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15555 SW HARCOURT TERRACE cr T n O c —I c. a� n CD i 15555 SW Harcourt Teiidce CITY �� TIGARD I�� MASTER PERMIT s PERMIT#: MST2000-00576 DEVELOPMENT SERVICES DATE ISSUED: 1/30/01 13125 SW Hall Blvd., Tigard, OR 97223 (.503) 639-4171 SITE ADORESS: 15555 SW HARCOURT TERR PARCEL: 2S111DA-13100 SUBDIVISION: APPLEWOOD PAPK NO. 3 ZONING: R-7 BLOCK: LOT: 124 JURISDICTION: TIG REMARAS: New SF detached. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED ' CLASS OF WORi'• NEW HEIGHT: 20 FIRST: 1,198 of BASEMENT: a1 LEFT: 5 SMOKE DETECTORS TYPE OF USE: 5F F UOR LOAD: 40 SECOND: 668 of GARAGE: 44n ,f FRONT: 20 PARKING SPACES TYPE OF COWS?: 5N DWELLING UNITS: 1 FINBSPIENT: of RIGHT: 5 VALUE: $172,884 00 OCCUPANCY GRP: R3 NORM: 4 9ATH: 3 TOTAL: 1,866.00 of REA.1.: 29 PLUMBING _ SINKS. 1 WATER -OSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN D^.AIN: 100 TRAPS LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN GRAINS: I CATCH BASINS: TUB/SHOWERS: 7 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS. OTHER FIXrURFS. MECH:4NICAL FUEL TYPES FURN<100K: 1 BOIUCMP<3HP: VENT FANS 4 CLOTHES DP.YER: I GAS FURN�-100K: UNIT HEATERS: HOODS. I OTHER UNITS: I MAX INP: blu FLOOR FURNANCES: VENTS: 1 WOODS LOVES GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER_ TEMP SRV /FEEDERS BRAN.-H CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 200 amp: WILVC OR FDR: 1 PUMPIIRRIGA110N PER IN:,PECTION: EA ADD'L 5005F: 3 201 400 amp: 201 - 400 amp: let W/O SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNALIPANEL IN P'AN MANU HMISVCIFDR: 601 • 1000 amp: 601+1Impa-1000v: MINOR LABEL 10004 amplvolt: PLAN P.EVIF.4 SECTION _ Reconnect only: —4 RES UNITS: SVCIFOR>-229 A.: >806 V NOMINAL: CLS AREA/SFC OCC: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ B COMMEP:IAL AUDIO 6 STEREO: VACUUM SYSTEM: At &STEREO: FIRE ALARM INTERCOMIPAG!NG. OUTDOOR LNDSC LT: BURGLAR ALARM: 9TH: BOILEq: HVAC LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENT iT10N M,=DICAL. OTHR: HVAC: DATArTELE COMM: NURSE CALLS TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 3,773.74 MATRIX DEVELOPMENT CORP LEGEND HOMES CORP This permit Is sub;ect to the I?gulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and 6900 SW HAINES ST STE 200 12755 SW 09TH AVE 0100 all other applicable laws. All work will be done in TIGARD,OR 972?4 TIGARD,OR 97223 accordance with approved plans This permit will expire if work is not started within 180 days of Issuance,or if the work is suspended fol more than 180 days ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rtes are set Rego: (I('. FP561 forth in OAR 952.001-001C thruugh 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 PLM/Underfloor Electrical Rough In Gas Line Insp Rain drain Insp Sewer Inspection Underfloor insulation Mechanical Insp Framing Insp Gas Fireplace Water Une Insp Footing Insp Crawl Drain/Backwater Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final Foundation Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Ins{ Firewall Insp Mechanical Final Post/Beam Structural Footing/Foundation Dr; Electrical Service Low Voltage Rain drain Insp Plumb Final Issued By : Pgrrnittee Signatu - Call ( 03) 639-4175 by 7:00 p.m for an inspection needed the next bu noes day CITYOF TIGARD SEWER CONNECTION PERMIT 1)E`JELOPMENT SERVICES PERMIT#: SWR2000-00394 13125 SW hall Blvd.,Tigard, OR 97223 (513) 639-4171 DATE ISSUED: 1/30/01 SITE ADDRESS; 155.55 SW HARCOURT TERR PARCEL: 2S1110A-13100 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 124 JURISDiCTION: TIG TENANT NAME: IDSA NO: FIXTURE UNITS: 0 CLASS OF WORK: 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 6900 SW HAINES ST STE 200 Typo By Date Amount Receipt TIGARD, OR J7224 PRMT CTR 1/30/01 $2,300.00 27200100000 INSP CTR 1/30/01 $35.00 27200100000 Phone: Total $2,335.00 Contractor: Phone: Reg #: Reauired 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 Ind 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 952-001-000. You may obtain copies o. these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: -� Permittee Signature: L L L Call 503) 639-4175 by 7:00 P.M.for an inspection needed the next business day .�tta n, Building Permit Application Datereceived:. - elrr) Petmitno./c1s7'�pa• City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR Til-23 Project/appl.no.: Expire date: \ Clti'ojTigard Date issued: ~ — B ' Phone: (503) 6394171 -� ;; . _ Y�,: '•f Receiptno,: Fax: (503) 598-1960 Case file no.: — Payment type: �- 3 I-and use approval — 1&2 family:Simple Complex: 8r.2 family dwclling or accessory Q Conimercial/industrial ❑Multi-family New construction ❑Demolition U Addition/alteration/rr.piaceme,lt 0 Tenant improvement Cl Fire sprinkler/alarm G Other. _ JOB SUE INDORNIATION _Job address: "�t:�� i %-/11k1�'lU K t rt.1�{Ll�G f _ _Bldg.no.: Suite no.: Lot: 114 _Plock:__ IT x.map/tax lot/account no.: iLff /a/ Project name �— _ i -� �'' f 32_, Description and Ideation of work on premises/special conditions: 1 Name: Z_Pg�n � oly.J��_ Mailing add ss,1,2 l do 2 family dwelling: City Cir r State Z[P_9 Valuation of work........................................ $ Phone: Go2G)�� Fax -r G E-mall: _ No.of bedrooms/baths................................. Owner's representative: ti-eY HI1)t f '01-j Total number of floors................................. Phone: E .'f- `Yj� IF= t id 1?fj ,t) E-mail: New dwelling area(sq.ft.) .......................... Garnge/carpori area(sq.fL)......................... Name:US Covered porch area(sq.ft.) ......................... Mailing L� - f;�_- _!�> �' r L - Deck area(sq.ft.)....................................... _- Ci Stated ZIP: Other strurture arca(sq.fL)....................... Phone: p O FaxLj Email: f'ommercial/lndustrlal/multi-famil - 1 Valuation of work............................. ,........ S. Existing bldg,area(sq.ft.) Business name: Z .a _-- — ----- New bldg.arra(sq.ft.) `�.. Address: 7 "- -- _ —- Num Stated 7IP:'I 7� ber of stories.......... .. ............I............ r�1 dL y' v T of construction ..................... Cit Phonc:[,dJ c� Hax:�Yf� ` E-mail: �J Occupancy group(s): CCB no.: _0110,17 3 - ___ New: _ City/metro lic.no.: '7 7 Notice:All contractors and subcontractors are required to be licemed with the Oregon Constniction Contractors Board under Name: 9- pmvisions of ORS 701 and may b-;required to be licensed in the Address: � jurisdiction where work is being pe.formed.If the applicant is /3 S_.!4i /�5 % - exempt from licensing the followin reason applies: City: 'Diad 1C.' m/ StatrW ZIP: '1224:!? p g g -- _Contact person: ytdi^LJ Plan no.: — - -- --—_.-._—.-- -.� PhonaG,Zp Fax:s- Name: '"e Contact person: Fees due upon application ...........................$ ,x.50 U Address: G vv) t vn Date received: City: T_."r"'Y"l jState< ZIP: 1/70 .1 Amount received ......................................... .$ r- SO , ILL) Phone: F.-mail: —� —Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not Ni Jwiixtictiolu acceig creditca"dr,ptesu call Jurirdicdon for mom ij(*nw oa. attached checklist. All provisions of laws and ordinances governing this U visa U MulerCatd work will be complied with,whether s cifred tic .in or nom Credit card twtnt�: Ex piresJ2I6 v Authorized nature: ate: _ —-Nam nt rmAhoidcr as shown oa t card— � S Print name:j~_pgY 'oo Cwthordusiputure Amount Notice:W3 perm//tt applicat' n expires if a permit is not obtained within 190 days after it has been accepted as compkle. 4441613(60WCOM) Mechanical Permit Application — Date received: IP, -.,.-mit P :mitno.: City nlt Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 -- Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment typz: Land use approval: _ _ �_ _ Building permit no.: ,411' &2 family dwelling or accessory U Commercial/industrial U Mult:-family U Tenant improvement l New construction U Addition/alteration/replacement U Other. .Job address: wtN Qtlrf i y IA-e-c- Indicate equipment quantities in boxes below.Indicate the dollar Bldg,no.: Suitt no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/a;.;ount no.: ptv6t.Value$ Lot•. f, .- --Block: _ Subdivision: Q� •See checklist for important application information and Project name_� / jurisdiction's fee schedule for residential permit fee. City/county: -7-t� ZIP: 1..1 _ _ ��91�� _!g _ - Description and l(Ahtion of work on premises: _ Fee(ft.) Toter! Est.date of complztion/inspection: -� - - — Description Ot . Res-only Res.only Tenant improvemet r change of use: Air handlingunit _CFNI Ise xist) space heated or conditioned?U Yes U No --�- At�con t�UonTng sut plan requutct} -' Ise ' mg space insulated?U Yes U No Alteration of exist ni gVAC system _Boiler/compressors Business name: State boiler permit no.: HP Tons BTU/H Address7jl/2, s �p� - ! — _ «r smo a Wiper—7s duct smo a electors City: p Stag ZIP: 9.7x,1 eat pump site p in required) -ITSPhone: - -7 7 Fax:,4371,9 E-mail: __ ncl rep ace7urn went line Including ductwork/vent liner O Pts U No CCB no.: I 1 nsla tap ac re ocateeaters-suspei_&e , City/metro lic.no.: �7 wall,or floor mounted - - Name(please print) Vent for appliance o�-eereianfamacc ReffigeraHow Absorption units BTU/H Name: �p/)� Chillers_ Hp Address: J - Com rtsson._-.-- _ , HP ronmenta ex rest an lent ton: City: Rv State:OQ ZIP: 9'7 Appliancevent Phoney -7,7,f)7FaxJs =)L. _y? E-mall: Dryer exhaust Irw3s,�1`ypi flflhrs. it cc et hood fire suppression system Name; p ,p �/� p/y Exhaust fan with single duct(bath fans) Mailing address:j ,t�- e._- Exhaust system a art from hesting or City: ' �y�' Statr� 7.IP:9 el piping ,OO up to outlets) Typpee: -.--LPG _— NO Oil Phone:/_r I Fax - &mail: Fue pi m eachaiflonal overt eta Chang Process p p Itt(schematic required) Name• LL Number of outlets ter tisted Slip Qance or equ p- T went: Addressr:gr !� Decorative fireplace City.`-- f-- air State: ZIP_ Phone:foal- !smo Fax E-mail: t—uveTpelletst—oar — �t Applicant's signature: Name (print): e 6 — _-_ Nd VI Jmidlc6ow rxep credit cadr,pk a ole jw diction fa rtwre Inr.-J n Petmit fee.....................$ O vas ❑Mulertaud Notice:This permit application Minimum fee................$ expires if a permit is not obtained Plan review(at — %) $ Credit card numher ._.__.... _.T -- _-- —�--- Eipiru within IAO days atter it has beat — s Stat surcharge(86) ....$ Nonofcudholdet u shown on creit cid accepted as complete. _ Cudholder signume- —Amount 410-1617(&O"W) Commercial Schedule 182 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE Furnace to 100,000 BTU Des`rVJon Table 1A Mechanical Code Qly Price Total including duds&vents 355 i)Furnace to too;txl00TU-----` --Furnace>100,000 BTO kldrWir _duds a vents 14 2)Fu max 100,000 BTU• - .00 including ducts&vents Inducting duds a vents` 17.40 1,170 T)Fkx t Fumad -- floor timate Indudirp vent 14.E - 4) Suspended healer,"N heater` Including vent 955 'x Ilaor mounted heater 14.00 suspended heater,wall heater 51 vent not Included In amftnx p@Mh 6.60 or floor mounted heater _^ 955 ..61 Repsk unIls v 12.15 Vent i,ot included in appliance permit 445 chedu a5 that M Pry 'Boller Hest Air Repair units 805 For Name 7-10,see or Pump Coad Oty Prkv Total r�tk 1�2 -• <3 hp;absorb.unit 7) 3HP;obsdb unk to 100K BTU 14.00 to 100k BYU955 e)s-1s HP;absom on+l - I00k to 30M BTU 25.00 3-15`Ip;absorb.unit 9)1!1 30 HP;absorb 101k to 500k BTII un5 F-1 mil BTU ss.00 ._� 1700 101>o-�NP;ebsoAi 15-30 hp;absorb.unit ��.�11.75 mil BTU 3220 .1)>50 IF;absorb unN>1.75 m5 Bi'U 501 Y.to 1 mil.BTU 2310 e7.20 ' 12)Ak handikp unM b 1o,OW C'FM 30-50 tip;absorb.unit 10.00 1-1.75 mil.BTU 3400 13) handlingunk10,000CFM 17.20 >50 h7;absort).Unit 141 Hon�otl.we evgnoraM cooler 10.00 >1.75 mil.BTU 5725 t5)Vest ten mrnnoder(o a aknp4 uti- Ah handling unit to 10,000 cfo.eo g m_ 656 10)VenUalbn syatam not tnduded M .Nr handling unit> 10,000 cfm 1170 ' t°_ °P_n"N 10.00 ---_ 17)flood served by meri,ank;al exhausl Non-portable evaporate colter _ 656 _ 10.00 vent fan connected to a single duct 446 1?)nomesuc tnCkleratnn _ 17.40 Vent syst.not Included In appliance permit 656 It,)c°na"erd'I a Iwmblal type k+dnerata oe.95 Hood served b mechanical exhaust 20)00w onw, y _ 656 tnduak,y wood.rove' 10.00 Domestic Incinerator 1170 21)au pk*v one to lour ordtea �- Commercial or Industral Indnerator 451305i4o 72)Mon than Oyer o"(sadjn Other unit,Including wood stoves,Inserts,etc. 656 - t.00 Minimum ParmM Fea 72.00 �- SUBTOTAL Gas piping 1-4 outlets, 360 6%sURCfIARUE Each additional outlet 83 RM REVIEW 25X OF SUBTOTAL Required Rw ALL commercial permNs only TOTAL OSMr k*Pftd& and Fees: 1. Inapecaons eAsHe of n-nw b.*M,M,n(ninYrane chary.-Iwo heoal 172 50 per h- 2. r' rd M 1 ate%a Is"*do IN i dl-4m(^inknwn-%.MeJW tour) Total Vslugtjon s725npe Fol Mu -- ] A.AtYlxx,ar pYn ra.lar mquh by dwge...6fNMs d rtMlon>b plea(rtJnYnxn div oonaA.a hour)372.50 par Mux $1.00 to$S,000.U4 - -slave C.oee.dn 11oMr c■w.daa,,"*" Minimum$72.50 '-a..eera.r AC eavw..see sae V...w pace e 1 a wl $5,001.00 to$10,000.00 572.50 for the first$5,000.00 and S1.52 for each additional$100.00 or fraction thereof, to and including$(0,000.00 S 10,001.00 to S25,OiA.00 TI i-8 5-6 for the fust$10,000,00 and-V.54 .54 for each additional$100.00 or fraction thereof,to and including$25,000.00 525,001.00 to$50,000.00 5319.50 for the fust$25,000.00 and$1.45 for each additional S 100.00 or fraction thereof,to and including$50,000.00 $50,000.00 and up $742,00 far the first 550,000.00 turd$1.20 for each additional S 100.00 or fraction thereof Plumbing Permit Application Uatereceived: /:. �� Permit uo.;�JrT,^Om"00S I(o City of Tigard Sewer permit no.: Building permit no.: T Address: 13125 SW hall Blvd,Tigard,OR 97223 ProjecUappl.no.: P.xpiredatc: City of Tigard phone: (503) 639-4171 Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ Case file no.: Payment type: 1 &2 family dwelling or accessory 0 Commercial/industrial U Multi-family 0 Tenant improvement id"New construction 0 Addition/alteration/replaccment CJ Food service 0 Other. — � 1 � —Description Qt _ Ece ea. Total Job address: N.w 1-and 2,-family dwellings only: Bldg.no.: Suite no.: (ImIudes100tt.for each utility connection) Tax map/taxco aUI U count no.: SFR(1)bath Lot: Block: Subdivision: SFR(2)bath Project name: t�� }7-W) i= __. SFR(3)bath — — City/county l Gj��,,� ZIP: Each additional bath/kitchen Description and lr 'auon of work on premises:___-- Catch basin/ Catch basin area drain -- — Drywells/leach line trench drain Est.date of completion/inspection: Footin reale►(no.lin.f�) t Manufactured home utilities — Fc siness name: GtJp�1 �L a _� Manholes dress: G 3 cv Ly0 Rain drain connector y: -qr _ State:� ZIP: Jit Sanitary sewer(no.lin.ft.) —_ Phone: b?- Fax:66 7_9 E-mail: Storm sewer(no.lin. .ft — CCB no.: Plumb.bus.reg. no: 0 Water service(no.lin.RJ —c�— ---- Fixture or Item- City/metro lic.no.: _ — Absorption valve Contractor's representative signaturBack flow preventer Print rlame: G d d� —7—' Date: Backwater valve _ — asins/lavatory _ Clothes washer :Addmss: '/p/ C'..� — Dishwasher ----__ —po Q el-f-,100 7 Drinkin fountain(s)State 1-1 7.IP: ��3t1 E•ectors/sumpA q' Fax: E-mail: Ex ansion tank�� Frxturr7sewer Floor drains/floor sinka/Itub — Name(print): `_lei-10 niQ„ S Garber a dis sal -__ Mailing adddress:%�_ G r-� Hgse bibb __— State9 :C e ZIP: '7.2:k� Ice maker _ Piton E-mail: Interceptor/grease Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance arid repair made by my regular Roof drain(commercial) _ employee on the ptuperty 1 own Ps per ORS Chapter 447. Sink(s),basin(s),IaysLs) —_ Owner's signature:-f // Sum2 Ttlbs/shower shower Pan Name: ---- Water closet Address: W aterTieatcr _—`�� ` 7 Other: City: Statex ZIP Phone: E-mail: Total _ — Minimum fee................$ Na.1 luriarictioa,.ccgw credit acre,pkate call luritdietbn for m«e Mr«,nuion Notice:This permit application plan review(at — %) $ _ —Cl Visa U MasterCard expires if a pernit is not obtained Slate surcharge(8%) ....$ credit card number __._— —_�__._. _ L -1- within 190 days after it has been t xrrrs TOTAL .......................$ —.-- accepted as complete. Ntme of e.—rdbo mel n Chown m erdiit cud $ Crdholdv tl1loature "Amount_ 4404616(&WCOM) P.LEA�.9.�IP1fEIE: FIXTURES (Individual) 1 Qty Rk�i«Lii Total Fittar•'rype Quntlt b WorkParfermed _ Sink - 16.60 - No L%v*d R•pl•ted R•movedfCappa Lavalor) 16.60 Sink _ Lavato _ Tub or Y uWShower Comb. - 16.60 Tub or TublShower Combination _ Shower Only - 16.60 Shower Only -- Water Closet ��- 18,60 Water Closet - Urinal -- Urinal 16.60 Dishwasher - -- Dishwasher _-� 16.60 Garbage Disposal - --- _ Laundry Room Tray - Galbaye Disposal y 16.60 Washing Machine Laundry Tray 18.60 Floor Drain/Floor Sink 2' - Washing Machine 16.60 4' - --- Floor Dtain/Floor Sink 2" 16.60 Water Healer _- Other Fixtures(Speci _ -- 3' 16.60 4' - 16.60 Water Healer O conversion O like kind 16.60 - -- Gas piping requires a separate mechanical perrnit; -- MFG Home New Water Service 46.40 - - MFG Home New SaNStorm Sewer 46.40 i Flose Bibs 18.60 COMMENTS REGARDING ABOVE: - Root brains 16.60 Dtinkkhg Fountain 16.60 - - - Other Fixtures(Specify) A 21.75 --v- - Sewer-1 st 100' `- �- - 55.00 Sewer-each additional 100' 46.40 Water Serytm-1 st 100' 55.00 Water Service-each additicnal 200'- -- 46.40 Storm&-Rain Drain-1st 100' 65.00 Storm 6 Rain Drain-each additional 100' 46 4C Commercial Baer Flow Prevention Device - 46.40 Residential Backflow P:eventlon Cesvice' 27.55 Catch Basin -- 16.60 Insp.of Existing Plumbing or Specially Requested 72.50 Inspections _ perthr Rain Drain,single family dwelling -� 65.25 Grease Traps - 16.6wo �- - QUANTITY TOTAL IsumeMfc or riser diagram Is F. ukcd I Ouarift Total Is >9 •SUBTOTAL 'r -- 8%SURCHARGE N "PLAN REVIEW 25%OF SUET)TAL Rewotal ired only 1 lbdura t.tl2> TOTAL il 'Minimum permit foe is$72.50♦E%a+durpe,except Resldefdlal Baddlow PreveMbn Devoe,wA ch h 136.25 a e%vx&4 rge "Al`New Cofnm•iclal Buildings reryuke plans with konrtric or flier diagram end plan review, Electrical Permit Application —� Date received: Peml l no.:/y S City of Tigard Project/apnl no.: Expire date: Ciry of"figord Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: �2f,,ily elling or accessory 0 Commcrciad/industtial D Multi-family ❑Tenant impiavernent �trrNew construction U Additionialteration/replacement U Other:_ U Papal Job address: , jwr 6 A1,°(1%'�ir7 Dkig,no.: Suite no,: Tax ma tax lodaccount n_o.: Lot: t Dock` Subdivision:_ 2 L&V,tt- Project name: _ Description and location of wotir on premises- Estimated date of rnmpletiorJnspection: Job no: Fee Max Dazri limn__ Qty. (ea.) Total no.lns Business name: p/ P -p--��!'-�- -�--- New resldeotlsl-single or nwlll-family per Address: �J, _ � dwxl0mgunit.includes attached garage. Cir,: sat ;04 ZII Servlcchrclnded Phone/ 4D Fax:G -7-7.611mail: 1000. .ft.or less 4 C o.: S- Elec.bus.lic.no: CT .S Each additional S00 aq.ft.or portion thereof Limited energy,residential 2 1tY Limited y,non-residential _ 2 s1S_ Zg dv Foch tnuwfActured home or modular dwelling lure supinisi gel Wcian(requited _Date - Service And/or feeder _ 2 Senlces or feeders-installation, Sup.elect.name(print): ✓ ,.- License no: Q Servlcalterattsit-ratlsoon orrelocation: 2W&tn s or less _ 2 201 amps to 400 amps 2 7Namc(print): p ij) 5 -- — 401 amps to 600 amps 2 ling address: >�, ' f w f'L. Q 601 amps to 1200&trips 2 : c $tetet3 ZIP: Over 1000 amps or volane:Ga1!>- Odd Fax:,,,-J '- E-mail: Reconnect only _ I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,tent,or exchange according to Installation,alteration,orrcbcatlon: URS 447,455,479,670,701. 200 amps or less 2 r7 � 201 amps to 400 amps _ 2 OWner'9 9: Itaturc: p / o (P' )ate: 2� t' 401 to 600 amps 2 man ik"111 Branch circuits-new,alteration, ��.� or extension per panel: Name'• 1 / —_ A. Fee for branch circuits with purchase of Address: y-j 01 service or feeder fee,each branch circuit _ 2- CitY: =' �� ,t B• Fee for branch circuits without purchase of service or feeder fee,tint bench circuit: 2 jElfulmll Phone: -' Fax: - - F.ttch sdditi�nd branch circuit: Miss.(Service or feeder not Included): O Service over 225 amps commercial U liealth-cue facility Foch pump or ircigation circle _ 2 _ O Service.over 320 amps-ruing of 1 R2 O Hazardous location Each sign or outline lighting 2— family dwellings U'Building ova 10.001 square feet four or Signal circuit(s)or a limited energy panel, O System rver600 volts nominal mare residential units in one structure alteration,or extension* 2 O Building over three stories O Feeders,400 amps or more •Dcuyi tion O Occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection over the aliornble ui any of the of ave: O EgressAighting plan U Other. _ _ Per inspection Submit_ sets of plans with any of the above. Investigation fee The above ate not applicable to temporary construction service. other Not al Jurtedktions MCC*emelt cards,please call luds"on for more brfamatim. Notice:This petmit application Permit fee.....................$ U Visa U MasterCard expires 1f it pear it is no(obtained Plan review(at__ %) $ ('mer rand number: _ LL— within 180 dayA after it has been State surcharge(8%)....S Bapird _ accepted as urmplc;e. TOTAL .......................$ Nara of cardhol r v above on credit crd.� S —--- Cvdholder danaure s_'� Amount 4404615(6MOMM) 4. Complete Fee Schedule Below: TYPE Off-WORK INVOLVED -RESIDENTIAL ONLY Number of Ins permit allowed - - _ Inspections per{� RestrlctEd Energy Fee. _-- ....................... $75.00 Service included: Items Cost Tota; (FOR ALL SYSTEMS) ................ 4a. Residendal-per unit Check Type of Work Involved: 1000 sq.ft.or less _ __ $147.15 _ Eadi additional 500 sq.ft.or - F] Audio and Stereo Systems portion thereof $33.40 f Limited Energy ~---� $75.00 --- -- Burglar Alarm Each Manufd Home or Modular --"`" Dwelling Service or Fe;der V- $90.90- _ 2 ❑ Garage Door Op ner' 4b.Services or Feeders Installation,siteration,or relocation ❑ Heating,Ventilation and Air Conditioning System' 200 amps or less $80.30 2 201 amps to 400 amps $106.85_ _ 2 F1 Vacuum Systems' 401 amps to 600 amps -- _- 5160.60_- 2 601 amps to 1000 nmps _ - $240.60 - 2 G] Other Over 1000 amps or volts -` - $454.65 2 -- - Recooned only $66.85 _ - 2 TYPE OF WORE(INVOLVED -COMMERCIAL ONLY 4c.Temporary Services or Feeders -- Inslanation,alteration,or relocation 200 amps or kss $66.85 2 Fee for each m systr+ ..... ^ : �"-��-`--_-- 76.00 (SEE OAR 918-260-260) 201 amps la 400 amps __ $100.30_---- 2 401 amps in 6(%0 amps _'-` $133.75 2 Check Type o1 Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems 4d.Branch Circuits New,alteration or extension per panel ❑ Boller Controls a)The fee for branch circuits with purchase of service or E] Clock.Systems feeder fee. Each branch circuit _ $6.65 2 b)The fee for branch drurils - -- ❑ Data Telecominur:icalion Installation wfthout purchase of service or feeder fee. ❑ Fire Alarm Installation First branch drain $46.85 Each additional branch drrxrlt -- $6.65 �� HVAC 4e.Miscellaneous (Servkm or feeder not kx wW) ❑ Instntmenlalir.f Each pump or Irrigation dree $53.40 _ Each sign or ordfine fighting $53.40�`^ n Intercom and Paging Systems Signal circuk(s)or a nmfted energy _ panel,alteration or extension --� $75.00 ❑ Landscape Irrigation Control' Minor t-abels(10) $125.00 4t, acfh additional Inspection over ^� ❑ Me+tical the allowable In any of the above Per inspection $62.50 Nurse Calls Per hour $62.50 In Plant -� $73.75 i,-" �� Outdoor Landscape Lighting' 5. Fees: ❑ Protective Signallnq iia.Enter total of above fees $ 6%Surdlarg9(.08 X total fres) $ �._�� ❑ Other Subtotaf j --------- -_-� Lib.Enter 25%al fine 6a for ^� ------Number of Systems Flan P^view If required(Sec,3) $ Subford! S No licenses are required. Lk raises are required fix all other Insufflations 1 I El Trust Arxount hl FEES: __-_-. -------- -----------.�_.Y_�_. Total balance Vile $ ENTER FEES 8%SURCHARGE(.08 X TOTAL ABOVE) TOTAL ; ---- -- FL Off' FLAN LOT #12 4, AFFL E WOOD FARC RlFID 251 11 DA TAX LO'r oi31OQ> 15555 5W �-1ARCOURT TERRACE S.E. 1/4 O;= SECTION 11, T.2, R.IUJ, W.M. GITY OF TIGARD W,45�41NGTON COUNTY, OREGON LEGEND WA1ER METER HOMES WATER LINE 16ITE t0U SS — — - SANITARY SEWER SD-- - - — STORM DRAIN �t ntlnl OFFICE (503) 620-8080 TIGARD, OR. 97223 ,h FAX M03) 5P6-8000 CCP/ 60563 Ve-- _ Or- STREET • MANHOLE ® CATCH BASIN PROPOSED STREET TREES [1J STREET LIGHT FIRE HT DRANT �'�""'• FRO-IDE EROSION CONTROL FENCE 1L FF_R. COMMUNITY } z -q til :1 U!'Liu) Q I1�C N� � ll)1 ' L Oi" 123 2013` N89'5d'25"E b r 915.47 1 /LOT 124 w~ I d 82d SQ. FT. / / / U I LORRIMER :t FIN. FLR. = 209.1' GARAGE FLR. • 206.9' % - - `4 7 1 , dl Q-------- � mbr -vil N LOT 125 CITY OF TIGARD 13125 S.W HALL BLVD. TIGARD, Gk,' 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VLY HWY#C ALOHA, OR 97006-1249 Electrical Signature Form Pprmit #- MST2000-00576 Date Issued: 1/30/01 Parcel: 2S111 DA-13100 Site Address: 15555 SW HARCOURT TERR Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 124 Jur sdiction. TIG Zoning: R-7 Remarks: New SF detached. Your company has been indicated as the electrical contractor for the permit indicated above. In order fer the electrical permit to be valid, the signature of the supervising electrician is required Please have the appropriate i.-idividual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MATRIX DEVELOPMENT CGRP GARNER ELECTRIC:; 6900 SW HAINES ST STE 200 21785 SW TUALATIN VLY HWY #C TIGARD, OR 97224 ALOHA, OR 97006-1249 Phone #: Phone #: 503-648-4552 Req #: LIC 121159 SUP 3707S ELE 34-3051, AN INK SIGNATUPE IS REQUIIRED T IS FORM X Signature of supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CIT'? OF TIGARD BUILDING INSPECTION DIVISION MSTca0,��, �L 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 SUPDate Requested _ AM PM BLD Location S 5.5 _5�ti., %,�,v C vu r _ Suite MEC Contact Person � Ph 5 7 S'- U �� 3 PLM Contractor Ph SWR UILDINCy-' Tenant/Owner ELC ---------- Retaining Wall ELR Footing Access: Foundation FPS __----- _ Flg Drain I -- SIGN Crawl Drain Inspection Notes'. ------ --- -- Slab --- — -—-- _.�_ ------ - - SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulatlor Drywall Nalling ---- —�— Firewall --�- --- Fire Sprinkler Fire Alarm — Susp'd Ceiling Roof MIs : i --- -- AS PART FAIL --- - --- ---- ---- -- -- PLUMBING Pest&Beam Ur,der Slab TopOut - -__-- -_ --_------__ ---....__--------- Water Service _ Sanitary Sewer - - Rain Drains Final -- PASS PART FAIL- MIECIJANICAL Post Hearn Rough In Gas Line - Smoke Dampers pASS:• PART FAIL ELECTRICAL - - - ---- -- --- Servlce W _ Rough In _ UG/Slab I_ow Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading _ -- Sanitary Sewer Storm Drain ( J Reinspection fee of$ _ _ required before next inspection. Pay at City Hall, 13125 SN Hall Blvd Catch Basin [ J Please call for reinspection RE: — JA _ [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date l' e'll Inspector,_ Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 1�11yc+' -G�� JJG 24-Hour Inspecticn Line: 639-417F Business Line: 639-4171 BUP N_ - -Date Requested S 76 _ AM_ PM BLD Louation_�S?-` �' Sw /(4,'(G _ Suite MEC Contact Person _ Ph sy G � 2 -3 PLM _ Contractor -----_ Ph —, SWR [BUILDING ^� Tenant/OwnerELC Retaining Wall ELR Footing Access: - - — Foundation FPS Ftg Drain I SGN - -- Grew,Drain Inspection Notes: -- Slab ------------ -- --------- SIT Post& Beam _-- ext Sheath/Shear Int Sheath/Shear — Framinr Insulation �- ------ ------- Drywall Nailing Firewall —_-------�_--- _-- Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final -- - PASS PART FAIL --- - -- - -- --- PLUMBING Post&Beam -�-- - -�- �- Under Slab Top Out - - - - Water Service ,Sanitary Sewer - Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam Rough In Gas Line ---- - - --- — Smoke Dampers Final ---.�- _ PASS PART FAIL LEC � -- ---------- - - .ie re Rough In - -- .—_----.T_-- _ UG/Slab tow Voltage --'------�-- F irgh�arm x,55 AR1FAIL --- --- - - — - - - - -- ------ -- -�- Backfill/Grading - -------- --`_._..-- --- - Sanitary Sewer Storm")rain [ ]Reinspection fee of$_- - __-required before next inspection Pa/ at City Hall, 13125 SW Hall Rlvd Catch Basil Fire Supply line [ ]Please call for reinspection RE. [ ]Unah1r,to inspect- nig access ADA /- Approach/Sidewalk Date ��\ �� L� Inspector 1A ,�:--_-- Ext Other _ - —C--- --- Final PASS PART FAIL F)O NOT REMOVE this inspections record from the jots site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — r— — iBLIP _ Date Requested S AM__ ._PM BLD rS5 114 yCO " �Location --_� Suite MEG Cc^tact Person _ Ph SrL y Z 3 PLM - k,oniractor Ph SWR BUILDING - Y enant/Owner _ Et-C Retaining Wall � — ELR Footing Access: C) 1 ;cam L Foundation ` FPS FIg Drain _ V^ n �� 1 r� r; Crawl Drain Inspection Notes: ';c9N — Slab Post 8 Beam ------- ---- --- --- SIT Ext Sheath/Shear Int Sheath/Shear �- Framing /' -J ! l��i�Cn'R E� � � S—�k .-J � ------ Insulation Drywall Nailing C'��/'i"" C' _ c�u � �/p� ►S ern [ �.1'Firewall Fire Sprinkler -of c.i ice• Fire Alarm L Susp'd Ceiling , J( 'C�� n �r 7r ti �'C _ (dJ-r 7 Roof r Misc: �� l4•-o S Final --- . ( •FS �--7 PASS PART FAIL _ - earn — Under Slab -1 op Out —` - ------ Water Service .vI►, - - Sanitary Sewer to, o - — -- - --- Rain Drains 0V SS PART FAIL. MECHANICAL — Post& dean, -- Rough In Gas Line - - -- -- --- -- - ---- -- - - Smoke Dampers f inal - - - ---- - ---- PASS PART FAIL - ELECTRICAL - - __----- -- --- - --- __ __— Service Rough In -- — — --`�- UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading - ----- Sanitary Sewer Storm Drain ( j Reinspertion fee of$ 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 ep "�0 Inspector�� Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIOARD Residentia_l Certificate of Occupancy Permit No.: Address: Owner/Contractor: Date of Final Inspection: _/- Gf/ Inspector: 'This structure has been found to be in substantial compliance with the provisions of the State of Oregon One& Two Fa►nily Mvelling Stv Cody and is hereby approved for occupancy.