El CANCEL 7 NO ACCESS lki FAIL $CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: \ (k____. Date: I 21\ V-70 t Phone #: (503) 718- E2.16 - 2--cr ' CITY OF ' - ' ��nm w n�'u TIGARD BUILDING DIVISION ' PERMIT ~~~~"~~~~""~~� ~~"°"~~"~~"° #: h4ET2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 602008 Phone: (503) 639-4171 � - |nepo��ionRequeata(24Hxe�:'(5O3)'G30=4175 - - — — --' '-- � INSPECTION WORKSHEET FOR DATE: TIME: PAGE: � 10/21/2008 � 7�OUAh8 � 10 SITE ADDRESS: � � CLASGOFVVORK� � 13812 SIN HALCY[}NTER SUBDIVISION LOT TYPE GERTZH0kAESATED@E� #: O0Q 00 3 � PROJECT NAME � GEQTZ HOMES AJEDGEW]0D DESCRIPTION: � NmwvSF. OWNER: GERTZ PHONE #: � ��T�Q0N�F�U��ANC#kdP�NY.|MC.. 503-69')503-69')-3390 ��g� � PHONE CONTRACTOR: #: GERTZCON8TRUCT|ONCoINC 603-692-3390 Inspection Request Scheduled For: Date Pour Time: ' � 10/21/2008 � Code # Inspection Description Confirm # Contact # Message 322 Shower pan 076986-01 503-78G-7795 N Corrections/Comments/Instructions: . XPASS |RAR�ALAPPROVAL -- �AN�EL ��NOACCESG I I __ . ' | I FAIL El CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Gb k' \ )& Date: 1 \ \ ( Phone #: (503) 718- , ' ' . ' .• . . CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2008-0001 6 13125 SW Hall Blvd D ATE ., Tigard, OR 97223 E ISSUED: 602008 Phone: (503) 639-4171 -481110161ltil' Inspection Requests (24 Hi (503) .z.11191' I-- INSPECTION WORKSHEET FOR DATE: 7/15/2008 TIME: 7: OOAM PAGE: 43 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. . OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough-in 072616-01 503-780-7793 N Corrections/Comments/Instructions: A PASS 0 PARTIAL APPROVAL D CANCEL 0 NO ACCESS rl FAIL 0 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: 0 4 \ Vi Date: "7 ) /g 3 r. Phone #: (503) 718- . , CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 543.12(308 Phone: (503) 639-4171 I ■"1 I • Inspetlion INSPECTION WORKSHEET FOR DATE: 5/27/2008 TIME: 7:01AM PAGE: 29 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: Nev SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-6913390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 5/27/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 070357-01 503-780-7793 Corrections /Comments/ Instructions: • n PASS 7 PARTIAL APPROVAL CANCEL 7 NO ACCESS H FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: _(321_%! Date: S (t'Y) Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION At PERMIT #: MST2000-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 , 74 i ll i t - - Insp - ettion Requests Hrs 639-4175 INSPECTION WORKSHEET FOR DATE: 5/1612008 TIME: 7:00AM PAGE: 18 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGIMOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: U1612008 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 070007-03 503-780-7793 N Corrections/Comments/Instructions: $1 PASS I I PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS 0 FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: CFO ' 11i Date: SI f C1,-ocn Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION A iiii I PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/812008 ; Phone: (503) 639-4171 . „.„,,,.iiiV - Inspection Requests Hrs (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/16/2008 TIME: 7:00AM PAGE: 17 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEYVOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-6913390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 5/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain . 070007-04 503-780-7793 Y Corrections/Comments/Instructions: PASS n PARTIAL APPROVAL 0 CANCEL P NO ACCESS fl FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: CroC14.-/c (At is-2., : Date SII'Cl Phone #: (503) 718- • . • ‘ i: ( ,,, -. ' ' CITY OF ��wx n ��m TIGARD ' BUILDING DIVISION PERMIT #: MST2008'0006 13125SVV Hall B|vd.. Tigard, ORQ7223 DATE ISSUED: 5/812008 Phone: (503) 639-4171 lil Inspection u@�d� 630=4175 ^ — INSPECTION WORKSHEET FOR DATE: 5/16/2000 TIME: 7:00Ahd PAGE: 21 SITE ADDRESS: 13912[W HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503'692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3350 Inspection Request Scheduled For: Date: 5/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 070006-01 503-780:7793 N Corrections/Comments/Instructions: ' • . �� 0� PASS 0 PARTIAL APPROVAL 0 CANCEL I I NO ACCESS | | FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: ^'T \lr*~--~ Date: ~~ | L 10 Y\ Rhone #: /503\ 718- . . . _ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 Inspection Requests Hrs): (503) 639-4175 Aar INSPECTION WORKSHEET FOR DATE: 5/16/2008 TIME: 7:00AIVI PAGE: 19 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: • PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603-6923390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 603692-3390 Inspection Request Scheduled For: Date: 5/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 070007-02 503-780-7793 Corrections/Comments/Instructions: • n PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS I FAIL 0 CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: (U k/r-A.-/ Date: 51 Phone #: (503) 718- • . . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/012008 Phone: (503) 639-4171 Inspection Hrsj): (503) 639-4175 A4- AL INSPECTION WORKSHEET FOR DATE: 5/1612008 TIME: 7:00AM PAGE: 20 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 5/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Watet service 070007-01 503-780-7793 Corrections/Comments/Instructions: PASS 0 PARTIAL APPROVAL 0 CANCEL I I NO ACCESS I I FAIL pi CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: CY Date: S1 1 k Phone #: (503) 718- CITY ��U��J�� / ��m m w OF n n��mwm�� ,` BUILDING DIVISION PERMIT #: k48T2000'00016 ' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 678/2088 Phone: (503) 639-4171 —' |rTsp �8.Iaw�'"�--. INSPECTION WORKSHEET FOR DATE: 12y10/3008 TIME: 7 PAGE: 7 SITE ADDRESS: j3812EW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES ATEDG[_VVO0Q DESCRIPTION: New SF. OWNER: ErTZ CONSTRUCTION COMPANY, INC., PHONE #: 603-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Oate: 1��1��Q� Pourllnng: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 078947'01 603780'7793 Y Corrections/Comments/Instructions: - . . 4 . mm r: AS ri PARTIAL APPROVAL pi CANCEL I NO ACCESS | | FAIL CALL FOR INSPECTION �� ADDITIONAL FEES ASSESSED Am. - ' � z(s_79_ |Inspector: Oeta� _~ 0 � Phone #: /603\ 71 �� .. .. . .. . , CITY OF TIGARD BUILDING DIVISION ' ' - A • , PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 , "Iliffittil'\ Inspettion Requegt“24 639-4175 „„..„..W INSPECTION WORKSHEET FOR DATE: 7/2312008 TIME: 7:02AM PAGE: 10 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: Now SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-69/3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 073084-05 503-780-7793 N Corrections/Comments/Instructions: 3V 4-6 . cov-0 r PASS 7 PARTIAL APPROVAL 7 CANCEL 7 NO ACCESS FAIL fl CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: .)-5 Date: ;33074?)(3 Phone #: (503) 718- _ . . CITY OF TIGARD . BUILDING DIVISION i ! , PERMIT #: NIST2000-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 518/2008 A Phone: (503) 639-4171 ‘,101411111\ --Irisp-actiOn-Re-q0e-sts-(24-Hr8-.)-:-(503)-639-74175 1- ---• INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7:02AM PAGE: 11 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 0 0 3 TYPE OF USE: ' PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: N SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-6913390 CONTRACTOR: GERTZ CONSTRUCTION co INC PHONE #: 5002-3390 Inspection Request Scheduled For: Date: 7/2312008 Pour Time: Code # ,,,- Inspection Description Confirm # Contact # Message i 275 ' Framing 073084-04 503- 78f17793 N Corrections/Comments/Instructions: e5 t i t - c)c 3 )g -3,,A. if ,c,,, . j s , R ' 3 c Q 11 be aT.N A 0 Q c) ) c.)e/r . lro) C ,r05 4--‘■ v -L. Coil n .Q_ c.4 : .,._ e ___ - o Dec,, 4., V R kfcs.irc) C.„ c)roo,e Jrc:vv‘ 5 r-- (-3 r i d / f ?o v.. +-• 1 0 Al elS Ey_cA- y-iCevi-..5 ) • ;ec PASS fl PARTIAL APPROVAL El CANCEL El NO ACCESS I FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: BS Date: 23 Sul 08 Phone #: (503) 718- 2 1)3 . . . ____ - - . 1TY OF TIGARD BUILDING DIVISION A PERMIT #: MST2008-00016 13125 SW Hall. Blvd., Tigard, OR 97223 DATE ISSUED: M3/2008 Phone: (503) 639-4171 irtillt irieriebtion INSPECTION WORKSHEET FOR DATE: 7/2312008 TIME: 7:02AM PAGE: 14 SITE ADDRESS: 131312 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: nO TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 603-.6923390 Inspection Request Scheduled For: Date: 7/23/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message Shear walls/anchors 07308401 503-780-7793 N Corrections/Comments/Instructions: e• 12ebu PASS PARTIAL APPROVAL n CANCEL El NO ACCESS I FAIL n CALL FOR INSPECTION [II ADDITIONAL FEES ASSESSED Inspector: 33 Date: 633 Ti■ (7 c Phone #: (503) 718- 'a 3 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/F)I2008 Phone: (503) 639-4171 Inspection Reguestt Rit 639=4175 -ft_o_MP' WI INSPECTION WORKSHEET FOR DATE: 7123/2008 TIME: 7:02AM PAGE: 13 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-G92-3390 Inspection Request Scheduled For: Date: 7/2312008 Pour Time: Code # , Inspection Description Confirm # Contact # Message 242 Interior shear walls 073084-02 503-780-7793 Corrections/Comments/Instructions: - rot 6 1 4 , 4 Mir/ (Seec: ck_ Pe • *PASS 0 PARTIAL APPROVAL LII CANCEL NO ACCESS 0 FAIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED InspectOr: 35 Date: _L,3=_Z4_y_C2L__ Phone #: (503) 718- 2'12_3 V CITY OF TIGARD BUILDING DIVISION AO PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 &W !J InspecticWRequests (2 (503) 639=4175 INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7:02AM PAGE: 12 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF- OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-6913390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503 Inspection Request Scheduled For: Date: 7/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 073084-03 503780-7793 N Corrections/Comments/Instructions: Gt Sc) El PASS 0 PARTIAL APPROVAL CANCEL 0 NO ACCESS 0 FAIL D CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: ti35 Date: ..3 )\ y 0 8 Phone #: (503) 718- 2.Y23 - _ CITY OF TIGARD BUILDING DIVISION ' PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2008 Phone: (503) 639-4171 . 414b Ainiii?ilit , Inspection Requests (24 Hrs.): (503) 639-4175 —.14• - ILL. INSPECTION WORKSHEET FOR DATE: 7/2212008 TIME: 7:01AM PAGE: 9 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/22/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 073007,03 5037130-7793 N Corrections/Comments/Instructions: ---- PASS 0 PARTIAL APPROVAL CC El NO ACCESS 1 FAIL 1 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: -- Date:? - . F1 Phone 4: (503) 718- act-- . . . _ CITY OF TIGARD , . BUILDING DIVISION 4 PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503)6394i75 INSPECTION WORKSHEET FOR DATE: 7/22/2008 TIME: 7:01AM PAGE: 8 • SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 50692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 603-692-3390 Inspection Request Scheduled For: Date: 7/2212008 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 073007-0.1 603-780.7793 Corrections/Comments/Instructions: • • n PASS n PARTIAL APPROVAL E CANCEL 0 NO ACCESS FAIL fl CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: 7 - 1 -0 Phone #: (503) 718- . . CITY OF TIGARD BUILDING DIVISION y PERMIT #: M5T2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 618/2008 A Phone: (503) 639-4171 iietlitit Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 7/18/2008 TIME: 7:00AM PAGE: 12 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDOEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603.692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/18/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 072876-04 603-780-7793 N Corrections/Comments/Instructions: ?e'--3ec,) _ R 35 r4 alie 4- we ////4/1 clic r S 52 ?e co i k da-N42c,) . 7 - / a a r i t )4 Dr5 J kv,;s5 L r curcoi C, - ihd ) SeeT...; 4 ( 1 , t S 1 t -i --- A-54.0 vl-e\f'S - 4.? 5 Q 10's _ eQAc r %.-yi Ve-4---- • c ‘i --- A-- \ 41/4,1 / troriek I • pi PASS PARTIAL APPROVAL 2' CANCEL 111 NO ACCESS _ n FAIL I CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: .3- Date: /gSc..5\ Og Phone #: (503) 718- P123 . _ . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &W2008 Phone: (503) 639-4171 JUL/lit Inspection Requests (24 Hrs.): (503) INSPECTION WORKSHEET FOR DATE: 7/18/2008 TIME: 7: Qom PAGE: SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF, OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 • Inspection Request Scheduled For: Date: 7/18/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 072876 503 Corrections/Comments/Instructions: 5ee cr ac) tnissei (seec',,t( 73 n PASS ■,74 PARTIAL APPROVAL I CANCEL EI NO ACCESS I I FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: '73-S - Date: 16 -au 1?/ 0 g Phone #: (503) 718- -2W ,1- CITY OF TIGARD • BUILDING DIVISION PERMIT #: IvIST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/812008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 1 639-4175 ,,, . INSPECTION WORKSHEET FOR DATE: 7/18/2008 TIME: 7:00AM PAGE: 10 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 • Inspection Request Scheduled For: Date: 7/18/2008 Pour Time: Code # Inspection Description Confirm # Message 1/1 275 Framing 072876-06 503-780-7793 Y Corrections/Comments/Instructions: ix) c., \-- ) e 1- at & 1/1Zetter 4 i v e., Con nec.- ,' (4. "PO t --- Qct It) '00-1 s C = - ) C e t t O v . 1 J e- , C i N C Y e a , " ' P a , " S ' go,r A-I I V a \ t i t N \ ° C t ' d C ?"‘ ("\ '-' rNICI (I TA 5 1/ (C4,4C- — lc. al/ (fil ov, kk 5 co ezvt/t, b \- Vk 3 v ictffie) L-r k w 4 PASS PARTIAL APPROVAL E CANCEL fl NO ACCESS _ — r _FAIL _ CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED Inspector: E., 5 • Date: teg So (,, os Phone #: (503) 718- -2-47123. CITY OF TIGARD BUILDING DIVISION VV PERMIT #: MST2008•000 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502008 Phone: (503) 639-4171 :#0511 Tr — - Inspection Requests (24 (503) INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 14 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GER12 HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # • Message 236 za Shear walls/anchors 072815-04 503-780-7793 Corrections/Comments/Instructions: Se t. r+ dca.c.e) 8- o (Z ( Sfeete_ Tit , eV 4) • fc 5 kbk 55) Q 4:4 5 '0 tlkfe--- p zi , 5 r c- El PASS PARTIAL APPROVAL CANCEL Lii NO ACCESS g CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED Inspector: 75 S. Date: /? ()V Phone #: (503) 718 2 /2 3 CITY OF TIGARD psi zoQa d6 °/ BUILDING DIVISION • PERMIT #: M1'2fi3apeow 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 7,41v1111°\ - -- Inspection Requests (24 (503) 639 -4175 -- — INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 16 SITE ADDRESS: SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 002 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. DEMO CREDITS APPLIED FROM BUP2007 -00167 TO THIS PERMIT. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503 - 692.3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503 -692 -3390 Inspection Request Scheduled For: Date: 7/1712008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 iZ G Mechanical rougtr -in 072815.02 503 - 780.7793 N Corrections /Comments /Instructions: See_ Re esr* cicc}ea `-i • 10 0 f3 (c �) (\, wog lr` @ 3 V€" �I a e 5 ,, /u.',,C'�v►. - 7 ! ow Jet . / '-'-1 - --) C - . ' V c:- o-r r cc- 4 )o A_ o if..- . . y) 1)151 3 1-, PASS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector Date: /7 01 08 Phone #: (503) 718- .Z./.2 3 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51012008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs:): (503) 639= 41 - 75� INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7 :00AM PAGE: 13 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEW00D LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF, OWNER: GERTZ CONSTRUCTION COMPANY, INC,, PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503 - 692 -3390 Inspection Request Scheduled For: Date: 7/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 072815 -05 503-780-7793 N Corrections /Comments/ Instructions: See - ee.ib_/ 4 c)& et) - S - O$ ( 73) 5 /5a 'NGc`C_i14c — co rred lay 6 r` 5 vn 'es54 5 etc, `Tn Veld k7e , r - ill ; No 10/e, SY, d •-• co f YC C f , d L11 2/5 (G )`feel &k n PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: p. S. Date: /730 ly Og Phone #: (503) 718- .2‘/.2 , . CITY OF TIGARD BUILDING DIVISION AllIo,A. PERMIT #: MST2008-00016 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 610/2008 Phone: (503) 639-4171 . iv lir Inspection Reguests (503) INSPECTION WORKSHEET FOR DATE: 7/17/20013 TIME: 7:00AM PAGE: 11 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGBNOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: W3-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 603-692-3390 Inspection Request Scheduled For: Date: 7/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 gt, Framing 072816-07 503-7807793 N Corrections/Comments/Instructions: See ? , —4 -10-0e. 7) t y , , k 4 5 s -- - / - c.)2, -. 2 3)-lec r— ( 7 " - •-, - 0 ez orsS "to - Q' C I3 I PASS I I PARTIAL APPROVAL )4 CANCEL I I NO ACCESS I I FAIL I I CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED Inspector: 3. -5 • Date: i?...luiy CO Phone #: (503) 718- 2 , ., .. CITY OF TIGARD ' A. BUILDING DIVISION #: M ST2008 -00015 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 " 4 p 1pii (, Inspection Requests (24 Hrs.): '(503) - 639 =4175 - '.6 - �I I.. INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: 7:00AM PAGE: 10 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/1012008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 072448 -04 503 -780 -7793 N • Corrections /Comments /Instructions: t) ?L___Vi\-#1 '1: i 4E7 IZ..t.2L)4,- (4 ------1 6.10 dAt-Dre--0 \ / (‘ e_ -1 - 1 -- 7/-4(-- -- . z ■ cDst:: 42 -L :' 4-0 - _ i s 1 7 7 - c , ' 3) i 0 f& s ao 1-. /A-t-L-s i „ () ' /$ `i "feu/41W/ 'L-- KO uA A-- 7 - `•f-. i L- 7 A/ Yr R-1- � YC)'7- . L1 re_y��.. .4=7Vi 'Z--7 ,-\ e_,----71-is 71 2 Ar PASS /a PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS Y4 FAI ' CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: L� �� r Date: Lo Phone #: (503) 718 - "T CITY OF TIGARD BUILDING DIVISION . PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6,o20o3 Phone: (503) 639-4171 Ak 1 1 1 141T \ Inspection Requests (24 Hrs (503)-639-4175 1 - .F).1.4. --4 - 1 -.. INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: 7:00AM PAGE: 11 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION:, GERTZ HOMES AT EDGE LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: Nevi( SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/10/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough-in 072448-03 503-780-7793 N Corrections /Comments/ Instructions: "T.054.. aic.,_:71 A/0 /1 e- 71 (..., . L-177 L . g_ e.-_-- I L— ....----. C,V - - :- ■ bk. 0 _.,„ 4.4 alf•r" Z.- , g,_ a : / ' ( Z- / Fate_ off-cm 4 /6 — ° 77 — Z. (a)-- / Zc .--- - -.A. --1,17 ..._ f 1 - Du e-- D 14-po W&LiC 4: .--..: • \A-1 &■ 4 El P IN -, RTIAL APPROVAL pi CANCEL 7 NO ACCESS ___,......Th W FAIL / A LL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: Date: '7 / a x , g Phone #: (503) 718- .... ..----■.....--- CITY OF TIGARD , BUILDING DIVISION PERMIT #: IViST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 A, A , Phone: (503) 639-4171 irt11‘11- Inspection Requests (24 Hrs):(503)-639:4175 1 INSPECTION WORKSHEET FOR DATE: 7/8/2008 TIME: 7:00AM PAGE: 21 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEVVOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF, OWNER: GERTZ CONSTRUCTION COMPANY, INC.,, PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors • 072322-01 503-780-7793 N Corrections/Comments/Instructions: AW 5 'L C c ( AtAsr - z-- \Ji 5,.e i i ii• • , V / kili tX, 4€-A_49■4a- A < --- 74 -Q ' Lr-- 1),X -- 2 - 1.2 (V tk It a---I'VL3--A ( 7-6 " .-4--- - El PASS PARTIAL APPROVAL D CANCEL 7 NO ACCESS _ -FAIL 7 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: \l/711 Date: V Vl one #: (503) 718- , _ CITY OF TIGARD )1a . ' 4' BUILDING DIVISION PERMIT #: MST2008-00016 s ' w • 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 5/8/2008 A A I,: A'-`• DATE IS Phone: (503) 639-4171 a o/ d 914111t 1 - Inspection Requests 639=4175 . - - ' 7 --,... • INSPECTION WORKSHEET FOR DATE: 7/8/2008 TIME: 7:00AM PAGE: 20 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603.692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 7/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 072322-02 503-780-7793 N , ,orrectiops/Comine s/Instructions , / _ r --- --,) V\ 5 "\/- cc-,a_ _ cozuzi_, r A . ..kj, Chi g --- k" L(Yr_.4_,(.1 (0 (...( 6) . _ -- /S,?- - ) i/t • 1 I PASS 0 PARTIAL APPROVAL fl CANCEL pi NO ACCESS 'K A I L I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED , v , V ' Inspector: Date:V ri Phone #: (503) 718- D'IV1 CITY OF TIGARD oigia BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502008 • Phone: (503) 639 -4171 T Inspection Requests - (24 Hrs): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 702008 TIME: 7 :00Ah+M PAGE: 32 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGE' VOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: W3-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 5036913390 Inspection Request Scheduled For: Date: 7 /8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior shea, thing 072318 -01 503 -780 -7793 N Corrections /Comments /Instructions: • _ I !rA 'ASS _ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \ 4 ; Inspector: Date: P hone #: (503) 718 z. , CITY OF TIGARD a ' BUILDING DIVISION , PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 A DATE ISSUED: 6/8/2008 Phone: (503) 639-4171 e " 410 1114 0 11# Inspection Requests (24 Hrs.): (503) 639-4175 ..,:44. - 1.11. INSPECTION WORKSHEET FOR DATE: 7/8/2008 TIME: 7:00AM PAGE: 31 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDOEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603-692 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 603-692-3390 Inspection Request Scheduled For: Date: 702000 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 0723113-02 603-780-7793 N Corrections/Comments/Instruc;F: 9 k?q73 , ,i' d — PASS pi PARTIAL APPROVAL 0 CANCEL I i NO ACCESS fl FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED \61 Ci r/ 6K Inspector: Date: / Phone #: (503) 718- • CITY OF TIGARD BUILDING DIVISION f PERMIT #: MST2008- 00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/0/2008 Phone: (503) 639 -4171 u n Inspection Requests (24 Hrs.): (503) 639 -4175 ,,_ INSPECTION WORKSHEET FOR DATE: 5/27/2008 TIME 7:01AM PAGE: 28 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 50.3. 692 -3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503.6913390 Inspection Request Scheduled For: Date: 612712008 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 070357 - 02 603.780 - 7793 dip Corrections /Comments /Instructions: 3 6 11.111 • % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • FAIL Fj CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / .i Inspector: Date: d Phone #: (503) 718- Z--'6Y 1%0 CITY OF TIGARD BUILDING DIVISION 444, PERMIT #: msnaoa-cgioi6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/812008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/27/2008 TIME: 7:01Alvi PAGE: 27 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGE:WOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-6913390 Inspection Request Scheduled For: Date: 5/27/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 070357-03 503-780.7793 Corrections/Comments/Instructions: r ) PARTIAL APPROVAL II CANCEL E NO ACCESS n FAIL 'El CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: 1 --1 Phone #: (503) 718- 27412 %1116 CITY OF TIGARD ., . BUILDING DIVISION PERMIT #: MST2008-00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 . tilfingtil l Inspection Requests (24 Hrs.): (503) 639-4175 ......,.....bfr ....... INSPECTION WORKSHEET FOR DATE: 5/14/2008 TIME: 7:04AM PAGE: 29 SITE ADDRESS: 13912 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503-6913390 Inspection Request Scheduled For: Date: 5/14/2008 Pour Time: 9:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 069866-02 503-780-7793 N Corrections/Comments/Instructions: 4 -/.1. ../... "-- _ Ail.. - '5 ,..z..4 ...---" - .f.t..._ - - ::-/: 4 -------- I I PASS I 1 PARTIAL APPROVAL 0 CANCEL El NO ACCESS FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: i 4 Date: -5 ici—a.f. Phone #: (503) 718- /-' . .. _ . . CITY OF TIGARD BUILDING DIVISION A . PERMIT #: MST2008-00016 13125 SW,Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 i&sdip # Inspection Requests (24 Hrs.): (503) 639-4175 - AIL INSPECTION WORKSHEET FOR DATE: 5/14/2008 TIME: 7:04AM PAGE: 30 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503-692-3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC • PHONE #: 503-692-3390 Inspection Request Scheduled For: Date: 5/14/2008 Pour Time: 9:00 Code # Inspection Description Confirm # Contact # Message 206 Footing 069866-01 503.780-7793 N Corrections/Comments/Instructions: ,---, I I PARTIAL APPROVAL El CANCEL pi NO ACCESS FAIL r7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: r A Date: 5 lel-- el g Phone #: (503) 718- 2.44ir' CITY OF TIGARD y tr BUILDING DIVISION PERMIT #: MST 008 -00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: al0/2008 Phone: (503) 639 -4171 A ��ygovi + Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/13/2008 TIME: 7:02AM PAGE: 40 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 503 -.682 -3330 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503 - 692 -3390 Inspection Request Scheduled For: Date: 5/1312008 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 2 Foundation walls 069762 -02 503- 780 -7793 Y Corrections /Comments /Instructions: `L./ /V CG t2 Gib S 1 c .v .. AI,,,r2o L 0 ) . ( I I PAS ' n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 5- /3— G S Phone #: (503) 718 - 4- i �_ s • CITY OF TIGARD BUILDING DIVISION PERMIT #: IvMST2008.00016 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 /,n�n�l�l�ii'�I Inspection Requests (24 Hrs.): (503) 639 -4175 __� INSPECTION WORKSHEET FOR DATE: 5/13 /2008 TIME: 7:02AM PAGE: 41 SITE ADDRESS: 13812 SW HALCYON TER CLASS OF WORK: SUBDIVISION: GERTZ HOMES AT EDGEWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: GERTZ HOMES AT EDGEWOOD DESCRIPTION: New SF. OWNER: GERTZ CONSTRUCTION COMPANY, INC., PHONE #: 603 - 692 - 3390 CONTRACTOR: GERTZ CONSTRUCTION CO INC PHONE #: 503 - 3390 Inspection Request Scheduled For: Date: 5/13/2008 Pour Time: 9:00 Code # Inspection Description Confirm # Contact # Message 205. Footing 069762 -01 503 - 780 -7793 N Corrections /Comments /Instructions: • sia a CLrcar/2e. L. t PA ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: = /1--.0 P, Phone #: (503) 718 /,- From:Mark Stewart Home Desig' 5035794132 07/21 )8 12:55 #413 P.001/001 By: Mark Stewart Column( 2000 International Residential Code (97 NDS)1 Ver: 6.00.81 Project: GERTZ BLACKHAWK EDGEWOOD OTT #3k Location: c-3 as in installed 07-21-2008 : 12:55:58 AM Summary: 5.5 IN x 7.5 IN x 10 FT / Dense #2 - Douglas Fir -Larch - Dry Use Section Adequate By: 2.7% Vertical Reactions: Live: Vert-LL -Rxn= 7513 LB Dead: Vert-DL -Rxn= 18115 LB Total: Vert-TL -Rxn= 23628 LB Axial Loads: Live Loads: PL= 7513 LB Dead Loads: PD= 16000 LB Column Self Weight: CSW= 115 LB Total Loads: PT= 23628 LB Eccentricity (X -X Axis): ex= 0.00 IN Eccentricity (Y -Y Axis): ev= 0.00 IN Axial Duration Factor: Cd- Axial= 1.00 Column Data: Length: L= 10.0 FT Maximum Unbraced Length (X -X Axis): Lx= 10.0 FT Maximum Unbraced Length (Y -Y Axis): Ly= 10.0 FT Column End Condition: Ke= 1.0 Calculated Properties: Column Section (X -X Axis): dx= 7.50 IN Column Section (Y -Y Axis): dy= 5.50 IN Area: A= 41.25 IN2 Section Modulus (X -X Axis): Sx= 51.56 IN3 Section Modulus (Y -Y Axis): Sy= 37.81 IN3 Slenderness Ratio: Lex/dx= 16.00 Properties For: Dense #2- Douglas Fir -Larch Ley /dy= 21.8 Compressive Stress: Fc= 825 PSI Modulus of Elasticity: E= 1400000 PSI Bending Stress (X -X Axis): Fbx= 850 PSI Bending Stress (Y -Y Axis): Fby= 850 PSI Adjusted Properties: Fc': Fc'= 589 PSI • Adjustment Factors: Cd =1.00 Cp =0.71 Column Calculations (Controlling Case Only): Controlling Load Case: Axial Total Load Only (L + D) Compressive Stress: fc= 573 PSI Allowable Compressive Stress: Fc'= 589 PSI �; ^tiv < "[ l:F; - l?- n"', r� .o. }1t . w. "!4''� :.�, .r;�,.. i f4t a b '�ft::�"+w i'u.�• �„v u+!, �3"'"-r`'^` y, !`•�a•1G.,'",Yrs' "�,:ma^a',�,Mw w,,;?: -:,,- r a ��^ �'� } ,p -�.�: . .��. `qd: �� 'L. 1,`:,`a. �j,aw��33`.{'�,✓+�:w -�i'� i4�s' � +� °ar+"'s ,41Jr Main Office Salem Office Bend Office .1 P:O. Box 23814 ti ,0 Hudson Ave., NE P.O. Box 7918 Tigard, Oregon 97281 Salem, OR 97301. Bend, OR 97708 • T P Fax(503 ) 684, -3460 Phone (503) 589 -1252 Phone (541) 330-9155 Carlson Testing, InC• Fax (503) 684 -0954 Fax (503) 589-1309 Fax (541) 330 -9163 Special Inspection Page of DAILY HELD REPORT Project: EDELC: L Date: - Job Address: J . U ) 2- 5'0 F4 P i_d_,"-/U 14 16'- CTI Job No. ,& } tJl Permit No.: M S A •• 2-006 _.. Po 0 / 1 Type of Inspection: Pt/ LL l ES z Field / © or Fab Shop Weather: i'J Inspection Notes (include location, testing data, substitutions /deviations, materials and methods of construction, non - conforming items, acceptance criteria, corrected non - conforming items, etc.): A 7 1-')1 p Pu Li_ ''T `STS N t 2-) /LL 7..r Z 7 Az - P:7% ✓"17 7' ✓cam i2� / �.► It _ IA/ �� - . (, /. it ,� C�� -, ?; r .,� - ooh /mss • Ao1 I/J 6 7 c7 d,,, use D 12_ (� ti' 7 . ( ' 'OE)T PS( A (-1i. "77 C /,'- X_c C l '77674 77b U h gc7:4 'S� . /� % "�`l / 7 / 7 ..z. d • • * ** CHECK ONE BOX ONLY * ** YES NO 1. This is a preliminary inspection only. — OR — /] ❑ 2. The work inspected conforms to acceptance criteria listed above. If "No," the portions of the work that are -�'� non - conforming itemsai a clearly stated above and will be added to the NCL. Remaining portions of the work, which 'El ❑ are not preliminary iin n ., the/work, are to, be considered as conforming, Ins ector: /, .�I_ ,� l/ l.� '�� Certification No.: - 7 9c) • • Use of the information contained in.this report constitutes acceptance of all terms on the reverse of this form and Carlson Testing, Inc.'s General Conditions. Information contained herein is not to be reproduced, except in full, without prior authorization from this office. • •e..+. t•. <:.rr. :a.L, y . ..s ' .:y i e � _ .�� ._._.._ . ..1,_,. ... .. _ .�i i�.. • Terms: Client recognizes that construction observation and/or testing services provided by CTI are techniques which may reduce the risk of construction defects, deficiencies, or omissions arising during or after con- struction. Services performed by CT! do not constitute a warranty or guarantee of any type. Even with diligent construction monitoring and /or testing by CTI, construction defects, deficiencies, or omissions in the Contractor's work may exist. In all cases, Client and /or the Contractor shall assign the Contractor the responsibility for the quality and completeness of the work and for adhering to plans and specifica- tions. CTI's work or failure to perform same shall not in any way excuse any contractor, subcontractor, or supplier from performance of its work in accordance with the contract documents. CTI will provide its professional services to Client with that degree of care and skill ordinarily exercised under similar circumstances by members of its profession. This representation is in lieu of other warran- ty or representation, either expressed or implied. It is also understood and agreed that statements made in C IT reports are observations based on technical judgments, and should not be construed to be con- clusive representations of fact. If conditions different from what are indicated in the reports come to Client's attention after receipt of the reports, it is recommended that Client contact CTI immediately to authorize further appropriate evaluation. CTI's work shall not include determining, supervising or implementing the means, methods, techniques, sequences or procedures of construction, CTI shall not be responsible for evaluating or reporting job con- ditions related to health, safety or welfare. City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 I N T I GARD June 16, 2008 Gertz Construction Co., Inc. 19200 SW 46 Ave. Tualatin ,OR 97062 Attn: Ken Gertz Re: Permit No. MST2008 -00016 Dear Mr. Gertz: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 13812 SW Halcyon Ct. Project Name: Gertz Homes at Edgewood, Lot 3 Job No.: N/A Refund: ❑ Check # in the amount of $ . ® Credit card "return" receipt in the amount of $167.00. ❑ Trust account "deposit" receipt in the amount of $ . Notes: Refund overpayment of plan review fees $750.00, less additional SDC fees due for Parks $403.00, TIF- Resident $160.00 and TIF -Mass Transit $20.00, = total refund $167.00. If you have any questions please contact me at 503.718.2430. Sincerely, ./ Dianna Howse Building Division Services Coordinator Enc. 1: \Building\ Refunds \ Administration \LtrRefund - Overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard or.gov • TTY Relay: 503.684.2772 City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Gertz Construction Co., Inc. DATE: 6/13/08 19200 SW 46'' Ave. Tualatin, OR 97062 REQUESTED BY: Dianna Howse Attn: Ken Gertz TRANSACTION INFORMATION: Receipt #: 2008 -746 Case #: MST2008 -00016 Date: 3/7/08 Address /Parcel: 13812 SW Halcyon Ct. Pay Method: CreditCard Project Name: Gertz Homes at Edgewood, Lot 3 EXPLANATION: Refund overpayment of plan review deposit, less additional SDC fees due. .REFUND INFORMATION: :' ... ' .....;• . : .Fee: Description From Receipt :., ' ' Revenue: A No • • • • • Refund Example: [BUILD] Permit Fee .. Exaiiiple: •'245- 0000 - '432000 • $ Amount :' [BUPPLN] Pln Rv Deposit 245 - 0000 - 433000 $167.00 TOTAL REFUND: $167.00 APPROVALS: If under $500 Professional Staff / / /' If under $7,500 Division Manager . ...1 (, - /= If under $22,500 Department Manager / If under $50,000 City Manager If over $50,000 Local Contract Review Board _ • - FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY, . • �'� • Case Refund Processed: I Date: I e .,/!.. 3 , / „”, I B I ,471,./ ....... ____ I: \Buildin \Refunds \RefundRc 05/23/07 Er CITY OF TIGARD 6/13/2008 13125 SW Hall Blvd. 4:53:29PM Tigard, OR 97223 503.639.4171 TIGARD. Receipt #: 27200800000000002068 Af-= 4 'z- / Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00016 [PKSDC] SF Park SDC 270- 0000 - 450000 403.00 • MST2008 -00016 [TIF -R] TIF Resident 210- 0000 - 448001 160.00 MST2008 -00016 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 20.00 Line Item Total: $583.00 Payments: Method Paver User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard GERTZ CONSTRUCTION DLH 02445B In Person 583.00 Payment Total: $583.00 G A a' N g - ° .Z :1) O W . 4 o D l N N to 9 vi �wv o ‘I L' col t �. = Qj .,.. 0 i ...el MI C ‘ r, .9 m t. g c a le 4, ...;', N C°13 a) en a CI) G a o Wx �V W v) w .1:3° 4 , 5 w x ea U. g .. \ g t °AaGxU tiO { a q a 0 i a cl ,t' 1 CITY OF TIGARD 6/13/2008 � 13125 SW Hall Blvd. 4:53:1 I PM Ti'ard.OR 97223 503.639.4171 'T[GARD: Refund Receipt #: 27200800000000002067 /C. Y _ Date: 06/13/2008 Line Items: Case No Trait Code Description Revenue Account No Amount Paid MST2008 -00016 Reversal - [BUPPLN] PIn RV Dep 245- 0000 - 433000 (583.00) Line Item Total: ($583.00) Refund: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid Credit Reversal GERTZ CONSTRUCTION 02445B In Person (583.00) Refund Total: ($583.00) m6..61,1.11)1 I'aee I u1 I ',._1'`7 CITY OF TIGARD 6/5/2008 l ii 4 13125 SW Hall Blvd. 8:05:50AM , Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000000746 o i �:,,vs,t - Date: 03/07/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00013 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00014 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00015 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00016 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00017 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00018 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 Line Item Total: $4,500.00 Payments: Method Payer User ID Acct. /Check No. Approval No. . How Received Amount Paid CreditCard KEN / GERTZ CONSTRUCTION BTT 02445B In Person 4,500.00 Payment Total: $4,500.00 • • accc1111.11,I 1'aj e I or I CITY OF TIGARD 6/13/2008 7 13125 SW Fran Blvd. 4:50:30PM , ' `; Tigard, OR 97223 503.639.4171 TIGARD. Refund Receipt #: 27200800000000002066 X. ir`+ //=72' `. S 4.. --- - Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid • MST2008 -00016 Reversal - [BUPPLN] Pln Rv Dep 245- 0000 - 433000 (167.00) Line Item Total: ($167.00) Refund: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Credit Reversal GERTZ CONSTRUCTION 02445B In Person (167.00) Refund Total: ($167.00) a.i • N o b O • ::\1 � 12 v a . • b a� ,.. . . cd �"� m . a O y .. u i n w a c o V^�° b ,� [n O Y O .+ 4 1 t L z C1 N 81 0 Ei A �0 ' 0 t:4 . � j C •� t"w o �W� � � o w , , h 4 Z v U � � s • Z ii N� m 4 N. - 8 ., .s Pt ' cds A� 4 g g D 0;5 v v t \. V H 0 CI 4J y M D c >~ o € 0. . o 0 A H w C4 a \ 2 eltcccipi.rpi I'agc I or I : :' : : CITY O TIGARD 6/5/2008 a 13125 SAC Ilan 131vd. B:OS:SOAM Tigard, OR 97223 503.639.4171 • TIGARIP; • Receipt #: 27200800000000000746 i/ /,2 e-c-,, . =74 Date: 03/07/2008 line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00013 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00014 [BUPPLN] Pln Rv Deposit • 245- 0000 - 433000 750.00 MST2008 -00015 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 MST2008 -00016 [BUPPLN] Pln Rv Deposit 245 -0000- 433000 750.00 MST2008 -00017 [BUPPLN] Pin Rv Deposit • 245- 0000 - 433000 750.00 MST2008 -00018 [BUPPLN] Pin Rv Deposit 245 -0000- 433000 750.00 Line Item Total: $4,500.00 Payments: Method Payer User ID .acct. /Check No. Approval No. Flow Received Amount Paid CreditCard KEN /GERTZ CONSTRUCTION BTT • 02445B In Person 4,500.00 Payment Total: $4,500.00 • • r1:••rivt.rya Pa_e I oI' 5/28/2008 ' a CITY OF TIGA Fees Associated With 9:53:04AM e . 13125 SW Hall Blvd. C #: MST2008 -00016 T I C A �t D Tigard OR 97223 503.639.4171 Zt)053 a s 741, 1 1 6 Jf _ • : Revenu ;�. , ; ;�_ Created�'_:�` � °.. :., • - Fee: ; Start t End. r ;a �. 'a, #�;.+ „ 1 Y! Type-' r' • 'Date ' - = • • '•Date' . Dept Descriptionri: .. -,; , . ; - .:.Y," rv-._ *Account Number, . ' By : ;.. ^ Date:*„ - ..Amoun Due BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 BTT 3/3/2008ov0 750.00 0.00 CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pin Rev 100- 0000 - 433060 BLS 3/18/2008 46.00 0.00 LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100- 0000 - 438050 BLS 3/18/2008 6.00 0.00 BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 BLS 3/18/2008 . 1 4 2 . 31,911-. 0.00 BPRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245- 0000 - 432000 BLS 3/18/2008 1,586.12 0.00 SURI 12/31/2007 12/31/2020 [TAX] Build 12% State Surchrge 100- 0000 - 207020 BLS 3/18/2008 190.33 0.00 MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245- 0000 - 229202 BLS 3/18/2008 340.75 0.00 MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245- 0000 - 431010 BLS 3/18/2008 134.10 0.00 SUR2 12/31/2007 12/31/2020 [TAX] MEC 12% State Surcharge 100- 0000 - 207020 BLS 3/18/2008 16.09 0.00 PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 BLS 3/18/2008 399.00 0.00 SUR3 12/31/2007 12/31/2020 [TAX] PLM 12% State Surcharge 100- 0000 - 207020 BLS 3/18/2008 47.88 0.00 ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220-0000-431510 BLS 3/18/2008 278.75 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 BLS 3/18/2008 33.45 0.00 ELRP 1/1/1990 12/31/2020 [ ELPRMT] ELR Permit 220 - 0000 - 431510 BLS 3/18/2008 75.00 0.00 SUR5 12/31/2007 12/31/2020 [TAX] ELR 12% State Surchrge 100- 0000 - 207020 BLS 3/18/2008 9.00 6.315- 0.00 PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270 - 0000 - 450000 BLS 3/18/2008 4,812.00 0.00 - TIFR 7/1/2002 12/31/2020 [TIF -R] TIF Resident 210- 0000 - 448001 BLS 3/18/2008 0 296 0 22 80 L ° 0.00 -+► � 6 TIFM 7/1/2002 12/31/2020 [TIF -MT] TIF Mass Tr 210 - 0000 - 448005 BLS 3/18/2008 22 ?Nd 0.00 - 30 EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100- 0000 - 207307 BLS 3/18/2008 88.00 0.00 ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 BLS 3/18/2008 28.60 0.00 ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 BLS 3/18/2008 28.60 0.00 Total Due: $0.00 -73 Ii . 'D 3 /' a 6 Page I of I CaseFees..rpt i r CITY OF TIGARD 6/5/2008 ' 13125 SAY Hall Blvd. 8:06:06AM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000001554 Date: 05/08/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00016 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 46.00 MST2008 -00016 [LRPF] LR Planning Surcharge 100 -0000- 438050 6.00 MST2008 -00016 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 1,030.98 MST2008 -00016 [BUILD] Bldg Permit 245 -0000- 432000 1,586.12 MST2008 -00016 [TAX] Build 12% State Surchrge 100- 0000 - 207020 190.33 MST2008 -00016 [METCET] Metro Const Excise Tx 245- 0000 - 229203 340.75 MST2008 -00016 [MECH] MEC Permit 245- 0000 - 431010 134.10 MST2008 -00016 [TAX] MEC 12% State Surcharge 100- 0000 - 207020 16.09 MST2008 -00016 [PLUMB] PLM Print 3Bth 245- 0000 - 431000 399.00 MST2008 -00016 [TAX] PLM 12% State Surcharge 100- 0000 - 207020 47.88 MST2008 -00016 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2008 -00016 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 33.45 MST2008 -00016 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST200S -00016 [TAX] ELR 12% State Surchrge 100- 0000 - 207020 9.00 MST2008 -00016 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2008 -00016 [TIF -R] TIF Resident 210- 0000 - 448001 2,800.00 MST2008 -00016 [TIF -MT] TIF Mass Tr 210- 0000- 448005 220.00 MST2008 -00016 [ERPRMT] Erosion Control 100 - 0000 - 207307 88.00 MST2008 -00016 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 28.60 MST2008 -00016 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 28.60 Line Item Total: $12,170.65 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check GERTZ CONSTRUCTION CO DEB 2885 In Person 12,170.65 Payment Total: $12,170.65 cRcecipi.rpl Page I or I RESIDENTIAL PERMIT APPLICATION REVIEW Permit No.: IMS j ,200 8 000 It% Site Address: /3 54) /4/ ii ern ice Subdivision: ker Neyme$ 4 Ed5e Lot No.: 3 Contact Name: / e0 ( -7er'f Business: F''1p ( sit c V,0 ( o .th Street: /9,26:) ,5 66 City: ' 7 i,4 /4 r State: d e Zip: C/ e5 2- 8 7 !J As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or "complex" as defined in ORS 455.467 and 455.469. The application is complete. ❑ The application is incomplete for the following reason: ❑ The submitted plans will be reviewed; however, a permit cannot be issued until the above information is reviewed and /or approved. n The submitted plans cannot be reviewed until the above information has been submitted and /or approved. ❑ The plans are deemed "simple ". j ] The plans are deemed "complex ". Signature: � - 3 / ( 0e Name: Brandon Shaw Date Title: Plans Examiner Phone: 503 - 718 -2425 E -Mail: BrandonS @tigard - or.gov I: \Buildin \Forms \RES- PermitAppRevw- Blank.doc 1/18/07