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13605 SW 122ND AVENUE 13605 SW 122"" Avenue CITY OF TIGARID 24-Hour BUILDING Inspection Line: (503)639-4175 3—pOc* () INSPECTION DIVISION Business Line- (503)639-41.71 �r'T BLIP Received _ .---.Date Requested S a —__ AM----____ PM _ BLIP r- Location _. a _SuiteMEG Contact Person ---_—._— Ph(--) PLM — - Contractor _._ —.-__-- Ph SWR BUIL DING Tenant/Owner - — — �___ _ ELC Footing — ELC _. Foundation Access: Fig Drain ELF! Crawl Drain -- Slab Inspection Nares: SIT __—_— Post&Beam I -- --- ----------- - ---- --- Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- - -- --- Insulation Drywall Nailing - --- - -- Firewall sire Sprinkler ___ - ---- --- -- Fire Alarm Suspd Ceiling - - - - - --- - - Roof Other: As PART FAIL IIN4 _ Post&Beam Under Slab Rough-In Water Service — — — - Sanitary Sewer Rain Drains — — - Catch Basin/Manhole Storm Drain — - Shower Pan PART_ FAIL — — --i--- -- - --- — ANICAL — - --- --- — — -- Pof i&Beam -- Rough-In -- -- — — - - Gas Line S e Dampers — -- -- -- — --- APRICAL PART FAIL — .. __...^ —___- ------_---- ---_-- Service --------- —_ —___.-- —_— - Rough-In - UG/Slab Low Voltage 'WFi Alarm nal! PART FAIL Reinspection fee of$-- required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. please call for reinspection RE:—.- — --_ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Data _ Inspoctor - _-- ut Other__ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL AAAAAAAAAAAAAAAAAAI AAAAAAAAAAAAAAAAA,AAAAAAiI►J� 4 ��` iii ' ► 4 (j �4� ► 4 ► ► Poo- 0. CD rD Poo. r`. ! z 7 ►—� ► T V) UQ ,—t ► ) C ► 44 Ul UQ A 'ti ► 7 � D 0 �� ► a ► i ��, f ► 44 44 4 ► � I ► i ► y � 10" o OR W cr .q � a n Q o � a 3 d a x CITY OF TIGARD 24.-Hour BUILDING Inspection Line: (503) 639-4175 MST -_- INSPECTION DIVISION Business Line: (503) 639-4171 BLIP _— -- --Received -. ----- Date Requested 3�a AM _PM BUP -- - Location .-__��_-�Z----- a` — �-Suite / MEC Contact Person __-_ 1 �_ Ph( ) 45 PLM 1-&0171 Contractor Ph( ) � - SWR _ BUILDING Tenant/Owner _ ELC tin - Foog ELC Foundation A('cess: Fig Drain ELR Crawl Drain — SIT Slab Inspection Notes: --- -- Post&Beam -- --- - __...------ Shear Anchors Ext Sheath/Shear --- -- Int Sheath/Shear _ — Framing Insulation Drywall Nailing - - -- --- - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Root Other: Final — P_ -PART- AIL LUMBI Post&Beam Under Slab — -------- Rough-In Water Service — ----- --- -- — _.—.� _ Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Ot --I - - PART_FAIL — MECHANICAL _. Post&Beam Rough-In -- Gas Linn Smoke Dampers — -.-- Final _PASS PART FAIL --�- ---- ---- _E_LECT_R_ICA_L __.__.-------__-_- Service Rough-In -- UG/Slab Low Voltage - Fire Alarm Final ] Reinspection lee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL SITE F] Please cel einspection RE: unable to Inspect-no access Fire Supply Line _ L7 �l y/e/ ADA Ext Approach/Sidewalk Dab - -- — Inspector --- Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL G,IT�f OF �'If�/�RD --- MASTER PERMIT PERMIT#: MST2003-00060 DEVELOPMENT SERVICES DATE ISSUED: 3/12/03 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13605 SW -i22ND AVE PARCEL: 2S103CC-10700 SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 054 JURISDICTION: TRY REMARKS: New SF detacheci, Pat's 1. BUILDING REISSUE: STORIES. FLOOR AREAS REQUIRED SETBACKS - REQUIRED CLASS OF WORK: NEW HEIGHT: :3 FIRST: 7AH4 sf BASEMENT: sf LEFT: S SMOKE DETECTORS: r' TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.410 sf GARAGE: dbr, s! FRONT: PARKING SPACES TYPE OF CONST: SN DWELLING UNITS: I THIM) sf VRIGHT: 1VALUE �,q(i 1: u OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3 b64 of - REAR: 2H PLUMBING _ SINKS: I WATER CLOSETS: 3 WASHING MACH: ' LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS. LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 Sr RAIN DRAINS: 1 CATCH BASINS TUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATER I INES: 100 BCKFI.W PREVNTR: 1 GREASE 1 RAPS OTHER FIXTURES MECHAVICAL _ FUEL TYPES FURN<100K. BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I _ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 on") 0 200 amp: WISVC UR FOR. PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 5003F: 7 201 400 amp: 201 - 400 amp: tat WIO SVC IF UR: SIGN/OUT LIN LT: PER HOUR: LIMITEU ENERGY: 401 600 amp: 401 600 wnp EAADDL OR CIR: SIGNALIPANEL: IN PLANT: MANU HWSVCIFDR: 601 1000 amp: 601+w1ps-1000v MINOR LABEL: 1000+amplvolt PLAN REVIEW SECTION Reconnect only: >,4 RES UNITS! SVCIFDR»225 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO R STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDBC LT: BURGLAR ALARM: OTH- BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATIUN: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,147.79 DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit subject tregulations contained In the Tigard Municicipal Code,,State of OR. Specialty Codes and 4230 GALEWOOD ST#100 4230 GALEWOOD ST,STE 100 all other applicable laws. All work will be done In LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 accordance with approved plans. This permit will expire If work Is not started within 180 days of Issuance,or If the work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Piro"•: 503.387.7538 Phone. Oregon Utility Notification Center. Those rules are set forth i.1 OAR 952-001-0010 through 952-001-0080. You Rao a �v :38737 ] may obtain copies of these rules or direct questions t0 OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection Foundation Insp Footing/Foundalion Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beam cturai PLM/Underfloor Framing Insp Gas Fireplace Electrical Final l \ , Issu4d BY f I _ Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day _ SEWER PERMIT CITY OF TIG,�R® DEVELOPMENT SERVICES PERMIT#: SWR2003-00054 DATE ISSUED: 3/12/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: :S 103CC-10700 31TE ADDRESS; 13605 SW 'I 22ND AVE SUBDIVISION: 1VIIISTI,I�,R'S WALK ZONING: R-4.5 BUCK: LOT: 054_ JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: l TPSWR IMPERV SURFACE: Remarks: Sewer connection fog new SF Owner: FEES DON MORISSL 1-TE HOMES Description Date Amount 4230 GALEWOOD ST #100 LAKE OSWEGO,OR 07035 1SWUSA]Swr Connect 3/12/03 $2,300.00 1 SWUSA]Swr Connect 3/12/03 $0.00 Phone: 503-387-7538 [SWINSP]Swr Inspect 3/12/03 $35.00 [SWINSP] Swr Inspect 3/12/03 $0.00 Contractor: Total $2,335.00 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 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 purctiase a"Tap and Side Sewer" Perm Issued by: ��;I'':; ft t_►�9`G'l _ Permittee Signature: �� I Call (503)639-4175 by 7:00 P.M. for an i,ispection needed the next business day ,. Build;If ig Permit Appikatian 24 City of Tigard\/� � I� dd''�� 'bt�ject/appl.no.: a date: Cavoffigard ► gard, 2 Address: 13125 sw 3 Phone: (503) 639-4171CC / Date issued: H Receipt no.: Fax: (503) 598-1960 F r B 0 7 2003Case Case fle no.: Payment type: � [_and use approval: ��11 Y OF (K3ARD /'' I&.!family:simple Complex: _ In W All ;-Jjd 2 family dwelling or accessary l]Commercial/industrial 0 Multi-family New construction ❑Demolition ition/alteration/replacement 0 Tenant improvement ❑Fire sprinkler/alarm ❑Other: dress: c' l' 3 �' Bidg. no.: Suite no.: Lot: c Block: Subdivision: ( Tax map/tax lot/account no' Project name: r _ Descnption and location of work on premises/special conditions: ' Onelliy'solar,etc.) Mailing address: 0; _ I &2 family dwelling: . '/ State( ZIP: ! Valuation of work........................................ S Q j24 City: ^hone: Fax:• .7 _mail: No.of bedrooms/baths................................. owner's representative: l j Total number of floors................. Phone: Fax: Email: New dwelling area(sq.ft.) .... SLIN Garage/carport area(sq.ft.).........I............... Name: Y ( Covered porch area(gq.ft.) ......................... Mailing address: C�,, Deck area(sq.ft.)........................................ City: State: Z!P: Other structure area(s ft.)......................... Phone: Fax: Email: CommerciailindustrlallmultI-family: Valuation of work........................................ $ _ Existing bldg.area(sy.ft.) ....... ............ Business name: 1i- 1 New bldg.area(sq. ft.) Address: _a�1.4'Y Z Q-L y7vvf, Number of stories City: State: LIF': Type of construction.... ............................ _ Phone: Fax: F-mail: OCCUn10," 'r I Exktints: INL��. City/metro lic.no.: — NoNee:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Hoard under Name: ��2�� Y y provisions of ORS 701 and may be required to be licensed in the Address: Gj�_�1i�Q �(� �_ jurisdiction where work is being performed.If the applicant is City: State: ZIP: ext mpt from licensing,the following reason applies: Contact person: Plan no.: _-- Phone: Fax: E-mail: ----- -R1 --- - _ Name: Contact person: Fees due upon application ........................... $ 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 _N(A at jurisdictions accept credit cards,please call jurisdiction for more inrotmancrt attached checklist. 61provisions of I ws and o dinances governing this U Visa ❑MasterCard work will be comp) wt ,whether. cified�ereifi r�eot. Credit rata number J - Authorized si atU+ Rime of cartlnrlder as shewti on credit card-- s- Print name: _. Z�,�Li"Y l f . _.-- _ Cardholder Bipature Amoum Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.611(WWOM) One-and Two-Family Dwelling Building Permit Application Checklist -Ra-- City ofTigard City of Tigard Associated permits: Address: 13125 SW Hall Blvd.•rigard,OR 97223 O Plectrical ❑Plumbing U Mechanical Phone: (503) 639-4171 o tither Fax: (501) 598-1960 MOM K I III 1 1 1 I Land use actions completed.See jurisdiction criteria for concun-ent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. — 4 Fire district _ approval required. -- 5Sept±c system permit or authorization for remodel.Existing system capacity— 6 Sewer permit. _ 7 WateE ct approval. — 8 SoilsMust cary original applicable stamp and signature on file or with application. 9 Erosirol ❑plan 0 permit required.Include drainage-way protection,silt fence design and location ofcatchotection,etc. 10 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 t/ if copyright violations exist. J` 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 4-11,elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including deck:;);location of wells/septic systems;utility locations;direction indicator.lot area;building coverage area; percentage of coverage;impervious arra;existinst structures on situ and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts•any hold-downs and reinforcing pads,connection details,vent sire:md_location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, — furnace,ventilation fans,plumbinE 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:.'tan one cross section :gay be requires 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. X 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actua:grade if the change in grade is greater than four foot at building envelope. Full-sine sheet addcndums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indican.details and locations;for -- non-prescriptive )ath analysis provide specifications and calculations to engineenn 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 wally. Provide cross sections and details showing placement of rebar.For engineered systems,see itern 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 Ion 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.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the project under review 23 Five(5)site plans are required for It.nn 1 I ='rove. Sits plans must be 8.1/2" x I I"or I I"x 17". 24 Two(2)sets each are reuimd for Items 16, 19,20&22 above. ?5 Building plans shall not contain red lines or tape-ons. 26 No rollui,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 department use only. 440-4614(60000cnM) Mechanical Permit Application " j rmit no /<AV. 5-&6' FcEivd.reeee City of Tigard Projectlappl.no.: Expire date: City ofrgard Address: 13125 SW Hall Blvd.Tigard,OR 97223 Dateisst:rd: BY ReceiPt to.: Phone: (503) 639-4171 Payment type: Fax: (503) 598-1960 Case file no.: _ Y YP Building permit no.: Land use approval: - 1 a' U I &2 family dwelling or accessory LI CommerciaUindustral O Multi-family U Tenant improvement �Iew construction O Addition/a:.;ration/replacement (i Other: - li 1 1 11111 f 41 1 Job address: )r� �' Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.. Suite no.: value of all mechanical materials,equipment,labor,overhead, profit.Value$ Tax map/tax lot/account no.: Lot: 1 Block: Subdivision: � (� P'-_� •Sec checklist for important application information and jurisdiction's fee schedule for residential permit fee. Project name: �' I r a CiCity/county: ZIP:/county: t t 1ta, t ► a M;ext Description and location of work on premises: Fee(m) Totai ' Description Qtv. Res.only Res.only Est.date of completion/inspection: AC: _ Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?U Yes U NoAir con iuoning(site plan requit ) _ Is existing space,insulated?U Yes U No A teration of existing VA system of edr-mpresst Ix State boiler perr it no.: Business name: ( lip Tons BTU/it Address: irdsmo a damper J uct smo a erectors _ State• ZIP: eat pump(site p an requir ) Y- City: L 11 - Install/replace rep ace fumac umer / Phone: Fax: Email: Including ductwork/vent liner U Yes U No CCB no.: _ nsta rep ace/re ocate heaters-suspendti City/metro tic. no.:N/A wall,or floor mounted _ ent or appliance o er th.n furnace Name(please print): - e erat on: Absorption units BTU/" Chillers _ NP Name: 1� � ��-� ' �--� - Com ressors ilP Address: ` r _ orunenta a tut an tent t on: City: State: ZIP: Appliance vent Ph-ne: Fax: E-mail erexhaust. res. tc a azmat hood fire su f ession system Name: ! ' Exhaust fan iih single duct(bath fans) -tom - aust s stem adistribution art tom eating or Mailing address: �) VL tie piping and t t tit oa(up to 4 nut gist City: L State ZIP _ Type: ___LPG -_ NO Oil Phone: 7- Fax: E-mail: tie piping each additional over outlets Igorocn+s p p ng(schematic require ) Number of outlets Name: t.er app ante or equ pment: Address y - _� Decorative fireplace nsert-type State: o stove/pe ctstove - Phune- — Fax -mail: 11 -U- 4ppllronf't slgnorur Date_. _ iter. Name 1 print I:- - —� permit fee..................... Not VI)unodicuow acep credit eardt,pkaoe toll iunkLciinn for mcwe infanuu^^1 Notice:This permit application Pe PP Minimum fee................S O Vii O MasterCard expires if a permit is not uutained plan review(at — `1b) $ _------ Cmdit cud numberExpife. within 1 g0 days after it has been State surcharge(8%) ....S --- aer ---- accepted as complete.ie of cudu h�lder thoWn an cmit cat TOTAL .••••••••••• ••••••••••s -------'—"— C►rdboldet upwture Amount ab rA11(frOtYf OM) Plumbing Permit _Application Datereceived: � ��''', Permit no.. City of Tigard — Address: 13125 SW Hall Blvd.Tigard,OR 97223 Sewer permitno.. Building pernritno.: City of Tigard Phone: (503) 639-4171 Proiect/appl.no.. Expire date:— Fax: (503)598-1960 Date issued: By: Receipt no.: Land use approval: _ Case�Ic no: Payment type: TYPE OF PERKff O 1 &2 family dwelling cc accessory U Commercial/i:idustria' U Multi-family U"tenant improvement New construction ❑Addition/altervion/itolacement U Food service U Othcr: INIMMIN1 ' 1 -A I1 I i i Job address: 1 c!,,,\,Aj lar r �11�. Description Q►v. F'ee(ea.) Total Bldg.no.: Swte no.: New I-and 2-family dwellings only: (includes 100111.for each utility con-ection) Tax map/tax lot account no.: __7S_ . (1)bath Lot IBlock: �utxiivision: f SFR(2)bath — — - Project name: SFR(3)bath City/county: ZIP: Each Td-ditional badv1dtchen Description and location of work on premises:_._ Site utWties: Catch basin/area drain _ E,t date of completionrnspection: �Footdjng ach line/trench drain in(no. lin,ft.) Manufactured home utilities _ Business name: Manholes Address: `` _ Rain drain connector City: State' ZIP: Sanitary sewer(no.lin.ft.) Phone: _,C Fax: _ E-mail: Storm sewer(no.lin.ft.) CCB no.: "?t_ Water service(no.lin.ft.) Plumb.bus. reg. no: - Flxture or item: City/metro lic. no.:NIA Absorption valve: Contractor's representative signature _ �_ _ Back flow preventer Print name �P _ _�(` U Backwater valve _ 3asinsilavatory Name:, Clothes washer Address: Dishwazher _ — Dnnkin fountain(s) Cir State: ZIP: Ejectors/sump Phone:u--- Fax: E-mail: Ex ansiontank Fixture/sewc-cap Floor drainsmoor sink.Aiub _ Name (print): -7 Garbage disposal Mailing address: , `� Hose blbb City: .(1 State ZIP: Ice maker Phone: - Fax: "7--)O E-mail: Interce tor'grease trap— Owner insrallation/residendal maintenance only: The actual installation Pnmetis) _ 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), asinis),Iays(s) Owner's si nature _ Date: Sump IIIIIIIIIIIIIIINI Tubs/shower/sh.-wer pan n n.l r Name _ Waterc!oset Address. _ Water heater __ t Cay: State _ ZIP: Other. Phone: -- Fax_ -�E-mail: - Total i Na dl lunwLcrioru amepr credit cvds.plwi call tun"cuon far more mtormauonNotice This permit applicotiun Minimum fee...... .........$ -O visa U MasterCard expires if a permit is not obtained plan review(at _ %) $ Credit cud number _. r�Lam_ within 180 days after it has been Sr'e surcharge(8%)....$ None o(cardholder v rharn on credit cud P accepted as complete, TOTAL. .......................S lCudhoider urnsiure 'Am nmi Electrical Permit Application Date received: Permit no.*rAr City of Tigard Pr:)ject/appl.no.: Expire date: (lrvo(7ilard Address: 13125 SW Hall Blvd,Tigard,OR 972'1.3 Date issued: By: Receipt no.: Phone: (503) 639-41-/l Pa merit t Case file no.: Y Yfx Fax: (503) 598-1960 Land use approval: _ — t 1 &2 family dwelling or accessory O Commercial/industrial U Multi-family 0 Tenant improvement New construction 0 Additiort/alteradon/repla,�:rnt"tit .a ;,Partial JOB SITE INFORNIATION Job address: Suite no.: Tax map/tax lot/account no.: 1.oc r Block: Subdivision: — Project name: Description and location of work on premises: Estirnated date of completion/inspection: 1 Fee M1tax Job no: Description Qty. (ea) Total no.lnsp Easiness ncme: New residential-arrgk or mild/-family per Address: dweWngunil.Includes attached garage. City: state: ZIP: Service included: - - 1000 sq.ti.or less 4 Phon t L 7j 1 Fax: E-mail: F,ach additional 500 a .It.or rdon thereof CCB no.: og Elec. bus. lic. no: Llrnitedenergy,residential _ 2 C: r� Limited energy,non-maidenual 2 G.� Each manufactured home or modular dwelling ryice and/or feeder — ature o su ervism eledrlefaA reaulred) Date r Se2 Servtcaorfeeders-Installation, Sup elect name(pnnn (� t - > Licrnseno alteration or relocation: 200 amps or less _ 2 201 amps to 400 amps 2 Neme (pflntl: ` � 401 amps to 6W amps 2 Mailing address: d 601 imps to 1000 amps 2 Clt s state ZIP: Over 1000 amps or volts 2 — 1 -� Owner's si natur, -mail: Rernnnrct only Phone: - Fax j Temporary services or feeders- owner installation: rhe installation is being made on property I own �nation,alteration,orrelocation: which is not interned for sale. lease.rent,or exchange according to ,(lo amps urless — 2 ORS 447,455,4" ' 70,701. 201 amps to 400 amps 2 Date: 401 to 600 ams 2 Branch circuits-new,alteration, or extension per passel: Name: A. I-ee for branch circuits with purcha a of 2 Address: service or feeder fee,each branch circuit —$_tate: ZIP: B. Fee for branch circuits without purchase 2 City: _ of service or feeder fee,first branch circuit: Phone: Fax E-mail- Mise. additional branch circuit:Mlsc.(Service or feeder not included): Each pump nr irrigation circle _ 2 ❑Service over 225 amps c:ommcrcdal ❑Health-care facility Each sign or outline ll htin 2 ❑Service over 320 amps-rating of 1&2 ❑Harardous location circuit(t)or a limited me panel family dwellings ❑Building over 10,000 square Sinal nY ,feet four or 1 2 ❑System over 600 vola nominal more residential units in one structure alteration,or extension• ❑Building over three stories ❑Feeders,400 amps or more •Desch tion — ❑occupant load over 99 persons ❑Manufactured structures or RV park Each additional:.tspeclion over the allowable in any of the above: t7 EgmssAighting plan ❑Other. -- Perinspeetion —r —^r--- Submit_sets of plans with any of the above. Investigation fee The above are not sppileabie:to temporary construction service. tither Permit fee.....................$ — Na all luriniicuons accept credit cards.please alt jurisdiction for more Infar"W" Notice:This permit application Plan review(at _ %) $ -- - ❑Visa ❑MasterCard expires if a permit is not obtained 1—,(_ within ISO days after it has been State surcharge(896) ....$ Crodlt card aumtrr _ $ T papirts accepted as complete. TOTAL ....................... tr•ne ofwratolder u sjowa on credo card s --- Cardholder dgnatute - !!44615(6AatCOM) Amount DON - 1� ORISSETTE 0BE : 2824 H0Y • s I N C 0 R r 0 2 A T 2 D LOT: 54 4 a 3 O O • L Z w n 0 D H T R 3 Z T LAX = 08 • E00. 0 a x a 0 N 87030 DATE: 01/28/2003 (803) 387 - 7838 FAX (603) 387 - 7816 PROPERT'x' lIHL4IZR'S—WALK CITY: TIG RD RECEIVED PLAN No w 239 OPTION 3 ELEVATION FF B 0 7 2003 CITY OFF TIGARD BUILDING DIVISION 2T-2, r----S 0 W Lu I® w1 St-.T L I I n I — 319 Lfl I ,r 3140 07 r �� 2 1.4• I (� FL 3 bath FFE. 3233' ». . . . 466 .q. rt. / a 2 car ger. _ FIFE. 323' I t� 32 ai! 319 I 0 29,.j, 20,-m' O ?' AGER MJBRUM �C ^ LOT COVERAGE I qc►mcv,— Z LOT AREA BUILDING AREA: 2,2LOT �4 9-L 5G �T 10034 PERCENTAGE. '28 CITY OF T I G A R D _ PLUMBING PERMIT PERMIT#: 5/2/03 3 00171 DEVELOPMENT SERVICES DATE ISSUED: 5/2/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103CC-10700 SITE ADDRESS: 13605 SW 122ND AVE ZONING: R-4.5 SUBDIVISION: WHISTLER'S WALK JURISDICTION: TIG _ BLOCK: - LOT: 054 __ -- ` 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 CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install irrigation backflow preventer. — _ _ FEES Description Owner: - — Bate Amount _ DON MORISSETTL HOMES1I1I I'1tlij I'rrnut l rc 5/2/03 $36.25 4230 GALEWOOD 5T #100 l AX I 8"" Marr fas 5/2/03 $2.90 LAKE OSWE60, OR 97035 -- Total $39.15 Phone : 503-387-7538 Contractor: ---- LANDSCAPE OREGON, INC 12200 SVV MYSLONY RD TUALATIN, OR 97062 REQUIRED INSPECTIONS RP/Backflow Preventer Phone : 503-692-5945 Final Inspection Reg #: I'll M 7804 This perrn t 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 clays ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of thEse rules or direct questions to OILING by calling (503) 246-6699. %�rcc LL Permittee Signature: )1 �(J� r Issued B Y• _-'`icer !{ d� Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Mad 01 03 12: 44p dan edmonds 503-692-01768 p. 2 FAM P u nbin _Permit Application. Rnccivcah/� n� JPlumbing . _- Date/B • -) U C�IJ Pcrmit No.l Planning Approval Sewer City of Tigard Datc/'1. permit Plan Review Gther 13125 SW Ifall Blvd. Gate/B . PcrmitNo.: 'Tigard,Oregon 97223 Post-Review Land Use Phone: 503-639-4171 Fax: 503-598-1960 Date/B : Case No.: Contact s.: See Page 2 for Internet: www.ci.tigard.or.us ContacMethod:_ Su lemental[nforn;atlon. 24-hour Inspection Request: 503-639-4175 - TYPE OF WORK _ FEL."SCHEDULE fors ectal information use checklist) pescriplion Qty. Fec(en.) Total ew construction O Demolition New t-&2-family dwellings _Addition/alteration replacement Other: includes loo ft.far each utility connection CATER- Ok'CONSTRUCTION SFR I bath !_ 249.20 I & 2-Family'dwellinb' commercial/Industrial SFR 2 bath 350.00 - cces Buuilding Multi-Family SFR 3i bath 45.00 Mastef Builder V❑ Other: _ Each additional bath/kitchen Fire s rinkler-s . ft.: Page 2 _ J06 St'I E INFORMATION and LOCA'f1UN Site Utilities _ Catch basinJurea drain 16.60 Job site address: . C. S Suite R: _ Bldg•/A�t# - n well/leach line/trench drain 16.60 Pro'cct Namc: `ljC I �1Ct� L Footin drain no.lincar ft. Pa c 2 _-- 110.00 M Cross street/Directions to job site: Manufactured home utilicics holes 16.60 I�I A'L� Mnn Kato drain connector 16.60 Sanitary sewer(no.lincar� Pa c 2 Storm sewer no. linear fl•) ha e 2 Lat# Pa e 2 Subdivision:(,V 1'1 S �� U�K Water service no.lincar ft. Tax ma /parcel : S 5 �' Fixture or Item - DESCRIPTION OF WORK _ Abso tion valve a e2 G1r.1 l3� Backflow preventer Pa e 2 5 Backwater valve 16.60 ' Clothes washer 16.60 Dishwuaher 16.60 Dr nkinst fcun_tu_i 16.60 PRr)PI.R'1'Y W ONER TENANT' E ectors/sum 16.60 16.60 - Ex ansion tank Nato F-r, n'��`Y1 SS -_ C - Fixture/sewer ca 16'60 Address. L0-� q_el �CCICC _. Floordrainifloorsink/hub 16.60 C' /State/'Lip:LC�IC ' Cs�ti U �-' Gurba a disposal 16.60 Phone: Fax: hose bib 16.60 - APPLICANT CONTACT PERSON Ice maker 16.60 Interec tor/ rcu4,trnn 16.60 Ke - Medical as-value: S Pn e 2 Address:/ � �= �� Primer 16.60 city/ tatc/zi �"ti 101 170 �-- Rourdrain commcrcini 16.60 Sink/basin/lavatory 16.60 ho Pne: �=.'S 4 FaX ��' Tub/shower/shower an 16.60 E-m ail: --- Urinal 16.60 CONTRACTOit Water closet 16.60 Business Name: GCS__"• Q1' '� I-- Water heater _ 16'6° Address: 1-;)200 4-fit-' . other. Cit /State/7.iCc A_ O� �G'G'�• other: p� Plutitl�in Pcrmlt Fees" Phone:kySubtotal 5 1 SS CCB Lic. #: Plumb. Lic.tt:� Minimum Permit Fee S72.5n s Authorized r Residential nnrkflow Minimum Fee$36.25 UlG^• r'zs Signature _- �C 1 1.I-' ate: Plan Review(25%of Permit Fee) S L+- � State 5urchargc Ali°io of Permit Fee S 9� /� _--• -- -- - - TU'1 Al•PERMIIT'FEE S _3�sl_�--- (Please print name) Nutice: This permit applieslion expires Ira prrntil Is oat obtained within Alier wi co_smlforipls341 n ll iiicw•reyulre 2 serist of plans with t+omrtrlc ur Ino days after.,has been accepted as complete. 'F'ee mcthodoloRv set by Tri•f ounly tiuliding Industry Service ttoarn c\DeLs\i'ennit Forms\PImPetmiIApp,doc 01103