Permit A CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00252
} ip DEVELOPMENT SERVICES DATE ISSUED: 7/14/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 .
SITE ADDRESS: 13815 SW SANDRIDGE DR PARCEL: 2S105DD -07600
SUBDIVISION: COSTIUC PART /MLP2001 -00005 ZONING: R -
BLOCK: LOT: 003 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: DR2732 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,380 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y .
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,547 sf GARAGE: 630 sf FRONT: 15 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT: 5
VALUE: 285,763.80
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2.927 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps - 1000x. MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY .
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
•
BURGLAR ALARM: 0TH: ALL ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,984.66
D R HORTON D.R. HORTON INC This permit is subject to the regulations contained in the
4386 SW MACADAM AVE., STE 102 4386 SW MACADAM AVE.
Tigard other r applicable cal Code, State work OR. Specialty Codes and
all other applicable prov All work will be done i
PORTLAND, OR 97239 SUITE #102 t
accordance with approved plans. This permit will expire if PORTLAND, OR 97239
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 244 - 5322 Phone: 503 222 - 4151 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 130859 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp & Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp
Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Rain drain Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Roof Nailing Mechanical Final
Fou • - ; • • PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Is ued By : i '/ Permittee Signatu :
1
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
•
. . To ( PT- 7 -) 0 - 0 /' tAv
Building Permit Applic . n ece FOR OFFICE USE ONLY
i ve d Building
I ilate/By(! - //x --- 0 3 Permit ///50()0 G'D a5a—
;` `' / --, — 1 'tanni Approv Other
City of Tigard - -, 1 , ; ' - m Date/B : Permit No.�T)/ 3 — A90 96 4i
� �A ;, \,\,/,, u Other
13125 SW Hall Blvd. P lan Review Q r
Tigard, Oregon 97223 Date /By: 7 - -. 3 Permit No.:
Phone: 503- 639 -4171 Fax: -503- 598 - -19.50, '! � // r rru p tP. V q Post - Review Land Use
--a-�i e I Date/By: Case No
Internet: www.ci.tigard.or.hs '
, 7. - I', GA _1 ,.t Contact Jul : ® See Page 2 for N)
24 -hour Inspection Request:, 5 - ,rQ-t, aN Name /Method: Supplemental Information O
TYPE OF WORK DATA: . U
M New construction ❑Demolition 1 & 2 FAMILY DWELLING
Addition/alteration /replacement ❑ Other:
•
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate 1
M
1 & 2- Family dwelling ❑ Commercial/Industrial- the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Accessory Building ❑ Multi- Family 2 gS 7(, 3 .
❑ Master Builder ❑ Other: Valuation $ 2
- • • JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:3 6
Total number of floors • �–
Job site address: �? � I B f G f yld/'1 2
f N ew d we lli ng area (s q. ft.) 7 ./ �•
Suite #: Bldg. /A? t #: garage/carport area (sq. ft.) e .3 U '1' N Project Name: LOS a-C 49/2 : c overed porch area (sq. ft.)
Cross street/Directions to job site: Ht- 14:Ree/'400415— Deck area (sq. ft.) •
Other structure area (sq. ft.)
P Cill'bk REQUIRED DATA: �/ COMMERCIAL - USE CHECKLIST
Subdivision: /QUf G 1/141 Lot #:
Tax map /parcel #: 3 o?S I C 5Dp - O 7Li DD ' Note: Permit fees" are based on the total value of the work performed. Ins cafe
. • DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, l . • .r,
overhead and profit for the work indicated on this application.
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
. Number of stories
XI PROPERTY OWNER I ❑ TENANT : Type of cons . ' •n
Name: D !` fl ffr - /{Q(j pdtgla /«'i Occ • • group(s): • Existing:
New:
Address: // / SW - /62"
City /State /Zip: / r17fl O/ q,2--4/ -
Phone: 03- ,2? 'I/ /q/ 1Fax: 6 - , '7�',3'f /? NOTICE: All contractors and subcontractors are required to be
0 �. CONTACT PERSON licensed with the Oregon Construction Contractors Board under
(
Ql / provisions of ORS 701 and may be required to be licensed in the
Business Name: • g • �Y h /pc - p y- �'jgt jurisdiction where work is being performed. If the applicant is exempt
Contact Name: / t 0 fr ii-pWs ii from licensing, the following reason applies:
Address: y.?' ,vti iik&Adc// i /1114 - /67- -
City /State /Zip: porno 0X '/7701 - •
,,,'N ' P - 202-G//y/ I Fax: 1/73 -?1fi . -37/7 - BUII�DIhiG PERMIT FEES* - -- .-
�J E -mail: Please refer to fee schedule.
SZ _ • . CONTRACTOR /�
Business Name: r7. / ' • / � Oh me- R?ad r- Fees due upon application $.
Address: yaks Mial AV/ /0— City /State /Zip: f' fj'i f , 0 V;-0/ Amount received $ .
Phone: 6 p 3 - n - ''/ /�j IF ax: 03- kip- 17 Date received:
CCB Lic. #: /71
•
7.77 U�f � y� � I
Si D Notice: This permit application expires if a permit is not obtained within
Signature: 180 days after it has been accepted as complete.
N / molt' HM/50/ 1 *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms \BldgPermitApp.doc 01/03 S 0
/'�.5 — G P-0 Z
Mechanical Permit A 1'c FOR OFFICE USE ONLY
Dacei Mechanical
Date/By: : Permit No.:
��' Planning Approval Building
City of Tigard r Date/By: No.:
13125 SW Hall Blvd. ��;� V® Plan Review Other
Tigard, Oregon •97223 1 �'� Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 - 598 - 1960 " � n 1 Post - Review Land Use
�%, i�az t 1' Date/By: No.:
Internet: www.ci.tigard.or.us . el Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 "" Name/Method: Supplemental Information.
TYPE OF WORK • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST .,,
New construction ❑ Demolition • Mechanical permit fees* are based on the total value of the work
Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION . mechanical materials, equipment, labor, overhead and profit.
IQ 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
0 Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description . I Qty 1 Fee(ea.) I Total
❑ Master Builder ❑ Other: - Heating/Cooling.
. • JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: 6 ? � } 1 ) / / < 5w c,--Ahdivir pi, Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
Project Name: ',OM, 4y- Hydronic hot water system 14.00
G Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
' Flue/vent (for any of above) 10.00
Subdivision: Subdiv � `f/jf / G��s Lot #: 0/ Repair units 12.15
Tax iv map/parcel #: outer FuerApplianees
Water heater 10.00
'•'7 ', DESCRIPTION OF WORK Gas fireplace 10.00
• Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue/vent 10.00
PROPERTY OWNER. . • - 1 - ❑ TENANT ��. '�'. •: -- ' Other: 10.00
are: D - R • I , /14 - /JOcyjQ ,_ / Environmental Exhaust & Ventilation .
Address: Gl?�6 , , Gr�GL�'1'1 Ave G -� f 0 /l � " _ ' Range hood/other kitchen equipment 10.00
, /L Clothes dryer exhaust 10.00 .
City /State /Zip: pefivn ,g 1.70. / Single duct exhaust
Phone: 913'172 r;/ /q/ Fax: 6N - d7y -37 / 7 (bathrooms, toilet compartments,
❑ APPLICANT ',gCONTACT PERSON utility rooms) 6.80
Name: N1 C L(/ ftSM � Attic /crawl space fans 10.00
Address: �? 4 5741 /Madam 4e *747 -- Other: Fuel Piping 10.00
City /State /Zip: /y1'/'/,t A / q. q7po / * *($5.40 for first 4, $1.00 each additional)
Phone: t 7 j 1 3 - yj2'y /0 I Fax: 5D3-) n' 37'7 Gas heat pum *5
as
p
E -mail: Wall/suspended/unit heater **
_ • - CONTRACTOR Water heater *•
Business Name: 1-1-v - k7 " Fireplace **
*5
Address: (��?� ( 5/4) �� ,47 R ang e
**
State
y
Cit //Zi
BBQ
p��0� Q � ��� � Clothes dryer (gas) *'
Phone:93 - (�� —3'f Fax: Other: as
C Lic. #: 0 Total:
Mechanical Permit Fees*
Authorized / ,, J Subtotal: $ •
Signature: /� Date: l/� / d 3
Minimum Permit Fee $72.50 $
NI i1 s/ii i Plan Review Fee (25% of Permit Fee) $
(Plea ri name) State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Notice: This permit application expires if a permit is not obtained within . *Fee methodology set by Tri- County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
is \Dsts\Perrnit Forms\MecPermitApp.doc 01/03
92/2912993 16:15 5936422800 ROSS ELECTRIC PAGE 91
02'/20/2003 16:10 503 - 222 -2675 DR HORTON PDX CONST PAGE 02
5 7 3 — t�v a- 5 Z
Electrical Permit Applica , G FOR OFFICE L:sC O LY
City an
of T' d r Planning Approval si8n
mti
J 1 Da' c ect No.:
13125 SW Hall Blvd. t ' > k • len \ Review Other
Tigard Oregon 97223 -C \� Dst/a " o : Pamir No.:
Phone: 503 - 639 -4171 Fax: 503- 598 -1960 . Q \� \- •oat- Rcvtew Land Use
ti., , '� ilril . ` •:,i ! ;: , , . Datc/B . Case No.:
Internet: wtvw.C7.tigaitl.Or.A3 c J i Cer met Juri:.: ® See Page 2 for
24 -hour Inv ection Request: 503 - 639 -4175 ' '
p 4 Name/Method: Su • ',mental Information.
•"Pi'i l' , ll -Pi I
NI.. S 'P , Y • ^�. ::'.4'..,, vq. : i r ea r i S• Dip Vi • ' h 1:. , 1p1r 4 ;
_•k ,.�, = TYPE�4 0 :;b..4i' ?': ' l�i�{t�ii<i,: l' a 1 ice. u'(.itl � � i ' itEE'ifuf:�:•'�•' _ , _•II a'4�"� '.1'': w . "L>��;..�r4;zi
1(.4t New construction • Demolition • Service over 22.5 amps- ■ Health -care facility
IN Addition/alttration/r •laoement • Other:
commercial ❑ Bilding Hazardous over 10.0
❑ Service over 320 ompa- rating of ❑'Building over 10,000 square ter -,
"j" Li 4,emi'.1°'yti'iu d,,' .",LATE u` OE C*3 - TO 'P' w: ° "`_3i';:iiti :ir0., ".: l a 2 family dwell four or more residential units in
•► 1 & 2- Fatnil dwell' _ • II CoMmerciaVIndustrial Q Much=
over 600 volts nominal one Much=
Accessory Building Multi-Family Building over three stories 0 Feeders, 400 amps or morn
• rY g Y [ Occupant load over 99 persons ❑ Manufactured structures or RV park
IN Master Builder • Other: L.! Egresill106ng plan ❑ Other: •
°:is ,1 i l /;1:�I1i:< 0BISI DDIFO�RNL4T)(m N+aiid�11;00K ,XON = ';- ,!..!; il•;? S4bmit sets of plans with any of the abort.
Job site address,,t�,�,,,, The above are not appliceble tempos cpnstrocttoe serriea
S address: : &A ! ^W + J t,,, �,
. �/ r //, /// � ,i�i�;�;l1h�,;�,.�?n %( iii ��i�f. .:y�r:!i�11;�,E!�E� S,4'�'IU�TYJ . k.. n�af�t�� '�,.1Vgar ; g;
Suite #:
B1 )Apt. #: Number of inspeetioas per permit allowed
Project Name: p4f74/ aeyf Description Qt' ( tree (aaa Total 1
Cross street/Directions to job site: New reoldeathhl- s114QIo or multi-funk per
1 dwelling colt Intrudes attached garage. •
Service iodated/ .
1000 sq. R. cr less 145.15 4
• Each a�itional 500 ip. ft or remioti thereof 33A0 1
Subdivision: PP(A_C Ci (yet- I Lot #: Limited celerity, tw march js.o0 7
_l rnct4Y. non tcstdaptial _ 75,00 2
Tax map/parcel #: Book manufactured home or modular dwoTling
`N5'%9 ci9i d:'i3k3! rMIN, se+rvlee sad/orfeedar 9090 2
Services or feeders - Inetatlation,
alteration or relocation:
• 290 ampr. or less 80.30 _ 2
201 amps to 400 Nnips 106.85 2
. 401 nape A 500 amps 150.60 2
! 07,1`.P7it9'Q" sl'' :, ..: I.�' TI'�14lI011:i "® a ..i , '' r1 ''y� i' ,�4' li'''^"°li!11G 601 arn1scto 1000omps - 249.60 Z
M Over 1000 amps %year 454.65 2
e / t ip - 1 ■ ∎ f1 /.l -: Recotneatant - 66.85 i
-
Address: 4 . nut ddi24 Aye 4 /07- Temporary services or feeders - installation,
Ci /State/Zi r: /, alteraften, or relocation:
a C .� / ' � ae 200 amps or Ica' 66.35 . 1
'hone: g -� 201 amps to 400 amps 100.30 2
�ti PBI< . am, R'i r:`:i:a ':!:il ti is >. i),e gy d CJr :rP R$s.11T} , ! t? 401 to 690 amps 137.75 2
i'lar
�' Branch circuits - new, alteration, or
Name: 1 e ,i i .lf erteesl prpanele
Address: ' ; • . ` ii / e . • / A. Fee for or ta th ptac1s •
;/ �� se r vice a feeder ctrmu for, oa th wi branch tireu of _ 6 65 2
r % /.`tt . L •/ / / ' 13. Fee for banish circuits without purchase of
service or Rader fee. ,first branch circuit 46.85 Z
Phone: 7j / ' • 7 • :.11.3MMIIMF1=111111 Each a6dttlooal bench citoalt 665' 2
E-mail: p { Mtso.(9ery cc a feeder cot included);
39' Pi' !god! 01110 ' :. ' ; iii 0 : 41 "x: 1 • -1 ` Nl a %ii t 7A: , ".: -N':: Y � Ai r, Ir . : Each pump Or irr1getion smelt — 53.40 2
SSgnal iu or a energy panel,
53.40 2
Job No: -
Business Mane: ;4,, / ( ' *ej altee+edon, or extension Pave 2 2
Description:
Address: 3X10 5 cAi. 0 NI, l e , C.N `
rlty/State/z117: i- 1 5 X00 Q /2 Each additional inseeehon over the,Uovrable in any of the above:
r jar in pecrIpr per hate (min. l hou) 62.50
Phone :Cr5l 2 - 2.FOC1 Fax: 5b3 - f.yL -58 est
(5 invlgsttico fee -
CCB Lic. #: it S S FS o1 I - , Lic. #: 3 /..c/i c. other:
If rilitligda•ii l.'Mpi4E Clad'i; il3 itrE4Vf15081lli )`il!` :15
Supervising electrician it,.. Subtotal S
signature required: • i(/f I P lan Review (25% of Permit Fee) S
Print Name: Stay{ , R05 5 1Lic. #: Y a.3 State Surcharge (8% of Permit Fee) §
TOTAL PERMIT FEE S
Authorized ' .Notice: This permit appiicttfoa expires if a permit is not obtained within
Signature: { • � � Dom: /4//// 6 140 days after it has bees. aeeeptod as complete.
V
`1 J� / A % / �__4/ *Fee methodology sot by Trt- Couttry Industry Building I Service Board.
1 (Plena print n ame)
i:\Dstt\Petmit Porms \ElcPcrmitnpp.doc 01/03
•
FEB -20 -2003 16:15 50363228 00 97' P.02 •.
02/21/2003 05:53 503- 644 -59139 CRAFTWORK PLUMBING PAGE 02
02/20/2003 16:08 503- 222 -2675 DR HORTON PDX CONST PAGE 02
B Fixtures FOR dI'11C�r r F OM .1'
Plumbin Permit A l�icataon .V Receiv _ Plumbing MS%�3 `�?� -5z
Panning. Posit No.:
Planning Approval sower
Ds{1e/$Y• Permit No.:
City of Tigard i T `i� ®. Plan movie other
Tigard, SW g Blvd. �- � " Review Parent No.:
Tigard, Ore on 97223 `�" ° cone Use
Phone: 503 - 6394171 Fax S03- 598 -1960 . { t . Il ,lt , � �� ,, \�\ A Case No.:
LL 11 nn lulls.: 1 la Sea Page 2 for
Internet: www.ci.tigard.or.us 4 ?:'�r Naic1? tnod: Suppiettsental[nfotmatioe -
24-hour Inspection Request: 503 - 639 -417 ' 1
Norm/Method:
aI � yy�,yI'' n �. ,, }.yy�� ISMS C ty ,� . Li.'r 1 10 , . r�r t I 7 , F� r'
,JTJ I.. - :y r I J 17 1 1 •fir.1,�� 1 i 1 4 ' ..5 r'.'/5 • �!t, 15 *, •. . . . �I••T1 r
.;r:;a,;L�'i'n�'rt!,iu � 'r�t+���E. I c I;Vi(OBIG _ Qty. ,I'�(n.) . Total
Desert • ton 2 ew construction II „ I .';� �yZl 441.* ' '°l� � ��'ltu''' lfl'���''y�1
• Addition /alteration/replacemtnt • Other: i � {i �;,�I��t ":: "�11'd',_ ',. era • n._rsl :, ..EGAR�t7 r(;7Di57R .Cif° T' t;:u':' "p +• SFR (1)bath 249.20
i j I & 2 - Famil dw'ellin: ❑ Commercial/Industrial SFR (2) bath 350.00
❑ Multi - Famil S FR (3) bath 399.00 '
■Access• Building
fa Master Builder • Other: Each additional bath/kitchen 45.OD r.
� e:JTs ,r• , •� Fire •Ankles -d.. ft: Pa:e 2
'r�,.. r:u d i��y��pr } �{ 7 (r ,ALL 1". ���n' a�l�l� -, Lao �:, � I d 'r r 79 �L 1� r�(�tly ��•�, j'• a (�ry,7( ef��ymgmn�r�.�111���m�+y��:ry���
.. n: Y S..��n,U. an�l� '1 (i'Inl►stAri'IC11Q!t1ri 4' � �".7�1 ��r;�l %'IA4gr1 �N I� -Tt'471i11 111Q1.•'IT�`: I IL•�F7!i uLi'' 4'- �� .i.•�'1!�Il'ti�J141.11�'1QU�7
Job site address: �>f�:f L /, Catch basin/arca drain 16.60 III
Suite #: B1d #: ' - / a veil/Lech line/trench drain 16.60
Project Name: { �'aGl �/ t% Footing drain (no. tine ft.) Page 2
110.00
Cross street/Directions to job site: Manufactured home .utilities 110.00
Manholes 16.60
Rain drain connector
. Sanitary sewer (no. linear a.) Page 2
Subdivision: m• /��
y�- Lot #' i Storm sewer (no. linear ft:) Page 2
���Il Water strvlre no. linen ft. . Pa' e 2
Tax map # � : y, . :� ,!, °y�` - 3M, ' ' i l[.. ' q ; a1 r.1 WiltiNi X a�u1, , wg
'.«.-5.1.V.:,:12'.., • I"r
1i!. fSivU Q '1D' 0 Ott . : i ,./.1 1 .'•! ' . Absotption valve _ 16.60
- • Baokfow prevenrer Page 2
, [ Backwater valve 16.60
• Clothes washer 16.60
• Dtshwe her 16.60
• Drinking fountain • 16.60
�. I��t' 1 )S146u?4 T,�r ' Ejectors/sump 16.60
I -% : 1.1.0 1�n� f 16.60
ame: I . ,r, - H(1 pre - J nG' p e r • Eapansionlank •
Flzturo/sewcr cap 16.60
a a . ' 4 .i . 11 . 4 Q, /i i 16.60
L D Eloor drain s
• Ci /Stet- Zi • :. 'pro ;,/ 40 : � /? Garbage disposal 16.60
H bib 16.60
_
P • t e:973- ' 16.60
i a ha w= • "`'''r n;i'*r g115 C 9.i ' ' I _-'1"
' Mar ANA Ice maker
Int .tor /'a ease ma. 2me:�� � it � "f Medical pas - value: S Page 2 '
Address: /// . /. .1./ A, p- Printer 16.60
CityIState/Zip: 0E4147 ' . 04 17711 Roof drain (coeranercial) 16.60
F ax: Sink/basin/lavaro 16.60
Phon ` • �- :� '
E -mail: . . . Tub/shower /shower.pan 16.60
��U�r : :,:• �
K". ••'•5 1,11. " Ffl:'r's!'. r tiCO . • T' 4:r :,.', ,•,ftVph:i . . . Iii.t4� 4 s Urinal 16.60 eta 16.60
Water se
Business. Name: ' A IA e / J /I / L% . Ao Water heater 16.60
Address: 7 So/ /Jiewbgg other.
Ci /StatelZi•: - / - r, 0 ' q 700a ," ; ' 3• rprH 1?kliFltiill, 1 Fw! ,11 1fL�1d1's " ^'11 Ira�w3
•i I c"t �.i•,Gtti I I�
Phone: C4- ',9• Fax: -.c 9 ' Subtotal $
9 & b Plumb. Licit: .20- e/ PIs. Minimtun Permit Fee btotal S
Authorized �� Rzsidendal Eacidlo�v Minimum Fes 53625
Signer= � I' /���' Date: �����3 Plan Rzview (25% of Pccnlit Fee) S
P A. //,rd State Surcharge (8% of Permit Fee) S
(lease lariat name) TOTAL PERMIT FEE S
Nonce :' nis pariah application exq)ir'ee Y a permit is not obtained witbto All new commercial building! require 2, ft of plans with Isometric or
ISO days after It has Deco accepted Rs complete. riser dlognm for plan review.
. not methedet set by Tri- County Building industry Service Hoard.
i :\DsuTerenit Forms\PlmPermitApp.doc 01/03 '
FEB - 21 - 2003 06:49 503 644 5 96% P.02
PRODUCT
#4 k DATA
VAPOR
BARRIER
•
•
' CHARACTERISTICS SPECIFICATIONS SURFACE PREPARATION
•
COLOR: OFF WHITE DRYWALL DRYWALL
1 CT. VAPOR BARRIER REMOVE ALL SURFACE CONTAMINANTS
2 CTS. ARCHITECTURAL TOPCOAT ' , BY WASHING WITH AN APPROPRIATE -
CLEANER. FILL CRACKS AND NAIL HOLES
COVERAGE 400 SO.FTJGAL AT ati , WITH PATCHING PASTE/SPACKLE AND SAND
• 4 MILS WET. MASONRY SMOOTH. JOINTS COMPOUNDS MUST BE
1.5 MILS DRY • 1 CT. VAPOR BARRIER CURED AND SANDED SMOOTH. REMOVE ALL
. 2 CTS. ARCHITECTURAL TOPCOAT SANDING DUST. .
DRYING TIMES @ TO TOUCH: 15-20 MIN. • , •
77'F. 50% RH TO RECOAT: WHEN DRY PLASTER
TO TOUCH 1 CT. VAPOR BARRIER MASONRY
2 CTS. ARCHITECTURAL TOPCOAT REMOVE ALL SURFACE CONTAMINANTS
FLASH POINT: 201 • F CLOSED CUP , WITH AN APPROPRIATE CLEANER. ALL •
. • COMPOSITION BOARD SURFACES MUST BE CURED ACCORDING TO .
1 CT. VAPOR BARRIER THE SUPPLIERS RECOMMENCDATIONS. '
FINISH: FLAT 2 CTS. ARCHITECTURAL TOPCOAT REMOVE ALL FORM RELEASE AND CURING
AGENTS. ROUGH SURFACES CAN BE FILLED
SOLVENT/REDUCER 'DO NOT REDUCE' TO PROVIDE A SMOOTH SURFACE.
VEHICLE TYPE STYRENE BUTADIENE
. - PLASTER
VOLUME SOUDS: 27.0 %+4— 2 BARE PLASTER MUST BE CURED AND HARD.
TEXTURED. SOFT. POROUS. OR POWDERY
WEIGHT SCUDS: 42.0 %+4 -2 PLASTER SHOULD BE TREATED WITH A
SOLUTION OF 1 PINT HOUSEHOLD VINEGAR
WEIGHT PER GALLON: 10.3 — 10.7 LBS. TO 1 GALLON OF WATER. REPEAT UNTIL
THE SURFACE IS HARD. RINSE WITH CLEAN
MAXIMUM VOC .4 LBS/GAL - WATER AND ALLOW TO DRY.
AS PACKAGED: 50 GMSJLITER
PERMS: 0.50 +4— 0.20 '
COMPOSITION BOARD
• REMOVE ALL SURFACE CONTAMINANTS
' WITH AN APPROPRIATE CLEANER. SAND
• ANY EXPOSED WOOD TO A FRESH
SURFACE. PATCH NAIL HOLE AND
• . IMPERFECTIONS WITH A W000 FILLER
OR PUTTY AND SAND SMOOTH.
r
000000000 4/91
A4 5 i acm 3 — cro2-5
• _;
• . ►
• ►
E TIFICATION
• ET TREE C T E R S R
• .
• ►
• . .
• .
II I, Eiii�prf , Owner /Agent for t -P'- 4oa
■ (PLEASE PRINT) (PERMIT HOLDER)
•
• ►
• ►
•
•
• Do hereby certify that the following location ►
• ■
• meets City County ■ ■
• • land use and development standards for street tree installation.
■
■
t ■
• ■
• ADDRESS: 1 S S. \V . �j,��D�IDGI E P124vE
• ►
• .
• D IVI ION: Pktft G S LOT: C SUB S � T .
• ►
• BY DATE: I i I D 0b ■
•
• RECEIVED BY: DATE: ( d 613
• ■
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ,3--U v
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 1 1 — 1 V AM PM BUP
Location / 3 a S Suite MEC
Contact Person h ( ) s/ 9 — 1 36 ( PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing Vat/if Insulation
� / � ,, 1/ / / �? o
Drywall Nailing ICJ/ C�
Firewall —+ ..
Fire Sprinkler `
Fire Alarm
Mk1 ,
Susp'd Ceiling H-1W-_,
Roof C
Other:
140 PART FAIL
' BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
_7
PART FAIL
E RICAL ` 3 / 6614
Service
Rough -In j O
Low olt g 41 / D�
Low Voltage l� v 7 G
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour 2
BUILDING Inspectioti Lined (503) 639 -4175 MST 3 J c-° _
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Re nested 1 v (P AM PM BUP
Location 3 g (s Suite MEC
Contact Person Ph ( ) S / - 9,3‘ ( PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access:
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear •
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers /
Final l' F• o O i�
PASS PART FAIL
ELECTRICAL
Service /Cy
Rough-In
UG/Slab
ktnrralfr g . L /c 0 o
Fire Alarm
SS PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date /j 6 �. Inspector li7 Ext
Ot her:
Final DO NOT REMOVE this inspection record fr m tte.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 - U 0
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Re nested 1 CP AM PM BUP
Location 3 8 is Suite MEC
Contact Person Ph ( ) 5 7 93 ( 0 1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot
anal
ASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line - il ADA
Approach/Sidewalk Date Inspector Est
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ?• C Z � L
INSPECTION DIVISION - Business Line: (503) 639 -4171
BUP
Received Date Requested / 7 AM PM BUP
Location 1 3 E / S G i J E d Suite MEC
Contact Person F /nfl p Ph ( ) 57' _ 9 3 Co( PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date (7 " / Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL