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Permit ' MASTER PERMIT CITY T I G A R® PERMIT #: MST2003 -00403 .�� DEVELOPMENT SERVICES DATE ISSUED: 9/17/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12438 SW ASPEN RIDGE DR PARCEL: 2S110BC -08000 SUBDIVISION: THORNWOOD ZONING: R -7 BLOCK: LOT: 051 JURISDICTION: TIG REMARKS: New SF detached, Path 1. BUILDING REISSUE: DM184 STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 32 FIRST: 1,652 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,393 sf GARAGE: 435 sf FRONT: 15 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 299 232 50 OCCUPANCY GRP: R3 BERM 4 BATH: 4 TOTAL: 3,045 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,824.13 DON MORISSETTE HOMES INC DON MORISSETTE HOMES INC This permit is Municipal Code, to the regulations contained C o i the Tigard Municipal Code, State of OR. Specialty Codes s and 4230 GALEWOOD ST #100 4230 GALEWOOD ST, STE 100 all other applicable laws. All work will be done in LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 387 - 7538 Phone: Oregon Utility Notification Center. Those rules are set 5 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You R °9 #: L IC 3877 may obtain copies of these rules or direct questions to 1 OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control Insp 84 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp Issued By : '�.- � -Q/J l,Gtx . L) Permittee Signature_ Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day • . .. 5.60R9693 -00 , • `x'Rk e • • ' o 1 bu` '� - 1440 } . "` ° -_ x , 1� y r ,"a +Kw.� - a- r kf gPermit '. 1 o . . w � 4 1 ETVED received: 1 $1 / Permit no. :�y�p �� } 1..� ii City of Tigard -. . "- Project/appl. no.: Expire date: City ofTigard OF Address: 13125 SW Hall Blvd, Tigard,l)? 9223 Phone: (503) 639 -4171 JJ 1 200 Date issued: B � I Receipt no.: Fax: (503) 598-1960 CITY 4f ` ase file no.: Payment type: Land use approval BUILDING D ,:�1. , . > ri' 2 family: Simple Complex: • .S' :e',1 "- 'j �IA } T. �A ,.+a �+�.Wit21 y }�,�:'k -t_ � 7 r t •, T ..1 F rtra�) (.: 7 `� ! �; 41,,� 4.. 4: - #� a W1- .? 44.:. ,kt 24�itt z Ra ` ? ., 4 . PL4 AVAL. ■ , ,. 5 ' . '!�(, a J "' y " 1 y ,. ' 1,., .,` §1 1 ,' , �� t F3 C2 4 - 'f =y a i`4 :i"- ::�C:r . ., i *�'NE._ n _..� - . fi a . L r � �, a � r.�' ' 4J¢�� �2 �r � ��;v �w .'�w"E 1 .. 4.tw ;„''fir+ i � q � � #� ;:� _ .e r. §: � ��,. � :Y�c�`+�'� 1-'t r �� !' �'a —T` �� 5�'�i 3� t r...1 '�s .�ry , sc !� . ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family 'New construction ❑ Demolition ❑ Addition/alteration/replacement 0 Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: • r C+#.� ��(,�, �. a4.p F a ' .3'" ' h "y i 'i. '�aj�� �,ay.' � �{ {�., �jn�y�F.w y y typ-t � "4it'_l.yr�+' W��k� )� 'j� fa. VA.N v'� SYR'A S NA9 6SWt "'gi O � %•�>'�A. ��O T . �� " r G ..'C g !� a'''.i E " { Job address: pis fi w►A .�murimm..... Bldg. no.: Suite no.: Lot: °") I Block: Subdivision: 15Y yVt.r(Yo Tax map /tax lot/account no.: Project name: — �- Description and location of work on premises/special conditions: ' A „ _S '' ' b_t y` ; FOI i SP1:t,IAI. IN ORMA T ION USE.'CrI IECKEIST� A,• fivt tvP ...> - j. .., ... a s � 't� 1 ,75i .. -. `, v i�. w + � o. ,,a t w 4 ‘•--10 � � n �'- � `" ` l ; lood lau>t; ci ` - " � ' Nr Mailing address: ap►io�y� 6 w'i/� i[iain 1 & 2 family dwelling: RE II unto. Emmo ZIP: . 7) .i"M Valuation of work $ Phone:. r "al7= ter No. of bedrooms/baths Owner's representative: . A •''' LTA i _ Total number of floors Phone: Fax E-mail: New dwelling area (sq. ft.) 1f Ar 0,44 d " '' ' APPLICANT , - .. Garage/carport area (sq. ft) Name: 1,- ( (\ _ , !'• Covered porch area (sq. ft.) Mailing address: ' a t,, Deck area (sq. ft.) City: I State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial /industrial/multi- family: CONTRACTOR Valuation of work $ IMEMSD A stfi1�� , Existing bldg. area (sq. ft.) New bldg. area (sq. ft.) Address: .41 `s Wi City: Number of stories ity: State: ZIP: Phone: I Fax: I E -mail: Type of construction CCB no.: 7j 5 Occupancy group(s): Existing: New: City/metro he no.: Notice: All contractors and subcontractors are required to be �' Mi V ' 7 1' A ITECT %DES( NER ;' q < <; �• :rr. '� t licensed with the Oregon Construction Contractors Board under Name: (•c , 0 U , � ,• provisions of ORS 701 and may be required to be licensed in the Address: �L� C. �V , jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: , ' ENGINEER Name: Contact person: Fees due upon application $ . Address: Date received: City: (State: (ZIP: Amount received $ Phone: I Fax: I E -mail: 1 Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. • a rovisions of I ws and o dinances governing this ❑ Visa ❑ MasterCard work will be comphee wr ar, whether cified ere i r tot. Credit card number: / / A �� �3) 1 Expires Authorized si u atu r A i f Name of cardholder as shown on credit card $ Print name: rr #(2 .K Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COM) ,/ One- and Two -Family Dwelling k tray s t 7t' .. Building Permit Application Checklist Reference no.: Cay of Tigard Cl Of Tigard Associated permits: g 0 Electrical 0 Plumbing 0 Mechanical Address: 13125 SW Hall Blvd, Tigard, OR . 97223 0 Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 , < ` , 1FIIE FOLLMVING,ITEMSKARE REQUIRED. FOR'P LAN REVIEW+ * - 4w ' t Yes No NIA= 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. • 3 Verification of approved plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. )( 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan 0 permit required. Include drainage -way protection, silt fence design and location of catch -basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed r/ if copyright violations exist. J� 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot v area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. • 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing - member sizes and spacing such as floor beams, headers, joists, sub -floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, l fireplace construction, thermal insulation, etc. J� 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. J� 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing locations. Show attic ventilation. /X 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. ii JURISDICTIONALSPECIFICS , :; „ • 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". )C 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. 26 No rolled, reversed or mirrored building plans will be accepted. • _ 27 28 Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440 -4614 (6,ro0icoM) Electrical Permit Application Received FOR OF US ONLY J �+ A El e ctrical Date/By: I // /7 /Q f/% Permit No.Pj7 {D City of Tigard Planning Approval / / Sign Date / Re Plan Review Permit No.: 13125 SW Hall Blvd. M'` Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503-59W-0001 M ' �I `t\ Post- Review Land Use V Date/By: No.: Internet: www.ci.tigard.or.us � A Contact Juris.: ® 2 See Page 2 for 24 -hour Inspection Request: 503 -63 , li1753F A . I Name /Method: Supplemental Information. BUILDING DIVISION _ `;4? , y3 , , ?:AYPE`QF `:ate W = , ., t, 5. r._ 4 PLANAREVIE,W;(Please:ctieekiall tNataPply),_ ° ® New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ El Addition/alteration/replacement ❑ Other: Hazardous ❑ Service over 320 amps - rating of ❑ Building Building over er 10 10,000 square feet, -: .;- , '="':- .';`: I & 2 family dwellings tour or more residential units in ® 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more III Accessory Building Ill Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: Z d g ;' .' ,.;JO < B` S1 -TE,INFORMATION an dyLOCATION'j: »; ,. Submit _ sets of plans with any of the above. p ^ ® n The above are not applicable to temporary construction service. Job site address: 12 �/ /" 3 3 $ � ,t? A df ✓fl- ' '«e;. ; ..t- .: , :. .Y' M: :lEE*:SCIJEDUI E N:4f ry W::``< > " `s , Suite #: Bldg. /Ap{ #: Number of inspections per permit allowed Project Name: D /14,,,.., // g3 , Description Qty Fee(ea.) Total Q New residential - single or multi - family per • Cross street/Directions to job site: Uu J L lever / f / dwelling unit. Includes attached garage. t• ([ Service included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: R N L )J5)2 Lot #: 5 1 Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling -:DESCRIPTION OF:W � ,:: : 1 -...,: -,.:- ' w service and/or feeder 90.90 2 N Services or feeders - installation, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 '. ® ?PROPERTY 'OWNER;: :7 : ": -`; 0 >TENAPIT:'';' ri4 `; : 43: < ;T :;,, I 601 amps to 1000 amps 240.60 2 Over 1000 amps or volts 454.65 2 Name: fi ,l H oti . M+ fA)C Reconnect only 66.85 2 Address: y23 6 6-, Lt W 660 Ste( sal/ /! Temporary services or feeders - installation, alteration, or relocation: City /State /Zip: L,4, ' ' C5i4/�, -p c ', €7703s- 200 amps or less 66.85 1 Phone: 33 7633 � Fax: 3 8-7— 7c/<. 201 amps to 400 amps 100.30 2 �, 1 , 133.75 2 0APPLICAT `_ ' :,- % " "ai;,' .: illCCONTACT`PL�'RSON s"'`•" : -.' 401 to 600 amps Branch circuits - new, alteration, or Name: extension per panel: Address: A Fee for branch circuits with purchase of 6.65 2 service or feeder fee, each branch circuit _ City /State /Zip: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit 46.85 2 Phone: Fax: Each additional branch circuit 6.65 2 E -mail: Misc.(Service or feeder not included): :° ;i° „fi,''.I; CONTRACTOR ;•:< :," ` ` ' { ^ . —rk t; Each pump or irrigation circle 53.40 2 " ' Each sign or outline lighting 53.40 2 „�' Job No: ( Signal circuit(s) or a limited energy panel, Q ,�` alteration, or extension Page 2 2 Business Name: t/ [ , J,4{ t LC - Description: ( Address, ° e t96, City/State/Zip: Each additional inspection over the allowable in any of the above: y p j�dl /dam C 7700-7 Per inspection per hour (min. 1 hour) 62.50 Phone: 357,„,- r4., 2 p' Fax: 0 3 _ gyy� Investigation fee: CCB Lic. #: 132222 - Lic. #: 3 y C Other: 1 �- %A ..;:*: �2,Ti"? :-WaElecti; ical ;Pe "rmit °Fees,.WTA��„�.,,;i f:C , Supervising electrician Subtotal $ signature required: y �,' G° _� Plan Review (25% of Permit Fee) $ Print Name: /_. A, e . Yo I.* . #: S State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: n Audio and Stereo Systems ri Burglar Alarm Garage Door Opener ri Heating, Ventilation and Air Conditioning System Vacuum Systems n Other COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls ri Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems ri Landscape Irrigation Control ❑ Medical ❑ Nurse Calls ri Outdoor Landscape Lighting n Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all other installations is \Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03 41 Mechanical Permit Application 1, i .: :. ,, Date received: Permit no.: �'l x..4"103 ' ""r'r1,% t ' • e ,y,. A � City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, RecTivED Date issued: By: Receipt no.: Phone: (503) 639 -4171 _ Fax: (503) 598 -1960 Case file no.: Payment type: JUL 31 2003 Building permit no.: Land use approval: - ,, - fli. s , L`F PERMIT .:: , b , :• , - s r. rail' . -: � c4t-4`.i �'�+a ..-.4 ?5k��' ,?t A-�' na � -. 4'. �I.l�r if I� :x c ::�,��w��,4 - -n;,5. �'•_x;.n,�se 4.:;.. - 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family CI Tenant improvement • ,Iew construction 0 Addition/alteration /replacement CI Other: .. 4 .:' °JOB'SITE INFORMATION -'r ` °.z4 r,. ; ° COMMERCIAL VALUATION SCHEDULE Job address: �' 1 ` r , J� Indicate equipment quantities in boxes below. Indicate the dollar • Bldg. no.: S ite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: ( profit. Value $ . Lot: ( 'Block: 1Subdivision: 1 h RAAT ' \ 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: '1- &2 FAMILY DWELLING PERMIT - FEE. SCHEDULE`".. Description and location of work on premises: AND COMMERICALIINDUSTRIALEQUIPMENTSCIIEDULE Fee(ea.) Total Est. date of completion /inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: • Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM g P Air conditioning (site plan required) Is existing space insulated? 0 Yes 0 No — Alteration of existing HVAC system MECHANICAL CnN'1'RnCTOR Boiler/compressors ,■■ State boiler permit t no.: Business name: \ 4 �,I / _ HP Tons BTU/H Address: TZ Fire/smoke dampers/duct smoke detectors _ Kat iESTIM ZIP: WAWA Heat pump (site plan required) II Phone: Fax: E - mail: InstalUreplacefurnacelburner BTU /H - ' ' Including ductwork/vent liner 0 Yes 0 No CCB no.: , - . Install/replace/relocate heaters -suspended, ■-- City/metro lic. no.: N/A wall, or floor mounted Name (please print): • ip Gio' � Vent for appliance other than furnace - - . CONTACT' PERSON Refrigeration: Absorption units BTU/H Name: ° - , -, , Chillers HP Compressors HP IIIII Address: &a.... 1 Ali (' 4ii Environmental exhaust and ventilation: City: State: ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust • - azmat .., -: . _. - ..; .. - QU`NER,, >�. = Hoods, ,TypeUlUres.kitt h� fire suppression system M�. u! Exhaust fan with single duct (bath fans) - Mailing address: • �a l � - 1r Exhaust system apart from heating or AC Ili ���N_ ZIP 4P � Fuel piping and distribut to 4 outlets) ■ -- �1 Type: LPG NG Oil Phone: lami Fax: E -mail: Fuel piping each additional over 4 outlets — • ENGINEER , . : : Process piping (schematicrequired) MiN Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert -type Phone: Fax: E -mail: Woodstove/pelletstove - b �O��� Other her. �-- iii Applicant's si�natu Date: Name (print): ., , , 1 ' • Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ Notice: This permit application Minimum fee $ ❑visa 0 MasterCard expires if a permit is not obtained Credit card number: I / Plan review (at _ %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ Cardholder signature Amount 4404617 (6A)0YCOM) • t .ta qty : .. .'k g <i F { t ` s. „,I..1„.. Plumbing Permit A pplication - a - ,.t. : • ' i- s . . il Daeereceived: Permitno. :�e�ty?,,�jC�� l � �lt� I City of Tigard EC r `/ 11 Sewer permit no.: Building permit no.: � -- Address: 13125 SW Hall Blvd, Tigard, OR 97223 Project/appi.no.: • Expire date: CiryojTigard Phone: (503) 639 -4171 JUL 1 2003 Fax: (503) 598 - 1960 Date issued: By: _ Receipt no.: — CITY OF TI Case file no.: Payment type: Land use approval: IVI - = . PERbITT T YPE' OF' r 0 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement b' New construction 0 Addition/alteration/replacement 0 Food service 0 Other. • JOB SIZE INFORMA11OPi - FEE SCHEDULE (for special intfarmation use checklist) Job address: C�L/ 2 , JV v a if DC, • Description Qty. Fee ( •) Total New 1- and 2- family dwellings only: ' B ldg. no.: I Sui no.: • (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: Block: Subdivision: gor SFR (2) bath Project name: SFR (3) bath City /county: j ZIP: Each additional bath/kitchen _ Description and location of work on premises: Site utilities: Catch basin/area drain Est- date of completion/inspection Drywells/leach line/trench drain .,., . .•EJ y ,s� :<y <, ., Footing drain (no. lin. ft.) `”' PL )Nlii1NG° C O i ItACTO 44 � Manufactured home utilities Business name V 1 N 1...k) t-' J 1 1.....q.. Manholes Address: T l Rain drain connector City: ' • State'�� ZIP: Sanitary sewer (no. lin. ft.) ��� —• �� ► Phone: Storm sewer (no. din. ft.) - Fax: �C r �� . E - mail: -� Water service (no. lin. ft.) CCB no.: t '• ' I Plumb. bus. reg. no: _ Fixture or item: City/metro lie. no.: N/A , Absorption valve Contractors representative signature 'rY Back tlow preventer Print name: 1 • o' I ll !!Liles Backwater valve • 1 • .,i C Ot I AC ,l t'I :KSON • ??' ` r 4 ' . `'" ; '' Basins/lavatory Clothes washer Name's 1{�` i ,����I �E Dishwasher Address: • / Ap V, w Drinking fountain(s) City: I State: ZIP: Ejectors/sump Phone: I Fax: E -mail: Expansion tank OWNER - Fixture/sewer cap IIIIII � �� Floor drains/floor sinks/hub — Name (print): • it t 1 .A 1 Garbage disposal Irj. tral Mailing address: i Hose bibb 111111 • City: L _ D . Ice maker MI Phone: 1 . – , 1 Fax: •,7-7kl IMMIIIII.1111111i Interceptor /grease trap — Owner installation/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: . Sump • ` " ENGINEER • Tubs/shower/shower pan Urinal Name: Water closet Address: Water heater City. I State: l ZIP: Other. t Phone: Fax: E - mail: Total Minimum fee ................ $ 'Not all lunsdicrioru accept credit cards. please call junsdicuon for more tnforrrution. Notice: This pl'.m1it application C Visa ❑ htisterCard expires if a permit is not obtained Plan review (at _ %) $ I / w ithin I SO days after it h be en State surcharge (8%) $ �— C.edit card number. Expires $ -� -- p TOTAL accepted as complete. Name of cardholder as shown on credit card S 4S0 -3616 t6' - � Cardholder signature � I • AAAAAAAAA A AAAAAAAAAAAAAAAA , AAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAA\ Tlow C�IZ'T' IFICA STREET TREE ► ■ 0" '� Owner/Agent for v) rJvi t'sse OE N„,.-,, I, 3-forKca /f9 ►'-'T� (PERMIT HOLDER) (P�EnSE PRINT) 4 ; . ■ A Do h ereby Certif3r that the following location ■ I. A meets City of Tigard /Washington County ` ► land ■ use and develo�»nent standards For street tree inistallation. �■ / d i ADDRESS: J1 ii .3 y,,.) .4 j/JG�'` . "e 1 / ■ 1 LOT: 5 ( SUBDIVISION: /�,.✓lvj� ■ 4 • 1 BY: DATE: V.-0Z —0Y ■ 1 RECEIVED BY: A C_ _ DA'1'D.: y7-2; ^v/ / TTTTTTTTTTTTTT TY YTTTTTTTTTTTTTTPTTTYVV VTTTVTTTTTTTTTTTTTT7 CITY OF TIGARD 24 -Hour 22 — DO ��ll C/0 /1 BUILDING Inspection Line: (503) 639 -4175 MST c3 3 INSPECTION DIVISION Business Line: (503) 639 -4171 3 BUP Received 3 + a P Date Requested �Z3 `� AM PM BUP Location l 2 _ ? �� -- (J uite MEC Contact Person l' Ph ( ) 269 7 PLM Contractor Ph ( ) SWR BUILDIN Tenant/Owner ELC Footing ELC Foundation Access: , ,< �p-2 eAe -c---- Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear /0 4 Vt � Ce � � , c'" l Framing � 1 '✓ Insulation ` ! ' c Drywall Nailing �C . 6041 1 "J� c Firewall Fire Sprinkler Fire Alarm j L�(1 //1?-6. ;4 4 . S 4((e_d Susp'd Ceiling t! Roof �� , VC " U f4- l s4AU Fi / ART FAIL �i I I �P PLUMBING '!.7 _ _,. �' , % .. I ' / / h , Post & Beam fa: S Ili ' Under Slab 6 45 ©" 5' Water Se egg / Q_ Y j � d (7 '/ Water Service �� • D'e /'t) G/ r/'}l'�(rr� l�Pill-Ulkd Sanitary Sewer � I Rain Drains "Ale ,1 00 AL.." .. Catch Basin / Manhole / Storm Drain .1 e I - 4 - - • r V' Shower Pan l A 544 Other: Final f PASS PART FAIL th4I CHANICAL IX) Post Rough -In Gas Line S Dampers Finale 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 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date Z 7 — ° Inspecto/ �-- C 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 MST o 903 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received 31 J F� Date Requested 2 3 —O CZ AM PM BUP Location 3 ? ' ' Suite MEC Contact Person Ph ) 2-€) 9 —e/cr3 7 PLM Contractor Ph ( ) SWR BUILDING 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 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 CTRICAL Service Rough -In UG /Slab Low Voltage m Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SIT Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Date Approach /Sidewalk �� 1 Inspector V �Q ' " `U Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL