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11385 SW NOVA COURT-1 13 VAON MS 589 L L F- v a O z R cn �s A 11385 SW NOVA CT I` � h� CITY OF T I G A R D _ .,ECHANICAL PERMIT DEVELOPMENT StkVICES PERMIT 9: MEC2005-00722 13125 SW Hall Blvd.,Tigard, OR 97223 503-639-4171 ;)ATE ISS JED: 10/27/2005 PAf XEL: 2S'i 03DB-03200 SITE ADDRESS: 11385 SW NOVA CT ZONING: R4.5 SUBDIVISION: GENESIS LOT- 0(` ' JURISDICTION: TIG Project Description: Wood stove insert. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT BEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: ^BOILERS/COMPRESSORS _ HOODS: FUEL TYPES _ 0 - 3 HP: DOMES. INCIN: OTH 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 36 -50 HP: WOODSTUVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN < 100K BTU: W AIR HANDLING :/f'i i'S OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: r GAS OUTLETS: 10000 cfm: Owner: FEES BRENT REED Description Date Amount 11385 SW NOVA COURT [MECHI Permit Fee 10/27/20( $72.50 TIGARD, OR 97223 [TAX]8%State Surchar� 10/2'/20(. $5.80 Phone: 503-639-3870 Total _ $78.30 Contractor: TOM BISHOP CONSTRUCTION 4578 SW 103RD AVE REQUIRED ITEMS AND REPORTS BEAVERTON, OR 97005 Phone: 503-644-7868 Reg#: LIC 155679 IL oe: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and 113 all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not (.9 started within 180 days of issuance, or if work is suspended for more than 180 days. A FTENTION-. 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 503-246x6699 or 1-800-332-2344. Issued By: / Permittee Signature: �- _ Call 503-639.4175 7:00 a.m.for Inspections that business ay. This paimit card slmll be kept In a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each Inspection. FROM H[JTSPOT FIREPLACE PHONE NO. 15035269138 Oct. 25 2005 12:44PM P1 1V xhanical Permit Application City of Tigard r TIRkeatived 0 0 ?Mr.* G j— 7 13123 SW HAI Blvd.,Tigard.OR 97223 R E V F I� P6 n Re'lew Pboee' 303.639.4171 Fax; 503.599.1960 wk..n : e70m po"41: Inspection Line: 503 639 4175 , Dae Roady/sy: ..►aaa s for 1 bmnr.t www.ai.tiprd.or.ua NodMdMtat�od: S ll,tle 41aul tarer.adve Q New oottttruction X Additicm/alteration/replacen=, Mechartial pww4my we hued on the valve of the work Q Disl3olition ❑Other: performed.Indicate the value(rounded to the nearest dollar)of all mechanical imterials,Miprnent,labor,ovalmd,and)+rout. Value:S 1-and Z-fwdly dwelling ❑Commcrcial/industTial ❑Acccssoi y building inti-!Emily ❑Master builder otheT. for 1 MI01 IVO M0110e ust L4WHiH. — Daecri�gon_ 7T—FA. Taai e 1 Hutto eodta Job to address: I Air conditioninS or heat pump Ct&qWmt* lea dowivi phomma 14.00 C1�SbtnrliP Q C�ir� -t-� 2 Furnace 100,000 BIU drewvem 14.00 mPumas 100,000+BTU(dn Wveaaa 17.90 L»o.• Project nage:m 0300 heat 14,00 Q=atreeddirwtiotn to Job site: Duct work 14.00 x _ Hydronic hot water nitern 14.00 Reridendal�o lerradiator or h L 14.00 —- Unit hasten(}lwl-type,net a). !„; ' _ in-ural!,to duot,t+wpattdrd,etc, 10.00 m.: Fludvent Atr any of above 10.00 _ Otho. 10.00 'Tn elap/pa red no.: fuel atapeaaou Water heater 10.00 _ >+ 10.00 Plus vent for water heeler or gap fire lace _ __ 10.o0 r 10.00 M _ w tet _ 10.00 Wood fireplamAnr.rt 10 10.00 Chime MMA �eudvmt 10.00 ` Othcr: .00 Eeviroantatal charm 404 Vadhillon r S60 O 1kf4 — Ran i Se hood/other ldrchen 1 -_T e IG.00 j Clotliea axhmaR 1000 R Fax:( ) SinO not exhaust(betlnoorn% _Witt corimmurmu,udli m me) 6.10 Attldmaw1sWe lana 10.00 --" 'Bvalntu ttatttt~ a i ye� ,r e J Other: Q Y% 14el Z- ----�-�--� SS.40 A+r ttrat[oar•51.00 dr each ttddidooal :Atblga: 5 c�2 SLS ( 1,f O a" 1 Futnaoo�tc. '•>.G�j/SaidZIP: 2:V-0y j 44 h OK M05 c ii�,�ata�dadNttit heater -- i (p Fax::( ) p�as Water hula w� 0 - L'_' .._ F lace into— UU .) raame:�� lql !� K Pte_ clot" dr�SW) {Aden: SAS —"ZJ l'jd Ll\. Other; U00 OPI, I-76o Pax: _ a Mhti"Urn permh he(172.30 Iia: �SSY,7 2 - Tlan rvvtew 3!i e!perlmnit A41) Stan.a (1111ti of t Ibe) TO'�AL P 'F FNilf Attlbadrred qf uftqr. TTda par'ak��•>Arsr«m41 p41raatt N a41a.antlaaa wlw.lee '� Barr aflar 1t 0041 teas aa,p%d ss aaaNe«. Pa-&AD*p set try Td-c-oaaty eapoly fi*i v Savlea hent CITY OF TIGARD BUILDING D!;►iSIGN PERMIT M: MEC2005.00722 13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: UY2N2005 Phone: (503) 63C-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 12190005 TIME: 7:04AM PAGE: 62 SITE ADDRESS: 11385 SW NOVA C1 / CLASS OF WORK: SUBDIVISION: GENESIS LOT N: 006 TYPE OF USE: PROJECT NAME: REED DESCRIPTION: V )od stove insert. OWN .n: REED, PRENT PHONE #: 503639.3870 CONTRAC i C 1 TOM 8",SIiOP CONSTRUCTION PHONE A: 503-644-7868 Inspection Request Sr;heduled For: Date: 12!9!2005 Pour Time: Codd # Inspection Description Confirm # Contact # Message 699 Mechanical final 023175.01 5M&-626-4652 { "W70 Corrections/Comments/Instructions: IL 0� Ui — - - PASS ❑ PARTIAL APPROVAL ❑ CANCEL - ❑ NO ACCESS FAIL ❑ CA FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspec+or. _ _ -- Date: ' PhTm (503) 718- • �.�� MASTER CITY OF � DEVELOPMENT SERVICES DATE ESSUEr: 8812a� "oo2a9 13125 SW lull Blvd.,Ti r rd,OR 97223 (503)639-4171 SITE AMRESS: 11385 SW NOVA C7 PARCEL: 2S103JB-03200 SUBDIVISION: GENESIS ZONING: R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG REMARKS: Bathroom remodel. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS i_ 2MUM"D CLASS OF WORK: ALT HEIGHT FIRST: of BAB[MENT: of LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: of GARAGE: Of FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: TMo of pow: VALUE: 2.000 00 OCCUPANCY ORP: SDRM: BATH: TOTAL: 0 of REAR: _ PLUMBMG SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAM DRAM: TRAPS: LAVATORIES: I DISHWASHERS: FLOOR DRAMs: SEWER LIN": SF RAIN DRAMS: CATCH SASPM: TUSMHOWERS: 2 GARBAGE DISP: 1YATEN WNCERS: WATER LINES: aCKFLW PREYNTIt: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN t ICOW r_ BOaJCMP a 2H►: NT FANS: CLOTHES DRYER: FURN"NOOK: UNIT HEATERS. HOODS: OTHER UNITS: MAX IP': btu FLOOR FURNANCES: VENTS: WOOOSTOVES: GAS OUTLETS: ELECTRICAL _ RESIDENTIAL UNIT SEFT2 j FEEDER TEMP SIMIFEEDERS BRANCH CIRCUIT$ ~MHBCELLANOUS_ ADIrL INBPECTrONS 10%!F OR LESS: 0 200 am;• 0 - 200 4fm: WISVC Or FOR: PUWNRIIGATOON: PER INSPECTION: 1A AD 7L 0009F: 201 •400 amp: 21)1 •400 amp: 1r t wo r vernp: 00 SIGNIOUT INN LT: PER HOUR: LIMIT'cff i ENERGY: 401 -MO amp: 101 -6000M. SA ADI A.M CIR: SIONNJPANEL: IN PLANT: MANU HASVCIFDR: 401 - 1000 amp: 001+amp-100ov. MINOR I awlL: 1000•amoAroK _ FL11N RIMEW LBCTKIN Rocannoct onh: >W RES UNITS: SVr:IFOR".225 A.: >MIO Y NOMINAL: CLS MEAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A-SF RESIDENTIAL 111-COMMERCIAL AUDIO S STEREO: VACUUM SYSTEM: AUDIO S STEREO: FIVE ALARM: INTERCOIMIPAGING: OUTDOOR LNDSC LT: eURGI-AR ALARM: OTH: DOILER: HVAC: LANDSCAPEARRIa: PROTECTIVE%GNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL S SYM VS: Owner: Contractor: TOTAL FEES: S 237.03 REEU, $RENT G w/I/ This permit Is subject to the regulations contained in the Tigard Muricipal Code,State of OR.Specio1y Code.. 1138'6 SW NOVA CT and all other applicable laws. All work will be done in TIGAR U,OR 97223 accordance with approved plans. This permit will elrpk e If work is not started