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Permit '' CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00131 , Alp- DEVELOPMENT SERVICES DATE ISSUED: 4/11/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 102 BA -02200 SITE ADDRESS: 09975 SW JOHNSON ST ZONING: R -4.5 SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 015 JURISDICTION: TIG Project Description: 163sf. bathroom addition. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 163 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: 5 VALUE: 16,156.80 OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 163 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL . FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 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: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes STROUM, DONALD M + CEDAR MILL CONSTRUCTION and all other applicable laws. All work will be done in ANDREA J COMPANY accordance with approved plans. This permit will expire 9975 SW JOHNSON ST 19465 SW 89TH AVE if work is not started within 180 days of issuance, or if the TIGARD, OR 97223 TUALATIN, OR 97062 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 639 - 2466 Phone: 503 - 620 - 0552 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 131345 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 627.80 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Issued By : t. , -'.L _I r. Permittee Signatu - • . _. :... c.� i_- _ 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. B Permit 'j• ► J 'is a ' , ` ' F OR OFFIC USE.O . City of Tigard / Receive,' B. r/ C`�j ?,,{5 PermitNo7- l -00 /3/ 13125 SW Hall Blvd., Tigard, OR 9722 fil Phone: 503.639.4171 Fax: 503 `" 1 i = `*1"'y4pu1 r Plan Review I Date/By Other Permit: Inspection Line: 503.639.4175 ry G A -. I Date Ready /By: J H See Attached Checklist for Internet: www.ci.tigard.or.us ���� O+ � t� Notified/Method: 1 ' Supplemental Information . - .. <> =` ,.. ':',,', >>: ,,��''` �.; �,. �;' `', t�. ...._. �:' „ mot- ' �:; � .::_:' ,�. , I ° :'',A; li ,, OF.t`WORK . -> ' ' ; <- ° - .N' =: 5r,;y,,, ,; - LY D !WE -,' ` ...,� _ '. .� 1�„t F REQUIREDDATA"�L:AN1) FADZI WE,L'`LIVG ".�,`. �,'r�- ,.`.,. i �5 ° , w-:. . ; °srr;.. �; - -�. _, � .. "�.� -`°� Ptt�:z ..�� ° ^,>; �,ro�•z" - � -r,.; <„ ;,:u r 3rrx „maZ. _. �sx; ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all )0 Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ~ ° work indicated on this application. � ' , ;,. : OF -; 0 � ; , � ' ;�:r.,�, ,, ,�iE „1; 4: : 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ El Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: �.,, ` '' : O B SITE' ° IIvEO Total number of floors: • �:., ., ,�, ^ �, „•.;JO RA7ATION.% AIVD ' :'I;ONCATI OI\ %:; < - - - %:. - ;,; - -.:' • Job site address: O t 15 S ‘ , y ) 1-- L,;., K1 Lb New dwelling area: i '.?.., square feet City /State /ZIP: f ' G 1 U (2, C - 7 Z2-3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: STR 301v‘ '?S/41 N glib )1 I I e, Covered porch area: square feet -- Cross street/directions to job site: Co' Deck area: square feet ;T;4 �,, s of i I q Other structure area: square feet . •REQUIRED DATA: COMV MERCIAL USE`CHECKLIS 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 • ���'> ; a ” � „' "� ` z 1t :' ,. work indic on this �j3 „� <'; DESCRIPTION, OF` r�, �,.� �.;,,, i " -' application. ” „rt „- } ,� ; ' : � : �a" �- rya.l'�.' `r >r�„� . . ., bi�r as ?;�;' »a - _e.- �.��'�. ,'�mA, •if>3;1.5,``0,�71�`?�s ifin A 7.31) 1 �l zni.71 11, , 6 A\ ` Valuation: $ Existing building area: square feet New building area: square feet ' , , ROP 'RT . O WNE R:! < : , � 4 `` '' s:. : r , ",ear „`' : ',A�a;•; E ' ���, � , TENA NT'_ "�° Number of stories: Name: U J p ::,:: 0 l . • „, Type of construction: Address: '9 '7 5 s t ,,. a — ,i/J;C%J.) Occupancy groups: City /State /ZIP: lI &A al.) Ia. 9 I ' z 3 Existing: Phone: (c ) d'g ( _7 (, 2 z Fax: ( ) New: ,. , „ , , ; ta i.. "'�y .. .a,?.�4ti'A ,�;� ,c - �- ,�APPLIGAN,T =: CONTACT: PERONk” , 'm' � °_ v Business name: ' `%b41`? ill 1 ` L, C "o /.).072 o A) L C All contractors and subcontractors are required to be Contact name: J....1,_0•-/- 6 Vp licensed with the Oregon Construction Contractors Board �►� �� under ORS 701 and may be required to be licensed in the Address: 19 Li (o5 ( _ ) Q :1:-.0—A t ; g_ jurisdiction in which work is being performed. If the City /State /ZIP: I 1 ^t �: .� � �l 9 Z apply: a ppicant; exer from licensing, the following reasons 1 , - T . Phone: i3) s ...9 3-7 0 Fax: : Cj> ) .F. S 9 3 c,,,,,..? el) E -mail: !Alin: :, rr,; :',. "^ ; .; T v - - . Y .-a .tee - .. �` NT ,; CO Business name: C6,--0,1a, y 1 t✓U CC : I r 4J4 j4r✓ Lc '� �s, :,: 'e . , ff'; ` ;B ILDII\G ;' ,,, 11TT;- FE ,, ES* ' ;, :l gi Address: 19 Li (0, S lti, e1� �,�� l Please refer to fee schedule City/State /ZIP: �, i . 4.1.-7.11 � ) Ot7 � � V, Fees due upon application Phone: eD3 ? ..... 7 3 `7d Fax: 3, ) zv5 EO Amount received CCB lic.: i .3 i .2„Lf 5 , ( 9.- (vi Date received: Authorized signature: ' "0.� _yy J0.A.— � „, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: :L J y b IAN Lot) w Date: 3 - _9 - 0.5 * Fee methodology set by Tri- County Building Industry Service Board i \Permits \BUP- PermttApp doe 12/03 440- 46t3T(I1/02 /COM/WEB) Mechanical Permit ! .. e ill ED "FUR OFFICE USE ONLY City of Tigard Received y: Permit 5 i No o 1) 13125 SW Hall Blvd., Tigard, OR 97223 U► ``� Q 2 (1 U 05 Plan Review Phone: 503.639.4171 Fax: 503.598.196�� ` [ tioit tpI, Date/By: Other Pernut Inspection Line: 503.639.4175 ' I Date Ready/By: Surfs: El See Page 2 for ard.or.us Internet: www.ci.ti -"' "" V '�'� g Y OF TIG A Notified/Method: Supplemental Information :g , ,.., w . ..,,. LII L�PING \ D VIS ON As 1 y''i` .- . &,. j am' ' " �?I" -«. .a 4 . ,;rl °,r" ,: x x , 4k `a-a.�s , & ,* �. ��. ? =;T��'P�=:;OF, ��!ORK ' ,�= C OlVINT "E"I2C1AL`� SCHEDULE s'(JSE1.C"HECKL °IST." ❑ 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. :. - - r - -_ - � ilr :;�; 34,E .;�rdri - - - - �`. r , . ,:' " win »'�z". Value: $ v'�,': CATEGORY OFrCONSTRUGrI®N 4 . ° . ".., *3wx .«..,,. ,.:�' <-.:.t. x avrr s ,,..u.t..�:A.,a . ,:.,... ^, ».:«.. :.:., ..,a « .....`f k .., ..,., :.d' r :isaz. >.+z,fi�r.;., " ..a. - ..,, . . -„ RESIDEN E ; . UIIVIE -N41, „ Y"S, .. TENTS '.F,'EE* [X 1- and 2- family dwelling 111 Commercial/industrial ❑ Accessory building ` ` For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total ,V. .m rite ' , °. JOB'STTEfY Rl,1-4A IO AND <LOCA`I'ION r ° < ,� fi ^ k Heating/cooling (] �y Air conditioning or heat pump Job site address: q ( 7 5 S_C,J - (p 01,,,e ZDIJ (requires site plan showing placement) 14.00 City/State /ZIP: � i I c4a_i (362 . 97 3 l Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: STgoUls P>ifT44,r Gas heat.pump 14.00 Cross street/directions to job site: 99 A (vi> `) Oki A%563. ) Duct work 1 14.00 11 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 Ill '4'ro�rw.3'.', .. -.' a, r> ''''At' K, - fir; 4 Water heater 10.00 . ...:; r ('.. :4,... .� = " ° D,,,.., IOty . R ORI< , ,, , O .... � 5 :," ":, ,..:Y ' ) i � � �� Gas fireplace 10.00 i.r:L Flue vent for water heater or gas fireplace 10.00 A'D7 I LII ,v 4 Coe 1-/r4 1) ,vim A/6-(--- '--A1).., Log p ca;n . Log lighter (gas) 10.00 Gaff Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ;. c „ a =., Chimney /liner /flue /vent 10.00 y°' 1 = v, IiOPERT OWNER 1 . f *s ,T ENANT , ... ,, ,, <, ,: " a t7r1 � , ' N = �_. ,= �_.,; ,_ _4 , r , �, ._� .ita .- _ _ Vii; Other: 10.00 Name: t 4�c30 r� U1,,,,... Environmental exhaust and ventilation Address: 99 '? S �i Range hood /other kitchen SL.� - �a0,,fsSa1� equipment 10.00 City/State /ZIP: Tg_A 2p V Q "') Z �r ,, Clothes dryer exhaust 10.00 1 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) I 6.80 k� >. (” .4.., ". x t O PP -...- a ' =.. t1 tr4 "" : £... � r_, y .'. , '�AGT PrERSON .. . ' Attic /crawlspace fans 10.00 Other: 10.00 Business name: . 2 i l > Goo.) ` - 2 Ud k3 13 Fuel piping ' P�P� g Contact name: 1-.1-0 'r VA).i L $5 ^40 for first four; $1.00 for each additional I fl Furnace, etc. Address: 19 -1 (e S S. i A Gas heat pump City/State /ZIP: ��4 rr 1 V= 9 `? 04,2_ Wall /suspended /unit heater Phone: (5,2:$ ) ! q _ c r ' 7© Fax:: ( ) 8o � / 3 Water heater 7S 'Fp Fireplace E -mail: Range z "a {„�'���i�:,b ?V , >�, fi r:;- ��;,�s` 5 ,�,�"'".. xs �= : �= �`r�'.�'' - ._ <,,;; ". «rz� &� ..�:�r,.rt.* °�; "� - P M ' t CONTRACTOER r , k P Barbecue Clothes dryer (gas) Business name: C K t ADO rtf e- 5 Other: Address: I-' 0 i g 7 6:,z_ MECHANIC FEES .• City/State /ZIP: ' 6AVeaoaJ �� 9 - 7o S Subtotal Minimum permit fee ($72.50) Phone: (S03) ( Lt+ — (420-7 0 Fax: ($D) ( 7) a - 1 9 Z(p Plan review (25% of permit fee) CCB lie.: j I 1 ('3 ( D - I 1 -a� CI ( State surcharge (8% of permit fee) 1 l I 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 i:\ Building \PernitskMEC- PermitApp.doc 12/03 4404617T (11/02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total ,radii = anon, i Perrin Fee `.'" $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 Electrical Pe 1"' ii $1 : FOR OFFICE USE ONLY H City of Tigard Received Permit No.: ifYLSI r 05 -- DO i 3 ( Date/By: 13125 SW Hall Blvd., Tigard, CAV (22 1 ZD dS Plan Review Phone: 503.639.4171 Fax: 5 3.598.1960 A�U 1 ,4 111 111/11'1 4k ' Date /By: Other Permit: Inspection Line: 503.639.41 r( OF . 1G �► Date Ready /By: Juris: El See Page 2 for Internet: www.ci.tigard.or.uss 1ILDIN DIVISIO" Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction 'Addition /alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ['Hazardous location EService over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential cjij 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ES over 600 volts nominal units in one structure ❑Building over three stories ['Feeders, 400 amps or more ❑ Multi family ❑Master builder ❑ Other: ❑Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park Job no.: Job site address: 9915 S yv, SN O PSc xi ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City/State /ZIP: 11 �p,2D Da. 972.2- 3 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: G �" � t7f FEE* SCHEDULE "- tN�0 , Q�ITttVJ Description Qty. Fee. Total °o Cross street/directions to job site: 9 9 Aug z N563\) New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 . 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.90 2 L l �T is rS ) . L.) i%C/. _ 5 A,- . M t-C' Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: r r �,0 R-Q I 601 amps to 1,000 amps 240.60 2 Address: iilt etC 5 • M D i, ) Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: 1 6. Q l e_ c:3)72z3 Temporary services or feeders installation, alteration, and /or 7 relocation Phone: ( ) 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel [APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with • service or feeder fee, each 6.65 2 Business name: L Et R v1/4 1 L c D ] , ! t t .-t ^J?j branch circuit B. Fee for branch circuits Contact name: J Lo'rb Au /Look) without service or feeder fee, I 4 D� Q �� each branch circuit ■ 46.85 D 2 Address: , C7 -1 (S ) .� , ? 1 '[ Each add'l branch circuit '.. 6.65 1"5 2 City/State/ZIP: Miscellaneous (service or feeder not included) ty ( ' — ' UA cars I � ) Q ' ��� Pump or irrigation circle 53.40 2 Phone: ( � � ) �S _ 9 % 7 , 3 ( 5 3 ) . » S . . . Fax: : » _ 93 i, Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or Ce.,‘N,-.1d,,,,,j_ extension. Describe: Page 2 2 Business name: •e-r, C) Address: (/ ,/ 06 �L " , - e — Each additional inspection over allowable in any of the above / ' Per inspection 62.50 City /State /ZIP: / r v!`- 970(9a— Investigation per hour (1 hr min) 62.50 Phone: ( ) 60 1- - 1 42_13 Fax: () OZ • 3 (95-2_. Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lie.: N Electrical Lic.: ' f ■S Suprv. Lie.: 7 D 0/ ( Subtotal (cO t 1 Suprv. Electrician signature, required: ' � % Plan review (25% of permit fee) J1 4,7,, n r %fie %6 State surcharge (8% of permit fee) 1 4 u ? l Print name: / . Date. 3 . (') TOTAL PERMIT FEE f i 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 \Pemrits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* Burglar Alarm I I Garage Door Opener* n Heating, Ventilation and Air Conditioning System* I I Vacuum Systems* Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: I I Audio and Stereo Systems n 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 RECEIVE Plumbing Permit AHlf of td it FOR :OFFICE USE ,ONLY City of Tigard �Y� j [ Rece ived Pemut No. 671 13125 SW Hall Blvd., Tigard, -FT 2OF TIGARD Date/By: �l'15 ( gyp - g al Plan Review Phone: 503.639.4171 Fax: 5 • . DivIslot4 A0040 Date/B• Other Permit No.: 24- Hour Inspection Line: 5( . e ' iI . Internet: www.ci.tigard.or.us ms.. Date Notified/Method: d /Met y: Juris. See Page 2 for Supplemental Supplemental Information =, ' ' ' J- � �` TYPE' OF- WORK , E StTHE {? ^1. :., " �,' ..i. 4 ar°_ ,...t.�� -, ..a s, ... .,.u: ,alt,' - c .- ...h.,t 4M6 Rte .._ -. . A :' -,, . „,.F., . °... .,.<.' ,, * ,.c ._ _. ......, .. , ❑ New construction ❑ Demolition For special information use checklist. Description Qty. Ea. Total iq Addition /alteration/replacement ❑ Other: - New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGOR O,, CON5TRUCTIOlY : SFR (1) bath 249.20 ��.; - . ,a,: �,4 m . , .._. . .�. e .ter .,,.. ».,. .,�.,� ..,.,n - ... `�' 4� 4 :.� - ... _ ., �.Ks, �,.. �. 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: ;s < _ r <>.:': , .tea: r ,,r:re - _;:,.;_ > xr , Fire sprinkler ( sq. ft.) Page 2 _•„ JO igifi 1Y1�ORWW& `F1 D a CASON' : ' . ` ' ` ' S ut Job site address: 9975 5 t ,,,, _J--01_,050.,\J Catch basin or area drain 16.60 City /State /ZIP: 1- i G � � t �Q Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: S T ROJM Qom A[prw)� Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: E x)Stk) A> )t q, Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item Absorption valve 16.60 ' "stk .i s t DESCRIPICIN T OF W O " v f `� �. �g ti? .. _ _ .- .- °,_,A... , 4r F° --. .e ... . ,., . -- ,.. ., .;e . . s.1 Backflow preventer Page 2 - 11-4(, / b 1 L67 S 1 N ( 1 O 2 eG. , Backwater valve 16.60 t S Clothes washer 16.60 Dishwasher 16.60 z. , ..: ilkiPRdiii. 6 & i .rzl • t Z r:a. Ti ., , s :' ? ". J_ N Drinking fountain 16.60 "� -t . Ejectors /sump 16.60 Name: Expansion tank 16.60 Address: GI 9 7 5 Sw -.--- 01../ S6),) Fixture /sewer cap 16.60 City/State /ZIP: 77 e N, ne 9 77 r2 Floor drain /floor sink/hub 16.60 Phone: (583) 1 --g 1 _ Fax: ( ) Garbage disposal 16.60 ' i f l 1 a r Hose bib 16.60 - •.PgLIC�ANT . � : T P , ,, ,o. m �-�� _ °g .... �:�� . �, 4 �,y- � <� -�. -1 �� �� � , �� _, .. Ice maker 16.60 Business name: C6bAz jnt 1 t t ein►.l It2v le7 r, t Interceptor /grease trap 16.60 Contact name: LLD 't' V4 (X/1.- a}-.) Medical gas (value: $ ) Page 2 Address: 19 L./ (a s SL' , g c / la q r- , , Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 xri / Sink/basin /lavatory I 16.60 Phone: (o3) ?TR 5- 376 Fax: (503) .2 S,� 431 $ ` / 0 Tub /shower /shower pan , 1 6.60 E -mail: „;. s =; ;, ;x;,. m. >a,s - -% ; , °,s Urinal 16.60 ". - ,-$ :�� .� O. �P GONT CTOR N lJ`..;1 . "" .= a. F ..- _.. ... .. Water closet j 16.60 Business name: L, F i/ E.C. -)4 , ) }tom (._.. Water heater 16.60 Address: ) %) 0-C 3 el q Other: t Subtotal City/State /ZIP: C g A C) R 1 Q "7 ®7..! Minimum permit fee: $72.50 Phone: (c ) ( t 0 _ 1_44 Cp Fax: (r ) (.;r s O - c.e f o Residential backflow minimum permit fee: $36.25 CCB Lic.: 1 2 -7 D / p Plumbing Lic. no.: 7 L 3 $ Plan review (25% of permit fee) Authorized signature: State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i.\ Building \ Permits \PLM- PermitApp.doc 12/03 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: ., _., .:;r:..: ..- •. - - lte tUt111ti 1 I Q � . gee #0 Tgfal 71a')C FOQ , I �eTI111 t X, F! ee.t Footing drain I' 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 _,, � - , _ ?aluation . : ; < Permit Fee . ; Storm & Rain Drain - 1st 100' 55.00 " $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each t3 'FeeF ea` ' additional $100.00 or fraction thereof, to and F xt rex Or T elif i' r , - Z o n a l including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100 00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1 45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 forthe 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 * . Quantify by, (15 fiNte) Work Perfgrmed • xtuce�)ype �' °Y fit= Repia eD, N ULL y zaV a t „ sh g ca pes Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" -3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter • Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i.\ Building \Permits\PLM•PermitApp.doc 3/03 MST - Ur ) CleanWater Services Our commitmcut i, clear. April 4, 2005 Lloyd VanLoon Cedar Mill Construction Company 19465 SW 89 Ave. Tualatin, OR 97062 RE: Addition to single family residence located at9975 SW Johnson St, Tigard, OR CWS file 05- 000824 (Tax map 2S102BA, Tax lot 02200) Clean Water Services has received your Sensitive Area Certification for the above referenced site. District staff has reviewed the submitted materials including site conditions and the description of your project(See attached site plan). Staff concurs that the above referenced project will not significantly impact the existing Sensitive Areas found near the site. In light of this result, this document will serve as your Service Provider letter as required by Resolution and Order 049, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. This letter does NOT elminate the need to protect Sensitive Areas if they are subsequently identified on your site. If you have any questions, please feel free to call me at 503 -681 -3605. Sincerely, /' Chuck Buckallew Environmental Plan Review Site plan attached E: \Development Svcs \SP 00- 7 \Concun Letters\2S 102BA02200 - no impact to water quality 04 -9.doc 2550 5W Hillsboro Highway • Hillsboro, Oregon 97123 Phone: (503) 681 -3600 • Fax: (503) 681 -3603 • www.CleanWaterServices.org . . CITY OF TIGARD .,... . BUILDING DIVISION 4/1110,„A ' PERMIT #: ei tvr iii T2 2 0 0 0 0 5- 5 00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 ke e d iViAllts Inspection Requests (24 Hrs.): (503) 639-4175 .a 41 . ...... • INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: 7:06AM PAGE: 513 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO, TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROM DESCRIPTION: 163sf. bathroom addition. 9/13/06 Permit reinstated for 30 days for final inspections, OWNER: STROUIvi, DONALD M ÷, PHONE #: 503-639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503-62&0552 . . , Inspection Request Scheduled For: Date: 1W3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 037519-02 503-332-6618 Y 441 Corrections/Comments/Instructions: el 0 • y PASS pi PARTIAL APPROVAL 0 CANCEL I I NO ACCESS I ' I FAIL I I ' LL FOR INSPECTION III ADDITIONAL FEES ASSESSED Inspector: Date: ( 2 Phone #: (503) 718- _______ • • CITY OF TIGARD . Asia 1111111 BUILDING DIVISION PERMIT #: MST2005-00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639-4171 _11644114 / Inspection Requests (24 Hrs.): (503) 639-4175 ailla '--... V INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: -. • AM PAGE: 59 , , SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 0-16 TYPE OF USE: PROJECT NAME: STROUNI DESCRIPTION: 163sf. bathroom addition. 9/13/06 Permit reinstated for 30 days for final inspections. OWNER: STROUM, DONALD M +, PHONE #: 503-63t1-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503_620..0552 .1 Inspection Request Scheduled For: Date: 10/3/2006 Pour e: Code # Inspection Description Confirm # Contact # ) -ssag: ik likik 299 Final inspection 037519-01 503•332-6618 Y Corrections/Comments/Instructions: S t ‘ - Z V P11 " 66— . PARTIAL APPROVAL 0 CANCEL I I NO ACCESS FAIL n CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED Inspector: -------'--- 0/)7 0 Date: Phone #: (503) 718- 2.--Y_Z-4 _ — _ _ - ^ CITY OF '� ��n m o m�`m TIGARD 0 BUILDING DUNG DUVUSUON *' ERN1|T #: KH OO1 1 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 4y11/2OO5 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 a 4.41■ ^ INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: 7: 06AM PAGE: 57 SITE ADDRESS: O9976SW JOHNSON SF CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 016 TYPE OF USE: PROJECT NAME: 8TR0U1H . DESCRIPTION: 163sf. bathroom addition. 9/13/06 Permit reinstated for 30 days for final inspections. OWNER: STR{)UM. DONALD hA+. PHONE #: 603-639-2466 CONTRACTOR: CEDAR MILL CONSTRUC11ON COMPANY PHONE #: 503-620-0552 Inspection Request Scheduled For: [)ate: 10/3/2005 Pour Time: ' Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 037619-03 503'332'6618 N Corrections/Comments/Instructions: . . . � ~ ~` S 0 PARTIAL APPROVAL 0 CANCEL NO ACCESS FAIL | I CALL FOR INSPECTION I ADDmONAL FEES ASSESSED . � � / ~� k� �� -� ���� �� |Inspector: k�� " ' Date: - � -' ~~ Phone #: (503) 718- - � . --�- � � � . CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2005-00131 13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 4/11/2005 Phone: (503) 639-4171 e t4100) I i f i 1 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 101312006 TIP' : - .16AM PAGE: 56 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: ' SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. 9/13/06 Permit reinstated for 30 days for final inspections. OWNER: STROUM, DONALD M +, PHONE #: 503-639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503-620-0552 Inspection Request Scheduled For: Date: 1013/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 037519-04 603-332-6618 N Corrections/Comments/I tructions: 7 1 rw A 0 " : X tdvx .4-2_ - 77 i riAl D of,./ 1 /4�r 0/A- Ala 6 to) 1 20 . / , .• /0 /3/ • A A , I I a/ 7.-- V-e. ■ ji ' ' Ss PARTIAL APPROVAL El CANCEL n NO ACCESS 0 FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION ■ PERMIT #: MS1'2005-00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639-4171 / �m �u , mg�ii4l6� A„.„\ l Inspection Requests (24 Hrs.): (503) 639 -4175 �_' 'f 1... INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 58 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 016 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 1630. bathroom addition. , OWNER: STROU PHONE #: DONALD M +, 503 - 639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503 - 620.0552 Inspection Request Scheduled For: Date: 4/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 005602 -05 503. 332 -6639 N Corrections /Comments /Instructions: ❑ PASS '' 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ ' /LL FOR INSPECTION El ADDITIONAL FEES ASSESSED / �f �j�� ) Inspector. - Ins Date: I / i v v Phone #: (503) 718 - P o CITY OF TIGARD 1 BUILDING DIVISION PERMIT #: MST2005 -00131 13125 SW Hall Blvd., Tigard, OR 97223 DA TE ISSUED: 4/11/2005 Phone: (503) 639 -4171 � �� t ppi i p6l� I l \ ' Inspection Requests (24 Hrs.): (503) 639 -4175 .. \\ INSPECTION WORKSHEET FOR DATE: 5/3/2005 TIME: 7 :14AM PAGE: \ 9 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 016 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503. 639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 603 - 620.0662 Inspection Request Scheduled For: Date: 6/312005 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 006973 -02 503-332-6639 N Corrections /Comments /Instructions: !P,61 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED Inspector: 4/1 0 - ( - -- Date: c/ > /©� Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION * PERMIT #: MST2005 -00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4!11/2005 Phone: (503) 639 -4171 4 ' A "'4Pypuq�l'j�hl Inspection Requests (24 Hrs.): (503) 639 -4175 ° ._.. INSPECTION WORKSHEET FOR DATE: 5/3/2005 TIME: 7:14AM PAGE: 10 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503. 639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503- 620 -0552 Inspection Request Scheduled For: Date: 5/3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 230 Underfloor insulation 005073.01 503-332-6639 N Corrections /Comments /Instructions: • L PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V L L --' Date ?/© Phone #: (503) 718- CITY OF TIGARD ‘A a_____ , BUILDING DIVISION ' PERMIT #: MST2000011 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2006 Phone: (503) 639-4171 a41/ lmypiOfi � Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/2/2005 TIME: 7:10AM PAGE: 49 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503-6392466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503 - 620 -0552 Inspection Request Scheduled For: Date: 5/2/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message i 320 {Lel Plumbing rough -in 005707 -01 503 -332 -6639 Y C rrections /Comments /Instructions: \ • (265 Ti r--,..e........ -? k,,k 1/4....,,, - j, V-2.-c / /e) g --- (73-‘,,A1) „2-,..) a d \ H � . - 1 i±- k 0-t, a _ lAr 1 , • 11,- S , 0-4c..A--- A--c 0 Ltd aAre - ( PL....„,„ - (er,"_ , «) 3 12,) L V v1/4-1V _ D c"- ___- CLA--:\;(--2 C--er\/\-- 54-1. 1--c-.....-k \Th) 1--2--( i VIA, ."`5■ (" Ds 4 ---- etc__ 0 ote_____ , n PASS , PARTIAL APPROVAL El CANCEL ❑ NO ACCESS n FAIL v ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Z-.4 C Date: / , Phone #: (503) 718- CITY OF TIGARD!f L , 0 1 BUILDING DIVISION N. PERMIT #: MST 2005-00 f31 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/'51/2006 Phone: (503) 639 -4171 d /U:1inj Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/2/2005 TIME: 7:10AM PAGE: 46 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: • ' PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M + PHONE #: 503- 6.$9 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 603- 620 -0652 Inspection Request Scheduled For: Date: 5/2/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 / Framing 005787 -03 503-332 -6639 N Corrections/ omments /Instruc 'ons: I) 1 _ 1 C --- komie — 1 4--- i of /A/Z ( ) o . 4 „.z... e s 1, , sS�5 :4 0.736 ( ek-e' ■reL__, - ' - , .-, IPM otA < U. ! 0 ; ta_c . L.411.,' PASS �' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED OA C )11--- Inspector: Date: 4- Phone #: (503) 718- CITY OF TIGARD i BUILDING DIVISION ` PERMIT #: MST2005- 00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4111 Phone: (503) 639- 4171° Inspecti on Requests (24 Hrs.): (503) 639 -4175 Jo INSPECTION WORKSHEET FOR DATE: 5/2/2005 TIME: 7:10AM PAGE: 48 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. . OWNER: STROUM, DONALD M +, PHONE #: 503- 639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503 - 620 -0552 Inspection Request Scheduled For: Date: 5/2/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 4 rough -in 005787 -02 503-332-6639 N Corrections /Comments /Instructions:. \_ ?6 rem d_ . kt ®f ---- -e....E_L. S - ' ) 5 0-- ) C-4--* ... cer-ft @ -Q-Lcrld4 . 9) LinA_ t■-\ „ - "- c..../A.,-,. Q --v-- W2--%---- SZ,,K-.--S -- , -/--si 5 -6—vv..._t `'ss .i a,L - . • 4 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: fi Date: V ( Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION ' . PERMIT #: MST2005-00131 13125 SW Hall Blvd., Tigard, OR 97223 Att . DATE ISSUED: 4/11/2006 Phone: (503) 639-4171 2 itievilli II\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 57 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503-639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 603-620-0662 Inspection Request Scheduled For: Date: 4/29/2006 Pour Time: Code # ' Inspection Description Confirm # Contact # Message 276 Framing 006692-06 503-332-6639 N Corrections/Comments/Instructions: der • GM n PASS PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS i* FAIL / 1 , / ALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED 1 L I ‘.-Z - Of - Inspector: Addillitl■ Date: . hone #: (503) 718- Mr W , • CITY OF TIGARD BUILDING DIVISION r' PERMIT #: MST2005-00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639-4171 Alkb- i ( Inspection Requests (24 Hrs.): (503) 639-4175 frai- — INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7 : 11 AM PAGE: 59 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: 1 SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503.639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 63-620-0552 Inspection Request Scheduled For: Date: 4/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough-in 005682-04 503-332-6639 N Corrections/Comments/Instructions ger IC--19 El PASS El PARTIAL APPROVAL II] CANCEL Li NO ACCESS ll FAIL 0 CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED / Inspector: _ AdallW, Date: Li _ Z1, 0 j Phone #: (503) 718- ,. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 00131 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/11/2005 Phone: (503) 639 -4171 ff a/) /����lp,���it Ins Requests (24 Hrs.): (503) 639 -4175 ..' ` -_.. • INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7 :11AM PAGE: 62 • SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROIJM, DONALD M +, PHONE #: 503'639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503.620 -0552 Inspection Request Scheduled For: Date: 4/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Postibeam structural 005662 -01 503-332-6639 N C rrections/Comments/lnstructions: .t 1E1 PASS r •ARTIAL APPROVAL ❑ CANCEL I I NO ACCESS n FAIL M C L FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: �/ Z 7 Phone #: (503) 718 - 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639 -4171 Altb flp iiph��lt Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:11AM PAGE: 55 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503 -639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #:. 503 -620 -0552 Inspection Request Scheduled For: Date: 4/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 005460 -01 503. 332 -6639 N Corrections /Comments/ Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 - 27-0(\ Phone #: (503) 718 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00131 13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 4/11/2005 Phone: (503) 639 - 4171 14pip @I�I�i�� Inspection Requests (24 Hrs.):. (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:11AM PAGE: 54 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: . SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503.639.2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503.620 -0552 Inspection Request Scheduled For: Date: 4/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 260 Roof nailing 005460 -02 503- 332 -6639 N Corrections/Comments/Instructions: • • P1/ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639 -4171 :n 8 11 /4111ilJ)f Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/2612005 TIME: 7:10AM PAGE: 82 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503 -639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503-620-0552 Inspection Request Scheduled For: Date: 4/26/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 250 Roof nailing 005357 -02 503- 332 -6639 Y Corrections /Comments / Instructions: 7t rO Nor' • ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED • Inspector: Ag Date: 1 Phone #: (503) 718- • CITY OF TIGARD . BUILDING DIVISION #: IY►ST2005 -00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2006 Phone: (503) 639 -4171 i� I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/26/2006 TIME: 7: 10AM PAGE: 83 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, _ PHONE #: 503- 639.2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503 - 620 -0552 Inspection Request Scheduled For: Date: 4/26/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 005357 -01 603-32 -6639 V Corrections /Comments /Instructions: 7) -z � • ❑ PASS " ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL , CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED /d Inspector: Date: � � ---- z , Phone #: (503) 718- CITY OF TIGARD s*_ BUILDING DIVISION PERMIT #: MST2005 0031 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639 -4171 � Ai, ie�NIfiv Inspection Requests (24 Hrs.): (503) 639 -4175 „ - -_.. INSPECTION WORKSHEET FOR DATE: 4/14/2005 TIME: 7:10AM PAGE: 67 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: . PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503-639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503. 620 -0552 Inspection Request Scheduled For: Date: 4/14/2005 Pour Time: 10 : 00 Code # Inspection Description Confirm # Contact. # Message 205 Footing 004482 -01 503-332-6639 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 4 l4- -o. Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: M T2QQ .00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2006 Phone: (503) 639 -4171 N Alh � u�Bl �t i ; I. Inspection Requests (24 Hrs.): (503) 639 -4175 -'. INSPECTION WORKSHEET FOR DATE: 4/14/2005 TIME: 7 :10AM PAGE: 66 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503 - 639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503. 620 -0552 Inspection Request Scheduled For: Date: 4/14/2006 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 004482 -02 503 - 332 -6639 N Corrections /Comments /Instructions: O P ,..t Lk LL A. ,,.pct -10.c- &2,r s-; z,.--_ 40 s'i7A -e i S 4 5/Ac,. A . : _/ / 4 so 1447 Jame) (/`. -. A- ___ of • C- 2,-C.✓ r-- A - s 5 vi,sS J 1 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A Date: 4- - 14--0 J Phone #: (503) 718- CITY OF TIGARD .. BUILDING DIVISION PERMIT #: MST2005 -00131 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/11 /2005 Phone: (503) 639 -4171 b # / / eN 1 414 :ilt Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/13/2006 TIME: 7 :10AM PAGE: 72 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503- 639 -2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503 -620 -0552 Inspection Request Scheduled For: Date: 4113!2005 Pour Time: 2 : 00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 004388 -02 503 -332 -6639 N Corrections/Comments/Instructions: ("'ii /LAW - I I PAS ❑ PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS FAIL - ❑ - CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: , Date: / 3 ----0 Phone #: (503) 718- • .. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00131 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1112005 Phone: (503) 639 -4171 � h#llhikiil pliIll Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/13/200 TIME: 7 :10AM PAGE: 74 SITE ADDRESS: 09975 SW JOHNSON ST CLASS OF WORK: SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 015 TYPE OF USE: PROJECT NAME: STROUM DESCRIPTION: 163sf. bathroom addition. OWNER: STROUM, DONALD M +, PHONE #: 503 - 639-2466 CONTRACTOR: CEDAR MILL CONSTRUCTION COMPANY PHONE #: 503 -620 -0552 Inspection Request Scheduled For: Date: 4/13/2005 Pour Time: 2 :00 Code # Inspection Description Confirm # Contact # Message 205 Footing 004308-01 603-332-6639 N Corrections /Comments /Instructions: '/ At --,1-/2 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS F AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A Date: — / - ?- - 06 --- Phone #: (503) 718- 1