12345 SW QUAIL CREEK LANE 12345 SW Quail Creek Lane
CITY OF TIGARD 24-Hour
BUILDING Inspection Lhie: (503)639-4175 - < ;
MST
INSPECTION DIVISION Business Line: (503) 639-4171 BUP
Received _ __--Date RegUested _� /� � AM-.— PM _-__.____— BUP - -
Location [ �'�� ,C.��-1 ?11e:..,; -_Suite k -�- MEC
Contact Person Ph(—) = �1 S J j'PLM
Contractor_ Ph(—) SWR --
BUILDING ienant'Owner _ ___ _ ELC
Footing J _ ELC _—
Foundation Access:
Ftg Drain ELR
Crawl Drain SST
Slab Inspection Notes: - -- -
Post&Beam - --- -- __
Shear Anchors
Ext Sheath/Shear _
Int Shoath/Shear
Framing _
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler m - --- -
Fire Alarm __ _
Susp'd CeilingC
Roof -
Other:
Final —
PASS_ PART FAIL
PLUMBING ----
Post& Beam —
Under Slab --
Rough-In
Water Service
Sanitary Sewer
Rain Drains �-
Catch Basin/Manhole
Storm Drain
ShowerPenOther:
Final _
PASS PART FAIL
MECHANICAL - ------ -- --
Post& Beam - —
Rough-In ------ — _
Gas Line
Smoke Dampers - -
Final
PASS PART FAIL --_-- -
ELECTRICAL _- -----
Servics � —� —!
Rough-In
UG/Slab
Low Voltage ---
Fire Alarm
F n Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA PART FAIL
S E Please call for reinspection RE:— [� Unable to inspect-no access
Fire Supply Line -��-^,
ADA Date_ _�''�7 �'`'''�— Inspoator t'" -fir/ �?/ - Ext_--
Approach/Sidewalk J ✓ J
Other:_
Final DO NOT REMOVE this lnsp-,action re,ji- l from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspcction Line: (503) 639-4175 c?J
INSPECTION DIVISION Business line: (503)639-4171 MST
BLIP
Received __ _ _Date Requested—_ — AM___ _PM_ ___- BLIP
Location ..i'�X.Suite MEC _-- ----_—
Contact Person 1? — F —) _- PLM —
Contractor_ —_ Ph( _) SWR
BUILDING Tenant/Owner _ _ ELC
Footing ELC
Foundation Access:
Ftg Drain ELFT - -
Crawl Drain .. —
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shenr
Int Sheath/Shear
Framing —
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler — - --- —
Fire AlarmZ
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. -----
A ., PART FAIL --- --------- ----- ----- -- -
Post&Beam
Rough-In ------ --- --------------- __-- — — --
Gas Line
Smoke Dampers --- --- - -- --- — - ---------- —_— _ — —
Final
PASS PART FAIL —_ -- — - - ------ — -- - ---
ELECTRICAL —_.--_ —__.-- ----- - -- ---- - _.—
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection Ion of$______—__—required before ne,,inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL _
Please call foi reinspection RE: ____.._ _--___— Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1. __ — In ape;tar _I T _',�'! Ext
Other:
Final r a0 NOT REMOVE this Inspection record from the Joh site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUIW NG Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 ois ,
BUP
�s
Received _— _Date R questedAM BLIP
Location2411�74_Suite MEC .---------___--
IL
Contact Person Ph PLM -- -__—__-
Contractor Ph( ) ____-- SWR ---_.----__--
BUILDING Tenant/Owner __ _ _..-__ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR --.-__
Crawl Drain
Slab Inspection Notes: SIT _—
Post&Beam --.---- -- -
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear - 2
Framing -
Insulation
Drywall Nailing �-
Firewall ��f'
Fire Sprinkler
Fire Alarm 4 23z a 2 �-
Susp'd Ceiling -
Roof -
Otbar: ---
PASS- PART -FAIL -- - �_
PLUMBING_
Post& Beam
Under Slab Y'� 2�/1_( Z �L = ��
RoughSe -- /r
Water Service -
Sanitary Sewer L
Rain Drains - -
Catch Basin/Manhole
Storm Drain -- '-
Shower Pan o'er o — ac�� G�/�J ,-
Other:_ _ --
Final
PASS PART FAIL --
MECHANICAL -_- -- - ---------------- - --
Post&Beam
Rough-In --- - ----- -- -- -- _.-._. _T__-`_-- --- ---
Gas Line
Smoke Dampers - ---- . - - --- — --.-- -_
PART_ FAIL ---- --- - --- -- -_ _------- -
ICAL
Service
Rough-In --- -- -- - ---- ---- ----
UG/Slab
Low Voltage ---
Fhe Alarm
Final Reinspection fee of$ - required before next inspectior. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ F-1Pleasecall for reinspection RE: -_-- - Unable to inspect-no access
Fire Supply Line ,�
ADA
Approach/Sidewalk rDate "' Z Inspector
Other: _
Final �– DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
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CITYOF T I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES E ISSUED:
#: 5/3/02PLM22-00145
DATE ISSUED: 5/3/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-117
PARCEL: 2S103CB-08200
SITE ADDRESS: 12345 SW QUAIL CREEK LN
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5
BLOCK: LOT: 031 JURISDIC""ON: TIG_
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TY13E OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
-__—— --- SINKS URINALS. GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of backflow preventer device.
FEES_
Owner: — Type By Date Amount Receipt
DON MORISSETTE HOMES PRMT CTR 5/3/02 $36.25 27200200000
4230 GALEWOOD ST#100 5PCT CTR 5/3/02 $2.90 27200200000
LAKE OSWEGO, OR 97035 =
Total $39.15
Phone 1: 503-387-7538
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone 1: 682-6076 Final Inspection
Reg#: LIC 6136
PLM 11558
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 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
-�X�,�1r
Issued By: � C.L Permittee Signatura �_
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
Plumbing Permit Applicatio
rDatereceived:
city of Tigard Sewer permit not: Building permit no.:
Address: 13125 SW Hall BRMWW Project/apol.uo.: Expire date:
Cityo7igard Phone: (503) 639-4171
Fax: (503)598-1960 Date issued: By: �, 1 Recpiptno.:
Land use-approval: Casefileno.: Paymenetype: .
1 - :4 Im
❑ 1 do 2 family dwelling or accessory . ❑Colnmercial/industrial O Multi-family ❑Tenant improvement
) ,New construction ❑Addition/altemtion/replacement ❑Food service ❑Utlic-r: __—_— ____
1 1 1 ' 1 1
l r I /i" I i Description . Fee(ea.) Total
Lobdress: t - New 1-and 2- ly dwellings only:
no.: Suiteno.: (includes 100%foreachutilltyconnection)
ap/tax lot/account no.: SFR(1)bath onY (.t 1/t! f 1 , �i! t SFlt(2)bath
ct name;( -i r I 1 L'"l t._) 3 ' _ SFR(3)bath _ - --
City/county: t ZIP: " 112,)4 Each additional bath/kitchen
Siteutililitles-
Desc�}Qtion andlocation oqf work on premises: --- Catch basin/area drain
IS Ate- Ct1CJ_-Qf Se4�1 - D — 1sReach liege tranch-�sait>r� _—
Est,date of completion/inspection: r' _ - _
Footing drain(no.lin.ft.)
1 Manufactured home utilities _
Business name: 6,i'0L-E SG(SfA Manho es
Address:a9?CIs 40 ain drain connector
Cit ; jJ S�f]UI� G �-Qwv
ZIP: 7) d Sanitary sewer(no.lin.
mall: Storm sewer(no.lin.ft.)
Phone:toga,-Ino'7 alq Fax: $ -Water service(no.
_CCB no.; (a(� Plumb.bus.reg.no: Future or sem:
City/metro tic.no.: 003a-7 Absorption valve
Contractor's representative signature: J Back flow reventer i SS
Plintname: � �1� S f►yrzrt�� Date: _' Backwater valve _
CONTAtTWERSON FBasins/lavatory-,_
Clothes washer
Name: Dishwasher
Address:� Q 4 S 9t) KLh ' Drinki_ng ountain(s)
State.OR„ ZIP: O Ejectors/sump
_City: 1�rUnUt It Cr _�
Phone:(oKA-loo?fo Fax:(AD- 90 E-mail: Ex ansion tank _
Fixture sewer camMW `
Floor drains/floor sinks/hub _ __-
Name(print):Dpn�n Y� 1SS��'>� Garbage disposal
Mailing address:14-20 a tW WA S7 l t] Hose bibb —
City: [,ta.K1. C� State: ZIP_q?0.31 camaker -
Phone: Fix: E-mail: terce tor/ rease trap
Owner Installation/residential maintenance only: The actual installation Primer(s)
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 Chapter 447. Sink(s),basin(s), ays(s)
Ownees signature: Date: Sum
Tubs/showerishower pan
tJrinal
Name: ,_ - __- rater c oset
Address: _�. Water he
City: r State: ZIPS_ Other:
Phone: E mall: otz
Fax:—_ _ �
Minimum fee................$
FuNot ailyuirdictioto rtccapt audit cmdrt,Please all)urixdictton for mote information. Notice:This permit application Plan review(at _ %) $
visa O MasterCard expires if a permit is not obtained State surcharge(816) ....$
dit Bard number, - .Ply within 190 days after it has been TOTAL .......................$
accepted as complete.
N.ora'Ao der u rhown on credit card s
Car older d�tratura 410—:b16(6U0/COM)
Amount
PLUMBING PERMIT FEES:
L �
••a" j nitt t � ii �r ra elrAly U I t Ud65ia I'pl Til P Fyµ w:
91k 16.60 tt,
Lavatory 16.60 One 1 bath 5249.20
Tub orTub,Shower Comb. 16.60 Two 2 bath $350.00
Shower Only
16.60 Three 3 bath 5399.00 _�
Water Closet 16'60 SUBTOTAL
18.80 a%STATE SURCHARGE
Urinal >�
Dishwasher 16.80 PLAN REVIEW 25%OF SUBTOTAL
TOTAL ,� `. ,' '',•�
Garbage Disposal - 16.60 --�
Laundry Tray 16.60
Washing Machine 16,60
Floor DrainlFioor Sink 2" 16'60
3"
r 18.60 PLEASE COMPLETE:
4„ 16.60
18.s0 fe fill, oa'•Pe.
Water Heater O conversion O like kind �t S l i
Gas piping requires a separate mechanical p k��
T j
rmit. 46.40 Sink - - --
MFG Nome New Water Service Lavato
MFG Home New San/Storm Sewer 46.40 Tub or TublShower
Hose Bibs 16,60 Combination
Roof Drains 16.60 Shower ON
16.60 Water Closet
Drinking Fountain Urinal
Cthor Fixtures(Specify) 16.60 Dishwasher
Garbage Dis osal
Laund Room Tra -
_ Washing Machine -
Floor Draln/Sink: 2"
Sewer-1st 100' 55.00 3"
Sewer-each additional 100' 46.40 4" -
55.00 Water Heater -
Water Service-1st 100' _ _- Other Fixtures
Water Service each additional 200 46.40 S eci
Storm&Rain Drain-1st 100' 55.00 -
Storm&Rein Drain-9a additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Resldentidl Backflow Prevention Device' 27.5E _
Catch Basin 16.60
Inspection of Existing PlTS REGARDING ABOVE;
umbing or Specially 72.50
Re uested Inspections erAtr _ COMMEN
Rain 65.25
Urain,single family dwelling
Grease Traps i6 60 --
QUANTITY T"'AL
Isometric or riser diagram is rej '.d If
uant Total la >9
'SUBTOTAL -
8%STATE SURCHARGE
"PLAN REVIEW 25°/.OF SUBTOTAL
Re ulred onl if fixture total Is>9
TOTAL s ,
r
*minimum permit fee is$72.50•r4 state surcharge,except Residential Backflow
Prevention Device,which Is$3e.25•a%state surcharge.
"All New Commercial Buildings require plans with Isometric or riser diagram and
plan review.
lAdsts\forms\plm-fees.doc 10/10/00
CITY w`(v-ij'F TIGARD MASTER PERMIT
PERMIT #: MST2002-00151
DEVELOPMENT SERVICES DATE ISSUED: 3/21/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12345 SW QUAIL CREEK LN PARCEL: 2S103CI3-08200
SUBDIVISION: QUAIL HOLLOW - EAST 'ZONING: R-4.5
BLOCK: LOT:031 JURISDICTION: TIG
REMARKS: New SF dwelling. Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRFD
CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1.553 at BASEMENT: at LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,397 at GARAGE: 462 at FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: of P.InHT: 5
VALUE: $280,31940
OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 2.95000 of REAR: 23
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS, SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS:
TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS- I WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN�100K: BOIL/CMP c 3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN>=1100K: I UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD1 INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPII^m"ATI PER INSPECTION
EA ADD'L 500SF: 5 201 400 amp: 201 400 emu: let WIO SVCIFDR: 00 SIGNIOUT UN I PER HOUR.
LIMITED ENERGY. 401 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNALIPANEL IN PLANT.
MANU HMISVCIFDR: 601 • 1000 amp: 60i+Amp%.l000V. MINOR LABEL
10004 amplvolt
PLAN REVIEW SECTION
Reconnect onlV:
>•4 RES UNITS: SVCIFDR>•225 A. >800 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL.•RESTRICTED ENERGY
A.SF RE31DENTIAL B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC LANDSCAPE/1RRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,578.66
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORISSETTE HOMES Tigard Munlr�ioal Code,State of OR. Specialty Codes and
42301 GALEWOOD ST#100 4230 GALEWOOD STREET all other applicable laws. All work will be done in
LAKE OSWEGO,OR 97035 SUITE 100 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:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg N! LIC 35533 forth In OAR 952-001-0010 through 952-001.0690. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Gyp Board Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection
Foundation Insp Footing/Foundation Drl Electrical Rough In Gas'-Ine Insp Appr/Sdwlk Insp
Post/Beam Structural PLM/Undarfloor Framing Insp Insulation Insp Electrical Final
IssueA'By ' �y. J(:_, �_ et Permittee Signature : ► 4
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TICARD __ SEWER CONNECTION rtRMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00105
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/21/02
SITE ADDRESS; 12345 SW QUAIL CREEK LN PARCEL: 2S103CB-08200
SUBDIVISION: QUAIL HOLLOW- EAST ZONING: R-4.5
BLOCK: LOT: 031 JURISCICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. GF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner:
--�--- FEES _
DON MORISSETTE HOMES Type By Date Amount Receipt
4230 GALEWOOD ST#100 _
LAKE OSWEGO, OR 97035 PRMT CTR 3/21/02 $2,300.00 27200200000
INSP CTR 3/21/02 $35.00 27200200000
Phone: 503-387-7538 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. 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 riot so located,the installer shall purchase a "Tap and Side Sewer" Perm
— -- --
Permittee Signature: �_
Issued by: — .. ---- --- q +Yl L.
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
Building Per P ' •
-_ -•—_ - y I Duereceived: ,PL Al 1 0";- Permit no.: 00,2- .
Maim City of Tigard /t� Project/appl.no.: Expire date:
-- -
CityojTigard Address: 13125 SW Hall Blvd,Tigard,OR 91M, -
Phone: (503) 639-4171 Date hutted: ( )I Receipt no.:
Fax: (503) 598-1960 Cl I*Y Uf f IUAirU Case file no.: Payment type:
Land use approval: BUILDING DIM1014 1&2 family:Simple Complex:
IM I r ,
O I &2 family dwelling or accessory O Commercial/industnal U Multi-family r�CNew construction U Demolition
U Addiuon/alteration/replacemcnt U Tenant improvement U Fire sprinkler/alarm 0 Other: —
r �
Joh address: ' Bldg.no.: Suite no.:
Lu Block: Subdivision: i , Tax map/tax lot/account 219
Project name: '�
Description and location of work on premises/special conditions:
E Mill 1111111W11111p
Mailing address: 1 &2 family dwelling: e
City: State ZIP: ) Valuation of work........................................
Phone: - Fax: -7 -mail: No.of bedrooms/baths.........I.......................
Owner's representative: _ I Total number of floors................................. �y
Phone: Fax: Email: New dwelling area(sq.ft.) ..........................
Garage/rarport area(sq.ft.)..... 4.1...Covered porch area ft. �__
Name: (sq. ) ........................
Mailing address:
L
Deck area(sq.ft.)........................................
City: I
Other structure area(s .ft.).........................Phone: Fax: ComrnerclaUlndustrialimulti-family:
lug Valuation of work................. $ --
Existing bldg.area ft) .
w ................
Business name: x-11 New bldg.area(sq.ftJ...
Address: Number of stories
_x'1,�_�l - ----
City: State: ZIP:
Type of conswction. .................... ........... -
Phone: Fax: &mail: Occupancy group( : Exis
New:
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: Lt,l(�F provisioas of ORS 701 and may be requited to be licensed in the
Address: ��`� �� _J 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: Fan: E-mail: --
None: Contact person: Fees due upon application ........................... $_
Address: Date received:
City: State: ZIP: Amount received ......................................... $
Phone: Fax: I E-mail: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all Juriadlctloor accept credit cards,please call junsdiction for more inforrrrarioe.
attached checklist. revisions of I ws and o��inances governing this U Vis& U MasterCard
work will be corn 1 wt ,whether cifieci IJerelfh r�)
Credit card numtwf _
p 7� �lAuthorized Si nate � [C - — Name of caidtolder as shown un cnxllt card
S
Print name: '�t t / —----cardholder signature Amatnt
Notice:This permit application expires if a permit is nut obtained within 190 days after it has been acceptcu as complete. 1444611(MUCOM)
Once-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
CityojTigarddud
City f Tigard Associated permits:
y Og D Electrical Q Plumbing 0 Mechanical
Address: 1315 SW Hall Blvd,Tigard,OR 97223 OOther:
Phone: (503) 639-4171
Fax: (503) 598-1960
iAgglyfamil 11 1 11 1 r f
1 land useaetlows completed.See jurisdiction critr is 101 concurTcni reviews. J
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved plat/lot.
4 Fire district approval required. i
5 Septic system permit or authorization for remodel.Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report.Must carry original applicable stamp and signature on file or with application. _
9 Erosion control ❑plan 0 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 tJ
if copyright violations exist. J� _
i 1 Site/plot plan dram to scala The plan must show lot and building setback dimensions;property comer elevations(if
There is mor,thmi a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot _
arca;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
l'2 Foundation plan.Show dimensions,anchor bolts,any hold-downy arra reinforcing pads,connection details,vent
size and location.
13 Floor plan+.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, `I
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to-npineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining"ails.Provide c--ss sections and details showing placement of rebar.For 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 bean/joist carrying a non-uniform load,
20 Manufactured floor/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.
Engineer's calculations.Whcn required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
1
23 Five(5)site plans arc requited for Item 11 above. Site plans must be 8-1/2"x 11"or 11"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. _
27 _
28 _
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for del;srment use only. 440.4614(&%COM)
Mechanical Per 't, IA
l'
r... Date received: Permi2i� t
w«.',.r'
City of Tigard Project/appl.no.. Expire date:
CiryojTignrd Address: 13125 SW Flail Blvd,Tigard,OR 97223 By: Rcceiptno.:
Phone: (503) 639-4171 Date issued: _ -
Fax: (503) 598-1960 C1 Y Ut f 1(JAKD Case file no.: — -� Payment type: _
Land use approval: BUILDING DrMION Building permit no.: '
TYPE OF PERMIT
O 1 .L 2.fam1y dwelling or accesFr)ry U CommerciaUindustrial U Multi-family U Tenant improvement
lEeNew construction U Addition/alteration/replacement U Other JOB S11EINFORNIATION COHMERCIALVALUATION1
Job address: 1C L c s ti lkc L I Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,lr'7or,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: -' 1_ Block: Subdivision: (�; i, 'See checklist for important application infommd n and
11 tis jurisdiction's fee schedule for residential permit tee.
Project name:
City/county: ZIP: _- - 7hand�ling
I " 1
Description and location of work on premises: Fee(ea.) ToiatEst.date of completiordinspection: Description . Rrs.only Res.onlyTenant improvement or change of use: unit CFM
Is existing space heated or conditioned?L3 Yes U No ning(site p an requir )
Is existing space insulated?U Yes U No I Alteration of exiaung AC system _
of er/compressors
State boiler permit no.:
Business name: � L` HP Tons—_BTU/H _
Address: r' �udsmcKedampers/ductsmoke defectors
City:! State• �1-.
eat pump(site plait require)
Phone fj. Fac: E-mail! nclu rep ace work/ eat liner
/
qIncluding c Vie h liner O Yes❑No
CCB no.: ��C1 Install/replace/relocateheaters-suspende ,
City/4(plea-s,
no.:N/A wall,or floor mounted
Namprint): _ enc or-ap iance other than furnace
efrigerat oin:Absorptionunits _ BTU/HNamJ �f2j- C- LL_
_ Chillers -- _--- WP
Compressors HP
Address: rn�� C. t _ Uvironment2i eXIIAUS11 and vent ton:
City: State: ZIP: Appliancevent
Phone: Fax: E-mail: erexhaust
s�Fype U111res.kitchenthazmat
hood fire suppression system -
Name: 7 Exhaust fan with single duct(bath fans)
Mailing adds ess: j N,' 1 haust systema art from eating or
-Tu-el AU
piping an distribution(up to outlets)
City: ----- 5Utte ZIP ) � Type: ._-LPG NG Oil _
Phone: 7' I .,. E-mail: uc�I-i ing eat addmonal ovor 4 Outlets
tocess piping(schematic requued) —
Number of outlets
Name ---_-�_ ter listed appliance or equipment: -
Address. Decorative fireplace
City - — --- State: ZIP: - ----- rt-type
Phone: -- --- Fax: mail: Woodstove/pel let stove
cher:
Applicant's signoras' Date: �' l Ut er. __—
Name(print): (� �L'l t I 1r'1'1r�11.
Nall jurisdictions accept credit tarda,please call jundicaon lux more InrormNim. Permit fee ................$
fee
Nix
Notice:This permit application Minimum fee................$
Ll Visa U MasterCard expires if a permit is not obtained plan review(at _ 96) S
Credit card number __ — Eapir s within 190 days alter it hits been State surcharge(8%) ....S —
Name of cardholdet u shown on credit card s accepted as complete.
TOTAL .......................$
�� '—i'rdholder at6itatum f Amount 4164617(&AMCnM)
Plumbing Permit Ap plication
D4tereceived: Pm=t no.: t�;"
Cit of Ti "
}� � Sewer permit no.. Building permit no.:
Address: 13125 SW Hall Blvd.Tigard.OR 97223
CityoJTigard phone: (503) 639171 Projecdappl.no.: _ Expire date:
Fax: (503)598.1960 C"lc-Xok I I UARU Date issued: by: Receipt no.;
Land use approvaBl T1LD C7 I,t Y s`� Case file no: Payment type:
t
❑ I &2 family dwelling or accessory O CommercialiindustmU O Multi-family O 1 enant improvement
Jew construction 0 Additiori/altentiori/replacemrnt ❑Food service O Other. -
JOB SITF INFORMATION 7 6
�� ,'��-1 �j I CI(-� t. Description
Fee(e2.) Total
Job address:
— Suite no.: New 1-and 1-fancily dwellingi only:
Bldg. no..
(include5 100 it.for each utility connection)
Tax ma /tax lot/account no.: SFR(1)bath _
Loc Block: Subdivision__ + ( 6 5 SFR(2)batii� ���- _
Project name: SFR(3)bath
City/county: ZIP: Each addiuonalal bath/kitchen
Descriptio,.and location of work on premises: Site utilities:
Catch basin/area drain
F-st date of completionrnspection: Drywells/leach h :,-/trench dr:u l _
Footing dram(no. lin. ft.)
Manufactured home utilities
Business name-,.- (?��, L��- -- Manholes -
Address: Rain drain connector
City: State• ZIP: ^^ Sanitary sewer(no.lin. ft.) _
Phone: . -�" Fax: Email: Storm sewer(no.lin.ft.)
Water service(no.lin.ft.)
CCH no.: ( -Z C Plumb. bus. reg. no: - Fixture or item:
City/metro lic. no.:N/A �� Absorption valve ---
Contractor's representative signature Back flow reventer
Print name - . .,_ I u ' Backwater valve
Basins/lavato
`� �I SP���I�� Clothes washer
Name --- Dishwasher
Address: 1r V Drinking :ountaints) _
Cit, State FEIP: E ectors/sump
Phone-�---- --- Fax: E-mail: Expansion tank
Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): _ ' ��` �- h Garbage disposal —
Mailingaddress: P _- Hose bibb
City. 1 _ State, ZIP: �� Ice maker
APhone:- - Fax:, 7-:7 E-mail: Interceptor/grease to
Owner instapation/retid ndal maintenance only: The acriai installation Pnmer(s)
will he made b,, me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the properly l own as per ORS Chapter 447. Sink(s).basin(s),lays(s) _
Owner's signature: Date: Sump
Tubs/shower/shower pan _
l_'nnal _
Name: Water closet
Address: 11 ater heater
Cin State ZIP: Other.
Phone:--::=F� ax: Email Total
Nos Zvi tun"cuoro sccepr credit cards,pie=tail)—diction for nwre mtamauon Notice:This permit application Minimum fee................$
U V'Isa U MasterCard expires if a permit is not obtained Plan review(at — %) S _-------
Credit cud number -1 - %ithin ISO days after it as been State surcharge(8°b) ....$ _ --
xp�tet hTOTAL . s
_ accepted u complete. "" ' """"""" ----
Nanx tit cudhoidet u dwwn on cmict cud s
l'ardhnldu ujnatute _, Amoun, 1Jo-1616 1r MCCV)
/
Hectrical Permit. lication
sm
,o
Date received: Permit no.: ��
City of Tig Project/appl.no.: Expiredate__
CifygTigord Address: 13125 SW Nall Blvd,Tigard,OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639-4171 Payment type:
Fax: (503) 598-1960 Case file no.: Y
�,1 t V ()p f i UAXU
Land use approvyl L( ��____.._
t
❑ I &2 family dwelling or accessory U Commercial/indust-nal U Multi family U Tenant improvement
New construction U Addition/alteration/replacement U i Jdict: . U Partial
OI SITE INFORMATION
Job address: L L., : PIdg.no.: j Suite no.: Tax map/tax lot/account no.:
Subdivision: tr'�� O '
Project name: I Description and location of work on premises:
Estimated date of compie tionriinspection:
SCIIIEDULE
Fee Max.
Job no:
_ Description Qtr. (e,.) Total ao.lnsp
Business name: 1 Now m-sidnitial-single or multi-family per
Address: dr►elling�uiif.tnrlu res att�cMd t�aragr.
City: State: ZIP: Se�a�tutkd
Phone: - I Fax: E-mail:
1000 sq.ft or less 4
Each additions)SW sq.ft or porion thereof
CCB no.: EIeC.bus.tic. no: Urnitedenergy,residential
C --- Uffutedenei-gy.non residential _ 2
Each manufactured hoax or modular dwelling
Date Service and/or feeder r—
afY►lOJJa eNIJU
an(required)
-- Services o-feeders IInstallation,
Sup elect name(print) 1
License no slteratton or relocation:
at 200 amps or less 2
201 amps to 4011 amps _ 2
Name (print): ` Mail:
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
ty �r 7_IP: c)verlt>y0ampsotvolts2Phone: - Fax:
Reconnectonly I
IhTemporary serrices or feeders-
vner installation: 1-he installation is being made on property I own iltttauadon,.lteradon,orrelondon:
which is not intended for sale, lease,rent,or exchange according to 200 amps or less _ — -
ORS-117,455,479,670,701. 201 amps to 400 amps _
Owner's signature: Date: 401 to 600 ams 2
Branch circuits-new,alleration.
or eattnslon per panel:
Name: A. Fee for branch circuits wr0 purchase if
Addresses service or feeder fee,each branch circuit _
ry. Slate: ZIPB. Fee for branch circuits without purchase
Ci
_ _ — -- of seryice or feeder fee,first branch circuit:
Phone: Fax: E-mail' Each addiuonal brinch circuit:
Ml+t.(Service or feeder not Included):
Each pump or irrigation Wrenn 2
1]Service over 225 amps-cornmemial U Healthcare fxibty Each sign cr outline lighting____._ _ 2
O Strvice aver 720 amps-rating of Ide2 O Hazardous locauoa Signal circuit(s)or a limited energy anal.
rmnilydwellmgs ❑Building over 10,000 square feet fouror g gyp 2
O System over 600 volts nominal more residential units in one structure
alteration,or extension'
•Building over three stories O Feeders,400 amps er more *Description:
U Occupant load over 99 persons U Manufactured structures or It V park Fjeh additional inspection over the■llovrable In any of the.above:
0 Egress/Iighungplan U Other-. -- Per inspection
Submit__sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
——
Permit fee.....................
No.all)urivdicuons accept credit Lards,ptea+e till jwisdictloo fa more tnfomuuon Notice:This permit application Plan review(at _ %) $
p Visa ❑MasterCard within
if a permit is not obtained
within 180 days after it has been State surcharge(876) ....$
Cmdit card numher _
pirca_ accepted as complete. TOTAL .......................S
Name of cardholder u shown on credit car
— s
Cardhdder signature Amount 440-4615(&MCOM)
DON • MORISSETTE �
H 0 M 9 3 1 N C 0 R P 0 R A T K D FEB � � 1011?
4 2 3 0G A L 9 R 0 0 0 9 T t t 9 T 3 U I T I 1 0 0
LAKE 0 9 w a G O• 0 R Z G 0 N 97000 �1'Y �� 1}(j
(
(50 ]) 907 - 7S 70 ► AX (S09) 9B7 - 7d 1 S LOT: 331r —W1 ��_�r
�pN
OPTION 3 ELEVATION DATE. 2/14/02
PROPER'T'Y: QUAIL—HOLLOW
CITY: TIGARD
SCALE: 1"=20'
PLAN No.: 139 _
293 2Y� u, •GJ
�® 0 /
�--'0 � 296 �n
i
0
a.
lD 950 eq. rt.
4 bdrm.
B 'r 2 lit ba th m
FF-E. 296.3'
I
RED f'L1FL,E - ' - r.469 .9. rt:
WWERE pcxeli �.� .:2 car g'ar.;°
APPROPRIATE--- FF.E. 296'
- --- 21'7'
8' VIDE P.u_c^ Concrete,'
2%
wl
�1 �I Aja
12 345 � l�.J, aLIA I L CREEK
LOT "31 r
S,m�E sq. rt
CITY CF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received __ ______—_Date Requested—_ 1-7 AM _ PM_ BLIP
------------ ---- ---
Location _----- �' .5 �J(.( < oazz C : / ite _ _— _ - MEC
Contaci Person --- - ------- - Ph(— 1 -- - - _ _ PLM
Contractor Ph(-- ) -_--- SWR
BUILDING Tenant/Owner _ _- ELC
Footing
Foundation EL.0
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 -- -
t
Roof 7
Other:
Final
_
PASS_PART IL - -
__PLUMBING
Post&Beam
Under Slab --
Rough-In
Water Service
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Dram --
Shower Pan
O T
l�'n
P PART FAIL -` --- ----------__---________.-� -_-- - -
HANICAL
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:_— E] Unable to Inspect-no access
Fire Supply Line //
ADA 0'
Approach/Sidewalk Dab�_ Z Inspector / _—Ext
Other:_
Final DO NOT REMOVE this Inspection record from the Jobs site.
PASS PART FAIL