Permit A '
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00333
:trill J D EVELOPMENT SERVICES DATE ISSUED: 8/5/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10910 SW HUNTINGTON AVE PARCEL: 1S133AC -12600
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 044 JURISDICTION: TIG
REMARKS: New SFA dwelling.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 32 FIRST: 48 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 640 sf GARAGE: 524 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 TIQRO: 728 sf RIGHT:
VALUE: 145,364.40
OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL: 1,416 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: 4 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: 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: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: 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 -1000v MINOR LABEL:
1000• amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 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: $ 6,199.57
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES I his permit is subject to the regulations contained in the
4949 SW MEADOWS RD SUITE 400 4949 SW MEADOWS RD SUITE 400 i and all Municipal Code, laws. Aof ll l o work wil by done in
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 acc rd ra cer applicable ed p. Al. This permit be done in
accordance with approved plans. This permi twill expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 233 - 0075 Phone: 971 233 - 0075 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Rog #: 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 Mechanical Final
Sewer Inspection Electrical Service Framing Insp Exterior Sheathing Insr Water Line lnsp Building Final
Footing Insp Electrical Rough -in Gas Line Insp Firewall Insp Water Service Insp
Foundation Insp Mechanical Insp Gas Fireplace Gyp Board Insp Smoke Detector
Slab Insp Low Voltage Insulation lnsp Rain Drain Insp Plumb Final
•
Issued By : .. ,l fit) �( Permittee Signature : _S...“ Q1Tc
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
,"“..e.._. � FOR OFFICE USE ONLY
' Building Permit R e�e;ved Building
gg Date/Bv: V 0 1 6 1 o Permit No. :/`��1 ,5 °A9 ..sue
Planning Appro
Other
City of Tigard Date/By: Permit / / Jr 47
13125 SW Hall Blvd JUN 2 7 200 Plan Review µ Other
Tigard, Oregon 97223 Date/By: 4 '.W U T — Permit No.:
I G ' ! it " Post - Review Land Use
Phone: 503 - 639 -4171 Fax 50��OT .t1�I Date/By: Case No.
BU I LDING DI
Internet www.ci.tigard.or.us °^ • Contact Juris.: 2] See Page 2 for
24-hour Inspection Request: 503- 639 -4175 Name/Method: I 7% ' I Supplemental Information
.
- . -- ". - - TYPE OF WORK .
REQUIRED DATA:
New construction I ❑ Demolition . • 1 &-2 FAiMII.Y DWELLING - .
❑ Addition/alteration/replacement I ❑ Other:
"'' - -- CATEGORY OF CONSTRUCTION - - • . Note: Permit fees' are based on the total value of the work performed. Indicate
gl & 2- Family dwelling I ❑ 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 Multi - Famil
❑ Master Builder ❑Other: Val uation / 2 9 6.`"
: =: ,:,JOB SITE INFORMATION and LOCATION -•:,. � S q S I No. of bedrooms: No. of baths: Z K2
Job site address: locuo SW 1-644nAl(, f h/r 'uc I Total number of floors
New dwelling area (sq. ft.) (/ 4 «
Suite #: I Bldg. /Apt. #: Garage/carport area (sq. ft.) 504'
Project Name: W KS lQeAcat, 177•1141401Vt1;S Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
5W I ' frvalUe AsJb SW.. 4MfiKr l3EAR Other structure area (sq. ft.)
S r er
_ .- . 1 ;' .' REQUIRED DATA:.
�// �� COMMERCIAL• -USE CHECKLIST :, : °;. : ' '- :
Subdivision: 44.14 &EA2ib 701. Mittiles I Lot #: I
Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
i ' . • ' DESCRIPTION'OF -. :: the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
C rguci L of NELJ S ST TA414 PCAVI
.PI,Ec-C" Valuation S
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 3
:• _ Type N
•�P.ROPERTY :OWNER: : - :... :': 17-0 'TE " AL�L'i' :--...7:: - YP e of construction V
Name: AU?Vr'ir�( PARK 7618- (P�I45WL'S L. L.L. Occupancy group(s): Existing:
R -3
Address: 950o s W B gul& gist,, CO r•E Z
City /State /Zip: `Poor-h�� , 02 q 7 2-19
Phone: Soo ' 2-' 7'S Fax:6a) PAZ-9E34 f NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
'IsitAPPLICANT:::::::::''.;ic.::::.z-:: : -Q- CONTACT. PERSON: .:: =' provisions of ORS 701 and may be required to be licensed in the
Business Name: je L. C_ Age:4,0 / ( • jurisdiction where work is being performed. If the applicant is exempt
Contact Name: rYi, K (.. 4,.() cat. lebclr Pe. Z from licensing, the following reason applies:
Address: gSt o Stfti •&tell ESL -Its l S(1 Ose 2ZO
City /State /Zip: kt2TZ1 02 q 219
Phone: -e 1 Fax:(503jeot2-6 .. • ..... - . lvl T s -
. :.
E -mail: ina- rk4. di bnoumASSex, czM - p lease'refe :to :feeici edule: - - - •
7. .. - - - -r . - - . -- . ,
-. •.�•.. - .�. . ..
.... - - CONTRACTOR` .. _
Business Name: 'bEekt L. gQL1G4J 4 AS9CX1' ; lei. Fees due upon application S
Address: ' x) svi g,4Q me, gLVD S1l ZZo
City /State /Zip: f bars. 7.1 Q2 97 2 19 Amount received. S
Phone: 892 -8'75 [ Fax: (6ds\ S '32- 8941 Date received:
CCB Lic. #: e69
Authorized /4 41#241(0 Notice: This permit application expires if a permit is not obtained within
Signature: //l - Da1e: 180 days after it has been accepted as complete.
fv `M ( C lV r 11-A1450}.) ) •Fee methodology set by Tri-County Building Industry Service Board.
(Please print name)
i :'.Dsts\Permit Forms\BldgPermitApp.doc 01/03
Electrical crcal Permit A lication FOR OFFICE USE ONLY
� � App Received
Date/By: Permit N � VE � rmit No.: � �C � �i� �,��
Ci of Ti and Planning Approval Sign
_
ty g Date/By: Permit No.:
13125 SW Hall Blvd. H IN 2 7 2003 Plan Review Other
Tigard, Oregon 97223 Date/Bv: Permit No.:
Phone: 503- 639 -4171 GUY 12IDB -3' 'ttgRD Date/By: Case No.: 4/11, Post - Review Land Use
k Internet: www.ci.tigarthhklliDINGDlVISION ■ 1j. e� Contact luris.: ® See Page 2 for
."
24 -hour Inspection Request: 503- 639 -4175 ' Name/Method: Supplemental Information.
• TYPE OF WORK I PLAN REVIEW (Please check all that apply)
(New construction ❑ Demolition u Service over 225 amps- ❑ Health —.arc facility
commercial ❑ Hazardous location
❑ Addition /alteration/replacement ❑ Other: pg 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
Erl & 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: 101 (0 SW U Tii ,T/x.) ki6Jue • FEE; SCHEDULE
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: „1-1,41AJKS 4 6 fiow,3f-ccNIES Description Qty I Fee(ea.) I Total
New residential- single or multi - family per +
Cross street/Directions to job site• dwelling unit. Includes attached garage.
,\.) 1 T_0 A VEpilie SAi N Service Included: d
v� Jt-/ 1000 so. ft. or less 1 145.15 I"\7.15 4
304 Each additional 500 sq. ft. or portion thereof I 1 I 33.40 g3_t.4O 1
,�• n'H �{ 44 Limited energy, residential 1 I 75.00 I -- 15 .� 2
Subdivision: 1 Lot #: �-[ Limited energy, non residential I 75.00 I 2
Tax map /parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK. service and/or feeder 1 90.90 1 2
Services or feeders - installation,
C �
e/� Cr 04E A.-) 3 51-0 / alteration or relocation: Q ,,
" A( -t7iW grime f' ,� 11 200 amps or less 1. 80.30 Gv .3) 2
. <- r` �yy, 'c7JJtu , 1 ,E 201 amos to 400 amps 106.85 I 2
401 amps to 600 amps 160.60 2
;'1QPROPERTY.O.. R':::.: • ;_,...I ❑TENANT: _.- _ . .
601 amps to 1000 amps 240.60 I 2
,, r � Over 1000 amos or volts 454.65 2
lgame: A - ra t 4 /2�X 1 1 4 9 3 1� 5 LLC Reconnect only 66.85 I 2
Address: C1503 SAJ (zAe_gUle.- gL SU rTc 22z
Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: (-b2TLA.7 %, ( 91 c9 2 19 r� 201 amps to 400 amps 100.30 � � j 200 amps or less 66.85 1
PhoneS (p3, 3 Z —r�58 Fax:(So \ & -S8 -t (
3 � 1 to 600 amps 133.75 I 2
2
APPL ANT p = '` = ,.�, _[] / C ' ONT Cr CT PERSON 77-;:;-• Branch circuits - new, alteration, or
Name: l tG L• Jl' e 4S "-7jE I l nt , extension per panel: of
Address: SCO e�-O.R.II>� ��b� S &t ZZO
A. Fee for branch fe feeder each purchase ui
t 6.65 2
service or feeder fee, each branch circuit
City /State /Zip: 'Rj,r , Op_ .9-7 21 of B. Fee for branch circuits without purchase of .
service or feeder fee. first branch circuit 46.85 2
Phone: 6, 9_8 156 Fax: (� 892 -8i4 I Each additional branch circuit 6.65 2
E -mail: vin, r a. d l tr t�1.Ja.SSoc , con -�
Misc.(Service or feeder not included):
Iv . Each pump or irrigation circle 53.40 2
: �,.... -. , • . - CONTRACTOR 2
-^ =' � r'� .;.. : � - - -.
� -�"'� " � '- - ' Each sign or outline li g h t i ng 53
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 any of the above:
503- 361 -1256 Per inspection per hour (min. I hour) 62.50 _
CCB: 116453 ELC: 24 -353C SUP: 2919S Other .
(2013 L1c. #: I Lic. #: - ••. . Electncal.Pe ...., :. _
Supervising electrician Subtotal S 1345 signature required: Plan Review (25% of Permit Fee) S 3 .'40
Print N. . e: Lic. #: State Surcharge (8% of Permit Fee) $ 2 + i
TOTAL PERMIT FEE $ 4 .. 0
Authorized nmr 4r Notice: This permit application expires if a permit is not obtained within
Signature: Date: r 0 3 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
tY1/1"Yt I L IQ . Serp
(Pleage print name) •
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
/ • FOR OFFICE USE ONLY
. Mechanical Permit Application Received Mechanical
Date/Br. Permit No.: / °0
Planning Approval Building
City of Tigard Date/By. Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 JUN 2 7 2003 Post-Review Land y: No.:
� � p Post - Review Land Use
Phone: 503 - 639 -4171 Fax: 5 AI I Y F G,., .4, , , ® Date/By: Case
Internet: www.ci.tigard.or.us (._ e . Contact Juris.: See Page 2 for
24 -hour Inspection Request: �9-'b4'9 �IVI1 ,. 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.
J'1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE. •
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** ( 14.00 04.CQ
Job site address: /0 9/ f] SW / /UNrN G To A) AV t Gas heat pump 14.00
Suite #: I Bldg./Apt.#: Ductwork l 14.00 I 14,.'
Ks -g ,rM TO W 1i H01N Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions to job sit (for radiator or hydronic system) 14.00
,S j30 I '` l'✓ ve A00 . ■ AfrlAieS Unit heaters (fuel, not electric)
- 7E s 2U i (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10 . w
/A W � l r P � �� Repair units 12.15
Subdivision: rT f Lot #: Other Fuel Ap fiances
Tax map /parcel #: Water heater 10 (u. °'
• DESCRIPTIONOF WORK - Gas fireplace 1 10.00 10. CO
C00 /S r a#Cna) QF !'W�(� J S-- 1-oeLt Flue vent (water heater /gas fireplace) 7 10.00 I 2U. iO
-T MJ 7f�mf. PoJ / ( ilo Sari") lighter (gas) 10.00
l `t Y Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY OWNER. -.:: • I ❑- TENANT --=.:---:- Other. 10.00
Name: l., l� K Ta WA A/004e LL.G Environmental Exhaust & Ventilation
7 I V t/ m A' / Range hood/other kitchen equipment , 10.00 10 .'°
Address: a ` 21 ski ue gi_JA 1 S 1Tr� Z ZO Clothes dryer exhaust 1 10.00 10
City /State /Zip: Pa2'2hiD de Q12 i q Single duct exhaust
Phone: So3)8012 -g7Sg Fax:(5, 992 -? i'( (bathrooms, toilet compartments,
[APPLICANT • ❑ CONTACT PERSON utility rooms) 4 6.80 11.4
Name: `>E€ ( 4. (aa 4"J s �45 • Attic/crawl space fans 10.00
� ) 1Img a , Other
f► ZZc� Fuel Piping
City /State /Zip: Tporr.'Zjf►.)S i de 91 Z-19 • *($5.40 for first 4. S1.00 each additional)
Phone:( NZ -0 Fax: r- y3,e.A2- e84( Furnace, etc. Gas heat pump ••
E -mail: ✓vvka, L `i d I beocJ/tO- dC - cot Wall/suspended/unit heater '*
• ... ::. -.. •• • • CONTRACTOR Water heater
Fireplace I «*
FORECAST HEATING & AIR CONDITIONING Range ••
17135 NE GLISAN ST BBQ
PORTLAND OR 97230 Clothes dryer (gas) ••
503- 253 -7020 _ Other. ••
CCB: 152194 Total: "i 6•
Mechanical Permit Fees*
Authorized 70 b k t o /o5 Subtotal: $ 1 3o , �n 6
Signature: i�/(/1�i t .V� Date: Minimum Permit Fee $72.50 S
ER VGA , Plan Review Fee (25% of Permit Fee) $ .3 2 ■ 6 5
(Please print name) State Surcharge (8% of Permit Fee) $ b(") . , fS
TOTAL PERMIT FEE , $ I I S. 70
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:\Dsts1Permit Forms\MecPermitApp.doc 01/03
liulluu ig r 1ALU1 C,
fl •III FOR OFFICE USE ONLY
id , Plumbing
Numbing Pe . 1 Itece;yed
i M Date/By: Permit No.: 1$1 i 4 2
City of Tigard JUN 2 7 2003 A Planning Approval Sewer
Date/By:
Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.:
Phone: 503- 639 -4171 F lLSDINEM117 ;s ION Post - Review Land Use
+
Contact ase No.:
Internet: www.ci.tigard.or.us �� t':
II Contac Juris.: E See Page 2 for
24 -hour Inspection Request: 503- 639 - 4175 Name/Method: Supplemental Information.
'TYPE OF WORK FEE* SCHEDULE (for special information use checklist) -
gi New construction ❑ Demolition Description I Qty. Fee(ea.) J Total
❑ Addition/alteration/replacement ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
I
fg 1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath t 350.00 3�'3<'_G s
❑Accessory Building ❑ Multi- Family SFR (3) bath 4-4 399.00 �'
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
• . JOB SITE INFORMATION and LOCATION Fire sprinkler - sq. ft.: Pane 2
Job site address: /0 °7f () i _c_a) Hum T/AJC7 )lv A UE Site Utilities •
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: N�4'1A) k� 3F 1� TOvJnI ! -1aw�G S Footing l/leach (no. linear line/trench drain 16.60
Footin drain (no. li ft.) Pane 2
Cross street/Directions job Manufactured home utilities
SLJ l �C� Alf �J" �i sit 110.00
S' � Manholes 16.60
36/11t. S? ! Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: /-1.4Wk' ,E4-RP Lot #: 4 - . Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2 • Tax map /parcel #: ... Fixture orItem . • - . . -
DESCRIPTION OF WORK A valve 16.60
atJ.SI7Lutc rciJ of P'JEIA) 3 Si(((YZJ I Backflow preventer Page 2
T7) tvwtf, PO- M.lEc.r (1 t J Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
. Drinking fountain 16.60
HPROPERTY'OWNER TENANT - Ejectors/sump 16.60
Name: .AUTU$I/J PrV.K To vJNF!OW1ES, LLC. Expansion tank 16.60
Address: q SCO SW I&I,e.gv2 L .k/a SUcNc Z Za Fixture/sewer cap 16.60
City /State /Zip: PoeTLAWD 02 Cri Z q Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone{ o3j 6 q2- 87 so Fax: � c I2- 084 I Hose bib 16.60
;APPLICANT' �:-. -.- . . -.- ❑CONTACT PERSON:;-- - Ice maker 16.60
Name: 1>E42EV L. 1320u//) g ASSOC.IA -t ii. Interceptor /grease trap 16.60
Address: cISCO S).,..1 gte.gt.iie. gLJAr Su i'I'i ZZa Medical gas - value: S Page 2
Primer 16.60
City/State/Zip: F}Je. ,4 , C . q -7 Z I t} Roof drain (commercial) 16.60
Phone 3) &Z- 6758 I Fax(503) seiR Sink/basin/lavatory 16.60
E -mail: wnm lc. ti, d. I taericanG cCe7 G • 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 • . -. :Plumbing
itFees*
CCB: 149035 PLM: 34 -391 PB - Subtotal S - ‘e
Minimum Permit Fee 572.50 S y3-0
Authorized l Residenti Backflow Minimum Fee 536.25 _ �
Signature: Il i, .,_./ -.. -.. Date: (e ka Plan Review (25% of Permit Fee) S �'`
i2U CePt/= State Surcharge (8% of Permit Fee) S . 4-I'R- 1'
(Please print name) TOTAL PERMIT FEE S S!A I
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric o f , ; 0
180 days after it has been accepted as complete. riser diagram for plan review. u d m -
•Fee methodology set by Tri-County Building Industry Service Board.
i:\Dsts\Permit Forms \PlmPermitApp.doc 01/03
1
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 -00333
Date Issued: 8/5/2004
Parcel: 1 S133AC -12600
Site Address: 10910 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 044
Jurisdiction: TIG
Zoning: R -25
Remarks: New SFA dwelling.
Your company has been indicated as the electrical contractor for the permit indicated above. I n 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
4949 SW MEADOWS RD SUITE 400 DBA SPECTRUM ELECTRIC
LAKE OSWEGO, OR 97035 2050 VISTA AVE #100
SALEM, OR 97302
Phone #: 503 - 233 -0075 Phone #: 503 - 361 -1256
Reg #: LIC 116453
SUP 2919S
ELE 24 -353C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Xd,d/f01,1/4i./
Signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE RECEIVED
PLUMBING EXPERTS INC AUG 1 0 2004
11925 SW PARKWAY CITY OF TIGARD
PORTLAND, OR 97225- 5 DIVISION
Plumbing. Signature Form
Permit #: MST2003 -00333
Date Issued: 8/5/2004
Parcel: 1 S133AC -12600
Site Address: 10910 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 044
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
4949 SW MEADOWS RD SUITE 400 11925 SW PARKWAY
LAKE OSWEGO, OR 97035 PORTLAND, OR 97225 -5413
Phone #: 503 - 233 -0075 Phone #: 503 -469 -0443
Reg #: LIC 149035
PLM 34 -391 PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X 7Po e Zeig —
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 639 -4175 MST .---66 .3-_.3
INSPECTION DIVISION / Business Line (L. 9 -4171
BUP
Received Date Requested 9- ---;) AM � BUP
Location / v 9/6 / 7 4 Suite MEC
• e
Contact Person Ph ( ) • , 40 — I PLM
Contr. • Ph ( ) SWR
= d LDIN e Tenant/Owner ELC
Fo•••=
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear aQ12 v cl , -2/) t-i` O sue' (2 ) ` c ^ Q 5
Framing �' (. 6 r v �r�
Insulation ( n `- 2 6 #'-
Drywall Nailing / 1/
Firewall
Fire Sprinkler i
Fire Alarm l l TI _� , i ��
Susp'd Ceiling
Oth
Roof
r: , �tgilire •� f -2 .
1
, PART FAIL
.
' 4 ' BING
Post & Beam
Under Slab
Rough -In
Water Service
t
Sanitary Sewer i f' i � ,
Rain Drains
Catch Basin / Manhole ,4
S
( I Li 1,
torm Drain 7 I
Shower Pan I ; / G ~
Other:
Final r
P ART FAIL �� '
M ICAL � ! ' / i Y
Post & Beam
Rough -In
Gas Line i f''
Smoke Darrfpgirs '
V / PART FAIL
CAL 7
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA (/ \
Approach/Sidewalk Date �t
` 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 X03 --60333
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested ! / AM PM BUP
Location 11 / Z Suite. MEC
Contact Person Ph ( ) 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 p5 F"(■ .
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:
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
• E1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line J
ADA l Optate Approach/Sidewalk Date Z' S Insp / - 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 aeon 3
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested - — IS AM PM BUP
Location ) U 7 Suite MEC
Contact Person Ph ( ) 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
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
CHANICAL
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 / S v /� �
Approach/Sidewalk Date J J / Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL