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Il D K '�C,� I '• h' ��.o ' t 4,0 f I OAK N14-" AwV6 \ 1 �N 6 OA 8,54001 " 02.1 1 70 • DEC 19 2003 CITY OFTIGARD BUILDING DIVISION NOTIC:E: IF THE PRINTORTYPE ONANY rl� ( � IIIIIII I � tli � t tllllll IIIII � I VIII ( IIr�"1 11"r''�TTT IIIIIII 1111111 1111 ! 11 IIIIIII 11111 ( 1 IIII11i 111IIilil111111 IIIIT� IIIIIII IIIIIII 1111 ! 11 I VIII 1111111 i1illli IIIIIII IMAGE IS NOT AS CLEAR AS THIS NOTICE, � cz c�J OC� / IT IS DUE TO THE (.QUALITY OF THE No 36 ORIGINAL DOCUMENT E b Z 8 Z G Z 8 7 5 Z t' Z E Z Z T Z O Z 0 t 8 I G I 9 T 5 T i I II 1111111111111111111�111111111111111111111 �111ll1 -u111 IIIIIIIII►LII� IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIlll H11l►IIIIII �IIIIIIIIIIIIIIIIIIII1l��111111Ii1111 Llllllll �ll 111.111.11 llll llll�l�k1► w M CD N a r T m v i 6 r 6760 SW Al_i=FEED ST rd-$6S.2 a 37065100 372 " Z-Q" gE,��cAy-1011 / wz Q � I C I g s C d II ,.l N O CC- F- 4 VTILI�Y � , M .� ' �AcMc ►.�-r 5 I j , �►l N uT'll.lt7 LINL`� y A r-1G rL- I O� S rp rt- 1 d R A,N N ( ,al A \ s rZos......f Cy,SriNL- (✓ S /�w rJ r• ri V A T t5 r--P>'= .z X -J.i c o-1 v V ,T �►S 7"o d r6 i I � I ' Q Is F'`y 77 0 A+- pG 6Or 44+ .. 1 E v; .- :.Oaj -000 i0 _ 1 xp I m r4':v 6 I I Cro 8 Remove t 5.0 � N , yiEwEit- � � I wAr�':- I — 0 SToz1-1 vfLAI1 . K' 137ti tt^ltd N has^ -� - dM X �.VAv - NU1r N �Mrw •.r> TU f2f......f. CJr�srINL' � \�J ' AIL&4& t c C, I V,rz`r F= 6,or 4(i 77 tihH cuoort 7t c 140I � oo+, v '04� , �rf�� ` ,fir,. N I�• �� Jl C f ELECTRICAL PERMIT- CITYOF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT #: ELR2004-00093 13125 SW Hall Blvd., Ticiard. OR 97223 (503) 639-4171 DATE ISSUED: 4/6/04 PARCEL: 1 S125DA-LP002 SITE ADDRESS: 06760 SW ALFRED ST SUBDIVISION: LAWRENCE PART/MLP2003-00010 ZONING: R-4.5 BLOCK: LOT: 002 JURISDICTION: TIG Proiect Description: JOB NO P6760 A.RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL:. HVAC: DATA/TELE COI.1M: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: _ TOTAL# OF SYSTEMS: Owner: v i Contractor: ----�----__�_ ROBERT LAWRENCE SYLVAN ELECTRONICS 15840 SW BOBWHITE 6802 SW CANYON RD BEAVERTON, OR 97007 PORTLAND, OR 97225 Phone: 503-975-0500 Phone: 503-92-1244 Reg #: 11( '58743 11 1 14-254c 1 I FEES _ Required Inspections^_ Description Date Amount Ceiling Cover 11'I.14WI-1 FLR Permit 4/6/04 $75.00 Wall Cover Elect'I Final � I A\I S",,State tiurrhart 4/6/04 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State 7R. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This perm,will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued by ��� ' _ Permittee Signature .,f-y _ OWNER INSTALLATION ONLY _ The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ _ — DATE'-__ LICENSE NO — Call 639-4175 by 7:00 P.M. for an inspection needed the next business day r ELECTRICAL PERMIT - CITY OF T I G A R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00093 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 4/6/04 PARCEL: 1 S125DA-LP002 SITE ADDRESS: 06760 SW ALFRED ST SUBDIVISION: LAWRENCE PART/MLP7.003-00010 ZONING: R-4.5 BLOCK: LOT: 002 JURISDICTION: TIG Proiect Description: JOB NO P6760 A.RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS. Owner: Contractor: ROBERT LAWRENCE SYLVAN ELECTRONICS 15840 SW BOBWHITE 6802 SW CANYON RD BEAVERTON, OR 97007 PORTLAND, OR 97225 Phone: 5113-975-6560 Phone: 503-292-1244 Reg #: IM' 58743 111 34-25-4( 11 FEES Required Inspections _Description Date Amount Ceiling Cover FI.R Permit 4/6/04 $75.00 Wall Cover Elect'I Final I \ State surrliart 4/6/04 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 'Specialty Codes and all other applicable laws. 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 worts is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued by 1 c.G�yYf� L— _ Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day FROM SILVAN ELECTRONICS FAX NO. 5032978956 Apr. 06 2004 09:04PM P1 El txiesl Per A Ifcatio>a ('ity of Tigard , ,w,,,1,U..: 13121 a w Hull Blued,7i1�ar1,OR 2♦J n mertew Phuic SC3,631),4171 t 5015'99:166 OdwrPamm't 4,rveotia«l.itw. ?03.639,417', Derr f:w haI l 1'v lntatttas v+vrw',ct.ngard.0r.ua l Notitiad?A•tbod � S a (Iahratlaan - 777 it JI� ' it ! r lirorINgf� .�!�.t \IOW4apIIamnoon []Addltion/ekerettott/raplaol mnt Pleaaeclteckall that.pp : , Dmesol7dtlm Other maervict Oyer 226 amna•oeren'l alimedoua:magon (]Stvvke 0vw 320 amps-ra3tt; Daulldng Over to o0o y n., ° r'41 t•; V '.rG h w:I�;J'• of 1.•turd IAmrilly 4"mn;e 4 m r new realamw '1-matt 2-Matly dwelling 0 Coracurtsal/indusimil At"Wry bud4ins OSymmo war 600 vtfltr nominal unitt in lata abixwre buildma over brae,rboria Upemm.400 onw w mere 1 Nulti-fa;ntily MaaW hider ❑Other; Rcoupmt lead over 0 pervlma c1manuf4ctured wuctmz or (329mWa4b6no plan RV pari lobnp. ,lb � lob mite sddrata ��I [�Haylth-ogre fioilip � � —.-- Submit Item of plans with any orthe above- GN y� The above ter not Wpllcab)l to to",%loery enriou")on ean'Ict. S'uta/bldg./spt no.- MIT,,."•1 ��, tih ►aq •,: TNA tuts KneUdire uQui;to Job site: Iraw dtatlal sin;le•or rmlo-family dwolloo deft. — - Jatluda aeached 1,000 .ft or Iaaa 117.1! -~ a LBabQlvblon Ji,ot na. 8a.add'1 S00 aq (�ar on 11.40 1 i 15.00 Tax atatelno.. iltohsEa dcndal 1 Undtcd�D'11onnaWo tW 75.00 _ 21 i �� ''r.: ..�'6'• G'� :dll �'.r' :? .�3 i eb fttefl'.Ifacwed 01 rlwf t=r da) Umt"Met md/er feeder 1 D0.90 2 9"em or faders isatyllatba,alWation,mn&or rdop a o _ ._ s00 amps cr team 1c.30 I2 201 Wnnn to 4W Mips 10t1.A! 2 401 anpl to 600 Imps i bc.6o Names d01 a to I,00c amnF 1x0,60 � 00 atr Over 1. s or Yalu 434 t 3 I a ammonnoo mlly 6664 1 2 oml+arary servim or readers locrMaloom.mtwetbn,mm&er �chu`m-( ) pax:( ) 300 tlanpa or h at �J�I imudlattan Is _Wq a on 1p MY dlat J own wbictt Is ant 30luotsudod for talo,Towel,tent;or ex.-hango,aoeo?ft to ORS 447,449,670,ttnd 701. 401 s to 600 a 2 C11Vaer ei aivar. —Dae:�,��, Hnaee tltrorstt�alfa,ahcratl.a,era q erpawl .,:r• , 06 Fee�'',r,tiz' cimtln with X '+_�n::�i p•.. P• .r:t +!i::t�'' ' I Oemce or&6&r foe.each 6 b1 3 Huawas norm e6s'fr ll6t c� citatull a ti7tic c�s (,�OaG�d tlartla ,6 �N hmi ftvk"nr tbeecr lee. Addleea• oost,bm ca ruit -4 s6 L4 _ Bulb mdd'1 attade 6b9 i rCily�9tlltr.21P; r 6 r2 d VLDL S-✓_ mceuaeeeua(m"ius or fmadmr the sada Ptaiw w Itt1 on didt $11-60-40 1.60 3 1y.laaiJ1 fOtd dreutt(a)ttrkrtitad- '� T: enmMCI,21021fon,or i extleai4n Dact:rlbc: Pap t 2 BwltNnrAm nelrfle: v .� h�'a,r ___ Addreai / J � � O� t4a 111 U said I en mvr� tte' awaNt is any of the above td [�V Trtncpnceiar. _ _.. 1_ iso *1WzV:C6 lnvµdjmdcr yet hour 0 rdwoi blso ! _ r rhos �SU� - Z�y�F>u I�C�J� _ t�tnduraial hour 73.15 gg Bltphical LIP.;��rj%7- ,s' �^9t 'I ic: subma flutxv,flacenoian at.�satutc,ttayuistxl; / �- E� fMet,evlevr tx 7'lrr or perKdt tile} Ott a►n, Gl v Date O y3tsua n+e6x;e(/1�mfpamit tt�e) AMbOAFAA*MAM ThE PrxwhIP0000on moire+It.yr ani,a est abtateea w1Ylu 1 C dopa attar t ha:peal w rated w wmvhto P Alt pRtY r �� Y1a1C se r--�' j e 1WrYede;ep r't r'Ir►Gwaq H J4dima I'd."L ..Floes w Nutelar or�peoltn:x per pernat aue..e. :V.1•fNrs•�u,,m,cr...y�.�a« �;�at •.a..a,nttowaKt►wwae CITY OF T IG A R D MASTER PERMIT PERMIT#: MST2003-00554 DEVELOPMENT SERVICES DATE ISSUED: 2/9/04 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639.4171 SITE ADDRESS: 06760 SW ALFRED ST PARCEL: 1S125DA-LP002 SUBDIVISION: LAWRENCE PART/MLP2003-0001(' ZONING: R-4.5 BLOCK: LOT: 002 JURISDICTION: 'I'IG REMARKS: New SF detached. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1921. of BASEMENT: of LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 904 of GARAGE: 935 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 Tuan of RIGH': 5 OCCUPANCY ORP: R3 BDRM: 4 BATH: 3 TOTAL: xVALUE: 287,136.90 ,625 sl REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WP SHING.MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHFRS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURE5: MECHANICAL FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 ;AS 'URN>-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: blu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 1 0 •200 amp: 0 -200 amp: W/SVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: r 201 - 400 amp: 201 - 400 amp: lot W/O SVCT DW SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY. 401 600 amp: 401 000 amp: FAADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 001 1000 amp. 601+amps•1000v: MINOR LABEL: 10004 amolvolt PLAN REVIEW SECTION Reconnect only: >-4 RES UNITS: SVCIFDR)--225 A.: >000 V NOMINAL.: CLS AREA/SPC OCC: ELECTRICAL•RF-STRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM INTERCOWPAGfNG: 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 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,424.18 ROBERT LAWRENCE OWNER This permit is subject t0 the regulations contained in the Tigard Municipal Code,Slate of OR. Specialty Codes and 15840 SW BOBWHITE all other applicable laws. All work will be done In BEAVERTON,OR 97007 accordance with approved plans. This permit will expire If work is not started within 180 days of Issuance,or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503-975-GSGO Phone. Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Rev a may obiain copies of these rules or direct questions to OUNC by calling(503)246.1987. REQUIRED INSPECTIONS Ersn Cntrl 681-4444 Post/Beam Mechanics Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Appr/Sdwlk Insp Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Rain drain Insp Electrical Final Footing Insp Crawl Drair+/Backwater, EleMrfcal Rough In Gas Line Insp Storm drain Insp Mechanical Final Foundation Insp PLM/Underfloor Fran ling Insp Gas Fireplace Water Line Insp Plumb Final Post/)16m Strucidl* Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final Issue Y : Permittee Signature :-v< Call (503) 639-4175 by 7:00 p.m.for an Inspection needed the next 1) iness day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00403 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/9/04 SITE ADDRESS; 06760 SW ALFRED ST PARCEL: 1 S125DA-LP002 SUBDIVISION: I.AWRFN( 1•. PART/N11.112003-00010 ZONING: R-4.5 BLOCK LOT: 002 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: I TPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF. Owner: FEES ROBERT LAWRENCE 15840 SW BOBWHITE Description Date Amount BEAVERTON, OR 97007 �,�V(ISAI Swr('onnect 2/9/04 $2,400.00 1, \t l ISA I Sw r C nuicct 2/9/04 $0.00 Phone: 501-975-09,0 1SWINS111S%„ Insl,ect 2/r J/04 $35.00 ISWINSP1 SN%r Insl)ect 2/9/04 $0.00 Contractor: — -- C Total $2,435.00 Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will bo forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm Issued by: ri Lr't ��r.� Permittee Signature: 1/,� motif��� Call (503) 6394175 by 7:00 P.M.for an inspection needed the nextbfisiness day -71 Bmildin r Permit A is ' ' ' - ON . V E D Received _ City Of Tigard Date/B / /9 OBJ GLK Pemul No-�:�s�/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review H p~s (� Other penult: � Phone 503.639.4171 Fax: 503.598.1wr i Cl 3 Date/By: Inspection Line: 503.639.4175 Date Ready/By: �7 ® See Attached Checklist lur Internet: www.ci.tigard.or.us CITY OF TIGARD Notifed/btethod: //tf Su, plemcnul lnlurmutiuu_ BUILDING DIVISION TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING Ncw construction ❑Demolition Permit fees'are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of ptl ❑Addition/alteration/replacement ❑Other: _ equipment,materials,labor,overhead,and the prof t for the work indicated on this application. CATEGORY OF CONSTRUCTION Valuation: u cr I-and 2-family dwelling ❑Commercial/industrial Number of bedrooms: ,I— Accessory building ❑Multi-family ❑ C]Other: Number of bathrooms: Master builder JOB SITE INFORMATION AND LOCATION total number of floors: Job site address: &76� SIA/ ,4 L F R�'7 5 T 2 E�'f"' New dwelling area; ;7 fA S square feet City/State/ZIP: 7-11-A M rp 012. Of 7 Z 2 3 ' Garage/carport area: �� square feel Suite/bldg./apt.no.: I Project name: Covered porch area: 20y square feet Cross street/directions to job site: s, t,•/, ~—=' G ItAi_a•ST' Deck area: Z y Z square feet rt I► t..F T F- t7 A r"V'M 6 x ,A (Suc k s 7'0 _ Other structure area: square feet 14 1►-t p 6,7-76 -$W A LG rL W p STT REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Ill hl 1--5i t w Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel nP o.: A2 4e_E� �rZ 2SSPWA"r equipment,materials,labor,overhead,and the profit for(lie DESCRIPTION OF 'WORK work indicated on this application Valuation: S Id l� y./ ,s, tt r—�.G F A rn t �ter- I--f a ^'� '�..r• Existing building area: square feet New building area: square feet PROPERTY OWNER i—� ❑ TENANT Number of stories: Name: !fie b c."f . L a'J I-C^ey Type of construction: Address: 15; 40 S,W. Bo b w h e, _ Occupancy groups: City/State.!ZIP: 8`.4.C e,To r Q r. Q-100 "7 _ Existing: Phone:(`703) q75- SC 0 Fax:(*I)41►O _,Q t'14— New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board Contact name: T7o b e H • Law e under URS 701 and may be required to be licensed in the Address: I S 4-0 s,VA w H i to G i rG L C-- jurisdiction in which work is being performed. If the — applicant is exempt from licensing,the following reasons City/State/ZIP: SeQL.�e, ror or . 87007 apply: _ Phone:(fo3) q 7 S►'l0 7 to 0 Fax: : E-mail: -- CONTRACTOR _ Business name: P PL t C A rl _ O vi hl to rz__ BUILDING PERMIT FEES* Address: Please refer to fee schedule. City/Stale/ZIP: Fees due upon application Phone:( ) iv Fax'( ) Amount received CCB tic.: Date received Authorized signature: /� _ �Z//9 O3 This permit application expires if a permit Is not obtained _ within 180 days atter it has been accepted as complete. Print name: Rp be r'r 1.1 : L a.�re r C.e.► Date: I-L—t"7—O tj • Fee methodo,ogy set by Tri-County Building Industry Service Board I�auildin&enyntMBUP•PermitAppdoc 12103 440•4613T(IIro2:COKWEB1 One- and Two-Family Dwelling Buildin>>? Permit Application Checklist F6R.0FF1.CE1ONLY City of Tigard p;e;dy' Permit Nu 13125 SW Hall Blvd.,Tigard,OR 97223 Associated pemnts Phone: 503.639.4171 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical Cl Phu 'Ing ❑ Mechanical Internet: www.ci.tigard or us ❑ Other I Land use actions completed. Sec unsdiction criteria fur concurrent reviews. 'F_ ri o�v RaCo(?r71 H 4, ❑ 2 Zoning. Flood plain,solar balance points,seismic soilsdesignation,historic district,etc 3 Verification of a roved plat/lot. _ __ ❑ 4 Fire district approval required. Name of district: ❑ 5 Septic sstem permit or authorization for remodel. Existing s stem capacity ❑ ❑ 6 Sewer permit. 7 Water district approval. t v ❑ _ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑- 9 Erosion control A 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 reviety cannot be completed if co ri ht 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;buildi,:,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,window size,location of smoke detectors,water heater, ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross sectlon(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. Li 15 Elevation views. Provide elevations for new construction;minimum of two elevations 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- ❑ rescri tivc 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. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beamijoist 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 a inlicable to the nroiect under review. 11 IRISDI(7110NAL SPECIFICS' 23 Five(5)site plans are required for Item I 1 above. Site plans must be 8-1/2"x I I"or I I"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"building plans will not be accepted. ❑ [.J 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. L1 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 tree protection measures as required by conditions 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\One-Two-FamilyChecklist.doc 12/03 Mechanical Permit A i" for ' _ -- _ Received Pemut No city of'rr and DatdBy: 1311.5 SW Hall Blvd.,Tigard,ORFR2h, , Plot Review Other Pernur. Phone: 503.639,4171 Fax: 503.598.1960 2��1� Date/73y- Inspection Line: 503.639.4175 Date ReadyiBy: lent ® Ser Page 2 for Inlerncl: www.ci.liSurd.or.us Notified/Melhod: Supplementallnformatinu I WORK COMMERCIAL FEE' SCHEDULE - USE CHECKLIST U Mechanical permit fees*are based on the value or the work ONew construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)or all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES- RESIDENTIAL I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklisi Multi-family ❑Master builder ❑Other: Description Qty Ea Total JOB SITE INFORMATION AND LOCATION Heating/cooling Air conditioning or heat pump Job site address: 7(�� S, IN . /A e-oclr?e 4 ST/IEE re uites site plau showing lacanleot) 14.00 City/state/ZIP: 7­%/../r/?C� /Er, 9 7 t Z ; Furnace 100,000 BTU( ducts,vei) / 14.00 Furnace 100,000+BTU;ductsveutsl 17.90 Suite/bldg./apt.no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: =� _ / o Gv f y' Duct work 14.00 _ H dronic licit waters stem 14.00 ev,4" p/:r/?a.X Z !g t cit L' Residential boiler(radiator or h dromic 14.00 V $.rF - r3��/��'� G 7 7o w• !��«��� ✓� Unit heaters(t'uel-type,not electric), in-well,in-duct,susoended,etc 10.00 Flue/vent for an oC above 10.00 Subdivision: ilii✓l-s yE w Lot no.: Other: 10.00 Tax map/parcel no.: p t,?e ry Owy t 3'ee-le /v Other fuel appliances DESCRIPTION OF WORK Water heater 1 10.00 Gas fireplace 1 10.00 Flue vent for water heater or gas fireplace 1 10.00 Lo liv►;er as 10.00 Wood/ eller stove 10.00 Wood fireplace/insert _ 10.00 Chinuie ilmer/flue vent 10.00 PROPERTY OWNER ❑ TENANT Other: T26r.14 oLors e r 1 10.00 Name: /�6s�� ,�, �,r,✓rl�G G Environmental exhaust and ventilation Range hood/other kitchen Address: �� e/,� „Sli,/ ����w�•!"�- Ci•e% equipment i0.o0 City/State/ZIP: Clothes dryer exhaust 1 10.00 Single-duct exhaust(bathrooms, Phone: Fax:( ) toilet compartments,utility rooms) 6.80 JK APPLICANT ❑ CONTACT PERSON Attic/crawls ace fans 10.00 Other_: 10.00 Business name: //009 __ Fuel piping _ Contact name: jf`/moi,:I-- /0V w.-055.40 for Iirst four;$1.00 for each additional Furnace,etc. f Address: .vim A,B Gas heat punip City/Slate/Z[P. --�--- ✓ Wall/suspended/unit heater Water heater 1 Phone:( ) ✓ Fax :( ) Fireplace 1 E-mail: Range G•r�fTei� I _ CONTRACTOR Barbecue _ Clothes dryer(gas) _ Business name: 7—i_AV!— Other: Address: p�G'"L's 'i��'- moi'`' MECHANICAL PERMIT FEES* Subtotal city/State/ZIP: 6?j,e e-ori' �i 7 �`. ✓'�/�, 7G��j ` Minimum permit fee($72.50) Phone: C/7 F Fax:( ) Plan review(2510 of permit fee) _ CCB tic.: / /7�I i�fi�O -=I /O�j'.J State surcharge(8P6 of permit tee) TOTAL PERMIT FEE This permit application expires If a permit Is not obtained within 190 Authorized signature: days after It has been accepted as complete. Date: Fee methodology set by Tri-County Building Industry Service Board Print name: i`8uildint\Permiu\MEC•Per"*App doc 12'03 440•4617T(I 1!02'C0M/WE9) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to$2,000.00 Minimum fee$72.50 $2,001.00 to$5,000.00 $72.50 for the r.st$2,000.00 and$2.30 for each additional$100.00 or fractiot, thereof,to and including$5,000.00. $5,001.00 to$10,000.00 $141 Su for the first$5,000.00 and $1.80 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,001.00 to$50,000.00 $231.0 � r the first$10,000.00 and $1.35 for each addi cional$I00.00 or fraction thereof,to and including $50,000.00. $50,001.00 to$100,000,00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or traction thereof,to at.d including $100,000.00. $100,000.01 and up $1,396.50 for the first$100,000.00 and $1.10 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC-PermitApp.doc 12103 2 NLY Electrical Perm ' FOR OFFICE USE ' ' City of'Tigard Received Permit No. ��11� ` iJ 7663 13125 SW Holl Blvd.,Tigard,OR 9 pu Plan Review Other Permit Phone: 503.639.4171 Fax: 503.5`99`�94Q� Date/By: 1�(( VVF T�GAa� Date Ready/By lura 0 See Tate 2 for Inspection Line: 503.639.4175 Supplemental Infurmunnu Internet. www.ci.tigard.or.us BUILDING'DIVISION Notifted/Method: TYPE OF WORK _ PLAN REVIEW Please ch:,A all that apply: New constriction ❑Addition/alteration/replacement []Service over 225 amps,comm'l ❑Hazardous location ❑D^molition ❑Other: ❑Service over 320 amps-rating ❑Bwldng over 10,000 sq it.. CATEGORY OF CONSTRUCTION of l-and 2-family dwellings 4 or more new residential ❑System over 600 volts nominal units in one structure I-and 7--iumily dwelling ❑Commercial/industrial ❑Accessary building ❑Building over three stories ❑Feeders,400 amps or more ❑Multi-family ❑Master builder ❑Other: []Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighRV parkting plan ❑Other: [)Health-care facility — Job no.: — Job site address (o7(v4 •S k/ �L/''�'f0 ST/E�G Submit 2 sets of plans with any of the above. : Cit /State/ZIPThe above are not applicable to temporary construction service. City/State/ZIP: �'�_ye /j /?'' 7Z Z 3 FEE' SCHEDULE Suite/bldg./apt.no.: .- Project name: — Des.riptlon Qtr. Fee. Tot°I ` Z--,o U/rsyr► New residential single•or multi-family dwelling unit. Cross street/directiotts to job site: ,w, G 2 d — Includes uttached garage. �-� 1,000 sq.ft.or less 145.15 4 f�li«s T� S Ea.add')500 sq.ft.or portion 33.40 1 Subdivision: e!,i.e-J ,��,/ Lot no.: Limited energy,residential 75.00 2 Tax map/parcel no.:�A'A'��L E/�LAT LP'ZW,; t�l. bD Limited energy,rlon-residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling,service and/or feeder 90.90 1_ ly�,eAIWAZ• Services or feeders Installation,alteration,and/or relocation 200 amps or less 80.30 2 201 amps to 400 amp: 106.85 2 PROPERTY OWNER _❑ TENANT 401 amps to 600 amps 2 601 ams to 1,000 ams 240.60 2 Name: /7,04"r­ /�, L< :✓��reG C� p P Over 1,000 amps or volts 454.65 Address: /S0 yp Lr/ , yL./��rG /�'�C Reconnect only 66.85 2 City/State/ZIP: el!/ll�'Lt�y i" 7 7 Temporary services or feeders Installation,alteration,and/or relocation Phone:( ;.,,N 971;-4 �li0 Fax:(ajO ) A/_W—.,?/ 7 200 amps or less 66.85 1 201 ams to 400 amps 2 Owner Iastallatlon:This installation is being made on property that I own which isnot p 100.30 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel APPLICANT ❑ CONTACT PERSON A,Fee for branch circuits ch service or feeder fee,each 6.65 Z Business name: 11,4 branch circuit — B.Fee for branch circuits Contact name: /?G`�, //.��pr/i��'t each without service or feeder fee, 46.85 2 each branch circuit Address: $pv� _ _ Each add'I branch circuit 6.65 Z City/State/ZIP: Miscellaneous(service or feeder not included) '� Pump or irrigation circle 53.40 2 Phone:1 ) Fax: : ( ) Sign or outline lighting 53.40 2 E-mail: _ Signal circuit(s)or limited- CONTRACTOR energy panel,alteration,or extension.Describe Page 2 2 Business name: f,r'�r.,E" `/!'l o':' Each additional Inspection over allowable In any of the above Address: i,2'✓ '?e 7 S Per inspection 62 50 Cit /State/ZIP: t' Investigation per hour(I hr nun) 62.50 y /��!tSdo,eo I� Industrial plant per flour 73 75 Phone:( �3) cCj %el C,-/ Fax:( ) ELECTRICAL PERMIT F,13* CCP I 3 .O 7 Electrical Lic.: i1-//9e, Suprv. Lic... j F Subtotal Plan review(25%of permit fee) Suprv.Electrician signature,required: State surcharge(B°/�oCpermit fee) Print name: 9,4 vim �;'O:%� Date: TOTAL PERMIT FEE Authorized signature: This permit application expires If n permit Is not obtained within 190 _ days after It has been accepted a complete Date: Fee methodology set by Tri-County Building Indusiry Sen ice 3oard Print name: ••Number of mspectioro per pemtit allowed. i(Building'Permits�ELC-PermhApp doc 12101 440-461 n(101021C0M/wE9 a Electrical Permit Application - City of Tigard Page 2 -Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: �Fee for all residential systems combined........ $75.00 Check Type of Work Involved: .Audio and Stereo Systems* ❑ Burglar Alarm Garage Door Opener" Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* D9 Other: COINIMERCUL WORK ONLY: _ Fee for each commercial system....................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other_ Total number of commercial systems: *No lice;.ses are required. Licenses are required for all other installations i�Buddin{`8emmu\ELt•Pem+hApq doe 0"3 I'lumbinj! Permit A M6"'n City of Tigard � r� DeceivReceived Penin No � 0 r �i 2��3 kyr s -mss 13135 SW Hall Blvd.,Tigard,OR 97223 Ulyl Plan Review Phone 503.639.4171 Fax: 503.595.1960 Date/By:: Udmr Penna No.: 24-Hour Inspection Linc: 50).639.4175CITY U� >IGAR I„I,I 0 see Pae t for P Date Ready By: & Internet: www.ci.tigard.or.us i�t;ING D)VI Notified/MelhOd' Supplemental Information TYPE OF WORK FEE" SCHEDULE New construction ❑Demolition For special in orvuatlon use checklist. Description I Qty. I Ea I Totul ❑Addition/alteration/replocement ❑Other: New I-3-family dwellings(includes 100 A for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 I(1-and 2-family dwelling ❑Commercial industrial SFR(2)bath 350.00 ❑Accessory building ❑Multi-family SFR(3)bath vi. 1 399.00 Each additional baih/kitchen 45.00 ❑Master builder Other: Fire sprinkler(__sq.It Page 2 JOB SITE INFORMATION AND LOCATION_ Site utilities Job site address: G) S, 1A, A L Fi2-- p ,$T20r 7— Catch basin or area drain ( 16.60 City/State/Z[P: -j-'j L-A ra ip cp R 7 Z Z 3 Drywell,leach line,or trench drain 16.60 Suite/bldg./apt.no.: - Project name: - Footing drain(no linear R.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions tojob site: S- u� U Z "' - e-& x^,o a s-T Manholes 16.60 O N A 4 tF M e:.-'-0 v rs n.u x, �. ?� e,.--I e j T-v Rain drain connector ( 16.60 r,T� " 316 N r•t 7 G 7 n S �A/ A t-F"Z AFw CP Sanitary sewer(no.linear R.•2ILCf 1 Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: Lot no.: d/(y Water service(no.linear fl.: Gp �� Page 2 1�c rl�'!' c�a � Fixture or Item Tax map/parcel no.: pA rZ G ` Z R vc.A r yi.t P Y pG aa0 10 Absorption)alve 1660 DESCRIPTION OF WORK _ iiackflow prevente GttAwl, ALAI ( Page 2 6 W 5 t ra v L E #-'- A KA14Y 1-4 o P- Backwater valve ( 16.60 Clothes washer 1 16.60 Dishwasher f 16.60 Drinking fountain 16.60 jj�PROPERTY OWNER _ ❑ TENANT Ejectars/sump 16.60 Name: -0e, b e,T H - L Gc 6' ♦ e I^a- dL"' Expansion tank 16.60 Address: 1 S c-1 Cj :a,trJ- 6ea L 16--11^ tt'C.. rC 1 tom. Fixture/sewer cap 16.60 ty G 11". ' e3 - Floor drain/floor sink/hub 16.60 Ci /StatdZlP: — Fax: t-�y Garbage disposal I 16.60 Phone:(5a;) Cy 7 S- 6 7G V � ) !;O " Hose bib Z, 16.60 APPLICANT ❑ CONTACT PERSON 16.60 Ice maker f Business name: N A Interceptor/grease trap 16.60 Contact name: TZ G y e .T 14 . L at w e "v 4­0 Medical gas(value:S ) Page 2 Address: Primer 16.60 City/State/ZIP: r Roof drain(commercial) 16.60 Sink/basin/lavatory rj 16.60 Phone: Fax: ( ) ( ) Tub/shower/shower pan $ 16.60 E-mail: Urinal 16.60 CONTRACTOR Water closet 3 1660 Business name: v/yi!_ i���� Water heater 16.60 Address: l t/✓ S.yr j old �Jv /"' Other: Subtotal City/State/ZIP: Ilex"Aad ogee �j,+i<, /,•� Minimum permit fee $72.50 Phone.(5M 3) e.yQ-,? 3-// Fax:( ) Residential backflow minimum permit fee 536.25 CCB Lic.: / 9 90 7 Plumbing Lic.no.: 3y e/yP� i- an review (25%of permit fee) ♦y�E 3v��T.P, State surcharge(8%ofpermit fee) Authorized signature: TOTAL PERMIT tEE This permit application expires Ira permit Is not obtained within Print name: 1-2!L 190 days after It has been accepted as complete. 'O le "Fee methodology set by Tri-County Building Industry Service Board I\tluildinjTemouVLM•Pem+itAppdoc 12103 ���' f/.�O 4404616T00/02/CONMFEn Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty' Fee(ea) Total Square Footage: I Permit Fee: Footing drain-I"100' 55.00 0 to 2,000 S 115 00 Footing drain-each additional 100' 46.40 2,001 to 3,600 5160.00 3,601 to 7,200 5220.00 Sewer-I st 100' / 55.00 7,201 and greater $309.00 Sewer-each additional 100' / 46.40 Water Service-Ist 100' / 55.00 Medical Gas Systems: Water Service-each additional 100' i 46.40 Valuation: Permit Fee: Storm&Rain Drain-Ist 100' / 55.00 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' / 46.40 55,001.00 to 510,000.00 572.50 for the first 55,000.00 and 51.52 for each Fixture or Item Qty. Fee(ea) Total additional 5100.00 or fraction thereof,to and including 510,000 00 Commercial Back Flow Prevention Device 46.40 $10,001.00 to 525,000.00 5148.50 for the first 510,000.00 and 51,54 for Residential Backflow Prevention Device each additional 5100.00 or fraction thereof',to minimum permit fee$36.25) 27.55 and including$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to 550,000.00 5379.50 for the first 525,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and including 550,000.00. specially requested ius ections-per hour 72.50 550,001 00 and up 5742.00 for the first$50,000 00 and SI 20 I'or Subtotal: each additional 5100.00 or:,action thereul'. Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",please Indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity b Fixture Work Performed Fixture Type: Replace New Moved Existing Capped Comments regarding fixture work: Ba tis /Font Bath -Tub/Shower -Jecuui/Whirl ool Car Wash -Each Stall -Drive Thru _ Cuspidor/Water Aspirator — Dishwasher -Commercial _ -Domestic Drinking Fountain Eye Wash — Floor Drain/sink .2" 3" _ 4" Car Wash Drain Garbage -Domestic Disposal -Commercial *dote: If the fixture work tinder this permit results in an -Industrial — increase of sewer EDtls,a sewer permit will be issued and Ice Mach./Refri .Drains — fees assessed for the sewer increase must be paid before the Oil Separator(Gas Station) Rec.vehicle Dum Station plumbing permit can be issued. Shower -Gang -Stall Sink -Bar/Lavatory _ Quatltity Total -Bradley Isometric or riser diagram is required if fixture quantich -Commercial — total is>9. -Service S%kimming Pool Filter Washer-Clothes Water Extractor __ Plan Review WaterCloset-Toilet _ Plan review is required if fixture quantity total is>9. Urinal Other Fixtures: ,Vtu0dtng1ernulWPLM-PemnApp doc 3 01 SEE 35MM ROLL# 22 FOR LARGE DOCUMENT CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IM1DORTANT PERMIT NOTICE G & B PLUMBING PO BOX 1269 HILLSBORO, OR 97123-1269 Plumbing Signature Form Permit #: MST2003-00554 Date Issued: 2/9/04 Parcel: 1 S125DA-LP002 Site Address: 06760 SW ALFRED ST Subdivision: LAWRENCE PART/MLP2003-00010 Block: Lot: 002 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached. 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 i�om 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: ROBERT LAWRENCE G & B PLUMBING 15840 SW BOBWHITE PO BOX 1269 BEAVERTON, OR 97007 HILLSBORO, OR 97123-1269 Phone #: 503-975-6560 Phone #: 503-640-2311 Reg #: MET00007.017 LIC 19907 PLM 34-44PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature of Authorized Plumber If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD. OR 97222 IMPORTANT PERMIT NOTICE DAVID JEROME ELECTRIC PO BOX 751 HILLSBORO, OR 97123 Electrical Signature Form Permit #: MST2003-00554 Date Issued: 219104 Parcel. 1 S125DA-LP002 Site Address: 06760 SW ALFRED S,r Subdivision: LAWRENCE PARTIMLP2003-00010 Block. Lot: 002 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the P Y electrical permit to be valid, the signature ,;f 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: ROBERT LAWRENCE DAVID JEROME ELECTRIC 15840 SW BOBWHITE PO BOX 751 BEAVERTON, OR 97007 HILLSBORO, OR 9712.3 Phone #: 503-975-6560 Phone #: 648-5'144 .1 Reg #: LIC .,. o"'k� SUP 2877~ F L F 34-1190 AN INK SIGNATURE IS REQUIRED ON TI4IS FORM Signature of Sup wising Electrician It you have any questions, please call 503.718.2433. i A CITY OF TIGARD MECHANICAL PERMIT nC\ICI r1DNJl='AIT QERVl�`FC PERMIT#: MEC2004-00481 AVAIAv�.. v ....�..+� . �. • •+ -- • • �--- DATE ISSUED: 7/21.12004 13125 SW Hall Blvd., Tiyard, OR 97223 (503) 639-4171 PARCEL: 1S125DA-12100 SITE ADDRESS: 06760 SW ALFRED ST SUBDIVISION: LAWRENCE PARTITION ZONING: R-4.5 BLOCK: LOT. 0W JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS _ HOODS: FUEL TYPES 0 3 HP: 1 — DOMES. INCIN: �_ Fl_F — –A 3 - 15 HF : COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITSOTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: :fit install Owner: _ �-- _ —_^- FEES --_ ROBERT LAWRENCE Description Date Amount 15840 SW BOBWHITE IMEC'III Permit Eee 7/21/200., $72.50 BEAVERTON, OR 97007 I'AN] x State Surchart 7/21/2002 $5.80 Total $78.30 Phone: 503-975-6560 — Contractor: OWNER REQUIRED INSPECTIONS Cooling Unt Insp Phone: Final Inspection Reg #: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6599. 1,,,, Issued By;y ... _ L Permittee Signature: --------- Call (503) 6394175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application FOR OFFICE USEONLY City Of F 1 and Received y Date,By: 31 PemrtNu �O(J'�' / 13125 SW I{all It c,l,'Tigard,OR 97223 Plan Revie 7�wv Phone 503.639.4171 Fax: 503.598.1960 TL�?*du Date/By: Other permit: Inspection Line: 503.639.4175 Date Rady/By: I m ® Seg Page 2 to, Intemer www.ri.tlgard.or.ua Notifei/Mettrod. _^ I Supple rental Informati m TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USECIIECKLIST Mechanical permit fees•are based on the value of the work New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the newest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhea i,and profit CATEGORY OF CONSTRUCTION Value:S 4" -- ------ RESIDENTIAL EQUIPMENT/SYSTV IS FEES* l-and 2-family dwelling ❑Commercial,industrial ❑Accessory building -For special information use cheirVist ❑ Mula-family ❑ Master builder ❑Other' Description Qty __F_­a­7 Total dOB,SITE INFORMATION AND LOCATION Heating/cooling � ,'� Air conditioning or heat pump Job site address: , 7��G Lv /�C ��f> sir re uires site plan showing placement) XOO City/State/ZLP: ��ir/� -� ,� Furnace 100,000 BTU ducwvents -- Furnace 100,000+BTU ciucts/vents) Swtebldg./apt.no.: Project name: �/<<, / <<i>sT• _ Gas heat u Cross street/directions to job site: &� -7 --,Zq Ni I ��•i, Duct work H dronic hot waters stem 14.00 Residential boiler(radiator or h dronic) 14.00 1 Unit heaters(fuel-tyre,not electric), in-wall,in-duct,suspended,etc. 1000 Subdivision: _ I L.ot no_ Flue/vent for an of above 10.00 ,i•f a� C 1>>(i Other. 10.00 :/1�eTax map/parcel no.: aY ,�* Jther fuel appliances DESCRIPTION OF WORK .Vater heater 10.00 Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 LOA lighter as 1000 1 J'�����• �_ �" n c s>? 3 e y Wood/pellet stove 10.00 Wood fireplace/insert 1000 F------ Chirnne /liner/tlue/vent 10.00 -� __,­-=M_PROPERTY OWNFR, CI TENANT Other I 1000 Name Environmental exhaust and ventilation _ -- Range hood/other kitchen Address: G�� C- .S6c/ ,� C i /r 4 equipment 10.00 City/State/ZIP: _7117 G-�H C / ,G Clothes dryer exhaust 10.00 — Single-duct exhaust(bathrooms, Phone:(AIq'y) L/ %d. C.) Far:{ ) toilet compartments,utility rooms 680 --_ APPLICANT„ — - Atnc/crowis ace fans 10.00 :CONTACT PERSON _ Other: 10.00 Business name: _--_- - --___---- Fuel pIpInK Contact name: �- $5.40 for first four;$1.00 for each additional Address: Furnace,etc. - -- Gas heat pump City'State/ZIP: Wall/sus endediunit heater Phone:( ) - - -- — Fax: :( ) Water heater ---- --- -- — Fireplace E-mail: Range k'— -- CON'T1 to TOR M Barbecue Clothes d Business name: 3 tx ate_____ ~_ - -- ---- - - Other _ Address: MECf1 i_C4L PERMIT FEES* City/State/ZIP: Subtotal oe Phone:( ) Fax:( ) - - _, Minimum permit fee($72 50) 717-. 570 Flan review(25110 of permit t-•.) CCB hc.: _ State surchcrge(Bolo of permit fee) _ TOI 4L PERMIT FEE Authorized signature: This permit Applicata--expires if a permit Is not obtained within ISO days after It has be,n accepted as complete. Pnnt name: j T w�is,e�•- Date: z, r Fee methodology set by Tri-County Building Industry Service Board i12udihn#TemuU$MC-P d« 1210r 440-4617T(IP02X0NCWE9) Mechanical Permit Application - City of Tigard Pale 2 - Supplemental Information _Commercial Fee Schedule: _ $1.00 to$2,000.00 _ Minimum fee$72.50 $2,001,00 to$5,000..0 $72.50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction thereof,to and including$5,000.00. $5,001.00 to$10,000.00 M41.50 for the fust$5,000.00 and $1.80 for each additional$100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and $1.35 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $1,396.50 for the first$100,000.00 and $1.10 for each additional$100.00 or fraction thereof. Note: ;VI new commercial ImildinP� require 2 sets of plans. i 13ut1d)ngTemuts'\IvIEC-PemntApp doc 12/03 2 r 0 Al G 0 � v o v v UW .., u b 'L7 A. II •rte Q 0 � �I '*I- r p o vN a O A o° CITY OF TIGARD 24-Hour _Ll BUIL'OING Inspection Line: (5004&'175 MST �� INSPECTION DIVISION Business Line: (5 )/ SUP Received y�2 �___Date Requested � AM PM BUP _ Location W, S T Suite MEC Contact Person Ph( �'� j 7`�� �? `> d PLM Contractor_ — __ Pn( ) SWR BUILDING Tenant/Owner . T ELC Footing :fT C Foundation ACC � . , / F:g Drain vV , RCrawl Drainslab In action NoteAt T Post✓3<Beam _ Shear Anchor - Ext Sheath/ ear Int Sheath/ ear Framing ---- �� - - Insulatio Drywall fling --- Firewall Fire SprAlarm er �'�Z ` — Fire Alarm V� �� �„� Susp'd Ceiling Roof Other: ---- - -- - --- -- I 240- /PASS.) PART FAIL --- Post&Beam Under Slab Me Rough-In Water Service - — — — Sanitary Sewer Rain Drains — Catch Basin/Manhole Storm Drain Shower Pan Other: --� Final PASS PART FAIL MECHANICAL Post$Beam Rough-In -- - Gas Line SDampers — inaLIA AS PART FAIL KEECII RICAL Se ice Rou In L ow VOM Isla ---- -- -- --- Fi� rm P 33 PART FAIL ❑ Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. E 0 Please call for reinspection RE: _ _ [] Unable to inspect-no access Fire Supply Line A � ADA Date Approach/Sidewalk —� Inspector Other: Final - DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY SOF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST 0o3 '�G INSPECTION DIVISION Business Line: (503)639-4171 BUP Received — -- _ Date Requested AM PM BUP Location __— --Suite MEC Contact Person __ Ph(—) L' PLM Contractor _—_— Ph( ) SWR — BUILDING Tenant/Owner __— — ELC Footing ELC Foundation Access: � Ftg Drain ,�� U V L }-(�(� � ELR — Crawl Drain (J /� 4 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 PLd1MBINC3 — —__—_-- __-- Post& Beam Under Slab -- -- — -------- Rough-In Water Service -- --- -- --- Sanitary Sewer r`-iin Drains — — ------- �- Catch Basin/Manhole Storm Drain -- -- _-- - - — Shower Pan Other: — -- —' Final 2HIANICAL PART FAIL -.---- Post& Beam Rough-Iii ---- ------- - Gas Line Smoke Dampers -- ------- — Final PASS PART FAIL - --- — ELECTRICAL Service — Rough-In — IG/Slab Low Voltage -__--- _ Fire Alarm Final F] Reinspection fee of s_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _ PASS PART FAIL SITE [� Please c II for reinspection RE:--.— Unable to inspect-no access Fire Supply Line r7l / r� ADA Data �� __---- Inspector.)_ Ext-- Approach/Sidewalk T -- Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL I CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 -7 8UP Received 7 Date Requested r ` ��_.. AM PM_ 8UP Location _____� -L— U I � Z _Suite MEC Contact Person _ Ph(___) PLM Contractor_ _ _ Ph(__—) 1" �( g SWR _ BUILDING TenanVOwner ELC _ Footing ELC FoundationACCs&ti: X_ Ftg Drain �� �� YYI��J ^ !3 L, ELR Crawl Drain Slab Inspection Notes: T 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: 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 Fi term AS PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Si _ — Please call for reinspection RE:_ Unable to inspect--no access Fire Supply Line ADA n(rNA Apptoach/Sidewalk Date_ _ l _._ Inspector._ 'v Le Ext Other: Findl DO I REMOVE this Inspection re ord from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639 ; �i-a3 , s INSPECTION DIVISION Business Llfie: (503) BUP Received ��_� Date Requested �j�� — AM- — M BUP Location E-'D _5j_ Suite __ �fa Contact Person ,.� Ph 1- ) 9 -S' � b� PLM Cont-nctor_ , 111 ) -_ SWR n _ BUILDING Tenant/Owner ELC Gv� Footing - ELC Foundation Access: ELR Ftg Grain Crawl Dram -------- SIT Slab Inspection Notes: 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 - ��� �� f•�� �� Q1 _�. PLUMBING Post&Beam Under Slab -— - — F lough-In Water Serv:ce - ---- Sanitary Sewer Rain Drains - "- Catch Basin/Manhole --- Storm Drain Shover Pan --- - Other:-_-- -- -- -- - Final - PASS PART FAIL MECHANICAL - ---- ----- - - ---"- - Post&Beam —_ -- Rcugh-In 44- Gas!ine Smoke Dampers -------#FinPART FAILRICAL Rough-In __-- —-- - -- UG/Slab Low Voltage - -- - ------ Fire Alarm Final L7 Reinspection foe of$--- -required before next inspection. Pay at City Hall, 13125 SV%!Hall Blvd. PASS PART IML SITE F-1Pleasecall for reinspection RE:-_------ Unable to inspect no access Fire Supply line_ ADA Date-��v-1" �S Inspector- _._ Zx Approach/Sidewalk -- Other: Final DO NOT REMOVE this Inspection record from the fob site. PASS PART FAIL CITY OF TIGAR© 24-Hour BUILDING Inspection Line: (503)639-4175 c INSPECTION DIVISION Business Line: (503) 639-4171 LJ BLIP �— Received7 - Date R�yues/ i -_ AM - PM - BUP Location -__L� �� /�-- Suite MEC Contact Person _ - Ph( )�7S 0 PLM Contractor _ Ph(_.`) _ SWR - BUILDING Tenant/Owner _ -_--- - - Footing ELC Foundation Ftg Drain Access: / ti, , ) E,� 3 Crawl Drain L--�7 V�J Slab msDection Notes: SIT (at--.J.- - —_ Post&Beam ,-_._. Shear Anchors �C- s LyA i L, - 7'^ Ext Sheath/Shear Int Sheath/Shear Framing - --- - Insulation Drywall Nailing - - - -- Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling ----� Roof Other:--- - j -T-- Final PASS PART FAIL �pC PLUMBING Post&Beam Under Slab ------ -- - - ----- -- — Rough-In Water Service ---- - - - - - Sanitary Sewer Rain Drains - ----- -- - -V Catch Basin/Manhole Storm Drain -- - _— `- Shower Pan Other:- -- ---- _ - - Final PASS PART FAIL MECHANICAL - Po3'& Beam Rough-In Gas Line Smoke Dampers ---- --- - - -� Firal PASS ART FAIL_ - ---- � - -- AL _ Pough-In - UG/SI wV ' - Fir arm al � Reinspection tee of$__ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PAS PART FAIL _SIT_ �� Please call for re'nspertion RF:- - _ Unable to inspect-no access Fire Supply Line ADA * 1 Approach/Sidewalk Dat* r 0 - Inspectot ----- Other: Final ! IYO NOT REMOVE this Inspection cord from the job site. PASS PART FAIL. J