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12333 SW HOLLOW LANE t � i# W W W cn O O r w a I I� i ; I s t 12333 S!M Hollow Lane CITY O1 TIGARD —___ MASTER PERMIT PERMIT#: MST2000-00526 DEVELOPMENT SERVICES DATE ISSUED: 12/12/00 13125 SW Hall Bi.d., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS- 12333 SW HOLLOW LN PARCEL: 2010'"7-06600 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 01 JURISDICTION: TIG REMARKS: S/F PATH 1 BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRE)SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,605 of BASEMENT: .I LEFT: 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,790 of GARAGE: 710 of FRONT: 20 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: of RIGHT 5 VALUE: E 310,501.00 OCCUPANCY GRP: R3 BDRM• 6 BATH: 3 TOTAL: 3.19500 of REAR is _ PLUMBING SINKS: I WATER CLOSETS, 3 WASHING MACH: I LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: a DISHWASHERS I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: TUB/SHOWERS 4 GARBAGE DISP: I WATER HEATERS. I WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FI 111N<100K: BOIL/CMP<3HP: VENT FANS 5 CLOTHES DRYER: 1 c 4S FURN>-100K: 1 UNIT HEATERS: HOODS: OTHER UNITS: I MAX INP: btu FLUOR FURNANCES: VENTS: I WOODSTOI/ES: 1 GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS LOGO SF OR LESS: 1 0 • 2c0 amp: 0 - 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF 7 201 400 amp: 201 400 amp: 1st WIO SVCIFDn: 00 SIGN/OUT LIN LT: PER HOI R: LIMITED ENERGY: 401 501)amp: 401 600 amp: EA ADDL BR CIR SIGNALIPANEL: IN PL<NT MANU HMISVCIFDR: 601 - 1000 amp: Gal#ampe•100ov: M"10R LABEL: loon.amp,00ll: Reconnect only: —'— PLAN REVIEW SECTION »4 RES UNITS: LVCIFDR>•225 A >600 V NOMINAI: CLS AREAISPC OCC: ELECTRInAL•RESTRICTEr cNEROY _ ,�.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT. BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTE'1TIVE SIGNL' GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS TOTAL a SYSTEMS: Owner: Contractor: TOTAL FEES: $ 4,972.06 DON MORISSETTE HOMES INC DON MORI!,SETTE HOMES This permit is subject to the regulations contained in the Tiga.rd Municipal Code.State of OR. Specialty Codes and 4230 GALEWOOD STREET 4230 'ALF WOOD STREET all other applicable laws. All work will be done in LAKE OSWEGO,OR 97035 SUITE 11'1 accordance with approved plans This permit will expired LAKE OSWEGO,OR 97035 work is not started within 180 days of issuanoe,or if the work is suspended for more than 180 days ATTENTION. Phone. Phone: Oregon law requires you to follow rules adopted try the Oregon Utility Notific.iion Center. T:1ose rules are set Rep N: (IC 11,531 forth in OAR 952-0/1-0010 through 952-001-0080. You may obtain copws of these rules or direct questions to OIJNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, PosUBeam Mechanica Mecha,iical Insp Framing Insp Gas Fireplace Appr/Sdwlk Insp Sewer Inspection Underfloor insulation Mechanical Insp Shear'Nall Insp Insulation Insp Electrical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Gyp Board Inso Mechanical Final Foundation Insp Footing/Foundation Drl Electrical Service Low Voltage Rain drain Insp Plumb Final PosUBeam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Water Line Insp Final Inspection Issued By : . ~1 � _ Permittee Signature": Call (503) C39-4175 by 7:00 p.m. for an ir5pection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2090-00361 13125 SW Hall Blvd., 'i igard, OR 97223 (503) 639-4171 DATE ISSUED: 12/12/00 SITE ADDRESS; 1:333 SW HOLLOW IN PARCEL: 2S103CB-06600 SUBDIVISION: (QUAIL HOLLOW EAST ZONING- it 4 5 BLOCK: LOT: 015 JURISDICTION: TIG TENANT NAME: USA NO. FIXTURE UNITS: CLASS OF WORK: NEVI' DWELLING UNITS: 1 TYPE OF USE: SIP NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWI-R IMPERV SURFACE: Remarks: Sewer connection for new SF detached. Owner: ---.— -- — FEES DON MORISSETTE HOMES INC Type ByA Date Pmount Receipt 4230 GALEWOOD STREET -- --- -- I LAKE OSWEGO, OR 97035 PRN1T CTR 12/12/00 $2,300.00 27200000000 INSP CTR 12/12/00 $35.00 27200000000 Phone: 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 arnount 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 su 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 Notification Center. Those rules are set forth in OAF: 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: t(f - Permit4ee Signature: 1 '�� LOAL y Call (503) 639-1175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application L�( 2i7�L'-0 D3G Datereceived: - Permit no.: c-r�i Y, �_ City of Tigard 5 � � //i c Address: 13125 SW Ball Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: City of"Tigard phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land u e a �roval �l�`t`'j C'°°°s 1&2 family:Simple Complex: U I &2 family dwelling or accessory Q Commercial/industrial U Multi-family >ltNCW construction ❑Demolition U Add ition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:_ Job address: I - ,�` 7, r Bldg,uo.: Suite no.: _ Lot: '- Block: Subdit cion: L I - Tax map/tax lottaccount no.: Project name: �- Description and location of work on premtQP,�',,pecial conditions: _ V Name:— Mailing address: -1 1 &2 family dwelling: City: I State: _I ZIP:q-? C.- Valuation of work........................................ $310 SU Phone: Fax:- - •) E-mail: No.of bedrooms/baths................................. Owner's representative: ` L Total number of floors................................. L Phone: Fax: E-mail: New dwelling areas ft. 3 `lS A"My, oil Garagelcarport area(sq.R.)......................... 2/0 Name: Y( Covered porch area(sq.ft.)......................... Mailing address: Deck area(sq.ft.) ........................................ City: State: ZIP: Other structure arca(sq. ft.)......................... Phone: Fax: E-mail: Commercial/industrial/multi-family: UONTRAtTOR Valuation of work..................... ............. Exi3ting bldg.area(sq. ft.) ..................... Business name: New bldg.arca(sq.ft.) ........ ...................... — City:Adds: Number of stories City: _ State: ZIP: Type of construction Phone: Fax: E-mail: .................................... — CCB no.: Occupancy group(s): Existing: - New: City/metro lie.no.: Notice:All contractors and subcontractors are required to be ILU licensed with the Oregon Construction Contractors Board under Name: Lnq t,�ILLY-,Aprovisions of URS 701 and may be required to be licensed in the jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing,the following reason applies: Conl-�t person: Plan no.: _ Phone: Fax: E-m.il: �^ KIM W Name: 4N%-i —L t Contact person: Fees due upon application .......................... $ Addre : V1t __ Date received: City: ate ZIP: Amount received ......................................... $-- Phone: - Fax: I E-mail: _ Please refer to fee schedule. hereby certify 1 have read and examined this application and the Nd all jurisdictions arceq cxdit catdt,please call jurisdiction rot mme inQxmation attached checklist.All provisions of laws and ordinances governing this U Visa O ntostercud work will be comp t lth,whether pecifi ere or not.1 1 y credit card somber / / Authorized i natuate: no, �I (,%) - -- �xptrcs le: Nurse of cardtalder as srtawn on credit cud Print name: \ is C"Rder sitnattrre Amoum Notice:This permit application expires if a permit is rot obtained within 180 days atter it has been accepted as complete. 44DA11(6 OCOM) i Mechanical Permit Application ^� -�-- Datereceived: Permit no.: City of Tigard Projectlappl.no.: Expire date: GryoJ7igord Address: 13125 SW Hall Blvd,Tigard,OR 9722 —---� Phone: (503) 639-4171 Date issued: By: Receipt no. Fax: (503)598-1960 Case file no.: Payment type: Land use approval: __ Building permit no.: U 1 &2 family dwelling or accessory U Cununercial/industrial U Multi-family U Tenant improvement b!CNcw construction U Addition/alteration/replacement U Other: ----__.___�_ _. I I IN COMMERCIAL VALUATION SCHEDULE Job address: ) L7 1/ I(; Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overlicad, Tax map/tax lot/account no.: profit.Value$ Lot: I C% -lock: Subdivision: t rSee checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: ) I De scripdon and location of work on premises: 4 t w I i _ 1,cc(ea.) Uo(al Est.date of completion/inspection: _ _ �I on O<y. Ktm•only R'es.only Tenant improvement or change of use: HVAC: Is existingspace heated or conditioned?U Yes U No Air conditioning unit CFM P con idoning(site plan rcquir ) Is existing space insulated?U Yes U No Alteration o existing A system Boiler/compressors Business name: State boiler permit no.: l0 Sl Y��- HP Tons BTUM Address: j _ K.t yr it smoke dampers/di smo a detectors City: ( Slate: ZIP: L eat pump(site pan requlr ) Phone E-mail; Install/replace mac umer ::::tIncluding ductwork/vent liner a Yes O No CCB no.: _ nsta I/replac re orate eatcis=susper nd� City/metro tic.no.: wall,or floor mounted Name(please print): enc fora lance other than furnace e erat on: Absorption units BTU/i1 Name: Chillers I I►' Address: Comresuxeos r ronmta exhaust ant rent la(ion: City: Statci Z3P: Appliancevent Phone: Fax: Email: ryerex gust _ Dols,Type res. itcFe azmat hood fire suppression system ---- Name: � 00 C, Exhaust fan wa single duct(bath fans) - Mailing address: ) _ aunt systemaart from heating or AC — Fuel piping astr but on(up to 4 outlets) City: Stale: Z1P: Type. LPG NO Oil PhoneFax -'1 F snail: ue l in ear additional over out els rocesspiping(schematicrequired) _ Number of outlets Name: ter lista appliance or equipment: Address: Decorative fireplace City. State: I ZIP: Insert-type _ Phone: F x: E-mail: a-dstove/pellet stove Applicant's signature: )ate: Other. Name (print):&Na `J'-1►'�( Not all Jurisdictions accept credit cods,please call Jurisdiction for a mc mfamatian. Permit fee.....................$ ---- Notice:This permit applicatiai Minimum fee................$ U Visa U MasterCard expires if a permit is not obtained Credit card number — --1 —1--. within I80 de s aRet it has been Ptah review(at _ 96) E Expires y State surcharge(8%) ....$ Name of cardhol kr as shown on credit card s accepted as complete. TOTAL .......................$ Colder signature Amount 440.4617(6A000M) Plumbing Permit Application Date received: Permit no.: (,ley of TigardDate no.: Building permit no: P- . ' Address: 13125 S'N Hall Blvd,Tigard,OR 97223 Sewer _ t iry„/7igard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: Ely: Receipt no.: Land use approval: _ � Case file no: Payment type: OFOERNIFIr U I &2 farnily dwelling or accessory 0 Coin mercial/industrial O Multi-family U Tenant improvement ew corsrnrction U Ad(liii(,n/alrcration/►rplacement U Food service U Other. 1 i i Joh address: Desc_rtelion _ (p Fee(e:r.) 'local -- ----- Nen 1-and 2-family dr,ellings only: B /tax lot/account no.: Suite no.: 4_ (Includes loo ft.foresch utility connection) Taxx mmap/aSFR(1)badi__ I.ot: ,t Block: Subdivision: SFR(2)bath -- Project name: SFR(3)bath City/county: ZIP: Each additional bath/kitchen - Description and location of work on premises: SiteutiUties: Catch basin/area drain Est.date of completion/inspection: Drywelisfleach line/trench drain PLUMBING CoNTRACFOK Footing dradn(no.lin.ft.) _ Manufactured home utilities Business name: 1U r �_ Manholes Address: ((` Rain drain connector City: State: ZIP: 7 _ Sanitary sewer(no.lin.ft.) Phone: Fax: I E-mail: Rfnrm sewer(no.lin.ft.) _ CCB no.: Plumb.bus.reg.no a1 -�� Water service(no.lin. ft.) City/metro lic.no.: Fixture or Item: Absorption valve Contractor's representative signature: Back[low preventer Print name: Date: t I Fz Backwater valve ONIACT t BastnsAavatory Name: Clothes washer Address: - Dishwasher City:City: tate: ZIP: Drinking fountain(s) SEjectors/sump Phone: Fax: E-mail: Expansion tank _ Fixture/sewer cap Name(print): t Floor drains/floor sirtks/hub - Mailing address Garhage dis sal _ Hose bibb City: State ZIP: Ice ma4_r Phone: '7- Fax: -7 E-mail• Interceptor/grease trap Owner instal lation/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 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's si nature: Date: Sump Tubs/shower/shower an Name: Urinal ---- --- Water closet Address: __--_ Water heater City: �- State: ZIP: Usher. - Phone: Fax: E-mail: Total Nd all jurir:icdom accept credit car,lt,please call jurirdktion for mare Informaion _ Minimum fee................$ Notice:"Ibis permit application U Visa O Mastercard expires if a permit is not obtained Plan review(at _ %) $ _ Credit cwd number �- —� within 180 days after it has been State surcharge(8%) ....$ F.apiree Namr of cudholdn u rhos,nn credit card accepted as complete. TOTAL .......................S _ --- CardholderNputure --- Am.,um r 4G.4616(WOC'OM) i Electrical Permit Applicav on Date received: Permit no.: 4—ity of Tigard Project/appl.no.: Expire date: City offigard Address: 13125 SW liall fllvd,Tigard,OR 97223 Date issued: By: Receipt rice: Phone: (503) 639-4171 --- -- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1 1 &2 family dwelling or accessory 0 Commercial/industrial is Multi-family O Tenant improvement New construction O Addition/alteration/rf�placement ❑Other. Ll Partial 1 SITE INFORMATION Job address: �7 1/ V 1 I Bldg no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: t Project name: Description_and location of work on premises: _ Estimated date of completion/inspection: 1 1 1 1 .lob no: Fee Max Business name: , Description Qty. (ea.) Total no.[nip - e"residential-si le or multi-family per Address: dwelling unit.Includes attacked V.rhe. City: state: ZIP: Sesviceincluded: Phone: Fax: E-mail: 1000 sq ft.or less 4 CCB no.: I Elec.bus.Ilc.no: Each additional 500 sq.ft or portion thereof Limited energy,residential 2 City/metro lic.n : Umitedenergy,non-residential 2 — Each manufactured horse or modular dwelling Signets f supervisin�Iem�tnc:,..n(required) Date Service and/or feeder 2 Sup.elect.name(nrint): License no: Services or feeders-Installation, ,o PROPERTY1 alteration or relocation: — 200 amps or less 2 Name(prin!): LiS 201 amps to 4W amps 2 Ft 401 amps to 600 amps 2 Mailing address: L 601 amps to 1000 amps _ 2 City: )� State: Over 1000 amps or volts 2 Phone. Fax. Reconnectonly I Owner inst<�lation:The installation is being made on property I own Temporary services or feeders- which is not inten,', :for sale,lease,rent,or exchange acco-..ig to b►cfallation,alteration,orrelocation: ORS 447,455,479,670.701. 200 amps or less _2 201 amps to 400 amps 2 Owner's si nature: Date: 401 to 600 ams 2 Branch cireults-new,alteration, or extension per panel: Name: A- Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: 71 P: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN HUNIEW(Please check all that apply) Misc.(Service or feeder not included): O Service over 225 amps-commercial l7 Heals care facility Each pump or irrigation cia:,e 2 •Service over 320 amps-rating of 16r2 O Hazar:sous location Fach sign or outline lighting 2 -_ family dwellings ❑Buildi ig over 10,000 square feet four or Signal circuit(s)or a limited energy panel, OSystem over 600volts nominal more residential un''sinone structure sitcration,orextension* O Building over three stories O Feeders,400 amps or more ODescrition: _ _ O Occupant load over 99 persons ❑Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: ❑Egress/lightingplan Q Other. i --- Per inspection Submit,_sets of plans with any of the above. Investigation fee 71te above are not applicable to temporary construction service. Other Na all jurisdictions accept credit cards,please call jurisdiction fol n-M informadon. Notice:This permit application Permit fee.....................$ ❑Visa U MasterCard expires if a pennit is not obtained Plan review(at %) $ _ Credit card number —L—L_ within 18'13 days after it has been State surcharge(8%)....$ Espires accepted tis complete. TOTAL .......................$ Name of cardholder u s wn an credit _ S Cardholder signature Amount 440-4615(WWOM) DON • MORISSETTE OBE : 1988 N 0 4 E 8 1 N C 0 R P 0 R A T E D 4 2 3 0 G A L E W O O D S T H E!; E T LOT: 15 LOSE 09NR G 0. 0 @EG0N 97033 DATE: 11-18-00 (6 0 3) 3 8 7 - 7 6 9 B F A X (6 D 3) 3 9 7 - 7 9 1 b PROPER'T'Y: QUAL-HOLLOW CITY: TIGARD SCALE: 1"=20" PLAN N o.: 181 OPTION 1 ELEVATION vViQI -Q.- 792' '?w' Ccs v[ �--• a 0'R1 PATIO:�e' 3 v .• EL.2w' 2B' ; EL• 92' � 395 aq. Ft. 5 bdrm. j 3 ba tai FF.E. 292.5' i Q j11. gym' 3 car ger. 25, F.F.E. 292' _ RG1a 9 EL-290' 0 •fir '�,: �41;`�;�:��.�.��r„�:. © 8' FUE = �Ccrcrete.: EL•790' "a*riw; i� ""i ''SIDEuI K4fr. T IY"'"+a* I� •291' EL•252' Approsch�� ° LOW L,4NE 4 ob LOT MI5 6,000 eq. Ft. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE HARRY + SON PLUMBING INC 7117 NORTH ARMOUR PORTLAND, OR 97203 Plumbing Signature Form Permit #: MST2000-00526 Date Issued: 12112100 Parcel. 2S103CB-0G600 Site Address: 12333 SW HOLLOW LN Subdivision. QUAIL HOLLOW - EAST Block: Lot. 015 Jurisdiction: TIG Zoning: R-4.5 Remarks. S1F PATH 1 Your company has been indicated as the plumbing contras►or for the permit indicated above. In order for the plumbing permit to be valid, please have the approprigte individual from your company sign be!ow 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 0\NNFR PL.UMBINO CONTRACTOR: DON MORISSETTE HOMES INC HARRY + SON PLUMBING INC 4230 GALEWOOD ST REET 7-1 -17 NORTH ARMOUR LAKE OSWEGO, OR 97035 PORTLAND, OR 97203 Phone #: Phone #: Reg #: I Ir. 00068900 PI M 26-448ob AN INK SIGNATURE IS REQUIRED ON THIS FORM Siqnatufe of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLS'!'. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CITY ELECTRIC + SUPPLY CO 8900 SW BURNHAM F-27 TIGARD, OR 97223 Electrical Signature Form Permit #: MST2000-00526 Date Issued: 12/12100 Parcel: 2S103CB-06600 Site Address- 12333 SW HOLLOW LN Subdivision: QUAIL HOLLOW - EAST Block: Lot: 015 Jurisdiction: TIC Zoning: R-4.5 Remarks: S/F 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 authorised until this completed form is received OWNER: ELECTRICAL CONTRACTOR: DON MORISSETTE HOMES INC CITY ELECTRIC + SUPPLY CO 4230 GALEWOOD STREET 8900 SW BURNHAM F-27 LAKE OSWEGO, OR 97035 TIGARD, OR 97223 Phone #: Phone #: 641-8012 Req #: SUP 3592S I, LIC 42422 ' ELE 26-289C AN INK SIGNATURE IS REQUIRED W4.THIS FORM Signa ure of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIVARD BUILDING INSPECTION DIVISION TMST 24-Hour Inspection Line: 639-4175 lousiness Line. 639-4171 � ^---- 2 `-- B U P ^_ Date Requested �� / / AMQ PM BLD Location Z 3 3 S w / /1Gw Suite MEC Contact Person Ph _ ?_ 66 ;?6 PLM iU/ �GGG Contractor _ Ph Z 7 SWR BUILDING Tenant/Owner ELC Retaining Wall Et R Footing Foundation ACcpSs: / v"v' �1�4.kc.c-,� '-� FPS ---------- --- Fig Drain �/ L �'�`-� �' ' Crawl Drain Inspection Notes: SGN Slab -------- ------- -- ---- —--------- SIT Post&Beam �— Ext Sheath/Shear -- Int Sheath/Shear Framing Insulation Dryv4l Nailing Firewall Fire Sprinkler ;c=-- -------___...-..-- Fire Alarm Susp'd Ceiling ------ ----------------- - - Roof Mise _ _._.. ._. --- - - - - -- ---- ------�� Final PASS PART FAIL os eam -- Under Slab Top Out - Water Service ---------------- -- - Sanitary Sewer Rain Drains in 1'A5 ,>PART FAIL CHANICA,. Post&Beam - ----- ------ ----- _..-.- Rough In Gas Line ------ Smoke Dampers Final --- PASS PART FAIL ELECTRICAL --- --- -- - - Service Rough In UGISIab Low Voltage Fire Alarm _- Final PASS PART FAILSITE Rackfill/Grading — -- Sanitary Sewer Storm Drain [ I Reinspection fee of$ ^required before next inspection. Pay a,amity Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ I Please call for reinspection RE:_— - _ [ I Unable to inspect no access ADA Approach/Sidewalk Date ` a i Inspector _ __ !� �.-� ` --'�� Ext � Other -- --- Final PASS PART FAIT_ DO NOT REMOVE this inspection record from the Job site. CITYOF TIGARD — PLUMBING PERMIT — DEVELOPMENT SERVICES PERMIT#: PLM 00026 13125 SW Hall Blvd.,Tigard, OR 97223 (503; 639-4171 DATE ISSUED: 01/26/2001 PARCEL: 2S103C13-06600 SITE ADDRESS: 12333 SW HOLLOW LN SUBDIVISION: QUAIL HOLLOW- EAST ZONING: R-4.5 BLOCK: LOT: 015 JURIaDICTION:TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS. SINKS: URINAl S, GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEW7-R LINE: ft WATER CLOSERS: W.'.TER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential irrigation backflow prevention device. FEES Owner: _ — Type By Date Amount Receipt DON MORISSE TTE HOMES INC PRMT CTR 01/26/2001 $36.25 27200100000 4230 GALEWOOD STREET 5PCT CTR 01/26/2001 $2.90 27200100000 LAKE OSWEGO, OR 97035 — --- Total $39.15 Phone 1: Contractor: PROGRASS LANDSCAPE SERVICES 2.9895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682-6076 RP/Backflow Preventer Reg #: LIC 6135 PLM 11558 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR. 952-0001-0080 YOU may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: I 11_x- Permittee Signature:�2./Ggz �7(i /`'1-Y 1---z 1 Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application Date received: 11,`(,L01, P_rmit no.:�U`,1 rd0/-QnO�& t► g City Tigard Sewer permit no.: Building permit no.. Address: 13125 SW Hall Blvd,Tigard,Ok 9723 --- r r �'igard phone: (503) 639-4171 Projcct/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: / Receipt no.: Land use approval: -_ __ case file no.: Payment type: cow NU I &Z family dwelling or accessory U Commercial/industrial U Multi-family l_ 'Tenant impruvcnl,n( L. New construction U Addition/alleration/replacement ❑Food service U Other: JOB SpITE INFORMATION t tMl I Job address:/a.3,3 3 3 lU /-to .)I 1 vC. Uescrlption _ Qty. Fee(ea.) To A Bldg.no.: Suite no.: New 1-and 2-family dwellhrgs only: Tax map/tax lot/account no.: (includes 100 ft.foreach utilil conneci i(in) SFR(1)bath Lot: Block: Subdivisio LtCLLt �I Qu) SFR(2)bath -------- --- -- Project name: Q,.t_(,jt C- _ _ SFR(3)bath City/county: l LM IA ZIP: 91 Each additional bath/kitchen Description�Qd - atio of work on premises:— Sheutilities: _?,cd l Catch basin/area drain Est.date of completion/inspection:/ Drywells/leach line/trench drain Footing drain(no.lin. ft.) _ Manufactured home itilities Business name: &/-AS:S L-a f)d SC G Manholes Address:, 811 ( a '1- ,o Rain drain connector _ City: t/Sen t -C, I Stat ; L I ZIPf ) ) Sanitary sewer(no.lin.ft.) _ Phone:( -ax - 9f') E-mail: Storm sewer(no,lin.ft.) — CCB no.: /.j ' - Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: OC,3,j. Absorption a or item: Contractor's representative signature L1� L-Llk- ;~L.A. Absorption valve _ _Back flow preventer ,55 :t7 SS Print name:[� ej) 4t rt• CTale: - c,t Backwater valve 1 Basins/lavatory Name: EQCn S lr Y C-Lu Clothes washer Address. < < - u1 1`t f'1 [ R. Dishwasher Cit : ) oN U i I i State:(fes ZIP: 1 7 020 Drinking fountain(s) y 1) _ Ejectors/sump Phone: x: -ci E-mail: Expansion tank Fixture/sewer cap Name(print) f floor drains/floor sinks/hub Mailingaddre39, G Garbage disposal o�.3(s �t-U Ll -tl� orjel Hose bibb city:L.et- ti 'Lk el State:(. ZIP:-,j ,3 C- Ice maker _ Phone;)Oq- ! $1 2. FAY- E-mail: Interceptor/grease trap owner instal lation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property 1 own as per ORS Chapter 447. Sink(s),busin(s),lays(s) Owner's signature: Date: _ Sum Tubs/shower/shower pan Urinal Name: — Water closet Address: Water heater �. City: State: ZIP: _ Other --J-- Phonc: Fax: E-mail: Total - - -- — Not all jurisdictions accept credit cards,pleas call jur4dicticm fa on.more inFl iMinimum fee................$ Notice:This permit application U visa U MasterCard expires if a permit is not obtained Plan review(at — %) $ _ Credit tend number: l i State surcharge(8%)....$ � c. l U Expires within 180 days after it has been - — - accepted as complete. TOTAL .......................$ �Nune of cudholAer u shewu on credit card _ S _ Cardholdet signature Amount 4404616(6MCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) _ QTY ea) _AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16,60 for each utility co_nnoction.Z____-- _ _ _ _ One 1 bath _ $24920 Tub or Tub/Shower Comb — V 16.60 Two 2 bath-- Y 5350.00 _ Shower Only 16.60 Three Lbath __ $399.00 Water Closet 16.60 — SUBTOT.;I_ _ Urknal— 1660 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL — Garbage Disposal 16.60 _ TOTAL Laundry Tray 16.60 Washing Machine 16 60 17loor DrainlFloor Sink 2" 16.60 3.,- - t660 PLEASE COMPLETE: 1" 16.60 _ _ Water Heater O ccnver io' O like kind 1660 QuanUt b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. _ _ Capped MFG Home New Water Service 46.40 Sink — MFG Home New San/Storm Sewer 46.40 Lavato Tub or Tub/Shower hose Bibs 16-0 1 Combination Roof Drains 16.60 Showir Only Drinking Fountain 16.60 Water Closet 16.60 Urinal _ Other Fixtures(Specify) _ Dishwasher _ Garbage Dis a,al _ Laundry Room Tra — Washing Machine Flcor Dr2inlSink: 2" Sewer- 1st 100' 55 00 31• — Sewer-each additional 1 UO' 46.40 4" Water Service•1st 100' 55.00 Water Heater Wate-Service-each additional 200' 46.40 Other Fixtures _ S eclb'i _ Storm&Rain Dral-.•1st 101' 55.00 Storm&Rain Drain-each additional 100' 46.40 Ili — Commercial Back Flow Prevention Device 46.40 — Residenlial Backflow Prevention Device' 27.55 j. Catch Basin 16.60 ` Inspection of Existing Plumbing or Specially 1250 Requested Inspections —� pi.rlhr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 _ -- Grease Traps _ 16.60 ---- ----- -- ----- QUANTITY TOTAL Isometric or riser diagram is required it _Quantity Total is >9 _- ---- -- �- *SUBTOTAL ---��— 8%S FATE SURCHARGE — — — -- -- "PLAN REVIEW 25%OF SUBTOTAL Requlred only i1 fixture q1Y total is>9 TOTAL S `1�1lnimum permit fee is$72 50.B%state surcharge,except Residential Backllow . reventlon Device,which 1s!16 25+B%state scrcharge "All New commercial Bulidinas require pl.is with Isometric or riser diagrem and plan review is\d';u�torms\plm-faes.doc 10/10100 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspectior Line: 639-4175 Business Line: 639-417 '/,i BUP _Date Requested_ --AM_ _!PM _ _ BLD _ Location Z 3',�' S'`✓ �'`'� t, — Suite MEC Contact Person Ph ' _ PIR Contractor _ Ph — SWR _ BUILDS Tenant/Owrer ELC — r►t-aiininngg Wall ELR F ooting Access: Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: — Slab _-- -- _-.--_.�-- ----- SIT _ Post&Beam Ext Sheath;3hear —. Int Sheath/Shear Framing -- --- --- -__ - —....- ---- ---- ---- -- Insulation Drywall Nailing - ----_.__--_----- ------------ ---- --- - Firewall Fire Sprinkler --- ---- ------- -- ---- ----_ �,.—-- ------ Fire Alarm Susp'd Ceiling - - ------ ---- --- - -- - --- Roof _ PART FAIL -- - -- -- - ---- - -- -- --- - —__ -_ PLUMBING Post& Beam ...------—_-------- -------- ------- -_-_------ -------.- Under Slab I op Out Water Service _ Sanitary Sewer - ----- -- ----- ------------ .---__--_-- --.-_...___..--- Rain Drains Final -------...___.__ _ ----- —_._--------------- ----- ---- PASS PART FAIL —�- -------- -- -- - -— -- --. - MECHANICAI. Post& Beam --- -- --- .-- - - --- __-- -_ .._, ------ -- Rough In GasLine - - ---- ---- --- --------- _ _- -- _.. ------- Smoke Dampers Final �------- -------------------_--_ ------- --._------- PASS PARI FAIL ELECTRICAL -- -- --. _..--- Service Rough 10 UG1SIab I_ow Voltage Firv, Alarrn --- ----- --------- - - ----- - f-n"al PASS PART FAILSITE FlackTilUGrading -- - --- ---— -- ---------- -- ---- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at Citv Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE [ ]UnaEle to inspect no access ADA Approach/Sidewalk — _ Date i Inspector_ _ Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. c E V � N o ~ � O o a L F V Cl. s ^+ u s _ y c � o SSI u L p .= O v: o w � _ O C � O (L, V 1 O 3 � y CITY OF TIGARD BUILDING INSPECTION DIVISION T •;� G� � `� 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requestgd �5—�— AM_ _PM 8L Location /G' yj //fG� '' C 1` Suite _ — — MEC _ Contact Person _ Phi ' �� _ PLM Contractor Ph SWR BUILDING --- Tenant/Owner ELC _�— Retaining Wall I outing Access: Foundation Access: FPS Ftg Drain - — --- Crawl Drain Inspection Notes: SGN — Slab --- -- ��S5y�--r`�. i " _ SIT Post R Beam — Ext Sheath/Shear Int Sheath/Shear -- - Framing Insulation - Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mise Final PASS PART FAIL. --------- _ _ Post&Beam - —�- — Under Slab Iop Out - --- - -- ------- - - Water Service Sanitary Sewer -- - - ---- -___. ,------- --. Drains fininLe _-- - - ---�----------__--_---_ --_ -- P, PART FAIL E ANICAL PostBBeam _-_-- ---------____------.-_ -- _ ____ Rough In Gas Line - - - -- - - -_... _ --------- — Smoke Dampers Final - --- -�_.. ---------.�—� ----- --- PASS PART FAIL ELECTRICAL -- -- - ----------- — ---- --- ._�—.---- -- Service Rough In _-_ --- ----------------- UG/Slab Low Voltage Fire Alarm Final �--�----4- - - PASS PART FAIL -------- - ---- -- -- -- ---- ------- _ --- SITE _ Backfill/Grading -- Sanitary Sewer Storm Drain ( )Reinspection fee of$ required before next inspection. Pay at City Hail, 13125 SW Hatl Blvd Catch Basin Fire Supply Line [ ]Please call for reinspet-don RE- ( ] Unable to inspect-no access ADA Approach/Sidewalk Date n J`7 i Other __-._ __ Inspector — JL..�/�- _ Ext�__� Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST, �,�,_�� a 2L 24-hour Inspection Line: 639-4175 Business Line: 639-4171 C -- BUP Date Requested T � _ AM C� 'S PM BLD Location .3 _5 ��' '//��✓ L✓� — Suite MEC Contact Person —_ PhPLM Contractor Ph SWR DI Tenant/Owner ELC L — — Retaining Wall ELR Footing -'�-' - Foundation Access: FPS Ftg Drain - Crawl Drain Inspection Notes: SGN _ -- Slab -----. ---... _ - ---- _--- SIT Post& Beam -- --- Ext Sheath/Shear Int Sheath/Shear �-( I Framing ' 1 �I ��'L L I ��LU Insulation Drywall Nailing - --- - _ __ -- Firewall c� Fire Sprinkler _ C",��"±�-�-` Fire Alarm Susp'd Ceiling �� -- _--- -----_-- - - Roof � - _ �-�'��=��'�� • —_ final SS PART ` rAl --- - ---- -----_.__ Post R Beam - ---- -�- - - Under Slab Top Out - --- --_— --_ Water Service Sanitary Sewer - - -- Rain Drains SASS PART FAIL MOM Post& Beam __-.-- Rough In Gas Line -- --- - _.-�- _- -- -- Smoke Dampers S ART FAIL EETEETTRICAL - - ----- ---- ---- Seivice Rough In ----- --------..._._ -- UG/Slab Low Voltage ,Fire Alarm Final ASS PART FAIL Wv- fill/Grading `` -- -- --- —---- - -- Saititary Sewer Storm DrainI Reinspection fee of$ required before next Ospectic i. Pay at City Hall, 13125 SW Hall Blvd Catch Basin 1 Fire Supply Line C ( J Please call for reinspection RE' __ - _-__ — _ [ J Unable to inspect-no access ADA oath/Sidewalk / Z ( - y ` S otr,er Date��}! _��e. Inspector__ _— Ext AS ` PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MS.• �lJ?j _40S"L 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIPDate Requested 2- '� - _ AM ,PM BLD _ Location r Z `� �� 6 vJ Suite MEC Contact Person— Ph U - f�� PLM Contractor r ` — ��c_ '�7"�C Ph _ SWR BUILDING Tenant/Owner ELC Detaining Wall ELR _ Footing Access: Foundation FPS Ftg Drain SGN 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 - ---- ,�— �1- �"` - ---------- — - - - Roof Misc: ___--- Final PASS PART FAIL - -_ - ---- - - --- --- ------ - PLUMBING Post&Beam Under Slab TopOut - -- - -- - -- --_ -. -- ---_ __ —...._------------ Water Service Sanitary Sewer Rain Drains Final -- -- ---- --- - -- -- PASS PART FAIL MECHANICAL Post& Heam - -- - -- --- -- --- --- -- - — Rough In Gas Linc --- - --- ----- ----- ---- — .. Smoke Dampers Final — - - ._----. - -- ----- _------_ ----_ PASS PART FAIL CTRIC L -- - - ..---- -- Service Rough In UG/Slab Low Voltage Fi rfn -- ---- _. -------------- - ( F' 710Si PART FAIL -- - -- .. -- —- -- ------ - -- VTt V__ BackNI/Grading ---- - - --—- _ -- ---- _ Sanitary Sewer Storm Drain I [Reinspection fee of$ _required before next inspection Pay at City 11,411, 13125 SW Ball Blvd Catch Basin Fire Supply Line [ )Please call for reinspection DE _ f_ [ I Unable to inspect nn access ADA Approach/Sidewalk Date Z �u-k/ Inspector f C Ext Other -- --- — -- -- _ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.