Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00314
�; DEVELOPMENT SERVICES DATE ISSUED: 12/23/2003
+�' I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
SITE ADDRESS: 10845 SW HUNTINGTON AVE PARCEL: 1S133AC-HB059
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 059 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: 484 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: 709 sf RIGHT:
VALUE: 147,744.80
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 wnp: 201 - 400 amp: 1st W/O 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 HM/SVC /FDR: 601 - 1000 amp: 601 +amps - 1000x. MINOR LABEL:
1000+ amp/volt :
PLAN REVIE W 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: $ 6,065.71
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES I N - ._ permit is subject to the regulations contained in the
igard Municipal Code, State of OR. Specialty Codes
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220
PORTLAND, OR 97219 PORTLAND, OR 97219 and all other applicable laws. All will be done in
This p
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: 503 - 892 - 8758 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
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Plm /undslb lnsp Plumbing Top Out Shear Wall Insp Water Line lnsp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insr Water Service lnsp Building Final
Footing lnsp Electrical Rough -in Gas Line lnsp Firewall lnsp Smoke Detector
Foundation Insp Mechanical lnsp Gas Fireplace Gyp Board lnsp Electrical Final
Slab Insp Low Voltage Insulation lnsp Rain Drain lnsp Plumb Final
Issued By : I 9 i_ - Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
ilii,•
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00314
44rlIt DE sE Ha ll L -I OP , t
MEN a , SERVICES 9iO3-4171 DATE ISSUED: 12/23/2003
SITE ADDRESS: 10845 SW HUNTINGTON AVE PARCEL: 1S133AC-HB059
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 059 JURISDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQU - SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 108 sf BASEMENT: sf EFT. SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 636 sf GARAGE: 84 sf - - ONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: 709 sf - IGHT:
VALUE: 147 744:0
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: S WER LIN • 00 SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 TER LINES: . 00 BCKFLW PREVNTR: GREASE TRAPS:
•
MECHANIC OTHER FIXTURES:
FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VE T FANS: 3 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS 2 OODSTOVES: GAS OUTLETS: 3
EL CTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRC • 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/FOR: SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: • • ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HWSVC/FDR: 601 • 1000 amp: : • 1 +amps - 1000x. MINOR LABEL:
1000+ ampNolt : .
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: VC /FDR =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - R TRI ' TED EN • - GY
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: DAT • • COMM: NURSE CALLS: TOTALS/SYSTEMS:
Owner: Contractor TOTAL FEES: $ 6,065.71
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES
This permit is subject to the regulations contained in the
9500 SW BARBUR BLVD., STE 220 9500 SW BARBUR BLVD #220 igard Municipal Code, State of OR. Specialty Codes
PORTLAND, OR 97219 PORTLAND, OR 97219 and applicable laws. Al. s will done in
accordance ordrd anrace with approved ed This p
plans. This permi t 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: 503 - 892 - 8758 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg r/: 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 Water Line Insp Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insr Water Service lnsp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Smoke Detector
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board lnsp Electrical Final
Slab Insp Low Voltage Insulation Insp Rain Drain Insp Plumb Final
Issued By : ��; . el Permittee Signature : `' : .
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Billlldl) Per FOR OFFICE USE ONLY
e Recei Building
7o ?x,13 - J�o3 /
es e ° Date/By: [% �' � .5 Permit No. .'/511
City of Tigard Datd Other
Bv: Permit No..QJ /l ?Go - �/
�2
13125 SW Hall Blvd. JUN IN 7 Planning Approval
` 2003 Plan Review - Other
Tigard, Oregon 97223 CITY OF TIGAR. Date/By: ID " 23 3 Permit No.:
Phone: 503 639 - 4171 FaxBDX11314$Q A/(S ' it i jll ' � Post - Review Land Use
1 Date/By: Case No.
Internet: www.ci.tigard.or.us *— ^^ �' Contact Juris.: El See Page 2 for
24 - hour Inspection Request: 503 - 639 - 4175 Name/Method: 77& Supplemental Information
TYPE OF WORK REQUIRED DATA:''':'''::::: :.:
•
ZNew construction ❑ Demolition .. I &-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 Li Multi- Family ,7 7yy 8a
El Master Builder ❑Other: Valuation $ - i
-=:m: TOB SITE INFORMATION and.LOCATION No. of bedrooms: 3 No. of baths: Z
Job site address: 10845 SW Alan 004 Alitti.JUt Total number of floors 3
New dwelling area (sq. ft.)
— N S-3
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) _ WV
Project Name: NAW WS %EA 'rc drlf4,MES Covered porch area (sq. ft.) Z.
Cross street/Directions to job site: Deck area (sq. ft.) L
s s w �� �� , i4 Kr IIEA Other structure area (sq. ft.)
• : - . 4 . : ' :l:== =-'::.
COMMERCIAL.:- USE CHECKLIST _ : = 2°r.::- ::: :
Subdivision: 4 g() '7 Ftt6( Lot #: Se' V
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, •
overhead and profit for the work indicated on this application. _
C� hlSre►c•nu i of NELJ 3 sro21 Ta�rl l'biv
'PeZ,Ec -lr , Valuation S
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
: %P.ROPERTYOWNER : 1 TENANT. .: _._ .. Type of construction V N
Name: AU . Ur1 t i PAg K 7616.11 4,446 i L . L. L . Occupancy group(s): F
R -3
Address: 95oo SW 1Z/tie-gut- &b SU Of Z 2-6
City /State /Zip: 'PoerLM. , 02 97 21
Phone: 603 i i2-eiss Fax :t 1'3) on--804( NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
APPLICANT:.: -.::< `' . : :.Q: CONTACT PERSON- _..' •. -7 provisions of ORS 701 and may be required to be licensed in the
Business Name: bfgEK 1, :3,2004 N � c ASSaCJA S / (it , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: &1/°k'e K (- GI-4W csL Qt,c t peA.) . from licensing, the following reason applies:
Address: gsao SbJ J Su (7 ZPo
City /State /Zip: prA2rb4 l 012 Q-i 2l t
Phone: f�42- 1Se f Fax:6sp'3j 2 - 60i4r : -
.BUILDING; PERMITTEES*
E -mail: ark4 - rbt.,�n 4 SSVC,f�M -
r+' l � Ylease •feesthediile.' �"
.. -- . - . . - - .l. ,. • ...... .. • -- -- - -.- .. .• -. ��:•: - . ., � .CONTRACTOR .. .. -
Business Name: *bEe kt: L. e.ere o 4 ASIA ;kit , Fees due upon application $
Address: arc) SW BAf1,Bue, gu b SIJll* ZZO
City /State /Zip: fbt2rl Ott -1219 Amount received $
Phone:( \ 892 - i3'P ( Fax: (563) 2 - 884 4 Date received: -
CCB Ltic. #: • Q( -
Authorized / � Notice: This permit application expires if a permit is not obtained within
Signature: (/� , D ate: `G (613 180 days after it has been accepted as complete.
r • 1 COO *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) •
i :\Dsts\Permit Forms\BldgPermitApp.doc 01/03
• Electrical Pen = licatioII FOR OFFICE USE ONLY
• .. Received Electrical A, �
V & VED Date/By: Permit No.ly 757 ,1J 3 - 0,9319
City of Tigard Planning Approval Sign
Date/By: Permit No.:
13125 SW Hall Blvd. JON 2 9 200 J Plan Review Other
Tigard, Oregon 97223 ate/By Permit No.:
Phone: 503-639-4171 § it 91 9i ao D y: Land Use
plVISIO Date / : Date/By: Case No.:
Internet: www.ci.tigard.or.us V C on t act Juris.: ® Se Page 2 for
24 -hour Inspection Request: 503- 639 - 4175 Name/Method: Supplemental Information.
TYPE OF WORK PLAN REVIEW (Please check all that apply)
XNew construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: 18 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
_R & 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: 1084S SW l,art•.z46J k16iJUl FEE* SCHEDULE
Suite #: B1cle. /Apt. #: Number of inspections per permit allowed
Project Name: ,1- 141A/g3 egaizZ �OW/�'r osit Ec Description Qtv I Fee (ea.) Total
New residential - single or multi - family per +
Cross street/Directions 5
" f/71 v V U site: ��"n_1 \ 4X .5 Ai K •/ dwelling unit. Includes attached garage.
IJ 1,� am" Service included: d
1000 sq. ft. or less E 145.15 "\7. (. 5 4
04 4 ,9YZI-CX- Each additional 500 so. ft. or portion thereof 33.40 66 ,SO I 1
Limited energy, residential l I 75.00 15 ,a� f 2
Subdivision: ,tllQ4'^E� 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,
C a ^ CrcF oil 3 sr alteration or relocation:
�/� . j 1 ) _ .., t! , 200 amps or less 80.30
A!. �'�`CW(C I''cZ1��CA 201 amps to 400 amos 106.85 2
401 amos to 600 amps 160.60 2
.- 601 amps to 1000 amvs 240.60 2
; 'PROPERTY.OWN RV= "1= ❑TENANT' _., , _
n. n 1� ,,,, � 9 � ",,� s Over 1000 amps or volts 454.65 2
Name: / ltd V k✓1 N4 F. fC NJ/49rvTi 1 -� Reconnect only 66.85 2
Address: q5j 511) gy4e J L- ? - ( SUiNc 22z Temporary services or feeders - installation,
`' i ) alteration, or relocation:
City /State /Zip: Frz_TL,Fr'), ore 9/ c 2 G ( a 200 amps or less 66.85 1
Phone SD 8 9Z -rl Fax:(5, \ &9 2 -s8 Li f 201 amps to 400 amps 100.30 2
� j 133.75 2
A PPL T:::::.::.: z - : -' p _: ❑.CONY Cr PERSON : . :: 401 t° 600 aaims Branch circuits - new, alteration, or
Name:' .. L. 1T3 d L-1-S -7Z5, / , extension per panel:
Address: 9 CO �1OR11� C Sal � no a Fee for branch circuits c hh purchase of
serv or f eeder fee. each branch circuit 6.65 2
City /State /Zip: {)e-r , Cie, '3 2l ei B. Fee for branch circuits without purchase of .
service or feeder fee. first branch circuit 46.85 2
Phone: 6 Fax: (So3) 6 92- -?,e 4 / Each additional branch circuit 6.65 2
E-mail: W1l. r K a.. d I tea ...)03a-ssoc , co-l-, Misc.(Service or feeder not included):
... > —> . : -.1 CONTRACTOR ..
Each puma or irrigation circle 53.40
• -'-= r`' Each sign or outline lighting 53.40 2
Electrum Inc Signal circuit(s) or a limited energy panel,
alteration. or extension Page 2 2
2050 Vista Ave #100 Description:
Salem OR 97302
503 - 361 -1256 Each additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) _ 62.50 ,
CCB:116453 EL,C:24 -3530 Stip:2919S Investigation fee:
Other:
CCB Lic. #: I Lic. #: 'M' .. • . :Electrical:Pertnit'Eees*'�;re- �,- _ _ .
Supervising electrician Subtotal S — _
signature required: Plan Review (25% of Permit Fee) 5 _,
Print Name: Lic. #: State Surcharge (8% of Permit Fee) S —
R e: TOTAL PERMIT FEE S -
Author re: 1 80 days after it has b Notice: This permit application expires if a permit is not obtained within
Signature: been accepted as complete.
'Fee methodology set by Tri -County Building Industry Service Board.
(Ple a print name) •
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
•
FOR OFFICE USE ONLY
Mcal Date/By hanical Pa 1 Cition Received Pe echa Mechanical
e7 ?"090-7/Y
JUN 7 JUN 2 �A 20 03 Planning Approval Building
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD Plan Review Other Date/Bv. Permit No.:
Tigard, Oregon 97223 BUILDING DIV Post - Review Land Use
Phone: 503 - 639 -4171 Fax: 503 - 598 -19 l � Date/By: No.:
Internet: www.ci.tigard.or.us . ' l , Contact Juns.: El 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. :: mechanical materials, equipment, labor, overhead and profit.
'1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS.FEE * •
Description I 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 14,00
Job site address: /0g4.5 Sft) HUN77N67oa) ,4UE-- Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Ductwork 1 14.00 14,"'
KS � � -row -) kka1� Hydronic hot water system I 14.00
Project Name: Residential boiler
Cross street/Directions to job sit (for radiator or hydronic system) 14.00
SL 1'50 / ` , 0U � 1� " 4/4-vies Unit heaters (fuel, not electric)
- 7 0 , 1 S47)(2661 (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10.
H AbJ/ $ JJAg9 ''y Re units 12.15
Subdivision: Lot #: Other Fuel Appliances
Tax map /parcel #: Water heater I 10.00 (0•'
• DESCRIPTION OF WORK Gas fireplace 1 10.00 to."'
C o / 7 o-c,70-) O 4E. 3 ,S t-t Flue vent (water heater /gas fireplace) 7_ 10.00 20 . "o
- 150J itor ie Pealed 0460 v) Log lighter (gas) 10.00
'[ Wood/Pellet stove 10.00
Wood fireplace/insert . 10.00
Chimney/liner/flue/vent 10.00
PROPERTY OWNER. -: -.. , I:' 0-TENANT:" _. -.._• • Other: 10.00
Name: A } i J W m 4 K - r Wu floes E s U-C Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 1 1 0.00 10. w
Address: a SW &42&'e iguk ,.S ix_ Z Zv Clothes dryer exhaust 1 10.00 O. *
City /State /Zip: p de CI (q Single duct exhaust
Phone:�So3) �12._Fn' ( F ( ) 99 2- i8' ( (bathrooms, toilet compartments,
- (gAPPL CANT ❑ CONTACT PERSON utility rooms) _5 6.80 20 .4°
Name: I)Ce L-• gpauPJ f A 4'r i AIC. Attic/crawl space fans 10.00
Other: 10.00
Address: q 142E42 reLA t/l?". ZZO Fuel Piping
City /State /Zip: Tort ZA / CY& 7219 ••($5.40 for first 4. $1.00 each additional)
Phone:(Sv3) NZ -0150 Fax: 3,0?2 �'-O( Furnace, etc. {
2 `i
/1 Gas heat pump .. E -mail: rha C d l broc..Jft0.VdC . Ci7/► -1 Wall/suspended/unit heater ••
CONTRACTOR Water heater I •• •
Smart Heating & Cooling LLC Fireplace {
7616 NE Everett St Range ••
BBQ ••
Portland OR 97213 -6347 Clothes dryer (gas) ••
503 - 254 -5096 Other. ••
CCB: 154133 Total: _ 3 5, 4 40
Mechanical Permit Fees'
Authorized r (264; Subtotal $ 12 3, �O
Signature: fri i Date: Minimum Permit Fee $72.50 $ -1 /(- COI) Plan Review Fee (25% of Permit Fee) $ .
-
(Please print name) State Surcharge (8% of Permit Fee) $ Q , 90
TOTAL PERMIT FEE $ _
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry aervlce warn.
180 days after it has been accepted as complete, **Site plan required for exterior A/C units.
i :\Dsts\Permit Forms NecPermitApp.doe 01/03
1Slllllllllb r 1LI.u1 CJ
FOR OFFICE USE ONLY
Plumbing Per i. 4 , r-- 1 _ n Received Plumbing
Date/By: Permit No/1Sj.2003 O( 3/y
City of Tigard Planning Approval Sewer
JUN 2 7 Date/By: Permit No.:
13125 SW Hall Blvd. 2003 Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
Land Use
Phone: 503 -639-4171 Fa LK/9 li560.... , ,. ®�+� r Post-Review
Case No.:
Internet: www.ci.tigard.or.us a � , Al' 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)
(T 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 (l) bath 249.20
Er 1 & 2- Family dwelling ❑ Commercial/lndustrial SFR (2) bath _ 350.00 , 350.
Accessory Building ❑ Multi- Family I SFR (3) bath 399.00 I
❑ Master Builder ❑ Other: Each additional bath/kitchen
1 45.00
• .. JOB SITE INFORMATION and LOCATION Fire sprinkler - so. ft.: Pace 2
Job site address: 108¢5 _s• to Alchv7IM 701,1 ,4vJ= Site Utilities
Suite #: Bldg. /Apt. #: � Catch basin/area drain 16.60 I
Project Name: NAHI k 7 .h TOk! rJ o Mg S Drywell/leach line trench drain 16.60 I
Footing drain (no. linear ft.) Pace 2
Cross street/Directions to job s t Manufactured home utilities 110.00
SLJ l'%0 �� S '� Manholes 16.60
36/4-k 0-rzkor Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Pace 2
Subdivision: /--//3WK S OEAgj) Lot #: $ 9 Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Pace 2
• Tax map /parcel #: Fixture or Item . ' .... `
DESCRIPTION OF WORK Absorption valve 16.60
C. tz• no.) of I.E1A) 1 smeL -/ Backflow preventer Page 2
- r -A,AJ , 1wlf P E0- ( ll ( p& so-A -) Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
.•jE"PROPERTY'OWNER . - I - D•TENANT • • . - - . Ejectors/sump 16.60
Name: AUT7) 01 •) PAf - K T vJN % r4'1 S 1 L1-.C.. Expansion tank 16.60
Address: c1 SCO SW 13ArzglJQ &.vbf Stilri Z20 Fixture/sewer cap 16.60
City /State /Zip: Poez7?J¢ Oa. q-72�q Floor drain/floor sink/hub 16.60
C, ,I Garbage disposal 16.60
Phone{ _ 3) 9 q.2- 81 SU I Fax: C ) 92 - S S'T ( Hose bib 16.60
;j�APPLICANT • • ,:__::: : " ::I] •CONTACT PERSON: -- . Ice maker 16.60
Name: 1>E k L. MOu//J s ASSOCIA -1 ) VA. Interceptor /grease trap 16.60
Address: 95,00 5t. t te.gJie, gi. Ar Su ert 22cw Medical gas - value: $ Page 2
Primer 16.60
City /State /Zip: rt,er2A4) � , Cr. Cl-7 z i 9 Roof drain (commercial) 16.60
Phone 3)892- 67 58 Fax (5:53 512 Sink/basin/lavatory 16.60
E -mail: Yylm,k. 1., d, l 3c .JnasTe G • co v•t Tub /shower /shower pan 16.60
CONTRACTOR - ',- • • ._ • . Urinal 16.60
Plumbing Experts Inc Water closet 16.60
P Water heater 16.60 _
11925 SW Parkway Other.
Portland OR 97225 -5413 Other:
503 - 469 -0443 .... _ ;:- ; Plumbing PermitFees• ... -: =; :..:::. _:;:
CCB: 149035 PLM: 34-391PB - Subtotal $ 3 S 0.°D
Minimum Permit Fee 572.50 S
Authorized /, Residential Backflow Minimum Fee $36.25 _
Signature: /0. ..! I.. _ I e: u �� / 0 � - Plan Review (25% of Permit Fee) S
.. a' (70E- C--tf)N(` State Surcharge (8% of Permit Fee) S 2 ..0
(Please print name) TOTAL PERMIT FEE S
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans wan 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.
iMsts\Permit Forms\PlmPermitApp.doc 01/03
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 -00314
Date Issued: 12/23/2003
Parcel: 1 S133AC -HB059
Site Address: 10845 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 059
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
Reg #: LIC 116453
SUP r
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X f 2/. e
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD T
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 -00314
Date Issued: 12/23/2003
Parcel: 1 S133AC -HB059
Site Address: 10845 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 059
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 34-391PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x IK/6
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
•
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land use and development standards for street tree installation.
® ADDRESS: 7-0,3243 _c Gl), citti-t_. _ ®
® LOT: 5 SUBDIVISION: ic M7b+ -
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CITY OF TIGARD 24 -Hour 1
BUILDING 411, Inspection Line: (503) 639 -4175 0 MS 3-66 3i
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested 2.3 AM P� BUP
Location / Rtic Alty7 Suite 7 / MEC
Contact Person Ph ( ) T 7 7 PLM
Contracto Ph ( ) SWR
B . DI ■ Tenant/Owner ELC
g 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:
C I
j ART FAIL
P MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS FAIL
M - AL
Pos & Beam
Rough -In
Gas Line
Smoke Dampers
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 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line (
ADA
Approach/Sidewalk Date 9/ 24-(- 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 40 03-663 1
INSPECTION DIVISION Business Line: (503) 639 - 4171
�
BUP
Received Date Requested 1 - Zd / AM PM BUP
�
Location . _ _ _ �4.1 �' .. _ 4 Suite MEC
Contact Person Ph ( ) _ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain - ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall I
Fire Sprinkler EV 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:
Final
PASS
MECHANICAL
eam
Rough -In
Gas Line
Smoke Damp rs
Fina
ASS ART FAIL
RICAL i 4/1111h Rough -In AMiti IMMinr
Service
lt � 'I- I- WPWMIP '_
Low Voltage
Voltage \_
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: D 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
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST It63'd'D 3
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested T' Zy ` AM PM BUP
Location I OS y5 HIT11 7»/ Suite L 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 .■
Ext Sr Anchors „RM
Ext Sheaea th/h /Shear
Int Sheath/Shear
Framing ,A
Insulation
Drywall Nailing
Firewall 1 7 U__!/ FrIL F t wrI ■
Fire Sprinkler 1 `�
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:
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
• Alarm
07111. Reinspection fee of $ required before next inspection. Pay at City. Hall, 13125 SW Hall Blvd.
- ASS PART FAIL
0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line ✓ 7 i // At hpoBeay ADA Approach/Sidewalk Date Y Y 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 w – CO 3l
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Received Date Requested 1 - 2 ' 9 ' AM PM BUP
Location /0 8'4 S Suite � MEC
Contact Person Ph ( ) 2((v — 'c f 7 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
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
40.
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 / n
Approach/Sidewalk Da te � - v '\ 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 4 ?e 7- 0 ,3 — a o .3
INSPECTION DIVISION Business Line: (503) 639 -4171
�BUP
Received ate Requested 3 AM PM BUP
Location 6 74
Suite MEC
Contact Person / • h ( ) 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:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Water � e _ / 74 pv../
Water Service �'�"7/
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: LI Unable to inspect — no access
Fire Supply Line
ADA �!
Sidewalk Date 9 3 �`7 Inspector /1� Ext
of e.
Final DO NOT REMOVE this inspection record from the Job site.
P PART FAIL