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Permit
,a C ITY OF TIGARD.. MASTER PERMIT PERMIT #: MST2006 -00136 _'I AA DEVELOPMENT SERVICES DATE ISSUED: 6/23/2006 '�" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BA SITE ADDRESS: 09620 SW SERENA WAY ZONING: R -4.5 SUBDIVISION: PICKS LANDING NO.2 LOT: 106 JURISDICTION: TIG Project Description: MASTER BEDROOM EXTENSION BUILDING REISSUE: CUSTOM n STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: , 4 to V HEIGHT: 14 FIRST: 200 sf BASEMENT: el LEFT: 5 SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf , GARAGE: at FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWEWNG UNITS: 1 THIRD: et RIGHT: 5 VALUE: 27,500.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 200 of REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: ' MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: 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: 1 0 • 200 amp: W /SVC OR FDR: 8 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 • 400 amp: 1st W/O SVC/FDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 800 amp: 401 • 800 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM/SVC/FOR: 801 • 1000 amp: 801 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: s=4 RES UNITS: SVC/FDR>=225 A.: > 800 V NOMINAL: CLS AREA/SPC OCC: ' ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 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 0 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other LYONS, JOHN T OWNER applicable laws. All work will be done in accordance with approved 9620 SW SERENA WAY plans. This permit will expire if work is not started within 180 days TIGARD, OR 97224 of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules 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 Phone: 503 -639 -9534 Contact #: of these rules or direct questions to OUNC by calling 503-246-6699 or 1- 800 - 332 -2344. Reg #: TOTAL FEES: $ 829.81 REQUIRED ITEMS AND REPORTS Issued By : i��C Permittee Signature : L�� _ _ Call 503 - 639 -4175 by 7:00 a.m. for an inspection that • usiness 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. • RE Building Permit Applicat CE I � >� rolz OFFICE t sc ONLY City of Tigard Received , ,( v 6 all PermitNo.: L _ r ,0C tom, 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 i Plan Revie c � �( ., Phone: 503.639.4171 Fax: 503.598.1960 p/ , tS'�' l 1 � DatelBy. ( ' • I 3• V O(g) Other Permit: O(g) Inspection Line: 503.639.4175 ` (� _ 'I I Date Ready/Sy: See Attached Checklist for �� Internet: www.tigard- or.gov j Op j 1 (j' Nofified/Method: // Supplemental Information tT 1DTNG r\Tryr 7%, • TYPE OF WORK REQUIRED DATA: I- 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 . CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2 -family dwelling ❑ Comercial /industrial Valuation: $ Z7 S Q 0 m ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: • Z JOB SITE INFORMATION. AND LOCATION • . To number of floors: l SQl/' site address: yb 2D L/ e,/il Li New dwelling area: • 1qu" are fee O O City /State/ZIP: ) / Qom. © wl 2 2� - Garage /carport area: 1 r( 1 J ps feet Suite/bldg. /apt. no.: ( Project name: 041 /T d/ t' tt°Otn Covered porch area: IQ 19- square feet Cross street/directions to job site: � r I Q j J t sQ,p� a. Ci- Deck area: An A square feet Left- - d ti Se�'e&I & cJ y h C7 ( Other structure area: �4 square feet [ rJ REQUIRED. DATA: COMMERCIAL - USE CHECKLIST . Subdivision: �1 G ( j • L.,.. L Lot no.: 1 'V (, Permit fees* are based on the value of the work performed. Tax map/parcel no.: 2 s 1.I.- 1 9 0 3 d Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DE SCRIPT OF 'WORK n , - n , - • work indicated on this application. l� 1 f' to X 4 A V'1' 1'n W 4 4 Z iZ ? I g oin-to /I Valuation: $ I P-,,v: 0 4 , ( f 8 a- Z Ai /.., Existing building area: square feet New building area: square feet • ` a PROPERTY OWNER P .0 TENANT'`' ' Number of stories: Name: JAL,. 1. 'f' 1 R.✓' L a i1 s Type of construction: Address: q6 2O St,,,,} S t etra c. U e ( Occupancy groups: . City / State/ZIP: / ,,,j , 4 / 2 r 9 7-'Z'Z - Existing: Phone: (.S -a3) L 9 a _ C S Fax: ( ) New: ❑ APPLICANT :❑ CONTACT PERSON . :r, • NOTICE" Business name: All contractors and subcontractors are required to be Contact name: - licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City / State/ZIP: apply: Phone:( ) I Fax::( ) E-mail: • - CONTRACTOR Business name: f' O Gah- �l • Address: /`'' BUILDING PERMIT FEES* Please refer to fee schedule. City /State/ZIP: Phone: ( ) I Fax: Fees due upon application ( 1q�. 