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Permit 7. i CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00325 AA ���;� DEVELOPMENT SERVICES DATE ISSUED: 9/19/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S136AB -05400 SITE ADDRESS: 10460 SW 72ND AVE ZONING: R - 4.5 SUBDIVISION: SKORO MLP93 -0008 LOT: 003 JURISDICTION: TIG Project Description: Shop /RV. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ACS HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: • TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 511 DWELLING UNITS: TURD: sf RIGHT: VALUE: 46 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: 1 0 D SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: IC' 0 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES:3 MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W/SMC OR FDR:' / / Q PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st WO SVCFOR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v. MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes JERRY OLNEY OWNER and all other applicable laws. All work will be done in 104160 - 72ND accordance with approved plans. This permit will expire TIGARD, OR 97223 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 Phone: 971 - 221 - 2522 Phone: 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 Reg #: direct questions to OUNC by calling 503 -246 -6699 or TOTAL FEES: $ 1,053.03 1- 800 - 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By . l rkigrLiJ 41_, . Permittee Signature : W I Call 503-639-4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • 1 3 Building Permit Au , l;' • 1VED FOR OFFICE USE ONLY `J g City of Tigard !! Received A �Q D DateB . / PermitNo.. r "5:, A 7' 13125 SW Hall Blvd., Tigard, OR 97223 EP 9 2005 Plan Review r, Phone: 503.639.4171 Fax: 503.598.19 i� "'' ° "r: �(,, Date/B . A J el • /`1- D 5 Other Permit: Inspection Line: 503.639.4175 -! Date ReadyBy: ®See Attached Checldist for .fl Internet: www.ci.tigard.or.us Notified/Method: SupplemeutalInformation CITY OF TIGARD O BUILDING DIVISION Ut TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ,(New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2 -family dwelling ❑ Commercial /industrial Valuation: $ d a Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Q � V Job site address: V,4,/, S. it ), 7? Q New dwelling area: square feet City / State/ZIP: ' . 5 - 1- Pie 7'A., Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: � 1 NI E L 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 profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: .3 Y i . U Ed Type of construction: Address: / b 8 5. L .. 72 Occupancy groups: City/State/ZIP: a�cf 7=z-1S � Existing: Phone: � ry1) ,t? ! 3 ...2,,z...1, 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 1 � /' e r 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:( ) I Fax::( ) E -mail: CONTRACTOR Business name: BUILDING PERMIT FEES* Address: d l.J n e Please refer to fee schedule. City /State /ZIP: Fees due upon application j 6„ , 1� Phone: ( ) Fax:( ) Amount received CCB lic.: . Date received: 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:\ BuildingTermits \BUP- PermitApp.doc 12/03 4404613T(II /02/COM/WEB) 1 One- and Two - Family Dwelling Building Permit Application Checklist fOIZ orrlcI. tisl. oN1_1 City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Date/By. Phone: 503.639.4171 Fax 503.598.1960 Associated permits: 24 -Hour Inspection Line: 503.639.4175 III O Electrical O Plumbing 0 Mechanical Internet: www.ci.tigard.or.us 0 Other. I'I -IE FOLLO\VIN(C I•I Ei7S.ARE IZL:QUIIZI I) FOIZ PLAN IRI VII \V vc• s No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. • • t! 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 0 ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: 0 ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. 0 ❑ ❑ 7 Water district approval. 0 0 ❑ 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- 0 ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ 0 ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area building coverage area percentage of coverage; impervious area existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ 0 and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ 0 ❑ 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. ❑ ❑ 0 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 0 ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ 0 ❑ 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 0 ❑ 0 architect licensed in Ore on and shall be shown to be licable to the o'ect under review. 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. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard 0 ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\ Building \Permits\BUP- RES- PermitApp.doc 2 Building Fixtures Plumbing Permit Application rOlz orrlc1: tisr: UN.1.\ City of Tigard Received Permit No�. _ `f 13125 SW Hall Blvd., Tigard, OR 97223 Review lvv �" ' � 32) Phone: 503.639.4171 Fax: 503.598.1960 APlan , '-I 4;, _. ',, Date/By. Other Permit No.: 24- Hour Inspection Line: 503.639.4175 _a_1 _a_1 I �,,,; Date Ready/By: ®See Page 2 for Internet: www.ci.tigard.or.us J Notified/Method Supplemental Information • TYPE OF WORK FEE* SCHEDULE 1T ew construction ❑ Demolition • For special information use checklist Description 1 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 (I) bath 249.20 ❑ 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ,Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 . ❑ Other. Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: "•2 y� 1, Sr f,,, ?e N vPAlf& Catch basin or area drain 16.60 City /State/ZIP: ,- or( 9 7 2 "3 Drywell, leach line, or trench drain 16.60 ! �'l v � , Suite/bldg. /apt. no.: Project name: 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 P f t //P,#lyi e �L1)G Backwater valve 16.60 ff� it. b <, Clothes washer 16.60 /` Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: `/ /,P ,e,/ L3 Expansion tank 16.60 Address: .i a 3c o, ■ r7L-y_� Aye Fixture/sewer cap 16.60 City / State/ZIP: e2" �e, 6/t 5'2 52 Z 2 3 Floor drain/floor sink/hub 16.60 Phone: (i'7/) Z ? • 2.10 Z Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Qt 1\J--V Medical gas (value: $ ) I Page 2 I Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 _ Business name: Water heater 16.60 Address: Ot , \- Other: City /State/ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25 %ofpermit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: I Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \Permits \PLMF- PermitApp.doc 06/05 440-4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard . > Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 ° 100' 55.00 O 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 additional $100.00 or fraction thereof, to and Fixture or Item Q ty. Fee (ea) Total 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 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Complex Structures Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria. accurately report fixtures could result in increased sewer fees`. Please check all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site utilities. Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi /Whirlpool providing services to human beings. Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service - Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system. Eye Wash Floor Drain /sink 2" Submit 2 sets of plans with any of the above. -3" -4 „ - Car Wash Drain Isometric or Riser Diagram Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor P Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. is\ BuildingO Pennits\PLM- PennitApp.doe 07/06/05 . E1eCtric41 Permit Application rOR Ol:I:lcl: USE ONLY City of Tigard Permit No 1 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503. 598.1960 //". •.v + 111`,'• D , Other Permit: Inspection Line: 503.639.4175 J ±ti . :1.1,;, Date Ready/By: tuns: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information • TYPE OF WORK PLAN REVIEW .g'New construction ❑ Addition/alteration/replacement Please check all that apply: ID Demolition ❑ Other: ['Service over 225 amps, comm'I ['Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2 family dwelling ❑ Commercial/industrial krAccessory building ❑System over 600 volts nominal units in one structure El Multi - family ❑ Master builder El Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address 4 01-care facility El Other: : z0r� S ' ��� ? 2 -- f, Submit 2 sets of plans with any of the above. City / State/ZIP: / � e'l'i)f 4de 77 3 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg. /apt. no.: Project name: d J) t 9' Description Qtr. Fee' Tad •• Cross street/directions to job site: `" New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: J3/. y i 3 rs -- n Limited energy, residential 75.00 2 fp !i/ Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less I 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 - 401 amps to 600 amps 160.60 2 Name: . .Q., Z2 JH t' 601 amps to 1,000 amps 240.60 2 n Over 1,000 amps or volts 454.65 2 Address: /e, ��� Si �� J z �G e. Reconnect only 66.85 2 City/State/ZIP: l , 5 4 /1 2 2 22 3 Temporary services or feeders installation, alteration, and/or cY ' relocation Phone: (f ,7J) z � — as -Z I Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 3 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: cL) si7 pa '' without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- CONTRACTOR 0 energy panel, alteration, or extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above © tee N Pifer Per inspection 62.50 City/ State/ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.:. Subtotal Suprv. Electrician signature, required: Plan review (25 %ofpermit fee) • Print name: Date: State surcharge (8% 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 • • Number of inspections per permit allowed. i:\ Building \Pmnits\ELC- PamitApp.doc 12/03 440-4615T(I0/02/COM/WEB Electrical Permit Application - City of Tigard • > • • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: - RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* El Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: • ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation El Intercom and Paging Systems El Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required • for all other installations i:\ Building \Pennib\ELC- PennitApp.doc 04/03 • a Permit #: AzS -60 3,9-‹ � OF ,/. '•''�"� Address / Id 77 � -, Issu:d by: ■ ! �/�'�, ..e_41 Date: /�9 ,..-5,,,=; • Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ,� A� �I 1. I own, reside in, or will reside in the completed structure. 4 A 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale 4 1 before or upon completion. 1 e t I'l 3A. My general contractor is - r (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR e 3B. I will be my own general contractor. V If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Prope • ers about Construction Responsibilities on the reverse side of this form. .moo :Z.e 9 /A-5 —(S' nature of permit appl t) JDate) (White copy to issuing agency permit file, pink copy to applicant) • • Information Notice to Property Owners About Construction Responsibilities • Note: This Information Notice to Property Owners about Construction Responsibilities was developed by' the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For niore information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1- 800 -829 -1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accident.; and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors.Board (PO Box 14140, Salem, OR 97309 -5052, 503/378- 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.pm4 1 /94 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200&00325 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/200 Phone: (503) 639 -4171 ti Inspection Requests (24 Hrs.): (503) 639 -4175 1 �.. INSPECTION WORKSHEET FOR DATE: 8/10/2007 TIME: 7:00AM PAGE: 30 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. 4/21/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 053795.02 971 -221 -2522 N Corrections /Comments/ Instructions: oP /124 t M��Zdc7� -oc3o eg A PASS E RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - 1 Date: / d b ? Phone #: (503) 718- Z.4 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 00325 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 i A Inspection Requests (24 Hrs.): (503) 639 -4175 `'I .. INSPECTION WORKSHEET FOR DATE: 8/10/2007 TIME: 7:OOAM PAGE: 31 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93-0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop /RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. 4/21/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Mess- • - 399 Plumbing final 053795.01 971- 221 -2522 lb Corrections /Comments/ Instructions: S c 7 f7 /i 7, / ° I► PASS leARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL % ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` ■ Date: 6 lo/c2 7 Phone #: (503) 718- 2-64/9 CITY OFTIGARD BUILDING DIVISION 1 PERMIT MST2005 00325 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSU D: 9/19/20 r- Phone: (503) 639- 4171y Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/27/2007 TIME: 7:00AM PAGE: 16 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR(1)J, (1)WATER SET & (1) SHOWER. 4/21/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: LNEY, JERRY PHONE #: 971 - 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 4/27/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough - in I iiir 047282 - 01 971 - 221 - 2522 N "4 Corrections /Comments/ 41 -11\ot i o ns: 4 "+s71A4ts N a & 1 & V 9 - G • 1/eAIL. c' h■rk @, -5- ca . . , OiCre Q§All �- U L.;.- .0 bi .PASS '.∎ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED vUlt 047 - Inspector: Date: 4 Phone #: (503) 718 - 4 CITY OF TIGARD BUILDING DIVISION PERMIT #: MS ?2; 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1 `J2 J :; Phone: (503) 639 -4171 - °pi g9� Inspection Requests (24 Hrs.): (503) 639 - 4175 ' W _ I INSPECTION WORKSHEET FOR DATE: (J1 /2{, OG • TIME: 7:O1 AM PAGE: 30 SITE ADDRESS: 10..'iF ;l 5W 7:44) AVE CLASS OF WORK: SUBDIVISION: S1 )R0 i't:I1 jet ?. Coot,: LOT #: TYPE OF USE: PROJECT NAME: i.)i..NFY DESCRIPTION: StiopfR ;'. 1111K3 ?;, ADDING 60 Or FO(. ?11NG DRAlN, AND F.;01.,x3F.H1q t NLY f Ok ('i)1 A': (1)i ATE :} ( 1) SHOWER. 4/21/2006 ADD 10t.CT = y OWNER: C.)i.-NE:Y, ,i Villa',` PHONE #: 471•221 - 2622 - CONTRACTOR: Ovt.1`iE:k PHONE #: Inspection Request Scheduled For: Date: 6/1/200;.-.; 0r: Pour Time: Code # Inspection Description Confirm # Contact # Message SeWV 03x092/ -01 0 i S -70/i: Corrections /Comments/ Instructions: a al • • • -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C Date: Phone #: (503) 718 - ��' _ei://144 CITY OF TIGARD BUILDING DIVISION PERMIT #: T:�c)11 0032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9!19/200 Phone: (503) 639- 4171u I M Inspection, Requests (24 Hrs.): (503) 639 -4175 `'' L. INSPECTION WORKSHEET FOR DATE: 5/23/2006 TIME: 7:03.AM PAGE: 27 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93.0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. 4/2.1/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: OLNEY, JERRY PHONE #: 971 - 221.2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/23/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 030418 -01 971 - 221.2522 Y Corrections /Comments /Instructions: le / - / 'PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ��� Date: -b Phone #: (503) 718- CITY OFTIGARD M sr BUILDING DIVISION PERMIT #: p��TD5 --O o 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 4171 illl Inspection Requests (24 Hrs.): (503) 639 -4175 -' `__ I q 1 3 INSPECTION WORKSHEET FOR DATE: TIME: • PAGE: SITE ADDRESS: / 4 6,0 7 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: / / — a 1 Pour Time: Code # Ins ection Description Confirm # Contact # Message q7/--- ZZ4_Z 2 3_ aaa i 4 f3 -- D Corrections /Comments/ Instructions: / /A(fcS o:. -6) D F D 3 i5 Lt.: °. . A /2—Ls/L--e - 12 1 F — Imil . ClAr ; e....e) e e/ V d i".14 ( 4- 7 .J;1 -4 l'--7,._ a, . 2 . . . i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: I VZVALC ne #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -0032 5 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 A,u �t' � ➢ i Inspection Requests (24 Hrs.): (503) 639 -4175 -IL INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 19 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 020848 -01 971- 221 -2522 N Corrections /Comments / Instructions: d fliASs ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I 1144_ Inspector: Y7 Date: Phone #: (503) 718- CITY OF TIGARD J BUILDING DIVISION ° ' 1 PERMIT #: MST2005 -00325 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 :mma Inspection Requests (24 Hrs.): (503) 639 - 4175 ` __ i q/Y INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 64 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/4/2005 Pour Time: Code # Inspection Description 0 Confirm # Contact # essage ) ./. 335 Rain drain L e 020349 -01 971 -221 -2522 Y Corre ns /Comments /Instructions: +7 r O -r- C I L-. — /C/k < LC. k : iNi . ,&._.-L-- / 0 0 --- VCANC PASS ❑ PARTIAL APPROVAL EL 111 NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4, () V Date: ) VVO Phone #: (503) 718- CITY OF ' BUILDING DIVISION PERMIT #: MST2005 -00325 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2006 Phone: (503) 639 -4171 44,11 Inspection Requests (24 Hrs.): (503) 639 -4175 " ' I .. INSPECTION WORKSHEET FOR DATE: 6/29/2007 TIME: 7:00AM PAGE: 6 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. 4/21/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/29/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 051210 -01 971 - 221 -2522 N Corrections /Comments /Instructions: 1/ pl -vt,(t ac 5 teli Nwt d ' w o w l (A/kaiimid i /14 /9 iti ---de.74 — e ; i4 ' p \/ 6k• WA Id PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FpR INSPECTION • ❑ ADDITIONAL FEE ASSESSED Inspector: < VI .. Date: D 7 hone #: (503) 718 - J /I • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00325 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 1 y( ��hl Inspection Requests (24 Hrs.): (503) 639 -4175 ' `_ INSPECTION WORKSHEET FOR DATE: 5/18/2007 TIME: 7:02AM PAGE: 29 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 - 0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. 4/21/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/18/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in \ 048630-01 971- 221 -2522 Y Corrections /Comments /Instructions: �---. �`"- ' �— ? (LOO IV, Q? Z o is - (2. eV T r 'O lam. TO a1 CA w - I`blk -i I.) 3 �`r� bC iST t4\& -. ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` `"w Date: sin 1 Phone #: (503) 718- 1.4 CITY OF TIGARD BUILDING DIVISION PERMIT #: {y1ST2005 00325 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 400 +� Inspection Requests (24 Hrs.): (503) 639- 4175ll.. INSPECTION WORKSHEET FOR DATE: 2/2/2007 TIME: 7:03AM PAGE: 20 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop /RV. 11 /1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. 4/21/2006 ADD 100FT SEWER, 100FT WATER LINE, 6 OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2J2!2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 042920 -01 971 -221 -2522 N Corrections /Comments/ Instructions: \ p`'Q'E '• (43.1 f 1 3 �g� C LGA(t.igr) c. Fla rv`, S N, c:+ 6 c ► OD 5 o cc. P2oi wi' s`j' _. PL4 . • 2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G `t V � Date: 2 1 J Phone #: (503) 718- 2 I CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S -00325 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 14ri Inspection Requests (24 Hrs.): (503) 639 -4175 `__— INSPECTION WORKSHEET FOR DATE: 12/1/2005 TIME: 7:08AM PAGE: 26 SITE ADDRESS: 10460 SW 72ND AVE. CLASS OF WORK: SUBDIVISION: SKORO MLP93 - 0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop /RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. OWNER: OLNEY, JERRY PHONE #: 971-221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 124 Electrical rough -in 022762 -01 971 - 221 -2522 Y Corrections /Comments/ Instructions: c V\ % l bDI' /,... ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL In CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Z z- c..,,.., Date:/_ 4 Phone #: (503) 718 - .7 kr CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S -00325 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 u,un Inspection Requests (24 Hrs.): (503) 639 -4175 U- "__ • INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 40 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. OWNER: OLNEY, JERRY PHONE #: 971 -221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 NS Electrical rough -in 021148 -01 971- 221 -2522 Y Corrections/Comments/Instructions: ,..A_ 1Q‘Y S o-i#AQ . 0.)) PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 c Date:/ /`/ !v Phone #: (503) 718- �� CITY OF TIGARD 11/ sr- BUILDING DIVISION PERMIT #:,006 o 3? ■5 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 64,01 0141111 1 ` Inspection Requests (24 Hrs.): (503) 639 -4175 - " INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: /b / 7a ^'1 A. --- CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: / / 3- 040 Pour Time: Code # Inspection Description Confirm # Contact # Message /1 - 7e/le-v; c� Corr- tions /C: •• - Its /Instructions: 1 f 1 i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO A('CE ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 1 / Phone #: (503) 718- IAA-- _ - , . "'A CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00326 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005 — Phone: (503) 639 -4171 a . v " ,0 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/18/2005 TIME: 7:17AM PAGE: 26 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop /RV. 11/1/05, ADDING 60' OF FOOTING DRAIN, AND ROUGH -IN ONLY FOR (1) LAV, (1)WATER CLOSET & (1) SHOWER. OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 021880 -01 971- 221 -2522 N Corrections /Comments/ Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: // /?Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 00326 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/19/2005 Phone: (503) 639 -4171 71#41t Inspection Requests (24 Hrs.): (503) 639 -4175 ,,!L .. INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 64 SITE ADDRESS: 10460 SW 72ND AVE CLASS OF WORK: SUBDIVISION: SKORO MLP93 -0008 LOT #: 003 TYPE OF USE: PROJECT NAME: OLNEY DESCRIPTION: Shop/RV. OWNER: OLNEY, JERRY PHONE #: 971- 221 -2522 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 018601 -01 503 - 932 -4948 N Corrections /Comments / Instructions: 0 (G c • i • s 4111 S ci €Eb W b 1 otio aekt. ) -- ( wsrakcA. Caucez_ Erg- Fr' DS AiLID ors M ?c-t2 ?c-t2 ftV d-(z - - - A t)( (NS . 0.- O . T 7* wo Ow. 1,,... - f.1■ t1/015-W6644/W- i ❑ PASS 4ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 1 0 ( (e (hone Date: #: (503) 718- _