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Permit MASTER PERMIT i * CITY OF TIGARD • PERMIT #: MST2005 -00039 �� DEVELOPMENT SERVICES DATE ISSUED: 3/14/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109BA 08200 SITE ADDRESS: 13634 SW LEAH TERR ZONING: R -7 SUBDIVISION: DAFFODIL HILL LOT: 008 JURISDICTION: TIG Project Description: New SF detached BUILDING REISSUE: MAS22151A STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,216 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,390 sf GARAGE: 552 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 254,805.60 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,606 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: 1 VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes GOODLETT MARSHALL BLDG & DEV. GOODLETT MARSHALL BLDG & DEV. and all other applicable laws. All work will be done in PO BOX 91551 PO BOX 91551 accordance with approved plans. This permit will expire PORTLAND, OR 97291 -0551 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 Phone: 503 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: LIC 100882 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 9,938.43 1 - 800 - 332 - 2344. • REQUIRED ITEMS AND REPORTS ■ Issued By :� / / __� , , ` Permittee Signature Efirefffffiatrill ! my Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. FROM : FULL HOUSE CONSTRUCTION PHONE NO. : 583 829 2822 May. 22 2005 08:25PM P1 , - 4 4 Electrical Permit As plication lalliiiiiill11111.1 L. , ‘ . / 11 Date received: Permit no.: OSra.D y od 0 5/ t °' J J City of Tigard Projecllappl. no -: Expire date: City of Tigard Address; 13125 SW Hall Blvd, Tigard (1i 972 Date issued: By: 1 Receipt no -: Phone: (503) 639 -41 Fax: (503) 598 -1960 Case file no,: Payment type: CITY OF TIGARD Land use approval: BUILDING DIVISION_. '1'%'PE OF Ph:RR•llT Cl 1 & 2 family dwelling or accessory ❑ Commercial/industrial Cl Multi- family Cl Tenant improvement mtt ew construction Cl Addition/alteration /replacement Cl Other: © Partial JOB Sri E EN FORM Al [ON ' Job address: 3 :• a_ erraC,L. Bldg. no -: Suite no.: "Tat map /tax lot/account no.: Lot: Block: Subdivision: Project name: 1 Description and location of work on premises: t.c, 7 ex- Estimated date of com .letion/inspection: ( :ON APPLICATION FEE SCHEDULE Job no: _ Fee Max Business name: a.I , , • F I C C-t-r ,.t .Ti4 , Description Qty. (ea) Total no. Imp Address; ?,3' S. fi pc) d w lvewr.g dcittial-singk fanrlly cllirtg t mid ],rreludes attached garrage. City: .A..4 a (, J , State: 04 ZIP: q '703. Serv(cetncluded: Phone: 8)..4 -a 9Q0L( Fax: $o?-2. E -mail- 1000 sq. ft. or less 4 Each additional 500 sq, ft, or portion thereof CCB no.: 16 2 3 G I A lec. bus. lie. no: _,3,--4.406 limited energy, residential 2 Cit /metro lie. no.: 6 to 0 Limited energy. non- residential 2 ^ 3 — 67 E manufactured home or modular dwelling t gr , re of • pervisingZ trician (req.ire Date Service and/or feeder 2 Sup. elect. name (print); e dam; License no; ,14,4 ,tBS twlces or feeders – installation, ` alteration or relocation: PROPERTY ()AVNER 200 amps Or less 2 Name (print): 201 amps to 400 amps 2 4 amps to 600 amps Mailtn address: ter' 601 amps to 1000 amps 2 City: A :� e: ZIP: Over 1000 amps or volts 2 Phone; • Pax: [E-mail: xecontteemnly - -, 1 Owner installation: The ' tarion is being made on property I own Temporary services or feeders - which is not inter or sale, lease, rent, or exchange according to Installation, alteration, or relocation: ORS 447, 455,'479, 670, 701. 200 amps or legs 2 • 201 amps to 400 amps 2 - Owner's Si „ . ture: _ Date: _ 401 to 600 amps 2 . ENGINEER Braach eil'colts - new, alteration, or extension per panel: Name: _ A. Fee for branch circuits with purchase of Address; service or feeder fee. each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase Fax: E-mail: of service or feeder fee, first branch circuit: - 2 Phone: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Mise.(Scrviceor feeder not included): ❑ Service over 225 amps-commercial Cl Health -care fa - - Each pump or irrigation circle _ 2 ❑ Service over 320 amps-rating of l &2 ❑ Hazard. - ocation Each sign or outline lighting 2 family dwellings Cl :.' . ing over 10,000 Sgtlare feet four or Signal circuit(s) or a limited energy panel. ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* r 2 ❑ Building over three stories CI Feeders. 400 amps or more *Description: — 0 Occupant load over 99 pe '.. - ❑ Mariuracturcd structures or RV park Each pdditemal Inspection over the allowable in any of the above: ❑ Egress/lighting plan CI Other:. Per inspection I I 1 F • • mit sets o'' plans with any of the above. Investigation fee The a ' ' ye are not applicable to temporary construction service. Other Fe . "Not all jurirdictiOns accept credit cards, olooto call jud dictio or more information, Notice: This permit application ee $ __ _ 3Yisa. CI, MasterCard r expires if a permit is not vlstai ed .---P- 1-°--Y1ew %) $ Credit Lard number: / / within 180 days a' as been State surd g 3': —$ • Expire* accepted as cot • ete. TOTAL - $ Name of cardholder as shp .n credit card V ` , 1\ 6\J c. \ C,,rdh. signature v Amount 440 4615 (6/ wcoM) t , . Building Permit 11 1 . 'r ,r, , � ,FOR O I FIC USE O #' x , ( t f i ' 1 '; ' � ,, Rec eived ! City of:T DateB / � —CYS PernutNo.: fl S1 e -- e aL.VS r Y 13125 SW ;,Hall Blvd., Tigard, OR 9 pr 9 Plan Rev _ 1 °' . Phone: 503 .639.4171 59 $. I 2005 O, A., X Date/By: -� Other Pe rnut ,p ,i. Pho.639.4171 Fax: 503. 7 Date/By: /� ^✓ 1 — /�) — D� �� '���� . '� Inspection : Line: 503.639.4175 Date Ready/By: _ J i�l See Attached Checklist for � Internet: www.ci.tigard.or.us ~ CITY F ry 7 g R D Notified/Method: � 1 v) / )4 Supplemental Information }.� CI A �1' 1 1�t74i�1/ • 4f, u .,`' cr ' g a : ,�,�'� ? �` �; ;.z ,' �'*:' u �' � ! � ,.. ' . N +� � ni,. � z�•�,, F .a° -. 4. : ` y . • �:nt3z3 =�i ..: "= :M. x ; '^�?: : : °�, : �; .� '-ter, 3 s t ; -,'; TI PE QF nW0 c,: 4 . a t~r . ,, „ i. . ' < . -ii ' . ?:12EQCIIt ED DAT y m i Po - ; 1N D 2^7fA �;. _� ... r�.,,�.� � . � w��,.- . .,.. . � ..., s.. ,as "r.i�Gr3 : ,�sW ... ' -x.. <. ,�.�, >.���r:z�.�.. .:..^ ' New construction [I] Demolition Permit fees* are based on the value of the work performed. t' 11 `` Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ,t',5. _yam i sa% -�;,. * . z :. . :c.: . .,:1;::'.iR"�'r�:"�`a #;`: Cs-z";•r 1 R J iac•,3c':1,5 ! : E:z i <i?.:.;.y'r r','F'i.,g'" A - CATEGORY OF CON , STUCTIO1 ° r' � * work indicated on this application , plication O- ;' ..,, . . .. e° ,.,, aaa vi, fk v.:� , r d.,. ^,�, ' ^,, a .._ � � Valuation: $ . I- and 2- family dwelling iii Commercial /industrial g 4 ❑ Accessory building ❑ Multi- family Number of bedrooms: El Master builder ❑Other: Number of bathrooms: 2 . t `' i a JOB STTE ON= AtND,)LO'CATIeQN .. - Total number of floors: Z Job site address: 13414-, 1+ k T.ew ce, New dwelling area: 24 square feet City/State /ZIP: I I y a i C172-2.4 Garage /carport area: 55 square feet Suite/bldg. /apt. no.: Project name: 'q -i I ( l I Covered porch area: �� 34 quare feet Cross street/directions to job site: �� "```` j Deck area: square feet Other structure area: square feet i v REQTakED--DA�T COMIVIERCIAW'USEICH:ECICIAST • Subdivision: Lot no.: 8 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 ' " R. "`, r ^ v 1'r work indicated on th appl -Z i , ' m ,� - it 4.;,....,, DESCRIP�ON QF�WO - W I A ' g ,,.. , al , . E : : ; :. l e - am i l re „� Valuation: $ ex ca z ,- \ C. nM L L ,) L[II, . f „ zi _ Existing building area: square feet 1dlKila7dlN W �` I New building area: square feet 4 ';fit dar , , , ' PR EER =TY Q 'NFi R.. „ m r ._, - ❑- TEN 1 T' t !' Number of stories: Name: e de Type of construction: Address: t 6110 --. • . /249 /24 Occupancy groups: City/State/ZIP: OA I (0 0 / rftq / Existing: Phone: ( ) 692.. 0 ,n } ° r «° '_ •.'. . effj &'.,..: -m s t < ll ,� `€.3 Fax: ( ) c-°t :. { %...: •x:,;✓?a,' x Ne w y c .; -,; . ` . . ,^ ,:.1- �• . s '•sa; ^ %.;^ ^;a €: c,.sR:: ^sr ;;F?; >` .: `;' �;d'3r' R'u:�.;: - "LAP.PLTCANT• 2. 7 .,.: GQNTACT PERSON `:� i .. v A ° :a �� � z s. � _ � >,::x u a � s �= w,, a s _ . - t, � �; .P A,-,:"1:-.1.::,14..4..,k4 r140O TICS fir �. r Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board 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: Phone: ( ) I Fax:: ( ) E -mail: xr. `, of t; :,. , ., : e Pte." M ; .�:- M.tIr ; <- r q; . v . -,, , „ . a „ -e § s; "."i : „.' Z fti ft# WW , ,` l9` i ezNi MCTici4.0 x l , ' '' .a, s e • Business name: f r FT YPLi 1 � = u4 !/ ' ��; I cc x'; r ,y ' s�BUILDII�GPERIVIIT F EES* • �. 'iL l ' 7 �.• , f;«ttk4 .... _ .. ., . ,; -te , ' Address: , Please refer to fee schedule. City/State /ZIP: 1)t• .4; / OfC. 9 V4 / —05-D7 Phone: ( 2) 2g1l , (gg ( Fax: ( ) //r/./6750 Fees due upon application , ``�� ff Amount received — - CCB he. oog 2 ei4 — Date received: Thi Authorized signatur w �,' /!'�` perm if a permit i taine • /// ` � ' within 1 80 it days application after it ex has been ires accepted .as not co mp ob lete d . Print name: , ?h (� D ate: • 1, • 0 6 * Fee methodology set by Tli -County Building Industry '-?, """' v v Service Board. I:\ Building \Permits \BUP- PermitApp doc 12/03 440- 4613T(1 I /02/COM/WEB) One- and Two - Family Dwelling . • Building Permit Application Checklist FOR OFFICEI. ONLY x, : =i -'4w '. s City of Tigard Received Permit No Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 /Gt n1l�gi ��w I ,A 24- Hour Inspection Line: 503.639.4175 ,__1�, 6. I I CI Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us " ❑ Other: `• '! •THE,FOLLOWING ITEMS.AREcREQUIRED FOR PLAN REVIEW , . /.. } . :Yes: Nd`yr,.:4 ` 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat /lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 SeiifiC.systerif 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. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete setsof legible plans. Must be drawn to scale, showing conformance to applicable local and state c l ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -sie ' sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. _ 1 1 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 may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding:material, footings• and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. . 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore: on and shall be shown to be as plicable to the •roject under review. : ' JURISDICTIONAUSPECIFICS , " ... 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 ❑ ❑ ❑ c • 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 \One - Two - FamilyChecklist.doc 12/03 • - • Building Fixtures Plumbing Permit Application 1 a _- R FO OFFICE USE ONLY • . `. City of Tigard FEB 1 y 1N5 Received z 3125 SW Hall Blvd., Tigard, OR 97223 Date/By: Permit No.: , , 062031 Phone: 503.639.4171 Fax: 503.598.1960 Plan Review JJ apt of TIGAR /,dntlµdl Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 . 1 uris: Internet: www.ci.tigard.or.us BUILDING D _r ��.� Date Ready /By: 0 See Page 2 for Notified/Method: Supplemental Information . r t :s „� .. <�:�s =r �, ., � „�i-,. �; =�F.,� =,+r.'e �iar.;ru�° , J'- ���- 'f�' cF �:r.,.3 -:z�?x - «x. sW , :a;+> R z,,,. a .' EQ , e, :: ^§ 'r,="i i Vii' W , x R .:s '�: ="` ` , . ' 4.„ 1 ,. : r OK. t :1 `.r. . iIIYPE 0 .WO , 4 � itP1 .,.tz. : .:FEE ? SGI :=ED[3L=E .�b.:�"'. �'n =?,,,..� -�s,.¢ ,�,� aTt��M.x' :.: w4 ^.:a �E,.":�.:,,;�- .�';3',�.46'.y; .: ;. ��`X'?m � ��": ^ - �:...amr:��: * �� ,..:�s� •.m. - - ° + = a.�r➢k'z...ev'a .,s� „�,.:.E;.°- s'.. a'- ^r ,., _.. .� � � - New construction ❑Demolition For special information use checklist M Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ��f�.,�: VOW' "� : a.v^s„r'x�,�- ,n�;�; T` �3a+: �: �sB; pN,- �,F }�:- ._�.��;r-- �z� °= �+' ���;° , z� ; , «, rs. 3_ -,`41%-,14 ; . GArEGOR' - O 'C6NSRTICT)!OlY E 1 `' SFR(1)bath 249.20 FA - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath, 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: =t. - .tom , �r _ ;,:.. ;:;�. .,.- ;U : .�,. Fire sprinkler ( sq. ft.) Page 2 iapV IT,Mr0I iV XTIO AI!IA OC TION � . e - Site utilities Job site address: , 34, 2 2.- $L') ,k ` 1e ' .c 4e. Catch basin or area drain 16.60 City/State /ZIP: lIcianfd Om 9722-4 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: ( li C IA Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: ����,,,,�� Manholes 16.60 ,,' U #491 4 .1 n Row few. .Rtu ,- Jur , ` IJ , , +o Rain.drain connector 16.60 ).� ck V ice t i) gh'�- k, I. ( 44 Leak. Sanitary sewer (no. linear ft.: ) Page 2 � Storm sewer (no. linear ft.: ) Page 2 Subdivision: . 144-11(x4 ( Ea I Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item t ::;.,., „_, ., . ,<s Yf ,_ :: 1=. s ue., . _• ;, ,o,, ., ,: Absorption valve 16.60 r J SCRIP T I ON bk' W ORK > _ , ,4 .= . e. r Z' -•.- , e.. a... `: -r Backfl ow p reventer Page 2 e IL( i0&) / C a Alt / 1t/ Backwater valve 16.60 del` Clothes washer ' 16.60 Dishwasher ' 16:60 F i PItOPERO :NE r _� `` '_.:' ' Drinking fountain 16.60 4 £.as ._ + �. - +.,.,. :-.- n. ,.... 's ,,,, .w,.. a "� � itik :INtil,i , -.44-, x `.:... ,. ,: :: •-5 ors sU Eject / mp 16.60 Name: Y Expansion tank 16.60 Address: 1).‘ d t1 Fixture /sewer cap 16.60 City/State/ZIP: ' (0), /7Z 7 ( Floor drain /floor sink/hub 16.60 Phone: ( '� � 6 Fax: ( ) Garbage disposal 16.60 _����:<sss`�= � "`,,�, ° yy � r .�`�: a ;�,�� �:3z �� M �. Hose bib 2, 16.60 01 ie t '; r 7l ar ^ :,:,^ AN t � 14 1cOV T fA s I r�Eli o, Y "' Ice maker 1 16.60 Business na. ,tpiclillt- li'lo✓Sha Interceptor /grease trap 16.60 Contact name: / / f:I ^ 6: 4J 10. it !i ( Medical gas (value: $ ) Page 2 Address: 4 4'* 0. i' A Primer 16.60 City/State /ZIP: t i e. Roof drain (commercial) 16.60 Phone: (g,) Sll • ( Fax: : ( ) • Sink/basin /lavatory 16.60 Tub /shower /shower pan 3 16.60 m - r3; °t :< a ^: s ',5 „ = Urinal 16.60 pittli, .rs, t - *• GO $RACd a _, i ,. 4 ,. - t R :,, -s :_ s:F. � ^ ,:: T Q R . B _� *,;a'' =; , : W ater cl oset 3 1 tzt°a. ��� -.�.. s.'��, �...�,�,�s� 2= ��_ „ ^ .��sr�n ,.�:�,i 6.60 Business name: Cel ? Water heater 1 16.60 Address: t/305--. Other: City/State/ZIP: c vL 0� i°1 Subtotal /_ Minimum permit fee: $72.50 Phone: () 0_(Q V • / !il 1 Fax: ) 2(Q (Q • 11# 2.,11 Residential backflow minimum permit fee: $36.25 - -- CCB Lic.: 3.672_ - - Plumbing Lic. no.: 37.1- Plan-review-(-25%-of-permit-fee)- - -- - - - -- State surcharge (8% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within I ` i �� _ � A,..a 1 /� A� 180 days after it has been accepted as complete. Signature • " uthorized Plumber * Fee methodology set by Tri -County Building Industry Service Board. r p o /ovcormwm.B] Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: 4ViVrtiiiiiiIVOROVArgitAgefl Qty Fee � e a ) . tar : A O a „ , ermtFee Footing drain - 1' 100' 55.00 • 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 -- = € R °Persmit; =I =:':... ... - . 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 " ; e „ ° b �„ additional $100.00 or fraction thereof, to and Items Fee(ea )a�Total Flxtureor 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 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: 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 * . ��� F � - , Quant�ty�,by(F�sture)or1t Performs @d FiXturefype "4 r a , as a tepl eet kW :WI ew � ove xist r ca` ped 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 increase of sewer EDUs, a sewer permit will be issued and Ice Mach. /Refrig. Drains 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 Isometric or riser diagram is required if fixture quantity - Commercial - 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- PermiiApp.doc 3/03 E D Mechanical Permit Applicatio FOR .O FFICE USE, City of Tigard FEB 005 Da[eBey d Permit No.:/ S 00 3 _ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Lfl l 0 t tea D Date/By: Other Permit: Inspection Line: 503.639.4175 P CITY ITY r' IL` {� Date Ready/By: luris: El See Page 2 for Internet: www.ci.tigard.or.us • 2 - • , .'� `, . • Notified/Method: Supplemental Information :A 3k `.AM+ "'+; . �FP°?s:. S'sru`.. '.at�"' ;'.s`b:. "i 5 ":i' =" - 1: er -�'�r � ? :,mac: ' - , :5:�' '�&.:.:axe�.. . •?.y - a �: :y "; ; „':, a . •.,.�•,: ti,z.,� ,. �l ; t .. ?i '* ., ^ "..;;.;.. R = * � � , «�, `?_, ,�COlV1Ta - „SCHI;, "� C�EIE . T- 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. :: i 1 - r r g '��"3LAT tatifi F COOiVS ita:I 17 ; a ” r.,. , , , Va ue, $„, «; .: ' t BESIDENT>AL F,•QURMENT b$YSTEIV)STEES* and 2 family dwelling ❑Commercial /industrial ❑Accessory building r For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total i <° s ,, I t ,,; O B 'SIT INFORMA ifir A xL®CA O 4 1 .: •1` Heating eliag— lob site address: eir conditionin or heat p �3(�3 . 514 �, T �Ire site plan showin pl O 14.00 City/State /ZIP: Ted } y� , Furnace 100,000 BTU (ducts /vents) 14.00 Suite/bldg. /apt. no.: Project name: v. c el 1 G Furnace 100,000+ BTU (ducts /vents) 17.90 ! —V� Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 C tG � Hydronic hot water system 14.00 Cztext, b /°" 1 v / fl ` •� / I �� ' 7 t' A�/ ' 1G ' ( ,e Residential boiler (radiator or a '1 rl.�. Unith 14.00 5 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Y ocGI' RI t I I Lot no.: g Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances ' a - DES W OR O WO K ` ' ' Water heater 10.00 /4 e,,�, ( I .C. Gas fireplace 10.00 & c1 ( v 1') talon i1N1' Q TI .C. , �C 'l4 ( Flue vent for water heater or gas 1 0,(414 10.145 /J� � V 4 Cook- V fireplace 10.00 -� . Log lighter (gas) 10.00 and / 1d (A ((� as Imes lb au e6 Wood /pellet stove 10.00 a 4'01(. Wood fireplace /insert 10.00 49 i -� "n -,: E t 7• Chimney/liner/flue/vent 10.00 <.k .:,.5:v,:,,,.,&,1.,,,,,,,,,? l20PERTX" OWI�YER' t l � r ; . a r t� EINANT er, 10.00 Name: Environmental exhaust and ventilation Address: Range hood /other kitchen equipment 10.00 City/State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 -:: �� ,,�.': ;c <:xa �' ±.i '�'.� rw "�,.a a'ts ., x:',- S::T ".. - .< �•rz�se*.: a -cs�- ��.. '; ig=° , x :_ =:a'` . ,. . k< "_; `: `` Attic/crawlspace .rr -« AIq:C,Nt# "; Sit ., .I GONppAG 'PERSON , ; P ' -`"1,� <, .? r'.:1w�:::Ft�+'� ;- •e .. ;.aai >a. .::urk� °.. s. r�� � „�:,g.`.... ;t,.a � . �».ztl..r,:r�'� "�r. ^•h;a . *x °?.�`�.�.�'?�; ace fans 10.00 a. Business name: p (4. ��/ /` a /,� Other: 10.00 �rcM / rlf�r� V` 614 f Fuel piping Contact name: M ( CJA- r/ - t $5.40 for first four; $1.00 for each additional Address: 7.a, / 5$ I ��1 Furnace, etc. L Gas heat pump City/State /ZIP: -k .. all; qtf .q ( Wall /suspended /unit heater Phone: () Zr! t rig( Fax: : (�) 217 , / ce Water heater �/ LL Fireplace E -mail: 144.+G cod coot cart, fl LT Range 44 5 , 00:''''' ' '': -;74'44,1g ,,,, , >4..v^ s.*. -t°:, : tv �.� - '"t'�'�x�,.; s 's',?1� "a 4IN', a ,,... . �:�t•:, . >x� . ; 5 � �` '',. a TOlT : �� r .. s , L L , d ; I� Barbecue ..".n . +l',d..33, _.. -✓, .. R, ..s. AS , i 4 d ,t.r r�_.,. >.$3` :e t.�'' � &�Yx.°, hz v p i L L t � e c ' a ( Business name: � � Clothes dryer (gas) Other: Address: ,zya ,:� ,.'rr :.... k: -. , :A.,• * ..w , . : ,. "1VIECHAIVIC AirgRtrTTI*FE`ES- ` , City/State /ZIP: Subtotal Phone_ ( ) - - (e Fax: a Minimum permit fee ($72.50) - [ G� 1 g?�— - — ) -- - - -- • Plan Plan CCB lie.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: r • l t LIM t7 mu/J04 Date: * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440- 46I7T(11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total ValiliTion , :, µinVIn t�Fee $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. • $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. • $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof Note: All new commercial buildings require 2 sets of plans. • • by i:\Building\Permits\MEC- PermitApp.doc 12/03 2 ''' i�ov� -3 Ay f Ni4 r T C r' S p -. ,/ I l! ► ,Owner /4ge f r 1 t� !.� i ; i � r , :1 l I .. • ) j (PLEASE PRINT) 4 , (PERMIT HOLDER) Do hereby cent fy tl a t 1e foll`owi! hg location yof �Ti�gar � meets ,Cit `N" gton County d %�ashi�n .+ � .�. r.s. ,,�.,A�� �x.. l and use and development standards for street tree installation. ADDRESS: 1 % 34 5 t, ) Lect,k "re LOT: 0 SUBDIVISION: laiii- n 1 {i 1 .I BY: _i ii fiV f� , DATE: , �' ®� 3 21425 1 0:. 0. 0,. RECEIVED BY: DATE: Dt- CITY OF TIGARD - - - / BUILDING DIVISION PERMIT #: MST2005 -00039 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3114/200; Phone: (503) 639 -4171 Inspec tion Requests (24 Hrs.): (503) 639 -4175 ' . INSPECTION WORKSHEET FOR DATE: 10/6/2005 TIME: 7:02AM PAGE: 69 SITE ADDRESS: 13634 SW LEAH TERR CLASS OF WORK: SUBDIVISION: DAFFODIL HILL LOT #: 008 TYPE OF USE: PROJECT NAME: DAFFODIL HILL DESCRIPTION: New SF detached. OWNER: GOODLL.I I MARSHALL BLDG & DEV., PHONE #: 503 - 291 - 1881 CONTRACTOR: GOODLETT MARSHALL BLDG & DEV. PHONE #: 503-297-1861 Inspection Request Scheduled For: Date: 10/6/2005 Pour Time Code # Inspection Description Confirm # Contact # Message 299 Final inspection 017604 -01 503. 502 -7092 N Corrections /Comments /Instructions: L ,6490-:- A K ' 3- I __ _PASS — n_PARTIAL_AP_P_ROVAL 1_1-CANCEL _ ❑_ NO_ACCESS_ 1 1 FAIL A CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED ./ Inspector: Date: l ® 6 O Phone #: (503) 718- // , • CITY OF TIGARD • BUILDING DIVISION PERMIT #: IVIST2005- 00039 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2005 Phone: (503) 639-4171 llip Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 9/29/2005 7:08AM 53 SITE ADDRESS: CLASS OF WORK: 13634 SW LEAH TERR SUBDIVISION: DAFFODIL HILL LOT #: TYPE OF USE: 008 PROJECT NAME: DAFFODIL HILL • DESCRIPTION: New SF detached. OWNER: PHONE #: GOODLE1T MARSHALL BLDG & DEV., 503.291-1/381 CONTRACTOR: GOODLE.I I MARSHALL BLDG & DEV. PHONE #: 503-297-1881 Inspection Request Scheduled For: Date: Pour Time: 9/29/2005 • Code # Inspection Description Confirm # Contact # Message 016994-02 503-502-7092 199 Electrical final Corrections /Comments/ Instructions: 714PASS I1_PARTIALAPPROVAL .111_CANCEL EkNO_ACCESS FAIL I CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED Phone #: (503) 718- Inspector: Date: //-1.12/-6 CITY OF TIGARD _ ,,, BUILDING DIVISION PERMIT #: MST2005-00039 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2005 Phone: (503) 539 -4171 iitIlii?` Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/6/2006 TIME: 7:00AM PAGE: 74 SITE ADDRESS: 13634 SW LEAH TERR CLASS OF WORK: SUBDIVISION: DAFFODIL HILL LOT #: 008 TYPE OF USE: PROJECT NAME: DAFFODIL HILL DESCRIPTION: New SF detached. OWNER: GOODLETT MARSHALL BLDG & DEV., PHONE #: 503- 291 -1881 CONTRACTOR: t3OODLEI I MARSHALL BLDG & DEV. PHONE #: 503 - 297 -1801 Inspection Request Scheduled For: Date: 10/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 017479-02 603 -5502 -7092 N Corrections /Comments /Instructions: f -PASS n -- PARTIAL- AP_P_ROVAL r_i_CANCEL ___Ti NO ACCESS n FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: it A Date: /t "S" Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION Y PERMIT #: MST2005 •00039 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3f14/2005 Phone: (503) 639 -4171 4,0,40 " Inspection Requests (24 Hrs.): (503) 639 -4175 'I_� INSPECTION WORKSHEET FOR DATE: 9! ?9l ?00 TIME: �.�� PAGE: 52 SITE ADDRESS: 1634 LEAH TERR CLASS OF WORK: SUBDIVISION: DAFFODIL. HILL LOT #: 008 TYPE OF USE: PROJECT NAME: DAFFODIL HILL DESCRIPTION: New SF detached. • OWNER: PHONE #: CONTRACTOR: GOODLETT MARSHALL BLDG & DEV., PHONE #: 503-291 -1881 UOODLETT MARSHALL BLDG & DEV. 503 -297 -1881 Inspection Request Scheduled For: Date: 9/2912005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 016994-03 503 -502 -7092 V Corrections /Comments /Instructions: 8 _ ��� /i 4 `�i / �� _ f" .. , / (0 'r .�Li �j� .4,I/ _PASS I_ _PARTIAL_AEEROVAL -- Q CANCEL �_NO. ACCESS FAIL I CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED r / Inspector: Date: Phone #: (503) 718 - 1