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Permit
7" 0 g • • !PI e Action Division T I G A R D Request for Permit Acon or Refund 47 TO: CITY OF TIGARD r }- ..7 - .:;) :' Permit System Administrator ` (/ ''' 13125 SW Hall Blvd., Tigard, OR 97223 . �l ' e �q 6' Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov -- .,- FROM: " " " "�� � wner El Applicant El Contractor ❑ City S (check one) • REFUND TO: Name: 7-11/1/0 (Business or Individual) / e, Mailing Address: l SC 3 7 7 5 GJ 1 3 6' it ('r/ W 0 1 D City/State /Zip: 77 C,4-llJ) , 0 /`-- 7 2 2 k l"^E- /fWe/g- Phone No.: 5 3 - C°2 d - (gam 3 g/04. PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED ( CANCEL PERMIT APPLICATION. '"" ►� REFUND PERMIT FEES . attach receipt, if available ( P ) IIII REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: /4I S T .Z a o 6 0 3/ Site Address or Parcel #: 95 — ©/ boa Project Name: • Subdivision Name: Lot #: EXPLANATION: p p GA '�.col A10 4 I s I-24_, A./-44^ -d LI- r o f !rf - Signature: Date: / /l/ 7■9 Print Name: • 7j /.3 T AA) • Refund Policy 1. The Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80 percent of the permit fcc for issued permits prior to any inspection requests. c) not more than 80 percent of plan review fee when an application is canceled before any plan review effort has been expended. 2 Refunds will be returned to the original Payer in the same method in which payment was received. Rte to Sys Admin: Date? -// - 6 By , Rte to Bldg Admin: Date • By Refund Processed: Date 50,q ek, By Invoice Processed: Date By Permit Canceled: Date 9 04, By Parcel Tag Added: Date By Receipt #04 - y Date Va3 /04, Method (, � L Amount $ 1:\ Building \Forms \RegPermitAction - dg do Rev 05/24/06 * `' A CITY OF TIGARD MASTER PERMIT PERMIT #: MST2006 -00231 �i�; DEVELOPMENT SERVICES DATE ISSUED: 8/23/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109AA - 01600 SITE ADDRESS: 14378 SW 130TH AVE ZONING: R - SUBDIVISION: WOODFORD ESTATES LOT: 004 JURISDICTION: TIG Project Description: 189sf basement finish, add full bath BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: 189 51 BASEMENT: of LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: at FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELUNG UNITS: 1 THIRD: at RIGHT: VALUE: 30,000.00 OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: 189 sl REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER UNES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < ]HP: VENT FANS: CLOTHES DRYER: FURN >=100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 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 W/O SVC/FDR: I SIGN/OUT UN LT: PER HOUR: UMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 - 1000 amp: 601 *amps- 1000v: MINOR LABEL: 1000+ ampNolt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC/FDR> =225 A.: n 600 V NOMINAL: CLS ARENSPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO S STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL R SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code,•State of OR. Specialty Codes and all other . TIN THAN THOMAS NGUYEN applicable laws. All work will be done in accordance with approved 14378 SW 130TH DBA RELIABLE CONTRACTOR plans. This permit will expire if work is not started within 180 days TIGARD, OR 97224 4907 SE HOLGATE BLVD of issuance, or if the work is suspended for more than 180 days. PORTLAND, OR 97206 ATTENTION: Oregon law requires you to follow rules 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 Phone: 503- 484 -3521 Contact #: PRI 503- 319 -3801 of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1-800- 332 -2344. Reg #: LIC 135032 TOTAL FEES: $ 538.41 REQUIRED ITEMS AND REPORTS 7 ..............z.t......_ Issued By : , ( � � ( � � � Permittee Signature - Call 503 - 639 -4175 by 7:00 a.m. for an inspection that busine` s 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. Buildin Permit A 11c • EN 4 EDA FOR OFFICE USE ONLY City of Tigard Receive Q f� p No. 13125 SW Hall Blvd., Tigard, OR 97223 Date/13 : b I �j LJ a T" .... , , _.,0 c43 Phone: 503.639.4171 Fax: 503.598.1960 AUG 2 3 200 -, Plan Revie Dat Other Permit: Inspection Line: 503.639.4175 .77 • f r Date Ready/By: In! El See Attadted Checklist for - ; Internet: www.ci.tigard.or.us CITY OF TIG " Notified/Method: Supplernental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA: 1- AND 2- 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 ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ t . -. ❑ Accessory building ❑ Multi- family _ Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 14378 SW 130 Ave New dwelling area: square feet City / State/ZIP: Tigard, OR 97224 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: Residential Remodel Covered porch area: square feet Cross street/directions to job site: From Hwy 99, turn right on Bull Mountain Rd, turn right Deck area: square feet on Green Field Dr.. turn left on BirdVlew, turn right on 130 Ave. Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: WOODFORD ESTATES, LOT 4, ACRES .20 Lot no.: Permit fees* are based on the value of the work performed. 2S109AA01600 Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: R2022142 equipment, materials, labor, overhead, and the profit for the work indicated on this application. DESCRIPTION OF WORK Valuation: $ Add a full bath room in an existing storage area in the daylight basement Existing building area: square feet Finish an un- finished area approximately of 189 sq ft In the daylight basement New building area: square feet Number of stories: ® PROPERTY OWNER ❑ TENANT Type of construction: Name: Tin Than Occupancy groups: Address: 14378 SW 130th Ave City / State/ZIP: Tigard, OR 97224 Existing: Phone: (503)484-3521 Fax: ( New: ( )tindtllan @yaltoo.com El APPLICANT ❑ CONTACT PERSON NOTICE All contractors and subcontractors are required to be Business name: licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the jurisdiction in which work is being performed. If the Address: applicant is exempt. from licensing, the o ing reasons City /State/ZIP: p � �y Phone: ( ) Fax:: ( ) /` ia'1 •G E -mail: 1 /y• (� l • O v CONTRACTOR Business name: THOMAS T NGUYEN BUILDING PERMIT FEES' Address: 4907 SE HOLGATE BLVD Please refer to fee schedule. City / State/ZIP: PORTLAND OR 97206 Fees due upon application Phone: (503) 319 -3801 Fax: ( ) Amount received 3 ad/.o3 CCB tic.: 135032 If a(s Date received: / This permit application expires if a permit is not obtained Authorized signature: within 180 days after It has been accepted as complete. ° Fee methodology set by Tri- County Building Industry t Print name: /J r‘/A7 Date: p/ Z ?/Q_6 Service Board. i:\ BuddingtPenazts \BUP.Pennit ppdoc / IL03 440- 4613T(II /02ICOM/WEB) Mechanical Permit o Applica �E ® FOR OFFICE USE ONLY Date/By: of Tigard � Received Permit Nof�l1�f dip, po?' ) 13125 SW Hall Blvd., Tigard, OR 97723 y ' � Plan Review Phone: 503.639.4171 Fax: 503.598.196, 2 3 ,00 • Alkk, D a t c/By: OtherPemtil• Inspection Line: 503.639.4175 U l7 Internet: www.ci.tigard.or.us TIG�`RD �� ��i{ -• Notified/Method: aura: See Page 2 for cvri pF DtvIS Notifieed/Md/Methethoo Supplemental upplmtentat Information BULLDIND Print name: TYPE OF WORK ❑ New construction ® Addition/alteration/replacement COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ Demolition ❑ Other: Mechanical permit fees° are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead, and profit. ® 1- and 2- family dwelling El Commercial/industrial ❑ Accessory building Value: $ ❑ Multi - family Ell Master builder ❑ Other: RESIDENTIAL EQUIPMENT /SYSTEMS FEES* For special information use checklist. JOB SITE INFORMATION AND LOCATION Description I Qty. I Ea Total Job site address: 14378 SW 130th Ave Heating/cooing Air conditioning or heat pump City / State/ZIP: Tigard, OR 97224 (requires site plan slowing placement) 14.00 Suite/bldg./apt. no.: Project name: Residential Remodel Furnace 100,000 BTU (ducts /vents) 14.00 Cross street/directions to job site: From Hwy 99, turn right on Bull Mountain Rd, turn Furnace 100,000+ BTU (ducts/vents) 17.90 right on Green Field Dr., turn left on Bird View, turn right on 130th Ave Gas heat pump 14.00 Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or — -- hydronic) 14.00 Unit heaters (fuel -type, not electric), Subdivision: WOODFORD ESTATES. LOT in -wall, in -duct, suspended, etc. 10.00 4, ACRES .20 Lot no.: 2S109AA01600 Flue /vent for any of above 10.00 Tax map /parcel no.: R2022142 Other: I I 10.00 DESCRIPTION OF WORK Other fuel appliances Water heater 10.00 Add a vent in a bathroom Gas fireplace 10.00 Replace flex heating ducts with metal ones Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 /. PROPERTY OWNER ❑ TENANT _ Chimney /liner /flue /vent 10.00 Name: Tin Than Other: 10.00 Environmental exhaust and ventilation Address: 14378 SW 130th Ave Range hood/other kitchen City /State/ZIP: Tigard, OR 97224 equipment 10.00 Clothes dryer exhaust 10.00 Phone: (503)484 -3521 Fax: ( )tindthan @yahoo.com Single -duct exhaust (bathrooms. C] APPLICANT 11 CONTACT PERSON toilet compartments, utility rooms) 6.80 Attic /crawispace fans 10.00 Business name: Other: 10.00 Contact name: Fuel piping $5.40 for first four; $1.00 for each additional Address: Furnace, etc. City /State/ZIP: Gas heat pump Phone: Wall /suspended/unit heater ( ) Fax: ( ) Water heater E - mail: Fireplace CONTRACTOR _Range L � Barbecue Business name: d Gip) L Clothes dryer (gas) Address: Other: MECHANICAL PERMIT FEES* City /State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) CCB lie.: Plan review (25% of permit fee) State surcharge (8% of permit fee) 6-, by TOTAL PERMIT FEE S O Authorized signature: (44--- This permit application expires it a permit is not obtai within / days after it tots been accepted as complete. 1 \ Bwlding1Pertnits1MEC- PermitP.pp doc 12103 440-4617r (11 /02/COM/WEB) v Electrical Permit Ap VED FOR OFFICE USE ONLY City of Tigard 2 3 Received Pemnit No.: ' ( b -* 9'?) 13125 SW Hall Blvd., Tigard, OR 97223 AUG 2 3 2006 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 OthcrPcmtit: Inspection Line: 503.639.4175 CITY OF TIGARD . 1 J- _ � Date/By. „ Date Ready/By awn 0 SeePage2 for Internet: www.ci.tigard.or.us BUILDING DIVISIO ' Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition/alteration/replacement Please check all that apply: ❑ Demolition ['Other: ❑Service over 225 amps, comm'I ['Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ® 1 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 E] Multi family ❑Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park Job no.: Job site address: 14378 SW 130th Ave ❑Health - care facility ['Other: 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. Suite/bldg. /apt no.: Project name: Residential Remodel FEE° SCHEDULE Description I Qty. I Fee. I Total Cross street/directions to job site: From Hwy 99, turn right on Bull Mountain Rd, New residential single or multi - family dwelling unit. tarn rinhf nn (rear Wialrl Tl• tarn Inff nn TA MMViawr f rinht on 178th A VP Includes attached garage. 1,000 sq. ii. or less 145.15 4 Subdivision: WOODFORD ESTATES, LOT 4, ACRES Lot no.: Ea, add'/ 500 sq. fl. or portion 33.40 1 /n /C1110 A A Al FM Limited energy, residential 75.00 2 Tax map /parcel no.: R2022142 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular • Add a full bath room In an existing storage area in the daylight basement dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation Finish an un finished area approximately of 189 sq ft in the daylight basement 200 amps or less 80.30 2 El PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: Tin Than 601 amps to 1,000 amps 240.60 2 Address: 14378 SW 130th Ave Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or relocation Phone: (503)484-3521 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT El CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, first branch circuit I 46.85 �k,s5 2 Address: Each add'/ branch circuit / 6.65 G fj� 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: ALL THINGS ELECTRICAL INC Address: 10004 NE 7TH ST Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: VANCOUVER WA 98664 -3808 t . Investigation per hour (1 hr min) 62.50 Phone: (503) 460 -9310 Fax: ( 1 ' Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES" CCB Lic.: 132095 Electrical Lic. , D li Suprv. Lic.: LiI,,( Subtotal J 3. /....ca Suprv. Electrician signature, required: Plan review (25% of permit fee) J Print name: Date: State surcharge (8% of permit fee) / 1. o , _ TOTAL PERMIT FEE 5 '7, 7 5 Authorized signature: /�� — This permit application expires if a permit is not obtained within 180 days after it has be accepted as complete /� � A � Print name: �� / Date: (/ / L 7/ un * Fee methodology set by Tri- County Building Industry Service Board ry e ( ** Number of inspections per pea it allowed. i \Building\Permas\ELC- PemntApp doc 12/03 440- 4615T(10/02/COM/WEB t Plumbing Permit ApEIELE VED ' FOR OFFICE USE ONLY City of Tigard AUG 2 3 2006 Date/13y Greiv Permit No.: X V 0 v'J 6, �DO]� 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1 Plan Review TY OF TIGARD i OtherPemtit No.: 24- Hour Inspection Line: 503.639.41MILDING DIVISIO':: " � I + : - Plan Re Date Ready/By.. J'u�/ El See Paget for Internet: www.ci.tigard.or.us Notified/Method: /{ Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ® Addition /alteration/replacement ['Other: New 1- 2- family dwellings (includes 100 ft for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 [11 Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: - -- - • - -- - Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 14378 SW 130th Ave Catch basin or area drain 16.60 City /State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Residential Remodel Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: From Hwy 99, turn right on Bull Mountain Rd, Manufactured home utilities 110.00 r......i. ht_ Gt ota nv r..... ton ,,.. Rt.elvtnm dm-. . tnht ..., r lath A.... Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: WOODFORD ESTATES, LOT 4, ACRES .20 Lot no.: Water service (no. linear ft.: ) Page 2 /C1110 A. AnrMill Fixture or item Tax snap /parcel no.: R2022142 Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 Necessary plumbing work for adding a full bath room in the existing storage area Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ® PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 - -- Ejectors/sump 16.60 Name: Tin Than Expansion tank 16.60 Address: 14378 SW 130th Ave Fixture /sewer cap 16.60 City /State/ZIP: Tigard, OR 97224 Floor drain/floor sink/hub 16.60 Phone: (503)484 -3521 Fax: ( )tindthan @yahoo.com Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City / State/ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: KKMJ PLUMBING INC Water hearer 16.60 Address: 8100 SW ELMWOOD ST Other: City/ State/ZIP: PORTLAND OR 97223 -1220 Subtotal Minimum permit fee: $72.50 Phone: (503) 475 -7043 Fax: ( ) 34 1 -i ill Residential backflow minimum permit fee: $36.25 7A ,5T CCB Lie.: 162896 (, orl - 1 Plumbing Lic. no.: t... I { t 1 p� Plan review (25% of permit fee) State surcharge (8% of permit fee) ` so Authorized signatrr ✓ TOTAL PERMIT FEE 7" u 30 Print name: /iL ,...-44----- Date: P 3/04 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 7 /,d *Fee methodology set by Tri- County Building Industry Service Board. 1.1Bwlding \Pemuts\ I PernoApp doc 06/05 440 -4 616T(I 0Po2/COM /WEB) CITY OF TIGARD 13125 S.W. HALL BLVD. • TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ALL THINGS ELECTRICAL INC 10004 NE 7TH ST VANCOUVER, WA 98664 Electrical Signature Form Permit #: MST2006 -00231 Date Issued: Parcel: 2S109AA -01600 Site Address: 14378 SW 130TH AVE Subdivision: WOODFORD ESTATES Block: Lot: 004 Jurisdiction: TIG Zoning: R - Remarks: 189sf basement finish, add full bath 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: TIN THAN ALL THINGS ELECTRICAL INC 14378 SW 130TH 10004 NE 7TH ST TIGARD, OR 97224 VANCOUVER, WA 98664 Phone #: 503 -484 -3521 Phone #: 360- 604 -0241 Reg #: ELE 37 -811C LIC 132095 SUP 46655 AN INK SIGNATURE IS REQUIRED ON THIS FORM • ature of Su ising 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 KKMJ PLUMBING INC. 8100 SW ELMWOOD ST. PORTLAND, OR 97223 Plumbing Signature Form Permit #: MST2006 -00231 Date Issued: Parcel: 2S109AA -01600 Site Address: 14378 SW 130TH AVE Subdivision: WOODFORD ESTATES Block: Lot: 004 Jurisdiction: TIG Zoning: R - Remarks: 189sf basement finish, add full bath 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: TIN THAN KKMJ PLUMBING INC. 14378 SW 130TH 8100 SW ELMWOOD ST. TIGARD, OR 97224 PORTLAND, OR 97223 Phone #: 503 -484 -3521 Phone #: 503 -475 -7043 Reg #: LIC 162896 PLM 34 -467PB . AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized P mber If you have any questions, please call 503.718.2433.