Permit a CITY OF TIGARD MASTER PERMIT
A PERMIT #: MST2004 -00284
� DEVELOPMENT SERVICES DATE ISSUED: 10/28/2004
— ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13743 SW LEAH TERR PARCEL: 2S109BA -09000
SUBDIVISION: DAFFODIL HILL ZONING: R -7
BLOCK: LOT: 016 JURISDICTION: TIG
REMARKS: New SF. 10/28/04, adding a/c unit prior to issuance.
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 26 FIRST: 2,088 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,133 sf GARAGE: 527 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 311
OCCUPANCY GRP: R3 BDRM: 3 BATH: 4 TOTAL: 3,221 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 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: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 ' WOODSTOVES: 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: 6 201 - 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: 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.: >'600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,535.35
This permit is subject to the regulations contained in the
GOOD LET /MARSHALL BLDG & DEV. CO. GOOD LET /MARSHALL BLDG & DEV PO BOX 91551 Tigard Municipal Code, State of OR. Specialty Codes
PO BOX 91551
PORTLAND, 91551
97219 PORTLAND, 91551
97291 and all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 297 - 1881 Phone: 503 297 - 1650 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 100882 rules are set forth in OAR 952 -001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Post/Beam Mechanical Electrical Service Low Voltage Storm drain Insp Mechanical Final
Sewer Inspection Underfloor insulation Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Footing Insp Crawl Drain /Backwater Framing Insp Gas Fireplace Water Service Insp Building Final
Foundation Insp PLM /Underfloor Shear Wall Insp Insulation Insp Appr /Sdwlk Insp
Post/Beam Structural Mechanical Insp Exterior Sheathing Ins Rain drain Insp Electrical F''inal
— —
u ed B : r_ / , i / /_ ii .'_ ' Permittee Signature : � ,
Call (503) • 9 -4175 by 7:00 p.m. for an inspection needed the next business day
v
CEIVE
Building Permit Avirdic:' FOR ql%l l( is li5F : l V ' . Received
City of Tigard SEP 2 4 200. Dana Permit No. f- C/
13125 SW Hall Blvd, Tigard, OR 97223 plan
Phone: 503.639.4171 Fax 503.598.1960 CITY OF TIG' '�� �; N1 n �r /U I y � �_
�_ �l/
iii
Inspection Line: 503.639.4175 B „ I' _ 'f . _ Daze Iteadyi y: 0 See Attached Checklist for
Internet: www.ci.tigard.or.us UIL171NG ®IVI ' O N No /, / , i � � Supplemental Information
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® New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other equipment, materials, labor, overhead, and the profit for the
NV- -i . = T .R: ,"'. :KZ r - ` w rl':: = :i ��.a::i3 x °'�r -'_M _,'- ' ».'?Y�d`.5'!(1.^: �- fir`., +K,..j, .- f R. .k<b'3ar - � Ssai ._�
> - A M t t '. t' err €: , s work indicated on this application.
v 2 ,6, _ , t;,: .x Y OF CONStRUCI'IQNr:a.'Tthi e- _ ,
� CATEGQR � �� �Y- .d�,. -.�,m�
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",},. >. '�„` ;...�,.� �:a G.. _.,s^ .�- ,i�z,r, ., Valuation: 1.50,000
® 1- and 2- family dwelling ❑ Commercial/industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: L12--
�� _ ; r 1 �' , ” - "'�`���' °' 3 �°.• �_� � Total number of floors: Z
g c , } �A ' 4, TttBITE i ! !?,, TION =AND I; _- �' .
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Job site address: `374 3 5■;,) 1-444-1 -[�(1;q. --'. New dwelling area: Z, :i3( square feet
City /State/ZIP: Tigard, OR 97224 Garage/carport area 5 Z7 square feet
Suite/bldg./apt. no.: I Project name: Daffodil Hill Covered porch area: g3 square feet
Cross street/directions to job site: Deck area: dj square feet
Other structure area: 0 square feet
RE ,- TatD,DA'fi C rogiF�i :;., '7riaz
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Subdivision: Daffodil hill I Lot no.: \ (p 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
` `L; Ttfr t;. .� r.:i`r sz' » £YZ$ _`s :,a.+:.,•`.?...*. r.:,zx, §....cjV /6:,x; i fi T N friri, .'b - �"- °..._-°' , Sj'i
z ���.� Std DFSCRII'TION"OE 3WORK2 "- , . % t*r,.` work indicated on this application.
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New SFR Valuation: $
Existing building area: square feet
New building area: square feet
z MIMIC ®PROPETY OR!NER �h `TF:NANT Number of stories:
�:-._. w . - sr.»:. ...: a sas i .a 9 3 ai•O x`PAMILIwa�a= .a;> -. IA1 .
Name: Goodlet/Marshall Bldg,. & Dev. Co. Type of construction:
Address: PO Box 91551 Occupancy groups:
City/ State/ZIP: Portland, OR 97291 -0551 Existing: •
Phone: (503)297 -1881 Fax: (503)297 -1650 New:
r: +�4�� =^ >'fl> ' � ��' - �.:�s�'�aze; < `c°`� r . : s�.ru, °`.,^�^ _,eer - °� =r-• a�;;��; _ _ x��x;.= rt�_:�r� �r���;�;. :'�;4� -
t� . APP y -? , _ . ,: �= -{ -CO v, ,. , ;.. r . . ,- €a . ; -
, � �. :a.. i h..� � , °,�-�. a. w �. NT „ PERSN=. ;.., �� >:. ' $;� � .; �'.xF �,.., . ��; ,t.,
«; : A . �,. ,. s .:,� _..a>s: rim:� .r, ' wr -.�:" 4 sue... ?_- �.... :.,::.rte ...er v.:a, , k:. u:.;:: �'.,. _ 4)tv 'Y�:. .,. _: i_, , a.f. �,._., .. , ,.
Business name: Patrick Schmitt, designer Inc. All contractors and subcontractors are required to be
Contact name: Patrick Schmitt licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2414 NW Stimpson Lane jurisdiction in which work is being performed. If the
City / State/ZIP: Portland, OR 97229 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 768-4573 I Fax: : (503) 246 -3559
E -mail: sdunittdesign@comcastnt
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Business name: Goodlet/Marshall Bldg. & Dev. Co. a w, :°r �, +. �^' ° t : k <:.: < > r , .r.
` e l BU II IN4 P . ,,.. F ,, „,, ` ` , •_ .
Sv c'o���z.�c.�':al�;�su'�.�^.v. � v.�s,�a- txxs`- ti_„��. *ay �ut�: a5; ��s :, ��ts� ° •'�;F' -��_
Address: PO Box 91551
Please refer to fee schedule
City/ State/ZIP: Portland, OR 97291 -0551
Fees due upon application
Phone: (503) 297 -1881 Fax: (503) 297 -1650
Amount received
CCB -lic :x10882 - -- __ . —
� Date received:
Authorized signature: '/ / �// I , • , This permit application expires if a permit is not obtained
( within 180 days after It has been accepted as complete.
Print name: Patrick II 'tt 1 Date: 1( 74f - I * Fee methodology set by Tri County Building Industry
1 Service. Board
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit No
13125 SW Hall Blvd., Tigard, 4 EIVED ttut Plan Review
Phone: 503.639.4171 Fax: V4,0 a4,..tVi.et, Date/By: Other Permit:
Inspection Line: 503.639.4175 „Ltr,,t Date Ready/By: luris: El See Page 2 for
Internet: www.ci.tigard.or.us SEP 2 4 2004 Notified/Method: Supplemental Information
[g] New construction eiarigiliftrANSICAllacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
. 4 'arid•Siii toi■istitueitcii■I Value: $ $5,500.00
p sy,pms
El 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
' JOB INFORMATIOT AND L - , Heating/cooling
Air conditiing h putnp
Job site address: 13743 SW Leah Terrace on or eat
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, Oregon 97224 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: Daffodil Hill
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Daffodil Hill Lot no.: 16
Other: 10.00
Tax map/parcel no.: Other fuel appliances
, 441 Water heater 10.00
:k• _ ,
Gas fireplace 10.00
New SFR 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
10.00
Name: Goodlet/Marshall Bldg. & Dev. Co. Environmental exhaust and ventilation
Range hood/other kitchen
Address: P.O. Box 91551
equipment 10.00
City/State/ZIP: Portland, OR 97291-0551 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (503)297-1881 Fax: (503)297-1650 toilet compartments, utility rooms) 6.80
. :!°,2 Attic/crawis 10.00
Other: 10.00
Business name: Patrick Schmitt, Designer Inc.
Fuel piping
Contact name: Patrick Schmitt $5.40 for first four, $1.00 for each additional
Address: 2414 NW Stimpson Lane Furnace, etc.
Gas heat pump
City/State/ZIP: Portland, OR 97229 Wall/suspended/unit heater
Phone: (503) 768-4573 Fax: : (503) 246-3559 Water heater
Fireplace
E-mail: schmittdesign@comcast.net Range
!*' Barbecue
Business name: Michaels Mechanical inc. Clothes dryer (gas)
Other:
Address: 1241 NE 194
M E C hAN1%.LPER1IIT FEES*
City/State/ZIP: Portland, OR 97230 Subtotal
Phone: (503) 661-6183 Fax: (503) 661-4341 Minimum permit fee ($72.50)
Plan review (25% of pennit fee)_
CCB lie.: 35795 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signatu '
1144404- This permit application expires if a permit is not obtained vvithin 180
days after it has been accepted as complete.
7 A1& 1.-c1T I ---- I • hs,
Building Fixtures
Plumbing Permit Application . ,
..,iii? City of Tigard Date received: Permit a acy
— Address: 13125 5W Hall filed, RE0 Y1 E® Sewer permit ao„ - -.. Building permit nu.:
CiyofTigard Phone: (503) 6394171 Prolect'cppi. no. • Expire dare:
Paw (SO3) 598 - 1960 sEP 2 4 200k "lath iac ued - By. i Receipt no.: —
Land use approval: _
uI TY Of Tf�,F,ii® case file no.: t Payment type: j
._.
Oil & 2 family dwelling or accessory Q CommerciaVindustrial 0 Multi- family 0 Tenant improvement
0 b Addition/alteration/replacement 0 Food Other service 0 Oth ,_•_ -- • I
New eont,tru aoa t � Y¢ _
- ' SCHEDIIJL ttiir s>iettat`wCo sti30 :64e Nteclklit4
I Job address: IVA3 s 0 (�.AN- - 7- 42•LAr-ft„ Description l • tv. Fee(ea.) l Total
- -- _ New 1- am - • . tinily dwe r •
i'tlti .:to,: ' i Suite no.: - Y &s only
"-.'.. ~'"_-_"' __.,,._. - -_.- (includes 100 ft, for each utility connection) i '
Tax map/tax lob'account no.: �
Lot: ( �fock: Subdivision: j p p)l, tw SFR ( bath ? -
- -- - -L -- .....__. _ N- -. SFR (2) bath r i t
Project name: • _ SFR (3) bath - ''f
City!cotmty:�G .4 , Wig ZIP: 177Z __-- - `tach additionrtf'githtkitchen j
I
i Description and :ocation of work on premises: _ Site utilities: I I
t
_...- _,......_. �._.. N S_ l Catch r;►s_inIarea drain l
+ Est. data ofcomp1etion/inspectioa:
--
T - - - Dryw'ellsArach iine/trench Stain 1 - 4 -
Footin
Mei: (no. iin, ft.) i I i
PLUMBING ;CAI�,I< AGT 3R -
Business name ��i a �� i rl
1lanufaclw ed home utilities j ;
'
�l r.. . i (� _ Manholes , •
AddreesiAl. , _ . � - Rain drafty connector ;
( `. IN:. ...( t .�an b _ St ::ALZIP: gliol % � Sanitary sower (no. ltn. — 1 j -
Phone, b
. 0 Fax: ,9�i E- tnaii: Stone sewer no- lin. ft.) T r
— "Water (no. lin. ft.) 1
CCrt no .: Plum- bus. reg. no: ... 7 p }� j ( ) ! f
.__... - -.. - Fixtur or item: ? '
I City/men lie. nu,: 0.0 y p I
Contractor's rt:presentati v e signatur .14.... _ l ^ fit ' - Absorption v A1v
e 1 I
} - __ - ._ Back flow p reventer i I t
Peat name: „
a
/ .,0,4 bate: kwa -
r 4ONTA(1 1'k:1RSON. v - -
Backwater valve
• . - 13 zs i ns /l �vniory i
Name: 'F -[(fit l� � Cb1t,,.(-r - -- _ Clothes washe ' I �?
ZZ�� 1� N W S'1'I N-t fe { Dishwnsnc: ----4-4----1------1 1
Address:
r- _. i
pp Drtnkuttonntain (s) - I
Ci tz ; ._. 1_ l ct� State: at't - i ZIP: - z2 _ Eitcw Phone so 7(0 4573 Fax:Zc4C•-35 Expansrestt taut:
fl E -mail: .. ta p _-
— _
°• ,• _0Vi : ,' i' Ftxturci:.ewtt cap 1
Name (Print): l ? p �ti aec. �,1�47 PAY O Floor dra sinks/hub
Mailing address: r0 (-As*: `�( j G ar b age • d I I ?
City 1 -i. 1 Stateo('t_ I ZIP 2 I Hose bibb _ _. - _.._ . _ r -
q ice maker -- T ?
Phonelo3 ZI7 -jj t jl ax: 7-___I I.E- mail : Interceptor / Teasttrap , -_... 1 i 1 -.
-� _ -_—t
Owner installatioonitvsidontlai maintenance only: The actual installation Primer _ - i
will be made by me or the maintenance and repair made by my regular Roonra :rscconunerclal) -- r___—
employee on the property I own ea per ORS Chapter 447. Sinl (vj1astu(s), lava(a)• - I . 1
Owners signature Date: Sump _ how -
`, TN
Tubs/shower/shower pan
-.• _.__ _ - Urinal - -.... ..._ -- - - ., ( - � �
Name:-
...._.,_._.., ...•...__ Water cioRO
Address _ Water heater • MOM -
I City: 1 State: , ZIP - Oth er. - �.� . .. . .
Phone: Pax: LE.-mail: Total t
Ntn 6{t }w7°ot.1ont aooep mwtit oa'6' PluM4 alt lertwic et to hie osnn„a "- Minimum fee $
Notice: This permit application • Pi review at %) U Visa t Masten:ard expires. if a permit is not o btained -
( l.re�lt card number: - i / within t 8Q days after it has been Stacie surcharge (8%) ..,. $ -. -_•-
G cpiteG
- accepted ted ar complete. TOTAL a
I( Tame of cardholder as ebawa 0e men asta I P p
L_.__ Cardiroldet atgnature AthOWII ,, 440- I 6 (4/OO,4OM)
• Ele ctr ic al P ermi tA pplicatio n _ , 4 f - ; �,33 . -& r .
Datereceived: Permit n iAd , i — C r c/
s: _ . , of T igard Project/appl.no.: Expire date:
city ofTigard Address: 13125 SW Hall Blvd, RE Q; 9 W ED D Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
�p 4 2004
CITY o - r
"? , -- h ti r 4 F t zs3T
'- UCH;- 2MitiN1 11 : 5 . y'3 ,i F i '')=- fir- [ .1i , T - ' I -V �.'i
.R.M rt>r>3 P.'
1 & 2 family dwelling or accessory Cl Commercial/Industrial O Multi- family 0 Tenant improvement
%ew construction O Addition/alteration /replacement 0 Other: O Partial
'' t� u <t Y :' .10 1SI I 1 I
�k 1I\>s,O.RII ti
F l0N w > 5,.4 , - .. d r- , ,, ,
y
�._
ztz^,. � a _ n d . , ,:;4bs.— �_ � :v vF . ,, y; +�'x�r.._aw, .,h"t ..., .nlrz... a �_ a� v ... . .. ,.;. /=,,.:1 : ., a'� ;� `$�. 4:'4a, ..a w ? ». u,R a 9
Job address: 743 S \) (,6464 - '' ttito, Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: ( Block: Subdivision:
Project name: Q • , • 1. ,1 Description and location of work on premises:
.A, w
o '
Estimated date of completion/inspection:
'''-;.:,-.?1 ` . - i•' ., CON__ .—, . IOR J PP11( \1IQN ' n � ,-... x•: , : : , r , „ ` . 1 > -'FFf SC11E DLL "C ,' - ' Y,',,I � -4
Job no: Fee
Business name: p Desist ion - Qty. (ea) Total Pa
Address: / ^ ' siij A ,S New residential - single or multi- family per
dwe8mgmrit . Includes attadiedgarage. ,
State 6 ■ ZIP: 7 7 , r" Serviceincluded:
Phone: r w Q --- MS E-mail: 1000 sq. ft. or less 4
no.: / !/ �1111111 Elec. bus. lic. n6 V 6 7 " Each additional 500 sq. fi. or portion thereof __
Lim energy, residential ___ 2
City/metro lic. no.: _ Limitedenetgy,non- residential ___ 2
� % O r Each manufactured home or modular dwelling
ignature of supervising electrician (required) Date Service and/or feeder ■■ 2
Services or feeders - illation,
Sup elect. name (print) /jw ea , � License no 7 r S alteration or relocation:
.
, ',4-.6; -. , _ A . : ;711 1 P R ' OY E R _ 1% O %1 ''VL •li 4la€t � _ 1, �a :� ff - V , _;
k . .._� z� u:a.., ... wx_.. >,W � ,, .om � 3;. 200 amps or less IIIII 2
Name (print): u i 'r 11.4o.n,14 P►.t4.. b1,p . 4 Og y, to 201 amps to 400 amps _—_ 2
Mailing address: O 4olc l 401 amps to 600 amps ___ 2
601 amps to 1000 amps S—_ 2
City: 9 , l c rp State: on_ ZIP: q7 25. I Over 1000 amps or volts MI= 2
Phone: - l , ' ( 02110112M E-mail: I Reconnect onl _1111._ 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to tio°+al tion,orr+elomtlon'
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 11111!_ 2
Owner's signature: Date: 401to600amps ME__ 2
." `'7 r . u *, '' Branch circuits - new, alteration,
orexteaslon per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
Phone Fax of service or feeder fee, first branch circuit: ■ 2
Each additional bmnch circuit: __
{ t a ' PLANn RLVICW (P lease cliecl. ill tli ttl tpp(4t) . . > 4 Misc. (Servioeor feeder not Included):
O Service over 225 amps - commercial O Health -care facility Each pump or irrigation circle ■� 2
O Service over 320 amps - rating of 18c2 0 Hazardous location Each signor outline lighting __ _ 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories O Feeders, 400 amps or more s . ;on:
O Occupant load over 99 persons O Manufactured structures or RV park Fads additional inspectioa over the allowable in any of the above:
O Egressllightingplan 0 Other. Perinspection __
t sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other .
Na all jurisdictions accept aunt cards, please cal jurisdiction fir more information. Notice: 'this permit application Permit fee $
O Visa O MasterCard expires if a permit is not obtained Plan rev (at — R6) $
Credit card number / /— within 180 days after it has been — State surcharge -(8%) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$ •
Cardholder signature Amount 440.4615 (6100/COM)
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STREET TREE CERTIFICATION
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(PLEA PRINT) (PERMIT HOLDER)
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l land use and development standards for street tree installation.
1 i • ADDRESS: 3 7 L) 3 $ ( J 1J»WL 0..
• LOT: , I 42 SUBDIVISION: 11 / al t)
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• RECEIVED BY: , DATE: j 0 , '
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CITY OF TIGARD - . _ ,
BUILDING DIVISION -- ` PERMIT #: ' MST200 4-0028'i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2004
Phone: (503) 639 -4171 414111i ,�
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7 :11AM PAGE: 79
SITE ADDRESS: 13743 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 016 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF. 10/28/04, adding a/c unit prior to issuance.
OWNER: COODLET /MARSHALL BLDG & DEV. CO., PHONE #: 503-297 -188
CONTRACTOR: GOODLET /MARSHALL BLDG & DEV: PHONE #: 503 -297 -1650
Inspection Request Scheduled For: Date: 4/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 005642-02 503 -502 -7092 N
Corrections /Comments /Instructions:
Po s<T .4.5i- 2 5
- -0t -' SS PARTIAL APPROVAL - - -- El CANCEL ❑_ NO ACCESS
___
❑ FAIL L FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
>
Ins ector: Date: 27 P--C #: 503 p � ) 718 -
CITY OF TIGARD
BUILDING DIVISION' S 1 PERMIT #: MST2004 -00284
' 13125 SW Hall Blvd., Tigard, 0 „ DATE ISSUED: 10/28/2004
Phone: (503) 639 -4171 im,�,,,di�l,,,lliigl;l
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 77
•
SITE ADDRESS: 13743 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 016 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL •
DESCRIPTION: New SF. 10/28/04, adding a/c unit prior to issuance.
OWNER: COODLEf /MMMARSHALL BLDG & DEV. CO., PHONE #: 603-297 -1881
CONTRACTOR: GOODLET /MARSHALL BLDG & DEV. PHONE #: 503 - ?97`1650
Inspection Request Scheduled For: Date: 4/29/2005. Pour Time:
p q
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 005645 -01 503. 502 -7092 N
Corrections /Com s Instructions: d
- - \ PASS - -- -- -O- PARTIAL-APPROVAL- - -- - ❑- CANCEL n .A
_ NQCCESS —
❑ FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
9 11- 1 Date: Phone #: (503) 718-
4
CITY OF TIGARD i. ,
BUILDING DIVISION PERMIT #: MST2004 -00284
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2004
Phone: (503) 639 -4171 i '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/6/2005 T IME: 7:10AM PAGE: 64
SITE ADDRESS: 13743 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 016 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF. 10/28/04, adding a/c unit prior to issuance.
OWNER: GOODLET /MARSHALL BLDG & DEV. CO., PHONE #: 503- 297 -1881
CONTRACTOR: GOODLET/MARSHALL BLDG & DEV. PHONE #: 503- 297 -1650
Inspection Request Scheduled For: Date: 6/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006268 -01 603 -602 -7092 N
Corrections /Comments /Instructions:
ASS n PARTIAL APPROVAL ❑ CANCEL _-- -n - NO - ACCESS
n FAIL ❑, CALL FOR INSPECTION
❑ ADDITIONAL FEES ASSESSED �.._
Inspector: Date: 5 Phone #: (503) 718-