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12330 SW KELLY LANE
CITY OF TIGARD 24-Hour
BUILDING Inspection Ling: (5-0),639-4175 rmsr,7)22 rCJ
a
INSPECTION DIVISION Business Line: (505)639-4171
BUP _
Received _ ! y� 2 I)ate Requested ` �� �J AM __ .__-_-PM __-___- BUP
Location 233 J j-_- 126 Suite MEQ —
'l
Cuntact Persor, 'f J - — - Ph PLM --- - -- - —
Contractor _ -_ Ph SWR
BUILDING_ Tenant'Jwner _ F L C
Footing - --- -
Acces,:
Foundation "- ELC
Ftp nrz;.. � � .:
crawl Drain _
Slab Inspection Nates: SIT —_
Post&Beam
SI-ar Anchors
Ext Sheath/Shear I �,
Int Shec'h/Shear
Framing ---- ---
Insulation
Drywall Nailing - - - - - —
Firewall
Fire Sprinkler
Susp'd Ceiling >'0.__. G S ----
Roof
Other: -- - --- -- - --- - -
L
ASS PARTFAILUMBSNG _ —_
Post& Beam �—
U,ider Slab
Rough-In
:Nater Service -- - ------- ----
Sanitr.ry Sewer
Rain "rains --- - - - — - - -- --
Catch Basin/Manhole
Storm Drain ------- -- - - -- -
Shower Pan
Other: --
Final —�
PASS PAR'S FAIL _ —
MECHANICAL
Post&Beam -
Rough-In
Gas Line
Smoke Dampers ----- - - --------
Final —
PASS PART FAIL
L. --- --- -- -- ----- --- -
ELECTRICA -� ---_- - - - _ _-
Service _.._ ---------------- - - ---
Rough-In I ��1� �� --- -- ------- --- ----
Low Voltage
F1w,-Aittrur --- -
r
RT FAIL Reinspection fee of$ - required befo next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE L� Please call for reinspection RE: _ - -- -__-_ - �, 0:able to inspect-no ak:,ess
Fire Supply Line
ADA
> �
Approach/Sidewalk Date� /`�'`% v ' —_ inspector �� Lr.l__�:-f r.3 / t �� Ext ._--
Other: / / //
Final - DO NOT REMOVE this Inspection record `#ram the J" site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
B�4'i.DING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BLIP
Received Z 1 z- pate Requested az�'�3 �3 AM_ PM _ BUP
Location _ /��2) 3 D Suite MEC
Contact Person — _� Ph( v �2-
I` LM
Contractor eL,�L_ 02Z'_-, -_ 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 -- -
ASS PART FAIL
PLUMBING
Post& Beam- —-
Under Slab
Rough-In
Water Service --- - -
Sanitary Sewer
Rain Drains — -- - ----- -- --
Catch Basin/Manhole
Storm Drain -- ------ -- _—_ -- — — --- -
Shower n
PART FAIL
KA&NICAL
Post& Eleam -
Rough-In
Gos Line
Smoke Dampers
Final
PASS PART FAIL - ----- -�--- —_ _ -- --- —. _
'ELECTRICAL
Service
Rough-In
UG/Slab --------------
Low Voltage
Fire Alarm
Final F] Reinspection fee of$ _ equi-ed b0ore next ins on. Pay at r 'v Hall, 13125 SW Hall Blvd.
PASS PAST FAIL
SITE Please call for reinspection RE:.._- -_ Lri, He to insp^ci- no access
Fire Supply Line
ADA I r} _ -'7 - Ext
Approach/Sidewalk Darty Inspector _�!
Other:
Final 00 NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TiG AHU 24-',our
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)6394171 MST
BUP
'2
Received _ r �_' Date Requested� _-_ _ AM_______� PM____ __ BLIP
Location __�2 3_3Q A,_ L_eSe. .... Suite_- __- MEC
Contact Person Ph ; ____ _ ) _ __ ___ PLM
Contractor -- - -- --__.__ _-___-- Ph SWR -- -------_._-__
UILDING Tenant/Owner -__-___-_ ---. ___ ELC
Foundation : ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab insoection Notcs: SIT
Post&Beam ---- --_---_--_
Shear Anchors - - --- - - -
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nalling - -- ---
Firv;
Fir, 3F i4ler -- - -
Fire A'::rm
Susp'd Ceiling
Roof
r: - -
SS PART FAIL ---- - - -
BING
Post&Beam
Under Slab -----
Rough-In
Water Service
Sanitary Sewer
nein 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 - - - --- --
E�ECTR;CAL
Service -- - -- _
Rough-In -
UG/S!ab
Low Voltapp
Fire Alarm ------WO--- � — --
Final 0 Reinspection fee of$ -__required before next inspection. Pay at City Hall, 13125 SW►-fail RIM
PASS PARI' FAIL
SITE Please call for reinspection RE:_. _ t' the to inspect-no a cess
Fins Supply Line
ADA
Approach/Sidewalk Date Irl -�� -- Inspector - - Z'1�s Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspectir 'ne: (503)539-4175 MST
INSPECTION DIVISION Buisine e: (503)639-41-1 ----
BUP -
Received __ Date Requested----Zab" /C13 AM_.-_ PM_ _ BUP
Location —1- -�SL!_ �/�,� IV, Suite MEC -
Contc'Ct Person __ _. _— Ph( )
--_----- FLM
Contractor -_-- —_-- Ph( ) — -__ -- SWR —_ --- -
PU _ Tenant/Ovmer _ ELC
Fogap ELC
Foundation Access:
Ftg Dmin ELF _
Crawl Drain __ _
Slab Inspection Notes SIT
ist 3 Beam
ihear Anchors
- ----
xi Sheath/Shear
Int Sheath/Shear
Framing - -
Insulation
Drywall Nailing - - ----- - - - -- - --
Firewall
Fire Sprinkler ----- - -- - --------- ----
Fire Alarm
Suso'd Ceiling - --
Roof
Other: - --
PART FAIL -
P
Post&Beam
Under Slab
Rough-In
Water Service -- -_- ---
Sanitary Sewer
Rain Drains - -- --
Catch Basin/Manhole
Storm Drain -- s- - — - -----
Shower Pan
Other: --
Final
_PASS _PART_ FAIL
MECHANICAL
Post& Beam
Rough-In -
-- ------ --------_._.__.__..--
Gas line — -
Smoke Dampars -- - ------ ------ - - --
Final
PASS PART FAIL — - - - - - -- --- - -- ----
ELECTRICAL
Service
Rough-In
UG/Slab —_�-.--
Low Voltage
Fire Alarm
Fina; Reinspection fee of$ - required I.ehxe next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA38 PART FAIL
SITE _- _ - � Please call for reinspection RE:-_ — � Unable to inspect-no access
Fire Suppiv Line
ADAl
Approach/Sidewalk Date / �� Inspector ��
Other: _
Final DO NOT REMOVE this Inspection ricord from the job site,
PASS PART FAIL
De 04 03 11 : 07a dan edmonds :703-692-0768 P, 1
Plumbing Permit Application - ' ' '
--- _.--.-- �. � i Received Plumbing
Pcrmit_No
City of Tigard Planning App:uval Sewer
Datr/p : _ OtherPeffnNo.:
1312$ $W 13411 1zlvd Plan Rcvicw -__- Other
Tigard,Oregon 9''223 Permit No.:
Phone: 503-6394171 17:x: 503-598-1960 Prot-Review land Use
Internet: wwwci.iigard.or.us U0t01BY: Case No.:Contact See Page 7 tar
24-!lour Inspection Requez:: 503-639-4175 NaatrrJMcthod: Snpplanental lnfarmntian.
_ TYPE OF WORKFEF:*SCIII?.DULE Ior special information use checklist)
New construction 10 Demolition _ Description Qty. Fel{ta.) Tatai
Additiontalteration/replacement Other: _ New 1-&Z-I'amily dwelungs
CATEGORY OF CONSTRUCTION . '-.• dudes udes 100 IL for eaeb utflity co neetion
&2-Family dwellingSFR 1 Lath 249.20 Commercial/Industrial SFR 2 bath _ 350.00
Accessory Building _ ylulti-Family SFR(3)bath 399.00
Master Builder_ )thee Each additional balWkitchen 45.00
JOB SfrE INFORMATION..nd LOCATION _ Fire s rinkler-sq.ft.:� Pae 2
Job site addres_s: .:Z330 .i w Ct l/ mac.,-A. T Site Utilities
Suite#: Bldg./Apt.#' Catch basin/arca drain 16.60 _
ProLct Name:: (,UH,:S f/sra WC�.4.k Jd'J- ,1+. DrywclUlcnch lineJtrcnch drain 16.60
) Page2
Gross street(Directions to job site: fLF22t 2Edr. .,no.linear Manufactured home wilitics _ 110.00
,St; 1.J -C 3 !s7-' �'�- Manholes _ 16.60
Rain drain connector 16.60
_ Sanitary sewer(no.linear fl Pae 2
_Subdivision' i,L)YUs Jcfs L0a_0_ I Lot#:,5Ci Storm sewer no.linear R. Pn e 2
Tax map/parcel#: , -_ Water service no.linear fl. i Page 2
DESCRIPTION OF WORK Fimtre or Item
-Absorption valve 1_6.60
LCLtII�SC' G �Gi.GIG 101[� G(�)lC p, W _Backflow pLcLventrr Pae 2
Backwater valve 16.60
Clothes washer 16.60
_Dishwasher _---^� 16.60
Drinking fmintain 16,60
ROPERTY OWNER TENANT _ L'cctoNsum _
�- p --- --
Name: is �'fe. 6/c+�y1�S 16.60Er.
Expansion _ _ 16.60 -
Address: A 3O -&LL) &,a t Q..tuo 0 4nu Fixlurc!sewer cap -� 16.60 -
Cit /State/Zip:L&V-r. C54AJ_e Cf JO_S Floor diainMoor sink/hub 1_1.60 y
-'
Garbage disposal - 16.50
Phone: Fax: Ilose bib 16.60_
PPLIT CONTACT PERSON [cc maker - 16.66
Name: &I C01 c amain tolercTtorlgreostrapT -_16.60
t�ddress:/. .70 O 4-W Yryt M Medical gas-value: S Page 2
City/State/Zip:-rJA_ .i_�4*Jf - Cl R: �j�JO(d �, Primer 16.60 _
Roof drain commercial M60
Pholle9d3 Ro9u_ Fax{. a Oa._ 0769 Sink/bas'n/lavato 16.60 `V
E-mail: Tub/shower/shower pan !o.60
:CONTRACTOR Urinal _ -- _ 16.60
Business Name: w
-Water
closet 16.60
[.o.i'1G(SCC.�aOQ �1"C�Qr `� heater �16.60
Address: la--ani Su3 �ji -` 's;he,r��,� other -
Cit /State/Zi :'T'Vt`A._a.#,6^1 �- S�R -rU(o� Other.
PhoneSaZ WJ S9y.S' Fax:9)3 09a -_Qrj(o ________ Plumbline Pa►imlt Fees*
CCB Lic. #: -7AIq Plumb. Lit. 7 So total S
Authorizer! Minimum Permit Foe$72.50 S
Residential Backflow Minim!nn Fee 536.25 -
Signatur!- 11� (L'l�I_�(� - Date:- (�j Plan Review 25%off'"..it Fee S
Ellen�C,���r Sd1te$tucharRe 8%of Permit Fee
r (Please print name:) - - TOTAL PERMIT_FEE S^�j�/
Notice- This permit application expires If a!term!t b not obtained within Alt new commercW buildmRs require 2 seta or plans with isometric or
140 days alter it has been a•eepted as comploe. river diel ram ror plan review.
•Fee meUiorlalapy,rt by Tri-County 4ullding Industry Service Roard.
/ ��� _ MASTER PERMIT
CITY OF T'GA
PERMIT#: MST2003-00397
DEVELOPMENT SERVICE: DATE ISSUED: 8/29/03
13125 SW Hall Blvd., Tigard. OR 97223 (503) 39-4171
SITE ADDRESS: 12330 SW KELLY LN PARCEL: 2S103CC-08300
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 030 JURISDICTION: 116
REMARKS: Const. new SF detached residence.
BUILDING
REISSUE: DM134 STORIES: FLOOR AREAS REQUIRED SETBACKS REOUIREC
CLASR )F WORK: KEW HEIGHT: 1 FIRST: .,:I1 sf BASEMENT: sf LEFT: SMOKE DETECTORSY
TYPE OF USE: SF FLOOR LOAD: 4n SECOND: I u,1H at GARAGE: ',Ili of FRONT PARKING SPACES:
TYPE OF CONST: CN DWELLING UNITS. TRRo sf RIGHT 5
p I,r,:vt3ii
OCCUPANCY GRt': R3 BORM: ,> BATH: TOTAL �'1; VALUE:iI sl REAR: I(�
PLUMBING
SINKS, I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: WO 'RAPS:
LAVAICRIES: 4 DISHWASHERS: i FLOOR DRAINS: SEWER LINES: 100 SF-RAIN DRAINS. I CATCH BASINS:
TUB/SHOWERS: 4 GARBAGE DISP 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR- GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
_ FUEL TYPES _ FURN<100K: BOILICMP<3HP:� VENT FANS I CLOTHES DRYER. 1
r,Ag FURN—100K 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP. hip FLOOR FURNANCE.S. VENTS: 1 WOODSTOVES- GAS OUTLETS: I
_ ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS A'01 INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 400 amp: 1st WIO SVC/FDR SIGN/OUT LIN IT. PER HOUR
LIMITED ENERGY: 401 • 600 amp: 101 600 amp: EA ADDL SR CIR SIGNAL/PANEL: IN PLANT.
MANU HMISVCIFDP.: 601 - 1000 amp: 501♦amps-1000v: MINOR LABEL:
1000 amplvolt: I
PLAN REVIEW SECTION
Reconnect only:
—4 RES UNITS: SVC/FDR--225 A.. >600 V NOMINAL: CLS AREAISPC OCC
ELECTRICAL•RESTRICTED ENERGY
A,SF RESIDENTIAL 0.COMMERCIAL
AUDIO&STEREO VACUUM SYSTEM: AUDIO R STEREO: FIRE ALARM. INTERCOMWAGING: OUTDOOR LNDSC 1.1'
BURGLAR ALARM OTH: BOILER: HVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
PAR%GE OPENER CLOAK: INSI RUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS:
Owner. Contractor: TOTAL. FEES. $ 5,708.0E
This permit is subject to the R:gulations contained in the
DON MORRISETTE HOMES DON MORISSETTE F40MES INC Tigard Municipal Code,State of OR Specialty Codes and
5000 SW MEADOWS RD 4230 GALEWOOD ST,STE 100 all other applicable laws All wcrk will be dine in
SUITE 151 LAKE OSWEGO,OR 97035 accordance with approved plans This permit will expire if
LAKE OSWEGO,OR 97035 work is not started within 180 days of issuance or if the
work is suspended for more than 180 days ATTLNTION.
Oregon law requires YOU to follow rules adopted by the
Phone: Phone: Oregon Utility Notification Center Those rules are set
forth in OAR 952-001-0010 thrcugh 952-001-0080 You
Rena: �y 3R7'7 may obtain copies of these rules or direct questions to
OUNC by calling(503)246 1987
a
REQUIRED INSPECTIONS
Erosion Control Insp 84 Post/Beam Mechanica Plumb Top Out Exterior Sheathing Insl Gyp h)arH Insp AppNSdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Draln/Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
PostiBeam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final
I �
Issued By :: . > _ �h _ Permittee Signature`r 4_
Call (50. 639-4175 by 7:00 p.m. for an inspection deeded the next business day
ter_
CITYOF TIGA.RD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00302
13125 SW Hall Blvd.,Tigard, OR 9)223 (503) 639-4171 DATE ISSUED: 8/29/03
PARCEL: 2S103CC-08300
SITE ADnRESS; 12330 SW KELLY LN
SUBDIVISION: WIIISIII,k'SX AIK ZONING: IZ-4.5
BLOCK: LOT: 030 JURISDICTION: II(i
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 detached dwelling.
Owner: FEES
DON MORRISETTE HOMES Description Date Amount
3000 SW MEADOWS RD
SUITE 151 1SWUSA) Swr Connect 8/29/03 $2,400.00
LAKE OSWEGO, OR 97035 ISWUSAI Swr Connect 8/29/03 $0.00
Phone: ISWINSI11 Sm Inspect 8/29/03 $35.00
ISWINSI'j ti\%r Inspect 8!29/03 $0.00
Contractor: - --�
---- — -- -— Total $2,435.00
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all tee rules ane' regulations of the Ck in Water Services. The permit expires 180
days from the date issued The total amount paid will be forfeited if the pe .,iit expires The Agency does not
guarantee the accuracy of the side sewer laterals 'f the sewer is not locF,tec. at the measurement given, the installer
shall prospect 3 feet in all directions iron the distance given If not so Iccateo, the installer shall purchase a"Tap and
Side Sewer' Permit and the Agency rill it stall a literal ATTENTION Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100.
You may obtain copies of these rules or direct questions, to OUNC by calling (503) 246-6699
Issued by: _ �Y"YL �'� Permittee Signature " - --
Call (503) 39-41 i5 i; 7:00 P.M. for an inspccti:on needed the next business day
CITYOF TIGARD PLUMBING PERMIT _
DEVELOPMENT SERVICES PERMIT#: PLM2003-00610
13125 SW Hall Blv,+ , Tigard, OR 97223 (503) 639-4171
DATE ISSUED: 1^/9/03
SITE ADDRESS: 12330 SW KELLY LN PARCEL: 2S103CC-08300
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 030 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFL JW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
�— SINKS: URINALS: GREACE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: L7stall irrigation backflow preventer.
F'EJ
Owner: =---- ____ --._
-- Description Date Amount
DON MORRISETTE HOMES ---'
5000 SW MEADOWS RD iI'I I %M1 I'IArnui I cc 12/9/03 $36.25
SUITE 15' i I,t\i ,� si,uc 12/9/03 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone :
Contractor:
LANDSCAPE OREGON, INC.
'1 2200 SW MYSL ONY RD.
T JALATIN, OR 97062
REQUIRED INSPECTIONS
Phone : 503-0921-5945 RP/Backflow Preventer
Final Inspection
Reg #: I IC LCB: 7904
III.M ALL PHS+SFS-PLL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OF,
Specialty Codes and all other applicable laws. All work will be done in ;accordance '.v,,h approved pl.. :is.
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 regUires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 9520001-0010 through OAR 952-0001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246.6699.
Issued By: �4-c �sl� - l --_- Permittee Signature:
CTII (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
)
CITY OF TIGARD
Residential. Ct rtificate O f* Occupancv
Permit No.: 3 -yo3 9 ,'7 Addre
Owner/Contractor: -1"'r �'c -S _______. .._
Date of Final Inspection: �z�/�f inspector:
This structure has been found to be in substantial compliance with the prnvisio, ;of the State of Oregon One& Two Family V"elling
S erialty Code and is hereby approved for occupancy.