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12213 SW HOLLOW LANE N N W O O r m •�k 1 1?.213 SIV Hollow -are CITY OF T I G A R D --- MASTER PERMIT PERMIT#: MST2001-00407 DEVELOPMENT SERVICES DATE ISSULO: 8/20/01 13125 SW Hall Blvd., Tigard. OR 9722.3 (503) 639-4171 SITE ADDRESS: 12213 SW HOLLOW LN PARCEL: '_z 103CB-05700 SUBDIViSICN: QUAIL HOLLOW - EAST ZONING: R-4 5 BLOCK: LOT:006 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS RECIUMED CLASS OF WOPK: NEW H-GHT: 23 FIRST. 1.701 at BASEMEN I: --at LEFT: 5 SMOKE DETECTORS: Y TYPE OF U,3E: SF FLOOR LOAD: 40 SECOND: 154n at GARAGE: 675 at FRONTPARKING SPACES TYPE OF CSr1ST: 5N DWELLING UNITS: 1 FINBSMENT at RIGHT: S VALUE: S 262.256 00 OCCUPANCY GRP: R3 BDRM. 5 BATH: 1 TOTAL: 2.14.'1 0(1 at REAR: :.3 PLUMBING _ SINKS: I WATER CLOSETS: .3 WASHING MACH: LAUNDRY TRAYS: RAIN DRAM!: 100 TRAPS. LAVATORIES: 4 MSHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: i CATCH BASINS TUB/SHOWERS: 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES: tu0 BCKFLW PREVNTH: I GREASE TRAPS: OTHER FIXTURES MECHANICAL __FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS, 5 CLOTHES DRYER: 1 I;AS FURN—100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNIT}: I MAX INI'• btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS Ota LETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp WISVC OR FOR: 1 PUMPIIRRIGATION. PER INSPECTION: EA ADD'L 500SF: r, 201 - 400 amp: 261 440 Ron) tat W'O SVCIFCR: 00 SIGNIOUT LIN LT: PER HGUR: LIMITED ENERGY 401 600 amp: 401 600 amp. EA ADDL OR FIR: SIGNALIPANEL: IN PLANT: MANU HM/SW'./FDR 601 1000 amp: 601+amps-1000x. MINOR LABEL: 10".0.amplyalt: PLAN REVIE✓y SECTION Retpnnect only: '—�—' >s4 RES UNIT; SVCIFDR>+225 A.: >400 V NOMCLS AREAISPC OCC'. ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL- _ _ B.COM!eERCIAL AUDIO R STEREO VACUUM SYSTEM. AUDIO R STEREO- FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT. BURGLAR ALARM OTH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INb,rUMENTA TION: MEDICAL: OTHR: HVAC: DATA/TELE COMM. NURSE CALLS TOTAL a SYSTEMS: Owner: contractor: TOTAL FEES: $ 7,559.89 DON MORfSSETI E HOMES DON MORISSETTE HOMES This permit is subjeca to the regulations contained in the Tigard Municipal Code, Slate of OR Specialty Codes and 4230 SW GALEWOOD ST 100 4230 GALEWOOD STREET all other applicable laws All work will be done in LAKE OSWEGO.OR 97035 SUITE 100 accordance with approved plans This permit will expire rf LAKE OSWEGO,OR 97035 „yolk is not started within 160 days of issuance,cr if the wcrk is suspended for more than 180 days ATTENTION Phone. Phone. Oregon law requires you to followrules.aoopted by the Oregon LIN:!, Notification Center Those rules ate set Reg 0. L.c 3553.1 forth in GAR 952-001-0010 through 952-001-0080 You may obtain copies of these rul-s or direct questions to OUNC by calling(503)246-1967 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Inso Shear Wall Insp Insulation Insp Plumb Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Final inspection Fooling Insp Crawl Drain/7ackwater Electrical Service Low Voltage Water Line Insp Foundation Insp Footing/Foundation Dr, Electrical Rough In Gas Line Insp ,\ppr/Sdwlk Insp Post]Beam Structural PLM/Underfloor Fr2ming Insp Gas Fireplrce Electrical Findl f y : � Issued B Permittee Signature \ Call X503) 639-4175 by 7.00 p.m. for an inspection needed the next buctiness day CITYOF TIGARD __ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00208 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 DATE SSU_D: 8/20/01 SITE ADDRESS; 12213 SW HOLLOW LN PARCEL: 2S103CB-05700 SUBDIVISION: QUAIL HOLLOW - FAST ZONING: R-4.5 BLOCK: LOT: 006 JURISDICTION: TIG TENANT NAME. USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UN11 S: 1 TYPE OF USE: qF NO. OF BUILDINGS: 1 INSTALL TYPE: Ll PSWR IMPERV SURFACE: Remarks: Sewer connection for new single family residence. Owner: — _ FEES DON MORISSETTE HOMES Type By Date Amount Receipt 4. 30 SW GALEWOCjD ST 100 _ _— LAKE OSWEGO, OR 97035 PRMT CTR 8/20/01 $2,300.00 27200100000 INSP CTR 8/20/01 $35.00 27200100000 Phone: 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 .cited if the p--mit empires. 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" Permit and the Agency will install a lateral. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain 6Up\es of these rules or direct questions to OUNC by calling (503 246-1987 r,'� Issu by: .��1�� Permittee Signature: A,61 Ld a, Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day �iw�Z Ouf-&U )v Building Fcrinit Application NJ —- — Dale received: o Permit no.:Nfiaa,�� o City of Tigard Pro ectla l no.: Expire date: Citvof igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 l pP — p Phone: (503) 639-4171 l� Date issued: Ry: _ Receipt no. \ Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval: _ 1&2 family:Simple Complex: all U 1 U I &2 family dwelling or accessory U Cornmerciallindustrial Cl Multi-family ,&NCW construction O Demolition U Addition/al teration/irplacemcnt 0 Tenant improvement U Fire sprinkler/alarm U Other: JOB mu INFORMATION Job address: L ~ �/ 1 yy Bldg.no.: Suite no.: v. Lot: Block: Sutxliv_ion: V , ,t t T"r rnap/ta I t/account no.: ,//j 3(%� to` �K Project name: 5 r Description and location of work on premises/special conditions: t Name: Y� L � Mailing address: r- lrL' II do 2 family dwelling: ' City: State4_ ZIP: Valuation of work........................................ $ Z Phonc: - Fax: )-7 -mail: No.of bedrooms/baths................................. �� r�- -1-:- Owner's representative: t Total number of floors................................. , Phone: _ Fa, - Email: New dwelling area(sq. ft.) .......................... • Guragelcarport area(sq.ft.)......................... '< < fN Name: Y Covered porch area(sq,ft.) ......................... V Mailing address. A,G 01 r y Deck area(sq.ft.) .................................... . . Citv• State: ZIP: Other structure area(sq, ft.) Phone: Fax E-mail: Commerchil/industrial/muiti-family: CONTRACTOR Valuauon of work........................................ $ Business name: - Existing bldg.area(sq.ft.) ....... ... ............ �� New bldg.area(sq. ft.) Address Z _ Number of stories................ ............ ........ City: State: Type of construction........................ Phone: Fax: — EE-mail:: CCB no.: Occupancy group(s): Existing:New: --- City/rnctro lie.no.: — - -- — _ Notice:All contractors and subcontractors are required to be ARCIwrEcVD�sIG.NERlicensed with the Oregon Construction Contractors Board under Nami L Y , f,—' 1-C• provisions of ORS 701 and may be required to be licensed in the Address: G am` �L ,r jurisdiction where work is being performed.If the applicant is City: State: I ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: Phone: I E-mail. — ------- Name: Contact person: Fees due upon application ........................... $ Address: Date received: City: State: ZIP Amount received ......................................... $ Phone: I Fax: I E-mail: Please refer to fee schedule. I hereby eertifv I have read and examined this application and the Na all jundictioru accept credit cards.please call jurisdiction for more informvion attached checklist. A rovisions of I ws and o dinances governing this U Visa U MasterCud wo•,;will he complrtql wt ,whether. cift ere' or ot.1 Credit cxd numb" _ Authorized st natur ate:�� tv ,_ Name if aranolder as shown on credit card ' S PnnCardholder sipiature Amount Nuuce:This permit application expires if a permit is not obtained within 190 days after it Sas been accepted as complete (6,T)WOMt One-and Two-Family Dwelling Building Permit Application Checklist Referenceno.: CitvofTigardCI pf i1anti Associ^:,dpermits: Tigard U Electrical O Plumbing O Mechanical Address: 13125 SW Hall Blvd.Tigard,OR 97223 0Other: Phone: (503)639-4171 Fax: (503) 598-1960 t t t , d. 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 pfatflot. 4 Fire district approval 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,etc. 10 _L Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral designdetails and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plant location and details.Plan review cannot be completed if copyright violations exist. I I Site/plot plat drawn to scale.The plan must show lot and building setback dimensions;property corner 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 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,dumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross mction(s)rind 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 Hews.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. 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 sizing,spacing,and bearing locations.Show attic ventilation. 19 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered systems,see itern 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 floor/roof truss design details. 21 Energy Code compliance.Identify the prescripti ve path or provide:alculations. A gas-piping schematic is required for four or more appliances. 22 Engineer'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 be shown to be applicable to the project under review. tAd ulgi 23 Five(5)site plans are required for Item I 1 above. Site plans must be 8.1/2"x 11"or 11"x 17", x 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. 44045i+,&W/C0M Mechanical Permit Application ----� Datereceived: Permit no.: City of Tigard Project/appl.no.: Expiredate: City of Tigard Address: 13125 SW Ifall Blvd, Tigard, OR 9'_'2-1 - - Phone: (503) 639-4171 Date issued: By: Receipt no.. Ru: (503) 598-1960 Case file no.: Payment type: Land use approval: _.--___--- Building permit no.: -- TYPE t 0 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement WNew construction U AdclitiurValtemtion/replacement U Other: INFORMATION1 ' VALUATION lob address: \/ Indicate equipment quantities in boxes below. Indicate die dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, rax map/tax lot/account no.: profit.Value$ Lot: C7 JBIock. I Subdivision: *See checklist for important application information and Pro)yct name; 2, jurisdiction's fee schedule for to permit fee. City/county: ZIP: I t Descr ption and location of work on premises: r t a' r t 1 t r _ — Fee(m) Total Est.date of completion/inspection: Ut.cr;pron illy. Res.only Res.only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned?❑Yes ❑No Air handling unit CFM rcondiuoning(site plan requtred) Is caisdng space insulated?0 Yes rU Nr, Alteration of existing HVAC system_ .��iler/compressors o Statt .oiler permit no.. Buairiess name: t _ Y" _j�V HP Tons BTUIH Address: (- 44 Fire/smoke dampersiduct smoke detectors City: Ll State ZIP: ZI meat pump(site plan required) Phone: Fax; Email: nsta rep ace urnac urner ' / CCB no.; C Including ductwork vent liner O Yes❑No nsta rep ace/relocaie eaters-suspende , City/metro lie. no.: NIA wall,or floor mounted Name(please print): NN6 _ E L— Vent fora lance other than furnace Re gerat on: Absorption units BTU/H Name: `� �, Chillers HP A.idress: C �l r Com ressors HP nrironmenta e�tltatut an ventilation: (ttv: _ State: ZIP: Appliancevent Phone: Fax E-mail: yere oust 7Hoods,Type res.kitcherdhazmat hood fire suppression system Name: �� ' Exhaust fan with single duct(bath fans) Mailing address: ) N,' Exhaust system apart from Seating or A City: State ZlP ) �' Fuelpiping an W ut ou(up to outlets) • _-._�_ Type: LPG __ NG Oil oNa ne: 7- I av: E-mail: Fuelpipingeacha ditiona over o rocesspipnt lschematicrequired) e. Number of outlets — ter listed appliance or equ pment! --- - - Address: -- Decorative fireplace C•it% State: ZIP: Insert-type _ Phone -- Fax:, -mail: o stovelpei et stove ` then. .4pplicant'r signatu k. Date: � Ut er. Name(printt-1� x r Nol dl)untdictioru wcept credit cards,plew call jurisdiction rot more information Permit tet..................... U Visa Ll MasterCard Notice:This permit application Minimum fee................E expires if a permit is not obtained Credit card number _ - ---�---�— within g0 days it has been Plan review(at __ 96) $ I Expires > State surcharge(8%) ....S Name or cardholder as:ho*u on credit card accepted as complete. u,tholder signature Amount d-tpJAl't6,V�"COM) F Plumbing Permit Application Date received: Permit no City of Tigard Sewer permit no.: Building permit no,: Address: 13125 SW Hall Blvd,Tigard,OR 9722; --- - City ofTigard phone: (503) 6394171 Project/appl.no.. Espiredate: Fax: (503) 598-1960 Date issued: By: Rec:iptno Land use approval: Cas,file no.: Payment type: t O 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi-family ❑Tenant improvement Jew construction O Addition/alteration/replacement.1011 SITE O Food service O Other: INFoRmATION FtlEt Job address: V �1� t Description _ 01y. Fee(ea.) Total Bldg,no.: Suite no.: New 1-and 2-family dwellings only: (includes 100 fl.for each utility connection) Tax mapitax lot/account no.: SFR(1)bath Lot Block: Subdivision: KA w1wi SFR(2)bath Project name: = l SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description and location of work on premises: ___ SiteutWtles: Catch basin/area drain Est.date of compie tion/inspection: Drywells/leach line/trenchdrain Footing drain(no. lin. ft.) _ Mant:°--^cured home utilities Business name• L�1��I � Manholes _ Address: _ Rain drain curinector City: �_ State- ZIP:_ Sanitary sewer(no.lin.ft.) Phone: -,6 Fax. E-mail: Storm sewer(no. in.ft-) Water service(no.lin.ft.) CCB no.: j()I;))?t- Plumb.bus.reg.no: - Fixture or Item: City/metro lic. no.:N/A Absorption valve Contractor's representative signature Back flow preventer Print name: U Backwater valve Basinsflavatory Clothes washer Dishwasher Address: G Y Drinking fountain(s) Cit}: State: ZIP: Ejectors/sump Phone: Fax: E-mail: Expansion tank Fixture/sewer cap }, Floor drains/floor sinks/hub Name(print): -Vil ,,�5`�F'TC� l M� ' Garbage disposal Mailing address: Hose bibb Ciry: 1) State T_1 P: ��r Ice maker Phone: - Fax: 7-70 E-mail: Interceptor/grease tma Owner instal/ndon/residendaf maintenance onlp:The actual installation Primer(s) will be made by me or the maintenance and repair mlde by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: _ C)atc: Sump Tubs/shower/shower pan Urinal Name: _ Watercloset Address: n Water heater State City ----7- ZIP: Other._ _ L� --- Phone: F : — E-mail: Total ax Nor all unahcumu rce credit cardr,plena call un"cuon fm more mfomuuon Minimum fee....... .... ) t p t Notice:This permit application Plan review(at � `1b) $ -- --- - O visa O NtasterCudred , expires if a permit is not obtained State surcharge(8%) ....E Cit card number !_ r! within 180 dans after it has been Expun Name of cudholder u shown on credit card accepted as complete 'TOTAL ....................... 1Y1 tf l6 lf�glLt(Fl Cardholder N`nahure — s Amount Electrical Permit Application Date received: Permit no.: City of Tigard ProjecUappl.no.: Expire date: City ofTigarrt Address: 13125 SW Fall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 — Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ TYPE OF PERMIT 1 &2 family dwelling or accessory O Commercial/industrial O Multi-family 0 Tenant improvement Ncw construction O Addition/alteration/replacement 0 Other: ❑Partial 11 SITE INFORMATION Job address: v Iy Bldg.no.: Suite no.: Tax map/tax lot/account no.:-- Lot: filock: Subdivision: 1 Project name: Description and location of work on premises: Estimated date of completion/inspection: SCHEDULE _b no: Fee 'Nax Business name: �_ Description Qty. (e-.L) Total no,[nip New residential-single or multi-family per Address: )' �� dwelling unit.Includes attached garage. City: State: LIP: Serviceincluded: Phone: ,j ( Far: Email: 1000 sq.f<.or less 4 Each additional 500 sq.ft.or portion therm; CCB no.: Elec. bus.lie.no: limited energy,residential 2 C Each manufactured home orual 2 Each manufactured home or modular dwelling afore o/supervtsrn`electrician(required) _ Date- Service and/or feeder 2 Sup elect name(print) " 1 Licenseno a Services or feeders—installation, alteration or relocation: 200 amps or less 2 "Mailing 201 amps to 400 amps _ 2 401 amps to 600 amps 2 _ ss: rIP,�-Li"r- . 601 amps to 1000 amps ^2 City r State LIP: Over 1000 amps or volts 2 Phone: - Far: -"7 - .-mail: Reconnectonly 1 Owner installation:The installation is being made on property I oven Temporary services or feeders- svhich is not intended for sale, lease,rent,or exchange according to installation.alteration,or relocation: 200 amps or less ORS 447,455.479,670,701. _ 2-_ 201 amps to J00 amps _ _ Owner's sl nature: Date: 401 to 600 ams 2 Branch circuits-aerv,alteration, or extension per panel: Name: A. Fee fat branch circuits with purchase a( Address: _ service or feeder fee,rich branch circuit City: SIIIte: ZIP: B Fee for branch cirrjiu without purchase of service or feeder fee,first branch circuit: 2 PItOnC Fax: Email: Fach additional branch circuit: Mise.(.Service or feeder not included): ❑Service over 225 amps-commercial ❑HealthrAre facility Each pump or irrigation circle 2 O Service over 320 amps-rating of 1&2 ❑Hazardous location Each sign or outline lighting 2 familydwellings ❑Building over 10,000 square fret four or Signal circuit(s)or a limned energy panel, ❑System over 600 volts nominal more residential units in one structure alteration,or extension' 2 ❑Building over three stories ❑Feeders.400 amps or mare "Description: O Occupant load over 99 persons ❑Manufactured structures or RV Park Each additional inspection over the allowable In nny of the above: O Egtrss/lightingPlan ❑Other Perinspection Submit_sets of plrns with any of the above. Ilnuesugaiion fee _ The above are not applicable to temporary construction service. I Other _ —Not all)uns.Lcu(ns scup credit cods,please all jurixticuan r«rrkli Infurm:uott Notice:This permit application Permit fee.....................$ — U Visa O MasterCard expires if a permit is not obtained Plan review(at ,._ %) $ Crcdlt:ard number / / within 180 days after it has been State surcharge(8%) ....$ accepted as complete. TOTAL .......................S Name of rsrtlhulder L lroWn on credit card _ S Cardholder signature Amount 440-4615(6MCOM) ( DON - MORISSETTE : � ^/_M�la7 R 0 H C S I N C O R P O R A T E D 4 2 9 D G A L R W 0 0 D S T. S U I T E 1 0 0 LAIR 0swRC. O, 0 R 9 G 0 N 07090 (503) 367 - 7538 PAX (503) 387 - 76 15 O8L : 1959 STANDARD ELEVATION ),,)T: 6 DATE: 6/26/2001 PROPERTY, QUAIL-HOLLOW CITY. TIGARD tt SCALE: 1"=20' I PLAN No.: 17C I 50.00, 286 a � o�* I e m N I 29� 1 I cont. � R\ 2 1 pat.ro _ e, x84 '0 © 3000 22'8 5 berm. 3 bath ro44 sq. Ft, le, f,. -- 3 car far. FF-E. 283' ` '� 51 : 6 6 6 yr 283 aCOncrsts- -`� -� - c; rlves -- 9 Dway 1 ra I � 283 A —---- — 283 a . 284 Apprcach y~ S(d�walk --_ — 13o,om' 12213 SZ. HOLLOWo Lm �Q LOT • Co 5000 sq. Ft. CITYOF TIGARD __PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00452 13125 SW Hall Blvd.,Tigard OR 97223 (503) 639-4171 DATE ISSUED: 9125/01 SITE ADDRESS: 12213 SW HOLLOW LN PARCEL: 2S103CB-05700 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 006 _ _ _ JURISDICTION: TIG - CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH. BACKFLOW PREVNTRS- 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: S'rORIES: WATER HEATERS: CATCH BA;INS: FIXTURES_ LAUNDRY T RAYS: SF RAIN DRAINS: `SINKS: URINALS: GREASE i RAPS: LAVATORIES: 01 HER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETF: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. _ FEES Owner: _ Type By Date Amount Receipt DON MORISSETTE HOMES PRMT CTR 9/25/01 $36.25 27200100000 4230 SW GALEWOOD ST 100 5PCT CTR 9/25/01 $2.90 27200100000 LAKE OSW`GO, OR 97035 - Total $39.15 Phone 1: Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE. OR 97070 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 682-6076 Final Inspection Reg #: LIC 6136 PLM 11558 This perrmit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law r c sires you to foEow 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 Mules or, direct questions to OUNC by calling (503) 246-1987. Issued By: Permittee Signature �r'/`-i•'C' �i i�07V Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application a �il Of al's 1 Datereceived: o `; /� Permit no.:G,l/ ,7,00l Tigard RECEIV+� Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 --- City ojTigard phone: (503) 639-0171 Projert/appl.no.: Expire date: Fax: (503) 598-1960 SEP 21 2001 Date issued: By:.'ft Recciptno.: Land use approval: COMMUNIIV ofyrioNMl W Case file no.: Payment type: U I & 2 family dwelling or accessory U CommercialiindustriA U Multi family U Tenant improvewent U.,New construction U Adclition/alteration/repiacenrent U Food service U Other: JOB StfE INVORNIATION .p Job address: JJ -:h j(l' IC'%!u LCL r Description jQlY. Fce(ea.) Total Bldg.no.: Suite no.: New 1-And 2-family dwellings only: ( Tax map/tax lot/account no.: 57 _ , ' SFR(1 bath oreAchsriiGtyconnectlon) Lot: L _ Block: Subdivision6D.U_s�t i-t H4 SFR(2)bath -- _ Project name:(,)AL eLL_-i2_- L --bl lCi SFR(3)bath City/county: _T1c G 44 1 i uF3S ZIP:e7" :2,3 Each additional bath/kitchen Description and lb ayDn of work on premises: Siteutilities: _ /�/9GlC �-i ,p2u rG� Catch basin/area drain Est.date of completionhr,�pection: CJ c�'f l'1 D ting drain(knelt.ft.) drain ting drain(nc.lin.ft.) _ 11 RING CONTRAC"I'014 I Manufactured home utilities Bus I. MSS L", Xr1 C' Manholes Address: q j (c RD Rain drain connector City: wWb, n U I I G State[ Sanitary sewer(no.lin,ft.) Phone - Fax: q7 E-mail: Storm sewer(no.lin.ft.) CCB no.: / Plumb.bus.teg.no; Water service(no.lin.ft.) City/metro lic.no.: 3o1Fixture or item: Contmctor's representative signature: Bac tion valve Print name: / e � Date: c� - �,1 Bac Clow preventer Backwater vnlvu 1 Basins/lavatory ` Name: 5/,Its Sp !'�i� Clothes washer Dishwasher Address:7Q$' /� 1( (� Drinking fountain(s) City: 1 FJ State: ZIP: 9707() Ejectors/sump Phone: q Fax:68x-9 , ' E-mail: Ex ansion tank ixturelsewer cap no: Floor drain floor sinks/hub Na — Garbo a disposal _ Mailing address: 3(j 00CU S1— HoseRR City; C79_t. State:CK_ ZIP. 03 Ice maker Phone: I Pax: I E-mail: Interceptor/ tease trap Owner installation/residential maintenance only: The actual installation mer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(comme: .al) employee nn the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's at nature: Date: Sump T anal ower/shower pan Urinal Name: _ Water closet Address: _ Water heater City: — State: ZiP: Other, - Phone: Fax: E-mail: Total Na all turisdictloro accept credit cards,please call iurlsdictlon for more Inlorm+Uon. Minimum fee................ .._�.• S Notice:This permit application plan review(at .___ %) $ __ Q Visa Q MasterCard expires if a permit is not obtained credit card number: within 180 days after It has been Name of shown on cit card State surcharge(896)....$ _ . — S accepted as complete. TOTAL .......................$ ardholder u Cardholdet signature Amount' 4"16(mW'ob1) PLUMBING PERMIT FEES: PRICE TOTAL rNow 7 and 2 family dwellings,only - - I r _ FIXTURE.' indivldual QTY ea AMOUNT I (.nciudes allplumbing fixtures In PRICE Sink - 16.60 the dwelling and the firstlOO ft. QTY (oa) AMOUNT for etch utility connection Lavatory 16.60 ^_ _Ono , bath L Tub or Tub/Shower Comb. 16.60 -AlLbat __ 5249.20 Two )bath TlO_AO Shower Only 1ti.60 Three�3)bath 5399.00 Water Closet 16.60 - SUBTOlA1. Urinal 16.60 ---8"/.STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL ILaundry Tray 18.89 -�---- --- -� Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" 15.60 - �- PLEASE COMPLETE: � 4- ,6.60 Water Heater O conversion O like kind 16.60 uantity b Work Performed Gas piping requires a separate mechanical kS ixture Type: Nov, Moved Replaced Removed/ permit. Capped- MFG Home New Water Service 46.40 ink MFG Home Now San/Slorm Sewer 46.40 Lavatory Tub or Tub/Shower - - -" - Hose Bibs 1 6.60 Combina'ion Roof Dralns 16.60 Shower Only _ �- Drinking Fountain 16.60 Water Closer_ - -- Other Fixtures(Specify) 16.60 Urinal - Dishwasher _ Garbage Disposal Laundry Room Tracer - - Washing Machine Floor Drain/Sink: 2" Sewer-',,at 100' 55.00 --- 3„ Sewer•each additional 100' 46.40 ----4" - -- Water Service-let 100' 55 on T` Water Heater :'later Service-each additional 200' 48,40 Other Fixtures Storm 6 Rain Drain-1st 100' 85.00 - ----- Storm&Rain Drain-each additional 100' Commercial Back Flow Prevention Device 46.40 Reeidentlal Bar-kfiow Prevention Device' , 27.55 ;?7 55 -- - - Catch Basin 16.60 i _ - Inspection of Existing Plumbing or Specially 72.50 -- Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - Grease Traps 16.60 ---- QUANTITY TOTAL r► --- - ---- Isometric or riser diagram Is required If a?, _-- Ouanitty Total is >9 _ `SUBTOTAL _ �J y 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL - Required only if fixture qty.total is>9 TOTAL $39 �5 *Minimum permit fee is S7 %.state surcharge,except Resl�-ntial Backflow Prevention pevice,which Is 53e 25 90 etIte surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review. LWstsVorms�pim-fees.doc 10/10/00 Ci•TY OF TIGARD BUILDING INSPEC71ON DIViSION MST "ZCZ,)/ 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ __Date Requested 1 3) AM _PM _ BLD _ Location Z i _�� v rr _ Suite MEC _ Contact Person Y Ph PLM PLM Contract Ph SWR _ UILDING Tenant/OwnerELC _V Reta g all _ - -----•-__ ELR Footing Access: Foundation FPS _-_--_ Ftg Drain SGN Crawl Drain 1,,ispection Notes: --- -- ------ Slab SIT -- ------ - - -- Post&Beam --- - Ext Sheath/Shear _ Int Sheath/Shear _ Framing Insulation Drywall Nailing Firewall - `-- Fire Sprinkler Fire AlarmC; -fz Susp'd Ceiling — �� Roof C r�-T �— Misc — — PART FAIL --- —PL4MBING Post&Beam �— Under Slab Top Out _— — -- - -- ---- ---- Water Service Sanitary Sewer Rain Drains _ Final PASS PART FAIL MECHANICAL Post& Beam Rough - - -- ---- --- Rough In Gas Line -- - —._ -- — Smoke Dampers n ---- ---- -- - _ AS PART - FAIL CrEMICAL Service: .� Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading — - - --------___ Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE:_ _ ( J Unable to inspect-no access ADA V' v Approach/Sidewalk Date V Other ___ Inspector _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. p. fD CD � O C• 1 CD w �v c cr W J � !J n \' CL C Li 0 a O 1 •+ n a .r 0 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — BUP J Bate Requested _AM —PM BLD _ Location _ / 2- -2- I _ _ Suite MEC _ Contact Person � ' __y— Ph �2 '2- PLM Contractor Ph SWR _ BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access. - Foundation FPS _ Ftg Drain SIGN Crawl Drain Inspection Notes: ---- Slab -- —.-- SIT Post& Beam ---- Ext Sheath/Shear _ Int Sheath/Shear _ Framing ---- -- ------- ---Insulation Drywall Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: - Final - PASS PART F IL PLUMBING Post& Beam Under Slab Top Out -- Water Service Sanitary Sewer - - -�-- Rain Drains PART FAIL f ,NKAT�_. --- - ---- - -- -- -- Post&Bearn Rough In Ga,Line -- ---- - -- ---- -- - -- - -- Smoke Dampers Final - -- -------- -------- ---- -- -- - PASS PART FAIL ELECTRICAL __-------___.__---_.-----�_.----__---- Service Rough In -_-- UG/Slab _ Low Voltage Fire Alarm r Ina, PASS PART FAIL SITE Backfill/Grading - --- --------._ ----- -- ------- Sanitary Sewer Storm Drain I ] Re nspection fee of$- required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please call for reinspection RE: [ ]Unable to inspect-no access Fire Supply Line --- ADA ApproachlSldewatk Other _- Date = f Inspector_ �°r�ly _ Ext _ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUII DING INSPECTION DIVISION MST -� l �'� �� 24-Hour Inspection Line: 63'. 175 Business Line: 639-4, BUP Date Requested,_ l L' - AM �PM BLD — Location l z 1 ; Suite MEC — Contact Person Ph 2 �� Y 3 % PLM — Contractor — Ph SWR BUILDING Tenant/Owner _ ELC -- Retaining Wall Footing I ELR -- Foundation Access: FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab Post 8 beam -.�---------- - - -�_--._-- SIT - Ext Sheath/Shear Int Sheath/Shear - raming - Insulation --' ---�`- Drywall Nailing I -- -- ---- - - ----- Firewall ---" Fire Sprinkler `_- Fire Alarm Susp'd Ceiling Root Misc --- ------ -- - Final PASS PART FAIL ----------- --_-------_---- - - i PLUMBING I'ost& Beam -- -- -----` ---- -- Under Slab Top Out -._. -- ---- — -- - Water Service Sanitary Sewer ------- - - -- - -�— Rain Drains PASS 11 PART FAIL Mr-CgANICAL -_--�- -- -- Post$ Beam -------.._____- Rough In Gas Line - Smoke Dampers Final - ---------- ----- ---- -_-� _------ PASS PART FAIL ELECTRICAL -- --- --------------- Service -------------------- Rough In UG/Slab _ Low Voltage �^ Fire Alarm AAVW PART FAIT_ Backfill/Grading --- ----- -- --- - --- -- Sanitary Sewer Storm Drain ! ]Reinspection fee of$ _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line f ]Please call for reinspection RE: - [ ] Unable to inspect- no access ADA Approach/Sidewalk , q �� 1� Other Date Inspector Ext _ Final PASS PART FAIL DO NOT REMOVE this inspection recordfrom the job site.