Permit 1
CITY T I G A R D MASTER PERMIT
DEVELOPMENT SERVICES DATE ISSUED: MS 03 3-00283
I'l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10835 SW 130TH AVE PARCEL: 1S133AC - HB010
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 010 JURISDICTION: TIG
REMARKS: New SF 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 DIM: 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: 1 BOILJCMP <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: EAADDL BRCIR: SIGNALJPANEL: 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 & 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: $ 6,072.45
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES INTigaTga u n is subject to the regulations ec C o I the
rd d Municipal Code, State of OR. Specialty Codes s and
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 all other applicable laws. All work will be done in
PORTLAND, OR 97219 PORTLAND, OR 97219 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 892 - 8758 Phone: 503 - 892 - 8758 Oregon Utility Notification Center. Those rules are set
forth in OAR 952- 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 58699 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8& Plm /undslb Insp Plumbing Top Out Shear Wall Insp Water Line lnsp Mechanical Final
Sewer Inspection Electrical Service Framing lnsp Exterior Sheathing Ins l Water Service lnsp Building Final
Footing lnsp Electrical Rough -in Gas Line lnsp Firewall lnsp Smoke Detector
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab Insp Low Voltage Insulation Insp Rain Drain Insp Plumb Final
Issued B : ' _�...__,L_ . _ __ Permittee Signature : - ,00,Q , .
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
f f 2
1 uilding Permit FOR OFFICE USE ONLY
yr _ Receiv / �, s ilding
Date/By: r��a If v Permit No Jf57iD3 - 00.2 PS
Planning Approval Other
City 01 Tigard Date/By:
Permit No.:st!)/2 003'46A/4,
13125 SW Hall Blvd. JUN 27 2U Plan Revie o, Other 11 Tigard, Oregon 97223 Date/By: fP Permit No.:
T = . \ Post - Review Land Use
Phone: 503 - 639 -4171 Fax: 50 U p a f I, Date/By: Case No.
Internet www.ci.tigard.or.us ^�° Contact Juris.: IZI See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: 7 /6 Supplemental Information
- " - -TYPE OF WORK REQUIRED DATA
ZNew construction ❑ Demolition 1 & 2 FAMILY DWELLING
❑ Addition /alteration/replacement ❑ Other:
' ., - CATEGORY OF CONSTRUCTION - . Note: Permit fees' are based on the total value of the work performed. Indicate
1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation Slyl 5 O . y°
. - -JOB SITE INFORMATION and LOCATION •: No. of bedrooms: No. of baths: Z
Job site address: I6835 SO (' .� Total number of floors _ .-
New dwelling area (sq. ft.) _ —
Suite #: lB. ld Tc e. /Apt. #: Garage/carport area (sq. ft.) _
Project Name: hlr4W ILS EAPI 4.1140 t .ES Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.) 1 L
SW 1 . SO ' ItVigOe ,b S.w. gA1.4Kv 13fh Other structure area (sq. ft.)
S . REQUIRED DATA
COMMERCIAL - USE CHECKLIST - =. - `_:
Subdivision: I! (IS 4144) 7N-44-6.-CS Lot #: l O
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
- DESCRIPTION OF WORK . - - the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Ce4SnaLLC..TY.4,t of NELJ 3 Crore.l Ta a Pjwf,
1%2+3,Elx- Valuation S
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
PROPERTY OWNER' 1 ❑ TENANT - - - Type of construction
Name: A UTUm IQ PAS K I- ''"_ NVLES i L . L • L . Occupancy group(s): Existing:
R-3
Address: g tSao S14 Vitegvit &.111 / 5U 0-E. 2
City /State /Zip: `PUe7Zh71 , 02 9 7 2-19
Phone: 66U "SE, 612 -' Fax:653) -ga NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
®' APPLICANT 0 CONTACT PERSON " . provisions of ORS 701 and may be required to be licensed in the
Business Name:' L .7,40u4 c ASSQUA*PtS i (4. , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: mike K (4r(Sen0 02 le4ct P ,402- from licensing, the following reason applies:
Address: ciScb so atAe- 1 Su (7-la 22.0
City /State /Zip: k/crul J 012 Q `1
Phone: l2 -8`tS8 1 Fax:(5o3j Z-6 ( .
. BUILDING PERMIT'FEES' '-
E -mail: .+ti0.rK br ASSVC , COm 'Please'referto fee schedule- _
CONTRACTOR ::
Business Name: 'b L. hJ 4 /4SkaAirec, Y'G, Fees due upon application S
Address: c iSxC) SlA/ gAtgui2 GLIB 2.Zo
City /State /Zip: Rbtz - ./oJ oz. 1 Z 1 1 Amount received s
Phone:(.\ 892 -13 ZS$ (Fax: ( sd3 2-8$4 l Date received:
CCB Lic ; : 809
Authorized J (2Q / Qr Notice: This permit application expires if a permit is not obtained within
' M
Signature: � , Date: l l 180 days after it has been accepted as complete.
r i me 'm e A ' *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03
• 'Electrical Pe ion FOR OFFICE USE ONLY p
• �''"� Date/By: Permit Electrical
" ,0 Q :3
City of Tigard Planning Approval Sign
Tigard JUN 2 7 2003 Date/By: PermitNo.:
13125 SW Hall Blvd. Plan Review ' Other
Tigard, Oregon 97223 CITY OF TIGARD Date/13v: Permit No.:
Phone: 503 -639 -4171 BilitiNtitibl9ftION , . ( Post - Review Land Use
J Contact Case No.:
Internet: www.ci.tigard.or.us eM 1 Contact Juris.: ® 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- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: 121 Service over 320 amps - rating of ❑ Building over 10,000 square feet,
CATEGORY OF CONSTRUCTION I & 2 family dwellings four or more residential units in
E1 & 2- Family dwelling ❑ 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.
Job site address: 1001,c SW 13[� tit The
SCHEDULE
Suite #: Bldg. /Aptt. #: 1i + , Number of inspections per permit allowed
Project Name: ,i..,AIA {'S eg !'z5. s -! t QL)/i?'fCJ✓lES Description Qty I Fee (ea.) I Total I
Cross street/Directions to job site: New residential - single or multi - family per +
N ) dwelling unit. Includes attached garage.
SW j U� .5 Service included: d
SI ►c.C& �
� ��� 1000 so. ft. or less 145.15 11 }5..1 p 4
Each additional 500 sq. ft. or pornon thereof I 33.40 - 46
Subdivision: 1if, tf LOt #; ' Limited energy. residential 1 75.00 15%/0 2
Limited energy, non residennal 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
- DESCRIPTION OF WORK service and/or feeder 90.90 2
" Services or feeders - installation,
(U�kS7'Z' C I i'J �4J 3 sr alteration or relocation: .. ,,,,
&// 1E t 200 amos or less
- — 80.30 2
'� W " ' flame 201 amps to 400 amps 106.85 2
401 amos to 600 amps 160.60 2
aPROPERTYOWN R 1- ❑ TENANT _ _ 601 amos to 1000 amos I 240.60 2
A r U /2 �d �ti -h^ES L
Over Reconnect amps or volts I 454.65 2
Name: yMt � f172 k � +'�"G LLC, Reconnect only 66.85
Address: C D SW �- guh, S(J 1N� 22,0 Temporary services or feeders - installation,
1' — IgLJ 7 alteration, or relocation:
City /State /Zip: T L A-r) , C. 9 2-19 200 amps or less 66.85 1
Phone So�) S-lca Fax :(x� 692 -58Li ( / 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
5 /APPL ANT` =° ,' ( CONT CT PERSON Branch circuits - new, alteration, or
Name: . L• gxi.,fio e pp S 1 xt extension per panel: of
Address: ' Cc) SW elviZlhP & ) SU o.f ZZO A. Fee for branch feeder each purchase ui
� service or feeder fee, each branch circuit 6.65 2
City /State /Zip: e /.,q,. , G' 9-7 2.1 Cj B. Fee for branch circuits without purchase of
� p�
service or feeder fee. first branch circuit 46.85 2
Phone: e Z) S 9_815 S Fax: (�3 p ) v f2 -ee4 / Each additional branch circuit 6.65 2
E -mail: yn r IZ d t to r.04JO- 'Soe Cor-n Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 _ 2
. ;.. ,..'r CONTRACTOR •.. •- ' - Each sign or outline lighting _ 53.40 2
Job No: r '1A" Signal circuit(s) or a limited energy panel,
alteration, or extension _ Page 2 2
Electrum Inc Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. I hour) 62.50
503-361-1256 Investigation fee:
Other
CCB:116453/ELC:24 353C/SUP:2919S - • • El P er uilt Fees* _ ..:: -
Supervising electrician _ Subtotal $ _
signature required: Plan Review (25% of Permit Fee) $
Print Name: Lic. #: State Surcharge (8% of Permit Fee) S
TOTAL PERMIT FEE S J
Authorized Notice: This permit application expires if a permit is not uui..ucu ......in
Date: ( as 180 days after it has been accepted as complete.
Sr gn atttre. �f F *Fee methodology set by Tri- County Building Industry Service Board.
VI C kJ , S�
(Ple a print name)
is \Dsts\Permit Forms 1ElcPermitApp.doc 01/03
RE 1 \/ D D. FOR OFFICE USE ONLY
/ Mechanical PePAPApp cation RecCived Mechanical,,
JUN 7 2003 Da nnin Permit No.: r7. -G - G?).-;',4" �
planning Approval Building
City of Tigard CITY OF TIGARD Date/By: Permit No.:
13125 SW Hall Blvd
Plan Review Other
Tigard, Oregon 97223 BUILDING DIVISIO Date/By: Permit No.:
Post - Review Land Use
Phone: 503 639 - 4171 Fax: 503 - 598 - 1960 ,, ,,. ' ,u , I ; , . Date/By: CaseNo.:
Internet: www.ci.tigard.or.us a e . Contact Juris.: ® See Page 2 for
-
24- hour Inspection Request: 503-639-4175 - Name/Method: Supplemental Information.
TYPE OF WORK .. ` "' COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
"New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
p 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.
Commercial/Industrial Value: S See Page 2 for Fee Schedule
01 & 2-Family dwellin g ❑ ommerc
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description Qty Fee(ea.) j Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add - on air conditioning ** I 14.00 144
Job site address: /0'3S' Siti /39 4 1/& Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work I 14.00 (+{.*'
kS "g ble TO � � i 10 Cc Hydronic hot water system 14.00
Project Name: 441/4 t� Residential boiler
Cross street/Directions to job site:, , A �� (for radiator or hydronic system) 14.00
.SLO j A tt Unit heaters (fuel, not electric)
--geNzI s i t (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 W. O7
� &1 Lot #: / ?)
Subdivision: 1114 k/K� Repair units 12.15 Other Fuel Appliances
Tax map /parcel #: Water heater l 10.00 10. -
DESCRIPTION OF WORK Gas fireplace I 10.00 I0 . °t'
C . 7 - /�u7l� QF Q 3 S-rote Flue vent (water heater /gas fireplace) Z. 10.00 20. '
– 16(AAJ 116 mF PepJ— (146 0 Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chinmey/liner /flue/vent 10.00
%PROPERTY OWNER - 1 0 TENANT' ..- • Other: 10.00
Name: AUTIhrini (MK Tp W g S Liz, Environmental Exhaust & Ventilation
) Range hood/other kitchen equipment I 10.00 10 . "'
Address: qcoo Sh/ V2IS1/e / SJ 1 Z Clothes dryer exhaust ( 10.00 10. °O
City /State /Zip: P de Q lq Single duct exhaust
Phone:5o3) 8012-5758 ( F C ) 8q 2-- 88 4( (bathrooms, toilet compartments,
- (APPL CANT 0 CONTACT PERSON utility rooms) _5 6.80 20 .
Name: I>C� L. gpo.4'J 4 cMA4 / • Attic/crawl space fans 10.00
C Biz ae._ ��! stmt ozo Othe 10.00
Address: Fuel Piping
City /State/Zip: T g4tr76 f oZ q-7219 * *($5.40 for first 4, $1.00 each additional)
Phone:(So3) E z -S'1SS Fax: (5033012-00( (5033012-00( Furnace, etc. I ** Gas heat pump **
E -mail: &A.-L. t C d I brown O- CC , C2,^ --\ Wall/suspended/unit heater **
CONTRACTOR Water heater ( **
Smart Heating & Cooling LLC Fireplace I **
7616 NE Everett St Range **
Portland OR 97213 -6347 BBQ **
Clothes dryer (gas)
503- 254 -5096 Other. **
CCB: 154133 Total: 3 5.4o
Mechanical Permit Fees*
Authorized to /2-i1id3 Subtotal: $ I 2.5.610
Signature: (� % "'C.� Date: Minimum Permit Fee $72.50 $ _
�UCE C�� _ Plan Review Fee (25% of Permit Fee) S _
(Please print name) State Surcharge (8% of Permit Fee) S ( 1.. , 10
TOTAL PERMIT FEE $ _
Notice: This permit application expires if • 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\MecPemvtApp.doc 01/03
,151111(llllb rlxtul c rr
. � ��
-. • Plumbing Per tilt n FOR OFFICE USE ONLY
Received Plumbing /`�S �,� , , � ��
JUN 7 2003 banning
Permit No.: f
Planning Approval sewer
City of Tigard
Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD Plan Review Other
Tigard, Oregon 97223 BUILDING DIVISIO,' Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: 503 -598 -1960 Post- Review Land Use
we,�: ,iii Date/By: Case No.:
Internet: www.ci.ti and or.u> I 1
g e•I Contact Case : El See Page 2 for
24 -hour Inspection Request: 503 - 639 -4175 Name/Method: Supplemental Information.
' TYPE OF WOR FEE* SCHEDULE (for special information use checklist)
E New constructio ❑ Demolition Description Qty. Fee(ea.) Total
Addition/alteration/replacement ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath �� 24920
1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 1 350.00 150,
Accessory Building ❑ Multi- Family SFR (3) bath t 399.00
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
JOB SITE INFORMATION and LOCATION Fire sprinkler - sq. ft.: Page 2
Job site address: /O Y; J .� G(/ / S & 4.2v A v&_ Site Utilities
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: HAW) kc 3F�2l - 1" - QvJI4 Pt7 Wlf S DryweWUleach line/trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job S t r ,� Manufactttred home urilities 110.00
SL) 1 �c7F�� ' Manholes 16.60
36/I ? Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: /-/AWX 5 G'E/ _D Lot #: / Y% Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: - Fixture or Item .... _.
` .
DESCRIPTION OF WORK Absorption valve 16.60
[7Pl 721A.L 11CP OF r1Eti) ST-Olaf Backflow preventer Page 2
--rCl 016 P ,IEoT ( i cob Sc) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
. •I PROPERTY`OWNER Q TENANT - - , E jec t ots/sump 16.60
Name: AO fJ P, . X Tn vtlN FICAtlES, I_ 1.-C Expansion tank 16.60
Address: gSa, Sv/ ,egtli &A/ SUttk ZZD Fixture/sewer cap 16.60
City /State /Zip: P0212A .rb olz Cri z 9 Floor drain/floor sink/hub 16.60
C C� I/ SS Garbage disposal 16.60
Phone( 3j B S.2 &i so Fax: � ') 92- I Hose bib 16.60
.APPLICANT • :.E CONTACT PERSON, - Ice maker 16.60
Name: ' elk L- geOvJf% S,4SSOCiAl'ES, le.) Interceptor /grease trap 16.60
Address: 95ao S,-.) f gum gi..liA, SU t'i'p 22a Medical gas - value: S Page 2
Primer 16.60
City/State /Zip: F r2.A CL° ct 2 l Roof drain (commercial) 16.60
Phone :(Sp3)f Z- S7S8 Fax (5.0') A.2. 6f / Sink/basin/lavatory 16.60
E -mail: IniAAnte. cl., ell ber3cmna.cce C • Ca r•-‘ 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 w- Plumbing Permit Fees*
Subtotal S 3 S 0 CCB: 149035 PLM: 34-391PB
Minimum Permit Fee $72.50 S
Authorized // Residential Backflow Minimum Fee 536.25
Signature: I.A. /... Date: (X /Z /01 Plan Review (25% of Permit Fee) S
U CE �f v G_ State Surcharge (8% of Permit Fee) S ?��O°
(Please print name) TOTAL PERMIT FEE
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans min isumc....
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
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
2050 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003 -00283
Date Issued: 11/3/03
Parcel: 1 S133AC -HB010
Site Address: 10835 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 010
Jurisdiction: TIG
Zoning: R - 25
Remarks: New SF dwelling.
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. Please 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 received
OWNER: ELECTRICAL CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC ELECTRUM INC
9500 SW BARBUR BLVD., STE 220 DBA SPECTRUM ELECTRIC
PORTLAND, OR 97219 2050 VISTA AVE #100
SALEM, OR 97302
Phone #: 503 - 892 -8758 Phone #: 503 - 361 -1256
Reg #: LIC 116453
SUP - 2 3 -
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x �i -��•-
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
PLUMBING EXPERTS INC
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
Plumbing Signature Form
Permit #: MST2003 -00283
Date Issued: 11/3/03
Parcel: 1 S133AC -HB010
Site Address: 10835 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 010
Jurisdiction: TIG
Zoning: R - 25
Remarks: New SF 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 34-391PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X 7e /
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
F TIGARD 24 -Hour
UILDING Inspection Line: (503) 639 -4175 MST ,9 3-6 0 Z83
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 7 ` 6 AM PM BUP
Location U 3 5 / 1--� Suite MEC
Contact Person Ph ( ) yed, -(4- 5`1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall / r r
Fire Sprinkler - A ' A , _. . / a1 4. •
Fire Alarm
Susp'd Ceiling
Roof
Other:
i t
SS___) PART FAIL
1 P UMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
,, ( r
Rain Drains j LJ
S in /Manhole /
Storm orm Drain
f ,Y
Shower Pan
Other:
Final f
PASS PART FAIL /
MECHANICAL //
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final n Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: _ Unable to inspect — no access
Fire Supply Line r"
ADA l V Approach /Sidewalk Date 7,..7 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 �� - � � L -�
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 7 — AM PM BUP
Location / G W3 s / L' i/1 Suite MEC
Contact Person Ph ( ) St/ ( (( RI 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
Ot r:
PASS PART FAIL
HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final n Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL _
SITE _ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA �C
A
C
pproach /Sidewalk Date /7( 1 / V 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 0266 3 - 60 2 -53
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 7 J Z AM PM BUP
Location / G E 3 S l ( Suite MEC
Contact Person Ph ( ) ce 8 ! c, 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 lar
Ext Sheath /Shear
Int Sheath /Shear
a, PUP P New 'i06 Q
Framing r ' V �sF - 6c-BP •
Insulation OLft 1D t ' P Z— - "21'57 H4-tie
Drywall Nailing
Fire wall 3 L ) G , e � C &
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof D $ R k=�� -- L� q� e' e" k'
Other:
Final Q V LTA
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
Low Voltage
Fire Alarm
SS PART FAIL I I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
I I Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line '
ADA 0 r
Approach /Sidewalk Date 7 v V ( In s p ec tor I _ . .i � ��(' L Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -1-tour
BUILDING . Inspection. Line: (503) ...* -,,4175 ft MST � - 033 — da 2g3
INSPECTION DIVISION Business Line: (51.) 61-171
BUP
Received Date Requested I A PM BUP
Location / 6 g / 3 v d /4-0-4_ G Suite �" / d MEC
Contact Person Ph ( ) - 6 gyp' ? 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 h , 1 , t , (L }!� w` t (} p----v ��� , 7 A-1/4 i i (1 -1=-)
Framing
Insulation -
Vl J� f LJS c ( l�
/ 'i srf C Cl k � ,_ '7 C) b 1
Drywall Nailing `-� j)_,/`.-T: r p �(? l ,
Firewall —5-j L.,1"\/1 Q A L.ZiV% ^ Gd 6 7
Fire Sprinkler
Fire Alarm r � V T .
r`rr
R Ceiling S� \ � �
/� ' t-c -, - . — `�tl.�)
Roof < v _) 1.A--W \ ' V
Other:
k.-
ASS PART FAIL 1
7-) c A-T-A cLub-4---5 .-„....,,,—Q ...st„,„,ot,
PLUMBING /� w - c—A — Q--C(_ ,...,....,,z....,d
Po & Slab /� � 1 1 � \ � �, _ o
Rough -In - '1,l.G --� k esA 1 �Q �V `r/�`-
` v� '� QQ ( , �
�-�'�LA. tk ✓ k �O N ,
Water Service
Sanitary Sewer
Rain Drains V AO , S
Catch Basin / Manhole r \2 C)-- C.-,/NA C--e--- C �A.l �0 ( (,✓ 1
Storm Drain �J
Shower Pan r Ce 5 v n Q & C_/40
Other:
Final Jr ' a PASS ECH PCRT FAIL 1 �1 � ` C ��
MECHANICAL '+ (i�� ` -�/ C C J � �� •
Post & Beam
Rough -In
Gas Line
S.. • e Dampers
'L,
%IP PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Ti Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line llL/
ADA Approach /Sidewalk Date v Inspect U `' y Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL