Permit MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2006 -00053
����; DEVELOPMENT SERVICES DATE ISSUED: 2/22/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BD -01500
SITE ADDRESS: 09800 SW RIVERWOOD LN ZONING: R -4.5
SUBDIVISION: COPPER CREEK STAGE 2 LOT: 044 JURISDICTION: TIG
Project Description: Interior alterations, kitchen /bath
BUILDING
REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: THROE sf RIGHT:
VALUE: 37
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 1 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: , 0 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: 1 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 SVCIFDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: 9 SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ ampNolt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: 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
LARRY /NANCY CHURCH DEARI NG & YUNG CONSTRUCTION and all other applicable laws. All work will be done in
9800 SW RIVERWOOD LN 9510 NE SANDY BLVD accordance with approved plans. This permit will expire
TIGARD, OR 97224 PORTLAND, OR 97220 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: 503 246 - 3969 Contact #: PRI 503 256 - 5130 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
TOTAL FEES: $ 995.84 Reg #: LIC 49812 direct questions to OUNC by calling 503 - 246 -6699 or
1- 800 - 332 -2344.
REQUIRED ITEMS AND REPORTS
Issued By : ∎. / . — �- - _ _ _/ __ Permittee Signature : i ' • = —
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
a
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 Permit • k\IEV) FOR OFFICE USE ONLY
Received
City of Tigard Permit o.: a 3
�' g Date/B . p to , v .. '�b b
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
P hone: 503.639.4171 Fax: 503.598.19 EB 2 2 200 ... � I' ` • Date/B . Oth Permit:
Inspection Line: 503.639.4175 �•: ='_ �. Date Ready/By: tt �R El See Attached Checklist for
Internet: www.ci.tigard.or.us ��(('' rq+l(� _,.�. Notified/Method �� Supplemental Information
B �� ��f i� j
ict REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction � A' ❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Jai- and 2 -family dwelling ❑ Commercial /industrial Valuation: 3 7 Set) $ , O 5 —
❑ Accessory building ❑ Multi- family Number of bedrooms: . •
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 4k 8 QD 5 w Rive/tux/0A L K) , New dwelling area: square feet
City /State/ZIP: r 0 , q 11-2,4 Garage /carport area: . square feet
Suite/bldg. /apt.'no.: Project name: Covered porch area: square feet
Cross street/directions to job site: j,)(4.rl a,%.l }2,, —i-0' t 0"5 D area: square feet
, 1 IA 40 1R 1 V �Q/r' / 00.4 • 4 B+ +6 gee, . Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: C c, pat 6.12., dreeg g -,rte,- :I:: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
.WA ON- _ \ 4'12rGL 61,5 .1`� 1�,. /.b.sictk Valuation: $•
PA- .-. Existing building area: square feet
New building area: square feet
•
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Fxidlia R j .4 7sJ y v� r _ 'Type of construction:
Address: S 13 o 3 W W-C41. {'B1r- IV V ' Occupancy groups:
City /State /ZIP: p j 1 — C l Z 1 0 Existing:
. Phone: 6603 ?j+ -:(o (a 1 F New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: DE AR(,!J 4 l LAIJ C ecJYLTf le.)}c7t91Z.5 . y N tom. All contractors and subcontractors are required to be
Contact name: j .)V" A b e.a...t . 1, licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
•
Address: CI 5 to t4 I/ ....11 . - 130)53 jurisdiction in which work is being performed. If the
1 applicant i; from licensing, the following reasons
City /State /ZIP: 7 4 - . , j.. ) (9 • 'ail 2,i. .) . apply: 1.15---. 1.15---. a-4 .
Phone: (� 3) 3 D ( '' 12 -L I Fax:: (9) 2i�'�'- t 7h. / q 1 ..29 49 • a 1
E - mail: - --------- --- D
CONTRACTOR TX .-f& 0
Business name: •
BUILDING PERMIT FEES*
Address:
' Please refer to fee schedule.
City /State /ZIP: Fees due upon application
Phone: ( ) f_ ?. ? -p - 7 Fax: ( ) .
CCB lic�q I Amount received
• l % Date received:
Authorized signature: This permit application expires if a permit is not obtained
'` within 180 days after it has been accepted as complete.
Print name' owl As G L
t QGL1r 1 1 Date: 2../0 ( • Fee methodology set by Tri -County Building Industry
I Service Board.
i:\ Building \Permits \BUP- PermitApp. 12/03 440.4613T(11/02/COM/WEB)
One- and Two - Family Dwelling
Building Permit Application Checklist FOR OFFICE USE ONLY
City of Tigard Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Date/By. soaat
Phone: 503.639.4171 Fax: 503.598.1960 G rvPlu, A\
As permits:
5 , ' q t_'�i ❑ Electrical CI Plumbing ❑ Mechanical
24- Hour Inspection Line: 503.639.4175 . �,l
Internet: www.ci.tigard.or.us _. 0 Other
• THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )• es NO iN/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 ❑ ❑ ❑
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 sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state 0 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 ❑ ❑ 0
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 indicatedetails and locations; for non- • ❑ 0 ❑
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 , 0' ❑ ❑
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, Soof truss) shall•be stamped by an engineer or ❑ ❑. • ❑
architect licensed in 'Ore on and shall be shown to be 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. ❑ ❑ El
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. El ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard • ❑ ❑ ❑
Street Tree List.
29 Site plan to include tree protection measures as required by conditions of approval. ❑ •❑' ❑
30 A Clean Water Services' Sensitive Area Pre- Screening Site Assessment form is required for all building additions, - ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
•
I:\ Building \Permits\BUP- RES- PermitApp.doc 2
Electrical Permi : On '' L VEE Foil OFFICE USE ONLY
+
Cit of Tigard Received
Date/B Permit No.: - ■
13125 SW Hall Blvd., Tigard, OR 97 B 2 2 2006 Plan Review
. ;
Phone: 503.639.4171 Fax: 503.598.1960 jw€ I I ` ' Date/B . Other Permit: iii, : I / • �/Q a
Inspection Line: 503.639.4175 -1_ r., ,' � J Date Ready/BY: : taris :,. ® See Paget for '
Internet: www.ci.tigard.or.us CITY T � I y G q � � � Noti - Supplemental Information
B T Wfl IP Bp 'GI' aSIOly } �� PLAN REVIEW
❑ New construction OAddition/aiteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
rE - and 2 - famil y dwellin g ❑ Commercial industrial 0 Accessory building ❑System over 600 volts nominal units in one structure
El Multi- family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: ❑Health -care facility ❑Other: _
Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 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: Go vt, Cgs E v S -044g �_ Lot no.: 44 Ea. add'I 500 sq. ft. or portion 33.40 l
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular .
- &II/VA' / , k . dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
. 200 amps or less 80.30 2
• ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 • 2
401 amps to 600 amps 160.60 2
Name: 1\1 Off,CAn 4 "4 _�M ( y IA 601 amps to 1,000 amps 240.60 2
Address: "l �-Q 5v J 17 I Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: '� ,,i2A ( ' , c2( ' Z l 0 Temporary services or feeders installation, alteration, and/or
' Phone: ( SO ) .A) t�
� ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not , 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 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
Contact name: without service or feeder fee, / 46.85 fil‘SK 2
Address: first branch circuit
Each add'I branch circuit / 6.65 sviS 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax : : ( • ) 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:
l ic:4.l Growl rs' + D 0.5 11 h
Address: 150 t ,m v I fke-'i s 2 A Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: & ) ._,,, k0 ,,,,,,, , • . CI qO 3a Investigation per hour (I hr min) 62.50
Phone:
( 9)3) (9 b tb — at 3 5'''s' Fax:.( ( 5 b q' + 7q1 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 11 ( L . Electrical Lic.: A ..qpi, ( J Suprv. Lic.: ( gAis - Subtotal •1 06 • 3 0
Suprv. Electrician signature, required: Plan review (25% of permit fee) .
Print name: Date: 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: Date: ' • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is Building \Perrnits\ELC- PermitApp.doc 12/03 - 440-4615T(10/02/COM/WEB
Electrical' Permit .Application - City of•Tigard _
Page 2 :. Supplemental' Information r
x '.
LIMITED ENERGY•'PERMIT.FEES: . .
t..
l RESIDENTIAL WORK ONLY: .
Fee for 'reside
ntial 'systems_combined:.....�: $75.00 ' - '
` all • C
;.• eck Type of Work Involvedi_
•
• . ® =" 'Audio and Stereo, Systems* - -
❑'`Burglar Alarm - - • -, I
❑ ' Garage Door Open& ., ,,• - ,
,Heating , •Ventilation and Air Conditioning: • .4 '
• '. System*
❑ ; Vacuum , Systems* , • ❑ Other: ; a y. _ - , `, ;� . r •:., ., •., i f .
• COMMERCIAL WORK ONLY: r 5, ; ; ',..
•
Fee for cach'commercial:sY stem. ' ' " ' E- -$75.00 .� .a
• ,(SEE OAR '918- 260 -260)' • : - - , : - • " " .,
Check -Type,of:Work Involved , t
,❑ Audioand.Stereo-.Systems•- ' :, '� ,� . o ,,j = r� e;• > } , -,u = .��, , •
❑ Boiler`,Controls' ", ' 1 � : . ` j' . , J r, f.,-.,.. , ,- ,, ,t..;e • ; 'J-, ..'
_
Clock Systems
❑ Data Telecommunication Installation. I • , , •
❑ Fire Alarm, Installation. -
❑ HVAC s. M
❑.:.Instrumentation'` . •
•
❑ Intercom 'and Paging Systems" - - ,
1: ❑ Landscape Irrigation Control* - '
,1,
® : Medical -
' ❑ °Nurse Calls , '` r `J1i' �a „i ^�.y.. f ` , �a ' J A r .,:'
. ., ���
Outdoor,. Landsc Lighting - ` , . " ' � . :. , "• - 1.-.' .. ." , , l',. �;,
1 ., : ❑;. Protective Signaling ,T-„ i ,h ,, . : {6•' : • i . ' ti
Other: - , ••
Total number of commercial- systems
• *No licenses are required. Licenses are.required -
for a - •, • , .,
I \ Buildm \ELC- PermitApp:doc 04/03 r V' • F 3 s
Mechanical Permit Application FOR OFFICE l'sE ONl..Y
City of Tigard Received e/By. Permit Nt> T , _," / , f100 3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ur- ,, 1 Date/By. Other Permit:
Inspection Line: 503.639.4175 ___ ..,�� 1I
.,�__ Date Ready/By: kris: ® See Page 2for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction 'Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Vi 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building
For special information use checklist.
Multi -famil
❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ggeb 5 W g ,$ay' w 1-h • Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: - c 1 4012„.D , c 7ZL(' Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: w 1Zd 4'l) I D3 ezal Duct work 14.00
S �, , L _ }\ VON 1..1.\ + Q
Residential is hot water system 14.00
�1'1Tf `LJ� Resid boiler (radiator or
*TWO hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
�
Ly I y� Flue/vent for any of above 10.00
Subdivision: pp� � �e [rJ'r Lot no.: '7 Other: 10.00
Tax map/parcel no.: . Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gins - cafe kA tit,. v..t 1"l, _ Gas fireplace I 10.00 I 6.ob
Flue vent for water heater or gas
/, ,, h - f L Y ., n 7 1 fireplace 10.00
V
( ` r/1 1 � Log Wood/pellet (gas) sto 10.00
dvM_�{,- -64--v-e) - Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: N oy VL ( .- Laterm Clw i , ,rc-1 , ._ Environmental exhaust and ventilation
Address: 5 1170 SvJ 1 o1Aft Din- Range hood/other kitchen
equipment 10.00 ' OA
City /State/ZIP: P� 4.. 1 c t � j C 11-10 Clothes dryer exhaust 10.00
�� i I toilet ( Single-duct (bathrooms,
Phone (S� ) 291 Fax: ( ) t corn comp alimeent utility rooms) % 6.80 L.6 0
❑ APPLICANT ❑ CONTACT PERSON Attie/crawlspace fans 10.00
Other: 10.00
Business name:
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 hater
Fireplace
E-mail: Range ` S , Lit
CONTRACTOR Barbecue '
Business name: 'j R l 5. m w g (�-� r IQ Clothes dryer (gas)
Other
,
Address: &'.4 49 q, 5 6 1 � j 1- MECHANICAL PERMIT FEES*
City /State /ZIP: , s, . . , 1d. ell Z3 L,, Subtotal 3Z. t o
I /� ` Minimum permit fee ($72.50)
Phone: (6 761 ' Z 1 Fax: (SO y ? 4e 1 ,�
`►' Plan review (25% of permit fee)
CCB lic.: 5g 30 11/17/07 State surcharge (8% of permit fee) Z, V7
TOTAL PERMIT FEE *3 4 . II
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
i:\ Building \Penniu\MEC- PnmitApp.doc 12/03 410.4617T(I1 /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 f �'
$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. w •
$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. •
•
. , 4 r ( •
•
•
•
II
t o ,.
y n •
1:\ Building \Permits\MEC- PermitApp.doc 12/03 2
Building Fixtur jP
Plumbing Permi c on FOR OFFICE USE ONLY
City of Tigard F R Rece Permit N
13125 SW Hall Blvd., Tigard, OR 9 2 3' 2 2 2006 Date/By. art^5fapo� 000
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 _ _ / , Date/By Other Permit No.:
24- Hour Inspection Line: 50 rti • I i .
Internet: www.ci.ti ardor OF ��� __, _ I Date Ready/By: Jung ® See Page 2 for
g i � g �
IT T)PJJSTON Notified/Method Supplemental Information
- fi P OF WY O WORK P I Ity1� . 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
al- 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:
Fire sprinkler ( sq. ft.) Page 2
' 'JOB SITE INFORMATION AND LOCATION . , Site utilities
Job site address: 1t goo .S VJ R (V �Wt L. h . Catch basin or area drain 16.60
City /State /ZIP: 14 pat, , ,. ) 0-2_, t Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
DUdv 4.0 2 Manufactured home utilities 110.00
Cross street /directio job site: �J1 `_ Manholes 16.60
TV I?/'4 I-r 1n ! .
. .- f , Rain drain connector 16.60
(2'O1) Sanitary sewer (no. linear ft.: ) Page 2
` Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
` DESCRIPTION OF WORK Backflow preventer Page 2
I44 4 N .4 - D14.A, •'b- ' i, Backwater valve 16.60
Clothes washer 16.60 /
Dishwasher / 16.60 /(,. O
` ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
��^_ � _ -ll
Ejectors/sump 16.60
�
Name: � 4- �,�GG CAA "1i1.Y"�
Expansion tank 16.60
• Address: 5 j 6w 11 j) tz _ s Fixture /sewer cap 16.60
City /State /ZIP: Payki, re, . Al12 t O Floor drain/floor sink/hub 16.60
1
Phone: (5) 24I, 1 51 /91 Fax: ( ) Garbage disposal f 16.60 4.6,0
- Hose bib 16.60
. ❑ APPLICANT ❑ CONTACT PERSON Ice maker / 16.60 /`, (po
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/basin/lavatory 'L 16.60 35, ZO
Tub /shower /shower pan I 16.60 / 4 .00
E -mail:
Urinal 16.60
CONTRACTOR • Water closet 2 16.60 'f u)
Business name: 3 3 )1 NMti1D I i r Ni G Water heater 16.60
Address: ( s i 1 G, pkPb cQ.
te Other:
UR , al 7Z ?j 3 Subtotal M
2'` .g o
��/
City /State /ZIP:
Q Minimum permit fee: $72.50
Phone: ( 5O3) &49/ .. 5047 Fax: 1 SO3 1 {12.- *lib 3 Residential backflow minimum permit fee: $36.25
CCB Lic.: W `l Lt 7) 3 Z 1 Plumbing Lic. no.: ZV • L"1' Plan review (25% of permit fee)
State surcharge (8% of permit fee) / 0. (eV
Authorized signature: et / TOTAL PERMIT FEE 1 a- Z
Print name: I Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\ Building \Permits\PLMF- PermitApp.doc 06/05 440-4616T(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 Fee:
Footing drain - I" 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100'. 46.40 2,001 to 3,600 . $160.00
3,601 to 7,200 $220.00
• Sewer - I st 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 It 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 Back flow 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 ofexisting plumbing or each additional $100.00 or fraction thereof to
specially requested inspections - per hour 72.50 and including 0
Subtotal: $50,001.00 and up $742.00 for the e first rust $50,000.00 and $1.20 for
t - , t each additional $100.00 or fraction thereof
Fixture Work: • Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria. .
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any. new commercial building
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower, ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings. •
Car Wash - Each Stall . ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities .where new•plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for' the food 'service 'area. • '
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
, . - Domestic dwelling units. ` • ,
Drinking Fountain
Eye Wash ❑ Any NFPA 13 -D multipurpose fire sprinkler system. ,
Floor Drain/sink - 2" ' Submit 2 sets of plans with any of the above.
-4'
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial - three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains'
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
.Shower -Gang -
' - -Stall
Sink - Bar/Lavatory • .
- Bradley .., r "
- Commercial ' .
- Service . " ,
' Swimming Pool Filter e . • , t • -
Washer - Clothes . *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet ' increase of sewer EDUs, a sewer permit will be issued and -
-Urinal fees assessed for the sewer increase must be paid before the '
other Fixtures: plumbing permit can be issued.
i:\ Building \Pennits\PLM- PennitApp.doc 07/06/05
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
JAY JAY'S PLUMBING
19447 E. BURNSIDE -
PORTLAND, OR 97233
Plumbing Signature Form
Permit #: MST2006 -00053
Date Issued: 2/22/2006
Parcel: 2S114BD -01500
Site Address: 09800 SW RIVERWOOD LN
Subdivision: COPPER CREEK STAGE 2
Block: Lot: 044
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Interior alterations, kitchen /bath
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for
the plumbing permit to be valid, please have the appropriate individual from your company sign below and
return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
LARRY /NANCY CHURCH JAY JAY'S PLUMBING
9800 SW RIVERWOOD LN 19447 E. BURNSIDE
TIGARD, OR 97224 PORTLAND, OR 97233
Phone #: 503 - 246 -3969 Phone #: 667 -8420
Reg #: LIC 14332
PLM 26 -177PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
S gnature of Au ized Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ELECTRICAL CONTRACTORS & DESIG
150 NE VICTORY SUITE A
GRESHAM, OR 97070
Electrical Signature Form
Permit #: MST2006 -00053
Date Issued: 2/22;2006
Parcel: 2S114BD -01500
Site Address: 09800 SW RIVERWOOD LN
Subdivision: COPPER CREEK STAGE 2
Block: Lot: 044
Jurisdiction: TIG
Zoning: R -4.5
Remarks: Interior alterations, kitchen /bath
Your company has been indicated as the electrical contractor for the permit indicated above. I n order for
the electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
LARRY /NANCY CHURCH ELECTRICAL CONTRACTORS & DESIG
9800 SW RIVERWOOD LN 150 NE VICTORY SUITE A
TIGARD, OR 97224 GRESHAM, OR 97070
Phone #: 503 - 246 -3969 Phone #: 503 - 666 -9358
Reg #: LIC 47712
ELE 26 -466C
SUP 1882S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006.00053
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/22/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7:01AM PAGE: 76
SITE ADDRESS: 09800 SW RIVERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: Interior alterations, litchen /bath. 4/19/05: Replace 60 ft of water service.
OWNER: CHURCH, LARRY /NANCY PHONE #: 503 -246 -3969
CONTRACTOR: DEARING & YUNG CONSTRUCTION PHONE #: 503. 256-5130
Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 039829-03 503-352-5547 N
Corrections /Comments /Instructions:
VQA t:Ye P.1 Gisy 1),1 1 1 sKtAim kaIL
F10 A L Q t- Y cSt1Q ct"CTi 60 totiVIMC
g � �w
•
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �_ 0B Date: 1\ 11 N Phone #: (503) 718 -7
CITY OF TIGARD
BUILDING DIVISION h PERMIT #: MVMST200 , -00063
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/22/200%
Phone: (503) 639 -4171 / r ah i i
Inspection Requests (24 Hrs.): (503) 639-4175 `__
INSPECTION WORKSHEET FOR DATE: 5/1/2006 TIME: 7:00AM PAGE: fg.
SITE ADDRESS: 0`3fl0O SW RIVERWOOD LW CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: Interior alterations, kitchen /bath. 4/19/05: Replace 60 ft (4 water service.
OWNER: CHURCH, LARRY /NANCY PHONE #: 503-246 -3969
CONTRACTOR: DE.ARING & YUNG CONSTRUCTION PHONE #: 503 - 256.5130
Inspection Request Scheduled For: Date: 5/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 028989 -01 503-667.0420 Y
Corrections/Comments/Instructions:
1 " ?cam
&,e__oQ1.1: t, C‘
( L Te___Ab5 AA 4 ( 44-1 ‘-‘
v'(--- (� c3 AD 3fT
1
■ P ' d
-ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cill F Date: f • 0 Phone #: (503) 718- 7---6-`�
•
- ,•-
• -
CITY OF TIGARD , •
BUILDING DIVISION . PERMIT #: NIST2006-00053
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2i27J2006
Phone: (503) 639-4171
I
Inspection Requests (24 Hrs.): (503) 639-4175
•
. INSPECTION WORKSHEET FOR DATE: 4/24/2006 TIME: 7:02AM PAGE: (.*
SITE ADDRESS: 09000 SW RIVERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE: -
PROJECT NAME: CHURCH
DESCRIPTION: litterior alterations,14tchen/bath, 4/19/05: Replace 60 It of water Wrice.
OWNER: CHURCH, LARRY/NANCY • PHONE #: 503-246-3903
CONTRACTOR: DEARING & VUNG CONSTRUCTION PHONE #: 1 .303 - 2.56 , 5130
Inspection Request Scheduled Date: 4/24/2006 Pour Time: AIA
Code # Inspection Description Confirm # Contact #
322 Shower pan 028508-01 503-318-7240
•
•
Correaions/Comments/Instructions:
• • •
•
• .
•
• • •
•
•
•
• •
•
•
•
• . •
.•
•
•
. ,
•
•
• •
•
•
) PASS #1 PARTIAL APPROVAL CANCEL • NO ACCESS
- 7 FAIL ra LL FOR INSPECTION Ei ADDITIONAL FEES ASSESSED.
f'eq
Inspect° Date:
■...411111■• Phone #: (503) 718-
•
• •
• • •.
.•
CITY OF TIGARD A '
BUILDING DIVISION ( PERMIT #:,4S T oo'- 00053
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED:
Phone: (503) 639- 4171 +
Inspection Requests (24 Hrs.): (503) 639 - 4175 "' �..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
N uirm, 5 d - » - 6
SITE ADDRESS: ii � j \/Pi✓VJOO ' 1-0. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
I PROJECT NAME:
DESCRIPTION:
OWNER: ✓' PHONE #:(57)3 — 3Ig- 72%
CONTRACTOR: f 0 VIA PHONE #:
Inspection Request Scheduled For: Date: 3, a-J— op. Pour Time:
Code # Inspection DeFippn Confirm # Contact # Message
i n
,C /C" ' "41-4 64 ments /Instructions: �ZO 0 c /C;3 S
—
k e, J _iL__. a[. - V
111, A
L_o 0
i\10 Pico Vil(__ .1 :- (5: ..(__-
S Gz-cv K (< Sif-o N,.( re.._ ¼i L V -. E_____ . s7-u5 _ --
- � S� (-v2( 't1 Sm2Y 6(.)r0�
- A / - ci• --- / - ar&'TD •
PASS � - M 'AR 4L APPROVAL , ❑ CANCEL ❑ NO ACCESS
FAIL r. ALL'FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: " Ph one #: (503) 718 -
P D 3
)
, r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00t153
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7J2212006
Phone: (503) 639 -4171 1r.
Inspection Requests (24 Hrs.): (503) 639 -4175 „, �"'. —
INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7 :01AM PAGE: 78
SITE ADDRESS: 09800 SW RIVERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: Interior alterations, Idtchen /bath. 4/19/05: Replace 60 ft of water service.
OWNER: CHURCH, LARRY /NANCY PHONE #: 503-246 -3969
CONTRACTOR: OARING & YUNG CONSTRUCTION PHONE #: 503.256-5130
Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Elecctric :al final 039829 -01 503 - 352 -6547 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -' N € (. Date: tit r I Phone #: (503) 718- 2-141-1-4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00053
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/220006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/24/2006 TIME: 7:02AM PAGE: EA
SITE ADDRESS: 09800 SW RIVERWOOD LW CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: interior alterations, Idehenibath. 4/19/057 Replace 60 ft of Water SWAM.
OWNER: CHURCH, LARRY/NANCY PHONE #: 503-246-39(i9
CONTRACTOR: DEARING & YUNG CONSTRUCTION PHONE #: 501256-5130
Inspection Request Scheduled For: Date: 4/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough-in 028430-01 501318-7246
Corrections/Comments/Instructions:
g 14 (4r FL-45 0-‘
!FA PASS "ARTIAL APPROVAL LII CANCEL El NO ACCESS
E FAIL C FOR INSPECTION E ADDITIONAL FEES ASSESSED
Inspector: ■1111■■ Phone #: (503) 718-
CITY OF TIGARD - .. . ..
BUILDING DIVISION PERMIT #: /4ST) 00053
. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 N pu
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: li K V e i vio O d LA" CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: .' PHONE #:(5 3— 3 /$- 7' 29
CONTRACTOR: f 0 OA PHONE #:
Inspection Request Scheduled For: Date: 5- 2.-/-- 0(0. Pour Time:
Code # Inspection De cript n Confirm # Contact # Message
g u-v.v ection Cb�i ments /Instructions: �ZQ U /7c' S /
Nor : CA -r—e: 0 _ _ �,1� - _ Ft/4-k)
41, - / .i: all' Loo 2
� 0 Pebvi1� ��-CoK_C 1c-5 .
tvo-f s' a 5 ��u K. (- sit° 1/4.,/e---42__ in L v e- T U J S/40 n �
A-14 S t= a)2 (` ."lt`N STt.2 U<<7�
•
P ASS 'AR L APPROVAL ❑ CANCEL . r] NO ACCESS
1 [ FAIL V ' AL /FOR INSPECTION EI ADDITIONAL FEES ASSESSED
Inspector: Date: (i1 (L Phone #: 503
p ( ) 718 -
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: MST2006•00053
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2/22/2006
Phone: (503) 639 -4171 � . ry � i i l i
Inspection Requests (24 Hrs.): (503) 639 -4175 &.. ` -_..
INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7:01AM PAGE: 75
SITE ADDRESS: 08800 SW RI VERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: Interior alterations, kitchen/bath. 4/18/05: Replace 60 ft of water service.
OWNER: CHURCH, LARRY /NANCY PHONE #: 503. 246 -3068
CONTRACTOR: DEARING & YUNG CONSTRUCTION PHONE #: 503 - 256.5130
Inspection Request Scheduled For: Date: 11117/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 039829-04 503 -352 -5547 N
Corrections/Comments/Instructions:
( V , (gr -------
pPAS
S ❑P ARTIAL APPROVAL ❑CANCEL ❑ NO ACCE SS
❑ FAIL _. IN CALL FOR INSPECTION ❑ ADDITI• AL F ES ASSESSED
l
Inspector: (0114 Date: li ! Phone #: (503) 718 - - Z 7- 7
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MST2006-00053
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2(22/2006
Phone: (503) 639-4171
_s_11.1 I
Inspection Requests (24 Hrs.): (503) 639-4175 •
INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7:01AIYI PAGE: 77
SITE ADDRESS: 09800 SW RI VER WOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: Interior alterations, kitchen/bath. 4/19/05: Replace 60 ft of water service.
OWNER: CHURCH, LARRY/NANCY PHONE #: 503-246-3969 -
CONTRACTOR: DEARING & YUNG CONSTRUCTION PHONE #: 503-256-6130
Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 039829-02 503 -352-5547
Corrections/Comments/Instructions:
A nip k
, f iL
eir I
•
•
7- -"/ASS n PARTIAL APPROVAL El CANCEL 0-NO ACCESS
El FAIL I l CALL FOR INSPECTION E] ADDITIONAL S EES ASSESSED
I Inspector: f Date: Phone #: '(503) 718-A2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006- 00053
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/22!2
Phone: (503) 639- 4171u' p$f�l
Inspection Requests (24 Hrs.): (503) 639 -4175 :� `__..
INSPECTION WORKSHEET FOR DATE: 6/12/2006 TIME: 7:03AM PAGE: 62 •
SITE ADDRESS: 09000 SW RIVERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 044 TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: Interior alterations, kitchen /bath. 4/19/05: Replace 60 ft of water service.
OWNER: CHURCH, LARRY /NANCY PHONE #: 503246.396;
CONTRACTOR: DEARING & YUNG CONSTRUCTION ION PHONE #: 503 - 266-5130
Inspection Request Scheduled For: Date: 6/12/2006 Pour Time:
Code # ' Inspection Description Confirm # Contact # Message
299 Final inspection 031520 -01 503.3 -7246 N
Corrections/Comments/Instructions:
.
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /l
p , ! ♦� Date: . Phone #: (503) 718- _244,S
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: MST O[1 rC +0053
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2212006
Phone: (503) 639 -4171 /a.I�
'Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/14/2006 TIME: 7:07AM PAGE: 62
`( / t , S (, ' r k c.444/ , en2( (-Aim
SITE ADDRESS: 03800 SW RIVERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: OM TYPE OF USE:
PROJECT NAME: CHURCH
DESCRIPTION: I nterior alterations, Iutchen!bath
• OWNER: CHURCH, LARRY/NANCY PHONE #: 503-246-n69
CONTRACTOR: DEARING & YUNG r ONSTRUCTION. PHONE #: 503-256-6130
Inspection Request Scheduled For: • Date: 4/1412006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 M ochaniral rough -in 028054.01 503- 31E3.8573 N •
Corrections/Comments/Instructions: • •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED'
Inspector: G1%h /
Date: 1 / 0 6 .Phone #: (503) 718 - ZIP l
CITY OF TIGARD ) 9 /n sr
BUILDING DIVISION PERMIT #rat OO 6- 0 3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 14:11111t
Inspection' Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 9 g D U d r l CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: • PHONE #:
•
• Inspection Request Scheduled For: Date: 3 - oZ co Pour Time: •� •
Code # Inspection Description Confirm # Contact # Message
WY)/ 3/ — 4 1(e'
Corrections /Comments /Instructions:
5 L AL
•
•
•
•
i
J f,
PASS , ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3 Phone #: (503) 718-
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CITY OF TIGARD • r ' S ?-
BUILDING DIVISION PERMIT #: 006 - 00 06
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Aproloto
Inspection Requests (24 Hrs.): (503) 639 -4175 `E
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: rig 6 0 01'1 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
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OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - 1 Pour Time:
Code # Inspection Description Confirm # Contact # Message
2 gD 3 8- 7 -yC - 7 -6 1'(-
Corrections/Comments/ Instructions:
11!
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n PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: - 2 Phone #: (503) 718 -
•
CITY OF TIGARD msr
BUILDING DIVISION PERMIT #: R006- b oo 5'3
13125. SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: q 8 /" , e4j - eA (-41.61-61:1 ' r
CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR:" PHONE #:
Inspection Request Scheduled For Date: 3' 3- Pour Ti - � /
Code # Inspection Description Confirm # Contact #
- 7S / s 3/ 7a`/ `-
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Correction / omments /Ins ctions:
L/ C 4
I') PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: = 2 ---o' Phone #: (503) 718- �--
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 1►'tSf� 0 0 °53
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
- Phone: (503) 639 -4171 1 1
Inspection Requests (24 Hrs.): (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: gs i1 J' -VVi Co 0 1 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: — PHONE #: g -72
CONTRACTOR: [ OYVx PHONE #:
Inspection Request Scheduled For: Date: j - � �� Pour Time:
Code # Inspection Description Confirm # Contact # Message •
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Corre . - • • - • s/ • s:
- /q9Si. C21&DAI6c4 4 3Cre , 4 4- (4-6 ,-
•
•
•
•
n PASS LI PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Date: 3- 22 Phone #: (503) 718- 2 4
•