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8890 SW GREENING LANE ©o w (D CD Cl) 1 ro ro ca r d ro 1 i �y 8890 SW Greening Lane CITY OF TIGARD MASTER PERMIT PERMIT#: MST2001-00206 DEVELOPMENT SERVICES DATE ISSUED: 4/17/01 13125 SW !Tal' Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 08890 oW GREENING LN PARCEL: 2S111DA-13800 SUBDIVISION: APPLEWOOD PARK NO, 3 ZONING: R-7 BLOCK: LOT: 131 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. BUILDING REISSUE: STORIES 2 FLOOR;MEAS REQUIRED SETBACKS REQUIRED _ CLASS OF WORK: NEW HFIGIIT. 28 FIRST: 1 121 if DA�.,MENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD. 1110 SECOND. 1"94 sl GARA3E: 4t1R of FRONT: 71 PARKING SPACES TYPE OF CONST: 5N OWE' ANG UNITS: 1 FINFISMENT sf RIGHT: 5 OCCUPANCY GRP: R7 BDRM: 4 BATH 3 TOTAL 1.n;�I nn sf VALU-: $220.01000 REAR: 266 _ _PLUMBING _ SINKS: 1 WATER CLOSETS: 7 WASHING MACH: i LAUNDRY TRAYS. RAIN URA+N: wo TRAPS. LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: n SEWER LINES: IWI SF RAIN DRAINS: CATCH BASINS. TUB/SHOWFRS GARBAGE DISP: I WATER HEATERS: I WATFR LINES: 100 HCKFLW PREVNtR I GREASE TRAPS: MECHANICAL 01 HER FIXTURES FUEL TYPES FURN c t00K i 8011-ICMp<JHP: VENT FANS: CLOTHES URYER 1 .SAS FURN>=100K UNIT HEATEF.S: HOODS: OTEER UNITS, 1 MAX INP. LIU FLOOR FURNANCES: VLA S: I WOODSTOVES: GAS OUTLETS, I ELECTRICAL _ — RESIDENTIAt.UNIT _SERVICE FEEDER_ TEMP SRVCrIhEEDERS _BRANCH CIRCUITS - MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS. 1 0 200 amp. 0 - 200 amp. WISVC OR rDR, PUMPARRIGATION: PER INSPECTION. EA ADD'L%00SF: 4 201 - 400 amp: 201 400 amp: lot WIO SVCIFDS: n0 SIGNIOUT LIN LT. PER HOUR: LIMITED ENERGY: 401 60'amo: 401 600 amr: EA ADDL BR LIR: I SIGNAL/PANFL: IN PLANTr MANU HMISVCIFOR: 601 • 1000 amo: 601.amps•1000r. MINOR LABEL 1000.amp'voll. PLAN HEVIE+V S'.CTION Re ;1Lnect only — ---- >=4 RES UNITS SVCIFDF»225 A. •600 V NOMINAL. CLS AREAISrti OCC ELECTRICAL-RES PICIEDENERGI_ _ -� A.SF RESIDENTIAL. - B.COMMERC,A( .'AUDIO R STEREO. VACUUM SYSTEM: AUDIO R STEREO FIRE ALARM: INTFRCOWPAGING OUTDOOR LNDSC L1 BURGLAR ALARM OTH Alt I NCOMH BOILLR HVAC: LANDSCAPEIIRRIG PROTECTIVE SIGNI. GARAGE OPENER CLUCK: INSTRUMENTATION MEDICAL: OTHR: HVAC: DA TA/TELE COM6c NURSE.CALLS: TOTAL N SYSTEMS: Owner: Contractor. TOTAL FEES: $ 4,229.90 LEGEND HOMES LEGEND HOMES CORPThis permit is subject to the regulations contained In the LEGE D O 69TH #100 12755 D O 69TH AVE RP Tigard Municipal Cede State of OR Specialty Codes and 12755 S PORTLAND,OR 97224 TI 755 S OR 97223 all other applicable laws All work will be done in accordance with approved plans This permit will expire rf work Is not started within 130 days of Issuance,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 Ut)l1ly Notification Center Those rules are set Rep Nt1c ecsea forth In OAR 952001-00'0 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/Blom Mechanical Plumb Top Out Exterior Sheathing Ins[ Gyp Board Insp Appr/Sdwlk Insp Sewer Inspection Underfloor irsulation Electrical Service Low Voltage Rain drain Insp Electrical Final Footing Insp Crawl Drain/Backwater Electrical Rough In Uas Line Insp Roof Nailing Mechanical Final Foundation Insp PL_N./Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final Post/Bearn Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Final inspection Issued By : �� .� - -tt,_ Permittee Signature : Lz-P,t` f_ Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day SEWER CONNECTION CITY OF �,IGAR® __ DEVELOPMENT SERVPERMIT#: S 00138 Ppft 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/117/017/01 SITE ADDRESS; 08890 SO.'