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Case File Creative Home Remodeling _ .- ---_-- --- --- --- ----- -{-.� ----_� _ __---- -- - _ __ l --- 7350 SW Lairchnar k Danes _ HORNE KITCHEN Portland OR 97224 OPTl�ON #5 - Phone # 503-639-2411 Fax # y� _ [02-19-03� Y A? /: � � . 3/8 Scale T 444 -- ---- — ---- _�. _--— - -------- — — - — 68 ---- - -- --- --- _. 30 10112 ... 10 1/2 —- 151/2--- 8 4 12 12 12 q7 12 12 I 14 j � � 7D �jMOk� �c`7`��Ta✓S 30 24 24 24 � 2436 1/4 0" �.. C 7- dN s i 25 3✓4 24 33 71 i '"�:' O •f` 4Y W .JS•��t'v q, 24 a ►► 'i '' V�.. 18 CA � Al � 48 16 / �•- �'`.t`• eIE- ft k �.< \.}•}�•.: b' / ^ #2 <. X �. F Y � ," :. ' y 13 1/2 24L.�.� 2 I 139 �i VO -. 101/2 271/2 j 3U 39 W24 24 �kG - . .� 30 ° _ a ' J LAP DOUaLL- r0P P ! CA L. t Af,=- PLAT - 4 FT. (M I ki.). OR. 4,072-22,q ;zx 4 lid Final nspe°tion approval � • regUired prior to p I �s 4 �x '; .- . X C U p a n C y. -- A l-Oved plans NEADL-R n sa e on job T;21 M M I tp - -- -. o 336 Lu K1NG SrUP o } - GILL - LIABILITY 1LL -LIAJIL,T,Y CITY OF TIGARD Approved ........................... Addres The O ty of Tigard and its y pp � shall be .� �VED -- conditlonalt A roved .....................: c �: and p°Sted �' �;� i CRIPPLE O io ees shall not be For only " work as deafted in: visible f roM street. '� 5rUa5 p PERMIT NO, responsible for discrepancies See Letter to: Follow..... t �� 03 which m,y appear herein. q tach.. .-.-.. _.._..3.. • C:l wlQr)ow - -pOF TI( RD` ' OLF PLAT 12oUGN O Pr N I NCJob Address: By: Cate: r3,JILDt��-a � VSIUN 4_ 40 NOTiCE: IF THE PRINT OR TYPE ON ANY I ( 11 ► � r I � l + l � t I + IJIII IIIIIII VIII + I I � I + I '1 II � L1 + 1 � IIf � IIt IIIII � I III III III III ill 111 III Ijl 111 III ( III III i ( I fll ' II � ill ill III ( II III Ilflll ( III fll ( ( VIII III III IIIIiII IMAGE S I I NOT AS CLEAR AS THIS NOTICE, 1 � 10 12 IT IS DUE TO THE QUALITY OF THE No.38 ORIGINAL DOCUMENT E 6Z SZ LZ 9Z 5Z � Z EZ A Z IZ OZ '6T 8i - LT 9 i � T - EI ZT iT I 6 8T- L - 9 • I I I I , lVIIIII IIlI illi illi �lll�llll illi illi illi illi lllllllll ��II IIIL ILII IIII IIIL Ilii IIII Ilii illi ilii illi illi IIII IIII IIII ILII II�i VIII Ilii illi lii� illi Ilii iiia ilii �I<< « � �I�l illi ll�l �1�� ll�� 111 u« � �.� ll.l 1.1.( fllllf�ll w r � v Er E C 0 p I 1 i I i 1 8515 SW AVON STREET CITY OF TIGARD 24-Hour BUILDING Inspection Line,: (503 - 75 INSPECTION DIVISION Business Line: �50 '1 MST ___ ©UP -- -- Received __ _ _ _____ Date Reque ted 1 __ AM—_._.____ PM -_ - OUP Location 54- —Suite. _ IWEC _ Contact Person ____ __.__- Ph (. _) Z- D d Y 3 PLM Contractor_ —------ --- ----- - -- Ph ( ) SWR ----- BUILDINGfenant/Owner _--_ - e_ ELC Footing _ ELC Foundation Access: Ftg Drain - / ELR Crawl DrainSlab Inspection Inspection Notes:,, / SIT Post& Beam - - ----- - �� -G�cZ�T�Ll /•�•P� Shear Anchors - - -- - - ---- -- -- Ext Sheath/Shear Int Sheath/Sheer Framing Insulation Drywall Nailing Firewall Fire Sprinkler - - -- - --- --- - - - -- -- -- ---- -- -- - - - Fire alarm Susp'd Ceiling --- -- Roof Fi 7 SPART FAIL - ost 8 Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain ----- - --- --- -- Shower Pan Other: - - --- --- Final PASS_ PART FAIL_ MECHANICAL Post& Beam Rough-In -- Gas Line Smoke Damper.. - - -- - - -- - -- - Final PASS PART FAIL ---- _ - - - ELECTRICAL - Service - Rouqh-In UG/Slab ---------- _ __ - ---- Low Voyage Fire Alarm Final u Reinspection fee of¢ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE - F-] Pleasecall for reinspection RE: Unable to inspect no access --- ---- / F ire Supply Line ADA Approach/Sidewalk Daft �� Inspoctor - --- - __ Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FRAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MS INSPECTION DIVISION Business tine: (503)639-4171 - BILIP Received �2`3C Date Requested__-_-- ____- ______ AM_— _ PM_ BLIP Location _ _ — SuiteMEC Contact Person — �� /� -- Ph( sy��1 . .3 .=�U �� PLM --_...---- - --- Contractor _ _ �'�-___1�� Ph ( _) --_- SWR BUILDING Tenant/Owner __--` ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain - ---- - Slab Inspection Notes: ? � SIT Post&Beam Shear Anchors , L. Q ,t.4L __.. ._--------- Ext Sheath/Shear 4U ' - Irt Sheath/Shear Froming --- _ Insulation --- -- ------- ---- Drywall Nailing - Firewall Fire Sprinkler ------ - --- Fire Alarm Susp'd Ceiling --- - -- Roof Other: _ - . - -- -- Final PASS PART FAIL PLUMBINGVP - - - - Bost 8 Seam-- --- - Under Slab _-- Rough-In Water Service -- Sanitary Sewer Pain Drains - - -- Catch Basin/Manhole Storm Drain - Shower Pan l� Other: - - Final PASS PART FAIL MECHANICAL Post 8 Beam --- --- - -- — Rough-In Gas Line Smoke Dampers --- —� _ Final i PASS PART FAIL -- - - - -- ELErTRICAL Service -�---- ------ -- — ------ -------- Rough-In _— LIG/Slab --------- - _-_ - ---- Low Voltaoe --- - -- -- -- -- - Fire AlauP i-nel.� ART FAIL F1 Reinspection fee of$--_ required before next inspection. pay at City Hall. 13125 SW Hall Blvd. SITE - - W_-- F] Please call for reinspection RE:_ - _ �� Unable to inspect -no access Fire Supply Line ADA U c' Approach/Sidewalk Data`___ —�_ Inspector Other: Final DO NOT REMOVE this Intspectlon record from the Jo, site. PASS PART FAIL CITYOF TIGARD MAs'TERPERMIT I 03 00109 DEVELOPMENT SERVICES DATE ISSUED: 3/31/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 SITE ADDRESS: 08515 SW AVON ST PARCEL: 2S111DD-07500 SUBDIVISION: CHESSMAN DOWNS ZONING: It-7 BLOCK: LOT: 001 JURISDICTION: I1(; REMARKS: kitchen remodel. BUILDING REISSUE, CUSTOM STORIES FLOOR AREAS REQUIRED SETBACKS _ REQUIRED CLASS OF WORK: At T HEIGHT, FIRST: sf BASEMENT. sf LEFT. SMOKE DETECTORS. y TYPE OF USE: SF FLOOR LOAD. SECOND el GARAGE at FRONT. IPARKING SPACES TYPE OF CONST: 5N DWELLING UNITS TMFkI if RIGHT OCCUPANCY GRP: R7 DVALUEDRM BATH. TOTAL. P s/ y.ir.r.i, REAR PLUMBING SINKS: 1 WATER CLOSETS. WASHING MACH. LAUNDRY TRAYS-. RAIN DRAIN TRAPS. LAVATORIES: C`.SHWASHERS: I FLOOR DRAINS. SEWER LINES SF RAIN DRAINS CATCH BASINS TUBISHOWER5: GARBAGE DISP-. I WATER HEATERS- WATER LINES: BCKFLW PREVNTR GREASE TRAPS MECHANICAL OTHER FIXTURES. FUEL TYPES FURN<100K: BOIL/CMP<]HP: 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 SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 0 - 200 amp 0 - 200 amp. WISVC OR FDR: PUMPIIRRIGATION PER INSPECTION EA ADD'L 5005F. 201 - 400 anp. 201 - 400 amp 1x1 W/O SVC/FDR lei SIGNIOUT LIN LT PER HOUR LIMITED ENERGY 401 - 600 amp. 401 - 600 anp E AADDL BR CIR: 1 SIGNALIPANEL. IN PLANT MANU HMISVC/FDR. 601 1000 amp. 601 man ps-1000v MINOR LABF'_. 1000.amplvolt PLAN REVIEW SECTION R,-connac t only -4 RES UNITS-. SVC1F OR>R225 A.: >600 V NOMINAL. CLS AREA/SPC OCL ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL- B.COMMERCIAL AUDIO 6 STEREO VACUUM SYSTEM. AUDIO 8 STEREO: FIRE ALARM. INTERCOWPAGING OUTDOOR LNDSC LT: BURGLAR ALARM- OTH BOILER: HVAC LANDSCAPEIIRRIG PROTECTIVE SIGNL: GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC DATA/TELE COMM: NURSE CALLS. TOTAL 0 SYSTEMS- TOTAL FEES: $ 419.91 Owner: Contractor: This permit is subject to the regulations contained In the HORNE.BRIAN D/CAROLYN K CREATIVE HOMES REMODELING T-gard Municipal Code,State of OR Specialty Cafes and 8515 SW AVON ST 7350 SW LANDMARK LANE all other applicable laws All work will be done in TIGARD,OR 97224 TIGARD,OR 97224 accordance with approved plans This permit will expire 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 adopted by the Phone: Phone. S03-639-2411 Oregon I,If l tv Notification Center. Those rules are set forth in r 952-001-0010 through 952-001-0080 You Rea" LIC 135706 may ob(. )pies of these rules or direct questions to OUNC by-ailing(503)246-1987. REQUIRED INSPECTIONS Mechanical Insp Electrical Final Plumb Top Out Mechanical Final Electrical Rough In Plur,b Final Framing Insp Final inspection Gas Linelmop,---__ Issu d By : Permittee Signature : , J��^1��U - Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day Buildin Permit Application Received Bui _ Tj 16 lding L r y E 1 V Date/B��--I�I-03 ) Permit N0 ?Ze CityCit of Tigard v Planning Approval Mier Datc/B : Permit No.: 13125 SW I lall Blvd, !:j'. r Plan Review Other Tigard,Oregon 97223 Date/B : --u '1 Permit No.: Phone: 503-639-4171 Fax: 503-59841960 Post-Review land Use Dale/By- Case No. Internet: www.ci.tipard.or.us Contact Juris.: See Page-2 for 24-hour Inspection Request: 503-639-4175 ` ' Narnc/Method: _-_ supplemental Information TIU TYPE OF WORK u REQUIRED DATA: New construction - _ Demolition —_ 1&2 FAMILY DWELLING Addition/alteration!rc Slav menu Other: — CATEGORY OF CONSTRUCTION _ Note: Permit fees*are based on the total value of the work performed. Indicate I &2 Family dwellin Commercial/Industria) the value(rounded to the nearest dollar)of all equipment,materials,labor, — stria overhead and profit for the work indicated on this application. AccessBuildin3— Multi-Family - -- Valuation......................................................... Master Builder Other: JOB SITE INFORMATION and LOCATION No.of bedrooms: No.of baths:_ — Job site address: C, -i- Total number of floors..................................... New dwelling area(sq.ft.).............................. -- Suite#: Bld ./A t,#: Gara e/ca ort area(sq.ft. Project Name: U n tf y —-- Covered porch area(sq.ft.)............................. Cross street/Directions to job site: Dcck area(sq. ft.)............................................ — Other structui .area(sq.ft)............................ REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: Lot -- Tax map/parcel#: Note Permit Ices*are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, --- � _• overhead and profit for the work indicated on this application. Valuation........................................................ -- Existing building area(sq.fl.)....................... - — - - - — New building area(sq.fl.)............................... Number of stories............................................ — PROPEIiTY OWNER !'ENANT Type of construction.......................... ........... Nar3e.�y LgIA2ii — L3 1 v-- Occupancy group(s): Existing: — �r New: Address: City/State/Zip: a�t-I P one: l J � � - � 1 � F NOTICE: All contr;,ctors and subcontractors ar^required to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Narne' jurisdiction where work is being performed. If the applicant is exempt Contact Name ' from licensing,the following reason applies. Address: ryn K- L aj:2lt_ --- -�- - City/State/Zip: 1 L>►.r �' _-L _- ---- -- ----- Phone:� _ q—c,!''� 1 l Fax: l0 3 q BUILDING PERMIT FEES* E-mai 1: _ Please refer to fee schedule. CONTRACTOR - ----- -- ---- ._. -- BuslnesS Namc: Fees due upon application.. .. ................... S Address: City/State/Zip: Amount received...................................... . S Phone: _ _ Fax: - Date received:_ CCB Lic. 1 — -- -- -- AulhOriZed 3 notice: 'rhis permit application expires if a permit is not obtained Nlthin Signature: Date:_ INO days after It los been accepted as complete. Sf tl;l- •Fee methodology set by Tri-('runty Building Indulin Scr%ice Rol,(I (Please print name) � Q OthtsT,whit I orms\BldgPermitApp.doc 01/03 Commercial Plan Submittal Requirement Matrix Ci<<,of Tigard FTYPE OF SUBMITTAL # of Plans (Includes New, Additions er Alterations) Required at Submittal l Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building i* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After pian review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3' technicians. i\dsts\forms\COM-matrix.doc 9124101 Building Fixtures 11 OFFICE USE ONI, Plumbinp, Permit Application Received I•lumbing Date/By: _ PcrtTut No.:r)1:,1190Y., City OfTi and Planning Approval Sewer Tigard Date/fly: Permit No.: 13 125 SW I lall Blvd. Plan Review - Other Tigard,Oregon 97223 Date/By Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Revicw Land Use Date/By: _ Case No.: Internet: www.ci.tigard.or.us Contact J Juris.: IN See Pale 2 for - 24-hour Inspection Request: 503-639-4175 Namc/Method: _ Snpplentental information. TYPE OF WORK _ FEE*SCHEDULE(for speclat Information use checklist New construction Demolition Description (1t) MCrl�a.l Intal Addition/alteration/re lacement _Other: New 1-&2-family dwcllhigs CATEGORY OF CONSTRUCTION includes 100 R.for each ntilit,connection 1 &2-Familyr dwellin ❑ Commercial/Industrial SFR I bath .00 - SFR 2 350 bath _ _ X50.00 Accessory Building_ Multi-Family SFR 3 bath399.00 _❑ Master Builder Other: Each additional bath/kitchen - _ 45.00 JOB SITE INFORMATION and LOCATION Firesprinkler-sq. ft.: Pae 2 Job site address: Oi1?. ISS rA Site Utilities y Suite#: Bid r./A t.#: Catch basin/area drain 1660 Project Name: Dr well/leach line/trench drain '16.60 -------- Footingdrain no. linear fi. Page e 2 Crgss street/Directions to job site: Manufactured home utilities 110.00 bh n � Manholes 16.60 Rain drain connector 16.60 Sanitary sewer no. linear ft. Pae 2 _ Page 2 iStorm sewer no.linear ft.) Page 2 Subdvision: � f Lot#: Water service - - --- --�- ubTax / steel #: (no.linear f%1 - Fixture or Item DESCRIPTION OF WORK _ ---- Abso tion valve _ _ 16.60 Backflow preventerPage 2 - �- --� ----e__-� Backwater valve 16.60 _. Clothes washer 16.60 ------ --- Dishwasher 1 _ 16.60 PROPERTY OWNER i TENANT Prinking fountain 16.60 Ejectors/sump 16.60 sine: Ian - �1 {or r1 --_- Expansion tank 16.60 Address:b.5-1 5 S W Fixturc/sewer cap 16.60 City/State/Zi Floor drain/floor sink/hub 16.60 G� -�- �-�'�--- - Garbage disposal 16.60 hone:Je3 -,,,)9/1Fa : Hose bib _ 16.60 _ PPLICANT NkONTACT PERSON Ice maker / 16.60 Name: c ham,,a - f Interceptor/grease trap 16.60 Medical as-value: S Pae 2 Adciress:'1�?� (. r .��'1C �j� - Primer 16.60 City/ tate/Zi1660 - Roof drain(commercial) _ 16 60 Phone:tp,q-cel q I I I Pax:_ _ Sink/basin/lavatory 16.60 E-mail: Tub/shower/shower pan 16.60 CONTRACTOR Urinal 16.60 _ Business Name: AA� Water closet 16.60 Water heater 16.60 Address: d)( y(]7 - Other: City/State/Zi HCf- + 10/A Other: Fees Phone: 1!q c Fax:1p --- Plumbing 1 Su total CCB Lic. # Sip Plumb. Lic.# - �; ? subtotal S .__.- Minimum Pemlit Fee$72.50 S Authorized ' ' - Residential Backflow Minimum Fee$36.25 Signature: _- I)atc:-_-_-.- plan Review 25%of Permit Fee S State Surcharge 8%of Permit Fee S (Please print name) __ TOTAL PERMIT FEF, Notice: 'I his perntU application expires if a per mil is not obtained Nithin All ne commercial buildings require 2 sets of plain Nath Isometric or IAO days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set M" ri-('eunty Building Industry Service Board. is\Dsts\Permit I:orms\PlmPemutApp.doc 01/03 PlumbinL, Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: kesidential Fire Supression Systems: Site Utilities Q(y• Fee(ea) Total Square Footage: -- Pr,rmlt Fee: Footing drain- I" 100' 55.(X1 0 to 2,000 — -- 1111500 ---� - Footing drum-each additional 100' 46.40 2001 to 3,600 1$160.00 _ 3,601 to 7,200 $220.00 Sewer-I st I(Xl55.00) --- 7,201 and realer __ _ _ $309M Sewer-each additional I00' 46.40 Water Service- Ist 100' 55.00 Medical Gas Systems: Water Service-each additional 100' 46.40 _Valuation: Permit Fee: Storm&Rain Drain-Isl 100' 55.00 $1.00 to$5,000.00 Minimum Ice$72.50 omt& Rain Drain-each additional 100' 4640 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and S1.52 for each _. additional$100.00 or fraction thcreor,to and Fixture or Item Qty. Fee(ca) Total— including$10,000.00. Commercial Back Flow Prevention Device 4r to $10,001.00 to 525,000.00 $148.50 for the first$10,000.00 and 51.54 for Residential Backilow Ptcvention Device _ each additional$100.00 or fraction thereof,to minimum pcimit free$36.25 27.55 and including$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to$10,000.00 $379.50 for the first$25,000.0x)and S 1.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or __ and including$50,000.00. specialty requested inspections-per hour 72.50 $50,00 LOU and up $742.00 for the first$50,000.00 and$1.20 for Suhartel: each additional$100.00 or flection thereof. F i:.hure Work: Arc poll capping, nwving or replacing existing fixtures? If ", please indicale woe k perforated by It Aure. Failure :o accurately report ftxfur-es could result in increased se%%er- fees*. Quantity by Fixupre WorkferforinA t'onunen(s regarding fixvire work: Fl Jure Type: Replace _ I New Moved Ealsnng Capped B i tistrv/Font Bath -l'ub/Shower -Jacuzzi/Whirl pool Car Wasl -Each Stall _._------- -Drive Thru Cus idor!Water Aspirator i -- Dishwasher -Commercial _ -Domestic Drinking Fountain E e Wash - -- ---- --- - - —- Floor Drain/sink -2" -4" — Car Wash Drain *N(ite: If file fixture work under this permit result%in an Garbage Domestic —__ Disposal -commercial — increase of sewer EDI Is.is sewer permit %i ill he i%%ard and -industrial fees assessed for file sewer increase n1u%t he paid In 1-til k the Ice Mach/Rcfri .[rains plumbing permit can be issued. Oil Separator Gas Station Rec.Vehicle Dump Station Shower -Gang -Stall Sink -13ar'1-avatury _ -Bradley _ -Commercial _ -Service_ Swimming Pool I liter -- Washer-Clothe., Water Fxtractor _ Water Closet-Toilet Urinal Other Fixtures: i:\Dsts\Permit Forms\I`lmPcrmn.AppPg2.doc 01/03 R OFFICE USE ONLY Mechanical Permit Applieatioll>t L—P eived ` Mechanical e'By: - _ Permit No.: r iL ning Approval Building City �r Tigard e/By: Permit No.: 13125 SW Hall Blvd. Review Other e/By: Permit No.: Tigard,Oregon 97223 t•Review land Use Phone: 503-639-4171 I-ax: 503-598-1960 Date/By: _ Case No.: Internet: www,ci.tigard.or.us Cvntact luris.: TMlice Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: ______L_suff lemenlal Information. TYPE OF WORK COMMERCIAL FEE"SCHEDULE-USE CHECKLIST New construction Demolition Mechanical permit fees*are based on the total value of the work Addition/alteration/replacement Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION_—)tmechanical materials,equipment,labor,overhead and profit. Value: S_ See Page 2 for Fee Schedule 1 & 2-Family dwelling Commercial/Industrial RESIDENTIAL EQUIPMENT/SYSTEMS FEE-SCHEDULE Accessory Building _ Vu—Iii-Family Description tv Fee ea. Total_ Master Builder _Other: ttcalln Cfin JOH SITE INFORMATI N and LOCATION Furnace-add-on air conditioning•' 14.00 Job site address: t Gas heatpump14.00 Bld ./A it.#. Duct work_ _ _ 14.00 Suite#: ----- - H dronic hot water system 14.00 _ Prosect Name: _ -- Residential boiler Cross slreeWirections to job site: for radiator or h1dronic s stem 14.00 /y t Ob [A34 � Unit heaters(fuel,not electric) ki in wall,in-duct,sus ended,_etc.— 14.00 Flue/vent for en of above — 10.00 -- Repair units _- 12.15 Subdivision: Lot#: _ Other Fuel A Ilances Tax map/parcel #: — Water heater 10.00 _ DESCRIPTION OF WORK Gas fireplace _ _ 10.00 Flue vent(water heater/gas fire lace 10.00 _- --- ---- Log li htcr(gas) 10.00 __ ---------- Wood/Pellet stove 10.00 Wood fire lace/insert __ 0.00 ---- — Chimney/liner/flue/vent _ 10.00 TENANT Other: 10.00 PROPERTY OWNER 1 ---- Environmental Exhaust&Ventilation _ Name: " i` Range hood/other kitchen equipment 10.00 Address: rI S Clothes dryer exhaust 10.00 Cit /State/Zi : L 1 ys+ �- Single duct exhaust Pt one: 9")t}� a (bathrooms,toilet compartments, -- APPLICANT CONTACT PERSON utilityrooms) 6.80 Attic/crawls ace fans 10.00 _ Name:brj1n. Other 10.00 Address: - Fuel Piping _ City/State/Zip: 41 _ (55.40 for flrsl 4,S1.00 each add**01 Furnace etc. " — Phone�j - ax: Gas heat pump "E-mail: _ Wall/suspended/unit heater CONTRACTOR _ Water heater - Business Name: -_ Fireplace .. Address: Range Ba •• Cit /State/Zi Clothes dryer(ga Fax- Other: Phone: total: CCB Lic. #: _ Mechanical Permit Fees' Authorized — _ Subtotal: S Signature: _— — Date:_. _ _ Minimum Permit Fee 572.50 S Platt Review Fee(25%of Permit Fce S State Surcharge(8%of Permit Fee) $ (Please print name) TOTAL PERMIT FEE $ Notice: This pernilt application expires if a permit is not obtained si ithin .Fe planaequ'.red for exterior A/f'tty set by Tri-4'ountyBunilding Industry Selvlee Board. Igo days after It has been accepted as complete. i\DstsV'ermit Fortes\MecPemlitApp doc 01/03 _Mechanical_Permit-Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1,00 to 55,000.00 _ Minimum fee$72.50 $5,1701.00 to$10,000.00 $72.50 for the first$5,(00.00 and 51.52 for each additional 5100.00 or fraction thereof,to and including$10,000.00 _ 510,001.00 to$25,000.00 5148.50 for the first 510,000.00 and $1.54 for each additional$100.00 or fraction thereof,to and including _ $15,000.00. _ 525,001.00 to 550,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,001.00 and up $741.00 for the first$50,000 00 and $1.20 for each additional$100.00 or fraction thereof. Assumed Valuat►,)ns Per Appliance: -- Value Total lxscri tion: fsa Amount Furnace to 100,000 BTU,including 955 ducts&vents Furnace>100,000 BTU including ducts 1,170 &vents Floor furnace inc'iuding vent Suspended heater,wall heater or floor 955 mounted heater Vent not included in appliance permit 445 Eta air uniU 805 _ I <3 hp;absorb.unit, 955 to 100k BTU --- 3-15 hp;absorb.unit, 1,700 101 k to 500k BTU 15-30 hp;absorb.unit,501k to 1 mil. 2,310 BTU 30-50 hp;absorb.unit, 3,400 1.1.15 mil.BTU >50 hp;absorb.unit, 5,725 >1.75 mil.BTU Air handling unit to 10,000 cfm 656 Air handling unit>10,000 cfm _ 1,170 Non-portable evaporate cooler _656 Vent fan connected to a single duct 446 — Vent system not Wed in appliance 656 rmit — Hood served by chanical exhaust 656 me Domestic incinerator 1,170 Commercial or industrial incinerator 4 590 Other unit,including wood stoves, 656 inserts,etc. Gas piping 14 outlets 360 Each additional outlet _ 63 TOTAL COMMERCIAL VALUATION: v\Dsts\Permit Forms\MccPcrmitAppPg2.doc 01103 Electrical Permit Application FOR ' ONLY Received Electrical Date/By: Permit No. City Of Tigard Planning Approval Sign y t Date/13y, Permit No + 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: I Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Revicw Land Use Internet: www.ci.tigard.or.us Date/By: Case No.: Contact Juris.: See Page 2 for 24-hour inspection Request: 503-639-4175 Name/Method: Supplemental infor•matiot,. TYPE OF WORK _ PLAN REVIEW Please check all that appy New construction ❑ Demolition Service over 225 amps- Ll Health-care facility commercial ❑hazardous location 'AdditlOn/alteration/rCp1aCCTTICnI�❑ O1hCr: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, CATEGORY OF CONSTRUCTION I &2 family dwellings four or more residential units in 1 &2-Family dwellin Commercial/Industrial ❑System over 600 volts nominal one structure AccessBuilding Multi-Family ❑Building over three stories ❑Feeders,400 amps or more Accessory —_l._—_ y _ ❑Occupant load over 99 persons ❑Manufactured structures or RV park ❑ Master i3uilder Other: —_ ❑Fgress/lighting plan ❑Other: JOii SITE INFORMATION and LOCATION Submit___sets of plans with any of the above. The above are not app.icable to temporary construction service. Job site addressGr1ST.f1-` - - _ FEE*SCHEDULE Suite#:_ _ $ld�./Apt. - - Number of fns_pectlons per permit allowed Pro ect Narne: Description _ "- Otv Fee(ea.) Total New residential-single or mull-fandh per Cross street/Direct'ons toob site: fJ 14al-1 J dwelling unit.Includes sltaehed garage. Service Included: 1(0)sq.fl.or less 145.15 4 Each additional 500 sq.R.or portion thereof 33.40 I Subdivision: Lot rk' Limited energy,residential 75.00 2 Limited energy,non residential 75.00 _ 2 'Fax map/parcel#: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder _ 90.90 2 Services or feeders-Installation, �11�W p I U�qS alteration or relocation: 200 amps or less80.30 2 101 amps to 400 amps _ -- 106.85 2 401 am (r00 160.60 1 PROPERTY OWNERr TENANT �v 601 amps to 1000 amps 240.60 2 ---- - --- I— --- Over 1000 am or volts 454.65 2 Name: ✓. Q rA _l uv ne Reconnect onlyA 66.85 2 �f s T(ee,T 1•emporary services or feeders-installation, Address: S1 �'j� — alteration,or relocation: Cit /State/Zip: g!/ I-,J�."i _ --- ..W amps or less - -- 66.85 1 Phone — 64 FFONTACT 201 amps to 4(X1 am _ 100.30 2 APPLIC NT PERSON 401 to 600 ami 133.75 2 Branch circuits• new,alteration,or NamC: extension per panel: Address: A.Fee for branch circuits with purchase of service or feeder fee,each branch circuit 6.65 2 Cit /State/Zi : -I69, D.Fee for branch circuits without purchase of .- —f� -— service or feeder fee,first branch circuit / 46.85 2 Phone: _ I�X_ Each additional branch circuit 6.65 2 E-mail: _ Misc.(Servicc or feeder not included): _ CONTRACTOR Each pump or imitation circle 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuits)or a limited energy panel, Business Name: - J alteration,or extension Pae 2 2 ` �� Description Address: — Cit /State/Zi '17 "71't�3 Each additional Inmos r tion over the allowable In an of the above: LSC Per inspection per hour min. I hour) 1 1 62.50 Phone:,9teif—(Iq Fax: Dlek !2 1 q q _12yestmation fee: _ CCB Lie, #: r'"' 1. 1 Lie.#: I Ic .. , ollrer. Electrical Permit Fees* - Supervising electrician Subtotal $ signature required: Plan_Revicw 25%of Permit Fee $ Print Name: LIC. #: State Surcharge(8%of Permit Fee S TOTAL PERMIT FEE S Authorized Notice: This permit application expires If a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee nrethednlogy set by Tri-('minty Buildinit Industry Service Board. —� (Please print name) i:\Dsts\Permit Fortns\ElcPermitApp.doc 01103 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL NORK ONLY: _ Feefor all s-stems........................................................... $75.00 Check'I)pe of Work Involved: I] Audio and Stereo Systems* CIBurglar Alarm Garage Door Opener* Itcaung,Ventilation and Air Conditioning System* Vacuum Systems* Other --- -- COMMERCIAL WORK ONLY: _ Fee for e t system.......................................................... $75.00 (SFF.OAR 918-260.260) Check Type of Work Involved: Audio and Stereo Systema Boiler Controls Clock Systems Data Telecommunication Installation Fire Alarm Installation HVAC Instrumentation Intercom and Paging Systems C� Landscape Irrigation Control* Medical Nurse Calls Outdoor landscape Lighting* ElProlective Signaling F] Other Number of Systems * N t licenses arc required. Licenses are required for all other installations is\Dsts\Petmit Fortis\ElcPcrrmtAppPg2.doc 01103 SEE 35MM ROLL# 22 � FOR � LARGE DOCUMENT = r 1 ICA o � m 45 AL I r G, V m M � r c rF V 1 r r I� 1 O N � V � � -IV• Q C y x N._ nl 6a fl K, r JrG. C. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE TERRY MASSEY PLUMBING PO BOX 2407 CLACKAMAS, OR 97015 Plumbing Signature Form Permit #: MST2003-00109 Date Issued: 3/31/03 Parcel: 2S111 DD-07500 Site Address: 08515 SW AVON ST Sub 'ivision: CHESSMAN DOWNS Block: Lot: 001 Jurisdiction: TIG Zoning: R-7 Remarks: kitchen remodel. Your company has been indicated as the p.,: iibing cintractor for the permit indicated above. In order fer the plumbing permit to be valid, please have thq 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: HORNE, BRIAN D/CAROLYN K TERRY MASSEY PLUMBING 8515 SW AVON ST PO BOX 2407 TIGARD, OR 97224 CLACKAMAS, OR 97015 Phone #: Phone #: 503-997-0324 Reg #: PLM 3-480PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature o' f AuthorizeIP umber If you have any questions, please call 503.718.2433. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50316 75 MS 3 _ 00 INSPECTION DIVISION Business Line: (503) 1 BLIP -- Received —___.._._-_.-- Date Requested � �4 AM _ PM------_.----- BUP ----------- --__ Location _- _- 1- - ---- Suite — MEC - -- - Contact Person `- _ Ph ( —) —___ PLM Contractor ----- -___---- Ph(— -) . SWR IN Tenant/Owner —_- - ELC Footing — ELC Foundation Access: Ftg Drain ELR Crawl Drain - SIT Slab Inspection Notes. Post&Beam ----- -- - Shear Anchors ^ Ext Sheath/Shear -- - - Int Sheath/Shear Framing - - - - - - - Insulation Drywall Nailing Firewall Fire Sprinkler ---- Fire Fire Alarm Susp'd Ceiling - - Roof Oth — --in - - P PART FAIL • Beam Under Slab _-_ - - --- - Rough-In Water Service --- ---- - — Sanitary Sewer Rain Drains --- -- - - --- - — Catch Basin/Manhole Storm Drain - — --- r Shower Pan Other: -- - �Fin PART FAIL MISCHANSAL -------- - -- — ---- - Post& Beam — Rough-In - - ---- --- Gas Line S e Dampers ---------- -�--- - -.-- -- in S8 PART _FAIL -- - -- -- - - --- -- - ---- - Service ---- --_-- --- ---- -_._. Rough-In --- ------ ------ - ---- ------- — -- UG/Slab Low Voltage - -------------- Fire Alarm Final PASS PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13126 SW Hall Blvd. SITE— [-1 Please call for reinspection RE:_- -_ Unable to inspect -no access Fire Supply Line - �f C --- - Approach/Sidewalk Date , / Inspector -- - -- -- Other:_ Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour /0? BUILDING Inspection Line: (503)639-4175 3- TIZ M3T —_ - INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received - ___ Date RequLe�ste�d, �--D�-S AM PM _____-___.__ BLIP -__-- Location Suite ------- MEC _------ --- PLM( ) _ Contact Person ---- Ph -------- -- Contractor_ — _ Ph(--) -_- SWR ---- — BUILDING Tenant/Owner — -`_ _. ___ _ ELC Footing I ELC -------- - ---- _ -_ Foundation Access: Ftg Drain ELR Crawl Drain -- - - Slab Inspect,on Notes: SIT - -.- Post&Beam Shear Anchors Ext Sheath/Shear ------- - Int Sheath/Shear Framing -- -- -- - - ---- --- -- Insulation Drywall Nailing - --- ----- -- - ----- ------- Firewall ,-Q A„� Fire Sprinkler OF I -- - , Fire Alarm Susp'd Ceiling I _ Root 5� - Other:--- - -- _- �� Final -- �i_—�L-, ----- PASS PART FAIL PLU_MBINGi ---- -- —_ ---a-- --- ....-- Post&Beam 'i Under Slab _—�_—_._._ - - ------ --- ---- Rough-In Water Service -------- _-- - -- ----- Sanitary Sewer Rain Drains -------- --_--------------- ---------- _--- -- Catch Basin/Manhole Storm Drain ----- --- ___—_— -_-- ------------- Shower Pan Other. --- _ ------- - - --- --_ Final PASS PART FAIL MECHANICAL - -- — - - -- -- Post&Beam Rough-In - --- -- Gas Line _ Smoke Dampers -- — Final _ PASS PART FAIL -- _ ELECTRICAL Service Rough-In -- UG/Slab Low Voltage 1 --- ---- ---- - '' Alarm I ._� Fi PARI FAILReinspection fee of$ —__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: - - Unable to inspect-no access Fire Supply Line ,� ADA �� Inspector - ��'� ! '� " ' - - Ext Approach/Sidewalk p � Other: _ Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD MASTER PERMIT PERMIT#: MST2003-00115 DEVELOPMENT SERVICES DATE ISSUED: 4/14/C3 13125 SW Ball Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 08515 SW AVON ST PARCEL: 2S111DD-07500 SUBDIVISION: CHESSMAN DOWNS ZONING: R-7 BLOCK: LOT: 001 JURISDICTION: I k REMARKS: Addition of 260 s I. BUILDING REISSUE: COSTGAI STORIES: 2 FLOOR AREAS REOUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 15 FIRST: 260 of BASEMENT: of LEFT: SMnrF DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: of GARAuE. of FRONT. t 5 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD of RIGHT: 5 000.00 OCCUPANCY GRP: RJ BDRM: BATH: TOTAL: 260 01 VALUE: 30, REAR' TS PLUMBING SINKS: WATER CLOSETS: WASHING MACH LAUNDRY TRAYS: RAIN DRAIN. TRAPS LAVATORIES'. DISHWASHERS: FLOOR DRAINS: SEWER LINES. SF RAIN DRAINS. CATCH BASINS: TUBISHOWERS GARBAGE DISP: WATER HEATERS. WATER LINES. BCKFLW PREVNTR. GREASE TRAPS: OTHER FIXTURES. MECHANICAL FUEL TYPES FURN<TOOK: BOILICMP<?HP: VENT FANSCLOTHES DRYER: FURN»100K: 0 UNIT HEATERS: HOODS: OTHER UNITS: MAX INP btu FLOOR FURNANCES: VENTS: WOODSTOVES'. GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp 0 200 amp: W/SVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 5005F. 201 - 400 amp. 201 - 400 amp: tat W/O SVCIF DRSIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 600 amp- EAADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 601 1000 amp: and ;unp+-1000' MINOR LABEL: 1000•amnlvoll PLAN REVIEWSECTION - Reconnect only, --- >•4 RES UNITS: SVCIFOR>=225 A.: >800 V NOMINAL. CLS AREFUSPC OCC. ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: N'1RSE CALLS: TOTAL If SYSTEMS: Owner: Contractor: TOTAL FEES: $ 646.47 This permit is subjbct to the regulations contained in the HORNE,BRIAN D/CAROLYN K PETERSEN CONSTRUCTION INC Tigard Municipal Code,State of OR. Specialty Codes and 8515 SW AVON ST PO BOX 2226 all other applicable laws. All work will be done in TIGARD,OR 97224 WILSONVILLE,OR 97070 accordance with approved plans. This permit will expire H 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 adopted by the Phone: Phone: 503-312-0043 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Rea": LIC 96688 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Footing Insp Electrical Rough In Electrical Final Foundation Insp Framing Insp Final inspection Post/Beam Structural Shear Wall Insp Underfloor insulation Exterior Sheathing Inst i Crawl Drain/Ba:kwater Rain drain Insp • r issued By : /�ZLL L : Permittee Signa ure --- Call (503) 639-4175 by 7:00 p.m. for an inspection neede a next business day FOR OFFICE USE ONLY Qui JJH'P- Permit Applieatio O ReceivedItrr,r+;r,� G� Date/By:!J rD4, Cts Permit No. )F Yr Ul 15` Planning Approval Other City of Tigaii-(I Date/fiy: --- Permit No.: _ 13125 SW Hall 13' Plan Review Other .a3 PR Datc/ll :�' L1-i)-0:; Permit No: igard,Oregon - _- N land Phone: 503-639-4171 Fax: 503-598-190 Post-Review Calc No. Internet: www.ei.tigard.or.us 3\1 — contact Juris. I N5ve Page 2 for 24-hour Inspection Request: 503-639-41iNv Name/Method: _ Sur lemental Information TYPE OF WORK REQUIRED DATA: — N w construction Demolition I&2 FAMILY DWELLING Addition/alteration/replacement Other: CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed. Indreatc - & 2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, _ _ -- overhead and profit for the work indicated on this application. �J Accessory $uilding_ Multi-Faro( ❑ Master Builder Other: Valuation......................................................... $ s CX.—. JOB SITE INFORMATION and LOCATION No.of bedrooms: (D No.of baths: —� Total number of floors.......................... .......... _ Job site address: lt7>_ 1.) AVOA3 New dwelling area(sq.ft.).............................. Suite#: Bld ./A L#: _- Garage/carport area(sq. ft.)............................ _Project Name: ,(G l _ _ Covered porch area(sq. R.)............................. _-_—_- Cross street/Directions to job site: 4A4-1-, e5L.N/D Deck area(sq. ft.)......................I..................... Other structure area(sq.fl.)............................ REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision _ - Lot#. -- - 'Fax map/parcel #: Note Permit fees'are based on the total value of the work performed Indicate DESCRIPTION-OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, -- overhead and profit for the work indicated on this application. Valuation......................................................... S_ -- ---- Existing building area(sq.fl.)......................... — ------ -- — --- -- New building area(sq. ft.)............................... Number of stories.................. ......................... PROPERTY OWNER TENANT Type of construction....................................... Nartle. A Occupancy group(s): Existing: ---__ New: Address: --W AV _City/State/Zip. 442-tD Fax: NOTICE: All contractors and subcontractors are required to be Phone:_ licensed with the Oregon Construction Contractors Board under APPLICANT CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: jurisdiction where work is being performcd. Ifthe applicant is c(cmpt Contact Name: - from licensing,the following reason applies: Address: — - ---- - -- - City/State/Zip: .-_-- -- — -- phone: Fax: --- ---- -------- _�_------- - - - BUILDING PERMIT FEES* E-mail: _ Please refer to fee schedule. WriTRACTOR - Business Name: _ ` 05S 1� - Fees due upon application.............................. S Address: Cit/Stale/Zi �1 . �t�}\)I If.� D Amount received............................................ 5 Phone:> h• Fax: _ Date received:.___ CCB L' . #: — -- -- Authori � - tiolice: this permit application expires if a permll Ic not o:tained Nithin Si atur _ Date: 3 Zed — Iso da>i after it has been accepted as complete. 'Fre mrlhodolnFv set by Tri-(ounh Ihrildinp IndusU.% tiervicr mooed. (Please print name) K M i-\Dsls\Permit Fonns\BldgPermitApp.doe 01103 ��Qa ' Yj•� One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: - -- Associated permits: 0tvofTigaid City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 UOther: Phone: (503)639-4171 Fax: (50:5) 598-1960 I Land use actions completed.Sec jurisdiction cntcrta Ior concurrent Iev1c A 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved pintllot. 4 hire district__. approval requited. 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 U plan U permit required. Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 3 fomplete sets of legible plans. Must he drawn to scale,showing conformance to applicable local and state huilding axles. Lateral design details and connections must he incorporated into the plans or on a separate full-size sheet attac'he'd to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. 1 I 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-It.elevation differential,plan must show contour lines at 2-ft.intervals);location of'casements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;huilding coverage arca;percentage of coverage;impervious area;exir.ting structures on site;and surface drainage. 12 Foundation pian.Show dimensions,anchor bolts,any hold-clowns 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 Crops section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,root constriction. More than one cross section may he 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 addendum%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 floorstroof assemblies,indicating member sizing,spacing,and hearing locations. Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rehar. For engineered systerns,sce nem 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 h eamijoist carrying a non-uniform load. 20 Manufactm ed floorlroof 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,0 c_ shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall hr shown to to applicable to the pn,irc t under rrview. 23 Five(5)site plans are required for Item 1 I above. Site plans must be 8-U2"x I I"or 11"x 17". 24 Two(2)sets each are required for Items 16, 19.20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not 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&location per approved project street tree plan(if applicable),and CUT Street"free List. Checklist must he completed before plan rev'••vv start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 4404614(NUIWOM) FOR OHICE USE ONLV Electrical Permit Application Received Electrical Permit NoOle.T Planning Approval Sign City of Tigard Date/By: Permit No. 13125 SW Hall Blvd. Plan Review other Tigard,Oregon 97223 Date/By: _ Permit No.: _ — Phone: 503-639-4171 Fax: 503-598-1960 Past-Review Land Use Date/By: Case No.: Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for - 24-hour Inspection Request: 503-639-4175 Name/Method: _-_— Supplemental Information. TYPE OF WORK PLAN REVIEW Please check all that apply New construction _ _J _ I�em011tlOn -_ Service over 225 amps- Health-care facility commercial ❑Ilazardous location Addition/alleration/replacement I Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, CATEGORY_OF CON_STRUCTiON I&2 family dwellings four or more residential units in I &2-Familydwelling Commercial/Industrial ❑System over 6(10 volts nominal one structure r- ---- ❑nuilding over three stories ❑Feeders,400 amps or more 3Accessory Building__ Multi-Family ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder H Other: ❑Egress/lighting Alun ❑Other: _ --- JOB SITE iNFORMATION and LOCATION Submit_sets of plans with any or the above. ob sitc'' ^A ' The above are not applicable to temporary.construction service. �Y— -- Je address: � 1 �� ='7• FEE*SCHEDULE ---- — —----- Suite#: —_--Bldg./AptA Number of ins ectiuc s per permit allowed Uc.crl Iron Qly Fee(Co.) Total Project Name: —�-- 1 New rng unit.Insingle(or oruill-iarbed garage.per CCOSS Street/DIrCCtiOnS 10 job site: �l.l� �--� dwelling unit.Innludes atlarhnd I;araee. Service Included: 1000 sq fl.or less _ ✓ 145.15 4 Each additional 500 s .0.or rortion thereof 33.40 1 -- '- Limited energy,residential 75.00 2 Subdivision: - _ Lot#: Lim_i.d energy,non residential 75.00 2 1haX map/parcel #: Eac,.aanufactured home or modalar dwelling DESCRIPTION QQNVORK service and/or feeder 90.90 2 - Services or feeders-Installation, !Iteration or relocation: _100 amps or less 8U. 2 _. -_ - ----- 201 am s to 400 ams 106.85 2 401 anips to 600 strips 160.60 2 PROPERTY OWN R TENANT' 601 r 1 s to 1 amps ems _ 240.60 2 —�'�, \ Over 1000 amps or volts 454.65 2 Name: r � !� ��, ` Reconnect only `- 66.85 2 Address: �� 'tti (�V _ Temporary services or feeders-Installation. altnrallon,or relocation: City/State/Zi - l A42-43 .-- 200 ams or less 66.85 _— I Phone: Paas: 201 ampat�aoo:mps -- 100.30 _ 2 401 to 600 ams 133.75 2 A_PPLIC NT (QTACT PERSON —_ Itranch circuits-new,alteration,or Name: `yI ,� extension per panel: A.Pee for brunch circuits with purchase of Address: 1 f Z�?(d service or feeder fee,each branch circuit 6.65 2 Cit /State/Zl 1s� �s�!� CJ1G_ �� d Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.85 2 Phone: ��Z C FaX:�j �ca�jg Z� Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): CONTRACTOR Each um or irri !tion circle 53.40 2 Each sign or outline lighting _ 53.40 _ 2 Job NO: Signal circuits)or a limited energy panel, -- -- alteration,or extension P e2 2 Business Name: tL�C;b�A1 t`[Y11 � Description:— Address: _ _ __ Cit /State/Zip: � � - Earh additional Inspection over the allowable In any of the above: Pcr inspection per hour(min. I hour) b2 5n Phone: - -97411 Fax. _ Investigation fee: _ -_- -. Orhrr. _.� CCB Lic. #: of Lic, #: EliV121 _ Electrical Permit Fees* Supervising electrician 0— 3 Subtotal _$ _ s ignaturee d: _ Plan Review(25%of Permit Fee : �' Lic.#: L,''P'� _ State Surcharge(8%of Permit Fec S - �� _TOTAL PERMIT FEE S _ �� Notice: Thls pernrlt application expires if a permit('s)"col obtained within _ Dater =�� 180 days after It has been accepted as complete. 11 -- -�_ • 'Fee methodology set by 1104 ounty 4trilding Ipt lxtry Service Board. _— (Please print name) �^ 1(), is\Dsts\Pemdt Porms\i7cPennitApp doc 01/03 `-' v Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systerrrs ............................................................ $75.00 'heck'I Npc of%%ork Iniolved: U Audio and Stereo Systems* ❑ 1Iurglar Alarm Ll [iarage boor Opener* Ilcating,'Ventilation and Air Conditioning System* Vacuum Systems* Other_-- _ _COMMERCIAL WORK ONLY: Fee for each system.......................................................... $75.00 (SIT OAR OIR-200.260) ('heck Type of Work Involved: El AudID and Stereo Systems F] Moiler Controls Clock Systems C� Data Telecommunication Installation Fire Alarm Installation IIVAC instrumentation Intercom and Paging Systems Ellandscape Irrigation Control* IJ Medical Nurse Calls Outdoor landscape Lighting* ❑ Protective Signaling [] Other _Number of Systems * No licenses are required. Licenses arc required for all other installations i\Dsts\Pcmn I Forms\GlcPcrmitAppPg2 doc 01/03 C JBo 6001 JI f1s, ell Oc, CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE TRI-CITY ELECTRIC 8395 S. GRIBBLE CANBY, OR 97013 Electrical Signature Form Permit #: MST2003-00109 Date Issued: 3131103 Parcel: 25111 L D-07500 Site Address: 08515 SW AVON ST Subdivision: CHESSMAN DOWNS Block: Lot: 001 Jurisdiction: TIG Zoning: R-7 Remarks: kitchen remodel. 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 �ippropriate individual from your company sign below and return thip Electrical Signature Form prior to the strirt 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: HORNE, BRIAN D/CAROLYN K TRI-CITY ELECTRIC 8515 SW AVON ST 8395 S. GRIBBLE TIGARD, OR 97224 CANBY, OR 97013 Phone #: Phone #: 503-266-9995 Reg #: Ltc' 50888 SUP 24055 ELE 3-214(' AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Elecian If you have any questions, please call 503.718.2433. i' t� MAR l-Y OF TIG _PING Dlv iSo t � U 5 PJ Rai _N - - J CITYOFTIGrARD SOF. I RD MAS FE R V,E RM I T COMMUNITY DEVELOPMENT DEPARTMENT 064 F'rRM I T #. . . . . . . : 11IST'�;' -I '�'i 131268W FWI Bhd P.O.Bac 23!07,TOW,Orpon 07223(603)630-4176 — --- 51TE ADDPF35. . . : 013515 SW AVON sial- PARCEL: c a1. 11GC 07";6 �jUPDIVISION. . . . : CHESSMAN DOWNS ZONING: R-7 L+I._OC;K. . . . . . . . . . . LOT. . . . . . . . . . . . . . 1. ---..__.___.•._.__ ________ ___-__.____. BUILDING ------------------------------------------- SSIJf : DWELL I NG UN I TSI: 1 [SASE MENT. . . . . . . . :0 5f LLASS OF WORK. :ADD BEDRMS:0 BATHS:0 GARAGE. . . . . . . . . . :0 s f' r l-E OF' USI:-_'. . . :SF FLOOR AREAfa ___._..__..........__.. REQUIRED SF-1*BACKS_---___..._..._-._-- 1 ✓t-'E OF' CONST. :5N F'IRST. . . . 1260 S L.EF=T. . :0 ft RIGHT. :O ft Ot (A)PANCY 1:3Rr°. : R3 5')EGOND. . . :i[, yf FRONT. :ili ft REAR. . : ib it THI RD. s f RE DU T I iL l GHT. . . . .. . . . : 1'j ft TO'FAI_ _______. s f SMOKE DETE.C,^TORS. : I L.UOR LOAD. . . . :40 psf VALUE. . . . . >>; : 11960 F=,ARKING SPACES. . :0 RAma1^ks : addition of j,60 sq ft -- -- --------- -- F'I_UMPING . . . . ^'� FLOORDRAINS. . . . :0 DACKF'LOW PREVNTRS. . :+r SINKS. . . . . ., LAVATORIL.S„ . . . . :0 WATER HEATERS. . . :0 TRAP,S. . . . . . . . . . . . . . :0 TUB/SHOWF_RG. . . . :0 LAUNDRY T RAYS. , . :it CATCH ELASIIVS. . . . . . , :ill WA IE R CL OSETS. . :0 SEWER LINE (ft ) . :0 GRE=ASE TRAP'S. . . . . . . :0 riI rl•IWASHERG. . . . :0 WATER LINE ( ft ) . :0 OTHER F1 XTURES. . . . . :0 GARBAGE DI!gr'. . . :0 RAIN DRAIN (ft ) . --0 WASHING MACH. . , :0 GF RAIN DRAINS. -0 MECHANICAL_ __..___.________.__-•_-- f EE=S UNIT HFRS. . :0 type amount by date ^� /GAS/ / / VENTS . . . . . :0 E;PRT 4 92. 50 JLH 04/09/92 MAX INPUTiia BTIJ VENT FANG. . : 1 BPLC 9 60. 1:3 JLH 04/+TL'/92 VURN ( 100K . . :0 HOODS. . . . . . :0 B5F'C $ 4. 63 JLH 04/09/9c: FURN > =].001 :0 WOODSTOVE�3- :ill MPRT $ :x. 00 JLH 04/09/92 F'I...CIC7R FURN. . . . :0 CI-O DRYE<:RS. : k'1 MRLC t 6. 25 JLH 04/09/92 I4lJIL /L:t+IP ( 3,I Ir':0 OTHER UNITS:O M PC $ 1.. 25 JI._11 04109/9c GAS OUTL.ETS:O i)wnet. _._..__._._.__... ..._....__....__.._..._.._.._...___._.____._ _.... PRIAN FIND ::AROLYN HORNE 6515 SW (.IV,)N IYr T I CARD OR 97224 Pl-lone #: '5b3-•-664-5997 !V. W. CUSTOM SUILDEF 5 JIM TATE PO LSC'X 123.3 6 T I CARD OR 37223 1=1hone #: 6:59 -5364 Peg #. . : 5.4508 $ 189. 76 TOTAL eit is iviued subject to the regulations contained it the ---- - -- Ri'(jUIHED 1NSF'E.CTIONS - -- �oa c Municipal Code, State of Ore. Specialty Codes and all other Foot/fa1.ind I nsp Merhan icai Fina l. -oplicable laws. Ali work will be done in accordance with approved Plast/Beam Struc_t Hi_1i lding Fina; :ars. This oermit will expire if work is not started within 198 Port/BL-am Meehan Er-osion Contra:i >,s cf issjance, or :f work is suspended for more than 188 days, Mechanical Insp f.r awl Brain F= siu Ins{ 5 iua r� 1.ir��, ; Ins�alat; inn In-sp _. Gyp Board JnR(^ « f v : Rain drain Iny[` f :,. i , f,,T- inr:r,p,_..+ ion 639-41.75 �1sjd �- CO PLN('K RECT # ' / CITY OF r � r` ��A T\�� 1,IKSI l�c 23)971vd. ., / �I 1 IG " l.1 hIMIT # ms t �f�s ('(�!�1MUN1-1 l hI;VI;LO1 MI�,NT 1)f�,l Afi'IT1EN"I' Turd,Orcgon 9771_; P j-�— --- (503)hl^4171 DATE ISSUED JOB ADORE SS: �,� 1 S S l,J a n ��} - n _ TAX MAP/LOT 1.7 f 1 DO U 1'.w SUB: LOT: � LAND USE: VALUATION: OWNEA ( SPECIAL NOTES NAME: _ R„AN (L;-- 1--q VAOk,N. _ REISSUE OF: ADDRESS: _S 1S alJ �AJZrn _ LAST REISSUE.: ______� -4 r3 L-1 _ _ FLOOD PLAIN/ PHONE: 5U3 (D%'A- b59 SENSITW7 LAND: CONTRACTOR �� pp APPROVALS REQUIRED NAME: �`'c`^ �'AT�- KW C!uL s}am \\ders PLANNING: Ole- ADDRESS: 33S (c ENGINEERING: ,s.HtuQ �R 'j-4a'a _ FIRE DEPT: w PHONE: OTHER: _Zlf____ _ CONTR. BOARD #: _tZ3SS _ EXP DATE: ITEMS REQUIRED �,,j�� SUBCONTRACTORS: PLUMB: _ _ LIST/SUBCONTRACTORS: G.IL-iL MECH: BUS TAX: ARCH ENGINEER CALCULATIONS: _ NAME: TRUSS DETAILS: ADDRESS: —_ — _ OTHEK: — PHONE: 'ROPOSED BLDG. USE: �-- (:IJMMENTS: F. `— v APPIICANT SIGN TURE Received By: _ !, � _— __ Date Received: PERMIT # ACCI # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE <4 10-432 00 Building Permit Fees 10-431 00 Plumbing Permit Fees — - -- _ 10-431 01 Mechanical Permit Fees 10-230 01 State Building Tax (5%) � � Building 6- t Plumbing Mechanical 10-433 00 Plans Check Fee _k,.3- Building Plumbing Mechanical 10-230 06 Fire _------- - --- -- 30-202 00 Sewer Connectien 30--444 00 Sewer Inspection ---� — ------ 25-448-02 Commercial TIF Fees - 25-448-04 Industrial TIF Fees ---- 25-448-06 Institutional TIF Fees - 25-448-03 Office TIF Fees 25-448-Cl Residential Traffic Fees 25-448-05 'Mass Transit TIF Fees 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev C,irg (SSDC) 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) _ TOTAL nm/3587P.WPF SCALL 1/8 1' N r- - - - - - - - - - - - - - - - - - I I I � I 1 , NL,�;W ROOM I �V1Co SQ v1, I 1 I I IOIZNI,-; IZI"SIIT NCL' 8515 S W AVON TIGAIII), OI? !R223 i LIABILITY: The City of Tigard, Oregon, or it's !'all not be rczponsible far discrepancys which may ap,?ear hereon. APPROVLD FOR CONSTRUCTICIN CITY OF TIGARD f fORNE RESIDEME 8515 S W AVON TIGA"l), OR 97223 X84-5y9{' LIABILITY: The City of Tigard, Oregon, or WS shall not be responsible for discreparicys which may appear hereon. APPROVED FOR CONSTNUCTION CITY OF TIGARD j PE.HvAIT N ftM3fit-u4 54 SITE ADDRESS_8S1i Sw A1 6 y L SIDEWALK i r.� - - - - - - - - - - - - - . . - - - - - - - - rn rn � c 0 n � X O rn `s rn 7 O O K i - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -� i i i i i i i i i _ > o rn7q i n 3 73 -ti O —; fJTI ril ------ 79 � __ _�! rn m rnIn rl Q to - - - - - - - - -- - - - - - - - - - - rn 1 { 06- CL CL , L� -- 1=III=''III-=III=III= � =1 1=-1 1=�-I t•=='I �i f 1=III=III±III_=III= �� . �=III=III=III=III=11 ��1 1=III=III- � ,� ' - , \ - - II =1 fI PI - 1 1 I I�KI III IN F I IIIl PH- � 1=III=III=III 1111111 ;-� �� =1-�1 k III=-II -- IIII � U v �- ��1�-III .. •, f II I I IIII \ rn IIII III III � � X 73 rn I=III=III=III , ; , -p i=--III=III=III 73 rn 70 � -- IIII U I PI_ I ; lull ; I n Q Fn I �iE-Ir- 1,1 1 1 1 1 r+ --------------- ---- ' r ' - , - ' '---------- . n V' '.................. r __________ ____ ____'+__-y,, = III 11 l 1L------------ --- ---j...... . ...... 1 rn rTl , r'- - '-- - -a 11 r_...._� 1 r� rTl ., 1 . ... ..I -- -- n ---.. _..--- -----_- r- j:> �r ------- r--------. . -- e� ------- - -- t O ' ----- - ------ ll -' n ------------ ' _ - -- -------- Z ---------- --- �l +—� -- ----- ---- - - ------ - 1 ---------- - - 1' - N I� U i el s' V J 1 O -- - - --- I T1 7Q - - -- rn V-- FTI � < D O v \ -- - �, >vz -n .r d -fl C1 n\S �, -I � N n N rn zzrn 7o z G, D r �- r Z (Y G j 7_ i c � N � � ' fi l� w 1. C DEPARTMENT OF LAND USE b TRANSPORTATION LAND DEVELOPMENT SERVICES DIVISION #350-12 WASHINGTON 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, �,�'j ,: ' PHONE: 503/640-3470 OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415 Peer! .'5u 11'758 ProDect y. P0024880 8t.atUL APPk,.jVLLi 1':±dee Appij.ad 10 2 Ieeued k7/14/92 Expi: :s 01/26/93 08/28/02 5.15 ; 37 RES F.LEC. Pez-YoIt Ti.t:1F SFR - F,LEi /,:1UIi,F.TS & LIGHTS OT11 Desc:i-ipti.:)n 'LIMITED LNZRG'Y ,fob Address 8515 SW AVON ST TI Owner N, 14ORNE, BRIAN T %t..'ARuLYN K Region U App 1 i c as alit* MORNE, CA1t,_I.Y!, & BT4 I AN phone numhpr 684-.5997 Vel�.iation 0 Apprr Inspector '.:ommente Re ectN�l._ I n4pec.t c 1 by -__r. %"i flapoc:tA or, Requested - Fin . equested. -Fin . ect.rical DEPARTMENT OF LAND USE & TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12 COUNTY, 155 NORTH FIRST, HILLSBORO, OR 97124 OREGON PHONE: 503/640.3470 INSPECTION R!cQUESTS (24 hours): 503/640-3561 or 693-4415 �U3175t3 Prolect, P00248gU Status- APPROVED Applied : U7/10/92 [ss+ e�<! t1'7/l 4/92 !~x 12 e,.• r,"�" 't oe �' p s 01/26/93 08/28/92 05 , 37 Permit Title .)FR ELEC/t)U ;,ETS b L'.(31-1 T.13 RESFLEC: Ge!�rraptaon L,Z � �EJ�;. :N^.TeGY OTH Jodi Address 8F 19��V� ��.-N 'T T1 Locat.lon 1)e,'.ail Apptioant Name HONE, CAROLYN & BRIAN Reglan r Pht_ ,,e number 684-51)"?7 v x. .iat i at. Applicant AAdt SE15 . .d AVON ST 0 TXGAiri, OR 97224 ['37-cel Nur,l::er 2'711 ir-i :)7r i)o ►napectic)n History Surwi.,�ry Cover & Servi ::a 07/30/92 AP :P OK FOR Cot . MECHANICAL PERMIT CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: MEC1999-00430 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/12/1999PARCEL: 2S111DD-07500 SITE ADDRESS: 08515 SW AVON ST SUBDIVISION: CHESSMAN DOWNS ZONING: R-7 BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERSICOMPRESS_O_ RS _ HOODS: FUEL TYPES 0 3 HP:� DOMES. INCIN: 3 15 HP: GOMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIF? HANDLING UNITS OTHER UNITS: 1 FURN >=:100K BTU: <= 0000 cfm: GAS OUTLETS: 1 > 10000 ch": Remarks: Installation of gas insert and gas piping to SFD. Owner: _ _ _ --- FEES_— —_— HORNE, BRIAN D/CAROLYN K Type By Date — Amount Receipt 8515 SW AVON ST PRMT KJP 10/12/19f $50.00 99-319019 1IGARD, OR 97224 5PCT KJP 10/12/19 $4.00 99-319019 Total $54.00 Phone: - _-- —� Contractor: FIRESIDE DISTRIBTRS OF ORE INC 18389 SW BOONES FERRY RD PORTLAND OR 97224 REQUIRED INSPECTIONS Gas Line Insp Phone: 503-684-8535 Misc. Inspection Reg #:LIC 00040979 f=inal Inspection ORIGINAL This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started witr in 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Orego i Utility Notification Center. Those rules are set fortis in OAR 952-001-0010 through OAR 952-001-0080 You may obtain coves of these rules or direct questions to OUNC by calling (503)246-9189. ISSUE B L' �/� > �,— Permih ie Signature: Y� - Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day )� 07 p IItI 18a FSA r,0:, 598 1960 C►Ti Uf T]G1R1) zi- 0v Plan Check M CITY OF TiGARDechanical Permit Applirntion Rood By 13125 SW HALL BLVDf�2FC iVF Commercial and Rosidential nala PeCd TIGARD, OR 97223O( 1 (I 7 �Q�� ` Date to P.E (503) 63941171, x304 \ Dale to DS M1 N C MUNITv EVELU ML r l Print or Type �'armlt c.armi — Tncomplets or isle ible a plications will not be acts led — - Norm of Dewiopmen0role-M Duscrbtion Table 1A Mechanical C deQty Price Amt Jou 5 et Addrpce ,,Lisa—x+ A Permit Fee - --� - l-" Address r3 1 ,x1� Avav, S4-• 1) Furnace to 100,00x:BTU -- includrng dv�s d lents 8.00 swot cnrstsu lip _ 2) Furnace 100,000 BTU+ — I i �Z-Z t� Indudhlducts 6 vents ---- 7.50 - Name lot name ce businesx) 3) Floc'Furnace OwnerI t 0,•�, i- C[7_l�`ryy� I - lnd@v udinent - 5.00 MelingMcfess -- 4) Suspended heater,wall heater C. ,11 or floor mounted heater _ 6.00 Cnyrstan Zip ptwne I SIrJ hi VO�t 5) Fent not included in appliance permit 1 — _ 3.UU _ I{.._ 71 P - �• �Q' -��'j CHECK ALL `Boller Heat A.r T-- vam name d b»insss) THAT APPLY, or Pump Coral Oty Price Aint Comp ', Occupant IdeiGngadon6)<3HP;absorb unit sa -�-_— -----�-_- 100K BTU 5 00 7)3.15 HP.absorb unit l;nyr3tus- —7,p-� Phone 1DOk to 5DOk BTU 11.00 E)15-30 HP;absorb -_--_ —_ --- unff.5-1 mil BTU 1500 rcont'ractor t'."e ---- - \ 8)30-50 HP;absorb 1 f1 c 1 unit 1.1 75 mil B rU 22.50 perm t N18ung Address 10)>50HPabsorb unit rC 3Issuancea copy I�3S9JW VIS + 7.50 of a"tcensesrsan Zip Prone 11)Air handling unit to 10.000 CFM are required f �vrCAI&A1,11D CX-912,ZLf- IDA Iq--BS 3 F - 453 expired in COT Oregon Conn :tont Scam Liar I E•p Dna 12)At hendhng and 1C COD CFM+ dats�sse 4_1- — _ _ 7.50 Architect13;No••pertable evaporate coolor — _ __�_ 1.50 or rAeuno Address -'-' 14)Vert fen connected to a sin duct 300 --� 15)Ventilation system not Inc uded in I Engineer cnyrsr•a 7Ip 'none appliance permit 4 50 6)rlood served by mechanics'exhaust ----j- - - - Describe work to be done _ ____ 4 50 •7)Dme ostic Inclneratare New C Repan O Rerlaoe mth like kind Yeo O No O 750 Residential 0 Commercial 0 18)Commercial or industrial t;pe incinerrtor 30.00 Add tonal information o descr pion of work _ 19)Repalr units '- —I �) I _ 450 n5 I�S - 1a_ ti0l4 � 20)Wood stove 21)Glo'hes dryer etc ' 4,5U T pe of ruel. oil O natural gas r LPG C electric C 22)Other units *-� ! , r -) O�b ) _ 156 I hereoy acknowledge that I have reee this application,that the i,formation 23)Gas piping one to tour cutlets J 1,5 � 3 IS g,,,an is correct,that I am the owne'or author,zed agent of -1 iw the owner,that plans submitted are Ir,compl ante wltn Oregon State laws 24)More than 4-pe'octle!(each) �- - Signatur a of Owner/Agent Date J5 --- Minimum Permit Fee$29.00 SUBTOTAL SURCHARGE Contect Pemnn Name — - - Phone --- _ PLAN REVIEW 2&34 OF SUBTOTAL Required for ALL commercial permits only Iq Kar c a,rst� C�� 53� TOTAL 'State Contractor B•'or Ce tlficaticn required- "I "ResideMial A/C requires site plan showing plAc-A"r"t o'urnt I�mechperm doc rev 07170'98 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST _ — //11 J Date RequestedBUP�V�� I n( I -AM _ PM � BLD Location AU 0-y' Suri MEC U4�-OV�f Conta,t Pcrsont�(' '{�Gv� :fit . Ph l'��-�S�3J"� PLM Contractor Ph (( SWR _ BUtLLING Tenant/Owne, _ aye '' �L1it� 4�f9.lYt._.. ELC _ Retaining Wall ELR Foong Foundation °,Cress: FPS _ Ftg Drain A.Tf ----- SGN Crawl Drain Inspectio tes: - --------- ---- 31ab -_ SIT Post&Beam � ------_ Ext Sheath/ShearQ Int Sheath/Shear Framing - Insulation C. 2C) ,) _, Drywall Nailing ,f—�,�: Firewall Fire Sprinkler Fire Alarm c �. Susp'd Celling -- Roof a d Misc: Final �— PASS PART FAIL -- --" PLUMBING L, / Post&Beam Under Slab Top Out Water Service Sanitary Sewer ----- Rain Drains Final PASS FAIL Rough in Gas Line K Smoke Damfi1'� P PART FAIL ELECTRICAL - Service _ Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL _.. SITE Backfill/Grading -- Sanitary Sewer Storm Drain [ J Reinspect'on fee of I requ red before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE: [ ]Unable to inspect-no occess ADA Approach/Sidewalk ' Other Date I �t----Inspectors ' -— Ext��y Final PASS PART FAIL_ DO NOT REMOVE this Inspection record from the job site.