Permit A '
�'�� ® � ���� MASTER PERMIT
PERMIT #: MST2003 -00275
P , ���i DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
- - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10955 SW 130TH AVE PARCEL: 1S133AC-HBOO2
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 002 JURISDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 108 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 636 sf GARAGE: 536 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 709 sf RIGHT:
VALUE: 149,008.40
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,453 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 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
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: 3
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,072.45
I AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES IN d Municipal c to the regulations contained C o i the
Tigard Municipal Code, State of OR. Specialty Codes s and
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 all other applicable laws. All work will be done in
PORTLAND, OR 97219 PORTLAND, OR 97219 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. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 892 - 8758 Phone: 503 - 892 - 8758 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 58699 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control lnsp 8L Plm /undslb Insp Plumbing Top Out Shear Wall Insp Water Line Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insf Water Service Insp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab lnsp Low Voltage Insulation Insp Rain Drain Insp Plumb Final
\\
Issued B • 1 , -AA! 1 L..o. Permittee Signature ;.4 2L.
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
4a,�e_. 1
1nil. Permit A lication FOR OFFICE USE ONLY
Received )(/ Building
. C E I V E ID DateBy : 0- , C`t� P errn tt No.:MS %o?003 `dGo
City f Ti and v Planning A val Other
ty g Date/By: Permit No.: - 5 -61,/.',200 - c)o 0 cp
13125 SW Hall Blvd. JUN 2 7 20 y Plan Review Ot - byt At c� Other
Tigard, Oregon 97223 Date/By: t0 Permit No.:
�4 - ;,
Phone: 503 - 639 -4171 Fax 503G16T$111C 4TIG ' ' i4 Post - Review Land Use
DateDate/By: Case No.
Internet www.ci.tigard.or.us BUILDING D • _ �
. , l 1
g I'' Contact Case El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: 776- Supplemental Information
TYPE OF WORK
. . : . . . . . : . - .REQUIRED D A T A : , >'.
ZNew construction ❑ Demolition • . 1 &I FAMILY DWELLING .j '
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION " = - Note: Permit fees* are based on the total value of the work performed. Indicate
1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building LI Multi- Family
9, 1 / y�i Mpg, y0
Master Builder ❑Other: Valuation
`.:JOB SITE INFORMATION LOCATION No. of bedrooms: 3 No. of baths:
Job site address: 10R55 S t t) t k) 44 h1/64A.hi, Total number of floors _ 3
New dwelling area (sq. ft.) _ lit sJ
Suite #: Bldg./Apt.#: Garage/carport area (sq. ft.) S 3 G - -
Project Name: NAW 1CS %CEO 1 14t nit S Covered porch area (sq. ft.) — 3 2.
Cross street/Directions to job site: Deck area (sq. ft.) 7
SkJ I &, m A-/iiJoE 4 sw. 44AKS BA Other structure area (sq. ft.)
-:,; REQUIRED DATA:. =
COMMERCIAL USE UII CKLIST ::-- - .
Subdivision: 1-b4weS R `►"GL» 1-6/4a Lot #: Z
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
. • DESCRIPTION OF WORK _ the value (rounded to the nearest dollar) of all equipment, materials, labor,
Cc�I t T overhead and pro fit for the work indicated on this application.
S�►zuc OF N r, �.I � S roei
.SE� Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
P.ROPERTY:OWNER'::: .f .❑ TENANT - Type of construction V N
Name: A lrfvrh 4 PAaz K Tbk(lsi{'lh Wt€ / L . L. C . Occupancy group(s): Existing:
R-3
Address: 95q500 5W toR� &Jib Su 0.f. Z 2.v
City/State /Zip: T'OleaA'3 , 02 9
Phone: 6o3) R42$ Fax :6D1) e z_ 4' NOTICE: All contractors and subcontractors are required to be
� --I licensed with the Oregon Construction Contractors Board under
(s' APPLICANT : s _'_�.; - DI' CONTACT PERSON:: _':r - provisions of ORS 701 and may be required to be licensed in the
Business Name: IFi..g 1.. - go.004 c 4 4S X1AS f (4 , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: olive K (. 4 . A2 ftcX pe,Z from licensing, the following reason applies:
Address: g2o SkJ (a? ) 1 Sii 17Yc 210
City/State /Zip: fk 4 Olt q- u `i
Phone: -e e 1 F ax: (5o3J 0 t2-604 ( * _ .::�:
-__ BUILDING: PERMIT TEES ` - " `'
E -mail: rrti a r k 4. d 1 brow~ ASSOC . COM Please - refei-to'fee schedule.
} : CONTRACTOR - .
Business Name: *beek4 L. $Qoc,11J 4 A59ex1A9`FS Y' Z , Fees due upon application $
Address: ctSX) Svi $Ai .&Ae gUIb SUcNc no
Rj2r/j
City/State /Zip: i) i 0 9721 (61 Amount received $
Phone:(11 892 -8159 Fax: (5193 2 -8S41 Date received:
CCB Lic. #: 586 9
Authoriz — Notice: This permit application expires if a permit is not obtained within
Signature di/ Date: ` r ( 180 days after it has been accepted as complete.
14114-4- ^A : ,A, �` 1 J ` 4i) S( 3 -Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Fonns\BldgPermitApp.doc 01/03
' Electrical Per�2►! \> FOR OFFICE USE ONLY
R ece i ved Electrical r � Date/Bv: Permit No.1/ 'c�003 - vOi . Y C
City of Tigard JUN t 7 2003 Planning Approval Sign
CI OF TIGARD Date/B : PermitNo.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 BUILDING DIVISI ' Date/B : Permit No.:
Phone: 503 - 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
Contact Case No.:
Internet: www.ci.tigard.or.us ■ n i j l ` t I Contact Juns.: El See Page 2 for
24 -hour Inspection Request: 503- 639 - 4175
Name/Method: Su Iementallnformatian.
TYPE OF WORK PLAN REVIEW (Plase check all that apply)
New construction El Demolition — 0 Service over 225 amps- ❑ Health -care facility
I commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: p9 Service over 320 amps - rating of ❑ Building over 10,000 square feet,
CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in
igr 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
Job site address: S
109 S Std f (� - * Ave UE The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite #: pp B1c11?. /Apt. #: Number of inspections per permit allowed
Project Name: ,1- 1,41AJ <S 62 TpGJ CN gc Description Qty I Fee (ea.) I Total i
New residential- single or multi- family per V
Cross street/Directions to job site: i � dwelling unit. Includes attached garage.
S ") 150 {"'' v�j.� lJ � Service included: i �� ' l �
3 0 S
� Each ad . iti or additional less 145.15 �� 3.10 _ 4
c.t,p/t Each additional 500 so. ft. or portion thereof _ 33.40 � i
Limited energy, residential 1 1 75.00 1' • a2 2
Subdivision: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
- DESCRIPTION OF WORK service and/or feeder 90.90 , 2
Services or feeders - installation,
C al4cr `'a -ra∎ -) cF 14644 3 sre7444 alteration or relocation:
// ,� 200 amps or less _ 80.30 I?
"'>�W eel, emu 201 amps to 400 amps 106.85 2
401 amos to 600 amps 160.60 2
601 amps to 1000 amps 240.60 2
SjPROPERTY OWN R. El TL NA / N '- T I - ,� Over 1000 amps or volts 454.65 2
Iiame: Aer /2/?rLX 1'dvJiJ1- w►ES LL C, Reconnect only • 66.85 2
Address: c6S0 5J ( gum guN SO'NL 22z Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: Irz_rmr'% Oe. 9-1 c
VC/ 200 amps or less 66.85 1
Phonesp' $ qZ -P Fax :(�s1CJ9 2 e l / 201 amps to 400 amps 100.30 2
100.30 2
APPL ANT ::4t' >: - "= D CONTACT PERSON' 201 amps
amps
Branch circuits - new, alteration, or
Name:) 1Z . L. J e p G'l � 'S5Ci*, iS 1 i /� , extension per panel:
Address: Q) 84 p ll0i fy.. U t1 1 � Z2.0 service Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
City /State /Zip: eri is , 0l2 9 2 I al B. Fee for branch circuits without purchase of
service or feeder fee. first branch circuit 46.85 2
Phone: A) N 2_ el ss Fax: (... �q ) v r 2 -e j 4 J Each additional brunch circuit 6.65 2
E -mail: me. r 4- d 1 tra(,,)aa -SSac , com
Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 2
,:...:. .;: • - - - . � 53.40 2
—a^r Each sign or outline li
Job No: -ne k Signal circuits) or a limited energy panel,
alteration. or extension Page 2 2
Electrum Inc Description:
2050 Vista .Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) 62.50
503 - 361 -1256 Investigation fee:
CCB :116453/ELC:24- 353C/SUP:2919S Other
-1.. • EIectrical Penh[tFees* ...._......:. .
Supervising electrician _ Subtotal $ —
signature required: _ Plan Review (25% of Permit Fee) $
Print N e: Li_ #: State Surcharge (8% of Permit Fee) $
/ TOTAL PERMIT FEE S -
Authorized � J /� r ( Notice: This permit application expires iC a permit is not obtained within
Signature; ccc/// Ill l/ L Date: ` 180 days after i t has been accepted as com plete
*Fee methodology set by Tri -County Building Industry Service Board.
Wi fug- IC Ski . Sea
(Plea& print name)
is \Dsts\Perrnit Forms \ElcPermitApp.doc 01/03
•
tsuttaiDg r l.Xl,ul
P iulitbin Per • • n FOR OFFICE USE ONLY
Received Plumbing „�yy ,
Date/By: Permit No.:r ,S /o 3 -00,2'25
City of Tigard Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. JUN r/ 2003 Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: 5CeR68QI§JaGAR P Post - Review Land Use
B UILDING DIVIS "' '�� 1 �` I Date/By: CaseNo.:
Internet: www.ci.rigard.or.us e . , I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: , Supplemental Information.
'TYPE OF WORK FEE* SCHEDULE (for special information use checklist)
(s New construction ❑ Demolition Description Qty. Fee(ea.) Total
❑ Addition/alteration/replacement , ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
®1 & 2- Family dwelling ❑ Commercial/Industrial - SFR (2) bath 350.00 150,
['Accessory Building ❑ Multi - Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
JOB SITE INFORMATION and LOCATION Fire sprinkler - sq. ft.: Page 2
Job site address: /0 95 SR/ /5O± 4v.5_. site Utilities
Bld /A #: Catch basin/area drain 16.60
Suite #: g• p t • ks DrvwelUleach line/trench drain 16.60
Project Name: HAW 3FJ�� TG�t� � Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s t Manufactured home utilities 110.00
SLJ l "() Al/� • Manholes 16.60
3E ■ S?Ylrrl Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: ///gW,<" S 0.6 D Lot #: 2i Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: Fixture or Item .
DESCR1PTI WORK Absorption valve 16.60
(' ON:S7'Qt c. nos) OF IV E� 3, Si oad Backflow preventer Page 2
- - rCAOJ OIN 6 PO-J)3CC/r () 4( SQ-k) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
. • •ROPERTY OWNER ..- 4- ❑TENANT .. _ --- - • Ejectors/sump 16.60
Name: AltrOVI nJ PA < Th AItJ 4or/leS, LLC Expansion tank 16.60
Address: - i &o SW EAle.g1/Q &.\/6 stee zzo _ Fixture/sewer cap 16.60
City /State /Zip: P0 Q2 c-72�q - Floor drain/floor sink/hub 16.60
Garbage disposal - 16.60
PhoneSc) B 9�2- 67 5e I Fax: C ) q'2- SS'(i Hose bib 16.60 ;APPLICANT' - . • - :ID-CONTACT PERSON, '_..... Ice maker 16.60
Name: i>EeEV L. (6P..O d S A- CSOCIA•• c I iJC Interceptor /grease trap 16.60
Address: 95,00 5 t.i g.t2 gUe., gl_l1A r Su t•I'E Z2c3 Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: P1erut06 , Ct q---/ 2 t Roof drain (commercial) 16.60
Phone:3)892- 5758 Fax(Sdn Sink/basin/lavatory 16.60
E - mail: h'lA•2IC. - di br 3c,Jna_CCc9 C • Co rte• Tub /shower /shower pan 16.60
CONTRACTOR 'I • ` . . Urinal 16.60
Water closet 16.60
Plumbing Experts Inc Water heater 16.60
11925 SW Parkway Other:
Portland OR 97225 -5413 Other:
503 -469 -0443 . • •...- _..3.- .�..` Plumb ing Pernik Fees* .. '•':_,.....z,:,:.:•; ,...
Subtotal $ 3 6 0
CCB: 149035 PLM: 34-391PB Minimum Permit Fee $72.50 $
Authorized / / 7 Residential Backflow Minimum Fee $36.25
Signature: ; Akt- Date: Z!� 01 _ Plan Review (25% of Permit Fee) $
r U C E- c&1 E-_ State Surcharge (8% of Permit Fee) _ $ . co
(Please print name) TOTAL PERMIT FEE $ -
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans N. .. °•
180 days after it has been accepted as complete. riser diagram for plan review.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\Dsts\Permit Forms\PlmPermitApp.doc 01/03
/
�EI FOR OFFICE USE ONLY
/ Mechanical Per on Receiv Mechanical
Date/By: Permit No.://57 75
J U N 7 2003 Planning Approval Building
' City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD Plan RCV10w Other
Tigard, Oregon 97223 Qt "' n r n Date/By: Permit No.:
° j1� `j60 fl Post - Review Land Use
Phone: 503 - 639 - 4 1 71 Fax: h , y. A . Date/By: C No.:
Internet: www.ci.tigard.or.us A 11 Contact Juris.: IS See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
TYPE OE WORK ' :`- COMMERCIAL FEE* SCHEDIILE - USE CHECKLIST - .
New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION. �•? mechanical materials, equipment, labor, overhead and profit.
H1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE' SCHEDULE.
Description 1 Qty Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE INFORMATION and LOCATION • Furnace - add -on air conditioning ** I 14.00 1'.g 00
Job site address: (09SS S'A) 1 0- A LI Gas heat pump 14.00
Bld /A t. # Ductwork I 14.00 (L{.°'
Suite #: g• p : Hydronic hot water system 14.00
Project Name: �1� TOvJIJ 4OV CS Residential boiler
Cross street/Directions to job sit (for radiator or hydronic system) 14.00
S( I 30 t'` U S A t eS Unit heaters (fuel, not electric)
-gutil,1 5-7-0.,61- (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10 • °i
Repair units 12.15
Subdivision: HA �x S � �� Lot #: v Other Fuel Appliances
Tax map /parcel #: Water heater l 10.00 Id. `
DESCRIPTION OF WORK Gas fireplace 1 10.00 l0. au
C -,. i5D- -2 Cnoi) OR .4� J 3 S-r , Flue vent (water heater/gas fireplace) Z, 10.00 20 • �o
-(AA rvic_ PoJ 1 146 v � Log lighter (gas) 10.00
CJ Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY OWNER - - - . • 1' I] TENANT ." Other. 10.00
Name: A, llm � K -- o WeJlia„iti s Lt-C, Environmental Exhaust & Ventilation
71 v v t '/ T`� ) Range hood/other kitchen equipment ( 10.00 10 . 43
Address: SW VQ -&/e Rt -A / SJ I Z w Clothes dryer exhaust I 10.00 10 • °Q
City /State /Zip: Arent D de (41 2 1 9 Single duct exhaust
Phone:(5oS 8 -8?SB I Fax: (S) 5) 892-- 884 1 (bathrooms, toilet compartments, 4°
. (gAPPL CANT 0 CONTACT PERSON utility rooms) _5 6.80 2 •
Name:
L. gam J A /A/c. Attic/crawl space fans 10.00
t � Other. 10.00
Address: Q X Bl�ravvi (4_1 ( Si/17. ZZC� Fuel Piping
City /State /Zip: T (472-19 • *($5.40 for first 4, S1.00 each additional)
Furnace, etc. I **
Phone:( PR2 -8'1 Fax: (� -�Ge�( Gas heat pump _ **
E -mail: y C Qi d I broc.J/r0.V c.)C : c Wall/suspended/unit heater **
CONTRACTOR Water heater 1 **
Smart Heating & Fireplace 1 `* Cooling LLC Range *1
7616 NE Everett St BBQ **
Portland OR 97213 -6347 Clothes dryer (gas) **
503- 254 -5096 Other: **
CCB: 154133 Total: 3 '5+40
Mechanical Permit Fees*
Authorized (e Subtotal: _ $ 1 Z 3. go
Signature: kL , < //OY
Date: _ Minimum Permit Fee $72.50 $ _
R (J G - a i0E--- Plan Review Fee (25% of Permit Fee) $ _
l (Please print name) State Surcharge (8% of Permit Fee) $ 9,_. '10
TOTAL PERMIT FEE $ / 33. 7 ()
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry Service !ward.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
CITY -CQ- F TIGARD 24 -Hour
$UI DING Inspection Line: (503, ; _ - 175 MST o2.l�d 3 6?. 7$
INSPECTION DIVISION Business Line: (50:.1 '4 171
BUP
. Received Date Requested O - 11 AM PM BUP
Location / O'9 S3 / 30 ( Suite // / MEC
' p
Contact Person Ph ( ) S to t ie 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear - '� S - /
Framing
Insulation C 0 _ x -- 1 5 4171 Mme ��
Drywall Nailing � V ` �"
Firewall *� 0
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
BING
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
• - Dampers
in
V- PART FAIL
E TRICAL
Se ice
Ro gh -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: Unable to inspect — no access
Fire Supply Line
ADA Approach /Sidewalk Date L ( " 7< Inspec ‘76.L_ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY- OF TIGARD 24 -Hour
..41LBUILDING Inspection Line: (503) 639 -4175 MST a/CV3
INSPECTION DIVISION Business Line: (503) 639 -4171
/L BUP
Received Date Requested '' / i T AM PM BUP
Location /0f5 /3dr Suite MEC
Contact Person _ 4 Ph ( ) F46 - -9 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
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 ��� p tF1 // d
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
e n tr :IC
Rough -In
UG /Slab
Low Voltage
Fire Alarm
CO PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI ❑ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA / /,,
Approach/Sidewalk Date [O V 1 4✓ " Inspector ) Ext
Y
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY - OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 0 43 75
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / ,�) AM PM BUP
Location /0 �S /3c ' " ''t Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: 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 / f
Other:
Final
PASS PART FAIL
PLUMBING _ 6
Post & Beam O; Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
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 El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date I Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
PLUMBING EXPERTS INC
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
Plumbing Signature Form
Permit #: MST2003 -00275
Date Issued: 11/3/03
Parcel: 1 S133AC -HB002
Site Address: 10955 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 002
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC PLUMBING EXPERTS INC
9500 SW BARBUR BLVD., STE 220 11925 SW PARKWAY
PORTLAND, OR 97219 PORTLAND, OR 97225 -5413
Phone #: 503 - 892 -8758 Phone #: 503 -469 -0443
Reg #: LIC 149035
PLM 34-391PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X A/76 5 / 01/7( (/(
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
2050 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003 -00275
Date Issued: 11/3/03
Parcel: 1 S133AC -HB002
Site Address: 10955 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 002
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC ELECTRUM INC
9500 SW BARBUR BLVD., STE 220 DBA SPECTRUM ELECTRIC
PORTLAND, OR 97219 2050 VISTA AVE #100
SALEM, OR 97302
Phone #: 503 -892 -8758 Phone #: 503- 361 -1256
Reg #: L1C 116453
SUP 2V108 a - S
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X � Alp
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
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