Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00243
iri� DEVELOPMENT SERVICES DATE ISSUED: 10/27/2004
ni l I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07868 SW BROOKLINE LN PARCEL: 2S112BA - BT020
SUBDIVISION: BONITA TOWNHOMES ZONING: R -12
BLOCK: LOT: 020 JURISDICTION: TIG
REMARKS: New SFA. DEMOLITION CREDITS FROM BUP2004 -00080 APPLIED TO THIS PERMIT.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 167 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 820 sf GARAGE: 585 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: 787 sf RIGHT:
VALUE: 181,320.30
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,774 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 BOIUCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 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 O FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL 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: $ 2,775.03
This permit is subject to the regulations contained in the
JLS CUSTOM HOMES JLS CUSTOM HOMES 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 Insp Plumbing Top Out Insulation Insp High strength bolts fins Smoke Detector
Footing Insp Plm /undslb Insp Framing Insp Shear Wall Insp Rain Drain Insp Electrical Final
Foundation Insp Electrical Service Roof Nailing Exterior Sheathing Insl Storm drain insp Plumb Final
Wtr Proofing Bsm't Wa Electrical Rough -in Gas Line Insp Firewall Insp Water Line Insp Mechanical Final
Issued Byy ' /_, , � � _ � _, Permittee Signature _ �=. --_
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
5�\ 2_5 nJ , " k, 5l,S,L-e20U 1101ZY
Building Permit Application ((�� f] FOR OFFICE USE ONLY
R �I�O \VlLLL��� �� Receive re" mi
City of Tigard I�� �/ DateB Pert No.
131 Hall Blvd., Tigard, OR 97223 y� ��' 0� \\/\..S ���� �u1y
Pl an Review 0 rru[
Other Per:
Phone: 503.639.4171 Fax: 503.598.1960 AUG 8 1U� /� A' / T ( t� DDate/By: v ! y /aff� P `
Inspection Line: 503.639.4175 8 Lu J e7 Date Ready/By: Juris: 12I See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental information
•
CITY OF TIGAR �' " . uv\ jam.
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V. . °,�: "-: - %'' . a . _,T �I'". ti .: ` .3, ir ` y " aa.i 4 gin,.. it.:�o.V .I 't:xi?a' -'sa.' i;:z *4:y ?.. ,.- .. ...
�z °a��'?;- th-.�.���� a��.- �`.�°`� r aid ''I ,�- :- r,�.zA�. _ �- �;;. �--; ..as. ..u. N.,_. >. >�.... - �
New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
„ w - ,.. € 31,1 x; ” 5 &E a:'*r sr ; '; >.''-tt " :"'-' 0 .c- %1; 7/V41.. �� .1nZ,Tr, work indicated on this application.
4 ' ' 3:t4 . ' "CA �TEG®RYfi:,O,B;
- ONSTRUal9r ' ika'i4 ', .� . a ;a '
.4h"r#,'. sx pct ' «i�;.. .4� _ "'+ „asaxr's=aat:.�r a,�.�.�%staA
lici +-[.- ;.'ex. >r^; =z;?:*+'rz -:`'" .:..
Valuation: $ �8 T�Z�
1- and 2- family dwelling Commercial /industrial
❑ Accessory building ❑ Multi - family • Number of bedrooms: 3
❑ Master builder ❑Other: Number of bathrooms: z L.
__ Pr " I'' : :: '`'' ; scf: f l f $ r"; r _ , ; ...- O ._.. - _ Total number of floors: 3
'' ., - JOB -ta f FOI,I FAN,„, N ~ ..
4
�, I'_. ,, r,rs*`ar_,�... ax _mow:.+ mss,; -
• !�� .--„, � ` ^� square feet
Job site address: ! l4 0?, 5 1.� V o o v,\ \ ,�.� \ \\r,..,___/ New dwelling area: 1 T 3.
City/State /ZIP1 ' C.?...... Garage /carport area: 5g5 z square feet
Suite/bldg. /apt. no.: Project name: AV O Covered porch area: ,_ 2 square feet
yn
Cross street/directions to job site: ‘ �r k i t— 1 Qy\ a VP Deck area: 1 1 square feet
•
Other structure area: square feet
QtJIRED DATA: eo,n ER, USEa,CBECKI:IST
Subdivision: n �t�n�►�(�rr�,S 4 Ltit , i>
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.: a equipment, materials, labor, overhead, and the profit for the O
` . 1 AID r IVIT -, rige.,1
G oleo i q t y ' ' ' w work indicated on this application.
Valuation: j u1/4 , 11 ._ $ 1 ja- `
- 4-3 , 8c
Existing building area: square feet
New building area:1 `� 6 1.4 L1 square feet N
:rr °_ °� �_�� Number of stor )
t .ER OWE s " r _tot)
� 4� >r.. Asa r � ��.•,..x ..� . . ,,.�,.
Name: \ .Vkd�� me_S Type of construction:
t li
Address: 1 O 1 �� �� _. Occupancy groups:
City/State /ZIP: t-+∎n 0 1Z- • C '3 D Existing:
Phone: (San) S , LICSQt ' Fax: ( 5 b ) % 3 �- {3■( e , New:
j ,�r „a . !g' a "�. -^+. x„..!'�,7•i 'en ; ,. f`S, -4 a t :01-:":2,,,11.7-,:;-
...., �� � �� - ar,.,' � :kris S'S9�C � v.'� '�'4'�s�m.'�.`. �� � x. Q
Business name: 5N1r)� All contractors and subcontractors are required to be
Contact name: ` licensed with the Oregon Construction Contractors Board
J V' $ under ORS 701 and may be required to be licensed in the n
Address: 3 E jurisdiction in which work is being performed. If the J
applicant is exempt from licensing, the following reasons
City/State/ZIP: apply:
1, C Y:
'hone: (SOS) °t (0C1, 1 3 Fax: : ( ) � �rl V
mail:
8 .�: tx. .k ss y SG � r.�'�b: � , � =ekS}_ ° °�t .. , - :x. :-a�.
ness name: 5 l ' L z , v , 5 az x ' ?i �; r * gas
L c ,:, . >. ,r, .., .N.0. :.B I G „, 4 „,VI'IT ,FEES .
,ss:
Please refer to fee schedule.
tate /ZIP:
Fees due upon application
( ) Fax: ( )
139 9 Amount received
Date received:
d signattrfe This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
1 t t . - a -� _ ` Date: * Fee methodology set by Tri -County Building Industry
1 Lp Service Board.
BUP- PernutApp doc 12/03 440- 4613T(I I /02/COM/WEB)
i Electrical Permit Application FOR OFFICE USE ONLY
Cit of City 9ECEIVED Received PermitNo.:
Plan R 13125 SW Hall Blvd., Ti ard, OR 9
Tigard, Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' H/(u' �° i� Date/By: Other Permit:
Inspection Line: 503.639.4175 AUG 18 2004 � Date Ready/By: Juris El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
.#a', 'rwG,'�; Yx:k'. -,' - - :�C.•ij,:,'. .�- R {'~'. -'�"� ;a�*irawx.,Za'2 °a;A�._ 'l:" ,+ms's '1 ':Q` iE "., _ ::irE `. - -
'4: ' - - - ::3.. :pfd; - ?, ^E':: z _'S:.. �s .
PI A N::: " V .y y ,
::..� ,'•�� I.'sll'iYP�'�F'•.`�'QRI� .,;F�..� .:°:.T� RE
.. r��- � °- s::�:: +,. -.,._, • " .lav a .,. -. ...� :�.,'= -_.� - .'.�ta��
❑New construction ❑ tti i aii'(aiteNtiMplacement Please check all that apply:
El Demolition ❑Other: ['Service over 225 amps, comm'I ❑Hazardous location
s > ',- ; * r r arm ;µ r .z, „> n . _ r;•� .;•:. -::: : -: wh; EService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
' A vs OATEGORY OF COI STR[JOF ^ ieraA: i-M� , '1 of I- and 2- family dwellings 4 or more new residential
`3 i .,. . ikgi.k3'i? §r, 11.- it.,,, . -
.,,, : ..,e^ r?.�iss 1- .:af .t;:,: : _ •__ .1 a.� :er_4, z. ,'.
-,
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories [Weeders, 400 amps or more
.,a -s; `. mrz ` st;gH -, .:�. =.rw�x ` .< s. ,:..; =` Win: . d o-, c persons Rv k
❑Oc upant load over 99 nutured structures or
e ❑
• �tt, JOB” SF TE N , O N�:,,.AND O ,� CA TI ON R ` x ` _: }R ❑Eg /lighting plan P
Job no.: Job site address: ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: �n ^ ,..A r\� • The above are not applicable to temporary construction service.
�,��. ,.,... '. :.FEE: -� SGHE I}>;E
Suite/bldg. /apt. no.: Project name �/1 s•K:.:'.._ s _ . , fir.'., "..V`
■ 1�� Description Qty. I Fee. Total
Cross street/directions to job s libe y‘ ' t l 01/4.A.- c � n yvo l S.2Q1(.. New residential single -or multi - family dwelling unit.
Includes attached garage..•
1,000 sq. ft. or less / 145.15 4
Subdivision �� l� '�� .• r Lot no.:� Ea. add'1500 sq. ft. or portion 33 40 I
Tax map /parcel no.: a S' 1 9 gl l Limited energy, residential 75.00 2
v� _ 1 r { Limited energy, non - residential 75.00 2
wag: x_, s,Y .d3 ±: x• •e •se.�g�.:�s x'r,:.�x:�z�_,vsa r� .,�
r n ; a '; ` •Q1 6 �"<'ORK�` a .; " "�ay .- ,'.°, Each manufactured or modular
• . dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
• 200 amps or less 80.30 2
r
,sra' • - . s -- , �n�s-,o s r : z x: :•e , a b ; tk n, .s: w .rt .'rr xr rix 201 amps to 400 amps 106.85 2
1 � 6 yiJ4 4 � � '- `Y.:OWN' . :5 - "'' I I. '„ -,' . }" � -
:.,`�tY </E LY3Wa+E+sl <'-= e'�,x:li..Ct:';',.. 9 S Y'Y.�.,6.... a _ -�i' n }i:. s
"� ,�t.� `� - -.- ='' 401 amps to 600 amps 160.60 2
Name: -31,S C .)sern \i�A 601 amps to 1,000 amps 240.60 2
Address: lc , agO IVt \ �,,� C k • Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
`�
City /State /ZIP� � � (. 1 Q� � ��� Temporary ora services or feeders installation, alteration, and/or • Phone: �/�0 Fax: � 5,) l relocation
( ba3 ) 533 z•W ( 53a- � 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: - Dater Branch circuits — new, alteration, or extension, per panel
trs,, ls ,.. p I4 a ClFA YER A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: . S , branch circuit
Contact name: — B. Fee branch circuits
without service servicic feeder e or feeder fee, 46.85 2
Address: each branch circuit
. C 1 l V Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: (.� �Q) To l . 1 / .Z I Fax ( ) cY4 M E Pump or irrigation circle 53.40 2
++..�� tL v Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
N.h 2,i COI ��R G' o a �� � dir energy panel, alteration, or
1 = a tip .mac :..e i= amt "
� �' l Q. c� r i C extension. Describe: Page 2 2
Business name:
Address: g 1 b L � �1 _ �Q.YN� 1 ` + t ` U - Each additional inspection over allowable in any of the above
JU Per inspection 62 50
City /State /ZIP: Ki 5�� t'O V e ` Q / 3 t73 Investigation per hour (1 hr min) 62.50
!
/ , ^ r` I Industrial plant per hour 73.75
Phone: (563) l�_sOv Fax: ) ( B, `S
;.,AVAPORI.G' NICI IVITF FEE_ S*': 51
CCB Lic.: , Saz I Electrical 'c.: LJ - . 4 1 Suprv. Lic.: C/2-3j2 Subtotal
Suprv. Electrician signature, required: ' = I lit. . Plan review (25% of permit fee)
Print name: S� Gvru -�-, I D State surcharge (8% of permit fee)
TOTAL PERMIT FEE
F L
Authorized si: +1: This permit application expires if a permit is not obtained within 180
�� days after it has been accepted as complete
Print name: c i; �. j 4. Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PennitApp.doc 12/03 440- 4615T(10/02/COM/WEB
Mechanical Permit Application FOR OFFICE USE ONLY
City "of Tigard ECE��E� Received
Date/By: permit No:
i` u v
13125 SW Hall Blvd., Tigard, OR 9 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 p AUG , s"sl , � w ection Line: 503.639.4175 / /rni tit �p $ I ,I\ DateBy. Other Permit:
1 1 Date ReadReady/By: Ins p�l± 1 Q 2004 , y . -
Juns: E7 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
x x'14.: a ' .� =*�zT �J• xi: =:. ,.a: - . x r >, • , � •
,. ,•�- '..,... „ -_. °.tt� s -, : ,, ,,, „ , , I , , , E .
: $ :CAEDUI E' TJSE CHECIQ IST
X New construction El Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
acre 2 �; "< °kc':: +f §'- "•�y�,•;`'' -sue= �Fct: _: r}.;...;,'°=- �t..=.: :.?zrtt•::.,g - :�: - isi4'" Yalu
.. ` r is . CATEGORY OF CONSTRUCTION- y Y , :.z ''?'
RESID,ENTTAL EQUIPMENT / FEES*
IrI and 2 family dwelling Commercial /industrial ❑ Accessory building 1 '' "'
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
��+ =ry 7. ��t� ;'.s� =�..::r`- v�`g.:'�4�:���,z �_ :�;a�cr.;c° =.. :.t.,. �F;, r�u ,»�:a'txs:rn:..�:.�.�.:,y�..; .y:,x;,;.�:..,v. ri .�: � z:: ;rw �.- ,.:..
i #JOB'SI E FORIYIATION A TDELOCA�'3A, 2 • •t'- *r;,r`, Heating/cooling
:��n � 2.r '�.A*Y < -.: .t .rr<v..c+�'r. - .. �a 'r u�:.: - qtr . t.r ..�," iii., 24- �m- .�,.
Job site address: Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/ State/ZIP: I i e-� • O le-. 911 Furnace 100,000 BTU (ducts/vents) / 14.00 /
1 Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
O'
(� t t Gas heat pump 14.00
Cross street/directions to job site: fi�,�wy\ .( SZ6 �� _ �- ►� � �J ...... / S Duct work 14.00
�l�? t' " ^^ E Hydronic hot water system 14.00
� Residential boiler (radiator or
• hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision � _ 7 � } Lot no a U Flue /vent for any of above 10.00 Tu. S Other: 10.00
Tax map /parcel no.: e, S 1 (...,.. 1 ^fi 1 Other fuel appliances
M ` �S °: , " ' -�".r_ ' c f ' '' t . a •, WaWater heater / 10.00 /0
rDESCRIP, OF�WO - A.
>•k%a -9f�'M °:'°a {`3"�a�� 4�sk�az."YF;a:c ,. -g :i=- tk^v- iw.- a:,�:Y =-� . �.- ^ :e , f.Sbd' :+ :,`• -° O
Gas fireplace / 10.00 /
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
• Wood/pellet stove 10.00
Wood fireplace /insert 10.00
,'- y s s.- _ . � r g f i Chimney /liner /flue /vent 10.00
` .PROPRTYs O�NERr =°' . , ,7 .. 1 t F E1 'AI T
. •,, :.r � ° �, .F � a§shxY,s� -. i�� ,
... � :�.°mnc:'�h.•ti ,: �a -, �r, nK �k`�:t<;;�' �- .�. R
Other: 10.00
Name: 3"-LS Ct l ' zr7 Environmental exhaust and ventilation
Address: / ��O A ! lv �� Range hood /other kitchen
u�oG 'vw equipment 10.00
City/State/ZI 2 02 r � QQ . Clothes dryer exhaust / 10.00 /0
`� Single -duct exhaust (bathrooms, 3 u
im
Phone: (503 )5' _ Odd Fax: (56 g ) 533. y366 toilet compartments, utility rooms) 3 6.80 2d
,: 'AP • - 1 J N G 670 Y 1 7
` � ..� £e <as�.�a ' �. e .- �.2.,4�- �� .. � a:e m'z� -s .'c.�re - �.tg �; ; Attic /crawlspace fans 10.00
Business name: Other: 10.00
<S� Fuel piping
Contact name: c r ( $5.40 for first four; $1.00 for each a ditional
Address: 3A 1 �J M C` Furnace, etc.
x Gas heat pump
City/State/ZIP: - Wall/suspended/unit heater 5 'f V
Phone: (565) 9 1 45 I Fax: : ( ) 5th • t� J Water heater 5
Fireplace
E -mail: Range
- ;i ,, .F` 'g `"`s ° _„` = ' , i . , �T i. as
- r - ... if �,� . (�® � L' T® 4 - ' Barbecue
. � � . .ate . � � �. At . • �;.
I YCL R ,..., cy Co� Other:
dryer (gas)
Business name:
Address: w I v � .;z :.�s�,- * ,:: < t, z':.
Co 5 b3 V k� R MEG HA N i'CrrAL, PRIVII TEEE S
City/State /ZIP: 1 O Q 91-NO `} p , Subtotal 0
Minimum
permit fee ($72.50) 7' S
Phone: (5c)/) 591 -9924 Fax: ( 563) gqB_ (Y) "„
Plan review (25% of permit fee)
CCB lic.: , 4 131 _ State surcharge (8% of permit fee) / 8 �
TOTAL PERMIT FEE
�ature: This permit application expires if a permit is not obtained within 180
Authorized sip
i = ture: - ` - - days after it has been accepted as complete.
Print name: p ':e ; 4„, - -ift keS Date: • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (1I /02/COM/WEB)
i Building Fixtures
Plumbing Permit Application FOR OFFICE USE ONLY y
�/� ''
City of Tigard Received Permit No :
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 AUG (� /yyiA�ptil i 'i Date/By: Other Permit No.
24- Hour Inspection Line: 503.639.4175 1 � Zoo t• J � Date Ready/13y: Ju 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental lnformation
.. -.?` - - : !`v'•• __ .� - - - - � "^'�'A'" _ - :'IFS: .AS °�?F's + . ^Se'.f.F�.. ' r..�,'.r,� T?Y•: - -
-t �;�"�'�":' >-' u'�'., °' ;:,�K`- ',�rr.` „�r�$ �"� . }�I+f ° � �` i < : � 4, .Ft:x ��l:s- ".�`?�`t.;�2;?' `t - :��, `fix �°,3- � "�w;'.z�` v� " O= .R ' , .�.'� , ^ i; , . .;. �,.t:. a.•? -
,3 Z M :L € ;S� _TYP U11 : - FE1.=..SCH-EDULE
t 3U1L4 Ll tvl�!.t )14 For special information use checklist
F. ~^ _
g New constructions Demolition
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
:. ,R SCAT G,OR1;. PIr R U ..._ .::-'; ... , ,_= j ,
riir.it « 1. f., - i a.�..,�;.eg:x <.=.34.4 it ,2k;ae ; .::;; i iii : SFR (1) bath 249.20
��k
til and 2- family dwelling XCommercial/industrial SFR (2) bath 350.00
III Accessory building ❑Multi - family SFR (3) bath 399.00
r1 Master builder El Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft) Page 2
�� -fit :- a Y 3i ® iE ' ^' )1T Q I e, -
* >.,....�.�� �a :rr, =��r �;:�t�..�.. ,.,,....at�- �::_�' , fri .. , ..c,-,,-a Site utilities
Job site address: Catch basin or area drain 16.60
City/ State/ZIP: 1 1 n ^ ` ���' O e q Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: �v 1 Project name: Footing drain (no. linear ft.: _) Page 2
C) V \ k . (` � ',` Manufactured home utilities 1 10.00
Cross street directions to job site r\ «- 'Y`C.), C Q Q t?
v � `` Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision �ot�..Cl / Ck _S Lot no.aQ Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: a 7._ l t Fixture or item
' Absorption valve 16.60
E ' � i .. ., . #frA4 x - w. -.,.max a.* •I l Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher ` 16.60
¢�r t I r y Drinking fountain 16.60
'' - - " -' `±` '`_' Ejectors /sump 16.60
Name: LS C 4 t 7 � Expansion tank 16.60
Address: l (D asO S � � h Fixture/sewer cap 16.60
City/State/ZIP: t ier-i nn. � , � cri- Floor drain/floor sink/hub 16.60
Phone: A ) y #41 , Fax: (SS )5 . . [l Garbage disposal 16.60
; 4 " � z t .,�- +'a`�.1M, Hose bib 1 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: � . ♦ Medical gas (value: $ ) Page 2
Address: 3p, E +� Primer 16.60
City/State/ZIP: Roof drain (commercial) 16.60
(503 0 � 6 � /1/53 ( ) Sink/basin/lavatory 16.60
Phone: Fa x:
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
,.-. - " 4 - ' J 2.._ s - :'xi - Water closet 16.60
Business name: ►' \� y\Q In1� ��� Water heater - 16.60
Address: a LJ `i `
/ ) ` a ` � 1 1 _ Other:
City/State/ZIP: H k c 1� JY+� f C .1 1.. Subtotal
V ++ a. Minimum permit fee: $72.50 q p
Phone: (66,3) / - L 6 `g� Fax: ( 33) 6 141 Residential backflow minimum permit fee: $36.25 ( /
CCB Lic.: 179a tD A 9 Plumbing Lic. no.:3q 1: 2/ 0 0.46 Plan review (25% of permit fee)
v State surcharge (8% of permit fee) 3 /
Authorized signatur .
, ` - -J TOTAL PERMIT FEE Gf3O . L - .
Print name: _ Date: 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.
'Buildin \ Pcrmits\PLMF- PemutApp.doc 12/03 440.4616T(10/02JCOM/WEB)
CITY OF TIGARD 24 -Hour C/ /
BUILDING Inspection Line;�503) 639 -4175 MST 2-00 7" --0d�/ei`�
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 7 AM. PM BUP
Location 1 / / • Suite MEC
Contact Person C Ph ( ) 7. V Z� PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing 13 '.' N � p, ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
- A PART FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date '2 `7 Inspect ' _�Ji _ / Ext
L
Other:
Final DO NOT REMOVE this inspection record from the • ' site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING. Inspection Line: (503) 639 -4175
MST c e 2 `t
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested ^ AM PM BUP
Location 7 S5 �o . 6411'64 (24-1:L/ Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall / %s 40 - �/,�i►
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
C HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: n Unable to inspect – no access
Fire Supply Line �•
ADA Date Inspector Ext
Approach /Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour A
BUILDING, Inspection Line: (503) 639 -4175 MST — et--2A3
INSPECTION DIVISION Business ine: (503) 639 -4171
BUP
Received ate Reid- es AM PM BUP
Locat 7 " _ � r - 'te MEC
Contact Person Ph ( ) PLM
Contractor y Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Roof / I I l qIj
.9414ert--, MOWER= RIMMI:
ASS PART FAIL 11 I v -
IN
Post & Beam
Under Slab r daiik Rough -In
Water Service , EMU Sanitary ry Seewer
Rain Drains
Catch Basin / Manhole marartvenaw
Storm Drain S — -
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
S _ okP Dampers
SS
'ART FAIL
ICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please cal for reinspection RE: ■ El Unable to inspect – no access
Fire Supply Line ��,
ADA ��
Approach/Sidewalk Date Inspector Wa ; Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
` rte'
October 1, 2004 �.� �f �I ; 4
CITY`O rrT_ T.11
JLS Custom Homes OREGO k! i
16280 NW Bethany „s,,. . ,:
Beaverton, OR 97006 `
iVi.,
RE: NEW TOWNHOME DEVELOPMENT ,< 1r ,, t i ;
Q
Tenant Name: Bonita Townhomes Occupancy Type: R3
x ;24: MAN .., r ..
Construction Type: VN Stories: 3 s , ` n . , .'-
The plan review was performed under the State of Oregon Structural Specialty Code (OSSC) _ , , ; i ',:;.ii
1998 edition; Rowhouse Construction Interpretive Ruling No 00 -10 (RCIR -10); and the ' + ` {; [`i4
Tualatin Valley Fire & Rescue Ordinance 99 -01 (TVFR99 -01) 1999 edition. The submitted ;`,``. •```'
plans are approved. The following permits are approved for construction subject to the ;. = ± = :
following conditions. = _•k
Lot 19 7872 SW Brookline Lane Permit Number MST2004 -00242 ;:.r;.,.
Lot 20 7868 SW Brookline Lane Permit Number MST2004 -00243 ?'_ ~`r'
:' .: :�.
Lot 21 7850 SW Brookline Lane Permit Number MST2004 -00264 %,; 'L"
-Z :;` ;
Lot 22 7838 SW Brookline Lane Permit Number MST2004 -00265 n =• 4-- -'_I
Lot 23 7820 SW Brookline Lane Permit Number MST2004 -00266 ti :� .
Lot 24 7804 SW Brookline Lane Permit Number MST2004 -00267 ;. f „,ti
CONDITIONS
1. Attached is a copy of Interpretive Ruling 00 -10. Please use it as a guide.
r
2. Shearwall Sheathing and Gypsum Sheathing shall be attached
g yp g and inspected in
stairwells prior to the construction of stairs or landings. 1
3. Special Inspection is required for STRUCTURAL WELDING and HIGH -
STRENGTH BOLTING. The special inspection agency of record shall furnish
inspection reports to the Engineer of Record, ROWELL ENGINEERING &
DESIGN INC., the General Contractor, JLS Custom Homes and the City of Tigard,
Building Division, attention Hap Watkins. All discrepancies shall be brought to the
immediate attention of the general contractor for correction. The special inspector
shall submit a final signed report stating whether the work requiring special
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772