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11230 SW NORTH DAKOTA STREET IS V1O)lV0 HIHON MS 0£ZL� i a CL Y ca O N T T � e y . yid M;� � n 4 G 11230 SW NORTH DAKOTA ST CITY OF T I G A R D MASTS.,.PERMIT PERMIT*: MST2001-00536 DEVELOPMENT SERVICES DATE ISSUED: 10/30/01 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 SITE ADDRESS: 11230 SW NORTH DAKOTA ST PARCEL: 1S134DB••06100 SUBDIVISION: PP1994-035 ZONING: R-4.5 BLOCK: LOT:001 JURISDICTION: TIG REMARKS: Garage and bonus room addition. Bonus room on lower level, 2 bedrooms and 1 bath on upper floor. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS _ REWIRED CLASS OF WORK: AM HEIGHT: 25 FIRST: 513 of BASIMENT: sl LIF r: 24 SMKM(EDETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,103 d GARAGE: 500 of FRONT: 20 PARKING SPACES: 2 TYPE Or CONST: 5N JWELLING UNITS: FINDSMIENT: of RIGHT: 14 VALUE: S 161,027.50 OCCUPANCY GRP: R3 BORM: 2 BATH: 1 TOTAL: 1,61600 sf REAR: 23 PLUMBING _ SINKS: WATER CLOSETS: 1 WASHING MACH: —_ LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISIAMW IERS: FLOOR OKAINS: SEWER LINES: SF RAIN DIWN& 1 CATCH BASINS: TUB/SHOWERS 1 GARBAGE UISP: WATER HEATERS: 1 WATER LINES: RCKFLW PREVNTR: UREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<]HP VENT FANS: 1 CLOTHES DRYER: GAS FURN>•t00K: 1 UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: OAS OUTLETS: 1 ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADC;INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 - 200 anto: WISVC OR FOR: 1 PUMPARRIGATION: PER INSPECTION: EA AOD'L S00SF: 2 201 400 amp: 201 400 amp: 1st WIO SVC/FDR: SIGN/OUT LIN LT: PER HOUR: LIMITED/ENERGY: 401 1100 amp: 401 -500 amp: EA AODL OR CIR: SKINAL/PANEL: IN PLANT: MANU HWSVC/FDA: 601 1000 amp: 601.amps-1000V: MINOR LABEL: 1000«arnpNoll: PLAN REVIEW SECTION Reconnect only: '•— �;/RES U►IrTS: SVC/F7R>■126 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO S STEREO: VACUUM SYSTEM: AUDIO i STEREO: FIRE ALARM: INTERCOMVPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEAPRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL- OTHR: HVAC: DATATTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 2,300.95 JACKSON,NATALIE S+CHAD H LYNN FEINAUER This per MR Is Subject to the regulations contained In the 11230 SW NORTH DAKOTl,ST 12820 SW RIVER RD. Tigard Municipal Code,State of OR. Specialty Codes and 11GARD,OR NORTH 1128HILL20 W RI OR RD. oil other applicable laws. AN work will be done Ir, Ilcootdance with approved plans. This permlt w/,I expire If +vork Is not started within 180 days of Issuance,or if the v.,ork Is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the On3gon Utlity Notification Center. Those rules are set Res N: LIC 30726 for!h:I OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct queslinns to mOUNC by calving(503)248-1987. 0 11 � 'JC`7�- �s`Il� SSU Y REQUIRED INSPECTIONS _�- W Erosion Control Insp S Underfloor insulation Plumb Top Out Exterior Sheathing Inst Ele,.trical Final J Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Mechanical Final Foundation Insp Fioting/Foundation Dr Electrical Rough In Gas Line Insp Plumb Final Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Final Inspect.,i Post/Beam Mechanical Mechanical Insp S tear Wall Insp Rain drain Insp lashed By : i� Permittee Signature: —"AL Call 50 639-4175 b 7:00 .m.for an Inspection needed next busin s da 3) Y P p Y /.0C % Building Perndt Appli tion City of Tigard Date received: l t'trmit no.: Pmject/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard, .9 223 -. Phone: (503) 639-4171 Date issued: By: Re ccipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: [1&2 family:simple Complex: p ti 1 &2 family dwelling or accessory U C'orrimcmial/industrial U Multi-family U New construction U Demolition Addition/alteration/replacement U•tenant improvement U Fire sprinkler/alarm U Other: 4r Jot)address: L230 0 tYr Bldg.no.: Suite no.: t' I.cm Bfock: Subdivision: FhA �� Tax map/tax lot/account no.: Project name.: Ta t Vicety lZtS. _ Description and location of work on premises/special conditions: MLA f I _Zoo", ph /♦w41 4✓t d,Zooms 4 t t3o��h eN Z" ` F�oor2 Name: l^ SIMMUMIM Mailing address: / 2j t'Y 5-fwJN ov I &2 faulty dwelling: City: i I'A,CA i cf State: Z ZIP: _ Valuation of work........................................ $_ 161,017. Phone: rps. jC -L`ra Fax: E-mail: -�- y� _�� No.of bcdroomslbaths................................. Owner's representative: �. Total number of floors................................. -7,1 _ Z Phone: ?D- 4ee tc Fax: E-mail: New dwellingarea(. ft. Garage/carper area(sq.ft.)_....................... Sao _ Name: Covered porch area(sq.ft.) ......................... Maihug address: Deck area(sq. i,.)........................................ - City: State: ZIP: Other structure area(sq, ft.) ....................... Phone: Fax: E-mail: CommerchUindmtriaU►Amit►,-fondly: Valuation of work...... .......................... ..... S Business name: t rIA, C V (4kt / Existing bldg.area(aq.ft.) ............... ......... Address: o 1. t)If �4 C j— New bldg.area(s ft�.............. ............. --— Number of stories .................. ................. City: . f /o State:p/f ZIP: Q 1z 3 Type of constructia i........... ......�. i Pbonc: o L I$- I . Fax: � E-mail: �' Occupancy group(s): Existing' — I CCB no.: p 7 — New City/metro lie.no.: Notice:All cont cions and subcontractors arc required to he licensed with the Oregon Construction Contractors Board under Name; J C r provisions of ORS 701 and may be required to he licensed in the d Address: jurisdiction where work is being performed. If the applicant is AC - exem Cit State: pt from licensing,the following mason applies: ZIP N : Contact person: Plan no.: - Phone: Fax: E-mail: m (� Name: Contact person: Fees due upon application ........................... S_, fL Address: Date received: City: State: ZIP: Amount received ......................................... Phonc_ Fax:_ -mail: Please refer to fee schedule. I hereby certify I have read and examined s application and the Na all Jud"dtom accep credit cards,please •an tMadtcdeo for move 1"rormrion. attnched checklist.All provisi o aw d ordinances governing this U Visa U MasterCard work will he complied wit he t ed lerein or not. Credit card numbs: Authorized signature: _ Date: Z 0 — Name etc Iden as.1.. ..credit card Print name:_ '`i. �- ) C✓ — —Cardho _s - - —–� lder si�natrtc Amatat Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as oomplefe. 4101613(WYCOM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: Ciry��,("fignrJ Cit of Tigard -_ Associated permits: City g U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Othe,: _ Phone: (501) 639-4171 Fax: (501) 598-1960 1 Land use actions completed.See jurisdiction criteria for concurrent reviews. _ 2 'Zoning.Flood plain,solar balance points,seismic soils designation,hisrcoric district,etc. _ 3 Verification of approved platflot. 4 Fire district approval required. Septic system permit or authorization for remodel.Existing system capacity_ a Sewer permit. - -- — -- 7 Water district approval. 8 Solis report.Must carry original ap icable stamp and signature on file or with application_ 9 Erosion control U plan U permituired.Include drainage-way protection,silt fence design a.rd location of catch-hasin protection,etc. 10 3 Complete sets of legible plans. ust be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details d connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross erences between plan location and details. Plan review cannot be completed if copyright violations exist. I I Site/plot plan drawn to scale.The planest show lot and building setback dimensions;property comer elevations(if there is more than a 4-ft.elevation differen al,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including cks);location of wells/scptic sy,tems:utility locations;direction indicator;lot arca;building coverage area;percentage of c verage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anch bolls,any hold-downs and reinforcing pads,connection details,vc,nt size and location. 13 Floor plans.Show all dimensions,room ide ification,window size,location of smoke detectors,water heater, furnace.,Ventilation fans,plumbing fixtures,b conics and decks 30 inches above grade,etc. _ 14 (toss section(s)and details.Show all framing- ember sizes and spacing such as floor beams Worsts,sub-floor, wall construction,'hwf construction. More than o cross section may be required to portray construction.Show details of all wall and sheathing,roofing,r(mf, ope,ceiling height,std' serial,footings and foundation,stairs, fireplace construction, the insulation,etc. 15 Elevation views.Provide eleval for new constru i ion imilrimum of two elevations for additions and remodels. Exterior elevations must reflect the al grade if tinge in grade is greater than four foot at building envelope. Full-size sheet addendums shoving founds ' evali6ps with cross references are acceptable. 16 Wall bracing(prescriptive path)an sten t plans.Must indicate details and kx:alions;for non-prescriptive path analysis c e speciticatiors an ttions to engineering standards. 17 Floor/roof framing.P e plans for all floors/roof assertiblies,in t uLiLnember sizing,spacing,and hearing locations.Show at ' entilation. 18 Basemedt retaining walls.Provide cross sections and d, ils showing placement of rehar. in"red systems, see ilern 22,"Engineer's calculations." 19 Beam eai:ul stlons.Provide two sets of calculations using curren code design values for all beams and multiple jot, . d over 10 feel_Iong and/or any bcam/joist carrying a non-uniform Ioa . p� 20 Manufacture 11 floor/roof truss design details. _ i" 21 Energy Code r ompliance.Identify the prescriptive path or provide ca ulations. A gas-piping schematic is required U) for four or more appliances. _ 1- 22 Engineer's calculations. When required or provided,(i.e.,%hear wall,rc. truss)shall he stamped by an engineer or .:1 architect licensed in Oregon and shall be shown to be applicable to the proj t under review. to W23 Five(5)site plans are required for item I I above. Site plans must be 8-1/2"x 1 "or 11"x 17". J -- 24 Two(2)sets each are required for Items 16, 19,20&22 above. _ 25 Building plans shall not contain red lines or tape-ons. 26 "Reversed' building plans must meet criteria outlined in the Permit&System Development Fees document. 27 No"mirrored"building plans will be accepted. _ 28 "Drawn to scale"indicates standard architect or engineer scale. Checklist must be completed before plan review start date. Minor chnnges or notes on submitted plans may be in blue or flack ink. Red ink is reserved for department use only. 4404614(MWIM) 4 r Plumbing Permit Application Date received: Permitrict PQ5 City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 sewer permit no.: Building permit no.: 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: ❑ I &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family ❑Tenant improvement L:1 New construction ❑Addition/alteration/replacemeni ❑Food service U Other: Job address: /(2 3 0 5. U) I`f p/+l, Q" 0 A Feeea. Taal Bldg,no.: Suite no.: New 1' jr only: Tax map/tax lot/account no.: v (lnclW a 100 ft.bratKhed ltycoarrerticm) Lot: BSFR(1)bathlock: Subdivision: SFR(2)bath Project name: _ SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description and location of work on premises:_ _ Slteadlklea: _ Catch basin/area drain Est.date of completion/inspection: DrywellsAeach line/trench drain Footin drain(no.lin,ft.) Manufactured home utilities Business name: �- Manholes Address:` OF — / / Rain drain connector City: State: ZIP: Sunitarsewer(no.lin.R.) Phone: Fax: I E-mail: Storm sewer(no.lin.ft.) CCB no.: _ Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: Fixhm!or ken: so valve Contractor's representative signature: Absorption— t Back flow preventer Print name: Date: Backwater valve hasins/lavato _ Name: Clothes washer Address: Dishwasher _ Drinkingfountain(s) City: State: ZIP: Phone: ectors/sump Fax: E-mail:Email: Expansion tank Fixture/sewer cap Name(print): Floor drains/floor sinks1hub Mailing address: Garbage dis sal ',lose hibb City: _ State: ZIP: Ice maker ` Phone: Fax: I E-mail: Im�rceptor/grease trap a Owner installation/residential maintenance only: The actual installation Primer(s) Hwill be made by me or the maintenance and repair made by my regular Roof drain(commercial) U) employee on the property I own as per VRS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: Sump J Tubs/shower/shower pan to 7�Ad7dres,: Urinal �— (j Water c osetJ Water .ater City: _ _ State: ZIP: Outer: Phone: Fax: E-mail: Tow Not all juridictinns credit card%,pkaie call iuridi-Nm for more information. Minimum fee................$ Notice:This permit application L)Visa ❑MasterCard expires if a permit is not obtained Plan review(at — %) $ _ Credit card nurtthm______. ______ / / within I80 days after it has been State surcharge(8%)....$ F`M1et TOTAL -- Nramr of cardholder as shown on credit card accepted a3 complete. .......................$ S ^� Cardholder rip ature -_ Arnmmt 4161616 PLUMBING P!RMIT FEES: PRICE YOTAL N"1 Wild 24-it t'ii�NlikW only: FIXTURES Indlvldual) QTY ei AMOUNT pndud�s ah Aunt Ing fixtures In PRICE TOTAL Sink 16.1510 the dwelling and On fimt900 fL QTY (e.) AMOIi�IT Lavatory -- 16.60 for each ud�tsonowtlon _ One(1)bath $249.20 Tub or Tub/Shower Comb. 16.60 Two(2)bath $350.00 Shower Only 16.60 Three 3 bath $399.00 Water Closet 16.80 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 Sin:,.. 2 16.60 -�_ - 16.60 PLEASE COMPLETE: 4' 16.60 Water Heater O conversion 0 like d 16.60 Quant b Work PAr10fri1W Gas piping requires a separate mechsnica Fixture Type: Nvw Moved Replaced Rilmoved/ permit. - MFG Home New Water Service 46.40 Sink _ MFG Home New Sari/Storm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 18.80 _ Combination Roof Drains .60 Shower Only Drinking Fountain 16. Water Closet _ Other Fixtures(Specify) 16.60 - Urinal Dishwasher Garbage Disposal _ --- Laund Room T Washing Macwa Floor Drat nk: 2' Sewer-1 at 100' 55.00 3' Sewer-each additional 100' 46.40 4- _ Water Service-Iat 100' 55.00 er Heater Water Service-each additional 200' 46.40 th Fixtures _ S Storm d Rain Drain-1 at 100' 55.00 _ Storm 3 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially T . Requested Ins ions _ r/hr COMMENTS REGARDING Rain Drain,single family dwelling 65.25 _ Y - Grease Traps 16.60 --- - QUANTITY TOT Isometric or riser diagram is rrq .d if IL OuantTotal is >9 - UBTOTAL N 8%STATE SURCHARGE - - "PLAN REVIEW 25%OF SUBTOTAL J Required ord if it j total Is>9 _m TOTAL $ W J *Minlmum parrnR fee is$72.50+sX state surcharge,except Resklentlel Backflow PreveMbn Device,which Is Sae 25•8%state surcharge. "All New Commercial Buildings require 2 sats of plans with homNrk or river diagram for plan review. I:\dsts\foi-ns\pIm-fees.doc: 06129!01 Mechanical Permit Application Datereceived: Permit no.: VXJ .pV 53 City of Tigard Project/appl.no.: Expiredate: CitynjTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Recei pt no.: Phone: (503) 634-4171 P Fax: (503) 598-1960 Case file no.: ?ayn.ent type: Land use approval: Bung permit no.: U I &2 family dwelling or accessory U CommerciaUiudustrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Otter: �- Job address: /1 z J 0 0 NoV A Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no. no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivision: 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: Description and location of work on premises: _ _ Fee(m) Total Est.date of completion/inspection: . Rea. Rea.od Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit . _CFM Air con uonrog(site Elan requr _ Is existing space insulated?U Yes U No Alteration of existing HVAC system d er.compressors Business name: /{ i 1 State boiler permit no.: HP --Tons BTU/H _ Address_ ri smo a amperi uctsmo a detectors City• __ State: ZIP: eatpump(site panregrtre )_ Phon': Fax E-mail: 7nsta rep ace urnace mace/burner CCB to.: Including ductwor-W-ent liner U Yes U No _ nsta rcp ac to ovateeaters-su�J,_ Ci(y/metft)I;C.no.: U j/ _ will,or floor mounted Name(please print): Vent fora ante other Nut fumace Absorption units _ BTI)/H _ Name: Chillers_ lip Address: Co r"Alit HP ---- - A rottressta ex "m rent e: City: _ State: ZIP: Appliance vent Phone: Fax: E-mail: )ryer-e-xTiaust Hoods,Type res.kitchenthatmat hood fire suppression system Name: Exhaust fen with single duct(bath fans) Mailing g address: _� x aust s stem a W romTieatinodA CL City: State: ZIP: nit will dWribation up to out eta a, Ty .: LPG NO __ Oil _ l.. Phone: Fax: E-mail: ue piping eac s luonTer outlets _ WJL� Prwm p ng(schematicreq — Name: _ Number of outlets Other 11iiiied siplowe or eet: "1 Address: Decorative fireplace V; City: State: ZIP: Insert-type W Phone: Fax: E-mail: stov pe et stove _J r. Applicant's signau re: Date: _— r Name(print): NM all inrisdictims arcep credit cards,please call Jurisdkaon fa more intormatl at. Permit fee.....................$ U Vist. ]MasterCard Notice This permit application Minimum fee................$ Credit card number: expires if a permit is not obtained plan review( ) $at 9F �_-- --.—'�—.—.L--- hsrircs within IRO days after it has been State surcharge(8%)....$ -- Name of cardholder as shown on credit card accepted as complete. TOTAL. cardholder siputare AmoaM M0�6t7 ) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: _ Desa"im: Ptlos Total $1.00 to$5,000.00 _ Minimum fee$72.50 _ Table 1 Code __ Amt $5,001 00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or Including duds&vents 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ _ $10,000.00. including duds&vents 17.40 $10,001.00 to$25,000 00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or I Including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25,000.00. _ or floor mounted heater _ 14.00 $25,001.00 to$ 000.00 $379.50 for the first$25,000.00 and 5) Vent not Included In appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and Including 6) Repair units $50,000.00 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Ched all that apply: Dollar Heat Alt $1.20 for each additional$100.00 or For Items 7-11,all or Pump Gond "Iracoon thereof. footnotes belor. comp « Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<31-111;abs unit to 100K BT 14.00 8%State S large $ 8)3-15 HP absorb unit 110Wo 500k BTU 25.60 25%Plan Review Fee(of subto s 9)15- HP;absorb Required for ALL commercial permits only unl r1 mil BTU 35.00 TOTAL COMMERCIAL PERMIT FEE: 144!:nt 1 30-50 HP;absorb ON 1-1.75 mil BTU 52.20 11)>50HP;absorb unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00 Value13 r handling unit 10,Wu CFM+ Description: __ Qty Ea 1770 Furnace to 100,000 BTU,Including 95514)Non ble evapc4-ate cooler ducts&vents _ 1000 Furnace>100,000 BTU Induding 1,17015)Ven"fin corn to a single duct duds b vents _ _ 6.80 Floor furnace Induding vent __ 955 16)Ventilation system not clad In Susper dad heater,wall heater or 955 a Ilance pyste _ 10.00 floor mounted heater ---Pp -- Vent not Included In applicance 445 17)Hood served by mechanical exha rmit117.11_Q() Repair units _ 805 18)Domestic indneralonr _ E 1 3 hp;absorb.unit, 955 t 19)Commercial or Industrial type Incinerator l0 100k BTU 3-15 hp;absorb.unit, 1,70 ---)69.95 101k M 500k BTU 20)Other units,Including wood stoves __ 15-30 hp;absorb.unit.501k to 1 2,310 _ 10.00 _ mil.BTU 21)Gas piping one to four outlets 30-50 hp;absorb.unit, 3,40 5.40 1-1.75 mil.BTU 22)Mon, than 4-per outlet(earh) --- _ a >50 hp;absorb.unit, 765-6 5 1.00 >1.75 mil.BTU MiniPit F 72.50 SUBTOTAL: _ ____ _ mum Permit Fee Alr handl;n unit to 10 000 dm N Air handling unit>10,000 cfrn 130 urc ~ - 9%State Surcharge _ , f } Non-portable ova connected cooler __ 858 TOTAL RESIDENTIAL PERMIT FEE >� t Vent fan to a single dud : _ __ 448 � -� Vent system not Included In 656 m a pliance permit ----- -� ur Othsr Ineesctlons and Few Hood served b mechanical exhaust 858 !' W Domestic incinerator 1,170 1 Inspections outslde of normal husiness hours(minlmum charge4wo hours) J Commercial or Industrial Incinerator 4590 $72.50 Per hour. - 2 Inspections for which no fee is arAw"calfy Indicated (minimum charge-half hour) Other unit,Including wood stoves. 656 $72 50 per hour Inserts,etc. 3 Additional plan revlew requlrod by changes,additions or revisions to plans(minimum Gas piping 14 outlets _ _ 380 charge-one-rhalf hrur)$72 50 per hour Each additional outlet 83 --- -- "Stall Cuniractor Boller CertMkatlon rear uMle'teOk BTU. TOTAL COMMERCIALn.,` "Rooldoneal AN.►«pdres alb plan she*"pec.rnant of unit. a $ VALUATION: __ All New Commercial Buildings requlre 2 sets of plans. i:\dsts\forms\rnech-fees.doc 08/29/01 Electrical Permit ApplicationMEN balereceivad: Permit no.:!!Kfo l 1,b5�ro City of Tigard Project/appl.no.: Expire date: CityojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case filen.: Payment type: Land use approval: ❑ I &2 family dwelling or accessory O Commercial/industrlal ❑Multi-family ❑Tenant improvement ❑New construction O Addition/alteration/replacement ❑Other:_ ❑Partial Job address: if Z.?0 µ0 . yLh Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: Project name: I Description and location of work on premises:_ Estimated date of coo letion/ins tion: Job no: Fee Max Business name: DgKflptiou Qty. ea Taal ao.laffp Address: All &md-M tiwtslrtrg WhL hscbia attscbed g waeL City: State: ZIP: SW*tl laded Phone: _ Fax: I E-mail: 1000 sq.n.or Im 4 CCB no.: I Elec.bus.lic.no: Each additional 500 sq.ft.or portion thereof lJmiledenergy,tesidential 2 City/metro tic.no.: — Limited energy,non-residential 2 _ Each manufactured home or modular dwelling Si nature of supervising electrician.(required) Dve Service and/or feeder 2 Sup.elect.name(print): License no: Services or feeders—basb stloa, ahertatlaa or relecatloa: 200 amps or leu _ 2 Name(print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 snips to 10W amps 2 City: _ State:— ZIP: Over 1000 amps cfvolts 2 Phone: Fax: E-mail: Reconnect only 1 Owner installation:The installation is being made on property I own Temporary set vteeaorbede which is not intended for sale,lease,rent,or exchange according to 1"'ralbstiam,"Me..tloa,orr'et°a'tl°"' ORS 447,455,479,670,701. 200 amps or leu 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 Bra wh clrcalla-new,alteration, or eateaalaa per poet: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP: R. Fee for branch circuits without purchase —' of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional bench circuit: Mime.(Ser rlee or feeder as bcbtded): U) U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Ifarardous location Each sign or outline lighting_ 2 family dwellings U Building over 10,000 square feet four or Signal circ,iit(s)or a limited energy panel, U System over 600 volts nominal more resmdentisl units in one structure alteration,or extension' 2 m U Building over three stories U Feeders,400 amps or more aDeKd tan: —_ (a U Occupant load over 99 persons U Manufactured structures or RV park Fico ed4dostal bm*c A ever the allowable bray of lbe dol WU F.gmeadlightngplan G Other. __ per ins on _ Robmk_sels of plane wkh my of the above. Investigation fee ' Ibe above are toot oppikable to te`uporary cotlts udloa serwke. Other Not all j sisdicUom accept credit camas.please call Jnrlsdkdon for nm hdormrion. Notice:This permit application Permit fee.....................$ U Visa U MuteK_'AM expires if a permit is not obtained Plan review(at _ %) S Credit card number: _-L,/ within 180 rlays after it has been State surcharge(896)....$ Expires accepted as complete. TOTAL. ............... ........ $ Name-- Nae of cardholder r Fe on credit card --- S Cardbalder sipwtre -- Amount 1141613(6i0arCOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY p Restricted Entergy Fee...................................................... $75.00 Number of Inspections per permit allowed) (FOR ALL SYSTEMS) Service Included: Items Cost Total `I' Check Type of Work Involved: Residential-per unit 1000 sq R.or less $145.15 4 ❑ Audio and Stereo Systems' Each additional 500 sq,ft.or portion thereof _ $33.40 1 ❑ Burglar Alarm Umiteci Energy _ $75.00 _ Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Alr Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 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 vroits $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system........ ................................................ $75.00 200 amps or less _ $66.85 _ 2 (SEE OAR 916-260-2t� 201 amps to 400 amps 100.30 2 401 amps to 600 amps _ 33.75 2 Check Type of Work In ved: Over 600 amps to 1000 volts, eas"b"above. ❑ Audio a Stereo Systems Branch Circuit ❑ New,alteration or extension per panel Co�s a)The fee for branch circuits wfth purchase of servfee or F-1 Clock Systems feeder fee. Each tram circuit $6.65_ 7 Data Telecommunication Installation b)The fee for branch circuits wMouf purchase of service ❑ or feeder Fire Alarm Ina',�Qatlon First branch circuit $46.85 ❑ Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service kr feeder not included) Each pump or Irrigation circle $53.40 Each sign or outline lighting Y $53.40 ❑ intercom and Paging Sy Items Signal ckcuit(s)or a Nmfted energy panel,alteration kr extension $75.00 ❑ Landscape Inigallon Contrc+' Moor label*(10) $125.00 Each additional Inspection over _ L-1 Medical iiia allowable In any of the above Per Inspection _ $6 ❑ Nurse Calls Per hour _ 50_ In Plant 73.75 Outdoor Landscape Lighting' Fees: Protective Signaling IL a Enter total of above fees $ ❑ ther.. -- - N 8%State Surcharge 7 $ Number of Systems 25%Plsn Review Fee i/ See'Plan RevIW section on $ No licenses are red. Licenses are required for all other Installations m front of application. _ --- Fees: J Total Balance Due $__ Enter total of above fees _ ❑ Trust Account N 6%State Surcharge $ Total Balance Due = All New Commercial Buildings require 2 sets of plans. 0dsts\forms\elc-fees.doc 08/30/01 PARTITION PLAT FEE NO. 93107391 , WASHINGTON COUNTY DEED F LOCATED IN THE SOUTHEAST QUARTER OF SECT TOWNSHIP 1 SOUTH, RANGE 1 WEST, WILLAMETTE CITY OF TIGARD, WASHINGTON COUNTY, ORE( LEGEND SET 5/8" X 30" IRON k0U O WITH PLASTIC YELLOW CAP NF(.II INSCRIBED "BURTON ENGINEERING" THERE IS NO GEODETIC MONUMENT 0 FOUND MONUMENT AS SHOWN WITHIN 1/2 MILL RADIUS OF THIS PARTITION PLAT. IR IRON ROD IP IRON PIPE S.N. SURVEY NUMBER R/W RIGHT-OF-WAY -- BASIS OF BEARING (S.N. 24,723) S 89'51'28" E 1532.48' — _94' S.W. c 1/2* IP ~ o0 22'0 ` E - — ----- NORTH R'TH— - -- — -- G, HELD �- - 20.00''08.90 12 8.7 9 S.N. 3090 42.15' - 66.47' 10' STREET DEDICATION 1/2" IP - - - - 83./5' 25.15 HELD 00'2-!'1(3" C� 5/8" IR S.N. 30110 HERTEL INITIAL POINT 5 d Ik 0.00' HELD YUELI. /A• Irt-- PARCEL i _ o HELD HFRTEL 10253 SO FT o 'O IIFLD OR 0.235 ACRES PON w v O PARCEL 1 m5/8" IR "RYDELL HELD Fok ` N 8951'28" W - E. LINE - 0 57.25' U) N N Z N 3 H+ i 0 o "t v 0 $ � a h� m N N 89'51'28" W p` c, c; 2.6.50' i � m b ::E m STATE OF "R IR YUELL r"I HELD FOR COUNTY .,Q E. LINE 5/8` IR ,�. I DO HER[ HERTEL COPY CEF HELD PARTITION W � nc TNc l; CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BRUNER PLUMBING PO BOX 23985 TIGARD, OR 97281 Plumbing Signature Form Permit M MST2001-00536 Date Issued: 10/30/01 Parcel: 1 S134DB-06100 Site Address: 11230 SW NORTH DAKOTA ST Subdivision: PP1994-035 Block: Lot: 001 Jurisdiction: TIG Zoning: R-4.5 Remarks: Garage and bonus room addition. Bonus room on lower level, 2 bedrooms and 1 bath on upper floor. Path 1 Your company has 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 Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: JACKSON, NATALIE S + CHAD H BRUNER PLUMBING 11230 SW NORTH DAKOTA ST PO BOX 23985 TIGARD, OR 97223 TIGARD, OR 97281 Phone M Phone #: IL Reg #: LIC 81837 oZ PIN 26-445PB AN INK SIGNATURE IS REQUIRED ON THIS FORM m W � Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGA':D 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE OK BROTHERS ELECTRICAL CONSTRUCTION PO BOX 231133 TIGARD, OR 97281 Electrical Signature Form Permit#: Ms'r2001-00536 Date Issued: 10/30/01 Parcel: 1 S134DB-06100 Site Address: 11230 SW NORTH DAKOTA ST Subdivision: PP1994-035 Block: Lot: 001 Jurisdiction: TIG Zoning: R-4.5 Remarks: Garage and bonus room addition. Bonus room on lower level, 2 bedrooms and 1 bath on upper floor. Fath 1 Your company has been indicated as the ei,xi-i:.ril contractor for the permit indicated above. In order for the electrical permit to be valid, the signature- o'the supervising electrician is required. Please have the appropriate indivNJual 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: JACKSON, NATALIE S + CHAD H OK BROTHERS ELECTRICAL 11230 SW NORTH DAKOTA ST CONSTRUCTION TIGARD, OR 97223 PO BOX 231133 972 Phone #: Pf�oC'ne#��97-4873 81 Reg #: LIC 49M SUP 43US ELE 34.451C R AN INK SIGNATURE IS REQUIR r ON THIIRM a� O � X Si :ldture oft6pervisirig Electrics n If you have any questions, NeGse call (503) 639-4171, ext. # 310 CITY ELECTRICAI.PERMIT OF TIGARD • PERMIT 0: ELC2001-00519 DEVELOPMENT SERVICES DATE ISSUED: 10/22/01 13125 SW Hall Blvd.,Tlaard, OR 97223 (503)639-4171 PARCEL: 1S134DB-06100 SITE ADDRESS: 11230 SW NORTH DAKOTA ST SUBDIVISION: PP1994-035 ZONING: R-4.5 BLOCK: LOT: 001 JURISDICTION: TIG Prolect Description: Install temp.service. _ RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: _ 0 200 amp: 1 PUMP/IRRIGATION- EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LT6: LIMITED ENERGY: 401 - 600 amp: FAIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10): SERVICE/FEEDER ERANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION- 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: >-4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVCIFOR>-225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: JACKSON,NATALIE S+ CHAD H OK BROTHERS ELECTRICAL 11230 SW NORTH DAKOTA ST CONSTRUCTION TIGARD, OR 97223 PO BOX 231133 TIGARD, OR 97281 Phone: Phone: 697-4873 Reg#: LIC 49562 SUP 43345 ELE 34-4510 FEES Required Inspections Type By Date Amount Receipt Elect'1 Service PRMT CTR 10/22/01 $66.85 2720010000( Elect'l Final 5PCT CTR 10/22101 $5.35 2720010000( Total $72.20 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 TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are s orth in O .4152- 01-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to n r'� Permit SignatureIssued By:. — r m OWNER INSTALLATION ONLY W The Installation is being made on property I owr which is not intended for sale, lease,or rent. J OWNER'S SIGNATURE: _ DA?E: _ CONTRA 4I STALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _ DATE:__ LICENSE NO:`V--1- Z(A Call 6A-4175 by 7:00pm for an Inspection the next business day ,.a Electrical Permit Application —�� Date received: I I Permitno.:CLC)U)l -,-7( City of Tigard Project/appl.no.: Expiredate: City n(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97163 Date issued: H Receipt no.: Phone: (503) 639-4171 / -- Fax: (503) 598-1960 ( ', �rf � Case file no.: Payment type: Land use approval: LO-f& 2 family dwelling or accessory U Commercial/industrial U Multi.-family U Tenant improvement U New construction U Add itien/alteration/re place ment U Other. U Partial Job address: I Z Bldg.no.: Suite no.: Tax mail/tax lot/account no.: Lot: Block: Subdivision: — Project name: SJ2� J( V,) Description and it,-cation of work on premises: W timated date of com letion/ins tion: Job Ino: tree Ma Business name: f_L I C_ es Total "'' New redtlealw-+da or�per Address: 6 (�6 Z3 '33 tiwol6tRarM.lssclsinone odprop. City: 1 fr,A(L;r State:O ZIP: Z Sr»c.indwr* Phone: _ S Fax: _ t E-mail: L 1000 sq.ft.or le!! 4 CCB no.: S -Z F. bus.lie.no: S�L Each additional 500 sq.9.or portion thereof _— 09 6 _1� Limited energy,residential 2 City/petro lic.n0.: 'vets /i' <'' v Limited energy,non-tesideuial 2 e( Each manufactured hone modular dwelling Sign o su isl electrician(required) Date y *1Z Service andlor feeder 2 Services or feeders—Itsstallatim, Sup.elect.name(print):L* License on: 3 altetmlon or reloesitka: 200 amps or less 2 Name(print): 201 amps to 400 amps 2 Mailing address: 401 to 600 amps 2 601 ami to 1000 amps 2 City: State: ZIP: Over 1000 amps or volts 2 Phone: u Fax: — E-mail: Reconnectonly I Owner installation:The installation is being Imade on property I own Temporary arsrkwerfeetian' which is not intended for sate,lease,rent,or exchange according to ORS 447,455,479,670,701. 200• or leas 2 201 amps to 400 amps 1 Owner's si nature: Date: 401 to 600 arnits 2 Branch circuits-new,alteratlass, or extersdon per passel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP: B. Fee for branch dreuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: Email: Each additional branch circuit: Mise.(Service or feeder tad Issels"): r. U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1 de2 U Hazardous location Each sign or outline lighting 2 j family dwellings U Building over 10,000 square feet four or Signal circuit(s)of a limited energy panel, U System over6OO volts nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,400 amps or more *Description: J U Occupant load over 99 persons U Manufactured structures or RV park F Wdkkwal�over the aMowsble fe my of Hie awl U Egt"Aightingplan U Other. —_ -- Penins tion _ Suborn_seta of plssss with my of the above. Inveati ation fee The above are sot spplicable to temporary con rulo!os tsesvke. other Not all ht.isdictions accept crr0t cmrh,please call jurisdiction fur mote Itdorrnation. Notice:This permit applicatirm Permit fee.....................$ U visa U MasterCard expires if a permit is not obtained Plan review(at __ %) $ _ V_ credo card number: —�—L— within 180 days after it has been State surcharge(8%)....$ Expires accepted as complete._ TOTAL .......................$ Natne of cardholder u shown on credit card Cardholder dpurrce Amount 440-4613(6lO 0170M) ELECTRICAL PERMIT FEEL: LIMITED ENERGY PERMIT KEW ,. , Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY R.striaed Energy Fes...................................................... $78.00 Numher of Ins ons per permit allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total Cheqr Type of Work Involved: Residential-per unit 1000 sq.R or less $14515 _ 4 ❑ Audio and Stereo Systems' Each additional 500 sq.ff.or portion"red $33.40 f ❑ Burglar Alarm Limited Energy _ $75.00 Each Monurd Horne or Modular ❑ Dwelling Service or Feeder $00.90 2 Garage Door Opener' Services or Feeder \ Installation,alteration,or relocatkm ❑ Heating,Ventilation r Conditla.'gSystem• 200 amps or less $a0. 2 201 amps to 400 amps $106.85 2 ❑ Vacuum Sys ' 401 amps to 600 amps $160.60 2 801 amps to 1000 amps $240.80 2 ❑ Other Over 1000 amps or volts S464.65 2 Reconnect only $68.8' 2 Temporary services or Feeders TYPE WORK INVOLVED-COMMERCIAL ONLY Installation,alteration,or relocation Fee for system.......................................................... $78.00 200 amps or less �_ $86.85 G,L,�: 2 (S OAR919-290-260) 201 amps to 400 amps $100.30 401 amps to 600 amps _ $133.75 2 C Type of Work Involved: Over 600 amps to 1000 volts, sae"b"above. [] Audio and Stereo Systems Branch Circuits Now,alteration or extension per panel Boiler Controls a)The fee for branch circuits with purchase or servfcs or ❑ Clock Systems feeder res. Each branch circuit $6.65 2 ❑ D Telecomm-micatfon Installation b)The fee for branch circuf.9 whhouf purchase ofenvfce or Awdw hs. Fite Ala Installation❑ First branch circuit $46.85 Each additional branch circuit $665 ❑ HVAC Miscellaneous — (Service or Moder not kx*rded) \\\ ❑ Instrumentation Each pump or Irrigation circle $53.44 ❑ Intercom end Paging Syn Each sign or outline lighting $53.40 Signal ckcult(s)or a Milled energy panef,ofteratlon or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) _ $125.00 Each additional Inspection over ❑ Medical the allowable In any of the above Per inspection $62.50 ❑ Nurse Calla Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting' IL Fees: � [_] Protective Signaling NEnter total of above fess $ / ❑ Other 8%State Surcherge $ Number of Systema m 25%Plan Review Fes See"Plan Review'section on $ No Ncensee ere requited. Licenses aro required for all other hislaNstlas front of application. J Fees: M Total Balance Due $ , Enter total of above Is" = ❑ Trust Account N 0%stall surcharge _ All New Commercial Buildings require 2 sets of plans. Total Balance Due $ 0lsts\fomvkic-fees.doc 09/30101 -CIl'*OF TIr,ARD BUILDING INSPECTION DIVISIO MST 1W 24pHour Inspection Line: 63M175 Business Line: 6 Date Requested [�' ' 2 O AM PM BLD Location 12- 3L' N Suite MEC Contact Person a _ Ph 2ZLL7 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC SOD Retaining Wall ELR Footing Access: Foundation FPS IFtg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Shpath/Shear Framing Insulation Drywall Nailing Firewall �^ Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof Misc: — Final PASS PART FAIL PLUMNO Post&Beam _ Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL y v MECHANICAL Post&Team Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELEC CAL ILerv�ce Rough In F UG/Slab N Low Voltage Fire Alarm J Fin _m S PART FAIL L7 . . J Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: [ ]Unable to Inspect-no access Fire Supply Line ADA Othe1� � oach/Sidewalk Date 10123421 Inspector 10L4 Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the ob sito. CITY OF TIGARD 24-Hour BUILDING * Inspection Line: (603)63IM175 � MST INSPECTION DIVISION Business Line: (603)639-4171 BtJP Received Date Requested AMj!;k�_PM )OUP _ Location � Suite MEC Contact Person Ph PLM Contractor Ph( ) - SWR U LDI Tenant/Owner _ ELC _ Footing -- ELC FoundationAccess: Ftg Drain ELFT Crawl Drain SIT Slab Inspection Notes: ! Post&Beam Shear Anchors Ext Sheath/Shear ` Int Sheath/Shcar Framing -- Insuiation Drywall Nailing Firewall Fire Sprinkler --�T Fire Alarm Susp'd Ceiling Roof Other: / PART FAIL PLUMBINCII _ - Post 6 Beam Under Slab -- Rough-In Water Service — Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: —- Final PASS PART FAIL Post&Beam Rough-In Gas Line IL SmoftDampersTWE — OC F- N &—Idb PART FAIL -I!M� ft L - — eirwme _m Rough-In U UG/Slab J Low Voltage — - Fire larm na Reinspection tee of S�. required before next inoddlon. Pay at City PART FAIL Hall, 13126 SW Hall Blvd. �jpS r] Please call for reinspection RE: Unable to Inspect-no access Fire Supply Line L-�� lJ ADA g�U L— lee'eofirsr Ext.�� Approach/Sidewalk Other: Final DO NOT REMOVE UNIS IMep0otlon lra001d ftM"M alb. PASS PART FAIL Pogo No. 1 CASE HiSTORY FOR CASE NO.: M1794-0416 TOM KENYA 11230 SW NORTH DAKOTA ST 07/22/97 Action Description Roq/ Schd/ End/ Action Notes Disp B1' Update Upd Code sent Done Darr Date By ....... .............................. ........ ........ ........ ......... .... ... ........ ... MSTA007 Application received / / / / 11/07/94 PALS KAR 11/07/94 BLT MSTA010 Plan check deposit paid / / / / 11/07/94 PACS KAR 11/07/94 BLT NSTA020 Plan check by 11/07/94 / / 11/07/94 PAU IT 11/07/94 ILT NSTA030 Check for prcl. restrict. / / 11/07/94 11/07/% PAIN AT 11/07/94 BLT MSTA092 (F) issue combination permit / / / / 11/16/91 PAN KAS 11/16/94 KS NSTA097 issue plumbing signature form / / / / 11/19/94 JF 11/15/94 JF NSTA097 issue plumbing signature form / / / / 11/15/94 JF 11/15/94 JF NSTA097 issue plumbing signature form / / / / 11;19/94 JF 11/15/94 JF NSTA097 issue plumbing signature fo-m / / / / 11/19/94 JF 11/15/94 JF PSTA097 Issue plumbing signature form / / / / 11/16/91 PASS KAs 11/16/94 KS PSTA705 Foot/found insp / / / / 11/15/94 A/N KS 11/15/94 KBS 0-1- room all lose material prior to placing concrete 0-7.- provide low point drain 0-3- maintain three inches clearance under reforcing /-4-pravido positive kayway 5-5- min' of twenty ft grounding rod for electrical NSTA70S Foot/found Insp / / / / 11/18/94 N-1- additisnsl @Mar panels at garage APP KS 11/18/94 KBS wall and catling NSTA710 Post/Beset Structural / / / / 12/07/94 pending- gueeet splices at girders; PASS RB 12/07/94 RB additional girder boom rsq'd at firopleca area. NSTA711 Post/Sammi Mechanics) / / / / 11/28/94 SUPPORT END FO PLENUM DIS 00 11/28/94 OES PSTA711 Po- 'Ream Mechanical / / / / 12/07/94 pending- support of fe0 en flex duct PASS RB 12/07/94 Rs L PSTA717 PLN/Underfloor / / / / 11/28/94 APP 01 11/30/94 OE$ a NSTA720 Mechanical Insp / / / / 02/06/95 PENDING- SOFFIT HEATING DUCT iN GARAGE; PASS R• 02/06/93 IS ENCLOSE NECH UNDER-STAiRS. NSTA720 Mechanical Insp / / / / 02/09/95 SEE FRAMING THIS DATE FAIL RB 02/10/95 Rs MNSTA720 Mechanical Insp / / / / 02/17/95 PASS RB 02/17/95 M 14STA722 Plumb Top Out / / / / 01/31/95 PASS HIS 01/31/95 iIS Vale No. 2 CASE HISTORY FOR CASE NO.: NST94-0416 TON KENYON 11230 SW NORTH DAKOTA ST Oi'/22197 Action Description now $chd/ End/ Action Notes Disp By Update Upd Code fent Dons Done Date By ....... ...... ........ ..... ....................................... .... ... ........ ... MSTA725 Fraiming Insp / / / / 02/06/95 SMEAR INSPECTION; LATERAL BRACE GARAGE FAIL RB 02/06/95 RS HEADER; A-34 GLU-LAM AT EXT WALL IN GARAGE; $NEAR BLOCK MING WALL$; SOFFIT HEATING DUCTS IN GARAGE; NAIL GYP ON OC AT FURNACE; ENCLOSE MECH UNDER-STAIRS; SHEAR BLOCK SNEAR PANELS (INTERIOR); POf11TVELY CONNECT PLATE$ AND BEAMS; BLOC( UNDER MICRO LAM IT OF STAIRS; N-3 CLIPS MISSING TNRU-OUT; ROOF LINE BLOCKING REG;D FMD DEN; AFT LIVING AREA- TJI CUT-; ACCESS REGOD TO ATTIC; STEPPED CEILING- STRUCTURAL MEMBERS MISSING; END BRACE TRUSS SYSTEM; CHASE DUCTWORK IN FWD BEDRM; NAILER$ NEEDED AT A FEW LOCATIONS- MARKED; METAL PLATE PROTECTION AT AFT LIVING AREA; ???INSULATION FOR MAIN ENTRY. MSTA726 Frsming <REINSP> / / / / 02/09/95 ENCLOSE LID OF UNUSABLE SPACE M/I-VENT; FAIL RB 02/10/95 RB ENCLOSE MECH UNDER STAIRS; LATERAL BRACE GARAGE HEADER; GARAGE ACCESS; MSTA726 Freeing <REINSP> / / / / 02/17/95 PASS RB 02/17/95 RB 14STA735 Gas Line Inep / / / / 02/06/95 110 DROPPED BELOW 100 FAIL RB 02/06/95 RB PSTA735 Gas Line Inap / / / / 02/09/95 LESS THAN 100 FAIL RB 02/10/95 RI NSTAT35 Gas Line Insp / / / / 02/17/95 PASS RB 02/17/95 RB NSTA740 Insulation Insp / / / / 02/17/95 PENDING- VAULTED 1NIULATION AT MASTER PASS RE 02/17/95 RS BEDRM MISSING; INSULATE FLOOR LEVEL AT TUB; INSULATE MAIN DOOR JAM; 0. PSTA745 Gyp Board Insp / / / / 02/24/95 APP KS 02/24/95 KBf a PSTA755 Rain drain [nap / / / / 12/02/94 need to run to ditch PART Mf 12/02/94 MRS need to gasp underfloor MSTA?55 Rain drain Insp / / / / 03/17/05 PASS MS 03/20/95 MRS MSTA760 Water Line Insp / / 1 / 11/22/94 PAff Mf 11/22/94 MRS 04STA765 Appr/Sdwlk Insp / / / / / / no sidewalk or spproeeh required, per N/A 10/19/95 JF UU Laths Tho ass, Engineering. MSTA770 Misc. Inspection / / / / 02/17/95 OWN SW/DRIVE PASS RB 02/17/95 RB MSTA795 Mechanical Final / / / / 10/11/95 0-1- support hest ducts at crawl DIS KS 10/11/95 KIS 0-2- need to locate law point drain NSTA795 Mechanical Final / / / / 10/13/95 APP KS 10/13/95 KBf �r Page No. 3 CASE NISTORY FOR CASE NO.: OT94-0416 TOM KENYON 11230 SW I=TN DAKOTA ST 07/22/97 Action Description Req/ Sohl/ End/ Action Motes Dap Ry Update Upd Code Sent Dons Done Date By .............................. ........ ...... ....................................... .... --- ----.... ... NSTA797 Pleb Final / / / / 10/11/95 PASS NO 10/11/91 MRS MSTA799 Building Final / / / / 10/11/45 1-1- driveway meds paved concrete or DIS KS 10/11/91 KBS asphalt 0-2- post at address 0-3- plating naedo flneled 0-4- Insulate attic access door 0-5- tinder fl insulation needs supported 0-6- re ave all loose wood and debris crawl a-lar•l N-7- Insulate under side of crawl access door N-B- commet down spout at rear of structure MSTA799 Building Final / / / / 10/13/95 A-1- driveway needs paved AM KS 10/13/91 KBS NSTA960 (F) Issue Cert. of occupancy / / / / 10/13/95 no sidewalk or approach requirod, per JF 07/22/97 VV Lethe Thomas, Engineering. mi led 7-22-97 PSTB706 Erosion Control / / / / 12/13/95 APP WS 10/13/91 of NOT1713 Crawl Drain / / / / 11/28/94 APP Ga 11/26/94 as L O 3 0 LI J CERTIFICATE OF ' C11Y OF T' OCCUPANCY PERMIT M. . . . . . . i MST94-0416 COMMUNITY -QM P.— DATE ISSUED► 10/13/95 13120 SW MM Mrd.TIMd,ar" m I PARCELS 1S134D1i-06100 SITE ADDRESS. . . 1 11230 SW NORTI.1 DAKOTA ST SUBDIVISION. . . . r MLP94-0005 ZONING a R-4. 5 BLOCK. . . . . . . . . . t LOT. . . . . . . . . . . . . it CLASS OF WORK. eNEW TYPE OF USE. . . oSF OCCUPANCY GRP. iR3 OCCUPANCY LOADt. 4. TENANT NAME. . . i Remarks - PATH I Owner: -------------------------------- TOM KENYON I L202`. SW NORTH DAKOTA 5T TIGARD OR 97,223 Phone #a 624-5716 Contract or i -------------------_,--------- YOUN I QUE HOMES TOM KENYON 11202 SW NORTH DAKOTA TIGARD OR 97223 i Phone #1 624-5716 � Reg il. . a 55633 This Certificate certifies that the above referenced building or portion thereof has been inspected for compliance with the Tigard Building Code for the grnI..tp And division of occupancyand �_� a for which the above r•eferenr_ed permit was issued► end occupancy is hereby granted. BUILDING INSPECTOR BUILDINGOFFICIAL 6 POST IN C'JNSPICUOUS PLACE C Q 9 u ��+iirMMr+IrriWiil�iYrtfGe.W.w� � CITY OF TIGARD PERMBI TN0. . . . .PERMIT w MST94-0064 COMMUNITY DEVELOPMENT DEPARTMENT DATE I SSUED a 05/11/94 13125 8W HW Blvd.T19wd,Oregon 874239199 (50)8381171 PARCEL: 1S134DB-MLP05 S:TF_ ADDRESS. . . : 11230 SW NORTH DAKOTA ST SUBDIVISION. . . . : MLP94-0005 ZONINGe R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . t1 ---------------------------------------------------------------------------------- CLASS OF WORK. . :ADD GARBAGE DISPOSALS. . eO TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . eO OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . e0 TRAPS. . . . . . . . . . . . . . ..0 STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . t0 CATCH BASINS. . . . . . . 30 FIXTURES-------------- LAUNDRY TRAYS. . . . . . e0 SF RAIN DRAINS. . . . . el SINKS. . . . . . . . . . :0 GREASE TRAPS. . . . . . . t0 LAVATORIES. . . . . :2 OTHER FIXTURES. . . . . t0 TUN/SHOWERS. . . . : SEWER LINE (ft ) . . . . &3 WATER C:I_OSETS. . : 1 WATER LINE (ft) . . . . :0 DISHWASHERS. . . . :0 RAIN DRAIN Remarks: PATH I ADDITION OF 750 SQ FT OWNERe ----------------------------- -------- FEES--------------- __OM KENYON BPRT $ 215. 50 SW 05/11/94 -- 804 41H BPLC $ 140. 06 JLH 02/16/94 94-248988 B5PC $ 1078 SW 05/11/94 - LAKE OSWEGO OR 97034 MPRT $ 44. 50 SW 05/11/94 - F?hone #: 697-3196 MPLC $ 11. 13 SW 05/11/94 - M5PC f 2. 23 SW 05/11/94 - Plumbing Contractor-:---------------- PPRT $ 60. 00 SW 05/11/94 - IV a m e :Z- P5PC 3. 00 SW 05/11/94 - _ Address : 1g4�' City: Pk4.Q6VNQ __ Statee -Ph one#: Reg #:_, .___��___. ------- REQUIRED INSPECTIONS -------- This permit is issued subject to the reg— ulations contained in the Tigard Municipal Foot/found Insp Building Final Code, State of Ore. Specialty Codes and all Pest/Beam Struct Erosion Control other applicable laws. All work will be done Post/Beam Mechan Crawl Drain in accordance with approved plans. This PLM/Underfloor permit will expire if work is not started Mechanical Insp within 180 days of issuance, or if work is Plumb Top Out IL suspended for more than 180 days. Framing Insp Insulation Insp Gyp Board Insp Rain drain Insp _ Mechanical Final m X _ _6F _ _ Plumb Final WNuthorized Plumbing Contractor Signature J Call for inspection - 639-4171.5 Contractor Notes: CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT DEPARTMENT PERMIT li. . . . . . . : MST94-0064 18125 8WH&N Blvd.Tlpsrd,OmW WW981163f05yft"7/ DATE ISSUED: 05/11/94 SITE ADDRESS. . . : 11230 SW NORTH DAKOTA ST PARCELS 1S134UB—MLPO5 SUPDIVISION. . . . : MLP94-0005 ZONINGS R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1. ---•--------------•---------------- BUILDING --------------------------------------- REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . sO sf CLASS OF WORK. :ADD BEDRMS:3 BATHS: 1 GARAGE. . . . . . . . . . :O sf TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS---------- TYPE OF CONST. e5N FIRST'. . . . :750 sf LEFT. . :33 ft RIGHT. s5O ft OCCUPANCY GRP. :R3 SECOND. . . sO sf FRONT. sO ft REAR. . :5O ft STORIES. . . . . . . : 1 THIRD— . :0 sf REQUIRED------------------- t 1L I GHT. . . . . . . . : 12 ft TOTfiL-------:750 sf SMOKE DETECTORS. :Y FLUUR LOAD. . . . :4O psf VALUE. . . . . $: 34500 PARKING SPACES. . eO Remarks : PATH I ADDITION OF 750 SQ FT ---------------------------------- PLUMBII!G ---------- --------- 'iINKS. . . . . . . . . . :0 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O LAVATORIES. . . . . :2 WATER HEATERS. . . s0 TRAPS. . . . . . . . . . . . . . :0 TUB/SHIJWLRS. . . . :2 LAUNDRY TRAYS. . . r0 CATCH BASINS. . . . . . . :O WATER CLOSETS. . : 1 SEWER LINE (ft) . e0 GREASE TRAPS. . . . . . . eO DISHWASHERS. . . . :0 WATER LINE (ft) . :0 OTHER FIXTURES. . . . . s0 GARBAGE DISP. . . e0 RAIN DRAIN (ft) . :O WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 ---------------- MECHANICAL -----------------------------•--- FEES --------------- FUEL TYPES------------ UNIT HTRS. . :O type amount by date reept /GAS/ / / VENTS . . . . . e4 BPRT $ 215. 50 SW 05/11/94 — MAX INPUT:O BTU VENT FANS. . :3 BPLC $ 140. 08 JLH 022/16/94 94-248988 BURN ( 1O0K . . :0 HOODS. . . . . . ..0 BSPC $ 10. 78 SW 05/11/94 — FURN ) =100K . . e 0 WOODST OVEES. :0 MPRT $ 44. 50 SW 05/11/94 — FLOOR FURN. . . . :0 CLO DRYERS. : 1 MPLC $ 11. 13 SW 05/11/94 — BOII__/CMF < 3HP:0 OTHER UNITS:O MSPC t 2. 23 SW 05/11/94 — GAS OUTLETS:O PPRT f 60. 00 SW 05/11/94 — Owner: -------------------------------.---PSPC $ 3. 00 SW 05/11/94 — 1 UIh KENYON 804 4TH I ' G LAKE USWEGL) OR 97034 i ,yN Phone #: 697-3196 V Contractor: --------------------I--- ---- — YOUNIQUE HOMES IUM t,LNYON 4. 1'0 BOX i2016 CK LAKE GROVE OR 97035 U) Phone #: 624-5766 rReg #. ., .- 5563?. -------------------------------- _------ C� t 487. 22 TOTAL m This perait is issued subject to the regulations ca in the ------- REQUIRED INSPECTIONS ------- C? Tigard Municipal Code, State of Ore. Spe 'alt ae� li other Foot/found Insp Gyp Board Insp applicable laws. All Mork will be don in ordance approved Post/Beam Struct Rain drain Insp plans. This persit will expire if Mo ' not starte tee Post/Beate Meehan Mechanical Final days of issuance, or if Mork is sus ed fog enre IN ays. derfloor Plumb Final Mechanical Insp► Building Final )'er'mittee Plumb lop Out 6.ros ion Control Framing Insp Crawl Drain 1 ss,_ted By Insulation Insp Call for inspection — 639-4175 Residential Buildin Permit Application � City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobslte Address: //�2 30 5-/./ Nv,,,-rA Subdivision: Lot• Valuation: Lyl, p:a Owner: -Tp j" AGvt NO i'1 Address: IZr S OtaQ 9, Phone: ! e) k Contractor: M�' yoa/J/btu il{•� r . �Orrt Cti�Oaf 4 5: Address: C G { Phone: (attach copy of current Oregon ttcense) Subcontractors: \ Plumbing: t 2tv - M1«altwttarp-e, attach*r of current OR Corhhacor's uoense) Architect/Engineer: Q VQ Address: ) l B a S'-/ �P' CYc✓\ tVe?'Ra 1 re & Phone number ed by: c. Date Received: Permit a Account Description Amount Amt. Pd. Bal. Due 501/ Bldg. Permit (BU:LD) 17/s. / /S.S '-T— Plumb. Permit (PLUMB) 0.0 GU.N Mech. Permit (MEC ) •o "-- • State Tax (TA)Q 0/ 1G. Bldg. Plumb: M ech: 2. Gg Plan Check (PLANCK) 1, � U r al, Bldg: Plumb: Me - Sewer Connection SA) Sewer Inspection (SWINSP Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSDC) \ Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) _ IL Industrial TIF (TIF-I) a Institutional TIF (TIF-IS) - K- Office TIF (TIF-O) .:.�...�_ m Water Oualitty (WOUALI __. . .. -• W Water Ouaritity (WOUA M Fire District (FIRE) of TOTALS: L O t: CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT 13126 6W H&N Blvd.T19ard.Or*W 67223.6166 (603)639-4171 PERMIT N. . . . . . . : MST94-0416 639-4171 DATE ISSUED: 11/16/94 PARCEL: 1S134DB-MLP05 SITE ADDRESS. . . : 11230 SW NORTH DAKOTA ST SURD I V I S 1 ON. . . . : MLV19 4-0005 ZONING., R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1 ------------------------------------- BUILDING ------------------------------------------ REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :656 sf TYPE OF USES. . . :SF FLOOR AREA5------ -- - REQUIRED SETBACKS--------_.--- 1-YPE OF CONST. :5N FIRST. . . . e1032 s f LEFT. . :5 ft RIGHT. -.0 f t OLCUPANCY GRP. :R 3 SECOND. . . :743 sf FRONT. :20 ft REAR. . :21 ft STORIES. . . . . . . :2 FINBSMENT:O sf REQUIRED ----------- ----- `-- HL I GH T. . . . . . . . :`13 ft TOTAL------: 1775 sf SMOKE DETECTOR:. :Y FLUOR LOAD. . . . .-40 psf VALUE. . . . . ♦: 125445 PARKING SPACES. . : 1. Remarks : PATH I ----------------------------------- PLUMBING -----__--.__---------------_----------- SINKS. . . . . . . . . . . 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . : 1 LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 1UB/51-IOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . : 1. WATER LINE (ft ) . : 100 OTHER F-I XTURES. . . . . :0 UARBAGE DISP. . . : I RAIN DRAIN (ft ) . :0 WASHING MACH. . . : 1 SF RAIN DRAINS. . : l --------------- MECHANICAL -------------- -------------------- FEES ----------------- FUEL TYPES- UNIT HTRS. . :0 type amount by date recpt /GAS/ / / VENTS . . . . . :0 TIF $ 1550. 00 KS 11/14/94 - MAX INGUT :O BTU VENT FANS. . :4 BPRT $ 498. 00 KS 11/14/94 - FURN ( 100K . . : 1 HOODS. . . . . . .. 1 BPLC f 323. 70 RT 11/07/94 94--258494 FURN ) =100K . . :0 WOODSTOVES. :O B5PC $ 24. 90 KS 11/14/"4 - I-LUUR F URN. . . . :0 CLU DRYERS. : 1 SSDC f 280. 00 KS 11/14/94 - L{UIL/CMI•. ( 3HG:10 OTHER UNITS: 1 PARI'. $ 500. 00 KS 11/14/94 - GAS OUTLETS: l MPRT f 43. 50 KS 11/14/94 - Owner-: ----------------------------------------MPLC t 10. 88 KS 11/14/94 - TOM KEAYON M5PC f 2. 18 KS 11/14/94 - 11 ;_:02 SW NORTH DAKOTA ST 3HTH $ 225. 00 KS 11/14/94 - P5PC $ 11. 25 KS 11/14/94 -- TIGARD OR 97223 EROS f 64. 00 KS 11/14/94 Phone #: 624-•5716 ERPC t 20. 80 KS 11/14/94 - Contractor: ----- --------- ---_- - --'-ERPC $ 20. 80 KS 11/14/94 YOUNI0UE HOMES IL TOM KENYON H 11202 SW NORTH DAKOTA TIGARD OR 97223 Phone #: 624-5716 Reg 1t. . : 55633 _m f 35'75. 01 TOTAL This permit is issued subject to the regulations contained in the -- ----- REQUIRED INSPECTIONS --- --- J Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp applicable laws. All work will be done in accordance with approved Post/Beane Stt,uct Gas Line Insp plans. This permit will expire if work is not startid within 188 Post/Beam Meehan Insulation Insp days of issuance, or if wnrh is suspended for tore than 180 days. Plm/undslab Insp Gyp Board Insp PL-M/Underfloor Rain drain Insp I r-, m i tteN )1f..T1at ur-r : �Y_7addcMechanical Insp Water Line Insp Plumb Top Out Appr/Sdwlk Insp J c e d 1-`y : F r•a m i n g Insp Mechanical Fina l Bail Fel- i"Opeettel 6109 4i;ps r CITY MJF TIGARD SEWER CONNECTION COMMUNITY DEVELOPMENT DEPARTMENT PERMIT 131!58W Mae 11W.Tigard.Oregon 9722341911 (SM 6*4171 PERMIT #. . . . . . . s SWR94-0369 639-4171 DATE ISSUED: 11/16/94 PARCEL: 1S134DB—MLP05 SITE ADDRESS. . . : 1 .1230 SW NORTH DAKOTA ST SUBDIVISION. . . . : MLP94--0005 ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1 ---------------------------------------------------------------------- TENANT NAME. . . . . : USA NO. . . . . . . . . . t FIXTURE UNITS. . . t CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1 TYPE OF USE. . . . . tSF NO. OF BUILDINGStl INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . t :sf Remarks: PATH I Uwner: ----- ---------------------------------------------- FEES --------------- 10M KENYON type amount by data rer_pt IIE02 SW NORTH DAKOTA ST PRMT $ 2200. 00 KS 11/16/94 — INSP t 35. 00 KS 11/16/94 — TIGARD OR 97223 Phone #t 624--5716 Contractor: ----------•--------------------- CONTRACTOR NOT ON FILE ------------------------------------- Phone #: t 2235. 00 TOTAL Reg #. . . REQUIRED INSPECTIONS ------- This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires 181 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. Permittee Signature: _ Issued By:'A Call for inspection — 639--4175 3 s u Residential Building Pennmit ARRiication •, Clay of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (n (503) 639-4171 A- 0 Jobsits Address: , l Subdivision: Lot M r �• valuation: /•2 5 y S «tttitt ,a .." .......... Comer Lot? Y Flap Lot? Y " t?wner. x�t�ata.Aeot�irrd Address: Pyrntp 77 Phone: 1�. C� 716 ----- Other Contractor: Address: C� / rrrrrr. Tniss Dote" Phone: Other Contractors Licensed copy_of..cunsnt rspon lkaenas) Contact Name & Phone: Subcontractors: Archkect/Enpltteek- U4/Plumbing: Address: Mechanical: Q � (attach coO of current OR Contractor's License) Phone: . -.-)n JOBSCRI N: ApP pl Sign e & hone number Received by: Dab Received: N IVN'i MCI7MDEVq"&&pP CITY OF TIGARD P PERMIT COMMUNITY DEVELOPMENT DEPARTMENT P � • • • • • • • r MST94-0416 13125 SW NUI Md.Tigard,Or*W *?Moll SO (04 804171 DATE ISSUED: 11/16/94 PARCEL: 1S134DB-MLP05 .;ITE ADDRESS. . . : 11230 SW NORTH DAKOTA ST MLP94-0005 l ON I NG: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1 - LLAGS OF WORK. . :NEW GARBAGE DISPOSALS. . : 1 TYPE OF USE. . . . sSF WASHING MACH. . . . . . . sl BACKFLOW PREVNTRS. . al IJCCJPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 STUklES. . . . . . . . .. WATER HEATERS. . . . . . % I CATCH BASING. . . . . . . :0 IXTURE�i----- -------- LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : 1 SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0 LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0 -CUB/SHOWERS. . . . : SEWER LINE (ft) . . . . s 0 WA1 ER CLOSETS. . -.3 WATER LINE (ft) . . . . t100 DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . sO Remarks : PATH I UWNLR. ------------------------------ ------------------FEES--- -----.------- 1011 KENYON TIF f 1550. 00 KS 11 14/94 - la.:.02 SW NORTH DAKOTA ST BPRT f 498. 00 KS 11/14/94 - HPLC $ 323. 70 RT 11/07/94 94-?58494 T IGARD OR 97222 BSPC t 24. 90 KS 11/14/94 -- Phone #: 624-5716 SSDC $ 280. 00 KS 11/14/94 - PARK t 500. 00 KS 11/14/94 - Plumbing Contractor:------- ---------- MPRT 6 43. 50 KS 11/14/94 - MPLC ♦ 10. 88 KS 11/14/94 - Name : �J `I R M5PC f 2. 18 KS 11/14/94 - Address � 3BTH f 22'5. 00 KS 11/14/94 - City :_ _ State : _ P5PC $ 11. 25 KS 11/14/94 Zip:` Pho #: EROS f 64. 00 KS 11/14/94 - Reg Additional fees not shown here. . . . . . . . . ------ REQUIRED INSPECTIONS ------- fhis permit is issued subject to the reg - ulations contained in the Tigard Municipal Fo ,t/found Insp Rain drain Insp Code, State of Ore. :specialty Codes and all r-ust/Beam 'Struct Water Line Insp other applicable laws. All work will be done Post/Beam Mechan Appr^/Sdwlk Insp in accordance with approved plass. This Plm/undslab Insp Mechanical Final pe ' will expire if work is ntt started PLM/Underfloor Plumb Final within180 days of issi-Lance, at, if work is Mechanical Insp Building Final Ouspen ed for more than 180 drys. Plumb Top Out Erosion Control Framing Insp Crawl Drain Fireplace Insp Gas Line Insp - - ,c Insulation In�.p Gyp Board Insp Aut iorized Plu_r ing Contractor Signature Call far inspection - 639-4175 Cantractor Notes: r