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11590 SW FONNER STREET it 11590 SW Fonner Street CITY OF TIGARD 24-Hour BUILDING Insper_ticn Line: (503)639-4175 INSPECTION DIVISION Businpss Line: (503) 639-4171 [.1ST - __:=G 1� BLIP Received — Date Re uested AM__ Pti! — aUP Location Suite MEr. - —_ Contact Person _ ^ Ph(_ ) _S�`j Y04 PLM -_- Contrartor - -- ----- - Ph(—) -- -- SWR - — -- ---- BUILDING TenanVO� ,ler _ _-_ __._ ELC Footing - _ ELC Foundation Access: �^ Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam - - - -- - -- _- — Shear Ai chora j Ext Sheath/Shear Int Sheath/Shear Framing ---- -- - - � --— - Insulation Drywall Nailing - -- - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - -- - -—..- -- Roof Other: Final PASS_ PART FA0_ PLUMBINGI Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catrh Elasin/Manhole Storm Drain Showe, Pan O"i 1c: Final PASS PART FAIL -MECHA'4ICAL _ —�_---- - — -- --- - .— ---- — ---- ----- Post P. Beam Rough.-In -- ---—.. - - ------ ----- ---------- _- Gar Line Smoke Dampers --- --- - ----- — — --__.-_--- ._.-- _`- Fir gal PASS PART FAIL ELECTRICAL Service Rough-In ---- --._..�_ -- -- --- - ------- -- UG/Slat, Low Voltage — Fire Alarm Reinspection fee of$^- -_required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PAsS ART FAIL SITE C7 Please call for reinspection RE:` _ Unable to inspect-no access Fire Supply Line r ADA ;z- % ' ^ 0/-/ Approach/Sidewalk Data_. _ _ inspector -_ - f Other: Final DO NOT REMOVE this Inspection record frorm the job site. PASS PART FAIL CITY OF TIGARD 7.4-Hour BUILDING inspection Line: (503) 639-4175 MST `'2 r�� -36 INSPECTION DIVISION Business Line: (503)639-4171 BLIP ReceivedBata Requested_ �Cv _i1L' Af,� -__ A _ __ BLIP _ - ----- Location �__� .5 r Suite---/ wte -_ _..--- MEC - Contact Person --_ Ph( ) PLM --_ -� Contra - Ph( ) - SWR - Tenant/Owner 5012! �Z 1-� ELC Footing !'-9U' '-S C' ELC Ft undation AccessELR Crawl Drain Slab Inspecticn Notes: SIT Poet&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - - Insulation i Drywall Nailing - -�-- Firewall Fire Sprinkler --- - Fire Alarm j Susp'd Ceiling -- RootJL Other: - - SS PART FAIL - - BIN44 - Post&Beam Under Slab -- — Rough-In ' Wates Service - Sanitary Sewer Rain Drains — --- -- -- ------ Catch Basin/Manho!e Storm Drain --- — �� Shower Pan Other: - "- Final -^---- PASS PART FAIL MECHANICAL Post& Beam Rough-In - Gas Line Smoke dampers - - -- -- -- ------- ----- ..- Final PASS PART FAIL ELECTRICAL Service --- -----� ��.._ - ----- , Rough-In -- UG/Slab Low Voltage Fire Alarm Final Reinspection fee of required before next i; spection. Pay at City Hall, 131253W Hall Blvd. PASS PART FAIL $h'E i- Please call for reinspection RE: - -_-____._-__�_-. Unable to inspect-no access Fire Supply Line > ') ADA ` Approach/Sidewalk Dab -- _ -- Insp4iiater-_ - �'�� .,,��- _ ____.-__. Ott _ Other: Find _ DO NOT REMOVE this Inspection record from the,job sllte. PASS PART FAIL CITY OF TIOARD PLUMBING PERMIT t DEVELOPMENT SERVICES PERMIT#: /15/ 002-00280 7 13125 SW Halt Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 7/15/02 PARCEL: 2S103CA-00207 SITE ADDRESS: 11590 SW FONNER ST SUBDIV ION: WOODCREST NO.2 ZONING: R-4.5 BLOCK: LOT: 029 JURISDICTION: TIG CLASS OF WORK: OTR GARq3AGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLUW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: �^ URINALS: GREASE TRAPS: LAVAT')RIES: OTHER FIXTURES: 2 TUB/SHOVERS: SEWER LINE: ft WATER CLOSETS: WATER LINT: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Relocate (1) hose bib and (1)kitchen vent for new construction. _ FEES Owner: Type By Date Amount Receipt WOODLEY, MICHAEL* CASSANDRA B PRMT CTR 7/15/02 $72.50 272002 j000 I 11590 SW FONNER 513CT CTR 7/15/02 $5 f 0 27200200000 TIGARD, OR 97223 Total $78.30 Phone 1: Contractor: OWNER REQUIRED INSPECTIONS Rough-in Insp Phone 1: 'Top-out Insp Reg#: Final Insprction This permit is issued subject to the regulations contained in thf. Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Iss4d By: / Permltte►: 5lgnature: Call (503) 639-4175 by 7:00 P.M. for an Infitneetton needed the next business day Building Fixtures Plumbing Permit Application OFFICE r Date received: 77t no.: e City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard, (W (•7223 — Cln of ngard 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 U Contmercialhndustr.al U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food se ice U Other: JOB e dfor special Information use checkliA) /r c;�� >, -�t, ,,,�4 t; Description Qty. Fee(ea.) Total Job addtcss: f- ____ __ - Bldg. no.: Sui(e no.: Tien'1-and 2-family dwellings only: Z— (includes 100 It.for each utility connection) Tax map/tax lotlaccount no.: _ SPR(1)bath Lot: Block: Subdivision: _ SIR(7)bath Project name: _ _ SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description an location of work 9npremises: r -'r-" Siteutilitles: / ffdSt b%� / k 4t ktyt 11-k Catch basin/area drain Est.date of completion/inspection: Drywe Is/leach line/trenc rain Footin drain(no.lin.ft.) Manufactured home utilities _ Business name: _J(C N Manholes Address: _ Rain drain connector City: State: Z[P: _ Sanitary sewer(no.lin.ft.) Phone: —=a _ I E-mail` Storm sewer(no,lin. fl.) CCB no.: T PI Imb. bus. reg,no: Water service no.lin.R. City/metro lie.no.: Fixture or Item: Contractor's representative signature: Abso tion valve Back flow preventer Print name: Date: Backwater valve Basins/lavatory -_ Name: Clothes washer Address: - Dishwasher ---- --- -- City: Drinking fountain(s) _ Stpte: 7.IP: — - �._ . _ Ejectors/sump Phone: Fax: C-tnail: Expansion tank _ Fixture/sewer cap Name(print): dCl �t- lFluor drains/floor sinks/hub Mail ing address: (f5'�J d ,S',r,L d�o►e a,t.e ti Ios a disposal ose i b City: T; CL rC& - State- le ZIP: Ice maker "hone: "46- 4- Fax: E-mail: Interce for/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or tile, nr inter nc and c air made by my r g70) Roof rain(commercial) on the pr vn OI hapter 447. Sink(s),basin(s),lays(s) 'L� Owner's s114111 ature:4 '") Date: /h Sump - Tu s/shower/shower pan Urinal Name: __— Water closet Address: _ Water heater City: _ State: z—1p 7 Other: i ,5 Phone: Total Not all Jurisdictions scrept credit cards,please call Jurisdiction fnr more 1nr0rmat11n. Notice: This permit application Minimum fee...........o) $ 7 U Visa U MasterCud expires if a permit is not obtained Plan review(at u /o) $ ` L Credit card number: State surcharge(8%).... $ within IRO days after it hes beer, ,•�� . fres Nme caroer sacown on credit cardaccepted as complete. TOTAL........................$ of dhld '— Cardholder signature s Amount 4141616(MCOM! PLUMBING PERMIT FEES: -�-� PRICE TOTAL New 1 and 2-farnlly dwellingb only: ' FIXTURES (individual) QTY ea AMOUNT (includes all plumbing fixtures In PRICE T��TAL Sink 16.60 the dwelling and the first100 ft. QTY (oa) AMOUNT Lavatory 16.60 for each util!ty connection _ 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 16.60 SUBTOTAL Urinal ^� 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16,60 TOTAL 4 Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 - PLEASE COMPLETE: a• 18,60 4^ 16.80 Water Heater O conversion O like kind 16.60 Quantic b Work Performed _ Gas piping requires a separate mechanical Fix',ure Type: New Moved Replaced Removedl permit. _ _ Capped MFG Home New Water Service 46.40 SI tk -_ MFG Home New San/Storm Sewer 46.40 L avato ry T ub or Tub/Shower Hose Bibs 16.60 Combination _ Roof Drains 16.60 Shower Onl Drinking Fountain 16.60 Wator ClosUnnet Other Fixtures(Specify) 1B.60 Dish I _ i�ltwasher Garbage Disposal Laundry Room Tray Washing Machine - Floor Drain/Sink: 2" Sewer-1st 100' 55,00 3„ Sewer-each additional 100' 46.40 4" Wafer Service-1 st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures (Specify) Storm&Rain Drain-lot 100' 55.00 _ Storm&Rain Drain-each additional 100' 11 46.40 Commercial Back Flow Prevention Device 46.40 - - Residential Backllow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 Requested Inspections _2er/hr COMMENTS REGARDING ABOVE: Rain Dain,single family dwelling 65.25 Grease Traps 16.60 -- - QUANTITY TOTAL Iscmetric or riser diagram Is raquired If Ouantity Total Is >9 *SUBTOTAL ---- - ----f 8%STATE SURCHARGE - - "PLAN REVIEW 25%OF SUBTOTAL Requirrd only II BKture qty total is>9 _ TOTAL 5 *Minimum permit fee Is$72 30+8%state surcharge,except Residential Backflow Prevention Devlre,which Je$36.25+8%state surcharge "All New^:^.. :::! auildings require 2 sets of plans with Isometric or riser diagram for plan review. I:\dsts\forms\plm-febs.doc 12/26/01 +CITY OF TIGARD 24-Hour BU;!DING Inspection Line: (503)639-4175 II'4SPECTION DIVISION Business Line: (503)639-4171 BUIP Q__ Date Requested AM _ PM BUP -- - Received MEC �- Suite— _ Location -) --- ____ �LMM Contact PersPh on - - ( SWR - Contractor - - - — _ ELC I ING Tenant/Owner ._ --- - -- ELCtion Access: ELRinrain SIT Inspection Notes: Beamnchors ath/Shear ath/Shear (--'- Framing p L Insulation --- Drywall Nait,ng Firewall V Fire Sprinkler Fire Alarm Susp'd Gelling Roof - Other: --- Final - PASS PART FAIL post& Beam --- Under Slab Rough-In Water Service Sanitary Sewer --- ----- - - --- Rain Drains Catch Basin/Manhole - — - -- - Storm Drain — Shower Pan - - Other-—_ I PART FAIL ANICAL_Beam-Inine Dampars S PART FAIL_TRICe h-Inlaboltagelarm Final L] Reinspection tee of$---- .required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL `.__ C Unable to inspect-no access SITE IN Please call for reinspection RE: Fire Supply Line ADA psb �9 ? Inspector ----��- Ext — Approach/Sidewalk Other: DO NOT REMOVE this Inspection record from the job site. Final PASS PART FAIL CITY OF TIOARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST _ INSPECTION DIVISION Business Line: (503)639-4171BU' /� P _ Received _ Date Requested AM —!J a PM SUP Location �_- -�L/ Suite MEC d-5�_ C'_� PLM _G�Gi L1 Contac,Person _ Ph( ) -- Contractor Ph(_ ) SWR . BUILDING Tenant/Owner _-_— _ ELC _ Footing - ELC Foundation Access: Access: Ftg Drain ELR --.- - Crawl Drain Slab Inspection Notes: SIT Post&Beam -- Shear Anchors _ Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler -- - - - Fire Alarm Susp'd Ceiling `---- -- Root Other:----- ---- --- - ------ —_------ - Final — PASS PART FAIL —� PLUMBING --- ----- ---- ------ Post&Beam Under Slab -------- Rough-In Water Service -- ---------- -_—_ Sanitary Sewer Rain Drains -- - --_ -- -- ---- __. .---- ----- ----- Catch Basin/Manhole Storm Drain --- ---_.---- - ---- —_----- --- -----_____ Shower Pan Other: --- - — -----.--- ----- ---_____ A PART FAIL -_.�-._--_-- _MtMANICAL - Post&Beam Rough-In ---_-y— _ —__--_.----- --- Ga:Line Smoke Dampers ---- — -- - ------- --- -- Final PASS PART FAIL -- -i - ----- ----u4 ELECI RIGAL Service — - _------------------ Rough-In -- UG/Slab Low Voltage — Fire Alarm Final Ej Reinspection tee of$__ f—required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to Inspect-nc access Fire Supply Line ADA Approach/Sidewalk ��-_._�-`--��------- Iln•p�elOt �Other_ _ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TI�iAR® MASTER PERMIT PERMIT#: MST2002-00303 DEVELOPMENT SERVICES DATE ISSUED: 7/12/02 1:3125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11590 SW FONNER ST PARCEL: 2S103CA-00207 SUBDIVISION: WOODCREST NO 2 ZONING: R-4.5 BLOCK: LOT: 029 JURISDICTION: Tia REMARKS: Add entry and bay window. BUILDING REISSUE: STORIES: FLOOR AREAS _ REQUIRED SETBACKS REQ01RED CLASS OF WORK: ALT HEIGHT: FIRST: 62 of BASEMENT: of LEFT: SMOKE DETECTCgS. TYPE OF USE: SF FLOOR LOAD 40 SECOND: if GARAGE, of FRONT: PAFKING SPACES TYPE OF CONST: SN DWELLING UNITS: FINSSMENT: of RIGHT: VP.LUE: $6,500.00 OCCUPANCY GRP: R3 BORM: BATH: TOTAL. 6200 at REAR: PL JMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS. LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATC14 BASINS TUSISHOWERS: GARBAGE DISP: WATER HEATERS: ;."TER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES. MECHANICAL FUEL TYPES FURN<10UK: BOIL/CMP-K 3HP: VENT FANS: CLOTHES DRYER: FURN>-100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADDI INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 •200 amp: WISVC OR FDR: PUMPARRIGATION: PER INSPECTION: EA ADOI 500SF: 201 •400 amp: 201 400 amp: 1st WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENEROY: 401 600 amp: 401 60J amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT: -AANU HM/SVC/FDR: 601 1000 amp: 601-amps-1000v: MINOR LABEL: 1^1n♦smplvolt PLAN REVIEW SECTION Reconnect only: »4 RES UNITS: SVCIFrR>-220 A.: >600 V NOMINAL: f:LS AREAISPC OCC: _ ELECT RICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO S STEREO: FIRE ALARM: INTERCOMIPAGING OU tDOOR!NDSC LT: BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEIIRRIG: PPOTEC11VE SGNL GARAGE OPENER: CLOCK: INSTRUMENTATION MEL.'AL OTHR HVAC: DATAITELECOMM: NURSECALL9 TOIAt aSYSTFMS: Owner: Contractor: TOTAL FEES: $ 281.77 This "'nit Is subject to the regulations contained in the WOODLEY,MICHAEL+CASSANDRA B TERRY PRATT Tigard Municipal Code,State of OR. Specialty Codes and 11590 SW FONNER PO BOX 1066 all other applicable laws. All work will be done in TIGARD,OR 97223 103 FLEISHAUER accordance with approved plans. This permit will expire H MCMINNVILLE,OR 97128 work is not started within 180 days of Issuance,or If the work Is suspended for more than 180 days. ATTENTION: Phona: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep N: LIC :n; forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Footing Insp Electrical Service Electrical Fmol Foundation Insp Electrical Rough In Final inspection Post/Beam Structural Framing Insp Underfloor InaWgtIon Shear Wall Insp Fe6tl-ng/Foundatlon Dn- Rain drain Insp i sued By : '�i _ Permittee Signature : Call (503) 639,4175 by 7:00 p.m. for an inspection needed the next bdsiness day Building Permit Application —_,— Date teceived: l Permit no.: City of Tigard Project/appl.no.: Expire date: Y t r' Ti and Address: 13125 SW Hall Blvd,' �,:d 1 8 I-hone: (503) 639-4171 CiDate issued: By:; Receipt no.: Fax: (503) 598-1960 1; 111)h t t9) Case CdPayment e no.: Y type: Land use approval . 1&2 family:Simple Complex. V&2 family dwelling or accessory U Commercial/industrial U MUIu-lanlily U New construction U Demolition j U Addition/alteration/replacement U Tenant improwemrnl U Fire sprinkler/alarm U Other: IJ 011111SITE 1 N FORMa Job address: r f .fa . — — Bldg.m.: Suite no.: Lot: Block: Subdivision: — 7'ax map/tax lot/account Project name: tj -p — Description and location of work on premise, special condition /- s�L•<rp _ ►-'� 'f -- - MEN Name: W � e _ (F1'odplain,sepillWhittlicitY, , lar,etc, Mailing address: _ 1 &2 tamil) dnclling: f City: State: ZIP: Valuation of work........................................ $ Phone: _ e Fax: E-mail: No.of bedrooms/paths................................. _ Owner's representative: Total number of floors................................. _ Fax: C-mail: New dwelling arca(sq, fl.) +- Phone: g �I. .......................... Garage/carport area(sq Il.)......................... _,- —_-- � . Covered porch area(s'IName: Deck area(sq. f.) ........................................ Mailing address �—L-- — — Other stwcture arca(s 11. .... 1� • c. states �ZIP:9 7/�� )............... ...... city: H r);��t�. I►� - Commercial/industrial/multi-family. Phone• a�_ 7 _ z I ,i•, L-mail: tValuation of work.............................. .... .... r— Existing bldg.area(sq. ft.) ............1....�./.. Business name: r New bldg.area(sq.ft.) ................./ Address: a a s i✓ Number of stories City: •- State: ZIP: Type of construction Phone: - Fax: _ E-mail: Occupancy gmyp(S)- Existing: CCB no.: New: City/metro lic. nu : Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Names provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed.If the applicant is cit %late. ZIP. exempt from licensing,the following reason applies: Contact person: Plan no.: Phone: Name:Name: l onlat l la IM 11, Fees due upon application ........................... $_ Address; - Date received: City: State: ZIP: _ Amount received ....... ............................. — I Phone: Fax: Email Please refer to fee sena_alc. —J 1, 1 hereby certify 1 have read and examined this application and the Not all jurisdictions acceo credit card!:,pleax call jurisdiction for more in;,n;n n attached checklist.All provisions of laws and ordinances governing this Uvisa UMastervard wort,will be complied with, ethers cifled herein or not. credit card nun,twf -___ _- —_ _1-L_ Expires Authorized signature g 1! Date: 1�j�-Or' Narne of cnrdltolder as shown on cmdh card $ Print name: r f —_. Cudholder dRnmure Araoura \ssslll"' Notice:111is permit application expires if a permit is not obtained within 180 days aRer it has been accepted as complete. +40 1613(GWICOM) I r 1' One-and Two-Family Dwelling Building Permit Application Checklist Reference no. As:,ocratcdpermits: city u/Pigurd Cit of Tigard City g rtfTe-ctrical U Plumhing U Mechanical Address: 13125 SW hall Blvd,Tigard,OR 97223 U Other: Phone: (503) 639-4171 - — Fax: (503) 598-1960 FT- II 111F [01110)VING I I UNIS ARF IZFQII 41111A) FOR PLAN HFIVIFIV I e% No N1,A 1 Land use actions completed.See jurisdiction criteria for concurrent reviews. ffi' 0-- 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. A.- 3 Verilkation of approved plat/lot. r� 4 Lire district-_ approval required. — 5 Septic system permit or authorization for remodel. Existing system capacityta- 6 Sewer permit. - V 7 Water district approval. v 8 Soils report.Must carry original applicable stamp and signature on file or with application. - y' 9 Erosion control U plan U permit required. Include drainage-way protection,sill fence design and location of, catch-basin protection,etc, V 10 3 Complete sets of legible plans.Must he drawn to scale, tihowing confonnance to applicable local and stale building codes. Lateral design details and comteclions nmst hr incorporated into the plans or on a separale full-sire sheel attached to the plans with cross references between plan Iocallon and delad, Him revic%s C;snot be completed if copyright violations exist. I I Site/plot plan drawn la scale.The plan intw show lot;rad huildhrg s(•lhack dinx•nsion',.Irt )Intl} coma elee;tonn',(il - there I,,III()[(-Ilran it 4-I1,clr%alnar ddh•renturl,phut trust show conlouI Inr nl 2 II urtrn ul•,1.Ilk anion of cax1111clik and drivcvk o,footp:mnl of sintrlurc(Including drekst:location of wclls/scpGc•;� ,trip,.uuhl� I kalnrns:dnrdUon indicator:lot area;building coverage ntvu:percentage of coverage:inyx•rvious arca:extsunt•tiuuctwrs on sue;;utd wrlacr drauwge. 12 Foundation plan.Show dimensions, anchor bolts,ally hold-downs and r•endurcing pads,connection details, vent size atnd location. 13 Floor plans.Show all dimensions,room life nitlicatloll.window site, IocaUon of smoke detectors,water heater, fumace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _ 14 Cross section(s)and details.Show all framing-member si/es and�pachtg such as 11(m)r heanis,hc,tdcrs. joitils,soh Ilaror. wall cons(niction,roof construction. More than one cross section nsry hr rc(;uired to clearly pons) con"truction,tiho" details of all wall and roul'shealhing,roofing. ruol ~lope.ceiling 11 -Ill.stdrng material,footing,and louadatik.nr,slain, fireplace comuurtion, thermal insulation,etc. 15 Elevation views. Provide elevations fur new construction:minimum of two elevations for additions and remodels. Lxteri( r cl %ations must reflect the actual grade if the change in grade is greater than four fool at building envelope. Full-size sheat addendwns showing foundation elevations with cross references are acccplahle. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locatmns:for non-prescriptive path analysis provide specifications and calculations to engineering standard, r Floor/roof framing. I'rmn , plans for all floorshoof asp,.nibiies, indicating member sizing,spacing,and hearing _ locations.Show attic \(nidation. 18 [casement and retaining walls. Provide cross sections and delails showing placement of rehar. For engineered - systems,sec item22,"L'n ineer's calculations." 19 Ream calculations. Provide two sets of calculations using current code design values for all beam:,and multiple joists over 10 feet long and/or any heam/joist carrying a non-uniform load. 20 Manufactured floor/ror f truss design details. tv 21 Energy Code compliance.identify the prescriptive path or provide calculations. A gas-piping schematic is required tj for four or more appliances. _ 22 Engineer's calculations.When required or prfi\ 1. +i c . hear wall.it -truss)sh ill he stamped by an engineer or architrcl hcrnsrd in Oregon and shall hr shown I')hr;y,hlrc,rhlc to Ihr prolan under ccs Wit V JURISDIVII10NAL SPECIFICS 21 Inc 15)t..te plans are required for Item I I ahove. Site plans must he 8.1/:"x I I"or I I" x 17". 24 Tv+o(2)sets each are required for Items 16, 19,20& 22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted, 26 "Reversed"building plans must meet criteria outlined in the Permit&System Devclopmenl Fees document. 27 "brawn to scale"indicates standard architect or engineers, sdc. 28 Site plan to include tree size,type&location per approve.J project;greet 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. 4404614(rvnrvcost) Electrical Permit Application Date received: Permitno.: City of Tigard Project/appl.no.: Expiredate: C'itynfTipard Address: 13125 SW Hall Blvd,Tigard,OR 97221 Date issued: B ; Phone: (503) 639-4171 Y Receipt no.: Fax: (503)598 1960 Case file no.: Payment type: Land use approval: INPE OF 2 farnily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement J Now constructer rt U Addition/alteration/replacement U Other: U Partial Joh address: ,SC'0 rC y ,I Bldg. no.: Suite no.: iTax map/tax lot/account no., l.ot: Block: Subdivision: Project name: _ Description and location of work on premises: Q � Fstiniawd date ol'completion/inspection: - SCHEDULE job no: Fe• Max Business narne: Description Qh. (ea.) lot+n! no.lns Address; New recldential-single or mutes fnmib Iw•r ---- dwelling unit.Includes atlnclavl hnrnge. City` Stale: ZIP: Service Included: Phone: Ft►,. _ [:mail: IWOsq.ft.orIesti 4 CCB ru).: Iaec.bus,lic.no: Each additional 500 sq.A.or portion thereof Limited energy,residential 2 City/metro lit.no.: _ Limited ene-gy,non-residential 2 I.ach manufactured home or modular dwelling S417W.' rc of su Ivising electrician ( cr,uired) pate -- Scrvicr and/or feeder 2 Sup.elect.name(print I I.icenseno: -Services or feeders-Installation, t OWNERPkRTV alteration or relocation: 200 amps of less 2 Name(print): / .T t_ t�, _/_ 201 amps to4(x)amps 2 Mailing address: / t. / S 401 amps loG00amps _ 2 6n 1 amps to 1(100 amps 2 Cily: state bv ZFpt, Over I1)00amps orvolts - 2 Phone a Fax: fi-mail: _ tzcc mteaonly -- I Owner installation:The installat,on is[icing made on property I own lemporaryservices orfeedem- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479, ,701. 2lxr amps or less 2 Owner's signature: t. ( tt 201 amps to 400 amps _ 2 •In 1 to 600 amps 2 Branch circuits-new,alteration. Name: or rxtcnsion per panel: — -- A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit , City:----- Stale: ZIP: B. Fee for branch circuits without purchase Phone: I i 1? mail --v— of service or feeder fee,first branch circuit: 11 Mach additional branch circuit Misc.(Service or feeder not Included): 11 Service over 225 amps(ononcncud U Health arvlacility Each pump oritrigationcircic O Service over320amps-rating of 1&2 U Ilazardouslocation Each sign oroutlinelighting 2_ family dwellings UBuilding over l0,(xx)square feel fouror Signal circuit(s)oralinutcdenergypanel. t7System over 600volonominal more residential units in one structure alteration,or extension* LI Building over three stories U Fcelen,410 amps or more •lkscri tion: U tkcupant load over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: U Egress/6ghtingplan U Other pains inspection Submlt__sus of plane with any of the above. Investigation fee The above are not applicable ao temporary construction service. other - Not all JuNalletiwrs accept credit cants,plrnx call jurisdiction 6n more intrxnnntirar Notice:'this permit application Permit fee.....................$ Ll visa U MasieK and expires il'a permit is t of obtained Plan review(at _. %) $ Cmilit csrd number within 180 days after h has been State surcharge(13%) ....$ xplm' accepted as complete. TOTAL $ Name of ca n r u shown on credit carte--- __—TiZolder signature Amount 440-4615(6I1)a1COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RE IDEN*rIAL ONLY f� Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) mI Service included: Items Cost Total Check Type of Work Involved: Residential-N.,r unit 1000 sq ft or less $145.15 _ ❑ Audio and Stereo Systems' Each additional 500 sq.ft.or portion thereof $33.40 ❑ Burglar Alarm Limitod Energy – $75 00 Each Manufd Home or Modular ❑ Garage Door Opener' Dwelling Service or Feeder $90.90— 2 Service.,or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $106.85_ 2 401 amps to 600 amps $160.60 2 6ul amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65_ 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED COMMERCIAL ONLY Inslallatio,,alteration,or relocation Fee for each system.......................................................... $75 00 200 amps or less $88.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 _ 2 401 amps to 600 strips $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)the fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6 65 —�. ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 6 C_ Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 —_ _ ❑ Intercom and Paging Systems Each sign or outline lighting _ $53.40 _- Signal circuit(s)or a limited energy panel,alteration 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 Calls Per hour $62.50 _ In Plant $73.75 Outdoor Landscape Lighting' Fees: ❑ Prolective Signaling Enter total of above fees $ ❑ Other 8%State Surcharge $ Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other Installations Set,"Plan Review"section on $ front of application - // Fees: Total Balance Due $ �✓ ri Enter total of above fees - ❑ Trust Account# __- 8%State Surcharge $ Total Balance Due = All New Commercial Buildings require 2 sets of pians. i,klsts%hrni%%elc•fccs.doc 0900101 CITYOF T IGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00271 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSVID: 9/26/01 SITE ADDRESS; 11590 SW FONNER ST PAR%.EL: 2S103CA-00207 SUBDIVISION: WOODCREST NO.2 ZONING: R-4.5 13LOCK: LOT: 029 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NE-W DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks- Connect existing resiC'ence to sewer. Septic tank must be pumped, filled and inspected. Owner: _ _ FEES WOODLF.Y, MICHAEL +CASSANDRA B Type B Date Amount Receipt 11590 SW FONNER Yp _y _ TIGARD, OR 97223 PRMT CTR 9/26/01 $2,300.00 27200100000 INSP CTR 9/26/01 $35.00 27200100000 Phone: Total $2,335.00 Contractor: Phone: Reg#: Required Inspections Sewcr Inspection Septic 12nk Filled This Applicant agrees to comply with ail the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount pais. Alill be forfeited if the permit expires. The Agency does not guarantee the accuracy of the lido sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in al! directions from the distance given If riot so Ionated, the installer shall purcha!ie a "Tap and Side Sewer" Perm Issued b Y �� ti1 �/l Permittee Signature: _ �_ Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day CITYOF TIGARD PLUMBING PERMIT _ /26/ DEVELOPMENT SERVICES PERMIT#: 00463 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/26/01 9126/011 SITE ADDRESS: 11590 SW FONNER ST PARCEL: 2S103CA-00207 SUBDIVISION: WOODCREST NO.2 ZONING: R-4.5 BLOCK: LOT: 029 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: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 30 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Connect existing single family residence to sewer. Sewer lateral is on property. Approxima!ely 30' of sewer line and inspect reversed plumbing under house. FEES Owner: --- Type By Date Amount Receipt WOODLEY, MICHAEL + CASSANDRA B PRMT CTR 9/26/01 $117.50 27200100000 11590 SW FONNER 5PCT CTR 9/26/01 $9.40 2.7200100000 j TIGARD, OR 97223 — _��'_ Total $126.90 Phone 1: Contractor: PETRA PLUMBING CO 14715 SUNSET BLVD SHERWOOD, OR 97'140 REQUIRED INSPECTIONS Phone 1: 62.5 4018 Sewer Inspection Misc, Inspection Reg#: LIC 70893 Final Inspection PI-M 34-221 PB 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 %Vill 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 b� the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. A �K'11 Is ued By: y / Permittee Signature: �. \__ Call (503)639-4175 by 7:00 P.M. for an inspection needed the next business day �-7 i Plumbing Permit Application Date received: 4 ��D� Permit n( �h�.Ol X63 City of Tigard Sewer permit no.: Building permit no.. Address: 13125 SW Hall Blvd,Tigard,OR 97223 Citvoffigard Phone: (503) 639-4171 Project/appl,no.: Expiredate Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use appro) al: - - Case file no.: Payment type: U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/;alteration/replecemenl U Food service U Other. Joh address ISIO ,5,�; '. /-o p.s2 e r Ikwcri tion (pv. Fte(ca.) "Total �` _ Bldg.no.: Suite no.: New 1-and 2-family dwellings only: Tax map/lax lot/account no.: —� (Includes 1111111.for each utiBlyConnect ion) -_ _ --- SiR (1)balh Lot: I Block: Subdivision: --_ _ ---- _ - -- SFIZ(2)bath Project name: - - SFR(3)bath --- City/county: ZIP: Each additional bath/kitchen - Description and location of work on premises:_ Siteutilities: Catch basin/area drain [-,St.date of completion/inspection: -- -- I)rywells/Ieachline/trench drain - rooting drain(no.lin.ft.) _ -- Manufactured home utilities Business name: ,�_ �-<- _ Manholes - - ----- Addres /s: 7 75 o`"p*t r Rain drain connector City: 1� Qwool7 Slate: aC ZIP: 7/ Sanitary sewer(no.lin.ft.) Phone: (p r, . c I( I Fax: _E-mail: Storm sewer(no.lin.ft.) CCB no.: _ Plumb.bus.reg. no: Water service(no.lin. ft.) City/metro lic.no.: Fixture or Item: --- Absorption valve _ Co ntrac_tor's_representative signature. Back flow reverter Print nam �- Date: Backwater valve Basins/iavatory _ -- Name: Clothes washer - - - Dishwasher _ - — Address: _- - Drinking fountain(s) City: Slate: - ZIP: _ [sjectors/sump _ Phone: Fax: E-mailExpansion tank Fixture/sewer cap Name(print): �{ Floor drainsltl(wr sinks/hub ---- Mailing address: p Garbage disposal City: '" Hose hibb -_ Y '' �� 0.r t>L State: ZIP: Ice maker Phone:s -j o Fax: I E-mail: Interceptor/ rease trap owner installation/residential maintenance only: The actual installation Primer(s) will he made by me or(!ie maintenance and repair made by my ular Roof drain(commercial) -- employee on the pr(, y4 o it tr O5 Cjte 447. OZ. Sink(s),basin(s),lays(s) - - Owner's si mature: Date: �G Snmp Tubs/shower/shower pan Name Urinal - --- Water closet Address: Water eater — City: State: ZIP: _ Other. Wit _t r� K-4140-* s Phone: Fax: Ls mail: 1'nlal Not Villa ud U ons>ac Cntd�ir earls. lease call Jurisdiction Gn morr information Minh t fee................$ _117. 1 M h 1 Notice: rhts permit application expires if a peanut is not obtained Fid..review(a( _ %) $ --� Credit card number: — -_� within 180 days after it has keen State surcharge(8%)....$ wires — - accepted as complete. TOTAL .......................$ L7r Name of c older u shown on credit trod p P $ +- o�Soa •°o C der dllmilure --- A1110111115! '90 440-4616(60MCOM) xay6r• 9° PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual)_ QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT 16 60 for each utility connection _ One 1 t bath $249.20 Tub or Tub/Shower Comb 16 60 Two 2 bath $350.00 — Shower Gnly16 60 Three(3)bath _- —_ $399.00 Water Closet — 16 60 — SUBTOTAL urinal 16.60 - 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _—_ TOTAL Garbage Disposal 16.60 - — --- Laundry Tray 1660 Washing Machine 1660 PloorDraiNFloorSink 2° - 1660 _ PLEASE COMPLETE: 3" 1660 ---- uantity b f Work Perfoed `rater Heater U conversion U like kirl r 16 GG Qrm Fixture Typo: New Moved Replaced Reapp edl Gas piping requires a separate mechanical perrnil _ —� Capped MFG Home New Water Service 4640 Sink MFG Homo New San/Sloan Sewer 46.40 Lavato Tub or Tub/Shower Hose Bibs 1660 Combination _ Roof Drains 16 60 V Shower_Only Drinking Fountain 1660 Water Closet — 16 60 Urinal _ Other Fixtures(Specify) Disnwdshet - - _ Garba a Disposal ---- - —` — Laundry Room Tra _ Washing Machine v _ _ Floor Drain/Sink: 2" Sewer-1 st 100' 5500 3° Sewer-each additional 100 4646— —_-4., Water Service- ist 100' 55 00 Water Healer _ — 46.40 Other Fixtures Water Service-each additional 200' — Sim 8 Rain Drain- ISI 100' 55 00 Slorm—&Rain Drain-each additional 100' 4640 — -- Comm-rcial Flack Flow Prevention Device 4640 -- '— --- Residential Backflow Prevention Device' 77 55 -- -- (;itch Basin 16.60 -- - _ -- — Inspection of Existing Plumbing or Specially 7250 f?ecLuesled Ins ectionsper/hr _ COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 — Grease Traps 1660 - ------ -- - --- QUANTITY TOTAL — Isometric or riser diagram Is mquirod It _ _ Quantity Total Is >9 `SUBTOTAL ---� - 8%STATE SURCHARGE _ --------- �— - ;'PLAN REVIEW 25%OF SUBTOTAL Required only it I'mure qty total is�0 TOTAL 'Mhdmum permit fee Is$72 50+8%state surcharge,except Residential Backflow Pmvenhnn Device,which Is$35 25•8%statr rcharge "All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. I\d.ts\forms\plm-fees.doc 08/29/01