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InitiallyGood r 12324 SW ASPEN' RIDGE DRIVE ,tea CITY OF TRGARD 24-Hour BUILDING inspection Line: (503)639-4":i MST INSPECTION DIVISION Business line: (503)639-4171 BUP _7 —_-- Received -- ----_-_ Date Re jested AM-----. PM -- BUP Location _ _1_ .. U - `- ' Suite— - MEC Contact Person Ph(_ _) ---- - PLM "-a d a 9O Contractor___-- _ --- - Ph( —) ---- SWR - -- - �r. BUILDING Tenant/Owr�er _ —_—__ ELC FootingELC _— Foundation Acchas: Fig Drain ELR Crawl Dain Slab Inspection Notes: SIT Post&Beam -- Shear Anchors Ext Sheath/Shear _- Int Sheath/Shear Framing — Insuiation Drywall N..ding - Firewa',I Fire Sprinkler - -- - - - - - - - ---- Fire Alarm Susp'd COling --- Roof l -- Fi-,al PQ;S PART FAIL PLUMBING — - -- Post R Pear, Under Slab Rough-In WatE�Service --- — — Sanitary Sewer Rain Drains - - Catcn Basin/Manhole Storm Drain --- Shower Pan tA PART FAIL. NICAL _ Post& Bbam Rougn-In ------- - - - Gas Line Smoke Dampers - - -- -- Final PASS PART FAIL - - - - -- ELECTRICAL Service Rough-In UG/Slab Low Voltage ------___. - Fire Alarm Final lPART FAIL t-� Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _SPASS ITE _ L� Please call for reinspection RE — __ _--__ r� Unable to inspect-no access Fire Supply Line —� ADA Approach/Sidewalk Date _ -� C? — Inspector Other: _ --- - Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST — INSPECTION DIVISION Busine. --ine: (503)639-4171 BU - -- BUP Received _.—.___Dateequested AM PM Location —___ - _L• 1 4_e- Suite MEC __ A - Contact Person PIN_ ( -- — _ -_ Contractor__.__ — --�-� SWR 11LDI#" Tenant'Owner ---_-__-- _---- -- ELC -- - ELC - Faotinr Foundation Access: ELH Ftg Drain Crawl Drain -- - -- SIT Slab Inspec,.ion Notes: Post&Beam --- -- - ---- Shear Anchors Ext Sheath/Shr',dr - -- Int Sheath/Shear Framing ------ _------------- insulation Drywall nailing Firewall -- - - Fire Sprinkler - - Fire Alai --- Susp'd Ceiling Roof Other: ASS' PART FAIL --- rk-UMPING — — Post&Bearo --- Under Slab Rough-In !I Water Service Sanitary Sewer _— Rain Drains - Catch Basin/Manhole Storm Drain Shower Pan .---------- Other: .__ Final ` - -- — -- — --- MASS_PARI" FAIL Post& Beam -- Rough-In Gas Line Smoke Dampers PART FAIL - Service Rough-In ---- UG/Slab ------_-_--_— _ larm Fin ^� �, Reinspection fee of$_� required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASSN PART FAIL [jUnable to inspect-no access ,S Please call for reinspection RE:--- . ❑ Fire Supply Line �r'7 '-Ext ADA Dstn—�`T�G- Inspoeor Approach/Sidewalk Other: -_--._- Final D® PIAT REMOVE this Inspection record from the job site. PASS PART FAIT_ +--^ ELECTRICAL PERMIT - CITY OF A I GARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00204 '1312 SW Had Blvd... Tinard. OR 97223 (5C3) 639-4171 DATE ISSUED: 7/16/03 PARCEL:- 2S11OBC-TS044 SITE ADDF;F:SS: 12320 SW ASPEN RIDGE DR SUBDIVI:',ION: THORNWOOD ZONING: R-7 BLOCK: LOT: 044 JURISDI(;TION: TIG Proiect DQscription: Inst2Il all encompassing low voltage — - A.RESIDEN t IAL _ B.COMMERCIAL AUDIO R STEREO: X AUDIO & STEREO: INTERCOM & PAGING. BURGLAR ALARM: X BO;LER: LA61DSCAPE/IRRIGAT: GARAGE OPENER: X CLOCK: MEDICAL: HVAC: X DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: -)UI'DDOR LANDSC Lim! OTHER: ALL. E:NCOMP : X HVAC: PROTECTIVE SIGNAL: INS T F'oMENTATION: OTHER- _ --- -- -__ TO�AL# OF SYST�_-Ni,, Owner: Contractor: DON MORISSETTE HOMES BRIGHTEN ELECTRIC,; 423 GALEWOOD ST PO BOX 5964 STE 100 ALOHA, OR 97007 I-AKE OSWEGO,OR 97035 Phone: 503-387-7538 Phone: 5r'3-387--1538 Reg #: 1-E111-3564 1973-25943=2 1 14-481(' FEES Required Inspections Description Date Amount Low Voltage Inspection I I LPRMTj ELR Permit 7/16/03 $150.00 Elpct'I Final [TAX] 8% Mate fax 7/16/03 $12.00 Total $162.00 L-- _.._ This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordanop with approved plans. This permit will expire if work is not started within 180 days of issuance,or if wort( is suspended for mor,, than 100 days. ATTENTION: Oregon law requires roti to follow rules adopted by the Oregon Utility Notification Center. Those rules ara set forth in OAR 952-001-0010 throuc Xnlz X Issued by .i�.f,�4L, ,,./ --��ti Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not Intended for saI6,lease, or rent. OWNER'S SIGNATURE: DATE:--_ CONTRACTOR INSTALLATION ONLY — SIGNATURE OF SUPR. ELEC'N DATE: —_ LIG'EN,-E NO: -- Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day Electrica: Permit 0 mon Received , ' - r Electrical DateB :" U Permit Nn5 Planning Approval roval Sign Cit of Tigard City g 16 l Date/By: Permit No.. J►Jl 13125 SW Hall Blvd, Plan Review Other Tigard,Oregon 97223 Y TIGARD Date/By: Permit No. Phone: 503-639-4171 Fa)�& "VISI ) Post-Review Land Use DateB : --TCase No.: Internet: www.ci.tigard.or.0 Contact Jutia.: ED See Page 2 for -� 24-hour inspection Request: 503-6394175 Name/Mcthod: 1 i LLSupplemcn(al Infornuttion. TYPE OF WORK PLAN REVIEW Please check all that apply) New construction — FI Dernolit'on 0 Service over 225 amps- El Ifealth-cart:facility - commercial ❑llazardow;location Addition/alteration/replacement ❑Other: ❑Service over 310 amps-rating of ❑Building over 10,000 square feet, CATEGORY OF CONSTRUCTION I&2 family dwellings four or more residential units in 1 &2-Family dwelling Commercial/Industrial ❑System over 600 volts nominal one structure Accessory Building Multi-Famil ❑Building over three stories ❑Feeders,400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder Other: ❑Egress/lighting plan ❑Other: _ JOB SiTE INFORMATION and LOCATION Submit_sets of plans with any of the shove. The above are oot appllcable to temporary construction service. Job site address: I Z 32Q �S&c/ A - _ FEE*SCHEDULE Suite#: I Bldg./'A"pt.#: Number of Ins sections per permit allowed Project Name: :Z&" Description -- Qty Per.(es.) I Total Cross streeMirections to job site: /'�v1CL -, /(e New residential-single unit.Includes or tackedmulti-garage.per � 0�1" dwelling unit.Includes attached garage. Service Included: 1-1000 sq.ft.or less _ 145.15 1 4 - Each additional 500 sq.ft.or portion thereof 33.40 1 Limited energy,residential 75.00 2 Subdivision: &oJA)kWiQ�_ _ Lot#: (L Limited energy,non residential 75.(Y- 2 1-ax map/parcel #: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 9u va 2 — - - - ------- Services or feeders-Installation, alteration or relocation: 200 amps or less - 80.30 _ 2 -----------.-.---- --------- ---- 401201 amps to 400 ams _ 106.85 2 am to 600 amps - _ 160.60 2 PROPERTY OWNER TENANT 601 am to 1000 am ________ __ 240.60 2 -- -------- - - Over 1000 amps or volts _ 454.65 2 Name: Reconnect only 66.85 2 Address: Temporary services or fcHey -installation, Nleration,or relocation: City/State/Zip: --- _ - -- - - - - 200 amps or less --- 66.85 1 IF Phone: IX: 201 ampsto 400 amps 100.30 2 LI ANT— — Q-CONTACT PERSON __— 401 to 600 amps 133.75 2 Branch circuits-new,alteration,or Name: extension per panel: Address: A.Fee for branch circuits with purchase of 6.65 2 _ - - .. _ - service or feeder fee,each branch circuit City/.State/Zip; B.Fee for branch circuits without purchase of - service or feeder fee first branch circuit 46.85 2 Phone: Fax: Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included) CONTRACTOR — Each pump or irri tion circle 53.40 2 -- - ---— - Each sign or outline lighting 53.40 2 Job No: Signal circuit(s)or a limited energy panel, Business Naire: `Lr alteration or extension Paye 1 2 Description: Address: k S9&q Cit /State/ 1 Each additional Inspection over the allowable In�n of the above: _ � �QQ-�— Per in9pection IMM hour(min. I hour) 62.50 Phone:V Fax: �� - 2 3 Invcstgation feed_ — Other: _ CCB Tie._132 2 ic. #: -x{83-G _ -- Electrical Permit Fees* _ Supervising electrician ( - Subtotal $ signattire re & Plan Review 25%of Permit Fee Print Name: L . # ��L4►1_r2 State Surcharge(8°/a of Permit Fee) S TOTAL PERMIT FEE Authorized " / Notice: 1 his permit application expires ifs permit Is not obtained<+Ithin Signature: __ ___ Date:_ __ 190 days after It has been accepted as complete. *Fee methodology tet by Tri-County Building Industry Service Board. (Please print nartx) i\Dsts\Permit Forrm\ElcPermitApp.doc 01103 Electrical Permit Application - City of'Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIMNTIAL WORK ONLY: iI�ee for all systems............................................................ $75.00 Check Type of Work lovolved: Audio and Stereo Systems* Burglar Alarm �( Garage Door Opener* I leating,Ventilation and Air Conditioning System* f)(i Vacuum Systems* C� Oth,r --- COMMERCIAL WORK ONLY: Fee for each system.......................................................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: Audi.,and Stereo Systems QBoller Controls Cleo Systems Data Telecommunication Installation Fire Alarm Installation ❑ HVA(' Instrumentation L] intercom and Paging Systems Landscape Irrigation Control* Medical Nurse Calls Ll Outdoor LAndicape Lighting* Protective Signaling Other--- — Number of Systems * No licenses are required. Licenses are redtdred for all other installations i\DsviTetmrt Forms\FlcPemntAppPg2.doc 01103 CITyY_ OF T'GARD MAST ER PERMIT PERMIT#: MST2003-00180 DEVELOPMENT SERVICES DATE ISSUED: 6/5/03 13125 SW Hall Blvd., Tigard,OR 97223 (503) 639-4171 SITE ADDRESS: 12320 SW ASPEN RIDGE DR PARCEL: 2S110BC-TSO44 SUBDIVISION: THORNWOOD ZONING: R-7 BLOCK: LOT: 044 JURISDICTION: "I'Iti REMARKS: Construction of new SF detached residence. BUILDING _. REISSUE: DM164 STORIES: 7 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HLIGHT: 16 FIRST: 1.97kI 51 BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE SF FLOOR LOAD: 40 SECOND: 1.344 %f GARAGE: 437 el FRONT: 15 PARKING SPACES: TYPE OF CONST' 5N DWELLING UNITS: I THRD of RIGHT: ` VALUE: 320911.10 U(,CUPARCY GRP: P.3 BDRM: 5 BATH: 4 TOTAL: 3 , .7,4 sl REAP,: 15 PLUMBING SINKS: WATFR CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 107 TRAPS LAVATORIES: 5 DISHWASHERS: FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: TUDISHOWERS: 4 GARBAGE❑ISP. 1 WATER HEATERS: 1 WATEP LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL - FUEL TYPES FURN<100K. BOIL/CMP<3HP: VENT FANS: 6 ;LOrHES DRIER: 1 VAS FURN>�100K. I UNIT HEATERS: HOODS: 1 ZITHER L114ITS: 1 MAX INP' btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLET S: 4 ELECTRICAL ---- _FESIDENTIA'.UNIT _ _ SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANECUS Ar1D'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 emp: let W/O SVCIFDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 w"p: EAADDL OR CIR: SI^NALJPANEL: IN PLANT - MANU HMISVCIFDR: 601 - 1000 amp: 61`1-amps-'1000v: MINOR LABEL: 1000+amplvoit: PLAN REVIEW SECTION Reconnect only: —4 RES UNITS: SVCIFDR>-225 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL-RESTRICTED ENEI'GY - - A.SI:RESIDENTIAL -_ - B.COMMERCIAL AUDIO 3 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO. FIRF ALARM: INTERCOP.VPAGING: OUTDOOR LNDSC L': BURGLAR At ARM' OTH' BOILER: HVAC: LANPSCAPLYIRRIG: PROTECTIVESIGNL: r:ARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC DAT NTELF COMM: NURSE CALLS: TOTAL-0 SYSTEMS: TOTAL. FEES: $ 6,047.02 Owner: Contractor: This perint is Subject to the regulations contained In the DON MORISSETTE HOMES DON MORISSETTE HOMES INC Tigard Municipal Code.State of OR. Specialty Codes and 4230 GALE'%NOOD ST 4230 GALEWOOD ST,STE 100 all other applicable laves. All work Will be done In STE 100 LAKE OSWEGO,OR 97035 accordance with approved plans. This pen-nit will expire H LAKE OSWEGO,OR 97035 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: Oregon Utility Notification Center. Those rules are set Phone: 503-387-7533 forth in OAR 952-001-0010 through 952.-001-0080. You Rea 0: LI -38737 8� may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTICNS Erosion Control Insp 8, Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwik Insp Grading Inspection Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Roof Nailing 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 Issued 8 �,�� ,' 1-� Permittee SignatureC- Y --�:>� Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT PF=RMIE#: SVt/R2003-00143 DEVELOPMENT SERVICES 13125 SW Hail Blvd., Tigard, OR 97223 (503, 039-417'1 DATE ISSUED: 6'-,/03 PARCEL: 2S11013C-TSO44 SITE ADDRESS; 12320 SW ASPEN RIDGE DR SUBDIVISION: THORNWOOD ZONING:: R-7 BLOCK: LOT: 044 __._ JURISDICTION:__l 16 TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: _ _ _ FEES DON MORISSETTE HOMES Description Date Amount 4230 GALEWOOD ST - STE 100 [SWUSA]Swr Connect 6/5103 $2,300.00 LAKE OSWEGO,OR 97035 [SWUSA]Swr Connect 6/5/03 $0.00 Phone: 503-387-7538 [SWINSP]Swr Inspect 6/5/03 $35.00 [SWINSP]Swr Inspect 6/5/0's $0.00 Contractor: _ Total $2,335.00 Phone: Reg#: Required Inspections 'This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If 0.3 sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance gives If not so located,the installer shall purchase a "Tap and Side Sewer' Perm Issued b _. zt- -�_ 4 Permittee Signature: Call (503) 6394175 by 7:'10 P.M. for an inspection needed the next business day T� ?T- �x,t�r ' t-��-� Building Permit A►pplieation ace. City of Tigard Uatereceived: yr50- PerrI;i;no.: u Pro�ecUappl.no.: Expire date: Cit n Ti nrd Address: 03125 SW Hall R�.��3tEI " �--E y f � Phone: (503) 639-�t171 `-� L` Date issued: _ Bya%' V, Receipt no! Fax: (503) 598-1960 AI'K 3 U 2003 -T i 6Case file no.: Payment type: ---- ---- Land use approval: _ t&2family:Wimple Complex: r iTY nF TIC � U;iW y dwelling or accessory U Commercial/industrial U Multi-family &New construction O Demolition Oteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: 1 ' 1 Job ' Bldg.no.: Suite no.: Lot: (- C Block: Subdivi ion: U �- Tax map/tax lot/account no.;' Project name: _ Description and location of work on premises/special conditions: _Name: r"��f '1G� ' Moiling address: 1 do 2 famlly dwelling: City: Stated ZCP: ' Valuation of work........................................ $ Phone: Fax: �,7Y -mail: No.of bedrooms/baths................................. ' Owner's representativTotal number of floors................................. Phone: Fax: E-mail: New dwelling arca(sq. ft. �-� Garage/carport area(sq.ft.) Name: �Y l _ Covered porch area(sq.ft.) ......................... Mailing address ' ,' ..(�. •,V Deck area(sq. R.) ........................................ _ City: t� State: ZIP: _ Other structure area(sq. ft.).... ....... . ... ...... _ Phone: Fax: E-mail: Commerclalllnductrial/muUl-famile: Valuationof work........................................ $ Existing bldg.area(sq.ft.) .......................... Business name: 1 New bldg.area(sq.ft.) Z[P: Number of stones........................................ City: State: ................................... _ _ Type of construction. Phone: Fax: I E-mail: _ Occupancy group(s): Existing: _ CCB no.: New: City/metro lie..no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board ander Name: �[L L� , q W provisions of ORS 701 and may be required to be licensed in the Address: -"i-T ��1�� ^iV _ jurisdiction where work is being performed. If the applicant is State: 7.11': exempt from licensing,the following reason applies: City: _ Contact person: � Plan no.: �---�_ -- - Phone: Fax: E-mail: `— Name: Contact person: _ Fees due upon application ...........................$ Address: _ Date received: _. City: _tate: - ZIP: Amo!tnt received ..................I...................... $ _ Phone.: Fax: E-mail: _ _ Please refer to fee schedule. I hereby certify I have toad and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more information attached checklist. A`11provisions of I ws and o dinances governing this U Visa ❑Mastercard — work will be compliedwith,whether cifiul�eret<i t. Credit card number: _ ---_-- /—J-- /�e , Expires 1 f �',{/ ---- ,�uthorized SI nalU� i lt�: — •-i �—Name of cardholder u Chown on credit cmd Print name: 1414 Z tl._L _---.— caroole•rsl[tnatT! Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complett. "04613 tdaacoMm ' i� One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: City ujTigardC>! of Tigard Associated permits: U Electrical U Piumbirg U Mechanical Address: 13125 SW hall Blvd,Tigard,()R 97223 Phone: 503 639-4 i 71 :J Other: -- - -- Fax: (503) 598-1960 1`11F 1-011101VING WF'UI1QI [HI'D 1:01? PIAN REVII11% Vis Ni) NIX I Land we 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 U plan J permit rrqu'.,ed.Include drainage-way protection,silt fence desi;n And location of catch-basin protection,etc. 10 J_ Complete stets 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 vocation and details.Plan review cannot be completed t/ if copyright violations exist. _ J� 11 Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if Were is more than a 4-11.elevation differential,plan must show contour lines at 24t 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 fiaming-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 will and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, Y fireplace construction, thermal,,r..!lation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for adaitions 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 calculctions to engine ig standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating mernoer sizing,spacing,and bearing __locations.Show attic ventilation. 1 R 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 canying a non-uniform load. 20Manufactured 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. 23 Five(5)site plans are required fot Item l l above. Site plans must be R-1/2" x 1 I"or I I 'x 17". 24 Two(2)sets c_ch are reed 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 oi, submitted plans may be in blue or black ink. Red ink is reserved for department use only. "ur 14(rroacoM) Mechanical Permit Application --- Date -ccived: Permit no.: ) _ City of Tigard Pcojecdappl.no.: Expiredate: City oJTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued. By: _ Receipt no.: Phone: (503) 639A I71 Fax: (503) 598-1960 Case file no.: Payment type: - Building permit no.: Land use approval: ;Job & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi-family U Tenant improvement w construction U Addition/alteration/replacement U Other. — 11 1 1 1 1 1 dress: Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: _- Suite no.: value of all mechanical materials,equipment,labor,overhead, profit-Value$ Tax map/tax lot/account no.: _ --' 11Vf -See check,ist for important application information and .ot: tq L Block: St ivision: Project name: jurisdiction's fee schedule for residential permit fee. 1 " D1 11 City/county: ZIP: t a t s 1 al t J0 pill Description and location of work on premises: - Fre(".) Total -- Desuiption Ql)'. Res.only Res.only Est.date of completion/inspection: VAC: - Tenant improvement or change of use: Air handling unit CFM-- — Is existing space heated or conditioned?0 Yes U No rconditioning(sitep an requir ) Is existing space insulated?0 Yes U No Alterationo existing li systen _ Boiler/compressors State boiler permit no.: BusinAno.: ' ( HP _ Tons BTU/H AddrFire/smoke ampers/duct smo a detectors City: LJ State Z[P: eat pump(site lan requir ) nstaI rrep ace maces)urner -bTL PhonFax: E-mail: Including ductwork/vet t liner 0 Yes 0 No CCB ,— ns�lreplac re ocate eaters-suspen e , City/metro tic. no.:N/A wall,or floor mounted ent ora lance o er han urnace Name(please print): r e erat on: Absorption units------ BTU/H -� , Chillers - HP Name: Com ressors.— IIP Address: .yN142__ 00), _ _ omnenta a oust e�ventilation: City: State: ZIP: Appliance vent Phone: —TF-ax:- E-mail: ere gust -Hoods, — Type /res. 'tchen/hazmat hood fire suppression system 7N� Y Exhaust fan with single duct(bath fans) address: Exhausts stem apart from 1leatin or C lie p p g and tit but on(up to 4 out ets) City: State,,, ZIP ) Type; '-PO NO Oil_ Phone: 7 ' I a� I mail ucl piping each a itiona over out els rotes p pmg(schematicrequired) Number of outlets Name: _ ter sl ■pp ante or equ pment: Address: _ Decorative fireplace ___..------- State: ZIP: City nsert-type --- — stove/pe let stove! — Phone: -- Fax: -mail: Other: Applicant's signatu 4 Date: ` Q. Ot er Name(print): L f ;Li jam(j, -- Permit fee.....................$ Not all iurisdiciiom accep cmdil cards,pl:sse till puiulicU°n far more infamutlan Notice:"iirmit application PP lication Minimum fee................$ O Vasa 0 MasterCard expires if a permit is not obtained plan review(at _ %) $ _ Credit crd number _— within 180 days after it has been x roa State surcharge(896)....$ - ^"Name of cardholder uu ilww�carE accept d as complete. TOTAL $ S _ - Cardholdu d6nalutt Amount — 410-4611(MICOM) 19 n Plumbing Permit Application Date received: Permit no.:f�r, � •� Cit of Tigard Y g Sewer perrrut no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 - City of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: I By: -Receiptno._`_ Land use: approval: Case file no.: Payment type: — _— 0 1 &2 family dwelling)r accessory U Cornmercial/indusuial 0 Multi family 0 Tenant improve.•ent New consuuction 0 Addiuon/alteration/replacemeni 0 Food service 0 Other. t 1 ' 1 11 1711 Flinflill Job address: Desct•iption Qty. Fee(ea.) "11701121 New 1-and 2-family dwellings only: Bldg. no.: — Site no._ (includes 100ft.foreachutitityconnection) Tax map/tax lot/ac.ount no.: �-�- SFR(1)bat.l Lot: L <-- Hlock� Subdivision_ �j'��V�( 'C_l- SPR_(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 completiort/inspection: DrywellsAcach line/trench drain Footing drain(no.lin. ft.) 11 Manufactured home utilities Business name anholcs Address: 1 Rain drain connector Ci State, ZIP: J _ Sanitary sewer(no.lin. It City: -- Storm sewer(no lin fe.) _ Phone: iL Fax: E-mail: --- — -- _ Water service(no.lin.ft.) CCB tto.: jyy, L Plumb. bus. reg. no: FLtture or item: City/metro lic. no.:N/A ^�� Allsorption valve — Contractor's representative signature --�.. Back flow preventer Print name. P.'� — 111 Backwater valve I 6-JBa ins lavatory �� Clothes washer Name `-L�:1� ------ Dishwasher Address _ 'V Dnnkine founuun(s) Citv: State: Z.IP, Electors sump — _ Phone: ______TFax: E-mail: Expansion tank Fixturelsewer capmaim _ z Floor drains/floor sinks/hub__ Name(print): � �� Jl�i.1 Garbage disposal Mailing address: _ Hose bibb Citv: 0 State ZIP:: Ice maker _Phone'.-� 2 Fay: -7(Gi Email: Interceptor/grea<e trap Owner instaUationlresidendaf maintenance anit�: The actual installation Pnmens) — will be made bx me or the maintenance and repair made by my repdar Roof drain(commercial) _ _ -- employee on the propem• I own a per ORS Chapter 447. Sirtk(s),basin(s), lays(s) Owner's signature: Date: Sump --�- Tubs/shower/shower pan _ Unnal Name: __ Water closet -- Address _ Water heater__ Cin- _State: ZIP. Other - - -:- —� Total _ Phor e: a.:: E mall — _ _ !Minimum fee................� ---- Na xII;unsduuav accep cmdit cards.please call lun"cuon for more tnf—tit Notice:This permit applicationPlan review(at � 0 Visa U MasterCard expires if a permit is not obtained � `16) -- C.edu card numtwt / within 180 days after it has been State surcharge(8`70) ....$ - taprtes To"TAL, _ accepted as complete. ....................... _----i Name or�dholder as shownoo creaht card S Cardhatdu sstEttattue Amoun'—. .ft0-•161616AUK'nMl • Ve,2trical fer ijt Application Received Electrical , ` Date : 7�7 PlanningApprov Sign City of Tigard JUl Dat" : -- Permit No.: 1.^125 SW Hall P1vd. 31TY OF I IGARD Plan Review Other Pemiit No.: Tigtlyd,Oregon Q72:$LIIt_DiNCI JiVIE'l0i'� Dat/B : And Post-Review [ and Use 1'..on.° 503-639-4171 Fax: 503-598- 960 Date/By: Case No.: lntetnet: www.ci*igard.or.u9 al Contact Juris.: See Page 2 for 24-how inspect on bequest: 503-63911 5 Name/Method: Supplemental Information._ TYPE('d WORK — _ PLAN REVIEW Please check all that apply) ' Dcn1011tion Service over 225 amps- Ilcalth-care facility CUnNtI'11Ct1Un _ ----- commercial �]Ilazardous location Addition_'elteration/rcplacement8::� thef_� Service over 320 amps-rating of ❑Building over 10,000 square feet. C 1TEGOF t'OI'CGNSTk:JCTION I&2 family dwellings tour or more residential units in ' System over 6W volts nominal one structure &2-Far-";1�'dw_ellin Comrncrcia; industrial F]❑ i _ . - -- - Building over three stones ❑Feeders,400 amps or more t�essor B '-A Fit ri Multi-FaC]milZ Occupant load over 99 persons ❑Manufactured structures or R\'park --•- —� — . - ❑Egress/lighting plan ❑Other: ,_ Ler Builder Other: — Submit sets of plans with any of the above. JO_B SiTE INF.9RMA_TIONladZLOC TION The ibo%-c are not an 11"ble to temporary construction service. Job site address_ _>�E"SCHEDULE -- Bid Number of I6eermit allowed Suite#: -- '- v Fee Total Description Pro'ect Name' /L�Q�/3�I�'�7 f1� fA�i! New residential-single of multi-ramlly per Cross street/Directions to Job site: dwelling unit.Includes attached garage. Service Included: 1000 s .ft.or less 145.15 4 Each additional SW a .ft.or ion thereof _ 1 I-imi ed energy,residential 2 rTax division: Lot#: - Limited ener ,non residential 2 ma /-arcei#: Each manufactured home or modular dwelling service and/or feeder 90.90 2 _ DESCRIPTION OF WORK Services or feeders-installation, alteration or relocation: —__ - --- 200 am s or less 90.30 2 201 amps to 400 amps 106.85 2 --- �w----- -- - 401 em s to 600 ams 160.60 2 - 601 an to 1000 am as 240.60 2 PROPERTY OWNER TEN ANT454.65 2 Over 1000 amps or volts 2 Name: Reconnect onl 66. 95 Address: Temporary services or feeders-Ins'allation. alteration,or relocation: 66.85 1 Cit /State/Zi 200 am s or less - -� - --- -- - 201 am to 400 ams 100.30 2 Phone: Fax: 401 to 600 ams 133.75 2 APPLICANT _ CONTACT PERSON - Branch circuits-new,alteration,or Na1l1C. extension per panel: (or brench circuits with purchase of 6.63 2 Address: L30T✓�S�Od /f sen ice or feeder fee,each branch circuit t7 ,�� B.Fee for branch circuits without purchase of 46.83 2 City State�Zl : �1IA� service or feeder fes_,first branch circuit Phone: — Fax: 3�'7-7L1�-� Each additional branch circuit- 6.65 2 Misc.(Service or feeder not included): 33.40 2 E-mail: Fact, in or irrigation circle `'CONTRACTOR _ �_�— Each si or outline Ightic t 3J 2 Job No - - Signal circuit(%)or a limited energy panel, 2 _- — alteration or extension Pa e2 �. ,s e* �� Description: A dre _j�� C� Each additional Inspection.ovca the allowable in any of the above: Cit /State/ Per inspection per our;min.1 tc:ur) - ±_60 - Phone. b'(, Fax: 2�- 23�__ t �nves►igation fee:— �- Others-- CCB Lic. #: / �_ Lic. #: 3b_ �.._ Electrical Perth Fees" Supervising electrician _Subtotal T s signature regLALred: Plan Review(25°6 of Permit Fee 5 ,--. State Surchar c 8%of Permit Fee f Print Name: , - --� — TOTAL PERMIT FEE $ Authorized -� [)ate Nollee: This permit application expires If a permit i%not obtained within Signature: --._._ __ 180 days after It has been accepted as complete. *Fee methodoloRv set by Tri-County Cullding Industry Service board. (Please nt name) is\Dsts\Pemtit Forms\ElcPermitApp.doc 0IM3 Electrical Permit Aaalication-City of Tigard Page 2 -Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL.WORK ONLY: Fee for all systems............................................................ $75.00 (beck Type of Work Involved: 11 Audio and Stereo Systems* Burglar Alarm L J Oarage Door Opener* LJ Beating,VentEation and Air Conditioning System* F1Vacuum Systems* Other COMMERCIAL WORK ONLY: _ Feefor each system.......................................................... $75.00 (S F F.OA R U 19-260-260) Check Type of Work Involved: u Audio and Stereo Systems Boiler Controls E] Clock Systems El Data Telecommunication Installation L' Fire Alarm Installation C� 14VAC Instrumentation Intercom and Paging Systems Landscape Irrigation Control* E] Medical Nurse Calls Outdoor Landscape lighting* Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all oilier installations i\Dsts\Permit Forrns\r;IcPernitAppPg2.dm 01/03 06/04/2_003 11:36 503-387--617 VEHTUPE PAGE 01 _ pAGE 02/02 ~ rjEOPACIFIC ENG 06/t34/2099 10:ti5 50359987 Geop Cm AaaI• aridesl%r Goonertru ti 5SUPPns (f J !/ �ny�iyarion-De�fy�,•GotlrtrucUort Support June 3, 2003 - Job Nc. 00-4"5 � Post-tY Fait Note 7671 Dale -PleeB Attentlom Andrew Thomas TO Ar Venture Proportles, Inc. pAene N Phnne k 4230 Galewocd Street, Suites 100 r A.ale Lake Oswego, Oregon 97035 Fax N - Fax No. (W-2)524,9512 RE- GEOTECHNICAL ENGINEER'S FOUNDATION EXCAVATION REVIEW THORNWOOO LOT 44 CITY OF TIGARD, OREGON Reference GeoPacific Engineering Inc., Soil Engineer's Summary qt Conc!usion of Earthwork, Thornwood City of Tigard, QrKon, dated March 16, 2003. GeoPeci is Engineer Jim Ir0 le, has visited the above•referenced ,ot on May 20" and June 2"" Tne r visit was primarily Ip .e view the foundation excevatiotl subgrade, and tooting proxir,lity purpose of our D Y to existing terrace cuts and rockery retaining wells. The nearest adjacent footing (southeast corner) for the subjeot residence Is approximately 4 feet Iran the beck of a 6400t tail rockery well, the 1`00109 bottom 16 now approximately 2 toot below the top of the wall; attar We requested deepening of the excavation to reach below the wall's tone of influence. At th a dista-ice, the foundation is ust belov a 1 H:IV plane from the back of the rockery wall and Is well Inte compacted Boils The tooting subgrode generally consialad of gngmeered fill which hand, probed stiff to very :,M after removal of the upper 12 Inches of existing suits Tho wreent subgrade is considered adequate for spread foundation support, provided compacted fill is replaced i-) Ih9 50uthwler1- CorttBi where the corner of the home ,* I, coded near a shots vertical cut for this column footing near the rockery wall deep@nint,. The contractor hes tiled the r:olumn footing to the home with grede beams. Hage , on our observa"Ions and with this minimal r;iruetural backfillllrg, the foundation subgrads and ex ,vation setbacks should ba +acceptable for s,�oport of the proposed sirtglp family horrv<r, No adds to till should be placed above the top of thr rockery wall. our work w1pe for this phase of geoterhnicel rsvlew pen ains to foundation bearing conditions only and is limited to the conditions exiMing and exposed sit the time of our site visits. If you have any further questions, pleas@ call. 1EP�'p ptt`�y?� Sincerely, Qeofsaclfic Engirw►ring,Inc. ��/ 14743 \ ORE Gt,IV James D Imbrie, P E., C.E.G. �\✓a�4 7, ,,,9� Geotechnical Engineer k l;iowC, fo Cu �s o tnrd/ 1►3fa 9W Durham Road Tal(503)6911•NN6 Portland,Oregon e7z24 cud(503)598.8705 02/11/2003 07:16 °1036926974 LAKEP.IDGE TERRACE PAGE 02 06/11/2003 10:45 503-397-7617 U6NTURE PAGE O1 Ali DON a MORISSIETTP, nisi �11 :�1►. s� •*1150 two ti . . _ .t s. . .* � . . , - ,s j . COBE. 2921 �. ai n1Ttr: 0e/10/2002 I I2320 61U. X484"=N RI LAR. �11o.i 104 ! 4 �I i s� ,r Ire ; irl,► 1af I �i 4.4 AAA tic f1L car GABA ! an 440' _ �'IZ MAIN PLAMM WT, 446,0' WAAWUWT &M. 4 IA' 440 b. n. E04 PPJL gra' e4le>K a.�or "role.n vc b � a a A 0 0 4-6 7m"ft"L, jL!: LOT GIT�f i DoT AREA 4.100 60 F1 LQf V4 f'�UILDINQ AREA 1439 50 FT 410 WD OAK MENCENT&OR: 9111 r �J SION' r: k? r—�NNN Y r)�'T1t:A1;tl.SITE p , ----- LAN REV1[?W kkllf NU.. VlSI(JNbacks: 'tW Al�pruvcd ❑ Not Approtc�d � Street Sick. /v .. Courage. -!)I Clestrance: Rear: Apr ved --- `r `aunt Eiuil�/int tietItt feet ❑ Nnt Apprnvc d '•'•viae f•. eider Letter kcquirect: yes QIN J1 1 K1\( f)FTA A. 01;4S: CJ loot Approved .11ti�rctved Not .�1�A�t� ❑ . Approved .,: ---�•—..._ !.?ate: ��' CI'1"Y OF TIGARU.SITE PLAN kN VE1;1Y BUtf.f)INf; PERN41I' NO.: J. PLANNING DIVISION: Required Setbucks: Side: © Approved (� Not ApProved Street Side: From, -- Garage: --..._ Visual Cfearnn Rear: Maximum ljuiidin ❑ Approved Ea Not Approved CWS Service Provider Letter Required: Cj Yes ❑ No Cis: ❑ Rrc•c•ived ✓1 NtiINLE;RING DEPAR-1-Ml;n� e Actual Siupe;,,,.,`% Site Platt: ❑ Approved [] Ncit Approved f7ntc: H [3 Approved Q Not Approved Yee6• Notes: • • 4e•• ••e•• • • • 6666 •r••ra • 6666 ••6s•• • •• • • • a • r••e4• • • • •••• • • D e • Sees— ser••• ••••re • •r i 6666 e a • • 4--6 re• •DD •6a • • e it •e• 6666• • r • • .a e• 6666• 6066 ' • • ••ear• • ••6• • • • •Dar •+6064 • • • • • r6 •• •6.4 1 CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00288 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/20/03 SITE ADDRESS: 12320 SW ASPEN RIDGE DR PARCEL: 2S11OBC-TSO44 SUBDIVISION: THORNWOOD ZONING: R-7 BLOCK: LOT: 044 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES_ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Instal irrigation backflow preventer. Owner: _ FEES Description Date Amount DON MORISSETTE HOMES -- 4230 GALEWOOD ST [PLUMI3] Permit fee 6/20/03 $36 25 STE 100 [TAX] 8%State"Tax 6/20/03 $290 LAKE OSWEGO, OR 97035 Total $39.15 Phone : 503-397-7539 Contractor: LANDSCAPE OREGON, INC. 122.00 SW MYSLONY RD, TUALATIN, OR 97062. REQUIRED INSPECTIONS Phone : 503-692-5945 RP/Backflow Prevenler Final Inspection Reg#: I'LM 7904 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 rules adopted by the Oregon ' 1 Issueo By:' L, Permittee Signature:_(� yl Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Jur .d 03 02: 01p dan edmonds 503-692-0768 p. 6 Plurlmbim PR ermit Avplicat%on • es:eived Plumbing may:�,_C�U'ami kPermit N.1112'y 00;d D City of Tigard Planning Approval Sewer �- DaieBY: 13725 SW Hall Blvd. Permit No: Ilan inview --- � other Tigard Oregon 97223 UaadEl;y: _ Perout No.: Phone: 503-639-4171 Fax: 503-598-1960 Poct-itrview, Land Use Internet: www.ci.tigard.onus _L_- I Case No.: Contact luris.: Sec Page 2 for 24-hour Inspection Request: 503-639-4175 N:une/Method: L Supplemental Information. TYPE'OF WORK "'` FEE*SCHED!AX for special inrormatlon use ihecklist ew construction Demolition Description Qty. Fce(ca.) Total Addition/altctation/ESpla_c_ernent Other: New 1-&2-ramify dwellings CATEGORY OF CONSTRUCTION_ includes 100 ft.for each null aonnectlon 1 &2-Fami�_dwellin� C_otnmercial/Industrial SFR 2 bath 350.00 SFR ath _ 24020 _ Accesso Build�� ru Multi-Family �_- SF R Qj bath 399.00 Master Builder Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION I'irc sprinkler- .2: page 2 Job site_address: /_),3do, ti ti site Utltities _ Bldg./Apt.t/: Catch basin/area drain -16 6D Prtajeet Name: 7Y10 ')'1 L�%cX C L07 UrywelUleach line/trench drnm 16.60 Cross Street/Utrectiens to job Site: hootin&drain no._IineaLftj Pa c 2Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 5anilr sewer no. hnear ft. _ Pam-2 _J --..-�--__S- __., Subdivision:-7hCrrt 6 e / -� Lot# L/ Storm sewer(no,linear ftp Tax � Wateservice no. line -Pa e`l ear R• a 2 _ � " -DESCRIPTION OF WORK Fixture or Itet6 _ f7 i71. Absorption valve 16.60 G; L ---T- --� i3ack(low�venter �_ _- -L pale Backwater valve 16.60 _ -_ Clothes washes 16.60 Dishwasher _ 16.60 OPF.RTY OWNER TENANT. -- Drinkingfountain 16.60 Ejcctors/surnp 16.60 Name: Zj� ry��'7-I S S t F �{DYN Expansion tank - 16.60 -^ Address: 30 SC U �� C�[t�G�.G(, T C•L3` Fixturdsewer cap --- 16.60 City/State/Zip: Cotte 64t r C3 O Q q 76_3 y, Floor drain floor sink/hub i 16.60 ��-"`-� rarba e disposal 16.60 _ Ph ne: Fax: �-�' PPLICANT CONTACT PERSON inose bib -_ 16.60 Name:47/e/2 Qv-r-O-[f_)- Ice maker _ - 16 60 Address: ��- _ _ Interrcpco-/grease trap / �06 .S Ll.) /YI L (71�l Medical ac-value: S pa e 2 Cit�lStatelZip:TZlli LC(_�171t O Q�� - Primer - --- 16.60 --- -- - --2 - RooFdrain(conunercial) 16.60 I hone:_S�3 (09,A - 59 y-5 I Fax:.,63 6,9d - ej7C_f1Sink/basin/lav 16.60 F-trig t l _ Tub/showedshower pan 16.60 CONTRACTOR- Urinal pT -i-- - 16.60 Business NamiC � dS Oct. 16.60_ Water closet .Address'/r7.Y(>� �((� I37 r S/CrYiC R/j Water beater - �Other I6.60 Cltq/St1itP�7.Ip:i?TCLL( liL D2 9 61 Other: M _ - Phonc50374 Fax: 963 01.1 -o7(- Plumbing Permit Fees* CCB Lc. #: '�Via✓'c f Plumb. LicA - -��_ Subtotal s Authorized Minimum Permit Fee 572.50 S Signatu��-�e� u (fit /�' Residential Backflow Minimum Fe Da 6. ��• S _ _ __. l _-r _ Plan Review(25%of Permit Fce) S _ state surci,ar a8%of Pcrrrrit Fce S (Please print name) TOTAL PERMIT FEE 59_ 1 _5 Notice: This permit apttnlleation expires If•permit is not obiatard within Ali rew commercial hoildings require 2 sets of plans with isometric or 180 days after it has been accepted as rnmPlrte. riser diagram for plan review. `Fee mcthodotopy set by Tri-c""'ounty fiuilding Industry Service lioard. CITY OF TIGARD Residential Certificate o f 0ccu Banc Permit No.:-?c 3- CLQ Address: Owner/Contractor: -LT— -- - - Date of Final Inspection: / i�-3- Inspector: -- Tbis structure has been found to he in substantial compliance with the provisions of the State of Oregon One& Two Family Dwelling S ecia! Cade and is hetet a roved for ocancy, y 8