14685 SW KLIPSAN LANE co
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14685 SW Klipsan Lane
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CITY OF TIGARD MASTER PERMIT
PERMIT#: MST2003-00021
DEVELOPMENT SERVICES DATE ISSUED: 2/12/03
13125 SW Hall Blvd.,Tigard, OR 97222 (503) 639-4171
SITE ADDRESS: 14685 S\P/ KLIPSAN LN PARCEL: 2S105DD-06900
SUBDIVISION: PACIFIC CREST ZONING: R-7
BLOCK: LOT: 041, JURISDICTION: 'I I('I
REMARKS: N
BUILDIN4
REISSUE: STORIES. 3 FLOOR AREAS _FEQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,380 of BASEMENT. of LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,352 of GARAGE: 64 i st FROM: :H PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 T14RD 830 of RIGHT: 5
VALUE. 347,7,0.50
OCCUPANCY GRP: R3 BDRM BATH: 4 TOTAL: 3,562 of REAR:
_ PLUMBING
SINKS: I WATER CLOSETS: WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: i FLOOR DRAINS: SEWER LIKES: 100 SF RAIN DRAINS: I CATCH BASINS:
TUB/SHOWERS: 5 GARBAGE DISP: I WATER HEATERS 1 WATER LW IS: 100 SCKFLW F,tEVNTR: I GREASE TRAPS:
OTHER rIXTURES.
MECHANICAL
rUEL TYPES FURN<10OK: BOILICMP<311P: VENT FANS: 6 CLOTHES DRYER: I
GAS FURN>=100KI UNIT HEA1 ERS. HOODS: I OTHER UNITS: I
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
REWDEHTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS _BRANCH CIRCUITS MISCF'LANECUS_ ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - ?00 amp. 0 200 amp- WISVC OR FDR PUMPIIRI41GAl101:. PER INSPECTION:
EA ADD'L 500SF: 7 201 400 amp: 201 400 amp 1 at W/O SVCIF UR SIGN/OUT LIN LT: PER HOU'L
LIMITED ENERGY: 401 600 amp 401 - 601,artlp: EAADOL OR CIR: SIGNAL/PANEL: IN PLANT.
MANU HM/SVC/FDR: 601 1000 amp: 601+amps•10W)w MINOR LABEL:
1000+amolvolt
PLAN REVIE'N SE CTK)N _
?.•connect only. >=4 RES UNITS: 9VCIFDR>=225 A.: >100 V NOMINAL: CLS AREAISPC OCC.
ELECTRICAL•RESTRICTED F:tERGY
A.SF RESIDENTIAL __ 5.COMMERCIAL
AUDIO 6 STEREO. x VACUUM SYSTEM. r. AUDIO&STEREO: =IRE AI ARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM x OTH: All F NCOMP B011CH HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL
GARAGE OPENER: x CL)CK INSTRUMENTATION: MEDICAL: OTHR:
HVAC, x DATA/TELE C)MM NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,599.44
This permit Is subject to the regulations contained in the
D R HORTON HOMES D.R.HORTON INC Tigard Municipal Code,State of OR. Specialty Codes and
5125 SW MACADAM AVE STE 145 4386 SW MACADAM AVE. all other applicable laws. All work will be done in
PORTLAND,OR 97201 SUITE#102 accordance with approved plans. This permit will expire H
PORTLAND,OR 97239 work is not started within 180 days of issuance,or If the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503-222-4151 Phone: 503-222-4151 Oregon utility Notification Center. Those rules are set
forth in OAR 952-001-0010 tt•,,cugh 952-001-0080. You
Ra®�. FIC 130851) may obtain copies of these rules or direct questions to
QUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Wtr Proofing Bsm't Wa Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Grading Inspection Pcst/Beam Structural PLM/Underflr,; Framing Insp Cas Fireplace Electrical Final
Sewer Inspection Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Footing I:Isp Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final
Foundation Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Issued By : E' 1 Permittee Signature
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#: SWR2003-00021
13-1?5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/12/03
SITE ADDRESS; 14685 SW KLIPSAN LN PARCEL: 2S105DD-069(10
SUBDIVISION. PACIFIC CREST ZOPII`JG: R-7
BLOCK: LOT: 04S _ JURISDICTION: I I(i
TENAN- NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSVVR IMPERV SURFACE:
Remarks: S
Owner: _ FEES
D R HORTON HOMES
5125 SW MACADAM AVE STE 145 Description — Date Amount
PORTLAND OR 97201 ISWUSAI Swr Coniwct 2/12/03 $2,300.00
1SWUSAISwr Connect 2/12/03 $0.00
Phone: sn3-222-4151 [SWINSI'] Swr Inspect 2/12/03 $35.00
ISWINSP]Swr Inspect 2/12/03 $0.00
Contractor: --
--- Total $2,335.00
Phone:
Re(
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Cervices. 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
'.he 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 small pUldiase a "Tap and Side Sewer" Perm
Issued by: l - �'1'L.LV'L_? Permittee Signature: /
Call (50#639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
Date received: t �, Permit no.:
City of Tigard —�
Projecdcppl.no.: Expire date:
Cityrl.(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By + Receipt no.:
Fax: (503) 598-1960 /l rr, ase file no.: Payment type:
Land use approval: _ 4 1&2 Family:Simple Complex:
WM Il W out]110 110 Im
❑ 1 &2 family dwelling or accessory ❑Cummercial/industrial 0 Multi-family P(New construction 0 Demolition
❑Add ition/alterat iun/replacement ❑Tenant improvement 0 Fire sprinkler/alarm ❑Other:
Job address: Bldg. no.: —no _
Lot: Block: Subdivision: VA ) Tax map/tax lot/account no.:
Project r MISX,
Description and location of work on premises/special conditions: (11,loodplain,septic capacity,solar,etc.
F011 SPE.ClAll, INF0111MATION, USE CHECKLIST
Name:
Mailing address: j21* 1 &2 family dwelling: eI
City: �' Sta.e:�� 'LIP: ZQ 1 Valuation of wurk,�;�.1,�.., 7y..4..... V...... $ 4�:__
....
Phone: � 51 Fax: - •'i� -mail: No.of bedrooms/baths.................................
Owner's representative: Total number of floors.................................
Phone: . 13 Fax: E-mail: New dwelling arra(sq.ft.) .moi ri7,_ _.
11110,1111 Garage/carport area(sq. ft.) ........................
Name: V t l Y In Covered porch area(sq.ft.) .................... ...
Mailing address: 6AMic As A k o v ti Deck area(sq. 1't.) .•................t73..........
City: I I I State: I ZIP: Other structure area(sq. ft.).........................
Phone: Fax: E-mail: Commerciallindustrial/multi-family:
Valuation of work........................................ $
Existing bldg.area(sq.ft.) ...
Business name: 12 . Z Hi Y-41 n New bldg.area(sq,ft.
Address: c�11,66L4 &A& am Number of sto . . ....... ............................
City: State:p ZIP:
Phone: Fax: Email: —� Type of st uction................................... _
—1,22.4/sr M, l — ()C¢aoancy group(s): Existing:
CCB no.: y3 p --!7 —
New:
City/metro lie,no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: P e , �-}�� r.a l,t provis,,)ns of ORS 701 and may he required to be licensed in the
Address: US jurisdiction where work is being performed.If the applicant is
Cit State. ZIP: exempt from licensing,the following reason applies:
CIL Plan no.:
*Phone:: -N/ i Fax: E-mail: _
Name: 141P ontact person: Fees due upon application ........................... $ —
Address: .56 J2,&11'h / Date receiv,d:
City: State:Oje, ZIP: /5' Amount recti.-ed ......................................... $
Phrnne.jo�- Fax:&Wfr-4W, E-mail: Please refer to fee r:hedule. _
I hereby,.ertify I have read and examined this application and the Nd all jurisdictions accept credit cods,please call jurisdiction for mote mformabnn
attached checklist. All provisions of laws and ordinances governing this Dviss ❑Mutei Card
work will be complied wi ,whether s-)eeified herein or not. credit card number.` Expires
/
Authorized signature: Date: _`_J� Name of cardh elder u shown on credit card
i
Print name: Ce signature _ Amount
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete, a.to-ral)tbtln/Confl
Mechanical Permit Application
Date received: Ih2 it Permit no..N•:r ., .::
City of Tigard Project/appl.no.: Expire date:
City f,rig ard Address: 13125 SW Hall Plvd,Tigard,OR 97223 —� —
Phone: (503) 639-4171 Date issued: Hy: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payrnem(ype:
Land use approval: _ _ Building permit no.:
J 1 & family dwelling or accessory ❑Commerciul/industrial U Multi-family J Tenant improvement
U New construction U Addition alteration/replacement U Other.JOB SITE INFORMATION CONINIEftcIAL 'W"'ll
�.
Job address: Indicate equipment quantities in boxes below. Indicate the lollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment, labor,overhead.
Tax map/t" lot/accouw no.: profit.Value$
Lot: Block: Subdivision: �tG/ *See checklist for;mportant application information and
Pros.ct nam'. v jurisdiction's fe- �.hedule for residential permit fee.
Ci.y/county: ZIP: _ tt t to 11101
r)escription and oration of work on premises: _ I s Q1 F1 10m 1114 Ell I-q X411 I Vil I Nil K01 I 1411
t
Fee(ea.) fatal
'St.date of completion/inspection: DescHpillon Qty. Rm.only Iles.only
tenant improvement or change of use: 1 AC:
Air handling unit CFM_^
"is
ng space heated or conditioned?U Yes ❑No 'Air conditionr
(site p :equire )
ng space insulated?U Yes U No A tc:^tion of existing RVAC system
toBoiler/compressors
Business name: V Stare boiler permit no.:
- HP —.Tons—BTU/11
Address: ire/smoke ampers/r uct smoke delectors
City: A Slate: ZIP: p Q eat pump(site p an re,
Phone: Fax: E-mail:
�-- !nstalUrepacefurnac urner
CCB no.: Including duetwork/vent liner Q Yes O No
Instal replac re orate heaters-suspended,
City/metro lic.no.: wall,or floor mounted
JName(please print): Vent fora lance other than furnace
i Refrigeration:
Absorption units BTUM
Narne: Ni t D/G mtdsoo Chillers lip
Address: Gj 6 �y.; ��, �y Com ressors HP
Environmental a alt and r� entFatlon:
City: kmn"10, State: ZIP: `D� Appliance vent
Phone -",. y.- / / Fax=-4—P/ E-mail: Dryerexhaust
Hoods,Type I/[Ures.kftcherilhazmat
/� hood fire suppression system
Name; 1� � �_ � _ Exhaust fan with single duct(bath fans)
Mailing address: y xhaust system apart from heating or A
City: a State:Q� ZIP: Fuelpiping nd distribution(up to outlets)
- Type: LPG NG I Oil
Phone: /f Pax: /I I E-mail: Fuel iping eac additional over 4 out cls
Process piping(schematicrequired) _
of outlets
Name: ell-141ei- GN r /h Numher
Address: Ot er st app once or equipment:
e/ Decorative L /�� Decorative fireplace
City: State_ ZIP: of'7o/5 nsert-ty e
Phone: Fax: t,40 42E;I E-mall: oodstov pellet stove
Applicant's si gnature: (hher:
PP 6 -,?V" Dare: 1 other:
Name (print):
Not all jurisdictions accept credit cards.pleat call jumdicaon rot more information Notice: Permit fee.....................$
U Visa O MasterCard if
permit application Minimum fee................$ _
expires if a permit is not obtained
Cred,,cud number _1_LPlan reVICW(at 96) $
gsp;re, within 180 days after it has been State surcharge(8%)....$
Name of cardlivIrler is shown on credit card accepted as complete.
_ _s TOTAL .......................$
Cardholder uputure Amount—_� 4[01617(6tlalCOM)
Electrical Permit Application
IDatereceived: 15 0!2 Permit no.: 4#�f yrv3-O�
City of Tigard Project/appl.no.: Expire date:
City ofrigurd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171
Fax; (503) 598-1960 Case file no.: Payment type:
Land use approval:
TYPE(W PERMIT
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
New construction G Addition/alteration/replacement U Other: ❑Partial
JOB SITE INFORMATION
Job addr•ss: Bldg. no.: Suite no.; Tax snap/tax lotlaccount no.:
Lot: lock: Su div',ion; (�(• _
Project name: rpf(, 111116,, fle4 TDescription anu location of work on premises: _—
Estimated date of cornpletion/inspection:
SCHEDULECONTRACTOR APPIJCA'f`ION FEE
Job no: Fe„ ''I"`
Business name: Description _ Olv. (ea.) notal no.insp
New residential-single or could-family per
Address: _ dwellintunit.InclurbatUclw�prage.
City: State:OP I ZIP Service Included:
Phone: rax: E-mail 1000 sq.ft.or less _ a
C•ih additional 500 sq ft.or portion thereof
CCB no.: �_ Elec.bus. lic.no: 4b - �'
_ Limited energy,residential
Cilv/metro lic. no.: Limited ener;,y,non-residential
r- Each manufactured home or modular dwelli ng
Si
Is 11'11 su main electrician(re uired)_ v Date Service and/or feeder 2
Sup.elect.name(pnntn. Licerseno: Servicesorfeeders-Imtallation,
alteration or relocation:
200 amps or less
g �_
201 amps to 400 amps 2
Name(print)
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: Slate: ZIP' 17WI Over 1000 amps or volts 2
Phone: , Fax: E-mail: Reconnect only I
Owner installation:The installation is being made on property 1 own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocation:
2
0R3 447,455,479,670,701. _ _
200 amps or less
201 amps to 400 amps
ONrner's 51 nature: Date: 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
rNam"e: j41-(,k _ 5 V m A. Fee fc, branch circuits with purchase of
Address: hy& service or feeder fee,each branch circuit 2
city; ` / State: 7.1P: 2L� B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: 2
Phone: Fax 0 E-mail: Each additional branch circuit:
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lightingi 2
family dwellings U Building over 10,000 square feet four r Sign,:I circuit(s)or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration,or extension*
*Building over three stories U Feeders,400 amps or mote *Description:
O Occupant load over 99 persons O M• 'actured structures or RV park FAch additional Inspection over the allowable in any of the above:
l7 Egress lighting f.an U Other. Per inspection ( —T�—�—^
Slubmlt_sets of plana with any of the above. Investigation fee
The above are not applicable to temporary construction service. Omer
�Nnr all Ju�nsdietions accept credit cards,please:all tunsdtctmn formote mrorrunan. Notice-This permit application Permit fee..... ...............$ ��
U visa O MasterCard expires if a permit is not obtained Plan review(at _ %)
Credit card number: _ ____ _// within 180 days after it has been State surcharge(896) ....$ _
Expars accepted as complete. TOTAL .......................$
"Nana of cardholder as shown on credit card
_ S
Cardholder signature Amount 440-4615 IM)WOMI
FPOM :C:PAFTiJORK PLUMBING FAX NO. :50-76445989 Nov. 01 2002 08:34AM P2
Plumbing Permit Application PIN
Date received:
mit
City of Tigard Sewer permit
1!e.. Nuih;ing permit no..
Address: 13125 SW Hall Blvd, Tigard,OR 97223 `—`—
City ofTr�;ord Phone: (503) 639-4171 Projet/uppl.no.: Expire rLdc:
Fax- (503) 598-1960 Date issued: Ry: Receipt no.'
Lnud use approval: Celt ale no.: _ 1'nymcnt lypc --
13 1 &2 6-1 fly dwelling or aeccssoty L'J Commercial/indt trial O Multi-family 7 Tenant imprnvemout
New constnlcr OAddition/nllcration/replacement ❑Food service O Other: _
Job ndclress: / S'��" J� ! �_ -- ptlnn _ Qtv. Iene(cn.) Total
Bldg. no. Site no.: i Ney 1-and 2 family dwellings only:
fox map/tnx lol/account no,: — (Inel•rden IOO n.ftir each utility cotnreclion)
IGO Lf Block: ---r5ubdiviaion; j� SFR(I)both
��
I I'rnieci no IWR(3)bath
r Clt�/county: I17 P _ Each Additional both/kitch_cti
Description and location Ci tAot4 on pror,iiscs: Site utilities:
Catch basin/area drain
st date of completion/inspectino: D wells/Ir ach lilm-Arel-IJI ruin
_Footing drnin(no. lin (l.) �I
Manufactured home utilities
usness name: � M L iManholes
NAds: / /jIN Rain drnin connector
ilvStn eek ZIP;F Sanitary sewer(no. lin. R.)^
Phonepi6 Fax yy,`q E-mail: Storm sewer(no, lin. ft.)
a'
CCH no.: 5Piumb bl.. reg. ���yQ' 14atet service ono. lin. ft.
Cor
itylmetro lic.no: j / Fixture on Item:
Contrectur's representative signature. Abs_ivalve _
-- Back flow prcvcntei _
Print name: / / Date: 33ackwatit-valve
Basnls/lavatory� _
Name.: Clothes washer
` 171shw03hcr
Address ,/ I Drinking fountain(a) -
City _ _ Slntc:G , 7.IP _ L)ectors- sum
Phone: E-mnil. Expansion tnnk s _
:1xnueisewer cap
Name(print): u. Floor drains/floor alnks/hub
Mailins Address: l lose h hbts osil
City; _ Stnt ZIP: Ice maker
Phone: 2,1Y ]12-mait Interceptor/gremutrlp
owner installntion/residenllnl maintcnanc- only. The actual installation Primer(s) —
will be mode by me or the mnintennnec end rcpair riat:�,Ly my regular Roof drain(cummerciul)
employee on the properly I own as per OILS Chnpter 447 Slnk(s),bssin(s),lays(s) _
owner's Si stature: Date: Sump -
I ubs/shower/chower pan _II
lrinal
7c�
_ Walerclosct Water heater s State:jV_j�ZIPL ' T-
PhoneE
, 1 Faxl I� E-mnil. Total
Nei nil jurud¢ptntt occco ertdir earth•pteonorm
t coil)urmlinn rot move inrnnrmNotice: Thi� prtmit epphcaU°n I'Inn
n. P1rir llmeview(fee S �.
r (at_ '%n) $
O V,m U MnllerCnlll expirci if a permrl is not nhtnined nrud,Coro At�nibur
within 180 days oiler it has been State.aurcha[l;e(Rol.).•..$
c _
�_,pTOTAL...... ................ S
Nndx of turd m r er nr Nrn+n un uredo emrl — necepled as complete —�
_ S
GrtAhnlder dpnututa Amount 440.4616(NgNf'01.11
01/14/2003 11. 16 503-222-2675 DR HORTON PDX CONST PAGE. Fit
Y�,.c�r•.�` CR.FS']' SI..TSDT'V ISIc7N
LOT - 45
cl-IrY OF' 'Z-1GARD
TUE APPRC.iACW 51:ALL a_
MINN"W"l OF 5"xl2'x20'
.` rq�.- O�\GL-
:krAN -IT GRAVEL
nd,e 6 0 . O lJ
' TE'IP.GRAVEL
+ DRIVEWAY r r
'
'L r
0 13
00
i y CsARAGE -c
C`) ; FIN CI_ = 510'
-- ------------
-_------ •------------- F°L4N . 35624 I
LIVING g —�- '
_------------------
0j --- -
(35
r
`l O 5NAL15 BE F�1SW D OR N I`ET`i
--.�•• .-.... �__�_ _—__ � SURFCJN[pFt? BT ER05ION CCNTRC-L
PRIOR TO Lm-'"AK OUT OF CO"11'UNITY
ER051^N CONTROL. FINISW:N D 5LOPE5
5w4t-L eF LE59 'WAN 2 T'O
>� NOTE 5E7 EAGK REQLIIRE"'1ENT5
I Rr�c� [DRAINS �o STorrr'
scat ter,, I LAT. IN ST"ET,
1, FOUNDATION (DT�IN5 TO FRONT YARD TC CIARAGL 20
SACr-TARJ SOAKAGE = 5
1'12FNGW 51DE YAR
=l
7 ' � � � 5EE etTAC1aEt) pFTAiL
REAR YEAR 16�J
AL C+l:99i iabM:iw KLiPptn.C' -ton Homes
PLAN,3"1A D.R. Hoi
sa.I_E oo 5125 5,UJ, Macadam Avencue
C+�TE in„o�
r.NV�9Co, i�4iD] �rcr+e yp4722/thl FWrt land Oregon FAY. 5M.21231il ^_
r �
C'IY OF TIGARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00626
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
DATE ISSUED: 1',18/03
SITE ADDRESS: 14685 SW KLIPSAN CT PARCEL: 2S105DD-06900
SUBDIVISION: PACIFIC CREST ZONING: R-7
BLOCK: LOT: 045 JJRISDICTION: 'IG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVN'i RS: 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:
TUBIS HOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of residential backflow prevention device for irrigation system.
FEES
Owner: — —
Description Date Amount
TERI RENICKER --
ERI EN KLIPSAN II'I t %IIt1 I'crmit I r-.� 12/18/03 $36.25
TIGARD, OR 9722.4 I:» tit Ur Surclsu 1l_/18!03 $2.90
Total $39.15
Phone
Contractor:
ESEGIUIEL ROBLES LANDSCAPING
7076 RIDGEMONT DR N
KEIZER, OR 97,303
REQUIRED INSPECTIONS
Prone : 503-390-4353 RP/Backflow Preventer
Final Inspection
Req#: i'I.M 7784
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 VOL] to follow rules adopted by the Oregon
i /j
Issued By: � �' Permittee Signature:
Call (503) 64-41175 by 7:00 P.M. for an inspection needed the next business day
� tilding Fixtures
i'l+gym:iing Permit Application Received Plumbing
Date/By Permit No. GN' C%G�� •L�
City of f igard Planning Approval Sewer
Date/By: Pei mit No.:
13125 SW lla!I Blvd. Plan Review Other
Tigard,Oregon 97223 Date/Bv: Permit No.:
Phone: 50:'-639-4171 Fax: 503-598-1960 Post-Review — Land Use
Internet: v ww.ci.tigard.or.us Date/By: Case No.:Contact J See Page 2 for
4-hour Inspection Request: 503-639-4175 Name/Method. Su lemental Information.
`TYPE OF{FORK FEE*SCIIEP 11LE(for special information use checklist
New construction _ Demolition Descripti it I t1t>. I fee( Total
Addition/alteration/replacement Other: New t-&2-family dwc!lings
CATEGORY OF CONS'[RUCTIONSincludes loo ft.fir each utility connection
1 & 2-Family dwelling Commercial/Industrial FR(I bath - 249.20
_
Accessory Building Multi-Family SFR 1,2)bath 350.00_ SFR(3)bath 399.00
Master Builder ❑ Other: Each additional bath/kitchen _ 45.00
JOB SITE INFORMATION and LOCATION Fire sprinkler-sq.ft.: Pae 2
Job site address: J 4" < < �I, t� _� Site Utilitie`
Suite#: TBld ./A tt.#. Catch basin,areadrain 16.60
Project Name: Dr ell/leach line/trench drain 16.60
Footing drain(no. linear ftPae 2
Cross street/Directions to job site; Manufactured home utilities 110.00
Manholes 16.60 _
Rain drain connector 16.60
--- -------------- - -- -
Sanitary sewer no. linear ft.L_ Pae 2
Subdivision: _ �l.o-t #: Storm sewer no. linear ft.) _ Pa•e 2
Tax map/parcel #: Water service(no. linear ft.) Pave 2
DESCRIPTION OF WORK AbsorptionFixture or Item _—
Q valve 16.(i0
Backflow preventer Pat 2
_ Backwater valve 16.60
Clothes washer 16.60 _
—`— �---�- -- Dishwasher 16.60
PROPERTY OWNER- TQ TENANT Drinking fountain i 16.60
Ejectors/sum 16.60
Name: j Y Expansion tank _ _ 16.60
Address: t ak SLU_ K 1'. on (-r' Fixturc/sewer cap 16.60
Cit /State/Zi ^V a 3 Floor drain floor sink-hub _ 16.50
Garbage disposal 16.60
Phone: Fax: Ho-,e bib 16.60
APPLICANT CONTACT PERSON Ice maker 16.60
Interco tow grease trap 16.60
Address: Medical gas-value. S Page 2
City/State/Zip: ~i Primer 16.60
— ------ Roof drain(commercial) 16.60 _
Phone: _ FaX: Sink,'basin/lavator 16.60
E-mail: _ Tub/shower/shower pan 16.60
CONTRACTOR Urinal 16.60
Business Name: Water closet 16.60
Water heater 16.60
Address: -70) M on Other:
Cid/State/Zip:Ko,.2-e v F_ T 7 Other:
Phone: Fax: Plumblutt Permit Fees*
CCB Lic. #: Plumb. LIC,#_ (�_ MiniPit Subtotal Fee VIM) S
~t c
Minimum
Signature _ Date Residential Backflow Minimum Fee S36 25
Plan Review (2501U of Permit Feel S
State Surcharge(P6 of Permit Feel S
iPlease print namct L TOTAL PERMIT FEE S r
��'ICe: THIS 11e'.Olil appllCal{On etplre5{f a permit iv um obtained +ithin All new commercial hulldings require 2 sets of plans with isometric or
Igo lad s aft•r It has been accepted as complete. riser diagram for plan res iew.
'Fee methodalog� set hs TN-(ounlh Building Industn Sersiee Board.
t bstsTernut Fornu PiraPermoArip doc 01'03
PlumbingPermit Appiic:Ltion - Cite of Tigard
Pagr 2 - Supplemental [nforr►iaticin
Fee Schedule: Residential FFire�Su�P�ression Systems: _
Site Utilities Qty. F^e(ea) Total Square Footage: I permit Fee
Footing drain-I"I(MY 55.(X1 0 to 2,00(:_ ---- $i 15.00
Footing drain-each additional 1(8)'--- 46.40 2,001 to 3,600 $160.00
w 3,601 to 7,200 20.00
---
$2 _
Seer- I st 100' 55.00 7,201 and greater — $309.00 -
Sewer-each additional 100' 46.40
Water Service- Ist I(P ' 55.00 Medica" Gas Ystems:
Water Service-each ad,litional 100_ 46.40tar luation: Permit Fee:
Slorm&Rain Drain-Ist 100' 55.00 $1.1X1 to$5,000.00 Minimum fee$72.50 __
Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 51.52 f-or each
additional$100.00 or fraction thereof,to and
Fixture or stem Qty. Fee(as) Totalincluding$10,000.00.
Commercial Hack Flow Prevention Device 46.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000 00 and$1.54 for
Residential Backflow Prevention Device I each additional$100.00 of fraction thereof,to
minimum permit fee$36.25) 27.55 _ and inctuding$25,000.00,
Ram Drain,single family dwelling 65.25 $25,001.00 to$50,000 00 $379,50 for the first$25,(X)1.00 and$1.45 for
--
Inspection ofexisting plumbing or each additional$100.00 or fraction thereof,to
specially requested inspections-per hour >ii and including$$50,000.0C.0i'
subtotal: `-- $50.00100 and up $742.00 for(tie first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof
Fixture Work:
Are you capping, moving or replacing;existing; fixturf,'! 11'
"yes",please indicate vvork performed by fixture. Pailtlre to
accurately report fixtures could result in incrcayed sester fees*.
Quantity by Fixtxue Work Perfortned Comments regarding fixture work:
Fixture Type: liteplac"
New Mored Eslstinx Capped --
Ha tisl iFunt
Hath -�ub(Shower -
-Jacuzzi,'Whirl til
('ar Wash -Each Ste II - ---_..
-Drive Thru -- — - —__--
Cus idor/Water Aspirator --
Dishwasher -Commercial
-Domestic
Drinking Fountain ----
E e Wash —
Flt.orDrainismk -1" ----- ---~
.4"
Cat Wash brain *Note: 1f the fixture work under this permit results in an
Garbage -Domestic _
Disposal -commercial increase of sewer E Dt's,a saver permit will be issued and
-Industrial _ fees assessed for the sewer increase must be paid before the
Ice Mach,Retii .Chains plumbing permit can be issued.
Oil Se2aralor.t.as Station)
R,ec Vehicle Dump Station
Shower -(fang
_ -Stall — -
;-Ink -Har%Lavaton _
-Bradley
-commercial
-service _
Swimming Pool Filter
Washer-Clothes
Water Extractor
Water Closet-1 oilet
Urinal _
Other Fixtures.
i(Dsts\Permit Forms`,PimPenmiL4ppPg2 doc 01 of
CITU' OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST _
INSPECTION DIVISION Business Line: (503)639-4171
i
Received Date Requested _. ___... AM_.__ PM BUP
13UP
I_acation .��.�_S S�-��1. �2 Shite__— _ MEC .� _��l
_-LI1 5
,ntact Person —._.___ Ph ;� ��Q� _ 0� PLfd ��—
,.,ontractor -- _-_-,- __-- ___-- ---.-_--_ —. Ph(- ) ___-__- SWR _
BUILDING Tenant/Owner _--- ____-- _-� ELC, 3 - 00 5
ELC
Foundation Access:
Ftg Drain UR
I Crawl Drain �.
I Slab Inspection Notes: SIT
Post& Beam -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing --- - - - - -
In3u6ion
Drywall Nailing ------- -
Firewall
Fire Sprinkler - -- -- - - -- - -- ---_.-
Fire Alarm
Susp'd Ceding
Roof
Other: - ----- - - - --- ___—
Final --- -~----
PASS PART FAIL
PLUMBING
Post 8 Beam---_---
Under Slab -- ----- --_.� - ---- -
Rough-In
Water Service ---- -- - - —- -_- _�- --__—_
Sanitary Sewer
Rain DrainsCatch Basin Basin I Manhole
Storm Drain - -• �_ _____-__-.�-_
Shower Pan
Other -
Final _
PASS FART FAIL -
,MECHA Q L
Post&
Beam
Rough.In _ - _ -__ -- --- - --------- -- ._
Gas line
Srnuhp Dampers - - -- ---- -- --
F"ina
SS PART FAIL - - -- - - --- - ----- --- -
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
F [_� Reinspection tee of$ _ _- _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART_ FAIL
SITE- [ Please call for reinspection RE' —__ _ -_ l__l Unable to inspect-no access
Fire Supply Line
ADA .-
Approach/Sidewalk Date 1 IRspwetor Ext
Other
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received . Date Requested---�_! AM_ PM BUP —_—_
Location —__ 1 CP __ .�--Suite_ MEC
Contact Person Ph( _) Z Z ]_._ PLM D uZ
Contractor ---- ------ Ph(---) - )-_ 3 -3 SWR --
BUILDING Tenant/Owner __-_ ELC — —
Footing
Foundation ELC _— -
Fog Drain ACC@SS:
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post$Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear - -- `-_--
Framing - -- -- --_.-- ---- -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - - - -
Fire Alarm /
Susp'd Ceiling -- ----- --- --------�__-_-_----
Roof
Other, ---- ---- ----- -- - - - --
Final
PASS --PART FAIL
Post$ Beam
Under Slab - --- -----_- ______--
Wat. ,Service - -- -- -
Sanita, ,Sewer -. -- -- ---.^-�- .--
Rain Drains
Catch Basin/Manhole
Storm Drain --- -- - -_-
Shower Pan r
Other: /' - - -----
PART FAIL �--------- — -- ^--MECHANICAL---
Post$ Beam
Rough-In -- - -_--�-,,as Line
;rnoke Dampers -
F,nal
PASS PART FAIL
ELECTRICAL -
Service - -----___--_— __-- -
Rough-In
UG/Slab -
Low Voltage
Fire Alarm
Final Reinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ _ C� Please:all for reinspectio RE: �_P� Unable to inspect--no access
Fire Supply Line - /
ADA
,�- L�' ��
Approach/Sidewalk Data l inspector _ 1-�_' t� 'U-- :s Ext
Other:
Final DO NOT REMOVE this Inspection record #om the Jib site.
PASS PART FAIL
CITY OF TIGiARD 24-Hour
BUILDING Inspection Line, (503)639-4175 MST
INSPECTION DIVISION Business Line. (.503)639-4171
BUP —
Received ______ Date Reque teltL.-.��._1AM _ PM BUP
Location _L" — C- Suiteo, _ MEG
Contact Person _ —_ _ Ph ( ) ( !r �3(( PLM
Contrador__-- _ _— _- _ Ph( ) SWR
BUILDING Tenant/Owner s _E )�t e-- ELC
Footing
Foundation Access: ELC --
Fog Drain ELR
,'rawl Drain —
Slab Inspection Notes: SIT
rost8 '3eam
Shear Anchors ---- - ---- -
Ext Sheath/Shear
Int Sheath/Shear
Framing -------._ ------ --- ---_.
Insulation - — -----' -- --^--
Drywall Nailing
Firewall - -
Fire Sprinkler --- --- - - ---- - _ �_ �_-T------ -
Fire Alarm
cusp d Ceiling --
Root
Other:
Fli n!
PASS PART FAIL
PLUMBING
-Post 8 Beam __--
Under Slab --,---
Rough-In
Water Service.
Sanitary Sewer
Rain Drains -_--
Catch Basin i Manhole
Storm Drain - --
Shower Pan
Other-
Final
therFinal
PASS -PART_- FAIL
MECHANICAL
Post 8 Beam
Rough-In
Gas Line ~—
Smoke Dampers
Final --------- ------------------
PASS PARI FAIL —
ELECTRICAL
Service
r?cwyh-!n
I ire Alarms p�� .
PASS FART FAIL ❑ Reinspection fee of$- _.-___ equired before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Siff _ 0 Please call for reinspection RE: _---_. _. �� Unable to inspect-no access
Fire Supply Lino ,
ADA - P -
Approach/Sidewalk pots -- Z.- -1 43 . Ins eetor._. _ _- Ext
Other:
Fina — DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received ____. -Date Requested__. -7 - 31 -_ AM_____ PM_. BUP
Location " -�._-� <� '- C-_'� Suite _ MEC
Contact Person ___ Ph PLM
Contractor _�-r_.___�_-- -__--v._-______.__-- Ph(---) -_,--__ SWR --
BUILDING Tenant/Owner ___._...._ _- _ �_-_ ELC -___-
Footing - -------�
Foundation Ei.0
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors ------- __-_----____- _�_- --- - -
Ext Sheath/Shear
Int Sheath/Shear - -
Framing -- - ----- -- ---_- --
Insulation
Drywall Nailing -- ----- - --- - ----- --- - --- --
Firewall
Fire Sprinkler --------_ --- -- ---_ ___------..__— _---__.--
Fire Alarm
Susp'd Ceiling -
Roof
Other: - --- - - - --- .---- --- ----- ---
'1*nk) -
PARTFAIL ___....-- _ _----- --------------- --�___ �.- -
MBING
I'oct&Beam�`---
Under Slab --- - - --- -- - - -
Rough-In
Water Service —.--- --- ----- -
Sanitary Sewer
Rain Drains ---- - - --- ----- - - --_--_ ._.
Catch Basin/Manhole
Storm Drain --..M—
Shower Pan
Other _----_- -- ----- --
Final
—PASS PART FAIL
MECHANICAL _
Post& Beam
Rough-In ----- - _- - - ---
Gas I.ine
SSnke Dampers ---- . -- - - - - ----- --
ina
SS PART FAIL - -. --- - -- --- - -- -- -
RICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alam
Final Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL -
SITEPlease call for reinspection RE:_ -_ _ Unable to inspect-no access
Fire Supply Line
ADA 7 Date __7
1/
Approach/Sidewalk `- ----- Irlspactor _ _ _--- ---- ------ --EXt��
Other:
Final DO NOT REMOVE this inspection record from the fob site.
PASS PART FAIL
Giop, 10
7312 SW Durham Road
Portland,Oregon 97224
Tel(503)598-8445 Fax(503)598-8705
January 15, 2003
Project No. 99-2791
D.R. Horton
5125 SW Macadam Ave. Ste 145
(}\ Portland, 09 97201
Fax No. (503)579-6002
ti Attention: Emery Smith
GEOTECHNICAL REVIEW OF FOUNDATION EXCAVATIONS
Pacific Crest—Lots 45 and 46
14675 and 14685 SW Klipsan Court
City of Tigard, Oregon
At your request GeoPacific Engineer, Jim Imbrie, arrived on site on January 15, 20C3 to review the
foundation excavation subgrade on the above-referenced lot. The foundation excavation generally
exposed competent native soils consisting of loessal silt and residual/colluvial clayey silt in deepest
areas. The blocky and fragmented silt in the upper 3 feet was mostly removed.
In our opinion, the exposed subgrades are suitable for spread fcundation support to an allowable
bearing pressure of 2,000 psf. The rear footing-to-slope setbacks should he adec.fate and interior
steps appeared to be appropriately placed for foundation walls such that footings should not be
supported above vertical cuts. The excavations are ready for formwork and placement of concrete.
Deck footing subgrades were also observed.
If the subgrades become softened due to prolonged exposure to wet weather, or sloughing of vertical
cuts occurs, then some mucking will be necessary; this is likely to occur in the deck footings, the most.
This review was performed to the local standards of practice for geotechnical engineering. If you have
any questions, please call.
Sincerely,
GeoPacific Engineering, Inc.
14743 a1
L'• RECD JAN ?003
James D. Imbrie, P.E. `�''
Geotechnical Engineer OREGON
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