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15570 SW EMPIRE TERRACE 0 M 3 M I P 15570 SW Empire Terrace CITY O F T I t�,�R D MASTER PERMIT PERMIT#: MST2001-00124 DEVELOPMENT SERVICES DATE ISSUED: 4/3/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 15570 SW EMPIRE TERR PARCEL: 2S111DA-14300 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 136 JURISDICTION: TIG REMARKS: New SF detached. Path 1 BUILDING REISSUE: STORIES: 2 _ FLOOR AREAS REQUIRED SEI BACKS REQUIRED _ CLASS OF WORK: NEW HEIGHT: 23 FIRST: 841 of BASEMENT: sof LEFT: 16 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,004 of GARAGE: 46o of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N OWFLLING UNITS: 1 FINSSMENr: of EIGHT: 8 VALUE: S 170,943.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,845.00 of REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 1 t SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<10OK: 1 BOIL/CMP<3HP: VENT FANS. 5 CLOTHES DRYER: 1 GAS FURN>-100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP. btu FLOOR FURNANCE3: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: 'W/SVC OR FDR 1 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 •400 amp: 201 400 amp: tat W/O SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 606 amp: 401 -600 amp: FA ADDL OIR CIR. SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR, 601 • 1000 amp: 601+amps-1000V: MINOR LABEL: 1000+amp/volt PIAN REVIEW SECTION Reconnect only: -• >-4 RES UNITS: SVCIFDR»225 A,: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VA,:UUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNOSC LT: BURGLAR ALARM: OTH: ALL ENCOMP BOILER: HVAC: LANDSCAPFARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OT HR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS- Owner: FEES: $ 3,848.60 Owner: Contractor: This permit is subject to the regulations contained in the LEGEND HOMES LEGEND HOMES CORP Tigard Municipal Code,State of OR. Specialty Codes and 12755 SW 69TH A11'-z 12755 SW 69TH AVE#100 all other applicable laws All work will be done in PORT LAND,C, 97224 TIGARD,OR 97223 accordance with approved plans. This permit will expired work is not started within 180 days of issuanoe,or if the work is suspended for more than 180 days. ATTENTION' Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg N: I IC 6051+1 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, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Final Inspection Footing Insp Crawl Drain/Backwater Electrical Scrvice Low 14.1ta ,e Water Line Insp Building Final Foundation Insp Footing/Foundation Dr: Electrical Rough In Gas. i- nsp Appr/Sdwlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final IssueLlBy : 7LT _ Permittee Signatewe Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next Wittsiness day SEWER CONNECTION PERMIT CITY OF TIGARD _ /3/01 DEVELOPMENT SERVICES PERMIT#: 1-00071 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE 13SUt=D: 4/3/01 4/3/01 SITE ADDRESS; 15570 SW EMPIRE TERR PARCEL: 25111 DA-14300 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 136 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: LASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: --- FEES _ LEGEND HOMES Type By Date Amount Receipt 12755 SW 69TH AVE PORTLAND, OR 97224 PRMT CTR 4/3/01 $2,300.00 27200100000 INSP CTR 4/3/01 $35.00 27200100000 Phone: 503-620-8080 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If 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' Permit and the Agency will install a lateral. 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: -! t?Z� ! �_y^ Permittee Signati:re; L Call (503) 639•4175 by 7:00 F.M. for an inspection needed the next husirr4ss day ` 1e✓JO/- 00�/ Building Permit Application CI of Tigard Date received: Address: 13123 W Hall Blvd.Tigard,OR 97223 Project/appl.ne�:A r�piredate: �'ttyoj77gard Phone: (303)6394171 Datt issued: By:,',:%) Receiptno.: `. Fax:(303)598-1960 / Case file no.: Payment type: 1&2 family:Simple Complex: =`- Land use approval: TVPE OF PERMIT 911 &2 family dwelling or accessory U COmmercia/inu.tstrial U Multi-family { New construction ClDemolitic.n 'T.y Cl Addition/alteration/mplacement U't'enant improve!nent U Fire sprinkler/warm U Other. _ 'INI 011N IATION Job address' '��,'7� ;�t F._J 1 r"�t 1'�2 fZ�Z-C Bldg.no.: Suite no.: Lot: �L Block: Subdivision: r.v vL'C� P!�{L.E Tax map/tax lot/account no.: Project name: / J E.LL i.2 De-sctipdon and location of work on premises/special conr!:tions:-fiviel _ ^ Name: 4 aad Ztb,0�69 , , Mailing add s: S' 1&2 family dwelling: City: State:p ZIP: 12GValuation of worts..........�,l.Q...,1..7.. .... 3 _ Phone: 4,.10-9-oFax-, E-mail: No.of bedrooms/baths....................I............ 3 J Owner's representative: 'F-t-.ts DIOL 1= Total number of floors................................. Z- Phone: E--1c� jFax: S` !IC/' E-mall: New dwelling area(sq.ft.) .......................... Oarage/carpott area(s+ft.)......................... ��- Name: Covered porch area(sq.ft.) ......................... _ — Mailing add ss: 02 J Deck area(sq.ft.)........................................ �-'3- � Other structure area( .ft)......................... City: d� Stste� Z1P:City: p Faxes E-mail: Commercial/induatrial/mnitl-family: Valuation of work........................................ $ I 11a I Jul Ulm Existing bldg.areal(sq.ft.) ......................... — Business name: Z 4 'J New bldg.area(sq.R) /,ddmss:),l,7 f' v 1 Number of stories........................................ stated City: v E-mail: Type of construction............... ................... _ Phone O o Fax' Occupancy group(s): Existing: _ CCH no.: (o p _� New: City/metro tic.no.: iLZ2L Notice:All contractors and subcontractors are required to be ARCHITIECUOLSIGNIEft licensed with the Oregon Construction Contractors Domd under Name: `p f provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed.If the applicant is s- exempt from licensing,the following reason applies: City: eggo, State[v ZIP: Contact person: jLdcL7 Plan no.: —"-- — —� Phone:(p Q O v Fax-- Name; .-Oe Contact person Fees due upon applit,adon ........................... S Address: /y fit, Date received: . City: State 7JP: y 7"&1 Amount received.........................................S Phone: p Fax: E-mail; Please refer to fee schedule. I hereby certify I have read and examined this application and the Aral alt,lwfadkvlem weep,uedii arts.please c.n ituixtic-don for mare fnfantrdaa attached checklist.All provisions of laws and ordinances governing this 13 Visa ❑MasterCard worts will be complied with,whether specified he in or not Authorized ature: OIs ate: Nwne of cara'bolder as shown an credit card Print name _ _' f // �i_---. Cattlid�er-datutttse Amount Notice:This permit applica' n expires if a permit is not obtained within 190 days after it has been accepted as complete. 44046113(6 o't) Mechanical Permit Application Date received: Permit no.: City of Tigard Projectlappl.no.: Expiredate: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223Date issued: Receipt no.: By:--- --- Phone: (503) 639-4171 _ Fax: (503)598-1960 Case file no.: Payment type: Land use approval: �__�, Building permit no.: _t:I '&2 family dwelling or accessory U Commercial/industrial L)Multi-family — u'Cenant improvement '- New construction U Additionlalterauon/replr-ement 0 Other: ARSI Job address: c r" L) L' Pt( l (� _ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials.equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ _ Lot: J Z, Block: Sutxiivision: �! 'See cher'Jist for important application information and Project nwoe_� jurisdiction's fc�;schedule for residential permit fee. City/colm11111 A ty: -'cx�a ,�` 1`1 t Description d i tion of work on Premises _ t Fee(m) Total Est.date of completion/inspection: Description Qty. Res.only Res.only Tenant improveme r change of use: ' Air hand - unit ---CFM— Is _ CFM Is existiJs ae heated or conditioned?U'.es UNo �u ciRI6Tg(sue plan required) _ Is e ' ung space insulated'?O Yes U No Alteration o exisung system Boiler/compressors — State boiler permit no.: Business name:� )`�J L1_ HP Tons BTUIH Address: C O r _ trc smoke c ampe— res duct smoke ,—irciors City: 7a _ Stn[t;;7�' 7_IP: 970? eatputnp s rep antcqutre 7 E-mail; nsta rep ace urnac u�—€iTU Phone: -7 7 Fax: 7Gy Including ductwork/vent liner I]Yes 0 No CCA no.: J � Instalrep ac re ocateheaters--suspen e , City/metro tic.no.: /,� / Y. wall,or floor mounted — Name(please print): Vent p i7 GY etfor appliance- o er an furnace c erat oil: Absorption units BTU/H Name: �1��)C( , Chillers_.-____ HP Address: c J — --- Co ressors_� lip rmamenta ex used s mrT ent ton: City: Po �' G State:o/t ZIP: 9 7), 1& Appliance vent J---E-mail: sex gust __ Phone -77 Fax ' -7G � — _ ;zR 1 yp0 Lr 1Vr 3. 'te ettlha7.mlat hood fire suppression system —_ Name: pQ _- Exhaust fan with single duct(bath fans) Mailing address: �„1��J' �- �Q �tQ- _ gust systema artTrom acro or City: t�;—Z;T Staty7�Q ZIP:j��,j3 Fuelpini�-� t utlon up to out ets r �/ T LPG NO —.—Oil _ phone:/"... � I r'� Ci I'ax. _ /17 E-mail: Fuel Ripinp each additional over 4 outlets Proem pipbag(schematic required) . / -_-_ —_ Numb.r of outlets 77::: - ufptnent_:tveapp - e re Address. Decorative fire e City �qState_ ZIP: nsen-is - ___—---- i Phone-:"Will - Gb Fax: E-mail: tov pe et stove Other i", Applicant's_signature: ' _a _} j e; -- Name (print) - -_sL Na all JuriActlons keep mea cards,p canjurixlidfon for rare In/ormadoa Permit fee.....................$ _ Notice:This permit application Minimum fee................$ crredo e..d nem, Visa C:MasterCarddexpires if a permit is not obtained Plan review(at — %) $ -- —�— within 180 days after it has been State surcharge(8%) ....$ -- - ted as complete.N��---�:aniholAer u show, credit cardacce S P P -- Cudbdder signature - Amauu 4141617(6MCoM) Commercial Schedule 1&2 Family Dwelling S�heduie ASSUMED VALUATIONS PER APPLIANCE Description Furnace to 104,000 aTU Table 1A Mechanical Coda _ Oty Prim Total Includingducts II,vents 959 1) F-enaos to 100,030 BTU trtctudkt�JucEi a vents 14.0 l: Fumce>100,000 BTU 2)Fwnaoa 100.000 en1' - tndvCMq dubs 3 vents 17.40 Including ducts&vents 1,170 :) FtootFumace floor fumace »n-tit dhn 14.00 4) S ,vended Nater,Brag heater Inducting vent 955 or 110.• :,ailed healer 14.00 suspended heater,wall hoater 5 veni not included in a ,tiance 0.80 or floor mounted healcr 955 8 Repair units 12.15 Glick all that appy: 'Boder Heat AN Vent not included in appliance permit 445 For Herm 7.10,sea of PWM Gond ay Prim Taal Repair units 805 roob'ot"1,2 7)dHP;absorb unit to (• <3 hp;absorb.unit 100K BTU 14,00 6)3-15 HP;absorb ua to 10f1M BTU 955 look to W%BTU 29.00 3-15 hp;absoei.Lnit 9)+5.30)tip;absorb unll.5-t rnit BTU 35.00 101 k to 500k rdTU 1700 10)JO Ohl HP;et7aoro unit 1-1.75 rt p BTU 0220 15-30 hp;absorb.unit 11)>50"P:.bsorb unit>1.75 mit BTU - 501 k to 1 mil.BTU 23108720 t2)Air hancft wit to 10;000 CFM 30-50 hp;absorb.unit 10.00 13)AY handling unit 10.000CFMr 1-1,75 roll,BTU 3400 17.20 14)Non-porUWe avaperaM oOaNr >50 hp;absorb.unit 10,00 >1.75 rill,UTU 5725 15)l dm tan connected to e skVIe duct -- 6.00 Air handling unit to 10,000 dm 656 1e)ventilation system nae kvckidea in Appliance PWMK Alr handling unit>10,000 cirri 1170 7)Hood w,r< medunteat uhaust to.00 Non ortable evaporate wiler _ 656 10Donraeondnerstors 10.00 vent fan connected to a single dud 446 17.40 Vent sLnL no:!.tcluded In appliance permit 655 121 conanerd.i or Industrial type khdnentx 69.95 Hood served b rnedlanical exhaust 656 other units, ud l dkv wood stoves _ 10.00 Domestic Incinerator 1 170 21)0"pointi one to k""o`tlets - -- 8.40 Commel 9ai or industral Incinerator _ 4590 22)Mae than 4"r outlet(ead,) Other 1 d Including wood stoves,Inserts,etc. 656 100 t. g Minimum Permll Fen f72.b0SUBTOTAL Cas;i Ing 1-4 011tlel9 360 '8%suacHAROE Each additional outlet 63 PIAN Ft"rN 25%OF SUBTOTAL Reoubed 1a ALL tom eercial permlet only TOTAL 00W kwowd ns ani Fees: t. YupaoYonf aW Ns d r.+md Melness hone(^��dwgeWo hour) a7Zae PM Ik„e 1. inspecWm ler.Mtn ro be 4 sowAicaM kOmsed(mkdnsen dwW Wt hors) Per t� Total Valuation r-- 3. AddA*so rbrW PV^rs.re+OWA W dwpes rdataom«revlafnns b Fls,n hriJner.* duwps-au hM hmo SUM Pw t- __ '9We eankwn.t1ola C.,anr fm mm**, $1.00 to$5,000.00 _ M'nimvm$72.50 "PAsItim""10 nwM `M°"""""'"e""'"°"'d re S5,001.00 to 510,000.00 S72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof, to and including$10,000.00 510,001.00 to$25,000.00 S148.50 for the first 510,000.00 and 51.54 for each additional S 100.00 or fraction thereof,to and including S25,00n.00 $25,001.00 to 550,000.00 $379.50 for the first$25,000.00 and 51.45 for each additional S 100.00 or tinction thereof;to and including S50,000.00 $50,000.00 and up k $742.00 for the first$50,000.00 and S 1.20 for each additional S 100.00 or fraction thereof i Electrical PermitApplication =" PAMM received: Permit no.: City of Tigard Project/appl.no.: Ly: date City of-rigord Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued, Receipt no.: Phone: (503)639-4171 Fax: (503)598-1960 Case file no.: nt type: Land use approval: RITZ t &.2 family dwelling or accessory CI Cornm,=ial/mdvstrial El Multi-family ❑Tenant improvement New cont action ❑Addition/alteration/replacement O Other. CJ Partial Job address: (eiLuF `T l Bld .aro.: Suite 11C.: Tax map/tax lot/account no.: Lot ( Block: Subdivision: Project name: Description and location of work on premises: _ Estimated date of con letionrinspection: 111,11111161 tail 01 1111= i Job no: Fre Max _D_nctipllon _ (ssa) Total no.hu Business name: 0/ l -- — Now to iles W-shsgie or multi-family per AddoeSs: dwellingurdt tnchrr)es attached garage. CityA LQ statCV4 IZIP Serviceincluded Phone – D Fax:G -MA-mail: 1(x10 sift or 4— C o.: i.: Elec.bus.tic.no: FY-6!1,31C Each additional 500 sq.ft.or portion thereof Urnited energy,residential 2 ity 379 7 _ Urnitedenergy,non-residential___ _ 2 s Each manufactured horse or modulardwelling nitureff supervts g el trician(required) Date Service and/or feeder 2 Sup.elect.name(print): .,g, License no: Q Bemires or feeders -histalistlon, rlteradon or relocatlon: 200 amps or leu 2 Name(print): ® 201 amps to 400 amps ^ 2 401 amps to 600 amps _ 2 Mailing address: 73'7 ' k" t'l 2 601 amps to 1000 amps 2 City: p Stateo. ZIP:f7 3 Over 1000 amps or volts 2 Phone:6dP Fax:s-? - E-trail: Reconnectonly I Owner installation:The installation is being made on property I own Tewporary services or feeders- which is not intended for gale,lease,rent,or exchange according to 20000 amps installation,alteration,or rrtnutiun ORS 447,455,479,670 701. amps oor 2 r leu - ? + � 201 amps to 400 amps 2 Owner's sl nature: t� C' 401 to 600 2 Branch Orcults-new,alteratloty or extension per panel: Name: A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 Statep Z>p9'7 B. Feeforbnnchcircuits withoutpurc$,:a. Phone: ever– G� Fax: Email: of service or feeder fee,first branch circui.: _ ? Each additional branch circuit: Mae.(Service or feeder not Included): Rm.m.ov.r 225 amps-commercial 0 Health-ane facility Each pump or irrigation circle — 2 0 Servicr over 320 amps-ruing oft&2 U Hazardous location Each sign or outline lighting -_ 2 family dwellings 0 Building over 10.000 square frit rouror Signal circuit(s)or a limited energy Pana 0 System over 600 volts nominal more residential units in one auvcturo alteration,or extension• _ 2'__ Budding over three stories 0 Feeders,40n amps or more *Description: _ 0 Occupant load over 99 persons 0 Manufactured structures or RV park Fach additional lespectlon over the allowable In any of the above: 0 EgressAighting plan 0 Other. - Per Inspection — Submit_set+of pbdw with any of the above. Investigation fee The above are not applicable to temporary construction servim other -- _— Na all Jurisdictions scrap peat earl.,r>lew,nil)uriwlicdea for mora hrr«muim Notice:This permit application Permit fee.....................$ 0 Visa 0 MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit cud number: _ �L_L within 190 days after it has been State surcharge(8%) ....$ Bspiras accepted as complete. TOTAL .......................S _-- --- None d o o u ovvo or e S _ Cardholder signature Arnotni 4404615(6AXWOM) T 4. Complete Fee ,Schedule eeluw: YPE OF WORK INVOLVED-RESIDENTIAL ONLY 1 Number of Insnections r permit allowed ----- -- Pe f� Restricted Energy Fee........................................ $75.00 Service Included: Items Cost. Total (FOR ALL SYSTEMS) 4a. Residential-per unit Cheat Type of Work involver!: 1000 sq.8.or less $147.15 _ 4 Each additional 500 sq.fl.or r ❑ Audio and Stereo Systems portion thereof $33.40 _ 1 Limited Energy $75.00 ❑ Burglar Alarm Each Manufd Home or Modular Dwelli g Service or Feeder $90.'10 2 -------- ---- ❑ Garage Door Opener' •lb.Services or Feeders Installation,alteration,or relocation ❑ Heating,Ventilation and Air Conditioning System' 200 amps or less $60.30_ 2 201 amps to 400 amps $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps _ $160.60 2. 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amp-,or volts _ $454.65 2 "- Recotwct only $66.65 ^ 2 TYPE OF WORK INVOLVED-COMMERCIAL ONLY 4c.Temporary Services or Feeder- Installation,alteration,or relocation Fee for each system....................................._...... $75.00 200 amps or less _ $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps - $100.30 _ 2 401 amps to 600 amps $133.75 2 Check Type of Wnrk Involved: Over 600 amps to 1000 volts, see"b"above. �] Audio and Stereo Systems 4d.Branch Circuits New,alteration or extension per panel ❑ 9oller Contr hls a)The fee for branch drains with purchase of service or ❑ Clock Systems feeder fee. Each biandh circuit - $6.65 2 ❑ b)The fee for branch circuits Data Telecomm micat'on installation without purchase of sen4ce ❑ or feeder fee. Fire Alarm Installation First branch circuit $46.85 Each additional branch cirwit ,- $6.65 _ ❑ HVAC 4e.Miscellaneous (Ser.4m or feeder not induced) I �� Inslr.mentr��lan Each pump or Irrigation circle $53.40_ __ Each sign or outline lighting $53.40 _� I ❑ Interu,om and!aging Systems Signal clicull(s)or a limited energy panel,alteration or extension - $75.00 ❑ Landscape Irrigation Control' Mirror Labels(10) $125.00 4f.tach additlomit Inspection over ❑ Medical the allowable In any of the above Per Inspection $62.50 ❑ Nurse Calls Per hou- $62.50 In Plant $73.75 �_` ❑ Outdoor Landscape Lighting' 5. Fees: Protective Signaling 6a.Fluter total of aoove fees $ 8%Surcharge(.08 X total fees) $ ❑ Other _ Suhrltal $ Sb.Eivtar 25%of line iia for �__-. Number of Systems Plan Review If required(Sec.3) Subtotal $ _ No licensee aro required. Licenses are required for all other hstallatlons C� Trust Acx;ourt It' - FEES: _ 1 Total balance Due $ _ ENTER FEES $,,. 8%SURCHARGE(.08 X TOTAL_ABOVE) $ TOTAL $ Plumbing Permit Application Date received: Permit no.: imilk City of Tigard `J b Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 CiryofTigard phone: (503) 639-4171 Project/appl.no.: �_- Expiredate: Fax: (503)598-1960 Date issued: By: Feceiptno.: Land use approval: ._ - Case file no.: Payment type: TYPE OF Ph'INUT, If1 &2 family dwelling or accessory U Commercia'Jindustfial O Multi-family 13 Tenant improvement afiew construction O Add ition/alterationimplact:ment U Food set vice U Other: 1 1 1 ! 1W it TM MR Job address: Icc t 1�"fc��/ti�L✓ Description . Fee ea. Total Nen 1-and 2-faamity dwellings only: Bldg.no.: Suite no.: _ (hrcludes 100 ft.roreach utility connection) Tax map/tax lottaccount no.: SFR(1)bath Lot: I Subdivision: — -— --- - SFR(2)bath Project name: t... C"UD — SFR(3)bath _ --- C ty/county: ZIP: T,7 Exch additional bath/l itchen — D-mcription and loEation of work nn premises: SiteudIldes: Catch basin/area drain Est date of completioNinspecdon: Drywells/leach line/trench drain ` Fooling drain(no.lin.ft.) Manufactured home utilities_ Business name: f CoT1dp Address: PQ 13&k c2e,0 Rain drain connector City:&'rgSha'/M I State:- ZIP:ig ?p Sanitary sewer(no.lin.ft.) Phone (,7_17,' l F,,tx:6G 7-9 E-mail: Storm sewer(no.lin.ft.) - -- CCB no.: j 3 Plumb.bus.mg.no: p Water service(no. Lin.ft.) ` City/metro lie.no.: Fixture or Item: / Contractor's representative aignatura: No ern Absorption valve Back flow pre enter Print name: O I o� Date: 3 _ �'/ Back-nter valve CONTACT — Basins/lavatory �— Name: /c, Clothes washer - - -- Dishwasher Address: pcp AdftAoo 7 Drinking foun n(s) _ City: IState• Ejectors/sum Phone:td Fax: E-mail: Expansion tank Fixture/sewer cap -- _- Name(print): p iJ Floor'drains/floor sinks/hub Mailing address: J,3- - G y -- Garbage disposal City: or a State: �Q ZIP: 9?.z:t�d Hose bibb — - e Ice maker Phone: a 22 1 Fax:;t f�Pk I E-mail- tepee tar mase trate Owner installation/residcntial maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own per ORS Cha ter 447. Sink(s) basin(s),lays(s) Owner's signature:ho / ?td I) Sum - ► ys/showershower Pan Naine: )rrUrinal —_ r Water CIOSet Address: — Water tet - City: Statex ZIP: 7 Other, Phone: _ pOs Fax. E-mail: Total Not dl Jurirdkriom wcW riemt ands,Oe m ad)urieclierlon for more 4tfermstion. Minimum fee................$ QVisa t]MasterCard Notice:This permit--plication Plan review(at _ %) $ expires if a pr nit i-mot obtained Cndll card numbw., within 180 days after it has been State surcharge(8%)....$ Nemo of cadholdef n shown on ctedir card Expitu accepted as'complete. TOTAL ................. .....$ _ S Cardliolder ri6narure — _— Amount 440 616(&MUOM) ' p1 Fpm COMPLETE: FIXTURES,(individual), :N�s ~Qtly ce; Tof31 Fixture type _ gwnU b Work performed Sink 16.60 New Moved Replaced ±p- Lavatory 16.60 Sink - - Lavatory ` Tub or Tub/Shower Comb. 16.60 Tub or rubJShower Combination Shower Only 16.60 Shower Only -- Waley Closet 18.60 Water Closet - _ _ Urinal Urinal 16.60 Dishwasher Dishwasher 16.60 Garbage Disposal Laundry Room Tray Garbage Disposal 16.60 Washing Machin.- Laundry achinaLaundry Tray 16.60 Floor DrairVF1'jor Sink 2' 3- Washing Machine 16.60 4• Floor Draln/Floor Sink 2' 16.60 Water Heater - d' 18.80 Other Fixturee(pedry) 4' 16.60 Water Heater O conversion O like kind 18.60 ----- Gas piping requires a separate mechanical permit. -- MFG Home New Water Service 46.40 MFG Home New San/Slor i Sewer 46.40 Hose Bibs 16.60 - COMMENTS REGARDING ABOVE: Roof Drains 16.60 Drinking Fountain 18.60 --- _ Other Fixtures(Specify) 21.75 ^- Sewer-1 at 100' 55.00 Sewer-each additional 100' - 46.40 Water Service-1 at 100' 55.00 Water Service-each additional 200' 48.40 Storm&Rain Drain-tat 100' 55.0 Storm 4 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 48.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Insp.of Existing Plumbing or Specially Requested 72.50 --- Ins dons _ per/hr Rain Drain.single family dwelling 85.15 Grease Traps 16.60 QUANTITY TOW,L r Isometric or riser diagram Is required t Quantity TOW l• ►9 'SUBTO i.IL eX SURCHARGE PLAN REVIEW 25%OF SUBTOTAL Required only If fixtureq- 1 .lldd Is>9 _ - TOTAL *Minimum permft fee b s72.5o♦e%sum harye,except Residential nacldlow PrevarMlon Device,which Is SM 25♦e%wdwge. All New Commercial Buildings require plans wsh I-nnw4rlc or riser diagram and Wan revlew. PLOD" PLAN LOQ" 1*13(o APPLEWOOD FAF-K R7PD 251 11 1),4 TAX LOT 014000 19 WATER METER 15510 6W EMPIRE TERRACE W_------` WATER LINE $S— — — — SANITARY SEWER S.E. 1/4 OF SECTION 11, T.2, R.1W, W.M. SD— - - — STORM DRAIN CITY OF T IGARD �----- It OF STREET A5l--IINGTON COUNT', OREGON MANHOLE 1, ® CATCH BASIN PROPOSED STREET TREES L � G � N D STREET LIGHT O FIRE HYDRANT M S •� I''�� 12766 811 69th AVZM8U17R 100 R OICR (606) 680-6060 TIGARD, OR. 97886 �►- nu`= FAX (606) 696-6900 CCD/ 60666 _ w ►= w w imw If I R m w LOT 131 II ' L -I -� +ss - - 202 8' - PROVIDE EROSION CONTROL FENCE /LOT 13 6 PER Cot-VUNITY I ! Il I ,�4,148 66. FT. EROSION PLAN 1 RONUJOOP �A w2033" I I I I I i I I L 5 3LIM. • FIN.FI I W I I \ !sAM 18'02'38 FLM !0 2B I I(a r 202.4' Q.- I 202.8' ' ► i L•29.16 202.1' W R•44 J •37' 8'34"' (J) 1 __ --589.54'25"W - \ 60. 3' I -- SD- 15' UTILITY' ' EASEMENT LOT 135 :1 1 g ry CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 Sin' TUALATIN VLY HWY #C ALOHA, OR 97006-1249 Electrical Signature Form Permit #: MST2001-00124 Date Issued: 413101 Parcel: 25111 DA-14300 Site Address: 15570 SW EMPIRE TERR Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 136 Jurisdiction: TIG Zoning: R-7 Remarks: New SF detached. Path 1 Your company has been ii, Jicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Forrn prior `.o the start of the work to the address above, ATTN: Building Dept. No ele;.trical inspections will be authorized until this completed form is received G\NNER: ELECTRICAL CONTRACTOR: LEGEND HOMES GARNER ELECTRIC 12755 S%V 69TH AVE 21785 SW TUALATIN VLY HWY #C PORTLAND►. OR 97224 ALOHA, OR 97006-1249 Phone #: 503-620-8080 Phone #: 503-648-4552 Req #: LIC 121159 $UP 3707S ELE 34-305C AN INK SIGNATORE IS REQUIRED ON T" F M Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BUILDING INSPECTION DIVIS"N 24-Hour Inspection Line: ,9-4175 Business Line: 63:,-4171 MST,,Zc.'O BUF Date Requested _ AM_ PM _ _ BLD Lc.ration -5 7 C: �5uite MEC — ------ ----- -- Contact Person Ph ��;L v `j - 3-37D PLM Contractor Ph SWR BUILDING Tenant/OwnerELC Retaining Wall — ELR Footing Accesf Foundation FPS Ftg Drain Crawl Drain Inspection Notes* SGN Slab SIT Post&Beam — -- Ext Sheath/Shear _ Int Sheath/Shear Framing __ Insulation Drywall NailingFirewall Fir? Fir?Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc: — lnai.> PASS R�T, FAIL — PLUMBI Post& Heam - -- Under Slab pop Out — -- —` -- Water Service Se nitary Sewer — -- Rain Drains Final —_-^— PASS PART FAIL P MECHANICAL Post&Beam — — Rough In Gas Line — ----- Smoke Dampers anal - -- — PART FAIL CTRICAL -- Service Rough In UG/Slab Low Voltage Fire Alarm _ Final PASS PART FAIL. SITE Backfill/Grading - -- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin i Please call for reinspection RE: Fire Supply Line [ ] p -- -- [ ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date R!3— c' Inspector Ext Final _ PASS PART FAIL DO NOT REMOVE this inipeetion record from the job site. CITY OF TIGARD PUILDING INSPECTION DIVISInN MST 24-Hour Inspection Line: 9-4175 Business Line: 63. .171 BUP _ ,_Date Requested AM PM BLD Location_ J -L, 7v � u Suite MEC _ Contact Person Contractor _ Ph SWR BUILDING Tenant/Owner E_C Retaining Wall ELR ^` Footing Access �— Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab --------------- ------_.-__---------__.----_____ -�._ SIT Post& Beam - -_ Ext Sheath/Shear 'nt Sheath/Shear "---'-- — - Framing Insulation - -- -- Drywall Nailing Firewall - -- �.—..—.--- --- -- ---- Fire Sprinkler Fire Alarm -- ---�-- Susp'd Ceiling Roof ---- Misc: — Fina! �- ---- _ PASS PART FAIL PLUMBING Post& Beam ----- -- --- --------- — Under Slab TopOut - -- - ------ -- -- - --- --------- Water Service Sanitary Sewer ---- —.- — - -- -- -- Rain Drains Final —� PASS PART FAIL MECHANICAL Post& Beam -- ------------- Rough it Gas Line Smoke Dampers Final ?ASG PART FAIL cLLE CTI•�ICAL _ -- --- --` Service Rough In - - --- �—_— �--� --- -- UG/Slab Low Voltage Fire Alarm ASS PART FAIL A - _ Backfill/Grading --- --- -- - - _. Sanitary Sewer Storm Drain [ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire,Supply Line [ Please call for reinspection RE: _ [ J Unable to Inspect-no access ADA Approach/Sidewalk Other Date V Inspector Ext _ Final PASS PART FAIL J DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD ril JILDING INSPECTION DIVISInN sT 24-Hour Inspection Line: ,9-4175 Business Line: 63, .171 BUP —Date Requestedcc -7 AM PM BLD Locatipn S-L-zU F-ai 402J,2,, I/_ Suite MEC Contact PersonPh 33 JC PLM Contractor elf Ph BUILDING Tenant/Owner ELC Retaininp Wall ELR Footing A�ss: ��ti_x` �� s Y ! W S tV°� _f FPS F,,undation Fig Drain Crawl Drain Inspection Notes: SGN Slab SIT Post&Beam Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Diywall Nailing _. Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc: Final; PASS PART FAIL --- —-- PLUM IN© i>f4 'Post Bevrn Under Slab y(1. Top Out `— ;tµ-Water Serv'ce Sanitary Sewer iyu Rain Drai in 31 PART FAIL _ NICAI. I Post&Beam (Rough In ('as Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG/Slab Low Voltage Fire Alarm _ Final PASS PART FAIL 81 Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Bassin [ j Please call for reinspection RE: ( ]Unable to Inspect-no access Fire Supply Line ADA x n t'� Approach/Sidewalk Date `J , a \ Inspector \ �.,\�-' EXt� ` Other — Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.