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12275 SW Hanco:k Court
CITY OF TIGARID 24-Hour
BUILDING Inspection Line: (5 4175
HAST --.—
INSPECTION DIVISIONT4'LC)uj Business Line: ( _4171 SUP __—
s�m /
Received Date Requested___ Co 36 AM. _. PM BLIP
r- ,
Location -._.—r_ —��y:-_.___� �-f _ r_.=:�-Suite —7 MEC
7T
Contact Persun -___._..--__—_ ": — PI ( ) �� PLM _
Contractor _-------....— . _--- Ph(--) _-- --__-- SWR -_--
BUILDING - Terant;Owner —..____ ___ - EL•C -- --
Footing ELC
Foundation A&G-S: -
ftg Drain ELR _--_- _--- ---
Crawl Drain
Slab Inspection Notes: SIT _ -- --
Post&Beam --- -_- - ---- _
Shear Anciwrs �/1 _ �
Ext Sheath/Shear ---
Int Sheath/Shear -
Framing
Insulation ,/► ' ) 61
Drywall Nailing -- _
Firewall ��`7- e _ - ���•-• ---.
Fire Sprinkler
Fire Alarm _
Susp'd Ceiling --- —�(� —�
Roof (L
_�tiyQ
Other. — 1 �--
7 124)
PASS PAR
IT
Post& Beam ----- \_�-�_�4�. �G Z 12 d °
Under Slab - -
Rough-In
Water Str\,ice `
Sanitary Sewer I ��Q� ��----�,r`�,•✓�. �����— —
Rain Drains - - -
Catch Basin/Manhcie LJ
Storm Drain — --- ��-
K::� -4-
Shower Pan — t 0002:Final '-- _ - f2--�1w� �..'yy 0= - —
PASS PART_
MECHANICAL
Post& Beam
Rough-In ---------- -- ---- ---- ------ —
Gas Line
Smoke Dampers -- - - -- -- ----- __--
na
PART FAIL -- ---- - -- - -
s6ECTWAL —
Service ---- -.__ _..---------
gough-In
UG/Slab ----------- ------- -_-._--
Low Voltage --_-- _ _---------____
Fire Alarm
Final Reinspection fee 0$___—__—required before next inspection. Pay at City Hall, 13125 SW Hell Blvd.
_PASS PART_FAIL
SITE Please call for re,nspection RE: -__ _-_—..___.__. L] Unable to inspect-no access
Fire Supply Line
ADA Date _3dLam( 4C� 7 I19spoef:oi'
Approach/Sidowalk
Other
Final DO NOT REMOVE this inspection record from the job site.
PALS PAPIT FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)530-41,5 7
INSPECTION CIVISION Business Line: (503)53£-4,171 MST -_
BUP
1;
7 - 1
ReceivedDate Requested—�_ -,i-AM PM BU
Location c�- -] VG� CC Suite - MCC
Contact Person Ph ( S' _5 ! PLM Contractor - ---- --—�_ Ph( ) — -- T_ SWR
BUILDINw 7enanUOwner ---_.N----- ELC
Footi,,ig -_-�
Foundal n Access: ELC
Ftg Drain ELR —
Crawl Drain
- ---
Slab Inspection Notes: - -�- SIT
Post R Beam , l %t,-,f ►�1 S �. �SL�I(�/�/� ---- -—
Shear Anchors — --_-
Ext Sheath/Shear
Int Shaath/Shear
Framing J�
Insulation 14 -- � Q •.. L --
Drywall Nailing V v 1
Firewall 1 I _ I D� �a
Fire Sprinkler - 1 ►'J - —
Fire Alarm C (�ti-� O
Suep'd Ceiling � -•— l 1/ Gtn,l
Roof
Other:,�__—
PASS BART FAIL - —
eam ' �•`
Under Slab
Rough In �`,� - G U
r Service ice
Sanitary Sewer "'t..1
Rain Drains — `
Catch Basin/Manhole
Storm Drain `
Shower Pan
in
PART FAIL —
_ ANICAL
Post& Beam —
Rough-In
Gas Line —- —
i
Smoke Dampers -
Final
PASS PART FAIL - ---
ELECTRICAU
Service _ -- - ----- -- r=- _
Rough-In -
UG/Slab -
Low Voltag 3
Fire Alarm ---- --
Final 0 Reinspection tee:of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_P_AS_S PART FAIL
SITE—� _ Please call for reinspection RF: -_. Unable to inspect-•no across
Fire Supply Line
ADA
Approach/Sidewalk Date `/ 6 Ir+r peetor _ w- _Ext ---_
Other:
Final DO NOT REMONIF this Inspection record from she job site.
PASS PART FAIL
CITY OF TIGARD ;14-Hour
Inspection Line: (503 A• 175
BUILDING Inspection _
INSPECTION DIVISION Business Line: (5 )GU9,417 SDP
Received __ Date Requested_ -3C� AM—��—PM - SUP - ----_-
a 7 S` �?�-D��if� Suite--------- MEC
Locat`,on •-
Contact Person , Ph( ) -- PLM —
Contractor__.._.___. __ Ph( ) SWR -
BUILDING Tenant/Owner _____ ELC
Footing ELC
Foundation Access:
Fig Drain ELR
Crawl Drain - SIT
Slab Inspection dotes:
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 _T-
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: -
SS PART FAIL
---- ANICAL
Post& Beam
Rcagh-In -__...
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL_
Service
Rough-In _-
UG/Slab
Low Voltage ----
Fire Alarm
Final RRinspection fee of$_--______.____ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS BART FAIL
81T0. Please call for reinspection RE __ __ ____.__—__.___—_.___ - Unable to inspect-no access
Fire Supply Line
ADA l,(/ �.
Approech/Fidewalk Date-_�—�__._-�_ Insp�!a�,�r Ext
_____�./" __— __—
Other.
Final - DO NOT REMOVE this 1irspectioll r,,icord Com the job s1te.
PASS PART FAIL
CITY
OF
T I G /�H R D _ PLUMBING PERMIT Y_
`(>�' PERMIT#: PLM2003-00265
' DEVELOPMEN-f SERVICEs DATE ISSUED: 6/12/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103CC-11700
SITE ADDRESS: "122.75 SW HANCOCK CT ZONING: R-4.5
SUBDIVISION: WHISTLER'S WALK JURISDICTION: TIG
BLOCK: LOT: 064 -- -— _
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOCILE HOME SPACES:
TYPE OF USE: ` L WASHING MACH: BACKFLOW PREVNTRS:
FLOOR DRAINS. TRAPS:
OCCUPANCY GRP: R3 CATCH BASINS:
STORIES: WATER HEATERS:
LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS-
URINALS:NALS:
_
FIXTURES-,---- GREASE TRAPS:
NKS"
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS. WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install irrigation backflow device. FEES
Owner: Description Date Amount
DON MORISSETTE HOMES IPLUMBi Permit Fee 6/12/03 $36.25
4230 GALEVVOOD ST tTAX] 8%,State Tae 6/12/03 $2.90
STE 100
LAKE. OSWEGO, OR 97035 Total $39.15
--
phone : 503-387-7538
Contractor:
LANDSCAPE OR--GON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone : 503-692-5945 Final Inspection
Reg#: PLM 7804
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 pertoit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699.
Issued By:
Permittee Signature: I
�i, ,_- _- 1.._—__
Call (503) 639-4175 by 7:00 P.M.for an inspection needed the next business day
Jun 12 03 07: 55a clan edlnonds 503-692-0768 p. 2
a
Plumbing Permit Application Received Plumbing
Date/B :•% Corntit No.. ,.r• ---
Planning Approval Sewer
City of Tigard Ua►e/dy: _ Permit No.:
13125 SW Hall Blvd. Plan Review other
Dale/By: Permit No.:
Tigard, Oregon 97223
Po:t-Review land Use
Phone: 503-639-4171 Fax: 503-596-1960 Date/By: Case No:
Internet: www.ci.tigard.or.us Contact 1uNs.: 1 29 See Pace 2 for
24-hour Inspection Request: 503-639-4175 NameJMethod: r Supelemental information.
�- TYPE OF WORKFEE*SCHEDUI,F. fors ectal Information use'beckiist
New construction _ _Demolition Description Qtr. IFcetea.) coral
New I-&24nmily dwellings
Addition_/alteration/replaceiuent Other:_ (includes 100[t.for each u 111ty conncetion
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
Vcc-essoty
-Family we lin Commercia_l/Industrial SFR 2 bath _ 350.00
Puildin !Ot
ulti-Ftx_mily SFR 3 bath 399.00
er Builder her: Each additional bath/kitchen 45.00
_ JOB SITE INFOMIATION and LOCATION Firesprinkler-sq. ft.: Pa e 2
Job site address:/2275. _CLL! 411V R:. ( Site Utiutics
Catch basin/area drain 16-6U
Suitt'#: Bld ./A�t.#: _ Dr well/leach line/trench drain 16.60 _
Project Name: la L ALE1-,, linear ft.) _ Pu e 2
Cross Street/Directions to job Site: Manufactured home utilities _ 110.00
a•L v j- /�-L,r P_ Manholes 16.60
Rain drain connector 16.61)
Sanitary sewer no.linear ft.1 Pae 2
1 -i.�� �)a C ---� Lot#. 0C/ Storm sewer no.linear ft, Page 2
Subdtvtsion:Ll /'L'S Water service no. linear A. Pace 2
Tax map/parcel#: Lp IS-c* I I Fixture or Item
DESCRIPTION OF WORK _ Absorption valve _ 16.60
1
tui dS tip Gv,L C'Cc>s1nter Page 2 .2 7 S
= Backwater valve 16.60
Clothes washer 16.60
-- Dishwasher _ _ 16.60
Drinking fountain _ 16.60
ROPERTY OWNER 7 ENANIT E•ectors/sum 16.60_
Name:D&'rl-M41 Ll SS C Y-ye--1 I ?1►d Expansion tank _ 16.60
Address: 2 . z�41 LE curl CCL LQ nt Fixture/scwer cap __ 16.60
- Floor drain/floor sink/hub 16.60
City/State/Zip: _a D; ,� 0)0-9 7�•? Garbage dis osal r _ 16.60
Phone: Fax: Hose bib 16.60
APPLICANT CONTACT PERSON ice maker 16.60
Name:&, t°. S at, n,U lnterce tor/ cease trap 16.60
Medical gas-vaiuc: S Pa e2
Address:/.? 6)(-) Y W /YL n KD Primer _ _ 16.60
Cil /$tate/Zi 77•( 0 -�"1�'L d IQ- 7(:to Roof drain(commercial) 16.60
Phone: 3 4�9a-SAYS Fax~sy3 (pyra2-��Yo
Sink/basin/lavatory 16,60
5'.
E-mail: Tub/shower/shower�an _- 16.60
CONTRACTOR Urinal 16.60
-- Watercloset 16.60
BuSineS&Name: C!/1C� et lam_ �7Y"'' G/�1 16.60
-. - Water heater
Andress: Other: -
city/state/zip: O Other:
- 2FPlumbin Permit Fees*
Phonc543 o � -�YS Fax5b.-3
Subtotal $ --.2
L CCB Lit:. #: 'ell Plumb. Lic* I Minimum Permit Fee$72.50 S
Authorized s ,/�) Residential Backflow Minimum Feql3r.1k 3
40
Plan Review(25%of Permit ri-el S
State Surcharge B%of Permit'-ec $ .;2 • `Yb
(Please print name) TOTAL PERMIT' f EE S 3 S
Notice: This permit sioplic.olon expires its permit is not obtained within All new commercial buildings require 2 sets nr plans with isometric or
180 days after 1t has been accepted as complete. riser diagram for plan review.
*Fee methodology set by Tri-County Building lndusir)Service!bard.
i\DstbNPermlt romu1,P1mPennitApp dec 01/03
FROM FAX NO. Dec. 23 2001 08:11F'M P3
(.14/90'20(13 09:08 FAX 0035841901) CITY OF TIG.AYD �hbd
CITY OF TIGARD
13125 S.W. HAIL BLVD.
TIGARD, OR 97723
IMPORTANT PERMIT NOTICE:
ANSPACH PLUMBING
MARK A LAW
18380 5 FERGUSON ROAD
OREGION CHY, OR 97045
PlurnbinG Signature Form
Pormit it: MS'12003.00024
Date Issued- 419/03
Parnel: 2S103CC-1 1740
Site Address: 12275 81,w HANCOCK CT
Sulallvlsi()n: WHISTLER'S WALK
E 106 Lof 064
Jurisdiction' TIG
Zoning: R-4.0
Remarks (:onsctructi4rr of new SF Detach*d resie-ince.
Your company has Elden Indicatod as tf* plumbing cor�ractor for the pernit indir:ated 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 Farm p�br to the start of the work tD the od(1ress epove, A I i N: 6uiiraing Division.
No plumbing Inspections will be aothorized until this completed form is raceived
OWNLR: PLUMBING CONTRACTOR:
DON MORISSETTE HOMES ANSPACH PLUMBING
4230 GALEWOOD ST MARK A I A.W
& iE 1aa 18380 6 FERGUSON ROAD
LAKE OSWEGO, OR 97036 OREGON CITY, OR 97046
Phor:A:U: 503-387-7538 Phone#:
503-263-8120
Rey' #. LIG 37735
PLM J-429P8
AN INK SIGNATURE IS REQUIRED ON THIS FORM
AL
3igneture of Authoriz lumber
If you hove any questions, please call 503.718.2433.
CITY O F T I G A,R D _ MASTER PERMIT'
PERMIT #: MST2003-00024
DEVELOPMENT SERVICES DATE ISSUED: 4/9/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4111
517E ADDRESS: 12275 SW HANCOCK CT PARCEL: 2S103CC-11700
SUBDIVISION: WHISTLER'S WALK ZONING: It-4.',
BLOCK: LOT: lJn-t JURISDICTION: I Il
REMARKS: COnstruction of new SF Detached residence
BUILDING
REISSUE: _ STORIES: 2 FLOOR AREAS RE(IUIRED SETBACKS REOLIIRFD
CLASS OF WORK: NEW HEIGHT: 25 FIRST. 1,553 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: v
TYPE OF USE: SF FLOOR LOAD: 4,1 SECOND: 1 747 of GARAGE: 613 of FRONT: 22 PARKING SPACES
TYPE OF CONST: SN DWELLING UNITS: I TRIM of RIGHT: 22
OCCUPANCY GRP: R3 BDRM 5 84TH: 3 TOTAL: 3.30,3 VALUE: 32?.969 90 of REAR: 41
PLUMBING
SINKS i WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER I*.ES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
T1IBISHOWERS 3 GARBAGE DISP: 1 WATER HEATERS. 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
MECHANICAL
OTHER FIXTURES:
____FUEL 1 YPES_ FURN<100K: BOILlCMP<U PVENT FANS: 5 CLOTHES DRYER: 1
� FURN>000K, I UNIT HEATERS: HOODS: ' OTHER UNITS: I
MAX INP: btu FLOOR rURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISrELLANEC JS ADD'L INSPECI;ONS
1000 SF OR LESS: 1 0 -200 amp: 0 - 200 amp: WISVC OR FOR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF 7 201 400 amp: 201 - 400 amp. 1st W/0 S\1C1F DR: SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 - 600 runp EAADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HMlSVCIFDR. 801 - 1000 amp: 001+ampa-10011V MINOR LAauL:
1000+amolvoit:
Reconnect only: PLAN REVIEW SECTION
>-4 RES UNITS: SVCIFDR-225 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL S.CON MERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM AUDIO A STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH. BOILER: HVAC: LANDSC.APEIIRRIG: PROTECTIVE SIONL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAIELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,613.31
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORIS3ETTE HOMES INC
4230 GALEWOOD ST 4230 GALEWOOD ST,STE 170 Tigard Municipal Code,State OR. Specialty and
all other applicable laws. All woo In
STE 100 LAKE OSWEGO,OR 97035 work will be done
LAKE OSWEGO,OR 97035 accordance with air plans. This permit will expire iF
work is not started within 160 days of Issuance,or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow ruler adc pted by the
Phone: 503-387-7538 Phone: Oregon Utility Notification Center. Those rules are set
5o 387-7 g forth In OAR 052-001-0010 through 952-001-01000. You
Rep N: Ll 353 may obtain copies of these rules or direct questions to
OLIN:by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam MechanIca Mechanical Insp Shear Wa i Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insf Rain drain Insp Plumb Final
Footing Insp Crawl Draln/Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Fooling/Foundation Dr; Electrical Rouph In Gas Line Insp Appr/Sdwl:,Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By a Permittee: Signature �I t
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF T O G A R D -SEWER CONNECTION PERMIT —
DEVELOPMENT SERVICES PERMIT#: SWR2003-00024
`k13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171 DATE ISSUED: 4/9/03
SITE ADDRESS; 1215 SW HANCOCK CT PARCEL: 2S103CC-11700
SUBDIVISION: WHISTLER'S WALK BONING: It-4.5
BLOCK: LOT: 064 — __ _ JURISDICTION: Fl(,
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF residence.
Owner: — FEES-- ----��
DON MORISSETTE HOMES ==------
42.30 GALEWOOD ST Description _ DF.te Amount
STE 100 1SWUSAJ Swr Connect 4/9/03 $2,300.00
LAKE OSWEGO,OR 97035
1SWUSA)Swr Connect 4/9/03 $0.00
Phone: 503-387-7538 1SWINSP)Swr Inspect 4/9iO3 $35.00
1SWINSI11 S�cr Inslirrt 4/9/03 $0.00
Contractor:
Total $2,335.00
Phone:
Req #
Required Inspections _--
This Applicant agrees to comply with all the rule, and regulations of the Clean Water Services. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accu~acy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: g ._ Z
X14 /:/l�( y/�t Permittee Si natute:' '
Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day `�
BuildC�Permit Application
"ateiled�•,���C!�/C :=/ - ( -��, Permit no.:
City of V F,a�d .�1.._1 V C
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: —__ Expire date: —
rY�lnB°rd Phone: (503) 639-4171 JAN �yn —
1 �� 7lll l� Dale issued: By '� Receipt nr•.:
Fax: (503) 598-1960 IR Case file no.: Payme.a type:
CITY OF TIGARf� — -
Land use approval: .31111 ntl.jr. I&2 fami ly:Simple Complex:
(U 1 & :family aling or accessory U Commercial/industrial U Multi-family New consduction U Demolition
U Addion/replacement U Tenant improvement U Fire sprinkler/alarm U Other: _
Job address: —7' 1f E) I Bids.no.: Suite no.:
Lot: Block: Subdivision: —� Tax ma /tnx lot/account no_�.y'' - -�
Project name:
Description and location of work on premises/special conditions:
Marne:
Mailing address: fAmrly dnQlling: q
V
City: x Stated ZIP:4 1 aluation of work........................................
Phone: - Fax: 7 -mail: No.of bedrooms/baths.................................
Owner's representative: ^t rl Total number of floors.................................
Phone: Fax: E-mail: New dwellingareas ft.
Gamge/carpnrt area(sq.ft.)......................... _
Name: W b — -- - Covered porch area(sq.ft.) ........................
Deck arca(sq.tt.) -- -
_Mailing address: C1 ........................................ --------
City: State: ZIP: Other structure atea(sq.ft.).. ......................
Phone: Fax E-mail: CommereiaUlndustriallmultl-family:
Valuationof work......................................... $
Business name: Existing bldg.area(sq. fl.) ..... ......... .....
— New bldg.area(sq.h.) ..
Address: __--
Z — Number of stories...........
City: State: ZIP: `+ '�-----
Photle: Fax: E-mail: Type of construction.. ................................
Occur.dtcy group(s): Existing:
CCB no.: � — -- New:
City/metro lic.no.: '1011ce:All contractors and subcontractors are required to be
A0011114474* !IGNIFR licensed with the Oregon Construction Contractus Board under
Nampm:isions of CRS 701 and may be required to be lir.aised in the
Address: jurisdiction whet-work is being performed. If the applicant is
City: State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.: —�
Phone: i-- Fax. E-mail: ---
Name: C trlttact person: _ Fees due upon application ...........................S
Address: Date received:
City: State: ZIP: _ _ Amount received ......................................... $_
Phone: Fax: E-mail: _ Please refer to fee st hedule.
I hereby certify I have read and examined this application and the Nm all jurirdictiarta accept credit cardt,please call Jurisdiction ror more Inrormatlom
attached checklist. rovisions of I ws and oldinances governing Utis L) aid
U Mastercard
work will be comp) w ,whether cified ereA t t. r rt J nrd number: / /
� Ea iter
Authorized sl atu '14, jg t ' '(J J -- Nam of Idet as shown7n credit card p
Print name: _t'1 i (- 'r1 I-1 L — det itputura s Amt
Notice:This permit application expire.,if a permit is not obtained within 180 days after It has been accepted as complete. 1101613 MW Cott i
One-and Two-Family Dwelling
Building Permit Application Cheek_I_ist Reference no.:
City of Tigard City of Tigard Associatedyermits:
Address: 13125 SW Hall Blvd,Tiganl,OR 97223 O Electrical O Plumbing O MechanicalQ Other.
Phone: (503) 639-4171 — —
Fax: (503) 598-1960
1 !$1!
I land me actions completed See jurisdiction criteria for concurrent reviews.
2 Zoning.Flood plain,solar Uance points,seismic soils designation,historic district,etc.
3 Verification of approved piat/lot. _--
4 Fire dbitrict- approval required.
5 Septic system permit or autimrization for remodel.Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Solls report.Must carry original applicable stamp and signature on Rale or with application.
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of
catch-basin protection,etc.
10 1 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes.Lateral design oetails 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 br completed t/
if copyright violations exist. _ J`
I 1 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if
there is more than a Oft.elevation cif eremial,plan must show contour lines at 2-11.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;ditecdon indicator,lot
area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundation plan.F'-ow dimensions, anchor bolts,any hold-downs and reinforcing pads,cc nection details,vent
size and location.
I ; Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans,plumbing fir.ures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and detalls.Show all framing-member sizes and spacing such as floor beams,heade;c,joists,Tub-floor,
wall construction,roof construction.More than one cross section may be required to clearly portray constn,,'U;o .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 view.. Provide elevation,.for ne construction;minimum of two elevations for additions and rema;els,
Exterior elevations must reflect the actual grade if the change in grade is grater than four foot at building envelope.
Full-sine 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 E+ath analysis rrovide specifications std calculations to engineering standards.
I7 Floorlroof framing.Provide plans for all floors/rooa assemblies,indicating member sizing,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rehar.For engineered
s stems,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/joist carrying a non-uniform loaf.
20 Manufactured floor/roof trwis design detaUs.
21 Energy Code compliance.Identify the prescriptive path or prc�,i4A calculations. A gas-piping schematic is required
for four or more appliances.
22 Engirt-_'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 projeci under review.
23 Five(5)site plans are required for Item 11 above. Site plans must be 8-1/2" 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 mlled,reversed or mirrored building plans will be accepted.
27 _
28_
Checklist must be completed before plan review star date. Minor change or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 44044614(WWOM)
� Mechanical-Permit Alltplication
Date received: P .mitno.:/y67";i(0 _000�,
City of Tigard Project/appl.no.: Expiredate:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Date issued: By: Feccipt no.:
Phone: (503) 639-417►
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: �.. RrildinRperm;[no.:
t
❑ 1 &2 family dwelling or accessory O CommerciaUindustnal U Multi-family ❑Tenant improvement
�*ew construction Q Addition/alteration/replacement ❑Other: _
INFORIMAT11ON COM51FRCIAL1SCHEDULt
lob address: C 'v t \ Indicate equipment quantities in boxes Wlow. Indicate the dollar
Bldg.no.: Suite no.: Y, value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: t Block: Subdivision: -J.4 V z 'See checklist for important application information and
_Project name: ( 1 wAsdiction's fee schedule for reside tial permit fee.
City/county: - Typ: — _ I &2 FAMILY IDIVELUNGx' X11
IULIE
Description and location of work on premises: t t I x t t
_ Fee(ea.) Total
Est.date of completion/inspection: Ihstripuou Qty. Res.only Res.only
Tenant improvement or change of use: MVAC: _
Air handling unit CFM
is existing space heated or conditioned?❑Yes ❑No Air con iuoning(site an required)
Is existing space insulated?U Yes U No Alteration of existing HVAU system
Boiler/compressors
Rosiness name. t State boiler permit no.:
1 •._ HP Tons BTU/H
Address: en n.4 _ ire/smokc dampers/du,,smo a detectors
Ciry: L! F State:, Z[P: cat pump(site pan requir ) _ __
Phone: Fax: �E mail: nstal replacefurnac urner B"t /
� �-_ ----- --- Including ductwork/vent liner U Yes O No _
CCB no.: -__ A
nsta rep acdrc(citeheaters-suspen e ,
City/metro lic. no.: N!Awall,or floor mounted
ent or appliance other than furnace
Name(please print): - �--- a eratlon:
Absorption units_ BTU/H
NameT '+1-lt: HP _._.
Address: Compressors
NP
� -.—---- onmenta a ustand rentilattan!
City: —_ State: ZIP: Appliance vent
Phone: Fax: E-mail: Dryer exhaust
s, ype / res.futcnarmat
hood fire suppression systemm
Name: _ I ' Exhaust fan with single duct(bath fans)
Mailing address: exhaust system ap}rt from heating or _
City: .� State ZIP ue piping SILddCstribut on(up to A outlets)
Type: LPG __ NO Oil
Phone: 7- Fax: I E-mail: Fucl i ing`eTfia-Jd—ifional over 4 outlets
rocess piping(schematic required)
Name: Number of Outlets
-1er1WWA-pp 1e or equ pment:
Address: Decorative fireplace
City: — -- State: ZIP: risen-type
Phone: Fax. '•mail: v oodstove/pelletstove
Other:
Applieant's slenaru ; Date_ t' % ter.
Name(print): f ' f1 -it re/l
Not all iuritdlctioru accept credit carts place call tun,ticuon for mm ttJormation Permit fee ................
71
fee
S
O Visa O Ma.tefCard Notice:This permit application Minimum fee................$
expires if a permit is not obtained plan review at _ %) S
Cted"ears"amhet ----- --1-� y`within 180 days after it has been
-"-�—"— ttpitet State surcharge(8%)....$
Name Rr Czaol r as than on credit cud - accepted as complete.
= TOTAL .......................S —
Cardholder tiputun Amount 4404617(600000M)
Plumbing Permit Application
Date received: Permit no.: S'
Cit of d
Y Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd.Tigard.OR 97223
Pro•ec.r/a I.no.: Expire date:Phone: (SU3) 639-4171 ' PP
Fax: (503) 598-1960 Date issued: By:-� Receipt no.:
Land use approval: �_ Case file no.: Payment type:
1
O I &2 family dwelling or accessory ❑Commercial/indust-nal O Multifamily O Tenant improvement
ew construction O Addition/al tention/replace rnr_it U Faid service c7 Other.
lo - Dcscription �)'• ree(ea.) Total
JOB SUE INFOR51ATION FEE SCHEDULE(for specibil Infamation use checklist)
Jobaddress: (,L' 7~f AN U(�4 = ��_ -
Bldg. no.: I Suite no.: '�-� ,; ew t-and 2-Cannily dwellings only:
(includes 100 ft.for each utility connection)
Tax map/tax lot/account no.; SFR(1)bath
Lot Block: Subdivision: -Y SFR(2)bath
Project name: SFR(3)bath
City/county: Each additional bath/kitchcn
Description and location of work on premises: SiteutWtles:
Catch basin/area drain
Est,date of completion/inspection:
- Drywells/leach I;ne/trench drain
Fuodng drain(no. lin.ft.)
Manufactured home utilities
Business name• � 1�, ��LI ' I t�lL -____ — Manholes
Address: `) Rain drain connector
City: State• ZIP___ _ Sanitary sower(no.lin. ft.) _
Phone: --` Fax: E-mail: Storm sewer(no.lin.ft.)
Water service(no.lin.ft.)
CCB rno.: t ��. Plumb. bus. reg. no: - Fixture or Item:
City/metro lic. no.:N/A Absorption valve _
Contractor's representative signature Back flow preventer
Print name } �1=- t t Backwater valve
Basins/lavatory
Name: �- Clothes washer
SP�17. 1 � - Dishwasher _
Address_ V Drinking fountain(s) _
State: ZIP: E Ejectors/5
Phone Fax: E-mail: Expansion tank —
ixture/sewer cap -
Floor drains/floor sinksthub
Name(print): Garbage disposal
Mailing address: < Hose bibb
City ( ,� State Z' Ice maker _
Phone: - Far: 7-70, E-mail: Interceptor 9%ase trap
Owner ins radurtonlreridendal maintenance only: The actual installation Primerts) ^--�
will be made by me or the maintenance and repair made by my regular Roof dein(commercia;l
emplw,ee on the property I own as per ORS Chapter 447 Sini:(s),basin(s),lays(s)
Owner's signature: Date: Sump
Tubs/show-r/.,how_er pan
Unna)
Nan
Water closet
Address Water heater _
Cin -- — State: ZIP: Other.
Phony _ - Fax: E-mail: Total
Na all tun"cuau accept credit cudt.pleas cail runsdictim fa nae inratntuan. Notice:This permit applicatlun Minimum fee..... ....... ..$
0 visa 0 MasterCardPlan review(at __ %) $
expires if a permit is not obtained State surcharge Wo) ....$
__------
Ctutil cvd number _ _ __ rpt fen within 180 days after it has been
-- accepted as complete.
TOTAL ......... .............S
Name of cvAholder a�tw�rn on�m1u cardv
f
Cardholdu siaiwe —-- —Amount
tn4x}x616 1 OMl
Electrical Permit Application �
Date received: Permit no.:
City of Tigard Projecdappl.no.: Expire date:
CiryefTigord Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: _ By; ReceipIno,
Phone: (503) 539-4171
Faye: (503) 598.1960 Case file no.: Payment type:
Land use approval:
t
1 &2;f:"flycdw-elling or accessory U Comrnerctai/utdu;tnal U Multi-family ❑Tenant improvement
New on CJ Addition/altemdon/replacement U Other. ❑Partial
Job addreC,t�( � (" Bldg.no.: Suite no.: JTax map/tax lot/account no.: _
Lot: r Block: Subdivision:
_Project name: —Description and loc^tion of work on premises:
Project
date of completion/inspection:
SCHEDULE
Job no: F« hlax
Business name: /� ``---��'_,, -- _ Description Qty. (ea.) Total nu.[asp- � Nen residential-single or mutti-family per
Addres =�_ dweBbtgunjt.Includes attacirdgarage.
-� 7 Service Included:
City: State: Z1P:
Phone:4,Ll Jj I Fax: E-mail' 1000 sq.h.or less _ 4
Each additional 500 sq.ft.or pt:rtion thereof
CCB no.: Elec. bus.lic.no: Limited energy,reaidentlal 2
C' Limited energy,non-residential 2
j Frclt manufactured home or mo',las dwelling
— ojtupervttrn`efecf►lefan(required) -- Tate Service and/or(ceder _ 2
Sup elect nameipnnn 1 (-f I icensrno a Services or feeders-installation, 1
alteration or relocation:
200 amps or less 2
S ` 201 amps to 400 amps 2
dame(print): l 401 amps to 6110 amps 2
Mailing address: 601 amps to 1000 amps 2
City: r State Z1P: Over 1000 amps or volts _ 2
Phone: z - Far: ) -"7- -mail: Reconnect only
Owner Installation:The installation is being made on property I o%%r+ Temporary ser-ores or seeders-
which is not intended for sale, lease, rent, or exchange according to r tut afnpsM.-less tton,orreiocstlon:
200 unps o;less 2 `
ORS 447,455,479,670,701. 201 unps to 400 amps --- _ 2
Owner's signature: Date: 1 401 in 600 amps
Branch circuits-new,alteration,
or extension por panel:
Name: A. Fee for branch circuits with purch ee of
Address:' _ service or feeder fee,each branch zircuit _ __ 2
City: Slate ZIP: B. Fee for branch circuits without purchase
of service or fader fee,first branch circuit: 2 Q
Phone: Fax. lb
Email: Fachadditionaranch,,retitle
PLAN REVIEW(Please check all that applyt� Misc.(Service or re.der not Included):
O Service over 225 amps-commercial U Health cue facility Each pump or irrigrtion circle 2
0 Service over 320 amps-rati igof 1&2 U I laLmdous location Fachsign nrnutlinelighting 2__.
(amllydwellings 0 Building over 10,000 squat t feet faro or Signal circuit(s)or a limited energy pa-el.
O System over 600 volts nominal more residential units in or.e structure alteration,or extension'
2 _
O Building over three stories 0 Feeders,400 amps or more *Description.._
0 Occupant load over 99 persons 0 Manufactured structures a RV park FAch additional Inspection over the allow hie In any of the above: _1
O Egress/lightingplan U Other _--- Perinspection r_
Submit_seta of plans with any of the above. Investigation fee
The above site not applicable to temporary construction service. Other
Not all jundictirm accept credit cards,please call jurisdiction rum more Information Notice:This permit application Permit fee.........•...........
s
U Visa 0 MasterCard expires if a permit is not obtained Plan review(at _ %) S
Credit card number within 180 days after it has been State surcharge(8%) ....S
Name of cardtrolder u shown an credit card __
Expires accepted as complete. TOTAL ..................... .S —
Cardholder signature '- Amount 440,4415(&OVCOM)
i
1 -
J
li
DoT - MORISSETTE OBE : 2834
H 0 Y R S I N C O R P O R A ' 0 LOT: 8'4
4 2 0 0 G A L E W O O D 8 T P E E T DATE: 1/7/03
LAKE 0SWEG0• 0 REG0N 97035
(5 0 3) 3 e 7 - 7 5 3 6 VAX (5 0 3) 3 e - 7 e 1 5 PROPERTY: WHISTLER'S—WALK
CITY. TIGARD
SCALE: 1"=20'
PLAN No.: 181
STANDARD ELEVATION
* 196' I i •_� 3EC
LOT %4 _ 301'
11,736 eq. rt. /
/ o
o 1
� ' I
I V l I
oeex y• ••
307
303
-
39.�.
3,300 eq. rt.
5 bdrm.
ir) 2 V2 b i th I
FF.E. 304.5'
LA
105' PPE.
— 79' LANG-
_ 613 da. rt. // / / SCAPE
,O7 3 car ear. /
FF.E. 303.5'
304'
r / 3C:-
/ •!• U LOT COVERAGE
/ " AREA: 11,236 5G: FT
- BUILDING AREA: 2,311 SG
PERCENTAGE: 20X
LEGEND
:��;,�, � � �� ''OI,• �� — —EX1811NG rREES
;.�• ; —2' PYRUS CALLERYANA •� TC REMG ti
'�Y—.,, -•y_�, `�� 'GNANTIGLEER PEAR' C
r ;"