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13450 SW 122ND AVENUE r � r 13450 SW 12211`' Avenue CITY OF TIGARD 24-Hour BUILDING Inspection r-ine: (503)639-417', --� MST INSPECTION DIVISION Business Line: (503)639-4171 _ BUP Receiw,d _Date Requested— 5 AM—PM--- BUP Location 1 '- Av-,e--Suite MEC �� ��� _ Ph �Z_ -- leo_42 PLM �� DG Z�11 � Contact Person ___-__ � � ( ) Contractor Ph SWR BUILDING — Tenant/Owner - -- ELC Footing ---_- ELC Foundation Access: Ftg Drain ELR - Crawl Drain Slab Inspection Votes: SIT Post&Beam -__-- -— Shear Anchors Ext Sheath/Shear - Int Sheath/Shear ----� Framing -- -- _ -- -- Insulation Drywall Nailing _ --- - -- -- ---- - Firewall Fire Sprinkler --- -- - -- ----- Fire Alarm Susp'd Ceiling - - Roof i Other: _.— Final PASS PART FAIL PLUMBIivQ - _ Post&Beam Under Slab Rough-In Water Service Sanitary Sewer _ Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other, _- -- -- - -- -) PART FAIL OffH—ANICAL - r si&Beam - Rough-In - - ------ Gas Line Smoke Dampers -- - - -------- Final -----Final PASS PART FAIL -__----- -- -__ - _ELECTRICAL - _ Service Rough-In _- UG/Slab Low Voltage - F49 Alarm Final ❑ Reinspection fee of E_---_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE ❑ Unable to Please call for reinspection RE: __ ❑ Inspect-no access Fire Supply Line ADA Approach/Sidewalk paW- -3 �-�- Inspector r /__ fit• _ _—E1ct- Other:__ Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIC.-.tA RD 24-Hour BUILDING Inspection Line: (503)639-4175 (y Mss) INSPECTION DIVISION Eusiness Lite: (503) 639-4171 -�: — .. Received Date Requested__--1 AM PM GUP -- Location Suite _ MFC _ Contact Person __ -__ acct, Ph _ ) —SILO? q?_37 PLM _ Contractor_ — Ph ( ) SWR BUILDING _ _ Tenant/Owner -_ — ELC Footing - Foundation Access: ELC F!g Drain Crawl Drain CLR Slab Inspection Notes: aD SIT Post&Beam _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear -- - Framing Insulation Drywall Nailing ---- -- - - -- -Firewall - Fire Sprinkler - _-- ---- '-ire Alarm Susp'd Ceiling _- Roof Other: ----- - — A PART FAIL_ -----�--- - — _MBING - Post& Beam•- - ---------------__._.----- --- — Under Slab Rough-In _ — -- Water Se vice Sanitary,fewer Rain Draivs _ Catch Basin/Manhole Storm Drain Shower Pan Other:------ - ---- Final - PASS PART FAIL -- MECHANICAL Pos•&Bearn Rough-u. - ------- ---..- Gas Line Smoke Dampers ZASSRR—ICA PARTf-AILLL DN Ce Rough-In UG/Slab — Low Voltage Fire Alarm - --- Final Reinspection fee of$ required before next PASS PART FAIT 4 Inspection. Pay at City Hall, 13125 5W Hell Blvd. SITE _— [� Please cell for reinspection RE: — F] Unable to inspect-no access Fire Supply Line ADA -� Approach/Sidewalk Date pector Ut Other: Final 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 EiUP — Received ___ Date Requested-_- 1 a r� AM— PM -.-- BUP Location L Z Suite___ - MEC __— Contact Person Ph(—) �O� '�c�-3 PLM Contractor --- - - Ph(—) ---- SWR BUILDING Tenant/Owner - --- _ -- - -__-. ELCFooling ELC - Foundation Ac:Ess: Fig Drain ELR _---------.__-- Crawl Drain - SIT Slab Inspection Notes: - - - - Post&Beam -_--_- _ -- - - Shear Anchors Ext Sheath/Shear - Int Sheath/Shear Framing - - - - ---- --- - -- - - Insulation Drywall Nailing - Firewall Fire Sprinkler - Fire Alarm 1� Susp'd Ceiling - Roof Other. ---- -- -- - - - - - -- - Final PASS_ PART FAIL _PLUMBING--- �- -- - - - Post&Beam Under Siab —---- Rough-In Water Service — - -- Sanitary Sewer Rain Drains ---- —-- -- _ -- Celch Basin/Manholu Storm Drain —_—....__--- -- ----_-__- ------- --•-- - -- Shower Pan — Other. --- - --- - Final PASS PART FAIL - MECHANICAL - Post&Beam Rough-In --------- -- - --- -- Gas Line Smoke Dampers -- - - - —— Final PASS PART FAIL _-- ELECTRICAL Service Rough-In UG/Slab Low Voltage ----— - _ ---------- --- - — Fire Alarm P PART FAIL C-� Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ----- l .� Please call for relnspectlon RE:--- — __ Unable tv Inspect-no access Fire Supply tine _ pp �;_ � ---�J �'_ inspect C ____. _,� _-- Ext Approach/Sidewalk Date- - �(T�JL~� Olher: Final DO NOT REMOVE this Inspection r-,cord from the Job site. PASS PART FAIL CITY �� ������ MASTER PERMIT PERMIT #: MST 2.001-00525 DEVELOPMENT SERVICES DATE ISSUED: 10/29/01 13125 SW Hall Blvd.,Tigard, OR 97223 (.503) G39-4171 SITE ADDRESS: 13450 SW 122ND AVE PARCEL: 2S103CB-11500 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 073 JURISDICTION: TIG REMARKS: New SF detached residence. Path 1 9UILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,129 of BASEMENT: a1 LEFT: 5 SMOKE GETLCTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,821 at GARAGE: 462 at FRONT: 2F, PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: sf VALUE: S 279,797.8n RIGHT: 5 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 2.950.00 sf REAR: 1 PLUM'ANG SINKS: 1 WATER CLOSETS, 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: I,AVATORIES: 5 DISHWASHER: i FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS 4 GARBAGE DISP WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FULL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 ,;AS FURN 3-000K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: W/SVC OR FDR: 1 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 400 amp: 201 400 amp: tat W/O SVCIFDR. SIGNIOUT LIN LT: PER HOUR. LIMITED ENERGY: 401 600 amp: 401 - 600 amu: EA ADDL SR CIR: SIGNAL/PANEL: IN PLANT: MANU HWSVCIFDR: 801 • 1000 amp: 60148mon-1000v: MINOR LABEL 1000•amplvolt PLAN REVIEW SECTION Reconnect only: a 600 V NOMINAL: CLS AREA/SPC OCC: a.4 RES UNITS: SVC/FDR)--225 A.: ELECTRIf'AL-RESTRICTED ENERGY A.SF R-91DENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM GYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Contractor: TOTAL FEES: $ 5,243.83 Owner: This penTlil is subject to the regulations contained in the DON MORISSETTE HOMES DON MORISSETTE HOMES Tigard Municipal Code,State of OR. Specialty Codes and 4230 GALEWOOD ST 4230 GALEWOOD STREET all other applicable laws. All work will be done In STE 100 SUITE 100 accordance with approved plans. This pen-nit will expire If LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 work is not started within 180 days of issuanoe,or If the work Is suspended for more than 180 days. ATTENTION: Phone Phone: Oregon law requii es you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg a LIC 36533 forth in OAR 952-001-0010 through 952.001-0080. You may obtain cupies of these rules or direct questions to OUNC by calling(503)248-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Exterior Sheathing Insl Rain drain Insp Mechanical Final Sewer Inspection Underfloor Insulation Plumb Top Out Low Voltage 1331n drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Gas Line Insp Water Line Insp Final Inspection Foundation Insp Footing/Foundation Drl Electrical Rough In Gas Fireplace Appr/Sdwlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Electrical Final .--. on IssLed By : .-L— Permittee Signature _ Call (503) 6 9-4175 by 7:00 p.m. for an Inspection needed the next business day CITYOF TI GAR L SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00287 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/29/01 SITE ADDRESS; 13450 SW 122ND AVE PARCEL: 2S103CB-11500 SUBDIVISION: QUAIL HOLLOW- EAST ZONING: R-4.5 BLOCK: LOT: 073 _ _— JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INS I ALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new SF residence. Owner: — _ FEES__ DON MORISSETI E HOMES Type By Date Amount Receipt 4230 GALEWOOD ST -- -- STE 100 ,NSP CTR 10/29/01 $35.00 27200100000 LAKE OSWEGO, OR 97035 PRMT CTR 10/29/01 $2,300.06 27200100000 Phone: 503-387-7538 Total $2,335.00 Contractor. Phone. Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the Installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm 8ed b 1 t f r �� L/�-Y! Permittee Signature: 41 V SUr - ��� Call (503' x.39-4175 by 7:00 P.M. for an inspection needed the next business day Building Perndt Application City of Tigard Datereceived: Permit no.: �� � -- Addres": 13125 SW Ilail Blvd,Tigffi'd;-UR 97223 Project/appl.no,: Expire date: Phone: (503) 039-4171 Date issued: Hy: r' 1 eipino.: Fay,: (501) 598-1960 Case rile no.: Payment type: Land use approval: _ 1&2 family:Simple Complex: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family &New construction U Demolition U Addition/alteratior✓replacement U Tenant improvement U Fire sprinkler/alarm U Other: i Job address: r I Bldg. to.: Suite no.: Lot: Block: Subdivision: Tax map/tax lot/account no.: i �J4, Project name: , Description and location of work on premises/special conditions: ' I' Name: Y, Mailing address: i do 2 family dwelling: ��. City: Stated ZIP: Valuation of work........................................ $ 7 Phone: - - Fax: -7 -mail: No.of bedmoms/baths................................. ) Owner's representative: Total number of floors ................................. Phone: Fax: E-mail: New dwelling area(sq.ft.) IlanE Garage/carport area(sq.ft.)......................... Name: ,� 1� Covered porch area(sq.ft.) ......................... _ - Mailing address: Deck area(sq.ft.)........................................ Other structure area(s . ............ City: _ _ _ State: ZIP: _ q ft) Phone: Fax. F mail: CommercfaUlndtlstrfal/multi-family: Valuation of work.............X;E*xi*sting. ..... S __ Business name: �'i Existing bldg.area(sq.ft.) ..... Address: New bldg.area(sq.ft.)..... ..... Number of stories _ City: Smote: : Type of construction Phone: Fax: - �E mail: CCB no.: Occupancy group(s): tng. City/metro lic.no.: New: _ Notice:All contractors andsubcontractors are required to be t licensed with the Oregon Construction Contractors Board under N 1111e L 1 k ,� y provisions of ORS 701 and may be required to be licensed in he Address: _ l{�� �(, jurisdiction where work is being performed. If the applicant is City: I State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: -- —'--- Phone: Fax: E-mail: -- --.__ N_ c Contact person: Fees due upon application ........................... $ __.-- Address: Date received: City: State: IZIP: Amount received ..................... ... ............... - --.- Phone: Fax: I E-mail: Please refer to fee schedule. _ 1 hereby certify I have read and examined this application and the Na art jurisdictions accept creifit rte.piear can imidiction for more Infrxnation. attached checklist.AILDrovisions of laps and oidinances governing this U visa U MasterCard lydir card number work will be compl ;wi ,whetheWcc ke or no ) _ - Expires Authorized sl nate+ ' ate: 1 ( None of cardholder u shown on credit card Print name: — t CaMlwl r rltnarure � Amount Notice:This permit application expires if a permit is not obtained within 180 days,tiler it has been accepted as complete. 4411-4613(WWoM) One-and Two-Fainly Dwelling Building Permit Application ChleckliSt Referonceno.: '--�— CirvofTiKard Cit-v of Tigard Associated permits: Q Electrical C)Plumbing O Mechanical Ade;.,...:;: 13125 SW Hall Blvd,"1"iga•�i,JR 9723 7 ether: Phone: (5' .,) 639-4171 -- Fax: (503) 598-1960 I Land use actions completed.See jurisdiction criteria for concurrent reviews. 2_Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. —� 3 Verification of approved platflot. -- 4 Firedistrict_ approval required. 5 Septic system permit or authorization for remodel. Existing system capacity _6 Sewer permit. V 7 Water district approval. — 8_Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan LI permit required. Include drainage-way protection,silt fence design and location oto _catch-basin protection,etc. 10 _-L Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes.Lateral design details and connections must 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 %f copyright violations exist. _ J` 11�Siteiplot plan drawn to scale.'Fhe plan must show lot and building setback dimensions,property comer elevations(if there is more than a 4-ft.elevation differential,plan must show contour lines at 241.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot arra;building coverage area ;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent 1 size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(,)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation dens.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. - Full-size sheet addendums show foundation elevations with cross references are,acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive.Patti analysis provide specifications and calculations to engineering standards. I7 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing 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 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured Boortroof truss design details. _ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or inure appliances. Lngineer'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 bn shown to be applicable to,he project undrr rrvirw. 23 Five(5)site plans are required for Item I I above. Site plans must be 8-1/2"x I I_or I I"x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. 26 No rolled,reversed or mirrored building plans will be accepted. 27 2g 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. 440-4614(6AXYMt) Mechanical Permit Application --- — _ Datereceived: Permit no'/` �' U/-0 c114 ' city of Tigard Project/appl.no.: _ Expired . . Cav of Figard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued:: By:— Receipt no.: Phone: (503) 639-4171 payment t e Fax: (503) 598-1960 Case file no.: yp Building permit no Land use approval: -- -- — ! C) I & 2 family dwelling or accessory U Commercial industrial U Multi-faruiiy ❑Tenant improvement consrrucuon O Additiori/alterauon/n placement ❑Other: -- It 1 1 t ! 1 Job address: �.� - r C Indicate equipment quantiucs in boxes below.Indicate the dol!ar Suite no.: L value of all mechanical materials,equipment,labor,overhead, Bldg. no.: profit. Value$ ---- Tax map/tax lot/account no.: *See checklist for important application information and Lot: Block: Subdivision: L 1� r juri:diction's fee schedule for residential permit fee. Project name: 1 1 City/county: ZIP: _ ! 1 1 1 1 1 Description and location of work on prrmises: Fee(ea) Total Description_-- Res.ool Res.only Est.date of completion/inspection: AC: Tenant improvement or change of use: Air handling unit CFNI Is existing space heated or conditioned?U Yes ❑No Air conditioning(site p an required) Is existing space insulated?U Yes ❑No A teration o existing FNAZ`system Boilu/compressors State boiler permit no.: Business name: HP Tons HT111H Address: irdsmoke amper duct smoke erectors Stat' ZIP: eat pump(site an requrr ) — City: nsta rep ace rnacrJburner / Phone: Fax: E-mail' — Including ductwork vent liner O Yes d No CCR no.: _ nsu repiace/relocate eaters-suspende , City/metro lic.no.:N/A _ — wall,or floor mounted -Vent ora�other than umace Name(please print): a emt on: Absorption units__ - HTU/H _ �,�,� Chillers _ HP Name: ,—VA CL L, Compressors HP Address: ' Environmental exhaust an rents at on: M Citv: Stat1:: ZIP: Appliance vent Phone: Fax: E-mail: .'yerix aunt 4,5iis,Typel/lUres. tc a azmat had fins suppression system -- Exi.!%.,t fen with single duct(bath fans) _ Name: aust-system apart from cion,or AL Mailing address. Fuel nipingan t ut on(up to out cis) City: L State- ZIP Ty LPG NG Oil Phone: 7- Fax: E-mail: tie i ring eac a rttona over out ets rocesspiping(schematicrequired) Number of outlets Name: Other listid appince or equ proem: .Address: Decorative fireplace --- - nsert-type Citi TState ZIP: _ a. stov pc et stove _ Phone — 11 Fax: •mail: er: Applicanr'r signatu ( Date: ter. Name(print): ' ' t Permit fee.....................S --- Nor all Jud"cuans swept credo cards,pleme cart)urHdlcuan far mae in(arrrWran. Notice:This permit application Minimum fee................$ — U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) S -- crrela card number — within 180 days afler it has been State surcharge(8%) ..•S — Name of cardholder u shawa an credit card s accepted ry complete. TOTAL ....................... -- "G-41617 16Rx)1COM) Ctrdholdel ilpratum _ Amount Numbing Permit Application Date received: _Y Permit no.: City of Tigard SeworDermitnu.. Duilding permit no.: Address: 13125 SW Hall Blvd•'Tibard• OR 9723 — CiryojTigard Phone: (503) 639-41 1 Projecuappl_no.: Expire date:_ Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case tilt nn: Payment type: TYPe OF PEJOUT O 1 &2 family dwelling or accessory U Commercial/industnal I]Mulu-family ❑Tenant improvement ew construcuon ❑Addiuon/alterauon/ieplacemeut 0 Food service ❑Other. _ JOB SITE INFORNIATION1 rinformation ttse checklist) dress: ? V%eTCVe , Oestri tion Qty. Fee(ea.) Total Job ad Bldg.address: Suite no.: New I-and 2-family dwellings only: (includes 100 ft.for each utility connection) Tax map/tax I( account no.: SFR(1)bath Lot Block: Subdivision: 775,aj R3 SFR(2)bath _--- — _ Project name: SFR(3)bath _ City/county: ZIP: Each additional bath/kitchen Description and location of work on premises: SiteurRides: Catch basin/area drain Est.date of completionlinspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.) _ Manufactured home utilities Business name vI L. Manholes Address: ` Rain drain connector _ City: State ZIP: Sanitary sewer(nn lin. ft.) Phone: -�'t_ Fax: E-mail. S1:am sewr r(no.lin. ft.) _ CCB no.: Z L Plumb.bus. reg. no: Water ser ice(no. in.ft.) Fixture or ltrin: City/metro lic. no.:NIA Absorpon valve Contractor's representative signature Back flow preventer Print name: ju Backwater valve Basins1lavatory Name: Clothes washer Dishwasher Addres �� ��"V Dnrtking fountain(s) _ Cin State. ZIP: E)ectors/sump Phone Fax: E-mail: Expansion tank Fixture/sewer ca Floor drains/floor sinks/hub Name (prino Garbage d sal Mailing address: Hose hib' City l StIce mak, Phone: - Fax!1470FT nterce tor/ ase tri Owner installadonlresidendal maintenance only: The actual installation Pnmens) will be macre b} me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s)• basinisi• lays(s) _ Owner's signature: Date: Sum - - M Tubs/shower/shower pan _ nnal Name: _ Water closet Address: _ ate-heater City State: ZIF: Other. Phone: Fax_ Email: Total Not All tuna i'll"acc►pr cmda cudf pielm can iunrhcuan far more tnfommton Notice Minimum fee................S • This permit application Plan review(at _ %) $ -- ❑visa o+tuterCard c�pires if a permit is no obtainState surcharge 8% $ Ctdlil card numher -- Erpuer within 180 da%s aner it has been TOTAL .....g.•.(. S Name d cudhoidet L rt ori on cruht cud accepted as complete "••"' f 4ardhoider ttlnaiure _ Amount tiro t616(6UtNOA11 Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: CiryojTisard Address: 13125 SW Hall Blvd,Tigard,OP. 972'3 Datcissuul: 3y: Receipt no.: Phone: (503) 63:1-4171 Fax: (503) 598-1960 Case file rn_ Payment type: Land use approval: t 1 &2 family dwelling or accessory 0 Commercial/industnal 0 Multi-family 0 Tenant improvement New construction 0 Addiuon/alteration/replacement Cr Other: 0 Partial JOB WE INFORMATIAN At Job address: ) Bldg.no.: I Suite no.: 17ax map/tax lot/account no.: Lot: Block: Subdivision (, 16N Project name: Description and location of work on premises: Estimated date of contpletion/mspeetion: 1 Fee Max Joh no: MElec. Desrriptian City. (ea.) Tabl ro.losBusiness name: �(� IVewm-Weritial-.ingleorintim-family per Address: dwelling unit.Includesattach d garage. City: 'n (.A LIP: � SerriaincludedPhone: .j 1mail: 1000 .ft.or leuEach additional 500 s .f<or pion thereofCCB no.: o: l united energy.residential 2 C: Limited energy,non-msidendal 2 ��— Each manufactured home or modular dwelling l>rte Service and/or feeder 2 re of supervising NecrrfNan(requ(reC) -t Senicesorfesders–lnr±allaUon, Sup elect name I pnnU 1 License rw O' alteration or relocation: 200 amps or less 162 201 amps to 400 amps 2 Name(print): ` 401 amps to 600 ams _ 2 Mailing address: 1i 601 amps to 1000 amps 2 City: .0r Slate T_IP' Over1000ampsorvolts 2 _ Phone: - FaK: : -� -mail: Reconnect oral Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended For sale, lease,rent, or exchange according to 4Wallatiom alteration,orrelocadon:200 ams ,jest 2 ORS 447,455,479,670,701. 201 amps to 400 amps 2 - Owner'S sl nature: Dale: 401 to 600 ams _-- _. 2 Branch circuits-new,alteration. or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit Stale: ZIP: _— 0 Fee for branch circuits without purchase 2 _ of service or feeder fee,first branch circuit: City; Phone Fax: Email: Each additional branch circuit Misc.(Service or feeder not Included): ' unyh por' U Service over 225 amps-commercial O Healthcare facrliry Eacmgsuon circle 22 O Service over 320 amps-rating of 1&2 U HuArdous location Each agn or outline IighUng famuly dwellings O Building over 10.000 square fc t four or Signal circuit(s)or a limited energy panel, •System over 600 volts nominal more residential units in one stricture alteration,or extension' O Building over Uvee stones 0 Feeders 400 amps or more *Description O Occupant load over 99 persons U Manufactured structures or RV perk Fjch additional inspectlon over the allowable In any of the stw� _ U F.gresulightingplan U Other ___ _ Per inspection .— Submit sets of plats with any of the above. I Imesugauon fee The above are not applicable to tempnrary corstructlon service. other Permit fee.....................S ---- -- Noi.0 jurisdictions accept credit cards,please till n•�. ri.u'a for Ma tnfmnauan Notice This permit application Plan review(Al 9b) $ expires if a permit is not obtained �- U Visa O MasterCard p Credit card nwriber _ �_.L._ within ISO days after it has been State surcharge(8%) ....$ _ �tp1fes accepted as cotrplete, TOTAL ......................$ Name of cardkolder u shown on CI" T s Cardholder signature Amount 440-4613(~OM) DON • MORISSETTE OBE : 202$ a 0 H s S 1330 9ALIT000 s ? sss ? 8VIT1 ioo LOT: 7 LAKs 09T2 a001 . ossa ON 97036 DATE: 10 01/ (6 o a) 3 8 7 - 7 e a a TAX (503) 387 - 7 e 15 PROPEyry: QUAIL--HOLLOW CITY: TIG.ARD SCALE: 1"=20' OPTION 3 ELEVATION PLAN No.: 139 i 26'-4' 302 100-001 dl I 30'1 rdlnr�rdn ._� /� f .— �0�10�1 Caatfp %14&-ve(_ - —�` 3©- j -3'bio-bag• a [ 4T,- 4- 3� 4- r r _—...—L I a l. 3 .s I 1 I'�� zi II'6 I I I e I ,6, I I I, I V LA1 I � I0 6' a..� 03 b�irm. 4 I1'4 •�I�' 4 1 rO I 4 v 2 I!2 bath ` 0 �Ite 71,x.469 sq. ft. FRE. 305 5' pr'tVewdy Z car gar. conc.l / I FF.E. 3m5' leb .paelo 304 I. 305 i 34'4' 304 306 e 1©©.00' s.. u1 1,04 3 1 8' WIDE P.U.E. ��o LOT 'rt3 5m eq. ft. CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00667 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/24/01 SITE ADDRESS: 13450 SW 122ND AVE PARCEL: 2S103CB-11500 SUBDIVISION: (,UAIL HOLLOW- EAST ZONING: R-4.5 BLOCK: LOT: 073 JURISDICTION: TIG CLASS OF WORM: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASH;NG MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIX T UPES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. _ Owner: — --- FEES -- Type By Date Amount Rece:pt DON MORISSETTE HOMES --- — 4230 GALEWOOD ST PRMT CTR 12/24/01 $36.25 27200100000 STE 100 5PCT CTR 12/24/01 $2.90 27200100000 LAKE OSWEGO, OR 970:35 Total $39.15 Phone 1: 503-387-7538 —� Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONViLLE, OR 97070 REQUIRED INSPECTIONS Phone 1: b82-6076 Final Inspection - Reg#: '.IC 6136 PLM 11558 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all u!hel applicab;e 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 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: Permittee Signature: Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next business day Plumbing Permit Application -- ������� .--- Date received: /,i %D 01 Permit no.:14y7(jQ/DOGE cityOf Ti F ewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 9722�� '( l'rojcct/appl.no.: rxpiredate: City of Tigard Phone: (503) 639-417bEC 2001 r 1 - Fax: (503) 598-1960 Date issued: By:& Receipt no.: CITY (0 1 Case file no.: Payment type: Land use appra vv ------ 7'ANew 2 family dwelling or accessory U Commercial/industrial U Multi-family U"tenant improvement construction U Additio .alteration/replacement ❑Food service U Other. _ , I Dcscti t�ion Fee(ea. Total Job address: 3�/ n a L' New 1 and 2-family dwellings only: Bldg.no.: Suite no.: _ (included loo ft for each utility connection) Tax map/tax lot/account no.: 5-� * , r� SFR(1)bath _ Lot: r Block Subdivision: tteiit. 04' SFR(1)bath Project name: Z-k. 7.3 SFR(3)bath ZIP: �/7 i Each additional bath/kitchen City/county: C CiC Site WOW DescrWtion an location of work on premises:— -- Catch basin/ar.a drain Paw AWK& Drywells/leach line/trench drain Est.date of completion/inspection: / - / Footing drain(no.lin.ft.) Manufactured home vtilitie.: Business name: Manholes -- Address:a- ?S Seep Kt!► _ Rain drain connector Stateb ZIP: C? 701A_._ Sanitary sewer(no.lin.ft.) City: .,i t I G Storm sewer(no.lin.ft.) Phrne:fcsd-WO'1 417 Fax: 8 -qQ7 E-mail: - -- Plumb.bus.reg.no: Water service(nn.lin.ft.) CCB no.: (a/3 Fixture or Item: City/metro lic.no.: 0031"7 Abso tion valve Contractor's representative signature: _L�t tz� Back flow reverter 7 5S Print name: -4tS �._I zt ` Date: 0 C Backwater valve 1 Basins/lavato Clothes washer Name: Itn a-or r ri.0 Dishwasher _ Address:lq Q9 5 !�W KW ny1_ Drinking fountain(s) City; State:OK, ZIP: _ E'ectors/sum Phone:(p$ I Fax:1a6;l-q 'rl E-mail: Expansion tank — Fixture/sewer cap -- Flc�or drains/floor sinks/hub __ Nance(print):Dpr1_Mr1 13Lf - ���� Garbage itis sal _ Mailing address: 14330 U) dif-Lu ILO ST . - Hose bibb - City: L c'ate: IQ ZiP:q A --- ce m er �- -- - - Phone; 11Fax: E-mail: Interceptor/grease trap owner installattor.residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employ^.e vii the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s)Date:Vall Sum - - Cwner's si nature Tubs/shower/shower an Urinal _ - Name _ _ _--_ --_ ----- Water closet --- -- Address: Water heater _ ---- -- City: State: ZIP: Other: Phone: Fax• otal E-mail:E-mai : - Minimum fee.. .............$ te' call Jurisdiction rot in i'do+m dOn Plan review(at — fib) $ _----- Na as luriadicdotta accept credit card,.pkaae J Notice:This permit application Ll VISA ❑MasterCard / expires if a permit is not obtained State surcharge(8%) ....$ Credit card numtet _-_ / within 190 days after it has been S� Expires accepted as completeTOTAL. ............. .......�� . N une or cudholder u shown on credit crd $ — 4bJ616(6001/170M) —' — —Cardho der rianature Amount PLUMBING PERMIT FEES: ling FIXTURES'MdiVidu51, T, gb. #,tnLlTY�1 j` ea ,:; '"AMC?UNT Zin �,�s""S�� Ii(rt L' Sink 16.60 h�w6111i4 r5 �' e" - U 4a it U 1'. r a .,• .�".�.- Lavatory-- avatory.- 16.60 - One 1 bath - _ $249.20 k Tub or Tub/Shower Comb. 16.60 Two(2)bath $350.00 Shower Only -- 16.60 Three 3 bath _ $399.00 Water Closet 16.60 - -�- SUBTOTAL Urinal 16.60 t%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal - 16.60 --_�.._ TOTAL Laundry•Fray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink " 16.60 T" 16.60 _ PLEASE COMPLETE: 3Y - q•' 16.60 Water Heater O conversion 0 like kind 16.50 rfo" Gas piping requires a separate mechanical Fiatr� Vype permit. j NO MFG Horne New Water Service 46.40 Sink --_ MFG Home New San/Storm Sewer 46.40 Lavatory__ _ Tub or Tub/Shower Nose Bibs 16.60 Combination _ Root Drains -16.60 rShower Only _ - - [Tdnkina Fountain 16.60 Nater Closet _ - Olher Fixtures(Specify) 16.60 - Urinal _ _ Dishwasher Garbage Disposal _ Laundry Room Tray - __- - Washing Machine - Floor Drain/Sink: 2" Sewer-1st 100' 55.00 � 3•• Sewer-each additional 100' 46.40 _- 4- Water Service-151100' 5560----- Water Healer Water Service-each additional 200' 46.40 - Other Fixtures _ _ Storm 8 Rain Drain-1s 100' 55.00 _ Storm&Rain Drain-each additional 100' - 46.40 FI at Commercial Back Flow Prevention Device 46.40 - -- Residential Backflow Prevention Device' L 27.55 Catch Basin 16.60 _ Inspection of Existing Plumbing or Specially 72.50 -- Requested Inspections _ er/hr _- COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps -- - -- 16.60 ------ -- - _ QUANTITY TOTAL � , -,, ,,,:."• ----- - ---- ----•------ Isomeldc or riser diagram Is required if Ouantlty Total Is >B / v�• .,. .'y�' --- -------. ----._ 'SUBTOTAL -- 8%STATE SURCHARGE + . 9D -- ..,M s "PLAN REVIEW 25%OF SUBTOTAL ?! {",t v""'• � °r` ' Required only if fixture qty total ls�-B TOTAL "•' " , $ `Minimum tiermlt fee is$72 50+8%state surcharge,except Residential Rackl1cw Prevention Device,which is Sae 25•8%state surcharge **All New Commercial Buildings require plans with Isometric or riser diagram amt plan review l:\dsts\forms\plm-fees.doc 10/10/00 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 , S �i �G'd SSS INSPECTION DIVISION Business Line: (503)639-4171 ( ' ©P Received -----Date Requested___l— AM PM BUP Location _/ 5 __ I 2- _— Suite—_ -- MEC --- ----- �' Ph _ c�_3�_ —_ -- Contact Person �_...___ �-- � ) PLM Contractor — ^—. ------ Ph (-- -) --- — SWR ------ — BUILDING Tenant/Owner _ _._ ELC — Footing ELC _—_-_-_-- Foundation Access: ' 1"✓'c l- L,e�`�', � ''��-'� � ELR Ftg Drain Crawl Drain SIT Slab Inspection Notes: -----� Post&Beam - —--_ ---- -_— Shear Anchors Ext Sheath/Shear - -� Int Sheath/Shear I }.�( ' ^do 1 _ � Framingming - Insulation ``",�•� CRX�; L Drywall Nailing ^- Firewall l�`� 6 bS G _--- -- —--- - - Fire Sprinkler Fire Alarm 4 � ,.tJC. -- Susp'd Ceiling Root n,�, wvv�.�l •% ___- l �'LE 0 2 -- Other!—.--,-- 1 _ _PASS PART — PLUMBING _ ---1-- Post&Beam Under Slab -- -b -- — Rough-In Water Service - Sanitary Sewer Rain Drains �1 Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL _MECHANICAL Post&Beam Rough-In - Gas Line Sm a Dampers -- - - ASS PART FAIL — Service Rough-In -- -- ------ ------ ----- -- UG/Slab Low Voltage _-__-- Fire Alarm Final Reinspection fee of$— _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE:------- _ ___ _ i Unable to inspect-no accn.,s Fire Supply Line f, \ ADA l Z' Inspector � Approach/Sidewal , �. Other:)ASA M�_�,b1 Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL h,AAAAAAAAAAAAA ►AAAA,AAAAAAA,►A, »AA,►A,kAAAAAAAA i'4F i r ► 44 a � i i � ► bn v ► ,� G a- ► 0 1-4 � ° �n $-4 — ► a ., o n ,4-4 o V) �4 Q Q °Ai . N ► bn n ► E-+ G T r o °' O ► a. ► U o ► V a) pq ► Q ► .b cn ► 71 ► w ► i w ► O > ► �IVVVVVV�VVVVVOV��'VV'VVVVVVVVVVV�VV�VVVVV�I��r \� a N o IO 0 s � � c p� a a w � F3 r y ry S n ~ E 1 ^ O wrz 7 S ` q ` O rn i Q 3 1 .1. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST — -- — BUP Received _ Date Requested _ t!"� _ AM_ — PM _ BUP Location __� SSC ��__�'I�`� Suite MEC Contact Person Ph ( ) 2 0`7 y X37 PLM Contractor _ Ph( ) SWR BUILDING _ Tenant/Owner — _- �— _ ELC Footing Foundation Access: ELC _-_— Ftg Drain ELR Crawl Drain — -- Slab Inspectio otes: SIT Post& Beam Shear Anchors --- �- __- Ext Shoath/Shear Int Sheath/Shear "- Framing Insulation _- -------------- Drywall Nailing - -- . .- _- _ ----- - - ---- ----- - �. Firewall -�------ - Fire Sprinkler - ---- Fire Alarm Susp'd Ceiling - - - - -- Roof -- ------------- _-------- Other. - - - - Final PASS PART FAIL - - - - -- ----- _ -- PLUMBING — Post —&Beam _ Under Slab Rough-In - _ -____-------- ---- --- - Water Service - _ -- - --- -- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - - - ------ --- Shower Pan Other - -- _------ - --- - PART FAIL - - -- ------- - -- CHANICAL Post&Beam Rough-In Gas Line Smoke Dampers - - Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm Final F—I Reins PASS PART FAIL pectlon fee of$ _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE— Please call for reinspection RE: Unable to Inspect-no access Fire Supply Line r ADA � D Z � � / Approach/Sidewalk Date 1_- Inspector. _� ��• Ext Other:_ Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL