Permit A6, C ITY OF TIGARD MASTER PERMIT
PERMIT #: MST2005 00197
Pi ,. DEVELOPMENT SERVICES DATE ISSUED: 6/23/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103AC
SITE ADDRESS: 12665 SW 113TH PL ZONING: R - 4.5
SUBDIVISION: HUMBOLT CREEK ESTATES LOT: 007 JURISDICTION: TIG
Project Description: Add living space to underfloor area. Other mechanical is duct work and gas fireplace.
BUILDING
REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: 595 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT:
VALUE: 54,978.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 595 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 2
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 2
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: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVGFDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
SHIPLEY, LANE A +LUCYA MORNING STAR CONSTRUCTION INC and all other applicable laws. All work will be done in
12665 SW 113Th PL 11180 SW ERROL ST accordance with approved plans. This permit will expire
TIGARD, OR 97223 TIGARD, OR 97223 if work is not started within 1130 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: Phone: 503 adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
Reg #: LIC 50683 direct questions to OUNC by calling 503 - 246 -6699 or
TOTAL FEES: $ 1,124.18 1 - 800 - 332 - 2344.
REQUIRED ITEMS AND REPORTS
• Issued By : �1 /lam ^ Permittee Signature : GGr� / /`��%� ie
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 FOR OF l ICE USE ONLY
._ \
City of Tigard �!!, C Dat u U ' V -PC Permit No` 5 , O 5 U c) i f
13125 SW Hall Blvd., Tigard, OR 9 2 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 I ( l� .�', // * * rq! Date/B : • I .- / - p 5 Other Permit:
Inspection Line: 503.639.4175 JUN •' (9 � I Date Ready/By: , ® See Attached Checklist for
Internet: www.ci.tigard.or.us FNgti od: i c '10 f ' r BM Supplemental Information
CITY of l.
I Irtin- E II H._ , -
,-. rs t� l l o i n t 1e T �Z.. '3.SO V t -
a 1�PEia WORK w F REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition .1b14 U 101)5 Permit fees* are based on the value of the work performed.
CITY OF I IuHku Indicate the value (rounded to the nearest dollar) of all
® Addition /alteration/replacement ❑Other. _ _ equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTIOI0UII - - - DIVi`.. work indicated on this application.
® 1 - and 2- family dwelling ❑ Commercial/industrial
Valuation: $40',000: sy , 97,5-
❑ Accessory building ❑ Multi - family
Number of bedrooms: —
❑ Master builder ❑ Other: Number of bathrooms: —
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
Job site address: 12665 SW 113' place New dwelling area: 595 square feet
City/State/ZIP: Tigard, Or. 97223 Garage/carport area: — square feet
Suite/bldg. /apt. no.: Project name: addition Covered porch area: — square feet
Cross street/directions to job site: Fonner St Deck area: — square feet
Other structure area: — square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S103ACO5600 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
add living space to under floor area Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Lane Shipley Type of construction:
Address: 12665 SW 113 place Occupancy groups:
City /State/ZIP: Tigard, Or. 97223 Existing:
Phone: (503)598 -8620 Fax :( ) New:
• ® APPLICANT ❑, CONTACT PERSON NOTICE
Business name: Morning Star Construction All contractors and subcontractors are required to be
Contact name: Tim Meeker licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 11180 SW Errol St jurisdiction in which work is being performed. If the
City/State/ZIP: Tigard, Or. 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 348 -6455 Fax: : (503) 968 -8227
E -mail: tim @mstarhomes.com
CONTRACTOR
Business name: Morning Star Construction
BUILDING PERMIT FEES*
Address: 11180 SW Errol St.
Please refer to fee schedule.
City/State/ZIP: Tigard, Or. 97223
Fees due upon application
Phone: (503) 348-6455 Fax: (503) 968 -8227
Amount received
CCB lic.: 50683
Date received:
Authorized signature: T� 4 : This permit application expires if a permit is not obtained
f !�i'w �! within 180 days after it has been accepted as complete.
Print name: Tim Meeker Date:.6 & 6 /1)r * Fee methodology set by Tri-County Building Industry
�^+ Service Board.
Electricgl Permit Application FOR ICE: t:sl: ONLY.
City of Tigard • permit No.
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
: L . O2p(���T U/
g Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 - , 4 R eceived A Date/B : Other Permit:
Inspection Line: 503.639.4175 ea. i ( Date Ready/By: lens: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
® 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other ['Building over three stories ['Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: 12665 SW 113th place ❑Health - care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, Or. 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: addition
FEE* SCHEDULE
Description I Qty. I Fee. I Total I **
Cross street/directions to job site: Fonner St New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or
Subdivision: Lot no.: q portion 33.40 1 p
Tax map /parcel no.: 2S103ACO5600 Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
add outlets and lights to new living space dwelling service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Lane Shipley 601 amps to 1,000 amps 240.60 2
Address: 12665 SW 113th place Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Tigard, Or. 97223 Temporary services or feeders installation, alteration, and /or
Phone: (503)598 -8620 I Fax: ( ) relocation 200 amps or less 66.85 I
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I ® CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Morning Star Construction branch circuit
B. Fee for branch circuits
Contact name: Tim Meeker without service or feeder fee,
each branch circuit 46.85 2
Address: 11180 SW Errol St
Each add'I branch circuit 6.65 2
City/State /ZIP: Tigard, Or. 97223 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 348 - 6455 I Fax: : (503) 968 - 8227
Sign or outline lighting 53.40 2
E -mail: tim @mstarhomes.com Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: GARNER ELECTRIC
Address: 2920 SW 247TH AVENUE #A Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: HILLSBORO OR 97123 Investigation per hour ( I hr min) 62.50
Phone: (503) 6484552 I Fax: (503) 642 -7925 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 121159 I Electrical Lie.: 34 -305C Suprv. Lie.: 3707S Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: Cl A //,, G ;y:4 Date J — —
vl — � - TOTAL PERMIT FEE Authorized signature: �' This permit application expires if a permit is not obtained within 180
days after it has been accepted as co mplete
Print name: Date: * Fee methodology set by Tri County Building Industry Service Board
•' Number of inspections per permit allowed.
i:\Building1Pon its\ELC- PemtitApp.doc 12/03 4404615T(10/02JCOM/WEB
Mechani Per mit Application FOR : I 1 :SF: ONLY
City of Tigard Received
Permit No. 5-512605^ D
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1 Other Permit:
Inspection Line: 503.639.4175 - I e•1 L Date/By.
Internet: www.eitigard.or.us ." "� Date Ready/By: 1uris: Supplemental See Page 2 for
g Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
ID New construction ® Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® 1- and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial/industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION. AND LOCATION Heating/cooling
Job site address: 12665 SW 113 place Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, Or. 97223 Fumace 100,000 BTU (ducts/vents) 14.00
Suite /bldg. /apt. no.: Project name: addition Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Fonner St Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: 2S103ACO5600 Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Relocate and add warm air supplies at new living space
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
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Lane Shipley Environmental exhaust and ventilation
Address: 12665 SW 113th place Range hood/other kitchen
equipment 10.00
City/State/ZIP: Tigard, Or. 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)598 -8620 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ® CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Morning Star Construction
Fuel piping
Contact name: Tim Meeker $5.40 for first four; $1.00 for each additional
Address: 11180 SW Errol St Furnace, etc.
Gas heat pump
City/ State/ZIP: Tigard, Or. 97223 Wall /suspended /unit heater
Phone: (503) 348 -6455 Fax:: (503) 968 -8227 Water heater -
Fireplace
E -mail: tim @mstarhomes.com Range
CONTRACTOR - Barbecue
Business name: Kentec Healing
Clothes dryer (gas)
Other:
Address: PO Box 233 MECHAMCAL PERMIT FEES*
City/State/ZIP: Woodburn, Or. 97071 Subtotal
Phone: (503) 982 -6082 Fax: (503) 982 -6284 Minimum permit fee ($72 50)
Plan review (25% of permit fee)
CCB lic.: 63621 State surcharge (8% of permit fee)
/% z4e /c TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit rmit is not obtained within 180
days after it has been accepted as complete.
// // r • Fee methodology set Tri-Co Building name: �^ � �C ` e ',� Date: / � �sy by � ding hidttstry Service Board
/ r
i:\ Building \Permits\MEC- PermitApp.doc 12/03 440 -46177 (t t /02/COM/WEB)
„
Plumbing Permit Application roll. OFFICI: LS1: ONLY '
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Permit No. 5 UaJ 7
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 t'� , DateBy:
- Other Permit No.:
24- Hour Inspection Line: 503.639.4175 ■ e• I 1 runs: H See Page 2 for
Internet: www.ci.tigard.or.us . - , , � ReadyBy.
g Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
0 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
El Master builder ❑er: Each additional bath/kitchen 45.00
Oth
Fire sprinkler (_ sq. ft.) Page 2
. JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 12665 SW 113 place Catch basin or area drain 16.60
City/State/ZIP: Tigard, Or. 97223 Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: I Project name: addition Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Fonner St. Manufactured home utilities 110.00
t
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: 2S103ACO5600 Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Relocated drain lines in crawl space and add 1 hose bibb Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
CI OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Lane Shipley Expansion tank 16.60
Address: 12665 SW 113 place Fixture/sewer cap 16.60
City/State/ZIP: Tigard, Or. 97223 Floor drain/floor sink/hub 16.60
Phone: (503)598 -8620 Fax: ( )
Garbage disposal 16.60
❑ APPLICANT 0 CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Morning Star Construction .
Interceptor /grease trap 16.60
Contact name: Tim Meeker Medical gas (value: $ ) Page 2
Address: 11180 SW Errol St Primer 16.60
City/State/ZIP: Tigard, Or. 97223 Roof drain (commercial) 16.60
Phone: (503) 348 -6455 Fax: : (503) 968 -8227 Sink/basin / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: tim@mstarhomes.com
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Rayborn's Plumbing Water heater 16.60
Address: PO Box 69 Other:
City/State/ZIP: Tualatin, Or. 97062 Subtotal
Minimum permit fee: $72.50
Phone: (503) 692 -4139 Fax: (503) 691 -2328 Residential backflow minimum permit fee: $36.25
CCB Lic.: 87852 Plumbing Lic. no.: 34-166PB Plan review (25% of permit fee)
Authorized signature: l! State surcharge (8% of permit fee)
/� �,.,�4.„ __ TOTAL PERMIT FEE
Print name: L /� ,,� i %" deg p , M G pate: G ---.7_ s � This permit application expires if a permit is not obtained within
I80 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\ Building \Pennits \PLM- PermitApp.doc 12/03 440- 4616T(10/02/COM/WEB)
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00197
13125''SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6J23/2005
Phone: (503) 639- 4171ar�p��i�G
Inspection Requests (24 Hrs.): (503) 639 -4175 �� .. I..
INSPECTION WORKSHEET FOR DATE: 9/1/2005 TIME: 7:14AM PAGE: 3
SITE ADDRESS: 12665 SW 113TH PL CLASS OF WORK:
SUBDIVISION: HUMBOLT CREEK ESTATES LOT #: 007 TYPE OF USE:
PROJECT NAME: SHIPLEY
DESCRIPTION: Add living space to underfloor area. Other mechanical is duct work and gas fireplace.
OWNER: SHIPLEY, LANE A + LUCY A, PHONE #:
CONTRACTOR: MORNING STAR CONSTRUCTION INC PHONE #: 5Q3- 3413.645
Inspection Request Scheduled For: Date: 9/1/2005 Pour Time:
Code # Ins.- '.0 Description Confirm # Contact # Message
199 Electrical final 014793 -01 503-348 -6455 Y
Corrections /Commen ctions:
C c '1! R:\ 'X,- )u))/\,) 1 2- RR., 0 (? ''11.-J.
a, PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL [ I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C V 0 681 " --- Date: e i - I - Q 7 Phone #: (503) 718 Ly‘Ak
CITY OF TIGARD
BUILDING DIVISION . . PERMIT #: M ST2005-00197
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005
Phone: (503) 639- 4171u�gNpu�i f1
Inspection Requests (24 Hrs.): (503) 639 -4175 ��2�
INSPECTION WORKSHEET FOR DATE: 9/9/2005 TIME: 7:07AM PAGE: 72
SITE ADDRESS: 12665 SW 113TH PL CLASS OF WORK:
SUBDIVISION: HUMBOLT CREEK ESTATES LOT #: 007 TYPE OF USE:
PROJECT NAME: SHIPLEY
DESCRIPTION: Add liying_space_to:underfloor- area. Other mechanical is duct work and gas fireplace.
OWNER: SHIPLEY, LANE A + LUCY A, PHONE #:
CONTRACTOR: MORNING STAR CONSTRUCTION INC PHONE #: 503.348 -6455
Inspection Request Scheduled For: Date: 9/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 015263 -01 503-348-6455 N
Corrections /Comments /Instructions:
1.
}
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
6 . ciA ______.
91
Inspector: Date:' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00197
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005
Phone: (503) 639 -4171 / fl u�l�low elf
`�
Inspection Requests (24 Hrs.): (503) 639 -4175 ' `'..
INSPECTION WORKSHEET FOR DATE: 9/9/2005 TIME: 7 :07AM PAGE: 71
SITE ADDRESS: 12665 SW 113TH PL CLASS OF WORK:
SUBDIVISION: HUMBOLT CREEK ESTATES LOT #: 007 TYPE OF USE:
PROJECT NAME: SHIPLEY
DESCRIPTION: Addling space.to underfloor area. Other mechanical is duct work and gas fireplace.
OWNER: SHIPLEY, LANE A+ LUCY A, PHONE #:
CONTRACTOR: MORNING STAR CONSTRUCTION INC PHONE #: 503.34B-E455
Inspection Request Scheduled For: Date: 9/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 015263 -02 503 -34B -6455 N
Corrections /Comments /Instructions:
F4A-8-6 --------
Il PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . \/ -. d a--- --- Inspector: Date: Phone #: (503) 718-