15497 SW HARCOURT TERRACE M
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15497 SW Harcourt Terrace
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BLIP
1" Date Requested — AM— PM BLD
Location-�. - 14L _ quite _ MEC
Contact Person _— P`I -_ PLM
Contractor_ _ Ph — _ SWR
BUILDING 1 Tenant/Owner ELC — -----
Retaining Wall ELIC
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 - --
Roof
Misc: _ --- ---- -- — -
Figal
PA NrRRT FAIL --- -- -------- —
LU, NG
Post& Beam
Under Slab -
Top Out
Water Service
Sanitary Sewer
Ra' Drains
PART FAIL
MECHANICAL
Post&Beall) I ---------- --
Rough In
Gas Line
Smoke Dampers
Finan --- -- -
PAS AR'r FAIL
Service
Rough In
UG/Slab
Low`/oltage
Fir larm -- . _. -- - - -- --- -- --
AS PART FAIL ---
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ J R.eirspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvo
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE [ J Unable to Inspectno access
ADA /�
Approach/Sidewalk
Other Date v InsspeCtO Ext
Final
PASS PART FAIL DO HOT REMOVE this Inspection record from the job site.
■
KW
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Busincss Ling: 539-4171 —
/ BUP
Date Requested -3� -13 __AMy—_`PM —_ BLp -
I oca'ion -5 Sui'.e MEC -
Contact Person r"I. PLM
;ontractor — ___ Ph - — _-- SWR -- __--
U D Tenant/Owner _ ELC
Retaining Wall _ ELF!
Footing Access: —
Foundation FPS
Fig Drain --- SGN
Crawl Drain Inspection Notes — --- ---" -----
Slab SIT
Post&Beam -- --_._
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing 0V 4/0(J'G' �;��d 'eS C .4uJC. —v5-U"e,57C —
Firewall
Fire Sprinkler �li '�/1 L✓.�,ZrZ�Sd i¢S NFi`�OSr�
Fire Alarm
Susp'd Ceiling
Roof
Mis
n �
ASS PART A ----- ------ -
PLUMBING
Post& Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final �^
PASS PART FAIL
*EEILWICAD
Post& Beam
Rough In
Gas Line
Smoke Dampers
i
W- 5,% PART FAIL
ELEC i RICAL
Service
Rough In
UG!Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading —"- -- - — ---"---- "-
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SSV Hall Blvd
Catch Basin ( ]Please call for reinspection RE:_ _- _
Fire Supply Line [ J Unable to inspec, no access
ADA A Approach/Sidewalk
Other Date _ �" � Inspector _ _ Ext
Final
PR3S PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION -�
: �'� -vc✓ '�c��
74-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST ---
BUP
--- Date
------- Requested �- AMy —_PM BLD
Location / 5�/� ' _54 W Suite MEC _
Goy Jact Person -- Ph PLM
Contractor Ph SWR
ILDIN�---, Tenant/Owner -- _--� ELC
Retaining 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 - ---- --
Roof
in
AS ART FAIL - ------- --- ----- ------------ - -- -_ -
PLUMBING
Post 8 Beam ---- ___----_--�----- - --- - ------ - -- --- -
Under Slab --- ------ ------- ---- -----
Top Out
Water Service
Sanitary SewerRain Drains
Drains --------- ---- ---- -- ---- -- --
Final
PASS PART FAIL
MECHANICAL
Post& Beam --- -- ----- - --- - - -- - -- — -- ------
Rough In
Gas Line —_—
Smoke Dampers
Final - -- ---- ---.�_---_� _-
PASS PART FAIL.
ELECTRICAL -- ---`--^.-- --- - --- -----
Service
Rough In ----- - -- -
UG/Slab -------- - --- - ---- ---------- -------
Low Voltaga
Fire Alarm ----— - -- -- - - ----- --- ---
Finil
PASS PART FAIL
SITE
Backfill/Gradinf --
Sanitary Sewer
Storm Drain I ]Reinspection fee of$ -.required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I ] Please call for reinspection RE. -__-_- _ ► ]Unable to inspect no access
ADA
Approach/Sidewalk
Other Date _ Inspector — _—_ Ext
Final
PASS PART FAIL j 00 NOT REMOVE this inspection record from the job site.
i
i
CITY OF TIGARD
Residential Certificate of occupancy
Permit No.: ; rt C 00,4-9 fg Address: j 5 4 q
Owner/Contractor:
Date of Final Inspection: inspector:
This structure has been found to be in substantial compliance with the provisions of the State of Oregon One& Two Family Dwelling
Specialty Cade and is hereby approved for occupancy.
May-10-00 10:21A Wo1cott P l umb i n47 503 667 9891 P .02
StreMAddrbaa 1NailinyAddmu
WOLCOTT 2050 N.W.Bumside P.O.Box 2007
Gresham,Oroyon Gresham.OR 9700
�LLIM$ING (503)667.,781 Fax(503)667.9891
CCU 023647
CONTRACTORS, INC.
May 10,2000
Building Aepartmtcnt _---
City of Tigard ._
13125 SW Hall Blvd. - - -
Tigard,OR 97223
Wc,lcott Plumbing Contructo s,Inc. docs hereby amhorizc a r!presenlutive of i.nge;nd
Homes to represent this firm whcn applying`.i plumbing pei-mits inside the jurisdiction
of The City of Tigard. Wolcott Plumbing Contractors, Inc rcalize that should the
agreement with Legend Homes terminate, we have the to withdraw our consent.
Name Title;
0
01 th
Signature Date
26.208PB _.�. 4281
State Plumbing License City License
CITY OF TIGARD
1 ' 12F S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GARNER ELECTRIC
21785 SW TUALATIN VAL-LEY HWY S
ALOHA, OR 97005-1248
Electrical Signature Form
Permit #: MST2000-00488
Date Issued: 11/13/00
Parcel: 2S111 DA-12800
Site Address: 15497 SW HARCOURT TERR
Subdivision: APPLEWOOD PARK NO. 3
Block: l_.ol: 121
Jurisdiction: TIG
Zoning: R-7
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 frorn 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 .nspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTR.AC T OR:
MATRIX DEVELOPMENT CORP GARNER ELECTRIC
6900 SW HAINES Sri STE 200 21785 SW TUALATIN VALLEY HW'Y S
TIGARn, OR 9722A ALOHA, OR '-17706-1248
Phone # 591-1320
Req #: uc 121159
SUP 37075
ELE 34-305C
AN INK SIGNATURE IS REQUIRED ON HIS FO M
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF T I G A R a MASTER PERMIT
PERMIT#: MST2000-00488
DEVELOPMENT SERVICES DATE ISSUED: 11/13/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE AC DRESS: 15497 SW HARCOURT TERR PARCEL: 2S11 IDA-12800
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7
BLOCK: LOT: 121 JURISDICTION: TIG
REMARKS: S/F PATH 1
BUILDING
+REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 19 FIRST: 1.198 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND. 668 or GARAGE: 410 of FRONT: 20 PARKING SPACES 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: al RIGHT- 5
VALUE: S 172,994.00
OCCUPANCY ORP: R3 BDRM: 4 BATH: 3 TOTAL: 1.86600 or REAR: 26
_ PLUMBING
SINKb. 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 5F RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN�100K: 1 SOIUCMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN>•100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: blu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS:
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 PLIMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 400 amp: let W/O SVCIFDR: 00 SIONIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HMISVCIFDR: 601 • 1000 amp: 601.ampa•1000v: MINOR LABEL:
1000.amplvolt:
PLAN REVIEW SECTION
Reconnect only: —
»4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 6 OTEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 3,761.74
MAIRIX DEVELOPMENT CORP LEGEND HOMES CORP This permit is subject to the regulations contained in the
6900 SW HAINES ST STE 200 12755 SW 69TIl AVE Tigard Municipal Code,State OR Specialty Codes and
TIGARD,OR 97224 1'IGARU,OR 9723 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 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
Reg N: 111, 00060561 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 Mechvnica Mechanical Insp Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall 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 Dn Electrical Service Low Voltage Water Line Insp Final Inspection
Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building sinal
Issued By : � � 1C-- — Permittee Signatut%.: L t.L �sz�
Call (503) 539-4175 by 7:00 p.m.for an Inspection needed the next business day
CITYOF TIGARD "_SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2000-00338
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/13/00
SITE ADDRESS; 16497 SW HARCOIJRT TERR
PARCEL: 25111 DA-12800
SUBDIVISION: APPLEWOOD PARK NO 3 ZONING: R-7
BLOCK: LOT: 121 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS-
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 -- "=-- -
6900 SW HAINES ST STE 200 Type By Date amount Receipt
TIGARD, OR 97224 PRMT CTR 11/13/00 $2,300.00 27200000000
INSP CTR 11/13/00 $35.00 27200000000
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
I his 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 lo.ated at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer sh 311 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 iii OAR 952-001-0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling(503) 24F-1987.
Issued by Permittee Signator
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
�i Date received:/,I2/ Permit no.:
city of f Tigard Project/appl.no.: Expire date:
CityojTigard Address: 13125 SW Hall l}lvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171 7�C%" Payment type:
c
Fax: (503) 598-1960 [' / Case file no.: Y Yp ,�'�3 �
=hnt-IY� 171 Complex:
Land use approval:
&2 family dwelling or acce sary U Commercial/industrial U Multi-family ldNew construction U Demolition
U Addition/alteration/replaccm nt U Tenant improvement U Fire sprinkler/alarm U Other. —
11
- Bldg.no.: _ Suite no.:
Job address: 3 — Tax map/tax Dot/account no.: ,�S /,�Vq-/,q
I,ot: Block: Subdivision:
Project name:
Description and location of work ion in
on premises/special conditions: J=
--, ,
OrIT711Q, FILM, 111154,11,111741 HT'I
Name: C�
� &2 farn;ly dwelling: /'SO��
Mailing add ss: �S� work........................................ $ J
State:p ' ZIP: �7 Valuation of i z-
one:
& - No.of bedrooms/baths................................. _ ,�--
D'hone: to.W- o� Fax: G� E-mail: ................................ J
Owner's representative: _ Total number of floors.
New dwelling arca(sq.ft.) .................•........
Phone.: Fax: Email: �3
' Garage/carport area(sq.ft.).........................
Covered porch area(sq.ft.) ........................
Name: Deck area(sq.ft.) ...............................
Mailing add ss: l0 Other structure area(sq.ft.).........................
City• Statep ZIP:
re
. � E-mail: CommerclaUindustrlaUmulti-family:
Phone: o- cry Fax Valuation of work.........****
ork................ $ —
,r, Exiting bldg.area(sq.fl •.
Business name: 7 _/ c- �l�S New bldg.area(sq.ft.)....... .......................
Address:),i 7J' ' Number of stories............ ----— ---
City: p Stated ZIP:`1'ZI Type of construction....................................
Phone: O Fax:,9 E-mail. Occupancy group(s): Existing: --
—�6 0 3-ro 3 New:
CCB no.:
City/metro lic.no.: l- 7 Notice:All contractors and subcontractors are required to be
t licensed with the Oregon Construction Contractors Board under
tie 1111 provisions of ORS 701 and may be required to be licensed in the
Name: O f jurisdiction where work is being performed.If the applicant is
Address:/ 3- exempt from licensing,the following reason applies:
Cit �d a Stately ZIP: 97 —
Contact person: baa Plan no.: __-----
Phone:(P,ZO - r) Fax - E-mail:
Contact person:
Fees due upon application ...........................
Name: S --
Date received:
Address: p ••• $
City:
'I.(P• Amount received ......................................
csi Statep d/�'1
--1� please refer to fee schedule.
Phone: paS Fax: __�E-mail:
VI jwi+dicUnw aocepe �car
Ptcall jurisdicUmorea+fa me informaUan.
I hereby certify I have read and examined this appli..ation and the Not visa o MasterCard
attached checklist.All provisions of laws and ordinances governing this 0 Vi aaa number: Expires
work will be complied with,whether s 'fled he in or not _
ate: Name of cardlwlder a shown on cK It cad S
Authorized,*nature: — amount
Print name)P"[ c.nti>al alpmure
// ted u complete. sa�u ta,�otA
tice:This permit appli^.-�t• n expires if a permit is not obtained within ISO days after it has been accepted
Mechanical Permit Application
Date received: Permit no.:
City of 'Tigard Project/appl.no.: � Expire date:
City ofTigard Address: 13125 SW Ifall Blvd,Tigard,OR 97223 Date.issued: By: I receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type `
Huildius permit no.: —�
Land use approval: - - ---
.E'!1 &2 family dwelling or accessory L1 Commercial/indusuial 0 Multi family U Tenant improvement
U New construction U Additional eration/replacement U Other.
tl 1 1 1 1 1
Job adurec s (rt vi s indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no. Suite no.: _ value of all mechanical materials,equipment,labor,overhead,
proft_Value$
Tax ma tax lot/account no.:
Lot: BJ�Jr; - Subdivision: ��p���Z- See checklist for important application information and
jurisdiction's fee schedule for residential permit fee.
Project name: c _ t11011AIA
City/county: ZIP:
Description and 1 tion of work on premises:- Fee(m) Total
— ---- -- Description e?ty. Res.only P.ex.only
Est.date of completion/inspection: - _--
Tenant improvemer change of use: Au!candling unit _CFM
Is existi space heated or conditioned?U.'es U No con inn ng(site p an require ) _-
Is e ' tng space insulated?U Yes U No r,rcerauono extsung ( system
IT or er compressors
State boiler permit no.:
Business nwnc: ,,vv,�//,,,,���� '�% .�� HP Tons BTUM _
T7� — trc smo a amper ucr s u10 a etectors
Address: _c �' [OS
City: a Statty ZIP: -7 eat pump site p an requ.regi
E-mail:
Instal rep ace umacec:amer
Phone: -7 7 Fax: "3-•7G1i — Including ductwork vent liner U Yes O No
CCB no.: f _ TnstaFreplitLetrelocate heaters-suspended,
City/metro lie.no.: wall,or floor mounted _-
�entora Itanceo er an urnace
Name(please print): 0n �" c goat on: --
mum Absoc prion units BTUAI
Chillers.— -- HP
Name: / l( —— Com ressnrs _ HP
Address: „��/,�J� ♦ onment exhaust ao ♦ent oo: _—
City: PO L6" State:0� ZIP: f 7,1�3 Appliance vent _ —
Phone- -7 J Faxo4s' 7L 2 E-mail: cr ez asst -
{ s, ype res, tc a azmat
hood fire suppression system ---
Name: Qq.AZj� D/�t2 S E:thaust fan with single duct(bath fans)
x aust s stem a an rom eaun or C
Mailing addressT,? J � ue p p L rtn rst ut on up to ou ets
City: YTfF6 Stated 7.IP:9 ,x,13 TYPe: LF'G NO Oil -
Phone: - O r] Faz: T E mail' uel t ing eac—Fi a loons over out els
Prove"piping(sc emauc required)
Number of outlets —
Name: _
ter ■PP ce or equ pment:
Address: /o Decorative frrc lace —
City: State: nsert-ty _ --
Email: tov pe etstove
Phnne: fo?l- lib Fax: er:
Applicant's signatur� ate: er
Name(print): e i o ................... —
n�' Permit fee. $
Na all Juewktlarn am"p credit c",p cait J"'i'dk�— don r0f on!i"r"MsdOn Notice:This unit. lication
Pe 'rPP Minimum fee................$ _ —
U Noss O MasterCard expires if a permit is not obtained plan review(at _. %) $ —
Credit crd member:.___. Dpires— within 180 days after it has been State surcharge(896)....$ ---
- accepted as complete. TOTAL .
Name or nudho u ahowa as t trd $
$
Cardholder sip inure Amounl 440A617(i�OUCOh)
Plumbing Permit Application
Date ieceived: Permit no.:
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 —` —
City of Tigard Phone: (503) 6394171 FrujecUappl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By_ _ Receiptno.:
Land use approval: _ Case file no.: Payment type:
TYPE OF�PERM IT
1 &2.family dwelling oraccessory U CommerciaUlndusirial L7 hfulti-family U Tenant improvement
f J-New c.-astriction U Addition/alteration/replacement U Food service U Other. _
1 { 1fit%d 10CEMM 2
Job address: �3. !Govt
ra+ S7 Descri tion 7ty. Fee(ea.) Total
New I-and 2-family dwellings only:
Bldg.no.: Suite no.: (inclrrde+100 it.for each utility connection)
Tax map/tax lot/account tio.: _ SFR(1)baht
Lot Block: Subdivision: S►R
Project name: �4i> ��- SFR(3)bath —— -
Cityh:ounty-I C 7-1P-_jj2,�. -s Each additional bath/kitchen
Description and lotafion of work on promises: -- Slteutilities:
Catch basin/area drain _
Est dl
to of eompletlo�nspecaon: Drywells/leach line/trench drain
_—
Footing drain(no.l:n.ft.)
` 1 Manufactured home utilities
Businets name:
Address- d 3n c2 eO Rain drain cornector
City: try State-o ZIl': n 3a Sanitary sewer(no.lin.ft.) - —_
Phone:f,"�- Fax:Gb 7_9 E-mail: Storm sewer(no.lin.ft.) _
CCB no.: Plumb.bus.rog_no: p '-Water service(no.lin.ft.)
Fixture or Item:
City/metro lic.no.: Absorption valve _—
Contractor's representative signatuT: 0 oyt� Back flow pmventer _ —_
Print name. Q / d o�7 - Date Backwater valve
CONTACTPERSON BasinsAavatory
Name: 'X-
Dishwasher
Clothes washer
�Or I.c ---- - Dishwasher _
Address: c2 d oo 7 _ _
�'� Dritildn fountain(s) .
City: (9r,,sh Stated ZIP: �J�3d Ejcctors/sum _
Phone: Fax: E-mail: Expansion tank _ _ -----
1 Fixtut sewcr cap
Name(print): t p Q S _Floor drains/floor sinks/hub
Garbage disposal—
Mailing address: 7,� oft� l f -- Hose bibb
city: Istate:e.0 ZW: Ice maker — _-
Phone: E-mail: Intel,tptor/grease trap
Owner installation/residential main'^_nance only: The actual installation Primer(s) _
will be made by me or the maintenance and repair made by my regular Roof drain(commeirial) —
employee on the property I own s per ORS('bapter 447. Sink(s),bastn(s),lays(s)
"Ower's signature: /� e: Sum
t Tubs/shower/shower pan
IN Urinal
Name: ♦ Water closet _
Address:kcj6 J4 Water hat
eer _ _
City: Statep ZIP:97 Other.
Phone: _ Qo�� Fax: E-mail: Total
Not all jurisdictions credit earls, ase call Jurisdiction for mare infunnadon Minimum fee............ ) $
�p Pk Notice:This permit application plan review(at ^ 96) $ —--
❑Visa t]MasterCard expires if a permit is not obtained
Credit cud number: Expires within 180 days after i has been State surcharge(896) ....$ —
�pi�, TOTAL .......................$
accepted as'complete.
N;&—o(cw of u shown on credit card
4104616(6OdCOM1
Cardholder signuttre Amount
Electrical Permit Application
"eived: Pcrmit no.:
City of Tigard �Praject/appl,no.: Expire date:
City of Tigard Address: 13125 SW Hail Blvd,Tigard,OR 97223 Date issued: By: Recciptno:
Phone: (503) 6394171 — �_
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
+
&2 famVy dwelling or accessory U Commercial/industnal U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Other: U Partial
It ! ' 1
Job address: / Bldg,no.: Suite no.: ITax map/tax lot/account no.:
Lot Block: Subdivision: 4, _
Project name: I Desc on and location of work on promises: — —
Estimated date of completion/inspection:
+ iolt APPLICATION FEL SVIIIEVULE
Job on: i d-O tK Max
-- Description Qty. (ea) Total no.lac
Business name:
GO,,
Address: New residential-single or multi-family per
� dtselBng unit.Includes attached pprage.
City: :,:,tea ZIP: Service dncluded:
Phone -113.26 Fax:G -7 -mail: locoaq.n orleen _ _— a
cR o.: S_ Elec.bus lis.
3 Each additional 500 sq.R.or portion thereof
no: 3 umitedenergy,residential 2
ity .3 70 Limited energy,non-residential _ 2
c Each manufactured home or modular dwelling
gra hire su rvis g el trician(required)_ Dete Service and/or feeder 2
Sup,dent.name(print): ,L Incense no: U Serrlcea or feeders—kriallation,
alleratlon or relocation:
1 200 amps or less 2
// 201 strips to 400 amps 2
Name(print): B/jl+P S — - -
- 401 amps to 600 amps 2
-
Mailingaddress:T 73-5� jw 1, �"l�¢ e _ --- -
601 amps to 1000 amps 2
City: p Stateo ZIP: 1 d 3 Over 1000 amps or volts _.__...__
2
Phone:G 0 4�d Fax:s-? - E-mail: Reconnectonly --- - — — l
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to Iastallatlon,alteration,orrelocation:
ORS 447,455,479,670,701. 200 amps or less 2
/� 201 amps to 400 amps 2
Owner's si nature: V 19 07 Date: 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per paneh
Name' 'G A. Fee for brans:.circuits with purchase of
Address: p service or feeder fee,each branch circuit 2
City: I Stated ZIP!J'7 B. Fee for branch circuits without purchase _ ---
Phone: - y+ Fax: E-mail: of service or feeder fee,ritst branch circuit: _ 2
Each additional branch circuit _
rM gum Mise.(.Service or feeder not Included):
t7 Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle --__ 2
OService over 320amps-rating oft&2 OHazardous location Each sign oroudinelighting 2
family dwellings O Building over 10,000 square feel four or Signal circuit(s)or s limited energy panel,
O System o:-r600 volts nominal mom residential units in one structure alteration,or extension' J_ 2
O Building over three stories O Feeders,400 amps or more •Descrition:
O OcLupant load over 99 persona O Manufactured structures or RV put Each additional hsspeetlon over the allowable It,any of the above.
O Egtesallighdngplan U Other. -- _ per inspection E___L �—
Subrult_^sets of plans with any of the above. Investigation fee_
The above are not applicable to ternpomry construction service. Omer _
Na all}udadic.dear accept edit web,please all}urir,tcdaa fo more Wonnadaa Notice:This permit application
Permit fee....................$ ---
U Visa U MasterCard expires if a permit is not obtained Plan review(at — %) $ —
Credit card number. _ L_1 _ within 180 days after it has been State surcharge(8%)....$
^Expifes accepted as complete. TOTAL .......................S
---- Name of wdhol ear ren wr lae�{ rand —�
_ S
--- cardbolde djnaturr Amount 4404615(&W/170M)
FL OT FLAN
LOT :1123, AFFL E WOOD 'ARK
RIFD 251 it DA
'rAX LOT *13000
15543 5W 44RCOURT TERRACE
S.E. 1/4 OF SECT ION 11, T.2, R.11A W.M.
CITY OF TIGARD
1U,454Ne�TON COUNTY, OREGON
LE Gz- E N' D ® WATER METER
losI HOMESWATER LINE
l2 55 511 99th AVENUE_-� •� SUITE too SS— — SANITARY SEWER
SD— — — —
OFFICE (503) 920-8080 TIGARD, OR. 97223 5TORM DRAIN
1nw+uis•
FAX (503) 590-8900 CCDM 80583 ¢e------ Q'i OF STREET
• MANHOLE
® CATCH BA51N
PROPOSED
STREET TREES
STREET LIGHT
}, FIRE HrURANT
N Y
PROVIDE EROSION
CONTROL FENCE
PER COMMUNITY
ER051ON PLAN v
f� 1., 20'-0" W H Q
w
, LOT 122 / IAL
I I
/ N89"54'25"E
I�
' I
I '
I„ ; 149.4' LOT 123 40'18'
!' 4,155 SQ. FT. JU
/
Q bURNAM .� - 2015'
tL FIN. FLR- • 210.6 ' p
Q .n GARAGE FLR • ZObAD
N89'S4'25"E I �
k' 2m15'J�
Lar 124 Q' I '
I