15795 15805 15815 15825 15835 SW GREENS WAY ' 1
o V ' Ln
n 3 y CO W
E cn X
0 rri
0 rn
»lcn
Ilk-
3::-
,3-<
t L � � war oLl
sI
co
LI
N � �j � cjrCpd ai, iC' y �1M ?
Ln
(a c ,G J
7 h;
'I ► t c vl N
W
to t rJ 1
v
y W
Lp
y� 0 LQ fidy
tj
'C < Tj) � � 3
r4.
Ni LI) O
1
i
i
15795, 15805, 15815, 15825, & 15'35
SW GREENS V44Y
v �
IA
Ell
OLo
ti (�}+J
t7 G)
lFY�
(J
Lo-
,U ,
l_l
�, � til _ -�� , •
1� P� •, 1 � l,,
11
�1
15795, 15805, 15615, 15825, F 15'-,35
---SW GRE 'NS WAY �-
CITY OF TIGARD BUI!_DI14G INSPECTION DIVISION
Ai!ST
24-1-lour Inspection Line: 633-4175 Business ,_ine: 639-4171 � � ---
' •��rJ 3
Date RegUested AM PM _ BLD
Location ! ��� j) 5�� C..i�.�; k. � ��aFc/t)J « " /Suite MEC -
Contact Person �C,� G L7r d� Ph C 3S" - PLM _ —
Contractor Ph 13WR — —
BUILDING -- Tenant/Owner ELC
Retaining Wal! ELR
Footing Access �y�y�1y..f -��
Foundation � �j tJ e FPS
Ftg Drain SGN
/ Crawl Drain Inspection Notes: —
Slab SIT
ost 6 Beam - —
Fxt SheathiSheai
Irt Sheath/Shear � —
Framing1 -
Insulation I l
Drywall Nailing ��— - - -- -
Firewall
Fire Sprinkler
Fire Alarm 1 J _ n r•
d Ceiling - ` �u Q` = -- '�'�`— rill' -------_--_- _—
'Hoo
Ind y
58PART FAIL I ------------ -- - - ------ ----- -
,PL_VWING w~
Post& Beam - _
Under Slat,
Top Out ---- t
Water Service _
Sanitary Sewer
Rain Drains _ -
- - - �
Final - -
PASS PART FAIL
ME,;IiANICAL
Pnst& Rpant
Rough In
Gas Line -- - - -' ----- --- -- --
Smoke Dampers
Final - -- - -- -PASS PART FAIL
ELECTRICAL ---`-`---- ---- _ -
Service —�
Plough In - -- -----------------
U(3/Slab
Low Voltage
Fire Alarm
Final _
PASS PART FAIL
SITE
l3ackfilUGrading - — - --- -- --- ---'� -- -'
Sanitary Sewer
Sturm Drain [ j Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ j Please call for reinspection RE: [ ] Unable to inspect-no access
Fire Supply Line
ADA
1pprSidewalk �V 5
then,- � Date —!14.46 U_ _ Inspector Ext
_. •� Y
Final —
PASS PART FAIL DO NOT REMOVE this inspection record from the ;A site.
CITY OF �'IGARD -- BUILDING PERMIT
PEKMIT#: BUP2000-00203
DEVELOPMENT SERVICES DATE ISSdED: 05/31/2U00
--4 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S111CC-07600
SITE ADDRESS: 15835 3W GREENS WAY
SUBDIVISION: SUMMERFIELD NO.2 ZONING: R-12
BLOCK: LOT: 10:3 JURISDICTION: TIG
REISSUE: _ _FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: �YW: �—
TYPE OF USE: MF SECOND: sf PROJECT OPENINGS?__ _
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUFANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
03MT?: MEZZ?- _ RECID SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: rRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDIZMS: LATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: N A
Remarks: Re-roof existing 5-Flex.
Owner: Contractor:
KRETZ-INGER, LOPEN W + RUTH C PACIFIC WEST CONSTRUCTION INC
15835 SW GREENS WAY PACIFIC WEST ROOFING
TIGARD, OR x1224 PO BOX III
Phone: LhE OSVone: d.JFG&�OWF 97034
Reg #: LIC 54111
FEES _ REQUIRED INSPE-,TIONS
-Type By Hate —Amount Receipt Final Inspection
PRMT GEO 05/31/2000 $:10.00 0002567
5PCT GEO 05/31/200C $8.80 0002567 ORIGWAL
--- !^ Total $118.80 ----
This permit is issued subject to the regulations contained in the Tigard Munich.! Code, State of OR. Spenalty Codes
and all other applicable law. All work 0", ire done in accordance approved plans. This permh will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTIGN. Uregoo. Ii-.
requires you to follow the rules adoited by the Oregon UMili;y Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling 1503) 2.46-1987.
Pe nn itee
Signature: 'rte
Issued By:
/Call 639-4175 by 7 p.m. for ai. inspection the next business day
Cl TV OF TIGARD Plan Check
13125 SW HALL BLVD Rec'd By.
TIGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date Rec'd:u_
V- 503-639-4171 X304 Date to PE:
F-503-598-1960 Date Permit DST: �3
Permit#����-oG�
Incomplete or illegible applications will not be aa:epted Called:
Name of Developmt%it/Business STEP,2. .NEW ROOFING ASSEMBLY
<, iM,,7 Cmt F t E�dJ _ Material Docurnentatlon UBC Appendix 1C)' y_
Street Address Ste a Please fill out applicable section and attach copy of roofing
Job Site 156!,5 «G^15 "ek-I specifications.
Blrig# City/State Zip Listed Assembl r� Acle 3Cu�Ie�a A,B or CL__
Name 11. Specification#:
B2140 J<r2✓r 5
Applicant Mailing Address _ 2 Manufacturer
?_U. &X ytiy
City/State Zip Phone "3a UL Classifiration:_____ __
LA" e.5 J4. a'10>N 05-2ti0
Roofing Name Listed UL Building Materials Directory Page#:
Contractor17f►'iCrC-. 0Et'7 g!:4 ra (OR)
(Prior to issuance Mailing 4ddress "3b Warnock Hersey :
applicant must O. 051K 91L4Ll
provide a copy of City/State Zip Listed Warnock Hersey Pirectory Page#
all contractor tAiX Www,,;. (A- qZ;�N 1%3y *COPY OF ASSEMBLY REQljIRED
licenses if Ph 1 Fax#
expired in COT V5- 9n 01 -ZZ 141 B. ICBO Research*
database) State Conslr Contr.Board# Exp Data
59I11 e,-(tf (7b DATED
BUILDING INFORMATION C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
Building-Type Of Use. (circle one) (rpvipw regUlred by plans PYaminpr)
SF SFA COM
Building- Type of Construction VALUATION OF PROJECT $
5 - ?I..EX \dnO) 9"TK_UL---TU LLE- --- sq ft _ of roof area _ --
Existing Deck Type: , Permit foe based on valuation"
Combustible (✓f Non-Combustible ( ) " see Chart on back $ —
RESIDENTIAL ONLY-Class of tMork:Alteration - City use only: WACO:
U RE=PAIR (MAJOR)(review required by plans examiner) (QUILD) (UBUILD) �_ u
Permit required ONLY when spaced sheathing is covered by
solid sheathing. Changes to roof line require Building Permit 0% State Surcharge
Applicatinn City use only: WACO'
SUBMIT TWOL2) SETS OF PLANS SPCCIFYING. (TAX) (-UTAX)
A. Roof area&nearest street. 'Required for major repairs of
Residential
H Attic vents-Provide 1 sq ft for each 150 sq. ft of attic or"C" above ' 65% Plan Relview
space. Vents shall be located in the upper 1/3 of the roof. City use only- Co.WA
Provide 1 sq ft.for each 300 sq ft when eave&attic BUPPLN) (UBUPLN)
venting is provided.
TOTAL $
STEP 1. COMMERCIAL ONLY I acknowledge that i have read this application and that the
Class of Work: Repair information given is correct, that I am the owner of authorized
Llesuihe work to be done (check appropriate hox) agert of the owner, and that the plans (if applicable) are in
LJ RE-ROOF (circle A,B or C) cornrliance with Oregon State law
A. Existing built-up roof covering to be REMOVED and deck _ _
repaired- %n,iture of Owner/Agent Date
B. Existing built-up roof covering to REMAIN note applicant \
must submit an engineer's review of the roof structural
elements. Review shall bear the seal(or stamp)of the
architect or enginter licensed in Oregon Contact Person Name Telephone
C Asphalt or wo-d shingle/shake
(PROCEED TO STEP 2) -----_ —�7P t tQ+•l )A7-✓�S__ _____ 635-�i7�(0
I.d st s\forms\roo f.re s.do c
8/26/99
\ CITY OF TIGARD -. ELECTRICAL PERMIT
PERMIT#: ELC2003-00604
DEVELOPMENT SERVICES GATE ISSUED: 9/30/03
13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 PARCEL: 2S111CC-07700
SITE AnrRESS: 15825 SW GREENS N AY ZONING: R-i2
SUBDIVISION: SUMMERFIELD NO.2
BLOCK: LOT: 104 JURISDICTION: TIG
Project Description: Installation of(4)branch circuits for remodel. Job No.486
_ __ RESIDENTIAL UNIT TEMP SRVCIFEEDERS _ MISCELLANEOUS
vI ,nn SF OR LESS: 1 00 0 200 amp: — PUMP/IRRIGATION:
FACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FUR: 601+amps - '1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _— ADD'L INSPECTIONS
0 20n -mp• WISERVICE OR FEEDER: PER INSPECTION:
23 - 400 amp: 1st W/O Sr,vC OR FDR: 1 PER HOUR:
401 • 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT.
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: T>=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/Fr)R—225 AMPS: Y_ CLASS AREA/SPEC OCC:
Owner: Contractor:
VOGEL WILLAMETTE ELECTRIC INC
15825 SW GREENS WAY PO BOX 230547
TIGARD,OR 97223 TIGARD OR 97281
Phone: Phone: 503-624-3631
Reg #: LIC 7509
— SUI' 19655
_ FEES
Description Date �^ Amount Required Inspections
�l LPRM I'� fil_C'Pcrniit � to nt ,$f;(i 80
[TAX 841,State-1 lx Rough-in
Elect'I Final
Total $72.14
i
This Permit is Issued subject to the regulations contained in the 1 igard 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 issuai ice,or if work is suspended
for more than 180 4ays, ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in 9AA 952-001-6040 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC a (503)246-6699 or
1-900-,332-2344. -�
1984d By: 1�_ ,[' 1 L < < _ Permit 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:
-CQNTRACTOR INSTA ATION ONLY
SIGNATURE OF SUPR. ELEC'N: �.____ f x... —__ __ DATE:__ _
LICENSE 140:
Call 634-41 75 by 7.00pm for an inspection the next business day
Electrical Permit Application
-- Received Electrical
Date/By: ��
f TI ra Planning Approval Sign
City o gard Dale/f3 : _ Permit No.:
13125 SW (tall Blvd. Pian Review Other
Tigaid,Oregon 97223 _(tale y: _ _- Permit No.;
I'honc: 503-639-41'71 Fax: 503-598-1960 Post-Review Land Use
InterlicL www.ci.ligaluLor.uS Cont ct _ case No.:
t'ontact )oris.: see rare i for
24-hour Inspection Request: 503-639-4175 Neme/Method: Supplemental Information.
TYCE'OF lYOKK ' ,'',''" �'�:''"�. '' ''VtPLAN REVIEW Please ehecic all that apply),,t"'
New construction _ Demolition Service over 225 snips- L1 I leaith-care facility
commercial ❑1lnzanlous location
ration/replacement Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet,
4'1 �CATECORY OF CONSTRUCTION a r "r la " I &2 family dwellings four or more residential units in
I & 2-Family dwdlinr ComtnereiaUlndustrioI ❑System over 600 volts nominal one structure
--.. -- -I'-. ❑Building over three stories F)1 ecders,400 amps or Wore
RAcccssoryBuilding Multi-Family [J Occupant load over 911 persons 0 Manufactured structu.-es or RV park
Mas(cr Builder _Other: []ligress/lighling plan I ❑Other:.
JOB SITE INFORMATION'and-1,t)CATION!;' "ice Sulrnrll- acts of plans with any of the above.
- 1'he above are nut applicable to tem orae•construction service.
Job site Iaddress: 5 4 �.• 1, - . ,.:ce-- � � ��_.,.� =+- �::�_._.��`�` _..._ FEE SC:IEUULFi _-.:�.=�'�, �_,' �I';r' .
Suite#: I Dldg./Apt.#: Number of Ins rection&per permit allowed
Project Name: 'iia , ( Description Qly Fee(ea.) Total
New residential Angle n,nmlll lamlly per
Cross strect/Directiods to job site: V dwelling unit.Includes attached garage.
Service Included:
1000sq.fl.or less_ 145.15 4
rach additional 500 sq.A.or portion thereof 33.40 1
_......._.-._�.. _ -�- Limited energy,residential 75._00 2
Subdivision: Lot#: Limited ensu non residential 75.00 2
Tax map/parcel #: -- - —_ ---- Fnch men:dacturcd home or modular dwelling
UESC'll'TION,OF WORK ?V' 7"o1'r t i411y service BiWor feeder _ 90.90 2
-- "' Services n-feeders-Installollon,
alteration or relocation:
200 arrips or less 80.30 2
----- - -- 201 am to 400 am s-- --- _ 106.85 _ 2
401 amps to 600 ams T- 160.60 2
IIR.O' 'Y,QWNER ` ti ,, J=N1 +' r �.r 601 amps to 1000 amps— ---- ---�- _ 140.60 -2
Over 1000 amps or volts __ _ 454.65 2
NalI1C_ R.ecnrmectonly _ _ 66.85 -- 2
_Address' Temporary services or feeder s in0ellalion,
alterallon,or relorstton:
City/5t8te/Zlp: 20U amps m less -- - - -- -- 06.85 --- 1
Phone: lax: 101am4t10smys ___-_ _ _ IUOJO 2
_ - ------ -- - -
�� 401 It,600 amps _ 133 15 2
i PGI ,,NT �� C=� IPSO • AL3 i'- Isrurch dreults-new,illerallon,nr -
Name: extenslon per panel:
Address: - A Pee for Manch circ-iih with purchas!of 6.65 2
_ _service or feeder fee,each branch circuit
City/State/Z1 B.Fee for branch circuits without purchase of
= -—�7-— service or feeder feefirstManch circuit 46.85 y� 1
Phone: - Fax: Each additional branch circuit 6.65 7 7- 1
.4
I' mall. Mlse.(Service or feeckr not included):
Cvch pump nr irrigation circle 53.40 2
COJ�T_ Each sign or outline lighting __ _ _53.40_ 2
Joh No: Signal circuit(&)or a limited energy panel,
dteration,or extension Pae 2 2
Business Name: W , 1, £ ,,, Description: - --
Address: PO z 3v
Fsch additional Inspection over the allowable In any of the above:
city/state/hp:_7 it. K n V1 O — - - — 62
- h
n � Per inspection per hour(min. I hour) .5(1Phone: 2 e, FRX: 4z y_L`!;Fr' Investigation fee: — _-
CCB Lic. #: S a Lic. #: sit - ?&- L Ot1ircil� —
Supervising electrician � Subtotal S
4
signature required: ;_ -___ _Plan Review(25%of Permit Dec) S
Print.Name: 0^ .v 1= 7 Lic. #: J S' Store SurchargeRi "/eTof Permit fed S S, s'
_TOTAL PERMIT FEE S 2
Authorized ,Notice: Thla permit application expires If a permit Is not obtained within
180 days alter It has been accepted as complete.
"Fee methodology set by Trld'ounly Building Industry Servlte Board.
-..--- (Please print name) ------
i:\Ihts\Penrril rorrns\FIcremtitApp.doc 01/03
Electrical Permit Atyulicalion - City ATigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
IMSIMN'I'IAL 1VORK ONLY:
H'ee for all sys(ems............................................................ $75.00
Check Type of Work Involved:
DAudio and Slcreo Systems*
F] burglar Maim
❑ (iatagt I)IM1r Opencr*
I I Ileahng,Ventllalion and An Conditioning Syslero*
Vacuum System:*
D011ier
('On1TIERCIAL N1'ORK ONLY:
Fee for cmich system.......................................................... $75.00
(SIT OAR 9111-2611-2611)
Chr ck Type of Work Invol•ed:
UAudio and Sir,:o Syslc111s
El Boiler Omhols
L� Clock Systems ,
uI)al■1rle_onn11�:ricalion Installation
(� fire Alarm Insinliation
IIVAC
LI Inslrumenlalion
Inlercnm and 1'891119 Systc.ru
I andscepe krigahon control*
1
Medical
Nurse Cells
LJ Outdoor Iandscape Lighh19*
Prolective Signaling
Other -- — --- —
Number of Systems
* Nn!kense! -e rer wired. Licenses are required for All
other installations
i.Ukt Veimil fottos\lilcl'e"mlAPpl'g2 doc 011111
CITYOF TIG.ARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00582
1317.5 SW Hall Blvd., Tigard, OR 972.23 (503) 639-4171 DATE ISSUED: :1/30103PARCEL: 2S'!11CC-07700
SITE ADDRESS: 15825 SW GREENS WAY
SUBDIVISION: SUMMERFIELD NO.2 ZONING: R-'12
BLOCK: LOT: 104 JURISDICTION: TIG J _`
— CLASS OF WORK: ALT FLOOR FURN: —� EVAP COOLERS:
1 YPE OF USE: SF= UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES? BOILERS/COMPRESSORS FOODS:
FUEL TYPES_ 0 - 3 HP: DOMES. INCIN:
1 Pry - 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 • 30 HP: REPAIR UNI IS:
FIRE DAMPERS? 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR ,iANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETF: 1
> 10000 cf n:
Remarks: A(l(lilitn, „r L!, lu,. I.0 ,.';", I„T
Owner: _ FEES —
VOGEL Description _ Date Amount
15825 SW GREENS WAY I'rrnu( I r• 9/30/03 $'2.50
TIGARD, OR 97223 9/30/03 $5.80
Tota! $78.30
Phone: ---- -------- - —_�..
Contractor:
,TAY'S GAS Pl:'ING
PO BOX 393
BEAVERCREEK, OR 97004 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503-632-8623 Final Inspection
Reg#: IIS 119836
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 Alill expire if work is
not started within 180 days of issuance, or if work is s-ispended for more than 180 days. ATTE1,4TION Oregon law
requires you to follow riles adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
r/
^
Issued By: --
j Permittee Signature:. .�� � — — -- -� ,
Call (503) 639-4175 by 7:00 P.M. for inspectinnc needed the next busine y
Nf echanical Permit Application ;trc:neJ1 Mechanical�/y,
[late/By d �7 _ Permit No.:1f t E ���
Its' Of Tigard �lrroingAppro al Building
�, Date:/By: — Permit No.
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.:
Post-RevPhone: 503-639-4171 Fax: 503-598.1960 Date/By:
Cane Use
Date/ _ Case No.
Internet: w•ww.ci,tigard.or.us Contact Juris. 1 0 See Page 2 for
24-hour Inspection Request: 503-639-4175 Name Muftd: _ /C I Supplemental Information.
TYPIr OF WORK _ COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
New construction Do.-molition Mechanical permit fees•arc based on the total value of the work
ddition/u `eration/regia •^ment LJ Other:
performed. Indicate the value(rounded to the nearest dollar)of all
_ CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
1� 2-FamilydwellingCommercial/Industrial Value: S Ser Page 2 for Fee Schedule
�-- — ---
RESIDENTIAL EQUIPMENTSYSTEMS FEE*SCHEDULE�J Accessory HUlldlng Multi-Family
Description n Fee ea. Total
Master Builder Other: _ Heatin ca►Ila
JOB SITE INFORMATION and LOCATION Fumace-add-on air conditioning" 14.00
Job site address: /S F;Zr .S,W . 6,-Qoi,S•&LpGas heat um 14.00
Suite #: _Bldg./Apt.#: Duct work 14.00
Project Name: H dronic hot waters stem _ —14.00
--�--- - — Residential bo,ler
Cross street/Direectio to job Sit / for radiator or hydronic system) 14,00
or, Unit heaters(fuel,not electric
(in wall,to-duct,suspended,etc.) _ 14.00
Flue/vent(for any of above)
Subdivl5ion: Lot#;
Repair units _ 12.15
Other Fuel Ap iliances
Tax map/parcel �:_ Water heater 10.00 --_
DESCRIPTION OF WORK gas fireplace _ _ 10.00
a aeuriaLLA-P., Flue vent(water heater/ as fireplace) 10.00
Log lighter as 10.00
Wood/Pellet stove _ 10.00
` �. f-e Wood fare lace/insert _ 10.00
Chimney/liner/flue/vent 10.00
ROPERTY OWNER TENANT Other: 10.00
Name: JCS �' S 0 Environmental Exhaust&Ventilation
Range hood/other kitchen equipment 10.00
Address: 2.l_ S W JtJr_- s --- -
Clothes dryer exhaust 10.00
City/State/Zip: I ex_ OR 7 Single duct exhaust
Phone:SPI- (-,,3 - G" Fax: (bathrooms,toilet compartments,
PPLICANT 1,0 CONTACT:-ERSON utility rooms) 6.80
Name: W f _ Attic/crawls ace fans 10.00
10.00
Address: 9777 f W Other:r0o,-C Sl`� r — Fuel Piping_
City/State/Zip: �}v� Q 7 � ••(55.40 ter first 4.SI.00 each additional)
Furnace,etc.
Phone:,M.y- (,� Fax: Gas heat pump
E'iRt?ttl:Ce SZJ /'' �D-- q .� Wall/suspended/unit heater
CONTRACTOR _ _ W.•er heater
Business Name: /' Fire IF:c _ ••
Address: Ran e — '•
l 6nr �� ✓ BBQ•--- �•
Clt /State/Zl :1. { 4++.c.t 1j, clothes diner(gas)
Phone: 9, ff >> Fax: " —tr Other:
CCB Lic. Total:
Authorized ,� Mechanical Permit Fees*
Si re: 11f _ Date: Subtotal: S
Minimum Permit Fee S72.50 S
_Plan Review Fee(250•of Permit Fee) S
(Please pnl�f nrmel _ State Surcharge(8°a of Permit Fee S
TOTAL PERMIT FEE S
Notice: This peruilt application expires if a perndt is not ohtsincd within "Fee methodolog} ret by Tri-(boob nuildiim Induxtn lien ire noard
IAO da.x after It has been accepted as complete. **Site plan required for exterior x s coin.
i ,Dsts Pemiii Futr s,MecPetmit.4pp dtx 01%03
Mechanical Permit Application - City of Tigard '
2 - Supplemental Information
Commercial Fee Schedule:
TOTAL VALUATION: PERINHY FEE:
_$1.00 to$2,000.00 Minimum tine$72.50
$2,001.00 to$5,000,00 $72.50 for the first$2,000.00 and$2.30 for each
additional 5100.00 or fraction thereof,to and
_
including$5,000,00.
$5,001.00 to$10,600.00 $141.50 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 30 for the first$10,000.00 and$1.35 for
each addition4i$100.00 or fracti,)n thereof,to
and including$50,000.00. _
$50,001.00 to$100,0110.00 $771.50 for the first$50,000.00 and S 1.25 for
each additional$100.00 or fraction thereof,to
_ and including S',00, 00.00.
$100,001.00 and up $1,396.50 for the first$100,000.000 and
$1.10 for each additional$100.00 or fraction
J_thereof.
All New Commendal Buildings require 2 sets of plans.
iABuiiding\Permit FormsWecPermitAppPg2 09.01-03 dre
CITY 4F TIGARD 24-Hour
BUILDING Inspection Line: (5021) 3 4175
INSPECTION DIVISION Business Line: (50(16 -4�yt MST
/ l �
B U P ----- ---
Received - --Date Requested 1. 1?�_ AM_..—__— PM/ BI
_jP
Location 15 �'Z S � � �- - S;,to---- 60 S_ 7
Contact Person _ __---_ Ph _
(— — ) - - .�..� ._ 1`"L� U PLM -----__---
Contractor— Ph( ) _.__- SWR _
BUILDING Tenant/Owner 11�
-.--- --- — -- ELC
Footing
Foundation ELC
Access: ELF!
Ftr,nrain
CmAI Drain
Slab Inspection Notes: L O SIT
Post& Beam
Shear Anchors V- v -- —'—
Ext Sheath/Shear
Int Sheath/Shear -.
Framing
Insulatiun /
Drv%�;ail Nailing — =
I
Firewall
Fire Sprinkler -- ----
Fire Alarm
Susp'd Ceiling —
Roof
Other:--- ------- _.— 1�+
Final C�i��_ l._y� _ / d U
PASS PART FAIL /�,� �-- --
PLUMBING �-�� �N '— - --�� � r�c-Q v---o`
Post& Beam �^� �
Under Slab —_
Z7
Rough-hi
Water Sery ce — -----
Sanitary Suwer
Rain Drains - — -- -- - ------ --
Catch Basin/Manhole
Storm Drain
Shower P,an
Other - - - --
Final
PASS PART FAIL - --------—- - - _ —- -
-EHA
Post—& Beam
Rough-In � � _ _--- ------
Gas Line
S oke Damper - — ----- — — --
i
P Sb PART FAIL -- ---- - —EUCTRICAL _
Service — —
Rough-In
JG/Slab
Low Voltage — --- —
Fire Alarm
Final Reinspection fee of$_. required before next inspection. Pay at City HriII, 13125 SW Hall BI,M
PASS PART FAIL
si E Please cal!for reinspection RE: -_ —_ Unable to inspect-no access
Fire Supply Line
ADA bj I n --
Approach/Sidewalk Date- -� l Inspector _ Ext
Other: _
Final —�� DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : PLM97-0464
15125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 11 / 19/97
PARCEL: 2S111CC--07700
SITE ADDRESS. . . ; 15825 SW C 121x:=NS WAY
SUBDIVISION. . . . : SUMMERF I ELD N0. 2.-.' ZGN I NG: R-12
BLOCK. . . . . . . . . . . L^T. . . . . . . . . . . . . : 101, ,URISDICTI:CN: TIG
CLASS OF WORK. . -ADD GARBAGE LISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYDF OF USE. . . . :tiF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIX, I-URES-------------- LAUNC)RY TRAYS. . . . . : 0 S RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 LIR I NALS. . . . . . . . . . . . ' GREASE 'T RAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : v1
IU13/bHLIWEPt3. . . : 0 SEWER LINL (tt ) . . . : t11
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Re marks : ADD RES I DENT T AI.- BACKFLOW PREVENTION DCV I C1` TO FAN EXISTING DWELL_I NG UNIT
Owner-: ___._______—_________________...___-___._____...__.__---_________.--__-- FEES
ANITA D FiRFFNWf1f1D type amo!-tnt by date r^ecpt
15825 SW GREENS WAY PRM'T $ 15. 00 GEO 11 /19/97 97--3010;.x'
T IGARD OR 97224 SPCT $ 0. 75 GFO 11 /19/97 97-30106`,
F'hon� #:
MODERN F11_LIMB I NG
1 1 120 SW 1 NDUS1 R I AL WAY
I UALA L I N OR 9706E
Phone #: 691-6166 $ 15. 75 TOTAL.
Reg fl. 000879
_— -- REDO I RED INSPECTIONS
This permit Is issi_ed subject to the regulations contained in the Misc. i t.spect i cin
Tigard Municipal Code, State of Ore. Specialty Coles and all other, RF'/Backflow Pv-ev
applicable laws. All work will be done in arcrrrlarce with Final Inspection
approved plans. This permit will expire if work is not
within 180 days of issuance, or if work is suspendtJ for more
than 180 days. ATTENTION: Oregon law requires You to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set " in DAR 952-0001-0010 through GAR 952-000'.-*N. you may
obtain copies of these rules or direct questions 'o OUNC bf calling
(503)246-1987.
I s s i-t e d B y : �`_� P e r^m i t t e e S i g n a t 1_i r e: __ r
++++++++++-1-i++++++++++i•+++++++++++++++. +++++++++++++•,+++++++++t++++++++++++++•1
Cal. l 639-4175 'qy 7:00 p. m. for an inspect ion needed the next hi-tsiness day
*+++++'+++++++++++++++++'+'++4'4'+++-f'+++++++++++++f'+++4'++T+++4-++++++++4++++++++++++
CITY OF TIGARD PlumbingA r;Cation Rec'd By _
�Nt. Dale Recd _
13125 SVS HALL BLVD. Commercial and Residential Date to P.E.
TIGARD, OR 97223 Dale to CST
(503) 639-4171 Permit►
Print ur Type Related SWR 0
Incomplete or illegible applications will not be accepted Called
Name of Devlopment/project / ; s' NeyLSlnaleforn Iv Resldep on[-. .cpti a '
Job ell�vAN6�<f�c=c l
p r1.BATt 1 HOUSE.i140�00 It r'tJs �!TH,� OUS 519' .
Street Address Suite "�'r3>,�,", r(Y,d [343 BATH FIOus 225.00;
Address -, ; �= r � L ,„«, ,�
'.'Fee Indudgs all plu`�mb nq flztures in the dwellt 'end the first 100 feet o.;
Bldg r Cit /-State Zip,,,, water service sanllary sevrer,and storm Ise,rfetSee.fees below St '. .°
�
.,..,••.-.,, . �r•. M. k tit•, .._!�.f1i95�r��:r.•,L'^-•:
� 7� C--7 ���- .,.rnwn"'.�.1 r.�+r., ,u--.i�.w.. .r..r.�?",Iw ''•.N'i' hk.Y� a' ' 1•
N me I V I FIXTURES(individual) QTY PRICE AMT
�l.l'f C�_ F� Sink _ 9.00
Owner !ling Add'essI Suite Lavatory 9.00
q,�ti ISfv.(IVr-r,yl`"d
..-.r- .
CI /Slate Zip Phone Tub or Tut.Shn.,nr Comb 0.00
Shower Only 9.50
Narm J 411ater Closet 9.00
Dishwater 9.00
Occupant Mailing Address Suite Garbage Disposal _- 9 r0
Washing Machine 9.00
.�ityrState Zip PhoneFloo3" 9.00
r Drain 2' -- 9.00
Nam � I
L " 1"y'\ Ukyy t b t L. - 4" _ 9.00
Contractor Mailinb Address 1 Suites Water Heater 9.00
nTyId _ Laundry Room Tray 9.00
ity/, ate Zip Phone Lh.nnl 9.00
t'A Citi Iy-1 �y� 6/�(n
Oie on Const.Coni BoardLiLic. Exp.Oale 011ie. Frixtures(Specify) 9.00
Attach Copy of , _ O(n - 1 ---` -__ 9.00
Current Plumbing Lic.It - Exp.Date ---�
9.00
Llconsr (1 JC' Sever• 1st 100"
9.00
Go r Business
Tax or Met-o0 Exp.Dategewer-each additional 100' 30.00
_- - -- Name -- - Water Servite•1^t 100' -- 25.00
Water Service-each additional 200' 30.00
Architect Mailing Address Suite` Sturm,.Rain Drain-1st 100't, __ - 25.00
or Storm Rain Drain-each additional 170' _ _ 30.00
Engineer City/Stale Zip ?hone Mobi!e Home Space X5.00
9 Commercial Back Flow Prevention Dev,ce or Anli- 2.5.00
I)e5cnbe work New O Additi Alteration 0 Repair O Pollution Device
to be done: Residents Non-r sidential O Residential Backflow Prevention Device' 15.00 1I
Ado l,onal descnpt in of%vork Any 'Trap or Waste Not Connected to a F;,(lure 9.00
" .!ch Basin 9 ou
Insp.of Existing Plumbing 40.00
_ per hr
Fxisbng use of Specialty Requested Inspections 47.00
huilding or oroperty �' j per hr _
Rain Drain,single family dwelling 30.00
Proposed;-se of - -
building or property_ Cts - Grease Traps 9.00
Areyou capping any fixtures? Yes p No p QUANTITY TOTAL .x.�►"Y1
sometr c or n:er dingram is req,nred if Quanity Total is >9 4�
:hereby acknowledge'�at I have read this applicatirn,that the infort,ation - 'SUBTOTAL +•:i :::�#+Mt -
given is correct Istat I am the owner or authorized agent of the ownei,and
th;,tt plans submitted are in c3mpli_ance with Oregon State Laws. ----- - - -
-�-• 5;ra SURCHARGE
Signature of Owner/Agent,'
PLAN REVIEW 25% OF SUBTOTAL "7u;�� tt/r�•�.��,
)•� �,- {I -- Required only it fixture qty tot,nhs>9- -- ''•Gr •`�'t"'•'^"
i...,:dCt f eitso -- ,t.. .._.�
U!;rne Phone
, TOTAL r '.:�;•;;t': ?•.
�1 1 ��Ll -� •hilnlmum permit fog is$25- 5%su,charae.except Residential Backrow
Prevention Device,which is$15+5%surcharge
\dst-�lpintapp.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-11our Inspection Line: 639-4175 Business Line: 639-4171 -
BUP
— —Date Requested!— AM PM BLD
Location �.`�.::yl`j `ii l-' C r S �� �vI Suite MEC
Contact Person Ph PLM
Contractor—� � iY� ,/ �l_/It`�//L•� _ Ph SWR —
BUILDING — Tenant/Owner Tirf��_ �r/ ELC
Retaining Wall ELR
Footing
Foundation A` NOT REQUi_STED FPS
Fig Drain FOUND DURiI IG RESEARCH SGNCrim
l Drain In NO INSPECTION(S) IN FILE
Slab
�i I SIT
Ext Sh eeh/Shear l / W, ---
Ir',Sheath/Shear
Framing _---- — ----- -- - ---
Insulation
Dr jwM:,;Nailing
Firewall r � `�- - / CLQ ------`-_,--9, --
Fire SprinRler � GLS.— � _—���L7
Fire Alarm �1 ,
Susp'd Ceiling —
Roof
Misc: -- ----- — --
Final ,
P PART FAIL - �� ------- ------------�-` ----- --
4151 1 lust
-- -- r - --- --------------
m
Under Slah - - �,��__--�--- -�— — ----- - --
Top Out
Water Service
Sanitary Sewer �e= �
Rain Drains _
PART FAIL
MUCAANICAL
Post& Beaw. ---------— -- ----
Rough In
Gas Line - __ ----- ----- --- --------- ---
Smoke Dampers
Final - ---- --- --- — -
PASS PART FAIL.
ELECTRICAL - - -- ------...---- ------- ----------- ---
Service ---------- -- --- --- -- - _- — ---
Rough n
UG/Slab - - —---------- -- - -- - —
Low Voltage
Fire Alarm --- — - ------ ----- — --- _ -
Final
PASS PART FAIL
SITE
Backfilt/Grading - ""--^-----
Sanitary Sewer
Storm Drain i ]Reinspection fee of$-------- required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RC -- [ ] Unable to inspect no access
ADA
Approach/Sidewalk ` -� _1 ;
Other _ Dated ,.gpecMr — _ Ext _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 _
BUP
Received _ _ Date Requested___Zd_-_7a-'L� AM _ PM __ BUP
Location � Suite_ c �1.—� __— MEC
Contact Person ___ --�J -------`Ph(_ ) ��'?V 3 PLM —
Contractor_-. _- __ _— Ph(—) _—_______—. SWR _--
BUILDING Tewit/OwnerELC
Footing ELC _--
Foundation Access:
Fig Drain ELR --_-_- _
Crawl Drain
Slat., Inspection Notes: /� � SIT —
Shear Anchors ---
Ext Sheath/Shea,
Int Sheath/Shear
Framing ------_-------
Insulation '
Drywall Nailing -- ----- �------�_ __-- - -------- --Firewall
f're Sprinkler __.--- ----- - -- ZJ_ ---------- ------------
Fit c3 Alarm
SLsp'd Ceiling --- ---- -- - -- __ - ----- - -
Root
Other:Final
PASS
PASS PA91-1 FAIL - --- - --
PLUMBING
Post& Beam
Under Slab ------ - ------ -._._ - --- ----_- - �_.-_— ---
Rough-In
Water Service ---.- - - ------- --- --- ---
Sanitary Sewer
Dain Drains —
Catch Basin/Manhole
Storm Drain ---__._-_--
Shower Pan
Other: ---- --- - - -. - -
Final
PASS PART FAIL --
MECHANIC_A_L - ---- --__._ .-- -- -- - -- --- - - –
Post& Beam
Rough-In - - -- -- -- --- ---------- --.__. _----
Gas Line
Smoke Dampers ----
Final
PASS PART FAIL -- --- --^- --
ELECTRICAL
-------- --
Service R
Rough-In
UG/Slab -- -----
Low Voltage
Fire Alarm
0IJPA
RT _FAIL
Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ -J L Please call for reinspection RE:----- _ --_ - Ll Unahle to inspect- no access
- ---
Fire Supply Line 1
ADATr
`� ctor �'"1r
Approach/Sidewalk Date l 'Z ---- Inspe -- --- __Ext
Other: -----__-
Final 00 NOT REMOVE this Inspection record fr Pir, the Jo site.
PASS PART FAIL