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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2003 -00276 i c t DEVELOPMENT SERVICES DATE ISSUED: 11/3/03 - I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10945 SW 130TH AVE PARCEL: 1S133AC-HB003 SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25 BLOCK: LOT: 003 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 Tram: 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 FOR: 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: 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 B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,072.45 AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES IN M n is Municipal Code, d the regulations ec C o i the Tlga d u h r ap l a law State work OR. 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 R ° s " 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 lnsp Plumbing Top Out Shear Wall lnsp Water Line lnsp Mechanical Final Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insl Water Service Insp Building Final Footing lnsp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector Foundation lnsp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final Slab Insp Low Voltage Insulation lnsp Rain Drain Insp Plumb Final • Issue By : LZrfA - ' Permittee Signature : LAC, %, j Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day 7'4 _Z- Enil Perm� p 4 FOR OFFICE USE ONLY Received Building Date/By: 4 Permit No.: rlSTaoB3 dca 7e, City of Tigard JUN t Date/By: 2003 D amungApproval Other ate/By: Permit No.: 5edA.200 3 - 5' 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CITY OF TIGAA 8 Date/Bv: ,O •Lt(r0 j5$J3 Permit No.: Phone: 503 - 639 - 4171 Fax$M 1'IVIS '61' 40jl1'. Post - Review Land Use - • t li ∎ I Date/By: Case No. Internet: www.ci.tigard.or.us . ,. • Contact Juris. I See Page 2 for 24 - hour Inspection Request: 503 639 - 4175 Name/Method: Tlt� Z 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 Z. 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 � 91 60 g . (to ❑ Master Builder ❑ Other: valuation ` :JOB SITE INFORMATION and LOCATION No. of bedrooms: .3 No. of baths: Z Job site address: I0S45 S W i 3v"' Avgait Total number of floors 3 1 New dwelling area (sq. ft.) __ ,T Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) J6 Project Name: HAW V.S ?QE.AA 'rc 1l01,M,ES Covered porch area (sq. ft.) IY Cross street/Directions to job site: ^-\ Deck area (sq. ft.) PL Sk.0.r„ /t . Iviue , S.hl 4/ 13tth4 Ks ) Other structure area (sq. ft.) =,,.: REQCIREDDATA::- . ::t.; : ,:'�._ :-..: - - COMMERCIAL:- USE CHECKLIST _ :'`= -• : :I'= ' •:'.:-: Subdivision: 1.4AtdeS K Tadligort4.S Lot #: 3 . 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. Cr,' 4,Sn3uc71 r( or NUJ 3 worry Togii I{-jwtf- 3,et5 (i 46\ Valuation S J Existing building area (sq. ft.) New building area (sq. ft.) Number of stories 3 -.-.Er PROPERTY :OWNER'•-:..: .J..❑ TENANT •- Type of construction V N Name: A JWrn nl PAg K 76�a wl cS i L . L. L . Occupancy group(s): Existing: R-3 Address: 9Soo SW gule &Jib 51/ Of Z2-6 City /State /Zip: ?ore M .A. , 02 q/ 2-19 Phone: 6.1) 692 -$751, Fax :6;3) 2-ge4( NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under V APPLICANT: -`.= . : '-[]. CONTACT PERSON:::; provisions of ORS 701 and may be required to be licensed in the Business Name: )FieEK L, .3,2004 c ASSauA tt / (4 • jurisdiction where work is being performed. If the applicant is exempt Contact Name: ri e K (-titr1cCA) G2 eta z from licensing, the following reason applies: Address: 9So Shi fy..41, I Sl1(7* 224 City /State /Zip: e 012 Q 21 c i Phone :93)912 -else 1 Fax:(5)eots-6V'1 BUILDING:PERNIITFEES _-- :'=:: '': :;: E -mail: n brou)6 ASSDG, CDM '. Please =refe :to:fee`feheduIe. - • • CONTRACTOR • .. _ --r''''''''-' - • -... • .. ... • — • • -- .. : '' _- . .. . - Business Name : . be,Er L. 142C6J1J 4 Agcotte vvt;, Fees due upon application $ Address: 92x) Sal BAt2(iul2 gun) i Split no City /State /Zip: Ebtz - j ,3 O2 7 2 Iel Amount received $ Phone:(�3\ 892-8159 ( Fax: ( St93)PA 2 -884 I Date received: CCB Lic. #: 5869 (24 Authorized f / Notice: This permit application expires if a permit is not obtained within Signature: Date: — ` 180 days after it has been accepted as complete. / Y btiC f"t'r sex *Fee methodology set by Tri-County Building Industry Service Board. (Please print name) • i :\Dsts\Permit Fomas\BldgPermitApp.doc 01/03 • • 1R FOR OFFICE USE ONLY Pylec rieal Per filmEat Received Electrical Date/By: PermitNo.: H 51i/)..92 - 0eic2 `i. City of Tigard JUN 7 2003 Planning Approval Sign Date/By: Permit No.: 13125 SW Hall Blvd. CITY OF TIGARD Plan Review Other Tigard, Oregon 97223 BUILDING DIM!, DateBv: Permit No.: Phone: 503- 639 -4171 Fax: 503 - 598 -1960 Post - Review Land Use t t': Contact Case No.: Internet: www.ci.tigard.or.us e.1 Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 �r Name/Method: Supplemental Information. • TYPE OF WORK PLAN REVIEW (Please check all that apply) e fStNew construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location ❑ Addition/alteration/replacement ❑ Other: pg 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 01 & 2- Family dwelling I ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more ❑ Accessory Building I ❑ 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: 10 a f�5 SGJ I' 3� F+y lit FEE• SCHEDULE Suite #: 1 Blois. /Apt.#: Number of inspections per permit allowed Project Name: ,1.141A/gS 6 1 TQW>.3440NtgS Description I Qty I Fee (ea.) I Total I New residential - single or multi- family per + Cross get W + " A i site: dwe unit. Includes attached garage. U ..S A) 1- 1 16 Service included: d 1000 sa. ft. or less k 145.15 1"17. 15 4 04 Each additional 500 so. ft. or vortion thereof I 1 I 33.40 I 3.40 I TN-464 Limited energy, residential I 1 I 75.00 -- 1 rj ,any 2 1.41,04 KcA Subdivision: LOt #: Limited energy, non residential I 75.00 2 • Tax map /parcel #: Each manufactured home or modular dwelling - DESCRIPTION OF WORK service and/or feeder I 90.90 2 Services or feeders - installation, C o tar - -C-T ( Cr o'er 3 sr alteration or relocation: '-tVG•) . �(. /10/14g J � 2 , 1 , I 200 amos or less I. 80.30 80.3) 2 r r''cZ1�l� - 201 amps to 400 amps 106.85 2 401 amps to 600 amps I 160.60 2 _. .. _. .. _. . , :..• , ;;,, • 601 amvs to 1000 amvs 240.60 �PROPERTY'OWPi R. -..: -- �- CI TENANT'. -- I �/ I IIl q � �'l"t: �rre5 � Over amps or volts 454.65 2 1V ae' A t e ! v (�►� h /� � i L Reconnect nnect nect only nly 66.85 2 Address: g guh co/0-(c 22Z Temporary services or feeders - installation, 7 alteration, or relocation: City/State /Zip: FbrzrL}Ir� C1 . 9 249 200 amps or less 66.85 1 Phone Spc, $1Z-SZSO F (� c -S.Sq( J 20! amvs to 400 amvs 100.30 2 133.75 2 : APPL ANT':.:: "= Q =: � : ❑.CONY Cr PERSON = 401 to 600 amvs • Branch circuits - new, alteration, or Name: le7ZE K L. tom'" e p 14%.3Q44-7 - ' SS X * S / / ,..t, extension per panel: Address: 9SCD � Q.R M RL\ SI) i f Z2O A. Fee for branch f d circuits eeeach c hh ranch circuit oit 6.65 2 of service or feeder fee. each branch circu 1 City/State /Zip: 9),t-; •t , CC 9'7 21 c1 B. Fee for branch circuits without purchase of . q Q ��+ �/ service or feeder fee. first branch circuit 46.85 2 Phone: 60 2 -8 Fax: 5:a ) t} 2, -864 / Each additional branch circuit 6.65 2 E -mail: & ' (1. d 1 tY'o (..),J0.csoc , co.--- Misc.(Service or feeder not included): Each pumo or irrigation circle 53.40 2 T'CONTRACTOR .� - - : - . 53.40 2 r: ; '' -` ': = °' '' ':- � Each sign or outline lighting Job No: -1 A- 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. 1 hour) 62.50 503 -361 -1256 Investigation fee: • CCB :116453/ELC:24- 353C/SUP:2919S Other: . Iectncal Pe - — .. Supervising electrician Subtotal _ 5 13 ,&5 signature required: Plan Review (25% of Permit Fee) $ 3 . 440 Print Nan) th Lic. #: State Surchar:e 8% of Permit Fee $ 2. ' r TOTAL PERMIT FEE $ ' ' ' . D Authorized L Notice: This perm a pplication expires if a permit is not obtained within ' Signature: D ate: LC (( Q3 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. iYly -k N , , seip (Plea& print name) • is \Dsts\Permit Fotmms \E1cPermitApp.doc 01/03 • 1SuJuing r !Atilt Pluinbin 4 n Received PeA FOR OFFICE USE ONLY Plumbing Date/By: Permit No. :/ 03' 06027L, City of Tigard JUN ` 7 2003 Planning Approval Date Sewer By Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.: Phone: 503 - 639 -4171 F I tar IaIOIV Arlfil Post - Review Land Use Date/By: Case No.: Internet: www.ci.rigard.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) (j New construction ❑ Demolition Description I Qty. I Fee(ea.) I Total ❑ Addition/alteration/replacement ❑ Other: New 1- & 2- family dwellings • CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection) SFR (1) bath 249.20 f NI & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 350.00 moo, °° I Accessor Building ❑ Multi - Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Fire sprinkler - s4. ft.: I Pace 2 I Job site address: / 09 1j (Slk) / y A.-►/` Site Utilities Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60 Project Name: HAW S 'a(ikLl -1"GtiJnl Porn.g S D Footing drain (no. linear drain 16.60 Footing drain (no. linear ft.) Pace 2 Cross street/Directions to job 1 , ,, Manufacrured home utilities 1 10.00 S1.,1/43 I �c� '� Manholes 16.60 I 36/lit grr-' Rain drain connector 16.60 Sanitary sewer (no. linear ft.) Page 2 Subdivision: Rj4WA 5 OERi1) Lot #: 5 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 vN.ST2ti.C. T lClJ OF 1 JEIA) I. S i (7tela Backflow preventer Page 2 --M k f , P ( fircoa S -.4 1 Backwater valve 16.60 ✓ Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 •••PROPERTY' OWNER. _-: -D - '.---.-• • . ;-- -•- Ejectors/sump 16.60 Name: AUT() N/I) PA - K T 1A/N i%614/1ES i L Expansion tank 16.60 Address: -I SOO SW lgA,e.g‘jQ &.vb1 SUtri lla Fixture/sewer cap 16.60 City /State /Zip: IpoQT1 D o Z q -i z q Floor drain/floor sink/hub 16.60 r Garbage disposal 16.60 Phone5So3, Sq2 81 S C, i Fax: $33) g 2- SSL I Hose bib 16.60 ; APPLICANT• ....- = ::❑CONTACT PERSON:i• -. Ice maker 16.60 Name: bUEV L. 6QOU1r✓ g 4 Socui- CSS, ii4 Interceptor /grease trap 16.60 Address: 95oo S>...) l 4f&lhe. glib, Su at 2Zo Medical gas - value: S Page 2 Primer 16.60 City/State/Zip: i. CIC Or? L I 9 Roof drain (commercial) 16.60 Phone:( Z- 6758 Fax(go3 &2 b&4( Sink/basin/lavatory 16.60 E -mail: rnAll. [. , di tarrjr.Jna.cco C. . C.a r`'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 ,- • .- ..,._.- Plurnbing• PerniitFees• _." " : ::-.4;: Subtotal S 3 S 0. CCB: 149035 PLM: 34 -391 PB Minimum Permit Fee 572.50 S Authorized } _ // // Residential Backflow Minimum Fee $36.25 Signature: ,(((� _ Date: Z / - Plan Review (25% of Permit Fee) S $Z. S > i t U L E &Vi State Surcharge (8% of Permit Fee) S lei • °D (Please print name) TOTAL PERMIT FEE S 4 ( 0 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 FOR OFFICE USE ONLY t. / r:Viechanical Per>I N - ! - 11 1 !` n Received Mechanical Date/By: Pemnt No.: !' $fe203 - O0,76 JUN 2 7 2003 Planning Approval Building City of Tigard Date/By Permit No.: 13125 SW Hall Blvd. CITY OF TIGAR r/ Plan Review Other Tigard, Oregon 97223 BUILIQING DIVI ON D Post - Rev st -Rev iew Permit se No.: Land Use Phone: 503- 639 -4171 Fax: 503 - 60 A Date/By: Case No.: W Internee www.ci.tigard.or.us ,4 C ."I Contact Juris.: El See Page 2 for 24 -hour Inspection Request: 503 - 6394175 ' 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. �•:` '1 mechanical materials, equipment, labor, overhead and profit. ' & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule ❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE' • Description I Qty I Fee(ea.) Total ❑ Master Builder ❑ Other: Heating/Cooling • JOB SITE INFORMATION and LOCATION - Furnace - add -on air conditioning** 1 14.00 14, Job site address: / QC 45 .5u) /3O A (/IC-- Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Ductwork 1 14.00 (t{.^' Project Name: 1 4WKS - g FA.eb TOW/.) 401M-CS Hydronic hot water system 14.00 Residential boiler Cross street/Directions to job sit (for radiator or hydronic system) 14.00 .SL { �'1/Fi•• 4.1 A JC S Unit heaters (fuel, not electric) - K04-2/1 547)(2ai (in wall, in -duct, suspended, etc.) 14.00 H1+WK$ OE A g,D Flue/vent (for any of above) 1 10.00 10. Repair units 12.15 Subdivision: I Lot #: Other Fuel Appliances Tax map /parcel #: Water heater I 10.00 10. . - • DESCRIPTIONO WORK " • Gas fireplace I 10.00 t0.''"' ` C. y.I 7&C7106J 4 OR - &V 3 S 1 - 0e-t_t Flue vent (water heater /gas fireplace) Z 10.00 20 ''�" '/- j � G , `` Log lighter (gas) 10.00 ��� �� ��� ` �� U Wood/Pellet stove 10.00 Wood fireplace/insert 10.00 Chimney/liner/flue/vent 10.00 PROPERTY OWNER - - • . : I'' 0 TENANT Other. 10.00 Name: itIT(Jr i K 1 �l-�awr e S LLG Environmental Exhaust & Ventilation ,�,'� �}}��,, ) Range hood/other kitchen equipment 1 10.00 (0. W Address: _cm/ ,s42lSI/e IS�-�A / SJ 17.€ Z 26 Clothes dryer exhaust I 10.00 (0. Q City/State /Zip: 2TLD de Q l 9 S in gle duct exhaust • So Phone: 3)gg2. -6758 Fax: (5.)� j 89 2- i 8q( (bathrooms, toilet compartments, 1gAPPL 'ICANT . '[] CONTACT PERSON utility rooms) 3 6.80 20.4 Name: t e& 1... gaot,)� S' �4SSccikr�s /dc • Attic/crawl space fans 10.00 � �� ^ 'g (A s Other 10.00 Address: c7w t ZZC� Fuel Piping City/State /Zip: To z it 47 l ot q-72.19 ••(55.40 for first 4. $1.00 each additional) Furnace, etc. I " Phone: (S03) PR 2- i?i'1S8 Fax: ( 84( Gas heat pump •• E -mail: y pa. t a d 1 brown - dC . cost-. Wall/suspended/unit heater " • . :1., - - . • • CONTRACTOR • • - Water heater I •• Fireplace ep � •• Smart Heating & Cooling LLC Fi r •• 7616 NE Everett St Range •• BBQ Portland OR 97213 -6347 Clothes dryer (gas) ',in, 503 -254 -5096 Other. " CCB: 154133 Total: 3 - 5, i-f0 Mechanical Permit Fees• Authorized f Subtotal: $ 1 �� Signature: ���.. Date: b /°5 • Minimum Permit Fee $72.50 $ I r (JG a co Nom. Plan Review Fee (25% of Permit Fee) $ 3°,95 (Please print name) State Surcharge (8% of Permit Fee) $ I 9 TOTAL PERMIT FEE $ ioit,u5 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 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 -00276 Date Issued: 11/3/03 Parcel: 1 S133AC -HB003 Site Address: 10945 SW 130TH AVE Subdivision: HAWK'S BEARD TOWNHOMES Block: Lot: 003 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 ', //6/4—,4e:////4 - 1'e--- Signature of Authorized Plumber If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ELECTRUM INC DBA SPECTRUM ELECTRIC 2050 VISTA AVE #100 SALEM, OR 97302 Electrical Signature Form Permit #: MST2003 -00276 Date Issued: 11/3/03 Parcel: 1 S133AC -HB003 Site Address: 10945 SW 130TH AVE Subdivision: HAWK'S BEARD TOWNHOMES Block: Lot: 003 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 s a..2,2 3 . ELE 24 -353C AN INK SIGNATURE IS REQUIRED ON THIS FORM X 7„�, �!� .,c Signature of Supervising Electrician If you have any questions, please call 503.718.2433. A4 57 CV3- cr ® AAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA - it. - C V 3 T EE I, _n u/0E CONE , 4 wner C gent for PE R E & 1-. 17R01.01si 4 4S,SDC (PLEASE PRINT) (PERMIT HOLDER) D. ® I�,� f .1 , ' Y V .. is I Ow,, ® Do hereb.. c .ri -f , ate , -� ,-, i F location Ist meets �` ; t . ., • gt on County ® f i r d/ a ' • ® l and use and development standards for street tree installation. 0. ® ADDRESS: / © 9 4.5" <s co /5 0 AVg 44 ra. ® LOT: SUBDIVISION: *14145 fi*EiQAD 1 BY: Ci DATE: lP /¢�7I� ® RECEIVED BY: DATE A VVVVVVVVVVVVVVVVVVVVVVVVVFVVV VVVVVVYTYVVVVVVVVVVVVFVVVVVVVV CITY OF TIGARD 24 -Hour • -BUIdING Elb Inspection Line: (503) 639 -4175 'a 3 • U ��7� INSPECTION DIVISION Business Line: (503) 639 -4171 / BUP Received Date Requested �/ t AM PM BUP Location C1 Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR B Tenant/Owner ELC Fos g Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: `� / r, �f SIT Post & Beam p f 7" 5 ' w Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: (- PAS) PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PAS . ART FAIL ;CAL Post & Beam Rough -In Gas Line Smoke Dampers AVM- 41 11) PART FAIL RICAL 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 V Approach/Sidewalk Date \ k Inspector _ Ext Other: Final DO NOT R MOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST _201 v INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received � Date Requested 4 //4 AM PM BUP / Location l 0 91 26 Suite MEC Contact Person Ph ( ) )4q 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 MPA4 61% Fr ' FGK I 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 fe LECTRIC rvrc Rough -In UG /Slab Low Voltage Fir= ,,, I; Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. aiND PART FAIL Please call for reinspection RE: Unable to inspect – no access Fire Supply Line �p iZL' ADA _ /PI W & Approach/Sidewalk Date � � v Inspector /O. -/ rl� 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 af43 ' 7 ro INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested O / AM PM BUP Location / %S / Vert Suite MEC Contact Person Ph ( ) `7v c _20 Z 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 LE ■ Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ( e Other: Final PASS PART FAIL 42a PLUMBING �� �Z Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: (g? 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 Approach/Sidewalk Date . / / f/ Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL