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Permit A• i CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00078 Pv DEVELOPMENT SERVICES DATE ISSUED: 4/7/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CD -RM004 SITE ADDRESS: 07946 SW CAROL ANN CT ZONING: R -12 SUBDIVISION: REBECCA MEADOWS LOT: 004 JURISDICTION: TIG Project Description: New SF detached. BUILDING REISSUE: PH24 - 030 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 669 sf BASEMENT: sf LEFT: 4 SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,024 sf GARAGE: 231 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 4 VALUE: 162 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,693 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: I VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: WISVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: 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 KEYSTONE DEVELOPMENT INC KEYSTONE DEVELOPMENT INC. applicable laws. All work will be done in accordance with approved PO BOX 476 PO BOX 476 plans. This permit will expire if work is not started within 180 days LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97034 of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 Phone: 503- 635 -4736 Phone: 503- 635 -4736 or 1- 800- 332 -2344. TOTAL FEES: $ 8,826.12 Reg #: LIC 71135 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 ...---- Issued By : )( y Permittee Signature : 41111111EL1lr ',MP' 6' I Call 503 - 639 -4175 by 7:00 a.m. for an inspection that busi ss del. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Appli ti . h � � � ��� �]� , • TOR USE-ONLY , City of Tigard Received Date/By: �), 0/e f � ,. Permit No.:nr tJ r - d - g 13125 SW Hall Blvd., Tigard, OR 97212.3A -i 1 Plan Revie t f Phone: 503.639.4171 Fait: 503.598i'9308 Q 2005 rA Date/By: Other Permit�j, ' i '000 Inspection Line: 503.639.4175 j n P' � a Da te Ready /By: Jura: ® See Attached Checklist fm (J � Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: y - ' ' ) T � G (j t 7 /C.s Supplemental Information BUILDING DIVISION SV ek-t, `-"V.) \ , _ TYPE OF:WORK : REQUIRED. DATA: 1- AND .2- FAMILY DWELLING New construction Permit fees* are based on the value of the work performed. ❑Demolition Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF C ONSTRUCTION . work indicated on this application. jai- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi family Number of bedrooms: ❑ Master builder 0 Other: Number of bathrooms: 2- 2 k ' ' `..JOB SITE INFORMATION AND; LOCATION Total number of floors: Job site address: , 7q y 5ti.) GA POL, .AI` t C I ' New dwelling area: I t et square feet City /State/ZIP: T(‘et fzP, O g720 Garage /carport area: 2'5 ( square feet Suite/bldgJapt. no.: Project name: Covered porch area: 2 square feet Cross street/directions to job site: C) (41.1..W.. a GjVO 141H ti (x) Plit Deck area: square feet Other structure area: square feet REQUIRED _DATA: COMMERCIAL - USE :CHECKLIST - Subdivision: g pje.CCA lAf A ')J Lot no.: I. Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2b 1 i2GP 1" ['OT I i� equipment, Indicate the value (rounded labor, to the nearest an the dollar) of all equipment, materials, labor, overhead, and the profit for the - application. DESCRIPTION OF WORK . work indicated on this appl tca N elk) S r WAC,:r{67 Valuation: $ f Existing building area: square feet New building area: square feet PROPERTY OWNER .❑ TENANT Number of stories: Name: il. `1S'r0 jJ i✓ a�JrI Jf/I 1 , Type of construction: Address: PO O)C 1 CL' Occupancy groups: City/State/ZIP: - LA j OStfJ 6-O 0 - 11034- Existing: Phone: (Ob3) 63 0 - A1Vp Fax: ( 5b3) (A - 1144 New: APLICANT ®- CONTA P ER S ON:. . ' ,- ,: .:P. .... -.:_. CONTACT NOTICE Business name: ii_p 1 DI3E pig ,,,, ,L,L, ( 1 NC, . All contractors and subcontractors are required to be Contact name: Po 60°4 41(e -Was POLO- licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: Or--s- zwebo I of- ct D 54- jurisdiction in which work is being performed. If the City/State/ZIP: / State/ZIP: applicant is exempt from licensing, the following reasons ty apply: Phone: ( ) SAME- Fax: : ( ) S E-mail: J foLAP3 cz 'Asis`r, NJ CONTRA - Business name: Kb0i✓ pt�'�l%I -OQM" t - „ B PERMIT, FEES* Address: �-/Arke Ac A Please refer to fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) Fax: ( ) 1 i Amount received CCB lic.: Date received: Authorized signature: „i1_ �_ This permit application expires if a permit is not obtained � within 180 days after it has been accepted as complete. ` ° 16Y Print name: M N P01AY— Date: '3 [ 0 10t * Fee methodology set by Tri County Building Industry Service Board. • Mechanical Permit Application FOR OFFICE _USE ONLY City cf Tigard F4t tU II V E D Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 PlateJBy. MS a�D - (�(�U7 Plan Review Phone: 503.639.4171 Fax: 503.598.1-960 Other Permit:. MAR � Q rr f ti .�q' P� D Inspection Line: 503.639.4175 AR 1 0 2005 � ,., I� F,fli Date Ready /By: Juris: l See Page 2 for ''tternet: www.ci.tigard.or.us Notified/Method: Supplemental Information CITY OF TIGARD - . BUfirglI DWOMN COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work /2 New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. - CATEGORY_ . OF CONSTRUCTION' Value: dwelling RESIDENTIAL.EQUIPMENT /SYSTEMS FEES* l - and 2 g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description `Qty. I Ea. Total _ ;, JOB SITE ^INFORMATION AND LOCATION Heating/cooling Job site address: , 6 4't 1 L- PIN 1\ G') • Air conditioning or heat pump • (requires site plan showing placement) 1 4.00 City/State/ZIP: .--14t.b - n&4 w 1 OF- 11 2.1"" Furnace 100,000 BTU (ducts/vents) 14,00 Suite/bldg.lapt. no.: Project name: Q �a... M PTIO 5 Furnace 100,000+ BTU (ducts /vents) 17.90 Gas heat pump 14.00 Cross street/directions to job site: - ,k)J pU P-O 1 ' I 0 Duct work 14.00 + S _ Hydronic hot water system 14.00 00 �O . APO G I ` Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), r � /�� in -wall, in -duct, suspended, etc. 10.00 � Subdivision: - gr ✓E.� V 4 A Oi S Lot no.: ' J Flue/vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIP T ION OF WORK Water heater 10.00 P Gas fireplace 10.00 N� S — P el' ACAA 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 _ Chimney/liner/flue/vent ... .. (}:'.PROPERTY' OWNER' ` _ °:' .: _,- ❑= TENANT. Other: 10.00 Name: 1'STa(J E. j) ai,D i%�I ( N C Environmental exhaust and ventilation Address: "( 1 P O 6 f L Range hood/other kitchen r �r equipment 10.00 City /State/ZIP: L I f .€.. oS 'Jec� o i OF- � 4- Q Clothes dryer exhaust 10.00 Phone: ( ) b 5 -. I -ribto ,J Fax (516) 01 -1-1 4"t Single duct exhaust (bathrooms, toilet compartments, utility rooms) 6.80 ' ❑ C ,-.,':::: - - CONTACT PERSON, •: ,- - Attic/crawlspace fans 10.00 • Other: 10.00 Business name: K S1t) O Pi -'1 El im '1' ti c.. Fuel piping Contact name: 'M5 V $5.40 for first four; $1.00 for each additional Address: lL e, As , jDv F,-. Furnace, etc. Gas heat pump City/ State/ZIP: IN I I Wall /suspended /unit heater Phone: ( ) (1 I 1 Fax: : ( ) Water heater ` E -mail: J O r K3 a MGAS Fireplace �lo. 7 N� Range CONTRACTOR' Barbecue Clothes dryer (gas) �� Business name: 6 t, y A. j Q Other: Address: - MECHANICAL PERMIT FEES* City/ State/ZIP: G ( a i2 Subtotal ''one' (S' /) .S-7 22' t0 Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) , 1 .;B lie.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized • a This permit application expires.if.a permit is not obtained within 180 days after it has been accepted as complete. Print name. �• f I Date:, �� I " Fee methodology set by Tri- County Building industry Service Board . RECEOVED Plumbing Permit Application .: FOR OFFICE USE ONLY ` - MAR 1 1 1.1 (� , Cl „ d/1f1 of Tigard C °I 2005 Received ' iA Date/By: Na -:m5 T,(7 � J -C�V 07 �/ p 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 50'i';8f1ia0 TIGARD % '� Date/By: Other Permit No.: 24- Hour Inspection Line: 503 ?L DIVISION `* '_ e". Date Ready /By: luris: Ei See Page 2 fur Internet: www.ci.tigard.or.us Notified/Method: Supplemental information TYPE: OF WORK FEE* SCHEDULE New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection -- . CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 01- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: ire in e ( spr 1 r sq. f[.) Page 2 -. JOB ;SITE' INFORMATION AND:-LOCATION. Site utilities Job site address: I''l» 5 t 3 CAT-01- A00 c r'. Catch basin or area drain 16.60 City/State/ZIP: ' t,, i a R \- 0,.23 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: l Project name: Footing drain (no. linear ft.: ) Page 2 Co~ i -r -` Manufactured home utilities 110.00 Cross street/directions to job site: S r'TII / ,�, vl _r Manholes 16.60 013 S A N0 CT. Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: �. �� M .l 5 Lot no.:(►Y Water service (no. linear f[.: ) Page 2 Fixture or item Tax map /parcel no.: - valve Absorption 16.60 ., . Q, " DESCRIPTION RIPIION OF WORK Backflow preventer Page 2 • NUJ 5f � -- Pl%FAC \ e) Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 PROPERTY mg ountam 16.60 -; O, ONE B (�1i�6:4 PEE fi? T Ejectors su 16.60 Name: Pf) Box 476 Expansion tank 16.60 Address: Lake Oswego, OR 97034 Fixture/sewer cap 16.60 City/State/ZZ1P: Floor drain/floor sink/hub 16.60 Phone: ( 53) 635 - ¶ - '13(o Fax: ( fig,) '91 - Li I Garbage disposal 16.60 '� • APPLICANT _ , ; ❑.CONTACT.. PERSON Hose bib 16.60 Ice maker 16.60 Business name: KEYSTONE DEVELOPMENT Interceptor /grease trap I 16.60 Contact name: P.O. Box 476 Oswego, _ Medical gas (value: $ ) Page 2 Address: Lake Oswego, OH 97034 Primer • 16.60 City/State/ZIP: Roof drain (commercial) - 16.60 Phone: ( ) friy■IL I Fax: : ( ) SPfw Sink/basin /lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: j QOLA1-3 e cootscA T, Nel" Urinal 16.60 - " CONTRACTOR i Water closet 16.60 Business name: � 146i- �4t er /_ /i! f b! Water heater 16.60 Address: p L,X 0?3338 Other: City/ State/ZIP: a ro q 7 � -� Subtotal `J � q Minimum permit fee: $72.50 Phone: ( ) 3) e j „2 t _ 0 Fax: ( »3) b. «/ -0S g- Residential backflow minimum permit fee: $36.25 `CB Lic.: / 35 7 Plumbing Lic. no.: $ 3Wet? Plan review (25% of permit fee) y � State surcharge (8% of permit fee) Authorized signature:�/`� TOTAL PERMIT FEE irs %v' Print name: �! C j� / 71 # p mi Date: /� 5 This permit application expires if a permit is not obtained within �t 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I0,5/ t9 irLtrOb DeiJID:2b44bt L1 b1-1 IHDUSE ELECTRIC PAGE 01 FRCiri :1 5 l'ONE fEkiELOMENT MECE (I WA's, • o --, :503 699 7741 rla i17 2LACT. 39: 15k 1 P2 -. ,. :, .. - -, ----.. -; Ns, - -'i " 7--;, • -,-j.. - :,:.. • r '' ."‘"y" -- y." 1 -- "?: . ''''''..:!:' , j-:'''' . 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T.,,ASCHYrACE. raOgit. : ' • i 1 !I I ; • r.' 1 I MAC& or faeder tor. .1a,:h , 1 e•-:,...-.0,5 13rtte __Ke5(4/ 00).4 bnolch Citnlil / ' .•••••••'. 1"1:1 B. rift tor burch Qinintl ' - 1 •; C •rgo.t rums: A lit 6 ,....„ 1 eve - tyr_ puth.... serkicc or tr;53c- fee i i - ! 4 Slrer,s _5d;ANVeL-AiJhbON4L' I Efitor v eCs t .. rirc ( Lit + _-&---.........--....-....-; 1 c ::■..-3L4e..Z:P: • ! Pdfirae4Ilannom (uer.ies nr (gothic not included: r _____L ' ..." - T7 1 - . r ____---- -- • - ---.. Fu eittit FRC . ( I __•___._ _ outline F.shring . i 1 3 ‘01,..._ _, I i *I f Or .itttita 1 . • sCONnitAMM ':.' rroli Pa nel. Moroi CT iat . . • ______„_,;.2.......--•-■.......--,....■.-.....:.--,-----....1 : ogfewitik. rkoCrit141: i I F.:at I I i .. . 1 ' lt. f1.1:at• ague; , • 79 e LA,. C.„, ._.‘...; -------'''--4-q--lt!!:22-AV-e7IA7-1 • - . .....-1------..-1---i . i • 31 toepactian altar sairnanbk in law el te e ..■ I.MyC • , ,........ ..,....-....--,---.. - -- •.^- - J ! Nu invpeedor• 62.50 : c.' lij ( 15,p hs p 1 e . ce.„. j Im.eitipt9n txr hou.- 0 ■te n■iW . az i3 --c' ..............-....-................----,-....., • i , , : trAlustrta: Ow Pe rtiN:r ' 1 --; 16.171 , • • • fiLNCTIU CAL . A/NUM' tits 15 -y r 2 - 51.01. . 7 :61 1 2 VIT. IAC :3 I sv : ... .J.146/ . , -.---7•••••••••-•-••-••••-•-t Li 1,1DIV Ei (CM r tail slYincuM, IE.qUift.4!. c..... Plo...,t,r...:f.; _ ... - -,------1 • . .747: f 1 --riC .---- 7-...1---t•-•:-2-1:: Stele eeramtgt. OK a peiTio I feel . .._j__ TOTAL FER'VIIT V 1 ,..:tre• it!'..1 ti.s131VM: . -- M. Perbal.prkAaies taai,at ti , pc i, .0 41):16%... - .40116 1.10 ---' - th,,i .in If hi& Wag ft OCC(MNI ti Centsj):, po tv,.. L DitiC. I • Fel rnet lc DYTtK:4• t t1 s: -.r • .-.-...- .• Nirrdar.r of 4npmt:tna pd. Pril.L.Iwwyd- . 4 ., , ....01*,,,:. &A .3: .. 4.4 433) •Iter,.•3/•;;R:C.WASIb • s -7 STREET E i . i A .. .. / I �� Owner /A for 4571/e /e 1/(Ulle'4adve /'vim.. (PLEASE PRINT) (PERMIT HOLDER) . ` `i A iF Y " Y Do hereby ce t x th e ` follow location Ot 1 4 , : i :.,- g , ° °' y° a % meets ; C%t r a / on Count land use and development standards for street tree installation. ADDRESS: - q 4 , s J Co .fr� A - /QA/ Cr P, ,e/n/ i : , ooh �c�78� LOT: S UBDIVISION: / BEcCar //4e- 4 S I BY: 74.--____ DATE: P as RECEIVED BY: 2,Z 22,E DATE: y 'S 0 j • CITY OFTIGARD 1. 1 BUILDING DIVISION PERMIT #: MST2005-00078 13125 SW Hall Blvd., Tigard, OR 97223 S DATE ISSUED: 4/7/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 8/15/2005 TIME: 7:05AM PAGE: 48 SITE ADDRESS: 07946 SW CAROL ANN CT CLASS OF WORK: SUBDIVISION: REBECCA MEADOWS LOT #: 004 TYPE OF USE: PROJECT NAME: REBECCA MEADOWS DESCRIPTION: New SF detached. 819/05: Added A/C unit. OWNER: KEYSTONE DEVELOPMENT INC, PHONE #: 503.635.4736 CONTRACTOR: KEYSTONE DEVELOPMENT INC. PHONE #: 503-635.4736 • Inspection Request Scheduled For: Date: 8/15/2005 Pour Time: • Code # Inspection Description Confirm # Contact # Message 299 Final inspection 013539-02 503-704-9505 Corrections/Comments/Instructions: ,• • • • [ PASS 111 PARTIAL APPROVAL Ej CANCEL fl NO ACCESS FAIL 11 CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED Inspector: /11A Date: - c9—/§ Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00078 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/7/2005 Phone: (503) 639 -4171 ik And , lin�y� , I Inspection Requests (24 Hrs.): (503) 639 -4175 '.. INSPECTION WORKSHEET FOR DATE: 8/3/2005 TIME: 7 :06AM PAGE: 30 SITE ADDRESS: 07946 SW CAROL ANN CT CLASS OF WORK: SUBDIVISION: REBECCA MEADOWS LOT #: DOq TYPE OF USE: PROJECT NAME: REBECCA MEADOWS DESCRIPTION: New SF detached. OWNER: KEYSTONE DEVELOPMENT INC, PHONE #: 603.635 -4716 CONTRACTOR: KEYSTONE DEVELOPMENT INC. PHONE #: 543 - 635 -4736 Inspection Request Scheduled For: Date: 802005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 012714 -01 503- 598 -9600 N Corrections /Comments/ Instructions: /2j -7- 54 0 .4_ 00-' 1 1/4_0 7 i 4.1--e-1-, 1,4Le/4 6 f' S Gam - At 7z . _ . 4- w c< %itir-te. 1 € o b45- ----- .1- . d-e____ f IA. i i 1917 ezzi% 1 • PASS ❑ PA'TIAL APPR• • . ❑ CANCEL _, NO ACCESS ❑ FAIL IP ALL FO r PE ION ❑ ADDITION , E ASSESSED Inspector: / Date: ■ 5 o Phone #: (503) 71 CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST`�00&.00078 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/7/2005 Phone: (503) 639 -4171 � i� IIIIpli (t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/15/2005 TIME: 7 :05AAM PAGE: 49 SITE ADDRESS: 07946 SW CAROL ANN CT CLASS OF WORK: SUBDIVISION: REBECCA MEADOWS LOT #: 004 TYPE OF USE: PROJECT NAME: REBECCA MEADOWS DESCRIPTION: New SF detached. 8/9/05: Added NC unit. OWNER: KEYSTONE DEVELOPMENT INC, PHONE #: 503.635 -4736 CONTRACTOR: KEYSTONE DEVELOPMENT INC. PHONE #: 503-635-4736 Inspection Request Scheduled For: Date: 8/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 013539-01 503-704 -9505 V Corrections /Comments /Instructions: • ';' / dor OV-Z. 04,1,taa-K- 44406 -he 5-2.45-6 .4,./c/Az • • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . Date: if -- /-S --- . Phone #: (503) 718-