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10700 SW NORTH DAKOTA STREET-3 19844 e30lea 41JON AAs 001.0E 0 .Y d 0 M 0 Z CD O V � W O r 10700 SW NORTH DAKOTA ST A,RD PLUMBING PERMIT CITY OF TIG DEVELOPMENT SERVICES PERMIT#: PLM2004-00496 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 11/11/2004/20040 SITE ADDRESS: 10700 SW NORTH DAKOTA ST PARCEL: 1S134DA-06500 SUBDIVISION: PP1995-023 ZONING: R-3.5 BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of tankless gas water heater. FEES Liwner: --- ---- Description Date Amount 12480BOBES W FIRST, RICHARD [I'LUMli] Permit Fee _ 11/1/2004 $72.50 12480 S [P,X] R State. Surchart 11/112004 $5.80 BEAVERTON, OR 97005 _ Total $78.30 Phone: 503-639-0237 Contractor: OWNER REQUIRED INSPECTIONS Phone • Rough-in Insp !— Final Inspection Reg#: a toe t- This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. a Specialty Codes and all other applicable laws. All work will be done in accordance with approved W plans. This permit will expire if work is not stdrted within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued`By: X ��(/QP�t?�2 Permittee Signature: r Call (503) 6394175 by 7:00 P.M.for an Inspection needed the next business day !gkbing Permit Application City of Tigard ID"At"y & "PeT.nit 13125 SW hall Blvd.,Tigard,OR 97223 Phone: 503.639.4171 Fax: 503.59$.1960 Plan Review Da /B Other Put No em_ 24-}lour Inspection Line 503.639.4175 Tete RoadylBy lure ^ 0 See Page 1 for Internet www.ci.tigard.or.us Notirled/Method Supplemental Information SCHEDUUIU ❑New construction ❑Det:olition Forspedal!n ormoNon use Checklist -- Description _ Ea. Total Q Addition/alteration/replacement ❑Other: Meir 1-2-family dwelling(includes 100 ft.for each utility connection) A•_ ,j;,`1a t ", SFR(1)bath 249.20 1-and 2-family dwelling y ❑CommerciaUinduatrial SFR(2)bath i _ 350.00 ❑Accessory building ❑Muiti-family SFR(3)bath _ 399.00 ❑Master builder — —� Each additional bath/kitchen _ 45.00 ❑Other: Fire sprinkler(r._sq.ft.) Page 2 Site utilities Job site address: i D -2o U A 416-r pf Catch basin or area drain 16.60 City/State/ZIP: /L 7 L L Drywell,leach line,or trench drain 16.60 Suite/bldg./apt.no.: Project name: Footing drain(no.linear ft Page 2 Cross street/directions to job site: Manufactured hoax utilities 110.00 ,f G G (� _ — Manholes 16,60 Rain drain connector 16.60 Sanitary sewer(no,linear ft.: Page 2 Storm sewer(no linear R.:_) Page 2 Subdivision: —� Lot no.: Water service(no.linear ft.:_ Page 2 Tax map/parcel no.: Fixture or item Absorption valve 16.60 Backflow preventer Page 2 �LA Kt,if-0s wArk- 4- C-A Backwater valve Clothes wcsher 16.60 Dishwasher 16.60 Drinking fountain 16.60 nip Name•. Ac�_ Ej passion tan _ 16.60 T Expansion tank 16.60 Address: ZQ 24)(� C f, L.A Wo y' Fixture sewer cap 16.60 City/St.te/ZIP: L(A b-L>> Q A— g 7 L L Floor drain/floor sink/hub 16.60 Phone:(;E3) —�— Fax:( ) Garbage disposal 16.60 „y Hose bib 16.60 Y Ice maker 16.60 Business name: -- interceptor/geese trap 16.60 Contact name: _ _ Medical gas(value:S ) Page 2 IL Address: Primer 16.60 City/State/ZIP: Roof drain(commercial) 16.60 Phone:( ) Fex: :( ) Sink/basin/lovatory 16.60 E-mail: Tub/shower/shower pan 16,60 Urinal 16.60 .: 77 Water closet 16.60 1: WIlusiness name: Water heater 16.60 Address: Other: City/State/ZIP: _ Subtotal e.( ) Fax: Minimum permit fee S72 50 Phon ( ) Residendal backflow minimum permit fee: $36.25 `�•� CCB Lic.: Plu bi Lic.no.: Plan review (25%of permit fee) Authorized signature: _ State surcharge(11%of permit fee) _ `TOTAL PERMIT FEE Print name: G ,¢. Q 2(,. Date. / This permit application expires If a permit is not obtained within 180 days after It has been accepted as complete. *Fee methodology set by Tri-County Building lydustry Service Eoard. i\Building\PermiMPt-M-PerntitApp doc 1213 4/04616T(10J0VC0MrwFB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression S stems: _ Footing drain-1"100' 55.00 0 to 2,000 S113.00 Footing drain-each additional 100' 46.40 2,001 to 3,600 S160,00 3,601 to 7,200 5220.00 — Sewer-1st 100 55.00 7,201 and Oster 5309.00 _ Sewer-each additional 100' ¢6.40 Water Service-1 sl 100' i 55.00 Medical Gas S ems: Water Service•each additional 100' 46.40 Storm&Rain brain-1 st 100' 55.00 --- SI.00 to$5,000-00 Minimum fee 372.30 Storm&Rain Drain-each additional 100' 46.40 S5,001 00 to$10,000.00 $72.50 for the first$5,000.00 and$1,52 for each i,l��te► 4 to additional 5100,00 or fraction thereof,to and �/i tl ;• ' inc!uding 510,000.00. Commercial Back Flow Prevention Device 4640 $10,001 00 to S25,000.07--and $146 50 for the first 510,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00�• fraction thereof,to minimum it fee 536.25 27.55 _ includin $25,000.00, Rain Thain,single(amity dwelling 65.25 $25,001.00 to$50,000. $379.50 for the first$25,000.00 and SI 45 for Inspection of existing plumbing or each additional 5100.00 or fraction thereof,to and including 550,000.00 s eciall requested inspections hour 72.50 550,001.00 and up 5742.00 for the first 550,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtur\If "yes",please indicate work performed by fixture. Failure to accursRttely repo t fixtures could result in Increased sewer fees*. FI><furt7`yplt h ry i1tl¢w �Mure mm is regurding fixture work: Ba tisn-iFo�l Bath -Tub/Shower — -- -Jacuzzi/Whirlpool Car Wash -Each Stall -Drive T hru Cuspidor/Water Aspirator - - --- Dishwasher -Commercial _ _ -Domestic Drinking Fountain —Eye Wash _ Floor Drain/sink 2" Y. --,4" Car Wash Drain - IL Garbage -Domestic Disposal -Commercial Industrial *Note: If the fixture work under th permit results in an Ice Mach./Refri .Drains increase of sewer EDXJs,a sewer per t will be issued and Oil Separator Gas Station fees assessed for the sewer increase mu be paid before the _J Rec.Vehicle Du Station plumbing permit can be Issued. (1fl Shower -Gang 0 -Stall _ Sink Aar/Levator uantity Total -Bradley Isometric or riser diagram is ro-quired if fixture quantity -Com rrii rcial -Service total Is>9. Swimming Por!Filter W tsher-Cicihes W iter ExtractorPlan Review wt.to Closet-Toilet` Plan review is required if fixture quantity total is>9. Urinal - Other Fixtures: i\AuildinjkPe mitc\PLM Pa itArpdoc 3/n3 f CITY OF T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICE] PERMIT#: MEC2004-00716 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 11/1/2004 PARCEL: 'IS134DA-06500 SITE ADDRESS: 10700 SW NORTH DAKOTA ST SUBDIVISION: PP1995-023 ZONING: R-3.5 BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIFE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO UR FERN < 100K BTU: _AIR HANDLING UNITS ITS: FURN >=100K BTU: <= 10000 cfm: OTHER UNITS: 1 GAS OUTLETS: 2 > 10000 cfm: Remarks: Installation of gas fireplace,gas piping for fireplace and tankiess cr hcafer. Owner: _ FEES BOBERG, RICHARD Description Date Amount 12480 SW FIRS1 [MECH]Permit Fee_ 11/1/2001 _ $72.50 BEAVERTON, OR 97005 [TAX]8%State Surcharl 11/1/2001 $5.80 Phone: 503-639-0237 Total $78.30 Contractor: OWNER REQUIRED INSPECTIONS Phone: Gas Line Insp Mechanical Insp Reg#: Final Inspection IL oc f- m_ This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes W —i 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- Signature: Permittee SI Issued Bk g Call(503)639-4175 by 7:00 P.M.for Inspections needed t e next business day Mechanical Permit Application_ city arrfgard a;°, Permit No w 13125 SW Hall Blvd.,Tigard,OR 97223 !y Plan Review Phone: 503.639.4171 Fax. 503.598.1960Dote/By: Other Permit. Inspection Line: 503.639.4175 Date Ready/By, Ju0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information UMC'HECKLIST ❑New constructionition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value S 0SIUENTIA1 EQUIPMENT/SVSTtMS FEES" tp 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building ---- — --- For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qry. Fa. Total MomP Heating/cooling Job site address: /b 700 5 � !L Air conditioning or heat pump f _ uire�site plan showing placement 14.00 City/StatC/ZlP: _ 1� L L -- Furnace 100,000 BTUsducts/vents) 14.00 Furnace 100,000+BTU(ducts/vents) 1790 Suite/bldg./apt.no.: Projc t name: _ Gea heat pump 14.00 Cross street/directions to job site: �Q(, Duct work — 14.00 H dromic hot water system 14.00 Residential boiler(radiator or h dronic) 14.00 _ — _ Unit heaters(fuel-type,not electric), in-wall in-duct,suspended,etc. 10.00 - Subdivision: Flue/ventfor an of above 10.00 Lot tlo.: Other: _ _ 10.00 Tax map/parcel no.: Other fuel alancea y Water heater -- W 10.00 Gas fi iace _ •� Iu d-7 �/�-1(J 6-4 04-P i 4e AC Flue vent for water heater or gas f l� Fi Q� /N /� W� fireplace — 10.00 Lo lighter as) 10.00 TTI V k_)t_ & "a- r� ,s L/ 4,Ic W224/Ellet stove_ 10.00 — Wood fi lacelinsert 10.00 t Chimney/liner/flue/vent 10.00 ,, . Other: 10.00 _ Name: J C 14,4 it, Q�B ti. R t Environmental eahoust and ventilation Address: 0 J v(:l �W AJ P4,116-r 4 Range hood/other kitchen equipment 10.00 City/State/ZIP: / /1. q:2, Clothes dryer 10.00 —�— Single-duct exhaust(bathrooms, Phone:( �j) �C/—V L 3 Fax:( ) toilet compartments,utility rooms) _ 6.80 4 n Atfic/crawlspace fans 10.00 Other: Business name: - �_ Fuel piping —_• Z Contact name: $5.40 for first four;$1.00 for each additional_ Y ----- - -- — Furnace,etc. ' _ n Address: Gas heat pump �. City/State/ZIP: ll ` Wall/suspended/unit heater Water heater Phone:( � � (J'gs� Fax::( ) --- Fireplace E-mail: Range- Barbecue an aBarbecue _! _J TIN IVIRMWIM Business name: Clothes d�_Sgas) -- — Other: Address: 1' — City/StateiZIP: �� _Subtotal Minimum permit fee(572 Phone: "— - Plan review(25%of permit feel CCB lic.: State surcharge(Bile of permit fee) S s, TOTAL PERMIT FEE ,. ('3 This permlt application expires If a permit is not obtained within Iso Of Authorized signature: `� days after It has been accepted as complete. Print name: LZ (C,t{{/?-1-D W $U br Date: ' Fee methodology set by Tri-County Building Industry Service Snard i\Auilding\Pemfu\MEC-s mit App doc 12/07 440.4617T(I 1;02ICOMlWr111) Mechanical Permit Application -• City of Tigard , Page 2 - Supplental Information Commercial Fee Sch nle: $1.00 to$2,000.00 nn fee$72._50 001.00t $5,000.00 $721,0 0 for the fust$2,0 .00 and$2.30 fbr euNjadditional$1 .00 or fraction _ thereof,tNpd inclu g$5,000.00. $5,001.00 to$10,000.00 5141.5('for a f17. 5,000.00 and $1.80 for eachionul$100.00 or fraction thereof,t A including _ $101000.00. _ S 10,001.00 to$5000.00 $231.50 for the,ust S1 00 and $1.35 for each dditional 0.00 or fraction there f,to and incl u g $50,000.00. $50,001.00 to$100,000.00 000.00 an$ 5 , $1.2fore ch Boditioaial S 100.00 or fiaction threof,to and including $100,000. 0. $100,000.01 and up $1,396.5for the first$100,000.00 and $1.10 for ach additional$100.00 or fraction t ereof. Note: All new commercial buildings require 2 sets of plans. i a a: m m W J is\Building\Permits\MEC•Pem.ithp.doc 12103 2 CITY OR TIGARD ChtGlrl. BUILDING DIVISION PERMIT#: MEC2004-00716 13125 SW Hall Blvd.. Tigard, OR 97223 DATE ISSUED: 11/1/2004 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/2/20(Y, TIME: 7:04AM PAGE: 6E3 SITE ADDRESS: 10700 SW NORTH DAKOTA ST CLASS OF WORK: SUBD.VISION: PP1995.023 LOT#: 001 TYPE OF USE: PROJECT NAME: B013FRG DESCRIPTION: InalAlatron of gas fir%Awe, gas piping far fired a and tmiwess water heater OWNER: BOBERG, RICHARD, PHONE #: 603-690237 CONTRACTOR: OWNER PHONE #: Inspection Request Scr•,eduled For: Date: 11/2/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanh:A final 020011-01 5036390237 N Corrections/Comments/Instructions: / / A0 Q.,�.c e .fly r-s, 2"r-2L 4 /`+'�}f/�� e-/10 Ll a3 J PASS PARTIAL , "DROVAL ❑ CANCEL ❑ NO ACCESS [ FAI ❑ CALL FOR 3PECTION ❑ ADDITIONAL FEES ASSESSED w _ Inspector. _ — Date: �� Z Phone #: (503) 719- CITY OF --=ARD BUILDING DIVISION PERMIT#: MEC2004-00711; 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1/2004 Phone: (503) 639-4171 Inspection Requests (7.4 Hrs.): (503) 639-4175 INSPEGTION WORKSHEET FOR DATE: 5/.26/2004', TIME: T27AM PAGE: 51 SITE ADDRESS: 10700 SW NORTH DAKOTA S7 CLASS OF WORK: SUBDIVISION: PP199r-,023 LOT#: 001 TYPE OF USE: PROJECT NAME: BOBERG DESCRIPTION: Inctallalion of gas firelnlace, clap piping for fireplace and tanWess wat-w treater. OWNER: BOBERG, RICHARD, PHONE #: 503.639-0237 CONTRACTOR: OVMER PHONE #: Inspection Request Scheduled For: Date: 5(26;2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 007814-01 5036330237 N Corrections/Comments/Instructions: m W PASS ❑ PARTIAL APPROVAL ❑ CANCEL �_� NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector:, _ _ Date: Phone #: (503) 718- CITY OF TIGARD 24-Hour BUILDING Inspection Liner: (503)'633-4175 MST C�Gb g INSPECTION DIVISION Business Lina: (503)639-0171 OUP Received _ ______ Date R quested AM -_ PM_ _ BUP -Suite_-_-�_ _ MEC Location - _c�__7 et---, Contact Person f ---.__— Ph(--) PLM Contractor ____ — _ Ph( ) SWR _�— BUILDING _ Tenant/Owner _ 3 7 r d ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl gain --- Slab InspectI 11 �t S: Sn' Post&Beam - - _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ---- - Insulation Drywall Nailing -" Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: i V&BI_ PART GAILNQ _ Post A 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 - -- -- IL Gaa Line SmoVe Dampers ---_ -- — fH Final N PASS PART FAIL -- ELECTRICAL -� Service ® Rough-In _ �- UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$__ required before nest Inspection. Pay at City Hall, 13125 SW Has Blvd. PASS _PART FAIL SITE Plaose call for reinspection RE:` __ E] Unable to Inspect--no access Fire Supply Line ADA DO%�/ 2. Approach/Sidewalk _ Othe.: Final - --- DSO NOT R:MOVE this Inspection record from the job site. PASS PART FAIL / ----- BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2002-00494 DEVELOPMENT SERVICES DAT7 ISSUED: 11/25/02 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 1S134DA-06500 SITE ADDRESS: 10700 SW NORTH DAKOTA ST SUBDIVISION: PP1995-023 ZONING: R-3.5 _ BLOCK: LOT: 001 JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FIRST: sf N: S: E: W: TYPE OF USE: SECOND: sf PROJECT OPENINGS? _ TYPE OF CONST: sf N: S: E: W. OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: f► REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE. PRO CORR: PARKING: VALUE: $ 6,500.00 Remarks: Adding foundation to residence. Owner: Contractor: BOBERG, RICHARD STONE AISEA 12480 SW FIRST 1740 NE PORTLAND BLVD. BEAVERTON, OR 97005 PORTLAND, OR 97211 Phone: 503-286-1456 Phone: 503-286-1456 Reg#: LIC 99819 ^ , ` FEES REQUIRED INSPECTIONS Description Date Amount Erosion Control Insp 846-8 [BLJPPLN]Pln Rv 11/12102 $71.83 Footing Insp BUILD Permit Fee 11/25/02 $1 10.50 Foundation Insp [ ] [TAX] 8%State Tax 11/25/02 $8.84 Finallnspection [CDCBLD]CDC Bid Re 11/25/02 $20.00 (additional fees not listed here) Total $231.17 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and ali other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Issued By: Pe rm Ittee Signature: Call 639-4175 by 7 p.m.for an Inspection the next business day Building Permit Application _ Date received. I- J �'�- Permitno� (� City of Tigard - Address: 13125 SW Hall Blvd,Tigard,OR 97223 Pmjecdappl.no.: Expire date: Ciry of Tigard r Date issued: B Receipt no.: Phone: (503) 63;-4171 ` ' y: p ,. Fax: (503) 598-1960 �]C C v Case file no.: Payment type:- Land use approval: ._ 1&2 family:Simple Complex: 0 1 &2 family dwelling or accessory Jltl�l U Multi-family U New construction U Demolition Addition/alteration/replacement Lbs —nipf".0,17►ent U Fire sprinkler/alarm U Other: Job address: 1,O V0,127H DA JlegTP Bldg.no.: Suite no.: Lot: I Block: Subdivision Tax map/tax lot/account no.: Project name: _ Description and location of work on premises/special conditions:_ l I1� nSf�/�T16y� �3lOC IL Name: 1 Mailing address: 1 k 2 family dwelllnR: (N City: Stat IP: Valuation of work........................................ $ 5,00, 00 Phone: Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: Total number of floors................................. Phone: Fax: E-mail: New dwelling area(sq.ft.) I...........I............. _ Garage/carport area(sq. ft.)......................... s. Name: Covered porch area(sq.ft.) ......................... Mailing address: Deck area(sq.ft.)........................................ City: State: I ZIP: Other structure area(sq.ft.)......................... Phone: Fax: E-mail: Comww.reiaUlndmtrlaUmalti-fancily: Valuation of work........................................ $ Existing bldg.area(sq.R.) Business nrme: Sf b?+7 - �4-;?'� ' .......................... Address: V7LA.0 Nlr R74- "AM'J 0 LL11ro New bldg.area(sq.fl.)................................ City: -fZ V9 � State: _j ZIP: a- 1 1 Numbcr of stories........................................ _ Phone ^ -( ax: E-mail: Type of construction.................................... _ CCB no.: Occupancy group(s): Existing: l' New: City/metro lie.no,: 7Notke: ontractors and subcontractors are required to be the Oregon Construction Contractors Board under Name: ORS 701 and may be.required to be licensed in the Address: here work is being performed.If the applicant is -Citz: State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: -- Phone: Fax: I E-mail: Name: Contact person: Fees due upon application ........................... $ Address: _ Date received: City: State: ZIP: Amount received ......................................... Phone: Fax: E-mail: Please refer to fee schedule. _ I hereby certify I have read and examir M this application and the Not all jmia ichor Kee q credit ends,p1eame caul lur rdirtian for more informwnn. attached checklist.All provisions of laws and ordinances governing this U vi:. O Mastercard work will he complied with,wl rer specifi d herein or not. Credit card numner: P.xnVres Authorized signature Date: ——acnatotarr as sign on craft card Print name: S -- - CarNrolder alputura Amount Notice:This penn;t application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 4611(~-OM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: CiryofTigard City of Tigard U Electrical U Plumbing U Mechanf.at Address: 13125 SW hall Illvd,Tigard,OR 97223 U Other- Phone: (501) 639-4171 Fax: (503) `+98-1960 HI-A)VIRED F-011.1 PLAN'11411111V I No NIA 1 Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance point seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. _ 4 Fire district approval required. 5 Septic syste ermit or authorization for remodel. Existing system capacity 6 Sewer permit. _ 7 Water district appro 8 Soils report.Must carry o 'sinal applicable stamp and signature on file or wi►.h application. 9 Erosion control U plan U ps it inquired. Include drainage-way protection,silt fence design an location of catch-basin protection,etc. 10 3 Complete sets of legible plans. ust he drawn to scale,showing conformance to appli ble local and state building codes.Lateral design details an onnections must be incorporated into the plans o on a separate full-size sheet attached to the plans with cross refere s between plan location and details.Plan re ew cannot be completed if sor fright violations exist. I 1 9ite/y?it plan drawn to scale.The plan must show%dbuilding setback dimensions;p erty comer elevations(if there is onore than a4-R.elevation differential,plan ntour lines at 2-ft.interys);location of easements and drrvev-y;footprint of stnicture(including decks);lols/septic systems;utyly locations;direction indicator,lot area;building coverage area;percentage of coveragearea;existing struct son site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-do ns and reinfo ' g pads,connection details,vent size and location. 13 Floor plans.Show all dimensions,room identification,window sizeNqeati9d of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 incNebovc grade,etc. 14 Cross sec'.on(s)and details.Show all framing-member sizes and spacin s as floor beams,header: tnigts,sub-floor, wall consauction,roof construction.More than one cross section may requy io clearly portray coin tion.Shaw details of all wall and roof sheathing,roofing,roof slope,ceiling hey ,siding ma at,footings and founuation,stairs, fireplace construction, thermal insulation.etc. _ 15 Elevation views.Provide elevations for new construction;/inum of two elevations additicas and remodels. Exterior elevations must reflect the actual grade if the chanrade is greater than four t at building envelope. Full-size sheet addendums showing foundation elevationsoss references are aces tab 16 Wall bracing(prescriptive pa(h)and/or lateral anally plans.Must indicate details and locatt s;for non-prescriptive path analysis provide specifications d calculations to engineering standards. 17 Floor/roof framing.Provide plans for all ;hors/r assemblies,indicating member sizing,spacing,an wring locations.Show attic ventilation. 18 Basement and retaining walls.Provide eros ections and details showing placement of rebar. For engineers systems,see item 22,"Engineer's calculati s." 19 Beam calculations.Provide two sets ofp6lculations using current code design values for all beams and multiple jo s d. over 10 feet long and/or any beam/jo' carrying a non-uniform load. 20 Manufactured floor/roof truss dqdgn details. U) 21 Energy Code compliance.Ide fy the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. _ J 22 Engineer's calculations hen required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or m architect licensed in q&gon and shall be shown lo he applicable to the pro.icct under review. W 23 Five(5)sitpKans are required for Item 11 above. Site plans must be 8-1/2" x 11"or 11"x 17". 24Two sets each are required for Items 16, 19,20&2'above. 25 wilding plans sha11 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 COT Street Tree List. 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. 440 4614(WWOM) .AO I i rJ C`� I r i V ( ' i li-p - 5o � f 1 3 a rn 30 - y 10700 OA IWTA 14 • ti , w CLr �iG%JT/&A . i + rr►z�rvy. ��c'rr'�tc. i . ,----- - -- .� RECEIVED Nov 12 2002 I CITY OF TIGARD BUILDING DIVISION 1 O LIABILITY The City of 7+gard and Its employees shall not be responsible for discrepancies which may appear herein. a. a m CITY OF PGARD Approved................................. CorKilfmalty Apprrowd......................( ) For or*y the work as deWtsd In: PERMIT No.Am� 'd 0 9 Bee Letter to:F016 w........................ ( ): Attach......... ( ): Job Address 06ZDO .Jw air, .._ Daft: s.- Ab A f IL Ilk � J , M a �YY II v. a � Lo 0 J CITY OF TIGARD 24-Hour BUILDING ® Inspection Line: (503)630-4175 AV _CgWY INSPECTION DIVISION Business Line: (603),639-4171 Received —____ Date Requested-.10116—P14 Z AM PM BUP Location _L142700 w _Suite_ — MEC Contact Person --_ _ _— ____ Ph PLM Contractor— _--- -- Ph( —) _—_-- — SWR UILDIN Tenant/Owner ELC ELC Ftg D Access: ELR _ Crawl Drain Slab Inspection Notes: SIT — Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath�Shear Framing - - Insulation T'(//�,�,L ��''-�N�► .- nl�,�r / fyt� Drywall Nailing Firewall Fire Sprinkler - Q/� — — Fire Alarm sT 7pr_w?111X Susi d Ceiling Roof 12?a2 /Vd% _ ZA2 !2_"7 121Wz4 OZ< 1�-AwSs PART FAIL PCUMBING ---_.--- — — --- Post&Beam Under Slab T_. Rough In /_U I�Ef w r o � _��✓ �4 �--�.. Water Service Snnitary Sewer A71,4/ 41ec4zr'7 /�Ka eo ^I — Rain Drains Catch Basin/ManholeC� Storm Drain -- Shower Pan S� b �. �171l� CBCs &9V 7116-IA� _— Other: Final PASS PART FAIL �G��. � ?G �Qe-E 4//S- MECHANICAL L� AV Post& Beam Rough-In --- IL Gas Line �jIP/►7 S — � Smoke Dampers .! — F Final PASS PART FAIL � -- ELECTRICAL Q Gv'1 '_1 /943Dr/0t__ AlU Z _ J Service n �� [ �G C F S ED Rough-In � -s- F3 t:9 UG/Slab ow Voltage -- -- - — -- -- Fire Alarm Final n Reinspection fee of$__- _ required before next inspection. Pay at Cfty Hall, 13125 SW Hill Blvd. PASS PART FAIL SITE PI Ase call for reinspection RE: Unable to inspect-no ac,wta Fire Supply Line ADA Approach/Sidewalk Other: _ Final DO NOT REMOVE this Iftfl eMe11 eem from title fob sit& PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING . Inspection Line: (503)639.4175 � MST INSPECTION DIVISION Business Line! (5105)639-4171 OUP Received Date Requ ted�_�._�$ A}M— —PM OUP Location U 7 Re MEC Contact Person P ) — PLM Contractor��Cl .�2,�2 Z�Fr'�"ACPh ) _.�L, _ng- 9Z.2 SWR BUILDING Tenant/Owner _ ELC ;�3:1 55 Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: 8R Post&Beam S.sear Anchors -- --- Ext Sheath/Shear Int Sheath/Shear -- - Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm r Suap d Ceiling Roof Other: - -- -- - - - Final _ PASS PART FAIL PLUMBING Post&Beam '- Under Slab Rough-In Water Service Canitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shoomr Pan Other: — Final v - PASS PART FAIL _MECHANICAL Post& Beam Hough-in -� CL Gas Line Smoke Dampers rn Final _PASS PART FAIL - J ELECTRICAL _ _ m v,C --- Rough-In W UG/Slab j _ow Voltage -- Fire Alarm - Final Reinspe(t on fee of$_____. required before nsxt Inspection. Pay of City Nall, 13125 SW Hall Blvd. SITE _ i ❑ !'lease call for reinspection RE: _ _ Unable to inspect--no access Fire Supply Line ADA / � Approach/Sidewalk, Da COC-Jt, IMpec#Dr C4 Other:_ Final DO NOT REMOVE this InspeWon rword from the Job sib. PASS PART FAIL CITY OF TIGARD ELECTRICAL PERMIT PERMIT 0: ELC2002-00551 Ali DEVELOPMENT SERVICES DATE ISSUED: 10117/02 13125 SW Hall Blvd..Tinard.OR 97223 (503)639-4171 PARCEL: 1S134DA-06500 SITE ADDRESS: 10700 SW NORTH DAKOTA ST ZONING: R-3.5 SUBDIVISION: BLOCK: LOT: 001 JURISDICTION: TIG Project Description: Installation of 1 200 amp service. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL: MANF HMI SVCI FOR: 601+amps -1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADIO'L INSPECTIONS 0 - 200 amp: 1 WISERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FOR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ampivolt: >-4 RES UNITS: -600 VOLT NOMINAL: Reconnect only: SVC/FDR>a 225 AMPS: CLASS AREAISPEC OCC: Owner: Contractor: BOBERG,RICHARD DICKINSONS ELECTRIC 12480 SW FIRST 8449 SW BARBUR BLVD BEAVERTON,OR 97005 PORTLAND,OR 97217 Phone: Phone: 246-3550 Reg 0: ELE 26-1400 FEES Description Date Amount Required Inspections I F I.PRMT)ELC Permit 10/17/02 $8030 ITAXJ 8%State Tax 10/17/02 $6.43 Rough-in Electect'I Service Total $86.73 Elect'I Final This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. At ,,,ork will be done in accordance with approved Flans. This permit will expire 1f work is not started within 180 days of Issuance,or K work is suspended fo:more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set for�h in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503 2468699 or 1-800-332-2344. Issued By: ,.1 'a zz_ �, ;/j Permit Signature:X CO) OWNER INSTALLATION ONLY J The installation is being made on property I own which is not intended for sale, lease, or rent. CD a OWNER'S SIGNATURE: DATE: W _ CONTRACTOR INSTALIATION ONLY SIGNATURE OF SUPR. ELEC'N: _ t% �.tLDATE: _ LICENSE NO: Call 639-4175 by 7:00pm for an Inspection the next business day Electrical Permit Application Tigard ,g Date received: o-i 7 (�r7.- Permit no.: City or i igard Pmject/appl.no.: Pxpire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 6394171 -- Fax: (503)598-1960 Case file no.: Payment typo Land use approval: _ &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement ❑Ncw construction U Addition/alteration/replacement U Other:_ U Partial Job address: (7Q 5 Bldg.no.: Suite no.: JTax map/tax lot/account no.: Lot: 131ock: Subdivision: Project name: Description and location of work on premises: Estimated date of comnletion/ins ction: _ .lob no: � Fx Max eaTotal no,hm Business name: C �� — Newreddealbd-aingieormKilaollyper Address: dwellimvati.lrIvalma t ebedgunge. City: r State ZIP; `7Z set.lceircloded Phone:5/!;-? L1 I Fax:�l 13 60q CIE-mail: lout)sq.n.or teas 4 — F-ach additional 500 sq.A.or rtion thereof CCB no.: s'. ?,, _ Elec.bus.lic.no: O G— Limited energy,residential 2 City/metro lic.no.: Limited energy,non-residential 2 �- W- 1 -D 15 Each manufactured horse or modular dwelling Signature of rvigjggltectriciAr( Service and/or feeder 2 Sup.elect.name(print): Lic nae no rJd Services or feeders-Installation, alteration or relocation: 200 amps or less 2 Name(print): c- 201 amps to 400 amps 2 Mailing address: i - --71--y 401 amps to 600 amps 2 601 amps to 1000 amps 2 CRY: Slate: ZIP: ^_ Over I(N10 amps or volts 2 Phone: Fax: I E-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporary eervicasorfeeders- which is not intended for sale,lease,rent,or exchange according to towallation,alleristion'°rrebaH°"` ORS 447,455,479,670,701. 200201 aamps to 4(10 amps 2mps or leas _ _ 2 Owner's si nature: Date: 401 to 600 ams 2 tgn ich circuits-new,alteration, or extension per panel- Name: A. Fee for branch circuits with purchnse of Address: service or feeder fee,each branch circuit 2 Q City: Slate: ZIP: B. Fee for branch circuits without purchase a — of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: N Misc.(Service or feeder not included): ❑Service over 225 amps-commercial U Health-care facility Each puns or irrigation circle _ 2 ❑Service aver 320 amps-rating of 1142 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 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,or extension* 2 W U Building over three ataries ❑Feeders,400 amps or more •Descrj tion: -1 U(>rcupant load over 99 persons U Manufactured structures or R V park Fich addklm l Nspedion oar the allowable ht my of dw above: U F.gressAightingplan U Other. Per inspection _ Submit__sets of Plias with any of the above. Investigation fee The above are not applicable to temporary construction wrrlce. other — —� Not all jurisdictions accept credit cards,p1mv call judadictian for mac Infr4molon. Notice:This Hermit application Permit fee.....................S ❑isa U MasterCard expires if a permit is not obtained Plan review(at ,_ %) $ ctcdit;srd number:—____ _� _ L_l_ within 180 days oiler it has been State surcharge(8%) ....$ F.apirta accrpted as complete. TOTAL .......................$ • �.� N.snue o(esaduolder a shown rm credit card _ S —� Cardholder signature Amount 4"Is(fit) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Restricted Energy Fee...................................................... $75.00 Number of Inspection* rmlt allowed (FOR ALL SYSTEMS) Service Inclur ': Items Cost Total Check Type of Work Involved: Residential-per ual: 1000 sq.R.or less $145.15 41:1Audio and Stereo Systems' Each additional 500 sq.R.or portion thereof $33.40 1 ❑ Burglar Alarm Lknkod Energy — — $75.00 Each Manurd Home or Modular Dwelling Service or Feeder $90.9.) 2 ❑ Garage Dow Opener' Services or Feeders Installation,sueratkrn,or relocation \ ❑ Heating,Vontilation and Air Con Ing System' 200 amps or less _ $80.30 V 2 201 amps to 400 amps $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts 54.65_ 2 Reconnect only -- _ .85_ 2 Temporary Services or Feeders TYPE OF WOR .VOLVED-COMMERCIAL ONLY Instrilation,aftc ration.or relocation Fee for each syst .......................................................... $75.00 200 amps n•less $66.8 2 (SEE OAR 91 60-260) 201 amp,to 400 amps _ $100.30 _ 2 401 amds to 600 amps $133.75 2 Check Type Work Involved: Over 600 amps to 1000 volts, see"b"above. ( Audio and Stereo Systems Branch Circuits New,alteration or extension per panel Boller Controls a)The fee for branch circuits _ with purchase of service or 1 Clock Systems feeder fee. Each branch circuit _ $6.65 ❑ Data Telecommunication Installation b)The fee for branch circuits wfthout purchase of swWce ❑ or fefe eder e. Fire Alarm Installation First branch circuit $46.85 _ Each additional branch circuit $6.65_ ❑ HVAC Miscellaneous (Service or fender not Included) ❑ Instrumentation Each pump or Irrigation circle $53.40 Each sign or outline lighting _ $53.40 Intercom and Paging Spiers Signal clrcuH(s)or a limited energy panel,alteration or extension $75.00 Landscape Irrigation Control' Minor[Abets(10) $125.00 Each additional Inspection over ❑ lost the allowable in any of the above Per Inspection $62.50 ❑ Nurse Cahn Per hour _ $62.50 In Plant $73.75 El Outdoor Landscape Lighting' IL Fees: ❑ Protective Signaling ly NEnter Pohl of above fees $ ❑ Other_____ 8%State Surcharge $ --Number of Systems 25%Plan Review Fee m See-Plan Review"sedlon on $ ' No licenses are required License%are required for all other Installations (a front of application. _ W Fees: Total Balance Clue $ Enter total of above fees ❑ Tnist Account fa< 8%State Surcharge $_ All New Commercial Buildings require 2 seta of plans. Total Balance Oue Ods"\fhmw\cic-r«s.doc 08/30/01