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Permit X. CITY ITY OF F TIGARD MASTER PERMIT . A PERMIT #: MST2005 -00253 i DEVELOPMENT SERVICES DATE ISSUED: 8/10/2005 `�'�� 13125 SW Hall Blvd.,.Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S104DB -05200 SITE ADDRESS: 13275 SW GREENFIELD DR ZONING: R -4.5 SUBDIVISION: LOT: JURISDICTION: TIG . Project Description: 720sf addition. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 720 sf BASEMENT: sf LEFT: 5 SMOKE,DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: Two: sf • RIGHT: 5 VALUE: 67 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 720 sf REAR: 20 PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: 1 OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: 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: 1 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W /OSVCIFDR: 6 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNALJPANEL: 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 LEBRUN, TIMOTHY LIN + SUSAN MAF NICK MILO DESIGN CONSTRUCTION and all other applicable laws. All work will be done in 13275 SW 132ND AVE INC. accordance with approved plans. This permit will expire TIGARD, OR 97223 4404 SW MARIGOLD if work is not started within 180 days of issuance, or if the PORTLAND, OR 97219 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 163533 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 1,422.82 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 4 ... Issued By : � ✓ ���il:,� / 2 _ Permittee Signature : ,!� Call 503 - 639 -4175 by 7:00 a.m. for an inspection that 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. Building Permit App a on ED roa OFFICE USE ONLY City of Tigard Received l® / Permit No.:'l Date/B . g JUL 21 1005 Plan Revie o� ' _'�� 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 g h..... , ( "i Date/B . .� S_ —u Sher Permit: Inspection Line: 503.639.4175 '•I _ I; � Date Ready/By: _ H See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF iTIG �± p R t � Notified/Method y of - 9a-- Supplemental Information L3 LWWNG DIMONV \ -e, )- v ® 1 u 4- Nv.SO • TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY 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. Valuation: $ 1- an O' (f :L------- - ; -Gd d 2- family dwelling ❑ Commercial /industrial / c 7, d r/5 El Accessory building ❑ Multi- family Number of bedrooms: 3 El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: I Job site address: / 3 .Z. 7 s. b/, C tic,cN ie/4Lh Dit, New dwelling area: 7Z Q square feet City /State /ZIP: `t', A. e OA. '7 72 z3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: 45' i 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. Valuation: $ A-D O 1 o N 10 NO u .t f_ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER " ❑ TENANT Number of stories: Name: T M (5-4,s.,./4/ Lt & tiN A/ Type of construction: Address: 113 z 7 5 - S.1' , e GN r../ f.L q 1) Occupancy groups: City /State /ZIP: Zt 4 o .h f O C f 7,223 Existing: Phone: (603) S3,5 Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business me: N I,- 4 Ai, L O EJ/4A✓ CoAtrrt (lU - IOA/ - ZA/G, All contractors and subcontractors are required to be Contact name: �,Gk M �O licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 4404. SN/ M4,t /4 oa q sr jurisdiction in which work is being performed. If the City /State /ZIP: p - n 7 el applicant is exempt from licensing, the following reasons apply: Phone: (j e,9 ? ay- 4, 77 Fax:: (5413) 241.-C — ,2o 7 a . E -mail: CONTRACTOR Business name: BUILDING PERMIT FEES* Address: JA /1/J 1 Please refer to fee schedule. City /State /ZIP: , Fees due upon application , Phone:( ) Fax:( ) / 3 s 3 Amount received CCB lic.: Authorized signature: 7„ 90� Date received: , This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name: N tc,K_ /� ! Lo Date: 7 71/ / 0, * Fee methodology set by Tri- County Building Industry ((( Service Board. i:\ Building \Permits\BUP- PermitApp.doc 12/03 440- 4613T(I I /02JCOM/WEB) • • I One- and Two - Family Dwelling Building Permit Application Checklist - FOR OFFICE USE ONLY Cl of Tigard 411,„ Received `r g Daze Associated permits: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Phone: - Ho .c Fax: 503.598.1960 2li{ ve 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical --�-+i Internet: www.ci.tigard.or.us "' ❑ 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 al I royal re uired. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and stature 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 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, venfsize ❑ ❑ ❑ and location. • 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 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 . • •licable 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 Electri a1 Permi ppl • t Aication FOR .OFFICE FOOFFICE USI ONLY City of Tigard r'CEIVEl Date P ermit No.: VYISI, r/ - - 6oa6, 13125 SW Hall Blvd., Tigard, OR 9722 I Plan Review Phone: 503.639.4171 Fax: 503.598.1960 " *.rir'(rrr ,'t1111 D Other Permit: Inspection Line: 503.639.4175 (��1 ._a _ ll. �. ? Date Ready/By: tans: ®See Page 2 for Internet: www.ci.tigard.or.us [JUL `a' . Notified/Method: Supplemental Information _ j Y Z 1 o1�tik;ARD PLAN REVIEW El �t s y J New construction Addit tiogu(, r 110,Wt7tent Please check all that apply: ❑ Demolition ❑Other: OService over 225 amps, comm'I ['Hazardous location OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or more new residential land 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories 0 Feeders, 400 amps or more DOccupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑E plan RV park 0 Health-care facility ❑Other: Job no.: Job site address: / 327S' J A) 6 i (6Al F l6 4' pg Submit 2 sets of plans with any of the above. City /State /ZIP: 7,, 4 a 4g 02 c, 7 z 2 3 The above are not applicable to temporary construction service. FEE* SCHEDULE _ Suite/bldg. /apt. no.: Project name: . Description I Qty. I Fee. I Total I " Cross•street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. • 1,000 sq. ft. or less 145.15 4 S ubdivision: Lot n o.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular ■ dwelling, service and/or feeder 90.90 2 fr -b0 / 7 0 Ai Services or feeders installation, alteration, and/or relocation 200 amps or less f 80.30 2 ❑ PROPERTY OWNER . I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: T /t2 4 J r.G.r .o'tl/ e. R- !Z /1/ 601 amps to 1,000 amps 240.60 2 • A ddress: - �Y' ,, G /� Over 1,000 amps or volts 454.65 2 4. ! 7 's s �' �� ~ ` /�G ,/ Reconnect only 66.85 2 City/State /ZIP: T 4 Atih D2 1 - 7.1.A.3 Temporary services or feeders installation, alteration, and /or . i Phone: (J ))) S 79 $' 3 o 3 I Fax: ( ) relocation 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 PLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each / Business name: i cI H, L PE, r( v ' ' C JJT. -.t/G, branch circuit 1� 6.65 2 /" / B. Fee for branch circuits Contact name: tiG !/C / ( 1,11 without service or feeder fee, each branch circuit 46.85 2 Address: 4.9r0¢ Set/ MA 4! 4 a t — 0 .J r., add'I branch circuit 6.65 2 City/State/ZIP: i a c7 I ®7' t - A 4 / e 2 L/ 9 Miscellaneous (service or feeder not included) Phone: (Co 1) 7 8l _ II ? 7 Fax: : ( ) Pump or irrigation circle 53.40 2 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: it/ i cdc M ! d D j / cowl P s,.. Xte, Address: Each additional inspection over allowable in any of the above • 62.50 City /State /ZIP: SA/lif Per inspection Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES * , CCB Lie.: • Electrical Lie.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: 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. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(IO /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAI:'WORK ONLY: I 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: t COMMERCIAL.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 i:\ Building \Permits\ELC- PermitApp.doc 04/03 Mechanical Permit Application FOR OFFICE USE ONLY • �` ` Received City of Tigard C E I �) Date/By Permit No.: (M S -� , _ o _ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review V v'tJV V Phone: 503.639.4171 Fax: 503.598.196 k afl- . .�� Date/ y: Other Permit: � I Inspection Line: 503.639.4175 UL 1 2005_, -_ Date Ready/By: Juris: ® See Page 2for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information CITY OF TIUARn BOTEIlftG ARLSION 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. CAT EGORY' OF CONSTRUCTION Value: $ . RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi family For special information use checklist. ❑ Master builder ❑ O Description I Qty. Ea. I Total • JOB SITE INFORMATION AND LOCATION _ • Heating /cooling . Job site address: / 3 2 733 S e / e Air conditioning or heat pump A f.( /—/ FL19 �R , (requires site plan showing placement) 14.00 City /State /ZIP: 7 -, , a,. , 04, 9-2.2X3 Furnace 100,000 BTU (ducts/vents) 1 14.00 Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90 Gas heat pump 14.00 Cross street /directions to job site: Duct work 1 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 (4-GC , I 10.00 Gas fireplace 10.00 A - on/ P7D 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 ❑ . PROPERTY OWNER ' ❑ TENANT Chimney /liner /flue/vent 10.00 Other: 10.00 Name: 72 Ai g,. JC(J .(51(.44/ Environmental exhaust and ventilation Range hood/other kitchen Address: /3 2 7 S ski C j /C et /eLD PR. equipment 10.00 City /State /ZIP: 7'15 Axe / O 4, 4 7 .2 7 . 3 Clothes dryer exhaust 10.00 • Single -duct exhaust (bathrooms, Phone: (S-03) 5 7 9 - S 3 6°,3 Fax: ( ) toilet compartments, utility rooms) / 6.80 • ❑ APPLICANT -❑ CONTACT PERSON Attic/crawlspace fans 10.00 - / Other: 10.00 Business name: "itch / w 1�r/ Oe'f/4 4V r t � t Fuel piping / V Contact name: /GK M!,z o • $5.40 for first four; $1.00 for each additional Furnace, etc. / Address: ¢4 O¢ Jtt/ A-FA A /4 '-0 _r7. Gas heat pump City /State /ZIP: Fox 1 , OA- 7 7 2 / c Wall /suspended/unit heater Phone: (SO) 7 5/ - 41 17 Fax: : ( ) Water heater Fireplace E - mail: Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) (�" Other: M ov f, /yETi& Address: J MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fcc ($72.50) • Plan review (25% of permit fee) CCB lic.: / `3 s-3 3 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: N, c -, G Al , Ld Date: 7 / /Q� * Fee methodology set by Tri- County Building Industry Service Board • i:\ Building \Pennits\MEC- PermitApp.doc 12/03 0 .4617T (I1 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information , Commercial Fee Schedule: Total Valuation:; Eermlt,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 Buildi>rg Fixtures Plumbing Permit A licatio - FOR OFFI USE ONLY ttoL i • CI of Ti and i ' Receive `� g Date/By.. Permit No.: S ,..3.a...6 , - CO ‘,2. s _ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.11 IL 2 1 70n; G;rr : d,' i � ; � ( D Other Permit No.: 24 Hour Inspection Line: 503.639.4175 ii L J l l ,' Internet: www.ci.tigard.or.us - --� Date Ready/By: ro "S 0 See Page 2 for �+ _ Notified/Method: Supplemental Information l.■l 1 -r i, • TVE 4 ,.., FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total ?4Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: / 3 2 2. S&/ C /tux, L d tQ Catch basin or area drain • 16.60 City/State/ZIP:-72 .fLRQ 0.2. � 7 zz� Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: v 4. 1 Project name: 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 Back flow preventer Page 2 / 4.-\ V At 7 t) Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑' PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 � Ejectors/sump 16.60 Name: / ! / 12 r „ J f A ...., v ., N Expansion tank 16.60 Address: /'S 2 7S J t/ (titiEf„() Fj a., ,1")2 Fixture /sewer cap 16.60 City /State /ZIP: 4 ALL I O ^ 9 2.2 z3 Floor drain/floor sink/hub 16.60 Phone: (, 3) s - ? ` $ 3 83 7 Fax: ( ) Garbage disposal 16.60 Hose bib I 16.60 APPLICANT ❑ CONTACT PERSON - / Ice maker 16.60 Business name: /t/ />k /"/ /41 Di'f /4 , 6 T 6't. Interceptor /grease trap 16.60 Contact name: ,/JGK X14 !4el Medical gas (value: $ ) Page 2 Address: 4lj ¢ fw M,4 aZ - j r , Primer 16.60 City /State /ZIP: /7 jt n t it c ? 2 / A Roof drain (commercial) 16.60 • Phone: (sv3) 2 z/ - T- 1 9 7 I Fax:: ( ) Sink/basin/lavatory j 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water c ' 16.60 Business name: 9O4, 2 Z Water heater ( 16.60 Address: ' ` '7 n 3a�- i q y'4 Other: City /State /ZIP: ' -\ a s_ q `j. Subtotal Minimum permit fee: $72.50 Phone: ()� . C . / /'!7 � t} Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: 523 7 Plumbing Lic. no.7y 7 -Q 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\PLMF- PermitApp.doc 06/05 440-46t 6T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information ' Fee Schedule: Residential Fire Suppression Systems: Site Utilities , Qty. Fee (ea) Total Square. Footage:.. - , 'Permit Fee:: . • • _ Footing drain - l 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 Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: . $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 Fixture or Item - . ' Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: - Plan Review for Complex Structures . Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria. accurately report fixtures could result in increased sewer fees *. Please check all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site utilities. Previous Capped Added Existing ❑ 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 ❑ Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system. Eye Wash Floor Drain /sink 2" Submit 2 sets of plans with any of the above. -3" -4" Car Wash Drain Isometric or Riser Diagram • Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or.more stories in height. - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor 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 - PermitApp.doc 07/06/05 i i JUL 2 s 2005 Ili J \�� E3y- _._....:,_...�•.. • Number D5 .n03) C1ca nWate \` Services Our corornihmunt i. qtr:,.. Sensitive Area Pre - Screening Site Assessment Jurisdiction t t. {- r Al2_D Date 7 / Map & Tax Lot _ _ Sc�4r - o5Zx Owner r M . jiff E (Satin/ Contact P/lCk .` e Site Address __/.3,2 7 j Si,i; Alf4 /Ewp Company 4 t-//c t' to*' .X Address _1Q J4�, Proposed Activity A , ! � ; • _ i City State Zip paler- dA 9 ?2z .ei ; - Phone s05 - 784-- 119 7 Fax SO 3 - .2 46 - .20 7: - Official use only below this line Y N NA Y N NA Sensitive Area Composite Map Stormwnter Infrastructure maps ❑ ® ❑ Map , .5/4l _....._._.. ❑ ❑ U i QS t ' Locally adopted studies or maps ❑ I 1 rAvi Other `-� �- Spec _ LJ - 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: 17 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. (K Sensitive areas do not appear to exist 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 04 -9, Section 3.02.1. All required permits and approvals must be obtained and . completed under applicable local, state, and federal law. El The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Comments: Reviewed By: C % 4 t __ Date: epp Post - 1r Fax Note 7671 Date .© trono / Returned to Applicant To From d redic &GM tie Mail X .Couuder comept. co. C Date g/ �O s By Phone Si Phone 9 5 . 03.68,- 'ever' / ti Fax M Fax X03 i • PP' CITY OF TIGARD 13125 S.W. HALL BLVD. . TIGARD, OR 97223 IMPORTANT PERMIT NOTICE POWER PLUMBING CO PO BOX 19418 PORTLAND, OR 97280 Plumbing Signature Form Permit #: MST2005 -00253 Date Issued: Parcel: 2S104DB -05200 Site Address: 13275 SW GREENFIELD DR Subdivision: Block: _ Lot: Jurisdiction: TIG Zoning: R -4.5 Remarks: 720sf 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: LEBRUN, TIMOTHY LIN + SUSAN MARI POWER PLUMBING CO 13275 SW 132ND AVE • PO BOX 19418 TIGARD, OR 97223 PORTLAND, OR 97280 Phone #: 503 - 579 -5383 Phone #: 503 - 244 -1900 Reg #: LIC 52378 PLM 34 -150PB AN INK SIGNATURE IS REQUIRED ON THIS FOR Signature of Authorized Plumber If you have any questions, please call 503.718.2433. RECEIVED AUG 1 2 2005 POWER PLUMBING CO. CITY OF TIGARD 13125 S.W. HALL BLVD. - TIGARD, OR 97223 IMPORTANT PERMIT NOTICE • BENTLEY.ELECTRIC INC . - 41330 SW EDNA LANE GASTON, OR 97229 -9625 Electrical Signature Form Permit #: MST2005 -00253 - Date Issued: 8/10/2005 Parcel: 2S104DB -05200 Site Address: 13275- SW.GREENFIELD DR Subdivision: Block: Lot: Jurisdiction: TIG Zoning: R - 4.5 Remarks: 720sf 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: LEBRUN, TIMOTHY LIN + SUSAN MARI BENTLEY ELECTRIC INC 13275 SW 132ND AVE 41330 SW EDNA LANE TIGARD, OR 97223 GASTON, OR 97229 -9625 Phone #: 503 - 579 -5383 Phone #: 503 - 985 -9500 Reg #: LIC 44467 SUP 3635S ELE 2 -20C AN INK SIGNATURE IS REQUIRED ON THIS FORM Sign tare of Supervising Electrician If you have any questions, please call 503.718.2433. CITY OF - ,, ..,•• BUILDING D,AVISION PERMIT #: MSl'200S-00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/100005 Phone: (503) 639 -4171 At° PIpi61�� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/17/2006 TIME: 7:04AM PAGE: 25 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720 sf addition. . OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503-579 -5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -781 -4197 Inspection Request Scheduled For: Date: 7/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 033168 -01 503 - 579-5383 N Corrections /Comments /Instructions: 0-I iii E �f� - TOiC-i 1/Y C!6 �Gb / • 2uo -' . a .„,,...,,,,,, ,., -PASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I f FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A Date: -l7---0 Phone #: (503) 718- 2 -ci-- CITY OF TIGARD ' • , 1 BUILDING DIVISION PERMIT #: MST200S -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 /6mvi�mll��l@I�I`�l Inspection Requests (24 Hrs.): (503) 639 -4175 "—a INSPECTION WORKSHEET FOR DATE: 12/12/2005 TIME: 7:02AM PAGE: 15 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 579 -5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -781 -4197 Inspection Request Scheduled For: Date: 12/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 023300 -01 503-781-4197 N Corrections /Comments /Instructions: ' (, • ' SS ❑ A TIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL / FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .1 Z o ne Inspector: _ ate: one #: (503) 718 - - � A C ITY ����������&���� �*mw n ��m mn�m��nn�� ' � BUILDING DIVISION ` ` hAET2DD��OU253 ~�~~....~..~~� ~�.°"~~"~~"° PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1012005 Phone: (503) 639-4171 Inspection Requests (24Hm.):(SO3)O3A'4175 -.&�' « 11... INSPECTION WORKSHEET FOR DATE: 12/6/2006 TIME: 7:02AM PAGE: 13 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720,4 addition. OWNER: LEBRUN, TIMOTHY UW+ SUSAN kUAR|. PHONE #: 503'579-5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION. INC. PHONE #: 603 Inspection Request Scheduled For: Date: 12/6/2005 Pour Time: Code # |nev"'•° m' .= .on Confirm # Contact # Message 199 e' ' inal 023013'01 503-751-4197 N Corn*cUonm/Comn '- ^' . w . • . • . . ��RARTL4LAPpRDVAL ��CANC�EL ri NOAC{�ESS � || FAIL L INS' ■ ` kJ■. [7 ADDITIONAL FEES ASSESSED _ ' �� Inspector: ~~' �r �^~- Date: " Phone #: (503) 718-1441) r f' CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2005-00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/20055 1 Phone: (503) 639 -4171 a IN��y�r °I � i Inspection Requests (24 Hrs.): (503) 639 -4175 IL INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 15 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: `'`PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 501579-5383 CONTRACTOR: NICK MILD DESIGN CONSTRUCTION, INC. PHONE #: 503 Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 018629 -02 503-781-4197 N Corrections /Comments /Instructions: 0/46- 1 , // W_& ' Sp -- &, 1315 7 l4-:. J,p( j ' a•-. .-r..? 40 S77 r 1,1 t7 si,. • PAW - 5 05 c2 . M r ■ / PASS 7 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL I v" LL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspecto . Date: /0 t jg ' 0 a I hone #: (503) 718 - 1111 , CITY OFTIGARD . BUILDING DIVISION PERMIT #: MST208 002 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 �+A Nm�ii�j� l Inspection Requests (24 Hrs.): (503) 639 -4175 , INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 14 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MART, PHONE #: 503-579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 - 781 - 4197 Inspection Request Scheduled For: Date: 10/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 018629-03 503-781 -4197 N Corrections /Comment Instructions: j A/L� • PASS • PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL " C LL FOR INSPECTION ( I ADDITIONAL FEES ASSESSED Inspecto : / Date: /0 > � , t7J Phone #: (503) 718- CITY OFTIGARD • BUILDING DIVISION A PERMIT #: MST2005-00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 2 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sfi addition. OWNER: LEBRUN, TIMOTHY UN + SUSAN MARI, PHONE #: 503-579-5383 ' CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: ' 503-781-4197 Inspection Request Scheduled For: Date: 11/3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 0202E4-02 50-781-4197 Corrections/Comments/Instructions: ki.91742.4.47 • PASS 1111 PARTIAL APPROVAL LI CANCEL fl NO ACCESS • FAIL ri CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Phone #: (503) 718- CITY OFTIG • BUILDING DIVISION PERMIT #: MST2005.00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 ism m'I � i,�l���I Inspection Requests (24 Hrs.): (503) 639 -4175 f1�-.. INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7 :06AM PAGE: 3 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY UN + SUSAN MARI, PHONE #: 503 - 5579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503781 -4197 Inspection Request Scheduled For: Date: 11/3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 020264 -01 503781 -4197 Y Corrections /Comments /Instructions: l9 0 J P ` 7 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Date : /1 Phone #: (503) 718- CITY OFTIGARD '' ., BUILDING DIVISION PERMIT #: MST2005 -00253 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 arm��llllf t Inspection Requests (24 Hrs.): (503) 639 -4175 __ INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 16 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720E4 addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 575383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503- 781 -4197 Inspection Request Scheduled For: Date: 101.18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 018629 -01 603-781-4197 N Corrections /Comments/ Instructions: (_____ LI // t-- 1, I- /.l ems O/ see,-C---ir ).`` 'gLPASS % 'ARTIAL APPROVAL ❑ CANCEL n NO ACCESS P] FAIL J LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ■_ — Date: /0 18'05 0S Phone #: (503) 718- lib CITY OF"TIGARD • -• BUILDING DIVISION PERMIT #: MST2005 -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 A, Inspection Requests (24 Hrs.): (503) 639 -4175 =� `•__.. INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 13 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720s.f addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503- 579 -5383 CONTRACTOR: NICK MILD DESIGN CONSTRUCTION, INC. PHONE #: 503 781 - 4197 Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 018629 -04 503`781 -4197 N Corrections/Comments/Instructions: tj0f U Jz /k/ A i kJ/ C,Z■ Mir 7, `', ocC PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL L FOR INSPECTION ` ADDITIONAL FEES ASSESSED Inspect. : _ _sue Date: / a -0 ) Phone #: (503) 718 - 0 I CITY OFaTIGARD . BUILDING DIVISION PERMIT #: MST2005 -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 y �� ��"dN u� " �I Inspection Requests (24 Hrs.): (503) 639 -4175 'I �.. INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 16 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 579-5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503- 781 -4197 ! f Inspection Request Scheduled For: Date: 10/12/2005 Pour Time: Oti Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 018103 -01 503.781 -4197 Y Corrections /Comments/ Instructions: 7 V 'ASS _ ' i' n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS II FAIL I. CALL �'" INSPECTION ADDITIONAL FEES AS ESSED ir, / 5 Inspector: Lie D ate: Phone #: (503) 71 !S CITY OFTIGARD 4 1 BUILDING DIVISION #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MST200S-00253 Phone: (503) 639 -4171 A 1012005 Inspection Requests (24 Hrs.): (503) 639 -4175 :':� INSPECTION WORKSHEET FOR DATE: 9/23/2005 TIME: 7 :07AM PAGE: SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 72Osf addition. OWNER: LEBRUN, TIMOTHY UN + SUSAN MARI PHONE #: 503- 579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE # : 503- 781 -4197 Inspection Request Scheduled For: Date: 9/2312005 Pour Time: • Code # Inspection Description Confirm # Contact # Message 230 Underfloor insulation 016501 -02 503-781-4197 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . Inspector: Date: 23�t Phone #: (503) 718 - CI* OF TIGAR.D BUILDING DIVISION PERMIT #: MST2005 -00253 13125.SVV, Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 - -• Phone: (503) 639 -4171 ��,11ii��jil Inspection Requests (24 Hrs.): (503) 639 -4175 '`:_.. INSPECTION WORKSHEET FOR DATE: ��� TIME: 7 :07AM PAGE: SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN % DESCRIPTION: 720sf addition. ` PHONE #: LEBUN, TIMOTHY LIN + SUSAN MARI, 503 - 579.5383 CONTRACTOR: ,NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503-781-4197 Inspection Request Scheduled For: Date: Pour Time: 9/23/2005 Code' ## Inspection Description Confirm # Contact # Message 225 Postlbeam structural 016501 -01 503781 -4191 Y Corrections /Comments /Instructions: 1 , PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS H FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: �� 35 Phone #: (503) 718- CITY OF TIGARD f' . BUILDING DIVISION ` PERMIT #: MST200S -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 Are Inspection, Requests (24 Hrs.): (503) 639 -4175 `:_.. INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7 :03AM PAGE: 32 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY UN + SUSAN MART, PHONE #: 503.5795383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -781 -4197 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 015783 -01 503 - 781 -4197 N Corrections /Comments /Instructions: Slok-(,)—• 9 ‘ 1.a J //-. C ' Q C-AriL \ 5 ) W cLIA e ve__,-„_,K . e 1 � J A --i --- Le- e , , e L A ,_-fr-„-.''' ..•*-Ls r (—L3 k-x:---' VZ-t-vi\----) ...---- k &1R5 n Qa10_„Q. fixit_ zke_p.(L_ ) -`* Q,i -- -- .,,\ 6 , <i-r,, A - c LAL - " . ‘ I - 3) L6 �`- I ' C-- 4 Th PAC u <,„ 9) y2p_v� .�-,--2 d-L. v-1-- 4,4- --P- c ,.,.s 'k S Z Vkl't -.--,,-° 172;`' 6A e o ic. r S' 5m) 42l- 4'7>) OGC,C55 . L-, s (p.) Z1)--1- Co ci S T (COO' ki.,;,,t c1( v\A2);-- rt. -0-c.f.3 LI-e-k,.4 . xA I I PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS Vil i IL if ,k(-S( I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ^ V — Date: "/ ‘ ‘ - ‘) (1, - U V � ? ' Phone #: (503). 718- 5 CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2005 -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 .. u� 11 m�l��i�l ° ,I Inspection Requests (24 Hrs.): (503) 639 -4175 ��'.W -'' �.. </G INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 31 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MART, PHONE #: 503 - 579-5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503.781 -4197 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 015783 -02 503-781-4197 N Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 4 ..)\ j: 0/)500 - Inspector: Date: 1 l Phone #: (503) 718 CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2006-00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 .ifi i,�p'(I Inspection Requests (24 Hrs.): (503) 639 -4175 „_,...W - INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 30 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: • PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503„579,5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503- 781 -4197 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection ` Description Confirm # Contact # Message 610 Gas line 015783 -03 503- 781 -4197 N Corrections Comments /Instructions: N ZS t N o --yvilizi - a PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS n FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Date: ( Phone #: (503) 718- e !C .c r CITY OFTIGARD , • . BUILDING DIVISION PERMIT #: MST200S -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 Avy Inspection Requests (24 Hrs.): (503) 639 -4175: INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7:07AM PAGE: .I1 SITE ADDRESS: 13275 SW GREENFIELD'DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition, OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503. 579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -F81 -4197 Inspection Request Scheduled For: Date: 8/30/2005 Pour Time: 2 Code # Inspection Description Confirm # Contact # Message 210 Foundation' walls 014600 -02 503. 781 -4197 Y Corrections /Comments /Instructions: i► ._ i pS l o _ — VL - ' . • 4 - O'c.) ®--,V _ .fo'V ►il b ©i -- PL -7V S PAS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL J LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector L ` -- ate: �`�SPhone #: (503) 718 - CITY OFTIGARD . . BUILDING DIVISION • PERMIT #: MST2005500263 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/10/'005 Phone: (503) 639 -4171 v �j Inspection Requests (24 Hrs.): (503) 639 -4175 A- ' INSPECTION WORKSHEET FOR DATE: &30/2006 TIME: 7 :07AM PAGE: 12 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: ' PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503-579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 - 781 -4197 Inspection Request Scheduled For: Date: 830/2005 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 014600-01 503 -781 -4197 N Corrections /Comments /Instructions: PASS If PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ' I AIL % //ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ` Inspector: Date: PKone #: (503) 718 - VISO CITY OFTIGARD ' . • BUILDING DIVISION PERMIT #: MS1-2006.00263 l 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8110/2005 Phone: (503) 639 -4171 Arfi 00ii Inspection Requests (24 Hrs.): (503) 639 -4175 M 4 =_L INSPECTION WORKSHEET FOR DATE: 8/7912005 TIME: 7:13Am PAGE: 48 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN NMAR1, PHONE #: 503. 579 -5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503..781 -4197 Inspection Request Scheduled For: Date: 8/29/2005 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 014477 -01 , 503 - 781 -4197 Y Corrections /Comments / Instruc ' a11 . + A.it i �/ . ❑ PASS________. n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS AIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED "A Inspector: Date: ____�L Phone #: (503) 718- w CITY OF TIGARD .. i BUILDING DIVISION PERMIT #: MST2005 -00253 � 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 /v�ea,�4Wll��l6 Inspection Requests (24 Hrs.): (503) 639 -4175 .�' INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 47 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 60367g.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503.781 ..4197 Inspection Request Scheduled For: Date: 8/29/2005 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 014477 -02 503-781-4197 N Corrections /Comments /Instructions: 4 A :' :,P ❑ PAS r I PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED A Inspector: l Date: e---2,---as Phone #: (503) 718- • CITY OFTIGARD . BUILDING DIVISION PERMIT #: MST2005-00253 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 :Inspection Requests (24 Hrs.): (503) 639 -4175 . __.. INSPECTION WORKSHEET FOR DATE: 8/78/2005 TIME: 7:08AM PAGE: 26 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503-781-4197 Inspection Request Scheduled For: Date: 8/26/2005 Pour Time: 2 : 00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 014385 -02 503-781 -4197 N • Corrections /Comments /Instructions: - i12 G 'A , -( ) < & ©i. S -g--' • PASS ❑ PARTIAL APPROVAL Li CANCEL ❑ NO ACCESS `FAIL ❑, LL FOR INSPECTION / El ADDITIONAL FEES ASSESSED g ---- a 6 ' — ‘ 75 , Inspector: Date: Phone #: (503) 718- CITY OFTIGARD . BUILDING DIVISION PERMIT #: MST2005.00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 A4 � �� POgl)ji l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/26/2005 TIME: 7:06AM PAGE: 26 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY UN + SUSAN MARI, PHONE #: 603- 579 5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -781 -4197 Inspection Request Scheduled For: Date: 8/26/2005 Pour Time: 2 :00 Code # Inspection Description Confirm # Contact # Message 205 Footing 014385 -01 503-781-4197 N Corrections /Comments /Instructions: v<r� . i‘H &S 6,O S .__ I PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS •i' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,, A Inspector: / / Date: F - '26 3 Phone #: (503) 718- CITY OFTIGARD BUILDING DIVISION PERMIT #: MST 200500253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006 Phone: (503) 639 -4171 iir " +: Inspection Requests (24 Hrs.): (503) 639 -4175 '� it INSPECTION WORKSHEET FOR DATE: 12/6/2005 TIME: 7 :02AM PAGE: 12 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 579 -5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -781 -4197 Inspection Request Scheduled For: Date: 12/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 023013 -02 503 -781 -4197 N Corrections /Comments/ Instructions: i _R 1 41 1 A ._ .:Iir .../A A .W Air, —ie., ii Au, /" Or , " / ' / .i' /4/-,..-_... ' . ii `_ , ..• '� i /sti , i � g ' //, `i ,ii i / 's °Y `AlliffjSill ..."/A-----e) dirr ..." 0 \\* r - ' ASS 4-PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL E /' , ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 071 Date: / ) Phone #: (503) 718- CITY OFTIGARD BUILDING DIVISION . PERMIT #: MST2005 -00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10 /2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 =� INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 7 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 579-5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 - 781 -4197 Inspection Request Scheduled For: Date: 10/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 018276-01 503- 781 -4197 N Corrections /Comments /Instructions: A.X -�' /✓b? -4 ice, CX PASS E PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: /n / / 3 10 1 - 7 Phone #: (503) 718- CITY OFTIGARD ,_ BUILDING DIVISION PERMIT #: MST2005-00253 13125 SW Hall Blvd., Tigard, OR 97223 7A, DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 I��ill�j�li LY Inspection Requests (24 Hrs.): (503) 639 -4175 11. ..... INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7 :03AM PAGE: 28 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 72OsF addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MARI, PHONE #: 503 - 579 -5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503 -751 -4197 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 015783 -05 503-781-4197 N Corrections/ Comments /Instructions: P ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: \i (}11. Date: t, ,� °S Phone #: (503) 718- CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2005.00253 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005 Phone: (503) 639 -4171 4$41 Inspection Requests (24 Hrs.): (503) 639 -4175 . � .. INSPECTION WORKSHEET FOR DATE: 9/1512005 TIME: 7:03AM PAGE: 29 SITE ADDRESS: 13275 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. OWNER: LEBRUN, TIMOTHY LIN + SUSAN MART, PHONE #: 5503..5579 -5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503.781 -4197 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 015783 -04 503 - 781 -4197 N Corrections /Comments/ Instructions: 6J - #13 lit C t I PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ,"A FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES SSESSED Inspector: 1' ��" V Date v,c Phone #: (503) 718- CITY OFTIGARD ,. BUILDING DIVISION • PERMIT #: MST2005 00253 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 811012005 Phone: (503) 639-4171 414fir i fl j Inspection Requests (24 Hrs.): (503) 639 -4175 `� :.I.. INSPECTION WORKSHEET FOR DATE: 9/16/2005 TIME: 7:03AM PAGE: 27 SITE ADDRESS: CLASS OF WORK: 13275 SW GREENFIELD DR SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LEBRUN DESCRIPTION: 720sf addition. • OWNER: LEBRUN, `TIMOTHY L,IN + SUSAN MARI, PHONE #: 503..579.5383 CONTRACTOR: NICK MILO DESIGN CONSTRUCTION, INC. PHONE #: 503.781 -4197 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 016783-06 503 -781 -4197 N Corrections /Comments /Instructions: ,PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Vi) 0 Inspector: D ate: 1 / 1 i .) j. Phone #: (503) 718-