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14500 SW HALL BLVD I l j. 14500 SW HALL BLVD '- CiTY OF TIGARD BUILDING INSPECTION I?IVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST BI;P Z`•k _Date Requested "_Z r (� AM PM — I f Sf J&o �� --- E3LD fJ Location_ rrSuite &0 MEC W 'QoZ Contact Person Ph' l - PLM _ Contractor _ C SDa �1.� o Ph SWR _ BUILDING Tenant/Owner ELC Retaining Wall - ELR Footing — Foundation ACCe33: c sem' FPS Ftg Drain - —�"-- Crawl Drain Inspection Notes: SGN Slab Post& Beam — SIT Ext Sheath/Shear Int Sheath/Shear moi•� - Framing Insulation Drywall Nailing _— Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: ---------- Final PASS PART FAIL PLUMBING Post& Beam -- ---- Under Slab Top Out -- - - -- --- Water Service Sanitary Sewer - Rain Drains Final - - -- PASS PART - FAIL MECHANICAL Post 13, Beam -In - Rough ast;Line: -- 9rnbkZ Dampers PASS PART FAIL LECTRICAL - - - - - SL,rvice Rough In - - — UG/Slab _ Low Voltage Fire Alarm Final PASS PAR? FAIL Backfill/Grading -- - - Sanitary Sewer Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE _ [ ]Unable to inspect-no access ADA Approach/Sidewalk Deur Inspector _ Other ----- P Ext Final PASS PART_ FAIL_j DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT AA. M-112L 13125 SW Hall Blvd., fivard, OR 97223 (503,1639-4171 PERMIT #. . . . . . . : MEC98-0268 DATE ISSUED: 07/09/98 PARCEL: 25112BB-04000 SITE ADDRESS. . . : 14500 SW HALL. BLVD #B SUBDIVISION. . . . : WILSON ACRES ZONING: R--12 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :005 JURISDICTION: TIG ----------------- CLASS OF WORK. . :OTR FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF' USE. . . . :MF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . : ? VENTS W/O APPA-: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . . 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES-------•------ 0-3 HP. . . . : 0 DOMES. I NC I N: 0 :GAS 3-15 HP. . . . : 0 COMML. I NC I N: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . s 30-50 HP. . . . : 0 WOODSTOVES. . : 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0 FURN ( 100K BTUs 0 (= 10000 cfm: 0 GAS OUTLETS. : 1 FURN )=100K BTU: 0 > 10000 cfm: 0 Re mark s : Installation of gas piping for pool shed. Owner.: _-----------------------------------_.------------------- FEES ---------------- GUARDIAN PROF' MGMT type amount by date recpt 4380 SW MACADAM STE 380 �" ,,,,.,,� F'RMT $ 25. 00 DEB 07/09/98 98-307240 PORTLAND OR 97201-0000 �D SPCT $ 1. 25 DEB 07/09/98 98-307240 'hone #: Contractor: ----------------------------- POOL & SPA HOUSE INC 13025 SW PACIFIC HWY -----------------------------.. !► 26. 25 TOTAL T I GARD OR 97223 Phone #: 620-9200 Reg #. . : 52188 ------- REQUIRED I NSPECT I O1VS This permit is issued subject to the regulations contained in the Gas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspect-. ion applicable laws. All Mork will be done in accordance with approyed plans. This permit will expire if work is net started within 18g da�,s of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are -— set forth in OAR 952-X81-Nlf through OAR 952-014M. You may obtain copies of these rules or, direct questions to OUNC by calling (563)246-9187. -- ISSUe B Permittee Signature : w .....+++++++++.+++++++++++.+-F+++++t++f++++++.4-++-r-+-4-4...t++f++++++.}+++++++++++...... Call 639-4175 by 7:00 p. m. for inspections needed the next business day 4++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.++ _J Plan Check#_ CITY OF rIGARD Mechanical Permit Application Recd By 13125 SW HAIL BLVD. Commercial arid Residential Date Rec'd� TIGARD, OR 97223 Date to P E. (503) 639-4171, x304 Date to DST Print or Type Permit# Incomplete or illegible applications will not be acceptedCalled_ _ Name of DeveiopmsrtVPro)eat Description ) M tAr--'afC_ Table 1A Mechanical Code on PRICE AMT Job Street Address Suites! A) Permit Fee .0- -0- 1000 Address I�SCv .SJ . 14r�� _ Bldg# cityrState Zip 1.) Furnace to 100.000 BTU 6 00 j including duds&vents �! Name(or name of business) 2.) Fumace 100,000 BTU+ 7.50 ! Owner including duds&vents Mailing Address 3) Floor Fumace 6.00 includingvent City/Slane Zip Phone 4.) Suspended heater,wall heater 600 or floor mounted heater Name(or name of business) 5.) Vent not included in appliance permit 3.00 Occupant Mailing Address 6.) Boder or comp,heat pump,air Gond. 6.00 to 3 HP:absorb unit to 100K BUT" Crty/State ZipPhone 7.) Boder or comp,heat pump, Ar eond 1 t 00 T 3-15 HP;absorb and to 500K BTLI_ Contractor Name 8.) Boder or comp,heat pump,air eond 15.00 v�f pu'C- J S 15.30 HP;absorb und.5-1 and BTU" Prior to permit Mailing Address 9.) Boder or comp,heat pump,air coed. 22.50 issuance,a copy S'�-o ei -r C 30-50 HP;absorb unit 1-1.75mil BTU" of all licenses C S Zip Ph6ne 10.) Boiler or comp,heat pump,air cons. 37.50 are.required if T ( DIz- 'Q 7�Qi (dt) 73O-D >50 HP;absorb unit 1.75 and BTU" expired in COT Oregon Conn.Ctint.Board Llo.0 Exp,Dots 11.) Air handling unit to 10,000 CFM 4.50 database S-> 18 1";g- 99 Architect Name 12.) Air handling unit 7.50 _ 10,000 C7 M+ or Mailing Address 13.) Non-portable evaporate cooler 4.50 Engineer City/State Zip I Phone 14.) Vent fan connected to a single duct 3.00 Describe work New 0 Addltlt,n O Afteratlon'11111111 Repair O 15.1 Ventilation system not included 4.50 to be done Residential 0 Non-residential O in appliance permit Additional Description of work: 16) Hood served by mechanical exhaust 4.50 I tJ&'T-Ict l Ji 1 CTS D � L ._NC 1 I 17.) Domestic incinerators - 7.50 Existing use of 1 18.) Commercial or industrial 30.00 building or property i-,--,o V `p, SCJ+•J-Y1,%, type incinerator 19) Repair units 4.50 I Proposed use of 20) Wood stove 4.50 building or property 21 ) Clothes dryer,etc 4.50 Type of fuel-oil O natural ges4D LPG O electric O 22.) Other units 450 I hereby acknowler ge that I have read this application,that the information 23.) Gas piping one to four outlets ( 2.00 , given is correct,It at I am the owner or authorized agent of _ the ow- that plans S 17 a mpliance with Oregon State las. 24.) More than 4-per outlet(each) 50 Sin tura of Owner/A mt Date 'SUBTOTAL q r(� C 5%SURCHARGE r {{ r contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL Required for all commercial permits on ^--_ TOTAL 'Minimum permit free is$25 i•5%surcharge "Residential A/C requires site plan showing placement of unit. 1.lmechprmt.doe rev 4/15/98 CITY OF TIGARD DEVELOPMENT SERVICES r4LJT.1,DT,1,4r:; PFRMTT PEPH 13125 SW Hall Blvd., Tigard,OR 97223 (503)6394171 DATE 1991.1ED: 06/18/98 BDIVTF31ON. . . . WTLSON ACR59 OrK. . . . . . . . . .4 . . . . . . . . . . . . . .. :0050 J 1.1 R I G V T CT T.Oh!-TT r rj.13,I J r7 n9S OF' WORR. t0TP rT.WST 0 f N S. E r,r, or usE. mr. !.,Er,[M1r). 0 1° r P(xrF.:c r ni Wt 'Pr. OF r_OW)l 0 f N F3 r-lippilliC"y f3pp. . 1 TOTAL - 0 F ROOF' F r Rl'.* F,'! CUPnt\lr_'y LTMD: V1 SASEMENT. - 0 sf f-ARF-n SEP. RPTED- (IR. : 0 HT: 1P f+ GnR004. . . 0 f' Of",Clj "'.3r-P. R(1)T L:F BGMTI : MF"'.7'' Rr.OD REOU I RED OOR L.00r). . . , 0 11,z F I.r.-i r. T: 0. rt P111 11 0 -V 1; F'T R 9'r-`1!L. IELMNG IINITS: 0 F.RN'r: 0 ft- Q1 fl: r-*TR PI_RM: HNIT)TEr., Al-" DRMF3: 0 DATHO- 121 rlylrj G1_jQr0CF. 0 r1pQ POW,:I 1�40- 'Pt tjr Rf,mai"k r, : Edgewood Mar,cr re-roofing permit for pool shed Own ei,- GUARnTAN r.4K)F, tv0KF n i't I I I', k7i At v 4,"Y',(.10 f7,W MA( 01YAM S71"' _80 JCC',!' 113 9 ti POF?Tt,AI91) OR EXPIRED i . n 000 r()T11 t I car t tj r Tm,rER`)Tn7'E ROOFMIG, M306ti W 714"r-i nw: TTGAPT) OP' P11.0nu 'his pervit is issued subject to the regulations contained in the F I 11A 1 Tigard Municipal Code, State of Ore. Sppcialtt Cods and all Wei applicable laws, All work will be done in accordance with approved plars. This persit will Pxpirf if work is not st6 d within 188 days of issuance, or if work is suspended for sort than 18e days. ATTENTION: Oregon law requires you to follow the rule5 adopted by the Or,egan Utility Notification Center, Those ....... rules are set frrt', in DAq 9 -001-NIP through DAR 952 P0101987, Vo,i #any obtain a copy of these rules or direct questions to OLWC by calling (503124E 1987. I n c>r•m i.t t�,�^ `': sg n a t ��►�-�,4�,�, �- � �`W ++ ++4- 1+++++4+++4-+ + f-4..i..{.,4++4-+4+- i 4- V++A- 4. -4, 4 },I_++ 1 4 4• f , , t 6'.3'.9 , 141-75 by 7:00 f:i. m. fill- i-11'3 I ftea i,� .q..4 +4_,..+..F'}-•F+++4•+++4..1. ++4-+++4+ 4 11-r OF TIGARD Recd By 3125 SW HALL BLVD Date Recd: IGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date to PE: - 503-639-4171 X304 Incomplete or illegible applications will not be accepted Date to# ST: ►5`fl4 -503-684-7297 Permit Called Name of Development/Business STEP 2. NEW ROOFING ASSEMBLY _ - a y),0yA)0/"1'— _ Material Do�cumsntatlon/U8C A ndlx 15 _ Scree Address Sle JI — ��"i�"'--'_ L.. Please fill out applicable section and attach copy of roofing Job Site /�r''S C)0 - 1{,yG specifications. Bldg# City/State Zip -- Listefd Assembly (C11-o10&Complete A,8 or C 2 2 A. r n� Name L vS 1 Specification* �� Owner M ling Ad ress dtL� �fll s �U�.N/,-t (, _ �{0 �t, / 2. Manufacturer: -_ icy `` ( I City/State Z. _ Phone 3a UL Classification: Name Listed UL Building Materials Directory Page#: (OR) f Roofing Mailing Address ttr 3b Warnock Hersey Contractor T,l'(Q!!� ,Sw (� — Prior to issuance Q tate Zip Listed Warnock Hersey Directory Page#: _ applicant must 7 nJftV r �: Zit (PROVIDE COPY OF ASSEMBLY) y provide atopy of Phone# ax# -----------•--------------------------- all contractor f� -.3C�S �. B. ICBO Research# licenses if State Constr.Contr Board# Exp. Dat4 expired in COT S�frfG, /�X DATED: database) COT Bus Tax,or Metro Lic# — E&_ to (PROVIDE COPY OF ASSEMBLY) BUILDING INFORMATION C SPECIAL PURPOSE ROOFING:-WOOD SHAKES' Building-Type Of Use (circle one) ('review required by plans examiner) SF SFA COM ( MF Budding - Type of Curs action: —� VALUATION OF PROJECT — c. l�6K-L wovb_Cly jar; Fxi ng De t-k Type: C. Cwt~, Permit fee based on valuation' Combustible O Non-Combustible ( ) ' s_ee chart on back $ RESIDENTIAL ONLY'-Class of Work:Alteration City use only_ i ACO: J REPAIR (MAJOR) (BUILD) i (UBUILD) Permit required ONLY when spaced sheathing is covered by solid sheathing. -__ 5% State Surcharge $ ��113M1T THREE(31_$EL$.S2E�1t�NS SPECIFYINSz. City use only - TWACO: (TAX r I (UTAX) % A. Roof area&nearest street - - 65% Plan Review 3 _ B Attic vents-Provide 1 sq ft. for each 150 sq. ft of attic City us_e Only: - CO: space& vents shall be;ocated in the upper 1/3 of the roof. _ (BUPPLN) (UBUPLN) Provide 1 sq. ft for each 300 sq. ft when eaves& attic _— ^�` TOTAL $ 4 STEP 1. COMMERCIAL ONLY I acknowledge that I have read this application and that the Ctass of Wont: Alteration Describe work to be done: (check appropriate box) information given is correct; that I am the owner or authorized J RE-ROOF (circle A ,B or C) agent of the owner, and that the plans (if applicable) are in A. Existing built-up roof covering to be REMOVED and deck compliance with Oregon State ia_w_. i epaired- Signature of OwnerlAgent pate B Existing built tip roof covering to REMAIN note applicant must submit an engineer's review of the roof structural elements Review shall bear the seal(or stamp)of the architect or engineer licensed in Oregon. Contact Person Name Telephone — — Asphalt or wood shinlshake ----- — — I ROC c'1 DOC(dsts) (PROCEED TO STEP 2) 8UlLS�I�L.�TIG�4RD TOTAL PLAN STATE BUILDING VALUATION OF PERMIT F.L.S. REVIEW TAX PERMIT PROJECT FEES (40%) (65%)� (5%) FEES 1-1500 25.00 10.00 16.25 1.25 52.550 1,501-1600 26.50 10.60 17.23 1.33 55.66 1,601-1,700 28.00 1120 1820 1.40 58.80 1,701-1,800 29.50 11.80 19.18 1.48 51.96 1,801-1,900 31.00 12.40 20.15 1.55 35.10 1,901-2,000 32.50 13.00 21.13 1.63 68.26 2,001-3,000 38.50 15.40 25.03 1.93 80.86 3,001-4,000 44.50 17.80 28.93 2.23 93.46 4,001-5,000 50.50 20.20 32.83 2.53 106.06 5,001-6,000 56.50 22.60 36.73 2.83 118.66 6,001-7,000 62.50 25.00 40.63 3.13 131.25 7,001-8,000 68.50 27.40 44.53 3.43 143.86 8,001-9,000 74.50 29.80 48.43 3.73 156.46 9,001-10,000 80.50 32.20 52.33 4.03 169.06 10,001-11,000 86.50 34.60 56.23 4.33 181.66 11,001-12,000 92.50 37.00 60.13 4.63 194.26 12,001-13,000 98.50 39.40 64.03 4.93 206.86 13,00114,000 104.50 41.80 67.93 5.23 219.46 14,001-15,000 110.50 44.20 7183 5.53 232.06 15,001-16,000 116.50 46.60 75.73 5.83 244.66 16,001-17,000 122.50 49.00 79.63 6.13 257.26 17,001-18,000 128.50 51.40 83.53 6.43 269.86 18,001-19,000 134.50 53.80 8743 6.73 282.46 19,001-20,000 140.50 56.20 91.33 7.03 295.06 20,001-21,000 146.50 58.60 95.23 7.33 307.66 21,001-22,000 152.50 61.00 99.13 7.63 320.26 22,001-23,000 158.50 63.40 103.03 7.93 332.86 23,001-24,000 164.50 65.80 106.93 8.23 345.46 2.4,001-25,Cuu 170.50 68.20 110.83 8.53 358.06 25,001-26,000 175.00 70.00 113.75 8.75 367.50 26,001-27,000 179.50 71.80 116.68 8.98 376.96 27,001-28,000 184.00 7360 119.60 9,20 386 40 28,001-29,000 188.50 75.40 122.53 9.43 395.86 29,001-30,000 19300 77.20 125.45 9.65 405.30 30,001-31,000 197.50 79.00 12838 9.88 414.76 31,001-32,000 202.00 80.80 131.30 10.10 424.20 32,001-33,000 206.50 82.60 134.23 10.33 433.66 33,001-34,000 211.00 84.40 137.15 10.55 443.10 34,001-35,000 215.50 8620 140.08 10.78 452.56 35,001-36,000 220.00 88.00 143.00 11.00 462.00 36,001-31 ,000 224 50 89.80 145.93 11.23 471.46 37,001-38,000 229.00 91.60 148.85 11.45 480.90 1 ROOF, DOC(dsts) CITY OF TIGARD DEVELOPMENT SERVICES PERM IT MAIM 13125 SW Hall Blvd,, Tigard,OR 97223 (503)639-4171 DATE 76SUPD: 061IS19a R r r--L x '131. 1 J?WA -04 1710 0 TE ADDRESS. . . : 4!W0 13W IHi. 131.V17 OP 'RDTVISHON. . . . : 411-501\1 ACRF7 rih,I NG: R 1 . . . . . IM I I P1 4:0 T C 1 111*4. r T G T S E-y,*1T.,r4IC)P WALL. (Jjt,V: �t'; -RK. -r,r� -)'!7 Of- WO -n 0 r 1q. FT- CIP 1-ISE. . . .MF 0 Sf PPOTECT OPErWIF-3 '!-IF nF rnNST. . 0 5F N r) .,I 11NINCY GPP. 7!--J TO! 1171 f RR10F= C01`4 13 T: F f RF-" I?V-'! 71 IFI()Nr.Y VOAD-- 0 0 f* ARFA SEP. Rn-rm: OR. 0 HT: 0 -F't G 0 P;CE. . . r 0 y,f 017.(-LJ GEP. WTE.T) ,!IT" MF7 7') - RIP17,11,111 RF D-..._.,._......_.__-_..._.. (7nh D---- - -- ----- (30P Lono. 0 (7 s f' fJ.-rT-. 0 Rr;I!T-. 0 rt 17TR !-Sr)I1'I,.: 11.311VO-W, D!- r)LJF,l I TNG (INT"m: 0 V�'WTT . 171 f i: R Fn R Clt f1. FIR AI RM: HNIDICF, W R,ty, 0 11 AT I-K'3- TMP IIJRFOUIF , P!%tl CORP_- m,r i,k i Edgewood Manor re-roofing p@reit for carport PROP yri--,y d I t-, -,A0 r,W IyIAr.ADrjII r,rq 1o1 t 411. 90 S 91F /1�8 '1r) 7 r t hi o n R ')7;7,1711 Vj 0 0 0 r—.17 I. t .... ...... 01110-000-0000, 1,1("L,% qW DOR)7 OR pertit is issued subject to the regulations contained in the it ar.-" Municipal rode, State of 0,F. Specialty rodPt and all other applicable laws. All work will be dope in ac"rdancp with approved plans. This persit will expire if work is t;pt started --- within IN days of issuancF, nr if work is susppndrd ine sort thail iN days, ATTENTION: Oregon law rpa,,tirps you in follow the rules adopted by the Oregon Utility Notification Center. Ttir-sv rulpi are set forth in 90 95c--@@11 WN through OAR 952-101019017, You sany obtain a ropy of thew rv)PA or direct qoPstions to 0I.W by calling (W)P461967, tel, rl 1 ,�111 r-,39 7.00 1 ,11 :ol 4. 1 a 1 1 1 :ITY OF TIGARD Recd By: 1 13125 SW HALL BLVD. Date Recd: tS-`1K IGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date to PE: V- 503-639-4171 X304 Incomplete or illegible applications will not be 3mepted Date to DT: F t -503-684-7297 Permit 0: 0 Called: Name of Development/Business STEP 2.,NEW ROOFING ASSEMBLY > MaEalal 0actnriw>jdw!ft!8C AppMdlx 18} Street Address Ste 0 Please fill out applicable section and attach copy of roofing Job Site I V,: 00 -&,(d &�!44A-v specifications. Bldg M City/State Lip Luted/Amomp�y �Cle�t� _ eRpNklJh�OF CI Tr�� . 2'e- IG722 A. -�— Name r 1. Specification!R __ Jam' /) op. h I m7--- — Owner Myitlin Adm,ress 2. Manufacturer ��- CiJ City/State Zip UVPhon�6 3a UL Classification- ��ff- eir Name c� Listed UL Building Materials Directory Page N:�` b Roofing Mailing Address t 3b Warnock Hersey Contractor me)%_jW -- "�-- iPrior to issuance tate Zip Listed Warnock Hersey Directory Page 0: appllgntmust o ( ►_ 2�-- PROVIDE COPY OF ASSEMBLY) r�� provide a copy of Phone N -/�►t axe 1 ______.---t---_-._.-------- --------------. all contractor tv ey - c --3c1� i�- B. iCBO Research* licenses if State Constr.Contr. Board$ Wax. Dat expired in COT Zf DATED: ti databaso) COT Bus. Tax or Metro c Mte (PROVIDE COPY OF ASSEMBLY) r BUILDING INFORMATION C. SPECIAL PURPOSE ROOFING: WOOD SHAKES' JI Building-Type Of Use: (circle one) ;! (•review required by plans examiner) SF SFA COM MF Buildifig- Type o C ction: _ _- VALUATION OF PROJECT $ X15 R uk)Cob l 10Coc_Sit co - — Exi-> pe: C lvcJo --- Permit fee based on valuation' Combustible (y) l Non-Combustible ( ) _ 'see chart on back $ RESIDENTIAL ONLY-Class of Work:Atteration City use only: ' WACO REPAIR (MAJOR) 1 (UBUILD) _ 2 c� r � Permit required ONLY v..ien spaced sheathing is covered'ay solid sheathing. _ 5% State Surcharge $ _ City use only: r WACO. SUBMIT THEE (3) SETS OF_P Aty,9.�PECIFYINQ2. �- (TAX) _ t (UTAX) A. Roof area&nearest street. 65%. Plan Review $__ B.Attic vents-Provide sq. ft. for each 150 sq, ft of attic City use only: WACO: space&vents shall be located in the upper 113 of the roof. (BUPPLN) (UBUPLN) Provide 1 sq. R for each 300 sq ft. when eaves&attic TOTAL $ STEP 1. COMMERCIAL ONLY I acknowledge that 1 have read this application and that the Class of Work: Alteration Descnbe work to be done (check appropriate box) information given is correct-, that I am the owner )r authorized J RE-ROOF (crcle A ,B or C) agent of the owner, and that the plans (if applicable)are in A. Existing built-up roof covering to be REMOVED and deck compliancp with Oregon State law. repaired- Slgnatu�f OwnsWltcgent Date B. Existing built-up roof covering to REMAIN: note applicant / must submit an engineer's review of the roof structural elements. Review shall bear the seal(or stamp)of the - ,Trc �7Cg hitect or engineer licensed in Oregon. Cont arson -- Telephone ( ,rAsohalt or wood shingle/shake -. .2_--- ._ Lin/KE I:ROOFI.DOC(dsts) Vs�•M�4r1MI M }.y! iJw� �!,dt ..lkl�I ?MdQ}MNlhrk AMlb�lM F4�N�•�I i1wM►"$(i•1vk '; r r CITY OF TIGARD DEVELOPMENT SERVICES E{LJIt_DING PERMIT 131911z SN!Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . . PLJ:198-1712 29 DATE ISSUED: PARCEL.-: :'S 1 12Bp,-.04000 SITE ADDRESS. . . : 14500 SW HALI__ E{I_VD #V S1.IBDIVISI(IN. . . . : WIL.``!ON ACRES ZONING- R s2 13L_OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .005 .JURISDICTION:TIG Rf:ISS1JF: D�Q FLOOR AREAS------_____ E-EXTERTnR WALI.. CONSTRUCTION- CL-ASS OF WORK. T` FIRST. . . . : 0 51' lu: S: F: W: T•YPI= OF IJSF'. . . :MF GECONI.?. . . : 0 ,f PROTECT OPENINGS ' _..._.__.-__.._... TYF'E OF CONST. : ') 0 sf N: Vii: E.: W: nCCLIPANCY CARP. : ? TOTAL—--.- - : 0 s f ROOF CONST: FIRE RET? : C)CC:UPANCY I...nAD: 0 BASEMENT. : 0 %f ARFA SEF'. RATFD: !3TnR. . 0 HT: 0 ft GnRAGE.. . . : 0 sf OCCU r3EP. RATED: SG)MT% : ME'77'? : REDD SFTBACKS--____._...._ RFOL)IRED-_.__.___._____._.__._. F'I_OOR I.-OAD. . . . : 0 F:,r..f I_-EFT.— 0 ft RGHT: 0 ft FI R SPKI.-; SMOK DET. . : T)WFL-.I..ING UNIT;: 0 FRNT: 0 ft REAR: 0 ft F'IR AI..RM: HNDICP AC'C: NEDRM':.�>: 0 BATHS: 0 IMF' SI.JRFAC:E: 0 PRO CORR: PARK TNG: 0 VALI-)E. $ .* 44.00 Rent at,k s - Edgewood Manor re-roofing permit GUARDIAN PROP MGMT •hype amoi-int by date rer-pt 43H0 SW MACADAM 5TF:' '3'RO yA PRM-T $ 50. ' 0 JSD 06/10/58 98--306416 PORTLAND OR 97201 -0000 :"A 1"" �ED 5Pf" f $ 2. 53 JSD OG/10/98 98—;306.41.F, Phone #: 000--•000•-0000 �> � ,�-IocJ Cantr•,.actnr: ----.__.._____..__.._._._........_...__.......---...-----_._.__ I NTE RSTA-f E ROOFING 1 065 SW 74TH AVE:' T I GARD OR 97223 Pti n n e #: 684 -561 1 53. 03 TOTAI_. ---RF ,)(l l PFD ACTIONS nr T NSr F['T T[)NF)---- _ This permit is issued subject to the regulations contained in the Mi Sc:. Inspec.,t i on ------ Tigard Munic. ial Code, State of Ore. Specialty Codes and all other Final. T n s pec•t i.on 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 fssuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95.: 0@1-0010 through OAR 952-00101987, You many obtain a copy of these rules or direct questions to OX by calling (5@3)246-1987. �I /`� `t.. 17'e r m i.t t Pe Si gnat 101P 1 "4, .-J I Fri By 1 + + +-+ + + Call 6.39--4175 by 7:00 p. m. for an insper_tian needed tl-re nP%tt bl-rsities s day ++++++.++++++++++++++++++f•++•!+++-F•4-+++++++++++++4+++ ++-F++++-+++++++++ 4 1 4 a ;ITY OF TIrARD Rer,'d By 3125 SW HALL BLVD Date Recd: TIGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date to PE: 'J- 503-639-4171 X304Date to DS ' Incomplete or illegible applications will not he accepted permit#: c-503-684-7297 Callen: Name of DevelopmentiBusmess STEF 2. NEW ROOf;NG ASSEMBLY _ Lia*�GC�ODU /Vt _Material Documentati2n_'(�BC Appendix 15j Street Address ///l Ste# Please fill out applicable section and attach copy of roofing Job Site 5 /Y4i 4:y-_ specifications. _ Bldg 0 Clty/State Zip Listed Assembly (Circle&Complete A,B or C) N 6�t 1 Speufication# / %f Owner Mai ng Address2 Manufacturer: O W SVS I S 3� Cilvist zl Phone 3<a UL Classification:- Name lassification:_,Name Listed UL Building Materials Directory Page#: G aS GV /U (OR) Roofing Mailing Address_ r L 3b Warnock Hersey Contractor 7J •S!� ) 7 / _ �.. ."nor to issuance �1tyltate � zip Listed Warnock Hersey Directory Pages _ applicant must � ' -Q�Y4-17ZL - _______ (PROVIDE COPY OF ASSEMBLY) rovide a copy of -15 one# Fax# all contractor y - X1.11 C H. ICBO Research licenses if State Constr.Contr. Board# Exp.,Dat expired in COT DATED: database) rocTo Bus.Tax or Metro Lic# p. to (PROVIDE COPY OF AS EMBLY) _ (, O l BUILDING INFORMATION C SPECIAL PURPOSE ROOFING WOOD SHAKES' ;3udding-Type Of Use: (circle one)Q ("review required by plans examiner) SF SFA %F _ 3uilding- Type of Construction: VALUATION OF PROJECT $ :xisting Deck Type: Yet,V.L9 Permit fee based on valuation' Combustible ) Non-Combustible ( ) _ "see chart on back $ RESIDENTIAL ONLY-Class of Work:Alteration City use only: WACO REPAIR (MAJOR) (BUILD) (U-BUILD) Permit required ONLY when spared sheathing is covered by solid sheathing. 5% State Surcharge $ City use only: WACO: �- MMIT THREE f31 SETS OF PLANS_SPECIFYING. (TAX) I (UTAX) A Roof area&nearest street. - 65% Plan Review $ B.Attic vents-Provide sq. ft. for each 150 sq.ft of attic City use only: WACO: space&vents shall be located in the upper 1/3 of the roof. (BUPPLN) (UBUPLN) Provide 1 sq. ft. for each 300 sq. ft. when eaves 3 attic TOTAL $ `0 1. COMMERCIAL ONLY �- I acknowledge that I have read this application and that the % of Work: Atterat)on work to be done: (check appropriate box) information given is correct;tQt I am the owner or authorized -)F (circle A,B agent of the owner, anf'hat N`ie plans (it applicable) are in •q built-up roof covering to be REMOVED and deck compliance wi on State law. �d- Slg atu:15erso]nNbV3& i t Date g bullt-up roof covering to REMAIN- note applicant/.ubmit an engineer's review of the roof structural-its. Review shall bear the seal(or stamp)of the a , .t or engineer licensed in Oregon. TlA 111 or wood shin le/shake a2t ,e GL Uyl�s v DCC(data) 09CV iv 7-d P` �� 30(l (PROCEED TO STEP 2) Y_Ll�?1 �1GARD_ TOTAL PLAN STATE BUILDING VALUATION OF PERMIT F.L.S. REVIEW TAX PERMIT PROJECT FEES (40%) (65%) (5%) FEES 1-1500 25.00 10.00 16.25 1.25 52.50 1,501-1600 26.50 10.60 17.23 1.33 55.66 1,601-1,700 28.00 11.20 18.20 1.40 58.80 1,701-1,800 29.50 11.80 19.18 1 .48 61.96 1,801-1,900 31.00 12.40 20.15 1.55 65.10 1,901-2.,000 32.50 13.00 21.13 1.63 68.26 2,001-3,000 38.50 15.40 25.03 1.93 80.8E 3,001-4,000 44.50 17.80 28.93 2.23 93.46 4,001-5,000 5050 20.20 32.83 2.53 106.06 5,001-6,000 56.50 22.60 36.73 2.83 118.66 6,001-7,000 62..50 25.00 40.63 3.13 131.25 7,001-8,000 68.50 27.40 44.53 3.43 143.86 8,001-9,000 7450 29.80 48.43 3.73 156.46 9,001-10,000 80.50 32.20 52.33 4.03 169.06 10,001-11,000 86.50 34.60 56.23 t.33 181.66 11,001-12,000 92.50 37.00 60.13 4.63 194.26 12,001-13,000 98.50 39.40 64.03 4.93 206.86 13,001-14,000 104.50 41.80 67.93 5.23 219.46 14,001-15,000 110.50 44.20 71.83 5.53 232.06 15,001-16,000 116.50 46.60 75.73 5.83 244.66 16,001-17,000 122.50 49.00 79.63 613 257.26 17,001-18,000 128.50 51.40 83.53 6.43 269.86 18,001-19,000 134.50 53.80 87.43 6.73 282.46 19,001-20,000 140.50 56.20 91.33 7.03 295.06 20,001-21,000 146.50 58.60 95.23 7.33 307.66 21,001-22,000 152.50 61.00 99.13 7.63 320.26 22,001-23,000 158.50 63.40 103.03 7.93 332.86 23,001-24,000 164.50 65.80 106.93 8.23 345.46 24,001-25,000 17050 68.2.0 110.83 8.53 358.06 25,001-26,000 175.00 70.00 113.75 875 367.50 26,001-27,000 179.50 71.80 116.68 8.98 376.96 27,001-28,000 184.00 73.60 119.60 9.20 386.40 28,001-2.9,000 188.50 75.40 122.53 9.43 395.86 29,001-30,000 193.00 77.20 125.45 9.65 405.30 30,001-31,000 197.50 79.00 128.38 9.88 414.76 31,001-32,000 202.00 8080 131.30 10.10 424.20 32,001-33,000 206.50 82.60 134.23 10.33 433.66 33,001-34,000 211.00 84.40 13715 10.55 443.10 34.001-35,000 215.50 86.20 140.08 10.78 45256 35,001-36,000 220.00 88.00 143.00 11.00 462.00 36,001-37,000 224.50 89.80 145.93 11.23 471.46 37,001-38,000 229.00 9160 148.85 11.45 480.90 1 ROOF 1 DOC(dsts) 4 IMPORTANT INFORMATION FOR USERS OF T11tc n'---- ROOF COVERING 14ATERIALS(TEVT) CDtr[inUed PREPARED ROOF COVERING MATERIALS(1FYit)—" _— ------ 89553 (N) 10 ROOF COVERiN,MATERIALS(TEVT) ContinuedHICAGO IL 60606 C MATERIALS(TFW1)— MASONITE CORP; S WACKER OR, for installation as Class mant C.OVERIN 82472 (N) SUITE 2880 shingtes, with an underlaay halt PREPARED ROOF les are to a prnvided 15(15 lb) P MATERIALS INC 46394 Nre retardant treated he shi glen ars of TypeDint GLOBE BUILDING WNITING 1N re ared roof cOveeino9f t pp 30(301b)or two IaY 2230 11 BLVD, and shingles,for installation as Class C t,be used under each butt anis`alt sheet roofing anis felt shingles, for installation as of at least one lay .()16.in.thick metal tab, Asphalt org halt organic roof organic felt,and a application. �.s, for installation as Clas^rse B prepared roof coverins. ASDshingle aPP r�,;ded with an underlay ►es, gin,thick p1Yw°od decks• during wind resistate s fibermatShing for installation as Class Ad prepared resistant roof Ffre retardant treated hard board s ^9 Asphalt g for installation as will prepared root coverings3 Capshin t a are to be p s.Suitable for fat that. on minimum 3/ ars of Type GG sheet le apPl�atfon thick metal tab is to be use raveling les, of two layers Dint during Shing Asphalt glass fiber mat shin9 under each butt J 818103 (N) coverings R11655 (N) GS ROOFING PRODUCTS CO iNC BLVD, IRVING TX NELCO ENGINEERING MARYViLLE TN 37801 prep ared root coverings SUITE 900 5525 MACARTHUR for installation as Class l P P and shin9 Formed plastic roof tiles, t wood deck when laid over i/2 in. gypsum 75038 les,for installation installations as 161D MUSTANG D 32 in. P roof covering in anis felt sheet roofing 8 in. ��,rr. Gp01gra Pacific Dens Deck". Asphalt organ Asphalt or felt shingles, board or 1/ oriels, for installation as Class 8 repareon d tp°f CpVeof rgovering. b Ies, for installation as ^d palmed plastic roof p with Pty of Type 30 felt followed Surto le to, installationon minimum 3/ suitable for use on nufacturers installation instructions. Suitable for use e Class C prepared ro° halt organic felt sheet, of thick plywood decks. Asp re ared roof accordance with ma roof covering in 2 in. plywood deck covered w shingles, for installation fn.thick plywood decks. minimum 1/ a G3 mineral surfaced cap resistant root coverings. resistant roof by one layer of Typ panels, for installation as Class C Asphalt glass fiber mat Shing as wind Formed plastic to P ars . Type 15 or one layer r mat shingles, for installation to ared roof coverings.Suitableee ur installation nn minimum 3/g wood deck covered with two lay C p accordance with manufacturers installation instructions. Suitable for use Asphalt glass fiber 2 in.p1Y for installation to Class P minimum 1/ halt organic felt. coverings. of Type 30 asp 82453 (N) Asphalt In wool felt shingles, ggtes Ies, for installation gsi�lathick ovetrngs. Asphalt miners I ryber mathshing as wind resistant roof cover n9 RGLAS CORP c as halt gla for installation as fiBE prepared Modlfied P s Suitable lot installation minimum OWENS-CORNING TOLEDO ON 43659 p1epared ronF covering ' halt glass Hber mat shingles, for installation as Class C P P re ared roof covering T-15 FIBERGLAS TOWER rep roof plywood decks. Modified Asp wood shingle Asphalt glass fiber mat sheet roofing, ass App wind resistant roof coven'les,for installationnaetitl over existing shingles, for installation Cthick plywood decks Asphalt lass at Shing T e 30 underlay roof coverings. le underlayment with minimum YP Asphalt glass fiber mat shin9on felt or shingle 2 thick when use Suitable tot Installation nit saturated 3/ roof. les, Classified in accordance with ASTM D3462, coverings• ment such as aspaccessory and on minimum 1/24 fur Asphalt glass mat shingles, with underly UL as a prepared rooting halt glass filre' "thick plywood Including tear resistance, R4299 (N) classified by mens. Asp I Doti decks without underlay lass fiber mat shingles for installation as KEY ROOFING CO Pn' Nation as Class C prepared roof coverings on minimum 3/ HERBERT M�p1AUMBIA BLVD KENTON STATION PO BOX ment.Asphalt g 3131 N prepared roof Wend resistantut uroofrkov I�^Class A for use in reroofing• pORTLANO t 97217 far installation as Class s P P French method shin9 Ies classified in accordance with ASTM 034 62, 17217, les, les,for installation as wind resistant shingles,Asphalt glass fiber mat shin9 halt glass mat rovenngs, Asphalt g IeS may bear the statement"Also i A�udinq tear resistance• R11271 (N) roof coverings•halt glass fiber mat st trig „ re ared DIV OF PACIFIC COAST Modified asp to 110 n�D(o� installation as Class C p P evaluated at win(Ive beroMet sheet roofing, PASCO ROOFING PRODUCTS' far installation as Class C Asphalt g BUILDING PRODUCTS CRAMENTO CA 95816 roof coverings. R10660(N) PO BOX 160488, and shingle`E4 for installation 3in thick s Asphalt glass mat sh^9 PRODUCTS lNC Asphalt organic felt sheet loo n9 HOOVER TREAA1EI HOMSON GA 30824 for installation as Class C prepared loo covetrrrg P ' for installation as wind resistant 7 wood ,shingles, ant of at least one A prepared roof coveiingslasstmat Slit^yles�lation on minimum 3 PO BOX yy plywood decks. Asphalt g Fire retardant treanedwtid cpn edar with anrga deTtalL coverings.Wind resistance his also been evaluated at wind velocities u repared roof cove 15 asphalt saturatedroof Payer of Classified TypeR5765 (N) to 110 mph. R18263 (N) CANADA WOOD INC 74454 when IKO INDUSTRIES LTDBfIAMPTON ON RE NEW 8114 ST,WAGONER OK ate d roof covering 71 ORENDA RD, Ies, for installation as Class C rooF coverings. 104 NW til'for installationnae class C prep Asphalt organic felt Shing re ared roof formed roofing for mst{oat9nstall Non ass[lasstAoPf p ver rigs. I of shingle underlay Asphalt o'glassffiberelt himet shingles, R8491 (N) Asphalt g for installation as wind resistant roof laid Duet one ply tAsphalt glass fiber mat shingles, E 68370 REINKE SNAKES INCl NEBRON re areof covering felt 89806 (N) 210 S 47N ST, Type 15 asphalt. coverings. °veted with merit of (resulting the deck being Formed'1ed with an inteilayr installation as Class IKO MFG INC WILMINGTON DE 19809 roof when aPP le rtnderlay over ve (resulting gin UL ,.with ea Type of UL C ass'Hed shingle applied °V"Dminimum s DeCk OveABYment" with all HAY RD EDGEMOOR, Ips far installation as Class C prepared 2 lay �• Dints applied directly to Asphalt organic felt shin9 Georgia- ac Corp the plywood j roof sum or Georg in, from roverrngs. n1c felt shingles,for installation as wind resistant roof coverings. eei df�nimudecks. Asphalt orgy for installation as[lass A prepared Stagg Asphalt glass fiber mat shingles, minimum 15/32 plywood 813271 (S) coverin•s. Ies, For installation as wind resistant roofCORP HORNE BLVD Asphalt glass fiber mat shin9 SE SUITE AMERICA P3430 NA1NT coverings. R11951 (N) SUITE 120 SKYPARK 3 TORRANCE CA 90505 crook Roofing Tiles," for installation as a 2 1 CANADA V3M 6V5 design' tiari,cally fastened over miniypem155Aspha INTERNATIONAL EXTERIORS LT BE re ared roof coverings Cement tiles, when me ars of Type Ti 1689 CLIVEDEN AVE, T p G3 QWens-Coming A prepared roof covet, as an option, one or more lay For installation as Class 8 P D min plywood roof Thick plywood decks, inane may be used. ql Formed aluminum shingle, tied river 1!2 1n Local d when applied with an May also be app Classified pPresistatice only saturate organic felt underlay fiberglas "Parma-Cap• aced fnr decks.These coverings have been investigated LOOK FOR MARK ON PRODUCT authorities having jurisdict,on should be consulted before installation. PnooasAr.rue 111f0 IO JOB UAW oAIF slnffl Jag—loc.rM 3(,j C1Iy 1F u s4ID ZIP Cot* -- - NOMF PNOrIf i WOOR PHONE tAM PHONE 4000CF QTY MAI[RIAI I�1 st FRI u►Y� sw } �PIYw NUMB � I VNIS —�— I JDo - IOW ^Z _ E I I otr LIBOR � --J 10 PRCIF � too VENT Cm sw 40 va IFr FI/C.1 --------— v® n— - N- 3 --- Fr-- CFIIP SoFI C)PwvCk)*d 1 _ SfM,__ _—_-- $t---—.— sue � _ RAN Slary I 7 3 I'h ek __—__ Fr. X 1 4 -- 112 layer$ 1 ___ _ ? _ 3 4 FW --rmM d OVSI_— __ II ACCESS FrJIfElR PROPOSA1 MIAMIIIED 10 JO!NAME DAIS SIREEI JO8IOCA N C11V StAtF A117 EA GOaE HOME PHOIIE WORIS PNONF. 10 PHONE — SODRCF wJIY-_—tAAll IIIAI� SNI - � �' - h'� - h �- - -- •p, FEII '1 U y, dody + --� - 14 x . Ly Sw I! , -�_ SKY plyw Lim VNtS 1111 _ . mvF MIL IOM ll 1 A41 - QIY IAAOR V b TO ra FELT -- _ICE MCH I � r LOAD IANC CAI - Sw EF OIL - VUY CNV ID SQ Va A IF 4 (-H FI)CE ORD Hi -- VEE 0_---- N — . �_ - �— ---— FI-.- ------ Sllb -------- W OoRrVCki*d 2 SLI _ St —_ Story I 1 J 1'hBE.--- _ Fl— X 11 _111 Layer 1—.-- 2 - m AMSS P(XYIR CITY OF TIGARIA _ PLUMBING PERMIT DEVELOPMENT SERVIC PERMIT#: PLM1999-00186 13125 SW Hall Blvd., Tigard, OR 97223 (5U3 DATE ISSUED: 6116199 SITE ADDRESS: 14500 SW HALL BLVD B PARCEL: 2S 11266-04000 SUBDIVISION: WILSON ACRES ZONING: R-12 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS: S, RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 60 ft DISHWASHERS: RAIN DRAIN: ft Rernarks: Installation of less than 100'for water service. FEES _ Owner: Type By Date Amount Receipt WIEK FAMILY LTD PARTNERSHIP PRMT DEB � 6/16/99 $38.00 99-316165 GUARDIAN MGMT CORP 4380 SW MACADAM #380 MISC UE=.B 6/16199 $1.90 99-316165 _ PORTLAND, OR 97201 Total _ $39.90 Phone 1: Contractor: R D PLUMBING INC 13900 NW SPRINGVILLE RD PORTLAND, OR 9722.9 REQUIRED INSPECTIONS Water Line Insp Phone 1: FAX 297-7344 Final Inspection Reg M LIC 000739 PLM 26-313pb this permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is oot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these roles nr direct questions to OUNC by calling x,503) 240-1987 Permittee Signatu Issueb By: u _ Call (503) 639-4175 by 7:00 P.M. fnr an inspection needed the next buck kips y CITY OF TIGARD Plumbing Permit Application Plan Che * 93125 SW HALL BLVD. Commercial and Residential Rec.'dBy J TIGARD, OR 97223 Date Recd Lit it (503) 639-4171 Dale to P.E. - Print or Type Date to Ds Incomplete or illegible applications Will not be accepted Permit# PL IL, / c Related SWR Called--,-----_-- -- - Name of Development/Pro)ecf FIXTURES (Individual) QTY PRICE AMT ,lob ED4GW0e)0 MAIJOk Sink ---- goo Address Street Address O .9eite Lavatory 9.00 14-50L, S W I-JA LL QLV D, TUb or TuhlShower Comb —- 9.00 "4041 City/Slate Zip Shower Only -- 900 ,- -"(Z.Q._gk q]Z?�:q Water Closet --- — -- 9.00 -- Name _ ILMEfVT,- Dishwasher 900 Owner Mai i,g Address Suite Garbage Disposal _._ Washing Machine _ 900 City/Stale Zip Phone Floor Drain/Floor Sink 2" 9,00 Name --- 3" 9.00 4" -- 9.00 Occupant Mailing Address Suite — Water Heater O conversion O like kind 9.00 Gas piping requires a separate mechanical permit. CitylSlate Zip Phone Laundry Room Tray 900 - - Urinal 9.00 Name -- D PL_ l N Other fixtures(Specify) 9.00 Contractor Mailing Address 9.00 900 NW fdfkafVI j1" Prior to permit City/State Lip Phone Sewer-1st 100' - 30 Dk Issuance,a copy + 04A T72-14 -7 4 Z?— of all licenses are Oregon Const Cont.Board 1-ic.# Exp. Date required if �q 13 _2-s_OQ Water Service-1st 100' — -- -� 30,0Q expired In COT Plumbing Lic.# Exp. Date Water Service-each additional 200' i 25 00 �• database 3 � -�'`� Storm&Rain Drain-1st 100' 3000 Name Storm 6 Rain Drain-each additional 100' 25.00 Architect Mobile Home Space - 25.00 or Mailing Address Sulte Commercial Back Flow Prevention Device or Anti- 2500 Pollution Device Engineer City/State Zip I Phone Residential Backflow Prevention Device' 1500 ,Irrigation timing devices require a separate Describe work to be done: restricted energy permit) _ New O Repair A Replace with like kind. Yes* No O Any Trap or Waste Not Connected to a Fixture 9.00 Residential O Commercial O Catch Basin 9.00 Additional description of work. Insp.of Existing Plumbing 40.00 _ edhr Specially Requested Inspections — 4000 �EQ_UgC_ L� 1�� SEeTION OF �l PE - - r/hr Raln r i,single family dwrllrng 30.00 Are you capping, tnoving or replacing any fixtures? Grease Traps — 9 op Yes O No if yes, see back of form to indicate work performed by _— --- QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required NQuantity Total is >9 _ -WORK COULD RESULT IN INCREASED SEWER FEES. 'SUBTOTAL I hereby acknowledge that I have read this application,that the information __ g given is correct,that I am the owner or authorized agent of the owner,and 6%SURCHARGE that plans submitted are in compliance with Oregon State Laws. 91gnro f Ownerl.ge Date ••PLAN REVIEW 25%OF SUBTOTAL 11 Required onlyH fixture qty total is>9 _ Contact Penson.NIme — Phone TOTAL 21 - •Minimum permit fee Is$25+5%surcharge,except ResidenL.rl Backflow 74 ZZ Prevention Device,which is$15+5%surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review I WstsY,himapp doc 7098 PLEASE COMPLETE: Fixture Type — Quantity by Work Performed ----_ New Moved TReplaced RemovedlC_apped Sink - - Lavatory Tub or Tub/Shower Combination Shower Only Water Closet -`i -----V--- -~-- — -_--___ Dishwasher - _ - � ---- - -- ---------- Garbage Disposal - — -------- Washing Machine_ —� ---�- --� -- -�-.--- - Floor Drain/Floor Sink 2"- -- 311 WaterLaundry Room Room Tray �- Urinal `--- ------- - Other Fixtures (Specify) I COMMENTS REGARDING ABOVE: CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested O " AM PM r BLD IJV Suite uMEC Location- / `7 Contact Person _ Ph -;)QQq'yJk PLM Contractor - �-� Ph SWR -- ' E L c — --- --— -- BUILDING Tenant/Owner Retaining Wall ELF' Footing Access: FPS Foundation Ftg Drain SGN Crawl Drain Inspection Notes' SIT Slab Post&Beam Ext Sheath/Shear -- - Int Sheath/Shear Framing - - Insulation Drywall Nailing ---- Firewall Fire Sprinkler Fire Alarm — Su Ceiling -- OU� -1/1 ASS PART FAIL - -- - - Pl_ . BING ----------- Post&Beam Under Slab - --— Top Out Water Service - - -- - --- Sanitary Sewer Rain Drains - -- Final PASS PART FAIL - MI CHANICAL Post&Beam - - Rough In Gas Line - Smoke Dampers - - Final --_ PASS PART FAIL -- - ELECTRICAL - -- Service � - - ---._----- - Rough In UG/Slab --_-- Low Voltage - ---— Fire Alarm ----- - --- Final — ------ ----- PASS PART FAIL SITE __--. .-- Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ [Please call for reinspection RE: ( )Unable to inspect no access Fire Supply LineADA 10 Approach/Sidewalk Date .. ` �__Inspector Ext Other _ J -- Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.