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12380 SW ASPEN RIDGE DRIVE
/ CITY OF T I V A R D MASTER PERM'.T
PERMIT#: 8/12/0103 00363
DEVELOPMENT SERVIr.E3 DATE ISSUED: 8112/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12380 SW ASPEN RIDC F DR PARCEL. 2S1 1013C-07600
SUBDIVISION: THORN'WOOD ZONING: R '
BLOCK: LOT: 047 JURISDICIIUN: Ii(;
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: DM157 STURIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK. NEW HEIGHT: 25 FIRST: 1,295 at BASEMENT: 1,068 of LEFT. SMOKE DETECTORS. Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.476 at GARAGE: 481 of FRONT: 15 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 THND at RIGHT
5.90
OCCUPANCY GRP: R7 BDRi�: .7 BATH: 3 TO'iAL: 2,771 at VALUE: 371,22REAR: 155
PLUMBING
SINKS, WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 Rf IN DR"1N: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN ORAINS: 1 CATCH BASINS:
TUB/SMJWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN c 110014: BOILICMP c 3HP: VENT FANS: 6 CLOTHES DRYER: 1
to FURN>.100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1
MA.'INP: blu rLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP ERVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 aenp: 0 -200 amp: WlSVC OR FDR: PUMPIIRRIGATION: PER INSPECTION
EA ADD'L 5005F: 7 20' - 400 amp: 201 - 4on alnp. 1H WIO 8VC/FDR. SIGNIOUT LIN LT: PER HOUR
LIMITED ENERGY: 401 600 amp: 401 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT.
MANC 'MIEVCIFDR. 601 - 1000 amp: 601+an,pe-1000v MINOR LABEL:
1 1000+amolvolt:
FLAN REVIEW SECTION
Reconnect only: -- --�—
>-4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL•RESTRICTED ENERGY
_ A.SF RESIDENTIAL B.COMMERCIAL
AUDIO B STEREO VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM. OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TO'I`AL FEES: $ 6,422.79
DON MORISSETTE HOMES DON MORISSETTE HOMES INC
This hperlrnl Is subject to the regulations contained in the
4230 GALEWOOD ST 4230 GALEWOOD ST,STE 100 all igard
Municipal Code,Stale o k wOR. Specialty Codes and
STE 100 LAKE OSWEGO,OR 97035 all other applicable laws. All work will be done it
LAKE OSWEGO,OR '' 035 accordance with approved pis-i. This permit will expire If
work is not started within 180 lys of Issuance,or if the
work is suspended for more tl 1 180 days. ATTENTION:
Oregon law requires you to fc w rules adopted by the
Phone: 503-387-7538 Phone: Oregon Utility Notification Ce' r. Those rules a e set
5 3forth In OAR 952-001-0010 0 ..ugh 952-001-008). You
Reg 0: L7C-3873AA St may obtain copies of these rules or direct questio is to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, PosUBeam Mechaoica Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Appr/Sdwlk Insp
Sewer Inspection Underfiool 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 Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final
Issued By i 12.za Permittee Signature
Call (503) 639-4175 by 7:00 f1.m. for ar, inspection needed the next business day
CITY OF TIGARD MASTER PERMIT
PERMIT#: MST2003-00363
10 DEVELOPMENT SERVICES DATE ISSUED: 8/12/03
—0- 13125 SW Hall BI Id , Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12360 SW ASPEN RIDGE DR PARCEL: 2S11013C-07600
SUBDIVISION: THORNWOOD ZONING: K
BLOCK: LOT: 047 JURISDICTION: 1 III '
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: DM15,' STORIES: 2 FLOOR AREAS REQUIRED SETBACKS I,EQUIRED _
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.295 of BASEMENT: 1.066 f LEFT: 5 SMOKE DETECTORS: 'r
TYPE OF USE: SF FLOOR LOAD: 40 SECOND. 1.476 of GARAGE: 461 of FRONT: 15 PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 TMPD of RIGHT:
VALUE: 771,225.90 `
OCCUPANCY GRP: C9 BDRM: BATH: 3 TOTAL: 2 771 of REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS* 4 WASHING MACH. 1 LAUNDRY TRAYS,: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWtR L."FS: 100 SF RAIN DRAINS: 1 CATCH BASINS.
TUSISHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS.
OTHER FIXTURES:
MECHANICAL
rUEL.TYPES FURN c 100K: BOILICMP<AHP: VENT FANS: 5 CLOTHES DRYER: 1
FURN>=100K: 1 UNIT HEATERS: HOODS: ' OTHEf')NITS: 1
MAX INP. blu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS _ MISCELLANEOUS ADD'L INSPECTIONS
1000 SF On LESS: 1 0 -200 amp. 0 -200 ampWISVC OR FDR: PUMPnRRIGATION: PER INSPECTION:
EA ADD'L SOOSF. 201 400 anp. 201 400 anp 1a W,O SVC Ir DR: SIGN OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 -600 amp'. 401 600 amp. EAADDL EIR CIR- SIGNALIPANEL: IN PLANT.
MANU HMISVCIFDR: 601 1000 amp 601+ernp8-1000V. MINOR LABEL:
1000+amplvolt
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVCIFDR>=225 A.: >900 V NOMINAL: CLS AREAISPC OCC.
_ ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL_ B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNOSC LT,
BURGLAR ALARM OTH. BOILER: HVAC LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,422.79
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD ST 4230 GALEWOOD ST,STE 100 Tigard Municipal Code,State OR. Specialty Codes and
STE 100 LAKE OSWEGO,OR 97035 all other applicable laws. All work Th be done i
accordance with approved plans. This permit will expir- If
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
aflorle: 503-387-7538 Phone' Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through 952-001-0080. You
19� 387375 $ may obtain copies of these rules or direct questions to
Roo
R0` l OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Guntrol Insp 8• Post/Beam Mechanica Plumb Top Out Exterior Sheathing Insl 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 Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final
Issued By : Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF I I GA R D SEINE R CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00292
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/12/03
SITE ADDRESS; 12380 SW ASPEN RIDGE DR
PARCEL: 2S 110BC-07600
SUBDIVISION: TIJORNWOOD ZONING: R-7
BLOCK: LOT: 047 JURISDICTION: I'lG
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
Owner: FEES
DON MORISSETTE HOMES
4230 GALEWOOD ST Description Date Amount
STE 100 1SWUSA]Saar Connect 8/12/03 $2,400.00
LAKE OSWEGO,OR 97035 1 ;\\'USA]S�%r Connect 8/12/03 $0.00
Phone: 503-387-7538 1SWINSP] S\%r Inspect 8/12/03 $35.00
ISWINSPI S\%r Ina,ecl 8/12/03 $0.00
Contractor: -
Total 62,438.00
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. T e total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer" Perm
Issued bya_,�4, a „ �,�� -e Permittee Signature*
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business dray
70
Building Per tion
/ ._ 1.., Date received: ��;I"", Permit no.: �
City of Tigard
City n/Tigard
Address: 13125 SW Hall Blvd,TfQard,01R Projecr/appl.no.: Exp.redate:
Phone: (503) 6394171 Date issued: Ry: ` fit) Receiptno.:
Fax: (503) 598-1960 CITY OFTIGARD Case file no.: Payment type:
Land use approval:
AUILDING DIVISION/��^ jgcy family:Simple Complex: v
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family ,&New construction O Demolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/aiarm U Other: _
Job ress: l^ c > Bldg.no.: Suite no.:
Lo Block: Subdivis on: Z)CA --- Tax map/tax lot/account no.:
PIN 'act n
Description and location of work on premise:dspecial conditions:
Name-
Y
Mailing address: (,�, 1 &2 family dwelling:
t
City: State:(_ ZIP: Valuation of work........................................ $ 7 c Z i
Phone: f No of';,i, ms/baths.....a:.::.....`,�............... '
—_--
C,v,ie-'sn, •:sewat; T,ttti number
Phone: Fax: =F'-4a—il j New dwelling area(sq.ft.) .......................... 7
r rcamort area(sq.ft.)
_ Y 1 Covered porch area(sq.ft.) ....�....Z
Name: ............
Mailing address l C�. �� Deck area(sq.ft.)........, ...zGo..............
City: State: ZIP: Other structure area(sq.ft.).1...............:........
Phone: 1 ax f m:ul: CommereiaUlnda9trial/multi-family:
IF.'f 011[11 Valuation of work.............../Existing:
.... $
----
Business name: 1
Existing bldg. area(sq. ft.) . .....
Address:
New bldg.area(sq.ft.)....... ..... --__--
City: State: ZIP: Number of stories............... ....
Phone: Fax: E-mail: Type of construction.........
Occupancy group(s): Existing:
CCB no. ��-- — New: --------
Citv/m —
Notice:All contractors and subcontractors are required to be
tj 1 �^ licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Address: ��. jwisdicdon where work is being performed. If the applicant is
CitX: State 'LIP: exempt from licensing,the following reason applies:
Contact person: Plan no.: —
Phone: Fax: E-mail: — —
Name: _ Contact person: Fees due upon application .......... ................ $
Address: Date received:
City: State: ZIP: Amount received ......................................... S
Phone: Fax: E-mail: Please reler to fee schedule.
I hereby certify I have read and examined this application and the Not all juri,dictiom wcM credit card, pleaw cdl jurisdicton fa mm information.
attached checklist. A rovisions of I ws and ofdinances governing this U visa U Mastercard
work will be complied with,whether cified ereA I Credit card number:
Authorized si n + l ! G Name of cardhAder u rhawn on credit card
+ L.�C41 f S
Print name- 1 - —
Cardholder dgnutue At>tarai
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 44tN613(600WOM)
Cine-and Two-Family Dwelling
Building Ptrmit Application Checklist Reference no.:
City of TigardpitAssociated permits:
y of Tigard l]Electrical O Plumbing O Mechanical
Address: 13125 SW Hall lilvd,"Pinard,0IJ 97,'.23U EleOthctrical
Phone: (503) 639-4171 Fax: (503) 599-1960
JuIN1 1 ' 1,1001*1 ilia
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 rf approved plattlot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel.Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Sofia report.Must carry original applicable stamp and signature on file or with application. _
9 Erosien control 0 plan U permit required.Include drainage-way protection,silt fence design and location of
catch-hasin protection,etc.
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist. J�
11 Sitelplot plan drawn to scale.The plan must show lot and buildin;setback dimensions;property comer elevations(if
there is 1 note than a 4-11.elevatit,n 4if..-renuw,plan must show contour lines at 24 intervals);location of easements and
dri%rwnv:footprint of structure i including decksr location of wells/sepbe systems;utility locations;direction indicator,lot
u_:,,building coverage-=a,percenurge of coverage:icipen wus,uea;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.
j 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater,
I furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and detr'Is.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, Y
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimun,of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change 1 grade is greater than four foot at building envelope.
_ Full-size sheet addendums showing foundation elevations witi, ,mss references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all tloors/r(x)f assemblies.indicating member.sizing,spacing,and heating
locations.Show attic ventilation.
18 Basement and retaining walla.Provide cross sections and details showing placement of rebar.For engineered
systems,see item 22,"Engineer's calculations."_
19 Beam calculations.Provide tv 1 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 desiirn details.
21 Energy Code compliance. Ide);tif_v t14c prescriptive path or provide calculations.A ;as-piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)sh ill he stamped by an engineer or
architect licensed in Oregon and shall be shown to he applicable to the project under review.
.11 11ANDU-111101AIll SPECIFICS'
23 Five(5):rife plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 1 i"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 raserved for department use only. 4404614 cGAWOM)
Mechanical PF* ion
'^ Date received: Permit no.:
City of Tigard Project/appl.no.: Expire date:
CityojTigord Address: 13125 SW Hall Blvd,tjLudkil 4d
Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 :.1TY OF TIUARD Case file no.: Payment type:
14OLDINGDIVISION Building permit no.:
Land use approval:
TYPE OF
O 1 &2 family dwelling or accessory O Contmercial/industrial O Multi-family O Tenant improvement
XNew construction O Add ition/alteration/replacement O Other.
� t � ' 1 7 f
Joh address: t ' Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Su a no.: value of all mechanical materials,equipment,labor,overhead,
Tax ma /;.ax lot/account no.: profit Value$ _
Lot: Block: Subdivision: VA 'See checklist for important application information and
Project name: jurisdiction's fee schr iu!^ for residential permit fee.
City/county: ZIP: i ti f
1111
Description and location of work on premises:
_ Fee(m) Total
Est.date of completion/inspection: :lmaiptlon Qty. Res.only Resd
h
Air handling
Tenant improvement or change of use: an
CFM
Is exisfin ace heated or conditioned?O Yes O No dling unit
g space conditioning(site p an required)
Is existing space insulated?O Yes O No Alteration of existing HVAC system
Boiler/compressors
State boiler permit no.:
Business HP Tans—_-BTU/11
Address: "T Fire/smoke dampersiduct smoke detectors
City L l State: ZIP: eat pump(site plan required) _
Phone: Fax E-mail: nN� rep ace urnar, urner
Including ductwork/vent liner O Yes O No
CCB no.: _ _ Instal I/repIace/relocate heaters-suspended,
City/metro lic. no.:N/A � wall,or floor mounted
Name(please print): (�LL C__ Vent ora liancen erthanfurnace
"�
C-- 1 e . gerat on:
mxj�%'l all MUNI Absorption units_ BTU/H
Name: ,`�,� - L- Chillers_ _ HP _
AddresCom rcssors HP
ns onrnenta ex ust an venula- on:
City: State: IziP: Appliance vent
Phone Fax: E-mail: Dryere gust
[foods, ype Iii Ithes.kitche azmat
hood fire suppression system
Name: ) Exhaust fan with single duct(bath fans)
Mailing address: ) �,' — u.aust system apart rc heatin or
Cit.,: Star LIP ) ue piping and (up to 4 outlets)
Type: LPG NG Oil
Phone: %' Fax: E-mail Fuel piping each additions over 4 out ets
roctsspiping(schematicrequired) _
Name: Number of outlets _
Ther llsiiZ appliance or equipment:
Address: __ Decorative fireplace
City _- --�—� State _LIP: nsen-type
Phone Fax: F•mail: o stovdpehststove
Uffier.
Applicant's signatu t- Date: � � >�il Ut er.
Name(print): -t 1�tt 1 fir'1 Not all jurisdictions accept credit cods.please call jurisdiction for rnm information. Permit fee.....................$
U Visa Cl MasterCard Notice:This permit application Minimum fee................$
expires if a permit is not obtained Plan review(at _ 96) $
Credit card number _---
-�� Expires within Igo days after it has been State surcharge(8%) ....$
Name of cardholder u showo on credit card accepted as complete.
$ 'TOTAL .......................$
Cardholder aisnaa re -- --Amount +40-4617(&MCOM)
Plumbin Pei#$(A*Iki"tion
'I 1l i) Nr, Due received: Perrnit no.� � Ofl� -
City of Tigard 'u� O Sewer pernutno.: - Bui' .ngpermitno.:—
Address: 13125 SW HaJI Blvd.�! rd,T%P' 3 Prorect/appl.no.; Expire date:
City of Tigard Phone: (503) 639-4171 (;IT OF OF
Fax: (503) 598-1960 RUILDINC DIV1510h1 Dateissued: By: I Receipt no.;
ase file no. Payment type:
Lard use approval: -r —
;ew
c 2 family dwelling or accessory 0 Commercial/industrial U Multi-family 0 Tenant improvement
construction0 Addiuon/alteraaon/replacement 0 Food service ❑Other.Description . Fee(ea.) Total
dress: — New l and 2-family dwellings only:
Bldg.no.: Su• a no.: — (includes ln0 it.for r2ch utility connection)
Tax map/tax lot/account no.: SFR(1)bath
Lot Block: Subdivision: 1 NI'1 SFR(2)bath — I
Project name: SFR(3)bath
City/county: ZIP: Each addiuonal badVkitchen
Description and location of work on premises: __ SiteutWdes:
_ Catch basinlarea drain
Drywells/leach line/trc.,ch drain
Est.date of completion/inspection: momd Fooung drain(no.lin. ft.) _.
newuntakIIIIIIIIIII Manufacnrred home utilities
Business name LManhole:
Address: Rain drain connector
CityState ZIP Sanitary sewer(no.lin. ft.)
E-mail: Storm sewer(no. lin.ft.;
Phone: _ Fax: Water service(no.lin.ft.)
CCB no.: l C��1 —] Plumb bus. reg. no - ) Fixture or item:
Cityimetro lic. no.:N A ,/ tbsorpuon valve
Contractors representative signaturedock Ilow presenter
Print name:
U ` i Backwater valve I
Basins/lavatory
Clothes washer I
Name: �P �r��. Dishwasher
Address: �C �� Dnn)ane foun[arnis)
Citi State: ZIP: Ejectorsisump
Phone Fax: E-mail: Expansion tank
FixtureJsewer cap
Floor drains/floor sinks/hub
Name (print): �- Garbage disposal I
Mailing address: Hose bibb
Citv l State ZIP: Ice maker
Phone: - Fax 7 ?{G1 Email: Interceptor',ease trap ---�
Owner insmfladon/residendal maintenance only: 11te actual installation Pnmens)
will be made b% me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the propet•ty I own u per ORS Chapter a47. Stnk(si.basintsi, lays(:)
Owner's si nature Date: Sum
MEMIJ Tubs shower/shower pan
l:renal
Name: _ — Water closet
Address: Water heater
Cit} State: ZIP: other
Phone: Fax: E-mail: Total
Minimum fee................$
Not 311 ur,"cuoru accept credit cards.pitaae;.ate sun"cuon fa mare infornaxion Notice:This permit applicau:n plan review(at _ %) S
C VIaa O Mastercard expires if a permit is not obtained State surcharge(8%) S
C.edit:ard number within 180 days after it has been
accepted u:omplete
Expires TOTAL Eap .......................S
Nurse W carawider U aur+n oo cruW'Md! s
- +rp.+6 16 1617pt'p S4
Cardhoider a curt Amours
Eketrical Perr>rn Received Electrical
DaWBv: _ _ Permit No.:
City of TigardT Planning Approval Sign
OCT .14 W.3 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review -- - Other "—
Tigard,Oregon 97223 Date/By: _ Permit No.:
Phone: 503-639-4171Fa>� - �'� Post-Review -- Land Use
";C} Date/By: Case:!S'upp'1`emcotaI
_
Internet: www.ci.tigard.or.us Contact June Pe 2 for
24-hour Inspection Request: 503-639-4175 Name/Method. llnformatlon.
_ TYPE OF WORKv PLAN REVIEse check all that apply)
New construction Demolition Service aver 225 amps- Health care facility
commercial ❑Hazardous location
Addition/alteration/replacement Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square tcct,
CATEGORY OF CONSTRUCTIONI&2 family dwellings four or more residential units in
f—& 2-Family dwelling Commercial/Industrial C]System over 600 volts nominal one structure
Accessory Budding Multi-Family ❑Feeders,400 amps or more
_�_- ❑❑Building Occupant load over over three stories
99 persons ❑Manufactured structures or RV park
Master Builder _Other: ❑Egressr1ighting plan ❑Other• _
JOB SITE INFORMATION and LOCATION Submit_sets of plans with any of the above.
lob site address: j-)� The above are not applicable to temporary construction service.
FEE*SCHEDULE
Suite#: Bld ./A 1.#: _Number of Ins ections per Itermit allowed
Project Name: eN/�ar/�se-r�� ,� G/t•J /1/ Description I Qty I Fee(ea.) roul
tiew residentlul-sin le or multi-family per
Cross street/Directions to job site: B Z� M ou g
V A�•4ht1 � dwelling unit.Includes attache)garage.
Service Included:
1100 sq.8.or less 145.15 4
Each additional 500 sq,R.or portion thereof 33.40 1
Subdivision: Lot#: Limited energy,residential _ 75.00 2
Limited energy,non residential 75,00 2
Tay: map/parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and or feeder 90.90 2
` Services or feeders-Installation,
alteration or relocation:
2011 amps or less 30.3(' 2
--- -- - - — 201 amps to 400 amps 106.95 2
401 amps to 601 ams 160.60 2
PROPERTY OWNER TENANT 601 amps to 1000 amps 240,60 2
- Over 1000 amps or volts 454.65 2
Name: , Reconnect only 66,85 2
Address: y7S� ���}( 4JO J ' /.:e, Temporary services or feeders-Installation,
Cit /Stave/Zi j f(K[(}rj((J tJ- alteration, le relocation:
�_ _�� � 200 amps or less 66.95 I
Phone: 3 Fax: 3&7 - j 201 amps to 4(x1 ams ---IW.30 2
APPLICANT CONTACT PERSON 401 to 6(x1 ams 133.75 2
Ilranch circuits-new,alteration,or
Name: _ extension per panel:
Address: A.Fee for branch circuits with purchase of
service or feeder fee,each branch circuit 6-6 5 2
City/State/Zip: 13.Fee for branch circuits without purchase o1
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)
C
_ ONTRACTOR Each pump or imitation circle 53.40 2
Each sign or outline fighting 53.40 2
.lob NO: _ Signal circuits)or a limited energy panel,
Business Name: alteration,or extension Pae 2 2
Address: Description.
Cit /State/Z•ip' ,�L �[a •C Each additional Inspection over the allowable In anv of the above:
� Per inspection per hour unm I hour) 62.50
Phone: 3 • �'(,� _ J Fax: &73 t14 Investigation fee:
CCB Lie. #: - Other
317 tic. #: C- Electrical Permit Feu'
Supervising electrician
Subtotal i5 _
signature required: _ Plan Review(250 16 of Permit Fee S
Print Name: L,�L z #; _ State Surcharge(80'o of Permit Fee 5
TOTAL PERMIT FEE I S
Authorized Notice: This permit application expires If a permit Is not obtained within
Signature: _ _ _ Date. _ —_ 180 days after it has been accepted as complete.
*Fee methodololty set by Tri-County Bvllding Industry Service Board.
(Please print name)
r'Dsts;Termit Forms',ElcPenmtApp.doc 01 03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RE:SIDEN"rIAL WORK ONLY: _
Feefor all systems............................................................ $75.00
Check'I'ype of%fork Ir.,olved:
Audio and Stereo Systems*
Burglar Alarm
Garage Door Opener*
El 1{eatiug.Ventilation and Air Conditioning System*
0 Vacuum Systems*
F1 Other _
COMMERCIAL WORK ONLY:
Feefor each system.......................................................... 575.00
(SEE OAR 91 9-260-260)
Check Type or Work Involved:
MAudio and S,ereo Systems
Boiler Controls
Clock Systems
Data Telecommunication Installation
Fire Alarm Installatiot.
HVAC v
Instrumentation
r7 Intercom and Paging Systems
0 Landscape Irrigation Control*
Medical
Nurse Calls
El Outdoor Landscape Lighting*
Protective Signaling
Other ----
Number of Systems
* No"censes are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01103
, DON - MORISSETTE OBE : 2924
9 0 m 9 s INCORPORATED LOT: 47
4 2 3 0 G A L 8 w 0 0 D 9 T R 8 b T 9 U I T R 1 0 0
LA [ R 0911E G0, • 0RaG0N 97096 DATE: 3/2$/03
(603) 387 - 7638 FAX (603) 387 - 7916
/ PROPERTY: THORIV�90f)D
OPTION I ELEVATION /2.3,j SCALE: T1"AR 0'
DAYLIGHT 5A5E71ENT 0 , PLAN No.: 157
r y
r
^� O Od r
46
s.+ Q '7 0 448'
_ Ohm sq. Ft.
T 4 cAr gar.
43rc FF.F. 44b'
y3c 5'Q, 2,171 sq. ft.
f a0
FF E. 446-S'
r
A:6 -�� •e. r -.__._-
, r
� i f
GARA6E HT: 44 6'
A:: 422' -ti __ ,
MAIN FLOOR NT: 4465'
320 X' f' BASEMENT NT: 4375'
Y / �
�.
ae e.,a a
418' -70.20+ 324 �. ----
RETAINING WAl•I_
LEGEND LOT COVERAGE
-- LOT A1-,=' %. 6 52A SGS, FT. LOT 041
BUILDING AREA !S60 SGS. FT.
—S'REET TREES SEE y ���24 sq. Ft.
RECORDED FLAT PEEtCENTAGE 30-.
FCR SIZES ANC TYPES
CITY OF 'FIGARU - SITE PLAN REVIPA' RECEIVED
fit iILDING PERM l I' NO.: S T 2:,t� : v( '
PLANNING DIVISION: R - 'r JUL 15 2003
Required Sethacks: gj�Approved ❑ Not Approved
Side: Street Side: u k;ITY OF TIGARD
From. ? t i:irage' a° Rear: 15 BUILDING DIVISION
Visual Clearance: Qff Approved ❑ Not Approved
Maximum Building Heighc 0 feet
C'4d'S Service Providet Letter Required: [,3 Yes to No
❑ Received
Date: v3
E:NtilNFt ING DE:PAR'I'MEW:
Actual Slope: % [ Approved ❑ Not Approved
Site Plan: (approved Q Not Approved
Eiv: ^stetZ Date: -7/Zs a?
Notes:
I
i ELECTRICAL PERMIT-
� �� CITY Oc: TIGARD► RESTRICTED ENERGY
DEVELOP,"AI:NT SERVICES PERMIT#: FLR2003-00:321)
+
13125 SW Hall Blvo . Tigard. OR 97223 (503) G39-4171 DATE ISSUED: 10;17/03
ITE. ADDRESS: 12380 SW ASPEN RIDGE DR PARCEL: 2S110BC 07E300
St r `IVISION:THOPNWOOD ZONING: R-7
31_OCK: LOT: 047 JURISDICTION: TIG
iiect ne cription: Low voltage for speaker wire.
RESIDFAT+'AL _ B.COMMERCIAL _________
�AUDIr. IZ. CTEREO: X AUDIO & STEREO: INTERCOM & PAGING
"URGLAP ALARM: X BOILER: LANDSCAPE/IRRIGAT:
ARAGE OPENER: X CLOCK: MEDICAL:
HV4C: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYS-r EM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#t OF SYSTEMS: _
Owner: Contractor:
DON MORISSEITE HOMES DIvERSE COMMUNICATIONS
4230 GALEWOOD ST 54/1 N 14TH ST
STE 100 ST HELENS, OR 91051
LAKE OSWEGO,OR 97035
Phone: 503-387-7538 Phone: 503-387-7538
Reg #: 1 1;11?-3664BE996
ILL 546CL.I
_FEES Required Inspections
Description Date Amount Low Voltage Inspection
IFATRMTj LLR I'ermir 10/17/03 $75.00 Elect'I Final
ITAXj 8%State Tax 10/17/03 $6.00
Total $81.00
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 epproved 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 r- `-Ilow rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-001-0010 throuc
r _ Permittee Signature
Issued by _.t
OWNER INSTALLATION ONLY
The installatirn is being made on property I own which is not :itended for Gale, lease, or rent.
OWNER'S SIGNATURE: DATE: _
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an Inspection needed the next business day
1
Electrical Permit Application
-. —_---- _
Received C i Iccu�eal � ✓
Date/By ,r✓/� /7 Pcrnitt'J ,x�J� 3 7�J
City of Tigard PlanningA neva Sign
y g Date,,Uy Permit No.
13125 SW Hall Blvd. Plan Review Other ----
Tigard,Oregon 97223 Date!By Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 �,� Post-Review Land Use
Date's : _ Case No.
Internet: www.ci.tigard.or.us Contact tuns.. I see rage 2 for
24-hour Inspection Request: 503-639-4175 I Name/htethod: s i)Ienicatai Inlormacoo.
TYPE OF N.'ORK PLAN REVIEW(Please check all that apply) _
—
New construction Service over 225 amps- Health-care facility
_ (7e_molition
commercial ❑Hazardous location
Addition/alteration/replacenlCtll 1 _Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet.
CATEGORY OF CONSTRUCTION I &1 family dwellings tour or more residential units to
I & 2-Familv dwelling C OmmeCClaUlnduStrlal ❑System over 61)o volts nominal one structure
❑Building over three stories ❑Feeders,400 amps or more
Accessory Building _Multi-Family _ ❑Occupant load over 99 persons ❑Manufactured structures or RVpark
Master Builder EJ Other: ❑Egress lighting plan ❑Other —
JOB SITE INFORMATION and LOCATION Submit__sets of plans with any of the above.
I - — The above are not applicable to temporary construction service.
Job site address: !.?3F o �G<,' _F�v i��i% FEE*SCHEDULE
Suite #: Bldg./Apt, : Number of ins ectlons per per_mit allowed
Project Name: Description Qi) Fee(to.) 7ot.l
Cross street/Directions t0 Oh site: New residential-single fit nmltl-fainih per
dwelling unit.Includes attached garage.
Service Included:
I(X)0 sq ft or less 145.15 4
Each additional 500 sq.Il.or portion thereof 33.40 1
Subdivision: _ Lot#: I imued encry residential 75.(N) __ 2
Limited energy,non residential 75 t8) 2
Tax map/parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK service anti or 1'eeder 9090 2
_T1 Services or feeders-Installation,
1 N S r-A f� l-4�•� VO/140,4A z a t c i alteration or relocation:
2W im s or less __ _ 80.30 2
-- 201 am to 400 amps 106.85 2
401 amps to 61x)amps 160.60 2
PROPERTY OWNER TENANT 601 amps to 1000 amps 240.60 2
Over 101)0 amps or volts _ 454.65 '_
Name: _ _ Reconnect only 66.85 2
Address: Temporary services or feeders-installation.
Alteration.or relocation:
Cit /StY ate/Ztpr. _ 2Wamps or less 6685 I
Phone: _ ---�-Fax: 201 amps w 400 amps _ 100.30 2
[A-PPLICANT CONTACT PERSON 401 to 6(x)ams 133?5 2
— Branch circuits-new,alteration,or
Name: extension per panel:
-� ------ A fee I'or branch circuits with purchase of
Address: —_ sen ice or feeder fee,each branch circuit 6.65 2
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: ---- - ---- Mise(Service or feeder not included)
CONTRAC TOR Each pomp or irrigation c::,le _ 53.40 1 2
— Each sign or outline fighting _5340_L_____ 2-
Job No: 1�J S_.2 _ Signal circuit(s)or a limited cnergv panel.
>7 t vE K C e alteration,or extension _ _ Pae 2
Business Name: 2
�,r• ��" ^'� t�3 Description
Address: ,;vs /�:J 410 1e k 5�,; 3�
�it /State/ZI i (�5 b o r o v ' ;� Lt! Each additional inspection over the allow tblr in am of the above: —_
Per inspection per hour(min. I hnum _ 6..SO
Phone: Qi ' 440 - 9 v Fax: .577 k-90 xJ3 y7 investigation fee —
_CCB Lic. #: /3 5_9`� Lic,#: ?f L E/4lf-q,�Za Other: — —
Electrical Permit Fees*
Supervising electrician -ell _
r Subtotal S 5 '
signature required: _ y ��/ _ PI to Review t2:5:%of Permit Fee) S
Print Name:_ t -T,1 ie. #: _47y?, Z rA Stat:Surcharge 18 of Pemnt Feel S
TOTAL PERNUT FEE I Sf
Authorized Notice: This permit application expires If a permit is not obtained within
Signature: _ _ _ Date: 180 dais after It has been accepted as complete.
*Fee methodolog-v set bs tri-County Building Industr% Service Board.
(Please print name)
i'Dsts\Penril Ftmro\ElcPelmitApp 'nc 0103
1
Electrical Permit Application - City of Tigard
. a
Page 2 - Supplemental Information t
LIMITED ENERGY PERMIT FEES.
RESIDENTIAL WORK ONLY:
i�ce for all systems............................................................ $75.00
Check Type of Work Involved:
Audio and Stereo Systems*
Burglar Alarm
Garage Door Opener*
Heating,Ventilation and Air Conditioning System*
Vacuum Systems*
Other
i
P�
�I
('OMMERCIAL WORK ONLY:
Feefor each system.......................................................... S75.00
(SEE OAR 918.260-160)
CL.eck Type of Work Involved:
Audio and Stereo Systems
Boiler Controls
Clock Systems
uData Telecommunication Installation
Fire Alarm Installation
IIVAC
Instrumentation
Intercom and Paging Systems
DLandscape Irrigation Control*
Medical
ElNurse Calls
❑ Outdoor Landscape Lighting*
LJ Protecti%c Signaling
L� Other
Number of Systems
* No licenses are required. Licenses are required for all
other Inst-illations
I'Dsts`,Permit Fortin E1cl'emutAppP92doc 01'03
CITY OF TIGARD 24-Hour a
BUILDING Inspection Line: (501)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171 BUP ---
Received —________�—Date Requested _�0 `2-1-- AM _._ _ PM _ BLIP -.-
Location /?-bc—o— fie'"'- - --Suite--- MEC
Contact Person —___�'a^^K __..-- ---- -- Ph 0 3 S(o 60 PLM --
Contractor -- — -- -- — Ph -- ) ----- _— SWR .- —_ ---
rBUILDING Tenant/Owner ._.._-- — ---- ---- ----
ELC
Footing ELC
Foundation FInsoection
: 3 — O O 3a-S
Ftg Drain -
Crawl Drain SIT --
Slab Notes:Post&Beam �----`'`=�-��
Shear Anchors V S l �i -
Ext Sheath/Shear
Int Sheath/Shear -
Frarring
Insulation
Drywall Nailing - -
r i rewall
Fire Sprinkler - -- -- -
Fire Alarm _ ------------ ----
5usp'd Ceiling - _—�- -
Root _ --- --
Other:-- -- ---- - -_.-.
Final
PASS PART FAIL
Post& Beam _ _ _-
Under Slab ---
Rough-In -
Water Service -
Sanitary Sewer — ----
Rain Drains
Catch Basin/Manhole —.---- -
Storm Drain --- --
Shower Pan ----_-_-- ---------
Other
Final - - --
_PASS PART FAIL --- -- --
ME_C_H_ANICAL
Post& Beam
Rough-In - --- -- ----- -�
Gas Line ---
Smoke Dampers
Final -
PASS PART FAIL
ELECTRICAL — _._— ---- -------- -- —-- — --- --- —-
Service
Rough-In _ _. --- ----- - ---- — --
UG/Slab --
Low Voltage ---
r F Alarm
r L� Reinspection fee of$__. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
--. — --- -
� Please call for reinspection RE: Unable to insF :ct-no access- -----
ire Supply Line
ADAOnto ��-- Inspector
Ext
Approach/Sidewalk - ---
r_)ther
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF
I I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00637
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-41 71 DATE ISSUED: 12;22/03
SITE ADDRESS: 12380 SW ASPEN RIDGE DR
PARCEL: 2S 1106C-07600
SUBDIVISION: THORNWOOD ZONING: R-7
BLOCK: LOT: 047 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: Install irrigation backflow preventer. _
FEES
Owner: — -
Description Date Amount
DON MORISSETTE HOMES -
,1230 GALEWOOD ST IPLt;NIBJ Permit I er 12/22/03 $36.25
5TE 100 I I AXJ S"i State 12/22/03 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 503-387-7538 --�`- —
Contractor:
I-ANDSCAPE OREGON, INC
12200 SW MYSLONY RD
fUALATIN OR 97062 REQUIRED INSPECTIONS
Phone : 503-692-5945 RP/Backflow Preventer
Final Inspection
Reg #: LIC LCB: 7804
PLM ALL PHASES- PLL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specially 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 rales adopted by the Oregon Utility
Notification Center Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100.
You may t1btain copies of these rules or direct questions to OUNC by calling (503) 246-6699.
Issued BY:
Permittee Signature:
,
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
C-, 1 `1 C13 Ota: 43a don Pcimond s
503-652-0768 F 2
FOR I UNLY
Plumb Permit A
n
_ Received �,? Plumbing
— t L,
rlonning Approval Sewn
City of Tigard n Dntcfiy PcnnitNo.:
1312S SW Hall Blvd. �r`` 1 2�fl3 Plan Review Other - - ----
Tigard, Oregon 9722 G A� hauler --- - Permit No.
PUSFRCVICW Load Use
I'h11
one: 503-639171 Fax: t ¢9 1S pate Case No.:
Internet: www.ci.tigard.or.us �1,nt1}N�p Contact turfs.: See rage 2 for
2d-hour inspection iZcyuest-- 5(73-o 7Y-4175 �Nante/Metlr�d _ '_J Supplemental information.
TYPE OF WORK FEE•SCIIEDULE?or special Inrormation use checklist)
New construction 17emolition Description Qty. Hee(ea.) Total
New I-At 2-family dwellings
Addition/alterat�on/re�lacem_ent__ Other: _ ,ndaaea too n,for i eb atllitr tonatc ion
CATEGORY OF CONSTRUCTION SFR 1 bath 249.20
1 &2-Familydwelling_ Commercial/industrial SFR(2)bath 350.00
AccessoryBuilding Multi-Fami�y SFR(3)bath _ 3`9`9 W
_ Master Builder ❑Other: Each additional bath/kitchcn 4500
_ JOB SITE INFORMATION and LOCATION Fire spnnklcr -M R-' g 2
Tog site address: IA3FO SW IK12eA- ��-+d� _ _ Site Utilities
Suite#: —� lied /A L#: Catch basin arra drain 16.60
-�=-� br elUltrch IinJtrench drain _ 16.60
Project Name:7hff/i"0�(, C 0 T t't'`/ E Doha drain no.linear R -
Cross street/Directions to job site: Manufactured home utilities 110.00 _
Manholes _ 16.60
Rain drain connector lG.6U
Sanitary sewer no.linear ft.) Page 2
Subdivision:_-Tr) n UJ 00d- �i of#�4 Stoml sewer(nu.linear R.) Page 2
Water service(nn. linear R.)
Tax ma /parcel#: 5—_�"-��0
��� �! F'ixtureorltem
_ DESCRIP•I•ION OF WORKabsorption valve _ 16.60
LZ"&Ca C.chcr.y G(U3I( e) Backflow preventet - Pa e 2
Backwater valve 16.60
Clothes washer 16.60 -_
Dishwasher 16.60
_ Drinking fountain 16.60
JEFLK-OPERTY OWNER TENANT -5j--to sum
Name: C)CM /1�(T ilk ,��_E�CtiY}t� _ Expansion tank _ 16.60
Address:4;Z 30 St,t` &,c ip-tAJ0Q CA-' Fixture/sewer cap _ 16.fJ
Cl /State/Zi LQ'�t'. CS urG Cf-1(J. Fluor drain/(loor sink/hub 16.60
__- p' - - ) Garbage disposal 13.60
Phone: _ I rax- lion bib _-� 15.60
PPLICANT _ CONTACT PERSON __ Ice maker _ 16.60
S a4-7-tu, Interceptor/grease tra 16.60
Name: &,_1�CJ`l
Address:l:.Z 00 4"0 rn4S4UnQ rZ0_ -Primer i gas-value_i _ _Pae 2
-
_ 16.60
City/Stale/Zip:-RA-OAall r\. t7 A y'd(4 a_-_- Roofmtn oomrnerctal) 16.60
PhoneSa3 toga. -S'i LI-51 FaxS. 53 iv9 a_01710 9 Sink/basin/lavatory -- 16.60
E-mail: Tub/shower/shower pan _ _ 16.60
CONTRACTOR __ _Urinal 16.60
Business Name: (�.ndSC' Of'C dye T--�(,1 Water heatecloser _ __ 16.60
/-� �----- Water heater _ _ —.-
Address: 1.)a00 _j'1 %AMA,4 9D Other_
City/State/Zip:-Muka-*xr,_ R_ _'4-106'a- _ Other: _ --- -
Phone_Sa33 (cfi?a- SV Fax (p9� - Q��o _Plwnbing Permit Fees'
CCB Lic. #: -780`4 Plumb. Lic.# _ --- — -s"b`�tal
Minimum Permit Fec ST2.50 S natur �� c
Authorized -�;, t Residential Backflow Minimum Fee 536.25
Si �� �_ dare:.a 1 1
s � 03 Plan Review(25"/e of Permit f•-ee) -s i
Ell ar reu Ctatc Surc112T&c 8°h of P,-Amit Fcc S Cy C1 -
TOTAL PERMIT FEE S____.3.-KJ '5--
Notice: this permit application erpires Ira per,nit is not obtained withlo All new eommtreial buildings require 2 sets or plans WPI';:::rt-,I-Ir�r
Igo days after it has hern accepted as coneplete. riser diagram for plan review.
•Fee methedobgy set by Tri t'ouoty Building Industry service Hoard.
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 _
BUP --_--T--
Received —_.__ ____.-_ Date Requested .-� - /__ AM --nn PM--__ BLIP
Location _-VO A A A_ \ . —_Suite �L MEC
Contact Person _--- -- ---- _--._ Ph PLM _.__- -----
Contractor-----___-. -_-. .____ -- Ph ( ) . _-- --- SWR --____--
BUILDING Tenant/Owner ELS
Footing ELC
Foundation ACCe`;S:
Ftg Drain ELR
Crawl Drain
Slab Inspection Note3: SIT -- _—_
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing --- -- -- .�— — ------ -- ----- --
Insulation
Drywall Nailing ---_-__-- _-___-- -_-- - -- - -----
Firewall
Fire Sprinkler ------- —-�- ----` -------
Fire Alarm
Susp'd Ceding -- _-- ----- ------ --------_-_ -- -_
Root
Other: --- --___- _---- ----------------_-
ASS PART FAIL
L--_-_-__
PG • __ _____ __ -- -------------------- ---- -�— --- --
Post&Beam
''-•'er Slab
Rrnu h-In
Water Service -- -- -- — -- - -------
Sanitary Sewer
Rain Drains - — - ----�—^
Catch Basin/Manhole
Storm Drain -- -- ---- ----- -- - --- ---- --
Shower Pan
rna > _
SS PART FAIL
MtCHXNICAL - -- -- ------- - --- — ------ -----
Post&Beam
Rough-In - - - - -- -- -- ----- ----
Gas Line
Smoke Dampers -- - - - -- --------- - - ----
,•t, Fina
ASS PART FAIL - --- _.-- - - -------- - -----
CAL- -- —
Service
Rough-In -- ---- - -- ---- -- -- -- ---- --- - ----
UG/Slab
Low Voltage
Fir larm
l� Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
-- L Please call for reinspection RE:_ _.._-- _- ❑ Unable to inspect-no access
Fire Supply Line 7 /I
ADA Date _/C y Inspector 4 _'��.�ti Ext _._.
Approach/Sidewalk
Other
Final DO NOT REMOVE this Inspection record from the Job -site.
PASS PART FAIL
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