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Permit ,,' 4 MASTER PERMIT CITY oF T I G A R® PERMIT #: MST2005 -00352 �11 ' , DEVE H P r S ORV 2CES 639 -4171 DATE ISSUED: 10/28/2005 PARCEL: 2S 103DA -05100 SITE ADDRESS: 10635 SW COOK LN ZONING: R - 3.5 SUBDIVISION: FANTASY HILL LOT: 008 JURISDICTION: TIG Project Description: Shop attached to house with breezeway. 14' BUILDING REISSUE: CUSTOM ` STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NE o HEIGHT: 15 FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: TYPE OF USE':' SF FLOOR LOAD: 40 SECOND: sf GARAGE: 1,200 sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: 5 VALUE: 45 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 2 CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: • MECHANICAL FUEL TYPES FURN < 100K: 0 BOIL/CMP < 3HP: VENT FANS: 1 CLOTHES DRYER: OTH FURN > =100K: UNIT HEATERS: 1 HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 2 0 - 200 amp: W /SVC OR FDR: 6 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W /OSVGFCR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: ' AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes IRENE MAWH IRTER J B FAB & SERVICE and all other applicable laws. All work will be done in 13960 SW 100TH AVE. 3823 FIRST ST. accordance with approved plans. This permit will expire TIHGARD, OR 97223 HUBBARD, OR 97032 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: 503 981 - 1933 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 166887 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 1,320.25 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Permittee Si nature v— Issued By : A .c Awe 4 �� g . Call 503 -639 -4175 by 7:00 a.m. for an inspection that business thy. 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. ' Zl Buf iain Permit A Application .FOR O F F ICE USE ONr Y ` City of Tigard ,✓ Received r 'f s�' Permit No.: - �♦ 4,01/435-2-- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.59 U *4,, /B1p��J 4 , ' Date/By: p5 Other Permit: 11`A I . � 2005 II: '� i A,) iv - 25 Inspection Line: 503.639.4175 _! �' _. Date Ready/By: Juris: ® See Attached Cnecidist for Notified/Method: Supplemental " ---- Internet: www.ci.tigard.or.us pp lemental Information " CITY OF �TI�GARD %N ® . , V�� r� 01 • REQUIRED DATA: P- AND 2- FAMILY DWELLING a • ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. a • Indicate the value (rounded to the nearest dollar) of all 0 • dditio ':Iteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the r CATEGORY 'OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ o0. ®U Accessory building ❑ Multi- family Number of bedrooms: o > • L] Master builder El Other: Number of bathrooms: JOB. SITE INFORMATION AND LOCATION Total number of floors: / Job site address: / b 6„ 3 5 5.ou , e-OB ik Liu New dwelling area: square feet City /State /ZIP: I'-I G q,ir/J9 a �a '911 3 Garage /carport area: i square feet _`4 5 , Suite/bldg. /apt. no.: .� Project name: G, f Fib s A 514, Covered porch area: square feet Cross street /directions to job site: '� - to a. - r '4 , --, 0 ,� , („ 14.-••• • Deck area: square feet rt { I V' Other structure area: square feet �f'V� (1 be? � !`-�fl �� ��I7� rtd'0�-' Mel � 3�> � . �� � q k` �s e...^. i .L ( 4° REQUIRED DATA: COMMERCIAL-USECHECKLIST Subdivision: - V{._�S N N 1 ', ` Lot no.: /) Permit fees* are based on the value of the work performed. ` Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: C I7 2 S 63 b* 5 f d� ® equipment, materials, labor, overhead, and the profit for the 17 DESCRIPTION OF WORK ' ° - work indicated on this application. ' Valuation: $ pi tip etA A It 4 `1-7) Phr-m. t.At_Low `V-r, 104,4.4 .¢-n.., �-r h Va4Yi Q A (i.a.. F�(",1 IT Existing building area: square feet • e I New building area: square feet A-.4 -- 7 - 1 .4- 3 � 4.0 �. ,P g PROPERTY' ❑ TENANT Number of stories: Name: i _ 01 p� h F `1 1 .1...e t ,— Type of construction: N Address: /3 7 ' + ) 1 t0 eil c „� p _ , Occupancy groups: City /State /ZIP: L r Q q ) a�� Existing: Phone: (5 p3) (03 c(%^0, 616” Fax: ( ) New: L APPLICANT - gCONTACT PERSON NOTICE n Business name: al 8, '4,6 , t 6 .6r . 0 ` 61.4 All contractors and subcontractors are required to be V ) Contact name: bA_R.. -c..A. 2 ji.M 4,S licensed with the Oregon Construction Contractors Board f under ORS 701 and may be required to be licensed in the • Address: e j 2„ g h j. e jurisdiction in which work is being performed. If the Cit City/State/ZIP: / / applicant is exempt from licensing, the following reasons Y iitt dvi , /NZ , 9 -7� g 2- apply: Phone: ('5 5) q� 9 - ` r 3 Fax: : ( ) S/i i � E- mail: iv) pj�� < u 5 . CONTRACTO ' Business name: 8 � � EaL ��� uoi, BUILDING PERMIT FEES* Address: AF a. 3 ,"4-1A, S't- - Please refer to fee schedule. City /State /ZIP I L� P , 6 k_,- g -� l , Fees due upon application Phone: (S' j ) 95 /„..) ! � 33 Fax: ( ) / ��G -, -.mac.— Amount received CCB fie.: 3 3 n r . ie if 88 - 2 /oh 7/o7 Date received: Authorized signatur"6�,\� �°" This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: DIV CZ B 441,1-14 Date: 6/22/115" * Fee methodology set by Tri- County Building Industry " Service Board. i:\ Building \Pernsits\BUP- PermitApp.doc 12/03 440 -4613T(tt /O2/COM/WEB) :, • One- and Two- Family Dwelling r` :� Building Permit Application Checklist FOR OFFIC USE ONLY • C1},�, an of Tl d R eceived `� g Date/By: Permit No.: j . 13,125 SW Hall Blvd., Tigard, OR 97223 Associated permits: 24- Hour Inspection Line: 503.639.4175 u . I1 Plumbing Phone: 503.639.4171 Fax: 503.598.1960 �� 0 ❑ Plumbin Mechanical l „. l Internet: www.ci:.'gard.or.us "”' ❑Other. . THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No ' N/A 1 Land use actio completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood p :in, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of a r 1 oved r Iat/lot. ❑ ❑ ❑ 4 Fire district a • r rov. re' uired. Name of district: ❑ ❑ ❑ 5 Se r tic s stem r ermit a authorization for remodel. Existin• s stem ca.acit • ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ . , - 8 Soils report. Must carry original applicable stamp and signature on file or with applicaf en. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ p it required. Include drainage -way protection, silt fe'' ce design and location of catch- ❑ ❑ ❑ protection, etc. /• ., 10 ( c omplete sets of legible plans. Must be drawn to scale, showing conform. • to applicable local and state ❑ ❑ ❑ • ding codes. Lateral design details d connections must be incorporated i . the plans or on a separate full -size sheet attached to the plans with cross re rences between plan location and d ails. Plan review cannot be completed if copyright violations exist. \ 11 Site /plot plan drawn to scale. The plan m ,t show lot and building se •ack dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differenti. , .Ian must show conto lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including .; cks); location of 'lls /septic systems; utility locations; direction indicator; lot area; building coverage area; percen 13 _e of coverag:, impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, . , hold -.owns and reinforcing.pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, dow size, location of smoke detectors, water heater, ❑ ❑ ❑ N furnace, ventilation fans, plumbing fixtures, balconies .. d .: ks 30 inches above grade, etc. ' 14 Cross section(s) and details. Show all framing -me .er size d spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More t one cross .ection may be required to clearly portray construction. Show details of all wall and roofs • athing, roofing, oof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, rmal insulation, etc. 15 Elevation views. Provide elevations for new onstruction; minimum two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual I .de if the change in grade i :, eater than four foot at building envelope. a Full -size sheet addendums showing found. ion elevations with cross refer ces are acceptable. i 16 Wall bracing (prescriptive path) and /r lateral analysis plans. Must in• ate details and locations; fo'r non • - ❑ ❑ ❑ prescriptive path analysis provide spec' 'cations and calculations to engineeri •• standards. - + 17 Floor /roof framing. Provide plans •r all floors /roof assemblies, indicating me ber sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. ' ovide cross sections and details showing placem: t of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer' calculations." ''+, 19 Beam calculations. Provide , o sets of calculations using current code design values ■ all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any +eam /joist carrying a non - uniform load. . t 20 Manufactured floor /roof • uss design details. 0 ❑ . ❑ 21 Energy Code complian •. Identify the prescriptive path or provide calculations. A gas -pipi ,• schematic is required ❑ ❑ ❑ for four or more appli. es. \ 22 Engineer's calculatio s. When required or provided, (i.e., shear wall, roof truss) shall be stampe.• by an engineer or ❑ ❑ ❑ architect licensed in 0re•on and shall be shown to be ...livable to the .ro'ect under review. • JURI SDICTIONAL SPECIFICS ` ;`• , ` 4 ® Five (5) site plans . e required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17". \ ,x ❑ 0 0 r Two (2) sets eac' are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans : all not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" b (ding plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ -4 " 27 `"Drawn to sc le" indicates standard architect onengtneer scale ❑ ❑ . ❑ 28 Site plan to in de tree size, type and location per approved project street tree plan (if applicable), and City of Ti • . a ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. . • ' ' ' ' ❑ ❑ ❑ i, 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- PermitApp.doc 2 'Mechanical Permit Application FOR OFFICE USE ONLY 'C. iBe ,p r Tg _Q0 35 City of Tigard Received Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR' 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 „,„,A,,,„,,,,.,, Date /By. Other Permit: Inspection Line: 503.639.4175 J� elk, Date Ready/By: Ju s ® See Page 2 for li Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK , COMMERCIAL FEE* 'SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction J&,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: $ 1:1 1 - and 2 dwelling RESIDENTIAL =EQUIPMENT`/ SYSTEMS FEES* y g ❑ Commercial /industrial yi A ccessory building For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: . Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating /cooling T Air conditioning or heat pump Job site address: 1 5 (� ') f �j ®� ^' (requires site plan showing placement) 14.00 City /State /ZIP: "f44 1 ( /} � V . . q 7 22 3 Furnace 100,000 BTU (ducts /vents) 14.00 ( l f V r/ /� � � Furnace 100,000+ BTU (ducts/vents) 17.90 f Suite/bldg. /apt. no.: Project name: d71�V� Gas heat pump' 14.00 Cross street /directions to job site: Gjt� W � \ 04 S to r.-� - Duct work 14.00 n (, t & � 6 tl 6-K ` e t R eside n i hot water ad 14.00 •P l K, vi/ - t� � Residential boiler (radiator or i1 �1- `- 0 14.00 Unit heaters fuel -ty e, n electric), I in-wan, in-duct sus en tc.� ' 10.00 • Flue /vent for any o e 10.00 Subdivision: 4 -0.4A,6r 414, Lot no.: b Other: 10.00 Tax map /parcel no.: r� � r1Q� zs(b 3 /),4.- o 6100 Other fuel appliances . DESCRIPTION OF WORK . ' Water heater I 10.00 �� �' ' LK'` Gas fireplace 10.00 L Flue vent for water heater or gas � ` ` � � _) fireplace 1 10.00 7� O ' Log lighter (gas) 10.00 i / ” Wood/ pellet stove 10.00 i Wood fireplace /insert 10.00 ❑ PROPERTY OWNER I ' ❑ TENANT Chimney /liner /flue/vent 10.00 ` Other: 10.00 Name: P.�. nit t n 44-.4 4/' Environmental exhaust and ventilation Address: 1 '3 4 (p 6 �J t. , , ( 17-11"1 Range hood/other kitchen • equipment 10.00 City /State /ZIP: —t4 c ,1",v OIL 2 q7 - Clothes dryer exhaust 10.00 "" Single -duct exhaust (bathrooms, Phone: (6D'3) 403 - ti. ils" Fax: ( ) toilet compartments, utility rooms) 1 6.80 ❑ APPLICANT - ❑ CONTACT PERSON Attic/crawlspace fans 10.00 . Business name: J.lb , t -(2 40 V f \ viL�_ Other: 10.00 ' "v " `'V Fuel piping Contact name: Cl Affil,{ QY i 6 A - $5.40 for first four; $1.00 for each additional Address: ? L I a d 1 . g }- j +- , Furnace, etc. 7 Gas heat pump City /State /ZIP: h c " A,� '�� iY/C13)2___ . -! D3 2 Wall /suspended/unit heater �g 131 Id? " 3 V . t I Fax:: ( ) Water heater Phone: (c — ,,,� Q V I' ( j b `. D w 1 5 �L! d ' Rangeace E -mail: CONTRACTOR . Barbecue Business name: Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal • Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB - 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: D AA 1 13 ,, f _ k „.. 4 Date: / -/r 0/ 5• s Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Pennits\MEC- PermitApp.doc 12/03 440 -4617T ( 1 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Su 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 ereof, to and including $5,000.00. $5,001.00 to $10,000.00 $1 .50 for the first $5,000.00 and $1.80 • r each additional $100.00 or fraction , ereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for th; first $10,000.00 and $1.35 for each a• •itional $100.00 or , fraction thereof, to :nd including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $51,100.00 and $1.25 for each additional ', 10.00 •. fraction thereof, to and inclu• _• $100,000.00. $100,000.01 and up $1,396.50 for the first $100,0 W.00 a d $1.10 for each additional $ 10.00 or fraction thereof. Note: All new commercial buildings re I ire 2 sets of plans. i:\Buildin PermitApp.doc 12/03 2 ' Building, Fixtures . Plumbing Permit Application • l:OR OFFICE, USE ONLY' City of Tigard De/Bey Permit No.:C 13125 SW Hall Blvd., Tigard, OR 97223 00353..... Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Ger� „f ; � '. ? ;\ Date/By Other Permit No.: 24- Hour Inspection Line: 503.639.4175 '' I Date Ready/By: Jens: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental TYPE OF WORK FEE* SCHEDULE . For special information use checklist. • Description I Qty. I Ea. I Total ' ' ' ' New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) CATEGORY OF a SFR (1) bath 249.20 cT- ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 A Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 , JOB SITE INFORMATION AND LOCATION Site utilities Job site address: f 6 6,,,,s , 6 , A Catch basin or area drain 16.60 • City /State /ZIP: 77 .42 44 -A i , 07 e Drywell, leach line, or trench drain • 16.60 Suite/bldg. /apt. no.: I Project name: h 4, '� Footing drain (no. linear ft.: ) Page 2 s7 I �y t, i tl , Manufactured home utilities 110.00 Cross street/directions to job site: is 5r J� c/ pp ✓ Manholes 16.60 (ter, an, ,4 h b'B .'`j' l 6°I, min LSO !x t . ` Ys Rain drain connector 2 16.60 33.a g l e - A i -a? kc ern 2 1 -4 a Sanitary sewer (no. linear ft.: ) Page 2 1. Storm sewer (no. linear ft.: 0, - ) Page 2 5 . '. r-, Water service (no. linear ft.: ) Page 2 Subdivision: , G41,4•10t. ,ge , •I I Lot no.: \j Fixture or item Tax map /parcel no.: ex itd, gsb 2, 5 ,0 3 /0574 0 Absorption valve 16.60 DESCRIPTION OF WORK Back flow preventer Page 2 r. 1 3/9-1 i h a i,.e. /6-,/ , Backwater valve 16.60 V ,i! . I Clothes washer 16.60 t Dishwasher 16.60 Drinking fountain 16.60 PROPERTY OWNER, ❑ TENANT � Ejectors /sump 16.60 Name: `rte[ ILA p ,� a . If°°° E xp a nsion tank 16.60 Address: �� r 3 1 6' 0 , 1 co 41 4„... ., Fixture /sewer cap . 16.60 City /State /ZIP: - 9' -2.,z- Z Floor drain/floor sink/hub / 16.60 /44 to Phone: ("0,5) ( i 34 p 9 (.`9a- -2.,z- Fax: ( ) / Garbage disposal 16.60 Hose bib 16.60 ,,© APPLICANT ❑ CONTACT PERSON Ice maker 16.60 • Business name: 42", pAib a - i� Interceptor /grease trap 16.60 • Contact name:1 At'i$°J$ Biel-24-h Medical gas (value: $ ) Page 2 Address: -3g2_3 'Fl 1 , s 4- . 5 -1- . Primer 16.60 City /State /ZIP: 1' ��06f t o 0 g °3� Roof drain (commercial) 16.60 Zl �! 7 Sink/basin/lavatory / 16.60 i i s Phone: ( 6 03 E I q i 3 3 Fax.. ( ) h 4 Tub /shower /shower pan / 16.60 /L, IT E -mail: A R'hftr� � ,� Urinal 16.60 � °` ,CONTRACTOR • � / • Water closet 16.60 id ® t Business nam ? � A . t ,• _ Water heater / 16.60 e J ) f Address: Other: City /State /ZIP: Subtotal / 7/, ,20 Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) / 3. 7 Authorized signature: 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. is \Building\Pernits\PLMF - PermitApp.doc 06/05 440 -4616T(10 /02/COM/WEB) d Plumbing Permit Application - City of Tigard , Page 2 - Supplemental Information `' ` • Fee' Schedule: Residential Fire Suppression Systems: Site Utilities Qt F (ea) Total: , Footage :.. , , Permit F ee:_ - • 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 1 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - I t \\ 100' 55.00 Medical Gas Systems: • Water Service - each\additional 100' 46.40 Valuation: Permit-Fee: Storm & Rain Drain - t 100' 1 55.00 j S $1.00 to $5,000.00 Minimum fee $72.50 _ Storm & Rain Drain -eac additional 100' 46.40 $5,001.00 to $10,000.00 $72:50 for the first $5,000.00 and $1.52 for each Fixture,or Item • Qt Fee (ea) Total additional $100.00 or fraction thereof, to and Commercial Back Flow Preven • s n Device 46.40 including for the • 1 t� $10,001.00 to $25,000.00 $148.50 for the • t $10,000.00 and $1.54 for Residential Backflow Prevention D •vice each addition. 100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and inclu g $25,000.00. Rain Drain, single family dwelling ' 65.25 $25,001.00 to $50,000.00 $379.50 ' or the first $25,000.00 and $1.45 for Inspection of existing plumbing or eac . dditional $100.00 or fraction thereof, to specially requested inspections - per hour 1M 72.50 including $50,000.00. Subtotal: $50,001.00 and up '.742.00 for the first $50,000.00 and $1.20 for A each additional $100.00 or fraction thereof. / • Fixture Work: • Plan Review for Co Structures ' " Are you capping, adding or replacing fixtures? I `yes ", - "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure , i system that meets any of the following criteria. accurately report fixtures could result in increased se r fees* Please check all that apply. Quanti by (Fixture) Work Perform ❑ Any new commercial building. Fixture Type: Replac ❑ Any new exterior plumbing site utilities. Previous Capped Added... - Existiu . ❑ . A commercial building with installation, alteration or addition Baptistry /Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi /Whirlpool providing services to human beings. Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service -Drive Thru , facilities where new plumbing fixtures, including interceptors, Cuspidor /Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ 4 y new residential building containing three (3) or more -Domestic Fr d elling units. Drinking Fountain ❑ An PA 13 -D multipurpose fire sprinkler system. Eye Wash Floor Drain /sink 2" S i mit 2 sets of plans with any of the above. 3" ,.. 4" Car Wash Drain Is metric or R i s er Diagram Garbage -Domestic • II Isometric or 'ser diagram is required for new buildings Disposal - Commercial A three (3) or ma .e stories in height. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regardi 1 : fixture work: Rec. Vehicle Dump Station • Shower -Gang -Stall . Sink - Bar/Lavatory • - Bradley - Commercial - Service Swimming Pool Filter . Washer - Clothes Water Extractor *Note: If the fixture work under this , ermit results in an Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: - plumbing permit can be issued. • i:\ Building \Pennits\PLM- PennitApp.doc 07/06/05 . t MAY -24 -2007 09:31P FROM: BADGER ELECTRIC, INC 503 -493 -7173 TO: 5035981960 P.1 ••■■••• aar•• 1 era saps.. a a.9,„araay..M..avaa • City of Tigard raztil permit No.- j a pp5- pD &6.aZ- 13125 SW Hall Blvd., Tigard, OR 972 Firm Review Other Fermis Phone: 503.639.4171 Fax: 503.598.1960 MAY 2 5 ZOO - - ' r ' Date/By: Inspection Line: 503.639.4175 .vii, >, 1I: Date Ready/By runs: Ea see Page 2 for Internet www.ci.tigard.or.us Q�iATV Or r i ' PnRot�, Notified/Method: - � i Supplemental Information - �iAb^!a7t,I $QOP1A' *b$1flSION PLAN REVIEW ❑ New construction Addition/alteratioNfeplacement Please check all that apply: ^' Y a K ❑Service over 225 amps, comtn'I ❑Hazardous location ❑ Demolition ❑ Other ❑Service over 320 amps - rating 0l3uildng over 10,000 sq. ft., CATEGORY OT CONSTRUCTION of I- and 2- fnnily dwellings 4 or more new residential d 2- family dwelling ❑ Commercial/industrial 0 Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories ❑Feeders, 400 amps or more ❑ Multi- family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park ❑Htatlth -care Iiicility ❑Other. Job no.: Job site address: ' 3 b c .'T . Submit 2 sets of plans with any of the above. City / State/ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt no.: I Project name: My 1144Vhipsrira FEE* SCHEDULE Fee. I Total Description Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes attached garage. 1,000 sq. (1. or less 145.15 4 Subdivision: ( Lot no.: Ea. add'! 500 sq, it or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: , Limited ener gy, non-residential 75.00 2 . DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.911 2 ^ It4Agr 00 '' VV S 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 ❑ PROPERTY OWNER ❑TENANT 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) l Fax: ( ) 200 amps or less ' 66.85 I Owner installation: This installation is being made on property that I own which is not ' 201 an 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 0 APPLICANT , ❑ • CONTACT PERSON A. Fee for branch circuits with service or (beder (be, each 6.65 2 Business name: branch circuit 13. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: ' Each add'1 branch circuit 6.65 2 1 City/ State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension_ Describe: Page 2 2 Business name: T36c)CO2 Ed Ayi,$„(„ l �,y�.. - � -sow �^ ^ f Each additional Inspection over allowable in any of the above Address: i� „ 0 . �o s- b Per inspection 62.50 City /State/ZIP: ` Pes o, GA , g Investigation per hour (1 hr min) 62.50 Industrial plant per hour 73.75 Phone: (� 'L.. "alb Fax: (r) g9� �� I�3 ELECTRICAL PERMIT FEES• CCB Lie.: i eafzZ 1 Electrical Lic.: 3-5'11(1 Suprv. Lic.: A95 1S Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) J State surcharge (8% of permit fee) w�h Print name: Cb Wale: TOTAL PERMIT FEE Authorized signature: This permit application expires it a permit is not obtained within ISO days after It has been accepted as complete Print name: I Date: • fee methodology set by 7ti- County Building Industry Service Board •• Maher per permit allowed T" at✓i ' l,il/� N r 0 \J Permit #: \MS j coo' ' 6 V-----" Address: 0 3 S .W Coot- L./✓ Issued b Date /I 6 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ggi 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. - OR N . 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. /G ° (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) • Information Notice to Property kooiit C•U0struct'on Respo0s^ Note: This Wort ,ation Notice to Property Owners about Construction Responsibilities was c/eve/opec/ byt 'e Construction Contractors Board in accordance with ORS 70/:055(D. if you are acting as your own coniracto o construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being 'ware of the following responsibilities and areas of concern. EM�10YER RESPONSIBILITIES: / If you hire persons not registered with the Con:trucon Contractors Board to do construction or improvement of a residential strucv:re, you will, in most instances 6e ruled to be an employer and the people you hire will be employees. AS the mployer, you ni St comply with the followi g: Oregon's withholding law: As an employer, are paid. You will be liable for the tax payments even if y u don't actually withhold the tax from your employees. For more inibrmation, call the Oregon Dept. of Revenue at 945-8091 Unemployment insurance tax: As an employer, you are reqt 'red t pay a tax for unemployment insurance purposes on the wages ofall employees. For more information, call the Oregon\! plQYment Department at 378-3524. Workers' compensation insurance: As an employer, you are 'uhic1to the Oregon Workers' C sation Law, and must obtain workers' compensation insurance for your employees. {f you ilto obtain workers' compensation insurance, you may bo subject to penalties and will be liable for uUu1oim costs i[wnoo[voor ployees is i jurcdonibojoh. For more information, call the Workers' Compensation Division at the Depart t of COnsum and Business Services at 945-7888. U.S. internal Revenue Service: As an employer, you iustwithhold federa' income tax from employees' wages. You will be liable forthc tax payment even ifyou didn't actually 'ithholdthe tax. Fnrmo'' information, call the internal Revenue Service at 1'800-829'1040: OTHER RESPO AREAS tF CONCERN: Code compliance; As the permit holder forpiis project, ynuure responsible for r000|ing any bai lure tomcr code requirements that niay be brought to your attention tho gh inspections. Liability and property damage insur Contact your insurance agent to see if you - uve adequate insurance coverage for accidents and omissions such as fallin toois, paint overspray, water damage front pipe Funetures, tire, or work that must be re-done. Time to supervise employees: ake sure you have sufficienttime to supervise your emplo)ees. Expertise: Make sure you have le expertise to act as your own general contractor, to coordinate tH work of rough-in and finish trades, and to notify building oficials at the appropriate times so they can perform the required i ,spcotiunu. if you have additional questions, write or call the Construction Contractors Board (PO Box l4}4U,`''u|cm,0R973O9'5052. 503/378'4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 |/94 10/11/05 23:17 FAX f 02 • ' Aug • 30 • 20050 2 : 19PM,a CLEAN WATER SERVICES 503 6814439 No . 8892 P I ®02 . rr)l I � r1. f' ) i • '';! AUG .2 3 2005 i 1 ?: I �i '131_ - _ ;J File Number CleanWate Services wr� w.w- . ' Out commitme i s clear. �� Sensitive Area Pre.Scroening Site Assessment Jurisdiction -- - :�.- .Auk -- Date OS` Map & Taos Lot M./15a &. •_. • Owrter _ 1 - + !, . A' . Applicant ,. Site Address 1. ;t1w .? : , Company ,7 -(0 ,,r t _ ) Address SS2-W R t i 1f7 - . Proposed Activity 4 City State Zip i z i g j e k igte `d1 - -th n) _ Phone Sol-i$ 1-!q a a _ Fax Est• By submitting We form the Owner, or Owner's authorized agent or representative. eeknawl.dgca and agrees that om pioyse0 of Chien Water Services have authority to enter the project ran at all reasonable times for the purpose of Inspedine project site conditions and gathering informstien related to the project site. • Otflstai mu oN totla. Oils line - OfficI& ma only 0►Iaw this itno OtlitAU LAN eeiy pale•. Nis Y N NA Y N NA t I Stnsltive Area Composite Map E � Storm water Stnrwater Infrahtnictura maps D i__I Map iC � L_! L` Cs It (Nis - ❑ ❑ { Locally adopted studies or maps ElEl Other t~ w5 f /`i� 13 l" Specify ❑ ❑ Specify 2.005+Adrpmi Based an a review of the above Information end the requirements of Clean Water Services Design•and Construction Standards Resolution and Order No. 04 -9r Seneitive cress potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OFA SERVICE PROVIDER. If Sensitive Ares exist on the site or within 200 feet on adjacent properties. a Natural Resources Assessment Report may also be required. • ® Sensitive areas do not appear to oxict on site or within 200' of the site. This pre - screening Site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 041, Section 3.02.1, All • required permits and approvals must be obtained end completed under appllcable lace!, state, and federal law. ❑ The proposed activity does not meet the definition of development NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewer Comments: (lases( rare revi c? a Q..eria py c c.f.";>ra c.r,� Est ' a co 0)1,3 r....:7 - c,02_ , is M ,p- • rr'._- . Reviewed By: Date: — : - - Post - it" Fa x Note 7671 �nt� p�/3p�� � g °t, el Official use only Returned to Applicant • '°. f) rte: wr4 Fmm ( 13.4.44./4 Marl Far Counre r 'Co . CLO5 Date V.Nyel By - _ More ie t qQ q hnonc " J�o3 6,9/ -5/op . Fa. -� —� os0S— t'f5� FOe/ CITY OF TIGARD 5i BUILDING DIVISION PERMIT #: �ijj) a®? Z 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 t91��� �� Inspection Requests (24 Hrs.): (503) 639 -4175 _.:' I 6 INSPECTION WORKSHEET FOR DATE: 4// TIME: / PAGE: r SITE ADDRESS: /Ob C Z/%__ CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: 4/4 t OWNER : 9n, / l /S G� j.t I PHONE #: CONTRACTOR: ,( 4 ! /7A 4,0 1-13e-. r PHONE #: Inspection Request Scheduled For: Date: Pour Time: N Code # Inspection Description . P # Contact # Mess a t/ / Z- `' • J /' % ' ie n 2N ., 7 - Corrections /Comments /Instructions: �� C CJ tha 5 &!944& • I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL ,FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD 5 BUILDING DIVISION ' Go PERMIT #: MST2005- 00352 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005 Phone: (503) 639 -4171 v� ,�� Inspection Requests (24 Hrs.): (503) 639 -4175 ' W I I.. INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 92 SITE ADDRESS: '10635 SW COOK LN CLASS OF WORK: SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAWHIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MAWHIRTER, IRENE PHONE #: 503.639.6645 CONTRACTOR: J B FAB & SERVICE PHONE #: 503 -901 -1933 Inspection Request Scheduled For: Date: 6/12/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 049987 -01 503-453-5620 N Corrections /Comments /Instructions: • i ot'f- A U `e Q n PASS PARTIAL APPROVAL ❑ CANCEL X NO ACCESS K FAIL n CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: (d// 0 7Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 &00352 13125 SW Hall Blvd., Tigard, OR 97223. DATE ISSUED: 10/28/2005 Phone: (503) 639- 4171 �ngp�ii @je Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/31/2007 TIME: 7 :00AM PAGE: 62 SITE ADDRESS: 10635 SW COOK LN CLASS OF WORK: SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAWHIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MAWHIRTER, IRENE PHONE #: 503 - 633.6645 CONTRACTOR: J B FAB & SERVICE PHONE #: 503- 981 -1933 Inspection Request Scheduled For: Date: 5/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 049305.01 503 - 684 -7985 N Corrections/Comments/Instructions: 0 b G 1�(i '\ Z A I C,6 rJ �l 4at'� �' wt4 1`�� AO. zoo - s`PIc,k\rL Pcczwka otJJ SAP01/4N -1_, I PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS A FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: l7 Date: "31, ® n Phone #: (503) 718 -1-10O CITY OF TIGARD BUILDING DIVISION PERMIT #: hi ST2005- 0352' 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 101280005 Phone: (503) 639 -4171 . Milt Inspection Requests (24 Hrs.): (503) 639 -4175 '• INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7 PAGE: 69 SITE ADDRESS: 10636 SW CCOK LN CLASS OF WORK: SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAIHIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MAWHIRTER IRENE PHONE #: 503 - 639 -6645 CONTRACTOR: J B FAB & SERVICE PHONE #: 503.981 -1933 Inspection Request Scheduled For: Date: 5122t2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 048594 -01 503-349-0282 N Corrections /Comments /Instructions: ` anti 6"b1 9 ti - rtael ' '13 6 1. V bV �� - " 6 K•a 6E4 ;,0 (344 -ex K& P FAN - RkN \O IV lg. WALL C.,13VETkirl 004 WiL 4 , q a.... _._.\ 4, tit.. i, ,... •Ku.s. ., •ii , 61...i ‘ .. \ t I_ (Z N_L, - • ik / -41C;4,& Pa.Q1q/ G oarEak-, -, Paoqvgbee Ritt.-ookb ti-ek,„,... Fog 6 Q Patti k Et. a_i Ci , , F6L c3 1k6 Vat41 c !A(b= 'IM 0 ea/0 0 t PASS n PARTIAL APPRO AL ❑ CANCEL ❑ NO ACCESS FAIL ACALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: G----4 �J L� 4 6 G Date: 2 3 ] Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.-00352 1125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 10128/2005 C` Phone: (503) 639-4171 r .. Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7:00AM PAGE: 100 SITE ADDRESS: 10635 SW COOK LN CLASS OF WORK: SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAN DESCRIPTION: :3hop• attached to house with breezeway. • OWNER: MAWHIRTER, IRENE PHONE #: 503-639-6645 CONTRACTOR: J B FAB & SERVICE PHONE #: 503-981-1933 In • • E Ins ection Request Scheduled For: Date: 12/7/2005 Pour Time: Code 4ipection Description Confirm # Contact # Message Electina -in 023046-01 503-407-6009 r Corrections/Comments/Instructions: R.2)Q2NO (SO • ,/ • • .•• „. )PARTIAL APPROVAL LII CANCEL 7 NO ACCESS 7 FAIL CALL FOR INSPECTION L ADDITIONAL FEES ASSESSED Inspector: N ‘e Date: ) Phone #: (503) 718- 2 J 4 i l f0 _ . . CITY OF TIGARD . BUILDING DIVISION ): PERMIT #: MS72005 -00352 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005 Phone: (503) 639-4171 � Ii iif Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 612212007 TIME: 7:01AM PAGE: 67 R' , usioric4 10635 SW COOK LN SITE ADDRESS: CLASS OF WORK: SUBDIVISION: FANTASY HILL 008 #: 000 TYPE OF USE: . PROJECT NAME: MAWHIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MAWHIRTER IRENE PHONE #: 503.639.6C:45 CONTRACTOR: 313 FAB & SERVICE PHONE #: 503-981-1933 Inspection Request Scheduled For: Date: 5/2212007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 048594 -03 503 - 349-1202 N Cora tions /Comments /Instructions: !� -� vn e--Q 1 -414 & 62. • t � , C, z C'5 (33) tai l - 444 4 _Lk,' -4.---,_„„ liLS A- e-V---( b t b Ola 1 : 1'i , . V?o Ck 7 n kl A v ) ',./A - /-2_6,07\ L:kv, to 1 1 2 sn t nip t'w (2___a_,,:v. C)-(2- 0 O o pit - 1 tit S ' 6 . 04 , 414) t "qk 6 t /.)--%--- kA"cg-il--(-41--(---N^I 0 CP ftpfr r cAt t� . I I PASS n PARTIAL APPROVAL n CANCEL I NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED p l� C� Inspector,: Date: v C �Z< � d 7 Phone #: (503) 718 - -2-\-1 Z CITY OF TIGARD 4 MST2005-00352 1 B DIVISION PERMIT #: 10028/2005 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 i �I p il � li Inspection Requests (24 Hrs.): (503) 639 -4175 � _ ;_.. INSPECTION WORKSHEET FOR DATE: 22/2007 TIME: 7 PAGE 10635 SW COOK LN SITE ADDRESS: CLASS OF WORK: - SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAWHIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MA IRTER IRENE PHONE #: 503 - 633 -6645 CONTRACTOR: J B FAB & SERVICE PHONE #: 503 Inspection Request Scheduled For: Date: 6/2212007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 048554 -02 503-349-1202 N Corrections /Comments /Instructions: 7 Lid �.r .. .......- v • ' 00 j • ASS_ / 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL 10 A L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718 - Z-‘1y CITY OF TIGARD 1 BUILDING DIVISION A . PERMIT #: MST2005-0032 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005 Phone: (503) 639-4171 „tt Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/23/2006 TIME: 7: 16AlVi PAGE: 25 SITE ADDRESS: 10635 SW COOK LW CLASS OF WORK: SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAWHIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MAWHIRTER, IRENE PHONE #: 503-639-6&15 J B FAB & SERVICE 503-981-1933 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 6123 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 032271-01 503-6847985 Y Corrections /Comments/ Instructions: \ 14PASS 0 PARTIAL APPROVAL 0 CANCEL El NO ACCESS FAIL 0 CALL FOR INSPECTION Ell ADDITIONAL FEES ASSESSED Inspector: ill - \ di Date: , --- Phone #: (503) 718- ,,- ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MS-r2000352 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 10/28/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 ..........4# ' ...... INSPECTION WORKSHEET FOR DATE: 211672006 TIME: 7:0 PAGE: 68 * SITE ADDRESS: 106 sw cooK u .. 4 CLASS OF WORK: SUBDIVISION: FANTASY - H LL LOT #: ow TYPE OF USE: PROJECT NAME: Komi RTEr DESCRIPTION: c,1 ouop attached t with breezeway. DO-Q- Ud OWNER: mAw -- rut< i ER, IRENE PHONE #: 503,639,6m6 CONTRACTOR: 6 FAB & SERVICE PHONE #: 503 . 1933 Inspection Request Scheduled For: Date: 211f,d2006 Pour Time: , _ • Code # Inspection Descr's . of L' Confirm # Contact # Mes e 1 i I 399 Plumbing final 026898-01 503 orrecti Y cC ( Pi L A,..... ■-7 , -z- i 12 - 1 -v4L ons/Comments/Instru elo ns: • JUCL- 4 --;AA ; t4 C' 4:c--:---k / 7) 1. \-a-- -41 l r-- 00 .--e --- 0-‘./S I btu V— 6- kva-e-xe--- ale D PASS [ I PARTIAL APPROVAL kf CANCEL I I NO ACCESS FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: IZZA Date: 2 / Phone #: (503) 718- - 7---V 2 - . V 10 ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00352 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005 Phone: (503) 639-4171 .741 t Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7:00AM PAGE: 99 SITE ADDRESS: 10635 SW COOK LN CLASS OF WORK: SUBDIVISION: FANTASY HILL LOT #: 008 TYPE OF USE: PROJECT NAME: MAWIIRTER DESCRIPTION: Shop attached to house with breezeway. OWNER: MAWUIRTER, IRENE PHONE #: 503-639-6645 CONTRACTOR: J B FAB & SERVICE PHONE #: 503-981-1933 Inspection Request Scheduled For: Date: 12 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough-in 023047-01 401407-6009 Corrections/Comments/Instructions: • (PASS H PARTIAL APPROVAL CANCEL NO ACCESS fl FAIL I I CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: ilAiAlf Date: II/ 7 0 Phone #: (503) 718- - i CITY OF TIGARD Al S BUILDING DIVISION PERMIT #:,27045-00,33 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 /w �lp�j�l� Inspection Requests (24 Hrs.): (503) 639 -4175 _:_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / D 6 3s C--4- --� fn CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3- /3- 0 c° Pour Time: Code # Inspecti scription Confirm # Contact # Message, WE I, ,K 3 cf9 ._ 0 z ?2_, Corrections /Commits / Instructions: ita I � . (JSTI RF C s- .- ; r TG C ❑ PAS '❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL CALL FOR INSPECTION n ADDITIONAL F ES ASSESSED Inspector: I Date: 3 1'5 e4`-7 Phone #: (503) 718= 24:7 CITY OF TIGARD , - W i BUILDING DIVISION PERMIT #: .2.010.S — ,00352.- 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 A �p Inspection Requests (24 Hrs.): (503) 639 -4175 -L INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: I O j 3' � C,.0 d CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Cor ections /Comments /Instructions: C eAP OtjeXe> -22Ar I r.-e.,5 — y scm j,\ \( • v.7\ vv., ? -\- - . c.. f . X PASS I I PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS FAIL (l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r f^ Inspector: V � Date: 111''' 1 I °_ 2 Phone #: (503) 718-