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Permit $ _ a '��� OF TIGARD MASTER PERMIT i ;t r I V PERMIT #: MST2008 00012 COMMUNITY DEVELOPMENT DATE ISSUED: 3/21/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25111 BC -05000 SITE ADDRESS: 14730 SW 103RD AVE ZONING: R -3.5 SUBDIVISION: MITCHELL- GALICH PARTITION LOT: 002 JURISDICTION: TIG PROJECT: YOX Project Description: New SF BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 15 FIRST: 2,362 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 737 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD' sf RIGHT: 5 VALUE: OCCUPANCY GRP' R3 BDRM: 3 BATH: 3 TOTAL: 2,362 sf 256,486 10 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 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: 1 BOIUCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 5 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF. 3 201 - 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 HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /vott : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: • BURGLAR ALARM: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: • GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable ROUNDSTONE CONSTRUCTION CO. ROUNDSTONE CONSTRUCTION CO laws, All work will be done in accordance with approved plans. This 9550 SW BEAVERTON - HILLSDALE 9550 SW BEAVERTON - HILLSDALE HW permit will expire if work is not started within 180 days of issuance, or HIGHWAY BEAVERTON, OR 97005 if the work is suspended for more than 180 days. ATTENTION' BEAVERTON. OR 97005 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 - 619 - 4668 Contact #: PRI 503 - 619 - 4668 questions to OUNC by calling 503.246.6699 or 1.800 332.2344. FAX 503 - 526 -3548 Reg #: LIC 163040 TOTAL FEES: $ 12,628.91 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 • Issue. By : / I : d %, P ermittee Signature : 1� Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. .Building Permit Application I � FOR OFFICE USE ONLY `J Tigard �'? Date / (/ f; �t City of Ti and Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 , 't ` • -, Plan Revie ' : Phone: 503.639.4171 Fax: 503.598. '9 0 °' 4'_ _ Date /B : I i Other Permit� C ; TIGARD Inspection Line: 503.639.4175 4 I D.te Ready /By: �to /jam 0 See Page 2 for Internet: www.tigard- or.gov t` ' ' — feed /Method: y/ rd Supplemental Information c't ..a \` 1 . ::.o-,.. a„ a., � . ter" = e a•,v� , : . �,� _; ,�>r Y 2:"i 1'* :�r'i` R :2- A1VIh DWELI��ING�,'.� �`�RE'\' I ED5DA1�i :1-= "AND .F L TYPE =OF��,WORK':'�t�. '�, "= ° .0 h � Q [ New construction ❑ De I{�avh2 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 -`" y work indicated on this 1; fr ;i : t ' application. :�x �(�� t �,, •,G O � <� '" . n., .. .. , ,... ��:•,% i i: 211.- Valuation: and 2- family dwelling ❑ Commercial /industrial ' El Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 2 !Z 3n C.. Fi3, _��C� s `� ci.£•�;- ,Ta'ij r ,, .. : <,4'l f.; •..s;= '} " °,,: 3 <'l. vxi.`.e y :�o: -''' ,.., ,;i K3` _,. : :s %,_;� ,� s,;% ,, -' : Total number of floors: JOg S ITE IlVFORIYIATI(. ;,, - D , -' ;LOCAT ION,,' S ' Job site address: - / 9 3 0 S W l 0 3 `' ) New dwelling area: 2 33 0 square feet City /State /ZIP: 777a4&i d—v' 9 7.;1-,2 Garage /carport area: 5 2 "] square feet Suite /bldg. /apt. no.: Project name: Ye) x Covered porch area: 1 3 2 square feet Cross street/directions to job site: Deck area: square feet C 00 rr/,�,.1 - f — / 0 3- Other structure area: square feet =REQ J iRED DATA -,COM REIALAISETIIECI{tIST : ,:. Subdivision: Lot no.: 2 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 �`e;,; «a > >' '�:� :a� >�: .� „ �- it'�';t.' ;.Y�:T tip, ” work indicated on application. �- '��''.�'w` ";�, ork Indic e o thi V S3� �`Hr , 3, . -' DE ; OF ,WORT . `M. ' t'r �� r .....,, ^ Valuation: $ Existing building area: square feet New building area: square feet pW `� ?•:TENANT,' ° <° Number of stories: X4;3.,. ;3 as,�•- „t� ,t "jbr„»g;Y't`�,:q,l., /� <r'1.'a?ai:�i�e',�,,5 �`: % „r -, Name: (Round i- CC:Yt S - co • 5 r Type of construction: Address: 9' 5.5 ( ik) � 1, O1 ( &L Occupancy groups: City /State /ZIP: O �j� 005 ) Existing: Phone: (`j63 (:7 I I — L / (l,6, 8 Fax: (e73 52.C, 3 se--/ New: ,.ti,; >N' °' ,pia'; ,`:' ,R: , — ,:��.,. 7 .' F ;'l�' ° ''t'= '�, ^D : ::�-- ;-o =,' r:�'.83';1a. 3 v,,. A ' PERS =�: °J' EAI' T'':�` fit , C.ONT G°I' O r <. , f. , ..,,.=,-:: = ,�U <,�,,' . CAN _h ° , :. _, m'..v{. :' ���;- ?1 ni = NOTICE ; . ; ' .,;: Business name: eOLJ d 5 & Q'l All contractors and subcontractors are required to be Contact name: (Q licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 3-6 6 /{ i-y-/ ,G ..146 jurisdiction in which work is being performed. If the , City /State /ZIP: - 4 '70°5— applicant is exempt from licensing, the following reasons J p apply: Phone: (_,�j3) , 1 � t 6,�s� L Fax:: (j-63) 52 ('—`�, 55' E -mail: (• 4 O . / na / SJ% , 6''' C eig (s a l �sl ,�i� ,.,'._ z' s:t3 ra ag , � � M& :'-�.. ...iii % : 4 , Business name: CONTRACI?OR ', [ *Erica' ^•. "sS. i� 1— ' R ) /��� � q lS�/ /t � ` _ � ���c � 'Bl 3II�DIIVGrPERMIT P�+EES -s:;"a aw l �x;} Address: i ,.. ' : >• Y,z - .,,.,,:•(Please re(er,t he e): i ° ra < n40O 3, :. :: Structural plan review fee (or deposit): 750 • City /State /ZIP: % / / ; Fax: (, —365 FLS plan review fee (if applicable): --1:5' Phone: ( j C (9 -4 ' 4-2 ( CCB lie.: 7103 G D �� ' Total fees due upon application: 756 Amount received: 7 CJ Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 61 'eire „-j 8s ivi Date: 2 a * Fee methodology set by Tri -County Building Industry Service Board. L \Building \Permits \BUP -RES PermitApp doc 11/6/07 440- 4613T(I l /02 /COM /WEB) • , Electrical Permit Application , FOR OFFICE USE ONLY "&, City of Tigard , 7) Date/By Received Permit No.: r ei .*,-., ' 4 - . 13125 SW Flail Blvd. Tigard, OR 97223 \ A Blvd., ' _ Z • Phone: 503.639.4171 Fax: 503.598," .■-"' ,,,P , III Plan Review Other Permit. (A) , - TIGARD Inspection Line: 503.639.4175 ,,,,,, \ 2---1 - ) Date Ready/By. Juris: - 10 See Page 2 for Internet: www.tigard-or.gov \ -'. O Notified/Method: Supplemental Information iVil# . 4... :14- Ak: ,,,,;,,', 04aq' 4 T ' 'RKY New construction Addition/alteration/rgAide ' ''' ''''''''414.rgi '';-*"; , ,'' -r7 EVP,Wgitlalr i , 49Ae.''," ; ;..:. 0,,4E: lYtC401 f- entOx ,-4 A. ' ' ' - -- - Please check all that apply (submit 2 sets of plans w/items checked below): IQ 0 C 0 Service or feeder 400 amps or more 0 Building over three stories. , 0 Demolition D Other: G \10#1' where the available fault current 0 Marinas and boatyards. . 4„; T., ,,,,,,,,,,, kA ,mikt. ,40:',,, exceeds 10 000 amps at 150 volts or 0 Floating buildings. Ilk,,,-,:a4SZ.:'2717T-41' 4 less to grou or exceeds 14,000 0 Commercial-use agricultural EEC 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or . ,, 0 Emergency system. larger separately derived system. t,,. :aolgw,:i:AiTaf W ' ;;111;k;:;' , NIA 0 Addition of new motor load of 0 "A" E - I-3 - , • Job no.: Job site address: / ea.. 100HP or more. occupancy. /.../ .73 0 , /0) 0 Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: -- I - 7 ) -,4,61 077 7..2-.)-4/ 0 Health-care facilities. 0 Supply voltage for more than 0 Hazardous locations. 600 volts nominal. / Suite/bldg/apt. no.: Project name: y 0/ 0 Service or feeder 600 amps or more. uriAtiA: f*gifkt1t0,4k,citigc Cross street/directions to job site: Description I Qty. I Fee. I Total I . i14.12--- New residential single- or multi-family dwelling unit. al ca (kohl f /6)3 Includes attached garage. Subdivision: Lot no.: 7_ 1,000 sq. ft. or less / 145.15 4 Ea. add] 500 sq. ft. or portion 3 33.40 1 Tax map/parcel no.: , , Limited energy, residential 1401i:it;44,11E1*' (withabovesq.11) j 75.00 2 Limited energy, multi-family A F residential (with above sq. ft.) 75.00 2 C. Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 V": ..--itr:rrTrgVAF°W,It:';:'';'01M W ' 'iMii'13 'Ss1V3'.0"`v 201 amps to 400 amps 106.85 2 Name: 4) Ild Es k C, .. 401 amps to 600 amps 601 amps to 1,000 amps 160.60 240.60 2 2 Address: 9 O 6 , j etch? /4//s4(a4 674ly Over 1,000 amps or volts 454.65 2 City/State/ZIP 5- Temporary services or feeders installation, alteration, and/or : , ';,--- 970d relocation Phone: (51t3) 6 tei- I - i (_,. c Fax: (e..Z3) 52.6,-35tik 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: ,.-- . Date: A. Fee for branch circuits with prigil :Iiij it,M11"gfria:401,?,:fiai above service or feeder fee, 6.65 2 each branch circuit Business name: , „ A . , 6 I. 6_,‘., , B. Fee for branch circuits without service or feeder fee, Contact name: -1-ce 4 .5 cr) first branch circuit 46.85 6 2 Address: 9 _Ckj i3V 10416 - Each addl branch feeder not included) ch circuit 6.65 2 i' ` 41 6 Ac Miscellaneous (service or City/State/ZIP: /.3- /01 ( 6 /7 y 005--- Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: c9 & icy- £j% 6a Fax: : (1 52( Reconnect only 66.85 2 E-mail: 6•-tetrt4' 2 4o0m1161-e -Ccro Pump or irrigation circle 53.40 2 titil'OttiketO.M,-SRAVIMANET: :AMIN111:14 Si or outline lighting 53.40 2 1 s. Signal circuit(s) or limited- Business name: 1 .. IS( I ( 61,6 6 _,44zA._ . energy panel, alteration, or Address: e 0 . 6 ,,, ,c, extension. Describe: Page 2 2 City/State/ZIP: - kb/9a.ed 6: 9 '740,3 .), Each additional inspection over allowable in any of the above • Per inspection 62.50 Phone: (57,t3 ) c&-/ _14 vo Fax: 07)) 9s, / .,-_/ , 4 . Y...., , .. , Investigation per hour (l hr min) 62.50 CCB Lie.: / (# &/ / Electrical Lie.: 7 C_ Suprv. Lie.: Industrial plant per hour 73.75 .9 4fAi..Ttg'iLP.Wclill:WWiktg::gtftEtkqa'OV!::',24i Suprv. Electrician signature, required: - Subtotal: ,Cil...--- - 1 Plan review (25% of permit fee): Print name: C 0 r .1 - Crztr6 Date: •,,/ 4„ 2 / State surcharge (12% of permit fee)• Authorized signature: .==:'..---------------" TOTAL PERMIT FEE: n_..... - This permit application expires if a permit is not obtained within 180 Print name: -6 5 cn Date: i 2- -co- days after it has been accepted as complete. * Number of inspections allowed per permit. 1 ABuilding \Permits \ELC-PermitApp.doc 05/23/06 440-4615T(11/05/CONI/WEB Mechanical Permit Application FOR OFFICE USE ONLY ' Received City of Tigard Re e Received • Permit No. �la� — : Q " 13125 SW Hall Blvd., Tigard, OR 97223 \ 999��� Plan Review 111‘ - Phone: 503.639.4171 Fax: 503.598.1960 (\ , �' Dafe /By Other Permit: 56A . �7 . _ / TIGAR.D Inspection Line: 503.639.4175 �� } J. ) Date Ready /By: ]uric El See Page 2 for Internet: www.tigard - or.gov . G n �: otified /Method: Supplemental Information „.4, 15,e <r nom•, i., a '"+��- �. "�+ -. P'�`� ; 3 r•;�,. :� ��,:•. ,::% ”, _ '. F.E -... -UCE _USE CHECI{LIST' . -..- , ::::.,3 r1. -. . TYPE,.QF " °WQ K �g,�f „�.,�.... -. COM117ERGIAIs CHE D ,.F.., ..,��- °-- ,�.,,.t. _...., -• m',z:,..;���� c °: >•` ;. -. • .: 'M9 ";1; "�`��i�?'. ^a- ���r`� = =`.v a °•.� .. .,. ... :e= :�nw.,z�.:�• -- _..... ,. .. M.. . - . -. m���,- r,,<,...,.a.. ,. 3- `t? pemit wk New construction El Addition /alteration /re�Ihch e`i� ��� �! performed Mechanical Indicate r fees* the value are based (rounded on the to value the nearest of the dollar of all El Demolition El Other: mechanical materials, equipment, labor, overhead, and profit. 1 . : ° Value: <•1'i3,;,' ,•��'. , sR , r, £ui.A „s ""�: , : "i,;;i<< • F :' , >r =a S AT x G RY:.O .i ONSTRU 1 s;• ;RESID CII EQUIP -117EN T, / S�'S E ES, * ;' , l and 2- family dwelling El Commercial /industrial El Accessory building " ° °' : -- v., ;.. <s;, ..:., For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total fJOB ^ T E INFORICTI IA Nir4* liO .0m, ,f " aaa, ° ' �H ... - , „�. - <a..��,:,�,•rsr .�. - .. y: ... ,, .... 0 :. � -- . -��� ,� �� �:�.,; � °�,�., Heating /cooling Air conditioning or heat pump Job site address: /0/730 5 _.j) 3LB (requires Site plan showing placement) I 14.00 City /State /ZIP: -72 6)1- 9 7...4)--y Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 1 17.90 Suite/bldg. /apt. no.: Project name: yOic Gas heat pump 14.00 Cross street/directions to job site: Duct work i 10.00 //// - Hydronic hot water system 14.00 ni e lk..). ,ti i -t-' la) Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue /vent for any of above ) 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances ,< _,. ;` '" Water heater 10.00 '�s,�.- D,ES,CRIPT'IClIV " �Ok';H;R>ORIC ,. Gas fireplace 1 10.00 /Vat/ f a Flue vent for water heater or gas fireplace . 1 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 ;, I Chimney/liner/flue/vent Wood fireplace/insert a, "i' 1,�`W:: _ „��,, � �z:. Chimney /I' 10 00 20_PER*,A# NETi;;= it :'<: ENANT<rn;:,r ,... „w '.`:. Other: 10 00 Name: gnu 4 d i 5 entsrj C„ Environmental exhaust and ventilation � J � , 4— Range hood /other kitchen Address: 9 „3,.., g „, /'`r �/�G41,4 ,A., equipment t 10.00 City /State /ZIP: by et ; /9 /` - GI `�1 ®� Clothes dryer exhaust / 10.00 (J Single -duct exhaust (bathrooms, Phone: (5Z/3 ) 4, (g-. X16. Fax: (593) 5:24,-35v ” toilet compartments, utility rooms) `1 6.80 a•: ;:, »% :` `.,`;,�:,,°, SZ .. i ravels % -f'` - ._?E' , % , I - - Att c/c ace fans 10.00 p F�: �:- � �'I'_I'IICAIVT� �,° �, � ° [G r ON�TACTy. P , ..:....� <, • ,l• ...�: r- 1a- tea..... - x ,,, .���z;w -. ......-- . -:.__ .,, ....;,�a Business name: / Other: 10.00 ©�l�/(� t(� C.K., - Fuel piping Contact name: c _ ..f , e t e `'” l � , / $5.40 for first four; $1.00 for each additional Address: /5 r'" 4/ Furnace, etc. te c> � �fG �e�,� / SStr �/a �} � Gas heat pump City /State /ZIP: Y� ! Wall /suspended/unit heater Phone: (!% 6, /1— of 4e% Fax: j : (173 )526 ?JeJ4/f Water heater ri Fireplace / E -mail: LJ Range t! 0:02:_':`Y ° -i Barbecue �?,, , RA ,� °. €;�,�r • _ Business name: f� n� L � Clothes dryer (gas) t ll�� " "����''''�y�y�����'� "''' �.` -""' Other: Address: 3� ME IAIVICA °L' PEItiti111 FEE *; < `: 5° - r . 33 R City /State /ZIP: et l Lt ,C7 q 7 /J / Subtotal (5)� ) Fax: 6131,— /q ' ( ) 6 3 � Minimum permit fee ($72.5 fee) Phone: Plan review (25% of permit fee) CCB lie.: i, 2 6,7 -.? �" �M.64-d __5 C/ State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 g days after it has been accepted as complete. Print name: ' ���� /� Date: , _ 6� * Fee methodology set by Tri- County Building Industry Service Board 1 \Building \Permits\MEC- PermitApp doc 01/19/07 440 -4617T (11/02 /COM/WEB) , Plumbing Permit Application ;, Building Fixtures \ \1 - - _ FOR OFFICE USE ONLY - 14 City of Tigard * ,„ } Received Permit No.:�S�7�- ! c O /2 v v 13125 SW Hall Blvd., Tigard, OR !7 23 �� y v ` Plan Review �y�p tg/ Phone: 503.639.4171 Fax: 503.598.196Q r, � �o Date /By. Other Permit No.: r ( �ive.'� `) -- tQ Inspection Line: 503.639.4175 �c, P+ TIGARD r � ra ° � C� *ate Ready/By: Juris: 0 See Page 2 for . .. Internet: www.tigard or.gov , f V F nA N ot ifi ed /Method: Supplemental Information - w. . v , . . �w „ ". , , .. - , .. �<- .... ° , M , ,.. .. . �,..."� >, � F FLED � °`i� "',,. :� �. TI E..OF' WORK °�..:� s� 3iz - EE* SC LIliE . "t:.�:, ��::> New construction ❑demolition For special information use checklist _ Description Qty. 1 Ea. Total El Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) ,`: <�'" sy GONSTRt?ICTT , �= ;.,:: " t ar,..�,,.. SFR 1 bath 249.20 s } "" ' ;,. _ "..:, ' 4 'r�,°„v>� �.r��:� * "�s,�a � , -xz �_-, .��.nt,,.,� =,o � ��4: �zTbs.�, ( ) 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 CI Accessory building ❑ Multi - family SFR (3) bath j 399.00 Each additional bath/kitchen 45.00 El Master builder Ire sprinkler 2 Other: F' spr kl r ( sq. ft.) Page ;,1 , >• is ,:, ,. ':JO S IT :`I1Vjt <ORiIaATiON AIVD LOCATION°;`,,:; °. A�,,:�� .... ... � " . .•._� � _.�..:�, =c� =�.� , , _.. M.:s��,:. - ..� »,��: = E�''' -: '���z Si te u t i l i t i es Job site address: ,/ ,,,,, /D 3 - Catch basin or area drain 16.60 City /State /ZIP: •7 ri.(/j 07/ 97.))-i/ Footing leach line, or trench drain 16.60 Suite/bldg./apt. n o.: / Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 M e-Puked" 7 /t0 / Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: _) Page 2 . Fixture or item Tax map /parcel no.: ° , °°, °.: ,,,: ",.,;;:: <.. �,� ,� Absorption orpt ton valve =`DE� ° 6:04 'OF': WORK:".:::. t 'i , ...,.:� ,:,,>3��.. . > ���, ti ".;, .��,�� _ �Jb... ,3,�t„e %.�.� �.�_�s�� �,a;tm _....�.. ....� Backflow preventer g A) , t .5 =ir< Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 lz;3a.'= ; r: , s ;r..,;, = =t a... ,... < ,"y ril- Drinking fountain 16.60 , is i � y�,: r „'� =.a. <: - [;... > iE ; ' "ROPERT, 17WER., S.,,, " " ".:' ° °_.. � .. ",. , .��h =,:,,,,,,. ..:::,{� ". .� . _� ... , ° � � ::_ ",: `��`'; l3 °,.; } ".��',,� :: ". �p,Ir °; -, - Ejectors/sump l6 60 Name: gn1 ) , (.l ne. c, y' Expansion tank 16.60 Address: /. 7 ,3J f �, � (_ Fixture /sewer cap 16.60 City /State /ZIP: f e (5"// q 7d 05- Floor drain/floor sink/hub 16.60 Phone: (D3 ) (,o (/` 116,44 Q Fax: (573) 4d'�'3.5-yd'i ar disposal Garbage dis o 16.60 -t Y.:ryS `. 2 ,Q V f� °;ism:.: .." .•" <: ,v.-;.;,rt. ,,_:" . Hose bib 16.60 [I PLIGANT ?;'' ;ONTi� "CT >PE r.�C -,.. w... ; ,�%.�...:.�K <- y.v�a;,, ,Kfi > ? °..�,, ._..�, ,°,.aA m,� °,<..a�. " "_;;3' Ice maker 16.60 Business name: f�� G (_'� 4 , , V Interceptor /grease trap 16.60 Contact name: 4 6 1: iffy rAsel . t , / Medical gas (value: $ ) Page 2 Address: i 5:5 ��) i g o ,.�, �/-,/4 `"/ Primer 16.60 City /State /ZIP: ` /Lit- q 7 " o �� ds - ���"""lll r "�_� Roof drain (commercial) 16 Fax: : s Sink/basin/lavatory 16.60 Phone: ( 3 ) L 9_ 4/6 L / () (° ✓ °`s Tub /shower /shower pan 16.60 E -mail: £ t Q. i n S77JYt(�/d dl #1 Urinal 16.60 Is�� Y, CONTI2r1GP 'U ;_� >h..- :: __:� x =: " `�� Water closet 16.60 �.; Wa e ose Business name: J . Water heater 16.60 ` L PL, .� / . /„ 1,r - '73 7 . „. 5 ,,,, GL v /�:.5 r/ ., , Other: Address: 7 City /State /ZIP: 6 £ 6' 97Or Subtotal M inimum permit fee: $72.50 Phone: ( ) � ify - g6 91 Fax: (4-63) 6 yy_ Xy Residential backflow minimum permit fee: $36.25 CCB Lie.: '7 .' ,�, Plumbing Lic. no.:2c __Ns) ipe Plan review (25 % of permit fee) State surcharge (12% of permit fee) Authorized signature: _ TOTAL PERMIT FEE Print name: _' , :err ‘.--/ .6�J C Date .. - L This permit application expires if a permit is not obtained within i•,� 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I \ Building \Permits\PLMF- PermitApp doe 12/27/06 440- 4616T(I0 /02 /COM/WEB) 5/28/2008 ` . N . .. CITY OF TIGARD Fees Assoc Wi 2:3 0:23PM - 13125 SW Hall Blvd. Tigard, OR 97223 503.639.4171 Case #: MST2008 -00012 TIGARD g 2 ryOS - 0442 , 0613S Fee Start End Revenue Created Type Date Date Dept Description Account Number By Date Amount Due BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 BLD 2/27/2008 14 fiot 0 750.00 0.00 CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 BLS 3/12/2008 46 00 0.00 LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100- 0000 - 438050 BLS 3/12/2008 6.00 0.00 BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 BLS 3/12/2008 957.79 0.00 BPRT . 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245- 0000 - 432000 BLS 3/12/2008 1,473.53 0.00 SURI 12/31/2007 12/31/2020 [TAX] Build 12% State Surchrge 100- 0000 - 207020 BLS 3/12/2008 176.82 0.00 MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245- 0000 - 229202 BLS 3/12/2008 307.78 0.00 MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245- 0000 - 431010 BLS 3/12/2008 114.40 0.00 SUR2 12/31/2007 12/31/2020 [TAX] MEC 12% State Surcharge 100- 0000 - 207020 BLS 3/12/2008 13.72 0.00 PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 BLS 3/12/2008 399.00 0.00 SUR3 12/31/2007 12/31/2020 [TAX] PLM 12% State Surcharge 100- 0000 - 207020 BLS 3/12/2008 47.88 0.00 ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220-0000-431510 BLS 3/12/2008 245.35 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 BLS 3/12/2008 29.44 0.00 ELRP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220-0000-431510 BLS 3/12/2008 75.00 0.00 SUR5 12/31/2007 12/31/2020 [TAX] ELR 12% State Surchrge 100- 0000 - 207020 BLS 3/12/2008 9.00 0.00 PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270- 0000 - 450000 BLS 3/12/2008 4,812.00 S21S 0.00 - y0'3 TIFR 7/1/2002 12/31/2020 [TIF -R] TIF Resident 210- 0000 - 448001 BLS 3/12/2008 a 94 , o 2,800.00.x 0.00 -Mit TI FM 7/1/2002 12/31/2020 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 BLS 3/12/2008 220.00 A`iU 0.00 -AO EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100- 0000 - 207307 BLS 3/12/2008 88.00 0.00 ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn PIn Rv CWS 100- 0000 - 207308 BLS 3/12/2008 28.60 0.00 ERPC 1/1/1990 12/31 /2020 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 BLS 3/12/2008 28.60 0.00 ELCA 6/25/2003 12/31/2020 [ELPRMT] Addl ELC Permit 220-0000-431510 BLD 3/25/2008 66.85 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 BLD 3/25/2008 8.02 0.00 PLCK 1 /1/1990 12/31/2020 [BUPPLN] Pln Rv Extra Set 245- 0000 - 433000 BLS 5/22/2008 62.50 0.00 Total Due: $0.00 %a 3 - l(, 0 20 75?, - ��_3 .- /6 7 A/6 - u Page 1 of 1 CaseFees.. CITY OF TIGARD BUILDING DIVISION " PERMIT #: MST2008-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3n1/2008 Phone: (503) 639-4171 At un Inspection Requests (24 Hrs.): (503) 639-4175 - it INSPECTION WORKSHEET FOR DATE: 3125/2008 TIME: 7:01AM PAGE: 16 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL-GAUCH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF OWNER: ROUNDSTONECONSTRUCT1ON CO., PHONE #: 503-619.4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 3/25/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 Temporary electrical service 067288-01 503-320-2703 Corrections/Comments/Instructions: I 0 / ihe c 0 / ( 9 \ AA /0 PASS fl PARTIAL APPROVAL n CANCEL fl NO ACCESS I I FAIL 1 CALL FOr INSPECTION fl ADDITIONAL FEES ASSESSED fry Inspector: _ Date: 1 0;r6 Phone #: (503) 718- "t4440' CITY OF TIGARD BUILDING DIVISION PERMIT #: MSTaf� 00012 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3!21/2008 Phone: (503) 639 -4171 : � Inspection Requests (24 Hrs.): (503) 639 -4175 . ''I INSPECTION WORKSHEET FOR DATE: 8/5/2008 TIME: 7.00AM PAGE: SITE ADDRESS: CLASS OF WORK: SUBDIVISION: 14730 SW 103RD AVE MITCHELL GALICH PARTITION LOT # : 002 TYPE OF USE: PROJECT NAME: VOX, DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE # : 503. 619.4668 CONTRACTOR: ROUND TON CONSTRUCTION CO PHONE # 503 -619 -4668 Inspection Request Scheduled For: Date: 8/5/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 073747 -02 603 - 3202703 Y Corrections /Comments/ Instructions: "121 R4•677 P .- c-lc, s ra `— ,,a:3z.-.: I PASS n PARTIAL APPROVAL n CANCEL NO ACCESS AIL I j CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: g - Phone #: (503) 718- - 2.41. -- T\ - ' - ' r. CITY OF TIGARD ` ` ��mn m n~pm uu����°�� �� . �UU ��U���� DIVISION PERM|T M��U�0012 | 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 "�-M 1.1- INSPECTION WORKSHEET FOR DATE: 6/2y2008 TIME: 7:02AKA PAGE: 2 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: k4|TCHELLGAL|CHPART|T|ON LOT #: 002 TYPE OF USE: ' PROJECT NAME: YD){ DESCRIPTION: New SF 5/25/08. adding temp swim. OWNER: R0UND8TANECQNGTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: R()WNQSTONEC0NSTRUCT|C)N CO PHONE #: 603-619-46U Inspection Request Scheduled For: Date: 6/2/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 070658-01 503'320-2705 N Corrections/Comments/Instructions: III PARTIAL APPROVAL 0 CANCEL 1 NO ACCESS n FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED J� ��\ .� �� 8 Inspector: ��'�� `� Dedo� o�~ -u�-��~^ Phong#: (503) 718- Z51-4-1) "• `` CITY OF TIGARD BUILDING DIVISION A) PERMIT #: 1VIST2000-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 :rtuptiliil' Inspection Requests (24 Hrs.): (503) 639-4175 ,1 ''■•■••• INSPECTION WORKSHEET FOR DATE: 5/28/2008 TIME: 7:00AM PAGE: 1 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: tvilICHELL•GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: VOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 5/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 070456-01 503-320-2702 N Corrections/Comments/Instructions: (--- Ri. ni g .Ci.: 71 --= -- 29 c 2 "- 2 C., v'":.-______ -- fl PASS 1 1 PARTIAL APPROVAL fl CANCEL 0 NO ACCESS 0 FAIL fl CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED Inspector: . Date: 5 - - Z 8 ---. Phone #: (503) 718- . __ • CITY OF TIGARD BUILDING DIVISION - - PERMIT #: IvIST2008- 00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2112000 lk Phone: (503) 639 -4171 a lir Inspection Requests (24 Hrs.): (503) 639 -4175 ��: �� INSPECTION WORKSHEET FOR DATE: 5/27/2008 TIME: 7:01AM PAGE: 22 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3125/00, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503- 618.4608 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 603 - 6194668 Inspection Request Scheduled For: Date: 5/27/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 070365 -01 503 - 320.2703 N Corrections /Comments /Instructions: ,x/1.7 e - 0 C_ r��� a znv ✓ 17 L IA / a f--__- /04:I-- • �► ''''' /) . % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS [Ft.I A . rg CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED , S 7 kg 6 t /' 1 Inspector: Date: Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST200B.00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2112008 Phone: (503) 639 -4171 A 10) . • Inspection Requests (24 Hrs.): (503) 639 -4175 ' E�1 �� INSPECTION WORKSHEET FOR DATE: 5/2712008 TIME: 7:01AM PAGE: 21 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MFI CHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3125108, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503 -619 -4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 5/2712008 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 07036&02 503320 -2703 N Corrections /Comments /Instructions: r . a ,,v► t Z_-i Th • 1111P n1110 i 1 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL t/; CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � Date: o _ Phone #: (503) 718- _` CITY OF TIGARD I BUILDING DIVISION PERMIT #: iVIST20013 -00012 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 4„,,l it Requests (24 Hrs.): (503) 639 -4175 �'W'II INSPECTION WORKSHEET FOR DATE: 5/2712008 TIME: 7:01AM PAGE: 20 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL CALICH PARTITION LOT #: 002 TYPE OF USE: , PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503- 619 -4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619 -4668 Inspection Request Scheduled For: Date: 5127/2008 Pour Time: Code # Inspection Description Confirm # Contact # Mes- - -k 295 Misc. inspection 070365-03 503 - 320 -2703 �'e Corrections /Comments /Instructions: , t &a1 r_.., e - i 7 `- &— . )c 1 0 k:-.- iJ 4- V ` E 9 f/ e,.../ --c) t r /` ` +P I n P ARTIAL APPROVAL ❑ CANCEL NO ACCESS ❑ FA❑ CALL _ FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED spe Da In c Date: Phone #: (503) 71 8- 2696 �_ 1� CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 hAtb Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/21/2008 TIME: 7:00AM PAGE: 1 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service.. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 603 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 Inspection Request Scheduled For: Date: 5/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 070230-04 503-320-2703 Corrections/Comments/Instructions: 1 c-774-41. - -v , z5 6 • PASS PARTIAL APPROVAL n CANCEL El NO ACCESS FAIL Ti CALL FOR INSPECTION Ti ADDITIONAL FEES ASSESSED Inspector: .1' Phone #: (503) 718- __,:4;rZ CITY OF TIGARD 1 • BUILDING DIVISION PERMIT #: MST200B- 00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 „ µ'�4pI1iu1��I I Inspection Requests (24 Hrs.): (503) 639 -4175 , INSPECTION WORKSHEET FOR DATE: 5/21/2008 TIME: 7:00AM PAGE: 4 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL-GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25108, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 - 619-4668 Inspection Request Scheduled For: Date: 5121/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 6 Mechanical rough -in 07023(1 -02 503 - 320 -2703 N Corrections /Comments/ Instructions: al .. , _ 1-/b-1 ‘,4'T -' icilyy us; <' P. 4-7 e.. - .�� r z -ru- ./ ❑ PASS -- APPROVAL n CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED A Inspector: Date: S"k�v a Phone #: (503) 718 -'z-Q' 4 & CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST200B 00012 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 Vial\ Inspection Requests (24 Hrs.): (503) 639 -4175 ,_. INSPECTION WORKSHEET FOR DATE: 5/21/2008 TIME: 7 :00AM PAGE: 6 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 5/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 070230-01 503.320 -2703 N Corrections /Comments /Instructions: = S✓ ,,f ®er ,4S ' Z.f .u• S ( 117 5 ❑ PAS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS •FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: , S/ -- Phone #: (503) 718- 2 CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2008-00012 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 3/21/2008 Phone: (503) 639-4171 "po l Inspection Requests (24 Hrs.): (503) 639-4175 ,_,AIV . .■ . . . . a INSPECTION WORKSHEET FOR DATE: 5/9/2008 TIME: 7:00AM PAGE: 6 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL-GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25108, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 5/9/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 069672-02 503-328.2703 N Corrections/Comments/Instructions: 7 r . ASS _ PARTIAL APPROVAL 0 CANCEL fl NO ACCESS n FAIL E CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Inspector: Ot Date: S --- c —o 0-) Phone #: (503) 718- e■ • CITY �7U�������� ��w m x OF m u����nn�� BUILDING DIVISION PERMIT KHGJ'2OO�QOD12 ~~~°"~~~~^"°~= ~~"~"~~"~°"° � | 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3f21/2800 Phone: (503) 639-4171 Alk Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/9/2008 TIME: 7:00Akd PAGE: 7 SITE ADDRESS: 1473UEW1Q3RDAVE CLASS OF WORK: SUBDIVISION: MITCHELL PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3126/08. adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 603'619 Inspection Request Scheduled For: Date: 51EV2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 069572-01 603'320-2703 Y Corrections/Comments/Instructions: PASS I I PARTIAL APPROVAL El CANCEL NO ACCESS || FAIL | CALL FOR INSPECTION ADDITIONAL FEES ASSESSED |nepeotor Ocde� �-- -�--� Phone #: (503) 718- �c»��l�7 / ^~r � ^~ ' ` ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/7/2008 TIME: 7:00AM PAGE: 11 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL - GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 603 - 619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503- 619.4868 Inspection Request Scheduled For: Date: 5/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 069520 -04 503- 320 -2703 N Corrections /Comments /Instructions: a'AIP L t ',s - ❑ PASS PARTIAL APPROVAL ❑ CANCEL [ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: / Date: " --��r� Phone #: (503) 718- 2-7-4_,->" CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2000 Phone: (503) 639 -4171 /arluy�411 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/7/2008 TIME: 7:00AM PAGE: in SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL - GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 603- 619 -4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 -619 -4668 Inspection Request Scheduled For: Date: 5/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 242 Interior shear walls 069620 -05 603- 320 -2703 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS PI FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: ;S'__ 7 —� Phone #: (503) 718- 7 4 � . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00012 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 « i Inspection Requests (24 Hrs.): (503) 639 -4175 s �_�� INSPECTION WORKSHEET FOR DATE: 5/7/2008 TIME: 7:00AM PAGE: 12 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 - 619-4668 Inspection Request Scheduled For: Date: 5/712008 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 • Shear walls/anchors 060520 -03 603-320-2703 N Corrections /Comments /Instructions: r -doll - Or 4 A , - ,t, i .e1 a • • n PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL I l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED A Inspector: Date: ,5 7 ate. Phone #: (503) 718- ZS/ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200s 00012 ' 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/2112008 Phone: (503) 639 -4171 4#4 ii Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/7/2008 TIME: 7:01AIM1 PAGE: 10 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELI..;•OALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503 - 6194668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503`619.4668 Inspection Request Scheduled For: Date: 4/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Po t/hearn mechanical 067988 -02 503-320-2703 N Corrections /Comments /Instructions: • J / a PASS % PARTIAL APPROVAL III CANCEL fI NO ACCESS FAIL % CALL FOR INSPECTION n ADDITIO AL FEES ASSESSED - 7 Inspector: _/ �� Da te: / Phone #: (503) 718 - §Pr IlMiguso . . . . CITY OF TIGARD BUILDING DIVISION A PERMIT #: ivIST2008-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 titiv011i'll` Inspection Requests (24 Hrs.): (503) 639-4175 11. INSPECTION WORKSHEET FOR DATE: 4/7/2008 TIME: 7:01AM PAGE: 9 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELLGALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 417/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Po Etrbearn SilUctural 067988-03 503-320.2703 N Corrections/Comments/Instructions: • d % PARTIAL APPROVAL El CANCEL fl NO ACCESS FAIL 0 C L FOR INSPECTION El ADDITIONAL FEES ASSESSED , 40111111. Inspector: Date: 4 7 7/43 Phone #: (503) 718- Zie %., • CITY OF TIGARD BUILDING DIVISION PERMIT #: tv1ST2008- 00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 312112001 Phone: (503) 639 -4171 , �ii� *I A\ Inspection Requests (24 Hrs.): (503) 639 -4175 M INSPECTION WORKSHEET FOR DATE: 3/27/2008 TIME: 7:03AM PAGE: 5 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/013, adding temp service, OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 603- 613 -4&8 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503. 618.4668 Inspection Request Scheduled For: Date: 3/27/2008 Pour Time: 11 :00 Code # Inspection Description Confirm # Contact # Message 210 f=oundation walls 067450 -02 503 - 5192512 N Corrections /Comments /Instructions: ..-- -/ /43774--L-C.- ,C/147Z_ :.04,i -5 - Zif' 7'1 S "i ..erg -4-5 5" �, _2_.- .? I r' i t-- -7 . — / - ., n/c� ,- IThS I I PARTIAL APPROVAL CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: 3 - 2:7 —0 S Phone #: (503) 718- X1-4- v >---- � 1 CITY OF � ��nn n ��w mu����no�* BUILDING DIVISION PERMIT #: MST2008.00012 | ' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/20013 Phone: (503) 639-4171 |nope�ionRaque��o(24Hmj:(503)63A-4175 .J.�- «, �� INSPECTION WORKSHEET FOR DATE: 3/27Y2008 TIME: 7:03Ah8 PAGE: 6 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: |N|TCMELL,8ALCH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/O8. adding temp service. OWNER: RAUN[>ST0NE CONSTRUCTION CQ.. PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503'619-4668 Inspection Request Scheduled For: Date: 3/27Y2008 • Pour Time: 11:00 Code # Inspection Description Confirm # Contact # Message 20r..) Footing 067450'01 503'5192512 Y • Corrections/Comments/Instructions: �� |*TpASS ri PARTIAL APPROVAL 7 CANCEL 7 NO ACCESS | I FAIL CALL FOR INSPECTION I | ADDITIONAL FEES ASSESSED . Inspector: - �^� » Date: ..7 2 7�- 9 � Phone #: (503) 718- 2-"4----t--) CITY OF TIGARD ' • BUILDING DIVISION A , PERMIT #: MST2008-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 :V Inspection Requests (24 Hrs.): (503) 639-4175 ,...„..„_.W ' --" INSPECTION WORKSHEET FOR DATE: 3/26/2008 TIME: 7:00AM PAGE: 44 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. -------- OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 Inspection Request Scheduled For: Date: 3/26/2008 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Messa e 205 Footing 06733601 503-519-2512 Corrections /Comments / Instructions: , - ,10 -- E7---__ S ::_ . i ._. _-. ww- A.■ . OF VA-, g-T..--'-- - 10 _____ W. "P ---_-..- ac)/(- wall I tri g_L-I.A.T 6A/ --' I Ta e_ / ./c" 1 .7rA i le- I I PASS rli PARTIAL APPROVAL [1] CANCEL D NO ACCESS . U FAIL fl CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED .• /IMP Inspector: _ A........ Date: Z-4 Phone #: (503) 718- 11 CITY OF TIGARD BUILDING DIViSION PERMIT #: M51 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 At° .4&10 Inspection Requests (24 Hrs.): (503) 639-4175 111. INSPECTION WORKSHEET FOR DATE: 3/26/2008 TIME: 7:00AM PAGE: 43 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELLGALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: VOX DESCRIPTION: New SF 3126/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: fiO3619-4668 Inspection Request Scheduled For: Date: 312&2008 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 067336-02 603-519-2612 Corrections/Comments/Instructions: C ab • —S • 1 I PASS PARTIAL APPROVAL 11] CANCEL I NO ACCESS fl FAIL pi CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: Date: 0 . Phone #: (503) 718- et/j/ - . CITY OF ^ ��n x n n�'m n n���m°��* r BUILDING DIVISION ^ PERMIT ~�~"^~~~~""°~° ~~"�"~~"~~"~ ^ - #: ��t�-2UD0'0(K�12 13125SVV Hall B|vd.. Tigard, DR07223 -- � / DATE|SSUED: 3121/2008 Phone: (503) 639-4171 Inspection Reque�o(24Hmj:(503)83Q'4175 -_,61- ^E. INSPECTION WORKSHEET FOR DATE� TIME: PAGE: � DATE: 8/7/2008 � 7�O1�Kd '15 SITE ADDRESS: 14730 S CLASS OFVVORK� � �/ 103RD AVE ��� � SUBDIVISION: LOT #: � TYPE � hN|TCHELL,GAL|CM 002 0 PROJECT NAME: � Y0x DESCRIPTION: � NewSF 3V/5/OB. adding temp service. OWNER: � PHONE #: R()UNDSF{}NEC��NSTRUCO(}NCQ.. 503^619-4668 � CONTRACTOR� R[>UND5UOMFC[}NSTRUCT|[)N CO PHONE #� #: 503-619-4668 Inspection Request Scheduled For: Date: Pour Time: � ' 817/2008 � Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 073892'02 503-320-2703 T Corrections/Comments/Instructions: ' • ` ` XPASS . PARTIAL APPROVAL -- CANCEL fl NO ACCESS || FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED . Inspector: ~°ri \\Vnr~~~-~' Date: 7 J.-6% Phone #: (503) 718- > >. CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2008 -00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3121/2008 Phone: (503) 639 -4171 Alk,4 l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/5/2008 TIME: 7 :00AM PAGE: 8 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL. CALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: Ne'm SF 3/25/0B adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503.619 -4G68 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 - 619.4661 Inspection Request Scheduled For: Date 8/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 073747 -01 503.320.2703 V Corrections /Comments /Instructions: 1 7.x , + 6 A- tom:., ,) c.c., TA .,.,; 6t, .4- -s-- PA v c (p k Te.e r v v ,,,- - c" A-v" S % -l 4 ..-4---t.t, vl k o joift c& a)/ p I v toL.L► .,,) e ; c-e ✓ Lo G ti, e.e o F Lcd v0 �T� rT ce, ;<8 Y N I leviv-e-A. /A at', \ 1NN A.,,..., I ¢_A.�c. P S e w fi�� ‘ cle vkz-e..t I 1 PASS I 1 PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS K FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CV kcN3 -^JCL `r—'" Date:Ttc1 3 Phone #: (503) 718- CITY OF TIGARD ' . BUILDING DIVISION PERMIT #: MST2008.00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2112008 Phone: (503) 639 -4171 /autl�j�� INI '�Irl Inspection Requests (24 Hrs.): (503) 639 -4175 .�' INSPECTION WORKSHEET FOR DATE: 5/7/2008 TIME: 7:00AM PAGE: 13 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL- GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/013, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503.61 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-619-4668 Inspection Request Scheduled For: Date: 5/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 069520-02 503 - 320.2703 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS ❑ FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: CFI) 1 /14--&-...i \ W Date: J / 0 C? Phone #: (503) 718- . , • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639 - 4171 «' Y�u���l� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/6/2008 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL - GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 603-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503 - 619-4668 Inspection Request Scheduled For: Date: 5/6/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 069438-01 503. 320.2703 N Corrections /,Comments /Instructions: I )' 1/0 ►Yr 10 CO ,.._., 1, C o ,_a., J..,, Me A c✓ ( F es" ' 974 6r\A A r - T - b Co u-e../ _I PASS PARTIAL APPROVAL ❑ CANCEL I NO ACCESS I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (7)\-)ti Date: O4- Phone #: (503) 718- CITY OF � ' ` | �=" " � =�" " "~��""�� | BUILDING DIVISION PERMIT #: MST2008.00012 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/Z\/ZOUO Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 A�N'' 67 E. INSPECTION WORKSHEET FOR DATE: 4/7/2008 TIME: 7:01AM PAGE: 11 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: kNDTHEIL LOT #: 002 TYPE OF USE: PROJECT NAME: VOX DESCRIPTION: New SF 3/35/08. adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 5U'3.619-4GG8 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-D18-4668 Inspection Request Scheduled For: Date: 4/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 316 Pue/bommo|umbing 067988-01 503'320'2703 N Corrections/Comments/Instructions: . �� PASS ri PARTIAL APPROVAL ri CANCEL I I NO ACCESS ^` | | FAIL n CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED Inspector: ` ■ |\ � Y-^.--' Date: /U 7/ 0 Phone #: (503) 718- ' � � CITY OF ' ' ��nw m ��m TIGARD - BUILDING DIVISION PERMIT #: k4ST2008'O0012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2 now Phone: (503) 639-4171 ' Inspection Requests (24 Hrs.): (503 ) 839-4175 AA 1.11, INSPECTION WORKSHEET FOR DATE: 4V1/2008 TIME: 7:01AM PAGE: 46 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELLGALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF I/25/00 . adding temp e emic e . . OWNER: R0QMDET0MEC#NS7RUCRDN CO., PHONE #: 503-619- CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503-614668 . Inspection Request Scheduled For: Date: 4/1/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 067618-02 503-538-1O40 N Corrections/Comments/Instructions: ' �� 0 RAGS RART|AL APPROVAL -- CANCEL NO ACCESS ,` | | FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: ~~f� �u�~~^�� Date: [} \ | | C>�� Phone #: (503) 718- ` ', . _� . `. ' 7 // � � ` ' CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2008.00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 Um" Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 411/2008 TIME: 7 :01APv3 PAGE: 44 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: hMlTCHELL :•GAL.ICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: VOX DESCRIPTION: New SF 3/25/013, adding temp service. OWNER: ROUNDS1 "LANE CONSTRUCTION CO., PHONE #: 503.619.4668 CONTRACTOR: ROUND STONE CONSTRUCTION CO PHONE #: 503- 6134668 Inspection Request Scheduled For: Date: 4/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 50 Sanitary sewer 067618.04 503.638 -1040 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C1nn..n,.21 - \\;∎. --- Date: '4 / 1 'CYO Phone #: (503) 718- CITY OF TIGARD • , BUILDING DIVISION PERMIT #: IVIST2008 -00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 / i ilt j fil Inspection Requests (24 Hrs.): (503) 639 -4175 ...;, __.. INSPECTION WORKSHEET FOR DATE: 4/1/2008 TIME: 7:01AM PAGE: 45 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: VOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503.019 -4068 CONTRACTOR: ROUN ®STONE CONSTRUCTION CO PHONE #: £03-619.466B Inspection Request Scheduled For: . Date: 4/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 067618-03 503 -638 -1040 N Corrections /Comments/ Instructions: LK PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ■ \ \ti--✓" Date: 4-I i I ) Inc Phone #: (503) 718- ' ' CITY OF • ' - ��um n ��m TIGARD ' BUILDING DIVISION PERMIT kAF��2080'OUD12 | ~~~~^~~~°""~~� ~°"°"~°"~~"~ � | 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 AA,i, |nspo/�ionRoque�a(24Hm.):(5O3)63A'4175 ~��0- e� |NSPECT|ONVVORKSHEET.FOR DATE: 4/1/2008 TIME: 7:01A&4 PAGE: 47 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YO}( DESCRIPTION: New SF 3/25/OO. adding temp service. OWNER: RDUMDS[[)NE CONSTRUCTION CD.. PHONE #: 5n 619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 603-619-4608 Inspection Request Scheduled For: Date: 4/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 057618'01 503-638-1040 N Corrections/Comments/Instructions: x PASS � ��|ALAPP��L � CANCEL � NDA�E8S El / / / / I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: \ Date: Li / / | ( 03) Phone #: 8503\ 718- , --__ ' CITY OF TIGARD BUILDING DIVI ' PERMIT MST2008-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4121,001:38 Phone: (503) 639 -4171 a e A Inspection Requests (24 Hrs.): (503) 639 -4175 �.'� 'll� INSPECTION WORKSHEET FOR DATE: 8/7 /2008 TIME: 7:01AM PAGE 16 SITE ADDRESS: CLASS OF WORK: 1473() SW 103RD AVE SUBDIVISION: MITCHELL- GALICI PARTITION LOT # 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE # 503-619-4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE # 503,.619 -4668 Inspection Request Scheduled For: Date: 81112008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 073892-01 503 320 -2703 Y Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS Li FAIL n CALL , R INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I Date: ' 74 1 .9 08 Phone #: (503) 718- �.--7-, CITY OF TIGARD BUILDING DIVISION 1 0_ PERMIT #: IVIST2008-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2008 Phone: (503) 639-4171 - "Vial t Inspection Requests (24 Hrs.): (503) 639-4175 A- -'''---. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 8/5/2008 7:00AM 25 SITE ADDRESS: CLASS OF WORK: 14730 SW 103RD AVE SUBDIVISION: LOT #: TYPE OF USE: MITCHELLGALICH PARTITION 002 PROJECT NAME: VOX DESCRIPTION: NOW SF 3/25/08, adding temp service. OWNER: PHONE #: ROUNDSTONE CONSTRUCTION CO., 503 CONTRACTOR: PHONE #: ROUNDSTONE CONSTRUCTION CO 503-619-4668 Inspection Request Scheduled For: Date: 8/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message ,- 199 r Electrical final 073723-01 603-981-4640 'S_ / Corrections/Comments/Instructions: / 6 q "'C) (20/7ec 1\477 ofe )L E . Ir 0 cr,./7 / 6 A7 i ---- I5-_.s AL 7 T -. 77f - A .re 45 11 A/0 pt/ .7:71j37 L,i_ i i A'-) ,Ze9Clee70 e-- I --- tf)l// * >,._ . i i4AVC770A/4 - 1.__, . I A 1 .41,>97z., -7-0 Nx :IR . s 4),...2...375. XaVrr AL 6-2on7 4S:S6S-S 6 / / A "IiIIL rumwr ,e3 --\-/(c_4,2 -- N. • N q 1 pa.s I I PART AL APPROVAL Ai El C' NCEL 0 NO ACCESS / o ' , IL 11, • LL FO" I 1 I1W a ADDITION FEES ASSESSED 4 , , • Inspector: IA , Date: 6 V #: (503) 718 -•)"" ( . , ., CITY OF TIGARD - BUILDING DIVISION ` PERMIT # ST 2OOti Ot1012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 31,2'1,2001.i Phone: (503) 639 -4171u 41m�i l Inspe Requests (24 Hrs.): (503) 639 -4175 =' f L. INSPECTION WORKSHEET FOR DATE 8/1/2008 TIME: 7 :00AM PAGE: SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: . SUBDIVISION: MITCHELL GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503 - 619 -4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 1-'03- 619 -466€3 Inspection Request Scheduled For: Date Pour Time: A. p G 8f 112000 A Code # Inspection Description Confirm # Contact # Message, Q 199 � Electrical final opt- 1 073680 -01 503981-4640 Y !i 41k Pia ® eirii J/ r 'F .SecVRE_HEC, , 6Re< 14 6 1ii ∎ ' ►2.s117 9-37 i. L-- Ge tFCD a, - o a/i.� o hG I /tH. - ekt A` ' ! lo / /� 1 bt /7 / _ leek t0 e !' ov ' ' ----- 6.1. -- 7" I -- AIMPA r- fla-r / c: - 0 A(' 5 C.–le7 0 iq A* ■--- Aili _ Dir 0 - 7 — tii ice'= ..„r • - , ' i A-0161'441( A ... ,--oyi_, 6-- A/ 77 I F 41 i ►I! Corr 4 - f --,'VK 2Yk D 11 /'DO , `i 3:5 . o 7 ®G i rR P lVcS ) , - DA /NFOi'✓ 1 N' & L. / iIV,, °' • 4 ! j • 4Os —_ e W • ■ 1/1 / ❑ PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS g FAIL 1 AL O'. INS'_- • N ► ■ AD ITIO AL EES ASSESSED -- Inspector: �� / A. Lam. Date: Phone #: (503) 71 or J CITY OF TIGARD .._ . BUILDING DIVISION PERMIT #: ISIS 2000 00012 I, l 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/21/2008 Phone: (503) 639 -4171 cr �isp� u�u���i�; Inspection Requests (24 Hrs.): (503) 639 -4175 .- A__.. INSPECTION WORKSHEET FOR DATE: 5/21 /2008 TIME: 7:00AM PAGE: 3 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL PARTITION LOT #: 002 TYPE OF USE: , PROJECT NAME: YOX DESCRIPTION: New SF 3/25/08, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503 -G19-4656 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO s PHONE #: 503.619-4068 Inspection Request Scheduled For: Date: 5/21/2008 Pour Time: s Code # Inspection Description Confirm # Contact # Message 135 Low voltage - 070230-03 503-320-2703 N I Corrections /Comments /Instructions: ' a PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS ' I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: �(z. � 112-112-(6 N66 LE Date: �U Phone #: (503) 718- iatiy' Q rt CITY OF TIGARD s BUILDING DIVISION PERMIT #: MST2008- 00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2112008 Phone: (503) 639 -4171 /� u�u�yl tp i � ,, Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/160008 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION: MITCHELL - GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: YOX DESCRIPTION: New SF 3/25108, adding temp service. OWNER: ROUNDSTONE CONSTRUCTION CO., PHONE #: 503 - 619 -4668 CONTRACTOR: ROUNDSTONE CONSTRUCTION CO PHONE #: 503.619.4668 Inspection Request Scheduled For: Date: 5/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service '070001 -01 503.981 -4640 Y 26 Ro Corrections /Comments /Instructions: W Ak1 2.,6 7 - crildak VIAt.at4 slubleica cr-N • vb-1 tte 1t4 VI LG FAN bC0x C'�' f -► C 60 5 1( 1- 110 R y e PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: N l Date: 811 ott Phone #: (503) 718- Pitt 4 Restricted Energy Electrical installer Log a City of Tigard Building Division T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 Inspection Line: 503.639.4175 Internet: www.tigard- or.gov PERMIT NO.: r'iST - _OC ISSUED BY: 7S. 5 DATE: v ,o,fh V TO BE COMPLETED BY INSPECTING JURISDICTION CHECK TYPE OF WORK INVOLVED: 1 & 2- FAMILY COMMERCIAL ❑ Audio and Stereo Systems* ❑ Audio and Stereo Systems ❑ Burglar Alarms ❑ Boiler controls • ❑ Vacuum Systems* ❑ Clock Systems ❑ Data Cabling ❑ Data Communication Systems Other All - evi C©V►7 ss ❑ Fire Alarms U ❑ HVAC ❑ Intercom and Paging systems ❑ Landscape Irrigation Controls* THIS MUST BE POSTED AT THE JOB SITE AT OR NEAR THE SERVICE ❑ Medical PANEL. IF THERE IS NO SERVICE PANEL, POST ON OR NEAR THE ❑ Nurse Calls INSTALLED PRODUCT. AN INSPECTION SHALL BE REQUESTED ONLY AP 1 ER ALL OF THE ABOVE FERMI LIB.D SYSTEMS HAVE BEEN ❑ Outdoor Landscape Lighting* INSTALLED, AND THIS LOG HAS BEEN SIGNED BY THE SYSTEM ❑ Protective signaling CONTRACTOR(S). OAR 918- 309 -0400. ❑ Other TOTAL NUMBER OF COMMERCIAL SYSTEMS: * Electrical licenses are not required for these items. Construction Contractors Board license is required for all installations. TO BE COMPLETED BY INSTALLER D System tiec4.)4"1 rYlo F`S O System Company: (11 Ca rtsm )1+1 Ph one: C: 0 Company: Phone: Address: o 5 co ;g ,d # c$ -�Z Address` CCB # Sig.: ac ° Lic. # 3) z LEA- Sig: Lic. # D Sys tem 0 System Company: Phone: Company: Phone: Address: CCB # Address: CCB # Sig.: Lic. # Sig: Lic. # D System D System Company: Phone: Company: Phone: Address: CCB # Address: CCB # Sig.: Lic. # Sig: Lic. # D System D System Company: Phone: Company: Phone: Address: CCB # Address: CCB # Sig.: Lic. # Sig: Lic. # D System 0 System Company: Phone: Company: Phone: Address: CCB # Address: CCB # Sig.: Lic. # Sig: Lic. # D System 0 System Company: Phone: Company: Phone: Address: CCB # Address: CCB # Sig.: Lic. # Sig: Lic. # I: \Building\ Forms \ELC- RestrictedEnergyLog.doc 02/01/07 918 - 309 -0400 Restricted Energy Electrical Permit Application (1) A separate Restricted Energy Electrical Permit Application Form and Restricted Energy Electrical Installer Log are created and adopted. (2) The Restricted Energy Electrical Permit can be taken out by a general or subcontractor, limited energy installer or property owner for the fee set by the board in OAR 918- 309 -0030 for limited energy transactions provided the requirements of this rule are met. The person applying for' the permit must: (a) Assume responsibility to call for an inspection when the permits are signed by appropriate persons, installations are completed and after all corrections are made and comply with the requirements of the restricted energy electrical laws and the restricted energy electrical rules; (b) Be responsible for all corrections required by the inspector under the permit, regardless of who performs the work; (c) Call for a final inspection when corrections are made and the work is completed. (3) Options. The person obtaining the permit may: (a) Limit the permit to only the work of the permittee; or (b) Include any and all limited energy installations including those done by separate installers, but the installations must be ready for inspection at the first inspection call. When this is done, the permit must be completed and separately signed by the person, also identifying the business responsible for each type of limited energy electrical installation. (4) The restricted energy activities to be covered by the permit must be declared at the time of the purchase of the permit: (a) It is not necessary to identify the contractor at the time of permit issuance; (b) New permits must be purchased for all other restricted energy installations; (c) If a contractor is changed, the contractor who completed the work must be identified. (5) Regardless of what was initially intended the permit only covers those installations that are in place at the time of the first call for limited energy electrical inspection. A separate permit must be purchased for all other limited energy installations whether the installations become ready for inspection at a later date or are done at a later date. (6) This rule does not apply to an industrial plant when ORS 479.560 is applicable. (7) The Restricted Energy Electrical Installer Log must be posted at the job site for signing by appropriate persons installing the separate electrical systems as shown on the form. A municipality may require'more than one log to be completed and left at the job site if it chooses to. I: \Building\ Forms \ELC- RestnctedEnergyLog.doc 02/01/07 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: � : � 1 /00 Phone: (503) 639 -4171 / u�il��yii�0 A\ Inspection Requests (24 Hrs.): (503) 639 -4175 �_! '' � � INSPECTION WORKSHEET FOR DATE: 8/8/2008 TIME: 7: 00AM PAGE: SITE ADDRESS: 14730 SW 103RD AVE CLASS OF WORK: SUBDIVISION MITCHELL- GALICH PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: Y0X DESCRIPTION: New SF 3/25/'08, adding temp service. OWNER ROUNDSTONE CONSTRUCTION CO., PHONE #: CONTRACTOR: 603-619-4668 ROUNDSTONE CONSTRUCTION CO PHONE #: 503.619 -4668 Inspection Request Scheduled For: Date: 802008 Pour Time: Code # Inspection Description Confirm # Contact # Message A / i \ Y 1 , b 299 Final inspection 073959 -01 503- 320 -2703 Y -I - D Corrections /Comments/ Instructions: S fee. +- 7% r9 X _ ,n S vlct ' v c Ik. C ct.sa- ¶ \ PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: nS Date: RAJ CS Phone #: (503) 718- ,;25/.23 _ • • , • •• • . 4,' ‘2 - , PERMIT NO. /1,9 7 jeleeeZ5Z , Z,,,? 4 CleanWater Services Our commitment Is clear. LOT EROSION CONTROL INSPECTION REPORT DATE Re49 INSPECTOR ,,thiSrhySUBDIVISION OWNER/PERMITEE ..e._64;5"/ SITE ADDRESS /(-X r, ,Tze xZ APPROVED FINAL INSPECTION THIS SITE MEETS THE POST-CONSTRUCTION EROSION CONTROL REQUIREMENTS SET FORTH IN CLEAN WATER SERVICES RESOLUTION AND ORDER -1 NOTE: IF POST-CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING EMPLOYED ON THIS SITE TO MEET CRITERIA FOR APPROVED FINAL INSPECTION, THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE -4 OR PERMANENT GROUND COVER IS ESTABLISHED. A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL. OTHER' • THANK YOU FOR YOUR COOPERA TION! INSPECTOR " '' 2 PHONE • - ' • , 1. . „ STREET TREE CERTIFICATION I 6t 13 S C , Owner/Agent for kOU ►'1. G e COnai (PLEASE PRINT) (PERMIT HOLDER) Do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation. ADDRESS: H 7 v c5 k) 10 3 SUBDIVISION: G' I - G[ft C / /CA LOT: 2_ SIGNATURE: DATE: 8-7-05 (O Lf�NER /AGEI\rl) RECEIVED BY: DATE: (CTTY OF TIGARD) I: \Building \Forms \StrcetfrecCertificate 01/19/07 City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • • • N • T I GARD June 16, 2008 Roundstone Construction Co. 9550 SW Beaverton - Hillsdale Hwy Beaverton, OR 97005 Attn: John M. Gerritz Re: Permit No. MST2008 -00012 Dear Mr. Gerritz: The City of Tigard has processed a refund for overpayment of permit fees on the above • referenced permit for the following: Site Address: 14730 SW 103r Ave.' Project Name: Mitchell -Galich Partition, Lot 2 Job No.: N/A Refund: ❑ Check # in the amount of $ ® Credit card "return" receipt in the amount of $167.00. ❑ Trust account "deposit" receipt in the amount of $ Notes: Refund overpayment of plan review fees $750.00, less additional SDC fees due for Parks $403.00, TIF- Resident $160.00 and TIF -Mass Transit $20.00 = total refund $167.00. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I:\ Building \Refunds\ Administration \LtrRefund- Overpay.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 li City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Roundstone Construction Co. DATE: 6/13/08 9550 SW Beaverton - Hillsdale Hwy Beaverton, OR 97005 REQUESTED BY: Dianna Howse Attn: John M. Gerritz TRANSACTION INFORMATION: Receipt #: 2008 -642 Case #: MST2008 -00012 Date: 2/27/08 Address /Parcel: 14730 SW 103rd Ave. Pay Method: CreditCard Project Name: Mitchell -Galich Partition, Lot 2 EXPLANATION: Refund overpayment of plan review deposit, less additional SDC fees due. REFUND :INFORMATION: • }' : I`Fee °•Description From Receipt : Revenue:Accoun't No:' • • 'Example: [$UILD] Permit Fee: .' - ;• Exaiinple : '-245 0000 432000 . - • $.Amount. fBUPPLN] Pln Rv Deposit 245- 0000 - 433000 $167.00 TOTAL REFUND: $167.00 APPROVALS: If under $500 Professional Staff �.- If under $7,500 Division Manager �; :� If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMAR;R'SYSTEM ADMINISTRATION. JSE Case Refund Processed: I Date: I 47[1 I: \Building \Refunds \Rcfundltequest.doc 05/23/07 Er CITY OF TIGARD 6/13/2008 13125 SW Hall Blvd. 4:39:26PM . Tigard, OR 97223 503.639.4171 `TIGARD • Refund Receipt #: 27200800000000002062 F I =- G. / ; � -. •* - Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid • MST2008 -00012 Reversal - [BUPPLN] Phi Rv Dep 245- 0000 - 433000 (167.00) Line Item Total: ($167.00) Refund: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid Credit Reversal JOHN M GERRITZ 05507D In Person • (167.00) Refund Total: ($167.00) c -. cn V o 0 N Q tu ' A 0 W u a, u •D y N W V ccd p 6 v CI Cdr O ✓ .r+ y 09 lc 3 a v o N a� .n <C C H V X ctS " .: N O IY e a~ A y v Q N C l) . a � � 0 --yyam� , co ,-. W _ t o v - -.. E st 04 a..+ g ci) y r.177, td �+ • V U ° O a A G� U 2 • o y gm . x E c. 43 cci \ 1 cd 0 O a3 a a q H w x a rRcrriIn.rr'r Pne I 0 I I 1.:'"x_I; CITY OF TIGARD 6/5/2008 • 2.L. a 11125 35 SW Hall Blvd. . 8:05:09AM "Tigard, OR 97223 503.639.4171 :ft GARD: Receipt #: 27200800000000000642 mi `G.; Ail- c'. Date: 02/27/2008 Line Items: Case No Iran Code Description Revenue Account No Amount Paid MST200S -00012 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 750.00 Line Item Total: $750.00 Payments: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid CreditCard JOHN M. GERRITZ BTT 05507D In Person 750.00 Payment Total: S750.00 ikia•ipI.ro I''1_c. I ul• CITY OF TIGARD 6/5/2008 7 13125 SW Fall Blvd. 8:05:26AM Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000000938 Date: 03/21/2008 Line Items: Case No Trail Code Description Revenue Account No Amount Paid MST2008 -00012 [CDCPLN] CDC Pin Rev 100- 0000 - 433060 46.00 MST2008 -00012 [LRPF] LR Planning Surcharge 100- 0000 - 438050 6.00 MST2008 -00012 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 957.79 MST2008 -00012 [BUILD] Bldg Permit 245 -0000- 432000 1,473.53 MST2008 -00012 [TAX] Build 12% State Surchrge 100- 0000 - 207020 176.82 MST2008 -00012 [METCET] Metro Const Excise Tx 245- 0000 - 229202 307.78 MST2008 -00012 [MECH] MEC Permit 245 -0000- 431010 114.40 MST2008 -00012 [TAX] MEC 12% State Surcharge 100- 0000 - 207020 13.72 MST2008 -00012 [PLUMB] PLM Print 3Bth 245- 0000 - 431000 399.00 MST2008 -00012 [TAX] PLM 12% State Surcharge 100 -0000- 207020 47.88 MST2008 -00012 [ELPRMT] ELC Permit 220- 0000 - 431510 245.35 MST2008 -00012 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 29.44 MST2008 -00012 [ELPRMT] ELR Permit 220- 0000 - 431510 75.00 MST2008-000 I 2 [TAX] ELR 12% State Surchrge 100- 0000 - 207020 9.00 MST2008 -00012 [PKSDC] SF Park SDC 270 -0000- 450000 4,812.00 MST2008 -00012 [TIF -R] TIF Resident 210- 0000 - 448001 2,800.00 MST2008 -00012 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 220.00 MST2008 -00012 [ERPRMT] Erosion Control 100- 0000 - 207307 88.00 MST2008 -00012 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 28.60 MST2008 -00012 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 28.60 Line Item Total: $11,878.91 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard JOHN M GERRITZ DEB 01593D In Person 11,878.91 Payment Total: $11,878.91 cReeeipLIpl Page I of -7' . ': CITY OF TIGARD 6/13/2008 II _ 13125 SW Hall I ;n d. 4:40:20PM . - h Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200800000000002064 Ai' 4. i ' ' Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid • MST2008 -00012 [PKSDC] SF Park SDC 270- 0000- 450000 403.00 MST2008 -00012 [TIF -R] TIF Resident 210- 0000 - 448001 160.00 MST2008 -00012 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 20.00 Line Item Total: $583.00 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard JOHN M GERRITZ DLH 05507D In Person 583.00 Payment Total: $583.00 t. a 1 , \ a /A CI 0 a r,) o o v ' I 2 - . o ;1l +� p y x .g. Ca. if il E a o u V O � - u ! o N d C b •4 4) I w o d V 1 V) ea 3 : �,a 0 a W`4 �j o �'' 5 =. yy 1 � dl 4..) g � M ►4 Y fr 464 u. a. z 8 u � A 1:4 o4 V 4.4 O N cl . dr V A 0 0 v — o II., sx a l I of I Er CITY OF TIGARD 6/13/2008 13125 SW Hall Blvd. 4:39:59PM • Tigard, OR 97223 503.639.4171 T[GA•RD Refund Receipt #: 27200800000000002063 t 2 ( - - Date: 06/13/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008- 00012. Reversal - [BUPPLN] Phi Rv Dep 245- 0000 - 433000 (583.00) Line Item Total: ($583.00) Refund: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid Credit Reversal JOHN M GERRITZ 05507D In Person (583.00) Refund Total: ($583.00) • i Reccipi.rpt 1'ne I or I ; _" e j �.; H A U IF ' I G A R D 6,/ 5/2008 • . r• i3i25SW Hall Blvd. 5:05:09AM • L.* I'iyard. OR 97223 503.639.4171 j • Receipt #: 27200800000000000642 "1 iS -il-V:t' - Date: 02/27/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST200S - 000I2 [BUPPLN] Pln Rv Deposit 245 0000 - 433000 750.00 Line Item Total: $750.00 Payments: Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid CreditCard JOHN M. GERRIT7 BTT 05507D In Person 750 Payment Total: $750.00 • • rR.•,ripiipi Pa_c I I I 5/28/2008 ' 11111 CITY OF TIGARD Fees Associated With 2 :30:23PM C 13125 SW Hall Blvd. C ase #: MST2008 - 00012 T 1 G n R D Tigard OR 97223 503.639.417 - 0442 1 0c ` En � . ,7 : -; 9, ..! <" , ..:,: . at B ed _ 4:- ( ixs. - :� F Type s, Dice y ' : t 9 P , A P i n:.. .. - ' `4 r l , - tN ='` 2 v . .hd', r ,• I. TYPe °•' Date •'•. •� D `'�� Date a t` ,-�Descri tion�`�.,- r �� ��1�+`e•Bye ; r , Dat • • .. Due BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 BLD 2/27/2008 14fw l) 75� 0.00 CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 BLS 3/12/2008 46.00 0.00 LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100- 0000 - 438050 BLS 3/12/2008 6.00 0.00 BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 BLS 3/12/2008 957.79 0.00 BPRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245- 0000 - 432000 BLS 3/12/2008 1,473.53 0.00 SUR1 12/31/2007 12/31/2020 [TAX] Build 12% State Surchrge 100- 0000 - 207020 BLS 3/12/2008 176.82 0.00 MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245- 0000 - 229202 BLS 3/12/2008 307.78 0.00 MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245- 0000 - 431010 BLS 3/12/2008 114.40 0.00 SUR2 12/31/2007 12/31/2020 [TAX] MEC 12% State Surcharge 100- 0000 - 207020 BLS 3/12/2008 13.72 0.00 PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 BLS 3/12/2008 399.00 0.00 SUR3 12/31/2007 12/31/2020 [TAX] PLM 12% State Surcharge 100 - 0000 - 207020 BLS 3/12/2008 47.88 0.00 ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220 - 0000 - 431510 BLS 3/12/2008 245.35 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 BLS 3/12/2008 29.44 0.00 ELRP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220 - 0000 - 431510 BLS 3/12/2008 75.00 0.00 SUR5 12/31/2007 12/31/2020 [TAX] ELR 12% State Surchrge 100- 0000 - 207020 BLS 3/12/2008 9.00 0.00 PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270 - 0000 - 450000 BLS 3/12/2008 4,812.00 S215 0.00 -41003 TIFR 7/1/2002 12/31/2020 [TIF -R] TIF Resident 210- 0000 - 448001 BLS 3/12/2008 A% o 2,800.00• -3- 0.00 TIFM 7/1/2002 12/31/2020 [TIF -MT] TIF Mass Tr 210 - 0000 - 448005 BLS 3/12/2008 220.00 }`W 0.00 -47 EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100 - 0000 - 207307 BLS 3/12/2008 88.00 0.00 ERPtJ 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 BLS 3/12/2008 28.60 0.00 ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 BLS 3/12/2008 28.60 0.00 ELCA 6/25/2003 12/31/2020 [ELPRMT] Addl ELC Permit 220 - 0000 - 431510 BLD 3/25/2008 66.85 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100 - 0000 - 207020 BLD 3/25/2008 8.02 0.00 PLCK 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Extra Set 245- 0000 - 433000 BLS 5/22/2008 62.50 0.00 . Total Due: $0.00 YO 3 /6 0 20 750 - -573 _ /6 7 «M Page 1 of I CaseFees..rpt