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12187 SW HOLLOW LANE f O O 12187 SW Hollow Lane CITYY O F T I ^ARD MASTER PERMIT 1 ("� PERMIT M MST2001-00516 DEVELOPMENT SERVICES DATE ISSUED: 10/12/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 634-4171 SITE ADDRESS- 121117 SVV HOLLOW 1_N PARCEL: 2S103CB-05400 SUBDIVISION: QUAIL H(T i_UW - EAS I ZONING: R-4.5 BLOCK: LOT:003 JURISDICTION: TIG REMARKS: Construction of new singlo family detached residence. Path 1 BUILDING REISSUL. STORIES: 2 FLOOR AREAS REQUIRED SIiTBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,010 of BASEMENT: of LEFT:- 5 SMOKE DETECTORS: Y TYPr GF USE: SF FLOOR LOAD: 40 SECOND: 1,248 of GARAGE: 450 a1 FRONT: 20 PARKING SPADES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RfGHT: 5 VALUE: $215,284 80 OCCUPANCYnRr: R3 BORM: 4 SAT!1: 3 TOTAL: 2.25800 of REAR: 3t PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATCAIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 2 GARBAGE DISP: 1 WATER HEATCPS: 1 WATER LINES: 100 BCKFLVJ PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL.TYPES FURN<tOOK: 801Ur 4P<3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 orHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS- 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEUERS HRANCH CIRCUITS MISCELLANEOUS AUD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 ',no amp: VIISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF• 4 201 400;.mp: 20v 4,00 amp: tel W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 800 amp: 401 •000 amp: EA ADDL BR CIW SIGNAL/PANEL: IN PLAN1: MANU HMISVCIFDR: 801 1000 amp: GO:+omps.IOOOv: MINOR LABEL: 1000+ImplVolt: PLAN REVIEW SECTIO Reconnnct only: >•4 RES UNITS: SVCIFDR-225 A, >1,00 V NOMINAL: CLS AREA SPI'OCC ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL. AUDIO 6 STEREO. VACUUM SYSTEM: AUDIO 6 STEREO: TIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALAI M: 01 BOILER: HVAC: LANDSCAPEARRIG, PROTECTIVE SIGNL: GARAGE OPENER: CLOCK- n'9TRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYS, Owner: Contractor: TOTAL FEES: $ 4,771.21 DON MORISSETTE HOMES DON MORISSETTE HOMES This permit is subject to the regulations contained in the 4230 CALEWOOD ST 4230 GALEWOOD STREET Tigard Municipal Code,State OR. Specialty Codes and LAKE OSWEGO,OR 97035 SUITE 100 all other applicable laws. All work will be done in LAKE OSWEGO,OR 97035 acoordance with approved plans. This permit will expire If work Is not started within 180 dav%of Issuance,or if the work is suspended for more inan 180 days. ATTENTION: Phone: Phone: Oregon:aw requires you to follow rules adoptFid by the Oreg,in Utility Notificatlon Center. Those rules are se; Rep N: 1.IC 35533 forth In OAR 952.001,0011)through 952-001.0080. Ycu Tnay obtain collies of these rules or direct questions tc OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 6, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Irsp Mechanical Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/ftvlk Insp P09UBearn Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Issued By L _�Z/Z!a±r' < Permittee Signature Call (503)639-4175 by 7:00 p.m.for an inspection needed the next business day / CITY OF TIGARD SEWER CONNECTIO14PERMIT _ DEVELOPMENT SERVICES PERMIT 4: SWR2001-00276 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/12/01 SITE ADDRESS; 12187 SW HOLLOW LN PARCFL.: 2S103C13-05400 SUBDIVISION: QUAIL HOLLOW- EAST ZONING: R-4.5 _ BLOCK:_ LOT: 003 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: "EW DWcLLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new single. family residence. Owner: -- — D-)N MORISSETTE HOMES FEES 4230 GALEWOOD ST Type By — Date Amount Receipt LAKE OSWEGO,OR 97035 PRMT CTR 10/12/01 $2,300.00 27200100000 INSP CTR 10/12/01 $35.00 27200100000 Phone: 503-387-7538 Total $2,33F Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency, The permit expires 180 days from the date issued. The total amount paid will be forfeited if Pie 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 r— Issued by: , ! -%r Z� �_ ^_ Permittee Signature: V\-6— Ca \—Call (503 639-4175 by 7:00 P.M. for an inspection needed the next business day n Building l City of Tigl xeived: o y o, Permit no.: : Expire date:no. CityojTignrd Address: 13125 SW n)ut urvu, t tgaru,vrc yip j t/appl. Phone: (503) 639-4171 �, Date issued: By: Recei�� to.: Fax: (503) 198-1960 \� / Case Ole no.: Payment type: _ _ Land use approval: _ 1&2 family:Simple Complex: L,% U I &2 family dwelling or accessory O Commercial/industrial U Multi-family XNew construction U Ikmttlition U Addition/alteration/replacement U'Tenant improvement C]Dire sprinklcr/al:u7n U Other:_ Job address: '\ , Bldg.no.: Suit:no.: Lot: Black: Subrli,istun, t ,V. _ tax r.:";t/tax lot/account no.: 2 /r'n — Project name: Description and location of work on premises/special conditions: 0I%NI It U011 Sill-CIAL INFORAI%1110N, I S11' ('111LUKITS11 Name: Y Mailing address: �J 1 &2 family dweBing: e. City: , State ZIP: ) Valuation of work........................................ $Z Phone: - Fax: -7 mail: No.of bedrooms/baths................................. Owner'%representative: Total number of floors............................... . e Phone: Fax: E-mail: New dwelling area(sq.ft.) Gamge/carport area(sq.ft.)......................... Name. 1�1n 1 Covered porch area(sq.ft.) ........................ Mailirig address � v Deck area(sq.ft) ....................................... _ City: State: ZIP: Other structure area(sq.ft.)......................... Phone: Fax I E-mail: ComrnerciaUlndustriaUmulti-fatnliv: Valuation of work........................................ $ Business name: Existing bldg.area(sq.ft.) ........... ............. Address .r�� New bldg.area(sq.ft.)......... ... ................ _ City: State: ZIP: Number of stories............... ................ Phone: Fax: E-mail. Type of construction................... .......I....... CCB no.: — �— Occupancy group(s): Existing: _ -- _ _ City/metro lir,,no.: New: Notlee AI1 contractors and ,bconuactors are requited to be licensed with the Oregon Construction Contractors Board under Name: .Ls /1 �(z provisi gas of ORS 701 and may be required to be licensed in the Address: —��., �(� -- jurisdiction where work is being performed.. If the applicant is �-- —'� exempt from Iicensin&,the following reason applies: Cit _ State:, /I1' ContaA person: Plan no.: Phone: Fax: F. mail• - Name: t'ttntact lr_•rxnr _ Fees due upon application ........................... 5 Address: Date.received: _ City: State: ZIP: Amount received ......................................... $ Phone: Fax: I E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Na on juriodictiom wcep credit cards,plwe cola jurisdktion for more infomwion. attached checklist.A rovisions of I ws and o dinances governing this ❑visa t7 MasterCard work will be comp) wt ,whether cift a or noq /r� Credit card m.m►x* 1 I `c —— — — xptrcs Authori�xd S atU f ' We: Name of cud oldrt u shown m cmht card Print name: — odder si mature Nmount Notice:This permit application expires if a permit is not obtained within 190 days after a has been accepted as complete, tro-u,l a(&MwroM) One-and Two-Family Dwelling Building Permit Application ('l-ecklist Reference no.: GtyojTigardCity of Tigard -` —`-�---- Associatedpermits:Address: 13125 SW Nall Blvd,Tigard,OR 97223 Q Electrical Q Plumbing ❑Mechanical,Ether: Phone: (503) 639-4171 Fax: (503) 598-1960 ' i r i Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. ' 3 Verification of approved platnot. 4 Fire district _approval required. 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. 7 Water district approval 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control Q plan Q permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed if copyright violations exist. J` 11 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 2-111t.intervals);location of easements and driveway:f«xprint of structure(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 drainage. 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,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation Hews.Provide elevations for new construction;minimum of two elevations for additions and remodels. _ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and Incations;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 bearing locations.Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems,sec 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 detalis. 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 be stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the project under review. JURINDICTIONALSPIECIFI(S 23 Five(5)site plans are required for Item I I above. Site plans must be 8-1 r: x I 1 ! 1 24 Two(2)sets each are required for items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. 26 No rolled,reversed or mirrored building plans will be accepted. 27 28 ---- Checklist must be completed before plan review start date. Minor changes or notes on submitted [)Iwl:; may he in blue or black ink. Red ink is reserved for department use only. 44D4614(MCOM) Mechanical Permit Application Date received:Io ti Permit no. &" City of Tigard Project/appl.no.: Expire date: Cityo(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: _ Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Building permit no.: Lund use approval: - - --- - TYPE OF PERMIT, O 1 &2 family dwelling r;i accessory O Commercial/industrial ❑Multi-family Cl Tenant improvement >:(Vew construction G Additiam/altcmdon/replacement ❑Other: 1 1 113M I F-Tv 1113n In1 y� r" (� Indic equipment quantities in boxes below.Indicate the dollar Job address: -NL-46 � l�'v Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit Value$ (07 Block: Subdivision: 'See checklist for important application information and � jurisdiction's fee schedule for residential permit fee. Project name: t ZIP: t City/county: �i t / e 1 Description and le-cation of work on premises: t.re Tota! Ilrsiriptiun Qty. Res.only Res.oal Est.date of completion/inspection: AC ------ Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?O Yes ❑No Air con itionini(sits plan requu ) Is existing space insulated?0 Ycs C1 No Alteration o existing A system Boiler/compressors State boiler permit no.: Business name: 1 k HP —_Tons BTU Address: 1 ire/smo e drmper tier smo a electors State- ZIP: cat pump(site p an required) City: U nstalUceprce umace/bumer Phone: Fax: - E-mail: Including ductwork/vent line. iJ Yes O No nstalVrep ace/re ocalehrraaters-suspended, City/metro lic. no.: N/Awall,or floor mounted - - e-n ora ia-T nce o-Fit cr than urnace Name(please print): - - Refrigeration: Absorption units_ BTU/N Chillers tIP Name: `� 1 Compressors tip Address: ' t;�� r Environmentale. ust an vent at on: City: State: ZIP: Appliancevent - Phone: -T x: E-mail: Dryerex aust s, ype res.kite enthitzmat hcod fire suppression system Name: �z- _ 1 Exhaust fan with single duct(bath fans) Mallin aJJress: _ haust system apart Tom eating . S _ �' tie p ping an t butiou(up to 4 out cls) City: State- ZIPf Type: _LPG NO Oil Phone: 1l +, I mail: uel ioingeac add;.tions overAoutets rocempiping(schematicrequircd) Number of outlets Name: _ ,_—_ )her a app anceorequpmeM: Address: Decorative fireplace City: _- -- — State: ZIP: _ nsen-type - — atoV_ Iletstove Phone: jiE.r.aail: Other: 5 Applicanf's siRnafu" Dale: Ot ter. _ Name(print): Jx1jYl_f_I ' ' 1 — -- Permit fee.. ..................$ Not:JI jurisdictions accept credit cants,please caul iunsdicunn for more inforrrAtM- Notice:'this permit mrinlicalion Minimum fee................ O Visa 0 MwterCerd // / expires if a permit is not obtained Plan review(at ,.,-- %) S ------- Credit card number _ Expires within 180 days after it has been State surcharge(8%) ....$ ___----- accepted as complete. TOTAL Name of carJholder u shown an credit car ..............•..•....s _-- s "a-4617(15MCOM) CrWboldu slgrtwrt Amount Plumbing Permit Application Datereceived: 1p y p Permit no.:NS�.'Itre City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 9723 City vjTigard Phone: (503) 639.4171 ProjecUappl.no.. Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: case file no.: Payment type: u U I &2 family dwelling or accessory U Commercial/industrial O Multi-family O Tenant improvement ew constmcuon U Addition/alteration/replacement O Food service U Other, JOB SITE INFO!� tNa SCIIE3jULE(for special information Job address: L �- �, t- 1 11 . Description _ . Fee(e:s.) TWA New 1-and 2-family dwellings only: Bldg.no.: Suite no.: (includes 100 R.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath _ Lot Block: Subdivision: .L t SFR(2)bath Project name: SFR(3)bath City/county: ZIP Each additional badulLitchen Description and location of work on premises: SitetrtWties: Catch basin/area drain Est.date of completionrinspection: DrywellsAench line/trench drain Fooung drain(no.lin. ft.) Manufactured home utilities Business name ��1�� �(� I *1(U —� Manholes Address: , Rain drain connector _ City: State ZIP Sanitary sewer(no.lin. ft.) Storm sewer(no.lin. ft.) Phone: .-�' Fa,K: F-mail: Water service(no.lin.ft.) CCB no.: fi ` Z%-- -_7( Plumb.bus. reg.no: s �- Waturor item: City/metro lie. no.: N!A Absorption valve Contractor's representative signature tvBack flow preventer Print name: _ I t)rT`'f ( Backwater valve Basins/lavatory _ Clothes washer Dishwasher Address: v V Dnakint; fountainis) City: state: "LIP. E)ectors/sump Phone: Fax: E mail: Expansion tank Fixture sewer cap Floor drains/floor sinks/hub Name (pent): - � - Garbage disposal Mailing address: A ` lF__7 Hose blbb City 1 tate ZIP: �+ Ice maker Phone: - Fax: NC E-mail: interceptor/ ease trap Owner lnstalladon/resldenaa/maintenance only: The actual installation Pnmerts) will be made by me or the maintenance anO repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Ch.nter 447. Sink(s),basin(s), lays(s) Owner's signature: _ Date: Sump Tubs/shower/shower pan l'nnal Name: W'ater closet Address: Water heater Citi- _ — Starr. ZIP: Other. Phone: Fax: Email: Tot ! Not all runrdrcuons accept credit cards.please call lunsdauon Im more information' Notice:This permit application Minimum fee................S — O Visa U MasterCard expires if a permit is not obtained Plan review(at — %) S _ Credit card number _ / I— «tthm 150 da%s after it has been State surcharge (8`'F) ....S — Espirn TOTAL . .......E Name tit cardholder v Nnru own on crcard aces,:trd u completa ........... S Cardhobtu sitnature Amwni 4."161NOWOM0 Electrical Permit Application –' �Wterecceived: 0 of Permit no.: q.yj O j CO.6 l A.7 om City of Tigard Projecdappl.no.: Expire date: CityoJ'Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503)639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: �nii 11 1X7N,.c1,'ns't'r1uction y dwelling or accessory U Cornmerciab'industnal U Multi-family U Tenant improvement U Additiott/altemtiotn/replacemen( U Other. U Pattial JOB WE INFORMATION Job address: 1 ti J T Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: I Block: Subdivision: 7" l i _ Project name: I Description and location of work on premises: _ V� Estimated date of com letionrinspection: 11111 Job no: Fee MAX Business name: Description Qty. (Pa.) Total no.Imsp New residential-single or multi family per Address: A dwelling unit.lncludr_s altached garage. City: _ State: 71 P:g��_ Serviceinclutred Phone: 1j- j Fax: F..-mail 1000 sq.ft.or less 4 C_CB no.: Elec. bus.IiC. no: Each additional 500 sq.ft or portion thereof ' Limited energy,residential 2 C' r� —'- Limitmanu energy, manufactured non-resider m 2 Each manufactured home or modular dwelling nacre IT,equlred) Date - Service and/or feeder _ 2 r Services or feeders-Installation, Sup elect name tpnntl1 1.icenseno r alteration or relocation: 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City , State ZIP: Over 1000 amps or volts 2 Phone - Far: -7 mail: ReconneLtonl 1 Owner Installation:The installation i being made on property I own Temporary servlcr or feeders- which is not intended for sale, lease,rent,or exchange according to butallatlon,alteration.orrelocation: 200 amps of less 2 ORS 447,455,479, 670,701. 201 amps to 400 amps 2 0%%ner's si nature' Date: 401 to 600 ams Ell2 2I Branch circuits-new,alteration. or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit _ 2 City: State ZIP: B Fee for branch cPrcuits without purchase - - — of service or feeder fee,first branch circuit. 2 Phone: Fax: E-mail: Each additional branch circuit: _ Misc.(Service or feeder not included): U Service over 125 amps com me:rciat O Health-care facility Each pump or imgstion circle 2 Q Service over 320 amps-rating of 1&2 O Hanrdous location Each sign or outline lighting _ 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, Q System over 600 volts nominal more residential units in one structure alteration,or %tension• 2 O Building over three stories ❑Feeders,400 amps or more "Description: O Occupant load over tM persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the abase: *Egress/lightingplan O Other Per inspectionr�— Submit+sets of plans with any of the above. Investigation fee �^ The above are not applicable to temporary construction service. odder Nd all jurisdictions accept ere lit cards,please call pmisdicuon for mune infamauon Notice:This permit application Permit fee..................... O visa O MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card cumber _ ___ _—_�L._ within 180 days after it has been State surcharge(8%) ....S Expires accepted as complete. TOTAL .......................S _Name of cardholder a shows oncedit card S Cardholder sTinaturey Amount 4AG-4615(~OM) DON - MORISSETTE II O N E 9 I N C 0 R P 0 R A 1 R D 1 A 9 0 GA. LSA00D 9T. 9U [ TE 1 31 ��� • + ^ 5� f• A l E 0 9 if fi G 0, O R f! G O N 0 7 0 9 .S • 1 til] tJ (603) � a7 - 7G 39 FAR (b03) 0a7 - 7a 16 LOT- 3 STANDARD ELEN/ATI0,4 DATE: 9/25/2.001 PROPERTY: QUAIL-HOLLOW CITY: TIGARD SCALE: 1"=20' PLAN No.: 132 �Q ITL L6?16" _Q i8(v 281 50�m 1 184 284 b � ( � I 1 I 1 I I I 1 I I I I cont. 28 patio Q 13' 14'8' 2,258 eq. ft. ry 4 bdrm.. 12.6 2 1/2 bath 3,6, 1, EF.E. 290' 24'4' S'-m• 450 eq Ft. 2 ca r g r. FF E. 28 16' D 2' e'6 89 --- - � 288 Concret I © Drive 289 bI> 281 . 251 IIV 166 1 �qs 12181 �,U,! Xl_�Wti. °> OL LOT • 3 1 /n� CITY OF T I G A R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2001-00629 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/23/01 SITE ADDRESS: 12187 SW HOLLOW LN PARCEL: 2S103C13-05400 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY k;RP: R3 FLOOR DRAIN& TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: UPINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft T'I�31-IWASHERS: RAIN DRAIN: ft Remarks: Backflow prevention device for irrigation system. — FEES EFS— ---- Owner: — --- ----- —GALEWOOD Type By Date Amount Receipt 4230 GAL E DON OD ST HOMES PRMT CTR 11/:8/01 $36.25 27200100000 LAKE OSWEGO, OR 97035 5PCT CTR 11/23/01 $2.90 27200100000 Total $39.15 Phone 1: 503-387-7538 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682-6076 RP/Backflow Preventer Reg#: LIG 6136 Final Inspection PLM 11558 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR, Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952.0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. l Issued By: ' a Permittee Signature-; Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day r Plumbing Permit Application �� Datercceived:���' Permit no.;,�C/✓,, /-/YlI a C City O Tigard Sewer perinit no. Building permit no.: City ofTigard Address: 13125 SW Ball Alvd M, �� D ProJ PPl,no.:ecda Expire date: Phone: (503) 639-4171 � P Fax: (503) 598-1960 Date issued: By: Receipt no.: t�ovUi11 Case Payment Land use approval: y type: ❑ 1 &2 family dwelling or accessory Cl Commercial/industrial ❑Multi-family ❑Tenant improvement ❑New construction CI Addition/alteration/replacement ❑Food service ❑Other: 1 1 1N FEE SCII I FDIJ LE(for special informalckliso Job address: /r /,, ./ :, ,.. / i' t t ,i _ Uescri tion (2ty. Fce(ea.) Total Bldg.no.: Suite no.: New 1-and 2-family divellings only: (Includes 100 ft.for each utility connection) Tax map/tax lot/aSFR(1)bath Lot: (,..�) Block: Subdivision: r r c�.� / 4 t�` SFR(2)bath ( Project name:Q-udt-Le 11 G►l:_) C ti T SFR(3)bath _--- City/county;r• x. '(Je,'( Gt)/ l� ZIP: '=1 7;,'a3 Each additional bath/kitchen t - Description and locatipri of work on premises:y Siteutilities: Jn Ll�l t rC Catch bas In/arca drain Est.date of completion inspection: /=� .�e C}i � Dwells/leach line/trench drain Footing drain(no.lin.ft.) Manufactured home utilities Business name: Pro ,mgs LQ C�0^ "XIIC-% Manholes Address: q $ RQ Rain drain connector City: G State:Cj ZIP: '7Q Sanitary sewer (no.fin.ft.) --- Phone _ 1 Fax:69,1-987 E-mail: Storm sewer(no:lin.ft.) CCB no.: no: Water service(no.lin.ft. City/metro lic.no.. QQ;;al_ Fixture or Item: Contractor's representative signature: Absorption valve Print name: / Date: Back flow preventer �7 5S' Backwater valve Basins/lavatory i. Name: L,II t $ ,(' _� i Cis es washer Ahwmhcr ddress: 4-�T Dng fountain(s) City: t e, State: I ZIP: C1176 E ecturs/sum Phone: Fax: Ja 9 E-mall: Expansion tank oil I'm 0 1Fixture/sewer cap Name(print): on mpr j SSe"-e. Floor drains/floor sinks/hub Mailing address: 3U S.(v ppm, SJ— Garbage disposal Ilose bibb City: ag State: ZIP. X70 Ice maker Phone: ax: E-mall: Interceptor/grease trap Owner instal!ation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance•rnd repair made by my regular Roof drain(commercial) employee on the property 1 own as per 0RS Chapter 447. Sin (s), rasin(s),lays(s) Owner's si nature: Date: Sum Tubs/shower/shower pan Name: Urinal — ------ ---- - Water closet Address: Water heater City: State: ZIP: Other. -� -- - --- Phone: Fax: E-mail: Total Not all Jurisdicdo u accept credit cards,please call Jurisdiction for more Worandon. Minimum fee................$ Notice:This permit application plan review(at __ %) $ , O Visa O MasterCard expires if a permit is not obtained - Credit cud number: — within 180 days after it has been State surcharge(8%) ....$ .2, 90 ap res TOTAI. ........... $ 31?. /S" None of euo:.d r as shown on credit end -- accepted as complete. S Cardholder signature Amount 4,10-4 16(6IW OM) PLUMBING PERMIT FEES: P �!e 1'and 2•tari111 tl`elli15.0 nly ; y F F ICE tTCTAL FIXTURES.'(lndividua� 4TY. a�eaA�11�1tJ1 (I ddeslp"�tm, ��'�us�n , 16.60 Re dwe'OB an"d the m 10 Wit. QTY (ea) AMOUNT Sink ' 16.60 -- 'for aac�i uGlit�`r co�iliecf(onL ____. - Lavatory One(1)bath _ $249.20 Tub or TublShower Comb. 16.60 Two(2)bath - $350.00 Shower Only 16.60 Three 3 bash $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 9%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25•/a OF SUBTOTAL TOTAL Garbage Disposal 16.60 Laundry Tray 16.60 Washing Machine 16.60 FloorDreln/Floor Sink 2" 18'60 - PLEASE COMPLETE: 3^ 16.60 4^ 16.60 --- `-" - -- Nork Performed ., i�Auanti b _ Water Heater O conversion 0 like kind 16.60 Fixturo Type: Now Moved ' kc placed d-W-Uvedl Gas piping requires a separate mechanical ' ; .:'Ci,.ed ennit. - Sink ----�- - ' MFG Home New Water Service 46.40 Lavatory MFG Home Now Sai JStcz.Sewer 48.4u Tub or Tub/Shower Hose Bibs 16.60 Combination - -- Roof Drains 16.60 Shower Only, Drinking Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 16.60 Dishwasher _ Garbage Disposal Lauhd Roorn Tra Washin Machine Floor Drain/Sink: 2" Sewer-1st 100' Sewer-each additional 10046.40 4" Water Service•1st 100' 55.00 Water Heater Other Fixtures Water Service-each additional 200' 46.40 + S bel11 Storm d 11 R11 ai10 reln-1st 100' 55.00 - Storm a Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 27 Catch Basin 16.60 Inspection or Existing Plumbing or Specially 72.50 Re nested Ins actions er'hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - _--- --- Grease Traps x,6.60 CIUANTIiY TOTAL -- Isometric or riser diagram Is required II if a,• `/. - Quart fTotalls >9 r` *SUBTOTAL 6%STATE SURCHARGE ^J **PLAN RY5 EVIEW •/s OF SUBTOTAL Required only-if Axture total la>g TOTAL $3Cf /5 *Minimum permit fee is S j-5o %state surcharge,except Residential Backflow Prevention Device,whit Is Sas 25- 90 state surcharge "Alt New Commercial Buildings require plans with Isometric or user diagram and plan revlow I:\dsts\fomu\pim-fees.doc 10/10/00 r; � �•f n a a 7a w (O o ` � .ti a .y C rD � rn N fl G 0 o � ro `M Re � x �'C �Q 3 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-HC'Lr Inspection Line: 63 175 Business Line: 639-4 NIST -Z 0-V 6 LIS'/ BUP _ Date Requested __AM_ I'M Bt_D Location } r 7 .c.� y J Suite MEC Contact Person Ph _ Z.-GI C? Y -S� PLM Contractor_ Ph SWR ( UIL IIJ� Tenant/Owner _ _ ELC Retaining Wall ELR W Footing Access: -----.---__-__-_ Foundatic,n FPS Ftg Drain ----- Crawl Drain Inspection Notes: SGN _ Slab Post& Beam --� - --- -- SIT -- — Ext Sheath/Shear Int Sheath/Shear ----- Framing -- _ !' " ` ?=�� O Insulation Drywall Nailing -_-t•/�- Firewall `------- - Fire Sprinkler Fire Alarm - "— Susp'd Ceiling Roof - Misc: it ASS ) PART FAIL 8 Post&Beam Under Slab 1 op Out - - Water Service Sanitary Sewer - - - ------ Rain Dral(i�^ rna ^ S PART FAIL v /r ME . ANICAI_ Post& Beane - ------ ----- Rough In Gas Line ----- - — ---- Smoke Dampers p Final --- -- --- Z z PASS PART FAIL ELECTRICAL ----�- Service U1 Rough In �- LIG/Slab Low Voltage � Ln Fire A.iarm ` - - - .----inal 4ss INK f ss PART FAILSITE 13ackfill/Grading Sanitary Sewer Catch Basin Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Fire Supply Line ,f� [ ]Please call for reinspection RE: [ J Unable to inspect no access ADA A roach/t3tdewalk Date 2 �O Inspector 1, the LISLE l�QS L*v _ P ( Fin P;RT FAIL DO NOT REMOVE this inspection record from the job site. ®AAAAA_AAAAAAAA AAAAAAAAAAAAAAA iAAAAAAAAAAAAA a ► P .4 ° � i n fl, v .� o o G ► p 4 ► 0 ► a d � U �' Q ► 44 pp- ► ^R! 07 ► 0. ► q Q Oi ► �►v��►���siii�iie�������s��i����ii�s�i��♦��ci�r� CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 63t 75 Business Line: 639-4'. -- BUP _ Date Requested_ / -7 —AM PM ESLD Location-_ i �•���` 1 Suite _ _ MEC Contact Person Ph �% ''S PLM _-- ----_-�- Contractor Ph �- SWR BUILDING Tenant/Owner --_- ELC ^__ Retaining Wall ELR Footing Access: FPS Foundation - --- Ftg Drain SGN Crawl Drain Inspection Notes. -- Slab SIT Post& Beam Ext Sheath/Shear - Int Sheath/Shear _ u Framing ���- y -SU� ��� •f��\ ; V74A`7p�T{�1..1� Insulation Drywall Nailing Firewall Fire Sprinkler ---... ----- -- -- — Fire Alarm Susp'd Ceiling -- ----- - - Roof Mise_ - -- - -- - - --- - Final PASS PART FAIL ----- - - - - ---- --- Post& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL. - MECHANICAL Pest&Beam - - - -- - - -- Rough In Gas Line --_.----- --- - -- - Smoke Dampers SS', PART FAIL _ TRICAL - Service - Rough In UG/Slab - - - ---------- - Low Voltage Fire Alerm -- Final PASS PART FAIL ----- - -----SITE _ Backfill/Grading Sanitary Sewer Storm Drain I I Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I Please call for reinspection RE: I Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date �2 Inspector -`-� - -- _Ext Other --� Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. MECHANICAL PERMIT CITY O F T I GA R DEVELOPMENT SERVICES PERMIT#: MEC2002-00368 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/27102 PARCEL: 2S103CB-05400 SITE ADDRESS: 12187 SW HOLLOW LN SUBDIVISION: QUAIL HOLLOW - EAST ZONING: P,-4,5 BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESS ORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: _ 3 - 13 HP: COMML. INCIN: MAX INPUT: BTU 15 - 31 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: DRYERS: FURN < 100K BTU: _AIR HANDLING UNITS OTHER UNITS: 1 FURN =100K BTU: <= 10000 cfm: — > GAS OUTLETS: 10000 cfm: Remarks: Installation of heat pump Owner: _ FEES DAVID KRUSE Type By Date Amount Receipt 12187 SW HOLLOW LN PRMT CTR 8/27/02 $72.50 272002000C TIGARD, OR 97223 5PCT CTR 8/27/02 $5.80 272002000C Phone:503-590-8654 Total $78.30-- Contractor: FOUR SEASONS HEATING & A/C PO BOX 66409 PORTLAND, OR 97290 REQUIRED INSPECTIONS Mechanical Insp Phone:503-775-5919 Final Inspection Reg#:LIC 48283 EXPIRED This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is su�nended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)2.46-9189. Issue By: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day 'Mechanical Permit Application v Date received:ry,Z y Pcrmit no. ! 4 Z,0 City of Tigard Project/appl.no.: Expire date: Cil),of I ix'"r Address: 13125 SW Hall Blvd,Ti lord,OR 23 Phone: (.503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 `j \ Case file no.: Payment type: ,��" y Lan us a prov I' I 1 liuildingpermit nu.: Y 1 &2 family dwelling or accessory U Conitnercud!indie.mal J N41116-family U Tenant improvement U New construction bl Addition/alteration/replacement J o nbct JOB SITE INFORMATION COM MERCIAL VALUATIONSCHEDULE Joh address: >F_ Sw Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.; value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ i Lex: Block: Subdivision:` *See checklist for important application information and Project name: lef f jurisdiction's fee schedule fir residential permit fee. City/coun!y: j ZIP: 9 7Z?,--3 - — l Description nd h •ation of wo un p emism: 1 1 t Fria) Est.date ofcompletion/inspectiotl: 11"riplion try. Re%.only Res.rrnb Tenant improvement of change of use: C: Is existing space heat,-d or conditioned?A Yes U No Air handling unit ----C['-M_ Is existing space in%ulaied?AYes U Nn Air conditioning(site pan required) A tcration o existing HVAC system toi er/compressors Business name: State hoiler permit no.: fill _ Tons--I3TU/H Address: Q Fir•smo c ampers/ uct smo a ctectors City: 40-1wo—If Slate: 7..1 P:f Z FO Heat pump(site plan required) Phone: installImplace furnace urner__BTUAI _ CCB no.: Z$3 Including ductwork/vent liner U Yes U No Y _.�. Install rep ace re ocate I�eaters-suspen ec, City/metro lit nn _v W�a��j p y-5 _ wall,or Oarr mounted Name( leas! I,noil i Vcnt far ap,�liancc�other t tan furnace e ger•at o-i n: Absorption units _ RTU/H Name: 7j Chillers Address: Compressors_ City: _ tate: rn exTiaii,l an ventilation: Appliance vent vent Phone: Fax:Jim I h-mail: �rycr7 exFaust�— I I oc s, ype res. iicTrt�at - --- hood fire suppression system Name: _ 4V r /� rH S e Exhaust fan with single duct(bath fans) Mailing address: Exhaust sstem apart from Gating of AC �- Tup p ng andistribution(up to 4 outlets) City: _ _ Stale: 7,If: Type: I.PG NG __ Oil Phone -"a : E-mail: vel piping each additional over 4 outlets roet4v pp ng(schematic required) Numhei of outlets Name: _ ter appliance or equ pment: Address: _ Decorative fireplace City: _ , I aV. ZIP: Insert-type Phone: ' ax: mail: oo stove/pe et Stove Applicant's signatu [)ate: ,7 O fx Tic " Name (print): - % 1ild — Not all jurimlicnons wcept credit cards,please call junxticrim ria mare information Permit fee..................... U Visa U MasterCard Notice:'Phis,termit application Minimum fee................$ _ Crecit card mumt,er: � expires if a permit is not obtained Plan review(at _ %) $ � - - s- plrc within Igo mdays after it has been Slate surcharge(896)....$ -- --- - Nae or carr aider as shown on credit co $ accepted as complete. TOTAL .......................$ � Cardholder sitnature Amount : . }` j i. � +�! 41114611(60WOMI MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 AMILY DWELLING FEE SCHEDULE: 'TOTAL VALUATION: FEE: Table1ADescription: Price Total $1 00 to$5,000.00 Minirnum fee$7^..50 Table 1A Mechanical Code Cry (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU Including ducts rk vents 1400 $1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+ fraction thereof,to and including Including ducts&vents 17 40 $10,000.00. 3) Floor Furnace $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and including vent 1400 _ $1.54 for each additional$100.00 or 4) Suspended heater,wall heater fraction thereof,to and including t4 00 _ $25000,00. or floor mounted heater _ _- _ $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit 660 $1.45 for each additional$100.00 or - ---- fraction thereof,to and including 6) Repair units 1215 $50,000.00 - - $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heal Air $1.20 for earth additional$100.00 or For Items 7.11,see or Pump Cond fraction thereof. footnotes below. Com 7)<31­!P;absorb unit X14.00 /y - - to t00K BTU _ ASSUMED VALUATIONS_PER APPLIANCE: 8)3-15 HP;absorb Value Total unit 100k to 500k BTU 25.80 Description: _ Qt Ea Amount9)15-30 HP;absorb Furnace to 100,000 BTU,including 955 _ unit .5-1 mil BTLI 35.00 ducts&vents _-_-__ 10)30-50 HP;absorb Furnace>100,000 BTU including 1,170 unit 1-1.75 toil BTU 52.20 ducts&vents 11)>50HP:absorb Floor furnace Including vont `- 955 _. unit>11.75 mil BTU 87.20 Suspended heater,wall healer or 955 12)Air handling unit to 10,000 CFM floor mounted heater _-- - 10.00 _ Vent not Included In applicance 445 13)Air handling unit 10,000 CFM+ permit _ 17.20 Repair units 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 10.00 to 100k BTU - -- 15)Vent fan connected to a single dud 3-15 hp;absorb.unit, 1,700 6.80 101k to 500k BTU - 16)Ventilation system riot Included in 15.30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00 mil.BTU 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 10.00 1.1.75 mll.BTU --- 18)Domestic incinerators >50 hp;absorb.unit, - 5,725 17.40 >1.75 mll.BTU 19)Commercial or Industrial type Incinerator Air handling unit to 10 000 dm 658 89.95 Air handling unit>10,000 etm _ 1,170 120)Other units,Including worx stoves Non-portable evaporate cooler 658 _ 10.00 Vent fan connected to a sin le duct _ 446 21)Gas piping one to four outlets Vent system not Included in 656 `_ 5.40 a fiance ermlt -- 22)More than 4-per outlet(each) Hood served by mechanical exhaust 656 1 00 Domestic incinerator 1,170 Minimum Permit Fee$72.50 SUBTOTAL: Commercial or Industrial Incinerator 44590 Other unit,Including wood stoves, 656 8%State Surcharge $ d Inserts,etc. _ Gas piping 1-4 outlets 360 _ 25%Plan Review Fee(of subtotal) $ Each additional outlet 63 Requited for ALL commptrial permits only TOTAL COMMERCIAL ; TOTAL RESIDENTIAL PERMIT FEE: $ VALU_AT_ION: I ?T'3O Other Inspections and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour 2 Inspections for wf.ich no fee is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by cnanges,additions or revisions to plans(minimum charge-one.hatf hour)$72 50 pur hour 'State Contractor Boiler Certification required for units>200k PTU. "Residential A/C requires site pian showing placement of unit. I:\dsts\formsUnech-fees,doc 10/11/00 I i r 1/1 M I 333 I 1 w h EXPIRED