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13402 SW 122ND AVENUE 13402 SM 122"" Avenua CITYOF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00265 13125 `.;W Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 06/21/2001 SITE ADDRESS: 13402 SW 122ND AVE PARCEL: 2S103CB-11700 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 `___BLOCK: LOT: 075 - JURI'DICTION: TIG CLASS OF WORK: ALT GARBAGE P;SPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTkS: 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: TUB/SHOWERS: SEW.7R LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow preventer device. —---------- Owner: FEES -- _ — _— —- -- — — - -- DON MORISSETTE HOMES Type By pate Amount Receipt 4230 GALEWOOD ST PRMT CTR 06/2.1/2001 $36.25 27200100000 STE 100 5PCT CTR 06/21/2001 $2.90 27200100000 LAKE OSWEGO, OR 97035 - Total $39.15 Phone 1: 503-387-7538 —.,— Contractor: PROGRASS LANDSCAPE SERVICE-S 29895 SW KINSMAN P7 WILSONVILLE, OR c 170 REQUIRED INSPECTIONS Phone 1: 682-6076 RP/Backflow Preventer Reg #: 1-iL 6136 Final Inspection 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 vri!i he 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 foliow 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. %1 Issued By: (.i-tom Permittee Signature: Cal; (503) 639-4175 by 7:00 P M. for an inspection needed the next business day Plumbing Permit App � ation "Dateeceived. p / Permit no.:� City O Tigard ( � Sewer permit no.: Vuilding permit no,: Address: 13125 SW flail Blvd,Ayt6rd,-DRA23 Cary of Tigard phone: (503) J39-4171 Projecdappl.no.: Expire date: Fax: (503) 59F :960 C0MM1)NITY DF0 i'. Date issued: Ey: _ Reccipt no.: Land use appm• ."I: � Case file no.: Payment type: TVPE OF PEMW r ❑ 1 2 fami'y dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement Ncw construction U Addition/alteration/repl icement U Food cervi,_c ❑Other: .1011 SITE.INFORMATION IVLE(for 4pecial inflorma , Job address: f-_1)L (� �, a /1�( _ Description Qty_ Fee(ea.) Total Bldg.no.: Suite no.: — New i1-and 2-family dwellings only: (includes 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: '' _ Block: Subdivision:O,t• 'Ut L t46!k iu SFR(2)bath �- Project name: aU aLiL Wt,(I61C, SFR(3)bath _ City/cojnty:T1 lam( LOAQM. ZIP: Each additional bath/kitchen Description andlocation of work on premises: Siteutilities: &•q[.(f-Ri--w . Catch basin/area drain Est,date of completion/inspection: (51 Drywelis/leach line/trench drain Footing drain(no.lin.ft.) _ Manufactured home utilities Business name: Pq&retZ Lards('l[Q(, 7n c, Manholes _ Address: ej 'e j -t 1 c kn Rain drain connector City: W r I ''Cm o G I State:00 ZIP: /'7Q 1 Sanitary sewer(no.lin.ft.) — Phone Fax:&&- Q7 E-mail: Storm sewer(no.lin.ft.) CCB no.: Plumb.bus.teg.no: _ Water service(no.lin.ft.) City/metro lic.no.: / — Fixture or Item: Controctor's re resentative signature: Absor•tion valve _ p g Back flow preventer ;2 7,5 Print mune: Elleq Date:( d(J Backwater valve ,, � _— Basins/lavato _ Name. LH/-1(' lr ('-( _Clothes washer Address:� Dis was er 2f'(/� &W e 1I Gi' _ Drinking fountain(s) City-- �� L. tr L. Statc;C k� ZIP: el'70r10 Ejecior�r Phone: Akj_ Fax:6b� v .g E-mail: Ex ansion tan ixture/sewer cap _ Name(print): Floor drains/floor sinks/hub Mailingaddress: ,3V SW e '��c'Cl S/— Hose bye disposal .. Hose bier City: L.'U_ 7 -t.Lec' State:6'I''`.I ZIP. '703• Ice maker Phone- ax: E-mat:: Interceptor/grease 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 ns per ORS Chapter 447. Sin (s),hasin(s), ays(s) Owner's signature: _ Date: Sum Tubs/shower/shower pan Urinal Name _ _ Watcrcloset Address: ater heater _ Citi State; ZIP; Other: Phone: Fax: E-mail Totall Not dl iurisdiclons reepi credit cards,piece cell iuds&clon for more inrormition. Notice:This permit application Minimum fee................O Visa n MasterCard expires if a permit is not obtained plan review(at _ %) $ Credit card number. ___..._� within 180 mays after it has been State surcharge(8%)....$ "—fix tie, - -- p accepted as complete. TOTA[. .......................$ ficredit _ e of c rrhoider u shown on cre it ci~ _ S Ca ho r denature Amount 110J6i616AQRO�t) PLUMBING PERMIT FEES: PRICE TOTAL New t and 2-family dwellings,only. FIXTURES ridividuai QTY ea AMOUNT' (iricludes till plumbing fixtures in PRICE TOTAL 16.60 the dwelling aro the first100 ft. QTY (ea) AMOUNT Sink _ Lavato 16.60 for each utility connection) One�1 bath_ $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00 Shower Oniy 1660 -� Three 3 bath ,- $399.00 Water Closet 16.60 -- SUBTOTAL Urinal 16.60 8%STATE SURCHARGE. Dishwasher 16.60 J PLAN REVIEW 25%OF SUBTOTAL_ Garbage Disposal -�--- -- 16.60 - �- ____-._NOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink r - 16.60 16.60 PLEASE COMPLE7L: 3" 16.60 _ Water I leater :5--conversion r likekind 16.60 Quantity by Work Performed Gas piping requires a separate hanical Fixture Type: Nuw Moved Replaced Removedl t ermit_ _-_.-- _ _ Capped MFG Home New Water Service 46.40 Sir k MFG Home New San/Storm Sewer 46.40 - Lavato ----- Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains - 16.60 Shower Only-_ - Urinking Fountain 16.60 Water Closet _- Other Fixtures(3pocN16.60 Urinal y) Dishwasher _ - - Garbage D' _- - LaundryRoo., _ - - Washing Machine --- Floor Drain/Sink: 2" �- Sewer-1st 100' 55.00 3" Sewer-each additional 100' 46.40 i 4" Water Service-1st 100' - 55.00 Water Heater v_ Water Service-each additional 200' 46.40 Other Fixtures (Specify -- - -- _-- Storm 8 Rain Drain-1st 100' 55.00 _ Storm d Rain Urain-each additional 100' 46.10 _ - Commercial Back Flow Prevention Device 46.40 --- Residential Backflow Prevention Device' 27.55 V7-35 --- Catch Besin 16.60 -- Inspection of EExlsling Plumbing or Specially 72.50 Requested Inspectlons erthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 .- ------ -- --- QUANTITY TOTAL- - -- Isometric or riser diagram is required 11 / 0?7. 5S d?. . J - - Quantity Total Is >_9 - - 'SUBTOTAL S - --o%STATE SURCHARGE ° �D --- - ---- - - "PLAN REVIEW 25%OF SUBTOTAL Required only If rldtufe qty total Is>g TOTAL $39 �r �Minhnum permit fat Is$7 slate surcharge,except Residential Backflow Prevention Device,which Is$36.25, °/slate surcharge "All New Commercial Buildings require plana NMh Isometric or riser diagram and plan revlr.w i.ldsts\forms\plm-fees.doc 10/1C/00 t CITY OF TICARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECEIVED IMPORTANT PERMIT NOTICEMAY !�� 2001 CITY ELECTRIC + SUPPLY CO COMMUNITY DEVELOPMENT 8900 SW BURNHAM F-27 TIGARD, OR 97223 Electrical Signature Form Permit #: MST2001-00229 Date Issued: 4/26/01 Parcel: 2S103CB-11700 Sire Address: 13402 SW 122ND AVE Subdivision: QUAIL HOLLOW - EAST Block: Lot: 075 Jurisdiction: TIG Zoning: R-4.5 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 electrici^n is required. Please have the appropriate individual from your company sign below and return this —lectr!cal 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 OV\/NER: ELECTRICAL CONTRACTOR: DON MORISSETTE HOMES CITY ELECTRIC + SUPPLY CO 4230 GALEWOOD ST 8900 SW BURNHAM F-27 LLSgqTE 100 TIGARD, OR 97223 Pnone�SVy�WI-0897035 Phone #: 641-80'12 �� :�8 Req #: SUP 3592S LIC 42422 ELE 26-289C AN INK SIGNATURE IS REQUIRED ON MIS FORM x _ Sign , of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 �� MASTER PERMIT •__ PERMIT#: MST2001-00229 DEVELOPMENT SERVICES DATE ISSUED: 4/26/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13402 SW 122ND AVE PARCEL: 2S103CB-11700 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT:075 JURISDICTION: TIG REMARKS: S/i= Path 1 BUILDING REISSUE' STORIES: FLUOR AREAS REQUIRED SETBACKS _V RFOUIRL-'D CLASS OF WORK: NEW HEIGHT, %.1 FIRST: I.b%6 of BASEMENT: of LEFT: In SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD'. nu SECOND: 1 564 sf GARAGE: 470 of FRONT: '0 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: t FINBSMENT: of RIGHT. `s VALUE: $263,743.50 OCCUPANCY GRP: BDRM: 4 BATH. f TOTAL: 3,14000 of REAR: 1t PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1U0 BCKFLW PRFVHTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIUCMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>•100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INP btu FLOOR FURNANCES: VENTS. I WOODSTOVES: GAS OU1 LETS: 1 ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS_ MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: t 0 •200 amp: 0 200 amp: W/SVC OR FDR: 1 PUMPnRRIGATION: PER INSPECTION: EA ADD'L S005F: 6 201 400 amp, 201 •400 amp tat W/O SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 •600 amp: EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 601 1000 amp: 6014ampa•1000v: MINOR LABEL: 10004 amolvolt: PLAN REVIEW SECTION _ Reconnect only: .4 RES UNITS: SVCIrDR»226 A.: >600 V NOMINAL: CLS AREAISPC OCC: > ELECTRICAL-RESTRICTED ENERGY A SF RESIDENTIAL B.COMMERCIAL _ AUDIO It STEREO. _ VACUUM SYSTEM AUDIO a STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM OTH BOILER: HVAC: LANDSCAPE/IRRIG. PROT5CTIVE SIGNL: GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC' DATAITELE COMM: NURSE CALLS: TOTAL A SYSTEMS: TOTAL FEES: $ 4,991.55 Owner: Contractor: T his permit is subject to the regulations contained in the DON MORISSETTE HOMES DON MORISSETTE HOMES Tigard Municipal Code,Slate of OR. Specialty Codes and 4230 GALEWOOD ST 4230 GALEWOOD STREET all other applicable laws All work will be done in STE 100 SUITE 100 accordance with approved plans. This permit will expire N LAKE.OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 work Is riot 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 UN;ty Notification Center. Those rules are set Reg 0: LIC 35533 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 Erosion Control Insp 8& Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Post/Beam Mechanlca Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Footing Insp Underfloor Insulation Electrical Service Low Voltage Water Line Insp Building Final Foundatlon Insp Footing/Foundation Drl Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Wtr Proofing Bsm't Wa PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Issued By : _ Permittee Signature �. Call (50 ) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: S26/01 -00150 DATE ISSUED: 4!26/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S 103CB-11700 SITE ADDRESS; 13402 SW 122ND AVE SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 075 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: ' TYPE OF USE: C7 NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Se»er connection permit for new single family residence. Owner: — _ FEES DON MORISSETTE HOMES Type By Date Amount Receipt 4230 GALEWOOD ST -- —' STE 100 PRMT CTR 4/26/01 $2,300.00 27200100000 LAKE OSWEGO, OR 97035 INSP CTR 4/26/01 $35.00 27200100000 Phone: 503-387-7538 Tot„I $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 not so located, the installer shall purchase a"Tap and Side Sewer" Permit 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNG by calling (503) 246-1987. Issued by: _ -e c..._ Permittee Signattire: D C"v"o— Call (503) 9-4175 by 7:00 P.M. for an inspection needed the next business day 5 00 1-OOlZ 1 � Building Permit Application Date received: Peltttft 10ol-pam � City ui V ward Address: 13125 SW Hall BlvdPhone: (503) 639-417.t Blvd,Tigard,OR 972 y� p Project/appl.no.: Expire date: City of Tigard Date issued: B Receipt no.: � Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ lZ 1&2 family:Simple Complex: U 1 &2 family dwelling or accessory U Commercial/industrial U Multi family , New construction U Den+olition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm O Other: a Job address: 1 .. I Bldg.no.: Suite no.: Lot: ) Block: Subdivision: (t',, t Z :, J t Tan map/tax lot/account no.: — Project name: Description and location of work on premises/spe.cial conditions: Name: Y 'Y1Q� (111oodplain,scot IC crip�nclt%,so la r,etc.) Mailing address: �L' I &2 fancily dwelling,• ,/ City: Stater ZIP Valuationofwork....cr ...63 �y� ........ S Phonc: - - Fax: 7 mail: No.of bedrooms/baths................................. _ Owner's representative: Total number of floors................................. Phone: Fax: IF-mail: New dwelling area(sq.ft.) a l..Y. 711-7 APPLWANT Garage/carport area(sq.ft.)......................... Name: ( Covered porch area(sq.ft.) ......................... - Mailing addres , City: - - Deck area(sq.ft.) ........................................ _ State:! ZIP: Other structure ( .)......................... _ rucure areasq. ft .— Phone: I,x f: mail: — Commerciallindustrial/multi-family: AIN U Valuation of work.....................1.... $ Existing bldg. area(sq. ft.) .. ...... ............ _ _Business name: 1 lt,{> Address: C-4New bldg.area(sq. ft.) ...... ................. AddAdd _ -- : State: ZIP: Number of stories.............. CityPhone: Fax _ Email: Type of construction CCB no.: G Occupancy gmup(s): Existing: — ._ New: — City/metro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be Lcensed in the Address: L (L Y jurisdiction where work is being performed.If the applicant is Cit State: 7.I P: exempt from licensing,the following reason applies: Contact person: Plan no. - --�---- -- - Phone: Fax: I E-mail: — 111111ilfri fill 110 t Name: Contact pet son: Fees due upon al plication ........................... $_ Address: Date received: --- City: State: ZIP: Amount received ......................................... $ Phone: Fax: E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the No all iuridictioni eccern arAi cards,please call jurisdiction for mope lnformWon attached checklist. rovisions of I ws and o dinances governing this ❑v.s ❑MaaerCnid work will be comp) wt whether. cifi a or not. �'�+'evil^^"'�' -------- --- a--L ,rc-1- �_1r� P Authorized A natu _' or None of cudholder u flown on uedl�car -- S Print name: Cardholdersignature Amount Notice:This permit application expires if a permit is not obtained within i80 days after it has been accepted as complete. 44016+?(M)WOM) One-and Two-Family Dwelling Building Permit A►pplieation Checklist Reference no.: -- Associated permits: City of Tigard City of Tigard ❑Electrical U Plumbing O Mechanical Addioss. 13125 SW Nall Illvd.Tisp.ard,OR 97223 I]Other illwne: (503) 639-4171 — Fax: (503) 59ti-19��+I Ll 14WAAKII Kill 1 11 t 1 Land use actions completed.See jurisdiction criteria fur concurrent revirws. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for mmodel.Existing system capacity— 6 Strwerpermit. 7 Water district approval. — 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. --- 10 -L Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes.Lateral design.details rnd connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed if copyright violations exist. I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4-ft.elevation differential,plan must show contour lines at 241.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage area;percen!a eg of coverage;impervious area;existin stntctures on site;and surface drains e. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. -- 13 Floor plans.Show all dimensions,room identification,window site,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. fireplace construction, thermal insulation,etc. -- - 15 Elevation views.Provide elevations for new construction;minimum of two elevations fur 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. _ 15 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Floorlroof framing.Provide plans for alp floors/roof assemblies,indicating member sizing,spacing,and beating locations.Show attic ventilation. _ — 18 3nsement and retaining walls.Provide cross sections and details showing pla;emrmt of rebar.For engineered systems,see item 22,"En7ineer's calculations." _ 19 Beans calculations.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any hca—oist carrying a non-uniform load. _ 20 Manufactured floor/roof truss design details. _ 21 Energy Code complian ce. Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more applia,•ces. I -- 22 Engineer's calculatiorw.When 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. 23 Five(5)site plans are required for Item I I above. Site plans must be 8-1/2"x 11"or I I"x 17". 24 Two(2)sets each are re uired for Item., 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 comp)-.ted before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 410-4614(6MI OM) Mechanical Permit Application �Z, L Date received: 7== prolect/appl.nu.:City of Tigard eceipt no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 pate issue : City of Tigard -��---- Phone: (503) 639-4111 Casc file no.: Payment type: Fax: (503) 598-1960 Bidding permit no,: Land use approval: -- 1 i ommcrciaUindustrial ❑ vi,ilti4amily ❑Tenant improvement TLI1 2 family dwelling or accessory 13 Addi6ott/alteration/replacement ❑Other.constriction 1 1 11 1 1 Indicate equipment Qu ntities in boxes below. Indicate the dollar Job address: value of all mechanical materials,equipment,latwr,overhead, Suite no.: profit.Value S _ Bldg.no.: _ -- Tax map/tax lot/account no.: _—_— *See checklist for important application information and `- S Block: utxhvision: r L' Lot: >diction's fee schedule for residential perntit fee. project name: MOM x IL1 City/county: ZIP: t 1 Description and location of work on premises: ---- --- Fee(m) Total _ -- Description - (hv• Res.only Rrs.only Est.date of completion/inspection: AC. Air handling unit — CtTi Tenant improvement or change of use: Air con iuoning(site p an rcyuircd) Is existing space healed or conditioned?Cl Yr 0 NO A terauon o existing AC system — U existing space insulated?O Yes O No mice compressors State boiler permit no.: BTUM C ; HP Tons Business name: rdsmo cua�nper uctsmo a electors _ f Address: ea ZIP: t Pur p(siie Tan requtrr City: L1 State usta ITep ace urnace/bumer Phone: Fax: E-mail: Including d.ictwork/vent liner O Yes G N CCB no.: 4 nstall/replac re txatcheaters-suspen wall,or floor mounted City/metro lic. no.:N/A enttorapplianceotner an furnace - Name(please print): E 1 efiigeration: BTUM Absorption units Chillers - -- 111 Name: - G '--1A�LL-r_ — Com ressors`_________ �1<- r rrronmental exhaust and ventitatiotc Address' �Y VN,( V_ _ State: ZIP: Ap liancescnt City: ail: ere aust Phone Fax S. ype res. tchery azmat - hood fire suppression system — Exhau fan with single duct(bath fans) _ --- Name: Y 1 - Y- -- ha, fm a art om�ieann or—Ti 1/L ue, I,._ an tr ut on(up to out ens► Mailing address: • � )_ P g C"` -- _- - State ZIP Ty LPG NO Gil Fax E-mail: tie i in eac t a iuona over 4 out ens - Phone: 7" roeess p ping lschemauc rcyuire ) Number of outlets t er a app auce or equ pment: Name: ----- — Decorrtivefire lace Address: - nsert-ty `- City' _ ___estate; Zl�_�-- n stove/pe let stove Phone: Fax. F•mail: Utter: 5 Appllrant's slgnatu Date: pt er. Name(Print) j~ s --_ f Permit fee.....................$ all)un+dtcuau accepi credit cudc pleme olt junedkure mmau on ror mofaon Notice:This Permit application Minimum fee................s ------ Na - NVISA c MuterCard expires if a permit is not obtained Plan review(at —. %) S -----— Credit cud numAer _.v—------------""" '-FspVrer within 180 days after it has been State surcharge(8%) $ ----- r_ accepted as complete. TOTAL .......................S — None of cndholder u Mowa on credit card s 440-4617(yppiCOM) ��—Cardhd,kr tlpulurt ` f Amount Plumbing Permit Application M1�n Date received: Permit nJ'•'STa-aU Cit of Tigard Y g Sewer permit no.. Building permit no.: Address. 13125 SW Hall Blvd,Tigard,OR 97223 CI1,;"17i.Sard Phone: (503) 639-4171 Projecdappl no.: Expire date: Fax: (503)598-1960 Date issued: _ By: Receiptno.: Land use approval: _ Case file no.: Paymenttype: 1 PERMIT U 1 &2 family dwelling or accessory O Commercvd/indusuial 0 Multi-family El Tenant improvement ew construction U Addition/alteration/r.placement ❑ Food sei,'_e U 01lier: 1 1 1 . i gill, 1 Job address: �'�D ti �- ) f Description Qty. Fee(ea,) Total Bldg.no.: Suite no.: New I-and 2-family dwellings only: Tax map/tax lot/account no.: (includes 100 •forcachutilityconn«tion) Lot Lj Block: I Subdivision: SFR(2)bath _ _ - Project name: - t, SFR(3)bath City/county: Flip Each additional bath%kitchen Description and location of work on premises: Siteutfllties: Catch basin/area drain Est-date of completion/inspection: Drywells/leach line/trench drain V_ Footing drain(no.lin.ft.) Manufactured home utilities Business name C,_ L a Manholes _ Address: Rain drain connector City State ZIP: Sanitary sewer(no,lin. ft.) Storm sewer(no.lin.ft.) Phone: -�' Fax: mail: Water service(no.lin.ft.) CCB no.: '?L Plumb,bus. reg.no: City/metro lic. no.:N/A Absorption Fixture or Item: - Abso tion valve Contractor's representative signature ---.� Back(low pmventer Print name: I U Backwater valve Basins/lavatory _v Clothes washer — Dishwasher Address: VIf rin ang fountain(s) City: I State: ZtP Ejectors/sum Phone: Fax: E-mail: Ex ansirn tank _ iMure.sewer ca Name (print) Floor drains/floor sinks/hub Garbage disposal Mailing address: Hose bibb City State 7_IP: Ice maker _ Phone: - I Fax '7 7(GI E-mail: Interceptor/grease trap Owner InstaUatdon/residenda/maintenance only:The actual installation Primer(s) will be made by rr,e or the maintenance and repair made by my regular Root'drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s), lays(s) Owner's signature: Date: Sum 'rubs/shower/shower pan Urinal Name: Water closet Address; Water heater City: State: ZIP: __ Other. Phone: Fax: Eail -m : Total Na VI)uri� u dreuaacap credl cards,,plese ul1)urlWkuon formrxe infamuUm Novice:This permit application Minimum fee................S Cl Visa O MasterCard expires if a Plan review(al — %) $ p permit is not obtained Credir cord surcharge(8%) ....S d ur d number __..._EAf�._ within 180 days after it has been -- Name dralder u rlw�rn ai creJu crd— — accepted as complete. TOTAL .......................S _ Card _ f _ nwder 4� nA4W Ameuni 410-4616(MCUM) Electrical Permit Application rate received: NernJt�o� �-os t 0O 2 Z City Or A Tigard 1pr`ard P;o 1cct/a� I.o0_e P � Expire date: J Cityu177f, rj Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: g Phone: (503) 639-4171 Y Receipt no,: Fax: (503) 598-1960 Case file no.: Payment type: Land use aj)Ilrovai: 1 ■ 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U AddiIton/al teration/replace ment U Other: U Partial 1 Job address: C I Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: ` > Block: Subdivision: , t Prcject name: Description and location of work on premises: Estimated date of completion/inspection: - Job no: Fee Warr Business name: Cl TY FI FCTRIC ANO] 4LIPPl Y Description "may. (ea.) Total no.ins Ne"resi e Address 8900 SW BURNHAM ST F27 d"ellinraal single or multi-rawly per City: IGAR Slate: OR ZIP: 97223 Servicegunided:t. daatlailrnlPara�+e. Service included: Phone: 503-443-1092 1 Fax503-825-305 E-mail: 1000 sq.ft.or less ) CCB no.. 42422 Elec.bus.lie.no: 28-289C Each additional 500 sq.ft.or portion thereof -- Limited energy,residential City/met no. 1 02604 Limited energy,non-msidential - Each manufactured home or modular dwelling Sin tore of_ ismg ectrician(required) Date Service and/or feeder 2 Sup clrrt name(prutt) CHAR[ FS FRIESFN License no: 35 Services a-feeders-Installation, alteration or relocation: s 2L10empr a 1err ` Name(print): 201 amps to 400 amps 2 401 amps to 6W amps Mailing address: 2 X01 amps to 1000 amps 2 City: Slate: ZIP: Over 1000 amps or volts Phone: Fax: _ E-mail: Reconnectonl — I Ov,.),.. installation:The installation is being made on property I own Temporary services or feeder- whic, not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocat!on: ORS 447,455,479,670,701. 200 amps,)r less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 ams 2 Branch circutu-siew,alteration, Name: or exterssion per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2_ City: Stale: ZIP 8. Fee for branch circuits without purchase Phone: Fax: E-mail: of service or feeder fee,tint branch circuit: 1 Each additional branch circuit: - Me.(Service or feeder not Included): O Service over 225 amps-cl mmerciW ❑Health-care facility Each pump orirrigation circle 2 U Service over 320 amps-rating of 1&2 ❑Hazardous iocalron Each sign or outline lighting 2 familydwellings ❑Building over 10,000 square feet four or Signal circuits)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension" 2 ❑Building over three stories O Feeders,400 amps or more • _ ❑Occupant load over 99 persons 0 MstructuresDkscri tion ❑Egreas/Ilghungplan LJ Other.Manufactured structures or RV parte Des additional Inspection over the allowable In any of the)bore: -- Pertns coon I I I -T- 3ubm11_sets of plana with any of the shove. Investigation fee - The above are not applicable to temporary construction service. other - Not all junsdicham arepi credit cards.please call)unaracuorr for mere inron, ion Notice:This permit application Permit fee.....................$ ❑visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Cmdti card number _ within 180 days after it has been State surcharge.(8%)....$ - -- accepted as complete. TOTAL .......................$ - Name r u n on credit e - s _ CSW wider sl a Amount 440-1615(WO/COM) DON • MORISSETTE OBE : 2030 � K 0 m a a I K C A a P 0 a A T aD 6330 0ALaw00D 8T1 = 1T 9UITI L 0 0 LOT; 75 LA = e oewaaa, 0aaa01 07035 DATE: 3/27/01 (5 03) 367 - 7536 PAX (503) 367 -• 7615 PROPERTY: QUAIL—$)U if CITY: TIGARD ALB: f"L OPTION ? ELEVATION P139 PLAN X10.: 18A i HOLLOW PIE 8lciawa Ik .001 -- — ---- � '4(ndrain i -. -----•�- C4301 r j 2,°. 50 eq. ft. • ' 4 bdrm. a 3 bath I0' 04�0 eq. ft. FF . 303' a' \ �1 C-onuet• Z car ear. N Drlvewey / FF.E. 302' parol 3YC: 301 .n ! ozo l 9 3+M in LOT 0'15 5,430 sq. Ft. ion"17!20a1 19:40 15036302882 JARDINE PLUMBINra PAGE 01 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 MPORTANT PERMIT NOTICE JARDINE PLUMBING P O BOX 186 ESTACADA, OR 97023 Plumbing Signature Form p-ermjt.#:__MST2D01-00229 - Date Issued: 4126101 Parcel 2S103CF3-11700 Site Address: 13442 SW 122ND AVE Subdivision: QUAIL HOLLOW - EAST Block: Lot: 075 Jurisdiction: TIG Zoning: R-4.5 Remarks: S1F Path 1 `tour company has been indicated as the plumbing contractor t .r the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form Is received OWNER: PLUMBING CONTRACTOR: DON MORISSETTE HOMES JARDINE PLUMBING 4230 GALEWOOD ST P O BOX 186 STE 100 ESTACADA, OR 87023 LAKE OSWEGO OR 97035 Phone #. 503-381-7538 Phone #: 503-630-5436 Reg #: I IC 10874T PI_M 3-320PS AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signal of Authorized Plumber If yoj have any questions, please call (503163941?1, ext. # 310 CITY OF TIGARD BUILDI":G HYSPECTION DIVISION 24-Flour Inspection Line: 639-4175 Business Line: 639-4171 ( MST BUIP Date Requested--`7 '"' "7 %M PM �'—"'� BLD n LocatioZ <.�_ �Z Z —___.— �?i� ,_ Suite MEC Contact Person Ph Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall — — Footing ELR Foundation Access: _ Flg Drain FPS _ Crawl Drain Inspection Notes: SGN Slab Post u Beam _ — - -- SIT Ext Sheath/Shear Int Sheath/Shear _ Framing Insulation ----- - --- _ Drywall Nailing Firewall Fire Sprinkler Fire Alarm _ Susp'd Ceiling 00 —_—._ Misc: / t Final - --- PASS i •", f FAIL. ------ - PLUMBING - - Post& Beam - -- - - _ Under Slab Top Out - - - /,. Water Service,'�' —� Sanitary Sew / RanrDrains - inal S PART FAIL ANICAL -- Rough in - - - - Gas Line Smoke Dampers — Final PASS PART FAIL- ELECTRICAL -- Service ough In UG/Slab Low Voltage F ire Alarm I-inal - -- _ P:-aS PART FAIL SITE Backfill/Grading ---- -- _ Sanitary Sewer Storm Drain [ J Reinspection fee of; Catch Basin required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Fire Supply tine [ )Please call for reinspection RF: ADA — --- [ )Unable to Inspect-no access Approach/Sidewalk10t FinDate _ 1 Inspector--_- �,,,� Ext? I —_ _ PASS PART FAIL 00 NOT REMOVE thi!; inspection record from the job site. f OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 39-4175 Business Line: 6.. 4171 ^, d BUP _ Date Requested n AM PM BLD Location _L 2-, 6=,----,Suite MEC Contact Person -��'� --- Ph 2-L' �% �T'3 -7 PLM Contractor _ Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access' FPS Foundation �(.a ��r, I J1G;��,C� �4 ,r Ftg Drain f� Y SIGN Crawl Drain Inspection Notes: Slab _ __-- _ SIT Post& Bea,. -- Ext Sheath/Shear _ _ _— Int Sheath/Shear Framing _ ...- --- ---- ---- ---- Insulation Drywall Nailing -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc:__ ----------- ---- --- --- - -- - - --- Final PASS PART FAIL ------- - - -- - -- --._- ----- _-�__._— - ------ - -- PLUMBING Post& Beam __F_— __.____--------_-------- ----- — Under Slab lop Out - Water Service Sanitary Sewer Rain Drains a; SSS PART FAIL LAICAL Post& Beam ---- ---- - --- --- _ -----_- ---- ------ Rough In GasLine --- -- _.. ---- ----------..--- -- ------ Smoke Dampers Final ------ - _ -�_----- -- ___.—_- - —��_--._-- PASS PART FAIL ELECTRICAL !,')ervlre. Rough In UG/Slab Low Voltage Fire Alarm - Final PASSPART FAIL _ -___----- ----_.. —_ _._------_._--- _---�- SITE Backfill/Grading - - -� -- - — --- -_�-- ^- Sanitary Sewer Storm Drain I I Reinspection fee of$ _ _ —_required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin I )Please call for reinspection PE _ _-, ) )Unable to inspect- no access Fire Supply Line ADA r, Approach/Sidewalk Date Inspector 11 �� ` �Q��up Ext Other ----- - --- --- Final PASS PART FAIL.. DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BI IILDING INSPECTION DIVISION MST '10 24-Hour InspeL"on Line: 6. -4175 Business Line: 639. 71 y BLIP -Date Requested Z D AM_ PM _ _ BLD Location 3 U Z_ sW / Z Z"`c( �v� Suite MEC Contact Person —_ — _ — Ph - 3 7_ PLM �— Contractor Ph SWR BUILDING TNnant/Owner - ELC Retaining Wall ELR Footing Access: — Foundation FPS Ftg Drain - Crawl Drain Inspection Notes: SGN Slab Post& Beam --- -- __.� �------- SIT _ — Ext Sheath/Shear Int Sheath/Shear Framing --- --- ------ ----- Insulation - -� Drywall Nailing Firewall ---_--" ---- Fire Sprinkler Fire Alarm --� Susp'd Ceiling _ — Roof Final PASS PART FAIL PLUMBING Dost& Beam — Under Slab Top Out - - --- - - - --- -- -- Water Service Sanitary Sewer - Rain Drains F inal -- - -- PASS PART FAIL MECi:ANICAL _ Post& Beam - - --- - - - - - --------------------------------- Rough In Gas Line - - - ------ -- Smoke Dampers - Final - -- ------ _ PASS PART FAIL service RoughIn -_------- ---- -- -- -- --------------- LIG/Slab - Low Voltage - Fire Alarm S PART FAIL Backfill/Grading - -- --- ---------- - -- - Sanitary Sewer Storm Drain I ] Reinspection fee of$ _ �—required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line l Please call for reinspection RE: _ ^— ]Unable to inspect no access ADA Other Approach/Sidewalk Date(� cT _n p Other inspector—_-__*-r- Ext Final - '-- ----- PASS_ PART FAIL DO NOT REMOVE this inspection record from the job site. i CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-417F Business Line: 639-4171 -- BUP _Date Requested —AM PM BLD Location— /� 3 4Gi 2, ��1. c f –Suite MEC Contact Person Ph �� 2 " 4 L'_Z- PLM Contractor v_— Ph _ —_ SWR BUILDING — Tenant/Owner ELC Retaining Wal! ELR — Footing Access: Fuundation FPS --- Ftg Drain - - S GN Crawl Drain Inspection Notes: ---- Slab _ -- - —.----_— SIT Post&Beam Ext Sheath/Shear — — Int Sheath/Shear Framing ----- Insulation Drywall Nailing — ,— -- -- -- -- -- __ _---.----- —_ Firewall Fire Sprinkler — --_---- - -- ----- -------- ----- _ _. __ Fire Alarm Susp'd Ceiling _ -- ---- ----- -------- --- — --- - Roof Misc: --- - _____.—__ —------------------_____. __ _----___—_-- ASPART FAIL -----_._.______ �.---_----- ------------ -----_.____. GING - __ -- - - ---- -- —---- --------_ _ —_ _ Pot A Beam Un r Slab Top ut Wate Service Sanity Sewer Rai Dr4ins J!Fis ASS WART FAIL _--.....-- MECHANICAL. Post a Beam ---------------------- Rough In _._._..__-._... Gas Line - __.__ _---- ----- ----- ----- Smoke Dampers Final - - ---- - --------- ---- _._.—� -- -- --__--_ - ---------•-- PASS PART FAIL ELECTRICAL Service Rough In I - _- LIG/Slab — --- - -- -- -------- --a Low Volta(w Fire Alarm -- — - ----- ---- Final PASS PART FAIL -----SITE —- ----- -—- __ Backfill/Grading - Sanitary Sewer Storm Drain [ )Reinspection fee of$ required before next inspection. Pay at City Hall, 13128 SW Hall Blvd Catch Basin [ )Please call for reinspection RE: ( ]Unable to Inspect-no access Fire Supply Line -- ADA Apprusch/Sidewalk Date Inspector. -' —Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record frorn the job site. ►.AAAAA ►AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAiiF c s � • 414 44 r a Poo- CDrD 44 ► r ► r v ► V (YQ CD ► � o p ► i �- �, ► "144 ru M M O' ► i ; i ► ON.- 414 : �' M ► : ° ► i44 ; i , Poo. 414 : ► �I�TTTTTTTTTT'ITTTTTTTTT'►TTTTTTTTTTTTTTTTTTT'ITT\ s vi r9 � � n J ) 'O -f 0-.0, o D 0 7 � � � O � � V fr+ 1 ~' 7 a � �1 S 5 3 in