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15571 SW HARCOURT TERRACE Ul Ch y s (%11 C tl _ tl, � 7 � � h O C d I � �f 1 I i a 4 E i 15571 SW Harcourt terraca CITY C�F �'I GA��D MASTER PERMIT PERMIT#: MST2001-011015 DEVELOPMENT SERVICES DATE ISSUED: 2/?C-;01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRES`j: 15571 SW HARCOURT TERR PARCEL: 2S111DA-13200 SUBWvtalON: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 125 JURISDICTION: TIf= REll1AIRK5: S/F Path 1 BUILDING RP.ISSUe, STORIES: I FLOOR AREAS REQUIRED SETBACKS _ RFQIARED CLASS Jr 11IORK• NEW HEIGHT: 16 FIRST: 1,581 of BA6EMENT el LEFT: 5 y SMOKE DETECTORS: 'Y TYPE.)F UBE: SF FLOOR LOAD: 40 SECOND: ai GARAGE: 41.- al FRONT 20 PARKING SPACES: 2 TYPE CF CONST: 5N DWELLING UNITS: 1 FINSSMENT: at RIGHT. 5 VALUE: $147,435.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,581.00 of REAR 24 PLUMBING SINKS: I WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN; 100 TRAPS: LAVATORIES: 3 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TU61SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: I WATER LINES: 100 RCK1`LW PREVNTR; 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL'YPES FURN<100K: 1 BOIL/CMP<3HP: VENT FANS: CLO-HES DRYER: 1 GAS FURN>•190K: UNIT HEATERS: HOODS: 1 OTHER UNITS: t MAX IW blu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: I ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INRPECTIONS 1000 SF OR LESS: 1 0 200 snip: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION EA AOD'L 50031`: 2 201 400 amp: 201 400 amp: lot W/O SVCIFOR: 00 SIGNIOUT LIN LT: PER HOUR LIMITED ENERGY: 401 600 amp 401 • 600 amp; EA ADDL RR CIR: SIONAUPANEL: IN PLANT MANU HMISVCIFDR: 601 • 1000 snip 801+ampe•1000V: MINOR LABEL: 1000♦amplvoll PLAN REVIEW SECTION Reconnect o,1IV: >4 RES UNITS 3VCIFDR—k25 A.: >600 V NOMINAL: CI.S AREAISPC OCC. ELECTRICAL•RESTRICTED ENERGY _ A.SF RESIDENTIAL B.COMMERCIAL AUDIO%STEREO: VACUUM SYSTEM AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: BOILER HVAC: LANOSCAPEARRIU: PROTECTIVE SIGNL: GARA E OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 3,597.09 Lt SEND HOMES LEGEND HOMES CORP This permit is subject to the regulations contained in the 12755 SW 69TH AVENUE#100 12755 SW 69TH AVE#100 Tigard Municipal Code,State ro OR Specialty Codes and PORTLAND,OR 97224 TIGARD,OR 97'.23 all other applicable prove All ans. will be done i accordance with approved plans. This permit will expire i1` work is not started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION• Pnona: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules ala set 10: LIC 60563 forth in OAR 952-001.0010 through 952-001-0080, You may obtPln copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, PosUBoam Mechanlna 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 Sheath!r1g Inst Rain drain Insp Plumb Final Foundation Insp Fooling/Foundation Dr; Electrical Service Low Voltage Water Line Insp Final inspection Post/Beam Structural PLMILInderfloor Electrical Rough In Gas Line Insp ApprlSdwlk Insp Building Final I Issued By : � _ Permittee SignatueiR,; Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT #: SWR2001-00015 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2;28/01 FITS ADDRESS; 15571 SW HARCOURT TERR PARCEL: 2S111 DA-13200 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 125 _ 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: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new single family residence. Owner: --FE ---- — — S LEGEND HOMES Type By Date — Amount Receipt 12755 SW 69 'H AVENUE #100 PORTLAND, OR 97224 PRMT CTR 2/7.8/01 $2,300.00 27200100000 INSP CTR 2/28/01 $35.00 27200100000 Phone: 503-620-8080 -- - Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. Issued by: "l} Permittee 3igna_re: c c I Call (503)V39-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application Datereceived. i /' Pertni:no.:!� City c f Tigard — Address: 13125 SW hall 1310,Tigard,OR 97223 Prciect/appl.no.: _-- Expire date: Cit,of"Tigard 1" Date issued: B Receipt no.: Phone: (503) 639- I Y� _ P Fax: (503) 598-19t,t1 Case file no.: Payment type: Load use approval: --� - 1&2 family:Simple Complex: TVPE 1 &..7.family dwelling o-accessory 0 Commercial/industrial Q Multi-family krNew construction U Demolition U Addition/alteration/rcplacement ❑Tenant improvement ❑Fire sprinkler/alarm U Other. 1 � Job address: /YT-71 +.- �. / jib Bldg.no.: _ Suite no.: Lot: Block: Subdivision: -w Z�LQ 1 'i$IL( Tax map/tax lot/account no.: S aU �- - —��-- Project name: _ Description and location of work on premises/special conditions: 1 Na►* pAQ� rc!�-S , LIai�Ing addd+3`j 1 &2 family dnelllug: N1�H.at , City: G State:p ZIP: 9 -� _ Valuation of work........................................ $ 72. Phone: G,ZQ- aSb Tax -` E-mail: No.of bedrooms/baths................................. Owner's representative: F"PeT- H DL t: tj,-j Total numlxr of floors................................ Phone: L'.2 - Fax: r-,'�,?jC t, E-mail: New dwelling area(sq.ft.) ......................... Garage/carport area(sq.ft-)......................... Name: Covered porch area(sq.ft.) ......................... _ -- - - Mailing c.ddr ss: 2 f�'s - ray Deck area(sq.ft.).......... ............................ City: Stated ZIP:Q- Other structure area(sq.R.)......................... Phone: 0 o Faxtj E-mail:— Comrnercial/InduslrlaUmulti-family: Valuation of work........................................ $--- — Business name: Address � ,p crd' Existing bldg.area(sq.ft.) .......................... --__--- i New bldg.area(sq.ft)................................ _ :!oL 7s' 1 � ....................................... City: p Stated ZIP:'77�a1. Numoer of stories —-- - Type of construction.................................... Phone: 01 G Fax y E-mail:—_ �- - Occupancy group(s): Existing: CCB no.: (p p -f New: _ City/metro lic.no.: : 7 Notice:All contractors and subcontractors are required to be� licensed with the Oregon Construction Contractors Board under Name: y j --- provisions of ORS 711 and may be required to be.licensed in the Address: —+7 jurisdiction where work is being perform d. If the applicant is exempt from licensing,the following reason applies: City: Statr&/ ZIP: Contact person: Xcr V,,,td0f7jPlan no.: ----- ------ -- - - -- ---- Phone:( 0 . O d Fax;5- Email: ----- - --- ---- — ---- - I Nainc: ,,� _ Contact person: Fees due upon application ........................... $ Address: jPyr 1+e,-jy C,11Date received: .-- _ ——-- City: ai 3tate� ZIP: `y 2'.1 Amount received ......................................... $ —, Phone — E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the N«dl iuriadkriau aoc c,edit cam,plraae can i�uiadkdon for mare infann;17W attached checklist.All provisions of laws and ordinances governing this o Visa u Mastercard work will he complied with,whetherspecified he in or not tvlh cwd a"°.ba: Expims Authorized. ature:_� ate: __.__Name of cxdhoida u shown on cmd t card Print name: -- — i ai6ruram _ J Amount Notice:This permit applicat' n expires;,Ns permit is not obtained within 180 days after it has been accepted as complete. uo�ist�c600T,>�+i Plumbing Permit Application City of Tigard Datereceived: Permit no.:Address: 13125 SW Hall Blvd,'Tigardf,OR 97223 Sewer permit no.: building permit no.: Cify.ifTigard Phone: (503) 639-4171 Project/appl.no.: Expiredate: Fax: (503) 598-1960 Date issued: By: Ra:eiptno.: Land tise approval: _ Case rile no.: Payment type: 1 &2 family dwelling or accessory ❑Commercial/industrial U Multi-family 1:1 Tenant improvement L&Ncw ctwstniction U Additiou/altemlio n/teplaccment U Food service U Other. 01 ILI 111101111111131 Job address: /hY5 "J� (�J Descrl nota ,, ., : � � � P Qt . Fad •row _ Nen 1-and 2-family dwelUngs only: Bldg.no.: Suite no.: (lucludes 100 ft.for each utllity connection) Tax map/tax lotlaccount no.: SFR(I)bath Lot: / Block: Sulxiiviston: -- --- -- SFR(2)bath Project name: k , C SFR(3�bath -^�___._� _ Citylcounty: / ZIP: —_ :Jitional ba lichen Description midEach at of work on premises: Slieutllltles: Catch hasin/area drain Est.date of compledon/inspection: Drywells/leach linehrencn drain __ Footing drain(no.lin.fQ Business name: /� � Manufactured home utilities �v�� M Dies Address_ f, aey Rain drain connector -' State:p LIP: 70 Sanitmy sewer(no.lin.ft.) _ Phene: L / Fax:(,G 7-9 &rnaiL Storm sewer(no.lin.ft.) CCB ito_ y Plumb.bus.reg.no: p. Water service(no.lin.ft.) V City/metro lie,no.: Fixture or Item: Absorption valve Contrar_tor's representative signature: p� o�tl-- Rack clow reverter - Print name: P % ' e �,� Darr,: Backwater valve ff m;:,ns/lavatory^� _-- Name: Q Clothes washer `- - Dishwashe— r Address: e 8,0 i�00 7 Drinking fountains) . City: _ State d ZIP: �,. e l3jectora/sum�t _ Phone: Fax: E-mail: Ex anion tank txturufsewer cap Name(print)• p. Floor drains/fl ,or sinks/hub-- �- -- -� Ciarba dis Mailing address: 7,x',5 /' A —� - — ___ _±!rsal ----- : o� -- l{4se bibb City:�J-- o _ State:e R ZIP: 97.z t ce ma cam--' Phone: - m _) Fax:dT - E-mail: Interceptor grease trap - Owner installation/residential maintenance only: The actual instal'ation 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. $i (a), asin(s),llays(s) Owner's si tures �� /�� _ i c % Summa_ Tubs/shower/shower pan Name: Urinal -. Water closet Address: Water heattr �- city: �- State- ZIP _— Other. -�----- Phone: _ poS�Fax: - [;-mail: , _`--- Total Not alt)wisdictlow accept credit cards,please earl)ortadlerion for more MtormationMinimum fee...... ......... Notice:This permit application U vita U MasterCard expires if a permit is not obtained Plan review(at __ %) $ Credit cant number: _ �— L_� within 180 days after it has been State surcharge(8%)....S —_-- Expires acce ted as compTete. TO T'AL .......................$ Name of carrfiol r u shown an�.24it cud.. _.- p p S Anwunl — _ 410.4616(60WOM) PLEASE COMPLETE: FIXTURES•(individual) .Qty :jP4tdtjy ;Tot',I FixtureT a YP Quantl b Work Porformed Sink 16.60 _ Now Moved Rept Rornoved/Cappo, Lavatory 16.60 Slnk Laveto -- Tub or Tub/Shower Comb. 16.60 Tub or Tub/Shower Combination Shower Only 16.60 Shower Only _ Water Closet 16.00 Water 1; _ Urinal Urinal 16.110 Dit hwasher Garbage Dis sal -- Dishwasher 16.60 -__ Laund Room Tra IL _ Garbage Disposal 16.60 Washing Machine - Laundry Tray �� 16.60 Floor Droin/Flocr Sink Y -- Washing Machine 16.60 4 Floor Droln/Floor Sink 2' 16.60 Water Heater 3' 18.80 - Other Fixtures(S d 4• 16.60 Water Heater O conversion O like kind 16.6^ ---- _ GasTin$re9ulres a separate mechanical permit. MFG Home New Waler Service -- MFG Hom-t New Son/Storm Sewer 46.40 - COMMENTS REGARDING ABOVE: Hose Bibs 16.60 Root Drains 16.60 Drinking Fountain 16.60 -- Other Fixtures(Specify) 21.75 -A_- Sewer-1st 100' 55.00 Sewer-each additional 100' 46.40 -- Water Service-1 at 100' 55.00 Water Service-each additional 200' 46.40 Storm R Rain Drain-1st 100' 65.00 Stone 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Baddlow Prevention Device' 27.55 Catch Basin 16.60 Insp.o1 Existing Plumbing or Specially Requested 72.50 Inspectionsper/hr _ Rain Drain,single family dwelling 65.25 Grease Tsps 16.60 QUANTITY TOTAL Isometric or dw dlWarn Is requited If Quantl Total Is >9 _ *SUBTOTAL 8%SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Requlred onl ref fixture qty.I"Is>_9 , _- TOTAL WInlmUm permtt fee Is$72.50♦8%sunlw",except tleskrerdtal Bacllbw Prevent"i Uevice.which Is$IS+8%kedwpe. '•A8 New Commercial Bulldlngs require plans with Is metric or rlsa dtagrom and plan review_ Mechanical Permit Application '-'- Date received: Permit no.: City of Tigard Project/appl.no.: ^- Expire date: t_'uyof Dgard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: 4 By: IReceipt no.: Phone: (503) h39-4171 ` Fax: (503) 598-1960 Case file no.: _ Payment type: Land use approval: Building permit no.: X1,Y&i family dwelling or accessory 0 Commercial/industrial U Multi-family U Tenant improvement NPw construction U Addition/alteration/replacement U Other. Job address: ) i c� / I y Indicate equipment quantities in boxes below. Indicate the.dollar Bldg,no,; Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax ma tax tot/account no.: profit Value S ..__ Lot: Block: Subdivision: *See checklist for important application information and Project name: � Jurisdiction's fa schedule for residential permit fee. City/county: -ter 1.1 Description and loAtion of work on premiaea: _ Fee(ea) Total Est.date of completion/inspection: r _Description tlZ( . Pcs.only Res.only Tenant improveme r change of use: Air handling unit -----CFM _• _ Is existi space heated or conditioned?U Yes U No con itionsng(etre plana regnuired) ' Ise ng space insulated?U Yes U No A terauon of existing KVAC system -Toiler comp BusiState boiler permit no.: _ness name: HP Tons BTU/ll Address: OS Fire/ssmoa amper uctsmo a detectors City: Stahl ZlP: 9707 eat pump site plan required) Phone: -7 Fax: -.7(,y E-mail: nsta rep ace urnac urner Including ductwork/vent liner O Yes O No _ CCB no.: ( f _ nsta rep ace rTTocate heaters-suapen e , City/metro lic.no.: / u.p11 or flour rnr,rented Name(please print); p/) a• Vent ora lanceo er an furnace �_\� a Gra on N RT . .11 Absorption units. BTU/H Name: �p��)G( _ Chillers_— Hp Address: Co to aten HP cl m ro ssor3 exhaust anR ventilation: City: pw State:0Q ZIP: 01,7;.42 Appliancevcnt Phone -77 FaXA- 7L E-mail: ertixTiaust �`— oo4�s,'1 ype res. tc en azrtrat aw hood fire suppression system -- Name: Qq,t►nA/ Z9 In 42 S Exhaust fan with single duct(bath fans) T 1 gust stem a -Iwm aun oiWA77 Mailing address: „? J �_ ✓Q-_ T�� L.[P:9ne p P nR 11°" """ """"'oo up to outlets) StatyS City: L/ ' —_� Ty : LPG __ NG __. oil Phone:/_,)o O e) Fax - E-mail: ue't m ea c additions over out eta P'rocess p ernaticrequi ) Number of outlets Name: W,,r-A Other Rded apptlance or equipment: Address: Address: ��, Decorative fireplace City: o►J State: ZIP: �w nsert-ty _ Phone:fo./ - W FaX: E-mail: tov pelietstove U: Applicant's signature: Other- Name therName(print): Ie Irl wee pt VI)euidicdnar p credll raid+,pD call Juridictim for mat Infamulm Permit fee.....................$ Notice:This permit application Minimum fee................$ U Visa ❑MasterCard expires if a permit is not obtained Cmdu cad number. _ --__I / _ Plan review(at _.__ %) $ --- Expires within Igo days atter it has been State surcharge(8%)....S Name�o cudhaldtr u tbowo un credit cid = accepted as complete. Cardhdikr�ipeuure Anutim 1104617(MCOW) Commercial Schedule 1&7 Family Dwelling Schedule ASSUMED VALUAT104S PER APPLIANCE oserlpoon ---..- Furnaceto130,000BT11 Table 1AtAschanicalCode _ �- Oty �Prks Total Including ducts b vents 1) Fumace o 100,,000)BTU n - g l 955 krdudlrT ducts 6 vents 14.no Furnace>100,000 BTU 2) Fumans 100,000 Brut Indud duds&veMs 17.40 Including ducts&vents 1,170 3) flowFumaoa Indud1dvont _ 14.00 floor furnace 4) 5usperded-Miler,willMiler Including vent 955 or boor mounted healer-------- 14.00 suspended heater,wall heater 5 Vern not tnckMed In appliance- artnN _ 6.00 or floor mounted heater 955 a Repsk unas 12.15 --- CherJ<eN!hal apple Bober Haal Air Ven!not included in appliance permit _445 For Meme 7.10,see or Pump Gond sty Prim Tow Repair units805 toobwtes f,2 Como •• _ 7)4HP;absorb--e4 to <3 hp;absorb.unit 10oK Biv 14.00 _ 6)3-15 HP;absorb una to 100k BTU 955 I00k to soak BTU 25.60 3 15 hp;absorb.unit 9)15-30 HP;absorb 33,00 - - rmN.5-1 mN BTU 1101k to 500k BTU 170010)30-50 HP;absorb -- unN 1.1.75 mi BTU 52.20- 15-30 hp;absotb.unit 11)a50HP;absorb unit 0 1.75 mu aTU 501k to 1 ml;.BTU 2310 6720 �. ._ 12)Ak handlMg will l0 10,000 CFM 30-50 hp;absorb.unit 100° 13)Air handtmg rmk 10,000 CFM• 1-1.75 mil.BTU 17.20 >50 hp;absorb.unit v�^ 14)Hon-potWAs evapmte 000(or 10.00 >1.75 mil.STU 5725 15)Vet len dmneded to a skVie duct e,eo Air handling unit to 10,000 cfm 656 te)verdastion system no Inckrded in Nance peffM 10.00 Air handling unit>10,000 cfm 1170 17)rood ser"d by mocha n exhaust 1p"0° Non-portable evaporate roller 656 1e) �Yrtlneraton -- vent fan connected to a single duct 446 17.40 19)C.rraneidal a Induslrtal type for Von:aysL not Included In appliance permit 656 __ 69.95 Hood served by medlanlcal exhaust 656 20)ether U;".tnekd4 wood tows -- 10.00 Domestic Incinerator 1170 21)ciao Fbh9 016 to 1ow oiAlets - 5.40 Commercial or Industral incinerator 4590 v)Mor.wn aper;-, (e.ch) too Other unit,Induding wood stoves,Inserts,eta 656 Mrmkeum psrmk Fe. 72 60 SUBTOTAL _ Gas piping 1-4 outlets 360 8%SURCHARGE Each additional outlet 83 PIAN NEVIEW 25%:)F S'JBTGTAL Ra*eked for ALL commercial permits only TOTAL Gear krepecdb eed reee: 1. Merl-ow of n-W I-kn-Men ImYrrrnun d-W-Mo lawn) 172,50 per hau 2. Vdpecads br v.1J11 m 4e M arow0mo,WVke Imir*r-dw9+140 rawul 172.5u per h" 19ULYaluation Fee 3. d"k A pim rem"'A'd Of dw*-,eddebne d WA"-'V'dela Ir'A-- dwge4n.baa haul$72.50 per hour •St.4 ccrkviw SORW c4eft eaar,me*od S 1.00 to S5.000.00 Minimum S 12.50 -m"Ae*,dW V9"°'`"SW"eA 0-*V VW "a d u-N $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 51._1 for each additional 5100.00 or fraction thereof, to and including S 10,000.00 S 10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and S 1.54 for each addition l$100.00 or fraction themf,to and including 525,000.00 $25,001,00 to$50,000.00 5379.50 for the first S25,000.t10 and S 1545 for each additional$100.00 or fraction thereof,to and including$50,000.00 550,000.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$1100.00 or fraction thereof Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: CiryrrfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Pilon: (503) 639.4171 — Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval: 1 J� &2 fancily dwelling or accessory U Commercial/industrial 13 Multi-family U Tenant improvement New construction U Adcii6orc/alteratien/replacement 0 Other_ p Partial Job addmaa: /•5 Sr Z/ - ,�e. < T- Bldg.no.: Suite no.: Tax map/tax lottaccount no.: Lot: >) " Block: Subdivision: � Project name: Description and location of work on premises_: Estimated date of completion/inspection: Job no: Fee. Mail Business name: UncrlPtlnu _ Qty- (es.) Total no.Ins tr Plea rrsillmdal-single or multi-lamely I*; Address: fj' - dwelling unit.Includes attoclrrlgarage. City: C� State; ZIP: Servlcebscluded: Phone, - Fax:G -7 f.1 mail: 1000 sq.fr.or leas q C o.: S� FICC,bus.lie.no: � F-ach additional 500 sq.ft.or portion thereof Limited energy,residential 2 try ,3 0 Limited energy,non-residential 2 FAch manufactured home or modular dwelling n cure supervts g el trician( uired) Date / -i Service and/or feeder 2 Su-elect.name rine: Services or feeden-Inalalladon, Slip. ) Wcerve�. alteration orrelocation: 200 amps or less 2 Name(print): d 201 amps to 400 amps 2 -� - 401 amps to 600 amps 2 Mailing address: 7rS`_ ', /� t2 2_. 601 am t to 1000 amps 2 City: o Stateo ZIP: Over 1000 amps or volt 2 Phone:6d0- D d Fax:s-q - E-mail: _ Recomnectonly 1— Owner installation:The installation is being made ori property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installadon,alteration,atrelocation: ORS 447,455,479,670 701. A 2W amps or less �^ -_ 2 ,/ 201 amps to 400 amps 2 Owner's signature: JPV ate: 401 to 6CO ams __— 2 Branch circuits-new,alteration, or extension per panel• Name: � - f n A. Fee for branch circuits with purchase of Address: 01� �p service or feeder fee,each branch circuit 2 City:,. - Stategf Zlp.-Y7- B. Fee fo,branch circuit without purchase -- Phon - ��p Fax: Email: of tervice or feeder fee,first branch circuit: _ 2 Each additional brunch circuit: MIw.(Service or feeder not Included): US.rvice over 225amps-commercial UHesith-cu'facility Each pumpe;irrigation circle _ 2 ❑Service over 320 amps rating of 1&2 U Hazardous[oration Each sign or outline lighting 1 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volt nominal more residential unit in one structure alteration,orexteruion" U Building over three stories U Feeders,400 snips or more "Deni ri tion: - U Occupant load over 99 persons U Manufactured structures or RV part Each additional 4tpedlon over the allowable to any of the above: U F$ress/lighdngplen U odor. —.-- -- I Puinspecdon ��Submit tela of plant with any of the above. Investigation feeThe above are not applicable to temporo-y construction service. Other Naw rri,mcrtaaaPermit fee.....................$ -- socept cre6t cards,Weare Cali durinHnlon ran more Idormrien. Notice:This permit application U Vin O MastuCara expires if a permit is not obtained Plan review(at —_ %) $ ._ Credit cant oumbtr: within I$0 days after it has been State surcharge(8%) ....$ Expiresaccepted as complete. TOTAL ................ ......S _ Name of carditoldler as shown ro credit card _ S Cardholder signature Amaral 440.4615(6011R70M) -- TYPE OF WORK INVOLVED-RESIDENTIAL ONLY 4. Complete Fee Schedule Below: -- _ Number of Inspections r emit allowed -00 - � PE• f� Restricted Energy Fee....................................... $76.Q0 Service Included: Items Cost Total y (FOR ALL SYSTEMS) 4a. Res:dential-per unit Check T.ype of Work Involved: 1000 sq.Q.or less _ _ $147.15 4 Each additional 500 sq.It.or - ❑ Audio and Stereo Systems portion thereof $^,3.40 1 Limited Energy $75,00 _ U Burglar Alarm Each Manufd home or Modular Dwelling Service or Feeder _ $90.00- 2 Garage Door Opener- 46.Services or Feeders Installation,alteration,or relocation E] Heating,Ventilation and Air Conditioning System" 2.00 amps or less $80.30 2 201 amps to 400 amps $106.85 _ 2 F1 Vacuum Systems' 401 amps to 600 amps _ $160.60 2 601 amps to 1000 amps $2.40.60 2 Other Over 1000 amps or vdts $454.65 2 Reconnect only $66.85-_�_ 2 TYPE OF WORK INVOLVED-COMMERCIAL ONLY 4c.Temporary Services or Feeders ---" Installation,alteration,or relocation Fee for each system.................._.................. _ 200 amps or less - $86.85_ _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps __ $100.30 2 401 amps to 600 amps _ $133.75 ? Check Type of Work Involved: Over 600 amps to 1000 volts. see"b"above. n Audio and Sterno Systems 4d.Branch Circuits New,alteration or extension per panel Boller Controls a)Tile fee for branch circuits with purchase of service or clock Systems feeder fee. Each branch ifG1N ----- $6.65 _ 2 Ej b)The fee for branch drndts Data Telecommunication Installation wfthout purchase of service �� or feeder fee. Fire Alar Installation Firs(branch cimjit _ $46.85 _ Each additional branch ch-cult $6.65 EJ HVAC 4e.Weetlarheous ❑ (Service or feeder not Included) instrumentation Each pump or Inigalion circle _ _ $53.40 Ej Fadh sign a outline righting $53.40_ Intercom and Paging Systems Signal circutt(s)at a limited energy pane;,alteration or extension - $7500 Landscape Irrigation Control' Minor labels(10) $125.00 4f.Each additional Inspection over F1 Medical tine allowable In any of the above. Q Per inspection $62.50 Nume Calls Per hour $62.50 In Plant $73.75 Outdoor Landscape Lighting' 5. Fees: Prote(,.ve Signaling Sa.Enter total of above fees $ __ e%Srxdhargo(08 X total fees) $ -__ _ n Other Subfofal $ 6b.Enter 25%of Nne Ea for _ - _Number of Systems Plan,Review HH��ired(Sec.3) $ isubtotal $ _ No licenses are required. t+1censes are required nor all other installations J� FiTrust Account N I Total balance Due - -$ - I ENTEF FEES - __-T-_�._�.__ 8%SURCHARGE t.08 X TnTAL ABOVE) TOTAL $ - RL OT FL ANI LOT #12 5, AFFL E WOOD PARK RIR[) 251 11 DA TAX LOT *13200 15511 51,U HARC:OURT TERRACE S.E. 1/4 OF SECTION 11, T.2, RJU1, W.M. CITY OF TIGARD WA&HINGTON COUNTY, OREGON LEGEND 6m WATER METER r" W-------- WATER LINE '�' �' 'O M SS—---- - SANITARY SEWER 12756 SII 89th AVENUE SUITE 100 yD-- - — STORM DRAIN / `;.111,!'•1.! OFFICE (509) 820-0080 TIGARO, OR. `'7229 FAX (503) 598-8900 CCB 60689 -- -- - t OF STREET • MANHOLE ® CATCH PROFOSE D S' REET TREES ® STREET LIGIAT ® FIRE HYDRANT PROVIDE EROSION CONTROL FENCE - --- PER COMMUNITY I" - 20' 0" a,w w 1 I 206.5' ALL — l94' 91.49 �4 ! ' - --- i - i w al 111 1-4, W �. r12-55 '. 4.325 SQ. FT. /� 2fA5�55D! Ill_wOURNAM C % _ I I lu �d FIN FLR. - 2fOO GARAGE FLP. 206b' d I }-_ Ir ulm• u I --- --•t-W -_414 V _--� �L 99.49' _206. CITr Of TIOARD Residential Certificate of' Occupancy Pcrmit No.: �&i /kXJ I Address: Owner/Contractor: y� 1�" s / Date of Final Inspection: �- "~Gt/ Inspector:This structure has been found to be in substantial compliance with the provisions of the Stare of Oregon One& Two Family Dwelli"K _§p erialty Code and is hereby approved for occu anc . i i 1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VLY HWY #C ALOHA, OR 97006-1249 Electrical Signature Form Permit #: MST2001-00015 Date Issued: 2128101 Parcel: 25111 DA-13200 Site Address: 15571 SW HARCOURT TERR Subdivision: APPLEWOOD PARK NO. 3 Block: I—ot. 125 Jurisdiction: TIG Zoning: R-7 Remarks: SIF Path 1 Yow 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 t'ie supervising electrician is required. Please have the appropriate ii,dividual from your company sign below and return this Electrical Signature Form prior to the start of the t,ork to the address above, ATM Building Dept. No electrical inspections will he atithorized until this completed form is received OWNERFLEGTRICAL CONTRACTOR: LEGEND HOMES GARNER ELEC'rRIC 12755 SW 69TH AVENUE #100 21785 SW TUALATIN VLY HWY #C FOYRTLAND, OR 97224 ALOHA, OR 9700b-1249 Phone #: 503-620-8080 Phone #: 503-048-4552 Req #: LIC 121159 SUP 3707S ELE 34-305C AN INK SIGNATURE IS REQUIRED ON THIS FORM X Sign ure of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF i IGARD BUILDING INSPECTION DIVISION MSTr�i�// 24-Hor.-r Insp^ction Line: 639-4175 Business Line: 639-4171 BUP Date Requested � „—AM PM _ BLD Location fo S �/ Sc.• Itti�C'c�vet —_ Suite MEC Contact Person Ph -59,J�—e> Z PLM Contractor Ph SWR BUIL Tenant/Owner ELC staining Wall y EL.R Footing Access: �- Foundation FPS Fig Drain -- Crawl Drain Inspection Notes. SGN Slab ------ ------- ------- ------ -- - SIT Post&Beam - Ext Sheath/Shear Int Sheath/Shear "-� - Framing Insulation -----__-- Drywall Nailing Firewall --- -- ------_—_ - ------ - Fire Sprinkler Fire Alarrn — Susp'd Ceiling ------ - - --- --- --- ----_ _�__ -- ----- -- — - Roof PAM- PART FAIL -- ---- —------ -- PLUMBING4 a, , --- Post& Beam --- --- ----- -- -- - -- -- -- Under Slab Top Out Water Service Sanitary Sewer --- Rain Drains Final PASS PART FAIL AIMERI�L Post&Ream Rough In Gas Lina — Smoke Dampers Fi %'21 - - A PART FAIL ELECTRICAL — Service Rough In - --- - UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Sanitary Sewer Sewer Storm Drain ( J Reinspc�:tfon fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I J Please call for reinspection RE.______ ( J Unable to inspect- no access ADA Approach/Sldnwalk Other Date - w*' -�-D/ Inspector �^Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGABD BUILDING INSPECTION DIVISION MST - 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 -- _Date Requested` AM PM BLD Location Suite MEC Contact Person Ph � UYl 3 PLM ^^� Contractor Ph SWR BUILDING 1enantiOwnerELC Retaining Wall ELR 'Foot?ng ---____.—_---.---.-- Access: Foundation FPS Ftg Drain ----.—�_-^-- Crawl Drain Inspection Notes SGN Slab _-- SIT Post& Beam - ----�-- Ext Sheath/Shear Int Sheath/Shear -� Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ----_____ —-- ---- ---- - Misc: ---_ - - --- - Final , PASS PART FAIL — 1 .------ -Lr-=��--- ---- ---------- PLUMBING Post& Beam Under Slab Top Out - --_------- - - - --.—._ Water Service Sanitary Sewer - ---- _ ----- -- Rain Drains ----- -------------- Final r PASS PART FAIL -- MECHANICAL Post& Bean` -- ------------ .__--_- .. ___` Rough In Gas Line --- ----— — Smoke Dampers Final — - - - - PASS ART FAIL ELECTRI ' = _ ----- -- - ----____ Service --- --------- --- Rough In UG/Slab Low VoltageLIL - e Atprm -- ------- ----- �. __— _ _ _-� Fi S PART FAIL ---------- -- ---_`—. -- --- -- - Sl Backfill/Grading -- ---- -- — --___.---_-- _ Sanitary Sewer Storm Drain [ I Reinspection fee of$ — required before next inspection. Pay at City Hall, 1312.5 SW Hall Blvd Catch Basin Fire Supply Line [ j Please call for reinspection RE:_ _ ( Unatre to inspect - nc access ADA Approach/Sidewalk / Other Date h �� — d � Inspector Ext Final t PASS PART FAIL DO NOT REMOVE this inspectiolli record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 6394171 0UP _ _—Date Requested_— 'L` ? _ AM _ —PM BLD Location 15-_S ?/ r,� �G v c c t'r _—___-- Suite MEC - -- Contact Parson _ Ph Z-3 PLM — Contractor _ Ph SWR _ BUILDING - Ten ant/Owner -- _ ELC Retaining wan — — — i ELR Footing Access Foundation FPS FPS Fig Drain Crawl Drain inspection Notes: SGN Slab - SIT Post& Beam ------._.�---- ---- —_..— ------- Ext Sheath/Shear _ Int Sheath/Shear — —`--- Framing Insulation Drywall Nailing Firewall FireSprinkler ____--__.------------..----.-----_____�----------------- -_--- Fire Alarm Susp'd Ceiling _-- ----__— - _—,___��__-----.-.___..__-_.--------------------.___ Roof Misc. _� ---- -- —- ._. ------ ------ — — Final _ ---- PASS PART FAIL ----- - -- -- ----- _._.�-- --------- --- --- .—_---- ------ - Lu�iv f•ost& Beam Under Slab Top Out Water Service --------- --- --- ....____--- ------------------- Sanitary Sewer .—_-- R ins real,- ---- ASS PART FAIL RfeCT"CAL ------------- Post& Beam ------ Rough - - ----Rough In Gas Line Smoke D:fnrpers Final - - ----- ._. -- ---- PASS PART FAIL ELECTRICAL - - - ---- - - -- Service Rough In _-_--------- - - ------_ UG/Slab Low Voltage _- --- ------ ----- ---------- �..—_-------- Fire Alarm Final PASS PART FAIL - ----- —.— -,— _-- ------_- SITE Backfill/Grading -------- — -- —.__, —__--_— —_—__-- -- Sanitary Sewer Storm Drain J J Reinrpertion fee of$ y----required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line l 1 Please call for reinspection RE: _ �— ) )Unable to inspect- no access ADA ch/Sidewalk � Other Date _- _Ext F inal PASS_ PART FAIL DO NOT REMOVE this inspection record from the job site.