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12230 SW HANCOCK COURT t F f N N W O SU O n 0 O z' i b i 12.230 SW hancock Court r CITY OF TIGARD 24-Hour RUILDINO 'nspection Line: (503)630-4175 !r— INSPECTION DIVISION Business, Line: (503)639-4171 MSTSUP W` Rinceived Date Requested Arlt____—__ PM.__.-- BUP Location '' L1 ----Suite-- _ __—._ MEC Contact Person .__ _YIL ►' Ph(�_ —) rj�_� p � __. PLM ContractorPh(._ .---) ____ SWR BUILDING Tenant/Owner _-_-_--- _ - ._ ELG Footing ELC Foundation Access: Ftg Drain ELR -- Cram Drain slat, Inspection Notes: SIT Post&Bsarnr—�—__- Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _- --- ------- — -- Firewall Fire Sprinkler -- - Fire Alarm Sucp'd Ceiling ------ - - ------ Roof N Other: Finui / PASS PART FAIT_ -- PLUMBING{ Post&Beam- Under Slab Rough-In Water Service ---- -----••-- Sanitary Sewer Rain Drains ------ -- --- Catch Basin/Manhole Storm Drain ------ - -- --- --- ___ ___� Shower Pan Other: Final — PASS PART FAR. MECHANICAL Post&Beam Rough-In Gas Lin-. Smoke Campers — Final _PASS PARI FAIL -- -- - --- -- - — — --- — -- ----- ---— ServiceRough-In UG/Slab UU/Slab Low VoltanP Fin-A.-,nl c Z� [] Reinspection fee of$__— ____ required before next inspection. Pay at City Nall, 13125 SW Hall Blvd. 1�A..., PARTFAIL SITE _ L__I Please call for reinspection Fire Supply Line RE'�_-_-__,.._____— — C Unable aspect-no access — ADA ons _: 0 ; ��t: : tor iXt Approach/Sidewalk p O her. F1, al DO NOT HEiMOVE this Irtrspection recil:4d from tier job sito. PASS PAFT FAIL ► i ! n `' d ► tTl ! r► 0 ► ! z �� ! �' ► -41 Q... cs.. r+ ► !I �► ► ' °'' Oil ► rN ! w tlm ► 4 L� ► ! o _ ; 44 r �r�r►��r��������s��► *��s.���vii��s�r�������sss�� E --� r - 1 .y co w '1 Air, rJ. � � a H fD n c 3 � � Re � •1 y _s Arz r CITY OF TIGARD 24-Flour BUILDING Inspection Linc: (503)639-4175 MST 3INSPECTION DIVISION Business Line: (503)6314-4171 BLIP _— Received ____. _ Date Reques'ad__ ��' .� �' _ P,M__ - -_- -__- PM -_- BLIP LocationMEC -- ��Suite-------- ---- Contact Person _ —. - ' _ Ph(� ) . G' - -' rLM - Contractor -_--- _-- —. — Ph( ) SWR ----_ ----.�_---___-- BUILDING TenanVOwner — ELC _— Footing -^ Foundation ELC _----------__--- F1g Drain ACCAS5: FLR Crawl Drain Slab Inspection Notes: SIT _ Post& Ream Shear Anchors - -- --- - Ext Sheath/Shear Int Sheath/Shear Framing inculalion Drywall Naili-q - F irewall _ Fire r prink!er - --- - -- Fire Alarm Su,p'd Ceiling ----- ---- - - Roof Other: --- - - - ----_-- -------- - A3 PART_FAIL _ BING -- Order Slab Rough-In ---- --------------- - Water Service --- --- _ --_--.-----. _-__ - - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain --- --- --� -_- Shower Pan Other: -- --------- - - --- -- - Final �- _PAS_S PART FAIL — MECHANICAL Post& Beam – – Rough-In Gas Line _-- --------_-+ Smoke Dampers Final PASSPART FAIL --- ---------- - --- _._r__-_.-_-__ ___.---- ELLCTRICAL - - Service ---------- --- ------_�_.._.__ ---_--__ Rough-In IJG/Slab Low Voltage Fire Alarm Final CJ Reinspectiu,.fee o1$__ required before next inspection. Pay at City Hall, 13125 SW'Hall rilvd. __PASS _PART FAIL SITE �- [] please call fir reinspection aE: -_-_ - C:J Unable to inspect-n,7 access Fire Supply Line � ADA Approach/Sidewalk DitO..._� ) C� -� 1►eAr�-mr4Qr.-- � --.____Ext —-- Other: Final DO NOT REMOVE thIs iia%Wi,Rctinvi rervr1d from the job site. PASS PART FAIL CITY OFF TIGARD 1312.5 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RECEIVED BRIGHTEN ELECTRIC 7 4 21103 PO BOX 5964 AF ALOHA, OR 97007 CI.1Y OF -fIGARD ,11 JJLDING DIVISION Electrical Signature Form Permit #: MST2003-00058 Dote Issued: 315103 Parcel: 2S103CC-11500 Site Address: 12230 SW HANCOCK (;T Suodivision: WHISTLER'S WALK Block- Lot 062 Jurisdiction. TIG "Lolling: R-4.5 Remarks: New SF detached, Path 1. Your companyhas been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit t-) be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature; Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: DON MORISSE T TE HOMES BRIGHTEN ELECTRIC 4230 C+ALE HOOD ST #100 PO BOX 5964 LAKE OSWI GO, OR 97035 ALOHA, OR 9'1007 Phone 0 503..387-7538 Phone #: 356-8629 Req #: SUP 46675 IW 132222 I I 1 34-4113C AN INK SIGNATURE IS REQUIRED ON THIS FORM i atur o .apervm g Electrician If you have any questions, p ease call 503.718.2433. MEKKERT9 J Cox F-1 Electrical Permit_Application Received Date/By: Permit No.: City of Tigard Planning Approval Sign Dstc/B�c Permit No.: 13125 SW Hall Blvd. Plan Review Other – Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-595-1960 Post-Review Land Use Date/BL Case No.: Sec _ Internet: www.Ci.tigard.oC.uS Contact Juris.: Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: S mental Information. TYPE OF WORK PLAN REVIEW_Please check all that appy) — Health-care facility New•construction _ _Demolition Service over 225 amps- - commercial El Hazardous location _Addition/alteration/replacement I no7th—er. p service over 320 amps-rating of ❑Building over 10,000 square feet, CATEGORY OF CONSTRUCTION I&2 family dwellings four or more residential units in &2-Family dwelling Commercial/Industrial ❑System over 600 volts nominal one stricture ❑Building over three stories ❑Feeders,400 amps or more Accessary'3uildin Multi-Family ___�-_ []Occupant load over 99 persons ❑Manufactured strictures or kV pork Lj Master Builder Other: p tgress/lighfing plan ❑Other: JOB SITE INFORMATION andLO ATION Submit__—sets or plans with any of the above. Job site address A The above are not applicable to temporary construction service. te– _ __ FEE*SCHEDULE _ Suite#: Bld ./A t.#: – _ Number of ins ectionsersermit allowed Project Name: 4 Uexcrl tion Qty Fee(ea.) Taial --- New residentlal-single or multi-family per Crass street/Directions to job site: dwelling unit.Includes altnche(I Raroge. Service InchtJed: IW)s .ft.or less 145.15 4 Each additional 500 sq.P.or portion thereof 33.40 I Subdivision:_- - - �[at#: Limited energy,residential _— 75.00 _� 2 --- Limited ener non residential 75.00 2 Tax inaR)/parcel t` Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 — Services or feeders-Installation, alteration or relocation: 200 am s or Icss _ 8(1.30 2 - - - - — -• 201 amps to 400 ams - _ 106.85 2 _ 401 amps to 600 amps -��- 160.60 2 PROPERTY OWNER 'TENANT 601 ams to 1000 amps _ 240.60 2 Namt�!1 Over 1000 amps or volts 454.65 2 _--__ Reconnect only6685 _ 2 Address: Temporary services or feeders-Installation, City/State/Zip:/State/Zl -J alteration,or relocation: 1� _ 200 amps or less 66.85 1 Phone: Fax: 201 amus to±22 amp., ____ 10030 — 2 APPLICANT �– CONTACT PERSON - 401 to 600 ams 133.75 2 - --- Branch circuits-new,alteration,or Name: _ extension per panel: Address: — A.Fee for branch circuits with purchase of service or feeder fee,each branch circuit 6.65 1 Cit�State/Zip: - B.Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.85 2 Phone: _ _- Fax:_ _ Each additional branch circuit 1 6.65 2 E-mail Misc.(Servir-(ir feeder not included) _ CONTRACTOR - Each um or irrigation circle - _ 53.40 2 -- -- - - --- - Each sign or uutiinelighting 1 53.40 t Joh No: __-- _ -_ Signal circuit(s)or a limited energy panel. aIteration,or extension Pa e2 Business Name: - ---� Address:� t;r� �r City) 0 G��G,y, Each additional Inspection over the allowable in an of the a cove: Per Inspection r hour min. I hour) 62.50 Phone:- b'�?� Fax: Z _ Investigation fee: _ —__ �_ CCH Lic.�3. 3 2 Z Lic. # - 3 c_ _ — -- Electrical Permit Fee! Supervising electrician _ _— subtotal $ sil�nahrre r,!! uiq red; _ Plan Revicwa�2_5%of Permit Fec $ — Print Name: r ic. _ _ State Surcharge 8"/a of Pct-init Fee $ TOTAL PERMIT FEE $ _ Authorized Notice: This permit application expires It a permit Is not cbtalned within Signature: ,��,t_lif' Date: 180 days after it has been accepted as complete. / *Fee methodology set by Tri-County Building Industry Service Board. -�� (Please print ntyfie) -- - 0Dsts\Permit Formt0Flcl'ermitApp.doc 01103 Electrical Permit AAp"lication - city of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Feefor all systems......................... .................................. $75.00 Check Type or Work Involved: FAudio and Stereo Systems* Burglar Alarm 11 Garage Door Opener* EJ I leating,Ventilation and Air Conditioning System* Vacuum Systems* Other -- _COMMERCIAL WORK ONLY: _ Fee for each system.. ...................................................... S75.00 (SEI?OAR 918-260-260) Check Type of Work involved: Audio and Sterrn Systems UBoiler Controls Clock Systems Data Telecommunication Installation ED Fire Alarm Installation E] IIVAC i ostrument0on ❑ Intercom and Paging Systems Landscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* Protective Signaling Other ___-- Numher of Systems * No I?censes are required. Licenses are required for all other install9111011s is\'Jst0crrrnt FomtstElcP(•rmnAppI1g2.doc 01/03 CITYO F T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00187 13125 SW Hall Blvd., Tigard OR 97223 (503116319-4171 DATE ISSUED: 4/14/03 PARCEL: 2S103CC-11500 SITE ADDRESS: 12230 SW HANCOCK C'1 SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 062 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNITHEATERS: VENT FANS: OCCUPANCY GRP: 12 i 'DENTS W/O APPL: VENT SYSTEMS, 1 STORIES: BOILERS/COMPRESSORS _ HOODS: FUEL TYPES _ _ 0 - 3 HP: DOMES. INCIN: WC-)D 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: FIRE DAMPERS?: 30 - 50 HP- REPAIR UNITS: GAS PRESSURE: 5C + HP: WOODSTOVES: i FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: <= 10000 cfm OTHFR UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Install wood stove and vent. Owners FEES DON MORISSETTE HOMES Description ^�— Date Amount 4230 GALEWOOD ST#100 LAKE OSWEGO, OR 97035 i%1I-CH) Permit Fee 4/14/03 $72.50 11:\\� S ti�ntr'l;is 4/14/03 $5.80 Phone; 503-387-7538 — Total . $78.30 Contractor: THOMAS BISHOP CONSTRUCITON 11525 SW CANYON BEAVERTON, OF; 97005-2170 kEQU1RED INSPECTIONS Phone: 503-62ti-4650 Wuodstove Insp Fire Damper Insp Rer #: LIC 00054696 Final Inspection This permit is issued subject to the regulations contained in the Tigard Mun cipal Code, State of Ore. Specialty Codes .and all other app icable laws. All work will be dine in accordance with approved plans. This permit will expire if work is not started within 180 days of issue%nce, or if work is suspended fcr more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-669V- Issued By: 41 A Permittee Signature: �_- Call (5U3) 639-4175 by 7:00 P.M for inspections needed the next businiss day i r FROM • HOTSPOT FIREPLACE PHONE NO. : 15036269136 Apr. 10 2003 03:51PM P1 Mechanical Permit Application / Date n=ived:/ City of Tigard 9 Li,,., Projmt/appl.no.: Bxpiredata: - City rfTigard Addreas: 13125 SW Nall Blvd, r•+g:trd,OR 97223 ai - Phone: (503) 639-4171 Daeeisstted: Byer) iteceiptno•: Fax: (503) 598.1960 Case file no.:—,�- Payment type; Land use approval: _ t.' Building permit no,; 1 &2 fancily dwelling or acces,;ory U Commemial/industrial ',3 Plulti"fit-miiy ❑Tenant irnprovcmont Cl Addilion/alteration/rt- lecetnen! U Other: O New construction Ll --- Job addrFss: �_��,�Q i s��e�C Cf _ Indicate equipmtsnt quantities in boxes Mow.Indicate the dollar Bldg.no.:� Suite no.: - _ value of all nwchmucal materials,equipment,labor,overhead, Tax map/tax tot/account no.: �• _ — profit Value S i o Block: Subdivision• �( "See checkli3t for important application information and jurisdirtion'l fee schedule for residential permit fee Project name: City/oounty: Description end,location o work on premises: Fee(eat.) Toad tion: Drscrsptl^° Kee,only Bas.o Est.date of coMpletion/inspe Tenant Improvement or change of use", Air handling unit _- CRM_- Is existing space heated or,conditioned?U Ycs Q No rcon tiontng site an ulro --- Is cxiAting space insulated?O Yes U No tern ono ex sting AC systemMUM — Ba er cemptessors State boiler permit no.: Busim"name:• �•r1(__ � f tip Tons _BTU/I1 ddtras: �-- r � uctsmo a electors A �`�i :t� / — city: �1/�,L) _ 3tttte: ZE, ! � Nealpun+p site on re u re ) orae rep ace nrna urner51 Ul" Phone': - 868 Fax: Email -- _ L.— - including ductwmWvent liner U Yes U No MI no.: 54,(`7� _-�.._ r,,,U .-VT.- re c;;E ie�t teae_auipen . City/t11- Iia no'; _-__ -- wall,or floor manned rnl ora anoe0 or Ln uTttaca Nturte( ease print): S�r.�_ Nrr e�ratx►o: - Ahsorpdon units BTU/H ---- Q �'hitlets__�— -- Name: HP Com -- rorres8ors, lip mesita a u+st an T"ditatioslit City_ titate:�� 7.iPaj Applirneevent Php Fax:—"lnz-E,.�j mail: s, y�i/lUres. tc enwfn sonar _ ood fire suppression system - - Name: Exhaust fan with single duct(bath fans) Eat avat s stem s aR om cerin of Mailing address:�'- �__ plpft ati op to 4 4101100111) City: State: 7_lk': 1 vpe: LPC .__ M __OU Fhotte l'nx° i ;nail -Fuel pi in eacha�iditoTna�rve �it�� Process!pli se' tette'reyui Number of outlets other e*PP-1 WWe ve RWV-erf: Addensas: Decorative ftrep ace Ly �S_tate: Zip: - nsen-•typpe�. _� � _ -- orrdstove� etatove I'ho Fax• &mail: cr: --- _--- Ap licatit's_signatu - 7 Date: - -- Pettttit fa;•....................$Net m*Values WOW credit aardt.yltwe°+et 1uu'�•"+°"ra►"""s�O""'"+0A' Notice;This permit Wlication MInimt�m fee................S440 Uvea► Q Mastarram expires if a permit i,q not obtained Plan review(at_ %) S �redlt cant rarmaer - - - within I$0 day^atter It has beat d .r,Rx State surcharge(89h)....S . � n at der t care accepted as rOrnKlete. ....$ TOTAL................... ` 11-____--=�� Atatea+N 4bp617 t6i0fYCS.At) ataast�aa CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Lina. (503)639-4111 MST p BUP Heceived _�Date Reque ted AM— —PM_ BUP Location y--S Suite—.— _ ITEC _ _ --- Contact Pe son _____- ----------- Ph 494 --_ PLM -- —v -7 - Contractor1, — ---- ----- - - ---- --______ ____--� Ph(._._.v) � SWR ------- BUILDING Tenant/Owner —� _ --_--_ ELC ------------- -- -- ---- Footing Foundation ELC --- Access: Ftg Drain PLR __-- Crawl Drain —_-- Slab inspection Notr,s: SIT Post& Beam Shear Anchors - -- Ext Sheath/She— Int Sheath/Shear -- Framing -- Insulation Drywall Nailing Firewall Fire Sprinkler - - -- --- Fire Alarm Susp'd Ceiling Roof Other._ ---- —___ �__ --- -- ---- -- --- Final PASS T FAIL — — --" — PL I_ Under Slab Rough-In Water Service — ---�'------ - -- -- Sanitary Sewer Rain Drains — Catch Basin/N anhola S'orrn Drain ----- - Showr:r and Oth -- n i'-N ASSPART FAILICAL Post 8 Beam Prugh-In Gas line Smoke Final PASS PAP7 FAIL -- `--- ---—' — - — ---- -- -- ELECTRIcAL Service—_-_---•_..__. � -- --_ _�__ -- - --. —__._ � __` Rough-In -- UG./Slah Low Voltage Fire Alarm Final Reinspection fee of$._— __ required before next Inspection. Pay at City Hall, 1312`"SW Hall Blvd. PASS PART FAIL Please c ,fu;reinspection 13E: — _ Unable to inspect-no access I Fire Supply Line ADA � s_.—_ ins �__ � Ext A�17rUf1�IliSiltbN�nll. Q�� -'"'�--- _-. inspector Ex Other: Final DO NOT REMOVE this Inspection record frorn the job site. PASS PAnT FAIL i CITY ®1 1 (G,, 1`�D PLUM5IN(3 PERMIT �L ^ PERMIT #: PLM2003-0' ,73 DI:.VE�,O!-'M!��dT SEFc !' „i�, .S 13125 SW Hall Blvd.,Tigard, OR 97223 (5;"3) 639-4171 DAE. ISSUED: 5/2/03 SITE ADDRESS: 12230 SW i-If-NCOCK CT PARCEL: 2S103CC-11500 SI IBDIViblON: WHISTLER'S WALK ZONING: R-4.5 BLOCK: LOT: 062 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSAL;: MOBILE HOME SPACES: T1 PE 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: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBI SHOWERS: SEWER LINE: fl WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: It Rei-tarks: Install irrigation backflow preventer. Owner: FEES -- Description Date Amount D'JN MORISSETTE HOMES - --- --- 4230 GALEWOOD S", #100 [III.I.A1131 Permit Fey 5/2/0:3 $36.25 LAKE OSWEGO, OR 97035 [TAX,1 VO State Tax 5/2103 $2.90 _ Total $3;9.15 Phone : 503-387-7535 --- Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALA T IN, OR 97062 REQUIRED INSPECTIONS Phone : X03-692-5945 RP/Backflow Preventer — Final Inspection Reg#: 111,M 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: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: p�F- t-7 t r'_ Permittee S. nature: Call (503) 639-4175 by 7:00 P M. for an Inspection needed the nsxt bus(ness day ., Mit%i 01 03 12: 23,0 dan edmnnds 503-692-0768 p, Pkinibi_ ng Permit Application Recc-ved ''�^� Plumbing Unte/t3y_r�_1 `U L� Permi:No,; City of Tigard Planning Approval Sewer Uate/P : Permit No. 131'25 SW ball Blvd. Plan Ruview W- Other - Tigard,Oregon 97223 DatdBv• Patmit No.: Phone: 503-639-4171 Fax: 503598-1960 Post-Reviv cw—` sand Use - - Internet: www.ci.tigard.or.usAli Date/13y: Case No. _Contact Juris. See Page 2 for — 24-hour Inspection Request: 503-G39-4175 Nume/Method: Supplemental Information. _-_ TYPE OF WORK - FEE*SCHEDULE fors eciat information use checklist) LID New con truction _-� Demolition Description I Qty. I Fce(en.) Tot,, ___Addition/alteratiom'replaccrn nt. Other: Now 1-&2-family dwellings - CATEGORY OF,CONSTRUCTIONi.icludes 100 ft.for each u Ilitv connection 1 &2-Famil dwelling mercial/:ndustrial SFs�bath — 24920 �--•-- -- � Co�mSFR(2)both 350.00 Accessory Building _ Multi-Fami-y SFR 3 bath 399.00 _ Master Builder Jj Other- Each additional bath/kitcheri 45.00 JOB SITE INFORMATION and LOCATION Firesprinkler-sq. ft.: Page 2 Job site address: UO KunCcic_Z Site Utilities Suite#: y Bid ./pz Apt_# Cutch basin/area drain_ 16.60 Project Name:l,-VA.,SfiQrS LQ%cLc-kC� -b ell/leach line/trench drain 16.60 Foolingdrain no. linear ft. Page 2 Cross street/Directions to job site; Manufactured horne utilities 110 no �.�:.� f.a-t 5�r '-'•� S t..�.. e.,✓fusNlti►S l ter�c ••'� Manholes 16.60 cam. t- L1'1Gt=C.� 10�L'�T Frain drain connector V 16.60 _ Sunitary sewer(no, linear ft.i Page 2 Subdivision: 1.13�LCS� ( �,l)4Q.(c- :Cf. Storrn sewer(no.linear ft_ Pa+e 2 —�—"- Water service nu.linear ft.) -Page Z T'ix map/parcel#: U 5 /,�iG _ DESCRIPTION OF WORK Fixture or Item- Absorption valve 16,66 CL#7ralt_ - g -__.. ..-_-___ Backflow prcventer Pa�c 2 f?Q[1C`flL'7�! GCL�L"/C __-------w Backwater vol�sc 16.60, Clothes washer 16.60 Dishwasher 16.60 PROPERTY OWNER -j�AN'I' Drinking fountain 16.60 N - -�-` - - ctors/sump 16.60 1\,ame: .j)�f�C S (_fes C�7')L.4- ElcEypansion tank _ 16.60 Address:IYL) % (Q— u CU-10c&- Fixture/sewer cap - 16,.60 r Floor drain/floor 16.60 rritv/State/Zf:C_t:.:t,le'e CS.LL G Oki,,V7/_'� -- 1— - Garba a disposal 16.60 Phone: Fax: Hose bib 16.60 APPLICANT CONTACT PERSON Ice maker M16.60 Narne_0�_�CL! a M) Interceptor/grease trap 16.60 _ Address: )L2i d(-L) temtj n Pa Medical us-value: S e 2 _ Zrity/Slats'/.Zip:"7'14.LaCt-1t7 � rJ (�,�,L M Pritncr _ 16.60 Roof drain commercial 16,60 Phone � _<� S R, Roof Sinleitinsin/lavatury - 16.60 E-mail: - Tub/shower/shower pun 16.60 _ CONTRACTOR Urinal i- 10.60 Business Name: /.Lt/),r(,{C t c_. �h? Wutcr closet _ - _ 16.60 --- "' ' Water heater 16.60 Address: .�L(``- m Lr 121a Other Li v/State/Zi :'niLZ..CG'Lf $•~ �;�0r-' 2.: Other Phone. > Fax: ��Q- 002 Plumbing Permit Fees`' r � Subtotal S :7'/ .S' CCB Llc. #: t) y_1 Plumb. LicA _ _ I --- I/ -S Authorized F - - Minimum Permit Fee 0 S� _ 9Residential Backflow Min Signature: _ /? /alt,Late: �OMinimum Fe $36.! Q3 plan Review 25%of Permit Fee S -- _ _.- ��� State Surge(S of Petmit Fcc 70 (Please print name) TOTAL PERMIT FEE S ,Notice: T'htr permit application expires it a permit is not obtained within All rew ennrcnercialbuilding.require 2 sets of plans with isometric or Igo days after It hot been accepted as complete. riser dirgrrrn for plan revs «. *Fee methodoinay set by Tr1-County liuilding Industry Service noard. hDitsTermit Forme\PlmhermitApp.doc 01.03 tzb 1 ,a yJ MASTER PERMIT CITY OF T I G A R D PERMIT#: MST9003-00058 DEVELOPMENT SERVICES DATE ISSUED: 3/5/u3 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12230 SW HANCOCK Cf PARCEL: 2S103CC-11500 SUBDi,ViSION: WHISTLER'S WALK ZONING: k-4.5 BLOCK: LOT: 062 JURISDICTION: "TIG REMARKS: New SF detached, Path 1. 6/19/U3, add a/c to permit. BUILDING REISSUE: STORIES: FLOOR AREAS _l REQUIRED SETBACKS REQUIRED _ CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,548 of BASEMENT Sf LEFT 5 SMOKE DETECTORS: TYPE C=USE: SF FLOOR LOAD: 40 SECOND: 1,642 of GARAGE. 552 of FRONT: V PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 TRAO 6f RIGHT: 113 OCCIIPANC"GRP; R3 BDRM: 5 BATH: 3 TOTAL. 7,190 of VALUE: 313'40 4,1 REAR: 30 PLUMBING_ _ SINKS: 1 WATER CLOSrI S: 3 WASHING MACH: I LAUNDRY TRAY,` 1 RAIN DRAIN: 100 TRAPS. LAVATORIES: 4 DISHWASHERS: 1 FLOOR GRAINS: SEWER LINES: 1:0 SF RAIN DRAINS: 1 CATCH BASINS TUBISHOWERS 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1'�O BCKFLW PREVNTR: I GREASE TRAPS MECHANICAL. OTHER FIXTURES. FUEL TYPES FURN<1OOK BOIL'CMP<3HP: 1 VENT FANS: 5 CLOTHES DRYER: 1 As FURN—100K. 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP, btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL_ RESIDENTIAL UNIT SERVICE FEEDER _TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS AOD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 amp: 0 -200 amp. WISVC OR FDR: PUMPARRIGATION: PER INSPECTION: EA ADUL 5005F. 6 201 400 amp: 201 - 400 imp tat W/O SVCIFDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 800 amp: 401 - 600 amp. EAADDL OR CIR: SIONAUPANEL IN PLANT MANU HMISVCIFDR: 601 1000 amp: r-011 amps-1000v. MINOR LABEL: 1000+amplvolt: PLAN REVIE W SECTION Reconnect only: —'— >-4 RES UNITS: SVCIFDR>=225 A.: >000 V NOMINAL.: CLS AREAISPC OCC ELECTRICAL•RESTRICTED ENERGY A.SF KESIDENTIAL B.COMMERCIAL _ Al 010 8 51 ERFJ: VACUUM SYSTEM. AUDIO A STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR Al ARM. OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS. TOTAL N SYSTEMS: O',vnor: Contractor: TOTAL FEES: $ 5,699.34 DON MIIRISSETTE HOMES DON MORISSEITE Hr1MES INC This permit is subject to the regulations contained in the 4230 GALEWOOD ST#100 4230 GALEWOOD ST a fE 100 Tigard Municipal Code,estate Specially Codes and all tither applicable laws. All work will will be done LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 accordance with approved plans. This permit will expire N wo;k iF 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: 503-387-1538 Phone: Oregon Utility Notifiration Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Rap N: 1 1�-387 75!�A� may obtain copies of these rules or direct questlGns to OUNC by calling(503)246-1987. PEQUIRED INSPECTIONS Erosion Control Insp 81 POSt/Bealn c:fructural PLM/Underfloor Electrical Service Shear Wall Insp Insulation Insp Sewer Inspection Post/Beam Structural PLM/Underfloor Electrical Service Shear Wall Insp Insulation Insp Footing Insp Post/Beam Mechanica Mechanical Insp Elect ical Rough In Exterior Sheathing Inst Rain drain In3p Foundation Insp Post/Beam Mechanica Plumb Top Out Frar ii..g Insp Low Voltage Water Line Insp Post/Rearrl Structural Crawl Drain/Backwater Plumb Top Out Shear Wali Insp Gas Line Insp Appr/Sdwlk Insp Issue By : kit "moi— Permittee Sig;mitre Call (503) 639-4175 by 7:00 p.m, fo; an inspection neeaed the next business day l J 0 J %J P i / CITY ®� '�I� /� �� _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003 00053 13125 SW Hall Blvd., Tigard, OF? 97223 (503) 639-4171 DATE ISSUED: 3/5/03 PARCEL: 2S103CC-11500 SITE ADDRESS; 1:230 SW 11ANCOCK CT 3UBDIVISION: WHISTLERS WA1,K ZONING: BLOCK: LOT: 062 __.. JURISDICTION: Ilei TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWEi LING UNITS: 1 TYPE OF USE: SF NO OF BUILDINGS: INSTALL TYPE: I_TPSWR IMPERV SURFACc: Remarks: Sewer connetion for new SF Owner:------ --- — FEES --------- -- [DON MORISSETTE HOMES Description Date — Amount 4230 GALEWOOD ST 11100 ------ ------ LAKE OSWEGO, OR 97035 [SWUSA]Swr Connect 3k5/03 $2,300.00 [SWUSA]Swr Connect 3/5/03 $0.00 Phone: 503-387-7538 [SWINSP)Swr Inspect 3/5/03 $35.00 [SWTNSP] Swr Inspect — 3/5/03 WOO Contractor: _.—�— -- ------- Total 52,335.10 Phone: Reg ft: Required Inspections This Applicant agrees to comply w;ih all the rules and iegrdations of the Clean Water Serrices. The permit expires 160 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does riot 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 a'I uirections 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 952-001-0100 You may obtain copies of these rules of direct questions to OUNC by calling(503) 216-6699. Issued by: � �J r�jy£�'_ �_ _._�_..._� Permittee Signature: - Call (503) 639-4,175 by 7:00 P.M. for an inspection needed the next business day � ti ** Building Permit Application � (� r ._-_- ' 0'� Permit no.: 'Y�t ._ I�alCffxCIVEd: 7 _ r City of Tigard, DProject/appl.no: MUM Address: 13125 SW Ha1143F�N;"��EVin 7223 By l . ltecciptno.: C3 Date issued: _ _ City of Tigard phone: (503) 639-4171 rr rrp 0 IB2 family'Smpe payment type: Fax: (503)598-1960 7 200 Case fie no.: ;!< AF1 !I^v lex: Land use approval: - �U lher, O I &2 family dwelling or accessory �j Commercial/industrial UMulti-family , New theruion 0 Demolition Addition alteration/replacement U Tenant improvement J f+n ti;nnkler/al:um ❑O ___-_--- --- rBldg.ria: Suite no.* � I Job addresv: c�,iv • ..�`_ ' Tax map/trot Eot/account no.: f Block: Subdiviston: USI: -• t'�:. _- Pmject name: Description and location of work on premises/special conditions:-_.-- _------- Nance: Y t �_ 1 &2 family dwelling: Mailing address: State� 7I-p• G'- Valuation of work...................................... . $ 7 mail: No.of bedracrosfbaths................................ �-'- Phone: - Fax: IISS. 'Total number of floors................................. , Own is represegtanve: - ' -mail: New dwelling ansa(sq.ft.) .......................... - Phone: rax: Garage/carport area(sq.ft.)......................... a2 =�o Covered porch area(sq.ft.) ............ - -- Name: Deck area(sq.ft.) ........... Melling address: L�' Other structure area(sq.ft.)......................... --- State: 71P_ Commerc;mtlindustriallmulti-fsmil I City:_ E-mail: Plume: rax: $ Valuation of work........ ..................... —•- I Existing bldg.arca.(sq. ft.) ............. ........... - �j Business name: New bldg.area(sq.ft.)......... ... ............... — • Address: -� L Number of stories.................. City: State: Zip: �_- Type of construction.,.......,1........ .............E-mail: E. ' ting: ------ Fax: -mail: _.-.-. Occupancygrcup(sl: Phone: __._-.___._.._ _ _ New: --- -- _--- -- _ Notice:All contractors and subcontractors are required to be Citylmetro tic.no.: I licensed with the Oregon Construction Contractors Board under provisions of URS 701 and may he required to he licensed in the �A'dmdrc! jurisdiction where work is being performed.If the.applicant is CLi Cly' lies: si h} --- exempt from licensing,the following reason applies: State: ZIP: _ City: Plan no.: __--- Contact person: __ _ mail: -- Phone: Fax: E Contactperson: Fees due upon application ....................... . . -------- Name: ______ Date received: ____-__---------- Addressmo : - Aunt received ••. ...... ....... $ City: M- - State. __ Please refer to fee schedule. Phone: Fax: _ Email: _ lean eau u--ri+���o"�0f^ '{nrormadan Nd�I jurixscNoro accept credit cards.p 1 I hereby certify 1 have read and examined this application and the visa 0MesterCnrcl attached checklist.A rovisions of I ws and o dinances governing this Ctedit Card numtwr: work will be contpl wt ,w1hethery cified�ereifiroi`,� IL/P� 1 �— { Autho:ircd sit natu M-L, Print name: + —. 4aoA(il)ttiONCOM) Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. One-and Two-Family Dwelling MOM Building Permit Appheatinn Checklist rtefereno:no. ` --- Associated permits: CfryofTigard city of Figrard U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other: _ Phone: (503) 639-4171 Fax: (.503) 599-1960 t t , 1 Land use actions completed.See jurisdiction cntcna I(ir cuncurreilt Irviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platAot. 4 Fire district_ approval required. - 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval --- R Solls 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-bwsin protection,etc. - — 10 _3 Complete seta of legible plans.Must be drawn to scale,showing conformance to hpplicable local and state building codes.Lateral design details and connections must he 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 Slte/plot"plan to scale.The plan must show lot and blinding setback dimensions;property comer elevations(if there is more than a 44 elevation differential,plan must show contour lines at 241.intervals);location of easements and driveway;footprint of structure(including decks);location of wellstseptic systems;utility locations;direction indicator,lot area;building coverage mea;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. — -I }3 Floor plans.Show all dimensions.room identification,window size,location of smoke detectors,water benter, furnace,ventilation fans., rmbing fixtures,balconies and decks 30 inches above grade,etc. 14__ ss Crosections)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 det.dls of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, v fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. E.merior 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. Ar 16 Wall bracing tprescriptive path)ind/or lateral analysis plana.Must indicate details and locations;for non-prescriptive ,ath analysis mop vtdP 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 walla.Provide cross sectio,.-and details showing placement of rebar.For engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations.Provide.two sets of calculatic.as 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 trmu design details. 21 Energy Code compliance.Identify the prescriptive path or provide calculations,A gas piping schematic is required for tour or moreavpliances. _ 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. 723Five(5)site plans are required for Item I1 above. Site plans must be 8-1/2" x I i"or i lx 17". wo(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 L28i - Checklist must be completed'4r,re plan review start date. hAnor changes or motes on submitted plans may be in blue or black ink. Red ink is reser,ed for department use only. W4614 MmalCOMI Mechanical Perinit Application Date : 4Permit no.: fj - ZS< City of Tigard Pro)ect/appl.no, Expiredate: City ofTigard Address: 13125 SW Hall Blvd,Tigard.OR 97223 Date issued: By: Receipt no.. Phone: (503) 639-4171 -- Fax: (503) 598-1960 Case file no: Paymert•.ype; Land use approval: __ Building permit no.. TYPE OF PERMIT U l Sc 2 family dwelling or accessory Q Cominerr-ial/industrial U Multi-family U Tenant improvement Jc:w construction U Additior>/alteration/rrplaccment U Other 1INFM-11AIJON COMIERt I lob address: V t :' _ (`t Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,averhead, Tax map/Lax lot/account no.: profit. Value$ Lot: IE BI«:k: Subdivision: ;,t y *See checklist for important application information and Project name: _ w� jurisdiction's fee schedule for residential permit fee. City/county: ZIP: t ANN I Description and location of work on premises: _ ' 1 / el t al ON I�er(ea.) Told( !AC sEst.date of completion/inspecti-nn: Dv!ic iption Qty. Res.only Res.otJy Tenant improvement or change of use: . —� Is existing space heated or conditioned?U Yes U No Air handling unit CFM Is existing space insulated?U Yes p No Air conditioning(site plan required) teration of existing HVAC system Viler compressors State boiler permit no.: Business name: fr _ HP Tons BTU/H _ Address: , y—� ire/smokeampss/ uct smoke detectors City: 1 Ll State- 71—P Heat pump(site planrequirnied) Phone: F r. E-mail: nstai 'r=rlace- rnac uer U/ Tf r'CB n �jr _ ---- Including ductwork/vent finer U Yes O No nstal rep ace/rc ocate eaters-suspende , City/metro lic. no.:N/A wall,or floor mounted Name f lease Tint): .L - entora IT'ance otherantFl Tu nace e oral on: Absorption units BTU/H Name: Chillers _ HP Address: _L ) Compressors HP a rii oamentil efhausi an ventilation: City: State: ZIP: Appilancevent _ Phone: Fax: I E-mail: Dryerexhaust -- _ ood}� s_,Type if res.kitcherilhazmat hood fire suppression system Name: �� Exhaust fan.with single duct(bath fans) Mailing address: "? (/�,' ) Exhaust system a art from heatingor A City: Sttae Z.IP tie piping andistribution(up to outlets) -- - Ty : __LPG NO Oil Phone: 7, ' I E-mail Fuel pipin each additional over 4 outlets rocempiping(schematicrequired) Number of outlets Name Other WWI applianceorequipment: Addr:ss: Decorative fireplace W Cit �- -.. S—tat—e:— ZIP: Phone: Fax: Email: _ stovdlr letst_t— nye Applicant's sig'ratu' a _� DatC: der -- t� L Name(print): ).et t [)�t'i riil-� _ Nd VI)unsdcunn acceptcredit rads,please till junalicuon for more mrmrutian Notice This permit application Permit fee............... .....$ 0Visa U htssxrcmd Minimum fee................s expires lCa permit is not obtained 1 Credit card number P,an review(at- Es i f within i Bd days atter it has been %) $ p State surcharge(8%) ....$ _ Nurse of cardholder u Mowo at credit cad accepted as complete. -- — ;' CadW&z silo tie Amount � TOTAL 410-4617(tS rOM) ) ;i Plunibing Permit Application Date received: Permit no.: City of Tigard Sewer permit Permit no.no.: Building —� Address: 13125 SW Hall Blvd,Tigard,OR 97223 _ City ojTigard Phone: (503) 6?9-41 71 Project/appl.no.. Expire date: Fax: (503) 598-1960 Date issued: ^— By Receipt no.: Land use approval' _ Case file no.: Payment type: t O I &2 farruly dwelling or accessory O Commercial industrial 0 Multi-family 0 Tenant improvement ew construction O Additioii/alteration/replacement ❑Food service A Other Job address: r ' C Description Qty. Fee( Total Bldg. no.. Suite no.: -_ NeN 1-and 2-family dweUings only: — - ------ Tax map/tax lot/account no.: (includes 100 ft.for rich utility connection) _ SFR(1)bath (tet Block: Subdivision: Cl P ,- SFR(2)bath Project name: SFR(3)bath --_..--' City/cot.tity ZIP: Fach additional bath/kitchen Description and location of work on premises:_ Site utilities: Catch basiri/area drain _ Est.date of compleuor>lnspecrion: Y Drywells/leach line/trench drain _ Footing drain(no.lin. ft.) Manufactured home utilities Business nam e• — L� L N Manholes Address: t Rain drain connector City: State• Z1P: Sanitary sewer(no. lin. ft.) Phone: ,-c- Fac: E-mail: —��— Storm sewer(no.lin. f�) CCB no.: -7 Plumb.bus. reg. no: — Water service(no.lin.ft.) Z' ( `--y--- nxtwe or item: City/mtetro lie. no.:NiA ��� Absorption valve Contractor's representative signature '� ` i Back clow reventer — — Print name: J` U c Backwater valve �— Basinsllavatory �— Name:. ���DI ti� — Clothes washer -- _ Dishwasher Address: G 4 "V Dnn'dng fountains) — (Citv: state. — Ejertorsisump Phone: Fax: E-mail: Expansion tank Fixture/sewer cap Name(print): Rcor drains/floor sinks/hub '' � —t -rJ1 Garbage disposal _ Mailing address: Hose bibb Ciry' Stag Z1P_L�` Ice maker _ Picone: - Fax: 7-741!- t�-mail: Interceptor/grease trap --- — Owner insral/adon/residendai maintenance oni'Y: The actual installation Pnmens) _ will be made by me or the maintenance and repair made by my regular Roof drain(cornmerci il) emplovee on the property I own as per ORS Chapter 447. Sink(s),basintsi,lays(s) — IOwner's si nature: Date _ Sump — Tubs shower/shower pan Name: Unnal _ — -- ----. water closet _ Address: _ k'aier neater City: State ZIP: Other. Phoneme Fax_ E-mail: Total Not an lunildicu.xn accept cntilit cards,ple se call turisdicuon rix more mrairnauon Notice:This permit application Minimum fee................$ O Visa O MasterCard expires if a permit is not obtained Plan inview(at _ %) S _ Credit,.aid number within 180 dad s after it has been State surcharge(8%) ....$ L•'trires — — accepted as complete. T01'AL ....................... Name or:ardholdtt u tbuwn on credit cad — P S l`ardheldu ujnature Amami .1.10-4616(6r10+r^r,Y} Flectric:al Permit Application --- "---- '�` Datereceived! ? Permit no.: City Of Tigard f ject/appl.no.: Expire date: City ofTilard Address: 13125 SW Hall Blvd,Tigard,OR 97223 teissued: By: __1Rcceiptno.: Phone: (503) 639-4171 �- - Fax: (503)598-!960 se file.to.: payment type: Land use approval: TYPE OF PERIVIq ❑ I &2 family dwelling or accessory ❑Corrunerciallindustrial U Multi-family ❑Tenant improvement New construction U Addition/al teratiorCreplace.rile tit U oder. ❑Partial 1 l t 1 Job address: ) {/1 Bldg.no.' I Suite no.: ITax map/tax lot/account no.: Project name: �Description and location of work on premises: Estimated date of completion/in pt�t inn: I Job no: Fn Msz �Yy j Description y Qty. (,a.) ro�nt �ro.In% Business name: `�� �, 1�t�,.e� New residential•single or muki-famitr p»r Address: �i1 �1: 7 dneuingunit includes:rttachedgamar. city: _ State: Zip: Serviceincluded: Phone L L 1j I Far: _ E-mail: Ifxx)sq.rt.or less _ _ 4 Each additional 500 sq.ft.or portion dier-of _ CCB no.. _ Elec. bus. tic. no:���= Uniitedenergy,residential 2 C' — Limited energy, sidntial _ 2 Isr h manufacturedred home o me or modular dwelling Ne ojsupen:stng eferrr(elon(regwlredj--- — Date Ser vire and/or feeder _ 2 Sup elect.name(print) 1 Licenseno S.rvicesorfeeders-brsiallation, al — tenNon or relocation: 2f0 amps or less 2 L -[-�- 201 amps to 400 amps 2 Name (print): .� !S� 101 amps to 600 amps _ 2 Mailing address: V\I it' 601 amps to 10ra amps 2 City: .� _ State ZIP:Cf —over l000amps c•voiu 2 Phone: _ Fax:-_ -� -mail: Reconnectonly 1 Owher Installation:The installation:is being made on property I own Temporary services or feeders- which is not intended for sale, Lase,rent,or exchange according to installation.altentiun,orrelocation: 2 200 amps or less _ URS 447,455,.179,670,701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits-new,alteration, or extension per panel: Name: — _ A. Fee for branch circuits with purrhase of Address: service or feeder fee,cacti branch circuit _� City: _ State: ZIP: B. Feefor branch circuits without purchase 2 --- ----• - of service or feeder fee,first branch-- circuit Phone: Fat. Each additional branch circuit: M1 Misc.(Service orfeeder not lnciuded): ❑Service over 225 amps-coir cm;at i:7 Health rare facility Each pump or irrigation circle O Service over 320 amps-raring of IA2 O Har utfous hxauon Each signor outline lighting 2 family dwellings ❑Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. 7 System over 600 volts nominal more residential units in one structure alteration,or extension' 2 O Building over three stories O Feeders,400 amps or more 'Description •Occupant load over 99 persons ❑Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: •EllmssfliP�tingplan 0Other � _ - Per inspection Submit_sets of plants with any or the above. Invesugauoo fee The above are not applicable to temporary construction service. Other _ No all jurisdictions accept credit cards.plesse call jurisdicuaa ror more inromution Notice:This permit application Permit fee.....................$ O Visa O MasterCard expires if a permit is not obtained Plan review(at -- %) S credit cud oorriber- _ (�__ within 190 days after it has been State surcharge(8%) ....$ FApitet accepted as complete. TOTAL — Name tit cardholder as Showa on c r eaN S _ cardholder ti azure Amount 440-4615(&AXWnM) OBE : 2832 Doli MORISSETTE TAT: 62 S 0 x 1R s 1 x c 0 R P 0 2 T s D DATE: 01/29/03 LAKs 00eisa0. sT011sa0KD Tv, 0se PROPERTY: WHMI.ER"S-WAU (e 03) 367 - 7538 TAI (503X87 - 7015 CffV-: TTGARD R E C E I v F:.LI SOALF: 1"=20' PlAk' No.: 16" FEB 0 7 2003 OFOTION-2 E>_FYATION I � I CITY OF TIGARD 21.4Z' 12' BUILDING DIVISION I I ' 1 � i I � I � I � I � I �\ 1 � 1 I I I i '3M I �LyI 8.6' / 311' f - -- w �' - •� I z 14I (L 4 he.-9 34 I LA J " z 3,Iw eq. ft. 5 bdrm. �o 2 In bath U, 1 �` --- 3 rl®'xe ' I 3 \ 301 t PATO O � I I �\ `` c+wlawY• a 592 eq. �t e 5 _ 3 car Qpr.309 I I in Sl I I i 3'4' T PRIVATE 15 DO' SC I� EASEMENT FOR BENEFIT OF LOTS 51-54 314 N AND 6144 ��4ti-11 I � ,••"' I©.490' P .E. /7• LOT COV/ER4r E LEGEND _OT ARE 9,010 50. FT. u �t4t1� BUIL DING AREA: 2,555 Sa. FT ---EXISTING TREES F'ERGENTAGE 28.4% -7- AGE4''RE' l TO REMAIN TC301eq.2 RED MAPLE' O f,• CITY OF T'IGARD 24-Hour B11.11LDINC Inspection Line: (503) 639- INSPECTION DIVIS1011! Business Line: (503)63 7 MST BUIl _ Received ___—Date Requested AM— Date _- __ - F'M ____ SUP I.ocation � �._ C--Q Cz.--Suite__- _-_.. EC - 1 _� Contact Person __ __ Ph( ) -_-- -__ PLM Contractor SWR _ SUIL DING Tenant/Owner ____ ELC Footing EL Foundation Access: —V Ftg Drain ELR _ Crawl Drain Slab inspecti�.,n Notes: ort ----- Post A,Beam Shear Anchors -� Ext Sheath/Shear _ Int Sheath/Shear Framing Y CA, Framing Insulation �1 S (�,Ap Drywall Nailing - Firewall V �_ Fire Sprinkler --- Fire Alarm Susp'd Ceiling — -�- --" Roof Other: — Final PASS PART FAIL PLUMBING Fost&Beam Jnder Slab ----- — — -------- -- Rougi.-In v Water Service — - - SanitF,ry Sewer Rain Drains -- Catch Benin/Manhole Storm Drain -*==- ---- — Shower Pan Other: — Flnel ---" PA PART.. FAIL — _ CHA L Pos &Be.am Rough-In —_— Gas Line Sr Dampers aS� PARI` L ' CTRICALi� Service — Rough-In -- UG/Slab Low Voltage Fire Alarm — Final [-1 Reinspection fee of$___._.__—p_required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE _ [�] Please call for reinspection RE: . � _ Fj Unable to Inspect-no access Fire Supply Line d ADA Approach/Sidewalk Other: Final Of) N01 REMOVE: this Inspection record from they job siite. PASS PART FAIL