Permit A. CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00011
4 i DEVELOPMENT SERVICES DATE ISSUED: 5/18/2004
" ''�I I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12073 SW WHISTLER'S LP PARCEL: 2S103CC -WW288
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R - 4.5
BLOCK: LOT: 088 JURISDICTION: TIG
REMARKS: New SF
BUILDING
REISSUE: DM186AS STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,517 sf BASEMENT' sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,958 sf GARAGE: 640 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 T sf RIGHT: 5
VALUE: 338 40
OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,475 sf REAR: 15
PLUMBING
SINKS: 1 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: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOILJCMP < 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/O SVQFDR: 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 8 STEREO: VACUUM SYSTEM: AUDIO 8 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: $ 8,492.37
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES INC DON MORISSETTE HOMES INC
4240 GALEWOOD ST #100 4230 GALEWOOD ST, STE 100 Tigard Municipal Code, State Aof ll l work k wil bey done n
and 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
Phone: 503 387 - 7538 Phone: ATTENTION: Oregon law requires you to follow rules
387 7 3g adopted by the Oregon Utility Notification Center. Those
Reg #: �q 35 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 Structural Mechanical lnsp Shear Wall Insp Insulation lnsp Water Service Insp
Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insl Gyp Board lnsp Appr /Sdwlk lnsp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain lnsp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line lnsp Storm drain Insp Mechanical Final
Foundation lnsp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Alli
Issued B : � -• . ./r Permittee Signature •
By irk. aai
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day '
•
,, Building Permit A lication
, I tfR
RECEIVED Datereceived: /27, , • Permit no.:
�i'i1 City of Tigard ye, Project/appl. no.: _ . ire date:
City of Tigard Address: 13125 SW Hall Blvd, rgNR � /�
Phone: (503) 639-417 I: Date issued: i Ii1 J 1 % Receipt no.:
Fax: (503) 598 -1 • • % Case file no Payment
ITY OF TIGARD y type:
o
Land use a. 'royal: BUILDING DIVISION 1 &2 family: Simple Complex:
- , "1 PE OF I'ERMIT. r
•
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family y 'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other
JOB SITE INFORMATION •
Job address: , rfirg� tE�� i,� Bldg. no.: Suite no.:
Lot: 4 7 Block: Subdivision:1i/ 1 ! iW ii----- �(� Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: •. , OWNER _ FOR SPECIAL INFORMATION, USE CHECKLIST .
Name: �l%JtIL1 � �ili=�i.
/
Ma (I 7oodplain,scpticcapacit' ,solar, etc.) .
Mailing address: 'en�,rar� 1 & 2 family dwelling:
City: c Statet'4 ZIP: 'x) , Valuation of work $
Phone:. ' "7- - )c- ) Fax j)) 7 -mail: No. of bedrooms/baths G7 3
Owner's representative: lina_� i- 1' f Ge r L Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.) (.
Name: - �' .A .a ' Covered porch area (sq. ft.)
Mailing address: 'ryle, * CC. Deck area (sq. ft.)
City: `State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/'mdustriallmulti- family:
CONTRACTOR Valuation of work..., $
Existing bldg. area (sq. ft.)
Business name: _ 1,,, L Ld] New bldg. area (sq. ft.)
i . Address: ,& L,r drAinIg4. , Number of stories
City: State: ZIP:
Phone: I Fax: I E -mail: Type of construction
CCB no.: 7-) 5 Cj �j ?J Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECC /DESIGNER - licensed with the Oregon Construction Contractors Board under
Name: C- 1et,,f, _ � : • provisions of ORS 701 and may be required to be licensed in the
Address: �, --,1� c . jurisdiction where work is being performed. If the applicant is
City: State: I ZIP:
exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
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 jurisdiction for more information.
attached checklist. • • rovisions of I ws and o idinances gove 'ng this ❑ Visa ❑ MasterCard
work will be compl - • wr • • , whether Hied tiere{n t. card number: / /
ill
�� / �/�' .I Cre c
Authorized si atu / /� i / ` f(f Name of cardholder as shown on credit card $ Expires
l
Print name: ' Z 7 t ( -e...... Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (6J00/COM)
•
One- and Two - Family Dwelling
•
' ' Permit Application " " '
Building Permit Application Checklist Reference no.: •
City of Tigard City of Tigard Associated permits:
g Y Cl Electrical Cl Plumbing Cl Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ' Cl Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Ci ^ ":',T
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. i
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 CI plan Cl permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc. J�
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 x
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, X
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. x
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.
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 ". x
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 (uooicoM)
•
Mechanical Permit Application
A k
^ Date received: Permi —ere/
�r CE9VE®
�{ j, •� City of TigE Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 .
Phone: (503) 639 -4171 JA 2 v 2004 Date issued: By: Receipt no.: _
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:CITY OF TIGARD Building permit no.:
. \ G DIVISION
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement •
XIew construction 0 Addition/alteration/replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE -
Job address: �J l�� " 11�1TLF11 fi r" , 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: gR) 'Block: - I Subdivision: U\}l/\_.(,� l .k 3 'See checklist for important application information and
Project name: L ' jurisdiction's fee schedule for residential permit fee.
City/county: j ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE.`
Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENTSCHEDULE
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
-- MECANICAL CONTRACTOR -- - - Boiler/compressors
H
Business name:���}}�� State boiler permit no.:
s��fi _�I.J _ HP Tons BTU/H
Address: T M Fire/smoke dampers/duct smoke detectors
City : � E emwa t wa Heat pump (site plan required)
Phone, J j . Fax: E -mail: Install/replace furnace/burner 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): j p e I�- - tag" ( .EL._ Vent for appliance other than furnace
CONTACT" PERSON Refrigeration:
Absorption units BTU/H
Name: i "` ¶�`A-.1 Et Chillers HP
Address: CIA c�� Compressors HP ,
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
O \V N E R , , ' . Hoods, Type l/ lures. kitchen/hazmat
hood fire suppression system
Name: T IIIN I MICI P MMPl a gra lli sa Exhaust fan with single duct (bath fans)
Mailing address: raglarMillEMITA Exhaust system apart from heating or AC
City: IMID ta ZlPR -- 70 5 Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: ppidi Fax: E - mail: Fuel piping each additional over 4 outlets
hN G I N E li R. Process piping (schematic required) ,
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
. Applicant's signatui:��,�, r�O,N Date: W MBa. Other
Name (print): kL.` yr f J][,'/'' lc / l
Not all jurisdiction information. accept credit cards, please call �unsdiction 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 it s w ithin 180 days after it has been
p State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
S TOTAL $
Cardholder signature Amount 440 -1617 (6/0C/COM)
•
• ' ca ti on z
P 1 ; 1=
- :M. �■ lip Date received:
Permit no.:)/Wee --.040 /
t T
,g. . . ' I1� C O 1 lg .`lY td A � ' �i Sewer permit no.: Building permit no.:
Address: 13125 SW Ha v gi'° 97223
City of d
Phone: (503) 639 o Ti Project/appl.no.: Expire date:
Tigard
Fax: (503) 598 1960 GTYOFTIGARD Date issued: By: Receipt no.:
BUILDING DIVISION Case file no.: Payment type:
Land use approve .
- 'TYPE OF PERMIT '
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
►: New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION ' FEE SCHEDULE (for special information use checklist)
n A) Description Qty. Fee (en.) Total
Bob address: New 1- and 2 -family dwellings only:
Bldg. no.: I Suite no.: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: PO MI Block: Subdivision: 1 11I A �IM.'"‘I SFR (2) bath. ME
Project name: T i SFR (3) bath
City /county: I 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
— Footing drain (no. lin. ft.)
".= . " PLUN1IIING ., CONTRACTOR Manufactured home utilities II
name: ` p L i Manholes
Address: .iRi��r2� Rain drain connector
1 ��at,, _�. �'� ZIP: Sanitary sewer (no. lin. ft.) IIIII
�1at E -mail: Storm sewer (no. lin. ft.) El
Phone: y A Fax: w Water service (no. lin. ft.)
CCB no : • 1, Plumb. bus. reg. no: —
Fixture or item:
City/metro lic. no.. N/A l �/ '/ Absorption valve
Contractor's representative signature ._ N _won Back flow preventer
Print name: • , I U • 1i Jr4 Backwater valve
. CONTACT PERSON Basins/lavatory
Name: •-
1 i , _sp.cf_D I N •• ,, E Clothes washer • •
Dishwasher
Address: /ha ' _ • / , v Drinking fountain(s) ME
City: I State: Ejectors/sump
Phone: Fax: Expansion tank
OWNER Frxture/sewer cap
_ ,�, ,�, Floor drains/floor sinks/hub (print): j :��� 1'� Garbage disposal
Mailing address: . • ' • Hose btbb
SIIIIM
���� Ice maker
City: L.. -, .
Phone: j • — A , Fax: PI, Interceptor /grease trap IIIII
Owner installation/residential maintenance only: The actual installation Pnmeris)
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), basln(s), lays(s)
Owner's signature: Date: Sump
Tubs/shov•er /shower pan
ENG[NGIiK Urinal
Name: Water closet
Address• Water heater
City: t State: ZIP • Other.
Phone. 1-Fax: 1E-mail. Total
Minimum fee $
n
'Not all tusdtcuons accept credit cards. please coil lunsdtcuon fa more informauon
Notice: This permit application
Plan review (at o)
C Vi 0 MasterCard expires if a permit is not obtained State surcharge (8%) •• -• $ �—
C.edtt card number ./ / w ithin 180 days after t t h b een $
Expires accepted as complete. TOTAL �—
Name or cardholder is shown on credit card •
S
A 4.10—S616 (6 -roM)
1/4. Cardholder signature i
Electrical Permit Application
R EC E i 911 ED Date received: Permit no,:}1 .ex 1 I
,. , .., rlr {s I'� City of Tigard Projectfappl.no.: Expire date:
�
City ofTigard Address: 13125 SW Hall Blvd, 9,441,210 9 ) Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
CITY OF TIGARD
Land use approval: BUILDIMn, nlVIRIAN
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
I New construction 0 Addition/alteration/replacement O Other. 0 Partial
- JOB SITE INFORMATION .
Job address: ify aymn g���f� Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: 10' Block: Subdivision: l V A, r i
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
cON l RncTOR APPLICATION FEE SCHEDULE -
Job no: 9 D 0 Fee Max
Business name: ��++ �._.,-� ] ^� 1 L Description Qty. (ea.) Total no. tarp
t_�l 1 `I 1-� �/ Nen residential -single or multi -family per
Address: rip IP .-` A C I I., • 6" " dwelling unit Includes attached garage.
ZIP:
S ervice included:
��� � � 4
Phone: m 7j - ! r� j j Fax: E -mail: .1000 sq. ft or less
Each additional 500 sq. ft or portion thereof
: no.: y ,ti� Elec. bus. lic. no: .„ , c 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) 1 A '� j License no 9 9 Services or feeders — installation,
AIL alteration or relocation:
• • PROPERTY OWN liR - 200 amps or less 2
201 amps to 400 amps 2
Name (print): ` • • ` tl(iky..A 401 amps to 600 amps 2
Mailing address: n� 50411 - 1 4A c T 601 amps to 1000 amps 2
City: L State a ZIP: 70 £ Over 1000 amps or volts 2
Phone: , '516 ' . ' _` 0EIM T i.%r -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
ENGINEER • 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: 'State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2 —
Phone: Fax: Email: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) - Misc. (Service or feeder not included):
O Service over 225 amps- commercial 0 Health-care Each pump or irrigation circle 2
arefacility 2
0 Service over 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting
•
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
O Building over three stories 0 Feeders, 400 amps or more *Description.
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other. Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
Not all lunsdicuons accept credit cards, please call jurisdiction for more information. Notice: This permit application
0 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
$
Cardholder signature Amount 440-4615 ( &t /COM)
CITY OF TIGARD Credit No.: 2004 -0001
Date Issued: 01/28/04
Engineering
A v
bill' Authorization
r rlfll;l
Date: 01/28/04
TRAFFIC IMPACT FEE
CREDIT VOUCHER 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.
eri:i P. ::),
Director
Date Permit Numbers Lot Numbers Credit Used Balance
Beginning Balance $ 50,606.07
Balance carried forward to TIF Credit No.
• Ordinance 379 provides for an expiration 10 years from authorization.
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST eX) cl /
-bOO(/
INSPECTION DIVISION Business Line: (503) 639 4171
BUP
Received Date Requested - AM PM BUP
Location / ° 7 3 �-L� r -.0' Suite MEC
Contact Person Ph ( ) 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 �" (-1 ;\
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 L � , - 11 4 U ?
Service
Rough -In
UG /Slab ) C�
Low Voltage ' � — i / �� Ti li �._�. - U 1 o C 0,4?‘ 6
Fire Alarm
"ASS Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
A SS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA / 6 i /
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGAR,D 24 -Hour • •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST ( 4-000
BUP
Received Date Requested 9- a AM PM BUP
Location 1 D-0 7 3 )1L -L .6ii..a Suite MEC
Contact Person Ph ( ) a v 5 — F37 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:
m9 `
PART FAIL
ANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
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 °� 1 p`t Inspector C7� 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 :5U °C)6
INSPECTION DIVISION Business Line: (503);39-4171
BUP
Received Date Requested — 3 AM PM BUP
Location a � ] �� �flili Suite MEC
Contact Person Ph ( ) c:20 – 4/(s237 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 9- 2.--O4—
Ext Sheath/Shear a6G ?ics F "4/fi- cPe17 9- /-o4- A2so
Int Sheath/Shear Su/�i�U�T A-S to t �iNs QAees. -�c L 6hed- zo,v7 -09L
Insulation
Drywall Nailing 'Poi wr Lc KO 4 L 5
Firewall
Fire Sprinkler ,oric L �' ,I - ���- ,uor l�S. -� - .� ,�
Fire Alarm
Susp'd Ceiling
�-��
Roof �� ' 1 2 4 . 7 S C O -Si - _
Other: -
�►i d lL‘ CA—tie/z2 S CO
SS _PART
• • = ING _ 7 &_;4 • 4 C r
Post & Beam
Under Slab
Water Service L -,
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
•- ASS PART
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: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 9— 3 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL