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12249 SW HOLLOW LANE :t a N N A U,? 2 O O r c� B �1 j I I; j( 1 12249 SW Hollow lane CITY OF TIGARD DUILDIN:a INSPECTION DIVISION MST 24-Flour Inspection Line: 635-4175 Business Line: 639-4171 �7 l BLIP --- �_ ---Date Requested _/_'7___�_ A M __PM BLD Location r'Z Z �! f c� /- /lor,�, _ Suite _ MEC Contact Person 'h '`"w,�— c(;' 3 7 PLM —� Contractor Ph SWR B IU LDING �" Tenant/OwnerELC Retaining Wail —�__-- -----_.._ �_ ---�-- ELR Footing Access __-- Foundation I FPS Ftg Drain -- AGN - - Crawl Drain Inspection Notes: --- ----- Slab SIT Fost& Beam -----_----- - -- ---- - Ext Sheath/Shear _ Int Sheath/Shear _ - Framing _f Insulation Drywall Nailing �- Firewall I/ / -- ------------__...--- ...._ Fire Sprinkler _-- _! �Jv , ��.n 4 lr r►cY ! _ - ----_ _ __-----_---- Fire Alarm i Susp'd Ceiling Roof — — Misc -- _---- -- — -- Final / PASS PART FAIL -- — -- ��_�!�;��^+res,e►i�; r p �+�i�.�sr p� -- __....-... PLUMBING Post& F team --- -- �_`-- -- _— --- — Under Slab I op Out _.- Water Service Sanitary Sewer Rain Drains Final PASS PARI FAIL r -- Post& earn I -- - -- -- —. _ Rough In res line IS noke Dampers '-PASS ` ART FAIL ttr_C7'RICAL Service Rough!n .-.—.----------- UG/Slab Low Voltage —...__---_— Fire Alarm _ Final � — — PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain + ( j Reinspection fee of$ _required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I I Please Gall for reinspection RE [ i Unable to inspect- no access ADA ApproachiSidewalk -7, Other Gate _- _� �_ —Inspector - �. .�_-"� r'c _.. ..__ Ext 36 z Final PASS —PART FAIL DO NOT REL'"OVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639.4171 - — BUP _ Date Requested_ AM— PM —�_ BLD Location--/ z2 Suite MEG Contact Person -- _ — Ph 2 c6P 3 % _ PLM Contractor — ,_ Ph —_ SWR BUILDING Tenant/Owner ELC Retaining Wall - ��--_-- "- ELR _--- Footing Access: -- _ Foundation FPS Ftg Drain Crawl Drain inspection Notes: SGN Slab Post& Beam _.._ SIT -- Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nailing Firewall - - - ------ -- Fire Sprinkler _ --------- _- -- ____ Fire Alarm ___ -- --- — -- Susp'd Ceiling Roof Misc Final --- ------ PASS PART FAIL -- --- - - --- —_— Post& Bearni -- Under Slab Top Out - ------- Water Service Sanitary Sewer -------- ---..-._. -- -- ----.--_ Rain Drains PASS,//PART FAIL �ANICAL Bost& Beam Rough In Gas Line - Smoke Dampers Final -_ - - -_ _ ------- ------- - -PASS PART PART FAIL. ELECTRICAL - - Service Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART 'FAIL SITE Backfill/Grading -- Sanitary Sewer Storm Drair [ ]Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Sarin Fire Supply Line ( ]Please call for reinspection RE:_ _ _ _ ( ]Unable to inspect-no access ADA Approach/Sidewalk J Date Inspector __ xt Final Pj1lifA PART FAIL DO NOT REMOVE this inspection record from the job site. 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Flour Inspection Line: 639-4175 Business Line: 639-4171 - BUP —_---Date Requested / _ �AM ______PM _ 13LD Location_/7-7-4 .51.,14Ile,k-/ 4,....- — Suite �> --- MEC _- Contact Person _ .. _ Ph ! �'- �d _-� PLM Contractor _—�—� Ph SWR -------- --- 13UILDING — Tenant/OwnerELG Retaining Wall --- --_— --_ ELR - ------- -.. Footing Access: Foundation FPS Ftg Drain SIGN Crawl Drain Inspection Notes -- --� - ----- Slab _ —_- �__`__`_.- SIT Post&Beam -- ------- --- Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing -�__--- Firewall Fire Sprinkler -�- _ ----- - ----- -- Fire Alarm Susp'd Ceiling - -- — - Roof Misc: — —-- Final PASS PART FAIL - ------ PLO BING _ Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam ------_-- — Rough In Gas Line I - ---- - --- --- -- -- Smoke Dampers Final - -- - --- - �- PASS PART FAIL Service Rough Ir. UG/Slab __--_.—_ I-ow Voltage File Alarm — ------- —--- F' ASSS~'PART FAIL --------_�---- --•----------_- - -____ _ __-.-- _ Backfill/Grading - Sanitary Sewer Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please call for reinspection RE:.�- _ ( ]Unable to inspect no access ADA Approach/Sidewalk Date -�( Inspector Ext Other ----- ------ Final PASS PART FAIL DO NOT REMOVE this inspection record from the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION Msr ��_�, r 24-Houi Inspection Line. 639-•4175 Business Line: 639-4171 — BUP ----- - Date Requested —_ 7-1 'Z__ —AM_.r_ PM _ — BLD ---- --- Location / Z Z `/J S4 - c'��o a� G,.� Suite MEC _ Contact Person _ _ Ph 4!� '7 �S 7-- PLM Contractor — Ph _ SWR ^- Tenant/Owner _ - ELC Retaining Wall �r T ELR Footing - - ---- - _ Foundation Ar;cess. FPS Ftg Drain -_ __--.-._.------__--- Crawl Drain Inspection Notes: -'� SIGN Slab ---_--__--- ----- ---- - - Post& Beam SIT Ext Sheath/Shear Int Sheath/Shear --- Framing Insulation Drywall Nailing _-- Fiiewall -- ------ - -- Fire Sprinkler — - Fire Alarm ---- Susp'd Ceiling - Roof - �__ _--------__.-_ M1K ___ -- --- ---- ----- —_ -- - � Fi I- S' PART FAIL `. _— _ Pf t3ING Post& Beam ----- ---- ----- - - --.. Under Slan Top Out --- - - Water Service Sanitary Sewer - -- - - Rain Drains Final PASS PART FAIL ------ ----- MECHANICAL. - - -�-`-- Post R Beam - ---- --- --- -- _-• _--- Rough In Gas Line ----------------------- -- - --- Smoke Dampers Final - PASS PART FAIL ELECTRICAL Service Rough In - UG/Stab Low Voltage ----- -- --'-- Fire Alarm Final ---_--------_ SSPART FAIL ---- ..., _� ----------_-__-- ---- --- -- - _-._ _____. IT Backfill/Grading ------- - ---- --- __.—_ _._ Sanitary Sewerp � Storm Drain �I I j Reinspection fee of$_ -required b0ore next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ J Please call for reinspection RE'. Fire Supply Line [ J Unable to inspect-no access ADA roach, /Sidewalk ` Y` Ot r u-v.,�� Date �..t � L'.�� Inspector_�.,�.�.___ E l tS PART FAIL DO NOT REMOVE this inspection record from tho job site. a Y "x O tv °tS � Y 1 C rti, ✓ L tr, Le V O R` O a � � J v Q, b v u 4� z o ,o O C ro c7 •." � c CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Bus°ness Line: ,39-4171 — BLIP ,_ —_-Date Requested_ Z"" AM v PM _ _ BLD _ Lo#:ation Z Z Z q� S 1 ) Ile,&°w Suite _v MEG Cornact Person _ — Ph s/f- `'S� Z- PLM Contractor —_ Ph - SWR BUILDING Tenant/Owner ELC Retaining Wall � ---�— ELR -- -------- ---� Footing Access: ------ _— Foundation FPS Ftg Drain Crawl Drain Inspection (votes: SGN Slab - SIT Pcst&Beam --- ---- Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nailing -_-- Firewall Fire Sprinkler Fire Alarm -- -- - ---- --- Susp'd Ceiling -- --- ---- - ---------_-------------- —�.---- Root Misc:_ _ ----- _... ------ — - _. _ —._-.-- -- --- ---- — Final PASS PART FAIL ----------.-----_---- _ -- _— - Post&Bea - .- -------- ---- — - Under Slab Top Out %0- Water Servi "� ----- Sanitary Sewer -- ---- - Rain Drains PASS PART FAIL -- ---------- *MCTi ANICAL --- Post&Beam - - - Rough In _ Gas Line --- Smoke Dampers Final -- - - PASS PART FAIL ELECTRICAL - Service Rough In - -- --- -- UG/Slab Low Voltage Fire Alarm Final ---. -- - --- PASS PART FAIL SITE BackfillIGradii iy -- - - Sanitary Sewer Storm Drain ( j Reinspection fee of$ -- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please call for reinspection RE: Fire Supply Line [ j Unable to inspect-no access ADA Approach/Sidewalk _ I t Crate � \ A ,( L,_� CCCJJJ _ S Other InspeCt�r Ext - Final PASS PART FAIL_ DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION Di'VISION MST 24-Hour Inspection Line: 639-4175 Business Line. 639-4171 -- BUP — Date Requested AM_ PM _ BLD Location !� /�C 11C,6LJ ��rv� �' — Suite _ MEC Contact Person _ _ Ph PI-M Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall v ELR Footing Access: Foundation FPS Ftg Drain ------ SGN Crawl Drain Inspection Notes. --- Slab — _ SIT Post&Beam ! --- --- Ext Sheath/Shear �'�'O '— `' a/ r;7 /� Y Int Sheath/Shear — Framing _ Insulation _ Drywall Nailing _ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof — Final PASS PART FAIL PLUMBING Post& Beam --- - -- — - Under Slab Top Out — Water Service Sanitary Sewer __---__-- Rain Drains Final _------ — _- PASS PARI FAIL MECHANICAL Post&Beam - --- - - Rough In Gas Line -- -- ----- Smoke Dampers Final ---- -_—_— — P T FAIL ELECTRICAL' -� --- -- Roush In ----------_-_---------_--- _ UcVslab -------------- - -- ----- —_._—_ __ __� W Voltages �i ASS jPART FAIL S Backfill/Grading �------ -�� --'- Sanitary Sewer ;.'-torm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ j Please rall for reinspection RE:— —_ [ I Unable to inspect-no access Fire Supply Line ADA _ Approach/Sidewalk Other Date �16 Inspector — Ext _ - ---- ----- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. Iww CITYof TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PI_M2001-00225 1312.i SW Hall Blvd.,Tigard, OR 97223 (503) 639-A171 DATE ISSUED: 06/04/2001 SITE ADDRESS: 12249 SW HOLLOW LN PARCEL: 2S103CB-06000 SUBDIVISION: QUAIL HOLLOW- EAST ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES_ _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of back flow preventer device. FEES___ _ Owner: — — — � Type By Date Amount Receipt DON MORISSETTE HOMES PRRAT CTR 06/04/2001 536.25 27200100000 4230 GA.LEWOOD ST#100 5PCT CTR 06/04/2001 $2.90 27200100000 LAKE OSWEGO, OR 97035 — — — Total $39.15 Phone 1: 503-387.7538 Contractor: PRnGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 682-6076 RFinal Inspection Reg#: I.IC 6136 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 accordant. 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. ATTENTI014: 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 952-00010080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued By: .,�/' ,f' , -- Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plwnbing Perliiit pplie"ltion _�� rDatereccived: e Pcnnit no.:�Lr112001 -rt(,>tty of rigard `, / (� ermit no. Buildin Address: 13125 SW Ifall Blvd, igard,O i gpermitno.: CrryafTigard phone: (503) 639-4171 --'� - Project/appl.no.: Expiredate: Fax: (503) 599-1960 t pateissucd: By Receiptno.: Land use approval: Case file no.: Payment type: 1 701 2 family dwelling or accersory U Commercial/industrial U Multi-family U Tenant improvement construction U Addition/,ilteration/replacemenr U Food service U C)ther: __ ___ niiiiiiiiiiiill JORSITEINFORMATIOF4 FEC SCIIEDULEI(or , , � QJob address:/dJt1y ,>tL' Jd- , LLL' sIr e(ea.) 'total Bldg.no.: Suite no.: Ne)v 1-and 2-family dwellings only: Tax map/tax lot/account no.: / - (includes 10011.foreachutility connection) SFR(1)bath Lot: Block:_ Subdivision�y UtC - 6-Vj( SFR(2)bath s Project name:QuO-L.�- j I L SFR(3)bath City/county: T7ycLtcC U-3/1914ZIP: Each additional bath/kitchen Description and focatf n of work on premises: Siteutillties: i/9C:ft 7 tt7u (BUJ rC ' Catch basin/area drain Est.date of completion/inspection: b Drywells/leach liue/trench drain — I tmimaiiiii Footing drain(no.lin. it.) Manufactured home utilities Business name: J-1 ((,riwS L114 CAA, Zn C� _ Manholes Address: c9ci C/ SW Jc kQ Rain drain connector - City: ( 1 t�vy-yI t C State:C:2- ZIP;9 7( ) Sanitary sewer(no.lin.ft.) -- - PhoneI Fax:&W- %1' E-mail: Storm sewer(no.lin.ft.) cc I Plumb.bus.reg,no: Water service(no.lin.ft.) City/metrolic.no.: / Fixture or Item: Contractor's representative signature: = C� Abso tion valve Print name: / t Datef`" %� C7 Back flow reventer 55 -17 r Backwater valve CONTACTBasins/lavato Name: 0 L/- rZ0 Clothes washer Dishwasher Address:- <�L' 'Sto tS1 iii .7 Drinkinofountain(s) City. I I)Il 1. �Ile, IState:( ZIP; C117&70 Ejectors/sump_ Phone: I Fax:68,�-c1E-mail: Expansion tank Fixture/sewer cap Name(print):J)C,--p1 Mt,-rC S set7l' - Floord'alns/floor sinks/hub Mailing address: 3u au Ci � r`,c:,�>CC- Sr- Hose di��al city: e bib-) Y (,1,�t( ' (~l,�t.t r , State:C{` ZIPS (103 raakrPhone: ax: Email: rcepior/grease trap Owner instal lation/residential maintenance only: The actual installationmer(i) will be made by me or the maintenance and repair made by my regular of drain(comma[^ial) employee on the property I own as per ORS Chapter 447. Sin (s),basin(s),lars(s) Owner's signature: Date: I Sum am 1,210101 Tubs/shower/shower pan Name: Urinal ` Water closet Address: Water hentet City: State; ZIP: Other: Phone: Fax: E-mail: _ I Total Not all Jurisdictions accept credit cards,please call Jurisdiction for more infortnad In. Plan review fee................$ _� '• �J_ Nance:This permit application O Visa 0 MasterCard expires if a permit is not obtained Plan re�+iew(at _ 5'0) $ Credit cud number: — - / / within 180 days•s after it has been State surcharge(8%) ....$ of cardholder u shown on arc it ear accepted as complete. Expires TOTAL .......................$ r—fie S Cardholder sl;ntwe Amount 40-4616(KCCOM) PLUMBING PERMIT FEES: New1acid2•faml�dwellings.only: . .T. FIXTURESIn � : QTY ea '.'; CAMOUNT (includes all:plumbiri8 iir`tures In PRICE 'TOTAL Sink 16.60 the dwetling and the ffrsf100 ft. QTY (ttaj ': i�MOUNT Lavatory 16.60 for each utilityconnectlon rY One 1 bath $249.20 Tub or Tub/Shower Comb. 16.60 _ Two(2)bath $350.00 Shower Only �~ 16.60 Three(3)balls $399.00 _ Water Closet 16.60 SU6Tt...aL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL �- Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor DraWFloorSink r 16.60 16.60 PLEASE COMPLETE: 4• 18.60 � _ Weser Heater 0 conversion 0 like kind 16.60 Qua Gas piping requires a separate mechanical Fixture Type: New Movedntity Rernaved! Replaced ;Work Performed Moved : . ermit. MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavato Tub or TublShower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only _ Drinking Fountain 16.80 Water Closet _ 16.80 Urinal - Other Fixtures(Specify) Dishwasher _ Garbs a Dissal Ca-undry Room Tray Washing Machine Floor Drain/Sini;: 2" Sewer-1st 100 i 65.00 3" Sewer-each additional 100' 46.40 4" _ Water Service-1st 100' 55.00 Water Heater --• Other Fixtures Water Service-each additionai 200' 46.40 Sed Storm 6 Hain Urain-1st too' E5.00 Storm b Rain Drain•each additional 100' 46.40 - Commercial Back Flow Prevention Device 46.40 "- Residential Backflow Prevention Device' f 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specialty 72.50 Requested Inspections er/hr _ _ COMMENTS REGARDING ABOVE: Rain Drain,single famlly dwelling 65.25 _ Grease Traps 16.60 - ---- QUANTITY TOTAL Isometric or riser diagrer,a required It Ouanl Torat is >g_'S "- - UBTOTAL S 8%STATE SURCHARGE -- -- -- - - " - "PLAN REVIEW 25%OF SUBTOTAL Required ons if fixture qtY total Is>g TOTAL $39 /J Minimum permit f 2 Is 571.54 t °.state surcharge,except Residential Backflow Prevention Device,which Is Sae 2S• 46 state surcharge "All New Commercial Buildings require pia,!with Iserretrc or riser diagram and plan review I,\dsts\forms\plm-fees.doc 10110/00 CITY O F T I G A R D ELECTRICAL PERMIT- � RESTRICTED ENERGY DEVELOPMENT' SERVICES _ PERMIT#: ELR2001-00137 13125 SW Hall Blvd., Ticiard. OR 97223 (503) 639-4171 DATE ISSUED: 5/10/01 SITE ACORESS: 12249 5W HOI_LOl,1/ LN PARCEL: 2S 103CB-06000 SUBDIVISION: OLIAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIC Proiect Description: Installation of wiring tnr audio/stereo and hurglar alaim systems A.RESIDENTIAL B.COMMERCIAL AUDIO & STEREO:yX AUDIO & STEREO: INTERCOM & PAGING: BURGLAR At-ARM: X BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMPA: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL.. INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: Owner: Contractor: DON MORISSETTE HOMES OWNER 4230 GALEWOOD ST#100 LAKE OSWEGO, OR 97035 Phone: 503-387-7538 Phone: Reg #: _ FEES Required Inspections Type By Date Y� Amount Receipt Low Voltage Inspection 5PCT ':TR 5/10/01 $600 2720010000 Elect'I Final PRMT CTR !,10/01 $7500 2720010000 Total $81.00 This Permit is issued subject to the regulations contained in t`, , Tigard Municipal Code, State of OR. Specialty Cc des 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 dzgs .ATTENTION Oregon law require,s,yoa-e-fnjloV/ rules adopted by the Oregon Ut"ity Notification Center. Those rule- are set forth in OAR 952 0010 '.nro g'h OAR 952-001-0080 You may obtain copies of these rules or dira t questions to OUNC at (503) 2.46 1987 Iss ed by 4Permittee Signature OWNER INSTALLATION ONLY The installation is being made o r perty I own which is not intended for sale. lease, or rent. i OWNER'S SIGNATURE: ? Z' �� i DATE: r, �^ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. EI_EC'N DATE: LICENSE NO: --� ---__—� -_—_--- _®- Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical permit Application Date received: /p Permit no.: AM city of Tigard Project/appl.no.: Expiredate: `Yn /'I'iwtrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dute issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: U I & 2 family dwelling or accemory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addifion/alleratir;n/reph,,tit(-tit U Other:-_ U Partial Joh address: 1'Z`! `3 1��(��" L','•P '%rr ^�r� r l� lia.lg.no.: Sunt no.: Tax map/tax lot/account no: Lot: C Block Subdtvlsion: (two• .� �w Project name: �Descripdon and location of work on premises: Estimated date of completion/insprAwn A?PLICATIONI Job no: i ec M1t:tt '— -- Ikwcriplioa BusiQ1t. (ca.) Iotal no.insp ness name:,•, � 1 / — -- - Newrrsidcntial singkormulti-familyper � i Address: d/rang unit.I w hjdew attached garage. City: State 1 /11' %ervicelmiuded —�--�: I(x)0 sq.ft.or IeSS 4 Phone: Fax: I L mail: _ - — Ea^_h oddttional SW sy.n ,,h,,;u-n ih'mol CCB no.:u Elec.hos.lie.no: Limited energy,residential _ _ 2 City/metro hc.no.: Limited energy,non-residential 2 Bach manufactured home or modular dwelling Signature of supervising electrician(required) hate �— Service and/or feeder _ 2 Sup.elect.novae(print): t i.-rise no: Serrlces or feeders-installation, alteration or relocation: 200 anyts or less 2 (print): ' l - t i j 201 amps to 4W amps — -- 2 Name Kr r - 401 amps to 6110 amps 2 Mailing address: �' - C��Q L,,, 'V L- _ 601 amps to I(100amps 2 City:.—.` r)In kllp lstatht;, ZIP: `I]!_)(e over I(NlOamps(it ynits Y 7 Phone: �c c 1tZL I Fax: ( L mall: Reconnectonly - I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to In illation,alteraflen,orrelocation: ORS 447,455,479, 7011. 201 amps of 00 2 r� �// Z01 amps to 400 ernes 2 (h,:nc�r's signature / Calc: ��t 401 to 60f1 amps ' -------- ---- --- Branch circuits-new,allerallon, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit __ 2 City: T Slate: 1.11: B. Fee for branch circuits without purchase �' —�-- - — of service or feeder fee,first branch circuit. 2 Phone: has I?-mail Each additional branch circuit. Mhe.(Servlet or feeder not Included): U Service over 225 t.mps-commercial U Healdreate facility Each pump or irrigation circle 2 U Service over 320 amps-rating or 1&2 U Hazardous location Each sign or outline lighting _ 2 familydwellings U Building over 10,000 syuatc lcct(„„t„t Signal circuit(s)or a limited energy panel. U System over 6110•Alstiommal more residential units in one structure alteration,or extension” 2 U Building over three stories U Feeders.4M amps or more •Descrit om. U Occupant load over 99 persons U Manufactured structures or RV park Fich additional Inspection over the allowable In any of the above: U Fgress/lighungplmt U other -- Perinspection Submit sets of plans with anv of the above. Investigation fee The above are not applicable to temporary construction wirvice, other Not all jurisdictiom wvept credit cardstrio re pletse call jurisdiction rot tre infomtation Notice:This permit application Permit fee.....................$ U Visa U MasterCard exph zs if a permit is not obtained Plan review(at _ 9E) $ Credit card number:r — within 190 days after it has been Slate surcharge(8%)....$ splro' accepted as complete. tit — _ ------ TOTAL .......................$ Name of can ;older u shown on ctrdi:card Cardholderailinatare — -- Amount 440-46 Is, JM) r Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL FShedule Below: ONLY Complete Fee c ---- — - p Restricted Energy Fee...................................................... $75-00' Number of Inspections per permit allowed (FOR ALL SYSTEMS) Servi:e inciudeo: Items Cop i Total Check Type of Work Involved: Residential-per unit 1000 sq,ft or less y $145 15 4 Audio and Stereo Systems Each additional 500.;q.ft.or porlion thereof $33 40 -__ 1 Burglar Alarm Limited Energy _— $75.00 _ u Ea,:h Manufd Home or ModularC] Garage Door Opener' Dwelling Service or Feeder $9090 7_ Services or Feeders Heating,Ventilation and Air Conditioning System' .,rstallation,alteration,or relocation 200 amps or less $80.30 2 Vacuum Systems' 201 amps to 400 amps _ $106.85 _ 2 401 amps to 600 amps $160,60 601 amps to 1000 amps _ $240Other .60 2 ---�- -- - —Over 1000 amps or volts $454.65 2 Reconnect only $66.85--� 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system......................................................... $75.00 Installation,alteration,or relocation 200 amps or less $66,85 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps ^_ $13375 _~ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits � Boiler controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or C:oCI(Systems feeder fee. �—1 Each branch circuit $665 _ 2 L J Data Telecommunication Installation b)1 Fre fee for branch circuits without purchase of service L—_I Fire Alarm Installation or feeds,fee. First branch circuit $46.85 (�j HVAC E,-ch additional branch circuit $6.65 u Miscellaneous ❑ Instrumentation (Service or feeder not included) Each PL mp or inigation circle $.53.40 _ _ � intercom and Paging Systems Each sign or outline lighting $53.40 _ Signal circuits)or a limited energy panel,alteration or extension $75.00 _ ❑ Landscape Irrigation Control' Minor Labels(10) ,y $125.00 _ Medical Each additional inspection over ❑ the allowable in any of the above Nurse Calls Per inspection _ $6250 Per hour $62 50 In Plent $73 75 _ Outdoor Landscape Lighting* Fees: l� Protective Signaling Enter total of above fees $ l Other 8.1.State Surcharge $ ___Number of Systems 25%Plan Review Fea — -- — See"Pian Review'section an $ No licenses are required licenses are required for all other installations front of application Fees: Total Balance Due $ - — Enter total of above fees ❑ Trust Account#, _ 8%State Surcharge = _. Total Balance Due = i klstslfonm\elc-Pecs doc 10/09100 CITY OF T I G A R D _ MASTER PERMIT C PERMIT#: MST2001-00147 DEVELOPMENT SERVICES DATE ISSUED: 4/10/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12249 SW HOLLOW LN PARCEL: 2S103C13-06000 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. path 1 BUILDING REISSUE. srOR1ES: 2 FLOOR AREAS REQUIRED SETBACK!i REQUIRED CLASS OF WORK: NEW HEIGHT: 19 FIRS f: 1,890 of BASEMENT: ■1 LEFT: 5 SMOKE DETECTORS. v TYPE OF USE: SE FLOOR LOAD: 40 SECOND: 1,070 of GARAGE: 624 of FRONT: 20 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 5 VALUE: $271,00800 OCCUPANCY GRP: R3 BDRM: 2 BATH: < TOTAL: 2,96000 of REAR: 15 PLUMBING -- SINKS: 1 WATER CLOSETS: 2 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS LAVATORIES: 3 DISHWASHERS: I FL OOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS. TUBISHOWERS -.I GARBAGE DISP: I WATER HEATERS I WATER LINES. 1D0 &CKFLW PREVNTR 1 GREASE TRAPS. OTHER FIXTURES: MECHANICAL _ FUEL TYPES FURN<100K. BOIL/CPAP<3HP: VENT FANS: 4 CLOTHES DRYER: I ,,AS FURN—1001: 1 UNIT HEATERS HOODS: I OTHER UNITS: I MAX INP: blu FLOOR FURNANCES: VENTS: I WOOD5TOVES: GAS OUTLETS- 1 ELECTRICAL_ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFI--EDERS BRANCH CIRCUITS MISCELLANEOUS_ ADD'L.INSPECTIONS 1000 SF OR LESS: 1 0 200 amu'. 0 200 amp: WISVC OR FOR I PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF 6 201 400 amp: 201 400 amptot WIO SVCIFDR: np SIGNIOUT LIN LT: PER HOUR. LIMITED ENERGY: 401 600 amp 401 800 amp' FA ADDL BR CIR: SIGNALIPANEL. IN PLANT: MANU HMISVCIFDR. 001 • 1000 amp: 601•amps-1000x. MINOR LABEL: 1000+amplvolt: PLAN REVIEW SECTION Reconnect onlV: >-4 RES UNITSSVCIFDR-225 A >000 V NOMINAL CLS AREAISPC OCC: : . ELECTRICAL•RESTRICTED ENERGY •___ J A,SF RESIDENTIAL � B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO 9 STEREO: FIRE ALARM: INTERCOMIPAGING OUTDOOR LNDSC LT BLIRGLAR ALARM: OTH. BC;LER: HVAC: LANDSCAPFIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER. CLOCK: INSTRUMENTATION: MEDICAL. OTHR ~ HVAC: DATA7TELE COMM: NURSE CALLS. TOTAL#SYS TEN S TOTAL FEES: $ 4,540.28 Owner: Contractor: This permit is subject to the regulations contained in the DON MORISSETTE HOMES DON MORISSETTE 'AOMES Tigard Municipal Code,State of OR Specialty Codes and 4230 GAI_EWOOD 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,or 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 Notification Center Those rules are set Rep#: LIC 35513 forth in OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Line Insp Final inspection Fooling Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwik Insp Building Final Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Postl'Beam Structural Mechanical Insp Shear Wall nsp Insulation Insp Mechanical Final — Issued By : --1--= Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT_ DEVELOPMENT SERVICES PERMIT#: SWR2001-00089 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/10/01 SITE ADDRESS; 12249 SW HOLLOW LN PARCEL: 2S103CB-06000 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 009 JURISDICT;ON: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING 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: — ,-- _ FEES DON MORISSETTE HOMES Type By Date Amount Receipt 4230 GALEWOOU ST#100 _ LAKE OSINEGO, OR 97035 PRMT CTR 4/10/01 $2,300.00 27200100000 INSP CTR 4/10/01 $35.00 27200100000 Phone: 503-387-7538 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections 1 his 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 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 Fide Sewer" Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-C91-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 2.45-1987 y: = _ Permittee Signature: \ -" Issued b �� Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next business day /77) �-- `.�� ' .1cec, eaQ8I Building Permit Application City of TigardDatereceived:a �p Permit no,:/8�,' City oJTigard Address: 13125 SW Hal �l Blvd,Tigard,OR 97223 - _ Projecdappl.no.: Expire date: -t Phone: (503) 639-4171 1l Date issued: By: IReceipt no.: Fax: (503) 598-1960 Case file no.: Payment type: tY Land use approval: 1&2 farnlly:Simple Complex: - U I &2 farnlly dwelling or accessory U Commercial/industrial ❑Multi-family &New construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: JOB SITE INFORM\TION Job address: r �j �� \t, Bldg.no.: Suite no.: Lot: Block: - Subdivision: t t, Z t ( Tax map/tax lottaccount no.:_'?,�:,le - e Project name: v j Description and location of work ori premises/spccial conditions: Narne..-Yt Mailing address: LLt I do 2 fatally dweftn City: Stated ZIP: ) Valuation of work...s .7�y. .V.. .......... $^ Phone: Fax: 7 mail No.of bedrewms/baths................................. _ Owner's representative: Total number of floors........... ..................... Phone: Fax: E-mail: New dwelling area(sq.ft. Garageicarport area(sq.ft.)......................... Name: ,Y iG Covered porch area(sq.ft.) ............... - - Mailing address: Cj, �� Deck area(sq. ft.) .................................I...... 3 _ City: Sta;e: ZIP: Other structure area(sq. ft.)......................... _ Phone: Fax: E-mail. Commercial/inductriallmulti-family: Valuation of work........................................ $ Existing bldg,area(sq. ft.) .................. ...... -- Business name: - ----- --- r t New bldg.area(sq. ft.) .............. ... .......... Address: --- ------- Number of stories ................ City: State: I ZIP: • Type of construction, Phone: Fax: E-mail: ........... ................ .. -- CCB no.: FJ r"J"�j 27 Occupancy group(s): Existing: --��.--------- New: City/metro lac.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name:-1 tr- , i�(' —� provisions of ORS 701 and may be required to he licensed in the Address: �� jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: -- - Phone: Fax: E-mail: _ -- Name: Contact person: Pees due upon application ........................... $ Address: Date received: _ City: _ State: ZIP: Amount received ...�.................................. S Phone: Fax: E-mail: Please refer to lee schedule. hereby certify I have read and examined this application and the Not all Jerisdictions accept credit cards.please rail jurisdiction for more mfomiation. attached checklist.AU tirovisions of I w-and o dinances governing this Uvisa OMastercard work will be comp) wi ,whether ecifu ere or n Credit card number _-, _ 1It t , _ Expires Authorized si natu ` 1te: Name of cardholder n shown on credit card � $Print name: —"Cmactider sip alure Amount Notice:This permit application expires if a peroit is not obtained within 180 days atter it has been accepted as complete. 440-4613 toMt One-and Two-Family Dwelling _Building Permit Application Checklist Reference no.: Associated permits: 01VrrjT'igurrl City of Tigard U Flectrical U Plumbing iU Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 u Other: Phone: (503) 639-4171 Fax: (503) 598-1960 1 land use actions completed.See_jurisdiction criteria for concurrent reviews. _ 2 'Zoning.McKA plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 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 U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin piotection,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 t/ if copyright violations exist. T F Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4-ft.elevation differential,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;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. _ T* 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 siring,spacing,and tearing locations.Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/oist_carrying a non-uniform load. 20 Manufactured floor/roof truss design detalls. 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 he shown to be applicable to the project under review. 23 Five(5)site plans are required for Item I I above. Site plans must be 8-1/2"x 11"or 11"x 17". 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 department use only. 444.614(6IOOICOM) Mechanical Permit Application --� Date received: 11400/0 Permit no.:If'r c City of Tigard Project/appl.no.: Expire date: CiryofTigard Address- 13125 SW Hall Blvd,Tigard, OR 97223 --- Phone: (503) 639-4171 Date issued: By: Receipt no: y Fax: (503) 598-1960 Case file no.. Payment type: Land use approval _�_-�-- -_- Building permit no.: TYPE OF PERMIT U 1 & 2 family dwelling or accessory U Comnu:rcial/industrial U Multi-family LI Tenant improvement >1�4ew construction U Addition/alteration/rcplacement U Other. JOB SITE INFORMATION1 1SCHEDULE Job address: LIV7, l 'v' LrA _ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/trot lot/account no.: �� profit. Value$ Lot: -1 Block: Subdivision: f�,Wu i 'See checklist for important application information and Project name: }" L jurisdiction's fee schedule for residential permit fee. City/county: "LIP: 1 &2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: 1 1 1 1 Fee(m) Total Est.date of completion/inspection: Description Qty. Res.only Res.only Tenant improvement or change of use: Air handling Is existing space heated or conditioned?Ll Yes U No Air conditioning unit _CFM _ (sne plan required) Is existing space insulated?O Yes L1 No Alteration of existing HVAC system Boiler/compressors State boiler permit no.: Business name i I( V� HP Tons BTU/11 Address: Fire/smoke dampers/duct smoke detectors City:, Stale' ZIP: Cj Heat pump(site plan required) Phone: Fax: Email: nsta rep ace fumace/bumer /I ---- Including ductwork/vent liner U Yes U No CCB no.: �� Instal I/rep I ace/re locate heaters-suspended, - City/metro lic. no.: N/A _ wall,or floor mounted Name(please print): _ 15 (�__(��-� Vent for ap liance other than furnace Refrigeration: Ab sorption units BTUM _ Name: `�; �L Chillers HP _ Address: L r Com re" HP _ - e omnenta exhaust an ventilation: City ^ State: ZIP Appliance vent Phone: Fax: E-mail: Dryer exhaust 'J cods, ypeV1Vres.Futchcnfhazmat hood fire suppression system Name: �� ! Exhaust fan with single duct(bath fans) Mailing address: )� �,' Exhaust system apart from heating or AC City State ZlP ) Fuel piping and distribution(up to 4 outlets) Type: LPG ___ NC Oil phone: 7- Fax: E-mail: uel nal over 4outlets rocessp It ag(schematicrequited) Name: Number of outlets — Address: _- — ter appliance or equ pment: Decorative fireplace CityState: ZIP:, Insert-type Phone: Fax: -mail otxtstove/pelleIstoye Other: _ Applicant's signore" Date: , I tit en Name(print): Not all junsdictiom accept credit cards.please call jun"cuon for more information Permit fee..................... on O Visa U MasterCard Notice:This permit not obtain Minimum fee................E —. expires if a permit is not obtained Credit card number — — s/ pints within 180 days after it has been Plan review(at , %) $ Name of cardholder as shoro on credit card - accepted as complete. State surcharge(8%) ....$ s TOTAL .......................$ Cardholder ri`natute Amount µp 1617(&"YC(7M) Plumbing Permit Application rDateived:� 0/ Permit('it of Tigard Y g rmit no.: Building permit no.: ;.ddress: 13125 SW Hall Blvd,Tigard,OR 97223 — — CUyof7ignrl Phone: (503) 639-4171 ProjecUappl.no.: Expire date: _Y Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ Case file no-_`— Payment type: TYPE OF U I &2 family dwelling or accessory U CommerciaUindustial PERMIT U Multi family U'I'enant improvement cw construction U AddiUontalteration/replacement U Food service U Other: IlSITE INFORMATION1 tInformal Job address: ' �� 't familyescrpdondwellings _ Fee ea. Total Bldg. no.: Suite no.: New 1-and 2-family dwellengs only: (include:1001t.for each utility connec(ion) Tax map/lax lot/account no.: SFR(1)bath Lot: eBltx:k: Subdivision: d HOIK4V SFR(2)bath --_ —� ---- - Project.name: ` ( . SFR(3)bath — City/county- ZIP: Each additional bath/ki(chen _- Description and location of work on premises: Site utilities: _ Catch basin/area drain _ Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no. tin. ft.) _ Manufactured home utilities Business name• 1tJU Manholes Address: , Rain drain connector City: ` State ZIP: Sanitary sewer(no. lin. ft.) — Phone.(C,-' Fax; E-mail: Storm sewer(no. lin. ft.) Water service CCB no.: "��- Plumb.bus. reg.no: - Fixture or item: lin ft.) Fi City/me,-o lie. no.: N/A - Absorption valve Contractor's r-oresentativ:signature �L`-" �W L3ack flow preventer -- Pnnt name: LI I Backwater valve Basins/lavatory Name:`1{��-� �P -L I�� Clothes washer Dishwasher Address: G 'ty �iV� _F Dnnking fountains) _ City State: ZIP: Ejectors/sump Phone: Fax: E-mail: Expansion tank Fixture/sewer cap Floor drains/floor sinks/hub Name (print): - � /= 1 � Garbage disposal _ Mailing address: _ Hose bibb _ City: l , State ZIP: C ice makerPhone - Fay r 7. ail: Interceptor/grease trap 0 neer instaUationlresidenaa/maintenance on/r: the actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s), lays(s) Owner's signature: Date: Sump Tubs/shower/shower pan Urinal Name: __. _—. Water closet Address. Water heater City: -- State: ZIP: Other. Phone: Fax: E-mail: Total Na all jurisdictions accept credit cards•please call jurisdiction for more informwonMinimum fee................$ _ — Notice:This permit application Q Visa Q MuterCud expires if a permit is not obtained Plan review(at _ %) $ Credit card number / / within 180 day „s after it has been State surcharge(8%)....3 - Expires accepted as complete. TOTAL........... .......... Name of cardholder as slwwn on credo card ---- Cardhaldkr afjrnature Amount aa(?Sfilb(f."1r'Oso Electrical Permit Application "Datereceioved ,�I,$Z`: /�l Perini,!ot �. Cit of Tigard _ - -- y b Project/appl.no.: Expire date: City ofTigard Address: 13125 SW flail Blvd,Tigard,OR 97223 Date issued: —--�- By: Receiptno.: — Phone: (503) 639-4171 — - Fax: (503) 598-1960 Case file no.: Payment type Land use approval: ■ I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant imptovenu•nt U New construction J Addition/al lerationhrplaceutenl U Other _ __ _-_ U Partial JOB SITE INI'ORMATION Job address: r _ C ( � ��_ �, Bldg. n... �tiuur no.: I;tr in,up/tax lot/account no.: Lo�� f3!tx k: Subdivision: U -Project name: Description and location of work on premises: �^ Estimated date of com letion/ins ction: Job no: _ Far MAX Business nam^: CITy F .TRIC?ANp Sl IPPI Y Description pry. (ea.) Total Ito_insp Nen m.idential-single or mailf-famlly per Address: 8900 SW BURNHAM ST F27 dtveliingunit.Includes sttachedgarage. City: rIGARD I state: Ori ZIP: 97223 "WI-Iiceincluded: Phone: 503-443-1092 1 Fax 503-625-305 E-mail: 1000 sq it.orless i Each additional 500 sq.ft.or pon thereof CCB no.: 42422 Elec,bus.lie.no: 26-2890 _ Limited energy,residrmial _ 2 City/met nor-(IO07_604 Limitedeneigy non residential 2 — r- Each manufactured home or modular dwelling sin tura of isin ectrician(iuired) Uate Service andior feeder Sup.elect.name(print); CHARLES FRIESEN License nn359 servicesorfeedenr-Installation, _ alteration or relocalr-n: 210 serape or k-Sr 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: Fax: I E-mail: Reconnectonly I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Inrhllation,niteration,orrelocallon: ORS 447,455,479,670,701. AM amps or less 2 201 amps to 400 amps 2 Owner's si nature: nate: 401 to 600 amps Branch circuits-nen,alteration, ar extension per panel: Name_ A Fee for branch circuits with purchase of Addr'Css: service or feeder fee,each branch circuit City: Slate: ZIP: It Fee for branch circuits without purchase - - - - ---' ---' - of service or feeder fee,first branch circuit. 2 Phone: I:tx E-mail: Each addiur.nalbranchcircwt� -- - Misc.(Service or feeder not included): U Service over 225 amps,„rnmercial U Health care facility Each pump or irrigation circle - 2 U Service over 320 amps-ratingof I&2 U Hazardcuslocafion Each signor outline lighting �_ 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited cortpv panel, U System over 600 volts nommal more residential units in one stnicture alteration,orextension' 2 U Building over three stories U Feeders,400 amps or more •lkscrition U Occupant load over 99 persons U Mnnufaclured structures or RV park FAch additional inspection over the allowable In any of the above: U Egress/lightingplan U Other: ----- Perinspection E7 Submit -_sets of plans with any orthe above. Invest! allon fee The above are not applicable to temporary construction service. other -� Not all jurisdictions accept credit cards,pleacall jurisdiction for Inner infomwwr- Notice:This permit application Permit fee.................. ..$ ac - U visa U MasterCard expires if a permit is not obtained Putt review(at — %) $ Credit card number' _ /_/ within 180 days after it has been State surcharge(S%) ....$ Explie& accepted as complete. TOTAL .......................$ — - �Name of c alder u shown on credit card _ Cardholder signature -Y� Amosint 440-4615 t6t WOMI 04/11/2001 19:11 15036:302882 JARhINE PLUMBING F'A(-3E 021 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE JARDINE PLUMBING P O BOX 186 ESTACADA, OR 97023 Plumbing Signature Form Permii #: MST2001-0014/ Date Issued: 4110/01 Parcel: 2S 103CB-06000 Site Address: 12249 SW HOLLOW LN Subdivision: QUAIL HOLLOW - EAST Block: Lot: 009 Jurisdiction: TICS Zoning: R-4.5 Remarks: r�)nstruction of new single family detached residence. path 1 Y our company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return This Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept No plumbing inspections will be authorized until this completed form is received OWNLR: PLUMBING CONTRACTOR DON MORISSETTE HOMES r.'1RDINE PLUMBING 4230 GALEWOOD ST #100 P O BOX 186 LAKE OSWEGO, OR 97035 ESTACADA, OR 97023 Phone #: 503-387-7538 Phone * Keg #: LIC 108747 PI_M 3-320PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X r Signatur uthori7ed Plumber f you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CITY ELECTRIC + SUPPLY CO 8900 SW BURNHAM F-27 TIGARD, OR 97223 Electrical Signature Form Permit #: MST2001-00147 Date Issued: 4110101 Parcel: 2S103CB-06000 Site Address: 12249 SW HOLLOW LN Subdivision: QUAIL HOLLOW - EAST Block: Lot. 009 Jurisdiction: TIG Zoning: R-4.5 Remarks: Construction of new single family detached residence. path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: DON MORISSETTE HOMES CITY ELECTRIC + SUPPLY CO 4230 GALEWOOD ST #100 8900 SW BURNHAM F-27 LAKE OSWEGO, OR 97035 TIGARD, OR 97223 Phone #: 503-387-7538 Phone #: 641-8012 Req #: SUP 3592S LIC 42422 FLE 26-289C AN INK SIGNATURE IS REQUIRED ON THWPO X Si na . of Su ervisinian 9 P 9 If you have any questions, please call (503) 639-4171, ext. # 310