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13533 SW BRIM PLACE w cn W W N X r I 13533 SW BRIM PL � I I SITE WORK PERMIT CITY OF T I G A R D DEVELOPMENT SERVICES PERMIT # : SIT2003-00008 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED : 5/16/03 SITE ADDRESS: 13533 SW BRIM PL PARCEL : 2S104CD-07200 SUBDIVISION: HILLSHIRE ESTATES ZONING : R-7 BLOCK- LOT: 072 JURISDICTION : TIG CLASS OF WORK: OTR PAVING ?: RESO. NO: TYPE OF USE: SF GRADING ?: VALUE: 2,000.00 EXCV VOLUME: cy LANDSCAPING?: FILL VOLUME: cy SITE PREP ?: ENG FILL?: STORM DRAINS?: SOILS RPT REQD?: IMPERV SURFACE: sf Remarks: Retaining wall. Owner: —_---- _ FEES_ - ALLERS, MARK + JENNIFER Description Date Amount 13533 SW BRIM PL — TIGARD, OR 97223 113U1LDJ Prmt Fee-Valu 4/30/03 $62.50 1 13UPPLNj Pin Ck-Valu 4/30/03 $40.63 Phone: 503-579-3015 1 1'AXj 8Q1n 5t`fax Valu 4/30/03 $500 Total $108.13 Contractor: _— OWNER Phone: Reg #: Required Inspections Final Inspection 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 Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699. Issued By: f ` Permittee Signature: _ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Site Work INN MaND61'. Building Permit Application)+ Received Building —Date/By: Permit No.St-r O 'ooDd r� CityCit of Tigard Planning Approval Other g Date/By: Permit No.: _- 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By! Permit No.: Date/By:Phone: 503-039-4171 Fax: 503-598-1960 Dy: land Use ate/ Case No. Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: _ Ma Supplemental Information _ TYPE OF WORK _ _ REQUIRED DATA: New construction Demolition I &2 FAMILY DWELLING Additio ieltgratio lacctne:,( 7Other: GORY OF CONSTRUCTION Note: Permit fees'arc based on the total value of the work performed. Indicate 1 & 2-Fam11 dwelling C'otnmercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, _._ •��_— -- overhead and profit for the work indicated on this application. ,'kcccss,-- Building-- Multi-Famil Master Builder Other: Valuation.................. 5 2-ow-co JOB SITE INFORMATION and LOCATION No.of bedrooms: No.of baths:--__ _ — Job site address: 1 Total number of floors..................................... New dwelling area(sq.ft.).............................. Suite#: B1dg./Apt.#1_ I r f Garage/carport area(sq.ft.).......... ................. Project Name: Covered porch area(sq.ft.)................ ............ —------ - -- Cross street/Directions to job site: Deck area(sq.R.)............................................ _ Other structure area(sq. ft.)..... .. . ................. REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: — Tax map/parcel#: Note: Permit fees•are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Valuation......................................................... S -- ----- Existing building area(sq.ft.)......................... - — -- ---------- New building area(sq.ft.)............................... Number of stories............................................ PROPERTY OWNER TENANT Type of construction....................................... Name: Occupancy group(s): Existing: `i-- New: _ Address:__l SL• City/State/Zi NOTICE: All contractors and subcontractors are required to be Phone: 1'If - _ Fax: APPLICANT CONTACT PARSON licensed with the Oregon Construction Contractors Board under 171 _ -- provisions of ORS 701 and may be required to be licensed in the Business Name:__ ___ _ jurisdiction where work is being performed. If the applicant is exempt Contact Name: — from licensing,the following reason applies: Address: ----- �---------__ — _ --- --- ---- Cit /State/Zig ------------------- Phone: BUILDING PERMIT FEES" E-mail: CONTPlease refer to fee schedule. ttACTO _ - — -Business Name: OW(yeo;& _ Fees due upon application.. ..... ... ... . g Address: City/State/Zi � Amount received......................................... ... S Phone: Fax, Date received- CCB Lic. # -. ------ - Authorized _` Notice: This permit application aspires If a permit Is not obtained ssitldn Signature: _ Date:(A-J /�� 180 dais after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. (Please print name) n(� i:\Dsts\Permu Forms\BlclgPermitApp.doc 01103 SITE WORK PERMIT CHECK LIST Commercial, Multi-Family (R-1 occupancy) and Residential: Please complete all items below, unless otherwise rioted. Excavation Volume: cu. yds. Grading Volume: (Soils report required for>5,000 cu. yds.) cu. ycls. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum densit cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other *Total new impervious area including all buildings, sidewalks, and paving sq. ft. Site Utilities Plumbing Work: Complete the Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit Application - Plan Submittal Requirements" attached. The following must accompany this application: Site Plan with Vicinity Map showing *Parking (including ADA)and ADA compliance _ Lihtin Plan Grading Plan and details *LandscapingPlan _ Erosion Control Plan anddetails Soils Report if required) Retaining Structures *Does not apply to 1 and 2-family dwellings. # of Plans TYPE OF SUBMITTAL Required at (Includes New, Additions or Alterations) Submittal Commercial 4 Multi-Family R-1 Occupancy 4 One- & Two-Family Dwelling 4 NOTE: Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). i.%dsts\forms\SIT-checkhst.doc 01/29/03 05/07/2003 wl:U 15: 12 FAX 503 2767643 Tripwire, Inc. Z002 002, U5/U7/UJ 1L: JJ r•AA OU354t$3525 - ,-WATHK SERVICES 16 001 04/50/200a 11'33 FAX 5036847297 city of Ticard 002/11- 3 RECEIVED 4141, w APR 3 0 7_D03 oF i IGARD C;1eanWater Se.rvl 'es _ File Number OLor coinnlitM ll, it citlar. �y• ��`�� -- Sensitive Area Pre-Screening Site Assessment /0`4270 JurisdIcAlon C' C gate LA3eb Map &Tax Loi _ Owner Site Address Contact _ Proposed Activity C,J \\ Address X333 Sk .-t L.Qt Picone -- -- offtgial uaW only heluw this lino Y N NA Y N NA L] ❑ sosltive Area Cnmposit6 Map ❑ ❑ Stormwlater infrastructuro maps Map#_ �� _ 2_ -- CQ8 #__ NNIS -- - - Y N NA Y N NA 17 IL �� I ocaily aduptud studip-s or reaps ❑ ❑ Other !>Porlfy -- -- - - Speuify govi& ..vr.i og4 Based an n review of the above friformatlon and the requirements of Clean Water Services ueslun and Coitstructiuli Standards Resolution sand Order No. 00-7: Ll Sensitive areas potwitially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SI:=RVir.F PROVIDER LETTER OR STORMWATER CONNECTION PERMll, if Sensitive Areas exist on tho site or wlthhi 200 feet on adjacent properties, a Natural Resources Asspissm©nt Report may also tae required. Sonsitive areas do not appear to exist on site or within 200' of the site. 'I-his pre- screening elte a.ssessinent dors NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered on your property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATF_R CONNECTION PERMIT. j Ti-, proposed activity does not meet the definition of developmc it. NO SITE ASSESSMENT OR SERVICE. PROVIDER LETTER IS RLQUIRED. Comments: �]� l .ta4(ern V,it view o ds;r"* 0,4d ��'Jo1 k-.Cr1�J,a' T A.�r�v T�c.... 7� 496 e—/�O/yfCnr oa:�� Ate• ',,!Dw/i'dra-f�.�L�r I'JC p lKj1r2io rger.�..I.�.y..�,_ Reviewed By: e' .�-+C_i -ti.�r..C.�. Date: -- &�'ZV9 3 ------ Post-le - --post-le Fox Note 7671 Dates f D ► / Refurtwd to Applicant To From Mail Fax te Ic- Counr r c Dale _ °as By Phone N Phone M,So�_liyti6- 3 S S/ Fax 0 0 l r i e• • 41041 A4 4K (Pit V7-1 C Of'PrOt) . / r4 V S GI�Y OF TIGARD I onditionelly prov,,d,„-_•. ' ' ar only the w rk de�cribpd fn 1 PEHMI?NO .�15 . SAe 1 ette' to p-P..�.-.Q���–� i allow Job Art ch r f — 13y, 04/29/2003 TUE' 07:05 FAX 503 2767643 Trtpwlre, Inc. [4j002;o05 Catch basis located 9" below drain discharge with river ; •,•• : ' rock cover. — —_ _. �. 'High strength IQ c;oncaVb fid with a 1 hole fq( discFlq'r9p -- ';1 hold for blectrical wirQ-wjtl-t rubber garment, 4 role8 h-& 1 114" `� wire meshiq_g_ discharge line to be buried 18" 115V, 60 HZ to a junction — — box with breaker - wiring for junction box is buried Flotec FPOS 1800A -- 18" inside electrical pipe ' Hf' 2880 gal/hr @ 5' of __ _- to junction box at house /4 head _. — _._.. \ C)w. Catch basin is backfilled with '/4" gravel 04/29/2003 TUE 07:05 FAX 503 2767643 '1'ripwlre, Inc. 14003/005 - -- #4 rebar vertical and hoizonatal 4' 211611 . . .,. 61' 12" 1 C:.3in tube with sock run the entire length of wall 04/29/1003 TUE 07:05 FAX 503 2767643 'Tripwire, Inc. f�004;005 r N N rt►. tt.f • / 1 I ^ 1 Y 1••• \ 1 1 1 1; I [ d f.t.1 1 1 VLi 1 1 I t Y CIDy w s Irl... • 1 ft.. . 111•.. tit. in N i 04/20/2003 TUE 07:06 FAX 503 2767643 Tripwire, Inc. 11005/005 Flotec Submersible Pump 1/4 IiP Sump Pump Model FPOS 180OA03 Automatic submersible -amp pump Maximum pumping capacity up to 2880 GPH Plastic construction Includes float switch and 8"power cord 1-1/4 discharge Power Type: Electrical Flotec Sewage Basin & Lid Model FPW73-15 22-gallon sewage basin Corrosion resistant, thermoplastic construction , . , • Material: Thermoplastic Diameter: 18" „ Length: ••,•, ' 18" Width: 18" ,..•. Depth: 24" •••• s • . • • •.•• I GA r•y D ELECTRICAL PERMIT CI i Y OF K PERMIT#: ELC2003-00242 DEVELOPMENT SERVICES DATE ISSUED: 4/30/03 13125 SW Hall Blvd., Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S104CD-07200 SITE ADDRESS: 13533 SW BRIM PL ZONING: R-7 SUBDIVISION: HILLSHIRE ESTATES BLOCK: LOT: 072 JURISDICTION: TIG Project Description: Install(1)branch circuit for lighting to retaining wall. RESIDE1 TIAL UNIT ___ TEMP SRVCIFEEDERS_ MISCELLANEOUS 1000 SF OR LESS: 0 ' 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICEIFEEDER. BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/St-RVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ __PLAN REVIEW SECTION 1000+ amplvolt: ­4 RES UNITS: _ > 600 VOLT NOMINAL: Reconnect onyx—_ SVCIFDR—225 AMPS: _— _ CLASS AREA/SPEC OCC: —� Owner: Contractor: ALLERS,MARK+JENNIFER OWNFR 13533 SW BRIM Pl. TIGARD,OR 97223 Phone: Phone: Reg #: FEES Description Date Amount _ Required Inspections )I 1,11RM1'1 ELC Permit 4 'O W $46.85 - ----- -- 1 1 R Statc Tax a 111 n3 $3.75 Rough-in F Elect'l Final Total $50.60 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 wirk Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to O AIC a (503)246-6699 or 1-800-332-2344. Issued By: c�r.t_Ct CL rtyL,.�c r_/f E Permit Signature: e \ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE:— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:_ _— LICENSE NO ------ Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application ' ' ' ' Received Llccalcal Date/By: PermiINo.4LLk-OD3 oOc>Z City Of Tigard Planning Approval Sign y Date/By: 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 I-and Use Date/By: Case No. Internet: www.ei.tigard.or.us Contact J�tris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method. upplemental Information. T t TYPE OF WORK_ PLAN REVIEW(Pscheck all that apply) New construction Demolition — Service over 225 amps- Health-care facility -- commercial [3 Ilaaardous location _❑ Addition/alteration/replacement Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, _ CATEGORY OF CONSTRUCTION I&2 family dwellings four or more residential units in I &2-Family dwelling ❑Commercial/Industrial ❑System over 600 volts nominal one structure ❑Building over three stories ❑Feeders,400 amps or more Accessory Building _ Multi-Famil _ G Occupant load over 99 persons ❑Manufactured structures or RV park _Master Builder EJ Other: _ _ _ ❑egressnighung plan ❑Other: JOS SITE INFORMATION and LOCATION Submit_sets of plans with any of the above. The above are not applicable to temporary construction service. Job site address: FEE*SCHEDULE Suite#: Number t�#_ - --- N_umber of It cc(ons per permit allowed Project Name: _ Description city Fee(ea.) Told New residentlal-single or multi-famlly per Cross streetmirections to Job site: dwelling unit.Includes attached garage. Service Included: 100(1 sq.0.or less 145.15 4 Gach additional 500 sq.ft.or portion thereof 33.40 I Subdivision: Lot#: Limited energy,residential 75.00 _ 2 Limited energy,non r:sidential 75.00 2 Tax ma / arLel#: Each manufactured home or modular dwelling ESCRIPTION OF WORK service and/or feeder 90.90 -2- Services Ser ices or feeders-Installation, - alteration or relocation: 200 amps or less _ 80.30 2 201 amps to 4M amps 106.85 2 401 amps to 600 amps 160.6G 2 !FR,OPERTY OWNER TENANT aJ 601 amps to 1000 amps _ 240.60 2 Over 1000 amps or volts _ 454.65 2 Name� ��t� �__ Reconnect onl 66.85 2 Address: \� �3 5;,, , �;s*„ Temporary services or feeders-inatallation. alteration,or relocation: Ci{_L�StCity/State/Zip: - �7I 2Gf)amps or less 66.85 I_ _ _ C t. . 201 amps to 400 amps _ 100.30 2 Phone: ,x e - Fax: 401 to 600 ams 133.75 2 APPLICANT CONTACT PERSON _ Branch circuits-new,alteration,or Name: extension per panel: Address: _ A.Fee for branch circuits with purchase of — service or feeder fee,each branch circuit 6.65 2 City/State/Zi : _ 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 irrigation circle 53.40 2 ---- — Each sipor outline fighting _ 53.40 _ 2 Job No. , ,w ay Signal circuits)or a limited energy panel. Business Name: alteration,or extension Page 2 2 Description Address: -- - - Each additional Inspection over the allowable In an of the above: City/State/Zip:/State/Zip: _ _ Per inspection per hour min. I hour 62.50 Phone: Fax: Investigation fee: _ --_ f- Supervising Lic. #: Lie.M Other: _ .__ Electrical Permit Fees* Supervising electrician _ Subtotal S�f� _ signature re uired: _ Plan Review(25%of Permit Fee) S Print Name: Lic.#: State Surcharge 8%of Permit Fee $ - TOTAL PERMIT FEE S Authorized Notice: This permit application expires If a permit is not obtained within Signature- _ Date: 4 `_ 190 days ener It has been accepted as complete. *Fee mcthodologv set by Tri-County Bullding Industry Service Board. (Please print name) i\Nts\Permit Fornrs\F1cPemulApp doc 01103 h Electrical Permit %pplication - City of Tigard : Pale 2 - Suppletnuil:rl lufornrition L1Vi1'llD I:NLRGY v,:in11T FEES: RESIDENTIA' WORK ONLY: Feeall systems........................................................... $75.00 Fx, (he-k'7%pe of Work Involved: A aio and Stereo Sestems* r] taut it Alarm ciarage Door Opener* ❑ I kmting,Ventilation and Air Conditioning System* Vacuum Systems* Other _ - - --- --- - COMMERCIAL WORK ONLY: Feefor each system.......................................................... $75.00 (Sri-"OAR 918-260-200) Check Type or Work involved: Audio and Stereo Systems Boiler Controls Clock Systems E] Data telecommunication Installation Fire Alarm Installation IIVAC Instrumentation Intercom and Paging Systems Landscape Irrigation r`onlrol* Medical Nurse('alis Outdoor landscape Lighting* Protective Signaling [] other_ ---_— Number of Systems * No licenses are required. Licenses are required for all other installations i:\Dsts\PetmitFomu\ElcPerrnitAppPg2.doc 01103 CITY OF TIG/ARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business I.Ine: (503)639-4171 BUP _�—__-- Received nate Requested, I I _�—_—__- AM--- PM__ _ BLIP — Location MEC Contact Person Ph( ) ___ PLM _ Contractor —_—_`_ Ph( ) SWR BUILDING Tenant/�er �1`�.� O , _-- ELC Footing P ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT - Post&Beam --- Shear Anchors -- Ext Sheath/Shear ���'�,���' ,- - -_ ---_ Int Sheath/Shear Lo- 1�� Framing [Q --- --- --- -- ----- ---- Insulation Drywall Nailing L[.` S`Ti� dF" GyAu.. c�Ntz' -TG=, [ l�c:.�• — - -- -- Firewall Fire Sprinkler - aYct�/iCE l ¢�f �L��•= ;=� �.c S�Lacc.! -- _-- Fire Alarm Susp'd Ceiling ----- — ---- ---- Roof Ott,ir: - i{ _ YAS _ RT FAIL PLUMBING Post&Beam Under Slab — Rough-In Water Service ----- Sanitary Sewer Rain Drains - -- - Catch Basin/Manhole Storm Drain - -^ Shower Pan Other: _. - -------- Final PASS PART FAIL MECHAN_ICAL___ Post&Beam _ Rough-In Gas Line .Smoke Dampers - _ -- ---- -- - --F.-1,11 PASS PART FAIL - - - - - - -- ELECTRICAL Service - --- - Rough-In UG/Slab Low Voltage Fire Alarm Final El Reinspection fee of$__..._- _required before next inspection. Pay at City I fall, 13125 SW 1 lall Blvd. PASS PART FAIL SITE Please call for reinspection RE: -_ _--_� -_ Unable to inspect- no access Fire Supply Line ADA Approach/SidewalkDete `` —� Inspector Ext--- Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL I