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15405 SW HARCOURT TERRACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639.4171 BLIPDate Requested - l G _Hnn Y PM BLD _ Location ,/•.'�_(/&Y v c c, .r J` _ Suite MEC _ Contact Person Ph . ,6 yr 3 �' �� PLM — Contractor P.6 SWR BUILDING Tenant/Owner _ Retaining Wall ELR _ Footing {-- Foundation Access: �� ,,.o� tom-./• FPS Ftg Drain - - {-, u 4 C&-J' ,t- LC. --- -- Crawl Drain I Inspection Notes: SGN Slab _ - SIT Post R Beam --"-- -- Ext Sheath/Shear Int Sheath/Shear Framing -- - ---- - -- ---_ - Insulation Drywall Nail'Ing -- _ --------------- Firewall "------- Fire Sprinkler - Fire Alarm _ _ --��.--- ------- ------ - Susp'd Ceiling -- Roof Mises —---- ------------- - - - Final'- — P PART FAIL ------ ------- - --- - _- �._�. � DI Post.°I Beam ------- - ---- - ---. --- ---------- - Llvd,:+r Slab Top t)ut Water Service Sanitary Sewer _ - --- ------- -- --`��•• ---------- R in Drains 9 PART FAIL (MECHANICAL ['ost& Beam Rough In Gas Line - - -- ------- -_— Smoke Dampers Final -- PASS PART ':AIL ELECTRICAL Service Rough In UG/Slab Low Voltage Fire Alarm Final � --------- -- ---- PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspertion. Pay at City Hall, 1312E SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: [ j Unable to Inspect-no access Fire Supply Line b — ADA 7 � , Approach/Sidewslk Date _ Inspector s„��v�--!� _ Other � / Ext —_- First - PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGRRD BUILDIN113 INSPECTION DIVISION MST -7 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — ' t3UP �paZe Requested AM f'M _— BLD Locaticn- Ms` s � �' .-7 _ �i�c ---- -- MEC Contact Person _— —_ Ph ,__-- PLM _ Contractor -------------- --- Ph ---- SWR ----......—..... -- UIL I - l enant/Owner ELC ----- e aining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection "rotes: --- -- - Slab ___.-_----------- ___ __-._-- SIT Post 8 Beam ------__.__---.-- - Ext Sheath/Shear Int Sheath/Shear Framing - ----------------------- ---- -- - Insulation Drywall Nailing _ Firewall Fire Sprinkler �,/ -------------___-__.Fire AlarrT Alarm Susp'd Ceiling ------__._- _.-- - -_--- _s_ Roof inal � S `PART FAIL - PLUMBING I'r,st& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS SRT ,FAIL Post& Beam - ---------- - _ - - Rough In Gas Line / - — Smake Dampers PART FAIL ELECTRICAL ------- — __—. Service _ Rough In UG/Slab Low Voltage Fire Alarm --- - - -- -- ----- -- Final PASS PART FAILSITE 1 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 [ ]Please call for reinspection RIF [ ] Unable to inspect-no acce.s ADA Approach/Sidewalk Other Date 1 O — c?L Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the jab site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 flour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested 4 -AM PM _ BLD — Location l j'le -S S c. ti re'O 6,4 y Suite _ MEC Cor' -ct Person — Ph I - ,3.3I 41 PLM Contractor Ph SWR BUILDING Fenant/Owner _ ELC _— Retaining Wall ELR Footing Access: Foundation FPS F:g Drain St,N Crawl Drain Inspection Notes --- - ------ ----- Slab _-- -- SIT Post& Beam -- -----— Ext Sheath/Shear Int Sheath/Shear — ---�-- Framing Insulation ----- -- --.�.n—_------ ----- --- --- -- --- Dryrwall Nailing Firewall Fire Sprinkler —_ Fire Alarm Susp'd Ceiling —.— Roof -- ------------ .".fisc . .... .-- Final - ---- PASS PART FAIL — PLUMBING Post& Beam -- ----__ .---- Under Slab Top Out --- - -- - Water Service Sanitary Sewer -- fi— Rain Drains Final PASS PART FAIL MECHANICAL — — Post& Beam --- --- --- --- - Rough In - Gas Line - ----- —--_� __ Smoke Dampers Final - -------- --- ---..�—_ PASS PART FAIL Service. Rough In - ----- - - — - -- UG/Slab Low Voltage — Fire Alarm rn PART FAIL Backfill/Grading — -- —--- — ------_—__.---- -------- Sanitary Sewer Storm Drain [ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I )Please caor reinspection Plll for RE: ect-no access Fire Supply Line --------_ _ I l Unable to ins P ADA Apppp roach/Sidewalk Other Date _ � Ittspr*ctor — _ Ext Final �� PASS—PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIOARD Residential. Certificate of Occupancy Permit No.: , Address: �5 U ` �l�,eG✓vim' _-- --__ — Owner/Contractor: Date of Final Inspection: Inspector: ( Inspector: --- This structure has been found to be in substantial compliance with the provisions of the State n/Oregon One& Two FandlY Mvelling Specialty Code and is hereby approved for occupancy• i s i i 4 i i s T'`i( C)F TIGARD MASTER PERMIT CITY PERMIT#: MST2000-00518 DEVELOPMENT SERVICES DATE ISSUED: 12/18/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 15405 SW HARCOURT TERR PARCEL: 2S1 11DA-12400 SUBDIVISION: APPLEWOOD PARK NO 3 ZONING: R-7 BLOCK: LOT: 117 JURISDICTION: TIG REMARKS: S/F PATH 1 BUILDING REISSUE `T Y STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,054 at BASEMENT: if LEFT: 4 SMOKE DETECTORS: r TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 992 at GARAGE: 482 of FRONT: 20 PARKING SPACES 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 0 or RIGHT: 4 VALUE: S 157,511 00 OCCUPANCY GRP: R3 BORM: 3 BATH: 3 TOTAL: 2,046.00 of REAR: 25 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDPY TRAYS: I RAIN DRAIN: 1OO TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS 1 CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFI.W PREVNIR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<t00K: BOIUCMP<3HP: VEVT FANS: CLOTHES DRYER: 1 GAS FURN>-100K: 1 UNIT HEATERS HOGuo: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BPANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPARRIGATION: PER INSPECTION: EA ADO'L 500SF: a 201 -400 amp: 201 - 400 amp: 10 W/O SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 900 amp: 401 •900.rnp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVCIFDR: 901 1000 amp: 901+ampe•1noov: MINOR LABEL: 1000+amplvoh PLAN REVIEW SECTION Reconnect only: >W RES UNITS: SVCIFDR>s225 A.: >900 V NOMINAL: CLS AREA/SPC OCC. ELECTRICAL•RESTRIr tED ENERGY _ A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: ,,DID 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LN13SC LT: BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEHRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS TOTAL A SYSTEMS: Owner: Contractor: TOTAL. FEES: $ 3,902.69 MATRIX DEVELOPMENT CORP LEGEND HOMES CORP This permit is subject to the regulations contained in the 6900 SW HAINES ST STE 200 12755 SW 69TH AVE Tigard Municipal Code,State Specialty Codes and TIGARD,OR 97224 TIGARD,OR 97223 all other applicable taws. All work will be done in accordance with approved plans. This permit will expired work is not started within 180 days of issuance,or if the work is Guspended for more than 180 days. ATTENTION. Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg 0. LIC Goseforth in OAR 952-001-0010 through 952-00 i-0080. You may obtain copies of these rules or direct questions to OUNC by catling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Foundatlon Insp Footing/Foundation Dr; Electrical Service Low Voltage Water Line Insp Final Inspection PosVBeam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwtk Insp Building Final Issued By : Perrnittee Signatur� Cell(SA) 639-4175 by 7:00 p.m.for an Inspection needed the next bu mess day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00358 " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/18/00 PARCEL.: 2S111 DA-12400 SITE ADDRESS; 15405 SW HARCOURT TERR SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 117 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELL.ING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached. Owner: — – _--�--_---� FEES -- MATRIX DEVELOPMENT CORP Type By Date Amount Receipt 6900 SW HAINES ST STE 200 TIGARD, OR 97224 PRMT CTR 12/18/00 5,2,300.00 2720000000( INSP CTR 12/18/00 $35.00 27200000000 Phone: �v Totr l $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Q— Permittee Signature: �- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next busi ess day Building Permit Application Date received: // Permit no.: rJS�?000 005/ l City of Tigard Project/appl.no.: Expiredate: t_uy of 1 igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 I �, Date issued: By: Receipt no.: Fax: (503) 598-1960 Case Me no.: Paymenttype: Land use approval: Idc2family:simpie Complex: TYPE 1 lir t &2 family dwelling or accessory U Commercial/indu.trial U Multi-ftntily IdNew construction U Demolition U Addition/alteration/replacentent U Tenant improvement U Fire sprinkler/alarm U Other: JOB SITE INFOUM',�:TION Job address: C, -L c � rt Z Jt�T ( 1�'I�L L Bldg,no.: Suite ria„ Lot: ( t'-7 Block: Subdivision: iaWt WLU.h -PAYZ K-_ I Tax map/tax 1ntfaccaiant no.: . Project name: l_Description and and location of work on premises/sIx-cial conditions: Name: 71GIn ilia Mailing add ss: /g-)j-,5 7, q 1 &2 famfly dwelling: i City:-?Cf&K. State:p ZIP: j7o2„� Valuation of work............. . .......... a �� � Phone: G,20,Pow Fax;$r• - -- E-mail: No.of bedrooms/baths................................. 5 Owner's representative: - -- 1✓Z-L71 J` Total number of floors................... ............. 'Z Phone: L Fax:r VL/E-mail: New dwelling area(sq. ft.) .......................... Garage/carport area(sq.ft.)......................... EZ Name: Covered porch area(sq.ft.) ......................... _ Mailing add ss: 07 Deck area(sq. ft.)........................................ -- StateQ ZIPOther structure area(sq.ft.)......................... City. ,� :- CommerciaUfndustrinUmulti-family: Phone: (, O Faxtj - . E-mail: 1 Valuation of work........................................ $ Existing bldg.area(sq.R.) .......................... Business name: Z erd New bldg.area(sq.ft.) " _Address:/,1 7s' Number of stories....................................... -- City: a C�State ZIP:'7 7� �- - TYPe of construction.................................... _ Phone ,V&9RF=SItfE-mail: Occupancy group(s): Existing: - CCB no.: 0 Ip 0 -fo _ New: City/metro lic.no.: 7 Nodee:All contractors and subcontractors are required to be ARCIIITECI'IDlicensers with the Oregon Conseuction Contractors Board under Name: J- V provisions of ORS 701 and may be requirrd to be licensed in the Addrtss: — jurisdiction where work is being performed.If the applicant is S s exempt from licensing,the following reason applies: Cit NI Stater' ZIP: 9 Contact person: Kel no.: Phone:(r,Zp - © v Faxi,q Email: — Name Contact person: Fees due upon application ........................... $ -�.,e Addir-s: aylp Date received: City: cri State p ZIP: 'J 7��_ Amount received ......................................... $ PE-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Na Shops WcW cnal tarda.pleae ull juri,r>kuon ror more information. attached checklist.All provisions of laws mid ordinances governing this o Visa o MaterCard work will be complied with,whether sjxcified herein or not. Credit card number:_ —.-- __ / _L__ Expires AUIh01'IZCd natUrC: ate: w Name of cardholder u rhown on ered0 card Print name: _—__ crdfroteer claruture Amount Notice:This permit applicat' n expires if a permit is not obtained within 190 days after it has hcen accepted es complete. 4401613(fiW/COM) Mechanical Permit Application Date received: Permit no.: City of 'Tigard Project/appl.no.: Expire date: Ciryof'Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 — Fax: (503) 598-1960 Case file.no.: Payment type: Land use approval: _ �_-__ _ _ Building permit no.: 1 .411 &2 family dwelling or accessory U CommerciaUindustfial U Multi-family U Tenant improvement New construction U Addition/alteration/replacement U Other..11011 SI I f,INFORMATION 1 Job address: tom) `���� -i _7LR- I Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: _ _ value of all mechanid.ai materialF,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: I -IBlock: Subdivision: A 'See checklist for important application information and Project nan►e: c,yC jurisdiction's fee schedule for residential permit fee. City/county: ;I-la ZIP: -�L.� l Description and 1 alion of work on premises: _ Fee(m) 'Total Est.date of completion/inspection: T Description Res.only Res.only Tenant improveme r change of use: A Air handling unit CFM Is existi space heated or conditioned?U Yes U No Air conditioning(site plan require ) Is a ng space insulated?U Yes U No Alteration of exisung RVAC system - - 1 130►er compressors State boiler permit no.: Business name: i HP —Tons B'rutH Address:Jay ' its—ino a ampers/ductsmoke detectors ^� City; Statg� I ZIP: 97d _ cat pump site p an require Ic) " Phone: -7 J Fax: -7L1 E-mail: _ nsta- rep ace umac urner__--E39'CT11f Including ductwork/vent liner U Yes Q No _ CCB no.: gy/31 Instal Urept ace7rclocateheaters-suspend e , Cityhnetro lic.no... a i wall,or floor mounted -- Name(please pont): /Dpn Vent ora appliance of er an furnace e era on: 1 Absorption units_____,__ BTU/H �p J -� Chillers �__ lip _ Name. 1� - Com miss ___ HP Address: J �— r roementa ex ust and vent at on: City: Pot State:OR I ZIP: Appliance.vent _ Phone• -77 ' Fax -7L"#JEmail erexhaust _ Hoo s,Ty / res.kitchenthazmat hood fire suppression sy:tem --- pJame: Exhaust fan with single duct(bads fans) 4 Mailing address: _), j-- _-�— OQ - x aunt s�s_t_emmaar ati Tom eaun or _ 973 ue p ping anni sl oe up to out ets f ity: f, Stat ZIP: _ Type:__LPG NG Oil Phone: - E Fax: ? lY Email: uel i ing eac i a ditional ove�ouiTeis rocesspiping(schematicequite3) Number of outlets _ Nam@ LI 2_e�� _ - tree �eT p&nce or equfpineW. Address: 4fe^. _ Decorative firenlace _ City: - U � ----- State ZIP: nsert--type Phone: (o0- - C� Fax: E-mail: tov pe et stove Other- Applicant's ier _ Applicant's signature: —ate: t� Name (print): Not all Jurisdictions ttccrpt credit cods, - cat jurisdiction for more iNormttdlon. Permit fee.....................$ ----, Notice:This pe-mit application Minimum fec................$ U Visa U MasterCard expires if a permit is not obtained CMdit cud number. _ _,L Expires�— Plan review(a[ __. 91') $ within 180 days after it has been + State surcharge(896) ....$ _ --- - -- accepted as complete. Name of cudhoider u shown on credit card p p S 'TOTAL .......................$ —— — Cardholder signacwe ---- — nnaunt 440-4617 t6ffl d:OM) Commercial Schedule 1&2 Family swelling Schedule ASSUMED VALUATIONS PER APPLIANCE tksalptwn Furnace to 100,000 BTU Table IAMechancalCode Oly Price Total Includingducts&vents 955 1) Fnnace toduds 11go00 BTU � kWuding &vents _ 14.00 Furnace>100,000 BTU 2)Furnace 100,000 BTU+ Including duds&!tnls 17.40 including ducts&vents 1,170 3) Floor Furnace Including vent 1.4.00 floor furnace 41 Guspended healer,wag healer induding vent 955 or flow mounted heater 14.00 suspended heater,wall heater 5)vent nol Included In appliance permit _ 6.60 or floor mounted heater 955 6) Re ,lr units 12.15 Check ail that apply' 'Boger Heal Alf Vent not included in appliance permit 445 Fw Nems 7-10,see of Pump Cond Qty Price Total Repair units 605 foo absorb unit to cum . <3 hp;absorb.unit I 00 erU _ 14.00 6)3.15 HP;absorb ung to 100k BTU 955 look to 500k BTU 25.60 3-15 hp;absorb.unit unit 15-30 HP: BTU � 35.00 101k to 500k BTU 5700 io)3e-5o P;absorb -- unit 1-1.75 mg BTU 52.20 15-30 tin;abstorbSO .unit 11)> HP;absorb unit>1.75 mil BTU iT- 501k to 1 mil.BTU _ 2310 &7.20 12)Air handling ung to 10,000 CFM 30-50 hp;absorb.unit 1000 13)Air handling unit 10,000 CFM+ 1-1.75 mil.BTU 3400 17.20 >50 hp;absorb.unit 141 Non-po(Uble evaporate cooler - St Vent Ten to a akOdu 10.00 >1.75 mil.BTU 5725 6.60 Air handling unit to 10,000 efm 656 16)ventilation system nol Included In Air handling unit> 10,000 cfm _ 1170 17)Hood �iveddbll io oo by mechanical exhaust`- Non- odab(e evaporate colter 656 1e)Domestle IrMneratols --- to 00 vent fan xnnected to a single dud 446 17.40 19)Commercial or industrial type Incinerator Vent cyst.not Included In appliance permit 656 00.95 Hood served by mechrnical exhaust 656 20)cher units,► ld+oy wood uoves� 10.01) Domestic Incinerator 1170 21)Gas p pkrq one to(our outkb SAO Commercial or Industrai Incinerator 4590 221 Mw than 4-pnr ov0e1 team) t.00 Other unit,Including wood stoves,Inserts,etc. 656 Minimum Parmli Fee$72.60 SUBTOTAL Gas piping 14 outlets 360 - 8%SURCHARGE Each additional outlet 83 PLAN REVIEW 25%OF SUBTOTAL Required for ALL commercial Permits only TOTAL 00-1(npedlona ane Flee: 1. Yupndlnw nW da d nemul!,nWAN horn(w** "n durparvM hmn) $72 SOP.Isar 2, In pedlont M WN1h-M M tpacgkaa,W 1.1od(nwNNr""n dwgo-hM ho r) a 72 50 per hr"> Total 11a1lQI1 Fees 2 Incisions plan mv*+-1-W by dn^ees aMnM Of revhlone ID pant t-inlrfr etwMeo hag hmol f 72 5J per hpe 'SUN Comb low Goss Ce V"(kn replied S 1.00 to 55,000.00 Mini.uuln 571.50 --Retki-"NC"Ar".ne pan tnowq pacamenl of on" $5,00. "+01o$10,000.00 $72.50 for the first$5,000.00 and S 1.52 for each additional S 100.00 or fraction therwf, to and'including$10,000.00 $10,001.00 to$25,000.00 S148.50 for the first$10,000.00 and$1.54 for each additional$100.00 or fiaction thereof,to and including 525,000.00 $25,001.00 to$50,000.00 5379.-0 for the fust$25,000.00 and 51.45 for each additional 5100.00 or fraction tht teof,to and including S50,000.00 00,000.00 and up $742.00 for the first$50,000.00 and S1.20 for each addi tional$100.00 or rTar.tion thereof Plumbing Permit Application Date received: Permit no.: City Of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,'Figard,OR 97223 —' CiryoJTigard Phone: (503) 6394171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: _ _ By: Receipt no.: Land use approval: _ —_ Case file no.: Payment type: 1 1 &2 family dwelling or accessory U Commeicial/industrial O Multi-family U Tenant improvement U-f;,-w construction U Addition/alteration/replacement O Food service U Other: 's JON IFFE-SCIiEDULE(for special inforinktIod use.check ist) Job address: 5 C13- 2C3U V (� _ Description (jty. Fee(ea.) 'total New 1-and 2-family dwetl'urgs only: Bldg.no.: Suite no.: (Includes lOUft.for eschutitllyconnection) Tay.map/tax lot/account no.: SFR(1)bath L.ot: � Block: Subdivision: SFR(2)both — - Project name: SFR(3)bath City/county: ZIP- `j7 - h additional bathilutchen Description and lo6ation of work on premises: _ 811teuti0ties: Catch basin/area drain Est.date of completion/inspection Dryweils/ieach line/treac tarn Footing drain(no.lin.ft.) t 1 MartufaLtvted home utilities Business name: Lj-)e C Address: C9 5,v Rain drain connector City:(210J State:p ZIP: 70 3 Sanitary sewer(no.lin.ft.) Phone: G 7- Fax:GG%-9 E-mail: Storm serer(no.lin.ft.) CCB no.: 3 Plumb.bus.reg.no: p Water service(no.lin.ft.) lhlxture or Item: Cityimetro Iic.no.: Absorption valve _ Contractor's representative signature: Ylptr v'n Back flow preventer Print name: Far / s O!I Date: Backwater valve 10 KtEJULLIM Basinsflavatory �' *et Clothes washer Name: ��o� � Dishwasher _ Address: Od B o f-)DO 7 Drinking f�untain(s) . Suttep ZIP: 3IJ Ejectors/surn Phone: Fax: L'•mail: Expansion tank Fixture/sewer cap _ Nano(print): L Q �' — Floor dmins/floor sinks/hub _ Garbage disposal _ Mailing address: 7j-, - Hose bibb _ City: o� d State:eiQ ZIP: Ice maker Phone:&0 - m Fax:d E-mail: _ nterceptor/grease trap Owner installation/residential maintenance only: The actual installation Primers) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own s per ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's signature: �,o e: l Z Z D U Summa_ Tubs/shower/shower pan _ Urinal Name: - - - Water closet Address: 6Water heater ity: Staten ZIP: Other. Other. Phone; _ ,0 0-5--f Fax: LE-Tail. Total Na atau.gyp C'"I Cards, Jurisdiction for��wanruwan. Minimum fee...........%) wlurisdiS Notice:This permit applicatiar, Plan review(at ,___. 96) $ O Visa 0 MasterCard expires if a permit is not obtained Credit cud number. — --�-- within 180 days after it has been State surcharge(8%) ....$ _ Expires accepted as•complete. TOTAL .......................$ ww at eardol a shown on credit card - Cardholder si6ruaure --�xuM 4104616(6wrOM) p1EASE COMPLFJE; FIXTURES (individual) Qty PyCe�.; Total Fixture Type Quantity by Work Performed 1 Sink 16.60 New Moved Reolaead Removed/Cepow Lavatory 16.60 Sink Tub or Tub/Shower Comb. _ 16.60 Laval Tub or TublShower Combination Shower Only 16.60 Shower Only Water Closet 16.60 Water Closet '-- _ Urinal Urinal 16.60 Dishwasher Dishwasher 16,601 Garbage Disposal Laundry Roo,n Tray Garbage Disposal 16.60 Washing Machine Laundry Tray 16,60 Floor Drain/Floor Sink 2' 3' Washing Machine 16.60 4' Floor Drain/Floor Sink 2- 16.60 Water Heater 3- 16.60 — Other Fixtures(Specify) 4' 10.60 —� Water Healer O cr rivers on 0 like kind 16.60 Gas piping requires a separa,e mechanical permit. — — MFG Home New Wal it Service 46.40 L -- MFG Home New SaniStorm Sewer 46'40 COMMENTS REGARDING ABOVE; Hose Bibs 16.60 Roof Drains 16.60 Drinking Fountain 16.60 --- --- --- -- Other Fixtures(Specifv) 21.75 Sewer-1 st 100' 55.00 Sewer-each additional 100' 46.40M Water Service-1st 100' 55.00 Water Service-each additional 200' 46.40 Storm 5 Pain Drain-1st 100' 55.00 Storm S Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Insp,of Existing Plumbing or Specially Requested 72.50 lnspeclicns _ rlhr Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram is required I Quantity Tow Is >9 'SUBTOTAL 8%SURCHARGE "PLAN REVIEW 25%Of'SU13TOTAL Required only I fixture qty.lolol Is>9 _ TOTAL 'Minimum permit too Is$72.50♦e%surcharge,except Residential Bar Dow r'rrverdkm Device,wh"Is$36.25•e%surcharge, "A9 New Commercial Buildings require p4ans with K(wieuk:or riser diagram and plan revlrw. mow• Electrical Permit Application —� - Datereceived: Permit no.: City of Tigard Project/appl.no.: _ `txpiredate: CilvofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By�Receiptno.: Phone: (503) 639-4171 - Fax: (503)598-1960 Case file no.: Pavnient type: Land use approval: 1 &2 family dwelling or accessory O Commercial/industrial U Multi-family C3 Tenant improvement New construction U Addition/alterarion/replacemeat j Other: U Partial Job address: 1 (�J 'p IL I�Ido!n��,.. .Suite no.: Tax map/tax lottaccount no.: Lot: II Block: Subdivision: t_;eoC1[ p Project name: 'lJi'_��T: Description and location of work on pr--raises: Estimated date of completioti/ins ction: Job no: _ Fre MAX Business name: Description _ try (ca.) Total no.bus New reddentia.l-dMle or multi-lamily per Address: 4 7_z1 unit.Ivelurlesuttac tApunge. City: Statep ZIP _ Servicelncluisee- Phone - lj I Fax:Z -79,1j -mail: I(Xx)sq.ft-or iet5 _ -- —� -- - 4 Each additionr'5W sqft.or portion thereof - C o.: 14#,5_q I Elec.bus.lie.no: 3 S C Lin»tedenergy,reaidentia! _ Z ity W_7141" ,3 07s ,_ (.imitAcnergy,non-residential 2 ' Each manufactured home or modular dwelling au ms el tnician(required) Date Service and/or feeder 2 ii name(prinq; .,l Liccnae no:- d ienkes or Ryden-installattori, dterallun or relocation: 200 amps or less 2 Name(print): �,,�P S 201 amps to 4(10 amps 2 401 amps u)600 amps 2 Mailing addr_es� 7'y- ' LrJ f$ Q_ - �_ I- 601 amps to 1000 amps 2 City: ' Statet3 ZIP:�' f"1� Over 1000 amps or volts -� 2 Phone:Goll- efd I Fax:S-q - E-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to %xitallatim,citeration,orrelocation: ORS 447,455,4799 670,701. 2(0 amps or less _ 2 �y 20,amps to 4IX1 amps 2 Ownee3 signature: f440'1/ c or 'ti.�Datc: ` ! Cp 401 to 600 tins _ - 2 Br*rich circuits-new,attention, m extension per panel: Name: / . A. Fee for bracch circuits with purchase of Address. O/� service or feeder fee,each branch circuit _ 2 City:'t. _ — StateiR ZIP9'7 B. Fee for brunch circuits without purchase Phone: / - G� F x F mail of service cr feeder fee,first branch circuit. _ _ _2_ Each additional branch circuit: Mbe.(Service or feeder not Included): U Service over 225 Rips-conuuretciat J Health-care facility Fah pump or irrigation circle _ 2 U Service over 320 amps-riling of 1 dr2 U Hazardous location FAch sign or outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal circuit(*)or a limited energy panel, U System over 600 volts nondnd more residential units In one structure alteration,or extension* 2 U Building over three stori-s U Freders,400 amps or more a tion: U Occupant loot over 99 persons U Manufactured structures or RV park FAch additional I Inspection or*the allowable In any of the above: — UlgressAightingplan C1 Other --- Per inspection _ F--T---T _ _ Submit_sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Outer Nd all Jwisdktlaa ac,,epd credit cards,please c '; iadk'uon ray rtaae WamYian, Notice:This permit application Permit fee.....................$ U Via O MasterCard expires if a permit is not obtained Plan review(at _ %) $ credti card number: / / within 160 days after it has been State surcharge(8%) ....$ Expires accepted as complete. TOTAL .......................$ Name of cardholder u shown an c— rhe it cid-- S (.anlholder sipwmre Awount 4411`4615(610nR'OM) TYPE OF WORK INVOLVED-RESIDENTIAL ONLY 4. Complete Fee Schedule Bek,ow: Number of Inspections per permit allowed Restricted Energy Fee.........................r......... $76.00 Service included: Items Cost Total (FOR ALL SYSTEMS) 4a. Residential-per unit i Check Type of Work Involved: 1000 sq.R.or less $147.15 4 Each additional 500 sq ft.or ❑ Audio and Stereo Systems portion thereof $33.40 1 I smiled Energy $75.00 ❑ Burglar Alarrn L acli Manufd Home or Modular Dwelling Service or Feeder $90.90 2 - ❑ Garage Door Opener' 4b.Services or Feeders Installation,alteration,or relocation ❑ Heating,Venlifation and Air Conditioning System' 200 amps or less $80.30_ 2 201 amp, 400 amps - $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 amps -~ $240.60 2 17 Other Over 1000 amps or volts $454.65 2 -- Peconnect only - $66.65 2 TYPE OF WORK INVOLVED -COMMERCIAL ONLY 4c.Temporary Services or Feeders _ `- installation,alteration,or relocation Fee for each system.............................................. $75.00 200 amps or less �i $86.85 _ 2 (SEEOAR 918-260-260) 201 amps to 400 amps _ $100.30 -�- 2 401 amps to 600 amps $133.75 i -� 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems 4d.Branch Circuits New,alteration or zxtension per panel ❑ Boiler Controls a)The fee for branch circuits with purchase ofservire or ❑ Clock Systems feeder fee. Each branch circuit -� $6.65 2 ❑ b)The fee for branch circuits Data Telecommunication Installation without purchase of service C� or feeder fee. L Fire Alarm Installation First brandi circuit $46.85 _ E] HVAC Each sddillonal branch circuli - _ $6.65 i HVAC 4e.Miscellaneous (`:r,:vice or feeder not Included) �,f Instrumentation Eaclr pump or Irrigation circle ___ _ $53.40 ; _ Eac sign or outline fighting - $53.40_ ❑ Intercom and Paging Systems Signal circuN(s)nr a IimNed energy papa,alteration or extension ^_ $75.00 _- [-jLandscapeIrrigation Control' Minor Labels(10) _ _ $125.00- 4f.Cach additional inspection overy ❑ Medical ttre allowable In any of the above ❑ Per Inspection _ $62.50 _ Nurse Calls Per hour562.50 In Pant $73.75 Outdoor Landscape Lighting' 5. Fees: ❑ Protective Signaling 6a.Entcr total of above fees $ _ 8%Sorrcharg^(-08 X total fees) $ - ❑ Other Subtotal __ _ 61).Enter 25%of line 5a for � -Number of Systems Ilan Review If reguhed(Sec.3) $ Subtotal $ __ No licenses are required Licenses are rr,aulred!or all other Installations UTnrstAc-couniA FEES: -- --- ---- _.,_ Total balance Due a ENTER FEES -- -�� 8%SURCHARGE(.08 X TOTAL ABOVE) S TOTAL $ May-10-00 10: 211 Wo'i�;--oLt Plumbing 603 667 9891 P,02 WOLCOTT5 N.W. a sa MNt.B x200 r V 2050 N.W.Burnside P.O.Bax 2Q07 Gorham,Omgon Gmsham.OR 97050 PLUMBING (803)68747A1 Fax(503)667.9891 CONTRACTORS, INC. CCB N"M47 May 10,2000 Building Department City of Tigard 13125 SW Hull Blvd. Tigard,OR 97223 W(Acott Plumbing Contractors,Inc. docs hereby authorize a representative of legend Homes to represent this firm when applying for plumbing permits inside the jurisdiction of'13te City offigard. Wolcott Plumbing Cuntmetora, Inc. realize that should the agreement with Legend Homes terminate, we have the right to v4thdraw our consent. y��� r- Name Title ignature Date 2.6-208P13 4281 State Plumbing License City license FL O I FLAN id /�f�r�c �2d 7/r--- LOT /r---LOff' #111 , AFFLEWOOD FAR< �S Ta47D - RIFD 251 11 DA - TAX LOT 012400 15405 5W 44RCOURT TERRACE r- %-I.E. 1/4 OF SECTION 11, T.2, RAW, W.M. GIT'T` OF TIGARD W,46+4INGTON GOUNTT, OREGON LEGEND HOMES �Iwl!� i 12766 811 8016 AVENUE BUITR l00 al/ I OMCR (603 PORTLAND, 628-8060 08. 97223 FAX (603) 698-8000 CCB/ 80683 O WATER METER W---- -- WATER LINE 55———— 54NITARY SEWER SD-- - - -- STORM DRAIN �- -_-_-- Q OF 5rREET i MANHOLE NCATCP BASIN PROP05ED STREET TF:'-S �{] STREET L IGH r TIRE HYDRANT PROVIDE ER05ION CONTROL FENCE r� y ,1 F'ER GOMMUNITi E R05I ON PLAN LOT 116 p A 20'1.9' N18'-3'E;14'25'E # -�5..4i__._._ I- � 81.03' •I.� �' ��,. i.x.07' 117 c3 lS`/ UJIN5TON A/ 'n U_ ,G ARACsE FLR 2lalb' I N89'54'2,"E I y l� to 81'18' 2013' 2f8�5', `; •. - - - —�—_.__ _19•:64___ L O 118 in (