The URL can be used to link to this page

Permit CIT OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00262 i DEVELOPMENT SERVICES DATE ISSUED: 8/15/2005 A- 6-- II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 BD -00412 SITE ADDRESS: 09700 SW MARILYN CT ZONING: R -3.5 SUBDIVISION: DARMEL NO. 3 LOT: 029 JURISDICTION: TIG Project Description: 1010 square foot addition. - BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 19 . FIRST: 505 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 505 sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 0 DIRD: sf RIGHT: 5 VALUE: 93,324.00 OCCUPANCY GRP: R3 ' BDRM: 2 BATH: 3 TOTAL: 1.010 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 3 WASHING MACH: 2 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 4 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL . FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 2 FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVCJFOR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 4 SIGNAUPANEL: 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 8 STEREO: VACUUM SYSTEM: ► y � ' � q,,�t AUUDIO 8 S TEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: f L BURGLAR ALARM: OTH: l. E COYA e 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 , RICHARD LUNDSTROM OWNER and all other applicable laws. All work will be done in 9700 SW MARILYN CT accordance with approved plans. This permit will expire TIGARD, OR 97224 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 - 684 -0472 Phone: 503 - 475 -3180 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 #: direct questions to OUNC by calling 503 -246 -6699 or TOTAL FEES: $ 1,699.69 1- 800 - 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : _:__11,41/...__" . g Permittee Signature 1 l lc n _ 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. Building P 4 " • I i �1 � / FOR OFFICE USE ONLY g 1 1 Received 7 Da te iv M��.� Permit No.:)�fjT�p0 ....a2426 Ci of Ti and 13125 SW Hall Blvd., Tigard, OR1 11 2 5 2005 3 Plan Review Other Permit: Phone: 503.639.4171 Fax: 503. T�GARD ��"" ilit DateB /,A V �! _/I -(.,- Inspection Line: 503.639.4175 CI1 Ur ! y . Date Ready / by: 3 El See Attached Checklist for Internet: www.c*.tigard.or.us DING DIVISION J Notified/Method: 1 _ Supplemental Information .- _ - a. ' _ • // lowmf.. 4 i 011, 1i ' TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ; Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. 4 . CATEGORY OF CONSTRUCTION • _ Valuation: $ LS ® q3 3a 'EL and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building El Multi-family Number of bedrooms: El builder ❑ Other: Number of bathrooms: 3 ' JOB SITE INFORMATION AND LOCATION , Total number of floors: Job site address: 7 � _/ C C T • 7 New dwelling area: square feet / pi b Cit State/ZIP: 'T n r& 'r) 'Z Z 9 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ /^� ? n �1 ��.G y Existing building area: square feet #..i 4 &t OE. To »4.'e a befit— v� _ n � AP-Pet r New building area: square feet 14 OWNER ❑ TENANT Number of stories: Name: \ G 1i E C fil" 0,-- 1 / Type of construction: Address: t 519g2 Occupancy groups: piA_ City/State/ZIP: In; v� Q R_ C ( ? 22. Lf 10 Existing: Phone: (563) �v u� � u —0(4 12 Fax: (51S 3) (p13 q —U q 7 Z New: KAPPLICANT1 ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State/ZIP: apply: Phone: ( ) I Fax: : ( ) E -mail: CONTRACTOR ` Business name: O 1) ti f_.2., , BUILDING PERMIT FEES* • Address: Please refer to fee schedule City/ State/ZIP: ° Fees due upon application Phone: ( ) 1 Fax: ( IL \ Amount received CCB lic.: �� Date received: Authorized signature . This permit application expires if a permit is not obtained w �' A� within 180 days after it has been accepted as complete. Print name:. is 1.f1'M Date: /— s —Q * Fee methodology set by Tri -County Building Industry Service Board. i. Building ,PCrmits\BUP- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB) One- and Two - Family Dwelling i. ' . Building Permit Application Checklist FOR OFFICE USE O City of Tigard Da1eai�ved Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated g � ated permits: Phone: 503.639.4171 Fax: 503.598.1960 � �� t 11' '' ❑Electrical ❑Plumbing ❑Mechanical 24- Hour Inspection Line: 503.639.4175 ■ {,1 e `I I ,. Internet: www.ci.tigard.or.us ❑ Other: THE FOLLOWING ITE1'IS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 , Fire district approval required. Name of district: ❑ ❑ ❑ • 5. = Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ t F. , 6 Sewer permit. 0 7 Water district approval. ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application.. g ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state tia, ❑ 0 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 64 ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, 51 ❑ ❑ 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. ' ''' . ,.,�,.,� ,, . j 15 Elevation views. Provide elevations for new construction; minunum of.two,elevations for additions and remodels. l(2(; ❑ , ••❑ Exterior elevations must reflect the actual grade if the change in grade is.greater than four foot at building envelope. c 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- V • ❑ ❑ 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 t- ❑ ❑ 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 a licable to the ro'ect under review. 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document.' ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre- Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. i:\Building\Permits \One- Two- FamilyChecklist.doc 12/03 • ' Electrical Permit ApEliELZ I " E D FOR OFFICE USE ONLY City JUL f Tigard I L 2005 Received ` 'h�W "5 --cogd 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Permit No.: M ' O Phone: 503.639.4171 Fax: 503.598.19 � /� A w DateB : ; • i \ Other Permit: 69TY OF TIGAR B Inspection Line: 503.639.4175 F. W Date Ready/By! Suns: ® See Page 2 for Internet: www.ci.tigard.or.us BUILDING DIVISI - it �:�l�l Date/13 1 Notified/Method: Supplemental Information .. TYPE OF WORK �`� 'PLAN .REVIEW ❑ New construction 4ddition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ['Hazardous location ['Service OF CONSTRUCTION " ': Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., . - of 1- and 2- family dwellings 4 or more new residential S1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family 0 Master builder ❑Other: ' JOB SITE• INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑ RV park structures or 0Egress /lighting P Job no.: Job site address: -, — 7 cd 3 ,,..1 ) fr.C1 DHealth-care facility DOther: Submit 2 sets of plans with any of the above. City/ State/ZIP: 4.. Ct ( Z Z L-.{ The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: J Project name: , - . FEE* SCHEDULE • `'; :, - Description I Qty. I Fee. I Total I .. Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. R. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular - dwelling, service and /or feeder 90.90 2 ervices or feeders installation, alteration, and/or relocation 00 amps or less 1 . 80.30 2 ' 'PROPERTY 0 R ❑ TENANT . - 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: k J d . 1/�i� 601 amps to 1,000 amps 240.60 2 ( Address: ) OO S l- ` C � I . Over 1,000 amps or volts 454.65 2 ` Reconnect only 66.85 2 City/State /ZIP: '1 r i 0 maxi. 7 7 2, y Temporary services or feeders installation, alteration, and/or Phone: ( ) ax: ( lll relocation 2 amp or less 66.85 1 Owner installation: Thi stallatio o .roperty that I own which is not 2 01 amps to 40 am 100.30 2 intended for sale IN rei, or exch.•r• ; to 447, 449, 670 and 701. ' ' pp 401 amps to 600 amps 1 33.75 2 Owner signature: Date: 1- - 05 Branch circuits — new, alteration, or extension, per panel AP.LICANT I . • CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits g / Contact name: without service or feeder fee, I 46.85 �� S 2 Address: each branch circuit Each add'l branch circuit ji 6.65 R • 4'Z 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) F es:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- CONTRACTOR , . . energy panel, alteration, or • .\ extension. Describe: Page 2 2 Business name: i)' w L G Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES*....... . CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal 73 T • Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) 5. 8 TOTAL PERMIT FEE ? ?. 55 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Building \Pemtits\ELC- PermitApp.doc 12/03 440.461 Sr(10/02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: • RESIDENTIAL WORK ONLY:' Fee for all residential systems combined .. $75.00 Check Type of Work Involved: .❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Prnnits\ELC•PermitApp.doc 04/03 ` Mechanical Permit Ap f ° IV E `•` FOR OFFICE USE ONLY City of Tigard Received 2 Date/By: Permit No.��A,�,r 00o9Og. 13125 SW Hall Blvd., Tigard, OR 97223 JUL 2 5 201 Plan Review I�!/.7 Phone: 503.639.4171 Fax: 503.598.1960 /uJ \ Date/By: Other Permit: Inspection Line: 503.639.4175 p CITY OF TIG t F I Date Ready/By: lug ® See Page 2 for Internet: www.ci.tigard.or.us BUILDING DI I 01 Notified/Method: Supplemental Information ' • ' _ TYPE OF WORK COMMERCIAL FEE* SCHEDULE . SE CHECKLIST ❑ New construction ZN Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • CATEGORY OF CONSTRUCTION . _ Value: $ and 2 dwelling . 'RESIDENTIAL EQUIPMENT /;SYSTEMS FEES* 1 y g ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total " JOB SITE INFORMATION AND LOCATION ' ' ' . • ' • ! Heating/cooling Job site address: C r? (Eit) 9 ,,L.) r t Air conditioning or heat pump s/ \L.CtP 1 Y V� �� (requires site plan showing placement) 14.00 City/ State/ZIP: e...--,,,,k �� 4(i. 2-2 y Furnace 100,000 BTU (ducts/vents) 14.00 Fumace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue/vent for any of above 10.00 Other: _ 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ' � PROPERTY OWNER ❑ TENANT Chimney liner /flue/vent 10.00 j� Other: 10.00 Name: R kc, „4 L , Environmental exhaust and ventilation Address: WW V t_,),,_ Range hood /other kitchen �� Oos S 2 = ` ^. cket \ tti C -, equipment 10.00 City / State/ZIP: A- c `j l ' '7 2, L q Clothes dryer exhaust 7 10.00 t Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) • toilet compartments, utility rooms) 3 6.80 - PPLICANT it■- ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Fumace, etc. Gas heat pump City/ State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range ' CONTRACTOR : Barbecue Business name: OD l 13 12 Clothes dryer (gas) J Other: _ Address: _ MECHANICAL PERMIT FEES *: ' City/State/ZIP: Subtotal /� Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) / - 5 0 Plan review (25% of permit fee) _ CCB lic.: State surcharge (8% of permit fee) 3 .80 • TOTAL PERMIT FEE -2 t . 3b Authorized signature: This p ermit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: I Date: ' • Fee methodology set by Tri- County Building Industry Service Board i:\Building\PermitsWEC- PermitApp.doc 12/03 440 -4617T (11 /02/COM/WEB) Mechanical Permit Application - City of Tigard • Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: , 'Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $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\Permitsuv1EC- PermitApp.doc 12/03 2 ' Building Fixtures, RECEIVED Plumbing Permit Appli�ltioi 2005 FOR OFFICE USE ONLY City of Tigard J� BUJ �� 2005 Received Permit No.: /`1hT,t�'� �a�, 13125 SW Hall Blvd., Tigard, OR 9722 ITY OF TIGARD Plan Review Phone: 503.639.4171 Fax: 503.598 - • . t %a +a ; Date/By: \ Other Permit No.: LDING DIVISI 4_ ` - 24- Hour Inspection Line: 503.639.41 �• I Date Ready/By: y: 10 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK .. • - ' FEE* SCHEDULE ' ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I 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 ❑ 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 V JOB SITE INFORMATION AND LOCATION Site utilities Job site address: c ) o'C) S J v\4veAt t.- Cl. Catch basin or area drain 16.60 City/ State/ZIP: �.. R "? Z Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I 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. line 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 • DESCRIPTION yF WORK Backflow preventer Page 2 A -d Q C,P■ ( cj k1 0 7Z) Backwater valve 16.60 --3 �- Do 4 t 4413 DU L. t P A - A 1 i r \ Clothes washer 2. 16.60 O + J Dishwasher 16.60 ' le.LROPERTY OWNER I ' ❑ TENANT Drinking fountain 16.60 2. W `avri� Ejectors /sump 16.60 Name: r l�.f e7� Expansion tank 16.60 Address: l b S /' AA, ` P IA Gsf, , Fixture/sewer cap 16.60 City/ State/ZIP: "k- T i e ,-e_k 1 (, I C{,'7 2 2,9 Floor drain/floor sink/hub 16.60 Phone: (. ) Fax: ( ) Garbage disposal 16.60 , APPLICANT'/ ❑CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax: : ( ) Sink/basi avatory H 16.60 C ub/shol,Yshower pan la 16.60 E -mail: Urinal 10 16.60 CONTRACTOR . Water closet 3 16.60 Business name: Water heater 16.60 Address: Other: City/ State/ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 /U-4° CCB Lic.: I Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) . bD Authorized signatur _ 4 TOTAL PERMIT FEE j Q',9.D Print name: A�i 4 Date - •, 1 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 \Pemtits\PLMF- PennitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total . Square Footage: ,. . Permit 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 Valuation:' ,. Permit Fee::' Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by (Fixture) Work Performed • Fixture Type: Replace New Moved Existing Capped 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 p 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 - Bradley Quantity Total -Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:\ Buildineermits \PLM•PermitApp.doc 3 /03 AUG 1 3 2004 File Number CleanWater S.e ist4 1 B y - - qR0 - - ping Site Assessment OW commitment is clear. F %I ... , QV N p\\i • Jurisdiction 13 776/1R17 _ _ [Ate 'IrS -0 Map & Tax Lot 24/ /J (5D OOY /A . Owner .00A Site Address 91Ob 'W ►L� Ct. rtc �u�d , a 5 l Z4 Contact row. Proposed Activity Adtlt;c+w,( Roa /i?stl, /o1 Address f)Oo Mai 1 N Ct. e•ACAIltk `022 Phone So - 8�{y - 25 Official use only below this line Y N NA Y N NA • Sensitive Area Composite Map Stormwater Infrastructure maps . Map# •Z,5 /4J ❑ L � t QS# 45/9 ❑ ❑ r Locally adopted studies or maps a ❑ ❑ Other Specify I Specify aods s : Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order NoMPrtiots p ygib ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE . PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. g Sensitive areas do not appear to exist on site or within 200' of the site. This pre- screening site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered qqp your property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATER CONNECTION PERMIT. ❑ The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Comments: Se V Se hettO • • do war- 04.0 rid E 41 PM' w A e+o "fop •r a e .rXe s.)` e. Reviewed By: `LAC,. Date: ze /.9/0 Returned to Applicant Mail X Fax Counter Date 11t /za�j y By_( , 155 N First Avenue, Suite 270 • Hillsboro, Oregon 97124 Phone: (503) 846 -8621 • Fax: (503) 846-3525 • www.cleanwaterservices.org Permit #: / Xi x0 - DO aZ�¢ Address: x-700 tit) f) ssued by: 'i ,& Datei / S Q • Notice to Property Statement: Information Not ce o ope y Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: 1. I own, reside in, or will reside in the completed structure. P ` 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. \C3 L—LAS \644 (Signature of permit applicant) (Date) 1 (White copy to issuing agency permit file, pink copy to applicant) information Notice to Property Owners About Construction Responsibilities Note: This Informnation Notice to Property Owners about Construction Responsibilitie.s was developed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, he ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax law: As an employer. you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. ifyou fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one ofyour employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even ifyou didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1- 800 -829 -1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any fai lure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, tire, or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work ofrough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052 503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.pm4 1/94 • CITY OF TIGARD - ' BUILDING DIVISION PERMIT #: MST2005.00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 -_.. INSPECTION WORKSHEET FOR DATE: 3115/2007 TIME: 7:01AM PAGE: 42 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6115/06: Added (1) 200 amp service & Low voltage all encompastAng. OWNER: LUNDSTROM, RICHARD PHONE #: 5031;34-0472 CONTRACTOR: O WNER PHONE #: Inspection Request Scheduled For: Date: 3/15/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 044868-03 503-849-6325 N Corrections /Comments/ Instructions: BA SS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I kY Oat- - $ 1 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/20(Y Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/25/2006 TIME: 7:16AM PAGE: 30 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARNEL NO. 3 LOT #: 02 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6115/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 °0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/25/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 322 Shower pan 036551 -01 503 - 849 -6325 Y Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: go WA- r Date: 7j2/ 04. Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2f0r, 00262 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/16 /2006 Phone: (503) 639 -4171 /,u. Inspection Requests (24 Hrs.): (503) 639 -4175 ,_ ��. INSPECTION WORKSHEET FOR DATE: 6/20/2006 TIME: 1:01AM PAGE: 17 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 - 684.0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/20/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 032008 -01 503-849-6325 N Corrections /Comments/ Instructions: \I. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /" 1 Date: 26/56 Phone #: (503) 718- 2 / -9 CITY OF TIGARD - , BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/161200'.; Phone: (503) 639 -4171 4 !1' 1 i�� 3,./ Inspection Requests (24 Hrs.): (503) 639 -4175 „J,11- `__1. INSPECTION WORKSHEET FOR DATE: 6/16/2006 TIME: 7:00AM PAGE: 66 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 031821 -01 503-849-6325 N Corrections /Comments /Instructions: 14I)__rW 0 K1 DAN / Ce 302) Th. 7 . Qc — critl.„-------- iNie.„ p t,tc. • 1 ' . . P-) 6 D . It■A") , ,400.00 0 I, / _ _. 6( r _ / 64 (.9' v ❑ PASS ❑ PARTIAL APPROVA ❑ ANCEL ❑ NO ACCESS IL CALL FOR INSPECT ADDITION 7 ASSESSED `� 1 1 L I_ r Inspector: l Date: 1!7 6 10 Phone #: (503) 718- Vdf CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1N/2.00/. Phone: (503) 639 -4171 �dlp� Inspection Requests (24 Hrs.): (503) 639 -4175 � _ .. INSPECTION WORKSHEET FOR DATE: 6/14/2006 TIME: 7:05AM PAGE: 9 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARNEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LIJNDSTROM, RICHARD PHONE #: 503- 604 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/14/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 031736 -01 503-849-6325 N Corrections /Comments/ Instructions: • ■ / J ' f, Ail - 44 r / .1"/..t - O r- Y -1 0 G?-) 0 1 )---- � %4 � = , iii_ . �■ . :....411161i1111•1111111(11 / MilliMill11111 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1911-- V FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /1441,r Date: l i G Phone #: (503) 718- 2 vi/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MSf2005- 00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/150001; Phone: (503) 639- 4171u Inspection Requests (24 Hrs.): (503) 639 -4175 _�' "'I I.. INSPECTION WORKSHEET FOR DATE: 5/30/2006 TIME: 7:15AM PAGE: 66 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSIROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD qC1 PHONE #: 503-6040472 CONTRACTOR: OWNER [' /'� PHONE #: Inspection Request Scheduled For: Date: 5/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 030714 -01 503.649 -6325 N Corrections /Comments /Instructions: / L am. /■ ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS IN IL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: CV Phone #: 503 p jr/ � ) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 81151200.5 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5130/2006 TIME: 7:15AM PAGE: 65 SITE ADDRESS: 09100 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARNEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 - 664 -0172 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Watei service 030714 - 02 503.849 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v I Phone #: (503) 718- 'f p ector: (4 3 Date: S CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 L. INSPECTION WORKSHEET FOR DATE: 8!19/2005 TIME: 7:07AM PAGE: 19 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL N0. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 CONTRACTOR: OWNER PHONE #: 503 - 475.3180 Inspection Request Scheduled For: Date: 8/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 305 Plumbing underslab 013931 -01 503 - 849 -6325 N Corrections /Comments /Instructions: L 1 J PASS ❑ PARTIAL APPROVAL ❑ CANCEL [1] NO ACCESS V ❑ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 6 �� Date: I / C Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: Msr2005 -002 2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/15/2007 TIME: 7:01AM PAGE: 44 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503-684-0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/15/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 044868 -02 503 - 849 -6325 N Corrections /Comments/ Instructions: • rir g ! 1 ' X ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL F R INSPECTION ❑ ADDITIONAL FEES ASSESSED 3 // /.0 2V Inspector: Date: / Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200G -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639-4171 i lol Inspection Requests (24 Hrs.): (503) 639 -4175 " __.. INSPECTION WORKSHEET FOR DATE: 6/16/2006 TIME: 7 :00AM PAGE: 63 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square Foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -6PA -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 031621 -02 503 -849 -6325 N 12.0 'l'F V4\ .j 0 1 30 el 1 .. e — Corrections /Comments/ Instructions: Q -- 1 O ISVI47� 1—,,s y.._ f-oa_ tisdQ i■Bo i 00 K ❑ PASS APARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: e306, 1 ` � 6 Ala Date: 6 1 b'6 Phone #: (503) 718- ZTLcb CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/7005 Phone: (503) 639 -4171 o�tP w l �l Inspection Requests (24 Hrs.): (503) 639 -4175 F: _.. INSPECTION WORKSHEET FOR DATE: 6/13/2006 TIME: 7 :22AM PAGE: 32 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -61W -04'/2 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/13/2006 Pour Time: Code # Inspection Description Confirm Contact # Message 120 Electrical rough -in 031642 -01 503. 849-6325 N Corrections /Comments /Instructions: I C1) � tke 'OW � 01 (.11 %CO fsa N a 614 &y 2.. J._icp F I V . 0 PM v tp1 s Mp 141' t� ESCC. ate' sio u rL aot itonrn, • NET 113.3 t� ) fi u% • P aa4 ��,,,, \\Mil 9I.SZARS - 441.) 1 a o� ( -sent, �cit N ' 2a Cfl(_ u &JtJ . 4 t �- w) 11-13‘).-16 7A An+) 0 V 4 g t S fd d i S KLL 0■N a Sate -- oPc' \a-6V ► o a - C R ` EE ..v 1 ■ t) b ET usraT po((L Nq s �L�c u D . Nvg_b\I a ItJS VLIT l (tJ I S Act ST ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS A FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: GAO Date: 6 - 1 3 ' 04 Phone #: (503) 718 -1-4 0 54, �e/K CITY OF TIGARD 1p Pi BUILDING DIVISION G � r PERMIT #: MST2005.00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 e ... INSPECTION WORKSHEET FOR DATE: 3//512007 TIME: 7:01AM PAGE: 46 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square loot addition. 5115/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 - 684 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 3/15/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 044868 -01 503- 849 -6325 N Corrections /Comments /Instructions: I `RASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: S� hone #: (503) 718- 9/4/6 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639 -4171 w �1 Inspection Requests (24 Hrs.): (503) 639 -4175 s' !L INSPECTION WORKSHEET FOR DATE: 8/1 /2006 TIME: 7:02AM PAGE 77 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 02g TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/1/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 034112 -01 503- 849-6325 Y Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _0 Date: g— /--D 0 Phone #: (503) 718 - t.4 -4-5-- L r" CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639 -4171 ..t 1 A l Inspection Requests (24 Hrs.): (503) 639 -4175 _'!. I — INSPECTION WORKSHEET FOR DATE: 7/31/2006 TIME: 7:06AM PAGE: 36 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -6134 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/31/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 034066 -01 503 -849 -6325 CY ) A Corrections/Comments/lnstructio s: a ( -- '7 2-6 U Cr■. G0 C. ' ACtif's■ j • X RA . ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cth/ Date: ` ‘/ .e56___ Phone #: (503) 718- Z-6*Y CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 -00262 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/15!2005 Phone: (503) 639 -4171 t agyitl l Inspection Requests (24 Hrs.): (503) 639 -4175 _ JAI- ' `'I r � I INSPECTION WORKSHEET FOR DATE: 7/26/2006 TIME: 7 :07AM PAGE: 69 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 - 6840472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 033740 -03 50849 -6325 N orrections /Comments /Instructions: �/ l �/[� W fi°r � R X41' S _ ft (tp E Z RC ` /U lz Nt oft$ Ft I f' e4-1 o teem - P v u c c 'in/ 2L6- ./ t • _ C m - r - A---74._._s il 'f c. d P v — Li[' -C._ ■ .cat ' Z g3a o . i'i -t - c f3y 2 K._ 6 a __ ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: chifp Date: 72-41'6 Phone #: (503) 718 - 2-6- 4" CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/26/2006 TIME: 7 :07AM PAGE: 70 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503 - 684.0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 033740 -02 5034349.6325 N Corrections /Comments /Instructions: c Q po12 _ y 6 P • g f Ass ❑ PARTIAL APPROVAL El CANCEL 111 NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C�� Date: 7 246, Phone #: (503) 718 - 264/9 CITY OF TIGARD ' BUILDING DIVISION PERMIT #: MST2005.00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639- 4171 ard�y�a r � Inspection Requests (24 Hrs.): (503) 639 -4175 I L INSPECTION WORKSHEET FOR DATE: 7/26/2006 TIME: 7 :07AM PAGE: 71 1 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. 6/15/06: Added (1) 200 amp service & Low voltage all encompassing. OWNER: LUNDSTROM, RICHARD PHONE #: 503684 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 033740 -01 503 -849 -6325 N Corrections /Comments /Instructions: G Ca/t/6 !G i 0i_ )5 /1'/0 V LDAss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cif/ Date: Phone #: (503) 718 -Z-46 9y CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639 -4171 ARu i Ix Inspection Requests (24 Hrs.): (503) 639 -4175 T I .. INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7 :05AM PAGE: 8 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503.684 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 020496 -01 503- 849.6325 N Corrections /Comments/ Instructions: ' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: // — 7- C Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/15/2005 Phone: (503) 639 -4171 - A I Inspection Requests (24 Hrs.): (503) 639 -4175 `:_.. INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 7 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503- 684 -0472 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 020496.02 503 - 849.6325 N Corrections /Comments /Instructions: i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - , Date: //— 7�) Phone #: (503) 718- i CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/15/2005 Phone: (503) 639 -4171 AivitiO Inspection Requests (24 Hrs.): (503) 639 -4175 `' —. INSPECTION WORKSHEET FOR DATE: 9/21/2005 TIME: 7:03AM PAGE: 23 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 CONTRACTOR: OWNER PHONE #: 503- 475 -3180 Inspection Request Scheduled For: Date: 9/21/2005 Pour Time: 12:00 Code # Inspection Description Confirm # Contact - # Message 220 Slab 016257 -01 5034849 -6325 Y -- Corrections /Comments/ Instructions: 0 . PASS // PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL I ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ■ _ Date: �/ � J Phone #: (503) 718 - Illy CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/15/2005 Phone: (503) 639-4171 ., (i Inspection Requests (24 Hrs.): (503) 639 -4175 "'I L. INSPECTION WORKSHEET FOR DATE: 9/2Q/2005 TIME: 7 :07AM PAGE: 51 5477 zit n-- SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 CONTRACTOR: OWNER PHONE #: 503-475-3180 Inspection Request Scheduled For: Date: 9/20/2A05 Pour Time: 12:00 Code # Inspection Description Confirm # Contact # Message 220 Slab 016131 -01 503-849-6325 N Corrections /Comments /Instructions: i .) I? oV ft, C Z ' 1.5/ / b t P( / ✓'1 L -"7a'/< (CM,. /6 r - Al ., - • . rml ot.4 . P 4-4-A/ S I -7 S Z ',INCQa E _ . Co Ve 'r c_ IP /P /Nt-1 - 'Tv 1P,o•T ? / 'JG - t F-Cmvn c-IGe 0 ❑ PASS % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS F AIL a ' ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED IMP, q Inspector: L Date: - Z v ' vr — Phone #: (503) 718 - • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639- 4171�ryl�l Inspection Requests (24 Hrs.): (503) 639 -4175 ° __.. INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 47 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 - 6840472 CONTRACTOR: OWNER PHONE #: 503 Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 265 Wtr proofing basement walls 015775 -01 503 -849 -6325 N Corrections/Comments/Instructions: A 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / Date: 9 — /C Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639 -4171 Ab Inspection Requests (24 Hrs.): (503) 639 -4175 I � .. INSPECTION WORKSHEET FOR DATE: 9/7 /2005 TIME: 7 :08AM PAGE: 1 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. • OWNER: LUNDSTROM, RICHARD PHONE #: 5Q3 -684 -0472 CONTRACTOR: OWNER PHONE #: 503. 475 - 318Q Inspection Request Scheduled For: Date: 9/7 /2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 255 Wtr proofing basement walls 015081 -02 503-849-6325 N Corrections /Comments /Instructions: <49 sm 4eppcw€c O3ME - —rw 10,...-• it m o-tx) edkvtitEek3T tya eNu.s k)fx til -71.1 (V/1..L Vee4Q- t &kr f R or,R --S (avt ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED Inspector: Date: I i C Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8!1512005 Phone: (503) 639 -4171 w yy I Inspection Requests (24 Hrs.): (503) 639 -4175 , . INSPECTION WORKSHEET FOR DATE: 9/7/2005 TIME: 7 :08AM PAGE: 2 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 CONTRACTOR: OWNER PHONE #: 5503 - 3180 Inspection Request Scheduled For: Date: 9/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 215 Footing drain 015081 -01 503 -849 -6325 Y Corrections /Comments /Instructions: qt1 I $-t� le i,ii • L �_. MAW . 1, • .MIA/k I. - ∎� V - w .7 ' w VFW On YET COM M rD TO j t ( c (E 1 4IK TEZ ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FIR INSPECTION ❑ ADDITI AL FEES ASSESSED il,k Inspector: NI Date: Phone #: (503) 718- CITY OF TIGARD ` BUILDING DIVISION PERMIT #: MST2005 -00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005 Phone: (503) 639- 4171u Inspection Requests (24 Hrs.): (503) 639 -4175 . -_' `-_.. INSPECTION WORKSHEET FOR DATE: 8/16/2005 TIME: 7:05AM PAGE: 37 1 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503- 684 -0472 CONTRACTOR: OWNER PHONE #: 503-475-3180 Inspection Request Scheduled For: Date: 8/16/2005 Pour Time: 1 :00 Code # Inspection Description Confirm # Contact # Message 205 Footing 013622 -01 503 - 849-6325 N Corrections /Comments /Instructions: Jar be_ 2- c __,r -* , U 5.---f2„ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: , Date: i - Phone #: (503) 718- CITY OF TIGARD , BUILDING DIVISION PERMIT #: MST2005 00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/112005 Phone: (503) 639- 4171 a��,�iII Inspection Requests (24 Hrs.): (503) 639 -4175 - I 1 INSPECTION WORKSHEET FOR DATE: 8/16/2005 TIME: 7 :05AM PAGE: 36 SITE ADDRESS: 09700 SW MARILYN CT CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 029 TYPE OF USE: PROJECT NAME: LUNDSTROM DESCRIPTION: 1010 square foot addition. OWNER: LUNDSTROM, RICHARD PHONE #: 503 -684 -0472 • CONTRACTOR: OWNER PHONE #: 503 - 475 -3180 Inspection Request Scheduled For: Date: 8/16/2005 Pour Time: 1:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 013622 -02 603- 849-6325 N Corrections/Comments/Instructions: // / 5132- ,¢,<-1Ca, - lo.Zt 5-1 z SMacl .-s / - s 5',44i42 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ii—/G - S Phone #: (503) 718-