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13810 SW MISTLETOE DRIVE-1 I 1 ua 3O13,i1SIW Ms Mc$ i l I 1 W Q r� LU IL m c C9 0 w M ..J r. 13810 SW MISTLETOE DR ELECTRICAL - CITY OF TIGARD i FSTRlr'•,EDE�NERIGY DEVELOPMENT SERVICES � PERMIT#: ELR2004-00008 13125 SW Hall Blvd.,Tigard, OR 97223 (503) S39-4171 DATE ISSUED: 1/21/04 SITE ADDRESS: 13810 SW MISTLETOE DR PARCEL: 2S109BA-05300 SUBDIVISION: HILLSHIRE SUMMIT NO. 2 ZONING: R-7 BLOCK: LOT: 039 JURISDICTION: TIG Proiect Doscriotion:All encompassing low voltage. A._RESIDENTIAL B.COMMERCIAL _ AUDIO& STEREO: X AUDIO&STEREO: INTERCOM & PAGING: BURGLAR ALARW X BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: X CLOCK: MEDICAL: HVAC: X DAIA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: OUTDOUF. ..ANr)SC LITE: OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF $*Y TEMS: _ Owner: Contractor: BRENT'NOOD HOMES QUADRANT SYSTEMS 14912 S:M SUMMERVIEW DR. PO BOX 14833 TIGARD, OR 97224 PORTLAND, OR 97293 Phone: 503-624-4663 Phone: 503-624-4663 Reg#: SEM-5558211JLE LIC` 96806 _ ELE 26-565CI-E FEES Required Inspections Description Date _ Amount Low Voltage Inspection �Fl PRNI-I'l ELR Permit 1/21,104 $75.00 Elect'I Final I A X 18"'0 State 1/21/04 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of iss-rance, or if work is suspended for more than 180 days. 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 952-001-0100. You may obtain copies of these rules or direct questions in OUNC at ;G03) d 246-6699. Issued by �J c�LLc kc_ Permittee Signature OWNER INSTALLATION ONLY ED The installation Is being made on property I own which is not intended for sale, lease, or rent. W OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _ _ DATE: _ LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 01/19/2004 13:21 5032352322 QUADRANT SYSTEMS F'AGE 02 Electr cal-Pe?wit AyOicati®n Received Electrical DntdB : / /"o Pcrnit .i Cit of Tigar Planning Approval Sign y Qie r�'� t)ate Hy; Permit No.: 13125 �:r' il!dl Blvd. , `{•••V Plan Review Other 'Tigard,Oregon 571273 a DatclB : Phone. 503-639-4171 Fax. 503-59JAW)C:0 Pnst•Review Land Use hitemet: www.ci,tigard.or.us Datc/BY_ Cue No.: Contact Luria Sec Rase 2 for 24-hour Inspection Request 5013-61.007 F ILDINGptVl81 Now.tMcthod: . amental Informatioti. d',�� ;'y �"II 'ts�'fICR'.�a L', � •�i iN•.-�S v�. .' ,�M. �'- '�rT�t"r!'�.L��W h�1' w.l ( r New construction F1 Demolition GScrvice over 225 amps- Health-cane facility Addition/altt;r:,,fi.jrt/re lacement Other: commercial ia► H Hnerng over location ❑Service ec over 320 amps-ming of Building over 10,000 aq+are feel, „ G r I &2 fomily dwelli,gs four or more rctidentinl units in I &2-Family dwelling Colninereial/Industrial System over 600 volts nominal one structurr: Accessary Building Multi-Family lJ Building over three,stories ❑Feeders,4(W)amps or mom y []Occupant load civet 99 persona Manufactured stnictures or RV park Master Builder Other: ❑Rgressnighting plan other: _ Submit__sets of plane with any of the above. Thiiabovearenell 11cable twPorarymaitructianot Job site address:) 10 S w rfj,Irt Lj.4 Sec- •-t Suite#: Bld ./A t.#: Nu.mber of Ins ectiodis Per PIt allolYed Project Name: FIN(es-) Total New resldeotlal-slnsk or muttl-family per Cross strcet/Directions to job site: dwellteg anit.includes alt■cbed prase. 9crVS , Q t L l tow se inrl r M �,C.� �'" towsq..ft ort 145.15 4 Bch a di i or portion thcg 33.10 T I Subdivision: I S trR. Lot# � "nice `° te.i entia► ----- .o0 2 Limited non Mlidn&l Tax ma / aroel#: Each manulhetumI home m modular dwelling service and!r _ 40.90 Servicer or feeders-installation, 1_:),Al Vol . ur Warr aftentineorrelocation: — �� -�� am or AAA dan T, 80.30 sm to —amps IQ6,85 2 40jam to 600 amps Yi._. .60 2 tN 6D]amps to 1M,1m 40.60 2 Nome_ f�rI w J� > � J ver 12N a or vole` _---- 154.05 a!ty66,85 12 Address: Tempor.ry services or reeders-installation, --- atfentlen,or rrlettHott: city/state/zip:t2ou un or less 66.gS Phone.A�A_*9 I t tea- Fax: 10 om to amps t. 1, to am Maps J . 2 ralBraneh tircuits-new,attention,or Name: extension per panel: Address: A.Fee for brenrh circuits with purchase of service or fmlcr fiM�mch branch circuit 6.63 2 Cl.t "/State/zi : B.Fee for branch circuits-ithoto prnrhase of service or feeder fee.Ocxt branch ci _46.85 2 Phone: 6.63 2 &mala Misc.(Sersice or feeder not indudrd): y EachLw�meor im i circle 33,40 2 ach sign or*Wine lighting 53,40 2 Job No: 3 1?ke Siungl cfmuft(s)or a limited energy pane U) Business Name: !3_ ` JY•r>,r 9110t,�o extension --- 2 Address: 1 F3� J Cit /Statelzi : dam( R rig-6 F■ch additional Inspection over the allowable n an ofthe above: 62.50 n ^� Phone. -4 3y- 9 Fax: SC& -43 t, lrrvw4qi�m fee: J _CCB Lie.#: CNO L Lic. #: { Supervising electricia 1 subtotal 3 'i signature required- –4 t --_T— Plan c Sew tL?59�.of PermitFee) Print Name: Lic. #: CXI /1 State Sumhggi; 8%of Patmit Fee $ to,vu TOTAL PERMIT PEE S Authorized Notice: this permit appliestion expire If a permit is not obtained within Signature: _ ��. Date: rI I bl 186 drys aMr It hos been accepted es eesnplete. *I!ree methodology set by TrWoanty M rlldins industry Service Beard. (Please print name) i\Dsts\PermitromislHlepcmdthpp.doe Ol03 CITY OF TIG'ARC 24-Hour BUILDING 0 Inspection Line: (503)639-4175 > --C��a 31, iNSPECTION DIVISION Business Line: (503)6'19-4171 �. BUP Receivid / --Date Requees�te�d, �/�/�AM —PM—_ P BU _ Location __ �1 j' '/L ,[ . ltL_ Suite MEC Contact Person � � f _ } �U z y �� PLM Contractor_ _— Ph(—) _ SWR _— BUILDING Tenant/Owner _. ELC Footing Foundation Access: ELC _ — — Fig Drain ELR — Crawl Drain _ Slab Inspection Notes: SIT — Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear — Framing _— — Insulation Drywall Nailing — Firewall Fire Sprinkler I — -- -- — Fire Alarm Sua;i d Ceiling -- — Moo- 0 Roo. -- Other: — Final PASS PART FAIL PLUMBRIG _ Post&Beam — — Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain -- ---- --- Shower Pan Fi P44 PART FAIL -�—�-- -- MECHANICAL Post&Beam Rough-In IL Gas Line Smoke Dampers - p.. Final U) PASS PART FAIL -- --- ELECTRICAL -i Service -- — --- m Rough-In t? UG/Slab a Low Voltage --- -� - Fire Alain Final Reinspection fee of$__ required befc-P next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F] Please call for reinspection RE:.__- v__ —__- _ E Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk DDDNNN��"' - ---_ _ Inspector _.__.n_._ —________T Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TI ARD 24-Hour BUILDING h ,rection Line: (503)639-4175 MS7;1; }3 -C�iJ 2c13 INSPECTION DIVISION Business Line: (503)639-4171 BUP -- _-_-- Received 1�� 4 —Date Requested -� _—L AM—__-_ PM BUP Location _ Z_3S _Suite —_ `` MEC — Contact Person -- = 'Y-�—) �' Wa24 PLM Contractor —_�— Ph( ) __ _--_ — SWR _--_ BUILDING __ Tenant/Owner —� ELC Footing roundation ELC --�_ - FIns—paction s F!g Drain ELR _- Crawl Drain Slab Notes: SIT Post &Beam �_ Shear Anchors Ext Sh !ath/Shear Int Sheath/Shear �� Framing - �� h- - ,f �L/ 1 -� IlL/��y, ��Ar Lam!00*111 u Insulation Drywall Nailing - Firewall Fire Sprinkler ---�-�- ---- -- Fire Alarm I Susn'd Ceiling - - Roof _ _�,�G !/c/'/`t �"♦ '�/ n ��_�/ ._,�,-�� r//..1.��/(/� Other: Final PASS PAnT FAIL PLUMBING _-- 1//l��Q G" /'' /d/�'/!ti✓✓4' -- /'��Q �.C- _.� r-,-,t&Beam T— Under Slab Rough-In Water Service -- ---- -- --- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - - Shower Pan Other: Final - PASS_PART FAIL - MECHANICAL Post & Beam Rough-Ir. Gas Line 0. Smoke Dampers -- - - -- ---- Ix Final N PASS PART FAIL - - - - ELECTRICAL Service ED Rough-In jj UG/Slab W Low Voltage Ful Fin F1 Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAIL Please call for reinspection 9E: -._— F, Unable to Inspect--no access Fire Supply Lina ADA y- Approach/Sidewalk Date�`Z'� _ Inspee er -!`G Ext Other:_ FlnPI DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL r ► kAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA ► / ► ► cl 1 ° W a � ► ► A p , Iwor o o ► A d o a �Of v H ► a � o I,y i � `� ► No � w o J � Q p o u ► cl / v Q p A a S �% ► A ,o ► a ► A ' ? Q ► 414 v -v or- Poo. M► ► CO)CL A A p ► ► 00 � az �� ► v i _ M i A Elmo `� ► as ► e CITY OF TIGARD 24-hour BUILDING Iwspectioa Line: (503)639-4175 MSTAffy.3 - Ul. _3 INSPECTION DIVISION Business Line: (503)639-4171 BUP _ Received LZ Date Requested `?1`1Q'(,/AMr___PM BUP Location l3 Yl CU_ 2 Arm _ aa�i.P . uite MEC � ` Contact Person si Ph(---) _ Q�� PLM — Contractor __ ?h( _ _) SWR BUILDING _ Tenant/Owner ------ _— ELC Footing ELC — Foundation Access. Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam - _ - Shear Anchors --- Ext Sheath/Shear — —_ Int Sheath/Shear Framing - -- --- - Insulation Drywall Nailing — -- --- - --- Firewall Fire Sprinkler --- ---- -- - - Fire Alarm Susp'd Ceiling --- - -- Roof ,-Final CPAW PART FAIL -- - --- - - -____-� UM81NG Post&Beam Under Slab -- -- Rough-In Water Service - ---- -- Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain -- - -- Shower Pan Other: Final _ PASS PART FAIL _ MECHANICAL _— _ _ —_-- _ -- --------_-_ -- Post&Beam - Rough-In --- Gas Line 4. a Dampers - — ---- ----- -- - - -- Q: Fin U P RT FAILEMOM --- ---- ICAL _--�- -- -- - -- -- Service Rough-In UG/Slab W Low Voltaga Fire Alarm Final El Re;---wction fee of$ ._ required b,9fore next Inspectior. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _..._ ❑ PIt: All for rei.ispection RE: _._—_ Unable to inspect-no access Fire Supply tine ADA DOU S j—U _-- Inspector Ext Approach/Sidewalk —�—�-- -- - - -- Other: _ _ Final — DO NOT REMOVE this Inspection record from tho job *Its. PASS PART FAIL CIO O U � a C C� o I O W � �O o w hM ^ O rL 1 • N V «5 CIL by a f ,A QYr w ° ° w � M CITY OF TIGARD 13125 S.W. IIALL BLVD. ' TIGARD, OR 97223 IMPORTANT PERMIT NOTICE AMP ELECTRIC"! .'ONTRACTORS INC 1573 SE HO LMAN AVE #3 DALLAS, OR 97338 Electrical Signature Form Permi•.#: MST2003-00293 Date Issued: 9118/03 Parcel: 2S109BA-05300 Site Address: 13810 SW MISTLETOE DR Subdiv'sion: HILLSHIRE SUMMIT NO. 2 E lock: Lot: !139 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of new SF detached residence. 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 from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: BRENTWOOD HOMES AMP ELECTRICAL CONTRACTORS INC 14912 SW SUMMERVIEW DR. 1573 SE HOLMAN AVE #3 TIGARD OR 97224 DALLAS, OR 97338 Phone #: 503-624-4663 Phone #: 1-503-831-0585 Req #: 1.1(' 117422 f[,E 27-65(. Sl IP 4783S AN INK SIGNATURE IS REOUIRED ON THIS FORM X _ Sign ure of S P6 g bectrician If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CRAFTWORK PLUMBING INC 7736 SW NIMBUS AVE BEAVERTON, OR 97008 Plumbing Signature Form Permit#: MST2003-00293 Date Issued: 9/18/03 Parcel: 2S 109BA-05300 Site Address: 13810 SW MISTLETOE DR Subdivision: HILLSHIRE SUMMIT NO. 2 Blcck: Lot: 039 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of new SF detached residenne. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Buildinp, Division. No plumbing inspections will be authorized until this completed form Is received OWNER: PLUMBING CONTRACTOR: BRENTWOOn HOMES CRAFTWORK PLUMBING INC 14912 SW SUMMERVIEW DR. 7756 SW NIMBUS AVE TIGARD, OR 97224 BEAVERTON, OR 97008 Phone #: 503-624-4663 Phone #: 644-8698 CL Reg #: LIC 79666 PLM 20-148PB AN INK SIGNATURE IS REQU!REQ ON THIS FORM r m w X _ Signature of Authorized Plumber If you have any questions, please call 503.718.2433. CITY OF T I G A R® MASTER PERMIT PERMIT#: M3T2003-00293 DEVELOPMENT SERVICES DATE ISSUED: 9118/03 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 SITE ADDRESS: 13810 SW MISTLETOE DR PARCEL: 2S10913A-05300 SUBDIVISION: HILLSHIRE SUMMIT NO 2 ZONING: R-7 BLOCK: LOT: 031) .JURISDICTION: TIG REMARKS: Construction of new SF detached residence. BUILDING REISSUE: CUSTOM 3TORIES: _ FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,910 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: v TYPE OF USE: SF FLOOR LOAD: 41) SECOND. 2.190 of GARAGE: 725 of FRONT: 15 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 11#R) of RIGHT: 5 : OCCUPANCY GRP: R3 BDRM: 4 BATH: J TOTAL: 4,I00 d VALUE399,578,30 REAR: 75 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF PAIN DRAINS: 1 CATCH BASINS: TUR/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFI.w PREVNTR GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FI IRN<100K: BOILICMP a 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP. btu FLOOR FURNANCES: VENTS: i WOODSTOVES: GAS OUTLr 8: 4 _ ELECTRICAL _RESIDENTIAL UNIT_ _ SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS _MISCELLANEOUS ADD'L INSPECTIONS 1007 SF OR LESS: 1 0 200 amp: 0 - 200 amp: WIBVC OR FOR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 8 201 - 400 amp: 201 - 400 amp. lot W/O SVCIFDR: SIGNIOUT JN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 800 amp: EAADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HWSVCIFDR: 601 1000 amp: 6014amps-1000W. MINOR LABF1 1000-ampNalf: PLAN REVIE',(SECTION Reconnect only: - —� -4 RES UNITS: SVCIFDR>-225 A.: >600'J NOMINAL: CLS AREAISPr.OCC: .ECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL 8,COMMERCIAL AUDIO d STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: WTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPERRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAfrELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,893.00 This permit Is subject to the regulations contained in the BRENTWOOD HOMES Tigard Municipal Code,State of OR. Specialty Codes and 14912 SW SUMMERVIF_W DR. all other applicable laws. All work will be done in T IGARD,OR 97224 accordance with approved plans. This permit will expire if work is nct started within 180 days of issuance,or if the work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 50;_624-46G3 Phone: Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-01) n080. You Rep R: may obtain copies of these rules or direct queMions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Insf Gyp Board Insp Appr/Sdwlk Insp Sewer Inspection Urr'erfloor Insulation Electrical Service Low Voltage Rein drain Insp Electrical Final Footing Insp CravA Drain/Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Line Inup Plumb Final Pos at Mechanical Insp L tear Wall Insp Insulation Insp Water Service Insp Building Final I S S u By : tPermittee Slgnatur : '�`—' �' --� Cali (503) 639-4175 by 7:00 p.m.for an insp,40lon needed the ex.bus,ness day CITY OF TIGARD SEWER CONNECTION PERMIT_ DEVELOPMENT SERVICES PERMIT#: SWR2003-00228 13125 SW Y Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 9/18/03 SITE ADDRESS; 1381 SW MISTU_TOE DR PARCEL: 2S 109BA-05300 SUBDIVISION: 1111- ,Hila:SUMN'IT NO. 2 ZONING: R-7 BLOCK: LOT: 039 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: t.,PSWR 1R4PERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: - - _ —-- �- FEES_ _ BRENTWOOD HOMES Description — Date Amount 14912 SW SUMMERVIEW DR. TIGARD, OR 97224 [SWUSA]Swr Connect 9/18/03 $2,400.00 [SWUSA]Swr Connect 9/18/03 $0.00 Phone: 503-624-4663 [SWINSPJ Swr Inspect 9/18/03 $35.00 Contractor: [SWINSP)Swr Inspect 9/18/03 $0.00 — - - Total $2,435.00 Phone: Reg#: Required Inspections IL W F- U) t J_ m This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 LU 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 measurerrgnt given, the installer shall prospect 3 feet in an directions from the distance given. If not so located, the installer shall purcha a"Tap and Side Sewer" Perm 00- lssued by: j Permittee Signature; r � --- Call (503) 394175 by 7:00 P.M.for an Inspection needed the next business day Building permit Application Datereceived: Permit no-: City of Tigard Tl� Projecl/appl.nJ.: Expire date: City ojTigard Address: 13125 SW Hall Blvd,Tigard,OR 972 3 �— B` ReceiP too.: Phone: (503) 639-4171 Date issued; Fax: (503) 598-1960 T ICaARQ Case file no.: Payment type. 16 Gil OF Lana use approval: „ ILDING OIVIStiGN 1&2 family:Simple Complex: TYPE OF PERMIT U I �Z 7_family dwelling or accessory U Commercial/industrial O Multi-family UY New construction O Demolition U Additiori/altera(ion/replaccment U Tenant improvement U Fire sprinkler/alarm U Other: - 1 1 ' 1 Job address: I'5Fs 10 q ILA) Mx5 Bldg.no.: Suite no I.ot: Block: Subdivision: WA} 5k�f` Tax map/tax lot/account no.: Project name: e t&tib_ Description and location of work on premiscs/special conditions: 1 1 1 i:"me• a1Rt:W �� MTO "comet t) ailing address: l y cl t a b O Slw+nvrti-a-�'f� O R _ l &2 family dwelling, S r J„ City: Tlah��o _ State:OR ZIP: a'1 a4 Valuation of work...,,�1......................"".. $ 093 _ ..-.-- Phonc:503 6'aH.ylotol Fax:.-zJ4.dr{•g6Y E-mail: No.of bedrooms/badis................................. Owner's representative: P.YRn1 1_A►��►iF4►srt Total number of floors................................. - - Phone:50'� '✓0'7 n o x Fax: L snail: New dwelling area(sq.ft.) ......................... Garage/carport area(sq.ft.)..........7. .• ---- Covered porch area(sq.ft.)......................... -- Name: (3 IP%tV0IW 06 0 H°M C,5 Deck area(sq. ft.) - ....................................... Mailingaddress: I491R 60 �l.tmrncRuietJ Ori -- - State:(fit 7.[P: 4't X-ay Other structure area(sq.ft.)......................... City: T I Ciq e-0 Commcrciat/industrlal/multi-family: Phone:5D3•ii,;t •4 to t• Fax:5i7's W`lji1.V E-mail: Valuation of work........... ............................ $ MIKU01 I I&MAIII Existing bldg.area(sq.ft.) .......................... _.— Business name: (39,fn)'t 0000 New bldg.area(sq.ft.)............� .......... Address: tt{gt? 6u) $kvrtr►t R t>i"' _ Number of stones........... ..... _ -- _City: 'i16AMO State: p Ft Z[P: G'1 014 Type of construe. �_ — Phone: P_3�,A jt +11ob9 Fax:�3•ro t yAw Email: Occup up(s): Existing: �— CCB no.: 1 b tl.'3 _ New: _ City/metro lic.no.: Notice:All contractors and subcontractors are required to be AIRCIIITECTIDESIGNER licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in t Name: (,gffpllkOr\ yJes V-Ar>5 lhlche jurisdiction where work is being performed. if the applicant is Address:•p.0. exempt from liccrsing,the following reason applies: City: pv. C.t, S tate: ZIP: ---_ Contact person: &D Ca(f LL .: l�d �— - Phonc:;Zy - Fax: E-mail: Nola la 101' Name: Contact person: Fees due upon application ........................... $ —-- Address: Date received: _ City: State: ZIP: Amount received ......................................... $ fax: E-mail: Please refer to fee schedule. Phone: _ - — I hereby certify I have read and examine:l this application and die Net anju,isdictions accept credit cards,please call jud.dkuon for mom Information t o- a visa O MasterCard attached checklist. All provisions of i M;a^ dinances governing this work will be compliW d herein or not. Credit cud number: __ — Explre� Authorized signatur �'+--� Marne or eudhobdc,a shown on credit card S Csrdho der signature Amount Print name:. ---- - — Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613(6, OICOM) ► Electrical Permit Application Date received Permit no.:HEGEIVED _ City of Tigard Project/appl.no.: Expire date: CirynJTigard Address: 13125 SW liall Blvd,T' d,OR Date Date issued: By: 31 no.: Phone: (503) 639-4171 JJll1l (�J�J — Fax: (503) 598-1960 Case file no.: Payment type: CITY OF TIGARD Land use approval: RUILDING DIVISION 1 0 J�"2family dwelling or accessory U Commercial/industrial U Multi-family — U Tenant improvement g Ncw construction U Addition/alteration/replacerricnt U Other: U Partial It SITE I.NFORNIATION Job address: Bldg.no.: Suite no.: Tax map/tax lot/accou.-it no.: Lot: 3 1block: Subdivis;on: 410c, ----- - ----- Project name: Description and location of work on premises: naKt4bllnn ^i Estimated date o1 compleljott/inspection: CONTRACYOR Job no: _ Pte Km fkscription Qty. (ea) Total no.Ins Business name: _AMP ��.��.Tr« �fV(a New residential-single ormuld family per Address: 1,3pl,3 .5f. HCOI mo.*A AVL 3 dwelling unit.Includes attached garage. City: p A LL At5 I State:O a I ZIP: q 7 3 a Serviccincluded: 1000 sq.ft.or less 4 Phone: Fax: Email: - Each additional 500 sq.ft.or portion thereof _ CCB no.: ^)y as Elec.bus.tic.no: A7- VSG Limitedenergy,residential 2 City/metro lic.no.: Limited energy,non-residential 2 Each manufactured home or modular dwelling Service and/or feeder 2 Signature of supervising electrician(required) Date & a' License no: •ticesorfeeders—Inatlallon, Sup.elect.name(pr int): alteration or relocation: 101 200 amps or leas 2 Name(print): 18VW,NT WOOD 11001IL5 201 amps to 400 amps _ 2 — 401 amps to 600 amps 2 Mailing address: ►yq►8 EuJ 9ukr+tdrlE(Gt)irt,uJ OR _ 601 amps to 1000 amps 2 City: T) yrARA State70% ZIP_9'12.)4_ Over 1000 amps or volts 2 Phone: Fax:XV&944W4 E-mail: Recennectonl _ _ I Owner installation:The instillation is being made on property I own Temporary wrvfceq or feeders- InsUllation,alteration,or relocation: which is not intended for sale,lease,rent,or exchange according to 200 amps or less 2 ORS 447,455,479,670,701. 201 am s to 400 amps 2 Owner's si nature: Date: _ 401 to 600 ams 2 Branch circuits-new,alteration, I or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 iState: ZIP: B. Fee for branch circuits without purchase City: J ---- of service or feeder fee,first branch circuit: 2 Phone: Fax: F, mail. Each additional branch circuit: _ Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2 O Service over 320 amps-rating of 1&'L U Hazardous location FAch sign or outline lighting _ 2 fanuly dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, J System over 600 volts norninal more residertial unit%in one structure alteration,or extension* ____2 U Building over threac stories U Feeder,400 amps or more *Description: U Occupant load over 99 pet..ons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: U Egres%/lightingplan U Other: —. — Pet Inspection Submit sets of plans with any of the above. Investigation fr- The abov^are not applicable to temporary construction service. Other i Permit fee.....................$ _ Not alt jurisdictions accept credit cards,plea%call jurisdiction for more information. Notice:This pemift application U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit cmd number �__-_ — L within 180 days afler it has been State surcharge(8%)....$ Expires accepted as complete. TOTAL ....................... -- None of cardholler u shown on credit cerA $ Cardholder tianaturc — Amount 44o-615(6'"VcoM) ► Mechanical Permit Application Date received: Permit no. �_ � 7 City of Tigard 1 _�u E D Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Iv ig r ,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 2003 -- — Fax: (503) 598-1960 JUL Case file no.: 1 Payment type: Land use approval: CITY OF TIGARD _ .,Idingpermitno.:— Igi ❑1 &2 family dwelling or accessory O Comr,ercialbridusirial Ll Multi-family U Tenant improvement 'New construction U Addition/alteratiun/replacemcnt Ll Other: 1 SITE INFORNIA]ION Job address: 17_&Q Si ly Y� erw p _ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overheard, Tax map/(ax lot/account no.: _ profit.Value$ Lot: Block: Subdivision: e. 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: 1-t6)4W ZIP: �5�t _ Description and location of work on premises: _ �-[A� CLK15S�t t.�.Q.�rl Fee(ea.) TaUI Est.date of completion/inspection: Description Q(y. Res.onl Res.onl Tenant improvement or change of use: Airhandlingunit CfTvl Is existing space heated or conditioned?U Yes U No Aircondiiion ng(sttep anrequtreaj _ Is existing space insulated?U Yes U No teration o existing HVAC system loller7i mpressors Business name: APS CT1f1 �EAT1ftlfa State boiler permit no.: r HP Tons BTU/H Address: V.6. e0X I a%a 6 _ _ it smo e- a damperV uct smoke detectors _ City: C A N Q Y _ _ State:OR ZIP: Ci'7013 cat pump(site plan required) Phone:S03 ,1at••37ya Fax: E-mail: Instal 11replace furnacethumer 3 Including ductwork/vent liner U Yes Q No CCB no.: I N DO _ nsta rep ac re ocate heaters-suspended, City/metro lic.no.: wall,or floor mounted Name(please tint): enc ora i—`i ncc of er an urnace Refrigeration: Absorption units__ _ BTU/H Name: RYtrJ 1..<}N6.HAlin Chillers__ HP Address: ►H r1 126 $w S uuyntrn E 4t0l*.+� O( Com ressors _ HP nr onmenta exhaust ,nd ventilation: City: T_16.Ar(Lo State;09, ZIP: qZ X a4 Appliancevent Phone: yJ0 •ii0.1 Fax: �a'-1-g4oy10 E-mail- Uryerex ausi s,` ype res. rte a azmat hood fire suppression syrtem Name: r6 d�L N T W 000 ft MES Exhaust fan with single duct(bath fans) Ex aust s stem a art rort heat' or r A Mailing address: 14 q I d St.J_ SIkMvYltit2►�lfiw R Fuel piping aodistribution(in to outlets) lX City: T'1ygRo State:01� ZIP: 9'1 day _ — Typc: _^_LYG NG ,_ Oil F— Picone:SO a -911it. Faxa,24.gV4V Email: vc tin each additional out t—fets— N rocess p p ngcscEema_tic required) _ Name: Number of outlets J ter listed app ancl{'a or equ pment: Address: _ Decorative fireplace City: — State: ZIP: nsert-:ype _ W Phone: Fax: E-mail: oot�tov pe et stove Other: Applicant's signature: — Date: Of er: Name (print): Not all jurisdictions accept credit cards,plea<e call jurisdiction for more infnrmaiion Permit fee.....................$ �— a Visa O MasterCard Notice:This permit application Minimum fee........ .......$ Credit card number L'_1 expires if a permit is not obtained Plan review(at _ %) $ �___ _. Fspircs within 180 days after it has been State surcharge(8%) ....$ _r_ �_ -- Name of cardisnider as a6own on credit card S accepted as temp ete. TOTAL .......................$ _—.-- Cardholder sisealure Amount 4104617(131110/COM) ]Building Fixtures I'lilmlalIIg PsunMtion 7D.. Plumbing �� i Date/By: `^ Permit No.:ft 003 C)u_9C1� 'City of Tigard pproval— Sewer Permit No.: 13125 SW Hall Blvd. JUL 1 �QD Plan Review other Tigard,Oregon 91223 CITY OF TIGARD Dat�y: ____. _ Permit No.: Phone: 503-6394171 .j R.JWLMVft t)N Post-Review Land Use Date/B : Cane No.: Internet: www.ci.tigard.w.us Contact _ Juris.: I Rg Ser Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: � Supplemental Information. TYPE OF WORK FEE. SC clal In 00"use checklist New construction _ `)emolition Description Qty. Fcoes.) To a, Addition/alteration/replacement Other: New &2-famlly dwellOgs CATEGORY OF CO ST ION nduda 1tlO R.fur ch uWl t a as I &2-Family dwelltn Commercial/Industrial SFR 1 bath 249.20 � _ z— SFR 2 bath 350.00 AccessoryBuilding Multi-Family _ SFR(3)bath 399.00 Master Builder Other: Each additional bath/kitchen 45.00 _JOB SITE INFORMATION au ATION Fires rinkter • tt.: Page 22 Job site address: r Suite#: _ Bld ./A t.#: Catch basin/area drain — 16.60 Project Name: Dr ell/leach line/trench drain 16.60 .1. Footing drain(no.linear.) Page 2 Cross street/Directions to job site: '43-p V VXv „u t Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector if bo Sanitary sewer no.linear ft. _ P•, e 2 Subdivisiotl: e � Lot#: Storm sewer(no. linear ft.) P► e 2 Tax map/parcel#: Water service no.linear ft. Pile 2 IDSWRM �t ON OF WO Absorption valve 16.60 Coy �WWAU n �i rta.L.t 4titrrt�A.�t _ Backflow pteventet Pae 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 _ Drin Afountain 16.60 O- -- E'ectors/sum 16.60 Name: 1. mw-, Expansion tack 16.60 Address: I qqt a S w S a rrn rr-k V Ve Fixture/sewer cap 16.60 Cit /State/Zi �� Floor drain/floor sink/hub 16.60 -1atR/ -� Garbage disposal 16.60 Phone: 3 Fax: a4' tot L Hose bib 16!,0 Ice maker 16.60 _ Name: Interco tor/ ease tra 16.60 Address: Medical as-value: S____ _ — Pae 2 Primer 16.6( City/State/Zip: ^V _ is — Roof- commercial 16.61) QC Phone: Fax: i-- Sink/besin/lavato 16.10 Tub/shower/shower an 16.60 t- E-mail: - — tn fid R_7 3' Urinal _ 15.60 J Business Name: ;, )CL ��M ,n • Water closet `--� 16.60 Water heater 16.60 0o Address: w Otber: Cit /State/Zip: Other: Phone: Fax: CCB Lie. #: Plumb. Lic.#: _. subtotal Minin, it Fee$72.50 S Authorized I Residential Backflow r _ n Fee$36.25 Signature: Date: _—. plan Review 25%of Permit Fee S State Surcharge 8%of Permit Fee S (Please print name) TOTAL PERMIT FEE S Notice: This permit application evistres If a permit Is not obtained within All new eommere,sl buildings require 2 seh or plans with isometric or Igo days after It has been accepted as complete. riser dlagrnm for plan review. •Fee methodolM art by TN-County Building Industry Ser cord. i:\Dsts\PertnitFoirm\PlmPermitApprfoc 01103 I I Plu:nbi_nQ Permit Application-City of Tigard Page 2 - Supplemental Information FSchedule: Residential Fire Suppcession Systems: .turtle# I! a 1" uare Foots e: _ 1 tnwt Fee: Foc tin tin-1"100' 55.00 0 to 2,000 5115.00 _,— Pouting in-each additional 100' 46.40 2,001 to 3'600 $160.00 — 3,601 to 7,200 $220.00 Sewer-1 st OW 55.00 7,201 and greater $309.00 Sewer-each kdalonal 100' 48.40 ---- -- -- water Service--tit loo' 55.00 Medical Gas Systems: Water Service-ea additional I(10' Y 46.40 Valuation: Permit Fee: Storm&Rain Drain N st 100' 55.00 _ 51.00 0 55,000.00 Minimum fee$72.30 Storm&Rain I)mtn-e additional 100' 46.40 — $5,001.00 to SI0,000.00 $72.50 for the first$5,000.00 and$1.52 tar each Fixture Or m Qty. !�(eaj Total additional$100.00 or fraction thereof,to and including$10,000.00. Commercial Back Flow Pre!N ior Device 46.40 $10,001.00 to$25,000.00 $148.50 for the first 510,000.00 and$1.54 for Pesidcnlial Backflow Preventio [levicc eact additirnral$100.00 or fraction thereof,to (minimum permit fee$36.25) 27.55 and including 325,000.00. __ Rain Thain,single family dwelling 65.25 $25,001.00 to$50,000 00 $379.50 for the first 525,000.011 and SL45 for each additional 5100.00 or fraction thereof,to Inspection of existing plumbing or and inclwti�$50,000.00. _ specially requested inspections-per hou 7250 $50,001.00 and up 5742.00 for the first$50,000.00 and 51.20 for Subtota each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing ures? If "yes",please indicate work performed by fixture. 'ailure to accuratelyrepo I fixtures could result in increased s er fees*. Quandl y Oz MslureWork t Comments regarding fixture work: Flxtnre Tyle: _Ba tp is+�y/Font�� _ Bath -Tuh/Shower -Jacuzzi/Whirlpool - Car Wash -Fath Stall _ -[rive Thru Cuspidor/Water Aspirator Dishwasher -Commercial -00meslic Drinking FountainEye Wash Flnnr Drcin/sink 2" 3" -4" — L'ar Wash Drain *Note: If the fixture wor under this permit results in an tl Garbage Domestic increase of sewer EDtJs,a se r permit will be Issued and Disposal -Commercial y p Industrial_ fees assessed for the sewer iner a must be paid before the to Ice Mach/Refri .Drains plumbing permit can be issued. Oil Scparetor(Ltas Station Rec.Vehicle Dump Station "J Shower -Gang Da -Stall Sink -Bar/Lavatory W -Bradley -Commercial -Service Swimming Pool Filter Washei-Clothes — Water Extractor Water Closet-Toilet _ Urinal Other Fixtures: is\Oats\Permit Forms\P1mPermitAppPs2.doc 01!03 w'-w•�wr..-w.. •.�Ir ��r .P VI�4 wrY!I'� fri>t,vryq� �u�' � by�t�•f�� t�t'Y�TlQARq. � •-,-•»- ?t►+•' t+�te!BU(�DI�IQ DIV;I$lON r1llt►� i' .� +Jrrf;17.9 �.rr�. I ISOM t7yt ♦..•q„ �/1',I, !I! j;lfr .f atl ttrryf! '/'.�� Top".) I.A rf.rltd 'ri.?1,. 01 1 b!'+ila:ll� C3 � b�+,e•rla�• ti u, MM w F Q7C1 b� � m 1 o A N O iu r3 r - - - Q ^� CTl (L s4 n, a � . .� u1 m 1�. u r �� •� . CITV OF CREVIEW -SITE PLAN , 91.11LnING PERMIT NO.: (� PLANNING DIVISION' �pVe7 [3 Not Appmvcd Regt�ired Setbacks: App v '{I 'side. _.jj— Street Side: �( F Rear, nom. —4r_ Garage- VI-ilial ara e:Ui,u+l Clearance; T�P-A� roved Q Not Approved Mn� m -i illItI � feet cWS Serv' •e P ovider Lcttcr Required: ❑ Yes d No (,] R ctiv ffun A -� nate: KIN(i nEPARTMEN ed a Nit Appmvrd pe: �% M APpr Nit A� roved Q� ApprovedQ !p a�C nate: Note%: IL oR rn CO a w a