Permit f MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2003 -00316
1r ;a
i��y DEVELOPMENT SERVICES DATE ISSUED: 12/23/2003
s 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
SITE ADDRESS: 10825 SW HUNTINGTON AVE PARCEL: 1 S133AC -HB061
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 061 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: 484 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRP 709 sf RIGHT:
VALUE: 147,744.80
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/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps- 1000x: MINOR LABEL:
1000* ampNolt :
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: $ 6,065.71
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES This permit is subject to the regulations contained in the
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 i and all Municipal laws. pal Code, of I OR. o k w wil b o ne i n
PORTLAND, OR 97219 PORTLAND, OR 97219 acct rd ra cer applicable ed Al. This permit done in
accordance with approved plans. This permi t will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 892 - 8758 Phone: 503 - 892 - 8758 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 58699 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Plm /undslb Insp Plumbing Top Out Shear Wall Insp Water Line Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insl Water Service lnsp 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 lnsp Rain Drain Insp Plumb Final
Issued By : .CTJ! -�. Permittee Signature : .
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
< .
< . FOR OFFICE USE ONLY
Ao Building Permit Application FOR
9�
. 1 Date/By: V iz 4 OP PermitNo.t1S1. - 003/ �o
City of Ti ECE I V E D Planning App val ' Other 1 A ® � y1UriV
°�/1 q
D y i
13125 SW Hall Blvd. Plan eB Review : o ther t No.� �+�/
Tigard, Oregon 97223 J N 2 7 2003 Date/By: /0' 23 -o3�13S1s Perm Permit No.:
Phone: 503 - 639 -4171 Fax: 503 - 598 -1960 ' I � Date/By: Case No. , L at Post - Review Land Use
Internet: www.ci.tig�tdT�tDF TIGARD - ' ( �. Contact Jtnis.: ® See Page 2 for
24 - hour Inspection likkildatiNODSVOS405 Name/Method: TW Supplemental Information
TYPE OF WORK
. - . REQUIRED DATA:'
ZNew construction El Demolition . • , 1 &2 FAMILYDWELLING : :. : - •
❑ 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 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 $�
El Builder El Other: valuation $,fl �q.
::::JOB SITE INFORMATION-and.LOCATION -: - No. of bedrooms: 3 No. of baths: Z
Job site address: 1062 -5 f'{(f 7/ t& /WAVE Total number of floors 3 —
New dwelling area (sq. ft.) / tts-3 —
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) • stet
Project Name: HAW VCS %FAA "ro.-114ftoM,65 Covered porch area (sq. ft.) s
Cross street/Directions to job site: Deck area (sq. ft.) F
sk.1 1&, .n, RVegVe ,4 S.h/ {(itWKT 3I Other structure area (sq. ft.)
S - ::;:: REQUIRED'DATA: _ -
-
COMMERCIAL. - :USE CHECKLIST :: -.
Subdivision: A*1 S (,F `,d, IThMkoviS Lot #: (p
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
' - r.:': .. DESCRIPTION OF • ,••• the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
C049r -cT ( of NELJ 3 srove.1 Toeul1 vig.
-Pez,Ea" Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
::jrPROPERTY:OWN•ER :•:. • f ID TENANT "•:'-= .7 _. Type of construction V N
Name: A Uf lin 4 Pr t K - 76% , 1/41 -1 15446 - i L . L • - . Occupancy group(s): Existing:
R-3
Address: gSoc) S W We gtJ� &-lllj Su 1) ,E . 27_6
City /State /Zip: 'PolorMO , 02 q 2.19
Phone: 601) 9i2-i3ISS Fax :&3) Pf32 -g34( NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
IR`APPLICATITr • ::••- -`. ' : : -ID: CONTACT PERSON-. :.: ;: provisions of ORS 701 and may be required to be licensed in the
Business Name: .e.K 1.. at2Ot.L4 c ASSCGAPtf I (4, , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: Mike K (-WSW 02 2tcL PeiwZ from licensing, the following reason applies:
Address: gSto SI,J €doe- &IZZI, I Su (7.e 2Z.0
City /State /Zip: km2_ ubi Oil q t.
Phone:(3)092 -6`158 1 "1 Fax: &5ije°t2-6e4( :... •• - ... • ....:.. • .
BUI LDING PERMIT' FEES*' 7: :—:: "- 1r*-.:
E -mail: - r K. 4 d l b roc.►Jn ASSVC. , COM - .Pl refer. :to fee`schedule:• - •
- ' ,........•.. ......, ....... .. - - -. _ - . • - .
-, •.: -� ._:. ..' .•CONTRACTOR :�, :._ :. .
Business Name: 'beat L. 11J 4 AS a.MIM vvG Fees due upon application $
Address: ' X) Sint gAt&M BLVD i Stltic ZZo
City /State /Zip: f bizr/ t3 Q2 - 1 2 I9 Amount received $
Phone:(3� 892-5 Zsb , ( F ax: ( 5 -63 2 -884 1 Date received:
CCB Lic. #: $( ° •
Authorized ( / 1 �p1 Notice: This permit application expires if a permit is not obtained within
Signature: ••//�� ./ � Date: `l ( ti 180 days after it has been complete.
accepted as com
gn I Y P P
1 r l/W?_ ' 1 `.. t kik4 0, .Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) •
i :\Dsts\Permit Forms\BldgPermitApp.doc 01/03
' t electrical IEB6,t,_48pgliifation FOR OFFICE USE ONLY
Received Electrical Received
Permit No. : iSte 2 0U3 ' OD3/(p
C of Tigard Planning Approval Sign
Date/By: Permit No.:
13125 SW Hall Blvd. JUN 2 7 2Uui Plan Review Other
Tigard, Oregon 97223i,, F
1446 l Date/By: Permit No.:
Phone: 503- 639- 417i' c:u 01 J60 Post-Review Land Use
1.1 i• I {
Internet: www.ci.tig fY 9n1f9 NG DIVISION .7 e II Contact Juris.: Date/By: Case No.: ® 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)
1St N ew construction ❑ Demolition ❑ Service over 225 amps- ❑ Health-care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: 0 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
ig1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building 0 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: 10925 510 44ukfro4r7Zwi /Waive FEE'''' SCHEDULE
Suite #: B1(la. /Apt. #: _ l' Number of inspections per permit allowed
Project Name: , 4 gs Icem , fi ,J1 E S Description I Qty I Fee (ea.) Total I
New residential- single or multi - family per 4' +
Crose\ I _x
street/Directions Q . 4- v to site: \ dwelling unit. Includes attached garage.
/ R v�/J U� �d„n_]Gx� - I-- Service included:
1000 a. ft or less E 145.15 I 4
3 Each
Each additional 500 sq. ft. or portion thereof 1. I 33.40 � ages 8v I
, V i� / ( Limited energy, residential ` I 75.00 .ao 2
Subdivision: 1 1..- IV/�tAj ,� 7 1 61 fJ vw" Lot #: (Q Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK. service and/or feeder 90.90 2
fC � Services or feeders - installation, - -
t c • of .J 3 sr alteration or relocation:
�L): ^� / r / 200 amps or less - 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
: :.I ame: - - RTICO R TENANT:: ' -' - _. _ 601 amps to 1000 amps 240.60 2 • Over 1000 amps or volts 454.65 2
Jgame: 40'� PAi2 K �QW N3 jti ff L I Reconnect only I 66.85 2
Address: C SW �+2 -gU� guh SUiNc. 2 w 2.z Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: 1:1)2.11A-7-) 2 t 91 c 249 �Q 200 amps or less 66.85 1
Phone (Sp') $92-�J�SS Fax (- A�92 -S 1/ 201 amps to 400 amps 100.30 2
A m
401 to 600 amps 133.75 2
APPL T:- , . ::`;; - - -- :: . ❑•.CONT CT.PERSON - -
Branch circuits - new, alteration, or
Name:'1 ZE . L. .h3 e- 4S r 5 /At,
extension per panel: of
Address: 9Sco SW 2f4J'lf (L'. a 5QO € Z2O
A. Fee for branch f feeder r fee. each purchase circuit 6.65 2
service or feeder fee. eac branch circui
City /State /Zip: RNeT 1.AA , oe. 9'1 2 i q B. Fee for branch circuits without purchase of .
p.., 692,-864/ service or feeder fee. first branch circuit 46.85 2
Phone: 6, Z-J'f �^ 7 - `58 Fax: ��3 \ 1 Each additional branch circuit 6.65 2
E -mail: W) n,,' 4.. d I tea t.J/J0.cSoc ' Com Misc.(Service or feeder not included):
• Each pump or irrigation circle 53.40 2
= CONTRACTOR ..� . - .. 53.40 2
� =" a i r=:.= " , _ .:: :. - — Each sign or outline lighting
Electrum Inc Signal circuit(s) or a limited energy panel,
2050 Vista Ave #100 alteration. or extension Page 2 2
Description:
Salem OR 97302
503 - 361 -1256 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) 62.50 ,
CCB:116453 ELC:24 -353C Sup:2919S Investigation fee:
Lic. #: Other
CCB Lic. #: I - , ... v.';'.: Electrical,Perm(t'Eetie .' =;. q . .
Supervising electrician Subtotal $ _
signature required: Plan Review (25% of Permit Fee) $ - -
Print Name: I Lic. #: State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $ •
Authorized , / i Notice: This permit application expires if a permit is not obtained within
Signature: �J • Date: 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
(Plea& print name) •
i:1Dsts\Permit Forms \ElcPermitApp.doc 01/03
"i FOR OFFICE USE ONLY
/
Mechanical canon Received FOR �1
Date/By: Permit No. J2.
/1 �003' 0 /'
.IUN 2 7 2003 Planning Approval Building
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD Plan Review Other
Tigard, Oregon 97223 B.JILDING DIVISION Date/By: Permit No.:
Post - Review Land Use
Phone: 503-63941 tax: 503 - 598 -1960 t;a Date/By: Case No.:
Internet: www.ci.tigard.or.us 11h I 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
❑ 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.
R1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDENTIAL EQU PMENT /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 14.00 (',''
Job site address: /0E25 5 A/U9117/AJ670N A UE Gas heat pump 14.00
Suite #: Blddg. /Apt. #: Ductwork 1 14.00 I (4.
KS "g1✓ U T �OV� -'S Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions t� . ���CS (for radiator or hydronic system) 14.00
3o
sw j ! `v Unit heaters (fuel, not electric)
-geA-g-I 5a 6i-- (in wall, in -duct, suspended, etc.) 14.00
/-/- V
'' // ,� 7 ' Flue/vent (for any of above) 1 10.00 (D Q. °'
Repair units I 12.15
Subdivision: g1� Lot #: (� J Other Fuel Appliances
Tax map /parcel #: Water heater I l 10.00 10.'
- DESCRIPTION OF WORK • Gas fireplace 1 10.00 l0.'"'
�y, .(. of Dt‘C(A) 3 i S - a t- Flue vent (water heater /gas fireplace) Z-, 10.00 20
�(A)i t tl7 n?Jr P / j 4 6 �) Log lighter (gas) 10.00
l 'L Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY OWNER - - 3 I' ❑- TENANT - -- . Other. 10.00
Name: rv1 T WiJflawiec LI,G Environmental Exhaust & Ventilation
Range hood/other kitchen equipment I 10.00 l0. w
Address: (3QJ SW %/wee IgLA / SJ Z7 2 Z ZO Clothes dryer exhaust 1 10.00 1Q. °o
City /State /Zip: Qotert d2 Q (9 Single duct exhaust
Phone:(' o3)e _8 7 I Fax: (5,) ) 892 - 86't1 (bathrooms, toilet compartments,
- [APPL CANT . I ❑ CONTACT PERSON utility rooms) 3 6.80 20 • 4
10.00
Name: L-. (gt?oct1' S A-SSCGIM cc, /�C • Attic/crawl space fans 10.00
� �� ^ ' g �A &,17. Other
Address: c) w 220 Fuel Piping
City /State /Zip: `�ociZ.4i.) _ l ot 9-72.19 * *(x5.40 for first 4, 51.00 each additional)
Phone:(So3) PR2- �'i'l56 Fax: ��?2 �'�-�i Furnace, etc. I `•
Gas heat pump
E -mail: mpg t C d 1 beocJno -SSc)C . C.0n. \ Wall /suspended/unit heater •`
.. • • • CONTRACTOR Water heater
Smart Heating & Cooling LLC Fireplace 1 "` Range ••
7616 NE Everett St BBQ ••
Portland OR 97213 -6347 Clothes dryer (gas) ••
503 -254 -5096 Other. •• t
CCB: 154133 Total: "S , 5,''f0
Mechanical Permit Fees*
_
Authorized
kt-C/C � ,n Z 3, �� Signature: �� W�f'i Date: /2 /U� Subtotal: $ I _
_ Minimum Pemrit Fee $72.50 $ E C9K)L= Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) , $ CI, , 10
TOTAL PERMIT FEE $ _
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry .,v..,« uua. u.
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
1Sullulug r 1Mul CJ
'Pluinbing Permit A plication FOR OFFICE USE ONLY
1 Received Plumbing H
• 111E1; V . Date/By: Permit No.: t 1.1%X0.3 -.06)34, C of Tigard Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. JUN 2 7 20111 Plan Review ocher
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: G El AKU Post - Review Land Use
U+v Date/By: Case No.:
Internet: www.ci.tigard.or.IBUILDINC DIVISI t. Contact Juris.: lE See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 -- 7 NameiMethod: Supplemental information.
TYPE OF WORK • FEE* SCHEDULE (for special information use checklist) I
(si New construction ❑ Demolition Description I Qty. 1 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 1 -1- 249.20
Cg 1 & 2- Family dwelling I ❑ CommerciaUlndustrial SFR (2) bath ! 350.00 moo,
Accessory Building ❑ Multi- Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: I Each additional bath/kitchen 45.00
- .. JOB SITE INFORMATION and LOCATION I Fire sprinkler - sq. ft.: Page 2
Job site address: /082 5 . C A 1 I h U N T / N C 7 Z ) j 4 V I Site Utilities
Suite #: Bids. /A.t. #: I Catch basin/area drain 16.60
Project Name: AU) k� 3F ) TovJt' , • N/lG C Fo rain (no. i ar drain 16.60 Page
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job sit Manufactured home utilities 1 10.00
SLJ l �C�� ' Manholes 16.60
36,14. z L)r Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: /f j4WK S GE/ J) I Lot Pr: (p / Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: - 1 Fixture or Item -
. . DESCRIPTION OF WORK I Absorption valve 16.60
C. f)N.Sr - i tc nctJ OF r4EIA) S oel-/ Backflow preventer Page 2
17 Al i PO -i).€(/1 ( ). ( o&j S 4l &) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
..E'PROPERTY'OWNER . - -: ❑•TENANT Ejectors/sump 16.60
Name: AUTUW l P,4t2 K T wlN 1 i L'LC - Expansion tank 16.60
Address: q CO s SW ,e.gv2 goie / SUcN Z Za Fixture/sewer cap 16.60
City /State /Zip: PO 2T]ittr.4;, Q2 q-1ztq Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone {So3) 8 S2- 8158 I Fax: (Sc�3) S 2- SS ( I Hose bib 16.60
;APPLICANT' - =: '- . - ' :❑ PERSON-:-- Ice maker 16.60
Name: bi✓,I iV L. &200 S,4SSoCui -`E , '',IL Interceptor /grease trap 16.60
Address: 9560 St. gte.gue, gL,Ike, Su at Z2a Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: Ut2)S , CE q-72, l 9 Roof drain (commercial) 16.60
Phone(S03)89Z- 6758 Fax (So3' 6 &4/ Sink/basin/lavatory 16.60
E-mail: vv tl . L d I taer3c..)ri a ccc9 c . CO Tub /shower /shower pan 16.60 ,
CONTRACTOR ...... " Urinal 16.60
Water closet 16.60
Plumbing Experts Inc Water heater 16.60
11925 SW Parkway Other.
Portland OR 97225 -5413 Other:
503 -469 -0443 ;.. `Plumbing Permit Fees* ::
._:_' '
CCB: 149035 PLM: 34-391PB - Subtotal $ 3 S 0...
Minimum Permit Fee $72.50 $
Authorized /`
//'' Residential Backflow Minimum Fee $36.25
Signature: � �A4i Date: G(� /Zl! /G� Plan Review (25% of Permit Fee) $
(/ (&i'/(` State Surcharge (8% of Permit Fee) $ 20. °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 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 -00316
Date Issued: 12/23/2003
Parcel: 1 S133AC -HB061
Site Address: 10825 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 061
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 3'
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signa ure of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
) 11V
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 -00316
Date Issued: 12/23/2003
Parcel: 1 S133AC -HB061
Site Address: 10825 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 061
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
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Sig ature of Authorized Plumber
If you have any questions, please call 503.718.2433.
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• Do hereby certify th tie follgwing location •
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• meets, i - of"'Z'i and / a hii on `Count
• • ■ land use and development standards for street tree installation. ►
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• ADDRESS: /0 i Z J S U) I C�%v •
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• //, 1 LOT: cY 1 SUBDIVISION: - &4L •
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• BY: DATE: / 0 / I ?J'�O f •
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• RECEIVED BY: DATE: •
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CITY OF TIGARD 24 -Hnr
BUILDING ' InspGe ion Line: (503) 639 -4175 MST' 3 =663/1,,
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / I — 3 AM ✓ PM BUP
Location Suite (P / MEC
Contact Person .L -C___O-- Ph ( ) R/e) 40-097 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:
SS>ART FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P Rt FAIL
CHAS
Post &Beam
Rough -In
Gas Line
Smoke Dampers
Fi
ASS -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 / ` 3 — Ext
Approach/Sidewalk Da % - 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 coo ;3 -boa ( ,
INSPECTION DIVISION Business Line: (503) 639 -4171
_ BUP
Received Date Requested / 0 S AM ✓ PM BUP
Location /6 ? a 5 ri.f a Suite MEC
Contact Person Ph ( ) S7/I ' — 4 gq 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 / .c
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:
in-
!' PART FAIL
,rHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El 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
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING ' Inspection tine: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST - 7.66 - ; - • 663t <n
BUP
Received Date Requested /0 _2.2) AM L PM BUP
Location 16 Z.S , yv Suite MEC
Contact Person 6i v��� (/ Ph ( ) go & Pg 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage A 0. e
Fii Alarm ■
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
de A4: SITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / . 2° Inspector - .••■ . - % Ext
Other:
Final DO NOT REMOVE this inspection record from the j site.
PASS PART FAIL