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Permit III p CITY OF TIGARD MASTER PERMIT $ COMMUNITY DEVELOPMENT Permit#: MST2014-00036 T E GA R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/09/2014 Parcel: 25111 BA12900 Jurisdiction: Tigard Site address: 14270 SW 97TH AVE Subdivision: 2013-009 PARTITION PLAT Lot: 1 Project: RANSDELL Project Description: Porch remodel. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First 0 sf Basement 0 sf Left: 0 Parking Spaces' 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors. Total: 0 sf Value: $2,000.00 Rear 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0 Drains. 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Tema SrvclFeeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v. 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: RANSDELL,DAVID E&SALLY E OWNER Required Items and Reports(Conditions) 14270 SW 97TH AVE TIGARD,OR 97224 PHONE: PHONE: FAX: Total Fees: $331.21 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification, Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o ct questions to OUNC by calli g .03. 2.1987 or 1.800 2.2344. Issued By: _� Permittee Signature: ��/_ �,� , ��`� Call 503.6 ' ii�:y 7:00 a.m.for the next available inspe on date. This permit card shall be kept in a conspicuous place on the job site until completion of the p'ject. Approved plans are required on the job site at the time of each inspection. Building Permit Application . `Residential �� � i ()1t ()1 I It I I 'NI u\L1 rr� Received In a City of Tigard R�V Date/B :_ Permit No.: II • 13125 SW Hall Blvd.,Tigard,OR 97223 Y Plan Revidw = Phone: 503.718.2439 Fax: 503.598.1960 Q lob, iV�, '� Other Permit: p DateB 1 t ci 1 R 1) Inspection Line: 503.639.4175 �PP �`a Ready i �jy� ® see Page l for Internet: www.tigard-or.gov Cr,. ,��,� Cod: -������Ir�� Supplemental Intormatioo �J ri TYPE OF WORK � rlv REQUIRED t ATM 1-AND 2-FAMILY DWELLING El New construction Demolit Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all gAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ o 1-and 2-family dwelling ❑Commercial/industrial I ---- ❑Accessory building ❑Multi-family Number of bedrooms: El Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 11-1-270 () 4118> / New dwelling area: square feet City/State/ZIP: t 6 p.„ T7 a4 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: 'j{nd 6/ Covered porch area: square feet Cross street/directions to job site: �" Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2 S PJ Zq� Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ pry /emc_rda- Existing building area square feet New building area: square feet X PROPERTY OWNER ❑ TENANT Number of stories: Name: ZO.iJjCl- 4 Ly vSde.lI Type of construction: Address: j 4.410 S(O 011 /Ore. , Occupancy groups: City/State/ZIP: OR_ gla_4 Existing: Phone:6.0- .61 a.(0 Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee sckedale) Business name: 5 Av . G 3 G r/tx Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: --—. Total fees due upon application: City/State/ZIP: Phone:( ) Fes: :( ) Amount received: '4 7..(og E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: 1-113 MeiW het"— Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. Permit Fee(includes plan review City/State/ZIP: and administrative fees): $180.00 Phone:( ) Fax:( ) o State surcharge(12%of permit fee): $21.60 CCB lie.: Total fee due upon appication: $201.60 Authorized signature: , 1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.-Li Print name: -/.I S 1 Date: 3.10 I/ *Fee methodology set by Tri County Building Industry r Service Board I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(1 I/02/COM/WEB) I Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY • t . trill City of Tigard Received Pernnt • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By • Phone: 503.718.2439 Fax: 503.598.1960 Associated permit. T 1 GA R U 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification, yindow size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum o at levations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provid v o is of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ c6Z)10 feet rig and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be :..livable to the .ro'ect under review. .II RItiI)I( "I IONAI. SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingplans will not be accepted. ❑ ❑ ❑ 26 "Reversed"buildingplans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) L Electrical Permit Application l OR or I I( I. 1 ',I. (l\I Received /4/5-7,21,0 i ii_ y)` City of Tigard `l�{ Receive Permit No.: �D • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1 V Date/By: Other Permit: i ,fc I Inspection Line: 503.639.4175 A Date Ready/By: Juris: la See Page 2 for Internet: www.tigard-or.gov Q O 4��� Notified/Method: Supplemental Information TYPE OF WORK �PR p 4 R�p PLAN REVIEW ❑New construction Addition/alteration/replac T-� Please check all that apply(submit/sets of plans w/items checked below): 1.t�� 1ylgl4 ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition 0 Other: C� ,w 1s(�� G° where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRIM exceeds 10,000 amps at 150 volts or ❑Floating buildings. BBBHHH'''aaa'''"'��' less to ground,or exceeds 14,000 ❑Commercial-use agricultural 01-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","l-3", Job no.: Job site address: V-1- 712) Stij q`7- 100HP or more. occupancy. ❑Aire, ❑Six or more residential units. Recreational vehicle parks. City/State/ZIP: '1i ©� 4?a ❑Health-care facilities. ❑Supply voltage for more than ,{ ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: �F-Y'1 ((�6(.t,.eiC ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I " New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 1 Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation PROPERTY OWNER] l ❑ TENANT 200 amps or less 100.70 2 1� et scu t v t 15d ei I 201 amps to 400 amps 133.56 2 Name: `Il\1iJ•l.�U� 401 amps to 600 amps 200.34 2 Address: l LI'��O 'I e �y q Ae 601 amps to 1,000 amps 301.04 2 (, Over 1,000 amps or volts 552.26 2 City/State/ZIP: Ti J • 4, , i OR- X73-3 T Temporary services or feeders installation,alteration,and/or ( ,f 14`; Ll ( ) relocation Phone: 4.� Fax: 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, =: 9 rent,or exc :e,accord'ng to SRS 447,449,670,and 701. i 401 amps to 599 amps 168.54 2 Owner signature: A _I . LI Ld.�I / ' Date. . i 0 Branch circuits-new,alteration,or extension,per panel CI APPLI ' A.Fee for branch circuits with ❑ CONTACT PERSO 1 above service or feeder fee, 7.42 2 Business name: each branch circuit . B.Fee for branch circuits without Contact name: service or feeder fee,fist ) 56.18 .(� 2 branch circuit I Address: Each add'l branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( ) Fax: :( ) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: t"f-D rn e 0 o ner Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above _ Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Investigation(1 hr min) 66.25/hr , Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 9000/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: �o •f,(/ Print name: Date: Plan review(25%of permit fee): t State surcharge(12%of permit fee): iii Authorized signature: 1 ( I I TOTAL PERMIT FEE: 0 This permit application expires if a permit is not obtained within 180 Print name: \( [ ( I 0 l Date: ,1 ) itt days after it has been accepted as complete. `� r * Number of inspections allowed per permit. I:\BuildinglPermii\ELC_PermitApp_ELR_ERE.doe Rev 05/21/2013 440-46t5T(11/05/COM/WEB Electrical Permit Application—City of Tigard ' • Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined $75.00 Description I Qty. I Fee I Total I * Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 IDAlarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 • >100 kva(fee in accordance with 552.26 2 ❑ Heating, Ventilation and Air Conditioning OAR918-309-0040) System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 ❑ Each additional inspection over allowable in any of the above: Other: Each additional inspection is charged at an hourly(1 hr min) 66.25/hr l Inspections for which no fee is 90.00/hr specifically listed(%3 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 ❑ Audio and Stereo Systems days after it has been accepted as complete. Number of inspections allowed per permit. ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical In Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:t Building\'ermits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 ' ' . Building Permit Number: "7 /y_000,3a, P . ' Building Permit Review Residential Projects TIGARD Site Address: 114210 SV\I q11I Ave ;Verify site address is valid. Project Name & Lot #: RAWICI I P09.610 t0s l2e- Clean Water Services —Service Provider Letter: (lot platted prior to 9/10/1995) Required: Yes ❑ No jgr Received: Yes El No Z Site P an Elements: tte plan must be on 8-1/2"x 11"or 11"x 17"paper R'I7i ree(3)copies of site plan aerawn to scale(standard architect or engineer scale) El orth arrow Ce p and tax lot number,site address,project or subdivision Cgrcotprint of new structure(including decks)with finished name,lot number,and zoning floor elevations [plicant information(name and phone number) E.' and building setback dimensions [ 1 operty corner elevations(2 foot contour lines if more than Rf t area,building coverage area,percentage of coverage and 4 foot differential) impervious area. ❑Utility locations [ 1 cation of wells/septic systems. Dxisting structures on site Eu$rface drainage El8 reet names DS- tree size,type and location L .rosion control(including drainage-way protection,silt fence DEZisting trees to be retained with drip line,and tree design,location of catch basin,etc.) protection measures Planning Review 2"-iland Use Case Number: c\S'pc g Zoning: ) 4,S E "Setbacks: t Front 2p' Rear I J� Side rj Street Side •I s Garage 2.0 1 a Landscape Requirement: N/A Lot Coverage Maximum: _tJ 1 it % i R Building Height: Maximum Height D Actual Heightt 121 (adc{titer n c r1 ly) ['Visual Clearance / Er-Easements [ 'Sensitive Lands: ❑ Yes Type CYUrban Forestry Plan Conditions Satisfied Approved by: knreS I-C IC.C2_ Date: J 3.20.2)11-I Notes: Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ I:\Bui Iding\Forms\BldgPermitRvw_RES_123013.docx • • '• Building Permit Submittal Original Plan Submittal: Date: 3/A07/4.t By: I�� Site Plans: # -5 Building Plans: # Create Case Record#: I 'EE er case# above for Building Permit Number. Workflow Routing: 2 Pi ning Engineering rmit Coordinator ding Workflow Sign-off: LYSign-off for Planning staff,including notes from planning review(page 1) Route Application Documents: ❑ Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ❑ Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Reviewed By: Date: eJ/$/f4 Notes: Engineering Review—reviewed by: gyu 1 -) /- Actual Slope: 3 ❑ Conditions Satisfied Notes: Approved by: I�L Date: 3-2(-/V. Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ 'e .,it Coordinator Review 111°Ponditions Met-Prior to Issuance of Building Permit Notes: Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant Revision Notice 3: Date Sent to Appli ca• Okay to Issue Permit- G � Date: 5/24A'di i:\Building\Forms\BIdgPermitRvw_RES_123013.docx FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. 114 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ■ Transmittal Letter e i i.,-„„ ,, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov r TO: fl Nd SoY DATE VED: DEPT: BUILDING DIVISION 1 VE GULL' APR 32014 FROM: �> � � CITY OF TIGARD COMPANY: /j BUILDING DIVI IONS{ �PHONE: ( ib?) 1 UYID 1 By:A `. RE: ` �0 SO G 1% fk*V* 7� /z/--cab ( ite dress) (Pemut Number ect n e or su division name and lot number) r r ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: .. Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: `M..II/Qor r- dl//S FOR OF ICE USE ONLY Routed to Permit Technician: Date: 4 f A Initials:- Fees Due: ❑ Yes Ofi10 Fee Description: Amount ue: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑No _ ❑ Done Applicant Notified: Date: Initials: 1:1Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 14270 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - No C of O MST2014-00036 Jeff Grove Violation Summary: Inspector Contractor