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Permit 04, CITY O F TIGARD MASTER PERMIT PERMIT #: MST2004 -00231 ,�li'j • DEVELOPMENT SERVICES DATE ISSUED: 8/30/2004 a 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11740 SW 114TH PL PARCEL: 1S134DC-01900 SUBDIVISION: 114TH PLACE ZONING: R - 4.5 BLOCK: LOT: 012 JURISDICTION: TIG REMARKS: Add 330 square feet for new kitchen. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 11 FIRST: 330 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 30,492.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 330 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: CLOTHES DRYER: 1 FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC/FOR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 2.00 SIGNAL/PANEL: IN PLANT: MANU HWSVC /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: Owner: Contractor: TOTAL FEES: $ 831.52 This permit is subject to the regulations contained in the DANIEL DEHAVEN JAMES E. BIRD Tigard Municipal Code, State of OR. Specialty Codes 11740 SW 114T1-1 PLACE 1348 SE 19TH CIRCLE and all other applicable laws. All work will be done in TIGARD, OR 97223 TROUTDALE, OR 97060 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 968 - 2441 Phone: 503 618 - 1063 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 57655 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp PLM /Underfloor Insulation Insp Foundation Insp Plumb Top Out Electrical Final Post/Beam Structural Electrical Rough In Mechanical Final Underfloor insulation Framing Insp Plumb Final C rain ckw er Exterior Sheathing Ins[ Final inspection I ued By : T k O i 4,lA ( 6,4l Permittee Signature : ��'. 1 11,I• IIt1!! _,!_ Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Building`Permit Applicatis t® • FOR OFFICE`USE ONLY - , City of Tigard l . � Received Ta '' Permit N l Y ate Re eB E. 1 / — /I 13125 SW Hall Blvd., Tigard, •t~`` oo Plan Review i r� G Other Permit: Phone: 503.639.4171 Fax: 50 .598.1960 1 `� 1. ry�N f lIi Date/B : 04 �'� J, Inspection Line: 503.639.4175 *\�G 1 all Date Ready/By: 1 Q 0 See Attached Checklist for Internet: www.ci.tigard.or.us r P�Q N. if Supplemental Supplemental information O l,G ∎S° Ao, / i. f • ❑ New construction ❑ Demolition based on of the work performed. Indicate the value (rounded to the nearest dollar) of all . tikAddition/alteration/replacement ❑ Other: equipment, labor, . and the profit for the idgiz_* K :CATEGORY Ol± :- CONSTRi74IO10.::: y,,-„.,fi 1- and 2- family dwelling ❑ Commercial /industrial Cli ❑ Accessory building ❑ Multi - family Number of bedrooms: �°�, 1719:6Z. �o El Master builder El Other: Number of bathrooms: ` '` �, Total number of floors: ,OB ' SITE INFORMATION BAND; LOCATION ' , :, ,;',I'.,,,,, ;'' -; `tit :''et'. _." . ' _ `° - ,,:, .,,.. , , 0k, ,- ,: ';,1,% ,.. ,, �. � ' , Job site address: /1 J /1 740 S. l , i i 4 i ,. CiQ New dwelling area: square feet City/State /ZIP: 7 c9c ‘, 0 c ` 7 2— Z Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: biz, IAA1 Covered porch area: square feet Cross street/directions to job site: Deck area: square feet ' z' L L . i2. > '> r ,xr ! 4 — or .. 4, --- • /4, Other structure area: 106,V square feet tom p D 2 S 5 -- IN f}-pL or- i-- 7v 0 DATA:; COMMERCI:ATWS CH E C REISTA Subdivision: / (4 p e 1 Lot no.: / Z Permit fees* are based on the value of the work performed. Tax map /parcel no.: 40 f g Indicate the value (rounded to the nearest dollar) of all ,; - ,,.;,,, „- ,,. ::::;; :;^ -r °jy;. ...: overhead, and the pro fit for the equipment materials, labor, over e a e ' = :. ''S :MfA _ '` ' » "•tis0 , ry f s '�s " work indicated on this .u.lication. . ;, °DES ; OFaWORK <r ADD D / L L�-i2�� „( , k . . Valuation: $ vv� rY�� Existing building area: square feet New building area: square feet PROPERTY :OWNER a >s, ' TENr�VT -': Number of stories: Name: D P c I i L 4- 4 uT De..... 44 Type of construction: Address: / (1 _4d 5 /1 Q � C , Occupancy groups: 1Tj G� City /State /ZIP:ANL j 1 U( 1 e7 7 7--2- 3. Existing: Phone: (5z3 ) - /44 I Fax: ( ) New: s.'vri u. - - ;K. 3c �. >�• �� ,:: " APPLICANT " � '� ® ,., F,;:� ��. w, ' � , .. ,.,� . : . .. ... . .. NOTICE == °``�.�� Business name: �' 1 �( - B e / Q��, j , is / t` Z , All contractors and subcontractors are required to be Contact name: at iti r }� S.,) 0 V A ) ' ` licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: l3 9 S ,g,11 mac; jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State /ZIP: -a,V pd'}-1.-E o 7.0 6e) apply: �+ � Phone: (- )6/2-._ l b 6 Fax:: ( ) !a r<v7` b ff- 4 s E -mail: !/J 6 ? ,' 1 c` a ea�.-b. L.l e c _ r, vu CONTRACPOR * ZadiA nr-M44,1 IT El Business name: j f 0.1 4� e. I UI C Pale -- ° ;.; »` ' ,'�BUII DI NG P ER M IF-EES * ^ hz� ' - ",,; �N, Address: 1342 5 , g ` ! 1g., Please refer to fee schedule. City /State /ZIP: - "Pa Ld r 9 4-1_17._ 6R...-- 17 . ( 03) !a 16 A ` b 3 (Fax: `7 4 ( t6,3 ),6 ( � Fees due upon application 0 Phone: f I CCB lie.: J 7 f „ 5 y /' /4 Amount received I ( Date received: Authorized signature: �� This permit application expires if a permit is not obtained 7 re within 180 days after it has been accepted as complete. . ) Print name: l A ? re c> Date: z f_ /6 * Fee methodology set by Tri- County Building Industry Service Board. i.\ Building \ Permits \BUP- PermitApp doc 12/03 440-4613T(1 I /02 /COM /WEB) , , . . .. Electrical Permit Application . . , FOR OFFICE USE ONLY • , a, City of Tigard 0 , Received Date/By: Permit No.: )10 --eV 7.3/ 13125 SW Hall Blvd., Tigard, OR 9722 S e Plan Review Phone: 503.639.4171 Fax: 503.598.1IM i l itilt Date/By: Other Permit: li Inspection Line: 503.639.4175 Juris: iii See Page 2 for Internet: www.ci.tigard.or.us „ - - - , v„,._,., %J.., N D Date ea d y h y o : d : Supplemental Information ,,, Shr*S.A*•.,144•W•NI 4%;11; 00 # : 0-::::::::@;:kpleANAIIVIT*1000n0r7,, : 0 kettiat10.!lartiff 1 WiVjii0• 14 000:tibC 4: 40:00:';.:: 7 ' , S.1 l'''' '-', ' A -... D New construction 121..AdditioGOAttmlOgi ['Service Please check all that apply: Service over 225 amps, comm'l Ellazardous location D Demolition 0 Other:100 _ ElService over 320 amps - rating OBuildng over 10,000 sq. ft., ekifidiiiifbf re&Sitiffdio . "; -}- Z;::';';i':;'4 of 1- and 2-family dwellings 4 or more new residential a; 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building 1=ISystem over 600 volts nominal units in one structure EiBuildin over three stories El Feeders, 400 amps or more 0 Multi-family 0 Master builder 0 Other: DOccupant load over 99 persons CI Manufactured structures or tintittEltkWaT„WijjEC*Jitaii,440#(0, 4,1 ',:'''',, ','.: V; El Egress/lighting plan RV park I:Wealth-care facility 00ther: Job no.: Job site address: // , /1.4.te ( riel_ee___, Submit 2 sets of plans with any of the above. City/State/ZIP: - ri,6_,Aocr, CyPe_ G t, 7 7-- 7.-<_ The above are not applicable to temporary construction service. ItS114WWWIRFterSOKOWT.:Q=2:';::,i,r4V, Suite/bldg./apt. no.: Project name: DE.1.441, Description I Qty. I Fee. I Total ss Cross street/directions to job , New residential single- or multi-family dwelling unit. Includes attached garage. 5 0-6(--- , & idi-1-0- - LA'- .APAtA.- 1.i4414A....e) 1,000 sq. ft. or less 145.15 4 Subdivision: / / +Ilk Lot no.: t r_.■ Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non-residential 75.00 2 a.,;;CINIMITOg§c11,q,MQg,F,.*00ZIMT a;-;:.;aiiik.;';',1110:41 Each manufactured or modular ... , CE4&.-XIMI c-f .'.IL,,,,, dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 i*WrgarOv:rlibliirlroWilli'AI*4 *300,44-,',:,'T,:ltjwifk.c:tr'744,4*Acti 201 amps to 400 amps 106.85 2 ' 401 amps 10 600 amps 160.60 2 Name: 7RCtIL + t W''• -K.)e4-A-vet,\ 601 amps to 1,000 amps 240.60 2 Address: Riq 0 L o ( tiffl-- 0(act. Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: Ti- 1 4. ,, r 4 0 t z 6 ), a) Temporary services or feeders installation, alteration, and/or relocation Phone: ( cR,%_.... aqt4 \ Fax: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on property that I own which is not 201 amps 10 400 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: *"4tL V..12.. 11 Date: - Branch circuits - new, alteration, or extension, per panel *Vtv,i'; 4iiihtierg.f ,1r2;': .:: pormtw ;,-, reaffkii4ifigot:WwW. A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, / 46.85 2 each branch circuit Address: Each add'l branch circuit ?.. 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: Sign or outline lighting 53.40 2 E-mail: Signal circuit(s) or limited- 1,44,4111#1MAPI,nj; -rag energy panel, alteration, or extension. Describe: Page 2 2 Business name: 4i3 i• t i2 Each additional inspection over allowable in any of the above Address: Per inspection 62.50 City/State/ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( . ) Fax: ( ) Industrial plant per hour 73.75 •. PgrAPWRatOttie CCB Lie.: Electrical Lie.: Suprv. Lie.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) State surcharge (8% of permit fee) Print name: Date: TOTAL PERMIT FEE Authorized signature: 4 /1. - L ) 0 . This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: ,-0„ D (--kve Date: g- * Fee methodology set by Tri-County Building Industry Service Board ** Number of inspections per permit allowed. i \Building\Permits\ELC-PermitApp.cloc 12/03 440-4615T(10/02/COM/WEB 1 Plumbing Permit Application - . FOR OFFICE USE ONLY - City of Tigard Eiew �� Permit No.: `i,ra.� _d0 - 13125 SW Hall Blvd, Tigard, OR 97223 �® /t Phone: 503.639.4171 Fax: 503.598.196 D �I Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.417 ^!-_ r !._ I� Date Ready /By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us \ '� I. Notified/Method: Supplemental Information :z_t1 .,,. s if »t e ..,. . . , - ,;sTYPE; ° °`OF Y'' ,.� K �Y � f� «';� .,�'��,'.�:::, -: . >.', ^:�i. ';•:t �aa.'��a<..��..�: a'.v��., +a.�e- :,�M:;c ;- x 4:;,.. i.,:':�y 4Y:< °'4$ a � Mo3: .. .+o y. r a.. __. .� :C. ': . ? . ., <- Ca >, H. _ a... %,,,;: � :^ :: � > > ` .'.x � :; . , „ <. .., ID New construction � l ^^`` h�tNpS \ °`_ For special information j use checklist. � Description X Addition/alteration/replacement ttler. New 1- 2- family dwellings (includes 1 ft. for each utility connection) * 3"' GATEG ORY:`OF .0 NSTRUCTION, ; 5 ::., _, ; :: ?.A. : SFR 1 bath 249.20 ,.,. �.. ,<...... , . >. -.. �- . >:��,•.,,���,..... ;�,•, "• .�> , , . ...a . ,.. ,.. �... .. ,. � . VI I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 I=1 Accessory building ID Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Mastcr builder 2 •::., �,, Fire sprinkler ( sq. ft.) g ,:. -.. ;;' � FORiVIATION;:ANI)���LOGQTION F��•,,:, - „ ..� -, ..„ ,g.� >: >� >, , ...,.... .. ,, ..�ama,..... ,•'•. �x�z�•,u. zt,c. ,,,, .�e.r,,, ��� � , �•,u�e�v.,. ,. Site utilities Job site address: 117 4 * 5 ,(-c.1 / (4.- Cl Catch basin or area drain 16.60 City /State /ZIP: 1-1 . i n, 1 .1 v a '7 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: � Q._ ( Manholes 16.60 F ( & St L"-' e l r' S4%6k., Rain drain connector 16.60 . - 14 W■ ti Of Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: t l QJ &? C pp J4� 2,..., I Lot no.: ( ?/ Water service (no. linear ft.: ) Page 2 / Fixture or item Tax map /parcel no.: Absorption valve 16.60 , v %% ' <_ tr DESCRIPTION'". OF; WOR - :':�" ' >' >, s.,::'.�.�: ... ,;�:,;,, '..�•,<;.���.� -,,.. .,: ...... ... :..'; Backflowpreventer Paget rk? 0 i 41,6-0 7 ar-- K,•ag0 4) Backwater valve 16.60 Clothes washer 1 16.60 Dishwasher I 16.60 .:' , PRO . PERTY, °..<: ; :l Ails' •'i' ', 7 ,M. , ,, s , F E . ;; = Drinking fountain 16.60 • "E =;TENANT'; :,'0 p'' Ejectors /sump 16.60 Name: - 4^ -1) h De ) V y� Expansion tank 16.60 Y 1 Address: ) l 7 (.� D S ( ,J if (fig'- Pl e Fixture /sewer cap 16.60 City/State /ZIP: 63 9 --1-7,„\a rd pie ' 7 a? Floor drain /floor sink/hub 16.60 Phone: V l {{{ ���b - R y Fax: ( ) C r ` I Garbage disposal I 16.60 7 ` ° ";.4�� ,`; ,�,„'..�•,,• e,r;r< .aa, =:.a Hose bib 16.60 " ANT:'; �' ; " ®t ONT ,...,;.. -,,, . r,C •,',:,i. $ C ACI' PERSON,. ` "em "':. ` Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 Sink/basin /lavatory ' 16.60 Phone: ( ) Fax::( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 H /' -:... <c ONTRACTOR: Water closet 16.60 Business name: 0 NL t Water heater 16.60 Address: Other: City/State /ZIP: Subtotal ?2.5 Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lie. no.: Plan review (25% of permit fee) 'Authorized signature: 7. /nom 6 -� State surcharge A % E M fee) j �O f'v TOTAL PERMIT FEE Print name: R 01 .t° /_ U e <n Date: C I D. -04 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. is \ Building \Pemtits\PLM - PermitApp.doc 12/03 440- 4616T(10 /02 /COM/WEB) � L Mechanical Permit Applicat�ri it COVE E FOR OFFICE 'USE ONLY • d ve ei City pf Tigard 20,4 Rec Rec 6 la' 0 PermitNo.: 1 / 4' -oo a31 p,UG 13125 SW Hall Blvd., Tigard, OR 97223 r, Plan R eview Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: M t a t lv Date/By: Y Inspection Line: 503.639.4175 - , 1 1 Date Ready/By: Surfs: a See Page 2 for Internet: www.ci.tigard.or.us G�TY� , Notified/Method: Supplemental Information RulLo1NG Div ,� ` ?°eC_tealm,,, ::,,. x: - .:lo r>r «',3' W. s . E g r'Ff'J .�9,`�'r� 4 ' 6. - gs •.x" fi l fiRCI r k, *k.``•� 'iF � - `, t T : WORK" *01 $ ,C,OMiV_ F ._'S = • 'TJSE C CHECKLIS 2S- *.,�..�`ir.�'"�,.. sr e"> . a-, �# �: � � .u�:.+.�:�..,.�.....�.�y -,_ ��s»� =,rem �" „���' . .< : e . _ 1°,', � k _ ..._ _ s, . Mechanical permit fees* are based on the value of the work ❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and. profit. ,. -..,_ ». s , ^, x -:max •r v ..,,. .�.., �;' � ,,,..e:�` « * Value' „�t i s - C'ATEGOR ,U is RI3 TI sE. vf. ' - , ._, , skn:; $. .an::..t.�iL��''.�s.tC:% :> ..wa.r:t>, � <;t�sP,.>,.... #,z.' °s r'ak7�csaa slim; ar<;ID, w•%"..�>4:...... �TY«e'�l�':.�:. cs k ",lr�'.: `>:._...<.« e ...... d:.' °.2 ° A " *i.'s!?s >'s.:?•+§.x'.M'. 7 ` - _ � 4 .. .. b °"'` ItBSIDENTIA :ti=EQUIPMTNT. /N ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ' °�`'�' -= F�G�� a.•' �.�.,. ,. , M builder For special information use checklist. M ulti - famil ❑ Multi ❑ ❑ Other: Description Qty. Ea Total �_ '.: 'a si ° �'`e ,.� � r ,'•" �.:. ��. z i�x: �� - �' �" x�.< x, �: x.;, �r�,>, �.•�.;�.wF���.,:�.x .;. rt��:. e�k : :' .r4 - �4•� °� ,...,::�.;�,.. ,.. .,. ....,�.. ��s r = ti SI r INFORMAL R � "'` `" fi i ' t off _, ;' ,: T A1t`D"4LOCA;) ,, e : :: L H '��x.,,�,�: .. �`�,. .f�`r'��as,•s�.eean..� - „�,,.,,; -; �.. a. �- .avp.... ,, aax...����u� 9:: ':K4� fts,1. .,..��s.,.a's / i �G� . 1 Air conditioning or heat pump Job site address: !. ! l L ,,J ,. u' .. l pi I�Gs_ (requires site plan showing placement) 14.00 City/State /ZIP: t < a - r ©( 7ZZ a Furnace 100,000 BTU (ducts /vents) 14.00 Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts /vents) 17.90 Gas heat pump 14.00 Cross street/directions to job site: 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.: Other fuel appliances V- ,? 1 z g ? DESC " O1 rr O . � , ' „ Water heater 10.00 a r �.� rv:.".s"`a a i4if..,>,m—�6.. ..xRLS; °a .'. � Lair.a- «c...e �w E4"� r± ' : � ,.Di.,, t may' � Gas fireplace 10.00 )(�, -e.�d2 / (y � ( -! 5 . 4 —t ' Flue vent for water heater or gas /J ��` J fireplace 10.00 Q -tXQ(/ Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 -� r i r a > r • I 6- q , . - Chimney /liner /flue /vent 10.00 �a' "'., . x. a ,PRQPERTY O 14,. -...'. 4 '. ..,. V A. / _° TENANT 0'4M,: - Other: 10.00 Name: 1)..t'�i4V r Environmental exhaust and ventilation Address: 44 Range hood /other kitchen / equipment ! 10.00 City/State /ZIP: Clothes dryer exhaust ' 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 '>P :; Attic /crawls s 1 F kiCONTACT° PERSOI`i ` I~° ace fans 10.00 P Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E - mail: Range S 3 �' ib i i ^ =$X+^'a$ Y�rRa: >:ir:'$�i.SiS. _. ,Nher.. '"F e`2 a n ��- ,. COIYTrI�AGTORa `- �" :: .%�; ,.?;�:T.[�.: -.� r>:,... as�,..��,'�:r��:� ;.•;•r:te .ate..., .,:��. _ ..`:. s ; .....:zr�? 41110 Barbecue Clothes dryer (gas) Business name: ....7i WL 1_ t (,�� , ' c) t. c t D a_ J Other: Address: j 3 ` S - jq )Z `1YIECH'ANI`C•AT PERIVT3T;FEES= ,': City/State /ZIP: `- k 1 D / ) 6/2-- 9 7 b (, Q Subtotal Phone: (`5 &l [C& Fax: ( ) i 4, f _ p7 9 > Minimum permit fee ($72.50) 7�, � Plan review (25% of permit fee) CCB lic.: 5 ' , ,- State surcharge (8% of permit fee) 5--./c) &I, TOTAL PERMIT FEE Authorized Signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: f p___D Date:. 4 Z ' Fee methodology set by Tri- County Building Industry Service Board i:\ Building 'Permits\lv4EC- PerrnitApp doc 12/03 440 - 46I7T (1 l /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: • TotalValuation _ Fee .m .. tea. . .. . � .. .. $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 CITY OF TIA�RD , ; N BUILDING DIVISION PERMIT #: IViST2004 -00231 13125 SW Hall Blvd., Tigard, OR 97223 DA TE ISSUED: 8/30/2004 Phone: (503) 639 -4171 ,N �p N P;41p i t r i i Inspection Requests (24 Hrs.): (503) 639 -4175 --_-_-_W ' /fmmv _ __ INSPECTION WORKSHEET FOR DATE: 4/13/2006 TIME: 7:10A1V1 PAGE: 79 SITE ADDRESS: 11740 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 603 - 968 -2441 CONTRACTOR: BIRD, JAMES PHONE #: 503 - 618 - 1063 Inspection Request Scheduled For: Date: 4/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 004369 -01 603-618-1063 Y Corrections /Comments /Instructions: /1Jd CY,. PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL MI CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - . Date: -� /.3 -'" Phone #: (503) 718- CITY OF TIGARD • - . . BUILDING DIVISION 0.--' PERMIT #: 44, MST2004 -00231 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/ Phone: (503) 639 -4171 mrd�p f l � Inspection Requests (24 Hrs.): (503) 639 -4175 . ' . I .. INSPECTION WORKSHEET FOR DATE: 4/6/2005 TIME: 7:10AM PAGE: 63 SITE ADDRESS: 11740 SW 114TH PL. CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 503 - 968 -2441 CONTRACTOR: BIRD, JAMES PHONE #: 503 - 618 -1063 Inspection Request Scheduled For: Date: 4/6/2005 Pour Time: "', Code # Inspection Description Confirm # Contact # Message 299 Final inspection 003829.01 503 - 618.1063 V orrections /Comments /Instructions: Ee_. f ,_ 0 \a_62 Me ' c 1 QQ 7 P �,w. 1, Y- l' 1 4 It 6 C OP L eA) - 1/% 7 1 c L '' ‘4 1/LC e../ P11 1/4.--vN C-6._ C (2_2 . v k o ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS X FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: V(A Ci t---- Date: /� /° Phone #: (503) 718- CITY OF TI'GARD fq ,. BUILDING DIVISION - s PERMIT #: MST2004 -00231 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2004 Phone: (503) 639 -4171 U vi r� NNNfp ' l l '' Inspection Requests (24 Hrs.): (503) 639 -4175 `__� INSPECTION WORKSHEET FOR DATE: 4/6/2006 TIME: 7 :10AM PAGE: 61 SITE ADDRESS: 11740 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 503 - 966.2441 CONTRACTOR: BIRD, JAMES PHONE #: 503-618-1063 Inspection Request Scheduled For: Date: 4/6/2005 Pour Time: , Code # Inspection Description Confirm # Contact # Message t'� 399 Plumbing final 003832 -01 503- 618 -1063 Y Corrections /Comments / Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V Date: L! / 0 Phone #: (503) 718- CITY OF TIGARD ,. 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ZED 4 1 —000 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested ✓ ' 3 AM PM BUP I Location l [ 7 7o 114 Suite MEC Contact Person 44/1 Ph ( ) 67 /6 <3 PLM Contractor Ph ( ) SWR UI Tenant/Owner ELC Footing ELC Foundation Access: l ' Ft Drain ELR raw in No s: ,/ Inspection /, \ SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fi - I i Itay V! , • FAIL MBI_G Post & Beam Under Slab Water Service Sanita Sewer in Drain Catch Basin / Manhole Storm Drain Shower P 414,0 Other: Fina AS PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line 9 ADA / Approach/Sidewalk Date v Inspector Ext Other: Final 1 O NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour AO, BUILDING Inspection Line: (503) 639 -4175• MST d 4 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM BUP Location ! r 7 T / 0 / / fL Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access Ft Drain Lr�' ✓ ELR ravel �� a Inspection No s: SIT Post & Beam Shear Anchors Ext Sheath/Shea Int Sheath/Shear Framing Insulation Drywall Nailing � ! , � - - .411 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART AS PLUMBING . P _ L/' ea `[ nJi er Slab ( e - 'ce Sanitary S- . - al I al :asin / Manhole Storm Drain Shower Pan • Other: F S PART FAIL HANICAL st & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm • Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date # I Inspector. Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL I � — CITY OF TIGARD - BUILDING DIVISION #: MST2004 -00231 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2004 Phone: (503) 639 -4171 �i ll i Inspection Requests (24 Hrs.): (503) 639 -4175 ':� °`__.. INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7:10AM PAGE: 78 SITE ADDRESS: 11740 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 503 -968 -2441 CONTRACTOR: BIRD, JAMES PHONE #: 503618 -1063 Inspection Request Scheduled For: Date: 4/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004370 -01 503618 -1063 N Corrections /Comments /Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /1 4 Date: c-/--/ 3 ` PS Phone #: (503) 718- F T� ARD . CITY O G BUILDING DIVISION PERMIT #: MST2004 00231 13125 sW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8130/2004 Phone: (503) 639 -4171 ,11 � I Requests (24 Hrs.): (503) 639 -4175 =.: '__... INSPECTION WORKSHEET FOR DATE: 4/6/2005 TIME: 7:10AM PAGE: 60 SITE ADDRESS: 11740 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 503- 968.2441 CONTRACTOR: BIRD, JAMES PHONE #: 503 -618 -1063 Inspection Request Scheduled For: Date: 4/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 003835 -01 503. 618 -1063 Y 7 Corrections /Comments /Instructions: 4m r 01%4.2.‘ mot a' iI,LV ` .� Afi / f / ice/ ' tL 1 is._ . aliA4 alilti A.. n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS a FAIL ❑ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 4 /4 " 718- Inspector: Date: Phone #: (503) 718 CITY OF TIGARD . 24 -Hour BUILDING Inspection Line: (503) 6 .. r. 75 INSPECTION DIVISION `' Business Line: (503 J 171 ' ' MST .*o(-74---06-1,31 BUP Received Date Requested / °-2 - 0 AM PM BUP Location / / - 7 4 //6 / / � P� Suite MEC Contact Person 9i- Ph ( ) 6 /f - ide3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: � Ftg Drain • V -05 7 30_ 3 - ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear kit Sheath/Shear Framing ■ n 1 m44'l i \✓ / ® F / _ / iV U \ iy' "-,acs Insulation �'" Drywall Nailing _ / l S • �� Firewall I Fire Sprinkler Fire Alarm 'f N 0 , ' C) ■ FG ie d . L,/4At l4 , Susp'd Ceiling Roof GoO K T P 1.✓ - 1W/V f.j ,A- ----- + g & % -f' 1 C?� Other: Final t Z.-/ 0 . 5 0- (e-- PASS PART FAIL PLUMBING - — •— - Post & Beam Under Slab 2--- / 6 / P ,, / ' `! �'C -( � � r ATV 67,1____ rd�C2 v /14- <S Rough -In Water Service -'L/ Sanitary Sewer Rain Drains " Catch Basin / Manhole , � ' . ~ 4 �` 61 ! Storm Drain - Shower Pan "=--' . , S ;../ ■ 4 A IC U Other: Anal UN 5i �Fe____4 PASS PART FAIL MECHANICAL .- ) S 3 v G ' / _."- 41--S 0 ex e-- FI -- Post. & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL 1 LiiEiEC.TR . "2-'56 4 $ 1 4 - .'14' N. ° F-- )3oK L UG /Slab Low Voltage Fire Alarm . as,,,r --- Final : Ill Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE w W / ❑ Please call for.reinspection RE: Illii ■ ❑ Unable to inspect - no access Fire Supply Line ADA (� `� Approach /Sidewalk Date v L�� r I nspector AllE Ext Other: Final DO NOT REMOVE this inspection record f • m e Job site. PASS PART FAIL CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2004- 00231 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2004 Phone: (503) 639 -4171 bopliiiWliill+ Inspection Requests (24 Hrs.): (503) 639 -4175 `__.. INSPECTION WORKSHEET FOR DATE: 4/6/2005 TIME: 7 :10AM PAGE: 62 SITE ADDRESS: 11740 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 503-968-2441 CONTRACTOR: BIRD, JAMES PHONE #: 503 - 618.1063 Inspection Request Scheduled For: Date: 4/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 003830101 603 - 610.1063 Y Corrections /Comments /Instructions: • X PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ik.gf Inspector: Date: I I — 6- #: (503) 718- CITY OF TIGARD , - BUILDING DIVISION PERMIT #: MST2004 -00231 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2004 Phone: (503) 639 -4171 :N/09141 ll'i ' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/29/2005/ TIME: 7:11AM PAGE: 19 - t> / SITE ADDRESS: 11740 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: DEHAVEN DESCRIPTION: Add 330 square feet for new kitchen. OWNER: DEHAVEN, DANIEL PHONE #: 503- 96B-2441 CONTRACTOR: BIRD, JAMES PHONE #: 503 - 616 -1063 Inspection Request Scheduled For: Date: 3/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 00310401 50 '3•618 -1063 Y ' 1 '3o Corrections /Comments /Instructions: I) 1 f. urn - - > 1i1 -, rHvii -c_ 6 15Era2G 3wL -6/--/zn r11 -c- 3tuSPc c-i1 Z) Ci e-ie: 'T?--1 c- ' (--_- F I AI %- ■ - 1b, L is • J i LN AI 6, = 1 :, S■l SP( % -1 ) .3) - Ni C5 i nI i1 L /t! ( TN (1�1N . -R ' i c '1.0 A/ irk. F�1 ii r F-Pcgr-rF1'o 4) C S CG �7 6 o &- i ,`Ni is < 1-1-r---e-r_ l��o i e Ai �q PP 20 �G G S - r- 0 1- - P4-4 S Sc=� -3 A o ,Al P /C Si-ATE-J7--- 1 K. 2v�2 ' Lei r ,q--- -- S ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ( FAIL MI CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` ∎, Date: - / a. one #: 503 p I _ ( ) 718 - CITY OF TIGARD . 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 MST t O° -- 00 3( INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested l � 2 ' , 3 1 AM PM BUP Location / 1 - 7 40 //' - (L.- Suite MEC Contact Person . 4-YI Ph ( ) 4 / g " l e)&3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: � ` 2 /g -rYl SIT Post & Beam J Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framin a io Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fi RT FAIL = ING, , Post & Beam Under Slab Rough -In Water Service Sanitary Sewer • Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA �� , Approach /Sidewalk Date �(7 Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3 / INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received 9 Date Requested /0 'a 7 AM PM BUP Location I ( 7 � d 1 1` 7 (Y.-z-` et, Suite MEC Contact Person 9(4•YL.) Ph ( ) / / ? - 1663 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear - raming Insuation � `. .- • . '-t -_ Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fin- _ ._ °ASS •AR PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In - Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City , 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: nable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date /, 7 7-° C' -- Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD . 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 MST ° � � 7 a( INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested — AM PM BUP Location / 1 7 L /6 t l I L-- Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ft Drain Access: �'i1 v'' ELR 9 Crawl Drain Slab Inspection Notes: SIT 'ost & Bea S ear nchors Ext Sheath/Shear • Ina Sheath/Shear Framing r�� c.D � U Insulation Drywall Nailing � LUh�1 �!'� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: r ` PART FAIL ' MBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL s . &Beam Rough -In Gas Line Smoke Dampers Fi PA PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE . : E Please call for reinspection RE. ❑ Unable to inspect – no access Fire Supply Line :50 I ADA Approach/Sidewalk Date © Y Inspector Est Other: Final DO NOT REMOVE this inspection r rd from the Job site. PASS PART FAIL CITY OF TIGARD . 24 -Hour BUILDING Inspection Line: 3) 639 4175 'd C7.— �d 23 IN DIVISION Business Li . (503) 639 -4171 Y•60 BUP Received "� ate Requested 9 / ® PM BUP Location • / / 1 = 01._ t Suite MEC Contact Person J Ph ( ) 6/R- / 063 PLM Contractor Ph ( ) SWR d Tenant/Owner ELC ^bp, an� +� Access: ELC `.. in ELR Crawl Drain Slab Inspection Notes: /0 Post & Beam �. Shear Anchors en/ Ext Sheath /Shear Int Sheath/Shear NL ®l Framing Insulation P D Drywall i Nailing Nailing Firewall Fire Sprinkler M/� �U / L !� 2__42" Fire Alarm - Susp'd Ceiling Roof ( • l- Oth at PAS PART FAIL ` I MBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE j Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line ADA Approach /Sidewalk Date Inspector s Ext Other: Final DO NOT REMOVE this inspection record the Job site. PASS PART FAIL CITY OF TIGARD - 24 -Hour BUILDING Inspection Line: .A ) 639 -4175 INSPECTION DIVISION - Business Line: 503) 639 -4171 MS BUP Received 1� , g �7 ` Date Requested 9 '� AM PM BUP Location // " / Suite MEC Contact Person 1h/1 Ph ( -) 3) 6/f /. ' PLM Contractor. Ph ( ) SWR Tenant/Owner ELC +otin• A ELC Access: 14g431 rst.D •rain ELR Crawl Drain Slab Inspection Notes: � ® SIT Post & Beam • Shear Anchors Ext Sheath /Shear ��'j ®� Int Sheath/Shear / T- Kr J! �i - tl� Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final ^` PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: LI Unable to inspect — no access Fire Supply Line ADA ' 7q, 02_7 Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection recd om the Job site. PASS PART FAIL • MST — Master Permit r -. 'I Inspection Description Date Passed By Notes Grading Footing /Setback , .� /�/ Foundation walls Slab �l/41?- S�Y�i✓ -' Footing drain Waterproof basement walls Plumbing underslab Crawl drain �`� _� ji 0/ 5/0 Post/beam plumbing 1/ Post/beam mechanical c 'S' o Y �� ✓ Underfloor insulation Post/beam structural ' c)/ Shear walls /anchors 1 Exterior sheathing ��� ^ ✓ _ e 7L4Y1. --" �' - -�! o 2-7_Q _ 1� 3S Plumbing top -out ! Q ( "�� '/; Gas line & test Mechanical rough-in —: Electrical rough -in / /0 'Z0 p y Electrical service _ Low voltage _ Sprinkler rough -in Backflow preventer Roof nailing Firewall Framing /0.2 -ey= MFG -Home set -up Insulation /G ZG- a ¢ Drywall nailing Rain drain g /.3q/ Sanitary sewer Water service Pump /fill septic tank Approach/sidewalk Street Tree Certificate _ Grading final Mechanical final Plumbing final Electrical final — Final inspection 4-- 13 —05" Special Reports SWR - Sewer Permit Inspection Description Date Passed By Notes Sanitary sewer _ • Final inspection • Inspection Record — MST (Master) Permits is \dsts \forms \InspRecordMST.doc 04/17/01 A CITY OF T I G A R® MASTER PERMIT PERMIT #: MST2004 -00231 kv.folr DEVELOPMENT SERVICES DATE ISSUED: 8/30/2004 '--" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11740 SW 114TH PL PARCEL: 1S134DC-01900 SUBDIVISION: 114TH PLACE ZONING: R - 4.5 BLOCK: LOT: 012 JURISDICTION: TIG REMARKS: Add 330 square feet for new kitchen. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 11 FIRST: 330 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 30 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 330 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: 1 FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: jut 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 MOO SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: ' ' LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 2.00 SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps -1000v MINOR LABEL: 1000+ amp /volt : PLAN REVIEWSECTION 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: Owner: Contractor: TOTAL FEES: $ 831.52 DANIEL DEHAVEN JAMES E. BIRD This permit is subject to the regulations contained in the SW 114TH PLACE 1348 SE 19TH CIRCLE Tigard Municipal Code, State of OR. Specialty Codes 11740 11740 S , OR 97223 TROUTDALE, OR 97060 and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 968 - 2441 Phone: 503 - 618 - 1063 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 57655 rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp PLM /Underfloor Insulation Insp Foundation Insp Plumb Top Out Electrical Final Post/Beam Structural Electrical Rough In Mechanical Final Underfloor insulation Framing Insp Plumb Final C rain ek1 Q er Exterior Sheathing Insi Final inspection ■ � ued By : ; �_ .l II , • � it 1 P ermittee Signature : ,`;.'. s _.� 1! IRO∎, .... _ � Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day