The URL can be used to link to this page

12130 SW KELLY LANE N W O Cl)C C X m r r z m 121::,,0 SW KELLY LANE CITYOF TIOARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-00344 13125 SW Fall Blvd., Tigard, OR 97223 (503) 639-4171 DATE iSSUED: 6/1/2004 PAR-0FL: 2S103CC-08800 SITE ADDRESS: 12130 SW KELLY LN SUBDIVISION: WWSTLFrTS WALK ZONING: R-4.5 BLOCK: LOT: 035 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPI_• VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES_ 0 3 HP: 1 DOMES. INCIN: ELE 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNI r., OTHER UNITS: FURN >=100K BTU: <= 10000 cll: f GAS OUTLETS: > 10000 ctin: Remarks: At ii-,t;ill Owner: _ FEES SCHIE LE, SCOTT Description Y Date Amount 12130 SW KELLY LANE IN1ECIII Permit Fete 6/4/2004 $72.50 TIGARD, OR 97223 ITAX1 8°0 State Surcharl 6/4/2004 $5.80 Phone: 503-590-7290 __ Total _ $78.30 Contractor: SPECIALTY HEATING &COOL ING 1601 SE RIVER RD HILLSBORO, OR 97123 _ REQUIRED INSPECTIONS Phone: 503-640-3607 Cooling Unt Insp Final Inspoction Rog#: LIC 66578 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is su�,,)ended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oiegon Utility Notification Center. Those rules are set forth in OAR 952 ,::1-0010 through OAR 952-001-0100. You may obtain cor;ies of these rules or direct questions to OUNC by calling (503)246-6699. A. Issued Bye t!'t �� Perrnittee Signature: Call (503) s39-4175 by 7:n0 P.M. for inspections needed the next business day CE USE NLY Mtc lattical i'er. txut,1 plication' Received 'L ' , D Mechanical,NN — t �� Dat"M • '/ Permit Dio.+n/��'�y ✓ '60 M 1?' Planning Apprnvo auilding City �bf T ligard q� O SW rt•,(��(�, Date/I3y: .. Permit No,; 1 13125 ,i�V I I all Blvd. \.� C,, Plan Review Other (' 1'lgard, Dreg m 91223 ,v U Dama/B f ctndl Nu.. J Phone 503-139.4171 Ftax: 503•��8=�Q Post-Review land Use l r-\. Date/By;; case No.: Internet: www.ci.tigard,or.us .� Q -- `\\. Contact 1 pec Page Z for 34-hour in:p:ccion Request; 303 -417j LNamelmethod —_� supplemental information J TYP.1S OF NVORi[C COMMERCIAL FEE-SCHEDULE-usE CREcxL.1sT New rot•struction I Demolition Mechanical permit Pecs"are based on the total value of the work Additlat/alteration/replacement I Other: performed. Indicate the value(rounded to the nearest dollar)of all -�- C4kTZGQRY OF Cl NSTRUC•1'IOI4 + mechanical materials,equipment,labor,overhead and profit. 1 dt .y Building 2•Fl+milY dwelliri Cotnmercial/Yndustrial Value: $ See Page?for Fee Schedule RESIDENTIAL.E�1.rrPMl%NT/SYS'rE111S FEE-SCHEDULE Aa:esso :vlulti-Family _ .-- MASter 11Ullder _ _ OtliCr: DeacriDtion Foo(ON.) Total --_. n Coolin JOI;SITE INFORMATION and'LOCATIONFurnace-add n stir conditiouin 14.00 Job situ add'eSS: ,13 S� _ T L+. Gas heatpump' 14.00 Suite 4: - Bld ./A to Duct work _ 14.00 Pro eci Nan le: Hvdronic hot water sw teat 14.00 - Cross ,;treet'Directions to job site: Residential boiler (for radiator oir hyd_onlc system) 14,00 Unit heaters(fuel,not electric) in wall in-duc;,suspended,etc.) 14.00 i Fluc/vent(for any of above) 10,00 Subdivision: Repair+tnits —- Other Fuel Apollancm _ Tax ma► /�_ar2cl #; VYater heater 10.00 DESCRIPTION OF WORK Gas frcnlace 10.00 _ Fluc vent(water heater/ as ri lace) 1 10.00 Log lighter asi I 10.00 WoodMellet stove I I u.bo Wood fire2lace/insert _ 1 10.00 _ Chimncy/hncr/luc/vcnt 1 10.00 p_R6FE-k-Y.1WYER TENANT _ Other! Name._, 1�Z_ G�1 Q_( Environmental Exhaust&ventilation Fangc houd/other kitchen equipment - MAO rAddress: Clothec dyer exhaust i— 10.00 Clt /State/��, ie duct exhaust 1.- __._.w.. Phone: ,y. o Fax: _ - (bathrow. • toilet compartments, APPLICAM'T �„ CONTACT PERSON ,` utility room-:, 6 R Name Attic/crawl space t.. s 10.00 Other: I 10.00 — _ Fuel o City/ tate/Zip, "(S5.40 for frst4,5i.o0 each. _ — arditlonal Phone: Fax: Furnace,etc. - "• —-�-- L Gas heat pl-np E-mai I' WaIV50pended/unit heater _ •' -� CONTRAC-FOR Water heater BUM('-ss T •ame. i C-� -�_ e C- t r Fireplace -� •" AddressI� LJ a,n �� ••_ eta I •• Cit /St-Ate/ZiE �� (.S� Gti J_Ly Clothes 0 ryer(q;s) _ I ,• Phoned –Fax: I- p -11-t 3 other: CCB Uc. ;l- �, �' } y Teta: i .Aaiion:: �Cd •-' Iytechanical P,rmit S+pnatute: Feet" �( , X1-1: 6/ subtotal: s �6�. -�-�-� (�— Date- '--' httni+..!m Ccrrrjt l'cc 572.50 S _ -y1m !•�!(- <'� (� t �'�` Plan Review Fee(L::^i"of Permit Fee) I S (Please print name) State Surcharge(8"0 of Permit Fuel ; S _ TOTAL PERMIT FEE I S 5 D Nntice: Chis p-rmit application expires if;;permit is not obtained wi.hin "Fee methodology set by Tri-County Building Industry Service Hoard. 180 day%after t hat hccn accepted as compleo. "Site plan required for exlerlor.VC unity. iPDsts\'+rmilF�mtfs�NtccP--_rmitApp.da: W/O z Cl t3 t �U ess EIl 7 21j 1 t-4eaH R 4 1 e t oaol, 016901 io ED unr SITE PLAN PL 35 P11 � i pl- STREET Specialty Heating & Cooling, Inc. 95"(28 SW Tigard Street Tigard, OR 97223 Phone 503.620.5643 Fax 503 .598.0718 Hillsboro Phoil,0, 503 .640-3607 Fax 503.681 .0793 F- -a RILD HGq EDq Zut-4VOH 911elQa49 wlEtol VD co unr CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT#: E -00323 DATE ISSUED: 6/88/2004/2004 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S103CC-08800 SITE ADDRESS: 12130 SW KELLY LN SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT : 035 JURISDICTION: TIG Project Description: Install (1)branch circuit. RESIDENTIAL UNIT TEMP SRVC/FE.EDERS _ MISCELLANEOUS 1000 SF _ OR LESS: 0 200 amp: _ PUMP/IRRIGATION: EACH ADD'L 50CSF: 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): SERVICErFEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE 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+ amp/volt: T=4 RES UNITS: �— >600 VOLT NOMINAL: Re(annect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: SCHIELE SCOTT SOHLER ELECTRICAL CONSTRUCTION 12130 SW KELLY LANE 41131 SW BURGARSKY RD TIGARD,OR 97223 GASTON, OR 97119 Phone: 503-590-7290 Phone: 971-832-0807 Reg #: LIC 158285 -- --------, ELE 34.667(. FEES �T----- S111' 594S Description Date Amount Required Inspections �F:LPR�1 I I I:LC Permit G/8/211(W $46.8.5 ---- -- 1 AN]8`io Stale Surcharge 6/8/2004 $3,75 Rough-in -- Elect'I 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 acrordanoe with approved glans This permit will expire if work is not started within 180 days of issuance, or if woilc 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 at(503) 246-6 699 or 1-8 00-332-23 Issued By: ,� < 4 _ Permit Signature: G OWNER INSTALLATION ONLY _ T .e 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: LICENSE NO: Call 639-4175 by 7:00pm for an Inspection the next business day JUN-04-2004 02 :40 PM JOE 11. SOHLEP 503 965 1076 P. 05 atrarT Ia�ysl�ran � 1'hw►A: lli,pl.It7I Tom'GA 91� l� ,r ��, 'upootlaol.tik ° d07„tfl.l >'o.nllNe:iL4 aoRNr, MM11�.wAM _ Now'Mwkudien ' ^ rw'�lleNlrop�°oNtlret _� r' r��. .••..--_, �detvkw OVetr 117 ttmpe,nonlrn'1 (7iMMtdew leter,o* am” I ofI-end1no wor 3-V �01Y•lrasi A l LJ' " I�wwt —dw^�uoetinAt �nwn:eew netaeod.i CMlIr irpMtA off tm ewtoe me rtuotu*c 00@U e1 IMA crwf 11° C3�"''A06 timer or mare '°'. Jeb 0% /o?/3U 0 4� rlrt uwegFle Caw�6oeterd eowcurq or , � J C.0 �C�, �fir✓ L A alt= MlI&ww h Uty 80Aw lohmtl am of pwul with wy of tete Ihat►e •""`••.•_,�.___ ,r,e, , n -- olPlleiru m 1Mt0a err,iva, 1640 ONUS" Y wolliodMnit r T v� arx: - Leine.:! ILA - �101rol ,rNIt11ru41 1.10 _.f car Or OF tewatdon _i Q0.1p N -7E_ - rA,A&M --1 .�..Cr__1�..�,.�, �L AC1 A AOD rr ►IO.W '� _ � �Lyltlo<IYZI*' ! t Will tD OU 447.449. on gop*01Y 101 le ebp •.-."....�-..., br-ww Iwo p — AL n a Anot 6wi�11 ASC �r P_ r-r.r L Mr"�Or ANw Aa weA C.'upu �MelftY C.6,7 z Adtlrwic1 ........_ r etrtrler .. .. j.4 �nM��t. �11L.iC..... ti~r+.c�asr.0 OR* 1 I4,e1 all. 171�.i�i.' pax: c e AatctreMe 1S:Sc Lc wrlon.11wtrrAo, t._p 1 I Z _ I lI Ask .aeMe ovr w.. �.._. (.1tvt'9'y��p,•-- --•- M C ._.�_ POP an _.,.�,'�. tOh_ rainy n�tAl�leve I 1trt:( f) - - --� M hour II R A2,10 ---� uImdl hwr 1 1 Ct A Lit e ! S- L_._v SOW Now: TOTAL P13utm its Sb Prim,saw, Mre«.tt.eq,Yr.f'�M�■ —-- >.Q .I. _ �' c7 r"A'4"e"�.e�b'* a+h►>t,�1,e1 tdr��r..ws ac.R tr.4aew'ewM►MLcPwrteefer tiAe wraetr•trd+ovfo:a,w1A w~rt��ter/.reltell.v.a ._�1 j } �rV"SIO v CITY OF TIGARD 24-HOUr BUILDING Inspection I i^e: kJ03)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST — BUF _ Received - .Date Reque ted--,;�—_- AM-_ __ PM.____—_ BUP Location _-__Aa-1 3 _ ______ Suite_-_ __"_ MEC Contact Person -- -- --- -- ----_ --- Ph(--- --) ---- ----- PLM Contractor---------..---.--- - _ Ph ( ) -----------_---- SWR —. BUILDING Tenant/Owner — _ _ ELC Footing ___ —"-- Foundation Access: ELC 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 Slub Rough-In Water Service --- - _- --_- Sanitary Sewer Rain Drains - - - --- — Catch Basin/Manhole Storm Drain -__- Sh-ver Pan Ot er: -- --- i ASS ' PART FAIL ANICAL Post& Beam Rough-In — - — -- _------ -- __._ Gas Line Smoke Dampers -- Final PASS PART FAIL -- -- ------- -------- ---_--- — __�__ ELECTRICAL _ Service --—Rough-In UG/Slab — — UG/Slab ------- -- -- --- ._-- __�.___� Low Voltage _ Fire Alarm Final — -- --�_- Final n Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART---FAIL SITE _ [ Please call for reinspection RE:-- Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Dote —3- Inspector 3-7 LI-w . I �. to-1._ - - Ext _- Other Final --- I DO NOT REMOVE this Ins;�ection record from the Job s Ito. PASS PART FAIL 'LAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA� AAAAAAAAAAAAA� ay r 0. oil poll rD CL fb rb CL n C ro ► . ►� o ► 4 � ro G � ► o Pt ~ ► t ► i ► CITY OF TIGARD 24-Hour BUILDING Inspection '.ine-,(503)639-4175 MST —yc) 4 INSPECTIVN DIVISION Business Line: %503)639-4171 BUP Received __ _ Date Requested AM. PM BUP _-- Location _—__�. "` f 3 6 __.Suite MEC Contact Person ___ �1'��- Ph PLM Contractor _ --_______—_ — Ph(—__) _ SWR _ BUILDING Tenant/Owner -- _._-. __.—_ ELC Footing Foundation ELC Access Ffg Drair ELR Crawl Drain _ _- Slab Inspection Notes: SIT Post& Beam -- -- -- --� - --__-T. Shear Anchors - — - -- Ext Sheath/Shear Int Sheath/Shear Framing !,sudation Drywall Nailing - ------- -- Firewall Fire Sprinkler ----_.-- - - - -- --�._------ -- - -- -- Fire Alarm SUED'd Ceiling - --------- ----__ — Root Other. - - ------- --__ - ---- Ftn SS I PART FAIL -- BIN Pos eam -� - --- ---- Under Slab - - - Rough-In - Water S,rvice ---- - - Sanitary Sewer Rain Drains -- - - ---- Catch Basin/Manhole Storm Drain - -Shower Pan n SS PART_ FAIL -- --- -- --- ---- ANICAL ------------------------ Post&Beam Rough-In Gas Line Smoke Dampers - --- --------- Final $S T __FAIL -- -- ---- ---- -- ----- ---- - _ RIC Rough-In UG/Slab Low Voltage ------------- .._. ----- - -- - —. --- F�1irra -Final Reinspection fee of$____ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd jPART FAIL _ —__ l__.I Please call for reinspection RE— - - linable to inspect -no access Fire Supply Line ADAT� Approach/Sidewalk Date � 3 _�- -_ Inspector / C,T�77 _ __ __ _ _Ext -- _----- Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP Recei%ed Date Requested AM.__.._ PM BLIP Location 2 130 S/_& u _ _ Suite MEC Contact Person _ Ph( � �� PLM _ ------ Contractor Contractor Ph( ) C>�d SWR BUILDING -QV-QZa 3.23 Footing Foundation ELC _ Fig Drain Access: 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 PLUMBING Post&Beam Under Slab _--.'�1 t�m►�..� Rough-In Water Service Sanitary Sewer Rain Drains - -- Catch Basin/Manhole Storm Drain — Shower Pan Other:_ Final PASS PART FAIL MECHANICAL _ Post& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL_KX - -- -- CTR CU Rough-In lt Low Vo - Low Voltage Fire Alarm in ❑ Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PART ST E_ Please call for reinspection RE:_." _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date- `�.-- - Inspector r V ` Ext Other: Final T DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspectio • Li - �- 3)639-4175 INSPECTION DIVISION Busihess LI e: 0 39-4171 MST /Dq 5 BUP �- — Received __ _Date Reque d AM PM _ BUP Location . _kl� _Suite EC y Contact Person ___._ — Ph( ) 4� PLM Contractor._ __ __ Ph( ) SWR ....... BUILDING Tenant/Owner ___ __ ELL Footing _ ELC Foundation Access'. Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam - -------------- -_-- Shear Anchors Ext Sheath/Shear _ Int Sheath/Shear �� ✓1� �-k E �" ,�,� C U 3 Z Framing l•- -,J /. (��i Insulation Drywall Nailing ----- -- -- Firewall Fire Sprinkler - - Fire Alarm Susp'd Ceiling -- Roof Lir �� S . Other: _ --------------------- Final PASS PART FAIL_ PLUMBING _ /� ' 6 �'�+�Nk - Post&Beam �x L-,A _ 1a Under Slab 1, `� "`.i Rough-In Water Service — Sanitary Sewer Rain Drains - --- Catch Basin/Manhole Storm Drain -- Shower Pan - ,, Other: -- v �� Final 12 ----- - U PASS PART FAIT_ --�� MECHANIC Rough-In - — Gas Line Smoke Dampers --- Final PASS rPAT T, FAIL. - ELECTRUAL Service --- - —� Rough-In UG/Slab Low Voltage �— Fire Alarm Final Reinspection fee of$_.__ _ ____required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL Please call for reinspection RE: Unable to Inspect-no access Fire Supply Line � /\ ` ADA / L� Approach/Sidewalk Date ®� .._ Inspector y+ __ Ext Other: _ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAii_ r CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Busine/ss,�Line: (503)639-4171 Received __ —Date Requested 4 �_J____--.—AM —PM G� ' tom Suite vieEc7 , •�4C-d -' f Location _ 40.4 Contact Person Ph( ) �� —}r�=-� PLM ------- Contractor .— ---_-.-_ _-__-- Ph( ) SWR BUILDING Tenant/Own- ___ ._.__— _ — _ ELC Footing ELC __-_- For rndation Access: Fig Drain ELR Crawl Drain - Slab h ispection Notes: SIT Post&Beam Shear Anchors �— Ext Sheath/Shear ---— Int Sheath/Shear Framing — Insulation Drywall Nailing Firewall Fire Sprinkler - -- Fire Alarm Susp'd Ceiling - ---- -----_— --__.__-__ Roof Other: Final PASS PART FAIL __PLUMBING - - ----- --- - -- -- — ---- -- ---- Post&Beam Under Slab - - - ---- --- Rough-In Water Service ------ Sanitary Sewer Rain Drains -- -__ ----- -- Catch Basin/Manhole Storm Drain Shower Pan Other: —. - -- _ — — ---- - Final PASS PART FAIL_ - - - ECHANICA - t&-ftam Rough-In - Gas Line Smoke Dampers ---- -- -- - --- �- - - t`rn S PART FAILfjXeCTRICAL -.— Service Rough-In --- UG/Slab _-----�------ _— -- --- Low Voltage -- - -- -- ----_. Fire Alarm Final L] Reinspection fee of$ __ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ - Please call for reinspection RE: Unable to inspect-no access Fire Supply Line A ADA Date 0 ". � - Ext-- Approach/Sidewalk I _.—_— Inspector - -- Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL MASTER PERMIT CITY OF TIGARD PERMIT#: MST2003-00065 DEVELOPMENT SERVICES DATE ISSUED: 6/18/03 13125 SW Hall Blvd., Tigard,OR 97223 (503) 639-4171 SITE ADDRESS: 12130 SW KELLY LN PARCEL: 2S103CC-08800 SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 03; JURISDICTION: HIS REMA,'<KS: Construction of new SF detached dwelling. BUILDING REISSUE STORIES: _ FLOOR AREAS REQUIRED SETBACKS REQU'RED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,570 of BASEMENT: st LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.730 of GARAGE: 530 of FRONT: 31 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: I Tlnau of RIGHT: 5 . OCCUPANCY GRP: R3 BDRM: a BATH: � TOTAL, 3300 of VALUE322,35380 REAR: ..- PLUMBING SINKS: I WATER CLOSETS: 3 CJ4SHING MACH. 1 LAUNDRY TRAYS. RAIN DRAIN: 100 TRAPS: LAVATORIES 4 DISHWASHERS. i FLOOR DRAINS: SEWER LINES. 1110 SF RAIN DRAINS: I CATCH BASINS: TUB/SHOWERS. 3 GARBAGE DISP I PIATFR HEATERS: I WATER LINES: Inu BCKFLW PREVNTR: 1 GREASE TRAPS- OTHER FIXTURES: MECHANICAL FUEL TYPES _ FURN�LOOK. BOIL/CMP<3HP: VENT FANS- 4 CLOTHES DRYER: 1 as TURN-=100K: I UNI'HEATERS: HOODS: 1 OTHER UNITS: I MAX INP bru FLOOR FURNANCES. V_NTS I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL. RE-_'-IDFNTIAL UNIr SERVICE FEEDER TEMP SRVCIFEEDERS _ BRANCH CIRCUITS MISCELLANEOUS ADU'L INSPECTIONS 1000 SF OR LESS. 1 0 200 amp 0 •200 amp: WISVC OR FOR: PUMPIIRRIGATION: PER INSPECTION: FA ADD'L 500SF n 201 400 arnp: 201 - 400 amp: tat W/O SVC/FDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY. 401 - 600 arnp: 401 - 000 amp: EAADDL eR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR. 601 - 1000 amp: 601-amps-1000x. MINOR LABEL: 1000+amp/volt PLAN REVIEW SECTION Reconllel;I 0OV: >•4 RES UNITS: 9VCIFDR>=228 A.: >800 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.sr RESIDENTIAL B.COMMERCIAL _ AUDIO 8 STEREO VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAUING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL. GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC DATAlTELE COMM: NURSE CAI LS TOTAL N 9`:51 EMS: Owner: Contractor: TOTAL FEES: f, 5,728.86 DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit Is subject to the regulations contained In the 4230 GALEWOOD ST 4230 GALEWOOD ST,STE 100 Tigard Municipal Code,State OR. Specialty Codes and STE 100 LAKE OSWEGO,OR 97035 all other applicable laws. All woo rk will be done accordance with approved plans. This permit will expire if LAKE OSWEGO,OR 97035 work is net started within 180 days of Issuance,or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 5UT_3$7_753$ Phone: Oregon Utility Notification Center. Those rules are set q� forth in OAR 952-001-0010 through 952-001-0080. You Rog N: q '38737f OUNobtain C by cablinies of g(503)24 r1987or direct questions to 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 Insf Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk I;Lsp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Prial � `�Issued By : _)L i 4-4-<<< �[,(Cc: Permittee Signature : '� Li Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00059 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/18/03 SITE ADDRESS; 12130 SW KELLY LN PARCEL: 2S103CC-08800 SUBDIVISION: WHISTLER'S WALK ZONING: It45 BLOCK: LOT: 035 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 for new SF. Owner: FEES DON MORISSETTE HOMES 4230 GAL.EWOOD ST Description Date Amount STE 100 1SWUSA] Swr Connect 6/18/03 $2,300.00 LAKE OSWEGO, OR 97035 1SWUSA] Swr Connect 6/18/03 $0.00 Phone: 503-3x7-7538 [SWINSP] Swr Inspect 6/18/03 $35.00 Contractor: (SWINSP]Swr Inspect 6/18/03 $0.00 _ Total $2,335.00 Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Glean Water Services. 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 Hstaller shall purchase a "Tap and Side Sewer" Perm Issued b � � �11� �� y; •�-� L /Gc. c/, , Permittee Signature: ,. VAzidX1 Cail (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application Datereceived: 1 Permitno.: City of Tigard g Address: 13125 SW Hall Blvd,Tigard O y 3 Project/appl.no.: Expire date: Ciry u(Tiganl I`� Date issued: BY: �% Receipt no.: l� Phone: (503) 639j417 v Fax: (503) 598-1960 t Case file no.: Payment type: l �� (� Land use approval: LEL Ni 1&2 family:Simple Complex: ___._ �U ❑ I &2 family dwelling or accessorym- merciaVfndustria! ❑Multi-family ,, New construction ❑Demolition U Addition/alteration/replacement ❑Tenant improvement U Fire sprinkler/alarm ❑Other: Yob address: t t `I _ Bldg.no.: Suite no.: _- . '� _ l Y _ Lot: � Rlock: Subdivision: �, }� (`� ( T'ax map/tax lot/account no.: /L, L Project name: Description and location of work on premises/special conditions: Mli Nils. Mailing_ address: �V 11 &2 family dwelling: City: -�__- St<ue�.r I_IP ' Valuation of work........................................ $ !"rune: 7- F.vt: i mail: No. of bcdroomsibaths -� Owner's repreti ntar^,e: 1 `�/, T; I Total number of floors................................. — Phone: F-)C E-mail: New dwelling area(sq ft.) .......................... _ Garage/carport area(sq. ft.)......................... Name: Covered porch area(sq. ft.) ......................... Mailing address: y t �• L Deck area(sq.it.) ........................................ ---- City State: ZIP: Other structure area(sq. ft.)......................... — Phone: Fax: Email Commercial/industriaUmulti-family: Valuation of work...................................... . $ Existing bldg.area(sq. ft.) ... .............. ...... Business name: —�� 3 New bldg.area(sq. ft.)::. ............ ............ ---- Address: Z- ti-y - C? R. _ _.- Number of stories .................. City: State: ZIP: Type of construction.......... .... ........... _ — Phone: Fax: E-mail: t ity/metro tic.no.: Notice:All contractors and sutwontractors are required to be licensed with the Oregon Construction Contractors Board under Name J , _ .) y z --- provisions of ORS 701 and may be required to be licensed in the — _ jurisdiction where work is tieing performed. If the applicant is Address: {�}� (�, )V�� ---- exempt from licensing,the following reason applies: Cit : State: ZIP: Contact person: — Plan no.: - — -- — �— -- Phone: Fax: E-mail: lag Ki Name: Convect person: Fees due upon application ........................... $ — Address: Date received: _-- City: State: ZIP:— Amount received ......................................... $ _— Phone: Fax: E-mail: Please refer to fee schedule. _ E-mail: — 1 I hereby certify 1 have read and exam;ned this application and the Not all jurisdictions scup credit cards,please call junutiction for more information. attached checklist. A�irovisions off ws and ofjdinances governing this o visa 0 MasterCard work will be compli w1 ,whether. cified lierein t Credit cant nowwr ----- .-- ----L-1— Fxpires Authorized SI natur _ -� t 1 : _.�_._�_ Name of cardholder ave shown nn credit card � _ S T t t f I r Caniholder slounue Amnum Print name: — Notice: rhis permit application expires if a prrmit is not obtained within 190 days after it has been accepted as complete. "0-4611(MYWoM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: —_ Associated permits-. City of Tigard City of Tigard U Electrical U Plumbing U Mechanical Address. 13125 SW Hall Blvd,"Tigard,OR 97223 U Other: Phone: (503) 639-4171 Fax: (503) 598-1960 I Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plotilot. _ 4 Eire district_____approval required. _ 5 Septic system permit or authorization for remodel. Existing system capacity _ 6 Sewer permit. _ 7 Water district approval. _ S Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control U pian U permit required.include drainage-way protection,silt fence design and location of catch-basin protection,etc. __ 10 3 Complete seth of legible plans. Must tr.drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate ful re sheet attached to the plans with cross references between plan location and details. Plan review cannot be comllieted _ if copyright violations exist. _ — I 1 Site/plot pian drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4-11.elevation differential,plan must show contour lines at 2-ft.intervals);lavation of easements and driveway;footprint of structure(including decks);lavation of wells/septic systems;utility to ations;direction of lot area:building coverage area;percentage of coverage:impervious area;existing stiuctures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor Wits,any hold-clowns and reinforcing pa Is,connection details,vent size and location. -- 13 Floor plans.Show all Jimensions.room identification,window size,location of smoke detectors,witer heater. furnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. — 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor. wall construction,roof construction. More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation.stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. — 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for _ non-prescriptive path analysis provide specifications and cal-ulations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/roofassemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. _ _ _ – 1 S Basement and retaining walls.Provide cross sections and details showing placement of rebar. for engineered systems,see item 22,"Engineer's calculations." – 19 Ream calculations. Provide two sets of calculations using current code design values for all he•ims and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Mufacured tIloorlroof truss design details. _ an - — 21 Energy Code compliance. Identify the prescriptive path or provide calculatiors. A gas-piping schematic is required 1. for four or more appliances. 22 Engineer's calculations.When required or provided,(i.e..shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. Ill 0 U LE I 11110B INS lit 23 Five(5)site plans are required for item 1 i above. Site plans must be S-1/2"r. 1 I"cr I I" x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. _ 25 Building plans shall not contain red lines or tape-ons. 26 No rolled,reversed or mirrored building plans will he accepted. _ 27 —_ 29 — Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614(60WoM) Mechanical Permit Application Date received: Permitno.:hST A03-6V0 S City of Tigard Project/appl.no.: Expire date: (itvujTigard Address: 13125 SW [tall Blvd,Tigard,OR 972"13 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type:__ Land use approval: _ Budding permit no.: TYPE OF PERMIT 0 1 &2 family dwelling or accessory 0 Commereial/indust:ial 0 Multi-family 0 Tenant improvement IeNew construction U Add ition/al temtiordre placement 0 Other.--- JOB SITE INFORNIATION1 1 _SCIIEDULE lob add-css: ' L4,A Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.- value of all mechanical materials,equipment,labor,overhead, Tax ma /tax lot/account no.: profit.Value S -_ Lot: _)r Blrxk: Subdivision: t v' 'See checklist for important application information and Project name:_ _�,'VL�. jurisdiction's fee schedule, for residential permit fee. City/county: �zIP� DWELLINGIIT FEE ' Description and location of work on premises: i 1 'fww1 i � t Fee(m) Toed Est.date of completion inspection --- Description Qty. Res.00ly Res.only r`" Tenant improvement or change of use: Air handling unit _ CFM Is existing space heated or conditinned'r 0 Yes U No Air conditioning(site plan required) Is existing space insulated?Li Yes U No Alteration o existing HVAC systemoil-In N -� Boder/compressors State boiler permit no.: Business name: �- I V ._ _ lip _-Tons BTU/11 Address: F:rcismrke dampers/duct smoke detectors _ - " -- ,. r eat um (site lanre required) City q- L! ��_ State:,. : pump P q rna Phone: ' _L--J YLL'�ax: -_--j E-mail: ------- nclu re�ork/vent liner 0 / Including ductwork/vent liner C:1 Yes O No _ CCB nstalureplace/relocateheaiers-suspended, City/metro lic. no.:N,A -� wall,or floor mounted Name(please print): NLl_�__ _ Fent for appliance other than furnace Refrigeration: Absorption unitsRTUAI ( (� E Chillers _ HP Name: -�C��-�•'� -� Comrressors lip Address: Y C r f nvirorttnental exhaust an ventilation: City _ —State: 7,IP: Appliance vent tN : : Fax: E-mail• UryerexhaustHoods, ype U l/res. itcherJhazmat hood fire suppression system (�� _ i ' _ Exhaust fan with single duct(bath fans); address: ) �,' Exhaust system apart from heatin or AC'ue piping an distributiin(up to 4 outlets) State 7-.IP �) T (.i'G NG __ Oil _ Type: - -- — Phone: 7- Fax: E-mail uel ii i�ng_each additional over 4 outlets Proces p ng(wliemaucrequirea)� Number of outlets _ ��- Name: '.----'.--� - UtTter Iu1�Ta�plrance or equipment: Address: Decorative fireplace --- --- _ - City: -Stale: ZIP: nscn-type -- - Woodstoveilxlletstove Phone: l a\ E•ma l: Usher: -- Appliranr's ti);na(u I Date f� )'�r Other: y -•L_--_ J - ----- ---- -- Name(print) l.__ Permit fee..................... Not all tunuticuons accep-credit cards,please call rynuficuon rix ionic-nfnrma-im Notices This permit application Minimum fee................$ -- O Visa U MasterCard / expires if a permit is not obtained Credit card number _, —.—— ____.L_1._— Plan review(at —_ �) �— F:,p1fS within 180 days after it has been State surcharge(8%) ....$ --- Name of cardholder u own on creak-card accepted a5 complete. sh s TOTAL .......................S Cardholder signaturt, -- Amount 1i0 1611(6OfLCOM) .Plumbhig Permit Application Gate received: Permit no.: �' City of Tigard sewer _ Address: 13125 SW Hall Blvd,Tigard,OR 97223 permit no.. Building permit no.. Ciry of Tigard phone: (503) 639-4171 Pro)ecVappl.no.: F�c"re date: Fax: (503) 598-1960 Date Issued: By: Receipt no.: Land use approval: Kase file nn.: Payment type: TYPE OF PEILMIT ❑ I &2 family dwelling or accessory ❑CommerciaUindustrial ❑ Multi-family 0 Tenant improvement ew construction ❑Addition'altt..-tion/replacement ❑Food service O Other. tt SFM INFORNUTION Job address: ' `�,ti' �� (l.S 1. 4'� Description QtY. Fee(ea.) Total Bldg. no.: Suite no.o " New Ind 2-family dweWngs only: Tax map/tax lot/accountno.: (includes 100 ft.foreachudlltyconnecdon) SFR(1)bath Lot Block: Sutxliviston (2)bath Protect name: ��/ (.( SFR(3)bath City/county: _ L1F: Each additional bath/kitchen Description and location of work on prernlscs: --_ Siteutilitles: _ Catch has iii/arca drain _ Est.date of completion/inspection: Drywellule:ach line/trench drain _ Footing drain(no. lin. ft.) ` ' Manufactured home utilities Business nameLC+(3_—_•_ Manholes Address: I _ Rain drain connector City: ` State ZIP: _v Sanitary sewer(no. lin. ft.) — �— Phone: .�' Fax: Email: Storm sewer(no. lin. ft) CCB no.. ( -7 Q Plumb.bus. reg. no: - Water service(no. lin.ft.) City/metro lic. no.:N/A Fixture or item: Abso Uon valve Contractor's representative signature _---.�Ci Backglow pre•:enter _ Print name: Oa l Backwater vae _ Basins/lavatory Name:.`1 � � �- �" Clothes washer Dishwasher Address: V —_ Citi -- Dunking fountain(s) _ State: ZIP Electors/sump Phone: _ Fax: E-mail: E.xpansioniank ---^— Fixture/sewer _— cap Name(print): ( � Floor drains/floor sinks/hub L -� � Garbage disposal Mailing address: T � Bose bibb City_ State _ ZIP: - Ice maker Phone: - Far., -7(�1 Email lnterce for/grease trap Owner in.stallatioxiresidentiai maintenance onh•: Fhe actual installation Primers) Y _ will he made by me or the maintenance and repair made by my regu!ar Roof drain(commercial) _ employee on the property I osvn as per URS Chapter 447 Sink(s), basin(s), lays(s) Owner's signature: Date: EMWI Summa 'rubs/shower/shower pan Name: 7 al ------------------ ---- Water closet _ Address: !_ Water heacerr City State: ZIP Phone_ Fax: F.•mail: Total Na ill iunxLcuonf accept credit cudt,pleau call lunmUcuon for mare mtannouon Notice:Thispermit application Minimum fee ...............$ — O Visa O MasterCard Plan review(at %) Sexpires if a permit is not obtained Credit card number - Expires within 180 Jays after it has been State surcharge (810) ....S p accepted as complete, TOTAL. ......................S Name ut cardtwlder v chnwn an cram card P pletC. ----- S Cmdholder usnalure Amounr 41n-1616(tvUrL(bM) Electrical Permit Application CityDatereceived: Perntit no.: of TigardTao_ City of TigardAddress: 13125 SW liall Blvd,Tigard,OR 97223 �Ofecdappl.no� Expire date: Phone: (503) 639-4171 Date issued: Fax: (503) 598-1960 By. Receipt no Case file no.: Payrnent t YPe: Land use approval: i l I &2 family dwelling or accessory ❑Commercial/industrial New constructionEl Multi-family O Tenant improvement ❑Addition/alteration/replaccment C]Other. O Partial 101 Job addresq: j Lot: ��l -�U L 1. t3ldg, no.: Suite no .: Taz map/[vc lot/account no.: ��- Block: Suixiivisioii t4i . Project nanlc: !cscnption and location of work on premises: Estimated date of completiorsnspection: � _ --_— Job no: Business flame 1 - Fee Max 1___ �F�l Description Address: ^� New residential-ddngk or Muhl-family per Qty (es) Total no.Imp City: 'T1 ! 17 State: I.IP q dwelling LIncludes attached garisgt- -�1 Senice Int luded PCB no.: �j 1 Fax' __ E-mail: IOOOsq.ft.orless CCB no.: --T Eich additional 5aln 00 sq-ft— 4 - _ EICC bus. IIC. no: `� - C United energy,residential _ - Limitedener _ 2 _ gy,non-residential 2 Eac nature of suprrs•rtoff t/reh manufactured home or—modular- dwelling rNclan(►equine•) -- - pate Service and/or feeder Sup.elect namelprmt Licenseno q Serricesorfeeden-Installation, /a ■ileraI(on orrelocation: Name1 200 Laps or less (print 1: �.1 201 unps to 4f)0 amps 2 Mailing address: 401 amps to 600 amps_ - 2 City: c S 601 amps to IOM amps _ State IIP: 2- Phone: - � - Over IOOn amps or volts +F,tt: _-mall: Reconnect only - 2 (hvnerinslullulinn: the installation is being made on property I own lemporaryservicesorfeeders- %%hich is not intended for sale, lease. rent, or exchange accordine to imialiation,alteralIon,orrelocation: ORS 447,455,479. 670,701. :M amps or less U amps I amps to 4fA)am2 Ouner's si nature: _ — 2 Date' 401 10 600 ern s —- Branch cirruits-new,alteration, 2 Natne orexlenslon per panel: Address: - -' - A_ Fee for branch clrcwts with purchase of service or feeder fee,each branch circuit 2 City_ S( Ct _IP: B Fee for branch circuits without purchase - Phone: Pdx: tLi ff. 111111ju MUM _ of service or hefee,first branch circuit: 14 mall' __ 2 Each addiuonal'.-r.m hcuant. -- OServiceover 225amps commercial OFfeallhM facility Mese.(ServiceorfeedernotIncluded): O Sen ice over 12O amps rating of 1,4: U Hazardous Irxaoon Each pump or irrigation circle Each sign- or outline lighting 2 fanulydwellings O Building over 10,(N)o square feet four or Signal circuit(sl or a limitrd energy panel. 2 U Syslettt over 6OO volts normnal more residential units in one structure U Quildingovcrtlrreeswnes alteration,or extension* 2 ❑Feeders.400 snip-or nrore O Usupa",local neer 99 persons U Manufacturnl structures or RV part'; -Descn tion _ — O Fgrcss/lit hungpl;un U Other _ Each additional Inspection over the■llowabie In any of the above: Submit_—_sets of plans with any of the above. per inspection Investigation fee The abort are not applicable to temporary constnrction service. Omer - --- ---- Nd all jurisdictions accept crxiir canis,r+lrax call judsdicuon for more infoor uonl ----_- O Visa U MasterCard Notice:This permit application Permit fee.........., LCiedocudmber expires if a pemtil is not obtained Flan review(at 96)- lwithin 180 days ager it has been State surcharge Fprrrs M cardhn alrr at shown on credit card — accepted as complete. TOTAL S ----- Cardholder signature -- Amount "0-4615(6•VOCObn DON • MORISSETTE OBE: 2805 i IS0m20 INCORPORATED 35 }'s G A L ! W O O D • T A E E T 4 E • 2/01/03 o3) aa° ° 1a rPZss) eT ° 'g—W�g PgOPEM: N CITY: TIG UM PLAN No.: tU9 OPTION-2 338 131" / / i IDD' f lm— — \ {/"PA "y . – 342 342 o 12 34: - 3E S. poplcw - - 622 sq. ft. r= 3 car ger. j FF,E. 342' n, 3,3W sq. ft 4 bdrm. \ V% beth FRE. 345V _� \ m 3A6 345 A0' LO? COVERAGE i LOT AREA. -1,815 SQ. FT. BUILDING AREA: 2,381 50 FT PERCENTAGE: 30.5% — aj�-rjc3 --ExISTING TREES +EXISTING TREE —0 -:' ICER RUBRUr- TC REMAIN TO REMAIN �•�t 035 , "?EC ^14PLE' o '1,815 sq. ft. I � - ELECTRICAL PERMIT - CITY OF T I G A R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00208 13125 SW Hall Blvd., Tiqard, OR 97223 (503)639-4171 DATE ISSUED: 7/18/03 SITE ADDRESS: 12130 SW KELLY LN PARCEL: 2S103CC--08800 SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 035 JURISDICTION: TIG Project Description: JOB NO. 3074 AUDIO SYSTEM A.RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: X AUDIO& STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: Owner: Contractor: DON MORISSF_TTE HOMES QUADRANT SYSTEMS 4230 GALEWOOD ST PO BOX 14833 STE 100 PORTLAND, OR 97293 LAKE OSWEGO, OR 97035 Phone: 503-387-7538 Phone: 503-387-7538 Reg#: M314'-55590002466 SUP 1211JLE LIC 90806 FEES I-I.F. r4q'd0C;8 Inspecti ons Description Date _ Amount Elect'I Final �I I.I'RNI I I I I.I: Permit 7/18/03 $75.00 1 AN 1811"Slate Tat 7/18/03 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, Slate of OR. Specially Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires ynu to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued by Permittee Signature OWNER INSTALLATION ONi-Y I lie installation is being made on property I own which is not Intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 117f 1 7/20"3 12:54 5032362322 01 IADRANT SYSTEMS PAGE 0' E ectrical Permit 4,pplication Received a Electrical r ' pa `e Cray of'Tigard �� V : �_% Pta ing App ■! — Permit No_ CLI �OD3 aD a D Darr/[; Sign 13125 SW Httu Blvct permit No: Tigard,Oregon 97223 I i i i r' Plan iteview Other --- -- 1 7UO3 llal Permit No.: Phone: 503-639.4171 Fax: 503-598.1900 Pbtt-ttev;ew Land Use — Internet: www,ei.tigard.or.US�a 1 r u t- 1-I UA I Oates Case No,: Inspection Request: '�el`3C iC t q contact lutis., Sec Page 2 far---- 24-hour Name/Mcthod: _ _ _ 9upptementallnfermntiorl, New construction _ Dernolition Service over 225 a mps i�ealth•cart farility Addition/ah'eration/r laCGment Other: cotmneroiai []Hazardous Ioeallon Service Ovr,r:120 ampl rating of ❑8uiidlnR over 10,000 squat feet, I &2-Fanlil d%vellin i ��2 family dwellings four or mnrr residential units tit --_&_ Commercial/Industrial 13 System over 600 VOIM nominal one q?UCtutr Acce$s0 Buildin , ❑Huilding over three stories___ � p_.-_-_ Multi-Fat17i1 I Pceders,400 amps or more Master Builder -�� - occupant Inxd over 99 persons dtltCt: �Egrege/l;ghhng pine � Manuthclurcd shucturr-s M RV park (.7 other:_ Submit sets of plane with any or the above. Job site address: I Z I'3 U S..f KA I - rat-.t' The above are nota' licable to tem ra constructlon scrvlec. Suite#: �Bld ./A t, ____ -- '-�-- - Nurnim of ins ectlone Eq ermit allowcdr Project Name; Description -..w-- (:rosy sh'e3t/Directitms to job site: New reside-Wis•slaeie,or malts-tt,mliy per Qty Fee(o■.) Tow p�'.V,p T LA k m O-C dwelling gait.facladee attached garage. Service lorloded: 1000 sq,M%a less Foch edditi0eal 500 yS It or�ioMon thereof - -- )]3.40 Subdivision: i��_�1 lAl alk Lot#: 3 S" - invited enenrv,ncsfdential _- 75.00 - - miced ertrrm,non reaidcntiai V 2 Tax ma / steel#; _� Each m4nuractured home or modulbr dwelti4— -F 7 2 aervica and/or feeder 90,90 ). .I Services Or feeder's-Isttallallon, (� alteration or relocation: 200 mor less - 2Dl am rn 4p0 unp� --- 80.30 2 t� -- l2g 2 1 o t°6o0'm�s --- -- lfi0,6ti- 6n1 nun to I_0001 fp9_ � - 2- Name: r - � over tooD a ,or volts ---- 240.65 z � e.rl�( .L�@.r`- ` F_�� --.--__---_ 454,63 _ �-- Reconnect onl1_ 66.85 2 Address:3t S: Temporary services or feeders-Inatailatlon, citx/ "`--" ■lWatfan,nr relocation: --�- -- -� - - __ 200 amps Or lou- 66,85 Phone:%n& 1, -4 la- to pax: 20lim s 11_400 - - 1 -�- _�' X00,30 z 4Dl to 600 amas _� 133,75 2 Hama: Branch clrrultt-new,alteration,or — eatenalon per panel: Address: — A.Fee for branch circuit+with purchase of Cit /State/Zip - 9" 'c'c or fbeder ftfte cath bench c uit 6.65 2 A.Fre far branch circutd without purchase or Phone: Fax: - - :mice or feeder fee,rrst branch circuit 46.85 z Each ad6itional bnurch circuit 6.65 2 lL-mall; Mltc.(Se vke or feeds not Included); PJChn?tP a im tion circle 53,40 2 Job No: �,,� .��.' •G d or otnline h _� _� —53.40 Sips)cireuit(s)or a limited energy panel,- - Business Name: AteraUon�orexten.iun_ Address: TO &ac 14 F.,- —- netmpn -�---- �°1 - z City/State/till: -Pe Each additional Inspectlen over the It X00lowahlr in a 'the above; - Phonc:S^u �_ $ �Cxl r - aS' rove ti Non r hottr(mta 1 hoar _ 62,50 CCB I-ic. #: _ "itao�•Supervising electrielmi suture required' � �_ L - - Subtotal S _ Plait Review 25%ol'Pe $ 5��- Print Name: - - L rmit Fee -'-� _ Lie,#: C•/j- State Surch a B%of Ia'crrrtit Fee 5 Authorized TOTAL PERMIT VICE SiRrtatUre: Date. Notke: Thla permit application elplres if a permit 14 flat obtained within _ 1 I�6 -- 190 dttya ager it has bean accepted Is complete. 'Ree mefhodOIDP set by 7r6Coanty Buildipg industry Service Board. :Please print narnr) —� �"sts\Permit FormsTlcrrrmithpp doe 01/03 A� PLUMBING PERMIT CITY OF TIGARQ .+ PERMIT#: P 00374 DEVELOPMENT SERVICES DATE ISSUED: 07/30/20/30/20 03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S 103CC-08800 SITE ADDRESS: 12130 SW KELLY LN SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 035 JURISDICTION: TIG CLASS OF WORK: AL1' GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: back flow preventor FEES Owner: — Description Date Amount DON MORISSETTE HOMES 4230 GALEWOOD ST I I'LUM131 I'rrmit I-cc 07/30/200 $36.25 423 100 I TAXI R". State I•ax 07/30/200' $2.90 LAKE OSWEGO, OR 97035 Total $39.15 Phone : 503-387-7538 Contractor: ANDSCAPE OREGON, INC 12200 SW MYSLON`( RD. TUALATIN, OR 97062 REQUIRED INSPECTIONS RP/Backflow Preventer Phone : 501-692-5945 Reg #: III 11 7M4 f his 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 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: i 2. tc-- Permittee Signature: Call (503 639-4175 by 7:00 P.M. for an inspection needed the next business day Jul- 29 03 02: 02p dan edmonds 503-692-0768 p, 2 _t'lurnbing Permit Application ReceivedPlumbing F Date/By: - Permit No�/1/,2�p3-�7 City Tigard Planning Approval— Sewer Y Ol g Ualc/B : Permit No.: _ 13125 SVS' Hall Blvd. Plan Review Other Tigard,Oregon 97223 Dotc/B :. Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review _ land Use Datd[3y _ Cas-No.: Internet: www.ci.tigard.or.us Contact fur Sec Page Z for r- 24--hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information. �- _ TYPE OF WORK _ FEE"SCHEDULE for special information use checklist_CVq - cw construction Demolition Description_ Qty. IFec(ca.) Tntnl Addition/alteration/replacement 1 Other: _^- New 1-&2-family dwellings CATEGORY OF CONSTRUCTION (includes 100 ft.for each u llity connection 1 &2-Famil dwelling SFR 1)bath - 249.20 _ y �, Commercial/industrial SFR 2 bath 350.00 A-ccessory Buildiniz LJ_Multi-Family SFR 3 bath _ 399.00 Master Builder Other: Each additional both/kitchen 45.00 JOB SITE INFORMATION and LOCATION Firesprinkler-sq. R.: Page 2 v Job site address:M/3 o S Lo /E!c_gL _ Site Utilities Suite#:� 1 71d -"-L/q t Catch basin/area drain _ 16.60 -`-` -"- r- ell/leach lineltrcnch drain 16.G0 Project Name: t�t9h�,s f"/ tJ<,(-t'..,ki LLQ; �3 _U Fooling drain no.linear R. Page 2 _ Cross street/Directions to job Site: Manufactured home utilities 110.00 SCLC 0 Ave--7 Manholes _ _ 16.60 Rain drain connectur _ 16.60 Sanitary sewer no.linear ft. Palle.2 Subdivision: LuhiS i-/erS I_L1aX-A_- Lot#: 3s` y Stonn sewer(n .linear R.) _� P_a c 2 __ Tax map/parcel#: t�Ss 6S; Water service no.linear R - Page 2 DFSCRIP'T10N OF WORK _ .Fi:lure or lter Absorption valve _ _ 16.60 /.s 2r- / . �`��Ct7 t� Backflow rcvcnter ---�iL�.. ---- p Page 2 X1. S J G&t.11/C e_- _ Backwater valve _ 1660 _Clothes washer 16.60 _--� Dishwasher - 16.60 OPERTY OWNER TENANT: Drinking fountain - 16.60 Name: E'ectors/sump _ 16.60_ �- _ /'Y")C'7'/S S c f {�, y17Yyr LS Expansion tank 16.60 Address: rixture/sewer ca X130 SLU GCt C._tvc�[•�C, ,SfY�a� - 16.60 _ Cit /State%Zi c Floor drain/floor sirk/hub 16.60 _ 'L _�- L k_(_- bSC.trc d C9 lc cj7L'3'! Garbagedisposal�- - -- 16.60 - Ph ne: Fax: rause bib _____ 16.60 PPLICANT CONTACT PERSON Ice maker �� - _ 16.60 Name:�7/c2•aCpctrrc ct.1 _ interim or/ reasetrd� _ 16.60 Address: ^,;t.0 06 .S Ltd h'1 L L Medical -value: $ -_ Page 2 City/State/Li Primer - 16.60 p7L+'Lt(Cl_�`j/1, t3/�_ Old Roof drain(commercial) _ _I6.60 Phone:543 (.0%A - S9 y5 Fax:S_63 6,94 - L/)'7'CSink/basin4avatory 16.60 _ E-mail: Tub/shower/shower awn 16.60 -- _ CONTRACTOR Urinal 16.60 Business Name: / ,, d_S l ct t-"r_e 1f �C, Water closet 16.60 -- �`---- -�"----�� Water heater 16.60 -^ - Address:/�JIJG SLt% I'Yt_cLSIC'1� R_b_ ---- - --Other: ---- 7u(1��_� Other: _Phone503 tn<{a. S`I�! Pax: r:;(13 Go9;_-_0- x^ Plumbing Permit Fees* -- CCB Lic. #t_-- �O dumb. Lic.#:y __ subtotal s Authorized "- Minimum Permit Fee$72.50 S Signature__ _ Ell u . �1 Residential Backflow Minimum Fe 6. •?Com Plan Review 25%of Permit Fee S _ C GrZeJ� _ _ _ State Surcharge 84/6 of Permit Fee S �;d %O (Please print name) _ _ TOTAL PERMIT FEF s _7, I' S__ Nntiee: This hermit application expires If a permit is not obtained within All new rammerrial halldlnp rrqulre 2 sets of plans wilh isometric or 190 days oiler it has been accepted as complete. :Iser diagram for plan review. *Fee methadolory set by Tri County Building Industry Service Boort. CITY OF TIOARD Residential Certificate icate O f` Occupancy Permit No.: / ddiess: /Z/ij K415F[_t_.r Owner/Contractor. Date of Final Inspection: 5/�/6�2 Inspector: - 'I"his structure has been found to he in substantial compliance with the provisions of the.State of Oregon One& Two family Dwelling pecialLy.Code and is hereby approved for occupancy. `_