Permit o' / /4"/ ' /45
•
CITY OF T I GA R D MASTER PERMIT
PERMIT #: MST2003 -00313
�I�+; DEVELOPMENT SERVICES DATE ISSUED: 12/23/2003
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10855 SW HUNTINGTON AVE PARCEL: 1 S133AC -14000
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 0581 JURISDICTION: TIG
REMARKS: New SFA dwelling. 9 -20 -04 AC unit adde
BUILDIN
REISSUE: STORIES: 3 FLOOR AI 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 el GARAGE: 484 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THR 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:
MECHANI
FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3 H , . 1 ) 1 \\ � 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 1N/0 SVC/FOR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 1 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 *amp6- 1000x. 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 6 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,112.08
AUTUMN PARK TOWNHOMES, LLC DEREK L BROWN & ASSOCIATES I Lhis permit is subject to the regulations contained in the
9500 SW BARBUR BLVD., STE 220 4949 SW MEADOWS RD STE 400 nd l all other la
Municipal Code, ws of All work kwil b o ne i n
PORTLAND, OR 97219 LAKE OSWEGO, OR 97035 and a ra applicable ed p. Al. This permit done in
accordance with approved 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: 971 - 233 - 0075 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg a: LIC 58699 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Slab Insp Low Voltage Gas Fireplace Shear Wall Insp Shear Wall Insp
Sewer Inspection Plm /undslb Insp Plumbing Top Out Gas Fireplace Shear Wall Insp Shear Wall Insp
Footing Insp Electrical Service Framing Insp Insulation Insp Shear Wall Insp Shear Wall Insp
Footing Insp Electrical Rough -in Framing Insp Shear Wall Insp Shear Wall Insp Shear Wall Insp
Foundation Insp Mechanical Insp Gas Line Insp Shear Wall Insp Shear Wall Insp Shear Wall Insp
Issued By :� Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
B � iilding Permit Application FOR OFFICE USE ONLY �1,�
1/ Received ! /a, /05 Permit No.f / sjo�t/O�' ®O /_3 j 'J WED B IJ Pla nning p
City of Tigar (/ Planning Approval Other �.
Date/By: Permit No.. GvR�1103 - 49 g�J
13125 SW Hall Blvd. a
P ► � R`a` 165 Other
Tigard, Oregon 97223 ' ' l I N 2 20 03 Date/By: 10 `23`4} Permit No.:
i . , � Post - Review Land Use
Phone: 503 - 639 - 417CITF 1 a c0 � F5� b960 ' I
' i I Date/By: Case No.
Internet www.Ci.ti ����5 � * ^ ^^ Contact Juti .: ®See Page 2 for
24 -hour Inspection Request: 503-639-4 Name/Method: 77�� Supp lemental Information
TYPE OF WORK .. . -. .
REQUIRED DAT : : : ..� .: .': � .:.. .' • .•
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
( 1 & 2-Family dwelling I ❑ Commercial/Industrlal the value (rounded to the nearest dollar) of all equipment, materials, labor,
.r-7 am overhead and profit for the work indicated on this application.
❑ Accessory Building Li Multi- Family Q' N 7e ft�
❑ Master Builder I ❑Other: Valuation _
'- :i:;JOB'SITE WFORMATION d.LOCATION .::.. _ •• No. of bedrooms: 3 No. of baths: 2
Job site address: 10655 SW A.).471AltrrirAJAWAJE Total number of floors — '3
New dwelling area (sq. ft.) _ 14 _
Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) _ 4gq
—
Project Name: I-W.414S il€�AA •ra U40MES Covered porch area (sq. ft.) 3 L
Cross street/Directions to job site: Deck area (sq. ft.) 7'
SkJ { A- °e AN)) &hi. 14M4Ks Btu Other structure area (sq. ft.)
REQUIRED - DATA:.
COMMERCIAL - USE C_ HECKI:IS T '- ':'
Subdivision: GS Ai gevtEs Lot #: 58
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
7 .' DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Ce4SrgUL Vog OF NEtJ S srovey Togg lrjly E,
• 1 3_Sec.l, Valuation S
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
%PROPERTY:OWNER'.::..: ..1:.❑ TENANT • . Type of construction V N
Name: AITTUrn 4 PAg K - 01.4 . 4f mes LL. . Occupancy group(s): New Existing:
-3
Address: 9Soo S W ate gue. &-(11)/ CU ()f Z Z.o
City /State /Zip: 'Pc 7 ,t .> , 0 2 9 2-19
Phone: 601) 6Q291S ' Fax:''So3' actz -g34( NOTICE: All contractors and subcontractors are required to be
L licensed with the Oregon Construction Contractors Board under
. sa'APPLICANr. :-•' - ' >;s •:: • . : •-D PERSON- z.; -- provisions of ORS 701 and may be required to be licensed in the
Ei -
Business Name: L. e. A J14PtS' / ( • jurisdiction where work is being performed. If the applicant is exempt
Contact Name: &like K (- A,.{S 02 etcr PeA -. from licensing, the following reason applies:
Address: g5tb Stn1 , Su (7Yc 2Po
City /State /Zip: Pc o r iA Oil Oi - I 2( t
Phone: (�3)�2 -6`66 1 Fax: &iiieot2-5e BVII.n . IVnTFEES
E -mail: rrtiat-r k 4. I b rvcvn ASSoc. , C,Oi► -t Please`refe .•to fee schedu _ . - -
s ..CONTRACTOR _.. -
Business Name: 'beekt 1- igi?..awN s A59c .Ji4 ; YvG Fees due upon application $
Address: amt) ski BAQsuie. (gun) SUirec ZZO
City /State /Zip: Rjartm. oia ' 19 Amount received S
Phone: 892 -5'1' ( Fax: � St93 Z - 60 1 4 l Date received:
CCB Lic. #: : g ci
Authorize. Notice: This permit application expires if a permit is not obtained within
Signature: Date: 48(03 180 days after it has been accepted as complete.
1 1/1/114,1C, ' I *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i :\Dsts\Petmit Forms\BldgPerrnitApp.doc 01/03
RECE FOR OFFICE USE ONLY
. - FIectrical Permit A I ica o Electrical
JUN 7 n Received � ® 3 >3
• JUN 2 0 2003 Date/By: Permit No/7
Ci of Ti and Planning Approval Sign
Tigard CITY OF TIGARD Date/By: Permit No.:
13125 SW Hall Blvd. BUILDING DIVISION Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
Contact Case No.: ®
Internet: www.ci.tigard.or.us _AI- e 'l i Contact Juris.: See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
TYPE OF WORK -•• PLAN REVIEW (Please check all that apply) •
XC 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
_a1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
0 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: (OS SW l,,Jri4y12. -J M6Jue I FEE* SCHEDULE
Suite #: B1 g. /Apt. r. Number of inspections per permit allowed
Project Name: ..14.4V/KS , • u '-rOwrii- 'ONlgc Description I Qt I Fee (ea.) I Total I I
New residential- single or multi- family per +
Cross street/Directions to job site: dwelling unit. Includes attached garage.
..5\1.) ' so -'"t AVE") 416 SA.) Service Included: d
1000 so. ft. or less 145.15 1 47• l 4
3 G SNI-IF/r Each ch additional 500 sq. ft. or portion thereof � Z I 33.•10 46 BO I
Subdivision: ` l.
' A ,� ! ,�- n' �� Limited energy, residential I I 75.00 1 ?; .co 2
I/11A_ / 1; ' LOt'1`: 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 90.90 2
A/ Services or feeders - installation,
��,�,5')Y'r l■t- CrICAJ Cl ' V\i,J 3 S alteration or relocation:
"-ta/. / < l / _ � f''�y �y t 200 amps or less
- - 80.30 - t
A1. '�`WIC 201 amps to 400 amps 106.85 2
401 amps to 600 amts 160.60 2
- 601 amps to 1000 amps 240.60 2
®}PROPERTY:OWNR TENANT:' _ . .
j � q I,,,,� Over 1000 amps or volts 454.65 2
/game: Au�Wl /`t PAT k 1S L L.L Reconnect only 66.85 2
Address: c1560 sij [ogle- gL\ SO o.. . 22z Temporary services or feeders - installation,
City /State /Zip: 1erb1 ) 0e- 91 219 200 amps or less 66.85
Phone spc)892.-a Fax:(SO � 2-S ( 201 amps to 400 amps 100.30 2
133.75 2
. fiirAPP AN I`:,.= r':..." : - : ❑:CONT CT'PERSON - 401 to 600 amps
Branch circuits - new, alteration, or
Name:1 ,.., R L. e p A S SC e S 1 / Ax , extension per panel: of
Address: 9SEb gi p-R J e KL\ b SL) l€ Z2 service A. 0 a Fee for branch f s with purchase or fee r fee. ee, each branch circuit 6.65 2
City /State /Zip: 1e-;l; , GtZ. 9-7219 B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: ��,p) N7 -8"15S - Fax: (:,.1) &t2.. ' / Each additional branch circuit 6.65 2
Misc.(Service or feeder not included):
'7-•.:::1-11';;:.74--.., E-mail: Y+'16./' }` 4 - d i ta O t J�0.c$OC , . . . . ... . - . Each pump or irrigation circle 53.40 2
CONTRACTOR ".- .
� " ' Each sign or outl 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
Each additional inspection over the allowable in any of the above:
503 - 361 -1256 Per inspection per hour (min. 1 hour) 62.50
CCB:116453 ELC:24 -353C Sup:2919S Investigation fee:
CCB Lic. #: Lic. #: Other. Electrl . ..
. .. - - -. ..... 'ea1.:Permit:Eees *
Supervising electrician Subtotal $ . _
signature required: Plan Review (25% of Permit Fee) S
Print Name (/ ' I Lic. #: State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $ d c__
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: v l ate: 4(7 180 days after it has been accepted as complete.
'Fee methodology set by Tri -County Building Industry Service Board.
MAW- t IQ . g-k) sdp
(Plea& print name) •
i:1Dsts\Permit Fortes \E1cPermitApp.doc 01/03
i FOR OFFICE USE ONLY
I M Permit Application ,ri Mechanical , sc�
a a � l Date/By: Permit No.: f 7 1 O 3 - Mgt-5 F 1 � I� \ ED Planning Approval Building
' City of Tigard �L �/J Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review otter
Tigard, Oregon 97223 OA 4 *if 20031 Date/By: Permit No.:
Post - Review Land Use
Phone: 503 - 639 - Fax: 503-59k 11 gg44aa Case No.:
lW 1 t� Contact
®
Internet: www.ci.tigard.orl ul (I A s a C .' JI Contact Juris.: See Page 2 for
24 -hour Inspection Req L(S 3 1 0 M • -" Name/Method: Supplemental Information.
.: _ .... : ' a. COMMERCIAL FEE* SCHEDULE - USE CHECKLIST •
:::._ ._.. :
. - �: TYPE OF WORK ' : >..: - ; ; : : ..
,New construction ❑ Demolition Mechanical permit fees' are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: I performed. Indicate the value (rounded to the nearest dollar) of all
: CATEGORY OF CONSTRIICTION- mechanical materials, equipment, labor, overhead and profit.
01 & 2- Family dwelling ❑ Commercial/Industrial I 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 14.00 14.0
Job site address: /08.575 .SGt. HUAMA1G�oxI AVE Gas heat pump 1 4.00
Suite #: Bldg. /Apt. #: Ductwork { 14.00 I Iii•'
1 4 5�e_Ae - b. TO 401M-Cc Hydronic hot water system 14.00 I
Project Name: . Residential boiler
Cross street/Directions / to job sit - 1 (for radiator or hydronic system) 14.00
S O 130 t'` / l v vc / Yv 4�� Unit heaters (fuel, not electric)
g I 5 e r (in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 1 10.00 10 . '
P L ot #: S Repair units 12.15
Subdivision:�}(,I/�5 ��/47�- I j Other Fuel Appliances
Tax map /parcel #: Water heater I 10.00 10.'
- • • DESCRIPTIONOF WORK Gas fireplace I 10.00 l0.•°''
69, : 7 - ,(ACT700 OR Ate ( 3 5 rD7e -t_,/ I Flue vent (water heater /gas fireplace) Z. 10.00 20 •'
�W� Atory/f, P� "L
JF� ( �) ( ( Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY OWNER - - - . - I: ❑ 3TENANT "' • - Other: 10.00
Name: Aviv m 4 2K To wgd flowl s LLG Environmental Exhaust & Ventilation
Range hood/other kitchen equipment I 10.00 10 . "'
Address: Si.,/ vebie goll, / SJ t? Z Zv Clothes dryer exhaust i 10.00 10. *
City /State /Zip: PoterL/ D de (4-7 2 i9 Single duct exhaust
Phone:(So3) Fjg2•EnSg Fax: C ) 99 2-- 8841 (bathrooms, toilet compartments,
• (APPLICANT . • ` . 0 CONTACT PERSON utility rooms) 3 6.80 20 .4
Name: I>Etr,9C 4. gacupJ S 4-5S Mi NC • Attic/crawl space fans 10.00
q icy $ �Lgii(L (4_111)1 S✓17t. Other 10.00
Address: ZZC� Fuel Piping
City /State /Zip: 7 iZ4, g e 9 72t9 * *($5.40 for first 4. S1.00 each additional)
Phone:(So3) NZ -5'150 Fax: 3'0/2 -0e2i( Gas heat etc. {
Gas heat pump
E -mail: IM/us- C C d 1 broC,) 7. de :c.42,-1-\ Wall /suspended/unit heater **
. • ,.r,: - -: - CONTRACTOR Water heater I 1
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 s. i-fO
Mechanical Permit Fees*
Authorized / o/ „ /� - Subtotal: S
I �. 3.4 O
Signature: i .�1�i Date: 61 - Minimum Permit Fee $72.50 - $ _
U RUGt, Cel JE Plan Review Fee (25% of Permit Fee) $ _
(Please print name) State Surcharge (8% of Permit Fee) S q , c i0 _
TOTAL PERMIT FEE $
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 Fotmms\MecPermitApp.doc 01/03
ISUll11111g r lALUI C3
' .PT * ing Permi s I•cation FOR OFFICE USE ONLY
Received Plumbing � DD3
E i v 0 Date/By: Permit No.: �S1a o zy
City of Tigard Planning Approval Sewer
Date/By: Permit No.:
13125 SW Hall Blvd. JUN 2 7 200 Plan Review Other
Tigard, Oregon 97223 ( J Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: SQ �� Z�foOTIGA �. Post - Review
1 t Datd Land Use
By: Case No.:
Internet: www.ci.tigard.or.us IL ®ING DIVI'.,[ e .111 Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 - 6394175 Name/Method: Supplemental Information.
.• • • 'TYPE OF WORK FEE* SCHEDULE (for special information use checklist)
(Fl New construction ❑ Demolition Description I Qty. Fee(ea.) Total
❑ Addition/alteration/replacement ❑ Other: I New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
®' 1 & 2- Family dwelling I ❑ Commercial/lndustrial SFR (2) bath 350.000,
❑Accessory Building El 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: /C'5$ SW //UA) 7 A LIE- Site Utilities
Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: I- 01A) vS �F�2� 'rOvJ,4 l-�GWLG S Dri elllleach line/trench drain 16.60
Footing drain (no. linear ft.) Page
Cross street/Directions to job s t Manufactured home utilities 110.00
SLJ 1 �C� A✓FJ/� S' � Manholes 16.60
36/11t - ar Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
L ot #: $ 8
Subdivision: /�f/4(n/K 5 CEA-�� Storm sewer (no. linear ft.) Page 2 Water service (no. linear ft.) Page 2
Tax map /parcel #: Fixture or Item
DESCRIPTI OF WORK Absorption va 16.6
C c LS t c rciJ OF IV Eb0 S, S i e?eti I Backflow preventer Page 2
•-r 4 P € ( )14( Sa J Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
ErPROPERTY'OWNER .- :`I..❑ • --- • _ Ejectors/sump 16.60
Name: AO PAre K Tn w/6/ i-b4ES / L L . Expansion tank 16.60
Address: (Ica) 5W �tegtJQ &)b Siicl Z ZC) Fixture/sewer cap 16.60
City /State /Zip: RjeTt .' 02 cr z iq Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone{ d, 9 92- 87 5a I Fax: W) 892- SOLI I Hose bib 16.60
;APPLICANT' ...i..7,.: : • - - ::12-CONTACT PERSON.:'- Ice maker 16.60
Name: 1>Eef v L.- ge0u//■ S As"Socoi^a, 1 1.k, Interceptor /grease trap 16.60
Address: 95a) s,...) fete. BUre. guff r Su at 22c) Medical gas - value: S Page 2
Primer 16.60
City /State /Zip: F}Je22,t , Cr. i Z l 9 Roof drain (commercial) 16.60
Phone:3)EZ- 6758 Fax( ) et .684/ Sink/basin/lavatory 16.60
E -mail: rr1A4, - LI, d, I ha z c • Co' r^'N 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:
. ....;.:i.-.:••7-Plumbing Perm Fees* . • - : '
503- 469 -0443 . • .. ...: .. _- �:.. - .- .:.._;_:.,; ::.:. .
CCB: 149035 PLM: 34 -391PB Subtotal $ 3 S 0• ap
Minimum Permit Fee 572.50 S
Authorized / Residential Backflow Minimum Fee S36.25 _
Signature: c / g i. , /... ,_ •. e: bk /O� Plan Review (25% of Permit Fee) $ _
i U C E �IV(� '
State Surcharge (8% of Permit Fee) S 2 P • °O
l' (Please print name) TOTAL PERMIT FEE • _.,-.
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans ................••
180 days after it has been accepted as complete. riser diagram for plan review.
•Fee methodology set by Tri-County Building Industry Service Board.
i:\Dsts\Permit Forms\PlmPermitApp.doc 01/03
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ELECTRUM INC
DBA SPECTRUM ELECTRIC
2050 VISTA AVE #100
SALEM, OR 97302
Electrical Signature Form
Permit #: MST2003 -00313
Date Issued: 12/23/2003
Parcel: 1 S133AC -HB058
Site Address: 10855 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 058
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 Inas 7Z 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.
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 -00313
Date Issued: 12/23/2003
Parcel: 1 S133AC -HB058
Site Address: 10855 SW HUNTINGTON AVE
Subdivision: HAWK'S BEARD TOWNHOMES
Block: Lot: 058
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 •
•
Sig ature of Authorized Plumber
If you have any questions, please call 503.718.2433.
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(PLEASE PRINT) (PERMIT HOLDER ■
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• Do hereby .certify that } e' following location ii. ■
• • meets xy 'lard /Washington County ■
• land use and development standards for street tree installation. ■ ► •
• •
ADDRESS: l 9 (5 CU) iiwu 7" / G7790V AV.
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• LOT: .f SUBDIVISION: �� 13mgp •
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• •
1 RECEIVED BY: DATE: l•
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CITY OF TIGARD 24 -Hour —WON
• BUILDING 0 Inspection Line: (503) 6 •-4175 MST X00 d o3(3
INSPECTION DIVISION Business Line: (5 0 i .< ' 1
IP BUP
Received Date Requested 9 - Z I AM P BUP
Location v g ss L — �4 �...�. _� .. Suite 5 MEC
Contact Person Ph ( ) We t!o — 1 e 7 PLM
Cont 3ctnr Ph ( ) SWR
13 DI ;) 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
,I ; ,
Susp'd Ceiling
Roof ' N§
t
Other:
dill1:1 \ i
- AS - PART FAIL e
PLUMBING r -
Post & Beam
Under Slab '
Rough -In i /
Water Service i '�'
Sanitary Sewer
Rain Drains °
Catch Basin / Manhole j
Storm Drain
Shower Pan
Other:
Final ,+`�`
PASS RT FAIL ,' j
HAN L
earn
Rough -In
Gas Line
Sm Dampers
I
1 PART FAIL
EL RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 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 c , ADA "�
b
Approach/Sidewalk Date a 1 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 ']11 3_ o(� 3i
INSPECTION DIVISION Business Line: (503) 639 -4171 �"
BUP
Received r Date Re u sted , 7 fa PM BUP
Location /D �ST5 15 7 Suite C MEC
Contact Person �-v- C � Ph ( ) PLM
Contractor Ph ( ) F6 7 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam -UM
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ■
Framing
Insulation F/ -eil FPV-- 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 PA T FAIL
TRIO'
Rough -In
UG/Slab
Low Voltage
Fir: • larm
- rIfII■
Aing, El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
0 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line / of ic
ADA
Approach/Sidewalk Date 9 l 7 I n spector
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 ,ZOD 7 —0 3/3
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested Zf AM F PM BUP
Location / D 353 / I Suite �,� MEC
Contact Person Ph ( ) Rio 'S o / PLM
Contractor Ph ( ) 13 -75-60 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:
c PART FAIL
M 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
Approach/Sidewalk Date � � 2 I I o `-1 Inspector ` 1 l Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL