Permit T. . »-
CITY O F T I GA R D MASTER PERMIT
PERMIT #: MST2003 -00278
DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
A,
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10925 SW 130TH AVE PARCEL: 1S133AC
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 005 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
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 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/F DR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: 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 8. 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 INTigard Municipal c to 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. Th is 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
Red "` 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 Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insf Water Service Insp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab Insp Low Voltage Insulation Insp Rain Drain Insp Plumb Final
M
Issued B : Permittee Signature : _ �gy/
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
' 1 ermBuilding Pitf361.E l R eceived FOR OFFICE USE ONLY
+ Buildi ng
Date/By: ..'/Z ° I /0:3 Perm No.e S% 0 3 - QD-Z 7,Q
City of Tigard JUN 2 7 Date/B Planning Approval Other
g 2�U3 DatelBy: Permit No.: S - guoI
13125 SW Hall Blvd. CITY OF TIGAR � i Plan Review Other
Tigard, Oregon 97223 n Date/By: /0 "Li 'OJ /i '1f Permit No.:
Phone: 503 - 639 - 4171 Fax: § RIVI * ^^ � " !:ri •; Post- Review Land Use
e .� I I Date/By: Case No.
w
Internet: ww.ci.tigard.or.us �' Contact Juris.: ® See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: fi/( Supplemental Information
:. TYPE OF WORK REQUIRED DATA • ?.. • :., • .
ZNew construction ❑ Demolition . I 8i-2 FAMILYDWELLING ..;. :.. :_ . - . -
❑ Addition/alteration/replacement ❑ Other:
• " CATEGORY OF CONSTRUCTION - •. • • . - Note: Permit fees* are based on the total value of the work performed. Indicate
Z. 1 & 2-Family dwelling I ❑ 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
J 0
❑ Master Builder I ❑ Other: V aluation y I / .—
:: TOB SITE INFORMATION and.LOCATION . :: No. of bedrooms: 3 No. of baths: Z
Job site address: 10425 SW 1 to t''it-t/tF de. Total number of floors
New dwelling area (sq. ft)
�✓r3 0 ` ��
8_
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) _ 5
Project Name: HAW KS 'RI€»4I2 `rc - 11414vJVtl;S Covered porch area (sq. ft.) 3 Z
Cross street/Directions to job site: Deck area (sq. ft.) 7 L
SW I'&7• Avalue ■7) S. j. 14t4Kr 304 Other structure area (sq. ft.)
SrM ' _
. _ .��,,. ..REQUIRED DA �� -
COMMERCIAL = USE CHECIOIST u' : : :`'... ..: :' ::.
Subdivision: 1.-A'1.KS gc Tr of #: 5 .
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.
Co4Sr euz:ncrt of NUJ 3 sT Tali! jiv
3,e,(. ( (¢0$) Valuation S
l Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
: P . R O P E R T Y OWNER.. :':..: ..f ::❑ .TEN = 7 . 7 - : - - L : . :: -- Type of construction
'nf�
Name: Aiffb PAig K TdkG•lFbw1.ES L.L.L. Occupancy group(s): New:
R-3
Address: 9S co SW Fite gale- BSI), CU Of Z2-6
City /State /Zip: T?o rLAJ , 0 - qri It
Phone: 601) Rj2 flS Fax :' 3) 6 4( NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
•(r APPLICANT.; ..' .'. s. .: ::-... , : • : '.- ;CONTACT PERSON ' :;-: provisions of ORS 701 and may be required to be licensed in the
Business Name: EieEK L .3r20 r Agszke J (4. . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: mike K (441.19A) a - eLce PeA -oz, from licensing, the following reason applies:
Address: g9D SW C 1 Su ( 2zo
City/State /Zip: pbeg Oil Q'l 21 `l
Phone: -6 Fax:(So -iiB°t2-5 4( .... .. . . . . . . . _ . ..
•BUILD :'
E -mail: rrtia..rk 44 b r ASSVC. , COi► - •► ' Tlease.refer:to Tee ;fehedule. -
.._.:. .: CONTRACTOR
Business Name: 'beat L. (4e,...) 4 As wore, ".J6, Fees due upon application S
Address: 91x) Zvi gAfl.Lme. gurb svec ZZO
City /State /Zip: Rj¢r iko i Q2 —i Z 9 Amount received $
Phone: 8 9
�So 692 -81SO [ Fax: �s�3) 2-804 Date received:
CCB Lic. #: 8699 r
Authorized 4( e (o Notice: This permit application expires if a permit is not obtained within
Signature: Date: "` days after it has been accepted as complete.
04 4 /� *Fee methodology set by Tn-County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Fotms\BldgPermitApp.doc 01/03
Electrical Perini FOR OFFICE USE ONLY
Received /ST�O 03 Doc? 74
�
Date/By: y: Ferm Perm N it No.:
City of Tigard Planning Approval Sign
J IIAI � ! 2 Date/By: Petm itNo.:
13125 SW Hall Blvd. 111Y Plan Review Other
Tigard, Oregon 97223 CITY OF TIGA 0 Date/Bv: Permit No.:
Post - Review Land Use
Phone: 503- 639 -4171 Fax: 5(i a `4,` DIV t: . 4‘ ,,N ,,I • Date/By: Case No.:
Internet: www.ci.tigard.or.us _I o f II Contact Airs.: 0 See Page 2 for
24 -hour Inspection Request: 503 - 6394175 ' - Name/Method: Supplemental Information.
TYPE OF WORK 1 PLAN REVIEW (Please check all that apply) •
'New construction ❑ Demolition I ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: ig 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
a1 & 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 I ❑ Other: ❑ Egress/lighting plan ❑ Other:
- JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
T he above are not applicable Job site address: loci 25 SW (30* q� tit plicable to temporary construction service. FEE* SCHEDULE
Suite #: pp Bldt?. /Apt. #: Number of inspections per permit allowed
Project Name: ,./4 6la'J'! TQW/-ji-rO nil E s Description I Qty I Fee (ea.) I Total I I I
New residential - single or multi - family per i
Cross street/Directions to job site: �, dwelling unit. Includes attached garage.
W
,S 1 -I''` A 1 / ue SA) - t / Service included:
� 1000 so. ft. or less E 145.15 146. 1 . ‘ „? 4
3 c244 Each additional 500 so. ft or portion thereof Z I 33.40 I 66 D 1
,�• n I Limited energy, residential t I 75.00 I 1' A:, 2
Subdivision: ' 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 1 90.90 I 2
J r Services or feeders - installation, I
/' ^ t CT1 Chi C Ai 61,J 3 sr alteration or relocation:
-t5W r 1 ) � l - , 200 amos or less I 80.30 2
W, t-,`CV✓�C f''�� 1 201 amps to 400 amps 106.85 2
401 amps to 600 amps I 160.60 2
-.
I, -❑ .... _. ..::: - 2
�PROPERTY'O R... . _ . TENANT -
601 amps to 1000 amps 240.60
t r U v ► L wis Reconnect nect amps or volts 454.65 2
Name' Nil � e � � dam/ t'+'Ti � Reconnect only 66.85 2
Address: ( 1560 SA) gale- gl-kh SUi - (c. 22Z Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: Fi)IZT uh.% CZ q- c 'a i 9 a 200 amps or less 66.85 1
Phone(spc) 8 92 -a FaX: (�)U9Z—(.'8q( J 201 amos emus 100.30 2
401 to 600 0 amps amps 133.75 2
: APPL ANT'S:::: "= Q ': , = : - • ❑-CONT Cr PERSON -- = - ` Branch circuits - new, al or
Name:19 K L. f4�.J� e S ch-res 1 l nX , extension per panel:
Address: 9C CO � &1.9 m Imo\ cut Z20
A. Fee for orfeedciree, each c hh purchase circuit 6.65 2
of
service or feeder fa, each branch circu
City /State /Zip: ,Z; t1'1 , O2,. c) C1 B. Fee for branch circuits without purchase of
service or feeder fee. first branch circuit 46.85 2
Phone: 6 Z) N9- 5$ Fax: (So3) 892—self / Each additional branch circuit ' 6.65 2
E -mail: rrar K Q.. d 1 trio Lo•Ja -cSOC , cOM Misc.(Ser +ice or feeder not included):
Each pump or irrigation circle 53.40 2
• r;; = - _'' CONTRACTOR Each sign or outline lighting 53.40 2
Job No: -ne k 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 an of the above:
Per inspection per hour (min. I hour) 62.50
503 -361 -1256 Investigation fee:
CCB :116453/ELC:24- 353C/SUP:29195 Other
`" :.. .Electrical. Pertnit:Eees - -
... .•_ -- .. .rte :�, __... .. -.. .
Supervising electrician Subtotal $ _
signature required: Plan Review (25% of Permit Fee) S _
Print Name: f Lic. #: State Surcharge (8% of Permit Fee) S
_
zed TOTAL PERMIT FEE S J
Aut // �` Notice: This permit application expires if a permit is not ....um' w
Signature: «<///( Date: `w 180 days after it has been accepted as complete.
t 1 e,,�, *Fee methodology set by Tri -County Building Industry Service Board.
MAYt t
(Plea print name)
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
-' 15ll11C1111b r IALLLl Ca
Plumbi Perm1 Received FOR OFFICE USE ONLY
Plumbing
1 Date/By: Permit No./zarPoO,l - dap 78
City of Tigard JUN Planning Approval Sewer
JUN 7 2003 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 g�I C u ITYOF TIGARD Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: " � 0 5 ' AN IVISI4 Post - Review Land Use
+ Date/By: Case No.:
Internet: www.ci.tigard.or.us a (� J 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. I 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
® 1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 1 350.00 'Uo,
❑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: /O' ,25 ,s /SQ *Li_ 4•(/ Site Utilities
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: HAN k 3Et -2, 'rGkl IJ portn.f S DryweWleach line. trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s t Manufactured home utilities 110.00
5.,k) l �c��� S. �' Manholes 16.60
36/11t Q -ria -( Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
r Storm sewer (no. linear ft.) Page 2
Subdivision: f f j4(n/K 5 06/4-1) Lot #: 7
Water service (no. linear ft.) Pace 2
Tax map /parcel #: . -- . - Fixture or Item • . `
DESCREPTIONOF WORK Absorption valve 16.60
(' v/.(5� 2LA.c TIC,J OF IV ElllJ ST Backflow preventer Page 2
- ro, .1 +!vw P2,sl €LT ( 111 ( o & Sp, -12.e) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
-21 ..- ::= I.: 0 TENANT - :.- • :::..- Ejectors/sump 16.60
Name: A11r7vt1 /J PA e- i< T vtliVF cWVieS L1--C. Expansion tank 16.60
Address: (i5 ) SW Eil egve (A).16 SUING Z Za Fixture/sewer cap 16.60
City /State /Zip: Po2TLAT..6 02 a z ig Floor drain/floor sink/hub 16.60
�/ Garbage disposal 16.60
Phone.{ 3j $q2- 67 5o 1 Fax: (S(13) 8 SS'T I Hose bib 16.60
:;APPLICANT• ...::_: :'- .. - .:.- :12-CONTACT PERSON: -..... Ice maker 16.60
Name: i>ae.EV L. 62Ou/lJ i ASSOCiA4'`C ji.X, Interceptor /grease trap 16.60
Address: 9560 S fete. gee. gl.11D, Su It 22cW Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: F},1212. , Cc. q i Roof drain (commercial) 16.60
Phone(c03)84Z- 675e, Fax ( S ' 5 2 661{1 Sink/basin/lavatory 16.60
E -mail: pr 1 7 d.1 t c r a CCei e, . Cr 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:
:. -; 'Plumbing Permit Fees* - .
503- 469 -0443 ...,. ::.,...:. ..... .
Subtotal $ S S L7 • °D
CCB: 149035 PLM: 34-391PB Minimum Permit Fee $72.50 5
Authorized / / Residential Backflow Minimum Fee 536.25 _
Signature: /�t Date: Z O� Plan Review (25% of Permit Fee) $ _
� r U Cj_ C.-6)N(` State Surcharge (8% of Permit Fee) S . °
(Please print name) TOTAL PERMIT FEE S � f.
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans w ad i su ie ur
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
FOR OFFICE USE ONLY
Medial______ kcal P er Received Mechanical -,
Date/By: Permit No.: /1-.5 7e -.7. )i - e G
Planning Approval Building
City of Tigard JUN 2 7 2003 Date/By. Permit No.:
13125 SW Hall Blvd. Plan Review other
Tigard, Oregon 97223 CITY OF TIGAR I Date/By: Permit No.:
Post- Review Land Use
Phone: 503 6394171 Fax: afaLDINJG !) VIS -` 1 . ia
Case No.:
W Da te/By:
Internet: www.ci.tigard.or.us - , .'II l
Contact Juris.: See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
::: TYPE OF WORK . -- - _ : ' = COMMERCIAL FEE* SCHEDULE - USE CHECICLIST • - --
H 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.. f- ..
mechanical materials, equipment, labor, overhead and profit.
E'l & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
El Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS. FEE *SCHEDULE.: •
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE INFORMATION and LOCATION - Furnace - add -on air conditioning** I I 14.00 14,00
Job site address: /092 S a/ /59 t- A C/ Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work I 14.00 (4.4'
�KS . gelid 1-0v.1� 14OW� - .gS Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions �/ to job site A���S, (for radiator or hydronic system) 14.00
SW t I ` . ✓ Unit heaters (fuel, not electric)
.7 .4N2Lei (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) l 10.00 10.
Repair units 12.15
Subdivision:///w“ (cl�f}pD Lot #: �j Other Fuel Appliances
Tax map /parcel #: Water heater I I 10.00 I0.
. • • • DESCRIPTION OF WORK Gas fireplace 1 10.00 t0.'"'
Col OR jj(J 3 S IE,L.( Flue vent (water heater /gas fireplace) Z., 10.00 20 • iO
Log lighter (gas) 10.00
���� Pea -��- ( ` 146 0 Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
PROPERTY•OWNER -- -... .I: - TENANT ... . -_ Other. 1 10.00
Name: A., 1m 4 2 n K To W'd r 4 I S LLC Environmental Exhaust & Ventilation
7l v' t7`T" ) Range hood/other kitchen equipment I 10.00 10 . 4)
Address: qS)d Sh/ j, 4Q ue ig LA / S1! IX- 726 Clothes dryer exhaust 1 10.00 (Q . '°
City /State /Zip: Qat2TL tA, de Q ( d 9 Single duct exhaust
Phone :(Sox) 8 -8 Fax: ($E j 89 2- 8841 (bathrooms, toilet compartments,
[APPL CANT . • El-CONTACT PERSON utility rooms) 3 6.80 20
Name: 1>EziE( L.. i aot,J� & A cMr`ec NC. • Attic/crawl space fans 10.00
Other. 10.00
r.
Address: Q 1fb2g✓YL (_JD Si/lT1E OW Fuel Piping
City /State /Zip: `Pb2iZ4fs)j 1 012. 9'7249 '•($5.40 for first 4, $1.00 each additional)
Phone :(SoSI 2R2 -8'158 Fax: (.,11e.541,-084( Gas heat e um I
e p **
E -mail: rr L L (2 d I brocunaS4cic ,Gas► --\ Wall/suspended/unit heater
• CONTRACTOR • . Water heater I Sc
Smart Heating & Cooling LLC Fireplace 1 '"
7616 NE Everett St Range
BBQ
Portland OR 97213 -6347 Clothes dryer (gas) **
503 -254 -5096 Other.
CCB: 154133 Total: 3 5, 40
Mechanical Permit Fees*
Authorized d z��v3 • Subtotal: $ 12 3. 'A0
Signature: /�� / Date: Minimum Permit Fee $72.50 $ _
/ /eU C•,6 co,JE _ Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ q.. 'TQ
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
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 -00278
Date Issued: 11/3/03
Parcel: 1 S133AC -HB005
Site Address: 10925 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 005
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
R #: LIC 116453
SUP 2
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 -00278
Date Issued: 11/3/03
Parcel: 1 S133AC -HB005
Site Address: 10925 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 005
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
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
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CITY OF TIGARD 24 -Hour r,
BUiLDIII.G 41 Inspection Line: (503) 639 -4175 jj �� 3 ^ U 2 7
. NSF. CTION DIVISION Business Line: (503) 6 - 1
BUP
Received Date Requested Le k AM PM BUP
Location l n '9 ZC 4 F+ Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
B 4a, 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
O . = r:
Fi.:i
SS PART FAIL
BING `` (\59-1
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer 17./1/
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS • - T FAIL
M 7 411= L
Post :earn
Rough -In
Gas Line
Srrtolse Dampers
ina .
PART FAIL
ECTRICAL
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 w
/ p
Approach/Sidewalk Date / \ J I nspector �" 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 MSi 6 '03 - ' 66 D- 7 k
INSPECTION DIVISION Business Line: (503) 639 -4171
Q' BUP
Received Date Requested ( O � v AM PM BUP
Location / D 7. 0 6 e l'h - 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 c
Framing
Insulation
Drywall Nailing
Firewall ,
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: / 4 ' � ��
Final t��� �i..__ �� r�iL+a. .
PASS PART FAIL 'war'
PLUMBING
Post & Beam
Under Slab °
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot
e S PART FA 1
HANICAL
. -& 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: 0 Unable to inspect — no access
Fire Supply Line
ADA OM /17
Approach/Sidewalk Dat Inspector � t
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 3 -�o a
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested PM BUP
Location AD y�,� � ,�O ' � Suit ' ` MEC
Contact Person ,4 7.« «— Ph ( ) rJ(p� "' -1/1 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 C4)
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall p.P � F _ P " '
Fire Sprinkler 1
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)
•
e
Rough -In
UG/Slab
Low Voltage
Fire Alarm
i PART FAIL 111 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 Date 16M 1 < 1 p PLBL5 5 Jt
Approach/Sidewalk J 1 Inspector
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 023 66011
INSPECTION DIVISION P Business Line: (503) 639 -4171 a
Received Date Requested l� — j
_ Req l AM PM B P
Location � t) 9 1 a 3 6 S A- Suite _ MEC
Contact Person Ph ( ) 266 — 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 ' / � `� / ` F? -
Framing V �/ ( (
/�
Insulation
Drywall -]� Y
Dwal Nailing ) ) �\ CiA � T ` ® �
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
•ASS PART Al
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
• SS PART AI
• 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
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL