12350 SW KELLY LANE N
W
O
CNC
C
m
r
r
r
z
12350 SW KELLY LN
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 3-
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUIP
Received Date Requested AM------- PM BUP
Location Suiie____ MEC
Contact PersonPh Pi-m
Contractor Ph FWR
BUILDING Tenant/Owner ------ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Shoath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
-
Roof
Other:
Final
PASS PART FAIL
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin i Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
omq&
PART FAIL LJ Reinspection tee of s tequirb-1 before next inspection. Pay at City Hall, 3125 SW Hall Blvd.
J-] Please call for reinspection RE. Unable to inspect--nois cess
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector G-AR. -V V) L-C Ext
Other U
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
►AAAAAA.AAAAAAA.AAA.A♦AAAA.AA.",AAA.AlAAAAA A♦AAAAA-J
Q >
rrl
C �
Vi
t �, } t� ►
._ bp.
r
\ i►
*zLlo
y
r v
" ►
►
d
> y -- ►
►
A o r � �►
i � I►
i ' I►
� ' I 1►
/ I
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 S LiT-7- �5
OUP
Received Date Request d 13UP
Location z 2-_L'-s Suite MEC
Contact Person ------- Ph PLM
Contractor Ph SWR
BUILDING TenantlOwner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 4
Framing -
7-- e) 4- 44,57 .
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final
j�SS Ss_, PART FAIL—
81ING
Post&Beam
Under Slab
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
I Smoke
ampere
Final
PART FAIL
- -
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of required WfOre;mxt insporlion Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE F] Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Deb704 inspector
Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 3_7
INSPECTION DIVISION Business Line: (503) 639-4171
BUII
Received �1140 41� 1Z. Date Requested _!�?_-7�0_qAM____PM BUP
Location -Suite MEC
Contact Person Ph(---) qY3 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Footing
Foundation AccessELC
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.
PLUMBING
Post& Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
WF
PART FAIL16A_L
Post&Beam
Rough-in
Gas Line
Smoke Dampers
Final
PASS PART FAIL
-
ELECTRICAL
Service
Rough-in
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART FAIL
SITE Please call for reinspection RE: Unable to Inspect-no access
FiADAre Supply Line
/7/
Approach/Sidewalk Date h
Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIOARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST _
INSPECTION DIVISION Business Line: (503) 639-4171 — ---
BUP
Received _ _ -___ Date Requesied AM__-_-_— PM _ _ BUP
Locations ��_.._.__ _—Suite_�� MEC
Contact Person _- _ Ph PLM1 s �
Contractor— ,/S _ Ph SWR
BUILDING Tenant/Owner _ _—_ ELC
Footing _
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain _
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors _-__-
Ext Sheath/Shear
Int Sheath/Shear
Framing - ---- - -- - - -- —
Insulation
Drywall Nailing - -- - -- - ---- - ----
Firewall
Fire Sprinkler - -- - --
Fire Alarm
Susp'd Ceiling - - --- ----- --
Roof -�
Other: - --
Final
PASS PART FAIL
Post& Beam j
Under Slab
Rough-In
Water Service — --- — —
Sanitary Sewer
Rain Drains --�-- -
Catch Basin/Manhole
Storm Drain --_--
Shower n
iF` (/
P PART FAIL"At --
--------------
CHANICAL —
Post&Beam
Rough-In - -
Gas Line
Smoke Dampers
Final
PASS PART FAIL. -- - ---- _
ELECTRICAL
Service -- ---- ------- - -
Rough-In
UG/Slab - - --- ---- _
Low Voltage
Fire Alarm ---------- - - ---- -- —
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall 910
PASS PART FAIL
SITE _ C-] Please call for reinspection RE: F_ Unable to inspect - no access
Firs Supply Line
ADA
Approach/Sidewalk Qete - -{�--t-- Inspector� Ext
Other:_
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL.
CITYu F T I GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2004-00145
zI. PW 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4,171 DATE ISSUED: 4/6/04
SITE ADDRESS: 12350 SW KELLY LN
PARCEL: 2S 103CC-08200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 02.9 JURISDICTION: TIG
CLASS OF WORK: ALT 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: WArER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: BACKFLOW PREVENTER
�J FEES
Owner: -_ -- _—
�— Description Date Amount
DON MORISSETTE HOMO-S
4230 GALEWOOD ST I I'LUMBI Pcrnnl I cc 4/6/04 $36.25
STE 100 ITAXI 8 'm1c Smchmi 4/6/04 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 503-387-7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY FAD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503.692-5945
RP/Backflow Preventer
Reg#: LIC 7804
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 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
Issued By: Permittee Signature: e-)q`
rail (5073))6639--4175 by 7:00 P.M. for an inspection needed the next business day __/
flpr 05 04 03: 03P dan edmonds 503-692- 0768 P• 2
Plumbing Permit Application t�i"d , plumbing
Datdo . Permit No -',4) . -0c�
SewLT
City of Tigard Dates�ppro�I Permit No.-.
13125 SW HAI Blvd. flan Review Other
Tigaid,Oregon 97223 Ekum :. Permit Na
Phone: 503-639-4171 Fa-.: 503-598.1960 Post-Review land Use
Intemet: www.ciAigard.c..us "Ontmeecct - urrm-
-,Sea Page 2 for
24-hour Inspection Reviml: 503-(394175 NamdMethod: Supplemental laformatlon.
TYPE OF WORK FEE*.S('MWULE(fors exlahiufotiaadon ase checklisit)
New const mction -MrDemolition Description Qty. Fee(ea) Total
Addition/alterati t:placement I EJ Other: New J1-&2-famllyArteULugs
_ CATECOR.Y.OF CONSTRUCTION. _�dada 100 It.roe sere h strut coasection)
1 2-Famllllin CommerciaUlndustrial SFR(1).bath - 24920
Ywe
---- SFR buh
350.W'
( ccesso Building Multi-Family SFR 3 bath- -- --� 399.00
❑Master Builder R fdiiier: Eadt additional bath/kitchen _ 45.00
JOB SITE 114FORMATION and LOCATION Fire nklcr- .R.: Page 2 _
Job site address: / S G Stat.' i<t Site Utilities
Suite#: -=BIdgJApt 4 C"b=Wwca drain 16.60
Myy dVkach lineArench drain 16.60 _
Project Name:i.0 h►S t!t'� W 0- IG Lt i L`% --_ t ortin drain oo-linear tt Page 2
Cross street/Uirectionslto job site: M�� om utilities 110.00
(,k-1 I %- I fi �`L1 Manholes 16.60
Rain drain connector 16.60 _
_-2-Y 1441Y Wwer no.linear R. _ le
Subdiv-sion: lLU VN, � .` LOOS_k�[.ot#: =� Ste'rm sewer(oo.Iinear fl.Tax trap/parcel#: (p C ' /j Water service(no.Imes>ur ft _
�'-' Fixture of-Item
DFS4:RIPTION OF WORK Absorption valve 16.60_
LL!!1QS G Gt�C'lG�I�u) G(U 1 C(. Backflow pMLcnter _� Pae 2 i
Paekrvain valve 16.60
Clod=washer --..� 16.60 _---
,TT_--. Dishwasher --- 16.60 -
Dtt fountain I G.GO
PROPERTY OWNER TENANT Britildinkiri/ 16.60
Name: pW____n _SErIS�4 k. 1-k�Ylc s- _B_xpatsion tank - _ --- 16.60
Address%: A 3O Sl.0_ t�y.�WQO � - Fixturdsewer cap 16.60
Cl /State/Zi :LIYV-£_ CSS u t j C17Ca3s Floor drain/floor cirdu'htrb 16.60
- --P - Gar) a dispatiA 16.60
Phone: __- Fax: Hose bib 16.6G
PLICANT CON'I'ACT�_OLV to maker - - 16.60 -----
Name::EJ I(Arl aS a-t-►'D L(_3 _ _ tnlesz toretrap 16.60
x,10 Q be.� -/'yl [(�yI -R� - Morh'tal Attu-value: S �- Page 2
Address. _
Ci /State/Zip:-(l,t._ dJ-%p,: primw - 16.60 --
Roofdfa6l(corluncroialL 16.60
PhoneSb3 to%-. YILLS I FaxSA3 log al- 071b 17 Sinklbesin/lavaw _ 16.60
E-mail _ Tub/shower/shower pan 16.60
COMT.AACTOR
_. � �.. .__ urinaA �-- _ 16.60
BusinessName: W� cAoset 16.60
Address: Wata heae16.60
Other:_
Ci /State%L 'MLi 4o-#Zr R (>'�.
_ Oth .
Phone � SR --_- biogPetitPeep
7. S
CCB Lic_ #: -79Vq Pltunb.Llc.#: - - stibtolal s _
Authorized �J ---! Minifnutn Permit Pae 577-50 S
5ignnturJr ��G ���� Z�1X L? Date:L C /r�q Residential Backnow Minimum Fee$36.25 _
/ �_-- Plan Review 25%oi_Permit Fee s
State Surcharge(SV.ofpamit Fee
nam
(Please print e) TOTAL P6_RMrr FEL► S � /y
N"nca: Thin permit appttrattas e:plres It a permit is net obtaiaed within All.err cemmereial buildtap require 2 aehr or plans with isometric or
1Ii0 days after It has been accepted as enmpleir_ riser dlaamrn for plan review.
•Fro ruethedele"sat by Tri-County Building Industry Ser-Oce Board.
CITY
O� ������ MASTER PERMIT
PERMIT#: MST2003-00522
[DEVELOPMENT SERVICES DATE ISSUED: 12/2/03
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12350 SW KELLY LN PARCEL: 2S'103CC-08200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 021) JURISDICTION: I1(i
REMARKS: Constof new SF detached residence.
BUILDING
REISSUE: DM198 STORIES: _ FLOOR AREAS REQUIREO SETBACKS_ REQUIRED
CLASS OF WORK: NEW HEIGHT: 2a FIRST: I I sl BASEMENT. %I LEFT SMOKE DETECTORS Y
TYPE OF USE: SF FLOOR LOADSECOND: I nnn 51 GARAGE. 683 sl FRONT: 20 PARKING SPACES 2
TYPE OF CONST: 5N DWELLING UNITS: I rHIR) S RIGHT:
10233.
:
OCCUPANCY GRP: R3 BDRM. 4 BATH: 7 TCITAI r�5i7 sl VALUE263, REAR: 15
_ PLUMBING
SINKS: I WATER CLOSETS I WASHING MACH: LAUNDRY TRAYS: RAIN".AIN: Inn TRAPS'.
LAVATORIES. DISHWASHERS I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS.
TUB/SHOWERS GARRAGE DISE' I WATER HEATERS: I WATER LINBS: 100 BCKFLW PREVNTR: GREASE TRAPS.
OTHER FIXTURES
MECHANICAL
FUEL TYPES FURN<100K. BOILICMP<3HP: VENT FANS: n CLOTHES DRYER: I
n FURN—100K I UNIT HEATERS HOOD&, 1 OTHER UNITS. I
MAX INP. btu FLOOR FURNANCES: VENTS. I WOODSTOVE-0. GAS OUTLETS. I
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVC!FEEDERS BRANCH CIRCUITS MISCELLANEOUS _ ADD'L 114SPECTIONS
1000 SF OR LESS'. 1 0 - 200 amp: 0 - 200 amp: W/SVC OR rOR. PUMPIIRRIGATION: PER INSPECTION,
EA ADD'L 5005F: 201 - 400 amp 201 - 400 amp: 1st WIO SVC4 OR SIGN/OUT LIN LT: PER HOUR.
LIMITED ENERGY 401 - 600 amp 401 600 amp: FAADUI.RR CIR SIGNALIPANEL IN PLANT:
MANU HMISVC/FDR: 601 - 1000 amp: 601-amps-1000V: MINOR LABEL:
10004 amu'volt
FLAN REVIEW SECTION _
Reconnect only. >=4 RES UNITSSVCIFDR>=225 A >600 V NOMINAL. CLS AREA/SPC OCC:
' ..
ELECTRICAL•REST RICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO R STEREO. VACUUM SYSTEM. AUDIO&STEREO. FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGL AR ALARM OTH- BOILER. HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL
GARAGE OPENER: CLOCK. INSTRUMENTATION: MEDICAL. OTHR:
HVAC'. DATA/TELE COMM NUPSE CALLS. TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,253.42
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This d Municipal
c al Code,
, the regulations SpeciContalty
Co in the
4230 GALEWOOD ST 4230 GALEWOOD ST,STE 100 Tigard Municipal Cade,State o OR. Specialty Codes and
STE 100 LAKE OSWEGO.OR 97035 all cordoAher applicable laws. All work will be done it
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 ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503-387-1538 Phone: Oregon Utility Notification Center Those rules are set
forth in OAR 952-001-0010 through 952-001-0080. You
Reg N: �I 387 t7 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erasion Control Insp 84 Post/Beam Structural Mechal,Ical Insp Shear Wall Insp Insulation Insp Water Service Insp
Grading Inspection Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Appr/Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain/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
Issued By : �� --=p--- •Q ' Permittee Signature : __ -
Call (503) 649-4175 by 7:00 p.m. far an inspection needed the nex: business day
CITYOF TIGARD 'EWER CONNECTION PERMIT—
DEVELOPMENT SERVICES PERMIT#: SWR2003-00386
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/2/03
SITE ADDRESS; 12350 SW KEI_L.Y LN PARCEL: 2S103CC-08200
SUBDIVISION: WHISTI-FICS W,\I.K ZONING: 1l4,5
BLOCK: LOT: 029 JURISDICTION: TI(
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 permit for new SF dwelling.
Owner: — -- _—
FEES _
DON MORISSETTE HOMES
4230 GALEWOOD ST Description Date Amount
STE 100 S W 11SA J Sv%r Conned 12/2/03 $2,400.00
LAKE OSWEGO, OR 97035 1SWUSAJ S%%r Connect 12/2/03 $0.00
Phone: 503-3217-7538 1SWINSPJ S%kr Inspect 12/2/03 $35.00
Contractor.
1SWINS111 Sv„ Inspect 12/2/03 $0.00
— —_ _
-- Total $2,435.00
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply with all the r )s and regulations of the Clean 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 installer shall purchase a "Tap and Side Sewer' Perm
Issued by: -- —t�`w— �. _ --- Permittee Signature: �� `'�-------
Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next business day
Buildinb Permit Application
City of Ti > .CEIVED Daterecetved: /D Gam— Pertnitnu.:(1t5j
Address: 13125 SW Nall Blvd,Tigard,OR 97223 1'rolcct/appl.no.: Expire date:
City of Tigard
Phone: (503) 639-417NOV '. () ?001 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no. Payment type:
Land use approv t QTY Ui. 1 IUAHDILfanuly:Supple Complex:
11VIS10"
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family ,,&New construction U Demolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
job adess: l L Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map/tax lot/account no.: XX_-Q Q
Project name:
C'
Description and location of work on premises/special conditions: 4
a L (,>,,' UOR SPI.1 IM, IN1,01011%I ION, USF 11111101ST
Mailing address: - — do I2 family dwelling:
City: StateC.i ZIP:: , x Valuation of work........................................ $
Phone: ^` Fax: ) .)-7 -marl: No.of bedrooms/baths................................. -
Owner's representative: /,'y-1 r t_K Total number of floors.................................
hone: F. iE- New dLL illlil`l area(sq. R,) .......................... _
Garage/carport arca(sq.ft.)......................... -�—-
rM.ailiFng
Covered porch area(sq.ft.) ........................
ss: (Z Deck area(sq. ft.) ..................................... ..
---v: State: ZIP: ether structure arra(sq. ft.)............. ...........
Phone: Far (:•mail: CommerciaUbtidu9trial/multi-family:
Valuation of work........................................ $ _
Business name
Existing bldg.area(sq.ft.) ..........................
Address: a
--- New bldg.area(sq.R.)..............I................. ----
City: State: ZIP: Number of stones........................................ _
-- Type of construction....................................
Phone: F_ax: E-mail:
CCB no.: Occupancy group(s): Existing:
---
New:
City/metro lie,no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: u l _�-, y� provisions of ORS 701 and may be required to be licensed in th
Address: ��. ,� jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.: — -- --
Phone: Fax: E-mail: -- - - - --
Name: _ Coma' i person: Fees due upon application ........................... $
Address: ^� Date received:
City: State: Z.[P: Amount received ......................................... $ _
Phone: Fax: E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not UI Jurisdlcuom accept credit cards,please call juriulictlon for more informWan.
attached checklist. rovisions of I ws and Credit card number:i dinances governing this O Visa ❑MasterCard
work will be comp) w ,whether cifieci creift t. �,
- v 11
Au'horized si pato T(,� Name o.cardholder as shown on credit cwd
J __ __ _S _
Print name: 4 f t.4l f ( L — _Cardholder signature Y Amouni
Notice:This permit application expires if a permit is not obtained within 180 days atter it has been rceepled as complete. 440.4613(6on"COM)
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
CiryojTigard Ci of Ti std Associated permits:
ty g ❑Electrical ❑Plumbing O Mechanical
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Ll Other:
Phone: (503) 639-4171
Fax: (503) 59F :'RO
U Ves No N/A1 Land use actions completed.See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain,solar balance points.seismic sola designation.historic district,etc. _
3 Verification of approved platflot. _
4 Fire district _ approval required. _
5 Septic system permit orauthorization for remodel. Existing system capacity_
6 Sewer permit.
7 Water district approval.
S Soils report.Must cavy original applicable stamp and signature on file or with application.
9 Erosion control ❑plan O permit required. Include drainage-way protection,silt fence design and location of
catch-basin protection,etc.
10 3 Complete sets of legible plans.Must be 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 full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist. K _
I 1 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if
there is mote than a Oft.elevation differential,plan must show contmir lines at 24 intervals):location of easements and
driveway:faxprint of structure(including decks);location of wells/sepffc systems:utility locations;direction indicator,lot
area:building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water 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, Y
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 cruas references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plass. Must indicate details and locations;for `
non-prescriptive path analysis provide specifications and calculations to engineering standards. _
17 Floor/roof framing.Provide plans for all floors/roof.assemblies,indicating member sizing,spacing,and hearing
locations.Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. Fur engineered
systems,see item 22,"Engineer's calculations."
19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non-uniform load. _
20 Manufactured noon/roof truss design details. _ _.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four or more appliances. _
22 Engineer's calculations. When required or provided,(i,c.,shear wall,roof truss)shall he stamped by an engineer or !l
architect licensed in Oregon and shall be shown to he applic.Ae to the project under review.
23 Five(5)site plans are required for Item I 1 abol e. Site plans narst be 8-1/2"x 11"or 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 be accepted. 4
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may lie in blue or black ink.
Red ink is reserved for department use only. 4404614(eMCOM)
Mechanical Permit,A cation
MUatereceived: Permit no.
City of Z I—� y Project/appl.no.: Expire date:
City c ngard Address: 13125 SW Hall l j ,)TiSwO,QR 97223
U Date iss,ed: By: Receipt no.
Phone: (503) 639-4171
Fax: (503) 598-1960Case file no.: Payment type: -
GIl'Y OF I I(aAF3L7 Building permit no.:
Land use approval: ,;;fir r,tr.lr, r IVI`,IC`^ _
TYPE OF PERMIT
O I &2 family dwelling or accessory G Commercial/industrial O Multi-family O'Ienant improvement
XVew construction O Add Ition/alteration/replacement O Other:
O: SITE INFORMATION COMMERCIALI
Job address: LLA Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suiten .' value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: 4 `See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: IS
Description and location of work on premises: t s t t ' r
Fee(m) Total
Est.date of completion/inspection: Desai on Qty Res only Res.only
Tenant improvement or change of use: VAC:
Is ezistin space heated or conditioned'?U Yes El No Air handling unit CFM r_
g P' Air con itionfag(site plan requrrt ) _
Is existing space insulated?Q Yes O No I A terauon of existing HVAC system
o� iler/compressors
Business name: State boiler permit no,:
I 14P Tons BTL711
Address: (^ Fire/smoke damper uct smoke detectors
City: Lli State� ZIP: eat pump(sue plan required)
Phone: Fax, I E-mail: nstal repacefurnacelbumer
Including ductwork/vent liner O Yes O No
CC$ no.: Install/replace/relocatereaters-suspen e ,
City/metro lic. no.:N/A wall,or floor mounted _
Name(please print): C '� � �( _ ent ora +anceo �r an furnace
e igeral on:
Absorption units BTU/H
Name: El L.- Chillers __ HP
Address- Col m ressors, HP
•ironmental a tut an ventflation:
Cita State: ZIP: Appliance vent
_^
Phone: Fax E-mail: erez gust
Hoods,Type 11res.kite en/hazmat
hood fire suppression system -
Name: y-� ' Exhaust fan with single duct(bath fans) _
Mailing address: ) �' yX .xhaust system apart from heating or AC
ne piping an distribution(up to 4 outlets)
City: titate ZIP J Type: __LPG _-_ NO Oil
Phone: Fay E-mail Fuel piping each adr itiona over 4outlets
roctesspiping(schematicrequired)
Name: Number of outlets
ter lista app ane or equ pmenl
Address: Decorative fireplace
Cit} State: ZIP: Tnsen-type
----- -- '-- Woodstove/peIIetstove
Photic _ Fax: Email: _
Other:
Applicant's sign atfu Date: - ✓ Ut era _ _
int) Yi f
Name(print):
Not all unsdictions accept credit cards,please call)unulictinn rot more 1W1_, tion. Permit fee ................$
Notice:This permit application Minimum feeee................$
O Visa O MasterCard expires if a permit is not obtained
Credit cad number within 180 days atter it has been Plan review(at _ 96) $
—" Expires >' State sur'-harge(8%)....S
Nome of cardholder u shown on credit c s accepted m complete. V
TOTAL .......................S
Cudholder s rAlure Amount 440-4617(&MCOM)
Plumbing Permit:application
-City of Tiga;d WED
Date received: Permit no.: 1 --
Sewer pernut i,..,. Building permit no.:
Address: 13125 SW Hall Blvd.Tilgard,OR 97223 —
Cay ofTigard Phone: (503) 639.4171 j�' t' J,!i Projectlappl.cn.. Expire date:
Fax: (503) 598-1960 Dare issued: By: Receipt no.:
GiTY OF ,rIGARD rase tilt no. Payment type:
Land use approval: _ 11 �i.r;IVIE)If9ti-
sid
O 13c family dwelling or accessory U Commercmi/indusuial 0 Nluki-family ❑Tenant improvement
New con suticuon 0 Addition/alteration/replacement ❑Food service O Other.
1 . SrFE tNFOFLMATIONa tULE(for special informal
C Desert tion l Fee ea. Total
lob address. -
New 1•and 2-family dwellings only:
Bldg. no . suit'! (includes 100 fl.for each utility connection)
Tax ma /tax lot/account no.: SFR(1)bath _
L,ot_ Block: Suixiivislon �, `-1 SFR(2)hath
Project name: SFR(3)bath
City/county: ZIP: — Each addiuonal bathilutchen _
_ Description and fixSite utilities:ation of work on premises:-_.A— ('arch basin/area drain
&-L date of co,mpletio�nspection: DrywelL�leach IineJvench drain —�
Fooung drain(no. lin. ft ) _� I
Manufactured home utilities
Business name: I Manholes _
Address: [ _� Rmn drain connector
City State ZIP S uutar+ sewer(no.lin. ft.)
'`- Storm sewer(no.lin. ft )
Phone: -1" Fax: J E-mail:
Water ien•lce inn.lin. ft.i I
CCB no [cmb, bus, reg. no: — FLrture or item:
Cityime ro tic. no.: NiA °° Absorption valve
Contractor's representative signature'._ Back llow prevcriter
Print name: U ' Backw.•-r valve
i3asi 1avatury
Clothes washes
Name. ti Dishwasher _ J
Address: Dnnline fountain(s) _
Cit" _ __�Sta<c:, TZIP. Electors/iump —
Phone Fax: Email: Expansion tank _
Fixturelsewer ca
Floor drains/floor sinks/hub
Name (print): r Garbage disposal
Mailing address: T Hose btbb
City: l State , ZIP:C ��Z 5, lcc maker
.Fax E-mail: Interceptor/ ease trip
Owner insradariun,residendai maintenance only: The actual installation Primers) i
will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _
employee on the proper I oven as per ORS Chapter 447. Sinktsl,basin(si. lays(s) � _-
Owner's signature Date: Sump _
Tubs/shower/shower pan _
Unnal �—
Name _ Water-luset
Andress: Water heater —
Cir. State: ZIP. Other.
Total
Phone. x: Email:
Fa
Na all uns,itatons zu Minimum fee................$ —
pr crethi suds.please can iunsdicuon fnr mme mfontucun. Notice:This permit applicaticn t
Plan revie�.v(at — `'�)
C Visa o M33tercard expires if a permit is not obtained State surcharge(8"o) $ -
C.edil cud number Expel — within 180 days afler it has been
accepted�complete. TOTAL ................... ...S
hare jf a .
rdwldet a dfown on.rn ,c.vd s
C.vuhoider a/narum Amount it0-�hl61tHACnA1l
Electrical Permit A tlication
L'La' Datereceived_ Permit no.: l;;y
City of Tigard ���l�~ °° Projecdappl.no.: - Expiredate:
City nfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97723 Date issued: - By: 71 Receipt no.:
Phone: (503) 6393171
Casa file no.: Paymenttypc:
Fax: (503) 598-1960
CITY C)F TIGl1.9D
Land use approval: I IILDING 01
O 1 8c, fatnily dwelling or accessory O Cominercial/industrial U Multi-family O Tenant improvement
New construction C-1 Addition/alteratiori/replacement U Other. U Partial
It 1
Job address: ���/�� E'� Bldg. Suite no.: _ __ Tax map/tax lot/account no.:
Lot: Block: Subdivision: J V I_J
Project name: _ Desctiption and location of work on premises:
Estimated date of completion/inspection: FEE
SCIIEDULE
CON I RACI(M \1111V WA I WN
Job no Fee lllaur
-- Description (ca) Total no.las
Business name: t�Z�-L - 1
� New residentiMin it.i -ludas tt ched family Per
Address: � "��T dwellinRsusitlncludaatWchedgnrage.
City: L� Mate: ZIP Serriabscluded
Phone 1000 sq.ft.or less 4
P —. � I Far. Email
-- i Each additional SW sq.ft or portion thereof
CCB no. Z� Elec. bus. lie. no: �'I !�m,teilenergy,residential 2
C — Limned energy,non-residenual 2
Each manufactured home or modular dwelling
nmurr_w curer,rsrnq elecf►ielan(requlred) Date Service and/or feeder 2
License nu? C -servtca or(riders-lnctallsliun.
Sup elect nameipnno 1 �� alteration or relocation:
200 amps or less _ 2
r 201 amps to 400 amps2
Name (printr ` 401 amps to 600 amps _ 2
:ailing address: 60I amps to 1000 amps _ 2
City: L Z, State Over IWOainprorvolts 2
Phone: -T Far:
--7L, -mail: Reconnect only I
Owner instnflation•the installation is being made on progeny I own Temponryservicesorfeeders-
instaliation altention.orrelocation:
which is not inlC'1dCd hid Stllc, Irasc, rent. Or cxchanke according to 'W amps or less 2
ORS 147, 355,474,670, 701. 2 oi Amps to 400 amps —_ 2
Owner's si nature: Date: 1 401 to 600 amps 2
a I Branch circuits-nen,alteration,
or extension per panel:
Name: K Fee for branch circuits with purchase of
Addre>s' service or feeder fee,each branch circuit 2
` zip: B Fee for branch circuits without purchase
City: 5L1[e
of service or feeder fer,first branch circuit
Phone: Fax: E-mail: Each additional branch circuli _
71n W1 On M tsc.(Service or feeder not Included):
Each pump or imgation circle 2
O Service over 225 amps-cnmrmrcinl U Health-care facility -- 2
U Service over 320 amps ruing of 1&2 U Hazardous locauon Each sign or outfine lighting
farmly dwellings U Building over 10.0(K)square feet four or Signil circuit(s)or a limited energy panel.
U System over 600 volts nominal more residential units in one structure alteration,or extension' ?
O Building over three stories U Feeders,400 amps or more •Desch tion: —
U occupant load over Q9 arsons U Manufactured structures or RV parA Each additional inspection over the allowable In any of the alcove:
U Egrr_;Jlighungplan U Other ---. --.— -- Pe.inspection
submit_sets of plaits with any of the above. Invesugation fee
The above are not applicable to temporary construction service. Other
_— Permit fee.....................S ---
NN all lurtsdicticxrs accels crenht cards.please call junsdictron for rraxe mlrxmution Notice:This pemitt application
U Visa U MasterCard expires if a permit is not obtained Plan review(at _, %) $ _—.-
Ctedir card aumher
within 180 clays after it has been State surcharge(8%) ....$
Expires accepted as complete. TOTAL .......................S
—Name of cardholder u shown on crnilt card
-- —-- Carahulder signatures Amarum 440-4615(WW,OM)
o
DON • MORISSETTE OBE - 2799 V�
HouleI N C o • T o N A T ! 9
4A a0 0 A L 2 W 0 0 D 8 T A 2 2 T LOT: 29
Lete oewsao. 0 ■ sa0N o7' oaa DATE: 1Q/14/09
(a o a) a a s - 7538 PAZ (a o a) a s - 76 i a PROPERTY: WHISTLER'S—WALK
UITY: TIGARL)
SCALE: 1"=20'
PLAN No.: 198A
OPTION 2 ELEVATION
12350 3UJ KELLY' LANE � 104
Dl mueuc—, 4, °d
SIDEWALK ;t
-_- EASEMENT 0 %
Tri' 911,2' �, 11 ,3 32"0.
A 325,
326
321
21oBm sq. ft. 3 car ear.
4 beth FF E. 348^
330
� n
g
331
32
� 333
\�33Fd
339; X
'33' V
s,
49.13' sus 3s�
LEGEND LOT CA"MAGE
LOT ARE4•: C--Cl SQ. FT.,
ACER RUBRUM BUILDINCI G¢�:: e' $Q. F?. LO? 41° ,
l`�/J ,RED MAPLE PERCENTAGE 2 .. 10 30 1 eq. ft.
_ CITY OF TIGARD- SITE PIAN REVIEW '
BUILUINfi PHINIFTNO.JryS
PLANNING DIVISION,
: ��nCVGl\/�D
Required Setbacks: .®'Approved ❑ N,,4 Approved \I
Side: ._.•;,L Street Side: '`
From. .ckL Garape: _ Renr•; 'AL NOV 10 2003
W-mal Clearrr,rre: 0 Approved Cl Not Approved
CITY OF TIGARD
N'Inxiti um Flt -will„• ;k,-Igtot• A-0 feet BUILDING DIVISION
uier Letter ILe%.16WCLI: 0 YCS No
❑ Received
Date: // - f 3 y 3
(N1_i DHIAK I MEN-1 :
M* ACtual Sl0pe:: A % M Approved ❑ Not Approved
Site Play: / Approved ❑ Not pproved
Nows:
ELECTRICAL -
CITY OF TIGARD RESTRICTEDENERIGY
DEVELOPMENT SERVICES PERMIT#: ELR2004.00027
13125 SW Hall Blvd.,Ticlard, OR 97223 (503) 639-4171 DATE ISSUED: 2/9/04
(E ADDRESS: 12350 SW KELLY LN PARCEL: 2S103CC-08200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 029 JURISDICTION: TiG
Proiect Description: All encompassing low voltage.
A. RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SYSTEMS
4230 GALEWOOD ST PO BOX 14833
STE 100 PORTLAND, OR 97293
LAKE OSWEGO, OR 97035
Phone: 503-387-7538 Phone: 503-397.7518
Reg #: SE34-555821 lJLE
11C 96806
I] I 26-565('1.1.:
FEES Required Inspections _
Description Date Amount Low Voltage Inspecti%m -1
[El,l,R%l I I F[ It I'.inui 2/9/04 $75.1") F I tiAk-- 1 NCTIL)
[TAX] R' State 2/9/04 $6.00
Total $81.00
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 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
952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699
Issued by �` < < �, ; � LI LL Permittee Signature Cc.:
II
i L 1
OWNER INSTALLATION ONLY
The installation is being made on property I own which is ,iot intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ _ _ _ DATE:
L,CENSE NO: i
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
IG/2004 15: 19 5032362322 QUADRANT SYSTEMS PAGE 02
tricot Permit ApplicationReceivcd Electrical
- ---
'Date/By-4 ? . , PermitNwe , 10'1 ,'Z-
Planning
,'
;its of Tigard a Planning Approval Sign
batdB : Pcmtit No.:
3125 SW Hall Blvd. �.` v Plan Review _ Otlicr
i igard,Oregon 97223 Permit No,: _
'hone: 503-639-4171 %
598-19�i�
Post-Review Land Use
Case No.:
intemct: wNvw.ci.Ngard.o ,u9 Contact Ju_ns Fee Page 2 for
24-hour inspection Y.equest 50 -�9 J�73t� \\l, NamcMtethod: Supplemental fnfnrmatlod.
New construction Demolition _ Service over 225 amps- licalth-care facility
r-ommercial LJ Hazardous location
Additian/alteration/re lacemerlt ❑ Ot11Cr: r Service over 320 amps-rating of C]Building over 10,000 square feet,
r•;f1 ti ' 4i' a "' 'r% 1 e4 2 family dwellings four or marc rcaidenlial units in
1 c4, 2-Family d)yellin& Comincrcial/ltldustrial ❑System over 600 volts nominal one strueturc
-- ❑Wilding over three stories ❑feeders,400 amps or more
AccessBuildin Multi-Famll
2�_ — y ❑Occupant load over 99 perxann p Manufactured structures of 1tV park
Master Builder Other: ❑L-grr"s/lighting plan [i Other:
r t Submit_sets of plant with any of the above.
The above are not a iicabie to tem orarz tonstructlon service.
lob site address: at_•.J_
Suite#: Fla.//Apt.#, _ Number of inspec on!"erkqmlt allowed
Project Name: _rrlo!� t+4> _s _ A•serlptton Qty Feetes.) Total
Cross strcet/L�irectiots to ob site: New resldentW.single or mulll-family per
1 dwelling au1L Includes attached garage.
Service locluded: S
1000$4.rt or Icss 145.15 _ 4
Lach additivnnl 500 sel.ti.or portion dtarcof 33. 0 1
- _ , 7--'--ti UI Limited cn tcsidential 75.00
Subdivision: ULh ST I F'.l ct�`�, Lot#: Limited energy,non residential __75,00 2
Tax ma / arcel #: Foch manufactured home or modular dwelling
service and/or feeder 90.90 l
Services or feeders-Installation, -
I�rw0.ra l .n t 4[ �� � � aileratlata or relotatbn:
-- 200 amps or less 80.3_0_ 2
101 amps to 400 amps 106.85 2
401 aurp9 to 600 Amps 160.60 2
A , (PCI amps to 1000 amps - —-- - 240.60 1
Over 1000 amps or volts454,65 2
Name: ti n M7 SCA q44 Erna Rcconntct Only _ _ 66.85 2
Address: Temporary services or(ceders-inAnflalion,
alteration,or relocolloni
Cit /Stat_ e�Ztp: _ _— 200 Amps or lett _ 66 85 1
Phone:Sri Pax: 201 am to 400_amps _-100,30 2
40110 600 ams 133.75 2
- ' MANEW1- Branch circuits-new,niteratfon,or
Name: extension prr panel:
—-- —� - - - - Ar Fee(br bench cirrtdts with purchase or
Addiess. _ _ _- service at feeder fee,each branch eircuit G 65 - 2
Cit /State/Zl l: S.Fee t'or branch circuits without p,uchane or
---- - - - - service or feeder fee,rirst txvtch circuit46.85 _ 2
_Phone: FBS Gch additional branch circuit _ 6.65 _-_ 2_
E-mail: Misc(senvica or fecdcr not included)
Qach pu,n,!ITU�Vaon Circle 51.40 2
_E!Lh_sijfr err outline lighting 53.40 - 2
Job No: 3 i-Rsignal clrcuit(s)ora limited energy panel,
Business Name:Qtu-��j ;-4nt - alteration,Or_eul_ension Par - -- 2
Description
Address:
� � Each additional inspection over the allowable In anJ�of the sbm�e:_..— -
Cit /State/Zip: ��. ( `��Z��''Z_ _ Per i�crian per buur min, I hour G2,.S0
Phone: S�3 ,134-� '— Fax 5a3 �3� a.3 I_ -_ 11tvestiptionfee!
_—
CCR Lic.#. "AWA Lic. #:
Supervising clectJlclaliv,
Subtotal S 76-W_-
s.i afire required: ✓�%l r Ll �i t->' flail Review(25%of Permit Fcc)
Print Name: �N t>• Lic. #: ( l Statc Sutchaw 13%of Permit Fee S —
�� — — TOTAL PERMIT FEE I s i 60
Authorizedl[ otlec: Thls permit application expires fira permit is not nhtsined within
Dole: ""'s t1 � 180 days ager It hax been Accepted as completr.
-
*Fre methodolory set by Tri County fluilding lndustrr Scrvlcr Flnard.
------
(Ple3sc.print name)
,.1Dst51,Pcmtit rorms\PlePermitApp doe n11n3 1
CITY OF TIOARD
Residential Certificate off' Occupancy
Permit No.: ;?et?� —/'�,Sr Z Address:
Owner/Contractor: __;
Date of Final Inspection: �L- .-p¢— Inspector: r %
'f'his structure has been found to be in substantial compliance with the provisions of the,State ol Oregon One& Two Family Owelling
_. wcialty Code and is hereby approved for occupancy.