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11780 SW KOSKI AVENUE 1 1 11780 SW Koski Avenue CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 ) INSPECTION DIVISION Business Line: (503)639-4171 MST BLIP — -- — - Received - Date Requested �_ M PM _-_- BLIP Location --_..--.-/- -� -_-- MEC -- - -- - - - C !art Person Ph(_ ) G1_- 3� � PLM -- Contractor , __ ----- -- -- --- Ph( - --) - — __ SWR BUILDING Tenant/Owner -- __-_- ELC ---- - ------- Footing - Foundation ELC Ftg Drain Access: - Crawl Drain [LR Slab Inspection Notes. SIT Post& Beam -- - - -- Shear Anchors ------ - -- Ext Beath/Shear - Int Sheath/Shear - Framing _�'G_. �u� I�t'�:0r ��..td.�. C 2i7�i1T0"V i7`Lk e W Insulation - - D.ywall Nailing t-JL7j-LN Firewall - - ---------- Fire Sprinkler - Fire Alarm - - Susp'd Ceilin -- -- _ Roof - Other: -- - ---- -- rrr _ AS _PART FAIL - Post& Beam Under Slab Rough-In - - Water Service Sanitary Sower ---- Rain Drains - Catch Basin/Manhole Storm Drain Shower Pan Other Final - PASS PART FAIL ---�- MECHANICAL Post& Beam Rough-In Gas Line - - -- -- Smoke Dampers PART FAIL ELECTRICAL ~ -- - Service------- Rough In - ----- - - - - UG/Slab - Low Voltage Fire Alarm FinFd - J Reinspection fee of$---_-_ required before next inspection Pay at City Hall, 13125 SW!tall Blvr1 PI�.SS PART FAIL p -. S Please call for reinspection RE: l Fire Su,ely Line - -- F] Unable to inspect-no access ADA /A Approach/Sidewalk Date _ 2 7�"� Inspector Other: P - ___ Ext Final DO NOT REMOVE this inspe.,.tion record front the job sH PASS PART FAIL ►AAA.&AAA.,L,AAAAAAAAAAAAI,AAAAAAAAAAAAAAAAAAAAAA a � � o e I►► C� � o Uri ro o �' ► A' � prri � �� ► ' cry a C44 , ► t (-, 44 ' � f\ ! ► p o ► i lop.1 �. r, ► 444 a o ! 4 44 4 s �ieeeieeeeeeiioeeeeeeeeeeeeeeeieeeeei�ieeeee v�► n ,� z n la Cc:' '' a a a � 0 o ,r ^�i. ^1 N \ n a n t O •o o r fi O 0 O � I � A � I0 r' '�o CITY OF TIGAI�D 24-Hour BUILDIFJG Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received _`.Date Req steel _..---- _s'�� AM _ -- __ . _ __ PM _- _ _ - BUP r � - Location ___ . l oy __.__ _�-'-� _ —.._Suite MEC Contact Person ---_. ---. ---------.-_ - Ph PLM Contractor -, --- - ---- _ Ph SWR - ------- _�-- - -- BUILDING TenanYOwner _.�_ — ___—_ _— ELC - -- Footing ---- _ ELC - Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes SIT Post& Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing - - - - - - - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other.- Final PASS PART FAIL PLUMBING Post& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain -- Shower Pan tWA -- — ------PART FAILNICAL Post& Beam Rough-In Gas Line Smoke Dampers _-__-�-_ _.— Final PASS PART FAIL - - - - ---- - - - —_ --- ELECTRICAL `,ervice Rough-In UG/Slab Low Voltagn Fire Alarm Final Reinspection fee of$ �—required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL F] Please call for reinspection RE: El Unable to inspect-no access Fire Supply Line �//�� ADA D 4h 6inoprotor�V_1�VA Ext Approach/Sidewalk Other Find - DO NOT REMOVE this hrspection record from the job site. PASS PART -FAIL 1 C 24-Hour BUILDING Line: (503) 639-4175 MST _ INSPECTION DIVISION Lire: (503)539-4171 BLIP Received (7�Date R uested __—_ J _ _ __ _ AM_ P11A_ — BLIP Location wU --__.Suite n_- '2 _ MEC ci Contact Person 8� 4— —_- -- Ph(__ ) Lz 0 3 PLM Contractor—_- __.__-- ---__-- _ Ph(--) SWRA; BUILDING Tenant/Owner _ -_ - ELC -- --------------- Footing ELC Foundation - Access: Ftg Drain ELR Crawl Drain _ Slab Inspection Nuieb. SIT - _--- Post&Beam Shear Anchors Fxt Sheath/Shear Int Sheath/Shear 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 Sjrvice 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 -----------__-- ------- - — — — _i___. Final PASS PART FAIL —-----�-- - ----_- ELECTRICAL _ ----- ------- Service Rough-In ------- --_—.--_— UG/Slab , Fire Alarm PART_ FAIL Reinspection fee of$_—_ —required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE — — Please call for reinspection RE: —_ Fj Unable to inspect-no access Fire Supply Line .14 ADA Approach/Sidewalk Date -� " _ � _ IIISprCt /fes _SC^-!� __ iExt Other: Final DO NOT REMOVE this Inspection record f om the job Ito. PASS PART FAIL ,---MASTER PERMIT CITY OF TIGARD PERMIT#: IMST2002-00483 DEVELOPMENT SERVICES nn ATE ISSUED: 121'i8/02 13125 SW Hall Blvd., Tigard,OR 91223 (503) 639-4071 SITE ADDRESS: 11180 SW KOSKI AVE PARCEL: 1S135CD-KM005 SUBDIVISION: KALAMOIIKA ESTATES ZONING: R-12 BLOrK: LOT: Inns JURISDICTION: 'I IG REMARKS: Construction of new SF Detached r 3sidence.Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS __ _ REQUIRED SETBACKS REQUIRED CLASS OF WORK: NL W HEIGHT: 22 FIRST: 823 at BASEMENT, sl LET r, SMOKE DETECTORS: Y Tyra OF USE: SF FLOOR LOAD: 40 SECOND: 942 of GARAGE: 41;0 st FRONT: PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: I THIRD of RIGHT OCCUPANCY GRP: A3 BURM: 4 BATH: 3 TnTAL: 1.765 at VALUE: , B1,6 l,n REAR. PLUMBING SINKS: 1 WATEP CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS. I.AVATORIES 4 DISHWASHERS. 1 FLCUR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS. TUHISHOWERS 1 GARBAGE 0WP: 1 WATER HEATERS: 1 WATER LINES: 100 RCKFLW PREVNTR: 1 GREASE'TRAPS OTHER FIXTURES- MECHANICAL FUEL TYPES FURN it 100K: BOILICMP<3HP: VENT FANS: 4 CLOTHES DRYER: I Gn, FURN>•100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INP: htu FLOOR FURNAN:ES: VENTS: I WOODSTOVES: GAS OUTLETS: I ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER _ TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 amp: 0 •200 amp: WISVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADO'L 500SF: 3 201 - 400 amp' 201 400 amp: let WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR. LIMITED ENERGY: 401 - 600 amp: 401 800 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT. MANU HMISVCIFDR: 601 1000 amp: 601+ampa•1000v: MINOR LABEL: r 1000+amp/volt: ' 1 PLAN REVIEW SECTION Reconnect only: >-/RES UNITS: 9VCIFDR>-226 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL-RESTRICTED ENERGY �.SF RESIDENTIAL B.COMMERCIAL AUDIO 5 STEREO: X VACUUM SYSTEM: X AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: ALL FNCOMP BOILER: X HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,869.14 This permit is subject to the regulations contained in the STEVE ECK CONTRUCTION ECK CONSTRUCTION INC Tigard Municipal Code,State of OR Specialty Codes and PO BOX 204 PO BOX 204 all other applicable laws. All work will be done in SHERWOOD,OR 97140 SHERWOOD,OR 97140 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: 503.62$-1305 Phone: 625 1305 Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-0010 through 952-001-0080. You Reg N: 1 II 11475 S may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Fooling Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Posf/ m Structur�F. PLM/Underfloor Framing Insp Gas Fireplace Electrical Final IsCedBy: A�LPI [ Permittee Signature Call (503) 631-4175 by 7:00 p.m. fr r an inspection needed the next business day CITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00328 13125 SW Hall Bled., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/18/02 SITE ADDRESS; 11780 SW KOSKI AVE PARCEL: 1S135CU-KMG05 SUBDIVISICN: KAI_AMOIIKA ESTATES ZONING: 1Z-12 BLOCK: LOT: 005 JURISDICTION:1- 1(1-TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection For new SF dwelling. Cerner: FEES STEVI_= ECK CONTRUC;TION Descriptic,n Date Amount PO BOX 204 — ------ - SHE:RW000, OR 9-040 40 1 SWIJSA)Swr Connect 12/18/02 $2,300.00 (SWUSA)Swr Connect 12/18/02 $0.00 Phone: S03-625-1305 [SWINSP)Swr Inspect 12/18/02 $35.00 [SWINSP)Swr Inspect 12/18/02 $0.00 Contractor: Total $2,335.00 Phone: Reg #: Required Inspections This Applicant agrees to comply with •311 the rules and regulations of the Clean Water Services. 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" Perm Permittee Signature: — --_ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day i t J Building Permit Application City of Tigard Datereceived: f.i Permit no.71 Address: 13125 SW Hall T Y/'C='t 1 Project/appl.no.: Expire date: — Ciry n/TiKar�l Phone: (503) 639.4171" Date issued: By: eceipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: ;Job &2 family dwelling or accessory O Commercial/industrial .J Multi family New construction U Demolition Addition/alteratiotL/replacement U Tenant improvement U Fire sprinkler/nlarm 0 Other: address: Bldg.no._ Suite no.: rt: Block: Subdivision: J /'� Tax map/tax lot/account no.: Pruiec t name: :Description and location of work on premises/special conditions: FOR SPECIAL INFIORNIATION, USE Name• CCJ-s' fir' f sepi le solar, C. y: g � State: ZIP: Valuation of work.... /...�.r...,..:r�.'..... Matin address: l dr 2 family dwelling: Phrne: kv Fax: I E-mail: No.of bedrooms/baths................................. Owner's tcpresen tive: Total number of floor s.......................... Phone: Fax: E-snail: New dwelling area(sq.ft.) .......................... l 7A417- Garage/carport area(sq.It.)......................... VQ.Q__ Name: J Covered porch area(sq, ft.) .......... .............. 40 Mailing address: �- Deck area(sq. ft.) .............................. ......... _ City: State: ZIP: Other structure area(sq.ft.)......................... d _ Phone: Fax: F-mail• Commercial/industrial/multi-family: t Valu;J,)n of work.................................. _ Existing bldg.area(sq.fry ........................ . Business manse: - � New bldg.area(sq.ft.; Address: Q-. .................................. _ -- City: State: 7.1P: Number of stones. ...r.................... Phone: p Fax Email: Type of construction....... .... _ CCB no.: (kcupancy group(: Existing: --- -- _ New: _ City/metro lic.no.: Notice:All contractors and subc, actors are required to be� licensed with the Oregon Construction Contractors Board under Name: ,.S'(xe&Z a✓'/s!6' Provisions of OILS 701 and may be required to he licensed in the Address: jrrisdiction where work is being performed. If the applicant is City: State: LII': exempt from li:.ensing,the following reason applies: Contact person: Plan no.: - --` jPhone' j Fax: G-mail: Name: L',7 /.seep ,- Contact person: Fees due upon application ........................... $ Address:;/ '041 -) .I' Date received: -- Ci City: •, Stat ZIP:97-Z'! Amount received ......................................... Phone jaf " Fax: E-mail: _ Please refer to fee schedule. i hereby certify I have read and examined this application and the Not all iurisdktions accept emlit carda,ptesse call 1wisdiction for more Information.' attached checklist. All provisions of laws and ohiinanees governing this O Visa U MasterCard work will be complied with,whether specified herein or not. credit card number: Expires Authorized signature -__Date: — __ None of cardbotder es shown on rredit card S Print name: ..5JKr11Z: J _ _ Cardholder si`ruture _— Amount Notice:This permit application expires if a permit is not obtained within 180 days oiler it has been accepted as complete 4464613(r KWOM) One-and'i wo-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: r in !iii n,1 City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW Ball Blvd,'1'igard,OR 97223 UOther: Phone: (503) 639-4171 Fax: (503) 598-1960 1111 F FOLLOWING ITEMS ARE 1 I FOltYes No /A F41 Land use actions completed.See jurisdiction criteria for con.urrent reviews. _ 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. Fire district _approval required. 5 Septic system permit or authorization ror remodel.Existing system capacity _ 6 Sewer permit. 7 Water district approval. 8 Soils report.Must carry original applmcuble 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 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. I 1 Silelplot plan drawn to scale.The plan must show lot and building,setback dimensions;property comer elevations(if thete is more than a O4 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;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. _ 12 Foundation plan.Show dimensions,anchor bolls,any hold-downs and reinforcing pads,connection details,vent size and location. _ 13 Floor plans.Show all dimensions,room identification,window size,Icxgtion of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show al framing-member sizes and spacing such its floor beams,headers,joists,sub-floor, wall construction,roof construction.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 addendurns 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 ataalysis prove:e specifications and calculations to engineering standards. — 17 Flour/roof framing.Provide plans for all floorslroof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. 18 Basement and 1 aining walls.Provide cross sections and details showing placement of rebar.For engineered systems,see item 22,"Engineer's calculations." _ 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any bt am/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance.Devitify tiac prescriptive path .mr provide calculations.A gas-piping schematic is required for four or more apphan xs. _ 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof true..)shall be stamped by an engince: or architect licensed in Oregon and shall he shown to he applicable to the project under review. 2:. Five(5)site plans are required for Item I 1 above. Site plans must Ix 8-1/2" x I I" 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plan. shall not contain red lines or tape-ons. 26 No rolled,reversed o;mirrored building plans will he accepted. 27 — — - 28 ---- 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 def-artment use only. 44x4614(~'OM) Plumbing Permit Application 7Datcieceive-d: Permit u,.: City of Tigard Building P,-rmit no.: Address: 13125 SW hall Blvd,Tigard,OR 97223 - -- 00,(?(Tigard Phone: (503) 639-4)71 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: 13y: Rc-ciptno.: Land use approval: ---_ _ - Case rite no.: _ Payment t:'pe: 1 &2 family dwelling or 1m accessory U Commercial/industrial U Mulu-family O Tenart r,ovement )(New constructiun U Addition/alteration/replacernent U Food service U Other: _ )11 SITL INFORNIM ION FFIL SO I LIM ILE(for special Information use checklist) Joh address: ��% �-� �`� D�crlption (jt f ec(ea. Total New 1•tro -/� •�-- - d 2-family dttellings only: Bldg.no Swte,.c.: (Includes lUU n.for each ulilhy connection) Tax map/tax loi/accounl no.: SFR(1)bath Lot: _ "' Block: Subdivision: Sl--,' (2)bath -- - -- - --- Project name: _ SFR(3)bath _ City/county: ZIP: ---_-�- Each additional batt/kitchen Description and location of work on premises: - SiteutlUtles: Catch bmin/area drain Ent.date of completion/inspection: - Dr welWleacb line/trench drain Footing drain(no.lin. ft.) Manufactured nornf•utilities Business nano' Manholes_--Address: 1&11;0 4:51 _ • Rain drain connector - City: _ _ Stat I?.11'. Sanitary Scwcr(no.lin. ft.) Phone: Fax: E-mail: Storm sewer(nu,lin. it.) - CCB no.: Plumb.bus.reg.no: - Water service(no. lin. ft.) Fixture or Item: Cityhnctro lie.no.: ---- Absorption valve _ Contractor's repmsentative signatute: �- _ Back flow preventer - Print name: Date: 9ackwater valve IRMIRI Basins/lavatory Name: Clot tomes washer - -- Dishwa�hcr ) Address: - _-T---- Drinking founitdn(s) City: State: ZIP: E'cclors/sunip - I -- Phone: Fax: EE-nt� ---- --` ~ Expansion tank Fixture/sewer cap Nimre(print): �_ floor drains/floctr siriks%hub - ailing address: Garble disposal ----�- __ lose bibb City: yt. - Stitt Z111_�fi Cx/� Ice maker Phone Fax: E-mail: Interceptor/grease trap Owner instal raion/resident ial maintenance only: The actual installation Prirner(s) - will be made by me or die maintenance and repair made by my regular hoof drain(commercial) employee r:,the property I own as per URS Chapter 447. Sink(s),basins)�aV.(s) _ Owner's signature: _ Date: ---_�-._ Sum _ '1'ubs/showcus;lower pan Urinal Name: - -� _- Water closet __ -- -- f,ddress: __ - Water heater _ City: ---p State: p-LIP Otter: Phone: Fax: E moil: -_ !'oral 4EE ----- Minimum fee................$ Nix ell Juriadicuatu uxtpl cmdii cant,plew cdl Jurisdiction rix imre inrornuuiea,. Notice: his penuit appli::atiun U Visa O MasrcrCunn s d expires if a pxr not obtained alar.review(at - %) $ -� Credit card numtur^ __. 1._1___ within 180 days r has been State surcharge(8%)....$ l xpirea 'TOTAL .......................$ ^ None of cardtwlder N shown on crodit card '— aeccplaJ as eomptae. - _ S c"hoideisisnattue —.— Amotrat 440.1416(6%WW Mechanical Permit Arplicai:on Date received Permit no.: City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Ball Blvd,Tigard,OR )7123 Datc issued, By: Receipt.m.: Phone: (503) 639-4171 ----- Fax: (.503) 598-1960 Case file no.. Payment type: Land use approval: �- �_._._----__ I Building permit no.. 0 I &2 fatnil,'dwellin f,or accessory U Commen:ial/industrial U Multi-family I'T:nant imprr vement New construction U Addition/alteration/replacenient U Odic r: 0 0 Joh adcJress: �i �� / Indicate equipment qu-unities in boxes below. Indicate the dollar Bldg. no.: _ Suite no.: - value of all mechanical materials,equipment,labor,overhead, apitax Int/account no.: _ profit. Valuc$ Tax m Lot: - Blor:k: __ Sulxiivision: - -- "dee checklist for important application information and -`_ _ jurisdiction's tee schedule for residential permit f-e. Project mune: 114111101 ion City/county: __- ZIP: Description and location of work on premises:_- Est.date of colnpletion/inspection� ---- -- Description _ qt . Re..,.onl Rei.onl Tenant improvement or change of use: Air handling unit _ _CFM-_ Is ex`sting space heated or conditioned?U Yes U No Airconditionmg((site plan�eyuired) Is existing space insulated?U Yes U No A tc�ation o�existt-ngFfC'iT syr stem - F3ofler/compre%sors tate boiler permit no.: Business name: �1 _ _C0_/1Q y HP Tons_ 137 U/f1 _ Address: Fir smoke :unpers7duct stn Detectors City: - _ State: - LIP: - llcal pump(sue p an reyuTredj- Phone: -� hax: �E-snail:ZI - InstalVrcplacc urnace/taurncr_-_TiZTJTII - Including ductwork/vent liner U Yes U No CCB no.: _- - __^ iwall/rep ace/relocate caters-suspends , wall,or floor mounted --_- Nande(please prinU: vent for appliance er t�othhan;urnaCC e r eration: n: Ahso•iplion units ,- BTU/I I Name: _ Chillers_ _- _ III' -------- - Compressors -_ ^^_ lip Address: _ -- stay omneota exhaust au.:^•tot ton: City: _-- Stale----7ZII': Applianccvent Phone. ---- Fax: E-mail: 15ryerexpaust liiv;klm��- or s, ype I res. its ten/hazmai hrxxl fire suppression system - - Natire: _ -- - Exhaust fan with single duct(bath fans) - - n� i, haust s stem a art from +satin Mailing^drltcss: L11� ue p p ng mod up to outlets) City: ,,•, _^ 'St;ttc: 7.IP: �z�ls 2 Tyr,,. NG Oil _ + '. r E-mail: fuel-piping each additionaTovcr 4 outlets roceaa.p 1;(sc teniaticrequire 1 Nnnplr,of outlets l Name: mer ire iipp�ance or III pp-mell ` - Address: _�_�_ Decorativefireplace City_ -_ - State- - ZIP: 7nscri YPc -_�tove _ --- - uodsta��Ica s – —_ Ptupne:--- Fax: E snail: Ut�c Applicant's signature: Date: ,^ Other: Name (print): -- - Permit fee... ................$ _---- -- Na all jurisdictions acepr credit cards.please call jurisdiction for m,re,nforniahm Notice: I;pisrmit application pe pP Wnunum fee................$ U Visa U Mmi Card expires it a permit is not obtained plan review(at %) $ cmdrn cad number:__ _ — ___L_Csircwillpip 180 days allrr it hnc F+ en State surcharge(8%) ....$ _ -- acrr ted as coon Icte. Nair of ardhol r u ahs wn nn cwt cm $ p p TOTAL .......................$ Can1h,>fder si6ntture M — Amount 410-4617(6MMM) i l� I $r 48.00' Q OT 5 rlf-F- TBACK e _ - ._ _ PROPOSED I I I IPE NID 11280PLA1 I I I I O ' /r F GARAGE —,J O• I S /c� I a I /Sc�. POWER -- a M O 4'THICK I I co N _ CONC 0 DRIVE I p Z D 48.00' -- -- - - 1 n O U '- c Lu a KO I- I r /C _ n �r�� S,`��, KOSK� DP� V C kph;��il a fwr n ,LINTEL FUME DESIGN,INC IS NOT l IABLE FOR THE ACCURACY OF THFL�6AL DFICRDTK7f1 �tza TOPOGRA.PHY INFORMATION IT IS - TI-E SOLE I?ESPONSaLITY OF THE TO BE ATTACHED E3UILDER 1O VERIFY ALL SITE - CONDITIONS,INCLUDING ANY FRl " — - hL.ACEr1 ON THE SITE,AND flJFORM oWNERS OF ANY POTENTIAL FIELD M» MODIFICATIONS woun«T,ascr CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST ii BUP Received __ Date Reg4ested_- -__ ' 4L_ AM.-- PM____ SUP - Locationc ------- - �- - Suite------_-- _ VEC Contact Person Ph (-----) - 1 �' - ` 1� ''LM Contractor Ph (__- -) --- SW'i BUILDING_ Tenant/Owner -- F_0 o-�ing CLC `-�_-_--_- Foundation Access: ELC Fiq Drain ELR Grawl Drain _ --- --------- Slab Inspection Notes: SIT Post& Beam --- —_ Shear Anchors ------- -- --- _ Ext Sheath/Shear Int Sheath/Shear —_..-..---- -- -- -- Framing Insulation - -- - Drywall Nailing _- _ _-------- -__- Firewall /> Fire Sprinkler Fire Alarm Susp'd Coiling --------- Roof ,p , Other: - - Final PASS _PART FAIL - -- - ----- - - PLUMBING Post& Beam Under Slab Rough-In - -- Water Service Sanhary Sewer - Rain Drains Catch Basin/M•rinhole Strrn Shower Pan Other. -- Ffrf _ ES _PART FAIL ------_.-- . --- --- - --- HANICAL Post 8 Beam -------- --------- - -------- - - Rough-In (Sas Line Smoke Dampers --- -- - -- -------- -- ------- --------------------------- Final ---- PASS PART FAIL - -- - -- -- ELECTRICAL Service - --- - ---- Rough-In Uv/Slab ------ - Low Voltage _- ire Alarm Final ❑ Reinspection fee of;� required before neat inspection. Pay at City Hali, 13125 S"'Hall Blvd PASS PART FAIL SifE Please careinspection [] Unable to inspect-no access ll for RE t_. Fire Supply Lige ADA rr Approach/Sidewalk Date _ ._ Inspector Ext Other:_ / Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TI GA RD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00191 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5118/03 SITE ADDRESS: 11780 SW KOSI<I AVE PARCEL: 1S135CD-11800 SUBDIVISION: KALAMOIIKA ESTATES ZONING: R-12 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TR,",PS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DR,^INS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow prevention device for irrigation system Owner: FEES — Description Date Amount STEVE ECK CONTRUCTION PO BOX 204 I'I.I'\11{l 11rrmit I rr 5/8/03 $36.25 SHERWOOD, OR 97140 1 I A\18" � ti(❑tr Id 5/8/03 $290 Total $39.15 'hone : 503-625.1305 — - --- Contractor: GROVER'S LANDSCAPE SERVICES ')6485 S. MERIDIAN P.D. AURORA, OR 97002 REQUIRED INSPECTIONS Phone : 503-678-170(1 RP/Backft-)w Preventer Final Inspoction Reg#: LIC I I SW This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 Iequires you to follow rules adopted by the Oregon Issued Ry; r i t �I � ) l�� c't-.ovl* J _ Permittee Signature: Call (503) 639-4175 by'x':00 P.M. for an Inspection needed/the next business day ;il( i>I g Fixtures PIumbillL Permit A ,)V1ieati0i rReceived s Plumbing —' Permit No.. Planning Approvul Sewer City of Tigard hate/liy: Permit No.: 13125 SW I Iu{I Blvd. Plan Review Other Tigard,O egos 97223 Post-Ry; Permit Use Post-Kcvlcw land llac Phone: 503-639-4171 Fax: 503-598.1960 r.. Date/U : Case No.: Internet: www.ci.tigard,or.us Contact Iuljg' See Pope a for 24-hour Inspection Request: 503-639-4175 Nainc/Mclbod v _ ^_ �►0 No t ticmentel Informatlon. TYPE OF WORK FEE"SCHEDULE fnr s)ectal Informatlon use checklist New construction I L I Mmolition Descrl ttiotr• Fer(C■•1 r+,tar New i-&2-family dwellings AdJll10f1/allCratlOn/re IQCCment Other: Includes 1w if.lar tacit u •+� v cot nec►lon _ CATEGORY OF CONSTRUCTION Sl It(l)bath _ 249.20 1 &2-Family dwelling ('ommercial/Industrial Spli 2 bush — 350.00 Accessory Buitdil�__ Multi-Family SI:K 3 buth 0____ Master Builder Othen: Duch additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Fires rinkler-sq. fl,:_ Page 2 Job site address: "T LG.� �`v Sile Utilities Catch basin/arca drain Ili.G(1 Suite#: Bld%�#-_ — Dr well/lcaclt line/trench drain 16.60 I'roiect Name: _ Foutin drain no.Iincur it. Pae 2 _ Cross strcet/DireetioQs to job site: fi' Manufactured home utilities 110.00 C'Grr�•r�'�c"�'' �° ,. Manholes MOIL) Rain drain cotnteclur 16.60 Sanitin y sewer no.linear 11. Pae 2 L.ol#: Storm sewer ntt u.linear . Pa c 2 Subdivision: �_. — Water service(no. linear ft) Pae 2 Tax map/parcel #: Fixture or Item DESCRIPTION OF WORK Ab12Lttion Ivo ~� 16.60 C141ti_ c ackilow reventct:• I'_a c2 ljac tl�walei valve 16.60 — _ Clothes NN:+shcr I6 fiU Dishwashher— I G.GO Drinking fou-. 'n _ 16.60 PROPERTY OWNER +$TENANT 1s'cctors/sum, — I6.60 Cx,ansion tank 16.60 _ Address: fixture/sewer ca 16,60 -- —— - _-- Floor drain/(lout sink/liub 16.60 City/state/Zip: Garbage disposal 16.60 Phone; Fax: Nose bib 16.60 APPLICANT r _ CONTACT PERSON lee maker I6.60 Name: Interco tor/ reuse trap 16.60 — Medical gas-value: $ Pae 2 Address: Primer 16.60— City/slate/Zip: _ Roof drain(cotnmcrcial 16.60 Phone: — HaX _ Sink/basin/lavatur _ 16.60 Tub/shower/shower pun 16.60 E-mail: iG.60 Urinal CONTRACTOR ____,— µater closet 16.60 Business Name: ' /A-lv ' ,� �f'�+' S — 16 60 _ f.itt.�1 µutcr heater Address:_ City/State/Zi c�thcr: aX:_S n 11 f Plumbing Permit Fees" _ phone: ,�� 6 7 LZ`�c• — _ Subtotal $ C.Cd Lie. # plumb. Lic.r`� m-_/_ MininwPcrmit Pcc S72.5U s .� Authorized ., ` f I C�.� Residential Hackflow Minirnurn Fee$36.25 gJ Signature: r t " Date_I__ __ -_ plan Review 25%of Permit I:ce $ l 1�,GL L J✓ �___...__ Slate Surcharge 8%of Iermil Fee s -- t(Please lit fill name) _ _ TOTAL PERMIT FEE s Not)c, '1'111%permll applic■tion espires u a permit Is not obtained within Ml new cont rcial bulldings require 2 sets of plans with Isometric or 180 days after It ha%been accepted a%conq,lete, rl%cr diagrarn for plan review. ,I-cc rnet11nd(pinay sc1 by I rl-ununty Bulld)np Induslry Service hoard. i:\f)sts\Pcnnit l:orn4%\PIn.I'cmutApp.dtvc 01103 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERNNIT NOTICE NORTH STAR PLUMBING 1445 SE OREGON STREET SHERWOOD, OR 97140 Plumbing Signature Form Permit #: MST2002-00483 Date Issued: 12/18/02 Parcel: 1 S135CD-KM005 Site Address: 11780 SW KOSKI AVE Subdivision: KALAMOIIKA ESTATES Block: Lot: 005 Jurisdiction: TIG Zoning: R-12 Remarks: Construction of new SF Detached residence.Path 1 Your company Inas been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR. STEVE ECK CONTRUCTION NORTH STAR PLUMBING PO BOX 204 1445 SE OREGON STREET SHERWOOD, OR 97140 SHERWOOD, OR 97140 Phone #: 503-625-1305 Phone #: 625-2679 Reg #: LIC 00090697 MET 00002694 PLM 34-255PB AN INK SIGNATURE IS REQUIRE ON THIS FORM Signat re of Authorir.,d Plumber J If you have any questions, please call (503) 539-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WILLIAM BUTTERFIELD CONTRACTING PO BOX 305 13120 SW MORGAN RD SHERWOOD, OR 97140 Electrical Signature Form Permit #: MST2002-00483 (late Issued: 12/18/C2 Par::el: 1 S135CD-KM005 Site Address 11780 SW KOSKI AVE Subdivision: KALAMOIIKA ESTATES Block: Lot: 005 Jurisdiction: TIG Zoning: R-12 Remarks: Construction of new SF Detached residence.Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for thp. 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, ATTI`i: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: STEVE ECK CONTRUCTION WILLIAM BUTTERFIELD CONTRACTIN( PO BOX 204 PO BOX 305 SHERWOOD, OR 97140 13120 SW MORGAN RD SHERWOOD, OR 97140 Phone #: 503-625-1305 Phone #: 503-625-6773 Req #: LIC 18554 ELE 3-54x( SUP 0935 AN INK SIGNATURE IS REQUIRED ON THIS FORM inna ure -SulIrvising Electrician it you have any questions, please call (503) 639-4171, ext. # 310