Permit 1
/ ‘ .
I P ►
CITY OF TIGARD MASTER PERMIT
PERMIT #:
46.-114C DEVELOPMENT SERVICES DATE IS UED: MS 2 03 03 00279
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10915 SW 130TH AVE PARCEL: 1S133AC-HBOO6
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 006 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 BOIUCMP < 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 SVC/F 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 8 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 p SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,072.45
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES IN This permit is subject to the regulations contained in the
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 Tlga othh er r a ap i Code, State Speo Codes and
all
PORTLAND, OR 97219 PORTLAND, OR 97219 pplicc able laws. All work will be d done in
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
Reg ": LIC 58699 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp B' Plm /undslb Insp Plumbing Top Out Shear Wall Insp Water Line Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insf 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 Insp Low Voltage Insulation Insp Rain Drain Insp Plumb Final ___ _ Issued i I Permittee Signature : _ 40.P -)2A
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
'� Z R L I V E D FOR OFFICE USE ONLY
■ � F ailding Permif App cation RecCived Building
JUN 2 7 1003 Date/By: 04;z /( °3 Perm it No.: /%Src 2 003 - 00e2 7/
City of Tigard Planning Approva Other
13125 SW Hall Blvd. P
CITY OF TIGARD P a n Fte Permit No.: 5 2.Mc200 �
Plan Review other
Tigard, Oregon 97223 I3UILDING DIVISI• Date/By: /0 /, aft Permit No.:
Phone: 503 - 639 -4171 Fax: 503 -598 -1960 � k 411T P ost Re ew Case d Noe
Inter www.ci.tigard.or.us Contact Juris.: ® See Page 2 for
24 - hour Inspection Request: 503 - 639 - 4175 Name/Method: 776 Supplemental Information
. TYPE OF WORK • -
REQUIRED D : .
2rNew construction ❑ Demolition 1 &I 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 Li Multi- Family •
❑ Master Builder ❑ Other: Valuation SW 0 y0
- :::':, ::JOB SITE INFORMATION LOCATION : ::. _ -. - No. of bedrooms: 3 No. of baths: Z
Job site address: 109 15 SW 150 h h/f,0utG Total number of floors
New dwelling area (sq. ft.) _ X4.5'3 _
Suite #: Blds. /Apt. #: Garage/carport area (sq. ft.) _ (36
Project Name: MAW KS €AA Tc .1NltboMES Covered porch area (sq. ft.) 3 Z
Cross street/Directions to job site: Deck area (sq. ft.) AZ
SW 13, TM Avj4E ,4 Sw. I4,44.4Kr SEA Other structure area (sq. ft.)
:, REQUIRED DATA
. COMMERCIAL: USE CHECKLIST
Subdivision:I -MA/ s Wik' 41 V I Lot #: Co .
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
.- :4 4- f• - •= . i;7:::::-''''... 1.7 - DESCRIPTION OF WORK •• • - the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Ce4SrP- -U .TU,*L OF NUJ 5 ST Tal/1 NC1wli,
`P123.SEu-- Valuation S
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
%P..ROPERTY :OWNER :.. •I••.❑ TENANT- -•. -•. • -. Type of construction V N
Name: Alrf 'rn 4 PASK TOk- 114149wtj i L .L•L • Occupancy group(s): F
R -3
Address: q500 SW Ebeguie. &-lib, Su of. Z2.6
City /State /Zip: l'Oend 0 , O2 q 219
Phone: S''3 9Q2- 75E, Fax :61:3) e 2.- 4( NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
wAPPLICANT.: . - : •0: CONTACT PERSON. -..' . provisions of ORS 701 and may be required to be licensed in the
Business Name: braefK L . EactLL4 e /1S ZJAPt / (At . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: rv',Ae V 4i474cao c,2 etrx Pe Z from licensing, the following reason applies:
Address: q9 o Sif.1 f i &de 1 Su t?Yc 210
City /State /Zip: N 012 Q 21 ci ��
Phone :(59teR2 -else ' Fax :(5o3iSari-60 ( _ MI
.
•BUILDING PERT'FEES* 7,-1
E -mail: rn0.r ic 4 d / b r ouhi RSSoe. , Co/v1 "Please:refeii to:fee schedule.'•• - •
_. -... .CONTRACTOR
Business Name: 'bEekL' 1- azio $ Agamtis, I.JG Fees due upon application $
Address: ' x) Stn/ gAbsule. gLVb 1, _5virec ZZO
City /State /Zip: fbt2rjJt Qt2 ? Kt Amount received $
Phone:( \ 892 -5 ?SS ( Fax: (563) 2 -884 l Date received:
CCB Lic. #: 58690
Authorized / / ql�(�3 Notice: This permit application expires if a permit is not obtained within
Signature: U t/�
Da 1. 180 days after it has been accepted as complete.
/t't ", t • c") r *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i :\DstsTermit Forms\BldgPermitApp.doc 01/03
Electrical Permit ictEET0ED FOR OFFICE USE ONLY —
Received Electrical
Date/Bv: Permit No.:/1 /�.2O .3 DOa 7 9
City of Ti JUN tl y 20! Planning Approval Sign
Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TI . RD Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503-913HLEArtIG D i * 1' Post - Review Land Use
Ot � � Date/By: Case No.:
Internet: www,c • 7 e .' I Contact Juris.: El 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) •
l<New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: ig 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
01 & 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: ❑ Egressilighting 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: logic SW 13oto AVed UE FEE* SCHEDULE
Suite #: I Bldg. /Apt.#: Number of inspections per permit allowed
Project Name: ,144 6l
S t /'!r.� TQGJ/-i1-1-oNIE S Description I Qty I Fee (ea.) I Total I I
New residential - single or multi - family per +
Cross street/Directions to job site: unit. Includes attached garage.
.5\1.) 1 T_! 1 �'' AI/E.-Joe S� N Service included:
1. 044 1000 ft. i or less 145.15 c 15 4
Each ch ad additional l 500 so. ft. or portion thereof D 33.44 _ 0 � u to 1
l4 , n I Limited energy. residential 1
75.00 I IS . 2
Subdivision: , lM'�' Lot #: Limited energy, non residential I 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
- - ' - DESCRIPTION OF WORK service and/or feeder I 90.90 2
Services or feeders - installation,
Cjt,sr cTIrn. cr oJEJ 3 5.7-6444 alteration or relocation: L
— td _ / )10,44g � � 200 amos or less 80.30 2
Wa— r *y 201 amos to 400 amos 106.85 2
401 amps to 600 amps 160.60 2
- - 601 amos to 1000 amos 240.60 2
(PROPERTY :OWIY R ::.: ]_ ❑TENANT: Over 1000 amps or volts 454.65 2
Name: 4J/7/01 f2A►2 K -raw/ 1J49wtes LLC, C, Reconnect only I 66.85 2
Address: c 60 SW &gLle- g■h co 1 7 , (c 222) Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: FbfL1LA'7- ce 9-72,19 200 amps or less 66.85 I
Phonec�c) $a2 -a lS8 Fax :(5159 z_eg •{( 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
APP ANT•;..4 :: - : - ❑' CONT CT'PERSOLY - Branch circuits - new, alteration, or
Name: l�K L QD , 'v e ZI-s ciA S, l /� extension per panel:
'CO n J i gL�' U l
A. Fee for branch circuits with purchase of
Address • W y �1+� Br1Y •A� Z20 service or feeder edd er r fee. each branch circuit 6.65 2
City /State /Zip: 9je t,4, , G(. C)1 219 B. Fee for branch circuits without purchase of
r q service or feeder fee, first branch circuit 46.85 2
�
Phone: 6 ) 7-Q Fax: (So3 1 2
� ' & 4I Each additional branch circuit 6.65 2
E -mail: vre,,,rK d. d l trso t,J..)a -SSoc , ion-,
Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 2
- :, - ..;'.::::;:;:::.:i.:--':;...31. - 7.7,....:: ''CONTRACTOR Each sign or outline • lighting 53.40 2
Job No: i"i kI- Signal circuit(s) or a limited energy panel,
alteration, or extension _ Page 2 2
Electrum Inc Description:
2050 Vista Ave #100
Salem OR 97302 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. I hour) 62.50
503 -361 -1256 Investigation fee:
CCB:I 16453/ELC:24- 353C/SUP:2919S Other
. •: -Electrical .Pertnit:Fees* -:n... _. ... . •
Supervising electrician Subtotal S _.
signature required: Plan Review (25% of Permit Fee) S _
Print Name: I Lic. #: State Surcharge (8% of Permit Fee) S
TOTAL PERMIT FEE S
Authorized Ai j / ( Ntice: This permit application expires if a permit is not obtained within
Signature: ` Date: l ` 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i N . ku s&
(Pleak print name) •
is \Dsts\Permit Forms\ElcPermitApp.doc 01/03
FOR OFFICE USE ONLY
r / i echa nleal Pe oII Received Mechanical
Date/By: Permit No.: /11/700.3 000279
• Planning Approval Building
City of Tigard JUN 2 7 2003 Date/By PermitNo.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
Phone: 503 - 639 Fa www.ci.tigard.or.us iI Iiil ISI iew Land Use
r� D Po Case Na.:
Post-Review
Internet ww.ci.rigard onus _.1,1: ` e`11 1 � Contact Juris.: I81 See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 - --- +.. Name/Method: Supplemental Information.
_..: • TYPE OF WORK • : =.. - "
- - ':. 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. 1--.-: mechanical materials, equipment, labor, overhead and profit. . -
H1 & 2- Family dwelling ❑ Commercial/Industrial Value: S See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE * •
Description Qty I Fee(ea.) Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION • Furnace - add -on air conditioning** 1 14.00 I I'{. °O
Job site address: / O 1 / ' sal /.50 ±b A- . Gas heat pump 14.00 I
Suite #: Bldg. /Apt. #: Ductwork 1 14.00 (4."'
Project Name: 1 I ^ 1•Ll . gFAe. TOW 40 Hydronic hot water system 14.00
7 ` Residential boiler
Cross street/Directions to Cobb site:, / ��� 5 , (for radiator or hydronic system) 14.00
SUL) j /' ~A f�t Unit heaters (fuel, not electric)
gy I 55Y26ei (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 O. '
Subdivision: /7/Au4K5 L36,4/ -O Repair units 12.15 Lot #: (� Other Fuel Appliances
Tax map /parcel #: Water heater I 10.00 10.'
- • DES p
IPTIONO F WORK Gas fireplace I 10.00 10. °i'
CO/4- - at.0 7106J OR !^4E.( 3 STa2L.( Flue vent (water heater /gas fireplace) 2_ 10.00 Z 0 •'°
- 2` LJ J iii Pe 'L
JF r (i 6 S � Log lighter (gas) 10.00
l Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY OWNER. - - -.. . I: ❑ -TENANT •'.. .. Other. 10.00
Name: 1t rUm 4 K -TO G.)4 Now e s LLC Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 1 10.00 10.c°
Address: ( 3Q41 SW 1/4211/e / SV /K. Z ZO Clothes dryer exhaust 1 10.00 10. °Q
City /State /Zip: AverUfA de Cli 21 q Single duct exhaust
Phone:So3) F 2_B7SS ( Fax (5) j 89 2.-.9841 (bathrooms, toilet compartments,
- (APPL CANT ❑CONTACT PERSON utility rooms) 3 6.80 2.0 ...Tv
Name:
� Ce L. gavu 4s !AlG . Attic/crawl space fans 10.00
/ Other. 10.00
Address: C4..0 Thakvi ( IUD St/i7 2Z6 Fuel Piping
City /State /Zip: Toci M, 1 p'lt 97219 • *(55.40 for first 4. $1.00 each additional)
Phone:(S4 E2 -elSB Fax: (So330?2-084( Furnace, etc. I
Gas heat pump ••
E -mail: mPe?... t C d I beac,yN - ce . cart-. Wall/suspended/unit heater "
- .. • • • CONTRACTOR • : Water heater
j
Smart Heating & Cooling LLC Fireplace �,
7616 NE Everett St Range
BBQ ••
Portland OR 97213 -6347
Clothes dryer (gas) .4.
503 -254 -5096 Other. "
CCB: 154133 Tom: ` 5 _5, i4fl
Mechanical Permit Fees*
Authorized % / We k S ubtotal: $ 1 2.3, go
Signature: i(/L�Q� CP-e- Date: Minimum Permit Fee $72.50 $ _
-
TJ)e-0 Cry e005--- Plan Review Fee (25% of Permit Fee) $ _
(Please print name) State Surcharge (8% of Permit Fee) $ q , 90
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 Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms NecPermitApp.doc 01/03
.Sill•1lllilg r 1X1.u1 co
fluffibing Permit Apt Re ceived FOR OFFICE USE ONLY
Plumbing
DateBy: Permit No.: /Y.S/o20/ii dO of 77
City of Tigard Planning Approval
Date/By: Sew Date/By: Permit No.:
13125 SW Hall Blvd. JUN 2 7 201 ' Plan Review Other
Tigard, Oregon 97223 Date/By: No.:
Phone: 503 - 639 -4171 Fax: 503 T F TIG RD Post - Review Land Use
L G DI ,":• t. i�,l I Date/By: Case No.:
Internet: www.ci.tigard.or.us 1;A I 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)
(sj New construction ❑ Demolition Description I Qty. I 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
Nf I & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath _ J 350.00 x, 50,`°•
❑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.: Page 2
Job site address: /0//-5 SGt) /50 n A t/6 Site Utilities •
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: HAW ks Z l> - 1 - 0 .1nl 140011✓ S I Footing l/leach (no. linear drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job s Manufactured home utilities LJ l - O A✓FJ��G t 110.00
S S � Manholes 16.60
'l36A -14.b criza,r- Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: / t/K 5 GEA-gb Lot #: 0 Storm sewer (no. linear ft.) Page 2
Tax ma p/ parcel #: �-tt Water service (no. linear ft.) Page 2
P P Fixture or Item `
DESCRIPTION OF WORK Absorption valve 16.60 ._
(' 6/4571ZutC 11GJ or If EIA) 3, SThea Backflow preventer Page 2
-r- k P .1Ec i ( f s-4) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
-21 _--::I.•0TENANT•••: . . = • • _ Ejectors/sump 16.60
Name: A lin) N/1 tJ PAte K T vVN 14014 es i LL.C- Expansion tank 16.60
Address: C sco sw 1?Are.gJQ &.'Jb SlltnE ZZO Fixture/sewer cap 16.60
City/State /Zip: Pj2Tu¢,.11;, 172 q 2 19 Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone {So3j 6q2- 815 Fax: 89 SS'( I Hose bib 16.60
•;APPLICANT•• ' :_. _ -. .:._. •- :::1] CONTACT PERSON Ice maker 16.60
Name: I>EREV L. &eo dI) S /45SOC *- , (l✓L Interceptor /grease trap 16.60
Address: 95 5 g tegui, guk, Su lT zza Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: F}Jer:.?S , Cc q-7 2. l q Roof drain (commercial) 16.60
Phone:3)89Z - 8758 Fax (jr03) 6 sink/basin/lavatory 16.60
E -mail: r,. dItan3(.)ha_cceG• c..a. . 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 .. ,Plumbing Permit Fees• '.... ":._ _ .
CCB: 149035 PLM: 34 -391 PB Subtotal S 3 S O. co
Minimum Permit Fee $72.50 S
Authorized Y1A-414,--6/11Le----Date: j / / Residential Backflow Minimum Fee $36.25 _,
Signature: 4 Z 0 ^ Plan Review (25% of Permit Fee) S
P C E C &iV ` State Surcharge (8% of Permit Fee) S _ 2 S . O°
v (�
(Please print name) TOTAL PERMIT FEE S 3 re
Notice: This permit application expires if a permit is not obtained within MI 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\PlrnPermitApp.doc 01/03
CITY OF TIGARD
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 -00279
Date Issued: 11/3/03
Parcel: 1 S133AC -HB006
Site Address: 10915 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 006
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 �1 a i!��
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 -00279
Date Issued: 11/3/03
Parcel: 1 S133AC -HB006
Site Address: 10915 SW 130TH AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 006
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- 3 '
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
SIZ - c 7- 0z7q
® ®®®®®AAAAAAAAAAAAAAAAAAAAAAA A®AAAAAA®®®®®®®AAAAAAAAAAAAAAAA
44 Is>
44 Erg-
T EET TREE 4 . S CERTIFICATION R
® I, gR.UC E GAVE caner/ f, gent for 1� 1E,�i'�. c. �i�wN 6�..
(PLEASE PRINT) (PERMIT HOLD R)
po
44 Et>
44 is-
® Do hereb - < `�` t :r-1 '�' 1 ►1 . i location
44 4:rir ® mee t s . ri:of�. :? o an W '4-i on ount Er
® , m...� .... ..,... y
® land use and development standards for street tree installation.
® ADDRESS: / 07 /S S.W. /
Al it*
44 rIt■
® LOT: (p SUBDIVISION: / 4Gt1Kl 1t4D 0.
41 It.
44 it.
