10235 SW HOODVIEW DRIVE !-J
O
n�
w
x
O
O
d
H
C=J
E
b
:U
H
c;
1
10235 SW HOODVIEW DRIVE
_ _ BUILDING PERMIT
/ \
CITY OF T I GA R D PERMIT#. BUP2002-00120
DEVELOPMENT SERVICES DATE ISSUED: 4/5/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111CB-01703
SITE ADDRESS: 10235 SW HOODVIEW DR
SUBDIVISION: HOOD VIEW ZONING: R-3.5
BLOC.: LOT: 2-3 JURISDICTION: TIG
REISSUE: _ FLOOR AREAS EX'i•F_...sJP.WALL CONSTRUCTION_—
CLASS OF WORK: REP FIRST: sf N: S: E: W:
TYPE. OF USE: SF SECOND: sf PROJEC I OPENINGS? _
TYPE OF CONST: 5N sf N: S: _ E: �W:
OCCUPANCY GRP: R3 TOTAL AP.EA: 0.00 sF ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMEN= sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FI_UOR LOAD: psf LEFT: ^ft RGHT: It FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BECRMS: BATHS. IMP SURFACE- PRO CORR: PARKING:
VALUE: $ %0,000.00
Remarks: Rebuild trusses in attic above bedroom — -- --Y'-- `�—
owner: Contractor:
DEREK ROTHERY ROLOFF CONSTRUCTION, INC.
1025 SW HGOUVIEW DR 1 1004 SW 37 TI , AVE.
TIGARD, OR 97224 PORTLANp, Oil 97^_19
Phone: 503-521-8990 Phone: 503-245-3895
Reg #: LIC 140721
FEES REQUIRED INSPECTIONS_i�
Type By Date Amount Receipt Framing Insp
Insp
PLCK CTR 4/2/02 '"152.95 ; (200200000 InsulFit
Final ;
Irr, , acctiotio
n
PRMT CTR 4/5/02 $235.30 27200200000
5PCT CTR 4/5/02 $18.82 27200200000
T*)tal $407.07
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applic, ale law. All work will be done in accordance with approved plans. This permit will expire if work Is
not started within 180 days of issuance, or if work is suspended for more than 180 lays. ATTENTION: Oregon idw
-squires you to follow the rules adopted by the Oregon Utility NotificAtlon Center. Those rules are set forth in OAR
952-n01-0010 through OAR 952-001-1987. You may obtain a cr+py of these rules or direct questions to OUNC by
calling (503)246-6699 or 1-800-332-2,.34'4, J/
Permittee
Signature: —
/i
Issued By: L
Call 639-4175 by 7 p m. for an inspection the next business day
Building Permit Application
City of Tigard I)ate received: �-2-b�-_ Permit no.:j3l(�Z pG 7.-b U !2
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Projecdappl.no.: Expiredate:
City of Tigard --
Phone: (503) 639-4171 I)ate issued: By: tteceipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1&2 family:Simple Complex:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
ddition/altcration/replacement U Tenant improvement U Fire.sprinkler/alarm U Other:
IIIIIIIIIII[H3 110 11 Kid I E#10--MMf
Job address: ir
G ,LFd Bldg,no.: Suite no.:
Lot: I Block: Subdivision: _•rax map/tax lot/account no.:
Project name:
Description and location of rk on premises/special conditions: f0eC le'(' 7`,e
Name:
Mailing address: 's ' T, 1 &2 family dwelling:
City: I Slate: ZIP: Valuation of work........................................ $ -_-
Phone: % Fax: E-mail: No.of bedrooms/haths................................. _
Owner's represcntalive: %/� /fyr:
c c, Total number of floors................................. _ _-
Phone: Fax: F•-mail: New dwelling area(sq.ft.) ..........................APP� ANT
_
Garage/carport area(sq. ft.)
-.
Name: Covered porch area(sq. ft.) .........................
Mailing address: i Deck area(sq. ft.) ..............................I......... - -
City: _ - f3late: LIP: Other structure arra(sq. ft.)......................... _
Phot•,c: I'a: 1 mail Commercial/Industrial/multi-family:
t Valua!ion of work........................................ $ _-..
Business narne: ! �'c 1 , i; — Existing bldg.area(sq.ft.) .................•........
State y ` .� — ----
Address: New bldg. area(sq.ft.)................................
�"` _ Number of stories
City: � � !r ZIP: r�1a
"rype of construction....................................
Phone: Fax:ft : 4 mail Occupancy group(s): Existing: --
_ - -
CCH no.: fr•
City/metro lic.no.:
- New:
tNotice:All contractors and subcontractors are r�quircd to he
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may he required to be licensed in the
Address: - junsdiction where work is being performed. If the applicant is
Cit State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.: -- —
Phone: FaX:
111111110
Name: ` e f-/7'
- Contact person._n: ,. Fees due upon application ........................... $
Address: ; ,' �, i:. Date received:
----- --
City: State•-,;L' ZIP: 777-7
.- z Amount received '
Phone: c _� , �)` Fax: Please refer to fee schedule.
hereby certify I have read and examined this application and the Not all jurisdictions accept credit card.%,plena•call jurisdiction for more Information.
attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard
work will be compiled with,whether spoeitit d h in or not. Croat card number:
�� n Expires
Authorized signallmc l e 4 Date: -��
Nene of c Ides as shown on credit card
Print name: `' 1 r l t E ( $_
Cardholder ddtnartve Amounts
Notice:This permit application expires if a permit is tint obtained within IRO days after it has been accepted as complete. 4104613(G%rOM)
I�
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
City rrfTigard -
Associated permits:
Cit of Ti Tigard g U Electrical U Plumbing U Mechanical
Address: 13125 SW Hall Blvd,Tigard,OR 97223 UOther:
Phone: (503) 639-4171 --
Fax: (503) 599-1960
Or,rWING ITE S ARE REQIfIRFD FQR
I [,and use actions completed.Sec jurisdiction criteria firr concurrent reviews.
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etr
3 Verification of approved plat/lot.
4 hire 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 appil"''tion. —
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of
catch-hasin protection,etc.
10 3 Complete sets of legible plans.Aust be drawn to scale,showing conformance to applicable local and state
huilding codes. Lateral design details and connections must he incorporated into the plans or on a separate full-si/c
sheet attached to the plans with cross references between plan location and details.Plan review cannot he completed
if copyright violations exist. _
1 I Site/pfol plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if'
tlicic is muie than a 4-1t.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/seplic systems;utility locations;direction indicator;lot
arta;building coverage atva;percentage of coverage;impervious area;existing.structures on site:,rod suaiace drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,nnni,'.uon details,vent
size and location.
I t Floor plans.Show all dimensions,room identification,window size, location oI smoke detectors,water heater,
furnace. ventilation fans,plumbing fixtures,balconies and decks 30 niches ahme grade,etc.
1-1 Cross section(s)and details.Show all framing-member sine,,and spa(me au:h as floor beams,headers,joists,sub I lour,
wall construction,roof construction. More than one cross section ma\ he w(junred to clearly portray construction. `ihow,
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding mat:vial,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 the actual grade if the change in grade is greater than four foot at building envelope.
Full-sine sheet addendums showing foundation elevations with cross references are acceptable.
i 6 Wall bracing(prescriptive path)and/or lateral analysis plans, Must indicate details and locations;for
nun-prescriptive palli analysis provide specif-LAions 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.
19 Basement and retaining walls.Provide cross sections and details showing placement of rehar, For engineered
Systems,see item 22,"Engineer's calculations."
19 Beam calculations.Provide two sell of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any heant/joist carrying a non-uniform load. _
0 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 Muss)shall he stamped by an engineer or
architect licensed in Oregon and shall he.shown Io he applicable to the project under review.
23 Five(5)site plans are required for Item I I above. tirle plans must he 8-1/2"x 11"or I I"x 17".
24 Two(2)sets each are.required for Rents 16, 19,20&22.above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted.
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. _
27 "Drawn to scale"inuicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street'Free List.
�_H
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for department use only. 4404614 MIWOM)
IN
CITYO F T ii G A R D _ MASTER PERMIT
PERMIT#: MST2002-00021
DEVELOPMENT SERVICES DATE ISSUED: 1/30/02
13125 SW Hall Blvd., Tigard, OR 97223 (5031 639-4171
SITE ADDRESS: 10235 SW HOODVIEW DR PARCEL: 2S111C13-01703
SUBDIVISION: HOOD VIEW ZONING: R-3.5
BLOCK: LOT: 2-3 JURISDICTION: TIG
REMARKS: L- ndry& kitchen remodel.
BUILDING
REISSUE: STORIES: FLOOR AREAS _ REQUIRED SETBACKS REQUIRED _
CLASS OF WORK: ALT HEIGHT: FIRST: 90 er BASEMENT: `sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SELOND: el GARAGE. st FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: FINSSMENT sl RIGHT:
5:."�oo•�nr
OCCUPANCY ORS: R3 BDRM: BATH: t TOTAL: 8000 oVALUE:f REAR:
PLUMBING
SINKS: I WATER CLOSETS: I WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN TRAPS:
LAVATORIES: 1 DISHWASHERS. t FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUSISHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PRI:VNTR: GREASE TRAPS:
MECHANICAL OTHER FIXTURES:
_
FUEL TYPES _ FURN<100K: BOILICMP c AHP: VENT FANS: 2 CLOTHES DRYER: 1
GAS FIIRN 3•10014: UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES. VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNII SERVICE FEEDER TEMP SRV0FEEDER3 BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 0 •200 amp: 0 •200 amp: WISVC OR FOR: PUMPARRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 •400 amp: 201 •400 amp: tat W/O SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 •300 amp: 401 •000 amp: EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 301 • 1000 amp: 301+ampe•1000v: MINOR LABEL:
1000+amp/volt:
Reconnect only: PLAN REVIEW SECTION
>e4 RES UNITS: SVCIFDR),=225 A. >$00 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 3 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GAPAGE OPENER, CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 679.45
DEREK ROTHERY ROLOFF CONSTRUCTION,INC. This permit Is subject to the regulations contained in Ine
10235 SW HOODVIEW DR 11004 SW 37TH AVE. Tigard Municipal Code,State of OR. Specialty Codas and
TIGARD,OR 91224 PORTLAND,OR 97219 all other applicable laws. All work will be done In
accordance with approved plans. This permit wil expire If
work is not started within 180 days of issuance,.1r if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rule3 adopted by the
Oregon Utility Notification Center. Those rules are set
Rea x: LIC 1.10/,21 forth In OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)248-1987.
REQUIRED INSPECTIONS
Footing Insp Electrical Service Mechanical Final
Underfloor Insulation Electrical Rough In Plumb Final
PLM/Underfloor Framing Insp Final Inspection
Mechanical Insp Insulation Insp
Plumb Top Out Electrical Final
Issued By 'r- e,clt._ ; ( L Permittee Signature ::;71 _�
Call (503) 639-4175 by 7:00 p.m. for an inspection necued the next business day
Building Permit Application
�- -
IDatc received: / �✓ d'1 Permit no.:Ivsmzz :3._pp t
City of 'Tigard
RojecUappl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Paymer type:
Land use approval: _ _ 1&2 family:Simple Complex:
U J�_2 family dwelling or accessory U Commercial/industrial J Multi-I:unily U New construction U Demolition
VAddition/alteration/replacement U'renant improvement U Fire Sprinkler/alarni U Other:
JOBSITIFINFORMATION
Job address: '7 ?, �� C!C lG�✓ Z 2 Bldgdg.nom Suite no.:
Lot: Block: Subdivision: I Tax map/tax lot/account no.:
Projert name: _
Description and location of work on premises/special conditions:
Name: �, S li
Mailing address: ,,:) t 1E i O✓r- f & 2 family dwelling: a-o
City: State: ZIP: Valuation of work........................................ $�Q �__
Phone:5 t3(r Zt S f Fax: E-mail: No.of bedrooms/batlrs =
Owner's representative: 'notal number of floors................................ __
Phone: Fax: E-mail: New dwelling area(sq.ft.) ..........................
Lin Garage/carport area(sq.ft.) ........................
Namc: Covered porch area(sq. ft.) ......................... X _
Mailing address: Deck area(sq.ft.) ........................................ 3S`V _
City: State: ZIP: Other structure area(sq. li.) ........................
Phone: Fax: F mailCommercinUindustriallmulti-famlly:
Valuation of work................................... ... $ —
Existing bldg.area(sq.ft.) ................. ....... —
Business name: /0 J_ ri$ v C ?'' A New bldg.area(sq,ft.) ......... ....... ............ —.
Address: p c "r-. C_"
Number of stories.................... . ............... _
City: '' c State4,e ZIP: 7Z/ Type of construction........
-- —
Phone.
CB ��F C?G f;ax ' y' E-mail:/01
_�— J �3•�-- j �cupancy group(s): f'sxistin _
Cno.: �� New:
i
ty/metro lic.no.: Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction ContractorF Board under
Name: provisions of ORS 701 and may be required to bE 1censed in the
- - jurisdiction where work is being performed. If the applicant is
Address:
Cit State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.: — --
Phone: Fax: E-mail:
Name: Contact person: Fees due upon application ........................... �—
Address: Date received:
City: State: ZIP: Amount received ......................................... $ —
phl E-mail: Please refer to fee schedule.
hereby certify I have read and examined this application and the Not ail Jurisdictions acccerm credit cards,please call Jurisdiction lex more information.
attached checklist. All provisions of laws and ordin ccs governing this U visa U MasterCard �
work will be complied vyjtb,r-1
rer � h or not.
Credit cud number: —
„ , _ rr erlrex
Authorized SlgnatucC`T<<iz Date: Z' Name of cardhoWt ax shown on credit card $
Print name: r74 t e L L n- Care: lder sidnsture tmount
Notice:This permit application expires if a permit is not obtained within 190 days after It has been accepted as complete. aa>u la t�lorroMi
>�� -'0 9
One- and Two-Fannily Dwelling
Buik g Permit Application Clizeklist
Reference no.:
Associated permits:
City ;I ii;ard (pity of Tigard U Electrical U Plumbing U Mechanical
Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other: _
Phone: (503) 639-4171
Fax: (503) 598-1960
TIIE FOLLOWINIG ! 1 F6111 PLAN RFVIPW Yes No NIA
110
I Land use actions completed. tics luntididuat criteria tui ,uncurrcnt review,.
2 Zoning.Flood plain,-.ulm balance points,seismic soils designation,historic district,etc. —
3 Verification of approved plat lot.
4 Tire 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 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.If- Site/plot plan drawn to scale.The plan must show!ot and building setback dimensions;property corner elevations(if
there is more than it 4-111.elevation differential,plan must show contour lines at 241.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locaffons;direction indicator;lot
arca;building coverage ansa;percentage of coverage;impervious arca;existing structures oil 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.Sh.)w 9!1 dimensions,room identification,window size.location of smoke detectors,water heater,
furnace,ventilativa fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _
14 Cross section(s)and details.Show all framing-member sizes and spacing such as Moor beams,headers.joists,sub-noor,
wall construction,roof construction.More than one cross section may be required to clearly portray constniction.Show
details of all wall and oof sheathing,roofing,roof slope,ceiling height,siding material,lxhtings and foundation,stairs,
fireplace construction, thermal insulation,etc.
IS Elevation views.Provi.ic elevations for new construction;minimum of two elevations for additions and remodel,;.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescr•'ive path analysis provide specifications and calculations to engineering standards. _
17 Moor/root framing.Provide plans for all floors/roof assemblie ,indicating member sizing,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining wails.Provide cross sections and details showing placement of rebar. For engineered
systems,sec item 22,"Engineer's calculations."
19 Beam calculations.Provide two sets of calculations using current cr.afe design values for all beams and multiple.joists
over 10 feet long and/or any hennh/joist carrying a non-uniform load.
20 Manufactured floorlroR truss design details. _
21 Energy Code compliance.Identify the prescript ve path or provide calculatiom:. A gas-piping schematic is required
for four or more appliances. -7
22 Engineer's calculations.When required or provided,(i.e.,;hea-wall,roof Irutisl shall he stamped by an engineer o�
architect licensed in Oregon and shall be shown to he apph(,hle to the prince(under review.
23 Five(5)site plans are required for item 11 above. Site plans must be 8-1/2"x I I"or I i"x 17". —
:4 Two(2)sets each arc required for Items 16, 19,20&22 above.
,�5 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
2S "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List.
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. 440-4614(6AW'OM)
Electrical PermitApplicatian
Date received: / Aa'j Permit :�5+r'ay.2-eeab,4/
am City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment viper
Land use approval:
TVPF0F
U I &2 family dwelling or accessory U)commercial/industrial U Multi-family U Tenant improvement
U New construction Addition/alteration/replacement U Other: _ U Partial
1 ' SITE INFORMATION
Joh address: rd� 5' Bldg. no.: Suite no.: ITax map/tax lot/account no.:�
Lot Block: Subdivision:
Project name: TDescription and location of work on premises:
Estimated date of completion/inspection:
CONIRAVI Olt A111111,1( ;k I ION
Job no: _L0 7-37/7,77, Vii' Fee ntn�
Business name: Co5'i/- •v7, cid ELc� / C tleorrpl7f,
Jr1'• (cit.) IMINI an.ie,p
Addres y Ne»rr cislentinl-single or nnr
�, da3elHop wlfl.Include511MIrlr
City: Stale:,'/ ZIP: 97 A7 Se nice Included:
100)0 s .It or less 4
Phon�:/.5�� •.3n - r'/ Fax: E-mail: - - -----
CCB no.: /-3(� Z 2 1 Elec.bus,lic.no: - 8 C Each additional 500 sq.ft.or portio thereof
Limited energy,residential
City/metro lic.no.: /0-q-4)3 /0- 0/-O )- Limited energy,non-residential
/ ' Each manufactured home of modular dwelling
1`—' L Service and/or feeder 2
Signature of superyising electrician(required) —__ nate
Sup.elect.Warne(print): ��I � .��• ,, 5erricesorfeeders-Installallon,
alteration or relocellon:
dL111ROPERTY OWNER 200 amps or less 2
Nam, (print): 1, V�LS �`L '�� k 201 amps to 400 amps - 2
401 amps to 600 amps _ 2
Mailing address: ,;' 'i c o'c Ute,^) 601 amps to I(Mamps 2
City: I State: I ZIP: Over 10(10 amps or volts - 2
Phone: Fax: I E-mail: Reconnect oIlly I
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,altenilon,orrelocation:
200 amps or less 2
ORS 447,455,479,670,701. 1
201 amps l0 40N)amps 2
Ownet's signature: Date: 401 to bon aro rs 2
Branch cl-culls-new,alteration,
or extension per pane,:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit _ 2
City: It. Fee for branch circuits without purchas,
y _ � titatr.:�ZfP_
Phone: I I ax: i 111,01 of service or feeder fee,first branch circuit: 2
Each additional branch circuit:
Misc.(Service or feeder not Included):
❑Service over 225 amps-conunercial U I Ieulth cant l ZR7 I .ch pump or irrigation circle 2
*Service over 320 amps-mling(if 1&2 U Hazardous location Fach sign nr outline lighting 2
family dwellings U Building over 10.0(x)square feet fnuror Signal circuits)or a limited energy panel,
LI System over600 volts nominal more residential units In one structure alteration,orextensinn• 2
U Building over three stories U Feeders.400 amps or more *Description: --
U Occupant load over 91 persons U Manufactured structures or RV park Fach additional inspection over the allowable In any of the above:
U Egress/lightingplan U Other ---- --- Per inspection ��r�— --
Submit_eels of plans with any of the above. Investigution fee _
The above are not applicable to temporary construction service. Other
—
Not all jurisdictions accept credit tartly,please call jurisdiction for mine infannanlm. Notice:This permit application Permit fee.....................$
U visa U MasterCard expires Kill permit is not obtained Plan review tat — %) $
Credit card number— —____— — t within 180 days after it has b,= Stale surcharge(8%)....$ _—
r:rtpires accepted as complete. TOTAL . $
Nsme of c o der as shmm on cre It cry----
S
codholdet signature ---�- Amount 440-4615(WYCOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY _
Complete Fee Schedule Below: —
Restricted Energy Fee..................................................... 175.00
Number of Inspections or permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit - -
1000 sq.ft.or less $145 15 t l___J Audio and Stereo Systems'
Each additional 500 sq.ft.or
portion thereof $33.40 — _ _ - 1 ❑ Burglar Alarm
Limited Energy $75.00
Foch Manufd 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 ❑
201 amps to 400 amps $108.85 z Vacuum Systems
401 amps to 600 amps $16060 2 ❑
601 amps to 1000 amps _ $240.60 2 Other
Over 1000 amps or volts _ $454 65 2
only Reconnect o $66.85 2
s or TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary tnly
Installation,alteration,or relocation Fee for each system................. ............................ ........... $75.UU
200 amps or less $68.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75_ 2 Check Type of Work Involved.
Over 600 amps to 1000 volts, ❑
see"b"above. Audio and Stereo Systems
branch Circuits ❑ Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑
with rnnchess of service or Clock Systems
feeder tee.
Each branch circuit $6 65 2 ❑ Data Telecommunication Installation
b)T he fee,for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fen.
First oranch circuit __ $46.85 ❑ HVAC
Each additional branch circuit $6.65
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or Irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40_
Sii,,, cimuil s or a limited en3rgy
panel,alteration or extension _ _—_ $75.00 ❑ Landscape Irrigation Control'
Minor Labels(10) _ $125.00 V _
Each additional Inspecl.on over E] Medical
the allowable in any of the above ❑ Nurse Calls
Per inspect!on $62.50
Per Irour $62.50
In Plant _ $73.75 ❑ Outdoor Landscape Lighting'
Fees: ❑ Protective Signa!!ug
Enter total of above fees $ ❑ Other
8%State Surcharge $ —Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required Licenses are required for all other Installations
front of application. — -Pees:
Total Balance Due
_ Enter total of above fees $
ElTrust Account#, —____ 8%State Surcharge $_
�— Total Balance Due $— ---
All New Commercial Buildings require 2 sets of plans.
1:ulets\forms\elc-fees doc 09/30/01
Mechanical Permit Application
"Datemmceived: /;{y�/,� Permit no.:
City of Tigard Project/appl.no.: Expire date:
CiryofTigard Address: 13125 SW Flail Blvd,Tigard,OR 97223
Phone: (503) 6394171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use.approval: _ _ _ Building permit no.:
❑ I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family LJ Tenant improvement
U New construction W'Addition/alteration/replacement U Other:
Job address: / d 2 j ` t Cr UO V/E-t /=fv- Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equiproent,labor,overhead,
Tax map/tax lot/account no.: - - - -- - profit. Value,$
Lot: Block: I Subdivision: _ *See checklist for important application information and
Project name: jurisdiction's fee schedule For residential permit fee.
City/county: �C„rJe�i� ZIP: FEE SCIIIEDUIX
Desch ion and Icxation of w rk on tses: � v.1 r .
eY k'cc' - L X c: lvc r • 1'!r(ea.) Total
Est.date of completion/inspection: Desai on Qt . Res.only Res.only
Tenant improvement or change of use: -0
Is existing space heated or conditioned?U Yes U No Air handling unit _ CFM
---------IAir
s existing space insulated?U Yes U No It con tnoning(site plan require )
� P' Alteration of existing 1 L system
Boiler/compressors;
Business name: �'Ci1'¢C Z //1��� ti State boiler permit no.:
�`" IIP Tons BTU/14
Address: �__ 1 S( o Fir smo campers/ uct smo a cteciors
City: State:Q& 1 ZIP: 422eat pump(site plan required)
Phone:(';-6 3 7(cJ Fax: E-mail: nsta rep ece urnace urnerBT
U/11
�-
Including duciwork/vent liner U Yes U No
CCB no.: 7qJ�� �, ��( nsta rer ac re ocale eaters-suspended, --
Ci(y/metro lic.no.: wall.or Boor mounted
tNa
(please print): Vent or appliance other furnace
e gemoon:
Absorption units BTU/H
: Chillers HP _
ess, om ressors HPty: State: ZIP: a ronmenta ex ust an vent ton:
_ Appliance vent
Phone I ., F snail: )ryerex aust ^V�
Floods,Type res.kitchen7finzmat
hood fire suppression system _
Name: Exhaust fan with single duct(hath fans) Z
_Mailing address: Exhaust system a art rom eaun or AC
City: --- State- ZIP: Fuel piping an st ut on(up to 4 out ets)
Type: Lf(i NG Oil
Phone: I'-ax: E-mail: - vF c1 fin cac-Ti-a--dit onal over 4 out ets
Process piping(sc ematicrequirei�-
Name: Number of outlets
Other Ippliance or equipment:
Address: Decorative fireplace
City: _ State: 7.IP_ nscrt-type
Phone: Fttx: E-mail• oo stov pc et stove
Applicant's signature: Crate: fJtter: -
Nance (print):
Not all jurisdictions accept credit cards,please call jurisdiction rot ntom tnforrtwtiop Notice:This Permit fee.....................$ _
U visa U MasterCard permit application Minimum fee................$
expires if a permit is not obtained
o'reditcaronamher: L_l.__ Plan review(at _ 96) $ _
Expires within ISO dads after it has been State surcharge(8%)....$ _
ane or c t caro r as shown on c accepted as complete.
_carrolder eTgnauae ��— $
Amount TOTAL .......................$
440 4617(601 COM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: - Price Total
$1.00 to$5,000.00 _ Minimum fee$72.50 Table 1A Mechanical Code Qty (Fa) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100.00 or^ including ducts&vents 14.00
fraction thereof,to and Including 2) Furnace 100,000 6TU+
_ $10 000.00. Including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or including vent 14,00
fraction thereof,to and Including 4) Suspended heater,wall heater
_ $25,000.00. or floor mounted heater _ 14.00
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 51 Vent not Included in appliance permit 6.80
$1.45 for each additional$100 00 or --
fraction thereof,to and including 6) Repair units
_ $50 000.00. 12.15
$50,001,00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Au
$1.20 for each additional$100,00 or For items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp
7)<3HP;absorb unit
Minimum Permit Fee$72.50 SUBTO'rAL: $ to 100K BTU 14.0
- - - -- 8)3-15 HP;absorb
- 8%State Surcharge $ unit 100k to 500k BTU 25.60
25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00
Required for ALL commercial permits onl unit.5-1 mil BTU
-- --- - 10)30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ ;;,,n 1-1.75 mil BTU 52.20
11)>50HP;absorb
snit>1.75 mil BTU 87. 0
ASSUMED VALUATIONS PER APPLIANCE: 2)Air handling unit to 10,000 CFM 10.00
`- --� Value Total 13)Air handling unit 10,000 CFM+
Description: Q Ea Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents _ _ 10.00
Furnace>100,000 BTU including 1.170 15)Vent fan connected to a single duct
ducts&vents 6.80
Floor furnace including vent 955 16)Ventilation system not included in
Suspended heater,wall heater or 955 appliance permit 1000
floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included in applicance 445 10.00
permit -- 605 18)Domestic incinerators 17 40
Repair units _
<3 hp;absorb.unit, 955 19)(.ummerdal or industrial type incinerator
to 100k BTU 69.95
3-1511p;absorb.unit, 1,700 20)Other units,including wood stoves
101 k to 500k BTU 10.00
F15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU 5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.PTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 10.0 0 dm 656 J 8•/.State Surcharge $
Air handling uni,>10,000 chn 1,170
Non- ortacooler 656 TOTAL RE$1�ENTIAL PERMIT' EEE: $
Vent fan connected to a single duct _ 448 _
Vent system not Included In 656
appliance permit
Hood served by mechanical exhaust 656 y Other n pection o and fees:
- --� 17Q i Inspections outside of normal business hours(minimum charge-two hours)
Domestic incinerator $e2 50 per hour
Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-halt hour)
Other unit,including wood stoves, 858 $62.3. Additional rhour
plan review required by changes,additions ur revisions to plans(minimum
Inserts,etc. charge one-half hour)$62.50 per how
Gas ng 1-4 outlets 360
Ead;additional outlet 83 --- 'State Contrarlor Boller Certification required for units>200k BTU.
**Residential A/C requires site plan showing placement Of unit
TOTAL L7MMERCIAI_ $
VALUATION: �_ All New Commercial Buildings require 2 sets of plans.
I:\dsts`f,rms\meoh-fees.doc 12/26/01
Plumbing Permit Application
Date received:/ e)V, Permit no.: Ar or ;I/
City of Tigard Sewer Building permit no:
(' .
Address: 13125 SW Hall Blvd,Tigard,OR 97223 -
City of Tigard phone: (503) 639-4171 Project/appl.no.: Exnire date:
Fax: (503) 598-1960 Date issued: uy: Receipt no.:
Land use approval: - _ Casc file no.: Payment type:
U 1 8c 2 family dwelling or act r m nY U('tnjunu trial/indu�tri:d U Mult:-family U`Tenant improvement
U New construction l:-t'JCddition/al terat ion/replacement U Fond r,ci icr U Other:
Job address: l '"� 00ct vlee"J, Description I QIti. Fe (ea.) 'Total
Bldg.no.: Suite no.: Ncir 1 and 2-family dwe I I inin;s only: -
(includes 100 Q.for each i ni il,connection)
Tax map/tax lot/account no.: SFR(1)bath
Lot: Block: Subdivision: ------ ___
SFR(2)bathe
Project name: SFR(3)bath _--- -
City/county: /C-/q i ZIP: Each additional bath/kitchen - --
Dtiription and location of work on pre ises: Sitentilitles:
tJ&d Ckr t it catch basuVarea drain
Est.date of completion/inspection: IOrywells/leach lineArench drain
Footing drain(no.lin,ft.)
