Permit ,
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00326
� DEVELOPMENT SERVICES DATE ISSUED: 2/4/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07830 SW WATER PARSLEY LN PARCEL: 2S112BA -07500
SUBDIVISION: BONITA TOWNHOMES ZONING: R - 12
BLOCK: LOT: 011 JURISDICTION: TIG
REMARKS: New SFA.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 266 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 760 sf GARAGE: 480 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: 793 sf RIGHT:
VALUE: 182 130.00
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 1,819 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 3
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVCQFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps -1000v MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,890.70
JLS CUSTOM HOMES JLS CUSTOM HOMES This permit is subject to the regulations contained in the
Tigard Municipal Code, State of OR. Specialty Codes
16280 NW BETHANY 16280 NW BETHANY and all other applicable laws. All work will be done in
BEAVERTON, OR 97006 BEAVERTON, OR 97006 accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 533 - 4006 Phone: 503 - 533 - 4006 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 139970 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Ftg Drain Bsm't Walls Mechanical Insp Gas Fireplace Structural welding final Water Service Insp
Sewer Inspection Slab lnsp Plumbing Top Out Insulation lnsp High strength bolts fina Smoke Detector
Footing lnsp Plm /undslb Insp Framing Insp Shear Wall Insp Rain Drain lnsp Electrical Final
Foundation Insp Electrical Service Roof Nailing Exterior Sheathing Ins Storm drain insp Plumb Final
Wtr Proofing Bsm't Wa Electrical Rough -in Gas Line Insp Firewall Insp Water Line Insp Mechanical Final
V ' - I
Issued By : - Permittee Signature : d� '1
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
n
Bu7ihIln2, Permit , Application FOROFFICEUSEONLY ..x
City of Tigard Recercd / /J r
1312 S \\ } {a Bi. f!Ea :;.0 F 9 -,,; DaI B Ia 1 �� 1� -- P_rn,,,.c - � vag _ a 6 Plan Re
Phone SQ_ r;';= 11 I Fax `', < i,:hil /2.-17%09/0 Oche, °erm,; �I1-62 r,/e L /(I
1n5 ccuon Linz c = n'9 a l E
F Dare Read. B ) S ec f I
]crcmet :, Iltard r u5 a ro No!i l:ec'.; e!h:d I �/ r I Sup 4c
ental he lnrenn
C - - .b ( Ul'l (- f' —
TYPE OF WO , RE i REQUIRED DATA: 1- AND 2- F.4NJ]LY DWELLING I
• firm)
_Ng_.+ construction ❑ Demil+huMU'F I Permit fees' 3rebased on the .alueof the work performed '
— — -- — — Indicate the +aloe (rounded to the nearest dollar) of all
❑ .- lddition'alicrauen replacement ` I � ❑-Qthec4.•;14,trit,i equipment. matenals. labor overhead and the profit for Ilse
CATEGORY OF C C \ i ` "ork Indicated on Ihls application
--4
V2 g Z 3 0 �_
n
X I - and 2- family dwelling — XCommerc!al:Industnal I _ °� �
t _
El Accessory building ill Multi-family I Number of bedrooms
- -- — - -- Other Number or bathrooms
❑ 2,.. --
Master builder ❑
—
JOB SiTE I AND LOCATION Total number of floors r5
Job site addres I . • ' �`, �a� l , I \'c ++ d• elhng a _ ea i� l ei square feet
Crtv''State-ZIP:, • ('AZ _ � Gara_•e carport area L4Sl- square feet
Sire 'bldg "api no - - i l I Pro)ect nume � � C'o+ ered porch area ,... square feet
• Cross street'direcnons to tob site' .c-C1.1.101, •
— _QY e>L i Deck area — f square feet
-- ----- ---- _ -__ -- — -- I Other structure 31 C3 square feet
1 REQUIRED DATA: COJI'1ERCIAL -USE CHECKLIST
Subdivision: slab - L !4( L �,� � p I Lot no. //
_i— Pemul fees' are teased on the aloe of the work performed
Q T
Tat map parcel nu as�� la `�1 i Indicate the +aloe (rounded to the nearest dollar) of all
equipment. materials. labor o. el head. and the profit for the
DESCRIPTION OF W O R K _ — I \ +ork lnchcnied on this application —
— 1 Valuation S
Exrs rrr building arca square feet
— I h e++ bulldinc rca square feel
A PROPERTY OWNER El TENANT J Number of stones
Name: Type of construction:
Address: 1Ipag° l\\' ` .f. '. •_ . Occupancy groups.
Cit.:StateZIP: � •' � u
f>-f 9 — l
r _ � I Exrsn
-
Phone. (563) S33_ ^ l(o t, n Fax 1503) 1- 1 Nev.
❑ APPLICANT CONTACT PERSON
NOTICE
Business name 5PT J All contractors and subcontractors are required 10 be
Contact name: — , c licensed with the Oregon Construction Contractors Board
unJer ORS 7O1 and may be required to be licensed in the
Address: `3q & jurisdiction in which work is being performed. If the
Cite State ZIP: ��� applicant is exempt from licensing, the foilowing reasons
apPly
Phone: (Sp3) Q( (.9- 1- I - l {S 3 Fax: - ( ) � �' y� � l
E -mail: I
' - CONTRACTOR _- _-
Business name- 5 ► J rn ��
' ` I BUILDING PERMIT FEES { •
Address-
Crh.: State. ZIP: Please refer ro fee schedule.
Phone: l ) V7 Fax:( ) 1 Fees due upon application 1
�
' �� n Amount received •
CCB tic.: `'I �
Date received:
Authorized stenatt)fe: � t r This permit application expires if a permit is not obtained
e7-- { within 180 days after it has been accepted as complete.
`Print came: 6 1 , C ` - � I Date: J • Fee methodology set by Tri -Counh Building_ Industry
1 Service Board.
:' Buildirrg 'Perrria ;2.03 as 0.4613
Ti I is M'CO'•L'V. -LB)
4
' 1
E lectrical Permit A lication -' OIFFICE USE ONLYV';'=.1:',7
City of Tigard Recelved
PC MITI No
DareS
I ' 3 1 2 f S \-‘; I lall 1:3d 1 r_,R 9 22 —
P1211 Re le,
Fbont f 0 3 659 - F.71‘. `'-':' .“.■.; I 2f-2-, Dale,T3: C ilv r Perrmt
Inspe:;:.:n is 503 039 _1; 7f 4dh 111...,1!. h Ipole Reac!.'B .'
- i e see P3ge 2 ler
inle.'mei --- ci lied c..r us NcmfiedTh.!,inc.,d I Supplemental Inlorm3non
TYPE OF WORK PLAN REVIEW
El New construction 0 .Addition. alter:mon:replacement P:e.tse ...I, .
.7:17;5. ,:Crrli [1] }-1 z r d o t, 5 location
11) Dcmoliiion - El Oiher
05.-e - . icc r....er ir.Ir... rimp.s - ratirg OButldng o.. er 10 000 sq 0 .
CATEGORY OF CONSTRUCTION co 1- . :.' ,. T . 2I7 . 1`. 4 , en.s d ( more !ley, rsideniial
E S S1'1 C . :CT (T'T'Cl ., Cd'o nomin im
al its in one srrtictlite
E] I - 415d 2 farniii: dv..elling 0 Commercial indlist,131 0 Accessory building
0 f3mIimc_ ,.% cr Three stones 0 Feeders. 400 amp: or more
0 It.dii 0 lasicr builder O Other
IllOc...i.pinn 11 lf Cr 99 unisons D.lanui lured sn uctui es OT
JOB SITE INFORMATION AND LOCATION 01- belirinr2 nix RV park
ElOthcr
Job no_ I -
lob soe ,,, dr ess 7Th' . t.ioral r) – .... m:41.eic El ieahh-coi 1
--- ,- 1 - .m . :! 2_ scs r-i pms ,., 13nv of Me above
City:Staic Z IP \---(" Inc 0,c .ir e nrri rippli,.. to rempor3ry construction service ,
I
Suite l bldg - apt no . ° 1 Project rioni_i_T
_I . Dr, ripiwil FEE* SCHEDULE I Or, 1 Frt Total 1 —
Cross street directions to job sile ck____ C,,,___ 1 No■ residential single- yr multi-Limil■ LI), elling unit.
1 — x" Includes otiochet) glrap:e..
I I J.'.
L i it."J :41 it or Ies
I
Subdivision. Lot no . (4 I La add I 5 sq I Or pornon I 33 .10 1
-------
p imited enc:12.. residential 75 00 2
Tai map/parcel no . ( -)S 1 ..r..__ 1 a C-31 _
1 immied encr.. non-residential 75 00 2
DESCRIPTION Of WORK - Fact, manufac;ured or MOduhr I
th scry;ct. and. Or feeder I on no
, .. . 2
- , L :•-•er or feeder nsiallation. alteration. aotror relocation
. i
71.to .imps or k SO 30 2 --
r 201 .,„,,, , _ft,' :,,,,,s 1 106 S 1 2
1 21 PROPERTY OWNER EJ TEN.A.NT -
.
7 .-1 .rinp:. to r-r amps I t 0 6C, F 2
N3rnei - al - S CiA.) i 0 , - , 1 . ,,, T , ;„ i _non amps 2 60 1 7
Address \ C ;. . - i . I
.-■ — rmeci cm.1 66.8 I 2
Cit3 'State7.1Paliaa\ar% ( ----f c I -Recc
, Temporar■ stir, ices or feeders installation. alteration. 3 ndlor
--1-1 l_relocation
Phone 10: ) S //CO (
1 P :1\ C5CS ‘,?0___, i 2t Ili 2mps 1)1 i C5, 1 66 85 1
Owner installation: This installation is being. made on property that 1 own \\ hich is not I 2i,1 . i' 4n0 „ I I oo 31) 2
intended for sale, lease, rent. of exchange. accordmr2. to ORS 447, -149. 670, and 17 01
r il amps to 00.,. amps I 1 -,-; -‘, I 2
. -- -
.
Owner signature - . Date. Lpranch circuits nen. alterution. or CN tension. per panel
• 0 APPLICANT .
X....CONTACT PERSON l Ai-ec. tot branch circuits with I
r
senace 01 feeder fee, each
65
Business name:
n ....._
..__, branch" circuit 1 G
13 Fee for branch circuits
Contact name.
e- - 11...4...—...,. wr ( hour service or feeder fee. 2
46 Sf•
Address: ill TYV-L C I) branch C ITC CI it
Each addll branch circuit 6_65
2
CityiStateIZIP: Miscellaneous (service or feeder not included)
Pump or m2ation circle
Phone: ( ( Or 1 (13-s Fax: : ( ) n 1Y1E- i
Sin or outline lighting 53 40
53 40 1 2
2
E-mail: Signal encuirr.F) or - limited-
- CONTRACTOR ' ' eller?) panel. allerakon. or
• nionsion DeCli
5bz Pae g 2
Business name: 1_12, C - I - A c ,______. I
Address: a....s 1 - o122Px--,E, Lis. I Each additional inspection o■er allowable in any of the above
EN inspecnon 62.50
CityStateiZIP: I - k v . cr,\ 0 e 9 VZS hwestiRation per hour 11 hr min) t
I 62.50
73.75
Phone: (SO3) ( 4 2 _a8(:) , Fax. 4/1) 6 g 5RIS lndustnal pia»r per hour
ELECTRICAL PERMIT F
, c.: q EES*
CCB Lic : gp,2 Electric3i 1 . _
. sup,„ Dc.:
Subtotal
- 1
r
Supr\ Electrician sienature, required: A t iff r iiiirt . Plan re.- ie.A. (25% of permit fee)
-SIOSeAki....
Print name: -
---o% --- iv Darr I
- I State surcharge (S% of permit fee) i
, TOTAL PERMIT FEE 1
I_____
Authorized si: • ,_
AL . alb .. _or _ AI■ This permit application expires if a permit is not obtained within 180
-
. c -.---..
, - t e_t_Ve e,__.\-e__I Dale days alter it has been accepted as complete
Print name. Fee methodoiog z.el by Tri-County Building Industry Service Board
Number of inspections per permit allowed. .
F Zoe 12 .240.4615T(10:02/CON1.--WEB
a
Mechanical Permit AApplication FOR.OFFICEUSEONLY
Cit■ Df Tigard RereBsed
Permit Nis
Date By
13125 S Hall Blvd , Tt2ard OR 9
-
Plan Re to ,
Plrcne 503 639 41 Fat -•n" scs 19(10 Cher Permit 3
Date .
lnspect!on Line 50= 639 4175
it . Date Read B., l,--s El See Page 2 Ir.r
Internet WW cr heard or to CI - -- Supplemental Information
TYPE OF WORK I- COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
New construction ❑ addition- alterauon7eplacement
` perrnII Ices' are based on the -aiue o! I ork
perfr•rctcd Ind:c t he •• clue Iroundcu to the near es; cc!lar; of all
❑ Demolition ❑ Other roe: ha n:ca1 n enals equipment !abc•r. overheat!. and pro!it
CATEGORY OF CONSTRUCTION — aloe g
— RESIDENTIAL EQUIPMENT( SYSTEMS FEES`
1- and 2-family du.elhne XCommcrclal-rndustn4l ❑ - Accessory buildins — -- -- -- - --
f or v :ric. rcl;rn uSe ckrCr: :(:
❑ lull - fanuly ❑ \]aster builder ❑Other' — - — - --
Dexnptir.o 1 Qt- I La ! Total
-
JOB SITE INFORMATION AND LOCATION Healing cooling_ _
—
Job site address' �.,e - ``
\ir coitthi mne o (real pump —
� � � _ _ I. • r - , , t � ' 1 i t e g e u e s s i t e plan ,h.,., rng placemrnt I 11 (.0
CIR'Slale.'ZLP: i 1 .( �. R � Furnace i l_ .1Bfl. Noels'.cntS) IJ (t T
1] r I j I fanucc I11CI -t1Uf ' l3Tl.l,iuca •rots( 1- 90
Suue.ildo_ apt nu -. 1 Project name�`
i___ — 11 O t
Gas heat pump — — I
.L�7YLl [� _
Cross siree('direcllons to lob site Ducl sot 14 00
- — � K 11\Jron :c hot Water s }stem 14 00
Rcstdenllal'Dotter Iradrator 01
lr rl rrict 14 00
— - -- H I L`ntl healers IILcl- ;•ape. nor electric).
m eC. Irt ,l.:i1. sumocnded, CI( 1 t 00
Suhdnlsion' T I Lot no-
Flue _int Inr - an_: of a- -tmc L to 00 • �'� Other - - 10 00
lax map: parcel no.. is. - I Other furl appliances _
DESCRIPTION OF WORK '( fi ler heater J 111 (0
—.— I Ci:rs i:rcp!:Iec - -- I fiI 0 0
I
I Hue %enm fin , '.1101 10e0101 or 530 I i
-- -- t tat:placi i lc. 00
1 1 ,,,, !; i u as) I lc) ii t�t
J v, oo,l pcl1(1 01e%c IU.U0
\\ cod I1 cpl: ee insen 10 00
— II, PROPERTY OWNER C hur ;r• It er Iluc s rn: I I r, f'1.)
❑ TENANT • — -
Other f 10 ■0
Name: ■. IFSnr1 -• L' Environmental exhaust and .entilation
Address. r 1 Ransc hood other kitchen
• • �' L. 1111.! ts. e 10 00
Gh"StateFZ b ris `► . eg ' Clothes dryer exhaust it? 00
Smote -duct exhaust (bathrooms,
Phone: L5 5. — (.{O Fax: (50 s ) x 33' y vp I toilet compartments, utility rooms) 6.80
APPLICANT-" X CONTACT PERSON Autc•craWispace fans 10 00
Business name: `��-\'m E Other 10 00 1 , Fuel piping
Contact name: c a.. I , 55.40 for first four: 51.00 for each additional
Address: 3P\ M\ - Furnace. etc
Gas heat pump
City/State/ZIP:
\'`'all:'suspended:'unil heater
Phone: (563) 4(09I- 1LSr Fax:: ( ) 5V-\ F l Water heater
E -mail: 1 Fireplace
Range • CONTRACTOR' Barbecue rt
Business name: ��� �`��y ,�_ II ••` ' Clothes dryer (gas)
`C.1 � , ; � Other • Address. !�^ `� MECA?.N]CAL PERMIT FEES*
I
City/State/ZIP: %16 O Q • 9 1 I Subtotal
�� I Minimum permit fee (572 50)
Phone (5c),) -' ) 591 2 ( i Fax: (5Q3) OLip_ UY) Plan review (25 % of permit fee)
CCB Itc.: 14 131 Li State surcharge (8`.' of permit fee)
v 1 TOTAL PERMIT FEE
Authorized sit. attire: r - .
This permit application expires if a permit is not obtained within I90
_ _
Print name _ dais after it has been accepted as complete.
—� �_ I ' Fee methodology set b- Count- Building Indusn Service Board
_F i t f i * S Dale. t
i 18utlding PermirApp doe 12.03 14 0.:617T (1 Ii021COMjWEB)
ii.
, .
Building Fixtures
Plumbing Permit Applic:ition :!
':'=
City of 'Tigard Recer-ed
Pettrrrr1u•
li25 S'• Hall Bkd . - F , go.rd, OR 97223 Flan Res less
Pbonc 503 639 4171 Fax 703 5 1960 4 Da:e•B:,. COW, Pen No
21 Hour inspection I.mc 503 639 -1175 atii*- k
.; Dare Re:Idyl See Page : tut
Internet A ,., Cl ii2ard or us l'.1orriled. Supplemental I nfor matron
. ....:.. . ,, . - ..-._ • . .. - . -
i . —
. l . : -- - • . - • .. _ . . -- " ,•_ . OF .WOR.E. • ',• • FEE* g
__,
------------•-
For special infortnarloo use checklist.
JAN ew construction
i El Demolition
D I (');•,• I E. F To; 31
E l ..\ddition 3 1 1 c : 1 3 1 1 ° 1 1 ' r epi a cement [] O Ne■■ 1 - 2 - farnii dwullings (in lutleS 100 it for °Jai uldit-,•connec6
.
:-. • .: . - ' CATEGORY OF coNsTRuCTION,. ,.. . -. • SFR ill t-dit-, 2-19 20
..-•.a ......- - .. - ..- .. • - . . .• ..'' -. _
1 - and 2- family tby6111,12 X SFR (21 b.2t11 37000
SIR 1,32 Faili Z 79900
0 Accessory buildine 1 Multi- famil■
-- - Lail additional bath/kitchen 4 (
01\ 1351if b°1(rift El Other•
Fire F. ( sq ft )
.-• - ' '•'_ r - .. . . , ' JOB SITE ENF.ORMATION AND LOCATION.;
....._ .-_ ,..• _ .-• •. . - • --- .,. - - -.. .• - - -----. ., - • 1 _ 1 „.„,..... s. _- ---:_,-- - .: . -.- . ...1.:.: , -.- .' .:)ite utilities
iota site address: "
•jr: e" ' Cah tc basin or al ea dram 1 16 60
...■ .. A... '........_.A t (11 1 11 • 1 / 2 .-.1 '"
r - ---_,..---
CihiStatetZIP• -\ 1 e ih k ee C' 4 ' ct - 1-- i r)r.well. leach line, or trench dram - _ 17 e1
------
Foutmg dram (no Imeor ft i ...... ,
Surte:bldg , apt no.: "Is Project name
Nlatititctured home utilities 1 i CI l'Xi
Cr oss street:directions to job site c r ,_ c ot___ Csk e k___
r•tanlioles 16 60
Rain Main connector I (i.(0
Sonitar, sr-, CT (no linear H ) Pace
,St6rin se-xer (no 111103r ft . i I Pace 2
_ ■■••■■
1r
\\mei 5er, •CC OW hnnt f
Sukliv (.. ..
ision: i t
s i l_ol noll _
Are or ite: t
Tax map•parcel no . ) ( Absorption , a I e ' I 7 71
. - .TASCRi OF _VVO - . •.. ,..... ..
.. .
134chilc.. pFeyeniet Pc. •
-.3I•.e 16 60
•. 15 70
_______ — --- --- ------
p 01 V, 3 S IIC 1 I 0 oi ?
Drinking fountain 16 (
* '..". Vi. iii6kkii,; ''-l ' •-"-..--'-'.--'-.. --",:. Ej-: i-E : . '''':7* , : . _
1 c, 60
Name: LS C .t ). ikt.iA II QLV—_S Expansion rank 16.60
Address. 1 ( a Ex) )(..,„.. _ • A i•vk_ . 5) \T cap 16.60
City/State./ZIP:Ylinvjg t ( 12_,. q--- Floor drain:floor sinlaub 16 60
i - 1
Phone. .503) 52 qtyy„, Fax: ( 56S ) 533 - q30(0 Garbage disposal 16 60
: ff Vi-14,il.i;,.. . /I °s e b' b I 16.60
..,- ': -•_....rn'-:.7.2;.,. lc e in , k„. 16.60
Business name:
In
'--C)---rtr\LI--- terceptor'grease trap 16.60
Contact name:
Medical gas (value: S ) Page 2
Address- 3P, m.f, Primer 16 60
Ciry/StateiZIP: Roof dram (commercial) 16.60
Phone: (562,) a 4%9! 11/53 I Fax: : ( ) (T TYVE tory SinIc•basin:la 16 60
Tub/showerishov,er pan 16.60
E-mail:
, , _ . _ Urinal 16 60
:::- .,': :.: ..... .......... :,;,'..,.::..: ,
16 60
Business name: E, P Water heater 16 60
. • . t. lb •
Address: ° ppm 5 t --)N),.) Other_
Cir)./StateIZIP: 1. ll(biC'\ ) C..12_4,_____9_3--A2S Minimum pe Subtotal
.3 rmit fee. S72.50
Phone: (56 (,32.- I co3a_. I Fax: (6 1 _ (.1633 Residential backflow minimum permit fee 83625
CCB Lic.: Ocia to Plumbing Lic. no.:3q -071,30-0L1 Plan review (25% of permit fee)
'
- 7 - State surcharge (8% of permit fee)
Authorized signarure ---
• / ‘-. ,T ..--- -. r— 23F:j
C 1... TOTAL PERMIT FEE
Print name: c -- .- Dare: 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_
,::. Building'Perrnits',PLMF PerrnitArp doc I 2103 ,,, 4EITR10/02/COMIWEB)
CITY OF TIGARD
t
BUILDING DIVISION PERMIT #: MST2004 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 7 1(il'\
Inspection Requests (24 Hrs.): (503) 639 -4175 ...�'!
INSPECTION WORKSHEET FOR DATE: 6/22/2005 TIME: 7:13AM PAGE: 22
SITE ADDRESS: 07830 SW WATER PARSLEY LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 011 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES, PHONE #: 503 - 5334006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503 -533 -4006
Inspection Request Scheduled For: Date: 6/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 009885 -07 503-209-6824 Y
Corrections /Comments /Instructions:
At l
' , WA
( l e ../ k , 1 it
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: dr/ ' Date: Phone #: (503) 718-
CITY OF TIGA D
BUILDING DIVISION PERMIT #: MST2004 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 214/2005
Phone: (503) 639 -4171 �0° A /iiiiiiviiii'l \ Isption Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/22/2005 TIME: 7:13AM PAGE: 21
SITE ADDRESS: 07830 SW WATER PARSLEY LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 011 TYPE OF USE:
PROJECT NAME: BONITA TOWNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES, PHONE #: 503 - 533 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503 - 533 -4006
Inspection Request Scheduled For: Date: 6/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 009885 -08 503 - 209 -6824 N
Corrections /Comments / Instructions:
a
6/17AC6. (6S
•
1
S ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,
Inspector: ✓�' ' ) , Date: J 20Phone #: (503) 718-
CITY OF TIGARD - • . ,
BUILDING DIVISION #: MST2004 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 m ' m m J oryu ul�rj i l'I
Inspection Requests (24 Hrs.): (503) 639 -4175 —'.
INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 21
SITE ADDRESS: 07830 SW WATER PARSLEY LN CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 011 TYPE OF USE:
PROJECT NAME: BONITA TOVVNHOMES
DESCRIPTION: New SFA.
OWNER: JLS CUSTOM HOMES. PHONE #: 603 -533 -4006
CONTRACTOR: JLS CUSTOM HOMES PHONE #: 503- 533-4006
Inspection Request Scheduled For: Date: 6/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 009993-01 503-209-6824 N
Corrections /Comments /Instructions:
4
I
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL Ell. ALL Fr R INS' CTION ❑ ADDITI )NAL EES ASSESSED
di 1 .t.
Inspector: rk Date: 411 7 3 IP Phone #: (503) 718-