Permit ✓./.
CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2004 -00124
I>Il DEVELOPMENT SERVICES DATE ISSUED: 4/29/2004
'=-� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12056 SW WHISTLER'S LP PARCEL: 2S103CD -WW269
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4 5
BLOCK: LOT: 069 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: DM199AS STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,610 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.790 sf GARAGE: 630 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRa sf RIGHT: 5
VALUE: 330 60
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3.400 sf REAR: 15
PLUMBING '
SINKS: 2 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS. SEWER LINES. 100 SF RAIN DRAINS: 1 CATCH BASINS.
TUB /SHOWERS: 3 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: 3 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: 7 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL 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: $ 8,439.08
DON MORISSETTE CUSTOM HOMES DON MORISSETTE HOMES INC This permit Is subject to the regulations contained in the
4230 GALEWOOD STE #100 4230 GALEWOOD ST, STE 100 Tigard other Code, laws. of All OR. wo b o ne i n
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 and rd ra cer applicable laws. s . This permit done in
accordance with approved plans. This permi twill expire
If work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 387 - 7536 Phone: ATTENTION. Oregon law requires you to follow rules
3 adopted by the Oregon Utility Notification Center. Those
Reg. i.9 387 7 55383 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080 You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Storm drain lnsp Building Final
Sewer Inspection Underfloor insulation Electrical Service Gas Line Insp Appr /Sdwlk Insp
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Fireplace Electrical Final
Found- ' "- - -- PLM /Underfloor Framing Insp Gyp Board Insp Mechanical Final
P. t/Beam Structural Mechanical lnsp Shear Wall Insp Rain drain Insp Plumb Final
sued By : 1 .'��� // , i _ O Permittee Signature : ,
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
To ? -1- I � - 0-7 -o� Mimi ���:!.is
0 9 `` Building Permit Application •
Date received: /A Permit no.: / ,,. ii _Iva.
t 1 yl City of Tigard Project/appl. n..: Expire date: ,
CityojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 C: se file no.: Payment type:
' 1 & 2 fa mil Sim le Com lex:
Land use approval: ' family: Simple p
"Fail: OF PERIi l IT -
Li 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family , New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement CI Fire sprinkler /alarm ❑ Other. fl
JOB SITE INFORMATION
Job address: rr�F�v�s L�%nlA�� ' Bldg. no.: Suite no.:
Lot: �, Block: Subdivision: I "k Block: , T/J o ax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER
•
FOR SPECIAL INFORMATION, USE CHECKLIST
Name:, n i 0 rl ( Iloodplain ,septiccapacity�,solar,etc.)
Mailing address: 'eimmg£ L ' as 1 & 2 family dwelling:
City: 1110 MIIIIMM EMMA ZIP: - 'Z; Valuation of work $
■
Phone:. ri alW A M OM , -mail: No. of bedrooms/baths
Owner's representative: � j f 61:k (I L1L Total number of floors g' __
Phone: Fax: E -mail: New dwelling area (sq. ft.) 7,MY.
• . APPLICANT . Garage/carport area (sq. ft.) wo
Name: Al L.
Covered porch area (sq. ft.)
Mailing address: ' r �i , a Ni c.... Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commerciallindustrial /multi - family:
CONTItACTOR " • Valuation of work $
Business name: Existing bldg. area (sq. ft.)
�"� 1 �n�= rlfwjat� New bldg. area (sq. ft.)
Address: �' &_
City: Number of stories
ity: State: ZIP:
Phone: I Fax: I E -mail: Type of construction
CCB no.: 7j 5 5-. Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
- ARCIIITECI /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: ( let c.& trt_ L provisions of ORS 701 and may be required to be licensed in the
Address: ` 2.411.V CUi CL,hriN0 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: 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 junsdiction for more information
attached checklist. A . rovisions of 1 ws and o dinances governing this ❑ Visa ❑ MasterCard
work will be complt- • wt., whether ified ere t. n u Name card number. / /
/
Authorized Si y . , ' A l ,: e v' Nae of cardholder as shown on credit card Expires
Print name: •:>, " Mr T zfftw t ( J! 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
' ' ' Application Checklist
Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard City of Tigard `J O Electrical 0 Plumbing U Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
•
, TIIE FOLLOWING ITEMS - ARE REQUIREDWFOR - PLCN - REVIEW • Yes
y
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 ❑ 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
if copyright violations exist. J�
1 1 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,
fireplace construction, thermal insulation, etc.
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.
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. '�(\
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. 'y
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.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ".
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.o0icoM)
jvi s - 7 - 0 2go y 00 12 1 1 -
1' Mechan Permit Application ., -
� Date received: , Permit no.:
, j ..•� J! City of Tigard Project/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement •
Iew construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION . - COMMERCIAL VALUATION SCHEDULE :
Job address: i '� & iWA_�%� Indicate equipment quantities 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: ram Block: Subdivision: iAl �rilylai 'See checklist for important application information and
Project name: . illI MIE 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 COMMERICAIJINDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion /inspection: Desaiption Qty. Res. only Res. only
Tenant improvement or change of use: HVAC: Ill •
Is existing space heated or conditioned? 0 Yes 0 No Airhandling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system - ME MECHANICAL CONTRA b
Bodeoomprer I ■■
����}}�� � State boiler permit it t no.:
_fs re HP Tons BTU/H
Address: tfl�M Fire/smoke dampers/duct smoke detectors _
Pts rgs ZIP: rj,_ ilg� Heat pump (site plan required) : ==
Phone: ,,j, . ' Fax E -mail: Install/replacefurnace/burner BTU /H
CCB no.: Including ductwork/vent liner 0 Yes 0 No
Install/replace/relocate heaters - suspended,
City/metro lic. no.: N/A wall, or floor mounted ■ --
Name (please print): lirrj G � � R ent for appliance other than furnace : ==
CONV • P bsrigeranion:
Absorption units BTU/i-I
OM i/ i ` Chillers HP ME
Compressors HP I
Address:
�- �L Environmental exhaust and ventilation: . --
City: State: ZIP: Appliance vent
Phone: Fax: E-mail: Dryer exhaust IIIII
•' n N
r q
\ \' ` _ Hoods, Type I/ lures knchen/h
azmat
hood fire suppression system III 1.ia, �t raM Exhaust fan with single duct (bath fans) - __
1 N Exhaust system apart from heating or AC —
Mailing address: x� � I / e_ �
Fuel p and d (up to 4 outlets) ■ --
�e��� Type: LPG NG Oil
Phone. SINIW Fax: E-mail: Fuel piping each additional over 4 outlets _
`- , ' ... FN G IN E I•: R , . Process piping (schematic required) - MINI
Name ' Number of outlets
Other listed appliance or equipment:
1111
Address: Decorative fireplace
City: State: ZIP: Insert - type
Phone: Ersommon Woodstove/pellet stove -
Other: I
- Applicant's signatu" _e � AI Date: ,ff Other. M
Name (print): ./ • ' • f 11111
Not all cunsdicuons accept credit cards. please call lunsdreuon for more information. Permit fee $
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at _ %) $
Credit card number Ex
Expires w i t hin 180 days after it has b ( )
p been surcharge (8 %) .... $ .
Name of cardholder as Chown on credit card accepted as complete.
S TOTAL $
Cardholder signature Amount 4464617 (&OOCOM)
Al 6 I a soe y —0 l elf
Plumbing Permit Application
y ,, �
. Daterecelved: Permit no.:
,' .�+1- , ∎'ilti
C of Tigard
Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd. Tigard, OR 97223 Projecdappl.no.. Expire date:
CiryofTigard Phone: (503) 639 -1171
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Case file no.: Payment type:
Land use approval:
•. • TYPE OF PERMIT - .
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
t._ New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION -• FEE SCHEDULE (for special information use checklist)
Job address: f / l v� Description Qty. Fee(ea.) Total
!L1I_ New 1- and 2- family dwellings only:
Bldg. no.: Suite no.: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: �,� SFR (1) bath
Lot. Mill Block: Subdivision: TL�V� :rI'1r�r'7 SFR (2) bath
Project name: J ��M� SFR (3) bath
City /county: I ZIP: Each additional bathilutchen
_ ^ Description and location of work on premises: Sitetttilities:
Catch basin/area drain
Est- date of completion/inspection: Drywells/leach line/trench drain
Footing drain (no. lin. ft.)
Manufactured home utilities
Business named >p,,,�QI L-U h I ' iL I Manholes
Address: Rain drain connector
Sanitary sewer (no. lin. ft.)
� ► State d ZIP: �'
City: � • – V� � Storm sewer (no. lin. ft.)
Phone. _ _ -« Fax: E -mail.
�-� Water service (no. lin. ft.)
CCB no.: [ (97L! – ] Plumb. bus. reg. no y – Fixture or item:
City/metro lic. no.: N A // Absorption valve
Contractor's representative signature �� ✓t"z .• 1 Back flow pre"enter
� •
I Print name: , 1Z r�ftl Backwater valve
• CONTACT I'1• :1(SON. - Basins/lavatory
\ -- DI 1J E Clothes washer
Name:. 1 Dishwasher
Address: akik 0 / 1 e , ,V Drinking fountains)
City• I State: ZIP: Ejectors/sump
Phone: I Fax: E -mail: Expansion tank
I O \1 \I R, . •• Fixture/sewer cap
Floor drains/floor sinks/hub
'Name (print): \ .3,,1 k--- 'elS AIL -672 Garbage disposal
g 4- f �) L ' • Art
Mailing address: T '. , Hose bibb ,
City: L._ . State ZlP:C/-20. , Ice maker
Phone: - 7- - }' --? Fax: x.7;70 E -mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Pnmer(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. I ZIP Other
Phone: I Fax: I E -mail: Total
Minimum fee $
Not all juns,Lcuons accept credit cards, please call hunsdcuon for mom infoinuuon
Notice This permit application
C Visa 0 vtssterCard expires if a permit is not obtained
Plan review (at %a) $
wit hin I80 days after tt his been State surcharge (8%) ...• $
C.edu card number
Expires TOTAL S -
accepted as complete
Name of cardholder as shown oa credit card
S
Cardholder signature Amount 4.1o4616 (60000M)
At sT OV'/ (0 /c2Y
t: ` . ` Electrical Permit Application .. - •
• Date received: Permit no.: •
1 ,
'• iVgj u I
l City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.. Payment type:
Land use approval:
TYPE OF PERMIT' -
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
►' New construction ❑ Addition/alteration/replacement ❑ Other. ❑ Partial
- JOB SITE. INFORMATION .
Job address: r rirr JP I1SI", �/ 'I _o . Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: &ill. Block: Subdivision: I �� l . 1V 0,16. 1/J .L_ 0
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
.rCON"I I(ACI012 Al'I't_ICA l ION - - - FEE SCIIEDULE -
Job no: Fee Max
Business name: v1 1
C ` aEL Description Qty. (ea-) Total no. hasp
�-- New residential -single or mufti- family per
Address: "1" gap • v . � _ at'.. • �" dwelling unit. Includes attached garage. 4.
City: ' • State:de ZIP: d" ..,_ , Service included:
Phone:242.1 j - I Fax: E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: .� f Elec. bus. lic. no: a(d'p9 (......1 Limited energy, residential 2
Limited energy, non - residential 2
Each manufactured home or modular dwelling
nature of supervising electrician (required) D ate Service and/or feeder 2
Sup elect name (print) 9 License 9 d5 Services or feeders — installation,
alteration or relocation:
(p rint ) : � U L Lr 7
200 amps or less 2
Name 1 �`^ „, tkr r� 201 amps to 400 amps 2
Mailing addres 2 , r L ..9
4 01 amps to 600 amps
s-• -c 601 amps to 1000 amps 2
City: 1_,D, [State ZIP: 70 Over 1000 amps or volts 2
Phone:"•.277 Fax :7- - 7k, E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 2
200 amps or less
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2 ,
ENGIIVEER Branch circuits - new, alteration,
or extension per panel:
Name: A Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: —
Each additional branch circuit:
. PLAN . REVIEW (Please .check all that apply) ;', ., Misc. (Service or feeder not included):
O Service over 225 amps- commercial Cl Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 ❑ Hazardous location Each signor outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stones ❑ Feeders, 400 amps or more •Descnpuon:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan 0 Other. Per inspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction sex Other
Permit fee $
Na all lunsdtcuons accept credit cards, please call junsdicuoo for more information. Notice: This permit application
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8%) .... $
, Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440 -4615 (600/COM)
• CITY OF TIGARD Credit No.: 2004 -0001
Date Issued: 01/28/04
0 Engineering
'}ri:�l� °�' �g� `L0 Authorization
'0
� G t,P �t� Date: 01/28/04
TRAFFIC IMPACT FEE 0 \- -c't �4,
CREDIT VOUCHER SO. Land Use
Casefile No.: SUB2003 -00004
In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) Venture
Properties, Inc.
developer) (name of
is entitled to $ 50,606.07 in Traffic Impact Fee Credits that can be applied to TIF charges for
development on lot(s) 1 - 29 of the Whistler's Walk 2 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.
er-1:::j P. 0, ,.
Director
Date Permit Numbers Lot Numbers Credit Used Balance
Beginning Balance $ 50,606.07
p
Balance carried forward to TIF Credit No.
• Ordinance 379 provides for an expiration 10 years from authorization.
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use and development standards (of street tree installation.
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CITY OF TIGARD 24 -Hour ` ■ .1_
BUILDING Inspection Line: (503)'639 -4175 MST ° T -:-CYO �°�
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 6 AM PM BUP
Location / oZ0 7 Lt) � � Suite MEC
Contact Person Ph ( ) a O 1 Cie 37 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:
M7 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
SS PART FAIL
EL RICAL
•
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date /o Inspector Ext
Other:
Final • DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ` �" Odla `C
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested — / AM PM BUP
Location teJ Suite MEC
Contact Person Ph ( ) v 5- ¥ ?37 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 4110
Footing "'
Foundation ELC
Ftg Drain Access: ELR ��
Crawl Drain "'AVM
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
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
1•ASS PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: abl- t. inspect — no access
Fire Supply Line
ADA -
Date ~ O V Inspector i Ext
Other:
Final DO NOT REMOVE this inspection from the Job site.
PASS - PART FAIL