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CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2004-00076
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE.ISSUED: 2/19/04
SITE ADDRESS: 13 '65 SW HAThiAWAY TERR PARCEL: 2S103CC-07700
SUBDIVISION: WHISTLER'S WALK ZONING: R-4,5
BLOCK: LOT: 0214 IURISDIC1ION: TIG
CLASS O'= WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACE',:
TYPE OF USE: SF WASHING MACH- BACKFLOW F'REVNTRS: 1
OCCUPANCY GRP- R3 FLOOR DRAINS: TRAPS:
STORIES- WATER BEATERS: CATCH BASINS:
F!X T URES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: JTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DIFHWASHERS: RAIN DRAIN: ft
Remarks: Installation of residential backflow prevention device for irrigation.
Owner. __ FEES -- --
Description Date Amount
DOJ MORISSETTE HOMES --
4230 GALEWOOD ST#100 1I'LUMB) Pernni I cc 2/19/04 $36.25
LAKE OSWEGO, OR 97135 I I nX l 8' „Slaw `inrluin 2/19/04 $2.90
Total $39.15
Phone : 503-387-75313 -- _�----- �� --
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQU!RED INSPECTIONS
Phone : 503-692-5945 RP/Backflow Preventer
Finai Inspection
Reg#: LIC 7904
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 wil! be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of is-uance, or if work is suspended
for more than 160 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
IssuedBy• % Permittee Signatures -
Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next business day
,)4 1 1 - J,la dan edmond-, 50a-692-076H P- 2
lbinp- Permit Application
._. ApplicationReceived .- _I1lutnhing
°'tom Pa, t No
.I
itY of Tigard �LiL� VGD �i7�jYJC[ 7�
Planning a Sewer
13125 SW hall Blvd. u"� _ i'errrtit N°" -
Plan Review Uther
Tigard,Oregon 972231 20 li _trZteiny:_ rR.r.t No.: _
Phone: 503-6394171 Fax: 5 R 9-1 r'°s'�'rieN Und Use
Ihtctdy:
Internet: www.ci.tigard.or.ua 17Y (�I t i!aACase No.:
l'� (�omacr seePagezfar
24-hour Inslrec60.1 Reyuest: tAV1, Narne/Medwd: Supplemrntal lnfotir stlon.
~` TYPE OF WORK FF.E•,SCHEDULE(fur srclal ititnrniitlon beociieckltst)
New construction Demolition Deser tion -' Qty. IFee(ca.) Tutal
Addition/alter'ahnn/r lacement Othet: Nerr 17&2-112mity.dweltit gs
CATECORYOF CONSTRUCTION; .,' " .r'» indudes.199 L roreaeit is flity touneetion
I &2-Family dweller Lj Commercial/Industrial SFR 1 batt' 249.20
SFR i2�badt 350.010
Acceaso Buildin Multi-Family SFR(3)bath __._" 349.00
Master Builder Other: Each additional batlt/kitchen 45.00
JOB SITE INFORMATION and LOCATION Fire sprinkler-so,ft: P v2
Job site add_r_ess:3 41�e S Sty ct y`il a.te_ t LqTUze Site Utilities -
'.uite#: TBldg•/Apt#:
CatcW basin/arm drain 16.60
:'rc'ect Name: ZLtyliL,t/Cr, LOCI��k, e o elMctch Ime/trendt drain _ 16.60
Footing lincarA- Pa e 2 _
Coss sh et:dDirectitms to job site: Manufactured home utilities 110.00
f4Manholes - �^ - 16.60
Rain drain connector _ 16.60
SanitarysewerLno.linear ft Pae 2
Subdivision: �h 15t7e ( 1 d.Q./t" jot#: Storm sewer(no.linear ft-) Page z
Tax trap/parcel#: Coc,,5 6S Water service no.linear ft.)
Pa e 2
DESCRIPTION OF WORK Flirti re or'Itim
iAbsorption valve 16.60
�LUIt�Sr ✓G1C7610t[) aW[CQ) backflow rpeventer - Y Page 2
Backwater valve 16-60
Clothes washer - 16.60
Dishwasher 16.60
Dri^�rnpi_ibuntain
PROPERTY OWNER TENANT Bjectors/sump '-u - 16.60
Name. DQn /��:�.�-� �-�r_]0'L��.._._._
Addre : }�30 SW &c *y.t� It nsto_y_tank 16.60
. -
-
Ftxtue/ wc _ 16.60
C /StateL ) L' LLkun q-j( CFlcordraintfloorsin /hu-b_
!6,60
Phone: Fax: Ho ebi d! 16.60
PPLICAN'/_ Hose bib 16.60
COIVTACT:I!ERSOIY Ice raker 16.60
Name:���!,��o`tIrro" o _ -� Inters torte trap 16.60
_Address:1to S.W m954 tryt PX Medial gas-value: S Pa e 2
Cl /Statatzi :-11.111-Q&Iif� --40K 9-10(c a- I rimrr 16.60
Phorc3�3 lo9.Z SR4S FaxSID3 b9a- (y//0VRaoftlrain t�rrartercial 16.60
Sinklbasin/lavatori_ 16.60
E-mail: Tubish-ower/shower pan 16.60
_ CONTPACI'7R - Urinal 16.60
Business Name- L reds [t4p� Down
-� Water Closet `_ _ 16.60
01"Cq
Address: (aaOd - lti
= aterheatcr _ _16.6q _
FCCD/State/Zip: ;� f2-. o - _ 0thcr onesba (cAa-54 y 5 Fax�3 (04� o''Ile --Elambl r n Pertmk Fees L;C. #: `78U'/ Pltemb.Lic.#: _ subtotal I S
Author'zed Mntimum Permit Fee 572."F,-3(,
Ds Residential 13acknow Minimum Fm$36.25G7le� a�� _ Plan Re:vicw(ZSX of T'etmit Fee` -Ellen State Surcher8X of Pctmit Fa S �?
(Please print risme) �- -- TOTAL PERMIT FEE S /S
tibtler. This permit appticattoe expires it a pe a- b notobtalaed wltlla ,'i,lt atM eosatssadat tsnl1d1u8s rt•quirt 1 sets of plans wltM Isnmetrk or
180 days snn it Ass born sr•eeptead u complete. rhes�1ilgrans for plan rrnk-W.
*pet V1Wb-%l0SY 10 t Y TI-i County linildiae Industry Service Board.
CITYOF T I G A R D MASTER PERMIT
PERMIT#: MST2003-00478
DEVELOPMENT SE=RVICES DATE ISSUED: 10/29/03
13125 SW Hall Blvd., Tigard, OP 97223 (503) 639-4171
SITE ADDRESS: 13665 SW HATHAWAY TERR PARCEL: 2S103CC-07700
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 0-114 JURISDICTION: 'TIG
REMARKS: New SF detached, Path 1.
BUILDING
_REISSUE: DM 139 STORIES: 2 _ FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT. 25 FIRST: 1 150 at BASEMENT: 0 LEFT: 5 SMOKE DETECTORS. .e
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.800 of GARAGE: 640 sf FRONT: 2u PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: I INFO sf RIGHT: 5
OCCUPANCY ORP: RVALUE; 290 173 603 BDRM: 4 BATH 3 TOTAL: 7,950 of REAR: t5
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: ta! SF RAIN DRAINS: I CATCH BASINS:
(USISHOWERS: 3 GARBAGE DISP I WATER HEATERS. 1 WATER LINES: Iwo BCKFLW PREVNTR GREASE TRAPS.
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100W BOILICMP<3HP: VENT FANS: 2 CLOTHES DRYER: 1
GAS FURN>-103K: I UNIT HEATERS: HOODS. 1 OTHER UNITS: 1
MAX INP: blu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDLR TEM'SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp o - 200nlnp W/SVC OR FDR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp. 201 - 400 amp 1st WD SVCIFDR. SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 - 600 anp EAADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601.amps-1000v MINOR LABEL:
Iona.amo/volt:
PLAN REVIEW SECTION
Reconnect only -- - - - -- - - ---
>-4 RES UNITS: SVCIFDR>-225 A.: >600 V NOMINAL.. CLS AREA�SFC OCC.
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL S.COMMERCIAL _
AUDIO&STEREO: VACUUM SYSTEM. AUDIO&STCREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LADSC LT:
OURGLAR ALARM: OTH: 801-ER: HVAC: LANDSCAPENRRIG: PROTECTIVE SIGNL:
GARAGE OPENER- CLOCK: INSTnUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS TOTAL a SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,427.99
DON MURISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations Contained in the
4230 GALE WOOD ST#100 4230 GALEWOOD ST,STE 100 Tigard Municipal State OR. Specialty Codes and
LAKE OSWEGO,OR 97135 LAKE OSWEGO,OR 97035 all other applicablea laws. All work will be done
accordance with approved plans. This permit will expired
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503-387-7538 Phone: Oregon Utility Notification Center. Those rules are set
187-7 forth in OAR 952.001-0010 through 952-001-0080. You
Roo 0: �q - Z may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Appr/Sdwlk Insp
Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Cra'xl Drain/Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
FoundationAnsp__ PLM/Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post Bam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final
Issued y : - �T� ( % Permittee Signature :
Cali (503) 639-4175 by 7.00 p.m. for an inspection needed the next business day
CITE( OF TIGARD _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00354
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/29/03
SITE ADDRESS; 13665 SW HATHAWAY TER!2
PARCEL: 2S 133CC-07700
SUBDIVISION: WHISTLER'S WAI.K ZONING: R-4.5
BLOCK: LOT: 024 JURISDICTION: II(i
TENANT NAME:
USA NO: FIXTURE JNITS:
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.
Owner: FEES�_�—
DON MORISSETTE HOMES Description Date Amount
4230 GALEWOOD ST #100 _
LAKE OSWEGO,OR 97135 jS%VLJSAJ S�Nr( ,mnect 10/29/03 $2,400.00
1 SWUSAJ Swr Conn,:ct 1C/29/03 $0.00
Phone: 503-387-7538 (SWINSPI Swr Inspect 10/29/03 $35.00
�,' 1W I ti ti l'j S\\l I n"hcct 10/29/03 $0.00
Contractor:
Total $2,435.00
Phone:
Reg A
Required Inspections
This Applicant agrees to comply Hath all the rules 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 accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer" Perm
Issued by: L E' Permittee Signature: I—
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
-
"Daterecci!ved, f ..JIB% Pernutno•:) rAle
City of Tigard
city nj•r;gard
Address: 13125 SW Nall Blvd,Tigard,OR 97223 Project/appl.no.: �Lpjredale:
�
Phone: (.503) 639 4171 Date issued: Byl cr Receipt no.: J
Fax: (503) 598-1960 �% ase rile no.: Payment type:
Iand use approval, I&�family:Simple Complex: \
O 1 &2 family dwelling or accessory U Commercial/industrial U Muiti-family ,CNew construction U Demolition
U Addition/alteration/replacement ❑Tenrm ant improvement Ll Fire sprinkler/alaU Other. _
Job address: I Bldg.no.: Suite no.:
Lot: $lock:Block: Tax map/tax lot/account,lo.: �~
Project name: _ — ---
Description and location of work on premises/special conditions:
Name: `+ �r.�` t. l"1�1 t t t
Mailing address: '\,'Lr—c)i L-4 ; 1 &2 family dwelling:
City: ISIaleCZIP: ' Valuation of work........................................ _
Phone: c ' Fax: 7 mail: No.of bedrooms/baths.............. ..................
Owner's representative: I ID Ct r I Total number of floors.................................
—r
Phone: New dwelling area(sq.ft.) .......................... c
F.tr: Email:
.. r : !• _:..y,... Garage/carport area(sq.ft.) ........................ )
Naruc:Y .Y 1� , Covered porch area(sq. ft.) ........I...............
Mailing address: �� Deck area(sq.ft.) ...........................•............
Other stnlctur,area S ft.
City: _ State: ZIP: _ (• )•••••• ••••••••••••••••••
Phone: Fax E-mail: CommerciaUlndus,rlaUmulti•tamily:
Valuation of work... .................................... $
Business name: , z''2-'E
Existing bldg.area(sq. ft.) .......................... --
Address New bldv.area(sq. ft.) ..........................
.•.............................
Number of stories
=��' �Z �
City: State: � ZIP: ........................................
- Type of construction..............
Phone: Fax: — E-mail: Occupancy group(s): Existing:
CCB no.: New: -
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: = _ provisions of ORS 701 and may be required to be licensed in the
_Addrres: c ,e 1 jurisdiction where work is being performed.If the applicant is
�1—� �G v
City: State: ZIP:
exempt from licensing,the following reason applies:
Contact person: Plan no.: --
Phone: Fax: E-mail: -
*lame: IC01WILt person: Fees due upon application ...........................$
Address- Date received:
City: State: ZIP: Amcunt received ......................................... $
Phone: I E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all Juriadicdona accept credit cards,plesse call iunsdktinn for mare tnfnrmation
attached checklist.A rovisions of I ws and o�fin inces governing this o visa U Mastercard
work will be compllql wl ,whethi ci}iai iiereA r,Aot.�� / Credit card number:
E, tret
Authorized sigriatum
ivir Name of cardholder as shown on credit card
Print name: 004 }t Cardholder signature — s
Arhount
Notice:This permit application expires if a permit is not obtaitrcd Aithin 180 days after it has been accepted as complete. ")-%13 tttmcoM)
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
City of Tigard Cit of Tigard _ Associated permits:
y O Electrical ❑Plumbing O Mechanical
Address: 13125 SW Hall Blvd,Tigard.:OR 977.23 ❑Other:
Phone: (503) 639-4171
Fax: (503) 598-1960
FOLLOWNWITENIS ARE RFQUl11FD'Y0R ,
I Land use actions completed.See jurisdiction criteria fir concurrent reviews.
2 Zoning. flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved platflot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report,Must carry original applicable stamp and signature on file or with application.
Erosion control ❑plan 0 permit required.Include drainage-way protection,silt fence design and location of –
catch-basin protection,etc.
10 -L Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed v'
if copyright violations exist. _ J�
I 1 Slte/plot plan drawn to sale.The plan must show lot and building setback dimensions;property comer elevations(if
there is more than a 44 elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems:utility locations;direction indicator,lot
area;building coverage area;percentage of coverage;impervious area;existing sttvcturm on site;and surface dminagc. _
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans,Show all dimensions,room identification,window size,location of smoke detectors,water heater, Y
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross sec ions)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof construction.More than one cro.,s section may be required to clearly portray construction.Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-sine sheat addendums showing foundation elevations with cross references are acceptable.
II lb Wall bracing!(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
nnn-prescriptive patii analysis provide specifiratious and calculations to engineering standards.
17 Fivioirfroof framing.Provide pians for all floors/roof assemblies,indicating member sizing,spacing,and hearing
locations.Show attic entilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered
systems,see item 22,"Engineer's calculations,"
19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to he .wplicable to the project under review.
i.
23 Five(5)site plans are required for Item 1 I above. Site plans must be 8-1/2" x 1 I"or I I"x 17".
24 Two(2)sets each are required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons.
26 No rolled,reversed or mirrored building plans will be accepted.
27
28 —
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in biue or black ink.
Red ink is reserved for department use only. 440-4610(600/COM)
Mechanical Permit Application
IlDat!Creceived: VIA," C? Permitno.:))�7(a,
City of Tigard Projectlappl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Date issued: By: Receipt no.:
Phone: (503) 6394171 _
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
1 �I'
❑ 1 &2 family dwelling or accessory L]Commercial/indusuial U Multi-family L1 Tenant improvement
Nconstruction O Additiori/alter^.Iiott/replacement ❑Other.
1 { 1 1 1
Job address: < ' of , Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no,: profit. Value$
Lot.- Block: Subdivision: ti, 'See checklist for important application information and
Project name: Av jurisdiction's fee schedule for residential permit fee.
City/county: L1P: 1 1
Description and location of work on premises: " 't• 1 a: I t' 1 + " I all
F"(ea.) Total
East.date of completion/inspection: Descrl on "y. Res.only Res.oaly
Tenant improvement or change of use: an
Is existingace heated or conditioned?O Yes Cl No Air handling unit CFM_
space r condiuonjng(sne plan require )
Is existing space insulated?❑ Yes ❑No Alterauon o eTexistingHVAC system
Boiler/compressors
State boiler permit no.:
Business name 1 ` t �1�VILL HP Tana H
BTU/ -
Address: Firetsmokedampers/ductsmoke etectors
City: & Lk Stat Hcat pump(site plan required)
Phone: -,.3 Fax; E-mail:_ nstal rep ace rnace/bumer
Including ductworklvent liner U Yes Q No
CCB no.: ?1, _ r.sta l/replace/relocateheaters-suspended,
City/metro lic. no.:N/A wall,or floor mounted
Name(please rine) - _t enc for a >Ijance other than furnace
e igerotion:
Absorption units_ BTU/H
Name: C_LL Chillers HP
Address: + L (A- �+
Compressors.--- HP
nr ontnentL7 ust and ventilation:
City: State: zip: Aapllance vent
Phone: Fax E-mail: Dryerexhaust
Hoods.Type V Il/res.kite enthazmat
hood fire suppression system
Nance: —�v 1 � ' Exhaust fan with single duct(bath fans)
Mailing address: ) ^�l,' F_xltaust system apart ftom heau or AL
Citv: State ZIP )
tie p p nI�{ g and distribution(up to 4 Outlets)
Type: LPG NG Oil
Phone: .: � � I -mail: uel tin each additional over 4 outlets
roeesspiping(schematicrequired)
Name: Number of outlets
tr listed appliance or equipment:
Address Decorati.e fireplace
City _ � - State: zIP: nsert-type
Phune Fay •mail oocstove/pelFzi&w r
Other:
4pplirnnr'5 sirnatu' Date: other^
t Name Iprint): x H
Not all junxllcuons xctpt credit cards,please c '1 jusulicuun ror more information Permit fee ................$
O Visa U MutetCard Notice:This permit application Minimum feeee................S
J expires if a permit is not obtained plan teview(at _ %) S
Credit card number _ --- within 180 days after it has been
Expires within surcharge(896) ....$ —..—
N.me )(cardholder u shown on cttdil c — s accepted as complete.
TOTAL ......................S --
Cardholder signame Amount 4 4,417(6CntCOM)
Plumbing Peanut Application
rDatcremccivecl: 9 t p' Permit no.:
City of Tigard Sewer perttut no.. Building permit no..
Address: 13125 SW Hall Blvd.Tigard. OR 9723
City of Tigard Phone: (503) 639-4171 Pro)ect/appl.no.: Expire due:
Fax: (503) 598-1960 ate Issued: By: Reeeiptno.:
Land use approval: ase rtr Prtymenttype:
Vlj&') a
0 I do 2 fatruly dwelling or ar-cessuiy 0 Commerclal/induslnal O Multi-family 0 Tenant improvement
`few construction 0 Addidon/alteration/replacement ❑Food service 0 Other-
Joh
SrM 1 t1 1
!tib address: > �=j (IJ L _ Drscripdon Qtv. Fee(eni.) Total
Bldg.address:
no. Suite no.: New -atilt 2-fsmily dwellings only:
(includes too n.for each utility connection)
Tax map/Lax Iodaccount no.: SFR(l)bath
Lot Block: Subdivision: SFR(2)bath — �-
Project name: SFR (3)bath
City/county: ZIP: Each addluonal battvlutchen
Descripuon and location of work on premises:- Site utilities:
Catch basin/area drain I
Est.date of compleuurvinspection: Drywellsvleach line/trench dr.un I
Fooung drain(no.tin. ft.) I
Manufactured home utilities
Business name i" _�L�'t- I�_l�____ Manholes
Address `t, Rain dr:un connector +J
City.
state* ZIP: Sanitary sewer(no. lin. ft.) _
Phone: "-�L Fax. E-mail: Storm sewn(no. lin. ft)
Yater service(no. lin.ft.) I I I
CCB no . �_J �] j P'umcbus. reg. no: -
Fixture or item:
City metro Ilc. no.: N A
Absorpuan vale
.:ontra.tot's representative signature Back claw pre,•:peer
Print name: (� u - Back%vater vale _
1X%KYU Basinsrlavamr;
Clothes .usher
m
Nae: S �— Dishwasher I
Address. fountain(s)
Cil% _Estate: ZIP: Eleuorssump
Phone: Fax: Email: Expansion tank
Fixture.'se%cr cap
Name (print):
Floor drmns/lloor sinks/hub
�
�_�,� Garbage dissal
Mailingaddrrss_ Hose bibb
State ZIP _ Ice maker _
Phone --�' Fay: �-"JN Email: lnterceptor'grease trap
Owner installadvn,Yesidendal maintenance onlY, The actual installation Prtmen s
will be made by me or the maintenance and repair made by m% regular Roof drain icon mercial)
employee on the proeertv I own as per ORS Chapter 347. .inkl s 1. baslnl c 1, lay sl s i
Owner's sienature Date: Sump _
- Tubs/sho%er/shower par
l.'nnal
Name: water closet
Address: eater heater
Cir. state, (ZIP Other s
Phone: Fax: , E-mail. Total
Nd ail lun>,t1c10ru sept:edn cyst.plesse all lunt.bcuon her mire inforrru wn NoticeThis btwn petriol a pF Minimum fee................5 _
li)
C Ysa O Nlutert"ard r / expires if a Permit is not� taia. Plan review(at _� %) S
d State surcharge(8%) ....S
e.e.ilt card number etp ret within 180 days after it has teen
accepted as complete. TOTAL .......................S
Name I cars'w,der ss shown,)a:terLr.yd
CyGloider utnmufe s Amuunr 44p.4616161)I1Cr)N7
llectrica Permit Application
PDatereceived: `l Pe"nitno.:
City of rlgard Project/appl.no.: Expiredate:
CiryojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phonc: (503) 639-1171
Fax: (503) 598-1960 1Case file no.: Payment type:
Land use approval:
1 1611
❑ 1 &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family ❑"Tenant improvement
New construction ❑Addition/alteratiort/replacement ❑Other. ❑Partial
JOB SITE INFORMATION
1 11 Job address: r (. Bldg.no.: Suite no.: Tax map/tax lot/account no.:
I ol: Block: Subdivision:
Project name: Description and location of work on premises: _
Estimated date of completion/inspection:
SCIIEDULE
Job no: i f- Fee Max
Description (m) Total no.btsp
Business name: New residential-singe or multi-fam'y per
Address: dwelling unit.Includes attached garage.
et-
Ci� State: LIP: _ 000s irccmdrle
1000 sq.ft.or less
Phone: �j - l Pax: E-mail: Each additional 500 sq.It or portion thereof
CCB no.: Elec.bus, lic. no: Umited energy,residential 2
Each manufactured home or modular dwelling
Off ne uirrdl Date Service and/or feeder 2
T nlure njtupenrstnr _q_
C�� be icesurfeeders-•imsiailation,
Sup elect name l pnn i License no alterrallon or relocation:
200 amps or less 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: 1J d�� 11 amps to 1000 amps 2
Cih: c — State ZIP: Over 1000 amps or volts 2
Phone: - i Far: ) -- -mail: Reconnect on] 1
Owner installadon:The installation is being made on property I own Temporary services or feeders-
installation,Alteration,orrolontlon:
which is not intended for sale, lease, rent.or-xchat,ge according to ton amps or less 2
ORS 447,455,479,670. 701. 201 amps to 400 amps _ 2
Owner's si nature: Date: 4011 „yam s 2
2 a, Branch circuits.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: ZIP: B Fee for branch circuits without purchase —
of service or feeder fee,first branch circuit: 2
Phone: Fax: E-mail: Uch additional branch circuit:
Misc.(Senice or feeder nct included):
U Service uver 225 naps-commercial U Health-care facility Each pump or imgation ureic
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting `
fancily dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel.
U System over 600 volts nominal
more residential units in one structure alteration,or extension' 2
U Budding over three stones U Feeders,400 amps or more 'Description
U Occupam load over 99 persons U Manufactured suuctur,:s or RV pari Each additional inspection;ser the allowable in sny of the above•
U EgmssAightingplan U Other. -- Per inspection I I
Submit`sets of plans with any of the above. Imesugation fee -- —
The above are not applicable to temporary construction service. Other
Permit fee.....................S _
Not all rynxtic^.ms rapt credit cards,please call jurisdiction for m,we mfdrmaum, Notice:This permit application Plan revleW(at �) $
❑Visa ❑MasterCsrd expires if a permit is not obtained
Credit cud numb r -- within 180 days after it has been State surcharge(8%) ....S
Expired accepted as complete. TOTAL ........I..............$
Name of cardhoider u shown on rtedit card e
4441615(6AhCOM)
Cardholder signature Amoum
IlkDON • MORiSSETTE 0BE : 2'794 '
x 0 m 0 a IN C 0 R P 0 8 A T 2 V �,r. 24
4 R R O G{ A L 79 W O O D 8 T R a S T
LAIR 08R = a0. 0 a a a 0 N • 7035 DATE. 9`8/;3
(503) 387 7630 1A l (503) 357 - 7615
PROPERTY: 1fIUMl0t'S—WA_LK
CITY: TIGARD
SCALE: i"=20'
PLAN No.: 139
OPTION 3 ELEVATION
1
lu
a
� + 7,.,31E ,
I 31' t' 1
sue' IrD4.0m' � w_J I
i I
61 a 4 bC�l'rT1
bath
Fq. ft. �. ` I
I
L P4110 a' FE. 3165' 9 I u j
313
'
t
640 sq.3 cer ger.FFE. 313'3
- -- - - - - - ° imams' - - ____ 1 1 _ 13 ,
I0.00 PUBLIC 61DElUI <
EASEMENT o ao d
z3'.b.
Al
LECiEND LOT COVERAGE dig
LOT ARE, 6'4C SGS.
?i.ILDING 4REA: 2.'?: 3G =7 LCT r14
O — ' AGER RUBRj- -EIRCENTAGE: 34LA% 6;40 sq. ft.
'REC MAPLE'
CITY car•rlr.atti) - tirrF: PLaN ltr;vtrw
131111.1, ` PF R N N,()."�r ,S_ 7
PLANNING DIVISION: N. 5
Rvylired setbaclts: �i ghprrneJ
Side: ❑ Nut Apprrnecl
- .. Strut sick: jo
('tont. �2. (i;imue- A& Rear: 15
1'i;pial hle;rr,rncr: ,� rproved
'�1;rxirrum (2uilJin,_ Ilei �; ❑ Not A0 ru%ca
CV-"S Service Pro%ik!rr hAter liquired: [;1 Yrs
!i (�, �Gt,t,ut,, Q Itecrit I
Dale: 17-45=03
f:NCi1Nt:GRlN<.i t)l PA.RTMF'N`f�: -
Actual Slnpc. S 0io KApproved
❑ Nut Approval
Site Flan:
13V: Approved �] of Approved
Notes:
CITY OF TIGARD 24-111our
BUILDING inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
Al / Buis
Received, J` Date Re ue ted _3l—�
q � AM _ _� PM _ BUP
Location —� _ ec-- _ ____._ Suite ?� _ MEC
Contact Person __ . ( ) L��pL '1 = UI�
Contractor _ Ph( ) - —�_ SWR - -- ---
BUILDING Lena UOwner _ ELC
Footing - ELC
Foundation Access: -
Fig Drain ELFT
Crawl Drain -
Slab Inspection Notes: SIT
dost b Beam
Smear Anchors - - -
Ext Shoath/Shear
Int Sheath/Shear
Frami!ig —
Insu;ation
Drywall Nailing --- _---- -- __.--_- _
Firewall
Fire Sprinkler -- --- -_- -...__--___-
Fire Alarm
Susp'd Ceiling - -- - -----------
Roof
Other: --
Final
PASS PART FAIL — —
PLUMBIN4
Post& Beam
Under Slab
IRough-In
'Nater Service _-
Sanitary Sewer
Rain Drains --- —
Catch Basin/Manhole
Storm Drain
Shower an
Other. ; U* -
Fi
r ---- - ---- -----..
_ A HART_ FAIL
HANICAL
Post& Beam
Rough-In
Gas Line - -
Smoke Dampers —------ -
Final
oASS PART FAIL--
ELECTRICAL
Service ----------__._.._�
Rough-In
UG/Slab - - - - - ----- -
Low Voltage
Fire Alarm
Final
PASS PART FAIL Reinspection fee ()t _ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE n Please call for rpinsnection RE: i� Unable to inspect-no access
Fire Supply Line
ADA %
Approach/Sidewalk Date � � // f ,' r (_ Inspector__ - Ext
Other:_
Final DO RIOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING In:;pection Line: (503) 639-4175 MST ��
INSPECTION DIVISION Business Line: (503)639-4171
BUP
ReGC:vgd _ - Date Requested_ ____ )_AM___- - PM __- -_ -_ _ BUP --
Location _�_�1�D !y ss. .�i.0.e:. _ - uite_ _-____ MEC
Contact Person �__ rte_ Ph PLM
Contractor _—__ _ Ph ._
BUILDING Tena*Owner _ _- - __-- ELC
Footing ELC
Foundation Access.
Ftg Drain ELR - -__-_-
Crawl Drain -
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheathe" aar '
'[mac '� ,1 • .......
Framing - --- =-f' -r
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling -- -
Root
Ot -- - -
C ' PART FAIL -
PLUMBING _
Post&Beam
Under Slab
Rough-in
Water
Water Service
Sanitary Sewer
Rain Drains -- ------
Catch Basin/Manhole
Storm Drain - - ------- - --.- - -
Shower Pan
Other. - - ----
Final
PASS PART FAIL — - - -- - ---- --- --- -
MECHANICAL
Post&Beam
Rough-In -
Gas Line
Smoke Dampers - ------ --.----- --
ina
PART FAIL
--- - - -
TRICAL
Service
Rough-In ----
UG/Slab
Low Voltage
Fire Alarm
Final F Reinspection fen of z - rekluired before next inspection Pay at City Hall. 13175 SW Hail Rk/d
PASS PARr FAIL
SITE - C-� Please call for rein ;x rti fit _1 Unable to inspect no acres:-
Fire Supply LineAA
I
Approach/Sidewalk Date �.W 11--_�'.� Inspector �' _ ` Ext
Other: -
Fir•ial DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
�f ►
� r ►
a �
.� x U ►
� � 1
- ►
J I op.
44 - 6 ^ 0-
AM
v w j ►
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t W '\/ Y ►
ill � �� } / ►
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Q ►
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Iry TTTVTTT♦♦TTTT"'vv vTVVTTVTTT-VTTVVvvvvvvvvv7\
_ f
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 S j 6D
INSPECTION DIVISION Business Line: (503)639-4171 ^" T/
BUP
Received 4//Q 11 Date Hequestedy -� �� AM—______ PM _- BUP
Location ----_ L , `'�-_. - !� bite________ .- MEC
Contact PersonPh( ) aL'__y % PLM
Contractor --- - -- -- Ph( ) ---- - - - -- SWR --- - - -- -
EUILDINGI Tenant/Owner _ _—_— _ ________ ELC
Forting _ ELC -
Fcundation Access.
Fig Drain ELR - -
Crawl Drain —
Slab Inspuction Notes: SIT —_
Post&Beam -- -- - -. - -- -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear `
Framing �� __ al }�vJ A�i1�r' - -_ __v► 5.1 �' - L�� -
Insulation ��
Drywall Nailing _.__ - —_.__--��__ -- ----------_
Firewall
Fire Sprinkler - - - - -- -- - ``�----Fire Alarm S`jtZp
Susp'd Ceiling -- - -- - -- _ - - _ _- -- - - ----- --
Roof - ------- -----
Final
PAS ART FAIL - -- - - -
Pos -✓i Beam_ —
Under Slab -- -----
Rough-In
Water Service - - -
Sanitary Sewer
Rain Drains _ - - -- -
Catch Basin/Manhole
Storm Drain -- - -_
Shower Pan
S PART FAIL - __--- --- ---- - -- - -- - ---
---- -
MEC_H_AMCAL —
Post&Beam
Rough-in -- -- -._. ------ - - - - - -
Has Line
Smc,Ke Dampers ----- - -- _ - _
Final
PASS PART FAIL - �-
L _
------ _
Sere ce
Rough-In -----
lIG/Slab
Low Voltage ---
Fire Alarm
(,Fl-hi Reinspection fee of$ require('before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
isA3 PART FAi — -
----
SITE � Please cali for reinspection RF: _ Unable to inspect-no access
Fire Supply Line
ADA Approach/Sidewalk Dat __. �� 9` - -- — Inspector -U-tom \ .:_ �1 � - Ext
Other
Final DO NOT REMOVE this Inspection recon from "he Job sire.
PASS PART FAIL
CITY OF TIOARD
Residential Certificate of Occupancy
Permit No.: !^<.- do Address:
Owner/Contractor: --
Date of Final Inspection: -/7-dr E Inspector: _
'I'his structure has been found to he in substantial compliance with the provisions of the State of Oregon One& 7'wo Fandly Owellink
S rcialty Code and is hereby approved for occupancy. _