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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2008 -00143 COMMUNITY DEVELOPMENT DATE ISSUED: 9/25/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25101 BC -03000 SITE ADDRESS: 12361 SW KNOLL DR ZONING: R -4,5 SUBDIVISION: PP1992 - 083 LOT: 001 JURISDICTION: TIG PROJECT: COSTA Project Description: Converting garage into habitable space. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: 2 BATH: 1 TOTAL: 0 sf 14,000.00 REAR: 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 SRVCIFEEDERS 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: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 2 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 Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable LUCIA COSTA OWNER laws. All work will be done in accordance with approved plans. This 12361 SW KNOLL DR permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080 You may obtain copies of these rules or direct Phone: 503 405 - 2135 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344 Reg #: TOTAL FEES: $ 960.43 REQUIRED ITEMS AND REPORTS Issued By: — . — . _ — — P_ermittee- Signature -• _- �4��— Call 50 . 175 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. a• or: Building Pe ppli Residential FOR OFFICE USE ONLY City of Tigard Re e �� Permit No.: - p��f(l 71 13125 SW Hall Blvd., Tigard, OR2 3 Vii o g � Plan Review Q Other Permit: C ' Phone: 503.639.4171 Fax: 503.5901'960 ; ')(0 Date /By: 9 - 3 ' �U T.1 GARD Inspection Line: 503.639.4175 Date Ready /By: luris• ® See Page 2 for Internet: www.tigard- or.gov GAD Notified/Method: ,; / 5 CC, Supplemental Information .. ''-'',+:: �TYPE � OF V� 1 \�,'C � T , m • REQUIRED DATA ::I - =AN) 2- FAMILY DWELLING `� Permit fees* are based on the value of the work performed. ❑ New construction "f UemohUon Indicate the value (rounded to the nearest dollar) of all Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ' work indicated on this a �° CATEGORY OFD CONSTRUCTION _ •- �)n�G Valuation: $ 4 and 2- family dwelling ❑ Commercial /industrial /15-6199-- ❑ Accessory building ❑ Multi - family Number of bedrooms: 2 ❑ Master builder ❑ Other: Number of bathrooms: r " ° .:STI'E : INFORMATION M AND' LOCATION° ' _ 'l*''''''' Total numbe of floors: 1 �., Job site address: l S W. k ola // de., _ New dwelling area: – � qua feet 1 V City /State /ZIP: a^ Of?, 1 C / 1� Garage /carport area: square feet Suite/bldg. /apt. no.: �^ � Project n ame: j''_, Covered porch area: square feet Cross street/directions to job site: / /All I/, jg 4 1< . -I f c/ Deck area: square feet j "ht,' /3;h i ``'" � °v Other structure area: square feet , ' REQUIRED DATA: CO =USE CHECKLIST., Subdivision: 1 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 h : : work indicated on this application. C�i4' a�9 % 1411 O - e�I.rDffhs ./ i Jcvtlj) Valuation: $ C le _ 1 J 4 Q 1/ , v Existing building area: square feet l hhh / New building area: square feet :,��PROPERTY, OWNER ` ❑TENAN' - Number of stories: Name: j (e 5-11 Type of construction: Address: ) 2 S t U. 14 0 1,-, Occupancy groups: City /State /ZIP: - >8.4 OR (77,2.2-3 Existing: Phone e: (& 3) L . -? – t O1 V 3L Fax: ( ) New: . g ;�-., `: 4 TD'APPLICANT'� . ONTACT PERSON; - : ` " v . _ = , � . 9 .. • - - ' • 'NOTICE ' .. . Business name: All contractors and subcontractors are required to be Contact name: /I is ke. 5.-k o vf licensed with the Oregon Construction Contractors Board l under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: 1 G . 43 . Phone: (S33) 406 j I Fax:: ( ) 1 7-45.1 C) E -mail: . .)0 . • CONTRACTOR . Business name: ti .. � e , wn t r. BUILDING PERMIT. FEES *,:,.' Address: { - . (Please.refer to fee schedul . City /State /ZIP: Structural plan review fee (or deposit): ‘, qq Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): Total fees due upon application: �J� `7 f7 — CCB lia: (t Amount 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: el (J(;( .4 ( J j( Date: 0947004 4 * Fee methodology set by Tri- County Building Industry Service Board. I:\Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB) Building Permit Application Checklist One- and Two-Family Dwelling . • FOR OF FICE U SE` ONLY City of Tigard Received Permit No.: Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: 1 a C Phone: 503.639.4171 Fax: 503.598.1960 24- Flour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical TIGARD Internet: www.tigard- or.gov ❑ Other. 1 `THE F OLLOWING ITEMS ARE REQUIRED° FO PLAN: REVIEW Yes fi No i NSA 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ Il 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ • 3 Verification of approved plat/lot. ❑ ❑ Ii 4 Fire district approval required. Name of district: . ❑ ❑ II- 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ [I 6 Sewer permit. ❑ ❑ II 7 Water district approval. ❑ ❑ III 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ II CI ID 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- basin 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- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section limy be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings . and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. . 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. . 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." _ 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required El ❑ ❑ 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 ❑ ❑ CI architect licensed in Oreg and shall be shown to be applicable to the project under review. , JURISDICTIONAL SPECIFICS - . 23 Three (3) 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 trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature 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 doe 03/21/06 440- 46t3T(I1 /02 /COM/WEB) Electrical Permit Application FOR,OFFICE USE p City of Tigard Received Permit No.: yV � J 1 ' ` ° 13125 SW Hall Blvd., Tigard OR 97223 Date/By: W g Plan Review 7 C Other Permit: Phone: 503.639.4171 Fax: 503 598 960 .t Date /By: T I G ARD p Inspection Line: 503.639 Date Ready /By. luris ® See Page 2 for Internet: www.tigard - or.gov i i` . ' v.1 A Notified /Method. Supplemental Information . , Ei OF WO RA 0,zgub : . , , , Feu ° . PLAN REVIEW ` -. I ❑ New construction Addition /alteration /replaceme Please check all that apply (submit 2 sets of plans w /items checked below): MY ®F -GA�® ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑Other: �A 1 1 Htl where the available fault current ❑ Marinas and boatyards. r ' a CATEGORY`.OF - COI � t . 'g ' , i ; ° ®i'1 exceeds 10,000 amps at 150 volts or ❑ Floating buildings. J less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB `S ITE INFORMATION AND {LOCATION 4 , ❑ Emergency system. larger separately derived system _ ,. - . x � ND ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: �[ r J I OOHP or more. occupancy. /� ..C'a � S. �^ 1 r j � l'1 �e / r 71� ❑ Six or more residential units ❑ Recreational vehicle parks. City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than i f cjrl/ � - �� ❑ Hazardous locations. 600 volts nominal Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more ' ` . , - FEE. S CHEDULE: : ., : . `._' ; ''. Cross street/directions to job site: Description I Qty. I Fee. I Total I * New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map par cel no.: Limited energy, residential ' - DESCRIPTION, OF WORK,- , . ° . . ` (with above sq ft.) 75. 2 n) Limited energy, multi- family 75.00 2 Acic 1 t hc;' --to j " residential (with above sq. ft.) I J Services or feeders installation, alteration, and/or relocation 200 amp or less 80.30 2 ..2 y ' ' . P ROPERTY',OWNER ., ° ' -' - ' ❑' TENANT .. . ' ' ' 201 a mps to 40 0 amps 106.85 2 Name: _j_ 401 amps to 600 amps 160.60 2 4 C. 1(q �U5 "1 �1 601 amps to 1,000 amps 240.60 2 Address: a..3 6 ( 5, 1,/ /< not C'i rl . Over 1,000 amps or volts 454.65 2 Temporary services or feeders installation, alteration, and /or City /State /ZIP: - t91 6R _ '72 3 relocation Phone: (s L/ " LQ 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, an 701 401 amps to 599 amps 133.75 2 'M1 Owner signature: ` Date: ✓ 7o %/ ` / Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with t j ❑ ``APPLICANT, ' •' ': ` - - ^ `;CONTACT PERSON : , • above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits M „ /! ^ 5 j ( 46.85 2 without service or feeder fee, ' Contact name: / ' i l e �j first branch circuit Address: Each add'l branch circuit `2,.., 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or / modular dwelling, service and /or feeder 90.90 2 Phone: (5:5" ) CET- , f 3 Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 ' CONTRACTOR - ' Sign or outline lighting 53.40 2 Ho Signal circuit(s) or limited - Business name: ( �o ;A n .i,- i energy panel, alteration, or Address: l extension. Describe: Page 2 2 City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lie.: I Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ' 'ELECTRICAL' .PERMIT FEES `. ' Suprv. Electrician signature, required: Subtotal: C 15 — Date Print -name: =O ): _ 9 � /�� — Plan review (25% of permit fee State surcharge (12% of permit fee): 2 7Z Authorized signature: TOTAL PERMIT FEE: Print name: C (Kt 1 4 co.frit This permit application expires if a permit is not obtained within 180 Date: /�� days after it has been accepted as complete. * Number of inspections allowed per permit. I' \Building\Permits \ELC- PermitApp doc 05/23/06 440- 4615T(1 I /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL AVO RK ONLY, '' ;'' , • , Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* 0 Burglar Alarm ❑ Garage Door Opener* O Heating, Ventilation and Air Conditioning System* 0 Vacuum Systems* H Other: ?:.COMMERCIAL WORK ONLY:-,,,, r Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: n Audio and Stereo Systems H Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n • HVAC 0 Instrumentation n Intercom and Paging Systems O Landscape Irrigation Control* O Medical Nurse Calls n Outdoor Landscape Lighting* • n Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.\ Building \Permits\ELC- PermitApp.doc 03/23/06 Plumbing Permit Application r Building Fixtures 8 \O: ' . FOR. OFFICE 'USE ONLY r . City of Tigard R eceived 4 2U Permit No 7 y � LI 3 , Plan Review IN q 13125 SW Hall Blvd., Tigard, OR 97223 RR DDate/By: O`�� _ Phone: 503.639.4171 Fax: 503.598.1960 S�P 1� Q Date/By: Other Permit No.: Inspection Line: 503.639.4175 Q TIGARD �, GP`� te ReadyBy g g : luris ® See Page 2for Internet www.ti and -or. ov / Method. Supplemental Information „ '�\I O F a AO �t ified , ' " , TYPE WORK: , , a.. r - . � _, FEE* SCHEDULE ' i r 4r :-; ❑ New construction ❑ D o Itton "°° For special information use checklist __. Description Qty. Ea. 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 `` dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 ' ' rrt ',.%-:. ":;JOBvSITE` INFORMATION' AND. LOCAIION . - t Vi _ .- > _� �- � _ w p . - Site utilities Job site address: / -G I S: � f / < d Catch basin or area drain 16.60 City /State /ZIP: ' j ;' , ,I 0/\ q 223 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Water service (no. linear ft : _) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 r ,., > 4 , D ON %OF WORK ,, ,_ x Backflow preventer Page 2 /7 4 II '7%,-1 0.-P t ' � rn. b �� S; r, . ci ,, //�� I o, /e= f" Backwater valve 16.60 ±t go, -,/ i-, ,r eI / fz l Clothes washer 16.60 Dishwasher 16.60 ' PROPERTY;OWNER, : - 9 ❑ ;T " ',1 , Drinking fountain 16.60 Nom;_... _ �. . . E /sump 16.60 Name: L , �' -" C( �0. J to ( Expansion tank 16.60 Address 5Q I'Yie ( _ f 5 /'�`� Fixture /sewer cap 16.60 City /State /ZIP: J ` Floor drain /floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 Hose bib 16.60 " - Ili APPLICANT. - 'X PERSON Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: /1 I r /< ,,, S 'ri Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: (5 E. ) r� -_ 2 \� 5 Fax:: ( ) Sinl:/basi ava o 16.60 hoover /shower pan t 16.60 E -mail: Urinal 16.60 , CONTRACTOR: n meter close 1 16.60 Business name: i i Water heater 16.60 Address: 00 in e,Wi .e r -. Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: Plumbing Lic. no.: Plan review (25% of permit fee) Authorized signature: State surcharge (12 %of permit fee) t TOTAL PERMIT FEE Print name: Lei crt a:I T if- Date: 0 1 /03 A oI This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I.\Building\Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information - • Fee Schedule: Residential Fire Suppression Systems: , SiteUtilities Qty Fee" (ea> Total: ' Square, Footage .Perm><t Fee 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 Fee;;;- : ::Permit: w _ . 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 F><xture Or <.Item :. Fee „(ea) Total ?{ additional $100.00 or fraction thereof, to and '`- including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001 00 to $50,000.00 $379.50 for the first $25,000.00 and $1 45 for 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 and up $742 00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial Fixture Work: ` ; Pla v iew Re : for;Plumbing'Installation' ":'F Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and =` Quanti ti fixture Wo`rk'Performed;.,. greater, except systems designed and stamped by licensed J + tY Y(F ) ,- -. engineer. Figture`.Types . ; . , . ;< , � ” � .- ? � °: :' � Replace;, , �� `Piev;ous 'Gapped Added ^' °E�stin�. ° ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru • Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain . _: - : Isometric,or.Riser `'- Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" -4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\ Building \Permits\PLM- PermitApp.doc 12/27/06 Mechanical Permit Application ,e' c - FOR OFFICE " USE ONLY c Recei 4 City of Tigard ti Permit No.: 't . �+ �, ' Phone: 503.639.4171 Fax: 503.598. y Q t ` Date/By: J 6� i ' mac 13125 SW Hall Blvd., Tigard, OR 972 pp \] 4 Plan Review .9 Other Permit: � cb Date /By: Inspection 503.639.4175 TIGARD Line: ,? � Q� Date Read /B Juris Internet: Line. gard- or.gov • ' -. y Ready/By: See Page Supplemental for r 1 Noti Method: Supplemental In TY1 E WO CV , ° N , : a . , COIVIMERCIAL- `FEE *, SCHEDULE: -. USE IST a ltaa p`'e t ieh Mechanical permit fees* are based on the value of the work ❑ New construction Addition/ ctl;'tent performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: C$5\'‘' V mechanical materials, equipment, labor, overhead, and profit. , " , °�'' `CATEGORY ; OF. CONSTRUCTION ' . . . < . Value: $ �� , " ," :' . " RESIDENTIAL EQUIPMENT,. /, FEES *; ; 'Ir 1 - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. '0 Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB °SITE - INFORMATI AND LOCATION -'° I Heating/cooling Air conditioning or heat pump Job site address: (requires site plan showing placement) 14.00 City /State /ZIP: / 6 j / S v / / n l ` � / 417,1_1o? 97223 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 1 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in - wall, in -duct, suspended, etc. 14.00 Flue /vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances ` • ' DESCRIPTION 'OF 'WORK .• . • - •` , • Water heater 10.00 L Gas fireplace 10.00 i( tribe_ /Lt lrehlp I rev G j,,,sP Flue vent for water heater or gas I P t /� (/ fireplace 10.00 a�6 Cl � Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 PROPERTY - OWNER, .= ° "� . _ ❑ ;TENANT , ° Other: 10.00 Name: LI G Environmental exhaust and ventilation Address: 22 / �h/ ) ' t / l�i Range hood /other kitchen /.23 2J E7 ��1� at t equipment 10.00 City /State /ZIP: +,---,. 4/ CA ` 97z ;-3 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 1 6.80 • ,p N "' ' "_ r. _ . - Attic/crawlspace fans 10.00 . � ❑ APPLICANT' : „ � , , r. - r = G ONTA_ CT P,ERS e: .. p Other: 10.00 Business name: Fuel piping Contact name: Ai( / ( 70,, .A' $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 • - - CONTRACTORS• . . r Barbecue • Business name: Clothes dryer (gas) Other: Address: . r. ` S,MECHANICAL`PERMIT FEES * . ,.. . " City /State /ZIP: Subtotal I Lo, e Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 2_.--. Plan review (25% of permit fee) CCB State surcharge (12% of permit fee) s ,70 TOTAL PERMIT FEE ` This permit application expir if a permit is not obtained within 10 / , uthorized si gn at u / days s after after it has been accepted as complete. '� Date: ^ .'"' 9.V of * Fee methodology set by Tri- County Building Industry Service Board I:\ Building 'Permits\MEC- PermitApp.doe 01/19 17 440 -4617T (11/02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total' Valuation: Permit $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. L\ Building \Permits\MEC- PermitApp.doc 01/19/07 2 • ... Information Notice to Property Owners About Construction Responsibilities Statement Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. [ORS 701.055 (4)] This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. PgezA.le c h.ecf the a rt ° ropriate box aY d complete the following statement: i own, reside in, or wiii ies.de in t .e cu , Meted structure and my general contractor is: '° CCB# Expiration Date I will instruct my general contractor th 11 subcontractors who work on the structure must be licensed with the Construction Contractors Board. 7 (,,,„„ performin n.., ork on r;. open ty I o Nn, a residence that I reside in or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mini' - hire a general contractor, I will contract with a contractor who is licensed vi ith the CC ad will immediately notify the office issuing this building permit of the name of the contractor. I have read and understand the I 'os tiaatiof; Notice to Property Owners about Construction Responsibilities contained on th. , -;! to,0 pl - <lid I hereby certify that the information checked and completed above is correct and : _ +r '. "2 LU tilt cos; + ir____ --- rint name of permit applic: Signature of permit applicant Date This form is supplied to building of Permit #: /hS7 Uc)/y3 permit offices by the Oregon Address: /' 2 f .S?,�/ / U// Or Construction Contractors Board, (r` r .i' as required by ORS 701.055 (6) ! : Issued by: 6 •1 • Date: /S This copy to issuing permit office City of Tigard, Oregon Page 1 of 2 ' City of Tiga� ., Oregon ,, a . , I > ' l . 7r tit[ / fr`t L3;rct 1, ::a ^rsf. dI!t „ t'. r E -C, (..) - 1 :1 j 4. t ki? "A� Place to (.,/I Home" �` Search (l Property ( Planning ( Crimes I Transportation I Utilities ( Aerials I EOC I I Summary I Permit Summary I Community I Hazards I Explorer 12361 SW KNOLL DR Property Summary [ 1 %, . 4411 I^ GARDEN PL. \__------- -- -° r s L �'" , �. L. t I 1i Z . 1 t.<e•b. _ t _ F T 1 z t f, � i ( '' '~ 'JED _ , � ! if ..._,_ j ii ^ i Ls? *1- / Property Owner Info Tax ID Number: 2S101BCO3000 Tax Account Number: R2028023 Site Address: 12361 SW KNOLL DR Site City: Site ZIP: 97223 Owner: COSTA, CLAUDIU & EMILIA Owner 2: 12361 SW KNOLL AVE Owner 3: Owner Address: Owner City: TIGARD Owner State: OR Owner ZIP: 97223 Acres: 0.18 Sq Ft: 7,840.8 Bldg SF: 1,228.00 Bldg Value: $ 105,670 Land Value: $ 147,310 Total Value: $ 252,980 http: // tiggisiw /mox52_multimap /index.cfm ?fuseaction= property. summary&CFID = 40029 &CFTOKEN =... 10/28/2008 CITY OF TIGARD BUILDING DIVISION 7 PERMIT #: MST2008-00143 18125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2512008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 IL. INSPECTION WORKSHEET FOR DATE: v0/200c/ TIME: 7 PAGE: 6 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: ppi992..033 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Convening garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/0/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 799 Final inspection 079516-02 503-477-0434 Corrections/Comments/Instructions: afro &1" I Kol Cf(a, PASS n PARTIAL APPROVAL CANCEL NO ACCESS ra AIL UN CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- _ 1 4°' %Mb CITY OF TIGARD BUILDING DIVISION • PERMIT #: MS1.2008.00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 905 Phone: (503) 639-4171 wilvii14. Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: ifei2009 TIME: 7.00Am PAGE: 7 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992-003 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 603,477.0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/W2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 079516.01 603-477-0434 N Corrections/Comments/Instructions: KePOR.1 o f.) Ce:›gle-e-=- 1 1R 'A ) PARTIAL APPROVAL El CANCEL 0 NO ACCESS FAIL iv CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED f • 4/0"__ Inspector: IP Date: Phone #: (503) 718- Z___6* . ,, Nil■ ___ , r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20lJt at1`'tri3 18125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ��5/:�006 Phone: (503) 639 -4171 iA NtiAi Inspection Requests (24 Hrs.): (503) 639 -4175 ges,A IL INSPECTION WORKSHEET FOR DATE: 1/6/2003 TIME: 7 :01AM PAGE: 8 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992 - 083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503.477-8434 CONTRACTOR: OVER PHONE #: Inspection Request Scheduled For: Date: //612009 Pour Time: Code # Inspection Description ,Confirm„# Contact # Message 199 Electrical final 079372 -03 503-477-0434 N Corrections /Comments /Instructions: 6 prrU PkRS Pi 'ALA_ 1E s`QActit,o -6n■ eft.) 6 ail R ti tow rJ _ w" Q6--v - 'V R.Q.1 s ri o S o foAni 66) i ilka - ' etgil'IO-. I I PASS _ PARTIAL APPROVAL, iii CANCEL ❑ NO ACCESS 'FT FAIL 3 X CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' W L Date: 15 7 Phone #: (503) 718- 2,ipyi, CITY OF TIGARD BUILDING DIVISION #: `T uo € -O 1 1125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/2008 Phone: (503) 639 -4171 � " Inspection Requests (24 Hrs.): (503) 639-4175 4i- 'I .. INSPECTION WORKSHEET FOR DATE: 12/29/2008 TIME: 7 :00Am PAGE: 5 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: faaP1992 -0t13 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA #: 603_477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/29/2008 Pour Time: Code # Inspection Description onfirm # Contact # Message 199 Electrical final 7923:2-03 503.477 -0434 N Corrections /Comments/ Instructions: 7(ON ►06 t) w -' `Y a.- il, L., 14 13 NI liKoock tiv)) 4 -10 1 1 off- S PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS at FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: , IV be Date: ` ) Phone #: (503) 718- 141417 CITY OF TIGARD BUILDING DIVISION At,A PERMIT #: MST2008-00143 1 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 905n000 Phone: (503) 639-4171 60111 09411i1 Inspection Requests (24 Hrs.): (503) 639-4175 ..4_4' '.. INSPECTION WORKSHEET FOR DATE: 1111000W TIME: 7 PAGE: 4 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992 LOT #: OM TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: £03.07-004 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/10/2008 Pour Time: Code # Inspection Description Cor7r - Contact # Message 120 Electrical rough-in 077894-03 503477-0434 N . , Corrections/Comments/Instructions: ■ PASS PARTIAL APPROVAL 0 CANCEL E. NO ACCESS • AIL I I CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: G 1\ e) LC Date: A( 1 0i 1 Phone #: (503) 718- AIL______ CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2008-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91250008 Phone: (503) 639-4171 by#4 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1113/2008 TIME: 7 PAGE: 22 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 111312008 Pour Time: Code # Inspection Description orifiirn # Contact # Message 120 Electrical rough-in 077552-01 503-477-0434 N Corrections/Comments/Instructions: 1W 0 % E Nal- i riNV14 „,_ - ....____. PASS) 0 PARTIAL APPROVAL D CANCEL 0 NO ACCESS . Am 0 CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED ---- u • 1 Inspector: "' ‘ce_) LE Date: 7-r'`A • I Phone #: (503) 718- 'AT° CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2ao8 -00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5i2008 Phone: (503) 639 -4171 / u� i / Inspection Requests (24 Hrs.): (503) 639 -4175 Awl- INSPECTION WORKSHEET FOR DATE: 10/20/2008 TIME: 7:014m PAGE: 2 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992 -083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Convecting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503- 405 -2135 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/20/2008 Pour Time: Code # Inspection Description C_onfirm # Contact # Message 120 Electrical rough -in 077277 -02 508 - 340.521: N Corrections /Comments /Instructions: �3 2-116 tom' f iZt. e vE its_ wl Z) W r 1 14.44S . if .siP -A , .: ,�� Ai E'er- iRQAL,inl6 - 4$ Ok5, �°�\•62b V iJ 1,-I e,'�VE vg►D ‘tJ fi f.Ls 0 . ttM . Ill Pt c 1 cZI e 6 c_tiT a 02 ei cal_ , ( 1 p kb v GI V\ - 1 IQ tv.)0 Mtiti■Lv7" "e c.:1 0- eA _ V.) n, I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL XLCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �• NI .2 Date: 1 ZI A Phone #: (503) 718 - xNlik CITY OF TIGARD A ..,/ BUILDING DIVISION ,. PERMIT #: IviST2008-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/2008 Phone: (503) 639-4171 4,47,4111IiI\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/6/2009 TIME: 7:01AM PAGE: 7 SITE ADDRESS: .12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992-083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 603-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/6/2009 Pour Time: Code # Inspection Description Confirm # Contact # Mes. ; :‘ 299 . Final inspection 07937244 503-477•0434 Corrections/Comments/In tructions: . _. cep," v \\ \ ..1 \ 0 PAS' fl PARTIAL APPROVAL n CANCEL .EI NO ACCESS IkFAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED It Inspector: cAlz,...--- Date: Phone #: (503) 718- _ . CITY OF TIGARD " BUILDING DIVISION A.„t\ PERMIT #: MST7008-001413 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/2008 Phone: (503) 639-4171 & usiiiiium ,6 Inspection Requests (24 Hrs.): (503) 639-4175 aggi• 11. INSPECTION WORKSHEET FOR DATE: 1/5p009 E: 7: NAM PAGE: 9 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: pp1991-003 LOT #: nal TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Reque Scheduled For: Date: 1/612009 Pour Time: Code # I spection Description Confirm # Contact # Me sag 399 . Plumbing final - 079372-02 503477-0434 N Corrections/Comm: ts/Instructions: APAKAA La - A /■_A.A - r _AL A -14 )A8'S El PARTIAL APPROVAL fl CANCEL Ti NO ACCESS fl FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED VC/ 2L-f 2,(1 Inspector: V A - G Date: g Phone #: (503) 718- _ „ CITY OF TIGARD BUILDING DIVISION . ' PERMIT #: MST2008-00143 13125 SW Hall Blvd., Tigard, OR 97223 A DATE ISSUED: 9060006 Phone: (503) 639-4171 4 / 0 / 1 1/ 1 40101# Inspection Requests (24 Hrs.): (503) 639-4175 .44. - li. INSPECTION WORKSHEET FOR DATE: V/29/2008 TIME: 7:00AM PAGE: 7 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992-083 LOT #: OW TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Conyertinq garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 6(.3-4770434 CONTRACTOR: OWNER PHONE #: • Inspection Request Scheduled For: Date: 12/29/2008 Pour Time: Code # Inspection Description r onfirm . Contact # Message 399 Plumbing final 079232-02 503-477-0434 N Corrections/Comments/Instructions: i46--tfct c.rj t7 s . 0 6 tqiixtoon., .t. mo Riok.)c...co,..etAilt wivim. 2- Q4 ' Z bkAIC• icr 'I to .Ait 'lb k i L L , , I I PASS El PARTIAL APPR_QVAL 7 CANCEL 7 NO ACCESS FAIL 0 CALL FOR INSPECTION II] ADDITIONAL FEES ASSESSED t. ■ ' Inspector: ( S c. ' Mek.< Date: %I./ 11) Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION i t . PERMIT #: MST200 001 '13 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: f.26. /1000 Phone: (503) 639 -4171 i i° Inspection Requests (24 Hrs.): (503) 639 -4175 - I �. INSPECTION WORKSHEET FOR DATE: 11/512000 TIME: 7 :01AM PAGE: 6 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992.083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503. 477 -043 l CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/5/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 370 Plumbing rough -in 077691-01 503-477-0434 N Corrections /Comments /Instructions: e vb -i-C. d wdAA --c ✓ P pi ■-%- r A-1 CO `r m ' P 1 v; X PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: Qi V►i `� Date: /1)51 0T) Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: tvt1 10ti8 CtS113 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2512008 Phone: (503) 639 -4171 A ry� Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' ° =�' l INSPECTION WORKSHEET FOR DATE: 10/17/2008 TIME: 7:02AM PAGE: SITE ADDRESS: 161 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1 - 083 LOT #: 00 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503 -405 -2135 CONTRACTOR: O R PHONE #: WNE Inspection Request Scheduled For: Date: 11111 /2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 076865 -01 503-405-2135 N Corrections/Comments/Instructions: I A- \.) LTC k,-. k ‘ ak- T i-ir-4--'\ L-01 P Q / ,dt- g-I— r. o E c) Uri =J,-' 4 .,.- riv -4.„ fie, NAL , ie..,A;1; \,. No c� -) - I C''._e_c. - 1 .� e a � J__( - ce `,,r�� • A PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: el 1� 1 \S Date: I D \ 1) lot Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: IVIST2008-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2512008 Phone: (503) 639-4171 ,_• 11 1 1 1 11 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 10/W2008 7:00AM SITE ADDRESS: CLASS OF WORK: 12361 SW KNOLL DR SUBDIVISION: LOT #: TYPE OF USE: PP1992-083 • 001 PROJECT NAME: COSTA DESCRIPTION: COnverting garage into habitable space. OWNER: PHONE #: COSTA, LUCIA 503 CONTRACTOR: PHONE #: OWNER Inspection Request Scheduled For: Date: latenoos Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 076435-01 503-405-2135 Corrections/Comments/Instructions: Asj t,1/4) (LV ru ) C i'vcsi tit 1?-c_ Pe „/ Lc P J A) zj I I Ot PASS ri PARTIAL APPROVAL 1 CANCEL NO ACCESS FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: di) Date: Jo Cti oct" Phone #: (503) 718- CITY OF TIGARD " 1 BUILDING DIVISION PERMIT #: M ST2.000-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 90672008 Phone: (503) 639-4171 ANAlmolli?\ • Inspection Requests (24 Hrs.): (503) 639-4175 , .K.4 11 . --• INSPECTION WORKSHEET FOR DATE: 1/5/2009 TI • 7:01AM PAGE: la SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: pp•1992_083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 603.4774434 CONTRACTOR: OWNER PHONE #: Inspection Requ't Scheduled For: Date: 11E12009 Pour Time: Code # spection Description Confirm # Contact # Meeag 6 9 9 Mechanical final 079372-01 603-477-0434 N Corrections/Comments/Instructions: • _PASS E k FAIL LPARTIAL APPROVAL 0 CALL FOR INSPECTION 0 CANCEL 0 ADDITIONAL FEES ASSESSED 0 NO ACCESS Inspector: IL Q{4 Date: ( 01 Date: 1 / S i Phone #: (503) 718-1)4 1' CITY OF TIGARD BUILDING DIVISION .{ PERMIT #: MST2008-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2612008 Phone: (503) 639- 4171 wu4pu� i" Inspection Requests (24 Hrs.): (503) 639 -4175 J 'IL INSPECTION WORKSHEET FOR DATE: 12/217000 TIME: 7:O0AM PAGE: 5 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: pp g 2 -OB3 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 6O3- .477 -t3434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/29/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 799 Final inspection 079232-04 503-477-0434 N Corrections /Comments /Instructions: e ` ❑ PASS _ _ I I PARTIAL APPROVAL n CANCEL [ _ I NO ACCESS F— ` 4 FA CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: A Date: I Z Z--1/ Phone #: (503) 718- 26 g !C , . CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2008-00i43 1'3125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/ • Phone: (503) 639-4171 4 , l Inspection Requests (24 Hrs.): (503) 639-4175 ,,--4.0■ t--. INSPECTION WORKSHEET FOR DATE: 12/29/2008 TIME: 7: 00A1s4 PAGE: 8 SITE ADDRESS: 12361 SW KNOLL. DR CLASS OF WORK: SUBDIVISION: PP1992 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: converting garage i— - e i nt o habitable space.. OWNER: COSTA, LUCIA PHONE #: 603,477.044 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1212912008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 079232-01 503-477-0434 N Corrections/Comments/Instructions: b ,4-7-7-e- Ec,c_D"-- - . PARTIAL APPROVAL fl CANCEL 0 NO ACCESS A. ,. N , Q72 FAIL VI CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED i ,-- .00' ■ 2 Inspector. Date: Phone #: (503) 718- _6# lib CITY OF TIGARD BUILDING DIVISION PERMIT #: ST2Qilk18tl1 3 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/2E42008 Phone: (503) 639- 4171 II f Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1//1012008 TIME: 7:02AM PAGE: 7 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1gg2 -033 LOT #: 1101 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: c03-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/10/20018 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 12 £ Exterior sheathing 077893 -01 503 - '177 -0434 N Corrections /Comments /Instructions: • ) - C ?, ea c A ,I -s' -o0 (A5) Cowl e1e1 Ala \\ v - e tagg El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /3S Date: /d4/0v48 Phone #: (503) 718- a ` i 23 CITY OF TIGARD BUILDING DIVISION - PERMIT #: MST2008-00 143 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 9/2612008 Phone: (503) 639-4171 /4471 4/ 1 141# Inspection Requests (24 Hrs.): (503) 639-4175 A. ■ 112. INSPECTION WORKSHEET FOR DATE: 11/10/2008 TIME: 7:02AM PAGE: 6 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: ppt992. 003 LOT #: 001 TYPE OF USE: PROJECT NAME: cosTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/10/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 i Framing 07789401 603-477-0434 N Corrections /Comments/ Instructions: 50 rioofs / ■ vt - - a /50 e _, n--,- b _.._ PASS PARTIAL APPROVAL [1] CANCEL fl NO ACCESS I FAIL I I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: Z3S Date: /A4/0 OS:" Phone #: (503) 718 2 . . ' CITY OF ' ��mo m n�'m TIGARD BUILDING DIVISION - PE RNi|T# | ~�~~"~~~~""~~= ~°"°"~°"~~"~ #: hAST2O08-00143 | 13125 SW Hall Blvd., Tigar . OR 97223 DATE ISSUED: 9,06/2008 Phone: (503) 639-4171 Airtvitt III Inspection Requests (24 Hrs.): (503) 639-4175 a��N- 11. INSPECTION WORKSHEET FOR DATE: 11K10/2008 TIME: 7:02AM PAGE: 6 SITE ADDRESS: 123G1GW KNOLL QR CLASS OF WORK: SUBDIVISION: pp1992-083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 603477-0134 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: j1/1[/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 077894'02 503-477-0434 N Corrections/Comments/Instructions: PASS 0 PARTIAL APPROVAL 0CANCEL Li NO ACCESS �y|| FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: 73 s Date: / oet Phone #: (503) 718- 292 —3 CITY OF TIGARD BUILDING DIVISION - PERMIT #: MST 2008-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 90512008 Phone: (503) 639-4171 a pl n■ ........rtli II Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/5/2008 TIME: 7:01A1v1 PAGE: 5 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992-083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/60008 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 077692-01 503 N Corrections/Comments/Instructions: eb z_z__:.." a— Ae../0-is .2, ,--,,,,,:" - • . ild 5 a , .------ El PASS PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS El FAIL 0 / ,, LL FOR INSPECTION D ADDITIONAL FEES ASSESSED ' ) A , Inspector: Date: //-- e Phone #: (503) 718- ... _ . CITY OF TIGARD BUILDING DIVISION Alk . PERMIT #: t vi 8T2 0 0 8m014 3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2_5/2008 Phone: (503) 639-4171 kooloolic,,, , Inspection Requests (24 Hrs.): (503) 639-4175 491 AL INSPECTION WORKSHEET FOR DATE: 11/5/2008 TIME: 7 PAGE: SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PRI992-083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-477-0434 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: '11/V2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 . Exterior sheathing 077693-01 503-477-0434 N Corrections/Comments/Instructions: A e (I/44.0 4.4 L. ___,,,.i.:s • PASS 0 PARTIAL APPROVAL E CANCEL I I NO ACCESS AI _.- . gL,FL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED i , I i7 ./. Inspector: Date:/ — ---. ---°- 0/ Phone #: (503) 718 • CITY OF TIGARD BUILDING DIVISION PERMIT # tviiST200B.00 43 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91:26/2008 Phone: (503) 639 -4171 Aregio Inspection Requests (24 Hrs.): (503) 639 -4175 'IL INSPECTION WORKSHEET FOR DATE 11/3/2008 TIME 7 :00AM PAGE: 23 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992 -083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 603_ CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 11/3/2008 Pour Time: Code # Inspection Description Confirm # ' Contact # Message 240 Exterior sheathing 077551 -01 5034177-0434 N Corrections /Comments /Instructions: 0 A-07 --- ...-----.. PASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS Ei AIL ❑ CALL FOR INSPECTION f] ADDITIONAL FEES ASSESSED Inspector: Date: /j— .3 — .e:fP, Phone #: (503) 718- 7- 4 ----"" CITY OF TIGARD ... . ,. BUILDING DIVISION A,a1,, PERMIT #: MST008-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9125/2008 Phone: (503) 639-4171 hedtifillit '\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 10/28/2008 7:01AM 3 SITE ADDRESS: 12361 SW KNOLL. DR CLASS OF WORK: SUBDIVISION PP1992-083 LOT #: 0 0 1 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-405-2136 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough-in 077277-01 503-340-213 N Corrections/Comments/Instructions: • j erF - ' , PARTIAL APPROVAL 0 CANCEL . pi NO ACCESS El FAIL a CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Date: 7° 7 1 Sg Inspector: .._■.&_____ Phone #: (503) 718- 19 1 INS .. ._ , CITY OF TIGARD BUILDING DIVISION PERMIT #: M T 008 0014 t 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 9/25/2 0 Phone: (503) 639 -4171 1/Il ii Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/21/2008 TIME: 7 :00AM PAGE: 9 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP1992 -083 LOT #: 001 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Coriverting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 503-405-2135 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 076988 -01 503-405-2135 N Corrections /Comments /Instructions: e FA - SS ❑ PARTIAL APPROVAL ' I CANCEL I I NO ACCESS ❑ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 23S Date: .o2/.Z7 Phone #: (503) 718- 2 3 CITY OF TIGARD BUILDING DIVISION PERMIT #: IIST 008 0014 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: :5/:0tfg Phone: (503) 639 -4171 /�noin V iti Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/2112008 TIME: 7 :00AM PAGE: 6 SITE ADDRESS: 1 1361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: f P1992 -0B3 LOT #: 00,t TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage: into habitable space. OWNER: COSTA, LUCIA PHONE #: 503 - 405.2135 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1 onn MOW Pour Time: Code # Inspection Description Confirm # Contact # Message / 1/1 230 Undebflaor insulation 076988 -02 503-405.2135 Y Corrections/Comments/Instructions: SS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . / . 5- 5 Date: a IOCTO C Phone #: (503) 718- 2 V23 CITY OF TIGARD ' 1 BUILDING DIVISION PERMIT #: 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MST2008 9/25/2000 Phone: (503) 639-4171 Inspection Requests Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10120/2008 TIME: 7:00AM PAGE: 3 SITE ADDRESS: CLASS OF WORK: 12361 SW KNOLL DR SUBDIVISION: LOT #: TYPE OF USE: PP1992 001 PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: PHONE #: 603.4 COSTA, LUCIA CONTRACTOR: PHONE #: OWNER Inspection Request Scheduled For: Date: 10/20/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 226 Post/beam structural 076916- 01 503-406-2135 N Corrections/Comments/Instructions: _. c, ,,z. ,--. vL-0..., zfrnaiv (---.... • . PASS F r7 CANCEL ri NO ACCESS 0 FAIL I I CALL FOR INSPECTION fit FEES ASSESSED , . A Date:M— ZO --ea , Inspector: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: Mar20110-00143 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9 9f2 5/2000 Phone: (503) 639 -4171 / . Inspection Requests (24 Hrs.): (503) 639 -4175 ,_,._,Iii ' I .. INSPECTION WORKSHEET FOR DATE: 10/8/2000 TIME: 7 :00AM PAGE: 2 SITE ADDRESS: 12361 SW KNOLL DR CLASS OF WORK: SUBDIVISION: PP139 033 LOT #: 881 TYPE OF USE: PROJECT NAME: COSTA DESCRIPTION: Converting garage into habitable space. OWNER: COSTA, LUCIA PHONE #: 603 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date 10/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Po fil earn structural 076436.02 503 - 405.2135 N Corrections /Comments /Instructions: Ig22-420___i_/,- e/j ' --. , -Z 'V <. L r 63 • El PASS _ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r Date: / --8 -GA Phone #: (503) 718- - 2.4-41