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13265 SW NAHCOTTA DRIVE Ha VIUOJHVN MS £9Z£I r r A F � O c ' � r � m 3 cr in N M 13265 SW NAHCOTTA DR CITY OF TI CSA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT PLM2004-00426 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 9114/2004 SITE ADDRESS: 13265 SW NAHCOTTA DR PARCEL' 2S105DA-17000 SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT: 058 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAIN-N: TRAPS: STORIES: WATER HEATERo: 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 residential backflow prevention device for irrigation. FEES ,:nor: - Description Date Amount fEVE NICHOLS [TAX]8%State Surcharl 9/14/2004 $2.90 13265 SW NAHCOTTA DR TIGARD, OR 97223 Ip(,UMHI 1'crmit Fee 9/14/2004 $36.25 Total $39.15 Phone: Contractor: ESEQUIEL ROBES LANDSCAPING 7076 RIDGEMONT DR N KEIZER, OR 97303 REQUIRED INSPECTIONS Phone: 503-3904153 RP/Backflow Preventer Final Inspection Reg#: PLM 7784 CL at: rn _ This permit is issued subject to the regulations contained in the Tiga, 9 Municipal Code, State of OR. 0° Specialty Codes and all other applicable laws. All work will be done in accordance with approved W 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 952-000,i-OWO through OAR 95 1-�1OA. You may obtain copies of these rules or direct questions to OUNC by calling (503) 46-6699. :sued By: �z4jea Permittee Signature: — Call (503),111-319-4175 by 7:00 P.M.for an Inspection need94 the next business day Building Fixtures Pluiv n2 Permit Application City of Tigard pv«B`a Permit No. .op _!�i 13125 SW Hall Blvd.,'Pigard,OR 97223 Plan Rcvie Phone: 503.639.4171 Fax: 503.598.1960 Pat Re Other Pernut No: 24-Hour L•lspection Line: 503.639.4175 Date Ready/By t 0 See Page 2 for Internet: www.ci.ligard.ur.us Notified/Method. SupplamentalInformation "W 1W lie 11aM I- For special Information use checklist ❑New construction ❑Demolition - - Description Qry. Ea., Total ❑Additiordalteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) SFR(1)bath 249.20 ❑ 1-and 2-family dwelling ❑Commcrcial'mdu.trial SFR(2)bath 350.00 SFR(3)bath 399.00 ❑Accessory building ❑Multi-family - --- ---- Each additional bath/kitchen 45.00 ❑Master builder Other: Fire sprinkler(__sq.ft.) Page 2 Site utilities - Job site address: ( � Sw /�(� Q �� Catch basin or area drain 16.60 Ci /State/ZIP: ` Drywell,leach line,or trench drain 16.60 ty '�d�d a R q -� a�3 Suite/bldg./apt.no.: Project name: Footing drain(no.linear ft. _) Page 2 --- - - Manufactured hoax utilities 110.00 Cross strict/directions to job site: Manholes 16.60 _ Rain drain connector 16.60 Sanitary sewer(no.linear ft.: Page 2 Storm sewer(no.linear ft.:`J Page 2 Subdivision: — Lot no.: - Water service(no linear R.:+� Page 2 Fixture or Item Tax map/parcel no.: � Absorption valve 1660 r ' '", rr. "._" �1 °;nBackflow preventer Page 2 1 1 Cil J•J e V e✓1 1 -------- Backwater valve 16.60 Clothes washer 16.60 v- Dishwasher 16.60 Drinking fountain 16.60 " 16.60 Ejectors/sump Name: t e v e ; C h 61 S _ Expansion tank 16.60 Address: 112W h 0Q �0aa Fixture/sewer cap 16.60 City/State/ZiPr .r, � 1 Floor drain floor sink/hub 16.60 � � r _ — Phone:( ) = Fax:( Garbage disposal 16.60 Hose bib 16.60 p J 'ce maker 16.60 Business name: -�s ft,1"P f\rj ��f lQ Nl�C(�Q�'��n Inte-, trap 16.60 Contact name: SQ pYk 9, Medic S ) Page 2 Pruner 16.60 — Address: 7 ' R. -0 4 � SA - IL—�`!- - City/State/ZIP: y d - Roof drain(commercial) — 16.60 -- Sink/basin/lavatory � 16.60 Phone:(�ti ) `7 Fax: ( ) Tub/shower/shower pan 16.60 J E-mail: Urinal 1660 ED • Sr y�i'1 1; ;Yt 1� Water closet 16.60 n s t JBusiness name: Water heater 16.60 Address: O� L Nk d,r ',D � Other: Subtotal City/State/ZIP: K2 l Z Q V ` . } Minimum permit fee: $72.50 Phone:(�b ' Fax:( ) Residential backflow minimum permit fee: 536.25 CCB Lic.: Plumbing Lic.no.: Plan review (2 5%of permit fee) State surcharge(8%of permit fee) Authorized signature: - TOTAL PERMIT FEE Print name: Date: �t{. C This per.-At application expires If a permit Is not obtained within 180 days after It has been accepted as complete. *Fe::methodology set by Tri-County Building Industry Service Board. i\BuildingTermealPLMF-PermitApp doc 12103 440-4616T(lo/o2iCOMrwta) Plumbinp, Permit Application - City of Tigard Page 2 - Supplemental Information O . Fee Schedule: Residential Fire Suppression S stems: _f ..r S i k•,f ,r"ISA►, ,, b� MJ 4 �d 1[!M' ARV Footing Footing drain- 1"100' 5500 0 to 2,000 5115.00 Footing drain-each additional 100' 46.40 2,001 to 3,600 5160.00 _ Sewer-1st 100' 55.00 3,601 to 7,100 $220.007,201 and greater $309.00 Sewer-each additional 100' 4640 Water Service-Ist 100' -- 55.00 Medical Gas 5y stems• Water Service-each additional 46.40 ? Storm&Rain Drain-I st 100' 55.00 C: $1.00 to$5,000.00 Minimum te$72.50 Storm&Rain Drain-each additional 46.40 S5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and S1,52 for each additional 1100.00 or fraction thereof,to and • __ Commercial Back Flow Prevention Device 46.40 $10,001.00 to S25,000.00 includin $10,000.00. $148,50 for the first 510,000 00 and Sl 54 for Residential Backflow Prevention Device each additional$100 00 or fraction thereof,to rrenimum permit fee$36.25) 27.55 _ and incWding$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 V79. for the first$25,000.00 and SI 45 for Inspection of existing plumbing or ditionnl$100.00or fraction thereof,to tial) re uested inspections-per hour 72.50 udin 550,000.00. Subtotal: $50,001.00 and up , 742.00 for the first 550,000.00 and$1.20 for each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accurate) re ort fixtures could result In increased sewer fees*. C ments regarding fixture work: Ba tistY/Font Bath -Tub/Shower --- -Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru _ - -- Cu idor/Water Aspirator _ _— Dishwasher -Commercial -Domestic — Drinkin Fountain Eye Wash Floor Drain/sink 2" 3" 4" d Car Wash Drain Garbage -Domestic N Disposal comme•ciai *Note: if the fixture work unde\1s mit results In an ig.-inDrriat increase of sewer EDUs,a sewerill beissued and Ice Mach/Refri .Dreitu.j Oil S arator Gas Station fees assessed for the sewer incree paid before the m Rec.vehicle Du Station plumbing permit can be Issued. ` Shower -Gang \\ W -Stall J Sink -Bar/Iavatory _Bradley Quantity Total -Commercial Isometric or riser diagram is required It fixture quantity _ -Service total is>9. Swimming Pool Filter Washer-Clothes water Extractor Plan Review water Closet-Toilet Plan review is required if fixture quantity total is>9. Urinal _ Other Fixtures: i\auildina\Pe WPLM-PemifApo doc N07 CITY OF TIOARD 24-Hour BUILDING ® Inspection Line: (503)639"175 INSPECTION DIVISION Bus'ness Line: (503)635-4171 MST -t-w ,�' OUP -- -- Received g ;e)Date Requested_ _ _AM____PM— OUP Location 3 ca —_Sufte MEC .� Contact Person Ph PLM c�20 d Contractor _ _ Ph(--) — SWR BUILDING Tenant/Owner _w � EL(, Footing ELC _ Foundation Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam She,w Anchors Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing -- --- -—Firewall Fire Fire Sprinkler - Fire Alarm Susp'd Ceiling - — Root Zoe rz ?/1 Other: _ Final PASS PART FAIL _ PLUMBING Post&Beam Under Slab —�-- _ Rough-In Water Service — Sanitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain --- ---------- Shower Pan Other: 4-� F VECI S PART FAILANICAtL Post$Beam Rough-In - 0. Gas Line Smoke Dampers - -- --- Final N PASS PART FAIL -- --- --- __._ ELECTRICAL Service LO Rough-In W UG/Slab --------- ----_..__�_— Low Voltage Fire Alarm Final ReinFpection fee o}$� required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ Flee.se call for reinspection RE: ` _.. / Unable to Inspect-no access Fire Supply Line T) f ADA b Qa � vA�_ 111Approach/SidewalkaPeow a! Other:_ _ _ _ Final �— DO NOT REMOVE thls Inspectlon record from Me job Gib. PASS DART FAIL CITY OF TIGARD 24-Hour q BUILDING * Inspection Line: (503)639-4175, M T �5 / INSPECTION DIVISION Business Line: (503)639-4171 BUP Received �Date Req este 3� 11 / - AM _ PM _ BUIP - Location —__—,cLz(49 _ --Suite-474 � 4? MEC - Contact Person -_ p�� _T Ph T=9 ?Z91 PLM Contractor U _ Ph( ) _. -- SWR - BUILDING Tenant/Owner _ ELC Footing Foundation Access: ELC Fig Drain ELR _ Crawl Drain --- Slab Inspection Notes; SIT Post 6 Beam Shear Anchors --- - Exi Sheath/Shear Int Sheath/Shear - Framing Insulation - i�I A� 1 ;cu � 6(y Drywall Nailing -�,L �w �l►� �_-- Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling -- - - -- -- - Roof Other Final PASS PART FAIL -- -- --- - PLUMBING Past 8 Beam -- ----- -- -----`—.- . Undei Slab __-- Rough-In Water Service _----__-- — - Sanitaly Sbwer Rain Drains - - - Catch Basin/Manhole Storm Drain -- — --- - Shower Pan Other. - ----- -- -- Final PASS PART FAIL --'- MECHANICAL Post& Beam Rough-In d Gas Line Smoke Dampers Final U) PASS PART FAIL - - ELECTRIC -� Service - m Rough-In UG/Sla J w Voltag I Reinspection fee of$_.__ required before nett inspection. PART FAIL — Pay at City Hall, :3125 SW Nell Blvd, SITE rj Please call for reinspection RE:— _._ Unable to Inspect-no access Fire Supply Line ADA � ^` q�n Other: ch/Sidewalk Dab 3 � _ A . ----- leep�ctor �1ySL LiC �t Other: _ Final DO NOT REMOVE this Inspoatloe rseord hem as fob sIbL PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested. o -AM PM BUP Location Z(�S _ Suite MEC Contact Person _. f�1� ___-- Ph L 6 PLM Contractor — ph --- __—___ – --- ( ) —.-----__ SWR _ BUILDING Tenant/Owner _ ELC Potting --�- - -- Foundation Access: ELC — Ftg Drain ELR Crawl Drain --- Slab Inspection Notes: SIT —__---- _ Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ---- - Framing ___ _ -___-----------_.__--- ---------------__-- _____. Insulation Drywall Nailing ---------- - - - - _-.- -------- ------ - Firewall Fire Sprinkler - ---- --- -- -----------_--.-._ - �_ - ---- Fire Alarm Susp'd Ceiling --- -- - ----------- - ---- - Roof Other. _ -------- -- - -- - ------ -------- Final - PASS PART FAIL -- - PLUMBING Post&Beam -___—__-- Under Slab _ Rough-In - Water Service -----__-- - ---__--- !- -----^-- Sanitary Sewer Rain Drains -------- --.. ---------- ---- -------- Catch Basin/Manhole Storm Drain - - -- - - --- --- -- - -- ----- Shower Pan PARI FAIL CHANICAL Post&Beam Rough-In -.— --- - --- -_.. - ----_ - --- ----- ------ Gas Line a Smoke Dampers - -- ---- - --- --- --------- - ----__� --------- Final U) PASS PAP.T FAIL - -- --- ----- --------- ------- - - - -- ELECTRICAL JService -- --------- -- ----- -- ._,--- Rough-In _ UG/I lab - - - — --- ----------- -------- - - WLowI 19e _ -- --- - --- - ----- -.- -- -----Fire, Final Reins ction fee of$ _ required before next ins PASS__ -_ART FAIL �-� � --- -- � rection• Pay at City Nall, 1312.'SW Hell Blvd. SITE -- [] Please�ch reinspectio RE:- -___-_- Unable to Inspect-no a"ss Fire Supply Line �( ADA Approach/Sidewalk �� Other: Final -- DO NOT REMOVE this Inspoatlon Ford from So fob silt, PASS PART FAIL ►eeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeeeeeeeeeeei � r 1 i i i i © i a o ► ► A t4 ► o 1 o o L ► ( ► p s, p i ., a II ► W o 44 n ,► �►� p ► -, j cu pool a / ► 44 44 A - ► ► 44 POO. J .44 LO ► Q ► plol Q E-H W ► .� � a as � ► �/TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT'� CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)638.4171'tr INSPECTION DIVISION Business Llne: (503)638-4171 BUP Receive _ _Date RequestedPM BUP Location ,1�2�2 r Suite A*—1o­ � 1 FAEC Contact Person — __. Ph(_ ) _ < ` � _ PLM Contractor. _ Ph( _) SWR BUILDING TenanVOwner �-- ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain _ Slab Inspection Notes: SIT - Post&Beam Shear Anchors ----i---- - � --� -- Ext Sheath/Shear Int Sheath/Shear -`-` Framing Insulation Drywall Nailing Firewall Fire Sprinkler — - ---- - -.-. Fire Alarm Su.sp'd Ceiling --- - - Roof in PART FAIL ----- `-- PLUMBING Post&Beam -- Under Slab Rough-In W,ter Service Sa0ary Sewer Rain Grains --- -- Catch Babin/Manhole Storm Drain - --------- —-. Shower Pan Other: — Final PASS PART FAIL -- - " MECHANICAL— Post& Beam Rough In Gas!_int d ampers -- -- — _ QG WELFCTORICAL co PART FAIL -- -- _ Service m Rough-In UG/Slab LLS Low Voltage - Fire Alarm Final Reinspection fee of$__ required before cgxt inspection. Pay at City Hall, 13125 SWI Hall Blvd. PASS PART FAIL SITE _ Plesse call!or reinspection RE:_ Ej Unable to Inspect--no amass Fire Supply Line ADA _ Approach/Sidewalk Dates —� -� —�- � Inspector Other: Final DO NOT REMOVE thle InspeWotn rewrd from the job sib, PASS PART FAIL c v o ` u e � I o no v � o a j U w IL A Q W o CITY OF TIGARD MASTER PERMIT PERMIT#: MST2003-00429 DEVELOPMENT SERVICES DATE ISSUED: 10/7/03 13125 SW Hall Blvd.,Tigard,OR 97223 (503)8394171 SITE ADDRESS: 13255 SW NAHCOTTA DR PARCEL: 2S105DA-17000 SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT: 058 JURISDICTION: TIG REMARKS: Construction of new SF detached residence. BUILDING REISSUE: DRHIS43 STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,454 of BASEMENT: at LETT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF F­OR LOAD: 40 SECOND: 1 133 of GARAGE: 144 of FRONT: 15 PARKING SPACES! TYPE OF CONST: SN DWELLING UNITS: 1 THIO al RIGHT: 5 2n'20 OCCUPANCY GRP: R3 BORN: 5 BATH: 4 TtlTAI. 2.587 at VALUE: 364, REAR: 15 FLUMBING _^ SINKS: I WATER CLOSETS: 4 WASHING MAC.H: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PRFVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP c 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN»100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP: bh. FLOOR FURNANCES: TENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANFOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 amp: 0 200 amp: WISVC OR rD R: PI/MPIIrRIGATION: PER INSPECTION: EA ADD'L 500SF: 1 201 - 400 amp: 201 400 amp: tat WR3 SVC/FDR' SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EAADOL BR GIR SIGNAUPANFI.: IN PLANT: MANU HMISVCIFDR: 601 1000 amn: 601*ampa-1000v MINOR LABEL: 1000•amnlvolt PLAN REVIEW SECTV3N Reconnect only: ­4 RES RES UNITS: SVCIFDR> 2211 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTFRCOMIPAGING. OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: .ALL ENCOMF BOILER: HVAC: I_ANDSCAPrnRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAfTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,909.97 D R HORTON D.R.HORTON INC This permit is subject to the tegulatlons contained In the 4386 SW MACADAM AVE.,STE 102 4386 SW MACADAM AVE. Tigard Munk ipal Code,State OR. Specialty Codes and PORTLAND,OR 97239 SUITE#102 all other viable laws All work will be done in PORTLAND,OR 97239 accordancewith approved plans. ThM pennN wNl expire M work is not started within 180 days of Lsuance,or If the work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to folbwrules adopted by the Phone: 244-5322 Phone: 503-222-4151 Oregon Utility Notification Center. Those rules are set forth In R Rap 0: may obtain c pies of these rules orldirecto questions 1-0080. You N LIC 130859 OUNC by calling(503)248-9987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp J Sewer Inspection Underfloor Insulation Plumb Tp Out Exterior Sheathing Insl Gyp Board Insp Appr/SdMk Insp Fooling Insp Crawl Drain/Backwater Electrical Service Low Voltage Rain drain Insp Electrical Final Foundation Insp Footing/Foundation Dr, Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace W ter Line s Plumb Final Issued By: d � Permittee Signahlre\: k&1��VVAV\ Call(503) 639-4175 by 7:00 p.m.for an Inspection needed the next business day CITY OF TI GARD SEINER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00323 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 10/7/03 SITE ADDRESS; 13265 SW INIAHCOTTA DR PARCEL: 2S105DA-17000 SUBDIVISION: PACIFICCREST ZONING: R-7 BLOCK: LOT: 058 _ JURISDICTION: 'rig TENANT NAME: USA NO: FIXTURE KNITS: 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 dwelling. Owner: �-------- — - -- D R HORTON ---" - FEES FEES 4386 SW MACADAM AVE., STE 102 Description Date Amount PORTLAND, OR 97239 [SWUSA]Swr Connect 10/7/03 $2,400.00 [SWUSA]Swr Connect 10/7/03 $0.00 Phone: 244-5322 [SWINSP]Swr Inspect 10/7/03 $35.00 [SWINSP]Swr Inspect 10/7/03 $0.00 Contractor: • — Total $2,435.00 Phone: Reg#: Req!dred Inspections_ IL oc w rn �t This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm \4 Issued b ?��'� ��2� Permittee Slgnp,ture: W)V� AA -- Call (503)6394175 by 7:00 P.M.for an Inspection no, Oed the next business day EUMME Building Ferinit Application Received Building tx — Date/e :� - 7-o� Permit No f9,;ldoU City of Tigard Planning Approval Other �' g Date/By: PermitNo�:-,w oo.3 - 13125 SA' Hall Blvd. (� Q Plan Review Other Tigard, Oregon 97223 REV t D Date/B A') 'Ns-OS Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use Date/By— Case No. Internet: www.ei.tigard.or.us A� Contact Juns. See Vage 7 for 24-hour Inspection Request: 503-639-4175 ` Name[Method: Su a"ag a�Information CITY OF TIGARD _ 11ILDING DIVISION ^_ TYPE OF WORK REQUIRED DATA: New construction _ Demolition 1 2 FAMILY DWELLING Addition/alteration/replacement Other: �n CATEGORY OF CONSTRUCTION Note: Permit fees*are based on the total value of the work performed. Indicate I &2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Accessory Buildin Multi-Family­_ Valuation Valuation......................................................... Master BuilderJH Other: S _ No. bedrooms: No.of baths: 4 Job site address: 13ZIX I& JOB SITE.INFORMATION a.nd LOCATION y� Total number of floors..................................... New dwelling area(sq.(t.).............................. — pc� Suite #: Bld ./APt _ _ Garage/carport area(sq.ft.)............................ 7 Project Name: �e �_� _ Covered porch area(sq.ft.)........................... Cross street/Directions to job site: J neck arca f . sq.....)........................... �- Other structure area e area _ 7'REQ&RED DATA: COMMERCIAL-USE CHECKLIST Subdivision: (� �ffc �ZLot#: ���` ----" Tax map/parcel #: Q� 6,7:0YI—17�'[�: Note. Permit fees*are based on the total value of the work performed. tate DESCRIPTION OF WORK the value(rounded to the nearest do>,,, pment,materia r, --' overhead and profit for the work indpp"ca — Valuation................................... S Existing building area(sq. ft.).. New building area(sq. ............................... Number of stories ............--........................ —' - PROPERTY OWNER TENANT Type of co ction...................................... Name: Ci_cu cy group(s): Existing: r New: _ Address: aweCity/State/Zip: - — g1z—V j Phone:�3-yn'y/ Pax: 5D3 - �Yj','yI/7 NOTICE: All contractors and subcontractors are required to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under -_ provisions of ORS 701 and may be required to be licensed in the Business Name: jurisdiction where work is being perforrc: If the applicant is exempt Contact Name: NJ 6 O/{ from licensing,the following reason applies: Address: fe�'Sw &tt M r}UG /6CL �-- - — - City/State/Zip: O/ �1 / — -- —�— -- N Phone: - Fax: 03_ ?a- 37/j ----- -: .. E-mail: BUILDING PERMIT FEES• -`- ' _J Please refer to fee schedule. J CONTRACTOR_ / Business Name: V. C�rj ����rGirr Fees clue upon application.............................. $ 3Address: ?dL 51� h'j�(lQ/f�!'Lf �'Xr/ /0�—' W Amount received............................................. S -J City/State/Zip: a. - I A( V&/_ Phone:e& - y�y -.