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11795 SW KOSKI AVENUE 11795 SW Koski Avenue CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD. OR 97223 IMPOF:TANT PERMIT NOTICE NORTH STAR PLUMBING 1445 SF OREGON STREET SHF_R%A 3D, OR 97140 Plumbing Siginatur4 l=orm Permit #: MST2002-011481 Gate Issued: 1/6/03 Parcel. 1 S135CD-KM011 Site Address: 11795 SW KOSKI AVE ,utadivision: KALAMOIIKA ESTATES Block: Lot: 011 Jurisdiction: TIG coning: R-12 Remarks: Construction of new SF detached resic.+ence. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, pionse have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address arove, Al TN: Building Division. n'o plumbing inspections will be ruthorized until this completed form is received OWNFR PLUMBING CONTRACTOR: STEVE FCK CONTRUCTION NORTH STAR PLUMBING PO BOX 204 1445 SE OREGON STREET SHERWOOD, OR 97,140 SHERWOOD, OR 97140 Phone 4: 503-625-1305 Phone #: 625-2679 Reg #: LIC 00090697 MET 00002694 PLM '4-255PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Sig ature of Authorized Plumber If you have Unv questions, please call (503) 339-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL TIGARD, OR 97223 IMPORTANT PERMIT N,JTICE WILLIAM BUTTERFIELD CONTRACTING PO BOX 305 13120 SW MORGAN RD SHERWOOD, OR 97140 Electrical Signature Form Permit #: .,'?1'02-00481 Datf� Issued: Q/03' Parcel: 1 S135CD-KMOl l Site Address: 11795 SW KOSKI AVE Subdivision: KALAMOIIKA Et�'l-ATES Bloch.- Lot: 011 Jurisdiction: TIG Zoning. R-12 Remarks: Construction of new SF detached residence. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical p:;rmit to be valid. the signature of the supb,vising 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 U;-,til this completed forrn is received OVVNER: ELECTRICAL CONTRACTOR: STEVE ECK CONTRUCTION WILLIAM BUTTERFIELD CONTRAG-1 iN( PCS BOX 204 PO BOX 305 SHERWOOD, OR 97140 13120 SW MORGAN RD SHERWOOD, OR 97140 Phone #: 503-625-1305 Phone #: 503-625-6773 Req #: I 1 I I M55.1 ELE 3-549( SUP 309.Zti AN INK SIGNATURE IS REQUIRED ON THIS FORM I X f l tc --- - ,,ignature of Supe icing Electrician If you have any questions, please call (503) 639-4171 , ext. # 310 CITYO F T I GA R D -- PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00192 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 518/03 PARCEL: 13135C D-12400 SITE ADDRESS: 11795 SW KOSKI AVE SUBDIVISION: KAL.AMOIIKA ESTATES ZONING: R-12 BLOCK: LOT: 011 —_—_---__ JURISD!CTION: Tlc-;— —' CLASS OF WORK: OTR GARBAGE D;SPOSAL.S: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PRI_VNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: �— URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow prevention device for irrigation system.��+ _ FEES Owner: Description Date Amount STEVE ECK CONTRUCTION I'LUM131 Permit Lr w 5/8/03 $36.25 PO BOX 204 SHERWOOD, OR 97140 5/8/03 --- — : 2W---- Total $39.15 Phone : 503-625-1305 Contractor: — GROIvER'S LANDSCAPE- SERVICES 26485 G. MERIDIAN RJ, AURORA, OR 47002 REQUIRED INSPECTIONS kP/Backflow Preventer Phone : 503-678-1716 Final Inspection Reg#: LIC" 11907 This permit is issued subject to the reclulations (.-otitained in the Tigard Municipal Code, State of OR. Specialty bodes and all other applicable laws. A l work will be done in accordance with approved rlatis. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for mope than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Permittee Signature: Issued BV: +�_ -- -_-__ Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next business day 13ttilding Fihtimes 1'ii►n>ii)i►►1,TPc►-►►►It np )Ilea►1111)1► Received Plumping Dote/py: E D3 PermitNo.: •M ��'G1019� Planning Approval Sewer Ity Ul1€;lll'OI 1)atc/l. • PemmNo.: 13125 S'l'J i loll Blvd. Plan Review Other I)alel8 Permit No Tigard,Oregon 97223 Post-Review Land list Phone: 503-639-4171 Fax: 503-599-1960 Date/By. case No.: Internet: www.ci,tigard.or.us contact Jaris•: See fake 2 for IJ 5u t Irncenlal Inrormalian. 24-hour inspection Request: 503-639-4175 Name/Mcthnd: - TYPE OF WnItK F'EE*SCIIEUULE iro t tectal I-n�foorrmation use checkli� -_ _New construction Demolition__ Des New I s1t>'• Fee(ra.j�Tnlal New 1-&2-fatnlly dwellings Adllition/alteration/reliac-.meat Other: Includes loo ft.for carie ulllll cutmrcllan CATEGORY 011'CONSTRUCTION _ SFR�h�th 249.2() -- '�1 & Tr t(dwclli„nom Commercial/Industrial Silt t2 bath _ 35000 399.00 Accesso Buildil��_ M_ulti-I amil�_ SFR(3 hath 45.00 Master Builder Other: I itch additional bath/kilchcn Fite s mnklcr-s .ft.: Pee 2 JOB SITE INFORMATION an LOCA'T'ION Site U(:itties /�/ '— _ — Job Sile address: Catch basin/arca drain - _ • 16.60 Job Suitt:#: g•/A�)t.#, Dr well/leach line/trench drain 16.60 I'ro'ect Name: _ — Footingdrain nu.linear n. Pae 2 Cross street/DirectioVs to job site: 7�' f� hlanufacturcd borne utilities 110.00 manholes 16.60 16.60 Rain drain connector Sunitar sewer no.linear n. 1 Sloan sewer tno.li'tcar tl. Page 2 Subdivision: __--- Lot ll' Water service no.linear 11 Pa c 2 Tax ma / areel #: Fixture or hent DESCRIPTION OF WORK _ - Ab ttiun v ve _ _lt'.60 - -77 ) ,� l N[�e b14 /s'P '��, _ - ackilow rcvcntci. � • _ Ila e2 - v��---- 16.611 � S x . -�_; 13acFCwutcr valve - �” Clothes washer Uishwashcr I G.GO _ ------------ -�- VD�rinkinfountain 16,60 PROPERTY OWNER TENANTumIfi.GO �Si�'� i"� lank IG.60 Name: ' !C o, —_ 16.60wcr cun/(loot sink/hub I6.60 City/State/Z,ip: _ - Uarba le dig osal 16.60 Phone: Fax: _ I lose bib 16.60 APPLICANT CONTACT PERSON Ice maker 16.60 Inlcrcc ltur/gtcusc tra _ c 2 Name: ____�__ _ Paae 2 ------- - Medical as-value. � Address: _ __-_- -_ Primer 16.60 City/State/Zip: _�.._.__ Roof drain curtlmcrcial 16.60 - - -- _--� _ 16.60 Phone: _t Fax: Sink/basin/lavalury -- 1'ub/shower/shower an 16.60 — E-mail: _ ---- Urinal I6.60 _ CONTRAC'T•OR Water closet 16.60 Business Name: t 1.v�� ►y Cateer: heater 16.60 )thWrAddress: , t ' ---1 - + UthcrCit /State/ Plwnbing Penult Fees* Phone: ,J'?5 6-7 -174(," I'aX: Sit ►11 _ Subtotal $ C.('B L1c. Plumb. Lic. _ ✓ - +vlintnnnn Pcrmit Fee$12.50 $ 7-,5 Audx,ri�ed ' Residential Ilackiluvv Minittuun Fce$36.25 3 F Signature: Date://, C_ Plan Rcvic.v t25^,o of Pcrmit Fee I _ � s State Surcharge S°.o of Permit Fee S C TOTAL Ft7l FI' (Pieasc III Int name) Notice: 'I mi permit tilpucation r%pirrs If a pet reit is not obtained wllhlll All new commercial huadings require 2%els of plans with humetric or ncer dlacrtnt for Plan re'Irw. 180 days trier II htn')cell accepted is complete. •For mrthodoloc) qct b) Ili-Count) ItulUng Induo y Service hoard. i'.\Dsts\i,ct"ot formOlmllerrnit Nprl do n 1 io; MASTE PMIT CITY OF TIGARD ERMIT PMS12 PE;IMIT#: MSi2.0U2-00481 DEVELOPMENT SERVICES DATE ISSUED: 1!6/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 63941171 SITE ADDRESS: 11795 SW KOSKI AVE PARCEL: 1S135CD-KM011 SUBDIVISION: KALAMOIIKA ESTATES ZONING: R-12 BLOCK: LOT: 011 JURISDICTION: I l(; REMARKS: Construction of new SF detached residence. BUILDING REISSUE: �. STORIES. FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT. FIRST: 1,02! s1 13ASFMENT: st LEFT: 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: i SECOND 603 st GARAGE: 500 of FRONT: 15 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: TI+'RD sl RIGHT: 5 VALUE: 00992. OCCUPANCY GAP: R3 BDRM: 7 BATH: tOtAl 1.6:6 t1 162. REAR: 15 PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR F)RAINS: 0 SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN r 1n0K: I BOIUCMP s 9HP: VENT FANS: 3 CLOTHES DRYER: I FURN>=1100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS _BRANCH CIRCUITS MISCELLANEOUS ADD,INSPECTIONS 1000 SF OR LESS: 1 0 •200 amp: o -200 amp: 1 WISVC OR FOR PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 2 201 400 amp: 201 - 400 atnp: 1stWIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - Ono amp: ISAADDL BR CIR SIGNAL/PANEL; IN PLANT: MANU HMISVCIFDR: $01 1000 amp: 601-amps-100ov: MINOR LABEL: 1000•amplvolt PLM!REVIEW SECTION Reconnect only: >=4 RES UNITS: SVr:IFDR>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY _ A.SF RESIDENT IAL B.COMMERCIAL _ AUDIO 6 STEREO: X VACUUM SYSTLM: X AUDIO G STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X 0TH: ALL ENCOMP BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR. HVAC: X DATArTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,782.30 STEVE ECK CONTRUCTION ECK CONSTRUCTION INC This permit is subjectto the regulations contained in the PO BOX 204 PO BOX 204 Tigard Municipal Code, e,Stale of OR. Specialty Codes and SHERWOOD,OR 97140 SHERWOOD,OR 97140 all other applicable laws. All wc,ans. will be done In accordance with approved plans. This permit will expire If work Is nest 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` 503-625-1305 Phone: '5-1305 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rlll'9 or direct questions to Reg a III 1 1'a OUNC by calling(503)246-198'. REQUIRED INSPECTIONS Erosion Control Insp 8, PosbBeam Mechanica Plumb Tap Out Fireplace Insp Water Service Insp Building Final Sewer Inspection Underfloor insulation Electriu..1 Service Gas Line Insp Appr/Sdwlk Insp Footng Insp Crawl Drain/Backwater Electrical Rough In Insulaticn Insp Electrical Final Foundation Insp PLM/Underfloor Framing Insp Rain drain Insp Mechanical Final Post/Be SSA4tural Mechanical Insp Shear Wall Insp Water Line Insp Plumb Final J � y fa Permittee Si Issued By : 1\.�- �-- i---- gnat.ire Call (503) 639-4175 by 7:00 p m. for an inspection needed the next business day www=w CITYOF TIGARD _ SEVER CONNECTION PERMIT DEVELOPMENT SERVICES PE'MIT#: SWR2002-00327 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/6/03 PARCEL: 1 S135CD-Kl`0011 SITE ADDRESS; 11795 SW KOSKI AVE SUBDIVISION: KAI,AM0)IIKA ESTATES ZONING: It-I BLOCK: LOT- 0I JURISDICTION: 11(, _— TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING U!",TS: 1 TYPE OF USE- SF NO. OF BUILDINGS: INSTALL T`i PE: I_TPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: _FEES STEVE ECK CONTRUCTION Description v ~^Date Amount PO BOX 204 — --- SHERWOOD, OR 97140 1SWUSAJSwr Connect 1/6/03 $2,300.00 1SWUSAJ Swr Connect 1/6/03 $0.00 Phone: 503-625-1305 [SWINSP]Swr Inspect 1/6/03 $35.00 [SWINSPJ Swr Inspect 1/6/03 $0.00 Contractor: ---- Total $2,335.00 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 be 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 Issu by: �.��¢1st� f-,`- 1Qy1^•-,p�j{ _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspec•lon needed the next business day Building Permit Application Date received: Pe,n City of Tigard d utnl _ cf :r�._• Project/appl,no.: Expire date: Cityq(Tigard Address; 13125 SW Hall Blvd,Tward,OR 97 � Phone: (503) 639-4171 Date issued: By:'.�tt Receipt no.: Fax: (503) 598-1960 " Case file no.: Payment type: Land use approval: I&2 family:Simple Complex: c 1 &2 family dwelling or accessory 17 Commercial/industrial U Multi-family New construction U Demolition U Addition/alteration/replacenrent U Tenant improvenivni Ll Fire Sprirklvr/alarm U Other: INFORMATION Job address: "�[ l ' � j. � Bldg, no.: Suite no.: 1 oL t3lock: Subdivision: Q rl/�fG j� Ifmis Tax map/tax lot/account no.: — Pr3ject name: _.-- D!scription and location of work on premises/special conditions: r 1 —C�'C G C (Fltt t7Namc:iling address: ��` 1&2 fatuily dwelling: .ty: - — _ Y2 State: ZIP: Valuation of work.............C.......J................ $ Phone: Fax: Email: No.of bedrooms/baths................................. Owner's represent.tive: __ Total number of floors................................. a : I',tx i titan New dwelling area(sq.ft.) .......................... Garage/carport area sq.ft.)......................... Name: Covered porch arra(sq.ft.) ......................... Deck area(sq.ft.) ........................................ Mailing address: City: - State: ZIF Other structure area(su. ft.)......................... . Phone; fax: Email Valuation Valuation of work............................. ..... .... 4-- CONTRAffOR Existing bldg.area(sq.ft.) .......................... Business name:: D.7r ' -��' New bldg.area(sq.ft.) Address: D -2� Number of stories........................................ --- City: State: ZIP: - TYIk of construction.................................... Phone: p Fr:-mail: � 1 ax' -� ---- -_p--- - Occupancy group(s): Existing: _._. CCB no.: �� _ New-: City/metro lie.no.: Notice:All contractors and subcontractors are required to be tIM1801111 licensed with the Oregon Construction Contractors Board under Name: �(� ✓ / 6 — provisions of ORS 701 and may be requited to be licensed in the Address: _ ,jurisdiction where work is being performed.if the applicant is City: ' State: 7_II': exempt from licensing,the following reason applies: Contact person: _ Plan no.: 1-mail• — --- Name: ontact person: Fees due upon application ........................... $—. Date received: City: G2CL Stat ZIP:5 7.W Amount received ......................................... $_.__---- Phone: ,;J / Fax: J Email: Please refer to fee schedule. 1 hereby certify I have read and examined this application and the Na ail Juridkt+ar=W aod+t earth,please call jurisdiction for mom infatmuioo. attached checklist. All provisions of laws and ordinances governing this Uvisa U MasterCard work will be complied with,whether specified herein or not. Credit card numbs Expires i _ Authorized signature: =�°�-��- Date: Nsr„e or raratx+ace a.rbown on cRmi era Print name: r4zz t''r --..- Cardholder Iipmum Amount Notice:This permit application expires if a permit is not obta ned witr:7 180 days after it has been accepted as complete. 440 4611(rAIUMM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: City ofTigard (;jt Of hlv and b ❑Electrical ]Plumbing U Mechanical Address: 13125 SW Hall Blvd,'rigard,OR 97223 ❑Other- Phone: (503) 639-4171 Fax: (503) 598-1960 1 1 1 1 I Land use sctiuk.c completed.tiec jurisdiction cruena for concuncnt reviews. 2 Zoning..'lood plain,solar balance points,seismic soils designation,historic district,,i, 3 Verification of approved plat/lot. 4 Fire district_ _approval required. 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 U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 31 Complete nets 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. I I Sitelplot lilan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is murc Ulan a Oft.elevation differential,plan must show contour lines at 24 intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage arra;percentage of coverage-,ir.tpervious 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 section(s)and details.Show all framing-memher sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross section may he 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 of two elevations for additions and remodels. Exterior elevations must reflect die 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.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any bcam/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 Oregon and shall be shown to he applicable to the project under review. Maw 11iffinman I"= 23 Five.(5)site plaurs are required for Item I I above. Site plans must he 8-1/2_x 11"or I I" x 17 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building flims shall not contain red lines or tape-on:._ 26 No rolled,reversed or mirrored building plans will he a-cepted. 27 28 Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 4444614 tryaaroM) Mechanical Permit Application Datereccived: permit no.: Cl>�' Of TigardProjecdappl.no.: Expire date c'i(vgf/'ig(IId Address: 13125 SW Hall blvd,Tigard,OR 9722:1 — � — Phone: (503) 639-4171 Date issued: by: Receipt no.: i lax: (503) 598-1960 Case file no,: Payment type: Land use approval: — — Building permitrto.: v I &2 i tinily dwelling:or accessory C 1 i'onunerciaUindutitnal U Multi-family U Tenant improvement New construction U .No lition/allt•r:uion/replacemcttt U Other: Job&1&ess: Indicate equipment quantities in boxes below. Indicate die dollar L.dg.no.: Suite no.: value of all mechanical materials,equipment,tabor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: Block: I Subdivision: 'See checklist !or important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: Description and location of work on premises: - I�eY•(ea.) Total Est.date of completion/inspection: Description Uly. Res.onl Rm.only Tenant improvement or change of use: Is exist ng space heated or conditioned?❑Yes U No A..nandlingt unit _- -CFM — Air conditioning(site plan required) Is existing space insulated?0 Yes U No A ieration of existing iV 11ANICAL CONTRACTORtotter compressors - Business name: LPGlate boiler permit no.: HI' Tons-BTU/11 Address: _ Fir smo a dampers/duct smoke detectors —�- -- City: Stale: ZIP: eat pump(site plan require ) - Phone• - Fax: E-mail: nsta rep ace uurrnac urner - Including ductwork/vent liner O Yes U No CCB ito.: nslall rep ace relocate healers--suspen , City/metro lic.nr): wall,or floor mounted Name(please tint): —� Vent fora Bance o let than furnace e[`rl�gera nn: Absorption units BTU/H _ Name: Chillers.-__ _ HP - -- ------- - ---- -—- Corn iressors — HP - - Address: :nv ronmenta ec ust an vent ton: City_-- Slate• ZIP: Appliancevent Photic Fax: E-mail ryerex aunt -- -- ___-- Hoods,Type res. itc a azmat hood fire suppression system Name:S,- Lxhaust fan with single duct(bath fans) - — Mailing address: ® --I3x1laust s stem a tart mm teau-'n orK47- -- Fuelpiping an sl ut on(up to out ets) City: State: l.11: �� Type: LPC __ NG Oil Phone; Fax: I: --T t i' in eachad itional over 4 outlets - Process piping(schematic required) Nur..Im of outlets Name: Ot rr lisstt�eiTap-'pfiince or ciju pmeT`nt: — 1-- Address: _ Ihxohativefihcplacc City: Stale: `- ZIP: _ - -- Tri.,ert- type Phone: Fax: Email: �oo3stoveTpe-Tiecstove V_ ch—hem Applicant's si,nature: Date: ter: Name (print): __ --- Not oil Jurisdictions accept credit carie,pleaw cell it tiedktiat for mar Infurnuaon. Permit fee........ ..........$ O Visa ❑MasterCard Notice:if a permit er it is riot Minimum fee................$ within if a days a e riot obtained Plan review(at v, %) $ within 180 days after it has been State surcharge(R9<) ....$ --- Nurc ofdh carolder n shown an credit card S lCCep!C as complete. TOTAL .......................$ _ Cardholder signature vAmount 440.4617(MUMM) Electrical Permit Application Date received: Permit no.: City of Tigard Projecbappl.no.: _ Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Daieissued; By: I Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use:pproval: �I &2 family dwelling or accessory U Coin met(.ial/industrial U Multi-family U Tenant improvement XNew construction J Addition/alteration/replacement j()tllei U Partial II SITE INFORMATION Job address: map/tax lot/account nub Lot: Block: Subdivision: Pro__ name: Description and location of work on premises: Estimaied date of completionlinspectioa: CONTRACTOR JFEE I ULE jot)no: . Fee M1tax Business name: (,�� % ,� a( Description Qt (cam) Total ria.insp New tial-single or multl•famlly per Address: AV O _ dwelling unit.includes attachedgarage. City: State ZIP: / Serviceincluded: 1000 sq.ft.or less 4 Phone: Fax: Email: Each additional 500 sq.ft.or onion thereof CCB no.:/ � j Elec.bus.LIC.no: 3�,fYrC Limited energy,residential Z City/metro lic.no.: Limited energy,non-residential 2 Foch manufactured home or modular dwelling Signature of..