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13680 SW 122 AVENUE
CITY OF TIGARD 24-hour
BUILDING !nspection Line: (503) 539-4175 3 `iF6 r Zj
INSPECTION DIVISION Business Line: (503)539-4171 BLIP
BUP _—_-- —
Received fL/I q Date Requested (G�l AM _ Pti1 __ BLIP
Location —_� 1114-1) Suite MEC
��—
Contact Person � � Ph(—) � > 7 PLM
Contractor-- V�� Ph(, ) SWR ____-
BUILDING Tenant/Owner — ELC
Footing ELC
Foundation Access:
g Drain ELR --------_-----_—_—
Crawl Drain -
Siab Inspection Notes: SIT - -- --
Post R Beam ___ -- --- —
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - - --- — - — - -- ---
Insulation
Drywall Nailing — - -- - - - - - - --- -
Firewall
Fire Sprinkler - - -- - -
Fire '+larm
Susp'd Ceiling -- - -- --
Roof
Other: - - -- - - -
Final — —
- ---PASS PART FAIL -- -- _- -
PLUMBING
Post S Beam
Undor S+ab --
Rough-In
Water Service - - -
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain _--
Shower Pan
FI
_ PART FAIL
MECHANICAL
Post& Bea n' --
Rough-In -- _- ------
Gas
--- --- ---- —— —
Gas Line
smoke Dampers
Final
PASS PART FAIL — -- ----�- - _T
EC ICAL
vi
R In _-----___
U ab
Lo oltage _
F rm
F al [�PART FAIL Reinspection fee of$_—_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
3
TE _ [� Please call for reinape tion RE-_ - -_- _ __ _ _— Unable to inspect-no access
Fire Supply Line /V
/
ADA ',/ /y
Approach/Sidewaik Date. I - Inspector _ -_...___ --__. _ Ext -- -
Other:
Final — DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)53y-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171 —
BUP
Received --_- __ Bate Requested 2 Z AM__-- -- PM -__ -_ BUP
Location 6., t~6 1_2,2- A-&--eSuite MEC
Contact Person . �- - ---- Ph ( - ) - -� - ?P3Z_ PLM _---------
Contractor._^ -- - ---_ _ Ph (------) -- --- ---- -- - SWR - ---- --
BUILDING _ Tenant/Owner -_ -_ ELC
Footing
Foundation ----- -----� ELC --- --- - —_
Access:
Ftg Drain ELR
Crawl Drain -
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors ---- --- _---
Ext Sheenh/Shear
Int,Sheath/Shear
Framing - -
Insulation
Drywall Nailing - -
Firewall
Fire Sprinkler -- -
Fire Alarm
Susp'd Coiling -
Roof
�ha
S_ PART FAIL
MBING _
Post&Beam
Under Slab - --
Rough-in,
Watar Service --- - -- ----
Sanitary Sewer
Rain Drains -- -- -- -- - ---
Catch Basin/Manhole
Storm Drain —- — — —
Showor Pan
Other: ---
Final -
PASS PART FAIL `--- --- -_----- ---
MECHANICAL
Pogt&Beam — --._.---- -- -
Rough-In
Gas Line
S e Dampers --- -- - -- -- - -- ----
/ PAS PART FAIL — ---- -- -- - --- --
ICAL
Service - - - ----
Rough-In -_ - -- - - ---- - --
UG/Slab
Low Voltage
Fire Alarm -- ----
Final Reinspection fee of$- - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RF Unable to inspect-no access
Fire Supply Line
ADA -�
Approach/Sidewalk Date--/ Inspector _--_ - Ext
Other:
Final - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MT) % _ C�rJ �Id_ /
INSPECTION DIVISION Business Line! (503) 639-4171
BLIP
Received __Date Requested �_.1 % LI --- AM PM BUP
Location '/ /,-1-� Suite - MEC --
L - PLM
Contact Person -__ Ph( ) --
Contractor � _ — Ph( ) - SWR
-
BUILDING Tenant/Owner - _ ELC _.
Footing ELC -_�n,,�_
Foundation Access: ELR �Gn3 �_
Ftg Drain
Crawl Drain ----
Slab Inspection Notes: SIT
Post&beam
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall _
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof
Other - - -- - - -- -
Final _
PASS PART FAIL
PLUMBING
Post& Beam -
Under Slab -
Rough-In
Water Service - --�
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain --- - - --
Shower Pan
Other: --- - - - -- ----
Final
PASS PART _ FAIL
------
Post&Beam
Rough-In
Gas Line
Smoke Dampers - ----- - - ------ -- - - --
Final
PASS PARTFAIL
LE -
IEC RA1CAl__ ------------- -- -- ---- --- - ---
Servioe
Rough-In -
UG/Slab
Low Voltage
Fire Alarm
PART FAIL
C_I Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
817E - Please call for reinspection RE: Unable to Inspect -no access
Fire Supply Line
ADA II, ' Iniapoctor
,'---
Approach/Sidewalk Dats Rxt
Other:
Final DO NOT REMOVE this Inspection record from the Jab site,
PASS PART FAIL
�i
CITYOF TIGARD PLUMBING PERMIT y
DEVELOPMENT SERVICES PERMIT#: PLM2003-00619
r
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/12/03
PARCEL: 2S103CC-09200
SITE ADDRESS: 13630 SW 122ND AVE
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 039 -----------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:
_ FIXTURED 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: tt
Remarks: Install irrigation backflow preventer.
_FEES _
Owner: Description Date Amount
DON MORISSETTE HOMES (PLUMB) Permit ler 12/12/03 $36.25
4230 GALEWOOD ST [TAX] 8%State 12/12/03 $2.90
STE100
LAKE OSWEGO, OR 97035 Y Total $39.15
Phone : 503-387-7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone : 503-692-5945 Final Inspection
Reg #: LIC LCB: 7804
I'I.M ALL PHASES- PLi.
This permit is issued subject to the regulations contained in the Tig ird Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordanoe with approved plans
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952--0001-0010 through OAR 952-0001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699.
Issued By 1 /t 1��� d/_ C�f-C� r� Permittee Signature:�T) aA""�fG e z-, .z
��
Call (503) 539-4173 by 7:00 P.M. for an inspection needed the next business day
vee: dan edmonds
Plumbing Permit A. lic.atior>! OFFICE
��` _ Received y� Plumbing
Date/l3 .1 �� 6 Pemiii No. Z100& -00 1
4"
t1 ii t. .. Planning A �wal S�-vvtr
City of Ti-ard ihtdRY: Pctmit No.:
13125 SW Hall BI.-L Plan Kcview othet
Tigard,Oregon 97223 i)at_ly:.-_-- Permit No.:
Phone: 503-639-4171 Fax. 503-598.1960 Par-nevi-w land use
[httcJfl : Gvc No..
Intenret: www.ci.tigard.or.us Contact Juris.: See Page 2 for
24-hour I:ispection Request: 503-639-4175 NarnrJMethod: Supplemental information.
TYPE OF WORK FEE*SCHEDULE(for special lnformntioa itse checklist)
New construction Dcrnolition Description Qty. I Fen(os.) Total
Addition/altetation/replacement Other: New 1-&�fatnily.dwellings
(includes too ft.for eaihutitt eonnsetioa
CATEGORY OF CONSTRUCTION
1 &2-Farnll dwelling CommerciaUlndustrial SFR 1 bath 249.20
Y SFR 2 bath 350.00
Accesso Building Multi-Family SFR(3)bath 399.0
Master Builder Other. Each additional bath/kitchen 45.00
JOB SITE INFORMATION and LOCATION Firzninkler-A.FU I Pa e 2
Job site address: /3 U, ', S U-; /1.xAdC A' site UtiU►.;es
Suite#: T Bldg./ L#: Catch bmin/area drain 16.60
Project Name:LA-41,s t�i,ri�i�'L/Lk (t T 3`j FOGting drain no.linear R. _ Pae 2
Cross street/Directions to job site- Manufactured home utilities 110.00
Manholes 16.60 -�
L L: Rain drain cnnncctor�J` 16.60
Sanitary sewer(no.linear ft.) Pale 2
Subdivision: ,(.4e r'G Lot#: 31 Sionn sewer no.linear 0. Pa e 2
Tax map/parcel #: ,�S water service no.linear R _ Page 2
`' Mature or Item
DESCRIPTION OF WORK Absorption valve _ 16.60 _
Ba.:ktlow-preventcr Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
ROPitRTY OWNER TENANT Drinking
16.60
Name: p(ty� M C1Y($S.Q - Nom[S Ex ansion tank 16.60
Address:4,k 30 S-W 0 C(> Fixture.'sewcr cap 16.60
Cl /State/Zip: 44PY.4 04 Q 7U3S' Floor drain/tloorsink/hub 16.60 _
Garbage disposal 16.60
Phone: Fax: Hose bib _ 16.60
PPLICANT CONTACT PERSON Ice maker 16.60
Name: El l t.�'1 .,p0-rrnQ Interco tod ew,!trap 16.60
Address:/J�G CLO m�slmn j 2 Medical gas-value: S Pae 2
Cil /State,/Zip:Tl.t ala--h1A D IC ti-70(o 3-• RoofPrimd 16.60
--�---- Roof drain(oornmereit><f 16.60
PhoneSoB tz%- -S94S�Fax:a�3 (09�- o�lo Il Sink/basin/lavaio - 16.60
E-mail: Tub0hower/shower pan16.60
CONTRACTOR Urinal 16.60 -
Business Natne: [„p.-MSCI',gyp O►Yq Water closet 16.60
(a:�{�tJ Ur Water heater 16.60
Address:
, y Other:
_Ci 1State17-ip:TLvz Q at_ 1-Xt-.- 7U� Other.
PhoneS7t3 W - "4 S Fax9)3 - 1)7J0 k Plumbing Permit Yetis" .2"7,S5
Subtotal S _
CCH Lic. #: -78V14 Plumb. L1C.#: Minimum Permit Fee f72.50 S
Authorized Residential Backliew Minimum Fee$36.25 3(a `S
Signatur��1_ l!/t.�±LL Dete: 1? /1 L?3 plan Review 25yG of Permit Fee S
EllC1) /.ZI State Surch-_"e i8%of Permit Fec $
(Please print name) _ TOTAL PERMIT FEE S ,
Notice: This permit application expires If a permit L%not obtained within All new Loom earcleal hulldiass require 2.sefs of plans with Isometrit:or
I140 Jaya atter it lass been accepted as complete. riser diagram for plan revkw.
*Fee methodnlot_v set by Til-County Building Industry Service Board.
CITYOF TIGARD _ RE TR TFDEN RIGY _
DEVELOPMENT SERVICES PERMIT#: ELR2003-00309
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639.4171 DATE ISSUED: 0/9/03
SITE ADDRESS: 13680 SW 122ND AVE
PARCEL: 2S103CC-09200
SUBDIVISION: Wl-IISTIFR'S WALK ZONING: R-4.5
BLOCK: LOT: 0:39 JURISDICTION: TIG
Proiect Description: All enconipassincl low voltage
A. RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL.
INSTRUMENTATION- OTHER:
TOTAL #OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SYSTEMS
4230 GALEWOOD ST PO BOX 14833
STE 100 DORTLAND, OR 97293
LAKE OSWEGO, OR 97035
Phone: 503-387-7538 Phone: 503-387-7538
Reg #: Sl2M-5558211JT.E
LIC 96806
FI.F 26-565^l.F
_ FEES _ Required Inspections
Description Date _ Amount Low Voltage Inspection
ELPRMT] LLR Permit 10/9/03 $75.00 Elect'I Final
I'AX1 tt'�,State Tax 10i9/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tiqard Municipal Code, State of OR. Special,y Codes
and all other applicable laws. All work will be done in accordance w0th approved plans. This permit will expire if work
not started within 180 days of issuance, or it work is suspended for more than 180 days. ATTENTION. Oreyon low
requires you to follow rules adopted by the Oregon Utility Notificatior Center. Those rules are set forth in ONZ
952001-0010 through C\R 952-001-0100. You n•ay obtain copies of these rules or direct questions to OU,JC at (503)
246-6699. `
Issued by '�' �, i' n� Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not Intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATF
`CONTRACOR INSTALLATION ONLY _
SIGNATURE IF $UPR. ELEC'N DATE
LICENSE NO:
Call 639.4175 by 7:00 P.M. for an Inspection needed the next business day
1 !1003 10:07 5032362322 QI!aDRQNT SYSTEMS
PAGE 0F>
iectrica.l Permit
- 111 1
A Received
_
Electrical cal
Permit No
Planning Sigi
City of Tigard U 3-nn
�1
Perrn;t No.:
13125 SW Hall Blvd. Plan Revicw Other --
Tigard,Oregon 97223 nere/13v: Permit No.:
Phane: 503-639-4171 Fax 503-598-1960 Post-Review Land Use
Dalc/H : _ _ Case No.: _
Internet- WWw,Ci.ti$Brd.ur.us Contact � � 7uris.: gee Page 2 for
our Inspection Request: 503-639-4175 NartxrMechod_ — su lementol Information.
t t „ pr �7 - -- ------
r ,,, ,T'Rf? .1�{�!�i�i',l�! rf1'M0'1 I ..�-�t�� l.. , h'.Y �,11
A New construction Derrichtion U Service over 225 amps Health-care facility
corrimcrcial ❑Naxardous location
D Addition/alteration/r lacementT7TOther, ClScrvire over 320 amps-rating of ❑Building over 10,000 square feet,
I &2 tamily dwellinis four or nrorc residential units,n
LAccessory
2-Tamil dwelling Commercla'Wnduslrial U Systcm over 600 volts nominal one snLctnre
- []Building over thrcc s`.ories ❑Fecders,400 amps or marc
Buildin Multi-Famil} Occu ant load over 99 rsons❑ p De. ❑Manufactured shucturr.4 or ltd park
ster A•tilder Ot11Cr' ❑Fgrest/lighting plan []Other:_^� y Submit__seta orpians with any of the abovz.
Job site address: I3 O SwI 22 The above are riot applicable to temporary construction service.
Suite#: Bld ./AptA _ _ _Number of ins ections er permit allowed
Project Name: _DOrl mnC sq,4 . Drscr{ tion Qry Fee(ea.) Te,t4-
New residentlal.ringlc or multi-farrilly prr - e
CroSS street/Directions to job site: dwelling cult.includes attached garage.
S'p ( C_�l� ServlceIncluded!
_100034 ft of less 145.15 4
Each additional Soo I' or portion thereof 33.40 1
Subdivision: l K,;-+LCe�S (1)n Ut- Lot#: 3 9 Limited en<s�,ro,ide,nnil _ -_ 5,00 -7 qcl 2
Limited ormKy.non resLq.--tT _ 75.00 2
Tax tea / arcel#; Goch manufocrurcd)rotate or modular dwelling
e service and/or feeder 90.90 2
i See-;eco or&edero-Installation,
w & m%1;�. _ alteration or relocation:
200 Annit or ies3 — "00.30 2
201 amps to 400 vitas .85 _ 2
101 am to 600 am
.017
to 1000 amps _ � 2
over f 000 rrrnp�t or vo1C� � 434,65 2
Name: 6615 2
Address: Temporary acrvicer or feeders-In.tallation,
Ci /State/Zi alteration,or rdocation:
_-� — _ 200 amps or lyi _ _ 66.85 1
Phone: Fax 201 amus to 4t>0s
Ila 600 auras 133.75 -- 2
Branch circuits-new,alteration,or
Name: --f QA,i, LG m — estenslon per panel:
A.Fee rer branch circuits with purchau of
Address: ice or few"f oaeh branch aitcult 6.65 2
Citl/State/Zip: - A.F�brr rh oirevii+"+thou,pw•ch,ae a
Phone: S• _r sr:rvice o[ .calor tba t bench cimmit _ t 8
��� l d`Ci — --
Eachodd �ph cin
E-tt]8i1: Misc.(snv :or feeder nW inehrded)- _
Each plan, r z1arion circ 53.40 2
Eachliar or out i li hrin� 3,00 - 2
Job No: SiRnal ci000it(1)or■ imbed anergy panel,
ahrra' nor extension
Business Name: � f�r� Description
r 2 2
Address: �� I y &33 _
C1 /State/ ,L 4-4(let, 931M "! Each additional Ina echo prrr the tdla ■ le in Im or the abor r
62.so
Phone - _
Fax: e731s • _ 3J..1- n �t�;__(mtn. t ltaa)
T I
CCD Lic.#. vt Lions', rr
.;
Suprervising electriciaM I _ Subtotal7f
� signature required: i �1 � __ —_ –
---1 _ �'._ Plan Review 23%of Permit cc* S
I Priest Name: r Lic, #: �( ( State Surrherac(8%of permit Fee s sJ
_ -L9TAL PERMIT i'EE S .du
Adthorizcd Notice: 1'hls permit application e:tplra 11 a permit is not obtained within
Signature: t. Date:10 _�_ i80 days rr It has been■ceepred as rnmplete.
'Per mrthndolop set by Tri County Building industry Service Ao■rd
(Ple■ae print name)
iADsts\Pcnnit Porrns\BlcPcnrWV4)p.dtra 01/03
�I���D _ MASTER PERMIT _
CITY OF IT PERMIT#: MST2003-00421
DEVELOPMENT SERVICES DATE ISSUED: 9/5/03
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639 4171
SITE ADDRESS: 13680 SW 12.2ND AVE PARCEL: 2S103CC-09200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 039 JURISDICTION: TIG
REMARKS: Construct new SF detached re,y'dence.
WILDING
REISSUE: DM199 STORIES: FLOOR AREAS REV.IRED SETBACKS !_ REQUIRED
CLASS OF WORK: NEW HEIGHT: F FIRST: 1,570 of BASEMENT: sf LEFT: 15 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD. 40 SECOND: 1,730 sf GARAGE: 74', sf FRONT: 70 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS I T"RD at RIGHT 5
VALUE: 325 147 00
OCCUPANCY GRP: R3 3DRM: 4 BATH i TOTAL 3.300 at REAR:
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: I SF RAIN DRAINS 1 CATCH BASINS:
TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: 100 BCKFLW PREVNTR. GREASF TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL rYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 3 CLOTHES DRYER: I
GAS FURN>•100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: I
MAX INP. btu FLOOR FURNANCES: VENTS: I 11VOODSTOVES: GAS OUTLETS: 4
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER 1 EMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp. 0 -700 amp: WISVC OR FUR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 7 201 400 amp: 201 400 amptat WIO SVCIFDR: SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDH: 601 1000 amp: 601+amps-1000v. MINOR LABEL:
10004 amplvolt: PLAN REVIEW SECTION
Reconnect only: >s4 RES UNITS: SVCIFDR»226 A.: >600 V NOMINAL: CLS AREAISPC UCC
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
INTERCOMIPAGING: OUTDOOR LNDSC LT:
AUDIO S STEREO: VACUUM SYSTEM: AUDIO d STEREO: FIRE ALARM:
LANDSCAPE/IRRIO: PROTECTILE SIGNL.
BURGLAR ALARM OTH: BAILER: HVAC:
GARAGE OPENER: CLOCK: INSTRUMENTATI MEUICn OTHR
HVAC: DATA7TELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
TOTAL FEES: $ 5,770.78
Owner: Contractor: This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORISSETTE HOMES INC 'Tigard Municipal Code,State of OR. Specialty Codes and
4230 GALEWOOD 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: 503-387-7538 forth Oregon Utility Notification Center. Those rules are set
3_ forth in OAR 952-001-0010 through 952-001-0080. You
T9c 3873, 8 ma's obtain copies of these rules or direct questions to
Rep a. OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanlca Plumb Top Out Exterior Sheathing Insl Rain drain Insp Electro.
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanlcai r u1,1i
Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final
Post/Beam Structural Mechanical Insn Shear Wall Insp Insulation Insp Appr/Sdwlk Insp
Issued B _ _- r�c _ Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
PERMIT#: 9/5/R20U3-00318
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171
DATE ISSUED: 9/5/03
PARCEL: 2S 1 U3CC-09200
SITE ADDRESS; 13680 SVV 122ND AVE
4.5
SUBDIVISION: WHISTLER'S WALK ZONING: It"
BLOCK: LOT: 00) JURISDICTION_ TIG� _
TENANT NAME
USA 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 residence.
Owner: _ _ _FEES _
DON MORISSETTE HOMES Description i Date amount
4230 GAI_EWOOD ST
STE 100 [SWUSAJ Swr Connect 9/5/03 $2,400.00
LAKE OSWEGO, OR 97035 [SWUSA)Swr Connect 9/5/03 $0.00
Phone: 503-387-7538 [SWINSP]Swr Inspect 9/5/03 $35.00
[SWINSPJ Swr Inspect 9/5/03 $0.00
Contractor: 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 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" Perm
Issued by: jjc Permittee Signature�i�L _ -�
Call (503) 6394175 by 7:00 P.M. for an Inspection needed the next business day
-Tv PT
3ing Permit A,pplicntion
City of Tigard ��rz rcceived�,-- .f, Permit no.: Saco
City nj7igord
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
Phone: (503) 639-4171 Date issued: Bye' Receiptno.:
Fa... (503) 598-1960 Case file no.: Payment type:
Land use approval: _ I&2 family:Simple Complex: \p
t
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family4h
�NCW constn�ction U Ucmolition
0 Addition/altenition/replacement U Tenant improvement U Fire sprinkler/alarm O Other.
t N o ^
uJob address; . v 1
- Bldg. no.: Suita no.:
Lot: Block: Subdivision: 1. .-4 Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
Name: �'���
Mailing address: L�
� 1 &2 fitmlly dwelling:
City; State:(, ZIP: Valuation of work......... $_
Phone: Fax: -7 -mail: No.of bedrooms/baths ........................
- ms/baths
Owner's representative: -t Total number of floors•........................... .
Phone: Fax: E-mail:
New dwelling area(sq. ft.) .......................... '
Garage/carport area(sq.ft.).........................
Name: i Covered porch area(sq,ft.) •........................
Mailing address: ��,. Deck area(sq. ft.)........................................
City: State: ZIP: Other stnicture area(sq. ft.).........................
Phor.e: I F.-mail: CommerclrUlndustrlaUmulti-family:
Valuation of work...................•.................... $
Busint i.s name: Existing bldg.area(sq. ft.) .......................•..
Addn .s: c ti Z LNew bldg.area(sq. ft.).............•...•..............
City: State:
-" ZIP: Number of stones
.................................•......
Phone: Fax: E-mail: Type of construction................................•...
CCB no.: — Occupancy group(s): Existing:
City/metro lic.no.: New _..__
Notice:All contractors and suhcontrnctors are requnr o oe
licensed with the Oregon Construction Contractors Bu .d under
Name: -A[Z �� � provisions of ORS 701 and may be required to be licensed in the
Address: "`7 �4. v jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing,the following reason applies:
Coptact person: Plan no.: — --
Phone: Fax: E-mail: -- —
Name: Contact person: Fees due upon application ........................... $
Address: _ Date received:
City: State: ZIP: Amount received ......................................... $
Phone: I E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Nd all juridktlau accept caths cud+,please call jurisdiction for more informatlm.
attached checklist. A11rrovisions of laws and oldfinances governing this O vasa U MasterCard
work will be compli wt?+,, whether shIciried flereA t'
Credo card number
Authorized sl nntu Name al�ar�wian.a:nav„o„paar e v
Print name: + a ( _Lo Cardholder sipature Amown--
Nolice:this permit application expires if a permit is not obtained within 190 days after it by been accepted as complete. 440aen(&"Wom)
One-and Two-Family Dwelling
Building Perwdt Application CheekliSt Reference ro.:
:i -- -- Associated permits:
City(if riga-d City of Tigard U Electrical U Plumbing U Mechanical
Address: 13!25 S W Nall Blvd,"rigard,OR 97223 1 U Other: __
Phone: (503) 6.39-4171
Fax: (503) 598-1960
1 Land use actions completed.See jurisdiction criteria for concurrent reviews.
2 Zoning.Flood plain,solar balance,pants,seismic soils designation,historic district,etc,
3 Verification of approved plat lot. —
4 Fire district__—approval required. 7_
_,)�
Septic .ysteni permit or aut:wrization for remodel.Existing system capacity
6 Sewer permit.
—7 Water diairict_approval.
8 Soils report.Must carry o ,final applicable stamp and signature on file or with application.
9 Erosion control U plan U permit required.Ir 'ude drainage-way protection.silt fence design and location of
catch-basin protection,etc. -
10 3_ Complete sets of legible plans.Must be drawn to scale,showing conformance to applicably,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
_ if copyright violations exist. _It Slte/plot plan drawn to scale.`rhe plan must show lot and building setback dimensions;property comer elevations(if
there is more than a 4-ft,e'evation differential,plan must show contour lines at 2-ft.interva;s);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility Iocations;direction indicator,lot
area;building coverage encu;percentage of coverage;impervious ama;existing structures or site;and surface drainage.
12 Foundailon plan.Show dimensions,anchor bolts,any hold-downs and reinfor pads,connection details,vent
size and location.
13 i'loor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _
14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof construction. More than one cross section may be required to clearly portray construction.Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,fernings and foundation,stairs, Y
fireplace construction, thermal insulation,etc. -
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full size sheet addendums showing foundation elevations with cross references are acceptable.
6 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prewn tive patf,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.
11( BY9eum and retaining walls.Provide cross sections and details showing placement of rehar, For engineered
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for al!beams and multiple ioi;ts
over I U I_et long and/or any b earn/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.;22Engineer's calculation•.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall he shown to be applicable to the project under review.
Five(5)site plans arc required for Item 11 above. Site plans must be 8-I/2"x 11"or 11"x 17".
24 Two(2)sets each are required for items 16, 19,20&22 above.
25 9uilding plans shall not coctain red lines or tape-ons.
26 No rolled,reversed or mirrored building plans will be accepted. _-
21 —_ ---� -----
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 f'ot department use only. 44tr 4614(&W/cOMI
Mechanical Permit Application
Date received: Permit no.fq
City of I,igard t�' Project/appl.no.: —__ Expucdate:
Address: 13125 SW Hall Blvd,Tigard,OR 9722Date issued: Receipt no.:
City ufri,;�rrrl AUG U •l 260'j, -- - - �� p
Phone: (503) 639-4171 rase file no.: Payment type:
Ru: (503) 598-1960 CITY OF TIGARD - — - _ -
w�Q1FAIJe�t Building permit no.:
Land use approval: _ :1 Hame
1
1 Multi- O'renant improvement
7Cwcunstruction
2 family dwelling or accessory ❑Com!nercial/industnal❑Addition/alteration/replacement a )then.
( 1 =1 1 1 1
r ►^ ' , Indicate cyuipm:_nt quantities tit boxes belo.v. Indicate the dollar
Job address: �v value of all mechanical materials,equipment.labor,overhead,
Bldg.no.: i Suite no.:
profit. Value S
Tax ma /tax lot/account no.: —� , —�)
See checklist for important applic tion information and
Lot: Block: Subdivision: �_t c jurisdiction's fee schedule for residential permit `^e.
Project name: _ ZIPti = ---- �!MUM
: 1
City/county: 1 1 �, t / 1
Description and location of work on premises: Fee(ea.)I Total
Description Qty. Res.only Res.only
Est.date of completion/inspection: - HVAC:
Tenant improvement or change of use: Air handling unit _—_CFM— — —
Is existing space heated or conditioned?0 Yes 0 No Air conditioning(site plan required)
I,existing space insulawd?0 Yes 0 No Alteration of existing vA system _ _
oder/compressurs
State boiler permit no.
Business name: �_ 'D ! r 4�G.:— HP _ Tons_ Btoll —
Address: I i , 'ircismo a dampers/dducr sm eke detectors
State ZIP: eat pump(sits p an require.1
City: L-.! tu
_ - Instal rep aceria&c/bu,.aer /
Phone: Fax E-mail: Including ductwo0u'--nt liner O Yes O No _
CCB no.: J nsit a I/replacdre ovate seaters-suspen e ,
City/metro lic. no.: N/A wall,or floor mounted
Rent ora liance other than umaee
Mune(please print): - efrigeration:
Absorption units,__ BTU/H
Chillers____ HP
Com ressors.— H='
Address: L L r ov onmenta ez)wtut an renu ali-w
City: State: ZIP: Appliance vent _
Phone: Fax• E-mail: erexFiaust
s,Type res.It ic-fiery tazmat
hood fire suppression system
Name: 1 Exhaust fan with single duct(bath fans)
ttaust s stem apart rom eaun or
Mailing address_ ) VU -y-u-eTp_fpjng and d t ut on(up to out cts)
City: State, 'ZIP ) Type: DPG NG __ Gil
Phone: 7- Fax. Email: tial i p ingeachad d i t i o n a 171,er outlets ----
rocem piping(schematic required) _
Number of outlets
Name. _ lerapp ance or equ pmenl:
Address: - _ Decorative fireplace
State: ZIP. nscrt--type
Clty -"— oodstovelpC I let stove
Phone: I •mail.
u�, Other:
Appl eanf't r.
slgnnfu Date: ) t te ---
Name(prin
Permit fee.........._... .....S ____----
N r all)unrdieuoru accept credit csnk,please till fansdhuan fa more information Notice:This permit application Minimum fee................$
G Visa O MuletCard expires if a permit is not obtained Plan revit:w(at _ `%i) $
Credit card number , spires within 180 days after it has been State surcharge(8%) ....S
accepted as complete. TOTAL .......................$ ---
Nome of cmdholder u UWWu on ertdit c =
I404611(W1'(-'OM)
— Cardholder signature Amount
1
Plumbincr Pernut :application
('� Date received: Permit
City of TigardF) � 1 ;ewer penrut no.. _ Building permit no..
Address: 13125 SW Elan Blv
CiryojTiga�d Expire date:
Phone: (503) 639-1.171 ProfecVappl.ao.:
Fax: (503) 593-1960 AUG 0"� 2L�03 Date issued. By: FR-eipt no.
Land use approval:
F TIGARD Case file no.: Payment type:
t " :I
0 I &2 farruly dwelling or accessory f]CommerciaUindustrial 0 Multi-family 0 Tenant improvement
vew construction 0 Addiuurv'altetauon/replacemeni O Food service 0 Other.
MEL 3I r' AI 4
Job address: <�'
J <���i 1 ' 1 1^ �. A-ve Description . Fee(n.) Total
'Ver l-and 2-family dwellings ordy:
Bldg. no.: Scare no.. (includes 100 ft.fureachutility connection)
Tax map/t.tx tot/a, ount no.. SFR(1)bath _
Lot t j Block: Subdivision: 1 f V - SFR(2)bath _ —
Project nan.e: SFR(3)bath
City/county: I ZIP. - Each addiuonal bativ1utchen
Description and locauon of work on premises:_ !_ Site utilities:
Catch basin/area drain
E t date of completmn inspection: Drywellsileach line/trench;drainq—:drain(no. lin. ft.)
Manufacrated home utilities _
Business name: Ll� Manholes
Address: Run driin connector
Citv State ZIP: Sanitar� sewer(no. lin. ft.) —
Phone Fir: Email: Storni,cwer(no lin. ft.)
Water armee(no lin. ft.) _ I
CCB 10 Plumb. bus. reg. no: - Fixture item:
city metro lie. no.: Absorption valve
:ontractot's representative signature_ ' ! Back flow preventer
Print -cam,.. A, 1 1 L)w Backwater valve r
Bastnsnavatory _
_ Clothes washcr
Name' tib`' 't- I Dishwasher
Address: Dnniune founLun(s)
Cir. State 21P Electorsisunlp
Phone: Fax: E-mai:. Expansion tank —
Fixture.'sewer cap
} Floor draim.ltloor unksihub _
Name (print): T Garbaga disposal
Mailing R — Hose blbb
Cir State ZIP. C Ice maker --__
Phone: •r, Fa�1 70 Email Interco todgrease trap _
Owner instulladort residential maintenance only: The actual Installation Pnmens) _
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. 5lnkls). bas ms), lays(s) _
Owner's sienature: Date: Sump _
Tubslshower/shower pan
Unnal
Name: Water eluset
Address Water heater
Cin I
State: ZIP: Other
Phone: Fax: E-muil: lbtal -
Na all'uns.Lcl,aeu ecce mbt cards. leve call unrlicuon far Mwe,ntomuua+
Minimumlreview
(at........../ _-
p. p l Notice:This permit application Plan rcvitw(at �. `'�) �
C Visa CI Mastercard espires if a permit is not obtained State surcharge(310) ...•$
C.edh:ard number --L—l-- within ISO dans ager it has been
t:apirer
accepted as complete. TOTAL .............. ........
NarM at:ardhu,der Is shown oa child card s
carehowu ritnaiure Amount 44o-t616(60WOM)
Electrical Permit Application
— Date received: Permit no.:g
City 4f Tigard Project/appl.no. Expire date:
CiryafTr)ard Address: 13125 SW Hall Dare issued. _ By: Receipt no.:
Phone: (503) 639-1171 i f
Fax: (503) 598-1960 Case file no.. Payment type:
Land use approval:
Nile, o
701 &2 family dwelling or accessory ❑Commercial/industrial LJMulti-family O Tenant improvement
lew wnstrucuon ❑Addition/alteration replacement O Other. LlPartial
It SITE INFORMATION
Job address: r Bldg.no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision: G� _
Project name: Description and location of work on premises:
Estimated date of rompletionMspection:
SCIIEDULE
Job no: Fee Max
-- _ Description Qty. (ei) Total no.lnsp
Business name: Nen residential-single or multi family per
A ddress: ) dwelWrg unit.Includes attached garage.
City: State: ZIP: serviceinclu'".
Phone: 1j l F:tx: E-mail: IOW sq ft.or less 4
Foch additional 500 sq.ft or portion thereof
CCB no.: Elec. bus. lic.no: Urnited energy,residential 2
Urnit
C' - r-e:��— Eachedenergtutedi home
2
Each manufactured home or nodular dwelling
at.
o ser ernurn e/Mrlclan(r¢ ulred) Date � 1 Service and/or feeder 2
License no ^� Seryices orfeedem-Instal lotion,
Sup elect name(print) 1 �` alteration or relocation:
200 amps or less 2
Name (print): ` l� 201 amps to 4W amps _-
401 amps to 000 amps
Mailing address: 1i 601 amps to 1000 amps _ 2
City: , State ZIP: 17_ �S OverlOWampsorvolu 2
Phone: Reconnect only 1
Owner installation:The installation is being made on property I own remporory services or feeders-
which is not intended for sale, lease, rent, or exchange according to ir►stallati.ln,dteraiion,orrelocation: 2
2W amps or iess _
ORS 447,455,479, 670, 701. 201 amps to 400 amps 2_
Owner's signature Date: 401 to 6W ams 2
a ) Branch circuits-nen,alteration,
or eatenslon per panel:
Name: A- fee for branch circuits with purchase of
- -
An ss: service or feeder fee,each branch circuit 2
Cj(y: a State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: _
Phone: Fax: Email: Each additional branch circuit:
u, Misc.(Service or feeder not Included):
❑Service over 225 ampscommemial ❑Healthcare facility Each pump or irrigation circle � 2
Eachsi nor outlinelighting2
O Service over 320 amps-rating of I dt2 O Hazardous location
family dwellings U Building over 10,000 syuam feet four or Signal circuit(s)or it limited energy panel.
❑System over 600 volts nominal more residential units in one structure alter:don,or extension' 2
❑Building over three stories ❑Feeders,400 amps or more *Description r
❑Occupant load over 99 persons ❑Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
❑l:gress/lightingplan ❑Other --- Per inspection
Submit_sets of plAm with any of the above. Invesugation lee _
The above are not applicable to temporary coacttuction service. Other
Not all jurt"coons accept credit cards,please till jurisdiction for more en(ormaurxt Notice:This permit application Petmit fee...... ..............$
U Visa U MasterCard expires if a permit is not obtained E ian review(tit _ %) $
Credit card number ! / within 180 days ager it has been State surcharge(11%)....$
-- �- - F'sp1fet accepted as complete. TOTAL $
Name of cardholder as shown on credit card
S
Cardholder signature Amount 4,44615(&WCOM)
0Hi1.R;2Hd3 1�:S4 503-A47-7617 VENTIAE p,t,GL U1
r C fit . . t w m . . OBE. 2809
0 i ����� �' r g��►�O� �• � i a �. LA0/1�/wO4f
CPNOM": `a—R,�L[
YCAIii l'"W'
``~ PIM fro.: l9Y
• ___�' 4e�R,�a�, ��' '"' ^h , dPI�ON • i111►I1tRON
J"J,
•'s / \ �4&
� / a 1 '. r
•� 1'�� / `� �� �� `;� fes' �.
�� '', �-�_ �-- "�e �"` -�" / �� l.Gt GTR/1fl�
i .i !I " 1 \ '. LOT a.QfA IC56 9Q. ■T
'• . ; A \ r \ OUiLQIWtx AftA� ]39W SQ Ft
tv J' J',d.'. 1�1
��bb� S�l.�l 1�2nc1 $� � ::� . .
Ave. � n
C:ITV OE TIGARD- SITE PLAN REVIEW
BUILDING PERMIT NO.:
PLANNING; DIVISION:
Required Setbacks: Approved ❑ Not Appro:rd
Side: ,��.. Si t Side: j.—
Front. Curage: y?,a_ Rear: ..4r–
Visuol Clearance: M Approved ❑ Not Approvru
Maximum Building Height-..la— feet
CWS Servic• 'rovider Letter Required: ❑ Yes ANo
❑ flee i. ;,d
It 1)atc:
FN( INEERING I&PARTMEN 1 :
Actual Slope:,..-."•oppruved Not Approved
Site flan: ,Approved [I❑ Not Approved
By: sK sT Date:
Notes:
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
dUP _--
Received Z Date Requested I — AM--- PM_ BUP
Location )(0 kc) 12- 2- �� ��' _ Suite _. — MEC
Contact Person4 _ ___ Ph( __) _ !F2 �-1 5 LIN,
Contractor ' Ph(-__ ) SWR
rBUILDING Tenant/Owne- �_ ELC
Footing -
Foundation Access: ELC
Ftg Drain ELF!
Crawl Drain
Slab Inspection (dotes: SiT
Post&Beam
Shear Anchors -_�--- -`
Ext Sheath/Sheaf
Int Sheath/Shear
Framing _ ---- - - - -------
Insulation
Drywall Nailing -----
Firewall
---Firewall
Fire Sprinkler - - -- - -- - -- -
Fire Alarm
Susp'd Ceiling ---
Roof
Other:—_ --- ---- -
Final
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab -- ---__
Rough-In
Water Service - - -- -_
Sanitary Sewer
Rain Drains - - - - - -
Catch Basin/Manhole
Storm Drain -
Shower Pin
PART FAIL -
M HANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers -- - —
Final
,*ASS PART_FAIL ----
L ICAL
Service
Rough-In
UG/Sleb - - -
Low Voltage
Fire Alarm
Final Reinspection fee of$ required before next ins
PASS PART FAIL u p - Inspection. Pay et City Hall, 13125 SW Hall Blvd.
SITE [� Please call for reinspection RE _ _ Unable to inspect-no access
Fire
ADASupply Line / , r '
Approach/Sidewalk Daft�__,-__� Inspector - - __- Ext
Ext
offipr
r i DO NOT REMOVE this Inspection record from the Job s1te.
PASS PART FAIL