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Permit AI (sh CITY OF TIGARD MASTER PERMIT PERMIT #: MST2006 -00115 V r i DEVELOPMENT SERVICES DATE ISSUED: 5/11/2006 - ��J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133CD SITE ADDRESS: 11721 SW WILTON AVE ZONING: R -25 SUBDIVISION: COTSWALD MEADOWS NO.3 LOT: 145 JURISDICTION: TIG Project Description: Masterbath remodel. Mechanical fees included in building permit -MAV BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST of BASEMENT: of LEFT: SMOKE DETECTORS Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES . TYPE OF CONST: 5N DWEWNG UNITS: THIRD. of RIGHT: VALUE: 1 5000 00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 s , f REAR: PLUMBING SINKS. WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS LAVATORIES: 2 DISHWASHERS' FLOOR DRAINS: SEWER UNES. SF RAIN DRAINS: CATCH BASINS TUB/SHOWERS: 1 GARBAGE DISP' WATER HEATERS: WATER UNES: BCKFLW PREVNTR: GREASE TRAPS. OTHER FIXTURES MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 1 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/FOR: I SIGN/OUT UN LT: PER HOUR: UMITED ENERGY: 401 - 600 amp: 401 - 600 amp' EA ADDL BR CIR: 2 SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 - 1000 amp 601.amps- 1000v: MINOR LABEL: 1000. amp/volt PLAN REVIEW SECTION Reconnect only: >n4 RES UNITS: SVC/FOR> =225 A.: > 600 V NOMINAL: CLS ARENSPC OCC. ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO E. 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 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 DIANNE ARMSTRONG KAYA INC applicable laws. All work will be done in accordance with approved 11721 SW WILTON AVE 5802 N GREELEY AVE plans. This permit will expire if work is not started within 180 days TIGARD, OR 97223 PORTLAND, OR 97217 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: Contact #: FAX 503- 283 -8191 of these rules or direct questions to OUNC by calling 503 - 246 -6699 PRI 503- 283 -8161 or 1- 800 - 332 -2344. Reg #: LIC 156019 TOTAL FEES: $ 467.28 REQUIRED ITEMS AND REPORTS 7 Ass ed By : £ I /1 I , _it, , Permiftee Signature : Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application FOR orFlCl liSI O I.y Received tly /�e, 6_ to //6" City of Tigard Re er . 5' 4 0 4 ' "` "° II to 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 0 Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Permit: TI G n It I) Inspection Line: 503.639.4175 Date Ready/By Jury+ � 65 See Attached Checklist for Internet: www.tigard - or.gov Notified/Method /V • Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ N construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all El 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 0 Valuation: $ /s, OOo ❑ 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: ' 1 Z ) 5 1,,,, L,- / .1 five New dwelling area: square feet City / State/ZIP: �1 C J (°Y/L Garage /carport area: square feet Suite/bldg. /apt. no.: l Project name: A2.H -.1-Qn kvp Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Ss /4.-.064.-. ( s J , / / Valuation: Si h/ Existing building area: square feet New building area: square feet OPERTY OWNER I ❑ TENANT Number of stories: Name: 191 4 ,,. • Type of construction: Address: ) f - -7Z J 5 -Li £ j ?9 7 ,., fi Occupancy groups: City /State/ZIP: S� dl2 Existing: Phone: (fV') / Fax: ( ) New: 2 wPPLL�1CANT ❑ CONTACT PERSON NOTICE Business name: vtc 7 S .7A. All contractors and subcontractors are required to be Contact name: 6.1,, e Afv licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: t ] s ny.. / , ., jurisdiction in which work is being performed. If the 1f ! applicant is exempt from licensing, the following reasons City /State/ZIP: ✓'ft,, D 72_-/ 7 apply: Phone: ( 2,) Z v3 -816 f l 1 (93) 83 "ill )Y E -mail: Oi 5 2 PC4 `` 3T/✓� I ow . Cos CONTRACTOR Business name: K.C.yy 2Jn._ BUILDING PERMIT FEES* Address: 5 i tl' /.e ti J /S./P (Please refer to fee schedule) . Structural plan review fee (or deposit): City / State/ZIP: - 7 v ,� / q 7Z / z / FLS plan review fee (if applicable): Phone: (53 j) 2123-23) 45 / I Fax: (573 )L $ 3 �) 7 ) CCB lic.: 1 S C O I Ij Total fees due upon application: J� Amount received: Authorized signature: / This permit application expires if a permit is not obtained I Print name: ��1 Date: within 180 days after it has been accepted as complete. ....1 61�} .91-7-- I 5111/616 * Fee methodology set by Tri -County Building Industry Service Board. I.\Bwldmg\Permin\BUP- RES -Pa nitApp doe 03/21/06 440-4613T( I I /02/COM WFB) One- and Two - Family Dwelling R .. Building Permit Application Checklist 1.0It (WHO'. us1. O,N1.\ City of Tigard Permit No.: 1 11 4 V 13125 SW HaII Blvd., Tigard, OR 97223 Associated permits. 0 Phone. 503.639.4171 Fax: 503.598.1960 TICiARD 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑Mechanical Internet: www.tigard- or.gov ❑ Other. I-IE FOLLO\VING ITI %'IS ARE REQUIRED FOR PLAN RI VIF\V 1 c No ,N/ :k 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ■ • • 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 ❑ ❑ - 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ 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, ❑ ❑ ❑ 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 Ore on and shall be shown to be licable to the o'ect under review. 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17". 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. 0 ❑ ❑ 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. 1•\ Bwlding \Permits\BUP- RES- PennitApp doc 0321/06 Electrical Permit Application rctli oisricl USE ONLY City of Tigard Received /r 04/ 9 Pert No.: 57 -ncii S V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Renew ' C : Phone: 503.639.4171 Fax: 503.598.1960 p��g . Other Permit: T I C A I: D Inspection Line: 503.639.4175 Date Ready/By reffl ®See Page 2 for Internet: www.tigard or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1 -and 2- family dwellings 4 or more new residential I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder El Other: ['Building over three stories ['Feeders, 400 amps or more DOccupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egess/lig RV park htingpian Job no.: Job site address: / 172 / S IV 1✓ ' /1� d _ ❑Health -care facility ❑der: T , ('�' Submit 2 sets of plans with any of the above. City/ State/ZIP: —1 J -,-0 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: / ,,.....----..... name R gill !. g 1,9 FEE* SCHEDULE Description I Qty. I Fee. I Total I •• Cross street/directions to job site: New residential single- or multi - family dwelling unit. • Includes attached garage. 1,000 sq. R or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular (� dwelling, service and/or feeder 90.90 2 e.'..... �l / Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: W`cs. A/'M,S f /0 601 amps to 1,000 amps 240.60 2 Address: . / S7A/ w, ' h 11,,e , Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/ State/Z1P: j is S �) / a Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 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 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature' Date: Branch circuits — new, alteration, or extension, per panel [�PPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with �� service or feeder fee, each 6.65 2 Business name: oC `'r` lq ��, c branch circuit 7 ' B. Fee for branch circuits Contact name: �c _ 1/ J 4,?T IA/ e without service or feeder fee, 1 46.85 �� g ( 2 � I , (a /� / first branch circuit Address: , .. G 7 .. /ere- `e- 4(./e-- ,' Each add'I branch circuit - G 6.65 / , /9 2 City/ State/ZIP: <F0,,1.- / t; t.- 02 Miscellaneous (service or feeder not included) Phone: (5o3 ) Z$ 3 — 6 Fax: : (03) Pump or irrigation circle 53.40 2 3"� 91 Sign or outline lighting 53.40 2 E -mail: O e ` 0 c',.ti.s fr„ f,'U,,, .. Ca Signal circuit(s) alterationlimited- energy CO gy patt 1 / /c to /IL c Ac G G rC ` extension. Describe: Page 2 2 Business name: — '�p�„� �� C � Address: 5 5q 7 � € +� '� � 1.- L.o L� 1-?-7— , Each additional inspection over allowable in any of the above I Per inspection 62.50 City/State/ZIP: t LL'- t i 02 9 7 2 y Investigation per hour (I hr min) 62.50 // Industrial plant per hour 73.75 Phone: (��jl -- 7 a 3 - 7 Fax: ( ) ELECTRICAL PERMIT FEES* . CCB Lic.: / 50 l 3, Electrical Lic.: 5 _5 Suprv. Lic.: 1 1790 5 Subtotal: t p0 . / S Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: Date: State surcharge (8% of permit fee): 1/ ., G g 0 TOTAL PERMIT FEE within / 6 • Authorized signature: G This permit application expires if a permit is not obtained V thin 180 days after It has been accepted as complete Print name: �� Al ,@� Date: 51/(/26 • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed I\ Building \Pennib\ELC- PetmitAppdoe 03/23/06 440- 4615T(l1 /05 /COM/WtB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: I, 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* El Medical El 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\Pamib\ELC- PamttApp.doc 0323/06 Building Fixtures t. Plumbing Permit Application City of Tigard Received Date/sy: j / 0 1, Permit No.:P ro/jOIp _ ex) // S O 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.: I I G ,\ R 17 Inspection Line: 503.639.4175 Date Ready/By: r 65 See Page 2 for Internet: www.tigard - or.gov Notified/Method '//(..kg Supplemental information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total _ ❑ Addition /alteration/replacement 0 Other: New I- 2- family dwellings (includes 100 ft for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ 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: 1 I 1 2I sW t /AI", 4 Catch basin or area drain 16.60 City /State/ZIP: -Tr S/ 1 Oa- Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: 1, Pr6ject name: p / / / - Footing drain (no. linear ft.: ) Page 2 r, r/� � �I L w 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 Back flow preventer Page 2 Sl• /ob M Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Vi n G,.t. 14611 <'l ,(. lo Expansion tank 16.60 Address: 1 / 7 2,1 s,"_ V / i..�; V0,.., 4-V [ Fixture/sewer cap 16.60 City /State/ZIP: 2 Floor drain/floor sink/hub 16.60 I Phone: ( )�� Fax: ( ) Garbage disposal 16.60 111/6 LICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: 1,( ` _ImG Interceptor /grease trap 16.60 Contact name: c�, Al A,2.7 Medical gas (value: $ ) Page 2 Address: O �e L j ✓ � Prima 16.60 City /State/ZIP: j� / n Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 , aD Phone: ( ri3j 4:C F _ . ax:: ( ) Z , co - Tub /shower/shower pan // „. f 16.60 k ,/ E -mail' l / ira akctxCo� 5 f l,.<" `e - , C" Urinal 16.60 CCoNTRAC OR Water closet 16.60 Business name: ��,,,/// �. L--/A r Water heater 16.60 Address: 7'F7 A f ` - 1 r2.f. Cr" _Other: Subtotal City /State/ZIP:� � /� ()� q - 7a7;. Minimum permit fee: $72.50 Phone: (5D3) (P 0 - 71690 Fax: ( ) Residential backflow minimum permit fee: $36.25 /p / [ ' CCB Lic.: gq 5 3 - ,. Plumbing Lic. no.: ,54I ' 5 - 7 p5 Plan review (25% of permit fee) Authorized signature: cji/ l.� State surcharge (8% of permit fee) y. 7i' • �S0 't/ L TOTAL PERMIT FEE • Print name: a/e t Arcr ' r it 1 Date: '5 This permit application expires if a permit is not obtained within / I8O days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1\ Bwldmg \Permits\P1.MF- PamitAppdoe 04/06/06 4404616T(IWO2ICOM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - I 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 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 • Storm & Rain Drain - 1st 100' 55.00 Valua 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 Back flow Prevention Device each additional $100.00 or fraction thereof to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 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 ❑ 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 • ❑ Any NFPA 13 - D multipurpose fire sprinkler system. Eye Wash 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 Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: _ plumbing permit can be issued. i•\Bwldmg\Pennits \PLM -Pc mitApp doc 07/06/05 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE JOHN D PLUMBING 7472 SW FIR STREET TIGARD, OR 97223 Plumbing Signature Form Permit #: MST2006 -00115 Date Issued: 5/11/2006 Parcel: 1 S133CD -11300 Site Address: 11721 SW WILTON AVE Subdivision: COTSWALD MEADOWS NO.3 Block: Lot: 145 Jurisdiction: TIG Zoning: R - Remarks: Masterbath remodel. Mechanical fees included in building permit - MAV Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: DIANNE ARMSTRONG JOHN D PLUMBING 11721 SW WILTON AVE 7472 SW FIR STREET TIGARD, OR 97223 TIGARD, OR 97223 Phone #: Phone #: 503 - 620 - 7600 Reg #: LIC 89537 PLM 34 -257PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Si ature A °'orized Plumber If you have any questions, please call 503.718.2433. • CITY OF TIGARD 13125 S.W. HALL BLVD, TIGARD, OR 97223 IMPORTANT PERMIT NOTICE TRADEMARK ELECTRIC LLC 5543 SE WILLOW ST MILWAUKIE, OR 97222 Electrical Signature Form Permit #: MST2006 -00115 Date Issued: 5/11/2006 Parat " 15133CD -11300 Site Address: 11721 SW WILTON AVE Subdivision: COTSWALD MEADOWS NO.3 Block: Lot: 145 Jurisdiction: TIG Zoning: R -25 Remarks: Masterbath remodel. Mechanical fees included hi building permit - MAV Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Pleas* have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the Start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form Is reteived OWNER: ELECTRICAL CONTRACTOR: DIANNE ARMSTRONG TRADEMARK ELECTRIC LLC 11721 SW WILTON AVE 5543 SE WILLOW ST TIGARD, OR 97223 MILWAUKIE, OR 97222 Phone #: Phone #: S03. 723 -8444 Reg #: ELE 3-536C LiC 150638 SUP 4790S AN INK SIGNATURE IS REQUIRED ON THIS FORM X -�-- Signature of Supervising Electrician If you have any questions, please call 503.718.2433. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006.00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 i ' it .. INSPECTION WORKSHEET FOR DATE: 1/26/2007 TIME: 7:00AM PAGE: 13 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit - MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 - 283-8161 Inspection Request Scheduled For: Date: 1/26/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 042584 -01 503-913-2657 Y Corrections /Comments/ Instructions: . .i .• . �../ _ _ '. ✓' J! • ■ f■•:.-- ''fit.. /� l ,,, A / iii j 2, g 1 riaM): .1 id, iditlg , i J iTr' I I/ (II / ,, f1\1 t j ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: I Z- -117 Phone #: (503) 718 - - i PL 0) p7 CITY OF TIGARD BUILDING DIVISION • PERMIT #: MST200S.00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 �o Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7:03AM PAGE: 4 SITE.ADDRESS: 11721 SW VVILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAY OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503- 203-8161 Inspection Request Scheduled For: Date: 1/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 042036 -01 503 - 913-2657 Y Corrections /Comments /Instructions: gi ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Y'1/ > Phone #: (503) 718- ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200G00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 n Inspection Requests (24 Hrs.): (503) 639 -4175 ` -� INSPECTION WORKSHEET FOR DATE: 1/8/2007 TIME: 7:00AM PAGE: 15 SITE ADDRESS: 11721 SW WiLTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503. 283 Inspection Request Scheduled For: Date: 1/8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 041894 -02 503 - 913 -2657 Y • Corrections /Comments /Instructions: • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /— S — o 7 Phone #: (503) 718- '7,¢$ -6te CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2006 -00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 _.. IL INSPECTION WORKSHEET FOR DATE: 1/6!2007 TIME: 7 :00AM PAGE: 16 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503.203 - 13161 Inspection Request Scheduled For: Date: 11W2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 041894 -01 503-913 -2657 Y Corrections /Comments /Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • Date: /— 8— e 7 Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006.00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 �h l � l Inspection Requests (24 Hrs.): (503) 639 -4175 " -_.. INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7:00Am PAGE: 40 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 • LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 Inspection Request Scheduled For: Date: 12/21/2006 Pour Time: Code # Inspection Description Confirm # Con ct # Message 199 Electrical final 041412 -01 .,03 -997 -0914 N Corrections /Comments /Instructions: • ...----_ / 1 / — WI } '_ ��vo 7K , ■ ► �� ! / • SS ❑ PAR L APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL . / L F•R I i ! IN . e : e AL F S ASSESSED V ' qq Inspector: / Dafe: Phone #: (503) 71® CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006.00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 l l�i�i Inspection Requests (24 Hrs.): (503) 639 -4175 � ' IL INSPECTION WORKSHEET FOR DATE: 6121/2006 TIME: 7:07AM PAGE: 10 ,- i u-f3 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503-2838161 Inspection Request Scheduled For: Date: 6/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # , :: - - . 120 Electrical rough -in 032075 -01 503 -997 -0914 Corrections/Comments/Instructions: /O.3 0-- / 1 O it PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I/i7 Date: .6,.7/06 Phone #: (503) 718- ISr/ . T CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006.00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ' v INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7 :00AM PAGE: 36 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: i45 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503-2133-8161 Inspection Request Scheduled For: Date: 12/21/2006 Pour Time: Code # Inspection Description Confirm # Conta Message 399 Plumbing final 041416 -01 50 13-2657 N Corrections /Comments / Instructions: idZ.3 PASS ❑ P' 'TIAL APPRr A ❑ CANCEL ❑ NO ACCESS ❑ FAIL CAL - - ECTION IN ADDITION,' FE ASSESSED � Inspector: Dat1 / / -- Phone #: (503) 7182 )' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/11/2006 Phone: (503) 639 -4171 A � l l Inspection Requests (24 Hrs.): (503) 639 -4175 °_ INSPECTION WORKSHEET FOR DATE: 8/3/2006 TIME: 7 :05AM PAGE: 56 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 146 TYPE OF USE: PROJECT NAME: ARMSTRONG • DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 - 2838161 Inspection Request Scheduled For: Date: 8/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # 1 -,- 322 Shower pan 034243-01 503 - 9132657 Corrections/Comments/Instructions: 'i; 'ASS . ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G// I Date: 8 . • Phone #: (503) 718 -26`7 / CITY OF TIGARD i. � BUILDING DIVISION PERMIT #: MST2006 -00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1112006 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 -� _.. INSPECTION WORKSHEET FOR DATE: 618/2006 TIME: 7 :03AM PAGE: 13 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 -2133 -8161 Inspection Request Scheduled For: Date: 6/8/2006 Pour Time: • Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 03139501 503 -752 -4079 N Corrections/Comments/Instructions: om _. 11J ote4 - 11110 ... / 0 IIMIN A.__ A &.A.L.r ' , -- r 4 \ e ''* , • p ' , , , , s.,, ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: '4/' Date: 0 6 Phone #: (503) 718- CITY OF TIGARD fi 7 BUILDING DIVISION PERMIT #p?�IXo —oo //5" 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 �w I A Inspection Requests (24 Hrs.): (503) 639 -4175 -IL INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 1 I — 7 I LIJiLL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: G -a 3 --61( Pour Time: Code # Inspection Description Confirm # Contact # Mess.- .e 2 ST .2;.--6-u_iLtizt ---k-mz-c...Ak_.) i S --- c — (-10- 9 ft ' iii` Corrections /Comments /Instructions: 4 �" ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ; , Date:--- 23--0 & Phone #: (503) 718 - —L-4-4/As CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST 2006-00115 110115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11 /2006 Phone: (503) 639 -4171 1411:111 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/22/2006 TIME: 7:01AM PAGE: 11 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 1Q5 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 -2R3 -8161 Inspection Request Scheduled For: Date: 6/22/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 032173-02 503-752 -4079 N Corrections/Comments/Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: d" Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 ui e r o q � I , Inspection Requests (24 Hrs.): (503) 639 -4175 l0im INSPECTION WORKSHEET FOR DATE: 6/22/2006 TIME: 7 :01 AM PAGE: 12 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit -MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 - 283 - 8161 Inspection Request Scheduled For: Date: 6/22/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing . 032173 -01 503- 752 -4079 N Corrections /Comments/ Instructions: • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • ,- Date:C— Z/-- (o Phone #: (503) 718- i14/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20U&00115 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 "' I � .. INSPECTION WORKSHEET FOR DATE: 6/6/2006 TIME: 7 :03AM PAGE: 1 2 SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit - MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 -2133 -8161 Inspection Request Scheduled For: Date: 6/8/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 031395 -02 503 - 752 -4079 N Corrections /Co I ments /Instructi• s: / Q ,, 4'61-Q b _ia r ! / / i \ t hAk ‘—•._)._. AA ANMAlk :I A . n 1 1 ._ 1 6 ' o , a >,♦ U' , 1 C .e.a 144 ..4 X36 n \e-d-- ulA s - vZ &`v - V0062- tv--.., vl � : . k0 e,d-, . V,A _ _ - (�.�ir,11 -ti t —i . - v \ I \ d UlA -- t4;1C A i • . ‘ ❑ P Oft ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 61— r ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \ 9 v ( A ■ ci t c,,.... _______ Inspector: Date: U- Phone #: (503) 718- 24 f - CITY OF TIGARD / BUILDING DIVISION PERMIT #: MST200C 00115 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/11 /2006 Phone: (503) 639 -4171 �9�ii Inspection Requests (24 Hrs.): (503) 639 -4175 41- : INSPECTION WORKSHEET FOR DATE: 5/16/2006 TIME: 7 :02AM PAGE: BB I SITE ADDRESS: 11721 SW WILTON AVE CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: ARMSTRONG DESCRIPTION: Masterbath remodel. Mechanical fees included in building permit - MAV OWNER: ARMSTRONG, DIANNE PHONE #: CONTRACTOR: KAYA INC PHONE #: 503 283 - 6161 Inspection Request Scheduled For: Date: 5/16/2006 Pour Time: 12:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 029835.01 503-913 -2657 N Corrections /Comments /Instructions: d) OAIS 2DA-1? . - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ill C LL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Inspector: Date: 6 Phone #: (503) 718 - 4- —