Permit ' a
CITY T I G A R D MASTER PERMIT PERMIT #: MST2003 -00280
� , 4 DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10865 SW 130TH AVE PARCEL: 1S133AC-HBOO7
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R -25
BLOCK: LOT: 007 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 THIRD: 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 FOR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,072.45
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES INTigard d Municipal is al C subject Code, the regulations contained C o i the
Til other Municipal Code, laws. All o OR. Specia Codes and
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 all other applicable rov All work will be done i
PORTLAND, OR 97219 PORTLAND, OR 97219 t
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. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 - 892 - 8758 Phone: 503 - 892 - 8758 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
R °9" LIC 58699 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8 Plm /undslb Insp Plumbing Top Out Shear Wall Insp Water Line lnsp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insl Water Service Insp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Electrical Final
Slab lnsp Low Voltage Insulation Insp Rain Drain lnsp Plumb Final
Issued c : ' �.. /'�1L:.ali Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
` Building Per e FOR OFFICE USE ONLY
�� Received wilding
IV Date/By: � v�7/0�3 ermitNo.:�S %o2D03"DOa�'0
City of Tigard Planning pro va
DatdBv: Other
Permit No.r
SCOR2d03 �da/3
13125 SW Hall Blvd. JUN 2 7 2003 Plan Review Other
Tigard, Oregon 97223 Date/By: 1 °5 /1 5 5 , Permit No.:
Phone: 503- 639 -4171 Fax: g:Mc4. Td @AR'`' t,pi Post - Review Land Use
BUILDI DIVI ,ft,�.- 6' I Date/By: Case No.
vtr.
Internet ww.ci.tigazd.or. Contact Juris.: IE See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: % /6 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
( & 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 4 /�9 008 �b
❑ Master Builder El Other: Valuation ..
+ SITE IIYFORMATION-and.LOCATION .3 No. of bedrooms: No. of baths:
Job site address: ! 0E5(25 StJ 156 4 `Ai/E0 Lit. Total number of floors New dwelling area (sq. ft.) _ / _
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) _
Project Name: FliN W..S 11,EAA -0%4 t t ,S Covered porch area (sq. ft.) Yi _
Cross street/Directions to job site: Deck area (sq. ft.)
StGi I - &, TM /11/4 ,4 S.isi. 14,414KS acive Other structure area (sq. ft.)
' ' •=:;;= • REQUIRED' DATA:. - ':;
COMMERCIAL = USE CHECKL•IST"•`:: =r.• :.••-.:.
Subdivision: 44A7"14 /SE/ 701.44./r-4* Lot #: Z •
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
.. . •': the value (rounded to the nearest dollar) of all equipment, materials, labor,
;s:'r : . : ,. DESCRIPTION OF
overhead and profit for the work indicated on this application.
Cr,'t*ISr'2u.cTk4.1 of NE .) S Crotty 1 1rjiv,
`1Pe,3SEtl" Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
.OPROPERTY:OWNER .y:.. :•.. . 0 TENANT; .. . Type of construction V N
Name: AlT(Ltri&I PAgK T6k1INlN0114,ES', L.L.L. Occupancy group(s): Existing:
R-3
Address: 9500 S 2 gust &-(11), Cu 11'E. Z 2.f)
W '[
City /State /Zip: 'Poeri t3 , 02 q 1
Phone: 603 OR2 - 1SEj Fax :6:3) p,2._ ?4i NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
. Ii` APPLICANI: :"::;--::•;_:_::::-•- : , . : [.'CONTACT PERSON:.'.:•_' provisions of ORS 701 and may be required to be licensed in the
Business Name: ie.EK L ."B(LO ! c A szAt / (4 . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: Mike K (449A) a2 eic.r AeA+02- from licensing, the following reason applies:
Address: qs D si J Ate, , Su 17 224
City /State /Zip: k i at q 2a9
Phone:(3)842 -e 1 Fax:(sAsoti-6e ( - sUII:puvG PEIt1vnTF>!.ES
E -mail: en bnot.,.'n Assoc. . .)-ti - - -
..... -... ..._. ;:... - . a .. ... . . . ` .. - ......1 ... . - , . ..- • ... ..
.. - : . - - •; ,- ;':i _ ..CONTRACTOR • -:::: • r
.Ylease�refeito °f ee;st:hedulc: ��
Business Name: BEY_ L. R2awN 4 ASSWA'C Y■16, Fees due upon application $
Address: 95:0 SW gAleSule. gL1/D( Slia1i 27.0
City /State /Zip: 4b¢rj 4 Q2 9-72161 Amount received $
Phone:(1\ 6q7,-8 � Fax: 5.ei 2 -88'41 Date received:
CCB Lic. #: 9109
Authorized / Notice: This permit application expires if a permit is not obtained within
Signature: ,/� Da te: 24 (Q3 180 days after it has been accepted as complete.
/1444.K Ala gib) *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) •
i:\Dsts\Permit Fotms\BldgPertnitApp.doc 01/03
. FOR OFF USE ONLY
Electrical Pern '1� �i Electrical , c. ,
.. Date/By: Permit No.: Z.) 7 ; 2 00 -/,Qapt')
City of Tigard JUN 2 7 2003 Planning Approval Sign
Date/By: Permit No.:
13125 SW Hall Blvd. Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
Phone: 503-639-4171 Fax.
g 9 .g3Vr�gbvlsl' Post- Review Land Use
Internet: www.ci.tigard.or.us y ;
��,''11y� Contact Case No.: a� IIII 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)
AtNew construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: (g Service over 320 amps - rating of ❑ Building over 10,000 square feet.
CATEGORY OF CONSTRUCTION I & 2 family dwellings four or more residential units in
a1 & 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 I Submit _ sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: 1091.A SW 13f� Ei�I UE FEE SCHEDULE
Suite #: I Bldg. /Apt. #: _ l i Number of inspections per permit allowed
Project Name: ,{-.j4 J <S IS TQGI/.-4OnflES Description I Qtv I Fee (ea.) I Total I
New residential - single or multi - family per +
Cross street/Directions to job site: dwelling unit Includes attached garage.
S W ' T_ �1 �''t A (J� SA) N Service included:
1000 ft. i or less 145.15 1 4 >• L 4
3 644 SN.rifir Each ch ad additional l 500 so. ft. or portion thereof i I 33.40 I G`.ie l
. n IN �� -7 Limited energy, residential 1 I 75.00 "(5 • ate T 2
Subdivision: ' I-Ot Limited energy, non residential I I 75.00 I 2
Tax map /parcel #: Each manufactured home or modular dwelling
' • DESCRIPTION OF WORK service and/or feeder 1 1 90.90 1 2
Services or feeders - installation,
(4S' CF O'ER 3 sr alteration or relocation:
/�,� �e 4 r 200 amps or less _ 80.30 2
- 77)1.-)&L �iL+"' r " 201 amts to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
15;bPROPERTY:OWNR2 ..: _. 1.:❑ TENANT" --
..... _. 601 amps to 1000 amps 240.60 2
/' Over 1000 amps or volts 454.65 2 I
Name: ,40-r - oi414 fAr k' 1 0 nJf4 _ es 1 -LC , Reconnect only I 66.85 2 I
Address: Q1j .gtJe- Quk SUiN� 227
Temporary services or feeders - installation,
alteration. or relocation:
City /State /Zip: P)2:1 Oe. (� - 219 q �(j 200 amps or less 66.85 1
Phone spc, S ae -8258 Fax:(SO -se -t 1 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2 • 'XAPPL ANT ° = "".._ 2." - " - ' ❑•. CONT CT•P.ERSON Branch circuits - new, alteration, or
Name: - 1EIZEK. L. 6€04> e 4S 5 / l /SIG , extension per panel: of
Address: 9 CO SW 9JZLh P�-�b Sul Z2.0 service Fee for branch feeder circuits with purchase ui
t 6.65 2
service or feeder fee, each branch circuit
City /State /Zip: 'Rler r: , 0t12 9 21 C1 B. Fee for branch circuits without purchase of
service or feeder fee. first branch circuit 46.85 2
Phone: (23) 7. -8'!58 Fax: ( ij 692 -8641 Each additional branch circuit 6.65 2
E -mail: ria, a- d 1 too t.Jw)0.c$OC , COM Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 2
><-, :. ._. CONTRACTOR - - -
.. -_ :,.,,.. .. _ _ :.:_ _� '. ..:. 53.40 2
Each sign or out li g h t i ng
Toll No: -'1? k Signal circuit(s) or a limited energy panel,
Electrum Inc alteration. or extension Page 2 , 2
Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) 62.50
503 -361 -1256 Investigation fee: ,
CCB:1 16453/E.LC:24- 353C /SUP:2919S Other.
' :.:::.Electiical.Pertait:Eees* ., ...v -_
Supervising electrician Subtotal $
signature required: Plan Review (25% of Permit Fee) $ _
Print Naimv Lic. #: State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Authorized ( Notice: This permit application expires if a permit is not obtained wrtnin
Signature: Date: I t(Z\� 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
re l IL IU . A-o seA3
(Plea& print name) •
i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03
. FOR OFFICE USE ONLY
On
' / Mechanical P Received Mechanical
Date/By: Permit No.: / ? - 0 0 0 0
` Planning Approval Building
City of Tigard JUN 2UU3 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Tr OF TIGARD D Post-Review Permit No.:
Post - Review Land Use
Phone: 503 - 639 - 4171 Fa 3 DA{ mnsi 9,,,6_4„ F t Date/By: Case No.:
Internet: www.ci.tigard.or.us �14 i I Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information.
TYPE OF WORK ' - � : COMMERCIAL . FEE *SCHEDULE - USE CHECKLIST • °.
H 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: S See Page 2 for Fee Schedule
Building Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE * •
❑ Accessory g ❑ y Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION - Furnace - add -on air conditioning** i 14.00 1 , 4 ,4*
Job site address: /l7Flv.5" S() /30 Q Gas heat pump 14.00
Suite #: Bldg./Apt.#: Ductwork 1 14.00 (t{."'
�� 1?FAeb - r . ' J HOW�+ES Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions to job sit (for radiator or hydronic system) 14.00
.SLO 150 l '` / ✓ Ui- / 4.-/ A • ''ACS Unit heaters (fuel, not electric)
- g I 54Paei (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 O. °i
Repair units 12.15
Subdivision: I-mu/K s rEA1) Lot #: 7 Other Fuel Appliances
Tax map /parcel #: Water heater I 10.00 (0.'
DESCR IPTION OF WORK -- • • Gas fireplace i 10.00 10. '"'
yST &L. ?C6 ) OR ge.(A 3 5 -01,2t -t Flue vent (water heater /gas fireplace) 2, 10.00 2(I . iO
tfCJ
(AW ,/_ rYIE P� Jam (N G' S ) Log lighter (gas) 10.00
l Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
. 0PROPERTY.'OWNER -: . ; I' 0 TENANT - " :. :: ----- .: -- Other: 10.00
Name: (JW tvi K -f W J/t» vi is" LLG Environmental Exhaust & Ventilation
Range hood/other kitchen equipment I 10.00 10 .
Address: S{1/ vague / S>/ tli2 Z w Clothes dryer exhaust ( 10.00 D. ° Q
City /State /Zip: Aa...r to de cr7 2 l9 Single duct exhaust
Phone: 503 pjg2 —ASS Fax: (5.)K J 99 2- 884( (bathrooms, toilet compartments, 40
IXAPPLICANT . ` ❑ CONTACT PERSON utility rooms) 3 6.80 20 •
Name: tCe( I-. gaotAPJ 8 A td / Jc • Attic/crawl space fans 10.00
Address:
9 61n) / ��! Other.
VI ZZO Fuel Piping
City /State /Zip: 'ortrzifi- S gre, - 12! I • *(55.40 for first 4, $1.00 each additional)
Phone:(Co3J NZ -0 Fax: 9-7249
3.p/2 -�G84( Furnace, etc. 1
Gas heat pump
E -mail: rhvka- C C d 1 brc O.. Svc . C.,.9 -\ Wall/suspended/unit heater ••
- •' . • CONTRACTOR • • - _ _ Water heater I ••
Smart Heating & Cooling LLC Fireplace I ..
7616 NE Everett St Range
BBQ ••
Portland OR 97213 -6347 Cloches dryer (gas) ••
503- 254 -5096 Other. ••
CCB: 154133 Total: 5 S, 0
Mechanical Permit Fees*
Authorized /Z� /� Subtotal: S 1 2.3, go
i
Signature: Date: Minimum Permit Fee $72.50 S _
C,E- CoNE.-- Plan Review Fee (25% of Permit Fee) S
(Please print name) State Surcharge (8% of Permit Fee) $ ail()
TOTAL PERMIT FEE S
Notice: This permit application expires if a permit is not obtained within :Fee methodology set by Tri -County Building Industry Service ouaru.
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
P IS jum lilb r ix�ul C, _
Plumbing Permi Receiv FOR OFFICE USE ONLY
Plumbing ,
Date/By: Permit No. /1J e2003 U r D O
City of Tigard JUN 2 7 2003 Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGAR ► Plan Review Other
Tigard, Oregon 97223 'LD DIVI • Date/By: Permit No.:
Phone: 503 -639 -4171 Fax: 5(2g 0 Post - Review Land Use
rt I t
Internet: www.ci.tigard.or.us a�,i. o f �I Date/By: Case No.:
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)
ET New construction ❑ Demolition Description I Qty. I Fee(ea.) Total I
❑ 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
Er 1 & 2- Family dwelling I ❑ CommerciaUlndustrial SFR (2) bath I j 350.00 SO, °°' I
['Accessory Building ❑ Multi- Family SFR (3) bath ( 399.00
❑ Master Builder ❑ Other: I Each additional bath/kitchen 45.00 I
• .. JOB SITE INFORMATION and LOCATION I Fire sprinkler - so. ft.: Page 2 I
Job site address: /0846" Ski /50 *� ,li,e_ I Site Utilities
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: 1-01AJ ks - iEA(1.1 TGk1ri l4Ghvltr S Drywell/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
SL) I ;c�� ' Manholes 16.60
36A-14. iz& r Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: ///4WK 5 OEA.b Lot #: 7 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 014Sj fZttc r&i OF r4E(A) 3, ST Backflow preventer Page 2
- T <A,A1 4,w f P E t.,r ( 11 ( o 6 SQ-12e) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
--E'PROPERTY'OWNER . - ::I • ❑ TENANT • .:.. •= • -• • . Ejectors/sump 16.60
Name: At1 TU ►Nl r i P,4ia K T wIN I%I4'1ES I Li-C. Expansion tank 16.60
Address: CI ScO SW 13At2gVe L .JD/ SUING lla Fixture/sewer cap 16.60
City /State /Zip: Po2T?Jir• 0 q z ict Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone {5j3j BS2- &T Sa I Fax: (3.3) 892- b8i4 II Hose bib 16.60
;APPLICANT• .: • -.- ':❑•CONTACT PERSON, • Ice maker 16.60
Name: )> V L. (3fpu/lJ S ASSOC-01'C ji•X, Interceptor /grease trap 16.60
Address: 95a) St.) ghee. Buz, qLl., $u tT€ ZZO Medical gas - value: S Page 2
Primer 16.60
City /State /Zip: F.TjJt=. , et q - 7'Z l 9 Roof drain (commercial) 16.60
Phone:3)EZ- 6758 Fax ( So3> & Z. 6&4f/ Sink/basin/lavatory 16.60
E -mail: MA, cl, d, I tarrj(,)nacce G • Co v" 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:
Plumbing Permit Fees" _ : •
Subtotal $ 3
503 - 469 -0443 ' • � '� - "" = �• � ao
S a
CCB: 149035 PLM: 34-391PB Minimum Permit Fee $72.50 S
Authorized �; J bk / Residential Backflow Minimum Fee $36.25 _ -
Signature: t/� Date: _ Plan Review (25% of Permit Fee) S .,-�
/p U C E_ �lV E- State Surcharge (8% of Permit Fee) S ' S4 ° _
(Please print name) TOTAL PERMIT FEE S 3 �'9 ^
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 J
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
PLUMBING EXPERTS INC
11925 SW PARKWAY
PORTLAND, OR 97225 -5413
Plumbing Signature Form
Permit #: MST2003 -00280
Date Issued: 11/3/03
Parcel: 1 S133AC -HB007
Site Address: 10865 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 007
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 Xi c
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
•
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223 ✓
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
2050 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003 -00280
Date Issued: 11/3/03
Parcel: 1 S133AC -HB007
Site Address: 10865 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 007
Jurisdiction: TIG
Zoning: R - 25
Remarks: New SFA dwelling.
Your company has been indicated as the electrical contractor for the permit indicated 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 to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
AUTUMN PARK TOWNHOMES, LLC ELECTRUM INC
9500 SW BARBUR BLVD., STE 220 DBA SPECTRUM ELECTRIC
PORTLAND, OR 97219 • 2050 VISTA AVE #100
SALEM, OR 97302
Phone #: 503 - 892 -8758 Phone #: 503 - 361 -1256
R #: LIC 116453
SUP S
EL E 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
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® BY: • ,f DATE: 7/794 it
® RECEIVED BY: / DATE: 6
CITY OF TIGARD 24 -Hour o'
BUILDING Inspection Line: (503) 639 -4175 MST `� 3 o°Z o O
INSPECTION DIVISION Business Line: (503) 639 -4171
Received Date Requested - S AM PM lJ BUP
Location / b C Z £D /3 0 Suite MEC
Contact Person Ph ( ) 7(0(0 q -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
Other:
• PART FAIL
MBING
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
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
Ap
P Date " 7/ ) J t � Inspector /4 P L
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 °n - moo
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested c�� //'' AM PM BUP
Location /6 O �O /. 6v4 � Suuite MEC )75
Contact Person 1.�-�— Ph ( .0(0 -" V17 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
Fi reveal I
Fire Sprinkler
Fire Alarm I/
Susp'd Ceiling -
Roof –{
Other: a – —
i –
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
11 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 0 Please call for reinspection RE: ❑ Unable to inspect – no access.
Fire Supply Line
ADA
Approach/Sidewalk
Other: Date a Inspector 02 0/ 0 Ext
t
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 c= 206 3 -6 6 7-E in
INSPECTION DIVISION Business Line: (503) 639 -4171
/ BUP - Received Date Requested 11 ,�o AM v PM BUP
Location /0 q� /3 d '" Suite MEC
Contact Person Ph ( ) 34 eo 1 - 8 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
murf
Ext Sheath/Shear
Ina /Shear (P � uec- 1 - g (i) ,, GF r /I ' Framing T c� 1 �t l �-
&GEp
Insulation 0 V T DC B' & 9- tV° �AD ( MUST HIV E'
Drywall Nailing
Firewall WARiPf,t?r Cat) WIZ) Cam _ ,
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /
Roof
Other: 6 �' �� �� l �l E �s B izEkILEI
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
Low Voltage
Fire Alarm
I �� PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
**IITTl� Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 4?PL 7 � � Inspector l - � �(� � Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BI,�ILDING Inspection Line: (503) 639 -4175 MST 063 d0 2 -FO
INSPECTION DIVISION Business Line: (503) 639 -4171
Received Date Requested .7 AM PM BUP
Location ! 0 76,s /3 v Suite MEC
Contact Person Ph ( ) g t (a -" 4 1 . d 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 / S L' V' .7/0 V F
Insulation _ate Ste, ; �.ee () ,� . 7 t 7 4n ( /6 6 �3
'
Drywall Nailing , ' U'�
Firewall - ► S 5 /2../ � (' i ( .r4.15 J
Fire Sprinkler
Fire Alarm �2 �G� �� 5 �e ` 4
Susp'd Ceiling �t n n (� l
Roof - T r I �- • — "A /0 Li l `r U�J
Other:
SS PART as D // �� p l
PLUMBIN �G7 t� r \ V
P r Slab t) \.YLGY`-e. ""— \ -Q K Q.�IJ y
Under Slab
Rough -In 4 ∎ "/\
Water Service
Sanitary Sewer ? , l \ Q, S'� . L(ny-e .
Rain Drains J I
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
lir PART FAIL
CTRICAL
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 El Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date ��� Inspector - " ' ' Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL