Permit CITY OF T I G A R D MASTER PERMIT
PERMIT #:
°1 ' +I'I DEVELOPMENT SERVICES DATE ISSUED: 4/2 /0404 -00086
„� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12062 SW WHISTLER'S LP PARCEL: 2S103CD -WW272
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R - 4.5
BLOCK: LOT: 072 JURISDICTION: TIG
REMARKS: New SF detached
BUILDING
REISSUE: DM198CO1 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,290 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,360 sf GARAGE: 451 sf FRONT. 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD sf RIGHT: 5
VALUE: 258 50
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,650 sf REAR: 15
PLUMBING
SINKS: 2 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS. RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 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: BOIL/CMP < 3HP: VENT FANS: 4 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EAADDL 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 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: . MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,855.12
DON MORISSETTE HOMES INC DON MORISSETTE HOMES INC This permit cip l C subject Code, the regulations contained C o i the
Tigard Municipal r applicable ipal Code, State work k w Specialty Codes and
4230 GALEWOOD STE #100 4230 GALEWOOD ST, STE 100 all other applicable law All work will be done i
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 t
accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 387 - 7538 Phone: Oregon Utility Notification Center. Those rules are set
5 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: L1`/- 3877 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 Ins F Gyp Board Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing lnsp Gas Fireplace Water Line Insp Plumb Final
Post/Be- - ru - al Mechanical lnsp Shear Wall lnsp Insulation Insp Water Service Insp Building Final
/ 7
Issue. By : ` _,: . I , __..1 „Al Permittee Signature : �`
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Building Permit Application =
lielli Date received: MjiI M Permit no.: rfrr e5 —*
i i i i Clty of Tilgard Project/appl. no.: Expire date:
City of Tigwd Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.: ,•
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
N
• TYPE OF PERI\IIT ..Z
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family , 'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other.
JOB SITE INFORMATION ,
Job address: _ —Rt ` ��wr Bldg. no.: Suite no.:
,, Block: Subdivision: �.f�SA�L(�J! map/tax ■
Lot:
n �A /�� Tax ma tax lot/account no.: ■•
Project name: •.
Description and location of work on premises/special conditions: rr
C
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
f Mr1]���n1.�f� a (Floodplain, septic capacity, solar, etc.)
Mailing address: 'eSi (! ' e i& 2 family dwelling:
EZNIMIIIIIMIIIMEDVA�� Valuation of work $
— i rj
Phone: F:durii=allEMagra, No. of bedrooms/baths
Owner's representative: . ; L� �� _ Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) � 4,0
• • APPLICANT Garage/carport area (sq. ft.)
Covered porch area (sq. ft.)
Name: & lt. ,� - s' 1& i
Mailing address: ' A. a _ V Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.) -
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
rid Existing bldg. area (sq. ft.)
Address: _ v` i
New bldg. area (sq. ft.)
City: State: ZIP: Number of stories
Phone: I Fax: I E -mail: Type of construction
CCB no.: )) t) c5-.7D-3 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: (- la u •- provisions of ORS 701 and may be required to be licensed in the •
Address: e <4 ti� ai -Y`w jurisdiction where work is being performed. If the applicant is
City: State: I 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: IZIP: 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 dinan ces governing this 0 Visa ❑ MasterCard
work will be compli - • wt .• , whether cified iierelll t. Credit card number: / /
9 ��� �n��y JJ �1 �
Authorized si a ate , /1 A ��� !!!yyy���1 ,. / Name of cardholder as shown on credit card Expires
Print name: l! L Air I 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 (6100/COM)
One- and Two - Family Dwelling
• e e e e • Reference no.:
, �., Building Permit Application Checklist
City ofTigard Cl of Tigard Associated permits:
g ❑ Electrical ❑ Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TIIE FOLLOW ING ITE1 ARE -REQUIRED FOR I 'cs — No N/A
• I 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.
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 t/
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, X
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. J�
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. y
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.
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 (6,00/COM)
�� A Mechanical Permit Application '
Date received: Permit no i / ,401.1 ti
111 r City of Tigard �: ty g Project/appl.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.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
XIew construction ❑ Addition/alteration/replacement ❑ Other.
. JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE •
Job address: [✓L�j: -f�iviwam 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: Mil Block: Subdivision: mg �rm' 'See checklist for important application information and
Project name: LAIIII AW 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 COMMERICAIJINDUSTRIAL EQUIPMENTSCII
Fee (ea.) Total
Est. date of completion /inspection: Description Qty. Res.only Res. only
Tenant improvement or change of use: HVAC: ill •
-
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM
g P Air conditioning (site plan required) MI
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system -
11ECE \NlCAL'__ _ _ State I ■■
��� _ __ State boiler permit no.:
�.Itis►i�� /_fi �I _ HP Tons BTU/H
Address: c� �� b -
Fire/smoke dampers/duct smoke detectors
E —_ —_
ISM ZIP: li i ff/A1 Heat pump (site plan required) ■ --
Phone:��� - ' Fax: E : Install/replacefurnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: — .i Install/replace/relocate heaters— suspended, ■ --
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): VIPj G 1JV R ent for appliance other than furnace : ==
, CO1 TAC "f ; efiigeratfon:
Absorption units BTU/H
FM i Chillers HP MI
Address: Compressors HP
11a_ ♦ �t Environmental exhaust and ventilation: ■ --
, City: State: ZIP: Appliance vent
Phone: Fax: E- mail Dryer exhaust MI
,., • -, . , Hoods, Type U II/res. Iutchen/hazmat ■ __
hood fire suppression system
_� .f� l� ai rtL 4 Exhaust fan with single duct (bath fans) -
Mailing address: irg�r 1 , „,„_ „i 1 Exhaust system apart from heating or AC MIN
EMSlr_11H EMINMfsi E Fuel piping and distribution (up to 4 outlets) ■ --
Type: LPG NG Oil
Phone. Irlire Fax: E -mail. Fuel piping each additional over 4 outlets —
E N G IN L I: R • Process piping (schematic required) = MN
Name: Number of outlets
Other listed appliance or equipment:
111
Address: Decorative fireplace
City: State: ZIP: Insert — type
Phone: IMEIMIErgal Woodstove/pellet stove -
Other: NM
. Applicant's signafu” .Awap 2 a Date: tj�J Other MI
Name (print): .(: • - ' ' I ilIl
P
Not all junsdreuons accept credit cards, please call junsdreuon for more information. Permit fee $
❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at _ %) $
Credit card number Es
Expires w i t hin 180 days after it has b ( )
p been surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440 -1617 (6/00/COM)
Pl umbing Permit Application ., , _ : „ , ...., _ ,._ ,.
.‘A Date received: ' ' ,�� �� • •
: 1 . i cy ; City of Tigard
� Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd. Tigard, OR 97223 date:
City ofTigard Phone: (503) 639 171 Project/appl.no.: Expire
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Land use approval: Case tile no : Payment type:
TYPE OF FERMI' -
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
►- New construction 0 Addition/alteration /replacement 0 Food service 0 Other.
- - -. . JOB SITE INFORMATION : . - FEE SCHEDULE (for special information use checklist)
Job address: t Description Qty. Fee(en.) Total
1�� • _ ► .� n 'mo New 1 -and 2-family dwellings only
Bldg. no.: Suite te no o.: . (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: I SFR (1) bath
Lot: —7 1u , _
Block: [Subdivision: SFR (2) bath
Project name: i< SFR (3) bath
City /county: ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Drywells/leach line/trench drain
Est date of completion/inspection: Footing drain (no. lin. ft.)
- PLL111131NG •` • CONTRACTOR Manufactured home utilities
Business name: 1 `7 L i Manholes
Address:
g Rain drain connector
Sanitary sewer (no. lin. ft.)
d�ial i l g ZIP:
City: ■!1J. w � Storm sewer (no. lin. ft.)
Phone:( 1 Fax: E-mail: lip Water service (no. lin. ft.)
CCB no [ (�q+ - � -] I P bus. reg. no: - - ..._ in. Fixture or item: 4 111, City/metro lic. no.. NIA . / — Absorption valve
Contractors representative signature..- ..../(,, -.1•10M _ Back Clow pre�:enter
� • .�
Print name: • 1�l = �fWariJ• Backwater valve
t 1\Ci l'I RSO\
cO Basins/lavatory
`'1 , ( N _D Clothes washer
Name: 1 N E Dishwasher
Address: aiA / # 1r , V . Drinking fountain(s)
City- ! State: ZIP: Electors sump
Phone: Fax: E -mail: ' Expansion tank
owN Ir it, , Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): -t1 �v`;�( 1s��1,� ta "�` � /� Garbage disposal
Mailing address: ,,,,,IL. 't 6' ' 11 ° Hose btbb •
Ciry: -() State ZIP:C 7C Ice maker
Phone: j7- -fS j Fax:52?7-7ki E -mail: , Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Pnmer(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
Unnal
Name .' Water closet
Address Water heater
City. i State I ZIP: Other _____ j
Phone. I Fax: I E -mail. -Total
Minimum fee $
.Lu
Noe all Iunscons accept credit cards, please call lunsdscuon for more information Notice: This permit application
C Visa 0 tilsstc Card expires if a permit is not obtained
Plan review (at _ %) $
C.edii card number / w ithin 180 days after it ha been State surcharge (3 %) .... $
Expires TOTAL $ -----
accepted as complete
Name of ur as shown oa credit card
Amount .i;0 -3616 (&' COM)
Cardholder signature �
Electrical Permit Application .
, . � D ate received: Permit no.: t " ` m �, 66x6 I
1 1 j; City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW W 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:
TYPE OF PERMIT -
0 1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi- family ❑ Tenant improvement
v New construction ❑ Addition/alteration/replacement ❑ Other. 0 Partial
� .� JOB SITE INFORMATION
Job address: oil /p m�_� rL/%7�.�I.I� Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: mi. Block: Subdivision: I1jtMi �iogirliral,
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
. . CON'I RAt_ I OR ,.1'1 ,VI ION'. ' • FEE SCHEDULE -
Job no: Fee Max
Description Qty. (ea.) Total no. Imp
Business name: ' � 1 New residential-single orniulti-fainil per
Address: ° r� �` a � dwelling unit. Includes attached garage.
��,,������ Z Service included:
' L1 1 �:�f�i1�/ fi �i=� Si ildd 4
Phone:L .j - l • J Fax: E -mail: 1000 sq. ft or less
//1 Each additional 500 sq ft or portion thereof
CCB no.: _ Elec. bus. lic. no: 0 eat lam Limited energy, residential 2
C r),.................. Eachtma manufactured home or modular 2
Each manufactured home or modular dwelling
nature of supervising electrician (required) Date ] 6 Service and/or feeder 2
Sup elect name (print) 1 ef. A Al License no I t� Services or feeders
A IL alteration or relocation:
,PROPERTY. 'OWNER',' t 200 amps or less 2
0 201 amps to 400 amps 2
Name (print): Mr • , • ` IST►�1L.w 401 amps to 600 amps 2
l
Mailing address: 9 , 7 . 1i,A D• s ; 1 D 601 amps to 1000 amps 2
Cit L.O IState '. ZIP: 70 Over 1000 amps or volts 2
Phone: , 75y - Fax: - - a . -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 2
200 amps or less
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature- Date: 401 to 600 amps 2
ENGINEER 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: 1 State: I ZIP: B Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each addtuonal branch circuit:
- PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial 0 Health-care facility pump or irrigation circle 2
[y - 2
O Service over 320 amps- rating of 1&2 O Hazardous location Each signor outline lighting
family dwellings O 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
O Building over three stones 0 Feeders, 400 amps or more 'Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egress/lighting plan ❑ Other Per inspection
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 lunsdacuons accept credit cards, please call lunsdreuoo for more information- Notice. This permit application
❑ 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
S
Cardholder signature Amount 440 -4615 (6AXYCOM)
CITY OF TIGARD Credit No.: 2004 -0001
Date Issued: 01/28/04
Engineering
� ��^'�F "��1�� Authorization
'�tp�n
�'L F - 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.
aritj 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.
login \viola \tif09. t
II 44 5 , — a,o-v y — a 8' &
LllllleAeee•eAAA4eAA AAAAAA r
a STREET
A
F , /)wuci /A fc�l Poo rlbyt 5serr� AMES
I, t�-" PRIM) (PERMIT HOLDER)
I
A
)o Iiei ehy cell i(y tliAt the ((Mowing location ►
1 meets Cit of 'lipid /Washington County
I 4 land use and clevclopincut stal►ch for stied tree installation.
i
ADDRESS: .l i3Oio2 5w w1 +(5 S L.-P -
A
� SIJI�I)IVISI< sl: AA/S hafil = - - -- - -- ,
4 LOT• — — — —
By: - --
d i
1 IdiCEIVED BY: I >ATF.- "7/('
Pff**** ∎ TTTTT TTTTTT TTT YTTYT1WV'Y TV *TTTTTTTYTT'TTT7YYYYTTTTTTT1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: ) 639 -4175 MST °
INSPECTION DIVISION Business Lin (503) 639 - 4171
BUP
Received Date Reque t AM - PM BUP
Location ) 4 .c-;v3 A - L- , ' Suite MEC
Contact Person 1Z Ph ( T ) PP " 1 V 9- 4 � 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 � t , i � _��
Insulation mil/ d
Drywall Nailing
Firewall
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
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service -
Rough -In
UG/Slab
Low Voltage
Fir= Alarm
, „ �i� Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
CO PART FAIL
SITE Please call for reinspection RE: Q Unable to inspect — no access
Fire Supply Line
ADA "�
Approach/Sidewalk Date / i / - 0 Inspector L1 Ext
Other:
Final. DO NOT REMOVE this Inspection record from the f ob site.
PASS PART FAIL
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MSTc2D6
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested - 7 — (3 AM PM BUP
Location / a v Co Suite MEC
Contact Person Ph ( ) n20 ?--(q3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire Sprinkler /Zi
Fire Sp l
Fire Alarm , L#, _ / j
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:
PART FAIL
ANICAL
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 call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA �j
Approach/Sidewalk Date v Inspector F / Ext
Other: 1,
Final . DO NOT REMOVE this Inspection record from the job site. •
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 175 MST cd '/ - ?
INSPECTION DIVISION Business Line: (50 -4 71
BUP
Received Date Requested 7 — / 3 AM PM BUP
Location I oZ0 a l i D k A 4-1 Suite MEC
Contact Person Ph ( ) 0 O ? — c(?3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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 Atit/\,/ Insul ation /1. - f� `afir (1 /� ltl� �C% Drywall Nailing C ��
Firewall p44t%®
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
_ - PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer - - e-c-,+ O/
Rain Drains
Catch Basin / Manhole . 0 jl<
Storm Drain � �
Shower Pan c ,,y
Other: t/v`--
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
•
TRICAL
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 E Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA Approach/Sidewalk Date 1-(--o Inspector Ext
Other:
Final . - DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL