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Permit
k fi CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00155 M1l. DEVELOPMENT SERVICES DATE ISSUED: 7/7/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15105 SW 98TH AVE PARCEL: 2S111 CA -14400 SUBDIVISION: ALDERBROOK FARM ZONING: R -3.5 BLOCK: LOT: 008 JURISDICTION: TIG REMARKS: Addition. Other mechanical is duct work.Other plumbing is (2)rain drain connectors. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 425 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 TURD: sf RIGHT: 5 VALUE: 39,270.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 4 TOTAL: 425 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: 4 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 4 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 2 MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 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: I 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 00 SIGNAL /PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v:: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 1,073.38 This permit is subject to the regulations contained in the MIRCEA CERBU OWNER Tigard Municipal Code, State of OR. Specialty Codes 15105 SW 98TH AVE and all other applicable laws. All work will be done in TIGARD, OR 97224 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 670 - 4844 Phone: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing lnsp Crawl Drain /Backwater Framing lnsp Electrical Final Foundation Insp PLM /Underfloor Shear Wall Insp Mechanical Final Post/Beam Structural Mechanical Insp Exterior Sheathing Ins[ Plumb Final Post/Beam Mechanical Plumb Top Out Insulation Insp Final inspection Underfloor insulation Electrical Rough In Rain drain lnsp • Issued By : � = _ _ — :. A� Permittee Signature : „...._______„_____A__yi. Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day • 1, ' ; � Building Permit Apt E® FOR OFFICE USE. ONLY - City of Tigard 2004 Date/By: •110 IIMMI Permit No. H5rp - 40 /5 13125 SW Hall Blvd., Tigard, OR 97223 JUN Plan Review Phone: 503.639.4171 Fax: 503.598.1 eNI Date/8 : 7 Other Permit: en OF TIGARD , t r��E'l l !\ � Inspection Line: 503.639.4175 n i- U �� Date Ready :y: 0 See Attached Checklist for Internet: www.ci.tigard.or.us- BUILDING Dlvi i � Notified/Method: Supplemental Information - - :#'.�: -� - .p2`zygx =• - • r°a �k '�:"'"F.v ,°•: 2;,`ix"° �: x I*. .;r;A - - , . < .s. „:'� * sr ;' <:;r 'TYPE OF W®RT 7 , . , , . k , �' RE : UIRED. DA' *TA -dt: h 2 5 ;;, DWEI I: . ix.,' �; � - � a€��.�'3a� . .. :x;•��:a.. �..'�e �+�:,. .a„�*` ,�.'•.'��, ;:s�`�ri �`�a ST*n...,���`';',n `,:„ ����,.. �. Qw,` a�` ��. x�: �.4�...�x'3'.d:.�.��: +��: <;,z°;� "�3 .. :.. .. • ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all .. 0 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ” ; .. t � t O CATEf bRY O .,A m GO S ifC TIO§ ; ^- work indicated on this application. QO fi; ..,._ .,yam : . . .,,,.: -tr,4 A-A . . ,.- ,r".,," 3 . . ,.. , -. 4 ., a Valuation: $ • 21 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 0 Master builder • ❑ Other: Number of bathrooms: 4 :� it rR , n ,� re . ..:rz = i ` = . r : . is . , : .:_ _ Total number of floors: � `.:. `k < . ,, B T E w T N O . AT' IO N AN L OC I >.. ..., 3 _ Job site address: f 4 o f j G IA) 91 -\ A- V - New dwelling area: #,v square feet City/State /ZIP: 1 ‘ (j .R P l O R- 97 aa1.f- Garage /carport area: • square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: 't� 4{-A- U.- (( I V of,.. -, . Deck area: square feet 5: ��,, t .1 .-- g �j ET LE �e� ) Ai G� 4 — 914 9 1 �'(,∎ , R{/ Ol�ietrslrficfure a]tea: 2 7 square feet f t 1 UY�. � 9 AM- e ( k- -Ka_ f-' REQTJII2ED DATrA COIYIMER 21A1 - IISE,CHECI{LIST 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 3'T" `''ks r' a rA' d s .a,^" r � 'I +a R n 4 c a �� D �$GR1P -0,, 5 .,; WORK S` . s - „ 1. : a 3 work indicated on this application. �� ��. �;. � ` '�� x „n�',. � <,r .�'.�, r, . � ,- �s+ .: -� �..�� ' .� .mot. i`. � � - I� �s,. q�5 ' Valuation: $ Existing building area: a (,y 5-0 square feet New building area: 4 square feet ��- `1 a - J J PRO ERT,Y O,'N R ` r , , a ®' ENAFPT ,1 Number of stories: 4- m Name: M 1 GEP. '- DELI 4- V. Ce2e, u Type of construction: Address: i 5 4 0 6 S W Q g .f (,,.. A. V. Occupancy groups: City/State /ZIP: T G At-r24 l 0 IL q 7 a- Existing: Phone: ( -(:3) G o If1 "1 4 Fax: ( ) New: ' "li. '. fin o, 'PPIsICAIa?r; ro x , a. t E,CONTACT I'ERSO c ,, mm ,', l.:tr at c p'i :; , , i ..,. N Ho-; " Asti.. ' .,x t� eF :. W F., a .._. sar „#�U;` ' i � NOTI O E Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: p : ..” R .` p" l':: ``x<m^ ^ *x *, c '.4 Ut fi r& ..,` - ,: tea-s a r P; . • M- K k�€ _ �� �s•- 4< -as � '� -� .�'- ` ,. ,.€>,��r - �.t..> ,e, Business name: ( � /J °- Q -. �' G B IILDIN?G PERIVIIT,� FEES* ° r ' :; Address: Please refer to fee schedule. City/State /ZIP: d � cc/ Fees due upon application • Phone: ( ) Fax: ( ) Amount received CCB lie.: Date received: Authorized signature: OA_ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: bC A k & v Date: 0 .(J 9 .Pit * Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \Pemtits \BUP- PermitApp.doc 12/03 440- 4613T( 1/02/COM/WEB) One- and Two - Family Dwelling • ' Building Permit Application Checklist • FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No : 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 /dnmr,Ml� lei i 24- Hour Inspection Line: 503.639.4175 0 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us --'' ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No. _ N /A. 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 .Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control El plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 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 ❑ ❑ ❑ 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- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 \One - Two - FamilyChecklist.doc 12/03 Mechanical ;Permit AREIG riu .. FOR OFFICE USE ONLY - i• , City of Tigard .1S4 Received Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 A \.M Plan Review Phone: 503.639.4171 Fax: 503.598.1960 n AS; Satvan , 0` 1 & Date/By: Other Permit: Inspection Line: 503.639.4175 ov r( OVI*1%. III . ° sV4111/ Date Ready/By: Internet: www.ci.tigard.or.us ,.... ..„..... .......a BU1LM tj 1 I : Notified/Method: Suns 2 See Page 2 for Supplemental Information 44: ::,, , ' ,. 1 , i:FM,' , 47.S . '.,i - fi-If''„ , ,*?,A1 , 44., ....„,,,,,,,, ,,,,,- ..- -„,....:„.„.....,.„. , New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work 0 X performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ , A7t .,„. surrisiENTmsysnmslEr ., t Z 1 and 2 dwelling 0 Commercial/industrial 0 Accessory building :0x.m...%-n.r, • For special information use checklist 0 Multi 0 Master builder 0 Other: Description Qty. Ea. Total 1iai*7ftMO "VIM Heating/cooling Job site address: I ki)5 5 tki C‘ 9 .. -11 AI , . Air cires onditioning site plan or heat showing pump (requ placement) , 14.00 City/State/ZIP: 'Ti G Pc (LID 0 ()_ 6 17 A .24 Furnace 100,000 BTU (ducts/vents) 14.00 I • Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: 4+ I u ot . --5 ) avtAi- Duct work I 14.00 Hydronic hot water system 14.00 fix 5 e ri-E 12., -) (A et 11 14^ . Av.0 Residential boiler (radiator or kt A, ket li e.tA Ire ecu 0 irtA 1-- Et,--f--. hydronic) Unit heaters (fuel-type, not electric), 14.00 in-wall, in-duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue/vent for any of above ....4. 10.00 to- Other: 10.00 Tax map/parcel no.: Other fuel appliances , T W ter heater IF,Tietweevartkakikiii; 41:7105rwakr144:4P;:,,,,at.,.,,,:,14,F3k a 10.00 - SA,,,,,,, ia,A 14,:,, ,:::,.. 0.4,,, , .,,,tw 4u4„.: --, . .. --..,*- Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 • Log lighter (gas) 10.00 • Wood/pellet stove 10.00 Wood fireplace/insert 10.00 Chimney/liner/flue/vent 10.00 Name: N 1 (L cc o 4. .c. e Pr Y . c.-c.(ul. U Environmental exhaust and ventilation Range hood/other kitchen Address: It 05 t1,1 q t -ft. . ik- v . equipment 10.00 City/State/ZIP: 'fl &A-R__ j) 0 R_, 1 7 9-4 Clothes dryer exhaust 10.00 Single-duct exhaust (bathrooms, Phone: ( / G - 7 0 If 1cf z; Fax: ( ) toilet compartments, utility rooms) t i 6.80 , T,„:.'i.$:,„:' , 't,-1 , •.: , : -- % ,,, v,..., , m,;R,t++4 , , , ;.034.'...:. :!1,4;,:f: '4 i';'.,-V i,re6 Attic/crawlspace fans 10.00 q7.ZitirAtt;0 ' EVY:' - .: ''°2' Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Furnace, etc. Address: • Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E-mail: ' Range Ar!0 .4t4i-.2 r4.,svteiyzttivpiiiwtkretVL:4W Barbecue WIRL, ,mi:k,--.;:itwwat, --...„: 1 Business name: L.'3 .3 Clothes dryer (gas) • Other: wt.o.. Address: it- `4.I.F,MM..Ak§.g.,;. • '' . ' City/State/ZIP: Subtotal Minimum permit fee ($72.50) 7? . 56 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lie.: State surcharge (8% of permit fee) s`. O TOTAL PERMIT FEE ii Authorized signature: This permit application expires if a permit is not obtained within 180 ,, days after it has been accepted as complete. Print name: .. (,( t'c Oa 0 Date: 0 P • P 1 , Pil- . Fee methodology set by Tri Building Industry Service Board 1: \Building\Permits \ MEC-PermitApp.doc 12/03 440-4617T (11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: k al aluat gn R Perlin .Fee � . t . 3 : . $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof Note: All new commercial buildings require 2 sets of plans. i:\Building\Pennits\MEC- PermitApp.doc 12/03 2 Building Fixtureb GOV ED Plumbing PermitR.hhcation, . FOR OFFICE USE ONLY ` ' f ira City of Tigard AUN oo� R e Date/By: ived PemutNo.:vf,, - -' / 00 / 13125 SW Hall Blvd., Tigard, OR 97223 1IGARD Plan Review Phone: 503.639.4171 Fax: 503.59 OF ^1 // a $i\ Other Permit No.: �� ix � IhV�i) DateBy: 24- Hour Inspection Line: 503.639�1�Q, 7NG 0 c i . . _`' I I Date Ready/By: El See Page e 2 for UU __. ` W Y Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information , ' 4 ,' . , x . ` l iv ' , is p ax - a ag.P Ivor K.r H D. z IFPE OF• ^�O .__, ,�: A,..f� � ,. , . . - -: ��s� ;W _ _�c�.,rls.° 1 : , . , �.. � xa?.�.. � u'A. , s� <a.: E .. .. .- �s >03�..r� €_ sue. - rs�.��` ..a,.�.�a,e«:,.c :a u`s.,x , ... ❑ New construction ❑ Demolition For special information use checklist. Description i Qty. Ea. Total Ef Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ' CAVE ORR4OF4eSTRU IT®51YY , „ , SFR (1) bath 249.20 [533 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 _ , - El Accessory building ❑ Multi - family SFR (3) bath 399.00 " - Each additional bath/kitchen J4 45.00 j,, _ �:6 7 ❑ Master builder ❑ Other ; Fire sprinkler ( sq. t.) Page 2 " 44 e Il\i'ORiVIATION 14 `UGC `�fiION'k 4 ` Site utilities Job site address: 1 5 (Q 5 5 W 9 prV , Catch basin or area drain 16.60 City/State /ZIP: j j G t 2 t p IQ_ 9 7 • Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: 9 Footing drain (no. linear ft.: ) Page 2 ^ n I U Manufactured home utilities 110.00 Cross street/directions to job site: A-c_ 'J ,t 1 Manholes 16.60 0 � 011 G E rue 2 ) (IA It at 2. DI 'f4. Rain drain connector 16.60 t n ik- k et( k Oki e 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 ,ir o- "' . - : ' _ " DESCRIF, TI,,, ONt`a:V: ,� - s (, � "• 1 Backflow P g ,r ,� o ,. ,.n_: ..=1-....-, ^ . - .. 1.. .e.. , reventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 a , :p ;i m87 �, t,4.„ s« y , Drinking fountain 16.60 .� P1t O P EI� + OW LVER , t € _ ENANT �, �. - ��„ � .t�s`. x�r�a"w� *ems ae�� gym: ..,max �..,�t;.�i. 3 za Ejectors /sump 16.60 Name: M i R C EA 4. r Et A.. U CE2f Expansion tank 16.60 Address: 6 5 S A) Q t . -k, • A V . Fixture /sewer cap 16.60 City/State /ZIP: 'r( (. 4('D I 0 (2_ l 6 1 7 -2,2-41- Floor drain/floor sink/hub 16.60 Phone: ( ) G70 4144- Fax: ( ) Garbage disposal 16.60 it , i � � wa x; mev PLIC 3 .f• 1 co ONTACT ERSQN � z, Hose bib 16.60 ® .. « a ,.• ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin /lavatory dt 16.60 - Tub /shower /shower pan / 16.60 E -mail: Urinal 16.60 i s r "', ° ' ta } Water closet l 16.60 Business name: / ) e , Water heater 16.60 Address: l� Other: Subtotal City/State /ZIP: Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: • _/' TOTAL PERMIT FEE Print name: I)Ef i j C (ID) I Date: 0 •0 P .(JIB' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\PLMF- PermitApp.doe 12/03 440- 4616T(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: ,gtt i _ ` . s . ' °�Qtx a ,,gj (eaj ¢, °FotaY all )C O 1G ge . 4 ry ; e1 in�lt ee k,V t� .<. ..ee'. '�v:... t - 5.�. . "'..:41ti .�•`, 1 • Footing drain - 1s 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 ( Storm & Rain Drain - 1st 100' 55.00 ,r,AaIU-atlall, .PAC `k er,ut wee , $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 'XtUrEOItelll �. ° �Qy ... ;��a� �: alp 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) 9 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . M r Quanrt y by (Eix ure} Work Pet forme$ = Fixture Type I - t a �Replce . P A i 6404 �Ex>sxtn` Cape ; Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" -3" Car Wash Drain Garbage - Domestic • Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach. /Refrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:\ Building \PermiuU'LM- PermitApp.doc 3/03 �> � FOR OFFICE USE ONLY , Electrical Permit A p City of Tigard Received y g Date/By: MMI' 13125 SW Hall Blvd., Tigard, OR 97223 04 I B Plan Review Phone: 503.639.4171 Fax: 503.598- (s �_ 64e t Date : Other Permit: Inspection Line: 503.639.4175 .t �- e' ' I! Date Ready /By: Juris: I21 See Page 2 for Internet: www.ci.tigard.or.us d G 1N OF TIGARG N c Notified/Method: Supplemental Information , w S I .: ; O RK V ° " r e:. N .z'I" .te , � AN�REVI'Iv'„W � _. ,�, �" �Z" �'� „ t =- ...r -� 's � eo.n * a as:� �� - � • ` sa S ._,.r *t r ❑ New construction Addition/alteration /replacement Please check all that apply: ❑ Demolition El Other: ernce ov er 320 amps co ti g Bu ldng over 10 sq f ❑S amps, '1 ❑S a rating ❑ t., t e 1 � - g � �'4` of 1- and 2 -famil . 'CAT OR, kCQ C� SI'R, LIt ON � '� . &* y dwellings 4 or more new residential Z 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories EFeeders, 400 amps or more ❑ Multi- family ❑Master builder El 'F ;,.,,,. ,a ,.t ";... r.«; N a: �;> , .:. RV. park P red structures or _ ❑Occu load over 99 persons Manufactu - ; , _ 1: '. r J®B ITE II Y' FOR "N A TCO rA ND Iti IOP k m - ` ❑E gress /lighting plan , �... r , §- 9v. -n a ,4S , ,a,§ r�rrm3.r. . m „ „,,,,„,' tcvm •A. a.,..,..a >. :..csa - ,.. .....a = 4 .�t4 ❑Health -care facility CI Other: Job no.: Job site address: L rj 45 E (J $ - �tf Submit 2 sets of plans with any of the above. City /State /ZIP: ( I G A-AQ_ D l Q 2 c 7 .9--.2-#- The above are not applicable to temporary construction service. ?:I „ F ?E*�,SC171071 1 741 " ;•W r , .r, . Suite/bldg. /apt. no.: Project name:` ._: " _ �.. - nc- .� ",. ; ._ . - Description Qty. Fee. Total Cross street/directions to job site: i LL S ( v . -- New residential single- or multi - family dwelling unit. _( p ,�• / Includes attached garage. (1n 1/(A- - \ VI ,f CT(,E IIL —) Mcyl i eZt I 1 .f ti .4 f 1,000 sq. ft. or less 145.15 4 Subdivision: D Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 Mill 125, 00174M.01014 WORK:. "" :- ,I, AfiallInti Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 e any i l l a , �- 201 amps to 400 amps 106.85 2 ,' PR,..- '' `'O V�ER s TENAN i` V ,. = " i j- `K . , X.: ,l_ - ,w , ,�' . >s" : 401 amps to 600 amps 160.60 2 Name: M 1 2 c e A.- 4- t) EU is- (f . CE2% U 601 amps to 1,000 amps 240.60 2 Address: ' 5 ^ c S W q g 41-U , Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: IT & Qt 1D 0 ci 7 0 2,24 Temporary services or feeders installation, alteration, and /or Phone: (5p1) 6 7 0 11 $ i I Fax: ( ) relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, change according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: _ .' • Date: 06 • of . 0 T Branch circuits — new, alteration, or extension, per panel ' ' - ." irk r xm A . '' "�` ''� 1' "''F 7i ` A A. Fee for branch circuits with " 'as >,� . � t,.,�. A PPI IG r v � EO ITA.CT PERSO�Nti >" r � � serv or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'1 branch circuit 5 - 6.65 , 2 City /State /ZIP: Miscellaneous (service or feeder n t included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - �� z " e " r ` l"" s energy � � °�° � �� t CQNC*,^x ®R:3�, � ,�`� <��at�s � "� �i� gY P anel, alteration, or f ur. .1., . Fi�Srr.'3s- n, `- «.; >+. , ,aF ..,..,.1'as_,�#,. _.•.� m,.. '"=; extension. Describe Page 2 2 Business name: n 1,0 0 e_) Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 :..- .. TAY6 of _ I EGTRIGATXPFD PI`f ?FE`',ES* . tik'.ri: , ...;r; _ CCB Lic.: Electrical Lic.: Suprv. Lie.: Subtotal • Suprv. Electrician signature, required: Plan review (25% of permit 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 \Pemvts\ELC- PermitApp doe 12/03 440- 4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls H Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls I Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i.\ Building \Pemnts\ELC- PemtitApp.doc 04/03 • Permit #: (v\SaOO 4 - 00 L 5S OF O 1�""rrte� � QF Address: 16 (D S SL) c A J F 3 Issued b .4 ' __ Date: 7/7/a, 1859 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: pq , 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. n 3A. My general contractor is I I (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 K/_2 3B. I will be my own general contractor. 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 ,s rrect and that I have read and do understand the Information Notice to Property Owners about Constructi ' esponsib'lities on the reverse side of this form. Mir (Signature of permit applicant) ( ) (White copy to issuing agency permit file, pink copy to applicant) • lIngorm;.tion NOUce to ProperRy Owners About ConstrucUon Mespons'ORMes 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. EMPLOYEE RESPONSIIBILMES: 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 more 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. Untertrk :11 ikevenue 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 RESPONSOBilL11TOES AND AREAS OF COMCEAM: 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 accident3 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.p m4 1 /94 June 17, 2004 Delia Cerbu 15105 SW 98 ave Tigard, OR 97223 RE: Addition to Single Family Dwelling Project Information Building Permit: MST2004 -00155 Construction Type: VN Address: 15105 SW 98 ave. Occupancy Type: R -3 The plan review was performed under the State of Oregon Structural Specialty Code (OSSC) 1998 edition; the State of Oregon One- and Two - Family Dwelling Specialty (OTFDSC) 2003 edition and the Tualatin Valley Fire & Rescue Ordinance 99 -01 (TVFR99 -01) 1999 edition. The submitted plans have been reviewed and the following information is required prior to issuance of the permit. ) The 2x6 ceiling joists shown in the cross section exceed the allowable span for such joists. The 4x4 beams shown sitting on 1' -3" plates at 6' o.c. through the existing garage exceed the allowable span for such members. X 2 The 2x4 and 4x4 stacked at the mid point of the new addition areas are shown to be sitting directly on the soil and do not provide adequate support for new joists. All floor framing and joists must have 18' of clearance from the ground and beams and girders must have 12" of clearance or such members must be pressure treated or decay resistant. X The under floor insulation must be protected with a black 6mil. Plastic ground cover and shown on the plans. Regular r -25 batt insulation will not fit in 2x6 floor joists. Please provide information on how under floor space will be insulated to min residential energy code Path 1. K Footing and foundation walls in seismic design category Dl are required to have (1) #4 rebar in the top 12" of the stemwall and (1) 3" clear of the bottom of the footing please show on plans. Crawl spaces must be sloped to a low -point drain and have ventilation per sec R408 of the OTFDSC. Please show prescriptive lateral bracing on plans or provide engineered lateral design. moke detectors are required in all sleeping rooms and outside of such in the ediate vicinity, please indicate smoke detectors on plans. lumbing permits for additions are done on a per fixture basis, please amend plumbing application to show number of each type of fixture to be added or moved. • When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Some of items above can be drawn in on the plans as we discussed at the counter but many of them need to be revised on the complete sets of drawings. Please feel free to contact me at (503)591 -9811 Respectfully, Mark VanDomelen, Plans Examiner City of Tigard n flu. JELYj (77Ljt j44L� Jun. 11 2004 09: 57AM P1 w , +�� ► f n FAX N0. : 5034920334 S r i Jun. 01 2004 10:50AM P1 • 4` 204 �' ri 0 1_t', ((. 1 1 11 \ i : i I-1, Filly Number kill. 1 ' .18 hall f`. Services ��� ,, ra,.rt. ii, A.4.r. Sensitive Area Pr - Screening Site Assessment ,i 8 fay. _ t .Q4.O ' Jurisdiction rt C- � W Data , Map & Tax Lot , Jil • L r .11 r . owner u Site Address 100 , Ma, __I ) U P2., TTOZ� Contact rR'i Proposed Activity _ Address _,q 4i11:3; Phone a 0-111: __ • _ , OIIMIuI atise only Aarow Ibis Una .. �__ . __ Y N . NA . . •-- - .. .Y N NA, - -- Senetfvs Area Composite Map Stormwater Infrastructure maps Q a Map # 'Z IOJr� in QS #_4 „•,._,.. p Locall adopted studies or maps Other © Specify Specify Based on a review of the•abova Information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No. O4 -91 0 Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required, 0 Sensitive areas do not appear to exist on site or within 200' of the site. This pre- screening site assessment does NOT eliminate the need to evaluate and protect water quality aensitive areas if they are subsequently discovered on your • property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED, THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATER CONNECTION PERMIT. ff , 0 The proposed activity does not meet the definition of development. NO SITE P. ' ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. ti Comments: . ~ Reviewed Sy. Date. • �r�.i 7 •d' L.—..,_. ,, Returned to Applicant Maid' Fax Counter Date /,�.. Jly zees SW Sillsboro highway • Hllisbero, Oregon, 27123 Phone: (603) 681.3606. pay; (603)601.443e • Vc 61st► tep1"tvicc NE Y n CITY OF TIGARD II BUILDING DIVISION PERMIT #: MST2004 -00155 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/7/2004 Phone: (503) 639 -4171 - ' ffl I�ui��,it iiii Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/26/2005 TIME: 7:07AM PAGE: 54 SITE ADDRESS: 15105 SW 98TH AVE CLASS OF WORK: SUBDIVISION: AL.DERBROOK FARM LOT #: 008 TYPE OF USE: PROJECT NAME: CERBU DESCRIPTION: Addition. Other mechanical is duct work.Other plumbing is (2)rain drain connectors. 12/01/04, added (1) service panel to scope of work. OWNER: CERBU, MIRCEA , PHONE #: 503. 670 -4844 CONTRACTOR: OWNER - PHONE #: Inspection Request Scheduled For: Date: 7/26/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 012126.02 503. 670 -4844 N Corrections /Comments /Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL — NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ' Inspector: hr) Date: 0 A I . Phone #: (503) 718- CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2004 -00156 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/7/7004 Phone: (503) 639 - 4171- �d7Uu�ioll &i�i!- Inspection Requests (24 Hrs.): (503) 639 -4175 ....._n" INSPECTION WORKSHEET FOR DATE: 8/4/2005 TIME: 7:08AM PAGE: 40 SITE ADDRESS: CLASS OF WORK: 15105 SW 98TH AVE SUBDIVISION: ALDERBROOK FARM LOT #: 000 TYPE OF USE: PROJECT NAME: CERBU DESCRIPTION: Addition. Other mechanical is duct work.Other plumbing is (2)rain drain connectors. 12101/04, added (1) service panel to scope of work. OWNER: CERBU, MIRCEA PHONE #: 503 - 670.4844 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/4 /2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 01281302 5503. 670.4844 N Corrections /Comments /Instructions: D nisi' — A-i7 S 5 _ 20 0 ,- X OJLf, a— QP oL .\1 ?"( PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL (l ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 8 `4' Phone #: (503) 718- 4 Y OF TIGARD .. UILDING DIVISION PERMIT #: MST2004 -00165 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/7/2004 Phone: (503) 639 -4171 J a�nd�4Ni��;ul6�Wi i , Inspection Requests (24 Hrs.): (503) 639 -4175 J INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7 :08AM PAGE: . 41 SITE ADDRESS: 15106 SW 98TH AVE CLASS OF WORK: SUBDIVISION: ALDERBROOK FARM LOT #: 000 TYPE OF USE: PROJECT NAME: CERBU DESCRIPTION: Addition. Other mechanical is duct work.Other plumbing is (2)rain drain connectors. 12/01/04, added (1) service panel to scope of work. OWNER: CERBU, MIRCEA PHONE #: 503 - 670 -4844 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8 /4/2006 Pour Time: Code # Inspection Description Co firm # Contact # Message 199 Electrical final s 281 01503- 670.4844 N Corrections /Comments /Instructions: • EZ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ A FOR INSPECT ON ❑ ADDITIONAL FEES ASSESSED Inspector: Date: < 4' Phone #: (503) 718- Zy.t • r �1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004- 0015 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7f7/2004 Phone: (503) 639 -4171 u�lml�iip� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/26/2005 TIME: 7 :07AM PAGE: 55 SITE ADDRESS: 15105 SW 98TH AVE CLASS OF WORK: SUBDIVISION: ALDERBROOK FARM LOT #: 008 TYPE OF USE: PROJECT NAME: CERBU DESCRIPTION: Addition. Other mechanical is duct work.Other plumbing is (2)rain drain connectors. 12/01/04, added (1) service panel to scope of work. OWNER: CERBU, MIRCEA PHONE #: 503- 570 -4844 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7!25/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 012126 -01 503 -670 -4884 N Corrections/Comments/Instructions: `PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / g Phone #: (503) 718- , t