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12290 SW KELLY LANE J N N �O O �c 6 X �D K �1 7 �D 12290 SW Kelly Lane I�� T— I�� MP�TER PERMIT PERMIT#: MST2003-0002L DEVELOPMENI' SERVICES DATE ISSUED: 4/17103 1312s SW Ball Blvd., Tigard,OR 9-1'.223 (503) 639-4171 SITE ADDRESS: 122'— SW KELLY LN P/1RGEL: 25103CC-08400 SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT. Ii'I JURISDICTION: TIG kFMARKS• Nevv SF detached, Path 1. BUILDIN i _ REISSUE: STORIES: FLOOR At EAS REQUIRED SETBACKS _ REQUIRED CLASS OF WORK: NEW F EIGHT: :5 FIRST: I.Sm ar BASEMENT: 0 LEFT: 5 SMOKL DETECTORS: e TYPE OF USE: SF FLOOF LOAD: .ui SFCOND i GARAGE: 521: .1 FRONT. 20 PAPMING SPACES: 1 YPE OF CONST: SN DWELLIF'G UNITS: 1"K1 sf RIG'1T: 5 VALUE. )07073.0 OC . OCCUPANCY GRP* R'I BDRM: 4 BATH• T TOTAL. I'+'• sf REAR: 52 Pl IIMBING_ -- SINKS i WATER CLU IETS: 3 WASHING MACH: L AUNDR�TRAYR 1 RAIN DRAIN: iO0 TRAP(,: AVATORIES. 4 DISHWASHE R9: 1 FLOOR DRAINS: SEWER LINES: 10r SF RAIN DRAINS. 1 CATCH BASINS: TUBIS.'OWERS: 3 GARBAGE DISP: I WATER HEATERS: 1 WATFO I INES: '.n ECKFLW PkEVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL _ FUEL T'PES FURN<100K BOIL/CMP<3HP: VEN'r FANS: 5 CLOTHES DRYER: 1 ,;Ag FURN>-100K: 1 UWtHEATERS: HOODS: OTHERUNI(S: I MAX INr: blu FLOOR FURNANCES: VENTS: 1 NIOODSTOVE9: GAS OUTLETS: I ELECTRICAL RESIDENTI AL UNIT SERVICE FEEDER TEMP SRVCIFEEJERS BRANCH CIRCUITS MISCELLANEOUS _ ADD'L INSPECTIONS 1000 SF OR, -RS: 1 0 200 ampn -100 amp' W/8C1.:OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 5009F: 6 201 • 400 amp, 201 - 400 amp tat W/O 8VC/FDR! SIGNIOUT LIN LT: PER 1 )UR: LIMITER ENERGY: 401 • 600 amp: 401 - 000 xnp. EAAODL BR CIR: 91GNAt IPAN_:..: IN PLANT: MANU HMISVCIFDR: 601 • 1000 amp: °"'.^.mps•I(X10v MINOR LABEL. 1000.antplvolt: PLAN REVIEW SECTN?J _- Reconnect onh` 0 600\'NOMINAL: CLS AR-!A/SPC OCC >=4 RES UNITS: SVC/FuR>=225 A.: ELECTRICAL-RESTRICT ED ENERGY _ A.SF RE91DENrIAI _ B.COMMER7IV.L AUDIO 8 STEREO VACUUM SYSTEM AUDIO 8 STEREO: FIRE ALARM. :,JTERCOWPAGING: OUTDOOR LND9C LT: BURGLAR ALARM OTH BOILER: HVAC: LANDSCAPEIIRRIC: PNCIECTIVESIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL OTF'R: HVAC: bATAnELE COM.Kc NURSE CALL i TOT 41 A SYSTEMS: TOTAL FEES: $ 5.584.20 0W.'er: Contractor: This permit is SubieT.i to the regulations ronta,ned in the DON MORISSETTE FOMES DON MORISSETTE HOMES INC Tigard Municipal Code,State )f OR. Specialty Codes and 4230 GALEWOOD S1 #100 4230 GALEWOOD ST,STE 100 all other applicable laws, All work will be done in LAKE OSWEGO,OR 97035 LAKE O SWEGO,OR 97035 accordance with approved plEins. This permit will expire If work Is not started within 180 days of Issuance,or if the work Is suspended for more than 180 dans. ATTENTION. Oregon law requires you to follow rule`:adopted by the Phone: i�3-387-7538 Phone: Oregon Utility Noliflcatlon Cpntar. Tose rules art,set forth In OAR 952-01-o010 through 001-OC80. You Reg A: 503-3$) 73�8� may ohtaln c,pies of these rules or direct questions to OUNC by calling -J3)246-1987. REQUIRED INSPECiICNS Erosion Control Insp 8 Post/Ream Mechanica Mechanical Insp Extelicr Sheathinq Insl Rain drain Insp Final Inspect-at Sewer Inspection Underfloor insulation Plumb Top Out Low%oltage Water Line Insp Footing Insp Crawl Drain/Backwater Llectrical Service Gas Line Insp Appr/Sdwlk Insp Foundation Insp Footing/Foundation DT'. Electrica Rough In Gas Fireplace EleArical Final Post/ rat PLM/Underfloor Framing Insp In dation Insp Plumb Final 1 ' Iss4ed By Z� Permittee Si nattjre--)�� y`L L : ----- erm `� Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TI GAR D SEWER CONNECTION PERMIT DEVELOPMENT" SERVICESPERMIT#: SWR2003-00030 13125 SW Hall B-1, Tigard, OR 97223 (503) 639-4171 DA'Z'E ISSUED: 4/17/03 PARCEL: 2S103CC-08400 SITE ADDRESS; 12290 SW KELLY L N c,UBDIVISION: WHISTLER'S \4'i\I.F: ZONING: R-4.1 BLOCK: LOT: 031JURISDICTION: I1(_i TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS- INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF. Owner_ FEES— DON MORISSETTE HOMES Description— — Date Amount 4230 CAt_EWOOD ST#100 LAKE OSWEGO, OR 97035 �ti\\ I '-;A S\%,t Connect 4/17/03 $2,300.00 Jti\\ I .;./\ Sktir Connect 4/17/03 $0.00 Phone: 503-387-753x ;'-\VINSI') S\�r Inspect 417/03 $35.00 �-,WINSI11 S_\r Inspect 4/17/03 --$0.00 Contractor: ----- ---- — - Total $2,335.00 Phone. ' Reg #: Requi—d Inspections_ ^_ _ Phis Applicant agrees to comply v.nth all the rules anJ regulations of the Clean Water Servirps. T'h: permit expires 180 days from the date issued. The total amount paid will be forfeitcr if the permit expires. The Agenc y 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 directlons from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer' Perm Is§ued by: �_ _� I�i�/u� Permittee Signature: k \�..�L L .._Jl L v� Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application �. Date received: / , A" Permit no,-h�,L&yj City of Tigard - City of Tigard Addmss: 13125 SW Hall Blvd,-heard,OR 97123 ProJecc'appl.no: Expire date- Phone: (503) 639-4171 Date Issued: By. Receipt no Fax: (503) 598-1960 INI1 1 i �� Case file no.. Payment type. ITY r)F TIUA�',D Land use approval: 1&2famil� , �r � y:Simple -� Complex • 1 &'2 family d,velling or accessory ❑Commercial/industrial 17 Multi-family XNew construction J Demoiiuon U Addition/altt mien/replacement ❑Tenant improvement O Fire sprinkler/alarm ❑Other: ob address: < �' ' 1 �, il'Z . Bldg.no.: Suite no.: ft off- Block: Subdivision: - 4 - ;r �f�/�l Tai. map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: 0-loodplaiii.%,cplic capacity.solar,etc.)Mailing address: �L' 1 de 2 family dwelling: City: Staled Z1� Valuation of work 7 3 . ZD Phone: -^ Fax: ) ? -mail: No.of bedrooms/baths.................. .. Owner's representative: y � -�rj L Total number of floors................................. Phone: Fax: E-mail: New dwelling area(sq. ft.) Oarage/�;arport area(sq.ft.) ............•........... Name: kA.. Covered porch area(sq. ft.) ......................... Mailing address: Deck urea(sq.ft.)........................ ............ _. City: State: 'LIP Other ,truc.ture area(sq.ft.)......................... 1 f'ttt ncA Fax: E-mail: Comn:erciallinda+trlal/multi-family: Valuation of work........................................ $ Business name: Existing bldg.area(sq.ft.) ................... f ly� Address: New bldg.arca(sq. ft.) ............. Z City: S Number of stories........".. J _ wte: _7.1P: .... Phone: Fax: E-m a Type of construction.. .. .. .......... ......I.......... .......... �- -....r,.. ..__.....__ _._ - - OrriJtlattcv grroi-lq): Fxkdrjg Notice:All contrar:.n,ane subcontractors are required to be M#X111111 11 R-1 Eng a 7.111111111 I with the Oregon Construction Contractors Board under provisions of ORS 701 ted may be required to be licensed in the —'" ��— `- ------ urise'iction where work is bele rforme Address: j g d.[f the applicant is City: _ - State: ZIP: exempt from licensing.the following reaaon applies: Contact pers in: _ Plan no.: _ —---- - Phone: ! I--ax: E-mail - --�- -- - — - -- Name: lContact person: Fees due upon application ............. ..... $ Address: Date received: City.. _ St:tte: Z.IP: Amount received ........................•......... Phone: Fax^— E-mail: Please refer to fee schedule. _- 1 hereby a_rtify 1 have read and examined this application and the Not all junsdktions accept credit cards,plesm call jurisdiction for mwe imonnati- attached checklist. A rovisions of I ws and o dinamces governing this ❑Visa 0 MaxterCud work will beisignatit mpl�wi ,whether, cified 6erc/ri (. Credit card number: Authorized !, t( — Name of cardholder as thownon credit cardPrint name: r 1 I:f1 1-r cr rtlpiiii___.._� Notice:This permit application expircs.f a permit is not obtained witlein 190 days after it has leen accepted as complete, wnaet3 taowcoml One-mid Two-Family Dwelling Buil_ding Permit Application Checklist Referenceno.: Associatedpernuts: CityCiryo�Tigard ofi anT � d U Electrical U F'fumbing ❑Mechanical Address: 13125 SW liall Blvd,Tigard,OR 97223 UOther: Phone: (503) 630-4171 `—�-- -- Fax: (503) 599-1060 k: THE F61,11,01VING1 1avam 1 land use actions completed.See jurisdiction criteria for concurrent r,vkews. 2 Z-ning.Flood plain,solar balance points,seismic soils designation,historic district,etc. — - ------ 3 Veritication_of approved pintllot. 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 U pi to U permit required.Include drainage-way protection,silt fence design and I c tion of catch-basin protection,. 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable!:cul and state ^ ' building codes.Lateral design details and connections roust 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 tJ if copyright violations exist. I F Sitelplot plsm drawn to scale.The plan must show lot and building setback dimensions;property comer elevations i if there is more than a Oft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(includrnp decks);locator,of wells/septic systems;utility locations;direction indicator,lot area;!iuilding coverage area;percentage of coverage;impervious area;existing strut tures,m site;and surface drainage. -12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforc ng pads,connection details,vent size and location. I; Floor plans.Show all dimensions,room idertification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches ahoy' rade,etc. III Cross section(s)and details.Show all f ening-member sizes and spacing such as Moor beams,headers,joists,sub-floor. wall construction,roof construction.More than one gross section may be required to.nlearly portray construction.Show details of all wall and roof sheathing,roofing,icof slope,ceiling height,siding materia:,footings and foundation,stairs, Y fireplace construction, Thermal insulation,etc. 15 Elevation views.Provide,elevations for new construction- minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the c.. , . in grade is greater than four toot at building envelope. Full-site sheet addenclums showing foundation elevations ,v.Ji cross references are acceptable. 16 Wal ,racing(prescriptive path)and/or lateral analysis plans.hAtst indicate details and locations;for _non-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Floor/roof framing. P u rode plans for all floors/roof assemblies,indicating member sizing,spacing,and fearing 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 oven 10 feet long and/or any beanVjoist carrying a non-uniform load. X _ 20 Manufactured floor/roof truss design details. V, _ 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more appliances. 22 F nglneer'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 he applicable to the project under review. I 23 Five(5)site plans are required for Item I 1 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. ?; 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-M14 abvacoMt Mechanical Permit Application --- --- 7ProjewtJ, I /%%r� Permit no.: � . • ..^ �_,;,o� City of Tigard o.: Expire date: City ojTigard Address: 13125 SW Hall Blvd,'Tigard,OR 97223 Datessue : By: Rccclpt nos: _ Phone: (503) 6394171 Payment t r Fax: (503) 598-1960 Case file no.: YP Building permit no.: Land usp approval t tt ` O I &2 family dwelling.r accessory ❑CommerciaUindusuial L] Multi-family LI Tenant improvemr:nt Q Jew construction 0 Addition/alteration/repiacement ❑Other: - &I ORt t t Jo address: , �Suitelllo-- `-idicate equipment quantities 1n boxes below. InCicate the dollar value of all me,hanical materials,equipment,labor,overhead, Bldg.no.: -- --- profit.Vit �e S _ --- Tax map/tax lot/account no.: _ fit; Plock; Subdivision: ',..j' "See checl..ist 'or)mpotZarst application information and juripdiction's c schedule for residential permit fee. Project name: _ - t I pt t city/county: ZTP: t 'a s t RAW s t t Description;tied locadon of work on premises: - Fee(m)I Total De,aiption Qty. Res.only Res.only Est.date of cowspletion/inspection: i AC: Tenant improvement or change .r use: A.r handling unitCFM-- Is existing space heated or conditioned?0 Yes L�l No Aar conditioning(srte p an r;-U.- ) Is existing space insulated'?0 Yes 0 Nn _A t:rauon of existing H V AC system Kotler/compressors State boiler permit no.: IIP Tons BTU/H Business name tLl.l�-�G.• _ Address: (� udsmo�nampers/ uctsmo cedeteclors _ Q-- teat pump(stie p an regvirK C)ty: Ll State: 71P: E-mail: nsta rep ace .ai urne�� Phone; Her• Including ductworkivent liner O%'es D No CCB nr �- nsta replaceirelocate eaters-suspended, City/metro tic. no.: N/A wall,or floor mounted ent fora Lance o cr an urnace Name(tlease prints- ,� - - e erat on: Absorption units__ -_ BTU/H Chillers - lip Compressors -- Address: ' L 0, t Ent onmenta exhaust an rents atio:r. Cin,; State: 71P: Appliance vent - Phone: - Fax E-mail: Dim exhaust s, ype res. tche a7.mat hood fire suppression system -- - Exhaust fan with single duct(bac fans) Ntune: �address, , - - Exhaust system a tit from h•_aun ur nr Mailing _ r-• Fuel p p (;an d t tit on(up to out els) City: State- ZIP j�)�-'Z Type: LPG NO Oil - Phone: E-mail: I fuel p1pillf,each additional over 4 out ets process piping(schematicrequired) _Number of outlets - Name -_________.__ �t er1 stpiCance or equ pment:� Addle: - - "- Decorative fireplace - - - - - -- - — risen tY State: 71P: _-- Cit� - -- oodstove/pelletstove Phom Fa •marl: Other: .4pplirnn('s si�naru s {, Date: other. Name tp�int j I C', t il/t,r3cJJ — Permit fee.....................$ . or"WM infoam'ron Notice:This permit ap?lication Minimum fee................$ NO all iunrd cuoru accent credit card+,please call jurisdiction f d Visa ❑Mastert.ard expires if a permit is nct obtained plan review(at .-. %) $ Credit cud eumbn - within Igo days atter it`las been Fxpires State surcharge(8%) ...$ acaptedascomplete' TOTAL . Name of cardho��u thowa wcredit cad .................... $ $ — {40-4617 M)OA-0M) -- Crdhdder i6nature �- mount Plumbing Permit Application Dater vernutno.: s� _eGa, City of Tigard Sewer permit no.: - t.'uildingpermit no.: Address: 13125 SW Hall Blvd,Tigard.OR 97223 FApre date: City of Tigard Phone: (503) 639.4171 F:ojecdappl.no.: P Fax: (503) 598-1960 Date issued: By: Receipt no Case file no.: Payment type: Land use approval: t :t U I &2 family dwelling or accessory O Commercial/industnal 1 Multi-fannly G Ter ant improvement eta construction O Addition/alteration/replacement 'J Faxl •,ervice U Other. t : t t :t tU 11 t millt c ' __ Description F e(ea•) Total Job address: C l�) '-��' ` f 1 ( �A �l New 1•and Z family dwellings only: Bldg.no.: State no.: y (Occludes 100 R.for each utility connection) Tax map/tax IoUaccount no.: _ _ SFR(1)bath Lot: Block: Subdivision: (/ U -V` ' SFR(2)bath Project name: L ( __�_ SFft(3)bath _ City/county: ZIP: Each additional badvkitchen Description and location of work on premises: Site utilities: _ Carch basin/area drvn Est.date of comp) tion/inspection: DrywellsAcach lineArench drain Footing drain(no.lin. ft.) _ Manufactured home utilities _ Business name: L„�t �� Manholes Address: _^ Rain drain connector City — State ZIP: Sanitary sewer(no.lin.ft.) Storm sewer(no, lin. ft.) Phone: Cax: E-mail: Water service(no. lin.ft.) - CCB Plumb.bus.reg.no: - '�' Fixture or Item: City/metro lic. no.:N/A /�\ Absorption valve _ Contractor's representative signature' Back flow preventer Printname: f Back%,ater v ilve Basins/lavat,)ry Clothes washer _ Dishwasher Address: r k V —___ Dunking fountainls) City State !II' __ Ejectors/sump Phone: Fax: E-mail: Expansion LwA Fixture/sewer ca _ Floor drmns/floor sinlcs/hub Ntsme (print): ' Garbage disposal Mailing address: 1 Hose bibb - City _ State ZIPa- ` Ice maker Phone: - Fax: 7-7(G1 E-mail: Intet,. tor/ eyse trap-� owner in.stallationlresidenaal mainrenanc?only: The actual it..,tallation Pnmerls) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee en the propem, I own as per ORS Chapter 447. Sink(s),basinis)• lays(s) Sump Owner's signature: Uate: Tuhsshower,shower pan Unnal Name: _ Water closet Address: Water heater y City State: _ ZIP: —_ Other. Phony: Fax: E-mail: Total --� —.. Minimum fee............. S _ — Nat all runwLcuont accept cm&cards.Mate call iunxf+cuon ror mac infarruuan Notice:Thus permit application Plan review(at __ %) S .-+--- O Visa ❑kinterCud expires if a p imut is not obtained State surcharge (8Cc) ....$ _ Cmdlt card number - -- within 180 da.s after it has Ixen $;tpuet ToTm. — accepted as complete. ....................... _ --Name of catdrwlder U�w..n mm crani cud S -- --- Amount iso t61 i 16g6CGM) Cardholder nrrfa�ure _ Electrical Permit Application �W(TreceieMd�: / d.S Permit nu.:ly 3•GYt?af� Y ity of Tigard Project/appl-no._ imdate: Cuv.;77grnl Addre,;: 13125 SW Hal! Blvd,Tigard, OR 97223 Datc issued: Byi ..'r: Receipt no-: Phur.c: (503) 639-4171 fax (503) 59°-1960 Case rile no.: Payment type: L;ur1 use ,thhroval: - —�---- 1 1 &2 family dwelling or accessory r]Commercial/industrial U Multi-f:.mily U Tenant improvement New construction U Addition/alteration/replacement Cl Other. _ 0 Partial JO6'SITE INFORMATION Job address: t ` ( n Bldg. no., S❑ire no.: Tax map/tax lot/account nil.: Loc I Block: Subdivision: — Project name: Description and location of work on premises: Estimated date of completion/inspection: 1 a Job no: _ F,r Max Business name: ` Descrplion thy. (ea.) Total�no.Insp Address: Zi— New rmidential-single or multi-timil.CA I. — dwe0ing unit Inciudm attached garat r. City It- -� State: LI Semi«included Phone: E-mail: 1000 sq.ft.or less _ 4 FAch additional 500 sq.ft or portion thereof CCB no.. �Elec, bus. lic. no: Uffuted energy,residential 2 C' _ Unutedenergy,non•residential 2 Each manufactured home or modular dwelling olure ajsupentsrn electrician(required) Date { Service ancUar feeder 2 � —�—'�—�- --LIP-•� Senlcnarfeed.:r+-Instsllallon, after Sup elect nameiporo 1 �— Licenseno Seryl mart Ion or relocation: 200 amps or less 2 N•me (primo: t '- t 201 amps to 400 amps - 2 Mailingaddresao1 amps to 6W amps 2 ns � 601 amps to 1000 amps 2 City: �Vr State ZIP: Over 1000 amps or volts 2 Reconnect only I Owner ln.stn/ladom the installation is heing made on property I ofvn Temporary services or feeders- which is not intended for sale, lease, rent,or exchange according to butalladmi slterstion.orrelocauon: 200 imps or leas 2 ORS 147,455,479,670,701. 2oI amps to 400 amps T_ -- _ 2 Owner's si nature: Date: 401 to 50o amps 2 1 Branch circuits-new,alteration, or extension per panel: Name: A Fre for branch circuits with purrh:se of Address: service or feeder fee,each branch circus. 2 City: Stale ZIP: J B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: =F.1 V E-mail: Each additional branch circuit: , PLAN ItEVIEW(Plewite check all Mail spoty" Misc.(.5ertice or feeder not included): O Service aver 7.25 an:,s-comi evoal U Heatth-care V,lity"aaaaaaa Each pump or irrigation circle 2 0 Service over 320 amps-rating of 1 Sr 2 O Hazardous locauon Each sign ar outline lighting 2 fatnitydwelling3 0 Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. ❑system over600 volts norninat more residential units in one structure alteration,or extension" 2 •Building aver three stories O Feeders,400 amps or more •Uescri u in O Occupant load over 99 persons O Manufactured structure-or RV park Each add,ional inspection over the allowable in any of the above: C3 Egmsstlightingplan U other _ — Per inspection L The submit--__sets or plans with any of the,lore. Invesugation fee above are not applicable to temporary ennstruction service. O,her Na all jurisdictions atop credit cards,please call Jurisdlcuoo for more infornuuon Notice:This permit application Permit fee.....................3 --- O Visa O MasterCard expires if a permit is not obtained Plan review(at — %) $ Credit cud number _L(__ within 180 days after it has been State surcharge(8%) ....S . Eapia` accepted as complete. TOTAL .............. ........S Name Wcardholder u rhown on c 't c _ S Cardholder iiiinature Amoum 440-.x615(/r04'COM) OBE : 2801. DON , MORISSETTE LOT: gi * 0mIE INCORPOBL ? ED aaao C ALswooa 8 T R X 2 T DATE: 01/07/2003 ( osj 9er °' isoaa � e16a s e -l s ) i ) 5 7 � PROPERTY: 1 KWUR'9—WALK CITY: TIGARD SCALE: 1"=20' PLAN No.: 170 `J OPTION 2 ELBA:ATION C�< 122W SUU KELLY LANE -3- 33E §� 626 oq. ft. �'•O 3 car ger. 4 J i F-F E. 3335, _s_m ,o i I 33: 4 bdrri. 2V2 beth in FFE 33'35' is-m, r 335 I I I � Z I 9) J- 3.to '^ mE-ER Jl 33 �� r LEGEND LOT OYERAGE 1 *G'''� LOT AREA: 1,635 90. FT. LOT 631 , -10, --2' ACER RUDRUM BUILDING AREA: 2,310 90. Fr '1,(,35 sq. ft. o RED MAPLE' PERCENTAGE: 31.0% \ CITY OF T I G A R D __ PLU',iBING PERMIT DEVELOPMENT SERViC ES PERMIT#: PLM2003-00266 13,125 SW Hall Blvd.,Tioard, OR 97223 (503) 639-4171 DATE ISSUED: 6/12/03 PARCEL: 2S 103CC-08400 SITE ADDRESS: 12290 SW KELLY LN SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 031 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSAL'�: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MAC.1: BACKFLOW `REVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: _ URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install irrigation backflow device Owner: FEES-- -------- Descr ption Date _ Amount DON MORISSE TiE HOMES ------_ _ 4230 GALEWOOD ST#100 1111 I \1111 I'('inul I-ee 6/12/03 $36.25 LAKE OSWEGO, OR 97035 11 n\ "!aw lax 6/12/03 $2.90 Total $39.15 Phone : 503-317-7538 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD, TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : 503-092--45RP/Backflow Preventer Final Inspr-.ction Rcg#: III N1 7804 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 Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 24E-6699. Issued B ! / Permittee Signature: 1 ! Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the r.ext business day Jun 12 03 07: 4'ia dan edmonds 503-692-0768 p• 2 Pluni0ing Permit Application ' RecciveJ Plumbing Panning r Permit No- ' __4 City of Tigard Planning Approval Sewer -' L)ale/8y: Permit No.: 13125 SW H::II Blvd, Plan Review _ Other 'rigard,Oregon 97223 i Date/By: Permit No Phone: 503-639-41-71 Fax: 503-598-1961 Post-Review Land Use Date/By: Case No.: Internet, www.ci.t'igard.or.us Contact lure's.: Sec Page 2 for 24-hour Inspection Request: 503-639-4175 Natne/Method: iG Snnplemental Information. _ TYPE OF WORK I FEE"SCHEDULE far special Information use ciiecklist) [Mdition/alteration/re w t nastruction Demolition I Descri,tion Q'y. F'cc(en.) total placeinent Other: New 1-&2-famlly dwellink, CATEGORY OF CONSTRUCTIONincludes 100 It.for each utillty connection 1 &2-Famil dwellin CommcrciaVIndustrial SFR I bath 249.20 _ SFR 2 hath 35n.00 Accessol E3uildig Multi-Family _ SFR 3 bath 39 .00 Master Builder Otlter: teach additional both/kitchen� 45.00 JOB SITE INFORMATION and LOCATION Fire sprinkler-se. fl.: Page 2 Job site address: /�J:gin 5Gt' Kt✓'Cr'c _hien c� Site Utilities Suite#:_ $ld ./Apt Catch basin/area drain 16.60 Project Name: Wil 1411,e/4 tl_IGI��G ,3/ Dr ell/leach line/trench drain 16.60 Fooling drain(no.linear fl.) Page 2 Cross strcet/Directions to job site: Manufactured home utilities 110.00 �L' /,P I J T Manholes 16.60 Rain drain connector MAO __ Sanitarysewer no.linear ft. Page 2 Storm sewer{no.linear ft. Page 3 Subdivision: Wil f.c t/<�s aQ.� Lot#: ) Water service�no.linear fl.) Pae 2 _ Tax map/parcel #: 60 C-S S Fixture or Item DESCRIPTION OF WORK - �Gl/1��,� Absorption valve _ 1ti.60 Backflow reveuter ' Pa e 2 , V-4 G�f/��L /C'a Backwater valve 16.60 e1 Clothes washer 16.60 -'-`" -- Dishwasher 16.60 46 Drinking fountain 16.60 PaOPERTY UWNER UTENANT "jectors/sump 16.60 Name; / eyyt e.S Expansion tank 16.60 Address: 'Re) atouic,-nc . Fixture/sewercap 16.60 Cit /State/ip:LrWe tJs tLeIC3 e?•70 3y Floor drain/floor sink/hub 16.60 Garbs a disposal I6.60 Phone: _ Fax: It Ise bib 16.60 APPLICANT CONTACT PERSON Ice maker 16.60 Nam: ft 1 'S'qul'rz t0 Interceptor/grease trap M.60 Address: GLi 6W /)3 t�jLy1V AD Medical gas-value: S Page 2 Cit �tti C i[7'7�t OtC 97C+(c$ Primer 16.60Roof drain(commercial) 16.60 phone:'�43 �,e/a- ,V 5 r Fax:5co a._ u r;nk/basin/lavatory 16.60 E-mail: Tub/shower/shower pan 16.60 CONTRACTOR Urinal_ _ 16,60 Business NamL.IauJIc/SeaA:2� Water closet _ - 16.60 Water heater 16.60 Address:/aJ ern �.0 G�/may)rl lti_� �d Other: - - _ Cit /State/Zl t a-M 1L.>0� r7 01. Other Phone:.Sa.5 &9J Sri'/S Fa ;D 3J 6clQ ` 4,1? Plumbing Permit Fees' CCB Lic. #: r7 O Plumb. Lic.#: Subtotal S .0 7•S Authorized Minimum Permit Fee$72 50 $ Residential Backflow Minimum Fes 36. Signature: Vu u;r % �' � Date: 4,11- 03 Plan Review(25%of Permit Fee) S State Surcharge(8%of Permit Fee $ a;J, Ll (Please print name) TOTAL PERMIT l'EE S lam_ Nutlet: This permit application expires It a permit Is not obtained within All new commercial hulldings require 2 sets of plans with Isometric or 180 days after It has been accepted as complete. riser diagram for plan review. *Fee methodology sit by Tri-County Building Industry Service Hoard. :%l)sts\Permit Porrm\PlmPermitApp.doc 01/03 CITY OF TIGARD 24-Hour ;ILDING Inspection Line: (503)639-4175 MST INSP- TION DIVISION Business Line: (503)639-4171 - ---''77 BUP _. Received Date Requested_____ 1 .�` `� _ AM_ PM _— BUP Location 1 a—�d t��c,-_ __ Suite /1� ,�f_ MEC Contact Person _— — -- Ph(— _) PLM —_ — Contractor - BUIL DING� TenanUOwner —. �__ _ ELC F.,oiing Foundation ELC Access: Ftg'Irain 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 Qthar: pA PART FAIL— MBING - -- Post& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains - - Catch Basin/Manhole Storm Drain Shower Pan Other: _ PAS PAX FA-L ANICAL Post& Beam - —�- - - Rough-In Gas Line Dampers Smoke A;S ART FAIL _- EtTsQTfhCAL Service Rough-in - UG/Slab Low Voltage Fire Alarm Fin Reinspection fee of$` --required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. bS _ART FAIL SS F-1 Please cali io+re nspection HE: _ EJ Unable to inspect-no access Fire Supply Line ADA ,. --- tn Approar,.h/Sidewalk Data - Lftp�.tor Ext _ _. _- _- _ Other:_, _ Final DO NOT REMOVE this Inspection record from the job site. PA-S PART FAIL N � ► � � U v ► 0 44 �; ► bn49 "' ► U ► pil- � � ice.. v '' ti pG ► ► N `� ► <1N ► a I�+■� ► i Q ¢ c ► s ► 'A►vwvvvvvvvv vvvvvvi*r*VVVVV VVVVVVVVVVVVVVvvI� CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST _ INSPECTION DIVISION Business Line: (503)639-4171 — BUP Received f` C Date Requested____.__7_ _____— AM—__ PM BUIP Location __ 2_7_-?-� �> Zt� 1-- _t_ Suite_ __ MEC _ _-- Con'act t--erson '�&-n ___ Ph ) klZ_?_LZSr PLM ,ontractor __ _ _____ Ph(__ _) SWR BUILDING Tenant/Owner ELC Footing _ Foundation -- ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT ___.__^._ Post& Beam - -- -- -- - - -- -- ----- --- — --- - Shear Anchors - -- ------.-"-- -- __--- Ext Sheath/Shear Int Sheath/Shear Framing -- - -- - - - - .__ -- ------------------—- - insulation Drywall Nailing w -- --- - --- --------- ----�_.- _ - ---- Firewall Fire Sprinkler -- ----- --- -- -- - — ------ - .__..._ .. Fire Alarm Susp'd Ceiling - Roof Other: - — — Final - PAS PART FAIL — - - - - --- - -- - 170-ST-9_B am Under Slab ------------------ ---- I lough-In Water Service - - -- - Sanitp-,Sewer (lain I'-.ins - -- -- --- Catch Basin/Manhole Storm Drain ---- -- --- -- - -- --- - -- Shower P Other: - Fifiall 3,S PART FAIL -- - - - --- - -- C NICAL Post& Beam Hough-In -- --- - Gas Line Smoke Dampers - - - Final PASS PART_ FAIL - - - ELECTRICAL Service -- - - - -- - -- _ lough-In UG/Slab 1.ow Voltage Fire Alarm ---_--- -- Fin'al �A Reinspection feb of� required before next inspection. Pay at City Hall, 13125 SW Hrif B vd. PASS PART FAIL SITPlease call for reinspection :iC ____ ___�_ Unable to inspect-no acce:•s Fire Supply Line ADA I " Date Approach/Sidewa k _. ins�toctor ✓� Ext Other: FinaltIHO Ift REMOVE this Inspection record from the job oke. PASS PART FAIL ry �. rL �I W rrrtz a Q + ^, N 1� ~ c Er \ J N � n o � 0 o � � r., 1 T C m