Permit .,
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2006 -10016
,L'a11ii DEVELOPMENT H PME111g Tigard, - 639 - 4171 DATE ISSUED: 3/14/2006
PARCEL: 2S102BC-08000
SITE ADDRESS: 12765 SW WATKINS AVE ZONING: R -4.5
SUBDIVISION: THOMPSON MLP 1999 - 007 LOT: 001 JURISDICTION: TIG
Project Description: Previous garage conversion remodel.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: DWELLING UNITS: THIRD: sf RIGHT:
VALUE: 3,000.00
OCCUPANCY GRP: BDRM: BATH: TOTAL: o sf REAR:
PLUMBING
SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 0 CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL 8. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other
SARA & GEO KRAL OWNER • applicable laws. All work will be done in accordance with approved
12765 SW WATKINS plans. This permit will expire if work is not started within 180 days
TIGARD, OR 97223 of issuance, or if the 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 - 001 -0010 through 952 - 001 -0080. You may obtain copies
Phone: 503 - 522 - 5733 Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1-800-332-2344.
Reg #:
TOTAL FEES: $ 281.34
REQUIRED ITEMS AND REPORTS
� �` Permittee Signature : ... c)-
Issued By : / /L <1 „L •r
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
a
�~
Building Permit A mica sa ' ' �` ° ` „ w l , . _.. I lc ���1 c �l ,,,,,E -tm
City of Tigard Daee /
a tB d j -- / y 7�6 -1-- Penult No. 3 -� ; //a
13125 SW Hall Blvd., Tigard, OR 97223 MAE' ( � 1 4 2U) 1 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �� / '''!' r, .. , f l l" Date/By.. j / C/ 0 Other Permit.
Inspection Line: 503.639.4175 JAj ^ `1 1• Date Ready/By: Juris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TI e:
_LVotified/lylethod Supplemental Information
�' u / 4.6 a /6 r
.TYPE OF WORK . 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
f' CATEGORY OF CONSTRUCTION work indicated on this application.
' Valuation: $ d • tyG'
❑ 1- and 2- family dwelling El Commercial /industrial •
El 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: 1276 `,J 5W Nettki h S Ave, , New dwelling area: square feet
City /State /ZIP: "T" LtQ v .-4 1 b y 1 2.2 Garage /carport area: square feet
Suite/bldg. /apt. no.: L Project name: J R ) - 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: 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.
Valuation: $
Existing building area: square feet
New building area: square feet
.. r24ROPERTY OWNER I ❑ TENANT Number of stories:
Name:
i Type of construction:
l�a IrQ. -I G *° GTYLt � 14v 1 YP
Address: 12:7 CD 5 5 I J Na --ki ,tS Ave_ . Occupancy groups:
City /State /ZIP: ✓ � I D� 7 �iZ Existing:
• Phone: (503) 2 . 573 Fax: ( ) New:
0. APPLICANT - _❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR
Business name: 1 BUILDING PERMIT FEES*
Address: ` a refer
City /State /ZIP: (.,tI C Fees due upon a pplicat ion Pp to fee schedule.
Phone:( ) Fax:( )
Amount received
CCB lic.:
Date received:
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: t s via , - / Date: 3// 4 * Fee methodology set by Tri= County Building Industry
Service Board.
. is\ Building 'Permits\BUP- PermitApp.doc 12/03 4404613T( 1 I /02/COM/WEB)
One- and Two - Family Dwelling •
Building Permit Application Checklist ° °1 ` , R cal u'- 0\ M -
k� '' a 1 td • wt - °
City of Tigard Received
Permit No.:
Date/By:
13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960 a�"
I ❑ Electrical ❑ Plumbing ❑ Mechanical
24 - Hour Inspection Line: 503.639.4175 - P1+0-_ -
Internet: www.ci.tigard.or.us ❑' Other
; tit ��Lc���N
� C I FIEMS .aIZ R EJK iii >r. E- iiiiii a -� . s .
r f ���� " ,iii s . .a. /� � 1'cs �i \u .� K-
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
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- 0 ❑ ' ❑
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 ❑ ❑ ❑
there is more than a 4 -11. elevation differential, plan must show contour lines at 2 -11. 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 ❑ ❑ ❑
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 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. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑
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 ❑ ❑ ❑
architect licensed in Ore.on and shall be shown to be • • •licable to the •ro'ect under review.
CS—S
23 Five (5) 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. ❑ ❑ ❑
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.
1:\ Building \Permits\BUP- RES- PermitApp.doc 2
„Mechanical Permit Application , .. n .b '1 .1i5L ON .; ` "` . ;
City of T Received igard Date/By. Permit No.:0,L1-iy�6 .,) t!1a i `
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review cc77 // 1 0
Phone: 503.639.4171 Fax: 503.598.1960 � �J,�, r : h,,x • , i;?;• Date/By.
Other Permit:
Inspection Line: 503.639.4175 I II' Date Ready/By: Juris:
Internet www.ci.tigard.or.us ". „, t Notified/Method: Supplemental See Page 2 for
g Supplemental Information
TYPE OF WORK COMMERCIAL, FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Addition/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 materials, equipment, labor, overhead, and profit.
. . CATEGORY' OF CONSTRUCTION Value: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2-family g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. 1 Total
JOB . SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
1217 (D� tsw � � `J Ave_ (requires site plan showing placement) 14.00
City /State /ZIP: - 1 7 1 G Qv O R ' . 7 Furnace Fuace 100,000 BTU (ducts/vents) 14.00
J d 1 I Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 1... Gas heat pump 14.00
Cross street /directions to job site: Duct work / 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
• ' . DESCRIPTION OF WORK . . • Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
III4ROPERTY .OWNER . l ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: arQ •t . t P. 11� 1 Environmental exhaust and ventilation
G L Range hood/other kitchen
Address: 1 2-7(0 5 i.7 W d-r ki YIS A V e , equipment 10.00
City /State /ZIP: I l� G C --/ OR 1 7 ZZ 3 Clothes dryer exhaust 10.00
` \ / ' / file s exhaust (bathrooms, rooms) �JV .3 5 . 57 3 Fax: (5` b (o 27 27 f/J 6 toilet compartments, art ments, utilit rooms ) / 6.80
0 -APPLICANT - ❑ CONTACT PERSON . Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( )
Water heater
Fireplace
E -mail:
Range
•
CONTRACTOR '. . Barbecue
Business name:
Clothes dryer (gas)
1 Ere...... Other:
Address: % MECHANICAL PERMIT FEES *
�-�
City /State /ZIP: ( \ Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) -7r. • d
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee) )
TOTAL PERMIT FEE 1' . �0
Authorized signature: k� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 5e-✓a KL A 1 Date: c I ltd * Fee methodology set by Tri- County Building Industry Service Board
i:\ Buildin8 \Permits\MEC- PennitApp.doc 12/03 440- 4617T(11 /02/COM/WEB)
ti
Mechanical Permit Application - City of Tigard
Pagel 'Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit, Fee:
$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
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 $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
& lading Fixtures
Plumbing Permit Application „r� - .^.� t�lz w � _>1 1 Icy S 7.0N \-'' ti i ` 4,A
City of Tigard Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Date/By d�$ r too b - ) d� i)19
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / /mr,6 >� D ate/By Other Permit No.:
I 24- Hour Inspection Line: 503.639.4175 _l l Date Ready/By: I "g El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental lnformation
TYPE OF WORK FEE* SCHEDULE •-
❑ Ne onstruction ❑Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
is '21/ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. 11.) Page 2
' JOB. SITE INFORMATION AND LOCATION. Site utilities
Job site address: 12-165 5 W cd - its Ave. t Catch basin or area drain 16.60
City /State /ZIP: - =i ,,Q.rd / 6,2 9 ` -1 1 2-2_,"7-) Drywell, (each line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: lN Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site: 9c . U\ a 1. h u4 Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.:. ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.:
Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Back flow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
ROPERTY OWNER I ❑ TENANT
i ) Ejectors/sump 16.60
Name: 5 a r� 1 Expansion tank 16.60
Address: 1 2,l(p 5 V'➢ 1Na-t YAS A-ve Fixture /sewer cap 16.60
City /State /ZIP: ----r a V 7) 11 223 Floor drain/floor sink/hub 16.60
Phone: (579 5 i 51 Fax: ( 50'3 1 6 224 ,-2_---/ Garbage disposal 16.60
❑ APPLICANT ' ❑ CONTACT PERSO Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( )
Sink/basin/lavatory / 16.60
Tub /shower /shower pan / 16.60
E -mail Urinal 16.60
CONTRACTOR Water closet / 16.60
Business name: pe.t ro P IA rn ,i‘,, v Water heater 16.60
Address: Po `0 l Other:
�!'` Subtotal
City /State /ZIP: 1,1 boil Vi lie. OR. 9 7D 7) -
Minimum permit fee: $72.50
Phone: ( 503) '/ / o /2_2_/ Fax: ( ) Residential backflow minimum permit fee: $36.25 1 i 5v
CCB Lic.: q'152# Plumbin Lic. no.: 3.- y09 -- P2 Plan review (25 %ofpermit fee)
j a,(...a._ State surcharge (8% of permit fee) j ; Authorized signature: . TOTAL PERMIT FEE -7 e.-, 3 0
Print name: ( 5 kc / Date: ,3/, //Q 6 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\PLMF- PermitApp.doc 06/05 440-4616T(I0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
:= Fee Schedule: Residential Fire Suppression Systems:
Site Utilities' " - Qty. • Fee (ea) . Total Square Footage: Permit`Feei
Footing drain - 1' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:,
Storm &Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 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
Fixture, or Item . =Qty. Fee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Back flow 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 $1.45 for
each additional $100.00 or fraction thereof to
Inspection of existing plumbing or and including $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 fraction thereof.
Fixture Work: Plan Review'forComplex- Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Types , Replace ❑ Any new exterior plumbing site utilities.
Previous Capped .Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA 13 - D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain Isometric or Riser DiagraM
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial -
Ice Mach./Refrig. Drains
Oil, Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter .
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor P
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
\ Building \Permits\PLM- PennitApp.doc 07/06/05
•
CITY OFD; IGAIRD •
BUILDING ,DIVISION PERMIT #: MST200& -10015
13125 SW Hall Blvd., Tigard, OR. 97223 DATE ISSUED: 3114/2006
Phone: (503) 639 -4171 •
Inspection Requests (24 Hrs.): (503) 639 -4175 _ •`L
INSPECTION WORKSHEET FOR DATE: 6/21/2006 TIME: 7 :07AM PAGE: 3
SITE ADDRESS: 1 2765 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: rHOMPSON PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: KRAL
DESCRIPTION: Previous garage conversion remodel.
OWNER: KRAL, SARA & GEORGE PHONE #: 503 - 522 -5733
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/2/12006 • Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 03204B-02 50'3 -522 -5733 Y
Corrections/Comments/Instructions:
6. •
399 Plumbing final 03204E -02 503-522 -5733 Y
•
PASS ❑ PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS
❑
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: l t Date: 6 s i/ CI CD Phone #: (503) 718 - �i'
1
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: 6 6.— )OD / (o
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 -II
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' °_.. ao ft‘
INSPECTION WORKSHEET FOR DATE: TIME: QM PAGE:
SI SUBDIVISION: D I ` " � ' " A,��C, v1.5 Ave_ LOT #: CLASS OF WORK:
TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:,7 j- -- bZ — s '
CONTRACTOR: ( /N I - q PHONE #:
Inspection Request Scheduled For: Date: 3—..--3 - 0 co Pour Time:
Code # Inspection Description Confirm # Contact # Messag
3:9,b0 A�9S
Prvt
Corrections /Comments /Instructions: 1
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: w Date:3 Ay, / Phone #: (503) 718-
. CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006 10016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 31/4/2006
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 • " 'IL .
INSPECTION WORKSHEET FOR DATE: 6/2212006 TIME: 7:01AM PAGE: 941
. 1
SITE ADDRESS: 12765 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: TIIOMPSON PARTITION LOT #: 001 TYPE OF USE:
• PROJECT NAME: KRAL
DESCRIPTION: Previous garage conversion remodel.
OWNER: KRAL, SARA & GEORGE PHONE #: 503 - 52.2 -5733
CONTRACTOR: OWNER PHONE #:
• Inspection Request Scheduled For: Date: 6/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # M •
299 Final inspection 032115 -01 503 -522 -5733 Y
Corrections /Comments /Instructions:
6/22/2006 - ,
299 Final inspection 032115-01 503 -522 -5733 Y
17•• •Th
( . - ' .
f • .
1
• ir _
•
0 ..ziass ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CH t 1p Date: 6 Z2 - ° ( Q Phone #: (503) 718- ZG /V
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200G1001G
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2006
Phone: (503) 639 -4171 Mill
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/21/2006 TIME: 7:07AM PAGE: 39
SITE ADDRESS: 12765 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: THOMPSON PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: KRAL
DESCRIPTION: Previous garage conversion remodel.
OWNER: KRAL,.SARA & GEORGE PHONE #: 503 - 5215733
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # M ssa e
699 Mechanical final 03204B.01 503-522 -5733 Y (�
Corrections /Comments /Instructions:
4
6/21/2006
699 Mechanical final 03204E -01 603 -522 -5733 Y
- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GAT r Date: 6-a- - 0 G Phone #: (503) 718 -Zh `7
I' (" f /'
CITY OF. TIGARD
BUILDING DIVISION � PERMIT #: MS'I a006 i(iia'16
13125 SW Hall Blvd., Tigard, OR 97223 ` DATE ISSUED: - 3/14/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/21/2006 TIME: 7:02M1 PAGE: 78
SITE ADDRESS: 1276E, SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: TI Sc N PARTITION' LOT #: 001 TYPE OF USE:
PROJECT NAME: KRAL.
DESCRIPTION: Previous garage conversion remodel.
OWNER: KRAL, SARA & GEORGE PHONE #: 503- 622 -{i733
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/21/2006' Pour Time:
Code # In'spection Description • Confirm # Contact # Message
275 Framing 028441 -02 _ 503-622 -5733 Y
Corrections /Comments / Instructions:
I ^ 1
4/2 i /200 -
27t Framing 028441 -02 503-522 -5733
-ek Z? (a (cei
•
f cfrv.Ac
PASS ARTIAL- APPROVAL ❑ CANCEL • ❑ NO ACCESS
. ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: " v Date: 1.7---1/47° 't' Phone #: (503) 718- %12— 1 I
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: lAST2006.10016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3114/2006
Veb Phone: (503) 639 -4171 tea' +
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.. ', FII
INSPECTION WORKSHEET FOR DATE: 4/21/2006 TIME: 7:02AM - PAGE: 76
SITE ADDRESS: 12766 SW\A/ATKINS AVE CLASS OF WORK:
SUBDIVISION: THOMPSON PARTITION LOT #: 001 • TYPE OF USE:
PROJECT NAME: KRAL
DESCRIPTION: Previous garage conversion remodel.
OWNER: KHAL, SARA & GEORGE PHONE #: .503-522-5/33
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough -in 028441 -03 a03- ,22•x;733 Y
Corrections /Comments/ Instructions:
4/21/200G
eLeA/C_
615 Mechanical rough -in 020441 -03 503. 522 -5733, V
'0 44- 5 )A9 ' ' '
0 ---1-1-) A-A ,,e)(A/0A-4,1/4_s tr •A.9- - 6 - 4--- . ._, ,
R `
, L.--., 661K . \76er -4-1) . ,
•
O .
❑ PASS KPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ FAIL ❑ CALL FOR INSPECTION • El ADDITIONAL FEES ASSESSED
Inspector: Date: P hone #: (503) 718-
- CITY QF TIGARD
BUILDING DIVISION PERMIT #: MST200€ 1001G
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2006'
Phone: (503) 639- 41714gptI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 412//2006 TIME: 7:02AM PAGE: 74
SITE ADDRESS: 12765 SW WATKINS AVE , CLASS OF WORK:
SUBDIVISION: THOMPSON PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: KRAL
DESCRIPTION: Prfwious garage conversion remodel.
OWNER: KRAL, SARA & GEORGE PHONE #: 503 - a22 - 5733
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/21/2006 Pour Time:
. Code # Inspection Description Confirm # Contact # ' Message
•
699 Mechanical final 028412 -01 503 -522 -5733 N
Corrections /Comments /Instructions: •
4/21/2006
2 (A-6 t - 5 /( - s
•
699 Mechanical final 020 442.01 503-522-5733 N
0 /95-5.e.
•
r( )9...4
C
D
❑ PASS ❑ PARTIAL APPROVAL KCANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 Date: ('L'/ P Phone #: (503) 718 -2,1/4{
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MST2006-10016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3114/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/21/2006 TIME: 7:02AM PAGE: 60
SITE ADDRESS: 12765 SW WATKINS AVE.: CLASS OF WORK:
SUBDIVISION: THOMPSON PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: KRAL
DESCRIPTION: PfCtifi01/fs grage cOnVelSiOn fernosiel.
OWNER: KRAL, SARA GEORGE PHONE #: 503-522-5/33
CONTRACTOR: OWNER - PHONE #:
Inspection Request Scheduled For: Date: 4/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # A 4
messa
226 Psi/beam siniCtural 028441..01 603-522 Y
Corrections/Comments/Instructions:
4/21/200G
226 Post/beam structural 028441-01 503-522-5733
ikAkc,,e -
PARTIAL APPROVAL CANCEL LII NO ACCESS
Ei FAIL El CALL FOR INSPECTION LII ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD 7l sr //
1 BUILDING DIVISION PERMIT #:° 7t)°6 4° / 1�
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A YI
Inspection Requests (24 Hrs.): (503) 639 -4175 I I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE RESS: / ( `', 41).-e----- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: .
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 '� 7-0(0 Pour Time: (a '
Code' # Inspection Description Confirm # Contact # Message
2 7S - 1 FO £`a..D.X G:TAI
r y—cfrorvi
Correcti mments /Instructions:
// Q ,IL.4/ X14. -,.r
oK `r c_d Yvb
6 1- f/� T-1w.S0t,4` t 0 . b < ?G72 / /QD v c
v��— Q . PLAyt.) S
❑ PASS 7.4 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL / ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
-101111=10 ' Inspector: ■ _ Date: J . a? 0 Phone #: (503) 718- /7/71