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12237 SW HOLLOW LANE
N w ti O O r 12237 SW !-follow Lane CITY OF TIGARD MO"'ER \• PERMITRMIT#:: MST2 MST2002-00019 DEVELOPMENT SERVICES DATE ISSUED: 3,25/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12237 SW HOLLOW LN PARCEL: 2S103CB-05900 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT:008 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE! STORIES: 2 FLOOh"REAS REQUIRED SET UACKS_ REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,010 of SAZL..16NT: H LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,248 of GARAGE: 464 of FRONT: 20 PARKING SPACES 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT. of RIGHT: 5 VALUE 5:.16.43300 OCCUPANCY GRP: R3 DORM: 4 BATH: 2 TOTAL: 2.25800 of REAR: 37 PLUMBING _ SINKS: I WATER CLOSETS: 3 WASHING MACK: 1 LAUNDRY TRAY:. RAIN GRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS. I WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES. MECHAWC^.L _ FUEL TYPES FURN TOOK: BOILICMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1 0,AS r FURN>-110014: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 0 MAX INPbW FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SR\'CIFEEDERS BRANCH CIRCUITS MISCELLANEOUS PDD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF. 4 201 400 amp: 201 400 at,,, tot W!O SVCIFDW 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY. 401 600 amp: 401 600 amp: EA ADOL OR CIR SIONAUPANEL: IN PLANT: MANU HM/SVC/FDR: 801 1000 amp: BOt.ampa•10tlOv: MINOR LABEL: 1000.omplvolt: PLAN REVIEW SECTION _ Reconnect only: >600 V NOMI SAL: CL S ARE OCC ��4 RES UNITS: 9VCIFDR>+225 A.: _ ELE.CTRI.AL•RESTR!CTED ENERGY S.COMMERCIAL A.SF RESIDENTIAL AUDIO A STEREO: VACUU9'C,S'EM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTL .'LNOSC L1: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSC ?EnRRIG: PROTECTIVE SIONL: GARAGE OPENER• CLOCK: INSTRUMENTATION: MFOICAL: OTHR: HVAC: DATAITELE C'IMM• NURSE CALLS: TOTAL 0 SYSTEMS. TOTAL FEES: $ 7,066.15 Owner: Contractor: This permit is subject to the regulations contained In the DON MORISSETTE HOMES INC DON MOHISSETTE HOMES T;gard Municipal Code,State of OR. Specialty Codes and 4230 SW GALEWOOD ST#100 4230 GALEWOOD STREET all other applicable laws. All work will be done In LAKE OSWEGO,OR 97035 SUITE 100 accordance with approved plans. This permit will expire If LAKE OSWEGO,OR 97035 work is not started within 180 days of issuance,ur if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility NGtlncation Center. Those rules are set Rep M: LIC 35033 forth In OAR 952 001-0010 through 952-001-0080. You may obtain copes of these rules Or tinct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS _ Erosion Control Insp 8, Post/Beam Mechanica PLM/Underfloor Framing Insp Insulation Insp Mechanical Final Sev'cr In;,,eJon Underfloor Insulation Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Water Line Insp Final inspection Foundation Insp Footing/Foundation Dr; Electrical Service Low Voltage Appr/Sdwlk Insp Post/Bea Stwelur81, Plmlundslab Insp Electrical Rough In Gas Line Insp Electrical Final 1� L._ <' l Permittee Signature Issue 8y f Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next business day �� --SEWER CONNECTION PERMIT CITE( OF TIGARD _ PERMIT#: SWR2002-00012 DEVELOPMENT SERVICES DATE ISSUED: 3125102 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103CB-05900 SITE ADDRESS; 12237 SW HOLLOW LN ZONING: R-4 5 SUBLi JISION: QUAIL HOLLOW- EAST JURISDICTION: TIG BLOCK. --- _ LOT: 008 --_- — — — TENANT NAME: FIXTURE UNITS: USA NO: � CLASS OF WORK: NEW DWELLING UNITS: 1 NO, OF BUILDINGS- 1 TYPE OF USE: SF IMPERV SURFACE: INSTALL TYPE: LTPSWR Remarks: Sewer connection for new single family residence. _^ Owner: FEES DON MORISSETTE HOMES INC Type By Dat© Amount Receipt 4230 SW GALE WOOD ST#100 PRM f CTR 3125102 $2,300.00 27200200000 LAKE OSWEG��,OR 97035 INSP CTR 3/25/02 $35.00 27200200000 Phone: 503-387-7538 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections I r This Applicant agrees to comply with all the rules and regulations of the Unifieo Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer" Perm Permittee Signature: Issue y: Caft 503)839.4175 by 7:00 P.M. for an inspection needed the next business day A �_ �i on _la ic�� Date received:I !} City of F 1gari� f l '1 !� Permit no.:/(T5� c _�n�/ City of Tigard Address: 13125 SW Hall HlyAMOD Project/appl.no.: Expire date: Phone: (503) 639-4171 Cl l ► Date issued: By: keceipt no.:Fax: (503) 598-1960 + ,D Case file no,: Payment type: Land use approval: «i-C 1&2 family:Simple Complex: t--- U U 1 &2 family dwelling or accessory U Commercial/industrial U Iviul:: family &New construction U Demolition U Addition/alteratioa/ret,la,;emcnt U Tenant improvement ❑Fire sprinkler/alarm U Other: Job address: AV {, `, ti V \ Bldg.no.: Suite no.: Lot: J Block: Subdivision; - i (, Tax map/tax lot/account no.: 07; 0 Project name: Description and location of work on premises/spccial conditions: Name: Y" Mailing address: �I 1&2 Wally dywelling: City: State ZIP: Valuation of work / / /-3�� S C Phone: Fax: _-'Z ...........-4/..��............. � mail: No.of bedrooms/baths................................. Owner's representative: �� Total number of floors ................................. Phone: F;tx: E-mail: New dwelling area(sq. ft.) .......................... Garage/carport area(sq.ft.)......................... Nanlc: _ Coved porch area(sq.f.) .........................( 0 —s Mailing address.: c Deck area(sq. ft.) ........................................ City: State: ZIP: Other structure aura(sq.ft.)......... ............... Phone: I E-mail: Commercial/industrlatimulti-farnlly: Valuationof work................................. ...... $ Business name: -A - Existing bldg.area(sq. ft.) .................................. Address: ` New bldg.area(sq.ft.)................. _ ... Number ostories _ City: Swtc: ZIP: f ........................ ............ Phone: Fax: =mail: Type of construction.............................. ... Occupancy group(s): Existing? City/metro lic no New: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: L �Y provisions of ORS 701 and may be required to be licensed in the Address: ��, jurisdiction where work is being performed. If the applicant is Cit : State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: Phone: Fax � Is-mai L• -- ----- ----- Name: Contact person: __ Fees due upon application ........................... $ Address: Date received: __ I City: _ State: ZIP: Amount received ......... , $_ . .......................... . . hone: Fax: E-mail: -- Please refer to fee schedule. -- I hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit tarda,please call iuriedictiai fix more inGxrtutian. attached checklist. rovisions of I ws and o inances governing this U visa O Mastercard work will be compl wt ,whether cif i e n or na� �k ) Credit card numb": LL_ Authorized tatuwd { ,71C. Z Expires Nun of cardholder as shown on credit card Print name: s Cardholder drt� ` Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. (60WOM) \ One-and Two-Family Dwelling Building Perinit Application Checklist Reference no. Associated permits: Cit of Tigard 3' g O Electrical O Plumbing O Mechanical Address: 13125 SW Nall Blvd,Tigard,OR 97223 OOther Phone: (503) 639-4171 Fax: (503) 598-1960 FOR 1 Land use actions completed.See jurisdiction criteria for cencufrent reviews. 2 Zoning.Flood plain,solar balance point;,seismic soils designation,historic district,ea 3 'Verification of approved plat lot. 4 Fire district _approval required. 5 Septic system permit or authorization for remodel. Existing system capacity i 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 ❑pl.n 0 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 buildhig 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 he completed t/ if copyright violations exist. J� 11 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevation.;(if there is more than a 4-ft.elevation different':.!,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage area,perrxntage 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 said 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 wail and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations 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 locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. 