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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00350 i DEVELOPMENT SERVICES DATE ISSUED: 10/21/2005 '' l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 • PARCEL: 2S103BC -00100 SITE ADDRESS: 12525 SW 121ST AVE ZONING: R -4.5 SUBDIVISION: LOT: JURISDICTION: TIG Project Description: New garage & addition. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 21 FIRST: 120 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 120 sf GARAGE: 626 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 'MR 0: sf RIGHT: 15 VALUE: 39,579,00 OCCUPANCY GRP: R3 BDRM: BATH: 2 TOTAL: 240 sf REAR: 15 • PLUMBING SINKS: WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: 1 UNK FURN >=100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: '1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: A 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCOFDR: I SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: — EA ADDL BR CIR: 7 SIGNAL /PANEL: IN PLANT: MANU HMISVCIFDR: 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 Munidpal Code, State of OR. Specialty Codes MIKE & LIND STEVENS JOAT ENTERPRISES INC and all other applicable laws. All work will be done in PO BOX 3527 PO BOX 3527 accordance with approved plans. This permit will expire WILSONVILLE, OR 97070 WILSONVILLE, OR 97070 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 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 68376 direct questions to OUNC by calling 503 -246 -6699 or TOTAL FEES: $ 1,091.18 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS ) Permittee Signature : (lf .1(.310 1 JJ 1 sued By : /I_ � /L _v � � _ 9 7� / 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. i r r o ' Building Permit Application . - FOR OFFICE USE ONLY' , City of Tigard e E EC E I ® E I.` Rec eiv y , _6 nv > _ Pert No.. � F � I �i 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re to Phone: 503.639.4171 Fax: 503.598.1960 #4,p °"�1 i Date/B : ID -7 ?2/)—k,/ r Other Permit: - Inspection Line: 503.639.4175 OCT 0 7 2 xl� . ' !I Date Ready/By: 0 See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information CITY OF TIGARD e�:Y„ z "a`" �;, z 4pz �, �,ax,:: w��, gym - - -° �, .,: *° kJ .;. � s ;� ' ?& '� .� . !."�"� «•: €,ta�:,,�sT�;.t�.'F 3?�'i • • .vx'�.i r'ia; � . * � f M ] t g ,p t - tI . „ .' .. REQUIRE D�.TA 1 A ; D -2 FAMII Y DWEI;I,IINC �,°�. ..�N� . �,., �2 ��.. err,= t. �.-. �.,,.,....«...._ :.�`'".€'m�'6�i ��'�.,:�.w e.,.�,r. .' -i? �.�.,,�Y� ..:�� >� p�2uh.'k,. -t r e.- ?�.aa....w`�,� ^.�;„�� -- . _� ;s ��..=:w ,r�:�^: ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the 3 4 4 ` f' j - CA'1?EOOR OF `OO'NSTR 'CT701 , b 9, z i work indicated on this application. - and 2- family dwelling ❑ Commercial /industrial Valuation: $ 0 rkb C'- Number of bedrooms: 3 i ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: Number of bathrooms: 2_ ` r t 3... OB SI� T IYFOI2MA tum, D immt0 it iily Total number of floors: 5 -2 5 S l �- ( Job site address: ) -7_ New dwelling area: 2140 square feet City/State /ZIP: '• v ,- A'li- 0 - 7 a)3 Garage /carport area: , Z square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: , 1 ' `J.2- square feet W '`N l.tit- Other structure area: square feet `,, � s,=. . Ail A' t I i F USE CHECKLIST:'' Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2-S . 1 U'3 00 100 Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the r w Y� r w; Rr . oDESC TION ®I! ^ y`^ work indicated on this application. N I f _ -A-4, e Valuation: $ • j eu l i 8 > ,� Existing building area: square feet �\l 1� New building area: square feet PROPERTY OW ®TEN� s N umber of,stories: Name: \ ' ' i� _ S ` We v 5 — L i PJ C' - A e l Type of construction: Address: J j L c .LO J J W Y �, , j t ( /, \ Occupancy groups: City/State /ZIP: tL i V< � v 1 ( L e u� q 7 () Existing: Phone: ( Sti ). -, - 9 k ( 0C - Fax: (5 ) ?� _01v New: _.n o „ _ . + `" . r s'a.; 't x# h'vF W?, a °y^ x,,:..c + L a , ", �,. ` A°PPLIC T� �`�., .�;� e�� CONY //'��= -. Q� � �a � �';'°�•'�. s�� -�:: ��° -n:�� n .��` e,"^» 4 . � �1\ AMU .L. x�T{ A�. i s a4 .. , e 'dn ,j"RV ae - ; . Y r nt t ^ ;%. ,;,,a ,..t:'.�"v=r4,,„. „t, ::ti^t � .; ,. ` : K . ,.., : :�a,• e ,.: ° .; , : R, .p r� , . '' .• r.t �.'1 ' 1 .. ~ N • 'i `� i � ..^ ,.a�, tai. >a.- �:>Lz. _.., �� po Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax: : ( ) E -mail: ' V,� 4 GOO NTRAGTOR a .. A , vi 1 I & Business name: J / - / ,! � � � = � -�?�wA - .�B.UTtDZNGi'P'ERNTIT�;F'EES* Address: / if q D J , ft.) G.J "f l fi}� L/ ' t CL 0 � _ :.... City/State /ZIP: ) l l V , , r kii U 12 - Please refer to fee schedule G�_l ` 9/0 _J , F5 , Fees due upon application ,, r1 - 8 a Phone: (l !4�'J 0 ax: `$) 945 CCB lic.: f, g z� 7 ( 11 6� Amount received u l Date received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: - Date: 1 ' 7 - OS * Fee methodology set by Tri- County Building Industry 1 Service Board. is\ Building \Permits \BUP- PermitApp doc 12/03 440- 46t3T(1 t /02 /COM/WEB) t I \ Building Division A �p ih'�� Plan Submittal Requirement Matrix Commercial & Multi - Family - New, Additions or Alterations City of Tigard �y eof€Submrttal� # oflans � ' rtlibliMalozge365 (faeludes new, adchtionscand lterations� , °ubmrtal L Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 1* Fire Protection System 3 ** Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, • Washington County, and Tualatin Valley Fire & Rescue) * For over - the - counter commercial tenant improvements, submit 2 sets of plans. ** "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i:\Building \Forms \COM- PlansubReq.doc 12/24/03 Electrical Perm Pi' :1,:1 i I i� N. � r . . FOR OFFICE USEO;NLY ' . City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, ofsin '23 Plan Review 2005 ,,A,,,‘ Other Permit Phone: 503.639.4171 Fax: 50k548!19 r t'h�. Date/B . Inspection Line: 503.639.4175 Jj� • „ . Date Ready/By: Juris: El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information . . B UILD poRK PLAN REVIEW ❑ New construction JXddition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comet ❑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 C } and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure b Multi - family 1:1 Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND "LOCATION 0Egress/lightingp1an RV park Job no.: Job site address: ( Z,5 5 /2, i ' L ❑Health -care facility ❑Other: �- Submit 2 sets of plans with any of the above. City /State/Z j / - D The above are not applicable to temporary construction service. Suite/bldg. /apt no.: Project name: FEE* SCHEDULE_ Description I Qty. I Fee. 1 Total I Cross street/directions to job site: 0/ L. AivT 0 <2l S f New residential single- or multi - family dwelling unit. Includes attached garage. • 1,000 sq. ft. or less i 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: 2, S /03 13 C- ` DU Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular N Al A ^ ^ i / 1 ` n � (Z ( W L � � S Serv service and/or feeder 90.90 2 / v IJ (,J �(�N ,/5 ( Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 • - 201 amps to 400 amps 106.85 2 PROPER O WNER ❑ TENANT . 401 amps to 600 amps 160.60 2 Name: MZ r ,S e Je,,,:s ,`- A_ iFriwQi 601 amps to 1,000 amps 240.60 2 Address: `e. \ , c'( t _ ,, 1 v .v ( l Over 1,000 amps or volts 454.65 2 Reconnect only i 66.85 2 City /State/ZIP( A .. V 4 IA Q [ Q"t � � Temporary services or feeders installation, alteration, and /or Phone: ( Q' J 3) CJ t F ax: C . 1� '\ J � 7 • 9 9 relocation / I ( 200 amps or less 66.85 l 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, re t, ore than a rdting to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 r Owner signature: - /f. fi ;4,,,G_ ,.,..--^" Date: Al' ( J � Branch circuits -new, alteration, or extension, per panel APPLICANT l ❑ CONTACT PERSON 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 Address: ! \ J---- - each branch circuit Each add'I 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- n CONTRACTOR energy panel, alteration, or • ( c extension. Describe: Page 2 2 ' Business name: �,y __ , W_ I I)(JIAA 11.. 6 crrei L t ` / Each additional inspection over allowable in any of the above Address: Per inspection 62.50 City/State/ZIP: { ( ' `/L I t 0/2____ Investigation per hour (I hr min) 62.50 Phone: (5 6,3g_ 1 s - 3 5 3 / F ax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* .. CCB Lic.: Electrical Lic.: Suprv. Lie.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board * * Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440.4615T( I0/02/COM/WEB Electrical Permit Application - City of Tigard ' Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: "RESIDENTIAL WORK •ONLY: �! Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm El Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: 1 COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: • El Audio and Stereo Systems • ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation El Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls • ❑ Outdoor Landscape Lighting* El Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC- PermitApp.doc 04/03 ,Building Fixtures ,• .ru'. Plumbing Permit Application - FOR OFFICE USE ONLY City of Tigard Received 1 EIV� 1,� DazeBy. Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 A� fii Other Permit No.: 24- Hour Inspection Line: 503.639.4175 OCT 0 7 21"4 � D r� rn�s: Date Ready/By: H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information . TYPE OW Ok TIC :FEE* SCHEDULE, ❑ New construction 8U IL De o�nON 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 SF R(1)bath 249.20 • 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ O ther: Fire sprinkler ( sq. ft.) Page 2 " JOB SITE. INFORMATION AND LOCATION Site utilities Job site address: I Z S Z� S W `�` �. , %f w Catch basin or area drain 16.60 �i4 V City /State /ZIP: (_ A ,-)r Cf '7 '�Z Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: J Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 (-Ai A L ( 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.: D. 5 VV 0y (�t` �^� �7 l Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 M -P.(,J GW -k Backwater valve 16.60 ( VA S (; PVT Clothes washer I 16.60 6 Dishwasher I 16.60 ❑ PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 f l^ Ejectors/sump 16.60 Name: J , S� e �}� �� 5 � �[��- F� a( , )4( , , ‘„c Expansion tank 16.60 Address: I ( ' Q S (,J ( • IJ I. L ,, Fixture /sewer cap 16.60 City/State /ZIP: ! c u - V i � l () - z Floor drain floor sink/hub • 16.60 • Phone: ([ Ci� -� t Fax: (� 9 �, - 3 L./ Garbage disposal 16.60 ' (SUS) . ❑ CONTACT PERSON Hose bib l 16.60 Ice maker i 16.60 Business name: .1 Interceptor /grease trap 16.60 Contact name: v\Y L._ ..- Medical gas (value: $ ) Page 2 Address: 3 (. / Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin/lavatory 2. 16.60 Tub /shower /shower pan t 16.60 E -mail: Urinal 16.60 • ' CONTRACTOR Water closet 2 16.60 Business name: 11 /i"'S .!• Water heater 16.60 Address: t . `. ", t 1 n'. Other: City /State /ZIP: _ q 4-07 Subtotal Minimum permit fee: $72.50 Phone: (_ Fax: (�' Residential backflow minimum permit fee: $36.25 CCB Lie.: ` I Plumbing Lie. no.: I Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: ,,L.7 TOTAL PERMIT FEE Print name: /' Date: /U - 7_�� -- 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\Penn its\PLMF- PermitApp.doc 06/05 440-461 6T( t0 /02/COM/WEB) • Plumbing Permit Application - City of Tigard " Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities' ti Q ty . 'Fee,(ea). 'Total. Square - Footage :. "Permit Fee : • Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation:, Permit Fee: Storm 8c Rain Drain - 1st 100' 55.00 $ 1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture. or Rein. . Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Back flow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to • specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof Fixture Work: Plan. Review 'for Complex. Structures Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria accurately report fixtures could result in increased sewer fees *. Please check all that apply. Quantity by (Fixture) Work,Performed, ❑ Any new commercial building. Fixture.Type:° Replace ❑ Any new exterior plumbing site utilities. • Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi/Whirlpool . providing services to human beings. Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service - Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor /Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ Any new residential building containing three (3) or more - Domestic Drinking Fountain dwelling units. Eye Wash ❑ Any NFPA 13 -D multipurpose fire sprinkler system. Floor Drain /sink 2" Submit 2 sets of plans with any of the above. -3" -4" Car Wash Drain Isometric or Riser. Diagram. Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor P Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. i:\ Building \Permits\PLM- PermitApp.doc 07/06/05 • • at :Mechanical Permit 1 -\ ariA 1 ED n FOROFFICE US ONLY City of Tigard Received Date /By. Permit No.: 13125 SW Hall Blvd., Tigard, OR 97 3: O ry 2005 plan Review Phone: 503.639.4171 Fax: 503.598. .0 l / �yi ■ A ,, ft; , Dme/By. Other Permit: Inspection Line: 503.639.4175 ■ 4. Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF "WORK - COMMERCIAL FEE* SCHEDULE — USE CHECKLIST, Addition /alteration/replacement Mechanical permit fees* are based on the value of the work ❑ New construction � , performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION . Value: $ dwelling RESIDENTIAL EQUIPMENT /'SYSTEMS °FEES * l - and 2-family y g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB , SITE INFORMATION AND LOCATION Heating /cooling 2 S eS 1 C2 t E� Air conditioning or heat e • Job site address: � � C Ve) , (requires uires site plan showing g placement) 14.00 City /State /ZIP: 71 r n Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: I Project name: c i eVLC M Gas heat pump 14.00 Cross street /directions to job site: G 2, f 3 f' 4 IA , , � Duct work " '2 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.: Z S `v3 8,L O1 `aD . Other fuel appliances . . - DESCRIPTION OF WORK Water heater 10.00 /_ Gas fireplace 10.00 f3 C2 7 \fS N Flue vent for water heater or gas PI( l�v ✓� t i 1 / G�/Yl (L) L l igh 10.00 l Log lighter (gas) 10.00 D r e " t/ -ei-it Wood /pellet stove 10.00 • A �j _ POI r Wood fireplace /insert 10.00 AA f.� Chimney /liner /flue/vent 10.00 PROPERTY OWNER ❑ TENANT Other: 10.00 Name: M f // ' 4 / / 5- c7r- Environmental exhaust and ventilation Address: ( a S� (� l L,Sc tJ If 2`( Range hood/other kitchen O� equipment ! 10.00 City /State /ZIP: (AA, `s�/J, at, )t2 q7 07 0 Clothes dryer exhaust %/ 1 10.00 Single -duct exhaust (bathrooms, Phone: (5 ) 9. q an Fax: ( )g) g Z. S— ? (y toilet compartments, utility rooms) 6.80 ,APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 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 CONTRACTOR Barbecue Business name: J 1 417 ej('n S ,.,/_,e✓'L Clothes dryer (gas) Other: • Address: SGliyf MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) p er: ( ) Minimum permit fee ($72.50) • 7G, Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) � D TOTAL PERMIT FEE Authorized signature: E `'1 L � GCL/ 6 j4�(e- This permit application expires if a permit is not obtained within 180 • \ \\ days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board i.\ Building \Permits\MEC- PennitApp.doc 12/03 440 -4617T (1l /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation:' , .Permit ,Fee: >- $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 TIGARD 13125 S.W. HALL BLVD. . TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WILSONVILLE ELECTRIC INC PO BOX 845 WILSONVILLE, OR 97070 Electrical Signature Form Permit #: MST2005 -00350 Date issued: 10/2112005 Parcel: 2S103BC -00100 Site Address: 12525 SW 121ST AVE Subdivision: Block: Lot: Jurisdiction: TIG Zoning: R -4.5 Remarks: New garage & addition. Your company has been indicated as the electrical contractor for the permit indicated above. I n order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MIKE & LIND STEVENS WILSONVILLE ELECTRIC INC PO BOX 3527 PO BOX 845 WILSONVILLE, OR 97070 WILSONVILLE, OR 97070 Phone #: 503 - 925 -9100 Phone #: 503 - 638 -5353 Reg #: SUP 3854S LIC 75752 ELE 3 -307C AN INK SIGNATURE IS REQUIRED •NTH • R • gnature of S •ervising Ele f/ rician If you have any questions, please call 503.718.2433. FROM BRUNER1PLUMBING FAX NO. : 6242173 Nov. 14 2005 01:17PM P1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE 0;0 BRUNER PLUMBING Q N 14 PO BOX 23985 N 'TGS TIGARD, 012 97281 G �� 1G �� Plumbing Signature Form Permit #: MST2005 -00350 Date Issued: 10/21/2005 Parcel: 2S103BC -00100 Site Address: 12525 SW 121ST AVE Subdivision: Block: Lot: Jurisdiction: TIG Zoning: R -4.5 Remarks: New garage & addition. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: MIKE & LIND STEVENS BRUNER PLUMBING PO BOX 3527 PO BOX 23985 WILSONVILLE, OR 97070 TIGARD, OR 97281 Phone #: 503 -925 -9100 Phone #: 503 -624 -4880 Reg #: LIC 81837 PLM 26 -445PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call 503.718.2433. • - CITY QF TIGARD BUILDING DIVISION PERMIT #: - ; c) 5 3 5 er. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (5'03) 639 -4171 / °"" , aml ll Inspection Requests (24 Hrs.): (503) 639 -4175 •__:. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / ,1 C - <1.--- / c s -..r • /W -2--- CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: _.,; /5 ---- 6 =' Pour Time: (.- .._ : 1 (17- Code # Inspection Description Confirm # Contact # Message ,... -- --�- Corrections /Comments /Instructions: , 1 .4 ...."3'..r , 1 e d. -� f /r �: 7 / " / L' 'r ° ,..' �l 'U l T - 9 . Al i 17 r i pe.014-- n -- 4 2— • . i0I1. (L. ' ...1.1. I / ttiAe/ A i A vil ..)., ct.rtiop,41,9 hz _ _ 4 , , 2 /d ,,,,_ -, f2S_ - • • Af2 1 iv P ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS ,1A '' . I C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED // Inspector: ‘7i.,- 3"4g-e b Date: ". -�. -- z Phone #: (503) 718- _ ¢4r�j — - CITY OF TIGARD 0 A , . . BUILDING DIVISION PERMIT #: 2 oQs 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 /�mr � I + I Inspection Requests (24 Hrs.): (503) 639 - 4175_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / a— 5'a $ ! a.. / ...4.--f CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 -1,- 0 Co Pour Time: 4,4mp Code # Inspection Description Confirm # Contact # Message 9 F,;-, ,_9 ,_______„7„,___/„..Q._ Corrections /Comments /Instructions: 30 —L z i s ?) , ❑ PAS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL i , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector:, • Date: �' <= Phone #: (503) 718- 'CITY OF TIGARD e BUILDING DIVISION PERMIT #: IVIST' 006 00350 13125 SW Hall Blvd. Tigard, OR 97223 DATE ISSUED: 9 �� 4�n �mimlBl�l�� 10t �`'l /i€,5 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 {__.. INSPECTION WORKSHEET FOR DATE: 2/14/2006 TIME: - :22i M PAGE: r ,.1 SITE ADDRESS: 12625 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: Ne,v garage & addition. 12/20/05: Added (2) servicelfeeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925-9100 CONTRACTOR: JC)AT ENTERPRISES INC PHONE #: 503_925 -91OO Inspection Request Scheduled For: Date 2/1412006 Pour Time: c / / 1 Code # Inspection Description Confirm # Contact # Mes - ,e . 0 0 399 Plumbing final 02687 .01 50:3-784-3850 t Corrections /Comments /Instructions: 0 RA, A )44-t! ' - 17 e IA iecie,,2 -- 71_,„e ` /2-a ci L___.1,5D' a OA- 1 7ers 7 <_.. 1/9 g " ° 6> / / 4 4/4/VJ a 7/7,6 d .--* -P---ce-4 dra,--;- 6_49__ILre c---7:LAJ �� .. 