Permit ,
% r- 1
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00318
jl�i D EVELOPMENT SERVICES DATE ISSUED: 7/28/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10920 SW BRIARWOOD PL PARCEL: 1S133AC-09900
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 017 JURISDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 108 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 636 sf GARAGE: 536 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 709 sf RIGHT:
VALUE: 149
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1.453 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: 3
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HWSVC /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 & STEREO: VACUUM SYSTEM: AUDIO & 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 # SYSTEMS:
Owner Contractor TOTAL FEES: $ 6,212.45
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES I his permit is subject to the regulations contained in the
9500 SW BARBUR BLVD., STE 220 4949 SW MEADOWS RD SUITE 400 n all Municipal Code, State All l w work wil bey done in
PORTLAND, OR 97219 LAKE OSWEGO, OR 97035 and a ra cer applicable laws. s . This permit done in
accordance with approved plans. This permi t will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 892 - 8758 Phone: 971 - 233 - 0075 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 58699 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 - 4444 Plm /undslb Insp Plumbing Top Out Shear Wall Insp Storm drain insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insf Water Line Insp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Water Service Insp
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab Insp Low Voltage Insulation Insp Rain Drain Insp Plumb Final
-
Issued By : .�e
1� Permittee Signature : .-{. Cits ?
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
fuild(ing Permit lQJE gam, FOR OFFICE USE ONLY
+
Received % ,C.-.W" . ® / � uilding
D c �
Date/By: d� No. .A','.. c* °49,,f t'
•
City of Tigard Planning APProval Other
Pet
JUN 27 Z I ( Permit No,rr10.� r->4.` t(:2
Date/By:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF Tit ARD Date/By: 42
'7' S2T Permit No.:
Phone: 503- 639 -4171 Fax: 503;3011p .0 G I 'd:i d1 �j 1� Date/Bv: ew4 Case Noe
Internet: www.ci.tigard.or.us =^'� C m1/4 �M Jun .: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Meth / • 77.&,- Supplemental Information
AN
. :
•. TYPE OF WORK .. : -
..REQUIRED DATA:.".:':',.',..,:-7,'.....:- :
ZNew construction El Demolition Demolition 1 & FAMILY DWELLING _ : . . . .
- : - -
❑ Addition/alteration/replacement ❑ Other:
-CATEGORY OF CONSTRUCTION " = • • - Note: Permit fees* are based on the total value of the work performed. Indicate
( ' 1 2-Family & 2 Fily dwelling 111 Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
,r overhead and profit for the work indicated on this application.
❑ Accessory Building L Multi- Family
❑ Master Builder I ❑ Other: Valuation $ q.) 13 • `'°
:i; JOB SITE INFORMATION LOCATION . No. of bedrooms: No. of baths: 2.
Job site address: I Og24 21/4 -60./ P1.-Ace Total number of floors
New dwelling area (sq. ft.) j Ca
Suite #: 1 Bldg. /Apt.#: Garage/carport area (sq. ft.) X4$
Project Name: HAW ICS '1,€)%42,11 Tot.INfi Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
SO I z r - /Naive A sw. 44A.Wr S Btu Other structure area (sq. ft.)
• -
•,:,, . R DATA :. .
• COMMERCTAL:- U C _ HE 1"-:2
Subdivision: (- tviC �FALL� TOtoJliora Lot #: 7
Tax map/parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
.- DESCRIPTION OF - the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Cc- lsrBucT tF NELJ S sro2. Tai Power
., ( 7) Valuation 5
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
- %P.ROPERTY :OWNER >::. " .1•:0 TENANT .. - -• - T yp e of construction V N
Name: Al�'l1 � PAt K 761�!`f!1�hv,ES 1 L . L. c . Occupancy group(s): E
R-3
Address: 9500 51x1 titegute g2s1)i St10.€ Z2.o
I\ City /State /Zip: 1'oerLA,a> , 02 9 2-19
O Phone: 4 o3) $42- - 7SE) Fax :63) Z- 4( NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
®' APPLICANT `- : []= 'CONTACT PERSON... � . provisions of ORS 701 and may be required to be licensed in the
m Business Name: 'bEieEK ... - gt201.14 c A sociA f f (� - jurisdiction where work is being performed. If the applicant is exempt
t\r Contact Name: rYi e K (41*1Sw az- teLc.t Pe Z from licensing, the following reason applies:
c\ Address: 'Sdo SbJ + Su ( 2Po
City /State /Zip: Q}�i277,/ 012 gi 21`1
( ' Phon . 9� 1 Fax:(So�jB°t2-6 4(
BUMPING'PERMITTEES
E - m ail : r+ Corn : P 'refei - • s. }:' . .i =• ..CONTRACTOR . - _.,: r;:: - •:,- ... _ .., .. ...�., ....,...,..,:f...7
._ ,_ _ :: . . .
Business Name: bEP 1- (?&C.JN 4 AsstaAsm, 3N6 , Fees due upon application S
Address: 95x) Stn/ gAi &i 0.Vb 11 Sll aic ZZO
City /State /Zip: 1,or1 k 4 (( o(L q-t 7 Ial Amount received S
Phone: k`77/ - A 3,3'Od7`c Fax Date received:
CCB Lic. #: 86901,
Authorized �1 Notice: This permit application expires if a permit is not obtained within
Signature: / Date: -[ G3 180 days after it has been accepted as complete.
[C. Jd
*Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i :\Dsts\Permit Forms\BldgPermitApp.doc 01/03
Electrical Permi lt'l I i s il II. FOR OFFICE USE ONLY
Received Electrical
DateB Permit y: Peit No " J -003/R
Cl of Tigard Planning Approval Sign
City g JUN ' � 2003 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 v CITY OF TIGAR / Date/Bv: Permit No.:
Phone: 503- 639 -4171 Fax: AY-I ItSII CP IVI ON Post - Review Land Use
� I 1 i i Date/Bv: Case No.:
Internet: www.ci.tigard.or.us I II Contact luris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
TYPE OF WORK PLAN REVIEW (Please check all that apply)
New construction ❑ Demolition ❑ Service over 225 amps- El Health-care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: jg Service over 320 amps- rating of ❑ Building over 10,000 square feet.
CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in
jl & 2- Family dwelling El Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
- JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
The above are not applicable to temporary construction service.
p
Job site address: 10 2.. Be (Aielder.ib PL ACE FEE *" SCHEDULE
Suite #: Blclg. /Apt. #: _ lI + , Number of inspections per permit allowed
Project Name: ,1_j4y�/i<S 6 eptz. . 7 LI>I C,✓IE S Description I Qty I Fee tea.) I Total l I
New residential - single or multi - family per +
Cross eet ) O Ct10nS to J li. site: \ LA- .! 46' dwelling unit. Includes attached garage.
t � 14.1./ Avi �/47\40, s 1J /'>/fti" `, Service included:
o � 1000 so. ft. or less k 145.15 145.13 4
S �A�Y Each additional 500 sq. ft. or portion thereof I 1 I 33.40 ;3,4.40 I
/ y Limited energy. residential 1 I 75.00 '1rj _a:, 2
Subdivision: Lot #. ` ( Limited energy, non residential I 75.00 I 2
Tax map /parcel #: Each manufactured home or modular dwelling
• - DESCRIPTION OF WORK. service and/or feeder I 90.90 I 2
Services or feeders - installation,
Cat4cr7L'A.- 71UJ cF O\IEr,J 3 sr alteration or relocation: Q,,
�(.M , 1 / Gv 200 amos or less t 80.30 • 2
�!/ . ? 0Z- 201 amps to 400 amps 106.85 2
401 arms to 600 amps 160.60 2
...... ,: -..j."-. 601 amps o 100 40.60 2
�}PROPERT7C 0.. R... ;_. �. =❑ TENANT:::
0 amps 2
Over I amps or volts 454.65 2
Name: Atrajo t ' /�4iz 'r LL.L Reconnect only 66.85 2
Address: C650 SAJ K4e_gue.- gt..IN l f s 22� Temporary services or feeders - installation,
(� alteration, or relocation:
City /State /Zip: 1�2TLh>�� oe. -17 21 9 200 amos or less 66.85 1
Phone Soc)$a2-8IS8 Fax :(� X92- 8`{t 201 amps to 400 amps 100.30 2
401to600amos 133.75 2
APPL ANT':::: .- -- ::= - : ❑1CONT CT PERSONfr' == ' •' Branch cir - new, alteration, or
Name :! R D
' L M) b op S+
`` - hh � �5/ / � , extension per panel: of
Address: i$C j SW.) Q. R 1 1i f fJ b; 5Ul 220
A. Fee for branch f d feeder e its with purchase ui
t 6.65 2
service or feeder fee each branch circuit
City /State /Zip: 'Rjer t , C ... 9-7219 B. Fee for branch circuits without purchase of
service or feeder fee. first branch circuit 46.85 2
Phone: 603)N2_81513 Fax: (So3) 892-e,e41 Each additional branch circuit 6.65 2
E -mail: v+'1G,/' Qr d l tHO t .JrJa cscc ,con -
Misc.(Service or feeder not included):
..=;::.. CONTRACTOR • ••••':',....:-.':::::f.'..- Each pump or irrigation circle 53.40
2
• Each sign or outline lighting 53.40 2
Electrum Inc Signal circuit(s) or a limited energy panel,
or extension Paget 2
DBA Spectrum Electric Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
503- 361 -1256 Per inspection per hour (min. I hour) 62.50
CCB: 116453 ELC: 24 -353C SUP: 2919S Investigation fee:
CCB Lic. #: Lic. #:
Other - - • _
...:. : • • ::.:. -.. • .:.: • Electrical Pe - , i r ..;�
Supervising electrician Subtotal $ z,33,b5
signature required: Plan Review (25% of Permit Fee) S 3 4 `4(0
Print Na I Lic. #: State Surely :e (8% of Permit Fee $ 2-
, / TOTAL PERMIT FEE $ ' ' ' . 0
Authorized G/ �r Notice: This permit application expires if a permit is not obtained within
Signature: l Date: ` 180 days after it has been accepted as complete.
iik) ^� *Fee methodology set by Tri -County Building Industry Service Board.
(Plc print name) •
i:\Dsts\Permit Forms \E1cPermitApp.doc 01/03
/. FOR OFFICE USE ONLY
/ Mechanical Per 9 3 on Received Mechanical
Date/By: Permit No.:/ifTo - 03 - 0113 /ef
Planning Approval Building
' City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. JUN 2 7 2003 Plan Review Other
g
Tigard, Ore on 97223 Date/By: Permit No.:
' 8
Phone: 503-6394171 Fax: 5(396a 1 • y a, Date/By: Case No.:
Internet: www.ci.tigard.or.us BUILDING D IGA Post - Review Land Use
IVI' P l
Contact Juris.: ® See Page 2for
24 -hour Inspection Request: 503 - 639 -4175 Name/Method: , Supplemental Information.
TYPE OF WORK • : .' =,' :. COMMERCIAL . FEE• . SCHEDULE- USE CHECKLIST • -
, New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION. mechanical materials, equipment, labor, overhead and profit.
jai & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE'-SCHEDULE...
Description Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE INFORMATION and LOCATION • Furnace - add -on air conditioning** i 14.00 I 14.
Job site address: MY „.20 Zk /AR woo b PL • Gas heat pump 14.00 I
Suite #: Bldg. /Apt. #: Duct work 1 14.00 14.
W "g{/ 1� - row t'- 14OY� - CS Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions to job sit (for radiator or hydronic system) 14.00
` f
.SLc) 130 T '1'1/ UC (4)04-v)ec Unit heaters (fuel, not electric)
BED 5er (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10. a '
Subdivision: H,4W/<5 ��41 ' D Re units 12.15
Lot #: / 7 Other Fuel Appliances
Tax map /parcel #: Water heater I I 10.00 IQ.
• DESCRIPTION OF WORK Gas fireplace 1 10.00 10. °t7
C O / al.C710.- OR 4E' 3 S- T-}R,Y Flue vent (water heater /gas fireplace) Z. 10.00 2U ..o
-W� krylc P�JF r (N � ) Log lighter (gas) 10.00
l 'S Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
J'PROPERTY•OWNER -. . • I •.' 0 TENANT"' - -_ Other. 10.00
Name: /}'(J77/m4 #9:1tKTo Now igc LLG Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 1 10.00 ID . 41)
Address: qQJ S !S,ye / SJ ik 7 Clothes dryer exhaust 1 10.00 IQ . °o
City /State /Zip: P de Q 2 i 9 Single duct exhaust
Phone:(' o3)&42. -g i Fax: (5.)) 89 2-- 88'4( (bathrooms, toilet compartments,
- I�'APPL CANT •C PERSON utility rooms) 3 6.80 ZD • `0
Name: 1> 1
4. igamd•J s 11-roc
' 1,46 • Attic/crawl space fans 10.00
� �� )gi/�L� S Other.
Address: c7W I7t ZZ Fuel Piping
City /State /Zip: `�o2iZ/fr>7j r 7 q-7219 "($5.40 for first 4, $1.00 each additional)
Phone:(So3) N2 -8150 Fax: ( -0e2e Furnace, etc. I " ( Gas heat pump *A.
E-mail: ytjvz t Q. d I brocoAcA- 'S'c'c . Ca■- Wall/suspended/unit heater
CONTRACTOR - • Water heater I "
Fireplace I
FORECAST HEATING & AIR CONDITIONING Ranee . ••
17135 NE GLISAN ST BBQ "
PORTLAND OR 97230 Clothes dryer (gas) ••
Other.
CCB: 152194 Total: : 5 5,40
Mechanical Permit Fees*
Authorized ] / _ /2 /�� Subtotal: S 1 23, 910
Signature: //` (i(f (.1�0 Da te: (l/ Minimum Permit Fee $72.50 S
' U Cod E____ Plan Review Fee (25% of Permit Fee) S o , g5
(Please print name) State Surcharge (8% of Permit Fee) S , to
TOTAL PERMIT FEE $ 10 t • 615
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. "Site plan required for exterior A/C units.
i:\Dsts\Permit Forms MecPermitApp.doc 01/03
js>),111 r lxtu1 C
to
' • ‘ Pilai 1bin b1II PermiREaffilitE6 Received FOR OFFICE USE ONLY
Plumbing
Date/By: Permit No./A1;20 - 043/f
City of Tigard JUN 2 7 2003 Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGAR r, Plan Review Other
Tigard, Oregon 97223 I?��1Lp �IVIS • Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 SgS 1 a Post - Review Land Use
I I� t Date/By: Case No.:
Internet: www.ci.tigard.or.us , Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
'TYPE OF WORK • FEE* SCHEDULE (for special information use checklist)
El New construction ❑ Demolition Description I Qty. 1 Fee(ea.) Total
❑ Addition/alteration/replacement ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (l) bath 249.20
I & 2- Family dwelling ❑ CommerciaUlndustrial SFR (2) bath I 350.00 moo,°°•
Accessory Building ❑ Multi- Family SFR (3) bath 399.00
.❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
- .. JOB SITE INFORMATION and LOCATION Fire sprinkler - so. ft.: Page 2
Job site address: /69.P -17 f_15Z(Ag-tVo 7L- - Site Utilities
Suite #: Bldg. /Apt. #: I Catch basin/area drain 16.60
Project Name: HAW V -E. b - �OvJk WC7Wlg c Drywell/leach line/trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s t Manufactured home utilities 110.00
SLR% I �c�� S. Manholes 16.60
36/1.4.) ctriar Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: / S GrEA Lot rr: j 7
Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: Fixture or Item • - :-
. DESCRIPTION OF WORK I Absorption valve 16.60
Ca ',is ncs3 OF I NiEIV) Z S i ia./ Backflow preventer Page 2
- P-noJ igrA446 P2J). Cc.T" ( ).14 S( 1 Backwater valve 16.60
✓ Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
- 1ErPROPERTY..OWNER ..-.:4 •I]•TENANT • -- . - -• Ejectors/sumo 16.60
Name: AUTUWI,J P,4 - i< T /l4140MgS L1-4- Expansion tank 16.60
Address: gSoO SW t pteg1JQ &A / Svitf ZZO Fixture/sewer cap 16.60
City /State /Zip: PoQT1 .iD 02 q z 19 Floor drain/floor sink/hub 16.60
G I / Garbage disposal 16.60
Phone 3i Bq2 81 S) Fax: �sc�3) S 2- seu i Hose bib 16.60
;APPLICANT' ' - ':o CONTACT PERSON.. - Ice maker 16.60
Name: brael;V L. Q2Gu/P S AS 1',IL Interceptor /grease tray 16.60
Address: cI5 ) St..-) g eBJ/L gu6, Su at 22cw Medical gas - value: S Page 2
Primer 16.60
City /State /Zip: F}jP.rz , CL° f `t-7 Z l 9 Roof drain (commercial) 16.60
Phone: 3)E2 - 6758 Fax(sQ3> 6641 Sink/basin/lavatory 16.60
E -mail: rnm,le. C d I ivr3c Jn a_cco c . CO ►^'N Tub /shower /shower pan 16.60
CONTRACTOR Urinal 16.60
Water closet 16.60
PLUMBING EXPERTS INC Water heater 16.60
11925 SW PARKWAY Other.
PORTLAND OR 97225 -5413 Other.
503 - 469 - 0443 . • . - .,�- ••:•Plumbing Permit Fees**.:•..=.;.
CCB: 149035 PLM: 34-391PB Subtotal S 3 S a • co
Minimum Permit Fee 572.50 S
Authorized Residential Backflow Minimum Fee S36.25
Signature: .> - =ate /a � /a� Plan Review (25% of Permit Fee) S € t .S
r UCE- C�N(� State Surcharge (8% of Permit Fee) S . °O
(Please print name) TOTAL PERMIT FEE S 4(2
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
•Fee methodology set by Tri-County Building Industry Service Board.
i:\Dsts\Permit Forms\PlmPermitApp.doc 01/03
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
nyff, )
IMPORTANT PERMIT NOTICE JUL 2 2004+
CITY OF TIGARD
PLUMBING EXPERTS INC BUILDING DIVISION
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
Plumbing Signature Form
Permit #: MST2003 -00318
Date Issued: 7/28/2004
Parcel: 1 S133AC -09900
Site Address: 10920 SW BRIARWOOD PL
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 017
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
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:
AUTUMN PARK TOWNHOMES, LLC PLUMBING EXPERTS INC
9500 SW BARBUR BLVD., STE 220 11925 SW PARKWAY
PORTLAND, OR 97219 PORTLAND, OR 97225 -5413
Phone #: 503- 892 -8758 Phone #: 503 - 469 -0443
Reg #: LIC 149035
PLM 34 -391 PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
/ i i 5 T - 3 ZOO 1 d
44 10-
44 It•
® STREET TREE C
..
A I EgvCE £ /E— , Owner /Agent for DErEg. L ."90)13 et 4 rcc .
A (PLEASE PRINT) (PERMIT HOLDER)
O.
® Do hereby certify that the' following location
44 _..
• meets ,City- of .Tigard %Washington County
A land use and development standards for street tree installation.
A
ii
A
•
• ADDRESS: 0920 Ss.LLJ. QRu4CIV661> PL_
4
I.
4
•
® LOT: I ? SUBDIVISION: AI -MJAIS ,'E/WP
-41 le-
® BY: DATE: /l2 7/05 to
44 iu.
A 111*
® RECEIVED BY: DATE:
44 % YYYVYYVYYYYVYYYYYVYYYYYYYYYYYyyyyyyyyyyyyyyyyyyyyyyyyyyyyy®
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 M ST 3 �3(
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received / Date Requested I � a AM PM BUP
Location ! o 9 22 � .�- //1- [.e.��� Suite MEC
Contact Person Ph ( ) Z6 _9 s>97 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
' PART FAIL
s BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
r_II(IECHANIC
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PART FAIL
EL CTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date / — ��� Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD . 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 • MST , s00 j '3/
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 1— I 1 AM PM BUP
Location /D 92 ' �J� Suite ' MEC
Contact Person Ph ( ) <� (gc v R'Q "7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Fi = = arm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA ;l �l 1
Approach/Sidewalk Date \ \\ ` C) S Inspector \\\ S G ` �l Ext
Other:
Final DO NOT REMOVE this inspection record fro the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST . (7-4'. --0 d 3 1(
INSPECTION DIVISION Business Line: (503) 639 -4171
/ BUP
Received Date Requested /— AM PM v BUP
Location d c f d- (� Suite MEC
Contact Person Ph ( ) g66 e7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear I
Framing ,,
Insulation
Drywall Nailing ��� Air
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
41, S ''PART FAIL
• CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
A Date 1 2i/ c5 Inspector Ext
Other:
pproach/Sidewalk / ,
/
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL