Permit A CITY O F T I G A R D MASTER PERMIT
PERMIT #: MST2004 -00173
i ii DEVELOPMENT SERVICES DATE ISSUED: 6/21/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12390 SW WINTERVIEW DR PARCEL: 2S110BC -04200
SUBDIVISION: THORNWOOD ZONING: R -
BLOCK: LOT: 013 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: DM170QA2 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,600 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,670 sf GARAGE: 406 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 MU" sf RIGHT: 5
VALUE: 313,906 20
OCCUPANCY GRP: R3 BDRM: 5 BATH. 3 TOTAL: 3,270 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 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: BOIUCMP < 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: WISVC OR FOR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: 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: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL b SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,035.78
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORISSETTE HOMES INC
4230 GALEWOOD ST. #100 4230 GALEWOOD ST, STE 100 Tigard Municipal Code, State of OR. Specialty Codes
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 and all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 387 - 7538 Phone: ATTENTION: Oregon law requires you to follow rules
5 - adopted by the Oregon Utility Notification Center. Those
3
Reg 6: 1,9 355533 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 Extenor Sheathing InsF Gyp Board Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final
Issued By : '� ' 7A-ot. _ _ # Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
To p'- (o -iS -aM '' iii - .1 0
Building Permit Application
AI, Date , y 0� -AA Permitno.:flg 00 /r13
City of Ti! EIVEU , •
=' '� �� g Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, O 7223
Phone: (503) 639 -4171 JUN 4 2UIJ Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type: •
CITY OF TIGARD /
Land use approval: BUILDING DIVISION l &2 family: Simple ADP omplex:
TYPE OF PERMIT �T
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family ,'New construction ❑ Demolition L
❑ Addition/alteration/replacement ❑ Tenant improvement 0 Fire sprinkler /alarm ❑ Other.
J
4
OB SITE INFORMATION
Job address: k ' 1 r1 ' 4 ,t,l J r + Bldg. no.: Suite no.:
Lot: (I7 Block: (Subdivision: , (AfeDa„. 1 Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: \\�
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name:, + � �' ( Floodplain ,septiccapacity,solar,etc.) �
�1 \
Mailing address: ' ei�EWi ' e e , 1 & 2 family dwelling:
City: MIIIIMIIIMMEEDIAELMNIZ Valuation of work $
Phone:., s1 '1 l , -mail: No. of bedrooms/baths
Owner's representative: , : its j ( C-k br Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) .i...
APPLICANT Garage/carport area (sq. ft.)
Name: � y ., �. - . A & � Covered porch area (sq. ft. C
Mailing address: 1. -yie , a a -t. Deck area (sq. ft.) I /
City: I State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi - family:
CONTRACTOR Valuation of work $
Business name: L Z �� nd � l Existing bldg. area (sq. ft )
Address: � ��L ,
New bldg. area (sq. ft.)
City: State: ZIP:
Number of stories
Phone: Fax: (E -mail: Type of construction
CCB no.: ?) 5 C5--2j5 Occupancy group(s): Existing:
City/metro lic. no.: New:
Notice: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: (-,1ti,-(,l t,r, k provisions of ORS 701 and may be required to be licensed in the
Address: c�) 1AQ C(k 'h 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:
Name: Contact person: Fees due upon application , $
Address: Date received:
City: (State: ZIP: Amount received $
Phone: (Fax: 1E-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. A . rovisions of l ws and o,(dinances governing this O Visa O MasterCard .. - �y ,
work will be compli - • wt ., , whether Hied here ' Credit card number: "/
_ / f t� � r""' �L Expires
Authorized si _ atu Name of cardholder as shown on credit card
Print name: r!>, 3 t ,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)
. l
A lb One - and Two - Family Dwelling
a :, � ,j - Building Permit Application Checklist Reference no.: J.
•
Associated permits:
City of Tigard Cl of Tigard 'J g 0 Electrical O Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 0 Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TIlE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. V
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 4
3 Verification of approved platlot.
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 Cl 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 t/
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 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 ` ,1
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. 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.
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 ".
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 (6100/COM)
1
Mechanical Permit Application
�; Date received: Permit no.� Y � /7 �,
�'1'►l , City of Tigard RECEIVED
�,�- -: ty g Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Ti ard, OR 97223
Phone: (503) 639 -4171 JUN 4 2004 Date issued: By: I Receipt no.: ._
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type: .
Land use approval: BUILDING nivisioN Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi family 0 Tenant improvement •
,few construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 0 j MI,' , , 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: ` (Block: I Subdivision 6YVttitf_51_, 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: I & 2 FAMILY DWELLING PERMIT FIE SCHEDULE
Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE
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. 'CONTRACTOR � Boiler /compressors
State boiler permit no.:
MILI�� f� I MI.� = HP Tons BTU/H
Address: iMO riM R Fire/smoke dampers/duct smoke detectors
_M�� 1r9 � Heat pump (site plan required)
Phone:,.jl] - - J-5)),D Fax: E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: '?-) c-5(1) ) lnstall/replace/relocateheaters- suspended,
City/metro Iic. no.: N/A wall, or floor mounted
(please print): � i I
Name (P P r y s ,� ' ���(___ P 1 Vent for appliance other than furnace
t � �
CONTACT PGIttiON Refrigeration:
Absorption units BTU/H
i ` Chillers HP
�� Compressors HP
Address: � UiI Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
O W N F It Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
11 .116 Ma ar Exhaust fan with single duct (bath fans)
Mailing address: R'�i �i� _a 7 Exhaust system apart from heating or AC ,
_ we.. IlwT�]
Cit '� � Fuel piping and distribution (up to 4 outlets)
�`
Y: • �� �r � Type: LPG NG Oil
Phone: .�� Fax: E -mail: Fuel piping each additional over 4 outlets
" . . ENGINEER Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City I State: J ZIP: Insert - type
Phone: Fax: E -mail: ',,� O Woodstove/pelletstove
Other:
Ne g 1� � j h� MOM her.
Applicant's si Wars Date:
Name (print): ,' •• . 1 ' . , 7
T
Not all junsdscuons accept credit cards. please call Jurisdiction 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 numlxr. Ex pi w 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 (6AO/COM)
l
Plumbing Permit Application
Date received: Permit no.if few -00/7 .
M City of Tigard RECEIVED Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd. Tigard. OR 97223 Project /appl.no.: Expire date:
City ojTigard Phone: (503) 639 -1171 JUN 4 2004
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
CITY OF TIGARD 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
►: New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)' -.
' * 1 Descri lion Qty. Fee(ea.) Total
Job address: .. iii �� ! S /� pi 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_ \ 5 IBlock: I Subdivision: IA _ SFR (2) bath
Project name: SFR (3) bath
City /county: I ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Siteutiliries:
Catch basin/area drain
Est. date of completion/inspection: _ Drywells/leach line/trench drain
Footing drain (no. lin. ft.)
PLUNII1ING, . CONTRACTOR • - Manufactured home utilities
Business name: pi, ` 7 L i Manholes
Address: • ) I , • Rain drain connector
City:
Sanitary sewer (no. lin. ft.)
• ► Stale ZIP: Storm sewer (no. lin. ft.) till _me
�jl.j Fax: E -mail: .� Water service (no. lin. ft.)
CCB no.: t, c •2 L( I Plumb. bus. reg. no: - - 1� ' Fi xture or item:
City/metro lie. no.: NiA ' Absorption valve
Contractor's representative signature t. Back flow preventer
Print name: jnii ` m
-Mo Backwater valve
CONTACT PERSON Basins/lavatory
Clothes washer -
Name:,. 1•-t ��DI E Dishwasher
Address: Z 6/,)� (_,1V - Drinking fountain(s)
City: State: ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
7.''.,•:,-.. OWNER • Fixture/sewer cap .
Floor drains/floor sinks/hub
Name (print): ait x�` Garbage disposal
' Ir mo . Mailing address: , • - • e_& 1 • Hose bibb
City: • () • State , ZIP :C 7O ' 7 Ice maker
Phone: 27 -" -I I Fax: N?7-7k • 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 ,
Tubs/shower /shower pan
Urinal
Name: Water closet ,
Address: Water heater
City I State. ZIP: Other
Phone: I Fax: E -mail. Total
Minimum fee $
Notice Na all l+^sd,cuoas aaccept m
credit cards, please call (tins Lcuon for more infouuon Ni This permit application O1 $
)
C visa u mber / MssterCard expires if a permit is not obtained Plan review (at State surcharge (34'0) •••• �-
C.edrt card nu w ithin 180 days after it has been
Expires TOTAL $ --
accepted as complete
Name of cardholder as shown oa credit card
$
430-1616 (6ga(Otit)
Cardholder signature Amount
•
Electrical Permit Application
REC EIVED Date received: Permit no.HSI 9 "lb/ �tj.
+}.•' I I '� City of Tigard P ro J PP • P
ect/a I no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tiggr(#, a 7 4 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171 �
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval: BUILDING DIVISION
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 Other. 0 Partial
JOB SITE INFORMATION
watiropPr
Job address: 11 -, / I Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: PI M Block: ubdivision: /PP
Project name: Description and location o work on premises:
Estimated date of completion/inspection:
CON I RAC I OR AI'I'I.ICA l lON FEE SCIIEDLY.E -
Job no: Fee - Max
D e scr i p tio n Qty. (ea.) Total no. (asp
Business name: �"`� Q.EC2 -' New residential - single or multi - family per .
Address: ' "' gip • � ` e (`` • E" dwelling unit. lncludes attached garage.
City: . tea 1, :l ZIP: d" ,, Service included:
Phone:1424.3 - ! dr, Fax: E -mail:
1000 sq. ft. or less 4
; / t.0 f � ` , C....- Each additional 500 sq. ft or portion thereof
CCB no.: t
Elec. bus. lic. no: ZJ` Limiteeenergy, d energyy, residential 2
C Limited energy, non-residential 2
Each manufactured home or modular dwelling
nature of supervising electrician (required) Dat Service and/or feeder 2
��p Q C, Services or feeders — installation,
Sup. elect name (print) 1 ef_ License no
l �✓ alteration orrelocation:
200 amps or less 2
o 201 amps to 400 amps 2
Name (print): Ur • Ill(���.rr� 401 amps to 600 amps 2
Mailing address: r ��j 101 _ /� 10 S .-, lb •
amps to 1000 amps 2
City: . a l S tate v ZIP: - 2,0 Over 1000 amps or volts 2
Phone: , .,,07- Fax: - -mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary services or feeders -
installation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
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: I State: 1 ZIP: B Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each addiuonal branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps-commercial O Health-care Each pump or irrigation circle 2
Health-care (acihty 2
O Service over 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting
family dwellings 0 Building ovu 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 •Descnption:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egress/ltghungplan 0 Other. Per nspecuon 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 junsdictions accept credit cards, please call jurisdiction for more Information Notice: This permit application Plan review (at _ %) $ _
0 Visa 0 MasterCard expires if a permit is not obtained
Credit card number. / / within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. TOTAL $
Name of cardholder u shown on credit card
$
Cardholder signature Amount 440-4615 (6t00/COM)
UO'I) LVU4 14:01 MA 5us51:1s1a8u CITY OF TIGARD 01001
CITY OF TIGARD Credit No.: 2003 -00001
Date Issued: 3/28!0
�,
A Engineering
`72;� j Authorization
` - Date: 3/28/03
TRAFFIC IMPACT FEE
CREDIT VOUCHER Land Use
Casefile No.: SUB 2000 -00008
In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) Don
Morissette Homes, Inc.
V (name of
is entitled to $ 168151.00 in. raffic Impact Fee Credits that can be applied to TIF charges for
development on lots of
p lot(s) � � the Thom Qd Subdivision 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 Pe a it.
r
w(oz-
I Date Permit Numbers Lot Numbers Credit Used Balance I
Beginning Balance $ 168,151.00
4 -F °4 tfl'1 Emil 1 57' 3 y 0 110570
y -1 - o3 yb5? Z.aoS•Oato 9.2 fl,a3SrJ 1yi 371
0
q 7 1 15f AA' IVY' I 4p90 LIP" / 41
o mCrao93 -00!33 /0 a 34o a5t 59l
Eft 03 rn6T,1oa3. oo 1[ _ ,0.3 i0 8,
5 0.q hrs tL6 [y, -, 22)b 4 / .1 r4Z2q6 .r, 153 S6
to /05 03 insT.��s_ 0040 r{ . ( .co
44 . M4194 A91/ 'I 'b AtiV' f;l l
• ao 0 fir-47339 -"CO tW °ELI a.i• 14 bill - ik
a3 h15 7 , - ,70 / $1 02 316- Pl_g ? 5", -
6 l''''� -5 `moo -- mJif3 a 07,390 _ i41
Balance carried forward to TIF Credit No.
�� . • Ordinance 379 provides for an expiration 10 years from authorization.
toginwtota\W 9.1
.T.
A S TYLI — cm 1
(44&. 4 1E-
a
STREET
T REE CERTIFICATION
A
A
- -- (I'I:IZAII'I' /lOt.I)ER)
1 I )c0 Iie'i eby c'et l I(y that the following location
meets City of 'I'igaicl /WashiIIgton County
®
land use and development sl;IIR6rcls for st reset tree installation.
: -: ADDRESS: __L9Q 50) /.44i1/ TeX 1/ eV. - - - -- •
LOT: /3 — SUBDIVISION!: -- _:/lavyntwotd .- —
)4,
DATE: _0?5 - 0? --
n I I 4 �3 a —
e t ij Ct:IVED BY: f I -- — - --
ffTYTTYYTTY TTITY Y TTYY TIV VVYY*VTYTYTTTYVVYV®TTYYTYVYTTY1 -
., , .,
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MSTo3)O 0 I 73
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested AM PM BUP
Location / , R39D t - Suite MEC
Contact Person Ph ( ) � 49 —1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing • AMA _ /�
Insulation 1 / a,, / •" ri d�:�' /�l d /�, A ✓..A 41 A
Drywall Nailing iv �� rL� LJ
Firewall IIIMPIMMIIMIMIZEIWYSIff.: Fire Sprinkler
Fire Alarm I MA� ' r FAWAV
Sus 'd Ceilin g
�.�
Roof V KWILM-TASIMMAVAW _
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
SS
, �9w v
Rough -In
UG/Slab
Low Voltage
Fire Alarm
As PART FAIL
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line / �` i
Date , �t1I
ADA D ae v ` 1
Approach/Sidewalk 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) 6394175 MST 2A •
7 " G 3
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested � �'oZ 3 AM PM BUP
Location / DN 39 (.IJ��L%vl4.)—(:_p_c—D Suite MEC
Contact Person /5.(' Ph ( ) v Z - 4 /73 . 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
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:
PART FAIL
M ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
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 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA Date q Z3 tO' 1 Inspector � I � �""�
Approach/Sidewalk P Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
1
CITY OF TIGARD 24 -Hour ' c1
BUILDING Inspection Line: (503) 639.4175 MST a 7�
INSPECTION GIVISION Business Line: (503) 639 -4171
�.. q BUP
Received Date Requested / ' 3 AM PM BUP
Location / a 9 D � L o� Suite MEC
Contact Person Ph ( ) c ' ---4 7 4 1?' 3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing c... EGA:— G—r,,lC'�L .G. ALC 'lam nro - ) 9 -23
Insulation
Drywall Nailing ��"4 n
Firewall A-41(
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
m
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
anal
ASj 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 D Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA D Q 2 3-- O 5L Inspector Ext
Approach/Sidewalk p
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL