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Permit
, 4 CITY TIGARD MASTER PERMIT DEVELOPMENT SERVICES ISSU 4/8 20005 00073 DATE '=--' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CD -13100 SITE ADDRESS: 07736 SW CYPRESS LN ZONING: R -12 SUBDIVISION: HAMBACH GROVE LOT: 029 JURISDICTION: TIG Project Description: New SF BUILDING REISSUE: STEINBECK STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 724 sf BASEMENT: sf LEFT: 0 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,000 sf GARAGE: 445 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 TURD: sf RIGHT: 5 VALUE: 171,356.10 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,724 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL . AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes LEGEND HOMES LEGEND HOMES CORP and all other applicable laws. All work will be done in 12755 SW 69TH 12755 SW 69TH AVE #100 accordance with approved plans. This permit will expire • SUITE 100 TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the PORTLAND, OR 97223 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 Phone: 620 8080 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: LIC 60563 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 8,914.64 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 i .tra Issued By : / _ . -• _ ,_ _ / _ . ) Permittee Signature : 'u�1u � _INI • Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the p • ject. Approved plans are required on the job site at the time of each inspection. . '1 Building Permit Ap'� 10 11 i , 41 ;? , :i woR OFiF10E usEloNUY , • t s '� ) Rece Ci of Tigard \i � ` � Permit No.: t 5 g u DateB 0- �/ \`�y1 �a(� 73 J y� H125 SW Hall Blvd., Tigard, OR 97223 Plan Review �_ Phone: 503.639.4171 Fax: 503:` 196 DO - 9Nh Date/By:/'?lC� t/ 11- Other Permit: � /— G S 5(,� -• dOd � , Inspection Line: 503.639.4175 ( \G \ Q`" � � A Date Ready /By _ luris VI ) Attached Checklist for Internet: www.ci.tigard.or.us `i 0' ON Noti_fieed/Method:7 / vs /q . • i i6 Supplemental,Information G \ r `14llI YD\4?RL IN " °> �. ° � :x: �� � ° 1I1t;�Di'Ai�TA: °; -<ANI? A :, G �. °�. ,' sue: " „ .. -.:, .. -_: .3�.�.�"..... ...dirr -�'s #z�';� -;,. .:,�.�.'� . � &e- .:�a , ,c; °,., ! .:.:r < e< - .-- ».�,.. .5��.`�3%: .�, ^ %.. _ - a`r'.a.;�::..:. ..- ., .,,... .•.�. -. .��. �.. ��:?: d:. -.� tu ® New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the -e�- }�:: >:.: .: ° <; ny: ; at� . .; , _.: „rc;: ^t^ :.,e.�-a.:t ;�;:ayss3.°:,:t..<s,r.;;r?5' .'sw%,..E. . ,: *s`' - .,�",�.."` ;:all ' °';, 'CA1' GORY °wOE C7IO*Mitti r,u^ work indicated on this application. a. Valuation: $170,111.10 Ni- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: 3 l I3 a ° R ,:h :Oki C° TIO,1V `? . ;:... .: -- s= ,' ^ Total number of floors: 2 oll. aiii$i G+ Iii•l`ibliiIA'I'IL?NA` Job site address: 7736 SW Cypress Lane New dwelling area: 1724 square feet 11- ' City /State /ZIP: Tigard, OR 97224 Garage /carport area: 445 square feet Suite /bldg. /apt. no.: Project name: Hambach Grove Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet 'IiEQTIIR4D AATAi COIIIN iietXtt *C1iEC1 1ST Subdivision: Hambach Grove Lot no.: 029 Permit fees* are based on the value of the work performed. Tax map/parcel no.: equipment, the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the , s , . . ..; , , :. i , z; work indicated on this application. DESCRIRTIO ,OIy,'Y:;W ^ORI °' . , . _ ;' 'W PP xr :, °.i. ::»r i. ,. � � , in"�s`�: &,a.,. ??;l; e %vier n, , r.. rrf' m�aL `a;��':.- or tri • d� n `,:Ts4;: >' =z. - ... Valuation: $ Existing building area: square feet New building area: square feet s' k.n174. : Number of stories: <�, '�. ;'iP�201'�12T\':;<'F ,N =PRn`' , ;��,e> %�z;:; � �t�,,, 'rENANT,V Name: Legend Homes Type of construction: Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups: • City /State /ZIP: Portland, OR 97223 Existing: Phone: (503)620 -8080 Fax: (503)598 -8900 New: ,. - -, A7 �< "CON ACT PFsRSON �,, � . „ OTI <.. , n._..,. ... ..�i?•w:'r,.:. ^, ...' �:r" '�a� ^ sa 5•. .r , '� e...;,...,:.AP�Ad�i.n....” . Ad. Business name: Legend Homes All contractors and subcontractors are required to be Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 12755 SW 69 Avenue jurisdiction in which work is being performed. If the City /State /ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 620 -8080 Fax: : (503) 598-8900 E -mail: slucas @legendhomes.com ,`;r; �;'' ''mom: "' — >:� e CON TRAC QR r ; . ' i ;,»�' >' : < _._,_ .. .,. „�`uii ^.,,.,.���x��,:.:xa .,_ � ^ ��<- �a',� -_ ,.. ^. t' e. �` �� �z�;. ,,,,.',r- ...z ^:m��:�._::��__,.: Business name: Legend Homes _ _. " �• "z`e §,> �' a', :.s = t3U;1LDIIVE,,, RMTT, Fes, , ': ::`. - > -- ': Address: 12755 SW 69 Avenue, Suite #100 ae Please refer to fee schedule. City /State /ZIP: Portland, OR 97223 Fees due upon application Phone: (503) 620 -8080 Fax: (503) 598 -8900 Amount received CCB lie.: 060563 ' iv \:: -- litift v --sk Date received: Authorized signatur \ VVVV - This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Steve Luca Date: 3/8 05 * Fee methodology set by Tri- County Building Industry Service Board. is \Building \Permits \BUP- PermitApp.doc 12/03 441- 4613T(I1 /02 /COM/WEB) 01/16/2003 00:15 6427925 PAGE 01 DEC -01 -2004 WED 04:30 FM Legend Homes FAX NO 5035988900 P. 02 Electrical Per>�t Application , t I( I',;E ,►. City of Tigard ...,, pa.....,,,,:,-,2.5---0,8, I3135 SW Ball J31vd «'l1J;erd,OR 97223 , , • , Plan Renew OdtrrPvnrtiu Phone: 503.6394171 Pltx: 503,3 y "';11tiw to/ y Y= 1P IM www. iO3.R3ori171 a >vo�ted/bta8>o� h 9ePPlstaearellaforoutIon !Mono* aK www.d,ti�wdAr.Ui - 1 ' I i a u ; f i ' i' �• l ( � ,,I1.t y�,.F l I Vp •'',, (.�i,',!ryT:... ' ph lTr y� a fj �((:I. r� ih L+SILI11!:•'!`�I l hl l ��l'f71iH•4915 ,7Id1+^l�'; f�J•d�Fll 32 ��4�i1A 6' ;�r�'f l ',� ,y „ 'l x t 1 ' { lii'> i 1 ` ill , 1;. ��t�I `I�41��ifL11��Ii,i���, iii, �f> '�n!��II;T,I!1YI:t��.1.LirR�ihl ! M'�iH'V � - 1 .. ,�. a.J- ,l �� '" °�� '' 1 n please cheek ell ; ... apply: +� r{�•WcWtAttrueHon • Addfiltin /91ter8t101f/1ePlOeottont © Soviet' over 225 amps, arm/ 12 Heserdous location Service over 320 amps - raring 0 av1ne ever 10,000 14 asqq ft.• ja Demolition Other l siat 1 ❑ •,� C � , � }�� , � , „ , , �� F1� '��„ri 0 Wrote tow rostdastdel lent f t Iiii�; { �� it����� Y 1i ,�ot„i V a li N �4§1 �J !E t a :'''.!11, u t�_ i ;3: ut1•ettd2- lYdwaninS 4 buildln Q5514"' ever 600 *1e namind /Alfa to one struvNro 1- And2- fatrillyd+�llin� • Cemttwta1 n1a1 1� • Accoee°?y g �3]]gulldinemar Ong statics QPemdore,400 wee wMore © Multt•fkmil 0 Master builder ■ Other (occupoet toad mor• persona ❑tbptwtbetured etro rd er t' . iI ^ vt RV k ro jr , ltrIE iEI t CTI "t+1 '' ' '2 4 ° h,L' rd`�S�i in ui1 7 Plan d N t. �� ��ji,��dil 1 }�' li 1�1a!t �+ iP . td� , , F.,.J.: `,. � • .:,( , S3L n ©Onto , � °° .f OFiesUh•sora funky Job no.: Job site address: 1 SW G■PZ -Es. LA 0 C submit setaof w i t h itly ' o 0�uuttW)upr► gOrvin. City /Seste/ZIP: Tigard, OR 07224 The above � { w �a to+ 7 h i NLritefE177LNUJ'l, i' T C1' l `" •1 f. , A d ��r1 } �� {; , i Saitalbldg•I • ho.: Pfoject Hama: flambee' C•stsov e �`iI� y - i.) ` :17 u 1iiis Crory Street/directions to job alto: Nov roddeattal SIR* o►oowU -Wm► • 0 le.lalea ataaciwd errs. 1,000 ea, it. or Tad 145,15 %45.t �.._.. Ba add'1500 aq.1t. or portion 91.40 w = 5ubdtvision:•Hnsabaeh Cnt:av4: Lot no -: oz Limited energy, residential 75,00 TUX A- eel Ummad ¢ner.i,non•rosldcngal MO . 9 s•� �© 4 r , +t'm'I'�i, o,�P' ""411r,91a ,� ular 1 J 11 ' l t�+ :lit l �ti'�' t i a„ °' a V ' i �i r : r � Ct,L1L1 J,i• ] L': '� 4 i - �9�}i! E CY,�� ;1�� ifW: #1IEi iuJ 1 � :7 !1 . �r alt 1 1.w,J Vo, �!.+� �_Atu, �w.. i. �.,u .n J �, i�. Ono i11aa1 s a 9f t fQ dtY: lin: : ee mtd/or finder • fisrviooe or feeder Inewaation1 alterntiva d/or reloendon 200 amps or loos 0.90 2 ,,ttII r ` A pi��p� n!! i � � , , � l :�nm. , .a^r1r 11 � ' 201 164(4° � 106.85 111111111131 i� ?J}� t I �1 ^* 1 r,nr W i.t °1 I �''Y t h..1 ;'i (1 f� �C� W� i �1 , j' -. --2 - MI 10.60 � i '� T d ,tn�1 .u,� "_�1 T!!t.ir1:..�1i? l 1� ' }aii�IU pit i i� I z 401 r to 600 amps Nem o Legetld Volpe$ 601 a • s to 1.000 antes Nil 240.60 1111•1111E/ Over 1.000 or volts 454.65 2 Address: 127S5 SW 69 Avenue, Suite /1100 p,,eeon 0 0t ci 54 .ds 2 City/State/ZIP: Portland, OR 97323 Temporary unite or teedore Inelutiaboa, afteratton. entvcr rotation Pion.: ($03)630 -8080 Pas: (503)59134900 200 ett,ps Wass 6615 I Owner iovte 1 lien: This iraiollatlon 16 being ms4e on property that 1 own which Is not 301 =vow= 400 run 100.30 2 intended for sole. leave, tent, or exchange, oopording to ORS 447, 449, 670, and 701, 401 urea to 600 amps 133.79 lel Owner signature DWG; ientooh eireatte —new• alteration, or extaraian,ileryin , r a ' : , r 1 . v '! ` a � d A. Fea for bin efrmiar With S R 6 �'+ ' !r " l i ' u ! 0.2 E.,� . _�, k ' } , K f �4 ,;,�, ,r. l�la 6 65 ,t�, �:- �t!,•f ?? ....,r . i � , � :,. 11 � n.a s... � acr• er feeder fee, qC . 2 Business name: Longest! notttoe Arline circuit B, Fee for brench eirouits Contoot now SSovs Luella withew orates or tta:dor foe. 46,133 2 sup branaltcircuit Address: 12769 SW 69 Avenue, Solt* 01106 —I Such add9 branch drank 6.63 2 City/State/ZIP: Po$$nd, OR 97123 1NtscL tlianoaue (rtertu+or loader cot laefu4vaq Petro or Irrigation Circle 53•40 2 Phone: (603) 6204060 Pax :: (S33) 3911-1000 Sign eroutline Tung_ Mg 93.40 pmErd E nlalil 0iucss i „ u,d 1H, L Slpnal chest: Ot) or limited• to z, . t : � i, tl i l l� ORa?ndAam1iPo L ' r ,rt i1:,. f�1'��'t` i."f'rnI' irRL r. • 'iii i . i �lFa4 `• ,¢ enemy ea+to►. Mien, or I . . . , • 2 uSt,ia:J��,I[�1filaih 1l.& ..1. J L extaidon.l> Pogo Busin4sa Rfam01 C. antes Electric •--1 --- aedun near allowable In a of the aorta Address! 2120 SW 247 Avenue 9 A Eaeb additional I con Pet inoPoolim 11111 62-50 M • City/mate/20g HWaboro, OR 91123 Intresngodat per hour tt hr rem Ile] � I. 6d2 -792 Industrial lent -or huur II Alters (503) 5 ( In ' 1; ^ ' `� ;,o , a �3) 1'; ; ( 911320 Flat il:iN1! '.L9 : 1'.oC�i"; v i 1 CCP tic.: 121169 Maculae! t ic, flp 9 • • , Lie.; 3707-5 Supra. te mi„,,, (2104 bePamit ha) State oenhenet crt of permit fva) (te gfo F E ecirichm signa requital: ir , j r Print rumor . TO1'wL PERMIT BEE ZZ : •lk Authorized signature; p.rtult rpp5er+» Ira pan* . sat: we whole tso Mir alrar hat Iaaaaecopiod sto w 1 hate: S' 45/0G • ha Jaetbodelosy subs Tri•CowrY among u,au cry 9erviae Otani Print rattle: • a• xeMber of irtipodlest Pa posit albWett i:leuiw0e0701011tni4•049901414. troy 4404wtatl vsscorev+se Plumbing Permit Application M x � ¢ r � i.{ ` FOR oF ` USE4ONLY , - Ci of Tigard Date/By: Permit No.: 1� \S OU�OOO73 13125 SW Hall Blvd., Tigard, OR 97223 7A �u Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 '',-.--' Date Ready /By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information _. �.---- r.»;.,- yr >..:x�xwr ., :,., ..n rn..:.:�_ ^ -• �..;� -;H-a° ,.�+.: - < , �. :�� �rtsywne � ga�4'+ - ?' , a,. s�a >� E /1�1}l:ilih'' >� , a- .. �, .,; ,Y .� .. 41 ��.�<, ..> 0..� t\, wa�w. ...... a. .aa.`\...A4me. \,.n.. ® New construction ❑ Demolition For special information use checklist. Description Qty. Ea. I Total ❑ Addition /alteration /replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) " Y „;•Ozf'CO1VSa §RiCTION `u" _`.'". °' _ SFR II bath 249.20 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 . El Accessory building El multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: \h , yy ,. Fire sprinkler ( sq. ft.) Page 2 OB - . B , INFORM 1 1 1(7N'; A3 LOCA TIO ,; g .: ,,, ? I'S % , ._. .' -_ _ _.. �� -tea ,�... .._�.> r�•c�ea - r,�.�•,. Site utilities Job site address: 7736 SW Cypress Lane Catch basin or area drain 16.60 City/State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Hambach Grove Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Hambach Grove I Lot no.: 029 Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: �" Absorption valve 16.60 D,l �Cl' , ,, ,4 . N `O ?eW.,QR iCt ^ \ .:,,a „ „„ Page 2 ,xF� ° ......., ,,-�``� -' ^. . ,: \,�_��,. =;,,;�... :,::;. ... <.�'i���;,' . >. `ate`: >._. _..,,,. Backflow Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ;,; . ;� Q::.. - ,,:::- : > y.... , . Drinking fountain 16.60 ®r PROPERTY s OWIY R ,: � �, x�,: e❑ `T T< ^'_ �: ; 4 t : , ,�_ ... _ �, .� � � ..,, -: >- ,. , „,. ,_k.- .�Q��a� :. - .� �%' z � „`:��� � , - ..,� - - -_ �� <,�sv�' Ejectors /sump 16.60. Name: Legend Homes Expansion tank 16.60 Address: 12755 SW 69 Avenue, Suite #100 Fixture /sewer cap 16.60 City /State /ZIP: Portland, OR 97223 Floor drain /floor sink/hub 16.60 Phone: (503)620 - 8080 Fax: (503)598 - 8900 Garbage disposal 16.60 '; 'r'E -iViii C�_:�.� ANN . +, "` ` .1701 „ a" (?IV'T <',� • „��: ,,...... Aert ;���:. Hose bib 16.60 iii Ice maker 16.60 Business name: Legend Homes Interceptor /grease trap 16.60 Contact name: Steve Lucas Medical gas (value: $ ) Page 2 Address: 12755 SW 69 Avenue, Suite #100 Primer 16.60 City /State /ZIP: Portland, OR 97223 Roof drain (commercial) 16.60 Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 .Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E - mail: slucas @legendhomes.com Urinal 16.60 i �< { ;! ;;?g:,, :'fegr r . . „ �,`' :' e ,:.,,�.,ir:, ^yam., -::2= § a ?,:' ;- .�.!;��:ay ; r r ° ,...,; tT C ,„„„„ :. 7, ,+ - . % . „. ..; Water closet 16.60 Business name: Wolcott Plumbing Contractors Water heater 16.60 Address: 1075 W. Historic Columbia River Other: Subtotal City /State /ZIP: Troutdale, OR 97060 Minimum permit fee: $72.50 Phone: (503) 667 -1781 Fax: (503) 667 -9891 Residential backflow minimum permit fee: $36.25 CCB Lic.: 23847 Plumbing Lic. no.: 26 -208PB Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Steve Lucas Date: 3/8/05 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i \ Building \ Permits \PLM- PermitApp.doc 12/03 440- 4616T(10/02/COM /WEB) • Mechanical Permit Application , .,._ • , ..,-,, ,...,.: ;.,•,,..4,,,::;„, .FOROFFICE.USE.ONLY City of Tigatd Recived Datee Permit No.: _ 176 — _ o 75 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review . Phone: 503.639.4171 Fax: 503.598.1960 Date/B Other Permit: Inspection Line: 503.639.4175 . d_lh'911140/1i y: .ico.,,' ' '1...:. Date Ready/By: Juris: IZI See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information 71,NiNgalletiiiialiak:91#001.1300116iiiiigiEM, rArl,t :4 New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work E ci performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. ' -,, U1:-tRtit .,,,,, ..,,e2.,,,,;13,-.....,4,,,iiiir':',:r ,,,,,,, :., Value: $ , , , ,,,,,,,, , ,00,,, , .., , ,,,,, , ,,,,,,,t. ,,,,-,..“,,;...,,,,,,,,',,,,,,,, Z 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building ' tiST.Eqt.e i0V i ; ,.V;:,0§Y,Oilet.OSPIe For special information use checklist. 0 Multi 0 Master builder 111 Other: Description 1 Qty. Ea. Total Itili6.40,P74(011080000Vif ftitali!fr4ii-2 Heating/cooling Air conditioning or heat pump Job site address: 7736 SW Cypress Lane (requires site plan showing placement) 14.00 City/State/ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: Hambach Grove Gas heat pump - 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel-type, not electric), in-wall, in-duct, suspended, etc. 10.00 Flue/vent for any of above 10.00 Subdivision: Hambach Grove Lot no.: 029 . Other: 10.00 Tax map/parcel no.: Other fuel appliances ta ok"ooroijji il l Water heater 10.00 Gas fireplace 10.00 Flue vent.for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 441ZA'%:'fVIroltijill.V,-6-Wk.7""*''Ig* -0:::,;:, llf*V„i;,v-,-,:knimpoy*- Chimney/liner/flue/vent 10.00 Other: 10.00 Name: Legend Homes Environmental exhaust and ventilation Range hood/other kitchen Address: 12755 SW 69 Avenue equipment 10.00 City/State/ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00 Single-duct exhaust (bathrooms, Phone: (503)620 Fax: (503)598 toilet compartments, utility rooms) 6.80 7;10180M, 4TOSIZ:12-;:t;:17,i-"M*11001n:,*017:AcriTS01P4 Attic/crawlspacc fans - - 10.00 • - — — - Other: 10.00 Business name: Legend Homes Fuel piping Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional Address: 12755 SW 69"' Avenue, Suite #100 Furnace, etc. Gas heat pump City/State/ZIP: Portland, OR 972223 Wall/suspended/unit heater _ Phone: (503) 620 Fax: : (503) 598 Water heater Fireplace E slucas@legendhomes.com Range WOISIIIPMEMIg0.#40.1(4311",:tii,41.4104a,vaziu Barbecue Clothes dryer (gas) Business name: Sunglow Other: Address: 2428 SE 105th ZNFVS'IEAk6 XM.,,,,,§.1ftw.w,-.,, City/State/ZIP: Portland, OR 97216 . Subtotal Minimum permit fee ($72.50) Phone: (503) 253 Fax: (503) 253 Plan review (25% of permit fee) CCB lic.: 48131 State surcharge (8% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: Steve Lucas Date: 3/8/05 * Fee methodology set by Tri-County Building Industry Service Board 1: \ BuddingWermits \ MEC-PerrnitApp doc 12/03 440-46 7T (I I/02/COWWEB) AAAAAAAAAAAAAAAAAAAAA& AAAAL®AA AAAAAA AA*A*AA *AAAAAA* 4 A a STREET TREE CERT IFIc A TI ON L. A lio A )1ttR711\) SAIJOGP.S or A I, MAW ANtM 6,�� l JJ , Owner /A for L Eb ,(Vo /k -tES A (PLEASE PRINT) (PERMIT HOLDER) A r A A r llo A ,!, a� t Do hereby:cert.I fy t= a. t e location ito a meets ,y' : Tigard /Wash ngton County l and use and develo ment standards for stree r ® p t tree installation. Ito j a A I A ADDRESS: 1 7 1 73(0 ( W _ yr1 .&S lept /6, 4k&) 9 9 Faa e ,. a to `l A Bo i LOT: 1- fig - ®a SUBDIVISION: HAMBA.c_14 C-Rcsc / I.Dti ®► A a to ® BY: Pkiznu 4 4. . n * << ... DATE: //vb 2, C • 0. 1 OP a DATE: a RECEIVED BY: ,� to, ®®®VVVVVV VVV VY VVYYYYVVY YVYYV YY VYVYYYVVYYYYVYYVVYYVYVYVYVVVVV® CITY OF TIGARD • . BUILDING DIVISION PERMIT #: MS-12005-00073 1 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/8/2005 Phone: (503) 639 -4171 a Ilnplpl ����� Inspection Requests (24 Hrs.): (503) 639 -4175 `'__.. INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7 :11AM PAGE: 49 SITE ADDRESS: 07736 SW CYPRESS LN CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 029 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF OWNER: LEGEND HOMES, PHONE #: 503 - 620 -8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620-8080 Inspection Request Scheduled For: Date: 8/30/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 014583.05 503-849.55247 N Corrections /Comments /Instructions: IVVPASS /p PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL % /ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I -411 111111111.11b, 530 , s0S Inspector: Date: Phone #: (503) 718- . • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00073 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/8/2005 Phone: (503) 639 -4171 • A. .. H ' ,414�g j, h l I Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7 : 11AM PAGE: 50 SITE ADDRESS: 07736 SW CYPRESS LN CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 029 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF OWNER: LEGEND HOMES, PHONE #: 503.620.8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080 Inspection Request Scheduled For: Date: 8/30/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 014583 -C)4 603-849-5247 N Corrections /Comments/ Instructions: 2 SU L1-=9 /V X j,... , PASS 7 PARTIA '.' ' : • ❑ CANCEL ❑ NO ACCESS ❑ FAIL / ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: — ■ Date: b Phone #: (503) 718 - , CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00073 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/8/2005 Phone: (503) 639 -4171 ub4��i (A Inspection Requests (24 Hrs.): (503) 639 -4175 . .' ` INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7 :13AM PAGE: 51 SITE 'ADDRESS: 07736 SW CYPRESS LN , CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 029 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF V OWNER: LEGEND HOMES, PHONE #: 503 - 620.8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620-8080 Inspection Request Scheduled For: Date: 8/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 014474 -06 503.849.5247 N Corrections /Comments /Instructions: I • • ,\PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL (l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 44rAll Date�5 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: sT 0S 0007 3 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/8/2005 Phone: (503) 639- 417111,l8tiii� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: &2W2005 TIME: 7 :13AM PAGE: 52 SITE ADDRESS: 07736 SW CYPRESS LN CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 02g TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF OWNER: LEGEND HOMES, PHONE #: 503 - 620 -8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 62Q-8080 Inspection Request Scheduled For: Date: 8/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 014474 -05 503. 849 -5247 N Corrections/Comments/Instructions: rli PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 6^-A •^~4 Date: ?1 ?A 10 c) Phone #: (503) 718- 1 .