13640 SW SANDRIDGE DRIVE 13640 SNti Sandridge Drive
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 r
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BUP
Received __ _Date Requested—_ -_� AM _ _ PM, _ BUP
Location �' 1 L � —Suite._ MEC
Contact Person (e((_—) �/ > —L3 �l PLM
Contractor _ Ph( ) 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
Other: __ ---------- _
ZW6_0
PARTFAIL
GG
--
Post&Beam -'_—_--- ------------ -- - ----W�.
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
Smoke Dampers —
Final
PASS PART FAIL
ELECTRICAL
Service --- —
Rough-In
UG/Slab
Low Voltage
Fire Alarm ------------_--__....-------
Final Reinspection fee of$�_-_._ required before next ins
PASS PART FAIL p Q inspection. Pay at City Hall, 13125 SW Hell blvd
SITE _— Please call for reinspection RE:— Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date _ Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 -2_d-)D 30,5--"INSPECTION DIVISION Business Line: (503) 639-4171 MST —_ `
BLIP
Received _ _ Date Requested AM PM BLIP
Location MEC
--
• _Suite_
Contact Person � _ ph(_ � _„���'•— �7�G/ PLM
Contractor �'
=.
k4Ph(-- l — --_ - SWR
-
BUILDING Tenant/Owner ELC
Footing
Foundation Access: FLC
Ftg Drain
Crawl Drain ELR 3 y.
Slab Inspection Notes: ✓ + e �` SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear —
Framing - -----� __
Insulation - - -- ---
Drywall Nailing
Firewall —
Fire Sprinkler _
Fire Alarm — -----
Susp'd Ceiling
Roof — ---- -—
Other:
Final -- ---_—._ -------
PASS PART FAIL - --- -- — — _-_—_
PLUMBING
Post&Beam -- --__ --- -- ------
Under Slab
-------------
Rough-In -
Water Service
Sanitary Sewer - -- --- — -----
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other -- -- -
Final --._.---- --
PASS PART FAIL -- ---- _
MECHANICAL
Post&Beam
Rough-In
Gas Line —
Smoke Dampers --
Final — --
PASS PART FAIL
ELECTRICAL
Service
Rough-In
UG/Slab —.
Oiri rgAlwrn --- -' —
ASS PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE:_ _ — Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dab -1 Qom_ Inspector — � —_Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171BUP
Received . S 7 Date LquestedAm PM BUP - — --
Location / 3 (v _�' __.—Suite _ MEC
Contact Person _ _. Ph(
6/_ PLM
Contractor _--_— __-- —_-- Ph(--) _ SWR -- -__—_--
IBUILDING Tenant/Owner __-_.._—__—__ ____ — ELC -
Footing ELC --__-
Foundation Access:
Ftg Drain ELR
Crawl Drain 04
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
Other: -- - -- -._
Final
P 5_ P RT FAIL
PLUMB -
Post&Beam
Under Slab - - -- - --...- -- - ---
Rough-In
Water Service --------- _ - -
Sanitary Sewer
Rain Drains -- - - - - - - -
Catch Basin/Manhole
Storm Drain ------ -- - ._ - -
Shower Pan
tOthePART FAIL
AN_KC AL
Post&Beam
Rough-In -
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL_-_
Service
Rough-In
UG/Slab
Low Voltage -..._ �_----_--- - ----- ------ -
Fire Alarm
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 5VV Hall Blvd
PASS PART FAIL
8I E- Li Please call for reinspection RE: -.- 0 Unable to inspect-no acces
Fire Supply Line wi l.1
ADA Orth a\?�_aInspector
Approach/Sidewalk -- --
Other: _
Final T DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour _
BJILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISIOM Business Line: (503)639-4171
BUP -
Received _— Date Requested _ AM PM- BUP
Location 31/ LA Q Suite —__ MEC
Contact Person Ph( )5��� g3�' PLM
Contractor.._—____—__ Ph( ) SWR
A—USHW
-
_ Tenant/Owner _.__.__ ___.. __ ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing S,� L�Y� 7 f
/ ' v _ 2 '9
-�_��
Insulation S Q T�,� ,Ct'.yL'e-ki - I>'/1k�0"z I/0,
Drywall Nailing
Firewall, l.1-K.�C.��✓1_��T���.�u•'1') - ��,�2 � a v ��1
Fire Spinkler
Fire Alarm
Susp'd Ceiling
Roof
Other
PASS PART AI -
PLUMBINR
Post&Beam
Under Slab —
Rough-In
Water Service —
Sanitary Sewer �---
Rain Drains --
Catch Basin/Manhole
Storm Drain - -
Shower Pan
Other: - --
Final
PASS PART_ FAIL --- - — - ` —
AN
Rough-In
Gas Line
SM9ke Dampers -- --- -- -
/FASSJ PART FAIL - - - - ---- -----
RICAL -+
Service -- ------- ----------------------------
Rough-In _
UG/Slab
Low Voltage
Fire Alarm �-- ------- — -
Final Reinspection fee o1$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART_FAIL
SITE - — Please call for rein3pection RE:-___�_._-____.______-___..__. - E] Unable to inspect- no access
Fire Supply Line G
ADA Date__' Q 2� In�+pwcM. - Y�
Approach/Sidewalk Ext , - -
Other:
Final — — DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF T I G A R D ELECTRICAL PERMIT-
RESTRICTED ENERGY
^
DEVELOPMENT SERVICES PERMIT ELR2002-00191
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/24/02
SITE ADjt2ESS: 13640 SW SANDRIDGE DP,
PARCEL: 2S105DD-04700
SUBDIVISION: PACIFIC CREST ZONING: R-7
BLOCK: LOT: 023 JURISDICTION: TIG
Proiect Description:All-encompassing low voltage.
A. RESIDENTIAL _ B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: i INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
D R HORTON HOMES AZIMUTH COMMUNICATIONS INC
5125 SW MACADAM AVE STE 145 P.O. BOX 508
PORTLAND, OR 97201 WILSONVILLE, OR 97070
Phone: 503-222-4151 Phone: 503-639-0110
Reg #: ELE 36-94CLE
SUP 2312&E
LIC 145828
FEES Required Inspections
Type By Date Amount Receipt _ Low Voltage Inspection
PRMT CTR 9/24/02 $75.00 2720020000 Elect'I Final
5PCT CTR 9/24/02 $6.00 2720020000
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 worts is
not started v4.ithin, 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires,Y66 to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0T-00 throu h OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1 87.
Issue by ' ' � �n Permittee Signature ' !.
M .111
OWNER INSTALLATION ONLY ,
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DAZE:
L ICFNSE NO: —-- �---�------- ---
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
----T7—, ,,,_ Datereceived: c'/ Permitno7t,
:I, 47
Project/appl.no.: Expire da
City ��f Tigard � (��1 - —�,bli'y ri l Date issued: By:,C o.:
Cityof'I'igard Address: 13125 SW Hall Blvd,�`�tfg --
Phone: (503) 639-4171 t Case file no.: Payment type:
Fax: (503) 598-1960
Land use approval:
1
U Multi-family U Tenant improvement
7V&2 family dwelling or accessory U Commercial/industrial �;,U partial
w construction U Addition/alteration/replacenu„I U Other:
1 .
Job address: Q Bidg. nu.: Suite no.: Tax map/tax lot/account no.: _
Lot: 1, Block; Subdivision: - ---- -
Project name: Description and location of work on premises: -- ,_
Estimated date of completion/inspection: i
1Ing al roij I I 1 (,.,. Max
Jo10110: tkscriptian Qly. (ca.) Tolal no.Ins
Business name: Z Mu (C'J)ll1V►^ 1L t} T/L'��S Newrerideotial-singleOrnudli-familyper
Address: 1f k/ dwellingunit.Inc•ludes a(l""hed{nrnhe.
L_S_S Slah.�^, ZIP: c7C�L' Service included: 4
City: t •M+rl LL E 1000 sq.ft.or less
Phone:56-k C 1/U Fax: L 3 Lff Oil., mail: Each additional 5(10 sq.ftor portion thereof
n
lie
bus.Elec. u . . o: E CCE 2
CCB no.: ElLimitedencrgy,residenlial 2
City/m ro lie.no.: 13mitedenergy,non-residential
t7l Each manufactured home or modular dwelling 2
— I)ute Service and/or feeder
signa urc of su ervisin elect (rc uircd) y lion,
elect.
11,rw Clio:�J ?ZC alteration or relocation:
Sup.elect.name(print): L/�t F 2
1 200 amps or Icss 2
201 arnps to 40.1["lips 2
Name(print): ' l W�`•� _- 401 amps to 600 amps 2
Mailing address: f��•1/s _ 601 amps to 1000 amps 2
OLD-- Slate: LIP: � Over 1000 amps or volts I
City: _ ---— Iteconnectonl
Phone:IAL- 1 Fax: E ["nil:
Temporary services or feeders-
Oa�ner installation:The.installation is being.�ade on property I own installation,alteration,or relocation: 2
which is not intended for sale,lease,rent,or exchange according to 2tNl OInpS of less ___—.
016 447,455,479,6 201 amps to 40()amps 2
Date: �741111o61N)loops
Oaener's si tutturr _ — — Branch circuits-new,al(eration,
or extension per panel:
Nance: A Fee for branch circuits with purchase of
service or feeder fee,each branch circuit
Address: — li. Fee for branch circuits without purchase
State: ZIP:
City: -- of service or feeder fee,first brunch circuit:
I'aK I:, .nail Eachuddltionalbranchcircuit:
Phone:
Mile.(Service or feeder not Included): 2
U Health-care facility Each um or irrigation circle 2
U Service over 225 coups-commercial Each sign or outline lighting
U Service over 320 amps-rating of 1&2 U!hazardous location8
Si nal circuits)or a limited energy panel,
family dwellings U Building aver!(1,000 square feet four or
more residential units in one structure alteration,or extension"
U System over Glx►volts nominal U Feeders 400 amps or more •(kscri tion:
U Building over three stories
U(kcupalu load over persons U Manufactured structures or IAV park Each addllMQ inspeclion over the allowable In any of the above:
U Epress/IighUngplmr d Other — 1'erins etion
Submit_sets of plans will(any of the above. Investigation fee
The above are not applicable to temporary construction service. Other Permit fee............. .......$
accept credit cards,please call jurisdiction far mom inAxmaucsa Notice:Tbis permit application Plan review(al _ %) $
Neu all)urisdicticwas
U vasa U MasterCardacceptc expires if a permit is not obtained
within IRO days after it has been State surcharge(8910....$
c te,m card namtwt ---.------------ 1 TOTAL .......................$ F'f c GrjL
accepted as complete.
Nome of cardholder u shown nn credo card S
_ 440.I615(6K1(N('0M)
c'erdhol r sl(tnature Amount
TY OF i I G A R D ------- M. ER PERMIT
PERMIT#: MST2002-00305
DEVELOPMENT SERVICES DATE ISSUED: 8/5x02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13640 SW SANDRIDGE DR PARCEL: 2S105DD-04700
SUBDIVISION: PACIFIC CREST Z014ING: R-7
BLOCK: LOT: 023 JURISDICTION: TIG
REMARKS: New SF detached, Path 1
BUILDING
REISSUE: Y STORIES: 2 FLOOR ARLAS - REQUIRED SETBACKS REQUIRED _
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,552 of BASEMENT: of LEFT: 12 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.540 of GARAGE: 778 of FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 5
VALUE: $311.400.80
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 3,14200 of REAR: 37
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS:
LAVATORIES. 5 DISHWASHERS: 1 FLOOR DRAINS: 0 SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUSISHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN c 10014: BOIUCMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN>•1100K: I UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: blu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS -ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATIOW PER INSPECTION:
EA ADD'L 500SF: 6 201 400 amp: 201 400 amp: tel WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIA: SIGNAUPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601♦amps-1000v: MINOR LAB!-'L:
1000•amp/wall:
PLAN REVIEW SECTION
Reconnect only:
>•1 RES UNITS: 9VCIFOR>•225 A.: >800 V NOMINAL: CLS ARENSPC OCC:
ELECTRICAL•RESTRICTED ENERGY
_ A.SF RESIDENTIAL B.COMMERCIAL
AUDIO B STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM. 0TH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIONL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TEI.E COMM: NURSE CALLS TOTAL a SYSTEMS:
Owner: Contactor: TOTAL FEES: $ 8,197.44
D R NORTON HOMES D.R.NORTON INC This permit Is subject to the regulations contained in the
5125 SW MACADAM AVE STE 145 5125 SW MACADAM#145 Tigard Municipal Code,State OR. Specialty Codes and
PORTLAND,OR 97201 PORTLAND,OR 97201 all other applicable laws. All work will be done
In
accordancecewith approved plans. This permit will expire B
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
Rep 0: LIC 130889 forth In OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Undarfloor insulation Plumb Top Out Exterior Sheathing Ins{ Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Building Final
Foundation Insp Footing/Foundation Drl Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By : < <T' Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00212
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/5/02
SITE ADDRESS; 13640 SW SANURIDGE DR
PARCEL: 2S105DD-04700
SUBDIVISION: PACIFIC CREST ZONING: R-7
BLOCK: LOT. 023 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS.
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF
Owner: - — ----
-�-- -- _ FEES _
D R HORTON HOMES Type By Date Amount Receipt
5125 SW MACADAM AVE STE 145
PORTLAND,OR 97201 PRMT CTR 8/5/02 $2,300.00 27200200000
INSP CTR 8/5/02 $35.00 27200200000
Phone: 503.222-4151 l Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
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?nstaller
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued by: �/_�_1"y__W"yPermittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
TT dsr7Zy, tz 9l
Building Permit Application
City of 'Tigard --
Date received: ef- Permitno.: q,
Address: 13125 SW Nall Blvd,Tigard,OR 97223 Project/appl.no.. Ee date:
City u/ftgnrd x ir—`-
Phone: (503) 639-4171 Date issued By Receipt no,:
Fax: (503) 598-1960 ase file no.: Payment type:
Land use approval: t 1&2 family:Simple Complex: A-- '
TYPk OF.PERMIT
ti
O I &2 family dwelling or accessory ZI Commercial/industrial J Multi-family >rNew construction ❑Demolition
❑Addition/alteration/replacement U Tenant improvement 0 Fire sprinkler/alarm Ll Other:
r ; siTE INFORMATIONt
Job address: Bldg. no.: JSuiteno..7
Lot: kb JBlock: Subdivision: Tax map/tax lot/account no.:
Project name.: VA6,41
Description and location of work on premises/special conditions:
OWNER
I.-Oil SPECIAL INFORMATION, USE CHECKLIST
V N-�►�t-a f h
Name: capacity, ,
Mailing address: !U.y�_ I &2 family dwelling: A ,
City: State:oft JZIP:JJZ4J Valuation of work.........,.. ... , 31 V66,
Phone: - +� Fax: - -JJ7 '-mail: No.of bedrooms/baths.................................
Owner's representative: N11W Total number of floors............... .. ..............
Phone: JW. l 3 I nx: Email: New dwelling urea(sy.ft.) ... .!s17r.,
APPLICANT Garage/carport area(sq.
Name: p• tiZ . �_"r"In Covered porch area(sq. ft.)
Mailing address: t_ AS a k O V-fi Deck area(sq. ft.) . . . ............... .. . ... ..
City: I State: I ZIP: Other structure arca(s( ft.)............
CommerciaUlndustrial/nettltl-family:
:
ItiLlmirelpi Phone: Fax: E-mail: ...................
Business
Valuation of work................
Existing bldg.area(sq. ft l ....... ......... _
Business name: V h New bid area(s , ft.) ....
Address: S �a�
City: State:D ZIP: Number of stories ..................................
Type of con ction. ................................. _
Phone: 15 Fax: E-mail: Occup Y group(s). Existing:
CCB no.: p — ew:
--
N
City/metro lie.no.: tiee:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: a provisions of ORS 701 and may be required to be licensed in the
Address: 'j;V ^S A k7,4 —� jurisdiction where work is being performed. If the applicant is
city: State: ZIP: exempt from licensing,the following reason applies:
Conutct person: 14 f Plan no.:
Phone: _qjgrl .Ili Fax: I E-mail: —
Name: .L� GNU ontact person: tJL&rZ_ Fees due upon application ........................... $
Address: 1 >'h Date rtceived:
City: Statc:d)Q- ZIP: p/ Amount received .........................................
Phone: Fax:&,Vf' -Jy E-mail: Please refer to fee schedule.
hereby certify I have read and examined this application and the Not alt lunuhctions accept credit cordo,plena roll iunutrction for nwre mfonnstinn.
attached checklist. All provisions of laws and ordinances governing this ovisa O MasterCard
work will be complied wit, whether specified herein or not, credit card number. _ __1_L_
Cxpircr
Authorized signature: �_ Date: _ �j�— Name of cardholder u shown an credit card— —
Print name: I DN — S
Cardholder eiiinature4moum
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "a-M131 ,
Electrical Permit Application
�- --�-- Date received: G)a Permit no.: -
City of Tigard Project/appl.no.: -Expire date:
Cityq/'Tigun/ Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By _ Receipt no.:
Phone: (503) 639-4171 —4 -
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: ... .
1
U 1 &2 family dwelling or accessory 0 Cummercial/industnel 0 Multi-family 0 Tenant improvement
New construction 0 Addition/alterttion/replacement 0 Other: ❑Partial
JOB SITE INFORMATION
Job address: LOlin L-. l31dg. ru,.: Suite no.: Tax map/tax lot/ACCount no.:
Lot: Block; Subdivision:
Project name: �C�4�" Description and location of work on premises:
Estimated date of completion/inspection:
C)ONTRACIrOR.APPLICATIONi
Job no: _ tee stat
Description (1ty. (m) Tolal no.insp
Business name: 6�1j-_ T I . `- Newresidential %ingleormulti-familyper
Address: dwelling unit.Includes altached garage.
City: V State: ZIP: ;2, Service included:
Phone: UA&- Fax: E-mail: 1000 sq rt.nr less _ 4
CCB no.: �0111:.bus. lic.no: Each additional S(N)sq.ft.or portion thereof
CCB no.: Elec.bus. lie.no:
._ Limited energy,residential
City/metro lic.no.: 7,,Ej" Li inited energy,non-residential 2
Fach manufactured home or nodular dwelling
Smart oLsVrrvcsing electrician(required) Date Service and/or feeder 2
Sup elect.namc(print): Licenscoo Services or feeders-Installation,
alteration or relocation:
PROPERTY
200 amps or less 2
Name(print): Q 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: Q -41 601 mops to Iw)o amps z -
City: State: ZIP: Over 1000 amps or volts 2
Phone: Fax: E-mail: Reconnectonly I
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 Installation.alteration,or relocation:
URS 447,455,479,670,701. 200 amps or It,, 2__ 2
201 amps to 4' ! 2
"Name:
' siture: _ Date: _ 401 to 600 am- s 2
Branch circuits-new,alteration,
5 V or extension per panel:
_ A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: State: ZIP: Q B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit 2
Phone: fax(//f I:-mail' Each addnnrnalbranch circuit,
PLAN RFVIEW(Please clieck all flint apply) Misc.(Service or feeder not Included):
O Service over 225 amps-comrnerut al U Henith care factlity Each pump or Irrigation circle 2
O Service over 320 amps-rating of 1 del U Hazardous location Each sign or outline lighting2
familydwellings U Building over 100)0 square feet four or Signal citcuit(s) r a limited energy panel__
n System over 600 volts nominal more residential units in one structure alteration,or extension' 2
•Building over three stories U Feeders,400 amps or mote •Desch+tion
O Occupant load over 99 persons U Manufactured structures or RV park PAch additional inspection over the allowable in any of the above:
O Egress/hghungplan ❑Other: Per inspection
—�—
Submll vers of plant with anv of the above. Investigation fee _
7
In,alws a are not applicable to temporary con,truetlon serylee. I Other
Not all jumdictiona accept credit cards,please call jurisdiction for more information Notice:This permit application Permit fee.....................$
O Visa El MasterCard expires if a permit is not obtained Plan review(at _ %) $
Credit card number: within 180 days after it has been State surcharge(8%) ....$
"p1fe' accepted as complete. TOTAL .......................$
Name of cardholder as shown on credit cord
S
Cardholder si/nature Amount 4404615(6100lCUMI
Mechanical Permit Application
\ — Date received: o' Permit no.:
City of Tigard ProjecVappl.no.: date: -- - -
City o(Tigord Address: 13125 SW Hall Blvd,Tigard,OR 97223 --- --
Phone: (503) 639-4171 Date issued: By Receipt no.:
Fax: (503) 598-1960 Case File no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
O I &2 family dwelling or accessory O Commercial/industdal O Multi-family O Tenant irnprnvement
U New construction U Addition/alteration/replacement O Other:
-IOR SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 46 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax snap/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: t
Description and ocation of work on premises: _ I 1 t 1 I
Fee(en.) Intal
Est.date of completion/inspection: _ Dw•ription Qty. Res.only Rm.only
Tenant improvement or change of use: AC:
Is existing space heated or conditioned?O Yes O No Air handling unit CFM
1s existing space insulated?U Yes -1 �'. Air conditioning(site plan required) _ _
_ teration of existing C system
MECHANICAL 1 Fioi er/compressors
Business name: (� �" State boiler permit no.:
Fi
Address: HP Tons—BTU/11 V
r snlo adampers/duct smo a detectors
City: State: ZIP: pQ -beat pump(site plan require ) ---
Phone: VU 4 1 Fax: E-mah: InstalUrcplace urnac urner__
CCB no,: Including ductwork/vent liner O Yes O No
Instal rep ace/re ocate heaters-suspended, _
City/metro lic.no.: — _!T wall,or floor mounted
Name(please print): enc for appliance other than furnace
CONTA(*Y PERSON Refrigeration:
Absorption units BTU/H
Narne: N/10 le S p Chillers HP
Address: S —� 7 �y Compressors--- IIP
- ZIP. • onmenta ex ust an ventilation-
City:
_�� Appliance vent
Phone 22Z- / Fax.-503-;t(,, E-mail: Dryerexhaust
Hoods,Type U Ithes. itc ten/ armat
hood fire suppression system _
Narne: L7. Exhaust fan with single duct(bath fans)
Mailing address: y r/ ExTust system apart from heating or AC ---
Cit re_ . -Turfpiping anddistribution(up to outlets)s)yr State:O( ZIP: Type: NG __ OilPone: / Fax: / 1: Fuel piping each-additional over 4 outlets
—
Process piping(schematic required)
Name: eo flee C1,Y, 111 f Number of outlets
-- --- - ter listedappliance or equipment,
Address: y �' Decorative fireplace
City: 6 d4. 1 State: ZIP: f''Jp/5 nsert-type
Phone: - Fax: WA 4iVFz 1 E-mail: wooastove/peiiet stove --
Applicant's signature: otliFr
Date: 1 er:
Name (print):
Not all lunsdicuntu accept credit cants,please call lunsdtctton log more ttdnrmatton Permit fee $
p visa U MasterCard Notice:This permit application Minimum fee................$
Credit cord numherexpires if a permit is not obtained
Plan review(at _ %) $
Expires within ISO days after it has been State surcharge(8%) ....$
Name of cardholder as shown on credit card accepted as complete.
TOTAL .......................$
Cardholder signature Amount 441(}.4617 INMCOW
Plumbing Permit Application
C
Date received: ptk Permit no.:�Ir &r ity of Tigard -
Address: 13125 SW Hall Blvd,Tigard,OR 972-11 Sewer permit no.: Building permit no.:
City n(Tigard Phone: (503) 639-4171 Projecb/appl.no.: I„xpire date:
Fax: (503) 598-1960 Date issued: B rt Receipt no.:
Land use approval; Case file no.. Payment type:
TYPE OF PERMIT
0 I &2 family dwelling or accessory ❑Commercial/industrial ❑ Multi-family J Tenant irnpruvenient
New construction 1-1 Addition/ahcration/replacement 0 Food service -1 Other:
II 1 1 r
IT ifay-1
Job address: Desert tion ..Qty. Fee(ea,) Total
Bldg.no,: Suit.:it New I-and 2-family dwellings only:
Tax map/tax lot/account no.: — (includes 100 fl.for each utility connection)
SFR(1)bath �I
Lot: Block: Subdivision: !S4' SFR(2)bath --� - -- --- --
Project name: �-- SFR(3)bath
City/county: A k-A I ZIP- _ Each additional badVkitchen
Description and ItIcation of work on premises: Siteutilitles:
Catch basin/arca drain
Est date of completion/inspection D wells/leach line trench drain
t Footing drain(no.lin.ft.) — —
Business name:
Manufactured home utilities
S Pl�nmbiVl Manholes
Address: a Z, --
Rain drain connector
City: State: ZIP: pp Sanitary sewer(no. lin. ft.)
Phone: 0134 1 Fax: E-mail: Storm sewer(no. lin. ft.)
CCB no.: Plumb.bus,reg.no:'.3 -( Water service(no. lin. ft.)
City/metro lic. no.: Fixture or Item:
Contractor's representative signature: Absorption valve
--- Back flow reventer
Print name: i,/ Date Backwater valve
CONTA(711'PERSON Basins/lavatory
Name: Clothes washer
Address: S/xs � �C — Disl was er
Drinking fountain(s)
City: '��hd StateD,� LFP:
Phone: 11Z F;tx: Ejectors/sum
E-mail: Expansion tank
Fixture/sewer cap
7_Nwme(pnint), J�. f f�T¢y�, /f-a�y/�S Floordrains/floorsinks/hub
s: �'/ ,atfia a dis sal
Hose bibb
State: ZLP: / ice maker
Phone: - Fax: Z 7/JE-mail: Interceptor/grease tray___
Owner instal lation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s), lays(s)
Owner's signature: Date: Sum
Tubs/shower/shower pan -
Narne: ! (/U` Urinal
L�— ��� Water closet -
Address: Water heater
City: l State: ZIP: Other:
Phone: Fax:�.V7 E-mail: oral
Not all junsdicuons accept credit cards,please call iuniaicuon rn<more nror,nnlion. Notice:This permit application Minimum fee................
Q Visa ❑MasterCard Plan review(at _ %) $
expires if a permit is not obtained - ---
Credit cud number �_- _ Expires within 180 days after it has been State surcharge(8%)....$ _
p ecce
-- ted as complete, TOTAL Iete. $
Name of cardholder a shown on nedu card p p
S
Cardholder signature Amount
44114616(&MCOM)
PACIFIC CRES-1- SUBDIVISION
LOT - 23
CITY OF T'[GARD
THE APPROACH SHALL BE
A MINNMUM OF 8"x12,10'
1 OF CLEAN IT GRAVEL
1 EL-57+' AND5CAPING FOR TWE ENTIRE LOT
N Q°5 4'Q 0"
"E EL•STB• WALL BE FINISHED OR TWE LOT
URROUNDED BY EROSION CONTROL
OPERTY CI RIOR TO BREAK OUT OF COMMUNITY
67. 10 0' ROSION CONTROL. FINISHED SLCPES
SHALL BE LESS THAN 1 TO I
SETBACK L E
------- --
I t
I
I O
1
I
1 I
NOTE:
0 0 i I.ROOF DRAINS TO STORM
LAT. IN STREET.
I 2. FOUNDATION DRAINS TO
�-- i BACKYARD 5OAKAGE TRENCH
3: SEE ATTACHED DETAIL
I^
O ^
C� I PL N : 3O69C l O cD
O SQ T. 2918 O
FIN • 511' O O
ri
M
co
z
i
ARAGE
FT. . 183
FI EL • 516'
ri
I
� I �
i ry~ I
e�
TEMP. AvEL
DRIVEL
c 0'
EL•SSS' �---- _
/1
21/2- M fARI WA R
�I El•S7A'
MAPLE
STC)Pl't L
SAN At
S F
SETBACK REQUIREMS
ENT
SCALE 1.2S-o' 2 J7 FRONT YARD TO GARAGE I5'
SIDE YARD 5'
71206 REAR YEARD 15
4 K AN,S,OiaO SW SANOIlID68D D.R. Horton Homes
PtiAN 306x
SCALE.I- .20'
DATE 6/2002 5125 S.W Macadam Aveneue
rWCNE.D03722.4I51 PCrtland Ore Cn PAX.5077223111