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Permit 4 7/05- ------ PpLA,:st--...d p • i t- MASTER PERMIT C I O F T I G A R® PERMIT #: MST2004 -00356 ���4 DEVELOPMENT SERVICES DATE ISSUED: 12/8/2004 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S1 11 CC 03300 SITE ADDRESS: 10280 SW CENTURY OAK DR ZONING: R -7 SUBDIVISION: SUMMERFIELD LOT: 056 JURISDICTION: TIG Project Description: 198sf. addition 2 -28 -05 Elec. adds 1- 200amp serv. and 6 circuits. 3/17/05, ADDITION TO PERMIT IS (1) DISHWASHER, (1) SHOWER & (1) TOILET. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 196 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 0 THRD: sf RIGHT: 5 VALUE: 18 295.20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 196 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: co SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 7.00 SIGNAL /PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes BARTHOLOMEW, BRIAN IN YOUR HOME and all other applicable laws. All work will.be done in 16869 SW 65TH AVE #332 16869 SW 65TH AVE #332 accordance with approved plans. This permit will expire LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97224 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 Phone: 503 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 Reg #: LIC 157737 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 776.66 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Issued B : A,_ — / I / i« 1 ' Permittee Signature : (( �l�l �� ��Ct uC Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. Th , 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. CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00356 r ill DEVELOPMENT SERVICES DATE ISSUED: 12/8/2004 --- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25111 CC -03300 SITE ADDRESS: 10280 SW CENTURY OAK DR ZONING: R -7 SUBDIVISION: SUMMERFIELD LOT: 056 JURISDICTION: TIG REMARKS: 198sf. addition 2 -28 -05 Elec. adds 1- 200amp serv. and 6 circuits. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 196 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 0 THRD: sf RIGHT: 5 VALUE: 18,295.20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 196 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EAADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W /OSVCJFDR: 0/ SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 7 0o SIGNAL /PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS.AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: This permit is subject to the regulations contained in the BARTHOLOMEW, BRIAN IN YOUR HOME Tigard Municipal Code, State of OR. Specialty Codes 16869 SW 65TH AVE #332 16869 SW 65TH AVE #332 and all other applicable laws. All work will be done in LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97224 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 819 - 0245 Phone: 503 819 - 0245 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through Reg #: LIC 157737 952 - 001 -0080. You may obtain copies of these rules or TOTAL FEES: $ 776.66 direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS Issued By : . Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business 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. w, CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00356 411 DEVELOPMENT SERVICES DATE ISSUED: 12/8/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10280 SW CENTURY OAK DR PARCEL: 25111 CC - 03300 SUBDIVISION: SUMMERFIELD ZONING: R -7 BLOCK: LOT: 056 JURISDICTION: TIG REMARKS: 198sf. addition BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 196 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 0 THRD: sf RIGHT: 5 VALUE: 18,295.20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 196 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: I WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: A FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: I WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:,* 0 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp:' 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 401 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 