0 1: ❑PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS A FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �" �' Date: � / ' �( Phone #: (503) 718 - r 24 CITY OF TIGARD BUILDING DIVISION ) _ PERMIT #: Mtn - - 200000360 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. Phone: (503) 639-4171 / Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 2/27/2006 TIME: 7 PAGE: 36 SITE ADDRESS: , — • . -. -- AV E LW!) ! I 21E7', 1 E CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE PROJECT NAME: STFVENS DESCRIPTION: W garage & addition. 12120105: Added (.'.I.) eel OWNER: STEVENS MIKE & LINDA PHONE #: 503.925-9 WO CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-925-9100 Inspection Request Scheduled For: Date: 1127/2006 Pour Time: Code # Inspection Description ' onfirm - Contact # Message 199 Electrical final R e::: : 027602-01 503-747763 Y • Corrections/Comments/Instructions: 0 3k • C.IIPASS 0 PARTIAL APPROVAL I] CANCEL 0 NO ACCESS ■ , El CALL FOR INSPECTION I] ADDITIONAL FEES ASSESSED Inspector: Date: 1 / 1 -'7 66 Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: iT145- 00360 11 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1ol21.0.01F t, Phone: (503) 639 -4171 7 Inspection Requests (24 Hrs.): (503) 639 -4175 =�. :_.. INSPECTION WORKSHEET FOR DATE: 212312006 TIME: 7:0iAlvi PAGE: 22. SITE ADDRESS: 1 )525 SW 121 ST AVE CLASS OF WORK: SUBDIVISION: LOT #: • TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. 12120/05: Added (2) servic:elfeeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 603-92f-0)100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-925-9100 Inspection Request Scheduled For: Date 2/23/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 027430-01 50a:1843850 Y TM Corrections /Comments /Instructions: — Pa 2 °1'7` ° O Zo , g_ca r ' cm.vir■A z, 1.6t. 6 8*. 01.41v v% N o 5 wwL. ( Va G4 .cziz&-aicl itst.\44 likkfi.d._. licL_ 1 ( -. WU '''' 'Pa_ cie..16,'01 hms)6 . baa lierik0 6ivizst. C__________SD -- PRs I Do< - ?ov,Ntig.. lo .. r -_. , ■ i _.k.4 er,§1_ is ,e- ' n PASS PARTIAL APPROVAL n CANCEL n NO ACCESS )t ACALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G ----, , `r C � Date: Zj 2)4 /0 Phone #: (503) 718 - OM 'O • CITY OF TIGARD BUILDING DIVISION PERMIT #: , ST2 t xi-00360 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/200 Phone: (503) 639-4171 hou v oi,r: Inspection Requests (24 Hrs.): (503) 639 -4175 Ail AL INSPECTION WORKSHEET FOR DATE: x16/2006 TIME: 7 :07At, PAGE: 26 SITE ADDRESS: 126'26 sw 12 AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STI=VENS DESCRIPTION: New garage & addition. 12/20/05: Added (2) service /feeders. OWNER: STEVENS, MMMIKE & LINDA PHONE #: G0 CONTRACTOR: 4IOAT ENTERPRISES INC PHONE #: 603- 9?!-9100 Inspection Request Scheduled For: Date 2/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 027016-01 603 - 784 -3860 N Corrections/Comments/Instructions: Ptkoks f Dt G Pe--k Prta oP - .eict nLi_ 3 wires ottoO .e■ A17 +•(4 6) t kg C4 g w f NO ckosta0 r 1 c of \) `P oxa- WtzZavz.v. 1 ' P awv►z z tpcui4 toot 4145 • tbAx Uii) • b(L R o s it, W l ct> R1 ; o f (toi Pc�•i A F- pQ ) Cry eporisvoi4 ' CZ1 ( 4)4^S n PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G. Date: 1 4 1 1 0 A) Phone #: (503) 718- 214410 CITY OF TIGARD BUILDING DIVISION , A PERMIT #: MST200600360 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 1001/2005 Phone: (503) 639-4171 11 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 28/2006 TIME: 7 PAGE: 7 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. 12/20/05: Added (2) service/feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925-9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 50:1-925-9100 Inspection Request Scheduled For: Date: 202006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 02660102 603-7843060 4 / ? ` 2 Corrections/Comments/Instructions: 71(2v Si 43- !I5 1 FC) LI • • PASS MI •ARTIAL APPROVAL I CANCEL [11 NO ACCESS INCFAIL VA ALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED ' (96 Inspector: ....411111111111ft■ Date: g Phone #: (503) 718 CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2005"00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639 -4171 /ti lt Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/21/2005 TIME: 7:01AM PAGE: 12 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: ilea garage & addition. 12/20/05: Added (2) service /feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 503 - 925-9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503 - 925 -9100 Inspection Request Scheduled For: Date: 12/21/2005 Pour Time: Code # Inspec is - l escription Confirm # Contact # essage . 115 Electrical servica 023861 -01 503-784-3850 Co : 'ons /Comments /Inst '•ns: O PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0 % t_g Date: itk I C Phone #: (503) 718- 2ii D CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST200&00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639 -4171 n�i�,��ii� t Inspection Requests (24 Hrs.): (503) 639 -4175 �_�� INSPECTION WORKSHEET FOR DATE: 12J1912006 TIME: 7:01AM PAGE: 1 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503 925 - 9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503 - 925 -9100 Inspection Request Scheduled For: Date: 12/19/2005 Pour Timer Code # Inspection Description Confirm # Contact # Message 115 = .Iectrical service 023713.03 503 -7th -3850 N Corrections /Comments /Instructions: �y 1 3 Visk, 2) zoo Al) I I PASS El PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL 4 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED .A Inspector: . / D ate: 1� b / W Phone #: (503) 718- Al7L__ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7 :06AM PAGE: '15 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503- 925 -9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503 - 925'9100 Inspection Request Scheduled For: Date: 12/16/2005 Pour Time: Code # • • - '. Description Confirm # Contact # Message 120 Electrical rough -i 023629-02 W3 -784- 3850 Y Corrections /Comments /Instructions: • isot muc-cRic yyverkc. J4L PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS I I FAIL CALL FOR INSP CTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /6 1S Phone #: (503) 718- 2i-/® CITY OF TIGARD , A , BUILDING DIVISION PERMIT #: iViSi200,5-00360 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i Phone: (503) 639-4171 tbleilit Inspection Requests (24 Hrs.): (503) 639-4175 ,-t-.)*-• ''''---. INSPECTION WORKSHEET FOR DATE: 2/23/2006 TIME: 7:01Am PAGE: 21 SITE ADDRESS: 12526 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. 12/20/05: Added (2) service/feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-92641100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503.9.N.:„.9100 Inspection Request Scheduled For: Date: 2/ 2312006 Pour Time: Code # • ' .• .` ription Confirm # Contact # Messes e : Op t 7>fl■ 39 Plumbing final 027430-02 50784-3850 Corrections ommen s nstructions: ic.-J.Pc)(7 7-- 1 '7 - o-K, 0 , 4 v tiv % 0 S P-,413kilviglY • . -----.1■11.11111I 021 PASS PARTIAL APPROVAL 111 CANCEL ril NO ACCESS 7 FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: - 1\it - Date: l 1 () Phone #: (503) 718- -2—L4Lv . , CITY OF TIGARD , BUILDING DIVISION PERMIT #: MST2005-00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21120M Phone: (503) 639-4171 . iftwtotAlilt\ Inspection Requests (24 Hrs.): (503) 639-4175 AO 11. INSPECTION WORKSHEET FOR DATE: 2/16/2006 TIME: 7:07Am PAGE: 24 SITE ADDRESS: 12625 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. 12120/05: Added (2) service/feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 503. gw CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503426 Inspection Request Scheduled For: Date 2/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 027015-02 503-784-3850 N Corrections/Comments/Instructions: 0 8 l'i 'RI • v ct- .44 :t ik I 6 . ,cArtegt-, c0 (1-cr.ikibar q A I ) iftikiii P;pio f 'a bltAit•I FK0AN 1 ibeiCL-41;4 Sotishp TV N ivoP 'ini b N. 4 - ECG PI,. Cgo..5.1i'Dit. 5NoviiNcti . b(4.711 . 1(2.11.)tv'ek, pg2 64Z: 1■3 vOit;:liti tl\P•Aszil- aasqs . , cgo v st•\ritc.. -Icz, I PASS PARTIAL APPROVAL fl CANCEL _ El NO ACCESS )FAIL 0 CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED &i n Inspector: 0 1"A e---- Date: 2.11 11040 Phone #: (503) 718-1* CITY OF TIGARD , . .. 1 BUILDING DIVISION PERMIT itialININMA I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2912005 Phone: (503) 639-4171 . A will t Inspection Requests (24 Hrs.): (503) 639-4175 J INSPECTION WORKSHEET FOR DATE: 12112/2005 TIME: 7:02AM PAGE: 35 SITE ADDRESS: 12626 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: Connect existing house to sewer lateral. Reimbursement District 18 fee paid this date. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925-9100 CONTRACTOR: BRIAN CLOPTON EXCAVATING INC PHONE #: 503 Inspection Request Scheduled For: Date: 12/12/2005 Pour Time: Code # Inspection Description Confirm # . Contact # Message 320 Plumbing rough-in 023294-01 503-794-3850 Y Corrections/Comments/Instructions: Pr 1\- 4 6 to eda P 1 z, ../..ss 0 PARTIAL APPROVAL ID CANCEL ri NO ACCESS I I FAIL El CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: k ii) Date: i ?q/ ,yp Phone #: (503) 718- CITY OF TIGARD . . BUILDING DIVISION A. PERMIT #: 00,16M603 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/29/2005 Phone: (503) 639-4171 400041mitit Inspection Requests (24 Hrs.): (503) 639-4175 ..A- 1 . L INSPECTION WORKSHEET FOR DATE: 12/8/2005 TIME: 7:00AM PAGE: 7 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: Connect existing house to sewer lateral. Reimbursement District 18 fee paid this date. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925-9100 CONTRACTOR: BRIAN CLOPTON EXCAVATING INC PHONE #: 503-682-0420 Inspection Request Scheduled For: Date: 12/8/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 023163-01 503-784-3850 N Corrections /Comments/ Instructions: ` . , lio inike) t i ra PASS n PARTIAL APPROVAL 0 CANCEL III NO ACCESS f FAIL 7 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 19/71) ti--- Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: M SiT2005- 00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: iO/71i2006 Phone: (503) 639-4171 emotlii?\ Inspection Requests (24 Hrs.): (503) 639-4175 I INSPECTION WORKSHEET FOR DATE: 2/17/2006 TIME: 7 PAGE: 3 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: New garage & addition. 12/ Added (2) service/feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 603_925.9100 CONTRACTOR: J)AT ENTERPRISES INC PHONE #: 503.,025_0100 Inspection Request Scheduled For: Date: 2/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 027123-01 503-7043850 Corrections/Comments/Instructions: NTLVINg. Lc Wi c414_, (PLuw F■t41%\-- 1A44‘939.1#1.— CaNI—L) ttt \■10 Mgoa • 0 PASS 0 PARTIAL APPROVAL CANCEL 0 NO ACCESS 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: s - N e , Date: 4) 1 Co /% Phone #: (503) 718- rei.A.A. CITY OF TIGARD ' N A BUILDING DIVISION PERMIT #: MST2005-0()350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/5 200 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 .4A '''!---• INSPECTION WORKSHEET FOR DATE: 202006 TIME: 7:01AM PAGE: 0 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. 12/20/05: Added (2) service/feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 603 926.9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-925-9100 Inspection Request Scheduled For: Date: 202006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 026502-01 503-7043850 N Corrections/Comments/Instructions: K t:ASS a PA: • AL APPROVAL 0 CANCEL fl NO ACCESS FAIL r4 A FOR INSPECTION El ADDITIONAL FEES ASSESSED ,------- ------ .4111111111111111111"- • '- g Inspector: INNII■111.6. Date: Phone #: (503) 718- CITY OF TIGARD al BUILDING DIVISION PERMIT #: MST200500350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •iC)/21 /. tip Phone: (503) 639-4171 ii� ° sl Inspection Requests (24 Hrs.): (503) 639 -4175 ,..„......W � _'' .. INSPECTION WORKSHEET FOR DATE: 12/2312005 TIME: 7:02AM PAGE: °I2 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: ' SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. 12/20/05: Added (2) service/feeders. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925-9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 50 - 925 -9100 i' Inspection Request Scheduled For: Date: 12/2:3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation / 023992-01 503-784 -3850 N Corrections /Comments /Inst uctions: _ t ___E„ ' . S ',,_Y-1;.--,_,L.,,,,_) - - v - e - - - - - Q _ . _ A _ - _ _' 9 -'- a • i A. IV . PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: (./(4-- ✓ Date: , �� vC- P hone #: (503) i P ) 718- „.._ CITY OF TIGARD - ,. . ,•? BUILDING DIVISION PERMIT #: MST2005-00360 13125 SW Hall Blvd., Tigard, OR 97223 (7) DATE ISSUED: 10121/2006 Phone: (503) 639-4171 . / to w e i I it Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1 7J 19/2005 TIME: 7:01AM PAGE: 2 SITE ADDRESS: 12626 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925.9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-926-9100 Inspection Request Scheduled For: Date: 12/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 ra ... . - rving 023718-02 503-704-3850 N 1,471AS-C--- Corrections/Comments/Instructions: • c _ A/L--vv(- S I. . II a , . e _ -, - .- 0 :,.._ .. • - -\--ti-e__S H PASS itA PARTIAL APPROVAL n CANCEL n NO ACCESS 0 FAIL • ',LL FOR INSPECTION ADDITIONAL FEES ASSESSED --- A Inspector: \/ (} Date: \ *6 /. Phone #: (503) 718---2Y2-11 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1W21/2005 • A Phone: (503) 639 -4171 a re,�mp�,��i�l&jIl�t J Inspection Requests (24 Hrs.): (503) 639-4175 ..._.. (� INSPECTION WORKSHEET FOR DATE: 12119/2005 TIME: 7:01AM PAGE: 3 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. l OWNER: STEVENS, MIKE & LINDA PHONE #: 503 - 925.9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-925 -9100 Inspection Request Scheduled For: Date: /2/1912005 Pour .• e: Code # Inspection Description Confirm # Contact # 1 essage 240 / exterior sheathing 02371301 503 - 784 -3850 V Cve– . — v L Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: C Date: � V 1 v . � h one #: (503) 718 - -2-y.2-v CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200500350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2006 Phone: (503) 639- 4171 �y��u� i� �l Inspection Requests (24 Hrs.): (503) 639 -4175 ._.....,_111 °` ... INSPECTION WORKSHEET FOR DATE: 12/16/2005 j TIME: 7:06AM PAGE: 10 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT : TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503825 -9100 CONTRACTOR: MOAT ENTERPRISES INC PHONE #: 503 - 325 -0100 Inspection Request Scheduled For: Date: 12/16/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 023628 -01 503-784-3860 . Y t k G PiVk Corrections /Comments /Instructions: 412'�i.: /) 4 ' 0 l:eit ' . :0 (4, 5 .0 srs ' d ? `(,) L , „ - Pe , �' G '77. 7 ./J ,/ 'G:. ✓ 4V a" 4 6 022._ ?4 — ii-, • 4 /J71-- 'P--Q--t'i 6 I PASS • PARTIAL APPROVAL ❑ CANCEL ( I NO ACCESS '''0 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4 Da t e: /?.��,6 G� Phone #: 503 718- 2- 7 0 4 p (503) CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2112005 Phone: (503) 639 -4171 upmy�ii�b' Inspection Requests (24 Hrs.): (503) 639 -4175 �' W �' L INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7 :00AM PAGE: 42 1 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925-9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503- 925.9100 I Inspection Request Scheduled For: Date: 121772005 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 023091-02 503 -784 -3050 N Corrections /Comments /Instructions: • • PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: . �° �" Date: 72 /77 65 5 Phone #: (503) 718- 7 fib r� r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200& - 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639 -4171 �Ipii��l��hl Inspection Requests (24 Hrs.): (503) 639 -4175 4 `:_.. INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7:00AlVI PAGE: 41 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503 - 925 -9100 CONTRACTOR: MOAT ENTERPRISES INC PHONE #: 503- 925 -9100 Inspection Request Scheduled For: Date: 12/7/2005 Pour Time: • Code # Inspection Description Confirm # Contact # Message 235 Shear vvallslanchors 023091 -03 503-784-3850 N Corrections /Comments /Instructions: /740Gae 02# / 9aAel.,f -e— ,i/2-e,) P /---y7-e4 44 e,e.ger • • PASS X PARTIAL APPROVAL _ CANCEL El NO ACCESS FAIL g CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED (n_ Inspector: / ' � Date/ Phone #: (503) 718- 2 . 7 ' CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST 2005-00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2006 Phone: (503) 639 - 4171 ii� Inspection Requests (24 Hrs.): (503) 639 -4175 iv _.. INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7:00AM PAGE: 40 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT # TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition, . OWNER: STEVENS, MIKE & LINDA PHONE #: 503 - 925 -9100 CONTRACTOR: . JOAT ENTERPRISES INC PHONE #: 503 Inspection Request Scheduled For: Date: 12/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 023091-04 503. 7843850 N Corrections/Comments/Instructions: / • • PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS -).. FAILS 1 ' CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: / l / Date: ) Phone #: (503) 718- . 7-70,6 V ,..-_ CITY OF TIGARD . A BUILDING DIVISION PERMIT #: MST2005-00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639-4171 irtlit Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7 : 00 AM PAGE: 43 SITE ADDRESS: 12525 SW 121ST AVE / CLASS OF WORK: SUBDIVISION: • LOT # TYPE OF USE: PROJECT NAME: STEVENS • DESCRIPTION: N garage & addition. OWNER: STEVENS, MIKE & LINDA PHONE #: 503-925.9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-925-9100 Inspection Request Scheduled For: Date: 12/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough-in 023091-01 503-784-3850 N Corrections/Comments/Instructions: 4 -Q-(A64r 6414 - 7 / 0 -7 47- 7 f,17 al e.,//2J-/i-eA A bait '') Si= /?et &kJ-en 4...ecrt.4 r ,,, zi PASS 0 PARTIAL APPROVAL fl CANCEL El NO ACCESS I FAIL pi CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED ; Inspector: , Oi.„-- Date: / 49 5 -- Phone #: (503) 718- i / CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10121/2005 Phone: (503) 639 -4171 ' aNN��m�(�l�i�h� Inspection Requests (24 Hrs.): (503) 639 -4175 �_' ...... INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 26 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: ,9 TYPE OF USE: PROJECT NAME: STEVENS ,f DESCRIPTION: - garage- &- edditi — r ' OWNER: STEVENS, MIKE & LINDA ,, PHONE #: 503 - 92 -9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503 - 925 -9100 Inspection Request Scheduled For: Date: 11/16/2005 Pour Time: 11 &i Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 021447 -01 503 -784 -3050 N Corrections /Comments/ Instructions: r /.,/ .. _ d �� _(, cr ) / m cG.c.o �� / ,sue a- ecL,z v� � ,., A �e_n, Ate 44,4 �� «/ /IC «- r152 zA 2 -- phOejF o -Q 1v/ ' d P- / 7,.a.i eLlaA cl "2 I / 7 4L ?' `Zit lei "26 f d C4 c,�rc.c. 2 le) ( _ p_12.A eL R,/7.4,6 ‘ 74 2 . re r 1 72gCl i PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL' I I CALL FaR INSPECTION ADDITIONAL FEES ASSESSED / Su 3.`3 - 5 7 -'"l 7/ Inspector: .• Date: ) / / P e'. Phone #: (503) 718- z i o & L CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 62 SITE ADDRESS: 12525 SW 121ST AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: STEVENS DESCRIPTION: New garage & addition. OWNER: STEVENS, MIKE & LINDA As 7 ---- PHONE #: 503-925-9100 CONTRACTOR: JOAT ENTERPRISES INC PHONE #: 503-925.9100 Inspection Request Scheduled For: Date: 11/14/2006 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 210 Foundation wails 021134-01 503-794-3050. V Corrections /Comments/ Instructions: Nei X e(47 7 PASS 1 l PARTIAL APPROVAL E CANCEL 7 NO ACCESS k i FAIL Or CALL FOR INSPECTION El ADDITIO ' L F S ASSESSED ( Inspect° : , Date: k i P5 Phone #: (503) 718- ‘• ., . r