Loading...
Permit IT MASTER PERMIT ['G I T Y O F TIGARD PERMIT #: MST2007 -00093 COMMUNITY DEVELOPMENT DATE ISSUED: 6/13/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134AC-02605 SITE ADDRESS: 11365 SW COTTONWOOD LN ZONING: R -4.5 SUBDIVISION: ENGLEWOOD NO.3 LOT: 162 JURISDICTION: TIG PROJECT: BURNS Project Description: 272 sq ft addition. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST. 272 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 272 sf 31,000.00 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS. 0 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: OTH FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 2 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 ADDL 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601-tamps-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 Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable ROBERT BURNS ROYAL REMODELING RESOURCES INC laws. All work will be done in accordance with approved plans. This 11365 SW COTTON WOOD LN PO BOX 230805 permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 TIGARD, OR 97281 -0805 If the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 590 - 1641 Contact #: PRI 684 - 7873 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: LIC 90746 TOTAL FEES: $ 833.34 REQUIRED ITEMS AND REPORTS (.....------ , r / Issjed By : _ # 0 � - ' P Si : - f /i _ __ _ __ 1 _ � , .11 • b y 7:00 a .m. for an inspection that business day. , i7� f -,4 This permit , ,. : 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. RECRVEI Building Permit Application mqy 2 4 2007 F'OR OFl IcF USE ONLY Receive J(�,� _ City of Tigard CITY C;',- '�� DatelBy : 1 0"1 I i i� Pern»tNo.: l 'l /1 Q KJ 1 `�♦ ° 13125 SW Hall Blvd., Tigard, OR 97 2�, ,1 LQ N Divi Plan Review �� Other Permit: Phone: 503.639.4171 Fax: 503.598.19M Date/13 : , io� Ti G A RD Inspection Line: 503.639.4175 Date Ready/By: Jun ® See Attached Checklist for Internet: www.tigard - or.gov Notified/Method: la{. Supplemental Information TYPE OF WORK, • . . ' REQUIRED DATA: 1- AND 24FAMILY'DWELLING ❑ New construction ❑Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Addition/alteration/replacement ❑ Other: • equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. j .--and 2- family dwelling ❑ Commercial /industrial Valuation: $ 3 (- CC:c) ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder - ❑ Other:. • Number of bathrooms: JOB SITE INFORMATION AND. LOCATION Total number of floors: COP/ t•6Y P.00N � Job site address: 11,34....5 , (,-I GoTTc s' l..1 bO,p L/J New dwelling area: 2"7 Z square feet City/State /ZIP: l � ` �(� C 9 ) 2 Z 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: t3 L.) r2.1 1 Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED, DATA: COMMERCIAL -USE CHECKLIST Subdivision: 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. . (- 1'T t O ) Valuation: $ Existing building area: square feet New building area: square feet OPERTY OWNER El 'TENANT Number of stories: Name: ( r3 1:3■ (3 L Type of construction: Address: 11, 3< SPA LO - 4- J 1.Jc-o I> Occupancy groups: City /State /ZIP: j 4 .. p Oi? • 9,ZZ,� Existing: Phone: ( ) 5 - I (. 4 I Fax: ( ) New: -APPLICANT . . ❑ CONTACT PERSON NOTICE Business name: ,2p��.cr. R .EImp lC::>T.. 1 J '.) All contractors and subcontractors are required to be Contact name: 6 — r �l„!�-j'"r licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: (56 5) /00 —7 Fax:: ( ) E -mail: v • CONTRACTOR ' Business name: (20 r fz ,),,, I n.) 4 BUILDING PERMIT FEES* . Address: Po 2-30 8 o (Please refer to fee schedule) City/State /ZIP: fl ‘4,.(?-1:> p R , 9 *-1-z.8\ Structural plan review fee (or deposit): a��Q Phone: Fes: FLS plan review fee (if applicable): (3,3 ) 48`k-`18�3 ( ) CCB lic.: GO, zke..„ Total fees due upon application: �-,-C__ Amount received: 4/3* 171° Authorized signature: This permit application expires if a permit is not obtained ' within 180 days after it has been accepted as complete. Print name: !44A 42 A E/ /` Date: 6 ,4.,,,,---) * Fee methodology set by Tri- County Building Industry Service Board. L\ Building \ Permits \BUP- PermitApp.doc 03 /21/06 440- 4613T( I 1 /02 /COM /WEB) Electrical Permit Application R ' EIVEC FOR OFFICE USE ON . Y Received City of Tigard 2 4 UU Date/By: . 7 9 O 1 Pennit No.: ki. -7 + 7 n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review II C .' ' Phone: 503.639.4171 Fax: 503.598.19411Tl ; }� 3 � it: Date/By: Other Perm T I CARD Inspection Line: 503.639.4175 BUILDING n t , } Date Ready /By: Juris• ® See Page 2 for Internet: www.tigard - or.gov t-�6L i Li n i Notified/Method: Supplemental Information TYPE-OF WORK PLAN REVIEW El New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more 13 Building over three stories. where the available fault current ❑ Marinas and boatyards. . CATEGORY' OF CON exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural *r I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. El Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or LOCATION ❑ Emergency system. larger separately derived system. JOB, SITE INFORMATION AND . ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ", 100HP or more. occupancy. Job no.: Job site address: I l 365 S 4,4 Gak -t.po...)y dO ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: I 14t o 2 9 q 1-2,z3. ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: • J Description I Qty. I Fee. I Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 ' , DESCRIPTION 'OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 itl...11) ' U residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ' ❑..PROPERTY OWNER - ' . - ❑ TENANT' 20 1 amps to 400 amps 106.85 2 Name: 1 10 ��ti !) 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: i ra -e- Sb4 6 0 + 4 7 3 O c - t- ∎)6 Over 1,000 amps or volts 454.65 2 City/State /ZIP: 'T - I lA�Z Temporary services or feeders installation, alteration, and/or relocation Phone: (a,,)3) . j c)(:) i 6 I Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT " ❑: CONTACT PERSON . above service or feeder fee 6.65 2 n each branch circuit Business name: �p ` 2 &'-&o c)64......1 ,v Cr B. Fee for branch circuits Contact name: �` without service or feeder fee, 46.85 I 2 �C. '� ' ' A�T first branch circuit Address: Each add'I branch circuit 6.65 I 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited- V1 -t E2 E-L� . energy panel, alteration, or Address: IS›.! Z3) is i extension. Describe: Page 2 2 City /State /ZIP: T'l !_^ 2 �' Each additional inspection over allowable in any of the above �C' �' ` Per inspection 62.50 Phone: ( ) 1.20 ( q Fax / O �o ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: V L Electrical Lic.: Suprv. Lic.: qa2 8 Industrial plant per hour 73.75 "'ELECTRICAL PERMIT FEES . Suprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): Print name: (---\- -'-t" E �E Date: State surcharge (8% of permit fee): Authorized signature: 1 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. 0 Number of inspections allowed per permit. 1:\Building'J'ermits\ELC- PermitApp doc 05/23/06 440- 4615T(t 1 /05 /COM /WEB i E EL Plumbing Permit ApplicatiodtlAY 2 4 2007 FOR OFFICE. USE ONLY , City of Tigard CITY CF TIGARD +R® Received �9`1 07 Permit No.:W / 7^ S'3 t CF ° 1 - u 13125 SW Hall Blvd., Tigard, OR ?3.B.0 j . DIVISIODIVISION Date/By: Plan Review Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK . FEE* SCHEDULE _ - • ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total 13- Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 (1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 El Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB, SITE INFORMATION: AND - - LOCATION Site utilities Job site address: (43 45 Sal Go `t, w 0.0 (, L,v Catch basin or area drain 16.60 City/State /ZIP: - ri G °11 Z_2 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Fjv2,,, Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: `Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 'DESCRIPTION OF WORK Backflow preventer Page 2 )ADD( ( ti) Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ROPERTY OWNER ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: 130 13L)t ' Expansion tank 16.60 Address:,r\C_ Fixture /sewer cap 16.60 City /State/ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: f2 p •-r-^ fZ ( C)-Lt '-- Interceptor /grease trap 16.60 Contact name: S C-C) 4-- �LA'T Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin/lavatory ' 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 • . CONTRACTOR • - Water closet 16.60 Business name: 2 € .- r - s 0,2,-._, L Water heater 16.60 Address: Po g> 49 Other: City /State /ZIP: -r - Lt' -�t c.) ° 1 - 70 2. Subtotal Minimum permit fee: $72.50 Phone: ( ) 4.°J2- 4131 Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: al V i Plumbing Lic. no.: 3q. I 144 Plan review (25% of permit fee) State surcharge (8% of permit fee) 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. I \ Building \Permits\PLM- PermitApp.doc 06/26/06 440- 4616T(I0 /02 /COM/WEB) Mechanical Permit Applicati . g x R ece i ved . FOR.OFI��ICE uSE ONLY City of Tigard Date/By: op / Permit No. 1 - /e r� . „ 0 -7,_ ew o - D q 13125 SW Hall Blvd., Tigard, OR 97223 MAY 2 4 2007 Plan Review Other Permit' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 CITY F TIGARD P t h Date Read B kris. ® See Page 2 for TfGARD Internet: www.tigard- or.gov BUILDING DIVIS ON Notified /Method: Supplemental Information ' ..TYPE OF WORK COMMERCIAL FEE* SCHEDULE = USE CHECKLIST ❑ New construction Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION • Value: $ RESIDENTIAL EQUIPMENT [SYSTEMS FEES* and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total ,JOB SITE, INFORMATION A ND "LOCATION. Heating/cooling 1 y L Air conditioning or heat pump Job site address: 3�i5 J if� Go ►•- 44 ( 00 Lv.+ - (requires site plan showing placement) 14.00 City /State /ZIP: - C( - z. or , , Furnace 100,000 BTU (ducts /vents) 14.00 �" _ Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: (Lrs. Gas heat pump 14.00 Cross street/directions to job site: Duct work I 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 Gas fireplace 10.00 ,I 4 DcD l T I p ti 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 0 PROPERTY OWNER. Chimney/liner /flue /vent 10.00 ❑ TENANT Other: 10.00 Name: p o f. P i et . ) .1 Environmental exhaust and ventilation Address: Range hood/other kitchen 'SA.t'� e_ equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 . ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CONTRACTOR , Barbecue Business name: C2,� 11 % I emsT I rJCT Clothes dryer (gas) Other: Address: Po fox 12 4S MECHANICAL PERMIT FEES* City/State /ZIP: CA....,v 3 Y p(Z 9 '1 O (3 Subtotal Minimum permit fee ($72.50) Phone: ( ) 'Z e-e*4._ (2 4 to Fax: ( ) Plan review (25% of permit fee) CCB lie.: , A 4 ,:: ›0 State surcharge (8% of permit fee) TOTAL PERMIT FEE if a permit is not obtained within 180 ■ This permit application e Authorized si ture: days after it has been accepted as complete. Print name: f 'eL g L. .q -f Date: * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 04/06/06 440 -4617T (11 /02/COM/WEB) Apr. 24. 2001 4:45AM No, 07b P. 1/1 APR - to -cuu r cc: 4E r Kura: ENDPOINT DE=SIGN 5034609317 TO: 583681 t -, -�7 r . 2 n RECEIVE* Q MAY 2 4 2007 I CITY OF T IGARD fit .APB 16 2007 1 BUILDING DIVISION CWS File Number 0 7- 0 0 / A s 2 CleanWate _ Spices. Our commitment is clear. Sensitive Area Pre - Screening Site Assessment Jurisdiction C ca l Q�h'CQ� Data 4 4 I ie 0'7 Tax Map & Tax Lot 15l3U p . > . Owner :. tltI'►: _.f1• Applicant . 4 _s_i_. . r Site Address Company ' i C. Ma CP R-lA n•Address LiCIALi Qg rt* i AirDro Proposed Activity �4„�Q� J e+ City State Zip i OP. tla} Phone _5 Ul..r'f?,l Fax i0 --Lit AS-C1 By submitting this form the Owner, or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering Information related to the project site. Official use only below this One • • fitetal use only below this Idle Official uie on y • = ow a 11 Y NA Y N NA 0 al ❑ Sen zp s t i t uve rot a cr posIte Map ❑ ❑ ri S r TT frastructure maps Locally opted studies or maps Other f LE ❑ ❑ Specify ad _ � T ._ ❑ ❑ 4d Specify Based on a review of the above information and the requirements of Clean Water Services . Design and Construction Standards Resolution and Order No. 04 -9: n Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. ra Sensitive areas do not appear to exist on site or within 200' of the alto. 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 04-9, Section 3.02.1. All required permits end approvals must be obtained and completed under applicable local, elate, and federal law. ❑ The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewer omments' V q,r ° ' - Reviewed By: �� - — _ _ Date: _ ' 7 Post -it'' Fax Note 7671 Data V /23/O I1a 2 / Official use only 7, From 9 5 /.... Returnd to Applicant :i . • co. 8 2 Q Date Y 3 inter , Phons # Phone # gad •.f D 1 . ,, row Fax # J' 'UP r39 Fax # Jun 26 07 07:43a Weber Electric, Inc. 503 620 6819 p.1 M! CITY OF TIGARD COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form IMPORTANT PERMIT NOTICE WEBER ELECTRIC INC PO BOX 231154 TIGARD, OR 97281 Permit #: MST2007 -00093 Date Issued: 6/13/2007 Parcel: 1 S134AC -02605 Site Address: 11365 SW COTTONWOOD LN Subdivision: ENGLEWOOD NO.3 Lot: 162 Jurisdiction: TIG Zoning: R -4.5 Project Name: BURNS Description: 272 sq ft addition. Your company has been indicated as the electrical contractor for the permit referenced 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. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: ROBERT BURNS WEBER ELECTRIC INC 11365 SW COTTON WOOD LN PO BOX 231154 TIGARD, OR 97223 TIGARD, OR 97281 Phone #: 503 -590 -1641 Phone #: 503 -620 -1906 Reg #: ELE 34 -442c LIC 44087 SUP 4028S AN INK SIGNATURE IS REQUIRED ON THIS FORM x X MeeZT GJ °2.8' Signature of Supervising Electrician Name (printed) SUP LIC # Jun. 14. 20071 3:01P1t 7Rayborns Plumbing No. 4840 P. 1 4.011 I I 4J I COMMUNITY DEVELOPMENT T [GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639 -4171 Plumbing Signature Form IMPORTANT PERMIT NOTICE RAYBORN'S PLUMBING INC PO BOX 69 TUALATIN, OR 97062 Permit #: MST2007 -00093 Date Issued: 6/13/2007 Parcel: 1 S134AC -02605 Site Address: 11365 SW COTTONWOOD LN Subdivision: ENGLEWOOD NO.3 Lot: 162 Jurisdiction: R -4.5 Zoning: TIG Project Name: BURNS Description: 272 sq ft addition. Your company has been indicated as the plumbing contractor for the permit referenced 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. Please mail the form to; City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: ROBERT BURNS RAYBORN'S PLUMBING INC 11365 SW COTTON WOOD LN PO BOX 69 • TIGARD, OR 97223 TUALATIN, OR 97062 Phone #: 503 -590 -1641 Phone #: 503 - 692 -4139 Reg #: LIC 90746 LIC 44087 LIC 87852 PLM 34 -166PB LIC 14008 AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized lumber Name (printed) CITY OF TIGARD " . BUILDING DIVISION PERMIT #: MST2007-00093 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 6/i3/2007 Phone: (503) 639 -4171 I F • i I Inspection Requests (24 Hrs.): (503) 639 -4175 J ___1. INSPECTION WORKSHEET FOR DATE: 7/13/2007 TIME: 7:00AM PAGE: 21 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition, OWNER: BURNS, ROBERT PHONE #: 503 -590 -1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -71373 b n � -�' n 1t- Inspection Request Scheduled For: Date: 7/13/2007 1) 6t . Pour Time: v Code # Inspection Description q Confirm # Contact # M sa-e 235 Shear walls/anchors ' 051967-01 503 - 209 -5391 Y Correction Comments /Instructions: g7 -z_ 5 , V. a ' - `4 s • (AKM--e‘ s P - ,.> � !' 5 a ; e ,w (VIA; ` . ''' ) N(-r" ------ - 2.i " C∎liQ --2CI___ ._. J . G) ' 3' C V ■ per' c __ r -A-- (------------"------- ...., O 1 I PASS II -, RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: � IN3 / g Phone #: (503) 718 - 7 T L C ITV ® i r „44, , ' .. +r x , i ' :„ a , : w4 .:4-,,i PERMIT #: MST2007-00093 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/13/2007 Phone: (503) 639 -4171 t 01 1 l3 Inspection Requests (24 Hrs.): (503) 639 - 4175 s .. 1; ,. INSPECTION WORKSHEET FOR DATE: 7/13/2007 TIME: 7:00AIdi PAGE: 21 SITE ADDRESS: 113£5 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq It addition. OWNER: BURNS, ROBERT PHONE #: 503-530.1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 664.7i n L 0}1--'' ° Inspection Request Scheduled For: Date: 7/13/2007 l � L ' Pour Time: l,� Code # Inspection Description Confirm # Contact # M a 235 Shear walls/anchors 051967 -01 503-209-5391 Y Correction Comments /Instructions: l — 2.___ c 5,,, , '..._A -\--- ,<_._,, _5,__,,e, \2( a' - -- eik_______c_. 1 ii___,, MC'5 — 2--/---- *---' .1*) V4 w J V t \ - 2; - % c_...1 72,"___G) ‘y Cli) _______, CL--e -- ...J' PASS APARTIAL APPROVAL Lf CANCEL I I NO ACCESS I I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED \ / 3 Inspector: Date: Phone #: (503) 718- 2 2.--Y • . CITY OF TIGARD . , - ` BUILDING DIVISION PERMIT #: MST2007- 00093 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13/2007 Phone: (503) 639- 4171 I 7fj � hl Inspection Requests (24 Hrs.): (503) 639 -4175 .. : _.. INSPECTION WORKSHEET FOR DATE: 6125/2007 TIME: 7:01AM PAGE: 46 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 503-590-1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6847873 Inspection Request Scheduled For: Date: 6/25/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message ' 315 Post/beam plumbing 050843.01 503-209-5391 Y Corrections/Comments/Instructions: 6 N\ • • t 1 1 j, 'iSS n PARTIAL APPROVAL I. I CANCEL n NO ACCESS • FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED ill 1 Inspector; / j ( J (503) 718 - • Date: 7 6 / Phone #: ( ) CITY OF TIGARD - 1. BUILDING DIVISION PERMIT #: MST2007 -00093 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U13/2007 Phone: (503) 639 -4171 //v�tj h�u�I� l Inspection Requests (24 Hrs.): (503) 639 -4175 atilar INSPECTION WORKSHEET FOR DATE: 9/19/2007 TIME: 7:00AM PAGE: 16 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition, OWNER: BURNS, ROBERT PHONE #: 503 -690 -1641 CONTRACTOR: -ROYAL REMODELING RESOURCES INC PHONE #: 684 - 7873 y Inspection Request Scheduled For: Date: 9/19/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 055952-01 503 -590 -1647 N Corrections /Comments /Instructions: rel PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: OTh h M.-J ► 5\ ^- f- Date: I (O \O 7 Phone #: (503) 718 - • CITY OF TIGARD ' BUILDING DIVISION r PERMIT #: MST20617- 17616193 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13/2007 Phone: (503) 639 -4171 molt Inspection Requests (24 Hrs.): (503) 639 -4175 -� . - INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:02AM PAGE: 52 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 503. 590.16 41 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -71773 Inspection Request Scheduled For: Date: 7/25/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 052634 -01 503- 209"5391 N Corrections/Comments/Instructions: c 7 C ) ' 6(0/1/1A l/le" — e0,1/Li ' j LI \ri /43 a_C A , ' (\f 6 L 'SrC , vvi 1.x., c 1 55 ---v._4---/ _b Co/ 1 � 41 Pi ( 2-- �1kl.A _.L ..1.Ii 1 ' VIA' ) 4jtA , ) A MG . 1 . . ,' ` < i ' �C-�) gad kz4 ,.... , , 6 . PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED • V&W Ins ector:- Date: ( 7)P2A/07 Phone #: 503 718 - P � ) CITY OF TIGARD 111111111117 - BUILDING DIVISION PERMIT #: M'3T2007 -00033 s . 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6113/2007 Phone: (503) 639 -4171 4pu 1 A Inspection Requests (24 Hrs.): (503) 639 -4175 .J "I I.. INSPECTION WORKSHEET FOR DATE: 9/19 /2007 TIME: 7:00AM PAGE: 15 SITE ADDRESS: 1136.5 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 503-590-1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6847873 Inspection Request Scheduled For: Date: 9/19/2007 Pour Time: Code # Inspection Description — Eon' Contact # Message 199 Electrical final 055952 -02 503 - 590 -1647 N Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS I I FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: G 0 QIQ Lt Date: q (11 t'n Phone #: (503) 718- 1-'f"fV CITY OF TIGARD . . ..,-, , . . BUILDING DIVISION . PERMIT #: MST2007-00093 13125 SW Hall Blvd., Tigard, 13/2007 k.,.4.,1 OR 97223 DATE ISSUED: 6/ Phone: (503) 639-4171 - -: illoViill` Inspection Requests (24 Hrs.): (503) 639-4175 AM. 11. INSPECTION WORKSHEET FOR DATE: 7/26/2007 TIME: 7:03AM PAGE: 41 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BU,RNS, ROBERT PHONE #: 503-590-1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684-7873 Inspection Request Scheduled For: Date: 7/26/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 0527913-01 503-209-5391 N Corrections/Comments/Instructions: • • O/ f4 K PASS I I PARTIAL APPROVAL fl CANCEL NO ACCESS I FAIL • CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Tii A Inspector: I r Date: Phone #: (503) 718- ... , _ .. ��',` CITY OF ' H ��mu m n��o m BUILDING DIVISION PERMIT #: ME1 | ' 13125SVVHall lvd Tigard, ORQ7223 DATE ISSUED: ' 6/VO007 Phone: (503)839�4171 Ai i Inspection Requests (24 Hrs.): (503) 639~4175 * i � rtl �� ' INSPECTION WORKSHEET FOR DATE: 9/21/2007 TIME: 7:00AM PAGE: 38 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS . DESCRIPTION: 272wqftaddition. OWNER: BURNS, ROBERT PHONE #: 503'590-1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 584 Inspection Request Scheduled For: Date: E/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 056079'01 503-209-2382 N Corrections/Comments/Instructions: ' . , . • • e PASS I I PARTIAL APPROVAL n CANCEL fl NO ACCESS n FAIL CALL FOR INSPECTION ( 1 ADDITIONAL FEES ASSESSED 1 Inspector: ^�� Date: 9 ""-?. Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00093 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 `�' $�':L. INSPECTION WORKSHEET FOR DATE: 9/19/2007 TIME: 7:00AM PAGE: 14 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 503590-1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873 Inspection Request Scheduled For: Date: 9/19/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 055952 -03 503-590-1647 N Corrections /Comments/ Instructions: • PASS PARTIAL APPROVAL n CANCEL NO ACCESS n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: 9- / g -05 Phone #: (503) 718 - •-4.4 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00093 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6 Phone: (503) 639 -4171 j t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/27/2007 TIME: 7:03AM PAGE: 41 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. • OWNER: BURNS, ROBERT PHONE #: 503 - 590.1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 - 7873 Inspection Request Scheduled For: Date: 7/27/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 05290401 209-503-5391 Y Corrections/Comments/Instructions: MA/ 4A" lI. <xe 1114 11.°111 PA Tilifidur a PASS fl PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 7- Z 7 - n 7 Phone #: (503) 718- _ Imo= . ._>: VA • /.r 2YR ': . BUILDING DIVISION PERMIT #: MST2007 00093 13125 SW Hall Blvd., Tigard, OR 97223 � � DATE ISSUED: 6/130007 Phone: (503) 639 -4171a Inspection Requests (24 Hrs.): (503) 639 -4175 _ "�'I�� t � INSPECTION WORKSHEET FOR DATE: 7/25/2007 TIME: 7:02AM PAGE: 52 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 503- 53(}1EW1 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -7873 Inspection Request Scheduled F.r: Date: 7/25/2007 Pour Time: Code # Inspection D•scription Confirm # Contact # Message 320 Pim 'i rough -in 052694-01 503- 209-5391 N Corrections /Com ►- nts /Inst . tions: ■ r _ (_Y20.. AM-V-le- .,,--) — VV j e,,,,,i .��� C 01 ow ) 6 ` C-4vl w> Ce 1 55 u.--e_-_g -- S - 1 4 2 ( ems!.- _ . L �t !i 1 I. s i VIA. l....(' lam`, ' I _7 NIL NI 4 ( I PARTIAL APPROVAL n CANCEL I I NO ACCESS I I FAIL [ I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED ttiVi t)/ / Inspector: Date: ( Phone #: (503) 718 - CITY OF TIGAR.D . . . ., BUILDING DIVISION PERMIT #: MST2007-00093 13125 SW Hall Blvd., Tigard, OR 97223 *-:., - ' DATE ISSUED: 6113/2007 Phone: (503) 639-4171 PA I iii■ Inspection Requests (24 Hrs.): (503) 639-41.75 •' I , ---. INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 46 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 ' LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS ---; DESCRIPTION: 272 sq ft addition. -,,_-- OWNER: BURNS, ROBERT PHONE #: 503-590-1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 6647873 Inspection Request Scheduled For: Date: 6/22/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 050767-01 503-927-9765 N I irr: ions/Comments/Instructions: 4A - , ,it "Zi A i ge , 7 e!A. -"74 /. (4 -i-i A-- ------- ,A_;■-.‘ n PASS PARTIAL APPROVAL I I CANCEL I I NO ACCESS AIL I I CALL FOR INSPECTION r7 ADDITIONAL FEES ASSESSED /5_ - . Inspector:- " , Date: ,,,._. --,--2,Z Phone #: (503) 718- ____ ______ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00093 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13/2007 Phone: (503) 639 -4171 '/471/1 4 it Inspection Requests (24 Hrs.): (503) 639 -4175 _ .! 'I INSPECTION WORKSHEET FOR DATE: 6/19/2007 TIME: 7:01AM PAGE: 74 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 50:3. 500.1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 - 7873 Inspection Request Scheduled For: Date: 6/19/2007 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 050446 -01 503 -20' --5391 N Corrections /Comments /Instructions: I Ad grna iL S. Z4 :Q- am ain ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS ❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718 - . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00093 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6113/2007 Phone: (503) 639 -4171 / ir+iv n l Inspection Requests (24 Hrs.): (503) 639 -4175 e�' .. INSPECTION WORKSHEET FOR DATE: 6/1412007 TIME: 7:00AM PAGE: 37 SITE ADDRESS: 11365 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 162 TYPE OF USE: PROJECT NAME: BURNS DESCRIPTION: 272 sq ft addition. OWNER: BURNS, ROBERT PHONE #: 503-590 -1641 CONTRACTOR: ROYAL REMODELING RESOURCES INC PHONE #: 684 -71373 Inspection Request Scheduled For: Date: 6/14/2007 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 050201 -01 503-209-5391 N Corrections /Comments /Instructions: ASS ❑ PARTIAL APPROVAL CANCEL n NO ACCESS ❑ FAIL 41 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: - I ©7 Phone #: (503) 718- ?-4441'6Y