Permit CITY OF TIGAk® MASTER PERMIT
4 !V" r PERMIT # MST2006 -00168
DEVELOPMENT SERVICES DATE ISSUED: 7/31/2006
aLli• -All 13125 SW Hall Blvd., Tigard, OR 97223 503- 6394171 PARCEL. 2S103DC -00816
SITE ADDRESS. 11265 SW FAIRHAVEN ST ZONING- R -3 5
SUBDIVISION VIRGINIA ACRES NO 2 LOT. 018 JURISDICTION. TIG
Project Description: 1344sf pole building
BUILDING
REISSUE CUSTOM STORIES 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK ACS HEIGHT 18 FIRST 0 sf BASEMENT Sr LEFT 5 SMOKE DETECTORS
TYPE OF USE SF FLOOR LOAD 20 SECOND of GARAGE 1 344 et FRONT 20 PARKING SPACES
TYPE OF CONST 5N DWELLING UNITS Twxoa et RIGHT 5
VALUE
OCCUPANCY GRP U1 BDRM BATH TOTAL
0 el 32 659 20 REAR 15
PLUMBING
SINKS WATER CLOSETS WASHING MACH LAUNDRY TRAYS RAIN DRAIN TRAPS
LAVATORIES DISHWASHERS FLOOR DRAINS SEWER LINES SF RAIN DRAINS 4 CATCH BASINS
TUB /SHOWERS GARBAGE DISP WATER HEATERS WATER LINES BCKFLW PREVNTR GREASE TRAPS
OTHER FIXTURES
MECHANICAL
FUEL TYPES FURN c 100K BOILICMP a 3HP VENT FANS CLOTHES DRYER
FURN > =100K UNIT HEATERS HOODS OTHER UNITS
MAX INP btu FLOOR FURNANCES VENTS WOODSTOVES GAS OUTLETS
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS AOD'L INSPECTIONS
1000 SF OR LESS 0 - 200 amp 0 • 200 amp WISVC OR FDR I PUMP /IRRIGATION PER INSPECTION
EA ADD'L 500SF 201 • 400 amp 201 - 400 amp 1st W/O SVC /FDR SIGN /OUT LIN LT PER HOUR
LIMITED ENERGY 401 • 600 amp 401 • 600 amp EA ADDL BR CIR I SIGNAUPANEL IN PLANT
MANU HM /SVC /FDR 601 - 1000 amp 601+amps-1000v MINOR LABEL
1000+ ampNoii
PLAN REVIEW SECTION
Reconnect only
>=4 RES UNITS SVCIFDR> =225 A > 600 V NOMINAL CLS ARENSPC OCC
ELECTRICAL • RESTRICTED ENERGY
A SF RESIDENTIAL B COMMERCIAL
AUDIO & STEREO VACUUM SYSTEM AUDIO & STEREO FIRE ALARM INTERCOM /PAGING OUTDOOR LNDSC LT
BURGLAR ALARM 0TH BOILER HVAC LANDSCAPE/IRRIG PROTECTIVE SIGNL
GARAGE OPENER CLOCK INSTRUMENTATION MEDICAL OTHR
HVAC DATA/TELE COMM NURSE CALLS TOTAL X SYSTEMS
This permit is subject to the regulations contained In the Tigard
Owner Contractor Municipal Code, State of OR Specialty Codes and all other
LEE MC COLL OWNER applicable laws At work wit be done in accordance with approved
11265 SW FAIRHAVEN plans This permit will expire if work Is not started within 180 days
TIGARD, OR 97223 of issuance, or 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
Phone 503- 958 -9131 Contact # of these rules or direct questions to OUNC by calling 503- 246 -6699
or 1 -800- 332 -2344
Reg #
TOTAL FEES $ 766.12
REQUIRED ITEMS AND REPORTS
Issued By . ' v /3%c�I% L — P ermi tt ee S igna t ur e . I / < ° GS f /% Call 503 - 6394175 by 7.00 a.m for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Pe Application b, C j . • I FOR OFrICE 11SE'ONL\`
City of Tigard 4 �a W 1st��! a Received /� I Permit No r
13125 SW Ball Blvd , Tigard, OR 97223, a -
Phone 503 6394171 fax 503 598 1960 vy .- L "` - _ 6 149,2?�01' ■ �, a : -3 , Other Penn
Inspection Line 503 639 4175 !� ' Date Ready /By ® See Attached Checidisi for
Internet www m hgard or 5 NuufiedRNtlhod I Su pplemental in formation
TYI tvVR I1'� \ REQUIRED DATA: 1- AND 2- FAMILY
❑ New construction J ❑ Demolition L V Permit fees* are based on the value o)e work performed - JUL 12 '1006 Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacement ❑ Other equipment, materials, labor, overhead, and the profit for the
a
CATEGORY OF CONSTRUCTION CITY OF TIGARD work indicated on this application 3 c 59 , a (�
�
dLI DIVISION Valuation $ c)f / c
El 1- and 2- family dwelling ❑ Commerma m I1 us l /
❑ Accessory butldmg ❑ Multi -family Number of bedrooms
❑ Master builder ❑ Other Number of bathrooms
JOB SITE INFORMATION AND LOCATION Total number of floors
Job site address / /02& 5t0 �� /16 ✓PZv' S r New dwelling area / r /,/ square feet
City /State /ZIP T94/ ' �i 97x23 Garage /carport area Y"WV square feet
SuiteT K
ldg /apt no Project name P heal e / ja/ <Y� / / ! ` iC eO Covered porch area square feet
e II" /sur(
Cross street /directions to job site Deck area square feet I ,
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 OFFF W mn ORK work Indicated on this application
T-✓ /r / � 1 /On! O Pole So /0//11 Valudt $
3a / x yd/ x / (F ' / Existing building area square feet
New building area square feet
❑ PROPERTY OWNER ❑ 'TENANT Number of stories
Name Zee ,e /_ / e 0 l( Type of construction
Address /61 4, 5 /7- lvi tie r / s r Occupancy groups
City /State /ZIP i7 j75 2 j V/ 97a ,23 Existing
Phone (5 9,1 Fax ( ) New
❑ APPLICANT ❑ CONTACT PERSON NO rice.
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 tf the
City/State/ZIP applicant is exempt from licensing, the following reasons
apply
Phone ( ) Fax ( )
E -mail
CONTRACTOR .
Ti Business name F co b 09:75 t 0,0 s7ztic77i ," BUILDING PERMIT FEES*
Address f o 6o7( g3 Please refer to fee schedule
City /State /ZIP A-!y, / _ sax ■ Cae( 97E2/
Phone r fax Fees due upon application
4"3)x - _ 0 e „, Fax (>, 3 ) 83S 7 O.2
l /� �/ J Amount received . 0 � 5
CCB be T I
2/7.S.7 Date received / /) /yfoit
Authonzed signgmre This permit appicaii n e T res if a permit is not obtained
+ within 180 days after it has been accepted as complete.
Print name Lee 2 111 e C� l I Date 7 -/Q -o • fee methodology set by 1 n- County Building Industry
Service Board
i \Building\Pennn.WUP- PenmlApp due 12/01 440J6I3T(I I /02/COMAVEa)
•
I • ,
One- and Two- Family Dwelling
Building Permit Application Checklist .. FOR ,OFFICE USE O NLY
City of Tigat'(I Received
Permit No
Datc/By
13125 SW Hall Blvd, Tigard, OR 97223 Associated permits
Phone 503 639 4171 Fax 503 598 1960 Nat ^ ' "'tWi'§ft °� ❑ gleclneV ❑ Plumbing ❑ Mechanical Hour Inspection Line 503 639 4175 y 4 ,.f _I I g
Internet www ci bgard or us ❑ Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/.
I Land use actions completed. See junsdiction criteria for concurrent reviews ❑ ❑ ❑
2 Zoning. Flood plain. solar balance points, seismic soils designation, historic district, etc ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district a • i royal re I uired. Name of district - . ❑ ❑ ❑
5 Septic system permit or authorization for remodel Existing system capacity_ ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils re i ort. Must Carr on .. nal . • •licable stam . and si u attire on tile or with . • hcation. ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required Include drainage -way protection, silt fence design and location of catch- • ❑ •
r bast rotection. etc
10 3 Co fete sets of legible plans. Must be drawn to scale. showing conformance to applicable local and state ❑ ❑ ❑
buddin es Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
�co• r, In violations exist 2'
OF rte /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if —
there is more than a 4 -ft elevation differential, plan must show contour lines at 2 -IL intervals), Ieee4iex-ofeeserneats
anddrtvnvey; footprint of structure (including decks), , ,direction
indicator; fir, _ ; eepex'sting structures on site, awl.
sinfihttabatrenage-
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads. connection details. vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, • ❑
furnace, ventilation fans. plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross sectron(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑
floor, wall construction, roof construction More than one cross section may be required to clearly portray
construction Show details of all wall and roof sheathing. roofing, roof slope, ceiling height, siding material. footings
and foundation, stairs, fireplace construction, thermal insulation. etc
15 Elevation views. Provide elevations for new construction, minimum of two elevations for additions and remodels ❑ ❑ ❑
1 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations. for non- ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineenng standards.
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑
systems. see item 22, ' Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet Ion: and/or an beam/cast carr in• a non - uniform load.
20 Manufactured floor /roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations A gas- piping schematic is required ❑ ❑ ❑
for four or more appliances
22 Engineer's calculations. When required or provided. (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Ore on and shall be shown to be ...licable to the •ro ect under review
JURISDICTIONAL SPECIFICS
23r e •lans are re *wed f o r Item I I above Site •lans must be 8 -1 /2" x I I" or I I" x 17" ❑ ❑ ❑
`
('sets each are required for Items 16 19, 20 and 22 above ❑ ❑ ❑
5 Buildin' slims shall not contain red lines or tale -ons "Mirrored" buildm• glans will not be acce•ted ❑ ❑ ❑
26 "Reversed" buddm • lans must meet criteria outlined in the Permit & S stem Develo Fees document. ❑ ❑ IN
27 "Drawn to scale" indicates standard architect or engineer scale ❑ ❑ IS
28 Site plan to include tree size, type and location per approved protect street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include tree protection measures as required by conditions of approval ❑ ❑ ❑
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995
I:\ Building \Permits \BUP -RES- PermitApp doe 2
' Ele Permit Application ' FOR OFFICE USE ONLY
City of Tigard D ECEIVED Dale/Bed Aj
Permit No C O DO/(7 1
13125 SW Hall Blvd, Tigard, OR 972 3 Plan Review
Phone 503 639 4171 Fax 503 598 1960 ,,,,,, " it £ 1 ",• Date/B Other Permit
Inspection Line 503 639 4175 JUL 1 2 2006 —3 I Date Ready/By June ® See Page 2 for
Internet www ci tigard or us Noufied/Method Supplemental Information
AZ ° PLAN REVIEW
❑ New construction ❑ Addition tePatYclacement Please check all that apply •
❑ Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other:
❑ Service over 320 amps— rating ❑ Buildng over 10,000 sq ft,
CATEGORY OF CONSTRUCTION of 1- and 2 -family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi-family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: J /fJ „ on e l0 ( S r above
❑ Flealth -care facility ❑
Late_ ��� '� S Submit 2 sets of plans with any of the above
City /State/ZIP �G ,9.> / V 9 7,2d3 The above are not applicable to temporary constriction service
Suite/bldg. /apt no.: ` Project name FEE* SCHEDULE
Description I Sty. I Fm I Told I •'
Cross street/directions to job site. New residential single - or multi- family dwelling unit.
Includes attached garage.
1,000 sq ft or less 145 15 4
Subdivision Lot no. Ea add'I 500 sq ft or portion 33 40 I
Limited energy, residential 75 00 2
Tax map /parcel no.: Limited energy, non - residential 75 00 2
DESCRIPTION OF WORK Each manufactured or modular
SG{ ID erg e CO v( I dwelling, service and/or feeder 90 90 2
/- C� [ At ? z o c / � b Services or feeders installation, alteration, and/or relocation
200 amps or less A 4 J 80 30 D. 3 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106 85 2
� 401 amps to 600 amps 160 60 2
Name: r/ eC ,e OOOO � C Co 11 601 amps to 1,000 amps 240 60 2
L
Address: // 4, 4,) (-74,,'t io use „/ S T Over 1,000 amps or volts 454 65 2
Reconnect only 66 85 2
City /State/ZIP —7 .' CC- 7c;),2...3 Temporary services or feeders installation, alteration, and /or
Phone: ( 3) 967 Fax ( ) relocation
200 amps or less 66 85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 30 2
intended for sale, lease rent, or -0-1‘ e�xcchhan e, according to RS 447, 449, 670, and 701 / 401 amps to 600 amps 133 75 2
,*
Owner signature. f`F. Date: 21 Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A Fee for branch circuits with •
service or feeder fee, each '
Business name: - branch circuit / 6 65 / yam, 2
Contact name B Fee for branch circuits ry v l
without service or feeder fee, 46 85 2
each branch circuit •
Address: Each add] branch circuit 6 65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53 40 2
Phone: ( ) F a x . : ( ) Sign or outline lighting 53 40 2
E -mail Signal circud(s) or limited -
CONTRACTOR energy panel, alteration, or
extension Describe Page 2 2
Business name: PF_ ,,a „o ,„,,,,„,
Address Each additional inspection over allowable in any of the above
Per inspection 62 50
City /State/ZIP• Investigation per hour (i hr mm) 62 50
Phone ( ) Pax:( ) Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES*
CCB Lic. Electrical Lie.. Supry Lic : Subtotal
Supry 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 Tn- County Building Industry Service Board
•• Number of inspections per permit allowed
i SBuiiding\Pam as'ELC- PeamitApp doe 12103 440- 4615T1I0/O2/COM/w'EB
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.
COMMERCIAL WORK ONLY:
Fee foreach commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems.
*No licenses are required. Licenses are required
for all other installations
I \BuIIdIng\Permas \ELC- PmnitApp dot 04/03
Building Fixtures
Plumbing Permit Application FOR OFFICE usi•.. ONLY
City of Tigard Received
III DateMy Permit No fr$ 'I W ti , DD i (�D
4 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review , . `J 1 O�
C Phone 503 639 4171 Fax 503 598 1960 Date/By Other Permit No
T 1 G A It D
Inspection Line 503 639 4175 Date Ready/13y Jun ® See Page 2 for
Internet wwwtigard- or.gov Notified/Method Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty [ Ea I Total
❑ Add it ❑ Other New 1 - - family dwellings (includes 100 fl for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 24920
❑ I- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi -family SFR (3) bath 399 00
Each additional bath/kuchen 45 00
❑ Master builder ❑ Other
Fire sprinkler ( sq fl) Page 2
JOB SITE INFORMATION AND LOCAL ION Site utilities
Job site address 7 / J / 4.- ��/ ,Q /T ier Catch basin or area drain 16 60
City/State /ZIP it,9 - rt 0 4 27 Drywell, leach line, or trench drain 16 60
Suite/bidg /apt. no I Project name
Footing drain (no linear fl ) Page 2
Manufactured home utilities 1 1000
Cross street /directions to job site
Manholes 16 60
Rain drain connector X 1660
Sanitary sewer (no linear ft _ ) / Page 2
Storm sewer (no linear ft ) Page 2
Subdivision Lot no Water service (no linear fl ) Page 2
Fixture or item
Tax map /parcel no
Absorption valve 16 60
DESCRIPTION OF WORK
Backflow preventer Paget
Backwater valve 16 60
Clothes washer 16 60
Dishwasher 16 60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 1660
Ejectors/sump 16 60
h �
Name L/(e2:;s / ' Expansion tank 16 60
Address / / 2 5 .- 5w r y ` e v/ a � " s f — Fixture /sewer cap 16 60
City/State/ZIP / ! „. Yfirn i y 9,2 2.2,7 Floor drain /floor sink/hub 16 60
Phone CO } ) 96 (---a2/3 ) Fax ( ) Garbage disposal 16 60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16 60
Ice maker 16 60
Business name Interceptor /grease trap 16 60
Contact name Medical gas (value $ ) Page 2
Address Primer 16 60
City /State /ZIP Roof drain (commercial) 16 60
Phone.( ) Fax ( ) Sink/basin /lavatory 16 60
Tub /shower/shower pan 16 60
E -mail Urinal 16 60
CONTRACTOR Water closet 16 60
Business name °jN y/ p�j Water heater 16 60
Address " - ' Other
City/State /ZIP Subtotal
Minimum permit fee $72 50 A ,
Phone ( ) Fax ( ) Residential backflow minimum permit fee $36 25 w
CCB Lic Plumbing Lic no Plan review (25% of permit fee)
State surcharge (8% of permit fee) kV
Authorized signature
��',ppq TOTAL PERMIT FEE 'J • . 3G
Pnnrn3Rre' - •� �, n .�� Date 7 -; , 'This permit application expires if a permit is not obtained within
�_ I80 days after it has been accepted as complete.
*Fee methodology set by l n -County Building Industry Service Board
10601(161g \Permits WLNIF-PermitApp doe 04/06/06 440-1616T(10/02/COM/W EB)
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 - r 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' 5500 Medical Gas Systems:
Water Service - each additional 100' 46 40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55 00 $I 00 to $5,000 00 Minimum fee $72 50
Storm & Ram 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 Backfiow 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 $I 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
Pmious 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 dwelling units
Dnnking Fountain ❑ My NFPA 13 -D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink -2"
-3"
Submit 2 sets of plans with any of the above.
-4••
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic U Isometric or riser diagram is required for new buildings
Disposal -Commercial three (3) or more stories in height
- Industrial
Ice Mach /Refng 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
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.
muddingPcim,u\PLM- PcnniiApp doc 07/06,05
CITY OF TIGARD . ..
•
BUILDING DIVISION PERMIT # MsT200G00168
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 7/31/2006
Phone (503) 639- 4171Nk_ II
Inspection Requests (24 Hrs.). (503) 639 -4175
INSPECTION WORKSHEET FOR DATE 11/2/2006 TIME 7:02AM PAGE 16
SITE ADDRESS. 11265 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES NO 2 LOT # 018 TYPE OF USE
PROJECT NAME MC COLL
DESCRIPTION. 1344sf pole building.
OWNER. MC COLL, LEE PHONE # 503-968-9131
CONTRACTOR OWNER PHONE #
Inspection Request Scheduled For. Date: 11/2/2006 Pour Time:
Code # Inspection Description Confirm if Contact # Message
399 Plumbing final 039214 -01 503-968-9131 N
Corrections /Comments/ Instructions:
`ReSS n PARTIAL APPROVAL CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION n ADDI / NAL FEES ASSESSED
Inspector / /1 " V/ /�, \�'�7`� CY Date `11.22` !l Phone # (503) 718- .�
CITY OF TIGARD . -
BUILDIN DIVISION PERMIT # MST2006 -00168
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006
Phone (503) 639 -4171 ^' 'll
Inspection Requests (24 Hrs.) (503) 639 - 4175 ,._;
INSPECTION WORKSHEET FOR DATE 11/212006 TIME 7 :02AM PAGE 9
SITE ADDRESS 11265 SW FAIRHAVEN ST CLASS OF WORK.
SUBDIVISION VIRGINIA ACRES NO. 2 LOT # 018 TYPE OF USE
PROJECT NAME MC COLL
DESCRIPTION 1344sf pole building.
OWNER MC COLL, LEE PHONE # 503-968-9131
CONTRACTOR OWNER PHONE #
Inspection Request Scheduled For Date: 11/212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 039222 -01 503-968 -9131 Y
Corrections /Comments/ Instructions -
PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1/— 2— o6-7 Phone #: (503) 718- 79-4c!"
CITY OF TIGARD . , A
BUILDING DIVISION PERMIT # MST200S00168
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 7/31/2006
Phone (503) 639 -4171 1l?"
Inspection Requests (24 Hrs ): (503) 639 -4175 Air f
INSPECTION WORKSHEET FOR DATE 10/4/2006 TIME 7 :02AM PAGE. 46
SITE ADDRESS. 11265 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES NO. 2 LOT # 018 TYPE OF USE
PROJECT NAME MC LOLL
DESCRIPTION 1344sf pole building
OWNER MC COLL, LEE PHONE # 503.968 -8131
CONTRACTOR OWNER PHONE #.
Inspection Request Scheduled For. Date. 10/4f2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Ram drain 037638.01 503 - 968 -9131 N
Corrections/Comments/Instructions:
a II a _ L � a—S
OF - Fr O
Sal
\ thASS I ] PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL t �I CCALL FOR INSPECTION ADDITIONAL FEES ASSESSED �/
Inspector:PI I K., e Date /t Phone # (503) 718- 2 C
. CITY OF TIGARD
BUILDING DIVISION PERMIT # MST2006 -00168
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 7/31/2006
Phone (503) 639 - 4171 , 1 _ ' III
Inspection Requests (24 Hrs) (503) 639 -4175 vs`i
INSPECTION WORKSHEET FOR DATE. 10/5/2006 TIME 7 :00AM PAGE 12
SITE ADDRESS 11266 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES NO. 2 LOT # 018 TYPE OF USE
PROJECT NAME MC COLL
DESCRIPTION 1344sf pole building.
OWNER MC COLL, LEE PHONE # 603.99131
CONTRACTOR OWNER PHONE #
Inspection Request Scheduled For Date: 10/6I2006 PourTime
Code : :- •. Descri.tion Confirm # Contact # Message
199 Electrical finalk 037757 -01 603 - 968-9131 N
Corrections omments /Instructions.
c7.0 IS 2Q- ON) \ 15 S " L IA - )
IN.i ?ASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector. V r -1 N vii LC. Date: I t Phone # (503) 718 - /.14 LO\
CITY OF TIGARD
BUILDING DIVISION PERMIT #. MST2006.00i68
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 7/31/2006
Phone (503) 639 -4171 .111-1111it
Inspection Requests (24 Hrs.) (503) 639 -4175 ‘_
INSPECTION WORKSHEET FOR DATE 1 0/2/2006 TIME 7:03AM PAGE 37
SITE ADDRESS: 11265 SW FAIRHAVEN ST CLASS OF WORK.
SUBDIVISION VIRGINIA ACRES NO. 2 LOT # 41g TYPE OF USE
PROJECT NAME MC COLL
DESCRIPTION 1344sf pole building
OWNER MC COLL, LEE PHONE # 503-968-9131
CONTRACTOR. OWNER PHONE PHONE #
Inspection Request Scheduled For. Date: 10/2/20066 Pour Time.
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037492 -01 603-644-3311 N
Corrections /Comments /Instructions
1
AlgAl Si
2 11 /1 rann / SS kid ii L.4a,f
A1? 074.64 1
❑ PASS PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
\ bIZSZAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date f t / 7i)o l' Phone # (503) 718 -0 WO
CITY OF TIGARD ' '(
BUILDING DIVISION • - PERMIT #• MST2006.00168
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. nginQQ6
Phone (503) 639 -4171 44141111k
Inspection Requests (24 Hrs ): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE 9/11/2006 TIME: 7:00AM PAGE 25
SITE ADDRESS 11265 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES NO. 2 LOT # 018 TYPE OF USE
PROJECT NAME. MC COLL
DESCRIPTION 1344sf pole building
OWNER MC COLL, LEE PHONE # 603
CONTRACTOR OWNER PHONE #.
Inspection Request Scheduled For. Date. 9/11/2006 Pour Time.
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough-in 03631401 503-968-9131 N
Corrections/Comments/Instructions.
a Cr ALL ftvg frL. %ohs � 43a`P'� vl%Rn if Low Fat
NC 2.C() Oa.
f C t - - to cm■)F2 t )la . Q& o ory ! 1
Wt ACLU .S 'f a 1-{Q QS 4-
6 B 0 -yy CrzootZ;c Lr/ P. -AFJ€ csbnv. . T & %2"
�J u st 'Toe be sob
G- ? ft € a k Q jrca FrsZ
� e t Ck L 1/4. c
I I _ f
PASS XARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL ❑ CALL FOR
K� INSPECTION ❑ ADDITIONAL FEES ASSESSED II'r
Inspector: �u� W Date �� 0`O Phone #: (503) 718- 2-44 •
CITY OF TIGARD
BUILDING DIVISION PERMIT #• MST2006- 00168
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 7/31/2006
Phone (503) 639 - 4171 . 1 lit
Inspection Requests (24 Hrs) (503) 639 -4175 ' `__.
INSPECTION WORKSHEET FOR DATE 6/28/2006 TIME. 7:00AM PAGE 13
SITE ADDRESS: 11265 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION. VIRGINIA ACRES NO. 2 LOT #: 018 TYPE OF USE.
PROJECT NAME MC COLL
DESCRIPTION 1344sf pole building.
OWNER. MC COLL, LEE PHONE if 503. 966.9131
CONTRACTOR OWNER PHONE #
Inspection Request Scheduled For Date: 6/28/2006 Pour Time.
Code # Inspection Description Confirm # Contact # Message
295 Misc. inspection 035662-01 503-644-3311 N
Corrections/ Comments /Instructions:
a i 4. M _ - O d J. _!.cG r N/yl C-
.
.
PASS PARTIAL APPROVAL CANCEL NO ACCESS
n FAIL , C LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector. a Date: R -25 —o e Phone #: (503) 718- �';N
CITY OF TIGARD
BUILDING DIVISION " PERMIT # MST200600160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 7/31/2006
Phone (503) 639-4171 ��,�'
Inspection Requests (24 Hrs ). (503) 639 -4175 2' °II
INSPECTION WORKSHEET FOR DATE 8/4/2006 TIME 7:04AM PAGE q3
SITE ADDRESS: 11265 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES NO. 2 LOT #. 018 TYPE OF USE
PROJECT NAME MC COLL
DESCRIPTION 1344sf pole building.
. OWNER MC COLL, LEE PHONE # 503 - 96&9131
CONTRACTOR OWNER PHONE#
Inspection Request Scheduled For Date. 8!4/2006 Pour Time. 9:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 034396 -01 503 -968 -9131 N
Corrections/Comments/Instructions.
I PASS 7 PARTIAL APPROVAL ❑ CANCEL NO ACCESS
1721CL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
4
Inspector: Jr. Ak Date. >A - 4 - -al Phone #: (503) 718 - 2y-h—s-±