(;REINING LN PARCEL: 2S111 DA-13800 SUBDIVISION: APhLEWOOD PARK NO, 3 ZONING: R-7 BLOCK: LOT: 131 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: `3F NO. OF BUILDINGS: INSTALL TYPE: !TPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new single family residence. Owner: — ��--`- -- FEES-- MATRIX EES _MATRIX DEVELOPMENT CORP Type B Date Amount Receipt 6900 SW HAINES ST STE 200 Yp y — p TIGARD, OR 97224 PRMT CTR 4/17/01 $2,300.00 27200100000 rNSP CTR 4/17/01 $35.00 27200100000 Phone: Total $2,335.00 Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given. the installer shall prospect 3 feet in all dire:.00ns from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OA'R 952-00 1-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 2,'5-1987 Issue by: Lac_L (�y Permittee Signature: u�� iG ' Call (503) 6394175 by 7:00 P.M. for an inspection needed the next busirles-s'daayy Mechanical Permit Application pDatereceived: -'/ Permit no.:(7r rpYl l r bo(�•( City of Tigard Project/appl.no.: Expire date: City ofTigord Address: 13125 SW flail Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ —' 6ui'ding permit no.: IV 7ew family dwelling or accessot7 U CornmerciaUindustrial J Multi-fartuly U Tenant improvement construction U Addition/alteratiordreplacement U Other. .1011 S1 IF INFOWMA11ON com.N11.1to;�t, VALUATION SCHEDUff- Job address: j C `.�Y�i (,' .k-(--t t kL, , Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: _ Suitt no.: value of all mechanical materials,equipment,labor,ov-rhead, 'fax map/tax lot/account no.: profit.Value$ _ Lot: 17� iBlock: Subdivision: •See checklist.for important application information and Projt ct name: '� je / �utisdiction's fee schedule for residential permit fee. City/county. ZIP: .�..1[�_. ^ Description and l ation of work on premises: Fee(m) Total Est.date of completion/inspection: Description _ . Res.onl Res.only Tenant improvemet r change of use: Is existi s ace heated or conditioned?U Yes U No co nit ,CFM P fir conditioning sue plan required) Ise ' rg space insulated?0 Yes ❑No Alteration o existing HVAC system- EMMUMEMM iit�ompressors State boiler permit no.: Business nam 9! _ IIP Tons_ BTU/H Address: /'0j-0j- — trc/smoke. amcT�p pct smoke-detectors City: f^ot �Stat�; ZIP: 9%nl eat pump site plan required) Phone: '3-7 7 !w:: �7Gy E mail: _ nsta rep ace urnac urn er,:-F1'U7{ Including ductwork/vent liner - Yes U No CCB no.: f Install/replace/relocate eaters-suspen e , City/metro lic.no.: 4 _ __`— wall,or floor mounted Name(please print): 01711 ent ora—lianceo er an urnace / r crat ow NTAUTPERSON Absorption units____ BTU/14 Name:_1l21�l7 C( Chillers--,--- -- HP Address: � —� - Com mssors _ HP �� J _ roemeo a ust an vent ton: '� State:o ZIP: City: p ra t` �� 97.f,42 appliance vent Phone• -7) FaxW,s-3--7L E-mail: Dryercxhaust floods,Type res. itc c azmat— hood fire suppression system Name; J p,� /� p/�P Exhaust fan with singl.duct(bath fans) _ Mvling address: L� J` erQ- must system a arty eating or (. Hr'tt 7- Statedj ZIP:O Feel piping an ut oe up to outlets) i Y /Gn i Type: LPG NG _.,Oil _ It i tone: - O G7 Fix; ? - ; E-mail: u��ri eac�i as ntona over outlets �roctw P P1 mg(schematic required) Number of outlets Name: eel,S 75ifieii[`i appliance or equipment: Address: Decorative fireplace City,- _ f mcg State: _ 7.II': Phone: W1/- Fax: E-mail: tov x / etstove er. Applicant's signature: Name (print): e - -- Permit fee.....................$ Nd W1)ud"c0ons accept credit cads,pk .call juria aetkm ror mme Infortnatton — Notice:This permit application Minimum fe-.... ...........$ -_ U Visa U MasterCard expires if a permit is not obtained L__...L... Plan review(at i %) $ -- _ r,,t11fL, within Igo days after it has been State surcharge(8%) ....$ — - --- - accepted as ora lete. Name of cardholder u Am I an credit cid s P P TOTAL .......................$ -- cardholder atgnatum -- — Amount - 440-4611(WWOM) Commercial Schedule A2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE Description Furnace Furnace to 170,009 BTU Table 1A Mechanical code oty Price Total Includingducts b vents 955 1) Furnace to 100,000 BTU ktcludlnq duds a vents 1400 Furnace>100,000 BTU 2) Furnace rq,000 BTU. Induct dorsi 6 vents i_ 17.40 including ducts&vents 1,170 3) Floor Fu,nace -'-- - -- Includin vent 14.00 floor furnace Sus;r'rl.�4 flea(ar,wait he Uer _ a for nioum,1 heater 14.00 Including vent 95_5 - suspended heater,wall heater i s v_r.,nol k%iudW h aalliance Permit 6.80 or floor mounted heater 955 a runits 12,15 Vent not included Ina Ilanca Frmit r14g chert .Y 17.10hat ly ever Heal �. pp p. For hems 7.10,Baa of Pump ..:onn City Price Total footnotes 1_2 Comp Repair units _ _ 805 7)r7HP;absutti mit to - _. 3 hp;absorb.unit look 137U _ 14.00 a)3.15 HH;abeo:b unit to 100k BTU _ 955 1oa:to soak BTU _ 25.n0 _ rb 3-15 hp;absorb.unit unM 5-11 mi BTU 3s.00 101 k to 500k BTU 1700 10)30.50 HP;absorb - - unY 1mi.1.75 BTU x2.20 15-30 hp;absotb.unit 11►>HHP;absorb unit-1.75 mit BTU 501k to 1 mil.BTU 2310 5710 -__ 12)Ar handicap unit to 10,000 CFM 30-50 hp;absorb.unit - - 1p00 - 13)Ar haM11rw unit 10,000 CFM 1-1.75 trill.BTU _3400 17 20 >50 hp;ahsorb.unit 14)Non-pe(taaa evaporate cooler 1n .00 > 1.75 inii.B1 IJ 6725 15)VeM lin rnnneded b a akpk dud Air handling unit:0 10,000 c1rr1 656 6.80 16)ventilation system cad Induded In Air handling unit> 10,000 cfin 1170 17)Hood as ed by mechanical exhaust -tine to 00 Non-7�artable 00 evaporate caller _ 656 ---- to 1 a)[)errlestic rldneraton rent fan connected to a single duct- "_ 6 17.40 - 19)Comnerclal or Industrial type Incinerator Vent cyst.not Included in appliance permll 956 69,95 201 Other units,including wood stoves Hood served by mechanical oxhaust 656 10.00 _ - Domestic Indnerator 1170 2')a•*v+P++a one a aw'ouneto - Commercial or Industra)Incinerator 4590 22)Mae than 4-per outbt(each) - 5.40 -. 1.00 Other unit,Induding wood stoves,Inserts,eta 656 Minimum Permit Fee 117230 sueToTAL Gas piping 1-4 outlets _ 360 a%SURCH AROE _ Each additional outlet 63 PLAN REVIEW 25%OF SUBTOTAL -_ Required for All commercial permits only TOTAL Ottw 4wparrbn and Fees: 1. htpedera Ma site ofWW Wsilieu houn(^'lnine+r"3rar9e twe hounl V2 DW hour 2. ll pa io.ax.0 1 1-M M.o-1ficsM Irdcsted(rnYrkrun durpa hO N-01 ( . i 1250PWPW+nMear•eTii br duroes,add4kK"a r 4ekma h caw itft"roan hW To.a�yaluali�n ] _r_._.-___ Fed_ d,arpl.enefid ho+et$72 5n per hear .Stale cmwadm ac"c.Wkiaon nqukM 31.00toS5,000.00 MinimumS72.50 -----��- - 'n"ee"'"C•°"'top(a"show" o"d"""er I S5,OOL00 to 510,000.00 _ S72.50 for the first S5,000.00 and$1.52 for each additional S100.00 or fraction thereof to and including$10,000.00 S 10,001.00 to 525,000.00 SI48.50 for the Hrst$10,000.00 an 51.54 for each additional$100.00 or fraction thereof,to and including$25,000.00 $25,001.00 to$50,000.00 $379.50 for the fact$25,000.00&rid 51.45 for each additional$100.00 or fraction therro f to and including 550,000.00 $50,000.00 and up -^- _-- t -- $742.00 for the first$50,000.00 and S 1.20 for each additional S100.00 or fraction thereof Buildiu r )Iate received: �' ?r.�C/ Permit no.: ( !�,;r •*'"'1 r City of of I Protectlappl.no. Expiredate: City of Tigard Address: 13125 SW Ball Blvd,Tigard,OR 97223 : - Phone: (503) 6393171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 1,W family:Simple Complex: ;V1&7.family dwelling or accessory 11 Comntercial/industrial ❑Multi-family ErNew con�'-uction 0 Demolition LU1 Addition/alteratioti/replacement O Tenant improvement 0 Fire sprinkler/alarm 0 Other:b address: 4e`' ( Bldg.no.:^ Suite no.: Block: -_Subdivision: �Q� ti a�c;LC� PAfLl Tax map/tax lot/ count non ' / // - pr' Project name:_ _-- i / Description and location of work on premises/special conditions: (11 loodplain,septic capacitY.solar,etc.) Mailing add ss:/ 7 S 3 � q t.,46�Q. 1 &2 family dwelling: o6w- City State:p ZIP: f�— Valuation of work...........%fi?Z1...1. : ...... SL2r'tCiCfj`i�' Phone: No.of bedrooms/baths.............................._ _—'-k— 3 Owner's representative: FTE-6-- hr-1 L 1 0 _ Total number of floors................................. 2 Phone: E:lV `'`�r�? Fax: 5`JC(fl CC) E-mail: New dwelling area(sq. ft.) .......................... �--4-Z-1 Garage/carport area(sq. ft.)......................... _ Name: Covered porch area(sq.ft.) ......................... —`— Deck area(sq.ft.)...................................... Mailing add ss: _.; _ - Cit StateQ ZIP: Usher structure area(sq.f:.)......................... _ Phone: �7 a- FaxLj E-mail: Com:ne:ciai/industrirl/multi-family: Valuation of work........................................ $ Alts Lu E� Existing bldg.area(sq.ft) Business name: Z ±' GTd gS New bldg.area(sq.ft)............... Address:Iet.7J,��G�� v'e ................ Numi:^,r of stories........................................ City: cr __1—TSt�a'a 07 7,;? I'ypeofcanstructlon _—. .................................... Phone: O o Fax "�/� E-mail: Occupancy group(s): Existing: _. CCB no.: 6 O New: City/metro lie.no.: 7 Notice:All contractors and subcontractors are required to be it with the Oregon Construction Contractors Board under Name: ��yp�}�p l _ provisions of ORS 701 and may be required to be:licensed in the jurisdiction where work is being performed.If the applicant is Address;//7j .l ti• IP• — exempt from licensing,the following rcason applies: city: a � StatcG 7 _ 97 Contact person: �da9 Plan no.: — —" —— Phone:(�)O - O c7 Fax;,-TX- ' E-mail: Name: .� I Contact person: Fees due upon application ........................... $ Addrtss: f A ay' d Nate received: City: ai _ Staten - ZIP: f 7.21� Amount received ......................................... $— Phone: p� Fax: E-mail: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not all juriadktiarn accept«edit cards,please call jurisdicdnn for morem infornudon attached checklist. All provisions of laws and ordinances governing this U Visa Cl MasterfAirct work will be.complied with,whether specified he in ur nom Credit cud number _ Expires Authorized gnature: e,I_ Name of cm0ni, u drown on credit card --- Print name: _ _—__ — — _ Crdholder signature M Amount Notice:This permit applicad n expires if a permit is not obtained within I g0 days after it has been accepted as complete. "GA13(&WCOM) f+t5 ('1 it, -"e', 1 �, ♦~F g�j bo r tf� (t "� �, Plumbing Permit Application Datereccived: Ai City of Tigard Sewer ermit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 p _ Building perniftno.: City ofTigard phone: (503) 639-4171 Project/appl.no.: _ Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ Case rile no.: Payment type: t ell &2 family dwelling or accessory El Commercial/industrial O Multi-family Q Tenant improvement la'l'Qew l:onstruction ❑Addition/alteration/replacement O Food service U Other. Job address: �, t r., Desai .lon _ ?✓ �C v�j C��i?t=�.�t ► � r l l . Fee(es.) Total --gidg. New 1-and 2-firmly direlUngs only: g• Suite no,: (rnclud-w 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot:.. 12, I Block: I Subdivision: SFR(2)bath '-- Project name: L~ C i'?C� '� �- (� SFR(3)bath - City/county:L ed7Jp; _ Each additional batit/kitchen Description and 1 •ation of work on promises: Site utilities: Catch basin/area drain Est.date ofcompletion/inspection: Drywells/leach line/trench drain - — O111 Footin drain(no.lin. ft.) PLIU3111ING CONTRACT Business nManufactured home utilities ame: �r1�Ld _...L ..__ Manholes Address: r G Do [fain drain connector City 01/Yri Statc:p ZiP:220 _^ Sanitary sewer(no.lin.ft.)- Phone:&(,7_ Fax:(,G 7-1 E-mail: Storm sewer(no.lin.ft.) CCD no.: Plumb,bus.reg, no: Water service(no.lin. ft,) — City/metro lic..nc.• Plxture or Item: Abs orption valve Contractor's representative signature opt Back flow Qteventer Print name: P d v� Backwater valve CONTACT. asirs/lavatory Name: /o/. f`a Clothcs washer —� -- Address: C9Dishwasher -d YQZ pp J Drinking fountain(s) . City: r"'8'rhCyy 2Q ZIP: Ejectors/sump Phone: ( Fax: E-mail: -Expansion tank - - t Fixturdsewer cap - —` Name(print): L Floor dmins/floor sinksthub Garbage disposal_ Mailing address: 7j]j- G se bibb City: o�� c State:oRHu _ z�: 97�� [lo maker —�— - -- Phone: -,Fe, W I Fix:.f - E-mail: Interuc tongrease trate -- -� Owner installation/residential maintenance only: The actual installation Primers) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I ower ps per ORS Chapter 447. Sink.(s), asin(s),lays(s) owner's Signature: r' ;V 1 /ta Sump Tubs/shower/shower pan Name: �r ' Water closet, _Urinal Address: L of AGI O`m s ----- Water heater City: Stated ZIP:�_ — Other. -- - -- Phone: _ pd_jFax: E-mail: Total Nd ill iwiadletlem wceft credit earth.*8W ca11 jurtadkdnn for mote In4xntukw Notice:This permit appliedtion Minimum fee................$ —_----- U Visa O MasterCard expires if a permit is not obtained Plan review(at —__ %) $ Credit card number F _ within 180 days after it has been State surcharge(8%) ....$ e ted ascnm lett. TOTAL ....................... Nime off ewdooldu u ecc shown on crt&cud --- P P 5 _ —T—� —Cardholder signatum —! — Amount-- -- - - - ------------- 4404616((vOM:OM) FIXTURES (Individual) % .Qty � 'a. Total -Fixturd Type Quantity b Work Performed Sink - 16.60 �"- Naw Moved Raplaced HamowdlCappw Lavatory 16.60 Sink -- Lavalor' '-- -- Tub or Tub/Shower Comb. 16.60_ Tub or Tub/Shower Combination _ Shower Only -` 16.60 Shower Only - Water Closet 16.60 Water Closet - _ Urinal - -- - Urinal -- ~---- 16.60 Dishwasher - -- Dishwasher 16.60 Garb4Ne Disposal _ Lauer Roam Tray Garbage Disposal 16.60 Washing Machine -- Laundry Tray 16.60 Floar Drain/Floor Sink 2' - -- _ 3. ---- Washing Machine 16.60 4• - - --- Floor DrairdFloor Sink 2' 16.60 Water Heater -- - - - 3' 16.60 Other Fixtures S ec& - - --- 4- _T6_6_0 __ - - - Water Heater O conversion O like kind 16.60 Gas piping requires a separate mechanical permit. -- MFG Horne New Water Semi 46.40 -- --- MFG Home New SafVSlnrm Sewer 46.40 Hose Bibs 16.60 COMMENTS REGARDING ABOVE: Roof Drains 16.60 _ - - Drinking Fountain 16.60 - - -- Other Fixture:(SpeGfy) 21.75 - Sewer-1st 100' �- 55.110 - Sewer-each additional 100' 46.40 Water Service-1 st 100' 55.00 Water Service-each additional 200'V 46.40 Storm&Rein Drain-tat 100' 55.06 Storm tL Rain Drain-ear h additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 -! Residential Backflow Prevention Devlce' 27.55 Catch Basin 16.60 Insp.of Existing Plumbing or Specially Requested 72.50 Inspections per/hr Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram Is required r qui nW Total h >9 'SUBTOTAL - 8% SURCHARGL ' k', "PLAN REVIEW 25%OF SUBTOTAL Required only r Wure qry.total Is x,9 ^_ TOTAL ' 'Minimum parmlt tea h$72.50♦8%sur harge,except ReslderAfal 6acidlow Prevent M tlevbe,whim h$:16.25•s%wclwge. "All Naw Commercial Buildings requke pUrns with homewc d rias diagram and plan review Electrical Permit Application Date received: Permitno.: H6 jrM,�a City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SSV Hall Blvd,Tigard,OR 97223 Date issued: By: Ise eeiptno.: Phone: (503) 6394171 — Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1�('l8c 2 family dwelling or accessory Q Commercial/industrial U Multi-family U Tenant improvement �d New construction O Addition/alteration/replacement C3 Other.. U Partial Job address: C'rB (' _ti,_k, ,{ l_ti,,� Bldg.no.: Suite no.: _Tax map/tax lot/account no.: Lot: �- lcxk: Subdivision: ��. - L � y'f-�f I Project name: Description and location of work on ptenuses: — Estimated date of comeletionfinspection: CON-FILVe-1 011A P 1-1.1 UNI[ON Job no: rx Max $U9lneas name: De+cription Q (ea.) Total no.Ins — New residential-dn&or mnitl-famfiy per Address: — 17 d"Utingunit.Includes attached garage. City: StateeR ZIP: Serrlwineluded: Phone /- j) Fax:G -711d '-mall: 1000 eq.ft.or less - 4 C lo.: Elec.bus.lic.no: JY-65'3 Each additional 500 sq.fG or portion thereof Limited energy,residential 2 Ity3 • (J 75 Litnitedenergy,non-residential _ ?_ Foch manufactured home or nodular dwelling n turn su rvrJr g el trician(required) Date Service and/or[ceder 2 Services or feeders Installation, Sup.elect.name(printf `� V` +ems Q alteration or relocation: W till 111 a'If SILI 112010 to 200 amps or less _ 2 None(print): / ,(/®r 201 amps to 406+mps _ 2 .5 401 amps to 60C amps 2 Mailing address: 601 amps to 1000 amps-� _ 2 City: o $tatet3 ZIP:772,L2 Over 1000 amps or volts^ 2 I'tu:5-9 - UmalL• Reconnect only - _ 1 Owner installation:The installation is being made on property 1 own Tempot•uy,er-ices or feeders- v,hich is not intended for sale,lease,rent,or exchange according to �B+tton,alteration,ormlocatlop: 200 amps or less 2 OPS 447,455,479,6/70,701. ..�ff 201 amps to 400 amps 2 Owner's signature: / U�' Date: ? 2_ v 401 to 600 ams - 2 Branch circuits-nen,alteration, or extension per panel: Name: r L A. Fee for branch circuits with purchme of Address: �y`�TL)�i��pii— service nr feeder fee,each branch cir.:uit 2 City:`�. vtate��ZfP_9'7 B. Free for brooch circuity without purchase - —•---� of servicr.or feeder fee,brat brooch circuit: 2 Phone. - Fax: E mail: Fxhadditioralbranch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-due facility Each pump or irrigation circle_ 2 - U Service over 320 amps-rating of 1&2 U Hanrdouu location F*-.h sign or outline lin Ung 2 family dwellings U Building over 10.000 aquae feet four or Signal circuit(s)sr a litmted energy panel, U System over 600 volts nominal more residential units in one structure alteration,or r(tension', - 2 U Building overthree_ .res U Feeders,400 amps or mote *Description: _ U Occupant load over 99 persons U Manufactured structures or RV park Fac►addhioeal hrape tion over the allowable In any of the above: U FgresMighting plan U Other. ._ _— _ _. — Perinspection Submit__-_seft of plans with any of the above. Invesugation fee The above are not applicable to tempor w7 construction setTice. 4 Other --- Permit fee.....................$ Not all)ud.sdktluxu BMW Credit arab,please call}uriadictlon[n tmre Inf«rnadm Notice:This pCrmil application --� U Visa ❑MasterCard expires if a permit is not obtained Plan review(at _ %) $ Cruor ora number / / within 190 days after it has been State surcharge(8%) ....S _ E'rpi"a accepted as complete. TOTAL .......... ............$ Ivsme rrf urdbolder u ahevao an etedlt'c�_ _ S ------ Cardholder aipumre �- Arrrotrat 44114615(&WWV0M) TYPE CF WORK INVOLVED-RESIDENTIAL ONLY 4. Complete Fee Schedule Below: Y Number of Inspections per permit allowed Restricted Energy Fee........................................ 575.0(1 Service Included: Items Cost Total (FOR ALL SYSTEMS) 4a. Residential-per unit Check Type of Work Involved: 1000 sq.ft.or less _ $147.15 _ 4 Each additional 500 sq.rt.or Audio and Stereo Systems portion thereof $33.40 1 Limited Energy $75.00 Burglar Alarm Each Manurd Home or Modular Dwelling Service or Feeder $90.90 2 Ej Garage Door Opener 4b.Services or Feeders Installation,alteration,or relocation 0 Heating,Ventilation and Air Conditioning System' 200 amps or less $80.30 2 201 amps lc 400 amps $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 0 Other (neer 1000 amps or volts $454.65 2 Recomhed only _ $66.65 _ 2 TYPE OF WORK 114VOLVED-COMMERCIAL ONLY 4c.Temporary Services or Feeders - ImIallation,alteration,or relocation Fee for each system.............................................. $76.00 200 amps or Fess _ _ $66.85 2 (SEE OAR 916-260-260) 201 amps to 400 amps _ _ $100.30 2 401 amps to 600 amps $133.75 . 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems 4d.Branch Circulfs New,alteration or extension per panel C] Boller Controls a)The fee for branch circuits with purchase a.'service or n Clock Systems reederfee. Cach branch dreult - $6.65 2 Data Telecommunication Installation b)The fee for branch circuits wtihorrt;hurchase of service Fire Alarm Installation or feeder fee. First branch circuit _- - $46.85 Each - -_ Eaaddltional branch tJrcuit $6.65 HVAC 4e,Miscetianeous Instrumentation (SerAm or feeder not Included) Each pump or Irrigation circle _ _ $53.40_ Each sign or outline lighting $53:10 _ Intercom and Paging Systems Slgnal orahlt(s)or a fimlted energy panel,alleration or extension _ - $75.00 Landscape irrigation Control' Minor t abets(10) _ _ $125.00_ Medical 4f.Lach additional inspection over tine allowable In any of the above t__J Nurse Calls Per Inspection $62.53 Per hour $62.50 ❑ In Plant $73.75 _ Outdoor Laniscape Lighting' 5. Fees: ❑ Protective Signaling iia.Enter total of above.tees $ ft%Surcharge(08 X total fees) $ -�� E] Other _-- Subtotal $ 6b.Enter 25%of IoM 6a for ----,---Number r f'.ysvTms Plan Review H Tq*s(!(Sec.3) $ Subtotal $ No licenses are required. Licenses are rertk;red for an o8her instatlation3 i -7 LI Trust Account p Total balance Due $ ENTER FEES -- - --• - �` 8%SURCHARGE(.08 X TOTAL ABOVE) $ TOTA L $ CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECF1VFD IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VLY HV.Y #C colowft1l DFVFt0r'MFN' ALOHA, OR 97006-1249 Electrical Signature Form Permit #: MST2001-00206 Date Issued: 4117101 Parcel: 2S111 DA-13800 Site Address: 08890 SW GREENING LN Subdivision. APPLEWOOD PARK NO. 3 Block: L-ot: 131 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of new single family detached residence. Your cornpany has been indicated 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 Form prior to the start of the work to the address above, AT'FN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELEk,TRICAL ,,ONTRACTOR: LEGEND HOMES GARNER ELECTRIC 12755 SW 69TH #100 21785 SW TUALATIN VLY HWY #C PORTLAND, OR 97224 ALOHA, OP 97006-1249 Phone #: Phone #: 503-648-4552 Req #: LIC 121159 SUP 3707S ELE 34 305C AN INK SIGNATURE IS REQUIRED O TH S F RM X Signa ure'of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 92UILDING INSPECTION DIVISI')N MST , a 24-Hour Inspection Line: 39-4175 Business Line: 6-_ 4171 BLIP Date Requested u—ZG AM PM BLD Location u `a ` � � Suite MEC Contact Person `�— Ph G 3,_3"72) PLM Contractor _ Ph SWR _ BUILDING Tenant/OwnerELC Retaining Wall — ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: -- ------ Slab _-- ---_._---..--- SIT Post$Beam Ext Sheath/Shear Int Sheath/Shear Framing —__—.--_—_-- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc rna. —a ---- ASS 'fiART FAIL PLUMBING Post& Beam --- Under Slab _ Top Out Water Service Sanitary Sewer Rain Drains Final _— PASS PART FAIL MECHANICAL Post& Bearn — Rough In Gas Line —--- Smoke Dampers SS PART FAI'_ 'ELECTRICAL — — — Service Rough In UG/Slab _ Low Voltage Fire Alarm _- Final PASS PART FAIT_ SITE Backfill/Grading Sanitary Sewer Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for minspection RE: [ ]Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Other _ Date - 2 �' ` Inspector _ Ex: Final PASS PART FAIL 00 NOT REMOVE this ,nspection record from the job site. ' r i CITY OF TIGARD ESI IILDING INSPECTION DIVISIO"t MST 24-Hour Inspection Line: 4115 Business Line: 639- 11 BUP _ ! _Date Requested rl" _ _ BLD AM PM ' Suite ��J MEC Location _ _.. _ Contact Person �- 'ti" 4h —3 ��( . PLM { Contractor �7 Ph SWR _ BUILDING Tenant/Owner ELC — Retawing Wall _ ELR Footing Access: FPS Foundation — Ftg Drain SGN Crawl Drain Inspection Notes. �-- - Slab __...__ ---- ----- SIT _ Post&Beam V— Ext Sheath/Shear Int Sheath/Shear Framing --- — -----------.— — -- Insulation Drywall Nailing — Firewall Fire Sprinkler - — - ..------------.—_— — `—_ Fire Alarm Susp'd Ceiling Roof Misc _ " --------- -------------_------------- ----------" aminal PASS PART FAIL --_-- ----- -- ----- ------------____.__._---_��. __ PLUMBING Post&Beam ----- _-_ -- -- — - -----__—_.-_.______--__ --__._.�_—�----------------------- - Under Slab Too Out Water Service Ssnitary Sewer Rain Drains Final PASS PART FAII_ MECHANICAL Bost&Beam — - ---- ----- — --—. --- -------- --- -- _.— Rough In Gas Line ---------- -- ------ - ----_---- -- — - Smoke Dampers Final --- PASS PART FAIL ELECTRICAL Service -- -------------- -- --.—.__ Rough In UG/Slab Low Volt;; Fire Alarm ,�_— ------— - ---- --- --- --— -- .PASS ART FAIL Backfill/Grading Sanitary Sewer Storm Drain [ J Reinspection fee of$ _required before ne t inspection Pay at City Hall, 13125 SW Hall Blvd Catch Bscln Fire 3uprly Line ( ]Please call for reinspection RE:� [ ]Unable to inspect-no access AIA Approach/Sidewalk Date �3-��-- Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD P' GILDING INSPECTION DIVIS1nN MST 24-Hour Inspection Line: ,.4-4175 Business Line: 63:. :171 BUP Date Requestt,i .�J� �,M PM BLD Location /'J � Suite MEC Contact PersonPh .��`i' 7G, PLM Contractor Ph SWR BUILDING^ - TenanUOwnerELC Retaining Wall _ ELR Footing Access: Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: -- -- Slab SIT Post&Beam -- `-"— cxt Sheath/Shear in Sheath/Shear Framing -- ------ ----- --. _`- „- _— —, Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling �_- Roof Misc: Final PASS PART FAIL PLUMBING Post& Beam Jnder Slab T op Out - Water Service Sanitary Sewer - ------�-�---~—~ � -- � - ---� Ram Drains PAS ' PART FAIL!gCIMNICAL Post&Beam Rough In Gas I ine Srnoke Dampers Final - -- - --- --- -- --- - -- PASS PART FAIL ELECTRICAL -------_�__-----------.._.___-_ ____-- -- --.- SPrvice r Rough In ,----------.—_-- _-. LIG/Slab ------- ------- _ _�----- -- - Low Voltage Fire Alarm Final PASS FART FAIL SITE Backfill/Grading -- Sanita y Sewer j Storm Drain ( ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 3W Hall Blvd ' Cetch Basin Fire Supply Line [ ]Please call for refnspactfon RE: ( ]Unable to inspect-no access ADA Approach/Sidewalk Other Date ..1��[L _Inspector - Ext . Final PASS PART FAIL DO NOT REMOVE this Inspection record frons the job site.