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8967 SW GREENING LANE E 00 rn ff -4 1 cn G) c� cn r d m I 8967 SW Greening Lane CITY Or TIGARD BUILDING INSPECTION [DIVISION MST .5 24-tiour Inspection; Line: 639-4175 Business Line: 639-4171 BLIP_ Date Requested_ -7 AM -(--�PM BLD Location� � 1'�,,� �r*-�� __-4."!� � Suite MEC Contact Person _ _! _— Fah _ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access Foundation FPz; Ftg Drain ISGN ----_ __� Crawl Drain Inspection Notes Slab ---- -- -- ----- -- SIT Post&Beam - --- - -- -- -- - - -- Ext Sheefh/Shear Int Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL — ------ Post&Beam Under Slab ITup Out Water Service Sanitary Sewer --. ----_�_ __--- -T----- ��----_ Rain Drains ASS PAR'' FAIL ANICAL Post&Beam --------------- Rough In Gas Line -- Smoke Dampers Final - - - ---- --- - ------ - - - PASS PART FAIL ELECTRICAL -- -- - - .- - - - Service Rough In UG/Slab Low Voltage -- --- - Fire Alarm Final -- --- -- - PASS PART FAI!SITE Backfill/Grading -- ---- -` Sanitary Sewer Slorm Drain ( ] Reinspection fee of$ _--` required before next inspection. Pay at City 'call, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( )Please call for reinspection RE: [ Unable to Inspect-no access ADA Approach/Sidewalk Other Date —� iC Inspector _ -__[ �t-"� Ext ^_ Final T PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST, .liy — �c3 4•-Hour Inspection Line: 639-4175 Business Line; 639-4171 BUP „_______date Requested "7 3' 7 _ AM PM BLD Locaticn-7_ GrSuite v — `— MEC Cor.°.Jct Person Ph PLM _ Contractor _ Ph SWR BUILDING Tenant/01^, !ei ELC Retaining Wall ELR Footing �, Foundation �CCeSS: FPS Ftg Drain -- Crawl Drain Inspection Notes: SIGN -----_- Slab _ SIT Post&Beam -------- - — Ext Sheath/Shear Int Sneath/Shear -`-- - -- -- - Framing _ Insulation - Drywall Nailing Firewall r - Fire Sprinkler Fire Alarm - Susp'd Ceiling Roof —-- -- - Mise Final PASS PART FAIL -- PLUMBIAG P-)st& 'searr - Under S'ab Top Out Water Service Sanitary Sewer --- ---- --- -- Rain Drains Final PASS PART FAIL MECHANICAL_ Post$ Be.rnr — Rough In - — - Gas Line - ----- --- Smoke Dampers Final - ----- -- - - ---- -- - - - --- PASS PART FAIL 1_EC rRl -- -- - --- -- .. -- -- - - ----- - UG/Slab --- -UG/Slab Low Volt._ie v Fire Alarm ASS ART FAIL Backfill/Grading ----_-- Sanitary Sewer Storm Drain ( I Rt,mspechcm fee of _ required befor94ext ins etion. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line f I I'Inase call fn[ rt inspection RF j Unable to inspect-no access ADA _ Approach/Sidewalk Date = inspect Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION M51. 'ee- 24-H..ir Inspection I-ine: 633-4176 Business Line: 635-4171 -��-- — BUP — _ Date Requested_ - 29-0/_ AM— —`__PM BLD Location F'kr i_` ►, ��-,5 _ Suite MEC _ _— Contact Person Ph PLM Contractor Ph _ SWR i BUILDING Tenant/Owner — ELC Retaining Wall _ ELR Footing Access Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes —Slab SIT ---- -----.�_. _ - --- - ---- - SIT Post&Beam Ext Sheath/Shear — Int Sheath/Shear Framing //i, 1ac„. .vs �i�i.•�.dG� � Z 7- rl Insulation Drywall Nailing Fi,ewvll Fire Spi inkrer --_ — Fire Alan:, Susp'd Ceiling — • — — Roof Misc: -- -- ASS PART FAIL - - UMBING Post&Beam Under Slab Top Out Water Service _ Sanitary Sewer _ Rain Drains _ Final PAS_ RT FAIL CHANIC Post& Beant -- -- Rough In Gas Line -__ —__ __ --' ___—R -- ----------- SM..ge Dampers AS'$ PART FAIL btlEdTIRICAL - -- - Service Rough In UG/Slab — Low Voltage Fire Alarm ----- Final PASS _ PART FAIL - --- -- -- ---------- -- ----- SITE - Backfill/Gi nding Sanitary Sewer Storm Drain ( )Reinspection fee of$, _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: J Unable to inspect-no access ADA / Approach/Sidewalk nate 2 Inspector ./ Ext Other - "— Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00307 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 6/27/03 PARCEL: 2S 111 DA•17500 SITE ADDRESS: 08967 SW GREENING LN SUBDIVISION: APPLEWOOD PARK NO, 3 ZONING: R-7 BLOCK: LOT: 16 i -----JURISDICTION: TIG CLASS OF WORK. ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PRc- NTRS: OCCUPANCY GRP: FLOOR DRAINS: 'TRAPS. STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of a back flow preventer J _ FEES Owner: ^' Description Date Amount TIFFANY MCKAY 1 PLUNIBI Permit t r 6/27/03 $36.25 8967 SW GREENING LANE TIGARD, OR 97224 ("rAX)K`4.Statc "('az 6/27/03 $2.00 1 otal $39.15 Phone Contractor: OWNER REQUIRED INSPECTIONS RP/Backflow Preventer Phone Reg #: This permit is issued subject to the regulations contained in the 'Tigard Municipal Code, State of OR Specialty Codes 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 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: .t Yl Z?-�tL_ Permittee Signature: Call (503) 69-4175 by 7:00 P.M. for an inspection needed the next business day 13ulltll11" V lxtul-eS Plumbinu, Permit Application ' ��_.. Received Numbing Date/By: _ Permit No.: dUj CityCit of Tigard Planning Approval Sewer g Date/By: Permit No.: 13125 SW Hall Blvd, Plan Review other Tigard,Oregon 97223 DatrJBy: Permit No.: - Phone: 503-639-4171 Fax: 503-598-1960 Post-Rcview land Use Dat/{3Y` Case No.: Internet: www.ei.tigard.or.us Contact Jutis.: Sec Page 2 for 1.4-hour Inspection Request: 503-639-417511, Name/Method 5u Icmental Information. TYPE OF WORK -` � FEE-SCHEDULE(for special information use checklist New construction Demolition Oescription cit). I FcelenJ total Add ition/alteration/replacement I Other: New I-&2-family dwellings CATEGORY OF CONSTRUCTION (includes 100 ft.for each u IlIty connection 1 &2-Family dwelling Commercial/Industrial SFR I bate, _ 249.20 SFR 2 bath 350.00 _A_ccessory Building_ Multi-Family SFR 3 bath 399.00 Master Builder _ Other: Each additional bath/kitchen _ 45,00 JOB Sig E INFORMATION and LOCATION Firesprinkler-sq ft.: Pae 2 X Job site address: " _ _ Site Utilities Suite#: _ Bld ./A #: Catch basin/arca drain 16.60 Project Name: Dr ell/leach line/trench drain 16.60 Footing drain no.linear ft. Page 2 Cross,street/Directions to job site: �y� C Q� Manufactured home utilities 110.00 SC1441'e-y- t`r j r(�W��� �a,�� Manholes 16.60 Nap, Rair drain connector 16.60 Sanitary sewer(no. linear ft.) _ Page 2 Subdivision: Lot#: Storm sewer(no. linear ft) Pa e 2 Tax map/parcel #: Water service(no.linear ft.) Pae 2 DESCRIPTION OF WORD: Fixture or Item ----- - - Absorption valve Ifi.60 Backflow yreventer Pae 2 Backwater valve _ 16.60 -'-�----,-- - --� - ---- Clothes washer :6.60 ---J-�---- --- -- - Dishwasher 16.60 J El PROPERTY OWNER �U TENANT Ejector fountain _ 16.60-- Ejectorfountain _ 16.60 TIS Name:__I Ex ansion tank 16.60 Address: ---- -- Fixture/sewer cap 16.60 Cit /State/Zi : t Q-r, pec_ 1� Z/ z Floor drain/floor sink/hub 16.60 -- Garbage disposal _ 16.60 Phone: �Y,Li U t/(e3 I Fax: Hose bib 16.60 _ APPLICANT I LJCONTACT PERSON Ice maker 1660 Name: Interceptor/grcase trap 16.60 Address: Medical gas-value: $ _ Pae 2 Cit /State/Zi _ Primer 16.60 ----p- -- --- Roof drain commercial 16.60 Phone: I Fax: `_ Sink/basin/lavatory 16.60 E-mail: Tub/shower/shower pan 16.60 CONTRACTOR Urinal 16.60 Water closet 16.60 Business Name: _ Water heater 16.60 �- Address: _ Other: _ City/State/Zip: Other: Phone: Fax: Plumbing Verntlt Fees" CCB Lic. #: Plumb. Lie* _ Subtotal 5 Minimum Permit Fee$72.50 S Authorized -- V / Residential Backflow Minimum Fee$36.25 _ Signature: [.- L bete: lOt.3 _ Plan Review 25%of Permit Fee S _ State Surcharge l8%of Pcrmit Fee S _ _ (Please print name) _ T_OTAL PERMIT FEE S Notice: ''his prrrnit application expire%If a penmll I%not obtained within All new rommerelet buildings require 2 sets of plan%%bb Isometric or INTI dad%a(tcr it he%been accepted as complete. riser diagram for plan review. 'fee methodology set by Trl-County Building Indu%tt% `er%Ice Board. i\DstsTennn I-omrs\PlmPermiI.App.doc 01103 Plumbing Permit Applil'ation - City of Tigard , Page 2 - Supplemental Information Fee Schedule: _ Residential_Fire Su ression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing dram- 1" 100' �- - 55 00 0 to 2j(K)0 $115.00 -_ Footing drain-each additional 100' 46.40 2,001 to 3.6W $160.00 3,601 to 7,200 $220.00 Sewer- I st 100 55.00 1,201 and greater $309.00 Sewer-each additional 100' 46.40 Water Service-1st 100' - r 55.00 Medical Gas Systems: Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Drain- Ist 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $51001.00 to$101000,00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and fixture or Item Qty. Fee(ea) Total including$10,000.00. Commercial[lack Flow Prevention Device 46.40 $10,001.00 to$25,000.00 $148 50 for the first$10,0v)00 and$1.54 for Residential[Backflow Prevention Device each additional$I W.00 or friction thereof,to minorum permit fee$36.25 27.55 and including$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to.'50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspcetien of existing plumbing or and including$50,000.00. specially re-,tested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and E 1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are,you capping,ruoving or replacing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Qua Lit V by Fixture Work Perfortned ('onttnents regarding fixture work: Fixture Type: Replace -^ New _Moved Existing_ Capped Ila rtistr /I-onl - ---- ---- - - Bath -Tub/Shower Jacuzzi/Whirlpool - -� Car Wash -Each Stall -_.- -_- --- --- - - -Drive Thru Cuspidor/Water Aspirator ------�-- -�- ��-���� Dishwasher -Commercial -- - ------ --' -Domestic Drinking Fountain Eye Wash -- -- -- - -_._- - Floor Ornin/sink -2" -V .4" - - Car Wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic increase of sewer FDI Is,a sewer permit will he issued and Disposal -Commercial __ -Industrial _ tees assessed for tilee sewer increase must be paid before the Ice Mach./Refri .Drains plumbing permit can Ile issued. Oil Separator Gas Station Rec.Vehicle Dump Station Shower -bang -Stall _ Sink -Bar/Lavatory -Bradley -Commercial -Service Swimming Pool Filler Washer-Clothes Water I'mractor Water Closet-Toilet Urinal Other Fixtures _ i'.\Osts\Permit Formc\PlmPemiitAppPg2 doc 01103 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 _— BUP Received _ __.. --_ Date Requested �' AMPM_ _ BUP Location -_ _ _ - -� /lir Suite _. MtC Contact Peraon Ph(-) SCD -Ce PLM Contractor Ph( —) SWR BUILDING _� Tenant/Owner _ _ ELC Footing ELC Foundation Access _ Ftg Drain /f/� ELR _ Ciawl 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 Root Other --�-- Final PASS PART FAIL. PLUMBIN_G -- Post&Beam Under Slab - - - - Rough-In Water Service ---- -- Sanitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain - Shuwer Pan Other:----- - -- _ _ 1 P S PART FAIL --- --- - - -- - --- --- - CHANICAL__ - Post&Beam Rough-In - Gas Line Smoke Dampors --- ----�_--- - -— ---� --. Final PASS PART FAIL — - - - --- -- - - - -- - - ELECTRICAL 5ervice hough-In UG/Slab Low Voltage Fire Alarm Final UReinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd. PASS PART FAIL gITL� Please c !I fer reinspection RE:___ _. __ unable to inspect-no access Fire Supply Line ADA / Approach/Sidewalk D&At Inspector _ Ext Other: Final �. DO NOT REMOVE this Inspection record from the job site. ?ASS PART FAIL I CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIK VALLEY HWY S ALOHA, OR 97006-1248 Electrical Sdognature Form Permit tt: MST2000-00508 Date Issued: 11129100 Parcel: 2S111 DA-17500 Site Address: 08967 SW GREENING LN Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 168 Jurisdiction: TIG Zoning: R-7 Remarks: SIF PATH 1 Your company has been indicated as the electrics: 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 start of the work to the address above, A17N: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELE("TRICAL CONTRACTOR: MATRIX DEVELOPMENT CORP GARNER ELECTRIC 6900 SW HAINES ST STE 200 21785 SW TUALATIN VALLEY HWY S TIGARD, OR 97224 ALOHA, OR 9 700 6-1 248 Phone #: Phone #: 591-1320 Req #: LIC 121159 SUP 3707S ELE 34-305C AN INK SIGNATURE IS REQUIRED ON HIS FORM X Signature of Supervising Electrician If you have any questions, please call (503) 639.4171, ext. # 310 o o � a a � n � n a � a 0 t TY OF T I G A -_- MASTER PERMIT KD PERMIT#: MST2000-00508 DEVELOPMENT SERVICES DATE ISSUED: 11/2:1/00 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 08967 SW GREENING LN r ARCEL: 2S111DA-17500 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 168 JURISDICTION: TIG REMARKS: S/F PATH 1 BUILDING REISSUE. STORIES. 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,127 sf BASEMENT: `0 LEFT: 4 SMOKE DETECTORS* Y TYPE OF USE: SF FLOOR LOAD: •:0 SECONn: 1,294 sf GARAGE: 488 ff FRONT: 23 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT: sf RIGHT: 4 VALUE. OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2.421.00 sf REAR: 19 PLUMBING _ - SINKS: 1 WATER CLOSETS. 3 WASHING MCCH i LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS. I FLOOR DRAINS: SEWER LINES: Inti SF RAIN DRAINS: I CATCH BASINS: TUBISHOWERS, _ GARBAGE DISP I WATER HEATERS: ' WATER LINES: Io0 BCKFLW PREVNTR I GREASE TRAPS: OTHER FIXTURES MLCHANICAL _ FUEL TYPES FURN<10OK: BOILICtAP ,3HP: VENT FANS: CLOTHES DRYER I FURN>=TOOK: 1 UNIT HEATERS: HOODS: I OTHER UNITS. I MAX INP- btu FLOOR FURNANCES: VENTS I WOODSTOVES: GAS OUTLETS I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLO NEOUS ADDS.INSPECTIONS 1000 SF OR LESS: 1 0 200 amp. 0 - 700 amp: WISVC OR FDR: I PUMPt1RRIGATIOW PER INSPECTION: F-A ADDT 50CSF: 4 201 400 amp. 201 - 400 amp: 1st W/O SVC/FDR: Oct SIGNIOUT LIN LT PER HOUR: LIMITED ENERGY. 401 600 amu: 401 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT MANU HMISVCIFDR: 601 - 1000 amp: 601+0mp6•T000V MINOR LABEL: 1000+amp/vJlt: PLAN REVIEW SECTION Reconnect only: >-4 RES UNITS: SVCIFDR-225 A. >600 V NOMINAL: CLS AREA/SPC UCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO. ',ACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM. INTE-RCOMIPAGING- OUTDOOR LNDSC L T. BURGLAR ALARM. OTH: BOILER. HVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAlTELE COMM. NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 4,172.29 MATRIX DEVELOPMENT CORP LEGEND HOMES CORP -This permit is subject to the regulations contained it (he Tigard Municipal Cod State of OR Specialty Codes and 6900 SW HAINES ST STE 200 12755 STN 69TH AVE all other applicable I:jws All work will be done In TIGARD OR 9722.4 TIGARD,OR 97223 accordance with approved plans This permit will expired work Is not started within 180 days of issuance,or if the work is suspended for more than 180 days A-l-TENTION Phone Phone: Oregon law requires you M followrules adopted by the Oregon Utility Notification Center Those rules are set Reg 0 1 iC. 0006056.3 forth in OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by ceiling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Ream Mechanica Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Foundation Insp FootinglFoundat.,i Dr; Electrical Service Low Voltage Watel Line Insp Finsi inspection PosUBearn Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwtk Insp Euilding Final Issued By : 1,VV� _- Permittee Signatur t Call 503 639-4175 b 7:00 .m. for an ins cction deeded the next bu Iness da ( ) Y P P Y CITYOF TIGARD SEWER C ON NEC T!ON F E RMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00350 13125 SLV Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/29/00 SITE ADDRESS; 08967 SW GRL ENING LN PARCEL: 2S111DA-17500 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: L OT: 168 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 'rYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: sewer connection for new SF detached. Owner: _ FEES _ MATRIX DE\'ELOPMENT CORP Type By Date Amount Receipt 6900 SVJ HAINES Sr STE 200 — TIGARD. OR 97224 PRMT CTR 11/29/00 $2,300.00 27200000000 INSP CTR 11/29/00 $35.00 27200000000 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Se✓✓er Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued. Fhe total amount paid will be torfeited if the peimit expires. The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. 'slued by: Permittee Signature �LLg Call (5 ) 639.4175 by 7:00 P.M. for an inspection needed the next busrfiess day Mechamcal Permit Application Date received: Permit no.: city of Tigard Project/appi.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,'figard,OR 97223 -Date issued: By:: Receipt no.: Phone: (503)63911171 _- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: __. __ Building permit no.: T&2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement O w construction U Addition/alteration/replacement U Other. .1011 S1.1 L IN FORNIA1110N Si W41, Indicate equipment quantities in boxes below.Indicate the dollaz Bldg.no.: Suit.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/accoa,unt no.: profit. Value$ � — hot Block: Subdivision: -" "See checklist for important application information and Project name: p eel. C--e- jurisdiction's fee schedule for residential permit fee. City/county: 4 7.IP: rJ" . W. 1101 Description and I—.1oe.ation of work on premi.;rs: Fee(ea.) Total Est.date of completion/inspection: Desai oo . Res.onl Res.only Tenant improveme r change of use: ' Is existi s ace heated or conditioned?U Yes 0 No Airhandlinunit� CFM P Aircondiidon,ng' (site plan reqire u ) Is e ' ng space insulated?U Yes U No —Alteration o existing HVAC system _Boiler/compressors State boiler permit no.: Business nerr►e: tt1�2_— t.���s�r _ - HP Tons_—D7'U/H Address: / 5 L� .� L'/ 1�;r 1 _� uds`mo dampers�uct smoke dctertors City: t_� i Cc f State:Q Q ZIP: �7G/�_- eat pump site p an requtr'-3e j Phone: ; a d /(� Fax: "/-3 E-mail: nstalrep a-lurnace76urner T t - - Including ductwork/vent liner U Yes U No CCB no.: �� (,,z - Install rep ac teocate eatc•s-susoende , City/metro lic.no.: // �� - _ _ wall,or floor mounted _ Name(please print): �, ent ora n: I of er an u�n—ac e— ate[ ent on: Absorption units_ BTUA I Name: jo 2 ��Q _ - ChillersHP — Comressors_ - HP Address:L�l s C �t t� .-r '� %y"`' r onsaenta ex sust and real ton: City: 0%v ,:, <V tate;�i ZIP:q 7(j 3 Appliancevent - Phoner E-mail: er ex.gust —_ oo3s,Type 11 II/res.kit"c en azmat hood fire suppression system Name: e cS Exhaust fan with single duct(bath fans) Mailing add ss:1,4,262-1- � c 7�y ,af ust system a artfrom h -n-g or AC City! 5,/ /a�1G✓ State" ZIP:;�J o? ye ..P on up to outlets) - - 7 —LPG NO __ Oil Phone e '� FaZs - Fuel tl to each additional over 4 outlets wp p 6(schematic r quire ) Number of outlets Name: e - 0(-r Wed appliance or equTmert: t Address: /,9 7 •rleJ _ Decorative fireplace _ City: State ZIP: _._Insert-tyae Phone; E-mail: Woodstov pe etstove Other: Applicant's signature: e Jf Date: Name (print): I i? / ✓ -ate ----- -- --•- --_---1-- Nd>II sx—pr credit cards,pku:cal,jv:iadktion fa mxe Inrannatfm. Penna fee.....................$ U Visa U MasterCard Notice:This permit application Minimum fee................S —_ ' , expires if a pennit is not obtained Plan review(at , %) $ _ .^ C moi,red wmbcr� _ -- Exp wi:hin 190 dnys after it has been State surcharge(8.36) ....$ _ —�F___ Narc d cardholder u abown oe Grafi,card accepted as c•om lete, l adhorder sisna,we .mown — "o-"17(6fnwom) Plumbing Permit Application Date received: Permit no.: City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 - Ciry ujTigard phone: (503) 639-4171 Project/appl.no: Expire date: Fax: (503)598-1960 Date issuc-d: -_ By: Receipt no.: Land use approval: _ Case file no.: Payment type: 1 &2 family dwelling or accessory 0 Commercial/industrial 0 Multi-family 0 Tenant improvement CJI(ew construction 0 Addition/alteration/replacement 0 Food service 0 Other. Job addle: / Description G �I iti�JiFee(ea.) Total Bldg.no.: 1T�o•: Nen 1-and 2-family dwellings only: Tax map/tax lot/account no.: - (includes 100 ft.foreachntlBtyconnection) _ Lot -- , -Block: Subdivision: SFR(1)bath SFR(2)bath - — -� Project_name:� !� ✓ SFR(3)bath City/county: r Cf I zip: `j � - Each additional bath/kitchen Description and location of work on premises: Siteudlitlec: Catch basin/area drain r--t.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft) Manufactured home utilities -- Business na ne: �, n Manholes Address: I 0 Rain drain connector City:! {l of I Stater ZIP:9 7p _ Sanitary sewer(no,lin.ft.) Phone: G�_ Fax:&6 7-9 Email: Storin sewer(no.lin.ft.) CCB no.: Plumb.Plumb.bas.reg_no: p Water service(no.lin.ft.) City/m.:tro lie.no.: Fixture or Item: Contractor's representative signature_ �}Z o~>t —' Absorption valve -y2- tc -- Back Cow preventer Daale: Backwater valve CONTACT Pntsq'N Basins/lavatory Name: �o� �,a Clothes washer Address: pep 8c ojee) 7 Dishwasher - City: Drinking fountain(s) City: Sft�''aJ - State ZIP: ?W-3d EjecW[s/9untp Phone: Fax: E-mail: Expansion tank Fixture/sewer cap _ Name(print): L.p o ��S Floor drains/floor smics/hub Garbage disposal Mailing address:1-4,7j-'3- cf 'z'� G Hose bibb City: 0/ �� State:a k i IP: �/7.z:�3 Ice maker _ Phone: a ) Fax: - Email Interceptor/grease tap- Owner installation/rasidential maintenance only: The actual installation Primers) will be made by me of the maintenance and repair made by my regular _K0--of drain(commercial) employee on the property 1 own INS per ORS Cha ter 447. Sink(s),basin(s),lays(s) _ Owner's signature: /� Sump _ Tubs/shower//shower pan NaUrinal nce. Water closet -'- Address: _ — — -- Water heater _ City: --,a 14 ISUted TIP: 7*lalj Other. Phone: 4 _ 20o� Fax: E_mail:� Total Not all juridkiiau rcept aedit cards,pleau call IurisdkNon for mcxe Infornutlon. Minimum fee................$ Notice:This permit application - 0 Visa U MasterCard %) $Plan review(at — _ expires if a permit is not obtained - - Crr sir card number: - _ _ �_- / ._ State surcharge 8r4 r..,,..�, within I80 days niter it has been K ( ) ""$ '--- - -- P p acre tori as cum le,.:. TOTAL .......................$ ---- -- —Name of car dho rlel r a abowrt on credit card ---- I Cridholder signature -— -- Amount --' -- —'----- 440461G(rvWOrOR1i PLEASE COMPLETE: FIXTURES (individual) • .,Qty F'rice; Total Fixture Type quantl b Work Performed - Sink -^ 16.60 NOW MOvad Replaced Ram0vad1Cappa Lavatory i 16.60 Tub or Tub/Shower Comb. 16.60 Tub or Tub/Shower Combination Shower Only i 16.60 Shower Onl ~- - --- Water Closet 1&60 Water Closet - Urinal _ Urinal 16.60 nishwasher `--'-- Dishwasher 16.60 Garbage Disposal Laundry Room Tray Garbage Disposal 16,60 Was Machine - Laundry Tray 16.G0 Floor Drain/Floor Sink 2' 3' Washing Machine 16.60 - 4' -- ---- Floor Drain/Floor Sink 2' 16.60 Water Heater 3' 16.60 Other Fixtures(Spec 4' 16.60 -_--- Water Healer O conversion O like kind 16.60 - ------ - ---- Gas piping requires a separate mechanical permit. MFG Home New Water Service 46.40 -- - -� -- MFG Home New San/Storm Sewer 46.40 ~- - _ COMMENTS REGARDING ABOVE: [lose Bibs 16.60 Roof Dkalns ------- 16.60 -- -- --- ----- -,'_-_ ~- Drinking Fountain `-� - -- 16.60 Other Fixtures(Spedfy) 21.75 Sewer-1 st 100' 55.00 Sewer-each additional 100' -- 46.40 Water Service-1st 100' -- �- 55.00 --- Water Service-each additional 200' 46.40 Storm h Rain Drain-1s1 100' 55.00 Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 48.40 Residential Backflow Prevention Device' 27.55 $•etch Basin -� i- 16.60 -- Insp.of Existing Plumbing or Specially Requested 72.50 Inspections _ tl r Rain Drain,single family dwe ling 65.25 Grease Traps 16.60 QUANTITY TOTAL IsomeMc at riser diagram is requW/Ouanety Total Is >9 'SUBTOTAL . 4 B%/.SURCHARGE "PLAN REVIEW 25%/.OF SUBTOTAL Requ�a<fixture qty.Mel Is>9 TOTAL d� - t� 'Minimum permll fee is$72.50 a 0%surdurrge,except ResUential 6acklkw Pre%wgion Device,whkh h$76.25•0%uxulm". "All Now Commarclal Buildings require plans with korneiric or dser diagram and plan mevkw Electrical Permit Application Date received: Permit no.: City Tigard of Ti d Pro'ect/a I.) pp no.: Expircdate: CifynfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Phone: (503) 639-4171 Hy Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: rtjf�'I & amily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement nstruction U Addition/aiteri.tion/replacernent U Other:_ U Partial JOB SITE INFORMATION Job address: ?' r ve Bldg.no.; Suite no.:_oil I IN I Tax map/tax lodaccount no.: L ot: �(�• Block: Subdivision: ~ Project name: Descripti d la anion of work on premises: ,Estimated date of ca ledon/inspection: 11111ATE mum Job no: > Fee MAX Business name: - Description New residential- or multi-fa (e°) Total no,bs Address: 5� �tV e1i� y pK dwelling unit.Includes attached garage. City; 10 big- IStateQ ZIP: Servhxhrcluded Phone �- I Fax:G lotto sq.ft.or less 4 C0.: S`f Elec.bus.lie.no: 3 Each additional 500 sq.ft.or portion thereof imedgy,residentia --- zicy Limited energy,non-residential _ 2 _ r Each manufactured home or modular dwelling n twe supervls g clef trician(required) Date Service andlo user 2 Sup.elect.name(print): chvw License no: Q Servicesorfeeders—Installation, aferadno or relocation: 200 amps or less 2 Name(print): 201 amps to 400 amps 2 Mailing address: J— �� �$ 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: d $talCtj ZIP:f71� Over 1000 amps ur volts — 2 Phone:6�- dj'6 Fax:Sq - E-mail' Reconne rorty ^� Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocation: ORS 447,455,479,670,701. 200 amps or less _ 2 Owner's si nature: 261 amps to 400 amps 2 "?119 / v tl� y,Date: 401 to 600 amps 2 Branch circuits-new,alteration, Name: or extension per panel: ' c n gr A. Fee for brunch circuits with purchase of Address: �u 0. O service or feeder fee,each branch circuit 2 City' , I Q - State p ZIP�y B. Fee:for branch circuits without purchase Phone: — C ' Fax: E-mail: of service or fader fee,first branch circuit: 2 Each additional branch circuit: Ehp vice or feeder not Included): U Service over 225 amps-comm-t ial U IkAth-care facility or imguion circle 2 U Service over 320 amps-rau,,gof 1&2 U Hazardous location r outline lighting — 2 familydwellings U Building over 10,000 squam feet four or it(s)ora limited energy Panel.U System over 600 volts nominal more residential units in one structure r extension' 2 U Building over three stories U Feeders.400 amps or more Description: G Occupant load over 99 persons U Manufactured structures or RV parte Fxh additbru)Inspection over the allowable U any of the ahrre ❑Egress/ligluingplan U Other Pet inspection Submit_acts of plans with any of the above. Investigation fee The above are not applicable to tempor•uy construction service. Other NM all lurisdictims mecum credit cards, care call jurisdiction fa more information Permit fee.....................$ 1� 1 Notice:This permit application --------- -- U Visa U Mmter('ard expires if a permit is not obtained Plan review(at _ %) $ Credit card number. _ ___L j___ within 180 days after it has been State surcharge(8%) ....$ F.,pirer accepted as complete. TOTA1, $ -- Name of cardholder u shown on credit cwt Cardholder signature Amount — 146-1415(6MIfbM1 4. Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Number of Inspections per permit allowed Restricted Energy Fee................................ $75.00 Service included: Iterns Cost Total (FOR ALL SYSTEMS) 4a. Residential-per unit Check Type of Work Involved: 1000 sq.fl.or less $147.15 4 f ach additional 500 sq.K.of ❑ Audio and Stereo Systems portion thereof _ _ $33.40 1 Limited Energy $75.00 ❑ Burglar Alarm Each Manufd Homr or Modular Dwelling Service or Feeder $90.90 _ 2 ❑ Garage Door Opener' 4b.Services or Feeders Installation,alteration,or relocation ❑ Heating,Ventilation and Air Conditioning System' 200 amps or less $80.30_ 2 201 amps to 4G0 amps $106.85 2 ❑ Vacuum Systems" 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 _ 2 ❑ Other Over 1000 amps or volts $454.65 - 2 Reconnect only $66.85�! 2 _TYPE OF WORK INVOLVED-COMMERCIAL ONLY 44c.Temporary Services or Feeders Installation,alteration,or relocation Fee for each system.............................................. $75.00 200 amps or less $66.85_ 2 (ScE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 401 amps l0 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems 4d.Branch Circuits tJew,alteration or extension per panel ❑ Boller Controls a)The fee for branch circuits with purchase of service or ❑ clock S�stelns feeder fee. Each branch circuit �_- $6.65 2 E-1 Oata TMocommunicalion Installation b)The fee for brands circuits withouf purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 Y ❑ HVAC 4e.Miscellaneous ❑ Instrumentation (Service or feeder not Included) Uadc pump or irrigation circle _ $53.40 ❑ Ladh sign or outline righting - $53.40 Intercom and Paging Systems Signal dreuN(s)or a limited energy panel,alteration or extension - $75.00 ❑ Landscape irrigation Control' Minor Labels(10) $125.00_ Medical 4f.Each additional Inspection over ❑ the allowable In any of the above Per inspection $62.50 ❑ Nurse C ills Per hour $62.50 _ ❑ :n Plant $73.75 _ Outdoor Landscape Lighting' 5. Fees: ❑ Protective Signaling Sa,f nter total of above fees $ 8%Surcharge(.08 X total fees) $ ❑ Other Sublolal $ Sb.Enter 25%of line 6a for _ _Number of Systems Plan Review H required(Sec 3! $ Subtotal $ _ No licenses are required. Licenses are required for all other Installations j ❑ Tntst Account 0 FEES: Total balance Due $ ENTER FEES - - -- 8%SURCHARGE(.08 X TOTAL ABOVE) $ - TOTAL $ May-30-00 20:22A Wolcott Plumbing 603 667 9891 PCO2 �v StreMAddreu McAVAddnu OLS 07T 2050 N.W.Burnside PA.Box 2007 Gresham,Oregon Gresham,OR 97930 PLLWnVd (503)6e7.1781 fax(503)ee7.9691 ON�1p�/� D�t �T/� CCd NI>r17 l la.�t�.l.rT oRs, n V• May 10,2000 Building Department City of Tigard 13125 SW Hall Blvd, Tigurd,OR 97223 Wnleott Plumbing C:ontractoTS,Inc. docs hereby authorim a representative:of Legend Homes to.represent this firm when applying for plumbing permits inside the jurisdiction of'11c City of Tigard. Wolcott Plumbing Contractors,Inc, realize that should the agreement with r.egend Homes terminate, we have the right to withdraw our consent, Name Titles Signature mate 2&208PB 4281 State Plumbing License City License i i 1 1 1''L.OT FL_AN ; _ --� s�►� j sw,��. v s o � LOT #1<o a AFFL E WOOD FARK RIPD 251 11 DA TAX LOT '011500 89(o7 5W GREENING LANE 5.E. 1!4 OF SECTION 11, T.2, R.IU), W.M. GITT OF TIGARD W,45H INGTON COUNT r, OREGON LEGEND HOMES12755 SM 99th AVENUE ITE 100 ,u OFFICE (503) 820-8080 PORTLAND, OR. 97223 FAX (503) 598-9900 CCB/ 80593 LOT 164 LOT I63 LOT 16; N89" 4'25"E N62.00' - I 206.4' - I" 20'-0" / - LOT IC07 L0716� � .n LOTib� 4, 311 5Q. FT. fWINUJO0 e FIN. FLR. ■ 20-1.5' / WATER METER GAP-AGE P-E FLLR. 205.5 W---- --- L WATER LINE 55--——-- SANITARY SEWER SD— - - — STORM DRAIN 4S, Y W 2Ga5.2' — - — Q OF STREET 2051' • MANHOLE ® CATCH BASIN8' UTILITY 20 I PROPOSED EASEMENT STREET TREES -- -- S P9' 54' 25" W STREET LIGHT SIDEWALK (02.00' , FIRE HYDRANT CURB N ------ --- -58------ -- —��SS--- PROVIDE EROSION --- — — — — — -- — 4 —� ; --- -- CONTROL FENCE PER COMMUNITY 51J GREENLING LANE EROSION PLAN ----- -- -----W----------- ---- -1---- --