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14411 SW 128TH PLACE L N s N ci 0 CD 14411 SW 128`x' PIa" i °Oul N Rey I,,'+0 NW 102nd Ave.PoWNW,OR 97229 111Kx- (504)297-9406 FAX(503)296.9681 encu paWa me*i)gwesl.nd November 1, 2001 City of Tigard �U13JECT: Excavation Inspection: Lot 8, Elk Hom Ridge Estates;Tigard, Oreg,un. Permit #MST 4901- 00471 Final site e ,avation and erosion control are in place. Surplus uncompacted soils have been excavated and trucked from the site. The building footprint consis.s of firm, native, V_rtland Hills Silt. All footings are setback beyond the minimum recomm% •.idation of the original geotechnical report. No seeps or springs have been observed in the excavation. The existing soils are compatible for a spread foc ting/folindat io n design up to an allowable hearing pressure of 1,500 p.s.f and column load of 30 kips. I f you have further questions or comments, please do not hesitate to contact this; office. Very truly yc s, Paul R. Carney, CEG AiNo 13EO�� CITY OF TIGARD 94-'i0ur BUILDING .nspection Line: (503)639-4175 MST L 61 �7� INSPECTION DIVISION Business Line: (503)633-4171 _ ) � � BUP Received ---.—Date Requested— � `�� AM /1`:'_ PM BUP Location y /';�S' /` Suite __— MEC Contact Person Ph( ) f% 7 PLM _ Contractor —_ Ph(� ) _— _ SWR BUILDING-_ Tenant/Owner _ ELC Footing Foundation ELC Ftg Drain Access: — Crawl Drain ELR Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Framing Sheath/Shear `� _ S 2-10 -177 __ N S 4s; - Insulation - Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PA --PART FAIL �-- - — - -- - MB Post-&Beam —— ^--_-- - -' Under S'abRough-In Water Water Service Sanitary Sewer - — Pain Drains Catch Basin/Manhold Storm Drain ShowerPan W�,Q Other: �-- _`"" V'p n�/ AF;S) PART FAIL M .,`HANICAL Post& Beam Rough-In Gas Line Smoke Dampers _ PART FAIL RICAL Service - ----- —Rough-In _ UG/Slab - - Low Voltage Fire Alarm — -- Final Reinspection fee of$_ _ required before next inspection. Pay at City Hall, 13125 SW Hall Fllvd, PASS PART FAIL SITE R Please call for reinspection RE:__ Unable to inspect-no acce�s Fire Supply Line _ ADA Approach/Sidewalk pat• -- J Z-e - InspectorExt 3 I Other: Final _ - -- DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY �� MASTER PERMIT PERMIT#: MST2001-00411 DEVELOPMENT SERVICES DATE ISSUED: 10/3/01 13125 SW Hail Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 14411 SW 128TH PL PARCEL: 2S109AA-04200 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 008 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 20 FIRST: 1.745 sf BASEMENT: Sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.377 Sf GARAGE: /55 SI FRONT: �0 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNIT: 1 FINBSME.NT• Sf RIGHT: 5 VALUE: $302.P7G.00 OCCUPANCY GRP' Al tDFW 3 BATH: 3 TOTAL: 3,122.00 of REAR: 59 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASKING MACH: 1 LAUNDRY TRAYS: i RAIN DRAIN, ton TRAPS: LAVATORIES: 4 DISHWASHERS I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS TUBISHOWERS: GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 SCKFLW PREVNTR I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN t 100K: BOIUCMP t 7HP: VENT FANS: 5 CLOTHES DRYER: I (,AS TURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS: i WOODSTOVES: GAS OUTLETS, I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISGELLANEOUS AOD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: WISVC OR FDP' PUMPIIRRIGATION: PER INSPECTION: EA ADD'L SOOSF• 6 201 400 amp: 201 400 amp•. tat W/O SVCIFG, SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 000 amp: 401 600 amp: EA ADDL BR Cl, SIGNALMANEL: IN PLANT: MANU HMISVCIFDR: 601 • 1000 amp: 601+ampa•11000v: MINOR LABEL: 1000+amplvolt PLAN REVIEW SECTION Recor.nect only: >•4 RES UNITS: SVCIFDR>•225 A.: >000 V NOMINAL: CLS AREA/SPC OCL': ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM- INTERCOMIPAGINP: OUTDOOR LNDSC LT: eUPCLAH ALARM: OTH: BOILER: HVAC: LANDSCAPEPRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MED'CA',: OTH-. HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS. Owner: Contractor: TOTAL FEES: $ 7,957.70 This permit Is subject to the regulations contained In the PAUL P.CARNFY INC PAUL R CARNEY,INC. Tigard Municipal Code,State of OR. Specialty Codes and 14317,NW 102N,)AVE 1480 NW 102NC AVE all other applicable laws. All work will be done in POk-!AND,OR 97229-5258 PORTLAND,OR 91229 accordance with approved plans. This permit will expire if work is not started within 180 days of Issuance,or if the work Is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Ren 0: 1 Ic 5Xn5; forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OLINC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Wtr Proofing Bsm't We Footing/Foundation Dr+ Framing Insp Gas Line Insp Appr/Sdwlk Insp Grading Inspectlon Post/Beam Structural PLM/Underfloor Shear Wall Insp Gas Fireplace Electrical Final Sewer Inspection Post/Bearrl Mechanica Mechanical Insp Exterior Sheathing Ins; Insulation Insp Mechanical Final Footing Insp Underfloor Insulation Plumb Top Out Low Vol tPle Rain drain Insp Plumb Final Foundation Insp Crawl Drain/Backwater Electrical Rough In Special Insp.required Water Line Insp Final inspection Issued .1ta :LPermittee Signature : Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day r CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00244 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED- ji3/01 SITE ADDRESS; 14411 SW 128TH PL PARCL.. 2S1C '\A-04200 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 008 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF UqE: SF NO. OF BUILDINGS: 1 INSTALL TYPE..: L T PSWR IMPERV SURFACE: Remarks: Sewer connection for new single family residence. Owner: F--- _ FEES PAIJI_ R CARNEY INC 1480 NW 102ND AVE Type By _ Date /mount Receipt FORT LAND, OR 97229-5258 PRMT CTR 10/3/01 $2,300.00 27200100000 INSP CTR 10/3/01 $'i5.00 27700100000 Phone: 503-297-3406 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date Issued. The total amount paid will bo forfeited if the permit expireg. The Agency does not guarantee the accuracy of the side sewer laterals, If the sewer is not located at the measurement given, the installer shall prospect 3 feet In all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm Issued by L Permittee Signature: -�- Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day l �tv Building Permit Application y . ,. Date received:r6-PZ-O Perrrutno.: �j�y� City of 1>tgard (I/y(/Tigard Address: 13125 SW Flail Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: �0 Land use approval: _. 1&2 family:Simple Complex: o� t � 1 &2 family dwelling or accessory U Conuncrcial/industrial U Multi-family U New construction U Demolition U Addition/alteration/replacement C Tenant improvement U Fire sprinkler/alarm rJ Other: O' t Job address: I'M 17W I Bldg.no.: Suitc no.: Lot; Block: Subdivision: �/ yr/� ;:s 'ax map/tax lot/account no.: Project name: ��► Description and location of work on premises/special conditions: /y C _ 5 / •r++t� ( j r C Name: f fi� _� Cwt.4� it Mailing address: L,1V o N t.�. o-Z,, r/ / v! 1&2 frmily dwelling: City: 7 _ State:O t ZIPS: ?2Z Valuation of work........................................ $ 72/ Phone: n3-Z7 7 rye Fax: z -'61r E-mail: r✓e..y.. ,,e No.of bedrooms/baths................................. Owner's representative: '� ,��/ �,,� .-._e ^' 7T-otal number of floors................................. Z 5 Fax 1:-mail Phone: �— New dwelling area(sq. ft,) .......................... % Garage/carport area(sq.ft. Nanne: I� Covered porch area(sq. ft.) ......................... /z G a are Mailing address: Deck • (sq. ft.) ........................................ .__. City: State: ZIP: Other structure area(sq. ft.)......................... _ Phone: CommercitUindusirihl/multi-family: Valuation of work........................................ Business name: y.,, Existing bldg.area(sq. It.) .................I........ Address: �. New bldg.area(sq.ft.) ....I.........I................. — State: ZIP: Number of stories ........................................ City: -- Type of construction.................................... Phone: _ _ Fax: E-mail; - - CCB no.: S" S3 S — Occupancy group(s): r:xisting: _ -- �---�`� (City/metro lic.no New: — - Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under \�^ Name: �— 7-t- AJ1 rte, provisions of URS 701 and may be required to he licensed in the \_ ) Address:_ Y/ 5 ,- S rr .. r r# jurisdiction where work is being performed. If the applicant is 111111�� Cit : A�T r, Sta[210 ZIP: "7 Q F exempt from licensing,the following reason applies: _Contact person: Mofke Plan no.: J Phone: I ar 1' mail _ Mt Name: outact person: Fees due upon application ........................... ) Address: Date recei;ed: (� 'ity: Istale: 7.IP: Amount received ......................................... $ Nhone: Fax: E-mail: _ Please refer to flee schedule. 1 hereby certify I have read and examined this application and the Nor ail jurirdfcarnre weer„credit cards,please tall jurisdieM>tr for mine tnrrnmsuon. attached checklist.All provisions of laws and ordinances governing dila u visa U MasterConi work will be complied_ th,whe r •citied herein or not. Credit card number B f K/S_ C5 �LpTL— Authorized si nature: ( Date: None ur cannralder n shown on II c iW— Print name:�0t,- r! ��" _ _ $ Cardholder dpruure Amount Notice:This permit application expires if a permit is nut obtained within 180 days after it has been accepted as complete. 440-41.1(~!Oki) I OHC-and Two-h'amily Dwelling Building Permit Application Checklist Reference no.: -- --�- -�— Associated permits: CuyuJ77gurd Cit Tigard City o �+ ❑Electrical U Plumbing ❑Mechanical Address: 13125 SW Ball Blvd,T ;ard,OR 9722 A U Other: Phone: (503) 639-4171 fax: (503) 598-1960 ilip FOLtOWING I UEMS ARE REQUIRE! 1 '_C , 1 Land use actions eomnleted.Seejuir,dietioncriteria h n concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platllot. _ 4 Fire district __approval required. 5 Septic system permit or authorization for remodel. Existing system capacity_ -- 6 Sewer permit. 7 Water district approval. _ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must he incorporated into the plans or on a separate full-size "Meet attached to the plans with cross references between plant locu!ion and details. Plan review cannot be completed if co yri ght violations exist. 11 Site/plot plan drawn to male.'rhe plan must show lot and building setback dimensions;pruiv.rty corner alevalions(it' there is mune than a 4-11.elevation differential,plan must show conlour lines at 2-ft.intervals);location of easements and driveway,lbolprint ol'structure(including decks);location of wells/septic systems;utility Iocafions;uirection indicator,lot arta;building coverage area;percentage of coverage;impervious area;existing structure on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and localirii. _ 13 Floor plans.Show all dimensions,room identification,window size,location ot'smoke detectors,water treater. furnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _ 14 Cross section(s)and de►gils.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall consuuetion,roof cons+ruction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sh•alhing,roofing,rool'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. lixicrior elevations must reflect the actual grade if the change in grade is greater than four foot at building enveinpe. Cull-size sheet addendunis showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive patb)and/or lateral analysis plans. Must indicate details and locations;for nun- rescri rtive path analysis provide spec iIiL ions and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing 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 axle db.-sign values for all beams and multiple joists - over 10 feet long and/or ny hearn/joist carrying a non-uniIf lad _ 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 lruss)shall be Stamped by an engineer of architect licensed in Oregon and shall be shown to be applicable t,,111, project under review 23 Five(5)site plans arc required for Item I I above. Site plans must be 8-1/2"x I I"or I I"x 17". — 24 Two(2)sets Cacti are required fur hent% 16, 19,20 8c 22 above. _ 25 Building plans shall not contain red lines or tape-one 26 No rolled,reversed or mirrored building plans will he accepted. 27 - 28 Checklist must be completed before plan review start date. Minor changes or notes on r ubmitted plans may he in blue or black ink. Iced ink is reserved for department use only. 4404614 RAXWoM) i Plumbing Permit Application Date received: . a2_o Permit no.: City Of 'Tigard Sewer permit no.: Building permit no.: Au, less: t.)125 SW Hall Blvd,Tigard,OR 9722; City of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no. Land use approval: V Case file no.: Payment type U 1 &2 family dwelling or accessory J Commercial/industrial U Multi-family J Tenant improvement U New comstni cion U Addition/alteration/replacement J Foodservice U Other: .1168 SITE INFORMATION' 1 Jot)..'dress: 9VI/l szf--- �� iJICS _ Description "Y. Fee.(ea.) 'Total New I-and 2-family dwellings only: B lot i,.no.: [Suite no.: Tax�ntap/lvt lol/accounlno.: (includes 100 ft.for each utility connection) SFR(1)bath Lot: F IB[ock: I Subdivision:'r IX fl-r„ 7Z.✓ 4 SFR(2)bath Project name: _ _ SFR(3)hath City/county: ZIP: Each additional bath/kitchen Dcscriptt'' n and location o work on premises: Al_--- 5..., L— Siteutilities: �.►�•. / _ .,,� r Catch basin/area drain _ tst.date ofcompletion/inslxction: Z Drywells/leach line/trench drain Footing drain(no. lin. 11.) Manufactured home.utilities Business name: .' jn �/.,�� 4,—,�� Manholes Address: Z / S. L _/�f Y• Rain drain connector _ City: Otrt ... C. r Stated ZIP: O Sanitary sewer(no.lin.ft.) Phone:-vb -)U_ ax: E-mail: Storm sewer(no. lin. ft.) CCB no.: Y o / Plumb.bus.reg.no: j -36Z Water service(no, lin,ft.) — - -� City/metro lic.no.: Fixture or item: Contractor's -- Absorption valve ... representative signahtrh: — -- - Back flow preventer _ Print name: Date: Backwater valve Basins/lavatory _ Name: Clothes washer _ Address: Dishwasher Drinking fountain(s) City: State: LIP: Ejectors/sump Phone: Fax: E-mail: Expansion tank _ Fixturc/sewer cap _ Name(print): Moor drains/floor sinks/hub Mailing address: v i(/e,� /� u c. Garbage disposal Cit State:6/2 ZIP: .2� Bose Aker - y .►T�� Ice maker _ Phone: - Fax:Z 46- 76p F..-mail: Intercc ttor/grease trap _ Owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I own as per ORS Chapter 447. Sin (%),Basin(s),lays(s) _ Owner's signature: _ Date: Sump Tubs/shower/shower pan Urinal Name: Water closet — Address: Water heater City: _ State: ZIP: _ Other: Phone: Fax: F-mail: _ Total NM all Jurisdictions accept rredit cards,please call jurisdiction fru mm infonrwion. Minimum fee................$ Notice:'flus pcnnit application - U Mma U Mastercard Plan review(at V %) $ expires if a pcnnit is not obtained Credit card number:—_ _— / / within I80 days after it has been State surcharge(8%)....$ _ ExpiresTOTAL . Name of cordholderushovvnoncredit cord accepted avcomplete. ••••••••••• ••• ••••••$ s Cardholder signature — Amount 4404h 16 trtMCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only- FIXTURES (individua) QTY ea AMOUNT (includes all plumbing fixtures in I PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 16.60 O for each utilityconnection Lavatory - --- _ _ One 1 bath $249.20 Tub or Tub/Shower Comb_. 16.60 _ Two(2)bath $350.00 Shower Only 16.60 Three(3)bath 1 $399.00 Water Closet _ 16.60 _ SUBTOTAL Urinal 16.60 1%STATE SURCHARiE _ - Dishwasher 16.60 _ PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal lh 60 __�- TOTAL Laundry Tray 16.60 Washing Machine 16.60 Fl:,or Drain/Floor Sink 2" 16.60 PLEASE COMPLETE: 3" 16.60 4" 16.60 Water Heater O cc iversion O like kind 16.60 Quandt b Work Perfo mad Gas piping requires a separate mechanical Fixture Type: New Moved Roplaced Removed/ permit. _ napped MFG Home New Water Service 48.40 Sink _ �- MFG Horne New San/Storm Sewer 46.40 Levator -- _-. _ Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) 1660 Urinal - _ Dishwasher - Garbage Disposal Laundry Room Tray ----- - Washin Machine Floor Drain/Sink: 2" _ Sewer.1 sl 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater Other Fixtures Water Service-each additional 200' 46.40 (Specify) Storm 8 Rain Drain-tat 100' 5500 _ Storm 8 Rain Drain-each additional 100' 46.40 _-- ---- Commercial Back Flow Prevention Device 46.40 -- Residential Backflow Prevention Device* 27.55 - - Catch Basin 16.60 Inspection of Existing Plumbing or Specially 7250 Requested Inspections perthr COMMENT S REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - Gtease Traps 16.60 --- ----------- --- - QUANTITY TOTAL - -- - ---- -- - - Isometric, Iser diagram Is squired If -- -- ------- Quantity Total is >8 - --- -- *SUBTOTAL ----- - - 8%STATE SURCHARGE --- -- ----- "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture gly total Is>g TOTAL 5 'Minimum permit lee Is$72 50•s%stale,surcharge,except Residential Backflow Prevention Device.which Is$36 25.a%state surcharge **All New Commercial Buildings require plane�Oth isnmetric or riser diagram and plan review I:\dsN\furms\p'm-fees.doc 10/10!00 Mechanical Permit Application "Datereceived; S oip�o Perp-rit no.: 1�Sti1o0/•qpT City of Tigard Project/appl.no.; Expii.:date: Ciryn(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 C tse file no.: Payment type: Land use approval: Building permit no.: tYlPt OF PERMIT ❑ I &2 family dwelling or azcessory ❑Commercial/iw)u%liiai U Multi-family U Tenant innprovenncfit ❑New construction U Addition/alteration/replacement U Other: 1 1 1N COMMERCIAL VALUATIONt Job address: Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: _ value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/accouni uo.: - profit. Value$ Lot: Block: Subdivision: *See checklist for imporcnt application information and Project name: jurisdiction's I'ee schedule for residemial permit fee. City/county: Description and location of work on premises 7Airhandlingunit LINK1 i hcc(r�.) 'Ibirl Est.dale of completion/inspection: - -- Desmi lon Ute. Rc..opl� 12t+.only Tenant improvement or change of use: CFN1 _ Is exisNnq pace heated rn conditioned?U Yes No Air conditioning(site plan required) Is existing space insulated?t.-i Yrs U No A teA t raiinn o existing ► s stem 1 Boiler/compressors Stair boiler permit no.: Business name: Gi/- TZ. 6, s _�_ _ HP Tons BTU/H _ Address: Z odd 1'. Co-* . C �...�, tr smoke damperFJductsmo c detectors City: 7-k--0,47-44, State: ZIP: 7 2U 6 Heat pump(s tic pTa�ri rcqurc ) nsta /rep ace. urnac urncr Phone:S03-G7S' Fax: E-mail — Including ductwotk/vent liner U Yes O No CCB no.: - rc ocateeaters-su�spen ed, City/metro lic.no.: _ /e1/ ��p�_ wall,or floor mounted Name(please print): —rT Vent for lance other than furnace 1Refrigeration: NTA(-r PERSON Absorption units BTU/H Name: ('lollcrs__- _ HP Com - Address: ttcssors_ 111' uv l tal exhaust%ind ventilation: City: _ State: ZIP: I Appliancevent Phone: Fax: E-mail: Dryer exhaust-.- I _ r uo.T, ype 17 filves.kitchc azmat hood fire suppression system _ —- Name: „t. - Com,,, c,t . L:_ Exhaust fan with single duct(bath fans) Halling address: .x aiN system n ianTrom-firatin or C'— City: State: 7.IP: Fuel piping an st ut on(up to 4 outlets) Type _ _ LPG —_ NO Oil Phone: (ax' Email: ueii in g each aciditional over aut ets Process piping(sc ematicrequire ) Name: Number of outlets Other listed appliance or equpment: Address: _ Decorative fireplace City: nsert-type _ -- Phone: Fax: E-mail: Woodslovelpelictstovc Other: Applicant's signature: �^ Datc: t er. Name (print): _ Nra all Judrrfictions accern cieeat cant.,pteae cell Jurisdiction I'm"Mm Inrormailon Permit fee.....................$ _ U Visa U MaslerCald Notice:71nis perms application Minimum fee.. .............$ _ expires if a permi.is not obtained plan review(at _ %) $ l redii card number._ _�-__ a iro within ISO days alter it has been p State surcharge(896)....$ _ �Tlame nrcu o r u a rnvn on c Il—rt-li t cod $ accepted as complete. -�-— Cardholder dRnatum Amtwal 441-4617 MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEC SCHEDULE: TOTAL VALUATION: PERMIT FEE _ -, Description: - Price- Total 51.00 to$5,000.00 Minimum foe$72.50 _ Table 1A Mechanical Cede Qry' (Ea) Amt $5,001.00 to$10,000.00 $72.50 fur the 1) Furnace to 100,000 BTI t first$5,000 00 and &vents 1400 $1.52 for eachadditional$100.00 or including 2) Furnace 1 ducts ducts BTU+ fraction therer` to and including t ao $10 000_0^ includingducts&vents _ 1 -- $107001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace vent t`t o0 $1.54 for each additional$100.00 or Including 4) Suspended heater,wall heater fraction thereof,to and Including 14 00 $25,000.00. or floor mounted heater _ $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or fraction thereof,to and including 6) Repair units 12.15 _ $50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For items 7-11,see or Pump Cond fraction thereof. !ootnotes below. Com - 7)QHP;absorb unit 14.00 Minimum Permit Fee$72.50 SUBT(5TAL: $ to 100K BTU _ 8)3-15 FIR absorh 25.60 8%State Surcharge $ unit 100k to 500k BTU _ - _ 9)15-30 HP;absorb 35.00 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU - _ Required for ALL commercial permits only _ 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 _ 11)>50HP:absorb ------ -- -- unit>1.'r5 mil BTU 87.20 _ 12)Air handling unit to 10,000 CFM ASSUMED VALUATIONS PER APPLIANCE: 10.00 -- Value Total 13)Air handling unit 10,000'JFM+ 17,20 Description: Ot Ea Amount -___- Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler 10.00 ducts&vents Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct 6.80 ducts&vents _ - `-- Floor furnace including vent 955 16)Ventilation system not Included in 10.00 Suspended ho3ter,wail heater or 955 a Bance permit _-_- floor mounted heater17)Hood served by mechanical exhaust 10.00 Vent not included In applicance 445 - - - permit _ _ 18)Domestic incinerators 17.40 Re air units805 ,r 3 hp:absorb.unit, _ 955 19)Commercial or Industrial type incinerator 69.95 to 100k BTU 3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves 10.00 101k to 500k BTU _ - 15-30 hp;absorb.unit,501 k to 1 2,310 21)Gas piping one to four outlets 5.40 mil.BTU - - -- 30-50 hp;absorb.unit, 3,400 22, More than 4-per outlet(each) 1.00 1-1.75 mil.BTU $ -" >50 hp;absoij.unit,_ 5,725 Mt,iimum Permit Fee$72.50 SUBTOTAL: >1.75 mil.BTU _ -- - -- Air handling unit to 10,000 cfm 65E 8%State Surcha. I $ Air handling unit>10,000 cfm 11170 - Non- ortable eva orate cooler 656 T OTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 _ Vent system not Included In 656 �- appliance permit Mer Inspections enc)Fees: Hood served by mechanical exhaust 656 Inspections outside of normal business hours(minimum charge-two hrn,rs) Domestic iocinerator 11170 172 5o per hour Commerclel or Industrial incinerator 4,590 2 Inspections for which no tee Is specifically Indicated (mleimu 'ti oo 4 I'llt noun) $72 50 per hour Other unit,induding wood stoves, 656 3 Additional plan review required by changes,additions or revisions to plans(minimun In•:erts,etc. chotge-one-hell hour)$72 5o per hour Gas piping 1-4 outlets _ 360 Each additional outlet 63 'State Contractor Boiler Certification required for units>200k BTU. - - -- ---- _ _ **Residential AIC requires elle plan showing placement of unit. TOTAL COMMERCIAL $ VALUATION: _ IAdsts\forms\rne.ch-fees.d,)c 08/06/01 Electrical Permit Application "Datereved: 3 a8 0( Permit no.:) City of Tigard Projecvappl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: ry: Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval: 'TYPE OF k9NIVY. U I &2 family dwelling or accessory U Commercial/industrial UMulti-family J Tenant snip ttee/jIfNnunt ew construction U Addi(ion/alteration/replacement U Odder: _ U Partial 1 SITEINFORMATION Joh address: no.: Suite no.: ITax nuylitax lot/account nn.: I.ot: Blcxk: Suhdivision: '"` TIle — Project name: Description and location of work on premises: iv Sv,-tat er Estimated date of cornpletionhimpection: i Job no: 777� Business name: ✓y.. i.� (' 7, L 1)w c ription Ory. New residential anek or multi lamiiy per Address: �' „'S ' io dtvenitt,;unit.Int lit("attaclx4i garage. City: Cj✓f /w) Slalc:b// ZIP: 97011 O Servicrlit,lutkd Phone: Fax: E-mail: 1((N)sy It,or less 4- CCB no.: O Q Elec,bus. lie.no: .�6- /O V1 �' Each additional 500 sq.ft.or portion thereof Limited energy,residential 2 City/metro lic.no.: /o i o Limited energy,non-residential 2 Each manufactured home or modular dwelling Signature of sulxrvising electrician(required) pate Service and/or feeder, _ Sup.elect.name(print I„,.,,�,.�,,, Servltworfeeden-Inetallatlon, alteration or relocation: 200 amps or less _ N•.unc(print): / -►- ��- • � ��_� .�C. 201 amps to 400 ams 2 Mailing address: 1198' U rl1(... e6 2 c c 401 amps to 600 amps 2 601 amps to 100( w ps 2 _ City: T�-+ 741 State:OPL ZIP: �,2� over 1000 amps orvjlts 2 Phone: Zf 7- ?qc G 1 Fax: I E-mail: Reconnect only - I owner installation:The installation is being made on property I own Temporary services or feeder- which is not intended for sale,lease,rent,or exchange according to Installatlon,alteration,orrelocilion: 21x)amps of less 2 ORS 447,455,479,670 701. 2011 atuc to 41)11 nm s 2 p r Owner's si mature: �./_ Date: S Z3—0 1 401 to 600 amps — - -- 2 Branch circult.-neh,alteration, or extension per panel: Name: or Fee for brunch circuits with purchase of Address: service mr feeder fee,each brant' rcuit 2 City: Slaw: ZIP: B. Fee for branch circuits without purchase Phone' hax: I 1'. mail: of service or feeder frx,first branch circuit: 2 Each additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-couuneicinl U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Foch si it or outline lighting 2 ^ family dwellings UBuilding over 10,000squarrfeet fuuror Signal.rcuit(s)oralimited energy pnncl, U System mef 6W volts nominal more residential units in one structure alterai ten,or extension” _ _Y 2 U Building over throe stories U Feeders,400 amps or more "Llescri don: U Occupant load over 99 persons U Manufactured structures or RV park FAch additional Inspection over the allowable In any 011ie above:' U Eltre..x/lightingplan U Other _ pertnspecoon Submit_rets of plain with any of the above. Invexog tion tee _ 71he above are not applicable to temporary construction service. other Nnl all jurlalb don srcrpt calm card%,plemw call juddiction fro more inftamuuion Notice:This permit application Permit fee..........�........S -_ _-- U Visa U Maslerc'aid expires if a permit is not obtained Plan review(at _ %) $ Cmdli card number _ L / within 180 days after it has been Stale surcharge(876)....S rapiers accepted as complete. TO'T'AL . $ Name of c"GI&I u show"on credit carr C. r sijptattue Amount 440-4615(6AXYCOM) Electrical Permit Fees: Limited Energy Fees: `— - ---- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee ScheiJule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOP ALL SYSTEMS) Service included: 'terns Cost Total W Check Type of Work Involved: asidential-per unit 1000 sq.it w less $145.15 _ q Audio and Stereo Systems Each additional 500 sq.It or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy — _ $75.00 Each Manurd Home or Modular Garage Door Opener' Dwelling Service or Feeder $90.90 Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 _ Vacuum Systems' 251 amps to 400 amps $106,85 _ 2 401 amps to 600 amps _—M $160.60 2 Other 601 amps to 1000 amps $240.60 — 7 Over 1000 amps or volts $454.65 2 Reconnect only _ $68.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system............. ........................... .... ......... $75.00 Installation,alteration,or rt ocation $68.85 2 (SEE OAR 918IfiO 2b0) 200 amps or less _- 201 amps to 400 amps $ 00.30 2 401 amps to 600 amps $13375 (;heck Type of Work Involved. 2 Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"abo a. Branch Circuits I Boller Controls New,alteration or extension per panel a)The fee for branch circuits Clock Systems with purchase of service or feeder fee. Each branch circuit $6.65— _ _ 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $46.85 HVAC Each additional branch circuit $665 Miscellaneous Ej Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $5340 Intercom and Paging Systems Each sign or outline lighting _ $5340 —- - Signal circuit(s)or a limited energy Landscape Irrigation Control' panel,alterag,)n or extension _ $7500 _. t1inor Labels 1101 $125.00 Medical Each additional Inepectlon over the allowable In any of the above Nurse Calls Per inspection $62.50 —�_ $62.50 Per hour —In Plant _— $73.75 Outdoor Landscape Lighting* Fees: Protective Signaling Enter total of above fees $ —. n Other 8%State Surcharge $ Number of Systetns 25%Plan Review Fee ' No licenses are required. Licenses are required for ell other insleltatinns See"Plan Review"section on $ _ front o1 application __-_- Fees: Total Balance Due $ Enter total of above fees S ❑ Trust Ar.rount M _ 8%State Surcharge S Total Balance Due S 0dsts\ferm+\cic•fees.doc 10/09!00 rCffYkOF ARD OREGON INTENT TO HAUL EXCAVATION (LOTS STEEPER THAN 20%) (print name), hereby certify that ALL excavation material on the subject property will be removed from the site and not be pla.;ed as file, except. for that amount necessary to back-fill the foundation ONLY. I Understand that failure to remove the excavation material will result in the requirement to remove the material or obtain a grading permit by submitting grading plans prepared b',, a licensed engineer accompanied by a geo-technical report regarding the placement of the excavation mcicerial as fill. I further understand that my footing in3pection will be denied if that inspection reveals that excavated material has riot been hauled, gild that work will be stopped and no further inspections conducted until the City has received and approved a plan and report from a geo-tE'clinical engineer regarding placement of the fill material. I 1 Signature Date Permit #: �IJT- �o�l ' CCcI 71 _— —,� ` Job Address: �� ' 1• rLO ��' IRC Subdivision, 9-Q _� `of f� I haul doc IDL'TI 7199 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)684-2772 --�� OL�� 4� ',;Z G arm _ I S 79i-Al;-- y?z ' J► CITYOF '1'°I GA R PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00165 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/16/02 SITE ADDRESS: 14411 SW 128TH PL PARCEL: 23109AA-04200 :SUBDIVISION: ELK HORN RIDGE ESTATES BLO%:K: ZONING,: R-7 LOT: 008 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; STORIES: WATER HEATERS: TRAPS: ----FIXTURES _ LAUNDRY TRAYS: CATCH BASINS: SINKS: SF RAIN DRAINS: OTHER FIXTURES: LAVATORIES: URINALS: GREASE TRAPS: TUB/SHOWERS: SEWER LIN--: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential back flow preventer. Owner; FEES _ PAUL R CARNEv INC :7 P5P e BY Date Amount Receipt 1480 NW 102ND AVE T CTR 5/16/72 $36.25 27200200000 PORTLAND, OR 97229-5258 T CTR 5/16/02 $2.90 27200200000 Phony 1: 503-297-3406 Total $39.15 Contractor GREENFIL LANDSCAPE IRRIGATION 21667 SW .JAY ST ALOHA. OR 97006-7072 REQUIRED INSPECTIONS Phone 1: 998-5708 RP/Backflow Preventer Reg #: PLM 7214 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for mor,1 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-00 a through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued B ir^ � f/ l y' _L �' Permittee Signature: Call (503) 639.4175 by 7:00 P.M. for an Inspection needed the next business day Plumbing Permit Application "eived: � Permit no. 1 X City of Tigard Sewer Permit no.: Building permit no.: Address: 13125 SV:Ball Blvd,Tig^_rd.OR 972'_':r - CitYofTigard 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: _ U 1 Bt:2=familydwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement ❑ New U Addition/alteration'replacement U Food service U Other: Description (?t . fee(ea.) Total Job address: !`-i L4!l S Zai' " Y L New 1-and 2-family dwellings only: Bldg.no.: Suite no.: (includes 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath — Lot. IBlo�ckk Subdivision: �ZJ�(j•} t21O6— SFR(2)bath / Project name: — SFR(3)bath Cit /count ZIP: Each additional bath/kitchen city/county: Ti1�o;z1� —�---- Description and location of work on premises:�? a✓ CatchSheu ba in/ Catch hasin/area drain -_ Drywells/Ieach line/trench drain Est.date of coil pletion/inspection: Footing drain(no.lin. ft.) Manufactured home utilities Business name: IZ t< i IC, LA��S�1�C Manholes Address 662—S,IJ• S,Q—r ST(PfT I Rain drain connector — City: /1Ce i la l Slate:O fL ZIP: 9`7bo Sanitary sewer(no. lin. ft.) _ ----- Stonn sewer(no.lin. it.)Phone: 4l g 5-77)8f Fax: 37 Z--86 1 E mail: 7 2-1 — Wal-n-service(no. lin.ft.) CCB no.: _- Lr umb.bus.reg.no: _ fixture or item: City/metro lic.no.: Absorption valve _ Contractor's representative signature. (Dl� E416w Back flow preventer 1 °riot name: Backwater valve -- Basins/lavatory -- Clothes washer Name: `—— Dishwasher Address: -Drinking fountain(;) City: --- -�Statc: ZIP: Ejectors/sump -_ Fa Phone: x: I: iIiall: Expansion tank --- _ Fixture/sewer cap Floor drains/floor sinks/hub - Name(print): 1�, Jt- �/4 ►fit;' _ Garhage disposal _. Mailing address: _ Hose bibb City: State: 7.IP: Ice maker _ Phone: Fax: E-mail: Interceptor/grease trap (honer installation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance mid repair made by my regular Rovf drain(commercial) - enrployee on the property I owu as per URS Chapter 447. Sink(s),hasin(s),lays(s) Uwner's signature: --- D:Urr. Sump Tnbs/shower/shower ar Urinal Name: -- _--_ Water clo:ci - - Atjdrcss: - ---- _— - __ _ Water heater City: - — State: ZIP: Other: _ Phone: _ Fax. I-,-,,jail: Total — �— — Minimum fee................$ Na w all jwisdictioamga credit cantxas ,please call jurivlktian trx tonne inrarmallrwr Notice:Ibis permit npplication U visa U MasterCard expires if a permit is not obtains Plan review(at . _ 91) $ _ (credit card number: --1 -L within 180 days nller it has been State surcharge(8%)....$ -------------------- Expires TOTA1. $ accepted as complete. """""""""""' - Name rr caditoldrr uiho n at credit cod s alKnerure 440.4616(60MLOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings anti: FIXTURES (individual) _ QTY_ ea AMOUNT (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 16.60 for each utility connection_- Lavatory __ One 1 bath -_ _ $249.20 Tub or TubrShower Comb. 16.60 Two 2)bath _. $350.00 Shower Only 16.60 Three�3Z bath _ $399.00 _ Water Closet 16.60 Urinal 16.60 8%PLSTATE SURCHARGE Dishwasher _ 16.60 AN_REVIEW_ 25%OF SUBTOTAL TOTAL Garbage Disposal 16.60 - Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink z" _16.60 - PLEASE COMPLETE: 16.60 q 16.60 - Quanta b Work Performed Water Heater O conversion O like kind 16.60 Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ Ca ed ep rmii. MFG Home New Water Service 46.40 Sink_,- _ �_- Lavato _ MFG Home Now San/Storm Sewer 4640 Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only - oun Drinking Ftain 16.60 - Water Closul _ Urinal Other Fixtures(Specify) 16.60 Dishwasher Garbage Disposal -. ---- - - Laundr R Tra Machine Floor Drain/Sink: 2" Sewnr-1st 100' 55.00 --3" - - Sewer-each additional 100' 46 40 4,.Water Heater --- Water Service-1st 10C1 55.00 Other Fixtures Water Service-each addilin^al 200' 46.40 (Specify) Storm&Rain Drain-I st 100' 55.00 - Storm&Rain Drain- jach additional 100' 46.40 - Commercial Back Fir w Prevention Device 4640 Residential Backflow Prevention Device' 27.55 - Catch Barin 16.60 _ Inspection of Existing Plumbing or Specially 62.50 Requested Inspectiors ep r/hr _ COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 -- Grease Traps 16.60 - -- -"-- QUANTITY TOTAL - --- Isometric or riser diagram is required if _ Quantity Total is >9 8%STATE SURCHARGE -- --- _ "PLAN REVIEW 25%OF SUBTOTAL - Reouired only If Ilxtore qty luta.Is>0 - TOTAL Y *Minimum permit foo Is$12 50+8%slate surcharge,except Residential 11e0flow Prevenflon Device,which Is$36.28•B%)tato surcharge �J / "All Now Commercial eulldings require 2 sets of plans with Isomslric or riser diagram for plan review I.\dsts\forms\plm-fees doc 12/26/01 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 N Business: Line: (503)639-41 1 INSPECTION DIVISION BLIP - —-- Received Crate R.iquested AMBUP Location _____._— L t Suite MEC / Contact Person __--___ — Ph (.---) , SWR (---) ----- Contractor _� _— __—�_ _ Ph � - BUILDING Tenant/Owner ____._ -._ ELC _ --- Footing ELC _ __�--- Foundation Access: Ftg Drain ELF! Crawl Drain — -- SIT _—_- Slab Inspection Notes: Post&Beam - -- -- ---- --- --- _. Shear Anchors Ext Sheath/Shear --- --- Int Sheath/Shear �- C-j -�- �� -L (, ► �S Framing - -- - - Insulation4tj _ Drywall Nailing --�N---� _ ------�---- -- ----__— Firewall _ — — Fire Sprinkler -.-__ ---__--- --- ------ Fire Alarm Susp'd Ceiling Hoot n �L — Other: -. -- -- rna, __ —_ --------- -- S' PART FAIL — Post&Beam Under Slab - Rough-In — Water Service — -- --- -- -�— Sanitary Sewer -_ Rain Drains -- —i - - — Catch Basin/Manhole Storm Drain -- --- -_-- Shower Pan ----- Other: ---- -------..-- Final _ --- — -_— - -- — PASS PART FAIL MECHANICAL ---._ — ---�— Post& Beam �— Rough-in ---- ----- .--- ----- —--- --- —- - Gas Line _�— Smoke Dampers ----- ----- -- Final PASS PART FAIL - ELECTRICAL ---- Service Rough-In _ ------ UG/Slab Low Voltage -- - - --- - - --- ------ --- Fire Alarm Final L Reinspection fee of$-- __--required br fore next inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS PART FAIL SITE �� Please call for rer;spection Unable to inspect-no at cess Fire Supply LineADA � Approach/Sidewalk Date A ----- Inspector v Ext Other: _--- Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FIUL a ► _s ► -21 AI 0 ► a 0— cn `" n ! 44 U N ir " loo. � ► 44 Pi �3- ► � � cL � p ► 494 , �' .+, ► a d d o h o a ► a '" ► 44 44 a /�, nq ► �44 ► 4 `� ► 444 4 i � I ► a ► n CD r1 � G• � M Q. a S � a w o \ Cp W a. � ` f o 6 ) ° �J t1 T, 7 r CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 ,r IMPORTANT PERMIT NOTICE loci 6k :1116 FRANKLIN ELECTRIC INC � 2889 SE 18TH CIRCLE lq*% GRESHAM, OR 97080 Electrical Signature Form Permit #: MST2001-00471 Date IssUed: 10/3101 Parcel: 2SI 09AA-04200 Site Address: 14411 SW 128TH PL Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 008 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of new single family detached residence. Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical 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, ATN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: PAUL R CARNEY INC FRANKLIN ELECTRIC INC 1480 NW 102ND AVE 2889 SE 18TH CIRCLE PORTLAND. OR 97229-5258 GRESHAM, OR 97080 Flione #: 503-297-3406 Phone #: 492-4651 Req #: uc 140170 ELE 26-1041C SUP 2260S AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature 6( i ervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 �F�d1 RMH PLUMBING CONTRACTORS INC J FAX NO. : 503 6328866 Oct. 12 2701 10:22RM P1 CITY OF 1`IvARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IIVIPORTANT PERMIT NOTICE RMS+ PLUMBING CONTRACTORS INC 21954 S LARKSPUR AVE OREGON CITY, OR 97045 Plumbing 'Signature Form Permit #. MST2001-00471 Date Issued: '1013101 - Rarwt .Z31'09AA=04200 Site Address- 14411 SW 128TH PL Subdivision: ELK HORN RIDGE ESTATES BlocK: Lot. 008 Jurisdict,on: 7IG Zoning. R-7 Remarks: Construction of new singlo famlly detached residence. Fath 1 Four company has boon indicated as the plumbing contractor for the permit inrjicate,{ ab ove. In order frtthe return plumbing peri-nit to be valid, please have the appropriate individual from your company g t11i6 Plumbing Signature Form print to tho start of the work to the address above ATTN• Building Dept. No plumbing inspections will be authorized until this completed form is recoived OWNER: PLUMBING CONTRACTOR. PAUL R CARNEY INC RVH PLUMBING CONTRACTORS INC 1480 N1N 102ND AVE 21954 S LARKSPUR AVE PORTLAND, OR 97229.5258 OREGON CITY, OR 97045 Phone #, 503-297-3406 Phone 13: 503-632-8689 Reg #. I In 140418 P( M 34.362PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized P imb r i have any guestioris, pease call (503) 639.4171, ext. # 310