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Permit .. - MASTER PERMIT IN vCITY OF TIGARD ,;, ., a : COMMUNITY DEVELOPMENT (o 1 Permit#: MST2013-00206 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2013 Parcel: 1 S135DCO2200 Jurisdiction: Tigard Site address: 12081 SW LINCOLN AVE • Subdivision: NORTH TIGARDVILLE ADDITION Lot: 63 Project: Wood Project Description: Repair to structural beams,mud sill,framing&sheathing. 10/23/13, reprinted to add(1)water closet,(1)lay and reinstall(1)furnace. . BUILDING • • Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 st Value: $12.000.00 Rear: 0 - PLUMBING. Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Pressure reducer valve MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or,Fdr: 0 ' Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: • Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: . WOOD,RALPH E DEREK XENOS PATTERSON Required Items and Reports(Conditions) 12081 SW LINCOLN AVE 18790 NW IDANHA ST PORTLAND,OR 97223 PORTLAND,OR 97229 . • PHONE: 503-320-9024 PHONE: 503-577-6296 FAX: . Total Fees: $653.39 . •This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will . be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTEN ••• • eeon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-s; 0 through OAR•• -001-00•; You may obtain a copy of the rules or direct questions to OUNC by calling 5 32.1987 or 1.800.33 .2344. Issued =y: �il i% _ ....1■—,... _ Permittee Signature: k Call 603.639.4176 by 7:00 a.m.for the next available Inspection date. 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. q CITY OF TIGARD MASTER PERMIT 14 _ a: _ COMMUNITY DEVELOPMENT Permit#: MST2013-00206 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2013 Parcel: 1S135DCO2200 Jurisdiction: Tigard Site address: 12081 SW LINCOLN AVE Subdivision: NORTH TIGARDVILLE ADDITION Lot: 63 Project: Wood Project Description: Repair to structural beams, mud sill,framing&sheathing. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $12,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Pressure reducer valve MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits _ 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All asin N Other: N Other Description: Ecom p 9 BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: WOOD,RALPH E DEREK XENOS PATTERSON Required Items and Reports(Conditions) 12081 SW LINCOLN AVE 18790 NW IDANHA ST PORTLAND,OR 97223 PORTLAND,OR 97229 PHONE: 503-320-9024 PHONE: 503-577-6296 FAX: Total Fees: $535.71 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done ' ccora dannce approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days ATTENTION: Oregon law re•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 -001-0010 through OAR 952-f• -10•1. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 Is ued By: , i _ _41 '-�� ,�A Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 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 Application l S., �2esidential FOR OFFICE USE ONLY RECEIVED p� f City of Tigard Date/By: 9 If /5 o/ Permit No.: /-(✓/�/5��a®(� 13125 SW Hall Blvd.,Tigard,OR 97223 y P 1 1 2013 Plan Review-IP 1 ' (�/2� (3 Other Permit: ' • o • Phone: 503.718.2439 Fax: 503.598.196w L.• U Date/By: r v r I I G n It D Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: /kip 3 Pr Supplemental Information BUILDING DIVISION WG)& c (((,�JJJ[/ 04,e4 47, TYPE OF WORK REQUIRED DATA:I-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 1 CATEGORY OF CONSTRUCTION work indicated on this application. L-and 2-family dwelling El Commercial/industrial Valuation: $ q /�( ❑Accessory building El Multi-family Number of bedrooms: l ''ll ❑Master builder 0 Other: Number of bathrooms: / P j�°,t"' JOB SITE INFORMATION AND LOCATION Total number of floors: I Job site address: / 008/ J (() Li-,cc)/t) Avg_ New dwelling area: square feet City/State/ZIP: 7-744/2.81 62 9'72 Z 3 Garage/carport area: square feet Suite/bldg./apt.no.: v Project name: a-e Covered porch area square feet Cross street/directions to job site: 9/ s7 i.,),CD/iv Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: 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,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Ve/TV2 ( /2 2 Valuation: $ _ L t2�M S I m vp ,LL/ s hi (, _ / Existing building area J�quare feet - -frielr1? • ' �� New building area: square-feet ❑ PROPERTY' �V ER ❑ TENANT Number of stories: Name: g,y,, k.,30 Type of construction: Address: ,7„' ca.ok:A S.w. Lon cb I n kV F Occupancy groups: City/State/ZIP: ft Ps---4- G(Z q'7223 Existing: ' Phone:603) 320-'1o21 Fax:( ) • New: APPLICANT CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: £R f!, z2 /\• ' Structural plan review fee(or deposit): . Contact name: r62-iLlicr_ ; Z"m.i5,'v FLS plan review fee(if applicable): . Address: t cit A).C.0. 2 J eo h A c__ City/State/ZIP: 2 rn-�t,r1 t� t�,2 !72 2 C1 Total fees due upon application: Phone: Q3) S L L ..r �0 a_ef �j Fax: :( ) / Amount received: ,0/66,.64// E-mail: jj PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* t;t4 7< (�r4�E e S 3!N l(1r1 /l! t1/\ Commercial and residential prescriptive installation of I CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel stem. Business name: T3Z 2sL ptcv *'1-----2S3/t,,,� Submit two(2 --ts of roof plan with c.• ectiondetails l C� and fire departmen : cess,alo ••ith the 2010 Oregon Address: t q O „`I , Li,_ Vie(#n h,4 s(. Solar Installation Speciar. . ode checklist. City/State/ZIP: P�o e\A0 4�ZZA Permit Fee udes pl. 'ew $180.00 :1 d administrative fees . Phone:( 3) S9- (a 243 ul. Fax:( ) Stat- urcharge(12%of permit fee): $21.60 CCB lic.: it ©22__ I I /Mil (l Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained P within 180 days after it has been accepted as complete. Print name: ,'�/ Date: q r c( . f,3 *Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) J Building Permit Application Checklist One- and Two-Family Dwelling . • FOR OFFICE USE ONLY • • City of Tigard Received Permit No.: II 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: °: C : Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: "I I t.A-R D" 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ' ❑ ❑ ❑ 7 Water,district approval. ❑ ❑ ❑ 8 Soils.report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ • 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc.: 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state .❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size . . sheet attached to the plans with cross references between plan location and details. Plan review cannot-be completed if - copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft. intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, •❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. - 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling'height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. ' 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ' ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ' ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ III ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be ar Ilicable to the rro-ect under review. . .JURISDICTIONAL SPECIFICS 23' Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ - 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. . ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ' ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. . . . 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, •❑ a ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. t:• I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440.613T(I1/02/COM/WEB) - • . Plumbing Permit Application q�, Building Fixtures 0) FOR oiTICl: USE ONLY Received C% n City of Tigard \3 Date/By: / �1(D Permit NO.:/ST7/1/3-�DQ 2 n 13125 SW Hall Blvd.,Tigard,OR 9� t73 �� Plan Review /3 v" 12 Phone: 503.718.2439 Fax: 503.598.190? , FtS� Date/By: Other Permit No.: Inspection Line: 503.639.4175 ``) G C ,` Date Ready/By: luris: 65 See Page 2 for T I G A R D Internet: www.ti ard-or. ov GG�� a�Q y y g g g Q1 Q�`•r��� Notified/Method: Supplemental Information TYPE OF WORK�``��A��(1,`v FEE* SCHEDULE ❑New construction El uernolition 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 312.70 El 1-and 2-family dwelling 1:1 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 'JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: / a 08 I S L,��,�ti � Catch basin or area drain 18.76 City/State/ZIP: �/1 �7 ZZ� Drywell,leach line,or trench drain 18.76 TI .3 f`-1/L Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 -- Cross street/directions to job site:- - 9/ -Manholes 18.76- Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 ff Yi G t'e / - /'tt e-c- t/a(ve- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 a PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: ¶. \ V v fit, Fixture/sewer cap 25.02 ` kv, Floor drain/floor sink/hub 25.02 Address: 1 a e t S.I,�J , L...t�,1i) Garbage disposal 25.02 City/State/ZIP: �� y,o Q O 2 GV 2Z 3 Hose bib 25.02 Phone:( Z? j.)c_C1 02_9 Fax:( ) Ice maker 12.51 'VKAPPLICANT • ACONTACT'PERSON Interceptor/grease trap 25.02 � pn C`^ Medical gas(value:$ ) Page 2 Business name: Icc.�Y 1 - �Qn L Primer 12.51 Contact name: 1C.G Roof drain(commercial) 12.51 Address: , o L),k.j TA 11A $T Sink/basin/lavatory 25.02 City/State/ZIP: P2,,a iN.N z C1 Solar units(potable water) 62.54 Phone:6tYj).- n-l0 24 l3(p Fax: :( ) Tub/shower/shower pan / 12.51 M.57 57 E-mail: ` Urinal -25.02 GlX \ tAtT'TE-asap its•JJ'ce.ry-N Water closet 25.02 CONTRACTOR f� Water heater 37.52 Business narrter D El g- '/til 6 - Water piping/DWV 56.29 Address: /0 1. 1 "`�°� ���VVVNYY���� Other: J 25.02 )s o City/State/ZI J/ox {kiti)1,6 77� 614- Pt 3� Subtotal Phone:(97)) 0 J Fa x:( ) Minimum permit fee: $72.50 -� 3 Plan review (25%of permit fee) CCB Lie.: /5-01( 30 Plumbing Lic.no.: 3-(001 0O State surcharge(12%of permit fee) 0 P"-7O Authorized signature: 21,07.0 TOTAL PERMIT FEE Print name: �/� Date: l�114 NL This permit application expires if a permit is not obtained within 180 days f L6/ / after it has been accepted as complete. Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(IO/O2/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-I'100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer- 1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service- 1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to h and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" - 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the.qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor WaterCloset-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 CITY OF TIGARD BUILDING DIVISION PERMIT#: /P1S T X15"00,204P 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 AO Inspection Requests (24 Hrs.): (503) 639-4175 - I 1' INSPECTION WORKSHEET FOR DATE: 440/3'3 TIME: / , PAGE: SITE ADDRESS: l20e 1 5W bwoln •CLASS OF WORK: • SUBDIVISION: LOT#: TYPE OF USE: P ROJECT NAME: DESCRIPTION: OWNER: PHONE#: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: L l//013 Pour Time: Code # Inspection Description Confirm # • , Contact # Message R? fi Corrections/Comments/Instructions: WiraVe-40 • ►� PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS - ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: Date: jib-di-3 Phone #: 503 718- o270 12081 SW Lincoln Ave. Tigard,OR.97223 Additional work to be completed on permit#: MST2013-00206 1. Replacement of approx. 16 2"X8"floor joists. 2. Install a bathroom vent fan with proper duct. City of Tigard Ap.roved Plans By V•i Date i o( 14-1 e 12.os1�) t(&)(ojj REVISION OFFICE COPY