'jq Phone: l ( Amount received Date received: i thd signature: (' / a fires if as permit is not obtaine within 180 days afte t h. `,., • • • • • • • e. Print name: J 0 L h 0 0s I Date: (1 4 / ion ti * Fee methodology set by Tri -Cou - Building Industry / '; j z Service Board. I:\ Building \Permits\BUP- PermitApp.doc 12/30/05 440 .4613711 /02/COM/WEB) One- and Two - Family Dwelling , Buildine Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 Atto, 4Y 'il lll ` ❑Electrical ❑ Plumbing CI Mechanical 24- Hour Inspection Line: 503.639.4175 , Internet: www.tigard- or.gov ❑'Other. - TI -IE FOLLOWING ITEMS 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. 0 ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ 4 Fire district a ' royal re uired. 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. E] ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- 0 ❑ ❑ • basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, 0 0 ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 ❑ 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 ❑ ❑ 0 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 • • .licable to the • o'ect under review. .JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x l I" 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. ❑ 0 ❑ 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 12/30/05 Electrical Permit I O Applic G EiV i� R OFFICE List: ONLV ' City of Tigard Received Permit No.: 15 r � �-D0', 13125 SW Hall Blvd., Tigard, OR 97 Plan Review �• -'� Phone: 503.639.4171 Fax: 503.5 0I. `: 2006 Date/By. Other Permit: T I G n It D Inspection Line: 503.639 Date Ready/By: furls: RI See Page 2 for Internet: www.tigard- or.gov 11 Y {p O (( F Notified/Method: TIGARD NotifiedethoNotified/Method: Supplemental Information TYPOF'I•DVOR DIVISION PLAN REVIEW ❑ New construction Addition/alteration/replacement Please check all that apply (submit a sets of plans w/items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. • ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 2-1_ and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ", Job no.: Job site address: � (� 'em a tj 6 J 4 �f ❑ Six o IOOHP or more. occupancy. r more residential units. ❑ Recreational vehide parks. • � — / Health -care facilities. ❑ Supply voltage for more than City/State/ZIP: I Q �� .0 2 2J, ID Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: L:7 0 N .t' 4J , ([ 9ii ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: — ** t , (ir lac vt1 g.t, to S4r , a- De,eeiption I Qty. I Fee. I Total I • �- New residential single- or multi- family dwelling unit. . /l 0 SQ.i!'2.vta (.Jc ci. 6 20 Includes attached garage. Subdivision: A C k .- t,a.. it Lot no.: / Q 6 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion • 33.40 1 Tax map /parcel no.: -2 S l / g IQ 3 ? 0 i Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) - n I C A ^ Limited energy, multi - family 75.00 2 Rep/ac c SI2 l/ I GQ /Z it l'a t�� , Ct r(it r � Is r yd residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation rib() A\ a t, JJ 1 d (,( QTS t c i !/'CL( i 1 ( / 1 lc lv ff. .E.:1 200 amps or less ' 80.30 2 PROPERTY OWNER // I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: del / h a R I L- e , . 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: cf ZO S V -K c Li C, y Over 1,000 amps or volts 454.65 2 City/State/ZIP: ofa r Temporary services or feeders installation, alteration, and/or 2 �.'2 q relocation . Phone: ( 5'03) lq 3 9 — e s- 3 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installatio is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sal e, t, ore ange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2 Owner signature: ?r1 ,"`...-- Date: d4//2/ t76 Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with • ❑ ICANT . I ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee 46.85 2 first branch circuit Address: Each add'I branch circuit ' 6.65 2 Miscellaneous (service or feeder not included) . City/State/ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: , LJ r-� energy panel, alteration, or • Address: �y extension. Describe: Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50 CCB Lic.: I Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: • Print name: Date: Plan review (25% of permit fee): permit application expires if a permit is not obtained within 180 State surcharge (8% of permit fee): Authorized signatu 3.......„--- TOTAL PERMIT FEE: Print name: Date: Th P erm J D� Q 6/� 3/ z �G days after it has been accepted as complete. • Number of inspections allowed per permit. I:I Building \Pmmits\ELC- PmmitApp.doc 0521 440- 4615T(I l /05 /COM WEB • Electrical Permit Application - City of Tigard , Pa'ge'2 - Supplemental Information • LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: • Fee for all residential system's 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 $75.00 system (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 \Ptrmim\ELC- PennitApp.doc 03/23/06 . . Mechanical Permit Application FoR OFFICE USE ()NIA Received City of Tigard Date /By. Permit No.: A�& OD 2 go ; � v 13125 SW Hall Blvd., Tigard, OR `1' FC El VE D Phone: 503.639.4171 Fax: 503.5:8 Other Permit: TI G A �t D Inspection Line: 503.639 Date Ready/By. tuns: la See Page 2 for Internet: www.tigard - or.gov Notified/Methort Supplemental Information JUN 1 r:. 2006 TYPE OF � ( 2 � dl t a l'�tfi�etl kOF TIGARD COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction PrAdditiot>atti;'I 1 SIGN 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: $ or 1 - and 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* y g ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling /'L s1 (� 'z.' �bt Q p Air conditioning or heat pump Job site address: �fy J W f 7 (requires site plan showing placement) 14.00 City /State/ZIP: / ( � a „�, (� R e �, Z 241- Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg. /apt. no.: d Project name: o .2 Furnace 100,000+ BTU (ducts/vents) 17.90 / la tot Gas heat pump 14.00 Cross street/directions to job site: Dime t R ' 47 fa ✓l Piet CI Duct work / 14.00 -�— r T p Hydronic hot water system 14.00 C p S e re-4-1 s (-1” /Ld / 6 Z d Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: '- .1-)l c �t - C.�i.t..l�su I Lot no.: I Q G Flue/vent for any of above 10.00 Other: 10.00 Tax map/parcel no.: 2 1/ (i a 1 .1. 3 S 0 / Other fuel appliances � J DESCRIPTION OF WORK / Water heater 10.00 Jl (tCrl d /(/ Q �l d L L E'(,( • GI iJ Q I' 1� (v ( /1/ j ( 3 e f Gas fireplace gas 10.00 Flue vent for water heater or fireplace 10.00 tr2.JJ' (1 a y. ¢'_ Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 [MJROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 10.00 Other: 10.00 Name: U 8 h w d, nl Q. L 0 hf Environmental exhaust and ventilation Q � t y � � Range hood/other kitchen Address: l i 2.0 J ' „n Q ., a t,f n y equipment 10.00 City/State/ZIP: r ,6 /� 9 Z Clothes dryer exhaust 10.00 ir k ` Single -duct exhaust (bathrooms, Phone: (CO G S frb l gs 34 Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Business name: Other: - 10.00 Fuel piping_ Contact. name: $5.40 for first four; $1.00 for each a dditional Address: Furnace, etc. Gas heat pump City /State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E-mail: Range CONTRACTOR Barbecue Business name: ` �� O W IN—k, r Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State/ZIP: Subtotal Phone: ( ) I Fax: ( ) Minimum permit fee ($72.50) 7 Z. 5C) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERMIT FEE s i.. 1/4 , Authorized signature: This permit application expires if a permit is not obtained within 180 A- days after it has been accepted as complete. I Print name: J I 1..1 ( 0,4 r I Date: ( / / 3 /2 6 ' Fee methodology set by Tri- County Building Industry Service Board 1 I :\3uilding\Pemtits\NEC- PermitApp.d e1 / 4404617T(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 $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 $100.00 or fraction thereof Note: All new commercial buildings require 2 sets of plans. • 1:\Building\Permits\NEC- PermitApp.doc 12/30/05 2 I Building Fixtures Plumbing Per fi t; t ''ttl�$. I OR OFFICE:. USE ON E\ ' i Received � y City of Tigard Permit No.: ra�(p -ev1 ; ' 13125 SW Hall Blvd., Tigard, OR 97223 Deceive 2006 Plan Review Phone: 503.639.4171 Fax: 50319 0 <+ /iN Other Permit No.: 24- Hour Inspection Line: 503.69.4175 , • 1.' tt ; ' � I � eRY mr,,. • Internet: www.ti d- or.gov Gil Y OFTIGARD - xi DateReadyBy: S SeePage2for Notified/Method: Supplemental Information BULL- INVAC WORQN 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 ,211- 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: q(�2 T SQ,(/��tn a._ (, f Q Catch basin or area drain 16.60 • City / State/ZIP: f (t Q f Q R q9--2:1.4_ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Q N , / f Q � f i - f i . o t. Footing drain (no. linear ft.: ) Page 2 r Manufactured home utilities 110.00 Cross street/directions to job site: ,�4 tr I a 26( , Ti-, S are he: et- Manholes 16.60 X - ReVZ h a a7 q & ' Rain drain connector / 16.60 • Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: ( 01 C ( � �� t � I Lot no.: ( 6 ( g Fixture or item Tax map /parcel no.: Z E i ( tt i cf. 1) 0 ( Absorption valve - 16.60 l DESCRIPTION OF WORK ! Backflow preventer Page 2 etc; C� j �/:t e/r G,v. d (// (Ti I /,,St M kJ Backwater valve 16.60 • IA/1 f'14 a a Su t 1 e- x 4 d Q' Z Ob1 1.1 e 7t's Clothes washer 16.60 Dishwasher 16.60 [PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 • Ejectors/sump 16.60 Name: big jut 1 * in gdel V. L pvt r Expansion tank 16.60 Address: q62 Sc1J Q✓`2..t1a 6.j& Fixture /sewer cap 16.60 City / State/ZIP: 7 ( a d, de a ?? 22_ Floor drain/Floor sink/hub 16.60 Phone: ( 5'03) e i S3 y.. 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: ( ) I Fax: : ( ) Sink/basin/lavatory / 16.60 Tub /shower/shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: O W �./ Water heater / 16.60 Address: Other: • City /State/ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backFlow minimuni permit fee: $36.25 7a • �� CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) a Authorized signature. ��G State surcharge (8% of permit fee) 5 , o U TOTAL PERMIT FEE Print name: J© N L 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. 1:\ Building \Pamits\PLMF- PermitApp.doc 12/30/05 440-4616T(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 - 1' 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer - 1st 100' 55.00 3,601 to 7,200 $220.00 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 Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: $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: 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 J ❑ 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. -3" -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 -Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor i of sewer EDUs, a sewer permit will be issued and Water Closet - Toilet � p Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: - plumbing permit can be issued. • is\ Building \Pennits'PLM- PennitApp.doc 07/06/05 Permit #:` 3 c, O 06/.36 Address: 96a D S ( 5 Issued by: _4 T/_(2 Date: 6 -,23-o Statement: Information Notice to Property 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 1 and 2, and either box 3A or 3B: pi 1. I own, reside in, or will reside in the completed structure. ,v 1., 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 Ow rs about Construction Responsibilities on the reverse side of this form. J LA_utL 2 00 (Signat re of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Information Notice to Property Owners About Construction Responsibilities Note: This Information Notice to Property Owners about Construction Responsibilities 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, be 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 thetime employees are paid. You will be liable for the tax payments even ifyou 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. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs ifone 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 perm it holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see ifyou have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, 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 of rough-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 #: MST2006.00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005 Phone: (503) 639 -4171 " Inspection Requests (24 Hrs.): (503) 639 -4175 .-- `':_.. INSPECTION WORKSHEET FOR DATE: 10/16/2006 • TIME: 7 : 03AM PAGE: 11 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503.639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 038257 -02 503 - 639 -9534 Y -01/ Corrections /Comments /Instructions: RLI e% P PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /D • 16 • 06i Phone #: (503) 718- 2 6 4/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006.00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23 /2006 Phone: (503) 639 -4171 Al° 'Ni' l ` Inspection Requests (24 Hrs.): (503) 639 -4175 1 INSPECTION WORKSHEET FOR DATE: 10/16/2006 TIME: 7 :03AM PAGE: 12 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM. EXTENSION OWNER: LYONS, JOHN T, PHONE #: 603-639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/16/2006 • Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 038257 -01 603. 639 -9534 Y Corrections/Comments/Instructions: • j . PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C.-Mr' Date: /6' / 6 ' 0 6 Phone #: (503) 718- Z-6`111 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20t3(40136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 -: - � 1 INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 33 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 1Q6 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 035064 -04 503-639-9534 N Corrections /Comments /Instructions: lJ p v q-a /,c y 'e e cI- of ►I - ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /tLI , Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200G -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 //�aa4� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/19/2006 TIME: 7 :00AM PAGE: 37 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 - 639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/19/2006 Pour Time: # Inspection Description Confirm # Contact # Message 115 Electrical service 033325-01 503-639-9534 N Corrections /Comments /Instructions: F tkL. F Ob% n % a ots G-Ra v(Z 67 - fe . l / PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: -----` 0 Ni U Date: 1‘9(010 Phone #: (503) 718- 1-144/0 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6123 Phone: (503) 639 -4171 r�p,� Inspection Requests (24 Hrs.): (503) 639 -4175 ,._ � INSPECTION WORKSHEET FOR DATE: 7/17/2006 TIME: 7:04AM PAGE: 13 `1:›Qet , Scams " SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 -639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 033184 -01 503. 639.95 N Corrections/Comments/Instructions: F ibc . ,,r‘ni / A) &A -vM PCB � 166. , , • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS / 4 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C4 - Date: 7.17-ot Phone #: (503) 718 - Z...6 C CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U23/2006 Phone: (503) 639 -4171 4 6 1 1 1' ' Inspection Requests (24 Hrs.): (503) 639 -4175 -- INSPECTION WORKSHEET FOR DATE: 10/10/2006 TIME: 7:06AM PAGE: 4 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO,2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503-639-9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 037962 -02 503-639 -9534 N Corrections /Comments /Instructions: a l - l i / /� , � �� � / / y � ' i! / ..21h `It PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G f{1 F Date: /0- /6 • a4 Phone #: (503) 718- Z6._r___X CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 Arid p o � A, ta Inspection Requests (24 Hrs.): (503) 639 -4175 "I .. INSPECTION WORKSHEET FOR DATE: 9/1g/200 TIME: 7:05AM PAGE: 62 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 - 633 -934 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/19/2046 Pour Time: Code # Inspection Description Confirm # Contact # Message 322 Shower pan 036767 -01 503. 639 -9534 N Corrections/Comments/Instructions: P i k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A \ \ ! 1 ) Date: ) ' I b 1� Phone #: (503) 718 - `\ CITY OF TIGARD ' BUILDING DIVISION . PERMIT #: MST200&- 00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 Ak Inspection Requests (24 Hrs.): (503) 639 -4175 , ' IL INSPECTION WORKSHEET FOR DATE: 9/16/2006 TIME: 7:01AM PAGE: 15 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503-639-9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8118/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 036704 -01 503-639-9534 N Corrections /Comments /Instructions: '0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G HIP Date: 1) ' • 04. Phone #: (503) 718- ZC y y CITY OF TIGARD BUILDING DIVISION #: MST200&00i35 • 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/23/006 Phone: (503) 639 -4171 u i Inspection Requests (24 Hrs.): (503) 639 -4175 =� INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7 :04AM PAGE: 20 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION • OWNER: LYONS, JOHN T, PHONE #: 503639-9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/4/2006 Pour Time: .QV Code # Inspection Description Confirm # Contact # es ge 1 320 Plumbing rough -in 034401 -01 503 -639 -9534 Corrections/Comments/Instructions: c PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED C Inspector: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -Q0136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 AP a Inspection Requests (24 Hrs.): (503) 639 -4175 .44- `'II INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7 :04AM PAGE: 76 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 - 639.9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 034378 -02 503 -639 -9534 N Corrections /Comments /Instructions: I T 5 A - §S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Al, Date: 0/ Phone #: (503) 718 C/ • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 rwu� l Inspection Requests (24 Hrs.): (503) 639 -4175 F 'I — INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7 :04AM PAGE: 71 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503.639.9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 03437801 503 - 639.9534 N Corrections /Comments /Instructions: • W PASS -- ---- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: l �' ( l , Z) Date:0/ Phone #: (503) 718 - Crag CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200600136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 ���1 1 Inspection Requests (24 Hrs.): (503) 639 -4175 . _,.. ` __.. INSPECTION WORKSHEET FOR DATE: 10/10/2006 TIME: 7:06AM PAGE: 5 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 105 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 603- 639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/10/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 037962 -01 503 -639 -9534 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: el-7P Date: / /a ' 6 e Phone #: (503) 718- ZZg CITY OF TIGARD BUILDING DIVISION 7 PERMIT #: MST200G -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 P'' L INSPECTION WORKSHEET FOR DATE: 8/24/2006 TIME: 6 :59AM PAGE: 39 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 - 639.9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/24 /2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 035483-01 503-639-9534 N Corrections /Comments/ Instructions: — 1 - 4AL i d4./C,) i- .j ��..Ql`;,- q e6 Gtre—e 5 St-63,-71 c" o 2-- e cp_A--A 4 ` 6 (A 7-4-e SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: i /J Date: / 7 V Phone #: (503) 718- 7---YL CITY OF TIGARD BUILDING DIVISION PERMIT #: MST7.001�001 6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6123/2006 Phone: (503) 639 -4171 A �l Inspection Requests (24 Hrs.): (503) 639 -4175 =�� '__.. INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7:03AM PAGE: 83 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503-639-9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 035183 -02 503 -639 -9534 N Corrections /Comments /Instructions: 06 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL 111 C . LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: -' < Date: 2P- a& Phone #: (503) 718- ijt-q-a CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 /*Fq Inspection Requests (24 Hrs.): (503) 639 -4175 ..• INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7:03AM PAGE: 82 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503-639-9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 035184 -01 503 - 639 -9534 N 275 — � ,.gar,, Corrections /Comments /Instructions: _. _ _ ryr�,g - SAPS Ste 1— ti . - i2 - — ' " - ) .61Q..-- ‘04-2-4.- ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: Date: ef — Phone #: (503) 718 CITY OF TIGARD BUILDING DIVISION . 4 110 PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 ;� , l Inspection Requests (24 Hrs.): (503) 639 - 4175 , NiIL. INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7:03AM PAGE: Elil SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503-639-9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 035183-01 503 - 639-9534 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . Date: /, -do Phone #: (503) 718- � `1-4"5--- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200G00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 . Phone: (503) 639 -4171 w �,�� Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' 1° INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 3 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503- 639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: • Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 035064 -03 503-639-953.4 N Corrections /Comments /Instructions: 40 V-ef �xll9u v --- -- -To ❑ PASSE ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: d Date: 8 16 Phone #: (503) 718- la '4E-1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 4w i � l �a te Inspection Requests (24 Hrs.): (503) 639 -4175 s .. INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 31 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 -639 -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 035064 -05 503 - 639 -9534 N Corrections /Comments/ Instructions: ' LLt, ,c /Az oauPl P - 44-r -77i- ; ' - •.Ar `. G6v - . - - ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - Date: - Flo — o& Phone #: (503) 718- i— CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 Tl ' ( Inspection Requests (24 Hrs.): (503) 639 -4175 F ' - INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 39 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 603 - 639 -9634 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 035064 -02 503-639-9534 N Corrections/Comments/Instructions: i1 0,44,9) ' /ti.0 ❑ S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: �� Date: 25 6 --z9U Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/231`2006 Phone: (503) 639 -4171 A 'A ,lll Inspection Requests (24 Hrs.): (503) 639 -4175 `__-. INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 43 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 - 639-9634 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 035064 -01 503 - 639-9534 N Corrections /Comments /Instructions: / JJ ❑ PASS ,'PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /6 Phone #: (503) 718- '---scit-e-1 s CITY OF TIGARD . r BUILDING DIVISION PERMIT #: MST2006-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 Ake Inspection Requests (24 Hrs.): (503) 639 -4175 _ °`'I � .. INSPECTION WORKSHEET FOR DATE: 8/7/2006 TIME: 7:02AM PAGE: 40 SITE ADDRESS: 09620 SW SERE :NA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503.639.8534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: d/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 034482 -03 503. 706-2118 Y Corrections /Comments /Instructions: id / - Zlr"---7 - Z: p ❑ P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: l ''4( \ Date: f Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200&.00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5]23/2006 Phone: (503) 639 -4171 1111111'. Inspection Requests (24 Hrs.): (503) 639 -4175 ..' .. INSPECTION WORKSHEET FOR DATE: 817/2006 TIME: 7:02AM PAGE: 39 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503.539.9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 034482 -04 503-706-2118 Y Corrections /Comments /Instructions: sAtc - i vy J ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: -4' Date: 7 Phone #: (503) 718 --?fj/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2f06-00136 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 612312006 Phone: (503) 639 -4171 4"01111111\ Inspection Requests (24 Hrs.): (503) 639 -4175 F' INSPECTION WORKSHEET FOR DATE: 8/7/2006 TIME: 7 :02AM PAGE: 42 SITE ADDRESS: 096x0 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 603.63g -9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 034482 -01 503-706-2118 N Corrections /Comments /Instructions: 0 ititi-r / ❑ P ❑ PARTIAL APPROVAL Ill CANCEL [I] NO ACCESS FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: Date: ,--7.--e&: Phone #: (503) 718- c CITY OF TIGARD BUILDING DIVISION - A PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/200G Phone: (503) 639 -4171 /An-, Inspection Requests (24 Hrs.): (503) 639 -4175 , —. 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INSPECTION WORKSHEET FOR DATE: 8/7/2006 TIME: 7:02AM PAGE: 41 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503 - 639.9534 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 034482 -02 503-706-2118 N Corrections /Comments /Instructions: , r —22% OF . ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: #A Date: ? ? ee-/ Phone #: (503) 718- ' & CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 Aa lid Inspection Requests (24 Hrs.): (503) 639 -4175 F' INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7 :04AM PAGE: 76 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503. 639 -9534 CONTRACTOR: owwER PHONE #: Inspection Request Scheduled For: Date: 8/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post /beam mechanical 03437803 503-639 -9534 N Corrections /Comments /Instructions: [azThetsg,_ ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED _ c )) ..__________ Inspector: V/ Date: c Phone #: (503) 718- � Z CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2006 Phone: (503) 639 -4171 �..a11q j�l Inspection Requests (24 Hrs.): (503) 639 -4175 .� _—_- I INSPECTION WORKSHEET FOR DATE: 6/3/2006 TIME: 7:05AM PAGE: 47 SITE ADDRESS: 09620 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 106 TYPE OF USE: PROJECT NAME: LYONS DESCRIPTION: MASTER BEDROOM EXTENSION OWNER: LYONS, JOHN T, PHONE #: 503.639 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Postlbeam structural 034295 -01 503. 718-2423 Y Corrections /Comments /Instructions: • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 6P-,?- - & , Phone #: (503) 718- CITY OF TIGARD i „y/f BUILDING DIVISION PERMIT #:” ° �� ��� ^ e� l � 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 A„u �� I�lln Inspection Requests (24 Hrs.): (503) 639 -4175 _�Ij ` __.. g INSPECTION WORKSHEET FOR DATE: I/ Z —/ /D(.0 TIME: PAGE: SITE ADDRESS: q z4 y CLASS OF WORK: SUBDIVISION: / LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: Jd It D 3 i 'D't PHONE #: CONTRACTOR: PHONE #: n tion Re e st 5 �" 6r 41 41? q the uled For. Dat : Pour Time: Code # Inspectipn Description Confirm # Contact # Message ?oC oe; vo 9971/ Corrections /Comments /Instructions: • ' SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 6 u tiv" Inspector: Date: i r2). 1 6 Phone #: (503) 718 - 7)4