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13874 SW LEAH TERRACE-1 I b. 1 s i 13874 SW LEAH TERR r ELECTRIC �LPERMIT CITY OF TIGARD _— PERMIT#: EL.C2001-00313 DEVELOPMENT SERVICES DATE ISSUED: 06/14/2001 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 ARCEL: 2S109BA-06900 SITE ADrRESS: 13874 SW LEAH TERR SUBDIVISION: HILLSHIRE SUMMIT NO. 2 ZONING: R BLOCK: LOT : 055 JURISDICTION: TIG Proiect Description: Installation of(1) aranch circuit for hot tub. _RESIDENTIAL UNIT_ _ TEMP SRy/C/FEEDERS MISCELLANEOUS _ — 1000 SF OR LESS: 0 - 200 amp: — PUMPARRIGATION EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC! FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVIC c/FEEDER BRANCH CIRCUITS —_ ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 arnp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _PLAN REVIEW SECTION __, 1000+ amn/volt: — >=4 RES UNITS. > 600 VOLT NOMINAL _ Reconnect only: ._ SVC/FDR >=225 AMPS.: --_—CLf.SS AREA/SPEC OCC: Oviner: Contractor: NE EGELI, JOHN F + DIANA M OWNER 13674 SW LEAH TERR TIGArD, OR 97224 Phone: 'hone: deg#: FEES — — Required Ins.)ections 'Type By Date Amount Receipt Elect" Fi,ial PRMT CTR �)e114/2001 $46.85 2720010000( 5PCT CTR 06/14/2001 $3.75 2720010000( Total $50.60 This Perm,t 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 e-+ire if work is not started within 180 days of issuance,u. Nork is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by tr e Oregon Mility Notification Centar. Those rr:les are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may ob ain cApies of these rules ordirect questions to 011NC at(503) 2466699 or 1-800-332.2344 r Permit Signature: �,�1�� ,� � 7� ;ssued by: OWNER INSTALLATION ONLY The installation is being made on property I own which is not int(.nded for sale, lease, or rent. OWNER'S SIGNA ORE: __.__—__ __ DATE:— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: 6G �!_E�t_ __—___—.--_-_.-.____— DATE:.— LICENSE N O: - --- —— — --- — —— ---- -- ------- Call 639-4175 by�':00pm for an inspection the next business day j Electrical Permit Application Datereceivedy al Permit no.: 1.aq313 City of Tigard i Project/appl.no': Expiredate: i t in of 1'i�unj Address: 13125 SW Wall Blvd,Tigan, 22a Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: — 6J I & 2 family dwelling or accessory U Comrnercial/inylil U Multi-family Ll Tenant improvement U New construction ,el Addition(aflcratiot>/u fr cement U Other: U Partial Job address: ! ^ 7� ' '� ' ! _/+ r Nldg.no.: Suite no.: 'fax map/tax lot/account no.: Lot: Block: _Subdivision: Project name: _ Dr;sct7ption and location of work on premises: Estimated date of co npletion/inspection— - - -- _ Job no: Fee Max y� -- 1)ksrripllnn uty• (ca.) Total no.Insr Business name: Q LAJ ra/.. _ Newn,ldrnliol-single or multi famllvper Address: _ dwelling unit.Includes atlached garage. City: Slate: ZIP: service included: Phone: Fax: E-mail: lax,sq.ft.or Iess 4 -- Each additional 5W sy,ft,or portion thereof CCB no.: Elec.bus.list.no: Limited energy,residential _ 2 C i(y/metro lie.no.: — - Limited energy,non-residential _ 2 Each manufactured home or modular dwelling — Signature of'supervising electrician(reyuto l i Date Service and/or feeder 2 Sup.elect.name(print): License no: services or feeders—Installation, alteration or relocation: gal amps or lees _ 2 Ndme(print): F e!+ r / /, ( t 201 amps to x,10 amps 2 401 amps to Gal amps 2 Mailing address: ( '' IN / �.� !_.F rt f t — -- 2 — 601 drops 10 10a)amps City: f ► r t A rJ r, __ Staler R-- ZIP: '77: ? 'I Over I000 amps or volts _ Phone:S,'e - y I fax. I E-mail: Reconnect only owner installation:The installation is heing made on property I own Tetnpontyservices orfeeders- which is not if for sale, lease,rent,or exchange according to Installation,alteration,or relocation: ORS 44-i,455,479,6701 701. 2W amps or lesr 2/ 201 nmps to 400 amps 2 Owner's si m.,ture =tit - Dille, 401 to 600 ams -- -- - 2 Branch circuits-new,alteration, or extension per panel!Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch orcuit 2 City: State? i',I1': B. Fee for branch circuits without purchase ----- ---- --- of service or feeder fee,first branch circuitI'hnnr I ak F. mail. Each additional branch Arcuie Mime.(service or feeder not Included): U Service over 22S tuops commercial !J I ICallh-care facility Each pump or irrigation circle 2 U Service over 120 amps-rating of 1&2 U Ilazardouslocation Each sign or outline fighting 2 famil;dwellings U Ruildin�over 10,000 square feet four or Signal circuits)or a limited energy panel, U System ever 6W volts no,ainal more residential units in one structure alteration,or extension* 2 U Building.weirthrix stories Ct Feeders,400 nmps or more *Description: U Occupant load over 99 persons U Manufactured structures or RV park Fisch additional Inspection over the allowable In any of the above: U Egress/Iightingpltm U Other .-------- Pel nspection y _ =T__ Submit _ sets of plants with any of the above. Investigation(re—---The above are not applicable to temporary toad,uction service. other rNot aft jurisdictions accept cmdir cards,please call jwiscliction for rune infmmntion, Notice:This permit application Permit fee.....................$ U Visn U MasterCard expires if a permit is not"brained Plan review(at -•_ %) $ Credit card number �_ within 180 days after it has been State surcharge(8%) ....$ 3 - 75_ F xptroa accepted as complete. TOTAI, $ 4 O --- -- — Name of cardholder as shown on credit card Cardholder sitinaurre AmounL—j 44C 4615(ISWCOM) :�ttr�adaalatttttrnmr ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: -- - --� TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below Restricted Energy Fee................... .................................. $15.00 Number of ins ections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq it or loss _ $145.1 __ ____ 4 Audio a id Stereo Systems' Each additional 500 sq it or r portion thereof $33.40 _ 1 L� Hurgiw Alarm Limited Enerqy _—__ $75.00 Each Manufd Hone or Modular Garage Door Opener' Dwelling Service or Feeder $90.90 2 Servicos or Feeders Heal )g Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 --- 1 Vacuum Systems' 201 amps to 400 amps _ —^_ $106.85 — 2 401 amps to 600 amps _ $160.90 2 r l Ott+er_ 601 amps to 1000 amps — _ $240.60 __ 2 l—_I Over 1000 amp,,or volts $454.65 2 Reconnect only _ $66.85— 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system.......................................................... $75.00 Installation,alteration,or relocation 200 amps or less _ $66.85 2 (SEE OAR 918-260-260) 201 amps to 100 amps J $100.30 �— 2 Check Type of Work Involved. 401 amps to 600 amps $133 7!i _ 2 yp Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"above. 1 Branch Circuits Boiler Controls Now,alteration or exlensior,per panel a)The fee for branch circuits Clock Systems with purchase of service or feeder lee. r Fach branch circuit $6.65 L� Data Telecommunication Installation b) I ho fee for branch circuits without purchase of service LJ Fire Alarm Installation or feeder fee. �6 _ First branch circuit _ $46.85 F—] HVAC Each additional branch circuit $6.65 Miscellaneous Instrumentation (Service or feeder not Included) Each pump or irrigation circle $53.40 lJ Intercom and Paging Systems Each sign or outline lightinq $53.40 Signal circuit(s)or a hoited energy Landscape Irrigation Control' panel,alteration or E xtenslon $75.00 Minor Labels(10) $115.00 —_, ❑ Medical Each additional Inspection over the allowable In any of the above Nurse Calls Per inspection $f�50 ---_.__— Per hour ——.-- $69 50 In Plant $73 75 Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ —__ -- Other 8%State Surcharge $ _ __ Numbo..r of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other Irstallation: See"Plan Review"section on front of application — - Fees: Total Balance Due $ . Enter total of above fees $— LJ Trust Account q 8%State Surcharge $— --— Total Balance Due $ — c\dsls\forms\ele-rees.doc 00/07/01 MECHANICAL PERMIT CITY OF TI GARD _ DEVELOPMENT SERVICES PERM:T#: MEC2001-00210 13125 SW Hall Blvd., Tigard, OR 97223 503 639-4171 DATE ISSUED: 06/'4/2001 9 ( PARCEL: 2S 109BA-06900 SITE ADDRESS: 13874 SW LEAH TERR SUBDIVISION: HILI_SHIR.E SUMMIT NO. 2 ZONING: R-7 BLOCK: LOT: 055 JURISDICTION: TIG CLASS OF WORK: ALT FLC:OR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HE,yTERS: VENT FANS: OCCUPANC GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: _BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT- BTU 15 - 30 H-1: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: F:IRN < 100K 3TU: 1 AIR HANDLING UNIT_S OTHER UNITS: FURN >=100K BTU: <= 10000 cfm GAS OUTLETS: > 10000 cfm: Remarks: Installation of furnace fo! hot!ub. Owner: — -- FEES _ NAEGF_LI, JOHN F + DIANA M Type — By Date Amount Receipt 13874 SVS! L E,^.I I TERR PRMT CTR 06/14/20( $72 50 272.001000( TIGARD, OR 97224 5PCT CTR 06/14/20( $5.80 272C0I00(ICI _Total � $78.30 Phone: ---------_- Contract,:)r: O VVN E R REQUIRED INSPECTIONS Mechanical Insp Phone: Final Inspection Reg #: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Sper;ulty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Th--:e rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain-copies of these reales or direct questions to OUNC by calling (503)246-9189. Issue By' �},�,f�' .��1� Permittee Signature: Call (503) (339-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application ---- Date received• yip J Pcrmitno.tPk,2y/) City of Wigard Project/appl.no.. Y Expire date: City of Ti and Address: 13125 SW Hall Blvd,Tigard,OR 97223 - Phone: (503) 639-4171 Date issued: By Receipt no.: Fax: (503) 598-1960 Case file no.: Paymr nt type: Land use appr1val: Br,ilding permit no.: -'U 1 &2 family dwelling or accessory U Commercial/industrial U Mull: Ianlily U Tenan' improvement U New construction -*7 Additio a�cetnetit U Otho: Job address: i ? r 6 1.4 Indicate equipment quan.ilies in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ _ Lot: Block: Subdivision: *See checklist for important application information and Project name: jurisdiction's tee schedule for residential permit fee. City/county: ( U V ZIP: P ' r Description and location of work on premises: j•�r a _ rRe-%.(on�iy Total Est.date of completion/inspection: A U DewcriptIon Res.onl Tenant improvement or change of use: Air handling unit CFM_Is existing space heated or conditioned?U Yes UNo Aon itonirg(si!^plan required) Isexistin) Iaceinsulated' UYes UNo A terationo exi:,ting system_ 3oi cr compressors Business name: State boiler permit no.: HI' _Tons BTU/14 _ Address: -- Findsmoke u(.tsmo c detectors Cry: Slate: ZIP: eat ump(sitc la rcr uire ) — ►'hone: �— Fax: E-mail: Inst'd r e furnace/y rner i PFU114 11;,1uding dticiWeTl(tvent lines ❑Yes L]Nr CCB no.: Instai:rep ac re ocatc treaters-suspended, City/metm tic.no.: wall,or floor mounted Name(please print) Vent for 11Lance other than furnace e gcrnri tion: CONT AUT,PURSON Absor.tion units Name: - Addre�.s: - - ------- - - Cmo orcmrnle ventilation: IIP ex aunt an vent al o-{ n: City: - --TS�.a'e: ZIP_- Appliance vent Phone: Fax: Email: Diyerex gust hoods,T ype V H res.kitch�7ir at - hood fire suppression system Name: Exhaust fan with single duct(bath fans) Mailing address: 'x tr :I — _xi._w.% system apart from isatin or AC Fuelpiping andistribution lop to outlets) City: Stat k 'ZIP: '; a _� Type: U'(1 _ NO -- Oil _ - Pltone' I;tx: E:-mail: I ucl i tin+eac a itiona over outlets rocess�tg(sc i�emai c�require ) Numh,r of outlets -biName: t er IM-iTappliance or equ pment: I — Addn:ss: Decorative fireplace _ City: State: 1.11': Phone: Fax: o sto E-mail: ow pe etstove Applicant's signaturb, -. , •,,.1' Dalc: (h cr: ,,, C l �. Name (print): SIM all,Jurisdictions accept credit cards,please call jurisdiction for morr inii nnti Permit flee..................... O Visa U NIrisletCard expNotires This permit application Minimum fee................$ Credit card oumhec - _ �L ( expires if a permit isnot oht�:rrad Plan review(at -- IMI) $ 5 &V , Expires within 180 days after:,nas been State surcl,irge(876)..,.$ ---� "— --- accepted as complete. Name or ear older es aFinwn o—nneclii card pTOTAL .............$ Cardholder signature Amount 440-4617(600 COM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: Dei,criptio'n Price Total TOTAL VALUATION: FEE: Table 1A Mechanical Code oty (Ea) Amt_ $1.00 to$5,000.00 Minimum fee$72.501) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72 - for the first$5,000.00 and Including ducts 8 vents 14 00 $1.52 for each additional$100.00„r 2jFurnace 100,000 BTU+ fraction thereof,to and including including ducts&vents 17.40 $10,000.00. - 3) Floor Furnace $10,001.00 to$25,000.OU $148.50 for th first$10,000.00 and including vent 14.00 ��- $1.54 for earh additional$100.00 or 4) Suspended heater,wall hector fraction thereof,to and including or floor mounted heater 14.00 $25 000.00. gj Vent not included in appliance permit $25,001.00 to$50,000.UO $379. 0 for the first$25,000.00 and 6.80 _ $1.45 Ix each additional 000.00 or 6) Repair units fraction thereof,to and inCIL ling 12,15 $50,00000. Boller Heat Air $50,001.00 and up $742.00 for the first$50,000.00 and ForCheck all that apply: 7-11,see or $1.20 for each additional$100.00 or footitems *notes below. Com Pump Cod fraction thereof, I _ -- 7)<31-IP;absorb unit 14 00 - to 100K BTU -- �D�. SSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb 25.60 Value Total unit 100k to 500k BTU _ scrl tion: Q Ea Amount g)15 30 HP;absorb r7uMace to 100,000 BTU,including 955 unit.5-1 mil BTU _ 35.00 ducts&vents _ 10)30-50 HP;absorb 52.20 Furnace> 100,000 BTU Including 1,170 unit 1-1.75 mil BTU - ducts&vents 955 11)>50HP:absorb - 87.20 Floor furnace fnduding vent unit>1.75 mil BTU Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM 1000 - floor mounted heater _ - ----- -- - Vent not Included In applicance 445 13)A handling unit 10,000 CFM+ ermil 17.20 _ Re air units _ 805 14)Non-portable evaporate cooler <3 h�p;absorb.unit, 955 _ 10.00 to 100k BTU 15)Vent fan connected to a single duct 6.80 3-15 hp;absorb.unit, 1,700 _,01k to to 500k BTU 16)Ventilation system not Included In 10.00 15-30 hp;absorb.unit,501k to 1 2,310 appliance permit - mil.BTU __ 17)Hood served b/mechanical exhaust 10.00 30-50 hp;absorb,unit, 3,400 -- 1-1.75 mil.BTU ei ators >50 hp;absorb.unit, 5,725 17.40 - >1.75 mil,BTU19)Commercial or industrial type incinei ator Air handling unit to 10,000 dm__ 656 Alr handlin unit>10,000 cfm 1,170 ?-0)Other units,Including wood stoves Non-podable evaporate cooler 656 10.00 Vent fan connected to a single duct _ 446 _ - _ 21)Gas piping one to four outlet, Vent system 5.40 In 5.40 - apQliance permit - - 22)More than 4-per outlet(each) 1.00 Hood served by mechanical exhaustT4,590 56 _ Domestic incinerator 70 - Minimum Permit Fee$72.50 SUBTOTAL: $ Commercial or Industrial incinerator56 $ Other unit,including wood stoves, 8%State Surchargeinserts,etc E Gas �i��1-4 outlets _80 _ 25'%Plan Review Fee(of subtotal) Each additional outlr: ___63 - Required for ALL commercial permits only TOTAL COMMERCIAL Z TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: --- Pther Insnectlone and Fe4s: 1 Inspections outside of non nal business hours(minimum charge two hours) $72 50 per hour. 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) $72.50 per hoer I Additional plan,eview required by changes,additions or revisions to plans(minimum charge-one-hell pour)$72 50 per hour `State Conlracto Seller Certification required for units,200k BTLI "Residential Alt:requlre3 site plan showing placement of unit is\dsts\forms\mech-fees.doc 10/11/00 .rierri� CITY OF TIGARD BUILDING iNSPEC i ION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIP _Date Requested AM --PM — BL., Location Suite MEC Contact Person Ph — PLM Contractor Ph G-.1 y- �YdJ' SWR BUILDING Tenant/Owner ---le"12lJ�cf�Lr /1 ice'- `t�< ELC Retaining Wall �ll'U j%(c' ELR _— Footing Ac l,. FPS Foundation NOT REQUESTED ---- Ftg Drain FOUND DURING RESEARCH SGN Crawl Drain Ing NO INSPECTION(S) IN FILE Slab SIT _ Post& Beam Ext She-ithe'Shear — -- Int Sheath/Shear Framing ----- ---—....----- ----------- - --- — ----- Insulation Drywall Nailing - — -- Firewall Fire Sprinkler - _..----- ----_ --- . -----_. - -_ Fire Alarm Susp'd Ceiling - ----- ...- - - - Roof Misc Final -- ..- -- --- -- -_ PASS PART FAIL PLUMBING Post&Beam Under Slab Top Out - Water Service -- - Sanitary Sewer Rain Drains Final t PAS$ PART FAIL _- MECHANICAL Post& Beam - - Rough In GPs Line - Smoke Dampers _ Final _----- PASS PART FAIL ELECTRICAL -- Service -- -- -- Rough In UG/Slab — - Low Voltage Fire Alarm - -- — --- Final PASS PART FAIL _ -_ -- ---- aITE Backfill/Grading Sanitary Sewer Storm Drain [ j Reinspection fee of$_ required before next inspection Pay at City Hall, 13125 SW Hell Blvd Catch Basin [ j Please call for reinspection RE: [ j Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date _.________Inspector Ext _ Other Final PASS FART FAIL J DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT 13125 SWHall Blvd., llgard,OR 97223 (503)639.4171 PERMIT if. . . . . . . : f ILM97 -O3168 DATE ISSUED: 09/29/97 PARCEL_: 2SI09BA-06900 SITE: ADDRESS. . . : 13674 SW LEAH TERR SUBDIVISION. . . . : HILLSHIRF_ SUMMIT #2 ZONING: R-7 PD BLOCK. . . . . . . . . . . L_O'T. . . . . . . . . . . . . :O55 JURISDICTION: TIG CLASS OF WORK. . :ALT GARBAGE DISPOSALS. ,. 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING (MACH. . . . . . : 0 BACKFLOW DREVNTRS. . 1 OCCUPANCY LRP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAP'S. . . . . . . . . . . . . . . 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 21 CATCH BASINS. . . . . . . : 0 FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . . 0 GREASE TRAP'S. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 14ATER CLOSETS. . 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 ROIN DRAIN (ft ) . . . : 0 Remarks : Install residential. backflow prevention device Owner: -_______._______- -------____._ .____.____.________.-----_.__.._ FEES -------------- JOHN NAEGEL_I type amoi.int by date recpt 13874 SW LEAH TER,R PRIMT f 15. 00 JSD 09/29/'J7 97-299620 T I GARD OR `3.7224 5P'l=:T $ 0. 75 JSD 09/29;97 97 -29962O Phone #: 590-0396 OWNER Phone #: $ 15. 75 TOTAL_ Req #. . : 999999 - ------ REQUIRED INSPECTIONS ------This permit is issued subject to the regulations contained in the RP/Backflow Prev Tigay-d Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All w0rk will be done in accordance with approved plat.%. This permit will expire if work is not started _ _ within 188 days 6f issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Lttility Notification Center. Those rules are set forth in OAR 952-A8014818 through OAR 9524881-WO. You may obtain cnpies of these rules or direct questions to ODIC by calling .. ........ 15P3�r'46-1987. lssi_Ied By : ,— Permittee Si gnat .tr�m 4++++•t+,++++i++++++ +++++++++++•4•+•4•++++f++++-'-++++++++++++++++++++++++++ Call 639-4175 by 6:00 p. m. for an inspection neede,-i the next bi.tsiness day f +•++++++...++++++++++-!•+++f•+++++++++•++4•+++++++++++++++++++++++++i••4•+++++++++++++++ Reed By CIT41t: TIGARD Plumbing Application ecd P � 131.25 5 SN HALL BLVD. Commercial and Residential Gale Date RR E. TIGARD, OR 97223 Date to P E. I (503) 639-4171 Permit* Print or Type Related SWR 0 �- Incomplete or illegible applications will not be accepted Called �~-- Name of Development/Project Job jA , '>,. i, , .- C- (A %,t FIXTURES (Individual) QTY PRICE AMT Address Street Address Suite Sink 9.00 Lavatory 9.00 Bldg X CitylState Zip Tub or TublShower Comb. 9.00 Name Shower Only 9.00 .3 c, ; ' ,) _ r r _e Water Closet 9.00 Owner Mailing Andress �� Suite Dishwasher 9.00 Garbage Disposal 9.00 City/Stale Zip Phone r 1 .1 9` ,i�� .�,J It Washing Machine-- - 9.00 Name Floor Drain 2 9.00 _ 3' 9.00 Occupant Mailing Address SW;a 4' 9.00 City/State Zip Phone Water Heater O conversion O like kind 9.00 - Laundry Room Tray 9.00 Name Unnal 9.00 Other Fixtures(Specify) 9.00 Contractor Mailing Address Suite 900 nor to issuance CilylState Zip Phone -_-_ _ 9.00 applicant must 9,00 provide all Oregon Const.Cont.Board Lic.0 Exp.Date 9.:)0 contractors _ _ - 9.00 license Plumbing Lic.0 Exp,Dale Sewe - 1;t 100' 30.00 information if expired Sewer-each additional 100' 25.00 in COT COT Business Tax or Metro « Exp.Date Water Service-1st''00 30.00 databasel, - _��-- -- Wafer Service-each additional 200' 25.00 Name Stone&Rain Drain- 1st 100' 30,00 Architect _ _ Storm&Pain Drain each additional 100' 25.00 or Mailing Address Suite Mobile Home Space 25.00 Engineer City/State Zip Phone Commercial Bacx Flow Prevention Device or Antl- 25.00 Pollution Device Residential Backflow Prevention Device' 15.00 D"cnbe work tlew • Addition O Alteration O Repair O - _ to be done Residential A Non-residential O Any Trap or Waste Not Connected to a Fixture 900 Additional description of work -� Catch Basin 9.00 Insp of Existing Plumbing 40.00 _ perRv Spscially Requested Inspections 4000 Existing use of [� _ __ _ per/hr building or property `� ` `t ' C- Rn n Drain,single family dwelling - i 3000 Proposed use of Grease Traps 900 building or property- _- I - QUANTITY TOTAL Isometric or riser diagram is required rt Ouanrty Total is >9 ^Are you capping moving or replacing any fi�3ures) Yes C] Noyl _(If yes see back of form) *SUBTOTAL I hereby acknowledge that I have read this application,that the information �- ----- 5% f URCHARGE t r J given is correct,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State Laws. - PLAN REVIEW 2S%OF SUBTOTAL Signature of OwnerlAgent net Required on rt riN R _ �{� �/ eq .,ry total is>9 ---- �l Xn-kl Con ct Person Name --� Phone 'Minimum pe;nit fee is S25*5%surcharge,except Residential Backflow r t l Prevention Device,which is S15+5%surc'iar e 11d%t4\V1 naop doe SNS P SASE COMPLETE AS APPROPRIATE TO PROJECT: Fixtures to be capped, moved or replaced Qty Sink Lavatory Tub or Tub/Shower Combination Shower Only , _ Water Closet Dishwasher Garbage Disposal _ Washing Machine Floor Drain ?_" 4" Water Heater Laundry Room Tray Urinal - Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I'at,slpl'n app,Xx 5,5' CITY OF TIGARD BUILDING INSPECTION DIVISION MST-fir ,� j'3 24-Four Inspection Line: 639-A175 Business Line: 639-4171 -- BUP 26m- C)CI-2s.3 _Date requested _ — AM _ PM — BLD Location_ !��,�,�S w �ti !i %�✓ — Suite MEC Contact Person Join n /f tf•'a F It Ph -��f C �U 3 fG _ PLM _ — Contractor _ P/h/ SWR _ (WO—TER, Tenant/Owner �-!�7�-'�� 1401 `� 'y� ,5� c ELC —� Retaining Wall u 7t ��`-7i�•-C + —�- ELR _ Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes. -- --- Slab -- - - -- --- - ------ SIT Post& Beam —'- -- Ext Sheath/Shear Int Sheath/Shear Framing -- -- -- --- -- -- _ -- - Insulation Drywall Nailing ------------ — - ---- ----------- --- Firewall Fire Sprinkler ---- ------- ----------- ---- ----- --- Fire P!arm Susp'd Ceiling ---------- --- -.—--- - -- --- -------- - ---— Roof M �'l. - - ------ -- �, A ART FA!L -_.__-- PLUMBING Post F. Beam - --- -__._—_--- _- Under Slab Top Out Water Service Sanitary Sewer ------ ----- ---- -- --- Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam i -------- ---- --- ----- --------- - --- -------------- Rough In GasI ine ------------------ ---- ----_--_____ ------ Smoke Dampers Final --- --- ---- ---- -- - - ---- --....._ PASS PART FAIL. ELECTRICAL. ----__ __-____._ _-------------------------------------_ _,-.-.__.__.-�—_-_-------- ----- Service Rough In - UG/Slab Low Voltage Fire Alarm Final ------- --- ----- - PASS PART FAIL SITE Hackfill/Grading -- - - ----- ------___-- ------- ---.—___._._.___. _ Sanitary Sewer Storm Drain I )Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I )Please call for reinspection RE: _--- - - I )Unable to inspect- no access ADA Approach/Sidewalk Other Date L � _ -Cc- Inspector Ext _ Final � �---i--- PASS PART —FAIL_ 00 NOT REMOVE this inspection record from the job site. 1 I C�� O� �I��D ELECTRICAL PERMIT PERMIT#: EL02000-00529 DEVELOPMENT SERVICES DATE ISSUED: 9/5/00 13125 SW Hall Blvd..Tigard. OR 97223 (503) 639-4171 PARCEL: 2S109BA-06900 SITE ADDRESS: 13874 SW LEAH TERR SUBDIVISION: HILI_SHIRE SUMMIT NO. 2 ZONING: R-7 BLOCK: LOT : 055 JURISDICTION: TIG Proiect Description: Installation of two branch circuits. _ RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS — MISCELLANEOUS —i-6-00 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTU: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps- 1000 volts: MINOR LABEL (10): .SF RVICE/FEEDER_— _ BRANCH CIRCUITS _ ADD'L INISPECTION., 0 • 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 '-(iP HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 ( PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION_—__ 1000+ amplvolt: >=4 RES UNITS: > cion'✓CLT NOMINAL: Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: _ Owner: Contractor: JOHN F NAFGE LI OWNER DIANNA M SCHUMACHER 13874 SW LFAH TERRACE TIGARD, OR 97224 Phone: 590-0396 Phone: Reg #: FEES _ —_ Required Inspections — Type By — Date -�— Amount Receipt Elect'I Service PRMT CTR 9/5/00 $53.50 2720000000( Elect'I Final PRM2 CTR 9/5/00 $4.28 272.0000000( - Total— $57.78 i This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws Ali work will he done in accordance with approved plans This permit will expire if work is riot started within 180 days of issuance,or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oreg)n 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 ordiiect questions to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE � _ ISSUE6 BY: OWNER INSTALLATION ONLY --_ The installation is bels rg 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: — —_�__ DATE: LICENSENO: -- ------- -- ------ -------- ---_— --- -- Call 639-4175 by 7 ;10pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Chc#- 1',!2r, 9vV HALL BLVD. pP Rec'd B�r Date Recd %" TIGARD OR 97223 Date to P.E. Type Phone(503)639-4171, x304 Print of Date to DST Inspection (503)63911175 Incomplete or illegible will not be accepted Permit# LCe-211 Fax (503) 598-1960 Calved 1. Job Address: omplete Fee Schedule Below: [!Lf Number of Inspections per permit allowed Name of Development r (-t— �t r1 _ _ — r= N a.p��. Service included: Items Cost Total Name(or name of business) aLe ___� t.- `, _.. �� „ (.` 4a. Residential-per unit Address t �f, 1 `-t 1,00 sq.ft or leas _—� $147.15 -_ 4 City/State/Zip Y<< a ` rt -1 "f _:ach additional 500 sq ft.or portion 1 3(eof _ $33.40 - 1 Limiled Energy $75.00 Commercial El Residential Each Manufd Horne or Modular - Dwelling Service or Feeder $00.90 2 2a. Contractor installation only: 4b.Services or Feeders (Prior to permit issuance,applicants must provide contractor license Installation,alteration,or relocation information for COT data base). 200 amns or less $80.30 2 Electrical Contractor 201 amps to 400 amps $106,85 _ 2 Address _ — 401 amps to 600 amps $160.60- 2 City— Stale Zip__— _ 601 amps to 1000 amps $240.60 _ _ 2 Over 1000 amps or volts _ _ $454.65 —_ 2 Phone No._ — - Reconnect only $6685 - 1 Job No. _ ---------- - E .Date 4c.Temporary Services or Feeders Elec. Cont. Lice. No. x- p - -- Installation,alteration,or reloca,ion OR Slate CCB Reg. No. -Exp,Date 200 amps or less _ $66.85 _—` 2 COT Business Tax or Metro No. Exp.Date—�_ 201 amps to 400 amps --` $100.30 _-_ - 2 401 amps to 600 amps $133.75 _ _ 2 Signature of Supr. Elec'n _ Over 600 amps In 1000 volts. sea"b"above. License No._ _ ____Exp.Date _ 4d.Branch circuits Phone No. _ - _ Now,alteration or extension per panel - — - a)The lee for branch circuits with purchase of service or 2b. For owner installations: feeder fee. Each branch circuit $6.65 -_ 2 Print Owner's Name J v IcL-v c,�c?(� b)The fee for branch circuits Address I '�P, It 'S�y r without purchase of service Q_ State c-)K Zip c J ,2.2 Y or feeder fee. / $46.85 r City—� c.-,-�_ First branch circuit _ Phone No. C7 `i 6__ ----- Farh additional branch circuit -�_ $665 1 he installation is being made on nroperty I own which is not 4e.Miscellaneous (Serve,e or fonder not Included) intended for salt, lease or rent Each pump or Irrigation circle _- $5340 Each sign or outline lighting _ _ $53.40 _ Owner's Signature y tit 61a'��'- Signal circuit(s)or a limited energy �— c — panel,alteration or extension $75 00 3. Plan Review section (if required):* Minor Labels(10) _-_ - $12500 4f.Each additional Inspection over Pease check appropriate itern and enter fee in section 56. the allowable In any of the above 4 or more residential units in one structure Per Inspection _ - $62 50 -�Service and feeder 125 an,ns or more Per hour _ $62..50 - - System over 600 voles nominal In Plant $73 75------ --classified area or structure containing special occupancy as 5. Fees: described in N E C Chapter 5 6a.Enter total of above fees $ - � 8"/o Surcharge(08 x total fees) $ �.; Submit 2 sets of plans with application whereany 0the above apply. Subtotal $ Not required for temporary construction services 6b.Fntnr 25%of line 6a for NOTICE Plan Review if required(Sec 3) $ - --- Subtotal $ _. PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR ❑ Trust Account# / WORK IS SUSPENDED OR ABANCONED FOR A PCRIOD OF 180 DAYS Total balance Due $ D AT ANY TIME AFTER WORK IS COMMENCED -- i Adtirs�l7um�`.cicrtri� n•� .6x Rlnfl .4RD BUILDING PERMIT CITY OF TIG _ PERMIT#: BUP2000-00283 DEVELOPMENT SERVIK"ES DATE ISSUED: 7/27/00 13125 SW Ha!i rilvd.,Tiaard,OR 97223 (503) 639-4171 PARCEL: 2S109BA-06900 SITE ADDRESS: 13874 SW LEAH TERR SUBDIVISION: HILLSHIRE SUMMIT NO. 2 ZONING: R-7 BLOCK: LOT: 055 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ACS FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP- R3 TOTAL AREA: 0.00 sf ROOF 'ONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ RF:.tUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR PARKING: VALUE: $ 3,556.00 Remarks: PA`IO COVER 14 X20 Owner: Contr:,ctor: JOHN F NAEGELI OWNER, DIANNA M SCHUMACHER 13874 SIN LEAH TERRACE Tl one! qU0_% A4 Phone: Reg#: FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Footing Insp PLCK BT2 7/7/00 $44.53 0003545 Framing Insp Final Inspection PRMT DEB 7/27/00 $68.50 0004034 5PCT DEB 7/271100 $5.48 0004034 ,DCB L -B 7/27/00 $20.00 0004034 Total $138.51 l his permit is issiled subject to the regL;!a+i,,- ,s co,itained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be dc,.ie in accordance with approved plans. This permit will expire ifwork is not started within 180 days of issuance, c-r ii work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center, Those rules are set forth iii OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-1987. Pennitee ) Signature: Issued By: Call 639-4175 by 7 p.m.for an Inspection the next business day r � Permit#: �\ Address: -- \N�. Isti�-iecl h — --- Date: -- Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, a►id plumbing permits. Licensed architect and engineer applicants, exempt frc-:t re„ oration under ORS 701.010(7), need not submit this statement. This statemc.nl will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, and ether box ?A or 31.1 VVI 1. 1 own, reside in, or will reside in the complcied structure. VSJ ® 2. 1 understand that I must register as a construction contractor it the structure is sold or offered for sale before or upon completion, U �A. My general contractor is LJ LJ (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Bt ard. OR INlB. 1 will be my own general contractor. 11' 1 hire subcontractors, 1 will hire onl} subcontractors registered with the Construction Contractors Board. If 1 change my mind and hire a general contractor, I will contract with it contractor who is re �ist�rcd with the CCB and will it notify the office issuing this building permit ofthe name of the contractor. 1 hereby certil'. that the above informal ion is corre:t and that I have read and do understand the Information Notice to Pro erty Owners about Construction Responsibilities on the reverse side of(his form. ` –7l � 7Oc� (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) information Notlre to Property Owners About Construction Responsibilities rtit�(a;'. f!tl', �It��.;i,l;llr�ill �Iil(t /(1�'injic,'+) (�i,71t 1� I(�t(tili � �•J!�(I'Jr','N)I! R<'1�YlY,. . �. �. �ll., ,. �,� ��,,, h..11 �,'i!;'11i1f� l ;!frt�i;r,�• itllU 7Y,�l .1' �',.7r,,J. r' i)��/( ()f{.C. 'f. . i' ill.. �il;ii ill II' :�II•ii I� I iit :Ill 11'.111 '\'-Ilt!? .ill. prcrlal( IIl.l11•) }'i!il' iil., y .t?..� J\tt: U1 ; 1':1(11111tVIl1p'. Il::,�.j�.,n.,,Iblilwc,'wd ait 'lIiLL:4I EMPLOYER HESPONSIBILITIE:; (i tIU 1111': 1�t't,,vli, fl �, It'•.'I+:it'I�;i 1',Illi l.11- ( tr:t`•IJ;.I��I �P , �11'�'--Itil� 1jt)Ull,f l'� 1111 i:lln�i In � tll',Iln'. I1II�, �, •C`lil•';11I'll ..Ilut_ll,'- -:,,i: •,611. I'1 11'i'•',t ,�+'•,911'1. 1 1"„• Ilfl '�f : iN' r11 ^I�?(11!m: . ..I ', 'ii flit':` \5'111 l),- t'I�lt)III,t.'I,'• '1 t.. il,t' ;'1�?IIIj' :,�'1! I'ri•;i. + �, .)I,I� ,'..1111 (I1C fI'llt+1'.11lf' l+It o,i Ns1t11IH1Ir1►111!t:ilFltl: A +n''11111111+.'(:( VI)+' Ir)'tl,vitlihol'i IrwolIlP twk( ., f'roill t'i11ploll °e V`lai'(^,.It Oh iI,!n.l Y oI! 11''1 i•'1 i,al4- trot lfv>t.w( 11,Ittlt!'Itlt f.>tiI"'I it \r1u IIoWt 'w1111111v wthllnt'! thr. n-.. rinillUn, .Ili Ilii' li�:g 1t1 i J(2pt (''f 1 ovvrltio at tJri°-t t191 f >1cn,111(1�ment it11stwance trim ilk'. It iifl For mart, tllton-notiun, ::'it11 cw t. !T?P1t)y ln..`71t UlA I`tlor w Olt: 1 Jcpa oiliCnl of lll.li.,,u, i,t + \4 nrkr rs'cono ensalion insm-ance: A,lilt ac �uhiccl 1 A4tIt L Ia t;t11liven,at iolI iIIsurano, fpl Iill c11) tll)N -I,-t.- if tout -..11"It'll il?:,'I �11i t', '.•aI I(i1r"miltle" ind 01Ihe�IlahlE�C)YJIi •l!llin('ntitS lrl)fter)�l'('+III I'. I+,Itfl- .I �{l phi` lI-`t' I'111�711 I 11h' W011..t i", t't.)illlk'nsatloll Divi,':;I. ;it I11t' I)CI)1lltrllt.+f11 ir( (11"WIU'I ;1(111 klivrws'i ,`fit"/Cly is -)1 ti,15.� .`i. Internal Rt. (atut,Set•vice: v,.ill e 1111uyar,'4011Ulu:,tWithholdtederulillL0111(”tiiX 'wdos. Y01! ,, I,H•Im thti tml p;ivr►lcnl t I_'n ii t illi t:lidn'I artuaIIy t\1111iicId the tati Flit mcwc inf•nrm(til+n,csili(he, Inlcrmil ilei OTHER RE SPONSIMLITIES AND AREAS Or- CONCERN, >(fr I•nmpliltltt'c: .1',th;�h;�rrtiit hultlrl ftlr'lu• 11ra11t'-I•},illl;u'r r''<1nill:ll)I(-(rtr rt•�+)l� inpr,uiI .' , Ji 111111' hC hrul.I1:',h! I� lcrtlr;lUt'fltl(In Ihrlrn!'tl InC1t('c'lIl1I1� I iability and piopce-11) (l,amiige itlstinancc: (:t,mat t�'uu1 In:,wan(' ~►1(114 u,;.>( if .stn,h,l\,.:,uft,'ciu81,.' ul Idt'rlt, ilntl 1111111'.itlll; tiu('li iv, Iall.tlig 4(111;`, I)Wllt I. lL1`.1KAv, ",;Jit 1 (1,111liiZ(.' (((1111 I11i)e I)(I;lt'IurCs. (Ilt.' VI �, ;Ir li �l1(111C,'+ N iflle to Supervise eiroployevs: 1;31;P CIIrC 1'4111 11aYt' 111414 u''lll I)nit' I, 111'4 i' I "i' 1 1"t I'vprtttiwr: 1ll;ikr>�nrr}141141n\'c thr.(ix I+cliirr tr)act at �'cntr c)\�n l*ener:ll rnnirtirtnr.tr)r�c,rdinatl"thh wrirk of rinit h in;Ind f 1111'i'. 111(1 101110ti(y hilildilip. jVrrFt!1i nc�>tegttittr)insl3ecti(tii5. If)I)ll ha\e Addiliunal (ilicsilml,>, u'lite itl calf the('uncf'ruetion Contrii(Ims 13ox 14140c',S;ilem,UI: wl lrin ,(t;/1"7'1-'16211 1. The Board i,, !heated at 701)Stimincr S1 NF S!111C 31)11, in Solent. i'�„t) IItAII 1+111.1 clT. OF TIGARD Residential Building Permit Application Plan Check#_ a Rec'd B,,- 13125 SW HALL BLVD. Additions or Alterations nano rec'd TIGA.kD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E.,! ' V 503-639-4171 Date to DST2- L `-7L ' F 503-684-7297 JC, Permit#AL82PP9 -00AF3 Print or Type Called—___. Incomplete or illegible applications will not be'accepted aL - -- Name of Project C: Job PA t t`' -- Architect Mailing Address Address Site Address City/ tate Zip Phone Name it Name Owner Mailing Address _ t )•r , �� R— City/State "Lip Phone Engineer Mailing Address - T r I f}(Z r> -L' =� ft' �_}`!k City/State Zip Phone General Name esc Contractor r� fes; (` Dribe work New O Addition O Alter tion Repair O Mailing Address to be done: %�1 :� ^ �?�'� ZQ U/742 Ca Prior to pe mit Additional Description of Worki issuunrn,a copy City/Stale--Zip Phone --_ ---- of all licenses are regwrea if Oregon Const Cont Board Exp Date PROJECT expired in COT Lic.# VALUATION _ database _ _ -- Mechanical l Name NEW CONSTRUCTION ONLY: Sub- y Ft. Nouse: — Sq. Ft.Garage Contractor Mail-- ,n9�lddress Indic the restricted energy installation by the electrical Prior to permit _ subcontr for in the_followin areas _�__ issuance,a copy City/State Zi' Phone p Restricted � Audio/Srereo i of all licenses _ are required if Oregon Const.Cont Board Exp Date Energy S stem _ rrarms Installations Vacuum Irrigation expired in COT Lic.# '-�Ys�tem System_ Numbing Nam'' (check all that OIRW Sub- apply) Mallin Address Corner Lot _ YES �NO Flag '_ut YES NO Contractor g (check one) __ (chec one) Has the Subdivision Plat repefded? YES NO Prior to permit City/State Zip Phone �- issuance,a copy _ of all licenses are Oregon Const.Clot.Board Exp.Date required it Lic# I hearby alckfi wledge that I have read this application, that the expired in COT --- informllilluen given is correct,that I am the owner or authorized XQent database Plumbing Lic # Exp.Date of the owner, and that plans submitted are in compliance.with Oregon State laws. -- -- Name- — - T— Si lure of Owner/Agent --- Date Electrical _ ont ct Person Name--rte Ph Cone# Sub- Mailing Address Contractor _ __ City/State Zip Phone ' Prior to permit t�s,uance,s copy _ _ _-._ FOR OFFICE USE ONLY: uf all licenses are Oregon Const Cont Hoa Exp. Date plat#: — Map/TL#: required If Lic# �� -�� 6 d expired in COT - database. Electrical Lic # Fxp Dale Setbacks: Zone: Flow Electrical Supervisor Lic # Exp Date Engineering Approval: Planning Approval: e\dsts\torms\sfaddalt doc 11/2019( Date Recd: ;;ITY OF TIGARD Recd By: SINGLE FAMILY ATTACHED OR DETACIJED (New, Addition) Plan Check #: APPLICATIONIPLANS SUBMITTAL REQUIREMENTS Applicants: Please complete 1. APPLICANT NAME:,____---- —_ PHONE #: 2. SITE ADDRESS: ___ FAX # 1 5 SITE PLANS (Fully dimensional, drawn to scale) labeled with: /I ❑ map & tax lot #, ❑ subdivision name, ❑ subdivision lot #, ❑ ite addrHss, ❑ zoning, ❑ applicant name, ❑ phone number. ' Size requirement: 8-112" x 11" to a maximum 11" x 17" at NOl attachedriding plans. A. North Arrow. B. Scale (any standard, architectural or engineering only). C. Street Names. D All building plans shall reflect actual building dimensions. E. Finished floor elevations (all levels, actual topographical). F. Garage finished floor elevation (acts Al topographical). G. Corner lot elevations (actual,topographical). H Driveway corner elevations. I. Zoning setbacks (front, side �rhd rear). J. The location of all public and private easements. K. The location, termination, and all Invert elevations of all drainage piping (sanitary and storm) showing all elevations necessary to show positive gravity flow to the approved drainage device (i.e : pee0holes, storm lateral, sanitary lateral). 1_ Residential drivewdys, sidewalks and wheelchair ramps will be shown on site plans and will be In accordance with the CITY OF TIGARD standards. Drive-way cuts shall not be permitted within 30 feet of intersecting right-of-way lines nor within 5 feet of(property lines. Weep holes/drain pipes will be installed 5 feet from adjoining proporty lines. Multiple driveways on individual parcels of land must have 30' of separation; joint use driveways require a formal agreement. M. Show all ero ion control devices proposed for site; refer to UNIFIED SEWERAGE AGENCY A .Technical Guidance Handbook (Revised 1994), or telephone USA at 648,F8621 for assistance. N Show locai,ion of existing facilities and new or relocated structures (mailboxes, power poles, water meter, light pole, stop sign, etc...). \ O. Indicate property slope directions. P. Existing and finished contours when slope in any direction exceeds 20%. (ADDITIONAL REQUIREMENTS MAY APPLY, SEE GRADING POLICY). i wsls\forms\s'req doc 4/20199 o 0% :L - asuo Ta\o a4 A74 W ILIr A. 4 LIALLM.The City of Tigard, Oregon, or -T-f cits employees, shall not be responsible for cl`lsvepancios which may Appear hereon. At sr-u Frew R I z vul� —c-ONSTRUCTION r i f LIXy S �e bQ. ♦j •(�'A�pP..c�.r ul� 7.X�lo fig W i.r ek. � T•P e� 1•yc 1.� �� 1 `Px91011 d ! k ri 1 j�e e�s na -,v As o G �(eve Q.r- tae eC LIABILITY:The City of Tigard, Oregon,or its employees, shall not be responsibie for _ PATr O dlsc+epancies which may appear hereon. 9x1[. e. rJ•ar. RA Isr._- R �h0 l�t.ck �� D�.^•N N 1 APPROVED TM� TI>°�RI7 UCTION A E Gr E 4 t,�9�1, C 0111 PERMIT NQ—,L,,_,' ��3 . AQURES 41L -5 'LC 1 �-qo . e'5q C. D x f Z -cl I 7 - o to .1.4CC4 _...�. � T n D 1 1 1 � O 11 zn S � rt -Ti W m r A I o o � � 0 d 44 m �- f ju 91 i U to w °. s� NLe E fn t CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ Date Requested AM� PM BLD Location 1-v PQ _ Suite _ MEC _ Cont-ict Person Ph 31`o - O,,s'`J PLM Contractor t,U.)At_L" fL- Ph _ _ SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access. Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: Slab -_ -_ SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing -.- Insulation i Drywall Nailing Firewall / Fire Sprinkler Fire Alarm Susp'd Ceiling - -- - -- -- --- Roof Misc: _ - --- -- - - - -- ------ Final PASS PART FAIL. --- -- ----- -- - - - -------- - PLUMBING Post 8 Beam ._.__ ----- ----__—_--- —.__--- Under Slab TopOut ___-- ------_ �_._ __----- --- -- --- -�.-._---.. Water F-prvice Sanitary Sewer - - -- --------- _ Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam - ---- -- ._ ... -------- -- - Rough In Gas Line Smoke Dampers Final -------- -----_. __ -.. - - - - - -- - T FAIL ELECTRICAL ' �ervu:e Rough In UG/Slab _ ---- - ----------_--- -- Low Voltage Fire Alarm -.-----_____-------._—._.__ ---- - - PAS PART FAIL - ---- ----- --- -- --- - --- _ - --- - Backfill/Grading Sanitary Sewer Storm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catc)Basin Fire F.upply Line [ j Please call for reinspection RE: _,-,-- __- ( ]Unable to inspect no access ADA Approach/Sidewalk Other Date GIn oector _ ____•__ E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.