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14423 SW 130TH AVENUE N !F> C/) W C7 C m Z C m 14423 SW 13a"' AVENUE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 339-4175 MST INSPECTION, DIVISION Business Line: (5031639-4171 G BUP ---- Received - Date Requested_ o 29-- AM___ __ PM _ BUP Location Suite `_._- MEC Contact Person Ph PLM _ Contractor _ Ph( ) n ____.-___ SWR BUILDING Tenant/OwnerC`-�--�- ELC Footing O / ELC _ Foundation Access: Ftg Drain ELR Crawl Drain Stab I Inspection Notes: SIT Post&Beam Shear Anchors ^ Ext Sheath/Shear int Sheath/Shear Frarnirg Insulation Drywall Nailing \ ------- _ ---- --- Firewall 1 Fire Sprinkler - - - Fire Alar in Susp'd Ceilinc, Roof Ott:- -- -- i -FI`nal %l - SSS�)PART FAIL --- a---^ --------- -- -__ L 0=1 GING --- -- -- - Post& Beam -- -- Under Slab ---- Rough-In Water Service - Sanitary Sewer Rain Drains Catch Basin/Mar.)ole Storm Drain -- ------ - ____ _-- Shower Pan Uther: Final PASS PART r A I I MECHANICAL Post&Beam- Rough-In -- - -- - - --- Gas Lind Smoke Dampers - Final PASS PP,NT FAIL ---------- ----- ---- - - ELE^TRICAL _ Service Rough-In UG/Slab Low Voltage Fire Alarm Final lPARI FAIL Roinspectlon tee of$-__-_--requiiea before next Inspectloti. Pay at City Hall, 13125 SW Hall Blvd PASSSITE Please call for reinspection RE:_ _-_ F-] Unable to inspect-no access Fire Supply Line J� ADA -- �9---1 Approact�.'Sidewalk Date -_- __ Inspector Other: Final DO NOT REM1011E this inspectlotri record from the job site. PASS PART FAIL CITY OF TIGiA,RD 24-Hour o 06Y � BUILDING Inspectic n Line: (503) 639- 4175 MST _3 - INSPECTION DIVISION Bus;,iess Line: (503) 639-4171 BLIP Received . --Date Requested.. - AM PM __ _ BUR - -- Suite _ - MEC --- Location -- C — Ph( - -) - PLM Contact Person Ph(--) SWR --. -- - Contractor_- — BUILDING Tenant/Owner _ Gl-t.�Jk-p �o EL(' LC---- - Footing E Foundation Access: ELL - - -- -- Ftg Drain Crawl Drain SIT — ------ ,b Inspection Notes: Peat&Beam _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear - Framing - - Insulation Drywall Nailing Firewall - Fire Sprinkler Fire Alarm _ Susp'd Ceiling Roof -- - Other. Final PASS PART FAIL PLUMBING -- - ---___--------------__-. Post&Beam — ----------_ _�_-__-- Under Slab - Rough-In Water Service -----_----- Sariftary Sewer ----.------- Rain Drains -- -` - -- —.--------- Catch Basin/Manhole "`- Storm Drain Shower Pan _ _ ----- ----�-- Other: Final ----- _�.----------- PASS PART-- FAIL _MECHANICAL Post&Beam --- Gas Line ---- - Smoke Dampers --' -- --- Final -- PASS _PART FAIL -�-"----- ------------ ELECTRICAL__ -- ------- ------ - __ -- - --- Servic Rough-In /�� -- ----- ---------- UG/Slab ---- Low Voltage ---- — --- Fire Alarm r6ft Reinspection fee of$ required before next insp�;tlon. Pay at City Hall, 1'J125 SW Hell Blvd PART FAIL- — Unable to inspect -no access SITE �] Please cell for reinspBction RE: , Fire Supply LineC ADA .-� � R Irespsetor�t � �� - Ext Approach/Sidewalk Date_41-/ -1-- Other: -— -------._ DODONOT REM0.W.F this inspection record from the j b site. Final PASS PART FAIL MASTER PERMIT CITYO F T I G A R D PERMIT M MST2003-00047 DEVELOPMENT SERVICES DATE ISSUFD: 4/7/03 13125 SW Hail Blvd.,Tigard,OR 97223 (503)639-4171 SITE ADDRESS: 14423 SW 130TH AVE PARCEL: 2S109AA-02400 SUBDIVISION: WOODFORD ESTATES ZONING: R-7 BLOCK: LOT: 032 JURISDICTION: TIC; REMARKS: Addition of 250 square foot sunroom addition. BUILDING REISSUE: STORIES: 1 _ FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 10 FIRST: 250 if BASEMENT: at LEFT: 14 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: s. GARAGE: sl FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: THIm. of RIGHT: 5 VALUE: 1),000 00 OCCUPANCY GRP: R3 DORM: BATH: TOTAL- 250 at REAR: 20 PLUMBII IG — SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: I CAT;H BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATLRS: WATER LINES: BCKFLW PREVNTR GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIUCMP<3HP: VENT FANS: CLOTHES DRYER: FURN UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTR^.AL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISC°LLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: o •200 amp: o 200 amp: WISVC OR FDR: PUMPIIR ZIGATIOW PER INSPECTION: EA ADD'L 50CSF: 201 400 amp: 201 400 emp: 1M'NIO SVCIFDR: 10) SIGNI7UT LIN Lr: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EAADDL BR CIR: SIGNALIPANEL: IN PLANT. MANU HMISVCIFDR: 601 1000 amp: 601-amps-looaw MING" 1000+a mplvolt: PLAN REVIEW SE C M IJ Recomoect only: >•4 RES UNITS9VCIFDR�•22S A.: a 600 V NOMIN., CLS ARk.NSPC OCC: . ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL a.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM INTERCOWPAGING: OUTDOO:<LNDSC LT. BURGLAR ALARM: OTH: BOILER: HVAr LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER CLOCK: INS1'RUMENTATKIN. MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL.N SYSTEMS: TOTAL FEES: $ 526.17 Owner: Contractor: This permit Is subject to the regulations contained in the WHITE,SCOTT A+ LAURIE L OWNER Tigard Municipal Cude,Slate of OR. Specialty Codes and 14423 SW 130TH AVE all other applicable laws. All work will be done in TIGARD,OR 97224 accordance with approved plans. This permit will expire N work is not started within 180 days of issuance.or If this work is suspended for more than 189 days. ATTENTION: Oregon law requires you to follow ru!us adopted by the Phone: Phone Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-00JO. You Rep w may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIO148 Footing Insp Shear Wall 1,sp Final Inspection t uundation Insp Exterior Sheathing Inst Electrical Service Rain drain Insp Electric"clugh In Electrical Final FroKng Insp Plumb Final Issued By Permittee Signature Call (503)639-4175 by 7:00 p.m.for an inspection needed the next business day Permit Addl 30TidL—_— R, 'Ll by:L , �a — Date: Statement: Information Notice to Property Owners About Construction Responsibilities Notc. Oregon Lau, ORS ;01.0ij(4), requires resici(rrn(►I co►►st►•crction per►rnit appli- cants who are not regi,%tered with the Construction Contractors Board to sign the fol,owing statement he/ore a building permit can he issued. This•statement is required fin- residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 70/.010(7), need not submit this•statement. This statement will he filed with the permit. Fill in the appropriate blanks and initial boxes I and 2. and either box 3A or 313: „19 1. i own, reside in,or will reside in the completed structure. CIO2. i understand that i must register as a construction contractor if the structure is sold or offered for sale before or upon completion. ta/3A. My general contractor is (Name) Contractor regis. # i will instruct my general contractor that all subcontractors who \wrk on the structure must be registered \\ith the Construction Contractors Board. 1 Olt II he my own general contractor. l� III hire subcontractors. I will hire only subcontractors registered With the ('01IStiu6011 Contractors Board. If I change my mind and hire a general contractor. I \kill contract \%ith a contractor \rho is registered with the('CB rind \g ill immediatcl\ notify the office issuing this building permit ofthe name of the contractor. I hereby certify that the above information is correct and that I have read and du understand the I nt•ormation Notice to Property 0%%ners about Construction Responsibilities on the re%erse title of this form. (Signature of permit applicant) (Date) (JI'hite c•opt•to is s uing agency permit fila, pink cops•to applicant) Building Perinit Application FOR OFFIICE USE ONl,V / 1 ------- Received ' 0,/,x,1 l3ualding �,.IJ'r,:Rey _,e rv? ' Date/By: _ Permit Nn.: — CityCit of Tigard Planning Approval Other g Date/By: Permit No.: e 1 13125 SW Hall Blvd, Plan Review �- Other Tigard,Oregon 97223 Date/By: ,; -I a 3 /C Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review (('rind o. 14 Date/H : ('ase No. Internet: www.ci.tigard.or.us Contact — Sec Prige 2 for 24-hour Inspection Request: 503-639-4175 Na a�tcthoct /( Supplemental Information Il2..Yl ��^/.lam_.. _ TYPE OF WORK REQUIRED DATA: New construction Demolition I &2 FAMILY DWELLING Addition/alteration/rep]acement Other: CATEGORY OF CONSTRUCTION_ Note: Permit Ices'arc based on the total value of the work performed Indicate I &2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)ul'all equipment,materials,labor, Accessory Building_ Multi-Family overhead and profit for the work indicated on this application. ❑ Master Builder Other: Valuation............ ....•,. JOB SITE INFORMATION and LOCATION No.of bcdrt,nms:--- No.of baths. -- 3q ,E Total number of Floors.................. .... . ........... Job site address; 14 2 A -- -- New dwelling area(sq.ft.)..................... .. . ... —----- Suite#: Bim./Apt.# Garage/carport area(sq. R.).............. ... _....... -- -- -- Project Name: -_ Covered porch area(sq. R.)............................. Cross street/Directions to job site; Deck area(sq. ft.)..................�,..... .. ............. Other structure area(sq.ft.).0.11.. . .. ?0...a... - ��— REQUIRED DATA: COMMERCIAL-IISE CHECKLIST Subdivision: 4_ - '.0--_ Lot #: $2— Tax Tax snap/parcel #: Note: Permit lees*aro bused on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nea, s(dollar)cif all equipment,materials,labor, n ) overhead anu profit Ihr the work indicated on this application. Valuation. ............................................. ... .. . S Existing building area(sq. R.)......................... - - --- -- - —---- -- - --- New building area(sq.A.).................. . ......... Number of stories............ .................... .......... PROPERTY OWNER I El TENANT Type ofonst tion.. ... .................. ........ UIAS Occupancyconstruction Bap Existing:: Address: - - ----- New: Cil /State//Zin: R – — Phone: — 12 Fax: NOTICE: All contractors and subcontractors are required to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under -- N - -- provisions of ORS 701 and may be required to be licensed in the Business Name: 47 __ jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing,the following reason applies- City/State/Zip: p _ -- Phone: 5� BUILDING PERMIT FEES" E-mail: ---- - Please refer to fee schedule. CONTRACTOR __--__— Business Name: Fees due upon application............. .._. ...... . S Address: z4ywoy, Cty/State/Ztt' Amount received...................... ... .... Phone: _ -- Fax: _-- _ Date received; -- CCB Lic. h_: — ------- -- Authorized — Ll , Notice: Thls permit application expires If a permit is not obtained within Signature: _ t3atc:1/�^j) �'t INO days alter It hrs been accepted rs complete. (Please print name) 'Fee methodolol ael by Tri-County Building Industry Seri lee Board. ilDsts\PermilFomns\BldgPermitApp.doc 01/03 ��dy Commercial Plan Submittal L TigardRequirement Matrix TYPE OF SUBMITTAL # of Plaos (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building �* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City cf Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For ever-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. 1:%dst9lfomts\C0M-mstrix.doc 9/24/01 Electrical Permit Application ' ` ' --. Received r( Electncal Date/8Y: l J Permit No.: City of Tigard Planning Approval Sign y g Date/By: Permit No.: 13125 SW flail Blvd. Plan Review Other ^— Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/By: _ Case No.: Internet: www.ci.tigard.or.us Contact V Juris.: See Page 2 fon - 24-hour Inspection Request: 503-639-417 Name/Method:_ Supplemental Information. TYPE OF WORK __ PLAN REVIEW(Pie check all that Apply) New construction 10 Demolition Service over 225 amps-i Health care facility commercial EJ Hazardovi location Addition/�,lteratior>'rc lacement Other:_ �?_ — _ commercial over 320 amps-rating of [I Building over 10,000 square feet, CATEGORY OF CONSTRUCTION I&2 family dwellings four or more residential units in EI &2-Family dwellinb Commercial/Industrial ❑System over 600 volts nominal one structure AccessoryBuilding Multi-FAmll ❑Building over three stories ❑Feeders,400 amps or more �__. _� y ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder _ Ll Other: ❑Egress/lighting plan ❑Other: JOB SITE INFORMATION and LOCATION Submit i sets of plans with any of the above. The above are not■ licable to temporary construction service. Job site addres ' ' /_) FEE*SCHEDULE Suite#: Bid ./Apt.#: _ Number of ins ectloils per pMitallowed Project Name: — Description Qty Fee(ea.) Total Cross street/Directions to job site: New rng unit.InslnKlc or ached fgndlp per .) dwelling unit.Includes attached Raraac. Service Included: I OW sq.ft.or less 145.15 4 Each additional 500 sq.ft.or portion therein__ 33.40 I Limited energy,residential _ 75.00 2 Subdivision: Lot#: Limited energy,non residential 75.00 2 Tax map/parcel #: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 1 -- - --- Services or feeders-Installation, alteration or relocation: 200 amps or less 80.30 _ 2 — -.-- .— --------- -- --- 201 amps to 400 ams --- ---�--- 106.85 2 401 amps to 600 amps 160.60 2 PROPERTY OWNER TENANT 601 amps to 1000 ams 240.60 2 -— Over 1000 amps or volts 454.65 2 Natile: _ Reconnect only 66.85 2 Address: Temporary services or feeders-Installation. alteration.or relocation: City/State/Zip __ _ 2(H)amps or less 66.85 1 Photic: rax: 201 amps to 400 ams 100.30 1 APPLICANT i�_ONTACT PERSON — 401 to 600 ams 133 75 2 Drench circuits-new.alleratinn,or Naiile: t I `C. -- extension per panel: �i 1� A.Fee for branch circuits with purchase of Address: v� c3u3 c�X:' / L- — service or feeder fee,each branch circuit 665 2 Cit /State/Zi //(" 13.Fee for branch circuits without purchase of ---— service or feeder fee,first branch circuit 46.85 _ 2 Phone: _ Fax_: _ _ Each additional branch circuit 6.65 2 E-mail Miu.(Service or reedo not included) CONTRACTOR Each pump or irrigation circle 53.40 2 —--- - -- Each sign or outline lighting 53.40 _ 2 Job NO: _ _ signal circuit(s)or a limited energy panel, Business Name: c alteration or extension _— _ Pee 2 2 Description Address: City/State/Zip:/State/Zi Each additional Inspection over the allowable In an of the above:— � 13 Per inspection pet hour(min, I hour) 62.50 Phone: Fax: Investigation fee: CCB Lic. #: _ Lic. #: - Other: Electrical Permit Flier" Supervising electrician _ Subtotal $ si ature required: _ Plan Review 25%of Permit Fee) S _ Print Name: Lic.#: State Surcharge(8%of Permit Fee) S TOTAL PERMIT FEE S Authorized Notice: Thls permit application expires If a permit Is not obtained within - Signature: __• Dater_-_ 180 days after It has been accepted as complete. 'Fee methodology set by Iri-Counts Building Industry Service Board. _ (Plcasr print name) ODsWilerrnit Forms\ElcPerrtntApp.doc 01103 Electrical Permit ARIjyj qQ - City of Tigard , Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Feefor all systems........................................................... $75.00 cberk'rype of Work Involved: Audio and Stereo Systcros* Iturglar Alarm 0arage Door Opener* Heating,Ventilation and AirCond;tioning System* y Vacuum Systems* Other i' I COMMERCIAL WORK ONLY: Fee for SLgk system.. ..................................................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: Audio and Stereo Systems Boiler Controls Clock Systems Il Data Telecommunir nstallation Dire Alarm Installation HVAC Instrumentation Intercom and Paging Systems lJ landscape imgation Control* El Medica! El Nurse Calls ClOutdoor Iandscspc Lighting* E J Protective Signaling F—] Other__ ..— ---. . . _Number of Systems * No licenses are required. Licenses are required for all other installations i\Dsts\Permit Forms\l lcPermitAppPg2.doc 01/03