13455 SW NAHCOTTA DRIVE l �
13.455 SW Nahcotta Drive
Cf i ' OF TIGARD 24-Flour
.;UILIJINO Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)f;' -4171 MST '
2 BUP _-
Received ____—___Date Requested ✓ _... AM____-____ PM OUP
Loc,ition - �1 ✓ S L Suite _ MEC
---------------------
Contact Person ---------- - -__-- Ph( ) SI q 9 /- P. M --- ----
Contractor _- - -_ —._-- - Ph(--) —__-- - -_- swR
BUILDING _ Tenant/Owner
Footing
Foundation ELC _
Access:
Ftg Drain FLR ------
Crawl Dain
Slab Inspection Nate,: SIT --_- --- -- ------ -_--
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
F,aming -- -_
Insulation
Drywall Nailing
Firewall
'orinkler - - - ---- -- _
;arm
d'd Ceiling -------
of
Other:
l — - —
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_ - - _--
MECHANICAL
Post&Beam - --
Rough-In
Gas Line
Smoke Dampers -----
Final
PASS PART FAIL —
ELECTRICAL
Service
Rough-In
UG/S'abFi— - - -- - -
OYV V0-Jfa� ���►'� �
re Alarm - --- -
_ �l
PA PART FAIL Lj Reinspection fee of$---- _required before next Inspection. Pay at Cly Hall, 13125 SW Hell Blvd.
Please call for reinspection RE:_ __ _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date
Other: _
Final OO NOT REMOVE this Inspee lon recor from the job site.
PASS PART FAIL
r
._ter
J
Geopacific
17700 SW Upper Boones Ferry Road,Ste. 100
Portland,Oregon 97224
Tel(503)598-0445 • Fax(503)598-8705
March 25, 2002
I
GeoPacific,.lob No. 99 OR 2791
D.R. Horton
5125 SW Macadam Ave. Ste. 145
Portland, OR 97201
Fax No. (500222-3717
Attention: Mike Loomis
SOIL ENGINEER'S SUMMARY AT CONCLUSION OF EARTHWORK
PACIFIC CREST
CITY OF TIGARD, OREGON
GeoPacific Engineering, Inc. conducted on-call testing and construction observation services for the
above-referenced residential development during the development construction portion of the project
The purpose of this report is to provide a summary of the information generated from our services and to
make general conclusions regarding the adequacy of the earthwork for single-family home development.
This report does not supersede any actual soil observations made during single-family home construction.
SITE PREPARATION AND FILL PLACEMENT
Based on our site observations during construction, after clearing of trees,adequately stripping vegetation
and topsoil and root removal and picking as necessary, engineered fill was moisture-conditioned, placed
in lifts and compacted to a maximum depth of 15 feet on the following lots:
Portion of Lots 2, 6,22,28 through 65 and Parcels A through D
GeoPacific reviewed the depths of stripped subgrade, ItE !ion for engineered fill and keyways and
subdrains as necessary. The contractor checked hori:. iiwits of the work areas. Based on our
density tests, the fill on these lots placed by Excel Excavation was adequately compacted in lifts to a
minimum of 90 percent of the maximum dry density obtained from the modified Proctor. A summary of
our test results for the project is attached, including tests for streets and utilities.
ROCKERY RETAINING WALLS
Several approximately 4 to 8 foot tall walls were constructed by Greg McCloud, an experienced rockery
retaining wall builder. The walls were constructed on Lots 5, 10, 12 through 15, 17 through 19,23, 53,
and 57. GeoPacific observed the walls Intermittently during their construction. In our opinion, the
walls were constructed in general accordance to our design and in accordance with local standards of
cr struction practice.
It should be noted that boulders walls, like many flexible wol! systems, should be expected to move
slightly before the retained soil reaches equilibrium. Bouldc:walls are highly dependant on the skills of
the builder and properly constructed bouloor walls should have a very low probability of requiring
localized future maintenance. Footings for homes should not be constructed on soils supported by a
boulder retaining wall. We recommend a minimum horizontal setback distance from its face equal to
Pacific Crest
Project No.99-2791
Page 2
the vertical retained height of the wall plus 5 feet. Footings closer than this distance will likely nee-J to
be deepened and should be reviewed by a geotechnical engineer.
SLOPES
Based on site observations and the grading plan by Westlake Consultants Inc., many of the lots are on
sloping ground, either naturally occurring or as a result of fill embankment. The fill embankments were
generally constructed per project specifications and the geotechnical engineer's recommendations. The
fill slope on Lot 54 is currently slightly steeper than 2H:1V, but need not be corrected because the future
home is expected to retain the slope. ;The following lots should be reviewed for footing-to-slope setback
issues:
Lots 28 through 66 t
These lots are on sloping ground and many will likely be planned for daylight basements or tall
crawispaces. Excavation of a minimum of four feet is to be expected on sloping ground to reach
adequate bearing soils.
BUI1 DING EXCAVATION
Foundation excavations should be carried through any rain-softened fill or loosely compacted excess soils
placed over the surface of the lots, and any soft or organic native soils. Based on our hand probing
obsurvations and discussions with the contractor, the above listed engineered fill areas have generally
received an average of 12 inches of uncompacted fill on their surface, but other lots also may have
existing topsoil and some disturbed soils. Because of the difficult geometry of the site and the fact that a
good portion of the construction occurred during the winter months, some localized areas of lesser
compact and inadvertent fill can be expected to be encountered and are likely Inevitable. Our final site
review did not discover any of these areas.
For prolonged wet weather conditions, we expect that some mucking of rain softened soils, or placement
of a thin layer of compacted rock fit; may be necessary for improve J spread foundation support and
protection of the subgrade.
FOUNDATIONS
The proposed residential buildings will most likely be founded on shallow spread footings bearing on
competent native soils or engineered fill. Spread footing design and construction is expected to conform
to the Oregon One and Two Family Dwelling Specialty Code. For protection against frost heave, spread
footings founded on medium stiff, low organic native soils, and engineered fill on the above listed lots.
Spread footing embedment should have a minimum embedment depth of 12 inches below e•,,terior grade
and have a minimum width of at least 12 inches for single-story 15 inches for two story, and 18 inches for
three story homes. Minimum steel reinforcement should consist of two horizontally continuous No. 4
bars in continuous footings and one In the stem wall. Based on our observations and the
recommendetions In the above-referenced report,competent native soils or engineered fill are considered
suitable for support of foundations to a maximum allowable bearing pressure of 1,500 Ibs/ft2 and a
maximum column load of 40 kips. For greater loads, a Soil Engineer should be consulted. The
coefficient of friction between on-site soil and poured-in-place concrete may be taken as 0.35 (no factor-
of-safety included). The maximum anticipated total and differential footing movements (generally from
soil expansion and/or settlement)
are 1 inch and 3/. inch between two adjacent footings, respectively. A
sufficient crawlspace low point drain should be provided and may outlet at the back of the lot.
Paye 2 of 3
Pacific Crest
Project No.99-2791
Page 3
CLOSING AND LIMITATIONS
Our reports pertain to the materials and locations tested/inspected only. This letter should be made
available to each housebuilder in the development. This letter should not be construed to relieve or
lessen the responsibility of the earthwork contractor or owner for site work, but is provided to meet the
minimum required governmental assurance in accordance with local engineering standards of practice.
Our services were provided on an as-requested basis. If conditions are encountered during foundation
excavation, which differ from this report, then the developer, the earthwork contractor, and GeoPacific
should be allowed to review the condition before corrective action is taken. Corrective work performed
by the builder without notification of the above parties will be considered as an acceptance of the
conditions encountered. It is the housebuilder's responsibility to educate homeowners for reasonable
expectations on foundation performance and standard levels of acceptable concrete cracking. Density
tests taken on public improvements are provided, however, GeoPacific provided no inspection or design
of public improvements.
We trust this information meets your needs. If you have any questions regarding this report, please call.
Sincerely,
GeoPacific Engineering, Inc.
.XI- U-PH FFS
�MGINEfq
14743
/ OREGOk
v
O
✓gA��S23.1L` 03
James D. Imbrie, P.E., C.E.G.
Geotechnical Engineer
Attachments, Field Soil Inspection Summary
Summary of Soil Field Density Tests
Site Plan with Lot Numbers
Summary of Field Asphaltic Concrete Ter,!s
CC: City of Tigard—Matt Harrel
Westlake Consultants—Pat Tortura
Excel Excavation—John Townsend
Page 3 of 3
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CITE( OF TIGARD 24-Hour �
BUILDING Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
c� BUP - - —
Received - _ Date Requested.-_— � � l AM PM_
M BLIP
Location _- —Suite_ MEC -_--------_ __ -PLM
.—
�_ 3 '� —
Contact Person _ _ — Ph( ) _----
Contractor___ -____-- Ph( ) SWR
BUILDING Tenant/Owner ______—_____--_ __ _ ELC
Footing- E LC _--
Foundation Access:
Ftg Drain ELR _.
Crawl Draln
Slab Inspection Notes- SIT _
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - ---- -
..a Alarm
Susp'd Ceiling ----- ----- - -- ---
Hoof
(F,n — - - _ -------- --- -- — ----
S ART FAIL
Post&Beam
Under Slab --------- —---_ — ----
Roilgh-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
F iS
SS ART FAIL
ETMTRICAL -
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 F] Please call for reinspection RE:— —_—_ Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk DateIns�sctot
- 3
Other:
Final DO NOT REMOVE,thi:. Inspection re 'rd from the job i1te.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BLIP
Received __ Date Requested 3 _� AM_._- PM BLIP _
location Suite-- --_------ _ Mac
Contact Person Ph( ) PLM
Contractor_ -- — Ph(--) — - SWR -- — ---r
BUILDING Tenant/Owner EL.0
Footing - ---------- ELC
Foundation Access.
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: - SIT
Post&Beam
Shear Anchors ---- ---
Ext Sheath/Shear
Int Sheath/Shear - -
Framing
Insulatiun
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
MECHANICAL _
Post&Beam —
Ruugh-In __-
Gas Line
Smoke Dampers ---- -.._.. - - - -- -.. -- - ---- ---
Final
PASS PART FAR
ELECTRICAL—
Service —
Rough-In
UG/Slab
Low Voltage
Fire Alarm -- -------__-.- ---_—.
V1-1Reins x1lon fee of$ _—_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
S . PA_RT FAIL
SI __ F-] Please call for reinsp,action RE:------- ❑ Unable to inspect-no access
Fire Supply Line
ADA - G�Js�L� SlJ_.
Approach/Sidewalk
����---
Other: Ext
---- /�
Final DO NOT REMOVE this hispection record from the job site.
PASS PART FAIL
�\ CITY ®F T I GA R D `— MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00124
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/18/03
PARCEL: 2S105DD-0350G
SITE ADDRESS: 13455 SW NAHCOTTA DR
SUBDIVISION: PACIFIC CREST ZONING R-7
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: —
TYPE OF USE: SF UNIT HEATrFRS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/C_OMPRESSORS HOODS:
FU_EL_TYPES0 3 HP: 1 DOMES. INCIN:
LLF — 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 50 HP:
GAS PRESSURE: 50 + tip: COD :
CLO DRYERS:
FURN < -100K BTU: AIR HANDLING UNITS _ OTHER UNITS:
FURN >-100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install exterior AC units. Cannot be placed in the required setbacks.
Owner: _ — _ —FEES ---_—_�—_--
D R NORTON Description Date Amount
5125 SVV MACADAM #145 - ---
PORTLAND, OR 97201 x%11 111 Permit fce 3/18/03 $72.50
1 StateTa.x 3/18/03 $5.80
Phone: 244-5322 _ Total $78.30
Contractor:
HVAC BY TERRY
6630 SW 207TH AVENUE
ALOHA, OR 97007 REQUIRED INSPECTIONS
Phone: 503-649-3458 Cooling Unt InspFinal Inspection
Rey #: LIC 54970
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 pia-s This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 190 days. PTTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules ate set forth in GAR 952-001-00
ii
Issued By: ;l Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for Inspections needed the next business day
FOR OF IC'L'IJSF
N/liechanical Permit Applicatiop RC11��.,, me'JinnicalONLY
Date/B /r e : r io, Pertnit No.A i(:.
Planning Approval Building
City of'Tigard Cate/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No- _
Phone: 503-639-4171 Fax: 503-598-1960 )ate/Bview Land o.:
'�'� Uate/B Case No.:
Internet: www.ci.tigard.or.us r Contact Jun! : See Page 2 for
24-hour Inspection Request: 503-639-4175 LNarne,Mctbod: Su IemeMet Information.
TYPE OF WORK COMMERCIAL FEE"SCHEDULE-USE CHECKLIST
19 New construction 7_Q Demolition _ Mechanical permit fees*are based on the total value of the work
Addition/alterati!, /re 1�acenient I D Other: performed. Indicate the value(rounded to the nearest dollar)of all
CRUmechanical materials,equipment,labor,overhead and profit.
CATEGORY OF GNSTCTION
1 & 2-Familydwelling Commercial/industrial Value: S See!'age 2 for Fee Schedule
----� - RESIDENTIAL E UIPMENT/SYSTEMS FEE*SCHEDULE
Accessoij Building _[ Multi-Family _ ueserlpuon qtv Fee ea. Total
Master Builder ❑ Other: lleatln &O 111111 —
JOB SITE INFORMATION_ and L�—O�CAAT�ION Furnace-add-on air conditioning" 1 14.00
Job site address: I �j1/IJ R,//rL►"A_ Gas heat pump _ _ 14.00
Suite#: BDuct work � !4.00
! dronic hot waters stem 14.00
Project Name:—� Residential boiler
Cross street/Directions to job sifor rauiotor or h dronic system) 14.00 _
Unit heaters(fuel,not electric)
(in wall,in-duct,suspended,etc.) 14.o0
Flue/vent for any of above 10.00
Repair units 12.15
Subdivision: i1�1 G G_ L _ Lot#: �� Other Fuel A s illances
Tax map/parcel rY: Water heater _ 10.00
DESCRIPTION OF WORK _ __ Gas Fireplace. _ 10.00
A D All, ` Flue vent(water heaters es fire lace) 10.00
—-- - Log lighter as 10.00
— - Wood/Pellet stove _ 10.00
_ Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
PROPERTY OWNER — M TENANT Other: 10.00
Environmental Fshaust do Ventilation
Name: IAL!J* .W 1 Range hood/other kitchen equipment 10.00
Address: "10 Sw _ DA>m Clothes dryer exhaust 10.00
City/State/Zip: Single duct exhaust
Phone: Z.12• Fax: _ _ (bathrooms,toilet compartments,
APPLICANT CONTACT PERSON utilityrooms 6.80 _
CANT_ - - Attic/crawl space fans F 10.00
Name: ------_-.. - — Other: l o.00
Address:
City/State/Zip ••(S5.40 for Ors(4,$1. each additional
- - Furnace,etc.
Phone: Fax: Gas heat pump "
E-mail: _ _ Wall/suspendedlunn heater
CONTRACTOR Water heater "
ireplace "
Business Name: F
_ G _ _.___—
Address: 5(/�� i�r Ran e
BB "
Cit /StatP/Zi : •_ � Clothes d
Phone: Fax: Other: "
Total:
CCB I,iC. #:44 Mechanical Permit Fen*
Authorizedi _ Subtotal: $ _
Signature: _ ___ Date: I rI7 _ Minim(.. ermit Fee$72.50 S
Plan Review Fee(25%of Permit Fee) $
(Please print name) State Surcharge(8%of Permit Fce S
TOTAL PERMIT FEE S _
Notice: This permit application expires If a permit Is not obtained"Ithin *Fee methodologv set by Tri-County Building Ino.:<<ro Service lioard.
180 days after it has been accepted as complete "Site pian required for exterior A C units.
ODst0ermil l:orn�a\Mecl'crmitApp doc 0103
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
$5,001.00 to$10,000.00 $72.50 for the first$5,05).00 and$1.52
for cacti additional$100.00 or fraction
thereof,to and including$10,000.00.
$10,001.00 to$25,000.00 $149.50 for the first$10,000.00 and
$1.54 f;reach additional$100.00 or
fraction thereof,to and including
$25,000.00.
$25,001.00 to$50,000.00 $379 501'or the first$25,000.00 and
$1 45 for each additional$100.00 or
Faction thereof,tc and including
_ —
$50000.00.
$SO,rxil tx)unJ up $742.00 for the first$50,000.00 and
$1.20 for each additional$100.00 or
fraction thereof'.
Assumed Valuations Per A (lance:
Value Total
Description: Qty (ES) Amount
Furnace to 100,(x))BTU,including 955
ducts&vents
Furnace>100,000 BTU including ducts 11170
&vents _
Floor furnace including vent 1 955
Suspended heater,wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Re air unite _ 905
<3 hp bsorb.unit, 955
to I Onp BTU --
3-15 hp;absorb.unit, 1,700
101k to 500k BTU
15.30 hp,absorb.unit,501k to I mil 2,310
BTU
30.50 hp;absorb.unit, 3,400
1.1.75 mil,B'rU
40 hp;absorb.unit, 5,725
>1.75 mil.BTU
Air hgndi;t-.i unit to iu.GCw)cfm 656
Air hani. 9 unit I0.000 cpm _ 1 170
Mon-portable evaporate cooler 656
Vent fan connected to a sinjll,duct v 446
Vent system not included in appliance 656
rtnil _ --
I food served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit,including wood stoves, 656
inserts,etc.
Gan i in 1-4outlets 360
Each additional outlet 63 _.
77TAL COMMERCIAL $ ,
VALUATION: `
i ADstsV'orrnit Forma\Mecpert 'AppPg2.doc (11/03
L.O1' I rm6T 2001• (Vill
THE MATISSE W) f'H DAYLIGHT BONUS (f�-*55
6W. NA14=PRA
Bedroom 4
Master Suite
71
a•.n i, i.. ------------ Desk --s-.
��i...
11,1111 1
O 1 i �_li • ~+ Nook
Illl In./e: I;+n+ilv Room \ I
I �:7 61m1�
Kitchen
Ilydnunn: 14rdown 4 All, 773
9XIhoilli;
Room
ri
III, I,F R I I. I, f I �1
w
eyioc. y��o
«'V� � r arage Lmn 1
ird Cat Garage/ Loving Rcmm '
flpnonal Den `.
Dells
r �
Redroom5 MAIN LEVEL
Bonus R1Mm
Is L7 Smragr
I• IN : 91iEb DAYLIONT DONt19 Room
Renderings tnd floorplans Aire orll.ts conceptions and are not intended to be
an actual depiction of the builc:ln,,n, fencing,walks, driveways or landscaping.
Square footages approximate.Windows vary per plan. In the inttreat of
continuous product improvenr,nt, D. R. Horton reserves the right to change
pricing and specifications without prior notice or obligation.
5/�4/a2
\ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT#: ELC2003-00142
DEVELOPMENT SERVICES DATE ISSUED: 3/18/03
13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 2S105DD-0350(1
SITE ADDRESS: 134551 SW NAHCOTTA DR
ZONING: F2-7
SUBDIVISION: PACIFIC CREST
BLOCK: LOT : 011 JURISDICTION: TIG
Project Description: Install 1 branch circuit to AC unit.
_ __RESIDENTIAL UNIT __TEMP SRVC/FEEDERS _ _MISCELLANEOUS
160-0—S F OR LESS: 0 200 amp: PUMP/IRRIGATION—
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG'
LIMITED ENERGY: 401 - 600 amp.: SIGNALPANEL:
M.ANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _ T— A' "L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPI -ION:
201 - 400 amp: 1st W/O SRVC OR FDR 1 PEh )UR:
401 - 600 amp: EA ADD'L BRNCIi CIRC: IN PLANT:
601 - 1000 amp: __ - — PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: _ SVCiFDR>= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
D R HORTON
5125 S1h'MACADAM tt W
PORTLAND,OR 97201
Phone: 244-5322 Phone:
Reg #:
FEES
Description Date Amount
Re(,,.!ired Inspections
[FLPRM1') IiL('Permit 3/18/03 $46.65 —+ — ----- ----__.
[TAX]8%Statc Tax 3/18/03 $3 75 Rough-in
Elect'I Final
ial $50.60
This Permit is issued subject to the regulations contained in the Tigard Municloal Code,State of OR.Specialty Codes and all other applicable laws. All
work will be done in accordance with apr -,/ad 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: Or pgon 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 t;opies of these rules or direc uestions to OUNC at(503)246&699 or
1-800.332-2344.
Issued By: ;,�,� ;,J.>- �� Permit Signature.
�__—
OWNER INSTALLATION ONLY
The installation is being made on property I own which is riot intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. EL F C'N: DATE:
LICENSE NO: _�—�. _ --- -- ---- —
Call 639-4175 by 7:00p►rr for an inspection the next business day
�rElectrical Permit Apmlieatiun Itecciye,, i:,ectrncal
Datc/D Permit Not -d 1)
Planning Approval Sign
city of rigard Date/By: _ Permit No.: _
13125 SW Hall Blvd. Plan Review other
Tigard,Oregon 97223 Date/By: Permit No.: —
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Date/By: ICase No.
Internet: www,ci.tigard.or.us Contact Juris.: See Page 2 for
24-hour Inspection Request: 503-639-4175 Namc/]Vlcthod I I Supplemental Information.
TYPE OF WORK PLAN REVIEW(Pie ase:beck all that apply
NeW COtl;truction _ 10 Demolition El Service ove, 225 amos LJ Health-care facility
----- commercial ❑hazardous location
Addition/alteration/replacement I Ej Cather: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet,
CATEGORY OF CONSTRUCTION I &2 family dwelling: four or more residential units in
1 &2-Family dwelling Cotnmercial/Industrial ❑System over 600 volts nooainel one structure
❑Building over three stories ❑Feeders,400 amps or more
Accessory Building Multi-Fant occupant load over 99 persons ❑Manufactured structures or R'✓park
Master Builder Other: ❑Rgressnignting rlan ❑omen _____-�
JOB SITE INFORMATION and LOCATION Submit—sets of plans with any of the above.
The above are not licahle to temporary construction service.
Job site address: Ifilill 40W— FEE*SCHEDULE
Suite#: Bld ./A L#: _ _ Number of ins�ectlons per pe mit allowed
_Pro'eet Name: Descrl tion — 1 Qb Fee(ca.) Total'- New residential-simile or multi-fancily per
Cross street/Dlrec tons to Job Site: dwelling unit.Includes attached garage.
Service Included:
1000 sq.Ill.orless 145.15 4
Each additional 500 sq.II.or portion thereof' 33.40 1
Limited energy,residential 75.00 2
Subdivision: IMMIL Lot#: 11 Limited en er ,non residential 75.00 2
Tax map/parcel#: Fach manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
D
E--PTIO Services or feeders-Installation,
AVD A — alteration or relocation:
200 ams or less 80.30 2
201 amps to 400 ams -— 106.85 2
401 amps to 600 amps 160,60 2
PROPERTY OWNER TENANT---- 601 am to 1(x)0 am 240.60 2
_--
N ,n ,/�y — ----- over 1000 amps or volts 454.65 2
ame: 1'�L"'• V 11., Reconnect only 66.85 2
`` Temporary services or feeders-In%tallation.
Addt'eSS:
— �` A&�yY alteration,or relocation:
City/State/Zi :_ -_l W 1 200 amps or less _ 66.85 _ I
PhonFax e: : 201 amps to 400 amps
10030 2
2 401 to 600 ams 137.75 2
APPLICANT I U CONTACT PERSON Branch circulls-new,alteration,or
Name: extension per panel:
-- — A.Fee for branch circuits with purchase of
Address: _ service or feeder fee oath branch circuit 665 2
C,icy/StatE/ZI B.Fee for branch circuits without purchase of
------- -- servicc or feeder fee,first branch circuit 46.85 2
Phone: _ I Fax: _ Fach adddinnal branch circuit 6.65 2
]✓-m811: - Misc,(Service or feeder not included)'
k ach Lump or irrigation circle 53.40 2
CONTRACTOR -- 53.40 2
_—_---_ Each sign or outline lighting
Job No: Signal circuit(s)or a limited energy panel.
aiwration,or extension Pa e 2 2
Business Name: - i r ' IL Fi,-wription:
Address: _ {N
— Each additional Ingectlon over the allowable In any of the above:
City/State/2 I 16L Pct ins tion per hour(min. I hour) 62 50
Phone: Fax: Investigation Ice -- - -
Other.
CCB Lic.#: Jic. #: _ r _ Electrical Permit Fees*
Supervising electrician e ¢ J —__ _ Subtotal S l
signature required: _ __ Plan Review(25%of Permit Fee) SL=1
Print Name: L1C.#_ — State Surcharge(8%of permit Fee S '
l'O'rALP T FEF. S
Authorized -- I Notice: This permit application expires if a permit Is not obtained within
Signature: 0";I� I).itc 311 180 class after It has been accepted as complete.
�y� 77 "Fee methodology wt by I*H-County Building Industry Service Board.
- Y/[�r
n I'lease print namerov Forrtts\FlcPermitApp.doc 01103
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY 13FRma FEES:
RESIDENTIAL N'0121i ONLY:
- — — ----- ------
-ee for all systems............................................................ $75.00
('heck'I ype of Work Involved:
DAudio and Stereo Systems*
burglar Alarm
DGarage Door OpLnet
U I Ieattng,Ventilation and Air Conditioning System*
ElVacuum Systems*
Other
COMMERCIAL. YORK ONLY:
Fee for ggib system..................................... .................... $75.00
(SCF OAR 918-260-260)
Check Type of Work Involved:
Audio and Stereo Systems
130iler Controls
Clock Systems
Data Telecommunication Installation
Fire Alarm Installation
f •' Y�..,
IIVAt t
Instrumentation
Cj Intercom and Paging Systems
IJ Landscape hrigation Control*
❑ Medical
Nurse Calls
Outdoor Landscape Lighting*
Protective Signaling r
J ()thet —�
—__Number of Systems
* No licenses arc required. Licenses are required for all
other installa(ious
i:"ts\Pemnt Forms\ElcPermitAppPg2.dr i 01/03
CITE OF TIGARD MASTER PERMIT
PERMIT#: MST2002-00421
DEVELOPMENT SERVICES DATE ISSUED: 10/16/02
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171
SITE ADDRESS: 13455 SW NAHCOTTA DR PARCEL: 2S105DD-03500
SUBDIVISION: ZONING: R-7
BLOCK: LOT: Ill 1 JURISDICTION: I Ili
REMARKS: Construction of new SF Detached residence. Path 1
BUILDING
REISSUE STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1.454 at BASEMENT: at LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLUOR LOAD: 40 SECOND: 1,133 Of GARAGE: 744 Of FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS 1 FINBSMENT: at RIGHT: 5
OCCUPANCY GRP: R9 BDRM: n BATH: i TOTAL: 2,587 at VALUE: 257,118 00 REAR: 37
PLUMBING
SINKS. I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LWES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 3 GARBAGE DIGP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOILICMp<3HP: VENT FANS: 5 CLOTHES bRYER: 1
�n'• FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER _TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR I ESS I 0 200 amp: 0 •200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 5005F: 5 201 400 amp: 201 400 amp: ts1 WIO SVCIFDW CO SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 •500 amp: EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 501 1000 amp: 5014amps•1000v: MINOR LABEL:
10004 amplvolt
PLAN REVIEW SECTION
Reconnect only: -
>•4 RES UNITS: 9VCIFDR>•725 A.: >BOC V NOMINAL: CL3 AREA/SPC OCC:
ELECTRICAL-RESTRICTED ENERGY _
A.Sr RESIDENTIAL G.COMMERCIAL
AUDIO d STEREO: X VACUUM SYSTEM: X. AUDIO 6 STIEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL
GARAGE OPENER: X CLOCK. INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATA7TELE COMM: NURSE CALLS TOTAL N SYSTEMS.
Owner: Contractor: TOTAL FEES: $ 7,832.31
U R NORTON D R NORTON INC This permit Is subject to the regulations contained In the
ADAM#145 4386 SW MACADAM Tigard Municipal Code,State of OR Specialty Codes and
5125 SW MAC
PORTLAND, A M# SUITE#102 all other applicable laws. All work will be done in
PORTLAND,OR 97201 accordance with approved plans This permit will expire if
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: 244-5322 Phone: 503-222-4151 Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through 952-001-0080 You
ROD N: LIC 130859 may obtain copies of these rules or iirect questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Plumb Final
Grading Inspection F'ost/Beam Mechanica Mechanical Insp Shear Wall Insp Gyp Board Insp Final inspection
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Appr/Sdwlk Insp
Foundation Insp / Footing/Foundation Dr; Electrical Rough In Gas Line Insp Electrical Final
Issued By : l_- �,t .�C� - -- -- -- Pormittoe Signature : % �i�L L�Cl( T
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00277
Wit, 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/1(;/02
SITE ADDRESS; 13455 SW N,AHCOTTA DR PARCEL: 2S105DD-0.3500
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: I_TPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached residence
Owner_ ----
---- FEES
D R HORTON Description Date Amount
5125 SW MACADAM #145
PORTLAND, OR 97201 [SWUSAJ Swr Connect 10/16/02 $2,300.00
[SWINSPI Swr Inspect 10/16/02 $35.00
Phone: 244-5322
Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180
days from the date issued. The total arnount 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 teet in all directions from the I stance given. If not so located, the installer shall purchase a"Tap and
Side Sewer" Peanh, and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699.
�-r
' 1 7� Permittee Signature: � —
Issued by: _��_ 1.�, , —_
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Buil inn Permit Application
`-- Dale received _ `" Permit no.: i
City of Tigard
I'rojecUappl.no.. Expire date:
Cin, fTi,t;anf Addres-.. I;125 SW Hall Blvd,'Fig ard,OR 97223
Phone: 003) 639-4171 Date issued: By:
� � Receipt no.:
Fax: (503) 598-1960 - ' +""
1 Case file no. Payment type:
Land use approval: tmpic Complex:
OF PFRMIT
O 1 &2 family dwelling or accessory U Commercial/industrial l] Multi-family New construction O Demolition
U Additiott/alteration/replacement ❑Tenant improvement J fire sprinkler/alarm ❑Other: _
JOBSITE INFORMATION
Job address: A.CrZ C%A j Y - Bldg. no.: Suite no.:
Lut: Block: Suhdivlsiun: 700ft,, I ax map/tax lot/account no.: 'T'j
Project name: VJACI _lL- �� - - `r G'" y - - I
z.
Description and location of work on premisesApecial conditions:
0WNEK FOR SPECIAL INFORMATION,
Name: f� HIH-b C�� .. (Flo--- t
dplain,septic capacity,solar,etc.)
Mailing address: r2l2.ry3AI &2(amok d"ellin}:
City: State: LIF': �— Valuation of work..................................... .
Phone: -; y( Fax: - -� ' mail: No.of bedrooms/baths.................................
Owner's representative: l p H,, likul I Total number of floorsZ»
.................................
Phone: 17j 71 . E-mail: New dwelling area(sq.ft.) ..........................
APPLICANT Garage/carport area(sq.ft.) .........•.......•...... '74 _
Name: Covered porch area(sq.ft.) .........................
Mailing address: 4-yytt Q1 G(Vj O V t'� Deck area(sq. ft.) ........................................ _
City: I I State: I ZIP: Other structure area(sq.ft.).........................
Phone: Fax: E-mail: Commereiallind I/multl-family:
(ONTRACrt , Valuation of work...,........,.;...............•......... $
Business name: H1 y-tl h Existing bldg.area(sq. ft.) ................... .. —_—
Address: G- S New bldg.area(sq.ft.).......... --
-- -- Number of stories .... . �...
City: State:p ZIP: \ —
Phone: - lc Fax: Zy-- E-mail: Type of const ton................I............•.........
CCB no.: p "---` Occupapey group(s): Existing: \
- — --�— New:
City/metro lie,no.: Notice:All contractors and subcontractors arc required to
1 licensed with the Oregon Construction Contractors Board under
Name: D. f-a h - —_ provisions of URS 701 and may he required to be licensed in the
Address: 15M ; jurisdiction where work is being performed. If the applicant is
City: State: Zip, exempt from licensing,the following reason applies:
Contact person: &Ig k1 F&V1 Plan no.: Z
Phone: / t lax: E-mail:
Name: .( ontact person: Fees due. upon application ........................... S
Address: $E /y(p fh_ _ _-- Date received:
City: State:p)e— ZIP: —/ Amount received ......................................... $
Phone:6j�3- Fax:&As� 44( E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all)unsdtcbons accept trait cares,please cell iunsdicbon lot more tntotmatton.
attached checklist. All provisions of laws and ordinances governing this :I visa 7 MasterCard
work will be complied wt , whether specified herein or not. Credit card number Expires te_
.Zl/-d�____,
Authorized signature: Gate: flame ul urslholder u shown nn credit cera
Print name:—ko- �— 7ardholder slpatttre Gmounl
Notice:This permit application expires it a permit is not obtained within 180 days alter it has been accepted as complete. 440.461 i(6MCOM)
Electrical Permit Application
Date received: Permit no.: /- R`
Jim k City of Tigard Project/appl.no.: Expire date:
Ciry,�rrigrrrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By Receipt no.;
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
TYPE.OF
❑ 18r 2 family dwelling or accessory U Comn ercial/industrial U Multi-family U Tenant improvement
New construction J Addition/alteration/replacement ❑Other; ❑Partial
INFORMATIONJOB SITE
Job address: llldg. nu.: Suite no.: ITax map/tax lot/account nu
Lot: I Block: Subdivision: f
Project name: G ��/'��,� Description and location of work on premises:
Estimated date of comirletiaJinshrr Linn -- –� –CONTRACTOR 1SCHOULE
Job no: _ Fee Max
- f)essriptiun _ oty. (ea.) rotaf no.cusp
Business name: ��, (� Newresidential-single ormuhi fanulyper
Address.: dwellinguait.Includes attached garage
City: State:D ZIP: Service includ-;.
Phone: Fax: 6j,PVVj E-mail: 1000 sq.ft.or less _ 4
CCB no.: Elec.bus. tic.no: �jh�- Each additional 500 sq.ft.or onion thereof
Limited erergy,residential _ _ 2
City/metro lic,no.: �7 ��' Limited energy,non-residential
f Each manufactured home or modular dwelling
S electrician(reuired)J! Date Serviceand/orfeeder — 2
tiup elect.nnn+e(pnntI License no: Services or feeders-inetallallon,
alteration or relocation:
PROPERTYOWNER200 amps or less
Name 1 nut): Tl 1�� 201 amps to 400 an _ 2
p _r1([ `--'� S 401 amps to 600 amps 2
Mailing address: Q N57 601 amps to 1000 amps �-
2
City: f"174 a I State: ZIP: Over 1000 amps or volts 2
Phone: Fax: E-mail: Reconnectonly I
Owner installatic .The installation is being made oar property I own Temporary services or feeders
which is not int• -r^d for sale,lease,rent,or exchange according to installation,alteration,or relocation:
ORS 447,455,41Y),670,701, 200 amps or less 2 _
201 amps to 400 amps
Owner's signature: _ Date: 401 to 600 amu
SESSION!NOL11 101 a 01 Branch circuits-new,alteration.
Name: r�� C (/, K A. Pee for branch
circuits
A. Fre for branch circuits with purchase nF
Address: —eg- /Z(j f2i 47el service or feeder fee,each branch circuit 2
City: State:4K I ZIP: B. Fee fur branch circuits without purchase
Phaxof service or feeder fee,first branch circuit: 2
one: P (/�f tit Ii-mail:
Each additional branch circum:
PLAN IIEVIFW(Ples.se check all Iliat apply) Misc.(Service or der not Included):
U Service over 225 arnps-comrnercial J I Icaith-care facility Each pump or irrigation circle 2
17 Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
family dwellings U Building over 10,000 square feet four or Signal circuafs)or a limited energy panel.
❑System over 600 volts norrunal more mudenhal units in one structure alteration,or extension* i
U Building over three stories U Feeders,400 amps or more •Descn uon:
U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
0 F-gress/lightingplan Q Other. —_ Per inspection
Submit__sets of plans with anv of the above. Invesugauonfer.
Ile above are not applicable to temporary construction aerviee. +)cher
Not all)unsd¢uons accept credit cards.please call runsdtcunn for more information Notice:This permit application Permit fee.....................$ —
U Visa U MasterCard expires if a permit is not obtained Plan review tat — %) $
Credit cud nurnber. _ _ within I80 days after it has been State surcharge(9%) ....$
Expires accepted as complete.
Name of cardholder as shown on credo cud
_ S
cirdhoider signature Amount_ 440.4615 16MCOMI
Plumbing Permit Application
City of 'Tigard Date received: Permitna/�t�j(
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
Cui-ofl'iburd Phone: (503) 639-4171 hroject/a I.no.:
PP Expire date;
Fax: (503) 598-1960 Date issued:
BY� Receiptno.:
Land use approval: — Case file no.: Payment type.
OF
❑ I &2 family dwelling or accessory 0 Commercial/industrial J Multi-family O Tenant improvement
New construction 0 Addition/altera!ion/replacement ;0 Food service ❑Other:
"-a lei 111jory
r ,
lob address: f2J& Desch tion
Qty. Fee .) Tatal
Bldg, no.: Suite no.: New I-and 2-family dnellints only:
Tax map/tax lot/account no.: (includes 100 ft.for each utility connection)
SFR(1)bath _
Lot: ItBlock: Subdivision: cue' SFR(2)bath -�
Project name: e 1 15�'- _ SFR(3)bath
City/county: y4 ZIP: Each additional bathildtchen
Description and I cation of work on premises: SlteutWties:
Catch basin/area drain
Est.Jate of completion/inspection Drywells/leach line/trench drain
PLUMBING CONTRACTOR
Footing drain(no. lin. ft.) —
�—ply Manufactured home utilities
Business name: Manholes
Address: 19 8 - - -�- —
��' ._�� Rain drain connector
City: State: ZIP: p Sanitary sewer(no. lin, ft.)
Phone: Fax: E-mail: Storm sewer(no. lin.ft.)
CCB no.: 1 I bb Plumb.bus.reg,no:"3 - Water service(no.lin. ft.)
City/metro lie.no.: Fixture or item:
Contractor's representative signature'. ��. , _ Absorption valve —
Print name: '� Back flow reventer
Date: Backwater valve
Basins/lavatory
Name: Clothes washer -
Address: /Z 914) Dishwasher
Drinkingfountain(s)
City: r fJ�Qy StnteD,( "LIP:
Phone: -71t—l/ Fax: --7 1: ectors/sump mall: Expansion tank
011 t� Fixture/sewer cap
Name(print): IC . J-f Vr./-yk? It7ol-eS Floor drains/floor sinks/hub
Mailing address: - Garbage disposal
City: — Hose hibb
Y dJ' State: ZIP: Ice maker
Phone: Z- Fax: E-mail: Interceptor/grease trap _
Owner installation/residential maintenance only: The actual installation Pnmer(s)
will be made by me or the maintenance and repair made by my regular Rauf drain(commercial)
employee on the property I own as per ORS Chapter 447• Sink(s), basin(s), lays(s)
Owner'! signature:_ Date: Sump _
T ibs/shower/shower pan
Name: 6 G }U/�H Unna) —
/�yS _�� / — Water closet
Address:
Water heater
City: •fI State: ZIP / Other:
Phone: .Z Fax:40v -1 E rnal;: TOIAI
Not all jurisdictions accept credit cards,please call jurisdiction for owm mlormation Notice:This permit application "Ainlmum fee................$
U Msa J Mastercard / expires if a permit is not obtained Plan review(at _ %i $ _
Credit card number. —� _t_ within 180 days after it has been State surcharge i 896) ....$ _
Y TOTAL
--- acct: ted as complete. •••• $
Nona of cardholder u shown on credit r-ud p P e• """""""" '
S
Cardholder signature Amourt
440-46 16 16AN('OM)
Mechanical Permit Application
Date received: Permit no.:
City of Tigard Project/appl.no.: Expire date.
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Paymenttype:
Land use approval: _ Building permit no..
❑ 1 &2 family dwelling or accessory :1Commcrcial/induscrial ❑Multi-family ❑Tenant improvement
❑New construction _J Addi';on/all".,,tion/replacement ❑Other:
1 1 1 -
Job address.
Indicate equipment quantities to boxes below. Indicate the dollar
Bldg. no.: _ Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdivision: _ -See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP; I &ZfAMILY DWELLING
Description and ocation of work on premises:
F•rrfea.) Total
Est.date of completion/inspection: Description 'qty. Res.only Reti.only
'tenant improvement or change of use: cc
Is existing space heated or conditioned?U Yes ❑No Air handling unit CFM
Is existing space insulated?U Yrs !J Nu Air conditioning(site plan required)
A teration of existing HVAC system
MECHANICAL CONTRACTOR Bot er compressors
Business name: �� State boiler permit no.:
HP Tons BTU/H
Address: _ ire/smv a amper uctsmoked eteciors
City: State: ZIP:0 eat pump(site plan require ) --
Phone: Fax: E-mail.- nsta Urep ace urnac urner
CCB no.: Including ductwork/vent liner ❑Yes O No
nstB replace/re ocateheaters-suspende ,
City/metro lic.no.: wall,or floor mounted
Name(pleaseprint): Vent for appliance other than furnace _
(ONTACT PERSON Refrigeration:
Absorption units B7 U/11
Name: N t D/G S p Chillers HP --- —
Address: Gj S ly C'om ressors lip
City: y State: ZIP: nv roomental exhaust an vrnt at on:
Appliance vent _
Phone 1�_y y- / / Fax - 3yl F-mail: ryerexhaust
Hoods,Type t res. 'tc en/ azmal
hood fire suppression system _
Narne: �. rfi ,l _ �_ _ _ Exhaust fan with single duct(hath fans)
Mailing address: y � x Busts stem a art from hea:u, or AC
Cit Q/( ZIP: are piping and (up to outlets)
Y l Q State: Type: LPG NO Oil
Phone: /f Fax: /7 E-mail: Fuel pipin each additional over 4outlets
ii
Process piping(schematic required)
Name: Number of outlets
Address: ter listedappHance or equipment:
_ �— L�IL �� Decorative fireplace _
City:ezf ( _ State: ZIP: "JO/� risen-type
Phone: zg Fax: tosP 4 W-1 I E-matt: oo stove/pet el stove
ffOle r:Applicant's signature: Date: er:
Name (print):
Nor all junsdicuom accept credit cards.pleue call jurisdiction for more mfomtatton Permit fee....................$
❑Visa O MasterCard Notice:This permit application Minimum fee................$
Credit card number expires if a permit is not obtained
within 180 days after it hes been Pla l review fat %) $
State SUrCharg..(896)....$
Name of cardholder as shown on credit card -- accepted as complete.
_ S TOTAL .......................$
Cardholder signature Amount 4164617 WMCOM)
P/NCIFIC CREST SUBUIV ISION
LOT - 1 1
CITY OF' TIG/-\RD
THE APPROACH SHALL BE
A MINNMUM OF 5"xl2'x2O'
OF GLEAN PIT GRAVEL
5T LHIE
'"^'� LANDSCAPING FOR THE ENTIRE LC"
— — SHALL BE FINISHED OR THE LOT
SURROUNDED B`' EROSION GONTRC-
OOT ELS o' PRIOR 70 BREAK OUT OF GOMMUN `
EROSION CONTROL. FIN15WED SLOPE6
- SHALL BE LE55 THAN 1 TO I
EMF GRAVEI.
DRIVEWAY
NOTE:
ARAGE I.ROOF DRAINS TO 5TOR'~
LAT, IN STREET.
FT 1
F EL 40'
2, FOUNDATION DRAINS '0
•
PsAGKYARD SOAKAGE TRENCH
SEE ATTACEIED DETAIL
CD C�
•� r� cQ
O
PL N 2551115
C) C SQ CD
FIN EL • 541' 0
71
I \I
Soo°5 " W
ELSse' ` e�.s.a
�X
ti 60 . 0
11 SETBACK RE0UIRF-lENT5
SCALE �'•m'-n I FRONT YARD TO GARAGE 20
510E -ARD
6- 604 REAR `"EARD
.4E 55 olo HomesD.R Horton
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST -------__._..
INSPECTION DIVISION Business Line: (503) 639-4171
(/ BUP _—
Received Date Requested _1�- �a — AM_ ___ PM_ BLIP
I_oca'ion __._______�_.3 L/SS_—_ - - Suite_ MEC
Contact Person . _—____— _ Ph(_ _) -7' TIP PLM
Contractor _ (— )
- -- I --- SWR --- - ----- --
BUILDING Tc-..nant/Owner _ _._ _— ___ ELC
footing-- ELC
i oundation Access:
Fty Drain ELR
Crawl Drain �-
slab Inbpection Notes: SIT - ----
Post& Beam — _ �+�- - --
Shear At
Ext Sheath/Shear
Int Sheath/Shear
Fraining - -- - -- --
Insulation
Drywall Nailing ----- --- _ - ----
Firewall
Fire Sprinkler
Fire Alam --
Susp'd Ceiling
Root
Other:----_--_ .
Final
PASS PART FAIL.
PLUMBINGiT�!�/1.Li.. d]�_ �L� ✓" - -
Post&Beam
Under Slab ---:�__
Rough-In
Water Service ------------_ ---_.-_--. ----._ - __ .
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain
Shower Pan
Ot r. ie. - - -- - ---
PASPART_FAIL ---
ANICAL
Post& Beam ---- -
Rough-In
Gas Line
Smoke Dampers -
Final
PASS PART FAIL
ELECTRICAL
Service _
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final LJ Reinspection tee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART_ FAIT_
SITE Please call for reinspection RE:—_ __ _-_ ___- L Unable to inspect-no access
Fire Supply LineADA
/
App oach/Sidewalk Dato ( " _�,� Inspectors Ext
Other: VV
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL