Permit 1 CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00057
mall, 0 11 DEVELOPMENT SERVICES DATE ISSUED: 4/1/04
`-" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15895 SW AVON PL PARCEL: 2S112CC -18800
SUBDIVISION: DURHAM OAKS ZONING: R -I2
BLOCK: LOT: 024 JURISDICTION: TIG
REMARKS: New SF Detached
BUILDING
REISSUE: BVH1605 - STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 22 FIRST: 616 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 989 sf GARAGE: 307 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: I THIRD: sf RIGHT: 5
VALUE: 156,293.30 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1.605 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 3 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL '
FUEL TYPES FURN < 100K: 1 BOIL /CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =100K: 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: 2 201 - 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: $ 7,228.18
BUENA VISTA HOMES BUENA VISTA HOMES This permit is subject to the regulations contained in the
all other r applicable e Code, State work OR. Specialty
one Codes and
6932 SW MACADAM #C 6932 SW MACADAM HOMES all other applicable law All work will be done i
PORTLAND, OR 97219 PORTLAND, OR 97219 t
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: 503 443 - 6033 Phone: 503 443 - 6033 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952-001-0080. You
Reg #: LIC 152235 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing ins F Rain drain Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain lnsp Mechanical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation lnsp PLM /Underfloor Framing lnsp Gas Fireplace Water Service Insp Building Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk lnsp
Issued By : �,Z .,- Permittee Signature : � . l/
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the ne i busi • ss day
/3
Building Pe _��_s_ Ala `,i',-Iii'.s!'Pitioil F:OR QF'F'1('E: t'SE:O \L1
v ,�r - s Received Buildin f ZO O bD 5
Date/By: Permit No.: 7
Planning Approval Other �l ZOO pp®
City of Tigard FEB 6 2*- s g
13125 SW Hall Blvd. ED Da Permit No.:
Plan Review Oth
Ti
Tigard, Oregon 97223 Date/ey/ v - 7 . '-'=)`/ Permit No.:
g g TIGARD
o l�� Aosti ! ` \ Post - Review Land Use
Phone: 503 -639 -4171
Internet: www.ci.tigard.t _al� •� I
� I Contact': � /Q� <- m Case No.
'� "� '� Contact f /e Juris.: el See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method:V.F1,/[J Supplemental Information • TYPE OF WORK .• .REQUIRED DATA:_'.." ..;.2. '-: .1 ,` . •
K New construction ❑ Demolition I &2 FAMILY DWELLING, :.'' "•:• . ' •
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
I & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation S
JOB SITE INFORMATION and LOCATION No. of bedrooms: ?j No. of baths:' i 7
Job site address: 15�1 S" St..., f ve , � (2i n;.<. Total number of floors
New dwelling area (sq. ft.) 0
Suite #: ( Bldg. /ADt. #: Garage /carport area (sq. ft.) -
Project Name: "v) l t Lit v Covered porch area (sq. ft.) -4 SF
Cross street/Directions to job site: Deck area (sq. ft.) 0
Ot her structure area (sq. ft.)
S v ti ' Nall g \v� 4 Sw O V A / how ,
• •- - -REQUIRED DATA::. =
Subdivision: OW' hl2-m Q (X«S 1 Lot #: �1 - COMMERCIAL =USE CHECKLIST
Tax map /parcel #: Note: Permit fees• are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
• ek, I e D � y ^ � �I Le overhead and profit for the work indicated on this application.
Ill 1 1. (� ^ 1 ; �' . , i_1 , Valuation S
- - — Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
} PROPERTY OWNER .. 1 ❑ TENANT • - . . Type of construction
Name: V jot \ ,5 Occupancy group(s): Existing:
Address: 1P�1�2, 5 M co 1 4 New:
City /State /Zis Pt /'4 m R 0 11"2_i'i
Phone: sly / p �, Fax: '- NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
APPLICA
❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: g\ff,ii jurisdiction where work is being performed. If the applicant is exempt
Contact Name: M \ In A\A\i PX� from licensing, the following reason applies:
Address: c - , (A)/Y\P. tu b ove,
City /State /Zip:
Phone: I Fax: • B . *
E -mail: . = - -
r }� n ..D: N..,�. :...: =.J-
al m ��,�tVt ��mC �•�.�Lr}`� Please refer_tafeeschedula
CONTRACTOR • �. .
Business Name: r PAG V i #3 Fees due upon application S
iv, Address: / 4 , ■ J i G I, L , Ii ii ii-C,
Cit /State /Zi . : r mm% ry Amount received S
Phone: . r. '.1 MN 1W Date received:
CCB Lic. #: j c,j
Authorized � 1 •� /
Signature: ` �./lN (./ �l t 'l U-' , Date: Z(
Y 6'f( Notice: This permit application expires if a permit is not obtained within
/ '/ 180 days after it has been accepted as complete.
41 Ite 1-664,,,i I
Fee methodology set by Tri- County Building Industry Service Boa rd.
(Please print name)
is \Dsts\Permit Forms \BldgPermitApp.doc 01/03
•
01/20/2004 16:22 5032537693 SUN GLOW INC PAGE 02
' FuR U1:G'1('t -: 1. tiE ONLY +�C�Ianical Fe t�u !l:1? w -! `:3 XQ� Received Mechanical
Data Permit Na.:
City of Tigard Planning Approval ? J _
FEB 6 2004. 1 aces
13125 SW Hall Blvd. Plus Review Mt'
Tigard, Oregon X7223 Date/B . - rnnit No.:
Phone: 503- 639 -4171 Fax: 0f T 1RD ,., , . . Pest.Review Land Use
�,
Crate/Ti CaseNo.:
mu
Nntetuet: ww.ei.tigard.or- uBUILDING DIVISI e ' _.� j i Contact furls.:
24-hour Inspection Request: 503 - 639 - 4175 J Name/Method:
EOF.WORK:. :., 1, Dr jrEF,'t,SCHTIDULEL`.UBE,+G338C+US't". •.
0 New construction 811 Demolition MechatliCal permit Fces° are based on the total value of the work
III Addition/altcration/re.lacement • Other: perEhrmed- Indicate the value (rounded to the nearest dollar) of all
_ s mechanical materials, equipment, labor, overhead and profit.
'
a ' :CONSTRUCTION
lo 1 & 2- l~amiil dwellin_ NM CommerciaUindusu'ial Volue: S See Pagge Ter r Feeee Schedule
111111 Accesso Buildin 1r Multi -Peril Ilescri.:an IIMI
I• Master Builder • Other: 1 - : , _ cooren
. • ' JOB SITE ENTORMATION.andi. e • . •• Furnace - add-on air conditioning +r 14 - 00
Job site address: i5 §i1' 5i..,., AK, Pl k. - Gas heat pump v-- • 14,00
Suite #: EIMEMIIIMIIIIII Duct work 14.00
Pto•ect Nate: J, / i ,ell ] HYdxomec hat water system 14.00
Residential boiler
• • • -• -Cross Street/Directions to job site: (fbr radiator or hydronie system) 14.00
D, 1 /� G ,P'{ 1 �� (fuel,
(in it heaters (Enot electric)
�L/r V (in wall, heaters (f t, , not
etch 14.00
Flue/vent (for any of above) 10.00
Lot #: ., 't units 12,15
Subdisision P . , / i1
. o :
/ D. Other Fuel Appliances
111012 .. ; Water hearer _____ 10.00
• E,SSCRIPTIONN OF WO " � Gas fireplace 10,00
MN = "4..„ � DPAIS� Flue vent (water neater /ps fireplace) 10.00
�� Lo_ li- , er ,as 10.00
L;A71aii �i� ' A IL Wood/Fellet stove ■ 10.00 MI
/'1 ETA Wood fire-lace/insert 10.00
.1111.11 Ghimne /llnedfluc /vent 10.00 •
;. :TEN ,,: Other: 10.00
c }l'}ft03 R'6Y'OWl'iER ' ,:: " Environmental Exhaust & Ventilation
� . '.� �� �� II��'� w R ange hood/oti kitchen equipment 10,00
Address: ►, ��i ") ATAIV ' i'� /. 1 M M ' clothes dryer exhaust 10.00
l � .Wi��� Single duct exhaust
Phone: 0 111 1�j %� s (ballrOoms, toilet tae partments,
iii APPLIC 'ST IyA : eNTACrPERSON utility rooms) 6.80
Name: V / / MEM wa•• 0 $ MS Attiderawl space fans 10.00
Address: . AV /A0 D> '. other Fuel leL t
"_ ..s0 for first • S .00 each additio . ml
I' ,
Pbon , Furnace, etc
Fax: curs heat am Mill "
E- naai1: W., I♦ , _'J /. 1f . i it _ !I wall /s ndcdlunit heater _ ' rE _
COl11FRAC OR Water heater
Business Name: Fire•lace .. MOM
Address: 'Z I '- IIIMMi
Ci /State/Zi.: p . . 0. • it Z b Clothes . as
Phone - 14 - 2.5 71' PA Other, Total: J ._
CCB Lio, #: t3 Mecaenaieu Facie •e&
Authorized - - } , Subtotal: 5
Signature. � _ __ bate: I ZU 09 Minimum Permit Fee S72.50 S
• . it 01 I, L.. ( Plan Review Fee 25% of Permit Fee) $
- State SurCh
(Please . • c name) - TOTAL PERMIT FEE S
*Etc ofetbodotogy set by Tri- County Sultan Industry Service Beira
Notice: This permit application expired rfa prrtrlit is not obtalntd within 0,4 9 1 te plan required for exterior A/C omits.
ISO days after it has been accepted as complete.
i:\ DstO rtrnit Forru\MeePermitApp.doc 01/03
01/20/2004 16:03 FAX 5036284633 THE MULLEN COMPANY !J002 /002
• . FOR i)f�1- 1C`1•: l'SE ONLY ;� mbiug erm><t Application Received Plumbing
•
Date/1 Permit No.: 1
City of Tigard Planning Approval Sewer
Date/BI Permit No.:
13125 SW Hall Blvd. PP a Review Other
Tigard. Oregon 97223 RE Zi E D Date/13Y: • Perm t No.: _ Phone; 503 - 639 -4171 Fax: 503.59$ -196 Poet- R,evlow Land Use
' ' ' ..• Dat . Case N -:
Internet: WWW,ei.rlgard.or.us 4 I1 1 f Contact Jobs.: Ste Page 2 for
24-hour Inspection Request: 503- 639 -4175 '''` ■ame/Method: 8 upplemtental Information.
CITY OF TIGARD
TYPEOP.WORK, '' Bl'ifL.ID111(5 MIS! I N FEE *;SCHERULE Pr ,•: 'tlartiimattsuirersZe dtltst '• • -
ei New construction ■ Demolition Description Q4Y• legea.) Total
• Addition /alteration/replacetnent I U Other; • " _. t �''` : ' : ` ; ' "� ,. _ '
'' ZILITA�itO 'OF;rObl:93IRVCTIOPI SFR l bath 249.20
1 & 2- Family dwelling r Commercial/Industrial SFR 2) bath 350.00
■ Accessory Building ■ Multi - Family SFR(3) both 399.00 MON
II Master Builder M Other: Each additional bath/kitchen _ 45,00
..TOR SITE INFO - ' ,• TIONaud•LOCCTION Fire sprinkler • sq. ft.; Page 2
Job site address: K6 6 `IS t 1 -k Kt-, //// • •.. UtU x ..
J�IJ l�/fy r/ ' - ..�_� " "`. ' ` �- �' � '..Site Vl�uil ►FC •,•r,.,�‘ii+e2.41ti�l�'.::' - ,
Suite #: Bld =. /A. t. #: Catch basin/area drain ( 16.60
l?ro'ect Name:
. . , e/.. "1I Drywell/leach line/trench drain 16.60
Footing drain no. linear EL) IIIIIIIIEETEI
Cross street/Directions t0 job site: Manufactured homy utilities 110,00 •
^/� own �� I I � //� R Manholes 16.60
y/ �/�/ 1 U �/ 1 I I ` V V l Rain drain t om►ector 16,60
Sanitary sewer (no. linear ft.) iii= Pa_c 2 iiIMMI
Subdivision: 9J M� MIN Lot #: N' Storm sewer (no. linear ft.) Page 2
Tax m &p/Ual Czl #'
Water service (no. linear ft.) Pane 2
. • Fiztrrrebe Item:' . .'•-• '
DESCRIPTION OF WO • Absorption valve 16.60
I Iilli fi VIE ,1 C eacicflow preventer Page 2
116i119IVAII I I O1STIN i MI Backwater valve 16.60
Clothes washer - 16.60
Dishwasher _ 16.60
Drinkin_ fountain 16.60
/a:+ PROPERTYOWNER ° . . - 16359' TENAII T • , :'•-• Ejectors/sump 16.60
Name: r ij I 'A/ / V� o i1 . et` 1fl Expansion tank 16 :60
Address: t ig'Vxy * If / _ l. �1 11� =� i Fixture/sewer cap 16.60
�
City /State /Zip: P l'I me - `� Floordrain/tloor sink/hub 16.60
n Garbage disposal 16,60
Phone: , L1 2,3-(10 Fax :` .'$ 2 1, Hose bib - 16,60
LA, +t . _� .. ►a CO. _ . .. ' LIMN . lee maker 16.60 _
ame: �� A.I� NMU ! h tnterce.tor /, ease tr• • 16.6
Address: • i 111_ j / / • d/a e - Medical gas - value; b Page 2
fit /State/Zi. : ]'rimer 16.60
}r pt Roof drain commercial 16.60
Phone:. • 9 0 02- Fax: • 4 24 sink/ navatory 16.60
'reAp /i I tat '. • 0 Tob /shower /shower pan 16.60
.. , • • , F,OMRAC COR . . ' Urinal 16 -60
water closet 16.60
Business Name: L 6 -- ,, / .A.1,
Water heater 16.60
Address: / . r... . ./ .E _ t. 0 Other: t• IMMO --
City /State /Zip; � j/ < h.ro OR 9 ?.-3 Other �,
;, ...altimb etaiisltrik —
Phon- fir : l F .SD - • �- Subtotal
CCB Lie. #: "14 i3 9 • lumb. J c. #: -,2O tot Minimum Permit Fee 572,50
Authorized '' Residential Rackflow Minimum Fee 536.25
Signature; 4 ‘-- Date:/ L ° ' �`'1 Plan Review 25% of Permit Fee S
Pft f / Stara Surel e (5% of Permit Fee S
(Pte print name) TOTAL PERMIT FEZ 5
Notice: This permit application aspires if a permit is not obtained within ' All new eemmerdal buildings require a sets of plans with isometric or
180 days after it has been aoeept4d 118 Complete. riser disgrokis foe plan review.
*Fee methodology set by Tri- Cooney Building Industry Service board.
i; \Rsa \Permit Fornts\P[mPermitApp.dee 01/03
01/20/2004 16:08 5036425815 ROSS ELECTRIC INC PAGE 01
r
Electrical Permit Application - FO12 f. >'htic r USE ONL
Received El ectr i ca l
Date/By_ Pemtit IN..: _
City of Tigard ®C���� P lanningAppmval Sign —
13125 SW Hall Blvd. ® �C ® th y Oth
Plan Review other Permit No.;
Tigard, Oregon 97223 •
�- Datc/By: Permit No.:
e
Phone: 503- 639 -417I 505R8.4960 j 4 h :f :: Post - Review Land Use
IvU�U •,,.�
Internet: www.cLtigard.or.u5 ,i
. Date./By: No.:
24 -hour Inspection R 1 ' : C
A ection e I/G pI 0 �uris i See Page 2 for
IG639 -4175 VISI AR Namc/Method: 1 Supplemental information.
• BVILDII
TYPEr WORK '
. � : 1'Rts�'1<Ew . 1�tse etieck MFthas` '�;
R New construction CU Demolition • Service over 225 amps. • Health -cam facility
M Addition /alteration/replacement ❑ Other: menial D Hazardous location
cam
❑ Service over 320 amps -rating of El Building over 10,000 square feet,
:CATEGORY'OF CC STRTICTTON..' . ... .... t & 2 family dwellings four or more residential units in
fiT1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ B
❑ Accesso $Uildin� uilding over three stories
• Multi -Famil ❑ Feeders, 400 amps to or mo
I A Master Builder ❑ Occupant load over 99 persons [] Manufactured structures or RV pant
Other: ❑ Egress/lighting plan ❑Other:
'' : . ' . TOB SITE • .IINFORIVIATIONII,i1EOCATION ..:: Submit sets of plans with any of the Above
Job site address: ( S6 7 r .51.,i 41 c-. Pi , The vi ce, `
Suite #: BId •. /A.t. #: • • above are not s ['cable to rem ra construction ser ,�Z ULE....,:..;..i= _... "-. . , ,
Pro ect Name: Number of ins . ections . er ' emit allowed
1 fi �� �f rlptl0n spy Foe (ea.) Total ,
Cross street/Directions to job site: New reside i Includes or meld-family per
` u v , /` Rot an, 1 I V vo • Servkc clu lacladea attached garage. �U�/ r' IC Servke included=
1000 sq. R, or less 145.15 4
Each additional 500 R. or •.rtion thereof 33.40 j
Subdivision: �„ �]� L imi ted ener , residential
.", L ot #: t• 75.00 — 2
Tax map /parcel #: ed home :..non residential or modular 7s.00 2
Each manufactured or modular dwelling .
UESCR1 TION.OF' WORX. • :: service and/or feeder 90.90 — 2
/�« / I 'I TZFR. i Servfces or - , tallgtion,
((����'" � ■ �FI9�Iw aitcrattna Or feeds relaeatiop;
it>i„�s idiP M ,rMt a i I ams
.: less 2
20l 200 am. ro 40p mn. 80.30
N 1 06.85 2
401 a ... to 600 a .s 160.60 2
y°$ 'PROPERTY owliER • • 121 .' :.• .: .. 601 am' to 1000 awl IIMI 240.60 2
Name: ".1 /+ t / I i Over 1000 am• or volts 454,65 2
Reconnect on
NMI Address: a 66.85 2
u I 111.411 A CJ T emporary services or feeders . instahadon,
CI IS . te/Zi a : 'tni /L j r or 200 alteration, r o e r � relotation.
Phone , ► C � 60•85 1
4. !AN I D o NI ��� 20 ( am to 400 am 100.30 2
ME
11R 1►7 CONTACT. PERSON: 401 to 600 am.; 133.75 2
Q y r extension t - alteration, or
1 cztenst nslon per per panel:
Address: ��Lf / i A. Fee for branch circuits with purchase of
& LOjd, service or feeder fce, each branch circuit II 6.65 2
C ityr/State/Zl a : B. Fee for branch circuits without purchase of .
Phone. liz, ID , a - ' 2414 fast branch circuit 46.85 — 2
i
1 ash additional branch circuit 6,65 2
.:. w V �J I /I rilli NIA / S . corn • Misc•(Servicc or Feeder not included); ■
:COi1 ABC OR': Each pump or irrigation circle
Job No: Each si or outline li: hcin 53.40 2
53.40 2
Signal circuit(s) or a limited energy panel.
Business Name: 1 " 06.5 i�a{� alteration, or extension 2
Add.ress: 3k) +1,1 q-rte.
Description: —
Cl /State /Zi.: Hi S 601- -, 0 r /71 �1 2 J Each additional ins . - ion over the allowable in an of the above:
Phone:.5 t3 Z 2$DO ax: i7 � _ � _ 62.50
CCB Lic. #,t: i 7891 Z� Other: f e . ,,
Supervising electtician :,. Elirtri l;Pet atItFtr •';: , , :..,;.:..
si;+ afore re. uired Subtotal $ $
Print Name: Ve ) 0� S Plant Review 25% of Permit Fee S
State Surch: : e 8% o£Permit Fee S
Authorized OTAL PERMI $ Notice: This p ermi t application ex tr ey If a
Signature: / e'z /77c/$4 p perm it is not obtained within
t _ Date: L i SO days after it has been accepted as complete.
*Fee methodology set byTrI- County Building Industry Service Board.
A //CC. ( C G..-i
•
(Please print name)
i:1bsts \Perrnit Forms \ElcPermitApp,doc 01/03
CITY OF TIGARD Credit No.: 200 - 000.3
Date Issued: 2/24/04
Engineering
� Authorization
Date: 2/2404
TRAFFIC IMPACT FEE
CREDIT VOUCHER Land Use
Casefile No.: SUB2002 -00009
In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) ECF
Durham Oaks, LLC
developer)
(name of
is entitled to $ 37,332 in Traffic Impact Fee Credits that can be applied to TIF charges for
development on lot(s) 1 -27 of the Durham Oaks Development. The use of TIF credits are subject
to the rules and limitations of the TIF Ordinance which are listed on the back of this voucher.
WARNING: This voucher must be presented at the time of issuance of the building permit, or if
deferral was granted, issuance of an Occupancy Permit.
a P.
Direct
Date Permit Numbers Lot Numbers Credit Used Balance
Beginning Balance $ 37,332
Balance carried forward to TIF Credit No.
• Ordinance 379 provides for an expiration 10 years from authorization.
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l and use and development standards for street tree installation.
AI 94/ n • ADDRESS l S 5 1 5 (Avon 1-71 0-
• LOT: SUBDIVISION: 1/4itm, a LS
• BY: g DATE: l o 0.
• RECEIVED BY:. / ,,�/ DATE Q - g a4�
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®YYYYY ® ® ® VV ® ® ®
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST °�� - a° 6 5
INSPECTION DIVISION Business Line: (503) 639 -4171
Q BUP
Received Date Requested — g AM PM BUP
Location / s F5 S Suite MEC
Contact Person Ph ( ) 7/0 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 4P' C, LL , (b ,e%; ,C?fftr.L?
Insulation
Drywall Nailing - �..� ,t...., . ,� ' C �� e "Li =L- •
Firewall
Fire Sprinkler / �=
Fire Alarm
Susp'd Ceiling
Roof
Ot'y:
•ASS 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
in l
ASS 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 Please call for reinspection RE: ri Unable to inspect - no access
Fire Supply Line
ADA rr
Approach /Sidewalk Date 9 d 0 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILBUILDING Inspection U " e: (503) 6394175 MST -- D x�-�
INSPECTION DIVISION Business Lin (503) 639 -4171
BUP
Received Date Requested AM PM BUP
Location / 6 -� PJ Suite MEC
Contact Person Ph ( ) 6 4 —/ c9- 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
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
'e c
/i`a. ab
Low Voltage
Fire Alarm
<`: PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE, ri Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line ,�
ADA
Approach /Sidewalk Dat PAS IcY inspector 4 s Ext
Other:
Final DO NOT REMOVE this inspection recor . from the Job site.
PASS PART FAIL