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12286 SW HOLLOW LANE N N 00 C� C T O O r m c� i d i ,.r,Is 12286 SW Hollow Lane CITY OF TIGARD BUILDING INSPECTION DIVISION(Yr ke r7 J l�Goo�o' 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ST BUP Date Requested --- _ —AM �PM _-- BLD _ Location. ( 2 2 Y�i w /PI&I-1 L "- _�— Suite MEC Contact Person _ v� Ph C��35 PLM Contractor _ _ Ph SWR — Tenant/Owner -rG 1C Cam G� a/"y �.•��_ c9?ELC -------- .. e airnnq Wall ELR Footing Access: ---_ ----- -- Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: ----- ---- _ Slab `IT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- --- - ------ - -- - -- Roof _ - Misc _ in ASS' P NRT FAIL __.. - -- ----- -— ---------- — PLUMBING Post& Burn _ - - ------ - - - - - ------ -------------.,___ -___----- - ------ Under Slab -fop Out - - - ----------- - Water Service ",unitary Sewer -- Rain Drains Final ----- -- --- PASS PART FAIL MECHANICAL — — Post& Beam - - Rough In GasLine --- ---- ----------- .- -------- Soloke Dampers Final ---- - - - - -------- - PASS PART FAIL_ ELECTRICAL --------- Service _ -- -- ----- -- -------------------------- Rough In UG/Slab --- ---- ---- ------- -- — Low Voltage Fire Alarm Final -------_ ..------------- — -- ----- — ----- - — PASS PART FAIL --- __ SITE Backfill/Grading — ------- --- - ------------------ ------ -- Sanitary Sewer Storm Drain ! ,Reinspection fee of$ requi•ed before next inspectior. Pay at City Hall, 17,1125 SW Hall Blvd Catch Basin [ ] Ple&se call for reinspection RE: __ _ [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Dated — I _—Inspector ' Ext --_ Final PASS PART FAIL- 1O NOT REMOVE this inspection record from the job site, m m �' s r < mco ri'l Gor cy cn n roto `; Gn cn z ` ' C Cn C: y R1 y m m ; y C Z /00 C/) m m m m ? �' m m b > m 0 Cf) ° p z HT1 � m o o s, o v 0 C7 �' z C� o y `n O ' CITY OF TIGARD BUILDING INSPECTION DIVISION F 24--Hour Inspection Line: 639-4175 Busines., Line: 639-4171 u BLIP__ _—� Date Requested_— y � AMPM _ BLD Location Suite --- — IlIEC _ Contact Person — — Ph pt.m Contractor --� Ph SWR IL — -Tenant/Owner ELC Rerai 'ng Wall ELR _- -- Fc n Access: - -- ----- Founda ion FPS Ftg Drai - - Crawl D in Inspec tion Notes. SIGN Slab - .--- - -... .-- - Post& B m;' ------------_ ------ SIT --- - --------- Ert Sheat / hear Int Sheath hear ---- ___ - Framing L!7 nsu alio -- - -�.-- Drywall aili g Zof rnkler rm Ceiling -- --- - - -----_ -- ------ -- PASS PART FAIL - -- - - ------- ------- -- -- _.---- -- -- LUMBI Post&13i?am ----- Under Slab Top Out - --- -- ------ Water Service Sanitary Sewer --- - --- ----- - -- -- ---- ------ Rain Drains Fin _-___--------- -- f'rX S .? PART FAIL Post& Beam -- -- -- Rough In - ____- ------- -.. - --- Gas Line - --------- ---- -- Smoke Dampers -- ------.____`�.,------- -_..__ Final - ---- -.. ------- - PASS PART FAIL - - ELECTRICAL - - - - - - -- ------- -- -----... - - -- --- Service Rough In -- --- ----- - ^_._�—_ Ur/Slab Low Voltage ----------— ---- ------- Fire Alarm Final ---------- ----- PASS PART FAIL SITE - - --- - ----- Backfill/Grading ----- --- ----- --- ------- ----- - Sanitary Sewer Storm Drain [ j Reinspection fee of$ A required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line l )Pleasa call for reinspection RF - -- [ j Unable to inspect-no access ADA Approach/Sidewalk Date P 1 -- -" Other � -�_.—--Inspector �'' — _ Ext 3' _ Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. O a 0 o v' y � c o O C 3 v M, �L, _5 (� . C13'Y OF TIGA-RL WILDING INSPECTION DIVISION I MST 24-Hour Inspe:tion Line: 639-4175 Business Line: 5394171 a/BUP ------ Date Requested _1 AM------FSM -- BLD �--- --- -- Location � '1"4#e"o /moi —__ Suite M_EC - Contact Person _ _ Ph Z f:�61,7 —G06 Contractor Ph 1( Z/ 7 SWR — BUILDING Tenant/OwnerELC Retaining Wall - — ELR _ Footing Access. Foundation FPS IFig Drain ----- SGN - C,awl Drain Insrection IJotes ------- - - - 'ICJSIT Post 6 Beam _ ------------ Ext Sheath/Shear _ Int Sheath/Shear N Framing Insulation Drywall Nailing Firewall - --- -- ----- -- Fire Sprinkler Fire Alai Susp'd Ceiling — -------------- Ruof -- ----- Misc: -- ---- - - ---- Final PASS PART FAIL - BI - Under Sla /_ Top Out lam+ Water Se e-r; - -_ Sanitary Sewer Drains F' 'A, PART FAIL -OECAANICAL -- 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 Backfill/Grading - - Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay At City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for relnspectior,RE: [ ]Unable to inspect no access ADA x �(= Approensp ch/Sidewalk Date � Inspector �� """'�•�r E w J Other - ----f-- — Final PASS PART FAIL nO NOT REMOVE this inspection record from the job site. -T0 CITY OF TIGAQ0 BUILDING INSPECTION DIVISION MST 24-Hour Inspection L 639-4175 Business line: 6394171 - BUP Cate Requested AM V PM BLP Location 6,3— Suite _ _..�_ _ MEC Contact Person _ Ph �-��l f" _ PLM _ T_ Contractor Ph SWR BUILDING Tenant/Owner _ _ ELC Retaining Wall _ EI_R Footing Access: Foundation FPS Fly Drain !�--- - Crawl Drain Inspection Notes: 5GN ----- , 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 -- P,• ;S PART FAIL - - PLUMBING Post& Hearn - Under Slab Top Out Water Service Sanitary Sewer - Rain Drains Final _- PASS PART FAIL MECHANICAL Post&Beam --- - Rough In Gas Line Smoke Dampers Final -- - - - - ASS P RT FAIL .ELg-GTRrML S�rvtz:� - Rough In UG/Slab Low Voltage -- -- Fire Alarm ASS AP7, FAIL Backfill/Grading ----- - - - - - - - Sanitary Sewer Storm Orain ( )Reinspection fee of$ required before next ction Pay nt cityt iall 13125 w i ran iwi Catch Basin Fire Supply Line ( )Please call for reinspection RE:_ __ ` 1 I l.lnabl" to In.;r-4 , ADA �J , Approach/Sidewalk � l) Other _ Date / Inspector ✓ _ � ,L� Ext Final PASS PART-- FAIL DO NOT REMOVE this inspection record from the job site. Plumbing Permit Application Date received: Permit no.:' n qui_ ,01" , City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW 1?all hlvd,'1•igard,OR 97223 City of Tigard Phone: (503) 639-4171 Noject/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case rile no.: Payment type: TiPE 1 U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement VVNew construction U Addition/alteration/rcplacement U Food service 'J Other: 1 �Uj 111 ' 1 a , Job address: k I IOLU ! ,,iC Urscri tion Qt . Pc_c(ca_) Total Bldg.no.: _ Suite no.: New 1-and 2-family dwellings only: (Includes 100 fl.forrach utility rdnnection) Tax map/tax lodaccount no.: /=i, SFR(1)bath Lot: Block: Subdivision:(�.0 ct�t z' ((`tU SFR(2)bath Project name: 1c I I o ui, SFR(3)bath — City/county: i Ir ,a�t t.. r_url'>ff Zfl': ` J 3U Each additional badulitchcri Descn'ptiond ocadon of work or.premises: SiteutWties: [ CJ't.(.J bet)t Lam, _ Catch basin/area drain Est.date of completion/inspection: i t j i k i I I Urywells/leach line/trench drain Footing drain(no.lin.ft.) Manufactured home utilities Business name: (-C t—ass L-o-ndgcLt4L, Manholes Address:,;2qg,q _ Lj e ll j�W U rl le O _ Rain drain connector City;(]i Statd. "IP�/'7 O'J Q Sanitary sewer(no,lin.ft.) Phone: - 1'1)Fax:&$R-9f Storm sewer(no.lin.ft.) t _3 no.: 1,3(,o 1 Plumb.bus.n,_;.„o: Water service(no.lin.ft.) City•metro lic.no.: 003 -- - Fixture or Item: Absorption valvc Contractor's representative signaturg;� f/.c,� n-� Back flow rep venter �7 Sa CZ cz- Print name: /"CnC� Date: �(a O Backwater valve PERSONBasinUlavatory Name: Clothes washer Ill eq Addirss:Z1/l?rjS k( (l/t i2C� Dishwasher _ LU i L Statclor ZIP:9 v 1 .1 inking fountain(s) City-IF, ejectors/sump Phone:6W-60'7Z Fax: ` - 7 mail: Expansion tank Fizturelsewer ca _ Name(print): Q dY jS er j� �aY)-)G$ 1-1oor drains/floor sinksMub -m Garbage d,sposal Mailing address: a30 &tu 6,,etl e-LoOt t Nose bibb City:&ijj�L —Ice maker Phone: Fax: E-mail: lnterce for/grease;rap Owner instal Iadon/residentIal maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. ;ink(s),basin(s),lays(s) Owner's si nature: Date: Sump Tubs/shower/shower pan _ Urinal. _ Namei _.. lvater closet Address: Water heater City: _ State: 7.IP: —A_ Other- Phone: Fax: E-mail: _ Total Not adl jurisdictions accept credit cards,please call jurlimEction for more Information. Notice:This permit application Minimum fee................$ U Visa U MasterCard expires if a permit is not obWnrd Plan review(at — %,' $ �� 1 Credit card number:--__ —_L_ / within 180 days atter it has been State surcharge(8961 ....$ `��- Expircs + Name of—cardholder-i;shown on credit acrd accepted as complete. TOTAL .............. ........$ S Cardholder signature — Amount 440-4616(6MW('M) PLUMBING PERMIT FEES: PRICE : . TOTAL New 1 and 2•family dwellings orry: FIXTURES plidividual) QTY oa AMOUNT (includes all plumbing fixtures n PRICE TOTAL 16.60 the dwelling and the fir-,tl00 ft. QTY (3a) AMOUNT Sink for each utllity cor,nectlon_ Lavatory _ 16.b0One 1 bath 3249.20 'rub or TublShowor Comb. 16.60 Two 2 bath 3350.00 Shower Only 16.60 Three 3 bath -t 3399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8•/.STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25•/.OF SUBTOTAL TOTAL Garbage Disposal 16.60 - - Laundry Tray 16.60 Washing Machine 16.60 FlcxtrDrain/FloorSink 2" 16.60 PLEASE COMPLETE: 16.fi0 4" 16.60 -- _ Quante b Work Performed Water Healer 0 conversion O like kir+d 16.60 Fixture Type: New Moved Replaced Removed/ Gas piplog requires a separate mechanical Capped ermit. Sink MFG Home New Water Service 46.40 Lavatory__ - MFG Home New SaNStorm Sewer 46.40 Tub or Tub/Shower Hose Bibs - 16.60 Combination Roof Drains _16.60 Shower Only - 16.60 Water Closet 0 inking Fountain Urinal - jot-her Fixtures(Specify) 16.60 Dishwasher Garba a Dis osal L aundry Room Tra ashin Machine oo rr Drain/Sink: 2" Sewer-1st 100' 55.00 3" 40 4" Sower-each additional 100' 46. Water Heater - Water Service•let 100' - 55.00 Other Fix# as ater Service each addKional 200' 46.40 W i --9,5-00 Slomt b Rain Draln-1st 100' . 46.40 Cie- storm iGSlorm 6 Rain Drain•each additional 100' - Commercial Back Flow Prever,don Device 46.40 Residential Bacxtlow Prevontion Device' 27.55 22-1:55- -- Catch Ba&ln 16.60 - Inspocllon of Existing Plumbing or Specially 7e�/hr COMMENTS REGARDING ABOVE: Re uesled Ins actions 65.25 ---- ----- Rain Drain,single family dwelling 16.60 Grease Trap-s�- QUANTITY TOTAL C ) �_ --- -- Isometric or riser diagram Is required if -217, -- Ouantity Total is >9 _ -- ----- •SUBTOTAL 3f�.a - -_--�- --- --- 81/6 STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required on!y.If 6 tura total is>9 TOTALS •Minlmum permit fee is$72,50 4-b%state sxcharqu,except Residential Backflow Prevention Device,which 1(638 25+8%state surcharg?,'.' . "All New commercial Buildings're uq a prang wn sTsomefric or riser diagram and plan review I.\dsls\forms\pim-fees.doc 10/10/00 CITYOF TIGARD PLUMBING PERMIT DEVELOKAFNT SERVICES PERMIT ii: PLk42001 00061 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED 3/2/01 PARCEL. 2S103C13-07600 SITE ADDRESS: '12286 SW HOLLOW LN SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 025 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: - SINKS: T !URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Back Flow Preventor Owner: FEES �— Type By Date Amount Receipt DON MORISSETTE HOMES ---PRM-1 CTR 312/01 $36.25 27200100000 4230 GALEWOOD ST 5PCT CTR 3/2/01 $2.90 :7200100000 Total $39.15 Phone 1: 503-387-7538 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REOUIRED INSPECTIONS Phone 1: 682-6076 RP/Backflow Preventer Reg #: LIC 6136 PLM 11558 This permit is issued s-ibject to the regulations contained in the 1 igard Municipal Code, State of OR. Sp^cialty Codes arid 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 ;lays 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 Signature: -)') ) �_L Inc _ k Call (503) 639-4175 by 7.00 1' M. for an inspection needed the next business day 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 Siyr.. :ure Form Permit #: MST2001-00008 Date Issued: 1116101 Parcel: 2S103CB-07600 Site Address: 12286 SW HOLLOW LN Subdivision: QUAIL HOLLOW - FAST Block: Lot 02.5 ,Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached 6weiling. Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for tie electr ical 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 electricai iiispections wil! be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: DON MORISSETTE HOMES CITY ELECTRIC + SUPPLY CC` 4230 GALEWOOD ST 8900 SW BURNHAM F-27 TIGARD, OR 97223 Phone #: 503-387-7538 Phone #: 641-8012 Req #: SUP 3592S LIC 4242; ELE 26-289C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 9'223 IrOPORTANT PERMIT NOTICE A, 0 CITY ELECTRIC + SUPPLY CO c�,�-'% 8900 SW BILP.NHAM F-27 ��' 4�� TIGARD, OR 97223 00 400 Electrical Signature Form Permit #. MST 2001-00008 Date Issued: 1/16101 Parcel: 2S103CB-07600 Site Address: 12286 SW HOLLOW LN Subdivision: QUAIL HOLLOW - EAST Block: Lot: 025 Jurisdiction: TIG Zoning. R-4.5 Remarks: New SF detached dwelling. Path 1 Four 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 8900 SW 6URNHAM F-27 TIGARD, OR 97223 Phone #: 503-387-7538 Phone #: 641.8012 Req #: SUP 3592S LIC 42422 FLE 26.289C AN INK SIGNATURE IS REQUIRED ON THIS FORM X _ - Sign ur-e of Supervising Electrician If 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 HARRY f SON PLUMBING INC 7117 NORTH ARMOUR PORTLAND, OR 97203 Plumbing Signature Form Permit #: MST2001-00008 Date Issued: 1116101 Parcel: 2S103CB-07600 Site Address: 12286 SSV HOLLOW LN Subdivision: QUAIL HOLLOW - EAST Block: Lot: 025 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached dwelling. Path 1 Your company has been indicated as the plumbing contractor for the permit indicate 1 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, ATTW Building Dept. N-) plumbing inspections will be authorized until this completed form is received OWNLP. PLUMBING CONTRACTOR. DON MORISSETTE HOMES HARRY + SON PLUMBING INC 4230 GALEWOOD ST 7117 NORTH ARMOUR PORTLAND, OR 97203 Phone #: 503-387-7538 Phone #. Reg #: 1 Ir 00068900 PI M 26-448ob AN INK SIGNATURE IS REQUIRED ON THIS FORM Signatur6 of Authorized Plumber If you have any questions, pleaso call (503) 639-4171, ext. # 310 CITY OF T I GA R D MASTER PERMIT PERMIT#: MST2001-00008 DEVELOPMENT SERVICES DATE ISSUED: 1/16/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12286 SW HOLLOW LN PARCEL: 2S103CB-07600 SUBDIVISION: (QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 025 JURISDICTION: TIG REMARKS: New SF detached dwelling Path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: FIRST: 1 1,3H sf BASEMENT: sl LEFT. SMOKE DETECTORS. TYPE OF USE: SF FLOOR LOAD: 41, SECOND 1. St GARAGE. I t! sf FRONI: Zn PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: + FINBSMENT: sf RIGHT: VALUE S•'H111•13ou OCCUPANCY GRP: R1 BGRM. •1 BATH: d TOTAI -{"5n fill sf REAR: 1 PLUMBING SINKS: WATER CLOSETS: 4 WASHING MACH. 1 LAUNDRY TRAYS: RAIN DRAIN: 10.1 TRAPS. LAVATORWS: DISHWASHERS- I FLOOR DRAINS: SEWER LIN'S. 100 SF RAIN DRAINS: + CATCH BASINS' TUSISHOWERS. 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES: tnr! BCKFLW PREVNTR: 1 GREASE TRAPS, OTHER FIXTURES. MECHANICAL FUEL TYPES FURN<100K BOIL/CMP�3HP: VENT FANS. ? CLOTHES DRYER: i FURN>=10VK. 1 UNIT HEA;FRS: HOOD'v 1 OTHER UNITS: 1 MAX INP btu FLOOR FURNANCES: VENTSI WOODSTOVE3: GAS OUTLETS 1 ELECT CAL RESIDENTIAL UNIT SERVICE FEEDER _TEMP SRVCIFEEDERS _ BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR Fr+!•'. I PUMPIIRRIGATIOW PER INSPECTION. EA ADD'L 5008F: 6 201 400 amp: 201 400 amp. 1St WIO SVCIFDR cul SIGNIOUT LIN LT PER HOUR. LIMITED ENERGY: 401 600 amp: 4111 500 amp: EA ADDL BR CIR: SIGNALIPANEL IN PLANT, MANU HMISVCIFOR: 601 1000 amp: 601-amos•1000r MINOR I_ABEL.- 1000H and: PLAN REVIEW SECTION _ Reconnect only: >=4 RES UNITS: SVGFDR>=425 A. 600 V NOMINAL CLS Al OCC EI ECTRICAL•RESTRICTED ENF RGY _ A.SF RESIDENTIAL B.COMMERCIAL AUDIO R STEREO: VACUUM SYSTEM AUDIL,&S1EREO: FIRE ALARM. INTERCOMIPAGING. OUTDOOR LNDSC L1 BURGLAR ALARM: OTH. BOILER: HVAC, LANr)SCAPEIIRRIG PROTECTIVE SIGNIL GARAGE OPENER: x CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC: x DATAITELE COMM: NURSE CALLS T>TAL 0 SYSTEMS. Owner: Glntractor: TOTAL FEES: $ 4,954.44 DON MORISSETTE: HOMES CON MORISSEITE HOMES This permit is subject to the regulations contained in the 4230 GALEWOOD ST 4230 GALEWOOD STREET Tigard Municipal Code, State OR Specialty Codes and all other applicable laws All woo rk will be done in SUITE 100 LAKEOSWEGO,OR p7035 accordance with approved plans This permit w`1l expired work Is not started within 180 days of Issuance,or if the work iS suspended for more than 180 days ATTENTION phono Phone Oregon law requlre3 you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg N: LIC 35533 forth In OAR 952-001-0010 though 952-001-0083 You may obtain copies of these rules or direct questions to OUNC by calling(50')246-1987 REQUIRED INSPECTIONS Erosion Control insp 8, Post/Beam Mechanica Mechanical Inst. F,arning Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation M•chanical Insp Shear Wall Insp Insulation Insp Mechanical Final Fooling Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Ire{ Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr, Electrical Service Low Voltage Water Line Insp Final inspectio 1 POStlBeam Structural PLM/Underfloor Electrical Rough In Gas Line Insp AppNSdwlk Insp Building Final Issued By : �_4! -.-�_ Permittee Signature Call (50 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT - DEVELOPMENT SERVICES PERMIT#: SWR2001-00007 AL 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/16!01 SITE ADDRESS; 1286 SW HOLLOW LN PARCFL: 2S103CB-07600 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R•4.5 BLOCK: LOT: 025 JURISDICTION: 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 lot new SF detached dwelling. Owner: --_...----- --- - --- FEES DON MORISSETTE HOMES 4230 GAL(-WOOD ST — ._ Type By Date Amount Receipt _ _ PRM? CTR 1/16101 $2.,300.00 27200100000 INSP CTR 1/16/01 $35.00 27200100000 Phone- 503-387-7538 Total `$2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued The total amount paid will be fc,rfeited 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' Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notificatic-i Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these r rales or direct questions to OUNC by calling (503) 246-1987 Issued by: Permittee Signature: Call (503 639 4175 by 7:00 P.M. for an inspection needed the next business day Z- 125 % *"� /- 04 Building Permit Application City of Tigard Datereceived: /AI/O/ Permitn0.:&X7Z00 U Address: 13125 SW liall Blvd,Tigard, OR 97221 Projecdappl.no.: F.xpiredale: City ofTigurd Phone: (503) 639-4171 Date issued: 8 Y:'P, Receipt no.: Fax: (503)598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: 1 U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family >1cw construction U Demolition U Addition/altemtion/replacement U Tenant improvement U Fire sprinkler/alarm U Other: JOB SITE INFORMATION Job address: '� . Bldg. no.: Suite no.: Lot: Block; Subdivision: dTax map/tax lot/account no.: Project name: /��1- 32. 36', 3 9 Al Description and location of work on premises/special conditions: Name: Mailing address: l C 1 & 2 family dwellin�� v City: ` Stiate: ZIP: Valuation of work............ 1. . ........ _ Phone: Fax: 2--#019E-mail: / I No.of bedrooms/baths................................. Owner's representative: Total number of floors.................... Phone: Fax: E-mail: New dwelling area(sq.ft.) .......................... ncAPPLICANT r Garage/carport area(sq.ft.)......................... _ 713 — Name: -, Yl Covered porch area(sq.ft.)......................... /U — Mailing address: Deck area(sq. ft.)........................................ City: State: ZIP: Other structure area(sq. ft.)......................... _ Phone; Fax: I E-mail: Commerciat/indtustrial/multi-family: 1 1 Valuation of work........................................ $—_ - Existing bldg.area(sq.ft.) ...... .........r ..... Business name: New bldg.area(sq, ft.) ............... Address: Number of stories City: State: LIP: Type of construction.............r. - ......... Phone: ---=Fax: E-mail; CCB no.: --- (k:cupancy group(s): Existing: _. GxZ New: City/metro lic.no.: Notice:All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Name: ( provisions of ORS 701 and may be required to be 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 prrsow Plan no.: - ---- Phone: Fax: I E-mail: -- a 1 a Name: " t Contact person: Fees due upon application ........................... $_ Addre : ,t Date received: _ City: c ate• ZI Amount received ........................................ $ Phone: - �] Fax: E-mail: Please refer to fee schedule. !hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please call lunsdiction for more infomution. attached checklist.All provisions of laws and ordinances g verning this O Visit 0 MasterCud work will be comp ith,whetherprciri f rcreor n t, Credit cad number. _ AuthorireJ i Hadar a 1 1 Expires - Date: ! Now of ardhotder a shown on credit rural Print nameA _ s Cadholder sisnaure Amount Notice:This permit application expires if a permit is not obtained within 180 days ager it has been accepted as complete 440-4613(doatCorr) Mechanical Permit Application Dale received: Permit no.: City of Tigard Project/appl.no.: Expiredatc: A City fTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 ---- Phone: (503) 639-4171Date issued: 4y: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Lar,i use approval: — Buildit.g permit no.: 1 0 1 &2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement A,lew construction 0 Additioti/alteration/replacement U Other: 1 1K toll M — Job address: Ci o d Indicate .quipnient quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: C Block: Subdivision: v I \J 'See checklist for important application information and Project name: C jurisdiction's fee schedule for residential permit fee. City/county: y ZIP: t t t Description and location of work on premises: t tit)I R j Jyj F1 10111 1t t Est.date of completion/inspection: IJrscrFee(m) Tots) iption Qty. Res-only Rrs.only Tenant improvement or change of use: 11 AC- Is existing space heated or conditioned?O Yes 0 No Air handling unit -_CFM Ajar conditioning(site plan required) -_ Is existing space insulated?U Yes U No Aiteration of existing IIVAC system CONTRACTOR Holler/compressors i-- �- Business name:-1h U t State boiler permit no.: __ HP Tons F�TU/H Address: � -� Kai Fjrelsmo aampervi uct-smoke deLctors City: Sta?Em ZIP: Lj meat pump(site plan required) -"- - Phone. ' Fax: ailnst�place umac �_urner / - - CCB no.: Including ductwork/vent liner Q Yes 0 No T,al rep ac relocate heaters-suspen ed, -- City/metro Iic.no.: _ ` — wall,or floor mounted Name(please print): -went foi appliance other than furnace T CONTACT PERSONcf etat on: Absorption units BTU/H Name: Ciillers^ HP _ Address: Com ressors_ Hp k.nvironmental exhaust and ventilation: City: Stale: ZIP: Appliance vent Photo: Fax: E-mail: Dtycrex gust — )foods,Type l res.kjtc e-iPFa mat 'aoxi fire suppression system Nar le: C Exhaust fan with single duct(bath fans) Ma!ling address: ) Exhaust system a art from heating or AC State: ZlP: C ue piping ad star ut on(up to 4 outlets) Type: LPC _� NG Oil Pht ne' - Fax: F. trail: FuclpipingeacFadditionalover 4outlets rotes p p ng(schematic required) Name: Nurnbei ofoutlets Other sl appliance or equ pmeal: �— Address: Decorative fireplace City: Stan ILII': nscrt--type - _ Phone: Fax �1 E nwll, Wswv pe ctstove Other: Applicant's signature >:itc other. Name (print):ln�n Not ail Jurisdictions accept credit cards,pleas call jurisdiction for rt x information. Permit fee.............. ..... 0 Visa 0 MasterCard Notice:This permit cpplication Minimum fee................5 Credit card number _ expires if a pertnit is not obtained Plan review(at ^ %) $ -- Eap res within 180 days after it has been State surcharge(8%) ....$ Name of cardhol r as atwwn one it c -- accepted as complete. S _ TOTAL .......................S _ Cardholder ripature Amount -- C1p e617 I600'Cr1Ml Plumbing Permit Application Date received: Permit no.: City Of 'Tigan' Sewer permit no.: Eiuildin Address: 13125 SW mall Blvd,Tigard,OR 97223 p g permit no _ City of Tigard phone: (503) 639-4171 Projecitappl no.: Expire date: Fax: (503)598-1960 Date issued By: Receipt no.: Land use approval: _ - Case file no.: Payment type: TYPE OF PERMIT O 1 &2 family dwelling or accessory ❑Commercial industrial ❑Multi-family U Tenant improvement ew construction U Add ition/al ter•.ttion/replacement U Ftxod service U Other: JOB SITE INFORMATION FEE SCI I EDULE(for speclal In format IoAf use checklis'll) Job address: ��y l \, Description Qty. Fee(ca.) Total New 1-and 2-family dwellings only: Bldg,no.: Suite no.: (includes 100 ft.for each utility connection) Tax map/tax lot/account no,: SFR(1)bath Lot: Block: I Subdivision: t SFR(2)bath -- -� Project name: SFR(3)bath City/county: Zip: Each additional bath/kitchen Description and location of work on premises: Siteutilitles: Catch basitt/area drain Est.date of completion/inspection: Drywells/leach line/trench dr.tin PLUMBING ooting drain(no. lin. ft.) - 1 I Manufactured home utilities Business name: r(' c `VA Manholes Address: (( Rain drain connector City: ( State: ZIP: '7 _ Sanitary sewer(no.lin. ft.) Phone: Fax: Email: Storm sewer(no.lin. ft.) CCB no.: � Plumb.bus.reg.no: Water service(no.lin. ft.) City/metro lic.no.: Flxture or item: tion valve Contractor's representative signature: Absorption --- Print name: '!( Date: C1 Back(low reventer -_ Backwater valve 1 1 Basins/lavatory Name: Clothes washer Dishwasher Address: —_ - - Drinking fountain(s) City: _...------- ----- State: r.LII': -- - L — -- -- Ejectors/sump _ Phone: - — - fax: F rnail Expansion tank Fixture/sewer cap _ Name(print): -,( ' Floor dmins/floor sinks/hub Garbage.disposal Mailing address L — - liose bihb City: State• ZIPS Ice maker _ Phone: 7- -- Fax: -7 Ci-mail Interceptor/grease tmp _ Owner instal lation/residential maintenance only: The actual installation Primer(s) _ will be matte 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) Owncr's signature: Date: S-'m ati to 0 0 1 Tubs/shower/shower pan Name: Urinal - - Water closet Address: Water heater City: _ State: ZIP: _^ Other. -- Phone: Fax: E-mail: Total NM all jurisdiction accelK credit cards•please call jurisdiction for mora intYxmation. Notice:This pern+i:application Minimum fee.,.............. O visa O MasterCardPlan review(at _ %) S expires If apermit is not obtained Credit card number-- _ //_ within 180 days atter it has been State surcharge(8%) ....$ _ Name of cardholder u shown on credit cid expire' TOTAL accepted ascomplete. •••••••••••••••••••••.•S -- -- _ S ii Cardholdet:ilnature _� Amount 44A-4616(6KMKTn6!r f lectrical Permit Application Date received: Permit no.: City of Tigard i'roject/appl.no.: Expiredate: Address: 13125 SW Nall IIIvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 6394171 — -- --- -- Fax: (503)598-1960 Case file no.: Payment type: Land use approval: TYPE or.PE WIT I &2 family dwelling or accessory O Commercial/industrial []Multi-family ❑Tenant improvement New construction U Addition/alteration/replacement U Other. _ ❑Partial JOB SITE INFORMATION Job address: Bldg.no.: Suite no.t Tai rnap/tax lot/account no.: Lot: 7 Block: Subdivision: tk ICN — Project name: Description and location of work on premises: Estimated date,of corn pletjon/inspection: SCHEDULECONTRACTOR APPLICA11 ION UE Job no: FK Max Business name; Uescriplion Ql . (ea) Total no,Imp Address: New residential-single or muft1 family per dwelling unit.Includes attached garage. City: Statc: ZIP; ? Serviceincluded: Phone: Fax: E-mail 1000 sq.ft.or less 4 Foch additional S00 sq.ft or portion thereof CCB no.: Elcc.bus.tic.no: Urnited eneNy,residential 2 -City/metro�Iluic.n Limited energy,non•rcsidential 2 Fach manufactured home or modular dwelling Signal . ofg a ectrictan(required) _ Date Service and/or feeder _ 2 Sup.elect.name(print). , License no: Services or feeders-Installation, PROPERTY OWNER altersUon or relocation: 200 amps or less 2 Narne(prinl): 'C 201 amps to 400 amps 2 �-- 401 amps to 600 amps 2 Mailing address: 4 601 amps to 1000 amps 2 _ City: L o State: ZIP: 7j� Over 1000 amps or volts 2 Phone: 7" Fax. -7 mail: Reconneetonly 1 Owner installation:The installation is being made on property 1 own Temporary services orfeeders- which is not intended for sale,lease,rent,or exchange according to illation,alteration,or relocation: ORS 447,455,479,670,701. 200 strips or less _ 2 201 amps to 400 smps 2 Owner's signature: _ Date: 401 to 600 ams z ' Branch circuits-new,alteration, or extension per panel: N:une: A. Fee for branch circuits with purchase of Address: service or feeder fee,each brunch circuit City: State: ZIP: B. Fee for branch circuits without purchase - —- -- of service or fader fee,first branch circuit: _ 2_ Phone: I'ax: Email: Fach additional branch circuit: M ise.(Sen Ice or feeder not Included): U Service over 225 amps arrnnwrcral U I lealth-care facility, Each pump or irrigation circle 2 O Service over 320 amps-rating of 1&2 U Hazardous location Fach sign or outline lighting 2 familydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, C3 System over 600 volts nominal more residenual units in one structure alteration,or extensi mo 2 U Building over three stories U Feeders.400 amps or more *Description: O Occupant load over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable in any of the above: U F.gressAightingplan U Other. - -------- Per inspection Submit_sets of plain with any of the above. Investigation tee The above are not applicable to temporary comtruction service. Other Not all jurisdictions accept credit cods,please call jurisdiction for move information Notice:This permit application Permit fee.....................Is rI Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) S Credit card number i within 180 days after it has been State surcharge(8%) ....$ p+res accepted as complete. TOTAL .......................S _— Ntme of cardherlder u shown on credit c Cardholder signature Amount ton u,i t,,ri, ,•,t DON • MORISSETTE OBE : 1978 4 2 3`O G A L E w O O DO R3 T R 8TH T LOT: 25 L A K 9 0sw900. 0 R 9 G 0 N 07036 DATE: 12/29/2000 (603) 387 - 7530 VAX (503) 3a7 - 76 1 6 PROPERTY: QUAIL-HOLLOW CITY: TIGARD SCALE: 1"=20' PLAN No.: 17C OPTION 6 C3 12266 S.W. HOLLOW LANE u � Q W E > _ •.� Approach EL■298' 60 EL•2?e, ' EL-2W' --- - — -_ !Concrete EL OW EL•25.�'. - H PL 56 - 1.6. EL+300 b69 eq. rt. car gar. ;3 FFE. FL•300' 41 2d Z 4 8 4^'0' � 3,050 sq. Pt. �' e• 0 _s 0 4 bdrm. 5 4• Q a 3 1/2 bath - 4,_•,�>� F.F.E. 301-S' I 61 EL.,3CO' 13 b ,• EL•301' I 91 ICC T= _ -- - 28•m. -- ----- - k 3r'_ 3CL, n,f cc EL■306' -;r' I LOT ' 25 6ID00 eq. ft. � i