Permit MASTER PERMIT
� ,
PERMIT #: MST2007 -00215
1 - ° -;.:: ...COMMUNITY DEVELOPMENT DATE ISSUED: 11/28/2
00 7
TIGARD; 13125.SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CD -08500
'SITE ADDRESS: 15925 SW SERENA CT ZONING: R -4.5
SUBDIVISION: KERWOOD ESTATES LOT: 002 JURISDICTION: TIG
PROJECT: SHEETS
Project Description: 13' x 16' addition
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 208 st BASEMENT: st LEFT: 5 SMOKE DETECTORS: Y ,
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE:
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 208 sf 19.757.92 REAR: 15
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
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 SVC/FDR: I SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 -.600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC:
. ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL p SYSTEMS:
This permit is'subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR.'Specialty Codes and all other applicable
RICHARD & LAURIE SHEETS ASHER TRADITIONAL HOMES laws. All work will be done in accordance with approved plans. This
15925 SW SERENA CT 15795 SW SERENA CT permit will expire if work is not started within, 180' days of issuance, or -
TIGARD, OR 97224 TIGARD, OR 97224 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 of these rules or direct ,
Phone: 503 968 - 6092 Contact #: PRI 503 620 - 6163 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #: LIC 89386
TOTAL FEES: $ 633.46
REQUIRED ITEMS AND REPORTS '
Issued y : Permittee Signature : / e if z
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. ,
This permit card shall be kept in a conspicuous place on the job site until completion of project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
• Residential t . FOR OFFICE'USE ONLY , i.
Received
City of Tigard Da teBy: l A Q� PermitNo.: 13125 SW Hall Blvd., Tigard O RE CEJEU
p Plan Review r
4 4 Other Permit:
Phone: 503.639.4171 Fax: 503.59$1L960 5 ' / � � 1 D a teB : ' • a
T I G A R D Inspection Line: 503.639.4175 L• I 2 Date Ready /By: J . . See Page 2 for
. Internet: www.ti U gard or.gov CITY o I IGTtD Notified/Method: ®o V ® Supplemental Information
,...1 tri i5fA n111RS�M L /w i—�,
TYPE WNW QUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION �
MI- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ! 0/
❑ 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: ) 5 VS- 3 w S'GRr A C7- New dwelling area: a square feet
City /State /ZIP: 77,4R F, O R 97p,9c. f. Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Or Itt f Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
re
o R (4Ar1 ,R 0 r Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
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.
i 3. / C. Fr R :0 OA/ BACK 0 F P-o -ie Valuation: $
Existing building area: square feet
New building area: square feet
VPROPERTY OWNER ❑ TENANT Number of stories:
Name: giC11/371D `>rhi vR 1P S t S Type of construction:
Address: / 5 7 S' S,r� c7 - Occupancy groups:
City /State /ZIP: 776 b ci? 72, St • Existing:
Phone: ( s7J3 g - / 7',7_ Fax: ( ) New:
ot APPLICANT CONTACT PERSON NOTICE
Business name: ' Y� n ? 21r�, , 7rQN � � ,L jM �� ts /. All contractors and subcontractors are required to be
Contact name: / �" licensed with the Oregon Construction Contractors Board
/ AAA✓ ,4 l Z under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: • applicant is exempt from licensing, the following - reasons
apply:
Phone: (503) no - 6/ 06 I Fax: : ( )
E -mail:
CONTRACTOR /
Business name: A C/� T�A �)rr'o',A t rcc! �/ /A G BUILDING PERMIT FEES*
o cr
(Please refer to fee schedule)
Address:
/ 7 9 5 _ ��5-0_, � � ?�A' r l v C'r Structural plan review fee (or deposit): Yb B —
City /State /ZIP:7(r �,? 0 6F 9' >2P S4 5
/^ FLS plan review fee (if applicable):
Phone: 0013) 7 5G _ 17 i I Fax: ( c Vial - ( 7 l r ? i
F? D � Total fees due upon appli cation:
Amount received:
Authorized signature:
A This permit application expires if a permit is not obtained
"�/ / � • Fee methodology set by Tri -Conn within 180 days after it has been'accepted as complete.
/�N /_ om' t //
Print name: Q _. Date: (v / D tY Building Industry
tJ T Buildin Indust
Service Board.
I: \Building \Permits\BUP -RES PermitApp.doc 02/23/07 440- 4613T(I 1/02 /COM/WEB)
Building Permit Application Checklist t.
One- and Two - Family Dwelling FOR OFFICE USE ONLY
Received
- City of Tigard Received Permit No.:
Il a 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960
T I G A K D 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard - or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I 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 otection, etc.
10 3 Co plete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state; ❑ ❑
buildin codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
attached to the plans with cross references between plan location and details. Plan review cannot be completed if
co right violations exist.
/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if I ❑ ❑
e is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and
surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon and shall be shown to be al Ili cable to the uro'ect under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x II" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440-4613T(1I /02/COM/WEB)
Electrical Permit Applicat FOR OFFICE USE ONLY
pity of Tigard Date/By: /I 2� 4? Permit No.: • 5/0 7- ��S
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598. I �fi6 , Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 4_�. r' r� 7 Date Ready /By: �o ! ® See Page 2 for
Internet: www.tigard - or.gov WV Of. 1 iLl�FZ1.1D Notified/Method: �/J ti
G{ Supplemental Information
r•P+o tttl f�i�rt
TYPE OF W �•• IIVl7tvt v PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 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
12F1 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", 'l -3 ",
/ C ` 1001-11 or more. occupancy.
Job no.: Job site address: .6-
1 ,�,
R- /� C! ❑Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: .776 O � l'• ❑ Health -care facilities. ❑ Supply voltage for more than
/ j ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: poi? fr64 M I�1 Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. fl.) 75.00 2
IP
Limited energy, multi - family 75.00 2
r t7 A• #10- C f i? e i1 S I --rr /7I U6 Y 0 0 � y residential (with above sq. ft.)
I Services or feeders installation, alt ation, and/or relocation
200 amps or less f 80.30 2
D, PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ' ? /G �/�i3 D --J v )Q i /1 s7 �3 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: / J '7j ' s/1.-- t5 ' Over 1,000 amps or volts 454.65 2
City/State /ZIP: �6 ') C) -� Temporary services or feeders installation, alteration, and/or
r relocation
Phone: (c3 )_c7 LG ...c0 92 Fax: ( ) 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 I I 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits wish
❑ APPLICANT KCONTACT PERSON above service or feeder fee, 6.65 2
/ each branch circuit
Business name:
f -/� 7 AA-,? % ,r e !.1/y,, ,h.� B. Fee for branch circuits
without service or feeder fee, / 46.85 2
Contact name: /3 ,) mAd A5 f L 7 / first branch circuit f
Address: / 3 ...5– SGT h Each add'I branch circuit l 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: `/ j6� I � /' � ?� I� Each manufactured or modular 90.90 2
I r � _!` dwelling, service and/or feeder
Phone: (J3) MO _ 6 i n. E _ Fax :: (J 6' 3n _ C / A Reconnect only 66.85 2
E -mail: g? R�� },. i /4SS /> 9 l , t jA G , COA-i / Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name:
(/� —��1 / � �J energy panel, alteration, or
Address: 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.: 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):
State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:U 3uilding \Permits\ELC- PermitApp.doe 05/23/06 440- 4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $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
1:\Building\Permits\ELC- PermitApp.doc 03/23/06
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received Date/By Permit No. fl f gay 7- crag '
1
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A R D Inspection Line: 503 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. 1 Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /936- nn a j� Iv Catch basin or area drain 16.60
City /State /ZIP: ,LD QrC_ 972_ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: e 5s% 5 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector ' 16.60
Sanitary sewer (no. 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
,4 v7 , 7 o tc-3 Backwater valve 16.60 .
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name:-' car( .. ti f - s Expansion tank 16.60
Address: 1\ /5 af ,Q ei Fixture /sewer cap 16.60
City /State /ZIP: e'ria4-/L7) (/L 9 7 9-2 -1 Floor drain/floor sink/hub 16.60
Phone: (SQ3) 7 •" epe9,-• 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
Sink/basin/lavatory 16.60
Phone:
( ) I Fax::( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRA OR Water closet 16.60
Business name: `N( j 1 `152 4 �� . Water heater 16.60
Address: A5-Z 1 (�! Other: IAA A
City /State /ZIP e7 7 030 Subtotal 1 60
Minimum permit fee: $72.50
Phone: 4 ' j , 6/.47 47 - 7 Fax: (5 2) // .U( S Residential backflow minimum permit fee: $36.25 7
cb
CCB Lic.: RV 35 7 4 , 5 1 , Plumbing Lic. no.: 6 (.9,"( 7 Plan review (25% of permit fee)
Authorized signature: ? l (d Pb State surcharge (8% of permit fee)
TOTAL PERMIT FEE A.
Print name: 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- PennitApp.doc 12/27/06 440- 46t6T(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 - 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling ' 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50 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 Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3"
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
.Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
1:\ Building \Permits\PLM- PermitApp.doc 12/27/06
Oct. 30. 2007 1:30PM . . , No. 3693 P. 1
t. Ks( �o�- .00 z o / 5
OCT L 2 2007 piEcevE Ive
CT 3 1 2007
CleanWa Services gy __�_N lTVpF �I
Our rommilmonl Is clear.
� s File Number
Sensitive Area Pre - p1U1SIO11 d'7 _ C y y 3 I
Site Assessment
Jurisdiction:
Property Information: (example 1S234A801400) Owner Information: • •
Taxlot ID(s): eZ ? /1/ db - 6 ' IC) () Name: l ?'C --6 j 7 F .S tiAi i S
Company:
Address: 5 9P 5 $e4 J t"
Site ddress: g�'� P � 42 q 7g.
ri61 6 q Phone/Faxj ri 3
Nearest Cross Street: p V 912i.1/}aJrt E -mail: •
Development Activity: Check all that a ly • Applicant Information:
Addition to Single Family Reside • (rooms eck, garage) l Name: 131z/ la / -W442
Lot Line Adjustment ❑ Minor Land partition ❑ Company /A S/ Di • / . L C ' &: //k c
Residential Condominium ❑ Commercial Condominium ❑ Address: riff 6 iq r.&' / G .I .
Residential Subdivision ❑ Commercial Subdivision ❑ 776 A i) i . t- 79 y •
Single Lot Com rcial ❑ Multi Lot Commercial ❑
Phone/Fax: CO3 7 15x0•- 4 06 / S C-T
Other 2 E - mail: 13 RI P AS14F y 6
Will the project Involve any off site work: YES ❑ NO St Unknown ❑ Location and description of of -slte work:
Additional comments or information that may be needed to understand your project:
This application does NOT replace the need for Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development
Permits, DEO 1200.0 Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lands and/or Department of
the Army COE. All required permits and approvals must be obtained end completed under applicable local, state, and federal law.
By signing Inls form, the Owner or Owner's authorized agent or repreeentetive, acknowledges and agrees that employees of Clean Water Services have authority •
to enter the project site at all reasonable limes for the purpose of Inspecting protect site conditions and gathering information related to the project site. I miry
That I am familiar with the information contained in this document, and to the best of my knowledge and belief, this Information Is True, complete, end accurate.
PrintType Na . _ • • • Print/Type Title: p/VigYppli-r
Signature: _ i 40" Date:
FOR DISTRICT USE ONLY
❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT
PRIOR TO ISSUANCE OP A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on
adjacent properties, a Natural Resources Assessment Report may also be required.
❑ Based on review of the submitted materials and best available Information Sensitive areas do not appear to exist on site or
within 200' of the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and
protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider
letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and
completed under applicable focal, State, and federal law.
Based on review of the submitted materials and best available information the above referenced project will not significantly
impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre-Screening Site Assessment
does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently
discovered. This document will serve•as your Service Provider letter as required by•Resolution and Order 07 -20, Section •
3.02.1. All requited permits and approvals must be obtained and completed under applicable local, state, and federal law.
❑ This Service Provider Letter Is not valid unless CWS approved site plan(s) are attached.
❑ The proposed activity does not meet the derinlllon of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE
ASSESSMENT OR ERVICE P VIDER LETTER IS REQUIRED.
Reviewed By: Date: /0/70/07
2550 SW Hillsboro Mphwey • Hillsboro, Oregon 97123 /
Phone: (503) 881.5100 • Fes: (503) 681 -4439 • yfw,r cicanwatcrncrvicc, erg
Rebus& Nay MOOT
•
., CITY OF TIGARD
. ° : COMMUNITY DEVELOPMENT
,TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
Electrical Signature Form R.
lip
()Li. 10 2007
IMPORTANT PERMIT NOTICE CII Y ur 1 IIJARD
WINNER ELECTRIC INC BUILDING DIVISION
5950 SW PROSPERITY PK
TUALATIN, OR 97062
Permit #: MST2007 -00215
Date Issued: 11/28/2007
Parcel: 25111 CD -08500
Site Address: 15925 SW SERENA CT
Subdivision: KERWOOD ESTATES
Lot: 002 •
Jurisdiction: TIG
Zoning: R -4.5 DEC
Project Name: SHEETS 4 RECV
Description: 13' x 16' a
Your company has been indicated as the electrical contractor for the permit referenced above. In 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. Please mail the form to:
City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681.
If you have any questions please call 503.718.2433.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
RICHARD & LAURIE SHEETS WINNER ELECTRIC INC
15925 SW SERENA CT 5950 SW PROSPERITY PK
TIGARD, OR 97224 TUALATIN, OR 97062
Phone #: 503 - 968 -6092 Phone #: 503 - 638 -5028
Reg #: ELE 34-150C
LIC 14794
SUP 2825S
, SIGNATURE IS REQUIRED ON THIS FORM
Signat= of Supervising Electrician Name (printed) SUP LIC #
•
Dec 06 07 04:36a Portland Plumbing 5037238801 p.1
V CI ■ Y OF TIGARD
COMMUNITY DEVELOPMENT
' ti 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
Plumbing Signature Form
IMPORTANT PERMIT NOTICE
PORTLAND PLUMBING CO.
16470 Si SWAN AVE.
OREGON CITY, OR 97045
Permit #: MST2007 -00215
Date Issued: 11/28/2007
Parcel: 2S 111 C D -08500
Site Address: 15925 SW SERENA CT
Subdivision: KERWOOD ESTATES
Lot: 002
Jurisdiction: R
Zoning: TIG
Project Name: SHEETS
Description: 13' x 16' addition
Your company has been indicated as the plumbing contractor for the permit referenced 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. Please mail the form to: City of Tigard, Building Division,
13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681.
If you have any questions please call 503.718.2433. •
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
RICHARD 8 SHEETS PORTLAND PLUMBING CO.
15925 SW SERENA CT 16470 S/ SWAN AVE.
TIGARD, OR 97224 OREGON CITY, OR 97045
Phone #: 503 -968 -6092 Phone #: 503 - 723 -8800
Reg #: LIC 162139
PLM 3 -530PB
LIC 14794
LIC 89386
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Authorized Plumber Name (printed)
CITY OF TIGARD
BUILDING DIVISION . PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUE ' 11/213/2007
'Phone: (503) 639- 417111l �j /
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 2f612008 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 15925 SW SERENA Cam' CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 042 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition 12/26/2007 ADD 200amp. service.
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 603.960 -6092
CONTRACTOR: ASI-IER TRADITIONAL HOMES PHONE #: 503 - 620 -6163
Inspection Request Scheduled For: Date: 2/6/2008 Pour Time:
Code # Inspection Description . Confirm # Contact # Message
299 Final inspection 064616 -02 503 - 780 -6106 N
Corrections /Comments /Instructions:
•
1\ \
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: v /6` Phone #: (503) 718 - . .
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: MST2007 -00215
13125 SW Hall'Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/6/2008 TIME: 7 :OOAM PAGE: 17
SITE ADDRESS: 15925 SW SERENA CT , CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS '
DESCRIPTION: 13' x 16' addition 12/26/2007 ADD 200amp. service.
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 503 - 968.6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503-620-6163
Inspection Request Scheduled For: Date: 2/6/2006 Pour Time:
Code # Inspection Description • Confirm # Contact # Message
399 Plumbing final 064616 -01 503- 780.6106 N
•
•
Corrections /C• -- -nts/Instruc '• Is:
•
•
•
•
•
•
•
•
•
•
PASS' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS .
❑ FAIL ❑ CALL FOR INSPECTION ❑, ADDITIONAL FEES ASSESSED
Inspector: Date: / / Phone #: (503) 7 -18-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2f3/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/14/2007 TIME: 7 :01AM PAGE: 14
SITE ADDRESS: 15926. SW SERENA CT CLASS OF WORK: •
SUBDIVISION: KERWOOD ESTATES LOT #: 002 ' TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 503-958 -6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503 620 - 6163
Inspection Request Scheduled For: Date: 12/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
336 Rain drain 061567 -03 503 - 780.6106 N
Corrections /Comments /Instructions:
•
•
•
•
•
•
•
•
•
•
•
aPASS ❑ PARTIAL APPROVAL ' ❑ CANCEL .❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . .
•
fit 1 (n _ 2 Z
Inspector: Date: �� / Phone #: (503) 718 Y
CITY OF TIGARD �``
BUILDING DIVISION PERMIT #: MST2007- 00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 W
INSPECTION WORKSHEET FOR DATE: 2/5/2000 TIME: 7 :01AM PAGE: 29
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition 12/26/2007 ADD 200amp. service.
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 503- 968.6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503 -620 -6163
Inspection Request Scheduled For: Date: 2/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 064508 -01 503-780.6106 N
Corrections /Comments /Instructions: .
I C/ /1 , _ � 1 1 47 0 . O ce_e
it, k
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: - Phone #: (503) 718 -
CITY OF TIGARD • '
BUILDING DIVISION PERMIT #: MST 2007-00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 e. _
INSPECTION WORKSHEET FOR DATE: 12126/2007 TIME: 7 :06AM PAGE: 5
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK: 1
SUBDIVISION: Kt=RWOOI) ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition •
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 503 - 968.6082
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503-620-6163
Inspection Request Scheduled For: Date: 12/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 062127 -02 503-780 -6106 N
Corrections /Co ments /Instructions:
0.1 4 / I
, , , ) .e" , .
6 I c
,ok \O 6,1A-tK. . . . '
LAN , ... 1 . ‘
0
(z
y 'ASS • PARTIAL APPROVAL . ' ❑ CANCEL ❑ NO ACCESS
',A IL ii i ALL FIR INSPECTION E ADDITIONAL FEES ASSESSE
Inspector: 11 Date:1 Z, V Phone #: (503) 718 -
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST 2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/28/2017
Phone: (503) 639 -4171 �fil
•
Inspection Requests (24 Hrs.): (503) 639 -4175 P:_
INSPECTION WORKSHEET FOR DATE: 12/28/200 TIME: 7:00AM PAGE 59
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
' SUBDIVISION: KERINOOD ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x'16' addition 12/26/2007 ADD 200amp. service.
OWNER: SHEETS, RICHARD & LAURIE PHONE #:. 503-968-6092
CONTRACTOR: ASHER TRADITIONAL. HOMES PHONE #: 503 - 620 -6163
Inspection Request Scheduled For: Date: 12/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 062251 -01 503 - 780.6106 Y
•
Corrections /Comments / Instructions:
•
•
•
❑ PASS ❑ PARTIAL APPROVAL -❑ CANCEL ❑ NO ACCESS
❑ FAIL , CALL FOR INSPECTION El FEES ASSESSED
.
Inspector: ✓. Date: f1f� z Phone #: (503).718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2007
Phone: (503) 639 -4171 . e 1 ° i�l
Inspection Requests (24 Hrs.): (503) 639 - 4175 F.
INSPECTION WORKSHEET FOR DATE: 11127/2007 TIME: 7 :00AM PAGE: 12
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition 12/26/2007 ADD 200amp. service.
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 503 - 960 -60g2
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503 - 620.6163
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 062207 -01 503 - 780 -6106 Y
Corrections /Comments /Instructions:
.1 u 192 L , 1 � v11- �i°G L 5
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .
Inspector: Date: `2_-. 2 7 c Phone #: (503) 718- a.`7 I �/
� )
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2007
Phone: (503) 639 -4171 4rr
Inspection Requests (24 Hrs.): (503) 639 -4175
,INSPECTION WORKSHEET FOR DATE: 12/26/2007 TIME: 7 :06RM PAGE: .
SITE ADDRESS: 15925`SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERW00D ESTATES LOT #: 00.2 TYPE OF USE:
PROJECT NAME: SHEETS
• DESCRIPTION: 13' x 16' addition
OWNER: SHEETS. RICHARD & LAURIE PHONE #: 503 -6092
'CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503 - 620.6163
Inspection Request Scheduled For: Date: 12/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # ' Message
275 Framing . 062127 -01 503.760 -6106 N
•
Corrections /Comments /Instructions:
•
•
•
•
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . '
Inspector: / Date: /2 - --0 7 Phone #: (503) 718- -2-`
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.), (503) 639 -4175 'I t
INSPECTION WORKSHEET FOR DATE: 12/14/2007 TIME: 7 :01AM PAGE: . 15
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 0Q2 TYPE OF USE:•
PROJECT NAME: SHEETS
DESCRIPTION: 13' x.16'-addition
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 603.968.6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503.620.61G3
Inspection Request Scheduled For: Date: 12/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
2.40 Ext,eiior sheathing 061567 -02 503 - 780.6106 N
Corrections /Comments /Instructions:
FILFACIA MEM' NMI ./A
•
•
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 44 / Date: (/ 6 i Phone #: (503) 718 -
CITY OF TIGARD N tr e p
/
BUILDING DIVISION 98 PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 -4171 I�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/14/2007 TIME: 7 :01AM PAGE: 16
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION:. KERWOOD ESTATES LOT #: 002 TYPE OF USE:
• PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 503-968-6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503
Inspection Request Scheduled For: Date: /2/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # . Message
235 Shear walls/anchors 061567 -01 503-780 -6106 N • •
Corrections /Comments /Instructions:
•
•
•
•
`R PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • ❑ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED.
•
•
Inspector: Date: 1#12/13 #: (503) 718-
•
CITY OF TIGARD
: BUILDING DIVISION PERMIT #: MST2007 -00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/201)7
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 " . L .
INSPECTION WORKSHEET FOR DATE: 12J5/2007 TIME: 7 :01AIyi PAGE: 20
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 603 - 968 -6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 603620`6163 ,
Inspection Request Scheduled For: Date: 12/5/2007 Pour Time: 9 :00
Code # Inspection Description Confirm # Contact # Message
205 Footing 060850 01 503- 780 -6106 N
220 5L4-o
Corrections /Comments /Instructions:
•
•
PASS III PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /4_-- 7 Phone #: (503) 718- Z 4-S'
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST007- 00215
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/20
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . I �..
INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7 :00AM PAGE: 30
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: UO2 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 603.968 -6092
CONTRACTOR: ASHER TRADITIONAL HOMES PHONE #: 503
Inspection Request Scheduled For: Date: 12/3/2007 Pour Time: 9 :00
Code # Inspection Description Confirm # Contact # Message
205 Footing 0610646 -01 503-780-6106 N
Corrections /Comments /Instructions:
go wT v
❑ PS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /2-- 3 -0 > Phone #: (503) 718 - 7_3
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2007 -00216
i l 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2001
Phone: (503) 639 -4171 Vit Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7 :00AM PAGE: 29
SITE ADDRESS: 15925 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: SHEETS
DESCRIPTION: 13' x 16' addition
OWNER: SHEETS, RICHARD & LAURIE PHONE #: 603"968 -6092
CONTRACTOR: ASHER 'TRADITIONAL HOMES PHONE #: 503-620-6163
Inspection Request Scheduled For: Date: 12/3/2.007 Pour Time: 5:00
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 0610648.02 503-780-6106 N
Corrections/Comments/Instructions:
t
❑ PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
Inspector: Date: / 2— 3 —v) Phone #: (503) 718-