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15497 SW HARCOURT TERRACE M CC 4 U) p1 C C � I CD N 0 (D 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