Permit (141) aillCITY OF TIGARD MASTER PERMIT
` Permit#: MST2018-00345
4 COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/26/2018
T r G a R Dg Parcel: 2S103BB08400
Jurisdiction: Tigard
Site address: 12415 SW 122ND AVE
Subdivision: LAKE TERRACE Lot: 11
Project: SMITH
Project Description: Replacing(1)window with a larger window and a larger header.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0
Heat Pump: N Hoods: 1 Other Units: 1
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SMITH,TIMOTHY&MOLLY STRAIGHT LINE DESIGN&REMODELING LL Required Items and Reports(Conditions)
12415 SW 122ND AVE 4640 SW BEAVERTON HILLSDALE
TIGARD,OR 97223 HWY
PORTLAND,OR 97221
PHONE: PHONE: 503-244-5463
FAX:
Total Fees: $651.92
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 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
952-001-0010 through OAR/4%-001-0090. Yo/ay obtain a c;,.4 of the rules• direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. `.
Issued By: l/./i./ '.I A_�.�I: . Permittee Signature: t - /j�I 07 �/�/ «/<�t
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. //
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1111 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2018-00345
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued:
T I i;a r C7 9 Parcel: 2S103BB08400
Jurisdiction: Tigard
Site address: 12415 SW 122ND AVE
Subdivision: LAKE TERRACE Lot: 11
Project: SMITH
Project Description: Replacing(1)window with a larger window and a larger header.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0
Heat Pump: N Hoods: 1 Other Units: 1
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SMITH,TIMOTHY&MOLLY STRAIGHT LINE DESIGN&REMODELING LL Required Items and Reports(Conditions)
12415 SW 122ND AVE 4640 SW BEAVERTON HILLSDALE
TIGARD,OR 97223 HWY
PORTLAND,OR 97221
PHONE: PHONE: 503-244-5463
FAX:
Total Fees: $651.92
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rul s are set forth in OAR
952-001-0010 through 0411:52-001-0090. You `�, obtain a copy of the rules direct questions to OUNC by calling 503.232.1987 or 1.800.33 344.
Issued By: rL1 ' ' IV l�A�1J` -.`�j Permittee Signature: 7,771— (I-- f
V Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the pro' ct.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential 1lz Oil l( I. sl GNI.v
City of Tigard 0Received
it
J >I 1M Permit No.:
A Date/B : ,
;� • 13125 SW Hall Blvd.,Tigard,OR 9722 e� '��, Plan Review '
_ :I Phone: 503.718.2439 Fax: 503.598.19 q G4 Date/B : _Loa
i (1 �li Other Permit:
T I G A R l� Inspection Line: 503.639.4175 c, t�,,, B ,,,, �I'D.e Ready/By: ,., El See Page 2 for
Internet: www.tigard-or.gov `' 'ii1?- ` fied/Method• ✓ /�'4�'� `j_ Supplemental Information
�cc G,OV``A'° e71/9. c- -C Eta
TYPE OF WORI3```�)\`v REQUIRED 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
Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 0
Ell-and 2-family dwelling 0 Commercial/industrial �� -b
�
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 124 I 5 14)) 1 2242f Ave-- New dwelling area: J"7`} square feet
City/State/ZIP: -'r I t,r 2& G 772.3 Garage/carport area: square feet
Suite/bldg./apt.no.: / Project name: '/ Covered porch area: square feet
Cross street/directions to job site: $w 1_ (vlw - S Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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 this application.
r ll// / Valuation: $
Iept9 Unr_ - 5 l w1Actdw IN:l6- 6 (1 77 u rcw. net,)
& e r--/ />jV`lt� j jN�r Ir/ �e� i10 f/i Existing building area: square feet
h
l K l� New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: JC;_r41., //VI / i T 3� Type of construction:
Address: /24 I l 4A)4 `l'l 2 4„t Occupancy groups:
City/State/ZIP: 71/ te/ Oa .1 7 Z Z Z Existing:
Phone:( ) Fax:( ) New:
APPLICANT 0 CONTACT PERSON / BUILDING PERMIT FEES*
(PleasBusiness name:S4- L4-- / 0�errlt del✓L 1 vieweref(rr depe t):schedule)
`'"�e �'�'�f' �'' ' f Structural plan review fee(or deposit):
Contact name: c. C,1 .- (4 r /
Address: / FLS plan review fee(if applicable):
� 4'� �� is,,,,,,,-1-„,, l i�,--ir't'e IW Total fees due upon application: j �o77
City/State/ZIP: 10--.? ,er40/1 I /`V� 7 7 6 e •
Phone:(51?3)44-5.4633 Fax::( ) Amount received:
i?...-.) E-mail: `y- 4/ �, AIc A ��
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
v. JA Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Si- Submit two(2)sets of roof plan with connection details
�T t�icy�� L- n{ ��S;•7 rl y `j yq r� L f✓L and fire department access,along with the 2010 Oregon
Address: 16 gr sin) ),u,,,C,l„�-, /ti/i G,t- ✓ Solar Installation Specialty Code checklist.
City/State/ZIP: 3L }- 7 700 !`�' / Permit Fee(includes plan review $180.00
ctiv{/” O / rJ ' [ and administrative fees):
Phone:( 4_ 546 s Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: �
L) 8 10//q//, Total fee due upon application: $201.60
Authorized signature
i —
This permit application expires if a permit is not obtained
.... ., within 180 days after it has been accepted as complete.
4.(--,,, ,,
Print name:5 f ed Date: l2./l j// *Fee methodology set by Tri-County Building Industry
G>7 " 1 n �' Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One— and Two—Family Dwelling wiz o I l I( I: 1 s l: 0\1 1
City of Tigard ReceivedIN permit No.:
r 13125 SW Hall Blvd.,Tigard,OR 97223 Associat
I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIG A K D Internet: www.tigard-or.gov ❑ Other:
"TIE FOLLOWING ITEMS ARE REQUIREI) FOR PLAN REVIEW les yo A'1
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑
3 Verification of approved plat/lot. 0 0 ❑
4 Fire district approval required. Name of district: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0
6 Sewer permit. ❑ 0 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
building 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 be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 0
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.
12 Foundation plan. Show dimensions,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;minimum 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- ❑ ❑ ❑
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,and bearing ❑ 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load_
20 Manufactured floor/roof truss design details. 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ---0 ❑ 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 ❑ ❑
architect licensed in Ore.on and shall be shown to be a.•licable to the •ro'ect under review.
JURISDICIIONAI, SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ 0 ❑
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. 0 ❑ 0
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 trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 ❑
and protection measures must be drawn to scale and must include the project arborist's signature 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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application roll of l,( 1. l SE o\1.1
City of Tigard „ E "' Daceiseyd . PermitNo.: • .o,;3 -
IN . 2
13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175 13 2018 Date Re
1 t c3 n R I i �_��.� Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF T IGARD
TYPE OF iklkiii DING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46,75
Job site address:12415 SW 122"d Ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Smith Duct work 1 23.32 23.32
Cross street/directions to job site:SW Walnut St. Hydronic hot waters stem 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. , 46.75
Flue/vent for any of above _ 23.32
Subdivision: Lot no.: Other: _ 23.32
Other fuel appliances: _
Tax map/parcel no.: Water heater _ _ 23.32
DESCRIPTION OF WORK Gas fireplace/insert - _ 33.39
Flue vent for water heater or gas
-Install new hood vent. fireplace 23.32
Install bath fan Log lighter(gas) _ 23.32
Wood/pellet stove _ 33.39
Alter heating system. Wood fireplace/insert _ 23.32
Chimney/liner/flue/vent _ 23.32
® PROPERTY OWNER 0 TENANT Other: _ 23.32
Environmental exhaust and ventilation:
Name:Smith,Molly&Tim Range hood/other kitchen
equipment 133.39 33.39
Address:121415 SW 122"d Ave Clothes dryer exhaust _ 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 1 _ 23.32 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT,PERSON Other: - 23.32
Business name: Straight Line Design&Remodeling LLC. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Steven Griffin Furnace,etc.
Address:9645 SW Beaverton Hillsdale Hwy Gas heat pump _
Wall/suspended/unit heater
City/State/ZIP:Beaverton,OR 97005 Water heater
Phone:(971)275-3261 Fax::( ) Fireplace _
Range _ _
E-mail:steve@straightlinedr.com Barbecue
CONTRACTOR Clothes dryer(gas)_ _ _
Business name:Straight Line Design&Remodeling LLC. Other: -
MECHANICAL PERMIT FEES*
Address:9645 SW Beaverton Hillsdale Hwy Subtotal 80.03
City/State/ZIP:Beaverton,OR 97005 Minimum permit fee($90.00) 90
Plan review(25%of permit fee) 22.5
Phone:(503)244-5463 Fax:( ) State surcharge(12%of permit fee) 10.80
CCB lic.:195218 TOTAL PERMIT FEE 123.30
This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Authorized signature:_S t ( "� r * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,�e UZn AY Date: /Z//t /i(
I:�Building\Permits\MEC_PennitApp_040113.doc 4 461 (11/02/COM/WEB)
Plumbing Permit Application
Building Fixtures OR (111.1( lt sly. OM.),
City of Tigard I W�r , eived
r 13125 SW Hall Blvd.,Tigard,OR 97223 G Plan
Review Permit No.:
■ Phone: 503.718.2439 Fax: 503.598.1960 ll E r, 13 2 Q 18 Plan
Date/By: Other Permit No.:
t i C A I.F� Inspection Line: 503.639.4175 e Ready/By: Juris: 63 See Page 2 for
Internet: www.tigard-or.gov CITY Ur 1 i ,tr.�.t d/ ethod: Supplemental Informal*-woo
"-
......1".".-
0
OF WORK `3UILDINGDIVISIN FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description Qty. ET-1 Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connectionL
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath . 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:12415 SW 122"Ave Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:Smith Manufactured home utilities 50.03
Cross street/directions to job site:SW Walnut St. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Install Bar sink,kitchen sink,bath sink,toilet,shower,and dishwasher.
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Smith,Tim&Molly Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:12415 SW 122"d Ave _
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Straight Line Design&Remodeling LLC. Medical gas(value:$ ) Page 2
Contact name:Steve Griffin Primer 12.51
Roof drain(commercial) 12.51
Address:9645 SW Beaverton Hillsdale Hwy Sink/basin/lavatory 3 25.02 75.06
City/State/ZIP:Beaverton,OR 97005 Solar units(potable water) _ 62.54
Phone:(503)244-5463 Fax::( ) Tub/shower/shower pan 1 12.51 12.51
E-mail:steve@straightlinedr.com Urinal 25.02
CONTRACTOR Water closet 1 25.02 25.02
Water heater 37.52
Business name:Troy Elliot Plumbing Water piping/DWV 56.29
Address:P.O.1958 Other: 25.02
City/State/ZIP:North Plains,OR 97133 Subtotal 137.61
Phone:(503)309-5750 Fax:( )
Minimum permit fee: $72.50
Plan review (25%of permit fee) 34.40
CCB Lic.:152130 Plumbing Lic.no.:34-402PB
-- State surcharge(12%of permit fee) 16.51.
Authorized signature:f. TOTAL PERMIT FEE 188.52
Print name:Troy E iot Date:12/13/2018 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PennitApp.doc 10/01/09 440-4616T(10/02/COM/wEB)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12415 SW 122ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00345
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12415 SW 122ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00345
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12415 SW 122ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00345
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12415 SW 122ND AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00345
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
Electrical approved on correct ELC permit, no electrical on this permit.
Contractor to schedule final inspection for MST 2018-00345 to close this MST permit.
Violation Summary:
Inspector Contractor