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8930 SW GREENING LANE a cn w a N y m �D 7 7� �Q r o� c� 1 8930 SW Greening Lane CITY OF •TIGARD BUILDING INSPECi ION DIVISF N MST 24.-Hot:r inspection Line: J-4175 Business Line: 639.4171 -- - _ I BUP Date Requested AM PM _ a �y _ ESLD Location`— D `l.�C� f�Q� I_.e- Suite � MEC Contact --- - Contact Person Ph �� ` _- PLM Coritractor Ph _ 7 G� SWR _— BUILDING Tenant/Owner ELC Retaining Wall EL.R Footing Access: - Foundation fps Ftg Drain - Crawl Drain Ins:)ection Notes: SGN Slab -___----- --- ---. _---_._ ----- Post&Beam SIT-- --- -- ---------- Ext Shc,:th/Shear Int Sheath/Shear ��! `-------- -- _-- Framing Insulation -- -----._._----------------_ ---- Drywall Nailing } Firewall Fire Sprinkler Fire Alarm ---��-�------ ---_ Susp'd Ceiling - Roof ---- --- ---- Kit I SC: ------------ Final ------ --� —_ ._.------- PASS PART FAIL -- —• __ PLUMBING Post& Beam - - --- Under Slab Top Out Water Service Sanitary Sevrpr - -- - - - -- - Rain Drains Final - PASS PART FAIL _ MECHANI:.AL Post& Bear) ----- Rc,ugh In - ---------- - ----- Gas Line -- - Smoke Dampers Finai -- -- PASS PART FAIL ELECTRICAL - -- - -- - Seryirp - -- -- -- Rough In --------- ------- ------ -- UG/Slob I_ow Voltage Fire Alarm PASS .PAR T FAIL - Backfill/Grading Sanitary Sewer Storm Drain ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW HtiA Blvd Catch Basin F lease call for reinspection RE: Fire Supply Line ] p [ ]Unable to inspect no access ADA Approach/Sidewalk Other Date r( J� G� Inspectors 0�1 tExt - Final -PASS --PART__ FAIL DO NOT REMOVE this inspection record from the job site. — t CITY OF TIGARD RI GILDING INSPECTION DIVISIr'v MST �,i 24-Hour Inspection Line: 34175 Business Li ie: 635--.171 i 3UP Date RequestedAM__ PM BLD _ I ��cation n G1 _'RC1 :�12 Suite MEC ,r,ntact Person Ph C'9 -33 70 PLM Contractor Ph SWR BUILDING i Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes. _--- - Slab - ---- - --------- SIT Post&Beam `----- -------- ----- Ext Sheath/Shear Int Sheath/Shear Framing Drywall Nailing Firewall Fire Sprinkler --- -------- ---.__.--------------___-- Fire Alarm Susp'd Ceiling - - — - ----- - ------._ —- ------- —---- — Roof - Misc: - Final PASS PART FAIL ------------ PLUMBING Post R Beam --- - -- - ------ - ---- _ ---_- Under Slab TopOut ------_-------- __,---._..�--- - ----- Water Service Sanitary Sewer - ---- - --T -- -- -....-- Ra' Drains -PE PART FAIL WCHANICAL Post& Beam - .----- - -- -- ---- - - --- Rough in Gas Line --------- _ -_ __ __�_------___-- Smoke Dampers Final -- PASS PART FAIL ELECT RICAL - Service Rough In -- UG/Slab Low Voltage ---- -- Fire Alarm Final PASS PART FA;LSITE Backfill/Grading -- Sanitary Sewer Storm Drain [ j Reinspection fee of$ — —requirW before next inspection. Pay at City Hall, 13125 SW Hail Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RIF _ _ )Unable to Inspect-no access ADA Approach/Sidewalk (� r Other Date c3 / 3i�j ' — Inspector %�_! L �A�`C Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DI`./ISInN M;T �v�cx� "4-Hour Inspection Line: x-4175 Business Linn: 63„ 171 BLIP _Date Requested '` AM PM BLD Location-----$ ,L�U _ __ Suite MEG Contact Person PhPLIVf Contractor Ph SV IR BUILDING y — Te Cant/Owner ELC Retaining Wall — ELR Footing Access' - -- --- Foundation FPS _�— Ftg Drain SIGN crawl Drain Inspection Notes Slab -- ------_��_-____ ___---- SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing _ — Insulation Drywall Nailinc Firewall -- ---------- _ _ _�, Fire Sprinkler - ---- - --- -- ---- --------- Fire -Fire Alarm - Y (Susp'd Ceiling Roof lmisc: 44 --------------—--- -- ------ ---.._-__ _-__...--- - -- - PAS ,QAR_T FAIL --- --- -- -- .---- -- --- -- -- ------ - --- ------ -------- PLUMBING Post&:3eam i Under Slab Top Out Water Service ��JG—��.,tej44 u- tJ Sanitary Sewer —- -----` ------- ----- --- ---- Rain Drains ------ Final -'Final �- --- � -- - PASS PART FAIL MECHANICAL Post&Bean -- - - ------ ---- Rough In Gas Line - _ -.-- --- ----- -- ----- Smok Dampers PAS ART FAIL EL RIC_AL --+-- Service Rough In UG/Slab Low Voltage Fvc Alarm Final PASS PAR I FAIL SITE r – Backfill/Grading - - -- Sanitary Sewer Storm Drain ( ) Reinspection ter�f$ required before next inspection. Pay at Cif)r Hall, 13125 SW Hail Blvd Catch Basin Fire Supply Line [ )Please call for reinspection ki _ -- [ )Unable to inspect-no access ACA �) , Approact,/SidewaDate.lk Other , _ _.�_" — O/ Inspector i • / Ext Final PASS PART FAIL J DO NOT REMOVE this inspection record from !'ip job site. CITYOF TIGARD MASTER PERMIT PERMIT#: MST2001-00205 DEVELOPMENT SERVICES DATE ISSUED' 4117101 13125 SW Hall Blvd., Tigard OR 97223 (503) 639-4171 SITE ADDRESS: 08930 SW GREENING LN PARCEL: 2S111DA-13700 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 130 JURISDICTION- TIG REMARKS: Construction of new single family de`.ached residence. path 1 BUILDING REISSUE, STORIES: FLOOR AREAS _REQUIRED SETBACKS _ R'Sr.'TIRED CLASS OF WORK: NFW HEIGHT. 73 FIRST- 1 3 sf BASEMENT: of LEFT. 4 SMOKE DETECTORS: V TYPE OF'13E: Sr FLOOR LOAD: 4D SECOND. 1;'Ori sl GARAGE: 495 sf FRONT 21 PARKI',:SPACES TYPE Or CONST: 5N DWELLING UNITS: I FINBSMENT: at RIGHT: 4 VALUF: $211,45300 OCCUPANCY GRP: R3 BDRM 7 BATH: I TOTAL: J.379 JO of REAR: 2O __• `_ __ PLUMBING SINKS: I WATER CLOSETS: ' WASHING MACH: I LAUNDRY TRAYS: I RAIN Do.41N: I Irl TRAPS: L!VATORIES: 4 DISHWASHFr,S FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS. I CAI CH BASINS: TUBIW'OWERS t GARBA;E DISP: I WATER HEATERS: WATER LINES: 100 BCKFLW PREVNTR: I CREASE TRAFS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<1001C BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER I i— GAS FURN IOOK: I UNIT HEATERS: HOODS: I OTHER UNITS I MAX INP- hW FLOOR FURNANCFS: VENTS: I WOODSTOVES GAS OUTLETS I ELECTRICAL v_ " RESIDFN7IAL UNIT SERVICE FEEDf R TFMP SRVCIFEE-DERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS _ 1000 SF OR LESS. 1 0 - 20o amp: 0 200 amp: W/SVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION. EA ADD'L 500SF: 4 ;01 - 400 amp: 201 400 amp: 1s'WIO SVCIFDR'. on SIGNhI IT LIN LT: PER HOUR: L IMIrED ENERGY, 401 600 amp: 401 - 600 amp: EA ADDL BF CIR. SIGNAL/PANEL: IN PI.ANT. MANU HM/SVCIFDR: 601 10u0 amp 601r•arops•1000V: MINOR LABEL: 1000+amp''04: PLAN REVIEW SECTION Reconnect on'v: i >e4 HES UNITS: SVC/FDR> 225 A. >600 V NOMINAL: CI_S ARE OCC: ELECTRICAL•RESTRICTED ENERGY_ _ A.SF RESIDENTIAL B,COMMERCIAL AUDIO 6`' EREJ. x %'ACUUM SYSTEM: Y AUDIO S STEREO: FIRE ALARM: INTERCOMIPAGING-. OUTUOOR l NDSC LT. BURGLAR ALARM Y OTH: BOILER. HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: x CLOCK: INSTRUMENTATION: MEDICAL: OTHR. HVACOAT'AITELE COMM: NURSE CALLS. TOl AL a SYSTEMS: Owner: Contractor: TOTAL FEES: $ 4,197.53 '-his permit Is subject to the regulations zontained in the LEGEND HOMES LEGEND HOMES CORP Tigard Municipal Code.State of OR Specialty Code=s and 12755 SW 69TH AVE 31100 127A5 SW 69TH AVE 31100 ;all other applicable laws All work will be done In PORTLAND,OR 97224 TIGARD,OR 97223 accordance with approved plans This permit will expire I work is not started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Ren n: LIC 1,05e1 forth in OAR 952-001-0010 through 952-ODI-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIC NS Erosion Control Insp 0= Post/Beam Mechanical Plumb Top Out Exterior SI'eathing Insf Gyp Board Insp Appr/Sdwlk Insp Sewer Inspection Underfloor insulation Electrical Service LoH Vollacie Rain dram Insp Electrical Final Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line InLp Roof Nailing Plumb Final Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Line Insp Final inspe.,tion Post/Beam Structural Mechanical Insp Shear Wall Insp Insulat on Insp Water Service Insp Issued(By : k Permittee Signature : 1(_' Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00137 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/17/01 SITE ADDRESS; 08930 SW GREENING LN PARCEL: 25111 DA-13700 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: '130 JURISDICTION: TIG TENANT NAIVE: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: Sr NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connectirn permit for new singe) family residence. Owner: FEES MATRIX DEVELOPMENT CORP 6900 SW HAINES ST ST E 200 Type By Date Amount Receipt TIGARD OR 97224 PRMT CTR 4/17/01 $2,300.00 27200100000 INSP CTR 4117/01 $35.00 27200100000 Phone: Total $2,335.00 J Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued the total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not sc located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. A rTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: ylt_.�..J�_( Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next husin4 day �r b� Bulli IDatereceived: Permitno.:lJ.rT _�•� City o ,Address: 131'1)J W Nall Blvd,'I'igard,OR 9'1223 D Proj^.cUappl.no.: Expire date: CiryojTirard ,� ate issued: 8y: �Re�cei tno.: Phone: (503) 639-4171 _ — _ ip Fax: (503) 598-1960 Case file no.: Payment type: I&2 family:Simple Complex- I ; Land use approval: _ _ TYPE OF PERMIT ilii&2 family dwelling or accessory U Commercial/industrial U Multi-family RrNew construction 0 Demolition O Add ition/alteration/replacement U Tenant improvement U Fite sprinkler;alarm U Other: FORMAT,J Oil SITE IN i Job address: p,1 .0 ',,, 4_4 r t t t k .t 1_I\t Bldg.no.: Suite no.: LotSubdivision: IoUaccount no.: Project name: Desrription and location of work on premises/special conditions: FOR SPECIAL, INFORMAIION, Name: ( t tsolar, Mailingad- ��----t` 1&2 family dwelling: City: &1elyll-W State:p ZIP: �—r7 Valuation of work........................................ $ 4 Phone: Fax- - e50 E-mail: No.of bedrooms/baths................................. 3_ - Owner's representative: V-7 C:- PI C.)L E-A0-1 Total number of floors..............................._ —_Z-- F= E-rnell: New dwelling area(s ft Phoac: i<:7�C.. � �1..-` S gt D g 4 ) .......................... Z3 L-� -- Gamgelcarpott area(sq.ft.)......................... -- Namc ��l'J/� OS Covered porch area(sq.ft.) ......................... --- Mailing addr6ss: of '� Q. Deck arra(sq.ft.)........................................ - - "�- Other structure area(s . ft.).............. .......... _City: �, _�State� ZIP: — Phone:t,jo qflOFaxtJ E-mail: Commercial/lndustriaUmulti-fami:y: 010 V Ax 41 K#I Valuation of work........................................ S— — Existing bldg.area(sq.ft.) .......................... _----_ Business name: LL Z-O cvj)g5 New bldg.area(sq-ft Address:/d, t_ Number of stories .................... ................ City: Qr Stated� ZIP:'17.7at. Type of construction �— Pltone: C o _Fax:5—I f t1: ��---- Occupancy group(s): ' ting: CCB no.: 9(p e)J--ry 3 _ ------ ---- — w': City/metro lic.no.: 7 Notice:All contr-actors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: �� y � j -- _ provisions of ORS 701 and may be required to be licensed in the Address: / j_�(�-�7 - jurisdiction where work is being performed. If the app;tcant is C;empt from lice',ising,the following reason applies: city: '�ao StateCv ZIP: q Contact person: — Phone:(r P O e) Fax:,5� Name:—� lContact person: _ Fees due upon application ...........................$-- Address: c-_�-f,& /-marl �, V� Date received: City: _f 4117,- _ Stared ZIP: �/7�1 Amount received ............... ......................... � Phone:'L 7,,p Fax: — E-mail: `—_ —i `Please refer to fee schedule. I hereby certify I have read and examined this application and theNa:n iudsd"ow cr=ept Bandit cxds,p!case can liuisdirtim for more tnformWon attached checklist. All provisions of laws and ordinances governing this Ll Visa U MaoterCard work will be complied with,whether specified lie in ornot. CnYul cane numerr: Authorized nature:_� ate: �> Z-k `J i - Name of cardholder as rhown on credit card Print namc:[ —_—. -- ------ Canthotdersignature Amount' Notice:This perr:-it applicati n expires ifs permit is not obtained within I RU days after it has been accepted as complete. 440-4613(sairroti:) Plumbing Permit Application Date received: !;f� ' Permit no.: r��Cr'� f di�' City of Tigard Sewer permit no.: Building permit no.: Address: 13125 S[.J Hall Blvd,Tigard,OR 97223 City of Tigard phone: (503) 6394171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: — _-- Case file no.: Payment type: TYPE OF PERMIT a I &2 family dwelling or accessory U CommerciaUndustrial 0 Muld-family U Tenant improvement tdNew construction Q Addition/alterationh•eplacement U Food service U Other. JOB SITE 1 /N FEE JSCI IFDULE'(for special Inforinatiorl Jobaddress_: X37' 77773 � ,zi��,_ ,� L.�N, Description Fecal. Total New 1-and 2-G[mily dwellings oniy: Bldg.no.: Suite no.: (includes 100 IL for each utilltycoanecdon) Tax map/tax lodaccouut no.: SFR(1)bath Lots 1 1 ' Block: Sufriivision: _ SFR(2)bath ---�' Project name: L)L-> f-?_ }L SFR(3)bath t City/county: -//k r ZIP: Each additional bath/kitchen Description and lotabon of work on premises: siteutind": Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.) 1 Manufactured home utilities Business name: _ -- Manholes Address: G /�c?��a74 _ _ Rain drain connector Cityl /-'4A LV/ State.:DZIP:7o Sanitary sewer(no.lin.ft.) ---- Phone:&(,7-17,P1 I Fax:46 7-9 r' 1 E-mail• Storm sewer(no.lin.ft.) - CCB no.: Plumb.bus.re no: �p Water service(no.tin.ft.) � ��"--�----`8� ��"`� City/metro lie.no.: Fixture or Item: Absorption valve Contractor's representative signature: Pof -n 7i ----- Print ttame: 'Tr.' / o;/ D s Z r Back flow�ceventet� _ Tjackwater valve 1 asins/lavatory Name: (0-/0/- t•2 Clothes washer -- _ Address: oo �, )�p 7 - Dishwasher City: /1 , o State LIP: /� Drinking fountain(s) — -- Phone: Fax: I E-mail: Expansion tank —_ 1 Fixture/sewer cap _ Name(print): L? q i�ffD�]PS Floor drains/floor sinks/W6 _ Garbage disposal Mailing address: 7,�- - Cf Z� G � Hvse bibb City:_r State:e O ZIP: Ice maker _ Phone:(,moi - Faz: E-mail: Interceptor/grease trap Ov.ner instal lation/residentinl maintenance only: The actual installation Primer's) will be made by me or the maintenance and repair made by my regul Roof drain(commercial) i employee on the property I own per ORS Chapter 447. Sink(s),basin(s),lays(s) �J Owner's signature:.L ✓� 1- _)1 Sump y- Tubs/shower/shower pan _^ _ Urinal Name: -- -r WAte[Closet Address: - -� � �� Water ter _ City: State p,� ZIP:�`�S Other. - - Phone _ pow Fax: E-mail: Total _ --.._ �_._._- N ail}uiwl"om accep a r"i caadr,plow call loHwActlon rnr mm inramatiaa Notice:'"his permit application Minimum fee............ ) ❑visa ❑MasterCard Plan review(at S expires if a permit is not obtained — 96) - Cmdlt cwt rumber. _. 1Iwithin 1110 days after it has been State surcharge(8%) ....$ E,�tro Named as shown ae nmlir card — accepted as complete. COTAL .......................S ��^Cardholder rignalar. �� Amount`_ 440-4616 J&%C•OM) PLEASE CQMPLETE: FIXT:JRES (individual) 1 (Qty F'�r�ces, ;Total Fixture Type -- QuantllY b Wark Performed 'iinik 16.60 New Moved Replaced Removed/Capp- Lavatory 16.60 Slne - -- Lavatory -Tub or Tub/Shower Comb. 16.60 _ 1'uS or TuWShower Combinalion Shower Only 16.60 Shower Only -- W,aer Closet 16.60 Water Closet " Urinal l-110al - - 16.60 Dishwasher _ 60 Dlshu asher 18. Garbage Disposal Laundr�r_Room fray -- Ga:oage Disposal 16.60 Washin Machine - - - Floor Drain/Floor Sink 2' Laundry Tray 18.60 _ 3'i Washing Machine 16.60 -"- 4• Floor Drain/Floor Sink 2- -- 16.60 Water fleeter - S(Specify) 3' 1 L 70- Other Fixtures. - 4- 16.60 _ _ - Water Heater O conversion O like kind _ 16.60 -�- Gas piping requires a separate mechanical permit. MFG Home New Water Service 46.40 - - - - - - - MFG Home New SarVSlorm Sewer 46.40 Flose Bibs 16.60 - COMMENTS REGARDING ABOVE: Roof Drains 16.60 - Drinking Fountain 16.60 -------- ---- ( her Fixtures(Specify) 21 75-- Sewer- 5Sewer-1st 1GJ' - 55.00 Sewer-each additional 100' 46.40 Water§eM e-1st 100' 55.00 Water Service-each additional 200' 46.40 Storm R Rain Drain-1st 100' - 55.00 Stone 6 Rain Drain-each additional 100' 46.40 -- Commerclal Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' - 27.55 Catch Basin -- 16.60 lnsp.at=xisllng Plumbing or Sped:lly Requested 72.50 y- Inspections Rain Drain,single family dwelling 65.25 Grease Traps - --�-- - 18.60 - QUANTITY TOTAL Isometric or riser diagram Is required I GuanUly Total b �9 -� ----- 'SUBTOTAL 8% SURCHARGE I "PLAN REVIEW 25%OF SUBTOTAL RequFed only I fbdureslr.total is>9 --^--_____ TOTAL `Mlnlmum permit fee is$72.50+S%srrcharpe,except ReskferrtiAl Sac"m Prev"K on Device,which Is$76.25+e%surrlvrpe. 'All New Comm*mlal BIJI'dings require plans with IsameW.at riser diagrarn and plan review. Mechanical Permit Applicatign Datereceived: ��rJ��/ P.:-rrritno.:J City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Rx: (503) 598-1960 Case file no.: Paymant type: Land use approval: — ____ rB uilding permit no.: &2 family dwelling or accessory ❑Commercial/industrial O Multi-family O Tenar.t improvement I New constnrctien U Addition/altcration/replacement O Other. Job address: � (j ',r r ,�ti cam- ,y� Indicate equipment quantities in boxes below.Ltdicate the dollar Bldg.no.: Suite no.: value of all m--chanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ ht: l Block:` Sur division: *See checklist for important application information and Project name-._ - jurisdiction's fee schedule for residential permit fee. City/county: -�;q rte/ WR 67Z11� IRA nW- Description and of work on premises:_ Fee(cc)7007.7 Est.date of completion/inspection:` —_- - Description Qt . Res.only Re�.nnly Tenant improveme r change of use: Air handling unit _ CFM Is existi space heated or conditioned?U Yes U No F Air-conditiong site plan mequuec)- Is e:W ing:n tcc insulated?U Yes O No A terauon of exisung system _ or er compressors State boiler permit no.: Business name: _ HP Tons BTU/H _ Address: pS- _ rrvsmo c a�mpFr_Tciuctsm_5 e__dtaxton — city: 0' �mtqpZIP; 97� cat pump site p an requir'�j- . � -7 7 Fax: _7(,y E-mai:: nsG. replace urnac urnts Phone — - J Including ductwork/vent liner U Yes O No CCB no.: pen ed, City/metro lic.no.: a , wall,or floor mounted nt — Natne(please print): C�l) _ efor ranee of er than urn ace— iRefrigeration: 011:11-I&VIN Eiji 110 Abwrptionuuits�____-__ BTU/H Name: %�Cj�!), --� Chillers.___ HP Con reasors_ __ HP Address: omen exhaust an vent ton: City: P."r State:0Q_ ZIP: 7),..42 Appliancevent -_ Phone• -77 Fax�;3 7L _>' E-mail: h'/erez aunt ooT", ypeT1T_kitrhen/hwnat hhocl fire s wppression system Name; Exhaust fan w;th singi-duct(bath fans) _^ Mailing address: =t �! Exhaust systema art from eatmj or C Fuel piping an rri ut on up to 4 outlets) CitySrato ZII:9 A L9 T�ue ---LPG LPG NG ---Oil Phone;-. - FaE-mail: iveliIn each additional over oucis C _ — 11"Irl 1101111 eapiping(sc etraucrr tic ) Number of outic;s _ Name: _ ter pp ce or equ pment: Address: (op�y _ Decorative fireplace` I City: State: ZIP: Insert-ty _ _. Phone:too)c- G� Fax: E-mail tov pei et stove _ err Applicant's signature: ��q„/� Name (print): '�ey,�r�P,�� -- - -- - Na VI Jurirdktlom rcrpt�crtdit cud+, c,a iurirUctlan for mom Inlonronan. Permit fee.....................$ - -- Notice:This permit application Minimum fee................$ — U Visa U MasterCard expires S a permit is not obtained I- Ilan rest number-, 1 Ian review(at __ 96) $ E:Itims within Igo days alter it has been State surcharge(8%) ....$ _- -- --- ecce ted ascom complete. — Nune of cu9iol(i I; thnwn on credit card = P Cudhdder sitnUue — Amount 4104617(~'W) Commercial Schedule 18x2 gamily Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE -- _ .-- Desalp;ksn Furnace to 100.000 BTU Table IA Mechanical Code (ly Price Total Indudk: ducts 8 vents 955 1) Furnace to 1170,000 BTU g Including dada 6 vents ---�— 1400 Furnace>100,000 BTU 2) Furnace+0),000 lira• Indudnis 17.40 Including ducts 3 vents 1,170 3)Fkhg Buda 6 v,iawFurnace Including vent 14.00 floor furnace A) ^Suspended healer,well healer Indudiiy vent 955 of Noor mounted ihester 1t.c^ suspended heater,waif heater sLvem not Included In appliance Permit or noor mounted heater _ 955 5) fiepait unks Check a1 that appy. 'ea Her Heal Air Vent not included in appliance permil 445 For Noma 7.10,see or Pump Cond oty Price Tout Re units 805 noair footnotes 1,2 conte " _ _P - _ 7)<lHP,absorb unit to <3 hp;absorb,anil 100K BTU 14.00 8)7-15 IIP;absorb unit to 100k BTU _ 955 took to 500«BTU 25.60 3-15 h absorb.unit. e)t5-3011P,absorb P% ung.5-1 mit alu 75.00 101 k to 500k BTU 1700 lo) F.HP;absorb unix 1-1.15 mi BTU 52.20 15-30 hp;absab.unit 11)>SWP;absorb unit>1.75 mil Bra) — — 501k to 1 mil.BTU 2310 _ _ e07-20 12)Atr furdYnp rnY_ b 10,WO CFM 30-50 hp;absotti.urit — 1000 13)Ak harming unit 10,000 CFM- 1-1.75_mli.BTU 3400 _ _ 17.20 >.rJ()�1�,ah^:�u.Uhllt ^--� 14)Non�ortablee%sporsteoOolor 10.00 > 1.75 mil B TIJ 5?25 15)Vent tan connected to a single ductSao — — Air hr ndling unit to 10,000(fin 656 10)Ventxatbn syalem not k chided InIn - -.— 10.00 A)r handling unit> 10,000 dm 1170 17)Hood served by mechanical exhaust— 00— No�ortable evaporate Collor — — 656 1e)DomesticInitineraton 100) vent tan connected to a single dud _446 _ 17,40 - -- 19)ComnMclal a kMuslrlal type hckfenilor Vent sysh.not Indu(;ad In appliance perm;l _ _ 656 �. 60.911 Hood served by mechanical exhaust — ^ 656 20)cWher frnxs.Indudkhg woad stoves _ ro.00 Domestic Incinerator _ 1170 2+►Gas ptvIna one b loin°`m"' _ -- — 5.40 Commercial or Industrdl Incinerator 4590 22)More than 4-0ar outlet(each) 1.00 011ier unit Including wail stoves,Inserts,etc 656 Minimum Permit Fee s7:6o —3LBTOTAL Gas piping 1-4 outlets _ _ 360 8%SURCHAAOE Each additional outlet PLAN REvtEw 25%c�sueTorAL --.--.---b3_ Regtrind non ALL commercial permits only — TOTAL , other initial and f...: 1. rmpawma,naafi.or nonny"kf have Inlirik—n dwP-,w hO1A1) 272-50—, 2, rup.esom nor Wt*h M r.d It apeee'Yaay r,dlofad(^vr+ry dura rxaa) T qts 27158 par ho,a otal Valuation _ —�y8e _ —�-—. — _ 5 AsrlHonr roar,-.w,ngL-k-w wrw-..wd#i u w ravl.bro n Puna dWgi—,,*4'W h—)211 so Per hone '&aft coMritax ataer c.rfak;aeo„mq w d S 1.00 to$5,000.00 Minimum$72.50 $5,001.00 to$10,000.00 572.50 for the,first$5,000.00 and$1.52 for each additional S 100 00 or fraction thereof, to and including$10,000 00 $10,001.00 to$25,000.00 S148.50 for the first$10,0f)0.00 and$1.54 for each additional$100.00 or fraction thereof,to and including 525,1700.00 $25,001.00 to S50,0n0 00 w $179.50 for the first 525,000.00 and$1.45 for each additional$100.t)n or fraction thereof,to and including 550,000.00 S50,1`100.00 and up T S742.00 for the first$50,000.00 and$1.20 for each additional S 100.00 or fraction thereo[ Electrical Permit Application) PDate received: d / Permrt no.: City of 'Tigard Prcject/appl.no,: Expire date: Ci(yof Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment ty;>e: Land use approval: Il &2 family dwelling or accessory U Commercial/industrial U Multi-family Cl Tenant improvement r New construction U Addition/alteration/replacement O Other. CJ Partial r Job address: F ?-(' r.: vv �_�r�� tt� .�`t�,�_ Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: 1�,( , y Bltxk_A' Subdivision: LE T, I '— Projec`n_ame: Description and location of work on premises:_ estimated date of compledonrnspection: "Job Fee Max Business name: p; j B �� Descrl ion (?t . (a.) Totalno.hu New residential-sbWje or mufti•6mlly per Address: ,Z 12 b' _t U— dwelling unit.tndudes attached rine. City: I Stated 21P: ,f�e Serviceincluded: Phone• Fax:6W-7 pjj -mail: 1000 tq.ft or loss_ - - 4 C o.: 14 5- E ec.b:� 3 - Each additional 500 sq.ft.or portion tht reof s.tic.nv' 3 C Limited energy,residential 2 ity 3 - Limited energy,non-residential 2 Each manufactured home or modular dwelling _n tura .su rvis gel trician( airer!) Date Serviceand/or;eeder__ 2 — Ser'vice+Pi feeders-Installation, Sup.elect.name(prinQ: � .,t„ License nu: n dteraGon or relocation: 2(y)amps or less 2 Name(print): �e� -5 201 amps to 400 amps x-- / 401 amps to 600 amps 2 Mailing address: �.3 j 'Y i tJ !i 'f'L 601 amps to 1000 amps_ -- 2 ivy: �f/�� S[etCrj 71P:!�J,� Uve:1000 amps or volts 2 Phone:L��tOL rpt 4�Zj �:5.1� - E-mail: Reconnectonir 1 Owner installation:The installation is being made on r;operty I own Temporary seances or feeder- which is not intended for sale.It ase,rent,orexch%ige according to hurtallatlon,alteration,orrelncitfon: ORS 447,455,479,670,701. 200 amps or less _ - 2 201 amps to 400 c-nps _ _ 2 Owner's signature: �� / a a� rr Date: 2Y c I 401 to 600eni a -' 2 Branch circuits-new,alteration, IIIPPw or extension per pane4 Name:. " � ' - A. Fee for branch circuits with purchase of Address:6 (i O•yy� 1p� service or feeder fee,each branch circuit _ 2 Stated ZIPg7 B. Fee for brand circuitswiJhoutpurchase - of service or feeder fee,fust branch circuit: 2 Phone: '��, - 'm Fax E-mail: Each additional branch cimoie — MIse.(Set rice or feeder a,A Lsclutied): r1�se;;!vice over 225 ampscommercia' U Healthcare facility Euh pump or irtigatio_n circle--_- 2 U Service over 320 amps-rating of I A2 U Hazanious location Each sign or outline lighting - 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension• 1 2 U Building over three stories U Feeders,400 amps ca•more .Desai tion_-- _ U(kcupant load over 99 persons U Manufactured structures or RV putt Each additional Inspection over the allowable In any of the shore: U EgressAighting plan U Other: Per inspection Subtelt—tats of plans with any of the:above. Investigation fee The above are not applicable to temporary constructloe service. Other �- _--� -- Na O lurk oioos ac"credit arra,please call jud dictice ror more,efonnatim. Notice:This permit,application Permit fee.....................$ —__--- U Visa U MasterCard expires if a permit is not obtained Plan review(at -_.— %) $ within ISO days after it has been State surcharge(896) ....$ Erpirrs accepted as complete. TOTAL .......................S _-- N of cad to da aihown on credit card _. _ S _ Cardholder signature Arnwnt 4404615(610WOM) I -` -� TYPE OF WORK INVOLVED -RESIDENTIAL ONLY 4. Complete Fee Sche,4rfle Below: Nun e. of Inspections per permit allowed Restricted Energy Fee......................................... $76.00 Service included: Items Cost Tota (FOR ALL SYSTEMS) 4a. Residential-per unit Check ype of Work Involved: 1(100 sq.a.or less _ _ $147.15 _ 4 Each additional 500 sq.8.or Audio and S(ereo Systems portion thereof $33.40 1 Limited Energy $75.00 ❑ Burglar Alarm Each Manurd home or Modular Dwelling Servicx or Feeder $90.90 N� - 2 L! Garage Door Openet- 4b.Services or Feeders Installation,alteration,or relocation Heating,Ventilation and Air Conditnril, System" 200 amps or less _ $80.30 2 201 amps to 400 wraps -_ $106.85 2 Vacuum Systems' 401 amps to 600 amps $160.60 _ 2 601 amp-to 1000 amps $240.60 2 F Other Over 1000 amps or volts - $454.65 ~ 2 Reconned only -_`- $66.85 2 TYPE OF WORK INVOLVED-COMMERCIAL ONLY _ 4c. Temporary Services or Feeders _ installation,alteration,or rekrcalion Fee for each system.............................................. $76X0 200 amps or less _ $66.85 - 2 (SEE OAR 818-260-260) 201 amps to 400 amps - - $100.30 2 401 amps tc 600 amps $133.75 ` __ _ 2 Check Type of Work Involved: Over 60O amps to 1000 volts, see"b"above. Audio and Stereo Systems 4d.Branch Circuits New,alteration or extension per panel 13oller Controls a)The fee for branch circuits wl(h purchase of service or Clock Systems feeder lee. Each branch druid $6.65 ^__ 2 �1 Data Te!ecommunication Installation b)the fee for branch Circuits without purchase of service Fire Alain Installation or feeder fee. Fkst branch dreuil _ _ $46.85 �V-- Each additional branch dicult $6.65 HVAC 4e.Miscellaneous �] Instrumentation (r,.Kvioa(x feeder not Included) Each pump or Irrigation circle $53.40 O Each sign or outline righting -A_ _ 153.40 in`.ercom and Paging Systems Signal Circuit(s)or a llmdrd energy panel,alteration rx extension ^_ $75.00 Landsh�pe Irrigation Control" Minor labels(10) $125.00 - -- - [] Medical 4f.Eacf-additional Inspection over tike atfowable In any of the above Nurse Calls Per Insp.lion _ $62.50 Per hour - $62.50 `- In Plant $73.75 ,-_ Outdoor Landscape i_Ighting' 5. lees: Ej Protective Sk3naling Sa.Fnler total of above fees $ _ 8%Surcharge(.08 X total fees) $ � Other _--- Suhlolal $ - Sb.Enter 25%of lire 62 tar Number of Systems Plan Review if required(Sec.3) f Subtotal $ _ No licenses am req-hlred. Lkenses are required for all other V.,tallalions l� i �--7 FEES -..��_..� -- -- Trust Account/ Total balance Due $ ENTER FEES ----- ----- -- BSG SURCHARGE(.08 X TOTAL ABOVE) TOTAL S ?r LOT FLAN LOT 1*1a0 AFFLEWOOD F'4R< R1f=)D 251 11 DA TAX LOT 1*14000 WATER METER 8930 5W r RE EN INCx LANE W ------ WA SS— — — — SANIT LINE NITAR'r SEWER S.E. 1/4 OF 5EGTiON 11, T.2, R.IW, W`1- SD-- - _ — STORM DRAIN GIT1'" OF71 r..3,4RD � --- -•--` Q OF STREET MANHOLE W,45�41Nr TON GOUNT1', OREGON CATCH BA51N PROFOSED T jDSTREET TREES :NT ® STREET LIGHT I HOMES FIRE HYDRANT 12755 911 69th AITNU6 BURS l00 lei lull 0►yICE (509) 620-8050 TIGARD, OR. 97,I! I'm (509) 598-8900 CCB# Bum I �.U�. GREENING LANE I` --- --- CURB 51DEWALIC 5 89' 54' 25" W 8' UTILITYi EASEMENT I 2043' ; PROVIDE EROSION 4.00' 2043' _- I 20_3.5' CONTROL FENCE 203.5' PER CJMMUNITY �— EROSION PLAN 1 /� \< x 4p0_ LOT 132 r 4,159 5Q. FT./ f LOT 129 I �� : �-� /�/ �I Rzc-!Er 11 a , / LOT 131 FIN. FLR. 20dB'/�� 4_ _-�" GAR FLR ■ 703.1' / �' 4.00' :;)3 -- -202 202.h' 2022' N Ic:Y UTILITY--- - --------�- -----_�-- ----_-�-_-._-_-�-- --:---------'20E EASEMENT- _202 -"�1 ----——__- � _ _ __-�_.-- - 5g�-----_--_- - _------- 201 ----- — _._-5 89, 52' O 11 W w2.00' LOT 23 LCAT 24 CITY OF TIGARD 13125 S.W. 'HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RECEIVED GARNER ELECTRIC Apr; 2 ;, 9-09` 21785 SW TUALATIN VLY HWY#C ComwiN11Y UEVROPMEN1 ALOHA, OR 97006-1249 Electrical Signature Form Permit #: MST2001-00205 Date Issued: 4/17/01 Parcel: 2S111 DA-13700 Site Address: 08930 SW GREENING LN Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 130 Jurisdiction: ?1G Zoning: R-7 Remarks: Construction of new single family detached residence. path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the stat of the wrrk to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: LEGEND HOMES GARNER ELECTRIC '12755 GW 69TH AVE #100 21785 SW TUALATIN VLY HWY#C PORTLAND, OR 97224 ALOHA, OR 97,006-1249 Phone #: Phone #: 513-648-4552 Req #: LIC 121159 SUP 3707S ELE 34.305C AN INK SIGNATURE IS REQUIRED G TH F M X Signature of Supervisirg Electrician If you havo any questions, please call (503) 639-1171, ext. # 310