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Permit CITY OF TGARD MASTER PERMIT PERMIT #: MST2006 -00048 ' II DEVELOPMENT H ®I BI ME T SERVICES 503-639-4171 DATE ISSUED: 3/10/2006 PARCEL: 2S105AD -11700 SITE ADDRESS: 14753 SW FERN ST ZONING: R - 12 SUBDIVISION: HILLSHIRE CREEK ESTATES NO. 3 LOT: 108 JURISDICTION: URB Project Description: Kitchen bath remodel. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: 12 FIRST: 30 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: 5 VALUE: 40 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 30 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: W0ODSTOVES: 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: 7 SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps•1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect onlv: >=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 Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes STEVE & TA JAYNES INSIDE JOBS LLC and all other applicable laws. All work will be done in 14753 SW FERN ST 11415 SW MUI RWOOD DR accordance with approved plans. This permit will expire TIGARD, OR 97223 PORTLAND, OR 97225 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: Contact #: PRI 503- 998 -5125 adopted by the Oregon Utility Notification Center. Those FAX 503 -641 -3297 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: LIC 154186 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 971.47 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS r , ., , . Issu d By : e...' _ /,/,..d_4_ Permittee Si • ::: W Call 503 - 639 -4175 by 7:00 a.m. for an inspection t . • •L- mess 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. IIPP vildiln� Permit A 1.-1. � Er �� . w. „. . al(,IZ • i i IN ' , - f et . 4 r, 4 .t e -;.& .v �14 tt n LtiS: c ". 'E llkvs''• NIC 4;i244 City of Tigard Received , D Permit No.: \ _ l a i • �: 13125 SW Hall Blvd., Tigard, OR 97223 , Plan Rehew , Phone: 503.639.4171 Fax: 503.598.196(f EB 21 200 �:��w, r � , Date/By. ^A 1/ 1 �7 - 0 6 Other Permit: Inspection Line: 503.639.4175 ,41t,P1 Date Ready/By: See Attached Checklist for Internet: www.tigard - or.gov CIT4 , 0 1 r( `` . ' ' "1 Notified/Method: 1 1 "supplemental information Y� j 11 1\ 1 f �� • 13pl ✓ ©F° WOK 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. 1- and 2-famil dwelling Valuation: $ L/0 oop IR y g ❑Commercial /industrial ❑ Accessory building El Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: it47 3 6 rev- n "61— New dwelling area: square feet City /State /ZIP: J t5a,-(i otz 9722 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 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: $ kii d. 0'1 an Po w d er beltk rem cycle( Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT . Number of stories: Name: 'r c 1 ,,,, . J A-Y n e S Type of construction: Address: JA✓) -1 e Occupancy groups: City /State /ZIP: Existing: Phone: O _.,,// Fax: ( ) New: E A •• PPLICANT' ❑ CONTACT PERSON NOTICE • Business name: -rns c4 e S s LL(. All contractors and subcontractors are required to be Contact name: � o c� E':1 licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: ( 4 i S so MA, r wo•cI jurisdiction in which work is being performed. If the City /State /ZIP: �7 f 1� nd ©a. 6i S applicant is exempt from licensing, the following reasons apply: Phone: 0; 'C% 1 5 i - c ( C - 0 3 ) Fax: : 03) (. l ' 3 2 - 1 71 E -mail: • I419 t .d ' o IPS L/ Co - ears -1-- . N e..:z CONTRACTOR Business name: . 5 t � z J ,b s L. LC „ ' BUILD PERMIT FEES Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) I Amount received CCB lic.: 194 l$(o +607 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: J AY po<f e:-t Date:..e, 2l eg Fee methodology set by Tri- County Building Industry 1 Service Board. I: \Building \Permits \BUP -TI- PermitApp.doc 12/30/05 440-4613T( I I/02/COM/WEB) Building Division � Plan Submittal Requirement Matrix Commercial & Multi- Family - New, Additions or Alterations City of Tigard Type of Submittal • # of Plans. (Includes new, additions and alterations.) , Required at Submittal Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 1* Fire Protection System 2 ** Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue) * For over -the- counter commercial tenant improvements, submit 2 sets of plans. ** "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. • 1: \ Building \Permits \BUP- TI-PermitApp.doc 12/30/05 440 -4613T(1 I /02/COM/WEB) i� a ° Q d 4 �;, °+ Mechanical Permit qgication = -� ° " . •=rt a ��- .��r r,lcl usl .)�' �1_ i i i � -.�,�: ��. City of 'I igard , D B y d , Permit No {� �/ 01 ( 0() ty 133 125 SW Hall Blvd., Tigard, OR 9 Plan Review )l C! Phone: 503.639.4171 Fax: 503.598.1960 iia +x a��i � ++ t Date/By. Other Permit: Inspection Line: 503.639.4175 it J Date Ready/By: Juris: El See Page 2 for Internet: www.ci.tigard.or.us FEB 21 2001 Notified/Method: Supplemental lnformation • y 111 p 1 C OMMERCIAL FEE* SCHEDULE USE CHECKLIST ❑ New construction a - { J�at i/�Itej'ati6 QN 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: $ L 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FE For special information use checklist. ❑ M aster builder ❑ Multi - family ❑ Other: Description 1 Qty. 1 Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Air conditioning or heat pump Job site address: 1 4 - ig 3 -StAS -rep- el (requires site plan showing placement) 14.00 City /State /ZIP: A"l ©12 7 c -z- .3 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: 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 k y l - � Gas fireplace 10.00 t t i e,*-, a vid T rte,..; c4 ¢- 6 c., +-PA ►^c.yy ci e , i 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 E PROPERTY ,OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 1 Other: _ 10.00 Name: S ••. .i - e..,1 �f�r> , V. - 7 P'I e S Environmental exhaust and ventilation Range hood/other kitchen Address: 5A-1-1.e. equipment 1 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 1 6.80 . ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 // c Other: 10.00 Business name: Tn S Cdr e •,Stir LL L Fuel piping Contact name: J A. yr a0J Er, $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: ( S ) / 32 1 7 Water heater ( S`o 03) �t 5! r j t Z S 3 �e Fireplace E -mail: ' t , . n t J e j D L , x p - co,,.„J CB, S 1` . N rc,C: Range ' CONTRACTOR Barbecue Clothes dryer (gas) Business name: 09. ---- Z60 t.../.,�, Other. Address: • MECHANICALPERMIT FEES * City /State /ZIP: Subtotal Minimum permit fee ($72.50) Phone:( ) Fax:( ) Plan review (25%o of permit fee) CCB lic.: i S� 1 g r„ i u o State surcharge (8% of permit fee) / TOTAL PERMIT FEE Authorized signature: �� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 'jay I Date: c Z i t 06 • Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Pennits\MEC- PennitApp.doc 12/03 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuations 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 Building Fixtures Plumbing Permit Ap l9 � ; , . P - - ' . i ()R (JI I I ce „ . . . -.- ,� .,•i� s ^� . ? City of Tigard Received Permit No.: a 13125 SW Hall Blvd., Tigard, OR 97223 Date/By. �� �.� Plan Review Phone: 503.639.4171 Fax: 503.598.1960 FED 21 20 l R *l , h l Date /By. Other Permit No.: � r I> 24- Hour Inspection Line: 503.639.4175 rl " k Date Ready/By: runs H See Page 2 for Internet: www.ci.tigard.or.us qq.� gg AA � Notified/Method: Supplemental Information TYPWOF \t • djV1 ` FEE* SCHEDULE BUILD t T I y r )�S i g ®1 v For special information use checklist. ❑ New construction V ` t► moldto P 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 1j 4- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 0 Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 • ' JOB SITE .INFORMATION AND LOCATION Site utilities Job site address: / Lf 7 5 '3 .r S Catch basin or area drain 16.60 City/State /ZIP: T' 0 . e,, Ott 9 - ZZ 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street /directions to job site: Manholes 16.60 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 Back flow preventer Page 2 k:a -C.VI 13R'14. J evhode I Backwater valve 16.60 Clothes washer -16.60 Dishwasher 1 16.60 . E PROPERTY OWNER I . .❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: ST Ti4y►. JA Vt p s Expansion tank 16.60 Address: SA 4 Fixture /sewer cap 16.60 City /State /ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 1 16.60 PPLICANT ❑ CONTACT PERSON Hose bib 16.60 0 A Ice maker I 16.60 Business name: T;h.6 44 c. J 04 ( - LC - Interceptor /grease trap 16.60 Contact name: .J y 13 rs <IE ..._‘ Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: (�io3) 1g 1 - e'1 Z < Fax:: ( ) Sink/basin/lavatory •L 16.60 //��,, Tub /shower /shower pan 16.60 E- mail: '"-, ode.. -3 o s t) ld Coen Cg s f" - NeZ Urinal 16.60 ' CONTRACTOR Water closet 1 16.60 Business name: mck ST: e__J 7 , is In c_ Water heater 16.60 Address: 12,4 4 $ Sc fk 5 Ley . Other: Subtotal City /State /ZIP: o ✓t'► ®✓L" ' 7 c( Minimum permit fee: $72.50 Phone: IUD()) 601 „ t Fax: (34;40 .ZS - $ 3 ■ 3 Residential backflow minimum permit fee: $36.25 CCB Lic.: 1 4 Z1 a I c � 1 l� b in g Lic. no.: 3 -- % t pB Plan review (25% of permit fee) f 1 Authorized signature: 7/1 101P State surcharge (8% of permit fee) 1 TOTAL PERMIT FEE Print name: ARls0 (11,457-6-w Date: 2.--/Z, ,, , This permit application expires if a permit is not obtained within i 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\PLMF- PennitApp.doc 06/05 440-46t6T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) To Square Footage: Perm Fee: Footing drain - 1 s, 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 Fixtore'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 $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 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 ❑ Any new commercial. building Fixture Type: 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 V - 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 pe will be issued and Urinal . • ' fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. i:\ Building \Pe'mits\PLM- PermitApp.doc 07/06/05 Feb. 21. 2006x1 lA 24 .1i �lCa FERRY ELECTRIC � No. 9939 P . 1 ty of Tigard '' °` .;' k ` � ,,,,,, , 1 ott oFI lCE t1SE i N *` w 3125 D Hall Blvd., Tigard, OR 97223 t ) i Ll r v Phone: 50 3.639.4t71 Pax: 503.598,1960 Inspection la / , n. \ Ilan Penxyt No \ 146, Line; 503 639 -4t75 /O4( vternet www.. agatd.ar us FEB 2 . i� � i Ducal . other r GO e : 1 � 1 1 ~ Note Um& errait 1 . tttl. • By. S See Page 2 for ❑ NeW construction I ® upplementat lotarmatioe struchon A. i.... 1 • .7' A�_ \fir ' . n .. t '-/,., I ' . F ' }I ,r ❑ Demolition { . DING TV , 1n tease check all that apply. Y + r' �� fc t lr r .v ,: f [ a ..t 1,. �r• ❑ Servce over 225 Ei 1 - and Z - : • _ r l} ,." f a ''Iii 1 , . u , , ,, a over 320 amps, rating ['Hazardous o location canon fsmily dweiling Q Co ` ;.1 ,_. c ; _ ' } o£ t• and 2•famil adwellings ing ❑Buildng over 10,000 s ft., ntmercial/industrial 0 Accessory building y 4 it more new resi truly + + ❑ Master builder d B , ❑ 3 ystern ever 600 volts nominal units in one structure 1 L i ❑ Other ['Building over three stories Job d I ' It ' �' ' i ress/ load over Feeders, 400 amps or more ❑ Multi fa no„ �`fL - ❑ er 99 persons ['Manufactured structures or B o Jo s ite address: f SR 7 s 3 S w ' ;.; , ' " ' ! ( ❑Egesallighting Flan RV. park City /State/ZIP: 1 ��,� r I ❑ti submit sets of plans with an ealtb care facility 00ther: ^ 4 . o f the above Suite/bldgJapt no.: The above are not Y Project name: I ? n applicable to temporary .. Cross S l rt f Ql ObJ _ P , �, , , , Paraty construction service. treet/directions to job site: e j,„ „it - ,1 ^. ' . i , .. , ,i ' . - - .;,. Description * it• r :' � New residential single. or Multi-family dwelling nit. .. includes attached garage. Subdivision: 1,000 sq. ft. or less Tax map/parcel no Lot no. :. I Ea. add'1500 sq, ft, or portion = ®_ 4 t Irk � ;' sr a Limited energy, residential 7 l • - !,.,',.1,,,,,r'.'.):.,!..,-_,,,,,, ,�, > T � � 75 ' d nuf 75.00 M 2 - ` �, ` _ ' �S � 8Y non-residential ME kr - �4F,, e , l , 0i n, n - I Each 75.00 ref,. tl ' manufactu or modular II MI 2 e dwellin _ service and/or feeder 90.90 Services or feeders Installation 2 .,. �a�; i 7:1-;k1_ tr I I i , q ,,; , ,, )`- ' � ll 200 s or I ,alteration relocation l an less , and/or cation N arne. — I '' :'.'l:,„ !.11:`'.:L'• fS l r sor , .:' t D' ^ ' h ° 201 amps 80.30 1 i s to 400 amps 106.85 2 lddiess: : j Over 1,000 a , 401 amps to 600 amps 2 601 amps to 1,000 amps = 160.60 2 1 try /State/ZIp; 240.60 2 amps or volts _� I I Temporary Services or feeders Installation, alteration, anti/or connect only 2 Re Phone: ( ) _ 66.85 _ . 2 PE Owner installation; This installation is being relocation intended for sale, lease, rent, Or exchange, according to O 447, 449, 670, and 701. 20/ 0 az11ps to 400 stops property that I own which is n. t amps or less Owner slgnatufe 1 L , , , Date 401 amps to 600 amps 100.30 2 Business "I 'i I.I ' W , ' ' , i r r n7 i 1 I ,! a, A.F for bra c , new, alteration or 2 name. branch circuit - i s A•Fee fo b , extension, Per Panel • - __,.. ranch circuits with Contact n service or feeder fee, each II 6.65 1111 2 fi e ' + B. Fee far b Address: ranch circuits without Service or feeder fee, 111111111 City/StatelZIp; each branch circuit or Each add'1 branch circuit 2 Phone: ( ) ■ ce se cellaneous (service v 6.65 E-mail: Pump or i ( ice or feeder not included) . Enta 2 P rrigation circle 'i ?_ a ? . Sig -' Sign or outline lighting 53.40 2 Business naname; _ -: ,'"'' <' ' t' + 1, r Signal circuits 53.40 2 !l O of {invited. B00ne Ferr E - 1•" en�BYPane1, alteratoon, or on. escribe Address: t extension. D. IN 2 P•0• $ox 628 City /State/Z1P: Each tsdditioaa! Wi 1 soni 12 a p� 97070 inspection over allowable in any Per inspection of the above Phone: (g_03) 652 -49 3 6 Fax Investigation _ 62.50 _ ' (5 0 682-7946 gahon per hour t br nl CCB l ' io '' 88482 Y. Electrical 3) U industrial .lent • cl hour min) IN 62.50 MIN cal Lic.; r Suprv. Electrician 0 3 2 2 3C Suprv. Lic.; `! 91 ., [i iii , 1y i1: I :, 13 e , required: , , I zlw f 11I I {r . !F int Warne: i Plan review (25% of Permit fee) Subtotal 9 3 5 �r.� /d f HiStRon Date: .7 2,/ Authorized signature: r pf I State surcharge g� 8 ( /o of permit fee) 0 TOTA , ; Print name: ; .L PERMIT FEE / 4 0 , Tate permit applicgNo e t bt inHulld¢r,p Date; days actor it h e na mlt Ia aol d *with! 110 8 amitKILGPere�tApp -doe 12/03 • Pee tpecbodolo acc epted pee of eom obtaine e eao.a6a3lparo2rcoMiwaa .' Nuarber of imp ctions Pa aerm;t * Building industry Service R �.a -, - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006- 00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/10/ Phone: (503) 639-4171 A. Inspection Requests (24 Hrs.): (503) 639-4175 440. INSPECTION WORKSHEET FOR DATE: 9/13/2006 TIME: 7:02AM PAGE: 46 SITE ADDRESS: 14763 SW FERN ST CLASS OF WORK: SUBDIVISION: HILLSHIRE CREEK ESTATES NO. 3 LOT #: 108 TYPE OF USE: PROJECT NAME: JAYNES • DESCRIPTION: Kitchen bath remodel. OWNER: JAYNES, STEVE & TAM PHONE #: CONTRACTOR: INSIDE JOBS LLC PHONE #: 503-998-5125 Inspection Request Scheduled For: Date: 9113/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 036431-03 603-998-5125 N • Corrections/Comments/Instructions: • — . de; ' - - PASS I 1 PARTIAL APPROVAL 0 CANCEL n NO ACCESS n FAIL El CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED Inspector: C-1 r Date: .1,13. 06 Phone #: (503) 718- Z6V 4/ CITY ��D~��� ������N�������� OF nn�����m�� BUILDING DIVISION ~°~°,~~~,,,°~° ~�"°,~,"~~"~ PERk4|T MST200800048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2V1OmO6 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 ,..4.141L INSPECTION WORKSHEET FOR DATE: 8/13/2008 TIME: 7:02AM PAGE: 47 SITE ADDRESS: 14763EWFERN ST CLASS OF WORK: SUBDIVISION: H|LLSH|RE ESTATES NO 3 LOT #: 1Oti TYPE OF USE: PROJECT NAME: JAYNES DESCRIPTION: Kitchen bath remodel. OWNER: JAYNES, STEVE & TAM PHONE #: CONTRACTOR: INSIDE JOBS LLC PHONE #: 5O3-998-5125 Inspection Request Scheduled For: Date: 9/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 056431~02 503-998-6i25 N • Corrections/Comments/Instructions: • K PASS PARTIAL APPROVAL n CANCEL | | NO ACCESS FAIL | | CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED � ^� �� |nInspector: �� Date: �'1~3. ���� Phone #: (503) 718- ^~^�ti � '' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST7006- 00048 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3//017006 Phone: (503) 639 -4171 Al�l 1 : Inspection Requests (24 Hrs.): (503) 639 -4175 s � __.. INSPECTION WORKSHEET FOR DATE: 9/13/2006 TIME: 7 :01AM PAGE: 48 SITE ADDRESS: 14763 SW FERN ST CLASS OF WORK: SUBDIVISION: HILLSHIRE CREEK ESTATES NO. 3 LOT #: 108 TYPE OF USE: PROJECT NAME: JAYNES DESCRIPTION: Kitchen bath remodel. OWNER: JAYNES, STEVE & TAM PHONE #: CONTRACTOR: INSIDE JOBS L.LC PHONE #: 503 - 998 - 5125 Inspection Request Scheduled For: Date: 91/312006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 036431 -01 503 - 998.5125 N Corrections /Comments/ Instructions: 61' PASS PARTIAL APPROVAL n CANCEL NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: .!� /(I Date: T'• I c' O.4 Phone #: (503) 718- 26 9 . CITY OF TIGARD 'V l rri $ BUILDING DIVISION PERMIT #: � O6 ---.°C)631 Ce 13125 SW Hall Blvd., Tigard, OR 97223 4 . ' R, DATE ISSUED: Phone: (503) 639 -4171 , Inspection Requests (24 Hrs.): (503) 639 -4175 4414 . INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 41 5 3 R-eAin CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: • Inspection Request Scheduled For: Date: 3 _ (S- o ( Pour Time: Code # Ins ection Description Confirmr. #• c- � Contact # Message 3 )___o , ��` , � . ; ' S ? 18 - 7 a 7 or Z- J \ — s /C is /Inst ns: c - _ 1/42(2_,v-vvo A ...z._9 . '9W V t-- t/Q'LA cs/ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS i n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED � �- O Date: 6 Phone #: (503) 2- 'V Inspector: � / N / ( ) 718 - CITY ®F TICa�4R® /91 S 7- BUILDING DIVISION PERMIT #: Z od 6 - ,!;76) y 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 - 4171 i�����vil` it Inspection Requests (24 Hrs.): (503) 639 -4175 n1!. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / y 7 5-3 -,-2J17 ,-' fill CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3—a 3- ®o Pour Time: Code # Inspection Description Confirm # Contact # Message ,0 a q ssage - - 5 1,201 1 9 Co rectio s /Co nts /Instructions: Pr i//j J e Y,5/ e ft r Q-AA k.1.4_ / 0; A/ 7 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS XFAIL 1 1 CA FOR INSPECTION n ADDITIONAL FEES ASSESSED or: Date: ' �- 9 -• Ph one #: (503) 7 ` 0 Inspector: ( ) 718 - CITY OF TIGARD O 41 5T - . • BUILDING DIVISION PERMIT #r 06 6 — C"?UO T g 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: Phone: (503) 639-4171 ei by iv ""I I Inspection Requests (24 Hrs.): (503) 639 -4175 .�'_ :. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 7 ...c3 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 a y- Pour Time: Code # Inspection Description Confirm # Contact # Message g- -75' z Fe) 4 Is ?q ,...,s--/ ,-S_ ' - vic� -mil; ck . wied-,,,.. CorrectioComments /Instructions: ve—s/ v—e" 2 3-° 4,",-- --OaQ- 2 7c c) . 6 (c = il z ❑ PASS PARTIAL APPROVAL ❑ CANCEL NO ACCESS n FAIL 1 1 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: Z� Phone #: (503) 718 -2 7 7