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QUARTERPOlr4T�ESIGN GROUP
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Nk OMm 97223
503-624-6388
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LOT 95
HILLSHIRE WOODS
WASHINGTON COUN Y, OREGON
NOTICE: IF THE PRINT OR TYPE ON ANY
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IT IS DUE TO THE QUALITY OF THE __- . No.36
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1j572 SW ASCENSION DRIVE
page No. 3 CASE HISTORY FOR CAGB NO.: MST97-0155
NINDNOOD HOMES INC
13572 SM ASCENSION DR
06/17/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
------- --•-------•-------------------- -------- -------- -------- --------------------------------------- ---- --- -------- ---
MSTA725 Framing Insp / / / / 09/26/97 Report dated 091897 framing/shear FAIL RB 09/29/97 J•H
incompleted issues, N1, 83, 86:
1. Garage attic ventilation.
3. Stair tread requirements by final.
6. Repair plumbing vents by insulation.
:7n',A726 Shear Nall Insp / / / / 07/23/9.1 Exterior Sheathing not approved: FAIL RB 07/23/97 J•H
1. HPAHD's too close to edges - marked.
2. Nail. sheathing as marked.
3. HD's missed at master bedroom and
main floor bedroom directly behind
garage.
1. Add etude and nail where lacking in
16" spacing of studs.
S. Engineor stamp missing from approved
plans.
1
MSTA726 Shear Mall Insp / / / / 08/05/97 hold-down missed in bedrm 3 FAIL RB 08/06/97 RB
MSTA726 Shear Mall Insp / / / / 08/20/97 incompleted issues PAIL RE 08/20/97 RB
MSTA727 Low Voltage / / / / 09/17/97 PASS HRP 09/17/97 J*H
MSTA735 Gas Line Ii.sp / / / / 08/20/97 PASS RB 08/20/97 RB
MSTA740 Insulation Insp / / / / 09/25/97 moo framing this date PAIL ICS 09/25/97 J•H
MSTA740 Insulation Insp 09/25/97 / / 09/29/97 PASS KS 09/29/97 J*H
MSTA745 On Board Insp / / / / 10/02/97 PASS OB 10/03/97 J+H
MSTA7S5 Rain drain Insp 06/15/97 / / 06/13/97 Note: Needs some rip-rap at outfall from PASS RAS 06/15/97 J*H
storm drain.
MSTA760 Nater Line Insp 06/15/97 / / 06/16/97 no water FAIL MS 06/19/97 J*H
MOTA765 Appr/Sdwlk Insp / / / / 10/24/97 PASS MSH 12/01/97 S+M
MSTA790 Electrical Final / / / / 01/27/98 Voltage at test 120 PASS BRP 01/27/98 J*H
GPCI trip test, kitchen N1-4ma, N2-4ma,
r-ar-9u&, front-4ma, bath-41ka,
garage-4ma, jet tub-Sma
MSTA795 Mechanical Final / / / / 02/26/98 See bldg final. PAIL RC 02/26/98 J*H
MSTA795 Mechanical Final 03/09/98 / / 03/06/98 PASS GS 03/09/98 J•H
MSTA797 Plumb Final / / / / 02/26/98 PASS MA 02/26/98 J•H
Page No. 1 'ASF HISTORY FOR CASE Nn.: PI1497-0452
WINDW00D HOMES INC
13572 SW ASCENSION DP
06/17/98
Action Description Rei/ Schd/ End/ Action Notes Disp By Update Upd
Code lent Done Done Date By
------- ------------------ --------- -- -------- -------- -------- ----- ---—--- --------------------- ---- -- - -------- ---
PIMAO03 Application received / / / / 11/14/97 RECD B 11/14/97 DST
PLMA005 Create Permit / / / / 11/14/97 DONE B 11/14/97 DST
PIMA050 (P) Inoue permit / / / / 11/14/97 PASS B 11/14/97 DST
PL14A750 RP/Backflow Preventer 11/14/97 / / 02/16/98 PASS WA 07/26/90 J"H
PIMA799 Final Inipection / / / / 02/26/96 PASS WA 02/26/98 J-H
PIMA800 Came Pi'laled / / / / 02/26/98 PASS WA 02/26/90 J•H
I
Page No, 1 CASE HISTOPY POP CASE NO.: ELR97-0329
WINDWOOD HOMES INC
13572 SW ASCENSION DP
06/17/98
Action Description Req/ Schd/ End/ Action Notea Disp By Update Upd
Code Sent Done Done Date By
P.LRA003 Appl.icati"i received / / / / 11/14/97 RFC? B 11/14/97 DST
C,LRA010 Permit created / / / / 11/14/97 DOW, B 11/14/97 DST
FLRA500 (F) Issue permit / / / / 11/14/97 PASS B 11/14/97 DST
F,LRA725 Low Voltage Inspection / / / / 02/26/98 PASS WA 02/26/98 J•H
ELRA799 Elect'l Final / / / / 02/26/98 PASS WA 02/26/96 J•H
FLRA800 Cane finaled / / / / 02/26/98 PASS WA 02/26/98 J•H
CITY GF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
tA:RTI'i- IC'ATE OF'
OCt-UPANC:Y
PERMIT #. . . . . . . : MST97••0155
DATE: ISSUED: 03/06/98
PNRCEL s 2S104CC-07600
r I TE ADDRESS. . . s 13572 SW ASCENSION DR
'UBDIVISION. . . . a HIL.L.SHIRE W[A]DS ZONING:R•-7 FAD
3LDCK. . . . . . . . . . s LOT. . . . . . . . . . . . . s095 JURISDICTIUNsTIG3
:-.LASS OF WORK. :NEW
TYPE OF USE. . . t SF
�'YPE or CONSTP s 5N
iCCUPANCY CARP. :R3
7CCUPANCY LOAD s i?
l emarks s Patti 1
Iwnei,e
JINUWOOD HOMES INC
14076 SW DENCHV IEW TERR
6ARD OR 97224
i 1hnne Ms 590- 4700
4I NDW00D HOMES
14076 SW DENCHVIEW TERRACE
i FAX 0 590-7606)
f'16ARD OR 97JAR4
(hone Ns 590-4700
flpn M. . s 50196
Prix Cer^tifiCPte grants occ:Grpancy of the aibaVe referenced hUilding or, portion
_her^eof and confirms that the building has been inspected for- r_omplianc:e wit►
hp State of Oregon Specialty Codes for- the grni-ip+, ocr-upancy, and uee under,
-Phirh the refpr•enced pet,wit was issued.
I N F C Till+ _.__...__ .._ _ S .. .....SOR
11011-DING
._ H"". L_/ I NSRF_CT: 1 C3
UPERV I aUR
POST IN CONSP I CLJOU5 PLACE
3 .5
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested:` 3 tr "74 _ .M. P.M. MST:
!
Location: s3-5/ryB[1P:_ —
Tenant: _ Suite: Bldg: MEC —
Contractor: k'l� V Phone. -'703-
FLM: _
Owner: Phone:
ELC:
ELR:
—
SIT:
BUILDING -
�)�on't) PLUMBING ECH ELECTRICAL SITE
Site Post/Beam Post/Beam Pos eam Cover/Service Sewer/Storm
Footing Roof llndFl/Slab Rough-hi Ceiling Water Line
Slab Framing 'fop Out Gas Line Rough-hr UG Sprinkler
Foundation Insulation Sewer Flood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt
v Approved ov Approved Approved
Appr/Sdwlk oved Not Approved of A proved Not Approved Not Approved
FINAL FINAL FINAL FINAL
O Call for reinspection r7l Reinspection fee of S __required before next inspection 0 Unable to inspect
Inspector:-- - -- ---- Date: Page— —of.—.
CITE( OF TIGARD
DEVELOPMENT SERVICES MASTER F,ERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERM I T #. . . . . . . MST97-01 55
DATE ISSUED: 05/27/97
F'ARCEI_: 2S 1O4CC--HWO95
SITE ADDRESS. . . : 1,3572 SW ASCENSION DR
SUBDIVISION. . . . :H I LLSH I RE WOODS ZONING: n--7 F,D
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :O95 JUR I ciD I CT I ON:
Remarks: Path 1
----------------- -------------------------------------------- BUILDING --------------------- -
REISStIE: STORIES.......: 2 FLOOR AREAS--- -- --- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-----------•--
CLASS OF WORK.:NcW HEIGHT........: 24 FIRST....; 12% s GARAGE.....: 714 sf LEFT..........: 14 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 48 SECOND...: 1202 sf FRONT.........: 20 PARKING SPACES: 2
TYPE OF CONST.:SN DWELLING UNITS: 1 FINBSMENT; 0 sf RIGHT.........: 14
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 3 TOTAL------: 2458 sf VALUE..$: 177064 REAR..........: 95
-_------------------------------------------- ------ ----- --- PLUMBING ----------------- -
SINKS.........: I WATER LLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: I RAIN DRAIN ft: 100 TRAPS.........: 0
LAVATORIES...., 4 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: I CATCH BASINS..: 0
fUB/SHOWF.RS...s 3 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINT ft: 100 ECKFLW PREVNTR: 1 GREASE TRAPS..: 0
0
_ .. _ ------------------------------------- -- ----- MECHANICAL -----------------------------
OT)rR FIXTURES:
FUEL TYPES----------- FURN l ION ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS..... : 4 CLOTHES DRYERS: 1
GAS FURN )=108K ..: I UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES.... : 0 GAS OUTLETS... : 1
RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS-- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
ION SF OR LESS: 1 0 - 200 asp..: 0 0 200 asp..: 0 W/SVC OR FUR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.; S 201 - 400 asp..: 0 201 400 asp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIKITED ENERGY.: 0 401 - 600 asp..: 0 401 - 600 asp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANz HM/SVC/FDR: 0 601 - ?008 asp.: 0 601+asps-1000 v: 0 MINOR LABEL -10: 0
1000+ asp/volt.: 0 --------------------------- PLAN REVIEW SECTION -----------------------------------
Reconnect only.: 0 )=4 RES UNITS..:
SVC/FDR)=225 A.: 1 680 V NOMINAL: CLS AREA/SPC OCC:
—
----------------- - -------------------------------- - RESTRICTED ENERGY --- ---- --- ------ --------- --- ---
A. SF RESIDENTIAL ----- ----------- - B. COMMERCIAL------------------------------ - -------- -------
AUDIO I! STEREO.; VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING- OUTDOOR LNDSC LT:
BURGI-AR ALARM..: 0TH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE S1GNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC............: DATA/TELE COW.: NURSE CALLS...., TOTAL # SYSTEMS: 0
Owner: ----------------------------------Contractor: ----------------------------- TOTAL FEES:$ 4636.78
WINDWOOD HOMES INC WINDWOOD HOMES
14076 SW BENCHVIEW TERR 14076 SW BENCHVIEW TERRACE
TIGARD OR 97224 f:GARD OR 97224
Phone 0: 598-4788 Phone #: 590-4700
Reg C.: 008501
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plaits. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days.
----- ------------------------------------------------------- REQUIRED INSPECTIONS ----------------- -- -----
Erosion Contol Post/Beam Mechan Electrical Servi Gas LOP Insp Water Service In Building Final
Brading Inspecti Crawl Drain Electrical Rougo Gas Fireplace Appr/Sdwlk Insp
Footing Insp PLM/Underfloor Framing Insp Insulation Insp Electrical Final
Foundation Insp Mechanical Insp Shear Wall Insp Gyp Board Insp Mechanical Final _
Post/Beae Struct Plumb Top Out L�ojw V t ge kain drain Insp Plumb Final
Issued By
U-III for^ inspection — C 17S
r
CITY OF TIGARD
20, iDEVELOPMENT SERVICES SEWER CONNECTION
k 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMITPERMIT #PERM . . . : SWR97-0]53
DATE ISSUED: 05/27/97
SITE ADDRESS. . . : 13572' SW ASCENSION DR PARCEL-: c'S 104CC--HW090
SUBDIVISION. . . . :HILLSHIRE WOODS ZONING: R-7 PI)
BL-OCK. . . . . . . . . . LOT. . . . . . . . . . . . . tO95 JURISDICTION:
---------------------------------------------------
TENANT NAME. . . . . :
11SA NO. . . . . . . . . . : F I X-"URE UN I TS. . . : 0
CLASS OF WORK. . . :NEW DWEI-LING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
fNSTALL_ TYPE. . . . :BUF,WR IMPERV SURFACE: 0 sf
Remarks : Fath 1
Owner,: —-- --------------------------------------------------- FEES --------------
WINDWOOD HOMES INC type amol.rnt by date r•ecpt
14076 SW BENCHVIEW TERR PRMT $ 2200. 00 JSD 05/27/97 97-2:95078
( TGARD OR 97224 I14SF' $ 35. 00 JSD 05/27/97 9'7—&95078
Phone #:
Contractor: ---- ------------•—_------.-----
OWNER
Phone #: --f--2235. 00 TOTAL.-----____
Reg #. . :
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulation, Sewer, Inspection
of the Unified Sewage Agency. The permit expires 188 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 the sewer is not located at the measurement --�T _
given, the installer shall prospect 3 feet in all ,directions from
the distance given. If not so located, th'�installer shall purchase
a 'Tap and Side Sewer' Permit and the A ndr will i�rstal! a lateral. -
f'r r m i t t e e S i.g n
'at
t t_i t'E, /
I cS�leCi �.
Call for inspection — 639-4175
Plan Check ' `
'. ITY OF TIGARD Residential Building Permit Application Recd By
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd 5 7-rz
-IGARD, OR 97223 Single Family Detached or Attached Date to P E.
:03) 639-4171 Date to DST_- '
Print or Type �l7-
Called . r % > 3 ?r- 6153
Incomplete or illegible applications will not be accepted
Name of Subdivision Lot# Na /
Job _/'///l<`1�.•t �Uo� 9� & /* v'
Address Site Address Architect Mailing Address
Jv w ��tctiSci lc�
�l 71 `� ���(CiIS/Un _ Cit /State Zip Phone z
Name
Owner Mailing Address Naft
C $tate Zip Phone Engineer Mailing Address
i
Nam it 9
— ^ Gity/State Zip Phone
General .5C{-1— Describe work ne�� addition O alteration O repair O
:ontractor Mailing Address to be done
Additional Description of Work: <J
C.,;y State Zip Phone
Oregon Const. Cont. Board Lic.# Exp Date
Attach copy or �/ Project Q l
Current COT Business Tax or Metro# Exp DateValuation_
Licenses _
Name _ NEW CONSTRUCTION
ONLY:
Mechanical 7111 d `� Sq.Ft. House Sq.Ft.Garage:
c l _
Sub.- Mailing Address
Contractor ( SL yb 'I Corner Lot Yes No Flag Lot Yes No
CPS a Zip one (check one) — (check one) r
f > _ X,F a/(Q/ Restricted Audio/Stereo burglar
Oregon_ Energy Const Cont Board Lac# Exp Date System Alarm
Attach Copy of '" 651- • [
Current COT BusinessaT x o, Metro# Lx2. pate Installation Garage Door
Licenses_ ':i! 1�16_�Y S 47 '9* c Opener Systems
Name (check all that Other: --
Plumbing apply).—.---,
:Sub- Mailing Address Will the electrical subcontractor wire for all Yes No
�� i� restricted energy installations?
Contractor 1 6G — Has the Subdivision Plat recorded? N/A Yes No
City/Sl a ip Phone
�UGYM yj fy _ --- —
Attach Copy of
Oregon Co R
st. Cont.Board Lie# Ex ate Reissue of MST# Solar Compliance
)/ ("0 ; $ (Calculation Attached)
Current Plumbing Lie # Exp Dae I hereby a,;k•iowledge that I have read this application,that the
Licenses �c a G information given is correct. that I am the owner or authenzed agent of
COT Business Taxor MetrLo# p,D ate G the owner, and that plans submitted are in compliance with Oregon
_ D State_laws _
Name — — Signatue�f r/ ent Date
Electrical ' J
me / -- �— Phone
Sub- Mailing Address /c � P
Contractor b Ski „t�j�nt FOR OFFICE USE ONLY:
City/State Zip Phone Plat#
« < Cz ���>3 �Y S b � II Map/1 L#
Ore�in Const Cont Board Lc# Exp Dat �1) , �0 1 ?'b Z'
, "
Attach Copy of _�/ 3 �r Setbacks one Solar:
Current E ectncal Lie # Exp Oatte�
Licenses 3c. A
COT Business Tax or Metro# 1 Exp Date Engineering Approval Planning Approval: TIF:
J
Jstsvnstapp doc �!`'
Permit # Account Description AM-Quill / At17L-E!1 Bal, Que
MST. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT) 275, �� � _ 27S
State Tax (TAX)
Bldg: 3/. r'-
Plumb. _ //,
Mech: 2
V/
ELC/ELR: � l
plan Check
MST: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN)CYY
CDC Review
`'ty Sewer Connection (SWUSA) 2200, ✓ c%2o v
Sewer Inspection (SWINSP) S• 3 S.
V/
Parks Dev Charge (PKSDC) /D�0 v
Residential TIF (TIF-R) /S 7G.
Yom"
Mass Transit TIF (TIF-MT1 /ZU /260
Water Quality (WQUAL)
Water Quantity (WQUANT) jou, ✓
Erosion Control Permit (ERPRMT) V
Erosion Planck/USA (ERPLAN) -JIT,V '
Erosion Planck/COT (EROSN) Pr
Fire Life Safety (FLS) _
TOTALS: G g ?- � -
i\dstsVnstapp doc
Rev 7196
Solar Balance Point Standard Worksheet
Address
Box A calculations: North-South dimension for the lot. Box A:
This dimension is determined by finding the midpoint of the North lot line and drawing
an intersecting line perpendicular to that point.
First, determine which property line is the North lot line. The North 'ot lines is the line
with the smallest angle from a line drawn east-west and intersecting tree northern most
point of the lot.
45°—►
NOQTI/ERN �. N0f1*VN\
l0T 11Nf, LOT UNE- N � �� E North-South
Dimension for Lot:
Measure the distance from the midpoint of the North lot line to the South lot line along
the described line.
feet
1
N
NONTHSOIlM DENENSIONf
Box B calculations: Shade point height for your residence. Box B:
1. Determine whether measurements will be based on the peak or eave of your Which describes
structure. The orientation of the ridge is also important. your residence?
1 a: If the roof line runs North-South, measurements will (circle one)
be based on the peak of the roof. T-5-5-5-C7
"�"'—► 1A 113 11C�
1 b: If the r000' line runs East-West and the roof pitch is
less '.han 5/12, measurements will be based on the
eave.
SNARE POINT EAIf
1 c: If the roof line runs East-West and the roof pitch is
5/12 or steeper, measurements will be based on the
peak.
Box B. continuetl Box B:
2. Measure change in elevation from front property line to finished floor elevation. If
the lot slopes up from the front lot line to tho foundation, the figure is positive. !f _
the lot slopes down from the front lot line co ttie foundation, the figure is negative.
3. Measure distance from finished floor elevation to the affect !d peak/eave. + _�' � �._- ft
4. If the roof line runs North-South, deduct three feet. If the roof line runs East-West, - _� _ ft
deduct nothing.
5. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property line, if the lot slopes up from the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing. _�� ft
6. Total figure for box B: J ft
Box C. Distance to the shade reduction line. Bax C:
1. Measure the distance from the North property line to the foundation near the Ll _ ft
affected peak/eave.
2. Measure the distance from the foundation to the affected peak or eave. + ft
3. Total figure for box C: AL3 ft
it is most useful to draw a vertical line to represent the appropriate figure found in box "A'and a horizontal line to represent the
appropriate figure found in box "C" The intersection of the vertical and horizontal lines determines the value found in box"D". The value
in box "D"should be compared to the value in box "B"; if the value in box "B"is less than or equal to the value found in box"D-, then
the building is in compliance with the solar balance code. If you have any questions, please contact us at 639-4171, x304 or at the
Community Development Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT (In Feet)
Distance to North-south lot dimension(in feet)
shade 100+ 95 90 5 80 75 70 65 60 55 50 45 40
reduction line
from northern
lot line Fin feet)
70 40 40 40 4) 42 43 44
65 38 38 38 3 40 41 42 43
60 36 36 36 3 38 39 40 41 42
55 34 34 34 3 36 37 38 39 40 41
50 32 32 32 3f3 34 35 36 37 38 39 40
45 30 30 30 ` 32 33 34 3.5 36 37 38 39
40 28 28 28 29 30 31 32 33 34 35 36 37 38
35 26 26 26 27 28 29 30 31 32 33 34 35 36
30 24 24 24 25 26 27 78 29 30 31 32 33 34
25 22 22 22 23 24 25 26 27 28 29 30 31 32
20 20 20 20 21 22 23 24 25 26 27 28 29 30
15 18 18 18 19 20 21 22 23 24 25 26 27 28
10 16 16 16 17 18 19 20 21 22 23 24 25 26
S 14 14 14 15 16 17 18 19 20 21 22 23 24
Box D. Maximum allowed shade point height: v / _ feet
h doc5\nancv\ventura\soIar.chp
Revised 2126/96
I
SEE 35MM
ROLL# 22
FOR
LARGE
DOCUMENT
1, CITY CSF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
I� I}
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
13125 SW HALL BLVD Date Recd:
TIGARD OR 97223 PRINT OR TYPE=
V- 503-639-4171 X304 Permit#: r L Rg
F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL,
v Restricted Energy Fee................,. ................: $40.00
(FOR ALL SYS-EMS)
,JOB Street Address Ste#
r Check Type of Work Involved.
ADDRESS /_i7 S 61 l,S7U-roe _
City/Statet Zipg/hill Phone# ❑ Audio and Stereo Systems
2,0.,,W OX" W
Name / ❑ Burglar Alarm
OWNER Mailing Address Garage Door Opener'
City/State Zip Phone# ❑ Healing,Ventilation and Air Conditioning System`
---- — -- F] Vacuum Systems'
Name
�,
t T�Ah' 4,440,5(
Other
CONTRACTOR Mailing Address
/-42,71 5u.' �;ojp�� ' ��-�' _TYPE OF WORK INVOLVED -COMMERCIAL —^
(Prior to issuance a City/State Zip Phone# Fee for each system.............................................. $40.00
copy of all licenses 7/1 "'- J9// (SEE OAR 918.260-260)
are required if Oregon Contr. Bid Lic # Exp Date
expired in C O T :5.
x'-436 elp Check Type of Work inv(,'ved.
data base) Electrical Contr. Lic # Exp Date
❑ Audio and Stereo Systems
a+ C O T or Metro is # Exp Date
(p y'l ❑ Boiler Controls
Owners Name
__ ❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State Zip—Phone# ❑
Fire Alarm installation
i t
This permit is issued under UAE 18-320-370 This appiirant agrees to
make only restricted energy installations(100 volt amps Or less)under this L-1 HVAC
permit and to do the following:
❑ Instrumentation
1 Only use electrical licensed persons to do insulations where required
Certain residential and other transactions are exempt from licensing ❑ Intercom and Paging Systems
These have asterisks(') All others need licensing,
ti
7 Call for inspections when installation under this permit are ready for Landscape Irrigation Control'
inspection at 503-6394175; ❑
Medical
3 Purchase separate permits for all installations that are not readv for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this pet.-..it
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and, ❑
Protective 3iynaling
5 Assume responsibility for calling for a final inspection when all of the _
corrections are completed L-� Other
Permits are non-transferable and non-refundable and expire if work is not
started within 180 days of issuance or if work is suspended for 180 days / _Number of Systems
The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other installations
authorized to bind the applicant A.
FEES
Signature ENTER FEES f_ �O
c'r
5%SURCHARGE(.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ 9.1
C,,esele doc 1296 _ __
CITY OF TIGARD
DEVELOPMENT SERVICES
jwjm 13125 SW Hall Blvd., Tigard. 4R 97223 (503)639-4171
L
Y OF TIGARD Plumbing Application R.cd ey-�
125 SW HALL BLVD. Commercial and Residential Data Recd
GARD', OR 97223 oats to P E.
_
03) 639-4171 Date to DST
Permit 8
Print or Type Related SWR r
Incomplete or illegible applications will not be accepted called _
Name of DevelopmenuProject FIXTURES,;p"Ividual)tZ4,
.lob //'// 1 Shalt 9.00
Address Street Address I Suds La111ory 9.00
Tub or TuWShower Comb. 9.Q0
Bldg 0 City/State Zip Shower Only 900
7-i� .MZD 4X!. Water Closet 9
Name .00
+J Dlatmasher 9.00
Owner Mailing Address SWIG Garbage OispOw 9.00
---- Washing Machin 0.00
city/State zip Phare Hoar Onimin r 9.00
Name
r 9.00
4- 9.00
Occupant Matlkq Address Suds Water Mesta► 9.00
Laundry Room Tray 9.00
Cilylstate ZIp Phone urinal - 9.00
Nana
Otter Ftltttlrea(Spat*) 9.00
9.00
ontractor Madln9 Address Surto 9.00
yc- 9.00
�Irtor to issuance Cky/Sfata ZIp Room _
applicant must 0.00
provide all Oregon Const.Cont.Boast Lic• G:.p.Osla9.00
contractors "" s-y j G910V
_ 9.00
I cons@ Pkim"Lit:.9 Exp.Data Sewer..,st too' 30.00
irlformation / I _r J} wo Sewer-each additional 10(Y 25.00
fix COT COT Bta rw%s Tax or Wtro• Exp.Date Water _to 100' -
database). 30.05
Name - - Water Service-each additional 200' 25.00
Architect Storm&Ran Oran-1st too' 30.00
of Malting Address Sade Storm d Rain Drain-cadt addill"100' 25,00 - -
Mobile Home Spam 25.00
Enyineer Qty/Slade Zip Phone Cortrnerrssl Back Flow Prevenbon Dewce or Aral_ 25.00
_ Pollution Devi=
',escnbe wort New O Acr'win 0 Alteration 0 Repair 0 Residential Backflow Prevention Device' 15.00
tM done Residential O hon residential O Arty Trap or Waste Not Connected to a Fixture 9.00
aeihonal description of worlt �- _
Catch Basin 9.00
Insp.of E�ost-19 Plumbing 40.00
per/hr
-- --- Specially Requested Inspections --- - 40.00
crating ise of
.:udding or property _ _ perfhr
Ram Drain,single family dwel!nq 30.00
ropnsed use of Grease Traps 9.00
iddtng or property
__ QUANTITY TOTAL
a You Cdppng. m°vV1() Or replacing any flxtURs? Yes❑ No 0 1 �or rtfat diagram b reouw"d Quenfy Total to >9 _ •: t w.;r :..s
If yes"s back of form) 'SUBTOTAL
hereby acitnowrkege that I have read thin appliption,that the information
rven is correct that I arr•7V-,owner or authonzed agent of the owner, and 5% SURCHARGF.
hat plans submitted are-n compliance with Oregon State Laws. '-
:Ignat'u .nf OwnerlAgent Date PLAN REVIEW 25% OF SUBTOTAL , ~
qrrauraa orw fpn.e poky s>9
- - TOTAL
:of biet Perum Nagle pen _ _ /7`i 7
'Mlnlrn ml permit fee o$25-+ 5%-surcharge.except Residential Backflow
44 703--2W-7 Prevendw Device.whrdi is S15•5%surcharge
Uplmapp.doc 12/96 (dst)
'LEASE COMPLETE AS APPROPRIATE TO PROdFcr•
Fixtures to be capped, moved cr replaced Q
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"-
4f?
"4" _
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
',OMMENTS REGARDING ABOVE:
1:\p1mapp.doc 12/96 (dst)