4,420 17 SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner Contractor: TOTAL FEES: $ 646.85 This permit is subject to the regulations contained in the BARTHOLOMEW, BRIAN IN YOUR HOME 16869 SW 65TH AVE #332 16869 SW 65TH AVE #332 Tigard Mu Code, State of l work k wil Specialty o ne i n LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97224 and all ra cer applicable ed laws. All This permit done in accordance with approved plans. This permi t will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 - 819 - 0245 Phone: 503 - 819 - 0245 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 157737 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp Crawl Drain /Backwater Shear Wall Insp Final inspection Foundation Insp PLM /Underfloor ' Exterior Sheathing Insr Post/Beam Structural Plumb Top Out Electrical Final Post/Beam Mechanical Electrical Rough In Mechanical Final • Underfloor insulation Framing Insp Plumb Final 0 .0 0 4 40 I / Permittee Signature Issu•d By : g / Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day t Building Permit Ap t' ( role OFFICE US o \i 76 6 City of Tigard u` tV '�° D LiBY if 244 b1� PennitNo.:� 00L /�0DJtrp 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.19(�Q 4 2004 "' "' yi i''l i °`' Date /By (���Y • lJ OtherPennit:. Inspection Line: 503.639.4175 lul V J ,' Date Ready/By: - Juris: H See Attached Checklist for Internet: www.ci.tigard.or.us Notifiid/Method:�4 j ( �(\ Supplemental Information Y g OF O T�GARD � * 1/1/ . TYPE CIT ' REQUIRED DATA: 1- AND 2-FAMILY DWELLING. ❑ New co truction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION , - work indicated on this application. --a 2- family dwelling ❑ Commercial /industrial Valuation: $ � .:9 5, ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: •JOB SITE INFORMATION AND LOCATION Total number of floors: ��� Job site address: 0 2 V b -) C ©G--L PI , New dwelling area: / 9�.�J s feet ll - City /State /ZIP: � tX ) OIL 9'72-2-1'f Garage/carport area: / square feet Suite/bldg. /apt. no.: Project name: /v 7- Covered porch area: square feet Cross street /directions to job site: /D'f , 1( -- . Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the . DESCRIPTION OF WORK work indicated on this application. I16-0 . , �---1. og b___,,,,,„_. Valuation: $ O, g -.- Existing building area: square feet New building area: square feet .ROPERTY OWNER ❑ TENANT ' • Number of stories: Name: •l L._ + L LL_ 8-v /4 t4 ' ey v et ` — Type of construction: Address: / 6'6 % r i ,v 6, 6 T t} . # 3 3 2_ Occupancy groups: City /State /ZIP: 1_6_.Lx2,_ b .-t,J ) (Da_ q 76 3 s Existing: Phone: (, 3) 'V 1 - D2_ Fax: (Jo3) 59 77 9a New: . kiRrAPPLICANT , 0 CONTACT PERSON NOTICE ' Business name: I.v y u tr )� All contractors and subcontractors are required to be Contact name: E, 1 f ti b -t- - (�-,� 0.._,L.5" licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 1 4,4'6 9 Sc o S i-e-i& e- 3 32_ jurisdiction in which work is being performed. If the City /State/ZIP: I G-+r b applicant is exempt from licensing, the following reasons I apply: Phone: ( 5 - 63) 819 -O . y-S I Fax:: (STD ) S e- 777 o E-mail: 731"-IgH jrj cf 2 I,111 ' 101� ' CONTRACTOR Business name: Address: S � (� BUILDING PERMIT FEES* Please refer to fee schedule. City /State /ZIP: Fees due upon application 146 /1' Phone: ( ) I Fax:( ) CCB lic.: )5'7 3 Amount received '7 Date received: Authorized signature: ' • / This permit application expires if a permit is not obtained • �h within 180 days after it has been accepted as complete. Print n iriY i .1, 7011 2 1111r Date: j 1 ' .- d * Fee methodology set by Tri- County Building Industry Service Board. •i: Building \Permits\BUP- PermitApp doe 12/03 440- 4613T(11 /02/COM/WEB) One- and Two - Family Dwelling Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 A Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 /�;r ❑ Electrical ❑Plumbing ❑Mechanical 24- Hour Inspection Line: 503.639.4175 I,l,' , Internet: www.ci.tigard.or.us 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. ❑ ❑ ❑ 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. ❑ ❑ El 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- ❑ ❑ ❑ basin protection, etc. , 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ 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. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4-fl. 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- ❑ ❑ 0 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. 0 ❑ ❑ 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 Cl ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 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." 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 ❑ ❑ ❑ 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•on and shall be shown to be ap plicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 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 tree protection measures as required by conditions 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. I:\ Building \Permits\BUP- RES- PermitApp.doc 2 Mechanical Permit A , . FOR OFFICE USE O Y . City, of Tigard Date/By: Permit No.. _ 13125 SW Hall Blvd., Tigard,`OR 7223 y 044 Plan Review Phone: 503.639.4171 Fax: 503.598. 2 4 2004 �errdyu Date/By: Other Permit: Inspection Line: 503.639.4175 N ��W Date Ready/By: Jun El See Page 2 for Internet: www.ci.tigard.or.us Y ���� OF - VIGpBD Notified/Method: Supplemental Information D F WORK 'N �lLiTP O COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction Ad dition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* .. „.0 -.. - 1 - - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating /cooling Job site address: 16'Z p 0 C� t C , (�, Air conditioning or heat pump O f� � I (requires site plan showing placement) 14.00 City/State /ZIP: ./ A (�//L 9 7 22 L- Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: l Project name: 1 b'Ze D Gas heat pump 14.00 1 IN Cross street/directions to job site: 1 D 0 Utr k6 , Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 L n Gas fireplace 10.00 d `�' �� Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 &)tQvIA- ,u Lr V) 6V-__ M i Wood/pellet stove 10.00 Wood fireplace /insert 10.00 ❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 10.00 Other. 10.00 . Name: im LkiLe.4f L_L- C___ & �lt� o O L&e.A. Environmental exhaust and ventilation Address: /6 00 s , J & _ '-e 4 k 3 3 Z Rangehood/other kitchen equipment 10.00 City/State /ZIP: LryLt_ ©$` -t.).e c s,p Oa y-7 2....2_y- Clothes dryer exhaust 10.00 `L 0 Single -duct exhaust (bathrooms, Phone: ,,--, 3 1 t '- 7 b 2 S : a.: (s 5 -77 0 toilet compartments, utility rooms) 6.80 1LICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: LA VD 0 I ( e Fuel piping Contact name: / a to V 1.0 iM. e.t. $5.40 for first four; $1.00 for each additional Address: j to g b ! 5 le, g 4 3 32-- Furnace, etc. Gas heat pump City/State /ZIP: Q r) guo.e �� ) b q76 3 S' Wall /suspended/unit heater Phone: (5t3) 8l�( - ©2 V� Fax: :('ro3) -77/ G b Water heater 1 _ t Fireplace E -mail: tr i ( IA 1 t 1 I t Nil Range CONTRACTOR Barbecue Business name: ' v ` Clothes dryer (gas) 5Y / Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: ! 5 7 73 7 State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized �gnaturex r This permit application expires if a permit is not obtained within 180 ! / days after it has been accepted as complete. Print nam F , / ff����� P I , M Date: /J 2.9- D * Fee methodology set by Tri -County Building Industry Service Board Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $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 12/03 2 Electrical Permit A 1iet1VE® TO P R OFrlct USE. ONI Y City of Tigard Received . Permit No.: g _ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Nov 2 4 2004 0<,-rp. 'I' �. Date/By. Other Permit: Inspection Line: 503.639.4175 „Al; = _ _-, Ready/ By: Read : Juris: ® See Page 2 for Internet: www.ci.tigard.or.us GM( O�(F� Notified/Method: Supplemental Information PLAN REVIEW ❑ New construction Addition/alteration/replacement Please check all that apply: El Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential d 2 family dwelling ❑ CommerciaUindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: /02,8 gu $ p ) D�Lti-�'(,t�t.., �- , ❑Health -care facility ❑Other: , / 11 Submit 2 sets of plans with any of the above. City/State/ZIP: 170/y�_� 0 9 7 '2,----V The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: 1 [T p FEE* SCHEDULE t Description I Qty. I Fee. I Total I *• Cross street/directions to job site: / D { v irk..6- ._--______ New residential single or multi family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular . /2 Q � �_\ r f _�� 1 l dwelling, service and/or feeder 90.90 2 (��/ - kb Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 f � 401 amps to 600 amps 160.60 2 Name: to..� I,J £ (j L L P-�J � ” l oI 14 l ✓ --/- o/ 1, C 601 amps to 1,000 amps 240.60 2 Address: / 4 8 t!j 9 ) 51-0 C c r $z'. _ W - 3 7/ Over 1,000 amps or volts 454.65 2 n Reconnect only 66.85 2 City / State/ZIP: /;G o _ b a-t �-1`Q / D 12 7 7D ' Temporary services or feeders installation, alteration, and /or 3 8/ 9* y 3 .9 8 7? 0 relocation Phone: (s c ) (� Z Fax: (�O ) 7 200 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 600 amps 133.75 2 Owner signature: _ --- Date: Branch circuits - new, alteration, or extension, per panel LICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each .. 6.65 2 Business name: �� cAk_ �_. b cir l B. Fee for branch circuits Contact name: �o-tr-/--1,` without service or feeder fee, 46.85 2 Address: /t S6 du- 6 s- ` Ave- 33-/-- each branch circuit Each add'I branch circuit / 6.65 2 City / State/ZIP: A__c_ D , D Oa_ CP 3S Miscellaneous (service or feeder not included) Phone: (9 7 j) 8) `� -O9.--( _ : (fi ) 591?" 77 / d Pump or irrigation lighting circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuits) or limited CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: W I l 5.0-1,1 V 1 � % i -1--- - / , .2L / L Address: A Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: /A ll • 4e... 6 D-2 o Investigation per hour (1 hr min) 62.50 Phone: ( 1 b`))' - S.35-5 Fax: ( ) Industrial plant per hour _ 73.75 7.57 S2-^ ELECTRICAL PERMIT FEES* CCB Lic. Electrical Lic.: 3"'3 07 C.. Suprv. Lic.: ' .g5'/ 5 Subtotal Suprv. Electrician signature, required: 7A1 P ,.4 4 Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. is\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(l 0/02/COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: • [ COMMVRCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required • for all other installations iA Building \Permits\ELC- PermitApp.doc 04/03 Plumbing Permit Application F OR OFFICE- USE ONLY' City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Plan Review Phone: 503.639.4171 Fax: 503.598.1960 D�riNd +i\ Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 ! �,� c! I Date Read B Juris p See Page 2 for Internet: www.ci.tigard.or.us ` "" Ready /By: g g Notified/Method: Supplemental Information + ' =t , , a'. MAt. ;..3s..r-- .: <urna�.i±tlE'1 .-,: �::t"" t�,yi.'.'.'k'-`S � =:3 ».v`:�'C,, .o,� - r - .. _.��. >�, ET, RK:��. �„•, , 4 . FE a., ;SCHE LIL a � , �,x.2N.�s,.:,'.��.,a wEr..-.,,, �_. C: a•<. �.. �..,. �.. 1 - rt. �p wMsa�}. �. u, uA. e. ���.„• ». "E,.a*,r.u- c�:^a...•pa;�.. •{k,;> .. u.,,..,-. s::: ar<` ih... �.,. t. .. , 3S:' a.: t:;;, fi .» x. ; ,,. ^§rza,r:;a ^ra.a,:.•: ,..-. , ,. ., .. . ❑ New construction • ❑ Demolition For special information use checklist. Description 1 Qty. Ea. Total Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) fjjk RA'I ., 'CO P` "' E 11 . r .• . SFR (I) bath 249,20 ,,- 1 nd 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 El Master builder ❑ Other: Each additional bath/kitchen 45.00 Fire sprinkler ( sq. ft.) Page 2 y` 4 v .IOB SITE RMA' T,IO ,A`ND u TION a t �4 . :-: �, ".•,$ --� =ate � t aka.. 4 -1 Site utilities Job site address: / 0 2 g U .) C. 4..A., - LAP- .4. , Catch basin or area drain 16.60 City/State /ZIP: ! I J j - 4 c i 72.-Z_ / Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: / d2- g p Footing drain (no. linear ft.: ) Page 2 ` 1 �-7 Manufactured home utilities 110.00 Cross street/directions to job site: / b l tG r Manholes 16.60 ( Rain drain connector / 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: • . n i DESCR liiii V4 W'OR " ' �s ` % t Absorption valve 1 .60 6 .. 14,.:L_ :: „.v i_ . ,.,_ a:�..,_ : .°o n-t. , „ 0, Backflow preventer Page 2 ' ati - t-4-• - -k, el C Backwater valve 16.60 Clothes washer 16.60 D ash er • 16.60 Y: s _ ik �,~� „ �z . �t •nking fountain 16.60 .. , .., 4:ROPERIWNE q g .i itj4 1 1't trots /sump • 16.60 Name: I, L- ) -/- LL- � ► tp � 1 Ave pansion tank 16.60 Address: 1 L86,9 O� to s W 33 Z,- Fixture /sewer cap 16.60 City/ State/ZIP: L_� 0 6,,,,,..). Dif2 _ �� 7a 3 .S--- Floor drain /floor sink/hub 16.60 Phone: o q r Garbage disposal 16.60 (��J) 8� -b2� Fax: s�/O 77�fl :4 r x y i ' GQN T'ACTPERSON # Hose bib 16.60 ' M ' "``fr >` Ice maker 16.60 Business name: y ,a_ Interceptor /grease trap • 16.60 Contact name: `F (q 1 Medical gas (value: $ ) Page 2 Address: 1 L 8 0 5-co ( S -- t - - -- )4.i - 33 i 2 Primer 16.60 City/State /ZIP: .-Ct.0___. Qt�l 3 t /2_ _ 9 7 p 3 Roof drain (commercial) 16.60 t/.asin /lavatory / 16 60 Phone: (517 g l9 -- b 2-4 S Fax:: ( ..c. , 3) ,s -7 79c u b /shower /shower pan 16.60 E -mail: 16.60 � K 10 1 u k t 10 / U rinal a Af� 4 ` - Z t _3��,. , b C'I Jt4 . i, <, . t it il Water closet 16.60 Business name: 61 0 )t _Q '7 .t,._•_1�t�- Water heater 16.60 Address: 1/ D77 L) ' 1 S Other: Subtotal City/ State/ZIP: 3 y Q 0g 9 '7 -2 1 Minimum permit fee: $72.50 Phone: ( Sb3) 4,•'2,0 gy'] f Fax: (6 ) 9 6. -7 3 j d Residential backflow minimum permit fee: $36.25 CCB Lie.: 3 O O g J Plumbing Lic. no.: 3 - / 28 P8 Plan review (25% of permit fee) Authorized signature: State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i:\Building\Permits\PLM- PermitApp.doc 12/03 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: _� - _ �`, ;r %v 3 ,*' ? l �. k;.x*' ``r `ee =(ea 5`rOtals . :. „.. .. . >; ;. - . -.. • Site ITtil><tres�, . _ } . .: > . �Squa i giVQ9tag.gz: _ „ pr.,mit Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 < _ valuatrou=: ;; Per!nit Fee ,_ 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 -; r, _ °f : �--r,,.,;��a ,a;: g ; 4 - additional $100.00 or fraction thereof, to and 1X Rric: Or A MI : ` ; < Y .._<'., X Cotal r_ a.r.. �° 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. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . . _ E Qu nttEy liy (F►xiuie) Work PerfnMned Frxtuz a l Re ;,.^ 4 � 4 a �, Replace a 'SOYA ids Mowti Ewshn1 ea, W Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower • - Jacuzzi/Whirlpool • Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash ' Floor Drain /sink - 2" -3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach./Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall • Sink - Bar /Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i .\Building\Pemtits\PLM- PermitApp doc 3/03 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WILSONVILLE ELECTRIC INC PO BOX 845 WILSONVILLE, OR 97070 Electrical Signature Form Permit #: MST2004 -00356 Date Issued: 12/8/2004 Parcel: 2S i 11 CC- 03300 Site Address: 10280 SW CENTURY OAK DR Subdivision: SUMMERFIELD Block: Lot: 056 Jurisdiction: TIG Zoning: R -7 Remarks: 198sf. addition Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: BARTHOLOMEW, BRIAN WILSONVILLE ELECTRIC INC 16869 SW 65TH AVE #332 PO BOX 845 LAKE OSWEGO, OR 97035 WILSONVILLE, OR 97070 Phone #: 503 - 819 -0245 Phone #: 503 - 638 -5353 Reg #: MET 00002128 SUP 3854S LIC 75752 ELE 3 -307C AN INK SIGNATURE IS REQUIRED ON • M ignature of , pervising Electr /an If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GLOBAL PLUMBING MAR 15 2005 NEDJO MARKANOVICH 11077 SW 81ST AVE CITY OF TIGARD TIGARD, OR 97223 -8454 BUILDING DIVISION Plumbing Signature Form Permit #: MST2004 -00356 Date Issued: 12/8/2004 Parcel: 2S 11 1 CC -03300 - Site Address: 10280 SW CENTURY OAK DR Subdivision: SUMMERFIELD Block: Lot: 056 Jurisdiction: TIG Zoning: R -7 Remarks: 198sf. addition Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: BARTHOLOMEW, BRIAN GLOBAL PLUMBING 16869 SW 65TH AVE #332 NEDJO MARKANOVICH LAKE OSWEGO, OR 97035 11077 SW 81ST AVE TIGARD, OR 97223 -8454 Phone #: 503 - 819 -0245 Phone #: 503 - 620 -8971 Reg #: LIC 38881 PLM 34 -128PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call 503.718.2433. CITY OF TIGARD BUILDING DIVISION 41A,,,; . PERMIT #: MST2004-00366 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/8/2004 o l Phone: (503) 639-4171 nlivilltll Inspection Requests (24 Hrs.): (503) 639-4175 LARI- 't .... INSPECTION WORKSHEET FOR DATE: 813117006 TIME: 7 PAGE: 56 SITE ADDRESS: 10280 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 056 TYPE OF USE: PROJECT NAME: BARTHOLOMEW DESCRIPTION: 198sf. addition 2-28-05 Elec. adds 1-200arnp serv. and 6 circuits. 3117106, Addition (1) dishwasher, (1) shower, (1) toilet. 5/12/05: Add: Gas fireplace wlgas piping. OWNER: BARTHOLOMEW, BRIAN, PHONE #: 503-819-0245 CONTRACTOR: IN YOUR HOME PHONE #: 503-819-0245 Inspection Request Scheduled For: Date: 8/31/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 014664-01 503-819-0245 Y Corrections /Comments / Instructions: ' • ,. ./1_ , PASS 11 PARTIAL CANCEL F I NO ACCESS n FAIL I/ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: dr Date: Phone #: (503) 718- - _ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00356 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/112004 Phone: (503) 639- 4171ugm�il� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/31/2006 TIME: 7 :03AM PAGE: 65 SITE ADDRESS: 10280 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 056 TYPE OF USE: PROJECT NAME: BARTHOLOMEW DESCRIPTION: 198sf. addition 2 -28 -05 Dec. adds 1- 200amp serv, and 6 circuits. 3/17/05, Addition (1) dishwasher, (1) shower, (1) toilet. 5/12/05: Add: Gas fireplace w /gas piping. OWNER: BARTHOLOMEW, BRIAN, PHONE #: 503-819-0245 CONTRACTOR: IN YOUR HOME PHONE #: 503 - 819 -0245 Inspection Request Scheduled For: Date: 8/31/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 014623 -01 503 - 819 -0245 Y Corrections/Comments/Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL . ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Date: ). /M Phone #: (503) 718- r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00356 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •2/8/2004 Phone: (503) 639 -4171 /nM �uYN� +� Inspection Requests (24 Hrs.): (503) 639-4175 °'I1. INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7 :07AM PAGE: 16 SITE ADDRESS: 10280 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 066 TYPE OF USE: PROJECT NAME: BARTHOLOMEW DESCRIPTION: 198sf. addition 2 -28-05 F_lec. adds 1- 200amp serv. and 6 circuits. 3/17/05, Addition (1) dishwasher, (1) shower, (1) toilet. 5/12105: Add: Gas fireplace w /gas piping. OWNER: BARTHOLOMEW, BRIAN, PHONE #: 503.819 -0245 CONTRACTOR: IN YOUR HOME PHONE #: 503 - 819 -0245 Inspection Request Scheduled For: Date: 8/30/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 014598 -01 503 - 819.0240 Y Corrections /Comments/ Instructions: V4. P A S_ S II PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL /, ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector. Date: Phone #: (503) 718- ii& CITY OF TIGARD .- BUILDING DIVISION PERMIT #: MST2004 -00356 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/8/2004 Phone: (503) 639-4171 � A «��r gmllgipn � I nspection Requests (24 Hrs.): (503) 639 -4175 ' "I_�.. INSPECTION WORKSHEET FOR DATE: 6/28/2005 TIME: 7:09AM PAGE: 3 SITE ADDRESS: 10280 CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 056 TYPE OF USE: PROJECT NAME: BARTHOLOMEW —� DESCRIPTION: 198sf. addition 2-28-05 Elec. adds 1- 200amp serv. and 6 circuits. 3/17/05, Addition (1) dishwasher, (1) shower, (1) toil .. -- - 'replace w /gas piping. OWNER: BARTHOLOMEW, BRIAN, PHONE #: 503 - 819 -0245 CONTRACTOR: IN YOUR HOME ,P C iclz.- OOP PHONE #: 503- 819 -0245 Inspection Request Scheduled For: • = 6/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 010335-01 971 - 563.5390 Y Corrections /Comme is /Ins ctions: n n �{ , C (L,O N ‘ _ . ^ �► 1 Z� . c a ,c1 t CA 1?),A Os ,, NA c. `(L. ‘,bt. V tak S - 1 \ t) • p Gr o " ' e. ■ ' 'IL w1 ' % o G k:b • 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: F--- �i Date: Z� _ Phone #: (503) 718-