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10829 SW HALL BLVD 1 i W O 1 C-)L�1 L I cr r--- U j W CY] <t {{pp z W h-- CY_ C] }, LiJ Q M W LLJ C14 c; z CD x U �' Q 00U ~ W i V) C-4 Q �I d +. U7a Q a- '� N �� 0 3 P C) l � j E-- � O d�' 0 � r � C + 1 °, T. L. 2100 w . -�• ►n 'cv 2U" OAK p V.- .".�•" ASPEN + as J z r- 7 2.51 ' '9 r x 2�- co i 82. 94' •�, 75.16 w 0 o � � C7 • OP o �- � � z ' / o a o o < w __ __ C.) 0 cel W �y Oo © SD 12I r' G� N (y W 2 V V � .- ��, �, 180. 181 .0 � 5 0 1 1 /4 D !�. n 36" OAK r--------- � _ Q Q rn 2 40 X I 12' OAK + � Q yVY r �- DUPLEX LOT #i l /' a w v Oil \ L z 0 a0 LOT AREA ESS ROAD / - '� Z EASEMENT 7 276 S.F. m 72IKI12" CEDAR �7`4 - o ce DUPLE LOT 2•# 11 'x25 P PARKING AREA N CC ap LOT REA ESS ROAD 179,9 \179.5 WITH 10 NTRY -� r7 (noo EASE NT =6,182 S.F. Q , RELOCATE EXISTING 16 OAK p0 3-- 9 x 20 o � o WATER SERVICE TO PARKING STA L R/O/W LI E � W . . z 36" OAK 1110855 SW HALL �p 14" ,�� w Q - _ 6" NAZELNU U? EX. HOUSE LOT #3 ' . • 2 BO , �O _ v) LCT AREA LESS - _��' _ _ O I EMEN T 6,1 -off 12" H NUOP 2" HAzELNu�, j r 20 OAK SD o _ --- ---- -_ �-- S sso 72.51 8 2.9 4 - .J 86.57 , 2' TO 3' HIGH WALL � 0 SUPPL.IMENT EXISTING ARBORVITAE HEDGE ��� T. L. 2301 WITH ADDITIONAL 1 GAL. ARBORVITAE AT 2 O.C. T. L. 230.3 TO PROVIDE= A SCREEN FOR PRO9 ERTY TO SOUTH 178 3 20 T.L.. 2300 0 RELOCATE EX. `n DROP FOR UND ROAD CURVE DATA o o 0 GROUND POWER PHONE R = 30.00 R 50.00 3R = 30.00 o 3 -•� A = 32'23'19" �- A 64'46'3 " • � = 32'23'19" r� PLAN- SCALE1 pL = 16.96' L = 56.53' L = 16. 96' SITE "=20' o ENGINEER : _ _ SURVEYOR : _ OWNER /DEVELOPER : LEGAL_ ESCRIPTION :`_ -- DONALD L. MURRAY CONSULTING, INC. BERNARD A. SUTTON PLS BILL REED TAX LOT 2200 LOCATED IN THE S.E. 1502 COUNTRY CLUB ROAD 16216 S.E. HAWTHORNE CRT. P.C. BOX 12564 1 /4 OF SECTION 35,T S., R. 1 W., W.M. LAKE OSWEGO, OREGON 97034 PORTLAND, OREGON 97233 PORTLAND, OR 97212 TIGARD, WASHINGTON COUNTY, OREGON DI-�nN� (rnA) R47-.-SQAd )r,.& _sv7?o NOTICE: IF THE PRINTOR TYPE ON ANY 1 �IjlI � Ilillll 1111111 1111111 1111111 Ilillll 111III1 Il.fll �T IJill111111111 Illllli 1111111 1111111 IIIIIII 1111111 11111II Illlill 111111 III MAGE ISNOT AS CLEAR AS THIS NOTICE, ►��lIII_I _iIII - -1SZ _.. LZ_-- _8__Z__- �_Z ---_EZ- --Z— -T-�Z--4---- T5_ 1�( I qIjl I 1 lTi12 lwl Dte, IT IS DUE TO THE QUALITY OF THE No 36 11 ORIGINAL DOCUMENT 6 11filllJill l .IIf1111 lil1111i111111 E II6Il111`11 lODoTll-il �l911111 III,l5lll llll ! fi �.I III IEIIiIIIT311111111111,1 TI 1111IIL11ll llllllll111,12 1 J .__ �lllllll�l1l 00 a 1 woo �t �W t �_frTj X i r i I0829 SW HALL BLVD 14-2A I CW3 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection ine (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:` Footing S4. Ceiling Sprink, Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL- Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Undertlr. Insul. Shear Wall Gyp. Bd. -tiled. Date Requested:_�_1 y�_ `Gl W Time:�AM PM Address: U r� c I Builder:(-��`�-R , £> 3 Z (� C� (c� Per,-,,it #: „ -C1�LC%�1 J�jp THE FOLLOWING CORRECTIONS ARE REQUIRED: -t C02 .. -7.T Inspector: Date:,'••2.'- APr'ROVED _DISAPPROVED —APPROVED SUBJECT TO ABOVE Call For Remsp. G, 5 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Dover/Service Foundation Water Line Ceiling Post/Beam Mach. Shear/Sheath Framing ec Plbg.Und/Flr/Slab Plbg.Top Out Insulation Elect.�� Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins Other. Date: A.M. P.M. nt - - Address: Tenant: ------ Ste:-- _ MST: ._ - - BUP: (t� 6wn: C. ZV - �LJ�— MEC _ PLM: ELC: _ THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: jPPInspr ROVED —DISAPPROVED/CALL FOR REINSP. CF CO r� CITY OF TIGARD DEVELOPMENT SERVICES An:2� 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 CERTIFIC04TE OF OCCUPANCY PERMIT ll. . . . . . . a MST95--0247 DATE ISSUEDt 02/28/96 PARCELs IS13SAD-04900 .,JTE ADDRESS. . . t 10843 SW HALL BLVD #1&2B uDDIVISION. . . . a MLP94--0016 ZONINGtR--12 BLOCK. . . . . . . . . . a LOT. . . . . . . . . . 10021 JURISDICTIONsTIO AAS OF WORK. tNEW 1 ,1:* OF USE. . . OUP I o­,L OF CONST Re5N OLCLIPANCY GRP. #R3 ncCUPANCY LOADo2 PATH I MAO (-oVEST PROPERTY CORP 1111 MAIN 97' VANCOVER WA 98660 Phone #a 223-730 11 & R ENERGY RESOURCES t0355 SW PORTER PORTI.AND OR 97c-125 r'hone 01 291E-5051 Reg #. . 1 000718 This Certificate grants t:wcupancy of the above referenced building ur F)clrtitln iliereof and confirms that the building haA been inspected for compliance with the CS t 1_,,,,eMon Specialty Codes for the group occu Xancy, Arid 1.150 UntlPt" ,_fo -anced permit was ivvued. whish RIJILUIIV I L I �GV,ECTO0 U I L D'I ANGOCF F I IAL POSIT IN CONSPICUOUS PLACE 1 i AUG— 1 5-95 TUE 6 : 45 JAMES G - P I ERSON , INC . P _ 0 1 r7rrrYy�r August 1 Vii, 1995 ucr� James G. Pierson. Inc. (pity of Tigard, Orcgon 13urvau of 13uildin s 6 �arNe� DUPLEX AT 10829 do 10843 SW HALL BIND. FOUNDATION OBSERVATION REPORT To Whom it tllay Conccrm This morning l ohscrvrd the excavation, lorrn work and rebar placrmera fur the 1lrglcc;t. The footings hear on itrrn native soil which will adequately support, the struclurc:;. (;ntss and wvvdl which have grown since lllr cxc:rvauun will b(' r(111OWd. The looting thickness will Ix 12" or greatcr which cm-cc•cls 1.114• sluxiGed dclAh. Thr reinlirrcing steel is hrolxrly positioned and tied. The footings and foundation walls arc formed with :! .\ 12)'s which will subsrclucsrtly be used in the framing. TIT' tot► of the footing is anchored lry uransvcrsc mbar which will no( clTect the structural integrity of the foundation. Thc concrete will splay out each side of the 2 x 12 fooung forms at the south end where grade falls oil'. This proccdurc saves additional lormwork and will riot Impact the load-bearing capacity of the looOngs. 1111 will In• installed around the buildings bringing grade up u, 'P- :3' abovc the bottorn of the footings, insuring adequate frust (rrotcctiurr. I take no excelrtion to the luundrttion installations which will rnorr than adcqu;ttcly support the proposed structures. tiince rg(0 PRof 57 OF1 (CAvG�ti111% �� EXPIRES 1V31// I CITY OF TIGARDMASTER ;--ERMIT PERMIT #. . . . . . . : 14ST95-0c'4Y COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/11/95 13126 SW Hall Blvd.Tigard,Oregon 97223oSigg (503)639.4171 PIARCU.L: It.'J'A35AD-REED2 #I ";UBD I V I E31 ON. . . . o ZONING:t,l_OCK. . . . . . . . . . w LOT. . . . . . . . . . . BUILDING RE,I SSUI." DWELLING UNITS..2 LAA 5 L.I 'ENT. . . . . . . . :0 S F '.LASS OF WORK. :NEW BEDRM3:8 BATH8:8 GARAGE. . . . . . . . . . .. 1000 Sf .'PE Cr" USE. . . :Dur, rum AREAS------ REQUIRED SETBACKS------- 'PE OF CONST. .5N FIRST. . . . : 11,00 5f LEFT. 10 ft RIGHT. s20 ft ,CUP,ANCY GRP. R3 SEC=OND. . . : 1600 S-F FRONT. 15 ft REAR. . -. 13 fl. , 0RIES. . . . . . . .2 F'INBSMENT:5,:O s f REQUIRED IGH I.. . . . . . . . :33 ft TOTAL . « ;3'7L-.0 5f S!101-',r- DETECTORS. :Y OUR LOAD. . . . :44 As VALUE::. . . . . 1i assio*( PARK I NZ Sr,ACES. . :2 ,misl-lis : PATH I 101UP,LEX PLUMBING N);S. . . . . . . . . . i FLUOR DRAIN5. . . 0 BACKFLOW PREVNTRS. . :2 iVATOR I ES. . . . . :8 WATER HE=ATERS. . . :2 TRAPS. . . . . . . . . . . . . . :0 !B/GH(JWERc;. . . . t 8 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0 ITER CLOSET S. . :8 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0 I i314 W(7113 1 i E P 5. . . . -2 WATER LINE (ft ) . c_:00 OTHER FIXTURES. . . . . ;0 UARBAGE DISP,. . . :2 RAIN DRAIN ( ft ) . 90 WASHING MFICI 1. ..2 Sr, RAIN DRAINS. . 12 MECHANICAL. FEES )CL TYFL')--- --- UNIT 11TRS. . :0 type amol.Ant Cay cute V ecpt LE/ ✓ V E N TS, . . . . . :0 TIF 3100. 00 B 08/11/95 95-PE191:1'8 ,IX INVAIT :121 BTU VENT FANG. . : 10 (3wm 4, 11c,0. 00 B "h8/I I/95 1)5 -Zk 9 2,-;6 JRN E 100X . . s@ HOODS. . . . . . t2 SWM $ a0121. 0121 B 08/11/95 95-269258 JRN > -I 00K . . :0 W000 3 T!,V E S. 1Z E,V`R T $ 6:30. 50 S 0(3/ 11/916 1)1...,_C,1)1 S f I _00R TURN. . . . :0 CLO DRYERS. BPL.0 $ 100. e10 „TG 0 0/i2'S/9 4 94--x::56011 )IL/CMP C 3HP:0 GTHCR UNITS;L n5r-C $ 141. 513 0 03111195 05. GAS OUI LETS:J-, PARK $ 1000. 00 B 08/11/95 95--2692,158 Ener- ' I---1-I-_­ ..­ _.1. ­ .11 ­ I $ 7"1. 00 D 08/11/15 93--L69,,`58 )Vt-.ST PROPERlY CORP' Ml:'LC $ 17. 35 B 03/11/95 9 S-21 6 9 L 15 a I MAIN ST M!3PC 11 3. 55 V 08/11:'95 95 .2692313 PPRT $ 450. 00 B 08/11/95 95-L69 58 &XIOVER WA 08660 P5PC t li'lo P 08/1 1/9S) une EROS $ 176. 00 B 08/11 /95 95 6 9 2 115 8 1;t.au t o I ERPC $ 7. J'I 0 B 03/11/13 9 Z" R ENERGY REE. ERP,C $ 57. 20 B 08/11 /95 95--8692:1. Z SW V,ORTER .,i,. ILAND OR 97225 ione #-. E.'92- 5051 71865 64136. 03 TOTAL. e,alt is issued subject to the regulations contained in the REDUIRED INSPIECTIONS ,ard NuriLipal Code, Stitt of ()re. Specialty Codes and All other Footing Insp I-",LM/UncJerfI oor ,plicable laws. All work will be done in accordance with approved Focmdation Insp FILM/Undev,f loor- &ns. This pervit oil) ex;ire if work it not started within 11750 Post/Beam Str�Licf rtng Drain Bsin' t -IS of Issuance, or if work is suspended f an 1 ys. Post/spam mechan Mec=hanical Insp r'ost/Beam Mechan Plojmb Top OlAt _IndLzr-floor inst.tl Plumt3 Top O+-it Lt-awl Drain Fr•aminrj Insp 5:.Ae,:J rlm/mndslaij Insp Gas Line Call for- inspection -- 6S9-4175 :EWER CONNECTION CITY OF TIGARD PERMIT #. . . . .PERMIT. . : SWR95-0249 -COMMUNITY DEVELOPMENT bikstirmENT DATE ISSUED: 00/11/q5 13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)839-4171 PARCEL: I5135AD--REED2 SITE ADDRESS. . . 10843 SW HALL K_VD 41&22 SJBDIVISION. . . . ZONING: PLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . ----------------------- TENANT NAME:. . . . . : USA NCI. . . . . . . . . . : FIXTURE UNITS. . . : CLAG5 or WORK. . . NEW DWELL-I NG LJN 1 T33. . ;2 TYPE OF USE. . . . . iDUP NO. OF BUILDINGS : 1 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : f Remarks: PATH I DUPLEX Otyrier,: FEES covrmr PROPERTY CORP, type -.A M 0 U n t by date V,ecpt ! III MAIN ST PRMT t 4400. 00 B 08/11/95 95-269258 r� INSP $ 71B. 00 L1. 013/11/95 95_.2C, VAMC OVER WA 90G60 Phar)e #: 1 -503-223-730 CONTRACTOR NOT ON f:'ILL 4470. 00 TOTAL Pew #. REQUIRED INSPIECTIONIS) This Applicant agrees to cosply with all the rules and regulations Sewer- Insp,,?ctiori of the Unified Sewage Agency. The perait expires 18e days from the date issued. The total amount paid will be forftited 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 instar` . :7.�r4 Call fot- inspection 639-4175 Residential Building Permit Application -Cffi�T_o# Tigard °! 4 7) 13125 SW Hall 61vd. i�' 1V 1 (-11-S Tigard, OR 97223 t, >,A q (503) 639-4171 t; r _{ log Jobsite Address: Office Use Only Subdivision: t Lot# . Planck/Rec #_10- 4 q R Valuation: Corner Lot? Y N Permit# Reissue of Flag Lot? / Y / N Map & TL# l'1�/ .� .���c-� r' �p.�� 2 i Owner, �U--- �D ---J---- Avorovals Required Address: --� / /�( J�' Planning / -W - �9rQ�Ln d - Engineering Phone: _ �-,�""�-ZZs- 31 c ._ Other Contractor: / --f C �� �- Items Required Address: Subcontractors Truss Details ~ Phone: -Y,0 4 Other Contractor's License #V 6� (attach copy of current Oregon license)/ Contact Name & Phone: Subcontractors: Architect/Engineer: 11 Ire e41 'Y / l Plumbing: �< � /�� �'-� Address: � `✓�j S J Z / Mechanical: � �/P �v � (attach copy of current ontractor's License) — Phone: �� �e/ ,�� e X<-j ,IOB DESCRIPTION: /� I -_-- _P/,�-/ _ ; S2- z/,--- 9� Applicant Signature & Phone number Received by: _ Date Received: N NNORMCDMDEVIRE SAPP Permit# Account Description Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD) V0. 3-V Plumb. Permit (PLUMB) J 1 00 y3Q-.a Mech. Permit (MECH) , oU ��• `" _ State Tax (TAX) _ Bldg: >J Plumb: Mech: , Plan Check (PLANCK) 7. 3 G G u 3> Ile Bldg: �yy Plumb: Mech: Sewer Connection (SWUSA) y u J Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) �fQ 0 _ ou U Storm Drainage Chg (SDSDC) S (,© - jrfi Residential TIF (TIF-r..) _,Lw6 6 ;.k&U Mass 'Transit TIF TIF-MT) Z y UN 0 -2q u Commercial TIF (TIF-C) _ Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-O) Water Quality (WQUAL) _ Water Quantity (WQUANT) Fire District (FIRE) Erosion Cntrt Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) �I TOTALS: ,_ O10 PLUMBINU PERMIT PERMIT SUED : . . . : M S T 9 5- 0.24 CITY OF TIGARD DATE ISSUED08/11/95 COMMUNITY DEVELOPMENT DEPARTMENT PARCEL.; IS135AD REED-2 13126 SW Hal I Blvd.T 19ard,OrOn 9722398199 (503)639-4171 1. - , -- — . 1 -1 & JBDIV15ION. . . . : ZONING: -OCK. 0 . . . . . . . . e LOT. . . . . . . . . . . . . . -ASS OF WORV,. . :NEW GARBAGE DISPOSA(-3— :22 'PE OF USE'. . . . .1)UP WASHING MACH. . . . . . . 12 BACKFLOW F,REVNTRS. . :2 .*CUPANCY GRP— R3 FLOOR DRAIN O. . . . . . . :0 TRAPS. o . . . . . . . . . . . . :0 70RIEC.,. . . . . . . . ..a WATER HEATERS. . . . . . :iR CATCH BASIN5,, . — . . :0 �.XTUREG-- LnUNDRY TNAYS. . . . . . :0 GF RAIN DRAING. . . .. . I N K S. . . . . . . . . . :2 GREASE TRAPS. . . . . . . :0 IVATORIES. . . . . .18 OTHER rIXTURES. . . . . :0 JB/SHOWERS. . . . : SEWER LINE (ft ) . . . . 10 71TCP% CLOSETS. . :fa WATER LINE (ft ) . . . . 1200 IjHWASHERS. . . . :2 RAIN DR(41N ( ft ) . . . . 10 PATH I DUPLEX 4NL-R. )VEST PROPERTY CORP T I F 4, --100. 00 ill MAIN ST SWM $ 360. 00 SWIl 11 2,00. 00 aNGOVEA WA 91366-0 BPRT t 630. 50 tone #,-, 1-503-222-730 Br-,L.0 t 100. 01 JG 08/25/94 94-256011 D 2-'?r I C $ 41. S3 1.umb I rig Contractor : FTIRK $ 101I0. 00 P194,IA61" MPRT It 7A. 00 MPL.0 f- 17. .35 d r e-3, Msim 3. 5C t V 1>R T t, 4-50. 00 p phonev . 28. 50 -4 04 661 -6-6-y 6— P5PC Additional fees not shown here. . . . . . . . . REOUIRED INSPECTIONS Vh 3.s permit i s issued s u b j e(--,t to t h e -e g -.dations contitined in the Tigard Municipal Footing Insp Plumb Top Out ".Dude, State of Ore, SpeciAlty Codes and all r o�-tn d at J.un Insp PlI(ML) TOP 01.At ither applicable laws. All work will be done PostlDeam Struct Framing Insp ii accordance with approved plans. This Post/Bvam Mechan Gas Line Insp permit will expire If work is not started Post/Beam Mechan Insulation Insp ithir, 130 d-,ys of is31.iance, oo, if work is Undei-Floor insul Gyp Boars! Insp -,spended fur more than 180 days. Crawl Drain Rain drain lns.p. Plm/-indiilab I,-.sp Water- Line FILM/Underfloor Water- Service In PLM/Un d P r f I alar Appr- ,Sdwlk Insp Ftng Drain Dsmlt Mechanical ir: inal L L rit Mechanical Inrip OdditionAl. . . . tractur Signature r TV Gell for inspec:tion G 31, 4175 jTlti ACtUt' NCA Pk J CITY OF TIGARQ MAS'fERPERMIT PERMIT f1: MST2004-00152 DEVELOPMENT SERVICES DATE ISSUED: 6/14/2004 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 SITE ADDRESS: 10829 SW HALT_ BLVD 1+2A PARCEL: 1S135AD-05000 SUBDIVISION: PP1995-086 ZONING: It-12 BLOCK: LOT: 003 JURISDICTION: IIL; REMARKS: Convert garage to bath and bedroom. Other mechanical is duct work. BUILDING REISSUE: CUSTOM STORIES, FLOOR AREAS REQUIRED SEI BACKS_ REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: ;176 of BASEMENT. of LEFT. SMOKE DETEC TORS: `. TYPE OF USE: Sf FLOOR LOAD: JO SECOND: of GARAGE: of FRONT. PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: THRO of RIGHT: OCCUPANCY GRP: R3 BDRM BATH: TOTAL 276 VALUE 16,000. el 00 REAR PLUMBING SINKS: WATER CLOSETS. WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS, FLOOR DRAINS, SEWER LINES: SF RAIN DRAINS CATCH BASINS: TUB/SHOWERS. GARBAGE DISP. WATER HEATERS: WATER LINES: BCKFLW PREVNI-R: GREASE TRAPS. OTHER FIXTURES: MECHANICAL. FUEL TYPES FURN<100K: BOIL/CMP<7HP. VENT FANS: CLOTHES DRYER: FURN—`100K. UNIT HEATERS HOODS: OTHER UNITS- I MAX INP blu FLOOR FURNANCES VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 0 - 200 amp: 0 - 2002111P WISVC OR FDR. PUMP/IRRIGATION: PER INSPECTION, EA ADD'L 50JSF. 201 400 amp: 201 -400 amp. let W/O SVCI°CR 'll SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY. 401 - 600 amp: 401 - 600 amp. EA ADDL SR CIRSIGNAL/PANEL. IN PLANT: MANU HMISVCIFDR 601 • 1000 amp: 601•ampa-l000v: MINOR LABEL: 1000•amp/volt: PLAN R EVI E W S EC TI ON Reconnoct only: >-4 RES UNII5 SVCIFDR-225 A.' >600 V NOMINAL: CLS AREAISPC OCC: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO R STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM OTH: BOILER: HVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL GARAGE OPENER. CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC. DATA/TELE COMM. NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 584.29 REED. LYDIA LUNC)BERG R + R ENERGY RESOURCES This permit is subject tc the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes 10355 SW PORTER 10355 SW PORTER and all other applicable laws All work will be done In PORTLAND, OR 97225 PORTLAND, OR 97225 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 Phone: 503-282-4896 Phone: 292-5051 ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those Req N: LIC 00071865 rules are set forth in OAR 952-001-0010 through 952-001-001?0 YOU may obtain copies of these rules or direct questiO,iS to OUNC by calling (503)246-1987 REQUIRED INSPECTIONS Mechanical Insp Electrical Final Plumb Top Out Mechanical Final Electrical Rough In Plumb Final Framing Insp Final inspection Insulation Insp Issued By Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day i RECEIVED Building Permit Application ONLY MAICity ot Tigard �_'� 004 Daie!I3c� PemutNo 13125 SW Hall Blvd.,'ri ard,OR 972230; TY OF YIGAAC) Review/, - S L � JS(��✓ 8 Plan Other Permit: Phone: 503.639.4171 Fax: 503.598.196ILOING DIVISI - Date/By w ►- In+pection Line: 503.6 .4175Date Ready/By Jur ! ® See Attached C'hecUstfor "itemet: i.t onus ^ C tifled/Metho�bb r(,• �n -` Supplemental Information wTYPF,�rfr1RK ;I QUIRF,D DATA:1-AND 2-FAMILY DWELLING []New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all m Addition/alteration/replacement ❑Other: — i equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1-and 2-family dwelling _ ❑Commercial/industrial — Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: - Number of bathrooms: JOB SITE INFORMATION AND LOCATION _ Total number of floors Job site address: Slid ►CLL Q Lq d a,Q New dwelling area: ?`h square feet City/State/ZIP: ` R 6 � Garage/carport area: square feet Suite/bldg./apt.no.: Project w1me: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: t� (+ Lor no.: Permit fees*are based on the value of the work performed Tax map/parcel no Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the i;` bESCI2IPT'iON OF Mavic —� work indicated on this application. r Valuation: S Existing building area: square feet New building area: square feet L. >itw.=. MI r. y Number of rtories: Name: — �L L �„&� y� Type of construction: Address: 7 �N L j,•I( L�j Occupancy groups: City/State/ZIP /� Existing: L�N (��. ]Z I Phone:( 'r L 3) a. Z a Fax (�;C7) Z i C 3 New: ,[ APPLICANT CONTACT PERSON _ NOTICE Business name. _ _ All contractors and subcontractors are required to be Contact name: 'I)A,l 1 Ay, UN licensed with the Oregon Construction Contractors Board - ------ under ORS 701 altd may be required to be licensed in the Address: ) �- /I Lk Q L V 1' jurisdiction in which work is being performed.If the City/State/ZIP: a applicant is exempt from licensing,the following reasons t- apply; Phone:( v V '' J3 L41 Fax: : E-mail: Business name: �Z k_ N E Q G y R E SQ U k( IR,, B11"ING PERMIT FEE,* Address: 7 tQ M L-14, ----— -- Please refer to fee schedule. City/Slate/ZIP: L A N y) 0 IL C Z - — Fees due upon application Phone:(� ) Z, Fax:(spa) 4 _ Amount received CCB lic.: E� -?_ Date received: Authorized signature: /�, r/ This permit application expires if a permit Is not obtained V �L within 180 days after it has been accepted as complete. Print name: _ 1� Date: S-ZS-Uy 1 * Fee methodology set by Tri-County building Industry Service Board. �AuildinaTermtsallP PernutAppdoc 12/07 440-461 JT(IIMCOWW8B) Cine- and Two-Family Dwelling BuildinLy Permit Application Checklist FOR OFFICE USEONLV City of Tigard Received Penrut No.. 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits Phone: 503.639.4171 Fax: 503.598.1960 0 Electrical O Plumbing O Mechanical 24-Hour Inspection Line: 503.639.4175 Internet: www.ci.tigard.or us O Other: I Land use actions competed. tiee�urisdecthon criteria for concurrent reviews. _ U_ 2 Zonln . Flood lain,solar balance points,seismic soils designation,historic dismct Cil ❑ 3 Vci erification of approved plat/lot. 4 FIre district approval required. Name of district. S Septic sstem permit or authorization for remodel. Existing system capacity _Y _ L ❑ 6 Sewer permit. — - --- — ❑- 7 Water district approval. __ �___ --- ❑ - 8 Soils report. Must carry original applicable star and signature on file or with application. 9 Erosion control ❑plan []permit required. Include drainage-way protection,silt fence design and location of catch- (� basin protection,etc. l0 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state J t✓ building codes, Lateral design details and connections must he incorporated into the plans or on a separate full-size sheet attached to the plan, ;th cross references between plan location and details. Plan review canna!be completed if co ri lir violations exist. I I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft inter ails),location of easements and driveway;footprint of structure(including decks);location ofwells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Shoe Ions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _ __ 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;min,mum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- rescriptive path analysis provide specifications and calculations to eriAineering standards. El_ 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ systems,see item 2:,"Engineer's calculations." 19 Beam calculations. Provide two sets of caic.11ations using current code design values for all beams and multiple joists over 10 feet long and/or any baa dist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ for four or motr appliances. -�- 22 Engineer's cat,culations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Ore on and shall be shown to be anplicable to the wo,ect under review. r JURISDICTIONAL SPECIFICS 23 Five(S)site tilans are required for Item I l ubo�v Site plans must be S-1 2"x I I"or i I"x IT' 24 Two(2)sets each are required for items 16, 19,20 and 22 above. _ 2SBuildin tans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 26 "Reversed"building plans must meet criteria outlined in the Pemut&Syste:;: Oevelo mens Fees document. _ 27 "Drawn to scale"indicates standard architect or engineer scale. _ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard Street Tree List. - 29 Site plan to include tree protection measures as required by conditions of approval. _ 30 A Clean Water Services'Sensitive Area Pre-,Screening Site Assessment form is required for all building additions, including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\Building'J'ermiLl\One-Two-FamilyChecklist.doc 12103 Building Fixtures QQ��,,,,�� Plumbin Permit awtatio�V E CityCit of Tigard Ree °e' � \, J �� PCf11lll NU. 13135 SW Hall Blvd.,Tigard,OR 974 AAU4 Dale/B '� ��- _b- -- -�- Plan Review Phone: 503 69.4171 Fax: 503.598 0 Other Permit No, �1 r i iuAHD Date B 24-Hour Inspection Line: 503.639.4 7 t -i Date Ready/By: Juni 0 See Page 2 for r Internet: www.cLtigard.or.us (ll JILDING DIVIS10 Notified/Melhod. Supplemental Informaiinn PE b1FW0If1C"} '+�N � !".,i iS:. .�(' _ `EE' SCifEb[TI E ❑New construction ❑Demolition Forspecial information use checklist _ --- - Description Ea, Total Q]Addition/alteranon'replacemctit ❑Other: _-- New I-2-family dwellings(includes 100 R.for each utility connection) ATEGOR.Y OF GONSTR(JC ON-- 5FR(I)bath 249.20 ] I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00 ❑Accessory building ❑Multi-family SFR(3)bath 399.00 - - - ❑Master builder Other: Each additional badi/kitchen 4500 ❑ Fire sprinkler(_sq.fl.) Page 1 Ob 4ql INF # Site utilities Job site address: IG 6 L ALL Y� Catch basin or area drain 16.60 City/State/zIP: T /'A�0 Dryweli.leach line,or trench drain 16.60 `Wite/bldg./apt,no.: Project came: Footing drain(no.linear ft.: ) Page 2 --- Manufactured home utilities 110.00 Crnss street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer(nolinear ft.: ..J Page 2 Storm sewer(no.linear fl.: Page 1 Subdivision: b Lot no.: Water service(nolinear fl.: ) Page 1 Fixture or Item Tax map/parcel nn.: - _ Absorption valve 1660 - �i DESCRIPTION OF WORK Backflow preventer Page 2 t C L" (1 tl.i (,Y�`� C_•___IL j I tJ 2 ^Z61 in Backwater valve 1660 Clothes washer 16.60 Dishwasher 16.60 M,PltOIpERTY. OWNER 1 11 TMANT_ Drinking fountain - 16.60 -- --- Ejectors/sump 16.60 Expansion tank 16.60 Address: [ PJ r,LY' 8LJ n - Fixture/sewer cap 16.60 —_ City/State/ZIP:_ n i� 7 7-1 z Floor drain/floor sink/hub 16.60 Phone:(�,w) z ` Fax:(5(3) Garbage disposal 16.60 - t. -r--: FR - Hose bib 16.60 W w PLICAN7' C' CT 0SON ` Ice maker 1660 Business name: __ _._..--__-___ Interceptor/gtroase trap 16.60 �J Contact name: A L� JA 4_ r 6 N --- Medical gas(value S ) Page 2 Address: 6 � f1 L K � �� Primer 16.60 City/State/ZIP: -Roof drain(commercial) 16.60 Phone:(563) i? I Fax::(rUy2-q G, 5 K Sink/basin/lavatory 16.60 Tub/shower/shower pan 1 16.60 Urinal 16.60 CONT�tAClhQit _ Water ciu-,t 16.60 Business natnc: y�Ati Q � �frg^C (� iw� Water heater 1660 Address. '7, U, �c� ji Other: --_-� n Subtotal City/State/ZIP: o+ ,ti, () R ]1 O S�� -- — �? -� 1 -- Minimum permit fee $72.50 Phone: , 7 -s'4 ^'e-64Fax: Residential backflow minimum permit fee: $36 25 CCB Lic.: ' -7/ 2 (9 , �t" Plumbing Lic.no.: ,.,Z4-( Plan review (25%of permit fee) State surcharge(8%of permit fee) _Authorized signature: I - �,J �_ -- �TOTAI PERM H FEE Print name: - J Date:S-L t-ei This permit application expires if a permit Is nut obtained within -v-•-- - 180 days efter it h^s been accepted as complete. "Fee methodology set b;•Tn-County Building Industry Service Board 19ui1dlnatPemdUTLMF•Petffdt,sp0doe 11103 440-/516T(IM21COM/WEa) Plumbinu Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule:_ Residential Hire Supp ession Systems: SIS .te_U_tilities _ Qty. Fee(es) roti ' p ° ua a Fbota e• Permit Fee: footing-tram- r, 100' 55'ti 0 to 2,000 —— $115.00 Footing drain-tach additional 100' 4640 2,001 to:3,600 � $160.00 3,601 to 7,200 _ $220.00 Sewer- 1st 100' 55.00 7,201 and greater _ _ $3.0_9_.0_0__ Sewer-each additional 100' 46.40 — Waterservice-tat 100' 55.00 Medical Gas Systems: Water Service-each additional 100' 46.40 Valuation: Permit Fee' Storm&Rain brain- Ist 100' 55.00 $1.00 to 55,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001 00 to$10,000.00 $72.50 for the first$5.000.00 and$1.52 for each Qty. Fee(ea) 'total additional$100.00 or fraction thereof,to and rt .l IxtUre or Item � including$101000.00. Commercial Back Flow Prevention Device 4t,.ttl $10,001.00 to$25,000.00 $148.50 for the first$10,000 00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to _(minimummpermit fee$36.25 27.55 and including$25,000.00. Rain Drain,Single family dwelling 65.25 $25,001.00 to$50,000,00 $379.50 for the first$25,000.00 and$1 45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to and includin $50,000.00. specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal each additional$100.00 or traction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures:' If "yes please indicate work performed by fixture. Failure to accuralele report fixtures could result in increased sewer fees*. tQuantity b F;,tturc Work PCrformed Fixture Type: Replace New Moved Flitting Capped Comments regarding fixture work: liaphsu3 I ami — ---- Bath -1ub/Shower _ - - --�-- -W�- -Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru - --� --- ---- Cu idor/Water Aspirator Dishwasher -Commercial _ -Domestic --- Drinkit;-g Fountain -- -—Eye Wash Floor Drain/sink 2 3. 4" Car — Car Wash Dram Garbage -Domestic Disposal -Commercial _ *Note: If the fixture work tinder this permit results in in -Industrial _ Ice Mach./Relri .Drains -- — increase of sewer EDUs,a sewer permit will be issued and Oil Separator Gas Station _ - fees assessed for the sewer increase must be paid heftrrr the Rec.vehicle Dump Station -' plumbing permit can he issued. Shower -Clang -Stall J Sink -Bar/tavatory -Bradley � -- Quantity Total -Commercial - Isometric or ricer diagram is required if fixture quantity -Semite total is?9. Swimming Pool Filter Washer-Clothes Water Extractor _ Plan Review Water Closet- iniiet _ _ Plan review is required if fixture quantity total is>U. Urinal — Other Fixtures: t\amldma\Permi s\PLM-PeriritApp dor. Y03 Electrical Permit Application & City of Tigard RECEIVED Date.es y. / Pcrtnit Nr, �7. 13125 SW hall Blvd,,Tigard,OR 97223 Plan Revie Phone: 503.639.4171 rax: 503.598.19(iQnY r) 'l 2D04 Date/By: OUtcr Permit: Inspection Line 503.639.4175 WAY Date Ready/By: guru 0 See Page 2 for Inlemet www;;i tigard lir us Notilied/Niethod Supplemental Information BL PLAN RE� Ll New construction �2 Addrtion alteration/replace ' meet � Please check all that apply. ❑Demolition _ (]Other: []Service civet 225 amps,comm'I [3 Hazardous location —_ ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft., CATEGORY OF CONSTRUCTION of I-and 2-family dwellings 4 or more new residential f 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building []System over 600 volts nominal units in one structure ❑Other ❑Building over three stories ❑Feeders,400 amps or more El Mugu-family E)Master builder T _ ❑Occupant load over 99 persons (]Manufactured structures or JOB ✓6k *kORMATION.AND LOCATION _ ❑Egress/lighting plan RV park Job no.: Job site add ass: I Z1 524 A �1- Y�L J []Health-care facility ❑Other: Submit 2 sets of plans with any of the above. City/State/ZIP: n The above are not applicahle to temporary construction service . " '. 'FEE- SCHEDULE�� Suitefbldgdapt.no.: Project name: oe,rrrprlon`I •• _ -_-.- -_ V�1. Far_ Tetai Cross street/directions to job site: New resider t60%Ingle-or nr..lti-family dwelling unit. Includes attached garage. 1,000 sq.ft.or less 145.15 4 Subdivision: �. ,t Q Lot no.: Ea.add'I 500 sq.it.or portion 33.40 1 Tax map/parcel no.: s _ Limited energy,residential 75.00 2 Limited energy,non-residential 75.00 2 D]ESCRIPTIOM`ON WORK Each manufactured or modular dwelling,service and/or feeder 90.90 2 Services or feeders Installation,alteration,and/or relocation 200 amps or less 80.30 2 - - PROP201 amps to 400 amps 106.85 2 1C��t'!'Y OWNERTEN TENANT 401 strips to 600 amps 160,60 2 Name: R t L L_ G -__ 601 amps to 1,000 amps 240.60 2 Address: 4 j_\j 1,1 U( M LOver 1,000 amps or volts 454.65 2 Z -- -- - - Reconnect only 66.85 2 City/State/ZIP: ` Z Temporary services or feeders Installation,alteration,and/or relocation _ Phone:(LSa 3) 7_8Z- C�Qj4 k Fax:( 63) Z I �'e v 200 amps or less _ 66.85 1 Owner installation:This installation is being made on property that I own which is not 201 amp,i to 400 amps 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 133.75 2 O%,mer signature: _ Date: - ______- Branch circuits-new,alteration,or extension,per panel `+ A.Fee for branch circuits with CONTACT PERSON ��' -1 Electrical Permit Aimlication - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIftNTIAL WORK QNLY: Fee for all residential systems combined........ $75.00 ('heck Type of'rt-'ork Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ heating. Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. CUtMMERCIAL WORK ONLY`: Fee for each commercial system....................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation �J Fire.Alarm Installation HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ (Other 1 otal numher ot,conumercial systems- 'No ystems-'No licenses are required. licenses are required for all other installations Huddmg Pernut,U LG PtrnutApp dn. 14,)t Mechanical Permit ARQ4 �✓C I� l. FOR OFFICE � Received City O) Tigard Penna No �•-' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan/B vio Plan Revi Phone: 503.639.4171 Fax: 503.598.1960 `, ] other Permit Inspection Line: 503.639.4175 MAY G 7 200 Date Re;.uyiBy: t,,s ® See Page 2 for — Internet: www.ci.tigard.or.us Notified/Method: Supplementallnfnrmatluit CITY OF TIGAR( . -- --- � t .'COMMERCIAL FEE* SCHEDULE -'USE CHECKLIST ❑New construction Atitittum/alteration/replacement Mechanical permit fees"are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other mechanical matenals,equipment,'ibor,overhead,and iofit Y� CATEIyOkY OF CONSTRUCTION r _ Value S RESiDENT1AL EQUIPMENT/SYSTEMS FEES" [(� 1-and 2-family dwelling—❑Commercial,industrial ❑ Accessory building y ❑Master builder Other- Foil special information use checkiist ❑ Uescti tion I Qty. Ea. Total JOB SITE 1[VF�,QRMATION,AND LOCATION _ � Heating/cooling_ Job site address, b 7 7- Air conditioning or heat pump U LL Q�� (requires site plan showing placement) 14.00 city/State/ZIP: r( ✓, A Furnace 100,000 BTU ductaivents) 14.00 Furnace 100,000+BTU ducwvents 17 90 Suite/bldg./apt.no.: Project name: Gas heatump 14.00 Cross street/directions to job site: Duct work 1400 H dronic hot waters stem 14,00 Residential boiler(radiator or h dronic) 14.00 -- -- ----- - Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc 10.00 _ Subdivision: 9 15Lot no.: Flue/vent for an of above 10.00 - O Other: 10.00 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK T Water heater 10.00 ----" Gas fireplace 10.00 t^ 1,r,o L Ax aa,kA('E G T+1 Flue vent for water heater or gas fireplace 10.00 - ----- - Log lighter as 10.00 Wood/pellet stove L 10.00 Wood fireplace/insert — 1000 Chimney/liner/flue/vent 10.00 PROPER Y OWNF,R ❑ TENANT Other 10.00 Name: t t_ �+ Il Environmental exhaust and ventilation � L� Range hood/other kitchen Address: J is I,V _ - _ equipment 10,00 City'Slate/ZIP: b it--i L411 I,( k 4Z 1 Z -^ Clothes dryer exhaust 10.00 Single-duct exhaust(bathrooms, Phone ( t�r� 7 P Z ( �P, Fax: �ri toilet compartments,utili rooms) 6.80 CONTACT PERSON Attic/crawls vicefans 10.00 -- - Other: 10.00 Business name: Fuel piping _ Contact name: t A _ {�t l $5.%. ..tr first four,$1.00 for each additional Address: vtJ _ Furnace,etc. -- Gas heat pump _ City/State/ZIP: N t (, 'L Wall/suspended/unit heater Phone: z ` part:;(S/�j) -) Water heater Fireplace _ E-mail ,�}�1-� - G N^J� y►yy H tj o t v"� Range _ q 1i8 "J, F Barbecue Clothes dryer(gas) Business name: �R.6 E�GU -- --- t�th�t Address: cl N ►h �� �. MECHANICAL PF.RMGIIT.RFES• City/State/ZIP: tl U F� �_ - Subtotal Phone:(s63) 28 Z Fax:(5Q7) G 3? Minimum permit fee rmit$72 fee) — __ Plan review(25%of potTrut fee) CCB tic.: 7 18 b S _ — State surcharge(8�n of permit fee) 'N'-f)� TOTAL PERMIT FEL Authorized signature: -�- This permit application expires If a permit is not obtained within 180 _ days after It has been accepted as complete. Print name:113 tV N,/ _ Date: S`Z ' Fee metbodology set by Tr-County Building Industry Service Board ,Buildlna%.Pertniu,MEC.PemutAppdoe 12103 440.4617T(I1/02ICONME13) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: 7otfifbQ:" `1;1.00 to$2,000.00 Mininwm fee$72.50 $2,001.00 to$5,000.00 $7.:.50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction _ thereof,to and including$5,000.00. $5,001.00 to$10,000.00 $141.50 for the first$5,000.00 and $1.80 for each additional$100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and $1.35 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $1,396.50 for the first$100,000.00 and $1.10 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i\Btjilding\Permits\N.EC-PertnitApp.doe 12/03 2 i CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RANDY ROGERS PLUMBING 44265 SE KLEINSMITH SANDY, OR 97055 Plumbing Signature Form Permit #: MST2004-00152 Date Issuer. Parcel: 1 S135AD-05000 Site Address: 10829 SW HALL BLVD 1+2A Subdivision: PP1995-086 Block: Lot: 003 Jurisdiction: TIG Zoning: R-12 Rernarks: Convert garage to bath and bedroom. Other mechanical is duct work. 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 OWNE=R PLUMBING CONTRACTOR: REED, LYDIA LUNDBERG RANDY ROGERS PLUMBING 10355 SW PORTER 44265 SE KLEINSMITH PORTLAND, OR 97225 SANDY, OR 97055 Phone #: 503-282-4896 Phone #: 668-0846 Reg #: LIC 00071201 PLM 3-286PB AN INK SIGNATURE IS REQUIRED ON THIS FORM_ x\ {{r��_� Sig ture of Aut prized Plurrer If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 SAIV. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE R + R ENERGY RESOURCES PO BOX 12564 PORTLAND, OR 97212 Electrical Signature Form Permit #: MST2004-00152 Date Issued: Parcel: 1 S135AD-05000 Site Addrer s: 10829 SW HALL. BLVD 1+2A Subdivisicn PP1995-086 Bloi a ' Lot: 003 Jurisdiction: TIG Zoning: R-12 Remarks: Convert garage to bath and bedroom. Other mechanical is duct work. 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 iodividual 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: ELECTRICAL CONTRACTOR: REED, LYDIA LUNDBERG R + R ENERGY RESOURCES 10355 SW PORTER PO BOX 12564 PORTLAND, OR 97225 PORTLAND, OR 97212 Phone #: 503-282-4896 Phone #: 249-7375 Red #: ELF 26-696( L.1c 71865 SUP 3fl+-,P AN INK SIGNATURE IS REQUIRED ON THIS FORM c� 7 X1 ; ,,..., a -L Signature of Supervising Elect ' 'an If you have any questions, please call 503.718.2433. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received Date Requested— — AM._______ PM_____—__ BLIP T ` , Location Suite_____._________.._. .__ MEC Contact Person Ph PLN Contractor _ Ph( ) �_ _ - --__ --- SWR .. buftm NG —� Tenant/Owner _-- ---.-__. ---._.._— -- ELC - Footing Foundation Access: ELC _ ---------- _. .._._ Ftg Drain ELR --.-._._.--------- Crawl Drain _ Slab Inspection Notes: �~ SIT Post& Beam Shear Anchors -- -- Ext E;ieath/Shear Int Sheath/Shear Framing —��-✓__ VL...I'�N ---- 1__—1___�_------ Insulation Drywall Nailing -- -- ----- -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- ----- Roof 1 oer --- --- - _ -- --- -- --- ASS PART FAIL Post&Beam ^^ Under Slab Rough-In Water Service ------- — -- Sanitary Sewer Rain Drains -- - — Catch Basin/Manhole Storm Drain Shower Pan Iin 5 PART FAIL HANICAL Post&Beam Rough-In Gas Lint, Smoke Dampen: - ----. _—_ Final 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 PARTFAIL SITE [� Please call for reinspection RE: _ Unable to inspect-no access Fire Supply Line ` ADA Approach/Sidewalk Date--�L `=�--- Inspector �--. - Ext Other Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD MASTER PERMIT PERMIT#: MST2004-00153 DEVELOPMENT SERVICES DATE ISSUED: 6/14/2004 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 SITE ADDRESS: 10843 SW HALL_ BLVD 1+2 PARCEL: 1S135AD-04900 SUBDIVISION: PP1995-086 ZONING: R-12 Rt_OCK: LOT: 002 JURISDICTION: 'I l(i REMARKS: Convert garage to habital space. Other mechanical is duct work. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: .'75 5 of BASEMENT: of LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 41" SECOND of GARAGE: of FRONT PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: rHRD of RIGHT: OCCUPANCY GRP: R7 BDRW BATH: TOTAL: VALUE: IF,000 00.75 sl REAR. PLUMBING SINKS: WATER CLOSETS. WASHING MACH. LAUNDRY TRAYS. RAIN DRAIN: TRAPS: LAVATORIES DISHWASHERS. FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: 2 GARBAGE DISP: WATER HEATERS: WATER LINTS: BCKFLW PREVNTR: GREASE TRAPS: MECHANICAL OTHER FIXTURES: `^ FUEL TYPES FURN<100K: BOILICMP<OHP: `s VENT FANS. 2 CLOTHES DRYER: FURN—100K: UNIT HEATERS: HOODS: OTHER UNITS I MAX INP: blu FLOOR FURNANCES: VENTS: WOOD.STOVEF. GAS OUTLETS: _ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER _ TEMP SRVCIFEEDERS_ BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS 1000 SF OR LESS: 0 - 2002mp. 0 200 amp: WIS'X OR FOR PUMP1IRRIGATION. PER INSPECTION: EA ADD'L 5003F 201 - 400 amp: 201 - 400 amp: let WIO SVGFDRSIGN/OUT LIN LT: PER HOUR. LIMITED ENERGY: 401 600 amp' 401 - 600 amp: EA ADDL BR CIR SIGN4LIPANEL: IN PLANT: MANU HMISVCIFDR: 111"1 - 1000 amp: 601-ampe-100ov: MINOR LABEL- 1000-amp/volt: Reconnect only: PLAN REVIEW SECTION ---- — --� '--- -- -4 RES UNITS: SVCIFDR-225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL-RESTRICTED ENERGY - _ A.SF RESIDENTIAL B.COMMERCIAL_ _ AUDIO&STEREO: VACUUM SYSTEM: AUDIO A STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR L NDSC LT. BURGLAR ALARM: OTH. BOILER: HVA, LANDSCAPE/IRRIG: PROTECTIVE SIGNL. GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS, Owner: Contractor: TOTAL FEES: $ 584.29 . LYDIA LLINDBERG R + R ENERGY RESOURCES This permit is subject to the regulations contained in the REED, LY PORTER 10355 SW PORTER Tigard Municipal Code, State of OR Specialty Coues PORTLAND. OR 97225 PORTLAND, OR 972?� 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 the work is suspended for mole than 180 days Phone: Phone 292-5051 ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those Rep 0: LIC 00071805 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' y calling(503)246-1987 REQUIRED INSPECTIONS Mechanical Insp Electrical Final z Plumb Top Out Mechanical Final Electrical Rough In Plumb Final Framing Insp Final inspection Insulation Insp Issued By : �L �1rt i' �: Permittee Signature : 2 Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business d4 - FGE=IVEE Building Permit Application City of Tigardit i"`d' S Pennit No 13125 SW 4all Blvd,Tigard,OR 97223 ; ea'e/F3 .eJ zffrim, _ lin(loile Ki Phone: 503.639.4171 Fax: 503.598.19604 rAmifiG �—r Other Pemut Inspection Line: 503.639.4175 UI Jurm (a See Attached Checklist fur Internet: www.ci.tigard or.us Notified/Meth : Supplementa of rmauun TYPEF WORK REQUIRED A:1-ANA 2-FANtILY DWELLING -[]New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement L]Other: equipment,materials,labor,overhead,and the profit for the work indicated on this a lication. CATEGORY OF CONSTRUCTION pp [�Q Valuation: S 4)o 1-and 2-family dwelling ❑Commercial/industrial I V _ ❑Accessory building ElMulti-familyNumber of bedrooms: ❑Master builder _ ❑Other: Number of bathrooms: " JOB SITE INFORMATIONON AND LOCATIONTotal number of floors Job site address: U 4 3 S H A(._ b 1 q 1) 1 •�•� New dwelling area: 2 7l square feet City/State/ZIP: -�'� C b R Garage/carport area: , square feet Suite/bldg./apt.no.: Project name: �T^ — Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet _ - 4EQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: a C1�t ( - - Lot no.: Permit fees*are based on the value of the work performed - - Tax map/parcel no: Indicate the value(rounded to the nearest dollar)of all _ ____ equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on tlu_s application. _ C lJ nivl ill i`L �1i1.� rU a�1T l� ! �1 f Ul1GU iY Valuation: S hx, sting building area: square feet New ouilding area: square feet _ ( pROpERTY OWNER T El TENANT Number of stories. Name: I 1� l IJ - — -_ Type of construction: Address: Z C �� C �( )C)LV _ Occupancy groups: City/State/Z[P: (�A-TI A�,d 6rQ 7 _- ---- - - - Existing: ^� Phone: Y (•�1,� �1� f ) � Fax:( ) New: It TCANT CONTACT PERSON Business name: _ All contractors and subcontractors are required to be Contact name: j licensed with the Oregon Construction Contractors Board r under URS 701 and may be required to he licensed In the Address: Z [ &V 1, jurisdiction in which work is being performed.If G e City/State/Z[P: �Z N �) _ U —��� I L applicant is exempt from licensing,the following reasons apply: Phone:(,5b.3) Pax: :c a3) q G� j-17 E-mail: Sfly dprJr, 1400. 6 r - Business name: `_. �� N G y (i SL ! kt y�.� -- —�---- P, . ING :PERN11IT PEES* Address: '� 4 G 1 N tx L K ( V Jl —_ _A_-------- - -- ---� - --------------- Please refer rn fee.,.nedu(e. Ciry/State/ZIP: ),v J-1 L AN U i� Ct Z 1 Z ---- Fees due upon application Phone:(�j C 2. Z 4 c,,ii, Fax:(_<61) L 4 (�r,,37 CCB lie.:'�(�/5 ^- Amount received Date received: Authorized signature: zyThis permit application expires if a permit is riot obtained `< r__ within 180 days after it has been accepted as complete. Print nameV t� V 1w• Nd JN Date: `Z�S•Q/� • Fee methodology set by Tri-County Bwldmg Industry Service,Board b ttPuddinp�PermiutaUP-PermitAypdoe I2r01 UO-4617T(IU07/COtsVWE9) One- and Two-Family Dwelling Building Permit_ pplication Checklist QNLV City of Tigard Received Pemut Nn. 13125 SW Hall Blvd,Tigard,OR 97223 Dater Phone: 503.639.4171 Fax: 503.598.1960 tpermits C3 Electrical 24-Hour Inspection Line: 503.639.4175 O Electrira cal O Plumbing U Mechanical Internet: www,ci.tigard.or.us O Utftei REQUIREDREVIFW N es No N/A I Land use actions completed. See jurisdiLtion criteria for concurrent reviews ❑ H 2 ?!! . Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ i TO — ----- 3 Verification of approved plat/lot. 4 Fire district approval required. Name of districi: _ 5 Septic sstem permit or authorization for remodel. ExistiqE system capacity 6 Sewer permit. r- 7 Water district approval. 8 Soils report. Must carry original applicable stamp and signature on file or with application. }_❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ _ basin protection,etc. _ 10 j3 )C'omplete sets of legible pians. Must be drawn to scale,showing conformance to applicable local and state ❑ l4ttdding codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if ro fright violations exist. _ I I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft, intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. J 12 Foundation plan. Show dimensions,anchor bolts,arty hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor pians. Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans plumbing fixtures,balconies and decks 30 inches above grade,etc. _ 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thennal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodel:,. I_ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelape. Full-size sheet addendurns showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for run- prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,an 1 bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beam:,and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ for four or more appliances. -i 22 Engineer's calculations. When required or provided,(i.e,shear wall,roof truss)shall he stamped by an engineer or architect licensed in 0 e on and shall be shown to be a Itcable to the i2roiect under review JURISDICTIONAL MCIFICS 23 Five 5 site tans are required for Item I I above. Site plans must be s-I x I l"or 11"x 17" 24 Two(2)sets each are required for Items 16, 19_20 and 22 above. _ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard _ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ] 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. t:\Building\Permits\One-'iwo-Family('hecklistdoc 12103 i Electrical Permit Ajwl � FOR OFFICE U4 6NI.Y .�.!�,_.1 - Received Permit No City of 11gard Data: __ _ _ _ 415TrA%4 13125 SW Hall Blvd, fi aid,OR 97227 K' Plan Review sOther Fermif. Phone: 503.639.4171 Fax: 503.598.4# 2. 7 2004 - Inspection Line: 503.639.4175 Date Ready/By: )wo ® See Page 2 for t www.ci.tigard or us Notified/Method —_ Supplemental Information Interne CITY 01' TTIIGAkD _ l -- r.y:, nc+.!r19►1�1s�!!Y PLAN REVMW — f ❑ New constrilclion Addition/alteration roplaccment Please chick all that apply ❑ Demolition ❑()thcr ❑Service over 225 amps,contrn'l []Hazardous location ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft., c.y CATF,SiQRY OF CONSTRUCTION - of I-and 2-family dwellings 4 or more new residential [� I-and 2-family dwelling ❑Commercial/industnal�❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories []Feeders,400 amps or more ❑Multi-family ❑Master builder ❑Other. ❑Occupant load over 99 persons ❑Manufactured structures or 0I411)�AfiSD. OCATION ❑Egress/lightingplLn RV park 1t 011calth-care facility ❑Other: Job no.: Job site address: 5`.,1 I- 1 f ; Submit 2 sets of plans with any of the above. City/State/ZIP: Q (rj The above are not applicable to temporary construction service Deaerlptlan'. z, FEE' SG. E" Sultc/bldg./apt.no.: Project name: -- .• Qty. I Fre_ foul Cross strcet/directions to Job site: New residential single-or multi-family dwelling unit. -- - - Includes attached garage. 11(00 sq.ft.of less _ 145.15 4 Subdivision: Lot no.: Ea.add'I 500 sq.11,or portion 33.40 1 9s Z-- _ Limited energy,residential 75.00 1 Tax map/parcel no. Limited energy,non-residential 75.00 2 I)E9C1 tftIaN"OF WORk ___' t Each manufactured or modular A G� _-�"U �1ciT� � �112�rZdG li`,�--- dwelling,service and/or feeder 90.90 2 _ -- Services or feeders Installation,alteration,and/or relocatlon 200 amps or less — _ 80.30 2 OROPERTV OWNER �❑ TENANT 201 amps to 400 amps 106.85 2 _... _— 2 --------- 401 amps to 600 amps 160,60 2 ✓U t Name: L L — _ 601 amps to 1,000 amps 24060 _ 2 Address: U E L Over 1,000 amps or volts 454.65 2 Reconnect only 66.A5 •2 City/State/ZIP: P.L)KI!-AN q I-7 Z I _ Temporary services or feeders installation,alteration,and/or Phone: G� Z 6 Z L Fax:(5[3) 7 4 (.�j 3 200 amrelocation -- 200 amps or less 66.85 l Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 10030 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 13175 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel d t A.Fee for branch circuits with APPLICANT ------.-- --- _ —i— service or feeder fee,each Business names branch circuit 6 65 2 -�� B Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 I each branch circuit Address: U { �'1 �� Each add'l branch circuit I 6.65 2 City/State/ZIP: L 1) - Z_)2 Miscellaneous(service or feeder not Included) Pump or irrigation circle 53.40 2 Phone: ( C,3) Sign or outline lighting 53.40 2 E-mail: 1q�I 130 N N Signal circuit(s)or limited- energy panel,alteration,or extension.Describe Page 2 2 Business name: y .' ti /�G SOU 14-f - _ Address: /)i L K Q LV Fach additional Inspection over allowable In any of the above Per inspection 62.50 h� City/State/ZIP: u�AY 1+ I) IZ , z investigation per hour(I hr min) 62.50 Phone: 03) Z L (� Fax.(s d3) industrial plant pet hour 73 75 •1 ,'}' t z, _ ticAt, PER _ CCB Lic.: ' e- Electrical Lic.: Suprv.Lic.: — Subtotal .r _ Suprv.Electrician signature,required: Plan review(25%of permit fee) Print name: pate: - State surcharge(8%of permit fee) TOTAL PERMIT FEE Authorized signature: L-�; (r -� This permit application expires if a permit is not obtained%,ohiu Iso days after It has been accepted as complete Print name: l - �h/l+ Date: 5 Z�; f Fee methcdology set by Tri-County Building Indusn)Service Board ••Number of inspections per permit silov cd. i�B6ddin`tPermiulEl.C-P•:rmitApp dnc 12/03 440.4615T(10/02/COM'WEB h:lectrical Permit Application - City of Tigard dlage 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RES`ChENTIAL WORT{ONLY: "11 Fee for all residential systenrs combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener" ❑ Heating,Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: UMURCIAL'WCO c�VI.Yi Fee for each commercial system....................... 'f3.Od (SEE OAR 918-260-260) Check I ype of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ ire Alarm lwtallation ❑ HVAC ❑ instrumentation [] Intercom and Paging Systems ❑ I andscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling [—❑ Other Total number of commercial systems: 'No licenses are required. Licenses are required for all other installations i�Boddin jlP at\ELC-PermilApp da 04103 Mechanical Permit ApM iron I VE dFOR OFFICE USE ONLV City of Tigard Date BePe"""N� ) ' 13125 SW Hall Blvd.,Tigard,OR 97223 y v`'-- , Phone: 503.639.4171 Fax: 503.598,1960 MAY 2 7 20 Plan Review Other Permit. Date/By Inspection Line: 503.639.4175 Date Ready/By: — Juru ® See Page 2 for Internet: www:i.ugard.or.usCITY OF TIGA Notified/Method: - T_ Supplemental It,form ion BUILDINQ,QUI , ---- TVI'E OF W ! rµvw: s ' Ci,?' � �RCIAL FEE* SCHEDULE - USE CHECKLIST big; - - Mech6nical permit fees*are based on the value of the work ❑ New construction ❑Add!n(in-al!cration/replacement perform-!d.Indicate the value(rounded to the nearest dollar,of all E]r)cmolition [�Other mechanical materials,equipment,labor,overhead,and profit, LATE ORY OF CONSTRUCTION �J—._ value $ - - --- " T RESIDENTIAL EQUIPMENT/SYSTEMS FEES* © I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building -- --- For spe(wl in1brmnfiun use checklist ❑ Multi-family ❑ Master builder ❑Other: Description _ Qty. I Ea. I Total JO$ SITE INFORMATION t,ND LOCATION Heating/coolitiFt `, l 1 )� ------- Air condi Job site address: n pp�//,, U conditioning or heat pump /V`l �-�A L L (requires site plan showing placement) 14.00 City/Slate/ZIP: ( (W6 6 (1, Furnace 100,000 BTU(ducts/vents) 14.00 -- - -_ Furnace 100,000+BTU(ducts/vent,) 1790 Suite/bldg./apt.no.: Project name. _ Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 lldronic hot waters stem 14.00 Residential boiler(radiator or h dronic) 1400 Unit heaters(fuel-typo,not electric), in-wall,in-duct,suspended,etc 10.00 (� Lot no.: Flue/vent for an of :bo„e 10.00 Subdivision: -1 � C�_-- --- Other. 1000 Tax map/parcel no.! Other fuel appliances _ DESCRCPTION QF FORK Water heater 10.00 Gas fireplace 10.00 C_6 a J L f i �, (L a(�(� ?( _���.r_) _�_-1 �Q kL0►"� Flue vent for water heater or gas fireplace _ 1000 _ _ _ -- Log lighter(gas) 1000 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 _ ,RItC)P'E[t1Y OWNER -^ ❑ 'C NANT Chirrne /liner/floc/vent 10.00 Other 10.00 Name: ,LL Environmental exhaust and ventilation Address: 01 ('J4- /r1 LK 6 L�V - - Range hood/other k tcher equipment 1000 City/State/ZIP: P b K-T L O id 9 7z — Clothes dryer exhaust 10.00 Single-duct exhaust(t,athrooms, Phone: Z. Q, 4 e q i.. Fax:(93 ) Z�{9 b,.3 7 toilet compartments utility rooms) - ti, M CONTACT PEMON Attic/crawls ace fans 10.00 -� -_-- Other: Business name: -- Fuel tin Contact name: ) I ��A„a G N f) _- _ $5.40 for flrst four;$1,00 for each addlttonal Furnace,etc. Address: 741) 1 K 6LV 0 Gas heat pump _ City/State/ZIP: VT L A N 0 Z 12 Wall/suspended unit heater Water heater Phone:( ) Z Q L 4� Fax: :r�jL.j) rh Z Fireplace E-mail: Z y,A}.I OCA' � L�'A Range - - - ,, „ CONT*ACTOR Barbecue Business name: Z R (4 t Clothes dryer as i_ itC < s�t < < Other Address: Z 4(� j L� � MECHANICAL PERMIT FEES* City/State/ZIP: _ _- _ Subtotal _ - Minimum permit fee($,2 50) _ Phone'( ) Fax: ( ) - _ Plan review(25016 of permit fee) T CCB lie.: i — —'-- - -� State surcharge(8%of permit fee) —_— _ _ TOTAL PERMIT FEE / This permit ipplicatton expires If a permit Is not obtained within t80 Authori?ed signature: ` i� �� ”F- dors after It has been accepted as complete. [Print,tame: Date: 1 4 Fee methodology set by Tri-County Budding Industry Service Board --- L1 i\nut'dingiPemuWMEC-PerinftApp doe 12/03 440.461 IT(I i 02/C0Nt W"l Mechanical Permit Application - City of Tigard I'age 2 - Supplemental Information Commercial Fee Schedule: _ 'CotaI Ixai1 atla .' hemi Wo: --- $1.00 to$2,000.00 Minimum fee$72.50 $2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction _ thereof,to and including$5,000.00. $5,001.00 to$10,000.00 $141.50 for the first$5,000.00 and $1.80 for each additional$100.00 or fraction thereof,to and including _ $10,000.00. $10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and $1.35 for each additional$100.00 or fi-action thereof,to and including $50,000.00. $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or fraction thereof,to and including $100,000.00. _ $100,000.01 and up $1,396.50 for the first$100,000.OG and $1.10 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 stats of puns. N 4 i.\Building\PenTit$\MEC-PennitApp.doc 12/03 2 Building Fixtures EGEIVED Plumbing Permit ApHfikaAiin7�Dy FOR OFFICE USF ONILN' City of Ti arc CIT, OF TIGARL) Received Pernut No 13125 SW[fall lllvd„TI and O��R ING DIVISION pate By. - g f� Plan Review Other Permit No Phone. 503,639 4171 Fax: 503. 9 0 pate 24-1-lour Inspection Line: 503.639.4175 Date Reedy/By. lura ® See Page 2 for Internet: www.ci tigard.or.us Notifled/Method Supplemental Information r . �, �;�'�-,- �,� _•'---r+- _ ':a �;r r ,<. ,y, ,.. � P� lbI! WOW{ EE 5t"'I#E��f`JI.IE _ For special information use checklist. ❑New construction i ❑Demolition Description Qty. Ea !� Total Addition/alteratiot>,'replacentent ❑Other: New I-2-family dwellin;g(Includes 100 ft.for each utility connection) CATEGORt OR CONSTRf1� ON _ SFR(I)bath 249.20 I-and 2-family dwelling ❑Commerdu cial/instrial 5FR(2)bath 350.00 - SFR(3)bath 399.00 ❑Accessory building ❑Multi-family —�---_-_—__-- ------ Each additional bath/kitchen 45.00 ❑ Master builder Eimer: Fire sprinkler( _sq.ft.) Page 2 r—�— .�.( ` _ 30111,30111, SIT E IfNFOItMAIgo' �� ' k ' Site utllltles _ Job site address. L, 4 3 L.L I L Catch basin or area drain 16.60 �_J _.._3 i u_.. City/5tate/ZIP: '�� 6 41(� � Drywall,leach line,or trench dram 16.60 Suite/bldg./apt.no.: Project name: Footing drain(no.linear R.: ) Page 2 ---- Manufactured home utilities 110.00 _ Cross street/directions to job site: i __--_ Manholes 16.60 _ Rain drain connector 16.60 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_J Page 2 Subdivision: - (, Lot no.: Water service(no linear fl.- ) Page 2 Fixture or Item Tax map/parcel no.: _ T _ _ — Absorption valve — 16,60 DESCRIPTION OF WORK �— - _ Backflow preventer Page 2 _ Backwater valve 16.60 Clothes washer 16.60 —-—---- -- -`-- Dishwasher J 16.60 -- --_- -- --- Drinking fountain 16.60_ PROPEItYTY T WN R fI TYANT 16.60 Ejectors/sump Name: 4 t C-_ 1 r) _- Expansion tank 16.60 Address: 7 4 ri I? 111111-K L �� Fixture/sewer cap 16.60 City/State/ZIP: -' 0 � - 7 2 I Z= Floor drain/floor sink/hub 16.60 ( — Garbage disposal 16.60 Phone: ,G?) �L �� Fax:(C'6) Z Li i ( � 16.60 Bose bib c't; 16.60 A��'p�F�strN ---- ------- Ice maker _ Business name: ------ Interceptor/grease trap 16,60 Contact name: 6U- (�/, N �,/ Medical gas(value.S_ ) Page 2 Address: Z M L rKoof 16.60 city/slate/zlp: t A N O - �` 7 (commercial) 16.60 /lovatory 16.60 Phone:( Q ) Z L ,r ^/shower pan 16.60 E-mail: 1660 Water closet Business name: f�N t G OLC ES Water heater - 16 60 Y Other: Address: p 1 L 9 Yt111k ALV __. Subtotal City/Sttite/ZIP: ►”tjA T L Ar,D _ 9 Z 1 Z Nimonum permit fee $72.50 Phone:( ) Fax:( ) Residential backfio%% c imum Rerinit fee $36.25 j CCB Lie.: Plumbing Lic.no.: — Plan n_,lew (25%of permit fee) titate surcharge(8%of permit fee) Authorized signature rOTAL PERMIT FEE 4 Date: ' This permit application expires if a permit Is not obtained within Print name: �,� p y- d N rJ G 180 days after It has been accepted as complete. 'Fee methodology set by Tn-County Building Industry Service Bnard i tBuilding\Peinm\PI.MF PermhApp doc 17/03 440-4616T(10t02/C0M(W!8) Plumbinp, Permit Application - City of Tigard Pale 2 - Supplemental Information Fee St.hedule: _ Residential Fire Suppression Systems: Site L'tilitic Qty. Fee(e°)- Total uae Foota Permit Fee_ Footing drain.-I' 100' - 55.00 0 to 2,000 $115.00 Footing drain-each additional i 00' — 46.40 2,001 to 3,600 $160,00 3,601 to 7,200 $220.00 Sewer-Ist 100' 55.00 7,201 and greater $309.00 _ Sewer-each additional 100' 46.40 Water Service-Isl 100' 15'00 Medical Gas Systems: _ Water Set-vice-each additional 100' 41,40 �A -- Vs►luat><oa; Permit Fee: Storm&Rain Drain-Ist 100' 55 In $1,00 to$5,000.00 Minimum fee$72.50 Storto&Rain Drain-each additional 100' 4,:.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each t Fee(04 Total additional$100,00 or fraction thereof,to and j'ixture 0 lteiri :�„> - Q y' including$10,000,00. omrncicial Back Flow Prevention Device 4040 $10,001.00 to$25,000.00 $148.50 for the first$10,000,00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$36.25) 27.55 and including$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and SI 45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and includinit$50,000.00, specially requested inspections-per hour 72.50 1 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes”,please indicate work per•iormed by fixture. Failure to accurately report fixtures could result In increased Sewer fees*. �uantit b Fixture)Wurk'Partornted Mixture Type: Replace New Moved Existing Capped Comments regarding fixture wort(: ha tlstr /Font -- Bath -Tub/Shower _ -Jacuzzi/Whirlpool _ — - ('at Wash -Each Stall -Drive Thru Cuspidor Water Aspirator _ -- — — Dishwasher -Commercial ---.- -Domestic _ Drinking Fountair --� Eye Wash Floor Drain/si-.k 2' 3„ __ - Car Wash Thain _ Garbage -Domestic — Disposal -Commercial *Nott-: If the fixture work under this permit results in an -Industrial — increase of sewer EDPs,a sewer permit 3%ill be issued and Ice Mach..Refri .Drains Gil Separator Gas Statior.l fees assessed for the sewer increase must be paid before the Rec vehicle Dump Station plumbing permit can be issued. Shower -Gang _- -Stall Sink -Bar/lavatory - - Qoantih•Total -flradley Isometric or riser diagr•ain is required if fixture quantic. -Commercial —� total is>y. -Service Swimming Pool Filter Washer-Clothes _ Water Extractor flan Review Water Closet-Toilet _ —_. Plaut review is required if fixture quantity total is tt. Urinal Other Fixtures. _ i�awldma\Permitj\Pl-M PerfdtApp dee 3/03 CITY OFTIGARD 24-Hour BUILDING inspection Line: (503)639-4175 M ST,;?60 V 220 INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested 7- / L/ AM PM BUIP Location to MEC Contact Person Ph 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 Sheaih/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall /V Fire Sprinkler Fire Alarm Susp'd Coiling Roof Other: Final PASS PART FAIL -PLUMBING Post& Beam Under Stan Rough-In Water Service Saritary Sewer Rtin Drains Catch Basin/Manhole Storm Drain - Shower Pan Other: Final PASS PART FAIL _MEfC_HANffA_L____ Post& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm r— neinepection fee of$ required before next inspection. Fay at City Hall, 13125 SW Hall Blvd. i'ASS PART FAIL. Please call for reinspection RE: Unable to inspect–no access Fite Supply Line ADA Date -0�___ Inspector Lim W Approach/Sidewalk Other: rol DO NOT REMOVE this Inspection record froem the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: 539-4175 MST INSPECTION DIVISION Business Line: (0- i�639-4171 BUP .-- Received —_ Date Requested ___J_7/.5-' PM ------____-_ BLIP _--___-_- Location1 l _ _- �D --_.--Suite ___._ .._.___._._._._._... MEC Contact Person _ _ ----�—�. --- - Ph(--------) ------ - -- PLM - --— -- Contractor - _---- ------- Ph(--) --- - -- -- - - SWR - --- - --- p TenariVOwner g ELC Foundation - — Access: Fig Drain ELR Crawl Drain - --- - -�-�— Slab Inspection Notes: SIT _— Post& Beam Shear Anchors --- -----�--- Ext Sheath/Shear Int Sheath/ShearffpS. Framing — - — - -- --- Insulation Drywall Nailing Firewall C-�/ y\ ►1 _ —_ Fire Sprinkler -- � ---- ----- Fire Alarm Susp'd Ceiling ---- — - f - - — -- Roof U C L Other: -i SS _ PART A ost& Beam r — Under Slab --- -- - .- - Rough In Water Servk_j --- -- - - Sanitary Sewer Rain Drains - -_ --- -- Catch Basin/Manhole Storm Drain - - - -- — Shower Pen OtaenhPART FAIL CAL Post& Beam Rough-In -- Gas Line Smo a ampere --- -- --- --- ---- - in, AS PART FAILAf—eRICAL Service - Rough-In _ UG/Slab Low Voltage Fire Alarm - Finai Reinspection fee of$-- require(!befoie next inspection. Pay at City Hall, 13125 SW Hall 91vd. PASS_PART FAIL SITE �- Please call for reinspection RE: p _ _ �--. � �Jnable to inspect-no access Fire Supply Line AA Vo� �fApproach/Sidewalk Dats --% Inspector ��__ - Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PAR r FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 6175 MST 6C-lq -00 INSPECTION DIVISION Business Line: (503)6 -171 BUP Received Date Requested _- 7 -_____._ AM­-------- PM ._-___ __ BLIP Location _Suite__ __- _-_. MEC Contact Person Contractor _—__- --_ _- . _ -- -_-- __ Ph(--- ) ___ _._ - -_._..__---- - _ SWR - BUILDING TenantJOwner ___----- ----......_ - -- ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Bearn Shear Anchors -- ----a— Ext Sheath/Shear Int Sheath/Shear i Framing Insulation Drywall Nailing -- - - --- - - _- _ _- Firewall Fire Sprinkler __ - -- - __------------ -_- Fire Alarm Susp'd Ceiling - --- — — --- Hoof Other - - -Final I _PART FAIL IV- P BIND_ Pot& Beam --� -- Undar Slab - - -.o— Rough-In Water Service ----- Sanitary Sewer Rain Drains -- - --- -- ,1---� Catch Basin/Manhole 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 P __- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I Please uall for reinspection RE:------,_ _.. -I Unable to inspect -no access Fire Supply Line ADA Date / O/Z Approach/Sidewalk - 7�1 r ` Inspector "- 4�______ �---- - -_ Ext --- Other: Final -, DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RANDY ROGERS PLUMBING 44265 SE KLEINSMITH SANDY, OR 97055 Plumbing Signature Form Permit #: MST2004-00153 Date Issued. 6/1412004 Parcel: 1 S135AD-04900 Site Address: 10843 SW HALL BLVD 1+2 Subdivision: PP1995-086 Block: Lot: 002 Jurisdiction: TIG Zoning: R-12 Remarks: Convert garage to habital space. Other mechanical is duct work. 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.- REED, ONTRACTOR:REED, LYDIA LUNDBERG RANDY ROGERS PLUMBING 10355 SW PORTER 44265 SE KLEINSMITH PORTLAND, OR 972251 SANDY, OR 97055 Phone #: Phone #. 668-0846 Reg #: LIC 00071201 PLM 3-286PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X i Sig ature of Authorize 016m 0r If you have any questions, please call 503.718.2.433. CITY OF TIGARD 1312.5 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE R + R ENERGY RESOURCES PO BOX 12564 PORTLAND, OR 97212 Electrical Signature Form Permit #: MST2004-00153 Data Issued: 6!1412004 Parcel: 1 S135AD-04900 Site Address: 10843 SW HALL BLVD 1-+-2 Subdivision: PP1995-086 Block Lot: 002 Jurisdiction: TIG Zoning. R-12 Remarks: Convert garage to habital space. Other mechanical is duct work. Your company has been indicated as the electrical i,ontractor for the permit indicated above. In order for the electrical permit to be valid. the signature of the �upervising 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 competed form is received OWNER: ELECTRICAL CONTRACTOR: REED, LYDIA LUNDBERG R + R ENERGY RESOURCES 10355 SW PORTER PO BOX 12564 PORTLAND, OR 97225 PORTLAND, OR 97212 Phone #: Phone #: 249-7375 Reg #: ELF 26-60►6c LIC 71865 st IP 2,1417S Z `i Y8 S_ AN INK SIGNATURE IS REQUIRED ON THIS FORM Signa ure of Sup&vising Electri 'an If yeu have any questions, please call 503.718.2433. SEE, 35MM ROLL# 23 FOR A. RGE DOCUMENT