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Permit /A i 4/ i7 , i •14A--/" ...x...,_4_ . i. }rl • -.0 r ¥ OF TIGAR MASTER PERMIT PERMIT #: MST2006 - 00247 COMMUNITY DEVELOPMENT DATE ISSUED: 10/11/2006 TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135AA-00905 SITE ADDRESS: 10200 SW 90TH AVE ZONING: R -4.5 SUBDIVISION: TOWN OF METZGER LOT: 004 JURISDICTION: TIG PROJECT: DENT Project Description: 300sf addition. +interior remodel and deck. Other fixture: (1) hose bib. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 228 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 78 sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 511 DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BORE: BATH: TOTAL: 308 sf 29.241.00 REAR: PLUMBING SINKS: 0 WATER CLOSETS: 0 WASHING MACH: 0 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 0 • MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 0 CLOTHES DRYER: 0 FURN > =100K: UNIT HEATERS: HOODS: 0 OTHER UNITS: 0 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 0 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: WISVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amplvolt : 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 B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 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 6 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable MICHAEL DENT OWNER laws. All work will be done in accordance with approved plans. This 10200 SW 90TH AVE. permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 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 of these rules or direct Phone: 503 -813 -6366 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 780.30 REQUIRED ITEMS AND REPORTS Iss d By : kliriN s ,_ Permitte Signature : �!IJ Call 503.639.4175 by 7:00 a.m. for an inspection that busine da This permit card shall be kept in a conspicuous place on the job site until c • pietion of the project. Approved plans are required on the job site at the time of each inspection. lAi t+ij Yi � ELECTRICAL PERMIT ' � CITY OF TIC r „ PERMIT #: ELC2008 -00576 'ff ° A'� , COMMUNITY DEV PMENT ∎ .4 DATE ISSUED: 10/9/2008 TIG ys, 1312 SW Hall Blvd., Tigard, OR 9722 503.639.4171 PARCEL: 1S135AA SITE ADDRESS:. 10200'SW AVE ZONING: R - , 4?5 SUBDIVISION: TOWN OF"ME LOT : 004 JURISDICTION: TIG PROJECT: DENT Project Description: (1) service and (3) branch circuits. Job No. 25692 RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 1.00 0 200 amp: PUMP /IRRIGATION: . EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: . SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: 3 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: ' PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: MICHAEL DENT MIKES ELECTRIC 10200 SW 90TH AVE. 11070 SW ALLEN BLVD TIGARD, OR 97223 BEAVERTON, OR 97005 Phone: 503 - 813 -6366 Contact #: PR1 503 - 649 -6991 FAX 503 - 641 -1902 FEES Description Date . Amount Reg #: ELE 34 -18c [ELPRMT] ELC Permit 10/9/2008 $100.25 LIC 50209 [TAX] 12% State Surchar 10/9/2008 $12.03 SUP 4230S Total $112.28 REQUIRED ITEMS AND REPORTS 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 maccer4ance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more t n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility N9titisation Center. Those rules are set forth in OAR 52- 001 -0010 through AR 1.2 -e a 1 -0100. You may obtain copies of these rules or direct quest to OUNC at 503.246.6699 or 1.800.332.2344. ir e Iss ed By: � / L , ! - ' 1 .) Perm itt Si ature: �— OWNER INSTALLATION ONLY i �� The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: • ____..--- INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N:/ L- --- _. „ , �L DATE: t , - __--- (t LICENSE NO: 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. • ' MASTER PERMIT � PERMIT #: MST20064)0247 2 1 �J�i . DEVELOPMENT SERVICES DATE ISSUED: 10 /11/2006 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1 S165AA -00905 SITE ADDRESS: 10200 SW 90TH AVE . • ZONING :, R-4.5 . SUBDIVISION: TOWN OF METZGER LOT: 004 JURISDICTION: TIG Project Description: 300sf addition. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 228 sf BASEMENT: - sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND:. 78 sf . GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: at. RIGHT: VALUE OCCUPANCY: GRP: R3 BDRM: BATH: TOTAL: 306 sf _27.000.00 REAR: PLUMBING SINKS: WATER CLOSETS: WASHINGMACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE. TRAPS: OTHER FUTURES: • MECHANICAL _. FUEL TYPES FURN < 100K BOILICMP < 3HP: VENT FANS: CLOTHES DRYER: FURN >=100K UNIT HEATERS: HOODS: OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER. TEMPSRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS AMYL INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 • 200 am p: W/SVC OR F OR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC/FDR. 1 SIGN/OUT UN LT: PER HOUR: UMITED ENERGY: 401 - 600'amp: 401 - 600 amp: EA ADDL BR CIR: SIGNALIPANEL IN PLANT: MANU HM/SVC/FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000* amp/volt : . . CO PLAN REVIEW SECTION CaN Reconnect only: >=4 RES UNITS: SVC/FDR>=225 A: > 600 V NOMINAL CLS ARENSPC OCC ELECTRICAL • RESTRICTED ENERGY 1 A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: .. . BURGLAR ALARM: OTH: • BOILER: HVAC: LANDSCAFEARRIG: PROTECTIVE SIGNL• GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE' COMM: NURSE CALLS: TOTAL 6 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code; State, of OR. Specialty Codes and all other MICHAEL DENT OWNER applicable laws. All work will be done in accordance with approved 10200,SW 90TH AVE. 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 moreThan 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 - 813 - 6366 Contact #: of these rules or direct questions to OUNC by calling 503- 246 -6699 or 1-800-332-2344. Reg #: TOTAL FEES: $ 689.96 REQUIRED ITEMS AND REPORTS Issued By : A S - a �_�- Permittee Signature ` ? . L/ ■ .,Yi i i4 1 , N 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 time of each inspection. CITY OF TIGARD MASTER PERMIT PERMIT #: MST2006 -00247 ,r%'ii, i DEVELOPMENT R C -639 -4171 DATE ISSUED: 10/11/2006 PARCEL: 1 S 135AA -00905 SITE ADDRESS: 10200 SW 90TH AVE ZONING: R - 4.5 SUBDIVISION: TOWN OF METZGER LOT: 004 JURISDICTION: TIG Project Description: 300sf addition. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 228 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 78 sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 306 sf 27,000.00 REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN >=100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 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: 1 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 B. COMMERCIAL AUDIO & 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 MICHAEL DENT OWNER applicable laws. All work will be done in accordance with approved 10200 SW 90TH AVE. 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: 503 813 - 6366 Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1 -800- 332 -2344. Reg #: TOTAL FEES: $ 689.96 REQUIRED ITEMS AND REPORTS Issued By : Permittee Signature : _ _ ♦ / , •n, out 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. • - MASTER PERMIT CITY' �� ®1 PERMIT #: MST2006- 0024 °k °�il i" 1 DEVELOPMENT 3 W H B E g r SERVICES -639 -4171 DATE ISSUED: 10/11/2006 . PARCEL:, 1 S135AA- 0 SITEADDRESS: 1:0200 SW 90TH AVE ZONING: R-4.5 SUBDIVISION: TOWN OF METZGER LOT: 004 JURISDICTION: TIG Project Description: 300sf addition. BUILDING REISSUE: CUSTOM • STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 226 sf BASEMENT:' st LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 - SECOND: 78 sf GARAGE: sf FRONT: PARKING SPACES • TYPE OF CONST: 5N • DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 306 st 27,000.00 REAR: - . PLUMBING SINKS: WATER CLOSETS: -WASHING,MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: 'LAVATORIES: DISHWASHERS: FLOOR. DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL. FUEL TYPES FURN < -100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN' 100K UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER , - TEMP:SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS - 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: WISVC OR FOR PUMP/IRRIGATION: PER INSPECTION: ' EA AMYL 500SF: 201 - 400amp: 201 - 400 amp: 1st W /O;SVC/FDR:, 1 SIGN/OUT LIN LT: PER HOUR: • UMITED.ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: - IN PLANT: MANUHM /SVC!FDR: '601 • 1000 amp :. - 601. imps-1000v: MINOR LABEL: 1000. amplvoh : ®. PLAN REVIEW SECTION _ CO Reconnect only: » 4 UNITS: SVC1FDR»225 A:: > 600 V NOMINAL:. CLS ARENSPC OCC: ELECT RICAL • RESTRICTED ENERGY 1 A. SF:RESIDENTIAL 0 B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO - 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: mb : ,BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL• GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL OTHR: - - DATA/TELE COMM: NURSE CALLS: 'TOTAL R SYSTEMS: r w •, This permitis subject:, to the regulations contained in the Tigard Owner: ontrac or- � Municipal Code, State of OR. Speciatty Codes and all other MICHAEL DENT OWNER ;'1' A applicable laws. All work will be done in accordance with, approved 10200 SW 90TH AVE. ti plans. This permit' will expire if work is not started within 180 days TIGARD; OR 97223 F i4 ofissuance, or if the work is, suspended for more than 180 days. • u f' ATTENTION: Oregon law requires you to follow rules adopted by i s r*" the Oregon Utility Notification Center. Those rules are set forth,in • OAR•952- 001 -0010 through 952- 001 -0080. You may copies Phone: 503 -813 -6366 Contact #: of these rules or, direct' questions to OUNC bycalling 503- 246 -6699 or 1- 800'332 -2344. Reg #: TOTAL FEES: $ 689.96 REQUIRED ITEMS; AND REPORTS" i Issued By; ., . - 0 Permittee Signature.; ! A� ,�� Tki,L/ ,I =- • lAd Call 503- 639 -4175 by 7:00 a.m. for an inspection that business day. This- permit card shall bed 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. p., • a Building Permit Application FOR OFFI( I: l SE OBI.\ / QQ ,(J I, City of Tigard 2006 Plan . /V . e760 / Permit No.: Y , — X00 9 ji , 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review M V ■ • Other Permit: Phone: 5 03.639.4171 Fax: 503.59&1960 r TIGARD Daze/By. . T I G A R I) Inspection Line: 503.639 DU4LI, i9V DIVISION Date Ready :y: � ® See Attached Checldist Infor for Internet: www.tigard- or.gov Notified/Method: Supplemental 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 ,E1 Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1- and 2 -family dwelling ❑ Commercial /industrial Valuation: $ 7 DQD ❑ 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: ( O sL„) 9 J k ' New dwelling area: a `P. square feet City /State/ZIP: .T t QV_ 9-72-2-3 Garage /carport area: square feet i Suite/bldg. /apt. no.: 1 I Project name: Covered porch area: square feet Cross street /directions to job site: 6 - GP m 6 u.r I ..l- V Lnt.0 `� Deck area: square feet La (0..%/Y\ -T O 9 0'I U 4th 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. (.t7hr:1 - 11 S IU c.F Q%J ■je_ 40 �.`i S`tk1- c Valuation: S \ A in building area: square feet Yl New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: 'm tc \ r‘n ) 12M—\ Type of construction: Address: , J D.00 St.) 9 0--(u fF-\,A Occupancy groups: City /State /ZIP: . `t t i W' U 1 0 / 1 22_ > ) pc K Existing: Phone: (c b)) t % ` 61-64 , : ( ) New: g APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: 1 ► L 1 �-�a.A \ , IC licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 1 0100 SW % f Yf,_ jurisdiction in which work is being performed. If the City /State /ZIP: la ©, 2 Z 3 applicant is exempt from licensing, the following reasons apply: Phone: (''03) -t - 4titi I Fax: : ( ) E -mail: CO RACTOR Business name: yak � - `� 'A ii uw C �t BUILDING PERMIT FEES* Address: 1/ W N ' v (Please refer to fee srbedole) Structural plan review fee (or deposit): City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: Amount received: 1 �j S10 Authorized signature: b This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:M t L. \ k A.,...„,„, Date: OcA a ` 0 (.I (1 * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits \BUP- RES- PennitApp.docc V 0 0-11.0.. 440.4613T(11/02/COM/WEB) `Z ban -Z�S\ � )R3 S-7 i v . . One- and Two - Family Dwelling Building Permit Application Checklist I oit OFFI( I. I SI. Om.) City of Tigard Received Permit No.: 1, ■ 13125 SW Ha ll Blvd., Tigard, OR 97223 Date/By. social Phone: 503.639.4171 Fax: 503.598.1960 Asocaate S permits: 24- Hour Inspection Line: 503.639.4175 t1 ❑ Electrical 0 Plumbing ❑Mechanical Internet: www.tigard- or.gov ❑ Other. 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: . 0 ❑ ❑ 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- ❑ ❑ ❑ 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 -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 ❑ ❑ ❑ 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 ❑ ❑ 0 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 project under review. 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. ❑ ❑ 7:1 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ — Q - 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, ❑ ❑ 0 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- RES- PmnitApp.doc 03/21/06 r. s it s..' .��.„ • r 7 vk Building Futures RECEIVE - Plumbing Permit Application IY)IZ OI I R I I til O\l.l City of Tigard : Permit No.: • 131 j a 5W 13125 Blvd., Tigard, OR 97223 t i �I 2006 D I .( 06 ' 00Pl Plan Review ■ Phone: 503.639.4171 Fax: 503.598.196(UTY TIGARC Date/BY Other Permit No.: T i G R D Inspection Line: 503.639.4175 BUILDING DIVISIC at ReadyBy: Juris: El See Paget for Internet: www.tigard- or.gov otifi Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total Addition /alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 isi 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath i 350.00 ID Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: l e0 .100 SL. C� I Catch basin or area drain 16.60 City /State /ZIP: - - k () 9 -? Z 2-1> Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I i Project name: Footing drain (no. linear ft.: ) Page 2 Cross street /directions to job site: ``-- Manufactured home utilities 110.00 1 - �'p �� `)`/`� , n( -us"c Manholes 16.60 L AC. u-k 4 SO A u- ( Rain drain connector ( 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: _ ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: - Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 if Jr 411 _ 1 - . Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 • ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 X Ejectors/sump 16.60 Name: rn iCA 1; . \ �`4..,‘'x� Expansion tank 16.60 Address: I 0 Zc7k) S (J q t'(l. A Fixture /sewer cap 16.60 City /State /ZIP: '"t 1 o.r t n 9 2,2 3 Floor drain/floor sink/hub 16.60 Phone: (sb3)ex(3 -. (,.5( Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 I Ice maker 16.60 Business name: \ (»^ n 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:( ) I Fax::( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 (TOR Water closet 16.60 Business name: o ui 41 , s -- Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 t a . 50 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) 5.150 Authorized signature: TOTAL PERMIT FEE Print name: M c... t - Date:Q(s Z 2.0c) 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 \Pnmits\PLMF- PermitApp.doc 04/06/06 4404616T(10/02ICOM/WEB) 9 Plumbin! Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 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 Storm & Rain Drain - 1st 100' 55.00 _ Valuation: Permit Fee: $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 Backflow Prevention Device each additional $100.00 or fraction thereof; to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $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 Subtoal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Complex 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 El Any new commercial building. Fixture Type: Replace El 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 Switnming Pool Filter Washei - Clothes *Note: If the fixture work under this permit results in an Water Extractor 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. islBuilding .PennitslPLM- PermitApp.doc 07/06/05 V Electrical Permit Application_ Ft)li.c)rrlc i.: Fsr. ONl.� 111 City of Tigard RECEIVED Received Permit No.\ 1 a„po _ pti A) • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 2006 Date/B . Other Permit: T I G n R D Inspection Line: 503.639.4175 Date Ready/By: luri RI See Page 2 for Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method Supplemental Information TYPE OntOttRING DIVISION PLAN REVIEW ❑ New construction si Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural , 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", `T ", "1 - ", "1 - 3 ", �„-(t� 100HP or more. occupancy. Job no.: Job site address: I t.) 2 x> s ( AS / v k ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than (.4) (.4) ( �� 2_2'; ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more. Cross street/directions to job site: Description G 1�2R /� r rUC �Q O LD�U �� FEE SCHEDULE J I Qty. I Fee. I . New residential single- or multi- family dwelling unit. L 6 Luv\ t] O`t4 t� Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 3 WO y G 4 d nt (I, AlW-t residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation r 200 amps or less 80.30 2 `S PROPERTY OWNER l ❑ TENANT 201 amps to 400 amps 106.85 2 Name: i ciL oLik ` p \ n ,�`� 401 amps to 600 amps 160.60 2 1�� 601 amps to 1,000 amps 240.60 2 Address: t 01_00 , (1 ) Lj 1 f i 4 kt ,-L_ Over 1,000 amps or volts 454.65 2 City/State/ZIP: 4- 9 � 7 2-•Z-5 Temporary services or feeders installation, alteration, and/or 7 relocation Phone: (S0-5) • J— (3 4,, Fax: ( ) 200 amps or less 66.85 1 Owner install on: This installation is b ade on property that I own which is not 201 amps to 400 amps 100.30 2 intended for : e, lease For exch. : • ing to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signat , .. Date: Branch circuits — new alteration, or extension, per panel Date: Q C Z- ` Z A. Fee for branch circuits with ❑ �� ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: • B. Fee for branch circuits Contact name: without service or feeder fee I 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/ State/ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) 1 Fax : : ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle 53.40 2 ONTRACTOR Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited- ® ' energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) I Fax: ( ) Investigation per hour (l hr min) 62.50 CCB Lic.: I Electrical Lic.: I Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): Print name: I Date: State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: M Date� ! This permit application expires if a permit is not obtained within 180 Print name: l 1 Y i �'e A days after it has been accepted as complete. • Number of inspections allowed per permit. I:\ Building \Pennits\ELC- PennitApp.doc 05/23/06 440.4615T(11/05/COM/WEB r � Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: 1BuildinglPcnnitskELC- Permi64pp.doc 03/23/06 Oct. 2. 2006 9:59AM CLEAN WATER SERVICES 503 6814439 No.4928 P. 2 AI_IG- 29 -2nws 160 FROM: -- 71:507 84B 3525 P.7/ rl i . b) [7;1.6 r; I; \, h AUG 2 9 2006 , RECE1VEL �.._..._ _...... CWS File NuriaYl 6,02 -- I Clean�Vater Services [ Uer co,nmil,ncnr is ercar. Sensitive Area Pre-Screening Site Assessment JurisdictionDate Tax Map & Tax Lot 009 Owner Applicant (.�.r _._ _ Site Address Company i(1ZQl? 'v,v/ 4 r Address /0 2,00 S�, '3''O IS 1v Proposed Activity City State Zip r ,. -_1 9 vra,).“ ti-, 1p /1.e Phone r , 3 - 6 306 Fax 366 By submitting this form the Owner, or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of Inspecting project site conditions and gathering Information related to the project site. Official use only below this lino Official use only below th $ line Official use only below this lino 7 N NA Y N NA Sensitive Area Comosite Map Stormwater infrastructure maps t� Mapft /5 /cop _ ® QS # `L1.ZQ ' I Locally adopted studies or maps El Other Specify Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No. 04 -9: El Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. re Sensitive areas do not appear to exist on site or within 200' of the site. This prescreening site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas If they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 04-9, Section 3.02,1, All required permits and approvals must be obtained and completed under applicable local, state, and federal law. The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE „PROV1DER "LETTER IS REQUIRED. Reviewer Comments: Reviewed By: e' c 444— Date: ? /6/') °�" f6 0¢ 144G). Official use only Post -Ir Fax Note 7671 9 °�I l , Returned to Applicant i To G�a l From vd k4e! jl�s/ Mail Fax C'punlcrr Co,nept. co. , , ,` 'Y� Date r47D6'1' Phone # Phurl 150i __p Fax # 50 3, 0/3 f ax ll /o goo Ad Ye— A) This fort is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. I m r '"� 4 �tt i TRANSMITTAL, LETTER TO: / DATE RECEIVED: DEPT: BUILDING DIVISION Q �.;, ; , , - - . s _ k t 1 E `' ` ;,1 0 ', 2001 FRONT: CA L. H ZE_LD S "`'; COMPANY: r! LV N 6�G'I S2 U S � L� q .. t , ; _ ._ ,i .< PHONE: - ' RE: bo o , Rio -,a-- �� E-- /17 4' -6.694 7 (Site/ r reesss))+ (Permit/CaseNum er) roject name or su rvision name an. of num.er j D 8 4,03(c) ATTACHED ARE THE FOLLOWING ITE 4 S: Copies: Description: Additional set(s) of plans. A Revisions: 4- Cross section(s) and details. Wall bracing and/or lat analysi Floor /roof framing. Basement and retaining wall i / / t Beam calculations. Engineer's calculations. J t S r d" Other (explain): /w" Pbr) REMARKS: FOR OFFICE USE ONLY Rout- • e ' - t Technician: Date: 7. a . , Initials:�� y) Fees Due: r: Y:. ❑ No Fee Description: Amount ue: $ -755 7 $ $ �1. Special — �JJ Reprint Permit (per PE): X No ❑ Done p licant Notified: Date: Z d _ . �]� Initials: I . 64 - lam/ /1 1: \Building\Forms \Transmittal Letter- Revisions.doc 4/4/07 Case Activity Listing 9/22/2008 7:23.03AM EL _. Case #: ELC2005- 0023 "6 ay - -: .,), .; 5 Actwt Descri tton Date l: . n... Date Z Date 3 ::,rr ...; , Dts B ., ELC101`0 Application received 4/5/2005 None RECD DER 4/5/2005 DER ELC 1020 Permit created 4/5/2005 None DONE DER 4/5/2005 DER ELC1280 Issue permit 4/5/2005 None DONE DER 4/5/2005 DER ELC1290 Reprint,permit 6/23/2005 None DONE JMT 6/23/2005 JMT ELC2115 Electrical service 6/23/2005 6/24/2005 6/24/2005 None PART HS 6/24/2005 010032 - 01 503' - 236 - 3657 — VM - STI Y - 150 ELC2115 Electrical service None APRV HS 6/27/2005 HS ELC1530 Permit expired by 4/5/2007 None DONE GN 9/22/2008 Owner instructed to. obtain new limitation GN permit to continue this work. He (Mike Dent) agreed to get the new permit before continuing work. This permit cannot be extended• Page 1 of 1 CaseActivity_rpt ro CITY OF T"IGARD BUILDING DIVISION .PERMIT #: MST2006-00247 13125 SW Hall Blvd., Tigard OR:_ 97223 Alk DATE ISSUED: at 110006 Phone: (503) 639-4171 �u�tlt'lh� Inspection Requests (24 Hrs.): (503) 639 =4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 10/17/2008 7:02AM 4 SITE ADDRESS: 10200 SW 90TH AVE ,CLASS OF WORK: SUBDIVISION; TOWN OF IUfFf7GE LOT #: TYPE OF USE: • PROJECT 'NAME: l 004 DENT DESCRIPTION: 300x1 addition. +interior remodel enctdeck Other fixture: (1) hose bib. OWNER: DENT, M CHAEL PHONE #: 603 CONTRACTOR: owNER PHONE #: InsPection Request',Scheduled For: Date: Pour Time: 10/17/2008 Code # • ` Inspection Description Confirm # Contact # Message 120 Electrical rough -in 076864-02 503 -705 -4857 N Corrections/Comments/Instructions: A PRo■JA,L VviL 1,. �R.VC L . ttg : S`� "Al2 W f 1. 6 >P00 V 9 k 1 L i 0 t•It • • V t. `Co c a • ` Wes cA Nom, T A1A ..r,rl,1 PA ' ❑- PARTIAL•APPROVAL ❑ CANCEL:. ❑ NO ACCESS L n 'CALL FOR INSPECTION, .n ADDITIONAL FEES-ASSESSED Inspector: } Date: I�� Phon ) e •/L f p - Y a #: (503) 718 = Ll � a . CITY OF TIGARD. ; 41 ,, B . w UILDING DIVISION PERMIT #: M aT20t16 0027 1 3125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: . 10/11/2006 Phone: ,(503) 639 -4171 44u Inspection Requests (24. Hrs.): (503) 639 -4175 -±i '''--... INSPECTION WORKSHEET FOR DATE 9/22/2308 TIME 7 :QOA6+01 PAGE: Q • SITE ADDRESS: CLASS OF WORK: 1000 S'�1•SQTH AVE SUBDIVISION:. TOWN OF IvIET:ZGER LOT #: TYPE OF USE: 004 PROJECT NAME: ' DENT DESCRIPTION: 30 €)sf addition. +interior remodel and deck. ,Other fixture: (1) horse bib.. OWNER: DENT, MICHAEL --- r■ PHONE #: 503 -813 -6366 CONTRACTOR: OWNER . PHONE #: Inspection Request Scheduled For Date: � Pour Time Code # Inspection Description Confirm # Contact # Message 199 Electrical final 075771 -02 503- 293 -3657 N . Corrections /Comments /In'structions: . `'' 1 CP 8 C rA;•c) A 3 4.3D kt zel 1 , .n._ 0 kg Dco&. Li9 AI c 1 -- 1..Tee-- 1 6(L. "Oc � c n U bZ , DONS ■� 2. ft l 1 42s8 �- D 6`), • Ct, PR.0vk®E• NAIL AT 1A1 Ai AS b 1 i • w .,, CW•rEi TL Gam. rr ae 1 KAN r I - li 1 72-- N Y\ kkAwN4 . - . 4 e-0 LL R sz) w \ N60 .4 ? 'N 67 4 . NN)A.\r-Lg WTiNv5 ON kk I V. 1- . • PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS , XFAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Rra� � (fi 9v V��L.� Date ( vL j Phone #: (503) 718- �� +� • CITY' OF •TIGARD 0 t • BUILDING DIVISION • PERMIT # Ttalt 0824 13125: SW.Hall`Blvd, OR 97223 _ DATE ISSUED:,' , Phone (503)'639 4171, Aftett.I iI I • Inspection Requests (24 Hrs.) (503) 639 -4175 _. >l,1. INSPECTION WORKSHEET FOR . DATE : - c ./"LftWiS TIME: PAGE: SITE ADDRESS:1 t2, 5t:A) Si O f 'V CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: . 'PROJECT NAME: DESCRIPTION: P OWNER: PHONE', #: ' CONTRACTOR: w tQ ,PHONE #s. Inspection Request Scheduled For: Date: ci •4(,1 -'(_D Pour Time: ` ' Code #' Inspection Description Confirm # - Contact # Message ., Corrections /-Comments /Instructions: . pcwb az s 4) coo to cia. m\it wod...f . zJa-1.4(si .. ,.... . ' ., ‘,..\c\ w., oy `PteAt .v. cu. 0 PASS n PARTIAL APPROVAL ❑ CANCEL 0 NO ":ACCESS • FAIL rp CALL FOR INSPECTION ] ADDITIONAL FEES ASSESSED • Inspector: ( ,Date: 1 . Ci ' Phone #: (503) 718- 1-91-ft• V • _ w w . .. r u1 { CITY OF TIGARD j M a _ A b x _ 1- a . , -- �,� . ��.� -,x .� .,:� 1. BUILDING DIVISION ti P ER M IT #'�V15�T2n. hh^^ 2� • W f 13125 SW Hall Blvd:, Tigard OR 97223 \ ) " DATE ISSUED: Phone: (503) 639 41.71 4 14 .; ip� I 1 fly" I .�,k G, + '- : ,, r : •.4 • I Inspection Requests ;(24 `Hrs ): (503) 639 -41,75 - i `.. L t w 'INSPECTION WORKSHEET FOR DATE :, , C \ •'Z Z � TIME: ' PAG . SITE`ADDRESS,1 ZOO SW 'q 0 4, '. - - CLASS OF WQRK " SUBDIVISION:- LOT - T O F USE,: ' PROJECT NAME: DESCRIPTION: \ ��� OWNER ,'-'. PHONE #, • CONTRACTOR ,, W ' r, PHONE #: • ..:Inspection Request: Scheduled For• ,.,; ;_, -. Date. ' : : .- Pour Time:; Code: # Inspection .Description Confirm # Contact #' " Message , , , / , \, . '1 ,1 N :.. T 5 1 1 \ '' 0 , . ., ,„,' ' ' Corrections /`Cornmentsl'Instructions - 1 S •Ga N 1 N V'E 0 i Q � 1 . NI , i : :- C V " p& - L 0 ., `e`t'` ''. ` 7 � DONE uN : 'cuapni - l,.c. z 0e4 t O51 ' r _ b 0 .,4p 1 a Gt: \r .(L.- W ALL. f p(Z- C I U "N' 1 . i .., • . • 5 - i\NI)visli• , , , .. , vLI■ \, ()L . r , (11wp (1 c‘ ' — ,. , ,..,., . • , n PARTIAL AP PROVAL n CANCEL. 0 'N O ACCESS � PASS � , .FAIL t CALL FOR INSPECTION 1 I ADDITIONAL FEES ASSESSED • ' • • Inspector; CrN . I Date:° 1 1'1 Phone # (503) 718- 1 ' 9 I GAR CITY OF T' BUILDING DIVISION - PERMIT #: MIST2006 002.17 13125, SW Hall Blvd., Tigard'; OR 97223. DATE ISSUED: ' Phone: (503) 639-4171 1Q/ s 1 12006° Inspection 'Requests (24 Hrs.): (503) 639 -4175 ' v INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 9122/2006.M 5 SITE ADDRESS: CLASS OF WORK 10200 SW 90TH AVE SUBDIVISION: . LOT #: TYPE OF USE: I ` ? N OF METZGER (fit PROJECT NAME: DENT 'DESCRIPTION: 300sf addition. 4- interior remodel and deck Other fixture: (1)' hose bib. OWNER: DENT MICHAEL: PHONE # 503-313 -6366 CONTRACTOR: O PHONE #: • ; Inspection Request °Scheduled. For: Date: 99/22 - Pour Time ,� - • • Code # Inspection Description Confirm # Contact # Message 399' ,Plumhing'final • 075771 -01 503-293..3657 N Corrections /Comrrmentsilnstructions: cog c fr-Cri • r • • • PASS i ,PARTIAL•APPROVAL 0 CANCEL ❑- NO ACCESS ri FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G7), Date: ,2 ) Phone ,# (503) 718= CITY O'F 1°IGAR® ,'"(11- e BUILDING DIVISION )e. PERMIT #: MS7200 %00247 `13125 SW Hall Blvd., Tigard,. OR 97223 :DATE ISSUED: 10/'11/ f) Phone: (503) 639,41'71 4„0 4 , 94111 Inspection Requests,(24 Hrs.): (503) 639 -4175 ; ., INSPECTION WORKSHEET FOR DATE:' 1/3/2008 TIME:. 7 :00A PAGE: 52 SITE.ADDRESS: 10200 SW'9OTH AVE CLASS OF WORK: SUBDIVISION: TOWN j+ OF ME ZGER LOT #: 004 TYPE OF USE: PROJECT NAME: DENT DESCRIPTION :. 300.4 addition. +interior remodel and deck: Qther blue: (1)hore't)it. OWNER: DENT, MICHAEL. PHONE #: 504- 813 -6366 CONTRACTOR_: IjV'R'I =1� PHONE #: Inspection Request Scheduled For: Date: •11312008 Pour Time: • ' Code # Inspection Description ' Co nfirm # Contact # Message 275 Halting . 06244&31' 503.293,3657: N Corrections/Comments/Instruction: - . f _ i_ 81)-1/11, jC. -,tic. —/ 4 e fyki ❑ PASS 14 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS fl FAIL CA L FOR 'INSPECTION n ADDITIONAL FEES,ASSESSED qzr Ins ector: - 0 , Date: U Phone #: (503) 718 / P CITY OF TIGARD BUILDING DIVISION PERMIT #: MS12006.00147 131,25 SW Hall Blvd., Tigard, OR. 97223 DATE ISSUED: 10/11/2006. Phone (503); 639- 4:171 a�bm� Inspection Requests (24 Hrs.): `(503)'639-4175 INSPECTION WORKSHEET FOR DATE: 5///12007 TIME: 7O1AM PAGE: 106 SITE ADDRESS: 10200 SW 90TH AVE CLASS OF WORK: SUBDIVISION: TOWN .OF,IvIETZOER • LOT #: 004 TYPE OF USE: PROJECT ,NAME: DENT DESCRIPTION: 300d edditinn. OWNER: DENT; MICHAEL PHONE #: 503- 813 -63G6 CONTRACTOR: OWNER - PHONE # Inspection Request 'Scheduled For: Date: 6/11/2007 Pour Time: ' Code # Inspection 'Description. Confirm # Contact .# Message ' 240 Exterior sheathing 098080 =02 503 -G49 -9977" N . Corrections /Comments /Instructions:. • • ASS 1 .1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL, ❑, CALL FOR. INSPECTION ADDITIONAL FEES ASSESSED Inspector: Dare :S i/ 07 Phone #`. '(503) 718 - ZA • . _..' • • ..'CITY OF TIGARD . . . , - BUILDING DIVISION Ili- ;PERMIT #: MS 2006 -00247 , ' 131'25 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED : 10/11/2006 ' " �j l � 1 Phone: (503) 639-4171 vud " Inspection. Requests (24,Hrs.): (503), 639-4175 � . . INSPECTION WORKSHEET FOR DATE: 6!1112007 T 7 :01AM PAGE: 107 SITE ADDRESS: 10200 SW 90TH • AVE CLASS OF WORK: SUBDIVISION: TOWN OF METZGER LOT #: 004 TYPE OF .USE: • PROJECT NAME: DENT DESCRIPTION: • 3UO f: additions: - OWNER: DENT, MICHAEL . PHONE #: 5503 - 83.6366 CONTRACTOR :, 'OWNER PHONE, #: Inspection Request uest' Scheduled p q ' , eduled For: Date 611112807 Pour Time: • Code•# Inspection Description Confirm # Contact # Message • • 235 Shear walls/anchors 048080.01 ' 503 -849 -9877 N Corrections /Comments /Instructions: ° • ASS I I PARTIAL; APPROVAL CANCEL .. • fl NO ACCESS 1 FAIL CALL FOR. INSPECTION ADDITIONAL FEES ASSESSED ;Inspector Date: J =-1 / --e 7 Phone #; ' 718- 2$34 ( K CITY OF TIGAR B 410 UILDING DIVISION PERMIT #: nis o caa24 1,3125 SW Hall Blvd., Tigard, OR 97223. , DATE ISSUED: 10/11/2006 , Phone: (503) 63 - 4 1 71 1 "ml1�61)�' Inspection Requests (24 17Irs.): °(503) 639 - 4175 INSPECTION WORKSHEET FOR DATE: , 10/12/7006 TIME: 7 :biAldi PAGE: 16 .'_ • " SITE .ADDRESS: 10200 $W 90'TH AVE CLASS OFVVORK. SUBDIVISION: TCy4! OF EviETZUiER LOT #: ,004 TYPE OF USE. 1 , PROJECT NAME: DENT DESCRIPTION :, 300sf:; addition. Y - OWNER: DENT, PHO It.: ' 503 813 -6366 DENT, MICHAEL � . 'CONTRACTOR OWNER PHONE #: Inspection Request' Scheduled For: - Date 10/12/2000 • - Pour Time: 2 :00 t' Code # ` Inspection Description Confirm # Contact * Message . ' 205 Footing 030105 -01' 5O3- 293 3657 N Corrections /Comments /Instructions: ' l " f. rJG rf Ltlt L S '".e rG e-eczS W-1. S G.%L • • • • • • tor PASS . I j PARTIAL APPROVAL LJ CANCEL ❑ NO .ACCESS Li FAIL, - 1 I CALL FOR•INSPECTION .: • ADDITIONAL, FEES ASSESSED : Inspector: Date: fr - r =rte Phone #: (503) 71`8 = Si , OF • CITY OF TIGAR BUILDING DIVISION . PERMIT #: Im1ST2Q06 -00747 13125 (W Hall Blvd Tigard, OR 97223 DATE ISSUED:, 10/11/1006 ,. Phone: 503 639-4171 • Inspection Requests :(24 Hrs.): (503) 639 - 4175 ;• INSPECTION WORKSHEET FOR • DATE'. : 10/1212006 TIME 7:01AM PAGE: i5, SITE ADDRESS: - ' _ CLASS OF WORK: 10(18 til�J 90TH AVE - , SUBDIVISION: SUBDIViSION: TOWN OF'.METZGER ' LOT #: 0 'TYPE OF USE: .PROJECT NAME: DENT i DESCRIPTION: 300sf addition: • • OWNER: DENT, MICHAEL • 'PHONE #: 603..8'13.6366 • i CONTRACTOR: OWNER PHONE #:. Inspection Request Scheduled For :: Date:. Pour Time: P q 10/12/2006 2:00 . Code # Inspection Description Confirm # Contact # Message r' 210 Foundation walls 03e105 -02 503-293-3657 W Corrections %Comments / Instructions_ • • • • • • • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ Na : n FAIL. CALL FOR INSPECTION n , ADDITIONAL FEES ASSESSED • ' t Inspector; Date: ':!f --- Phone # (503) 718 4. {