Manufactured home utilities
Business name: - Md U�`�7�1 i N 5 r,.. _jt,t Manholes
Address: _ Rain drain connector
CityState: ZIP: Sanitarysewer(no.lin.ft.)
Phone:5(3 gZ5 ? Fax:
E-mail: �'� Storm sewer(no.lio ft.)
CCB no.: Plumh.bus.reg.no: Water service(no.iin.ft.) -_
City/metro lic.no.: -- Fixture or Item:
- Absorption valve
Contractor's representative signature_ isack flow revemer _
Print name: I t tl'' Backwater valve
Basins lavatory
Name: -L l Clothes washer r
Address: Dishwasher i
City: > c State: ZIP: Drinking fountain(s)
Ejectors/sump
Phone: S Fax: E-mail• Expansion tank -
Fixture/sewer cap
Name(print): S Floor drains/floor sinks/hub _ -
Mailing address: J �� Garbage disposal_-
_LpHose hibb
City: State: ZIP: Icc maker
Phone. Fax: E-mail: Interce for/gn ase trap _
Owner instal lotion/residential maintenance rmly: 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. Sink(s),basin(s),lays(s)
Owner's signature: _ Date: _ sump
Tubs/shower/shower pan _
Name: Urinal
---- -- - - -- atcr closet
Address: Water heater
City: State: _ ZIP:
--_-- - �—_ Other:
Phone: IFax: 1 E mail: Tots
Not an juriadictinns accept credit earls,please call Juduliction fa more information. Minimum fee................$
Notice:'llnF permit apphcaticn , %) $-_ -- _-""-�-
U Vies U MtaterCard 1 Ian review(at
expires if a hermit is not obtained ----
Credlicard number:^---.-----_ __-. r�_ within 180 days after it has been State surcharge(8%) ....$
P
- — -- accepted as complete. TOTAL .......................$
Name nr cartPalder u shown on credit card P t`
S _
—•---� C der slRrtaturc -- — Artwunt — 440a616(Yvaa/COM)
PLUMBING PERMIT FEES:
r16
RICE TOTAL Now 1 and 2-family dwellings only:
FIXTURES individual_ -- _- QTYea AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink .60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection
--- One 1 bath $249.20 _
Tub or Tub/Shower Comb. - 16.60 _ Two(2)bath _ $350.00
Shower Only - 16.60 - Three 3 bath - _ _ $399.00
Water Closet �- - 16 G0 -
--
Urinal - 16SUBTOTAL
8%__8%STATE SURCHARGE
LA
Dishwasher 16 60 P _N REVIEW 25%OF SUBTOTAL
Garbage Disposal - -- -16 60 -- _ TOTAL
Laundry Tray _ 1660 �.
Washing Machine -16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 --- PEASE COMPLETE:
4" 16.60
Water Hoater O conversion O like kind 16.60 _ Quantit by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. I Capped
MFG Home New Water Service 46.40 Sink _
MFG Home New San/Storm Sewer 46.40 Lavatory
Huse Bibs
16.60 -- Tub or Tub/Shower
Combination
Roof Drairs 16.60 Shower Only
Drinking Fountain 16.60 Water Closet �-
Other Fixtures(Specify) 16.60 Urinal !-
Dishwasher
_ Garbage Disposal _
- Laundry Room Tray -
----
Washing Machine _
Sewer-1st 100' 55.00 Floor Drain/Sink: 2"T - -
Sewer-each additional 100' 46.40 -q"
Water Service-lot 100' 55.00 Water Heater
Water Service-each additional 200' 46.40 Other Fixtures
Slone&Rain Drain-1st 100' (Specify)
55.00
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 62.50
Re uested Inspections per/hr _ _ COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 -
Grease Traps - 16.60 - - ---- '- ---i
QUANTITY TOTAL __ -- - -- ------
Isometric or riser diagram is required if -- -------------- _s. __.-_
Quantity Tolel Is >
`SUBTOTAL - --- ---- -- -- -
8%STATE SURCHARGE i
"PLAN REVIEW 25%OF SUBTOTAL - - -
___ Required only if fixture city.total Is>9
TOTAL
"Minimum permit fee is$72.50+A%,stale surrharge,except Residential Aarkilow
Prevention Device.which is$38.25+8%stale surcharge
""All New Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
i:\.dstsrformsk)Irn-fees.doc 12/26/01
CITY OF TIGARD
13125 S.W. HALT_ BLVD.
TIGARn, OR 97223
IMPORTANT PERMIT NOTICE
i.US'TOMIZED ELECTRIC
1282 3RD. UNIT U4
LAFAYETTE, OR 97127
Electrical signature Form
Permit #: MST2002-00021
DatH, Issued: 'i/30/02
Parcel: 2S111 CB-01703
Site Address: 10235 SW HOODVIEW DR
Subdivision: HOOD VIEW
Block: Lot: 2-3
Jurisdiction: TIG
Zoning: R-3.5
Remarks: Laundry & kitchen remodel.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical perimit to be valid. the signature of the supervisinq eiectrician is required. Pleabe 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, ATM Building Dept.
No electrical inspections wiil be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
DEREK ROTHERY CUSTOMIZED ELECTRIC
102.35 SW HOODVIEW DR 1282 3RD. UNIT 84
TIGARD, C�l< `. 7224' LArAYET-rc, o r. 07 127
Phone #: 503-620-5509 Phone #: 503-307-2416
Req #. EL.E 36-87C
SUP 4628S
LIC 135922
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervi ng Electrician
`.
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
3 MOUNTAINS PLUMBING
PO BOX 386
SHERWOOD, OR 97140
Plumbing Signature Form
Permit #: MST2002-00021
Date Issued: 1130102
Parcel: 25111 CB-01703
Site Address: 10235 SW HOODVIEW DR
Subdivision: HOOD VIEW
Block: Lot: 2-3
Jurisdiction: TIG
Zoning: R-3.5
Remarks: Laundry & kitchen remodel.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
DEREK ROTHERY 3 MOUNTAINS PLUMBING
10235 SW HOODV,. 3R PO BOX 386
TIGARD, OF-7. c 1 LL4 SHERWOOD, OR Q7110
Phone #: 503-620-5509 Phone #: 503-925-1342
Reg #: I Ir 141187
PI M 34-368PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signatuw e of Authorize Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
1
CITY OF TIGARD BUILDING INSPECTION DI iSiUN
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST —
BUP
Date Requested — y d _AM PM BLD
�'{
Location '(; 3 Sf I;(�(�� IJ� L t) ✓ Suite MEC — 1 �1
Contact Person Ph — PLM
Contractor_ Ph SWR
BUILDING Tenant/Owner ELC _
Retaining Wall - ELR
Footing ------- —.
Foundation NOT REQUESTED FPS
Ftg Drain '- --
Crawl Drain FOUND DURING RESEARCH SGN
Slab NO INSPECTION(S) FOUND IN FILE -- SIT
Post&Beam
Ext Sheath/Sheaf
Int Sheath/Shear /1� ` / A /9 I ----
Framing �P �,�.,✓l,J( ����'�---�� ZI�..�U [�—Insulation ----
Drywall Nailing _- G�� _ ✓ 1 (/V" ,�-tJ' Z� 7� Cl�r--- —__ . -- -
Firewall - ---
Fire Sprinkler ------- -- ----- - -- ------- --
Fire Alarm --- -�- ----
Susp'd Ceiling
Roof �.
Final
PASS PART FAIL --___--.—_. -- - --�------_-
PLUMBING
Post&Beam —_ _----------- - ---
Under Slab
Top Out - - --- -- - 1
Water Service
Sanitary Sewer ----- -- — .- -
Rain Drains
Final �--
PASS PART FAIL
Post& Beam _ _ ------ -
Rough In
Cas Line
Smoke Dampers
in
SS PART FAIL —
EL TRICAL
Service
Rough In
UG/Slab
Low Voltage —_—
Fire Alarm
Final
PASS PART FAIL --_-__.._- ----_--.-SITE
Backfill/Grading ----- --
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ _—� required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RF [ ] linable to inspect -no access
ADA
Approach/Sidewalk r ?
Other _—^ Date 1 tJ UInspector �--- Ext
J� V
_ . . -- - -- ------" ---- ._ -
Final
PASS PART FAIL 00 NOT REMOVE this inspect.on record from the job site.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 j
INSPECTION DIVISION Business Line: (503)639-4171 MST _
BUP
Received _-_ Date Requested_ � 7 — AM--- PMBUP
Location ---
--I,� o' MEC _
Contact Person --- -- -- sl,•� �' Ph 7C' 3,;�?4 PLM _---
Contract��_— Ph(_ _) -- --- — SWR —
UILDING Tenant/Owner ELC
_Uw4ing
Foundation ELC
Ftg Drain Access: _ ---- — -----
Crawl Drain _ �- ELR
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 ----- -- _—_-_- -
Roo( --
U ti
Other:aiT
4 Ina
FAIL
--- --------
om -.--- --- - -
Under Slab
Rough-In —
Water Service -------
Sanitary Sewer -�
Rain Drains -- - - - -
Catch Basin/Manhole
Storm Drain - -- --
Shower Pan
Other. -- - -
AA PRT FAIL -- -
Rough�lTr - - - -
Gas Line
Smoke Dampers _----- --- - - _
in12
T FAIL -- ------ - ----- ---- -
RICA
110u( -n
UG/Slab _--
I ow voltage
-ire Alarm
inal j PART FAIL ,ieinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd.
_
—
[-] Please call for reinspection RE: _ Unable to inspect-no access
Fire Supply Line ]
ADA Z' j `./ -
Approach/Sidewalk Dates_--- _-`' -� hs�ctor Ext
Other: _
Final DID NOT REMOVE this Inspection record from the)alb site.
PASS PART FAIL.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP _------ ------
Received _ --_ Date Requested._, Jo__: l - AM_—. PM BUP
Location —- .- U a 3 S _� - Suite MEC
Contact Person —_---�__ I-111 i-___ Ph(---) _1�� _ �Q�,� PLM ___---
Contractor _
- ------ --- --_�— Ph(-- -) --------__. SWR _
BUILDINGS Tenant/gll erg—-. _ --cl"SOL _ ELC
Footing -----— - `--
Foundation Access: ELC ---------
Ftg Drain ELR
Crawl Drain —-- - -- --
Slab Inspection Notes: SIT
----- -
Post$Beam ----
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear - -----
Framing -- -- - - -— —__---__.------- —
Insulation ----- -- -
Drywall Nailing ---- ----- --- - -- ----- ---_-----------....
Firewall
Fire Sprinkler -------
Fire
--Fire Alarm - --® -�----- - --
Susp'd Ceiling --- ---- - - - - - -- - �— --- - - --
Roof
Other:-_ — --- - -- --- -
Final
PASS PART _FAIL ''--
PLUMBING _ _
Post&Beam
Under Slab
Rough-In — _ ---- -
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain ---__...-.-------__.._ ---- -__.-.
Shower Pan
Other: __---
Final
_PASS PART FAIL
MECHANICAL'
Post&Beam
Rough-In
Gas Line -
Smoke Dampers ----__
XSS PART_ FAIL ---------- --�--._ _
RICAL
Service ---
Rough-In
UG/Slab `----
'_ow Voltage
-ire Alarm
- -- -- - -
Final
iPASSnclPART FAIL Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd.
SITE [] Please II for reinspection RE: _. ❑ Unable to inspect-no access
Fire Supply Line
ADA x `
Approach/Sidewalk Date -4! Inspector _/ Ext
Other:
Final DO NOT REMOVE this Inspection Fecord from the job site.
PASS PART FAIL
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2.003-00286
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/30/03
PARCEL: 25111 CB-01703
SITE ADDRESS: 10235 SW HOODVIEW DR
SUBDIVISION: HOOD VIEW ZONING: R-3.5
BLOCK: LOT: 2-3 JURISDICTION: TIG
CLASS OF WORK: ALI' FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VrNT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL. TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
OD
GAS PRESSURE: 50 +• HP:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS C
<= 10000 cfm: OTHER UNITS:
FURN >=100K BTU: GAS OUTLETS:
> 10000 cfm:
Remarks: Unit cuinut he placcd \%ithin required setbacks
Owner: r FEES
PATRICK CORRIGAN Description Date Amount
10235 SW HOODVIEW DR `
TIGARD, OR 97224 [M[�.XCli] I'rrn�it FCC 5/30/03 $72.50
[TA1 9"4,Sl;iw I:i\ 5/30/03 $5.80
Phone: 503-598-4732 _�_____ _ Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
TIGARD, OR 972.23 REQUIRED INSPECTIONS
Phone: 503-624-2704 Mechanical Insp
Final Inspection
Reg#: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if worts is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
Issued By: �r7r �.r� _ Permittee Signature: �z ���
Call (503) 639-4175 by 7:00 P.M. for Inspections needed the next business day
Mechamcal•I'ermit Application
�L '4 �° Datereceived: '� Permit no.
City of Tigard t \ f V F D
Project/appl.no.: Expire date:
C'iryq/Tigurd Addreq%: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: _ ByA I Receipt no..
Fax: (503) 598-1960 Case file no.; Payment type:
Land use approval: ;:;, Building permit no.:
U I &2 family dwellinj,or accessory U('rnnmercwVinclustnal U Multi-family U Tenant improvement
U New construction ;dA(I<htiun/alteration/replacement U Other: __-
Job address: Qs�. Su /[x1 �i�L�/G_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg, no.: Suite nu.; value of all muchanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: `See checklist for important application information and
Project name: — - im kdi(tion's foo schedul,- for residential permit fcc.
City/county: **6PA* t,d ZIP:
10111 Sol
Description and location of work on premises:.
NNIUM Aq �� _ Fee(ea.)E�l
oEst.date of completion/inspection: t cri tion Cit Res.only Rtw.
Tenant improvement or change of use: Air hanuling unit _ _CFM
Is existing space heated or conditioned?U Yes U No Air conditioning(site plan i cyuire )
Is existing space insulated?U Yes U No
Alteration of existing H'VAz system
of er compressors
State boiler permit no.:
Business name: Otter • Hp Tons BTU/H _
Address: 6 OX � it smo a amper uct smokedetectors
City: �� State: ?_IP: 1 Hent pump($tc p an reyuirc
Phone:(,a��• 2d'� Fax E-mail: nstal rep ace urnac urnrr
Including ductwork/vent liner U Yes O No
CCB no,: '_` 3 nsta rep ace re ocate heaters-suspen e
City/metro lic.no.: __ _ wall,or floor mounted
Name(please print): o�S�/� Vent ora ianceother than furnace
Remit ena tion-
Absorption units_____ BTU/II _
Name:
P Iy OA /b�( Al vo Chillers
m ___ _ lip
� Coressors A J III,
—
Address: n ronmenta ex ust an vent ation:
City: ---�_-� State: 7..IP:_— Appliancevent
Phonc: Fax: E-mail: Dryerexhaust
Hoods,Type /res. itc en aarnnt
hood fire suppression system
Name: L �Q,tt/_LL_ /`-1
Exhaust fan with single duct(bath fans)
Mailing address: 'x Q ��— y -- � iaust s•,stem a art from eatin or C
711'. up p p ng andistribution up to outlets)
City: ttll�.� — _ISial( ? 'L'7.y� lvpc L.PG NG __ Oil
Phone: Fax: I, mail: ale i in eac a ditionnl over 4 outlets
rocessp ping(scernaticrequire ) _
Number of nutlets
Name: _- —�_ 13Tt pr!Red applGnce or equTment
Address: Decorative fireplace �.
City: State. "7.IP Insert type_
� ��--——— _—
Phone: Fax: E-mail: nixlov�cllK ilei stove �_,_ T ---
t erg
Applicant's signature: , Date: ,
A ,.p ter:
Name (print): o�r��� L�—
Na all jurisdictlow reap credit cards,pl"w call jurisdiction for more infotnution. Permit fee............ ........:} �^ _
Notice:This permit application Minimum fee $
U Visa p MastrrCard pirer exp;,es if a permit is not obtained Plan review(at °lo) $
Credit card narnit" _. — xwithin 180 days after it has been a _
ted;scom lete. State surcharge(9%) ....$ —_
Nurse o r o rhowa on credit c $ ecce p p TOTAL .......................$
Cardholder siputure Amount 4444617(60WO)M)
r
RECEIVED
et��
//�� ' n 4 MAY 3 0 2UU3
eO.. �% ";17Y of r IGARD
HEATING & COOLING, INC. BUILDING DIVISION
9900 S.W. BURNT IAM ROAD, SUITE E 110
TIGARD, OR 97223
(503) 621-2704
FAX (503) .598-027f)
a
0
� I
JOB ADDRESS: �� �5&j 40.1 G4% 404ttAe-,
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
I �
1,4
Q
v � N vC6 ,
EL
L y
LL x
L
CLr
U- CLui
�
rw
Vl
nn
old `' vi W
CD
W
AN
CM
U 0 'n
E o ,Y
x Qr Ca.s
F- rn � � Q
1
w
lQ k%
(JI3
n
m
'4O
I N
I
r0
I/ok �"
d
Wit• CS�3� -7 7 3 Z� Cr l i
DO
-z ti
Q0Lu
VN
3 �,
p� '`Ua
- �,> /
�r No �.
N
N
t
•
I
i
-1" c
n
CL
I
I
I
N �
w - ,• _
a
` a
• , +jai
`.' y •'A
r
J.
k
igb
{
C