13691 SW LEAH TERRACE A�_
O I I PATRICK SCHMITT,
Q
I designer Inc.
NI I I Cudom Horrid Onsign,Planning 3 Zonae"
8 , do d,0 o Stne
n ot
PO ,1 i
Ta
5, 4 62 S. F.
1 F.(503)?U-43731 j _ a-rasih uu+menywaporl.00m
Q —'
1 I I 011ten nmendans an those erering foal NOVO
tn1
`• to 20 Prea.aenae o.wr !edea ainensbrf. Conlroelor
ty to, 01i
I `•� I n.1 I I --_ Osla r I c•MUM•mth eni 0. P ane Consent SCI-ent•e
and cnnalllanf an the Ie0 PA TAM'rf SLtinaTT,
any -,.otion from ay.eneare Nt forth h*,a.M
95
i 1, N Q SITS P! ,�,� ' MUTES
`\ I 1 } .7~, A j I — i This document If the Property of PATRIr SCHNITT,
1 1.nr_ l\_ '"'S, .�i0re1 Inc.Ir) and if Ip l t ..M only IM one
y speelfle pre)eat as no-ad oelow. No reuse of
repr�0ycllar n any form �. d:awea +�thoul the
1 a Na Rr r^I`lan concert a PATRICK SGIAITT,
I ; , LEGAL DESCRIPTION I
- -__-- - .
1 \
(JI CN W I Leri is
'� DAffodll VIII
N 89 E
5. 00 I = o = �: IOC
- _ c� Q , co ��ITE ADDRESS
5. 0 0 , 5 5. 0 — ^~ I 11316151 6AU LEAN TERRACE
LL..bb� n..bbBA
\ \ O W TIGARD,L4111000N 81224
C)
ALr S o - - LOT COVERAGE
ADJUSTED REAR �;`.� '� ,� �1;•' W i . .
CV ~ w } = I \`� . ;:{ '. Ol ` / "I W n LOT AMA • 6287 U
RE �i J� cJ SETBACK LINE .� \ �� \`` \ �'\ � i ' r CL � OUILDMG AMA . 7.363 0
V_ e� l I I `,\ \ \ • i i ; ,'' •� Q� . I (n4CLUDINb EAvE6) 4-1 L
} TOTAL LOT COYER K:,E 7363 ) 052 (IM) •31.1111tr I N
N -fl�l3 SETBACK _
14
LINE i
�; \ `` EL- i w I I EROSION CONTROL NOTES:
M \' 1 'ti , OC
a R� o
` \� ,•� \ '1 , \\\•\�,`\\�• ,, I ';'�� ER To TNe CITY cr PORTLAND '�I�r�elcN CCNTI�oL MA.�Io�'
-�-� co
� E S �� \"' :�.�. . {\� `\` \\ \` • A`n. j 'F^- W POR ADDITIONAL.DETAIL6 AND EIR061CM 074TROL
N1 ( `\• \\�•`` �` ;• \•''\`\\\ I (��� "'^1 I v, I ^ 7)COVER ALL D16TURI=ChFX ND AR"DETUEE4 OCT.I TO ~
\ �r APRIL M.COVER MTw MULCH,BCD,GRASS,PL.ABTIC OR E
O ' \\ �,` \' \ti.\ •\ `• ' �+• j�, OTWR APPROVED MATERIALS A6 6P'ECPI[O IN TWE '1R0610N 0 ,�
M t OrlvrerarsAe+40 MrM1oM1l3lnerrvwH V .' . `•. \',• 1,.•' \ \ -\ \ `•`` ' O CONT1♦OL MAI�JAL'
N
/' �Iwn.� \ ,\�• \ ` r/� .may
\`\\ •\` \\ I I D)SEDIMENT MARRIER TJ BE INSTALLED PRIOR TO EARTRLVWL I Con Lvi
�` �`\� \;N \ I O RETIOVE OILY APTEF4GROUND COVHR 18 ESTAID1.1"D.
• `�'� r.�`rw f OT e 1'1 ` �\ \ \ \ \\,' • 1 �' / X�y 4)NO 601L ALLED TO ERODE OR D! TRACKED OPP 6iTC.
"NMIOnes"
'_� :' O \ ,'\ �` ' \ \
C) LEGE
• rW:;•`,::. . ` ''7 w'� '''• ` � .\ \ \ \ ♦` ` .� }may
��yi• -tit: ; *":2•^'`- ,f.,�.n,.,., , I II .`.�`�\\�\\ \ ' \,N•\\\ `• .I I I (1•`T/� •y"'. ND W-4
..-r , yr:,T,{�r••''� to feeen en6 �
12
r � � \•.� \` � '\•\\•\ \,\`'`\'\ \• •\,\\ ,�` I .._
a .r .yxl'•' �\ \\\`' }r�l�l` � I SL9 R \•\\ I ( GRA `VL CONSTRUCTION ENTRANCE - WE
r)GTAJL AAA At LEFT Y OF
\\,\ ,\\�:\ \•, ,.\�\`,•�\ , f ' PORTLAND E0
'EIS61O14CONTROL ANUAL
O IN T14E MIT
\ '
� lie•' 'TlOd.t1�Q11E�ICE ,` ,�.\.•\•\ �\\ .,� •\ '•. \Q \ `. �. •
��erre..rw,. [' '••' er.re�eflr \\\\,��`•�•\`:\` `,� \�\\\�,\\ ,•`?, \ •` I 2 I
+Mrr a..r.rr...\ / •'�" I II \\ `•\,\ ' ` \\� \\ O l - - ' I COVERED STOCKPILES (�
co►IsrrrutlloN Ennnw7E - wo0?34 rA" \,; CD
LUORPC 6T a3INo i MATERIAL STCRA4E AREAe
wee as* rerr.0 r� \
I:-e'e ryy pwwr�.r 11
L .•bbd / WOODEN 071®RAI'IP - SEE DETAIL 4L1 AT
�T P LEFT ORIN THE CITY OF PORTLAND TR1MCN
.00/�J 0 i CONTROL,MAMAI.'
_':_!'a'.,::.::r;•,y..fi/:Were :: •.. WRAFD
510MA" suk!RADE L— 6. .J 6 P ' C DETAIL
R46 CITY
LAPOWT AND PER --
..
25 �-
DETAIL DRAWINd.9 4.IA- CrRAVEL C0N8TRLIGTION ENTR."--E i' I nate: Jan 3,2002
SETBACK / \ y/i --•---._.` ___— - ____ .�__...._.__ . 6ED'•'ENTPILTERI�AIGIN3 U�
- I \L INE j/ Plan: Custom SFR
rn Fi.�►;4lP+c.w)rsrf! ._ Tref rnp r crate
riT I""J6f3 _� --- — \ � / • -' J W . WATER LINE -
c \ •� ' Aft r PVC LINE PROM METER TO Nou6E) Jab No.: PS-1259-02
' 5R
6D • 6TON 1 6EU.ER LINE -
(USE 3'ADS LINE PRf�M LATERAL TO WOU6E) Revision:
1
. 54 '1SEUIER
1 6 0 1 !� f
88 ANIp INi P11L1 LATERAL TO NOU6E) ---
�' } R-- 4 0. 0 0 l Sheet Title:
N ! L�.�
� � �1 � P _..jr I 0 . WATEk1GMETER dAlE+"1�1T
L - 62. 83
Site
Plan
S . W . LEAH o I
TERRACE CCI PROJECT NIi*—,
...........
............
of
0 1 5
1069
..+ - � !MMM' R •,,►.,.� U► � � �nl ` V J 1
•. rar r�rPJe
� "'„'�"�'""� . �' ._ ___ ---• N ,89°58, 12 105. 81
--DETAIL DRAWMIG 41A- TEI.IPIDRART SEDIMENT FEND!
COPYRIGHT 7007 - PATAKK SIO,, 117, designerin°. 13 --
„ r
.'.-Aeli —......v-Y,rA ...-' .: rA•... �� ns �� w,r_�_ . ..-`.^AWS ... - n_.-_ -..: -._.__ ... ,. .,..- -....... ..�.,. 1,1 R.� ...,.... ,� a ..\.. ..r,.t.�.. _ w,..,.n•.......� �'.t•YMi1MM.•h�..nr.�ew.nFtw;.
JPTI r r I T. �_ i i i I I I ► r I 1 r i I I r 1 r T_ -1 I •.� � I- I I 1 f I _I I I i I I �•I III I I t 1 I_ _I I _I I . 1. �. j .� L. .` I I I I I. 1 t 1 I I I I 1�.� f I I �I I+ I L j .I I I ti .+
NOTICE: IF THE PRINT OR TYPE 0- ANY PTI III III I I I I q j � 1 I I ( 1 T 1 I I 1 1 11 I 1 T I T I I I 11 +
11 I I I C I ! I I I
IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 _ Z :;
[74 _� _ 6 8 10 11' 1 !r �5
IT IS DUE TO THE QUALITY OF THE No.38 6' M"'" '' ,
ORIGINAL DOCUMENTEZ 8�_ LZ 99 9Z � Z f.Z Z TZ OZ 6T 8I 1:, T 9T 9T � T Ei ZT iI t 6 8 L 9 9 �' E Z iDiva
11[101 111-11-11611 �!�� 1111�.1.11� IIIA 1111 Illi .loll ll l 11 ll 11H161-1 til _11 Illi Illi Illi Illi IIII 1111 IIII 1111 IIII IIII IIII sill Illi IIII IIII illi III! Till IIII fill 1.1.11 Illi l.lal 11� . IIIiP
r
,:,;.x e`p+^f^ "'•.�I'r'�":8 3•i4'!r l�f'NsfIs�VF':r:.M'i? .*•`h"Y!4'tF9;� .. •�1P.F,11.,nfi rAtS'9a,�R`�P�it'jTryt. :
t aF
R
w
• co
c �
N
r
c�
I z
2
i
1
1
13691 SW Leah Terrace
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)63q-4171
/ BUP _
Received Date Requested_._..__ l_� __— AM. PM_ T_ BLIP
Location quite_— Mt`
Contact Person Ph(--) 7,(l PLM
Contractor__ Ph( _) _— — SWR
B DI _ 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 �L (JM �I C^l � � C
Framing
Insulation / C , � --
Drywall Nailing ( � 1 Imo.+- EIWAL- -
FirewallS7_P1 7-KCE CG-eo T
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
4Oth Roof
_ASS PART (.FAIL-
PLUMBING c�o G t� �� tazt�
Post 8 Beam ----
Under Slab _.-
Rough-In
Water Service -.-
Sanitary Sewer
Rain Drains -- - - ------ - - -_--
Catch Basin!Manhole
Storm Drain -Shower Pan
Other: - -- -- -- - -- -- -
Final
PASS PRT_ FAIL --..- --__------ ---- — -------.—_____._
CHAN AL _
earn
Hough-In
Gas Line
Sm a Dampers
PASS---,PART FAIL -- ---------- - -- -__ --. ---- --- -- -
ELECTRICAL
--- -------
Service
Rough-In — _---- -- - -- -- - -----
UG/S:ab
Low Voltage - -- ------------ ----------- --
Fire Alarm
Final C-J Reinspection fee of$ _.-.-__-_._required before next inspection. Pay at City Hall 13125 SW Hall Blvd.
PASS PART FAIL
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 fre-1, the job site.
PASS PART FAIL
► ►.IAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA i►
t � CA ►
00.
rri
t7 ti CD
.4 r C� cr ►
CD
canCrQ
� I Z hit
1 I Q, •�
` r
05 ►
44 UQ ►
0
r rD G �, ►
44 G `� ►
1 ~� ►
4 ` ►
t44
►
h - ►
bJ ►
44 Poo.
i.4
44 c, ►
A pill.
4 ►
4 ►
CITY OF TIGARD 24-Hour f
BUILDING Inspection Line: (503)639-4175 MS't
INSPECTION DIVISION Business Line: (503)639-4171
BUP —
Received . 7 �Date R quested ^_ _ AM PM— BUP
I..ocation ._ Suite — MEC
Contact Person _ Ph(_ ) f1 ( ��`� 7 PLM
Co tractor —___— rii( _) -- SWR —
UIL_DING Tenant/Owner __ —_ ELC
Oting
undation ELC _—
Access:
g Drain ELR
ravel Drain
s ab Inspection•. Notes: SIT
P st& Be --_-_
S ear An ors -
E Shea /Shear
Int hea /Shear
Frain --- --------- ---------_---..,------ -_- _-_-._--.---
Ins at n
D I Nailing - -- ---- ----- -- -- -
Fire II
Fire rinkler -�-
Fir Al rm
Su p.d eiling
R of
ther:
fhal ---
PASS PART FAIL — - - - -
PLUMBING
Post& Beam T
Under Slab --- - - -- - --- -
Rough-In
Water Service --- - -------- ---------------- -- -------------
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain --._...----- - - - --- -- -
------ --- --
Shower Pan
Other. -- - ----- - - - -
_�___ --
__ AS PA16 FAIL_ ------
74M
AN AL� --- ------ -- — --- - — — ----
Po & B m
Rou9�► -.— ---- -- ------
Gas A
e Das --- - . -- -- - _ --
i al
ASS PART FAIL - --- -- -- -- ------------- --- —---
E_LEC_T_RICA_L
Service - - --- -- - - --- - - — -
Rough-In
UG/Slab
C W' arm elle
- - ----- - - ----------- - -
Fin -SS PART FAIL I-� Reinspection fee of$_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
A
` I .. I Please call for reinspection RE:--. _ -- Unnble to inspect-no access
Fire Supply Line
ADA Z_y %_�
Approach/Sidewalk Date inspector � -_ _____ Ext —_
Other:
Final lT DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 -3 —aoo
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received __—_ Date Requested___` _ AIA____—___ PM_ — BUP
Location Suite—_ MEG
c—
Contact Person __— Ph( __) ;;?- PLM _--__—
Contractor —_ Ph (----.----) SWR
BUILDING Tenant/Owner — —__ ELC ---
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain --
Slab Inspection. Notes: SIT
Post& Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear _--
Framing -
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler --------- ---- -------
Fire Alarm -
Susp'd Ceiling - -------
Roof
i PART FAIL --- ---- --- ---
RING - —
Post& Beam
Under Slab
Rough-In
Water Service ---- ---- __-__-___--_ __--
Sanitary Sewer
Rain Drains - --- --- - ----- -----
Catch Basin/Manhole
Storm Drain - ---- --- - ------- - _
Shower Pan
Other:
Final
PASS PART FAIL - -- ------___ --- --�--
MECHANICAL _
Post&Beam —
Rough-In --- --- ...--- -- - - - ----
Gas Line
Smoke Dampers ----- -- - --- ---- - - ----------
Final
PASS PART FAIL -- ---- - - - — ----- - -------___.___—
ELECTRICAL
Service
Rough-In -
UG/Slab - -- -..- -_�. ---- - ---
Low Voltage -- . ---- -- -- --- ----------- ------- -
Fire Alarm
Final Reinspection fe,-of$ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd,
PASS PART FAIL
SITE - _ [] Please call for reinspection RE:___ Unable to inspect-no access
Fire Supply Line r
ADA ---
Approach/Sidewalk Date Inspectors —
Other:_ _ "
Final DO NOT REMOVE this inspection recor from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
6UILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 —
BUP
Received Date Req ested_.�TT._�'�_. AM_ - PM_ BUP
location —_ _ i_� J. _Suite MEC
Contact Person _— Ph PLM 3_' d�
Conlractor - ------- --- --- ---- 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 - - - -
Faming __---- ----- - ---- ----- --
Insulation
Drywall Nailing -- - - --- ---
Firewall '
Fire Sprinkler -----
Fire Alarm
Susp'd Ceiling - -- — -— -
Root
Other: -__ --
Final
PASS PART FAIL__ -
-_PLUMBING
Post& Beam -
Under Slab
Rough-In
Water Service ----- ---------__-- - --i�
Sanitary Sewer I
Rain Drains _ -_------_-._--
Catch Basin/Manhole
Storm Drain - --- -- ---- - --
Shower Pan
Other: - - -' - ----- -- --- -----------
AS PART _ FALL __. -_----- _--- - ----- ---- -- -- -MECHANICAL
Post
--Post& Beam - - -- - -----Rough.In -
Gas Line - —
Smoke Dampers --
Final
PASS PART FAIL -- - ----------
ELECTRICAL
----------
Service
Rough-In
-
UG/Slab ------- -
Low Voltage
Fire Alarm
Final
El
PASS PART FAIL Reinspection fee of$ req,lired before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Please call for reinspection RE:_-_ ___- _ r Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk -Date_ a �' Inspector k"', ��t''L-__ -__- Ext _
Other
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CJTY OF TI GARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00400
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/5/03
SITE ADDRESS: 13691 SW LEAH TERR PARCEL: 2S109BA-09200
SUBDIVISION: DAFFODIL HILL ZONING: R-7
BLOCK: LOT: 018 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
T SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install residential backflow preventer.
FEES
Owner:
Description Date Amount
HEIGHTS CONSTRUCTION —
PO BOX 91249 IPLUMBi Pcnnil I�cc 8/5/03 $36.25
PORTLAND, OR 97291 ITnXI x .�
�� terax 8I5I03 $2.90
Total $39.15
Phone : 503-291-2550
Contractor:
THOMAS CONSTRUCTION
P.O. BOX 91283
PORTLAND, OR 97291 REQUIRED INSPECTIONS
Phone : 503-690-4925 RP/Backflow Preventer
Final Inspection
Reg#: LIC 6361
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 issuance, or if work is suspended
for more than 180 days. ATTENTION. Oregon law requireF you to follow rules adopted by the Oregon
Issued By: �( � <'t__ { F /'� Permittee Signature: t,
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Fixtures
Plumbinu Permit Application Received Plumbing ,� 'n
Date/B ri 1 , Permit No.:` r"t,l-�( !3"v T
City Of Tiand Planning Approval Sewer
g Date/By: _ Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By I Permit No.:
Phone: `03-639-41'71 Fax: 503-598-1960 Post Review land Use
Date/By: Case No.: ___
Internet: www.ci.tigard.or.us Contact —v loris; Sec P.gc 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: 1 -� Supplemcnlal Information.
TYPE OF WORK FEE*SCHEDULE(for special Information use checklist)
-❑New construction — _ _U Demolition Description �b'• Fec(ca.) Total
❑ Addition/alteration/rehlacemcrlt ❑Other: W— - New I-&2-family dwellings
C_ATEGORV OF CONSTRUCTION Includes 1011 ft.for each utllit rnnnectlon _
SFR(I)hath 24920
1 & 2-Family dwelling Commercial/Industrial SFR(2)hath ^— -- 350.00
AccessorIuildi� _Multi Family SFR(3j bath 399.00 _
MastCr Builder' Other: Each additional bath/kitchen _ 45,00
JOB SITE INFORMATION and LOCATIONFires sprinkler-sq. fl.: _ F'u e 2
- Site Utilities
.lob site address^/j 4 7 J ,�"i;i �P�ti_ T_e'� --
Suite#: Iild /A t.#: Catch basin/area drain _ 16.60
��—�--- Ur welldeach line/trench dram 16.60
Project Name: /1,
Footin dram no. linear fl. Page 2
Cross street/Directions to job site: _Manufactured home utilities 110.00
/ irClnciMry %Pr+' Manholes —16.60
Rain drain connector 16.60
_Sanitary sewer(no. linear R.) Pae 2
Subdivision: Lot#: Sturm sewer(no. linear fl ) — _ Page 2 -
Water service no. linear fl.l 1 Page ge 2
Tax Wrap/parcel #: Fixture or Item
DESCRIPTION OF WORK Absorption valve 16.60
Backflow preventer , 1 Page 2
Backwater valve i6.60
Clothes washer 16.60
- -- - - --- -- Dishwashcr 16,60 —
_ Drinking fountain M.60
PROPERTY OWNER ---11] �cTENANT I-jectors/sump _ 16.60
Nallle: ,'c Lj� �.+�7 rK./��� Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/Zip: Floor drain/floor sink/huh 16.60
- - - ---- Garbage dis posal 16.60 I
Phone: =Fax: _ Dose bit. 16.60
—APPLICANT CONTACT PERSON__ Ice maker_ 16.00
Name: Interco ton rcasc trap^^ 16.60
Address: Medical B-Xs_value: S Page 2 _—
City/State/Zip: Primer _ 16.60 --
) - _ - --_ -_- Roof drain(commercial) 16.60
_Phone: Fax: Sink/basin/lavatory 16.60
E-mail: Tub/shower/shower fan 1660 _
CONTRACTOR Urinal 16.60 —
Business Name j -s6„f-� _Watet closet _ 16.00
mY� i2-t- M _ Water heater I G.G(1
Address, � k /�_3 other: - - ---
C /State./Zip: G x,72 other: - --
Phone: yz,) 419,Zs- Fax: _Plumbing Permit Fees* _
C_C_B Lic. M (3eo/ Plumb. Lic.#:/2471 --- subtotal 5
Minimum Permit Fee$72.50 5
Authorized Residential Backflow Minimum Fee$36.25
Signature: - rM Date:_/s/�3 — Plan Review(25%of Permit Fee) 5
State Surcharge 8%of Permit Fee 5
(Please print name) TOTAL PERMIT FEE
Notice: This permit application expires if a permit Is not obieined within All new commercial buildings require 2 sets of plans with Isometric or
180 days after It has been accepted as complete. riser diagram for plan review.
*Fee methodology set by"fri--oun' Building Industry Service Board
i:\Dsts\PermitForms\PlnillermitAppdoc 01/03
Plumbing Permi_t_Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppressionstems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain- I" 100' 55.00 0 to 2,000 __ $115.00
-- 46.40 2,001 to 3,600 __- $160.00
Footing drain-tach additional 100' — 3,601 to 7,200 __ $220.00 —
Sewer-1 st 100' 55.00 7,201 andrg eater $309.00
Sewer-tach additional 100' 40.40
Water Service-Ist 100' 55.00 Medical Gas S StCms:
Water Service-each additional 100' 46.40 _ Valuation: Permit Fee:
Storm Rain[)rain• 1st 100' 55.00 $1.00 to$5,000.00 _— Minimum fee$72.50
Storm 3c Rain Drain-each additional 100' 46 40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1-52 for each
additional$100.00 or fraction thereof,to and
Fixture or Item Qty. Fee(es) Total including$10,000.00.
Commercial Back Flow Prevention Device 4(,40 $10,001.00 to$25,000.00 $149.50 for the first$10,000.00 and$1.54 for
each additional$100.00 or fraction thereof,to
Residential Backflow Prevention Device _ and including$25,000.00.
minimm uemiit tee$36.25 2i.55 —
Rain Drain,single family dwelling 6515 S25,001.00 to$SO,OU(1.U0 $379.50 far the first$25,0(10,00 and$1.45 for
each additional$100.00 or fraction thereof,to
inspection of existing plumbing or and including$50,000.00.
�specially requested Inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
F-- Subtotal: each additional$100.00 or fraction thereof.
Fixture `'York:
Are you capping,ntoYing or replacing existing fixtures' If
,,Yes",please indicate ivork perforated by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
uantit h Fixture Work Performed Comments regarding fixture work:
Fixture Type: Replace
New Mu,ed Existing __Lpped
Baptist /font --""—
Bath -Tub/Showcr
-Jacuzzi/Whirlpool --
Car Wash -Hach Stall _ -- --- ----
-Drive Thru
Cuspidor/Water Aspirator _
Dishwasher -Conmtercial - -'-
-Domestic
Drinking Fountain
Eye Wash
Flom-Drain/sink 2" -
3.,
Car Wash Drain *Note: If the fixture work under this permit results in an
c',arhage -Don>rstic -- increase of sewer EDUs,a sewer permit will be issued and
Disposal -Commercial _--_ —
-Industrial _ fees assessed for the sewer increase must be paid before the
Ice Mach,/Refrist.Drains plumbing permit can be issued.
Oil Separator Gas Station —
Rec.Vehicle Dump Station
Shower -Clang -
-Stall
Sink -Bar/lavatory
-Bradley
-Commercial _
Service
Swimming Pull Filler --
Washer-Clothes
Water Extractor
Water Goset-Toilet —
Urinal _
Other Fixtures:
i\Dsts\Permit Forms\PlmPcmtitAppi'g2.doc 01103
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
DAVID JEROME ELECTRIC RECEIVED
PO BOX 751
HILLSBORO, OR 97123 MAR 0 '7 2003
CITY OF TIGARD
BUILDING DIVISION
Electrical Signature Form
Permit #: MST2003-00004
Date Is�-:,ed: 3/5/03
parcel: 25109BA-09200
Site Address: 13691 SW LEAH TERR
Subdivision: DAFFODIL HILL
Block: Lot: 018
Jurisdiction- TIG
Zoning: R-7
Remarks: New SF detached, PAth 1.
Your company has been indicated as the electrical contractor'ror 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: Bl;ilding Division.
No electrical inspections will be authorized until this completed form is reckeived
OVVr4FR: ELEC- RICAL CONTRACTOR:
HEIGHTS CONSTRUCTION DAVID JEROME ELECTRIC
PO BOX 91249 PO BOX 751
PORTLAND, OR 97291 HILLSBORO, OR 97123
Phone #: 50-" .,.',91-2550 Phone #: 648-5144
Req #: 1.1( 36051
SIT 28771
1'.111 34-11Q('
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of SupervSsmg Electrician
If you have any questions, please call 1-;03.718.2433.
�\ CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00158
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 6/10/03
SITE ADDRESS: 13691 SW LEAH TERR PARCEL: 2S109BA-09200
SUBDIVISION: DAFFODIL HILL ZONING: R-7
BLOCK: LOT: 018 JURISDICTION: TIG
Proiect Description: All encompassing low voltage.
A. RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: X AUDIO&STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVA,1: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTE 0: X FIRE ALARM: OUTDOOR L.ANDSC LITE:
OTHER: ALL ENCOMh : n HVAC: PRO''^CTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
HEIGHTS CONSTRUCTION QUADRANT SYSTEMS
PO BOX 91249 PO BOX 14833
PORTLAND, OR 972.91 PORTLAND, OR 97293
Phone: 503-291-2550 Phone: 234-5558
Reg#: MET 00002466
SUP 1211.1,,
_ LIC 96806
FEES ELL Fl6q`6f'i}Itnspections
Description Date Amount Low Voltage Inspection
I1:1-PRMT] 1'1.11 Permit 6/10/03 $75.00 Elect'I Final
iTAX] 8°i4State'lax 6/10/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard PAunicipal Code. State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance wi,h a)proved plans. This permit will expire if work is
riot started within 180 days of issuance, or if work is suspe,ided for more than 180 days. ATTENTION Oregon law
requires you to follow ruies adopted by the Oregon Utility Notificaticn Cf.nter 1 ._se rules are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain copies of These rules ordirect questions to OUNC at (503)
746-6699 -7
i
Issued by NLti.t,['�1 Permittee Signature_ /-�-
OWNER INSTALLATION ONLY
The install?tion is being made on property I own which is nit intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SU'PR. ELEC'N _ DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
-16/10/2003 07:55 5IKKe362322 QUADRANT SYSTEMS PAGE 02
Electrical Pernod. ApplicationReceived . Electrical -
-- DatelD C -OIL V'i�� Permit No: --�
Planning Approval Sign
City of Tigard DatofBv; PernlitNo _-
13125 SW H,.11 Blvd. Plan Review+ Other
Tigard,Orcg n 97223 Pcrrrtit No. —
Phonc: 503-639-4171 Fax: 503-598-1960 Post-Rcvicw i.and Usc
Datc� Case No,:
Internet: wvw.ci.tigard.or,w Contacts. -See Page.2 for
24-hour)nspcction Requcgt: 503-639 1175 Nome/Method; i�t I supplemental Inforntatlon.
WORK PLANREVMW.(Pletaee check ill,thftt fiPel►�New construction ❑I)cmohtion service over 7.25 amt Health-carr facility
-+��— Commercial 0 Flazltrdous location
U Addition/alteration/repla'eementl (Jibe!: ❑ten ice over 320 snips voting of ❑Building over I O,OW square.fcc6
'r:ATEGrORX QrF CONST01if_'1ION . _ _ 1 &.2 family dwellings four or more rc%idential units-ti
l�l1c 2-F2mily dwelling Comm.rcial/Inaustrial ❑System ovcr 000 volts nominal one 9tTUetUte
Building over Three stones ❑Feeders,400 amp+nr more
J&c�.cesso Buildtn Multi-Famil occupant load ovcr 99 persons ❑Manufactrtrod rtruclures or Rv pat'•
aster Builder —El Other: rJ esressniRt,nnR plan other__
J06 5Ti'Fi'IN1tTr1RM#`I ON"ntld LOCATION Submit sets of plans svith any orthe above.
The above arc irt applicable to temporary cunatruction service.
Job site address 13 9 �1-- -�i - +t���---1-` --- ;FET":,s4` ED .,.
Suite #: Bid •/Apt.#: Number of ins ectMns er ermit allowed
Description _ 7 Vty Fel(ea.) Total
New residential-single or multi-famlly per
Cross StrcetmlT/CCt1U17S toJOb Site: dwelling unit.Ineludee attached garage.
A^ It J h;Jn1 Q r-+ Service Included
/i 1000 qq R ur less _ 145.15 4
U Each additional 500±S R oran theteor
-L- Limited energy,residential 75.00 2
Subdivision- _ 1•ut#: Limited rrrc a non residential - 75.00 _�- Z
Tax ma /parcel : Fach mmwdnatured home or modular d�Img
p g ";`4DESCRiPTION'aWORK sen ice and/or feeder __ 9n.90 2
errvkeq nr reelect-installatialterationm, altetlon or releeatlnn:
200 amps or lase
20l�mpe to
401 amps to 600 am 1 2
601 am,to 1000 amoo 60 2
- 454.65
purr 1000 a or voila2----____--
� __---
Name: _ _ a eonneet only 66. s 2-
Address: - _� T :mporary services or feeders-Installntion,
ai-rotion,or relocation:
City/State/Zip: 200 amus or Icss __- 66.95 1
)'bone: Fax; I am�eto400amps____ —too-_10 2
- f,� IN ACT.'PWOlv1 401 to C>nU am a 133.75 - 2
PICANT;,,' _ _ — Branch circuits neer,alteraNnn,or
Name: _ exten%Ion per panel-
A.Fn fat branch circuits with purchase of
Address: J _ _s^rvice of feeder fee each branch circuit 6.65 2
ice of r. circuits w-brat h circuit
of --
__ !:
ice or kxder fee.first branch circuit 4105
Phone: Fax: — - e " ,dditionol bench circuit 6,65 2
N I• .(Service or frcder not included)!
r'CONT ► i F ,t taanp or irriptian circle —_--- 43.40 _-- 2
A afgn or oulli_ ne 53.40 2
Job No: 3t-u a- _
_ goal cireuiNe)m a limited energy panel.
- AUeratirm m extetainn Page 2 2
Business Naixte: _ ad�, � �+S !� Dt,eripl nn — -
Addr_ess: ?p tSL-.)l 1 P•33 V' _ _
- -- -- � Each additional inspection over the allowable In an of the above:
L�/State,/Z'i ti`s r rI.T Z) 1J r! f:�inspection t.aur mind ho>u� 62.50 -
Phone: 23. a.34 55�- Fax:S�3 .I-i ' �aJ- Inveati�alion Ice
CC_S Lic. #: Lie.#: �� S�5 cCP _ ot►+er: nrd>tt"ck►1: rEl
Supervisin- electrician J _ _ J� subtotale
signa*are xc. uued. Plan Re"icw(25%of Pe mit Fec $
J -
Print Name: .h�lG.LL „�• i� Lic.#: j lI Z __ State Sureha a t3°/a of Pctmit Fee _
- - _ TOTAL PERMIT FEE s v
Authutizcd Notice: his permit applitAtien expire%if a permit t not obtalned a•Ittlln
Signature Cate. K�_•,a3 180 doya ager It has been ureptrd a.complete.
•Frt methodology%rt by I rl-'onnh Fluilding Inds' -v Service Bnard.
—
(Pleavc print tame)
i.\r)sta\PermtiFrnmr,',ElcPermitApp.doc 01iO3
CITY OF TIGARD MASTER PERMIT -
PERMIT#: MST2003-00004
DEVELOPMENT SERVICES DATE ISSUED: 3/5/03
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171
SITE ADDRESS: 13691 SW LEAH TERR PARCEL: 23109BA-09200
SUBDIVISION: DAFFODIL HILL ZONING: R-7
BLOCK: LOT: 018 JURISDICTION: TIG
REMARKS: New SF detached, PAth 1.
BUILDING
REISSUE: STORIES. 3 FLOOR AREAS REQUIRED SETBACKS _ REQUIRED
CLASS OF WORK: NEW HEIGHT 13 FIRST: 1 51H of BASEMENT: %f LEFT: 20 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD 41.-, SECOND: 1 555 of GARAGE: 61: of FRONT: 17 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 1MR0 908 of RIGHT: 5
_
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL •+ VALUE: 194 000 80.u01 of REAR: 12
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH. 1 LAUNDRY TRAYS: 1 RAIN DRAIN: n TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 1 RF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1 P,�KFLW PREVNTR: GREASE TRAPS:
MECHANICAL OTHER FIXTURES:
FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS- CLOTHES DRYER: 1
'lA5 FURN> 1OOK: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: blit FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLE-'S: 5
_ ELECTRICAL
RESIDENTIAL U'41T – SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS__
1000 SF OR LESS ' 0 - 200 arm 0 -200 amp WISVC OR FDR PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF. H 201 - 400 amp. 201 400 amp Iat W/O SVC/FDR. SIGN/O'JT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600, rn 401 000 amp. FAADDL BR CIR. SIGNALIPANEL. IN PLANT:
MANU HMrSVC/FDR: 60! 1000 amp: 601 pampa-1000'. MINOR LABEL.:
1000.4mplvolt
PLAN REVIEW SECTION
Reconne^.t only' — --- --
-4 RES UNITS SVC/FDR-225 A.: G00 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL-RESTRICTED ENERGY _
A.f F RESIDENTIAL B.COMMEFCIAL
AUDIO 6 STEREO: VACUUM SYSTCM: AUDIO 8$1 EREO: FIRE ALARM: INTERCOM/PAGING, OUTD)OR I.NDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG PROTEC i1VE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL. OTHR.
HVAC: DATArTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner. Contractor: TOTAL FEES: $ 8,479.14
This permit is subject to the regulations contained in the
I1EIGHTS CONSTRUCTION HEIGHTS CONSTRUCTION LLC Tigard Municipal Code,State of OR Specialty Codes and
PO BOX 91249 PO BOX 91249 all other applicable lav/s. All work will be done in
PORTLAND,OR 97291 PORTLAND,OR 97291 ar.Cordance with approved plans. This permit will expire if
N.,ri•is not started within 180 days of issuance,or if the
7v is suspended for more than 180 days. ATTENTION
1. Dn law requires you to fellow rules adopted by the
Phone: 503-291-2550 Phone: 501-291-2550 - .yon Utility Notification Center. Those rules are set
forth in OAR 952-001.0010 through 952-001-0080. You
Reg 0: LIC 133745 may obtain copies A these rules or direct qu,,stions to
OUNC by calling(503)2=6-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Electrical Rough In Gas Line Insp Water Service Insp Building Final
Sewer Inspection Crawl Drain/Backwater Framing Ir,Sp Gas Fireplace Appr/Sdwlk nsp
Footing Insp Mechanical Insp Shear Wall Insp Insu.ation Insp Electrical Final
Fo.ndation Insp Plumb Top Out Exterior Sheathing Insl Rain drain Insp Mechanical Final
Post/Beam Structural Electrical Service Low Voltage Water Line Insp Plumb Final
Issued By : s •' Permittee Signature :
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bu-!,iness day
CITY OF TI GARD _ SEWER CONNECTION PERMIT
PERMIT#: 3/5/03 3-00010
DEVELOPMENT SERVICES
DATE ISSUED: 3/5/03
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171
PARCEL: 2S 109BA-09200
SITE ADDRESS; 13691 5W LEAH TERR
SUBDIVISION: DAFFODIL HILLZONING: It-7
BLOCK: LOT: 018 JURISDICTION: 'FIt;
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE. CF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF.
Owner: FEES
HEIGHTS CONSTRUCTION Description Date Amount
PO BOX 91249
PORTLAND, OR 97291 [SWUSAI Swr Connect 3/5/03 $2,300.00
[SWUSAISwr Connect 3/5/03 $0.00
Phone: 503-291-2550 [SWINSP) Swr Inspect 3/5/03 $35.00
ISWINSPI Swi-Inspect 3/5/03 $0.00
Contractor: Total $2,335.00
Phone:
Reg #:
Required Inspections
1 his Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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 ,ide sewer laterals. If the sevver 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 and Side Sewer" Perm
�j Permittee Signaturry
Issued by: .1 /: /��''�1fi��-> —
Call (503) 639-417-. by 7:00 P-M. for an inspection needed the next busine s day
YkJ�= I •�r' t r � � ,
Building Permit Application
Date received: I Permit n9M
City of Tigard
Address: 13125 SW Ifall Blvd,Tigard,OR 972 . Projecdappl.no.: Expire date: V
Ciryoffigard Date issued: By: Receipt no.;
Phone: (503) 639-1171 1 `i, _i
Fax: (503) 5984960 a Case file no.: Pit)irent type:
'/
Land use approval: _ V ' I ���` _00 1&2 family:Simple Comp?^x:
, 1
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition '.
U Addition/alteration/replacernent, U Tenant improvement U Fire sprinkler/alarm 0 Other:
{ SITE INFORMATION
(� \ :�� ,fa .•� t�1,B, �1 BldB•n i Suite no.:
Job rddress: _ '•� _ -
Lot:_l i Block: Subdivision^pA DAA \LI✓ ='ax map/tax lot, ccount no.: 7
Project naraeil'+ L \1.L -�-
Description ind location of work on premises/special conditions: sll�lZLh[�LL` _1� 1_Q �L _ I
0%I Nl'lt I OR SPECIAL INFORMATION, USE
Mailing address: p, ( —q - _ 1&2 tamUy dwe1I1W
City p���.C�-1�D _-__IState:p�i ZIP: '� Valuation of work....................................... $
Phone: -2°I
v Fax: 9 - f E-mail: No.of bedrooms/baths................................. _ 4_
_Owners representative: Q H Total number of floors.................................
f I
Phone:Su'y.9(o5-4573 Fax: G-3S5q E-mail.Sulnrrrp Q 1`lew dwelling wra(sq,ft.) ..........................
Ciarage/carport area(sq.ft.) .I...................... W L_----
Name: PPrT¢�UL �h�ry I> Covered porch area(sq.ft.) ......................... b e
Mailing address: 51 Z 4 MP'�IgUU 0 �?I. Deck area(sq. ft.) ........................................
�-
-- _ �____
City: L;;'r 0 v� Stated ZIP: Other structure area(sq.ft.).........................
Photic.'I -AS T 3 Fax:LAO-3164 E-mail: " CommercInVind lRumulti-family:
Valuation of work......\\.... ................. ........ $
WN I[U111 Eli
Existing bldg.area(sq.ft) ...... . ..............
Business name: �} h�(5 p� 1,7 New bldg.area(sq. ft.)ft ...... ..........
Address: - -- — Number of stories.........
—._ --
city: state:pe. ZIP: 291
�— Type of construction✓:..............................
Phone,: L��'jf 5p Fax: 291.(All I E-mail: Occupancy gro Existing: __ --
_CCB no_��tj _ _—_-- New:
City/metro lie.no.: Notice:All contractors and subcontractors are required to be-
ARCHITECtIDESIGNER licensed with the Oregon Construction Contractors Baird under
Nance: 1(► C 'L^ provisions of ORS 701 and may be required to be licensed in the
Q�e1G jurisdiction where work is being performed.If the applicant is
Address: AL2 V 3W (' 91.
City: p State ZIP:�7 exempt from licensing,the following reason applies:
Contact person: MACY- _ Plan no.
Phone: 1 tj Fax: -3'�F Err..il: "` --------- —__._.._
Name _\� Contact person: Fees due upon application ....................... ... $ —
Address: �p 4J AEoi1r11�fiTQ Date received: _
-- —
city: Vp,�k_ A State.:\j ZIP: Amount received ......................................... $
Phone: Fax: _ro0' Etaai�: Please refer to fee schedule. ' v—
1 hereby certify 1 have read and examined this application and the Not all jurisdretiorr recto ae t cards,plomse call juridiufm for mcxc information.
attached checklist. All prnvisionj of laws and ordinances governing this ❑Visa U MasterCard
work will be complied w s .cified herein or not. credit card number ----- -_- —1 -1—
If Expires
Authorized signature: __ Date: �l ot, — y— Now of eardhotder as shown on credit card
1+r1�-. {.( ---
Print name:..-._ 1 l� - — cadlydder dprnure _ Amoaot
Notice:This permit npr.lication expires if a permit is not obtained witf.in 190 days after it has been accepted as complete. 4404611(tultYc'oM)
CU I PROJECT ('
1069 - 013
RECEIVED CCI #
JAN 2 4 2003 1 0 00
Clair Company,Inc-- By JLT
Building Fixtures
Plumbing Permit Application
Date received: Pe-n it no.:
CityCit of Tigard ------- --- _. __ --------- ------
g Sewer ncimit no.. Building permit no..
Address: 13125 SW Hall Blvd,Tigard,OR 97223 --- ----
Cay of Tigard phone: (503) 639-4171 Project/appl no.: �— Expire date:
Fax: (503) 598-1960 Date issued: By. Receipt no.: _
Case rile no.: Payment type:
Land use approval: TYPE OF
PERMIT
Vw2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement construction U Addition/alteration/replacement U food servicU Other:,
Description I Qty. Fee(ea.) Total
Job address: ��j(�( _6_#4W "«_ _ ----- Nen 1-and 2-family dvrellirgs only:
Bldg, no.:T Suite no.: (includes 100 ft.for each utility connection)
Tax map/tax lot/account no.: SPR ())bath
Lot: Block: Subdivision: ,_ SFR(2)bath
Project name: pp,, p\L Nom.,, SFR(3)bath
City/cooY: Gl�`1 plT%4je*A,. ZIP: - '1*72.71 k Each additional bath/kitchen
Description and location of work on premises: Qy�-, Irk SF'2— Site utilities:
Catch basin/area drain
DrywEst.date of completion/inspection: Footing
drat ( line/trench drain _ ^_----
Est. drain(no_lin. ft.)
CONTRACTOR Manufactured home
Business name: �M��i,�M6w�- _ Manholes
Address: O io,f• _]),(�Q— Rein drain connector
City; State: /(_ ZIP: c�'7 Sanitary sewer(no.lin. ft.) - —
Phone: Fax: L L F-mail: Storm sewer(no.lin.ft.)
_ (A-41-A 4-� -- L• — Water service(no.lin.fl.
CCB no.: Plumb.bus.reg.no: �6
-- �� 9--� Fixtureor item:
City/metro lic.no..__ dapp f tp g _ Absorption valve
Contractor's representative signature: Back flow preventer
Print name: Date: Backwater valve _
CQNTACT PERSON Basins/lavatory _
Name: ( � �k i..tl7� Dishwaoffii—essher washer
,, Dishwasher _
Address: L(./ d,I.J S 1 Drinking fountain(s)
City: Qrf(I,''1✓lp 10 SState:ojZIP: 1. Ejectors/sump _
Fax Z�G'3 Sq E-mail: s Expansion tank
Phone:j 57? p _
Fixture/sewer cap
Floor drains/floor sinks/hub
Narnc(priul): -p.(L, PI t. s.-
- _�1�.�.�—`-- -- --- ----- Garbage disposal
Mailing address: P t7 pt _TLA
_ Hose bibb
State' ti i1.1P
City: Vog _._� —__1,--_`L1 X11_ Ice maker
Phone: • t-55o Fax zZ° II-O Email Interceptor/grease trap
Owner in6tallation/residential maintenance only: 111c 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: _ Sump
Tubs/shower/shower pan _
Urinal
Nvnte: —
Water hewer
City: State: LIP: Other:
Phone: Fax: E-mail: Total
-- --- --- Minimum fee. ............ $
Not all jurisdicsions actepr credit cods,plusc call jurisdiction for more informarkm Notice: Phis permit application U MasicrCarS
U viJ
sa ct Plan review(at 9 %)
esPires if a lx;rmit is nM obtained (K°.'°)State surcharge(
Ciedif cud number. —__—_ _ -. I I — within 180 days after it- has been
- Expires
accepted as complete TOTAL. s
Name of end a svn no credit V—
'-"......'•"••""•"
Cardholder N`naturc — -_ Amount __ 440L 4616(&WCOM)
CCI PROJECT
1069 .. 01 ,E
JAN .- `l,►r;± �o
Clair cmp my�Inc, yv
Electrical Permit Application
Date received: Permit no.:
City Of Tigard Projecdappl,no.: Expire date:
CiryoTigard Address: 13125 SW hall Blvd,Tigard,OR 97223 Date issued:-L _ By: Itcccipt no.
Phone: (503) 639-4171
Fax: 1503) 598-1960 Case file no.: Payment type:
Land use approval: _
TVPE OF PERMIT
IItic 2 family dwelling oi accessory U Commercial/industrial U Multi-family U Tenant improvement
ew construction U Add ilion/ailcratlon/replacement U Other: U Partial
I SITtl INFORMATION
Job address: / Bldg. no.: — Suite no.: Tax map/tax IoVaccount no.: - _—
Lot;--- Subdivision: F�jpl�, �41t•l,, — —
Project n A, r0Q Il. }i i��- Description and location of work on premises: IN l;a SFR.- -
Estimated date of completion/inspection:
CONTRACTOR APPLICATION
Max
JTool Job no: _ _ ��
-- llescriptlon Qty. (ea) no.lnsp
BttSIneSS lame: ).Pr. S - --- �II�IC.i_ �— Newreddlentiat-sirmleormulli-landlyper
Address: V*C,f ��\ _ dwellingurN.Inciudmattached garage.
City: Stale attllf'_`(1i2.3 -- tienicehrclnrkd
I oleo sq.ft.or Inas 4
Phone: Coo$ 5144 raX:G4 L3 E-mail: _ Each additional=oo sq.ft.or portion thereof - --
CCB no.: ILe061 1 Elec.bus.lic.no: L_ Limited energy,residential _ 2
City/metro lic.no.: _- Limited uncrgy,nr c r-dential _ 2
Loch manufactured home or modular dwelling
Signature sup
of eryricia
ising electn(required) Dot �9 Service and/or feeder _ 2
I.iccnscnu. -fir bc.wlmorfeeders-Installation,
Sup.elect.name(print): t0 hZ�( , attention or relocation:
PlIfOPER'll-VOWNHI200 amps or less_ I 2
201 amps to 400 amps --- -- - - - 2
Name(print): �jf.4(z tiF MRR �- _ -- 401 amps to 6W amps --_- 2
Mailing address: 601 amps to 1000 amps 2
City: � �� Stateon- ZIP: `77Z Ov�r_I(M1tr -,a or volts -- —— — I
rax:!Oi�' 1'J E-mail: Re-.,nnecionly
Phone: 7-11-Z 5(o �,�� - ---- -
-
Owner installation: temporary services or feeders The installation is being made on property I own Inslallatlon,alteratlon,orrcloatlon:
which is not intended for sale,lease,rens,or exchange according to 21x1 amps or less2
201 am
ORS 447,455,479,670,701. - ---
amps to 400 amps 2
Owner's signature: Date: 401 to 600 am-)a 2
Branch eircut s-sen,alteration,
or extension ter panel:
Name: _ __.__ A Ire,for hrmu h circuits with purchase of
Address: service,or feeder fee,each branch circuit 2
Stale: ZIP: B Fee for branch circuits without purchase
City: _ of service or feeder fee,first branch circuit: 2
l br
Phone: Fax: L mail Each additionaach ncircuit: _- -
Mise.(Service or feeder not Included):
O Service over 225 amps-commercial Cl Ileelth-care facility FAch pump or irrigation circle 2---- 2
❑Service over s20 amps-rating of t&2 U Hazmdous location Each sign or outline lighting _ _
familydwellings U Building over 10,0(10 square feet fournr Signal circuit()or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration,or extension"
U Building over three stories U Feeders,400 amps or more •1>escription:_ -.—_— ----- ------- --
O Occupani load over 99 persons t 1 Maruractwed suucmtcs or RV park Each additional inspection over the allowable In any of the alcove`
O Lgress/lightingplar U Other 1'erinspcction _
isubmlt____sets of plana with any of the above. Invcsugation tee- _ _�_
The above are not applicable to temporary construction service. Other
Permit fee.....................$
Not nn jurisdictionsore accept credit cards,please call jurisdiction for minfonnaltoa Notice: Ibis permit application
OVisa U MasterCard expires if a permit is not obtained Plan review(at __ %) $ __-- — -
hc
Credit card number --- within Starr.surcharge R%180 days ailer it has been t' ( ) ."'$ —--
-- Expires a:.cepted as complete. TOTAL .......................S
Name d cv�id-dn a dawn on cralh
—cod-'--- s
--- Cxtdbtdrkr xiNururt - -- - --TAmswnt_ 441:4611(6,faV('1W
i
CCI PROJECT N -'
1069 - 013
IIECEMID
JAN -' ; ZG03 0 0 ID
Clair Company,Inc. Hy
Mechanical Permit Application
Datereceived: Permit no.:
City of Tigard Projecve l.no.: _. _
Address: 13125 SW Hall Blvd,Tigard,OR 97223 PP _ Expire date:
CiryojTigard g �T ,--
Phone: (503) 639-4171 Date issued: _ By: P-cipt no:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval. _ Building permit no.:
A I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/mplacement U Ocher:
WJ P in 10 K1111 LW
Job address: \' (^I � L�� �(��, _ Indicate equipment quanlilies in boxes below. Indicate the dollar
Bldg.no.: — rSuite no.: _ value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: __ profit. Value S ..__-
Lot: Block: (Subdivision: 'tire checklist for important application information and
Project name_ j� ��_�}�LV - jurisdiction's fee schedule for residential permit fee.
City/county i AjLip. ZIP: �ZZ ----
------- -
Description and lavation of work on renriscs: t10 11 ti fm Rul I I Ll
Est.date of completion/inspection: Desai Qt . Res.oal !ft.only
Tenant improvement or change of use: C:
Is existing space heated or conditioned?U Yes U No Air handling unit CFM
Is existing space insulated?U Yes U No 1r con oniig(s to pan require ) _
lei Tere no existing AUC .ayslcm
loi--i er/compressors - -- -----
Business name: hI ACLSAt�c},,` State boiler permit no.:
Address: 1 - - ftp Tons BTU/H
--� t� ---- __ C'irclsmoTce3ampers/ductsmokedclectors --— -
Cit-: fl"I�Pr-� State ZIP: '�Z�O pump p n—required—)`- -- ---
d Heat um (ate a
Phone: Fax [�� E-mail: n5 rep Ice umace7liurner.� '�)' --
CCB no.: - �j�5- Including r uclwork/vent liner U Yes U No
nsT-talUrcp ac re ocate eaters-suspen --
City/metm tic.no.: _ - wall,or floor mounted
Name(please p int): �— Q — 'Vent or app iance other thanurns'ace --
UONTAUf PERSON
efr goat od:
Absorption enol.-� BTU/N
1Vtinte:�AT((lGl(r '�[ M Iii Chillers--_ —_ _ _ Ni'
Address: _501-(w? SU lna,tLkr-.A —� -` Com essors _ lip -
_Cit y --State �tv rorunenta ex rid to rent at on:
- �T :Qlt� 7.[P: Appliancevent
Phone11 Fax: -3 S i E-mail: Y.Fill ryerex aunt - - -
s�`Ype res. uc a a2mat --
hood fire suppression svctem
Name: l� � Mp,O ��f _ Exhaust fan with single duct(bath fans)
Mailing address: _ 17r '��TqM auiT-st a stem eiart from from or AC
City_ vf)ry State: N 7.IP: 2Gl( -T-"el p p ng mit st ut on up to out ets
Phone: -- rYPe ----LPC( Na Oil
Fes' E I' Ue I in,ac ad rtwna over out els
r'oceas p (schematic required)
Number of outlets --
Address: — i rcr a or —
fkcora.tive fireplace
-state: -__ ZIP: nseit type_ -
Phone-- _ - -1_� r .L --- � v�T e�ove- -
Applicant's signature: - Date: [ - -
Name (print): �� - 3 Other: ----
Na rl JrMractlas ccep c",cards,ptcese can Jri,diction for mare Idam kit -- Permit fee..................... --
U Visa U MasterCard Notice:Thio permit application Minimun,fee................$
Credit rid mimbr: - expires if a permit is not obtained Plan revicH f at 9c) -
C,p re, within 180 days slier it has been --------
--h"p° "rdir rrW—— accepted ac complete State surcharge 18%) ....$ _
t
TOTAL _..... .............. $ --- ---
_-_ CrdhaJde�-jnN�re—- Amy"
41044517(NOWOM)
CCI PROJECT I",",
1069 - 015
RECEIVED CC[ #
JAN 2? 4 2003 1 006
Clair Company,Inc. BYAL
C
o�
0
� c
0 1
v
�` H
ti
r \ L y
E
O
f\ `7 i y
•IV v 'f
U = �
�0
CL
J �
3 