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Permit • ` MASTER PERMIT ~‘' n' CITY OF TIGARD PERMIT #: MST2007 -00122 ° COMMUNITY DEVELOPMENT DATE ISSUED: 7/24/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134CA-00201 SITE ADDRESS: 11675 SW NORTH DAKOTA ST ZONING: R - 4.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: MIRANDA Project Description: 468 sq ft addition BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 9 FIRST: 468 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: of GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: 43,243.20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 468 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: W /SVC OR FDR: 1 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC/FDR: 1 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAUPANEL: 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 ARENSPC OCC: ELECTRICAL - RESTRICTED ENERGY . A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: • HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL B 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 ANTONIO S. MIRANDA UNIVERSAL REMODELING LLC laws. All work will be done in accordance with approved plans. This 11675 SW NORTH DAKOTA 13945 SW HAZEL ST permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 BEAVERTON, OR 97005 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through 952 -001 -0080. You may obtain copies of these rules or direct Phone: 503 - 590 - 4181 Contact #: pRI 503 - 547 - 5755 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503 -641 -1628 Reg #: LIC 176815 TOTAL FEES: $ 923.71 REQUIRED ITEMS AND REPORTS Issued By : - Permittee ■ Signature : - . Call 503.639.4175 by 7:00 am. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Appli _ itn, Resi tC EVED 1 FOR OFFICE USE ONLY Received City of Tigard (P q v 7 Permit No.: M 5��d 7 �l a� ° 13125 SW Hall lvd., Tigard, OR 972)i N 29 2007 Plan Revsle+ i C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: I'( tti 7 /7 0 Other Permit: TI G n x D Inspection Line: 503.63941 7 f'7 AA y Vi' ' �'if� Date Ready/By: �� D /,� �° t� ` ®pp emental f informalion Internet: www.tigard o r.gov iii Not' ed/Method: B ,DINGS ❑VISION ....: / TYPE OF WORK ' QUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all . • ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this applicati n. y dwelling ❑ Commercial /industrial Valuation: $ 5 l J .O o ❑ 1- and 2 -famil dwellin ❑ Accessory building El Multi-family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: / /6 7 S 5� n )nRT,+ �/f s T; New dwelling area: �QD Q square feet City /State /ZIP: i A _ R 0 a, 57 •"a -- ��''II Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: ryil RA ri/ 4 4 S Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 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 DESIQkWTION OF WORK work indicated on this application. ( � \ Valuation: $ t D IT1 oN1 ' in Existing building area: squ are feet New building area: square feet • ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: A purro Ai, r r +4 i, a,?-iu 04 _ Type of construction: Address: ii t; 7s. S w O� TN- >.'1-)1-0(,0 " I T -- S Q' Occupancy groups: City /State /ZIP: 'l A_AN b R... ' , a 23 Existing: Phone: ( 3 3 3) r" ?6 _, 41 LB / Fax: ( ) New: ❑ APPLICANT f ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be , Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) I Fax:: ( ) E -mail: CONTRACTOR Business name: C ...4 _ BUILDING PERMIT FEES* Address: _ (Please to fee le) 3� y s t�L ...7 Structural plan review fee e ( (or deposit)osit): : 450 4"€) City /State /ZIP: q, •VElm, d q 2 0 ©s Phone: � _ X 5 4 -7 _ 5 7 , S " ' " F : (SO3) 6 ' ^ I b / 9 FLS plan review fee (if applicable): CCB lic.: , -7 G ei , 61 T Total fees due upon application: / , I .+ Amount received: Authorized signature: •��! /,I / //I . This permit application expires if a permit is not obtained . I I4dit. within 180 days after it has been accepted as complete. Print name: �/ e , r rn _c n . ) Date: 4/ 9/02 • Fee methodology set by Tri-County Building Industry I / • Service Board. I:\Building\Permits\BUP -RES PermitApp.doc 02/23/07 440 -4613T( 1/02 /COM/WEB) • Building Permit Application Checklist ,) One- and Two - Family Dwelling FOR OFFICE USE ONLY 54 City of Tigard Received Date/By: Permit No.: 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical TIGARD Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the . ro'ect under review. .ili USDICTIONAL SPECIFICS kA . plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ ets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ - 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening SittAssessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\ Building \Permits\BUP- RES- PennitApp.doc 03/21/06 440.4613T(I1 /02/COM/WEB) , Electrical Permit Applicati Cet ( _ I FOR OFFICE USE ONLY V , t ed City of Tigard - 'Da B , A9 47 Permit No.: . 5 'la-. ea !a, p... 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4175 9 2007 DateReadyBy: inns: SI See Page 2 for TIGARD Internet: www.tigard or.gov CITY OFHU HRO' ttfied/Method: Supplemental Information ❑ New construction ❑ A diit On/3 CeC�18CQ IVISION1 Please check all that apply (ssubb se ts 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 ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. A ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: n�\\ 1001W or more. occupancy. 1 t 7 S S te) f0A-QTIf A j(T c 1J Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP :� r^ ❑ Health -care facilities. ❑ Supply voltage for more than 6 4._1(3.. 17 9 7 .9 "PL-3 ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: /44 1 1 A) 14- r ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty I Fee. 1 Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 l Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 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 I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: /�/J 401 amps to 600 amps 160.60 2 frk r1/1 0 � �Q- / 1 f rR -N4I I) 601 amps to 1,000 amps 240.60 2 °- -- Address I 1 ^ J I e � , r i+ < T Over 1,000 amps or volts 454.65 2 • City/State /ZII �� 26 (7 e � 7 .-?.."..3 ^ 3 Temporary services or feeders installation, alteration, and/or relocation Phone: 6'0 r- A Fax: ( ) 200 amps or less 66.85 l Owner installation � This i tallStion is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or 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 _ g A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, r 46.85 2 first branch circuit _ • Address: Each add'I branch circuit 1 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 Business name: SCI ktts Signal circuit(s) or limited - ' I ' ` ` m` � energy panel, alteration, or Address // D -7n , -'L.J�N extension. Describe: Page 2 2 City/State /ZIP: ��. " ,� z)e) dZ_ tz ' - _ Each additional inspection over allowable in any of the above ���I Per inspection 62.50 Phone: 6 ) ,t 4 '?- 69f/ Fax: (5 w/.. Me ,y- 1 Investigation per hour (1 hr min) 62.50 CCB Lic.: 50.01 I Electrical Lic.: sei -(8e,. Suprv. Lic.: ib soy Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I :\Building\Permits\ELC- PermitApp.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 ❑ Garage Door Opener* V ❑ 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 V ❑ Boiler Controls • ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation • ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical . ❑ Nurse Calls , . ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 Mechanical Permit Applic E I � a i „ ,,,, r �7 n City of Tigard 9 D Received a e y: tB �Q / Permit No.: 6rAe,?- 6 2_ 14 JUN 2 2007 • 13125 SW Hall Blvd., Tigard, OR 97223 �►►`"' C Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: Date/By: T I G A It D Inspection Line: 503.639.4175 at R eadyBy: orris: El See Page 2 for Internet: www.ti ardor. ov ` � IU g g oti f ie d /Met hod: Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: For specsl rnfornuition use checklist. Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling I ) r `i 4 7A 7.--- Air conditioning ho or heat pump Job site address: II 6 7 5 S w N /� S / (�[� g (requires site plan showing placement) 14.00 City/State /Z TTa A_ II,6 a • q 7 a...._3 Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg. /apt. no.: I Project name: Furnace 100,000+ BTU (ducts/vents) - 17.90 in / 214,,J 6/Q- C Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: I Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 J v e Lt.) 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 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: /l _ f Ise) fi) l p s Environmental exhaust and ventilation Range hood/other kitchen c 5 Address: I I / 7 k) /►. it /41.140--)-14._ s' 7-- equipment 10.00 City /State /ZIP : — t xo t () 12_ g 7 a D3 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone:1 j03)Seo — 4 / Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: ( ) I Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer (gas) Business name 0 u +VL �_�N?) ;,2.J mks / Other: Address: CR g,�j9 - 2L s7- MECHANICAL PERMIT FEES* n City /State /ZIP:3 ��� / 9 7 C Subtotal CiS Phone 1541) _ 5-7 S , i Fax: Sb3.) G y — /4., Minimum permit fcc ($72.50) Plan review (25% of permit fee) / CCB lic.: i l� / p3 5 bl7 f o? State surcharge (8% of permit fee) III , TOTAL PERMIT FEE Authorized signature: III permit application expires if a permit is not obtained within 180 / %/✓ /// days after it has been accepted as complete. "4111W Print name: _ h— Date: G i� • • Fee methodology set by Tri- County Building Industry Service Board 01 i 1:\ Building \PermitsVMEC- PermitApp.doe 01 /19/07 440- 4617T(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:\ Building \Permits\MEC - PermitApp.doc 01/19/07 2 Jl u 1. 9. 2007 12: 50PM 2C50 P. 1 r? ` i I RE9V Lli JUL 0 6 2007 I ? �-�� JUL 2 4 200 CleanVit; Services Out commitment it elem. Cif? t-r.'*s Fire imCik Sensitive Area Pre- Srrree - [ D ', q Site Assessment Jurisdiction: , h Property intonation: (example 15234AB01400) Owner Information: TaxfotID(s): /5 ft /ee4 et0,3,6 Name: juiA Ei1 !/tile ) l7L} • Company: Address: 1 i 615 S•cca L1 6121 Dag: MA 3r. Site Address: jj in , j 17csAeu D tl 1 rl 7 o'Z .- -- j2 00- Q7 aa.,- Phone/Fa q T .1/ -f— Nearest Cross Street: E-mail: • Development Activity: Check all that apply Applicant information: Addition to Single Family Residence (rooms, deck, gereye) Name: u ctri I ,rj Lot Line Adjustment ❑ Minor Land Patition ❑ Company: r_ IR /v-0 ,) + ,i,tvV G, Residential Condominium ❑ Commercial Condominium ❑ Address: 1. 94d tSr vz Residential Subdivision ❑ Commercial Subdivision ❑ k odia izroni 412. 574)(2 Single Lot Commercial _, C] Milt ❑ PhaneiF /i —S7s.S !✓ � 6 --16 4 Zt Other "...C.0'1 ( L �`�r F.-mail; gce,AJTfk i(.D213 6)p vim& C.0 4 Will the project involve any off -site work: YES ❑ NO p Unknown ❑ Location and description of off -alto work: _ Additional comments or information that may be needed to understand your project: s app cat n oea rep scathe need for Grading and Erasion Control Permlte, Connection Permits, Building Permits, Site Development Permits, DEQ 1200-C Permit or other permits as teaved by lie Depar of Environmental quality, Department al State Lands andtor Department of the Army COE. All required permits and approvals must as obtained and completed under applicable local, stale, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, eckno :'i'edgea and agrees employees of Clean Water Services have authority to enter the project aite at all reasonable tenet for the purpose of inspecting project site condldons and gathering information related to the project Site. I certify that I am familiar with the information contained in this document, and to the best of my Knowledge and ballet this information is true, complete, and accurate. PrintfType , I e: _r. t,. __ Print/Type Title: /r7 't1r4•, 14 Si. nature. .�.- .�r'�► Date: FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSE$SMP PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. It Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas If they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained end completed under applicable local, State, and federal law. ❑ Based on review of the submitted materials and best available Information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pm- Screening Slte Assessment does au eliminate the need to evaluate and protect additional water quality sensitive are €s if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Seeger, 3.02.1. AU required permits and approvals mu3t be obtained and completed under applicable local, state, and federal law. ❑ This Service Provider Letter is not valid unless CWS approved elte plan(s) are attached. ❑ The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. , q Reviewed By: 04vj ,s,. _ Date: - 4M) . 1-- 2560 SW Hdisboro Highway • Hillsboro. Oregon 97123 Phone: (503) list -5100 •Fax: (503) 661.4430 • rw.w rtcann•nernenicte.o4, I � X � /t � //'&?. Rehm,: m01,2401 / e CITY OF TIGARD • COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form IMPORTANT PERMIT NOTICE MIKE'S ELECTRIC 11070 SW ALLEN BLVD BEAVERTON, OR 97005 Permit #: MST2007 - 00122 Date Issued: 7/24/2007 Parcel: 1 S134CA -00201 Site Address: 11675 SW NORTH DAKOTA ST Subdivision: Lot: Jurisdiction: TIG Zoning: R - 4.5 Project Name: MIRANDA Description: 468 sq ft addition Your company has been indicated as the electrical contractor for the permit referenced above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: ANTONIO S. MIRANDA MIKE'S ELECTRIC 11675 SW NORTH DAKOTA 11070 SW ALLEN BLVD TIGARD, OR 97223 BEAVERTON, OR 97005 Phone #: 503 - 590 -4181 Phone #: 503 - 649 -6991 Z- Reg #: ELE 34 - 18c LIC 50209 SUP 4230S AN INK SIGNATURE IS REQUIRED ON THIS FORM X . � 1 (4924_5 3' / 4, ,'/e /2_ 4 ,320 S - • • nature o upervis, Electrician Name (printed) SUP LIC # , . 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007.001:�2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2412007 Phone: (503) 639 -4171 4c -A , l Inspection Requests (24 Hrs.): (503) 639 - 4175 "'f �� INSPECTION WORKSHEET FOR DATE: 1/7/2008 TIME: 7:00AM PAGE: 23 SITE ADDRESS: 1 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: t16f3 sq ft addition OWNER: MIRANDA, ANTONIO • PHONE #: 503-5904181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503-547-5755 Inspection Request Scheduled For: Date: 1/7/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 239 Final inspection 06268801 503-547 -5755 N Corrections /Comments / Instructions: f � 7 �-2r,0 /L— (il7k.'4rZ6sv A-451-:' c � i a� ' 3 5) 9 ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A Date: / ` 7 - 0 Phone #: (503) 718- -t- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1f24/2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7 :00AM PAGE: 62 • SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 4613 sq It addition OWNER: MIRANDA, ANTONIO PHONE #: r03Ci�it1 Q1131 CONTRACTOR: UNIVERSAL REMODELING LI.0 PHONE #: 503 - 547 -5755 Inspection Request Scheduled For: Date: 12/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 060590.01 503. 547 -5755 N Corrections/Comments/Instructions: ‘Milt / 0 c p- -- " - ❑ P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /Z —3'—'> Phone #: (503) 718- CITY OF TIOARD BUILDING DIVISION PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/:i'4/2(107 Phone: (503) 639 -4171 n lil Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/10/200 TIME: 7 :00AM PAGE: 8 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 50359(4191 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503547 -5765 Inspection Request Scheduled For: Date: 1/10/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 062981 -01 503547 -5755 N Corrections/Comments/Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED A Inspector: _ Date: / —!b -- 0 9 Phone #: (503) 718- CITY OF TIGARD - • BUILDING DIVISION PERMIT #: MST2007-00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/224/7007 Phone: (503) 639 -4171 i r � Inspection Requests (24 Hrs.): (503) 639 -4175 ''I . INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7 :00AM PAGE: 74 SITE ADDRESS: 11676 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 469 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503.590.4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503. 547 -f,765 Inspection Request Scheduled For: Date: 11/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 069343-01 603649.6991 N Corrections /Comments /Instructions: )4Mkh s itiviLk PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED �1 V ' 0 II? Inspector: Date: Phone #: (503) 718 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 X14 "I1111 Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 11/2/2007 TIME: 7 :01AM PAGE: 77 SITE ADDRESS: 11676 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 603. 690.4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503.547 - 5755 Inspection Request Scheduled For: Date: 11/2/20p7 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 068869.01 603.649.6991 N Corrections /Comments /Instructions: 1� l 1 l� i J /f//7 All./a 00 kFC / e/ kWf, iLd4 , /.... /.L.'s i i it ' l.A. ! , ' -d 1 ! i,.wi ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS t o g FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 6 l Phone #: (503) 718- CITY OF TIGARD - - BUILDING DIVISION PERMIT #: MST2001 -00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/240007 Phone: (503) 639- 4171gi�l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/21 /2007 TIME: 7:00AM PAGE: 1 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503-590 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503-547 -5755 Inspection Request Scheduled For: Date: 8/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 054411 -01 503-649.6991 Y Corrections /Comme is /Instructions: • �i ■ 0 715) a Ik: PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL pg , LL FOR INSPECTION ❑ ADDITIONAL FEE ASSESSED Inspector: Date: /e I Phone #: (503) 718.— ,. CITY OF TIGARD X5.1n - 0d \ 22 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 4 .. 11j Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: MA/70 TIME: PAGE: SITE ADDRESS: I I UJ IJ Y f IC +A CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 12 mac (14/‘1-6‘ (� ' Corrections /Comments /Instructions: ?law 6/Wo SS IARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL % . L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 0 7 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MS12007- 00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 �W Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/20/2007 TIME: 7:02AM PAGE: 53 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503-590-4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503- 547 -5755 Inspection Request Scheduled For: Date: 8/20/2007 Pour Time: Code # Inspection Description Confirm # Contact "# Message 120 Electrical rough -in 054259-01 503 -547 -5755 N Corrections /Comments/ Instructions: mod' h I v1 1•62O,n (p'i hS ttetoS4-8-1") lLep, q a, Vcr ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ctor: Date: 4 °J T Phone #: (503) 718- CITY OF TIGARD S1 7.61- MT?' BUILDING DIVISION PE MIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 , u 1 �yl ,I i(l1 Inspection Requests (24 Hrs.): (503) 639 -4175 ■.' � : _.• INSPECTION WORKSHEET FOR DATE:' hX) / 6 -) TIME: PAGE: SITE ADDRESS: ' I (Q/ I VVV T V & KA_ i �-- CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code) Ins ection Description Confirm # Contact # Message / Corrections /Comments /Instructio s: (1:7 C C...4/Nr\i (7,-/(D) \e:2/ &kJ.- — ("44/ oL,,V tiuk 121,JThri PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: te C� Date: U ? Phone #: (503) 718- Z-'41' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007 Phone: (503) 639- 4171jit 13? Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/9 /2007 TIME: 7:00AM PAGE: 8 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503-590-4181 CONTRACTOR: UNIVERSAL. REMODELING LLC PHONE #: 503- 547 -5755 Inspection Request Scheduled For: Date: 8/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 053712 -01 503-547 -5755 N Corrections /Com nts /In tructions: � ii—e-- 0 - .._ gwy„ ,(zi -k---b w c....,,,A A-./t, e l_GMZILg, KA:Al (_ ( c-->e_ s S w•J t 12 , k 1 c--jV ..v.-- 6 f 0' cA �� s , . . S 1- z-t--k-ic. (---e9 Ne L� . te--t-, Q x,` s % _ , . (•-•:;, ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: j6i‘— Date: 8 6 Phone #: (503) 718 - 2'4 F , CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2007- 00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 � L INSPECTION WORKSHEET FOR DATE: 8/9/2007 TIME: 7:00AM PAGE: 10 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503 - 590 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503.547 -5755 Inspection Request Scheduled For: Date: 8/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 053710 -01 503 - 547 -5755 N Corrections /Comments /Instructions: ( Q - 0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V6 V Li Date: a (" 1 Phone #: (503) 718- 'I 11 • CITY OF TIGARD BUILDING DIVISION r PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 A il i / Inspection Requests (24 Hrs.): (503) 639 -4175 ,-.& °__.- INSPECTION WORKSHEET FOR DATE: 8/9/2007 TI : 7:00AM PAGE: 9 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503 - 54181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503- 547 -5755 Inspection Request Scheduled For: Date: 8/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 053711 -01 503- 547 -5755 N Corrections /Comments /Instructions: VG VIAL C J C Z...../6...---/e ----- " 4 4._../ .......-- PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ��` V Date: C16 b 1 Phone #: (503) 718- --1-'L CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 I DATE ISSUED: 7/24/2007 Phone: (503) 639- 4171�1I�I �. Inspection Requests (24 Hrs.): (503) 639 -4175 . �..- ` -- INSPECTION WORKSHEET FOR DATE: 8/3/2007 TIME: 7:03AM PAGE: 10 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 460 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503. 590 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503- 547 -5755 Inspection Request Scheduled For: Date: 8/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post /beam structural 053404 -01 503 - . 547 -5755 N Corrections /Comments / I nstructions: e 65� �,�.,:, ,.......„e_ �,��u� ( ‘, / ,.3 . o ::„.5, �c l -6 L_i 0,0--it , 6(i___ 1/1_/b b J, C2 v sswp_s ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS MAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` Date: J 3 / 6 Phone #: (503) 71822( CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 di DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 j Inspection Requests (24 Hrs.): (503) 639 -4175 _J `'' � .. INSPECTION WORKSHEET FOR DATE: 8/3/2007 TIME: 7:03AM PAGE: 11 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503-590 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503 - 547 -5755 Inspection Request Scheduled For: Date: 8/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 Post/beam mechanical 053403 -01 503547 -5755 N Corrections /Comments /Instructions: — i/l �4 J ( P \-- 6 .. J Cja W . (.1 \re k,v\-- 5 Q _ . . . e . . , . . i /.....-;,,,' .‘ ye.„„.., _v.v.- ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: �/� Dat e: �( >( P hone #: (503) 718- �� z_1/4, CITY OF TIGARD . BUILDING DIVISION PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 i DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 W `'' J INSPECTION WORKSHEET FOR DATE: 8/3/2007 TIME: 7:03AM PAGE: 9 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503.590 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503 -547 -5755 _x - Inspection Request Scheduled Date: 8/3/2007 — pp) ' Pour Time: d Code # Inspection Description Confirm # Contact # Message i 230 Underfloor insulation 053405 -01 503- 547 -5755 Y Corrections /Co ments /Instructions: 1 ' 6.4 'L +D -- (AA-56....)---C ` 66se.4( .�U.4 .In ^ I/JgV--to y PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \ Date J fri Phone #: (503) 718 - Z q `1 CITY OF TIGARD . . BUILDING DIVISION PERMIT #: MST2007-00122 AA 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ''� INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 66 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 4613 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503.590 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503 -547 -5755 Inspection Request Scheduled For: Date: 7/31/2007 Pour Time: 2 :00 Code # Inspection Description Confirm # Contact # Message 210 Foundation walls 053053-01 503 - 547 -5755 N Corrections /Comments /Instructions: 10 5 , ----0c 0--v. c `2z s & ■ (})- 1 ,-1.4 \111-k.A...._;- vv 9 - - / - k _ V t c, I I %% ' ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v • ( } -4/ Date: '.7 3 N / 1 Phone #: (503) 718- l 174 CITY OF TIGARD - • BUILDING DIVISION - PERMIT #: MST2007 -00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 A i f Inspection Requests (24 Hrs.): (503) 639 -4175 `'� � INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 66 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503 - 590.4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503 -547 -6755 Inspection Request Scheduled For: Date: 7/31/2007 Pour Time: 2:00 Code # Inspection Description Confirm # Contact # Message 4 205 Footing 053052 -01 503. 547 -5755 N 1?" Corrections/Comments/Instructions: s I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . 4 ) 1/ Date: V 7 2 1 .6 Phone #: (503) 718 - 2'I 24 CITY OF TIGARD / . BUILDING DIVISION #: MST2007-00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007 Phone: (503) 639 -4171 I Inspection Requests (24 Hrs.): (503) 639 -4175 _.' '' .. INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 64 SITE ADDRESS: 11675 SW NORTH DAKOTA ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MIRANDA DESCRIPTION: 468 sq ft addition OWNER: MIRANDA, ANTONIO PHONE #: 503.500 -4181 CONTRACTOR: UNIVERSAL REMODELING LLC PHONE #: 503 - 547 -5755 Inspection Request Scheduled For: Date: 7/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 053054 -01 503-547 -5755 N Corrections /Comments /Instructions: , A- / 1ij a UOJA). -e- ee. & t @ L-wJ ? 0 L.-NAJZ . Gz, . A-r-.... _ .......„...._ 42 , -4,) 64,A. J --2 t.) - :-,.. ( V: Z e •et. C U &� (ANL) ° /: WAX V� _(\/L A 2 ___ 6b . / Ovt . L., tln S - AJ co5ri -isa v. • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL 'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED lit; p 7i� Inspector: Ci� Date: --) t /r? Phone #: (503) 718 - 2,