Permit :1 ~ CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2008 -00054
COMMUNITY DEVELOPMENT DATE ISSUED: 5/14/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134AC-02660
SITE ADDRESS: 11338 SW COTTONWOOD LN ZONING: R - 4.5
SUBDIVISION: ENGLEWOOD NO.3 LOT: 226 JURISDICTION: TIG
PROJECT: LOLICH
Project Description: 224 sq. ft. addition. Mechanical other- duct work.
BUILDING •
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 10 FIRST: 224 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
OCCUPANCY GRP: R3 BORM: BATH: TOTAL: VALUE:
224 sf 21,483.64 REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: WASHING MACH: 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: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: 1 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVCIFDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
CHERYL LOLICH HOWARD BINGHAM CONST laws. All work will be done in accordance with approved plans. This
11338 SW COTTONWOOD LN 4440 SW 110TH AVE permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97223 BEAVERTON, OR 97005 if the work is suspended for more than 180 days. ATTENTION
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952- 001 -0010
through 952 -001 -0080. You may obtain copies of these rules or direct
Phone: 503 - 590 - 9281 Contact #: PRI 503 643 - 5511 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #: LIC 40448
TOTAL FEES: $ 992.33
REQUIRED ITEMS AND REPORTS
Issued : I I i IA 4 �. 1 Permittee Signature :,
Call 503.639.4175 by 7:00 a.m. for an inspection that business d.
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.
1/ 3 3 ?-- 1;c-t) , cc (...&.-ut..) Le.../v-__
D uildina.Permit Applicati n
Corrimercial . ' FOR` OFFICE' USE ONLY
of Tigard t
Rec eived
City Cit Permit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223 61 ���0� DateB : L r i o, / w • p '� „
g Q � !� Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 P DateB : 1 5. 7 / o8
T I G A R D Inspection Line: 503.639.4175 rt . i s G . - Date Ready /By: kris: ® See Page 2 for
Internet: www.tigard- or.gov ` "� N Y -� o l �� Notified/Method: /� Supplemental Information
TYPE OF WO REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all 7 ),
Ejltgition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application' RI , .../8 3 . g Y
and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE. INFOR MATION AND LOCATION Total number of floors:
Job site address: + a 3 9 3 k.) C, e , - \ -- (,_) C,c, New dwelling area:, 0 • 22 G/ square feet
City/State /ZIP: Q 0-r) 1 2-3 Garage /carport area: square feet
Suite/bldg. /apt. no.: \-) Project name: ( i Covered porch area: -- square feet
Cross street/directions to job site: Deck area: ,.---- square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
tiCI �D - (.9 fl .\ Q.�_ -J i1 3u Valuation: $
t " „ "� ,l � 4 / r 1G � Existing building area: square feet
V // ( New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: (L l __0 ) Type of construction:
Address: ( Co - 6 77 S l x) 1---.j. -, -u) L.--d, Occupancy groups:
City /State /ZIP: T t alCxr D b e7 ') a 3 Existing:
Phone: b3) 5 - c� g I Fax: ( ^^ ) New:
[f - APPLICANT �CUNTACT PERSON
' f n NOTICE
1
Business name: 4o V ) C t }v L ti t-o Cry./ � 1. All contractors and subcontractors are required to be
Contact name: ( () i r`J J�� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: .4 t,.( c.1, 0 5 L.) j 1 et jurisdiction in which work is being performed. If the
City /State /ZIP: & c�.v{, -d--or` Z „ G 7 °C.1 applicant is exempt from licensing, the following reasons
// C apply:
Phone: .. f 5 4 43 - ( )
E -mail:
CONTRACTOR
Business name 1:-/006,,D 4 j J he,- C,�1l r , BUILDING PERMIT FEES*
Address: t( 0 S t,„1 11 0 1 (Please refer to fee schedule)
City /State /ZIP: 6e l uC/�Yt 6 , Structural plan review fee (or deposit): 4S'� 17 7-
Phone: I3 ) ( 4 5f// Fax: ( ) /,.�_ FLS plan review fee (if applicable): �—
CCB lie.: U O:`jR / Total fees due upon application: L Li F
Amount received: 1-1 ; Li sr
,Authorized signatu
This permit application expires if a permit is not obtained
i2 A:""‘.1------'-'...---- within 180 days after it has been accepted as complete.
Print name: r J it' Date: `7 c * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(I1/02 /COM/WEB)
•
.
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty -five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 10/30/07
, Mechanical Permit Application - FOR OFFICE USE ONLY
' , s' City of Tigard Received
`1
Date/By: i B o rs , • nit No.: LI
Al 8 "IL
1 ,14 - ' ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review •J
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI GA RD Inspection Line: 503.639 Date Ready /By: Buis: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYKE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
L( � A / Mechanical permit fees* arc based on the value of the work
El New construction ddition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
��/ RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
It I and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea Total
. JOB SITE INFORMATION AND LOCATION . Heating/cooling
l 1 ,S 1,✓ � �� ��) (� �� Ai heat pump
Job site address: l
!) (requires site plan showing placement) 14.00
City /State /ZIP: J S w r Oa_ ', -}. 3 Furnace 100,000 BTU (ducts /vents) 14.00
t Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: \
Gas heat pump 14.00
Cross street/directions to job site: Duct work i 10.00
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. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
ROPERTY OWNER ❑ TENANT
Other: 10.00
Name: LC)I w ) c f ^ ` Environmental exhaust and ventilation
Address: `` -s ca , ..,� to ) / _ „• - " _,e. Range hood /other kitchen
�`''�" equipment 10.00
City /State /ZIP: r • ‘,....^.,2 t;/ et. ' '? Clothes dryer exhaust 10.00
4 Single-duct exhaust (bathrooms,
Phone: ( u 3 ) v. —J O) Fax: ( ) toilet compartments, utility rooms) 6.80
illAPPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: /� / Other: 10.00
l Oii, 1 4 .' tt� J _. i ( `s �t Fuel piping
Contact name: i,.._ � fJ� J J $5.40 for first four; $1.00 for each additional
4 j 0 C() i/ p (C 11 Furnace, etc.
Address: '" `i d
Gas heat pump
City /State /ZIP: 44. (/ -k.'s /'(lam (.',, Wall /suspended/unit heater
) Ts. / _) > 5 Fax: : ( )
Water heater
:
f
Phone
Fireplace
E -mail:
Range
CONTRACTOR. Barbecue
Business name: c l� 4 �f e G A � L ( Clothes dryer (gas)
/ " ` Other:
Address: f 74$ 5 /1 2, C� ^ ) MECHANICAL PERMIT FEES*
City/State/ZIP: Pwn> ,i v > q � � - Subtotal
Phone: ( 76 Fax: ( ) Minimum permit fee ($72.50)
/ 6 / — ( .5---;3 ' (� Plan review (25% of permit fee)
CCB lic.: -71 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: / V This permit application expires if a permit is not obtained within 180
y days after it has been accepted as complete.
! 1 /
Print name: j D ate: 7— 7 * Fee methodology set by Tri- County Building Industry Service Board
t:\ Building \Permits \MEC -PermitApp.doc 01/19/07 440 -4617T (11 /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.
1:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2
. Electrical Permit Application FOR OFFICE USE ONLY
ce
Reived N..� o too s y
City of Tigard Receive PermitNo.: ')1
° 13125 SW Hall Blvd., Tigard, OR 97223 P lan Review
III •
C '`t Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
T lGARD Inspection Line: 503.639.4175 Date Ready/By: luris ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction [g Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND-LOCATION A
❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: Job site address: I, 3 2 1�-� C� a W �L S ix or or mo a r es. occupancy.
/ ! 0 or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: c„ > a a ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: U Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: CL e A - / ( L l ) L( 401 amps to 600 amps 160.60 2
`� 601 amps to 1,000 amps 240.60 2
Address: l \ 7 7 3 8 � C wGp,) _ Over 1,000 amps or volts 454.65 2
City /State /ZIP: J , - '� 23 Temporary services or feeders installation, alteration, and/or
(, ( nr G C/ 1 oc relocation
Phone: (3)3 ) 't D .- 2 p t Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
[APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: 2 e*) U,-) 1 1-, i, C 0, 14- B. Fee for branch circuits
Contact name: L t) � ``` f i r st without service or feeder fee, I 46.85 2
C) ✓lJ first branch circuit
Address: L.4 L"'( 1.4 o S' ' C (d i-41 Each add'I branch circuit I 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: f c L i .t,,...(-&,, U (� „ 4 7 (..? o s Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: e ) (c,/ 3- A Fax:: ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
' , CONTRACTOR Sign or outline lighting 53.40 2
`� ( Signal circuit(s) or limited -
Business name:
�(l-cf S I ( (. - T L j v, L energy panel, alteration, or
Address: 117 C _(, 9 ., ( L , extension. Describe: Page 2 2
City/State /ZIP: . x . 6_,)�,/ .ii-e.1 - 4' S
o) te_ Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (w) ) C n - --`'tFl) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: 7 i Electrical Lie.: '3(4 _,'a�SL Suprv. Lic.: 1 (017-5 Industrial plant per hour 73.75 J
6 ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: S — E S'/ 6N4-7-4t /l ,c76'-X/% TOTAL PERMIT FEE:
• This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
. Number of inspections allowed per permit.
I:\ Buildin g\Permits\ELC- PermitApp.doc 05/23/06 440- 46t5T(l 1 /05 /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:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom- and Paging Systems
❑ Landscape Irrigation Control*
n Medical
I - 1 Nurse Calls
❑ Outdoor Landscape Lighting*
❑ 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 03/23/06
Plumbing Permit Application
Building Fixtures FO OFFICE USE ONLY
City of Tigard Date/By: Received
t-[ 7 .61 (ir Permit No.: /7'07).v( -UC1Cb
!PI
- a 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date /By: Other Permit No.:
T 1 G A RD Inspection Line: 503.639.4175 Date Ready /By: Juris. ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* •SCHEDULE _
❑ New construction III Demolition For special information use checklist
� Description Qty. Ea. Total
❑ Addition/alteration/replacement er: � ( New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
Ind 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
El O ther:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 33 C� �_ vo " w� �.. Catch basin or area drain 16.60
City /State /ZIP: % oi / � _ q' - 7 )- -,- ?� Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 I Project name: Lo\ ; Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
. Backwater valve . 16.60
Clothes washer 16.60
Dishwasher i 16.60
PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
C _ , \ j ( L �' Ejectors /sump 16.60
Name: �1v,."�W, Expansion tank 16.60
Address: , ` '33 2 ,� C -Vc,� 6 - Fixture /sewer cap 16.60
City /State /ZIP: - ) ) i, D � a 7 11) Floor drain /floor sink/hub 16.60
Do �
Phone: (. 6 s t -q _ 6 1 Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
APPLICANT ❑ CONTACT PERSON
. 1"
( Ice maker 16.60
Business name: Ir' `) (A. 7.w5',�� n.- 0
f Interceptor /grease trap 16.60
Contact name: C 6 ue t 3°, p' Medical gas (value: $ ) Page 2
Address: `4 U k{ 0 ' j3 0 0 Primer 16.60
City/State/Z1P: atc ii e v , A C N - Roof drain (commercial) 16.60
Phone: (s'O5) rn ) - /' 6 3 Fax : : ( ) C Sink /basin/lavatory 16.60
7 J Tub /shower /shower pan 16.60
E -mail: / SS e Urinal 16.60
CONTRACTOR. Water closet 16.60
Business name: (,)f� °-S ., Q( o i �j.I v • Water heater 16.60
Address: 7- q E.
,.i 'v.)114- f {d 5I. Other:
City /State /ZIP: PUr 2 -( - 7d -1 °7 Subtotal
( U Minimum permit fee: $72.50
Phone: ( 9 -: 7, 7). Fax: ( ) Residential backflow minimum permit fee: $36.25 _
CCB Lic.: /f( Plumbing Lic. no.: 1 6 - O Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signatur J TOTAL PERMIT FEE
Print name: , � , ,,- ! - Date: 4. b e ..This permit application expires if a permit is not obtained within
� 180 days after it has been accepted as complete.
5' E -C / C \ S I 77 // /e-E A' /2/11 '&57 *Fee methodology set by Tri- County Building Industry Service Board.
1:\ Building \ Permits \PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities , Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1' 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 & 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 Item 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 Backflow 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
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped, Added Existing , ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall ❑ Any complex structure as defined in OAR918 780 - 0040.
-Drive Thru
Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
- 3"
-
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang •
-Stall
Sink - Bar /Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i \Building\Permits\PLM- PermitApp.doc 12/27/06
04/29/2006 11:07 5036435415 HOWARD BINGHAM PAGE 02/02
, a CITY OF TIGARD
COMMUNITY DEVELOPMENT
r.' \ 1 w 13125 SW Hall Rlvd., Tigard, OR 97223 503.639.4171
RECE W D
Plumbing Signature Form APR 3 0 2008
CITY OF TIGARD
BUILDING DIVISION
IMPORTANT PERMIT NOTICE
Permit #: MST2008 -00054
Date Issued:
Parcel: IS 134AC - 02660
Site Address: 11338 SW COTTONWOOD LN
Subdivision: ENGLEVVOOD NO.3
Lot: 226
Jurisdiction: R
Zoning: TIG
Project Name: LOLICH
Description: 224 sq. ft. addition.
Your company has been indicated as the plumbing contractor for the permit referenced 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. Please mail the form to: City of Tigard, Building Division,
13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681.
If you have any questions please call 503.718.2433.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
CHERYL LOLICH - I A / / 9 - TS p L_ t /•11., a I (?•I 6
11338 SW COTTONWOOD LN 7 c 3 S'
TIGARD, OR 97223 ) a . /J / UAL c i 7.9 I S
Phone #: 503- 590 -9281 Phone #: co3 ,•-�'(9 -3 7 a-6
Reg #:
f 3 6- &_ 600-0-P a
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Z 02 y
Signature of Authorifed Plumber Name (printed)
04/29/2008 11:08 5036435415 HOWARD BINGHAM PAGE 92/02
%40H T TIGARD
COMMUNITY DEVELOPMENT
rif'nl i7 13125 SW Half Blvd., Tigard, OR 97223 503.639.4171
RECNED
F W
Electrical Signature Form E
APR 3 02008
IMPORTANT PERMiT NOTICE CITY OF TIGARLi
BJILPN.� nIviS lCN
Permit #: ST2008 -00054 - -
I'
Date Issued:
Parcel: eS134AC -02660
Site Address: 11338 SW COTTONWOOD LN
Subdivision: ENGLEWOOD NO.3
Lot: 226
Jurisdiction: TOO
Zoning: R - 4.5
Project Name: LOLICH
Description: 224 sq. ft. addition.
Your company has been indicated as the electrical contractor for the permit referenced above. In order for the electrical
permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from
(our company sign below and return this Electrical Signature Form prior to the start of the work. Please mail the form to:
of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 5 03.624.3681,
f you have any questions please call 503.718.2433.
Jo electrical Inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
CHERYL LOLICH Enders Electric Inc
11338 SW COTTONWOOD LN PO Box 1661
TIGARD, OR 97223 Beaverton, OR 97075
Phone #: 503-590 -9281 Phone #: 503 -626 -4813
503 - 646 -3871 fax
Reg #,CB# 26728
Lic # 34 -265C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
i 4 9 6 i/1
W o�3ew-TS °kJ S
SUP LIC #
)nature Supervising lectrician Name (printed)
Ili II . . .
RECEIVED
APR 2 92008 RECEIVEp '.
CITY OF TIGARD
BUILDING DIVISION
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t TIen Ar e. ,.. x'11'2215
1 . III 111
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: jaVE2
PLANNING DIVISION:
Required Setbcks: a Approved,' ❑ Not Approved
Side: g— Street Side: t�
G rage: Rear: —
Front. + ❑ Not Approved
\f isua! Clear�tx►ce• t_.
_> Maximum Buildio ; He :.`'i test ❑ No
CWS Service Provider Let; r Required: 0 Yes
❑ Received
,,{. Date: Lt WI /aY
ENGINEERIN DEPA TMENT e d 0 Not Approved
Site P% ' j��� : A pproved • Z - 8 ot ' .proved
Site P!
B /L_ ■ Date:
war
Notes: ryr/- d'"r`w' ,
CITY OF TIGARD - SITE Pf AN REVIEW
[BUILDING PERMIT NO: /� - zy��j
S?aeet Trees: Approved ❑Not Approved
--- 11' Approved 42 O ° AY: Dte:
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2008.000 4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639- 4171u�j�i��� f lil
Inspection Requests (24 Hrs.): (503) 639 -4175 ��
INSPECTION WORKSHEET FOR DATE: 7/3/2008 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 503 -690 -0281
CONTRACTOR: HOWARD BINGHAM CON 7T PHONE #: 503. 643 -6511
Inspection Request Scheduled For: Date: 7/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
200 Insulation 072169-02 503. 515 -7703 Y
Corrections /Comments/ Instructions:
F PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7- 3-- -a Phone #: (503) 718- Z"r—
CITY OF TIGARD - - ..
BUILDING DIVISION PERMIT #: MST2008 -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2000
Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 8/25/2008 TIME: 7:00AM PAGE: 341
SITE ADDRESS: 11330 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work
OWNER: LOLICH, CHERYL PHONE #: 503-690-9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503 - 543 -5511
Inspection Request Scheduled For: Date: 8/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 074524 -01 603. 515.7703 N
3Qb 0104.
Corrections /Comments /Instructions:
iXt PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: QZLvM,.), \q Yi.�- Date: 7 12.5 0 T. Phone #: (503) 718-
CITY OF TIGARD - .
BUILDING DIVISION PERMIT #: MST2008 -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 /an 4p 1
Inspection Requests (24 Hrs.): (503) 639 -4175 `LL.
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7 :01A1v1 PAGE: 62
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD N0.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct wort;.
OWNER: LOLICH, CHERYL PHONE #: 503 -590 -9281
CONTRACTOR: HOWARD GINGHAM CONST PHONE #: 503- 643 -5511
Inspection Request Scheduled For: Date: 5/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 071697 -01 503.516.7703 N
Corrections /Comments /Instructions:
A PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: `J V � W f — Date: G' 23 1 D� Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2008 -00054
13125 SW Hall Blvd., Tigard, OR 9723 DATE ISSUED: 5,11412008
Phone: (503) 639- 4171wv 4j iii J u l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/6/2000 TIME: 7 :01AM PAGE: 48
SITE ADDRESS: 11330 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: L.OI..ICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 503 - 590.9201
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503 -643 -5511
Inspection Request Scheduled For: Date: 6/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
315 Post /beam plumbing 070963 -02 503.515 -7703 Y
Ci/oEw D - )Ai so.
Corrections /Comments/ Instructions:
1 „ - 4 I 13 A c- ,z. C/ 1 d.... (.l t--) G., r la d,/ tQ ;✓a. t LA
•
[a PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: cT1w4.,_J\ \'V'-: -*- Date: 6 I I ( ci`, Phone #: (503) 718 -
CITY OF TIGARD - • •,.. 1/
BUILDING DIVISION o PERMIT #: M ST200t -000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/°14/2000
Phone: (503) 639- 4171 � v Ins pection Requests (24 Hrs.): (503) 639 -4175 ` --
INSPECTION WORKSHEET FOR DATE: 6/4/2008 TIME: 7:01AM PAGE: 31
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOUGH, CHERYL PHONE #: 503 -590- 0281
CONTRACTOR: HOWARD BINGHAM CON ST PHONE #: 503 - 643-5511
Inspection Request Scheduled For: Date: 6/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 070809.02 503 - 515.7703 N
Corrections /Comments /Instructions: ( �,
______________-- Ct -•-\ Xi
Q--
e L-1-
[ Ob ( D%C w,06-u3 vz,..> .
LeA),LN — Ait.„,..61,e___. -km) A,kit_,,, ,,
z,-1--, o
\ ,
I tl, PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED V,
' tp ( U\ i b ( 2A
Inspector: Y V Date: Phone #: (503) 718 -
p � )
1
CITY OF- TIGARD
BUILDING DIVISION PERMIT #: MST200B- 000&4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED - 5/14/2008
Phone: (503) 639- 4171�v
Inspection Requests (24 Hrs.): (503) 639 -4175 �� . . "f ��
INSPECTION WORKSHEET FOR DATE: 8/28/2008 TIME: 7:00AM PAGE: 55
SITE ADDRESS: 11338 SW COTTONWOOD LhJ CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 503-590-9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503- 643 -5511
Inspection Request Scheduled For: Date: 8/28/2008 Pour Time:
Code # • Inspection Description Confirm # Contact # Message
299 Final inspection 07474342 503 -515 -7703 Y
Corrections /Comments /Instructions:
If .
dr
I IPA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 0 ° Z-� --692) Phone #: (503) 718-
___ —__--__'-----'—__-- ___
C ITY OF ��n m n *�'m m n����nm�° .. _
BUILDING DIVISION PERMIT #: M8T2008-00064
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639-4171 . |nupeoion Requests (24 Hrs.): (503) 639'4175 04.111 *�
INSPECTION WORKSHEET FOR DATE: 8/28/2008 TIME: 7:00Ah4 PAGE: 56
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: EMGLE\AtO()DN{}.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOUCM.CMERYL PHONE #: 503-590-9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503-643-5511
Inspection Request Scheduled For: Date: 8/28/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 074743-01 503-615-7703 N
Corrections/Comments/Instructions:
.
~�PA8S -- PARTIAL �� �ANC�EL �� NOAC[�ESS
_ _ _
0 FAIL I i tI CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: A Date:8 , ---b ' — C' 2- Phone #: (503) 718- 2.1-c1-3"
C F TIGARD -
BUILD NG DIVISION PERMIT #: MST2008- 00054
1312'`SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/200f3
Phone: (503) 639 -4171 gy ro w �jp o lplj�l�
Inspection Requests (24 Hrs.): (503) 639 -4175 :� i :_..
INSPECTION WORKSHEET FOR DATE: 7/2/2008 TIME: 7 :01AM PAGE: 40
•
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq..ft. addition. Mechanical other.- ductwork.
OWNER: LOLICH, CHERYL. PHONE #: 503590 -9281
CONTRACTOR: HOWARD BINCHAM CONST PHONE #: 503 - 5511
Inspection Request Scheduled For: Date: 7/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 072122 -01 503. 515.7703 Y
Corrections /Comments/ Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL i dk CALL FOR INSPECTION U ADDITIONAL FEES ASSESSED
Inspector: / Date: - 7— Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2Ot)B -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 Ail/
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/1/2000 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft- addition. Mechanical other- .duct work
OWNER: LOI-ICH, CHERYL PHONE #: 503-590-9281
CONTRACTOR: HOWARD t3INGHAM CONST PHONE #: 503 -643 -5511
Inspection Request Scheduled For: Date: 7/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
2 Framing 072069.01 503-516-7703 Y
Corrections /Comments /Instructions:
2 �e
PASS ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: - 7 — /- 6 8 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION #: M ST2008 00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 " Ak lpu ' 'll
Inspection Requests (24 Hrs.): (503) 639 -4175 .....,..„,W r
INSPECTION WORKSHEET FOR DATE: 7/1/2008 TIME: 7 :00AM PAGE: 22
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work
OWNER: LOLICH, CHERYL PHONE #: 503 -530 -9201
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503 -6x13 -5511
Inspection Request Scheduled For: Date: 7/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 072059 -02 503- 515.7703 Y
Corrections /Comments /Instructions:
(0 0/ - (-
•
SS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ A
Inspector: Date: 1--d S' Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2008 -01054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51/4/20011
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/20/2008 TIME: 7 :02AM PAGE: 38
SITE ADDRESS: 1.338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGL.EWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: 'LOLICH
DESCRIPTION: 224 sq. ft_ addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 503-590 -9281
CONTRACTOR: HOWARD BINGHAM CON ST PHONE #: 503-643-5511
Inspection Request Scheduled For: Date: 6/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
24 Exterior sheathing 071617 -02 503-515-7703 N
Corrections/Comments/Instructions:
•
•
PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: —oar Phone #: (503) 718 -.
i .P
A
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 1'iST200f3 0;701
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51/412008
Phone: (503) 639 -4171 m �llitlj �ll �
Inspection Requests (24 Hrs.): (503) 639 -4175 = :_..
INSPECTION WORKSHEET FOR DATE: 6/20/2008 TIME: 7:02AM PAGE: 39
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEVOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
•
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work
OWNER: LOLICH, CHERYL PHONE #: 503. 590 -9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503 - 643.5511
Inspection Request Scheduled For: Date: 6/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
235 Shear wane/anchors 071617 -01 503. 515-7703 N
Corrections/Comments/Instructions:
-' a 14/0 6TE A69-/ / 4-A -u 5p-Z- --.5
/C deGu -6 yrv
6 - . )aL ihft7 ' , L3 &1- ScY-.t , s? -L .sr9 -CG
/
PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: , 4,iT
Date: ‘�� Phone #: (503) 718 --qE��
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2008 -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/200083
Phone: (503) 639 -4171 # 11010 Inspection Requests (24 Hrs.): (503) 639 -4175 �..;�. ..
INSPECTION WORKSHEET FOR DATE: 6/17/2008 TIME: 7 :00AM PAGE: 41
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOI_JCH
DESCRIPTION: 224 sq. ft, addition, Mechanical other- duct work.
OWNER: LOUGH, CHERYL PHONE #: 503 - 590.9281
CONTRACTOR: HOWARD I3INGHAM CON`3T PHONE #: 503- 643.6511
Inspection Request Scheduled For: Date: 6/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
235 Shear walls/anchors 071460 -01 5503 - 615 Y
Corrections/Comments/Instructions: /�
%�/ AJA-iG �G 6" S",- 7 ( 4L /2 G I o - i� - S /G d l `� /- a- a�C,
a y r / ' U/Z-s - --/ -- . • r�r,,L_
� r no . 4i -- 77.2.9 -rte 4vc4., s,,,--e-` , e �• (
❑ PA ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
F AIL CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: Date: 4 7 —O 0 Phone #: (503) 718-
F
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2000.00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2008
Phone: (503) 639-4171 i "
Inspection Requests (24 Hrs.): (503) 639 -4175 ..14- : ' � 11. ..
INSPECTION WORKSHEET FOR DATE: 6/9/2008 TIME: 7:01AM PAGE: 26
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work
OWNER: LOLICH, CHERYL PHONE #: 503-590-9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503-643-5511
Inspection Request Scheduled For: Date: 6/0/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
21 5 Footing drain 07108! 01 503. 515.7703 Y
Corrections /Comments/ Instructions:
. PASS ❑ PARTIAL APPROVAL fJ CANCEL ❑ NO ACCESS
I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: — ��e , g— Phone #: (503) 718- --e_g.
I •
CITY OFTIGARD .,
BUILDING DIVISION PERMIT #: MST2008 000 4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 . till
Inspection Requests (24 Hrs.): (503) 639 -4175 ...„W
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:01AM PAGE: 49
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD "NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLIC ~H
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 503 - 590.9281
CONTRACTOR: HOWARD BINCHAM CON ST PHONE #: 503-643-5511
Inspection Request Scheduled For: Date: 616/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
22 Post /beam structural 070963 -01 503.5155 -7703 Y
- Avrir /l2 A-
Corrections /Comments/ Instructions:
I' ASS n PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • r- Date:li -6 --a Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200t3- 00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 �mnr�mu�'
Inspection Requests (24 Hrs.): (503) 639 -4175 :.
INSPECTION WORKSHEET FOR DATE: 6/4/2008 TIME: 7:01AM PAGE: 34
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work
OWNER: LOLICH, CHERYL PHONE #: 503 -590 -9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503
Inspection Request Scheduled For: Date: 6/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
225 Post/beam structural 070809-01 503.51a -7703 Y
Corrections /Comments /Instructions:
AV
�1 Y A-7-03-14- j r- 0/- . 1 - LG�4�rc_
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Co- Phone #: (503) 718 -/
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2000 -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6.{14/20013
Phone: (503) 639- 4171�u7��pplMlf"
Inspection Requests (24 Hrs.): (503) 639 -4175 - , Y `'I I.
INSPECTION WORKSHEET FOR DATE: 5/29/2008 TIME: 7:00Alvl PAGE: 39
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD N0.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOL.ICH, CHERYL PHONE #: 503 -590 -9281
CONTRACTOR: HOWARD BINOHAM CONS - 1 - PHONE #: 503-643-5511
Inspection Request Scheduled For: Date: 5/29/2008 Pour Time: 9:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 07046301 503- 515 -7703 N
Corrections/Comments/Instructions:
1 - ..1� • - .. -V' Prime- ' . ! �� < _ a-
r'
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL H NO ACCESS
❑ FAIL n CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
Inspector: Date: - 8 D - Pi Phone #: (503) 718-
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2008 -000' 4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 i ,,,,, a , 1. l Inspection Requests (24 Hrs.): (503) 639 -4175 __�
INSPECTION WORKSHEET FOR DATE: 5/29/2008 TIME: 7 :00AM PAGE: 35
SITE ADDRESS: 11335 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 03- 560- 9281
CONTRACTOR: HOWARD BINOHAM CONST PHONE #: 503 - 6435511
Inspection Request Scheduled For: Date: 5!29/2008 Pour Time: 9:00
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 070469 -02 503-515-7703 N
Corrections /Comments/ Instructions:
/� /,41S L . - ".aG "--
P✓ ASS H PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 5""29 ---°e Phone #: (503) 718 - '�J
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IvIST2008-00054
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 5/1412000
Phone: (503) 639-4171 I L .
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 807/2008 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 11338 SW COTTONWOOD LN 9 LASS OF WORK:
SUBDIVISION: ENGLEWOOD N0.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: 224 sq. ft. addition. Mechanical other- duct work.
OWNER: LOLICH, CHERYL PHONE #: 503-590-9281
CONTRACTOR: HOWARD BINGHAM CONST PHONE #: 503-643-5511
Inspection Request Scheduled For: Date: 8/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 074643-01 503-793-2037 Y
Corrections/Comments/Instructions: NAL% 4 ,1) - 1 7 17°
PASS 0 PARTIAL APPROVAL 0 CANCEL 7 NO ACCESS
7 FAIL 0 CALL FOR INSPECTION 0 ADD TIONAL FEES ASSESSED
Inspector: Date 1 Phone #: (503) 718-
CITY OF TIGARD r--
� BUILDING DIVISION PERMIT #: MST2008 -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51/412008
Phone: (503) 639- 4171 ,I�i� ( t
Inspection Requests (24 Hrs.): (503) 639 -4175 r��...
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: 43
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: E.NGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOUGH
DESCRIPTION: 224 sq. #t. addition. Mechanical- other: duct work.
OWNER: LOLICH, CHERYL PHONE #: 5n590 -9281
CONTRACTOR: HOWARD EBINGHAM CONST PHONE #: 503- 643 -5511
Inspection Request Scheduled For: Date: 6/2.312008 Pour Time:
Code # Inspection Description C nfir • Contact # Assage
120 Electrical rough -in /71720 -01 503 - 7935196 Y
Corrections /Comments /Instructions:
,,,--:,
T N4V I D‘ ?•) A/vv • R . • ' a
. c---% ct-t)Q \ NIG i S ( '%V% N'I 6 Pi` AA A10-4"
W P■O Nit Opi4-
ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N ()Es L Date: 4'13' O Phone #: (503) 718-
•