Permit C ITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2003 -00282
.�lIl DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
1 '�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10845 SW 130TH AVE PARCEL: 1S133AC-HBOO9
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R -25
BLOCK: LOT: 009 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: 149,008.40
OCCUPANCYGRP: 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 BOIUCMP < 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 BR CIR: 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 & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOWPAGING: 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 INTigard Municipal i i al C subject Code, the regulations contained C o i the
a l l o d other Municipal Code, State work k w Specialty Codes and
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 all other applicable laws. All work will be done i
PORTLAND, OR 97219 PORTLAND, OR 97219 t
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 Insi Water Service lnsp Building Final
Footing lnsp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector
Foundation Insp Mechanical lnsp Gas Fireplace Gyp Board Insp Electrical Final
Slab lnsp Low Voltage Insulation lnsp Rain Drain lnsp Plumb Final
Issued B : - _ . .. .1 Permittee Signature : ,...)QOA
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
,° q--Le_- s RECEIVED
. building Permit Application FOR OFFICE USE ONLY
Received g
J z 7 1003 Date/By: � 27/D � P No.:� ,t
/S�.?-0 ^ �Q�..Z
�l
City 01 Tigard CITY OF TI Planning Approval
D Date/By: y: PennitNo.:, rGdgc °C / 67gis
13125 SW Hall Blvd. BUILDING D • N Plan Review _ ?
Tigard, Oregon 97223 Date/By: /0 ' - e' - Wye' "I Permit No.:
Phone: 503 - 639 -4171 Fax: 503 - 598 -1960 a �' j 'i 'I Post
11 DateBy: Case N o
Internet www.ci.tigard.or.us - ��i' Contact Ju ® See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: % /6- Supplemental Information
TYPE OF WORK . . - -
- REQUIRED DATA -
aNew 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
Alg. 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 Li Multi- Family Q j �' 00 8 R Master Builder ❑Other: Valuation , i
-... - _ . SITE INFORMATION and LOCATION .:. - No. of bedrooms: .3 No. of baths: .7 3
Job site address: /0845 SW (33 4 +,4t/E. ' Total number of floors
— / yam ._
New dwelling area (sq. ft.) — S3`
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.)
Project Name: HAWKS 'B App TLM�M _ CS Covered porch area (sq. ft.) 3z.
Cross street/Directions to job site: Deck area (sq. ft.) 72.
51.1 1 TM Av e ,4 S.h/. 1.1,KS 304 Other structure area (sq. ft.)
REQUIRED DATA
COMMERCIAL -USE C ECKLIST r ~. -'�`'
h
Subdivision:(.4A1'(6 tj lu I Lot #: R
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.
Ce49 NELJ 3 srort1 i? 4 l w
iPZ3 _Sea' ( I 4- <Px) Valuation S
/ Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
. PROPERTY OWNER' l ❑ TENANT --- - - = _. - . Type of construction EAEEEEEEE
Name: AUTUT 4J PA K T�j1-lr�ll-bw>eS L .L.G. Occupancy group(s): Existing:
R -3
Address: C? SCC S W e gale &-t, Cu Of Z ZED
City /State /Zip: 'PUerUt , D 2 q 2_19
Phone: 503 642-' -'S ' Fax:6o3) ER2_ f NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
fa APPLICANT 0 CONTACT PERSON r provisions of ORS 701 and may be required to be licensed in the
Business Name: ierFK I„ .E(2L3 J4 L fK$LIUAtiC f (st , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: rvlAe K (4 G2 letCE Pe/4)Z- from licensing, the following reason applies:
Address: g5ao &J f k- l su (7-e 2P-0
City /State /Zip: Pexerubil Oil qi 2a C t
Phone:(S03)012- 6 Fax:( .3jeat'l 8€ t ( . -
.. . ,_B UILDING;PERMITTEES *
E -mail: n- a r k 4. d i brown ASS . C OA
'Please'refei •to fee schedule. '
Business Name: bee L. e2a,JN 4 Asseohste, WG , Fees due upon application $
Address: 950c.) SUI Mme. gun, ( S i irk ZZO
City /State /Zip: 1berub.) oe ? 2 9 Amount received S
Phone:��33 Sg2 -S `l5 ( Fax: 630i 2-884 ( Date received:
CCB Lic, : g(
Authorized 11/247 , /ii7 Notice: This permit application expires if a permit is not obtained within
Signature: Date: l / `( GG( CU 180 days after it has been accepted as complete.
" (Yt . .i ' *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i:\Dsts'Permit Forms\BldgPermitApp.doc 01/03
FOR OFFICE USE ONLY
• Electrical Permit �p�l o>�- Received Electrical
Date/Bv: Permit No.: / 0 3 " Q 1.2 A.2-
Cit CI of Ti and JUN / 211113 Planning Approval Sign
y g Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGAIS Plan Review Other
Tigard, Oregon 97223 BUILDING_ DIVI ON Date/By: Land Permit No.:
Phone: 503 - 639 -4171 Fax: 503-598-196u Post Review Land Use
1111I1, Date/By: Case No.:
Internet: www.ci.tigard.or.us )�, e411 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)
XNew construction ❑ Demolition I — 0 Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: 4 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
5in & 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 INF RMATION and LOCATION Submit _ sets of plans with any of the above.
The above are not a to temporary construction service.
Job site address: O SW ( 3v+�' A�IE�I �E FEE* SCHEDULE
Suite #: I Bl4l;. /Aptt. #: Number of inspections per permit allowed
Project Name: ,,/44 J{<S e --! pc,),J ToffigS Description Qty j Fee (ea.) 1 Total I I
New residential- single or multi - family per +
Cross street/Directions to job site: i mij frs dwelling unit. Includes attached garage.
, ' J ) '50 +bl AVeij Ue S i Service included:
1000 so. ft or less 145.15 1 45. d 4
G SI-Ye•Clir Each additional 500 so. ft or mon thereof l 33.40 I G!<.LO I
Limited energy. residential ( 1 75.00 1 'lc1 .ceg 2
Subdivision: .,,F �I, I L : Lot #: • Limited energy, non residential [ 75.00 I 2
Tax map /parcel #: Each manufactured home or modular dwelling
- DESCRIPTION OF WORK service and/or feeder 1 90.90 2
Services or feeders - installation,
C p4SN/ cT1CJt- C 1/'61 3 sr alteration or relocation:
--tVi..) ( l J le 200 amps or less — — 106.85 c
80.30 L "
A(• CrCWI 201 amps to 400 amps
401 amps to 600 amps 160.60 2
&PROPERTY OWN FR, I. ❑ TENANT _ -- .. , - ,.; .:.. - 601 amps to 1000 amps 240.60 2
,, ,, Over 1000 amps or volts 454.65 2
Name: ��N' 4 rn 1 V n g N.J-19 5 LL Reconnect only 1 66.85 2
Address: C1560 StAj gum @L' ''7 co',.. 22z Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: ebrLrL Ar�, G12 q/ '2,19 200 amps or less 66.85 1
Phone �A) 3 - r7SS Fax:(5o e92 -GAS 1 201 amps to 400 amps 100.30
133.75 " 2
2
[APPL ANT . ?r J CONY Cr PERSOPERSON 401 to 600 amps
o ,,, ,�, Branch circuits - new, alteration, or
Name: K L. �'" e p 5 � � �, c%RiS / extension per panel:
Address: 9SCO S 8i-2JZ» fy....V CQl'f Z20 A. Fee for branch circuits with purchase of
service or feeder fee. each branch circuit 6.65 2
City /State /Zip: 'Rj i , Ge_ 9'7219 B. Fee for branch circuits without purchase of
service or feeder fee. first branch circuit 46.85 2
Phone: 60T) N 2 -8158 Fax: ( 2.) 892 -8E4 / Each additional branch circuit 6.65 2
M isc.(Service or feeder not included):
E -mail: 1M�� r a- d I tee; tA1�A -SSoc , Com 2
. ;CONTRACTOR - Each pump or irrigation circle 53.40
-°" Each sign or outline lighting 53.40 2
Job No: -T-) Signal circuit(s) or a limited energy panel,
Electrum Inc alteration, or extension Page 2 2
Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) 62.50
503 - 361 -1256 Investigation fee:
CCB :116453/ELC:24- 353C/SUP:2919S Other`
.. Electrical Permit: Fees* :,-. . .F._
Supervising electrician Subtotal S
signature required: Plan Review (25% of Permit Fee) S _
Print Name: Lic. #: State Surcharge (8% of Permit Fee) S
/ � / ( TOTAL PERMIT FEE S _
Authorized t, tr l i ij \ 3 Notice: This permit application expires if a permit is not obtained wrmtn
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
m � 1U . -A SeA3
(Pleak print name)
i:\Dsts\Permit Forms \E1cPermitApp.doc 01/03
FOR OFFICE USE ONLY
Y Mec hanical . > tion Received Mechanical
� 'r Date/By: Permit No.: /�l_S < Z.r ` - e' G ,-'
Planning Approval Building
7
' City of Tigard JUN 20U3 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
Post - Review Land Use
Phone: 503-639-4171 1I 9 6ION a ' I Date/By: No.:
Internet: www.ci.tigard.or.us .c.' I Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 - Name/Method: Supplemental Information.
TYPE OF WORK - COMMERCIAL FEE* SCHEDULE - USE CHECKLIST .
permit fees* are based on the total value of the work
New construction ❑Demolition
[ M echanical p Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRIICTION mechanical materials, equipment, labor, overhead and profit.
j'1 & 2- Family dwelling ❑ Commercial/Industrial Value: S See Page 2 for Fee Schedule
Building Multi-Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
❑ Accessory g ❑ am y Description Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 1 14.00 i4 ,61°
Job site address: /Y Sic) /f ij' ± A- ✓E__ Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work I 14.00 14,-
j " ^ (4 - I - � Cc Hydronic hot water system 14.00
Project Name: + W Residential boiler
Cross street/Directions to b siteti (for radiator or hydronic system) 14.00
SW i Iy ! r /47, a S Unit heaters (fuel, not electric)
- 704-2-I S'71ear (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 Q. a.
R epair u nits 12.15
Subdivision: hIAA/KS C,504-g-2 Lot #: 9 Other Fuel Appliances
Tax map /parcel #: Water heater I 10.00 If).'
DESCRIPTION O r F WORK Gas fireplace 1 10.00 10.'‘
Co LtcreuLTlc&) of 141- IA 3 S�oti at Flue vent (water heater /gas fireplace) 2 10.00 24
w� i F Peaj (j46 0 Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
OPROPERTY OWNER I` 0 TENANT : -- Other 10.00
Name: AP 2K - -- 1 - 0 WiJ/ 0/14EC Li'-C Environmental Exhaust & Ventilation
I ' }� hood/other kitchen equipment ( 10.00 10 . 11/
Address: ( 3 30 SW ` ke , $ l t?'€ 220 Clothes dryer exhaust I 1 0.00 l0. e°
City /State /Zip: A grubls de Qz 2 I 9 Single duct exhaust
Phone:(So3) pin. -ASS i Fax: (- ) �� $9 2- ge4( (bathrooms, toilet compartments,
NAPPL' CANT ❑ CONTACT )
r NTACT PERSON utility rooms) 3 6.80 20 . `
Name: t Ee < l••. gOV,.J� fi 14SS MQ'6S, /niG • Attic/crawl space fans 10.00
9 �C) - vgg ( l `' Othe 10.00
Address: c 7W ) t/11� � .W l� z� Fuel Piping
City /State /Zip: `p j l ac q -7 219 * *($5.40 for first 4, 51.00 each additional)
Furnace, etc. *5 E 2 -8"158 Fax: (��E92- �iL'�( Gas heat pump '*
E -mail: y AvZ_ t C d l broc,.)Ac:Lvde , c4,s1-\ Wall /suspended/unit heater `*
CONTRACTOR Water heater I "
Smart Heating & Cooling LLC Fireplace I
7616 NE Everett St Range "
BBQ "
Portland OR 97213 -6347 C lothes dryer (gas) *.
503-254-5096 Other:
•* ,
CCB: 154133 Total: 3 Si 4-i0 Authorized
Mechanical Permit Fees'
7 --_____ : ,
Z
Signature: d .[/f^ ( — k^ Date' / G Subtotal: $ I 1.5. k) /� Minimum Permit Fee $72.50 $ —
7 r )(10 E_ Co J E.— _ Plan Review Fee (25% of Permit Fee) $
r (Please print name) State Surcharge (8% of Permit Fee) $ '. , 'TO
TOTAL PERMIT FEE $ —
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service noaru.
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
, t$Ui1U Jlb .r iA.Lul Ca
' Plumbing Peififffaibillfrifion Received FOR OFFICE USE ONLY
Plumbing ,y
Date/By: Permit No.: / /5/c e/0 � d'�
City of Tigard JUN 2 7 2003 Date/By: Approval Sewer
ateBBy: Permit No.:
13125 SW Hall Blvd. Plan Review ocher
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
(I N� 1�q IO�1 Post - Review [and Use
Phone: 503 - 639 -4171 F 503 =39E 4 0" is Ali,
.w , , Date/By: Case No.:
� ,rii: ,I
Internet: www.ci.tigard.or.us e•I I C ontact Juris.: E 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)
i' New construction ❑ Demolition Description Qty. Fee(ea.) Total
❑ Addition/alteration/replacement ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 Ct for each utility connection)
SFR (1) bath 249.20
E' 1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath • 1 350.00 150,
❑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 - sq. ft.: Page 2
Job site address: /()W45" .S k) /1, A 1J- Site Utilities
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: NkW kS - 60 TQvJri pom f S Drywell/leach line/trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s M anufactured home utilities
SL) l 7 -,c.) I. ' A✓FJl t S. �' 110.00 Manholes 16.60
1 o v Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Pace 2
Subdivision: //,4WK S CEA(] Lot #: 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
C. 6r.(ST2 -Zit OF IY tIA) I. Si (0-∎ Backflow preventer Page 2
-1-CANAJ yp%6 Pa4Qc&r () )was sQ -P4- ) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
E'PROPERTY'OWNER - .. TENANT Ejectors/sump 16.60
Name: AUTUMN) P,49- K T vJN (-Or 4 S, L LC. Expansion tank 16.60
Address: G I S a ) SLR - g j a (3LJa Sulam Z 20 Fixture/sewer cap 16.60
City /State /Zip: poen Qr'ij o2 q z 9 Floor drain/floor sink/hub 16.60
/ Garbage disposal 16.60
Phone 8 S2- 67 5a Fax: (S4 92- S'S'T I Hose bib 16.60
ZAPPLICANT• :. . ::D CONTACT PERSON -• Ice maker 16.60
Name: 1>G l_- 82ouJI) S 45Socui -ri^e, 11.X, Interceptor /grease trap 16.60
Address: 95,00 51.,-) &ft -gut& gu)D r Su irf 220 Medical gas - value: $ Page 2
Primer 16.60
City/State/Zip: Fberl , CL° 2 l Roof drain (commercial) 16.60
Phone )& Z- S7S81 Fax(503)6I2 68 Sink/basin/lavatory 16.60
E -mail: l"1/ Ic d) t>n'3c,ihaCCeC • C.a r,^ Tub /shower /shower pan 16.60
CONTRACTOR Urinal 16.60
Water closet 16.60
Plumbing Experts Inc Water heater 16.60
1 1925 SW Parkway Other. _
Portland OR 97225 -5413 Other. • 503- 469 -0443 .., - °:.Plumbing Permit Fees*
CCB: 149035 PLM: 34-391PB - Subtotal $ 3 S 0 • °°
Minimum Permit Fee $72.50 $
Authorized Residential Backflow Minimum Fee $36.25
Signature: ....' r ` Date: l� /c. 1o� Plan Review (25% of Permit Fee) $
IOW
P U E (&lV� State Surcharge (8% of Permit Fee) S , . °O
(Please print name) TOTAL PERMIT FEE S
~-
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
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
2050 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003 -00282
Date Issued: 11/3/03
Parcel: 1 S133AC -HB009
Site Address: 10845 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 009
Jurisdiction: TIG
Zoning: R - 25
Remarks: New SFA 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 2) 2 3 -S
ELE 24 -353C
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
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 -00282
Date Issued: 11/3/03
Parcel: 1 S133AC -HB009
Site Address: 10845 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 009
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 34-391PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X o� //d
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIGARD 24 -Hour
' BUILDING Inspection Line: (503 9 -4175 m s - 0 6 6 3-00 Z
INSPECTION DIVISION Business Line: ( 3) 39 -4 1
BUP
Received Date Requested �1� — / AM PM BUP
Location /0 L t 5 /3 C Suite MEC
Contact Person Ph ( ) 7 7 PLM
Contr .. Ph ( ) SWR
= ' ILD Tenant/Owner ELC
g 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
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ce' ing
Roof
Other:
in.
PART FAIL
• 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
MECHANICAL
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 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / ( i
Approach /Sidewalk Date t / I nspector �J 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-663 -oda
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received p Date Requested — I AM PM BUP
/0 1
Location / 0 d / 3 t �n - ` 2 -- Suite MEC
Contact Person Ph ( ) 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:
.i,
Or 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 n Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Vir 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 C 3 � Z
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received / G Date Requested AM PM BUP
Location L G p y5 / 3 4--u-e_ Suite MEC
Contact Person Ph ( ) �(o (to PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT IPA
& Beam
Shear Anchors
Ext Sheath /Shear
Ina Sheath /Shear - pet_ N CC - • //d 6 . 8 (5) G FGf � g°7 4 c6
Framing V 'T (5)
Insulation r5-tO b
Drywall Nailing c�
Firewall W at)Cfc &) 136 C n n.
Fire Sprinkler (� 111., J
Fire Alarm
Susp'd Ceiling
Roof ',0 • PI SPDS - NE � G -- ?(6 l�
Other:
Final co
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab R.. 6,6 U 2G4.) 6--D
Water Gip V f
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
PART FAIL n Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA � O
Approach /Sidewalk Date Inspector IC, Nt >R - Y Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING 0 Inspection Line: (503 9►4 75 MST , ==q 06 ��
INSPECTION DIVISION Business Line: (50 ) 63 - 71
BUP
Received Date R equested AM PM BUP
Location / O g 14-S-- l / a d lct.�2 Suite MEC
Contact Person Ph ( ) c((‘2 u f L / 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 `�-�, /
Int Ext
Sheath/Shear Sheath /Shear , U5 Z/T11�1 i / 6L ( ( 3 - t'
Ina „ l n 4 A C ►
Framing /I VV
Insulation / k— 1 V a C n �" - 7 0 4
Drywall Nailing v`� G /� B
Firewall , ._ -- Z Y -� c .
Fire Sprinkler
Fire Alarm
1, �ti5 Q.-e-t/ik---Z--17.\ ∎,e Susp'd Ceiling n A _ , Roof `Q fZ--ei e c v\ ; — rOVO N
Other:
PA PART k U J -j S _. j a
�J
PLUMBING �--Q. 1 \ ✓ WC I
Post & Beam C 'u _ n p _
Under Slab 1 � , V C�-� ,
Rough In i / s � c—,
Water Service _I
Sanitary Sewer �G� cp - ` ` @ ^- l�cl�� ,: Q �M
Rain Drains te-7)\.IPL. C �t
Catch Basin / Manhole V l�(G c ./e.) L....1....... (, )
Storm Drain
Shower Pan
Other: ---51-----)S •
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
'Tina
PART FAIL
ELECTRICAL
Service
Rough-1n
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 r/�
Approach /Sidewalk Date /C1 � � Inspector v v Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL