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10815 SW HUNTINGTON AVE
CITY OF TICARID 2, H--ur
(
BUBUILDINGInsP Inspection !_ii�. 503)639-417MST •�5 Qo4) —_ �'d=3r?
INSPECTION DIVISION Business Line: (503)639-4171
BIJP
Received ____ __. ------- Date RequestedAM___ PM __ Blip
Location Suite
MEC --------- --
Contact Person _ _------_--_-_ Ph i� -- V, -7 PLM — ------ -__--- -_
Contractor - _- -- _ Ph(-- - -) _ - SWR -------- -_-
BUILDING Tenant/Owner _ ELC
---- ------ -
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam - _. ---_-----___--
Shear Anchors - ---- --- -- ---
Ext Sheath/Shear
Int Sheath/Shear
Framing -- - —
Insulation Y,
Drywall Nailing - -
Firewallb `k A C _,`� L 1.
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling ---
Roof
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
�ier:
Frttbi -------_
PASS_ PART FAIL
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL—
ELECTRICAL
Service ---- — -�_� ---- - --- _� --- ----------- ---- --
Rough-In --�--
-
Fire Alarm 4�'
(�] Reinspection fee of$___ _required before next inspection. Pay at City Hall, 13125 SW[loll Blvd.
FAS FPARQV�
Please call for reinspection RE:_.- _.. Unable to Inspect- no access
Fire Supply LineADA
l
Approach/Sidewalk Date Q 1 _ Inspector _ ""�`- �''"- _ Ext
Other:_-
Final DO NOT REMOVE thinr inspection recordfrom th Job site.
PASS PART FAIL
CITY OFTIGARD 24-Hour
BUILDING Inspection Line: (513)639-4175 MST SOU 3'�3
INSPECTION DIVISION Business Line: (503)639-4171 BUP
Received - _ Date Requested— __ AM � PM ____ BUP
Location _ ����� v+lite MEC _
Contact Persor _ Ph PLM
Contractor Ph( ) _. _ SWR
BUILDING Tenant/Owner ELC
Footing --- ELC -_.-
Foundation Access:
Fig Drain ELR
Crawl Drain -- -----------
Slab Inspection Notes: SIT _----- .----- ---.
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - - - - -
Insulation
Drywall Nailing - -- -- -- - -
Firewall ri'1✓ /
Fire Sprinkler ,J — ----�
Fire Alarm _
Susp'd Ceiling
Roof I -- -- —
Other:
Final
PASS PART FAIL
PLUMBING_
Post&Beam
Under Slab ---_ — _----_—� —_ --
Rough-In
Water Service -- - --
Sanitary Sewer
Rain Drains - ----- �_ —. -
Catch Basin/Manhole
Storm Drain
Shower Pan
PART FAIL — - -
CHANICAL
Post&Beam
Rough-In — -- - - -- - —
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In --
UG/Slab
Low Voltage _ ----____— -----_—_ — —
Fire Alarm
Final F-1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ F� Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date �_ � U Inspector_ - -- Ext
Other:-- -- - ------
Final DO NOT REMOVE this Inspection record trona the fob site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (50 MST MST �DG�3�d03(7
INSPECTION DIVISION Business Line: (50 1
BLIP
Received __ _ Date Requested f CJ ._�� _ AM---,PM 8UP _
Location ._-_—f L x I�� 244ea413_!�11 -4111 Suiitee�_��L�—__ MEC
Contact Person Ph(._ ) = _ PLM
Contractor Ph( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation EI_C
Access;
Fig Drain ELR
Crawl Drain
Slab Inspection Noies; SIT _-_—
Post&Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear ` ` ' �_�_
Framing
Insulation
Drywall Nailing - 1• --
Firewall
Fire Sprinkler
Fire Alarm l-,l 6 If-�" tv a r -a-rC
Susp'd Ceiling
Roof
Jther:. (�
"SS PART
frAIL ' 1
PLUKARING
Post&Beam — 1p
Under Slab
Rough-In r 1 L-
Water Service
Sanitary Sewer Inn � ' `
Rein Drains — r 1 V^ s
Catch Basin/Manhole
Storm Drain ----- `. --
Shower Pan
Other-
Final
_ PASS_ PART FAIL
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers ------ -- — - --
t=in
AS PART -- — -- ----
E TRICAL
Service --- -- ---- � `_--�
Rough-In
UG/Slab
Low Voltage —. --- -- — ----------- - - -
Fire Alarm
Final ❑ Reinspection fee of$ required before next Inspection. ^ay at City Hall, 13125 SW Hall Blvd.
_PASS PART FAIL
SITE Please call for reinspection RE: — C1 Unable to inspect-no access
Fire Supply Line rr
ADA � b \ D
Approach/Sidewalk Date—_ -- _._ Inspector _ _ _ 4/�--'"' Ext --------
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGrARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
FiUP
Received . Date Requested_ l�' " AM____PM_ 6!1P
Location T_�L' _ Suite MEC
Contact Person — - __,. Ph( ) �(v w ` `17 _-_ PLM -----_—_-- _ --_
Contractor_— -- --- - -- -- - Ph(,---) SWA
-
BUILDING _ Tenant/Owner ._.-_ -__— - _ _
ELC
Footing
Foundation ELC
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 - --- - - -
Roof
Otflr:-- -- ---- - ---
&AS
r _.�ART FAIL
_ INC,1��
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& Bearn `'
Hough-In j QGas Line (Smoke Dar ` �\�
s -
ma -
1SASS PART FAIL - - - - --
ELECTRICAL
Service
Rough-In ---_---- _------- -- - —
UG/Slab
Low Voltage ----._ ---- - _- -- --- --- _----
Fire Alarm
Final U Reinspection fee of$- _-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
PASS PART FAIL
SITE Please call for reinspection HE: _ -� Ur:able to inspect-no access
Fire Supply Line
ADA r1.
Approach/Sidewalk Date �� ��_fl [_ Inspector .-Z l� _ Ext --
Other:
Final DO NOT REMOVE this Inspection record frons the,fob site.
PASS PART FAIL
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MASTE
ERMIT
CITY OF TIGARD PERMIT
: MST2
PERMIT#: MST2003-0031.1
DEVELOPMENT SERVICES DATE ISSUED: 12/23/2003
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171
SITE ADDRESS: 10815 SVV HUNTINGTON AVE PARCEL: 1 S133AC-HB062
SUBDIVISION: HAWK'S BEARD TOWNHOMF_S 'ZONING: R-25
BLOCK: LOT: 002 JL' JSDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIS 32 FIRST: 105 of BASEMENT, a1 LFFT: SMOKE DETECTORS: 'r
TYPE OF USE: SFA FLOOR 40 SECOND: 035 of GARAGE: 404 of FRONT. PARKING SPACES
TYPE OF CONST: 5N DWELLING UI 1 THRO: 709 N RIGHT
VALUE: Iq1 744 BU
OCCUPANCY GRP: R3 BDRM I BA1. 2 TOTAL: 1,453 a1 REAR
PLUMBING
SINKS. 1 WATER CLOSETS: WASHING MACH. 1 LAUNDRY TRAYS: RAIN DRAIN 10^ TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS. CATCH BASINS:
TUB/SHOWERS 1 GARBAGE DISP: I WATER HEATERS. I WATE, .INES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTNFR FIXTURES
MECHANICAL
_ FUE.L.TYPES _ FURN<10OK: 1 BOIUCMP<3HP: VENT FANS: 1 � CLOTHES DRYER: 1
1 PG FURN 1=150W UNIT HEATERS: HOODS: I OTHER UNITS: I
MAX INP blu FLOOR FURNANCES VENTS: z WOODSTOVES: OAS OUTLETS: 3
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: W/SVC OR FOR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 5005F- 2 201 400 amp: 201 •400 amp: tat W10 SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: I 401 •600 amp: 401 5110 amp: FA ADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 501 • 1000 amp: 501+ampa•1000v: MINOR LABEL:
000+amolvoll
PLAN REVIE W S EC TION
Reconnect oniv:
>=4 RES UNITS: SVCIFDR>•225 A.: >800 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO&STEREO. VACUUM SYSTEM: AUDIO&S1EREO: FIRE ALARM, INTTRCOMIPAGING OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LQNDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,065.71
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN 8 ASSOCIATES Il�his permit Municipal
subject to the regulations contained in the
9500 SW BARBUR BLVD.. STE 220 9500 SW BARBUR Bl "'j#220 and
al other pal Code,State of l work
Specialty Codes
PORTLAND, OR 97219 PORTLAND, OR 41219 and all other applicable laws. All work will mi done in
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 18r,days.
Phone: 503-892-8758 Phone: 503-892-8758 ATTENTION: Oregon law requires yoo to follow rules
adopted by the Oregon Utility Notification Center. Those
Roo 0: LIC 58699 rules are set 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
Ersn Cntrl 681.4444 Plm/undslb Insp Plumbing Top Out Shear Wall Insp Water Line Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insl Water Service Insp Building Final
Footing Insp Electrical Rough-in Gas Line Insp Firewall Insp Smoke Detector
Foundatlon Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab Insp Low Voltage Insulation Insp Raln Drain Insp Plumb Final
Issued By : lam" .__ - Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF T I GA R D SEWER CONNECTION PERMIT
DEVELO' '/TENT SERVICES PERMIT#: SVVR2003-00251
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/23/2003
SITE ADDRESS; 1081.5 SW HUNTINGTON AVE PARCEL: 1S133AC-HB062
SUBDIVISION: IIAWK'S 13LAR1)'1OWNIIO%11`S ZONING: R-25
BLOCK: LOT: oo-, JURISDICTION: 116
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW (DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SFA dwelling.
Owner:
FEES _
AUTUMN PARK TOWNHOMES, LLC Description ' Date Amount
9500 SW BARBUR BLVD , STE 220
PORTLAND, OR 07219 ISWUSA]Swr Connect 12,'23/200: $2,400.00
S W USA] Swr Connect 12/23/200: $0.00
Phone: 503-892-3758 1SWINSP)Swr Inspect 12/23/200; $35.00
Contractor:
ISWINSP) Swr Inspect 12/23/200; $0. 00
— — -
- --- Total $2,435.00
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180
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. ATTENTION: 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 nines or direct questions to OUNC by calling(503) 246-6699.
Issued by: moi' 1 _ Permittee Signature:
Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
FOR 0- FICE USE ONL*
• B11lildin Permit Application ReceivedBuilding
f/Y Permit No.
Planning Ap val Other
City of Tigard Date/By: Permit No.:S ;2!
Plan Review Other
13125 SW Hall Blvd JUN �I,��I� Dawg ; PermitNo.:
Tigard,Oregon 9721.��jtr.'L56�8460
Post-Review [and Use
Phone: 503-639-4 DateJBv: Case Na.
G D l V l g i 0 nl
Internet: WWW.Cl.h n_ Contact Juris.: See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: SuRplement2i Information
TYPE OF WORD REQUIRED DATA:
New consf
Demolition I &2 FAMILY DWELLING
Addition/ re lacement Other:
Y OF CONSTRUCTION Note: Perrtat fees*are based on the total value of the work performed. Indicate
1 &2-Fain Commercial/industrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
overhead and profit for the work indicated on this application.
Accessory Buildin Multi-Family
Other: Valuation.................. ..................................... I i/ y4 N
Master Builder No.of bedrooms: No.of baths: A
JOB SITE INFORMATION and LOCATI N Total number of floors..................................... _ �i —
Job site address: I C New dwelling area(sq. ft.)..............................
Suite#: Bld ./A t.#: Garage/carport area(sq. ft.)............................
Pro '4 Name: W1CS t 'tvw!►�lF4�M6S Covered Nath area(sq. ft.)............................. _
Deckarea(sq. ft.)............................................
Cross street Directions to job site: Other structure area(sq.ft.)............................
SW I To— AV"E fa+b S.hJ. gAws 13th,
STS ' , REQUIRED DATA:
COMMERCIAL-USE CHECKLIST
Subdivision: ova Lot#:
Tax ma /parcel #: Note: Permit lees'are based on the total value of the work performed. lnd4care
DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials.labor,
overhead and profit for the work indicated on this appiic:tion.
1�4T�rrl_ NFLJ S Srayte G
V-duatton.........................................................
Existing building area(sq.ft.).........................
New building area(sq. ft.)...............................
Numberof stones............................................
--�• —T Type of construction...................................... _—
PROPERTYOWNER TENANT Occupancy group(s): Existing: —
Name: UTLm fJ P K V-1 .`4, '�
New:
Address:95W hl Rine &- Sl1 Cit /State/Zi : 7co) O G�?_19Phone: So3 �Q2$75 Fax:�3 �� NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
PLICANT CNTACT PERSprovisions of ORS 701 and maybe required to be licensed in the
Business Name: Agal#s jurisdiction where work is being performed. If the applicant is exempt
from licensing,the following reason applies:
Contact Name: rhe K (•�ibJ.� u at- ie r PeA%j _
Address: St3o SA Mae- 210
CiT /State/ZipL. t2 X q.7 21 _
Phone:(�;�8`32O Fax: Sc�Z 8°iZ'S BUILDING PERMIT FEES*
E-mail: en o-r k lb W6 ASSvG,C-O/*1 Please refer to fee ichedule.
CONTRACTOR —
Risiness Name:ILCCCC L. &awfa Al l4S&V#f4 I N6 Fees due upon applic.ition.............................. $_ _
A.ddress: S lnl B AQfiule Amount received.......9�dU Sv a* '42,0 ...................................... $--
- -
Ci /State/zip_R�¢r_ 2 _
Phone:So3 892-$7�S Fax: 2-t7� l Date received:___ —
Authonzed E /1� Notier This permit application eipirei if a permit;s not obtained within
Signature: — Date' t� 190 days after?t has been accepted as complete.
_ "Fee methodology set by Tri-County Building Indusia Service Board.
(Please print name)
i:\Dsts\Permit Forma\BldgPetmitApp.doc 01/03
'Electrical Permit Application
Received Elcctncal
.� Date/Bv: _ /
/ t PlanningApproval t/
City of Tigard�� DatriB ' PI sign -_
13125 SW Hall Blvd. — Permit N°':
Plan Review I Other
Tigard,Oregon 97223 11 .b+ Date/13v: Permit No.:
Post-Review --
Phone: 503-639-4171 :Y_'-598-1960 Land lase
�M!,
BvCase No.Internet: wwv.ci.tig24-hour Ins ection Re"tiZSt`'I�����311` `tSee Page:for
P Q ne;MethodSupplemental Information.
TYPE OF WORK - PLAN REVIEW_ (Please check all _._that I
� 1`iew construction Z Demolition Service over 225 amps- LJ Healthy are fat,:tv
_ELAddiaon/alteration/re lacement commercial ❑Hazardous location
Other: 0 Service over 320 amps-rating of ❑Building over 10,000 square feet,
CATEGORY OF CONSTRUCTION I &2 family dwellings four or more residential units in
I & 2-Family dwelling Commercial/Industnal r7System over 600 volts nominal one structure
❑Building over three stories ❑Feeders,400 amps or more
wcessory Building I L Multi-Family [J Occupant load over 99 persons ❑Manufactured srrictures or RV park
Master Builder Ll Other: ❑Egress/lighting plan ❑Other.
JOB SITE 1NFMNIATION and LOCATION Submit_sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: SW �TWot J ry FEE*SCHEDULE
Suite #: Bl v.,''A t.#: Number of inspections per permit allowed
Project Name: s Description Oty I Fee lea.i I Total
Cross Street/Directions t0 job site: New residendgkingle or multi-family per
5�1
1�� 1 dwelling unit.Includes attached garage.150 V
� � G"U f_ A41 � Service Included: d
1000 sq. a.or less 145.15 1�7�15 4
Each additional 500 sq.ft or portion thereut 37..1_0 G`�� 1
Limited energy,residential 75.00 2
Subdivision: ( � Lot#: Z Limited energy,non residential 75,00 2
Tax map/parcel#: :ach manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
Services or feeders-Installation,
S?rl,�12.710 J Cr 1-J alteration or relocation:
--I {>P fIFG� 200 amps or less 80.30
141 amps to 4+)o amps 106.83 2
1 amos in 600 ams 160.60 2
ROPERTY OWNER TENANT 601 amps to IUOo ams z4t).6o 2
Name: y✓i lQ QW IIJ LL-(1Over I IN)o amps or volts 454.65 2
Reconnect oniv 66.85 2
Address: C1l*- L,Y't) S_0'174L 22Z Temporary services or feeders-installation,
City/State/Zip: T- I alteration,or relocation:
CP- Z,Z cl 20U ams or less 66.85 1
Phone 9Z–F-?S 201 am s to 400 amps —IU0.30 2
APPL AN'r _ CONT CT PERSON 401 to 600 ams 133.75 2
—i Branch circuits-new,alteration,or
Name:l� d S C1�4->�S j^Y_, extension per panel:
Address: Q' Sk1 UIQ ZZO A.Fee for branch circuits with purchase of
service or feeder fee,each branch circuit 6.65 2
City/State/Zip: po 1 CC 0-7 21 B.Fee for branch circuits without purchase of
Phone: service or feeder fee,first branch circuit 46.85 2
-Y ` FaY �� -ee Each additional branch circuit 6.65 2
E-mail Yr1 �. d 1 Ll D i�J�0.S$Oe ,coir Mise.(Service or feeder not included):
.. CONTRAC:TOR - Each um or imaation circle 53.40 2
Each siloor outline lighting 53.40 2
Electrum Inc Signal cimuiMe)or a limited energy panel,
2050 Vista Ave #10O alteration,or extension Pa e2 2
Salem OR 97302 Description:
503-361.-1256 Each additional Ins ecNon over the allowable in any of the above:
Per inspection per hour(min. I hour) 62.50
CCB:116453 FLC':24-3530 Su11:29195 -investigation fee:
CCB Lic. #: Lie. #: Other
Supervising electrician Electrical Pernilt Fees* 7
signature required: _ _ Subcecal S
Plan Review(254'e cf Permit Feel � S
PriLt N e: I State Surcharge(8%of Permit Fee) S
TOTAL PERMIT FEE S
Authorized -�_ Notice: This permit application expires if a permit is not uu,. ,.,. ,..••
utin
Signature: Date: 180 days after it has been accepted as complete.
M?I ti,
9 A-)
*Fee methodology tet by Tri-County Building industry Service Board.
(Pleale print name)
i:\Dsu\PermitFamis\ElcPemiitAppdoc 01/03
1�,� ° tt -119) 1
` Mecham P� nn�t Ap�lieatio»1 Received Aechanical
Date/Bv: Permit No.It9�1
Planning Approval Building
City of Tigard JUN 2 7 2003 Date/By Permit No..
13125 SW Hall Blvd. Plan Review Other
CITY OF TICi,a -{' Date/Bv- Permit No.:
Tigard,Oregon 97223 �y Post-R,-.view Land Use
Phone: 503-639-4171 Fiu�lw-wbd DatcSv: _ Case No.
Internet: www,ci.tigard.or.us Contact tuns.: Sec Page 2 for
24-hour Inspection Request: 503-639-4175 Narnr1Mcthod: Suppli-mental Information.
TYPE OF WORK . --� COMMERCIAL FEE"SCHEDULE-USE CHECKLIST
New construction 1 11 Demoliti„n Mechanical permit fees'are based on the total value of the work
P
Indicate the value(rounded to the nearest dollar)of all
_ Addition/alteration/re lacement Other: mechanical materials,equipment,labor,overh A and profit.
_ CATEGORY OF CONSTRUCTION
`• I & 2-Family dwellin Commercial/Industrial Value: S See' of :2 for Fee Schedule
RESIDENTIAL EQUIPMENT/SY6TEMa rTE•SCBFnfTLE
Accesso Buildin Multi-FamilyDescription Qa Fee(ea.) Total
[� Master Builder _ ❑ Other: Heatinp/Cooun
JOB SITE INFORDIATION and LOCATION Furnace-add-on air conditionmk” 14.00
Job site address: /S `. (19JThJC•. T V Gas heat um 14.00
�Bld ./A t.#: Duct work 1 14.00 "'
Suite#: Hvdronic hot water system 14.00
Project Name: TUW Q Residential boiler
Cross street/Directions to jib sit � , (for radiator or hvdronic system) 14.00
SLA) (i*J Unit heaters(fuel,not electric)
(in wall, in-duct,suspended,etc.) 1 14.00
Flue/vent(for anv of above) 1 10.00 D•"'
Repair units 12.15
ivi
Subdsion: 14W D Lot#: Other Fuel An liances
Tax map/parcel #: Water heater ( 10.00
DESCRIPTION OF WORK Gas fireplace l 10.00 0.
57--��C-n QF Gt/t/ S �1' Flue vent rwater heaters as fi•eplacei Z 10.011 Zl1
G, Log lighter(gas) 10.00
U)� r►'I P2� �� v Wood/Pellet stove 10.00
Wood fireplace insert I C.00
Chimnev/liner/flue/vent i 10.00
PROPERTY OWNER I El TENANT Other: I =10.00
Environmental Exhaust&Ventilation
Name: �11TUm K'1`QI,J�1f�onr rs LLC to
Range hood/other kitchen equipment 10.00
Address: 4�0 S N/ _ �' SJ 11", 7.24) Clothes dryer exhaust I 10.00 (p.'O
City/State/Zit): rZf de Q-7 2( _ Single duct exhaust
Phone: So3 2- S Fax:(Sri S1 (bathrooms,toilet compartments, 6.80
APPLICANT CONTACT PERSON utilitv rooms)
Attic/cmwl fans 10.00
Name: �• ga0w f�I SPLIlfit_, ace�G• Other: 10.00
Address: � � 'W 6 A, 5V 5i, 7 I Fuel PlpinR
C1tV/State/Zl 2t � 21� �_ '"(S5.40 for first 4.S1.0 each additional)_
Phone: SaS 892,-e-7'50 Fax: 503 E�2-��' ( Furnace,etc. _ "
Gas heat pump "
E-mail: ryt&?,L d I broc,JnaiQc)C C_M Wall/su ended/un)t heater
CONTRACTOR I Water heater
Smart Heating & Cooling LL(' Fire late
7616 NE Evelctt St Range
B8 r•
Portland OR 97213-6347 Clothes dryer(gas)
5Q3-254-50t)(1 Other: � •'
C('11: 154133 _ Taal:
_
Mechanical Permit Fees°
Authorized �� C;� Subtotal: S
Signature: Date: Minimum Permit Fee$72.50 S
Plan Review Fee(25%of Permit Fee) S
(Please print name) State Surcharge 8%of•Permit Fee
TOTAL,PERMIT FEE S
Notice: This permit application expires if a permit is not obtained within "Fee methodology set by Irl-County Building Industry Service tsoard.
180 days after it iins been accepted as c., iplete. "Site plan required for exterior A/C units.
r\DstsTermit FormslMecPermitApp.doc 01/03
1Slllll1i111L; 1' l�l.u1 ��
FOR OFFICE USt ONLY
PlunlbinQPermit application R�e,�ed Plumbing
_ _ Datv'Bv: Permit No.: I
( V�.,1 h/ if_L_. Planning Approval Sewer
City of Tigard DatrBv: _ I Permit No.
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 JUN 7 21Il � DataEv: Permit No.:
Phone: 503-639-1171 Fax: 50 � � Post-Review tans Use
. _h"� UatoDv _ Cue No..
Internet: www.ci.tigard.or.us �, ,ylt �h3�, Contact Juns.: See Pace:for
24-hour Inspection Request: 503-O��OIL/ U I NamUMethod: Sunplementai Information.
TYPE OF WORK FEE*SCHEDULE(forspecial information use checklist)
New construcnon Detnolinon Description Qty. FeNea.) Tot,l
Addiuon/alteration/re
cement Other: New 1-t. enc u dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft.for or tech utility connection)
ColnmerciaUIndustnal SFR(')bath 249,20 �J
1 �Yt ?-Fattuly dweillne SFR(_)bath 350.00 A 50,
ACcessory Bulldins Ntulti-Family I SFR(3)'oath 399.00
Master Builder i Other: Each additional bath,kitchen 45.00
JOB SITE IVFORNIATION and LOCATION Fire sonnkier•sa. ft.: Palle 2
Job site address: A Site Utilities
:suite #: Bld¢.i:� [.#; � Catch basin/area drain 16,60
_� rr� Drvwell/leach line.,trench drain 16.60
Pro ect Name: �_ Foonne drain(no. linear ft.) Pace=
Cross screet/Directions to job sit < � Manufactured home utilities 110.00
SLS 1 5c3 r, �1/E�t�>✓ Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no. linear ft.) Palle 2
Subdivision: /-{AW< I Lot#; 02, Storm sewer:no. linear ft.) Page 2
Water service(no. linear ft.) Palle
Tie map/parcel #: Fixture or Item
DESCRIPTION OF WORK Absorvnon valve WoO
Cf)k5MutZT-iCj,) F S7-0.4 Backilow preventer Palle 2
1 (pfj rj _� Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
ROP ERTY OWNER TENANT Ejectors/sumo 16.60
Name: A117" Mt,) r4t2 VI/Nd,-,-41ES�L1..L Expansion tank 16.60
Address: 9GX SVJ ?Y�e_gtJ2 &A, SUtli ZZO._f Fixturmzewercao 16.60
Ci 1$tate/Zi Q D Q2 '72 Floor drairvilnor sinlubub 16.60
Garba¢e disuosal 16.60
Phone. 5k)3 2- $e I Fax: 566 9Z-i e4 I Hose bib 16.60
APPLICANT' - CONTACT PERSON Ice maker 16.60
Name: L•' vjI ) J ASS QCiA4- C. I IJC Intercatnor/grease tray 16.60
Address: 95X S,.J 4W gjv, i.vb, $U tT� ZZJ Medical as value: S Pae 2
Primer 16.60
City/State/Zip: Pmt , Cr_ q-7 Z 1 Roof drain tcommerciall 16.60
Phone• 3 & Z_ ^Sa Fax so��e,Q'L-��' Sink/basinllavatory 16.60
E-mail: A tic dL I tv,,; C. Ca r-� Tubishower/shower pan 16.60
CONTRACTOR I Unnal 16.60
Plumbing 1 .r perts Inc Water closet 16.60
1 Water heater 16.60
11925 SAI Parkway Other.
Portland OR 97225-5413 Other:
503-409-0443 _ Plumbing Permit Fees• " t`
CCB: 149035 PLM: 34-391 PB Subtotal S 3 a m
;__ Minimum Pemut Fee 572.50 S
Authorized / /�� Residential Backflow Minimum Fee 536.25
Signature: 1 Date: (i� Plan Review(251'a of Pertut Fee) S
Goon State Surcharge(s"'a of Permit Fee) S .,r�•_'_"_
(K.,ue print name) TOTAL PERMIT FEE I S _f
Notice- This permit application expires Ira permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
Igo days after it has been accepted as complete. riser diagram for plan review.
'Fee methodology set by Tri-County Building industry Service Board.
i•`.Dstu,Permtt FormsTlmPermitApp.doc 01/03
PROJECT NO. HAT004
STREET BARRICADE DATE: 7/903
61.0' WATER Y: 1
��> — ..... 2C, METER. ._ \ o� '� i
I 4" S-S I -
f
LOT 62 t fiaAmb
d 1 2,440 SF 1 7\tG DIVI ION
PIAD ELEV=206. I I o�
0
I I o ul
61.0'
> V) LL1 N
in
I LOT 51 o t 4i x
- I h o I - > Ln1 1,830 SF o 00
Q , o
.o I W4,T R p S N
PIELEV=206. MET I . z rz
W m
L
I �„ c.S '`� I I— •�� Q O v
I 1 61.0'
.... ......--}..__..... z 3 ' �
43 1 i (� Ln Qr
_ f LOT 60 o Ln 'ZLu a
r,
1,830 SF
to I
RA D ELEV=204.C IJ W
I r3 o (n f v,
61.0' - .
. t ao
o
--77
r
\"i� LOT 59 I I ^�' > I o
a ` I
1,830 SF 1 �p o o � z a O
LD
P ELEV=204. I I t MET R tn
z ® o z �
L J 41 O O
SS 41 t"_ .
61.0' 1 Ll." ,0 rn z o
.?O ---- O Z
_1 7-0 I LOT 58 '"� '� u i x Q
�I I 2,196 SF 1 W I W
l _ - - - _ .. � . �....� co
o � Q,, o t—
o ,
202 -P ELEV-202. I M �]
cO; I - I 00
t M' L ail - I Ln
t � I �S � o
L
� t 6" SD
61.0' 8' P U E
- - - - - - - o, ? x_
SETBACKS: 1`�.. 101 NO
GARAGE (PUBLIC) = 20' REAR YARD = 15'
GARAGE (PRIVATE) = L90SIDE YARD = 3' 58 46 62
FRONT YARD (PUBLIC) = 15' - (6' PER FIRE CODE)
FRONT YARD (PRIVATE) = 3' STREET SIDE = 10'
SCALE: (1 =20
_ CITY OF I a�./%KD- SITF PLAN 149VIFW
BUILDING PERMIT NO.: d
PLANNING DIVISION:
Required Setbacks: Approved ❑ Nut .Approved
Side: 2 a Street Side: �L`_'_
Front. _�. (00 age �° I5
Visual Clearance: Approved Q Not Apprmed
Maximum 13161dinv Might, feet d
CWS Service Pnwider Letter Required: ❑ Yes No
[ Ree:i•ed
EN61NEE ING DEPARTM NT:
Actual SkTe'. -/ % fl?A pproved 0 Not Approved
Site Plan: [i-Approved ❑ Not Approval
N�Na S:
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
,i650 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003-00317
Date Issued: 12/23/2003
Parcel: 1 S133AC-HBO62
Site Address: 10815 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 062
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 DiviFion.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL_ 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 97302
Phone #: 503-892-8758 Phone #: 503-361-1256
Reg #- LIC' 114453 j
SUP Now 3
ELE 24-3530
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 #: MST2003-00317
Date Issue: 1112312003
Parcel: 1 S133AC-1-113062
Site Address: 10815 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 062
Jurisdiction: TIG
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 #: 503-8e2-8758 Phone #: 503-469-0443
Reg #: LIC 149035
PLM 34-391 HB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIOARD
Residential Certificate O f Occupancy
Permit No.: = �� Address: 44 .11%, .n- -- -
Owner/Contractor: dl t1.5_— 141. —
Date of Final Inspection: fir--;-e _ Inspector:
'Phis structure has been found to be in substantial compliance with the provisions of the,State of Oregon One& Two Fanrily Owelling
.S ecial y Code and is hereby approved for occupancy.
c