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Permit `` MASTER PERMIT C ITY OF T I C A R D PERMIT #: MST2005 -00002 DEVELOPMENT SERVICES DATE ISSUED: 1/7/2005 '- I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 09865 SW JOHNSON ST PARCEL: 2S102BA -01800 SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R -4.5 BLOCK: LOT: 020 JURISDICTION: TIG REMARKS: Partial foundation replace, remove shower and move toilet. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: VALUE: 7,500.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL /PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 286.08 RYAN PADDOCK OWNER This permit is subject to the regulations contained in the 4340 SE JOHNSON CREEK BLVD Tigard Municipal Code, State of OR. Specialty Codes 434 J , OR 97222 and all other applicable laws. All work will be done in MI 0 SE E accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 228 - 0475 Phone: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Res #: rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing lnsp Foundation lnsp Crawl Drain /Backwater Framing Insp FinaJ,inspection i .7 Issued By : I `- __.. - -fT �� 1 �,/'/(� Permittee Signature l Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the t business day • Bu Per i t EV\t/ ED '' ion FOR OFFICE USE olvLv ; City of Tigard ll 11 �oO� Received i© // / J t0� 13125 SW Hall Blvd., Tigard, O iRJ /3 Plan Review OJ PemritNo.: Phone: 503.639.4171 Fax: 503.598.1960 /fi /ij Plan Review VIII I I DateB : Other Permit: Inspection Line: 503.639.417IT� OF TI °J I — 1,` . 'I Date Ready/By: RI See Attached Checklist for Internet: www.ci.tigard.or.0 1 VISIO . Notified/Method: Supplemental Information M LDI �I .` , -z. :aY ;r ' ,,! . Q I}I? A I, t.,P"T ,v row, IN; -, s.-:-__°;. �,: s-:; �tti ;�,.�;la.p.F:. .. �, - ,...�� �<t- -_.... ..r r ss � ,. . , . .�. �� � .r.W -.,. ...,.., �- �;..:� arcs:-- .��.,. _ s.. .�"`� <:: „^ate � sa+«� � -,��- ,: ❑ New construction El 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 OA�EGORY QE O STRIrdi DN y 7 work indicated on this application. r� Valuation: $ 1- and 2- family dwelling ❑ Commercial/industrial cop ;�I ❑ Accessory building El Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: ,, -O E ' U.ItMA iI a l , A 0 L1 I,o"c iq f := ' Total number of floors Job site address: cf f86 C S W • I'okKs ov► % , New dwelling area: square feet City/State /ZIP: 'ri 9o g. q ? 'L'L3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: C,p 64 S W / dz&tt,4 Ott. A Deck area: square feet IbLI11) ern. S •t, y Other structure area: square feet D AT . , GO , ° -_ T: E` ' O Subdivision: a �.- z �,,..�::r�.. ,._«,�z.�. .:..•.- -: "�v N.,,44.,_ "j', ,4,4, u t1g, Aid 1. Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 1,5 (OZ 134A 0 , goo Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the 9< " h ..b �r£'i'6 sS"�;�" . s,',C:a'va -r' "�, a a ? $€ s=.: - .-..:,.."., ;tom ; , 4. ,- � I?ESrC tIP O„ a m „W, © ',tK , `r ' " work indicated on this application. 1) l ar l 4 � e L•_. _ „ Valuation: $ li C "r ti "� _ _ -'° "'"""'1 Existing building area: square feet 'j tuwe. it 3' le S taw, a. m.. New building area: square feet r e 'vit}I.ERTX Ttr > "", p t 40-1 ' ANT a Number of stories: Name: gyo44, Pa. /t,+M. t..1-C_ Type of construction: Address: 41s 4 5E . itSe„ �,. eel a. Occupancy groups: • City/State /ZIP: /1,t l i f tle4e.. , C) . ell Z,ZZ Existing: Phone: (SO)) 12,8 - 3 $ Ya WO Fax: (5o3) 224` oCf75' New: , y €P g F AP-PT;T t1NT7 „, 3 . _ ' , ,; �:::a ::�. • : ` ..” 4 ,:r ,_- F-.: „- 0 . - - aE oN , r , mad r .. Business name: Qcia 9.00,0_, I 1 - “-- All contractors and subcontractors are required to be Contact name: (I Palms • licensed with the Oregon Construction: Contractors Board VII 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: 50.44AL 42.6104— applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax: : ( ) 1 E -mail: r�/J L50.G,• CAM \�1�0) DuM�✓ • "E •T``r5 -- �' '�. +5 t r s;_ r: s. PS�.4 -d P' E. Business name: 01,0/0 €-Q----. r ,..,, x ” , Address: City/State /ZIP: - Please refer to fee schedule. Phone: ( ) Fax: Fees due upon application ( ) CCB lie.: Amount received l Date received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: � 12. a � Date: ( i 5 * Fee methodology set by Tri-County Building Industry I Service Board. is \Building\Permits\BUP- PermitApp doc 12/03 440- 4613T(11 /02/COM/WEB) A 1 '.„ 0 Plumbing Permit.. ; t; i (e FOR OFFICE USE ONLY City of Tigard Received g k 5�2 Permit No.: , -006,e-006,e, 13125 SW Hall Blvd., Tigard, OR 97223 �\ /4 Phone: 503.639.4171 Fax: 503.598., Daze/By. 7 Q ,,,, li \ Plan Review 1 b f\ Other Permit No.: 24- Hour Inspection Line: 503.639.417 ► •! Date Ready/By: t�s-, H See Page 2 for Internet: www.ci.tigard.or.us •F ti } . Notified/Method: ( Supplemental Information \ _ FEE* SCHEDULE - ❑ New construction V l ❑ Demolition For spe information use checklist Description I Qty. I Ea. I Total ❑ Addition /alteration/replacement - ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- 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: 7vpS 5( �(q,`t j.iD.. W. Catch basin or area drain 16.60 City /State /ZIP: r' _9-L / 0K- q? Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street /directions to job site: Coyyu,®, r a Y S e ,,, ) 1- Manholes 16.60 4 £ vo+.,A-- 5 (- • Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: N 7- v; (( ,/ 01�,L� I Lot no.: Water service (no. linear ft.: ) Page 2 �T C'°"' Fixture or item Tax map /parcel no.: Z,5 ( 2. 134 D/ 't () Absorption valve 16.60 D ESCRIPTION OF WORK Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 .❑` PROPERTY OWNER I ❑ TENANT Ejectors/sump 16.60 Name: OAK. Pddciori ,,,,.....1.- P 1 Expansion tank 16.60 Address: y3 sto 5E cr. Q (t i. Fixture /sewer cap 16.60 City /State /ZIP: 4k I ,µ(:, ` ,r te , 0 q 72-17Z... Floor drain/floor sink/hub 16.60 - Phone: ( ')'b3) 2 .....l 6,„..4.,) Fax: ( 5;3) 2.2.5 � a - zs Garbage disposal 16.60 - ❑ APPLICANT CI CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: 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: ® I.') OE Q Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 , S CCB Lie.: Plumbing Lie- no.: Plan review (25% of permit fee) i G State surcharge (8% of permit fee) J 't) Authorized signature: /� ` TOTAL PERMIT FEE 7s' , 3C...T Print name: ( , / /� Date: (/7/05 This permit application expires if a permit is not obtained within /2,41, 1 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\PLM- PennitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities, . ' Qty. Fee.(ea) Total Square Footage: Permit Fee: , • , Footing drain - 1' 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 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 N 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 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: • , . . Are you capping, moving or replacing existing fixtures? If "yes", please indicate work performed by fixture. Failure to . accurately report fixtures could result in increased sewer fees * . Quantity by (Fixture) Work Performed Fixture Type:' - Replace New Moved Existing , Capped Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower ' - Jacuzzi/Whirlpool Car Wash -Each Stall , -Drive Thru' • . Cuspidor /Water Aspirator ' - • ' ' Dishwasher - Commercial - Domestic . Drinking Fountain , ' Eye Wash Floor Drain/sink - 2" -3" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach. /Refrig. Drains p Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall • Sink - Bar/Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:\ Building \Permits\PLM - PermitApp.doc 3/03 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200E -00002 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/7/2005 Phone: (503) 639 -4171 i��� @igfll , Inspection Requests (24 Hrs.): (503) 639 -4175 .. J!JP i!. INSPECTION WORKSHEET FOR DATE: 6/16/2005 TIME: 7:10AM PAGE: 98 SITE ADDRESS: 09866 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 020 TYPE OF USE: PROJECT NAME: PADDOCK DESCRIPTION: Partial foundation replace, remove shower and move toilet. OWNER: PADDOCK, RYAN ) ) PHONE #: 503 - 228.0475 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/16/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 009379 -01 603 -349 -1216 N 7 Corrections /Comments /Instructions: • .. °:I ° Y ; PASS ❑ PAR AL APPROVA • ❑ CANCEL ❑ NO ACCESS ❑ FAIL • • .. L d I �! ❑ ADDITIONAL FEES ASSESSED 6 / Inspector: � Date. : Phone #: (503) 71