Permit .. .
,•
•
. .
A CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00319
1; DEVELOPMENT SERVICES DATE ISSUED: 7/28/2004
'�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10930 SW BRIARWOOD PL PARCEL: 1S133AC-10000
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 018 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 THROE 709 sf RIGHT:
VALUE: 149
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 W/O SVCIFCR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amp6- 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: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,212.45
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES I1Yhis permit is subject to the regulations contained in the
9500 SW BARBUR BLVD., STE 220 4949 SW MEADOWS RD SUITE 400 i iapal Code, S wo rk k will ill be e y doo bne ne i n
n
PORTLAND, OR 97219 LAKE OSWEGO, OR 97035 and d all other of theer applicable laww s. All wo A
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 a: LIC 58699 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 Plm /undSlb Insp Plumbing Top Out Shear Wall Insp Storm drain insp Plumb Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insr Water Line Insp Mechanical Final
Footing Insp Electrical Rough -in Gas Line lnsp Firewall lnsp Water Service Insp Building Final
Foundation Insp Mechanical lnsp Gas Fireplace Gyp Board Insp Smoke Detector
Slab Insp Low Voltage Insulation Insp Rain Drain Insp Electrical Final
Issued By : it/ _ _ _, . . Permittee Signature : _.3.L.-c, \
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Building Permit App LhC FOR OFFICE USE ONLY
Received / / Building `A 3 -00209
lD o�' O� mit No..�/
'JUN 2 7 200 Date/By: Planning A I Other
City of Tigard CITY OF TIG • ° D Date/By: Permit No.:- Ced,26 1
13125 SW Hall Blvd. Plan Review ocher
Tigard, Oregon 97223 BUILDING DIV 10 Date/Bv If" 'l7 - cl` e$Z3 Permit No.:
Phone: 503 - 639 -4171 Fax: 503-598-1960 s Post - Review Land Use
_.1 e . ' ) I i Date/By: Case No.
Internet www.ci.tigard.or.us * ' ^^ °'' Contact Juris.: ® See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: 77& Supplemental Information
.. OF W ORK
- .REQUIRED DATA: •'.'':::
aNew 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 LA Multi- Family
❑ Master Builder ❑ Other: Valuation $ i 1 4 149 • m
: -;;.-:: JOBSITE INFORMATION-and .LOCATION .••• • - No. of bedrooms: 3 No. of baths: Z
Job site address: 1 Oct 3 g2jAe 2t) e t-ck Total number of floors
New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.)
Project Name: HAWKS %CAA 1-0,44flowtS Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
SCI I 'S o TM aIUE , Sh!. 14hwKS BEAR-, Other structure area (sq. ft.)
S � ' ; (/ 40 4 . REQUIRED'DATA:
COMMERCIAL =-USE CHECKLIST :;.777_,.;_:::0.: :
Subdivision: REAR. 1DL..hl�, M' Lot #: 16
Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
7 ::;' , '" DESCRIPTION OF - WORK - the value (rounded to the nearest dollar) of all equipment, materials, labor,
Ce( /%164.) 3 sr o2 � T2;44 NC1n�
overhead and profit for the work indicated on this application.
`SEcA--- Valuation S
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
• PROPERTY:OWNER :•::.. .•f `0 TENANT. --. "- :-..:;..:::-7:::-... .. Type of construction V N
Name: AtTI7rnI n1 Pfae K -- o1 ial-io N1,c L .L.L . Occupancy group(s): New:
R-3
Address: 9500 SW V e gue &Sbi CU 0 226
6
� 2
City /State /Zip: 'pocadt , 0 9 7 2-19
Phone: So" 2-$7SS Fax PAZ-894 I NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
IIRr APPLICANT: . r<_. _ : =• -, , . :. Q. CONTACT PERSON.: provisions of ORS 701 and may be required to be licensed in the
Business Name: ierEK 1..3,2 J# a ASscom f / (4. . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: rv1Ae K (4•1c01) cn_ et,c.r Pedua, from licensing, the following reason applies:
Address: q9r o Sr^1 €,Iiteue- &116 i Su rise 220
City /State /Zip: Nr, r/ O2 q- 21 `t
Phone:( 93) &2- +E F ax: (So3j 03t2 -504 ( . .. ..
_ BUILDING PERMITTEES *• -
E -mail: r+tict- r K 4 d 1 b nvwn RSSVe , CD/t"► Ylease to fee; schedule.' - -
.. - -1 ......_ -_ - , ,- .l. . ....., ... . . - .. -.._ . ... ..
• � : . • •CONTRACTOR -
Business Name: *bee C L.. N 4 Agaborec, vu.. Fees due upon application S
Address: i x) Slnf gA1uiu►e QUID .5Ut C Z. ZO
City /State /Zip: 1.berUb.) oe 97211 Amount received S
Phone:3\ 692 -g 750 ( Fax: �51:43)092.-8g4 1 Dat received:
CCB Li Q( •
Authorized y Cf /1? Notice: This permit application expires if a permit is not obtained within
Signature: r� Date: 4 wtw 180 days after it has been accepted as complete.
M Aw- -lc.- Cni/ *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) •
i :\Dsts\Permit Forms\BldgPermitApp.doc 01/03
' : Electrical Per *C . I 1 n FOR OFFICE USE ONLY '
Received
Permit Date/By: Permit No — ®f 3/9
City of Tigard Planning Approval
a Sign
J UN 2 °� 2003 Plan No.:
13125 SW Hall Blvd. Plan n Re Review Other
Tigard., Oregon 97223 Date/13y: Permit No.:
tp 9f 9�tpAR p Post-Review Lund Use
Phone: 503 - 639 -4171 Fax: DateJBy: Case No.:
13 I DIVIS�Il
Internet: www.ci.tigard.or.us c' I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 ' Name/Method: Supplemental Information.
• TYPE OF WORK PLAN REVIEW (Please check all that apply)
4:New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: 4 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
.... & 2- Family dwelling ❑ 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: tocro BQ( jb Pt -,ACE FEE *•SCHEDULE
Suite #: Blcig. /Apt.#: Number of inspections per permit allowed
Project Name: .J44 /{<S eE fiQW1JtL'OM g S Description I Qty I Fee (ea.) I Total I
New residential - single or multi - family per j
Cross street/Directions to job site: dwelling unit. Includes attached garage.
S \W 150 +$1 AVE")U6 SA) 1-1 Service included: d 7
1000 sq. ft. or less k 145.15 (A, 15 4
l ,(�� Each additional 500 so. ft. or portion thereof ` 33.40 g3,�O I
Mug ,� 70,444,v103 11 Limited energy. residential 1
75.00 'jrj ,av 2
Subdivision: 1 1.1 V {d1,U Lot #: j') Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufact home or modular dwelling
- DESCRIPTION OF WORK - service and/or feeder 90.90 , 2
�� Services or feeders - installation,
c a cAJ C1 9I 3 sr✓a7 alteration or relocation: a,,
�W . / 1) � 42Z 1- r - 200 amos or less 1 80.30 O. O 2
Al, t ft:V✓IL f''cZlJicL.I 201 amps to 400 amps 106.85 2
401 amps to 600 amos 160.60 2
(::❑ 601 amos to 1000 amps 240.60 2
?PROPERTY OWN R:' .. TENAN.T: -= ' - =
q �,"" ,�� Over 1000 amps or volts 454.65 2
Name: �vY/ P k -rdrvie5 LL Reconnect only I 66.85 2
Address: ci) SA) gue- gt-•\ SU i t . 22Z Temporary services or feeders - installation,
7 alteration, or relocation:
City /State /Zip: r=b2rL ). 012. 9 219 200 amps or less 66.85 1
Phone(S6c) P��
—SS F ax :(:iG92 -be � 201 amps to 400 amps 100.30 2
� ... 401to600amos 133.75 2
APP ANT•:.. ;:
_ : = : -: D:CONT PERSON^ - Branch circuits - new, alteration, or
Name :1�€Zl t4 L. f t p i g 5 QA-TT5 1 l t , pension per panel:
Address: FS� $ eizthe L 1 SUl ZZO A Fee for branch feeder fee. each purchase o f
service or feeder fee each branch circuit 6.65 2
City /State /Zip: 'Rj/r t , Ge, 9`7 21 B. Fee for branch circuits without purchase of
� Q service or feeder fee, first branch circuit 46.85 2
Phone: C��)89 `5p Fax: ��3) 6 f aq 2 " 4I Each additional branch circuit 6.65 2
M isc.(Service or feeder not included):
E -mail: r�� r 4 - d la t�1.JacSoc , Co rm 2
. .... Each pump or irrigation circle 53.40
::.:�C.ONTRACT R . .
.. — .. :•r.: � = .. -°^` . .` . ' .- I 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 Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in an of the above:
503 - 361 -1256 Per inspection per hour (min. l hour) 62.50
CCB: 116453 ELC: 24 -353C SUP: 2919S Investigation fee: .
Other.
CCB Lic. #: I Lic. #: ... " •Electncal Pe n-.,._. - '..
Supervising electrician _ Subtotal I S 7 j 3,85
signature required: Plan Review (25% of Permit Fee) S 5.4(0
Print Name: Lic. #: State Surcharge (8% of Permit Fee) S 2- 0 +
/ TOTAL PERMIT FEE S 444.
Authorized �( /� �r r Notice: This permit a pplication expires if a permit is not obtained within
Signature: (((/// LL` (� c Date: `7'4 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
Mete- IC iU . / SeA
(Plea& print name)
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
FOR OFFICE USE ONLY
V Me Pe> r e on Rec Mechanical ,
Date/By: Permit No.! /S7: ' D03/9
Planning Approval Building
City of Tigard JUN 2 7 2003 Date/By. Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD te /By: Review Permit No.:
Tigard, Oregon 97223 Post Review Land Use
�b
Phone: 503 - 639 -4171 Fax UISI A 4:114 1 Date/By: : Case No.:
Internet: www.ci.tigard.or.us I I i Contact Jutis.: ® See Page 2 for
- 24 -hour Inspection Request: 503- 639 -4175 __ Name/Method: Supplemental Information.
. TYPE OF WORK_ .:. :. :. COMMERCIAL FEE *'SCHEDULE - USE CHECIQ:IST • .
, 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
mechanical materials, equipment, labor, overhead and profit.
::: •- CATEGORY OF CONSTRUCTION.
jai & 2- Family dwelling ❑ Commercial/Industrial Value: S See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDENTIAL EQUIPMENT /SYSTEMS.FEE`SCBEDULE.
Description Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning** i I 14.00 14,0
Job site address: / Qq!o gP/A2u/OOD PG. Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work I 14.00 I I.'
Project Name: 11 V� nn I�� IgLG/421� TO v.)� I4ovA -CS Hydronic hot water system 14.00
7 �'Y� Residential boiler
Cross street/Directions to job site:, (for radiator or hydronic system) 14.00
SW j30 f '` /1 / 4741 0 6 . AA'7,t)eS Unit heaters (fuel, not electric)
-V.,,I 1266 (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10. w
Repair units 12.15 I
Subdivision: J- {A�t/K5 Q2D Lot #: /8 Re Other Fuel Appliances
Tax map /parcel #: Water heater I I 10.00 (0.'
DESCRIPTION'O WORK ' • °t
Gas fireplace i 10.00 10.'
CO/4-TraLCT1c&) OF !'WG� 3 S �v�Y Flue vent (water heater /gas fireplace) 2., 10.00 20
w J tfU ,/_ Iry?F P)JFi7- / l 1 4 6 �) Log lighter (gas) 10.00 I
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY. OWNER - - - . • I' ❑ TENANT - --- , -• Other. I 10.00
Name: 1/ivle4 / 2KT i J/ 46c. Ll_t Environmental Exhaust & Ventilation
/ Range hood/other kitchen equipment I 10.00 10 .
aSC�
Address: d SN/ l Sll 1y/� , 1 Z w
Clothes dryer exhaust I 10.00 IQ. °Q
City /State /Zip: Paral.10D de Q l9 Single duct exhaust
Phone:5,93) 2,2_8' 8 I Fax: ( ) 842- im4I (bathrooms, toilet compartments, 4°
. I APPL' CANT ID CONTACT PERSON utility rooms) .5 6.80 20 •
Name: ' bEQ..* 1. i aot.J� 8 A-Si fees, / , JG • Attic/crawl space fans 10 00 10.00
� 'X ^ -gam �� Other:
Address: c�W ' ►?Y. OW Fuel Piping
City /State /Zip: ortr z,fr'. / OIZ 7219 "(S5.40 for first 4, 51.00 each additional)
Phone: PR2- e'l58 Fax: 1,.30?2 -084( heat etc. I ••
Gas heat pump •• Gas
E -mail: V► ins. C a d I browna.SSc'c ,c..,7,-..- Wall /suspended/unit heater "
-"-"-"' • """"' .. Water heater I **
Fireplace I *'
FORECAST HEATING & AIR CONDITIONING ..
17135 NE GLISAN ST BBQ
PORTLAND OR 97230 Clothes dryer (gas) _ ••
CCB: 152194 Other: ••
Total: 3 5.
11,23 LAC. it:
i Mechanical Permit Fees*
Authorized / Subtotal: $ 12.3. go
Signature:
gifole .� LF�
Date: 443 • Minimum Permit Fee $72.50 $
uvc _ a tu Plan Review Fee (25% of Permit Fee) S 3o ,q5
g5
(Please print name) State Surcharge (8% of Permit Fee) $ . 9O
TOTAL PERMIT FEE $ :Olt .625
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
bantling r UUI,ul c
' : , ` lumbing Pe it lion FOR OFFICE USE ONLY •
I r 1,1 l Received Plumbing
Date/By: Permit No.://1 5 6O. /9
City of Tigard . JUN 2 7 2003 Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD Plan Review other
Tigard, Oregon 97223 n p OF niv JSION Date/By: Permit No.: ra.
Phone: 503- 639 -4171 Fi RY 8- I"6/60 Post - Review Land Use
U+e* j Date/13y: Case No.:
Internet: www.ci.tigard.or.us rr�,j�f II i Contact Juris.: El 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)
N New construction ❑ Demolition Description Qty. 1 Fee(ea.) I Total
❑ Addition/alteration/replacement ❑ Other: New 1 - & 2 - family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
®' I
1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 350.00 moo,
Accessory Building 111 Multi-Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: I Each additional bath/kitchen 45.00
• .: JOB SITE INFORMATION and LOCATION Fire sprinkler - so. ft.: Page 2
Job site address: /0 93 0 l3gIARcJOOP PL Site Utilities
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: r] lJVc ZF•(Li TGtilti pawlGs Dr'well/leach line/trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s t Manufactured home utilities 110.00
SLR% 1%0 � ' Manholes 16.60
egE g g-ria,r Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: /{ig(n//C' 5 009gb
Lot #: / ) Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel #: Fixture or Item
DESCRIPTION OF WORK A valve 16.60
C. CNSTZ TI& OF ni EIS 3, S i eLl Backflow preventer Page 2
T J 140144f, Pa cc ( i 4 ( St) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
-- E'PROPERTY'OWNER . .--:`(••Q TENANT • :.. • --• Ejectors/sump 16.60
Name: lJ() WI /• P,4 - K T vk/N I k7W1eS l L1-C- Expansion tank 16.60
Address: ci So) s w EA e.gjQ &.i6, cuti-E Z ZO FixtureJsewer cap 16.60
City /State /Zip: poe- r2_4'.J1, 0 a, q z 19 Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone 3) 6 S2- SZ SS 1 Fax: ((.13)8i2.- SO I Hose bib 16.60
•;APPLICANT' • '•,:. = -•:_' .- - :.E CONTACT PERSON,- -. Ice maker 16.60
Name: 1>FeEV L. 620u/6 S ,4 SOCI,- t'`ES, jf✓L Interceptor /grease trap 16.60
Address: 9560 St...) fete. Bum guJA r SU at Z2c.3 Medical gas - value: S Page 2
Primer 16.60
City /State /Zip: F}7121 , CL° q i Roof drain (commercial) 16.60
Phone { S p 3 ) E Z - 6758 Fax (sc53 81L 68if f Sink/basin/lavatory 16.60
E -mail: rev4vz.lc C d. I t]rtj it Ce C' Ca r--• 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 . -. . -.. `- Plunibing PertnitFees* .. ..
CCB: 149035 PLM: 34 -391 PB _ Subtotal $ 3 S 0 • °D
. , - - - 1 Minimum Permit Fee $72.50 $
Authorized // Residential Backflow Minimum Fee 536.25
Signature: / I .L... Pate: G(� /Zd/o� Plan Review (25% of Permit Fee) S 43 ?. So
,? U L E_ C-tr)lVL State Surcharge (8% of Permit Fee) S 2 S • x
(Please print name) TOTAL PERMIT FEE S 4 la ' 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 `' 200
CI T k-
PLUMBING EXPERTS INC eU �� c � D ivSio N
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
Plumbing Signature Form
Permit #: MST2003 -00319
Date Issued: 7/28/2004
Parcel: 1 S133AC -10000
Site Address: 10930 SW BRIARWOOD PL
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 018
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
/ 7/4 Sigre of Authorized Plumber
If you have any questions, please call 503.718.2433.
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® I, PIZV ca CONE- , Owner /Agent for per E/( L. (5 Oat/ ASSOC
(PLEASE PRINT
• � ) (PERMIT HOLDER) ti
A
• ■
® `: •
® Do hereby certify that the following location
• • meets ,CityoflTigard%Washington County
A land use and development standards for street tree installation ■
4
A
A ADDRESS: /Me SW tR/ARG14O PL .
1 LOT: L I F SUBDIVISION: 4 4 VA re4 Pp
41 O-
A
• BY: D ATE: 1 /z 7 /O5
1 RECEIVED BY: DATE: 0.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST P� a.3 i
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / Z AM PM BUP
Location / 0 T3d Suite // / ` MEC
Contact Person Ph ( ) 36(� `-�' W7 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 7 JCi V /�� � �.c.� �,.� �L��l'� /- 2_/— o S' S.
Insulation
Drywall Nailing =E .4rr�c /�i� P e)
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
•
Shower Pan
Other:
Final
PASS RT FAIL
I►R CHANICAI? _
o steam
Rough -In
Gas Line
Sm Dampers
1l � - ASS 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 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date /— O 7 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 MST -ao 3 t,
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / (`T n AM PM BUP
Location l 6 o ) G 1-ezi 1 Suite MEC
Contact Person Ph ( ) " ? ? 7 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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: }
Final
V 41
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
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• RT FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA L1 � C
Approach/Sidewalk Date \' � \ ^ D Inspector \\ �� \ \ \01 ` 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 MST a J am' 3 �1
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested I AM PM BUP
Location Suite MEC
Contact Person Ph ( ) 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
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:
.►
PART FAIL
ANICAL
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 ---'f\
Approach/Sidewalk Date lidj Inspecto Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL