13610 SW 122ND AVENUE 1 x610 5W 122ND AVENUE
CITY OF ! IGN/"�RD _� MASTER PERMIT
1
/
PERMIT #: MST2003-1)07.55
DEVELOPMENT SERVICES DATE ISSUED: 7/14/03
13125 SW Hall Blvd., Tigard OR 97223 (503) 639-417 1
SITE ADDRESS: 136310 SW 122ND AVE_ PARCEL: 2S103CC-10200
SUBDIVISION: WHISTLER'S WALK ZONING: K-4.5
BLOCK: LOT: 049 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: DM166 STORIES: I FLOUR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT FIRST 1.9'10 sl BASEMENT: at LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE' SF FLOOR LOAD: 40 SECOND: sl GARAGE: 392 at FRONT 20 PARKING SPACES
TYPE OF CONST: SN DWELLING UNITS: I THRD s; RIGHT: 5
VALUE: 175,P45.60
OCCUPANCY GRP: R3 BDRM: 3 BATH: TOTAL: I,8K st REAR: 15
PLUMBING _
SINKS: I WATER CLOSETS: 3 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 3 GARPAGE DISP: I WATER HEATERS: WATER LINES: 100 BCKFLW PREVNTR GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 4 CLOTHES DRYER: I
GAS FURN>+100K: UM',HEATERS. HOODS: I OTHER UNITS: I
MAX INP" btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAb OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUIT MISCELLANEOUS _ ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 •200 amp: WISVC OR FDR PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF 3 201 - 400 amp: 201 - 400 ynp. 1 at WIO SVC/FDR. SIGNIOUT LIN LT PER HOUR:
LIMI'F0 ENERGY: 401 • 600 amp: 401 600 amp. CAADDL SR CIR: SIGNALIPANEL: IN PLANT:
MANLI HMISVCiFDR. 601 • 1000 amp: not-amns-1000v MINOR LABEL-
1000-amolvolt: PLAN REVIEW SECTION
Reconnect only: =4 RES UNIT 9VCIFDR„225 A,.: 600 V NOMINAL: CLS ARENSPC OCC
_ ELECTRICAL• 11:1 n:CTED ENERGY ___ � —
_ A.SF RESIDENTIAL Y B.CUMMERJIAL
AUDIO 11 STEREO: VACUUM SYSTEM JDIO d STEREO: t:RE ALARM: 1N1 ERCUMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG• PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA'TFLE COMM: NURSE CALLS: TOTAL 0 SYSTEMS,
TOTAL FEES: $ 4,531.97
Owner: Contractor: This permit is subject to the regulations contained in the
r;ON MORISSETTE HOMES DON MORISSETTE HOMES INC Tigard Municipal Code,State of OR. Specialty Codes and
42.30 GALEWOOD ST 4230 GALEWOOD ST,STE 100 all other applicable laws. All work will be dorte in
STE 100 LAKE OSWEGO,OR 97035 accordance with approved plans. This permit will expire If
LAKE OSWEGO.OR 97035 work.is not started within 180 days of issuance,or if the
work is suspended for more than 180 days, ATTENT1014:
Oregon law requires you to follow rules adopted by the
Phone: Oregon Utility Notification Center. Those rules are set
PhO"� 5'13-387-7538 forth In OAR 952-001-0010 through 952.001-0080. You
Reg w: 503 3$1378 may obtain copies of these rules or direct questions to
Lll OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS �"�
Erosion Control Insp 8, Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp
Grading Inspection Post/Beam Mechanica Plumb Top Out Exterior Sheathing Insl Rain drain Insp Appr/Suwlk Insp
Sewer Inspect)^ri Underfloor insulation Electrical Service Low Voltage Storm drain Insp Electrical Final
Footing Insp Crawl Draln,Backwater Electrical Rough In Gas Line Insp Roof Nailing Mechanical Final
Foundation Irlgp� PLM/Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Issu d B .12 Pprmittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
I
CITYOF TIGARD _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMiT#: SWR2003-00194
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/14/03
SITE ADDRESS; 13610 SW 122ND A 'E PARCEL: 2S103CC-10200
SUBDIVISION: WHISTLI It'S WALK ZONING: R-4.5
BLOCK: L jr: 049 JUPISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL_TYPE: L.TPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF residence,
Owner: —
_ FEES __
DON MORISSET,rE HOMES Description Date Amount
4230 GALEWOOD ST
STE 100 [SWINSPI Swr Inspect 7/14/03 $35.00
LAKE OSWEGO,OR 97035 [SWINSPJ Swr Inspect 7/14103 $0.00
Phone: 503-387-7538 [SWUSA] Swr Connect 7/14/03 $2,400.00
[SWUSA]Swr Connect 7/14/03 $0.00
Contractor
Total $2,435.00
Phone:
Reg#:
Required Inspections
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 `;ode Sewer" Perin
( moi
Issu d by: ��� Permittee Signature:
Call (503)639.4175 by 7:00 P.M.for an inspection needed the next business day
00 97
' Building Permit Application
Date rer;eived•� Permit no .
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.. Expire date:
CityojTigard Phone: (503) 639-4171 Date issued: _ ByF' Receipt r.o.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: V A 2601- i f_ I&2 t'amily.Simpie Complex: —
J 1 a amily dwelling or accessory U Commercial/industrial U Multi-family &New construction U Demolition
U Addition/alteiation/replacement U Tenant improvement U Fire F:)nnkledalamt U Other: _
JOB Sff I.IN FORMATION
Job address: ( �7 t� Bldg.no.: Suite no.:
Lot: Block: Subdivision: q L Tax map/tax lot/account no
Project name: _
Description and location of work on premises/special conditions:
Name: d" '+C.r
Mailing address: \,• _ F family dweftg:
City: Sta►e� ZIP: ) ion of work........................................ $
Phone: - - Fax: -7 -mail: bedrooms/baths................................
Owner's representative: �-t y j number of floors...................c...�.... ( _
Phone: Fax: Email: t Fla
welling area(sq. ft.)
III N Loki eJcarport area(sq.ft.) JName: Y red porch area(sq.ft.).......... Z G
Mailing address: Deck area(sq.ft.) ........................................aa
_
City: state. =ZIP.. Other structure area(sq.ft.).........................
Phone: Fax: E-mail: CommerciailindustriaUmulti-family:
Valuation of work.......................I......
..:/$
Business name. . - Existing bldg.arta(sq.ft.) ......�. .......
New bldg.area(sq. ft.)
Addres Ile,....................
City: State: ZIP: Number of stories...................... .................
Phone: Fax: E-mail: Type of construction....................................
Occupancy group(s): Existing:
CCB no.: 15
�)_;�2 New:
City/metro lie.no.: Notice:All contractors and subcontractors tut required to he
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to he licensed in the
Address: ��� jurisdiction where work is being performed. If the applicant is
Cit State: exempt from licensing,the following reason applies:
Contact person: Plan no.: —
Phone: Fax: E-mail:
Name: _ Contact person: Fees due upon application ........................... $-
Address: _ _ Date received:
City- _ State: ZIP: Amount received ......................................... $
Phone: i ax: [i mail Please refer to fee schedule.
I hereby certify I have read and examined this applicatioi.and the Nat d)iundkdom accept credit cards,Plena cal Jurisdiction t«mexe inturmanon
attached cher"klist. A rovisions of I ws and oid�tnances governing this Uviu O MasterCard
work will be compli wt ,whether sifted Nerelfr t. Creat card numbs: — — _ ___1-
` ,, _ _
Authorized sl nate erne of ca,dhotder u shown on credit card
S
Z.
Print name: 4 LL]ezil 1 I AL Grdholder sipwure Amamt
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44o4613 t )WOM)
One-and Two-Family'Dwelling
Building Permit Application Checklist Reference no.:
Associated permits:
City of"Tigard City of Tigwd r)Elcctncal J Plumhing U Mechanical
Address- 13125 SW Hall Blvd,Tigard,OR 97223 IJ Other
Phone: (503) 639-4171
Fax: (503) 598-1960
t
1 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 plat/lot. _
4 Fire district approva. required. _
5 Septic system permit or authorization for remodel.Existing system capacity
6 Sewer permit. _
7 Water district_approval.
8 Soils report.Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan U permit required. Include drainage-way protection,silt fence design and location of
catch-basin protection,etr.. _
10 y3 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
if copyright violations exist. —
I I Sitelplot pian drawn to scale.The 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 2-ft intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot
area;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 remforrntg pads,connection details,vent
size and location. —-- -
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,wit-: ater,
furnace, ventilation fans,plumbing fixtures balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,Worsts,sub-floor,
wall constriction,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, Y
fireplace construction, thermal insulation,etc. / —
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable. _
I r, Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations:for
non- rescnptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations.Show attic ventilation. —
18 Basement and retaining waUs.Provide cross sections and details showing placement of mbar.For engineered
systems,see item 22 "Engineer's calculations." —
19 Beam ealculattins.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet;ong and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall,toof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be apph,_able to the project under review.
FMIII ILI Kit
23 Five(5)site plans are required for Item I 1 above. Site plans must be 8-1/2"x I l"or 11"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
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink,
Red ink is reserved for department use only. 4404614(b iCOM)
IYlechanical Permit Application
-- Date,received: Permit no.:
City of Tigard Project/appl.no.. Expiredate:
City of Tigard Address: 13125 SW flail Blvd,'Tigard,OR 9722.,, Date issued: By: Receipt no.: _
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: _— Payment type_
Land use approval: — Buildingpemutno.:
1
0 1 &2 family dwelling or accessory O Commercial/industn:d U Multi-fa:nil'; O Tenant improvement
>(New construction 0 Add ition/alteration/replacen,ent U Other:
1711;UNIA011 1 in 1
Job address: (rj r,)lr'\i I, c 'NC, Indicate equipment quantities in boxes below.Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account ro.: profit. Value$
Lot: Block: Subdivision:�, (� 'See checklist for important application information and
Project name: - jurisdiction's fee schedule for resi(icntial permit fee.
City/county: ZIP: I T_010
Description and locatbn of work on premises: 1 r 10 1 x 11 s f l 1
Eer(ea.) "Total
Est.date of completion inspection: A -Description qty. Res.only Res.only
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned?O Yes ❑No Air conditioning(site plan required)
Is existing space insulated?0 Yes 0 No A teration o existing A system —_
Boiler/compressors
State boiler permit no.:
Business name: t HP —_Tons BTU/H
Address: ue/smo e dampers/duct smoke detectors
City: Li State, ZIP: eat pump(site plan required)
Phone-. Fae: Email: instal rep ace rnac umer
Including ductwork/vent liner 0 Yes O No
CCB no.: nsta rep acdrelocatcheaters-suspended,
City/metro lic. no.: N/A wall,or floor mounted
Name(please print): _ ent for a Ian- ce other t an furnace
cfrigent on:
Abserpticjn units_._ BTU/H
Name `� _ Chillers __ HP
Compressors HP
Address: f •nr rountenta ex tst an rent at on:
City; State: ZIP: Appliance vent
Phone: Fax: E mail. erexhaust
rHoods, Typeres.kite Eeazmat
hood fire suppression system -
Name: -�� i Exhaust fan with single duct(bath fans)
Mailing address �� -% �/�, haust systema art from eaun or
AC
ue piping an distribution(op to -outlets)
City; State ZIP 1 Type: LPG NO Oil
Phone: 7' Fax: F-mail: ueTpiping each additiona over4out ets
roeess p
ping(schematic required)
Number of outlets _
Name: —_� i_ ter I ed applianceorment:
Address: Decorative flrc lace
City State: Z.IP: nsert-ty
Fay: F•mail: o stove/pe let stove
Phone
er:
Applicant's tlgnatu Date: % ter.
Name(print)
----� Permit fee $
�—
Noe all juri"cuons acceq cmW cards,please call)unsdscuon fur mae inrermmia+ Nodes:This permit application ..................... --
Minimum fee................S
0 visa 0 MasterCard expires if a permit Is not obtained
Cada cud numher _ __ - -- within Igo days after it has been Plan review(at _.__ c $
Y
---- -
--- accepted as complete. State surrhargc(896) ....S
Name of cardholder u Mown on cads card s TOTAL .
Cudholder apuute Amount 4464617(W COM)
Plumbing Permit application
Daterereivcd: Perntitno. =-
City of Tigard Sewer permit no.: Building permit no..
Address: 13125 SW Hall Blvd.Tigard. OR 01223
Ciry-fTigar1 Phone: (503) 639-3171 Prolect/appl.no.. Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Case File io. Payment type:
Land use approval: —
e a•
0 I &2 family dwelling or accessory 0Cummercial/industnal 0 'Multi-family Cl Tenant improvement
Vow construction 0 Addition/alteration/replacement O Food service 0 Other.
Int a lf-C Description 'Qty. Fee(f=.) 'Total
Job address: ��?(y' C% ` - ti New 1 and 2-family dwellings only:
131 dg. no.; Suite no.: (includes 100 ft.for each utility connection)
Tax_map/tax lot/account no.: -� SFR(1)bath _
Lot Block: Subdivision: �0SFR(2)bath
Project name: SFR (3)bath
City/coun:v: ZIP: F.ach additional hadvi Itchen
Description and location of work on premises: SiteunLn's:
Larch basin/area drain
Est_date of curnpletioruinspecuon: Drywellsileach line/trench drain
Footing drain(no.lin. ft.)
Manufactured home utilities
Manholes
Business name
Address: Rain drain connector
City: State ZIP: Sanitary sewer(no.lin. ft.)
Phone: Fax: Email: Storm sewer(no. lin.ft-)
--� Water service(no.lin.ft.)
CCB no.: (C,9-7 LPlumbbus. reg.no: - I
Fixture or item:
Cityimetro lic, no.: N,A J�; Absorption valve
Contractor's representative signature�____ i Back flow preventer
Print name IP,Ic 1 ;:7* I U _`� ' ) Backwater val—
NO -OWN
�,�,., --
Clothes washer
Dishwasher _
Address: 1c "V Dnniane fountain(s)
Cit" State: ZIP' Electors/sump
Phone Fax: E-mail: Expansion tank
Fixture/sewer ca
Floor drains/floor sinks/hub
Name (print): Garbage dis sal --
Mailing address: Nose bibb .
City .0 State ZIP: 17 Ice maker
Phone , !,F•a.,.: 7 7N Email: Interceptor/grease trap
Owner instntladordresidential maintenance only: The actual installation P'nmcns)
will be made by me or the maintenance and repair made by my regular 1 'Nof drain(commercial)
"Ownen-s
property I otvn as per ORS Chapter 447. Sink(s),basin(s), lays(s)
re: _ Date: Sump
Tubs/shower/shower pan
Unnal
Name _ W ater closet
Address: Water hea
Cits v State ZIP: (;then-
Phone--- Far: E-mail. 1"oral
Minimum fee................S _ -
Not all run"cuoru xcepr crtdu cud&,ptesm can lunsdreuon for mare,nfamution Notice*This permit application
C V133 O MasterCard -�_ expires if a permit is not obtained Plan review -•_- %) S
C.edlt card number within 180 dais ager it has been State surcharg;ee(8%) ••••s -----------
L{apuer TOTAL ...S
accepted u;ompletc """""""""••
Nuri a catdfwlder it uw*n oe credit cud S
CYdhmder a arute Am„ani 4gJd16lt1WR70M1
Electrical Permit Application
Date received: Permit no.ti i�.U!"I'le)
Projectlappl.no.: Ezpiredate:
City of Tigard
By: Receipt no.:
Address: 13125 SW Hall Blvd,Ti .rd.(�R 9"7223 Date issued:
City of Tigard Phone: (503) 639-4171
Case file no.: Payment type:
Fax: (503) 598-1960
Land use approval: ^_.------ -
L)Multi-family 0 Tenant improvement
O I &2 family dwelling or accessory Q Commerciallindustrial U Partial
New construction Addiuon/alterat;onlreplacement O Other._
� t �
14 Bldg.no.: Suite no.: Tax m=p�tax lot/account no.: _
Job address: ') �V
U)t: Block Subdivision:Ul i uo and uon of work on premises:
Project name:
Descrip —
Estimated date of completionTiinspection: l
Fee Mas.
Qty. !�) Tonal no.lncn
Job no: Description
Business name:
\ Wen reddentw-;; or multi-family per
s: dwelling unit.includes attached garage.
Address: Sen;«included:
City: State: ZIP: 4
1000 in.h.or less
Phone: 7j - I Fax: E-moil: Each additional 500 s .ft.or noon thereof
2
CCB no.; Elec.bus. IIC. h0: Limitedenergy,residenud 2
ted energy,non-residential
C' Foch manufactured home or modular dwelling
/ 2
Dote Service and/or feeder
aturtn/suprrvurn tlrArldon(rrqulrrd) Services Or Feeders-htstallalion,
t License no alteration or relocation:
Sup elect r inciprinti 2
200 amps or less 2
201 amps to 400 amps 2
Name (printf. ` 401 amps to 600 amps 2
Mailing address: ti 601 amps to 1000 amps 2
Stale ZIP: Over I W amps a;volts I
City: c , Reconnectonly
Phone: - Fax: _'7 mail:
'temporary services or fecden-
Owner installation:The installation is being made on property I uton insiallation,alteration,orrvlocatlon: 2
which is not intended for sale, lease,rent,or exchange according to 2a)amps or Irss —
i
ORS 447,455.379,670,701. 201 amps to 400 amps 2
Date. 401 to 600 am s
Owner's signature: _ __ Bunch circuits-new,siteralion,
a ?t or extension per panel:
A. Fee for branch circuits with purchase u 2
Name: -- service or feeder fee,each branch circuit _
Address: B Fee for branch circuits witha't purchase 2
--
State: ZIP:
City: -- of service or feeder fee,first branch circuit: - —
_-
Phone:
Fast: E-mail' Each sdditional branch circuit:
mlmiml
Mbe.(Senlce or feeder not included): 2
Will =MMM Each amp or irrigation circle 2
O Service over 22.5 amps-urmmercial U H°altn tine►auluy Each- sin or oudine'ighting
U Service over 320 amps-toting of 11¢.2 U tiatnrdous location g
Si nil circuit(sl or a limited energy panel. 2
familydwellings U Building over 10,000 square feet four or
Alteration or extension'
U Systeni over 6o0 volts nominal more msidenutd units in cne structure -
O Feeders.400 strips or more •Desch uon _ - -�
I]Occupant
10Uthree stories p Each additional inspection over the allowable In any of the-bore:
U Occupant load over�persons U Manufactured structures or RV ark _
•Egress/lighungplan U Mer --- - Perinspecuon
Submit sets of plans with any of tine above- InvesD�ertiaeon fee
INC above are not applicable to temporary construction service. �._—
Permit fee.....................$ __-- --
ion
11xlicuons rmp criidii cards,pksae till juriidktloo for morn intarmaucri Notice:1feS if 8r permit is notrobttained
Plan review(At —. `1b) $
Visa U MaaterCud ', // within 1St)days after it has been State surcharge(8%) ••••S
Ciotti,card number _— F TOTAL .......................S ----- ---
accepted as complete.
N��caNMilder u rhowo nn a n e $ 4444615(600iCOM)
Cardholder signature ---- Amount
lotDON - MORISSETTE OBE : 28vi
HOHE9 INCORPORATED LOT: 49
4 2 3 0 G A L E W O O D 9 T R E E T
LAKs 09V9G0, OREGON 97035 DATE: 8/3/03
r503> 3e7 - 7538 PAZ (e03) 3e7 - 7e15
PROPERTY: WHISTLER'S—WALT.
CITY: TIGARD
SCALE: 1"=20'
PUN No.: 188
OPTION 1 ELEVATION
ui
ry A
I I
EASEMENT
_
323' --- X
f324
----
f. 3S2 eq. Ft.
T�
� i�• •..6'`. FFE. 324_ ,
N
J I Y _6.••�' � i f4
I Bm0 sq. is
3 bdrm.
I I 2 bath
I I FFE. 3255'
� I I
I
ne
313
ill
I
i 1
A
LOT COVERAGE LES-iEND
LOT ARE" Y .7
BUILJING AREA :? LOT 049
PERCE'v'"Ge. Ile EIR L E'dR (� � eq. Ft. ,
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00493
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/19/03
SITE ADDRESS: 13610 �W 122ND AVE PARCEL: 2S103CC-10200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 049 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALo: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Irrigation backflow _
FEES
Owner:
—� Description Date Amount
DON MUFtISSETfF HOMES PLUMB ermit Fee ` 9/19/03 $36.25
4230 GALEWOOD STREET
SUITE 100 I r.gXj State Tax 9/19/03 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 274-5223
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503-692-5945 RP/Backflow Preventer
Final Inspection
Reg #: PLM 7804
This permit is Issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Cregon law requires you to follow rules adopted by the Oregon
Issued By: r rl ``' Qiy,� _,� Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the i ext business day
;ep 1.1 03 1F': 04p dan edmands 503-692-0768 P. 3
Plumbic Permit Anpli Lion Itcaca vd Plurrrbis�g
e Pcxmit wo.-
ri L'` Ptaming Approval - ---- Sewer
City of, Agard mwcy: _remit Na.:
13125 SWI Hall Blvd Plan Req'cw Other
Fester@ No-:
-I'igard,Oregou 97223 post..ftvicw - based Use
Phone: 501-639-4171 Fax: 503-59.x;t,96o pt, y� Cox No.:
lrttemet: Www.ci_tigutLor.as '1 `�I, cRtntact iuiis Sex loge 2 for
24-hour)"spectin Rrqucsv 503 9 175 P.Ar -IMeth.d: _ suppiement LI tnformsdorl.
�i TYPE"OM WORK FE1[ 'SCE�DUGR-(fjrt0edalinfbrM2U0II ase Checklist
cw constnwtion
_ _ DemwhtivnDescriptionetr. Fer(ca.) Total
Additiudaltcra>ioil/replaceincut [�Other: 4N 1-•dr'7,-[Dimity dtaellings
(irsdradi IIN R rir ire tEAtj wnu_e~tian
_ I :-.CATEGORY OF CONSTRUCn0N. SFR 249.20
4ACCCS�2g
&2-Familydwelling _Comtnerci&Wustrial -SFR 350.00
Building Multi-Falmd'y SFR(3)bath 399.00aster Builder (Other - Hach addieimrtal batblkitclten -_"- 45.00
JOB SITE INFORMATION and ji CATION Fi inklcs sq_R: - °
Jo o site siddress: 31<� cs si.0 1 a X raj. S"abe vtlT_-_ities�
Suite#: BW ! t.# Cwch basd�� -- 16.60 _
clVleach line tmch drain 16.6.0
Project I4Atrte'i.W KA 0•1-eYS I-l. _ ":/ • _ Fov' drain tto.liars R) ---- - Pagt z
Cross sirwtions to job site: Manuf wtun l home oaliries 110.00
mwdwlra - -- 16-60
S �"�' , 1°� `7 " - Rain drain connecW - T 15.60
Solitary newts oo,lita�ar� Page 2
Suhdivis�ltln:" t! Lot Su m sewer(too.linear 9 _ _Pae 2 -
Tax ivi I M. water st2triCC(ao.liner int ,_. t 2
Aid-Grelit item
DESCRIlT10N.QilrWORK - Abwet* m valve - 16_.611 _
Ii LX-/7 xt Back(low prcvcstter j_ �. "
Gl.0 Uf C<. __ Back watm valve 16.60
Cwhcs,nraastaQ - 16.60
Dish wsshm _ 16.60
fountain-� _ -- -16.60
011RRf'Y:�OWNLR T�lTIOIANT 16.60
Name: G s S Cao: ZqY e sEupaasm tank _- 16.60
Address: O G[2 4giucczb 4rr - Fitbumisewert�aE-_. ._ 16.60
City/StBtdMp: LWe- dSctrc Q QR-q7 Fkpordraitr/iloorsmkFaub -- - 16.t , --
Garb%ge disposal 16.6
Ph nc:I Fax: [law bib - 16.60_
;PLICANT CONTACT PER".`; ke rNbm
Inoeroeptndgtea- trS! - - - 16.60
prism. 16.60
Addresk: aU[j► tt) !YI
90 _
Medical,-nos--value- s rage?
Ci tkwzw" -7UA4A-e7,,L 6/0- Roof dtaio1oormaaeiat) 1 G.GO
Phone: Loyaip6 Fax: U3_/a9u1 - 6-14,,P Sial u,navato- r�-- ---- - 16.60
E-mails '11"xb show.m _ - 16.60
CONT'IUCTOR:':4 - thinal 16.60
Business Name: + arS C �►-2wttrrr closet 16.60
Address:/�Aa0C, 4LO /'h c ,$,/[3-Y► " water heater -- i 6.60 _
t»:
Ci /StistdZiP--,r1ic�Ctrt. _021.7 o(0 j,
Phone��n3 ��4a - 5-9�[. Fax:5W (092 -O7C- ----:- -��umning•t trFen•
CCB Laic. #: rr0 Plumb.Lic.#: - ---- _ Su7"0btDtal s
Authwi Mflow M Paann Fm STLSo s
Signatur l��/!_ _.1-t, c�-)Dsfe:4 R�sidattn_I fiadcflow�Mfnianun
_ Plain Review 25%of Pray;t pte) s
_ f* sn 0.1'I'L►z lJ c� r _---- She Sumboffne am of Pe mit Fee S e? D
mise print soots) - _ _ _ Tta'I AL PF;Wq Wl S S
Natire: 'MIs jwnwit ap'iem0mo mpim If a pas oft Is rest obtaitrtst vMWn Ap weir r.uaratrehl diiagc rrspairy 2 sets of pisas with tcometric nr
I BD days atter it bas been accepted as riser disgrss tar plun rr tiew.
"Fre methodology ser by Tri.Counly Building Industry Srrv!cc Board.
CITY OF TIZ'aARD 24-Hour
BUILDING Inspection Line: (503) 639-4575 2-5 5
INSPECTION DIVISION Business Line: (503)639-4171
' EtiUP - -- --
; '-7
Received _ Date Requested-- " / --- AM — PM__ - __ BUP _-
Location ___� � 11 _Z42_2 - ` /'J�e--� Suite MEC
Contact Person Ph ( --) 20 `4F3 J PLM - ------_..
Contractor . ---- - - Ph (- ) , SWR .. ----- ---
BUILDIN — Tenant/Owner - - ELC
0o ing ------ ELC
- --- --
Foundation Access:
Ftg 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
Susp'd Ceiling -_ -- - -
Roof
ger.-____------ - - ------ - - -- _-- _ -
Fina
_FAIL ---- ------- --
-Post& Beam -
Under Slab ---- --- ---
Rough-In
Water Service --- -- --- --_ ---
Sanitary Sewer _
Rain Drains - - ----
Catch Basin/Manhole
Storm Drain -- ------- —ShowerPan
Other-
al --^ ----- -.----
$ .PART FAIL ------...----------
Rough-In - -- - - - -- ------ --
Gas Line
Dampers _- __ ---- - ---- - — --- _...
FI
AS, PART FAIL ---- --- - ----__ .-____
Rough-In --- ---
UG/Slab
Low Voltage -- --- - -_- --- ----- - - -- - -
Fire Alarm
T FAIL Reinspection fee of$ _-. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SS BAR
_. -.. -
Please call for reinspection RE:_____-___ __ _ ._ __ 0 Unable to inspect--no access
Fire Supply Line /
ADA 10jDate IInspector
Approach/Sidewalk
Other: _
Final -- DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
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crry OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP _
Received _.__—_Date Requested_-_fid. _ AM PM BUP —
Location __/S Ce 10 n� Ave, ____Suite- __ — MEC _—
Contact Person -_-- e le,, —�. PhLM
Contractor T— -- —_ Ph SWR _—
BUILDING Tenant/Owner __ ELC -_
Footing — ELC
Foundation Access:
Ftg Drain EL.R _.
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear
---- - ------- _._----
Shear Anchors -
Ext Sheath/Shear _ _-
Int Sheath/Shear
Framing -- -------- - - ---_ - - --------------- -_-�
Insulation
Drywall Nailing - --- ---- ------ --_-___ -- ---.�--
Firewall
Fire Sprinkler ------ -- --- --- - - - - ---
Fire Alarm
Susp'd Ceiling -
Roof
Other: -- - ---- A—
Final
PASS PART FAIL - ----- �--- -------
PLUMBIN_G _ ------_
Post& Beam
Under Slab -----_ ----- --- - - --- -
Rough-In
Water Service -.� -- -- - --- - ------ -
Sandary Sewer
Hain Drains - - -- -- - - ----
Catch Basin/Manhole
Storm Drain - ------ - --
Shower Pan
OtheS; O1Ai' -- -- - ---- ------ -
F:crdl s
PA PART FAIL _ - - - --- -- ---------- - - ------ - ----
CHANICAL �-
Post& Beam ----
Hough-In ---
Gas Line
Smoke Dampers - -- - —
Final
PASS PART FAIL -"---- - -_ - -- ---`
ELECTRICAL
Service _� - -----
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final u
PASS PA'?T FAIL Reir3pection fee of$_ required beto-e next inspection. Pay at City Haii, 13125 SW Hall Blvd.
SITE n Please call for reinspection RE:_- _-__ _- --__...-__ Unable to inspect-no access
Fire Supply Line I p
h3l
ADA
Approach/Sidewalk [late 1. _ Inspector --___ Ext
Other
Final DO NOT REMOVE this InsPectlon record from the job sift.
I PASS PART FAIL