within 180 days oS issuance,or If N Rq work le suspended for more than 160 days. PhOn.: 503-639-3870 Phr ATTENTION: Oregon law requires you to follow rubs adopted by the Oregon Utility No"cation Center. Those D Rag a: rules are se"orth In OAR 959-UU:•0010 through 952.001-0080. You may obfeln copies Of these rules Or direct questions to OUNC by calling(503)246-1987. S _ REQUIRED INSPECTIONS _ Plumb Top Out Plumb Final U Electrical Rough In Final inspection Framing Insp Insulation Insp Electr+-al Final Issued Ry : .,�'Ar>< Permittee Signature Call(303)8394175 by 7:00 p.m.for an Inspection needed the next business day Building Permit Application D City of Tigard E,��C Received Daft : Permit No. - y a � �eI q 13125 SW hall Blvd.,Tigard,OR Pion Review Phone: 503.639.4171 Fax: 503.598.1960 ryttll Date/A . Other Permit Inspection Line: 503.639.4175 11 Lu4� y y W see Arra!bad Cherktlat for AUGv Date Read !fl Jury Internet: www.ci.ligird.or.ua Notified/Method: Snpplernent11Information ARD QWEUING ❑New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ►ddthon/alterstionhTlacement ❑Other. equipment,materials,labor,overhead,and the profit for the y work indicated on this application. Valuation: s 6690 ew 1-and 2-family dwelling ❑Commercial/industrial — ❑ Accessory building ❑Multi-far»ly Number of bedrooms: D Master builder []Other: Number of bathrooms: --- . Total number of floors: Job site address: //��j'S ts(� /DUt:c GT New dwelling area: _- square feet City/su"c/zIP: 7 V r OK 117LZ3 Garage/carport area: square feet Suitelbldg./apt.no.: -- I Projxt n;,meCovered porch area: square feet Cross street/directions to job site: 6%irr�'W �� -� Deck area: square feet Other structs-re are@: square feet 099 CHECIKWT Subdivision: r!Q `� S — Lot no.: Permit fees'are based on the value of the w, k performed. Tax map/parcel no.: Indicate the value(rounded to,he nearest dollar)of all equipment,materials,labor,overhead,and the profit for the , ` work indicated on this application. Valuation: S Existing building area: square feet New building area: square feet Niln ber of stories: — Name: ! l:C� Type of construction: Addrt:ss: �'� 8 J < �1 Aljk/k G7 Occupancy groups. City/State/ZIP: L � Existing: Phone:(3(J_T) 387,j Fax:( ) New: -- Business name: —� All contractors and subcontractors are required to be Contact name: licensed with the Oregon Consmiction Contractors Board -- - - under URS 701 and m '.:required to be licensed in the 6. Address: `- jurisdiction is which work is ceing performed.If the City/State/ZIP: applicant Is exempt from licensing,the following reasons — — — apply: Phone:( ) Fax j E-mail: - -�----- Business name: �W—Mvp Address: — --- --- --- Pfease refer to fee schedule City/State/ZtP: — City/SFed due upon application Phone:( ) Fax:( ) Amount received CCH Iic.: Date received: Authorized signature: 014< - -- This permit appilcatlon evplres if a permit is not obtained within 190 days after It has been accepted as complete. Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board. i\Building\Permn;`AIIP-PermitAppdoc 12113 440-4613T(1 I MCOt.Uwatl) One- and Two-Family Dwelling Buildine Permit Application Checklist City of Tigard Received F-t tJo D 13125 SW Hall Blvd.,Tigard,OR 97223 A-'e'B ted permiu _ Phone: 503.639.4171 Fax: 503.598 1960 24-flour Inspection Line: 503.639 4175 O Electrical Q Plumbing O Mechanical Internet: www.ci.tigard.ur.us O Other: i Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district etc. 3 Verification of approved plat/lot. 4 Fire district approval required. Name of district 5 Septic sstem permit or authorization for remodel. Existing system capacity 6 Sewer permit. _ I—f-T7 7 Water district approval. 8 Soils report. Must carry original applicable skp and signature on file or with application 9 Erosion control ❑plan ❑permit required. In Ne drainage-way protection,silt fence design and location of catch- basin protection,etc. I0� _L Complete sets of legible plans. Must be drawn scale,chowing conformance to applicable local and state wilding codes. Lateral design details and connections ust be incorporated into the plans or on a separate full-size s t attached to the plans with cross references betwee plan location and details. Plan review cannot be completed if copyNght violations exist. I I Site/plo nn drawn to scale. The plan must show lot building setback dimensions;property comer elevations(if there is mor ;.i a 4-ft.elevation differential,plan must s w contour lines at 2-R.intervals);location of easements and driveway; ". int of structure(including decks);local n of wells/septic systems;utility locations;direction indicator;lot area;bing coverage area;percentage of cov rage; impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dime . ns,anchor bolts,any hold- owns and reinforcing pads,connection details,vent size and location. _ 13 Floor plans. Show all dimensions,room i i[cation,windo size,locar on of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,bale_ and deck 30 inches ibove grade,etc. _ 14 Cross section(s)and details. Show all framing-membe s d spacing -uch as floor beams,headers,joists,sub- floor,wal construction,roof construction. More than one cross n�quired hearly portray construction. Show details ofall wall and roofsheathing,roofin ,roo siding material,footings 1 and foundaticri,stairs,fireplace construction,thermal insulation, tc. 15 Elevation views. Provide elevations for new construction;minium of two elevations for addrhonrBTetnevers Exterior elevations must reflect the actual grade if the change in ade is greater than four foot at building envelope. Full-size sheet add,-ndums showing foundation elevations with cr ss 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 t en ineen.ng standards. _ 17 Floor/roof framing. Provide plans for all floors/roof assemblies,i dicating member sizing,spacing,and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details owing placement of rebar. F:ir engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current ce design values for all berms and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. _ 20 Manufactured floor/roof truss design details. CL 21 Energy Code compliance. Identify the prescriptive path or provid-cculations. A gas-piping schv vatic is required for four or more appliances. H 22 Engineer's calculations. When required or provided,(i.e.,shear wall, oof truss)shall be stamped b;an engineer or N architect licensed in Ore on and shall be shown to be awlicable to the ro'ect under reviev. 23 Five 5 site lana are r wired for Item I t above. Site plans must be S /2"x I I"or 11"x 17". m 24 Two 2 sets each are required for Items 16, 19,20 and 22 above. (j 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building lans will not be accepted. W 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. J 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 hce protection measures as r wired by conditions oCapprnval. 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 structure;to existing residential dwellings on a lot of record approved prior to September 9, 1995. i:\Building\Perrnits\One-Two-FamilyChecklist.doc 12/0- Building Fixtures Plumbing Permit'Application City of Tigard Received P.mrit No. 13125 SW Hall Blvd.,Tigard,OR 97223 Date/9y. - - Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Parmit No: _DatelBy. __ 24 Hous Inspection Line 503.639.4175 Dats Ready/8y: heir Ql Sa Pap Z for Internet: www.ci.tigard.or us Notil)ed/Method: Supplemental Information New construction Fors special fn ormation was clYeckUst 0 Demolition _--�' _ - - Description _I Qty, I Ea. Total iEPkdditiotv,•iteration/replacement ❑Other: New 1-2-family dwellings(includes 100 fl.for each utility connection) SFR(1)bath 249.20 jj�,1•anci 2-fancily dwelling ❑Commercial/industrial SFR(2)bath +' 350.00 ^ Arcessory building - ❑Multi-family SFR(3)bath 399.00 ❑Master builder 0 Other: Each additional bath/kitchen 45.00 Fire sprinkler(.sq.R.) Page 2 Site utilities Jab site address! 11 L3� _ ��No 116 'C e Catch basin or area drain -16.60 City/State/ZIP: -49a 6th (JK- 3 Drywell,leach line,or trench drain 16.60 Suite/bldg./apt.no.: - Pmiect risme: � ( Footing drain(no linear ft.:__j - Page 2 / Manufactured home utilities 1 10.00 Cross street/directions to job site arl- . ,J(O Manholes 16.60 Rain Arain connector 1660 Sanitary sewer(no.linear ft.: Pege 2 Storm sewer(no.linear R.: Page 2 Subdivision: Lot no.: - Water smice(no linear _ - Tax mWpam-1 no.: Fixture or Item Absorption valve 16.60 Backflow preventer Page 2 01 _ Backwater valve 16.60 --_-- Clothes washer 1660 -- Dishwasher _ 16.60 - Drinking fountain 16.60 Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: l�rJS cs(� Juiy4 c4- Fixture/sewer cap - - -16.60 City/State/ZIP: T Floor drain/!loor sink/hub 16.60 per:(5d3) ' _ Fax:( ) Garbage di-1posal 16.60 Hose bib 16.60 _ Ice maker 16.60 Business came: - - —_ Interceptor/grime trap 16.60 Contact name: Medical gas(value:S�) Pae 2 _ B IL Address: — Primer - --� - 16.60 R City/State/ZIP: _ Roof drain(amnrtercial) 16.60 � Fax: ( ) :( ) Sink/bmin/l.vatory 16.60 Phonic ho Tub/ihower/shower pan i6 60 - E-mail• Urinal 1660 tfM%,1_� i! , Water closet 16.60 a Business name: T-fi 15 M f - !ulcer heater 16.60 J Address: Other: City/State/ZIP: `__ Subtotu Minimum permit fee $72.50 Phone:( ) Fax:( ) Residential backflow minimum t fee: 536.25 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) Aath(,tizerl signature, State surcharge(8%of permit fee) - - _ TOTAL PERMIT FEE Print name: 2.� Date: This permit application expires If a permit Is not obtained within 186 days after It hu been accepted as complete. *Fee methodology set by TH-County Building Industry Service Board. teeildinaNrer,ru\PLMF-rematAppdoc 12103 +404e1M1MVc0nvw8e) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: i Footing drain-to 100' 55.00 7- Sewer 2,000 $115.00 Footing drain-each additional 100' 46.49 1 to 3,600 — $160.00 1 to 7,200 5220.00 Sewer-1st 100' 55.00 1 and ater $309.00 -"ch additional 100' 4640 water Ser;-.-- 1rt loo' Ss oo Medical Gas Systems: Water Service-each additional 100' 46.E 0 Storm&Rain Davin-1 st 100' 55. < $1.00 to(3,00749 m fa$72.30 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to for the first$3,000.00 and$1.52 for each al 5100.00 or fraction thcrcof,to and ng 510,000.00.Commercial Back Flow Prevetition Device 46.40 $10,00100 to , for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee 536.23) _ 17.55 and including$25,090.00. _ Rain Chain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379,50 for the first$25,000.00 and Sl.45 for Inspection of existing plumbing or each additional VC0.00 or fraction thereof,to special)special)i requested inspections-per Niur 72.30 and including 550,000.00. Subtotal: 530,001 00 and up 5742.00 for.he first 530,000.00 and S1.20 for ace additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",please Indicate work performed by fixture. Failure to accurate) re ort fixtures could result in Increased sewer fees"'. Comore is re ding fixture work: Rath -Ti ower �— -- — - -Jacuzzvwtndv.l _ --- Car Wash -Each Stall -[hive Thru — Cuspidorlwater Aspirator — -- Dishwasher -Commercial -Domestic — -- — Unnkin Fou-ltain ---- E e Wash_ Floor Thain/sink 2" — 3' -- --— 4" — a Car Wash Drain R tiarbege -Domestic NDisposal Commcrci^1 *)Vote: I[the fixture wo k tat oder this permit results in an -Industrial increase of sewer ED[Js, sewer permit will be issued and Ice Mach./Refrig.Drains oilSeparator Oas station fees assessed for the sewer ncrease must be prld before the ® Rec.Vehicle Dun Station plumbing permit can be iss ed. Shower -Gang W -Stall Sink -Bar/lavatory Ouantiiv Total -Bradley comme Isometric or riser diagram is equired If fixture quantity -cnmmrn aI -Service total is>9. — Swimming Pool Filter — — Washer-Clothes Water ExtractorPlan Review Water Closet-Toilet — Plan review is required If fixture quantity total is>9, Urinal Other Fixtures: i.\BuitdingXPenn Cr 1-M-PertrriUpp cim 3/03 Electrical Permit Application City of Tigard ReceiYed PemitNo.. C 13125 SW Hill SM.,Tigard,OR 97223 Dsie/B Plan ReviewOther Phone: 503.639.4171 Fix: 503.59A.1960 DetelD Permit: Inspection Line: 503.639.4175 Date Ready/By:dy/By: '- '— Jury as sP.ge 2 for Internet: www.ci.tigard.or.ua Nonfled/Method: aupple.nentatlnformation []New construction ddition/alteration/replacement Please check all that apply: ❑Demolition n Other: fjService over 225 amps,comm'I ❑Hazardous location ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft., of i-and 2-fiemily dwellings 4 or more new residential �l and 2-ftunily dwelling ❑Commercial/industrial Ei Accessory building ❑System over 600 volts nominal units in one structure ❑Multi-family ❑Master builder ❑Other: ❑Building over three stories ❑Feeder,400 strips or more []Occupant load over 99 peraom ❑Manufactured structures or ❑Egmss/lighting plan RV park Job no.: Job site address: �� ❑Health-cart facility ❑Other:— — Submit 1 sets of plans with any of the above. City/State/ZiP: o 'the above are not applicable to temporary construction service MINSuite/bldg./apt.no.: Project name: �• .3_ -Description Qb, lea. Tetai Cross street/directions tooL site: 1 , New residential single-or multi-family dwellingunit. — J — /C) �/ tSh _ includes attached garage. 1,000 sq.A.or leas �� 145.15 _ 4 Subdivision: Lot no.: Ea.add'i 500 sq.ft.or portion 1 _ 33._40 1 Limited energy,residential 75.00 2 Tax map/parcel no.: Lirteted aria _— - gy,non-rraidential 75.U, 1 2 Each manufactured or modular )„ �� C / !� dwelling,semce and/a,feeds 90.90 2 � LSL �Pr✓5.�� /l:� �,(�(�A QServices or feeders last_ailatlen,alteration,and/or relocation 200 amps or leu 80.30 --- 2 201 snips to 400 amps 106.85 2 �% � 401 amps to 600&nips 160,60 2 Name: 601 snips to 1,000 arMs 140.60 _ 2 Address: Ova 1,000 apps or volts 434rM 2 — `, — Reconnect only b6.85 2 City/State/ZEP: a L c- 7 e Z -3 Temporary servlea or feeders Installation,alteration,and/or Phone: _ 3��U — relocation G� (5d3) Fax:( _► 200 arras or leas 66.95 1 Owner Installation:This installation is being made on property that I own which is not 201 arras to 400&trips 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 70 1. 401 amps to 600 amps _ _ 133.75 _ 2 Ovmer sig rr Date: _ Branca circuits-new,alterstle (w e:teasbn,per p&nel A.Fee for branch circuits with service or feeder fee,each 6.65 2. Business name: branch circuit _ B.Fee for branch circuits Contact name: _ without service or feeder the, 46.85 '7>m 2 Address: each branch circuit ch sdd'I branch circuit __ 6.65 2 a City/State/ZIP: Miseellaaeoas(service or fa_der not Included) Phone:( ) Fan: ( ) Pump or irrigation citcie53.40 2 Sign or outline lighting 53.40 2 E-mail: Signal circuit(s)or limited-_ erergy panel,alteration,or Business name: extension.Desimbe: Page 2 2 - (? Address: Each additional Inspection over allowable In Any of the above W — -� -- —� Per inspection 62.50 -•l City/State/ZTP: Investigation pe•hour(I hr min) 62.50 Phone:( —) Fax:( ) Industrial plant hour 1 73.75 CCB Lic.: -- Elect*ical Lic.: _ Suprv.Lic.: Subtotal Suprv.Electrician signature,required- — Plan review{2596 of permit fix) Print names Date: State surcharge(8%of permit fee) � -- TOTAL PEWITT FEE 1 Authorized signature: This permit application expires If a ps, h not itioned within Ito days after It has been Per opted u cossplare Print name: - Date: Fee methodology Why by Tri-County Bt0iing Ittlastry Service Board ••Nt FAW of hweetion per permit allowed i\Eaitdmg\aermitret.C-remwAppdx 12103 W-aatsrliorovcotwwne Electrical Permit Auglication - City of Tigard , Page 2 -Supplemental Information LIMITED ENERGY PERMIT FEES: Foe for In residential systems combined.....•.. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air onditioning System* ❑ Vacuum Systems* ❑ Other: 1 Fee for Wk commercial system....................... 105.00 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems .r ❑ Boiler Controls ❑ Clock Systems F-1 Data Telecommunication Installation ❑ Fire Alarm Installatinn ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems j ❑ Landscape Irrigation Control* ❑ Medical I r l Nurse Calls ❑ Outdoor Landscape I.ightin ❑ Protective Signaling ❑ Other Total number of cumme ial systems: *No licenses are requir d. Licenses are required for all other Installations i:VkWmg\ewmtv%ffLC-rE.ffdup eac OW3 CITY OF TIGARD 13125 SM. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE MIKE'S ELECTRIC 11070 SW ALLEN BLVD BEAVERTON, OR 97005 Electrical Signature Form Permit #: MST2004-00249 Date Issued: 8/24/2004 Parcel: 2S1 C3DB-63200 Site Address: 11385 SW NOVA CT Subdivision- GENESIS Block: Lot: 008 Jurisdiction: TIG Zoning: R-4.5 Remarks: Bathroom remodel. 8-31-04 Change In electrician from owner to Iic. contractor. You; company has been indicated as the electrical contractor for the permit indicated above. In order for the eleutiical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACYOR. REED, BRENT MIKE'S ELECTRIC 11385 SW NOVA CT 11070 SW ALLEN BLVD TIGARD, OR 97223 BEAVERTON, OR 97005 Phone #: 503-539-3870 Phone #: 503449-6991 Reg #: MET 00003 13 Lit; 50209 SUP 4230 ELF. 34-18c AN INS( SIGNATURE IS REQUIRED ON THIS FORM 04 1 09 Si nature&Sue n Electrician 9 P If you have any questions, please call 503.718.2433. FROM :Norths+FSC FAX N0. :5036495544 Oct. 12 2004 FA:04PM Pi 10/12/2001],:16 FAX 6Q359A1/60 CITY OF TIGM 2001 zew�W BLVD. RECEIVED TraMW, OR Gr03 p(;1 12 20U4 IMPORTANT PERMIT NOTICE Cffy OF TIGABD NA1rTF1's PLUMBING BIJIl.01NG pIV1510N 17120 Sill SHAW BEAVERTON,OR A'�007 Plumbing 6IEnPtar'0 "'ten Permit#: MM004-00340 Date issued: 8/2412004 Parcel: 28103De-03200 site Address: 11385 BW NOVA CT 3ubdMalon: (I11111INESISot: 004 Block Jurisci tion: Till Zoning: R-4-5 iRemerks: asewocm remodel. O.SJ44 ChorW in electrician from owner to Ib. con6wtor. Your Company has been IndoaW**the plumbing coMr&.In ft,-e the psi,-,iit IndiCal above` nnbaiow end the plumbing permit to be valid. P1911180 have the sppror--'.�t" inn' rldual from you company b return this Plumbing Signatures Form prior to the siert of gw wol1<to"addrees above,ATTN: Bulkling Division. N0 oiumbling inspections will be auvwMed until this oomplelad ibrm 19 roosivsd OWNER: PLUMBING CONTRACTOR: REED, ANT NORTH'S PLUMBING 11388 tllW NOVA CT 17120 HW SHAW TIGARD,OR 0742111 BEAVERTON,ON 07007 Phone#: 8t13-S - ro 0: 64046" Reg# 'OLM 018'B IL AN INK SIGNATURE 19 REQUIRED ON TRIS FORM Slgnatu,,v vP Authorized Plumber It you have any questions, please call 503.718.2433. I CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)1139 4175 INSPECTION' DIVISION. p Business�L�i�ne: (603)B30.4171 ' 1 MOW Received Date Re3uested -y- I' AM PM BUP _ Location — L�� Suite MEC Contact Person t —�c5 — Ph 32 3 F26 PLM Contra to —__ —_ Ph(_ ) ___ SWR LLNN Tenant/Owner ._ ELC Footing ELC Foundation coess: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SR Post 8 Beam Shear AnchorsLJZ - Ext Shesth/Shear 1! Int Sheath/Shear Framing Insulation Drywall NAlling — - Firewall Fire Sprinkler - -------— Fire Alarm Susp'd Ceiling - - ---- — ----- Roof Other: — — ----------- - in ASS ART FAILPLUM -- - — NQ --- - --- — - — — Post A 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 A Beam--- Rough-In — a Gas Line T Smoke Dampers - -- N ASS PART —FAIL ELECTRICAL Service Rough-In _ W UG/Slab -1 Low Voltage _—_— Fire Alarm Final Rein on fee of$ required before nsott PASS PART FAIL spectl --req ktepectl' Nat CMy Hall, 19125 SW Hall Blvd. SITE F1 Please call for reinspection RE:_— FlUnable to hoped-no actress Fire Supply Line Ai.A / Approach/Sidewalk (Do%�� G�-- ImWeetm 100, —� Other: Final J DO NOT REMM thle t evil hm so J"till►.. PASS PKAT FAIL CITY OF TIGAIRD 24-Hour BUILDING inspec o;.,,n L:ne: (643)631"175 MST -,Doa 149 INSPECTION DIVISION . Business Une: (603)6394171 §UP Received _ Date Fequest �� __. AM ____—PM____, Location __ _ rat_. Suite MEC Contact Person Ph -,3?7 O PLm Cot trActor Ph( SWR BP.ILOING Tenant/Ownor ELC Footing ELC Foundation ess: Fig Dra:1 ELR Crawl Drain "—" Slab Inepecti Notes: SIT Past A Beam p i— Shear Anchors — Ext Sheath/Shear Int Sheath/Shear -' Framing Insulat!on Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 747 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: PART FAIL MGMANICAL Post S Beam - - ---- _ Rough-In _ d Gas Line R Smoke Dampers h Final N PASS PART FAIL — — ELECTRICAL_ 5 Service Rough-lo W UQ/Slab ...1 Low Voltage Fire Alarm Final ❑ Reinspecllon fee of required before next Ins-ectlon. Pay at City H411, 13125 SW HaM Blvd, PASS PART FAIL WIM ❑ Please can for reinspection RE:,._.___—_—_w. ___ ❑ Unable to fnapect no atom Fire Supply Line ADA ApproacWSidewalk 1111111111900M`r-i=' Other: Final DO NOT RIIAM t W& IMil-rd fto*a JO dw PASS PART FAIL CITY OF TIGARD ' 24-Hour BUILDING Inspection Line: )63E-4175 0Mer f)O�-evo.. & INSPECTION DIVISION• Business Line: (503)3x4 3171 / SUP Received / -Date R uested ( � _AM PM SUP Location Suite MEC Contact Person (—) -6, PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Footing ELCFoundation ccess: )tsUN: S L Ft a ELR _ Crawl Drain Slab Inspection Notes: SIT — Post A 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 Lir, d Smoke Dampers Final N PASS PAF . FAIL ELE_Ci'RICAL Service Rough-In _ j UG/Slab W Low Voltage - Fire Alarm FAIL ;tS97) PA WT Reinspection fee of$ required before next h>spectlon. Pay at City Nall, 13125 SW Hell Blvd. _ LJ Please call for reirs:pection RE: _ Unable to Inspect-no snows Fire Supply Line ADA iDsib Z �_ o tttlzt Approach/Sidewalk �1_ IIM'eeler Other: Final DO NOT awl i PASS PART FAIL