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Permit • /` CITY OF T IGARD MASTER PERMIT PERMIT #: MST2004 -00353 ,�.�� ®w W O Hall ME d , SERVICES 39 -4171 DATE ISSUED: 12/20/2004 SITE ADDRESS: 10223 SW KENT CT PARCEL: 2S114BB -21000 SUBDIVISION: RIVERVIEW ESTATES NO. 2 ZONING: R -7 BLOCK: LOT: 054 JURISDICTION: TIG REMARKS: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004- 00631. BUILDING REISSUE: CUSTOM p � � STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ,..0:1;1( 1 ' HEIGHT: 24 FIRST: 0 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 710 sf GARAGE: , sf FRONT: PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: VALUE: 250,000.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 710 sf REAR: PLUMBING SINKS: WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 4 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN > =100K: 0 UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 1 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: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCJFDR: 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: $ 2,811.72 This permit is subject to the regulations contained in the ADDY, DANIEL P AND MICHELLE S LHL CONSTRUCTION INC Tigard Municipal Code, State of OR. Specialty Codes 10223 SW KENT CT 11580 SW 67TH and all other applicable laws. All work will be done in TIGARD, OR 97224 TIGARD, OR 97223 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: Phone: 503 - 624 - 7714 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 54727 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 Mechanical lnsp Special insp. required Plumb Final Post/Beam Structural Plumb Top Out Gas Line Insp Final inspection Post/Beam Mechanical Framing lnsp Insulation lnsp Underfloor insulation Shear Wall Insp Rain drain Insp PLM /Underfloor Exterior Sheathing Ins Mechanical Final • Issued By : 4,1 ,44 ,0... ,..7:-. /__.) Permittee Signature :,'' \ '1 Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Building Permit Appli � ;EIV ED FOR OFFICE USE ONLY / City of Tigard Received Date/By Jet/ �' 4. Permit No.: ).6 .6.) N� r 13125 SW Hall Blvd., Tigard, OR 97223 1 8 20 0 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 " ' +Ij� Date /By: V , j'A - Jy -6 Other Permit: T�G "' Inspection Line: 503.639.4175 CITY OF 1t` I Date ReadyBy: 3 ; H See Attached Checklist for Internet: www.ci.tigard.or.us BUILDING DI • , Notified/Method: Z �J" /y f ( L6, Supplemental Information . SR CA"- ) Y c " TYPE OF WORK REQUIRED DATA 1 AM) 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 j 2LAddition/alterationtreplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ' = m CATEGORY OF CONSTRUCTION work indicated on this application. 0 .1- and 2 -family dwelling El Commercial /industrial Valuation: $ .I TO/ 000 ❑ Accessory building El Multi-family Number of bedrooms: El Master builder El Other: Number of bathrooms: JOB. SITE INFORMATION AND LOCATION ,: , Total number of floors: Job site address: i b ab SU....) Vex\ 7 New dwelling area: square feet City /State /ZIP: •-/-fi ell 'la- L i Garage /carport area: square feet , Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street /directions to job site: Deck area: square feet / 01 114 q Dot? ho nn - 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. VC/nri ckg-q,1 VQtiZ I ( k. Q_K (�‘,� Valuation: $ 0 C G� ‘\ UYYk e._, 'C [ Existing building area: square feet c a v New building area: square feet ., y .' . °-PROPERTY OWNER ❑ . TENANT Number of stories: Name: Dc3„ , N L(lc 16O , Type of construction: Address: 1 Occupancy groups: City /State /ZIP: Existing: Phone:( ) Fax:( ) New: ' . : ,01 APPLICANT . .. ❑ CONTACT PERSON NOTICE -% Business name: 1 L S 'r„..y.t C All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board I C IC � 19t under ORS 701 and may be required to be licensed in the Address: , 1 gc SCE 6 Ttl- jurisdiction in which work is being performed. If the -�-� applicant is exempt from licensing, the following reasons City /State /ZIP: \ t 65-130/12© r GR. .. � / apply: Phone: ) 6 c 7 - � - I - 7 .7 / Li Fax: : ( Z( ) 6 3 CI S E -mail: d /?dk '(4v1 Q/ f i X UYy . CC1T�l . CONTRACTOR Business name: 6 a S I /9/�C'Utn -f BuELDiNG PERMIT -FEES* , Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application tram* at? Phone: ( ) Fax: ( ) �] Amount received 0 1 Date received: Authorized signature: / - This permit application expires if a permit is not obtained JJ --<. within 180 days after it has been accepted as complete. Print name: f , f n Rip • ilat■I Date: l t A • * Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Pennits\BUP- PemiitApp.doc 12/03 4404613T(11 /02/COM/WEB) One- and Two - Family Dwelling r r Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Re ceived g Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associy: Phone: 503.639.4171 Fax: 503.598.1960 y id , \ Associated permits: 24- Hour Inspection Line: 503.639.4175 .;� I ❑ Electrical . ❑Plumbing ❑Mechanical 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. ❑ ❑ 11 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. 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 signature on file or with application. ❑ ❑ 0 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, vent size ❑ ❑ ❑ 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- ❑ ❑ 0 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. 0 ❑ ❑ 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 applicable to the • o 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 1 Mechanical Permit Application r FOR OFFICE USE ONLY Received City, of-Tigard I'AF CE C E Date/By: PermitNo.: rI5T P494l ..0+935'3 13125 SW Hall Blvd., Tigard, OR 97223' Plan Review Phone: 503.639.4171 Fax: 503.598.1960 :VII Date/By: Other Permit: Inspection Line: 503.639.4175 l\ . ,� ■ -. ; V I. l' 2t3 I Ju s: 0 See Page 2 for ; e. D ate Ready /By: g Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information riTY OF TIGARD Blity J QE NSW" R* COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction ►`;. Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all . ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION 1 AND LOCATION Heating /cooling Job site address: l O . \ a � S (� ^ 1 Air conditioning or o wing placement) 14.00 heat pump l 1 _ r h, (requires site plan showing City/State /ZIP: T ( D ( ' eD Ti 9- Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 /© 3 R°L f /)up, /1 C FVI Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 ,C,1/ �^- /� Gas fireplace 10.00 ' f � ' $ t r74 7 1 1 —r G 5#t (GZ cj CCi7 1 c41'I e 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 Oter: Chimney/liner/flue/vent 10.00 Other: 10.00 Name: �t l 0 - . f -t �� 1(e Environmental exhaust and ventilation Address: �J Range hood/other kitchen Al if_ 10.00 City/State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 t isir APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 /�/ Other: 10.00 Business name: li/ C_ �/r✓1 -eS Fuel piping . Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue L l/ �" 4Q -6 �� Clothes dryer (gas) Business name: �n Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal Phone: ( )� Fax: (_ _ ) Minimum permit fee ($72.50) Plan review (25 %o fperrniffee) CCB lic.: State surcharge (8% of permit fee) 1 TOTAL PERMIT FEE • Authorized sl nature: / This permit application expires if a permit is not obtained within 180 g ic.f days after it has been accepted as complete. tint name: tC A Date: b Fee methodology set by Tri-County Building Industry Service Board 1 -t'V +'1 - 7 l`►o i i ( �� Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction 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 $1 00.00 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 Plumbing Permit Application ,..; F OR OFFICE USE ONLY • • • z �, • r , a City of Tigard � .. Date/By Permit No.: *r 4..ed 353 13125 SW Hall Blvd., Tigard, OR 97223 � ° r y F Plan Review L CE \\'J Phone: 503.639.4171 Fax: 503.598.146' �0 / /yu�n.Nl�i�U 9I' i DateBy: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 • Juns: Internet: www.ci.tigard.or.us Date Ready/By: See Page 2 for g °j Hil Notified/Method: Supplemental Information �` :: ?'a ' ' ;,v"'' ,.'L w ;i. ;.: ;- : °Ea?q .` ; i -:,r„z . w, ' M, 'F-: ' ;� -i r r- . :fro ' : : * „' . rss < ; ,,.,y ,. 7, , �+a a FEE , *r ' i . . -. - . - • = ,i..:.� � .: ,TYP O:F1 = ,, a A ": �: X.,: n ,._ M :;,,,:"'n',-,:-.1c:';:;:,-A& t: 5A ,. <._.. ,,e,r- ['New construction CITN (13:D4rnolihon For special information use checklist. ^Ill IUIV Description Qty. Ea. Total Addition/alteration / replacement BUILE II��Other:5 New 1-2-family dwellings (includes 100 ft. for each utility connection) r 1 b a P- ' SFR 1 ' . ,1 , J1n a.: 1 , °;' # . { :�CATEGOR : - CU1 f5f .UCTION its..: ••i5g i . -<: ....e.::' ( ) bath 249.20 Pi 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 ❑ Ot her Fire sprinkler ( sq. ft.) Page 2 1 �z Oil SIT ` TAI FORMA.. IO N ANI LOCAT O -* w � ....: �� , P, *o- ;.�.. -s. - At W : � �s , F A - m. - os:a Site utilities Job site address: /0L�3 st n T Catch basin or area drain 16.60 City/State /ZIP: I t y 1 0 (v , 7, -)-L/ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: t t P / roject Project Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: J D CJ z !) G/ A Manholes 16.60 / R � 8 owe A cirri 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.: 1 ,.' ::,"...,,,& ; ..1X : i : p: �:' ": T-9 ..: _,.�•k • :.' i'x 3 -...:- valve Absorption . � . 0 _ � ._A a „t DESC121P'I'TO OF W . °; :. I a. i a , ., ' ,.. Backflow preven ter Page 2 P k 4r vt y el + /,L /'Q Backwater valve 16 60 Clothes washer 16.60 // Dishwasher 16.60 , .f /'v ,. t . _s r° �r .3 Drinking fountain 16.60 ,. 1 ROPE. "O ,0 R a r ..� te j f: ' ,.., .,., _ � �� t :�,.. � J . .. . � ... _ - .,«. - � - . - .��. ��,<_.� , Ejectors /sump 16.60 Name: n e / i f c/, / 4 ADI/ y Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City/State/ZIP: Floor drain /floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ,��r;'. °�ti " �.;��, .�r.:,.� -�� ;.�� •� >,;. -� ,:. �,� 7 �,;� Hose bib 16.60 1 � APPLICAI1t ' ' °" s x . ' CONTr1C PERSON �,,,��' „� m �.. . - w 'Ai _ . ' >,, x *,:- ....cam.'. t � a Ice maker 16.60 Business name: G 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 �� E, -, .," , '�ma'' . ' ` k:; "z. /.; o .,�;:,�, ; ti. � :::b =, .":a ;„", °pb,k,: ^` , €m* e at. ^; v s�,,,r. = . ^;;:t'.= -r v.,; tote "n CONTR, CTO - .. t :: ., `: , , ` Water closet 16.60 Business name: �/ 1 p4 AA( l ten4 k� 6 irk Water heater 16.60 Address: Other: City/State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic:: - - Plumbing Lic. no.: Plan - review- (25 % - of-permit -fee) - - - - -- 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- 46t6T(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard . Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: I. :� " �� ' s � ,, ':i S ' X33 ,,, ";..i .ckz�hn =51- . }r.�i • _ Qtye� =(ea)otaS' ware Fo`ota a Permit S><te Vtihtie_s,a��:�,�� � � g q g Footing drain- P 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 alu9 - , t,pe;_mltJee _ - ,, $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 " Vt ^`i ` ' - t : iF "ee ` "` additional $100.00 or fraction thereof, to and gl%tl1 e- 00:4111. . , 1 1< Q y t i ,.. .Total,^ 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 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: 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 * . z` r Qu nt�Ey liy (Rixtu e} Work1'er#prm k fixture Type 44 r t Repla �� ; r 'N tv , , M ea AllAsAg e p 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 CITY OF. TIGARD BUILDING DIVISION ` PERMIT #: MST2004 -00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639 -4171 i' ll i Inspection Requests (24 Hrs.): (503) 639 -4175 ,_-_,61- INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 62 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and tire restoration of existing house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE S, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 6/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message . 399 Plumbing final 009977 -04 503-3413-3003 N Corr ctions /Comments /Instru� - - a T b - wcUiz ik__Jok,1/4_. Qff--- '"" •-- z,e) 6 . "•■. -L/ ■C,,,L ci \ 7—.6 4) Le JUL-6,.. \ 40,C G,, ---- 5 . _ P -- •3 ./ r — t-e S..A r.,J -- cam. ± " .0 • ____El _PASS ❑ .PARTIAL_AP_P_ROVAL _ _ ❑_CANCEL _ ❑_NO_ACCESS r Ira FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD [K? 5 BUILDING DIVISION PERMIT #: /� 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:�6 L6 `T - is 6 ,js_3 Phone: (503) 639 -4171 �!��� ° . Inspection Requests (24 Hrs.): (503) 639 -4175 ° 'I �.. INSPECTION WORKSHEET FOR DATE: J -- c� TIME: PAGE: SITE ADDRESS: 70 Z Z 3 /' & l� CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #:3 y 8_3003 Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message P c Corrections /Comments /Instructions: ptfii R` T • PASS- - - -H- PARTIAL -APP- ROYAL- - - - -- - ----n- CANCEL - -- - - -- - NO- ACCESS i I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /771,Z. Date: / Phone #: (503) 718 - CITY OF TIGARD - , BUILDING DIVISION ' ; PERMIT #: MST2004-00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639-4171 Ai : :Akiiii1141 Inspection Requests (24 Hrs.): (503) 639-4175 ,„61- - -1. INSPECTION WORKSHEET FOR DATE: 6/24/2005 TIME: 7:09AM PAGE: 23 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: . SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004-00631. . OWNER: ADDY, DANIEL P AND MICHELLE 5, PHONE #: . CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 6/24/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 010112-03 503-349-3003 Y orrections/Comments/Instructions: _ 0 . \ • PASS _ 0 PARTIAL APPROVAL r] CANCEL ____NO_AC_CESS. Ei FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED _ Inspector: / 69''__1.__.„,4,e 7 / 6,_—___ Date: Z ---- -.44 ,- Phone #: (503) 718- 'CITY OF TIGARD BUILDING DIVISION PERMIT #: MS1 "2004 0035 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639 -4171 " "�� °p "'NI $ Inspection Requests (24 Hrs.): (503) 639 -4175 ''' - INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 61 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE S PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 6/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message A A/tA 299 Final inspection 009977 -05 503 -348 -3003 Y 1j—e. Corrections/Comments/Instructions: 1') iA( 666 Z,-)__PL ‘ CC,ee. - S (-- � C . /') 1'1') ems, C�- �, � _ �e -x. 4 co .1 - &-) &-Ii t- A GC.c,-S's filia-f cf-fw)--- ,-/--/-/ A.12 . :''' , . wl Lw"- fl PASS _ ❑ CANCEL NO. ACCESS _ __ V FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: " ' �' Date: "`( 1/3 (O r Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION _ _ PERMIT #: MST2004 -00363 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639 -4171 � Inspection Requests (24 Hrs.): (503) 639 -4175 ••=1.E. INSPECTION WORKSHEET FOR DATE: 6/24/2006 TIME: 7:09AM PAGE: 22 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 064 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE S, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 6/24/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 010112 -04 603 -34& -3003 Y Corrections /Comments /Instructions: • 1/94 7 ...„. / IAPASS _ _❑ _ PARTIAL_AP_PROVAL__ _ _❑ CANCEL n NO ACCESS _ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . Inspector: 174v-i-hl Date: �o�- Phone #: (503) 718 - CITY OF TIGARD \ P .4, BUILDING DIVISION :, • PERMIT #: MST2004-00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639-4171 ' /A„fi i 4 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 63 SITE ADDRESS: 10223 SVV KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004-00631. OWNER: ADDY, DANIEL P AND MICHELLE S, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 6/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # • Message 699 Mechanical final 009977-03 603-3411 . N Corre tions/Comments/Instructions: , . • LW -I■1 9-7./L1 4 - HX-J2 C t / h /'vt-t° 0.i/W__d_s:j2r---e-- lik PASS Ei PARTIAL APPROVAL_ _El CANCEL _ fl NO ACCESS I I FAIL I] CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: V Date: te( Phone #: (503) 718- ' ^ CITY �����7W���&���� � ��um m ��n� mw���mnm�� � ' / BUILDING DIVISION ' ^ PERMIT #: k4E;T2004'00363 /All 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/10/2004 Phone: (503) 639-4171 Inspection Requne�C24Hmj:(5U3)G3A~4175 „ IA- w�1. INSPECTION WORKSHEET FOR DATE: 6/25/2006 TIME: 7:12AM PAGE: 12 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: R|VERVlEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2O04'00631. OWNER: ADDY, DANIEL P AND MICHELLE 5, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 624-7714 Inspection Request Scheduled For: Date: 6/25/2006 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 220 Slab 007716'01 503-348-3003 Y Corrections/Comments/Instructions: • . - �� �4�DAL/\�28[�AL_ �� NOA��E8S - . . ...~. .. . � � -__�~�-~~..~�^ -- -- ' _�' _- | | FAIL 0 CALL RJR INSPECTION El ADDITIONAL FEES ASSESSED ~~~ � Inspector: ^��'~/ �\ Da�g� "��- �� •;.) Phone #: (503) 718- \ CITY OF TIGARD • • BUILDING DIVISION PERMIT #: IviST2004-00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:08AM PAGE: 7 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 064 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004-00631. OWNER: ADDY, DANIEL P AND MICHELLE 5, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 3/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 002594-02 503-348-3003 Corrections/Comments/Instructions: IQ PASS fl PARTIALAPPROVAL___ DCANCEL NO ACCESS. I FAIL CALL FOR INSPECTION 11 ADDITIONAL FEES ASSESSED ■/".. Z 04 - Inspector: ■t. Date: Z one #: (503) 718- CITY OF TIGA,RD BUILDING DIVISION PERMIT #: MST2004- 00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639 -4171 .angiimpt��� Inspection Requests (24 Hrs.): (503) 6394175 INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:08AM PAGE: 9 I SITE ADDRESS: 10223 SW KENT CT ? CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of exitting house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE 9, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 3/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 002584 -01 503 -348 -3003 Y PM Corrections/Comments/Instructions: i ti/ A 4 /AYG. -L.. 5 6 I,I4_ -ASS ❑ PARTIAL APPROVAL . ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ Date: 3 2. � "`Phone #: (503) 718- • CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2004 -00353 13;125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639 -4171 rrkilt, Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:00AM PAGE: fi SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE 5, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 624 -7714 Inspection Request Scheduled For: Date: 3/2312005 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 002594-04 503-348-3003 Y Corrections /Comments /Instructions: geres i i� G J CAS' H5 � 1.= Z5 PASS _ n PARTIALAPPROVAL ❑ CANCEL __ __ n NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: z3 one #: (503) 718 CITY OF TIGARD . .. BUILDING DIVISION PERMIT #: MST2004- 00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2004 Phone: (503) 639 -4171 / ° �llli\ Inspection Requests (24 Hrs.): (503) 639 -4175 .�' INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:08AM PAGE: 6 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existin house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE , - PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 624 -7714 r Inspection Request Scheduled For: Date: Pour Time: P q 3/23/2005 Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 002594 -03 503 -348 -3003 Y Corrections /Comments /Instructions: Ec=7 - ,..,(1--c/ .,- , s ILIfrorir 3 •-i-s ue- c_-o ,—t t < _ �-r- -7 - -� _ ASS _ . .. n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' Date: b one #: (503) 718- CITY OF TIGARD BUILDING DIVISION #: M ST2004 003 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12(20/2004 Phone: (503) 639 -4171 4 9 / /j Inspection Requests. (24 Hrs.): (503) 639 -4175 ....�4 __.. INSPECTION WORKSHEET FOR DATE: 3//22/2005 TIME: 7:13AM PAGE: 61 SITE ADDRESS: 10223 SW KENT CT CLASS OF WORK: SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 054 TYPE OF USE: PROJECT NAME: ADDY DESCRIPTION: Remodel and fire restoration of existing house. Electrical work done under separate permit, ELC2004- 00631. OWNER: ADDY, DANIEL P AND MICHELLE S, PHONE #: CONTRACTOR: LHL CONSTRUCTION INC PHONE #: 6247714 Inspection Request Scheduled For: Date: 3/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 002422 -01 503. 348 -3003 N Corrections/Comments/Instructions: -r - L S , 64;1/' ...-i v2 ...- hie Ur <- O t. t- i 2 - IAi5 c-270 / -- 1 .0 .r..t_ J/ - ---: %,t' ! n. PASS IM<RTIAL APPROVAL ❑ CANCEL 0 NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i Inspector: Date: '3 -- 2 �S Phone #: (503) 718- CITY OF TIGARD - 24 -Hour - BUILDING Inspection Line: (5031639-4175 MST 6 y -6 63573 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received / Date Requested / AM PM BUP Location . l d a 3 1' cJ2.- )f Suite MEC Contact Person Ph ( ) 4 8 _ 306 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access:: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam ��L Shear Anchors ra - Sheath /A SA ming - Sheath/S - - r ..-- - --- -- — _��.. _ — Insulation Drywall Nailing A- 7 rt - L_ a4/2-1 CC Firewall Fire Sprinkler. Fire Alarm Susp'd Cei ' g Roof Other: Fi ,t Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains - Catch Basin / Manhole Storm Drain Shower Pan Other: - Final PASS PART FAIL MECHANICAL ; = s ra Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART 'FAIL ELECTRICAL Service Rough-In_ UG /Slab Low Voltage Fire Alarm Final 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: ❑ Unable to inspect- no access Fire Supply Line ADA D �� O S Approach /Sidewalk inspector Ext Other: Final . DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST off" W INSPECTION DIVISION Business Line: •3) 639 -4171 BUP Received Date Requested /D AM PM BUP Location 6 2 Z ' Suite MEC Contact Person 77 44/(/' Ph ( ) 3 ef „l G 0 3 PLM Contractor Ph ( ) SWR BN G Tenant/Owner ELC CEsioling) Foundation iey� ELC Ftg Drain ACCeSS. �A���`'� °1��3 � � _ � � ELR Crawl Drain Slab Inspection Notes: �j SIT Post & Beam c2 ;CD Shear Anchors F -62-4/A- Ext Sheath /Shear Int Sheath/Shear = S _� , ( I �, (✓`-( tr . , Framing (/� rV - - Insulation Z 1 _ 1 Drywall Nailing ' Fire wall I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Ot al PASS 'ART FAIL INGn P ost & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains - Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL ,MECHANI6AL Post- & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL :ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: _ 111 Unable to inspect — no access Fire Supply Line ADA d, Approach /Sidewalk Date v Inspector - + t Other: Final DO NOT REMOVE this inspection record fro Job site. PASS PART FAIL • •