The URL can be used to link to this page

9256 SW ELROSE STREET t P-1 --1 0 P 1-1--i AN' Illi 111, 114C.:. V( ) 1'( )X /_ A( I IYVI I( ;AId ) ( W 1) 2; I 1 a...... sir'err s.�w�•..• III I. i d i i1_ + � wi...i.ii.i. q CR (p 5 \Af y-0,5 Q Scale 1/8" == 1 ' Wes- (_)wnsIxmj9 ;jtul ctinwhpaco cl pili► to sliclol ` Idowallc s and clrivowlly aI►I►mai ► Icr c;liy cuclo. /Tv r -- vA moo OZw"* �S o to, ' 4,0OAT G v� Wlfo►� M .Q '` 4L � ...--- Ter) ce CJ o � Q 1_71- v - pa vrJ 7Z o FL,_.- �..-. 'rte �"'��.-_-�'-- • a 6 v r to v� • - , r-• r 6a _ �d �•- - t �� w a I � � C12 6• 6 4.80' 00 F v .C.J I p v\ 00 D 5,,8" .k. W; DEHAA,: �r ASSOCIATES IN Y �r( 1 , �•� U t�U 5/8" IRON RO �p •, W/YPC MARKED 'n "DT. BURTON LS 2248" c6 SN 26165 Q LOT 5 1ct: IR 94. ,588 sq, ft. �I N rn -' -� o D l tw G in 12 ui 62.28' NOTICE: IF THE PRINT OR TYPE ON ANY r ( 11 ► II IIiI � � IIIII � III IIIIIIi IIIII ) I II ! III IIl III III ' ! II II ! III III I I I � ! ! II � IIIIIi � lllll III III III III IIl II ! 111 III III Illi ! I + ! I i I ! I I I III I I I ! I I I I I I I I I ' IMA i I I I I 1111 i ItIII I I iiI _ _-� ; , GE S NOT AS CLEAR AS THIS NOTICE, ! I I 1 I , cE, 1 2 3 4 ! IT I UE TO THE QUALITY OF THE �� 7 8 9 No.36 _ ».. ._ IGINAL DOCUMENTOR E 6Z gZ LZ gZ Z � Z gZ Z TZ o7 6 >'i1 Gi 9T 4I fiI Ei ZT TI --- '111.11 6 8 i L 9 S Z I a,Ml�w illllllllillillllilililiillllillllllIII( (IIIlll11111L11illlll.11ll. 11llllll. 11ll Illlllllllllllllllllllli IIIIIIIIIIIIIIIIIIIII{IIIIIIIIIIIIIIIIIIIIIIIilllllllllllll III.IIII IIIII.IIIut ' l.11 lilt 'II I ,Ww V• N 01 CN C m 0 N �D t,. 9526 SW Elrose Street CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIP _ _Date Requested_ ° t AM__--PM BLD — LocationZ ZG Sw l��r �r Suite MEC Contact Person Ph ��'y- �/ t(�/ Z. PLM __— Contractor _ Ph — SWR ------ BUILDING _ Tenant/Owner — — - ELC _ Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes. - —T Slab ---- - - ---------------- --- SIT Post&Beam _-- Ext Sheath/Shear __------- -__ Int Sheath/Shear Framing ---.- -- ----- Insulation Drywall Nailing --- -- ---- - ---- - --- --- -- -----._-.._ -- Firewall Fire Sprinkler ---- -------------- - --- --- ----_ _--- - Fire Alarm Susp'd Ceiling --- -- --- --, - --- -------_ _.- ------- - -- Roof Misc: __ - ----- -- --------------- _ -- ------------- Final PASS PART FAI - - -- - __-------- -- - -- --- - Post&Beam ------ ... -------- --- _ --------- -_. -- -- - --- Under Slab ---- --- - -- - --------- --------- ---- - - Top Out Water Service Sanitary Sewer Rain Drains I ASS PART FAIL MeCTiANICAL Post& Beam --- - - - ---- -- ---- - -- - -- - - -- Rough In Gas Line -- --- ---- - - ---- - ---- - Smoke Dampers Inal PASS PART FAIL ELECTRICAL --------------- - - - -------------- ------_— Service --- - ------ -----__- ---- Rough In UG/Slab --- Low Voltage Fire Alarm --.---- - Final PASS PART FAIL - -- --SITE Backfill/Grading _ Sanitary Sewer Storm Drain [ j Reinspection fee of$ _required before ned Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Please call for reinspection RE: [ j Unable to inspect-no ace!ss Fire Supply Line ADA Approach/Sidewalk Ext3 Other nate Inspector ` 6, _ _ -- - - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- BUP _ Date Requested .S Z Z" AM PM BLD Location�j se, �,✓�f 1C _ Suite _ � MEC Contact Person _ Ph PLM Contractor Ph _ SWR BUILDING Terant/Owner ELC _ Retaining Wall ELR Footing Access: Founddtion FPS Fig Drain SGN Crawl Drain Inspection Notes: Slab _J----._^__ _- ---_ _-_ SIT Post&Beam - - Ext Sheath/Shear _ Int Sheath/Shear Framing - ---------- - ------ --- --------- -- Insulation Drywall Nailing -- -- -- -- -- - --- -----J--- ---- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ ! t2 Roof Misc: - Final PASS PART FAIL 1 / _- PLUMBING D u-") V D Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam - -- - --- - Rough In Gas Line Smoke Dampers Final ----__---_--_-- PASS PART FAIL Service Rough In UG/Slab Low Voltage Fire Alarm _ �§A�S��S__ ART FAIL -�- ITE Backfill/Grading - - - Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fare Supply Line [ ]Please call for reinspection RE: [ J Unable to inspect-no access ADA 7 Other Date Det@ � �"�� Q f/ Inspector 0 Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST .. '� ?.4-Hour Inspection Line: 639-4175 Business Line: 639-4171 — BUP Date Requested % � _�AM PM �� _ BLD Location G��; �� C1-G-f' Suite _ MEC Contact Person _ Ph PLM Contractor Ph SWR (IfiUILONG Tenant/Owner ELC retaining Wall ELR Footing Access: Foundation FPS Fig Drain SIGN — Crawl Drain Inspection Notes: ------ - — Slab __. SIT Post& Beam —�- Ext Sheath/Shear Int Sheath/Shear ^A-- Framing Py' is 5T t ry SJ L L*na nl c;;rzt: -- Insulation Drywall Nailing3,1.,k -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof PASSAP R. FAIL -----PLUMBING Post Post&Beam --- _-- - ---_- Under Slab Top Out -------- - ---- -- Water Service _ Sanitary Sewer Rain Drains Final — T FAIL _ ---------------------------- ------------- MECR L Pos Beam Rough In 7 Gas Line — Smoke Dampers tj ASt' PART FAIL ELECTRICAL Service Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE [ ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date U -/y �'/ Inspector _Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 7h- �s to /lot• "'j 1,e7 e7 71-40 '1117 .7%e- �srlC/dr�/c'�YIC�� 4�I �tG ,6d�k�idi^c/ — tv�i:i� CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ C .—Date Requested U� _AM PM BLD Location __ i Suite MEC Contact Person _ Ph �!/b T [� � PLM _ Contr a ctPh SWR _ BIfIL jgr- Tenant/Owner _ _ ELC Retaining Wall �— � — ELR Fnoling Access. Foundation FPS Ftg Drain —� Crawl Drain Inspection Notes: SGN Slab SIT Post&Beam ------ --_ Ext Sheath/Shear Int Sheath/ShearG/ Framing cL ��'� Amrryc Insulations - Drywall Nailing Firewall - -- Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mi SS PART FAIL. PtVMBiNG Post&Beam _ ------ ----- ----- Under Slab Top Out --- Water Service - - Sanitary Sewer Rain Drains Final - - - — PASS PART FAIL MECHANICAL I'cist& beam Rough In Gas Line - - Smoke Dampers Final - - — ------ -- - - PASS PART FAIL ELECTRICAL orvice Rough In UG/Slab Low Voltage Fi:a Alarm Final Y --- PASS PART FAIL SITE -_ _--- - Backfill/Grading --- - -- --- --- -- -- Sanitary Sewer Storm Drain I ]Feinspection fee of$ —required 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 access ADA Approach/Sidewalk Other Date �_`_� s d/ Inspector Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. ° OP, n " � � n 01 ~ " N n N o ` " M ^� a m � n F O i� �e 3� 70 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE INTERSTATE ELECTRIC INC PO BOX 7342 SALEM, OR 97303-0068 Electrical Signature Form Permit #: MST2000-00494 Date Issued: 12/26100 Parcel: 2S111 BA-11100 Site Address: 09526 SW ELROSE ST Subdivision: LAUTT'S TERRACE Block: Lot: 005 Jurisdiction: TIG Zoning: R-4.5 Remarks: SIF PATH 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: NEWCASTLE HOMES, INC. INTERSTATE ELECTRIC INC P.O. BOX 230459 PO BOX 7342 1 IGARD, OR 97281 SALEM, OR 97303-01368 Phone #: 503-684-7543 Phone #: MBL 393-2223 Req #: LIC 117121 SUP 14795 ELE 24-354C AN INK SIGNATURE IS REQUIRED O THIS F Signature of Supervising Electrician if vo�u have any questions, please call (503) 639-4171 , ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NORTHWEST PREMIER PLUMBING P.O. BOX 23338 TIGARD, OR 97281 Plumbing Signature Form Permi! #: MST2000-00494 Date Issued: 12/26/00 Parcel: 2S111 BA-11100 Site Address: 09526 SW ELROSE ST Subdivision. LAUTT'S TERRACE Block: I_ot. 005 Jul isdiction: TIG Zoning: R-4.5 Remarks: S/F PATH 1 Your ccmpar.y has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbkig permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN. Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: NEWCASTLE HOMES, INC. NORTHWEST PREMIER PLUMBING P.O. BOX 230459 P.O. BOX 23338 T!GARD, OR 97281 TIGARD, OR 97281 Phone #: 503-684-7543 Phone t?: 503-624-0582 Reg #: I Ir 135022 PI M 34-348PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. ## 310 MASTER PERMIT CITY OF TIGARD PERMIT#: MST2000-00494 DEVELOPMENT SERVICES DATE ISSUED: 12/26/00 -� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 09526 SW ELROSE ST PARCEL: 2S111BA-11100 SUBDIVISION: LAUTT'S TERRACE_ 73NING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: S/F PATH 1 BUILDING REISSUE: S70RIES: 2 FLOOR AREAS REQUIRED SETBAC',5 REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1.170 of BASEMENT: at LEFT- 1/ SMOKE DETECTORS: Y TYPE OF US6: SF FLOOR LOAD: 40 SECOND: 1,230 at GARAGE: 594 at FRONT: 2,1 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT at RIGHT: 5 VALUE: S 224.154 00 OCCUPANCY GRP: R3 BORM: 4 BATH: 3 TOTAL: 2.40000 at REAR: 27 PLUMBING SINKS: 1 WATER CLOSETS: -+ WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 4 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP c 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>=100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: + WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: I 0 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 400 amp: 201 400 amp: tat WIO SVC/FDR: 00 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 •500 amp: 401 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 • 1000 amp: 601+ampa•1000v. MINOR LABEL: 1000+amp/volt: PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: 9VC/FDR>=225 A.' >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO 9 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT. BURGLAR ALARM: OTH: 1301LER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,829.27 This permit is subject to the regulations contained in the NEWCASTLE HOMES,INC NEWCASTLE,TOMES Tigard Municipal Code,State of OR. Specialty Codes and P.O. BOX 230459 PO BOX 230459 all other applicable laws. All work will be done in TIGARD,OR 97281 TIGARD,OR 97281 accordance with approved plans. This permit will expired 1 work is not started within 180 days of issuance,or if the work is suspended for more then 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted b; the Oregon Utility Notification Center. Those rules are set Rey N: LIC 59667 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)248-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanlca Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor Insulation Mechanical Insp Shear Wall Insp I lsulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Ins( Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr; Electrical Service Low Voltage Water Line Insp Final inspection Post/Seam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final Issued By : , _ Permittee Signature : l�, Call ( U3) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00342 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/26/00 SITE ADDRESS; 09526 SW ELROSE ST PARCEL: 2S111BA-11100 SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIG TENANT NAME: USA NO: FIXTI IRE UNITS- CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached. Owner: NEWCASTLE HOMES, INC. - FEES P.O. BOX 230459 _Type By Date Amount Receipt TIGARD, OR 97281 PRMT CTR 12/26/00 $2,300.00 27200000000 INSP CTR 12/26/00 $35.00 27200000000 Phone: 503-684-7543 _ Total $2,335.00 Contractor: Phone: Reg #: Required Inspections _ Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued b / Y� __ Permittee Signatur��.-G-�L',L..( f Call (50 6) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application Date received: Permit no.: 5 zwl\;� Y City of 'Tigard � u.„�Ir,ud Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: p4 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alan:n U Other: t Job address: C1 5 Z. 5 W yL Bldg.no,: Suite no.: Lot: 5 1 Block: Subdivision: 5 T U/Ct Cj Tax map/tax lodaccount no.: Q_. Project name: /33 //, /•Z, Description and location of work on premises/special conditions: (Floodplain,septic capacity,solar,etc.) Mailing addre.._P-6 .?� S 1 &2 family dwelling: City: ; State:Oe ZIP: C17 Z8 Valuation of work.............................. .... .... $ Phone: ax: 0 E-mail: No.of bedrooms/baths................................. 3 Owner's representative: Total number of floors................................. Phone: Fax: E-mail: New dwelling area(sq.ft.) .......................... D 0 — Garage/carport area(sq.ft.)......................... 259 q Name: K(,-r h i CIC to r Covered porch area(sq. ft.) ......................... _ Mailing address: f 56tmt Deck area(sq. ft.) ... ................................... City: State: ZIP: Other stntcoue area(sq. ft.)......................... — Phone:� i nx: E mail: Commercial/industriallmultf-famlly� Valuation of work........................................ $-- Existing hldg.area(sq. ft.) ........... .............. Business name: J/ (L, L/1 Addrr.::s: New bldg.area(sq.ft.)..................... .......... _ `5 Number of stories ........................................ City: State: ZIP: --- Type of construction........................ ........... Phone: Fax: Email: Occupancy group(s): Existing: New: City/metro lie.no.: Notice:All contractors and subcontractors are required to be ' licensed with the Oregon Construction Contractors Board under Name: provisi-ns of ORS 701 and may be required to be licensed in the Address: jurisdi;tion where work is being performed.If the applicant is Cit State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: Phone: Fax: E-mail: Name: ! ,' (,,,Q_/ �-i is j r ut-c r,: Contact person: KLV r'n Fees due upon application ........................... $ .ZSD.,01 Address: rj7 C &_r� j,,CU Date received: —_ City: CSC StateO"j:' ZIP: 9-7,2 1 Amount received ......................................... $ Phone:,,o3 7 (;I FaxtiVtc 3c-5 1 E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all Jurisdictions accept credit cants please call jurisdiction few more information. attached checklist. All provisions of laws and ordinances governing this U Visa U Mastercard work will he complied with whether specified herein or not. Credit card number __._----- — J77 -- Expires Authorized signature: t �'�'�` Date: /C''Z-7 Name of cardholder as shown on credit car Print name: K-6 1%; rl f KL'r —` -- Cardhokkt i_j tature ---� s Amount Notice:This permit application expires if n permit is not obtained within 190 days after it has been accvrpted as complete. _ 4404613 OWCOM) One-and Two-Family Dwelling Building Permit Application Checklist Referenceno.: Associated permits: it y of Tigard City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,"Tigard,OR 1'1223 UOther: Phone: (503)639-4171 Fax: (503) 598-19611 REOVIRED FOR W(AN REVIV%V Yes No N/A 1 Land use actions completed.lice jurisdiction criteria for concurrent reviews. 2 Zoning,Floud plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. a �! 4 Fire district approval required. _ 5 Septic system permit or authorization for remodel.Existing system capacity Sewer permit. _ 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. t.. 10 Complete seta of legible plans.Must be drawn to scale,showing conformance to applicable local and state, building aides.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 Sitelplot 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/sepfic 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 sire and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans, Ip umbing 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,rix)[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:he actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums sht-wing 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 analysi! provide specifications and calculations to engineeringstandards. _ 17 Floor/roof framing.Provide plans for all noors/roof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. 18 Basement vnd retaining wsdls.Provide cross sections and details showing placement of rebar.For engineered systems,see item 22,"Engi-.^r's calculations." 19 Beam calculations. Provide 1'70 sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any bearn/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 archil^ct licensed in Oregon and shall be shown to be applicable to the project under review. w 23 Five(5)site plans are required for Item I I above 24 ---- --- 25 — - -- 26 27 Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 44nd614 t610WOM Mechanical Permit Application Date received: Permit no.: City of Tigard CitynfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Phone: (503) 6394171 Date issued: By Receipt no.: A ' Fax: (503)598-1960 Case file no.: Payment type: , --E 11MIJKLI"I W N jWA - Land use approval: Building permit no.: 1 &2 family:dwelling or accessory U Commercial/industrial U NIIJ10 lunily U Tenant improvement =New consinU Addition/alleration/replacement J Othrr- ff"d ILI 111.11 WINI Job address: �� S W &1/t7 St? - f- Indicate equipment quantities in boxes below, Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: I Subdivision: LGtv-tf"5 T c.¢_,., 'See checklist for important application information and Ptx)ject name: jurisdiction's fee schedide for res.-l2ntial permit fee. City/county: i' ZIP: T761 t Description and I ation of word on premises: _ Est.date of completion/inspection: YJ� on f M( •) Total - Q�'. Res.only Res,only Tenant improvement or change of use: 11VAIIA -' Airhandlin Is existing space heated or conditioned?U Yes U No g unit __CFMT � Au conditioning(sae plan rcyulre�- Is existing space insulated?U Yes U N A teration r comof existing C system or epressors - -- Business name: • State boiler permit no.: F f�U r -�E U-Stir ,� {}f [� r n HP Tons HTUlH Address: Q$ (p(p qQ 9 ire/smoke amper uct smo'taeteclors Cit - - y: � ✓ � State:pfe ZIP: eat pump(all; p aTn reyu,re ) Phone: t1Fax. 7 // E-mail: nsta rep acefurnace/burner -- CCB no.: w Including duclw-rk/vent liner U Yes U No Insta rep ac re ocaie heaters-suspen ed, City/metro lic.no.: _ wall,or floor mounted Name(pleaseprint): Vent for appliance other than furnaceKIL Refrigeration: Absorp!iununits_ HTU/H Name: Chillers HP -- --- Address' Com ressnrs IIP -` ronmenta ex aunt an ventilation: ('ity: �~- ___TS late: -- ZIP: Appliance vent Plume: I.IV F-mail' hyerex aunt loads,Type 1 res. itc.e azmat - hood fire suppression s}stem Name: r_xhaust fun with single duct(bath fans) Mailing address tt gust s stem a art from eaten or AC - �- 7-Fuel ue p p ng an st ul on(up to out ets) City: tii;,l i II' 7ylx Lf(J NG Uil Phone: I;l� I nail. i 'n each additionalover4outlets - Process piping(schematicrequire ) Nance: Number of outlets --- - ter R app noes or equ pinent: Address: Decorati ve f ireplace City: -State -�7.;p; asset-type Phone: 1:1x: 1: mail: - --- Woodslove/pellet stove Ot ec -- -- Applicant s signature: �A Date: t Name (print): --- Not W jurisdictions accept credit cams,please call juri%diction rat awwr infnnnanon Permit fee.....................$ _ U Visa U MasterCard Notice:This permit application Minimum fee....... .......$ expires if a permit is tint obtained Credit card number: 1_L_ Plan review(at __.. 9F) $ Expires within 180 days after it has been State surcharge(8%)....$ _ �^ Name or cardhoWt as shown rn do caret - accepted as complete. -- -- -- $ _ TOTAL ....................... --_� $ Cudholder signature Amm ou -- i40-4617(&U"M)) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: Description: Price,Total FEE: $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) _Amt _ 1) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents 14.00 $1.52 for each additional$100.00 of2) Furnace 100,000 BTU+ fraction thereof,to and including including ducts 0 vents 17.40 $10.000.00. $10,001.00 to_$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace cludin vent 1400 $1 54 for each additional$100.00 or q Suspended fraction thereof,to and inc uding ) d heater,wall heater 14 00 $25,000.00. or floor mounted heater _ $25,001.00 $50,000.00 $379.50 for the first$25,060.00 and 5) Vent not included in appliance permit To 6 80 $1 45 for each additional$110 00 or fraction thereof,to and Including 6) Repair units 12.15 $50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heal Air $1.20 for each additional$100.00 or For items 7-11,see or Pump Cond fraction thereof. footnotes below. Comp* " 7)<31117`;absorb unit _ ------ to 100K BTU 14.00 ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb �- - Value Total unit 100k to 500k BTU _ 25.60 Descs ription Qty (Es)- Amount _ 9)15-30 HP;absorb Fumace to 100,000 BTU,including 955 uril.5-1 mil BTU 35.00 durts&vents 10)30-50 HP;absorb Furnace>100,000 BTU Including 1.170 unit 1-1.75 mil BTU 52.20 ducts&vents --- 11)>50HP.absorb Floor fumace inciuding vent 955 - unit>1.75 mil BTU _ 87.20 Suspended heater wall heater or 955 1-2)Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13)Air handling unit 10,000 CFM+ permit _ --- - 11.20 - Repair units 805 _ _ 14)Non-porlable evaporate cooler <3 np;absorb.unit, 955 1000 to 100k BTU - ?5)V -t fan connected to a single duct 3.15 hp;absorb.unit, 1,700 _ 6.80 101k to 500k BTU - 16)Ventilation system not included�7-1- 30-50 15-30 hp;absorb.unit,501k to 1 2,310 appliar.e permit 10.00 mil.BTU 17)Hood served by mechanical ex hp;absorb.unit, 3,400 10.00 _ 1-1.75 mil.BTU -- 18)Domestic incinerators >50 hp;absorb.unit, 5,725 17.40 >1.75 mil.BTU 19)Commercial or Industrial type incinerator Air haodlingunit to 1 0,000ofm 056 69.95 Alr handling unit>10,000 cfm 1,170 20)Other units,including wood Fioves Non-portable eva orate cooler 656 _ 10.00 Vent fan connected to a single duct 44821)Gas piping one to fou outlets Vent system not Included'n 658 540 a fiance permit _._ 2.2)More than 4-per outlet(each) Hood serv_ed_by mechanical exhaust 656 _ 1.00 _ Domestic Incinerator 1,170Mlnimurr.Permit Fee$72.50 SUBTOTAL: $ Commercial or Industrial Incinerator 4,590 Olt,er unit,including wood stoves, 656 8%State Surcharge $ Inserts,etc. _ Gas pi Ing 1-4 outlets 360 _ _ -- 25%Plan Review Fee(of subtotal) $ Each additional outlet _ 63 Required for AI-L commercial permits only TOTAL_ COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: - Other Inspections and Fees: 1 Inspections outside of normal business hour;(minimum charge-two hours) $72 50 per hour 2 Inspections for which no fee is specifically indicated (minimurr charge-half hour) $72 50 per hour 3 Additional plan review required by changes,adc itions or revisions to plans(minimum charge-one-half hour)$72 50 per hour State Contractor Boller Certification required for units>20nk PTU. "Residential A/C requires site plan showing placement of unit I:\dsts\fom sUnech-fees.dcc 10/11/00 �rrrrrrr� Electricai Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: Cirvafl'i/:ard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 - Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement Jia New construction U Addi ti on/al teration/repl acement U t Ilhrl U Partial .1011 SITE INFORMATION I Job address: R5Z(o 5W ►'die Sfi Bldg.no.: Suite no.: Tax map/tax lot/account no.: L,ot: Block: ISubdivision: a Project name: I Description and location of work on premim-, Estimated date of coo lesion/inspection: Job no: ca L - Fee Max Business name: s}-Q ,C- Description Qty. (ca.) Total no.insp Address: gd 3 -2- — New r-iderrlial-single or multrfamilv per dwellingmdt.Includes atlachrd garage. City: ,S0 State:0 730 3 Service Included: Phone: 22 Fad F,-mail: 1000 sq.ft.or less - I 4 CCB no. / 1 a2. I Elec.bus,lie. m Each additional 500 sq.ft.or portion thereof 1- I.imited energy,residential 2 City/metro lic.no.: Limiled energy,non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician(required) _ Jate Service and/or feeder _ 2 Sup.elect.name(print): License no: Services or feeders-Installation, alteration or relocation: 200'amps or less 2 Name(print): ti -vk. ;=t.57 L E t bM 95 201 amps to 400 amps — 2 Mailing address: p 6 2-36459 — 401 amps to 600 amps 601 amps to 1000 amps _ _ 2 City: (4— Slate' ZIP: Z8 f Over 1(x)0 amps or volts 2 Phone. 5 431 Fax: I E-mail: Reconnect only — — - I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocation: ORS 447,455,479,670,701. 200 amps or less _ 2 201 amps to 400 amps 2 Owner's sl nature: Date: 401 to 600 ams _ 2 Branch circuits-new,alteration, Nanta: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 Clly: _ Slate: ZIP: P. Fee for branch circuits without purchase F'honc: ttill --- Fax:-- - — of service or feeder(cc.first branch circuit: 2 I:-m:ul: F.ach additional branch circuit. Misc.(.Service or feeder not Included): U Servitt over 225 amps-commercial U Health care facility Each pump or irrigation circle 2 ❑Scrvitt over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 famiry dwellings U Building over 10,0(x)square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,orextension• _ 2 U Building r verthree stories U Feeders.410 amps or more •Dcscri tion. U Occupant load over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: U EgressAighting plan U Other: _ -- Per inspection Submit-_sets of plans with any of the above. Investigation fee 11te above are not applicable to temporary construction service. Other i -- - -- - - -- ---- Not all jurisdictions accept credit cards,please call jurisdiction for ore infonaation. Notice:This permit application Permit fee..................... m U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _ Credit cord number:_ / / within Igo days after it has been State surcharge(8%) ....$ Expires accepted as complete. _ TOTAL .......................$ Name of cardho der u shown on credit card _.. _ S _ --_ — Cardholder signature Arnounl 44U4615(61W-0M) t'. .A Eirctrical Permit Fees: Limited Energy Fees: --- ----�— �� TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: —__ ---- p Restricted Energy Fee............................................... ...... $75.00.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total l Check Type of Work Involved: Rcsidentlal per unit 1000 sq ft.or less $145 15 _ 4 ❑ Audio and Stereo Systems Each additional 500 sq ft or portion thereof _ _. $3340 _ 1 Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular F1 Garage Door Opener' Dwelling Service or Feeder $9090 2 Services or Feeders Heating,Ventilation and Air Conditi ening System' Installation,alteration,or relocation ` 200 amps or less _ $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $10685 2 401 amps to 600 amps _ $160.60 :' 601 amps to 1000 amps T $240.60 2 Otl er Over 1000 amps or volts `_ $454.65 2 Reconnect only _ $66.85 7 p ry Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY TemInstallation,alteration, Feeder Fee for each system.......................................................... $75.00 200 amps or less $66.85 2 (SEE OAR 918-260.260) 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits Boller Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of sprvice or F] Clock Systen is feeder fee. Each branch circuit $665 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder lee. First branch circuit $46.85 _ _- E:] HVAC Each additional branch circuit $6.65 Miscellaneous ❑ Instrumentation (Service or feeder not included) Fach pump or irrigation circle _ $53 40 y Intercom and PagingSystems Each sign or outline lighting $5340 Signal circuit(s)or a limited energy panel,alteration or extension $7500 ❑ Landscape Irrigation Control' Minor Labels(10) $125,00 Medical Each additional Inspection over the allowable In any of the above F-] Nurse Calls Per inspection $6250_ Per hour _ $62.50 _ In Plant $73 75 El Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ Number of Systems 25%Plan Review Fee See"Plan Review"section on $ No licenses are required Licenses are requ ed fon all other Installations iront of application -- Fees: Total Balance Due ---- —- Enter total of above fees ❑ Trust Account p _._ 8%State Surcharge -- -. - ------- Total Balance Due $-- — i:\dsts\forms\elc-fees.doc 10/09/00 Plumbing Permit Application Date rcccivct;: Permit no.: Cit of Tigard City g Sewer permit no. Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: It U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U 1'enant improvement U New construction U Addition/alteration/replacement U Food service j O1Lrr: .IORSITE INFORNIN)ION 1-k-4- SCIII-111111I.E.(for%pegial Information use checklist) Job address: 9 5d fp W1✓r ,Q r Description Qt . Fee(ea.) Total Bldg.no.: Suite no.: New 1-and 2-family drellings only: Tax n /tax IoUaccaunt no.: — (includes 1000.for each utility connection) P SFR(1)bath Lot: Biock: Suhdivision: LC. If.�Tet'/Q rAJ SFR(2)bath Project name: _ SFR(3)bath City/county:Tl' c(,r ZIP: 9 7d Each additional baM.itchen Description and location of work on premises: Siteul111Hes: _ Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trcnc;t drain Footing drain(no.lin.ft.) Manufactured home utilities _ Business namt: #fir - rYi"p-r' PI U m b in Manholes Address: FL) BpX A. 338 Rain drain connector City: i' State ZIP:tJ7.-8 I Sanitary sewer(no.lin.ft.) _ Phone:$ 3.19 ax: I E-mai!. Storm sewer(no.lin.ft.) CCB no.: 13 L5 d a A I Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: — Fixture or item: Contractor's representative signature: Absorption valve Back flow preventer Print name: Date: Backwater valve Basins/lavatory_ rlame: Clothes washer Address: Dishwasher _ Drinking fountain(s) _ City: State: IP: Ejectors/sump Phone: Fax: E-mail: Expansion tank mmFixture/sewer cap__ Floor drains/floor sinks/hub Name(print): Garbage disposal _ Mailing address: Hose Garbage City: ,i State: ZIP: Ice maker _ Phone: Fax: E-mail: Interceptor/grease trap Owner installation/resideniial maintenance only: The actual installation P-imer(s) will be made by me or the maintenance mid repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sin (s),basin(s),lays(s) _ Owner's si nature: Date: Sump Tubs/shower/shower pan Urinal Name: _ Water closet _ Address: Water heater _ City: State: ZIP: Other: _Phone: Fax: I E-mail: Total Not all jurisdictions accept credit cords,please call jurisdiction for more Wonnation. Notice:This permit application Mininiuni fee................$U Visa U MasterCard expires if a permit is not obtained plan review(at __ 96) $ Credit card number__ _.— —�-_1— within ISO days after it has been State surcharge(11%)....$ Name of cardholder m drown on credit card L:xpires -- accepted as complete. TOTAL .......................$ _ S Cardholder d(tnature Amount 4404616(6MCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual QTY es AMOUNT (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory — 1B 80 for each utility connection) One�jl bath _ $249.20 _ Tub or Tub/Shower Comb. 16.60 _ T_wo�bath $350.00 _ Shower Only 16 6o Three 3).bath $399.00 Water Closet 16,60 - ------ --- _ SUBTOTAL _ Urinal 16.60 _ 8%STATE SURCHARGE _^ Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16,60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3.. 1660 -- PLEASE COMPLETE: 4- 16.60 Water Heater O conversion O like kind 16.60 Quantity b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ ----Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavat Tub or Tub/Shower Hose Bibs - 16.60 _ Combination Roof Drains 16,60 Shower Only - Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) ~� 16.60 Urinal -� Dishwasher L Garbage Disposal — LaundryRoomTray _ -- - Washing Machine _ Floor Drain/Sink. 2" Sewer-i st 100' 55.00 3" — Sewer-each additional 100' 46.40 _ 4" Water Service-1st 100' 55.00 Water Heater Water Service-each additional 200' 4640 Other Fixtures _ S eci Storm&Rain Drain-1st 100' 55.00 _ Sturm&Rain Drain-each additional 100' 46.40 -. Commercial Back Flow Prevention Device 46,40 — - -- - Residential Backflow Prevention Device' 27.55 -^- - Catch Basin 16.60 -- Inspeclio t of Existing Plumbing or Specially 72.50 _ Ra uq estedInspections _- per/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 `_- Grease Traps 16.60 - QUANTITY TOTAL -- - - Isometric or riser diagram Is required if — -- gluan_tity Total is >9 --- *SUBTOTAL ---- - - - `8%STATE SURCHARGE -- "PLAN REVIEW 25%OF SUBTOTAL Required only if fixture qty total is>9 TOTAL b - Minimum permit fee is$72 50-8%state surcharge,except Residential Barkllow Prevention Deice,which is$36 25•8%state surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review i:\dsts\forms\pIm-fees.doe 10/10/00 SEE 35MN-1, ROLL# 22 FOR LARGE DOCUMENT I CITYOF T I GA R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-0044,' 13125 SW Hall Blva., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/7/2004 PARCEL: 2S111 BA-11100 SITE ADDRESS: 09526 SW ELROSE ST SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIC, CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE C.117 USE: SF UNIT HEATERS: VENT FANS: OCCUPANC t GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 •• 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE:: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS — OTHER UNITS: 1 FURN >=100K BTU: <= 1J000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Install exterior A/C,(to not install within the requirckl selhacks Owner: _ FEES KEVIN! MARTINELLI Description Date Amount 9526 SW ELROSE ST \11:CHI Permit Fc•e 7/7/2004 $72.50 TIGARD, OR 97224 TAX) 8 State Surchart 7/7/2004 $5.80 Total $78.30 Phone: 503-598-9450 ----- Contractor: TRI COUNTY TEMP CONTROL 13150 S. CLACKAMAS RIVER DR OREGON CITY, OR 97045 _ _REQUIRED INSPECTIONS Phone: �( : sli7-2220 Final Inspection Reg#: LIC 72623 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 within 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 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699 Issued By: _ jl-tL Permittee Signature: needed the next uffilness da Call (503)t639-4175 by 7:00 P.M for inspections Y JU1 05 04 05: 25p Tr i Count-d Temp f'ntro l 5035570919 P. 1 Mechanical Permit Avi lication FOR City of Tigard Rece;ved ' 13125 SW Hall Blvd„Tigard,OR 97223 Da"Y: PertnrtNo.ffutA�C J ' Phone: 503.639.4171 Fax: 503.598.1466 Plan Review -` —1 Inspection Line: 503.639.4175 DatelBy: Other Perm;t•. Internet: wvw.ci.dgard.or.us Date Ready/Hy; - Juni Bl See Puae r.,. NOOEedfMeehad' Supptemeat I Information .f„"LYP]9'�CtrtW(71t)fll�t.',: T.: a ^;,4.e,;,, .�:11,. Oil, [ tC1G :TRE»:6CIiED.QCE' C) Et'CH1tC[Q;LS'C' ❑New construction Acid ition!altrradbn/replacement Mechanical permit fees*are based on the valu of the work performed.indicate the value(rounded to the n crest dollar)of ail * iy'r, ❑l.. ___ mechanical materials,equipment,labor overhe d and rofit. ?� y;'`' tv;•';r EGORY OF CONS tL�CTION Value; I-and 2-family dwelling ❑CommcrctaUindeutrial Q ❑Accessory building RE3IDENTJAL'E. 111[PMENTI SYST NIS FEES* Multifamily ❑ Master builder ❑Other: For special inormation use chec ist. �, Descnptient T Sotal r ' OB;SIT Q y Ea. thv (i2hIA' I!K'AND LOCATION,� HeadarYcoolina Job site address: q WWrox Air conditioning or heat pump rre u{re2 stet Ian showia lacement) Ciry(StatWZIP: '� _ Furnace 100,000 BTU(ducwvents) 4,00 Suitafbldg./apt.no.: Project name, Furnace 100,000+B iU duow-nis 7.90 Gas heat u 4 00 Cross street/directions to job site: Duct work 4.00 _ H dronic hot water s stem 4.00 Residential boiler(radiator or h drof;ic� 4,00 Unit heaters(fuel-type,not electric), _ in-wall,In•duct,3u ended,etc. O.OD Subdivision: Lot no,: Flue/vent for an of above 0.00 Other: 0 Tax map/parcel nu.. Other fuel a fiances _ L " ► Water heater 00 lGas I-ir lace 1 .00 Flue v-_n:for water heater or gas fireplace l .00 ` — Lo h hienf ) 1 •00 w'aod/ eller stove I .00 Wood fire Iace/insert 1 .00 (',irrute /liner/flue/vent ` ¢ OI'�R1Y OWNEki'`, .. ry �,,TENANT_sw Y 1 .00 iatr +,.�' '� a,. 1n n _— other: DD Name: Environmental exhaust and ventilation Address: &MRange hood/other kitchen ` -- - e ui ment i .00 CityfStatafZfP: Clothes dryer exhaust I .00 Phone ( ) �Q D (- )- Singie-duct exhaust(bathrooms, �T^� Far toilet corn anments utilityrooms 80 `'ff AEP,t,[G.' . : ata; +^ A1VTP .. t .:,:". !.+re r>.Z CbIV1`ACCFP�R3bN Attic%tawl eo fans l .00 $nstnesa Warne: TO Ce T� C0� -. other: _ l .00 Fuel piping Contact name: 55.40 for lirst four;SI.00 for each add conal Address: a Q �r r 1�` VGh ce,etc. Y V V _� eat u CitylStatdZlP: 1'? L l`Phone:(aab) 55 Fax::( ) 5 7 ( heater F•mail: ace Ran e ,}I'+,. 4 ' ':,•. Barbecue t �_ •' - ::n.-.,.` iii � Business name: W ) r i Clothes dr er�as� Address: , �(i5(� ��y- - Other AIN150✓v 1 i,. at' JN C} ANIGTXT:PERl1 1 �1»ES CitylStatdZlP: 0- C _ Subtotal Phone: C `( Minimum Fax;(Gj()':s permit Cee(S72.50) "'�/ ( Plan review(25%or permit fee) State surcharge 8%oC ermit fee) TOTAL PEMUT FEE Authorized signantre: � ' '�—' T6N permit application expires if a permit Is not obra as w n teo �f ,n days aver it has been accepted as eomple . Printname: .IJ�Q.��l Nl �n Date: Fee methodology set by Tri-County Building Industry emice Board 1BuikmlWP nluuV.(aC-yerriL*.Mdoe 12M) 4e"6177(1;1021COWWRB) Jul 05 04 05: 25p TriCeunty Temp Cntrol 5035570919 p. 2 U D C: C rn o N of V� t A z P I NIIr 1Tb � �J fff � co a � I goo/Eoa F;o r 0 1, 1 1 CITY OF TIGARD 24-Hour BUILDING Inspection Linz: (503)63 75 INSPECTION DIVISION Business Line- (5 9-4171 MST BUP Received ___ _.__Date Requested - ��`1 AM_� PM _ BUP Location �.5 �- p _ 4 --Suite-------- Contact uite _--_—_—Contact Person AA _- Ph( ) —. �� +�� PLM Contractor-__ ____- SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: 'i're Fig Drain ELR ----_-__-, __-- Crawl Drain _ Slab Inspection Notes: SIT Post 6 Beam Shear Anchors --— - - --- Ext Sheath/Shear Int Sheath/Shear V\/\ Framing - -- Insulation Drywall Nailing - - - Firewall Fire Sprinkler - -- Fire Alarm Susp'd Ceiling — Roof Other: Final PASS PART FAIL PLUMBING Post&Beam -- Under Slab Rough-In Water Service --- Sanitary Sewor Rain Drains - Catch Basin/Manhole Storm Drain - Shower Pan Other: Final PASS PART_ FAIL MECHANICAL Post& Beam Rough-In }/�/� Gas Line �'Vt Smoke Dampers — _rPAi4 PART FAIL -- _~_ TRICAL_- Service ~ Rough-In UG/Slab Low Voltage Fire Alarm Final Reinspection tee of$ required before next ins PASS PART FAIL i — 4 Inspection. Pay at City Hall, 13125 SW Halt Blvd. SITE Please call for reinspec tion RE• Unable to Inspect-no access Fire Supply Line ADA ata_ 1___ .- �% _ Inspseter Approach/Sldewalk D � - - Other: Firial DO NOT REMOVE this Inspection recer4( rom the job site. PASS PART FAIL