^u rvising electric;en(reyulted) Data Service and/or feeder 2 License no Servlcesorfeeders-Installation, Sup.elect.name(print): alteration or relocation: *rROPFRTY OWNER 200 amps or less 2 _ 201 amps to 400 amps 2� Name(I:.int): - - --- -----. 401 amps to 600 amps 2 Mailing address: _ 601 amps to 1000 Amps 2 City: State: ZIP: Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnect only I Temporary services orfeeders owner installation:The installation is being made on property I own installation,alteration,or relocation: which is not intended for sale, lease,rent,or exchange according to 200 amps or less _ 4 ORS 447,455,479,670,701. 201 amps to 400 amps 2 Owner's si nature: Date: _ 401 to 600 ams -' Btanch circuits-new,alteration, 21 lot N Nar extension per panel: Name: A. Fee for branch circuits with purchase of Addmss: service or feeder fee,each branch circuit 2 City: Stale: ZIP:_ _ B. Fee for branch circwta without purchase y�. of service or feeder fee,fit.,branch circuit: _ 2 Phone: Fax: Email: Each additional branchcimuif. Misc.(Service or feeder not Included): Erich pump or irrigation circle 2 ❑&:rvice over 225 amps•commercial U Health-care facilrty - -- - 2 U'�ervicc over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting _ 'anulydwellings O Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, U iystem over 600 volts nominal more residential units'n one stroaure aheration,or extension* 2 G 3uilding over three stories U Feeders,400 amps or more *Description:. -- U Occupant load over 99 persons U Manufactured structures or RV park FAch addition-'inspection over t're allowable In any of the above: U Ear.._'IlghUngplan U Other: _ -- Perins action Submit_sets of plana with any of the above. In oestillistion fee The above are not applicable to tempomry condruction service, other __ Permit fee..................... NW all!udsdkttcns ercep credit cards,please call)uduliction for mom infamull n Notice:This permit application Plan review(at ___ `fo) $ U visa U MuterCArd expires if a permit is not obtained Credit card number __ / / within 180 days after it has been State surcharge(8%) ....$ _ Rxp'm' accepted as complete. nle TOTAL. .......................$ HaC I V OWn nn C --_- $ C slprvure R(U� � Amount 440615(6t0atCOM) Plumbing Permit Applic:d*ion Date received: Permit no.: City of Tigard Scv er permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of Tigard Phone: (503) 639-4171 Project/appl,no.: Expire date: Fax: (503)598-1960 Date issued: By: Receipt no.: Land use approval: __ Case file no.: Payment type: TYPE Of," PERMIT AI &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant impruvernent New construction U Addition/alteration/teplacement U F(x)d service U Other: 01111SITE INFOitMATION Job address: j'',`�t 1-.� Description tion Qt . Fee(ea.) 'i'otal Subtc nu.: New 1-and 2-fatally dwellings only: Bldg.no.: �— — (Includes1UQtt.for each utility conneclion) Tax map/tax lot/account no.: SFR(1)bath _ Lot: 77Block: Subdivision lip SFR(2)bath Project narr:e: _ SFR(3)bath City/county: ZIP: Eneh additional ath/kitchen Description and location of work on premises: Siteutilitles: Catch basitt/area drain Est.date of completion/inspection: D wells/leachline/trench drainPLUMBING CONTRAC-17OR Footing drain(no. in. t.) __ Manufactured lure utilities Business name: Manholes _ Rain drain connector City: Stat Phone: Fax: 1,11' �'�l Sanitarysewer(no.lin.ft.) ; E nutil: Sturm sewer(no.lin.Ct.) CCB no.: Plunbb.bus.reg.uu: Water service(no.lin. ft.) City/metro tic.no.,. Fixture or Item: Absorption valve Contractor's representative signature: Back flow preventer I''I nnntC: I''t'' Backwater valve 1 Basins/lavatory Name: _Clothes washer Address: Drinking fountain(s) City: State: ZIP: E'ectora/sum Phone: Fax: I E-mail: EYYP tank Fixture sewer cap _ If ssinks/Inb Name(print): �rarbage disp2sal _ Mailing address: Hose bibb Cit;: -- Stat Z1P: Ice maker Phone '' Fax: I E-mail: lwerc, tod rease trap Owner lnstallanon/rusidential muEntenartce only: The actual installation Primer(s) will be made by me or the maintenance and repair ma'_by my regular Roof drain!.;ommercial) employee on die property I own as per URS Chapter 447. Sink(s), .usin(s), ays(s) Owner's signature: Date: _ �_ Sum 1'ubs/shower/shower pan Urinal Name: _ — Water closci _ Address: W-iter heater City: _ Y State: ZIP: Outer: Phone: 1'ax: E-mail: Total Nd all urivacUons acapl cr"'cards,please call�wiscliction for mom Information. Minimum fee................$ i Notice:This permit application Plan review(at — 46) $ V visa O MastetCard expires if a permit is not obtained Credit card number: within 180days atter it has been State surcharge(8%)....$ P� _ ecceptr'�'as complete. TOTAL ....................... _ Nome of caldlwldu u srwwn on credit card s cardholder sirsilutt Amount 44U4616(61txlCOM) 0 0 5200' 41. 1� LOT 11 ® I P . PROPOSLU RESIDENCE GARAGE PLAN#1802 r G I C (REVERSE) CKCONC I �AVOW�R VFi f 11 h 0 DRIVF cu N 50.3-V 12 z ECK CONSTRUCTION I t� P.O. Box 2.04 ON 0 Sherwood,OR 97140 J Q � U S,W, KOSKI DRIVE lJr'1T Ch. ccrrar i SUNTh,HOME DESK-3N,NC IS NOT \ LIABLE FCN ME ACCURACY OF THE L�QAL DC/G2DTKD(1 TOPOGRAPHY NFORMATION IT IS - - THE SOLE f?ESPONSIBILITY OF THE TO BE ATTACHED - BUILDER TO VERIFY,",LL SITE CONDITKDNS.INCI UDIrK-�ANY FILL _ PLACED ON THE SITE,AND INK)MA OWNERS OF ANY POTENTIAL FIELD -. Pl MODIFICATIONS ~" : "' CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 a o BUP Received _— Date Requested----------- _ AM __ __ PM _—_ BLIP _ Location �L�-Iq ?_ --_-- __-- Sui,e- — MF.; Contact Person _--__.---.------_-_--- - -- --- --____-- Ph( -- j �__ 3 _'LM Contractor Ph(-- ) _- ---- _ ___ SWR ------_____-- BUILDING Tenant/Owner _ -_ _____ __---____.__�___-___ ELC Footing ELC Foundation Access: Fig `)rain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors ----- - ----- Ext Sheath/Shear Int Sheath/Shear ---- _----�--- _- -- --- Framing ---------- ---- - - - Insulation Drywall Nailing -- ------ --- - - ---- - -- -- - - -Firewall - Fire Sprinkler -- -- --------- ---- - - - ---- Fire Alarm Susp'd Ceiling --- --- ---- -�- Hoof O!her: --- -- ----- - Final PASS PART FAIL - - ---------- --- — PLUMBING Post&Beam---_p Under Slab --------- _ ----_� Flough-In Water Service Sanit 1 ry Sewer Rain Drains _. --- --- -- ---- -- -- - - Catch Basin/Msnhole it(,..n Drain 13hower Pan SS PART FAIL --___-- MECHANIC_AL Post& Beam -- Rough-In -------------- - - - -- - �_—_ _ .__— Gas Line Smoke Dampers --- - --- ---- --- - ---.- Final PASS PART FAIL EL ECTRICAL — _ Service Rough-hr UG/Slab Low Voltage ----------_------ -Fire Alarm Alarm - e Final ( -� Reinspection fee of$__- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL _ SITE Please call for reinspection RE:-_ --_ [ ] Unable to in�ppct-no access Fire Supply Line _ ADP, -� Approach/Sidewalk Date _.� Insp�stot ____ - -_ Ext Other:`-___--- Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGA D 2^-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST _ BUP Received _ ___Date Requested_—_`51� AM—___ PM__—_ BUP Location __ �__._ -- _ - Suite _ _ MEC Contact Person Ph(--_-) __ F0 '3?_1 PLM Contractor — __ --_-_---- __ _ Ph (_--_) _ SWR BUILDING _ Tenant/Owner -_ _ __-_-- ELC Footing — ELC Foundation Accesi: _- Ftg Drain ELR _ Crawl Drain Slab Inspection Notes: SIT Post&Beam — ---- - --- - ------ ----- Shear Anchors ------------ - Ext Sheath/Shear _ Int Sheath/Shear Framing _-------__-- Insulation _-- Drywall Nailing Firewall Fire Sprinkler -------- _.___._ ..___._..._----__-- Fire Alarm Susp'd Ceiling - — - -------- Roof Other: — - ---- Fina! _S_3_ PART FAIL PLUM_Blh�— Post&Beam Under Slab -- ------ - ----- - -- - ---- — ------ —------- - Rough-In -- Water Service Sanitary Sewer Rain Drains -- ----- - Catch Basin/Manhole _toren Drain --------- - - .. __ .�__-------- -- Shower Pan Other: ---- Final PASS PART FAIL MECHANICAL Post& Beam Rough In ------ --- - - Gas Line Smoke Dampers Final PASS PART FAIL - -- -- -- -- --- - - - -- - - - ELECTRICAL Rough-In _— -- -- — — UG/Slab n Low Voltage - Fire Alarm PART FAIL Reinspection tee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ----- SITE Please call for reinspection RE:_— _ �______ __�_ U Unable to inspect-no access Fire Supply Line / ADA Date C h /� lie 0 � f -- ��"- Ext _ AppnachlSidb�valk .,.�-- � Other. Final DO NOT IVEMOVF,this Inspection record from the Job site. PASS PART FAIL �►.aeeeeeeeeeeeee.�eeeee�♦eeseeeeeeeeeeeeeee,►eei� � d ► IN ' r rD ro Poo.f D M ,<i � ► n cfq y ' CL ► 44 �-+, aq ► A s ° 0 00. o p -i '--] V) U� r'� -►t ° ti• O tTi M 44 , 0 Poo. D G ► a ► ► Poo 44 I � ► A \ 01 ► •44 `� M-] ► . �-+ ► y 0 0 a ,n W Q -ti C a f � a �D OM ,:k O � T � Q O a ti A G x CITY OF TIGARD 24-Hour _ �U / BUILDING Inspection Line: (503)639-4175 MS _ _ INSPECTION DIVISION Business L!ne: (5031639-4171 (� BLIP Received ///- �_Date Requested,__.-'1._�, _ AM-_ _PM _ _ BUP _- Location .�. L L 7� _ _ L_G-� ` Suite MEC _.�----- ---- Contact Person __ C''T -�'�_ Ph(^—_) �� PLM Contractor_— _-----`_��----- _ Ph(—) _—_- --.__—_s SWR _ -- UI r _G Tenant/Owner _ . __� ___ ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Ancrwo;, --- -- - -- --- Ext Sheath/Shear Int Sheath/Shear Framing --- Insulation Drywall Nailing - - - -- - - ------- Firewall Fire Sprinkler ----- --- Fire Alarm Susp'd Ceiling __-_- Roof Other: rn ' _PART FAIL - ------ - - PLUMEINd - �T-- Post& Beam Under Slab --- - ..---- - Hough-In Water Service ---- —--- Sanitary Sewer Rain Drains - -- - Catch Basin/Manhole Storm Drain - - -- --- -- Shower Pan Other: -- - ------ - -_ _ Final PAS PART FAIT_ - --._ ...- --- -- - --- - ----- .__ CHA I AL _ os earn Hough-In - Gas Line Smoke Dampers -- --- - ------ -- . ma PART FAIL -- --- - -- ECTRICAL _ Service Rough-In I.JG/Slab Low Voltage Fire Alarm Final Reinspection fee of$_ required before next inspection. Pay at City Nall, 13125 SW Hall Blvd. re .. _PASS PART FAIL SITE C, r1lease rail for reinspection HF _.- -__ _. -_ �-i Unable to inspect- no access Fire Supply Line ADA li- d Approach/Sidewalk Date ,_- Inspector - __. Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP _. Received -- —Date Requested AM — PM —.— BUP � � -7..�_ G Location -_ —t' "<- Suite MEC — � �� o�ma'' Contact Person ___ ___.__. _--_ _ Ph(_ ) .� � PLM Contractor_.____ _ __— _ Ph( ) -- -__ SWR -- BUILDING Tenant/Owner _ _ __— ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT ----_______�_-_ Post&Beam - -- -------- -- -- _ _ Shear Anchors - �- Ext Sheath/Shear _�.. ---- -- -------- Int Sheath/Shear Framing - -- ---- �..------ - - -- - - Insulation Drywall Nailing ---- -- - - -- --- ---- -- -... - Firewall Fire Sprinkler ----- — - --- - - ---- - - - -- Fire Alarm > Susp'd Ceiling - - -_---------- - ---- � _- Roof O:her:----- --- ,/ ---- Final PASS PART FAIL_ PUJMBING Post&Beam Under Slab --- - —- - -- - - - Rough-In Water Service Sanitary Sewer Rain Drains -- ----- --- __- - Catch Basin/Manhole Storm Drain -- ---- -- ---- -- -- Showerer:X Pan �? r: ----- 1r�P AS PART FAIL ANICAL - Post&Beam Rough-In -- -- ------- -- - -- Gas Line Smoke Dampers - ----------- .... -- - -- - - Final PASS PART FA-11- ELECTRICAL AILELECTRICAL -_ -- _ - Service Rough-In UG/Slab Low Voltage - ...--- ---- - -_----- - Fire Alarm Final L] Reinspection fee of$__- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL SITE �� Please call foi reinspection RE _ -__---_.__ — Unable to inspoot -no access Fire Supply Line /+ ADA Approach/Sidewalk Date �_ Inspector✓ L/ Ext - Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL