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Permit ; :,5,;,,11,..,,....:, , i h ' . , MASTER PERMIT PERMIT #: MST2007 00112 x4, ' , COMMUNITY DEVELOPMENT DATE ISSUED: 7/5/2007 ,T IG A 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103DA - 04100 SITE ADDRESS: 13365 SW 107TH AVE ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: LASATER Project Description: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 685 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1,480 sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: 99 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 685 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 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: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 10 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 1 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADOL 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 applicable KARL LASATER OWNER laws. All work will be done in accordance with approved plans. This 136 NW 107TH AVE permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97229 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 -314 -0652 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 1,835.18 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Bolts in concrete Issued Permittee Signature : "0" .dail„ 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. Building Permit Application 'd�' ovv,t2 F 'd k t wf +d�1 ,*,01'ej�a.. t *la �,i' ru.��, } ti�"�'�n kvrv�yi!'�i Residential . }��,. r is a' m �•FOR "OFFICE USE ONLY ','A , ,, 4 i r t:';' a , U ��r 7. 60/ la, E' Received /^ / ' • City Of Tigard . ` : AC :kJ a • b i,, .,,. ? Date/By: L ReQ 07 Permit No.: 1 111 V 13125 SW Hall Blvd., Tigard, OR 72 3 g Plan Review = Other Permit. C Phone: 503.639.4171 Fax: 503.598.1960 Date /B `= 2A ' Inspection Line: 503.639.4175 JUN 2 e 2007 Date Ready /By: 65 See Page 2 for T I., A FZ n N otified/Method: 1 Internet: www.tigard or.gov � Supplemental Information CITY of t 0 EzQF REQUIRED DATA 1- AND 2- FAMILY DWELLING ' li DIVISION' - Permit fees* are based on the value of the work performed. ❑ New construction em 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- family dwelling ❑ Commercial /industrial Valuation: $ ?3/ / re, 70 ❑ Accessory building ❑ Multi - family Number of bedrooms: Q ❑ Master builder ❑ Other: Number of bathrooms: O JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 133 lOs 5j 1 O 7V A frE New dwelling area: ( sr square feet City /State /ZIP: T ( C' P(1 P OjL 1 7 . -)- s3 Garage /carport area: / square feet Suite/bldg. /apt. no.: Project name: I!z A L LP 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. A fl D I �Titta TO C= X (s % ING ,5% -(/C 7-14:26— Valuation: $ Existing building area: square feet New building area: square feet c'1rROPERTY OWNER . ❑ TENANT Number of stories: Name: V A Q L. JS47 Type of construction: Address: ! 3 7 Cc SW /6? Z Occupancy groups: City /State /ZIP: .-- Qe GI 7 .7)'3 Existing: Phone: (5J 3 i y 0 (p S- Fax: ( ) New: ❑ 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: 00- BUILDING PERMIT FEES* (Please ref to fee schedule) Address: Structural plan review fee (or deposit): City /State /ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax:( ) CCB lic.: Total fees due upon application: 6(L * .00 j1 Amount received: �v I n ot o Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: , 41J Z Date: / ) 0 2 * Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \BVP -RES PermitApp.doc 02/23/07 440- 4613T(11/02/COM /WEB) Building Permit Application Checklist , y Dwelling jl OR OFFICE:rUSE ONLY { �, One-.and Two -Famil d)wellin s4. x �� Recei ipii City o f Tigard Date /B Permit No.: a 131 SW Hall Blvd., Tigard, OR 97223 y Associated permits: 2 , Phone: 503.639.4171 Fax: 503.598.1960 ❑ Electrical ` - ❑ Plumbing ❑ Mechanical .T -tGARp __,,,, , Internet: www.tigard- or.gov ❑ Other . it .g* HEtRjt OWING ITEMS A'REXREQUI'_RED, Foif tVAWft VIEWII W " k , Y g* NI rSUA 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 Oregon and shall be shown to be a. , licable to the sroject under review. '' ,, x - -_ y D ~. s'IC'nttl' -1ak' : ' .: ai k" ;{ a (i. Sw�l_.� r a ( "tr f s .< �° 1.i - `ak.� i ' i' „ URISDIG S PCCI .;ICS ' ,. ,, :.__'.,:_ r .5 .., .v , * 3a }y� t , e� . <... rF_, z k- .�.,,` , _ .1 . _., _ - f -3. : t.... �.�.. ... ,.. d!�`s .�'�� -e `` f s �d�. ?k k i:� ��..z'yf �i[xialS':. _ �"i9:�w. s)�:I_ .� .,s.i�:w'� ..+� 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 wil 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 03/21/06 440- 4613T(1 l /02 /COM/WEB) +, � d § r;�d r1' +rrrA ar x x 7 r s n , 8aui � , � � Mechanical Permit A R1!cation %� `' liZi ,44. i � 0, FOR OFFICE USE ONLY 7 c' a (, 'd'�^+�l. ., «)l�:M1l �' +tN� +�.11�- .rl w;y �. t,Mn.aur re.,. �.r. n7S +,:�7cS " - ,H t � „3 J. ...n. r in rei r� , :. avu ' A �. hr : f-‘, . e�7 Permit No.: o d? H r,, 7 -tom /I 2- Phone: 503.6394171 Fax: 503.598.1960 Other Permit: ' 1p � Date/By: I C A It ' ij Inspection Line: 503.639.4175 �U 2 L 00 Date/By: Ready /By: MI See Page 2 for Internet: www.tigard - or.gov ; Notified/Method: Supplemental Information L . Irr Off 7 3 * — TY 3 1 ` \i 1 g COMMERCIAL FEE SCHEDULE USE CHECKLIST , ❑ New construction ❑ Q tt1 0r 1/a teration /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: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total - JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: /33 6,3 - % , Air plan or heat pump (requires site showing placement ) 14.00 City /State /ZIP: 77 C72 ,) ,. 3 Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name �L GfiZ Gas heat pump O 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not elect in -wall, in -duct, suspended, etc. 14.00 Flue /vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 ¢ c.. 0,,� (..).-t d_7 Flue vent for water heater or fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ®441 OPERTY OWNER : Chimney /liner /flue /vent 10.00 ❑ TENANT Other 10.00 Name: ,,..9,e z.. i..-J -7r'j_ Environmental exhaust and ventil: on Address: 13_3 < _ 1 v ' ` p 2 2 ,9-z,—&---- Range hood/other kitchen equipment 1 0.00 City /State /ZIP: TI G,Gr -2—,9 aj'/L . Y-J� Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (3) 3 / (.7 o ( Fax: ( ) toilet compartments, utility rooms) 6.80 . ❑ 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 • ach additional Furnace, etc. ' Address: Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range . CONTRACTOR - Barbecue Business name: O I ^ ` N L Clothes dryer (gas) l r /� Other: Address: MECHANICAL PE ES* City /State /ZIP: Subtotal Minimum permit fee ($72.50) Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 g days after it has been accepted as complete. Print name: 1 7L/✓i Date: 0 - 461 L 7 * Fee methodology set by Tri- County Building Industry Service Board I.\Building \Permits \MEC- PermitApp.doc 01/19/07 4 7T (11 /02 /COM /WEB) Mechanical Permit Application - City of Tigard Page 2 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. 1:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2 , Plumbing Permit Appli ation , 7 g Building Fixtures t J j b E ''t = -' ` }1 r ji , ' T ' f' � ` FOR OFFICEri USE r ONLY Cl , ., 1111 , E' iew permit No.: 1 3125 S W Hall Blvd., Tigard, OR 972 U 201 Date S r 7 v j( 2 �,, Other Permit No.: Phone: 503.639.4171 Fax: 503.598. D ate B y: Inspection Ins p �� Y Line: 503.639.4175 ,r 1 • , Y�+ l - i G A R 0 • ° ` Date Ready /By: Juris: ® See Page 2 for Internet: www.tigard or.gov 1 • - T` 1 0 a Notifed/Method: Supplemental Information TYPE Rj1 �} (iDi. V l0a. 11 FEE* SCHEDULE ❑ New construction ❑ Demolition _ For special information use checklist Description 1 Qty. 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 ❑ I - 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 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: /3) ,6s c / / 7 2 /a/1- ? Catch basin or area drain 16.60 City /State /ZIP: 776 /�JQ Q/2 . 7 j 3 Drywell, leach line, or trench drain 16.60 Suite bldg. /apt. no.: Project name: y, 1 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.: [c / Page 2 Subdivision: f 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 Backwater valve 16.60. Clothes washer 16.60 Dishwasher 16.60 ,.._, � Drinking fountain 16.60 gli OPERTY OWNER ❑ TENANT - Ejectors /sump 16.60 Name: / t''2L ��f�N..._ Expansion tank 16.60 Address: 7 33 n S . 51, 1 r - / (a 7 2:3 A Fixture /sewer cap 16.60 City /State /ZIP: 1 /‘A/ 0 - a 5 7 Z- Floordrain/floorsink/hub 16.60 Phone: ( 5633 /(. -C ( Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ ,CONTACT PERSON 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 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 • CONTRACTOR Water closet 16.60 Business name: T ' 7Z_ Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature TOTAL PERMIT FEE Print name: ��72 �7.f: Date d ‘ 0 7 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. 1:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(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) Total Square Footage: Permit Fee: 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 ValilatlOII' 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 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including first 0.00. Subtotal: $50 and up $742.00 for the e first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: .. Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric Or Riser D Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. - 4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\ Building \Permits\PLMM- PermitApp.doc 12/27/06 hA rai r �5 ° ,7 a �4 r b '' 1k t �+ TiF` f� 4 j ++ t> =i j li li T i ir, , Electrical Permit Application � � �� .� F 0FFICE.11S� ONLY 4 1 e „ � 4. x , r � 4' .,-''','.<,'t'4;.,., ' s Jkan _ Received 3 4< 3 o f Tigard . M Date/B Y. ./ Re 07 Permit No.. 1 r *x 7- / ° 13125 SW Hall Blvd., Tigard,. li{ . an Review .% C : r, Phone: 503.639.4171 Fax: 3.�q 1960, ' Other Permit: [ s� ' Date/By: T 'GAR n A Inspection Line: 503.639.417 Date Ready /By: lu / ® See Page 2 for Internet: www.tigard- or.gov `ll 9 Notified/Method: ( Supplemental Information TYPE. OF WORK 9 U 200! PLAN REVIEW ❑ New construction ❑ Additioret i �ilrt/ •eO ce A _ 1 x >' 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 0 Other CATEGORY , q .,. � % CT ON - where the available fault current ❑ Marinas and boatyards. A A1 �C(� DIVISION 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 0 Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ", Job no.: Job site address: ( 33 i 5-0/ /c 7 3 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: 7/ - '.€ a� 9 2 333 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: G mi-ht,Vz ❑ Service or feeder 600 amps or more. FEE SCHEDULE'. ' Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 New residential single- or multi- family dwelling unit. 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. ti.) • Limited energy, multi- family 75.00 2 /t / 1 74 Gz -i e. s� -2-1/c,- residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 1 80.30 2 21-F1FOPERTY OWNER ❑ TENANT. • 201 amps to 400 amps / 106.85 2 Name: L,L L�r 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: /3) 6 J S'iA....-14%, ,,L ,4-e Over 1,000 amps or volts 454.65 2 City /State /ZIP: 776,9-7447 Qi 7 j- _3 Temporary services or feeders installation, alteration, and/or relocation Phone: (56 ) 3 / 1.( (f*,�� Fax: ( ) 200 amps or less 66.85 1 '40r ,1 201 amps to 400 amps 100.30 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, ren or e ch g % ng to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 / Branch circuits — new, alteration, or extension, per panel Owner signature:( Date: A. Fee for branch circuits with ❑ A ❑ 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, 46.85 2 first branch circuit Address: Each add] branch circuit --4— 1 n 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: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 . •CONTRACTOR • Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited - vl // X 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: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): Authorized signatur0,_, TOTAL PERMIT FEE: f 0 ) This permit application expires if a permit is not obtained within 180 Print name: /Z�� G L� 09 rT (V Date: t / days after it has been n accepted as complete. * Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440-4615T( I I/05/COM/WEB 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* n Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work‘Involved: n Audio and Stereo Systems n Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n 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:\Building \Permits \ELC- PermitApp.doc 03/23/06 JUN'' -27= 2007 09 .,1;9 'AM Centric Elevator 503220,, , IC , iI!e � L :;La 1' j - !urn 2 7 ?o o? i ' /Y IST ��d �l2— ._ JUL 02 2007 t' __ — - � J �C�rI CITY (fit 11uA C;leanWate Services - . 7 BUILDING DIVISION Uda.1J._9�� 5J'� Ff 1SIO Our connnihbcnl Ir vicar■ CW5 P116 Number Sensitive Area Pre - Screening I .098 I Site Assessment - Jurisdiction: t2 f 4P• Property Information; (example 1S234A30140M Owner Information: Taxiot ID(s): 5/ o3DA o'/ /0O Name: 1 9L_ I- -S,¢: ✓t_ Company: Address: /33 6S — S4./ / 7V) r Site Address: /33 G S ...re-'10 7 A mod` 77a-/ o l'7,-..-3 Phone /Fax: ..AreD 3 i tj'O 6..s7. / Nearest Cross Street: q11,./ t.tJ Fuse - sr E -mail: ,i C C 6` .- WL.rii,e, , - 7 - Development Activity: Check all that app a pplIIcant Information: Addition to Single Family Residence (rooms, deck, garage) El l ame: di e , 415 0 e6 Z.,.9-3707e Lot Line Adjustment ❑ Minor Land Partition 0 Company: Residential Condominium ❑ Commercial Condominium ❑ Address: /236.3 J/ 7C 7,a7 ' Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial ❑ phone /Fax: S77 2/ yo 6r)-/- Other E -mail: M Cir.* - �'-? t c .',! '-7` • Will the project Involve any off -site work: YES ❑ NO a' nknown ❑ Location and description of off -site work: , UC 4f #r ,5 me spiv®771 /kgs , • m a d'I✓ L43 Additional comments or Information that may be needed to understand your project MVP .J") ar This application does NOT replace tho need for Grading and Erosion Control Permits, Connection Permits, Building Permlte, Site Development Permits, DEQ 1200.0 Permit or other permits ae Ieeuad by tna Department of Environmental Quality, Department of State Lands and /or Department of the Army COE. All required permits and approvals must bo obtained and completed under applicable local, state, and federal law. By signing 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 projeot site at all reasonable times for the purpose of Inspecting project vita conditions and gathering information related to the project site. I certify that I am familiar with the information contained In thls document, and to the best of my knowledge and belief, this information 10 true, complete, and accurate. PrintfType Name: ._. ..' L �I Print/Type Title: e✓ Signature : :=:j:..^.. .. Date: ' c FOR DISTRICT USE ONLY ❑ Sensitive areas potentially on site or within 200' of the site. TNE MUST PERFORM -A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre - Screening 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 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. Based on review of the submitted materials and best available Information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site :This Sensitive Area Prescreening Site Assessment does Jy,QZ eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. [l This Service Provider Letter Is not valid unless CWS approved site plan(s) are attached. ❑ The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. z Reviewed By: /4- Date: G/2 ff/O 7 2650 9W Hillsboro Highway • Hillsboro, Oregon 97129 /14 Phone: (603) 681.6100. Fax: (503) 881 -4439 • www$leanwaroriervicee.ora Ravine: May 1, 2007 • Permit #: S 1 r 4 OO7 °x(22/ l Z Construction Contractors Board 700 Summer St NE Suite 300 714 - �''.�t PO Box 14140 Address: � 3 (o S _. SL-t) ((� �l � � t Salem OR 97309 -5052 Issued by: —'/ Date: 7/ Phone: 503- 378 -4621 Web Address: www.ccb.state.or.us Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: [J 1. I own, reside in, or will reside in the completed structure. - Q 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. n 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities,on the reverse side of this form. (1-1 5 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06 -01 -04 .. , • Acting as Your Own General Contractor?:- . . . :. • - • "-- - INFORMATION NOTICE TO PROPERTY OWNERS • • - - ABOUT CONSTRUCTION RESPONSIBILITIES . • . . —.------ 1 . . . • . . NOTE: This Information Notice to Property Owners about Construction Responsibilitie s was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature, . . , . . . _ . . If you are acting as your own contractor to construct a new home or Make a substantial improvement 16 an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employer Responsibilities . . . . You will, in most instances, be ruled to be an - employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure, As the employer,you must comply with the following: • . , . Oregon's Withholding Tax Law: As an employer, yoti must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your - ' employees. For more information, call the Department Of-Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposeS . on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. . .,. •• , • ._., . • . „_ .. . .. ., The Oregon Business Identification Number (BIN) is a combined -number for both Oregon Withholding and Uneinployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.cior.state.or.usiformslpay.htm11 for the appropriate forms. .. - - Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could b'e subject to penalties and be liable for all claim costs if orie of Your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from,employees' wage You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their web site at www.irs.gov: -- . - . • . . . . . .. . . .. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. - . . - -, . - . . Liability and Property Damage Insurance: Contact insurance agent to see' if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. • . , '.-,, -■ • Time: Make sure you have sufficient time to supervise your employees.' • .., ' - . - .. - . • . . . . . . . ... _ .., _ . Expertise: Make sure you have the skills' to act as yobr osxier general contractor, to.coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_ownendoc 06-01-04 l yob -i -ee,7 �� U •-1 '` d yG ". � � �IiV CITY � 4Z-04i-t-- PERMIT PERMIT #: MST2007 -00112 ''`` - ° ;`{ COMMUNITY DEVELOPMENT DATE ISSUED: 7/5/2007 TIGARDr 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103DA - 04100 SITE ADDRESS: 13365 SW 107TH AVE ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: LASATER Project Description: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 685 sf BASEMENT: sf LEFT: SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1,480 sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: 112,064.10 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 685 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 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: 1 0 - 200 amp: W /SVC OR FDR: 10 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 1 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 0 401 - 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 8. STEREO: X VACUUM SYSTEM: X AUDIO & STEREO: • FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: ALL ENCOM BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X 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 KARL LASATER i OWNER laws. All work will be done in accordance with approved plans. This 136 NW 107TH AVE permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97229 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 -314 -0652 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 2,190.37 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Bolts in concrete f Issued B : j, / i� _•Ilealli Permittee Signature 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. This form 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. ' ' r ; °' nnr i! BUILDING BUILDING DIVISION ISI ®N � �� JO ,2 T RJ TRANSMIT TAL LET TER TO: (_�� DATE RECEIVED: DEPT: BUILDING DIVISION ,✓ FROM: w i o , / 1 a • .P-0 - 0 COMPANY: / PHONE: ,,F5 \ - )1/4 S , / 1, By RE: • T a -oa'1- 0 a t k (Site Address) ermi ase 1 um'er (Project name or subdivision na . ..nd for number) ATTA HED ARE THE FOLLOWIN I I , MS: Copies Description: / Copies: Description: Additio ' . et(s) of p . ns. X Revisions: Ern r r •Q,r' L ( a pkk Cross se `on .nd 4 .ills. Wall bracing and /or lateral analysis. loor /roof \ ing. Basement and retaining walls. 13,.m calcula ` n . Engineer's calculations. Othe�<e . lai s .• REMARKS: FOR OFFICE USE ONLY Routed to Permit Technician: Date: \ • ?) C Initials: kg„1, . Fees Due: ❑ Yes [No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes kNo ❑ Done Applicant Notified: Date: \ • -- • Q 5S, Initials: yA I \Building \Forms \Transmittal Letter- Revisions.doc 4/4/07 SF ' t Y' MASTER PE O ! G PERMIT #: MST2007 -00112 COMMUNITY DEVELOPMENT DATE ISSUED: 7/5/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103DA -04100 SITE ADDRESS: 13365 SW 107TH AVE ZONING: R - 3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: LASATER Project Description: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 685 sf BASEMENT: sf LEFT: SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1,480 sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 685 sf 112,064.10 REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS: LAVATORIES: 1 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: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 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: 1 0 - 200 amp: W /SVC OR FDR: 10 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 1 201 - 400 amp: 1st W/0 SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 0 401 - 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 8 STEREO: X VACUUM SYSTEM: X AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: ALL ENCOM BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X 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 KARL LASATER OWNER laws. All work will be done in accordance with approved plans. This 136 NW 107TH AVE permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97229 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 - 14 - 0652 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 2,190.37 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Bolts in concrete i Issued By : / _ _ _d, J" J / Permittee Signature : 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. This form 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. BUILDING DIVISION fTIGARD TRANSMITTAL LETTE TO: � 41■ _ _ • DATE RECEIVED: DEPT: BUILDING DIVISION FROM: t - _ p. ! 4& A COMPANY: PHONE: '`y 3 ■4 0 a By: RE: _ i�. f� r��.. ' . C�� 2- e — ss 'ermi 1 um.er 'roject name or s i •'vision name an• I* um 'er qfP ATTACHED ARE T I. FOLLOWING IT r.'•+' S: 1 O I • 0 Copies: Descriptio : � Copies: Description: Additio .1 set(s) of plans. Revisions: Cross :ection(s) and details. Wall bracing and /or lateral analysis. Floo /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): ci QC LC\ 0 REMARKS: FOR OFFICE USE ONLY uted to it echnician: Date: Initials: Fees Due: e ❑ No Fee Description: U n mq t Amount CJik rtd.) , ? s - Special A/J11, ,% Instructions: Re rint Permit er PE): Yes ❑ No ❑ Done Applicant Notified: /0S0 c. fm-i14.-co/ /54 , / Initials: 1: \Building\Forms \Transmittal Letter- Revisions .doc 4/4/07 �/ �� o / 4. • lj U Vr 1.o u � MASTER PERMIT IT . OF TIGARD IN PERMIT #: MST2007 -00112 COMMUNITY DEVELOPMENT DATE ISSUED: 7/5/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 103 DA - 04100 SITE ADDRESS: 13365 SW 107TH AVE ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: LASATER Project Description: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. . BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 885 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1 sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: 99 258.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 685 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS: LAVATORIES: 1 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: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: - W00DSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS . MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 10 PUMP /IRRIGATION: PER INSPECTION: EA • • D'L 500SF: 201 - 400 amp: 1 201 - 400 amp: 1st W/O SVCIFDR: SIGN /OUT LIN LT: PER HOUR: LIMITED 'Y: 0 4D1 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: • ' ANU H ' SVC /FD 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 AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: X VACUUM SYSTEM: X AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X •TH: ALL ENCOM BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X - CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X 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 KARL LASATER OWNER laws. All work will be done in accordance with approved plans. This 136 NW 107TH AVE permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97229 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 -314 -0652 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 1,916.18 REQUIRED ITEMS AND REPORTS Ersn Cntr1681 -4444 Bolts in concrete 1 Issued By : �� IL., Permittee Signature : 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. ' "1 "' /f / �` 7 ' :I ✓L1-1 /(�64 –t— MASTER PERMIT ill l . CITY :i� TI " PERMIT #: MST2007 -00112 „,, COMMUNITY DEVELOPMENT DATE ISSUED: 7/5/2007 ,TI GARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103DA - 04100 SITE ADDRESS: 13365 SW 107TH AVE ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: LASATER Project Description: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 685 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 1,480 sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: gg 258.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 685 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS: LAVATORIES: 1 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: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 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: 1 0 - 200 amp: W /SVC OR FDR: 10 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 1 201 - 400 amp: 1st WIO 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 HMISVC /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 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 # 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 KARL LASATER OWNER laws. All work will be done in accordance with approved plans. This 136 NW 107TH AVE permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97229 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 - 314 - 0652 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 1,835.18 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Bolts in concrete Issued By . • . _ ..� _ _ Permittee Signatur ,e___ 4 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. /0365 ,l,t) /67 -/=--- This f orm 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. IN . . . . .. . _, . , . , BUILDING DIVISION ::71 c A R b' TRANSMITTAL LETTER TO: W rcA , n e- DATE RECEIVED: DEPT: BUILDING DIVISION MERE" O C T 5 2007 FROM: KAML- L4547 . CITYOFTIGARD COMPANY: p(,✓N•eYL BU NGDIWSION PHONE: S'o 3 3/ y U {v S �-- By. SLID RE: C 3 3 (o S` SW /0 7 MS7 — co//2- (Site Address (Permit/Case Number) S , - 4 rCW / (Proje name or subdivision name and to % . . er) ATTACHED • 1' THE FOLLOWING ITE t:: / • Copies: D 'cription: Copies: Description: , r dditional set(s) of plans. / 3 Revisions: Ya to rH ) a ci 642.4Gas Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calcula io Engineer's calculations. Other (explai : . REMARKS: FOR OFFICE USE ONLY outed to Permit a cian : Date: \ \ • 1 . Cf l Initials: Fees Due: ❑ Yes K No Fee Description: Amount Due: $_______6!: Special _ In Re rmt Permit er PEI: [ Yes ° 0 No El Do Applican // 6 4krifle-7 /// Initial 4 • I:\Building\ Forms \Transmittal Letter - Revisions.doc 4/4/07 ; N - City of Tigard, Oregon o 13125 SW Hall Blvd. a Tigard, OR 97223 ; .`w # r r _I41 GARD , June 16, 2008 Karl Lasater 13365 SW 107``' Ave. Tigard, OR 97223 Re: Permit No. MST2007 -00112 Dear Mr. Lasater: The City of Tigard has processed a refund for the deposit of fees on the above referenced permit for the following: Site Address: 13365 SW 107`'' Ave. Project Name: Lasater Job No.: N/A Refund: ❑ Check # in the amount of $ . ® Credit card "return" receipt in the amount of $274.19. n Trust account "deposit" receipt in the amount of $ . Notes: Refund fees paid for detached garage included on permit with residential addition; new garage fees collected under new permit number MST2008- 00086. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I: \Building\ Refunds \Administration \LtrRefund- Deposit.doc 01/16/07 Phone: 503.639.4171 o Fax: 503.684.7297 0 www.tigard- or.gov o TTY Relay: 503.684.2772 City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Karl Lasater DATE: 6/16/08 13365 SW 107t Ave. Tigard, OR 97223 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 2007 -5584 Case #: MST2007 -00112 Date: 12/28/07 Address /Parcel: 13365 SW 107th Ave. Pay Method: CreditCard Project Name: Lasater EXPLANATION: Refund 100% of permit fees paid for detached garage portion of permit that was permitted under a separate permit. ',REFUND INFORMATION: Fee'Description From Receipt Revenue Account No. • Refund ' Example: [BUILD] Permit Fee Example: 245- 0000- 432000 •• $ Amount. [BUPPLN] Addl Pln Rv 245 - 0000 - 433000 $32.95 [BUILD] Addl Permit 245- 0000 - 432000 50.70 [TAX] Build 8% State Surchrg 100- 0000 - 207020 4.06 [CDCPLN] CDC Pln Rev 100 - 0000 - 433060 46.00 fLRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 [METCET] Metro Const Excise Tx 245- 0000 - 229202 134.48 TOTAL REFUND: $274.19 APPROVALS: If under $500 Professional Staff If under $7,500 Division Manager , a � f�' . ,, • If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board . FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY • Case Refund Processed: Date: -�%' �. - By I -`' • 1:\ Building \Refunds \RefundRequest.doc 05 /23/07 .. • Qi"s` a1 . = Yu µ „ CITY OF TIGARD 6/16/2008 { : o .;:, 1312 spy Hall tiled. 2:05:05IM "I igard. OR 97223 X03.639.4 71 • Refund Receipt #: 27200800000000002080 / ' L .�� A 4=T : / :=9-L Date: 06/16/2008 Line Denis: Case No 'Fran Code Description Revenue Account No Amount Paid MST2007 -00 1 1 2 Reversal - [CDCPLN] CDC Pln Re 100- 0000 - 433060 (46.00) MST2007 -00 1 1 2 Reversal - [LRPF] LR Planning 100- 0000 - 438050 (6.00) MST2007 -00I 12 Reversal - [BUPPLN] Add1 Pln R 2 45- 0000 - 433000 (32,95) MST2007 -00 1 1 2 Reversal - [BUILD] Addl Permit 245- 0000 - 432000 (50.70) MST2007 -001 12 Reversal - [TAX] Build 8% Stat 100- 0000 - 207020 (4.06) MST2007 -00 1 1 2 Reversal - [METCET] Metro Cons 2 45- 0000 - 2 (134.48) Line Item Total: ($274.19) Refund: Method Payer User ID Accl. /Check No. Approval No. Ilow Received Amount Paid Credit Reversal KARL LASATER 021 170 In Person (274.19) Refund Total: ($274.19) m O 0 v O N -n -o O . W u v p" y w a " f N om ° 4. � \ 0 G ..0 ,``) ..� 0 u y o u \ a _~ o Q cC . cd C e� y b a R a v fi u v °� �, v v o tit v c 5 p •. -: P . o � . ` W ° ,, U ca o W V-: FI te N 7, s l c t vi o F, v 6 4.1 5 5 ., a) u ce a: o p < a. cd Q H i.1r P4 -, 1_c I or I 4 f= CITY OF TIGARD 6/16,/2 08 a iii 131 25 SW' Hall Blvd. o I0:44:5 5A \ %1 ; �¢ , Tigard, OR 97223 503.639.4171 Fi GVg Receipt #: 27200700000000005584 6 :' / := / . , z_ -.. Date: 12/28/2007 Line Items: Case No Trail Code Description Revenue Account No Amount Paid MST2007 -001 12 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 46.00 MST2007 -00 1 1 2 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST2007 -001 12 [BUPPLN] Addl Pln RV 245 -0000 - 433000 32 MST2007 -001 12 [BUILD] Addl Permit 245 -0000 - 432000 50.70 MST2007 -00 1 1 2 [TAX] Build 8% State Surchrg 100- 0000 - 207020 4.06 MST2007 -001 12 [METCET] Metro Const Excise Tx 245- 0000 - 229202 134.48 Line Item Total: 5274.19 Payments: Method Payer User ID Acct. /Check No Approval No. Hogs Received Amount Paid CreditCard KARL LASATER BB 021 170 In Person 274.19 Payment Total: 5274.19 iRrr,yn.i.pt P ic,2 I of I I Community Development 40.0 j , id Request for Permit Action T4 G AjRD TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 . Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov FROM: Owner ❑ Applicant ❑ Contractor ❑ City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) �. n Q _ L . b .riarrtE-R-_ Mailing Address: ( 6 S S % ,./ 10 7:14-, - g 7 /- City /State /Zip: T/ 6 � - Q/7". 9 7 �--- 3 Phone No.: 3 3 ( 06 S L I PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ( LICATION. " 0 ' FUND ERMIT FEES .ttach receipt, if available). ii • i FOR EES DUE` (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). s\` Permit #: M ..(/ , 7 -- CIO /71-- Site Address or Parcel #: / 3 3 ( . 'ltZ /Cj /'7 , Project Name: ( Z S_ Subdivision Name: Lot #: .S:.,r 9 /1/49/c 7 EXPLANATION: lee 2 ' 1 G1f •'� G Ff - 72-/fx ---- ',. • 141 & '�Z /n /7 6-4- / 711 .0 ,,,t . - ere, a . ---- ck... 4 / _ - f Signature: ✓ i � Date: 62// d� 1' Print Name: %Z A-,e L -J29 2 7L / . Refund Policy t The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80 of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80°'o of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1-2 weeks for processing refunds. A t �°..� t4 4. irPar t a , F®1 Ti. B ONLY ,�. � rt x u .�._R;FFICE�. S .. �. ��MROM Niki, *r.4 Rte to Sys Admin: Date By Rte to Bldg Admin: Date to / /(�: /c. • By 4 " Refund Processed: Date C, /fCr, /0. By.t nvoice Processed: Date f By Permit Canceled: Date A1/41- By Parcel Tag Added: Date By Receipt # Date ` Method Amount $ I: \ Building \Forms \RegPermitAction.doc Rev 07/26/07 - - - -�.� „Zoe 2- . 23v , c c 7 -,J /// 033'0 i SGir9 C0'7 ,5 - may % CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007-00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 702001 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 'I I� INSPECTION WORKSHEET FOR DATE: 6/5120013 TIME: 7:OOAM PAGE: 15 SITE ADDRESS: 133€i' SW 187TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. Added detached 526 Flap. . 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. OWNER: LASATER, KARL PHONE #: 503. 314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/6/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 070938-02 503 - 314 -0652 N Corrections /Comments/ Instructions: Od_ P1 O ,A W c / / /. go y okel., lift/0 iiiim44,/ter- P' •S \ XPARTIAL APPROVAL ❑ CANCEL n NO ACCESS 1 FAIL n CALL FOR INSPECT! N ❑ ADDITIONAL FEES ASSESSED Inspector: OcZb �'' Date: • // one #: (503) 718 -142 CITY OF TIGARD BUILDING DIVISION PERMIT #: Iii ST2007- 00'1'12 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7l5/2001 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE: 16 • SITE ADDRESS: 13366 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space arid 1480 sq ft of garage/shop. Added detached 526 gara ge. 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. OWNER: LASATER, KARL PHONE #: 603- 314 -0662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 070602 -02 503.3140652 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL Il NO ACCESS — FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ab `/1 new , � i L Date: ,c1,30 Tht Phone #: (503) 718- ` • ��N7�� N�� ^ ' CITY ��m�� nm�� . BUILDING DIVISION PERMIT #: M0'2007-00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 ' Phone: (503) 639-4171 Inspection Requests (24Hmj:(5D3)83Q-4175 .� ° � �� INSPECTION WORKSHEET FOR DATE: 1/10/2008 TI : - - 7:OUAttli PAGE: 40 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685no space and 14BO sq ft of gaiageishop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. l/4/O8. adding water helVwr and venting. OWNER: LASATER.KARL PHONE #: 503'314'0653 CONTRACTOR: OWNER PHONE #: Inspection Req Scheduled Foc Date: 1/10/2008 Pour Time: Code # Kspection Description Confirm # Contact # Message 320 ^Q Plumbing rough-in 0E2869-01 603-314-0652 N Corrections/Comments/Instructions: ASS 0 PARTIAL APPROVAL ID CANCEL NO ACCESS n FAIL 0 CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED - ^ / \ b �� . � � �� Inspector Date: � / � I w - ` Phone #: (503) 718- �- ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: "7/5/)0:17 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/3/2000 TIME: 7 :00AM PAGE: 14 SITE ADDRESS: 13365 SW •10 rIl AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 6035 -';q ft of habitable space and 1400 sq tt § f gaiage/: hop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASATER, KARL PHONE #: 503-314-0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/3/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Plumbing rough -in i7 002501-02 503.314-0652 Corrections /Comments /InstYuctions: Lo , ( . 4 v J q a �� s Q.�� P, .p ; c. 5 r F 1 ; 6 k arc, " .€ . . "fr o t . ✓ LA_ ip <Y G \A 3 O L.- J-,(Y 0 . a'ruL -I-I./tut l-J\Ar e ;\,,,_[\„v 'PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (1 Date: ) 3 ) Dpi Phone #: (503) 718- =CITY OFTIGARD BUILDING DIVISION PERMIT #: MS12007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639- 4171��' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/6/2007 TIME: 7:04AM PAGE 41 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of gr OWNER: LASATER, KARL PHONE #: 503 - 314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/6/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 053459 -01 503-314 -0652 Y Corrections /Comments / Instructions: 2N Bc v ■4 ` ( i "ci X PASS n PARTIAL APPROVAL n CANCEL NO ACCESS FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Qa 1 1' Date: 1 / 0 `? Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION _ PERMIT #: MST2007- 00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7150007 Phone: (503) 639 -4171 `i Inspection Requests (24 Hrs.): (503) 639 -4175 ��:_:� P._.. INSPECTION WORKSHEET FOR DATE: 5/3012008 TIME: 7:01AM PAGE: 14 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of ;arage/shop. Added detached 626 garage. 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. OWNER: LASATER, KARL PHONE #: 503 -314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 070602 -04 03- 314 -0652 Y lb asit Corrections /Comments /Instructions: tip /zoo Ilvdrb / 0 k_ t - 11blt t � 0 -.■� w■ i' rth�.� // 1F //��C J r /6461 # - . / o , zV : \ ' 7 , 1 / ' %4//,4 e ' / oK & N . 1 _...66i-4 mc „pith", / ay. / i 1 dttAr ,=.2. - X7 l5 n PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS [ FAIL cg CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED D ate: ' /C Ph #: 503 Inspector: A r�� ( ) 718 - CITY OF TIGAR® BUILDING DIVISION PERMIT #: MST 21107 -00 1 1 2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/512007 Phone: (503) 639 -4171 <i l'I�I Inspection Requests (24 Hrs.): (503) 639 -4175 .,.L °__,_ INSPECTION WORKSHEET FOR DATE: 6/6/2000 TIME: 7:00APA PAGE: 16 SITE ADDRESS: 13365 SW 107 AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 ::q ft of habitable space and 1480 sq ft of garage /::hop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. OWNER: LASATER, KARL PHONE #: 603- 314 - 0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/5/2000 Pour Time: Code # Inspection Description (c - Confirm -# Contact # Message 199 Electrical final \ 070838 -01 50.314-0652 Y Corrections /Comments/ Instructions: • ,4 ) PASS I I PARTIAL APPROVAL ❑ CANCEL 1 I NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: - t O J L. ----- Date: Co ' (Tb Phone #: (503) 7181'44) CITY OF TIGARD , BUILDING DIVISION PERMIT #: MST2007-00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639-4171 A : Inspection Requests (24 Hrs.): (503) 639-4175 „.,,,,,, ,,t INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE: 15 SITE ADDRESS: 13365 SW 107111 AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: „Addition of 685 sq ft of habitable-space and,1480 sq ft of garage/shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. OWNER: LASATER, KARL PHONE #: 503-314-0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 070602-03 503-314-0652 N Corrections /Comments/ Instructions: -kr 11/147070i/O , , • re-L(y - (d -(11-e q" 4 — Ati447 / kt & 4 4 aviii,/^ 6 ) mew ai4- Aux ,/ ile (-rce.... / 1 _/,,, 1 ' 1 f ' i ' - ' .... Al , i 6 4 If .it....L.A -- _ -..1 A filar 1 .4.11 .1 I f AI /ji / / " 1 ' f) 'I f 44 ill( cJ 3m 1101:4/6 a v 1 4,4-1 1 .49 int-,4(//4- fl PASS fl PARTIAL APPROVAL El CANCEL NO ACCESS _ X FAIL CALL FOR il n OR INSPECTION D ADDITIONAL FEES ASSESSED Inspector: Wit) Date: Li ;t) Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: M ST2007- tX)112 ' 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/5/200/ Phone: (503) 639 -4171 1 �;�: ,1'�I�I Inspection Requests (24 Hrs.): (503) 639 -4175 ._ '''_ —. INSPECTION WORKSHEET FOR DATE: 17/140007 TIME: 7:01AM PAGE: 18 SITE ADDRESS: 1336.x! 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition ot, 685 sq ft of habitable space and 1480 sq ft of garage/shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASATER, KARL PHONE #: 603.314,061.:,2 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 061564 -01 503- 314- 06f Y 4 v lb Corrections /Comments /Instructions: X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED v Inspector: /LIP Date: Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: ST2007_00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/ .)007 Phone: (503) 639 -4171 p Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/14/2007 TIME: 7 :01AM PAGE: 17 SITE ADDRESS: 1336 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1400 sq ft of garage/shop. Added detached 626 garage. 11/10/2007 Add all encompassing low voltage. OWNER: LASATER, KARL PHONE #: 503 - 314 -0& 2 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12114/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 061564 -02 503-314-0652 N Corrections /Comments /Instructions: X PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS _ FAIL n CA i FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,�� Date: / v 'Phone #: (503) 718- CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2007- 00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/50007 Phone: (503) 639 -4171 „�,�� Inspection Requests (24 Hrs.): (503) 639 -4175 Wiz _ INSPECTION WORKSHEET FOR DATE: 12 TIME: 7:00AM PAGE: 16 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASATER, KARL PHONE #: 503 - 314 -0662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 061071 -03 503.311 -0552 Y Corrections /Comments /Instructions: ,\4 �lLi 12 - / L,r 9--- MA Wg l ��ll� -r/l ' Y 1 / At' !, ti ffiZ'' o s � � n PASS n PARTIAL APPROVAL CANCEL n NO ACCESS FAIL 7I FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: _ -6 Phone #: (503) 718- 1 CITY OF TIGARD , BUILDING DIVISION - PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2001 Phone: (503) 639 -4171 . „'CIA Inspection Requests (24 Hrs.): (503) 639 -4175 ,_': `'� INSPECTION WORKSHEET FOR DATE: 12///2007 TIME: 7:0OAM PAGE: 17 SITE ADDRESS: 13365 SW 1O7TI-i AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 635 sq ft of habitable spare and 1480 sq ft of garage/shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASATER, KARL PHONE #: 503- 314 -06'y2 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 061071 -02 503.314- 0652 N Corrections /Comments/ Instructions: r / "' ik ; 4 d l I .° ,t % /., / I , • . ' .A / 4 /. (7 , ""yf' 7) Pk d - d 11 r ? r i 4 ', , :! of,5- (4,4 / ) t . ' :. Q ,` A1.. o " /.. I l' ci f ii' . e -t i t 0 Z-1 ' � �� NI )) 4 \ . R /e f 1 1/ j' . V1 / jz/3 I1t i,/i ( l A 5 . , ( A r ,,,,,, .44Adi , I I PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL ' CALL F•R INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 14 / i ) Date: ( ' d 1 1 01 Phone #: (503) 718- J CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 /h/ A0U7 Phone: (503) 639 -4171 '' p ] ';' Inspection Requests (24 Hrs.): (503) 639-4175 II,, INSPECTION WORKSHEET FOR DATE: i2/7/2007 TIME: 7:00AM PAGE: 18 SITE ADDRESS: 13365 SW 10TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: 1..ASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASAI ER, KARL PHONE #: 503-314-0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electiical service 061071 -01 503 - 314 -0652 N Corrections /Comments /Instructions: • p PASS ❑ PARTIAL APPROVAL fI CANCEL n NO ACCESS FAIL 1 1 CA FOR INSPECTION _ ADDITIONAL FEES ASSESSED Inspector: 1 2 Date: 0' 01 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MS12007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 ICI Inspection Requests (24 Hrs.): (503) 639 -4175 .alt INSPECTION WORKSHEET FOR DATE: 11/16/2007 TIME: 7 :01AM PAGE: 24 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1400 sq ft of garage/shop. Added detached 626 garage. OWNER: LASATER, KARL PHONE #: 503 -314 -0652 CONTRACTOR: OWh.3ER PHONE #: Inspection Request Scheduled For: Date: 111160007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 0691327 -02 603-31 , 662 Y Corrections /Comments /Instructions: ❑ PASS ❑ PARTIAL APPROVAL 34 CANCEL n NO ACCESS FAIL n CALL R INSPECTION . ❑ ADDITIONAL FEES ASSESSED . IN I I/ (pli9 Inspector: I Date: Phone #: (503) 718- CITY OF TIGARD . BUILDING DIVISION PERMIT #: MSS 2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5f7007 Phone: (503) 639 -4171 V 'i Inspection Requests (24 Hrs.): (503) 639 -4175 'F:_L INSPECTION WORKSHEET FOR DATE: 11/16/2007 TIME: 7 :01AM PAGE: 25 SITE ADDRESS: 13365 SW 10T11H AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: l..A aATER DESCRIPTION: Addition of 5/35 sq ft of habitable spac :e and 1460 sq ft of garage/shop. Added detached 626 garage. OWNER: LASATER, KARL PHONE #: 503- 311 -0652 CONTRACTOR: OWNER v , PHONE #: Inspection Request Scheduled For: Date: 11/16/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 i "lee.srical service 059827 -01 503 - .3140652 , Y Corrections /Comments /Instructions: I ) PASS _ PARTIAL APPROVAL CANCEL ] NO ACCESS n FAIL n CALL FOR INSPECTION ] ADDITIONAL FEES ASSESSED r.itic ,I Inspector: Date: �`' d Phone #: (503) 718- / CITY OF TIGARD V'e`t "' , BUILDING DIVISION ("It PERMIT #: M T2007 00111 13125 SW Hall Blvd.; Tigard, OR 97223 61 f DATE ISSUED: 7/920)7 Phone: (503) 639 -4171 llli�� Inspection Requests (24 Hrs.): (503) 639 -4175 '. .., INSPECTION WORKSHEET FOR DATE: 11/16/2007 TIME: 7 :O1AM PAGE: 23 SITE ADDRESS: 13365 SW 10T11 AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 ' q ft of habitable space and 1480 sq ft of c aragelshop. Added detached 526 garage. OWNER: LASATER, KARL. - PHONE #: 50 -314 -0652 ' CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/1612007 Pour Time: v Code # Inspection Description Confirm # Contact # Message �,K 295 Misc. inspection 059827 -03 503- 314 -0652 Y ( a • 1 Corrections /Comments /Instructions: (it- L` cam„` - ( ‘• A- 54 6 ,„i • cd, 6./( col< PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' ,l Date: bi 1 ffo7 Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 '�I . Inspection Requests (24 Hrs.): (503) 639 -4175 ^ _., INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE: 17 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: L. 7ATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft garagetshop.__Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. 1/4/08, adding water heater and venting. OWNER: LASATER, KARL PHONE #: 503-314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 070602-01 503.31+0652 Y Corrections /Comments/ Instructions: X PASS _ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ❑ c, LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i Inspector: . Date: / Phone #: (503) 718- 1 CITY OF ' ' ° �m m m�"m- TIGARD BUILDING DIVISION ' ' ~°~~""~��""°~� ~~"°"~,"~~"� PERMIT #: hdST20O7'D01 13125SVVHaUB|vd,Tigavd.ORQ7223 DATE ISSUED: 7/60007 Phone: (503) 639-4171 (4.„ Inspection Requests � � Hrs.): 639'4175 .�J��`� INSPECTION WORKSHEET FOR DATE: 1/11/2008 TIME: 7:01A114 PAGE: 70 SITE ADDRESS: 139G5GW1Q7TMAVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition oy605 sq ft of habitable space and 1480 sq ft of m/nhmp. Added detached S26garage. 11/19/2007 Add all ncornpa:ing low voltage. 1/4/O8. adding water hmatmr and venting. OWNER: LASAJER.K&RL PHONE #: 503-3i1'0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/11/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 062959-03 503'314'0652 N Corrections/Comments/Instructions: i4 PARTIAL APPROVAL 0 CANCEL Li ` FAIL ri CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED � _� «� �� V n�� w �� 7 -1 Inspector: w ~^ ' v^ ^�~— Da�a� ' Phone #: (503) 718' � CITY OF TIGARD BUILDING DIVISION PERMIT #: M T20t1 "C OC?61 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 1111 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11.012008 TIME: . 00AM PAGE: ;36 SITE ADDRESS: 13366 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 ..q ft of gawage /::hop. Added detached 526 garage. 11/1912007 Add all encompassing :ing low voltage. 114/08, adding water hea.er and venting. OWNER: LASATER, KARL PHONE #: 503-314-0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/100008 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 0 62359.02 503 - 314 0652 N Corr ctions /Comments /Instructions: r-y-zi.vvit.t.4 C .e.j■ t 212. 1-40 LA". ... S 6 A k) C Z A V.C‘I \9 4- Chttfr 4(.1/kJIA- '10L4A,k)-7/ e.A.1 ' . SS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Ins ector: ` V /v Date: / l Phone #: (503) 718 - . V 4 74 P CITY OF TIGARD BUILDING DIVISION PERMIT #: i'r1ST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 �/ DATE ISSUED: 7 /Til2 07 Phone: (503) 639 -4171 e Inspection Requests (24 Hrs.): (503) 639 -4175 .__. �, c'fI -II INSPECTION WORKSHEET FOR DATE: 1 /3/2008 TIME: 7 PAGE: 15 SITE ADDRESS: 13366 W 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: / j lition e:,f 6051 ft of habitable sp,;:ur::e and 1410 sq ft of quragei' hop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASATER, KARL PHONE #: *03- 314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/3/2008 Pour Time: N Code # Inspection Description Confirm # Contact # Mes ge 616 Mechanical rough -in 062501 -01 503- 314.0662 's: Corrections /Comments / Instructions: 0 c 1 o w ojkl- 4e--etiC — ek- k}- S S o.—r'. Go p Ott ,, 14 LJ &A-ca_ we:4,)c \j,.-ii i'D N p2_,71&1- dr e iti , , . 1 c_ p di ! tif-.)____. L_ \,,,-- A/ (i„,R, �. ( ,l, 7 0-- . .s.. PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V/1 y ° L� Date: / Phone #: (503) 718- �� t4 $ Z �f r,i 147 4, MILLER CONSULTING ENGINEERS FACSIMILE TRANSMITTAL FORM TO: Kerry Vanderzanden & FIRM: Partin and Hill Architects Carl Lasater FROM: Althea Bean PROJECT: Lasater Addition/ Remodel DATE: Thursday, December 20, 2007 PROJ. NO.: 070545 FAX NO.: TIME: 2:56 PM ❑ Copy to follow via ❑ US Mail ❑ Courier Service ® Other Total number of pages: 1 , including this page. Please call (503) 246 -1250 if you do not receive all pages. MESSAGE: Dear Mr. Vanderzanden, Miller Consulting Engineers, Inc. received a call from Carl Lasater concerning embedment of two Simpson Set Epoxy anchors. The anchors are located on an existing eight foot section of wall that is between the existing garage and the new storage space. The plans had originally specified a 15 inch embedment of the 5/8" rod into the existing footing. Drill bit length limited the depth of the hole, current Simpson tested values for SET epoxy adhesive show that a 10" embedment of the 5/8" rod will be adequate for the loads required by the Simpson PHD2 hold down. If you have any other questions or concerns please call. Respectfully, ��, �� _PRO Miller Consulting Engineers, Inc. �� 8's 4111P (?2. 41110 , ORE ON IA" Prnc pale, P.E. q Rl� � � � IZ 1U /v ri) TJ 9570 SW Barbur Blvd., Suite 100 Portland, Oregon 97219 -5412 Phone (503) 246 -1250 Fax (503) 246 -1395 CITY OF TIGARD BUILDING DIVISION !,' PERMIT #: M ?T2007- 0(Y112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/a'2007 Phone: (503) 639 -4171 AI I Inspection Requests (24 Hrs.): (503) 639 -4175 11ii INSPECTION WORKSHEET FOR DATE: 12127/2007 TIME: 7:00AM PAGE: 14 SITE ADDRESS: 13385 SW 10TrH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: tA rATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garac)eishop. Added detached 526 garage. 11/19/2007 Add all encompassing low voltage. OWNER: LASATER, KARL. PHONE #: Ira O 3-31 ii- 6(552 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/27/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 062205 -01 5.03.314 -0552 N Corrections /Comments /Instructions: ti � � 2 L J - _S P /.1' 111 -,_//er4-c.• ._. 44) ° r . ,, r/.: ,��1�.�, 4/ LL�a .1 /izAZ' ie- ,4 $ 4'4L4/L ❑ PAS. -- - ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ) CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' Date:/i-- > Phone #: (503) 718 -art ' CITY OF ~— - ��un w ��w mon�|��m�� BUILDING DIVISION - PERMIT #: M8TI007-00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) G3974171 Inspection Requests (24 Hrs.): (503) 630~4175 ~��»��^ ! INSPECTION WORKSHEET FOR DATE: 9/102007 TIME: 7:00AM PAGE: 20 | SITE ADDRESS: 133GGBVV1O7[MAVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 605 sq ft of habitable npGc* and 1480 mqft of garage/shop. DyyNEIR: LASATER, KARL PHONE #: 503-314'0662 CONTRACTOR: OWNER PHONE #: L Inspection Request Scheduled For: Date: 3/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message / 235 8hoa/walu/onnhuxm 055397-01 503-314'0062 N Corrections/Comments/Instructions: ' ` ^ / - 1 PARTIAL APPROVAL 0 CANCEL 7 NO ACCESS / pi FAIL ri CALL FOR INSPECTION U ADDITIONAL FEES ASSESSED ' Inspector: A Da�m� ��-��'-- ^o�r Phone#� (5D3)718' -�� /, ' . "; „ - '= ^ • '��~�� OF ��w m n n��m— w w��n�� BUILDING DIVISION ` PERMIT #: MST2007-00112 13125 SW Hall B|vd., Tigard, OR 97223 DATE ISSUED: 7 Phone: (503) 639-4171 Inspection Requests (24 Hrs.) A191,1: �(5O3)G3Q'4175 / A 1j, INSPECTION WORKSHEET FOR DATE: 9/10/2007 TIME: J:DDAM PAGE: 1� 1 3��S�VV1D7TH�V� SITE ADDRESS: CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of OWNER: LASATER, KARL PHONE #: 503'314-0662 CONTRACTOR: OWNER NE #: Inspection Request Scheduled For: 9/1 Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 055397-02 503-914'0652 N Corrections/Comments/Instructions: PASS fl PART APPROVAL 7 CANCEL fl NO ACCESS FAIL CALL FOR INSPECTION | | ADDITIONAL FEES ASSESSED Inspector: . �^� Date: Phone #: (503) 718- ? CITY OF TIGARD BUILDING DIVISION = PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 A DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 ';1 ° ,1 i j llr l 4 Inspection Requests (24 Hrs.): (503) 639 -4175 .. . : _.. INSPECTION WORKSHEET FOR DATE: 9/4/2007 TIME: 7:01AM PAGE: 59 SITE ADDRESS: 13365 SW 10TFH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 E:q ft of habitable space and 1480 sq ft of garage /shop. OWNER: LASATER, KARL PHONE #: 503 - 3140652 CONTRACTOR: OWNER PHONE #: E Inspection Request Scheduled For: Date: 9/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 055010 -02 503- 314 -0652 N Corrections /Comments/ Instructions: 1- 2ov,/l.1 AIYA•c.c' r7 A //1y L-5 rD /4- S, _( • PAS 1 I PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED . , . Inspector: Date: q?-- ¢ 7 Phone #: (503) 718 - 2) CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 Phone: (503) 639 -4171 ' i 1; Inspection Requests (24 Hrs.): (503) 639 -4175 "�' I INSPECTION WORKSHEET FOR DATE: 9/4/2007 TIME: 7:01AM PAGE: 60 SITE ADDRESS: 13365 SW107rfil AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 G.q ft of habitable space and 1480 sq ft of garage /shop. • OWNER: LASATER, KARL PHONE #: 503 - 314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear waflFJarnchors 055010 -01 503 - 314-0652 Y Corrections /Comments /Instructions: / n 4onz,I L fir" / o _ htGO /Dow 3 l� - r.,5.:a. u - t tip-, �6t _„‹ /' d 1 f P SS • ❑ PARTIAL APPROVAL U CANCEL n NO ACCESS FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED • Inspector: Date: -4 --0 7 Phone #: (503) 718 - CITY OF TIGARD' BUILDING DIVISION PERMIT #: MST2007- 00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 A ,, ; i Inspection Requests (24 Hrs.): (503) 639 -4175 .7_ INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:OOAM PAGE: 20 SITE ADDRESS: 13365 �` W 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. OWNER: LASATER, KARL PHONE #: 503-314-0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 054614 -01 503- 314 -0652 Y Corrections /Comments /Instructions: PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED ....,, Inspector: , A D e - -6 7 Ph one #: (503) 718 - CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2O07 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/51:2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639- 4175 - INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:OOAM PAGE: 10 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. OWNER: LASATER, KARL PHONE #: 503-3140652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 05461403 503 - 314 -0652 Y Corrections /Comments /Instructions: PASS ❑PARTIAL APPROVAL ri CANCEL n NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . Date: e- ?4 Phone #: (503) 718 - '¢{Cf • CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 IJI Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:OOAM PAGE: 1f3 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq 8 of habitable space and 1480 sq ft of garage /shop. OWNER: LASATER, KARL. PHONE #: 503314 -0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 054614 -02 503314 -0652 Y Corrections /Comments /Instructions: ASS PARTIAL APPROVAL ❑ CANCEL 1 1 NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 67 Phone #: (503) 718 - `� CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171° � Inspection Requests (24 Hrs.): (503) 639-4175 e, INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:OOAM PAGE: 17 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. OWNER: LASATER, KARL PHONE #: 503- 314 - 0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 230 Underfloor insulation 05461404 603- 314 -0652 Y Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: s D ate: g — �1 —zs "S� Phone #: (503) 718- CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 �'�L� Inspection Requests (24 Hrs.): (503) 639 -4175 �±�i _.... INSPECTION WORKSHEET FOR DATE: 8/20/2007 TIME: 7 :02AM PAGE: 29 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. OWNER: LASATER, KARL PHONE #: 503- 3140552 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/20/2007 • Pour Time: Code # Inspection Description Confirm # Contact # Message 225 ostibeam structural 054315 -01 503-3140652 N Correction Comments /Instructions: !ALS [,L. 042A(4)c. ' 1i ►.4..c cA it 4 S.Ae.k i2vw ,' lgtwv.. r- /5—GGv *7 /5"o1.47--22. - 2 677-... , i �/./ wi -71 z 7 ",4-a JO-- i' iSTIl'w Ui1/l. - �L G?6cth0vi c:4-C� 1 1 PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS AIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED , 'Al -----/ Inspector: % Date: 9— 20 —a? Phone #: (503) 718 - 2 � CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/51200/ Phone: (503) 639- 4171�'��, °i�� Inspection Requests (24 Hrs.): (503) 639 -4175 :�' ".. INSPECTION WORKSHEET FOR DATE: 7/26/2007 TIME: 7:03AM PAGE: 35 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage /shop. OWNER: LASATER, KARL PHONE #: 503. 3140652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/26/2007 Pour Time: 2 :00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 052804 -01 503- 314 Y Corrections /Comments/ Instructions: !su STALL AuG1452 /Ts s, ze 51'4e ,‘/ 1 - PASS ❑PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑'CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: _ % . Date: Phone #: (503) 718- r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 ��gl Inspection Requests (24 Hrs.): (503) 639 -4175 �__,. INSPECTION WORKSHEET FOR DATE: 7/18/2007 TIME: 7:O1AM PAGE: 33 SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: ' PROJECT NAME: LASATER DESCRIPTION: Addition of 686 sq ft of habitable space and 1480 sq ft of garage/shop. OWNER: LASATER, KARL PHONE #: 503 - 3140652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/18/2007 Pour Time: 2 :00 Code # Inspection Description Confirm # Contact # Message --\ 205 Footing 052246 -01 5036314 -0652 ) Y -, _. , � _ Corrections /Comments /Instructions: <-- 0 / Kt l, M ii, i )-L L&-(- o.- ' o _/ A..- /�C If .(/l 4 - _ 41 : -2 ` ra .WL► AP /AGS 111/ c�11 ,x.. /,. L— - , - . , i PASS PARTIAL APPROVAL ❑ CANCEL I 1 NO ACCESS FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: / , J : Date:' —i 7 -©7 Phone #: (503) 718- ZV- CITY OF TIGARD ° BUILDING DIVISION / PERMIT #: MST2007 -00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 All ;fl Inspection Requests (24 Hrs.): (503) 639 -4175 s _!� INSPECTION WORKSHEET FOR DATE: 7/11/2007 TIME: 7:01AM PAGE: 1! SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LASATER DESCRIPTION: Addition of 685 sq ft of habitable space and 1480 sq ft of garage/shop. OWNER: LASATER, KARL PHONE #:. 503 - 314.0652 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7J11/2007 Pour Time: /igi . r Code # Inspection Descri tion Confirm # Contact # M sag l > �O s , 405 Excavation 05181E01 503- 314 - 0662 Y Corrections /Comments /Instructions: D PASS 1 1 PARTIAL APPROVAL — CANCEL U NO ACCESS // FAIL 1 1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED / 1 Inspector: Date: Phone #: (503) 718- / U,... 1" C r c. w v' -ft ep. w n &-L- -� 1.."-- :7-' - tFc.z 4 C 2 -9-i JE , : , ,, 1 V f i i M y ! / FIBER GLASS BLOWING INSULATION BATTS AND BLANKETS THERMAL PERFORMANCE (ATTIC APPLICATION) When installed in accordance with the man- The stated thermal resistance (R- value) is provided by installing in accordance with the manufacturer's instructions, the ufacturer's recommendations, Knauf batts required number of bags per 1,000 sq. ft. of net area, at not less than the labeled minimum thickness. Failure to install a'nd blankets will provide the full R- value. both the required number of bags and at least the minimum thickness will result in lower insulation R- value. R VALUE" THICKNESS �'' l BAGS/1,000 SF . _COVERAGE • I I EG UM MINIMUM • THIC K MINIMUM , -. �, MAXIMUM : .. • _._._ -.:. ._._. GE�_ ..,_ : _)HEIGHT _ .._._ THICFtNESS .__. To obtain an Installed insulation To obtain an The number of bags/ Contents of this bag The weight/SF Installed insulation insulation resistance should not be insulation resistance 1,000 SF of net area should not cover of installed insulation should not be (11-Value) of: less than: (R- Value) of: should not be Tess than: more than: should not be less than: less than: R -38HD 10.25" R -60 31.7 31,5 SF .952 LBS 19.75" R -38 12.00" R -50 25.8. 38.7 SF .774 LBS 16.75" R -30HD 8.25" R-44 22.1 45.3 SF .663 LBS 14.75" R -30 10.00" R -38 19.0. 52.7 SF .569 LBS 13.00" R -26 9.00" R -30 14.4 69.7 SF .431 LBS 10.25" R -22 6.50" R -26 12.4 80.9 SF .371 LBS 9.00" R -21 HD 5.50" R -22 10.4 95.8 SF .313 LBS 7.75" R -19 6.25"" R -19 8.9 111.8 SF .268 LBS 6.75" R -15HD 3.50" R -13 6.1 164.3 SF .183 LBS 4.75" R -13 3.50" R -11 5.1 197.6 SF .152 LBS 4.00" R - 3.50" Bag Weight - Nominal 30 lbs., Minimum 29 Ibs. R - 2.50" This product conforms to the performance requirements of ASTM C 764, Type I, and cancelled Federal Specification HH- I- 1030B, Type I, Class B. R- values are determined in accordance with C 687 and C 518. " "0 -18 in a 5.5" cavity. Conforms to ASTM C 665 and ' "R" means resistance to heat flow. The higher the R- value, the greater the insulation power. To get the marked R- value, it Is essential that the insulation Federal Specification HH- I -521F. be installed properly. If you do it yourself, get instructions and follow them carefully. Instructions do not come with this package. EQUIPMENT REQUIRED FRAMING ADJUSTMENT To achieve labeled R- value, this product must be applied with a pneumatic blowing To compensate for framing members, the number of bags per 1,000 sq. ft. of machine and a corrugated hose with a minimum .25" internal corrugation, a mini- area to be insulated should be as shown below. mum length of 150 ft. and a diameter of at least 31 Coils in the hose should not be - - ' JOI S L DAGSIMSF DAGSIMSF less than 36" in diameter. Acceptable material feed rate is 5 -35 lbs. /minute. '; R - VALUE DIMENSIONS _ 16" 0.C. FRAMING 24" D.C. FItAM117G Recommended feed rate is 15 -25 lbs. /minute. 2x4 31.2 31.3 R -60 2x6 30.8 31.1 BUILDER'S INSULATION STATEMENT 2x8 30.5 - 30.8 Batts and/or blankets have been installed in conformance with the above recom- 2x4 25.3 25.4 mendations to provide a thermal resistance of... R - 50 2x6 25.0 25.2 2x8 24.6 25.0 • R VALUE THICKNESS 2x4 21.5 21.7 - R-44 2x6 21.2 21.5 Attic Area R 3 fr;. at /l j Inches 2x8 20.9 21.2 2x4 18.4 18.6 Sloped Ceilings R at Inches R - 38 2x6 18.1 18.4 2x8 17.8 18.2 Walls R- at Inches 2x4 13.8 14.0 Floors (over an unheated crawl space) R at Inches R - 30 2x6 13.5 13.8 2x8 13.3 13.6 Crawl Space Perimeter R - at Inches 2x4 11.9 12.0 2 R -26 2x6 11.6 11.8 , Date Installed % 3 ' �� 2x8 11.3 11.6 2x4 9.9 10.1 Blown insulation has been installed in conformance with e above R -22 2x6 9.7 9.9 recommendations to provide an R -value of: R- J using 2x8 9.4 9.7 3Y bags of this insulation to cover / L1 square feet 2x4 8.5 8.6 of area at a minimum thickness of / inches. R - 19 2x6 8.2 8.4 2x8 7.9 8.2 /� ✓ 2x4 5.6 5.8 Insulation Contractor g oatm„ C77/7/-4- /_ •� R -13 2x6 5.4 5.6 / ,4 2x8 5.1 5.4 Company ABr TIGHT gNSULA � Date R-11 2x6 4.3 4.5 Home Budder (signature) $200 ICE'. C+i_.+$1n .y •ty , va f 2x8 4.1 4.3 Company 360-690-3a26 VVTGct'tr:3ve'S �,J l ',3,0651 ygp Date • BW - AC - 14 APR 2004 KNAUF INSULATION GmbH One Knauf Drive, Shelbyville, IN 46176 (800) 825 - 4434 ext. 8300 FAX (317) 398 -3675 wv✓w.KnaufUSA.com © 2004 Knauf Insulation GmbH City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • • • T I GARD June 16, 2008 Karl Lasater 13365 SW 107 Ave. Tigard, OR 97223 Re: Permit No. MST2007 -00112 Dear Mr. Lasater: The City of Tigard has processed a refund for the deposit of fees on the above referenced • permit for the following: Site Address: 13365 SW 107t Ave. Project Name: Lasater Job No.: N/A Refund: ❑ Check # in the amount of $ ® Credit card "return" receipt in the amount of $274.19. ❑ Trust account "deposit" receipt in the amount of $ Notes: Refund fees paid for detached garage included on permit with residential addition; new garage fees collected under new permit number MST2008- 00086. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. 1: \Building\ Refunds\ Administration \LtrRefund- Depositdoc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Karl Lasater DATE: 6/16/08 13365 SW 107 Ave. Tigard, OR 97223 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 2007 -5584 Case #: MST2007 -00112 Date: 12/28/07 Address /Parcel: 13365 SW 107th Ave. Pay Method: CreditCard Project Name: Lasater EXPLANATION: Refund 100% of permit fees paid for detached garage portion of permit that was permitted under a separate permit. 'REFUND INFORMATION: . . Fee D From Receipt Revenue Account No Refund' Example:.•[BUILD] Permit Fee Exaniple: 245- 0000 - 432000 • $ Amount. [BUPPLN] Addl Pln Rv 245 -0000- 433000 $32.95 [BUILD] Addl Permit 245- 0000 - 432000 50.70 [TAX] Build 8% State Surchrg 100- 0000 - 207020 4.06 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 46.00 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 6.00 [METCET] Metro Const Excise Tx 245- 0000 - 229202 134.48 TOTAL REFUND: $274.19 APPROVALS: If under $500 Professional Staff /12' r. • If under $7,500 Division Manager ' : L t( • If under $22,500 Department Manager j f If under $50,000 City Manager If over $50,000 Local Contract Review Board • ; . FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY• ;:::.., .40` Case Refund Processed: Date: I . / ' , / c ,f I B I / I: \Building \Refunds \RefundRequcst.doc 05/23/07 . Mil CITY OF TIGARD 6/16/2008 13125 SW Hall RRlvd. 2:05:05 PM Tigard, OR 97723 503.639.4171 TIGARD • Refund Receipt #: 27200800000000002080 /'CV /LS q Date: 06/16/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid M ST2007 -001 12 Reversal - [CDCPLN] CDC Pln Re 100- 0000 - 433060 (46.00) MST2007 -001 12 Reversal - [LRPF] LR Planning 100- 0000 - 438050 (6.00) MST2007 -001 12 Reversal - [BUPPLN] Addl Pln R 245- 0000 - 433000 (32.95) MST2007 -001 12 Reversal - [BUILD] Addl Permit 245- 0000 - 432000 (50.70) MST2007 -00I 12 Reversal - [TAX] Build 8% Stat 100- 0000 - 207020 (4.06) MST2007 -001 12 Reversal - [METCET] Metro Cons 245- 0000 - 229202 (134.48) Line Item Total: ($274.19) Refund: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid Credit Reversal KARL LASATER 021 170 In Person (274.19) Refund Total: ($274.19) • c v 2 ° v o 0 p -� a CU +. a... .J in a i54 g. (� • y •G w O v a � u 0 b 4i Ti k/ h ° C •� ` t—, E A v x cd -t A y u v a °' aA , N t'v y a s v. cef A n a q 3 " « N G a x ,1 � x � 2ww s c v y v k. � \ U � °,A 1 �4a;V �0 N a �. A sx o € Ei .. • p ca ca ta,) \ A F 1 w' P. we I u f I CITY OF TIGARD 6/16/2008 • 13125 S W Hall Blvd. 10:44:55AM Tigard, OR 97223 503.639.4171 TIGARD • Receipt #: 27200700000000005584 '2/ Date: 12/28/2007 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2007 -001 I2 [CDCPLN] CDC Pln Rev 100- 0000- 433060 46.00 MST2007 -001 12 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 6.00 MST2007 -001 12 [BUPPLN] Addl Phi Rv 245- 0000- 433000 32.95 MST2007 -001 12 [BUILD] Addl Permit 245 -0000- 432000 50.70 MST2007 -001 1 2 [TAX] Build 8`Y, State Surchrg 100- 0000 - 207020 4.06 MST2007 -001 12 [METCET] Metro Const Excise Tx 245- 0000 - 229202 134.48 Line Item Total: $274.19 Payments: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid CreditCard KARL LASATER BB 021 170 In Person 274.19 Payment Total: $274.19 dtc:eiptspi Page I or • e ; ° Community D evelopment TIGARD Request for Permit Action TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: VI ❑ Applicant ❑ Contractor ❑ City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) K (\ - Q -L / 4- S'1/i Mailing Address: I 3 3 Co S S I J 1 Z O 7 G ' City/State /Zip: T/ 6 /97'.? O!' 9 7 1 .? - 3 Phone No.: .? 3 3 Y O(P .�1-- PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): r LICATION. 0 ' FUND ERMIT FEES . ,ttach receipt, if available). • o F y • (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). • Permit #: r7 e 9-- - a - o? —Co // Site Address or Parcel #: / 3 3 cc ,S'Lt/ /0 7 14t Proje Project Name: , ct Subdivision Name: Lot #: sa 6 /o 7 ' EXPLANATION: "e ve .07709 riet9 Rao, e .°E3z/n /T ,87LA -7 i T / Jr , 27 ,f' -- e es Signature: l� - 1 i Date: (p / /4 ar Print Name: /41 Ll aZ Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date ' By Rte to Bldg Adniin: Date to / /(c /Ca By ti Refund Processed: Date 6/ (. By • j • nvoice Processed: Date By Permit Canceled: Date A/ /if By Parcel Tag Added: Date By Receipt # Date Method Amount $ I: \Building \Forms \RegPermitAction.doc Rev 07/26/07 0 20 7- . 934 aoe -J /// 0 2oo7 - _CD 99 <1od -7 -5.5",y