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11571 SW ELTON COURT ,r %, 4 �V• Y ; Opv _c 1A � s t oa .9 ! �> 4.1 CPI a 4- tu — Ce\ {� N ^t i ` ) V Go»C. Yap /1 QOGV( �-- A pv "� 000 � � � `rte- —�.._ - - - �_1.�� L• ------•---------- .__ -._ "�� _____ _ - 1, �` M_ ._ �.-._.-�H.tiJr..r__ •-' w.�wvw.wv.�.r-•w r.�_•r._.-.-- .-...w .�......._. ��r.ra�O..�r._..-.-. �._..✓r.+wY+..rw�ww•�1�.. ++w+�wM.r .. ...r._+w rw ✓w��w+.��w.....A r..-.-r......._.-..r .«... ..rtr....-rr.r.w..i.w-. ..r.�.�,w. r. �.-w-w.w.r....`.�.r�..�r _..__ _.. u � , illi Ali � I ' ' ' l ' � I r� i ij-� � i � i � � iii i � � Ali Ali � � � ilti � � i � � i iii � � � � r� r err ii � i ij � 1 gI' llli p-rrT-p ijillii ill lip ill � � � i - NOTICE: IF THE PRINT OR TYPE ON ANY ( I I I ( i i f 12 y { IMAGE IS NOT AS CLEAR AS THIS NOTICE, ITIS DUE TO THE QUALITY OF THE No.�s � '�'�.^'• _ __ _ !_�------ — -- _._ --- _ -- —_ — __. __ _ _. _ _ _�. �_ ___ ORIGINAL DOCUMENT TZol 6 8 L 8 ' I M�' � ► i 11. 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Illi lllllllllli{�IIIlillll, ,�IIIIIIIIIIIII�lillll,llllilllflilli��► i�llli 1 `� 4 N m 0 0 n 0 11571 SW Elton Court Ci i r ur TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 , d 0 INSPECTION DIVISION Business Line: (503)639-4171 , BUP _ Received — --Date Requested�� s u�' AM— __— BUP Location 1 r� /_! 1- I ._-- -- Suite_—_ MEC Contact Person —/-- Ph( _) . — PLM Contractor ✓L' l - � lf G�`�� — Ph(.— ) _— SWR BUILDING _ Tenant/Owner . — — ELC Footing — ELC _ Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear — — Int Sheath/Shear Framing Insulation Drywall Nailing � --�— - - --- - ---- Firewall Fire Sprinkler ----- --_.._------ --- -- ----- --- ---- Fire Alarm Susp'd Ceiling — -- .-_- ----------- -----�------------- ------ Roof Other: -- ---- ---------- ----- ---__ __ --.-____--_- ---- Final PASS PART FAIL ----------- Post&Beam Under Slab — -- -- — —- —--------- --- ------ ---- ---- -- Rough-In Water Service — Sanitnry Sewer Rair,Drains - — ---------------- ...-- ---- —-- Catch Basin/Manhole Storm Diain ---- — -----___ -- — _._—_ Shower Pan Other: --- Final PASS PART FAIL --�- ---- - - --- —_--- -- --- MECHANICAL__ _---- Post&Beam Rough-In ----_-- -- ---- ---- --_ -------- -- Gas Line Smoke Dampers -- _-- ---- ---- -- ----__ _-_ — Final PASS _PART FAIL —�- -------- -----" - --- — L Service Rough-In ---- UG/Slab Low Voltag ---- Firc Alarm dim F] Reinspection fee of required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. EEM PART FAIL F] Please call for reinspection RE [� Unable to inspect-no access Fire Supply L;,ie ADA Approach/Sidewalk Date Inspector ___ << qL� Ext------ Other: ---- Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour Inspection Line: (503)639-4175 BUILDING MST . -----c - - .----.. J INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received Date Requested AM_--__ PM----- BUP - -- Location S �--- p- �Y�--- - -_Suite - MEC Contact Person -___- Ph( _) _ PLM Contractor— - Ph(___ ) ._ - SWR BUILDING Tenant/Owner ELC Footing ELC - - - Foundation Access: Ftg Drain EI_R -__ -- -- Crawl Drain ------- - - SIT Slab Inspection tloles. Post&Beam f- - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - --- ---. __ Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling Root Other: -------- --- - --�--- - — Final ' P RT FAIL L - - LUMBIN - --- --- Under Slab — Rough-In Water Service ' Sanitary Sewer _ Rain Drains Catch Basin/Manhole -- Storm Drain Shower Pan -_____—_.---- ----— Other: QASS_ ' PART FAIL ANICAL Post A Beam- -- -_ Rough-Ir Gas Line Smoke Dampers Final _PASS PART FAIL - ELECTRICAL - - Service Rough-In -- UG/Slab Low Voltage --------- -- _---"-----_ Fire Alarm Final ❑ Reinspection fee of$ _. _ required before next inspection. Pay at City Nell, 13125 SW Hall Blvd. _PASS PART_FAIL _SITE ❑ Please call for reinspection RE:_ —_ __—__ -- ❑ Unable to inspect-no access F,.q Supply Line ADA Date Inspector_ Approach/Sidewalkt+-T" - Other:.-.------- Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL G W -,�A�AA�AAAA�►A� tAAAAAAAAAAAAAAA AAAAAAAAAAAAAA, A pop. A110.r 4 lop. A O pop. A oil. 110. . W A � A I No. A pool fj o ► -� Q ► V - ► 44 v ► a s ► o * s. H H o .� �o Q Q ► � v -d ` ► A . ► O " bn ► W U � v 1 U u P ■� ^d ► ► 44 SN � 10, poll t � i w b � ► . ► I ► . r A.. lop.a Q • ► t A G U ► . � �►♦vvvvivevvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv� Street 'Thee Planting List .and Use & Development Stand:rets __j Ash, Green;fraxinus pennsylvanica Ash, Raywood; fraxinus oxycarpa 'Raywood' Ash, White, fraxinus americana Bec,�h, American; faqus grandifolb Beech, European; Tagus sylvatica Birch, Whitespire, Japanese White; bet ila;)latyphylla, varjaponica Blackgvin, nyssa sylvatica Cherry, Flowering; prunus sp. Coffeetree Kentucky; gymnocladus dioicus Dawn Redwood, metasequioia glyptostroboides Dogwood, 1'ousa; cornus kousa Elm, American, Ufmus americana Elm, Lacehdrk or Chinese; ulmus parvifolia Ginko, gmko biloba Goldenrain Tree, koelreuteria paniculata Hackberry, Common; celtis occidentalis Hawthorn, crataegus Honeylocust; gleditsia triancanthos, 'var.inermis' Hophornbeam, American; ostrya virgiana Hornbeam, American, carpinus caroliana Hornbeam, European; carpinus betulus Japanese Snowbell; styrax japonicus Katsura Tree; cercidiphyllum japonicum Lilac, Japanese Tree; syringe reticulata Linden, American; cilia americana Magnolia, Cucurnbertree; magnolia acuminata Magnolia, Star; magnolia stellate Maple, Black; aver nigrum Maple, Hedge; acer Campestre Maple, Paperbark; acer griseum Maple, Red, acer rubrum Maple, Sugar; acer saccharurn Maple,Tatarian; acer tataricum Maple,Trident, acer buergeranum Oak, English; quercus robur Oak, Northern Red; quercus rubra Oak., Oregon White, quercus garryana Oak, Pin, qw rcus palustris Oak, Sawtooth; quercus acutissima Oak, Shingle; quercus imbricaria Oak, Shumard: quercus shumardii Oak,Swamp White; quercus bicolor Oak,Willow; quercus phellos Pagodatree (a.k.a. Scholartree); sophore japonica Poor, Callery;pyrus clleryana Redbud; carols Serviceberry; amelanchler Sweetgum, American; liquidamber styraciflue Zelkova; zelkova serrate i:\dsts\forms\Street7reeLlst.doc 08/30/01 Street Tree Planting Requirements Community Development Code 18.745.040 Street Trees Cit ,of Tigard I C. Size and skint;of street trees. 1. Landscaping in the front and exterior side yards shall include trees with a minimum caliper of two inches at four feet in height as specified in the requirements stated in Subsection 2 below; 2. The specific spacing of street trees by size of tree shall be as follows: a. Small or narrow-stature trees under 25 feet tall and less than 16 feet wide branching at maturity shall be spaced no greater than 20 feet apart; b. Medium-vized trees 25 feet to 40 feet tall, 16 feet to 35 feet wide branching at maturity shall be spaced no greater*hati 30 feet apart; c. Large trees ov;r 40 feet tall and more than 35 feet wide branching at maturity shall be spaced no greater than 40 feet apart; d. Except for signalized intersections as provided in Section 18.745,040 I1,trees shall not be planted closer than 20 feet from a street intersection,nor closer than two feet from private driveways (measured at the back edge of the sidewalk),fire hydrants or utility poles to maintain visual clearance; e. No new utility pole location shall be established closer than five feet to any existing street tree; f. Tree pits shall be located so as not to include utilities(e.g.,water and gas meters)in the tme well; g. On-premises utilities(e.g.,water and gas meters)snail not be installed within existing tree well areas; h. Street trees shall net be planted closer than 20 feet to light standards; i. New light standards slial not be positioned c:aser than 20 feet to existing street trees except when public safety dictates,then they may be positioned no closer than 10 feet; j. Where there are overhead power lines,the street tree species selected shall be of a type which,at full maturity,will not interfere with the lines; k. Tires shall not be planted within two feet from the face of the curb;and 1. "frees shall not be planted within two feet of any permanent ha:d surface paving or walkway; (1) Space between the tree and the hard surface may be covered by a nonpermanent hard surface such as grates,bricks on sand,paver blocks and cobblestones;and (2) Sidewalk cuts in concrete for tree planting shall be at least four by four feet to allow for air and water into the root area. i:\dsts\fonns\StmetTreeCOde.dlx 08/30/01 C) n rp p EL ~ N ro con " n � a 001\ r0 o N Nod o v ti I' b a w � n 4 I � CD o r N 0 V7 a 1 o � � c g �T, F ' O A i• S �e x __I PERMIT NO.ZcZ-vaLL EROSION CONTROL INSPECTIOIS REPORT DATE INSPECTOR -Tu"i F-iu..uc.¢. CleanWater Services OWNEIt/PERMITEE L eGC.(.Y �LLccar + �- c� SUBDIVISION �-h��c�_c _A LOT SITE ADDRESSI I Y_7/ S.IAJ_ l Jfoj C4 A "OV D PP11 E p: FINAL INSPECTA � ,. THIS SITE MEETS THE POST-CONSTRUCTION EROSION CONTROL REQUIREMENTS Q TS SET FORTH IN CLEArw WATER SERVICES RESOLUTION AND ORDER NOTE: IF POST-CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING EMPLOYED ON THIS SITE TO MEET CRITERIA'FOR AN APPROVED FINAL INSPECTION, THE MEASURES)MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE OR PERMANENT GROUND COVER IS ESTABLISHED. A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL. OTHER THAN YOU FOR YOUR COOPERATION! INSPECT _ -- - PHONE 8y6 - F�tk CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST �1��-Gu ZG INSPECTION DIVISION Business Line: (503) 639-4P�1 BUP �- � � AM (-._. �M�/��n � BUP Received ___ _ Date Requested-// Location S ✓_f�,(f�,� C � - Suite —_-- MEC ( —) 1- Contact Person — Ph t (oPLM Contrac ---- _ Ph ( ) SWR - --- � — UILDIN Tenant/Owner _ ELC -- ------- Footing ELC - Foundation Access: Ftg Drain ELR - Crawl Drain - -- --- --- - SIT Slab Inspection No'(-;. Post&Beam -- - — Shear Anchors Ext Sheath/Shear - Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof her. - ------ - - -_ --� J Find-' -- PART FAIL / Nd _ - ---- -t�l-- -- --- - -- Post&Beam Under Slab ------ Hough-In Water Service --- ---— ----- — - - -�- Sankary Sewer - Rain Drains -- —------ Catch Basin/M inhole - Storm Drain -- ----------- -- - — —_---_-_� Shower Pan ------ Other.---- ---- - ---------— Final - ---------- —- ---------- __—� PASS PART FAIL Post&Beam Rough-In - --- --- - -- -----------_ Gas Line _- Damp wl; -- -- Fi PART FAIL `--- -_--- -- ,--- -- Sery a — Hou In _— UG/SI b Low Voltage ------ _ - --- - -- — !9rm final /'t•--- L_.1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd. 'PASS PART FAIL SITE _ Please call for reinspection RE:_ Unable to inspect-no access Fire Supply Line A ADA Date__ ) ()\'�� Z� lettspe�tor Approach/Sidewalk - - Other: Find DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL MASTER PERMIT CITY OF T I G A R D PERMIT M MST2002-00269 DEVELOPMENT SERVICES DATE ISSUED: 6/26/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11571 SW ELTON CT AS SHOWN ON PLAT PARCEL: 2D1038D-10000 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 012 JURISDICTION: TIG REMARKS: Construction of new SF detail led residence. Path 1 BUILDING REISSUE: STORIES: 3 FLOOR AREAS REQUIRED DCTQaCKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 931 at BASEMENT: 420.00 at LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 9ECOi:O: 1,180 sf GARAGE: 440 sf FRONT: 20 PARKING SPACES: 2 RIGHT: 5 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 0 at VI.LUE: $237,968 60 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2.09100 at REAR: 1� PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER I,NES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUSISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER INES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<1100K: BOIL/CMP<2NP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FLIRNANCE9: VENTS: 1 WOODSTOVE3' GAS OUTLETS: 1 ELECTRICAL AADD'L INSPECTIONS RESIDEN1ll UNIT _ 9ER�nCE FEEDER TEMP SR'/CIFEEDER9 BRANCH CIRCUITS MISCELLANEOUS WISVC OR FDR: I PUMPIIRRIGATION. PER INSPECTION. 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: PER HOUR. 1st WIO SVCIFDR: 00 SIGNIOUT LIN LT: EA ADD'L SOOSF: 4 201 400 amp: 201 400 amp: IN PLANT LIMITED ENERGY: 401 800 amp: 401 600 amp: EA ADDL BMINOR LABEL CIR: SI OR LAABBEL. EL: MANU HM/SVC/FDR: 601 1000 amn: 601-amps-1000v: 1000+amplvolt: PLAN REVIEW SECTION Reconnect only: >-4 RES UNITS: 9VCIFDR>-225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY B.COMMERCIAL A.SF RESIDENTIAL AUDIO 6 STERE VACUUM SYSTEM: AUDIO 6.STEREO: FIRE ALARM, INTERCOMIPAGING: OUTDOOR LNDSC LT: BOILER: HVAC MEDICAL: PROTECTIVE SIGNL: BURGLAR ALARM: OTH: MEDICAL: OTHR. GARAGE OPENER: CLOCK: INSTRUMENTATION: DATAI'f ELE COMM: NURSE CALLS: TOTAL a SYSTEMS: HVAC: TOTAL FEES: $ 7,175.99 Owner: Contractor: This permit is subject to the regulations contained in the LEGACY HOMES LLC LEGACY HOMES LLC Tigard Municipal Code,State of OR. Specialty Codes and PO BOX 446 PO BOX 446 all other applicable laws. All work will be done In SHERWOOD,OR 97140 SHERWOOD,OR 97140 accordance with approved plans. This permit will expire if work Is not started within 180 days of issuance,or If the work is suspended for more than 180 days. ATTENTION Phone: Oregon law requires you to follow rules adoFted by the Phone: Oregon Utility Notification Center. Those rules are set Reg N: LIC r,46e7 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8� WIT Proofing Bsm't We Footing/Foundation Dn Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Grading Inspection Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Insulation Insp Mechanical Final Sewer Inspection Post/Beam Mechanlca Mechanical Insp Shear Wall Insp Footing Insp Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Low Voltage Water Line Insp Final Foundation Insp Crawl Drain/Backwater Electrical Service Inspection L. Permittee Signature Issued By : � ��'��'a- Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGAR® SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00175 13125 SAN Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/26/02 PARCEL: 2D103BD-10000 SITE ADDRESS; 11571 SW ELTON CT AS SHOWN ON SUBDIVISION: RLN rER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: ()12 _ JURISDICTION: TIG 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 permit for new SF residence. Owner: FEES LEGACY HOMES LLC Type By Date Amount Receipt PO BOX 446 SHERWO 46 OR 97140 PRMT CTR 6/26/02 $2,300.00 27200200000 INSP CTR 6/26/02 $35.00 27200200000 Phone: 503-925-0506 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agencyrhe 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 the sewer is not located at the measurement given,the installer ..hall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION. Oregon law requires you to follow re', s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR -001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the ext bt 4ess day Building Permit Application -- u-- —~�� Date reccived4� City of Tigard . ,> ProjecUappl.no.: Expire date: Cityn/'Tigard Address: 13125 SW hall Blvd,'I it-.0 1. iR 97223 Phone: (503) 639-4171 Pr. Date issued: By Receipt no.: Fax: (503) 599-1960Case file no.: Payment type. .t �.It t i _}4'•-_jA.� Land Use approval: 1, moi._r ____ 1&2 family:Simple Complex: 9F PERMIT I &2 family dwelling or accessory U Commercial/industrial U Multi-family of New construction U Demolition Addition/alteration/replacement U"Tenant improvement U Fire sprinkler/alq:m U Other: 1 1 1 Joh address: 1 1,5.1 I ]VV E,I roQ 7. Bldg.no.: I suite no.: Lot: 12, 1 Block: subdivision: J1JTvz's LA l'ax map/tax lot/account no.: 1000 Project name: . I " � ; IZ20gq 153 _ Description and location of work on premises/special condrtnms: 1 ' SPECIAL INFORMATION, Name: LEGACY NOMES�I •l- C, (Flood plain,%eplic capacity,solar,etc!. Mailing address: C) px �INro I & 2 family d"elling: L- �. City: gH OO D state: R LIP: Valuation of work........A337 ........,.. $lrb&M6i 00 Phone: Zt) Cax: M-e E-mail: No.of bedrooms/baths................................. Owner's representative: bepre `. Total number of floors................................. Phone; I ax: F-mail: New dwelling area(sq.ft.) .......................... —.—Z.-5 Garage/carport ahrca(sq. ft.)......................... q0 Name: '< ()(,( t'jcl~ Covered porch area(sq, ft.) ......................... -- Mailing address: Deck arca(sq.ft.) ........................................ - ---- Other structure arca(.sq. ft.)....................... City: State: 'l.II': - - I'h me — -- I li-mi►il: comluc.r.iaL'industrinUmulti-family: 1 Valuation of work................... .. $ Existing bldg.area(sq.ft.) ........................ Business name: 5 New bldg.area(sq, ft.) ........................ ..f r Address: Number of stories .. ................................. City: stale: ZIP: Type of construction ............................ ....... Phone: f'ax _ C:nhail: Occupancy group(s): Exi ting: CCB no.: New: City/tnctro he.no.: Notice: All contractors and subcontractors are required to he R1111111 XMIAlmma�j- licensed with the Oregon Construction Contractors Board under N:unc: -1—cm provisions of ORS 701 and may be required to be licensLd in the Address: P X •} jurisdiction where work is being performed.N the npphcant is Cit H H/OCA state: Q 'I_II': exempt from licensing.the followipg ason applic.- Contact person: pNl I Plan no.: Z 511 ---- Phone: G2,5• Cax z�j•I E-mail: -- Name: t'ontact person: Cees due upon application ........................... $ Address. ---- Date received: City: state: ZIP: Amount received ......................................... Phone: Fax: I E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the NM art jtnisdlctions accept cwhl olds,Please call jurisdiction fa marc information. attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will be complie h,whether s ccil ed herein or not. crcdir`ud"amber:_ BsPlrcs Authorized signatu e: Date:5.2 a.0 Name of cardholckr u shown on credit crd 7PILIL __ S Print name: _.- Cardholdtr si`nattue Amount Notice:This permit application expires if a permit is not obtained%vidiin 180 days after it has been accepted to complete. 4444613(NOYCOM) Electrical Permit Application — Date received: Permit no.: I City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,'rigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 6394171 — -- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U I Rc 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/aherrtionlrrplacenun( U Other: _ U Pallial AOR SITE t Job address: 1 ' Bldg,no,: j Suite no.: ITax map/tax lot/account nn.: l Lot: 17, 1 Block: Subdivision: 5 LQ X10000 Project name: Description and location of work on premises: I:stinulled dale of cont letion/in,,prclinn 1SCHEDULE Job no: Fee oras lkscriplion _ 01i, (ca.) total no.ins Address:_Business nan1el � _ __ New residential-single orrratlti-familyper 1 Addres0 � �� dvrrllinp rmit.Includes altached Karage. City: titan" ZIP: seri Ire inelurkd: Phone: From •-mail: Inunsy It m less a CCB no.: Elec,bus.lie.no: Each additional 500 sq.fl.or portion thereof I -- Limited energy,residential 2 City/ ctr 1 c. Limited energy,non-residential 2 ,- �" zb•OZ Fachmanufactured honteorntodLlnrdwelling Signature of su rvisin 1 eleclriclan(required) bate Service and/or feeder Su .elect.name( rinO: H Q I License no: Sertolcesorfeeders-installation, alteration or relocation: 11111113 2(1(1 amps or less 2 Nome(print): lrGp►CY N pMES , L.L.C 401 amps lu 4W amps 2 Mailing address: (� s,�G 401 mnpsto6twnn,ps - 2– en 1 amps to I WK)snips City: Stale ZIP: Over l(NXlampsorvolts 2 -- l'honePJ Fa L-mail: Reconneclonly - I Owner installation:The installation is being made on property I own Temporaryserricesorfeeders- which is not intended for sale,lease,rent,or exchange according to Insnallatlon,alrerstion,orrelnrnlinn: 2(X)nm s or less 2 ()RS 447,455,479,670,7(11. 201 amps or 41X1 atop. 2 -- Owner's si nature: Date: 401111 600 am,s Branch circuits-new,alteration, ores tension per panel: Name: A Ire for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 Cily: State: — /.I I': It. Fee for branch circuits without purchase l'Itnlle: _ I"it X: F:mail: of service or feeder fee,first branch circuit 2 Each additional branch r;-ruu Misc.(Service or feeder not included): U 3erviceovei 225 antps commercial U health can•lac,l,ls Each pumporirrigation circle _ 2 U Service over 320 amps-rating of 1&2 U Hazardous Imaliort Fach sign or outline lighting 2 will lydwellings U Puilding over 10,(XX)square feet fouror Signal ci-cuit(s)or a limited energy panel, U System over60O volts nominal ntore residential units in one structure alteration,or extension* _ 2 U[Ito Holing over three stories U Feeders,400 snips or more "Description: _ U Occupant load liver 99 persons U Manufacturer)structures or ItV park finch additions!s,r,,Kcllon over the dlowable W any of the above: U F.grrss/IlghNngplen O Other - Perinspection Sobinll__-sen of plans with any of the above. Investigation fee The abole ata not applicable(o temporary construction service. Other Not all jurisdictions accept credit cant,please call jurisdiction for trrtre informatinn. Notiee: nils permit application Permit fee.....................$ _ U Visa U MasterCard expires if n permit is not obtained Plan review(at _ %) ('urdit card nu nlxr _,_,_ _ / / within I RO days atter it has been State surcharge(8%)....$ Expires accepted as complete. . TOTAL .......................$ None of cardhnlr r as shown on credit car s Coo holder sl`nature Amount440 4615(611U MI) Mechanical Permit Application City of Tigard Datereccived: Permit no. r_,j..�r; _ i City ofTigard Address; 13125 SW liall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Phone: (503) 6394171 Dale issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: 1 U) &2 family dwelling or accessory ❑Commercial/industrial New construction New U Tenant improvement J Addition/alteration/replacement U ether. Job address: To C t 'r. Indicate.,equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lo(/account no.: 5 IQU�/R20991 profit. Value$ Lot: i Block: Subdivision: -r 'See checklist for important application information and Project Hama: 0p �I-, jurisdiction's fee schedule for residential permit fee. City/county: I A K. 7.IF': t Description and location of work on premises: Est.date of completion/inspection: �— --- b"er1 pthm'Tenant improvement or change of use: dry ltly.lnlly I-tM.,,,,ly Is existing space heated or conditioned?U Yes U No Air handling unit CFM I ` Is existing space insulated?U Yes U No icon 1 Ecinmg(sue p an reymre ) teras ono existing system - N111 ( ILANI AL ! t ' or er compressors Business name: A RE ATt►JG Stale toiler permit no.: Address: jcc s d. Tons BTU[" rc/smu a amper uct sena a electors City: RI IJ G Shue: ZIP: "� — ea!pmnp(sue p an rcyuire ) Phone; I nx E-mail: nstal rep nceturnece urner (1(111 no.: -- Including ductwork/vert Ptier U Yes U No f'ily/me(ro lic.no.: nsta rep ac re ocale enters-suspen(e , wall,or floor mounted Name( lease print): G T K cot ur a ,lance of cr t an urnace - -- _ Refrigeration: Name: t2 q C) M 1 L.LC p Absorption units_ IlT11/11 __ Chillers IIP Address_—�j _ Compressors --- ---- III' City: e' W. State: ZIP. -1 lEnvironmentalex au+l and ural at on: Phone: - Fax:(-'� Applian�event 1 - I1-I11alI: ry:.'rcx auq of s,Type res. tc en lazmat -- Name: LEG A C:Y hood fire suppression system K O Nl E S L L C Exhaust fan with single duct(bath fans) Mailing address: PD 130 X j_4 yr :x aunts stem a art from heating or-C7--- -- -- City: H VJ 00D State:O ZlI. 1 y TUe P P ns an sur tit oh up to OUI els) Phone: Fax ZrJ (79 E-mail: YIx LPO NO Uil ruepiping eacn aaditional over 4 outlets --- roces+p p np(sc ematicrequire() Name: Number of pullets Address: 1 erifsle+Ta - --.._— PP�nc�oo �u pnrTent: -' Decorativefire lace City: State: ZIP: _ nsert-type Phone: Fax F; l: oo stov Pe etslove - Applicant's signature: CL yI •( i J Dale.S• JJZ ( t fer: Name(print): Not all jnlivilcl'n n,n•cept embi cords, UVisa U Mastrr('r rd nleaa call Juriwlicthxt fix more inhxmation Notice:This permit application Permit fee.....................$ _ ..............$ Plan review Minimum fee .. _ (Wilit card number _ expires if a permit is not obtained e..(at 4f,) $ F.x�� within I Rr'days alter it has been --- Name of nrdhnhkr as a own on ctrl a card accepted as complete. Slate surcharge(8%).... 8%)•,,.$ --— s TOM. ....................... (ard_holtkl dEnnara A%wnt $ ------ 440J617 16110/MM1 Plumbing Permit Application City of Tigard nate received: I'cnnnn„'. Address: 13125 SW Hall lilvd.Tigard,OR ) t Sewer permit no.: Building permit n, citynf77gard c 77� _ Phone: (503)639-4171 Project/appl.no.: Expi edate: Fax: (503) 598-1960 Date issued: � By: Receipt no.: Land use approval: cast file no,: Payment type: TYPE OF U I &2 family dwelling or accessory U C'ununercial/intluslrial U Multi-gamily U Tenant improvement ltd'New construction U Add iIion/al tern(inn/replacement U Food service U Other: _ � I IN P — - Job address: (51( $VV hair 1 CT Uewriplirttt (My. Hee(ea.) Total Bldg.no.: Suite no.: Keo 1 ruin 1 lantily dwmllings only: Tax map/tax lot/account no.: (hrclude%Inaft.for each Wilily connection) Lot: Z Block. Subdivision: SFR(1)bath a SI12(2)bash -- -- ---- Project name: _ W Op p OC) SFR(3) ath — City/county: D ZIP: Erich a ditiunal Iath/kitchen Description and location of work on premises: 6ilieutllitles: Catch hasin/area drain List.dale of con letion/inspection: Drywells/each ire/trench drain PLUMBING CONTRACTORFooting drain(no,lin. ft.) Business name: x4anufactured home utilities n sAddress' �-1E Rain drain connector CiState: ZT: Sanitary sewer(no.lin, It.) Phone: 0 Fax: ( E-mail: Storni sewer(no,lin. fi,) CCB no.: Plumh.bus.reg.no: Water service(no, in. City/metro tic.no.: Fixture or Hem: C'ontractor's representative signature Absorption valve I'rrat name: 111ack I ow preventer `f E l CK n111e Backwater valve Bnsins/lavatory Name: Clothes washer Address: r his lwasher City: D -- State ZIP: r Drin in fountain(s) hoar. _� (p lax. f:-rnatl: eclors/swn x ansion tan Fixture/sewer ca Name(print): 1 - MESS Lr I..rC.• oor rains/tloor sin s/hu _Mailing address: p — Garbage disposal City: Hose big ce maker Phone: 01Z 0 Fax: E-mail: Interceptor/grease trot) Owner installation/residential maintenance only: The actual installation Primer(s) - will he made by me"or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sin (s),hasin(s), nvs(s) — Owner's signature: Date: Sum Tubs/shower/shower an Name: Urinal Address: ater Jo-set C'it Water eater Y State, ZIP: Other: Phnnet _ Fax: I E-mail: Total — NW all juNuhcthms accept cmlit cads.pleats call jurisdiction rot more Inrortnarinn. Minimum fee.. ............$ ❑Visa U MasterCard Notice:This permit application plan review(at %) $ Credit card number ___ / / expires if a permit is not obtained _ Expires within ISO days alter it.las been State surcharge(89h)....$ -- Name of canlhubkr as shown or nedn cane accepted as complete. TOTAL .......................$ _ s Cardholder dtnalum Amount 4r1.1616(NnrVCOM) SEE 35MM ROLL # 2 0 FOR OVERSIZEll DOCUMENT