Permit /- i
CITY OF T I GA R D MASTER PERMIT
PERMIT #: MST2003 -00541
�I� DEVELOPMENT SERVICES DATE ISSUED: 1/12/04
�'�' � --� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12365 SW WINTERVIEW DR PARCEL: 2S110BC -03600
SUBDIVISION: THORNWOOD ZONING: R -
BLOCK: LOT: 007 JURISDICTION: TIG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: DM181 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,590 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,875 sf GARAGE: 606 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 Two. sf RIGHT: 5
VALUE: 334,891 80
OCCUPANCY GRP: R3 BDRM: 5 BATH. 3 TOTAL: 3,465 sf REAR: 15
PLUMBING
SINKS: 1 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 SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 7 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: 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 & 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: $ 6,113.06
DON MORISSETTE HOMES INC DON MORISSETTE HOMES INC This
iga perm is Code, to the regulations contained in the
4230 GALEWOOD ST #100 4230 GALE WOOD ST, STE 100 all other o thh er r applicable licable laws. All work will M ip Co State Sped ill by done Codes and
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 all wn i
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
SQ3 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
LIC
Rag #: 38737 may obtain copies of these rules or direct questions to
l S OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Ins[ Gyp Board lnsp Appr /Sdwlk lnsp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing lnsp Crawl Drain /Backwater Electrical Rough In Gas Line lnsp Storm drain Insp Mechanical Final
Foundation lnsp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation lnsp Water Service Insp Building Final
Issued By : Ai .. . _ . . / Permittee Signature > C 0(..._
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
.7.---1
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ii, • e r `Q -o c itD , i. , e039°
Building Permit App lication , .... n ...i,,� F i . 1 ; .a °f r •'� :
Date received: /, fl Permit no : )14" 1'4110$'2 1
City of TigardRECEIVED :II..
�` '� - g Project/appl. no.: Expire date:
R 97223
City ojTigard Address: 13125 SW Hall Blvd Ti ard,
Phone: (503) 639 -4171 DEC 18 2003 Date issued: Receipt no.:
Fax: (503) 598 -1960
CITY OF TIt3ARD, ase file no.: Payment type:
• Land use approval: : l • 1 r O 1 / , tat ■ I/" I &2 family: Simple Complex:
1
TYPE Or PER111'f
❑ 1 & 2 family dwelling or accessory O Commercial/industrial U Multi- family ,'New construction ❑ Demolition
O Addition/alteration/replacement ❑ Tenant improvement O Fire sprinkler /alarm 0 Other.
t JOB SITE INFORMATION ,� ,'f,.T.
Job address: 1� + / '�� �T Bldg. no.: Suite no.:
Lot: 2 I Block: (Subdivision: S aQ__, (Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name:' A n �; 0 ; ',� (I loodplain 'scpticcapacity;solar,etc T ` _ 1 , ,
Mailing address: ' eSi r tiT /3I. rtiali 1 & 2 family dwelling:
City: rattn'■ ZIP: . Yip" Valuation of work $
Phone:. r rep ,. -mail: No. of bedrooms/baths
Owner's representative: , ''• yyL j if CO' (I Le-.._ Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/caracrt area (sq. ft.)
Name: � � A '� �
Covered porch area (sq. ft.)
Mailing address: �L _ Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CON7 ILACIOIt Valuation of work $
Existing bldg. area (sq. ft.)
Business name: � (�/]
e: I V �V New bldg. area (sq. ft.)
Address: L v ` � _a
City: Number of stories
ity: State: ZIP:
Phone: I Fax: I E -mail:
Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
_ • _ . „ARCH ITEC77DESIGNER . _ licensed with the Oregon Construction Contractors Board under
Name: (- .4,( L - provisions of ORS 701 and may be required to be licensed in the
Address: c ' ek 4'ti"� ( 4 I C -rj\ 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: (ZIP: Amount received $
Phone: ( 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. • . rovisions of 1 ws and o dinances governing this 0 visa 0 MasterCard
work will be complr wt . , whether cified iierer'rt t. Credit card number: / /
1 ��j� � 403
Authorized si a • • • _ i f A ` ' e: I me Expires of cardholder as shown on credit card
Print name: 1 s_ - ' ' f L $
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (6t00ICOM)
r-�
One- and Two - Family Dwelling
,... Building Permit Appheatton e g Reference no.: .
CiryofTigard Cl of Tigard Associated•pennits:
g 1 �� 0 Electrical 0 Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ® • 0 Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 gJaT 15/n10
a0
ant ratA 4 1 1 t
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 platfot.
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 0 plan 0 permit required. Include drainage -way protection, silt fence design and location of , f
catch -basin protection, etc. J�
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 r/
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. 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. x
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 ". k
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 (600/COM)
Mechanical Permit Application -: ,, ,i7_-' .
� � Date received: Permit no.: HyT 3.-�5
'
�,u `Y' I! . City of Tig ` E Project/appl. no.: Expire date:
Ciry igard Address: 13125 SW v Igar , OR 97223
• Phone: (503) 639 - 4171 1 Date issued: By: Receipt no.: -
Fax: (503) 598 -1960 DEC 1 0 2403 Case file no.: Payment type:
Land use approval:00TY oFTIGARD Building permit no.:
_ IaIc•\L:IQN
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
iew construction 0 Addition/alteration /replacement 0 Other.
. •:_ JOB SITE INFORMATION - • - - COMMERCIAL VALUATION• SCHEDULE •-- . t *
Job address: ,, t� & :�� i �■ 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: I Subdivision:1 j B, *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: I ZIP: I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE'
Description and location of work on premises: AND COMMERICAIANDUSTRIAL EQUIPMENTSCIIEDULE
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? 0 Yes 0 No Air handling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No _ Alteration of existing HVAC system
;., , ,, , MIECI;IANICAL, CON"I RAC "FOR,,:, Boiler /compressors
�����}}�� State boiler permit no.:
�.l�s�i���(� ��.J rm HP Tons BTtl/H
Address: tfr��b_ Fire/smoke dampers/duct smoke detectors
. a U State :VAIMIllif I ail Heat pump (site plan required)
Phone: � M Fax: E -mail: Install/replace furnace/burner BTU /H
c� Including ductwork /vent liner O Yes O No
CCB no.:
7i9' T ",}' 1 install/replace/relocate heaters-suspended,
- City/metro lic. no.: N/A wall, or floor mounted
Name (please print): j , t �-- PJ V (• Vent for ap • fiance other than furnace
CONTACT, PERSON Refrigeration:
Absorption units BTU/H
Name: �i� Chillers HP
Address: Com. ressors HP
�- • UJI Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
' Phone: Fax: E - mail: Dryer exhaust
O \1 R;; :i Hoods, Type I/ IVres. kitchen/hazmat
n,f i " "" _ ^ = , ; -.. '`• h ood fi re suppression system
Name: sy __ a al Exhaust fan with single duct (bath fans)
Mailing address: 1 xW Walla Exhaust system apart from heating or AC
Y �� .�.�� L� Fuel piping and distribution up to 4 outlets)
Cit h�t::rgtiit�•�r ype:
Phone: g�ii Fax: E -mail: Fuel piping each additional over 4 outlets ,
ENGINEER Process piping (schemauc required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: Fax: E -mail: Woodstove/pelletstove
Other:
Me Applicant's signatu "A, WI jjr- Date: E�1 Other.
Name (print): ( l, J ?v f na/• nl / 1
P
Not all jurisdictions accept credit cards, please call more for ore rnforn ation. Permit fee $
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at _ %) $
Credit card number Ex i with 180 days after it has been
Expires State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
S TOTAL $
Cardholder signature Amount 440 -1617 (&OO/COM)
Plumbing Per 't A lication ` 4> : t ' , ,a "fir "ib. ,� • " ' ' .iu " ` >. ` , �; b
City b E ��' Date received: Permit no.: / j ,,, _ i O
�,,- tj Cl of Tiaar
It Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Bl �tg4r C 223
City o f and
8
Phone: (503) 639 - 4171 .
Ci Ti uCt{rr Prolect/appl.no.: Expire date:
Fax: (503) 598 -1960 CITY OF TIGARD Date issued: By: Receipt no.:
Land use approval: BUILDING DIVISION Case file no.: Payment type:
T OF PERMIT • ' '
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: , -I♦ Vci L . T r - - Description Qty. Fee(ea.) Total
New 1 and 2 family dwellings only:
Bldg. no.: Suite no.: eachutility ('includes 100 ft. for connection)
Tax map /tax lot/account no.: * SFR (1) bath
Lot: Block: Subdivision: 16,44i . J0, SFR (2) bath
Project name: SFR (3) bath
City /county: J ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
— Footing drain (no. lin. ft)
• PIA! \IIIING CON FRAC FOR Manufactured home utiliues
Business name: Q ` p L. i Manholes
Address: • Rain drain connector
1232111— ZIP: Sanitary sewer (no. lin. ft.)
-vim to �
Phone. ,1 Fax: E - mail: Storm sewer (no. lin. ft.)
ti/ •� Water service (no. lin. ft.)
CCB no.: [ "7 k... Plumb. bus. reg. no: - ; or
Fixture or item:
City/metro lic. no.: N/A l ( / ! ' Absorption valve
Contractor's re signature ..... .�(/ a Back flow preventer
Print name: 6. " u. "1 N, IMP Backwater valve
• . CON I Acr PERSON :,_ Basins/lavatory
Clothes washer _
Name: 1�-, ��D(� E Dishwasher -
Address: _ aa i . / ` tc _, ,V - Dnnkine fountain(s)
City: State: ZIP: ■ Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer cap
s.......• . Floor Floor drains/floor sinks/hub
Name (print): \ ,j _alb `� � Garbage disposal = •
Mailing address: S �rsir:�IA1 H ose btbb
City: L L. g m ZIP: 0 Ice maker _
. Phone: J . - A , Fax: � E Interceptor /grease trap
Owner installation /residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s). basin(s). lays(s)
Owner's signature: Date: Sump
ENGINEER Tubs/shower /shower pan
Unnal
Name Water closet
Address: Water heater
City. State: f ZIP. Other.
Phone: — I Fax: E - mail: Total
Minimum fee $
Na all lunsycuorts acceq credal cards. please call iunsdLcuon for more mfornuuoa Notice• This perm app Plan review (at %) $ �—
0
Visa l7 NtuierCard / / expires if a permit is not obtained State surcharge (8 %) .... $
C.edit card number w ithin 180 days after it has been
Expires TOTAL S _--
accepted as complete
Name of cardholder as shown oa credo cud
S
A 4404616 (6,aput:OM)
` Cardholder signature /
Electrical Permit Application r }�, .
Date received: Permit no.: if 4, —i s
: ..-:r .� 1
.1 City of Tig c 1V Project/appl. no.: Expire date:
City of Tigard Address: 13125 S $a I, 7223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 DEC 10 2003 Case file no.: Payment type:
Land use approval 1y OF TIGAR'
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
►' New construction 0 Addition/alteration /replacement 0 Other. 0 Partial
1 ;- JOB SITE INFORIVIATION
Job address. ) yrpdrgir `-I Bid!. no.: Suite no.: Tax map /tax lot/account no.:
Lot: `) Block: Subdivision: 0 ln./&Jli a
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR ,A l'1'I:ICA ION • - .... - - : . , ; : . . . . - - FEE SCHEDULE .. . ...... :.... •...
Job no: /i'. tir Fee Max
Business name: li 9 ' , Description Qty. (ea.) Total no. insp
New residential - setgle or multi- fatn7y per
Address: jr, _ EP `` at'� dwelling unit mdudes attached garage.
_ ' g Service included: '
Phone: ,,, 1000 ft or less 4
?j - l j _ Fax E -mail: ad
CCB no.: Elec. bus. lic. no:
WM Each additional 500 sq. f . or portion thereof
y o' Limited energy, residential 2
C` Limited energy, non - residential 2
//")) Each manufactured home or modular dwelling
nature of electrician (required) Date 0 Vj Service and/or feeder 2
Sup. elect name (print) 1 - - _ License no C 9 J Services or feeders— installation,
_AL. r 1 alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name rin[ : 201 amps to 400 amps 2
(P ) i • • • 1N ►,�rrts� 2
401 amps to 600 amps
Mailing address: �'
g ���1 - ��� , �i ■ — 601 a mps to 1000 amps 2
�� � Over 1000 amps or volts 2
Phone: , I r .,a ✓� .Z i t, 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, 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: 'State: [ 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):
O Service over 225 amps-commercial 0 Health-care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 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 'Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighungplan 0 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 ser ice. Other
Permit fee $
Hot all )unsdicuons accept credit cards, please call 'urisdictioa for more infomuuon. No tice: This permit application
0 Visa 0 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 (60000M)
p_3( � ,
CITY OF TIGAR BUILDING PERMIT
PE RMIT #: BUP2003 -00115
�� - Y_. DEVELOPMENT SERVICES DATE ISSUED: 3/14/03
- II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12400 SW BULL MOUNTAIN : • PARCEL: 2S110BC -01000
SUBDIVISION: THORNWOOD ZONING: R -7
• BLOCK: LOT: 7 JURISDICTION: TIG
REISSUE: ■ • - ' REAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR S : SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PR' C : PARKING:
VALUE: $ 2,900.00
Remarks: Construction of 8' fence and retaining wall combination, located at t of lot f / 8 & 9.
Owner: o or:
VENTURE PROPERTIES, INC Dia- ON MORISSETTE HOMES INC
4230 SW GALEWOOD ST., #100 4230 GALEWOOD ST, STE 100
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
Phone:
kilia.. Phone:
Reg #: 1503- 387 - 733633
FEES REQUIRED INSPECTIONS
Description Date Amount Foot/Found Insp
[BUILD] Permit Fee 3/14/03 $72.10 Masonry Insp
[TAX] 8% State Tax 3/14/03 $5.77 Final Inspection
[ BUPPLN] Pln Rv 3/14/03 $46.87
[BUPPLN] Addl Pln Rv 3/14/03 $62.50
Total $187.24
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Oh
`
` �'
Issued By: ' / '
Pe rm ittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
kliAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
4 ■
A ►
•
• CERTIFICATION S THE ET TR EE►
i Q , Owner /Agent for 12 1•1®a156a rE gDM
I, B LRKe�-
es
(PLEASE PRIN.]) (PERMIT HOLDER)
■
■
■
Do hereby certify that the following location •
I meets City of 1. igard /Washington County
i A land use and development standards for street tree installation. • •
A
ADDRESS: /2.30' 5w o/tirogi eis Die,
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LOT: 1 SUBDIVISION: V W D
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CITY OF TIGARD 14-Hour
BUILDING Inspection Line: (503) 639 -4175
1 INSPECTION DIVISION Business Line: (503) 639 -4171
/ BUP
/ /
Received Date Reques ed ` 12 79 PM BUP
Location / 2 3 6 t .'/4,1JZ 1� toil) Suite MEC
Contact Person � � Ph ( ) 7 )9 </e 7 PLM
Contractor Ph ( ) SWR
BUILDING `7ee_ 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 nn
Framing r rA.c" Z- c� `15, 4/ 4' —C 4 —
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceilin.
Roof
."ASS P. - T FAIL
- BING
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
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect – no access
Fire Supply Line //,4
ADA
Approach/Sidewalk Date 4 -/ ��- Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING i Inspection Line: (503) 639 -4175 536/
INSPECTION DIVISION Business Line: (503) 639 -4171
L/ ,p BUP
Received 7 . Z Date Requested y 4 - 0 e */ AM PM BUP
Location / 2 3 la 3 G� ,?.uc.�c_v Suite MEC
Contact Person Ph ( ) � c l - «4,3 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot
• PART FAIL
' CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL
cBtE
Service
Rough -In
UG/Slab
Low Voltage
!` Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
„WW PART FAIL El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA 4 1 / l«lllll e 1 U L(
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspectio 03) 639 -4175 4 0 3 59,
INSPECTION DIVISION Busines • Li . - . (503) 639 -4171
BUP
j AM PM BUP
r < Received 3 ` �� Date Requested
Location /236,5 ZiLL thwaiit) Suite MEC
Contact Person 6eafze Ph ( )-2 )9 < P 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 I � f) SA ER ) F CN &L
Insulation 0- GG
Drywall Nailing
Fi reveal l 31 1 S U L.4'i'=[ t� (- e T
Fire Sprinkler J
Fire Alarm 4-/ 1 ,L �- • Sµ�: - 74�N =T�i G-t 2 ' A I✓A-4-4- 5 ZNSPEc.'T
Susp'd Ceiling
Roof Np i A 4 SS •7s/a _ FA L_ - - S • • o aQ)
Final
SS PAR 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 • Dampers
Fi" COPART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City , 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: A U ble to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 2 1 O Inspector sr.
� � �_
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL