Permit e� r i {t al �1 T-F-'r a.ckl,a Leo r lz -- .5/ , `o - S LA)
Ill CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2006 -00326
COMMUNITY DEVELOPMENT DATE ISSUED: 3/13/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134DB-07700
SITE ADDRESS: 11222 SW FOREST LN ZONING: R - 4.5
SUBDIVISION: STONECHASE LOT: 001 JURISDICTION: TIG
PROJECT: STONECHASE
Project Description: New SF detached. 8/6/07 ADD a/c unit.
BUILDING
REISSUE: SC408 STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 16 FIRST: 2,446 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 766 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST. 5N DWELLING UNITS: 1 THIRD. sf RIGHT: 10
VALUE: 2 45,952 20
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 2,446 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 1 VENT FANS: 3 CLOTHES DRYER: 1
NAT FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: 0 GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: n 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 LW/SC LT:
BURGLAR ALARM: OTH: ALL - ENCOM 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 Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
FOUR D CONSTRUCTION CO. FOUR D CONSTRUCTION laws. All work will be done in accordance with approved plans. This
PO BOX 1577 PO BOX 1577 permit will expire if work is not started within 180 days of issuance, or
BEAVERTON, OR 97075 BEAVERTON, OR 97075 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 - 0805 Contact #: PRI 503 - 590 - 0805 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
a
FAX 503 -590 -1751
Reg #: LIC 71037
TOTAL FEES: $ 10,693.57
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Issued By / ..ii / P Signature : ,.� 41,-
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.
lk C' • r'I n ent
Building Permit Application "Q j . ' i oROFFIcE USE ONLY
City of Tigard ECEIVED R Datee/By la oC-� { Pertnit Ta j_,,o
13125 SW Hall Blvd., Tigard, OR 97 Plan Review
Phone: 503.639.4171 Fax: 503.598.19( C 1 1 2006 D • • g • 0 A ' Other Pe -I R. ! At •
T I G A R D Inspection Line: 503.639.4175 Date ReadyBy: ® See Page 2 for
Internet: www.tigard -or.gov TIGAFiD �No e thod : � �� �� SupplementalInformati
CITY OF on
∎. . • VIVO . NA , _
. . TYPE' OF WORK. , ' ® / REQUIRED DATA: 1- AND - AMILY"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
0. Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
' . CATEGORY', OF CONSTRUCTION work indicated on this application.
g1 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
(" Master builder ❑ Other: Number of bathrooms:
. ' JOB SITE 'INFORMATION AND LOCATION _. Total number of floors: I
• Job site address: 1X22 z g R ,p �- z N ,,,,,_ New dwelling area2 square feet
• City/State/ZIP:-773 /9 /2 `le, yZ 9 7 2 2- Garage /carport area: 7 ‘ 6 square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: 270 square feet
Cross street /directions to job site: Deck area: _ -6, _ square feet
Gt I Other structure area: ._b — square feet
• QVD `254.c i i i a :— J /3 REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: .. S*-7 67. _ I 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.
e L � � /4-L/C-A— Valuation: $
• " /
f Existing building area: square feet
New building area: square feet
pf PROPERTY OWNER - . ❑ TENANT ; Number of stories:
Name: %e.e,�. '7) (?_,, Sy- ree_,c « a •� al— Type of construction:
Address: of)r 2.x. /z- 7 7 / Occupancy groups:
City /State /ZIP: '-ei .J..� 1 c i_-- - 9 7 p ?g Existing:
Phone: (3 3 FA"'t' Fax: ( 3) ..1 — /7 T/
New:
. APPLICANT . , ❑ CONTACT PERSON NOTICE.
Business name: JP 1-e-- , ell.‘ 4V All contractors and subcontractors are required to be
Contact name: ` mod U e- � 7 #1,/ ,e). * 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:
CONTRACTOR
Business name: • g/rY'te i51-4' gi 0 t!•-¢+ ' _ , " BUILDING PERMIT FEES* .
Address: '(Please,refer lo fee schedule) ,
City /State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: 7/ os Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained ..t a....._
within 180 days after it has been accepted as complete.
Print name�e... )) a���xp ei -- Date: /2___7� d * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building \Permits \BUP -TI- PermitApp.doc 03/23/06 440- 4613T(I1/02 /COM/WEB)
1
t f
•
. a '_ ;' ° Building Division
Plan Submittal Requirement Matrix
TI GARD Commercial & Multi- Family - New, Additions or Alterations
Type of :# of Plans'
(Includes new, additions and al'terations.) Required at
Submittal
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 2 **
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 \Permits \BUP- TI- PermitApp.doc 03/23/06
Electrical Permix Applicati RECEIV FOR ,OFFICE USE o
•
iphi City of Tigard DEC 200 Da e/B . Permit . T O
' 13125 SW Hall Blvd., Tigard, OR 972 Plan Review
: ' Phone: 503.639.4171 Fax: 503.5983 OF TIGARD Date/By.. Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Juris: RI See Page 2 for
T I G AR D BUILDING DIVISION
Internet: www.tigard- or.gov Notified/MetNotified/Method: Supplemental Information
TYPE OF WORK, PLAN REVIEW
N. New construction El 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
( 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family c$ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
. , JOB SITE' INFORMATION AND LOCATION ['Addition of new motor load of ❑ "A ", `T ", "1 -2 ", "1 -3 ",
Job no.: Job site address: J /222 S't � ,2- Six or or more. Recreational
e � - L/�/� 0 or more residential units. ❑Rre vehicle parks.
City /State/ZIP: l fJ , / c^ ` 0 / < ` 722 ❑ Health -care facilities. ❑ Supply voltage for more than
i ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
•FE E SCHEDULE "
Cross street/directions to job site: i r / -u.4L B acripti °n I Qn• I Fee. I Total I •
� New residential single- or multi - family dwelling unit.
r //1 �(/ C - 1/ 14- n
J � -. Includes attached garage.
Subdivision: 27 e- I Lot no.: / 1,000 sq. ft. or less / 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion / 33.40 1
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: CI) 57: /1� 401 amps to 600 amps 160.60 2
C� 601 amps to 1,000 amps 240.60 2
Address: cp 0 , Z 1,5-7 7 Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP:
B/ tJ ie-, d / 2_ 9 7 (0 7 ,..., relocation
Phone: �Z'S3) s ty- t, c Fax: (S7:53) Sg ®_ / 7S/ 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1.00.30 2
' intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
'R APPLICANT • ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: S/yste- .4Y /,--f V U-e- B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) 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:
/` o ,b -e,�TS 6/e. cr�-rc- energy panel, alteration, or
Address: s 7 S 9' 5. (ti; a cp /, (). extension. Describe: Page 2 2
City /State/ZIP: ?� 4`7 0A-.. Each additional inspection over allowable in any of the above
Fax: ( ) Per inspection 62.50
Phone: (
Zt. �� 77,j S G Investigation per hour (1 hr min) 62.50
• CCB Lic.: 9 3 c ? d , Electrical Lic.:3 23 C Suprv. Lie.:3 S Industrial plant per hour 73.75
j ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: G OL4_ 2, Subtotal:
Print name: 7? 7 044 Date: /2 _ 0 Plan review (25% of permit fee):
State surcharge (8% of permit fee):
Authorized signature: f - , ,.� TOTAL PERMIT FEE:
� �e �, J . ,
This permit application expires if a permit is not obtained within 180
Print name: �L�[ �� / , Date: - c, days after it has been accepted as complete.
Number of inspections allowed per permit.
1 Building \Permits\ELC- PemritApp.doc 05/23 /06 440- 4615T(11/05 /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:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
E l Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
• El Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
•
. • ❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
. El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Pertnits\ELC- PermitApp.doc 03/23/06
f
Mechanical Permit Application role OFFICE USE ONLY
Permit No
Rece ived
Ci of Tigard i 2
tY g Date/By. r n/— — m 3
a
13125 SW Hall Blvd., Tigard, 0 CI V, ! '''"
' • ® t :"..i ' Phone: 503.639.4171 Fax: 50 i E I V E Plan Review
4°' Date/By Other Permit
TIGARD Inspection Line: 503.639 Date Ready/By: tuns: El See Page 2 for
Internet: www.tigard - or.gov DEC 1 1 2006 Notified/Method: Supplemental Information
;1 * • TIGARD
. TYPE I h ' ■ DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
. I N construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION - Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
(xi 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ' Master builder ❑ Other: Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION, Heating /cooling
�"" qq ' `� Air conditioning or heat pump
Job site address:
1/2 , � � e(�v, 1`O $ L ry Qv dit (requires site plan showing placement) 14.00
City /State /ZIP: - 779 /la o,e_., Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street /directions to job site: 0,046 q- //3 Duct work 14.00
•
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: ��/As� Lot no.: / Flue/vent for any of above 10.00
. Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
LC.- / � tl . // Gas fireplace vent for 10.00
La Imo''"' d' -���— 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
(a.PROPERTY OWNER " CI TENANT
Chimney /liner /flue/vent 10.00
Other: 10.00
Name: '14 ` �I� 57 Environmental exhaust and ventilation
Address: ( C7 , . x / 7 7 Range hood /other kitchen
6 equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (,5b3) ,S yo... 00 Fax:,) 3 — / 76-1 toilet compartments, utility rooms) 6.80
pit APPLICANT , ' ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: h-yyu A /i16 e a _ Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR , Barbecue
Clothes dryer (gas)
Business name: �,/o. .a � y�e/
--7 . �y � J Other:
Address: /szo Q *). 9�G / I, ,vT�r z./-- t MECHANICAL PERMIT FEES*
City /State /ZIP: 9 "LI V ,t_ 5' 7 ;7,9-3 Subtotal
Phone: J1 t, •_ 3'(�, v.3 Fax: ( ) Minimum permit fee ($72.50)
J Plan review (25% of permit fee)
CCB lic.: Io 4 s-7d State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: �yyy �C� , ,a This pencil application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Print name: Ahae fd,4 . //Q tiS Date: / — / � 6 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits'MEC- PetmitApp.doc 04 /06/06 4404617T(II /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:\Buildin PermitApp.doc 12/30/05 2
Building Fixtures RECEIVED
Plumbing Permit Application DEC 1 2006 Received FOR OFFICE USE ONLY .
City SW IT OF TIGARD Date/By. Permit N q �,� Sr . e2006 _ o0 3a10. 3a
n 13125 SW Hall Blvd. Tigazd OR 97 Plan Review
o,,° Phone: 503.639.4171 Fax: 503.59 &DING DIVISION Date/By. Other Permit No.:
T I G n R D I nspection Line: 503.639.4175 Date Ready /By: )aria: Ei See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
For special information use checklist
Ig New construction ID Demolition
Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
RI I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building 1:1 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
g Master builder ❑ Other:
= Fire sprinkler ( sq. ft.) Page 2
. JOB. SITE INFORMATION AND LOCATION Site utilities
Job site address: //272.2 S', W. Z?. S 7 L H ,V ,,t Catch basin or area drain 16.60
City /State /ZIP: 1 /i x' „,,e_... Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: - i x'
Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site: Manholes 16.60
M i t, - ` )A e 6'77a 4- / /3 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
, o DESCRIPTION OF WORK' Back flow preventer Page 2
P i,C. / L 2) /, e... _) a -a..._ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
X PROPERTY OWNER . ' ❑. TENANT '
y �, /� Ejectors/sump 16.60
Name: C J � � 'w / t - `. L��L Expansion tank 16.60
Address: (fi "a 9 As 7 Fixture /sewer cap 16.60
City /State /ZIP: , ' ' ' li e.._ '7 0 70 Floor drain/floor sink/hub 16.60
Phone: (.)-) ,.;s -- Oci 0S Fax:, Z3)5o - / 7s-/ Garbage disposal 16.60
Hose bib 16.60
. Isr APPLICANT . ❑ CONTACT PERSON ,
/ Ice maker 16.60
Business name: S Ai b a v.
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: 53 ?it /i Water heater 16.60
Address: 15-�� S mil_ it, 0-4.___, Other:
Subtotal
City /State /ZIP: /GL f 6,1 / 0 " 21:4-,3 Minimum permit fee: $72.50
Phone: (j) C O - 23 /7 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: l9 9 Plumbing Lic. no� edeVP6 Plan review (25% of permit fee)
Authorized signature: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Print name: /1L1,I , 1,,,lL„er Date /2 - 9__ v 6 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.
1: \Building\ Permits\ PLMF- PermitApp,doc 04/06/06 440.4616T(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:' : e <- .C„,„ '-'1-i- .:;
Footing drain - I 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
Sewer - 1st 100' 55.00 3,601 to 7,200 $220.00
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 .
Storm & Rain Drain - 1st 100' 55.00 Valuation: . . . Permit Fee: - , , •
$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 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
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
and including $50,000.00.
specially requested inspections - per hour 72.50
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.
. Q uantity 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 dwelling units.
Drinking Fountain
❑ 'Any NFPA 13 - D multipurpose fire sprinkler system.
Eye Wash
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
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
City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
.
,.• *- ®.
K c re
I GA1D
RESIDENTIAL PERMIT APPLICATION REVIEW
Permit \uinhcr ` . , �
Lot No.
Sulitln i- on - gyp • tic_ -
\ddress
Z. Bt1'111eS Feu r —
Stlltt I Pc. ' Is
(:in ,PCL\).e -c)(1 State I I Zip f
As required by the 1999 Legislative action (Senate Bill 587), your residential permit application
and plans have been reviewed to determine if it is complete and if the plans are deemed
"simple" or "complex" as defined in ORS 455.467 and 455.469.
r_?El
The application is complete.
The application is incomplete for the following reason:
The submitted plans will be reviewed; however, a permit cannot be issued until the
above information is reviewed and /or approved.
I I The submitted plans cannot be reviewed until the above information has been
submitted and /or approved.
I ] The plans are deemed "simple ". The plans are deemed "complex ".
If you have any questions please call Loraine Williams at (503) 718 -2708. Ts: ECEIVED
DEC 0 7 2006
Name of Plans Reviewer I 0(9 CITY OF TIGARD
Date
BUILDING DIVISION
Phone: 503.639.4171 • Fax: 503.684.7297 a www.tigard- or.gov • TTY Relay: 503.684.2772
iti3 r crv(o - av3.2 (a
STREET TREE CERTIFICATION
/. 7/71vaas , Owner /Agent for f v.e. ee/t/s7)-we7?CJ
(PLEASE PRINT) i (PERMIT HOLDER)
Do hereby: certify that the f location meets
City of Tigard and Washington County
land use and development - standards. _ :for street tree installation.
ADDRESS: // Z 2 2 5w ,-(7,cFS 7 LAJ
SUBDIVISION: 5'7T £ C , ,sE LOT:
SIGNATURE: i DATE: 9/V/.7
(O � R /AGENT
RECEIVED BY: DATE:
(CITY OF TIGARD)
I:\ Building \Forms \StrcetTrecCertificate 01/19/07
CITY OF TIGARD - . . ., ...,. . ..
- A
1 - BUILDING DIVISION PERMIT #: MST200600326
I - 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3113/2007
Phone: (503) 639-4171 kihzofll
Inspection Requests (24 Hrs.): (503) 639-4175 ::.s.11. ■ '' i
INSPECTION WORKSHEET FOR DATE: 8129/2007 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 00i TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached. 8/6/07 ADD a/c unit.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503,590,0805
CONTRACTOR: FOUR D CONSTRUCTION - PHONE #: 503-590-0805
Inspection Request Scheduled For: Date: 8/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 054830-02 503-120-7445 Y
Corrections/Comments/Instructions:
X PASS 0 PARTIAL APPROVAL I I CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: (----n 1-1 \ \ I ``-'---- Date: 712-q ID Phone #: (503) 718-
CITY OF TIGARD k_
BUILDING DIVISION PERMIT #: MST2006 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 � ��l
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:' `:_..
INSPECTION WORKSHEET FOR DATE: 9/5/2007 TIME: 7:00AM PAGE: 3
SITE ADDRESS:, 11222 SW FOREST IN CLASS OF WORK:
• SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached. 8/6/07 ADD a/c unit. -
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 590-0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 500 -0805
Inspection Request Scheduled For: Date: 915/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 055169-02 503 - 720 -0012 N
Corrections /Comments /Instructions:
•
r
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: Date:-- S Phone #: (503) 718 - "2
. CITY OF TIGARD .. ,. ,,
BUILDING DIVISION PERMIT #: MST2006- 003'26
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21(thfi
3/13/2007
Phone: (503) 639 -4171 +
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/5/2007 TIME: 7:00AM PAGE: 4
SITE ADDRESS: 11222 SW FOREST LW CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE I
DESCRIPTION: New SF detached. 8/6/07 ADD a/c unit.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 -590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503.590 -0805
Inspection Request Scheduled For: Date: 9155/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 699 Mechanical final 055169-01 503 -720 -0012 Y
Corrections /Comments /Instructions:
0 SEac- 41404.-4-60 c c - . --(0 i't -4
n
PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 41. -`-07 Phone #: (503) 718= -2.4.46
'CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200G-00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 � �tl '� I
Inspection Requests (24 Hrs.): (503) 639 -4175 A:_..
INSPECTION WORKSHEET FOR DATE: 8/28/2007 TIME: 7:00AM PAGE: 63
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached. 8/6107 ADD a/c unit.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 580.0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 -590 -0805
Inspection Request Scheduled For: Date: 8/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 054711 -02 503.720.7445 Y
Corrections /Comments /Instructions:
�.n� l t �o✓ �(w�.toi;,� �i �� ( c�✓ ✓; �� - 1��✓ �$�a�� Law lotv ic2
Ise i S P L, I✓\ 2 o c 00,2 '7 �I )1 I O t, tv 1 0 I (4,1, A..,
A1
il Tt '� �T ' - P -'' 200-7 o c 2 cr cl ro ,
I I PASS PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector �3 ��a� -��`�b �^-a— Date: 7 Phone #: (503) 718-
-
CITY ���H�~�� ����7�N������ m�mnn�� °- . ,. .: ' •
) oo��nx~u�x u�n �po��n� nm n ��w m �
UUUU K�U ' ��U ~��K��0 '
K��� ��U A PERMIT #: � k4ST2O0�DD32G
13126SVV Hall B�d.. Tigard, ORQ7223 DATE ISSUED: 3V13/2007
Phone: (503) 639-4171
Inspection Requests (24Hm.):(5O3)G38'4175 ^Ja ° ���
INSPECTION WORKSHEET FOR DATE: 6/14/2007 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
�
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO. PHONE #: 503590-0806
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590.0805
Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 050240-01 603-720'7445 N
Corrections/Comments/Instructions:
.
-
,.
-
c ,A .
A PASS .
n PARTIAL APPROVAL n CANCEL n NO ACCESS
| | FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
: U�� Inspector: Oata� Phone#� /5U3� 718' " - /''/L/'
'.
CITY OF TIGARD 'Y • . ,. • .
BUILDING DIVISION PERMIT #: MST200G-00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 ii�'tll r
Inspection Requests (24 Hrs.): (503) 639 -4175 . �' ■ ■
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 78
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503.590- 0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590.0805
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 060125 -01 503 - 720 -7445 N
Corrections /Comments /Instructions:
CJ --n2A1--
PASS I I PARTIAL APPROVAL n CANCEL I I NO ACCESS
-FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: 1/1 Ili Ii�� Date: / / '6 Phone #: (503) 718 -
r
CITY OF TIGARD . . ,.
BUILDING DIVISION PERMIT #: MST2006- 00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 a 4� u�i, ,.. : .. l
Inspection Requests (24 Hrs.): (503) 639 -4175 "
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503. 500 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590.0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
315 Post/beam plumbing 046712 -03 503- 720 -0012 N
Corrections /Comments /Instructions:
M, PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CYZ Date: Li I (TIC Phone #: (503) 718-
CITY OF TIGARD , , . ,., •
i BUILDING DIVISION PERMIT #: MST2006-00326
A
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ir
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO-. PHONE #: 503-690-0806
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0805
Inspection Request Scheduled For: Date: 4/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 046696-02 603-969-4631 N
Corrections /Comments/ Instructions:
K PASS I] PARTIAL APPROVAL 0 CANCEL El NO ACCESS
I I FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 01 hi-A-AA ‘L.--:- Date: Lill 'CIA Phone #: (503) 718-
.. .. . . '
„ • .
• -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 Ah
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 43
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 590 -0805
CONTRACTOR: FOUR D CONSTRUCTION _ PHONE #: 603- 590.0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 046696-03 - 503.969 -4631 N
Corrections /Comments /Instructions:
r
PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CV Date: q1)710-7 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 /iir �b11�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 42
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 -590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 Storm drain 046696-04 503-969-4631 N
Corrections/Comments/Instructions:
PASS I I PARTIAL APPROVAL n CANCEL I NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 09 -w + t t �., Date: '-J I rri 61 Phone #: (503) 718-
. p / +
CITY OF TIGARD , . .. .. - .
BUILDING DIVISION PERMIT #: MST2006.00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: .(503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 iirlt :_..
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 -590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590.0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 046696-05 503 - 969.4631 N
Corrections /Comments /Instructions:
la PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 07 iii--w i t Date: L i 1 1c71() Phone #: (503) 718-
CITY OF TIGARD , . .
BUILDING DIVISION PERMIT #: MST2gf3C� 00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171
A uUl a bl) I
Inspection Requests (24 Hrs.): (503) 639 -4175 s ' . U U.
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 45
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503.590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
310 Crawl drain 046696-01 503-969-4631 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ` NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4I Lr,- -w i t t....,._ Date: Li/ / 71 07 Phone #: (503) 718-
CITY OF TIGARD .,
BUILDING DIVISION PERMIT #: MST2006 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639- 4171 N�ii�y j � l �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/28/2007 TIME: 7:00AM PAGE: i al
SITE ADDRESS: 11222 SW FOREST LW CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached. 816/07 ADD a/c unit.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503-590.0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0805
Inspection Request Scheduled For: Date: 8/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054711 -01 503- 720 -7445 Y I C
Corrections /Comments /Instructions:
\/
•
•
'PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ❑ CALL ' OR INSPECTION I ADDITI NAL FE S ASSESSED
or D
Inspector: , Date Phone #: (503) 718-
CITY OF TIGARD A ,. _
1 BUILDING DIVISION PERMIT #: MS'l "2006 -003 6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 . irr jm�� i��'
Inspection Requests (24 Hrs.): (503) 639 -4175 ,
INSPECTION WORKSHEET FOR DATE: 6/19/2007 TIME: 7:01AIVM PAGE: 2
1 SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503-590.0005
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590-0805
Inspection Request Scheduled For: Date: 6/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 050496 -01 503-720.0012 N
Corrections /Comments /Instructions:
e&V\ Vt 14 1 /4/ ‘ A / E..—.
J
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL ❑ CA, FOR INSPECTION I 1 ADDITI•NAL FEES ASSESSED
Inspector: Al9 Date: Phone #: (503) 718-
CITY OF TIGARD .. .. ..
BUILDING DIVISION PERMIT #: MST2006 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 A,
Inspection Requests (24 Hrs.): (503) 639 -4175 L.. mint
INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 590.0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503. 590 -0805
Inspection Request Scheduled For: Date: 6/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 050058 -01 503-720-7445 N
Corrections /Comments /Instructions:
I
,PASS ❑ PARTIAL APPROVAL n CANCEL ( I NO ACCESS
FAIL ❑ CALL OR INSPECTION n ADDITIONAL FEES ASSESSED
1-
Inspector: .I Date: `` ( " Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2008 -00325
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3113/2007
Phone: (503) 639 -4171 / uy�fp�tl6j� l •
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503-590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590 -0805
Inspection Request Scheduled For: Date: 6/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 050058 -02 503.720 -7445 N
Corrections /Comments /Instructions:
!J)(I PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CAL. FOR INSPECTION I I ADDITIONAL FEES ASSESSED
& Z /0
Inspector: Date: Phone #: (503) 718 -
CITY OF TIGARD , _ •
1 BUILDING DIVISION PERMIT #: MST200 ?
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 _"�NPWI@ ��I
Inspection Requests (24 Hrs.): (503) 639 -4175 ':_..
INSPECTION WORKSHEET FOR DATE: 6/25/2007 TIME: 7 :01AM PAGE: 25
SITE ADDRESS: 11222 SW FOREST LW CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: Nrm SF detached,
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 5 503 -590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590 -0805
Inspection Request Scheduled For: Date: 6/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 050861 -01 503 - 720 -7445 N
Corrections /Comments /Instructions: /
L a/ /a/LI /?1A',UC .
•
7 IPASS PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED •
Inspector Date: t ^ 0 7 Phone #: (503) 718-
______/5)-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 �1n I�
Inspection Requests (24 Hrs.): (503) 639 -4175 �' L .
INSPECTION WORKSHEET FOR DATE: 6/15/2007 TIME: 7:02AM PAGE: 20
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR l:? CONSTRUCTION CO., PHONE #: 503590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590 -0805
Inspection Request Scheduled For: Date: 6/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 050316 -02 503 - 720.7445 N
Corr ctions /Comments /Instructions:
v /,g' c rw�77 v") /mss/ v/7.--4 `3— ✓c..rr-
/
/f00 G /,.O
7 /N- c
PASS e iKPARTIAL APPROVAL n CANCEL* n NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r Date: "' -/s 7 Phone #: (503) 718-
• CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MST2006-00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/15/2007 TIME: 7:02AM PAGE: 19
SITE ADDRESS: 11222 SW FOREST LW CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503-590-0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503°590-0805
Inspection Request Scheduled For: Date: 6/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 050316-03 503-720-7446
• Corrections/Comments/Instructions:
0 1 1 '
e_CPASS PARTIAL APPROVAL I CANCEL NO ACCESS
LII FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
, e77 Inspector: Date: — /J Phone #: (503) 718-
-- :- --- ,- - 7,-
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005- 00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 ! 0 a� i
Inspection Requests (24 Hrs.): (503) 639 -4175 ,, I �.. ■
INSPECTION WORKSHEET FOR DATE: 6115/2007 TIME: 7:02AM PAGE: 21
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE: -
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 590 -08066
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 500 -0805
Inspection Request Scheduled For: Date: 6/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 050316-01 503.720 -7445 N
Corrections /Comments/ Instructions:
6 71e5.-op
IS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: %� % /% Date: 6 °16^o7 Phone #: (503) 718-
.. .
CITY OF TIGARD - .
BUILDING DIVISION PERMIT #: MSr2006 0032 i
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 F + nii
Inspection Requests (24 Hrs.): (503) 639 -4175 „_._W "I � ..
INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7 :01AM PAGE: 99
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 590.0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 690 -0805
Inspection Request Scheduled For: Date: 6/4 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
24 Interior shear walls 049451 -03 503-720-0012 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: - Date: 6 07 Phone #: (503) 718 - �9-4--"
r .
CITY OF TIGARD " -
BUILDING DIVISION PERMIT #: MST200&- 00:325
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1312007
Phone: (503) 639 -4171
A II
Inspection Requests (24 Hrs.): (503) 639 -4175 Jail !..
I
INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7:01AM PAGE: 100
SITE ADDRESS: 11222 SW FOREST LW CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 590.0805
CONTRACTOR: FOUR D CONSTRUCTION - PHONE #: 503-590-0805
Inspection Request Scheduled For: Date: 6/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 049451 - 02 503 N
Corrections /Comments /Instructions: ,, � ,
•
•
7
I PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
n FAIL ,❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: � ' Date: G- 4-- ® `7 Phone #: (503) 718 - ___
k
CITY OF TIGARD - - ,_
BUILDING DIVISION PERMIT #: MST200G -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 :Nil Milt
Inspection. Requests (24 Hrs.): (503) 639 -4175 _.,14-
INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7:01AM PAGE: 101
SITE ADDRESS: 11222 SW FOREST LW CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503-590 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 -590 -0805
Inspection Request Scheduled For: Date: 6/4 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
235 Shear walls/anchors 049451 -01 503 -720 -0012 N
Corrections /Comments /Instructions:
=" i , __ -6 -5 G 4/,/ wa,s /6 d G "% � s s
n PASS PARTIAL APPROVAL n CANCEL NO ACCESS
• FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: A Date: ÷ -07 Phone #: (503) 718 - - 2.9 --44---
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 Avryltit
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 12
00 SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 - 500.0605
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590-0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
605 Post/beam mechanical 046712 -02 503 - 720.0012 N
Corrections /Comments/ Instructions:
•
•
ASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . % Date: –/ ?— 0 7 Phone #: (503) 718- 2-¢
CITY OF TIGARD .
1
BUILDING DIVISION PERMIT #: MST2005 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 /��uu- +n�pmif�
Inspection Requests (24 Hrs.): (503) 639 -4175 ' :_..
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 11222 SW FOREST LIB CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: Now SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503 -5110 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590 -0805
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
225 Post/beam structural 046712-01 503-720-0012 N
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • . A
/)/-/ Date 4 7 7 P #: (503) 718- 7--4-44--
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: rSr200Fr00326
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 / imd d
Inspection Requests (24 Hrs.): (503) 639 -4175 'I L
INSPECTION WORKSHEET FOR DATE: 4/11/2007 TIME: 7:00AM PAGE: 4
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: New SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503.630 -0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503- 530 -0806
Inspection Request Scheduled For: Date: 4/11/2007 Pour Time: 9:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 046342 -01 503-720.7445 N
Corrections /Comments /Instructions:
•
ASS P ARTIAL APPROVAL CANCEL
❑ ❑ E NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: — 7 Phone #: (503) 718- ZJ
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006 -00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 n A 1 iii! %ih
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/11/2007 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 11222 SW FOREST LN CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 001 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: Now SF detached.
OWNER: FOUR D CONSTRUCTION CO., PHONE #: 503-590-0805
CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503.590 -08055
Inspection Request Scheduled For: Date: 4/11/2007 Pour Time: 9:00
Code # Inspection Description Confirm # Contact # Message
210 Foundation waifs 046343-01 503-720-7445 Y
Corrections /Comments /Instructions:
T PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 4 0 V Phone #: (503) 718- -7-4-41;-6---