19 Basement and retaining walls.Provide cross sections and details showing placement of rehar. 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 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 be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review 23 Five(5)site plans are required for Item 1 I above. Site plans must he R 1/.' x I 1 !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 plans may be in blue or black ink. Red ink is reserved for depanntent use only. 44&146[4(ryaaroM) Mechanical Permit Application Datereceived: 1 G i Permit no.)!',, r� City of Tigard Projecl/appl.no,: Expiredate: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By Receipt no.: _ Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval: Building permit no.: --! Sol ❑ 1 &2 family dwelling or accessory ❑Commercial/industrial El Multi-family ❑Tenant improvement XNew construction O Addition/alteration/replacement ❑Other: 1 t t 1111LUJO ULTIAM Kin 11 ' t -- Job address: Jj „ j _ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: _ value of all mechanical materials,equipment,labor,overhead. Tax ma tax lot/account no.: profit.Value$ Lot: ) Block: Subdivision; ( c •See checklist for important application information and Project nam^: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: _ r y t Description and location of work on premises:.— l t al11rill s t a t Fee(ea.) TOW Est.date of completion/inspection: Wwnptlon try. Res.only Res.orly Tenant improvement or change of use: Is existing space heated or conditioned?❑Yes ❑No Air handling unit _ cl•T4 Is existing space insulated?O Yes ❑No Air con iuomng(site p an require ) - terauan or existing HVAC system _ oiler/comprr-ssors - ----�- Business name: t State boiler permit no.: ~ IIP Tons BTUM Address: lip a ampers/ uct smoke detectors City: LI I State• ZIP: eat pump(site an requtred) Phone: Far: Install/replace rnac urner BTU/ -" -1 CCB no.: - Including ductwork/vent liner J Yes O No �_ nsta replac reoca(e heaters-suspended, - - City/metro lie. no.:N/A - wall,or floor mounted Name(please print): _ ��� ent fora Bance o er than furnace e ernt on: Absorption units BTUM Name: t ��-] - �� Chillers-- ---- HP --- Address: -! G � Compressors HP unromental exhaust an rent ton: Clty: eStat•: ZIP: Appliance vent Phone: Fax: E-mail: Dryerexhaust oods,Type U11/res.kite,en azmat hood fire suppression system Nie' _ Exhaust fan with single duct(bath fans) Mailing address: ) gusts stem n an from eatin or City: Stale LIP ) Fuelpiping ae t but oe(up to 4 outlets) Phone: 7 TY : LPG NG Oil- Far: E-mail: Fuel piping tach additional over 4 outlets rocessp p ng(schematicrequired) Name: Number of outlets - — ter listed appliance or equipment: Addre35: i-� Decorative fireplace Cit}" State: ZIP: risers-type _ --_— Phone: Fax: -mail: oodstove/pellet stove Gthet Applicant's sI);nuru � Date: 'l. ter. _ Name(print): (�-� 1 f j]��rYnr I - Not all jurisdictions accept credit cards,please call juriswcuon for more information Permit fec.....................E — O Visa ❑MasterCard Notice:This permit application Minimum fee...... .........S Credit card number / / expires if a permit is not obtained Plan review(at _ %) $ Expires within Igo days after it has been Name of cuu State surcharge(8°6) ....$ .......................dholder shown on credit cud s accepted as complete. TOTAL $ ;_— Cardholder signature Amount 44GA6I (GAnMM) 1'iumbin2;Permit AppiiciltionEn \ — ---- Date received: / oo 9- Permit no.: I, OrJA�9 City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer perrrut no.: Building permit no.: City of Tigard Phone: (503) 639-4171 Projecdappl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ CUO file no. Payment type: t (7 1 &2 family dwelling or accessory J Cumrnercial/Industnal U Multi-family O Tenant improvement ew construction O Addition/alteration/mplacement O Food service U Other t . srrE INFORMATION7tSCHEDULE Ifor special information use cliecklist) Job address: L-246 ) C �1 Description Qty. Fee(ea.) Total New 1-and 2-family dweWngs only: Bldg.no,: I Suite no.: (Includes lOCit.for each utilityconnectiou) Tax map/tax lot/account no.: SFR(1)bath L.ot Block: Subdivision: 4 \ 'V SFR(2)bath ��--- - — Project name: SFR(3)bath _ City/county: ZIP Each additional bath/kitchen Description and location of work on premises: _ SiteutWties: Catch basin/area drain Est date of completionfinspection: Drywells/leach lineitrench drain Footing drain(no. lin ft., Manufactured home utilities Business name- Manholes Address - Rain drain connector City: State ZIP: Sanitary sewer(no. lin. ft.) Phone: -451-1 Fax: E-mail: Sturm sewer(no.lin. ft.) Water service(no. lin.ft.) _ CCB no.: fl � 'Z LPlumb.bus. reg. no: - Fixture or item: City/metro lic. no.: N/A i % Absorption valve Contractor's representative signature ' Back flow preventer Print name: Ua Backwater valve Basins/lavatory Name: �-I ����� �� Cluthes washer Dishwasher Address: V Dnnking fountain(s) City: State: ;up: F)ectors/sump Phone: Fax E-mail Expansion tank Fixture/sewer ca Flour drainst loor siaks/hub Name (print): _k:y l�j`_- �_ Garbage disposal Mailing address: T Hose bibb City,_ .(_i -_ State �e!IP,G Ice maker _ Phone. 1 ' - Fay: 7rG1 E-mail: Interceptor/grease trap Owner lnsta/ladon/residendal maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Raw(drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(sl, basinlsl, lays(s) Owner's signature: Date: Sump - - Tubs/shuwer/shower pan Unnal Name. --- ----- Water closet Address: Water heater City ----- State: ZIP: Other. Phone: _-- — F x: _ E-mail: Total _ Na all iunfdreuona accep credit cucU,pleatt rail iunrLcuon for moremfartruuon Notice. This permit application Minimum fee................$ ❑Vii sa O!MasterCard expires if a permit is not obtained Plan review(at _ %) S Ctedir cad number ( State surcharge(8`70) ....$ — � within IRO dais after it has been Name d cardholder L shown oil credit cad aptres accepted as complete TOTAL .......................S _ f C—rd t,oldtr—it nrtute Amount (6Varom) L;lectrical Perinit Application ID&ereceIved:/ 'j G t Permit no.:j ri/xd /_Cp/9 City Of Tigard Project/appl.no.: Expire date: Ciryo�Ti)arrf Address: 13125 SW Hall Blvd,Tigard,OR 9722-1 Date issued: By: Receipt no.: Phone: (503) 639.4171 Payment type: Case file no.: _ Y Fax: (503) 598-1960 Land use approval: - TYPE 1 ❑ 1 &2 family dwelling or accessory O Commcrcial/industrial ❑Multi-family ❑Tenant improvement New construction ❑Addition/alteration/replacement ❑Other ❑Partial JOB SITE INFORMAIUON Job address: �� Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: v t -- Project name: I Description and location of work on premises: Estimated date of completion/inspection: l Fee max Job n0: r- Total no.lm -- - _ Description Qty. f ) P Business name: 1 New m%lde iiaf-single or mold-famuy per Address: ,j) 4-��f dwclWtgunit.tnclucesattachedguage. City: State: L1P: Serviceincluded: 1000 sq.it or las 4 __ Phone: 1j- I Fax: E-mail: Each additional 500 sq.h or portion thereof CCB no.: All Elec.bus. lic.no: Umutedenergy,residential 2 _ C: ^ Limited energy,non-residential - - Each manufactured home or modular dwelling — asure o supervrsrn efeariefan(r aired) Dare Service and/or feeder 2 Services or feeders-Installation, Sup elect name(print) 1 License no alterstlon or relocation: 200 amps or less 2 -- 1 201 amps to 400 amps 2 Name (print): ` 401 amps to 600 amps 2_ --- Mailing address:,/jQ 601 amps to 1000 amps _ 2 Clt Y' G s ZIP: On-101 2 r Slate — arnpsorvolts t Phone: - Fax : -� : mall: Reconnectonl Temporary services or feeders- Owner Insralladon:The installation is being made on property 1 own bubliatimsiteration,o-relocadon: which is not intended for sale, lease, rent,or exchange according to 200 amps or less _ 2 URS 447,455,479,670,701. 201 amps to 400 amps 2 Owner's si nature: Date: 401 to 600 rIps 2 Branch circuits•new,alteration, or extension per panel: Name: A Fee for branch circuits with purchase of 2 Address: service or feeder fee,each branch circuit - — _ State: ZIP: B Fee for branch circuits withour purchase 2 City: ----- of service or fader fee,first branch circuit: Phome: E-mail: Eachadeliuonalbranch circuir. Misc.(Service or feeder not Included): Each pump of irrigation circle 2 O Service over 225 amps commercial 9 liealth-care facility Fach signor oudine lighting _ 2 U Service over 320 amps-rating of 1&2 ❑Hazardous location Si nal circuit(s)or a limited energy panel, family dwellings O Building over 10,000sgti:uefeetfouror g 2 •System over 600 volts nominal more residentia!units in one oructure alteration,or extension* _ O Building over thea stories O Feeders,400 amps or Mone *Description -- U Occupant load over 99 persons O Manufactured structures or RV park fach addifiorwl insper:tion over the allowable In any of the shove_ O Egress/lightingpl,m O Other Perirapecuon Sul,mit__seta of plats with any of the above. Invesugation fee The above are not applicable to temporary construction service. Other Perms fee....... ............. _ Not all jurisdictions scup,cr&bi cards.pteau call jurisdictina ra more iota mason Notice:This permit?i�plication Plan review(at — %) $ _ O Visa Cl MasterCard expires if a permit is not obtained within 180 days after it has been State surcharge(8%) ....E Credit card numher accepted as comf tete. TOTAL .......................S Warne of cardholder as shown on credit card i —Y Cardholder sigrialiue Amount_- 440-4615(tLOaCOM) DON • MORISSETTE I a M ; ® 1 x c 0 V P 0 2 A T ■ D ♦ a 3 0 O A L 9 W 0 0 D 6 T 6 U I T 11 1 0 0 t6n�jss0r� T6tl6' Ili:a (6oi?a67a� � eiB QBE : 161 STOVAP0 ELEVATION LOT: 8 DATE: 1/08/02 PROPRET. Y: QUAIL-HOLLOW CITY: TIGARD SCALE: 1'-20' �� r I. 11�1PLAN No.: 192 - 3�� Ze q .S 3rd1 ��.�.,. 299 es ui 301 I W I I I 2 I ILu -, ccMc: 1 f'l'a ..T2 paha - I l 4 315 -�- I1 13' 14'g� 2.2$8 6th. ft. 4 bdrtn. 301 2 1/2 bath FF.E. .302-5' 3'6 46�4 6q. fit. 14„E. . 300 2 car far. 30 = - a �ncr�tet •_. I I I 9 e' RUQ 299 - '�g �Approach� 3f^ I '!OQ 1223"1 8-W- HO L L OUJ �0 3 � ft. r �� m q• R n z 3 , o s o ' Con EL _ a ^ a \ J s y � \ O j 1\ T 3 CITY OF T I G A R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2002-00161 13125 SW Hall 131v , Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/9/02 PARCEL: 2S103CB-05900 SITE ADDRESS: 12237 SW HOLLOW LN SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 008 _ JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCU''ANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: __________F_I_XTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: _ v URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSE 7S: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow preventer device. _ FEES Owner: Typo By �lDate Amount Rect:ipt DON MORISSETTE HOMES INC pRMT CTR 5/9/02 $36.25 27200200000 423() SW GALEWOOD ST#100 5PCT CTR 5/9/02 $2.90 27200200000 LAKE OSW,':-GO, OR 97035 _ —�-- Tgtal $39.15 Phone 1: 503-387-'338 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS RP/Backfirjw Preventer Phone 1: 682-0076 Final Inspection Reg #: LIC 61126 F'I_M 11553 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. J Issued By. , Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITYCITYO C TI G /� R D __ PLUMBING PERMIT r r'1 DEVELOPMENT SERVICES PERMIT #: PLM2002-00161 DATE ISSUED: 5/9/02 13125 SW Hall Blvd., Tigard,OR 97223 (503) 639-4171 SITE ADDRESS: 12237 SW HOLLOW LN PARCEL: 2S103CB-05900 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: it-4 5 BLOCK: LOT: 008 JURISDICTION: T IG CLASS OF WORK: CTR GARBAGE DISPOSALS: MOBILE HOME SPACES: 'TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRANS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE. TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: It WATER CLOSETS: WATER L.INE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow preventer device. _ --��-- _FEES � Owner: Type By Date Amount Receipt .� DON MORISSETTE HOMES INC PRMT CTR 5/9/02 $36.25 27200200000 4230 SW GALEWOOD ST#100 5PCT CTR 5/9/02 $2.90 27200200000 LAKE OSWEGO, OR 97035 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 #: LIC 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. Issued By: �,� /_ _ Permittee Signat C�vt c Call (503) 639-4175 by 7:00 P.M. for an inspactioh needed the next buslnes day n� T I S /� R D _ _ PLUMBING PERMIT CITY DEVELOPMENT SERVICES PERMIT#: /9/02 2-00161 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5 5/9/02 SITE ADDRESS: 12237 SW HOLLOW LN PARCEL..: 2S103CB-05900 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: OOH JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER H'A'rERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE It DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow preventer device. ___ FEES Owner: — Type By Date Amount Receipt DON MORISSETTE HOMES INC PRMT CTR 5/9/02 $36.25 27200200000 4230 SW GALEWOOD ST#100 5PCT CTR 5/9/02 $2.90 27200200000 LAKE OSWEGO, OR 97035 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 #: LIC 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. Issued By: t Permittee Signatu�,'� Call (503) 639-4175 by 7:00 P.M. for an Inspectloh needed the next buslnes day Plumbing Permit Application - -- Daterecoived: Permit no.: IJLH7l -DO/ City Of Tigard Sewer permit no.: I Building permit no.: Address: 13125 SW Hall blvd,Tigard,OR 57223 CiryofTigard phone: (503) 639-4171 Pro}ecVappl,no.: _ Expire date: _ Fax: (503)•598-1960 �+ 1 Dateissued: _ By:10' I Recelptno.: Land use approval: I ' Casefileno.: Payment type: L 1 &2 family dwelling or accessory . ❑Commercial/industrial ❑Multi-family ❑Tenant improvement ' ,New construction ❑Addition/alteration/mplacement 1 ❑Food service O Other: SCHEDULEJOB SITEINFORMATION FEE Information Job address: �v� 3 7 L�' / 'i �•<i Dt-I Lam- __ I)cs�rllttion tZty. l ee(ea.) Total Bldg.no.: suite no.: New 1-and 2-family dwellings ooly: (includes 100 ft.for-acir utility connection) Tax ma /tax lot/account no.: SFR(1)bath Lot Block: Subdivision: ac(_ 14V ll SFR(2)bath _ Project name: l,l acX_ c 1 (t'L(-- L' SFR(3)bats _^ City/county:' q a u( I oo a S b' ZIP: 9 7 Each additional bath/k4chen Desc don and location Qf work on premises; _ Site utilities: A Cor- - gal)-_.Gt r4)i Catch bashVarea drain Est.date of completlon/inspection:`.�' •�\ 13_ Drywells/keaehlineltrenchdrain Footing drain(no.lin.ft.)I'M IMMING CONTRACTOR _ Manufactured home utilities Business name p y13.9 S [t24 LI SG Manholes Address:*")-9 Pj 9- S u7 Rain drain connector City:wi)Vnu G Ptatebl` I ZIP: '70 7 0 Sanitary sewer(no.lin.ft.) Phooe:tag�,-lab`I e.0 Fax: -cje7 E-mail: Storm sewer(no.lin.ft.) CCB no.; /.1U Plumb.bus.reg.no: Water servtce no.lin.ftq _ City/metro lic.no.: 003Z-"7 _ Fixture or Item: Contractor's representative signature: Absorption valve Back flow preventer iL55 Print nam-:E.I berl SG Ai:r-z• '% Backwater valve CONTACT PERSON Basins/lavatory Name: t p 1'1'Z"�1�-7 Clothes washer — --- Dishwasher _ Address:Ztq Q45 S-vW Kin j M 4A M Drinking fountain(s) Sta e:of , ZIP: o Ciry: Ut1t, Eiectors/sump Phone:(pgd-0076 Fax:lord-9VI-1 E-mail• Expansion tank Fixturc/sewer cap Name(print): (17%_e_� fe f f drys{S' Floor drains/floor sinks/hub _ Garbage disposal _ Mailing address: 'i30 t U Dleeu 0(X) ST Hose bibb City: LO-InnState: R, ZIP:q _ ce maker Phone: Fax: E moll: Interceptor/ :ease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by-ny regular Roof drain(commercial) employee on the property I own ns per ORS Chapter 447. Si (s), asin(s),lays(s) (Owner's si ature: _ Date; Sum Tubs/shower,(shower pan _ Urinal Name: — W Water closet t Address: Water heater City: State: ZIP: Other: Phone: Fax: E-mail: Total c-- rtot an Jurisdiction,accept credit cards,please call jurisdiction for more information- Notice:This permit application Minimum fee................$ O Visa ❑MasterCard expires if a permit is not obtained Plan review(at r %) $ D --- Credit-ard number. _ 1 L within 1 BO day:ager it has been State surcharge(896) $ ��— Expires -�Yni o der eardholu shown er on edit cud = accepted as tort ,oio. TOTAL ...................... 3 rr2 Cardholder signature Amount 4104616.(SWCUM PLUMBING PERMIT FEES: C i Fill fir ;A�Inm� 'A"F JA eO L'Iejr'� Sink 16.60 T-: ne. Lavatory 16.60 One(1)bath $249.20 Tub or Tub/Shower Comb. 16.60 Two(2)bath $350.00 Shower Only 16.60 Three(3)bath $399.00 Water Closet 16.60 - - SUBTOTAL F71'15.17. I.I.Inal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL i'ON Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" r 16.60 P!-EASE COMPLETE: 4" 16,60 Water Heater 0 conversion C like kind 16.60 q Gas piping requires a separate mechanical 1 Zr a permit. MFG Home New Water Service 46.40 Sink MFG Home Now§-a-n/Storm Sewer 46.40 Lavatory Hose Bibs 16.80 Tub or TubtShower Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures 13pi;@1fj-)- 16.60 Urinal Dishwasher Garbage Disposal Laundry Room Tray I Washina Machine Floor Drain/Sink: 2" Saw it-1 st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater Water Serv',. 46.40 Other Fixtures each additional 200' 1 (specify) Storm&Rain Drain-1st 100' 55.00 Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 4e.40 I t Residential Backflow Prevention Device' 27.55 17,5S Catch Basin 16.80 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16,60 QUANTITY TOTAL Isometric or riser diagram Is required If Quant Total Is >I *SUBTOTAL 8%STATE SURCHi!,RGE ry C) REVIEW 25%OF SUBTOTAL fi Required only If fixture qly.total 4>9 TOTAL *Minimum permit fee Is$72.50+8%state surcharge,except Residential Backflow Prevention Device,which is See 25+a%state surcharge *.All Now Commercial Buildings require plans with isometric or doer diagram and plan review I s\ds Ls\forms\pIm-fees.doc 10/10/00 CITY OF TIGA'RD 24-Hour BUILDING inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP —_-- - Received — _ quested_ ` � AM _--- PM BUP Date Requested Location ��__�_ - �,�- �Suite_ MEC r Contact Person _ Ph(—) ,_7 PLM — QZ C (,j Contractor _—_ Ph( ) 4� l ' SWR BUILDING Tenant/Owner _____— _ ELC _ Footing ELC — Foundation Access: Ftg Drain ELR Crawl Drain - SIT - Slab Inspection Notes: Post&Beam - - -- — - Shear Anchors Ext Sheath/Shear - Int Sheath/Shear Framing - Insulation Drywall Nailing Firewall Fire Sprinkler —" Fire Alarm _ — Susp'd Ceiling "--- Roof Other: .w►,. .. Final PASS PART FAIL PLUMBING -- -- Post& Beam Under Slab - Rough-In _ Water Service -_-- -� Sanitary Sewer Rain Drains Catch Basin/Manhole — Storm Drain Shower Pani T; ---- Ot ---- _ PART FAIL JhANICAL — Post&Beam Rough-In Gas Line Smoke Dampers Final _ PASS PART FAIL ELECTRICAL Service Rough-!n UG/Slab _ Low Voltage - -- Fire Alarm Final Reinspection fee of$_._—_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART_FAIL SITE u Please cal!for reinspection RE: Unable to inspect-no access Fire Supply Line 71 ADA Data �^ ,1" t` Ext -- ApproachiSidewalk 'L Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour �,� BUILDING Inspection Line: (503)639-4175 �1 MST �60 INSPECTION DIVISION Business Line: (503) 639-4171 BLIP -- - --- Received _— Date Requested AM PM -- BLIP - Location �- Z l �''_ quite MEC - Contact Person Ph( PLM Contract - SWR ILDING tenant/Owner ELC _ ELC Foun Access: ELR Ftg Drain —--� — Crawl Drain51T 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 Roof - -— in _ RT FAIL I P . earn Under Slab -- Rough-In Water Service -- -- Sanitary Sewer Rain Drains Catch Basin Basin/Manhole _ Storrs Drain -- Shower Pan — Ot r: r------- _ AS _ FAIL ANIC - - -- - m Rough fh Gas Line Svop Dampers --- m S; T FAIL - Ro -In -_ UG/ lab In oltage - F' a arm in ❑ Reinspection fee of$ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd. PASS PART FAILUnable to inspect-no access SITE ❑ Please call for reinspection RE:..—__ - ❑ Fire Supply Line )^ ADA Date_ f fJ Inspector (/ ` Ext -. Approach/Sidewalk Other: DO NOT REMOVE this inspection record from the job site. Final PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4115 MST INSPECTION DIVISION Business Line: (503)6394171 / BUP Received _ -_ Date,Requested _ _� � / 3 AM PM __.__ _- -- BUP - Location — 1 - -- 1 b�l v Suite -- - MEC - - Contact Person _- — _ Ph( ) _-_ PLM - - Contractor_ __ Ph(-- ) SWR - BUILDING Tenant/Owner - - ELC - Footing ELC Foundation Access: Ftg 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 Roof Other: Final PASS PART FAIL iPLUMBINQ �—^ Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains -'- Catch Basin/Manhole — Storm Drain - -_ - ._.-._.------.--- Shower Pan _— Other: Final PASS PART FAIL MEC_HANIC_A_L - -- — Post& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ---- _ ELECTRICAL — Service Rough-In -- — UG/Slab Low Voltage — Alarm inal PART FAIL Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S — Please call for reinspection RE: [� Unable to Inspect-no access Fire Supply Line �- ADA Dati-�` ���_ Inspector_ — Ext Apr .ch/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL (71TY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 C)C� INSPECTION DIVISION Business Line ;3)639-4171 MST BUP Received __ Date Requested AM___ PM BLIP Location Z Suite _ MEC Contact Person __ _ _ _ Ph(_—) _ PLM Contractor__ _ Ph(—) _ ___ SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain Slab inspection rlalotes SIT Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing ---- - --------------- ---- Firewall Fire Sprinkler - �-- --- - -- - — Fire Alarm Susp'd Ceiling Roof Other: — — Final PASS PART FAIL_ _ --- - PLUMBING Post& Beam — Under Slab -- _--_ Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: I _ A PARTFAIL A_NICAL_ _ Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL _ELECTRICAL Service ---- Rough-In UG/Slab Low Voltage _ Fire Alarm Final F_j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL SITE _ Please call for reinspection RE: _ F] Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date._ _ Ilnspelstor _ _ Ext Other:_ r Final DO NOT REMOVE this ieispection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST '�� INSPECTION DIVISION Business Line - (,5,3) 639-4171 BUP Received Date Requested `'�q AM PM BUP Location - _-_ - z� – —Suite MEC Contact Person _ Ph ( _) S/ PLM - - Contractor _— Phi ) SWR BUILDING Tenant/Owner _ ELC - Footing - ELC foundation Access: Fie Oram ELR Crawl Drain _.- Slab Inspection Notes: SIT Post R 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 -- ---- - -- -9h Ori Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain -- Shower Pan Other. Fi PASSRT FAIL - NICAL — Post& Beam / Rough-In Gas Line Smoke Dampers - - Final PASS PART FAIL —- -- —"- ELECTRICAL 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 RE: _ —.._ -__ l Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date- `'K Z �, Z Inspector � r , 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) 639-4175 MST INSPECTION DIVISION Business Line 33) 639-4171 - Received Date Requested BLIP - - — i_ocation _ _ ,, r ulte MEC -_ Contact Person — - -- Ph PLM -- - - Contractor Ph ( _ _ ) _ SWR BUILDING Tenant/Owner - - ELC Footing -� ELC Foundation Access. Ftg Drain ELR gray—- Inspection Notes, SIT Post&Beam Shear Anchors - F_xt Sheath/Shear Int Sheath/Shear Framinga. --'� Insulation - srz Drywall Nailing Firewall - Fire Sprinkler ---- -- t - n C Fire Alarm a' )AJ 0 -U1 Susp'd Ceiling ----. - _ - --- _'--- - Root Other ---- — Firtia} fiAS PART FAIL - -_�_ --- ---- - �Lt�_ Post& Beam Under Slab Ftouyh-In --- ------- ---- $ i ar Sew Aam Dr - Catch Basin/Manhole ��ot�we'. r_Pante .— Other: - — Fina AS PA FAIL — __ ftg'k IL — - Poet& Beam Rough-In Gas Line Smoke Dampers - Final PASS PART FAIL --- — ELECTRICAL 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 - — Pleare call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA . Inapertor ., �l Approach/Sidewalk Date Fixt� _ Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL