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8255 SW NORFOLK LANE NI )IIOAION MS 5Sz8 IL Ix � J ... O m Z W N r � Ln N 00 8255 SW NORFOLK LN CITYOF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2005-00179 13125 SW Hall Blvd.,Tigard, OR 97223 503-639-4171 DATE ISSUED: 4/29/2.005 PARCEL: 2S112CB-16700 SITE ADDRESS: 08255 SW NORFOLK LN ZONING: R-7 SUBDIVISION: HAMPTON COURT LOT: 016 JURISDICTION: TIG Project Description: Installation of backflow device. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: — FEES RASSMUSSEN, HANS&KELLY Description Date Amount 8255 SW NORFORK LN _ TIGARD, OR 97224 [PLUMB] Permit Fee 4/29/2005 $36.25 [TAX]8%State Surcha 4/29/2005 $2.90 Phone: 503-620-0224 Total $39.15 Contractor: DRAKES 7 DEES 16519 SE STARK ST PORTLAND, OR 97233 REQUIRED ITEMS ANC REPORTS Phone: 503-256-2223 Reg#: PLM 5259 SUP AL1. PHASE& BA a ac t� U) r CD m' This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codas and all other W applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling 503-246-6699 or 1-800-332-2344. Issued By: 'eajfPermittee Signature: Call 503-6394175 by 7:00 a.m.for an Inspection that business day. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each Inspection, Plumbing Fermi' AI)ID O E I V City of Tigard p Receivea,J�y, 03 Permit No?� --a gz 13125 SW Hall Blvd.,Tigard,OR 97223 {{PR ? �! Dan Review Phone 503.639.4171 Fax: 503.599.1960 Date/By. Odwr Permit No. 24-Flour Inspection Line: 503.639.4175 Dau Ready/By: Jut; ® See Page 2 for Internet: www.ci.tigard.or.us CITY OFT Notified/Method Mr Supplemental Information J YGY�• SC![ .Dl1�.E ❑N w construction ❑Demolition For spechd information use checklise _ Description t . _ Ea.ET' Total Addition/alteration/replacement p Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 7 _ r'lrj, CA7'ECOItX ops-'6SFR 1( ) bath 149.20 I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00 ❑Accessory building ❑Multi-family SFR(3)bath _ 399.00 ❑Master builderOther: Each additional bath/kitchen 45.00 ❑ Fire sprinkler f sq.ft.) Page 2 ir Site utilities Job site address z 55- Jt.-j Nd✓ FoeK 4 e Catch basin or area drsin 16.60 City/State/ZIP:'3 r�t, c e • q 7 2-'2-y Drywell,leach line,or trench drain 16.60 Suite/bldg./apt.no.: Project name: �1 V SS e h Footing drain(nu.linear ft.: Page 2 Cross strect/directions to job siteManufactured home utilities 11000- Manholes 16.60 Rain drain connector 16.60 Sanitary sewer(no linear ft.: Page 2 Storm sewer(no.linear R.: Page 2 Subdivision: Lot no.: Water service(no.linear fl.: ) Page 2 - Fixture or Item Tax map/parcel no.: Absorption valve 16.60 +16" Ir _ T .•'i; Backflow preventer ( Page 2 t eve" r, at. rq7N Backwater valve 16.60 Clothes washer 16.60 Dishwasher 1660 �• Thinking fountain 16.60 Ejectors/sump 16.60 Name: v1S rJM_V1s �` Expansion tank 16.60 Address: Z No! o r k L to.^ Q Fixture/sewer cap 16.60 City/State/ZIP: - e, A 72- 11 Floor drain/floor sink/hub 16.60 Phone:(!b 3 )(02-t- '�2.'L Fax:( ) Garbage disposal 16.60 Hose bib 16.60 Ice maker 16.60 Business name: r♦ �.S 7_ t es i n C• Interceptor/grease trap 16.60 CL Contact name: A I.,L �A j t Medical gas(value:S _) Page 1 Address: 1�- / a r s Primer r 16.60 City/State/ZIP: O( 0.,?N r e. 7 2_33 Roof drain(commercial) 16.60 �57l)21 H r7 y p _ (�3)Z S(� Deb Sink/hasin!lavatory 1660 Phone: Fax: : Tub/shower/shower pan 16.60 -J E-mail: Urinal 16.60 r. Water closet 16.60 LU Business name: ( ���� Water heats 16.60 _j rAddress: ( ,S) w J ,C f pY� -- Other: city/slaldzrn: ��t q Z Z 3� ___ Subtotal f - Minimum permit fee: $72.50Z Phone:(S`03)Z LZ y Fax:(5�07)2s�(o-Qy�js Residential backflow minimum it fee: $36.25 CCB Lic.: fZ -1Plumbing Lic.no.: lJ ( Plan review (25%of permit fee) State surcharge(8%of permit fee) 2 .4 J Authorized signature ' _ TOTAL PERMIT FEE . Print name: 4"1 ��r f M ( C Date: V-2 ilos- This permit application expires if a permit Is not obtained within 180 days after It has been accepted as complete. 'Fee methodology set t y Tri-County Building Industry Service Board. i\Building\Permiu\PI.M-PermitAppdoc 12/07 440-4616T(1W2/r'QMlWP.B) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Mems: n� Footinsdrain-1 100' 55.00 0 to 2,000 1 $115.00 Footing drain-each additional 100' 46.40 2,001 to 3,600 1 SIfJ.00 S 3 601 to 7,200 _ F220.00 Sewer-1st 100' 55.00 7,201 and greater 1 $309.00 Sewer-each additional I(X)' 46.40 Water Service-Ist 100' 55.00 Medical Gas Systems: Water Service-each additional 100' 46.40 Storm&P-in Drain-lit 100' 55.00 _ $1.00 to$5,000.00 Minitntm fa 572.30 Storm& _.n Dain-each additional 100' 4640 55,001.00 to$10,000.00 $72.50 for the first 55,000.00 ind S 1,52 for each additional$100.00 or fraction thereof,to and including$10,000.00. _ Cornmercial Back Flow Prevention Device 4640 $10,001.00 to$25,000.00 $148,50 for the first$10,000.00 and$1 54 for Residential Backflow Prevention Device 31_.Z each additional 5100.00 or fraction thereof,to minimum permit fee$36.25) 1 37.55 V and including 525,000.00. Rain Drain,single family dwelling 65,25 $25,001.00 to$50,000.00 $379.50 for the first$25.000.00 and S1 45 for -- each additional 1100.00 or fraction thereof,to Inspection of existing plumbing or and including 550,000.00. specially requested inspections-per hour 72.50 550,001.00 and up $742.00 for the first 550,000.00 and S1 20 for Subtotal: L each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing tasting fixtures? If "yes",please indicate work performed by fixture. Failure to accurately report fixtures could result In Increased sewer fees*. '1 Comments regarding fixture work: BapfistryfFont Bath -Tub/Shower -- -lacuui/Whirl I Car Wash -Each Stall -Drive Thru — Cu idor/Water Aspirator --- Dishwasher -Commercial -Domestic _ -Drinking Fountain -Eye Wash Floor Drain/sink 2" ;„ — — --- 4,. CL Car Wash Drain Garbage -Domestic -— — NDisposal -Commercial _ *Note: If the fixture work under this permit results in an Industrial Ice Mach./Refri .Drains increase of sewer FDUs,a sewer permit will be issued and J oil S arator Gas Station fees assessed for the sewer increase must he paid before the m Rec.vehicle Dump Station plumbing permit can be Issued. Shower -Gang W -Stall J Sink -Bar/Lavatory Ouantity Total -Bradley Isometric or riser diagram is required if fixture quantity -Commercial total is>9. -Service — Swimming Pool Filter Washer-Clothes Water Extractor Plan Review water Closet-Toilet Plan review is required if fixture quantity total is>9. Urinal Other Fixtures: i�Suildina`.PerrnittkPLM-PernntArp doc t/Ol CITY OF TIGA►RD@) � BUILDING DIVISION PERMIT#: PL.M2005.00179 13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 4/29/21105 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 At INSPECTION`A'JRKP'BEET FOR DATE: 6117/2005 TIME: 7.11AM PAGE: 87 SITE ADDRESS: 08265 SW NORFOLK LN CLASS OF WORK: StuBDIVISION: HAMPTON COURT LOT #: 016 TYPE OF USE: PRO,ECT NAME: RASMUSSEN DESCRIPTION: InMallation of baddlow device. OWNER: RASSMUSSEN, HANS&KELLY, PHONE #: +503-6200224 CONTRACTOR: DRAKES 7 DEES PHONE#: 503-26&2223 Inspection Request Scheduled For: Date: 6/17/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 326 RP/bacidlow preventer 009484-01 971-21 0483 N Corrections/Comments/Instruction:;: T-7 IL __.—_ - -- —----- - --- ---- ------- — oe M rn - --- — - --------.- --— —-- t LU 7 J BASS F1 PARTIAL APPROVAL [j CANCEL [] NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDIT-IONAL FEES ASSESSED n Inspector: ._ Date: �(1.� Phone #: (603) 718- 1 IIII � o i C C C 3 Vl 'BVI U o � ' 7s a� CL Ln � o M m � c J Z ULd ir; V [ H N V CITY OF TIGARD BUILDING INSPECTION DIVISION MST ZO&V-e--Q U7 U 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ Uc1te Requested Z" Z- 7 AM PM BLD Location d Z�S—S �✓ �— Suite —� MEC Contact Person _ — Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC — ——� Retaining Wall ELR Footing Access: - Foundation FPS Fig Drain SIGH - `- Crawl Drain Inspection Notes: ---- --- Slab Post&Beam ------ -- Ext Sheath/Shear Int Sheath/Shear Framing Insulation ~— —'--- --�--- Drywall Nailing Firewall — Fire Sprinkler Fire Alarm Susp'd Ceiling Roof inal Final Final -� PASS PARI' FAIL --�/L_ PLUMBING Post&Beam — Under Slab Top Out — - - Water Service Sanitary Sewer Rain Drains _ Final -- PASS PART FAIL MECHANICAL — Post&Beam Rough In Gas Line ---- — Smoke Dampers Final - - - -- — -- — PART FAIL QELECTRIOt8 — — ---�— � — - - a Se � Rough In F- UG/Slab U) Low Vclte.;e --_ -- Fir nn m S ART FAIL W Backfill/Grading Sanitary Sewer Storm Drain [ j Rein -se of$ _required before next inspection. Pay at City P!;!!. 13125 SW Hall Blvd Catch Basin - Fire Supply Line [ j Please call for reinspection RE:_ _____ j linable to Inspect-no access ADA Approach/Sidewalk Other Date _ O Inspector Ext Final — PASS PART FAIL J DO NOT REMOVE this Inspsctlon meord from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST -70 Z) c/7U 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested�'" _ —_AM—J--'—PM __ _ BLD Location Z S=� (,✓ U✓ l� — Suite _ MEC Contact Person Ph FLM Contractor Ph SWR IL TenantJOwnerELC Retaining Wall �! — -� — ELR Footing Access: Foundation FPS Fig Drain SGN - Crawl Drain Inspection Notes: -- Slab _ SIT Post&Beam - -'"-- Ext Sheath/Shear _ Int Sheath/Shear - Framing -- Insulation Drywall Flailing -------•-- ------- -_-- -- -- Firewall Fire Sprinkler _-----__- Fire Alarm Susp'd Ceiling Roof Misc: ---- -_-- - --- *OSJ PAT FAIL -- - - - ----- --- -------- B1 Post& Beam Under Slab Top Out - ---- --._-_.. -.------ - Water Service Sanitary Sewer ERain mina PART FAIL Post& Beam - - -- Rough In Gas Line -_-- Smoke Dampers PART FAIL VEETMICAL a Service � Rough In -------- - --- -• - ---- --- -- - UG/Slah Low Voltage -- --_ --- Fire Alarm "j Final m PASS PART FAIL w SITE J Backfill/Grading --------- - --- ------ _ _ ____.___-- -_---. Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required[,store next Inspection. Pay at City Hall, 1312.5 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE:-, [ ]Unable to inspect no access ADA Approach/Sidewalk Other Date ^ Inspector ! Ext ----- -- -- Final PASS PART FAIL DO NOT REMOVE this Insp octtlon record from the job site. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VALLEY HWY S ALOHA, OR 97006-1248 Electrical Signature Form Permit#: MST2000.00470 Date Issued: 10/25/00 Parcel: 2 S 112 C B-16700 Site Address: 08255 SW NORFOLK LN Subdivision: HAMPTON COURT Block: Lot: 016 Jurisdiction: TIG Zoning: R-7 Remarks: S/F PATH 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form Is received OWNER: ELECTRICAL CONTRACTOR: LEGEND HOMES GARNER ELECTRIC 12755 SW 69TH AVE 21786 SW TUALATIN VALLEY HWY S PORTLAND, OR 97223 ALOHA, OR 97006-1248 Phone #: 503-620-8080 Phone #: 591-1320 Req #: LIC 121139 SUP 37079 p, ELE U30SC F- AN INK SIGNATURE IS REQUIRED ON 'HISF M m ' W Signatu of S p rvising Electrician If you have any questions, please call (593) 639-41' 1, ext. # 310 �� �� ������ �-• MASTER PERMIT Ail DEVELOPMENT SERVICES DATE IS UPERMIED: 10/25/000 00470 AXIIIHM 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639-4171 SITE ADDRESS: 08255 SW NORFOLK LN PARCEL: 2S112CB-167n.0 SUBDIVISION: HAMPTON COURT ZONING: R-7 BLOCK: LOT:016 JURISDICTION: TIG REMARKS: S/F PATH i BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKI REQUIRED CLASS OF WORK: NEW "FIGHT: 22 FIRST: 7111 of BASEMENT: -•'-or LEFT: 6 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 10 SECOND: 1.120 of GARAGE: 436 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: A VALUE: S 176,492.00 OCCUPANCY GRP: P3 BDRM: 3 RATH: ? TOTAL- 1,40400 of REAR: 26 PLUMBING -- SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 1 DISHWASHERS: 1 FLOOR DRAINS: SFY'ER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS- 2 GARBAGE DISP: 1 WATER nFATFRS: 1 WATER LINES: 100 RCKFL W PREVNTR: 1 GREASE TRAPS: OTIIER FIXTURES: MECHANICAL FUEL TYPES FURN c 100K: 1` r BOILICMP t 3HP: VENT FANS: 1 CLOTHES DRYER: 1 GAS FURN>-100K: UNIT HEATERS: HDODS: i OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUYl-ETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADIYL INSPECTION$ 1000 SF OR LESS: 1 O 20C Arno: 0 - 200 Amp: WISVC OR FOR: 1 PUMPIIRRIOATION: PER INSPECTION: EA ADD1 6009F- 3 261 - 400 nmp: 201 400 emp: 101 Wb SVC?DR: 00 SIGN/ill LIN LT: PFR HOUR: LIMITED ENERGY: 401 600 ornl 101 - 600 amp: EA AnnI_aR CIS: SIGNALIPANEL: IN PLANT: MANU HM(SVCIFDR: 601 1000 env: 601-ampr1000v: MINOR LABEL: 1000.ompNoh: PLAN REVIEW SECTION Roconnact onN: - >-4 RES UNITS: SVCIFDR"229 A.: >600 V NOMINAL: CLS ARFAISPC OCC: ELECTRICAL-RESTRICTED ENERGY A.BE RESIDENTIAL B.COMMERCIAL AUDIO A STEREO: VACUUM SYSTEM: AUDIO S STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE.IRRIG: PROTECTIVE SIGNL• GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELF COMM: NURSE CALLS: TOTAL 6 SYSTFMS: Owner: Contractor: TOTAL FEES: : 5,915.66 This permit Is subject to the regulations contained In the LEGEND HOMES LEGEND HOMES CORP Tigard Municipal Code, State of OR Specialty Codes and 12755 SW 69TH AVE 12755 SW 69TH AVE all other applicable laws All work will be done in PORTLAND,OR 97223 TIGARD,OR 97223 accordance with approved plans. This permit will expire M Q, work is not started within 180 days of Issuance,or If the a work is suspended for more than 180 days. ATTEPJTION: Phan.: Phone: Oregon law requires you to follow rules adopted by the U) Oregnr.Utility Notification Center. Those rules are set Rog 0: LIC nOW563 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 � REQUIRED INSPECTIONS JErosion Control Insp 8, Post/Ream Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Memanical Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Final Inspection Footing Insp Craw('Drain/Backwater Electrical SRrvice Low Voltage Water Line Insp Building Final Foundation Insp Footing/FoLlndatlon Dr. Electrical Rough In Gas Line Insp Appr/Sdwlk Ir-,p Post/Seam Structural Mechanical Insp Framing Insp Gas Fireplace Electrical Final or Issued By J,0-9—. Plannittee Signature,, Call(501) 639-4175 by 7:00 p.m.for an Inspection needed the next bu Iness day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00322 ff-1 Mm 13125 SW flail Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISS( ED: 10/25/00 SITE ADDRESS; 08255 SW NORFOLK LN PARCEL: 2S112CB-16700 SUBDIVISION: HAMPTON COURT ZONING: R-7 _ BLOCK: LOT: 016 _ _ JURISDICTION: TIG TENANT NAME: USA NO: FlxTURE UNITS: CLASS OF WORK: NEW DWEi LING UNITS: 1 TYPE OF USE: SF NO. r r BUILDINGS: 1 INSTALL TYPE: LTPSWR iF'rJERV SURFACE: Remarks: Sewer connection for new SF detached. Owner: -- --- — ------� FEES LEGEND HOMES ----- _"FEES ---- 12755 SW 69TH AVE Type By DsCe Amount Receipt PORTLAND, OR 97223 INSP CTR 10/25!00 $35.00 2720000(,000 PRMT CTR 10/25/00 $2,300.00 27200000000 Phone: 503-620-8080 ---�� Total 62,335.00 Contractor: Phone: Reg#: Required Inspections Sewer Inspection IL �c rN C J This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires LU 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 directons from the distance given. It not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregcn 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. Issued by: Permittee Signature ',-L CAII (503) 39-4175 by 7:00 P.M. for an inspection needed the next business Building Permit Application Date received: JQ 16-OV Permit no.: o�D Q S/ Q City of Tigard Project/appi.no.: Expire date: Address: 13125 SW Hall Blvd,Tigard.OR 97223 Dateiaaued: By: Receiptno.: City ofTigard Phone: (503) 639-4171 — Fax: (503) 598-1960 Can file no.: k,iyment type: I&2 family:Simple cowPies I.nd use approval: - �- &2 family dwelling or accessory U Commercial/industrial U Multi-familY RrNew constniction U Demolition "U U Addition/alteratiun/replacement U Tenant improvement U circ sprinkler/alarrrt U OUx r. ,�- Bldg.no.: Suite no.: J ob address: �J — - _ ot: Block: Subdivisio : Tax map/tax lot/account no.: _7,5 1 12 c G-l(,7uv roject name: Description and location of work on pmmises/special conditions:------------ MAIN onditions: ------ - \ a Name: O I ' Mailing add ss: ,Z?s-135 1 lc 2 family dwelling: ,_j y i� Ci / Statc:0ZIP y7 Valuation of work............ ........................... i-y�3' r Y: G Phone: 4,2Q-, o Fax - G� E-mail: No.of bedrooms/baths................................. .- -- Total number of floors................................. v Owners representative: P New dwelling arta(sq.ft) ......................... Phone: O Fax: s"y:� E-mail: y 3s Garage/carport area(sq.ft.)......................... Coverd porch area(sq.ft.) ......................... 0 t Name: Deck uta(sq.ft.)........................................ --- Mailing add ss:1-1 Other structure arra(sq.ft.)......................... City: Stated ZIP: CoutmerdalMdmtrlaUnulti-family: • Phone 0 o Faxt� E-mail: .............. $ Valuation of work........................................ Existing bldg.area(sq.ft.) .......................... Business name: L New bldg.area(sq.ft.)................................ Address:Id 7J' �" Number of stories........................................ City; o. State:M Type of construction.................................... - Phone- O p Fax:5 E-mail: Occupancy group(s): Existing: CCB no•: {J (o O �o _. New: City/metro lie.no.: J Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the R Name: D�f- jurisdiction where work is being performed.If the applicant is IL Address: 'S' -'iz' exempt from licensing,the following reason applies: ZIP City: VC, f a StateCn : ) — — Contact person: yl,lo Plan no.: Phone-x,1,0 • o D Fax- - E-mail: J mConen• Flea due upon application ........................... � Name: �.+� . tact prsos W Address: Date received: _ -- J S�v ....................ZIP: 'c17� — Amount received .....................$ -- City: ai Please refer to fee schedule. Phone: . �' Fax: E-mail: No an lattIdk. MO WOW uea eudr. se pkaall ae t 1 d0"for nMr0jan I hereby certify I have read and examined this application and the OYia o MasterCard attached checklist.All provisions of laws and ordinances governing this cr"e are MR*W - -- t=_r rra - work will be complied with,whether s ifled he in or n� Authorized nature- te: Name ar a ateewo on cre�r card = — � Amema Print name: 4"13 t MMOK Notice:This permit applicati n expires if a permit is not obtained within 180 days after it has been accepted d complete. Mechanical Permit Application Datereceived: Permit no.: City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 1312.5 SW Ball Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503)639-4171 Fax: (503) 598-1960 Cane file no.: Payment type: Land use approval:,011 Building permit no.: 8c 2 family dwelling or accessory U Commercial/industrial O Multi-ftmily U Tenant improvement U New construction U Addition/alteration/mplacement U Odw. Job address: o Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: to no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit Value$ _ Lot; Block.: Subdivision: -o�YiD lra4 1!202 $See checkkA for important application information and Project name: pm �i+il C�/�/ Jurisdiction's fee schedule for residential permit fix. IRMO City/country: r�rvajdZIP: 1. Description and locition of work on premises:____ Fee(41116) Total DescrlKidm Qt.Est.date of completion/inspection- _ Rei. Res.aei �l F�'�'�'i': Tenant improveme r change of use: ,W handlin unit .— CFM ` Is exists space heated or conditioned?0 Yes U No u ►non n ante'—Tan requires Ise C54ng space insulated?U Yes U No A tersuon o existing_HVACsystem of er compressors State boiler permit no.: Business name:Ji +� HP Tons BTU/H Address: /.3?) S C �`� t amo etun uctsmo a etector State:O ZIP; 7G eat ump site an requ _ C nsu rep ace urns mer Phone: $'�-�_L� Fax: '�- E-mail: lnchk.ing ductwork/vent liner U Yes U No CCB no A (002 3 _ nsta rG ocate eaters-suspen , City/metrolic.no.: / eZ wall,or floor mounted Name(please print): a ens a Bance other an runace e Kola Absorption units BTU/11 Chiller HP Name: o Z"� - — _Chillers---— HP Address: 'p jC tri D rotsueot czltaust�s trestt n City: p/o pn C. f State ZIP: yO 1 a, A�lia�ncevent Phone: �J-„U,fd Fax:v S� E-tel: "`�"` a - s,Type11res. tc inKAMatt hood fire suppression system Exhaust fan with single duct(bath fans) d Name: L _ .o grid o aunts stem m eaun or .0— Mailing ad s:/ tF (,rr FwAP up to outlets) N City: —>`��I)e l StateQ ZIP f 7 i1 LPO NO _Oil -- Phone:( 0 G ;sti'J email' tie ► to a a ons over ou eta — ec emetrcrequ _ m Number of outlets , Name: a ap tece or M pse:et: W Address: /, ( .11 l) Decontiveflteplace _ City: r p/ Stat Email' Woodslov etstove Phone OS o Fax-,S - --- Applicant's signature: 411,V4Date: Name • t): JP f«mere NIAN. *a Permit fee.....................$ Not an Ji adkdene WCC eredt nrdt,ptene call JarlaNetton Notice:This permit applicatio." Minimum fee................ U Visa o MasterCard expires if a permit is not obtained Plan review(at _ %) $ Ctedtt card numbw___— --es 4— within Igo days after it has been State surcharge(8%)....$ NowAder cardw as shrine oe t card accepted as complete. f '[Q'[AL....................... Cadlatder siptYtre — Araaatt 4"17 WIMCOat) Plumbing Permit Application City Of Tigard Datereceived: Permit no.: _ Address: 13125 SW Hall Blvd,TiguSew«pemtitno.: 9uildingpermitro.:d,OR 97223 - City ojTigard phone: (503) 6394171 Project/appl.no.:' Expire date: Fax: (911; .1911-1960 Date issued: By Receipt no.: Land use approval: Can eilcno.: Payrrl�nttype: I&2 family dwelling or accessory O CommerziaUiudustrial I]Multi-family L1Tenant improvement Uf4ew construction ❑Addition/alteration/replacement ❑Food service O Other. Job address X02.5 5— �-� L Irl . Fee ea. Total Bldg.no.: S e no.: New I-and 2-Mmily dwellings only: -- ---- (lstdodea 100 R.forearh 1Rllity connection) Tax map/tax lot/account no.: SFR(1)bath Lot: (� Block: Subdivision: SFR(2)bath — Project name: _ SFR(3)bath City/county: 441 ZIP: Each additional bath/kitchen Description and I ation of work on premises: �^ sheutfllties: Catch basin✓area drain Est.date of completion/inspection: D well each lincltrench drain Footing drain(no.lin.ft.) Manufactured home utilities Business name: G✓o�Co Man les Address: DD Rain drain connector Ciry: �yiyy Stat e:p ZIPQ7o Sanitarsewer(no.lin.ft.) Phone: Fax:(,1,7-9 E-mail. Stoma sewer(no.lin.ft.) CCB no.: Plumb.bus.reg.no: p Water service(no.lin.ft.) City/metro lic.no.: Flxtur, or Item: Abso Contractors representative signature: Otion valve Back flow venter Print name: o / �� Darr: Backwater valve 13asins/lavatory Name: Clothes washer _ Address: /Jo B d h 100 7 - Dishwas -r City: State; ZIP: �jIJ Drinkingfountain(s) E'ectors/sump Phone: [Fix: E-mail: Ex ion tank Fixturelsewer ca Name(print): Z Q S Floor drains7floor sinks/hub ge disp Mailing address: ��- G i osal(lose bibb Q City: o ri state:o ZIP: 9?,zce m er Phone G� m Fax: - E mail: terse ase trap ~ Owner installationtresidential maintenance only: The actual installation Primer(s) U) C will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Cha r447. Sink(s),basin(sj.Tays(s)i J Owner's signature: L / Sump_�� ED Tubs/shower/shower pan 0 Urinal JName: Water closet Address: ` ester r - City: a.,4Statep ZIP: — Phone: doh Fax: I E-mail: _ Total all ;.atnt�.-r-4K t ab.vtwe an H.+sasc+teo r«m�wanwtm. Nodi:This Minimum fc.................$ Na N Visa13MasrerCud permit application Plan review(at _ %) S expires if a permit is not obtained Ctedli"'d O mbar ---- -- .- r:. within IRO days aller it has been State surch,,irge(8%)....$ Name d crdhM u ghmvn an'avJk cid accepted ai omplete. TOTAL .......................$ _ i Crdbokw dSuam Aewuer 41 A616 0WCOM) B.EME COMPLETE- FIXTURES (individual) � :Qly �•� dei, Total Sink 18.80 Fihrtun Tyl» OAN W - _- nhr � aMved/carhya I Lavatory 18.80 Sink Lavatory Tub or Tub/Shower Comb. 16.60 Tub or Tubl>;hower,�ombinatlon Shower Only 16.60 Slower Only Water Closet 18.60 Water Closet Urinal tkinal 16.60 Dlshwasher - Dishwastler 16.80 l - Room Tray Garbage Disposal 16.80ne _ Laundry Tray 18.80 Sink 2' - 3' Washing Machine 18.80 4. l loor Drain/Floor Sink T 2' 18.80 gift ON l' 18.80 16.60 Water Heater O convcrsion O Vke kind 18.80 Gas plping requires a separate mechanical permit. MFG Home New Water Service 46.40 - MFG Home New Ssn/Slorm Sewer 46.40 Hose Sibs 18.80 COMMENTS REOARDINO ABOVE: Roof Drains 16.80 Drinking Fountain 18.80 Other Fixtures(Specify) 21.75 Sewer-tat 100' 55.00 Sewer-each adr"katal 100' 48.40 Water Ser*m-tat 100' 65.00 Water Service-each,adc'itlonal 200' 46.40 Storm it,Rain Drain-1st 100' 55.00 Storm d Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 49.40 Ruai, n'lal Backflow Prevention Device' 27.55 - Catch Basin -^- 16.60 Insp.of FAsft Plumbing or Specialty Requested 72.50 Irspedions _ _ fir Rain Drain,single family dwe" 65.25 Grease Traps - -- 16.80 QUANTITY TOTAL Isomelrk or r1w diagram Is required If Ousroy Tow is y a d •SUBTOTAL. 8%SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL J R If 8xkre city.Wal Is r a 7 � TOTAL `Ur -- W *Minimum pennk fee is$7150,a%surcharge.reoe1 Reelft"Baditw Pnwrraorh -) DewMk vAdd Is SM25♦a%s rcharga. "AN New Commercial 130dkgn require plans with barheb orrbw diagram and pin rwvkw. Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no Expire date: Cityojrgard Address: 13125 SW Hall Blvd,Tiga,•-d,OR 97223 Date issued: By: Receipt to.: Phone: (503) 639-4171 - Fax: (503)598-1960 Case file no.: Payment type: Land use approval: =New y dwelling or accesaory O Commercial/industrial O Multi-family O Tenant improvement uction O Addition/alteration/mplacement O Other. O Partial Job address: 5 _ Bldg.no.: Strife no.: _ Tax map/tax lotlaccount no.: Proj n Description and location of work on premises: - Estimated date of compledon/ins 'on: Job no: Fee Mutt -- . ea TOW Im tar Business name: pi werrrs+MralMW- WM�� Address: _ peaitB�It,laeyritr,mii�eiprrBe City: 1,0 ha, I Stated ZIP: 9erdoerebedetk Phone - Fax:G -��aj ' mail: 1000 .ft.or las 4 3 Each eddidond 500 e� R or portion thereof C o.: 14#4_47 Elec.bus.lic.no: _ Wilted ilted energy,residendal 2 ttyKIVVIA37075 --- Umitedener-gy,non-residential _ 2 Each manufactured home or modulo dwelling tum a us el cion( ulred u Date Service and/or leedrr 2 1Rerrkaa or feeim-brbuntlota, Sup.elect.name(print): .,t„ U nee no: Q owed.,ar� 200 amps or lea 2 Name(print): / B�,p 3 ��� ,,,� 201 to 400 amps 2 Mailing address: -2, to � � 401 ro 600 2 — 601 to 1000 amps 2 City: c StEtC>3 ZIP: Over 1000 ux volar 2 Phone:GolU- O�f'd Fax:. -q - E-mail: Reconrimonly 1 Owner installation:The installation is being made on property 1 own Teseperarytavkeaorkedea which is not intended for sale,lease,rent,or exchange according to brta�a0Mfillerrtloa,Orrebeatloat ORS 447,455,479,670,701. 201 amps to 4W 2 /� 201 amps to 400 amps 2 Owner's sl 4ttre: V p to 401 to fns() 2 Wta ch chrais-new,akerattoa, or eatesriea pff l�k Name: r ___ A- Fee hx bmncli circuits with purchase of IL Address: servim or feeder fox,each branch dfcWt 2 � City: ,. StatE� ZIP9�— B. Fee for branch dreniu wfdnotht putrehue f` Phone: - m Fax: Fmail: of service a feeder Pee,first branch dresiC _ 1 N Each sddidond brunch dmuit: i Mkc.(9ervke or feeder not iackde ft J O Service over 225 ampa-comma,d ❑Health-carefeWity Each or irrigation circle 2 O Service over 320 amps-sting of 1 dc2 O Harudowlocedon Each dpi or oodine lighting 2 hmily dwellings ❑Building over 10,000 square feet four or Signal elmoh(s)or a limited energy panel, O System over 600 volts nominal more residential units in one structnre altendon,or extenslon• _ 2 J O Budding over three stories O Feeders,400 amp or mom a ❑Occupant load over 99 persons O Manufactured atrnctures or RV park F.Odh ddNewel haageetloa Oar Ibe sJlewabk r ray of 1M abo O Egresa/lightingplan O Other: peri on Submit_huh of pbum with any of the WWW Investigation fee Ilse above are not applicable to temporary constr d=senlee. other - [Not all}uria�cdons accept creat arils,*w can jwbdkdm far rnore kifnnrtl,a. Notice:This permit application Permit fee.....................$ ❑visa ❑Maatetcam expires if a permit is not obtained ��review(at _—96) $ aed1,and number-- --- within 180 days ager it has been Stall'surcharge(896)....$ _-- Moe ofcaniholdern shown on cre&cad '-- opted as complete. TOTAL,......................$ catihokier i signature Awoahr 4"19(66050 M) -�4. Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Number of Inspections per permit allowed Restricted EneW Fee_...... ....... =76.00 Service included: Items Cost Total (FOR AL SYSTEMS) 4a. Residential-per unit - Check Type of Work Involved: 1000 sq.&or less $147.15 4 Each additional 500 sq.f.or ❑ Audio and Stereo Systems potion thereof _ $33.40 1 United Energy - $75.00 ❑ Burglar Mann Each Manufd Home or Modular Dwelling Service or Feeder $90.00 2 ❑ Garage Door Opener- 4b.Services or Feeders Installation,alteration,or relocation ❑ Heating,Venlilstion and Air Conditioning System" 200 amps or less _ $80.30_ 2 201 amps to 400 amps _ _ $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 amps -- $240.60_ 2 r 1 �r Over 1000 amps or voila Y $454.65 2 L.J -- - -- Reconnect only - $66.65 2 TYPE OF WORK INVOLVED-COMMERCIAL ONLY 4c.Tereporary Services or Feeders - -- Installation.alteration,or relocation Fes for each system................................. $75.00 200 amps or less $66.85 2 201 snips to 400 amps $100.30 2 (SEE OAR 91�2E0-280) 401 amps to 600 snips $133.75 2 U eck Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems 4d.Branch Circuits New,alteration or extension per panel Boller Controls a)The fee for branch drains wM pumhast of servlce or Clock Systems feeder ret. Each branch dreuft _ $6.85 2 LJ Data Te b)The fee for branch circuits Telecommunication Installation widrout purchase of service ❑ or feeder nee. Fire Alarm Installation First brands drwN $46.85_ Each addltbnal branch circuit $6.65 ❑ HVAC 4e.Miscellaneous ❑ (Seor ieeder not tckded) Instrumentation Eacti pump or"allon circle _ $53.40_ Each sign or oullBa lghft $53.40 ❑ Intercom and Paging Systems Signal circuit(s)or a lirnited energy - pacxel,alteration or extension _ $75.00 ❑ Landscape Irrigation Con trvr Mirror Labels(10) $125.00 e 4f.iEaeh addiflonal Inspection over - ❑ Medical the allowable In any of the above Per Inspection $62.50 ❑ Nurse Calls a IPel hour _ $62.50 In Plat $73.75_ Outdoor Londerspe Lighting' 5. Fee:: ❑ Protective SignakV ~ rAL EMe•total of above fees $ rn 6%Surcharge(.08 X total fees) $-- ❑ Other Subtotal $ J 6b.Enter 25%of line 6a for ^--Number of Systems; m Plan Review K rued(Sec.3) $ Subtotal $ ' No kenaes roti required. Morisse arenyuit br all other l IMlsasns W !I ❑ Trus!AocouM N_ f i Total balance Due $� ENTER FEES $ 8%SURCIIARt3E(.04 X TOTAL.ABOVE) TOTA'_ $ May-10-00 10221A Wolcott Plumbing 803 967 9891 P.02 ar.M,waw taWnAeaws. OLC= 3MM.W.SwrAw P.O,sat 1007 DaMArft omw OtaIMm OR PLTIwnve,r pool err t»� Psr ts00)dA•!Mt ccawsta CONTRACTORS, nvc" * I May 10,2000 Building Department. . ,. City of Tigard .. •• ,,.; ,,...K...,, _ 13125 SW Tull Blvd. Tigwd,OR 97223 WolLou Plumbing Contr:u tam.lnc.docs hereby authorize a represenandve orl.egend Homes to represent this f►zm wheal applying for plumbing permits inside the jurisdiction of'Phe City of Tiksrd. Wolcott Plumbing Cuniraetors,Inc.t aliza that should the agreement with Legend Nowa%terminate,we have the right to withdraw our eonscaL fid._ter h , Name Tide ignuttrc nate a 26�20gPB 4251 State Plumbing License CIty Llcenaa rn M w a Oct-18-00 10: 30A p-O3 PLOT PLAN LOT 01ro , PAMFTON COURT RIPD 251 11 DA TAX LOT 6255 SW NORFOLK LAND S.E. 1/4 OF SECTION 11, T-2, R-IUJ, W.M. CITY OF TIGARD WASP INGTON COUNTY, OREGON IgI EG ND H SQ s , 100 wr es (Nos) sto-ow TT um, 011. "m PAT (sm) "o-tow �, ....� LOT lei SOW �. WATER METER ------ WATER LINE Pj LOT W- �'. ray— -- EANITART 9E'UJER 46 SO. FT.STOP" DRAIN NGER OF BtREET p t . LR 200 /r'r IS39' MANHOLE GARAGE FLR �/ •��•% w71 'Cc r�oPo��D STREET TREE'S t� STREET LIGHT FIRE I.IYORr4N7 --- -- - - -- __ - - 199b _m 9.S' rl1G 1993' .J gs9'7©'IPJ"U1 SIDEWALK '. 4�•Ib fir.._------ PROV'IDE EROSION --G11Rd -- CONTROL rins;F _ _aq_ —� -Ql�.-•—.— .S I( PER COMf"NJNITY 1 EROSION _ S.W:1�IO OL-K LANE