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15525 SW HARCOURT TERRACE w N CiT N 1 � n a c N G1 �r i 1 3 1 f F,525 5 v'v Harcourt Terrace n CITY I TY O F TIGARD IGARD MASTER PERMIT _+ PERMIT#: 1O3T2000 00544 DEVELOPMENT SERVICES DATE ISSUED: 12/28/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 15525 SW HARCOURT TERR PARCEL: 2S111UA-12900 SUBDIVISIO V: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 122 JURISDICTION: TIG REMARKS: S/F PATH 1 BUIL DING _ REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED ;;LASS OF WORK: NEW HEIGHT: 24 FIRST: 1,054 of BASEMENT: of LEFT: 4 MQKF rETECTORS: Y TYPE OF US!. SF FLOOR LOAD: 40 SECOND: 969 of GARAGE: 480 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWPLLING UNITS' i rl;.nLsMENT: of RIGHT: 4 VALUE: S 105,48100 OCCUPANCY GRP: R3 DDRN: 3 BATH: 3 TOTAL: '-.02300 of REAR: 38 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRA-N: +u0 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWEk LINES: 100 SF RAIN DRAINS I CATCH BASINS. TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 (NATER LINES: 100 BCKFLW PHEVNTR: I GREASE TRAPS: OTHER FIXTURES: 0 MECHANICAL. _ FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>a100K: I UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INP. btu FLOUR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER T°MP SRVCIFEEDERS BRANCH CIRCUITS _ MISCELLANEOUS ADD'L INSPECTIONS 1D00 SF OR LESS: 1 0 200 amp: 1) 200 amp: W/SVC OR FDR: I PUMPARRIGATION: PER INSPECTION: EA ADo'L 5003F: 3 201 400 amp. 201 400 amp: tet WIO SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 4n1 600 amp: 401 - 600 amp: EA ADDL BR rIR: 0 SIGNAL/PANEL: IN PLATT: MANU HMISVCIFDR: 601 - 1000 amp: 15011-amps-1000v: NiiNOR LABEL. 1000•amplvoll PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC/FOR-=225 A.`_ >601 V NOMINAL: CLS AREAISPC OCC: ELECTRIt.AL•RESTRICTED ENERGY _ A.SF RESIDENTIAL _ _, B.C OMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: nUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC: DA'fA/TELE COMM* NURSE CALLS TOTAL 0 SYSTEMS. Owner: Contractor: TOTAL FEES: $ 3,872.48 This permit is subject to the regulations contained in the MATRIX DEVELOPMENT CORP LEGEND HOMES CORP Tigard Municipal Code,State of OR Specialty Codes and 6900 SW HAINES ST STE 200 12755 SW 69TH AVE#100 all other applicable laws. All work will be done in TIGARD,OR 97224 TIGARD,OR 97223 accordance with approved plans. This permit w1l expire if work is not started within 180 days of issuance,or If the work is suspended for more than 180 days. ATT!--'JTION. Pane: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg 0: LIC 60563 forth in OAR 952-001-0010 through 952-001-0030. You may obtain copies of these rules or direct questions to OUNC by calling,,503)246-1987. REQUIRED INSPECTIONS Etosion Cc:ntrnl Insp 8& Post/Beam Mechanica Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Final Sewer Inspection Underfloor Insulation Mechanical Insp Low Voltage Water Line Insp Final Inspection Footing Insp Crawl Drain/Bbckwater Electrical Service Gas Line Inm Anpr/Sdwlk!nsp Building Final Foundation Insp Footing/Foundation On Electrical Rough In Gas Fireplace Electrical Final PosVSeam Structural PLM/Underfloor Framing Insp Insulation Insp Mechanical Final issued By: �t. • ' iL Per mittee Signatures Cali (503) 639-4175 by 7:00 p.m. for ao inspection needed tho next htil ness day CITYOF T I GA R D SEWER CONNECTION PERMIT DEVELOPME"I i SERVICES PERMIT#: SWR2000-00371 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/28/00 SITE ADDRESS; 15521) SW HARCOURT TERR PARCEL: 2S111DA-12900 SUBDIVISION: ADPL E=WOOD PARK NO 3 ZONING: R-7 BLOCK: LOT: 122 JURISDICTION: TIG _ TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: L FPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF dwelling. Owner: -- FEES MATRIX DEVELOPMENT CORP Type By Date Amount Receipt 6900 SW HAINES ST STE 200 —�---- TIGARD, OR 97224 PRMT CTR 12/28/00 $2,300.00 27200000000 INSP CTR 12/28/00 $35.00 272000',k IU Phone: _ Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. Ti ie permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measu-ment given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires iou to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. Issued by: tt -- Permittee Signatur$:�.i t. L Ca!I (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application �� Date received: Permit no.: jDp ��S City of Tigard ityoJl'i�urd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: C - Phone: (503) 6394171 Date issued:_ _ By: E2eceipt no.; Fax: (503) 598-1960 Case file no,: Payment type: Land use approval: —� 1&.2 family:Simple Complex: TYPE 1 Ur'l &2 family dwelling or accessory 0 Commercial/industrial ❑Multi-family krNew construction LI Demolition O Addition/alteration/replacement ❑Tenant improvement U Fire sprinkler/alarm O Other: __— tiINFORUATkON Job address: L75 2S ti,J t r " C%� T' ii i-t-e- Bldg.no.: _ Suite no.: Ent: l'� Block: �T1Sutxii iision-�f� wpr,-0.3,AW1 (,L--- map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: j12 c ' 3 7-7i 1 ' 1 Name: t t r Mailing add s � q 1 &2 family dwelling: _ Cite Statc:p�/ 7.IP: �7a?e� 7 Valuation of work $ Phone: GeZQ— c Fax - E-mail: c� No.of bedrooms/baths................................. Owner's representative: _ Total number of floors................................. Phone: Fax: ! E-rnail: New dwelling area(sq.ft.) .......................... �/ Garagdcarpott area(sq.ft.)......I.................. Name: '&CA v Covered porch area(sq.ft.) ......................... _ Mailing add ss: 1,1 geek area(sq.ft.) ........................................ _ City _ Staten ZIP: Other structure area(sq.ft-)......................... -- Phone: (,_ , i- Faxtj . F.-mail• t.'ontniercial/industrial/multi-famiiy: 1 1 Valuation of work........................................ --- Existing bldg.area(sq.ft.) .......................... Business name: Address: New bldg.arca(sq.ft-)),Z��s ' ��t - Number of stories ........................................ City: � SratetD ZIP: 7��. -- Type of construction.................................... Phone: O Q Fax:j E-mail: CCB no.; -- Occupancy group(s), Existing: O _ -��' __ City/metro lie.no.: < 7 New:Notice:All contractors and subcontractors are requited to be licensed with the Oregon Construction Contractors Board under 7Nae: f�� provisions of ORS 701 and may be roquireci to be licensed in the ess:/ .3 J Vic/ �� jurisdiction where work is being performed. If the applicant is exempt from licensing,the following reason applies: �� a statew/� ZIP: g; Contact person: Key flan no.: _ -------- -- -- — -- Phone:(P,Zp - v v I rax:s- E-mail — Name: —,-,,e Contact person: Fees due upon application ........................... $ _ _Address: joC C Date received: .__-�___ City:_ oil St ,U_3 Amount received ......................................... Phone: 74,z—Fax: E-mail: _ Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all urlad eons accept credit cards.please call jurisdict+on for more inrormatiort _ attached checklist. All provisions of laws and ordinances governing this a visa ❑MauetCard work will be complied with,whether specified he in or not. credit card number: L— i •—� aspires Authorized�j t'nahrre: CAc ate' (2 b `rte of urdhoider as shown on credit cool _ Print name: Psi - - -- •f -- CambNAder dputure ----Amount Notice:This permit applicat' n expires if a permit is not obtained within 190 days after it hes been accepted as complete. se64615(WWOM) Mechanical Permit Application Date received: Permit no.: City of 'Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dateissued: By: -- Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: - P;ymcnt type: Land use approval: __ Building permit no.: 1 _JJ'I &2 family dwelling or accessory U Commercial/industrial ❑Mniti-family U Tenant improvement VNew construction U Addition/alteration/replacenrcnt U Otter. 1 1 Job address: ZS 44-Alk-CO 41--T `F'•EK t2 Indicate equipment quantities in boxes below. Indicate die dollar Bldg.no.: Suite no.: — value of all mechanical materials,equipment,labor,overhead, Tax ma /Ptax lot/account no.: profit.Value S — — Lot: 2 Block: Subdivision: �- •See checklist for important application information and Project name: C,, jurisdiction's fee schedule for residential permit fee. City/county: ' -rE ZIP: 1 Description and Iodation of work on premises: 1 t o f 1 t Fee(ea.) Total Est.date of completion/inspection: — Descri .lou _ � • Rea.only Res.only Tenant improveme r change of use: Auhandling unit CFM v Is existi space heated or conditioned?O Yes 0N Atr oniiiuo in ng(su plan-plan v _ Ise ng space insulated?0 Yes ❑No A ieration o existing system Boil er compressors State boiler permit no.: Business name: _ HP Tons BTU/H Address: OJ- Fire/smoke amper uct smo a detectors City: v Statim 7.[P: 9701 eat pump site plan required) Fax: -7G 1 E-mail: nstal rep ace urnaccr umer Phone: -7 J Including ductwork/vent liner ❑Yes O No CCB no.: fnsi'�lacc/rt.acT ateheaters-suspen e , City/metro lic.no.: 7 40�— wall,or floor mounted Namt(please rint): p,-)1) ri ent for a ranee o er an urnace ed9tradom CONTACT PEMON. Absorption units BTU/H _ Chillers__-- tip _ Name: / Com ressors HP Address: f r onmenta exhul t an vent ton: City: PatState:oQ ZIP: J7; Appliancevent Phone -7J Faxes' -"JL E-mail: ererviiet _ 0o stype 1T res. 'lc a iazmat hood fire suppression system — Name: f Pgj� O/y Exhaust fan with single duct(bath fans) Mailing a�.1e- :x aunt system mart from eatin ar C tie p P ng an afst on up to out ets City: rt Stated ZIP:���— Tyle: LPC; —_— NG Oil Phone: - O G� Fax E-mail: tie PPt��in��eac a iuonTTove-rd out cis rocess plping(sc sematic required) _ Numb-r of outlets �______� ter ae� p—p�iroce or e�Tqu P�neot: Address: . Pecorauvetimplace _ City: ���y•�1 State ZIPZIP: - Insert-ry = - -f---� E-mail. stov pe ctstove — Phone 1v.2 Gam' er. Applicant':} signatjre: at 1 lO 0 D er. Name(print): Permit fee.....................$ Na dl Jurirdktiam aceept credit unls,pt r.eau Jurir tictior.for more infammtan. Notice:Thisrm fklt application Minimum fee................$ O Visa O MasterCard expires if a perm'is not obtained plan review(at Credit card number: ---- � within 180 d ' it has been _ days eer State st:rcharge(8%) ....$ of cudholder u crcredit cad s accepted as complete. TOTAL . $ --- ---Cardhdder d6nuwe ���— Amami 4464617(6MCOM) Commercial Schedule 1&2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE nesoiptwn Furnace to 100,000 BTU Tab!1A Mechanical coda oty r(tn Total 1) R.maa-w 100.000 HTU Including ducts&vents 955 Including d5&vents 14.00 sumacs>100,000 BTU 2) Furnace W0,000 BTU• 17,40 _ Includl22-td3&vents Including ducts&vents 1,170 3) Fwor Furnace Including hent 14.00 floor furnace 4) Suspended heater,wall heater Including vent 955 or 11oa rnuunled heater u.00 suspended heater,wall heater 5)vane na+r��dea M amt ancg m,a �H e.eo or floor mounted heater 1 955 6 R air ands 12.15 Check art that apply: I 'Boller ileal Air Vent not includsd in appliance permit 445 For kerns 7.10,see or Pump Cond Oty Price Total lootrhotea i,2 Cam - Repair units _ 805 7)<3HP;absorb unit to <3 hp;absorb.unit LOOK BTU 14.00 e)3.15 HP;absorb unit to 100k BTU 955 took to soar BTU _ 25.60 3-15 hp;absorb.unit unit bbl m4BTU ro` 101 k to 500k BTU 1700 10)30.50 HP;absorb unN 1-1.75 and BTU 52.20 15-30 hp;absorb.unit 11)>SOHP;absorb unit>T75 ndt 97u y s .zo _ 501k to 1 mil.BTU 23 t rl 12)Ah handling unit to 10,000 XM --' . 10.00 30-50 hp;absorb.unit 13)Ak handling unit 10,000 CFM* _ 1-1.75 mll.BTU 3400 17.20 >50 hp;absolb.unit - 14)Non portabie evaporate«toter 10.00 >1.75 mil.BTU 5725 15)VaM fon wnnaded to,'Ingle duct 4.e0 Air handling unit to 10,000 cfm 656 1a)vendstwn system not;OZd r, to 00 aunce .rnk Alf handling unit>10,000 cfm 1170 17)Hood served by mechanical exhaust 10.00 Non-portable evaporate culler 656 18)Domestic Incinerator vent tan connected to a single dud Industria /7.46 19)ComrtherrJal Or al type lnc�klerolor Vent syst.not Included In appilance permit 6 65 69.95 Hood served by mechanical exhaust 656 20)other units,bolding wood stoves69.95 Domestic Ir-''ierator _ 1170 21)13.plpinq one to won outlets 5.40 Commercial or Industral incinerator 4590 22)INrxeihan 4 qer outlet(each) 100 Other unit,including wood stoves,Inserts,etc. 656 Minimum Pernik Fee f72.50 SUBTOTAL Gas piping 1-4 outlets 360 a%SURCRARoE PLAN REVIEW 25%OF SUBTOTAL Each addiflonal outlet 63 Required for ALL commarcbl permits 1Ni1y TOTAL IL Older hrepeetl"esd Fe": t. k ped.dWkN d n"mhal WSWs hU,Ma(mW I Mh dWWWO 1lelea) $72.50 pet hour 2. jn p ,,,,,q to.,ter w les h snedncaay ind"led("WWMMn degFhea 1100 i1a.50,her Ave addnbns W rvlsbns b plana NrWWrsa" Total Valuation Fee. ' dltl011 1.1%01'""""0 SOM "'a"0"' dnerpetxr troll'ar�172,60 pt hdx .SWW r,,*,clw 1W0 CWW-I-r ,*.d S 1.00 to$5,000.00 ^� Minimum$72.50 -P..W f"W AX WIW"is.aa"st-*,g v1--4a urn 55,001.00 to 510,000.00 $72.50 for the first 55,000.00 and S1.52 for each additional 5100.00 or fraction thereof, to and including$10,000.00 $10,001.00 to S25,000.00 5148.50 for the first$'0,000.00 and S1.54 for each additional S 100.00 or fraction thereof,to and including$25,000.00 525,001.00 to$50,000.00 $379.50 for the first S25,000.00 and S1.45 for each additional$100.00 or fraction thereof;to and including S50,000.00 550,000.00 and tip_ h $742.00 for the first S50,000.00 and$1.20 for each additional S 100.00 or fraction thereof Plumbing Permit Application �Y Date received: Pcrrni!no.: za City of Tigard m�it no.: B,Admg permit no.: Sewer pe Address: 13125 SW Hall Blvd,Tigard,OR 97223 --- CiryojTignrd phone: (503) 639-4171 Project/appl.no.: _ Expire date: -~ Fax: (503)598-1960 Date issued: By: Receipt no.: --, �---- Land use approval: _ Case rile no.: Payment type: PERMIT- dl &2 family dwelling or accessory Q Commercial/industrial 0 Multi-family 0 Tenant improvement Utflcw construction O Add ition/al teration/ieplacrment ❑Forxl service O Other: JOB SITE INfOANMTION Job address: a Description ____ ��,�S�ll�_-(-f��2T `TI�(Z .._. � �Y• Fce(ea.) Total Bldg•no•:_ Suite no.: New I-and 2-family dwellings only: Tax map/tax lot/account no.: (includes 1001t.for eNchutility connection) SFR(1)bath LAX: �2� 131xk: _ S rbdivision: �Q1.VW vtA) AriK SFR(2)­h______________-------. —� Project name: SFR(3)bath City/county: �- LIP: Each additional bath kitchen Description and 1 ation of work on premises: `i Siteutilltles: Catch basin/area drain Est.date of completion/inspection:_ Drywells/leach liline/trench drainlutuallilm _ Footing drain(no.lin. ft.) - 1Manufactured home utilities Business name.: �0�����- Manholes Address: -�3o k aDp ` Rain drain connecter -- City: . ,ajii t _ Stater ZIP: 703d SaniGvy sewer(uo,lin. ft.) _ - -- Phone: (, Fax:GG 7-q E-mail Storm sewer(no.lin. ft) CCB no.: �"�`� Plumb.bus.reg.no: 'p, Water service(no. tin.ft.) City/metro lic.no.: -` Fixture or Item: Contractor's resentative signature: Absorption valve Back now prtventer Print name-�O Da Z (i oe� Backwater valve 'CONTACT.PEPSONBasins/lavatory Name: Clothes washer Address: o8e�pp 7 Dishwasher — City: t o Stated ZIP: w3e) Drinking fountain(s) _ Ejectors/sump Phone: Fax; E-mail: Expansion tack _ ! Fixturt:/sewer cap — Floor dmins/floor sinks/hnb� i Name(print): �•pc �� ,� � i ir�S Garbage dis sal v Mailing address:'7,3 4w, G t -- ° Hose bibb City: C,r / State:o'- Zip: 9,2'2� lee a Phone: ) I'itx:� ' rE-mail: (nterce liar/grease trap- — — Owner instal lation/residentii I maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Raof drain(commercial) employee on the property I own s per OR3 Chapter 447. Sink(s),basin(s),lays(s) - Owners signature: 1 a d;ilatc:� (iOhca Sump '— mutt 101,1111 Tubs/shower/shower pan Urinal -- Name: �V, Water closet Address: L SZ1Z IAP-- 09—_-�--- Water heater City: _ I Stater ?.IP:` "7 Other. - —f---- Phone: G _ 00O Fax_ E-mail: Total Not sit imisticliotu accept ercdit cud.,please call jurtadiction rix mare inframatiott Minimum fee................$ Notice:This permit application U visa O MasterCanr expires if a permit is not obtained Plan review(at _— %) $ Credit card number. F / within 180 days after it has been State surcharge(8%)....$ p ted ascomplete. TOThL .......................$ Now Naof cud6ot a s diown wi crodu cad arse P adholder al`aature Amount �i� —_ 4444616(MOrOM) FIXTURES (individual) ;Qty Phi,ce't: Total Fixture Type Quantity ti Wo Hc Pariormed Sink 16.60 Now Movod Replaced RemwedrCappa 18.80 Sink -- - -- Lavatory --- - __ Tub or Tub/Shower Comb. 16.60 lavatory Tub or Tub/Shower Combination Shower Only 16.60 Shower Only - Water Closet 18.60 Water Closet _ Urinal Urinal 16.60 Dishwasher - Dishwasher 16,80 Garbage DI_Posal Laundry Room Tray Garbage Disposal 16.60 Washing Machine Laundry Tray 18.80 Floor Drain/Floor Sink 2' '- Washing Machine 16.60 4• Floor Drain/Floor Sink 2' V 16.60 V+'ater Heater - 3' 16.60 Other Fixtures(Specify) 4' 16.60 Water Heater O conversion O like kind 16.60 --- -- C,as pipingrequires a separate mechanical permit. MFG Home New Water Service 46.40 -`- MFG Home New SanlSlorm Sewer 46.40 COMMENTS REGARDING ABOVE: Hose Bibs 16.60 Root Drains 16.60 Drinking Fountain _ 16.60 Other Fixtures(Specify) 21.75 Sewer-1 sl 100' i 55.00 - Sewer-each additional 100' 46.40W"� .� Water Service-1st 100' 55.00 Water Service-each additional 200' 48.40 Storm a Rain Drain-tat 100' 55.00 Storm 6 Rain Drain-each additional 100' 48.40 Commcrdal Back Flow Prevention Device 46.40 Residential Backflow Prevention Dev,ce' 27.55 Catfi Basin _ 16.60 Insp.of Existing Plumbing or Specially Requested 72.50 Inspections perthr Rain Drain,single family dweiiing- 65.25 -dr-ease Traps 15.60 QUANTITY TOTAL ` Isonvetric or riser diagram Is requhrd N Quantity Total Is >9 'SUBTOTAL 8%SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only N fixture qty,kAsl Is>9 _ TOTAL *Minimum permit fee Is 172.50+a%surcharge,except Residential BacMlow Pmvenrkxr Device.whkih is 1136"25+0%sradwge. "AN New Commercial Buildings require plans with homeW or riser diagram and plan review Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: City of7"igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt r+o.: Phone: (503)639-4171 — Fax: (503)598-1960 Case file no.: Payment type: Land use approval: "112 family dweliing or accessory D Commercial/industrial U Multi-family U'Tenant improvement 6 ew construction U Addition/alteration/rcplacement U Other:—___�— U Partial 11010111K,111 I Job address: � "�-�tLf31dg.no.: Suite no_--- Taz map/tax lot/account no.: 1.ot: IZ1. Block: Subdivision: C.ez" oto P0►...t� Project name: _ _ I e ription and location of work on premises: Estimated date of completion/inspection: — 11%E SCHEDU11' Job no: _ vee 11U,x Description Qt). (ea.) Total Business name: i ...P _ New residential-aingleor multi-randly per Address: ,5 dwellbtgntll.lncltrdesattschedRa-age_ City: StateeD I ZIP: SeMcelncluded: Phone F- , Fax:G -7&j -mail: 1000 sq.ft or less - 4 Each additional 500 sq.ft.or portion thereof C ' o.: 's Elec.bus.tic.no: 3 - -- [.irutedenrrgy,residential 2 tlY d 75 Limited energy,non-residential —� 2 Each manufactured home or modular dwelling rilturedy supirvism, el cion( ulred) Date I Service and/or feeder 2 Servka car feeders-Installrrtlon, Sup.elect.name(print): ,,,t„ License no: Q altentlon or relocation: 200 amps nr less + Name(print): ® 201 amps to 400 araps" 2 401 amps to 600 amps 2 Mailing address: - — __�J -. 601 amps to 1000 amps 2 City: p Statco ZIP: 2 Ovtr 1000 amps or volts 2 Phone:G�zO- oct'd Fax: - E-ttralh Reconnectoaly 1 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 Installation,olteratlon,o-relontlow ORS 447,455,479,670,701. 200 amps or less _ _2 /J .l 201 amps to 4(N)amps _ _ 2 Owner's signature: J_p / ?� %�' 'iy Date: p 401 to 601 n J:s 2 Branch circuits-new,alteration, or extension per panel: Name: � j A. Fee for branch circuits with purchase of Address:,) #C),,-' service or feeder fee,each branch circuit 2 City: ,. --- 5tategi ZIpg7 B. Fre for branch circuits without purchase V!service or fiedei!ee,first branch circuit: 2 Phone' - p Fax: F. mail - — Each additionalbranch circuit: Misc.(Service or feeder not Included): U Service over 225 snips-commercial U Health-care facility Each pump or inigo:ion circle -� - 2 U Service over 320 amps-rating of[Q2 U Hazardous location Each signor outline lighting _ 2 family dwellings U 9uilding over 10.000 square feet four or Signal circuits)or a limited energy panel, U System ov:r 600 volts nominal more residential units in one structure alteration,or extension' L 2 U Building over three stories U Feeders,400 amps or rtx *Description. U Occupant load over 99 persons U Manufactured structures or RV park F�rch addNior.al Inspection over the allowable In any of the above ❑F.grraa/lighlingplen O Other: __-_-._ Per inspection Subrdt_ulcus of plate,with.ay of'he above. Investigation fee The above arc not applicable to temporary construction service. Otha Not all)urisdktlnus accept uedlt cards,please call}urisatcdae for more matl me woron. Notice:This permit application Permit fee,....................$ U Visa U MasterCard expires it permit is not obtained Plan review(Pt _, %) $ Cmdit cud an credit c Expires accepted as complete.number. - L_L_ within 160 days after it has been State surcharge(8%) ....$ None of cardhol - TOTAL. ................. .....$ .rwr+ _ S _ Cardholder signature Amount 440-461 (&WrOM) -- TYPE OF WORK INVOLVED-RESIDENTIAL ONLY 4. Complete Fee Schedule Below: Number of Inspections per permit allowed Restricted Energy Fee........................................ $76.00 Service included: Items Cost Total (FOR ALL SYSTEMS) 4a. Residential-per unit Check Type of Work involved. 1000 sq.ft.or less _ ;147.15_ _ 4 Each additional 500 sq ft.or Audio and Stereo Systems portion thereof $33.40 Limited Energy $75.00 F.urglarAlarm Each Manufd Home or Modular Dwelling Service or Feeder _ $90.90 2 C Garage Door Opener' 4b.Services or Feeders Installation,alteration,or relv,;ation Heating,Ventilation and Air Conditioning System' 200 amps or less $80.30_ 2 201 amps to 400 amps _ s $106.85 A 2 Vacuum Systems' 401 amps to 600 amps ®^ $160.60 __- 2 601 amps to 1000 amps _ 5240.60 T 2 Other _ over 1000 amps or volts �- _ $454.65 - 2 -~ - Reconoed only -� $56.85 2 _TYPE OF WORK INVOLVED -COMMERCIAL ONLY 4c.Temporary Services or Feeders __ Installation,alteration,or relocation ,-^Y -� Fee for each system.............................................. $75.00 200 amps or less _ $66.85 2 (SEF OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps _ $133.7r -. 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 extension per panel 13oiler Controls a)The lee for brandy circuits With purchase of service or Clock Systems feeder fee. Each branch circuit _ $6.65 _ 2 b)The tee for branch circuits � Data Telecommunication Installation without purchase of service or feeder fee. Fire Alarm Installation First branch cirrxdt _ $46.85 Eadh additioi ial branch rlrcui'. $6.65_ J HVAC 4e,Miscellaneous Ej Instrumentation (Service or feeder not Included) East pump or irrigation circle $53.40 _ Fach sign or outline.fighting $33.40 Intercom and Paging Systems Signal circutt(s)or a limited energy panel,alteration or extension S75.00 E] Landscape Irrigation Control' Minor I abets(10) $125.00 41.Each additional Inspection over, Medical the allowable In any of the above Per inspection _ $62.50 Nurse Calls Per hour $62.50 In Plant _ $13.75 - Outdoor Landscape Lighting' r. Fees; Protective Signaling Sa.Enter total of above fees $ 8K Surcharge(08X total fees) 5 "her Subtotal $ Sh.Enter 25%of tine Sa for Number of Systems Plan Re,.iew H required(Sec 3) $ Subtotal $ _ No kenses are required. Licenses are required for all other Installations EJTrust Account q_____,�__i, _., FEES: total balance Due $ ENTER FEES 8%SURCHARGE 1.08 X TOTAL ABOVE) $----- TOTAL ---_TOTAL $ FL Off' FLAN LOT #12 2 AFFL E WOOD FARC Rlf= D 251 11 DA I ) D TAX LOT 012900 15525 SW 44RCOURT TERRI AGE S.E. 1/4 OF SEG*rICN 11, T.2, R.lW, W.M. CITY OF TIGARD 1,U,45PINGTON COUNT-1 , OREGON LEGEND 61 WATER METER ■���� HOMES W------- WATER LINE DRAIN STCi 55-�——— SANI''ART 5EWER a h " 12755 SW 09th AVENUE SUITE 100 D— - - •-- ;M OFFICL� (503) 820- 8080 TICARD, OR. 972;3 S FAX (603) 698-8900 CCH* 60503 -- — -- 4 OF STREET O MANHOLE CATCH BASIN PROPOSED 5TREETTREE5 STREET LIG-IT �T "RE HYDRANT lr I - PROVIDE ERG,.-)ION CONTROL FENCE PER COMMUNITT ER0810N PLAN f•) Jig � � 'r-``, LOT 121 izw o j 2D8.5' A 2083' N 89'54'25" EiL / / lu i �Lof 122 d14,1I1 SQ FT. U IN5TON C I FIN. FLR. 210.0' Q z j,4RAGE FLR • 208.4 it T M8�'94'25"E LOT 123 CITY OF TIGARD -13125 S.W. HALL BLVD. TIGARD, OR 97,223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VALLEY HWY S ALOHA, OR 97006-1248 Electrical Signature Form Permit. #: M T2000-00544 Date Issued: 12128100 Parcel: 2S111 CA-12900 Site Address: 15525 SW HARCOURT TFRR Suhdivision: APPLEV I'OOD PARK NO. 3 Block: Lot: 122 ,Jurisdiction: TIG Zoning: R-7 Remarks' S1F PATH 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to 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, AT-TX Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MATRIX DEVELOPMENT CORP GARNER EI-EC1 RIC 6900 SW HAINES ST STE 200 21785 SW TUALATIN VALLEY HWY S Tlr;ARD, OR 9722..4 ALOHA. OR 97006-1248 Phone #: Phone #: 591-1320 Req #: LIC 121159 SUP 3707S ELE 34-305C AN INK SIGNATURE IS REQUIRED ON FIS FORM r X( 1007.d'r Signature of Sup rvising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BUILDING INSPEC',f ION DIVISION "'" L MST 24-Hour Inspection Line: 6394175 Business Line: 639-4171 E3UP _ Date Requested2- ' 2 AM PM 1 — BLD Location�� _ 4�' Suite MEC Contact Person l�'S"z l'►l C 0 ra y _ rh l �u' RLN. Contractor Ph SWI2 BUILDING A 1 enant/Ov ier ELC: Retaining Wall ELF: _ Footing Access: �^ Foundation FPS Ftg Draiii SGN Crawl Drain Inspection Notes -- - Slab - —_.-------- SIT Post&Beam -- --- _.—__ Ext Sheath/Shear Int Sheath/Shear Framing Insulation ---- Drywall Nailing Firewall lVer- &Oe av Fire Sprinkler _ Fire Alarm Su:;p'd Ceiling Roof Misc: _ Final PASS PART FAIL PLUMBING Post& Beam Under Slab Top Out Water Service _ Sanitary Sewer —' Rain Drains _ Final PASS PART FAIL MECHANICAL Post& Beam --- -- Rough In Gas Line Smoke Dampers Final -- PASS PART FAIL ELECTRICAL Service _ Rough In UG/Slab Low Voltage _--� — -- --� - Fire Alarm ------- Final __ _.Final PASS PART FAIL _ Qm acktill/Grading ---- — Sanitary Sewer Storm Drain ( ]Reinspection fee of$_ required before next Inspection. Pay at City Hall, !3125 SW Hall Blvd Catch Basin Please call for reinspection RE: Fire Supply Line [ ] P —� _ r [ ]Unable to Inspect no access ADA pproact��dem Date °�'S _._----� Inspector _ �`? ` 7� -- -- —Ext I/,f Final PASS PART AIL DO NOT REMOVE this inspection recc:d fro,n the job site. I I CITY W TIOARD Residenlial Certificate of' Occupancy s C Permit No.: — dC 54�f- Address: —j �577 S Owner/Contractor: z5,/P Pate of aminal Inspection: � Inspector: "his structure has been found to he in substantial compliance with the provisions of the State of Oregon One& Two Family Dwelling �erialty Code and is hereby a� roved for(x--.upancy. CITY Or TIGARD BUILDING INSPECTION DIVISION MST Joao-Dy S cl 24-HOUr Inspection Line: 639-4176 Business Line: 639-4171 BUP _Date Requested_ ,___AMy� PM _ BLD Y~ Location_ />; Z SC.", / Y oc' f i Suite MEC _ �– Contact Person L Ph —0 7� PLM Contractor Ph SWR UILW -- Tenant/OwnerEI.0 Retaming Wall EI.R Footing Access: --� Foundation FPS Fig Drain Crawl Drain Inspection Notes: —' SGN Slab _ SIT' Post&Beam --- --- Fxt Sheath/Shear _ Int Sheath/Shear �- - Framing Insulation Drywall Nailinn Firewall F ire Sprinkler Fire Alarm Susp'd Ceiling Roof ---------------�-_._._-- ---..-----_ ____ Misc: r RIli - SS.-`PART FAI'_. -- - ------ ----__ —_ ----- - --------- -- ----._.. _ _ PLUMBING Post& Beam -- .. ----- -- --- --- --- ----_ -- Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final _-- ----___-------------------- PASS PART FAIL Post& Beam Rough -- - - ---- -- - ---- - - ---- - Rough In Gas Line - ------ -- - - — - ---- ---- Smoke Dampers Fi � -__.._..------------------ PASS PART FAIL ECTRICAL ----- -- --- Service Rough In ------- .._..- -------_�.r_ UG/Slab Low Voltage -_- Fire Alarm Final PASS PART FAIL --- - - ._------__.---.___---__ _------____-- SITE Backfill/Grading - - ---�_--�— Sanitary Sewer Storm nra�;, ( ]Reinspection fee of$ required befc.e next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ] Please call for reinspection RE: _ [ ]Unable to inspect no access ADA Approach/Sidewalk Date '� Other _. 1�'__�-L..L�___ _ Inspector _��_^ _Ext Final PASS PART FAIL , DO NOT REMOVE this inspection record !rom the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 Hour Inspection Line: 639-4175 Business Lire: 6394171 - BUP Date Requested// _ S'��� AM !/ PM BLD Location_ S� Z�J Sw �7G v c r,r Suite _ MEG Contact Person Ph ; y '3 3 7 u PLM _ _ — Contractor _— Ph �— SWR BUILD Tenant/Owner ELC _ Retaining Wall ELR Footing ! Access: Foundation I FPS _ Ftg Drain Crawl Drain + Inspection Notes: SGN Slab _ _ - SIT Post&Beam - Ext Sheath/Shear Int Sheath/Shear / r nL y Framing / az '1'ZL-'nin•'ic_ Insulation Drywall Nailing Firewall Fire Sprinkler % 1 L �lU Ir;, ��✓��!/`�� F� /'fi�l L�GT/�. Fire Alarm Susp'd Ceiling _ �n�q Z cT Roof Misc. - Fin y- S PART FAIL -------- P UMBING Post&Beam `--- Under Slab Top Out Water Service Sanitary Sewer - Rain Drains Final _ _.------------- - P PART FAIL _ L Post 8 Lie�� am - Rough In Gas Line e Dampers PASS PART (I AIL ELECTRICAL Service ~� Rough in _-.----- UG/Slab Low Voltage FireAlarrn ------ ---- ---- — ---- - -- --- ----- -- - Fin,il PASS PART FAIL SITE Backfill/Grading _--- Sanitary Sewer Storm Drain I ]Reinspection fee of$ required before next inspection Pay at City Hall, 13126 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: - [ ] Unable to inspect- no access ADA Approach/Sidewalk Date Other -___. -� �inspector _---------_- Ext -_- Final PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspect+on Line: 639-4175 Business Line: 639-4171 - —' BUP :� ^^ —Date Requested_ 7- G AM PM BLD Location_ /2377S-2 -!r- CGL %ri✓ Suite _ MEC _ Contact Person =_ _ Ph 7-776) PLM Contractor Ph _ SWP 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 Nailing — Firewall t FireSprinkler —_.__.--- --------__- __—_ _---_-------------.__.._-__ Fire Alarm Susp'd Ceiling _----___-- Roof Misc ___ - ---- ---- __.— -- --- - - ---- — .— F final -- PASS_ PA T FAIL - — --- - --------- _� .--- --- ----- — ---- --_._ LUh1B! G Post 8 BearYr __..._--------_ __----- -.—..--------- Under Slab TopOut �.—_--_--------------_------____--__._---- - Water Service Sanitary Sewer RMELPrains Vrlai PART FAIL _ ---- - - ---- T __, ANICAL Post& Beam - Rough In Gas Line - -- -- --- -------- — Smoke Dampers Final --_ — - - ----- - PASS PART_ FAIL ECT -- -- - ——,— Service Rough In --- — ------------- UG/Slab Low Voltage --�-- Fiir_g Alarm (it •tr'A—Sj PART FAIL Backfill/Grading -- —— — `— Sanitary Sewer Stone Drain ( I Peinspection fee of$_ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( I please call for reinspection RE ( ]Unable to inspect-no access Fire Supply Line --- ADA Approach/Sidewalk Other Date Inspector_ Ext _ Final PASS PART FAIL- DO NOT REMOVE this inspection record from the job site.