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15425 SW HARCOURT TERRACE I CJl ,P N VJ 2 1 n Q C 1 1 0 I � t 15425 5W Harcourt Terrace CITY OF TIGARD BUILDING INSPECTION DIVISION MST Zero-oo .siy 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ _.__Date Requested_z7 -'/ J AM &--" PM BLD Location J — Sw //Av C6w.-/L Suite _ MEC Contact Person _ Ph PLM Contractor Ph SWR BUILDING Tenant/Owner _ ELC Retaining Wall ELR Footing --------- Foundation Access: FPS Fig Drain _ Crawl Drain inspection Notes. SGN Slab Post&Beam --- SIT Ext Sheath/Shear Int Sheath/Shear -- Framing Insulation Drywall Nailing - Firewall Fire Sprinkler Fire Alarm t _ Susp'd Ceiling Roof Misc: Final --- PASS PART FAIL PLUMBING_ Post&Beam -- Under Slab Top Out -- — Water Ss^/ice Sanitary-ewer - - Rain Drain! Final -- _—"- -PASS- PART FAIL MECHANICAL — Post R Beam - Rough In Gas Line Smoke Dampers Final -- ---- PASS PART FAIL Service _ Rough In UG/Slab Low Voltage Fire-Alarm A PART FAIL Backfill/Grading --- - - - Sanitary Sewer Storm Drain [ J Reinspection fec of$ ___required before next inspection Pay at Cfty Hall, 13125 S'N Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE — ( ]Unable to inspect- no-ccess ACA Approach/Sidewalk Other Oate / _ d _.Inspector �- _ Ext Final - -- - PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST -��%-�„' 4 �1 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — �/ BUP Date Requester —_`'f" —AM PM gLr, Location Suite.�3 wl�r GGc. of -� ' ` _ Suite _— MEC Contact Person _ _ Ph — PLM Contractor Ph SWR BUILDING — Tenant/Owner ELC Retaining Wall ELR Footing Access Foundation FPS Fig Drain SIGN Drain Inspection Notes: Slab ------- _--__ _ _-- SIT Post R Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation ------------- Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- --- - - -- - _ ----- -__---- - - Roof Misr.' -- - --- - --- ---- ---- - Final PASS PART FAIL -- ----- ---- Post&Beare Under Slab Top Out Water Service Sanitary Sewer rains Fin 'SSS PART FAIL HANICAL Post& Beam - - -- Ruugh In Gas Line - -- ------ Smoke Dampers Final - - -- - ------ ----._ PASS PART FAIL ELECTRICAL --- Sc.Vice Rough In UG/Slab -- .. -- — -------- -- ----- Low Voltage Fire Alarm — Final PASS PART FAILSITE Rackf ll/Grading --- — "— --`— -- �- --— Sanitary Sewer Storm Drain [ j Reinspection fee of$_ _-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ] Please call for reinspection RE _ !___ __ ( j Unable to inspect-no access ADA ` Approach/Sidewalk L !� 6 Other Date /i_ Inspector-_ ___ Ext Final - PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST ,�Uc�-wSl y 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIPD� `e Requested— �I r� — AM --f'NI ---- BLD _ Location_ y 2-5- 54- /A Y-- _ _ Suite MEC Contact Person — PhPLM Contractor Ph SWR Tenant/Owner ELC - Retaining Wall ELR Footing Access: --- - - -- Foundation FPS — Fig Drain SGP: Crawl Drain Inspection Notes ------ — SlabSIT --- - -- --- ---------------------__:..__ Post& Beam Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing ------ -- -— ---------- ----- ------ - --- __ ..- —----- Firewall Fire Sprinkler Fire Alarm — Susp'd Ceiling - - -- - ---- ------ -- Roof Misr-. -- in�lr' 'OAS$ PART FAIL - -- -- --- - - -- ----- --- --. ---ITUUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final ----- -- - -- L-PA66--PART FAIL Post$ Beam - --- - -- ---- --- -- ------------- -- Rough In Gas Line -- ----- Smoke Dampers -^W PART FAIL ELECTRICAL - - -- ---- - ----Service Rough Rough In UG/Slab Low Voltage F ire 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 reinspection RE _ ^ —_— _ [ ]Unable to inspect no access ADA Approach/Sidewaik Date Inspector_ Fxt Other —- Final —~V----- PASS PART--.-FAIL_j DO NOT REMOVE this inspection record from the joh site. 4S� C11 OF TIOARD Residential Certificate of Occupancy Permit No.: r�L - 7 _ -- Address: 15-42-,YH&,C6'L),&= Owner/Contractor: Date of Final Inspection: =17—ell Inspector: This structure has been found to he in substantial compliance with the provisions of the.State of Oregon One do Two Family Dwel ing S eeialty Code and is hereby approved for occupancy. I TY OF TIGARD 'GARD �MASTFR PERMIT PERMIT#: MST2000-00519 DEVELOPMENT SERVICES DATE ISSUED: 12./18/00 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 15425 SW HARCOURT 'rERR PARCEL: 2S111DA-12500 SUBDIVISION: APPLEWOOD PARK NO. 3 ZOWNG: R-7 BLOCK: LOT: 111 JURISDICTION: TIG REMARKS: S/F PATH 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,054 of BASEMENT: at LEFT: 4 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 969 of GARAGE: -180 of FRONT: 26 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT: of RIGHT: 4 VALUE: S18548100 OCCUPANCY GRP: R3 BDRM: 3 CATH: 3 TOTAL: 2,023.00 of REAR: 28 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 3 GA'BAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 13CKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES. MECHANICAL FUEL TYPES FURN<100K: BOfLICMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN>.t00K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS- 1 MAX INP: btu FLOOR FURNANCES: VENTS: i WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL 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 FOR 1 PUMP11RRIGATION: PER INSPECTION: EA ADD'L SOOSF- 4 201 400 amp. 201 400 amp: 1st WIO SVCIrDR 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EA ADDL BR CIR SIGNAUPANEL: IN PLANT: MANU HM/SVCIFDR: 601 1000 amp: 601+amps-1000v: MINOR LABEL: 1000+amp/volt PLAN REVIEW SECTION Reconnect only: >-f RES UNITS: 9VClFDR>=225 A.: >800 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO d STEREO: VACUUM SYSTEM: AUDIO 6 STERE FIRE ALARM: INTERCOMlPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL. GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 3,853.13 MATRIX DEVELOPMENT CORP LEGEND HOMES CORP This permit is subject to the regulations contained in the 6900 SW HAINES ST STE 200 12755 SW 69TH AVE Tigard Municipal Cede,State Specialty Codes and TIGARD,OR 97224 TIGARD,OR 97223 all other applicable laws All work w Th be done In accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or If the work is suspended for more than 180 days. ATTENTION Phone- Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set ReQN LIC 60563 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8& Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Mechanical Insp Shear Wali Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr, Electrical Service Low Voltage Water Line Insp Final Inspection Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp /Building Final Issued By : T,-�?yu 2 — Permittee Permittee Signature Call (103) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITE' OF TIGARD ISEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00359 13125 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/18I00 SITE ADDRESS; 15425 SW HARCOURT TERR PARCEL: 2S111DA-12500 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: _ LOT: 118 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF V'IORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached. Owner: FEES ---- - MATRIX DEVELOPMENT CORP Type By Date Amount Receipt 6900 SW HAINES ST STE 200 TIGARD, OR 97224 PRMT CTR 12118/00 $2,300.00 27200000000 INSP CTR 12/18/00 $35.00 27200000000 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by railing(503) 246-1987. Issued by: L- - Permittee Signature: L% Call (50;) 639-4175 by 7:00 P.M. for an inspection needed the next busine , day Building Permit Application _ City of Tigard Gate received: Pcrmitno.:/w ?.400-005/CiryojTigard Address: 13125 SW liall Blvd,Tigard,OR 97223 Project/appl.ne.: Expire date: — — Phone: (503)639-4171 ( Date issued: By: 1.Receipt no.: Fax: (503)598-1960 7 I Case file no.: Payment type: Land use approval: 1&2 family:Simplc Complex: ltd 1&2 family dwelling or accessory U Commercial/industrial ❑Multi-family WNew construction U Demolition U Addition/alteratioidreplacem--nt U Tenant improvement U Fire sprinkler/alarm U Other. 11 SITE INFORNIAT1 Job address: 5(Z t't"CTCV 14 7— '"lZe7lle H2c I Bldg.no.: Suite no.: Lot: Block Subdivision• /bg _fW[ jr.)D_po472J�_ Tax map/tax lot/account nc.: A$//115 -/o?SO Project name: V=C— Description FDescription and location of work on premises/special conditions: 11%NER FOR SPECIAL INFORMATION, Name: O (Floodplain, , Mailing add ss: q A 4 1 &2 family dwelling: �9 City: G State:O ZB?: f7 Valuation of work........................................ $L _.�AELL Phone: 4i W- a Fax E-mail: No.of bedrooms/baths................................. .1 �� Owner's representative: :� , 1=1 t l c_ Total number of floors................................. Phone:0 20'WS0 Fax:CX%•Wc-0 E-mail: New dwelling area(sq.ft.) .......................... 5L — Garage/carport area(sq.ft)......................... --� Name: - Covered porch area(sq.ft.) ......................... Mailing add ss: lLi 25-'s— Deck area(sq.ft.)....................................... -- City• ,Statep ZIP: Other structure area(sq.M)......................... Phone: (�_ e� ) Faxt> E-mail: Commerciabladustriallmulti-family: 1 Valuation of work.......................*. ............ $— - Existing bldg.ara(sq.ft.) . ........... —__----- Business name: New bldg.area(sq.ft)...... ........... Address:lCi 7,rle Number of stories............... ........... ........ _ City: e' Stated ZIP:'17,rt� 1: Type of construction.................................... ---- Phone: OJ o E-mai Occupancy group(s): Existing: CCB no.: (o e) New: City/metro lic.no.: L 7 Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Nam provisions of ORS 701 and may be required to be licensed in the Address: 1 jurisdiction where work is being performed.If the applicant is s^ exempt from licensing,the following reason applies: city: � a. Statcw ZIP: 'j) � Contact person: Xcr $d.0171 Plan no.: — Phone:620 - o D I Fax:. _5 E-mail: - —� r Name: Fees due upon application ........................... $ Ad L Da Date received: _ — City: ai State:d :ZIP: ay 2,,7.13 Amount received ......................................... $ Phone: p� Fax: E-mail Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all}addktiotu Weept credit curt+.pleue call itaisdkdat for mote infarnwion attached checklist.All provisions of laws and ordinatnces governing this U Visa U MatcrUrd work will be complied with,whether s •ified he in or not. Credit card n•,mber: — — /— / Expltu Authorized nature: �G' ate:_ Z �� Name of wr$toldu u shown on credit cant — S Print name, ___ Cardholdet denature Amount Notice:This permit epplicat' n expires if a permit is not obtained within 180 days after it has been accepted as complete. wa46u(r>oac�M) Mechanical Permit Application Date received: Permit no.: City of Tigard Projecdappl. Expire date: — City gTigcrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 -- Phone: (503)639-4171 Date issued: --_ By: 1Receipt.no.: — Fax: (503) 598-1960 Case file no.: _ Paymcnt type: Land use approval: __—______ _ Building permit no.: - TYPE'OF PERMIT .ell &2 family dwelling or acc,;ssory 0 CummerciaUindustr.al U Multi-family U Tenant improvement U New construction U Add ition/alte ration/replacement U Other. 10111 SI I L 1 1 1 Job address: lz�t{-Z4::�- •�, ) - jV -`i_ '_ Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: I Suit.no.: — value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: 1 If, Block: Subdivision:! *See checklist for important applicatira information and Project name: ,�}p�1 jurisdiction's fee schedule for residential permit fee. City/county: --"r _ ZIP: 9 7 I ' PERMIT FEE SCIIEDCLE Description and loAtiol,of work on premises: Fee(ea.) Total Est.date of completion/inspection: Description QtY• Res.only Res.-only Tenant improveme r change of use: -UrAC: Is existi apace heated or conditioned?0 Yes Ll No _Air handling unit CFM Ise ' n s insulated?0 Yes O No Arrc� fhanmg(s onaite plan require ) g space Alteration of existing HVWC system 1Boiler/compressors Business name: :hate boiler permit no.: - HP Tons BTU/H Address: �Qy 7v smo a amper uct smoke detectors City: elI State ZIP: .est pump(site plan require' d)-- Phone: ' -7L,y E-mail:-7 7 Fax: nsta rcp ace furnacelbitmer 1 Including d,tctwork/vent liner O Yes U No CCB no.: msu rep iD-T c/rTocate heaters-suspen e , City/metro tic.no.: IoI7 _ wall,or Floor mounted _ Name(please print): pn "b entiorr lantan�eo er an urnace to ;eratlon: Absorption units BTU/H ` Name: / Gf Chillers---------- HP — - Address: `�— Co masors� HP nntnen Teal eat z ust and vent al on: City: P.,,r v State:O q_ ZIP: 9;,)�2 Appliance vent _ Phone -7) Fax -j -)L ,` E-mail: Dryert,x gust Hoods,Type res. 'tche a7r ai hood fire suppression system Name: Pq�j tom/ pmQ S Exhaust fan with single duct(bath fans) Mailing address://,?-" J— ,Q ate- � sst asystema art m Ilea City: Staten ZIP:97 3 Fuelpiping an on up to out Type: LP(; __ NG oil Phone: - J r] Fax: E-mail: ue t mg each additional over 4 outlets am ocenpiping(schematic required) _ Name: J �� Number of outlets -- ter st appljance or equ I pment: Address: Decorative fireplace City: State: ZIP: nsert-ty Phone: !o?l- 'Gb Fax: E-mail: ton pe et stove er: Applicant's signature: j , ale: v: -- Name(print) eerQ -- - —_ - Not ail juriadkdoan xvep credit cards,pkaik can imuwalon to more Information. Permit fee..................... U Visa O MasterCard Notice:This permit application Minimum fee................$ Credit card number: expires if a permit is not obte.ined Plan review(at _ %) $ ._ — �_�— ---- Expires within 180 days after it has Eeer, State surcharge(8%)....$ _ --- accepted as complete.Name or cudho u shown on credit cr�fi s P P TOTAL .......................E -----Ciedholdet,,`nature Amami— 4444617(&W COM) Commercial Schedule 18r2 family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE �� --- Furnace to 100,000 BTU [-1) F-aco able(A Machanicat Code city Pmbe Total includingducts&vents 955 to 100,000 BTU indud!duds a vents 14.00 Furnace>100,000 BTU 2) Furnace 100,000 BTU+ indudnm9 duds oL vents _ 17,40 including ducts&vents 1,170 3)Flora Furnace Mdueivent 14.00 floor furnace 4) suspected hearer,wall heater i ncluding vent 955 or floor mounted heater 14.00 uspended heater,wall healer rm 5) Vent not included In appliance peit 6.60 r floor mounted heater 955 8 air unK% 12.15 Check all that apply: *Bailer Heal Mr ent not included in appliance permit 445 For Items:•10,see a Pump Cond Oly Price Total units 805 footnotes 1.2 7)OHP;absorb unit to <3 hp;absorb.unit IOOK BAw 14.00 8)3-15 HP;absorb unit to 100k BTU _ _ 9.55 look to soak BTU x5.w 3-15 hp;absorb.unit 9)1530 HP;absorb unit.51 mil BTU 15.00 101k to 500k BTU 1700 10)30.50 HP;absorb 17 unit 1-11.75 mit BTU 52-20 15-30 hp;abso(b.unit 11)>50HP;absorb unit 01.75 mil BTU 501k to 1 mil.BTU 231067.20 12)Ak handling unit to f O,OuO CFM 30-50 hp;absoib.unil 10.00 11)Airhandling unN 10,0011 CFM♦ 1-1.75 mil.BTU 3400 17.20 >50 hp;absorb.unit 14)Non"riable evaporate cooler 10.00 > 1.75 mil.BTU5725 15)Vend(an aonnaded to a single dud 6.50 Air handling unit to 10,000 cfnt 656 16)Ventilation system not Included in appliance permit 10.00 Air handling unit>10,000 chn 1170 17)Hood served by mechar.wal exhaust Non-portable evaporate culler 656 10'00 � p 16)Oortmaslic(ndrmenton vent fan connected to a single duct 446 17.40 19)Commerwl or Industrial type Incinerator Vent syst.not included In appliance permit 656 69.05 Hood served by mechanical exhaust 656 20)Other�nNs,Including wood stoves.' 10.00 Domestic Incinerator 1170 21)Gas piping one to lour"leu 5.40 Commercial or Industral Incinerator x590 22)Nara than 4-per owlet(eadm) - 1.00 Other unit,including wood stoves,Int31 is,etc. 656 Minimum PormK Fee$72.60 SUBTOTAL Gas piping 1-4 outlets 360 a%SURCHAROE Each additlonal ou let 63 PLAN REVIEW 25%OF SUBTOTAL Required for ALL commercial permlls only TOTAL OIMr MepMMms and Feea: I Mpedlora oWkJe of nm W buss n►s horn(mkWnun dnraa lvq hoof) 172.W pe ha+ 2 hull z"s kv~M kill Is aPadaMh amdkaled Irnnnkmrnn chs'"haK M nl 1 F2.M Per t- Total Valuation Fee _- s Adi:1111b^'r OW~"""p N°d W`wVel.wMdio-t d WA-W%b p.m(-44- d. -44 m,da 2e orn{na huh$72.W per hour slate e-eraclor Boaer ca ft"lo n"*ad S 1.00 to$5,000.00 Minimum$72.50 --- - -ae+d"Wof Arc m-q*"Of Pram 0-Ano NaoemeM d rma $5,001.00 to 510,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional S100. 1 or fraction thereof, to and including S 10,000.00 $10,001.00 to$15,000.00 5148.50 for the first S10,000.00 and 51.54 for each additional S100.00 or fraction thereof,to and including$25,000.00 $25,001.00 to 550,000.00 i $379.50 for the first 525,000.00 and 51.45 for each additional$100.00 or fraction thereof,to and including 550,000.00 $50,000.00 and up m 5742.00 few the first 550,000.00 and S 1.20 for each additional$100.00 or fraction thereof Plumbing Permit Application Datcreceived: Permit no.: City g of Tigard Address: 13125 SW sial! Blvd,Tigard,OR 97223 Sewer permit no.: Building pet-nit no.: -- - Ciiy of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: 3y: _Receiptno.: Land use approval: _ Case file no.: Payment type: TY- PE-OF PERMIT &`l family dwt;ling or accessory U Commercial/industrial U Multi-family U Tenant improvement LXNew construction U Addition/alteration/replacement U Foci!service Cj Other: `t 11011 f t t t Job address: I `r_U) f WV'i`l,W Description _ illy. Fee(ea.) Total New 1-and 2-family dwellings only: Bldg.no.: Suite no.: (includes 100 R.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: It Q Block: Subdivision: ' SFR(2)bath — Project name: ` _1P �Lvcz-3D 2(� SFR(3)bath _ City/county: r O nyd fI ZIP: Each additional br.th/kitchen Description and lotation of work on premises: SiteutWtles: Catch basin/area drain Est.date of completiotVinspection: Drywells/leach line/trench drain — Footing drain(no.lin.ft.) Manufactured home uuhti-s Business name: rc, L� _ Manholes Address: /P O 5 0,� Q ea _� Rain drain connector City: �yState:p ZIP: 7o3� Sanitary sewn (no,lin.ft_) Phone: Fax:6b 7-9 E-mail: Storm sewer(no.lin.ft.) CCB no.: �- Plumb.bus.t,g.no: p Water service(no.lin.ft.) City/metro lic.no.: Fixture or Item: Contractors representative signature: Absorption valve Back flow reventer _ Print name: v Dat;: Backwater valve 1F PER.SONBasi!is/lavatory Name: Clothes washer _ - Address: od p0 7 Dishwasher Drinking fountaiu(s) City: State ZIP: W26 Ejectorstsum Phone: Fax: E-mail: Expansion tank 1 Fixeire/sewer cap Name(print): L Q S Iloor drains/floor sinks/tiub Garbage disposal Mailing address: 7j- - ti Hose Hgsc b:bb City: yr o State:a ZIP: 97.z:t3 Ice maker Phone: -,Vo X IFax: nO2t I E-mail: (meter tor/ tease trap Owner installation/residential maintenance only: The actual installation Primers) _ will be made,by the or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I own per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: / f/O Sump Tubs/shower/shower _ Urinal _ Name: r Water closet AWaterea-b ter -- City: Statex ZIP: _ Other. Phone: _ pos Fax: E-mat.: Total Not all lurirdictiam accept twat earth.please call Jurisictim for true inrormuian Notice:This permit application Minimum fee................$ O visa O MasterCard expires if a permit is not obtained Plan review(at — %) $ _ Credit card nrmberi .--L within 190 days after it has been State surcharge(11%) ....$ Ex tea _ ...... _ game at cartatoltla u drown on credit cant-- accepted as•complete. TOTAL ................. s __ Cardholder dou `nsture --�- Amnt 4"16(610000M) PLEASE CQMP_LETE: FIXTURES (individual) Qty .;hPrlH�to : Tota➢ Fixture Type � quantity b Work Performed Sink 16.60 -- New I Moved Replaud RemovadlCavpe Lavatory 16.60 Sink avalo Tub o,Tub/Shower Comb. 16.60 Tub or Tub/Shower Combination Shower Only 16.30 Shower Only Water Closet 16.60 Water Closet _ Urinal Urinal 16.60 Dishwasher -- Dishwasher 16.60 Garbage Diseosal ---- Laundry Room Tray_ _ Garbage Disposal 16.60 Washing Machine Laundry Tray 16.60 Floc,Drain/Floor Sink 2' - 3' Washing Machine 16.60 4' - Floor Drain/Floor Sink 2' 16.60 Water Heater 3' 16.60 Other Fixtures(Specify) _ 4' 16.60 Water Heater O conversion O 1'ke kind 16.60 Gas piping requires a separate mec'ianical permit. MF3 Home New Water Service 46.40 �'- MFG Home New SanlSlorm Sewer 46.40 Hose Bibs 16.60- COMMENTS REGARDING ABOVE: Roof Drains �~ 16.60 _ Drinking Fountain 16.60 --- Other Fixtures(Specify) 21.75 Sewer-1 at 100' 55.00 Sewer-each additional 100' 46.40 Water Service-1st 100' 55.00 Water Service-each additional 200' 46.40 Storm 6 Rain Drain-1st 100' 55.00 Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Bat*flow Prevr:nllon Device' 27.55 Catch Basin V 16.60 Insp.of Existing Plumbing or Specially Requested 72.50 I�dlons perthr _ Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANT(TY TOTAL Isom" or riser diagram Is required r OuanlNy Total Is >g *SUBTOTAL R%SURCHARGE , r "PLAN REVIEW 25'x4 OF SUBTOTAL R!T*W onljr_M fixture gty.1081 la>a TOTAL. 'Minimum pormlt Iva Is f72.50+a%su"arpe,except ReskfentW Backflow Preverdk•n Devke,which.s$36 25+a%surcharge. "All Now Commartlal Buildings require plans wMh Isometric or riser diagram aid plan review Electrical Permit Application -'- Date received: Permit no.: City Of 'Tigard ProjecUappl.ro.: _ Expire date: City of Tigard Address: 13125 SV1+Hall Blvu,'Tigard,OR 97223 Date issued: _ By: Receipt no Phone: (')03) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: WI W 1 kJ I l li[2.family dwelling or accessory U CommerciaUindustrial U Mull i-farnily U Tenant improvement `�LNew construction U Addition/alt-ration/replacement U Other LI Partial + { SITE INFORNIATION Job address: -e ''�� ; ''i"U12 i T a1�C— Bldg.no.: Suite no.: Tax ma /tax lot'accnunt no.: Lot: Block: Subdivision: CM _ Project name: •-.,r" I Description and location of work on promises: Estimated date of complelionlinspect.ion: e Job no: fee Max --- Description pry. (ea.) Total no.tnsp Business name: O/ New m.idenl(al-sirgleormulN-family per Address: 5 dwelling unit.lnclwles attached M-Rge. City: StateQ ZIP: cervi«included: -mail: 1000 sq.ft or less 4 Phone 57 Fax:G -7f Foch additional 500 sq.ft.or portion therenf ( o.: S� _ Elec.bus.lie.no: 3 3 C Limited energy,residential 2 1 icy t, 3 7075 Limited energy,non-maidential 2 s Each manufactur»d home or modular dwelling 2 r cure supervrs gel t ician(required) Date Service and/or feeder e i.iccnseno: C Services or feeders-Installation, np.eect nnmcfprint) "� siterationorrelocation: 1 200 amps or less _ 2 201 amps to 400 grips 2 Name(print): rte' d i 1 E' S 401 amps to 600 amps 2 Mailing address:1 jj-23 601 amps to 1000 amps 2 City: StS[et3 ZIP: Over 1000 amps or volts 2 Phone: GdP- ,0(F6 Fax:S-4 - E-mail: Reconnecionl Owner installation:Tete installation is being made on pruperty I own Temporary services or feeder- which is not intended for sale,lease,rent,or exchange according to Install.N°n,altentloo,orrelocation: 200 amps or:-as 2 ORS 447,455,479,670,701. 201 amps to 4ot'strips 2 Owner's signature, r' 401 to 600 snips 2 Bistsrchcircuits new,allerallon, or extension pe panel: ` / -_ A- Fee for bran.h circuits with purchase of Address- 7" p service or fader fee,each branch ci.cuit 2 Clty:�,.�y _ State1q, ZIPS`7 B• Fee for branch circuits without purchase - —L Pyc-�- of service or feeder fee,first Ornish circuit: 2 Phone. - G� Fax: F,mail: Each additional branch circuit: _ Mbe.(Service or feeder not included): O Service over 725 amps convneraal Ll Health care facility Each pump or irrigation circle _ 2 _ U Service over 320 amps-rating or 18:2 O Hazardouslocation Each sign or outline lighting 2 family dwellings ❑Building over 10,000 square feet fcur or Signal circuit(s)or a limited energy panel, ❑System over 600 volts nominal mote residential units in one structure alteration,or extension* ?_ ..- ❑Building over three stories O Feeders,400 amps or more •Descri tion: ❑Occupant load over 119 persons U Manufactured structures or RV park Fisch sdd�itional Irispecltpr over the allowable In any of the above: O Egress/lightingplan U Other. -- - ....__-- Per inspection Submit`sets of plans with any of the above. Investi °tion fee _ 11te above are not applicable to lemporary condrucdou service. Otho Permit Nm an jurisdictions accept credit ads,please call jurisdiction for more information Notice:This permit application .....................$ - U Visa Q MasterCard expires if a permit is not obtained Pllananrrfee eview(at _ �) S ('Rail card number_ _J_L- within 180 days after it has been State surcharge(11%)....$ _ F"r"" accepted as complete. TOTAL ....$ Named cardholder a shown one it cord S _ Cardholder dputum—l— --�— Atnouni 116.4615(tit00r..'OM) TYPE OF WORK INVOLVED-RESIDENTIAL ONLY 4. Complete Fee Schedule Below- Number of Inspections per permit allowed Restricted Energy Fee................. 175.00 service included: Items Cost Total (FOR ALL SYSTEMS) 4a. Residential-per,unit Check Type of Work Involved: 1000 sq.Q.or less _ $147.15 4 Each additional 5uu Eq ft.or Audio aad Stereo Systems portion thereof _ $33.40 Limited Energy $75.00 _ Burglar Alarm Ear.h Manufd Home or Modular Dwelling Service or Feeder _J� $90.90 2 Garage Door Opener' 41J.Services or Feeders Installation,alteration,or relocation Heating,Ventilation and Air Conditioning System' 200 amps or less $80.30 _ 2 201 amps 10 400 amps Y $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 _ 2 601 amps to 1000 amps _ $240.60 2 Other _ Ovru 1000 amps or volts $454.65 - 2 - Reconnect only _ $66.85 _ 2 TYPE OF WORK INVOLVED_-COMMERCIAL ONLY _ 4c.Temporary Services or Feeders Installation,alteration,or relocation Fee for each system............... $75.00 200 amps or less $66.85 2 (SEE G.'XR 918-260-260) 2131 amps to 400 amps _ $100.30 _ 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audis and Stereo Systems 4d Branch Circuits tiew,alteration or extension per panel Boller Controls a)The!ee for branch dicuits with purchase of service or Clock Systems feeder fee. Each branch dre,iit $6.65 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service r-h L J Fire Alarm Installation or feeder fee. First brand circuit _ $46.85 _ Each additional brand dreuit $6.65 _ HVAC 4e.Miscellaneous (S^rvkm or feeder not Iriduded) Instrumentation I Eacti pump or lrriC,dorl circle 153.40 Each sigr or outline fighting _ - 557.41 _ Intercom and Paging Systems Signal circuf'(s)or a limited energy panel,a leration or e>lension $75.00 _ _ Landscape Irrigation Con'.rol' Minor Latr,ls(1n) _ $125.00 4f.Lach additional Inspection over - Medical the allowable In any of the above ❑ Per Inspection $62.50 Nurse Calls Per hour $62.50 r---� In Plant $73.75 t J Outdoor Landscape Lighting' 5. Fees: LJ Protective Signaling Sa.Enter total of above fees $ 8%Surcharge(.08 X total fees) $ Other Subtotal $ Sb.Enter 25::of line Sa for Number of Systems Plan Review if r_e ug Ired;.iec,3) $ _ Subtotal $ _ No kenses are required Lkxnses are required for kill other Installations Trust Account p FEES: Total balance Due $ ENTER FEES 8%SURCHARGE(.08 X TOTAL ABOVE) TOiAI $ May-10-00 10:21A Walcott Plumb-;ng 603 667 9891 P.02 Street Address Mailing Address WOLCOTT 2050 N.W.Burnside P.O.Box 2007 /r Gnahanr,Oregon Gresham,OR 87030 1803)667-1781 FLUMBIFax(503)667.9891 rdG Cca 02311147 CONTRACTORS, INC. May 10,2000 Azj r j� I Building Department City of Tigard ;13125 SW Hall Blvd. 'rigurd,OR 97223 Wolcott Plumbing COntrucU)rs,Inc. docs hereby authorize a representative of Legend Homes to represent this firm when applying for plumbing permits inside the jurisdiction of The City of'Tigard. Wolcott Plumbing Contractors, Inc. realize that should the agreement with I.egend Homes terminate, we have the right to withdraw our consent. E4- Lm�r Name Title lei 01 Date i gnatutc �i11e 26-208PB 4281 State Plumbing License City License FL Off' FLAN LOT *'118, A "- FL E WOOD FARK RI PD 2,51 11 DA TAX LOT *12500 15425 5W NQRCOURT TERRACE S.E. 1/4 OF SECT ION 11, T.2, RJW, W.M. C I T T OF TIG ARD W ASN 1NGsTON COUNTY, ORE6iON LEGEND AR HOMES 12760 ttW 09th AVKNI1R BIJITR 100 OmCR (003) 020-0000 PORTUNO, OR. 97223 FAA (003) 090-0900 CCB/ X0003 WATER METER W- ---- WATER LINE 55-- -- 5ANITARY SEWER SD— - - -- 5TORM DRAIN - --- - 4 OF 5TRZEET MANI4OLE ® CATCN BASIN I N PROPOSED STREET TREE.9 STREET LIGPT - - FIRE HYJP,ANT I Y I" - 20'-0" �� PROvIDE EROt7ION -Q ti� CONTROL FENCE_ I In p� PER COMMUNITY EROSION PLAN ! LOT 111 J� 2fd 12' h.5' l� b N89'S4';25"E l9 I In r. jz : 209.8' Lor 118tn�/ I lC_ 4,333 50. FT. , 00, �� i / I _ WIN57CN C mp FIN. FLR. - 2052' �- ;� GARAGE FLR - '.01.7' 21 .2' I 'F , N 89' 4 25 E 91.h9' I lL I I, _ I LOT 119 I CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 F� IMPORTANT PERMIT NOTICE ti0 GARNER ELECTRIC 0��.$' 21785 SW U1NALLEY HWY S ALOHA, OR97006-1248 Electrical Signature Form Permit #. MST2000-00519 Datc IsGued. Parcel: 2S111 DA-12500 Site Address: 15425 SW HARCOURT TERR Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 118 Jurisdiction: TIG Zoning: R-7 Remarks: SIF 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. PIE-ase have the appropriate individual fror.l 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: MATRIX DEVELOPMENT CORP GARNER ELECTRIC 6900 SW HAINES ST STE 200 21785 SW TUALATIN VALLEY HWY S TIGARD, OR 97224 ALOHA, OR 979061248 Phone # Phone #: 591-1320 Req #- LIC 121159 SUP 3707S ELE 34-305C AN INK SIGNATURE IS REQUIRED O THIS F RM X ��'� - - Signature of . upervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310