Permit , CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00177
t 1yJ DEVELOPMENT SERVICES DATE ISSUED: 6/16/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12055 SW WHISTLER'S LP PARCEL: 2S103CC -14400
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R - 4.5
BLOCK: LOT: 091 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: DM199AS STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,625 sf BASEMENT' sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,890 sf GARAGE: 630 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRE sf RIGHT: 5
VALUE: 340 00
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,515 sf REAR: 15
PLUMBING .
SINKS: 2 WATER CLOSETS• 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: 1 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: 7 201 - 400 amp: 201 - 400 amp: 1st W/O SVaFDR: 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 REVIE W S ECTION
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: BOILER: HVAC: LANDSCAPEHRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,505.68
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD ST., #100 4230 GALEWOOD ST, STE 100 Tigard Municipal Code, laws of All work k wil b o ne i n
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 and all ra cer applicable ed p Al. This permit done in
accordance with approved plans. This permi t will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 387 - 7538 Phone: ATTENTION: Oregon law requires you to follow rules
S0 387 adopted by the Oregon Utility Notification Center. Those
Reg #: 1,1 3 rules are set 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) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Rain drain Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp
Issued By : Ii, i, _ _ _ AP /
_ _ ,_ Permittee Signature
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
i X2200 / -DO 121
` Building Permit Application
Date received: , y 0 ' i ' ' t no, fJ' ,, - j
4 l I
, , jJ ,1 :f 1 l i • City Project/appl. no.: Expire date:
City nfTigard Address: \ +1 Blvd, Tigard, OR 97223 '
Phone: (503) 639 -4171, li mi t 04 Date issued: By: Receipt no.: , ,.
Fax: (503) 598 �0 L Case file no.: Payment type:
Land use�r�i4-ti TIGARD ( &2 family: Simple Complex:
G u1VaSI
TYPE OF PERMIT
\ 1
�..s it
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial Cl Multi - family ›'New construction ❑ Demolition ;
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job add ss: il�`m'ai� [ i ,/ Bldg. no.: Suite no.: 1
Lot: _ Block: Subdivision: vmmmymmi Tax map /tax lot/account no.:
lib
Project name: ■-
Description and location of work on premises/special conditions: '.....
OWNER ' FOR SPECIAL INFORMATION, USE CHECKLIST
Name: •,r - Y ‘ ', , 1 1 S ( hloodplain ;sc�iticcapacitj,solar,etc.)
Mailing address: . .-.) I .,(,•V• C ' 1 -, : It- 4) 1 & 2 family dwelling:
City: �'m ZIP: -' '2) . 7 Valuation of work $ ''/
Phone: " bi fJ `a� m, -mail: No. of bedrooms/baths `i" _,Z
Owner's representative: , j if C Y I Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) 3 I S
:, APPLICANT Garage/carport area (sq. ft) = cs
rEilbia l arsT • Covered porch area (sq. ft.)
Mailing address: ' rk Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
Business name: L �� A(dSiL! Existing bldg. area (sq. ft.)
Address: NyL
New bldg. area (sq. ft.)
City: State: ZIP: Number of stories
Phone: I Fax: I E -mail: Type of construction
CCB no.: S C:3 7� Occupancy group(s): Existing:
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: (-ict, i , t, L , provisions of ORS 701 and may be required to be licensed in the
Address: S l. b,V ) cL l cc. -rN, jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
• -- • • ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
'attached checklist. A . rovisions of 1 ws and o dinances governing this 0 Visa Cl MasterCard
work will be complt - I wi i , whether cified 1ere i r ftot./ / s Credit card number / / '
f It - l i ►— v 1 Expires
Authorized si _ atu e: Name of cardholder as shown on credit card
Print name: ra - ' _ T 2122. 1 ( - - Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6 nWCOM)
One- and Two - Family Dwelling
A - ' ' ' ' ' ' Reference no.:
;; ,s „ ,, Building Permit Application Checklist
Associated permits:
City of Tigard City of Tigard `, ❑ Electrical ❑ Plumbing 0 Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
— - --
THE - FOLLOWING - ITEMS ARE REQUIRED PL Yes No -N /A
•
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. V
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. i(
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc. Jc
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. J�
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. ' x \
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. X
20 Manufactured floor /roof truss design details. X
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 ". X
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.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28
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 (6I00/COM)
•
' Mechanical Permit Application
� Date received: Permit no: f , _�j7
"1'l! City of Tigar t ly E is/ Project/appl. no.: Expire date:
Address: 13125 SW Hal "i5" gar , O 97223
City of Tigard Date issued: By: Receipt no.: _
Phone: (503) 639 - 4171 JUN / 2U0
Fax: (503) 598 - 1960 JUN o Case bile no.: Payment type:
Land use approval: CITY OF TIGARD Building permit no.:
- IP NG DIVISION
- ' TYPE OF PERMIT .
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement •
,Iew construction ❑ Addition/alteration/replacement ❑ Other.
JOB SITE INFORMATION ' - COMMERCIAL VALUATION SCHEDULE. -
Job address: 1`% j/ L 7111 ` Milll 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: PI_ Block: Subdivision: YIP 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: - 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res.only Res.only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM
g P Air condluoning (site plan required) -
Is existing space insulated? ❑ Yes ❑ No _ Alteration of existing HVAC system -
MECHANICAL .;CONTRACTOR d or boiler permit no.:
�.II��Z� .4 �I.� HP Tons BTU/H
Address: aNirib Fire /smokedampers/duct smoke detectors -
to MEMIre 9 R Heat pump (site plan required) Mil
Phone: „�4• _ ' Fax: E - mail:
Including place furnace/burner nt liner BTU /H ■ --
Including ductwork /vent liner ❑ Yes ❑ No
CCB no.: j lnstalUreplace/relocate heaters – suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): '°r�'j ■ --
i / Vent for appliance other than furnace —
� j jZ
:. C Refrigeration: II
IIMIE NT�f L'GIZSO
IC " .. -- - - • Absorption n units BTU/1i
A� , ; . Chillers HP
Address: Compressors HP -
� 46 �� Environmental exhaust and ventilation: - --
City: State: ZIP: Appliance vent
Phone: Fax: E-mail: Dryer exhaust MI
Hoods, Type V IUres. kitchen /hazmat ■ __
hood fire suppression system
` • -
'• Exhaust fan with single duct (bath fans)
Mailing address: �' 7 1 I� Exhaust system apart from heating or AC (♦
��1 �' --
Il � Fuel piping and distnbution (up to 4 outlets) ---
� Type: LPG NG Oil
Phone 14 Fax: E-mail: Fuel piping each additional over 4 outlets —
'`'' , ENGINE EA...., _. ,2 -,. . , Process piping (schematic required) -
Name: Number of outlets
Other listed appliance or equipment:
In
Address Decorative fireplace
City' State: ZIP: Insert – type ME
Phone: IMENNIMIE E -mail: Woodstove/pelletstove -
Other:
MI
Applicant's signors JlWAIII Date: n -, ���. Other.
Name (print) .(- ., , , 1 ME
Not all junsd,cuons accept credit cards, please call jurisdiction for more tnfomuuon Permit fee $
Notice: This permit application Minimum fee $
O Visa ❑ MasterCard expires if a permit is not obtained
Credit card number / / 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 -7617 (600 OM)
A Plumbing Permit Application .
_ _ ® Date received: Permit no.T/SrX� q-,, Int
31{�I j j City of 91 ! (' Sewer permit no.: Building permit no.:
�c#"/' 1 Address: 13125 SW Hall Blvd, Ti a rd, OR 97223 date:
City of Tigard Phone: (503) 639 } ��a 0'7 2 4 Project/appl.no.. Expire
Fax: (503) 598 -19 Date issued: By: Receipt no.:
CITY OF TIGARD Case file no.: Payment type:
Land use a., ulYJING DIVISIrIN
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
►• New construction ❑ Addition/alteration/replacement ❑ Food service 0 Other.
JOB SITE INFORMATION - ' FEE SCHEDULE (for special infortnatian use Checklist): •
=� �� 1 J► . L Description Qty. Fee(ea.) Total
Job address: _ N ew 1- an 2 - family dwellings only:
Bldg. no.: Suite no.: (includes 100 9. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot 9 ( 1 Subdivision: = 7 -' SFR (2) bath
Project name: SFR (3) bath
City /county: ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Est- date of completion/inspection: drain
_ Drywells/leach line/trench drn
.. Footing drain (no. lin. ft.)
')--- l'LL! %1I3ING i CON I RACTOR' :' , Manufactured home utilities
Business name: liS �p L i Manholes
Address: ,�����a_i Rain drain connector
��!'»
fr-� ZIP: Sanitary sewer (no. lin. ft.)
t �, -vim Storm sewer (no. tin. ft.)
Phone: y a Fax: E-mail: 1 Water service (no. lin. ft.)
CCB no.: t, c9-7 LI -] I Plumb. bus. reg. no: - - Fixture or item:
City/metro lic. no.. ti ;A /'/ ' Absorption valve
Contractors representative signature, ✓f/ � �1 WO Back tlow pre' enter
Print name. , \ • • , — I v —!A-II Backwater valve ,
. CONFAC: f PERSON Basins/lavatory
Clothes washer
Name: .1 {\H PC� -DI E Dishwasher
Address: mA i / dip 1: , ,V - Dnnkine fountain(s)
City: State: Ejectors/sump
Phone: Fax: Expansion tank •
-'4 ''' ". O. \C \ lift Fixture/sewer cap ,
_
Name (print): y� Floor drains/floor sinks/hub
.�t� t Lam` Garbage disposal
Mailing address. .. • ' • 1 • t Hose bibb
City: - ) , ca�iampr sos Ice maker
Phone: '5� -2 -7 - TFa..: 7 -7(d E-mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Pnmens)
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
, r ENGINEER '' . • - Unnal
Name: Water closet
Address- Water heater
City I State• I ZIP. Other.
Phone I Fax: I E -mail Total •
Minimum fee S
No( 3.11 lunswplease ons accept credit cards please call suns information
for more This permit application
Plan review (at _ %)
C visa 0 StasterCard expires If a permit Is not obtained
C.edtt card number State surcharge (S%) •••• $
/ 1 within 130 �1a}s after It has been
Expires TOTAL ____—__—
accepted as complete
Name of cardholder as shown oa credit card
S
Cardholder signature Amount 440 -•3616 (■00■COM)
° Electrical Permit A l ication
A Datereeceived: Permit no.:/ ar0 /, { IIII City of Ti al u Project/appl. no.: Expire date:
City of Tigard Address: 13125 SWHa T ;e 1tpR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598- 1960ITY OF TIGARD Case file no.: Payment type:
Land use approai!LDING DIVISION
• TYPE OF PERMIT .. '
0 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi - family 0 Tenant improvement
I' New construction 0 Addition/alteration /replacement 0 Other. 0 Partial
JOB SITE INFORMATION '
Job address: •K r� r t i Bldg. no.: _ Suite no.: Tax map /tax lot/account no.:
Lot: .111111 Block: Subdivision: 1 /11Mi r '
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
. : :CONTRACTOR APPIA'ATION - FIE SCHEDULE_ - - • - .
Job no: I.' Fee Max
Business name:
CA—OA � Description Qty. (ea.) Total no. insp
1 _ New residential- single or multi-family per
Address: gip _ • �` t•�C (--" AI dwelling unit Includes attacbedgarage.
RE 11111121 �tiblial t /12,10 Service included:
�� •
Phone: i ...3 - I _AU Fax: E -mail: 1000 sq. ft or less 4
Each additional 500 sq. ft or portion thereof
CCB no.: _ Elec. bus. lie. no: i c 90 (f . Lrnutedenergy,res 2
C' Lirmted energy, non - residential 2
Each manufactured home or modular dwelling
s nature of supervising electrician (required) Date v' ifi [g1 Service and/or feeder 2
License no � a Services or feeders - installation,
Sup elect name (print) .. .a . 1 i! mj alteration or relocation:
- - . PROPERTY :.OWNER' • 200 amps or less 2
201 amps to 400 amps 2
Name (print). 1. tN►���� 401 amps to 600 amps 2
Mailing address: J .( �)� �• I 601 amps to 1000 amps 2
City: . I State 4 ZIP: 70 Over 1000 amps or volts 2
Phone: , !yam _A Fax: _- ) - , -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
imYallation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENG�EI� Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: [State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
_ - - PLAN REVIEW (Please check all that apply) • . Misc. (Service or feeder not included):
❑ Service over 22.5 amps- commercial 0 Health-care facility pump or irrigation circle 2 2
0 Service over 320 amps- rating of 1 &2 0 Hazardous location Each sign or outline lighting
. family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stones ❑ Feeders, 400 amps or more •Description:
0 Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other. Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
Not all lunsdicuons xcept credit cards, please call jurisdiction for more information Notice: This permit application Plan review (at _ %) $
0 Visa O MasterCard expires if a permit is not obtained
Credit card number / / within 180 days after it has been State surcharge (8%) .... $
, Expires accepted as complete. TOTAL $
Name or cardholder as shown on credit card
$
Cardholder signature Amount _, 440 -4615 (600/COM)
. CITY OF TIGARD Credit No.: 2004 -0001
Date Issued: 01/28/04
Engineering
^I;; f �l � Authorization
Date: 01/28/04
TRAFFIC IMPACT FEE
CREDIT VOUCHER Land Use
Casefile No.: SUB2003 -00004
In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) Venture
Properties, Inc.
(name of
developer)
is entitled to $ 50,606.07 in Traffic Impact Fee Credits that can be applied to TIF charges for
development on lot(s) 1 - 29 of the Whistler's Walk 2 Development. The use of TIF credits are
subject to the rules and limitations of the TIF Ordinance which are listed on the back of this
voucher. WARNING: This voucher must be presented at the time of issuance of the building
permit, or if deferral was granted, issuance of an Occupancy Permit.
G
P. 0 ._ ,_„ ....._
Director
Date Permit Numbers Lot Numbers Credit Used Balance
Beginning Balance $ 50,606.07
Balance carried forward to TIF Credit No.
• Ordinance 379 provides for an expiration 10 years from authorization.
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1 STREET TREE CERTIFICATION
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(PLEA.s l'121N I) oqiimirr tioLnER)
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1 I )() lici chy call( hit Ilic ((;ilowingl()( ;it lull
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meets (,it y of Tigai (I/Washington Comity
-4
-11 [and use ilicl development siiindm 101 street I rec instalimion.
A DDR ESS:
, . . .
. -
' 4 LOT: q/ S 1 1 R I ) 1 V ISION:
.
IY: DATF.:
A .
RECEIVED B Y: .'"/ 7 1 / ` - 4 ---- ---.-. I 1ATF.:
r • -_:-..---- - - .
AFT-*****-i-CfrYTYV7Iinfluiv VT'S' YYVVYYTNITTV1iNTYTTVV-ii-iirirTivITYVVYYTYVYTTY1 '
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST -6° 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested .(71 AM PM BUP
Location l' O S S kt -- Pew Suite MEC
Contact Person Ph ( ) a D c 1 — qe 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing 4i 4.-e27 ,7 V SI/9LG
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: -
ART 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
Smo e Dampers
AS PART FAIL
ELECTRICAL •
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE LI Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
• Approach/Sidewalk Date Q I — 14 -- 04- Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ' bb --DO 7
INSPECTION DIVISION • Business Line: • (503) 639 -4171
BUP
Received Date Requested 9 - 76 AM PM BUP
Location I a- O 5 "E -P4 O Suite MEC
Contact Person 3J Ph ( ) ,vn ?— g' 3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC �1
Ftg Drain ELR
Crawl Drain rJ /
Slab Inspection Notes: SIT ■1 -
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall �/ C folL 41
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL (*WO' MECHANICAL 4662- ,057 ®f , I?
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
___ • Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
4_, ADA
Approach /Sidewalk Date Inspector l Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST °? o D 9 - d 6 / 7 -7
INSPECTION DIVISION Business Line: (503) 639 -4171
c BUP
Received Date Requested ` - 3 AM PM BUP
Location 10 0 S I5 ( ktitiOA4– Suite MEC
Contact Person Ph ( ) ■'— 41137 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall A _K"
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof r
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:
/
• �� PART FAIL
HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL •
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please c II for reins ection RE: Unable to inspect — no access
Fire Supply Line
ADA /Yr)/
Approach/Sidewalk Date D Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL