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Permit l L a- P CITY OF TIGARD MASTER PERMIT i - PERMIT #: MST2008 - 00048 COMMUNITY DEVELOPMENT DATE ISSUED: 5/8/2008 ,TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104CB -01700 SITE ADDRESS: 13075 SW ASCENSION DR ZONING: R -7 SUBDIVISION: HILLSHIRE WOODS LOT: 033 JURISDICTION: TIG PROJECT: WOLF Project Description: 727 sq. ft addition BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 16 FIRST: 727 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: 100,000 0 0 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 727 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 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: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: WISVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAUPANEL: 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: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEJIRRIG: 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 BRYAN & MAUREEN WOLF ROBBINS VALLES CONSTRUCTION LLC laws. All work will be done in accordance with approved plans. This 13075 SW ASCENSION DR PO BOX 297 permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 MARYLHURST, OR 97036 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: 503 756 - 7749 Contact #: PRI 503 756 - 7749 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 342 -6915 Reg #: LIC 173545 TOTAL FEES: $ 2,574.95 REQUIRED ITEMS AND REPORTS sr I ued By : I / / / . / L � ► ;,, Permittee Signature • , �' v Call 503.639.4175 by 7:00 a.m. for an inspection t :t b siness day. This permit card shall be kept in a conspicuous place on the job • - until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential FOR OFFICE USE ONLY City ri g ,/ 2n L I� O QI D A� C 1 OfH a l l a n d 0 Date /B Received : 7 I. 0 �� f Permit No.: [ (J !iC/T� I - ° 13125 SW Hall'Blvd. Tigardl, ORDI?i7223 Plan Review Fl x: n f b 5/i Other Permit: Inspection Line: Phone: 503.639.,4141 Fax: 503.5 8..��9¢0 Date /By: ma, t �7 T 1 G AR D rP . X03.639;41.75 • ",:t: ' i. Date Ready /By: h t . ® See Page 2 for tg r - * ' ocg 1 Z 9 Div BUIL Notified/Method: .. - 77(g .. - 77(g a/ - 7 l fa'. Supplemental Information Internet: www.t tgard- ov, j t t ,;,- r-4 - ' ()k CA ( Ph" 00 TYPE OF WORK REQUIRED D 'TA: -1- AND 2- FAMILY DWELLING ❑ Ne construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION, work indicated on this application. 12 and 2- family dwelling El Commercial /industrial Valuation: $ , 00 gc)rocz) _ 1.:Nr-> ❑ Accessory building El Multi-family Number of bedrooms: El Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10 cz -j 5 - j .w. A'S CS St rats �d : V `. New dwelling area: •2 square feet City /State /ZIP: `--\ '‘. Av %7R. 9 7 -_- 4 Garage /carport area: square feet ■ Suite/bldg. /apt. no.: Project name: LA.._ \ F. Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the p • fit for the DESCRIPTION OF WORK work indicated on this application. � r.r - �o•7rr ^ 6Jp; ; ; N Valuation: $ �'"� Existing buildin• . ea: 'square feet New building area: ' square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: � rvAN V.-"S'" Type of constructi!,': Address: 13 Z 7 ► j 5, v C. � SL � >t9 S ; "0�1 C vs: v�. Occupancy g = City /State /ZIP: \ ; L 1 <:::,,N, Q - - 1-- Existing: Phone: (561) 5761 _ cz:N=ers k 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: 1` ® „b, RS VaAt.S5"[' -, ,,N .BUILDING PERMIT FEES* Address: P o- 3ok .2_91 (Please refer to fee schedule) �a .\- ( L c\7 a Structural plan review fee (or deposit): City /State /ZIP: .ma .� - � 0 3 Phone: ( 1) -7s (, _7- Fax: (5 34(^2_ _ (oq r 5 FLS plan review fee (if applicable): Total fees due upon application: 151 oZp - 3 � CCB lie.: 1-7 /S Amount received: g 5 3 7 Authorized signat ,:jeay/08 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: d,, .-.../Gl,\: Date: 4. ZZ , m$ * Fee methodology set by Tri -County Building Industry Service Board. 1: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11 /02 /COM/WEB) ' v Building Permit Application Checklist One- and Two - Family Dwelling . : , , FOR OFFICE, USE'S ONLY City of Tigard Received Permit No.: Date /By: III - 'a 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: • • - Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 El Electrical O Plumbing 0 Mechanical TIGARD Intemet: www.tigard- or.gov ❑ Other: ' THE FOLLOWING ITEMS ARE:REQUIRED FOR:PLAN'REVIEW , Yes N o N/A 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. 1 1 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, ❑ El ❑ 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- ❑ ❑ D. 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 ❑ El ❑ 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 applicable to the project under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ El ❑ 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. ❑ ❑ El 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 trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ 12. ❑ and protection`measures must be drawn to scale and accompanied by the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ El 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(11/02/COM /WEB) Electrical Permit Application E , I FOR OFFICE USE ONLY 1' City of Tigard APR 6 z 2008 Received e g" A Date /By: O Permit No.: //V � 6 y --POO a - a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503 9€0. 11r OF 1 �G Date/By: Other Permit: TIGAKD Inspection Line: 503.639 BUqLUI� u,E1�3satbl /By: lurk: fa See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction ❑ Addition /alteration /replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION . exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. El Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ID Emergency system. larger separately derived system. El Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", •7'S p � 1 ixor or more. Recreational Job no.: Job site address: V3 S• ��• f'iSL2.nS:o't1 C.( • Cl Six or more residential units. ❑Receational vehicle parks. ❑ Health -care facilities. ❑ Supply voltage for more than City/State /ZIP: i L ` A , , r o, 4 : = r L , O % 7 • _ • • , 4 600 volts nominal. ❑ Hazardous locations. Suite/bldg. /apt. no.: Project name: ‘ 1 Ql. ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I 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. ft.) n Limited energy, multi - family 75.00 2 L—; ... I\N¢.w `� `o•oT /:\ a..1 v residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation V- .3,- m...-N{N 7 ¢- re•-•OOA -- 200 amps or less 80.30 2 ❑ PROPERTY , OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 � , r• Ut ��\t= �' 601 amps to 1,000 amps 240.60 2 Address: \-� x - 7 5— e-.W a_mS; 1:54- 0•"' Over 1,000 amps or volts 454.65 2 ' • City /State /ZIP: \ Temporary services or feeders installation, alteration, and/or C,s� C:= C 7 Z - "L tc relocation .' Phone: (561) S Q5.2::••OI Fax: ( ) 200 amps or less 66.85 1 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 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, first branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 3 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: G,r \(•;N Q \ ems Y \ C - energy panel, alteration, or Address: \ 4 �� \ =• - ST• extension. Describe: Page 2 2 City/State /ZIP: c e _ v ......., Ci %.\._. 9-7 p,,45 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( 5 (p _ of e SB Fax: (5163 ) 5S-7 - I Sy Investigation per hour (1 hr min) 62.50 CCB Lic.: 35 I 1 -1 Electrical Lie.: 3 4. 4 L Suprv. Lie.: 4Z 4 1' 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 (12% of permit fee): Authorized signatur TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 �, Print name: ,,_,.� \ j Date: 4. -,.... p�cB days after it has been accepted as complete. � '� * Number of inspections allowed per permit. 1.\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 l /05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: -- r p,00' - a \ ( RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 \ 1 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: COMMERCIAL ONLY: • Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ .Fire Alarm Installation n HVAC • n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n 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 ' Plu mbing Permit Applicatio n E a i \ frz 1 Buildi>tlig Fixtures U " � `� APR 2008 FOR OFFICE USE ONLY City of Tigard Receive 1 14 - V OF !G A DateB %; 0- O Permit No.• S /��e -4 e r q 13125 SW Hall Blvd., Tigard, OR 9722dTb O T! GA ��� Plan Rev Phone: 503.639.4171 Fax: 503.5, 8111 9 66 )6N i Oi)fViStCN Date/By: Other Permit No.: ' Inspection Line: 503.639.4175 Date Read /B ® See Page 2 for TIGARD Ready /By: g Internet: www.tigard- or.gov Notified /Method: / (Cs Supplemental Information T YPE OF WORK FEE* .SCHEDULE . ❑ New construction El Demolition For special information use checklist. Description Qty. I Ea. I 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 E - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 CI Accessory building ❑ Multi- family SFR (3) bath 399.00 El Master builder Each additional bath/kitchen 45.00 ❑ Ot her: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 13 (73 -7s- S, W, r--}SLe,. o , y ---■-•t, , Catch basin or area drain 16.60 City /State /ZIP: ‘ y p,, .::::::4‘.. . . or--71_ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: ,,,\ „,,,N Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: _) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 r •,-.1\t; V-a ■_-....vJ Ps CCJ T 0 `- 1 o Backwater valve 16.60 • 1 q_N ��M �o �` Clothes washer 16.60 Dishwasher 16.60 El PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: -��00,,e.4 IN ,,Vi-.-- Expansion tank 16.60 Address: 13 qs•S w. A‘5LQwg', o.a C, , Fixture /sewer cap 16.60 City /State /ZIP: - -t-- ` , c: ,‘‘ .. _ q-7 -Z- Floor drain /floor sink/hub 16.60 Phone: (c�th/) l Z 7 - jam \ Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT El R CONTACT PE SON 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 Phone: Sink/basin/lavatory ( 16.60 ( ) Fax: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 'CONTRACTOR Water closet 16.60 _ Business name: 1 A ` v i P ■ vM }> , V2 - 0 1 q (�) Water heater 16.60 Address: P, Q . Q , 5Q:c7 Other: Subtotal City /State /ZIP: '; (... •‘. 0 17 e:>q, 4 Minimum permit fee: $72.50 Phone: ( 503 ) 6S 7 - 3`l ( 9 Fax: ( '3) “ 7- 3 9 4 t Residential backflow minimum permit fee: $36.25 Plan review (25% of permit fee) CCB Lic.: 1 SS 17?�� /G �� Plumbing Lic. no.: 3 -tf Z3 P b State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: •••■,AA \\ Date: 4.1,2 ,a0 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I:\Building\Permits\PLMF- PermitApp doe 12/27/06 440 -46 I6T( I 0/02/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 - li 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: . Permit Fee:. . Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46,40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture. or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000 00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100 00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for.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 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 Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -3" - 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\PLM- PermitApp doc 12/27/06 Mechanical Permit Application R Er , U FOR OFFICE' ONLY I rReZei.S City of Tigard APR 2 `) Dte7B ,/�' ,g Permit No f�ST ff • lig - e 131 25 SW Hall Blvd., Tigard, OR 97223 APR 2 2OO ) Plan Review Phone: 503.639.4171 Fax 503.598.1960 r t Date/By: C!TY Other Permit: TIGARD Inspection Line: 503 C•T �F � :�, �g ,IGlateReadyBy: lur (tee ® See Page 2for Internet: www.tigard- or.gov BUILDINGt) (6t ed/Method: / / Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction E Ad dition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONST RUCTIO N Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building Multi-family M builder For special information use checklist. ❑ y ❑ ❑ Other: Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION . Heating/cooling Job site address: k3 � - 7 S •J , w . ^ `g z V f Air conditioning or heat pump �C S wS c:10,1 � . (requires site plan showing placement) 14.00 City /State /ZIP: ; 69 o.rp sue, ei 7 Z"Z..c Furnace 100,000 BTU (ducts /vents) 14.00 Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: w.. c \F Gas heat pump 14.00 ` Cross street/directions to job site: Duct work 1 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 • ` /� Gas fireplace 1 10.00 �j ns r 1 A (-L ∎ ^% N`yv A6.) %"Ti •=ev ? Flue vent for water heater or gas fireplace 10.00 • Log lighter (gas) 10.00 \(=_-- s r ∎`.1 \C-rR_NA•Z-N1 -3\ -0z-rvti c \ Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ❑' PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10 00 Other: 10.00 Name: —a I-3 ‘1.5 ex\ Environmental exhaust and ventilation �7S S. W p � � Range hood /other kitchen Address: v3 �""'eS L�v15 ■ ot�1 � e . equipment 1 10.00 City /State /ZIP: --7- cg1e ,n a Z- Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, (Sys) Phone: S71 _ c■2> a 1 Fax: ( ) toilet compartments, utility rooms) 6.80 ' ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer ( gas) Business name: C_____,..-\-- t� os \....\_.<,... Ttt�U Other: Address: 7 13 L N . E" S Se ANN S - MECHANICAL PERMIT FEES* City/State/ZIP: y Pc„,c„1 �„cf), cx\.• an z os3 Subtotal Phone: ( 5gs3) 22:,,,6 Z�5ct Fax: ( s -03) Z�b �SS - 1.. Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: 47q7 $ State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: ���� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: \ ....../ \,\, Date: * Fee methodology set by Tri- County Building Industry Service Board I \Building'Permits\MEC- PermitApp.doc 01/19/07 440 -46I7T (I l /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. I:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2 .--,,, 5 . • 4 2 . -11f," 07 45'-0 , S . p °2 "E _ 0 m I � C a o • 137.47' 0 - , MINIM t G N rn r N o c-) 1 I m �' r o ,D, I 1 / ° O I 1 :::� Dom: oo I Z / 1 c�z . g� I z p _ 1 Opp I o o � / 1 o / c / n \N4 0 / r / 9 ,9 p X 0 2 I �' / I I I // / / ;r x � • I z C / . / / 1 . / / \349 ,\ _ / / • / • / : � . �\ , 0 of / . \ / I SITE PLAN y ; N W RESIDEN BY: ATTON BOBBINS V NC.' TOPOGRAPHY rT1 Vi' DESIGN WATTO DESIGN C Y O NOT m VALLES CONSTRUCTION WORKS, INC.' IT IS THE p M E . WOLF RESIDENCE, BRYAN & MAUREEN IL LAME77E FALLS SOLE RESPONSIBILITY OF THE IT 175 S.W. ASCENSION DRIVE 1875 WILLAMETTE BUILDER /�' CITY OF TIGARD, WASHINGTON COUNTY WEST LINN DR. CONOITONS, WCLUDILLT - -- _ - — - - - - - _ - -- - -- - --- - OREGON 97088 ON THE SITE THWG AT ANV MAY F CAUSE PLACED OFFICE 50 3.853.1001 OF ANY POTENTIAL FIELD MODIFICATIONS. CITY OF TIGARD SR Il E PLAN REVIEW BUILDING PERMIT NO 11_ �b. PLANNING DIVISION: Required Setbacks: L] Approved 0 Not Approved Side: — Street Side: it) Front. i Garage: �D Rear: S� Visual Clearance: y `--° Maximum Building Height. 2 s feet ®Not Approved ! CWS Service Provider Letter Required: 0 Yes i4 No B ; 0 Received - 6- D ate: L f / - (3/68 / ENGINEERLN - DEPARTMENT: Actual S ope: „% ,; Approved 0 Not Approved B ite PI a Approved 0 Not Approved . _ Notes: ,i c32y j ■ Date: Z3 O CITY OF TIGARD - SITE PLAN R EVI � W BUILDING PERMIT NO: 5T, •Og -- 00 0 _ A roved ® Not Approved Street Trees: pp ;Protected Trees: ( Approved ®Not Approved Date ' J o 9 By: / . ) & ( - Notes: i • •,: . ", MASTER PERMIT IN 1 , PERMIT #: MST2008 -00048 ° COM MUNITY DEVELOPMENT DATE ISSUED: 5/8/2008 TIGtARDI 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 r � "` ' PARCEL: 2S104CB -01700 SITE ADDRESS: 13075 SW ASCENSION DR ZONING: R - SUBDIVISION: HILLSHIRE WOODS LOT: 033 JURISDICTION: TIG PROJECT: WOLF Project Description: 727 sq. ft addition BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 16 FIRST: 727 st BASEMENT: 5f LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: st GARAGE: sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THIRD: 51 RIGHT: 5 VALUE: 100,000 0 0 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 727 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: . OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ' ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: , PUMP /IRRIGATION: PER INSPECTION: EA AMYL 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/0 SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: ' LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL 8R CIR: 3 SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 '.amps- 1000v: MINOR LABEL: O 1000. amp /volt : (0 0 PLAN REVIEW SECTION W Reconnect only: 1 > =4 RES UNITS: SVC /FDR> =225 A.: : > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY 0 A. SF RESIDENTIAL . B. COMMERCIAL O AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO B STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: 0 BURGLAR ALARM: OTH' BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: ‘3******. GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: I� This permit is subject to the regulations contained in the Tigard ` • Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable BRYAN & MAUREEN WOLF ROBBINS VALLES CONSTRUCTION LLC laws. All work will be done in accordance with approved plans. This w ' • 13075 SW ASCENSION DR PO BOX 297 permit will expire if work is not started within 180 days of issuance, or l_ TIGARD, OR 97223 MARYLHURST, OR 97036 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 CP Phone: 503- 756 -7749 Contact #: PR1 503- 756 -7749 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. • FAX 503- 342 -6915 0 Reg #: LTC 173545 <JJ TOTAL FEES: $ 2,574.95 C.A REQUIRED ITEMS AND REPORTS ..r5 • . ..„72 • I ued By :0 • /�(4,�/ Permittee Signature Call 503.639.4175 by 7:00 a.m. for an inspection t : tbysiness day. This permit card shall be kept in a conspicuous place on the job_ •te until completion of the project. • Approved plans are required on the job site at the time of each inspection. IN .,, 0,, , c rr ■ ®F Ti. ,- A R D _ . ' MASTER PERMIT ° COMMUNITY DEVELOPMENT -- --PERMIT #: MST2008 00048 E ISSUED: 5/8/2008 .1'4 GA D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104CB -01700 • SITE ADDRESS: 13075 SW ASCENSION DR ZONING: R -7 SUBDIVISION: HILLSHIRE WOODS LOT: 033 JURISDICTION: TIG PROJECT: WOLF Project Description: 727 sq. ft addition BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 16 FIRST: 727 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: y TYPE OF USE SF FLOOR LOAD: 50 SECOND: sf GARAGE: 5f FRONT: 15 PARKING SPACES : 2 • TYPE OF CONST: 5N DWELLING UNITS: THIRD: 51 RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 727 sf 100.000.00 REAR: 15 • PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: • SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: . OTHER FIXTURES: • MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =10OK: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ' ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS Z 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: , PUMP /IRRIGATION: PER INSPECTION: tn EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/0 SVCIFDR: 1 SIGN /OUT LIN LT: PER HOUR: ' LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAL/PANEL: IN PLANT: �n 1• P MANU HM /SVC /FDR: 601 • 1000 amp: 601•amps- 1000v: MINOR LABEL: 0 1000* amp /volt : ( 0� PLAN REVIEW SECTION • W Reconnect only: 1 > =4 RES UNITS: SVC /FDR> =225 A.: • > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY O A. SF RESIDENTIAL B. COMMERCIAL 0 AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: a BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: rV GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a 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 BRYAN & MAUREEN WOLF ROBBINS VALLES CONSTRUCTION LLC laws. All work will be done in accordance with approved plans. This 13075 SW ASCENSION DR PO BOX 297 permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 MARYLHURST, OR 97036 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- 756 -7749 Contact #: PRI 503- 756 -7749 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 342 -6915 Reg #: LIC 173545 TOTAL FEES: $ 2,574.95 REQUIRED ITEMS AND REPORTS z., /-> • I ued By / _f1 A ; Permittee Signature • , f Call 503.639.4175 by 7:00 a.m. for an inspection t t b siness day. This permit card shall be kept in a conspicuous place on the job • . until completion of the project. Approved plans are required on the job site at the time of each inspection. 4 • CITY OF TIGARD ,{ BUILDING DIVISION PERMIT #: MST2008- 000118 13125 SW Hall Blvd., Tigard, OR 97223 . . DATE ISSUED: 5070I38 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639- 4175 INSPECTION WORKSHEET FOR DATE: 7/200008 TIME: 7.03AM PAGE: 6 SITE ADDRESS: 13076 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIR1 WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503.756 -7745 CONTRACTOR: ROI3BINS VALLES CONSTRUCTION LLC PHONE #: 603756 - 7749 Inspection Request Scheduled For: Date 7/28/2008 , Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 073308 -01 603- 766-7749 N Corrections /Comments/ Instructions: M PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: 4 11 wt.n...)■\ \`.--2_ Date: ,,y_IaV1 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/0/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/16/2006 TIME: 7:O0AM PAGE: 4 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503 - 756.7749 CONTRACTOR: ROBE3INS VALLES CONSTRUCTION LLC PHONE #: 503 - 756-7749 Inspection Request Scheduled For: Date: 6116/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain n 071426; -01 503.75E -7749 Y Fo +■(3,rfU K. ot v 1Qx1r./‘ Corrections /Comments /Instructions: , .dam A ti L L v'-( w'�.r(, c�l.;_,0.4 -' �/ . u f 40 tre.J\.) 4' rd ` JV?.J\.n, VLPASS ❑ PARTIAL APPROVAL ❑ CANCEL • Et NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CT?)\evv."%i\ Date: L‘ t \o c; Phone #: (503) 718- ✓, CITY OF TIGARD BUILDING DIVISION PERMIT #: MS( ? {lU8- OOI�18 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 18/2000 Phone: (503) 639 -4171 1i^ r y l Inspection Requests (24 Hrs.): (503) 639 -4175 ':�! 'IL. INSPECTION WORKSHEET FOR DATE: 7/31/7008 TIME: 7:OOAM PAGE 15 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRC WOODS LOT # : 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 72.7 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503 - 766.7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 7/31/2008 Pour Time: Code # Inspection Description Confirm # Contact # . Message 280 Insulation 073541 -01 503-756-7749 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL A] CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: - Date: 7-3/-de Phone #: (503) 718 - Z[4- - CITY OF TIGARD 4 BUILDING DIVISION PERMIT #: tviT00i 00t1Q 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 "''_I INSPECTION WORKSHEET FOR DATE: 7/3W2008 TIME: 7:01AM PAGE: 9 SITE ADDRESS: 13076 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: hill.LSHIRE WOODS 033 # 033 TYPE OF USE: PROJECT NAME: WOI 1 DESCRIPTION: 721 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503.756-7749 CONTRACTOR ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503. 758.7749 Inspection Request Scheduled For: Date: 78 Code Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 073469-01 503 - 756-7749 N Corrections /Comments /Instructions: e n PASS -❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 7 - Y -Q a Phone #: (503) 718- "L-q — CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 602008 Phone: (503) 639 -4171 _ u ]�I Inspection Requests (24 Hrs.): (503) 639 -4175 " INSPECTION WORKSHEET FOR DATE: 7/9/2008 TIME: 7:0OAM PAGE: 7 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 , TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq.. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 603 -766 -7749 CONTRACTOR: ROL3E31NS VALLES CONSTRUCTION LLC PHONE #: 603.766 -7749 Inspection Request Scheduled For: Date: 7/9/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear avails 072391 -01 503- 756 -7749 N Corrections /Comments /Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL 7 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: , 4 Date: 7- 9-dg Phone #: (503) 718 - Z-5--- CITY OF TIGARD ._ r BUILDING DIVISION PERMIT #: MST2008 -00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 „° i (4 , Inspection Requests (24 Hrs.): (503) 639 -4175 _�� INSPECTION WORKSHEET FOR DATE: 7/7/2008 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 13076 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 603 - 756-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503 -756-7749 Inspection Request Scheduled For: Date: 7/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 072257 -04 503 - 756 -7749 N Corrections /Comments/ Instructions: (`P- ) P� Ci= (z"i) F i.t.:_ cl_e , aW /41 ccA tLett - t IN � c-e r il h„44,1_, ( / yes , tior-. 1J., at_404- 1/1,15 n PASS 'PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL pi CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ` � .< Yj ' 7/ Inspector: v l� Date: //i/ 1 r Phone #: (503) 718- v� -2L/ • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 50/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ' ='''f I .. INSPECTION WORKSHEET FOR DATE: 7/7/2008 TIME: 7:OOAM PAGE: 11 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 72/ sq. ft. addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503456 -7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503 - 756-7749 Inspection Request Scheduled For: Date: 7/7 /2008 Pour Time: Code # / Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 072267 -02 503 - 756 -7749 N Corrections /Comments / Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 u7 61 ` Date: i_ .Phone #: (503) 718 - V I 24 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200T3 0004E 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/012008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 .. °1 f I q-- INSPECTION WORKSHEET FOR DATE: 7/7/20013 TIME: 7:00AM PAGE: 12 SITE ADDRESS: 13(175 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, E3RYAN & MAUREEN PHONE #: 503 - 756 -7749 CONTRACTOR: ROC3E3INS VALLES CONSTRUCTION LLC PHONE #: 503456-7749 Inspection Request Scheduled For: Date: 7/7/2008 Pour Time: Code # Xnspection Description Confirm # Contact # Message 610 Gas line 072257.01 5503 -755 -7749 N Corrections/Comments/Instruction, s: . -..c 4 i c>04,--C.,--- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED fe i J Inspetor: � / (/ ` Date: #: (503) 718- L/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00048 13125 SW Hall Blvd., Tigard, OR 97223 % DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 Iii ll' Or Inspection Requests (24 Hrs.): (503) 639 -4175 ...._ .. <__ INSPECTION WORKSHEET FOR DATE: 7/3/2008 TIME: 7:OOAM PAGE: 3 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition • OWNER:. WOLF, BRYAN & MAUREEN PHONE #: 503 - 756.7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 7/3/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 •Gas Tine 072213 -01 503 - 756.7749 N Corrections/Comments/Instructions; L 10 I r --.\ ` El P' : ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED b � Inspector: OA j. D ate: Phone #: (503) 718- Z • CITY OF TIGARD BUILDING DIVISION --- PERMIT #: MST2008-00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51812008 Phone: (503) 639 -4171 A �,,� 1 ,' � Inspection Requests (24 Hrs.): (503) 639 -4175 1. L. INSPECTION WORKSHEET FOR DATE: 713/2008 / /7:O0AM PAGE: 2 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: • PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503-756-7749 CONTRACTOR: ROBBIN S VALLES CONSTRUCTION LLC PHONE #: 503- 756-7149 Inspection Request Scheduled For: Date: 7/312008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 072213 -02 503 - 766 -7749 N Corrections /Cents /In tructions: ' lam`-/' d 1 \% L K I ') _ � Q 1/4/Le. - ` 10 5 d \/cS G.1,1__k. c--uc k _ v C oe .> s (71 r--47 n P ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS P I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED '1 i 3 Inspector: \�� Date: Phone #: (503) 718- • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00X18 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/812008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/27/2008 TIME: 7:O1AM PAGE: 6 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503 - 7567749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: I Date: 6f27/20Q8 Pour Time: Code # Inspection Description ks Confirm # Contact # Message 275 Framing 071957 -01 503- 756-7749 N Corrections /Comments/ Instructions: 4c&r j$0V OLtda.d t , kt Iri/ / 4 ) 1 PAS./ (i PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 0 Phone #: (503) 718- CITY OF TIGARD `Y BUILDING DIVISION A __ PERMIT #: MST2O()B -00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2000 Phone: (503) 639 -4171 49 ;1°11t Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 6/27 /2008 TI :O1AM PAGE: 5 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILL SHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN 8, MAUREEN PHONE #: 503-756-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 5017556 -7749 Inspection Request Scheduled For: Date: 6/27/2008 Pour Time: Code # ('} 'Inspection Description Confirm # Contact # Message 235 `, Shear walls/anchors 071957 -02 503- 756-7749 N Corrections/ omments /Instructions: ti 1 le - i 1 °V W a C tillAr , 0j • � ❑ PARTIAL APPROVAL ❑ CANCEL Ti NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED � Ins ector: Date: 10f �� O Ph one #: 503 718 - p � ) 2..*1 G CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/812008 Phone: (503) 639 -4171 K■f�l Inspection Requests (24 Hrs.): (503) 639 -4175 _, `'__... INSPECTION WORKSHEET FOR DATE: 6/27/2008 : - PAGE: 4 SITE ADDRESS: 13076 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILL SHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 711 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503-756-7749 CONTRACTOR: ROIBBINS VALLES CONSTRUCTION LLC PHONE #: 503-7567749 Inspection Request Scheduled For: Date: 6127/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 4 ., 240 Exter sheathing 071957 -03 503-756-7749 N Corrections /C ments /Instructions: I iN M . / idk ( 5) _ S CINNIP ASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED V4,• • 1n Inspector: (" Date: ` / 27) f 1.°- Phone #: 503 718- 2.-y 2_, V p ) CITY OF TIGARD BUILDING DIVISION - PERMIT #: M 2001 -00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: E18 /2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 J • INSPECTION WORKSHEET FOR DATE: 6/25/2008 TIME: 12:48PM PAGE: SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503 - 756-7749 CONTRACTOR: ROE3k3INS VALLES CONSTRUCTION LLC PHONE #: 503. 75&.7749 Inspection Request Scheduled For: Date: 6 /26/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 415 Grading 071873 -01 503- 756-7749 N . Corrections /Comments/ Instructions: 11,DASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASS D r z Inspector: Date: Phone #: Ins 503 p (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20013-000413 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502000 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 - INSPECTION WORKSHEET FOR DATE: 6/24/20013 TIME: 7: 03AN/I PAGE: 6 SITE ADDRESS: 13076 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HI LLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503-756-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 6124/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 415 Grading 071794-01 503 756-7749 Corrections/Comments/Instructions: n PASS n PARTIAL APPROVAL CANCEL NO ACCESS El FAIL n CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- , , Main Office .ilem Office Bend Office P.O. Box 23814 4060 Hudson Ave., NE P.O. Box 7918 Carlson Testing, Inc. P Oregon 97281 Oregon ) 589-1252 Bend, Oregon 97708 6d�� L Phone (503)03) 684-3460 Phone hone (50503)589 -125125 2 Phone (541)330 -915-915 330-9155 Fax (503) 684 -0954 Fax (503) 589 -1309 Fax (541) 330 -9163 Daily Report of Proprietary Anchors Client MEYER CONSTRUCTION - RICH MEYER Project: WOLFE RESIDENCE - ADDITION CTI Job #: T0807302. Address: 13075 SW ASCENSION DRIVE TIGARD OR Jurisdiction: TIGARD CTI representative R. RYAN OBOA 808 was on site this date Jun. 11, 2008 to perform Special Inspection for: Permit MST2008 -00048 DFS #(s) PO Number: SCOPE OF INSPECTION Location of proprietary anchors inspected [to include grid 1. Checked in with superintendent or client representative. lines, elevations (floors) and drawing details): Name: RICH Company: RVC (2) 5/8" ALL - THREAD RODS WITH 10" MINIMUM EMBEDMENT PER NOTES ON SHEET 4. 2. Inspection was "IBC" ® Continuous ❑ Periodic 3. Work performed: © In the field ❑ At precast shop PER CONVERSATION WITH E.O.R. (NAVA) , USE OF SET PAC EZ IS ACCEPTABLE. 4. If shop inspection do they have fabrication and QC procedures? ❑ Yes ❑ No IN N/A PROPRIETARY ANCHORS REPORT SUMMARY Yes No N/A 1. Reviewed previous inspection reports? x 1. Work inspected was: © Completed ❑ In progress 2. Reviewed evaluation report? x 3. Verified manufacturer's anchor use conforms 2. Completed work inspected was in compliance with x Approved plans and specifications Shop drawings acceptance criteria in report summary. © PP P P ❑ P s g Verified following items meet manufacturer's ❑ RFI ❑ Design change ❑ Submittal ❑ N/A published installation instructions. 4. Verified minimum embedment depth of the Document #(s) Dated: anchors. x 3. Noncompliance item(s) were noted this date, details on 5.Verified installation of the anchors . x_ __ following page(s). ❑ Yes ❑ No - ❑ N/A 6. Verified anchor diameter. x 7. Verified steel grade. x 4. Noncompliance item(s) were reinspected this date, details 8. Verified hole diameter. on following page(s). El Yes ❑ No © N/A x 9. Verified type of drill bit used. x ❑ Conform ❑ Remain in progress 10. Verified cleanliness of hole and anchor. x 11. Verified adhesive application. x Report(s) findings were discussed and left with RICH Evaluation report number 1772 of RVC Name of product being installed SIMPSON SET PAC EZ Batch Number 049094QQ Expiration Date 11/09 Based on the Code, approval is required from the Building Official before the SPECIAL INSPECTED items noted above can be covered. Carlson Testing has no authority to direct work of contractors or subcontractors. ❑ See additional report page(s). ❑ Distribute attachments. Page 1 of 1 Daily Report of Proprietary Ancho,.,. For: 06/11/2008 CTI Job #: T0807302. Project: WOLFE RESIDENCE - ADDITION Notes: In some cases more than one box may be checked for a given item on the front page. Our reports pertain to the material tested /inspected only. Information contained herein is not to be reproduced, except in full, without prior authorization from this office. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Russell Grant Review Date: 06/18/2008 RR /JWA MEYER CONSTRUCTION - RICH MEYER Fax /503 641 - 3743 TO: CITY OF TIGARD BUILDING DIVISION NAVA CONTRACTING & ENGINEERING INC - MATT NAVA WATTON DESIGN WORKS - TOM WATTON FAX/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639-4171 L L INSPECTION Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: ' 42 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 6/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exteriot sheathing 071723-01 503-3111.9608 N Corrections/Comments/Instructions: 0 ' - 1)1 c V 2 1 -?1,4"--s O' • ..---' I I PAS 111 PARTIAL APPROVAL Ei CANCEL 0 NO ACCESS FAIL CALL FOR INSPECTION All 0 ADDITIONAL FEES ASSESSED / . Inspector: Date: 6- 7,3-4:76 Phone #: (503) 718- ___ _______ I CITY OF TIGARD BUILDING DIVISION PERMIT #: M ST2008.0001B 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2008 Phone: (503) 639 -4171 � ' �# Inspection Requests (24 Hrs.): (503) 639 -4175 s' 1 �.. INSPECTION WORKSHEET FOR DATE: 6/20/2008 TIME: 7:02AM PAGE: 23 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: FIILLSHIRE "WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & IVIAUREEN PHONE #: 503 - 756 - 7749 CONTRACTOR: ROI3BINS VALLES CONSTRUCTION LLC PHONE #: 603- 756 -7749 Inspection Request Scheduled For: Date: 6/2012008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 071649 -02 503.310 -9608 N Corrections /Comments/ Instructions: ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ‘ ,.2 " °'• Phone #: (503) 718- ,;'e29 -4--a'--- CITY OF TIGARD 4. BUILDING DIVISION PERMIT #: MST2008-00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 518/2008 Phone: (503) 639-4171 .1411 Inspection Requests (24 Hrs.): (503) 639-4175 - INSPECTION WORKSHEET FOR DATE: 6/2012008 TIME: 7:02AM PAGE: 24 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 711 sq. if addition OWNER: WOLF, BRYAN 8, MAUREEN PHONE #: 503-756-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 6/20/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 071649 01 5O3 310960O Corrections/Comments/Instructions: A_ALe v •-041 • —if,- To-A--0 • ..--• 7 PASS 7 PARTIAL APPROVAL 111 CANCEL fl NO ACCESS FAIL CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- 2.ot.q•tr • rm:a.anson r esung inc. 1 o:mtT MK t.vna i rttJJN - KI%.n melt tK : YUULrt KtblUtNL t 1 :U[ lib 11 VARItiPil I -U4 i g U2-0$ Maw Office SalemO7 ice BeiidOtlice �A s+ �t O_ Box 23814 4060 Hudson Ave., NE P.O. Box 7918 Carlson Testing Inc. I Tion 03)68 -3461 Phone Bone (541 -915 O . Phone (503)684-3460 Phone (503 )589 -L252 Phone (541)330 -9155 Fax(j03)684 -0954 Fax (503)589 -1309 Fax (541)330 -9163 Daily Report of Proprietary Anchors Client: MEYER CONSTRUCTION - RICH MEYER Project: WOLFE RESIDENCE - ADDITION CTI job #: T0807302. Address: 13075 SW ASCENSION DRIVE TIGARD OR Jurisdiction: TIGARD CTI representative R. RYAN OBOA 808 was on site this date Jun. 11, 2008 to perform Special Inspection for: Pennit MST2008 -00048 DFS #(s) PO Number: SCOPE OF INSPECTION Location of proprietary anchors inspected [to include grid 1. Checked in with superintendent or client representative. lines, elevations (floors) and drawing details]: Name: RICH Com an ( 2 ) 5/8" Ar,r,_THRFAD RODS WITH 10" IN1NTMPM p y: RVC � EMBEDMENT PER NOTES ON SHEET 4. 2. Inspection was "IBC" x Continuous n Periodic 3. Work performed: In the field I At precast shop PER CONVERSATION WITH E.O.R. (NAVA). USE OF SET PAC EZ IS ACCEPTABLE. 4. if shop inspection do they have fabrication and QC procedures? n Yes f 1 No ® N/A PROPRIETARY ANCHORS REPORT SUMMARY Yes NoN /A 1. Reviewed previous inspection reports? X 1. Work inspected was: Completed Il In progress 2. Reviewed evaluation report? X 3. Verified manufacturer's anchor use conforms 2. Completed work inspected was in corripliance with to acceptance criteria in report surnuuuy. X LI Approved plans and specifications ❑ Shop drawings Verified following items meet manufacturer's i RFI 111 Design change ❑ Submittal ❑ N/A published installation instructions. 4. Verified minimum embedment depth of the Docwnent #(s) Dated: anchors. X 3. Noncompliance item(s) were noted this date, details on 5.Verified installation of the anchors. X following page(s). n Yes n No ^ N/A 6. Verified anchor diameter. 7. Verified steel grade. X 4. Noncompliance item(s) were reinspected date, details 8. Verified hole diameter. X on following page(s). ❑ Yes n No 1 x N/A 9. Verified type of drill bit used. x ❑ Conform ❑ Remain in progress 10. Verified cleanliness of hole and anchor. X 11. Verified adhesive application. X Report(s) findings were discussed and left with RICH Evaluation report number 1772 o f RVC Name of product being installed STMPSON SET PAC' F.7. Batch Number 04909400 Expiration Date 11/09 Based on the Code, approval is required from the Building Official before the SPECIAL INSPECTED items noted above can be covered. Carlson Testing has no authority to direct work of contractors or subcontractors. See additional report page(s). ❑ Distribute attachments. Page —1 of Fm:Carlson Testing Inc. To:MEYER CONSTRUr - RICH MEYEK:WULrt KtSIL NGt min min mourn i-ua rg us-uo Daily Report of Proprietary Anchors For: 06/11/2008 CTl Job #: T0807302. Project: WOLFE RESIDENCE - ADDITION Notes: In some cases more than one box may be checked for a given item on the front page. Our reports pertain to the material tested/inspected only. Information contained herein is not to be reproduced, except in full, without prior authorization from this office. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Russell Grant Review Date: 06/18/2008 RR %JWA CC: MEYER CONSTRUCTION - RICH MEYER FAX /503- 641 -3743 CITY OF TIGARD BUILDING DIVISION NAVA CONTRACTING & ENGINEERING INC - MATT NAVA WATTON DESIGN WORKS - TOM WATTON FAX/ CITY OF TIGARD BUILDING DIVISION ._ PERMIT #: MST2008 -000.18 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/83 /2008 Phone: (503) 639 - 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ,1_111111 INSPECTION WORKSHEET FOR DATE: 6/5/2006 TIME: 7:00AM PAGE: 10 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HIL.LSHIRE. WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503756-7749 CONTRACTOR: ROF3EBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 6/5/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 215 Footing drain 070942 -01 503- 756 -7749 N Corrections /Comments/ Instructions: • [PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: t9/C7d-C(' - P hone #: (503) 718 CITY OF TIGARD - BUILDING DIVISION - PERMIT #: MST2008.00040 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 x " Phone: (503) 639 - 4171 1 8 " 1 Inspection Requests (24 Hrs.): (503) 639 -4175 ,- 1.1.. INSPECTION WORKSHEET FOR DATE: 5/23/2008 TIME: 7:OOAM PAGE: 16 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF. BRYAN & MAUREEN PHONE #: 503 - 766 -7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503.756.7749 -- - - Inspection Request Scheduled For: Date: 6/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 27fy I 070322 -01 503. 310 -9608 Y - z-2-s - ,Pv5� 4.- • S uciG/ orrections/Comments/In - ructions: PASS ` PARTIAL APPROVAL El CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: A Date: _5 — Phone #: (503) 718 - -29 -ss; CITY OF TIGARD -.--- BUILDING DIVISION A As - PERMIT #: IvIST2008-00018 13125 Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 _i1191. All ....._.._.. ___ INSPECTION WORKSHEET FOR DATE: 5/23/2008 TIME: 7:00AM PAGE: 15 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503-756-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 -- - t Inspection Request Scheduled For: ' Date: 5/23/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 070322-02 503-310-9608 y Corrections/Comments/Instructions: — PASS 0 PARTIAL APPROVAL D CANCEL • 0 NO ACCESS 1 1 FAIL . CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: ' , Date: 5 23 —6 .6 Phone #: (503) 718- -74.-1-.>---- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00018 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 -4171 I � 1 Inspection Requests (24 Hrs.): (503) 639 -4175 ...' �.__. INSPECTION WORKSHEET FOR DATE: 5/21/2008 TIME: 7:0OAM PAGE: 12 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503-766-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LW PHONE #: 503756.7749 Inspection Request Scheduled For: Date: 5/21/2008 Pour Time: 11:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 070221 -01 503. 781 -0576 Y Corrections /Comments / Instructions: 4 - D 1 Al Si1_.'- A.cvG /-keic .3 f.r--, ¶, ZE 7 - -€ J' / , - ! 4z- Gr le.- 44./A L %. e,r,9is. ate ;: -- --- -- A-.7 . .e_4— PASS ❑ PARTIAL APPROVAL ❑ CAN CEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED A z., Inspector: Date: , 5'" -S Phone #: (503) 718- t251--c CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00048 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/13/2008 Phone: (503) 639 -4171 �^ 1 l Inspection Requests (24 Hrs.): (503) 639 -4175 "' INSPECTION WORKSHEET FOR DATE: 7/7/2000 TIME: 7:OOAM PAGE: 10 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503756-7749 CONTRACTOR: [ OBBINS VALLES CONSTRUCTION LLC PHONE #: 503-756-7749 Inspection Request Scheduled For: Date: 7/7/2008 Pour Time: Code # • Inspection Description /Confirrn,# Contact # Message 136 Low voltage 072257 -03 \ 503-756-7749 N Corrections /Comments /Instructions: PAS ❑ PARTIAL APPROVAL ❑ CANCEL [1] NO ACCESS ° ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6 i Date: I Qf Phone #: (503) 718 - IW CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2000 -00018 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008 Phone: (503) 639 - 4171'' Fl�l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/2 /2008 TIME: 7:01AM PAGE: 2 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503-756- 7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION L.LC PHONE #: 503- 756.7749 Inspection Request Scheduled For: Date: 7/2/2008 Pour Time: Code # Inspection Description Confirm # Contact # Me 120 Electrical rougli -in 072142 -01 503-756-7749 Y Corrections /Comments /Instructions: /1SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 7 Z 4f Phone #: (503) 718- • CITY OFTIGARD BUILDING DIVISION PERMIT #: MST 008 0Oa18 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/0/2008 Phone: (503) 639 -4171 u�equ Inspection Requests (24 Hrs.): (503) 639 -4175 �:_.. INSPECTION WORKSHEET FOR DATE: 6/30/2008 TIME: 7 :Q0AM PAGE: 11 SITE ADDRESS: 13075 SW ASCENSION DR CLASS OF WORK: SUBDIVISION: HILLSHIRE WOODS LOT #: 033 TYPE OF USE: PROJECT NAME: WOLF DESCRIPTION: 727 sq. ft addition OWNER: WOLF, BRYAN & MAUREEN PHONE #: 503- 756-7749 CONTRACTOR: ROBBINS VALLES CONSTRUCTION LLC PHONE #: 503 - 756 -7749 Inspection Request Scheduled For: Date: 6/30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 072009 -01 503-756-7749 N Corrections /Comments /Instructions: CtAAAPAi v�C, ��Q (1( M UJ I CAA.i. Ho 1h »1 e, ko mi • ❑ PASS ❑ PARTIAL APPROVAL , y� CANCEL ❑ NO ACCESS 111 FAIL ❑ CAL FOR INSPECTION ❑` ADDITIONAL FEES ASSESSED Inspector: Date: * t Phone #: (503) 718- 1. V