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Permit r 4 CITY OF TIGARD MASTER PERMIT PERMIT #: M ST2007 -00166 COMMUNITY DEVELOPMENT DATE ISSUED: 1 0/18/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S1 12CC - G F009 SITE ADDRESS: 15680 SW 81ST AVE ZONING: R-12 SUBDIVISION: GAGE FOREST LOT: 009 JURISDICTION: TIG PROJECT: GAGE FOREST Project Description: New SF BUILDING REISSUE: MS3A -GL STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 973 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1.352 sf GARAGE: 408 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 2 35.911.03 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,325 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 NAT FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADDL INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: WISVC OR FDR: . PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 - 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: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVC /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 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: ALL - ENCOM BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 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 J T ROTH CONSTRUCTION, INC. JT ROTH CONSTRUCTION INC laws. All work will be done in accordance with approved plans. This 12600 SW 72ND AVE 12600 SW 72ND AVE STE 200 permit will expire if work is not started within 180 days of issuance, or SUITE 200 TIGARD, OR 97223 if the work is suspended for more than 18D days. ATTENTION: PORTLAND, OR 97223 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: 503 639 - 2639 Contact #: PRI 503 639 - 2639 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 624 -0239 Reg #: LIC 31700 TOTAL FEES: $ 12,047.08 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 / / Permittee Signature : �/ Issued By : �_� o ,/ g -iii/ _,, Call 503.639.4175 by 7:00 a.m. for an inspection that busine .day. This permit card shall be kept in a conspicuous place on the job site until comp - • n of the project. Approved plans are required on the job site at the time of each i pection. /3—&10 51.C) gl 5 7' Building Permit Application RECEI R i°y $ 28 d' S/ t i MsT1� (66 City of Tigard D PermitNo.: ;� • 13125 SW Hall Blvd, Tigard, OR 97223 8 I, /�^7� q 0 2 8 2007 Pl an Review OthWQ2 .� LL I Phone: 503.639.4171 Fax: 503.598.1960 AUG DateEly: MA d k, — G T I G A R I� Inspection Line: 503.639 Army Date ReadyBy: l7 - 7 er Permit 5 See Attached Checklist for Internet: www.tigard- or.gov �� ti . Notifi e: g � Supplemental Information TYPE OF WORK Y REQUIRED DATA: 1- AND 2-F fi t: Y 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: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: 2 'f Z JOB SITE INFORMATION AND LOCATION Total number of floors: 2.. Job site address: /--4 ge (v Ti ST . '/� J-p _ New dwelling area: .13 Is square feet City /State/ZIP: Tigard, Oregon ` " Garage/carport area: y rr square feet Suite/bldg. /apt. no.: Project name: GAGE FOREST Covered porch area: —* square feet Cross street/directions to job site: Hall Blvd and SW Langtree Street Deck area: ,..---. square feet Other structure area: . square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST , Subdivision: GAGE FOREST Lot no.: Q y Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.. equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. NEW SINGLE FAMILY DETACHED Valuation: S Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ❑ TENANT Number of stories: Name: J.T. ROTH CONSTRUCTION, INC. Type of construction: Address: 12600 SW 72 AVENUE, SUITE 200 Occupancy groups: City /State/ZIP: PORTLAND, OR 97223 Existing: Phone: (503)639 -2639 Fax: (503)624 -0239 New: 0 APPLICANT ❑ CONTACT PERSON NOTICE Business name: J.T. ROTH CONSTRUCTION, INC. All contractors and subcontractors are required to be Contact name: DAVID JENSEN licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 12600 SW 72 AVENUE, SUITE 200 jurisdiction in which work is being performed. If the / City/State/ZIP: PORTLAND, OR 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 639 -2639 Fax: : (503) 624-0239 E -mail: DAVIDJ@JTROTHINC.COM CONTRACTOR . Business name: J.T. ROTH CONSTRUCTION, INC. BUILDING PERMIT FEES* Address: 12600 SW 72 AVENUE, SUITE 200 (Please jQlol°°"f"d"1`1 City/ State/ZIP: PORTLAND, OR 97223 Structural plan review fee (or deposit): revi ! Phone: (503) 639 -2639 Fax: (503) 624 -0236 FLS P��' fee (if applicable): / CCB lic.: 31700 Total fees due upon application: f Amount received: Authorized signatur - This permit application expires if a perm! � •°- e. '~ -- within 180 days after it has been accep/ Print name: 'h Date: n ;1. / /�j JFifi / � � • Fee methodology set by Tri- County Built %' Service Board. l:\BuildingPem ia\BUP- PennitApp.dac7 /06 440. 46131'(11 /O2/COM/WEB) , s . Electrical Permit Ap ltifiECE VED , ,,, , I , .., „N., ., City afTigard pm,* s: ✓ #4, -Cc) %. 'h 13125 SW Hall 81d.Tignd, 97221 U 2 8 2007 Phonic 503.6394171 Fele 503. /� Mgr Pbmie 10t v 503.639.4173 B �VU" T� 1 a'°` S leePga7Oat foo teaoC aww► -or. �w nVf<7e sapp+exaserd Lalo.>eatleea TYPE of WORK PLAN REVIEW ® New coosaactioa ❑ Addidoohiteratlooheplaeemmt Raffia drdew>aa+ovtr(,.boe 1 aas ottatani wwian eherhed whorl ❑Serri awe O &d re dlesexardewwo. ❑nEmOlitiOet ❑Ot1iC: wassetheasistels thateseetaes aleei.ae rod bo.ywd. CATSC.ORY OP C01 came 1Q000 sure ar fSO.ees of ❑ main ►maditat. • L - end 2 - fatttil dwelling ❑ &Cea9DeT building taste 6e re aude14,000 OCeeaaarmel -sessi (adaeed ® Y �g ❑ Commercial A asp ihra0other iiralhothes. buildings. ❑ Mu10'famiy 0 Master Wilda ❑ Other: O Fla pmap. p hsellstie. er7S 1f VA or JOE NM E DEFORMATION AND LOCATION CI glen' tgaaardr *Mist ayes. 51-- p eat,* seeen moor kder C1 1- r.'f -s•. Job ao.: lob six address: /5 SCC> 7/ psis ar oma asido:d vat O tsawe.e_ veto perks. Q t y / S t a tr l Z > P : ?tgerd, Oregon Ofbab se 0oil'*iea. O 9eo * wasp fa , c da m O Ftmwdess Imam. 600 toes ateoirtal. Suite/bidB✓ep1. 00.: Project name GAGE FOREST OServicetetmlata ate wtorste Gross stmet/disecdona to job sitm AA Blvd & SW Lan a Street . PEE SCHEDULE , eta.aesnea I ten 1 tn. I lase 1 • .: x or seM1- ,1 r twang wNe sttnehed garage. Stibdtvision: GAGE FOREST { Lot po; e 9 . 1.0t)0 sq it a las / 145.15 - 4 Tat map /peed no.: Es. W11'1500 seq. IL or portion ` 3 33.40 1 Liaised maw. residential / 75.00 2 DESCRIPTION Of WORE (with show saw 6.) . Limited energy, �� - if NEW SINGLE FAMILY DL"1'a ere D • residential (with ■h ma. a.) 75.00 2 Services or thdns feepd6d{eetoltemtixo, and/or telee8ws man >aura or lass 14130 2 CIS PROPERTY I ❑ TZNANT 201 mew to 400 amps 106..85 2 Name .I.T. ROITI CONSTRUCTION, INC 401 ethos to 600 Gape 160.60 2 Address: 12600 SW. 72 AVENUE, SUI'T'E 200 601 r 1,000 amps ps amps 750.60 2 Oset 1.000 aamps az volts 454.66 I 2 • City/Stat& ZrP: PORTLAND, 01897223 Temponey see"lee: or/Seders tnmdlieion.Almaden, and/or Phone: X2639 1 Fix: (503)674.0239 200 w4 nor tae 66.85 1 Owner ation: This installation is being made on pmp tyy that I own which is not 201 °I°111 to 400 amps 100.30' 2 1e Wtfl intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 90L 401 lam to 599 as>µwm 133.75 _ _ • 2 Owner signature: Date: A. dimes — mew, aelteeap pe e.i, orrstswien, r panel A. Fee Ow bomb camas wide 15i1 APPLICANT I 0 cOrrn*cf PERSON above service or toed. fee 6.65 2 each breath Wrath 805111019 Re is J.T. ROTH CONSTRUCTION, INC. B. Fee for brume Wreath ' Whole service or fearer the. Contact a: DAVID Jls7 I first branch circuit 46.65 .xs 2 cme . Addtt ts:12600 SW 72" AVENUE, SUITE 2E0 ' Each add'1 trends circuit 6.65 _ 2 Ifoadhosseue Nora = or Stale; eel Inelurled) City/StaEe 1P: PORTLAND, OR 97273 Each twmwtexaattderr - dWcllept. novice endla ftedee _ '10.90 12 Phone: (503) 639.2639 - I Fete : ( !) 624 -0239 y ' Iteconsect adip 6685 1 2 E-mail: DAVIDICOSTROTAINC.00111 Pomp or it otan circle 53.40 CONTRACTOR Sign or outline 55btieg 53.40 2 I Business name: JEROME ELECTRIC INC. Signal aa°tith) or li or o pearl alteration. or Atldrnen PO BOX 751 etaendoe. Desea3 . Page 2 2 City /StaaJZlP:1QLLSRORO. OR 97173 Zed. addMted trspedeta ewer astable is oaf doh. *brie , Per iompeaiaa 62.50 Phone: (589) 64&3144 Fax: (503) 665 -9723 Iavoeigetioepiethour ( lhr mirl 62.50 CCR Lie.: 1514119 Ekariaal Lie.: 2877S Snprv. lea: 34-119C Titdtaaid pleoc pa pour 73.75 ELECTRICAL PERMIT PUSS Sr prv. Electrician signature. reparak automat Plaannwiew=6 aeon& In): Print name: DAVID A. JEROME I Data no ILO_ State Authorized signature: e7<�� ..01--......"' TOTAL PBRAUTFEB: Ptaotname: I tr o ' b+pa+is appllealan =Ora de pram wear ebtetetd wow tie Alps aMerRM feet saasesei..es tpletv. • Number eriaepe eeiaes dew l pee pewit eta. Aar aims 446goi ttitrter sowae 08/17/2007 10:34 5036709064 THERMAL FLO PAGE 02 Aug 17 07 10202 JT Roth Construction, Inc (503) 624 -0239 p.2 i .� RE� . � E Mechanical Permit A► lilcatilo ) � �:. � � ( I 1 ( a . 1 -r ■ � �. r ; • C' of Tigard Received 0.Y AUG Nhd1Sy: V MAMMA ,1, 13125 SW HAS Bled.. Tura, OR 97223 G 8 2007 0 PlanRev I. Mac: 503.639.4171 Fax 503.598.1960 p OtbsePami!: „.... „ r . 1cop li /� on Line: 503.539.4175 Vr tr ( r Dote R0 . B aft See 3 Far w loterect: ww.tiprd- er.gov BUl Ir a : B Il.pple ed Saar TYPE OF WORK COMMERCIAL FEE• SCHEDULE - USE C113:CIGLIst ® New construction ❑ 4dd ticeNdteratiooheplaamont IdechamC.l Funk fom• rue bead on tbe'vatue artful sec* ' performed. bdiente the whre (Toweled to the neatest dollar) of all ❑ Demolition ❑ Other: mednuioal materials. equipment, later. ovahmd andproct. CATEGORY OP CONSTRUCTON Value's ® l - and 2 - family dwelling ID CommereisVindustrial 0 Accessary bolding R> N>rIA1. l SYS U1S ' ❑ Multi - Fatally ❑ Muter builder ❑ O For special b�6rmalfan use efieafirs Deaeription [cry I En. J Total JOB SITE INFORMATION AND LOCATION Reatlwficallok Job site address: /��0 ■5'& a /3 Ci Ala conditioning e r hem ptnnp : i (rog sae den Agin -riuosl 1 14.00 City/State/ZIP: TIGARD, OREGON Fmrmce 100,00013Th (duerravents) ( 14.00 S1dteIb1dg.i pt. no: IProject name: GAGE FOREST Furnace 100,00C* aTU tm�a.r a,a1 17.90 Gas brat pump 14.00 Cross srtaetldaeeetioes to job Me: hall Blvd & SW Langtree Street Duct wort 14.00 , Fliataie ha watatjyuern 14.00 . Rmidatrisl Anler (atSator of ' hyrtroaio) 14.00 DUI Neaten (Elul -type. not aleariu). 6rn.all. in-duct. su peaded. ate 10.00 Subdivisiad: GAGE FOREST I Wm: 6? Flue/vent li r arty of above 30.00 Oda= 10.00 Tax map/parcel 110.: Other wpliatteer DESCRIPTION OF WORK , Water Meter / 10.00 . Gas NEW SINGLE FAMILY DETACHED fireplace ( 10 .00 Flue writ fin wiener bean or en • . fireplace _ 10.00 • h (ge) 10.00 Wood/pellet =ova 10.00 ' Wood fireplace/insert 10.00 ta PROPERTY OWNER j 0 TENANT ChIIW*3 ufazlHtta/vart 10.00 Outer 10.00 Name: J.T.'ROTH CONSTRUCTION, INC. Environmental eawt and veer linden Address: I$00 SW 72" AVENUE, SUITE 290 oWerkitahen / 10.00 • equipment Ctty/StatrJEIP: PORTLAND, OR 97223 i Clothes dtYrr =haw / (0.00 Single -duct exhetul (bat cams, Phone (50#)639 -21139 Faac (503)62: -0239 toilet comportments. ub1i� rooms) 3 6.80 ® APPLICANT ❑ CONTACT PERSON Attir/aevls�.ec fans 10.00 Other. j 10.00 Business nabs: J.T. ROTE COIVSTRt1CT11ON. INC. rid t►lpire . • Contact save DAVID JENSEN 115.40 for tdnl tam 51.10 for each dditimaal Tamara. etc. Address: 12300 SW 72" AVENUE, SUITE 200 Ci.s ham City/Sfa df P: PORTLAND. OR97Z'+3 Well/ruapeodedAetil healer Water/seiner Water/seiner Phone: S) 689 -2639 Fax:: (903) 624 .0239 (SO Feeephee E -mail: DAVIDJQJTROTHINC.COM Ranee CONTRACTOR Barbecue Clothe drew Oran) Business ualee: THERMAL FLO. INC. ,, Oaten: Address: 7236 SW DURHAM ROAD 9100 MECHANICAL PERMIT FEES' Ciry/State P: TICARD.OR97224 Sebtobl - Phone: S 03 ) 67 0.8343 I Talc (503) 670.9864 Minimum permit fee (:72.5) ( Plan review (J516 of permit fee) CO lic.:1511147 SIac surcharge (3'1I of permit fee) - - TOTAL PERMIT FEE • '�� Thb remit .oil a1ee meet if • permit k *Want anat wMii 10* Avdtulizod saigoatem: . 9$�1rWiJ / 41.y. .+tee h.. b aeaxpted o eowpM� I Print mamas: - P2/..42,r1 Ar1 C17 . S I Dace. '-ii-c' I � Fee mwb odnrogr set by TrbCanrty Building Indu sy Service Bead > Wablleal.Powitrp,doe awmeot .ta►t6afr n racroOrr:atem • 08/17/2007 12:42 5036445989 CRAFTWORK PLUMBING PAGE 03/04 Aug .1 t 07 12;11p JT Roth Construction, Inc (503) 624.0239 -. p.3 • . Plumbing Permit An . l CEFVED C ,,,„ „F,,. ,. i , „ \, \ � Tigard SW Ha ll Blvd, Tigmd. dR 1 2 8 2 0 0 7 a°"'"°° Permit Na: Phone 503.639.4171 Far 503 /p�� PlestReriew 1s/ if u1 I > iQ i ; „ inspection Lino: 50 3.639.4175 e � Dangly! OrhmPsemdNa_ Iatlemeo erww.tigard-0rgov BU1 Dsrr W,t — " """ . 17oeG R 1 °so I B see Pena lEr TYPE OF WORK J, soppkone l llrtbrnsy en [� Addi I q t ❑ DfltmH ' Dcxri l rO7 / ' • r ❑ Other. _ �', 6a. Total G►iBOORY Oar Cbtt978DCTIOPi Nor I- (includes 100 #! for mail utility eonaootioa) ® 1- and?+Ormtiy darElliag SFR C1l bath 249.74 ❑ C®0nercial imfiretriel SFR (J) bath ---- 350.00 0 Alcessaly Wipin ❑ Maf4- thirdly SPR (3) bath j 399.00 • El Master builder Each ` Each additional bathdotcken _ 45.00 +o8 SITS RTFOHIMATI+ON AND LOCATION 't` �_ "4 S) P age 2 Sire Job silo addteta Ile+ : 45 --- S aJ 87 y f'y -e--- Cab* basin or aret drain 16.60 City/SgoJZIP: TIGARD, OREGON Dryaell. leach Hoe. or bench drain Suit bldg Atilt ao, : Ptajert tto>,tE: GAGE PO){tEST Fos dm tub 6p —.—�_ Ling Wa lin ear R.: ,.,� Page 2 Cross sltttxt/tlire m job site: MIL Blvd & SAP Lawn Shen 1 Haru�oad lune utilities 110.00 Manholes 16.60 Reiadrmoi connector 16.60 Sanitary ewer (an linear A.: !) Page 2 Storm =ow (no, linear A.: _) p age 2 Sabdivisfon: GAGE FOREST = Water service (no, linear ft: _) Page 2 Tax may/ps>rcel nn.: Maley or Rae DESCRIPTION OF WORK aalva 1660 • Beekfler • NEW SINGLE FAMILY DETACHED Oav pr 0 Page 2 Rack ater ask 16.60 Clothes washer 16.60 Dishwasher _ 16,60 ® PROPERTY OWI ❑ TENANT nhiaking fenntura 16.60 Name: J.T. ROTR CONSTRUCTION, INC. di p 16 60 Address: 1 600 SW 72" AVENUE, SUITE 200 Caxpaaeian ink 16.60 Fiume/sewer nay I O City/Statel p: PORTLAND, OR 97223 Floor drain/floor ei k/hub 16.60 Thom (50.3)639 -2639 Fax: ('503)62} 9 arebage disposal 16.60 �' Thom e APPLICANT [l CONTACT P lime bib 16.60 ERSON Bardeen one: J.T. ROT'S CONSTRUCTION, ENC. 'ce =MOT . 16.60 Connect name: DAVID JENSEN Were bap 16.60 — Medical are (value_ S ) Page 2 Addre s:12600 SW 72 AVENUE, SUITE 200 Primer - [6.60 City/Sttlte/VP: PORTLAND, OR 972x1 Roof drain (oammereiel) 16.60 _ Phone (SAi) 639-2639 Fax ; (503 6240239 _ ° 1 °" 1 y 16.60 Enall: DAVIDLICITROTHJNGG10M r�+blshowars>sotverpen 1660 CONTRACTOR 16.60 wo,s es closet 16.60 —_, Business mac: CRAFTWORX PLUNTIONG, INC. Wares hewer 16.60 Address: 7737 SW CARUS DRIVE Other Cit State'ZIP: BE,AVERTON, OR 97005 — Sabos) Phone: (303)64'1 -3698 Fax: (303)644~ Residouial backfloa mma mini �i Re: 5,55 puymie the: 533 Cal Lis: 79s5u36 ae � ,., 'v.. so.: 20-1411141 P A 1, l<ae: /� /` , � StRk snaahmpe (89'e of permit fee) Authorised signa TOTAL PERM/T FEE v I , Dm % ••"( 19 I% permit mit appttcatiert expires Ws part in not obtained • ttbin pred as III) days after tt been ece auasPlel<, .Fee methodology set try Tri has .C ostly bee Bu Ind s�try Serv Bosrd t :Vaatltliarlpeee107— M4Ronitgrpeac o62tas ao+stsx0) • City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 I1 July 2, 2008 • TIGARD J T Roth Construction, Inc. 12600 SW 72 " Ave., #200 Tigard, OR 97223 Re: Permit No. See "Notes" Below Dear Sir /Ms.: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: See "Notes" Below Project Name: Gage Forest Job No.: N/A Refund: ® Check #58047 in the amount of $1,200.00. ❑ Credit card "return" receipt in the amount of $ ❑ Trust account "deposit" receipt in the amount of $ Notes: Refund for overpayment of TIF -R fees due to calculation error at $240.00 for each of the following permits: MST2007- 00163, 15731 SW 81St Ave., Gage Forest, Lot 29 MST2007- 00166, 15680 SW 81' Ave., Gage Forest, Lot 9 MST2007- 00165, 15767 SW 81 Ave., Gage Forest, Lot 31 MST2007- 00164, 15706 SW 81 Ave., Gage Forest, Lot 8 MST2007- 00162, 15672 SW 81 Ave., Gage Forest, Lot 10 If you have any questions please contact me at 503.718.2430. , (614 1 ( 77- e-- Dianna Howse Building Division Services Coordinator Enc. I:\ Building\ Refunds\ Administration \LtrRefund- Overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: J T Roth Construction INC DATE: 6/12/08 12600 SW 72n Ave #200 Tigard, OR 97223 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: Various – See Attached Case #: Various – See Attached Date: Various – See Receipts Attached Address /Parcel: Various Pay Method: Check Project Name: Gage Forest EXPLANATION: Refund overpayment of TIF -R fees REFUND INFORMATION: • • Fee Description From Receipt. Revenue Account No: Refund Example: [BUILD] Permit Fee Example: 245- 0000- 432000 $ Amount [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 TOTAL REFUND: $1,200.00 APPROVALS: If under $500 Professional Staff , If under $7,500 Division Manager -./7-.08` If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM' ADMINISTRATION USE ONLY %Z Case Refund Processed: I Date: (p!2S`i ,? I By: I — I:\ Building \Refunds \RefundRequest.doc 05/23/07 STREET TREE CERTIFICATION I r 0E Owner/Agent for c% r/7 ei/V5, (PLEASE PRINT) (PERMIT HOLDER) Do hereby certify that the following location meets City of Tigard and Washington County land use and development standards for street tree installation. ADDRESS: /, (LI /vi 3 col Jo (o SUBDIVISION: Gfyyl�� LOT: SIGNATURE: DATE: (OIVNER /AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) 1: \Building \Forms \StrectTreeCertificate 01/19/07 CITY OF-TIGARD BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1011812007 Phone: (503) 639 -4171 , . , Inspection Requests (24 Hrs.): (503) 639 -4175 ''I INSPECTION WORKSHEET FOR DATE: 4/21/2008 TIME: 7:00AM PAGE: 3 SITE ADDRESS: 15680 SW 81ST AVE: CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 603 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #:503.639.2639 Inspection Request Scheduled For: Date: 4/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 239 Final inspection 068677 -03 603 N Corrections /Comments /Instructions: r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS IL CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED Inspector: ' / Date: 1- - 2- i — G 5 Phone #: (503) 718- 2-4.95 CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1812007 Phone: (503) 639-4171 + . ICI Inspection Requests (24 Hrs.): (503) 639 -4175 , _.W INSPECTION WORKSHEET FOR DATE: 4/21/2008 TIME: 7:00AM PAGE: 4 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New Sf OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 639 -7638 Inspection Request Scheduled For: Date: 4/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 068677 -02 503- 806-0602 N Corrections/Comments/Instructions: • =ASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 4--2 /-6 8 Phone #: (503) 718 - 4.5--- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10118/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . -' .! I INSPECTION WORKSHEET FOR DATE: 4/15/2008 TIME: 7:02AM PAGE: 3 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: 3 F ROTH CONSTRUCTION, INC., PHONE #: 503 639 - 2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 Inspection Request Scheduled For: Date: 4/15/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection Q68403 -09 503 806.0602 N Corrections /Comments /Instructions: +�`Z �CiEGo &- L- 4tcn2cc , ' - -C-. ,7 Gl21cl-1» 4 ,s c ' #, ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS �i'F.41L CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /c-c 15 Phone #: (503) 718- CITY OF.TIGARD BUILDING DIVISION PERMIT #: MST2007 -0U166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1W10/200/ Phone: (503) 639 -4171 ��� Inspection Requests (24 Hrs.): (503) 639 -4175 I '__ • -. INSPECTION WORKSHEET FOR DATE: 4/2/20013 ME: 7:00AM PAGE: 7 SITE ADDRESS: '1568(1 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New :a'F OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503.639.2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503.639 -2633 Inspection Request Scheduled For: Date: 4/2/2008 Pour Time: l Code # Inspection Description Confirm # Contact # Message 299 Final inspection 067740.05 503-806 -0602 N Corrections/Comments/Instructions: � C I "9 wv tom. w. _ n � .- '� ° t , . 4/216 ( ) Me „ Ve-e- c ' C1 c - : 61_ I dri 6 ; u W__ I. t..1., %, V N s -6 0 .qx.„-A. 5 - 3 d N b-' i sc-urcs N At' -cxtiA a - 1\-i 6 PV/ 1 1;1 , -1 L.t.t.Th PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED /�i_ : * 2 -"/ 6r Z Y Z Inspector: � [/`' Date. Phone #: (503) 718 - 7 CITY OF.TIGARD BUILDING DIVISION / PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 lifl DATE ISSUED: 10110/2007 Phone: (503) 639 -4171 /�auWn IC l l l� n Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/7/70011 TIME: 7:00AM PAGE: 18 SITE ADDRESS: 16681) SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639.2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 1/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message vr 242 Interior shear walls 062689-05 503 - 806 -0602 N Corrections /Comments /Instructio s: D i ,.- c.)., -A \kj &du - L j(__ : --e S 1 0--L Le , '] -PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: W Date: ` / Phone #: (503) 718 - a I CITY OF.TIGARD BUILDING DIVISION PERMIT #: MST2007- 01166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2007 Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 .. • `. INSPECTION WORKSHEET FOR DATE: 1/3/2008 TIME: 7 :Q0AM PAGE: 8 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639.2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 - 639.2639 Inspection Request Scheduled For: Date: 1/3/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 062504 -04 503-806-0602 N Corrections /Comments/ Instructions: • i t PARTIAL APPROVAL El CANCEL ❑ NO ACCESS 111 FAIL CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Inspector: Date: / .S Phone #: (503) 718 - ._7—.6W illo CITY OF.TIGARD - - BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2007 Phone: (503) 639- 4171 °" Inspection Requests (24 Hrs.): (503) 639 -4175 ,-„, 1., I iI INSPECTION WORKSHEET FOR DATE: 1/3/2000 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: (;AGF FORLS I LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503- 639 -2639 CONTRACTOR: J ROTH CONSTRUCTION INC PHONE #: 503. 639 -2639 Inspection Request Scheduled For: Date: 1/3/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 052504 -03 503 - 806-0602 N Corrections /Comments /Instructions: O ' Z.- Z t b A ea. _ ` ,�A C -.0 MFL T 7 asa��: 3E I rr .� —mot% S ■ . t , 40 "Ir?tgli- V p O il lf lArt r' PAS' /I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS a • IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . — Date: Phone #: (503) 718- CITY OF.TIGARD - BUILDING DIVISION PERMIT #: M T2007 -o0 X66 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10110/2007 Phone: (503) 639- 4171dgg Inspection Requests (24 Hrs.): (503) 639 -4175 °7 I — INSPECTION WORKSHEET FOR DATE: 12131/2007 TIME 7 :00AM PAGE: 2 SITE ADDRESS 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGF FOREST LOT #: p09 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF - OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503"639 -2639 CONTRACTOR: sr ROTH CONSTRUCTION INC PHONE #: 503 - 639-2639 Inspection Request Scheduled For: I Date: 12/31/2007 Pour Time: • Code # Inspection Description Confirm # Contact # Message 6 IS Mechanical rough -in 062361.01 503.806.0602 N Corrections /Comments /Instructions: 10 °ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCEF ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i Inspector: 1 Date: j+JD h one #: (503) 718- _ • CITY OF.TIGARD BUILDING DIVISION PERMIT #: MST2007 -00 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/78/2007 TIME: 7:00AM PAGE: 3 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF. WORK: SUBDIVISION: GAGE FOREST .-LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503- 639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 12!28/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 062298-03 503- 806 -0602 N Corrections /Comments /- Instructions: • i mu/ reft g:e6Lieffs2_, kow-o i -- ) - (A--i2 . 41 9 / 2116 1/s 7 ille4e law\ ,A./uie,,,J2-- J a , / r -7.,X(p A o CA . / 1 Ok 40, ( abA ❑ PASS ❑ PARTIAL APPROVAL - ❑ CANCEL . ❑ NO ACCESS X FO INSPECTION • ❑ ADDITIONAL FEES ASSESSED Inspector: • - Date: v ah ne #: (503).718 - CITY OF.TIGARD - BUILDING DIVISION #: 5T 007 -q ass 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: X0/18 /2007 Phone: (503) 639 -4171 Hs 1 i l Inspection Requests (24 Hrs.): (503) 639 -4175 F'IL. INSPECTION WORKSHEET FOR DATE: 12/28/2007 TIME: 7 :00AM PAGE: 2 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J J ROTH CONSTRUCTION, INC., PHONE #: 503-639.2639 CONTRACTOR: Sr ROTH CONSTRUCTION INC PHONE #: 503.633 -2639 Inspection Request Scheduled For: Date: 12/26/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 236 Shoal walls/anchors 067298 -04 503.806-0602 N Corrections /Comments/ Instructions: • 1 i • 11 i l l i I 11/A" VIM/ & If — 6Z K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED (M / 9 7 Inspector: Date: hone #: (503) 718- mo & Ci CITY OF.TIGARD • 1. -- BUILDING DIVISION PERMIT #: MST2007 -001G6 13125 SW Hall Blvd., Tigard, OR 97223 A I ik DATE ISSUED: 10/02007 Phone: (503) 639 -4171 l 4p ri 11 Inspection Requests (24 Hrs.): (503) 639 -4175 °__ INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7 PAGE: 13 SITE ADDRESS: 15680 SW B1ST AVE CLASS OF WORK: 1 SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 12/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 062041 -04 503.806 -0602 N Corrections /Comments /Instructions: //% ,1 i.?-1,, .. •a56t 0 - %--t..1 1--r b - A._,A,_ 9,..._. . Q.( I—TT, . , tr Kr- -- 1 c rLeJ4 -./D- C. `-`) I VY\ Ic0 4 •tf J U5 4 ., ( &c-- JU.-6 -.' CO I \A-ItLCA 41 AL/ I L • �,1 _ 1 a 5 L' o �-," Ci � -. 1I1 \/ (Ai CL_ ^� Q & . o 1 "' tom: • V`--+' \ LAk,07...A--/-4 ., . c _.t '- V `✓L-.f o . 1 i' i ‘ s\S ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS V FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: k/ZA v Date: 1 2 l U - Phone #: (503) 718- v � 1 I ' CITY OF TIGARD - � i 441 t,e, BUILDING DIVISION PERMIT #: MST2007 00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1812007 Phone: (503) 639 -4171 41 AA u6 Insp Requests (24 Hrs.): (503) 639 -4175 . 1 1. . INSPECTION WORKSHEET FOR DATE: 12/21/2007 IME: 7:03AM PAGE: 14 SITE ADDRESS: 16680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAG: FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639.2639 CONTRACTOR: ..IT ROTH CONSTRUCTION INC PHONE #: 603 -633 -2635 Inspection Request Scheduled For: Date: 12/2.1/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 062041 -03 603 806-0602 N Corrections /Comments /Instructions: .i ' c� 11 "i 4 — 1 I ; E 1 CO 473 27 -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: VC c Date: 17 Phone #: (503) 718 - 1 CITY OF: TIGARD ' ., .. I . BUILDING DIVISION PERMIT #: MST 007 00'i66 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1Q /18/2007 Phone: (503) 639 -4171 Vit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 122/5/2007 TIME: 7 :Q1AM PAGE: 5 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: OAGF FOREST DESCRIPTION: New SF ' OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503.639.2639 Inspection Request Scheduled For: Date: 1215/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 06086502 503806+0602 N Corrections /Comments/ Instructions: C F i` . i / iFetf,74_,/ i k e, 6/1 1,04 41te 'PlA■9 ItO p ritA4--) 9 A ❑ PASS in PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL IN - ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / ` i ! I Date: ) S U hone #: (503) 718- �J r CITY OF TIGARD = BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/02007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7 :00AM PAGE: 55 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FORT'S LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST • DESCRIPTION: New SF OWNER: J 1 ROTH CONSTRUCTION, INC., PHONE #: 603- 639 -2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503- 639 -2639 Inspection Request Scheduled For: Date: 12/3/2.007 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 }hear wall anchors 066610.04 503806 -0602 N Correco ns/ o ents /Inst uctions: %AIL. ' / .�. �: /L✓ . I ' // 'I rit ITII�Vf 1.► l I/ /�` ' _ 1L:E1'I WNA! M - / ZIPANN • / • .1 / � i / f M : /Il■: _ )ii /44. /Le.41 • (2 1111) ® kv etA jw� 19 ' / vii L h4 / f. L.. L . �'/ /�. _/ _ ) ' WV% IOWA APPOOP - • I . l `\ ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / Phone #: (503) 718- , CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/18/2007 Phone: (503) 639 -4171 A it Inspection Requests (24 Hrs.): (503) 639 -4175 At INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7 :00AM . PAGE: 66 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 603 - 6342639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503- 639 -2639 . Inspection Request Scheduled For: Date: 12/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 060610 -03 503. 806.0602 N Corrections /Comments / Instructions: 7 1 ' 1r ",„/ / AO , 1 /ta 4 -0 / ` t 1/ ,/ i I - D , s5' 4 "oc 4) 9e .1 l n-,cJ 8 d -31 ° c- 11-- P ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS `fie FAIL CALL. FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Da te: i 70 Phone #: 503 718 - / Lib Inspector: ( ) CITY OF.TIGARD BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1R/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 4..11■\ . INSPECTION WORKSHEET FOR DATE: 10/31/2007 TIME: 7:00AM PAGE: 34 SITE ADDRESS: 15680 SW 8151 AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 001 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: SF ROTH CONSTRUCTION INC PHONE #: 503.639 -2639 Inspection Request Scheduled For: Date: 10/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 058733-06 503-1306-0602 N Corrections /Co ments /Instructions: n z t 1 \`N x p 1,2.1/4-0 ..-- )C o/tI k ., , Y . -2741,—,, ,5e 5S • 44 , ,' ,1-4/....w4 ‘P 6-1.ti c - C ( 1 6 ( ` c C A/kik - NA L- V/14 A '1 4„pe_ a PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL - ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Vit., Lit. Date: VUI V ( J'- Phone #: (503) 718- CITY OF.TIGARD BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/18120(17 Phone: (503) 639 - 4171 ICI Inspection Requests (24 Hrs.): (503) 639 -4175 .�•!!� 'LL INSPECTION WORKSHEET FOR DATE: 10/31/2007 TI : 7 PAGE: 35 SITE ADDRESS: 1 680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 603- 639.2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503.639 -2639 Inspection Request Scheduled For: Date: 10/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Po t/beam mechanical 058733-05 503 806-0602 N Corrections /Comments/ Instructions: ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Vire-/- Date: 6/31/6/ p Phone #: (503) 718 - i CITY OFTIGARD - il BUILDING DIVISION PERMIT #: MST2007-00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2007 Phone: (503) 639 - 4171? ° � Inspection Requests (24 Hrs.): (503) 639 -4175 1 ' I.. INSPECTION WORKSHEET FOR DATE: 10/22/2007 TIME: 7 : 00AM PAGE: 7 SITE ADDRESS: 15600 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE. FOREST DESCRIPTION: N ew SF 1 OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503- G312639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 - 639.2639 Inspection Request Scheduled For: Date: 10/2712007 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 058050 -02 503 - 806.0602 N Corrections /Comments /Instructions: / ( mil/ rill,. dl . — - . .I . OP _ i " '. G 1 - / - / i 4 1 , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /d— >7 -07 Phone #: (503) 718- 2.54- CITY OF.TIGARD BUILDING DIVISION PERMIT #: MST2007- 00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/180007 Phone: (503) 639- 4171gw�t Inspection Requests (24 Hrs.): (503) 639 -4175 "�' 1.. INSPECTION WORKSHEET FOR DATE: 10/22/2007 TIME: 7 :00AM PAGE: 8 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: QQg TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J 1 ROTH CONSTRUCTION, INC., PHONE #: 503639.2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 603- 639.2639 Inspection Request Scheduled For: Date: 10/22/2007 Pour Time: 10 : 00 Code # Inspection Description Confirm # Contact # Message 205 Footing 050050 -01 503.806.0602 N Corrections /Comments /Instructions: ' eu, 2- —rn �r . n4 .6,:c r o- 44.e,ei I lJFe - o- C- -tom) u - AI sre-G0 4_A-S PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ,4.1-2 - -a7 Phone #: (503) 718- 1 CITY OFTIGARD • BUILDING DIVISION PERMIT #: MST2007 -00 ih6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10118/1031 Phone: (503) 639 -4171 q Inspection Requests (24 Hrs.): (503) 639 -4175 .' `:_.. INSPECTION WORKSHEET FOR DATE: 4/21/2008 TIME: 7:00AM PAGE: 5 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 603-639-2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 603 - 639 -2639 Inspection Request Scheduled For: Date: 4/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Elect.iical final 068677 -01 503-806-0602 N Corrections/Comments/Instructions: • a PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 0 ( Z ( 1 0 1( Phone #: (503) 718- CITY OFTIGARD BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/113/2007 Phone: (503) 639 -4171 �B O • Inspection Requests (24 Hrs.): (503) 639 -4175 ��� `__.. INSPECTION WORKSHEET FOR DATE: 4/16/2008 TIME: 7:00AM PAGE: 7 SITE ADDRESS: 15.;80 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503- 638 - ?639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503-638.2639 Inspection Request Scheduled For: Date: 4/1612008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 068475 -01 603 806 -0602 N Corrections /Comments /Instructions: e Dd4 Ace-) e,4 Y �� %L Z1© /2— c-ev-r-t-I fre 1NR- 10 ❑ PASS ❑ PARTIAL APPROVAL ❑XADDITIONAL CANCEL El NO ACCESS AIL KALL FOR INSPECTION FEES ASSESSED '7 d Inspector: Date: r Phone #: 503 P � ) 718 - 1 CITY OF TIG.ARD • BUILDING DIVISION PERMIT #: MST2007- 00166 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/1B/2007 Phone: (503) 639 -4171 d ,a �B' I <•� Inspection Requests (24 Hrs.): (503) 639 -4175 .� :_ � __.. INSPECTION WORKSHEET FOR DATE: 4/3/2009 TIME: 7:02AM PAGE: 40 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF W K: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE O USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J 1' ROM CONSTRUCTION, INC., PHONE #: 503639-2639 CONTRACTOR: JC ROTFI CONSTRUCTION INC PHONE #: 503.6332639 Inspection Request Scheduled For: Date: 4/3/2008 Pour Time: Code # Inspection Description Confirm # C ntact # Message 199 Electrical final 007823 -01 03806-0602 N V Corrections /Comments/ Instructions: 1 1 (0,9, - f.__ / kol ----- A G,_4 ,- dv.` /�,` - / -,� T LC / - '7 / ( r( • haz- - ./D • 4 , ,lc ❑ PASS ❑ PARTIAL APPRO • ❑ CANCEL ❑ NO ACCESS AIL BO/ ALL FOR r: = 1 ❑ ADDITION • FE / #'ASSESSED Inspector: Dater - C, v Phone #: (503) 7 1 / \ • • i ' r r _ • • • • • • Olt • • CITY OF. TIGARD • BUILDING DIVISION PERMIT #: I✓�;T2007 -00 X66 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/19/200'1 1 Phone: (503) 639 -4171 1 it Inspection Requests (24 Hrs.): (503) 639 -4175 . _, INSPECTION WORKSHEET FOR DATE: 12/11/2007 TIME: 7 :00AM PAGE: 11 SITE ADDRESS: i55'60 SW 131ST AVE CLASS OF WORK: SUBDIVISION: GAGE_ FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503. 639 -2.639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503 - 639-2639 Inspection Request Scheduled For: Date: 12/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 061292-01 503 - 806-0602 N Corrections /Comments /Instructions: k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: i4 Date: i Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00 I66 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 101181201)7 Phone: (503) 639 -4171 "''Ei� Inspection Requests (24 Hrs.): (503) 639 -4175 �' ' p'I L. INSPECTION WORKSHEET FOR DATE: 12/11/2007 TIME: 7 :00AM PAGE: 10 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 00g TYPE OF USE: PROJECT NAME: GAGE; FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 63 9 - 2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 639.2639 Inspection Request Scheduled For: Date: 12/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 061292 -02 503-806 -0602 N Corrections/Comments/Instructions: I , i !IS PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ' Inspector: b Date: li 1 Phone #: (503) 718 - CITY OF TIGARD _ BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/200/ Phone: (503) 639 -4171 d- i � Inspection Requests (24 Hrs.): (503) 639 -4175 _' �__.. INSPECTION WORKSHEET FOR DATE: 12/11/2007 TIME: 7 :00AM PAGE: 8 SITE ADDRESS: 16680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639-2639 CONTRACTOR: .,Pf ROTH CONSTRUCTION INC PHONE #: 503 - 639 -2639 Inspection Request Scheduled For: Date: 12/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 061292-03 503.906.0602 N Corrections /Comments /Instructions: • *1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED f I ti D nspector: rlri Date: ` Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00 166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2007 Phone: (503) 639 -4171 : 4_114 'I Inspection Requests (24 Hrs.): (503) 639 -4175 ...' INSPECTION WORKSHEET FOR DATE: 4/16/2008 TIME: 7:00AM PAGE: 6 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 4/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing fins! 058476.02 503- 806 -0602 N Corrections /Comments/ Instructions: • X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (3 ii i.1 (,JZ\ \ i N,,"....< Date: ( 1)110 1 OT Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2.007- 00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18000 / Phone: (503) 639 -4171 ag���Fj f l l f I nspection Requests (24 Hrs.): (503) 639 -4175 � INSPECTION WORKSHEET FOR DATE: 4/15/2008 TIME: 7:02AM PAGE: 4 SITE ADDRESS: 15613() SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503•G39 -2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 -639 -7639 Inspection Request Scheduled For: Date: 4/15/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 068403 08 503.806 -0602 N Corrections/Comments/Instructions: 2 gel ge v► d/'rH1 P u l a.✓ e q oce_ cOvs--ems. 8LA; Jlm, ��4,� Gi � '1 p., J r t.,. F p- Covv-� VQ2-%., — P f p c .L." ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS rAFAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (Ti �►� -��� \" ----- Date: L{ I I c( ®< Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10116/20117 Phone: (503) 639 -4171 4114110 1 ��l Inspection Requests (24 Hrs.): (503) 639 -4175 __.. INSPECTION WORKSHEET FOR DATE: 4/2/2008 TIME: 7:00AM PAGE: 8 SITE ADDRESS: 16680 SW B1ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639 - 7639 CONTRACTOR: Jf ROTH CONSTRUCTION INC PHONE #: 503 Inspection Request Scheduled For: Date: 4/712008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 067748 -04 503'806-0602 N Corrections/Comments/Instructions: 0 1 ∎n, V-.-(o i, Pe cec- Le- U aloe. a ±t ro t\jo 12.,f.,,„t o r l �,, ,.. �,, p�,�a - t € , ter- c-e. A- Pro el.k_ ■s 1 0. 3 T:e ge -,po /c Al SAS -� Cc, t,1 f o P e_ - "ti `j` v V4 13 c pv 4-1 Cn 1 3 e o v Le_ € r t - ti- ( w� ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS M FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C v lA Ul_l...r -2-- Date: L J [2 I CA) Phone #: (503) 718- I CITY OF TIGARD • . BUILDING DIVISION PERMIT #: MST1007-00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1B/2007 Phone: (503) 639 -4171 i t i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/7/2007 TIME: 7 :00AM PAGE: 42 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: q09 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503-639 -2639 Inspection Request Scheduled For: Date: 12/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 061050 -02 503806 -0602 N 1 Corrections /Comments /Instructions: 1 • 1 LPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: _ 7 .,J , \ \ A Date: 12' 7 / 07 Phone #: (503) 718- CITY OF. TIG.ARD " - . BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2007 Phone: (503) 639 -4171 A I l Inspection Requests (24 Hrs.): (503) 639 -4175 ....., .. INSPECTION WORKSHEET FOR DATE: 10/31/2007 TIME: 7:00AM PAGE: 36 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: Q09 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503.63g-263g CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 503.639 -2.639 Inspection Request Scheduled For: Date: 10131i2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 058733 -04 503 806 -0602 N Corrections /Comments/ Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V (i� �� . Date: t V 1 3 / Phone #: (503) k `� I ) 718 - CITY OFTIGARD t 1 BUILDING DIVISION PERMIT #: MST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/ 18/2007 ' Phone: (503) 639 -4171 4u�N fil Inspection Requests (24 Hrs.): (503) 639 -4175 s_' " -_ INSPECTION WORKSHEET FOR DATE: 10/29/2007 TIME: 7:01AM PAGE: 8 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503-639-2639 CONTRACTOR: Jr ROTH CONSTRUCTION INC PHONE #: 50.639.2639 Inspection Request Scheduled For: Date: 10/29/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 06854302 503 - 806-0602 N Corrections /Comments / Instructions: x PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (Ta Vv 1 t L— -- Date: 1012)110 Phone #: (503) 718- CITY OF.TIG.ARD . . _ BUILDING DIVISION PERMIT #: MS 20D7_Ot1166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1t111(3/2007 Phone: (503) 639 -4171 ,V,11 ill Inspection Requests (24 Hrs.): (503) 639 -4175 ....&.. �__.. INSPECTION WORKSHEET FOR DATE: 10/24/2007 TIME: 7:00AM PAGE: 18 SITE ADDRESS: 15600 SW 91ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639-2639 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503639-2639 Inspection Request Scheduled For: Date: 10/2412007 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 058261 -06 503 - 806.0602 N Corrections /Comments /Instructions: 1,2t PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Crb\vA.J i 1 I % * p r v n - 4 . Date: 1 b IV-110 Phone #: (503) 718- CITY OFTIGARD • BUILDING DIVISION PERMIT #: IvMST2007 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ���� -' INSPECTION WORKSHEET FOR DATE: 10/24/2007 TIME: 7:00AM PAGE: 20 SITE ADDRESS: 15680 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 009 TYPE OF USE: PROJECT NAME: GAGE_ FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, RUCTION, INC., PHONE #: 5 6 CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503.639 -2639 Inspection Request Scheduled For: Date: 10/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 058261 -04 503- 806.0602 Y Corrections /Comments /Instructions: • K PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Q t \10,.. Date: /6/2•x//6 Phone #: (503) 718- • CITY OFTIGARD - . BUILDING DIVISION PERMIT #: MST2007 -001G6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •10/ 18/20117 Phone: (503) 639 -4171 AW '�I Inspection Requests (24 Hrs.): (503) 639 -4175 ∎ `. -. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 10/2QI 7:00AM 19 SITE ADDRESS: 16600 SW 81ST AVE CLASS OF WORK: SUBDIVISION: GAGE FOREST LOT #: 000 TYPE OF USE: PROJECT NAME: GAGE FOREST DESCRIPTION: New SF OWNER: J T ROTH CONSTRUCTION, INC., PHONE #: 503 - 639 - 2G39 CONTRACTOR: Jf ROTH CONSTRUCTION INC PHONE #: 503-639-2639 Inspection Request Scheduled For: Date: 10/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 058261 -05 503 - 806 - 0602 N Corrections /Comments/ Instructions: (X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (51% V ► 1%.-4.. Date: ir° I"'j /a7 Phone #: (503) 718- City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • July 2, 2008 TZGARD J T Roth Construction, Inc. 12600 SW 72n Ave., #200 Tigard, OR 97223 Re: Permit No. See "Notes" Below Dear Sir /Ms.: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: See "Notes" Below Project Name: Gage Forest Job No.: N/A Refund: ® Check #58047 in the amount of $1,200.00. ❑ Credit card "return" receipt in the amount of $ ❑ Trust account "deposit" receipt in the amount of $ Notes: Refund for overpayment of TIF -R fees due to calculation error at $240.00 for each of the following permits: • MST2007- 00163, 15731 SW 81" Ave., Gage Forest, Lot 29 MST2007- 00166, 15680 SW 81" Ave., Gage Forest, Lot 9 MST2007- 00165, 15767 SW 81" Ave., Gage Forest, Lot 31 MST2007- 00164, 15706 SW 81" Ave., Gage Forest, Lot 8 MST2007- 00162, 15672 SW 81" Ave., Gage Forest, Lot 10 • If you have any questions please contact me at 503.718.2430. Sincerely, A14 Dianna Howse Building Division Services Coordinator Enc. I: \Building\ Refunds\ Administration \LtrRefund- Overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard or.gov • TTY Relay: 503.684.2772 City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: J T Roth Construction INC DATE: 6/12/08 • 12600 SW 72n Ave #200 Tigard, OR 97223 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: Various — See Attached Case #: Various — See Attached Date: Various — See Receipts Attached Address /Parcel: Various Pay Method: Check Project Name: Gage Forest EXPLANATION: Refund overpayment of TIF -R fees REFUND INFORMATION: • Fee Description From Receipt Revenue Account No. Refund Example: [BUILD] Permit Fee Example: 245 - 0000 - 432000 $ Amount [TIF -R] TIF Resident 210- 0000 - 448001 $240.00 [TIF -R] TIF Resident 210- 0000 - 448001 $240.00 (TIF -R] TIF Resident 210- 0000 - 448001 $240.00 ITIF - R] TIF Resident 210- 0000 - 448001 $240.00 [TIF -R] TIF Resident 210 - 0000 - 448001 $240.00 TOTAL REFUND: $1,200.00 APPROVALS: If under $500 Professional Staff - If under $7,500 Division Manager / / y • 08 If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY ✓ Case Refund Processed: I Date: I 67294 I By: I e .,,e 1: \ Building \ Refunds \RefundRequest.doc 05/23/07 17111 . CITY OF TIGARD 6 /11/2008 �� 13125 Sir Han Blvd. 12:31:31 PM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200700000000004850 Date: 10/31/2007 Line Items: CTO,le. FO're,5 i 1' Loi 29 Case No Tran Code Description Revenue Account No Amount Paid MST2007 -00163 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 46.00 MST2007 -00163 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST2007 -00163 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 169.67 MST2007 -00163 [BUILD] Bldg Permit 245- 0000 - 432000 1,414.87 MST2007 -00163 [TAX] Build 8% State Surchrg 100- 0000 - 207020 113.19 MST2007- 00163 [METCET] Metro Const Excise Tx 245- 0000 - 229202 290.52 MST2007 -00163 [MECH] MEC Permit 245- 0000 - 431010 83.70 MST2007 -00163 [TAX] MEC 8% State Surcharge 100- 0000 - 207020 6.70 MST2007 -00163 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST2007 -00163 [TAX] PLM 8% State Surcharge 100- 0000 - 207020 3 I.92 MST2007 -00163 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2007 -00163 [TAX] ELC 8% State Surcharge 100- 0000 - 207020 22.30 MST2007 -00163 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST2007-00 163 [TAX] ELR 8% State Surcharge 100- 0000 - 207020 6.00 MST2007 -00163 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2007 -00163 [TIF -R] TIF Resident 210- 0000 - 448001 3,200.00 MST2007 -00163 [TIF -MT] TIF Mass Tr 210 -0000- 448005 240.00 MST2007 -00163 [ERPRMT] Erosion Control 100- 0000 - 207307 88.00 MST2007 -00163 [ERPLN] Erosn PIn Rv CWS 100 - 0000 - 207308 28.60 MST2007 -00163 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 28.60 Line Item Total: $11,340.82 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check J T ROTH CONSTRUCTION BB 13262 In Person 11,340.82 • Payment Total: $11,340.82 dteceipl.rpl Page I or 1 MI . CITY OF TIGARD 6 /11/2008 q . 13125 SW Flan Blvd. 12:27:39PM Tigard, 012 97223 503.639.4171 TIGARD Receipt #: 27200700000000004697 Date: 10/18/2007 Line Items: � FOi L 9 Case No Trail Code Description Revenue Account No Amount Paid MST2007 -00166 [CDCPLN] CDC Pin Rev 100- 0000 - 433060 46.00 MST2007 -00166 [LRPF] LR Planning Surcharge 100- 0000- 438050 6.00 MST2007 -00166 [BUPPLN] Pin Rv Balance 245- 0000 - 433000 150.51 MST2007 -00166 [BUILD] Bldg Permit 245- 0000 - 432000 1,385.40 MST2007 -00166 [TAX] Build 8% State Surchrg 100- 0000 - 207020 110.83 MST2007 -00166 [METCET] Metro Const Excise Tx 245- 0000 - 229202 283.09 MST2007 -00166 [MECH] MEC Permit 245- 0000 - 431010 97.30 MST2007 -00166 [TAX] MEC 8 %, State Surcharge 100- 0000 - 207020 7.78 MST2007 -00166 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST2007 -00166 [TAX] PLM 8% State Surcharge 100 -0000- 207020 3 I.92 MST2007 -00166 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2007 -00166 [TAX] ELC 8 %, State Surcharge 100- 0000 - 207020 22.30 MST2007 -00166 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST2007 -00166 [TAX] ELR 8% State Surcharge 100 - 0000 - 207020 6.00 MST2007 -00166 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2007 -00166 [TIF -R] TIF Resident 210- 0000 - 448001 3,200.00 MST2007 -00166 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 240.00 MST2007 -00166 [ERPRMT] Erosion Control 100- 0000 - 207307 88.00 MST2007 -00166 [ERPLN] Erosn Pin Rv CWS 100- 0000 - 207308 28.60 MST2007 -00166 [EROSN] Erosn Pin Rv COT 245- 0000 - 433010 28.60 Line Item Total: $11,297.08 Payments: Method Paver User ID Acct. /Check No. Approval No. Flow Received Amount Paid Check JT ROTH CONSTRUCTION BB 13249 In Person 11,297.08 Payment Total: $11,297.08 cReccipi.rpi Page I or I rfli! CITY OF TIGARD 6/11/2008 13125 SW Hall Blvd. I2:27:22PM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200700000000004652 Date: 10/17/2007 Line Items: C7Ckae, ro si Lo 31 Case No Tran Code Description Revenue Account No `-) Amount Paid MST2007 -00165 [CDCPLN] CDC Pin Rev 100 - 0000 - 433060 46.00 MST2007 -00165 [LRPF] LR Planning Surcharge I00- 0000 - 438050 6.00 MST2007 -00165 [BUPPLN] Pln Rv Balance 245 -0000- 433000 105.88 MST2007 -00165 [BUILD] Bldg Permit 245 -0000- 432000 1,347.51 MST2007 -00165 [TAX] Build 8% State Surchrg 100- 0000 - 207020 107.80 MST2007 -00165 [METCET] Metro Const Excise Tx 245- 0000 - 229202 272.00 MST2007 -00165 [MECH] MEC Permit 245- 0000 - 431010 97.30 MST2007 -00165 [TAX] MEC 8% State Surcharge 100- 0000 - 207020 7.78 MST2007 -00165 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST2007 -00165 [TAX] PLM 8% State Surcharge 100- 0000 - 207020 31.92 MST2007 -00165 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2007 -00165 [TAX] ELC 8% State Surcharge 100- 0000 - 207020 22.30 MST2007 -00165 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST2007 -00165 [TAX] ELR 8% State Surcharge 100- 0000 - 207020 6.00 MST2007 -00165 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2007 -00165 [TIF -R] TIF Resident 210- 0000 - 448001 3,200.00 MST2007 -00165 [TIF -MT] TIF Mass Tr 210 -0000- 448005 240.00 MST2007 -00165 [ERPRMT] Erosion Control 100- 0000 - 207307 88.00 MST2007 -00165 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 28.60 MST2007 -00165 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 28.60 Line Item Total: $11,200.44 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check J T ROTH CONSTRUCTION INC DEB 13175 In Person 11,200.44 Payment 'Total: $11,200.44 eRrreipi.rpt Page I or I Er CITY OF TIGARD 6/11/2008 13125 SW hall Blvd. 1 2:27:09PM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200700000000004656 Date: 10/17/2007 Line Items: GG9e, Fvres I_of S Case No Tran Code Description Revenue Account No Amount Paid MST2007 -00164 [CDCPLN] CDC Pin Rev 100- 0000 - 433060 46.00 MST2007 -00164 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST2007 -00164 [BUPPLN] Pin Rv Balance 245- 0000 - 433000 156.83 MST2007 -00164 [BUILD] Bldg Permit 245- 0000 - 432000 1,364.35 MST2007 -00164 [TAX] Build 8% State Surchrg 100 -0000- 207020 109.15 MST2007 -00164 [METCET] Metro Const Excise Tx 245 - 0000 - 229202 276.02 MST2007 -00164 [MECH] MEC Permit 245- 0000 - 431010 86.60 MST2007 -00164 [TAX] MEC 8% State Surcharge 100- 0000 - 207020 6.93 MST2007 -00164 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST2007 -00164 [TAX] PLM 8% State Surcharge 100- 0000 - 207020 31.92 MST2007 -00164 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2007 -00164 [TAX] ELC 8% State Surcharge 100- 0000 - 207020 22.30 MST2007- 00164 [ELPRMT] ELR Permit 220- 0000- 43I510 75.00 MST2007 -00164 [TAX] ELR 8% State Surcharge 100- 0000 - 207020 6.00 MST2007 -00164 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2007 -00164 [TIF -R] TIF Resident 210- 0000 - 448001 3,200.00 MST2007 -00164 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 240.00 MST2007 -00164 [ ELPRMT] Erosion Control 100- 0000 - 207307 88.00 MST2007 -00164 [ERPLN] Erosn Pin Rv CWS I 00- 0000 - 207308 28.60 MST2007 -00164 [EROSN] Erosn Pin Rv COT 245- 0000 - 433010 28.60 Line Item Total: $11,262.05 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check J TROTH CONSTRUCTION INC DEB 13174 In Person 11,262.05 Payment Total: $11,262.05 cltxcipl.rpl Page 1 01 I r CITY OF TIGARD 6/11/2008 13125 SW Flail Blvd. 12:26:53PM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200700000000004654 Date: 10/17/2007 Line Items: Gate. Eo (e5 -I1 0„o-- tO Case No Tran Code Description Revenue Account No Amount Paid MST2007 -00162 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 46.00 MST2007 -00162 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST2007 -00162 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 161.46 MST2007 -00162 [BUILD] Bldg Permit 245- 0000 - 432000 1,402.24 MST2007 -00162 [TAX] Build 8% State Surchrg 100- 0000 - 207020 112.18 MST2007 -00162 [METCET] Metro Const Excise Tx 245- 0000 - 229202 287.08 MST2007 -00162 [MECH] MEC Permit 245- 0000 - 431010 97.30 MST2007 -00162 [TAX] MEC 8% State Surcharge 100- 0000 - 207020 7.78 MST2007-00 I 62 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 399.00 MST2007 -00162 [TAX] PLM 8% State Surcharge 100- 0000 - 207020 31.92 MST2007 -00162 [ELPRMT] ELC Permit 220- 0000 - 431510 278.75 MST2007 -00162 [TAX] ELC 8% State Surcharge 100- 0000 - 207020 22.30 MST2007 -00162 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST2007 -00162 [TAX] ELR 8% State Surcharge 100- 0000 - 207020 6.00 MST2007 -00162 [PKSDC] SF Park SDC 270- 0000 - 450000 4,812.00 MST2007 -00162 [TIF -R] TIF Resident 210- 0000 - 448001 3,200.00 MST2007 -00162 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 240.00 MST2007 -00162 [ERPRMT] Erosion Control 100- 0000 - 207307 88.00 MST2007 -00162 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 28.60 MST2007 -00162 [EROSN] Erosn Phi Rv COT 245- 0000 - 433010 28.60 Line Item Total: 511,330.21 Payments: Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid Check J TROTH CONSTRUCTION INC DEB 13174 In Person 11,330.21 Payment Total: $11,330.21 eRecripi. l'age I of I