%/ j Fax:bj ,3' ��?�3? l7 taste received:__ CCB Lic. #: /3b --- -----_ Authorized ' / Notice: Thir permit application expires Ir a permit is not obtained within Signature: _ Date: L Igo days tiler It has been accepted as complete. ale �'w5a 1 •Fee methodology set by Tri-County Building Industry service Board. (Please print name) i:lDsts\Permit Formu\BldgPermirApp.doc 01!03 Mechanical Permit Ap2licationUM Received Mechanical' DateBy _ _ Permit No.: 7— City of Tigard HLUENLU Planning Approval Building — Date/By. Permit No. 13125 SW Hall Blvd. AI�� �) 7 2 3 Plan Review Other Tigard,C regon 97223 Date/By- Permit No.: Phone: 303-639-4171 Fax: 503,09T11001' TI [i Post-Review Land Use Date/B : Case No.: Internet: www.ci.tigard.or.us BUILDING Contact — loris.: See Page 2 for 24-hour Inspection Request: 503-639-4175Name/Method: _ Supplemental Information. (-- TYPE OF WORK _ COMMERCIAL FEE'SCHEDULE_-USE CHECKLIST—1 New constructionDemolition Mechanical permit fees*are based on the total value of the work J�Other: performed. Indicatr.the value(rounded to the nearest dollar)of all Addition/alteration/replacement - mechanical materials,equipment,labor,overhead and profit. CATEGORY OF CONSTRUCTION I &2-Family dwelling Commercial/Industrial Value: S_._ See Page 2 for Fee Schedule Accessory Building Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE — Descri on Fee ea. Tatd Master Builder Other: Hesting/Co oling JOB SITE INFORMATION and LOCATION Furnace-add-on air conditioning" 14.00 Job site address: /'.� �rBid N�{'7"LM Pt-- Gas heatpumE___ _ 14.00 Suite#: g./Apt.#: Duct work 14.00 Pro ect Name: f lldronic hot water system _ 14.00 Residential boiler Cross street/Directions to job site: for radiator or hydronic system 14.00 Unit heaters(fuel,not electric) in wall in-duct,suspended,etc. 14.00 Flue/vent for any of above 10.00 Subdivision: Lot#: Repair units Other Fuel Appliances 12.15 Tax map/parcel#: Water heater 10.00 DESCRIPTION OF WORN j _ Gas fire lace _ 10.00 Flue vent water heater/ as fir lacee) 10.00 Log lighter as _ 10.00 _ — —— Wood/Pellet stove 10.00 _ Wood fireplace/insert 10.00 Chimney/liner/flue/vent 10.00 PROPERTY OWNER TENANT "'•"'+tr4, Other: 10.00 -- Environmental Exhaust&Ventilation dm Range hood/other kitchen equipment F6.'180 0 Address: Clothes dryer exhaust 0 City/State/Zip: /( _f���'��NL_ Single duct exhaust Phone: '� Fax: - j�s-31 (bathrooms,toilet compartments, APPLICANT CONTACT PERSON_' utilityrooms) Name: Kl (fj MAI Attic/crawls ace Cans_ 10.00 Address: addm -*7,R— Other: Fuel Piping Cit /State/Z,ip: Ppmax � ""55.40 for lust 4.$1. each additional Furnace etc. a Phone: 72 -qlf Fax: Gas heat pump _ E-mail: Wall/suspended/unit heater N CONTRACTOR �_ Water heater _ Business Name: Fireplace _ 5w U/'�7�h, Range " Address: ' Bim_ _ •� m City/State/Zip:f�'f r " Clothes dryer as — UJ Phone• Fax: Other: " _J Total: CCB Lic. #: Mechanical Permit Fees* _ Authorized Subtotal: S _ Signature: //1 Data 7//Y/D� Minimum Fern-it Fee$72.50S Plan Review Fee(25%of Permit Fee S ---------- State Surchar a 8%of i'ermit Fee S Please ria name) �_� TOTAL PERMITFEE I S Notice: This permit application expires if a permit Is not obtained within "Fre methodology set by Tri-County Bulldinit Industry Service Board. 180 days after It ham been accepted as complete. "Site plan required for exterior A/C units. i\Ds1s\Perm0 'l;,rnswlecl`eimitApp.doc 01103 0`,�c7i�003 16: 15 5036122990 P05S ELECTPI'-- PAGE 01. 02/20/2003 16:10 503-222-2675 DP HORTCR+ PDX CONST PAGE 02 i Electrical Permit 1DV1iC3ti0JL. RBeelvrd �ltl al _DIWBY-. Permit .; ? r,9 orh'C.c REGENLU City Ott Tigard ��Apprvvrr t C�lNo.! 13125 SW Hall Blvd. Plan Review otfuT TtgvxL Oregon 97223 AUG o 72 Daromy; P"Mi ^ro. J; Phone: 503-639-4171 Fax: 503 p0u'RGv1C"' '�r�K 1,I! Y V r r I .Dr Cyte No.: Catemcr WwW.ci.tigardor.1m G carton Jui:: ® aerradezfor 24-hour Inspection Request; 5034JQ" Nunc/Metllod: _ 9u emrotal infbrmptlon NBiulding truction Demolition tJ serl-i o�or735 amps- Nealth.arc hail(ty lteration/re laaement Other: C°%nc avrcial ❑Haiudeua er 10on ❑lerviee ovrr720 empt-ra11nR o!' ❑6uildinp tmr 10,000 sgtura Atr., Y OF ICIN 3 funily dwellinFp four err mare retklential unlit in is dwell Catattnercial/Llduattial System over 600 Vela norrnmi one stnecnae lt�.171 MUjb,_Fylillj Au.tding agar dune Bance ❑FBedets,do0 antpn a mare� ❑Occupant)md ovcr 99 persons Q Manu6robmd itruotues a RV ptrk Master Buildor Other: i Egreernlghungplan 1 ❑odwr, Sabrait_MS of plant n4tb any of the above. ' i](ElNFURa1ATJ(_ The 2bo"are ntil speficable to L101pnrig t graado rtrvirc Jab site address: „.:; P,i. Nv,:^41(i., !;'itti '' tf;',rdtl�lt�• '' Suitt „Number of tn>t ectioas poor,Petmit.allowed ProjtCt Name: r c Dtxrl elan q Rs(a.) Total 0093 street/Directions t0 job site. New rrAldaetlak1 tole or mohl-rams per dwelllet BAIL Intledee 31tact ed earIe L Swnta4 ia�ledndt 1000 34.R.or len 145.15 4 Exch ;eon S00 .ft or on dneroof 13,40 I Subdivision ! C Lut odi`� idol"rcs2 ' and non tt:ata Gist 75.00501 2 Tax map/parcel Bank teanufaehred home or modular dwell* t, ,;v �,•«, %ervlcamdorfkeder 90.90 2 .�;'W13 •I q�,t;� � 4''UF.9 ,'Df'.WOB1G ;i,,,,. • - F Sen•ces or leaders.leateluilee, sittration or mloestiam 2Q_DAm1m or Post 80.30 2 i — 20_ 1 to 400 10685 2 4a 10 llM1umSoso ` ItLPt 60i':t: ."_- �i �ya•I: � b nix; h0 2 ovgL000 wet 454.65 2 Nagle: Y[L� R�an,r.arocl cues z Adilms: f IGW M4 ' / . - Temporary rerv)res or feearrs-lestanabou, q�,� altetatlen,or reser-alien: C1tV/StattfG'I 200 amps or kte 66,85 1 Phone: F :16V3-477 -5"7V7 2 amp to 400 unpa_ 100.30 2 �}5 _ ! 401 In 6QO weps 13175 2 Breech 4lreuln-neor,alttratien,or Name: triewdon F-W pan441 A.ree for brunch olrouio with"chmta of AddrW%WcrfkOdLrejchbr%wh4irrWt 6.65 i CI /SG1tC/ZL}l: ' - B�Fee for Nwwh c4aula veltheot purchas of evict or Mda Ibe b%T=h Siquit / I Phone:kz2,-'WIAI (� ax:Qy f7 titch aadroaoat Which cir-2t 61915 2 F tTisil: Mho•(SerAre et ttMQer tat included); E.4 P!TROr;assertioneimie SIA0 2 I"h sign or outline ll�)rCnd 3140 7 a Job No: Silvol P.i10A fn tx l mIt I—V panrt, - Business Name: G Dti or 4xamm°n— 2 2 CA Addzess: �3�!0 5 w"��� J 'Ci /Stale/zip: Ffl I l 5�o►'D p l� mEach additleeal sveaVoil wur the Wit nab le Is a of tlt eabore: CD Phonc:4Y 2- 2-Fo 1 Pax: 5113-Ly5 ,5 L- x1Iavettl e•atico Do — "Z _ 5 CCB Lic. 9. It g K d I Lic.#:-3 y y G c odour. J Supervising electricitan Subtotal -S si I1ihIIE IC hired: �Z�/� _ ?Ip Rmew(7S%of Minit Pee) S Print Name:5t 4-'V-L tzo 5 5 Lic. #: Y-2 3 ;L State SUTEbdr a8Ya 0 Pesti Fee TOTAL PERMIT ME t Auihtxixcd _ NO11 : rhit permit applintlea"PIM;f B p4rmit it Not obtalped*;thin Siptenture d�r1?- oxe:714117� W day,otter it hot hree steepted at eotapirte_ �T •Fee mathede0oRy tel hp Tt•t-Centeriy 11u;ldiBR iadntveyServiet Reard. (Fk,m print name) i:�Dser\lermit PonrnlElcParrrnitApp.doc 01103 FEB-20-2003 16:15 5036422900 9?% P.02 02' 21 '2003 95:53 503-5.1 t-59 9 CPAFTI,10PI/ PLUMBIIIG PAGE 92 02/29/2003 16:08 503-222--2,7'; DR HORTal PDX CONST PAGE 02 Building Fixtures Plunnbin Perini lttxeivcd p1u�m� Doe . 1No.:�N` OLS' (� mwm 'L3noinE Approval 9c Wer City of Tigard 1h1e/sY PenrotNa: AUG Plan Aewe- ote,et 13125 Sw flat Blvd. �,dp • permltNo.• ____ Tigard,Oregon 97223 {{V par-FaNeW sand UK phone: 5o3-639.4171 Fax: 503-S4}160)l 11 ape _�_ CsieNo.: Con1a<t MIS,: to Page 2 r« Internet tu.vw.cl.tigartl oT.uS `' [�1Nr N,n,dMectiod: Suemoanl rnrotetdiee 24-lana Incpecnon Request-. 503-A4�75 ' "',,+C.Iulii>t,'hJ�i�'i't'o �wp�! �•';'Q ._a�1{�g1K.'q�il_j,•i:iM.ii•' .rot/��it `i i• - I/47[ tion Qh• Kt Tetal New constnrcnan Demolition n1,t��4�y a 0'T q1 � Addition/almration/rgla.cement Other: {�-', j' R 1'7NSTR C SFR 1 brrh 249.20 1 &2-Fun il dwellin LJ CofnmerciaVinduetrial SFR(2 both 350.00 [).access Bull= Multi-Famil SFR bath 399.00 Other: Each additional bsth/iatchen 45.00 Mosta Builder - P e I i r r,•r: Fires rinkles •ft.: (x1r11fI,RT1C?Q tlHti Ami, atm t,e address: Job'4i Gtcb bacin/aree drala 16.60 suite# Bid /A tot+: D cll/lRaoh line/trench dt'ain 16.60 Pro'oot Name: LI r/ FOtxin drain no III @. Pa 2 Cross stTect/Directions to job site: Manufactured born[utilities 1to.0016.60 Manholes _ P.un drain C41mector 16.60 Saaoitar .ewer no.linear a. Pagc 2 Storm sewer tto.linear.1L. Pe C7 Subdivision: QU Lot water service no•linea tt. Page z Tu ma arccl#: �i �,. ;J1Y�qu in M tail' . r!'°' " ;,R, t "' " 16.60 wK'; : :, Irl y ur•: ,�1 Abeo. ',un mat-t B3000worevciriter Pa 2 Bac"Min valve _ 16.60 Clathet rfasAer 16.60 Dishwasher 16.60 Drinkingfountain 16.60 16.60 .� Expansiontaak 16.60 eine: _ f�D_fj' rizntro/fewcrcap M ^_j 152- Ad&ess: rr_' rotx draWRhoor ait� ub 16.60 Ci /State Zip: DI' Al Garbe Qla anal __ 16.60 Phone: Fax: A;1-- 3lr ? Hose bib 16.60 t.ijM i� l l(JI Cso1 . 1u►t>s1t _ 16.60 Interc tcp/ease trap 16.60 aulc' , Medical value: S, P16.60 -� Ci i StatelZi 1✓� l� �C 1 Z71I Roof drain(corn m tciaq 16.60 S; � Sink/b=n4avattxy _ _ 16.60 L Phone: _/? ._ 16.60 F R]Ail• 7LWshawMshowcr _ q Urinal _ 16.60 1660 y,;.':,;.'1't(�. v• Vr'atcr closet Business Nam + Wtter heave 16.60 Address: ]l Z S w at'a' Ci /State)/ .,i O 9 ?!b U Other rr Phones 4-PCr9 Fax_li _s"9PQ' ,;a. tal,.r,a� Subto I i J LCCB Lic. 4: 91 &fi Plumb. Lic.#:.2p�y PJs Minimum Permit pec 172.50 S Authotircd �7�� A.esidendsil Eacldlow Mlnrmurn Fes 336,25 9lgnanuc Date• Plan ReviewL K of Perntlt Fee T Stat Surchnr ege n of Femdt DO- TOT L eeTOTAL PFRMrr FEE F_ (p+rmue print nmat trph ltaateMe x ,el S Notlee: Tbit parRtic opplicatlen"Piret if a permit tv not eel?incd within All nem conrnterelst trvildln�+regaGre 2 yNt atpla 180 days after It hat tlfet accepted as eomPlct- Alta dlynv for ivi y Tr;.. ^pet rottAadelaQ+xt by Tr;-Comb 1hdltNne Ueaetty 5rrrlrt tSoard. i,%0su%Pcmidt Fo"nt1PlniF=Mi0.pp doe 01103 FEB-21-2073 06:49 503 644 5999 96% P.02 �-�` fIr'ACIF'IC CRES"I' SUFiDIV ISICJN V - »--- =7 LOT - 58 •I'1 .t i �r, l. 1 f y' 1 ' _ .. CITY C> -rlCiARD�,� t t, r.t•,�'. `ti,��•t�t3�' 1..11 :r,�'�h�l'��' t211tf1�Y.1�1 �f rl fr Ib wil;* 101-11,•t..t I ..... 161.1 j.1Ito Jt Il, EL-438'WATER la t. :a'trlL'r'21111:gri`� LAT. t� \ ` GRAVC/tL D1F1 MAY� \� A OACH 5 LU 1AIL� (} 1 2. T T N �� '$IINNMU e"x x4 ,1 PIT . .. L-445' �\ \ 14 \ `•' RL\Gt`,9FT 144, \` ` PL`.14N : 31b43a-,\ FIN SEL\ 436' p 1 \ C, FIN \ \ ` 6 ``3 2\' `. EL-402' a R CO) SHALL BE FINISHED OR THE LOT SURROUNDED BY ERO£iION CONTROL TF S COMMUNITY w EROSION CONTROL.FINISHED SLOPES m z� (n SHALL BE LESS THAN 2 TO I w 5 8 SETBACK REQUIREMENTS SCLC 1*-20'-0' [ROOF DRAINS TO STORM FRONT YARD TO GARAGE 20' LAT. IN STREET. 67657 S F 2. FOUNDATION DRAINS TO SIDE YARD 5' REAR YARD 15' BACKYARD SOAKAGE TRENCH ADDRE55:13265 5W NA tt1 Drlvw PLAN: 3643A D.R. Horton omes SCALE: I" . 20' DATE 1i11/03 5125 S.W. Macadam Aveneue n+oNE:503222.4131 Portland Oregon FAX,903222.31n CITY OF TIGARD-SITE PLAN REVIE RECEIVE® BUII-DING PERMI-T NO.: thew PI_.ANNING DIVISION: AUG 0 l 1003 Required Setbacks: Approved ❑ Not Approved CITY OF TIGARD Side. Street Side: /0 From. 1 (;Hrage. 2-0 Rear: LS BUILDING DIVISION Viwul Clearance: Approved ❑ No; Approved Ma+cimum I3u;klinK lleight 5- feet CWS Service Pr viler Letter Required: [I Yes l No �j 0 R,cr'ved D;ttr: Q3 ENC;INLLRING I)EI'ARIMEN'I': Actual SIopo.: !L % 2� pproved ❑ Not Approved site : Ian: Approved ❑ NM Approved Hy: Date: Notes: J