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10810 SW HUNTINGTON AVENUE C) 00 a N z C 2 Z O Z D 1� rn i f t 10810 SW HUNTINGTON AVE Main Office solom Office Bend Office PO.Box 23814 30 Hudson Ave.,NE P.O. Box 7918 Inc. Tigard,Oregon 97281 Salem,OR 97301 Bend,OR 97708 Phone(503)684-3460 Phone(503)589-1252 Phone(541)330-9155 Carlson Testing C FAX(503)684-0954 FAX(503)589-1309 FAX(541)330-9163 Special Inspection FINAL SUMMARY LE17ER July 12, 2004 T0405321.G.GTI City of Tigard 1312.5 SW Hall Blvd., Tigard, OR 97223-8199 Attn: Building Department Re: Hawks Beard Townhomes (Lots 31-42) — Lot#37 10810 SW Huntington Ave - Tigard, OR Permit No.: MST2003-00307 Deal Sir or Madam: This is to certify that in accordance with Section 1701 of the Uniform Building Code, Title 24, we have performed special inspection of the following item(s) per our inspection reports only: Installation of Epoxy Anchors All inspections and tests were performed and reported according to the requirements of Project Documents and, to the best of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the strouctutal engineer's design changes, approvals and verbal instructions. Our reports pertain to the material tested/inspected only. ;nformatior intained herein is not to be reproduced, except in full, without prior authcrization from this office. If there are any further questions regarding this matter, please do riot hesitate to contact this office. Respectfu submitted, CARLSO, TESTING, INC. Jam T. Hietpas a 'ons Manager F /tt i cc Derek L. Brum & Associates Inc. -Bruce Come Froelich C isulting Engineers - Todd Nagle Mentrum Architecture -Bayard Mentrum CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 3 MST Z�'6_5 INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received Date Hequested__ '�` AM-. PM— BUP Location .___�d xSuite MEC Contact Person __- __ — Ph(_�__ _..) ��'` g�� ._ PLM Contractor _ - Ph SWR BUILDING Tenant/Owner _ ------- ELC - Footing Foundation —�—� ELC - -_ Access: Ftg Drain ELR _ Crawl Drain Slab Inspection Notes: SIT __-- Post&Beam __.-_-- Shear Anchc. Ent Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - - -_---- - -- -- Firewall �; Fire Sprinkler - �dL _"zi � . --- Fire Alarm Susp'd Ceiling - - — -y�- -- --- - -- ---- Roof n Other: Final PASS_ PART FAIL ---- �- -—�-- -- PWMBING _ Post& Beam Under Slab Rough-In Water Service - - Sanitary Sewei Raid Drains - ---- -- - - Catch Basin/Manhole Storm Crain Shower Pan Other: - -- ----..___ _ -- - F J_rlA)S PART FAIL - - -- -- -F4ec-HANICAL Post& Beam Rough.In Cas Line Smoke Dampers -_--- ---- _ Final PASS PART FAIL_ -- ELECTRICAL Service Rough-In UG/Slab L ow Voltage - - Fire Alarm Final L=1 Reinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _ PASS PART FAIL SITE ( Please all for reinspection HE:_ _—_-- �� Unable to inspect-no access Fiie Supply Line ADA Approach/Sidewalk Date - Inspector —_ Ext ---,- Other: xt _ ..-Other: Final DO MOT REMOVE this Inspection record from the Joh site. PASS PART FAIL �A AAAAAAAAAAA AAAAAAAAAAAAAAA_ 1AAAAAAAAAAAAA 4 v � b � ► A c ► CL r,, IR► a rD 4I � Q ° � �. ► 4 ;LA ro ► d d rD 4 Poo. 7 A G- b x•. �C `� ► t-+� m �T- O ( ► 4 r7rl M p " ► � yb � O O+ 1e�1 ► ro1�1 ► � r 4 j 4 � T ► pool � o y � I► 4 4 I � i a ► � s• rvivvvvvvvvvvvviTivvvvvvvvvvvvvvvvvvvvvvvvvva� CITY OF "rIGARD 24-Hour BUILDING Inspection Line: (503) " 175 MST �'� 3cJ INSPECTION DIVISION Business Line: (5 17; 1' BUP Received _- _ Date Requested— 7 Z"y __ A ___ __ Pk !_' BUP Location LJ S', U Suite ) MEC Contact Person _ � ��-r�? Ph(—. ) PLM _. Contractcr _ _ Ph SWR ----- _- ----- UILDING. Tenant/Owner —___ -__ __- ELC -- --� Footing— Foundation --- Ftg Drain Access: Crawl Drain ELR Slab Inspection Notes: SIT Post& Beam Shear Anchors —� - - Ext Sheath/Shear Int Sheath/Shear )/I, -, �^ Q -� 1 Framing 1 __ �' ` ��, , �- 7 J] Insulation (.W~ 44AI d l G/ Drywall Nailing Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling — Roof -- PASS PART Al — -�-- -- — PLUMBING Post&Beam Under Slab A L Rough-In - Water Service -- —� 1 S S Sanitary Sewer % S Rain Drains Catch Basin/Manhole. S �- Storm Drain - Shower Pan �ti. (� Other:--_,-_-- - Final U PASS PART FAIL MtEzaal. /171 Post&Beam Rough-In S Gas Line Sm ke Dampers it A PART FAIL - - -- -- -- — — CTRICAL Service Rough-In UG/Slab —_- ------------ Low Voltage Fire Alarm ------ -- -------�_` _ — Final PASS PARI FAIL Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. BITE — C] Please call for reinspection RE:_t — �� unable to inspect-no access Fire Supply Line ' _ /" ADA ! ` C' Approach/Sidewalk Date-- C �!. ---- Inspector �y rL_ Ext Other: __ Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY GF TIGARG 24-Flour BUILDING Inspection Line: (50 -41 T5MAST 1,0� 3-003c)-7 INS ECTION DIVISION Business Line: ( -41i1 BUP Received Date ,,Requested -T ! _ _ - AM------ _ PM- -__. BLIP _- Location /r✓ at o I -cam �-.r.��' Suite MEC Contact Persona"1�t-�{ - ph(_ _) 'Solo— 4 F2 PLM Contractor Ph(_ ) SWR BUILDING Tenant/Owner _ ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain _____ -- -- - Slab Inspection Noes: SIT Post&Beam Shear Anchors -- - --------- - Ext Sheath/Shear Int heath/Shear Framing _ Insulation Drywall Nailing --- - - -- - ----.. — --- - - — - - -- — Firewall Fire Sprinkler - — ---- ---- Fire Alarm Susp'd Ceiling -- - ----- - - -- — ---- Roof Olt --- SS PART FAIL -- - ING Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains --- Catch Basin/Manhole Storm Drain - -- -----�- ------ -- --- Shower Pan `• Other: - - --- -- — - Final PASS PART FAIL ----- -- ---- MECHANICAL Post& Beam Rough-In - Gas Line Smoke Dampers ---- Final T_ PASS PART FAIL -- - --- --- --- _ ELECTRICAL _ Service -- Rough-In UG/Slab Low Voltage _- Fire Alarm —�— — -- - - Final Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL -SITE Please call for reinspection RE:— _ Unable to inspect-no access Fire Supply LineADA / Approach/Sidewalk Date /Z\� JL — Inspector Other: Final _ DO NOT (REMOVE this Inspection record from the job site. PASS PART FAIL !� CITY OF .rIGARD _ MASTER PERMIT PERMIT#: MS-l-2003.00307 j DEVELOPMENT SERVICES DATE ISSUED: 12/23/2003 13125 SW Ha d.,Tigard,OR :17223 I,iXI3)639-Al 71 SITE ADDRESS: 10810 SVV HUNTINGTON AVE PARCEL: 1S133AC-11900 SUBDIV!SION: HAWK'S BEARD TOWNHOMES ZONING: R-25 BLOCK: LOT: 037 JURISDICTION: TIG REMARKS: New SFA dwelling. 6/15/04: Altered plan front 3 to 2-bath. BUILDING REISSUE: STORIES 3 FLOOR AREASREQUIRED SETBACKS REQUIRED _^ CLASS OF WORK: NEW HEIGHT: 32 FIRST: 4n of BASEMENT_ of LEFT: SMOKE DETECTORS: 'r TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 64�.; of GARAGE: 'C4 of FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS. 1 THRO 77H of RIGHT: 1 OCCUPANCY ORP: R3 BDRM. ,' BATH: TOTAL i 415 of VALUE 45 364 40 REAR: PLUMBING SINKS: 1 WATER Cl OSETS . WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN- WO TRAPS: LAVATORIES: 1 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: uiu SF RAIN DRAINS, CATCH BASINS: TURISHOWERS:. I GARBAGE DISP: 1 WATER HEATERS. i WATER LINES: 170 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL. FUEL TYPES TURN a 100K: 1 BOILJCMP<3HP. VENT FANS: 4 CLOTHES DRYER: 1 LPG FURN>•1001i: UNIT HEATERS: HOODS: 1 OTHER.UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 3 ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS _ _ MISCELLANEOUS ADO'L INSPECTIONS 1000 SF OR LESS: 1 0 200amp: 0 - 200amp WISVC OR FDR PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 2 201 •400 amp: ?.Of -400 amp tat W O SVC/FOR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 1 401 600 arr.-: 401 -600 amp. EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT MANU HMISVCIFDR: 661 • 1000 amp: 601+am1m-1000V MINOR LABEL: 1000+amp'Volt PLAN REVIEW SECTION Reconnect only: x•4 RES UNITS: 9VCIFDR),•225 A.: >600 V NO,:!MAL: CLS AREA/SPC OCC: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL. AUDIO R STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LN LT: BURGLAR ALARM: 01 H: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: OATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner. Contractor: TOTAL FEES: $ 6,073.29 AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN&ASSOCIATES 'hThis permit is subject to the regulations contained in the Igard Municipal Code,State of OR.Specialty Codes 9500 SW BARBUR BLVD., STE 220 4949 SW MEADOWS RD SUITE 400 and all other applicable laws. All work will be done In PORTLAND, OR 97219 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire If work Is not started within 180 days of Issuance,or If the work Is suspended for more than 180 days. Pllonc: 503-892-8758 Phone' 971-233-0075 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Rego: LIC 58699 rules are set forth in OAR 952-001-0010 through 952-001-0080. You me obtain copies of these rules or direct questions to OUNC by calling (503)246-1987. REQUIRED INSPECTIONS Ersn Cntrl 681-4444 Slab Insp Mechanical Insp Framing Insp Shear Wall Insp Shear Wall Insp Sewer Inspection Plm/undslb Insp Low Voltage Gas Ling Insp Shear Wall Insp Shear Wall Insp Footing Insp Electrical Service Plumbing Top Out Gas Fireplace Shear Wall Insp Shear Wall Insp Footing Insp Electrical Rough-In Framing Insp Insulation Insp Shear Wall Insp Shear Wall Insp Foundation Insp Mochanlcal Insp Framing Insp Shear Wall Insp Shear Wail Insp Shear Wall Insp Issued By :?-�' ' ^•� _ Permittee Signature : 4' Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGARD 13125 S.W. WALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ELECTRUM INC DBA SPECTRUM ELECTRIC 2050 VISTA AVE #100 SALEM, OR 97302 Electri:;al Signature Form Permit #: MST2003-00307 Date Issued: 1212312 (" Parcel: !c133AC-I-IB037 Site Address: 10810 SW HUNTINGTON AVE Subdivision: HAWK'S BEARD TOWNHOMES Block: l-ot: 037 Jurisdiction: TIG Zoning: R-25 Remarks. New SFA dwelling. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER. ELECf"RICAL. CONTRACTOR: AUTUMN PARK TOWNHOMES, LLC ELECTRUM INC 9500 SW BARBUR BLVD., STE 220 DBA SPECTRUM ELECTRIC PORTLAND, OR 97219 2050 VISTA AVE #100 SALEM, OR 9'1302 Phone #: 503-892-8758 Phone #: 503-361-1256 Reg # 1 1( 110453 �. 1) tow i I 1 24-353C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician If you have any questions, please call 503.718.2433 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE PLUMBING EXPERTS INC 11925 SW PARKWAY PORTLAND, OR 97225-5413 Plumbing Signature Form Permit #: MST2003-00307 Date Issued: 1212311003 Parcel: 1 S133AC-HB037 Site Address: 10810 SW HUNTINGTON AVE Subdivision: HAWK'S BEARD TOWNHOMES Block: Lot: 037 Jurisdiction: 1 iG Zoning: R-25 Remarks: New SFA dwelling. 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 Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: AUTUMN PARK TOWNHOMES, LLC PLUMBING EXPERTS INC 9500 SW BARBUR BLVD., STE 220 11925 SW PARKWAY PORTLAND, OR 97219 PORTLAND, OR 97225-5413 Phone # 503-892-8758 Phone #: 503-469-0443 Reg #: LIC 149035 PLM 34-391 PB AN INK SIGNATURE IS REQUI`<ED 0.14 THIS FORM Sigr;ature of Authorized Plumber If you have any questions, please call 503.718.2433. CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SVVR2003-00241 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/23/2003 SITE ADDRESS; 10810 SW HUNTINGTON AVE PARCEL: 1S133AC-HB037 SUBDIVISION: I IAWK'S IWARD TOWNHOMES ZONING: R-25 BLOCK: LOT: 037 JURISDICTION: 1-1(i TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SUPFACE: Remarks: Sewer connection for new SFA dwelling. Owners ------- �.____ ---- - _ FEES _ AUTUMN PARK TOWNHOMES, LLC -�--- -- ��- 9500 SW BARBUR BLVD., STE 220 Description !Date Amount PORTI-AND, OR 97219 [SWUSA] Swr Connect 12/23/200: $2,400.00 (SWUSA] Swr Connect 12/23/200; $0.00 Phone: 503-892-8758 ISWINSPI Swr In.;pect 12/23/200; $35.00 ISA'INSPI Swr Inspect 12/23/200< $0.00 Contractor: Total $2,435.00 — Phone: Reg #: Requited Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 130 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 later,'. AI-TENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these roles or direct questiuns to OUNC by calling(503) 246-6699. Issued by: �. Permittee Signature- Call ignature Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business clay VOR IUME,ONLY Building Permit flDlication Received , N, Building tt r 1 �°%'I DatefBv: �% °: Permit No. �Q3 Planning Appro I Other JGI�/2''d �,' n City of Tigard JUN Z "7 ?�1DateJBv: PermitNo.: 13125 SW Hall Blvd Plan Review other Dir a ". 0; 6f Permit No.: Tigard,Oregon 97223 CITY OF 7 1 Post-Review [arid Use Phone: 503-639-4171 Fax: 503} @{� (. Date/Bv: Case No. Internet. www.ci.tigard-onus Contact tuns.: I 2g See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: 72 CLI Supplemental Information - TYPE OF WORK REQUIRED DATA: ' New construction Demolition I &2 FAMILY DWELLING Addinon/alteranon/re lacement I Other: CATEGORY OF CONSTRUCTION Note: Pemut fees'arc based on the total value of the work performed. Indicate the value(rounded to the nearest dollar)of all equipment.materials,labor, 1 &2-Family dwellin Commercial/Industrial overhead and profit for the work indicated on this application. Accessory Buildin Multi-Farnilv ��iS3Ly 00 Other: Valuation................. .............. Master Builder No.of bedrooms: No.of baths: Z 2 JOB$ITE INFORMATION and LOCATION Total number of floors..................................... Job site address: 10e( S ^� llJ I New dwelling area(sq. ft.).............................. Suite#: Blde.!A t.#: Garage/carpon area(sq. ft.)............................ 5s�_ P oiect Name: N W ICS "I�� "21ANcM�S Covered porch area(sq: ft.)............................ — Deck area(sq. ft.).. Cross street/Directions to job site: Other structure area(sq. ft.)............................ Sw1 13t�TM , VfWVg /a+� Sr/. Jl�tWcCs BEA f I REQUIRED DATA: COMMERCIAL-USE CHECKLIST •. ubdivisl,on: I' a Let#: '1 Tax rilaD/parcel #: Note: Permit fees*are based on the total value of the work performed Indicate DEsr_RIPTION of woRx the value(rounded to the nearest dollar)of ail equipment.materials,labor, overhead and profit for the work indicated on this application. nu( oF= NELJ 3 srtc+ wt>E - Valuation......................................................... S FLt� Existing building area(sq. ft.)......................... _ New building area(sq. ft.)............................... Number of stories............................................ ROPERTY—OWNER TENANT Type of construction....................................... - P. Occupancy group(s): Existing: Name: ITfLrn fJ P*K T0N.lrl L L•L•G New: Address: 4<.&) S W Lam'-RUte 9 SV Z Zf� _CL/S : -flU�t" �� , c 2 q-7 2-11 2 5 FaX: 3 I%A2 NOTICE: All contractors and subcontractors are required to be Phone: 5o3 � '� � licensed with the Oregon Construction Contractors Board under APPLICAJq -CO�NTACT PERSON - ' provisions of OILS 701 and may be required to be licensed in the Business Name: AgU#6 4 jurisdiction where work is being performed. If the applicant is exempt from licensing,the following reason applies: Contact Name: ry1 tt K l•�Kw a2 elct �''Z Address: qSo S,0 �, �zw City/State/Zip: X12 Yort Phone: 4J? 092-E- 8 _ Fax: 15bZ eal? BUILDING'PERMITFEES*, E-mail: •,i I lexsf refer to fee schedule. - CONTRACTOR Business NaI71�: r L— �dG_t ASY!AKI 1AJ61 Fees due upon application.............................. Address: '15W Stn/ kaw_ 9U[D j SUA ZZc7 ................I............... s City/State,/Zl_�__: 1�¢r_(� q� Amount received............ Phonj3-6q?,-f�7s8 Fax: SrtS FJg2- Date received:_ — CCB Authorized `` �� Notice: This permit application expires if n permit is not obtained within �ilgnanlre: 1' l Date: ^l[ IRo days after it has been accepted as complete_ MA-4 , � � *Fee methodology set by Tri-County Building tadustry Service Board. (Please print name) 1:\Dsu\Ferrmt Fortro\BldgPetmitApp.doc 01/03 NLY _Electrical Permit Application FOR ° ',t,� t _ DatFA Permit No.: �/.S A 0,91' City of Tigard R EC E i V Planning Approval Sign DatelBv: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223I I DateMv: __ _ Permit No.: Phone: 503-6394171 Fax: 503-59 - �� FEIst-Review Land Use hr, Internet: vww.ci.tigard.or.us CITY OF ' DateBy Casc No.:Contac' Juris.: Z See Page 2 for 24-hour Inspection Request: Name/Metr,ad: Supplemental information. TYPE OF WORK PLAN 1%V,EW(Please check all that apply) New construction Demolition Service over 225 amps- Health-care facility commercial ❑Hazardous location Addition/alteration :r: ;iacement Otller: Service over 320 amps-rating of ❑Building over 10,000 square feet. C_A.TEG( R' OF CONSTRUCTION 1 &2 family dwellings four or more residential units in 1 & 2-Family dwellins �_ommerciaUIndustrial ❑System over 600 volts nominal one strucnire Accessory Building Multi-Family E]Building over three stones C]Feeders,400 amps or more _ ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder I LJ Other: ❑Egressr1ighting plan ❑Other: JOB SITE INFORNLMON and LOCATION Submit_sets of plans with any,)f the above. The above are nota Ilcable to temporary construction service. Job site address: I la_ 5W ,JTW4*J FEE*SCHEDULE Suite#: Bl g./A t.#: Number of Inspections per permit allowed Project Name: S iKEM ! LsJNfI(JfyiC5 Description I Qty I Fee(ea.) I Total New residential-single or multi-family per i Cross street/Directions to job site: /�, dwelling unit.Includes attached garage. S� ��" Service Included: d 1000 sq.ft.or less 145.15 IA5,15 4 CA4 Each additional"00 sq. ft.or portion thereof L 33.40 66.#0 1 1 Limited ener .residential 75.00 ii1q.W 1 2 Subdivisioi ,tl" (IIenal 75.00 2 Tax maTj_/parcel#: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 Services or feeders-installation, A11/ -C��JFJ Cr EJ_) 3 sralteration or relocation: --fV W wf �k� to 200 amps less 80.30 2 201 amps to 400 ams _ 106.85 12 401 amps to 600 ams 160.60 1 2 ROPERTY OWN R. TENANT 601 ams to 1000 ams 240.60 2 'IOver 1000 amps or volts 454.65 2 -I,,� Name: (J� ��T iJe►"G,5 LL_ Reconnect only WY 66.85 2 Address: q 54A) t"e-QL- SU INS 22Z Temporary services or feeders-installation, Alteration.or relocation: City/State/Zip: f TL}}r'( Ce '?,19 200 am s or less ^` 66.85 I Farr 92 201 amps to 400 amps 100.30 2 Phone — �� 401 to 600 amps "-- W-75 2 APPL ANT CONT CT PERSON Branch circuits-new,alteration,or Name: ETZZ Lt Ar;Jc,�$ i i X, extension per panel: Address: U 1� Z20 A.Fee for branch_ircuits with purchase of 6.65 2 ISCservice or feeder fee,each branch circuit C1 /State/Zi G�. 2 B.Fee for branch circuits without purchase of pC service or feeder fee.first branch circuit 46.85 2 Phone: �2 S Fax: 563 W Each additional branch circuit 6.65 2 E-mail: Misc.(Servtce or feeder not included): «T CONTRACTOR Each tunp or tmgation circle 53.40 2 Each signor outline lighting 53.40 2 1'1ml-11111 111C Signal circuit(s)or a limned energy panel. 2050 Vista Ave 11)11 alteration.orextension Page Z 2 Description: Salem OR 97302 503-361-1?��) Each additional insnectlon over the allowable In any of the above: Per ins ction per hour(min. I hour) ('C'B:116453 ELC:24-353(' S1,111:2919S Investition fee: Other Llc. #: r. CCB LIC. #: Electrical Pertii[rFea' Supervising electrician Subtotal S signature required: _ Plan Review(25%of Permit Fee) S Print Na Lic. #: State Surcharge(8%of Permit Fee) S — TOTAL PERMIT FEE S Authorized Notice: This permit appl:cation expires If a permit Is not o--cu wnntn Signature: _ Dater 180 days after It has bren accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. CV?nf-Ic S03 (Pleaft print name) 1:\Dsu\Permit Forms\ElcPermiL4,pp.doc 01/03 s•4a FOR OMCE USE ONLY MQ� chars cal Permit Application ,�eived Mechanical �,S Datemv: Pertnit No. ,V REC L t 4 E L Planning Approval Building City of Tigard Datc/Bv: Permit No.: 13125 SW Hall Blvd- Plan Review other Tigard,Oregon 97223 (()N i n(i; Date/Bv. Permit No.: Phone: 503-639-4171 Fax: 503c i Y ")F� Post-Review Land Use DatcrBv: _ Case No.: Internet: www.ci.tigazd.or.us Contact Juns.: See Page.'for 24-hour Inspection Request: 50f-Wj Q� DI Namc.Method: Supplemental Information. TYPE OF WORK COMMERCIAL FEE'SCHEDULE-USE CHECKLIST New construction I I I Demohtio_n Mechanical permit fees'arc based on the total value of the work Addition/alteration/re lacement I Lj Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical matenals,equipment, labor,overhead wid profit. 1 &2-Famil dwellin Commercial/tndustnal Value: S See Page:for Fee Schedule Accesso Buildin Multi-FamilyRESIDENTIAL E UIP11VfENT/SYSTEMS FEE*SCHEDULE Descri tion I QL' Fee(ea.) Total Master Builder Other: Heating/Cooling JOB SITE IINFORIMATION and LOCATION Furnace-add-on air conditioning" 14.00 Job site address: 0,Y/ A) O 77 GTpIJ tle I Gas heat pump J _ 14.00 Suite #: I Blde./A t.#: Duct work 14.00 I .°° Project Name: �" ,, � Hvdromc hot water system 14.00 Residential boiler Cross street/Directionsto j ob sit (for radiator or hvdronic systern) 14.00 �-M .Sw � A,/ UC, SW 414-111A�S Unit heaters(fuel,not elecmc) (in wall,in-duct,suspended,etc.) 14.00 Flue/vent(for anv of above) 10.00 I U•a Subdivision: Ah/ EAE'D Lot#: Re air units A 12.15 Other Fuel Ap liances Tax ma / arcel #: Water heater 10.00 ju.•' DESCRIPTION OF WORK Gas fireplace 10.00 to, w 77 OF Co) 3 S1-oe Flue vent(waterheater/ as firep lace) 10.00 2.v." W� Y►'i P(?,) ELS ' S(>1 Lo lighter( as i (0.00 Wood/Pellet stove 10.00 Wood fireplace/insert 10.00 Chirnne /liner/flue/vent 10.00 PROPERTY OWNER / TENANT Other: 10.00 Name: m l T()W J q0 Y! S L� n Enviromental Exhaust&Ventilation Range hood/other kitchen equipment ( 10.00 10.10 Address: ,;W SN/ SJ i k Z Z'() Clothes dryer exhaust 10.00 10 a Ci /State/Zi a-r je Q-7 2 l Single duct exhaust Phone: 503 'Z- S Fax:(5S)89Z- '' (bathrooms,toilet compartments, APPLICANT M CONTACT PERSON utility rooms) 6.80 Z�•Lv Name: ( . B(?nW� b �4SS�c/M'CS /�C Articicrawl ace fans 10.00 --�-- Other: 10.00 AdI (�L ' �1I?* ZZv Fuel Piping City/State/Zip:, Tot-7'l�r'71 d 2l •"(55.40 for first 4.S1.00 each additional) Phone: Su3 �2-8'15 Fax: Sri ?'-ee Furnace,etc. " Gas heat um _ " E-mail: r>vow&C(2.d I brdcje%c sVc)(: .c4r-,, Wall/suspended/unit heater " CONTRACTOR --� Water heater " Fireplace I " Sn)art Heating & Cooling LLC --- 7616 NE Everett St Range 6BQ Portland OR 97213-6347 •• Clothes dryer(gas) 503-254-5096 Other: " ('('B: 154133 — Total: _ — Mechanical Permit Fees* Authorized Signature: Date: Subtotal: S 'Si C�.(nC� �- t'" Minimum Permit Fee$72.50 S Plan Review Fee(25%of Permit Fee) $ (Please print name) State Surcharge(8%of Permit Fee► S •'t TOTAL PERMIT FEE S Notice: This permit application expires If a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board. 1110 days after It has been accepted as complete. **Site plan required for exterior A/C units. i:\Dsts\Perrnit FormswecPetmitApp.doc 01103 tS1111U111b t lel ut c T��1 t. FOKOF CE USE ONLY ng PlumbiPerim ADDIW Plum Received bing on - DataB l Permit No.: S Planning Appmvai Sewer City of Tigard SUN 2 7 20D,� Data]3v: PennitNo.: 1.3125 SW Hall 131vd. Plan Review other Gl7Y OF 1 IGAFiI. DVJBv_ Permit No.: Tigard,Oregon 97223 ;Datei Review Land Use Phone: 503-639-4171 Fax:IM905k f VISI( Bv: Case No..Internet: www.ci.tigard.or.us act Jurs.: Tybee Page 2 for 24-hour Inspection Request: 503-639-4175 _ h,,d: Supplemental Information. r ,: OF WORN FEE` SCHED[J`i.E.(for special information use checklist) New constivcnun Demolinun Description pty. I feetea.l Total _ New 1-& (arttily dwellings (]^Ndditlon/altei at1O1L're_Lacement Oiher (includes 100 ft.fur each utility connection) CATEGORY OF CONSTRGCTION SFR i i 1 hath 241)20 `2_ . Commercial;Lndustrlal 350.00 -- 1 & � Camil� dwellint- I SFR i_)bath u . Accessory Build[nt ! tilulti-Fannly _ SFR 131 bath 399.u0 y•� I- Each additional bath/kitchen 45.00 Master Builder I Other: Fire spnnNaer-Sa. ft.- Pace 2 JOB SITE INFORMATION and LOCATION Site [itilities Job site address: r til /A'( 7 Catch basin/area dram 14.60 Suite +: _ B1da.rapf" --�---� Drvwellileach llne.,trr_nch drain 16.60 Pro ect Name: k �FA�Z"T) �LG�- Founns drain Ino. linear ft. _I_pale Manufactured home utilities I 110.00 Cross streeUDtrections to job si/t,. p�W��S _ L� , !�v tom, ,�h/E^��E JtM� Manholes Ih.60 Sirlfi Rain drain connector16.00 � Sanitary sewer i no. linear ft.) Page 2 Storm,ewer ino. linear tt.lPaee 2 ion' Lot 7 Waterservceno. linearft.l Paeemaoi afCel #: Fixture or item DESCRIPTION OF WORK Absorption valve 16.60 Paee_ )rlSi �+C nC�-Q__� Backilow reverter 16.60 Fir UJ3S��. I p Backwater valve pf�, LT- L� (.0 SQL t Clothes•washer 16 60 _ _Dishwasher 16.60 _ Dnnkin r fountain 16.60 RO�L�F OWNER TENANT E ectorsrsump 16.60 �Narmne: K1[J moi! -r hf�y� 5 �!„(�� Ex ansion tank _ I 10.60 -,�' rl I Fixture;sewer car) 16.(10 _ Address: �&X 5 VJ f�`�2 �l-�!Sal' Z ZL) Floor dratrvfluor smluhub _ 16.60 City/State'Zip: fl2taCONTAC �Z Garba¢cdis osal 16.60 Phone. > 503Cq I Hose bib 16.60 APPLICANT T PERSON Ice maker 16'60 pl(,. Interce tor/grease trap 16.60 Name: t>U� k I __(�, vJ/J d��OC1�H I_.- - - Paee 2 a ,) (Z,(Cg�,L 91-VL, SU tTt Z2c� Medical las-value S address: 9,;� � Primer 16.60 City/State C-4-1 It Roof drain i cum_merciall 16.ri0 4 l� Sinlubastrrlav_atory Ifi.60 _ Phone3� �s�' F�'rSOj___ 1 - _ 16.60 Tub,showerrshower an Email: r,•lpcic d i , <crL�_ r'` __ --16.60 _ Unnal CONTRACTOR - _ 16.60 - -- -' Water CIUSCt Plumbing FAIlt-•I'ts 1110 Water heater _- � 16.60 119-15 SW Parkway Other: IIto Ikind OR 97225-5413 Other Plumbing Permit Fees' 503-469-0443 Subtotal S q CCB: 149035 PLM: 34-�91 P13 I Minimcum Permit Fr572.50 S Authorized / Residential Nackflow Minimum Fee 536.25 Signature: /:_r� E Dare: � , �3 - plan Review 125°'.of Pet�rttt Feel S r'CmN� State Surcharge 18%of 11ermit Feel S� --_ _ (Please..print name) _"TOTAL PERMIT FEE S _ Norice: This permit application expires if a permit is not obtained within All new commercial buildings require-sets of plans with isometric or IAO days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri-4-aunty Building industry Sen ice Board. `.)sts�Permrt Forms•PlmPenmtApp.doc 01/03 , PROJECT NO. MATO S.W., HQNTING ,dN AVE. STREET 8 SS BARRICADE DATE: 2L9L0_3_ F . D L ---------- DRIVE DRIVE r t3LUW—Ur. C ITY QF TIGARD ILDING DIVISION ............ 29.0 34.0'/,-, WATER METER _Z_ a 1 3 Ch WATER METER 8' PUE 6" SO I 1 —7 C) 0 I I ad LOT 37 100 m LOT 3E 1-t 't I 1.392 SF 1,632 SF rz PAD ELEV=2C7.0 PAD ELEV=207.c 29.0 34.0' LOT 35 LOT 36 c%4 1,285 SF 1,506 SF D ELEV=207.0 PAD ELEV=207.0 Lu 1" WATER 0 CL < 1" WATERCZ 00 Z 2.5' PUE 0 �- C) 29.0' 34,0' co 3: zx 0 M, �b Z= Li Z ry -00 0 Z) 0 0 (A 0 = V) LA Ln ;-0 0 DRIVE `4T C4 o DRIVE IL 000 co it 8" rL Ss okA 0 - < rJ00*07'18"W_-1 < Z 0 Z S D a_ On BRIARWOOD PL. 0151. 0 C) NOTE: WATER METERS FOR _aETE3/lCKS LOTS 33 AND 34 ARE GARAGE (PUBLIC.) = 20' LOCATED ON THE NORTH GARAGE (PRIVATE) = 80 SIDE OF WOODBRIDGE LANE, FRONT YARD (PUBLIC) = 15' WEST OF BRIARWOOD PL, FRONT YARD (PRIVATE) = 3' is REAR YARD = 15' 35, 36 SIDE YARD = 3ri��' 0 PER FIRE CODE) STREET SIDE = 10' S N4e" _20') CITY OF TIGARD - SATF PLAN REVIEW B L J I L D I N G PERMIT NO.: 42D03 3 PLANNING DIVISION: Required Setbacks: I .4,pproved J 0 Not Apprmed �Idv: Street Side: I F'rnnt. Garaue: r� hear: _:... Visual( learance: Q9 Approved ❑ Not Approve(I maximum Building Height. 3,, feet CWS Service Provider Letter Required: Q Yes No _ [7 R.k•(.-ived Date: NI::E-'1 N(i DEPARI MI NT: r-kCtUal Slope:_j2_% [TApproved 0 Not Approved Site plan: ['Approved ❑ Not Approved ;v Date: Y 2LI03 Cl" OF TIGARD Residential Certificate of Occupancy Permit Q (J d �y Address: No.: .,-1.. --- --- - - - - - Owner/Contractor: Date of Final Inspection: 9/.)'(/6 L Inspector: _This structure has been found to be in substantial compliance with the provisions of the State of Oregon One& Two Family Dwelling Specialty Code and is hereby approved for occupancy. -- --