Permit • ihi,
CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2003 -00323
VP DEVELOPMENT SERVICES DATE ISSUED: 7/28/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10970 SW BRIARWOOD PL PARCEL: 1S133AC -10400
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 022 JURISDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 108 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 636 sf GARAGE: 536 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: 709 sf RIGHT:
VALUE: 149,008 .40
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1.453 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: 3
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: 2 201 - 400 amp: 201 - 400 amp: 1st VVIO 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 HMISVC /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 AREAISPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,212.45
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES This permit is subject to the regulations contained in the
9500 SW B and all BLVD., STE 220 4949 SW MEADOWS RD SUITE 400 i d al Mu othee iMunicipal l Code, of wo rk k will ill be e y doo bne ne in n
PORTLAND, OR 97219 LAKE OSWEGO, OR 97035 r applicable laws. l All l wo
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 - 892 - 8758 Phone: 971 - 233 - 0075 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 58699 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
dired questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Plm /undslb lnsp Plumbing Top Out Shear Wall Insp Storm drain insp Plumb Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insf Water Line lnsp Mechanical Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Water Service Insp Building Final
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Smoke Detector
Slab Insp Low Voltage Insulation lnsp Rain Drain Insp Electrical Final
Issued By : . 4iIo. _ ' 4/ Permittee Signature : _..--e— Pry\c'
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
'l Ft 1 uildiII Pe rmit Ica FOR OFFICE USE ONLY
on
g pp R e c eived ' .- Building
JUN 2 7 2003 Date/By: r+ •").-` •").-` ice✓ V Permit No. � �. U®g
Planning Approval Other ® � o ����
City O Tigard CITY OF TIGA - . Date/Bv: Permit No.:s? a ril
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 BUILDING DIVI :ION Date/By: if Z g - 0 7 / PetmitNo.:
Phone: 503 - 639 -4171 Fax: 503 - 598 -1960 4 ''' ( Ji't !.iiil' Post - Review Land Use
--i Date/By: Case No.
Internet: www.ci.tigard.or.us s ^ ^^ Contact Jun .: I CO See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method:e Supplemental Information
:: . 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
Aig 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 Li Multi- Family
❑ Master Builder ❑ Other: Valuation $ i J 1 g(o • `°
:i :;JOB SITE INFORMATION and.L CATION ;•••• - No. of bedrooms: 3 No. of baths: Z
Job site address: I 09 &21,02-‘406 PLAC Total number of floors
New dwelling area (sq. ft.) (
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) 48
Project Name: HAWKS P €Ap. 17 ItLi0M.ES Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
SO 1.x,Th Av e ,,,b S.h! 14414Kr BIEA Other structure area (sq. ft.)
e ` •' ••
, :,; REQUIRED'DATA:. - =
COMMERCIAL USE CHECKLIST : -° =,-
Subdivision: 4441 AS Ij,kR) Tdwd Ik 9 Lot #: 2 Z
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK • •- . the value (rounded to the nearest dollar) of all equipment, materials, labor,
,' C `, , s C I c N 3 Sr T` ' , overhead and profit for the work indicated on this application.
l. i to_S , ((,i 4 6 LJ� Valuation $
rtw Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
: PROPERTY.-_OWNER ::.. 4: 1:1 TENANT . - .. : : :- - Type of construction V N
Name: A lTf)rn nI PAg K 761441 v1c i 4.L.6. Occupancy group(s): New Existing:
R-3
Address: 9500 SW Fite gate- &-ibi Su Of. Z u)
City /State /Zip: "PoeTLhli , ore_ 9 - 7 2_11
Phone: 603 $92$7S ' Fax :6:3) P/12.- '1 NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
®` APPLICANT.: . :_ -.❑. CONTACT PERSON •. provisions of ORS 701 and may be required to be licensed in the
Business Name: ie.EK l..Bao1.1,04 c Ago 006 / (- , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: rviAt K ( -WSol.) az_ eicL PeAoz, from licensing, the following reason applies:
Address: 9Stb SW IRAe6lae futb. t Su ("?•e 210
City /State /Zip: keZ Cr.. q
Phone:(�3)�2 -e/SEI 1 Fax:6p3i 03a-6V-1( _ :.. _ .. ... • •- .. - ..;
BULL DING:PERMIT 'F F.ESt - . - • : k ' :.-
E -mail: ma ASSOC. , CD/v1 - �:Pl ease': refer - to : fee Fe hedule.' " -.'`: : •.- —
.,: .- .•CONTRACTOR _. , ' _ , ' ... ... -., ... ..... •
Business Name: *beect L. e4ecwo 4 4 &runt v.JG, Fees due upon application $
Address: 'lie) SUl gAi2&ile gLl/b 1 SU ZZo
City /State /Zip: Ther 012 — i 219 Amount received s
Phone: )3\ 692 -8 `15' [ Fax: (5 2 -5 "(l Date received:
CCB Lic. #: I 8 9 °1 /
Authorized 6 ication expires permit is not obtained within
(, - Date: I 180 days after it has been accepted as complete. fi g
/ (6 ij ' 4 kJ ao *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03
. ` .Electrical Permi® FOR OFFICE USE ONLY
Received Electrical
Date/B . Permit No.: ..0 Y ";.-j ° 0®3C
City of Tigard JUN 2 7 2003 Planning Approval Sign
Date/Bv: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGA' 1 Date/Bv: PermitNo.:
Phone: 503- 639 -4171 Fax: ARINAJ N DIVI'l • + Post Review Land Use
D onta c t Case No.:
Internet: www.ci.tigard.or.us I Ii Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503 - 639-4175 ""Zili
Name/Method: Su . lemental Information.
TYPE OF WORK PLAN REVIEW Please check all that a..1
XNew construction ❑ Demolition • Service over 225 amps- • Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: Service over 320 amps - rating of ❑ Building over 10.000 square feet.
CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in
En & 2- Family dwelling I ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: 10 9 - 70 Becket xib PLACE FEE *SCHEDULE
Suite #: 1 B1 . /Ap }' . Number of inspections per permit allowed
.�4l .J4
Project Name: ,1 S 6 l �/ Qt _ i& ' k,I; S Description I Qty I Fee (ea.) I Total
New residential - single or multi - family per 4
Cross street/Directions to job site: dwelling unit. Includes attached garage.
S n l 50 --'a Alib-Jute SA) 1-f Service included:
1000 g Each a ft. i or less 4 145.15 ( "\7. 1 5 4
Each additional 500 sq. ft or portion thereof ` 33.40 I ga,L.40 I
4 � , • J Limited energy, residential t 75.00 1c ,ao 2
Subdivision: ' Lot #: Z Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
- DESCRIPTION OF WORK - service and/or feeder 90.90 2
Services or feeders - installation,
� t1c7 - C-rIGNJ Cr olEJ 3 sr alteration or relocation: QQ,,,,,
j � � ,� �j� l 200 amps or less I. 80.30 aJ . 2
�W ^� r�"'u- r "� 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
gbPROPERT.Y OWN R.' ..... :; ❑ TENANT.' 601 amps to 1000 amps 240.60 2
�. _ ." Over 1000 amps or volts 454.65 2
lame: ,41J17J frvm4 /ILK Tdv N451okreS L LC Reconnect only 66.85 2
Address: C5D Sk) (ague- gL J cu '- 222> Temporary services or feeders - installation,
p ) alteration, or relocation:
City /State /Zip: Fi XLAr % Gil?
, . ch 21 d I 200 amps or less 66.85 1
Phone sp 'c, g 92 - fl Fax:(So &92 -Lq SLi( 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
)grAPPL ANT:.....: ::❑.CONT CT.PERSON Branch circuits - new, alteration, or
Name : g . L. b-P0 t .S� es /t • extension per panel:
FSW Q � n � g \ , S A Fee for branch f a hh purchase of
Address: W gCV i f�- U l 220 service or feeder r feee, each branch circuit 6.65 2
- B. Fee for branch circuits without purchase of
City /State /Zip: /fir ,11, , CJQ, 9 5
7 2 t service or feeder fee, first branch circuit 46.85 2
Phone: 69Z) N2_8-156 Fax: (So3) E392, S92'-8E4/ Each additional branch circuit 6.65 2
E -mail: yr 0,, K a, d 1 t r weia -csoc , Coft.--1 Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 2
=':'r: i-::_ .. :::' :.;:r;...: :.'C.ONTRACTOR • - ' ..
Each sign or outline lighting 53.40 2
Electrum Inc ' Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
DBA Spectrum Electric Desorption:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
503 361 - 1256 Per inspection per hour (min. I hour) 62.50
CCB: 116453 ELC: 24 -353C SUP: 2919S Investigation fee.
CCB Lic. #: Lic.
Other ..,. ..
...
�
. #• -: � Y . ,: �..,... ::.`:•.:Electrical. Permlt:Eees* w ;� = . —
Supervising electrician Subtotal ` $ 7 - 1 33 ,Y� 5
signature required: Plan Review (25% of Permit Fee) $ 3 . 1 449
Print Nam . I Lic. #: State Surcharge (8% of Permit Fee) $ 2-0 , l
TOTAL PERMIT FEE $ 444. o z-
Authorized . R ( Notice: This permit application expires if a permit is not obtained within
Signature: Date: 7 1 3 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
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(Pleak print name) •
is \Dsts\Permit Forms \ElcPemiitApp.doc 01/03
• �CahOII FOR OFFICE USE ONLY -
.. • Me R eceived Mechanical
Date/By: Permit No.lyS? P - ®A3A 3
Planning Approval Building
City of Tigard JUN 2 ? 2003 Datr/Br. Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGAR Date/BV: Permit No.:
g , � q � , Post - Review Land Use
Phone: 503 - 639 - 4171BUFEDII C11p1 W I , +' Date/By: Case No.:
Internet: www.ci.tigard.or.us Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 - i ' - Name/Method: Supplemental Information.
_ TYPE OF:WORK • 7.-:;',..1i.'' ..... COMMERCIAL •FEE *'SCHEDULE - USE CHECKLIST
, 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.
R1 & 2- Family dwelling ❑ Commercial/Industrial Value: S See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family I
RESIDENTIAL EQUIPMENT /SYSTEMS FEE! SCHEDULE.: •
Description I Qtv I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE INFORMATION and LOCATION = Furnace - add -on air conditioning** 1 I 14.00 I 1'i, °
Job site address: /0 9 ']Q ('fAIeWBO.D ft.. Gas heat pump 14.00 I
Suite #: l Bldg. /Apt. #: Ductwork 1 14.00 (l{."'
K5 l � \ . row HQ CS Hydronic hot water system 14.00
Project Name: U Residential boiler
Cross street/Directions to job s it - 1 (for radiator or hydronic system) 14.00
,S(,,t) j30 t►. /11/C YV r eS Unit heaters (fuel, not electric)
- gE 4) S ry2 X (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 I 10.
Repair units 12.15
Subdivision: yi�GVj�sL��/t' Lot #: L Z Other Fuel Ap liances
Tax map /parcel #: Water heater I 10.00 IO.'
. . - • DESCRIPTION OF WORK Gas fireplace 1 10.00 l0.'"'
C 1T -Cncai OR 4E-.0.) 3 i S -� -L Flue vent (water heater /gas fireplace) 2_ 1 0.00 1 2(7 .'
--rai,o.i &J'► -i PoJFr (146S) Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chininey/liner /flue/vent 10.00
PROPERTY OWNER. - : • I' 0-TENANT - -- - • -• Other: 10.00 I
Name' Pl'l KTQWiJ�Iowiec LLL Environmental Exhaust & Ventilation
(JYTf ni �(L ) Range hood/other kitchen equipment 1 10.00 10.'
Address: a Sh/ vaye / $ / Th2. Z Zl� Clothes dryer exhaust ( 10.00 IQ . °o
City /State /Zip: Ayer itr3D d2 Ci'l 219 Single duct exhaust
Phone:�5o .) 801/-8 I Fax: (5)K j 89 2-- 8841 (bathrooms, toilet compartments,
- ['APPL CANT . I ❑ CONTACT PERSON utility rooms) 3 6.80 20 .'0
Name: 1>C� L. g�loctlJ 8 A -coon i /A/G • Attic/crawl space fans 10.00
Other
Address: q Sk) giiL (_ t
L16 v ZZc� Fuel Piping
City /State /Zip: e pocrt4 7j i ce, 9 ••($5.40 for first 4, $1.00 each additional)
Furnace, etc. I . Phone:(So3) 2Jg2 -8156 Fax: c,QA2 -084( Gas heat pump ..
E -mail: ✓ vol- C d I brown - c)C . C,c7n -M Wall/suspended/unit heater "
... . • CONTRACTOR Water heater I "
Fireplace I "
FORECAST HEATING & AIR CONDITIONING Range
17135 NE GLISAN ST BBQ
PORTLAND OR 97230 Clothes dryer (gas)
CCB: 152194 Other. Total: - 3 5. 40
Mechanical Permit Fees*
Authorized /2€/0.3 Subtotal: $ 1 2.3, qo
Signature: A,i.(.l Date: �/ ! Minimum Permit Fee $72.50 $
(DUCE- C6N5— Plan Review Fee (25% of Permit Fee) $ 30,q5
(Please print name) State Surcharge (8% of Permit Fee) S 4 1, , 1
TOTAL PERMIT FEE $ 10 if , (a5 ,
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
liuuurng r ihl.ul
.Plumbing Permit: , FOR OFFICE USE ONLY
G r 1 Receiv Plumbing
, Date/By: Permit No.. .S Y 2 OaS Q®3 J
City of Tigard y:
Planning Approval Sewer
Plan R Permit No.:
13125 SW Hall Blvd. JUN 7 200 Plan Review Other
Tigard, Oregon 97223 CITY OF TIG . - D Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 50 � Post - Review Land Use
LIILL7IIVLa DR c, + Date/By: Case No.:
Internet: www.ci.tigard.or.us _si t4 III Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
" TYPE OF WORK FEE* SCHEDULE (for special information use checklist)
(s New construction ❑ Demolition Description I Qty. I Fee(ea.) I Total
p Addition/alteration /replacement _ ❑ Other: I New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
IZ 1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath . 1 350.00 3
Accessory Building ❑ Multi - Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
• .. JOB SITE INFORMATION and LOCATION Fire sprinkler - so. ft.: I Page 2
Job site address: /O / U g,r/ g 1 i)D Pc- t Site Utilities
Suite #: Bldg. /Apt. #: I Catch basin/area drain 16.60
Project Name: HfrAJKS Z i> -rov..lr1 Womg D Footing drain line/trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s t Manufactured home utilities 110.00
SLJ l ... A1/F��F. > S. Manholes 16.60
36A4) b fix-' Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: //,4Gt/K 5 OE,1D Lot #:_2_� Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: Fixture or Item
DESCRIPTION OF WORK Absorption valve 16.60
C [7h(S t.C• 11Ci3 OF N OA) 3, S i C t I Backflow preventer Page 2
- ri -Aosi ii-to to C-
PQ r () c96 SQ-120 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
- -IETPROPERTY'OWNER ... -.. I •Q - - . - Ejectors/sumo 16.60
Name: .AU1)WltJ PAR. XT0/61A0144ES, LL - Expansion tank 16.60
Address: '1O Svl - EAt e , g�Q &)b SUt € Z20 Fixture/sewer cap 16.60
City /State /Zip: PoQnJ17.. D o2 q� Z 1q Floor drain /floor sink/hub 16.60
Garbage disposal 16.60
Phone { S o 3 ) B q 2 - &Z S Fax: (3.3) & 2- SS I I Hose bib 16.60
.: APPLICANT : -. i• .:•- . .::❑•CONTACT PERSON:: Ice maker 16.60
Name: 1>E4EV L. gel:ha/1/4 i ASSOCiii-`e, j'J(i Interceptor /grease trap 16.60
Address: 95,00 St.i figure, gi-lib, Su Crt Zzo Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: F}Jer)s , Ce. C► 2 l Roof drain (commercial) 16.60
Phone:03)E2- 6758 Fax (so3>?J 2 (S 4I Sink/basin/lavatory 16.60
E -mail: r 0 d I taer3 f,.Jn a Ccd C • Ca r`'N Tub /shower /shower pan 16.60
CONTRACTOR - ' `- • . ` • -- Urinal 16.60
Water closet 16.60
PLUMBING EXPERTS INC Water heater 16.60
11925 SW PARKWAY Other.
PORTLAND OR 97225 -5413 Other:
503- 469 -0443 ,_. _. >�;.:. umbin Per Pl g Subtotal
niitFees* ...- _� •..,.: ":.� _:,:
CCB: 149035 PLM: 34-391PB _ $ 3 S a. m
Minimum Permit Fee $72.50 $
Authori
zed Signs tuurr - 7 A 6--)L--/ b/a /Q-7 Residential Backflow Minimum Fee $36.25
Signae: v Date: Plan Review (25% of Permit Fee) $ cert. SO
--, f& UCi= (&iV i State Surcharge (8% of Permit Fee) $ °O
(Please print name) TOTAL PERMIT FEE _ $ 4 Ce 5 SO
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
•Fee methodology set by Tri-County Building Industry Service Board.
i:\Dsts\Permit Forms\PlmPermitApp.doc 01/03
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
.. 1 UU l rr-- l ll l S l SS a `J : ? U \ \ V //
PLUMBING EXPERTS INC
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
CITY - Tit'
GUIDING Di`
Plumbing Signature Form
Permit #: MST2003 -00323
Date Issued: 7/28/2004
Parcel: 1 S133AC -10400
Site Address: 10970 SW BRIARWOOD PL
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 022
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for
the plumbing permit to be valid, please have the appropriate individual from your company sign below and
return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC PLUMBING EXPERTS INC
9500 SW BARBUR BLVD., STE 220 11925 SW PARKWAY
PORTLAND, OR 97219 PORTLAND, OR 97225 -5413
Phone #: 503- 892 -8758 Phone #: 503 -469 -0443
Reg #: LIC 149035
PLM 34 -391 PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x (/ a- " ( ✓ - �
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
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• ■
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STREET T CERTIFICATION
•
• •
• •
• I, 5R VC E COVE , Owner /Agent for DV RL l� tvi. 1TRowN 4- 4. $OC. ►
(PLEASE PRINT) (PERMIT HOLDER)
• ►
• •
• Do hereby certify that the following location ■
• meets, of�'I'ig /Wahington Count • ■
• l and use and development standards for street tree installation. ■
• ■
1 ■
■
• ADDRESS: 1 0 R ?O 5. . jj Q iAgwoo) P�- - ■
• ►
• ■
• • LOT: Z Z SUBDIVISION: HAWKS ge4Rp j
• ■
• BY: \ DATE: //`f/'- ■ ■
• •
•
1 11 •
1 RECEIVED BY: DATE: l l 6 `7-c it•
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CITY OF TIGARD 24 -Hour
BUILDING Inspection tine: 4503) 175 •
INSPECTION DIVISION • Business Line: (50 MST o300 3VUO3Z --.3'
BUP
Received Date equested 1 AM PM 1.----- BUP
Location / 4 9 70 L4 Suite MEC
Contact Person Ph ( ) n6 - %eS 1 7 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
Othe
i PART FAIL a
'1t • BING
Po . t & Beam
Un..r Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan . ,,,_.
an ; .y " °.
Other: '
Final
PASS PART FAIL
MECHANICAL
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 Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
� .' a
Approach/Sidewalk Date l � Inspect t Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
ElUILDING 1111 Inspection•Line:.(5 175 4. MST o74T — 03Z -
INSPECTION DIVISION Business Line: 03 - 4171
BUP
Received c � Date Requested / —,/ 0 AM PM BUP
Location / 0 1 -7b a° Suite / MEC
Contact Person Ph ( ) V(C la — ct 7 PLM
Contract Ph ( ) SWR
IL G Tenant/Owner ELC
noting
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear •1 3
Int Sheath/Shear I
f ,N; r� /J /r E`,�y _ /1 - O
Framing f i 1 VS . f�I V v7cA� v l / X19 /�
Insulation , . ! `7 k L .2J� 1 'l1 .Q.f 0 n _,_ P LeA/� 2� � fC -
Drywall Nailing �` "►
Firewall 1
Fire Sprinkler p S `^� ` ��� �--�` -- '* C�,S L-vc" _ `
Fire Alarm ‘ ' �� a _Q ' v�l \r-e. � PI ,b
Susp'd Ceiling /�
Roof i to 4 P �` _ o / "� •
Other: r •
: all / ) l �. v - ` \ JCL ` (—L -r1/4 c-�.*
PASS PART / n
PLUMBING 1 10 r � r
Post & Beam
■
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan NeA-e, - ,, "'1 r e - ► -� S 1 A A,,i L -±-2)
Other:
Final „9-./---.1„/L — I.,.1 d ,
PA ,;• • - T FA
AL .; C - 4-6J ,-®-w► d k
- • s & Beam
Rough -In S Q4 c-1Z—
Gas Line
S • ,e Dampers / � n �j (� (� ”
4,
AO PART FAIL �V UK �S bLn -5 L�f-,V - 6 `-L V ,- - I
TRICAL f l
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA `, /` O. /6 \// t
Approach/Sidewalk Date / J Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL