13640 SW 124TH AVENUE ca
as
0
c
h
r
13640 SW 124"" AVENUE
\ CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT M PLM2003-00286
3125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/20/03
SITE ADDRESS: 13640 SW 124TH AVE PARCEL: 2S103CC-07200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 019 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING EACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURE-G LAUNDRY TRAYS: SF RA V I)R.-kINS:
SINKS: URINALS: GREASE TRAPS:
L.".VATORIES: OTHER FIXTURES:
TU1313HOWERS: SEWER LINE: ft
WA l'ER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: it
Remarks: Instill iriq itic n backflow preventer.
Owner. —.----.FEES
. — -FEES
- - — Descr;ption Date Amount
DON MORISSETTE HOMES INC - --
4230 GALFWOOD STE #100 IPLUM131 Permit I,ee 6/20103 $36.25
LAKE OSWEGO, OR 97035 ITAX]3%State Tar 6120/03 $2.90
Total $39.15
Phone : 503-387-7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUAL.ATIN. OR 97062 W::QUIRED INSPECTIONS
Phone : 503-692-5945 RP/BackfIrw Preventer
Final In,:pectlon
Reg #: 11I.M 7804
This permit is issued subj,sct to the t,jgulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and ail ether applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is riot starters 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
Issued By: ���. ,_. ec Ld(_. r j�� Permittee Sir,nature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Jun 18 03 01 : 27p clan edmonds �� 503-692-0760
� 1U�
Plumbing Permit Application tOROF WtUSEQNLY
-
Received/ Plumbing•---
llaWk3Y d. ' �� L Pcrmit
CityClof Tigard Planning Approval Scwrr
to Dat lny Pcmiit No.: _
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By. _ Permit No.:
Phone: 503-639-4171 Fax: 503-598-19.50 lost-Review rand tlsc
C_�tI JBY: Case No.Internet: www.ci.tigard.or.us Contra Scc Pare 2 Cor
24-hour Inspection Request: 503-639-4'75 Namr/Method: Supplemental Information.
TYPE OF WORK FEE*:SCHEDULE'for erW biformatlon use cheekllst)
ew constn action Demolition Description I Qty- IFec(ca.) T'atai
Addition/alte ation/replarernent _Other: New t-&24a.mlly dwellings:
C
CATEGORY OF ONSTRUCTION includes 100 R.for each u Ilty connection
Famil dwellin Commercial4ndustrial SFR. t bah 249.20
SFr. 2 bath
350.00 +
Accessory Building _ Multi-Family SFR 3 bath 399.00
Mastcr Builder El Other: Each additional bath kitchen _ 45.00
JOB SITE INFORNW1710N and LGCATION Fire sprinkler-sq.fL. Pae 2
Job site address: /.3 Ce 1/0 .3 6t /3 yr, Site Utilities
Suite#: B1dglP.pt.#: Catch basintarea drain 16.60
Project NamtAW1 rS/'1e!e:s toecL,+_ L-4;r /1-�j DrywclYlcach line/trctich drain 16.60
Fnatinx drain(nu.linear a.) _ Page 2
Cross street/Directions to job site: Map-:;actured home utilities 110.00
.5 u; /d/ S 7- A-Vr Manholes 16.60
Rain drain connector _ _ *16.Sanitary sewer(no.linear ft.Subdivision:Wh►St/er's t eStorm sewer no.linear R.-.(.)ate Lot#: / > 5. �Water service noline ar RJ
Tax ma,parcel#: (�S S /a S _ Flrture or lterd
•DESCR ION OF WORK Abso ion valve 16.60 _
C(S ee*�-69- 7-rI� &-Y?OYL. Backflow preventer - Page 2 ;47. SS_
Backwater valve 16.60
Clothes washer 16.60
Dishwasher16.60
__ -
OQER'i YOWNER TENANT '- Drinking fountain _ 16.60
-- -- E'ectors/sum 16.60
NamP: Expansion tank _� _16.60
Address: �3p SCJ
��(
t+.uaM ; t# FixturcJrewcr cap _ 16.60
Ci /State/Zl e_ 644,kr< U Okq•,ro.;y Floor-!rain/floor sink/hub 16.60 -
-- Garbage disposal 16.60
Ph ne: Fax: Mose bib 16.60
PLI 71e CONTACT rERSON Ice maker 16.60
Name:�f/ til liI�/p-LC,) __--T Interce toL!gease trap 16.60
Address: ,a pb S W /YI L1Y1 120 -_ Medical gas-value: S _ Pie 2 ,
City/Stategp-Moiay7r, /� _� Primer 16.60
Roof drain corrvncrcial 16.60
Phone:Sly (AA -!5-9y-6- �: 613 4090 - r);i Sink/basin/lavatory �- 10.60
E-mail: _ 'ruNahower/shower pan 16.60
CONTRACTOR Urinal _ _ 16.60
Business Name: L.,g,:ndS C`5Pt lD .1G Water closet 16.60
Address:/,X106 4LL;' rYl y S,/CT1!V Qt) Water hatter 16.60
Other
Ci /State/:ip:-ntatrx�f1�O� 16;(o,j, Other: -
Phone!503 tort j - 595 Fax: 563 (o9a _p7C.ki Plumbing Permit Feea•
Subtotal S
CCB Lic. #: �L, Plumb. Lic.#: Minimum Permit Fee$72.50 s
Authorized-'d Residential Flackflow Minimum Feat;� •?6. a.S
Signaturev�-��SII_ Date: /� U3 Plan Review(25%of Permit S
State Surcharge 8°.6 of Prrtttit Foe S
(Please print name) TOTAL PERMIT FEE S aq. I $
Notlrr '1 his permit a-rpllcatlon expires if a perndt is not obtained within Mi new eommerriai buildlegs require 2 sets or plane with Isometric or
IA(1 dais alter it Ir°i hecn acrepterl as rompleir rtset diagram for plan review.
*Fre methodology set b-Tri-County Building Industry Service Board.
May 9, 2003 (OREG(M F iIGA RD
Don Morissette
4230 Galewood Street#100
Lake Oswego, OR 97035
RE: NEW SINGLE FAMILY DWELLING
Project Information
Building Permit: MST2003-00153 Construction Type: VN
Acid ess: 1640 SW 120' ave. Occupancy Type: R-3
Plan # 170 Cottage opt. 1 Stories: 2
The plan review was performed under the State of Oregon Structural Specialty Code(OSSC)
199$ edition; the State of Oregon One- and Two-Family Dwelling Specialty(OTFDSC) 2003
edition and the Tualatin Valley Fire & Rescue Ordinance 99-01 (TVFR99-01) 1999 edition.
The submitted plans have been reviewed and the following information ;. r , aired prior to
issuance of the permit.
1. Please provide details for the deck shown on the elevations including the attachment
of the ledger board.
2. The engineering calls for 2' shear walls at the dont of the garage whereas the
foundation plan shows V-9"of concrete stemwall. The 7' height limit for these walls
exceeds the allowable height/width ratio. Please clarify how the sheathing diaphragm
will be constructed to meet the 3.5 to 1 ratio requirement.
3. Please provide detail for header attachment to center front garage shear wall and
show if header is continuous or spliced at this point.
4. Please provide floor framing plan showing headers for 3 car garage and provide beam
calculations for such.
When submitting revised drawings or additional information, please attach a copy of the
enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of
Tigard in 'racking and processing t12c documents.
Re--pectfully,
Marie VanDomelen,
T'lans Examiner
131 SW t fall Blvd., Tigard, OR 97223(503)639-4171 TDD(5503)684-2772
CITY
OF
TI ^ARD ,_, MASTER PERMIT
�j PERMIT M MST2003-00153
DEVELOPMENT SERVICES DATE ISSUED: 5/22/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
SITE ADDRESS: 13640 SW 1241-H AVE PARCEL: 2S103CC-07200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 019 JURISDICTION: TIG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: DM170 STORIES: 1 ____FLOOR AREAS_ REQUIRED SFTBACKS REQUIRED
CLASS OF WORK: NFW HEIGHT. FIRST: 1,510 51 BASEMENT: sf� LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE. SF FLOCK LOAD: 40 SECOND. 1,620 sf GARAGE: 641 sf FRONT: 15 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: I TISRD sf RIGHT: 5
OCCUPANCY GRP: R1 6URM: 4 BATH: I TOTAL: ].190 sl VALUE: 314,329.30 REAR: 15
PLUMBING
SINKS: 1 WATER CLO£ETS: 1 WASHING MACH: 1 LAUNDRY TRAYS: 0 RAIN DRAIN. 106 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS, SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASIN$:
TUBlSHOV IERS: I GARBAGE DISP. I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR. GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K BOILICMP<3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN—100K: UNIr HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP hlu FLOOR FURNAHCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
CLE.CTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp: 0 -200 anp: WISVC OR FOR: PUMPIIRRIGATION: PER INSPECTION:
EA ADU'L 500SF: 6 201 400 amp 201 400 amp: 1st W/O SVC/F DR: SIGH ..LIN L T: PER HOUR:
LIMITED ENERGY: 401 600 amp. 401 - 600 amp: EAADDL BR CIR: Slf,NALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp601-amps-1000v' MINOR LABEL:
1000♦aniplvolt:
PLAN REVIEW SECTION
Reconnect only: —
>m4 RES UNITS: SVCIFDR>-225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR L.NDSC LT.
BURGLAR ALARM: OTH: BOILER: HVAC LANOSCAPFIIF r ,. PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR:
HVAC DATAITELE COMM: NURSE.CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL. FEES: $ 5,861.43
This permit is subject to the regulations contained In the
DON MORISSETTE HOMES INC DON MORISSETTE HOMES INC Tigard Municipal Code,State of OR. Specialty Codes and
4230 GALE WOOD STE#100 4230 GALE WOOD ST,STE 100 ail other applicable Ihws. All work will be done in
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97085 accordance with approved plans. This permit will expired
work Is not started within 180 days of Issuance,or If the
work Is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503-387-7538 Phone: Oregon Utility Notification Center. Those rules are set
5 187 ) forih In OAR 952-001-0010 through 952-001-0080. You
Reg# I�l5i; may obtain copies of th,se roe-j or direct questions to
OUNC by calling(503;246-1967.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp
Grading Inspection PosUBeam Mechanics Plumb Top Out Exterior Sheathing Inst Rein drain Insp Electrical Final
Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Roof Nailing Mechanical Final
Footing Insp Crawl Drain/Backwo-er Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final
Issued By : s�lj ' A 1_ L _;�_ j L _ Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day
I
1
CITYOF TIGARD — SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00125
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/22/03
SITE ADDRESS; 13640 SW 124TFI AVE PARCEL: 2S103CG-07200
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: ul'� _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF.
Owner: -
- — ---- ---
DON MORIc'SETTE HOMES INC -------FEES
— FE --
4230 GALEWOOD STE #100 Description Date Amount
LAKE OSWEGO,OR 97035 SWUSA Swr Connect 5/22/03
l 1 $2.300.00
Phone: 503-387-7538 [SWUSA]Swr Connect 5/22/03 $0.00
[SWINSPI Swr Inspect 5/22/0:3 $35.00
[SWWSPI Swr Inspect 5/22/03 $0.00
Contractor:
ToCal $2,335.00
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 he forfeited if the permit expires. The Agency does not guarantee
lhp accuracy of the side sewer laterals If the sewer is nut located at the meas ;ment given, the installer shall prospect
3 feet in all directions from the distance given. If not so located, the installer shAl purchase a"Tap and Side Sewer" Perm
Issued by: T >< < « Permittee Signature:
Call (503) FS94175 by 7:00 P.M. for an Inspection needed the next business day
Building Permit Application GJ
City of TigardUatereceivcd: `t (5 03 Permitno.:j�4jA
City ojTigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: FxVKG date:
Phone: (503) 639-4171 Date issued: By V Receipt no.:
Fax: (503) 598-1960 Case file no.: — ` Payment type:
Land use approval: 18c2 family:Simple Complex:
U I &2 family dwelling or accessory Q Commercial/industrial U Multi-family ,,&New construction ❑Demolition
O Addition/alteration/replacement O Tenant improvement U Fire sprinkler/alarm U Other:
Job ,^ ti - v Bldg,no,: I.Suite-to.:
Lot: Block: Subdivision: t�" , 't Tax map/tax lot/account no.:
Prole name: --
Description and location of work on premises/special conditions:
Mailing address: L'V 1 &2 family dwelling:
City States( 'LIP: ) - Valuation of work...............
Phone: Fax: 7 _ ......................... $
mail: 77171
No.of bedrooms/baths................................. ,
Owner's representative: G I(1 Total number of floors.........
Phone: Fax: E-mail: New dwelling area(sq. ft.)
Garage/carptirt area(sq. ft.)
Nance. OC,ri HCA- l .��,,��,,,����� I Covered porch area(sq.R,) ........... .............
Mailing address: a;1ft'r1 V_ a(; ',\, I Oeek area(sq. ti.. ...............................
City State: I"LIP: '' :ucture area(sq. ft.,
Phone: Fax: E-mail: CommerciaUindustrial/mull!-family:
Valuation of work........................................ $
--
Business name: Existing bldg.area(sq. ft.) ..........................
Address: Z New bldg.area(sq.ft.)................................
City: _ State: ZIP: Number of stories........................................ _
Phone: Fax: E-mail: - Type of construction....................................
CCD no.: Gj 7 3 7-� _ Occupancy gre-jp(s): Existing: _—
Ciry/metro lic.no.: New:
7exempt
contractors and subcontractors are required to be
h the Oregon Construction Contractors Bard under
Name: L g" f ORS 701 mid may be required!v be licensed in the
Address: �� -- wher. w:, k is being performed. If the applicant is
Cit•: State: ZIP: licensing,the following reason applies:
Contact person: Plan no.:phonr FaxEmail: _
Name: _ _ Contact person: Fees due upon application _
Address: r Date received:
City. State: ZIP: Amount received ......................................... $
Phone: Fax E-mail: Please refer to fee schedule,
I hereby certify 1 have read and examined this application and the Not All iunuacnoru acceq c,rrar cards,please rail jurisdiction for more inromwtonn
attached checklist, rovisions of I ws and nidinances governing this U visa Q Mastercard
work will he comp) i , whether ified licrA ypot I Credit rad cimher.
Authorized si natu
� Mune of cardAois i�ershown on clad!!card
Rine name: 4 zfz1t I (-L--- _Cadhdder dpra:ure s Amouni--
Notice:This permit application expires if a permit is net obtained within 180 days after it has been acc,!ptcd as crnnplete. 440-4613(waCOM)
One-and'Two.-Family Dwelling
Building PermitApplication Cheeklist ftcferenceno.:
CiryojTigard City of Tigard Associated permits:
Address: 131.L, SW Hall Blvd,"Tigard,Ol!. 97223 U Electrical U Plumbing t7 Mechanical
Phone: (503) 639-4171 O Other: —
Fax: (503) 599-19bi)
1 Land use actions completed.See.junsdictioa 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 approval required.
5 Septlt system permit or authorization for remodel. Existing system capacity_ —
6 Sewer permit.
E7 %ter district apprnval.report. Must carry original applicable stamp and signature on file or withapplication.
n control ❑plan ❑permit required.Include drainage-way protection,silt fence design and location ofbasin protection,etc.
10 3 Complete sets of legible plans.Must he 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 r
_if copyright violations exist. X
1 I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if
there is rro a 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
L1area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
2 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details, vent
size and location.
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors, water heater,
furnace,ventilation fans, )Iwnbing 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,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,stair;,
fireplace construction, thermal insulation,etc.
15 Elevation views,Provide elevations for new construction;minimum of two elevations for additicns and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater titan four foot at building envelope.
Full-size sheet addendums showing 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 path analysis.provide specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member siring,spacing,and bearing
1<1
locations.Show attic ventilation.
19 Basement and retaining walls. Provide cross sections and details showing placement of rebar.For engineered
_--astems.see item 21,"Engineer's calculations."
19 Beam calculation.Provide two sets of calculations using current code,design values for all beams and multiple joists
over 10 feet long and/or any bears/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design detaW. --
21 Energy Code compliance. Identify the prescriptive path or provide calculations.A gas-piping schematic is required
for four or more appliances.
)( F
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by art engineer or
architect licensed in Oregon and shall be shown to he applicable to the project ander review.
Ka" ?MV—►
23 Five(5)
site plans are required for Item I I above. Site plans must be 8-1/2"x 1 I"of I I"x 17".
24 Two 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 ba accepted.
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440.414(&MICOM)
Mechanical P'ernut Application
D.termeivad: u / 0-j Per nit no. 3.-
Al� .1 City of Tigard Project/appl.no.: _ Expire date:
Cityofrigard Address: 13125 SW Hall Blvd,Tigard.OR 97223 patcissur4: By: Receipt
Phone: (503) 639-4171 -- -
Fax: (503) 598-1960 Case file no.: — Payment type:
Land use approval: Building permit no.:
t
=1 & ly dwelling or accessory O Commercial/industrW U Multi-family U Tenant improvement
ruction 0 Additionlalteratior✓replacement Ll '):her:
11 or
Wf'N COMMERCIAL NA11,11JAMON'S011EDULE
Job address: 1_ `( Indicate equipment quantities in boxes below.Indicate the dollar
Bid$.no.: I Suite no.: value of all mechart cnl materials,equipment,labor,overhead,
Tax map/tax lot/account no.: pmftt.Value$ —
-a—F-IT JBIock: Subdivision: ( 'See checklist for important-pplication information and
Project mune: { jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: rjo! t
1.
Description and location of work on premises: t t ( a' i l )r s t'sti y e ' tr 1311r
- Efx(e2.) Total
Est.date of compledon/inspection: Al:� Description Otyy. Res.only Rey.only
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned?1]Yes 0 No Au cin iuoning(site plan requve ) _
Is existing space insulated?U Yes O No Alteration of exist A system
of u compressors
State boiler permit no.:
Business name: HF Tons BTU/}i_
Address: ir^lsmoke dam r uct smoke detectors —
City: _ te ZIP: pump(situ an raquir )
�! Sta
Phone: _ Vy"Fax: Email: nsta rep ace mac urner T,
Including ductwork!vent liner U Yes El No _
CCB no.: ?� ���('-�_ nstal replace/relocate heaters-suspen ed,
City/metro lic. no.: N/A wall,or floor mounted —
ON
me(please print): _ L�u _ ent fora ranee o er an furnace
e geral on:
Absorption units $TUM _
me: `Va r-7 � Chillers HP _
C '�- Com res
HP
Address: av ronmenta a ust an ventilation.
City: State: Z!P: Appliance vent
Phone: Fax E-mail: ryere aust_755
s7'IypeP/ res.lutc a azmat
hood fire suppression system
Name: 'f Exhaust fan with single duct(bath fans)
Mailing address: ) �' Exhaust system:•)art fromheaun or AC—
Fuel p pin.-sudistribution(up to 4 outlets)
Citv: State* ZIP ) Ty : LPG NG Oil
Phone: y 7- =ax: E-mail: tiepipingeac a itiona over outets
Process piping(sc emancrequired)
Number of outlets
None: ( t�Tser 1WR appliance or equ pment:
Address Decorative fireplace
Cite ---- — -_--- State: ZIP: nsert-tykeV5W _ --
Phunc - - ----- Fax^ E•malr. stovu:/pe etstove
Other.
Appflcant's sign vru Date: [ ter.
Name(print) . I)'I
Noi W1 Juri"cuoru wctpi neral cards,pleett cdl puiwticnMOO.on for me udofnu(ian Permit fee ................ --
Notice:This permit application Minimum feeee $................S
O Visa U MasterCard expires if a permit is not obtained
Credu card numhet ___—___ — within 180 days after it has been Plan review(at _- 96)
tplrtt State surcharge(896) $
$
accepted as complete.
None of cardholder u shown ar crtdir cam- TOTAL ......................$
Crdholder ti`rsture Amour 44DA611(WOOL'UM)
Plumbing Pert it Application
IDa recet,-ed: y j6 n 2 Permit no: l r
City of Tigard Sewer pernut no.: Building permit no.: ,
Address: 13125 SW Hall Blvd.Tigard• OR. '? { --
Ciry„/Ttti,ir'i Phone: (503) 639-4171 I'rolect/appl.no.. Expire date:
Fax: (503) 598-1960 Date issued. By Receipt no
Land use approval: Case rite no.. rPayment type:
1 '
O I &2 family dwelling or accessory ❑CommerciaUindustrial O Multi-family U Tenant improvement
New constriction U Addition/alterition/replacement U Food service 7 Other. —
;Job address:
,� �_ I- �L +- [ascription Qty. Fee(ea.) Total
� ,�• �L ,Jy_ _
Bldg. no.: Suite no.: - Nen 1-and 2-family dwellings on!y:
(includes 100 ft.for each utitity eonoeetion)
Tax map/tax lot/account no.: SFR(1)bath
Lot: J,c. 1 jBlock: Subdivision: SFR(2)bath
Project name: SFR(3)bath
City/county: ZIP: Each additional bath/kitchen
Description and location of work on premises: Siteutilities:
_ Catch basin/area drain _
Est-date of completionrnspection: Drywells/leach line/trench drain
Footing drain(no. lin.ft.)
Manufactured home utilities
Business name- IN9_A
� L,I) J I�_ ManholesAddress: Rain drain connector
-i � Soni saver '•Cit). State• 'LIP: Lary (no.un.ft.)
Phone: -�' Fax: Email: Storm sewer(no. lin.fL)
Water seivic�(no.Fin.ft)
CCB no.: "Z t_ Plumb.bus. reg. no: - Fkture or item:
City/metro lic. no.: NIA % Absorption valve _
Contractor's representative signature��_ Back flow pmventer — -
Ptint name: h U Backwater valve i
Basins/lavatory_
Clothes washer
Name: _
Dishwasher
Address: 1r "V Drinking fountain(s)
City: State: ZIP: E ectors/sum
Phone: Fax: E-mail: Expansion tank
Fixture/sewer ca
Floor rains/floor sinksthub
Name (print): Garbage dis sa:
Mailing address: Tobibb
City: _ ) State ZIP: Ice maker
Phone: - Fax: 7-70 E-mail: Interco for/grease• ap
Owner instaf/adon/resldendal maintenance only: The actual installation I Pnmer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(com !rcial)
employee on the property I own as per ORS Chapter 447. Sink(s),basins lays(s)
Owner's signature: Datc: sum
Tubs/s ower/shower_pan _ —
Unnal
Nam, _ Water closet
Address: Water heater
Cit} State: ZiP: Other. _
Phonr�� _� Fax: E-mail: ,� Total
---- - --r
Na all un"ruotu ace mdii cudi. kme call unutrnion a mote mrarrnauan Plan
fee............ ) S r _
i r� v i Nrlice:This permit application Plan review(at �- `�) S --
O M9sa ❑klaererCud a<pires if a permit is not obtained
Mate surcharge(84{0) ...•$
Credit card number within 180 days after 1t has been -_
•Rprret TOTAL .......................$
_.
Nurse of cudhoWn u rho+n on credit card accepted as Complete, ——
f
Canlholdu up+uurt Amwnt 4xr.-uS16(6 OCOM)
"P
Electilcal Permit Application
rDatcremcrcived: is lo-l) Perr ut no.:q,,1 •.(x�(r j
City of Tigard Project/appl.no.: Expire date:
CiryafTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: BY: Ru eipt nom:
Phone: (503) 6394171
Fax: (503)598-1960 Case file no.: Payment type: -
Land use approval:
TYRE OF r
❑ I &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family ❑Tenant improvement
New construction O Addition/:dterauott/replacement ❑Other. El Partial
JOB WE IN FORMATION
Job address: t V=77Bldg.no.: Suite no.: I Tax map/tax iotyaccount no.:
lot: �_ Block: Subdivision:
Project name: Description and location of work on premises_
Estimated date of completionlinspecaon:
a t
Job no: `et max
——_."- -- Dencripron Otv. Ira.) I Total nu.in%p .
Business name: _� NewresidmtW-singleormuhi-farrulyper
Address; ) dwelling unit Includes attached garage
City: �(.� State: ZIP: serviceincluded:
I0W sq.ft-or less _ 4__
Phone: �j- 1 Fax: [-,-mail:
- —
Each additional 500 sq.ft_or portion thereof —^
CCB no.: EIeC. bus. IIC. no: united energy,residential
C: Limited energy.von-residential 2
Each manufactured home or modular dwelling
start o su ervrrtn etedAelan(re ulred) Date Service and/or feeder
Services or feeders—hntallation,
Sup elect namelpnntl 1 License no
alteration or ml. 2tion:
U.11111 id (A).Amps or less 2
201 amps to 400 amps _ _ 2
Name(print): M 401 amps to 600 amps —� 2
Mailing address: r 601 amps to 1000 amps _ 2
City: c s State CK LIP: Over 1000 amps or volts _ 2
Phone: - Fax: -^] rr all: Reconnectoi,ly I
Owner installation:'[be installation is being made on pro n Teraliatirysererativices orfeedeoca
hsstallatlon,alteration,or relocation:
which is not intended for sale, lease.gent,or eschfnge according to 200 amps or less 2
ORS 447,455,479,670,701. 201 amps to 400 amps 2
0%%ner's signature: Date: 401 to 600 ams 2
Branch clrcwits-new,alteration,
or txtension per panel:
Name: _ A Fee for branch citt:uiL with purchase of
Address: service or feeder fee,each branch circuit — 2
City: Stale: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: — 2
Phone: Fax: E-mail: Each additional branch circuit:
t Misc.(Service or feeder not Included):
O Service over 225 amps-wnunercial O Healthcare facility FAch pump or irrigation circle 2
OService over'f2Uamps-rating ofldr1 Otlazardouslxation
Each sign or ontiine lighting 2
frtrttilydweihngs U Building over 10,000 square feet four or Signal circuit([)or a limned energy panel,
U System over 600 volts nominal mim residential units in one structure alteration,or extension• 2
O Building over three stories O Feeders,400 amps or more *Description _—
O Occupant load over 99 persons O Manufactured swctura or RV park 1 sch additlonat Inspection over the allovrable in any of the above:
O Egress/lightingplaa U Other _ — Per inspection
Submit_sets or plans with any of the above. Investigation fee
The above are not applicable to temporary comtrvction service. Other
Permit fee.................... --
Na all jurisdictions accept errant cards,please call ludwictioa for more informauan Notice:This permit application Plan review(at _ 96) 5
U visa U MasterCard expires if a permit is not obtained
Credit card nun•tw _ L— within ISO days after It has been State surcharge(896) ....$
pil
es accepted as complete TOTAL,
Name of cardholder as shown on credit card —
-----Cardholder upiuure � s .;tv�uN 44446I1(6M'OM)
L-! a? O=3t�
DON ° MORISSETTE O : 2789
80Yaa INC0RP0FATZD LOT. 19
4 a 3 0 0 A L E M O 0 D 8 T d Z )lE T
LAI ! 05WZG0, 0 2 1 a 0 N 970 . 5 DATE: 4/9/03
(eo3) 387 - 7538 VAX (503) 387 - 7815 PROp',�R' : WE STLER'S-•WAL8
Cll l: tIGARA
SCALE: 1"=20'
PLAN NO.: 170
OPTION 1 ELEVA11ON
V %
FIECE
APP 15 2003
n_ E i F`IVISioN
u 331 104.00' J, 319 I ,
,f I
-� (11 - 330 _ 1
DECK
3,1W 8a Fr. 1
I I 33¢ 4 SWRM. r'
1 Iri HATH
gE._ER .r I FF3:. -330b,
I } 641 8a FT.
1 3 CAR GAF
1 r FFE_ -330.0' ;� I
1 111
37• I
1 I /
33C
�ua-Be J q 1 II
1 AD
331 l I
I
N I 104Z.01.�
10401
J
i
t
041
F
L
L
F
F
LO? COVERAGE LEGEND
9 LCT AREA: 6..:sC SC. F"
BUILDING AREA. 2 365 SG F• r_;.e euep L07 '19
A PERCENT-\GE 31 o h�4a 8C�_ Ft
A
Mtrraoo5_00 Ls3
PITY
5 u,+ L,� na i nal- wsrk- Haar 1�-0 W440-
�dj�St
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (50'3)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 M:�T
BUIJ
Received __ pate Requested /� ' a g A"A __
PM BUP —
Location _ . -- 3(e '�U L ��`KSI P$v-V-e -Suite MEC ._
Contact Person __ _ Ph (_-__.) ___ _ PLM
Contractor---------------- -_.-- - Ph ( - ) _..-- _-_--- SWR
BUILDING _ _ Tenant/Owner ELC
Footing
FounJatron Access: ELC __--
Ftg Drain ELR
Crawl Drain --
Slab Inspection Notes: SIT —
Post& Ream -- ----- --- --
Shear Anchors ------- -
Ext Sheath/Shear
Int Sheath/Shear -----
Framing - ------- -- -- -- _..�-- --
Irsulation
Drywall Nailing ---- -- ----__�--- --- --- --- -.
Firewall
Fire Sprinkler
Firo Alarm
Susp'd Coiling
Poof
Other: - ----
Final
PASS PART FAIL -- --- -- �� ----
PLUM_BIN_G_
Post& Beam
Under Slab - ___-_ --
Rough-In
Water Service
Sanitary Sewer
Rain Drains - ---- ---—
Catch Basin/Manhole
Storm Drain - - - -
Shower Pan
Other:
t
W4ss'!F ART_FAIL --------- - -
CHA��tCAL -- -
Post&Be,'m -- -
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL - - --- ---
ELECTRICAL
Serjlce --- - -- - -
Rough-In -_
UG/Slab -----�
Low Voltage _ -
Fire Alarm
Final 11 Reinspection fee of$ _ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE:_ -_ - Unable to Inspect-no access
Fire Supply Line
ADA
Approach;Sldewaik In+sp Oct -'t/'� Ext
Other:
Final IQO NOT REMOVE this Inspectlon record from the job site.
PASS PART FAIL
�►♦AAAA♦AAaAoAAAAAAAAAAAAAA►AAAAAAAAAAAAAAAAAei�
9Al
►
con
NI
y
14
►
0. �-+ 70 ►
d d o o ►
- , TOJ
2 Oil
►
0
VN
b ;
44 poll►
4 ►
4 I►
CD
CD
ry °
<
w � �
^A
CD
° IT N
W �
et
G.
r-.
n (�
s -
1
� rQ
Tr
° -
O K �
0
c
3
d
z
3
x
CITY OF TIGARD 24-Hour
WILDING Inspection Line: (503)6,39-4175 MST 3 —Gd
INSPECTION DIVISION Business Line: (503)639-4171 BUP — — —
Received Date Requested �— `� -- AM PM BUP
Location _.__-____ �[t_ ___ `. - '�= -—�'uite —.— MEC
Contact Person Ph 3 PLM
l --)� --
Contractor__-- ------- — - ---- Ph - ) -- - SWR — -----
BUILDING Tenant/Owner _--_ _---_--- — - - --------- ELC --- - --
Footing ELC —�
Foundation Access:
Fig Drain ELR
Crawl Drain — SIT
Slab Inspection Notes: --— —
Post& Beam -------- --- - - — - - ------ r_.
Shear Anchors
Ext Sheath/Shear 11 ---- "—--
int Sheath/Shear -----
Framing
Insulation
Drywall Nailing
Firewall —
Fire Sprinkler
Fire Alarm _ --�__--
Susp'd Ceiling
Roof --
Other:
PASO--
PART FAIL — —
MBING—J _— ----- — --
Post& Beam ^
Under Slab — -Rough-in
Water
Water Service --------
Sanitary Sewer _
Rain Drains ----
Catch Basin/Manhole
Storm Drain —
Shower Pin —
Other. J --- ---- --
Final — --- -
&I—PART FAPL
MECHANICAL — -— --- --
Post eam
Rough-In -------
Gas Line
Smoke Dampers —
na
P ART FAIL - -- -- -- - -
'ICAL — -- -
Service
Rough-In --
UG/Slab
Low Voltage --- -- -
Fire Alarm
Final Reinspection tee of$___— -._required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
__— -------- Unable to inspect--no access
SITE [ Please call for reinspection RF
Fire Supply LineADA —
Approach/Sidewalk
Date . ,7 ' Z `�' 3 Inspector Ext
__-
Other: . .
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITU' OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST 3
INSPECTION DIVISION Business Line: (503)639-4171
�� BUP
Received --.-..----Date Requested- -7 7_ -�__ AM PM _ BUP _
Location � O _� V-�'l_ prv--� _Suiteeq - � _ MEC
�, (�
Contact Person _ _ _ - Ph( ) -'�-e7 ''01 -
Contractor____ _ _ Ph(_--) SWR
BUILDING Tenant/Owner _- _ __- ELC
Footing - --� ELC
Foundation Access-
Ftg Drain ELR
Crawl Drain SIT
Slab Inspection Notes: —-
Post& Beam
Shear Anchors -
Ext Sheath/Shear - - ---
Int Sheath/Shear
Framing ------- -- ---- ---
Insulation
Drywall Nailing
Firewall �-
Fire Sprinkler C
Fire Alarm
Susp'd Ceiling -- -
Roof
Other. —_
Final _
PASS PART FAIL
PLUMBING_ _ — -
Post$ Beam
Under Slab
Rough-In
Water Service - —
Sanitary Sewer
Rain Drains
Catch Basin/Manhole _
Storm Drain
hower Pan
=HAN-ICA-L
PART FAIL - - -
- ----- - - - -----
Post& Beam
Rough-In - - - - --- - --
Gas Line
Smoke Dampers --- - --------
Final
PASS PART FAIL - -!-
ELECTRICAL
Service -
Rough-In
UG/Slab
Low Voltage -- --- - -- --
Fire Alarm
Final Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL.
—-----
Please call for reinspection RE: __ l Unable to inspect - no access
Fire Supply Line -,
ADA Date Inspector " Ext
Approach/Sidewalk —
Other:
Final DO NOT REMOVE this Inspection record from the job site..
PASS PART FAIL
CITY OF TIOARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received _..-_Date Requested__ 7 ^ ;- J_-__ AM--- PM--- BUP _
Location __ Q—_.�s.� -=_ _
Suite----- MEC
Contact Person _ _ _ ., Ph( ) -� -i �, -�—y PLM
Contractor ------ ---- — Ph —) - -�-- SWR
BUILDING — Tenant/Owner -- _-_ - — ELC
Footing ---------—
Foundation Access: '— ELC
Ftg Drain ELR
Crawl Drain ------._--_
Slab Inspection Notes: —" SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ----- --------_
Framing _—_—
Insulation ----- — - ---. ---
Drywall Nailing --- — -- -----_------ --- — _
Firewall
Fire Sprinkler ---- _. —_
Fire Alarm ----------- ----- ------
Susp'd Ceiling ----------..._._
Roof _ —
Other. --- — -------- ------
PASS PART_ FAIL -- —_—
PLUMBING
- ----
est 8 Beam -- --
Under Slab
Rough-In
Water Service --
Sanitary Sewer -- -
Rain Drains
Catch Basin Basin/Manhole
Storm Drain -
ower Pan
Other:
Final
PASS PART-FAIL -- - -
MECHANICAL
—PuBeam---.__
sl 1i - -
Hough-In
Gas line
Smoke Dampers
Final -
PASS PART_FAIL
EL
ECTRICAL
Service ---- — -- - --
Hough-In
LOW Volta
-- - ---
rre arm -
-PABS RT FAIL Reinspectlon fee of$— _- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE _. F] Please call for reinspectiun RE: _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Gnts Z Inspector
Other - i v-�-r �
Ext
Final DCS NOT REMOVE this Inspection record from the b sits.
PASS PART FAIL