® BY: , DATE: //
RECEIVED
Al to-
BY:
U DATE: l /
11 S,vv,vvvvvvvvvvvvvvvvvvvvvyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy'
�� ®®®®®Ll®® ®®® ®®® ®®®®®®®®®®®®®®AAAAAA AAAAAAAAAAAA AAAAAAAAA
/4STV.00 X
STREET TREE C
M
K
I, 1RUCE- CiME , Owner /P gent for 7 R1 K I - trss906 4 AS _ .
.�BG
(PLEASE PRINT)
- ' `! (PERMIT HOLDER)
Do hereby '`
y�:c tl%i:t` fgllowing location b
s `�:' V.
meets gar / Was n on :C ounty
land use and development standards for street tree installation.
I>
ADDRESS: J09/ -& 5. »
LOT: SUBDNISION: 1:444._ 6.-Q4044-
BY: I
DATE: ,S" Y1O S
lto
RECEIVED BY: DATE:
FVVYVVVVVVVVVVVVVVVVVVVVVVY'. VVVYVVVV VYVVYYVVYVVYVVVVVYVVVV
I
CITY OFTIGARD
BUILDING DIVISION PERMIT #: MST2003 00279
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1 /3/2003
Phone: (503) 639 -4171 Al
Inspection Requests (24 Hrs.): (503) 639 -4175 �:
INSPECTION WORKSHEET FOR DATE: PAGE:
5/10/2005 TIME: 7 :16AM 55
SITE ADDRESS: 10915 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: HAWK'S BEARD TOWNHOMES LOT #: 006 TYPE OF USE:
PROJECT NAME: HAWK'S BEARD TOWNHOMES
DESCRIPTION: New SFA dwelling.
OWNER: PHONE #:
CONTRACTOR: AUTUMN PARK TOWNHOMES, LLC PHONE #: 503- 892 -8758
DEREK L BROWN & ASSOCIATES INC 503- 892 -8758
Inspection Request Scheduled For: Date: 5/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 006496 -03 503 - 866 -4897 Y
Corrections /Comments /Instructions:
1 .-j ' G, F 1q,1 -9L tr pfff.6 vg.p
I►`, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C9 ( ify j 4 Date: /Q e/ Phone #: (503) 718-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ° 003 ay.
INSPECTION DIVISION Business Line: (503) 639 -4171
p BUP
Received Date Requested �O �1 — � a AM PM BUP
C�
Location / 0 / /3- /3 l� �t 4_u Suite / MEC
Contact Person Ph ( ) S'6 c/ 0 � r `t o p 9 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 C f�
Fire wall
L
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
Oth-
FAIL
6
H-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 . ID Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA te ` ° �
Approach/Sidewalk Da/ Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2003Q0279
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1113!2003
Phone: (503) 639- 4171i�
Inspection Requests (24 Hrs.): (503) 639 -4175 " __..
INSPECTION WORKSHEET FOR DATE: PAGE:
6/1W2005 TIME: 7 :16AM 60
SITE ADDRESS: 10915 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
HAWK'S BEARD TOWNHOMES 006
PROJECT NAME: HAWK'S BEARD TOWNHOMES
DESCRIPTION: New SFA dwelling.
OWNER: PHONE #:
CONTRACTOR: AUTUMN PARK TOWNHOMES, LLC PHONE #: 503- 892 -8758
DEREK L BROWN & ASSOCIATES INC 503 - 892 -8758
Inspection Request Scheduled For: Date: 511Q/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006496 -01 503-866 -4897 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:. -- /a Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2003017279
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A Ii 11 Inspection Requests (24 Hrs.): (503) 639 -4175 - ^ _ ..
INSPECTION WORKSHEET FOR DATE: PAGE:
5,10,2005 TIME: 7 :16AM
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION:
10916 SW 130TH AVE LOT #: TYPE OF USE
PROJECT NAME: HAWK'S BEARD TOWNHOMES 006
DESCRIPTION: HAWK'S BEARD TOWNHOMES
New SFA dwelling.
OWNER: PHONE #:
AUTUMN PARK TOWNHOMES, LLC, 503. 892 -8768
CONTRACTOR: DEREK L BROWN & ASSOCIATES INC PHONE #: 603-892-8758
Inspection Request Scheduled For: Date: 5/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
.' l
299 Final inspection 006496 -02 503-866 -4897 Y
Corrections /Comments /Instructions:
OSP Lair e L c. ' A S— C -
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4
Inspector: — f Date: 5 _ —1d Phone #: (503) 718-