Permit .. C I TY O F T I G A R D MASTER PERMIT
PERMIT #: MST2003 -00227
�I� D EV W HO B T S � ER 3 639-4171
DATE ISSUED: 8/15/03
13125 4a L2d
SITE ADDRESS: .3 W NAHCOTTA DR PARCEL: 2S105DA -16700
SUBDIVISION: PACIFIC CREST ZONING: R -
BLOCK: LOT: 055 JURISDICTION: TIG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: DRH3562 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 35 FIRST: 1,380 sf BASEMENT: 830 sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,502 sf GARAGE: 645 sf FRONT: 15 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 Thum: sf RIGHT: 5
VALUE: 364,571.90
OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 2,882 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 5 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 6 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 5
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 FD R: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 7 201 • 400 amp: 201 • 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps - 10001x. 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: $ 8,806.26
This permit is subject to the regulations contained in the
D R HORTON INC - PORTLAND D.R. HORTON INC Tigard Municipal Code, State of OR. Specialty Codes and
4386 SW MACADAM AVE #102 4386 SW MACADAM AVE. all other applicable laws. All work will be done in
PORTLAND, OR 97201 SUITE #102 accordance with approved plans. This permit will expire if
PORTLAND, OR 97239 work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: Phone: 503 222 - 4151 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 130859 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8' Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insl Rain drain lnsp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation Insp PLM /Underfloor Framing lnsp Gas Fireplace Water Service lnsp Building Final
Post/Beam Structural Mechanical lnsp Shear Wall Insp Insulation Insp Ap. Sdwlk Insp
Issued By : L'L/, Permittee Signature : / : 1 • .
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
To Pc I- / 3 -o-a ,�,_
FOR OFFICE USE ONLY
Building Perm p °t b" Received //-- Buildin
Date/B : (0/flat
�LI Permit No.: N , _4/ - Ma,
Plannin Approval Other
City of Tigard y ��� 03 2:23 Date/B : Permit No. . II/. - 000 /
13125 SW Hall Blvd. • � Plan Review Other
Tigard, Oregon 97223
�.i 1 *' Y OF TICK , Date/By: 'r Permit No.:
�i w ,+'t Post - Review Land Use
�
Phone: 503 - 639 -4171 Fax: S�t5�S'��6oIVi' „ �w , ^ }� I II Date/By: Case o.
Internet: www.ci.tigard.or.us * ^� • '�'' Contact Ju..: • ® See Page 2 for
24 - hour Inspection Request: 503 - 639 - 4175 Name /Method: Of Supplemental Information
K i
• TYPE OF WORK REQUIRED DATA:
, •., •... , New construction ❑ Demolition 1 & 2 FAMILY DWELLING
Addition/alteration /replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees' are based on the total value of the work performed. Indicate
1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Accessory Building ❑ Multi- Family 3 Y S 7/. $
El Master Builder ❑ Other: Valuation
JOB SITE INFORMATION and LOCATION . . No. of bedrooms: 6 No. of baths: 41
Total number of floors 3
Job site address:• ;,�f;fi 4 i / ,, gin i New • d we lli ng area (sq. ft.) 3.7 // -.
Suite #: A Bldg. /Apt. #: Garage/carport area (sq. ft.) `` r
Project Name: P /OP/ r21 S -fr Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.) 35 t
Other structure area (sq. ft.)
REQUIRED DATA:
„..,� -- COMMERCIAL - USE CHECKLIST
Subdivision: it / ' Cfes ,.JEot #: I-
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indic.
' DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labs ,
overhead and profit for the work indicated on this application.
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
"PROPERTY OWNER I ❑ TENANT Type of constructi. - ..
Name: j I` — /h( pniqu /«'1 Occupancy ! : p(s): Existing:
New:
Address: (, 51ti Al / / i., i il, (6a'•
City /State /Zip: /pr -t7fl 0 l J7a'D( •
- - - Phone: ' 3 3 - ) ''ii f ( Fes 6D3 2.22-314_1 ,' i-1 NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
0 APPLICANT 0. CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: • K • / '{7(1i / pG - Ry- t8h.'( jurisdiction where work is being performed. If the applicant is exempt
Contact Name: Ni / / 0 /.( , '$, h from licensing, the following reason applies:
Address: 1 1349 ,vii) iihae ilry1 ,1z4 -4- /6 7- - '
City /State /Zip: forfl »I / 0g _/71 •
Phone:03 222 -1 ' / I Fax: /173 may - 37/7 - ..: .
' BUILDING PERMIT FEES* - - - -.
--
refer to fee schedule.
, C ONTRACTOR '' - '- -
Business Name: /7. / ' • fv/h /lie ” /3Yfl�G,/ Fees due upon application $
Address: 4 /33k SV miff!a 411/4 ''/07 --
City /State /Zip: fOfj/ l/[ g Amount received $
Phone: 05 - 2- »y -- IF ij Fax: 03 - gdp--3? 17 Date received:
CCB Lic. #: /08
Authorized v(/ ignature: � 1� Date: t( ,e /��6U�1 � Notice: This permit application expires if a permit is not obtained within
j ��f� 180 days after it has been accepted as complete.
N i le /i/1 *Fee methodology set by Tri- County Building Industry Service Board.
• (Please print name)
is \Dsts\Permit Forms \BldgPermitApp.doc 01/03
• _
Mechanical Permit Application FOR OFFICE USE ONLY
pA DateBy: Received f is ` Q - 7
DaDate/By: (
Permit No.. : : �( OSQ/ Q
Pemtit O `
City of Tigard Planning Approval Building
Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 � Post - Review Land Use
. �' +�
Date/By: No.:
Internet: www.ci.tigard.or.us • d ill Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 �''''" r Name/Method: Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST . ,
19 New construction ❑ Demolition • Mechanical permit fees* are based on the total value of the work
Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
I.Accessory Building El Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) Total
❑ Master Builder ❑ Other: Heating/Cooling
- . . JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address 514i NONPtili Pk. Gas heat pump 14.00
Suite #: (3 Z't b Bldg. /Apt. #: Duct work 14.00
Project Name: Q1 /f'7(j r- Hydronic hot water system 14.00
/ (/ Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
. Flue /vent (for any of above) 10.00
Subdivision: U j a � , D I Lot #: 42 Repair units 12.15
l �(/ Other Fuel Appliances .
Tax map /parcel #: Water heater . 10.00
. • DESCRIPTION OF WORK Gas fireplace 10.00 _
Flue vent (water heater /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
PROPERTY OWNER I ❑ TENANT. Other: 10.00
Name: . ' / _ //^ Pip yov/C .: Environmental Exhaust & Ventilation
L m0 7 G Range hood/other kitchen equipment 10.00
Address: ? 6 J• ,adAm hve -#/o-- Clothes dryer exhaust 10.00 •
City /State /Zip: pornAf , 1,e 11 Single duct exhaust
Phone: 503'727-' ti/ *--/ Fax: `j� - '2)- —37/ 7 (bathrooms, toilet compartments,
11 APPLICANT `CONTACT PERSON • - utility rooms) - - - -- - 6.80
Name: Ni l .(j Sfri Attic /crawl space fans 10.00
/,( /�� ,lie Other:
1 0.00
Address:
"I�O �S //Wtva fj�j 'dl"L • Fuel Piping
City /State /Zip: PP/Wax `{ i 4x 70 / * *($5.40 for first 4, $1.00 each additional)
• Phone: 63- y�1 -yj�/ Fax: �jD3-) -i -3'/ Gas heat pump
P um
P **
E -mail: Wall/suspended/unit heater **
' CONTRACTOR Water heater **
Business Name: H- ' 4 ' 7' Fireplace **
(40 ( SIN ��, �1v **
Address: Range ** •
City/State/Zip :Mp f &' p 9- MOD? Clothes dryer (gas) **
Phone:4 - (�� --3q Fax: Other: **
CCB Lic. #: 0/7 j] Total:
Mechanical Permit Fees*
- zfi 0 Fax
• $ •
Signature: Date: 0/a3 Minimum Permit Fee $72.50 $
N / I o Swi Plan Review Fee (25% of Permit Fee) $
v (Please ri name) State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 - -
02/20/2003 16:15 5936422800 ROSS ELECTRIC PAGE 01
i
02/20/2003 16:10 503- 222 -2675 DR HORTON PDX CONST PAGE 02 Li
Electrical Permit Application Reedved h G Electrical 9•:
. 17;1 sr -��7
>av
City of Tigard PlarmingAppr'ove sun
i DateIBy: permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,. Oregon 97223 Duo/Ay: Permij No.!
Phone: 503 - 6394171 Fax: 503.598 -1960 Poal- Review Lana the
Intemet-. www.ci.ti ardor.ua .t.'( ( -
g r•1 Contact Juns.: 1S) 5ce Pogo 2 for
24 -hour Inspection Request: 503 - 639 -4175 r' NamrJMethod: Y
Supplemental Informalion.
'n',y11.1 :i!> S::A ?- 1:1 V ' O :' ; . {; : ti Iy i,•
,11rd , 'I' I91;,�';'. 'I, r1LI'LSRIEWt(• e • ' a: r. Al ' ' �' „ 'ni.�'.f3,;:k;i:.,�., .
: TYp$fll�l Q' ;'4 c. :etc `.? 'u[ ct l • . �•
[.,: New construction ■ Demolition • SCrV CC over 225 amps- V Reahh -care facility
commercial
Is Addition/alteration/r' •lacement Ii Other: Service over v ❑'Buildings an
❑ 320 amps - ,sties of [] 'Building over er 10 l0,OD0 square far.,
r. 'lyet.S111 !'iu1'd'•; t:1): TE (''f* ;OEr -.0 IN • , ' " r'°' v ; "+ ,
• ; IH} '�� ;+•`: •�4f'S';�i" : �'� t & 2 family dwallinga four or ,,rote residential units in
111k1 & 2- Farnil dwell' - r■ Coirlmercial/Industriai I System over 600 volts nominal one structure
Bu 11din ■ Multi-Family m Building over three stories ❑ Feeders, 400 amps or mom
• Accessory g Y Occupant load over 99 persons ❑ Manufactured structures or RV park
• Master Builder I Other: Egress/lightng ❑ Other: •
!';i. i e 7 :.E •• e,parr lu hlt'oSidBL00010.14. ;'!:,'I. '0. Submit _ sets of plans rvltb any of the above.
The above are not appiiesble to temporary tons service.
Job site address �9�% �j / (/ 'r w l''''5I• Ir T 1''�i I , OP') 1,5, 7. !• .t_ 1 n +,
L:.,r i / I i fi I , ..44r.il!,..0 : ..!....1 � ; ; ;;)0>:I1J,gm ��'�7'Dv l t ,,gafr.Kira,, �1 E;, 4;,. -:a
Suite #: - Zq BldgJApt. #: Number of inspections per permit allowed
Project Name: .4 4 t c' ei ' Description Qty I ger (an.•) Total 1
Cross street/D�rCCtions to job Site New reoIdamtlal- sill{tta or mull!- family per •
J dwelling salt Introits =ached garage.
Stcvtce ;eetoded!
_ 1000 sq. R. or less 145.15 4
• Each wildieonel 500:0. R or portion thereof 31 1
Subdivision: parr 0�st 1 Lot #: Jr. . kimitcd art rte; retidet�f't1 L `fs.00 a
1,rCtlmi atctTLV, non teaidePtiat
75,00 2
Tax mat . arcel #: Bach manufactured home or modular damning
.. 6 1n.19 ri i 01't 0E? 4 !t7 i" 3' ^" ,''r suer star r' service sndlor fee4ar 9190 y 2
Sen'kes or feeders - Installation,
alteration or relocation:
290 anon. or 1ess 80.30 2
201 Imps to 400 Amps 10685 2.
-
401 ammo la 600 amps 160.60 2
I . t::'a ti '. if • ; I O' idled i'14i,' a R.; - ,a • iLli ;.a d1!f:1 ; li' - i :; '-.::'1 n`i11:11 601 amp= to_I000 amys •9.60 2
r t, .re- ' ! i ��� 11� - , i �,// / Ove:1000 amps oewi 454.65 2.
p T ( 4 . Recotrnaarol _ - 66.85 , 2
Address: 'r, 8 • _ ' ., // ; , , ( , i i t /D Temporary services or feeders - installation, •
% alteration, or relocation:
1 / i/ �/ 200 amps or lcse
66 25 • 1
Phone: TA - d - 201 unps m 400 yaps . 100.30 _ -2 .
12M/d'' ' c r "•:' <. "i'>'" lor5[Z , :Q • e ' 9:i 4t11 640 amps 133 -75 2
' II Branch *cults - new, alteration, or
Name: / � tsteesioa per pallet 1
A. Fee for branch ctrauits with purchase of
- - A.d.dress. r . 4 /1 / tt / • - i1 1 g' 4 0^ tervice or feeder fee. dsetibranoti 4rrr:uR _' 6.65 - — - - 2 -
k . te ., ` . e r . i. / 2D B, Fee ter branch cirauiec without mach= of .. ' -
service or Murder fee. Brit branch circuit 46.85 2
Phone: '7/ /. ' . '7 • J 7; Each add(gocel branch ciroalt 6 65 ' 2
• E -mail: Miso.(Service or fender not included): •
S'P' i��l�,+ !10i1�! *k�.�e''` ` . ' , V',•' l!!" Nif "u e :iir' tin' � , : ;1, 1 1°. I�y EathPumpOr OrfaRtionCireIc — - 53.40 - 2
r' . • - e n • '3 ;, . : r 'l r t dJ;4 aA . , Sach si/ptt or outline lighting 53.40 2
Job No: ' Signal eimtit(i) or a limited margy panel, -
Business Nafne: !•1,,, , G f .4,, alteration. or =Taejon Pare 2 2
Descrtprion:
Address: - 'f 36 0 5'' 0 v I C.41/41 • _
'Ci /State/ZI e : /-h 115(o° V•1, , 0 i2 Each additivenl Invpoation over the alloerabie in ttnYef the above:
Ile, inspoctipp per haul (min. I hour - 61,50
Phone: (r`{ 2 - 2.S'c • tnvestigr�on few
CCB Lic. #: iL � SFSa l Omer. _
I .1 , f lciit iii ti41:1Ziit!! niii!ETe l t[ iN1 ffEi'4�'i lifiriN' pltil`i11;!4iu�tia�lii:(fG;('r;
Supervising electrici`pn I Subtotal _ S
signature required: _ --� /� / Platt Ravicw (25% of Permit Fee) S
Print Name :51 ' . 205 5 ,LLic: #: y n. Suite 5w (8% of Permit Fee) 1
TOTAL PERMIT' FEE S
Au Notice: This permit applianoe expires :f a permit is not obtained within
Signature: ��r Date: V/3/�5 180 days after it has Inca accepted as complete-
�j /� /A /' /i 'Fes rnettrodNogy set by Trt - County 'IdiagIndustry Service Board.
/ iV/ (Please p r i t name) '
i :1Ds \Permit ParrnslElcPamotApp.dac 01/03
FEB -20 -2003 16:15 5036422800 97% P.02 (Ai
l
02/21/2003 06:53 503 -644 -5989 CRAFTWORK PLUMBING PAGE 02
4 192/20/2003 16:08 503- 222 -2675
- DR HORTON PDX CONST PAGE 02
Building Fixtures FOR 01'1 1'sF C1`i1.1!
Plumb_ing Permit Application Received / 1
• Dnto53y: 1 O � Permit No.:
PL1nning Approval Sc'r'am
City of Tigard Aa1e/Sr. PerrrotNo.:
Ilan Review other
13125 SW 1:Iall Blvd. �rd13Y • Permit No... Tigard, Oregon 97223 Pose- Rck+ew Lana use Phone: 503 -639 -4171 Fax: 503 - 598 -t960 . , a lb s;_. � ,
; ygv; Case Na.: _
• ).: 1I Sea Page 2 for
Internet wvvw.ci.tigard or.u5 i j.: F:-...,.„ '
Nan,c# ethod: Supplemental Infor'tnation.
2q -beta Inspection Roquest: 503 - 639 -4175 -
rte � y.�� f� ;" In [b ", � . - ��b`►�fC1�+`tk�'� �'?�
p •Ui.e.40 -'. silk' inl " •
iV` S: ,i171�....4 } OCR ' , ". f( d.. ��VC�• 11 , i 0404
dt�3ili�l6u' 'T:�iv'� °.Idz�'l�k {z ;'Vi70gIG;94 i ICE J QrY• stl l 1 rural
! New construction 1 - Description Demolition ; , n, u xi ru
1 c(e i.)q�U:ti' ��?jTojal j
II tionlalteration/repi Other: .. l , r �± F W ' i r -� l .�+ ire , r , 1
otitis, a,cement ■ fl), h 'Vill rlC��,�S�,e76' ..'� a� �� ;'� - .th
EG OD15TR . N;ri r;:u:'' 1. SFR (1) bath 249.20
i►;; I & 2- Fatnil dwe11in: ❑ Commercial/I SFR (2) bath 350.00
t . Bb 1. s r' ❑ Multi -Famil SFR (3) bath 399.00
• • Other: Each additional batb/gatehen 45.00
Master Buildr ; I r.
. f + �.a ?:r,.r. , Fires•rinkler -9• ft
::.P: • �Ea • r • �'IC1N�'�HtL'�tl ;.� LDi�d.-
.'.^�..:,;..te n i � 4,','FAl' ;i1,F1= 'Act!' fir',° N•it �t1 � iP! i •9 s 8 ''' u
- 1 /ArJ� - / � GT•,'. c � -.��. iAYM'1 ir• t'I:. "*�'fau.� � N �.fr.! i. � �
Job si address. `y`;�: ; , l. /`� Caleb /at a drain 16.60
Bld • _ A.t. #: ' basinr
Catch llAe /a l drai :rtch *sin 16
Project Name: aGr (/ �/ e `er Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities 11 0.00
Manholes
Rain drain connector 16.60
. So lit sewer no. linear 13. Pa:c 2
Stain sewer (no. linear ft.) . Page 2
Subdivision: ~! Lot #: Water servtae rno. lints R. . Pane 2
Tax map/parcel #: • r•,: -THYD, '12:;�A il. '.,41 ' 'la?. r li � tF,.AA{fg hit.:" ;,rip
;i1. i ;Ktili iG li • ": 4t.itiES' 'art . o -, : :OII'�� IVC)11 i;; 7 ,�ti . ) ,.:r..�. � . Absorption valve 16 60
Baaktlowprevarter Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain • 16.60
E.+1 i 6 7 57 • ' ".t.tt. ' 31j0Mbli-,q ` ,. MO riT0 -- dL�4'- J•s :i4 .0. ,: �Y . uW Ejectors/sump - 16.60
ame: r . ; . ,K111 LN, y eY / . Expansion tank . 16.60
' Al * 0 16.60 .
Fixture/sewer cap
Address: .� 11 . : , /, /� J. Floor drain/ floor sittldhub 16.60 •
Ci /StItt - Zi s :. '11Y . ,/ % I : / /" Garbage disposal 16.60
Phone: r - ! 2. • -:. Hose bob 16.60
V_I iE3 �A% C - O1RiLNtl _ _ .Ice maker .. 16.60 16.60 , - -
. Interceptor /grease trap
wine: � ,l � �<l4 �/ Medical gas - value: $ Page 2 , .
Address: , jj / i /� �� • Primer ' 16.60
e l' i / Roof drain (commercial) 16.60
F ax: , Sink/basin/lavatory 16.60
Phone: ' e _ � �� '
E -mail: . . T ub/shower/shower•pan . 16.60
:. 16.60 y
T ;,. - .r3 :ti. o 11 .''W r.'w :5 ;7Aila T !
1 ' 0 „ " *.',,'4�.C4n:� r•t . 0 . , :1 4•.1 ,4 P 5 Urinal ' _ 16.60
Watts Closet
Business Name: 'f4 ti , / a ., !, i L� 4,• water heater 16.60
Address: 77yat. SW ,(/r,.bat " .., -
Ci /State/Zia: ,L - - t, 0 ' q 700r a Other: i2irarN4" ^'it • :w� "}Lk $1' -w fl li `li f ° '.r,
IU.
Phone: 4- P!''9 Fax: -S 9 subtotal $
CCB Lie. #: 9 & re Plumb. Lice # :.20 - y P1°, Minimum Permit Fee $72.50 $ •
Authorized ,�� Residential Beddow Minimum Fee 936,25
9lgnattue 44 Date: �/ Plan Review 259'. of Permit Fee) 5
g A A l a State Surcharge (&% of Permit Fee) • S _
Plleasewine TOTAL PERMIT FEE S
Notice:' This pencil application expires of ■ permit Is not ebtalncd wlthie Allen commercial pl trending 2 vets of plans with Isometric or
190 days after it has beep accepted as complete
'Tee methedelor• set by Tri-County Building Industry Service Board,
i:\DstsWermit FormstPlrtPermitApp.doc. 01/03
1 FEB -21 -2003 05:49 503 644 5999 96% P.02
p.,5 azi 3— x-027.7
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• (PLEASE PRINT) (PERMIT HOLDER) •
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• Do hereby" cer that the" following location ■
• meets,, ir_cf; and /Was-hington_ County ■ "
• • ■ land use and development standards for street tree installation. ∎ -
• ■
• I Z elD ■
• • ADDRESS: 14364tt. SW W . JAN D ■
• L OT: J SUBDIVISION: 6I IFI( CItzST ► o.
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• BY: DATE: 1 'a� •
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1 RECEIVED BY:. % - ° DATE: v • •
•
CITY OF TIGARD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175 MST 3 '_d6 1 - Z 7
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Re nested I Z AM PM BUP
Location Suite MEC
Contact Person 1 Z-`.5.6 Ph ( ) 6 G I PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab �f
o to e 0"'n
Fire Alarm
` PART FAIL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Unable to inspect — no access
Please call for reinspection RE: � p
Fire Supply Line
ADA /
Approach/Sidewalk Date / _ l� `' Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175 ��ly .3 -- 00 22,7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Yl3 Fx Date Requested l/ `{/ S/ AM PM BUP
Location / Suite 5 MEC
Contact Person - i�'L �.�..:y Ph ( ) c5 / '4 7 / PLM
Contractor 6E • , Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
• S PART FAIL
PL TMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
SS ampers
S PART FAIL
- ICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date / " /4 c 4— Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour -7
BUILDING Inspection Line: (503) 639 -4175 MST 3 J �' 2 r
INSPECTION DIVISION Business Line: (503) 639 -4171 •
BUP
Received /3 Z- ) Date Requested / — (3 AM PM BUP
Location 'roe Suite MEC
Contact Person f/Yf Ph ( ) --S/ ' - 93a./ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ,
Insulation / i
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm • -
Susp'd Ceiling
Roof
Other:
Final ► �(,�� ' ( (,v f
PASS PART FAIL
PLUMBING ( ( / —
Post & Beam /
Under Slab
Rough -In
Water Service 7(?-7//7/,//1, Sewer f 2 ( ' Rain Drains �
Catch Basin / Manhole �p
Storm Drain L��' `' -�'T� r
Shower Pan /
, Other:
•
• - PART FAIL
CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA �J
Approach/Sidewalk Date v Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL