Loading...
Permit . MASTER PERMIT CITY OF TIGARD PERMIT #: MST2005 -00407 1 .V Alit DEVELOPMENT SERVICES DATE ISSUED: 12/13/2005 ` J . % 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S108AA -02300 SIT 'ADDRESS: 14763 SW GRANDVIEW LN ZONING: R - SUBDIVISION: BOLL MOUNTAIN ESTATES LOT: 005 JURISDICTION: URB Project Description: Adding 182sf of interior habitable space. 4 4 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: st BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF c FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: • VALUE: 1 6,816.60 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 3 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC!FCR: 1 SIGN /OUT LIN LT: PER HOUR: CO LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: 4 SIGNAL/PANEL: IN PLANT: MA MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v. MINOR LABEL: 1000+ amp /volt : O PLAN REVIEW SECTION O Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY U 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: This permit is subject to the regulations contained in the 0 DANIELS, DALE R + JANICE R OWNER Tigard Muiapal Code, State kwil by Codes 14763 SW GRANDVIEW LN and all other applicable laws. All All l work will be e done in accordance with approved plans. This permit will expire TIGARD, OR 97224 if work is not started within 180 days of issuance, or if the DIED work is suspended for more than 180 days. ��,,++ i! ATTENTION: Oregon law requires you to follow rules Phone: 503 - 590 - 7270 Contacti#i adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 514.88 1 -800 -332 -2344. REQUIRED ITEMS AND REPORTS Issued By : . - _ /!1 Permittee Signature : y Call 503 - 639 -4175 by 7:00 a.m. for an inspection that busin ss day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Inspections Required for: M."1'2005-00407 ✓ I Code I Inspection Description I PASS Date I By MST - Master Permit 405 Excavation 410 Fill 415 Grading X 205 Footing ; ?./4/f/t 805 MFG - Structure grading/footing 210 Foundation walls 215 Footing drain 305 Plumbing underslab 105 Underground/slab cover 220 Slab 310 Crawl drain 315 Post/beam plumbing 605 Post/beam mechanical 225 Post/beam structural 230 Underfloor insulation 235 Shear walls /anchors 240 Exterior sheathing _ 242 Interior shear walls 245 Firewall 250 Roof nailing ..,` 255 Wtr proofing basement walls 265 Masonry _ 270 Reinforcing steel (rebar) 320 Plumbing rough -in r<m 322 Shower pan 610 Gas line X 615 Mechanical rough -in 110 Temporary electrical service 115 Electrical service q6 X 120 Electrical rough -in • JS 0I) G�A� 135 Low voltage �V % ` 910 Sprinkler rough -in �� X 275 Framing ( of /P ' 810 MFG - Structure set -up c, 280 Insulation 330 Water service 335 Rain drain 340 Storm drain 505 Sanitary sewer 350 Septic tank 285 Drywall nailing 289 Approach /sidewalk EiG 295 Misc. inspection: 899 MFG - Structure final 7/f /d 498 Grading final t I �� X 699 Mechanical final V 399 Plumbing final X 199 Electrical final X 299 Final inspection ]:\Building \Inspection Cards \Forms \MST - InspCard - Blank.doc 12/09/2005 _og `' MASTER PERMIT CITY O F TIGARD PERMIT #: MST2005 -00407 ;n-llli DEVELOPMENT SERVICES 3- 639 -4171 CES DATE ISSUED: 12/13/2005 13125 SW Blvd., PARCEL: 2S 108AA -02300 SITE ADDRESS: 14763 SW GRANDVIEW LN ZONING: R -7 SUBDIVISION: BULL MOUNTAIN ESTATES LOT: 005 JURISDICTION: URB Project Description: Adding 182sf of interior habitable space. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: TKRo- sf RIGHT: VALUE: 16 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W10 SVC/FDR: 1 SIGN /OUT UN LT: PER HOUR: LIMITED ENERGY: 401 - 800 amp: 401 - 600 amp: EA ADDL BR CIR: 4 SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amts- 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 & 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: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes DANIELS, DALE R + JANICE R OWNER and all other applicable laws. All work will be done in 14763 SW GRANDVIEW LN accordance with approved plans. This permit will expire TIGARD, OR 97224 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 Phone: 503 -590 -7270 Contact #: adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 514.88 1- 800 - 332 -2344. REQUIRED ITEMS AND REPORTS Issued By : ` y . /!_l Permittee Signature : ���►�� Call 503 - 639 -4175 by 7:00 a.m. for an inspection that busin-ss day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Apt- ' R FO OFFICE USE ONLY mi1 tEOVED f Received City of Tigard Date/B / : I q . err ' Permit No.. 5 �` A .0 • 13125 SW Hall Blvd., Tigard, OR 97223 CC Plan Review Phone: 503.639.4171 Fax: 503.598.190EC 0 5 2005 4.4.14 Date/B : Other Permit: Inspection Line: 503.639.4175 Date Ready/By: ® See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified /Method: 4 g upplemental Information l.D RUl ING :.......: .: .... DIVISION .. >�.:...�...,.:.....:,::......: ; ,,, : .....,.. F ...... : .....:.. ::.:.:..:,:::.,:.TYPE •OE RE UIREDDATA:..1 =AND2= FAMILY >DWELLING'' ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all IN Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the • .::,.::..:. .: • CATEGORY' OF�CONUGTION ` • work indicated on this application. �::y�;.;y'�:.��;�...:,;•;; '::'..`: .:..STR;:::'':. ":::.';.; <; ::''�:'':...:. - _ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $410 b p 00 ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: 2 Total number of floors: 2 Job site address: 14763 SW Granview Lane New dwellin g area: 182 square uare feet City /State /ZIP: Tigard, OR 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Daniels Addition Covered porch area: square feet Cross street /directions to job site: Grandview and Bull Mountain Road near 150th Deck area: square feet Other structure area: square feet ; 11EQUIREDDATA COMMERCIAL-I :CHECKLIST ; Subdivision: Bull Mountain Estates Lot no.: 5 Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, t overhead, and the profit for the work indicated this application. on Valuation: $ Existing building area: square feet New building area: square feet ::;.,,,:�.::.:- .::�:. ..PROPERTY UWNER•s�:...�:..;:!1::: �: � : :�.::�;�: _ Number of stones. :::,;:.:� TENANT•.;: =; ' ''..: Name: Dale Daniels Type of construction: Address: Same as above Occupancy groups: • City /State /ZIP: Existing: Phone: (503)590 -7270 Fax: ( ) New: .:... :.... ,... 3 ........:........�. ®...APP ICANT . , ..... •.:•:•:•••• - ........... Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax: : ( ) E -mail: • ,. CONTRACTOR.::. ....:.:.° •�:��' '��. • Business name: OW .k. �(L .. BU1'[LDING.`PERMTP� FEES; :. ° - ":: •``'' Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax:( Amount received CCB lic.: Date received Authorized signature: ' T per application expires if a permit is not obtained / '1 S 70S within 1811 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board. is \l3uilding \ Permits \BUP- PermitApp.duc 12103 440- 4613'r(11 /O2JCOM/WEB) Mechanic Permf�EggeablD Received FOR OFFICE USE ONLY City of Tigard Date/By: Permit NoWei 06 y0/ 13125 SW Hall Blvd., Tigard, OR 0 5 2005 Plan Review Phone: 503.639.4171 Fax: 503.5 Date/By: Other Permit: Inspection Line: 503.639.4175 .I ® __ Date Ready /By: Juris: See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified /Method: Supplemental Information BUILDING DIVISION :.�':: E' OF ,-:..,..:: ;v�,�;:::. • ' COMMERCI.Aii'; FE CHEDULE - [15E:,CHE(>IIY':iS1';.` P E'' S Mechanical permit fees* are based on the value of the work El New construction ® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. .. -:�:x::.:.:;;x::� �:�;r =:::::;.. �::. x:,.:..:,..,.:.. „..,,::m.. �x :�::.:..;::..�:...: Value: :......:..... : . :< : : ` ",.'.,,.:..:�.:;..:.:� :: ... . ' RESIDENTIAL::E UIPMENT'1 SYSTEMS FEES.`:..::::: ;` ......:..:..::..:...:.: . 0 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total :�:..� >: ;:: ..� ,:..:.::.....,. JOB AND. LOCATION:=.; �...: .:..�:.. Heating/cooling Job site address: 14763 SW Grandview Lane Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (duets/vents) 17.90 Suite/bldg. /apt. no.: Project name: Daniels Addition Gas heat pump 14.00 Cross street /directions to job site: Bull Mountain Road/Grandview Lane Duct work 14.00 Hydronic hot water s 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: Bull Mountain Estates Lot no.: 005 Other: 10.00 Tax map /parcel no.: Other fuel appliances • Water heater 10.00 . • : �:::.: •:: DESCR IPTL QN >::OF.:.WORK;;' �::':. �:,r::....,:, :::�:..:..... .........: : .........: ..,:....::::::.::.. Add vent Gas fireplace 10.00 Flue vent for water heater or gas Modify intake for down stair from wall to cieling fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimne /liner /flue /vent 10.00 ...; PROPCRTY ,; x °• :::.. : :: . . : :::: ; TENAN . ' ,. ,.... _.. <............... �...... ....:.... ......:.........:.:�.�:�....��: ... .... ��x :ra:: .:.... ,:, ::::;: Other: 10.00 Name: Dale Daniels Environmental exhaust and ventilation Range hood/other kitchen Address: Same as Above equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utilit rooms) 6.80 ` . O lc craw p ce fans q : ;.. -n :: ...:: APPLICANT:. • ..:.:.:...: C NTAGT BERSON ::: ; :' :::..,, s a Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range ...:: . Barbecue Business ,r� Clothes dryer ( usiness name: v wit Other: Address ECHANICAL' PERMIT: FEES...'... y'; `� ;; City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: C a-(5 -(C) This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board i:\ building \t'ermits \MEC- PermiiApp.doc 12/03 .140 -4617f (11 /02/CC)M/Wt.•13) r Electrical Per � �• 1 -11 i` - V ;: FOR OFFICE USE ONLY Received City of Tigard Date /B : Permit No. f , p06 — 0 d i 13125 SW Hall Blvd., Tigard, I . ::72 5 2005 Plan Review Phone: 503.639.4171 Fax: i 8.1 60 - . 71911 . i?' DateB : Other Permit: Inspection Line: 503.639.4175 ■ Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.usCITY OF TIGARD Notified/Method: Supplemental Information TYPE OF WORK ; • :0,','!1::g1:::::::'.'*:' :::... .... jLANs REVIER' 6::0' :0:'r . •: -:: ❑ New construction ® Addition/alteration /replacement Please check all that apply: El Demolition El Other: ▪ over u , ❑Service over 320 amps rating ❑Bu ['Hazardous over 10,000 sq. ft., C ATEG...OFi CoNSTRIJ,CTION g � , - of 1 -and 2- family dwellings 4 or more new residential ® 1- ORY and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ Multi- family 0 Master builder 0 Other: .•:::: r::: : _ :::::...... .;: :...:..:::: .::...::::.:ra:,::::k::,. , .... persons Occupant load over 99 a ['Manufactured structures or :,',WIl , «:.. :4: : , • . :. JOB S ITES:INFORMATION. AND:.,WATION r:. : ; RV park ,�..� .... . ,:..:r;.: , . .......... ... �� ... .. ❑Egress/lighting plan P ❑ Health - care facility ['Other: Job no.: Job site address: 14763 SW Grandview Lane Submit 2 sets of plans with any of the above. City /State /ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service. .:: . . & :: , :.:.:: ... * ..... .. � � ;. � ' °. :,.. , � ° ; FEE. _ .SCIlEDULE °';° .' '� :.:'a:'::::.;: Suite/bldg. /apt. no.: Project name: Daniels Addition Description I Qty. I Fee. I Total I *' Cross street /directions to job site: Bull Mountain Road/Grandview Lane New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Bull Mountain Estates Lot no.: 005 Ea. add'I 500 sq. ft. or portion 33.40 1 . Tax map /parcel no.: Limited energy, residential 75.00 2 :; : energy, non-residential 75.00 2 •.:::....:::. :::.:: :::.,:: ::.:::.:::. :.:::::::...::.DE WORK' : � ' :..::.., � :x:.::. : .• : : ' :.: ; • : , .�... , �::..::.._ ... .......:..� t,ixx:: :%.;..:: Each manufactured or modular Install recessed lighting and elecctrical outlets for room addition dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation Install recessed lighting in kitchen, add exterior plugs, 200 amps or less 80.30 2 ';:n:x ;:. :.:.: :.; ,::. ::-:,�::� . .: ::R :::.:.:::.:..::: :::, :x:.: : .:.:: 201 amps to 400 amps 106.85 2 �,::;::..:.. :.:.: ; ; .; ®;:PROPERTY�UWN ER ::; ..;.;:.:. ..... - - ® .TENANT::: ' ......... .:..:... 401 amps to 600 amps 160.60 2 Name: Dale Daniels 601 amps to 1,000 amps 240.60 2 Address: Same as above Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: Temporary services or feeders installation, alteration, and/or Phone: (503)590 -7270 • Fax: ( ) relocation 200 amps or less 66.85 1 Owner installation* _ / .being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, le.::��> ange, according to ORS 447, 449, 670 and 701. 401 amps to 600 amps 133.75 2 Owner signatur Date: I3 0� Branch circuits — new, alteration, or extension, per panel •:: _ a : ; ..5 A. Fee for branch circuits with ._.... ..... a . .::: t,.: APPLICAN 'T' . ..:.,: :: ': ❑ . ° CONTACT n I'E .:. O . . ,..., ..... _ service or feeder fee, each 6.65 2 Business name: . branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit J 46.85 2 Address: Each add'I branch circuit L/- 6.65 2 City /State /ZIP: Miscellaneous - (service or feeder n t included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- .. . ..,....1... ... t: •:' -' :: : : : :,:: .: - 4:: energy panel, alteration or ...:.:::.:::: :. : ...... ..... :. .... CONTRACTOR•:,::::::::., -. �` .: ':F >: : � :�;� ; : : ;-x::::�:�.: "; .: gY x:.� .:...: :.:::::...:.: Describe: Add 2 2 > extension. escri e: A 2 c Page Business name: 0 w0=et LIZ__ Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone ( ) Fax ( ) Industrial plant per hour 73.75 x ELECTRICAL'- PERMIT:;: FEES! Z r::i ;,;; • ' ,. CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: ,� n State surcharge (8% of permit fee) �/ TOTAL PERMIT FEE Authorized signature: 0. - 4111,4 111 ." (2_ 5/4 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board *• Number of inspections per permit allowed. is \ Building \ Permits \ELC -PcrmitApp.doc 12103 440-- 4615T(10 /O2/COM/wEB Permit #: 1116 r2-©p6 — 00111 Address: 14 3 Si t) G<Q(c - D \.J 1 to Issued by: Date: • Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the 1 following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. —Fill in the - appropriate blanks and initial boxes -1 and 2, -and either- -box 3A or 3B: - - - ai 1. I own, reside in, or will reside in the completed structure. . 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale 0 before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 14,„ 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change rriy mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the .. • 1 ve . • ormation is correct and that I have read and do understand the Information . Notice to Property • • _ • • 1 ut Construction Responsibilities on the reverse side of this form. de � l `/570C - (Signature of permit applicant) (D ) • (White copy to issuing agency permit file, pink copy to applicant) • finformsUon-HoUce to Property Owner About Constr°rrucci ort R esponsbi es , • • \;Note: This Information Notice to Property Owners about Construction Reslionsihilities \vas developed by the Construction Contractors Board in accordance with,bRS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSlf U T IES: If you hire persons not registceked with the Construction Contractors Board to do lrn bor in constructing or assisting in the construction or improvement of residential structure, you will, in most instances, .'e ruled to bean employer and the people you hire will be employees. As the\employer, you must comply with the followin • Oregon's withholding tax law: Asan employer, youmustwithholdincometax ` sfromemployeewagesatthetimeemployees are paid. You will be liable for the tax pa :ments even if you don't actually wAhold the tax from your employees. For more information, call the Oregon Dept. of Revel le at 945 -8091. f 9/ Unemployment insurance tax: As an employe you are required to p<y' a tax for unemployment insurance purposes on the wages of all employees. For more information, call . ie Oregon Emploti Department at 378 -3524. Workers' compensation insurance: As an employer, yc are subject to the Oregon Workers' Compensation Law, and must' obtain workers' compensation insurance for your employees. fidou fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs ifone, ' ¢vour employees is injured on the job. For more information, call the Workers' Compensation Division at the Department 'Cot •umer and Business Services at 945 -7888. U.S. Interna@ Revenue Service: As an employer, you must withhold fe e al income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withyt tax. Form. - information; call the Internal Revenue Service at. 1- 800 - 829 -1040. .�� OTHIER iRESPo Sl lLmES AND AREAS OF CONCERN: Code compliance: As the permit holder for thi ject, you are responsible for resolving any fat e to meet code requirements that may be brought to your attention through/inspections. • Liability and property damage tnsurapee: Contact your insurance agent to see if you have adequate insu ice coverage for accidents and omissions such as fallin_'tools, paint overspray, water damage from pipe punctures, fire, or wor • gal must be re -done. • Tsme to supervise employees° ake sure you have sufficient time to supervise your employees. Expertise: Make sure yo - lave the expertise to act as your own general contractor, to coordinate the work ofrough -in and finish trades, and to notify bt ' ding officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem;.OR 97309 -5052. 503/378-4621). ' he Board is located at 700 Summer St. NE Suite 300, in Salem. • • prop- own.pm4 1 /94 CITY OF TIGARD _ BUILDING DIVISION PERMIT #: MST2006.00407 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ,_' - "'I INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7 :06A■ PAGE: 6 SITE ADDRESS: 14763 SW GRANDVIEW LN CLASS OF WORK: SUBDIVISION: BULL MOUNTAIN ESTATES LOT #: 0055 TYPE OF USE: PROJECT NAME: DANIELS DESCRIPTION: Adding 102sf of interior habitable space. OWNER: DANIELS, DALE R + JANICE R, il PHONE #: 6,03- 590 -7270 re) CONTRACTOR: OWNER I PHONE #: Inspection Request Scheduled For: Date: 9/1512006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 036623-01 503. 627 -1644 N Corrections /Comments /Instructions: CD C i 6 NO ■3 - k) g i PAO ''s-.1t,a.mo 1..7HA Vitalft krAZ -45-w V cob a9 bL6 , • V PASS ❑ PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _v tk, US, Date: C if 151 Ot Phone #: (503) 718- 2 0,. _.„. , . , _ . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00401 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/13/2005 Phone: (503) 639-4171 'II� Inspection Requests (24 Hrs.): (503) 639 -4175 ,,— IL. INSPECTION WORKSHEET FOR DATE: 8/15/2006 TIME: 7:05AM PAGE: 18 SITE ADDRESS: 14763 SW GRANDVIEW LN CLASS OF WORK: SUBDIVISION: BULL MOUNTAIN ESTATES LOT #: 005 TYPE OF USE: PROJECT NAME: DANIELS DESCRIPTION: Adding 182sf of interior habitable space. OWNER: DANIELS, DALE R + JANICE R, PHONE #: 503. 590 -7270 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/15/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 034980 -02 503590.7270 Y Corrections /Comments /Instructions: /Jor ' p:'D r i old- w a t k, S c1 j c le. Q r-2- _ , `_ . h 'CYO-- r-t—l o Sl-e-- u¢ --..e-/e c. `e. o . •i p - •rJ•0.-' I ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / - 1 (2-- 0 Date: f - iS — G Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200F ,-00407 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2005 Phone: (503) 639- 4171i�l Inspection Requests (24 Hrs.): (503) 639 -4175 _�' 1.L. INSPECTION WORKSHEET FOR DATE: 8/15/2006 TIME: 7:05AM PAGE: 19 SITE ADDRESS: 14763 SW GRANDVIEW LW CLASS OF WORK: SUBDIVISION: BULL MOUNTAIN ESTATES LOT #: 006 TYPE OF USE: PROJECT NAME: DANIELS DESCRIPTION: Adding 182sf of interior habitable space. OWNER: DANIELS, DALE R + JANICE R, PHONE #: 503 - 590 -7270 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/15/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 034980 -01 503 -590 -7270 Y Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: gedij Date: Phone #: (503) 718- - 1 CITY OF TIGARD • • BUILDING DIVISION PERMIT #: MST200b-00407 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . ' `'� INSPECTION WORKSHEET FOR DATE: 7/6/2006 TIME: 7:03AM PAGE: 96 SITE ADDRESS: 14763 SW GRANDVIEW LN CLASS OF WORK: SUBDIVISION: BULL MOUNTAIN ESTATES LOT #: 005 TYPE OF USE: PROJECT NAME: DANIELS DESCRIPTION: Adding 182sf of interior habitable space. OWNER: DANIELS, DALE R + JANICE R, PHONE #: 503 - 590 -7270 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/6/2006 Pour Time: Code # Inspection Description Confirm # Contact # • Message 120 Electrical rough -in 032662 -01 503. 580.7270 Y Corrections /Comments/ Instructions: PiZit4I OK 5 To q" 66 ®g I J - A °I ►N .k w &LI-() ? c5 P CZ ►O 2-z A rn\o• Ci cZ,c..v c7 10 ZAP 0 orzsAN — z/. w 1 &c_, � ?ctm� P a 6o rr�Y -� -- ,,LL- 6--izo v££ cast,4 -1ocL c oU . , A s e 1 bcJ .. ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C) U VU Date: 9 f 6f6 6 Phone #: (503) 718- ZA 1 1 • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00407 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2005 Phone: (503) 639 -4171 ,,mm .I � I � a Inspection Requests (24 Hrs.): (503) 639 -4175 - ii- INSPECTION WORKSHEET FOR DATE: 6/30/2006 TIME: 7:01AM PAGE: 19 SITE ADDRESS: 14763 SW GRANDVIEW LN CLASS OF WORK: SUBDIVISION: BULL MOUNTAIN ESTATES LOT #: 005 TYPE OF USE: PROJECT NAME: DANIELS DESCRIPTION: Adding 182sf of interior habitable space. OWNER: DANIELS, DALE R + JANICE R, PHONE #: 503-590-7270 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 032506 -02 503 -590 -7270 Y a © Corrections /Comments /Instructions: ait "NridN1110' - ei.-.`'''S i 1r • • PASS. ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FORVSPECTION ❑ ADDITI • NA EES ASSESSED Inspector: h` Date: AN Phone #: (503) 7186V2. CITY OF TIGARD - -T t-I BUILDING DIVISION PERMIT #: MS 005.0040Y 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13f200 5 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 _�Vlilitl _ .. INSPECTION WORKSHEET FOR DATE: 12/23/2005 TIME: 7 :02AM PAGE: 28 SITE ADDRESS: 14763 SW GRANDVIEVY I -N CLASS OF WORK: SUBDIVISION: BULL MOUNTAIN ESTATES LOT #: 005 TYPE OF USE: PROJECT NAME: DANIELS __ DESCRIPTION: Adding 182sf of interior habitable space. OWNER: DANIELS, DALE R + JANICE R, PHONE #: iO3- 590.7270 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/ ?312005 Pour Time: 1 :00 40 ?o Code # Inspection Description Confirm # Contact # Message 205 Footi 023945.01 503-590-7270 Y Corrections /Comments/ Instructions: V PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FE ASSESSED Inspector: Date: - 9,5 .% Phone #: (503) 718- 270 ,. ,, K . ,,x: - - „ , � .r ax;??i... .- a. - - _ _ �' . :.. �' .� g'w�;""� *� -. ` r • n p"e'",.', _ �. ., ay ':+:‘,;. � °°� - R�Yr � �' _ � � ' 6S e.. . _ �M, . , , . .,: s .'_. _. - ���, .I ».� ;,. - ,�^ c � �°2 x -,� r� y . . s„ ' A € , . _ �' > n, °. :x sr ., _ �� . »� 'emu a ' �a :,.. � , a 4 .. - . . . e .. � - � ...e _. . �r ... ::.. '� ' �. - - aaw:a`�a - .�., : - .» ,... � m a, °�:. ..a rea.: . � � T a ,Ric 8 a i en RB , F ii _ . ,R . 4 R _ -� � r ., . Yw � :. � ads � =:. ��'+ aa, r „ aC? � "w�. �'r� = , � ,,. � s .�5�"� - File Edit Options Window Help • Exit New Open Talk List OBE GIS 1 4 0 igi I 4tiik € D Qt F Close Edit Project Group Add Clone P Activity People Fees Valuation Conditions Gase Notes T Documents GIS Case ;'.. ,. . g p j i jJ : - . I.' 3 .. , , t x = iv - % ;:r- ..'4::x3 d :;Narrie:0#NIELSDALE`. l ± :)ANfCE R', � U pdafe'd :12/7 G eneral il GR ND IE �III LN ;.' _ = y <. , , ., a < ',11'.- ' De ` scriptian: h # M ST200 -0040 ~ Pra ect DANIELS ,e- ai iidjng ,,: ' ' 2 ' ., d Y -w i ;Adding 182sf of i nter i or habitable space. L am . 7 Meeh al ,, • ' . >; ;r. ' : . z , * % Plumbing = City "C " ontact: " 1- 4 Qa ::R µ dg , s =,...„,, , ,, i �•. , »r 'F .El Date rss' VV .,gF <<' r a "'• :'�,�. - ,.4�,.' ."$+ ,r'a.: < `Cla a Work - - r SF x : '.Received:.J12fw 2005 w -- . i - ;:71-;,", ,I . i e�af:,Use: ;ai s,., �- F , `,.,w =', - -. -' ,. -x' m ,n 4 s ° em " Tar e t • T " e; o f C on s t r uc ti on: N �h� a; -'71.1'.2....(--13-t2''''-6-65'` _ , -. . .x l ,,ved: , . ; ,:a - { E Occupancy :Group.:„,-, �R3 .. a %�.. $ s H - ,�f,-*:- -- .-�, - ' t, .R e strict e d ' ,; , , ; € `: ' u p , y , p : ,, � :�,. ^^ ... = e :� .« .fi . ,. ., '? . . xr: • , . Expi /1, _ ., ,, ;., ,' Elecrical x' ' To V aluat i on 1 ' $ 80 ,,� ` ; -R a ka :r Fi na le d i ' 3 : K e -. ' . , < ,, : ,g ,,< -1 ,A. Re strict e d ' .� ,-. . ;..F. y Commercial J �x s r ,dt - 4 , ....w . .,1,,.: - .1aelc,,,...i i ,,,,..„At t4 - [ iew /A dd Activities s..? 'fi e�' u1! d Ac tva: i»+- 9Y :7 .. •o .,- ->n a xr � atte u w. „, ,w�, na„ai ... . +5' r ^ a.z :7: - :-- v?ucvrmi s s RS.a, xa . „, , , . * wau! ,� y _ . -+�., _ te; xinr .�assx -as.':rxet« �'" . .d . � P ai � f .,,-,,,,,,;,..41.1.,,,-. . : r'. « . -3 ' - .: - - rz ys5: -' • mi ' �+ .. ,,: w„ti " � t ,,, i ' '' , f + , ^ t -., ' - C i, - ''', ' z� '"'4i . � . i ,. €, ; ` •. 4°Z -bt ":" �'� }v aYS. -�' 1c � � � - � . ,1L S� ., 2 . S �� �+a -- �u _ C' 1 u J�€ '" F�:;^ {ta �, .� Tidemark =i�dax�. r. . . � • s �v _ .. �a.. ,, . } . . �.. = .. — _ _ , . . • ,.. ; . fi r ; e z €Jr 1 �; �1~ 1 $i a > , ., ,�':. • •_ pea . k i S ° ".� T-? ' ' '".A•^ i.. d { "' „` ' - �._ ::..... . .. - .. .....: ; ... .. Utz, . , ' s� .. , • °m <.. ,� Y C� °' 3�a.- . g° -.bw, �.,M.,esJ��z.r ? �+.:� �..t�- �..::- sE�...... F...�a`. Case Activity Listing 1/23/2008 CCEL1 1:21:28PM Case #: MST2005 -00407 :Activity .: Description : Date!:: Date :x ::....•. ,::...: Date:3 ... Hold; ...- Disp... To .... By n ;, By ... ;. €. , ... Notes MST1010 Application received 12/5/2005 None RECD BB 12/5/2005 BLD MST1020 Permit created 12/5 /2005 None DONE BB 12/5/2005 BLD MST1030 Check for parcel 12/5/2005 None DONE BB 12/5/2005 tags/CWS BLD MSTI 100 Building plans 12/5/2005 None APRV BB 12/5/2005 approved by PE BLD MST1065 Begin plan review 12/13/2005 None DONE CW 12/13/2005 CW MSTI 100 Building plans 12/13/2005 None APRV CW 12/13/2005 approved by PE CW MSTI 110 Approved plans 12/13/2005 None DONE CW 12/13/2005 routed to PT CW MST1240 Post - review 12/13/2005 None DONE BB 12/13/2005 completed BB MST1280 Issue permit 12/13/2005 None DONE BB 12/13/2005 BB MST2205 Footing 12/22/2005 12/23/2005 12/23/2005 None PASS JM 12/23/2005 023945 -01 - 503 - 590 - 7270 - VM - STI MST2615 Mechanical rough - in 6/29/2006 6/30/2006 6/30/2006 None CNCL JMT 6/30/2006 032506 - 01 - 503 - 590 - 7270 - VM - JMT N Page 1 of 2 CaseActivity..rpt Case Activity Listing 1/23/2008 4,CCEL Case #: MST2005 -00407 1:21:28PM ..; ... . . Active De tion, • • Date :1. ' , Date 2 Date P ; • : ...� w , • Hold s e 3 °> H Id~ Disp � `.Tod; B' By Notes MST2275 Framing 6/29/2006 6/30/2006 6/30/2006 None PASS DAN 6/30/2006 032506 -02 — 503 -590 -7270 — VM - STI Y MST2120 Electrical rough -in 7/4/2006 7/6/2006 7/6/2006 None D I c/ ° ( GN 7/6/2006 032662 -01 — 503 -590 -7270 -- VM - GN Y MST2120 Electrical rough -in 8/14/2006 8/15/2006 8/15/2006 None PASS HS 8/15/2006 034980 -01 — 503- 590 -7270 — VM - STI Y MST2I 15 Electrical service 8/14/2006 8/15/2006 8/15/2006 None PASS HS 8/15/2006 034980 -02 — 503 -590 -7270 -- VM - STI Y MST2120 Electrical rough -in 9/14/2006 9/15/2006 9/15/2006 None PASS GN 9/15/2006 036623 -01 -- 503 - 627 -1644 — VM - STI N Page 2 of 2 CaseActivity..rpt