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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2003 -00054 �+ DEVELOPMENT SERVICES DATE ISSUED: 3/14/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13646 SW LEAH TERR PARCEL: 2S109BA -08100 SUBDIVISION: DAFFODIL HILL ZONING: R -7 BLOCK: LOT: 007 JURISDICTION: TIG REMARKS: Construction of new SF detached residence. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 30 FIRST: 1,524 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,454 sf GARAGE: 644 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 290 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 2,978 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 1 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: 1 W0ODSTOVES: GAS OUTLETS: 5 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS 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: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADOL 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: 0TH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,686.04 This permit is subject to the regulations contained in the HEIGHTS CONSTRUCTION HEIGHTS CONSTRUCTION LLC Tigard Municipal Code, State of OR. Specialty Codes and 1 PO BOX 91249 all other applicable laws. All work will be done in PO BOX 91249 PORTLAND, OR 97291 accordance with approved plans. This permit will expire if PORTLAND, OR 97291 work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 291 - 2550 Phone: 503 291 - 2550 Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through 952 - 001 -0080. You Reg #: LIC 133745 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control Insp 8i Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insi Rain drain Insp Mechanical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Line Insp Plumb Final Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Service Insp Building Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Appr /Sdwlk Insp Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final / ' Permittee Signature : ALard IA � Issued By : g -- _ . Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day T o _ /+tiaJ T / 6 Sw12 •, — � o 5/ Building Permit Application Date/By: FOR OFFICE USE O DaceiBete /By: d �(�,,/� Permit Building t1r6 3 -c)0054/ 5-c)0054/ a c9. -4, '-/rJ No.t � o� City of Tigard Date/By: Permit No.: 13'125 SW Hall Blvd. RECEIVED Plan Review Other Tigard, Oregon 97223 Date /By: Permit No.: • Phone: 503- 639 -4171 FF 0 8 �A Planning Approval Other ] �� Post- Review Land Use [) li �!: t� ! /�iauv Date /By: Case No. Internet: www.ci.tigard.or.us .a Contact Juris.: ® See Page 2 for 24 -hour Inspection Requol'.l'`$Qi►3T91N3D Name /Method: Supplemental Information BUILDING DIVISION ` :.` : ° '. -; ; - .,c °:TYPE OF= "WORKe t_ ,:: � >.:: ' r R EQ UI RED DA . t , M New construction 111 Demolition �1 &e 2 FAMILY P t nt El Other: , Aadrtion/alteration/re laceme `; CAlEGORY~OF,CONSTRUGTION Z rt Note: Permit fees* are based on the total value of the work performed. Indicate 1 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ❑ Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation $ as 9e , 8./�. 1 ;..Je ,a = -,,- .JO andL,QCATION ;Tv ; No of bedrooms: No of baths: Total number of floors Job site address: \C0 <j Ica L Pr "c" New dwelling area (sq. ft.) Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: Fopr1■ 1t}11.L Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) , 7, � ' RE ; v COIVIMERGIAL USE CHECKLIST �" , Subdivision: Lot #: i -_ ,. ° a „,.- ., ,, .i �- ,5 „ = .:. _W .=._.,Ciarat ,. < <e Tax map /parcel #: o 2,S1 Do p,•0 5sI 00 Note: Permit fees* are based on the total value of the wok performed. Indicate a ,y- .r, , :i ,�; „_, , ,,,,_,._E. SC RIPTIQNQF, __..�._.4_.. WO 1): ,,: >. _ . the value (rounded to the nearest dollar) of all equipment, materials, labor ; .)% *,.2 9-- overhead and profit for the work indicated on this application. Valuation $ Existing building area (sq. ft.) New building area (sq. ft.) ' Number of stories A ® ,,PROPERTYOWNER >`:`° +:i 1 Es ;,4TENANT t "" ?` ` $' 7,:y: .''# Type of construction Name: ltiN'(S 0-)1,y,;CItiVG'(�OA3 Occupancy group(s): Existing: N ew: Address: IR O Y,O v °1U'Ap1 _, City /State /Zip: tx,ZlpeJD on_ 41 -nni- tot% - 1,SSG , � - Ci1 . NOTICE: All contractors and subcontractors are required to be Phone I FaX Z , licensed with the Oregon Construction Contractors Board under 'fIghirAtt:EIGANTNial4:A01;Er.C.05101A provisions of ORS 701 and may be required to be licensed in the Business Name: ?u-11t,k.c4- 5c-61p-tell', p or'si- ) jurisdiction where work is being performed. If the applicant is exempt Contact Name: ' '(t'Lu.1e-- S( —, -,r j from licensing, the following reason applies: Address: 6121Q ►it Aral o SI. City /State /Zip'Qo9.- , oft_ 1/ 2 Phone: 503.110$ • 4613 Fax:505 - 2AL , - 3,5- 0 i ' � ° � . 6 , s ' � BUILDING�PERMITFEES � � � , � , ' �, E-mail: l�t,1� s., 1ZY @ I oit( - i � '� Please ref r t0 f e schho � o e t _ „ ,,,,, i CONTRACTOR ; '. x .. E- . Business Name: k1- vtg,0rts Go4.5ti..oG Fees due upon application $ Address: ('t) "o 1Q-4cl City /State /Zip: (70(11 -o JJ t D A.- `11 t ( Amount received $ Phone: So -111 'icc0 Fax: t t -LA( 7 Date received: CCB Lic. #: 133 . S - Authorized r/ / � , /,, Notice: This permit application expires if a permit is not obtained within 11 -- - Signature: - 7' Date :1 d 180 days after it has been accepted as complete. PO u` `� { {{ 111 ",1 *Fee methodology by set b Tri- County Building Industry Service Board. (Please print name) f i s \Dsts\Permit Forms\BldgPermitApp.doc 01/03 One- and Two - Family Dwelling • • Permit • • Checklist Reference no.: j'o� wilding Permit Application Chec t Associated permits: City of Tigard City of Tigard ❑ Electrical ❑ Plumbing LI Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 3 Verification of approved plat/lot. 4 Fire district _ approval required. 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 ❑ plan ❑ 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. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect 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 - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing; spacing, and bearing locations. Show attic ventilation. • 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted. 26 "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 (6 /00 /COM.) \4 A . , . Mechanical Permit Application' t: Date received: Permit no.:4/1.5 , 49 , U ) 1.1 '' 'i'I City of Tigard Project/appl. no Expire date: Cityaf 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 type: Land use approval: Building permit no.: x ,. ', _. T} PE OT PERIVII I ° , . '1:': ' i ,.?.� < 4: Y r§ A 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: ".''''''',-'47'-'4',"- . " ' ,JOB SITF INFORMATION `f , . x' , COMMERCIAL. VALUATION`SCIIEDULF` a Job address: Zj ■ (O 'T'i'dI1,YO -C.E_ 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/account no.: profit. Value $ . Lot: Block: Subdivision: *See checklist for important application information and Project name: so , P‘ t... 11.• jurisdiction's fee schedule for residential permit fee. City /county: f a • , ZIP: 'y 22 k 44.2 FAMILY ;II1WELICING PERMIT FEE ;SCHEDULE `° Description and location of work on remises: AND COMMERICALfINDU EQUIPMENTSCILEDULE� visa sF�— Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res.onl Res. only Tenant improvement or change of use: HVAC: ■ Air handling unit CFM Is existing space heated or conditioned? D Yes 0 No Air conditioning (site plan required) NM Is existing space insulated? CI Yes 0 No Alteration of existing HVAC system M • - ' , i4 .- t . - ` ` ` w '; Boiler /compressors MECHANICAL . CONTRAC TOR = ;: ' , ______ _______ ■ � State boiler p ermit no r- HP Ton BTU /H Address: ( j • I k. Fire/smoke dampers/duct smoke detectors City: f,p 1.4;z!...)60 ELM Z IP : �j �? 3p Heat pump (site p an required) = P •jbl' AI Fax: -q3 4 E - mail: InstaWreplacefurnace/burner B U H ■-- 3 $ . ; Including ductwork /vent liner 0 Yes 0 No CCB no.: Install/replace/relocate heaters-suspended, ■-- City /metro lic. no.: wall, or floor mounted Name (please print): ` pa, Q, r ! N Vent for a ipliance other than furnace i i" :�, c j { ;wCUn`TAC TMPERSO - , ' ,,� . 3 '. Abso t on BTU/H ■ • Name: ' A cy,,....- �,, -r-j Chillers HP MI Com t ressors HP Address: 51 , SU hZc*A- 40_= '` , vrronmental exhaust and ventilation: 111 Mare '( —:D State:d (V ZIP: ' 7 lil Appliance vent Phone. f Dryer exhaust - 1` " • R , : . , :,, • a " .. .j. • r` k Hoods, Typel/ II/res. kitchen/hazmat ■_— ' ' " r hood fire suppression system Name: { p 0,4 ts"14•061.4\ L Exhaust fan with single duct (bath fans) - __ Mailing address: P t „, - 2A°1 Exhausts stem apart from heating or AC MI City: f -I' .. State :an. ZIP: ..- ZCI ( Fuel pip : and diet bution up to 4 outlets).-- Type: LPG NG Oil Phone: 1 -Z d rifflgirailli E - mail: Nei piping eac additional over 4 outlets In -”' ENGINI TR•" i . Process p pmg (schematic required) iMN/MlMMNIMNM � Name. Number of outlets NM • t er app ce or ■ pment: ■ - Address: Decorative fireplace City: State: ZIP: Insert -type 1. Phone: MarilMill E-mail: Woodstove/pellet stove = Applicant's signature: irei' Other. li Date: Other: a MI Name (print): 6g f 1 , - _ — Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 0 Visa ❑MasterCard Notice: This permit application Minimum fee $ Cmdit cord number: j— — expires.if a.permit -is not obtained — Plan review (at %)-$ Expires within 180 days after it has been State surcharge (8%) .... $ Name of cardholder as shown on credit card accepted as complete. TOTAL $ $ Cardholder signature Amount 440 -4617 (6/00/COM) � z M � A ll Electrical PermitApplication F- : - _ . - Date received: Permit no.: j:-" y(}3_a..)06 r - , , i l i t i ) 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 type: Land use approval: : = { ' , '''` �` ;,: s t n ' : TY P E a OFJ E : y ' Ili- 1 t- _ 't, 1. M ° - -. 'd - . S ta y .,. 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family O Tenant improvement % New construction O Addition/alteration /replacement O Other: ❑ Partial a i y '� , . � 'E ' 1:4 9 ys" -`"'� y '- t � �. > � .. �..� ,,.v .-..x ` a �' Z~�> � '� �t .2' � i4F `, ii. a , , `mo t t ;, ,, ` ' � - ' c ; -r: , , JO B _ S I7 E RIVIA } I O V . � t z -,.: 4.4 @ ,_ .,: ' � �mi. � 4�. .ASr �..� _.: � �.-�,h. , fin_ �>i. �r'�- - ` w, N° �- r- : . . _ . m . _ . � ,. �. . ... r..., ��a�� �m, �':....,. 1��.�6 °ire a � 'A . "'Se_ ,�': � . Job address: . , f ., l Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: -_ "? Block: Subdivision: ,.1%,, 414`,, Project name: pp {1 p . t W Description and location of work on premises: 1■), - I 5F17.... Estimated date of completion/inspection: f �. j 1., FEE -I SCHEDULE r , '- . n . _' . C0 AP,PLIGATION', � ,3/4;,"',,,P1,474(•,,41-, .� ` _. _ , ,, " /-r - , . ., , � . s� ,. � � � d ,>�. �: :.,mot �� � . �;: Job no: Fee Max Business name: '7,- , '�_Lr "Cie. C. Description Qty. (ea.) Total no. insp New residential - single ormulti-family per Address: ea L,;. 1 \ dweilingm ,it. Includes attached garage. State:00.. ZIP: 11 - Serviceincladed: Phone: -5 I etro< MIENNEEll E -mail: 1000 sq. ft, or less 4 4 061 e \ G Each additional 500 sq. ft. or portion thereof ___— CCB no. Elec. bus. IIC. no: Limited energy, residential _—_ 2 City /metro lie. no.: Limited energy, non residential ___ 2 IX i, Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 111111 2 Sup elect name (print): tPO ' y License no Z1j77 s Services or feeders— installation, alteration or relocation: t tian 5 PROPEI 1 iNR ' ' � , ��. t.���<`. r• »�.� ,,� ,.. -,-Y �t.�' ., WE :,� -vet .,���' 1��rt �• . :,. 200 amps or less IIIIII 2 Name (print): „♦ 1`'3 201 amps to 400 amps —__ 2 401 amps to 600 amps ___ 2 Mailing address: -.p. %.� 9 A 601 amps to 1000 amps =� 2 City: ,' -4,1, Statep(L ZIP: 'M ° Over 1000 amps or volts ___ 2 Phone: L-1 I - 7. SSO Fax: Z, - 7 E -mail: Reconnect only ___ 1 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 ,tdteration,orrelocati 200 amps or less . 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps M__ 2 Owner's signature: Date: 401 to 600 amps IIM__ 2 '._ r t+ w � ,.t. Branch circuits - new, alteration, A ENGINEER -- _,.:.._ : .._ — ,, a, .. x. _,, ,,,. » n . .4. w. , -:! E ,=� w or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit:.■ 2 Phone Fax E Each additional branch circuit: __ _— _- PLANIILVIEW (Please chc e k all that a pply) = ', , Mi .(Serviceorfe ■■ 0 Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 0 Service over 320 amps - rating of 18z2 0 Hazardous location Each sign or outline lighting ::: 2 family dwellings CI Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* 2 O Building over three stories 0 Feeders, 400 amps or more *Descri . tion: 0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: 0 Egress/lightingplan 0 Other. Per inspection __ Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ _ ❑ Visa ❑ MasterCard expires if a permit .is not obtained Plan review (at ^ %) $ Credit card number: - / / within 180 days after it has been State surcharge (8%) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00/COM) 01/14/04 02:1eP P.002 Patrick 5chm l t t , designer Inc. (503) 246 -5553 _.. -- _ Art- Z2E_,s- //7/ sotil1 Cs°53 ( 2C 9 - / 1 9 `1 Plumbing Permit Application Y" . ti,... , . = ;. a Date received: Permit no.:� ongoet g"�� r } '' � ri,. City of Tig ' Sewer permit no.: Building permit no.: / ? , 7 a _ �'Y}� y 1u -- Address: 13125 SW Hall Blv Tigard, OR 97223 City of7igard phone: (503) 639 -4171 ProjectlappLnO.: Expire date: Fax: (503) 598-1960 Daze issued: By: Receipt no.: Land use approval: Case rite no.: Payment type: kJ z;, x i t . ti, r c 1 1 .1 r©1 1'1 I21111 ` t W e Y; tr, ��z } vi :% J I & 2 family dwelling or accessory O Commercial mdusttial Cl Multi- family Cl Tenant improvement O New construction O Addition/alteration /replacement 0 Food service O Other C' ° , `i t ', e,l ' „t. '.10ENITE. IN1 Otl�tlA'l 10\ � M , } , ... l„Jt ] S( III^ l)t'I I (fur 4eiialr nforin:tiort cl►c¢li 0 Descri , lion Fee(ea.) Total Job address: (3 � l LA . ett C� New 1 -and 2-family dwellings only: r 0 Bldg. no.: I Suite no.: ( iactmdeclOtlR .[or+EachutlIltycomnectlon) (`A _ 1 Tax map/tax lot!account no.: SFR (1) bath �y (J Lot: 1Block: l Subdivision: SFR (2) bath - L ( N-- Project name: SFR (3) bath CX City/county: I ZIP: Each additional bath/kitchen s 5iteu ilities: f ! % Description and location of work on premises: �o Catch basin /area drain • I T, Est date of completion/inspection Drywells/ieach line/trench drain ( ., Footing drain (no. lin. ft.) lu , ,, , ” 4 Pl ;t 1 � (. t ; 1164 . 414: ? u r , . ;. ` Manufactured home utilities { r. , Business name: - v.P.c„....41 %+ d r 4 . ,` c /i i — Manholes i . • Address: ler , O , oar. D'. / Rain drain connector City: ,_ k t 0 s ` . ,, A State: ®!'( ZIP: 9 p 3_1 Sanitary sewer (no. lin. ft.) _ Phone: �?s�Z 7 f - Y Storm sewer (no. tin. ft.) Fax: _ `� `/ p E -mail: �..,. 8 2 — Q -- Water service (no. lin. ft.) CCB no.: ,� jp Plumb. his. reg. no: 3- 7 i 315114:,_ Fixture or Item: City /metro tic. no.: Abso • , : on valve Contractor's representative signature: Back flow preventer Qv Print name: ,t�, G ' .-� . Date Bacwater valve = • ,fr i , , s " ( O ; I Al I`PLRS( :.,-- . '. z � '' °. ti .P''' ', B asrnsllavatory • Clothes washer Name: Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: Fax E-mail: Ex , : ion tank -;()3.1,1 K, . ' ,ate #, 2 Y `', . •: , ;,. Fixture/sewer cap Floor drains/floor sinks/hub Name (print): Garbage disposal Mailing address: Hose bibb City: I State: I ZIP: Ice maker Phone: :Fax: 1E-mail: Interceptorigrease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my tegular 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 rfc, " w` r "`" I N( Ir1'L LI( > ; Tubs/shower /shower pan a x. Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: Fax: 1E-mail: Total um $ 'roc Mt jurisdictions coda cards. please salt i * {or mote `O Notice: 'this' permit application Plan r Minim um. ee f ee % D visa O MasterCard expires if a permit is not obtained view $ (at $ Credit card anatUc E xp es within ] 80 days after it has been Plate r (at (8%) %) TOTAL $ • accepted as complete. Name of cardholder as shown on credit card $ Cardholder *Pet= Amount 440 -4616 (6100/COM) CITY OF TIGARD �® 13125 S.W. HALL BLVD. TIGARD, OR 97223 � 0 0 IMPORTANT PERMIT NOTICE V\P\ F, \GPSov\ o \`I\ DAVID JEROME ELECTRIC \L ,‘‘Ac", .\\\0P* PO BOX 751 ®\ HILLSBORO, OR 97123 ®\ \ Electrical Signature Form Permit #: MST2003 -00054 Date Issued: 3/14/03 Parcel: 2S109BA -08100 Site Address: 13646 SW LEAH TERR Subdivision: DAFFODIL HILL Block: Lot: 007 Jurisdiction: TIG Zoning: R - Remarks: Construction of new SF detached residence. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: HEIGHTS CONSTRUCTION DAVID JEROME ELECTRIC 1 PO BOX 751 PO BOX 91249 HILLSBORO, OR 97123 PORTLAND, OR 97291 Phone #: 503 -291 -2550 Phone #: 648 -5144 Reg #: LIC 36051 SUP 2877S ELE 34 -119C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician If you have any questions, please call 503.718.2433. 6 21 - ) - b\ AA®® AAAAAA® AAAAAAAAAAAA • • • ® 1 5 ATION E TIF IC TREE T • • . „ ,,,„ • ,, , 4 • I , wner /A ent for //6/6i-77 Con) 0 ,7`, , • i • (PLEASE PRINT) (PERMIT HOLDER) o • • fi • a, • • • • Do hereby e6rtzy t ilt} th'e f location ® meets Citr -' Ti /Wash g ton County • . r" V1•. u':.. aA+l .°m�NN t+?a+m:ws ^.nsr.USti%`mnmy M14Ar.NSS amn's,$ ro]1 ?Ht�,A[':a^MMt: • land use and development standards for street tree installation. • • • • ADDRESS: ) 3 ( 5 , A). L- i ./ ,e • • • 1 LOT: 7 SUBDIVISION: DcP(rD i b , o /, • • f DATE: N Z C� 44 BY: Lai _. 7 1 RECEIVED BY: � DATE: 2-7d `f- • ® ®®®yyyyy VVVVVVVVVVVVyyTVVVVVVFVVVVyV VVYYTyy yyyyVVVVVVy vVy® CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 3 - 6e).2_5 ---1 1 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received / Date Requested / / - AM PM BUP / Location 3(o L__Ati Suite MEC Contact Person Ph ( ) , d PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain / ELR Crawl Drain E ' V Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL earn Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Ot er: anal SS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL 1 ad coZ d / - l Service Rough -In Slab A ) J p //7 r\ rm "��> Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE - Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line / Approach/Sidewalk Date /\ , / Inspector - tat / Ext Other: Final DO NOT REMOVE this inspection record from th Job site. PASS PART FAIL CITY OF'TIGARD 7 24 -Hour BUILDING Inspection Line 175 MST .J r 1 00 d s cf INSPECTION DIVISION Business Line: 639 -4171 BUP Received Date Requested / 3 AM 7 PM BUP •catio' I3 to 7 . A Suite MEC Contact Person Ph ( ) e c 9 / 7 - - PLM Contractor Ph ( ) SWR Tenant/Owner ELC 0 • Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear 6 N - : 1164- �� Z e n i. s Framing �f Insulation 61A,LII- V () , �-r &A.; 1 A n *. N a � � Drywall Nailing \ 05—AL `JV � J� �' ` r Firewall \ Gg- l , 2 / 6 ( I ( • Fire Sprinkler J �J' 'f ��"7S> — 1 ��/� -sl,S Fire Alarm - i ' i D Susp'd Ceiling S Roof Other gl PASS PART QQJMBI Post & Beam YlAcA-- i� ® �, � A ` b 4 C 3--F ) Under Slab l "" 1 Rough -In Water Service Sanitary Sewer -- ` ( i ),,.)Ca - Cs—. c- `) YNC7 Rain Drains _ _ Catch Basin / Manhole CL c Storm Drain � Shower Pan t /mss 1"e . \ 7 0 Othe f anal L L--� S � -.. -� \ PASS PART F AIL / �j E CHANIC.)4L Post & Beam , ! Rough -In Gas Line - 1 _� _� QQ S . Dampers G.-� 1 / ^V R -c. -��� ina�' ® Gj �'T��.' UU C7t2 +%vac. ° PART FAIL CTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: 0 U ble to inspect - no access - - Fire Supply Line i ADA Da L 6 Ins actor X Ext Approach /Sidewalk P Other: -� Final" DO NOT REMOVE this inspection record from the job site. PASS PART FAIL 4 CITY OF7IGARD 24 -Hour ' BUILDING Inspection Line: 39 -4175 41111 MST 3 —6063 INSPECTION DIVISION Business Line. •,- ` -4171 BUP Received // Date Re ested _ _ /-5 AM ` PM BUP Location / 3 'P14' ��� Suite MEC Contact Person Ph ( ) .024q°±79 1 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: j �_ v ` � �"'� A , 1 � SIT 3- (3°D Post & Beam I v Shear Anchors 1 3 ■ 5 Ext Sheath /Shear • Int Sheath /Shear ij /�- �� 1 / l ° q C - l 55 Framing a I/ ✓� C ! "I Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 1AAL;• Roof �:�r i g 7- Other: - 7' �' AA, kC S - L--1r q �� In -y ' - v BINGRT FAIL 1 (� - o Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain / ‘ Shower Pan Other: �� PART FAIL • ■ ANICAL _ Post & Beam Rough -In Gas Line Smoke Dampers ' Final . PASS PART FAIL - r" ELECTRICAL i Service • Rough -In UG /Slab Low Voltage Fire Alarm Final Q Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE - El Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA 0 c(e) \ Approach/Sidewalk Date Inspeeter Ext Other: • Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL •