Permit .t CITY OF TIGARD MASTER PERMIT
. 3 - COMMUNITY DEVELOPMENT Permit#: MST2015-00036
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/12/2015
Parcel: 2S104DD07900
Jurisdiction: Tigard
Site address: 12858 SW MORNINGSTAR DR
Subdivision: MOUNTAIN HIGHLANDS NO.3 Lot: 37
Project: DeCastro
Project Description: Kitchen remodel, opening wall and replacing with beam.
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: $1,500.00 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: 0 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: 0
Other Fixture Units:
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'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 5
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:
■
DECASTRO,FRANCISCO A GIBB CONSTRUCTION&REMODELING INC Required Items and Reports(Conditions)
12858 SW MORNINGSTAR DR 15755 SW SERENA WAY
TIGARD,OR 97223 TIGARD,OR 97224
PHONE. 503-914-5830 PHONE: 503-407-9686
FAX: 503-549-8986
Total Fees: $354.75
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a m�.e rules or direct questions to OUNC by - .• • 1987 or 1.800.332.2344.
r ( i'
Issued By: —.. — __ Permittee Signature: `�
..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
Residential 11141;1 ED I OR OI I It l til t l\I 1
City of Tigard �i Da - Amu Permit No.: i-t /",(J/T-xi)S6,
14 13125 SW Hall Blvd.,Tigard,OR Plan Revie ♦��
Phone: 503.718.2439 Fax: 503.60 4 2015 Date/B : ,IMe�\��I��P
Other Permit:
I 1 0 \1 p Inspection Line: 503.639.4175 Date Ready > lurk: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF l'IG,y RD Notified/Method: ,/N�/r�r Supplemental Information
RUILD I qpF70i t--.1 7 .. cp.
TYPE OF �MAN 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.
Valuation: / ?
l-and 2-family dwellin g ❑Commercial/industrial
❑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: i 2455'3' 4 M pp. (J L.,c0,F{-p-- p(L . New dwelling area: square feet
City/State/ZIP: "p.,1,74-0..-0 pa- 17 2 Z, Garage/carport area: square feet
Suite/bldg./apt.no.: l Project name: gezeiS rt.) Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
�7 {)E Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
/i Sr"1-)1— 'EN/J L �t rt'tf Cam( by'Z Valuation: $
Existing building area square feet
New building area: square feet
g PROPERTY OWNER I ❑ TENANT Number of stories:
Name: P-IM EY - 1Vk_ D 'A-STS Type of construction:
Address: i Z-S$ i,ij /14 elf IA/l.1 b 9r-44- t4 . Occupancy groups:
City/State/ZIP: 7)L,yq-/).0/, e72_2_3 Existing:
Phone:(0-5) y l 4 - 55. 3v Fax:( ,�.f) New:
lid APPLICANT . ICI CONTACT PERSON BUILDING PERMIT FEES*
Business name: G- ,P,., C Srlh.t_t,rt,-. -4r �eZ,a�b (Fkare►KertofrscheE4le)
Structural plan review fee(or deposit):
Contact name: ` -Ai._ & 3/
5 60 r4 L{ FLS plan review fee(if applicable):
Address: (Z7 SS- .-d
s2D o Total fees due upon application:
City/State/ZIP: `P(7A- .L
��7,Z Amount received: r�.[P6'
Phone:( 1 4v? -at(ag 1-, Fax::( ) _,
•E-mail: bfeiPjGOniSrt21.�.LTt cv C tG-A- T. r i ET PHOTOVOLTAIC SOLAR PANEL SYSTEM PEE
Commercial and residential prescriptive installation of
CONTRACTOR roo- ,• mounted Photo Voltaic Solar Panel System.
Business name: (e,p, (�•_s Tt?it.t_LT 1 r.,-t 4 (? jt t---g, Submit . 2)sets of roof plan with connectiot • .1 s
and fire dep. • access,along with •• 110 Oregon
Address: I .s-3- 4.4 9 ---p-e.4.1 A c-r. Solar Installation Spe t Co.• ecklist.
City/State/ZIP: 'n L?,} °(. - Permit Fee(inclu4>: . :. eview $180.00
/ and .. mistrative -- _
Phone:(517 IV i)1- el.6810 Fax:( ) State su •. ge(12%of permit fee): $21.60
CCB lie.: ,<4,4-,p t //j y 1 1( Total fee due upon appication: \ 201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
i�j� *Fee methodology set by Tri-County Building Industry
Print name: Date: 3I L s Service Board
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLI
Received
City of Tigard Permit Nu
71 ..
+ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated.
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T I G 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 I es `" \/`
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 ❑ ❑ ❑
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:••licable to the 'ro.ect under review.
JI RISI)I( I'IO\.\I, "l'I:( IFI(''
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 Buildingplans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"buildingplans must meet criteria outlined in the Permit&System Development Fees document. Cl ❑ ❑
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, ❑ ❑ ❑
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. _
I:\Building\Perntits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application 1.01( Ot l l( I l ',I oN1.1
City of Tigard RECEIVE ee (5 � Permit No.:13125 SW Hall Blvd.,Tigard,OR 97223 D `By , r
' . Phone: 503.718.2439 Fax: 503.598.1960 Date/By:Review Other Permit:
DateBy:
1 1,, \1,i, Inspection Line: 503.639.4175 Date Ready/By: luris ® See Page 2 for
Internet: www.tigard-or.gov MAR 4 2015 Notified/Method: Supplemental Information
TYPE OF WOIKII
TY OF I IGARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Ilv(�e�I"� Mechanical permit fees*are based on the value of the work
❑New construction 1 1cL'��itnn V Addition/alte SIOJ\ performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
_ Air conditioning 46.75
Job site address: I 24 cif M oYl-,J+4-G f 1-i1-4- .0 2 r Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -1 b ra.-(}.4 ( 7l q 7 ZZ 3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: II Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
/-._„-„ -fir Unit heaters(fuel-type,not electric),
Q f�tY tit in-wall,in-duct,suspended,etc. 46.75 .
Flue/vent for any of above 23.32 .
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert i , 33.39 33.3 CI
Flue vent for water heater or gas .
N (-1.0-P 0 L t Cur fireplace 23.32
�t �-P� /.�/5F12 -r Log lighter(gas) 23.32
" �� Wood/pellet stove 33.39
1^tiry 5 ,--h,--if ' tm., ebvlc Top Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
V PROPERTY OWNER 1 ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: R"mei�� i (},J 1,- DCT2-o Range hood/other kitchen � i
equipment A 33.39 33 c
Address: /1'S 4,� tAr%)J(4 t 5-r44. 04 . Clothes dryer exhaust 33.39 .
City/State/ZIP: M1,4(}0 ,, Gi 71-'5 Single-duct exhaust(bathrooms,
/ toilet compartments,utility rooms) 23.32
Phone:(S lr) ) 6111-f - S3 30 Fax:( ) Attic/crawlspace fans 23.32
APPLICANT (] CONTACT PERSON Other: 23.32
1 Fuel piping:
Business name: (3 i Gp+4 51 L(Tt t� 't oDat rvj,
514.15 for first four;54.03 for each additional
Contact name: t Furnace,etc.
/ Gas heat pump
Address: 5']S� 7� ��3-rol4 CT. Wall/suspended/unit heater
City/State/ZIP: Le-, -(V i ell ei 2 a 7-4- Water heater
Phone:(9 ) Li c -et 65 b Fax::( ) Fireplace
Range
E-mail: 6j tpA-2 CU•.i S-r(),t,c(,Tt Cr.-4 a CD't c-.A.S r i xi-el. Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: 17 6r ` [ ----0ISTQ 6,..r_012,> der:
MECHANICAL PERMIT FEES*
Address: •a :,,, - . . - . ►o -. I . , ,'39
Subtotal
City/State/ZIP:
/rjOC.`=4-,f='EY D. Minimum permit fee($90.00)
I Plan review(25%of permit fee)
Phone:(1A 2` ' ' "-2-1-2-4+9 Fax:( ) ��D 2 ��Dy State surcharge(12%of permit fee)
CCB lic.: -{J f, 0 0C, 4* 79 5p�����-(9 / TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: \ 1,12: :)--� - • Fee methodology set by Tri-County Building Industry Service Board
Print name: C/%C � Date: 3
1:\Building\Perrnits\MEC ermitApp_040113.doc 440-4617T(I1/07/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional $100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\BuildingWermits\MEC_PermitApp_040113.doc 2
Electrical Permit Application ECEI% l
SiCity of Tigard o ��i5-4LX)
13125 SW Hall Hlvd-,Tigard,OR 97223'AR 4 2015 ��Review
Phone: 503.718.2439 Fax: 503-598.1960 DatefBy. Rrlared Permit e:
Inspection Line: 503.639.4175 Q(� Ready D sre/BY' +� see Page 2 for
Internet: www.tigldor.gov I,iTY'OFTI(>iARU _Notified/Method Supplemental Information
.�a ,. _- PLAN REVIEW .-
Please check all that apply(submit j sets of plans Witco's checked):
❑New construction W: Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition • Other: _ where the available fault current ❑Marinas and boatyards.
________ - exceeds 10,000 smpe at 150 volts or ❑Floating buildings.
Accessory bllild less to ground,or exceeds 14,000 ❑Commercial-use agricultural
1-rill 2-1Yttuily{dwcllitys CammttciaUitldustrial ❑ r5 amps for all other installations. buildings.
Multi-family Weer builder ❑Other: °Fire pump ❑Installation of 150 KVA or
ny`}r _ °Emergency system. larger separately derived
(.24 - — °Addition of new motor load of system.
Jobs lob site address: 4,,,1 mcaN Psi c51Xiii t t00HPormore. ❑ A^, E °t-i»^I-3"
r�rp r� °six or more residential units- occupancy
City/State/ZIP: IrA�r/r�� t4 . 1 7 2 7 °Health-care facilities. ❑Recreational vehicle parks.
i
CI Hazardous locations 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: Q Service or feeder 600•A • or more. 600 volts nominal.
Cross street/directions to job site t '
gip'
New resideedal single or multi•-tinily dwelling unit.
Subdivision: 1 Lot#: Includes attached garage.
1,000 sq.ft.or less I I 168.54 4
Tax p #: Ea add'l 500 sq.ft.or portion 33.92 1
r..••• ;.�
•«� ta : °di �iii=° � - . . Limited ier .residential
75.00 2
(with above sq.II)
e /i t / �"J t7 z lip D l,-46-11-13 Limited energy,multi-family 75.00 2
! residential(with above sq ft.)
Renewable Energy ❑ See Page 2
i:Y: ,;;:.erg.of F�' . .._ ,a Wit �3.:► .L.ve- 's' Service'or feeders installation,alteration,and/or relocation
Name: �M II F70'A-Kk- e T f?U 200 amps or less 100.74 2
Address: /1,1513 44,3 M pry IK to 51.4 fZ DX* 201 amps to 400 amps 00.56 2
401 amps to 600 sops 200.34 2
City/State/ZIP: --1764..0,4 On,, q77 Z3 601 amps to 1,000 amps 301.04 2
Phone:(51,3) dj f 1.4 - cig 30 I Fax:( ) Over 1,000 amps or vats 552 26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 i I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 emus to 599 amps 168.54 2
p Hunch circuits-new,alteration,a extension,eer paad
� �M «= °^m* A.Fee c branch circuits with
Business name: p>p, Lt,tx, I cN 4 t,00t�-f^'v above service or feeder fee, 7.42 q 2
2 each branch circuit
Contact name: . I✓'�- (V c OJ,-) B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: j -i cr SW,f 4 C7 branch circuit
City/State/ZIP:•l(�'A-(l4 t'7%- • q)74-4
Each edd'I branch circuit 7.42 1 2
I --- Miscellaneous(service or fader not included)
Phone:(5t3) / G-7 -Cl. C-8%, Fax::( ) Each manufactured or modular
67.84
2
dwelling,service and/or feeder
Email: bi P P,t.t 57'+-u c,-1-r e.' L Ccrot1 C.A17- . ,t./t_
Reconnect only 67.84 2
- • altrRACTOR . Pump or irrigaion circle 67.84 2
Business name: 3 l,li1Lv e ,.., t. F' C- Signor outline lighting 67.84 2,
Signal circuits)or limited-energy ❑ See Page 2 2
Address -4..2 2-5-0} — panel,alteration,or extension
/StaceZlP: _ �Y.�a l� l r � Each additional Inspection over allowable in any of the above
(Cl
I. S Additional inspection(1 hr min) 66.25/hr 11:of.. (tS, ) S w �2'1 J Fax:( ) investigation(1 hr min), 66.25/hr
Industrial plant(1 hr min) 78.18/hr
EMMI: ks Ltv'l.c'V te (t u. 1 ie e --,,s u l 1."''—. Inspections for which no fee is
spectfucally Itstad(%r hr min) 90 00/hr
CCB Lic.: 1�`1' �-, I Electrical Lic.: C -`�L l> Suprv.Lic.: c;8 (S "
�t�// 71•I 17 fail*e F [ i�;;saga,
5urprv,Electr'ici s� required: Subtotal: e.i.. e .:
❑Plan Review Required(25%of permit fee): ,
Print name: �, t t.t'1t— �j AF\c Date: 13 /(5 State surclnrgc(12%of peanut fee):
Authorized signature: �L jRjftR f sir- 1 TOTAL PERMIT FEE: '1 6s7, 17"
This permit application expires if a permit is not obtained within 180
Print name: f• .1.::, 'k Date: y/ /!) days after it has been accepted as complete_
�... • Number of inspections allowed per permit.
IiBuilding\PermiisSELC PmutApp_ELB_EREdoe Raw%/21/20I4 44046151(1 t/05,COMIWEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12858 SW MORNINGSTAR DR, TIGARD, OR,
97223
Residential - Master Permit
199 Electrical final
PASS
MST2015-00036
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12858 SW MORNINGSTAR DR, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00036
David Young
Contractor updating carbon monoxide detector on floor with sleeping rooms.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12858 SW MORNINGSTAR DR, TIGARD, OR,
97223
Residential - Master Permit
699 Mechanical final
PASS
MST2015-00036
David Young
Violation Summary:
Inspector Contractor