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Permit Oil - _ :j .,_ - ice? ._ems T 1 C T OF T I GA R® _ PERMIT PERMIT #: MST2003 -00039 - . �i� DEVELOPMENT SERVICES DATE ISSUED: 1/27/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13714 SW LEAH TERR PARCEL: 2S109BA - 07700 SUBDIVISION: DAFFODIL HILL ZONING: R -7 BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: New SF detached dwelling. Path 1. 4/27/04, a a /,c unit :__1 BUILDING ti REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 20 FIRST: 1,812 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,042 sf GARAGE: 614 sf FRONT: 29 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 281,401 80 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2.854 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: 1 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: 1 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: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EAADDL 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: Owner: Contractor: TOTAL FEES: $ 7,743.59 GOODLET /MARSHALL BLDG & DEV GOODLETT /MARSHALL BLDG* *USE This perm u n is to the regulations ec C o in the M P.O. BOX 91 551 OTHER Tigard Municipal Code, State of OR. Specialty Codee s and 97291 OTHER BOX 91551 all other applicable laws. All work will be done in PORTLAND, 51 accordance with approved plans. This permit will expire if PORTLAND, BOX 15 91551 97291 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 adopted by the Phone: 503 768 - 4573 Phone: 503 - 297 - 1881 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: LIC 100882 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS . Erosion Control Insp 8g Post/Beam Mechanical Plumb Top Out Shear Wall Insp Insulation Insp Appr /Sdwlk Insp Sewer Inspection Crawl Drain /Backwater Plumb Top Out Shear Wall Insp Insulation Insp Misc. Inspection Footing Insp Footing /Foundation Dr; Electrical Service Exterior Sheathing Ins Insul . ion Insp Electrical Final Foundati• • - PLM /Underfloor Electrical Rough In ' Low Voltage Rai drain i lns. Mechanical F. Pos.: • iechanical Insp Framing Insp Gas Line Insp Wa er Line' Ins. PI I m. ' al Issue. 1� _ I ' �� r Permittee Signature :. ; I JO I Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next - si ess day Mechanic a� Permit Application FOR OFFICE USE ONLY - r� I City of Tigard Date/By: 7 l/ '( Permit No.: <Az) j_ q / 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax 503.598.1960 Ap Da te/By: : Received Other Permit: Inspection Line: 503.639.4175 .I Internet: www.ci.tigard.or.us ard.or.us s �.. Notified/Method: Date Supplemental Suns See Page 2 upplemental IInr Ivlenformation a ; n vt fk t" '".,'�, ; 4R ff" . e .>�:i '�.r , f e'•,3 o -. „, ays « ^ t�..i % > �; . tz , v ' sz �, t ,. w.v,: ,.; lt _ , ::_4 ;.,, ,3 �,'` TYP 01 i.` V,1?®RK , ;:r : '_*° , , ,._ „,_ f ;, _ = ' COlVINI : EEE *':S'C , _ , E” = ^ U SEsCH ECKI3IST ". Mechanical permit fees* are based on the value of the work ❑ New construction E1 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. -, t' i a�k� a s' Value:$ , eCAT EGO RiY ®F C ONSTRE J CTION " , : .-` . , ._ -- .,4 RESIDENTIA EQUIPMENT L SYSTEMS "FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist._ Description Qty. Ea. Total I .;�. , ., ,°,;SOB. >S1TEgIN.F._ORM'ATIOe "'';,'DtxLO TION :t ;•. _g. ,..� .;:a7 ;, .�.��r�u. � `� > �._ <:�.;: ";,.,.,:..,�:,<;�- , =e:���,;., ,,.. >:,�,; -.;3", .n . `'��ge;�t,:w :':::a Heating cooling ,+f� . Job site.address: — J / 3 7 /L( �W L e a ', 1 wa Air conditioning or heat pump 14.00 / T ' per, (requires site plan showing placement) City/State /ZIP: T'' jr4 rd Furnace 100,000 BTU (ducts /vents) 14.00 �� r -- i s Furnace 100,000+ BTU (ducts /vents) 17 90 Suite/bldg. /apt. no.: Project- nadfe: f f 1 H, I, Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 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. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances s -'4 it r i w ` `° ;y :Q fi gyJ�/- m �G " Water heater 10.00 : , �"1 f `" DG .A:rl \il s�` 45 ♦.Y.V . tF `'. _ 4 - N " - 3`` +-`z, .d - .�.� �:. _ . ;.�.,,, �..�+�<�xrr�ur.�w. �'� rte, -�.�, ... -� _ » F _ �3'. �. =mss ". ...:, /J i - --- Gas fireplace 10.00 • Q/ 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 .i .r .� t.,,, ry r., ❑ TEF , a Chimney /liner /flue /vent 10.00 ; ar„, ,„ ,PROPERTY, "iOWPIER.: . `.. . ° » r,1, e n._ ' 4 � �-, -�� :.: � . ,..� , .a r _ . � � ': Other: 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 ` , t a ,®�APtP I i v.,,.., } a ,f' y<.. i , ii= ITACT ERS ,. r. s ; Attic /crawlspace fans 10.00 Business name: Other: 10.00 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 x =LOI O.g a� . � .r z r,._ C,NaTRA iOR . .. «. ; _ . ,. ' .�; "_ ...`i „; Barbecue Business name: A, boy /jo 1 5 Clothes dryer (gas) Other: Address:?; 0, gtx 6 p �5-�I ,;:^ a "; ; , ....., .,-, City/State /ZIP: ,.._ -,,, ~Ear � 'N;r��� � M:E.CHANI_ �PERIVITT FEES* Subtotal Minimum permit fee ($72.50) J � O r f let IxQ ( 9 rr.. / � Zq � ,� L 00 _Phone: -( ) _Fax:-( ) - Plan review (25 %of permit fee) CCB lie.: J State surcharge (8% of permit fee) /, / }. TOTAL PERMIT FEE /A / 9 Authorized signatur > This permit application expires if a permit is not obtained within 180 l i ] days after it has been accepted as complete. + v l Print name: j( l ( ,. „ „k Date: • 21 , 0 G(! * Fee methodology set by Tn- County Building Industry Service Board i:\ Building \Pemdts \MEC- PermitApp.doc 12/03 440 -4617T (I 1/02 /COM/WEB) Mechanical Permit Application - City of Tigard ,r Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuat oir t 0Rermit $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 ,5 3 D 0 Building Permit Application FOR OFFICE USE ONLY Received Building y Date /By: � 3 � 3 Permit No./ /.f/ p�OO 039 Planning Approval Other City of Tigard Date /By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date /By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 -^ _di, -14/11-$11141W/11;- i ( Date /By: Case No. Post- Review Land Use Internet: www.ci.tigard.or.us C Ju�rS ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name /Method: / / E' Supplemental Information < R . ,1kT O ' TYPE.OF WORK .. . .Z 'a` .'?:,171'''',',::: �k r REQUIRED DATA R r - 51 ' ' New construction El Demolition _ 1 & 2 FAMI • Addition/alteration/replacement ❑ Other: °°,it,,,,::;;; °,,,,� ,,, , GATEGQRY :OF.CONSTRUCTIQN " > 3 Note: Permit fees* are based on the total value of the work performed. Indicate 1!" 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. Accessory Building ❑ Multi- Family El Master Builder III Other: Valuation $ a �l, 'lot, �D g T . g :, JOB SITE INFORMATIQNiand :I CATI oQ ` , No of bedrooms: 3 No of baths: Z I Z Job site address: /_9 2 jy sc.() L e/f� j' Total number of floors i , New dwelling area (sq. ft.) • • • Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) - / Project Name: *ct \ ICI kl Covered porch area (sq. ft.) Cross street/Directions to job site,: Deck area (sq. ft.) i t.4 4 N f_j'f 0 L - ' U 1 Y11i 11 ` i ll r t Other structure area (sq. ft ) ' E ' _ R DATA 40 ; COMMERCIAL USE CHECKLIST Subdivision: 1�9FF0.6/4 f}iGc -- 1 Lot #: 3 b 4 ,,_1, � �. A „ �� Wz,,:.,. _ „ &M .,,T _ W Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate >.. 16;0 „ DESCRIP CI f the value (rounded to the nearest dollar) of all equipment, materials, labor, ON OF WORK 4 .. Sl�'l7” � overhead and profit for the work indicated on this application. 1 € w�� e t � nt S bn Li kc , Valuation $ v Existing building area (sq. ft.) New building area (sq. ft.) Number of stories �_ ” __ _ ` `° .. °�� g : 6 T ,. ��PROE�ERT #Y:OWIVER :��:a' ,� ,, �,;® TENAN � ` ".�� � ��.;. "�. "� :� Type of construction Name:(" gf�t Occupancy group(s): Existing: Address: t ltJ 1 - 9i ;51 II City /State ip: e fil ei I P .ne: ° IS� Fax 5i a7' t (rSb NOTICE: All contractors and subcontractors are required to be �4 .. �� .._ licensed with the Oregon Construction Contractors Board under ,; APPLICANT. „ " `,.. , _. . rt ' in CONTACT PERS W < N; ,; ,i; i provisions of ORS 701 and may be required to be licensed in the usiness Name: - �,I d t ii ni Y , A p r„ ' jurisdiction where work is being performed. If the applicant is exempt Contact Name: ' oil /' from licensing, the following reason applies: Address: PO... -1" EX 55"1 City /State /Zip: urn ini q72.4/ Phone: SA • 75 J' rut ' 5 •2 7 ' ) (057j s, v,,, , ms,µ - Fax. • 4 , BUIL PERMIT E -mail: ^�'� 2. Q,, '& V� YI Il'�� '' nPleasefref r to fee schedu e Mg 4 , , � � ��.� e ms_ �� � .� Ai43��a < . ; ..,CON�TRA�CTOR�: .M..t � ,,. __� Business Name: 0 Jr. t 1 , i i l'� „ . 6 , Fees due upon application $ 0 SO • 07J Address: 1), 0 . gi5S i 1 Amount received $ ca-50 • O City /State /Zip: P ” ��� (0)-67 � I/ 24 / Phone: . 141 • j ' i Fax 5'03 ' Z'i "I t Date received: .. 0z3Ar 3 ��_ . CCB Lic. #: cos' - Authorized te 1 _ t�,�,� r O Notice: This permit application expires if a permit is not obtained within Signature: - _ /, 1 ;,:: j44 Date —) 180 days after if has been accepted as complete. fil i i ‘itrit I *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03 One- and Two- Family Dwelling 0..4 s Reference no.: 4 � �y Building Permit Application Checklist Associated permits: City of Tigard City of Tigard ❑ Electrical ❑ Plumbing LI Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 0 Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 THE FOLLOWING ITEMS ARE REQUIRED 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. 3 Verification of approved plat/lot. 4 Fire district approval required. 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. 9 Erosion control ❑ plan O 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 -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 Oregon and shall be shown to be applicable to the project 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 & 22 above. 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not 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 & location per approved project street tree plan (if applicable), and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. . Red ink is reserved for department use only. 440 -4614 (6 /00 /COM) littecixanicalrerinit App Datetece}ved: / 23 43 perm[ %� 03 d , . 3 T � p -no.: Receipt no.: City of lz s SW Blvd, Tigard, OR 97223 Dateissued: 2.1 Address: 13 payment type: ry o8 Phone: (503) 639-4171 Case file no.: Fax: (503) 39 &196 guildingpermit no.: Land use approval TYPE OI 1 RM11 I ❑Tenant improvement O Commercialfindustdal ❑ Multi-family d welling or accessory acement ❑Other Ne 2 ons ❑ A.ddltion/alteratxon [ p �i�il Kt 11L �' \I.L Ai 4 LL' .... 0 f New construction the dollar .1(113 SITI 1 \F O1t11 < lON Indicate equipment quantities in boxes below Indicate ��� materials, equipment, labor, overhead, LSD value of all mechanical Job address: ... 3 (off Z Suite no.: profit Value $ - information and Tax no.: important application inform Lot lot/account no -: *See checklist for imps permit fee. Block: Subdivision: jurisdiction's fee schedule for residential p Lot: S a 1 &,' 2 I mi:L1 Dvv L1 NG 'Planar FEE' s rc Project name: pv p t L. ...\ L 7 Z , Z p � .� AND tO)iRll lt lt.lLtlti Ul- tSTiZI �l• EQUIP F (�;X City/county: (.. S CL Reseonl Res. only �ription and location of work on pretruses: �� De�°D - otJi lion: : ` C. �- r Tenant date of co mpletion/inspection : man Air handling unit _. _— .- --- -. ro vementorchange ofuse: Cl o Air co ndiuoning (site plan required) v � Tenant itnp space heated or conditioned. O ;Yes VAC system Is existing P terationo existing Is existing space insulated? CI Yes ❑ No Boi er /coropresso TRACTOR State boiler Tons i�BTU1H ;A1Lfl \Ni E CO. — i Fire m — name RD u ' 11111.011 D v � � . 2 Z IP: rJ7a /3 um F ___ -- . Business -�.�: Address: r• � Heatp F� � er BTU/H State p Install/replace g d liner O Yes O No �� 1 • Gb- Iz- - Fax:3o3. -3 i em Ins[ all / eplacelcetocateheaters- suspended' Plion n - EX • • 9 - /7- n ��� ' CCB no: ! s,/od 8 wall, or floor mounted �� Vent for G� ■�- City/metro a ha no /J 32 C � , K� �,o.. BTUIH _ Natne(pleascprtnt) Go r Ab HP PP = -_ t __ _ p{ ltSO Chillers Coro • .. ne , - and vcn a I on: 11111011111 h^ pa liancevent - Address: S t ate: c'I. I Ary exhaust ■— b / ' � Dryerexha azmat • kitchen/h _ 7Co� �`� OWNER .' o ods , Yl� . t ` hood foe supp r�ioa systen► Exhaust fan with single duct (bath fans) VL 4 t ai , `• / Exhaust system a • : from heatin: or AC �� Name: ���� Y ' v I el p ping and arr ,•, ion (up to 4 auk,) �� NG _— ��� Mailing address: • O State :on_ ZIP 17,4-' Type: ________LPG additional over 4 outlets �� City: . ' �l. r .,,. cs Trinail Fuel`«'i eac (s = '� n: Phone 7i, � e3 � 1 1 It " Number [lets S- . Name: Decorativefireplace 11111111111111111111111111111 Insect - type etstove -�- Adorer ZIP woodstov pe �� ' ' ilia Phone: p� • arose: /� ......- $ Applicant's sign ` t t - �?' petmit fee ......... Name ( info oo- Notice: This permit a pplication Minimum fee (at ....... $ , i cards. t Jurisdiction more exp if a Permit in not obtained Plan review ( %) Na all jard and GOS � with t80 days after it has been States harge ($ri) .... $ OYisa ••-' $ ti rya numb« tBa accepted as complete. TOTAL ... 440-4617 ( _. on dtdit cod Name of as O s - Am Cardhoidrr dgp.� I 1 J 111 ()COPYRIGHT 2002 - PATRKX Sa TT, des ly'w 7J) - . u in 'i Lures msra -003 oflo.3 J iCa Oil 1 o cF `'BE pm ). 1 Plumbing Permit App , ` 0 • of Date received: Permit n•. " ,t•'�� , 1 11)1 City of Tigard Building nu.: - Sewer permit so,: $ ' •'. Address: 13125 SW Hell Blvd, Tigard, OR 97'12'3 City of Nord Ph one: (503) 639.4171 Proleet'nppl. no . - Expire date: Pax: (503) 39$- 1960 Date ;anted: By IlLecisipt no.: Case file no.: LPayrnent type: Land use approval: _ - - �} - - -- m Xi & 2 fa mily dwelling or accessory 0 Commercia1Jindustrial Multi-family 0 Tenant improvement _- Other: ,,, i New conatrw.uon p 0 Adduton /alteratlottlre Addition/alteration/replacement Food ' se rvice .IV1 MI I INFORMATION.. E SCHEDULE friar ecial iufarfaliwt w e :cliieckt . ia� t +t . Fec(ea -) I Total I d Description J Job address: J 3 VIZ 510 Lt t � E t ___. - -- - Nevi 1- and 2- family dwellings only: i t j Suite no.: --• (includes 100 ft. for each utility connection) 4 Tex mapita ioU_aceount no.: __ - ; _ -- — SFR (1,) bath - i ook: Subdivision: FR i _.._ 2 'bath _ I Lot; 5 11:1tloCk: } t - y--- • name: PAFc�o taw �tt,t - - - -. _ .._. _ _ —_ SFR (31 bath — -Y., each addinonrtY hath�kitclten I City /county: � M – - -- i ZIP: Ii ZZ 4'__. ....._... --- •- --•— � .. Description and 'ocation of work on premises: -.. . - `-F-t -' Site utilities: t 1 Catch bctetn /arta drain ; !__ __ _; E6t _ drain I - 17c�•tvellsReach line/trench dato of -- completion/inspection: Footing c raiii (t,o. lire -ft•) • 1 I •_• ` •1'LU1V181N Cr[1N](lttAC01<L Manufactute home utilities t i . ' Business name: _ , • .. i t,�sec1 2111 s�C ___.. Manholes i '7-- ' , � s , . ,, _ Rain dram connector — _-,. -+.- Address , Y - ..� Sanit.' sewer (na. lin. tt.) I i y: Stara ZIP: g'tn1 ._... { l ` .. sMb 1 - _L X6 E- tneil: Storm sewt:r no. lin. ft.) I Phone: d • Fax: Wate serv ieelno. list. ft.) _ t { , CCTI Up.: Pl - -bus . reg no, -- 3 '" `-/ s / Fixture ori temt 1 i C_ iry /metro lie. 00.:3_00. b + i .. Absorption valve L._ . t Convractt3r's representati ..e signature; - .�gsy $cl: flow p 8 rev i - -, Pant name r e . • .. t ,i,,,,„ ,i,,,,„ ackwater vn� - - - • Date; v ..�— i , - t , CONTA 3 1'1b1tS0 ` .E ` Basins/Invl2!2 _ � Clothes washer Ncmc: PST :�Ui- _ 1-M� { - - - -- - - - - -- Disbwna j __. • I Address C Z((1_ ..°`J ..r"_Afl •''') 5I-_ • Drinkni�fosntai _ _____ � . = Z.( � _ State :b� ZIP 7Z•��1 :.,..- Ejtctt�ral8ump _,.�_ __, ' _ • Phone: p! Fax 1 fi mail Expansion tart}_ -- -- , - -_ -- 1 r • 4 S'i'1`1 '1-';''i Fiatutr /se t�rer cap O Floor dims/110r sinks/hub L,y — ~.. Nettie (p lint ✓x7171( 11-- ..- .ylf(}cti TA-01 4' LY- _,_....w u arb4g e di4Qos2l _ __: ; - o f2nx ct151.1 _ Hose bibb _ Meiling address: p -� -- t _ • Scat >-- ZIP- � J �)-.e. l Ice m aker ' _ __ ' ricy: �� � __ tp -�- - .. __- _�- -- 1_ l i P er 'if f✓ _ __.._. Fax: Zq —t 5 0 E - mail: 'interceptor/nose reap 1 -M ' Owner installation/residantial maintenance only: The a ctual i nstallation Prirner's _ l rl 1 �_ ._ will be made by me or the maintenance end repair made by my regular Rooi keotnmercca1) I employee on the .p:opctiy I own se per OM Chapter M9. Sink(t+) brtsln la va s)- -- Date" Sump ...._. turset's ss — — —w. _� 1 'l�b slshow_ ;; pan 1;NfilN�il`.R' Uritttit -- _---) _ I Nante: 0 -- W C;ZIoitot • '' Address: �...'. - Water heater ..... . - .. MOM _� State: IP Other: ' C 'h ____� ' ` ''``j�p�_rrlail- _�.---- ..._... Total $ Phone; ....... t- X - ---- "'._. . ---- ; Tonto: This permit application Plan revi0w (St %) $ `- 1JOt aHr•��t woo m� Y 1.ub 11 1)�1i101allan S0► n�0+e '''''"°°- '''''"°°- - t is_nGt_ obtained_ Minimum fee o Visa — .attpires -it' o -permi _ Stato /o) —s I t3 V1i l) Manttt.ard within t 8Q days after it has been I Crotfic we otuaUcr. ----^ --.{.40d, I accepted as complete. '�()"d'Al;... a .� -..- -- -- Name or cola* el . howt3 e n ucait eerC -1--A717 -_ 4i(+ -4x.16 (6400/GbMi �p10U / • p� /`.Sf...,?0DJ O•D3`7 I A ElectriicalPermitApplication Date received: Permit no._ /!;, old, -%. d- City of Tigard Projcct/appl.no.: Expire date: CityofTYgard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: y Phone: (503) 639 -4171 Case file no.: Payment type: Fax: (503) 598 -1960 1 Land use approval: :, ' , TYPE P L OE PLRtil11' 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement New construction O Addition/alteration/replacement 0 Other. 0 Partial 308 rsi[T INFOItii'1AZIOh Job address: (077i . ..a , A,. • h Bldg. no.: Suite no.: Tax map/tax lot/account no.. Lot: 5 Block: Subdivision: pipf Ezp IL tt-4t(1..- Project name: Description and location of work on premises: V Estimated date of completion/inspection: 2'. 5 . CONTRACTORAPPLICA`1I0i\ FEE SCIIEDL.LE Max Job no T otal ao. imp Business name: a2 � � Newreddet�l- sro�cu'n�u-fa>r�r>� Address: / S� rti �� dwetliogtmiLlndodes attached garage. . State: 6+i ZIP: 7 7 0 ' ' Serricetndnded: l000�.f<.orl� Phone: r q- - Fa x. 6 _ ' E -mail: Each additional 500 sq. R or . • mien thereof _ _ CCB no. / !O r _ Elec. bus tic. nti: 3 5/- 6 I .• l e denergy,res id eat ial �� 2 City /metro tic. no.: . , . . (o - 0 j Limited enrergy, non - residential '� � d ..r- - -i Each manufactured home or modular dwelling 1111111 . 2 ,,,-.:„0"-,, .��� - � ' � Service and/or feeder : p. elect. a of supervising electrician ( aired) Date / ■ � [lce no ,� J Y „S Services orfeeders— Installation, Sup. e]ect name (pnnU ��i� �t < l alteration or relocation: PROPERTY OWNER. 200 amps or less 2 - � 201 amps to 406 amps ��_ 2 Name (print): "AA* MAI i.�� 1Cw $ r/ l�r rr 401 amps to 600 amps ____ 2 Mailing address: - a pj .. � tJtIG9 State:G 3'c' '' �J5 / c7 601 amps to 1000 amps ___ 2 City: ZIP: r eq f - C j I O ver 1000 amps or volts 2 Phone :�7 i � - S° Faa 7' l E-mail: II Owner installation: The installation is being eing °r feeders - I own Temporary R econnect only services __ t made on property ,al oa,orrelocatimu 2 which is not intended for sale, lease, rent, or exchange according to 200 amps or less ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 11111111 =1 2 • Owner's signature Date. 401 to 600 .11.. __ 2 F \GIllECIt ‘' Branadreuits-new,alteranee, _ . orexteasion Perpanel: Name: A. Fee for branch circuits with purchase of 2 Address: service or feeder fee, each branch circuit State: ZIP: B. Foe for branch circuits without purchase 2 City: of service or fader fee: fast branch Circuit: ■. 2 Phone Fax E -mail , ... _ .. ' + i'LAN RLVILW use : check alli'that :. ' '''':','''.'1.,'1+, M ise.(Ser.I eeri ceder not includedk ■� 0 Service over 325 amps 2 commercial 0f alth -carefacility Eachpumporirrigationcirde 2 D fervice rn amps rating of I 8c2 O Hazardous location Si circuit(s) Each signor outline lighting it(s) or a limited energy panel. ■■ 2 farmlydwelliwellin dwellings Cl over Building ov 10.000 square feet four or !� O System over more residential units in one structure alteration, or extension* 0 Building over tlueestories 0 F°°d &400 amps omore sue. ..• 0 Ooh load over 99 persons 0 Manufactured atomics or RV park Each atbStiood inspesdon over the allowable I = _— 0 Egress11ightingPlan Cl Other. Pamspearon Submit sets of plans with any of the above. Investigationfee cable to temporary consign ser Other The above :remit appll Permit fee $ `Not all jurlsdictkata accept anti cam, please call jurisdiction for more information. Notice: This permit application Pl rev (at — %) $ 0 Visa CI MasterCard expires if a permit is not obtained State ev rg ( .) $ Credit card number: I I within 180 days after it has been TOTAL $ n'm accep a s complete. Name of cardholder ea shown on credit card 3 440-4615 (61001COM) Cardholder signature Amount CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 003? INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date R nested AM PM BUP Location / 3 7 / 7 - -i,' Suite MEC Contact Person � _e� Ph ( )q70 — 38c9, PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Ina Sheath /Shear L A J �D�� ���� 1 1 Q O Framing 1 1 Q .1/4 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final P RT FAIL UMBIN Post eam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: 'I AS PART FAIL M - NICAL Post& Beam Rough -In Gas Line Smoke Dampers - Final PASS PART FAIL E CTRICAL Se ice Rou• -In (51, UG /SI•b Low V. Fi - lar F'- a Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS P' -T FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA 13 Approach /Sidewalk Date 0 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 Jcz 'd 3 INSPECTION DIVISION _ Business Line: (503) 639 -4171 (� BUP Received c / Date Re uested / AM PM BUP Location / �� / (c- Q/I7l- Suite MEC Contact Person 'KM ui Ph ( ) < lc - 38 PLM Contractor Ph ( ) SWR • BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Dry Insulation lNailing / ,, P Drywall N L. tC 1 �t� Fi rewal I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 411011 '•ART FAIL BING 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 Post & Beam Rough -In Gas Line Smoke Dampers F PASS ART FAIL LEC, RICA 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: ❑ Unable to inspect — no access ADA Approach/Sidewalk Date L 3 h, 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 ' 3 — 0 0 0 3 9 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP ReceivedDa e t Requested l 6/ AM PM BUP Location ! 7 I Suite 3 MEC Contact Person �� Ph ( ) 2� PLM Contract Ph ( ) SWR UILD Tenant/Owner ELC Footing Foundation ELC Access: /(� i Ftg Drain ELR Crawl Drain Slab Inspection Notes: V _.4 o ��� SIT Post & Beam Shear Anchors c Ext Sheath/Shear Int Sheath /Shear Framing i its if. ■ Insulation no t./ L 471 ti� Drywall Nailing Firewall .113 Fire Sprinkler S uX, �--L� �t, �,2 /L4. S c).7 ��l� (— Fire Alarm Susp'd Ceiling Roof 45/?el See; .v N r20 L C Nc i ) O 'ASS PART PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS___PART FAIL 'MECHANICA Pos eam Rough -In Gas Line Smoke Dampers � 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: Unable to inspect — no access Fire Supply Line • ADA /4' _ �' Approach /Sidewalk Date 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 4111 MST 3 — 37 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Req ested Zg AM PM BUP Location l 3 Suite MEC Contact Person Ph ( ) 71 3 R'?- 4 f PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain � � C (r c � /� _ ELR Crawl Drain Slab Inspection Notes: ( SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PAS RT FAIL �U ING Post& Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan 0th i` , / -^� �'� '7 anal •^ / f f/v 4 � / � r eG 767( Ho l L few o © A( P SS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL • Service Rough -In UG /Slab Low Voltage Fire Alarm ____� El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 1460 FAIL 0 Please call for reinspection RE: ❑ Unable to inspect - no access - Fire Suppty Line ADA Approach /Sidewalk Date e/.2/0.3 Inspector — ' \ Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL