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13515 SW 122ND AVENUE IF N rT 13515 SW 122 AVE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 539-4171 BLIP _ '4)Date Re / - Z / AM - PM---__ BLIP Received //V questr;d_—� // — � `�� Z Z t�� -[/ - Suite � — MEC Location _ `'� Contact Person - — _ �s� �D'�C Z c5�1' PL �.-- Ph( ) Contractor � —�� Ph( ) _ SWR-' -- BUILDINu T,jnant/Owner _ ELC -- Footing ELC -- - . Foundation Access: Ftg Drain ELFt __-_---- _- Crawl Drain - SIT Slab Inspection Notes: - Post& Beam - --- Shear Anchors Ext Sheath/Shear -- - - !nt Sheath/Shear Framing --- -- - - - nsulation Drywall Nailing Firewall Fire Sprinkler — -- - - Fire Alarm Susp'd Ceiling --- - -- -- - - - - - - Roof Other: Final _ PASS PAR4 PAIL _ - Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rein Drains - Catch Basin/Manhole Storm Drain Shower P Other: J�.�� AS PART FAIL _. MECHANICAL --------. -- - ---- - - --- Post& Beam Rough-In Gas I .ne Smt Ko Dampers ----- - Final PASS PART FAIL --- -- ----�� - ELECTRICAL Service — Rough-in UG/Slab Low Voltage --- - - - Fire Alarm Final PART rAll �] Reinspection fee o!$ required before next Inspection. Pay at City Hall, 13125 `.sd 1 Lill ran�l SITE _ [] Please call for reinspection RE:- - Unable to Inspect-no ecce=c, Fire Supply LineADA Approech/Sldewelk Date + ' Inspector Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART PAIL CITY 4F TIGARD 24-Hour BUILDING inspection Linc.: "'" 639-4175 MST INSPECTION DIVISION Business .i";?; �;3 t)639-4171 / SUP Received Date Requested —_! w� Z� kM__._____PM— __ BLIP Location �. �S 1.� -_!/(�f `E= Suite G� MEC _ Contact Person 644 _ _-- Ph(—) d ! ' ��7 PLM Contractor— _ Ph( _ ) SWR BUILDING Tenant/Owner _ _ E'LC Footing - -- ---------- Foundation EI_C -- -- . ---- _ Access: - Ftg Drain /J ELR Crawl Drain -- Slab Inspection Notes: SIT Post&Beam Shear Anchors - -- -- - - - -- Ext Shoath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _ - - ----- — ---- Firewall Fire Sprinkler ---- Fire Alarm Susp'r Ceiling - Root ---- -Other: - Final SS PART FA_;L - _-- PLUMBING Post& Beam Under Slab _ Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Mk•nhole St xm Drain - - - - Sh)wer Pan Other:_Final PA:S PART FAIL MECHANICAL Post& B.48m Rough-In — Gas Line Smoke Dampers --- --- — - Final PASS PART FAIL —- ---- ---- ELECTRICAL Service Rough-In UG/Slab Low Voltage %Fi mPART FAIL ❑ Reinspection fee of$_ required before next Inspectlon. Pay at City Hall, 13125 SW Hall Blvd. _ 1 Please call for reinspection RE:_- -_ Unable to inspect-no ac cess Fire Supply Line ADA , Approach/Sidewalk Data _ Inspector_.._ -' Other: _ _ _ Final DO NOT REMOVE this Inspection record from the jo site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST -J INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received ____— _.Date Regyesteedd 2� Z-="AM _—PM _. BUP _--- __--- Location ____ 35"i �" —Suite —_ MEC Contact Person - �— Ph( ) PLM _ Contractar -- - —_-- Ph(---) — SWR BUILUING Tenanl/Owner — ELC --—�— Footing ELC - -- -_ - Foundation Access: Ftg Drain Et R -- -- - Crawl Drain --� -------- Slab Inspection Notns: SIT Post&Beam -- Shear Anchors I - - -- -- -- Ext Sheath/Shear -- mt Sheath/Shear Framing - -- -- - - --- k-e Insulation -- V Drywall Nailing - —J-� -- - Firewall Fire Sprinkler _ Fire Alarm S)asp'd Ceiling Roof Other. - Fina! - PASS PART FAIL PLUMBING Post&[-learn Under Slab --- - - -- Rough-In Water Service - -- - Sanitary Sower Rain Drains --------_.---_ Catch Basin/Manhole Storm Drain - --- Shower Pan in S� PART FAIL — M NICAL. Post&Beam Rough-in - --- ----- Gas Line Smoke Dampers - Final PASS PART FAIL _ELECTRICAL _—_ _ Service Hough-In UG/Slab Low Voltage --.-------- Fire Alarm Final Reinspection fee of$-_ —required before next inspection. Pay at Cly Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ Please call for reinspection RE: — __ Unable to inspect-no access Fire S,--ply Line ADA Approach/Sidewalk Date - -� UInspector Ext _ Other Final DO NOT REMOVE this Inspection re:mid from the job site. PASS PART FAIL t ��,♦ee�..eeeeeseeeeeeeeaeeseeeeeseeeeee,eese.e.�,eeee� ► i r w a �. y G rp ..• � ► t cra' O ► ft rtR t44 M * n ► No. No. 4 t � ► t j z I♦♦♦♦♦v♦♦vvvvvvv♦♦vvvVVVVTTVVVVTTTVVVVVVTVVVI i 0. Q � a a r w ar O a. M .� CD rD n 1 l'V W Vi .- fp o O a tv O z Art a a � N J � a 00 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 - INSPECTION DIVISION Business Line: (5031639-4171 SUP -- Received Z Z l�.'.(a`1 bate Requested / ?--3 Location ,�,AM _PM — BUP -� ---� Z Suite MEC Contact Person _ Ph( ) �' � 7 PLM Contractor lat� �� Ph( ) SWR BUILDING Tenant/Owner ELC Footing EL.0 -- Foundation Access: ELR Ftg Drelrt Crawl DrainSI ---"- Slab Inspection Notes: -- Post&Beam - - --- Shear Anchors _ Ext Sheath/Shear Int Sheath/Shear Framing --- - ,_ - Insulation Drywall Nailing _ -- Firewall _ - Fire Sprinkler - - Fire Alarm - ------- ----- Susp'd Ceiling — RRobof�. A PART FAIL PLUMBING -- - Post&Beam _ Under Slab — Rough-In Water Service -- - - - Sanitary Sewer _ - Rain Drains ------ - —__ —- Catch Basin/Manhole Storm Drain -- - ^ Shower Pan Other: Final PASS PART FAIL MECHANICAL ---- - - - — - - Post&Beam Rough-In -- --------- ----Gas Line Line _--- Sm,¢k@ Dampers ----- PART FAIL --- ELEC_TR_ICAL -- --- 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 � Please call for reinspection RE: Unable to inspect-no access Fire Supply Line4� 1 AICA Date ? - 2 3_- - a --- Inspoetor_ -- —Ext---- Approach/Sidewalk Other: -- Final DO NOT REMOVE this inspection record ftom the Job site. PASS PART FAIL CITY OF TIGARD / PLUMBING PERMIT QEVELOFMENT SERVICES PERMIT#: PLM2003-00623 13125 SW Niall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/16/03 SITE ADDRESS: 13515 SW 122ND AVE PARCEL: 2S103CC-10400 SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 _—BLOCK: _ _LOT: 051 _ JURISDICTION: TIG 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: TUB/SHOWERS: SEWER LINE: ft WATER CI-OSETS: WATER LINE: fl DISHWASHERS: RAIN DRAIN: ft Remarks: Install irrigation backflow. Owner: _ FEES DON MORISSETTE HOMES Description Date Amount 4230 GALEWOOD ST I I'LUMB] Pertnit I.ec 12/16/03 $36.25 STE 100 ITAXI 8";,State 12/16/03 $2.90 LAKE OSWEGO, OR 97035 — Phone : '�IL1-"187-7518 Total $39.15 --- — Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : ,0, (02-5945 RP/Backflow Preventer T Reg #: I Ic L('[i: 7804 Final Inspection III 11 ALL. PIIASES- PLL 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 �`,'otification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100 'lou may obtain copies of these rules ur direct questions to OUNC by calling (503) 246-6699. Issued By: �t / / , t, Permittea Signature: } 1 Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit A» licai'o_n ' Rtxcived Plumbing-, � q'"' JED AatrJB Permit No City of Tigard R �IF•"+ Planning h t sewer -" Dnte1B Permit No.: - -- 13125 SW Hall Blvd. 91 Plan Review Other Tigard,Oregon 97223 (�E Date/R : Permit No.: Phone: 503-639-4171 Fax: 503'=59-1 i Post-Review [and Use Internet: r��www.ci.tigard.or.us ard.or.us �(o "GA Date/By: Case No.: 1V Contact "- ]Wia.: See Page 2 for 24-hour Inspection Request: Vib V NamoNethod: Snprlemental Informiq!u I TYPE OF WOItICREE'SCIIEDULE for et3a1 inform tion use checklist) constniction Ll Demolition Description IQty. Fec(ca.) I Total f Addition/alteration/r lacement Othcr: -New I.-Ar 2-family dwellings _CATEGORY OF CONSTRUCTION includes 100 R.for each uhli 'connection I &2-Family dwelling Commercial/Industrial SFR 1 bath 249.20 SFR 2 bath 350.00 _ Accessory Buildin inti-Famil SFR)bath 399.00 Master Builder Other: Each additional bathikitchen 45.00 JOB STPE INFORMATION and LOCATION '' Fire Tonkler-sq.ft.: Page 2 Job site address:139 i S Siris /4--kn +V 4:..j _ Site UtWtles Suite#: Bld ./Apt.#: Catch basin/area drain 16.60 V Project Name: )r i lei L�J4-Q./G 4AS/ - D elUlcach line/trench drain 16.60 Footing drain no.linear R. Pae 2 - Cross strcet/Directions to job site: Manufactured home utilities 110.00 VJ! Manholes 16.60 _ Rain drain connector 16.60 Sanitary sewer no.linear ft. Page 2 Storm sewer no.linear ft. Page 2 Subdivision:LO h tS19erS r Lot ^ Water service no.linear R Pa e 2 Tax ma arcel M to 5S K 5 DESCRIPTION OF WORK -_ Fixture or Itim - Absorption valve 16.60 GA.I'1d f�e- *ac cirio.c) G«.y LC e-) back now prevcnter P e2 Backwater valve 16.60 Clothes washer 16.60 -- '- - 1-shwasher 16.60 Drinkingfountain _ 16.60 ROPERTYOVYNlE;R �TENANTw Ejectors/sump _ 116.60 Name: DQ-n irYl i S + Y»�� _ __ Expansion tank _ 16.60 Address:4;z 34 S.LL U �L�UO dJ Fixture/sewer ca 16.60 City/State/Zi : 4"Ck e_ C'%&AJ-r_ Q 1[J3� - Floordrain/800r sink/hub 16.60 Gtsrbago orAh 16.60 Phone: Fax: Bose bib _ _ 16.60 PPLICANT CONTACT PX SQN Ice maker 16.60 Name: 6l l C,r SP0LrrVX0 Interco lore cm,,*� 16.60 Address:)��oo ►'r4sl�mu R0 Medical gas-value: $ Pae 2 /State/Zi :-rV'L a11( O !2 y7Q(p L Roof 16.60 Cit Roof drain (Commercial) 16.60 PhoneS3 te9aa.. -514_5Fax:%-i b9 a- 070 p Sink/basin/lavatory _ 16.60 _ E-mail: Tub/showerishower pan 16.60 _ CONTLtACTOR Urinal 16.60 Business ivarne: LAMSC' (�j/Y i 1 Water closet _ 16.60 Address 1231 to - Water 1-eater 16.60 � ��_)� Outer: _ t✓ity/StatC/Z ip:"•nk6L.�.D._' Nr,, I- -20(0'L' Other: _ Phone S3 &yU- SV Li FaxSD3 (p a _ rl% PlumbingPermitFeiss 55 CCB Lic. #: "78Uy Plumb. Lic.#: _ ___ ___subtotal s Authorized Minimum Permit Fee S?2.50 S Date..- /S Residential Backflow Minimum Fee$36.25 `3� Plan Review 2576 of Permit Fee S State Surcharge 8%of Permit Fee sr r (Please print name)T TOTAL PERMIT FEE S ,39• /5 Notice: This permit application expire..If a permit is not obtained within AU e _cw commercial bulldln`s require 2 ass of plain with Isometric or I80 days after H has been accepted ax romplete. Auer diagram for plan review. *Fee methodulagv set hr Tri-Comfy Building Industry Service Board. 1 d 89L0-Z69-E05 sput-)wpa uttp QtiE 1917 ED 91 oea ELECTRICAL PERMIT- CITY OF TIGAR® RESTRICTED ENERGY DI NELOPMENT SERVICES PERMIT#: ELR2003-00337 13125 SW Hall Blvd., Tivard, OR 97223 (50) 639-4171 DATEISSUED:CEL: 2S 03CC 10400 SITE ADDRESS: 13515 SW 122ND AVE ZONING: R-4.5 SUBDIVISION. WHISTLER'S WALK JURISDICTION: TIG BLOCK: LOT: 051 Project Description: All encompassing low voltage — _ — A.RESIDENTIAL B.COMMERCIAL - --� AUDIO & STEREO: X AUD'7 & STEREO: viNTERCOM & PAGING: AUBOILER: LANDSCAPE/IRRIGAT: BURGLAR& ALARM: X CLOCK: MEDICAL: GARAGE OPENER: X NURSE CALLS: H" kC: X DATA/TI=LE COMM: VACUUM SYSTEM: X FIRE ALARM: OUTDOOR i_ANQSC LITE: HVAC: PROTECTIVE SIGNAL: OTHER: ALL X INSTRUMENTATION: OTHER: —� OF SYSTEMS: Contractor: Owner: (_)UADRANT SYSTEMS DON MORISSETTE HOMES p( ROX 14833 -6230 GALEWOOD ST I'OI',TI AND, OR 97293 STE 100 LAXE OSWEGO, OR 97035 Phone: 503-387-7538 Phone: 503-387-7538 Reg #: SM4-555S211JLE LIC' )006 III 26-565C1.1� FEES Required Inspections _ Description Date Amount Low Voltage Inspection I.L.1,1tM-1'1 ELR Permit 10/30/03 $75.00 Elect'I Final I A X I R"-i,State 10/30/03 $6.00 I Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Munici, al Code, State of OR. Specialty Codes and all other applicable laves. All work will be done in accordance with appro :d plans. This per IONII Orelgon law re if work is not started within 180 days of issuance, or if work is suspended for more the . 180 day3. requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 Issued by _tet i <, . .Jc<- -L�'�— Permittee Signature �' )AJ -res- OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rout. OWNER'S SIGNATURE: DATE:_ CONTRA G'fOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N - DATE: LICENSE NO: _ __—_— Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 10/29/2003 15:20 5032362322 QUADRANT SYSTEMS PAGE 02 .lElectlrieal Permit _A HICatIOU Received 7-c--,, /O Y —,90 3 7 Dotc/Bt_-i .' '- e. Planning A vel City of Tigard DalelBy:13125 SW Hall Blvd. Pian Review Tigard,Oregon 97223 Datc/Id ` se Phone: 503-639-4171 FAX: 503.598-1960 Date/By:Mew Land o. Date/By: Case No.: �- internet: www.ci.tigard,orms Contact Juris.: Ser Page z for 24-hour Inspection Request: -563,67,9-4 i 75 Namc/Mcthod: supplemcntstl tnformntic,t +,Pihi',��',::�,�, a l�qa a�;'r� ;�T- .� ,�,' y �.M,+,t�r tt^'�"• % ' ' ''t� ,%�Pt .. VIE l�l��s@,tll�c�ll:t}i'. ppy .,..1 �5,..��;r. - Demolition Scrvice aver 225 arnm- LJ Hcalth-circ facility New construction commercial [�[larardnus location Additi� on/al_icrat n rcplaee',nent Other: ❑Service over 320 amps-rating of []Building over 10.000 square leer, upf,w i �y �j, '� 9�C;'';r'►;; 1&2 family dwellings four or morn residential units in �1 IiV �'� 3' tN ..• .., 1 8c 2-Family dwellin r� CommerciallIndustrial ❑System voce 600 volts nominal one Structure ❑Sul lding over these stories []Feeders,400 amps or neves Aecesso Buildin Multi-Farrifly Occupant load ovcT 99 persons ❑Manufactured sttuctutes or RV park Master Builder Other — 8 FgmcsitAlghtJng plan El other 11 `1 �t�r submit,vett of plans with any of the above. M'N The shave rare net a licahlr to ternporar construction service. Job site address: 1 3 'iB � 4 Suite#: Bld R,IA t.#: Number of Inspect ns Der it allowed Description Qty I Fee(fit.) To.d Pro CCt Name: 1 >, M-5t-S -U u►Y!lS _— New reridenllRI-single or multi-family per Cross street/Directions to,job site: dwelling unit.Includeq attached gar age. service Included; or4 145.15 4 Each additional 500 so,ft.or rtlon thereof 33.40 1 �inilill gngw,re3idential 173.00 21 Subdivision: --P.vs-!L.t4s WAl�IL Lot#' Si imited cncTJrY.ran residential 75,00 2 Each manufactured home or modular dwriling Tax ma / aICel M lJ"'i,J, " $ !1 ' ,x "Moo and/or Ibcder 90,Q0 2 i .•� ! Services or feedom-Installation, alteration or relocatlonr - 200 ams or leas _-- 9030 2 CILwti rL S{.tuc � f d=� _ 201 am to 400• --___-- 1 G,85 2 401 Af"21 to 600 Aylp3 0 am to 1000 am 140. - ! I over 1000 am or volts -- 4,6 2 Name: i�.r U,o-r� � Reconnect only .ss 2 Address: Temporary services or feeders-hrstnllstion, --{I ■Iteration,or relocation: Cit /Stat a/Zi : __ _ 200 amps or less 66.63 _ 1 201 am a 400 I,M 100 30 _ 2 i?110ne 7-01- - -�4ol to 600 ems 13 75-1 2 JWL.. irrsneh elrcuits-new,alteration,or Naini:: extension per panel: " '" A.Fee for branch circuit%with rumhase of Address: __ service or rWder Ne.each branch circuit 6.63 2 City/state/71P: _ B.Fee for branch circuits without purchase of�- service or feeder C�first branch circuit 4655 Phone, i Each additional n c ' 6. C, lttall: Mbc,( erviceatfeeder"atineluded); T ��gF• or Inn tion_circle _ 33.40 2 I rN 4„t �� rn •=-'�^"' o s at outline 11 htin 53.40 Job No: Signal aircutt(s)or o limited conrgy panel, Ih rstion,or exterston Business Name:�..�adMnf !14rG r1$ Description! Address: t1if I'I%fd3 _ Bseh additional Inspection ever the allowable to a q of the�■buva: Cit /Stale/Zi -A Qr�LR 1 eirn rhour min. I h Phone:'-3 say Fax: ,ZL %34P 7.311 investigation fee! 1 her CCB I.,ic. At: 1-0to � I.1C #: L• Supctvioing cicctrictA signature a requires:_ _ �'��t �'-�� Plantcvie�w(23y6 f Permit Ftic 9 Print Name- G'�. N trt.1� Lic. ( I State Surchar a 8%of Permit Foo $ TOTAL PERMIT FEF, $ Authorised "-� f Notice: This permit appllcatlon expires If a permit is rant rhtalned within Signature -1Lhh''C�}� � _. Ostia: �t Z Q'�O 180 days after It has hmn accepted as complete. 8 •Fcc method dully set by Tri-County Buildln.Induvtry Service Board. (Please p nt nam) i,%1)3ts\Pcrmu Pornu\BlcParmltApp doc 01103 10/31/2003 13:51 FAX 5035981900 CITY OF TIGARD Building Division Applicant Request to Cancel Permit City of t smurd - RECEIVED NOV 1 2 2003 TO: CITY OF TIGARD,BUILDING OFFICIAL fil 13125 SW Hall Blvd., Tigard,OR 97223 11 Phone: 503.639.4171 Fax: 503.598.140 FROM: Applicant Name: Q�A,a_clr—&A 4 ` Mailing Address: 1',o e',p-f 19 912, 1 City/State/Zip: -?3 ot 4-d O'k ci4*L q �W Phone No.: 5 v 3- -13`1- 5 5 5 Fax No.: K PLEASE CANCEL PERMIT APPLICATION AND REFUND PERMIT FEES, IF ANY, FOR THE FOLLOWING: Permit No.: E LLL 7,w 33�- Type of Permit: -C V C 16 i. Site Address: ► 3 S C- S—) i t �'' ►4 Subdivision: wQs4LM'z A Uc-. Lot No.: ca 5 EXPLANATION: Signature: �.�.b b"H �� Date: Print Name: L�>�,it & cam-- -� --_--- '-- Foil OFFICE VSE.ONLY Route to Admin.: Oate: 113v- Permit Canceled: Aate: Refund Processed: Date: r-7 0 i\Si jj ao:g`,Forms`3tegl:Ancr1Prm11%doc 04/03 M A ATER PERMIT CITYOF T I G A R D PERMIT#: MS12003-00416 DEVELOPMENT SERVICES DATE ISSUED: 9/17/03 13125 SW Hall Blvd.,Tigard, UR 972.23 (503) 639.4171 PARCEL: 25103CC-1 G400 SITE ADDRESS: 351" SW 122ND AVE ZOWNG: R-4.5 SUBDIVISION: WHISTLER'_ WALK LOT: tl5l JURISDICTION: TIG BLOCK: REMARKS: Construct new SF detached residence — - FLOOR AR AS-- SETBACKS RECUIRED REISSUE. STORIES: — HEIGHT: 74 FIRST: t an.+ sl BASEMENT. at LEFT: 5 SMOKE DETECTORS: Y CLASS OF WORK: NEW FLOOR LOAD: 40 SECOND: 1.397 at GARAGE: 457 at FRONT: JIB PARKING SPACES: TYPE OF USE: SF , HAND 0 RIGHT: , TYPE OF CONST: SN DWELLING UNITS: I VALUE: 280.788.90 OCCUPANCY GRP: RJ BDRM: a BATH: TOTAL. r„5 at REAR: 15 PLUMBING TRAPS. SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 LAVATORIES 4 LISHWASHERS: I FLOOR DRAINS. SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS. WATER LINES: 100 OCKFLW PREVNTR: GREASE TRAPS. TUBISHOWE9S. 4 GARBAGE DISP: I WATER HEATERS: OTHER FIXTURES: MECHANICAL _ FURN<1COK, Rpll ICMP<JHP: VENT FANS: 4 CLOTHES DRYER: I FUEL TYPES OTHER UNITS: I i'.AS FURN>-TOOK: ' UNIT HEATERS: HOODS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODS.OVES: GAS OUTLETS- 4 ELECTRICAL ADD'L INSPECTIONS RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS 1000 SF OR LESS I r 0 - ZOO amp 0 -200 amp: WISVC OR FOR. PUMPIIRRIGA11ON: PER INSPECTION. EA ADU'L 500SF 5 201 440 amp 201 400 amp: tat W10 SVCIFDR: SIGN/OUT LIN LT: PER HOOF LIMITED ENERGY 401 BOO amp: 401 - 600 amp: EAADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 801 1000 amp: 601rampa-1000V: MINOR LABEL. 1000+amolvolt: PLAN REVIEW SECTION Reconnect only: >800 V NOMINAL. CLS AREAISPC OCC: »4 RES UNITS SVCIFDR>*225 A.. ELECTRICAL•RESTRICTED ENERGY B.COMMERCIAL A.SF RESIDENTIAL AFIRE ALARM: INTERCOM PAGING OUTDOOR LNDSC LT AUDIO 6 STEREO: ACUUM SYSTEM: AUDIO 6 STEREO: BURGLAR ALARM. CTH: BOILER: HVAC: LANDSCAPEIIRRIO: PROTECTIVE SIGNL: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: GARAGE OPENER: DATAITELE COMM: NURSE CALLS: TO'.AL M SYSTEMS: HVAC: TOTAL FEES: $ 5,366.64 Owner: Contractor: This permit is subject to the regulations contained in the DON MORISSE17E HOMES DON MORISSETTE HOMES INC Tigard Municipal Code,State of OR Specialty Codes and 4230 GALCWOOD ST 4230 GALEWOOD ST,STE 100 all other applicable laws. All work will be done in STE 100 LAKE OSWEGO,OR 97035 accordance with approved plans. This permit will expire if LAKE OSWEGO,OR 97035 work is not started within 180 days of issuance,or If the work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: Oregon Utility Notification Center. Those rules are set phone: 503-387-7538 forth in OAR 952-001-0010 through 952-001-0080. You Roo N: 8737 3 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS _ Eroglon Control Insp 8, Post/Ream McLhanica Plumb Top Out Exterior Sheathing Insl Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Plumb Final Footing Insp Crawl Draln/Backwater Electrical Rough In Gas Line Ir.sp Water line Insp Foundatlon Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Well Insp Insulation Insp Appr/Sdwlk Insp / , 1' Permittee Signature - Call (503) 639-4175 by 7.00 p.m. for an inspection needed the next business day CITYOF TI CARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00316 13125 SW Hall blvd., Tigard, OR 97222 (503)639-4171 DATE ISSUED: 9/17/03 PARCEL: 2 S 103 C C-10400 SITE ADDRESS; 13515 SW 122ND AVE SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 051 JURISDICTION: 116 TENAN' NAME: !)SA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO, OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF dwelling. Owner: - _ FEES DON MORISSETTE HOMES Description Date Amount 4230 GALEWOOD ST — STE 100 1SWUSA]Swr Connect 9/17/03 $2,400.00 LAKE CSWEGO, OR 97035 ISWUSAJ Swr Connect 9!17103 $0.00 Phone: 503-3h7-7538 [SWINSP]Swr Ir-,nect 9/17/03 $35.00 [SWINSPJ Swr hv- ,;ct 9/17103 $0.00 Contra_tor: Total $2,435.00 Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will he forfeited if the permit expires. The Agency does riot guarantee the accuracy of the side sewer laterals. If the sewer is not Ionated at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm Issued by: ____ �.�� +G��-' _ Per ", a ' --- ►nittee Signature: Call (503) 539-4175 by 7:00 P.M. for an inspection needed the next business day (AAJ :ate.'.�j� a:"'�'�• �/ d��-t�� ,� Pennitno. l ' Datereceivefin '��I City of Tigard City njTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Pr°Ject/appl.no.: fxpiredate: Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type Land use approval: I&2 family:Simple C-mplex: 51 W U I &2 family dwelling or accessory I7 Com merci at/industrial U Multi-family &New construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alami U Odier: `. ' qk Job address: n .� _ 7b�, — 131dg. no.: _ Suite o.: Lut: r Block_ ]S-ubdivision: ,ti - r� C Ta_x map/tax lot/account no.: ,/0,/(Xj Project name: Description and location of work on premises/special conditions: —_ Name: Mailing address: + V Lv- 1 &2 family dwelling: City: , State:L I ZIP: Valuation of work...... ............I.................... Phone:. -� - Fax: -7 -mnlL• No.of bedroomv'naths................................ Owner's representative: II} art v IL Total number of floors......... ....................... - Phone: New dwelling Fax: G mail: at^a(sq. ft.� .......................... ' Garage/carport area(sri. ft.) ....................... 7 Name: Y 'Z 7Deck Covered porch arca(sq. ft.) ......................... Mailing address: C� �� Other structure arta(sed area(sq. ft.) ...................................... City: State: "LIP: ft.).........................Phone: f';,� 1 rtt;tilCommercial/industrial/multi-family: Im Valuation of work........................................ $ Business name: �v 1E Existing bldg.area(sq. ft.) .......................... �- - �" New bldg.area(s ft. Z, b q ) ................................ Address: - City: State: ZIP: Number of stories........................................ -- Phone: Fax: E-mail: --- Type of construction.................................... Occupancy group(s): Existing:no.: — �Noflce: New:City/metro lie no.: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Boanl under Y=14� Z� provisions of ORS 701 and may be required to be licensed in the jurisdiction where work is being performed. If the applicant is exempt from licensing,the following reason applies: City: Start:: ZIP: p g� g pp Contact person: Plan no.: - — Phone: - las E-mail - - — — - Name: Contact person: Fees due upon application ........................... S Address: -- - Date received: City: State: -LIP: Amount received ........................................ $ _ Phooe: Fax: _ E-mail: Please refer to fee schedule. 1 hereby certify 1 have read and examined this application and the Nor all jurisdictions accelrt credit cards,please call juriwhcoon for more infomuuion attached checklist. envisions of I ws and o�jdinances geverning this 0Visa ❑MasterCard work will be comp) ' wr whether. cified liereA t. �, Credit card number __ _—L-1. - _ �xpin•. Authorized si nafU , l-�t 1C. Name of cardholder u shown nn credit cad Print name: Cardhoder Bipature Amnunt Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete 440-4e11(6nx IA1 One-and Two-Family DwellingAt I _Building Permit Application Checl{liSt Referenceno.: City ojTigardC11ty of Tigard Associated permits: O Electrical ❑Plumbing ❑Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 9722.3 p Ether: Phone: (503) 639-4171 1 -- -- Fax: (503) 598-1960 I Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Float plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platllot. — 4 hire district _approval required. 5 Septic s- .em permit or authorization for remodel. Existing system capacity _ 6 Sewer permit. -- 7 Water district approval H Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control J plan U permit required. Include drainage-way protection,silt fence design and location of catch-hasin protection,etc. 10 3 Complete sets of legible plans. Must tk 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 t/ if copyright violations exist. I J` –if Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more Ulan a 44i.elevation differential,plan must show contour lines at 241.intervals);location of easements and driveway;footprint of strucnrre(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface dr�jnage. _ 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. _ 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,elumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as fluor 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. _ ml 5 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 plats.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 19 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered __X systems,see item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured 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 22 Engineer's calculations. Whe,h required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licrnsed to(hcgon and shall be shown to be applicable to the project under review. 23 Five(5)site plans are required for Item 1 I above. Site plans must be 8-1/2"x I I"or I I" x 17" 24 Two(2)sets each are required for Itcros 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. ~ 26 No rolled,reversed or mirrored building plaits will be accepted. 27 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 departmw use only. u44614(rxxvroM) I�lechamcal Permit Application Date received: Permit no.:A Vl9 ;&-73 City of Tigard Project/appl.no.: Ezpiredate: Cirynf'fignrd Address: 13125 SW liall Blvd, g76 �W.G — Phone: (503) 639-41?1 Date issued: — By: Receipt no.: Fix: (501) 5984960 AUU Case file no. _— Payment type: Land use approval: _ Building permit no.: U 1 &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family U•Fenant improvement �ew construction 0 Addidon/alterauor/replacenicnt 'J Ocher. _ li SITE INFORINIATION COMMERCIAL1SCRIOULE Job address: ' Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials,equipment, labor,overhead, Tax map/tax lot/account no.: profit. Value S Lot: 131ock: Subdivision: TIII I ) 'See checklist for important application information and m Project nae_ jurisdiction's fee schedule for residential permit fee. City/county: LIP: 1 1 Description and location of work on premises: _ 1 1 11130CIT4111 I= Fee(m) Total Estdate of completion/inspection: Description Qty. Res.only Res.only Tenant improvement or change of use: VAC: Is existing space heated or conditioned?0 Yes U No Air handling unit CFM l_� Air-conditioning(site plan required) IsIs existing space insulated?U Yes Q No A teratton o existing HVAC system --- Bo, ler/compressors Business name: r State boiler permit no.: y i ir4 NP Tons BTU/11 Address: iretsmoke—dampers/duct smoke detectors City: LOy I State: ZIP: licat pump(site plan required) -- Phone: _ Fax: E-mail: --stall/repiacc lure ice/btimer TU/F — e Including is ductwork/vent are h liner ❑Yes O No CCB no,: �-~ jnsnalVreplacdrelocateheatcrs-su,pended. City/metro lic. no.:N/A wall,or floor mounted _ Name(please print): - -� Vent for ap Nance other Kiran furnace Hefrigerat on: Ahsorption units BT U/14 Name: Chillers tip — Addrcss . Com ressors _ lip SCS Gl�� CL :nv ronmenta ex oat an ventilation: City State: LIP: Appliance veru _ _ Phone Fax: E-mail: Drmexhaust loons Type res. itchen/hazmat hood fire suppression system Name: Exhaust fan with single duct(bath fans) Mailing address: Echaust svuem apart from heatingor AC - tie piping an d tr ut on(up to 4 out ets I Oily: State 7..11 ) Type: LPG NG nil _ Phone: 7' Fat F-mail: velt ring each additions ovrr out ets — rocess piping(schematic required) _ Number of outlets Name: _. ---- - ------ ter app ante or equ pmeol: Address V—_ Decorative fireplace Cit" _ State ZIP: insert -type _ — _-�-�-- VTuodstovdpellet stove _ — Phone, - Fax: F-mail: — Anrfit_ant'i signnruDate Z ' _ ) Other. �T.— _ Name(print): r'I f_1�f - -_- — Pcrinit fee........ ...... .....S Nd all Junsdlcuotu scup credit canis,Aleve call Junulkudt fog rtwxe inrixhuuan Notice:This permu application Cl Vi . . so U MasterCard expires if a permit is not obtained Minimum fee.... .... ... ..S -� Credit card number within I RO days ager it has been Plan review(at %) S c State surcharge(8%) ....$ --— Name of c"older u shown on credio cud - accepted as complete. TOTAL .. ....................$ S Cardholder stptatum Amount 4444617(601Cf)M) Plumbing Permit.application \ --- Date received: Permit no.4y r` �� .004 City of Tigard Sewer pe�rttt no.: — Building�tTmit no.: UZ Phone: 05)39 Address: 13125 66.19-411 e SWHall nl' b r i1 b CiryojTigard (` - ` Prolec�appl.no.: Expire date: Fax: (503) 598-1960 n Date issued: � By: I Receipt no.: lU �) 70 3 rase file no. Payment type. Land use approval: MAI 1 ;Job 3 farruly dwelling or accessory U;4t9FLIPW"wd8sQI� p 11u1u family O Tenant improvement w const.ricuon ❑Addition/alterauon/replacement ❑Food service O Other.l inn use checklist) ' "1 Fee ea. Total dress: ) f New 1-and 1.-family dwellings only: Bldg. no.: Suite no.: (includes 100 ft.for each utility connection) Tax map,'iox lot/account no.: SFP (1)hath Lou Block: Subdivision: �� f t .. SFR(2)bath _ Project name_ 1,U1��T= SFR(3)bath City/county: ZIP: — Each addiuonal bathllutchen Description and location of work on premises: ___ Site utilities: Catch hasin/area drain Dr;wellsileach lineltrench drain _ Est.date of cempletion/inspecuon: Footing drain(no.lin. ft.) _ Nanufactut'ed home utilities Business name ;S.. l_�_r i�11 0- Manholes ___ Rain dein connector Address: State. ZIP. Sanitary sewer(no.lin. ft.) City Storm sewer(no.lin. ft.) Phone –�'t_ Fir: E-mail: Water service(no.lin. ft.) CCB no.: "Z ,-t Plumb.bus. reg. no: Fixture or item: — City/metro lic. no.: N A Absorudon valve -- Contractor's representative signature Back tlow oreventer Print name: Qc U Backwater valve Basins/lavator; Clothes washer — Name: VN-1 1� Dishwasher Address: IC –,Drinking founLain(s) Citv State: ZIP' E ectors/sum Phone Fax: E-mail: Expansion tank — -- Fixturelsewer cap Floor drains/floor sinks/hub Name (print): Garbage disposal -- Mailing address: AJ,7 Hose bibb _ — CinL State ZIP: Ice maker — Phone Fax- 7-'7k'f E-mail: Interceptor/grease trap— – Owner instaUation/residendal maintenance only: The actual installation Fin mertsi _will be made by me or the maintenance and repair made by my regular Ra)f drain(cummercial) employee on the properT I awn as per ORS Chapter 347. S!nk(si,basin(s), lays(s) _ — Owner's signature. Date: Sump Tubs/showerlshower van Unnal — Name Water closet Water heater Address: ---- Cit} — St;tte: Z1P: Uthcr _ — Phene. Fax: E-mail: iota -- _ Minimum fee........-...... S Na 1Vt iun"cuom rcept crrxbi-ard1 pieale aii iuri"cuon rnr mae mrorrnauon Notice:This permit application Plan review(at i S O visa O MaterC.vd expires if a permit is not obuined State surcharge (81c) - S --- C.edii cud number Expireswithin 180 dais ofter it has been accepted as complete. Narrre jf=dboider s,Noun ae cte+hr card s 110-1616 I IylX1t'O M 1 l'arutradu a lrore Amouni Electrical Permit Application -----'— l — Date receival: City Of 'rigard R E C T I q/ E D Projeclizppi.no.: Expire date: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Ry: Receipt no.: City of Tigard --- — Phone: (503) 639-4171 AUb U b 2003 Case(ileno.: Payment type: Fax: (503) 598-1960 Land use approval: rlry nl=Tl!_Aor� - ❑ I &2 family dwelling or accessory Ll CommerciaUindustrial U Multi-family Q Tenon[improvement New consttUction U Addition/altembonheplacement Cl Other: CI Partial 1 sim,INFORMATION !ob address: �� e �% l" Bldg.no.: Suiten .: Tax map/tax lodaccount no.: Lot: G- Block: Subdivision: -- Project name. (Description and location of work on premises: Estimated date of completionlinspecuon: t Fee Max Job n0: Z40 -- Description 4?tY• (ea.) Total no.Insn Edd ss name: =�-1 �_ 7�' Nenrwrkntial•sinpJeormuttl-family 4� s: - � �� ) 'i �" dnellingunit.includesattachedgarage. �„�A7 L►P Serviceifr.orle v - 4 t Cts State: _ 410t)U xy ft.or less�2-�, Fax: Email:J ' Each additional SWsy (t or Portion thueof0.� Elec. bus. Iic. n0: Linutedenergy,residential _ 2 �- Limited energy,nonresidential 2 C Each manufactured come at modular dw-lling 2 - Date Service and/or feeder _ aru►t ojsuptnrsrnq tledricfon Ire ufreJ) - - Services or feeders-installation, I icrnse no Sup elect nameiprinu 1 �'-/T ■Itenlionorrelocation: 200 amps or less 2 201 amps to 400 amps 2 EPhone:�� (print): �-� c 40I amPs a)600 amps _ 2 ng address: 2 �0 601 amps to 1000 amps — 2 z Stalc ZIP: over i000ampsorvoltsmail: Reconnectonl= __- Fax: ) - Temporary services or feeder. Owner installation: The installation is being made on property I own i,�,llalion.alteration,orrelocation: k%hich is not intended for sale, lease,rent,or exchange according to lot)amps or less 2 2 ORS 447,455.479,670,701. 201 amps In 400 amps Ow'ner's signature: Oate: 401 to”)amps _ ' Branch circuits-new,alteration, or extension pet panel: Name: __—___ A. Fee for branch circuits with purchase of 2 Address: service or feeder fee.each branch circuit _—.— Stair.: ZIP: B. Fee for branch circuits without purchase 2 City: of service or feeder fee,fist branch circuit: _ Phone: Fax: E-mail: Fachaddrtionalbranchcircuit: -- Use.(Service or feeder not Included): 2 Each pump or imgauon circle_ _ _ _— O Service over 225 amps-commercial O Health care facility Each sign or outline lighting 2 •Service over 320 amps-rating of 1&2 Cl Hazardous location circuit(s)omnergypaea, finulydwellings U Building over lo,000 square feet four or Signal r a liitede 2 O System over600 volts nominal more residential units in one structure alteration,or extension* O Building over three stories O Feeders,400 amps or MOM •Desch tion _--_ U occupant load over 99 persons O Manufactured strictures or RV pati' Fach addition•rl inspection overthe alhwable in any of the above: O EgresslllghtingPlan U Other — ---- Pennspecuon Submit__sets or plans with any of the above. Inve:ugation fee "t abuse are not applicable to temporary construction service. Other _ -- - Permit fee.....................S _ - Not all jurisdictions accept credit cards,please call rwt.dicnoo for more rnforrnaurntNolir:e:This permit application Plan review(at __ %) S — U Visa U MuterCard expires if a permit is not obtained '' '' I within 180 days after it has been State surcharge (Ryfo) ....$ Credit card number --FApires ' accepted as complete. TOTAL .......................s None or c4rdhoider as shown on credit c s 410-4615(tS(xYCOM) Cardholder signature _AmountA 08113!2003 11:58 503-387-7617 VENTURE PAGE 04 OBE : 2821 DONMORISSETTE� o0P02 AT2 T IAT: 51 aomse 7/22/03 aa9a aALawo0v I• T •e �•o sj a •°s� a i' s i YR (s o os)i s r i i i a PROPERTY: WHISTLER'S-WALK CITY- TIGARD SCALE: 1 "=20' PLAN No.: 193 OPTION 2 ELEVATION RECEIVED AUG 15 700", 313' 8. GIT r OF I I(JAHI PUILDING �NIfi�IUN IL rt. W ! , 4 bdrm. q M. 3 beth : ..,.. - �D r4tio I -ldl4j( (y 1 � , w ; u N cAr ger. - a •< 314' r- .n 313 1 j.,4 , .^ 00 — LEGEND TRFeS RED M01"LP_' LOT GONERAO-zE LOT AREA f4lea 562. KT. 15uILDING AREA. 7,711 50 FT LOT 51 , PE�CENtAGE ��?n 6;'19 eq. ft I CITY OF TIGARD-SITE LAN MEVIEW BUILDING PERMIT NO.: ' PLANNIN6 DIVISION' rove Q C) Not Approved Required Set f cks: � App Side: �-.— Street Side Krs+r: Front. ��}— Garage. roved N�>> A p Visual Clearance: 13 Approved��"tett Q P Maximum Building Heol. . vr, N� CWS Service Provider t.,e�ter Required' Q �,• T 10 R iv t ENGINEERINGil) AMMENT: NAed Actual Slope:,% Q Approved [3utpprov ro%cd r] Approved Q Not Apl Site Plan: Date: H : Nuns: i a t