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13590 SW SANDRIDGE DRIVE 13590 SW Sandridge Drive ,r CI'T'Y OF TIGA RD 24-Hour BUILDING Inspection Line: (543) 639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST -_ SUP _-- Received _ Date Requested 3 AM PM BLIP Location -_-1 �_ Suite MEC Contact Person . _. Phf-.-- ) PLM Contractor _—_ —__ Ph(_ ) SWR BUILDING _ Tenant/Owner _�- ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler -- - �- — Fire Alarm Susp'd Ceiling — --- Root t,{ J 3 Other: e,VT Final PASS PART FAIL PLUMBI_NG— _ _ if Post&Beam Under Slab CIA.L-IN Rough-In Water Service -- Sanitary Sewer Rain Drains -- --- —_- Catch Basin/Manhole Storm Drain --- --- - — Shower Pan Other: - - AW- S PART FAIL HANICAL Post&Beam — --^---^ Rough-In Gas Line Smoke Dampers ----- Final PASS PART FAIL - ------- - -— - ----—ELECTRICAL Service - Service Rough-In UG/Slab -- Low Voltage ---- —-- - -- — - --- Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART_ FAIL SITE - E] Please call for rei spection RE:--��— _— Unable to inspect-no access Fire ADASupply Line r •1 l q /1 Approach/Sidewalk Date_ Inspector L Ext Other. Final DO NOT (REMOVE this Inspection record from the Job site. PASS PART FAIL S.AAAAAAAAAAAAAAAAA►AAAAAAAAAAAAAAAAAAAAAAAAAA /� r ► tTl rTl '► lop J a i rp `n r ! V ' 44 rD cn D ! Uq ► ,® a ?� p ► �j p-' ► rD cr4 ► :07' o_ (, ► 4 ` { U2 a o ► ► 1 ' r+ 41 r-t lo..by ► ® a ON. M ► a � i w ► ► riiiieeeeee�is . �i�ieieeeeseeee� rii�eeeeii%�ee� ro d 0. �^ O a n N o � ` w n rD r4 r. ,"... a � � O Q Q O 0 e v � r F O F T Z CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BUP Received _ _—__- Date Re que ted__ 3 AM_- PM BUp Location _ — —Suite _ MEC Contact Person Ph( _) -SL `? --`27 -_ PLM 1I Contractor_ _ _ __— Ph(--) SWR ` BUILDING TenanUOwner Footing-- — — - ----- LC --- -- - — Foundation Access. ELC — Ftg Drain Crawl Drain ELR _ Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nailing //ZE'✓i�— Firewall -- Fire Sprinkler Fire Alarm - — Susp'd Coilln Roof Other: PASS PART FAIL --- _ BING Post& Beam ___-- tinder Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: - -- - Final — ----Y-- PASS PART_ FAIL MECHANIC.;! Post& Beam - Rough-In Gas Line Smoke.Dampers Fin . SS,'PART FAIL - - CTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm - Final F1 Reinspection fee of$ required before next Inspection.PASS PART FAIL Pay at City Hall, 13125 SW Hall Blvd. SITE _ 0 Please call for reinspection RE: - I_.J Unable to inspect-no access Fire Supply Line ZA ADA Approach/Sidewalk Date Inspector _ —Ut Other: Final DO NOT REMOVE this Inspection record from the,fob site. PASS PART FAIL. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 KPI ST SUP Received Date R uestedAM._.._-..- PM BUP Location _Suite _ - MEC Contact Person h PI_fui Contractor__ _ _ Ph( ) -- _ _ SWR BUILDING Tenant/Owner - _ _ — ELC 00 /� Footing ELC Foundation Access: — Ftg Drain v- f / ELR Crawl Drain - - - Slab Inspection Notes: SIT Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - Firewall Fire Sprinkler --- \ Fire Alarm Susp'd Ceiling - Roof Other: Final ----- . -- PASS PART FAIL_ - -- - PLUMBING_ Post 6 Beam Under Slab _— — Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Stoim Drain Shower Pan Other:_ - ----- -- - Final PASS PART FAIL - MECHANICAL Post& Beam / Rou Gas Line i e Gas Lne Smoke Dampers _----- Final RT FAIL - - ErTRIC Se Rough-In UG/Slab Low Voltage Fire Alarm PART FALL EJ Reinspection fee of s. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE _ Please call for reinspection RE:_� _ Unable to inspect-no access Fire Supply Line ADAC` Approach/Sidewalk �� 3 Inspector _ ut Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY O` I r T I GA R D ELECTRICAL PERMIT PERMIT#: ELC2003-00141 DEVELOPMENT SERVICES DATE ISSUED: 3/18/03 - 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S105DD-04600 Sl rE ADDRESS: 13590 SW SANDRIDGE DR SUBDIVISION- PACIFIC CREST ZONING: R-7 BLOCK: LOT : 022 JURISDICTION: TIG Project Doscription: 1 branch circuit to AC unit. RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP,:4RIGATION:i EACH ADD't. 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MANF HM/ SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: I PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SEC1ION 1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL.: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contrar;tor: D R HORTON 5125 SW MACADAM#145 PORTLAND,OR 97201 Phone: 244-5322 Phone: Rey #: FEES Description Date Amount Required Inspections �I I.I'RNITI IiL( 11cmin �_� 18M3 $46.85 — I:\NJ 81,11 Slab Elecctt''/lFinal h� ; I8 W $3.75 Rough-in nal Total � $50.60 This Permit is Issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codeg and all other applicable laws. All work will be done In accordance with approved plans. This permit will expire if work Is not started within 180 days of issuance,or If work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-600.332-2344. Issued By: �yC��1�_'_ 4 _ Permit Signature:_ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _.__ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: t ICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day �� I FOR OFF11ft USE ONLY Elecaical Permit Application Received F.Icctncel Permit No:17L Planning Approval Sign City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-6394171 Fax: 503-598-1960 Post-Review Land Use Date/By; Case No.: Intc-net: www.ci.tigard.or.us Contact Juris.: 0 See Page 2 for 21-hour Inspection Request: 503-6394175 Name/Mctho& i Supplemental Information. ` TYPE OF WORK ^ v T PLAN REVIEW Please check ill that apply) NCw Construction � j Demolition Service over 225 amps- Health-care facility commercial ❑Hazazardrdous location Addition/alteration/re lacement DOther: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, CATEGORY OF CONSTRUCTiON I&2 family dwellings four or more residential units in 1 &2-family dwelling Commercial/Industrial ❑System over 600 volts nominal one structure --- ❑Building over three stories ❑Feeders,400 amps or more Accessory Building Multi-Family ❑Occupant load over 99 persons ❑Manufactured structures or RV park Mastcr Builder Other: ❑Egress/lighting plan []Other ___-- Submh_sets of plans with any of the above. JOiI SiTE INFORMATION and LOCATION The above are not aplip cable to temporary construction service. Job site address: 3 ��D FEE*SCHEDULE Suite#: Bld r./A�t.#: Number of its pections per permit allowed Pro act Name: Desert tion Qty Fee(e•.) Total New residential-single or multi-family per Cross Sireet/D1rCC 1o11S t0 JOb site: dwelling unit.Includes attached garage. Service Included: 1000 sq fl or less 145.15 _ 4 Each additional 500 s .il.or pion thereat 33.40 1 Limited energy,residential 75.00 2 Subdivision: ` Lot Limited energy,non residential 75.00 2 Tax!pH/parcel #: Each manufactured home or modular dwelling service and/or feeder 90.90 2 _ DESCRIPTION OF WORK Services or feeder-Installation, A DD ■Iteration or relocation: -- ---- --- 100 amps or Icss _ 80.30 2 -_ 201 amps to 400 amps106.85 2 --- __�.--- 401 amps to 600 ams -- ---- 160.60 2 + 601 am ps to 1000 ems — 240.60 2 PROPERTY OVVNF.R TENANT -— over 1000 amps or volts 454,65 2 Name: _ Reconncctonl 66.85 2 Address: 3 �`�-MOM Temporary services or feeders-installation, rIteration.or relocation: 66.85 1 City/State/Zip. * 1 2(>D am rs or less. — __--_ 201 amps to 400 amps__ _ i�30 2 Phone: 1 )% r• 0 Fax' 401 to 6W ams 133.75 2 'APPLICANT _ CONTACT PERSON Branch circuits-new,alteration,or Nanie: - __ _ extension per panel: --- --- A.Fee for branch circuits with purchase of E 6.65 2 Address: service ar feeder fee each branch circuit Clt �State�Zl B.Fee for branch circuits without purchase of u ti 2 - service or feeder fcc first branch circuit 46.85 Phone: Fax: _ Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): t',ach pump or irrigation circle 33.40 2 CONTRACTOR l'ach sign or outline lighting 53.40 2 Job No: — Signal circuits)or a limited energy panel, -- - alteration or extension _ Pae 2 2 Business Name: "j�L — Description: Address: -._�W_lLl -- Each additional Ins action over tht allowable In an of the above: Cit /State/Zi tatel Per inspection per hour(min. I hour) _ 62.50 � Phone: • _ FaX: investigation fee: - -— Other CCB Lic. #: Ltc. #: Electrical Permit Fces* i Subtotal S t4 Supervising electrician `--�---- signattire required: ___ Plan Review 25%of Permit Fec $ Print Name: Lic.#: State Surcharge 8%of Permit Fee S .� 75 _ - 'TOTAL PERMIT FEE S "e, (00 Authorized) �� Notice: This permit application expires if a permit is not obtained within Signature: __ -_-_-_-_� Dale 190 days after It has been accepted as complete. •Fee methodology set by 7 ri-('ounty Building Industry Service hoard. -- � (- Please print name is\Dsts\Permit Forma\ElcPermitApp.doc 01103 Cildry OF T i G A R D _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: M -00123 DATE ISSUED: 3/18/0318/03 ma 13'125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S105DD-04600 SITE ADDRESS: 13590 SW SANDRIDGE DR `SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT:022 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR 17URN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYS1 EMS: STORIES: _ BOILERS/COMPRESSORS _ HOODS: __ FU_EL TYPES `_ 0 - 3 HP1 DOMES. INCIN: ELF _ 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 1001( BTU: ` _AIR HANDLING UNITS _ OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfrn: Remarks: Install exterior AC unit. ('annot he 1,IaceJ in the rryuirc�l ticth,icL Owner: FEES �_ Y D R HORTON Description Date Amount 5125 SW MACADAM#145 �R11.('III Permit Fcc 3/18/03 $72.50 PORTLAND, OR 97201 I' � x" state'I ax 3/18/03 $5.80 Total $78.30 Phone: 244-5322 Contractor: HVAC BY TERRY 6630 SW 207TH AVENUE ALOHA, OR 97007 REQUIRED INSPECTIONS Cooling Unt Insp Phone: 503-t,49-3458 Final Inspection Reg#: I iC 54970 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 C/ Issued By: y ll, LL S Permittee Signature:` -- ----- Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day r ti „ FFICE USE ONLY lechanical Permit Application Received , ' Mechanical, Dale/B : , " ,tJ Permit No. C� Planning Approval Building City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Dale/B Permit No.: Phone: 503-639-4171 Fax: 503-598-1960Poet-Review land Use •-,,• Date/By: Case No.: Internet: www.ci.tigard.or.us Contact 1uris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Mcthod: — Supplemental Information. TYPE OF WORK _ COMMERCIAL FEE*SCHEDULE-USE CHECKLIST New construction Dem..iltion Mechanical permit fees'are based on the total value of the work Addition/alteration/replacement lacement Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. 1 & 2--amily dwelling Commercial/Industrial %Blue: S See Page 2 for Fee Schedule Accesso Butldin Multi-Famil RESIDENTIAL E UfPMENT/SYSTEMS FEE*SCHEDULE _ --1�'-- Description t Fec ea. Total Master Builder Other: Ilcatln Conlin JOB SITE INFORMATION and LOCATION_ Furnace-add-on air conditionin •• 14.00 Job site address: 1�0—"q�y^ 01LP Gas heat um _ _ 14.00 Suite#: Bld ./A l.tl: Duct work _ 14.00 Pro�ect Name: � (r' H dronic hot waters stem 14.00 Residential boiler Cross street/Directions to job site: for radiator or h dronic system) 14.00 _ Unit heaters(fuel,not electric) in wall,in-duct,suspended,etc. 14.00 Flue/vent(for any of above) 10.00 Subdivision: � Lot#: Repair units 12,15 Other Fuel A Ilances Tax ma / arcel #: Water heater 10.00 _ DESCRIPTION OF WORKGas fireplace _ 10.00 VP A C-- T Flue vCnt(water heated as fire lace) 10.00 Lo li hter as _ 10.00 _ — -- ---- Wood/Pellet stove 10.00 Wood fireplace/insert IU.00 Chimnc /liner/flue/vent_ 10.00 4'ROPERTY OWNER C TENANT — Other: 10.00 Name: Environmental Exhaust&Ventilation • " — —V PW Range hood/other kitchen equipment 10.00 Address: 451 t` sw M Clothes dryer exhaust 10.00 City/State/Zip: rp"—T— _ Single duct exhaust Phone: IFax: (bathrooms,toilet compartments, L CANTCONTACT PERSON utilityrooms) 6.80 - Name: _ Attic/crawls ace fans i 10.00 __ - Address: – T_— Other: Fuel Piping 10,00 _City/State/Zip: **($5.40 for first 4,$1.0 each additional — _ Phone: - Ll ax: Gas heat pump E-mail: Wall/sus ended/unit heater •• __ CONTRACTOR Water heater Business Name: _�Y — Fireplace •• Rana •' _ _ Address: 5(/ ic __ BB Cit /State/ZI _� !._� _ Clothes dryer.(gas) _ •• Phone: _ Fax: Other: �____ '• CCB Lic. #: v- �, ------- total: _ -- — ------- Mechanical Permit Fees' Authorized _ Subtotal: S Signature: Date:- 3�i-VA Minimum K:miit Fee$72.50 S '� ► �y�� Plan Review Fee 25%of Permit Fee $ -�-L a f� Surcharge - ------- --- - - State 8%of Permit Fee) S _�� (Please print name) TOTAL PERMIT FEE S Notice: This Permit application expires If a permit is not obtained Nithin •Fee methodology set by Tri-County Building Industry Service Board. 1110 days after It has been accepted as complete. "Site plan required for exterior A/C units. i:\Dsts\Permit FormsWeePennitApp doe 01103 Le I,I, �►�' THE MATISSE M'1'TH DAYLIGHT BONUS 'Z'�Z• ` I� 13510 �yv. S/trvDWDc�E Nrdronm 4 M.t,t,t Surte K\ f)rt k 111 ,rte eft ,i.ttlt Nmk 1I t u, l I•armly Ronm I_ 1 I.I�M _ l Kitchen t hrdnii�ui. hrilt„��tn 4 i�+ � I hinnF Nrxrm ............. gID� y#ILD Garage F.nuv Living Room ini Cor Garage/ N t tl,rionsl Den �„ + I)nk t r � J liedrnnm 5 M A I N 1.!V E L Bonus Ronm 6• `nr.tFr t I FINISH En DAYLIntiT BoNU9 Room Renderings and Iloorplans are artists conceptions and are not intended to he an actual depiction of the buildings, fencing,walks, driveways or landscaping. Square footages approximate.Windows vary per plan. In the interest of continuous product improvement, D. R. Horton reserves the right to change pricing and specifications without prior notice or obligation. ,r,/s4/oz FROM :CRAFTWORK PLUMBIIJG FAX NO. :5036445989 Nov. 01 2002 08:34AM P2 Plumbing Permit Application MIN DAtc received: pemnit nn,: _ City of Figai-d Sewer permit no.: Building permit no.: Addross: 13125 SW Hall Hlvd,Tigard,OR 97223 City ejrigard phone: (503) 639-4171 Project/appl.no,: Expire date: - Fax: (503) 598-1960 Date issued: Ay; _ Receipt no. Land use approval: _ _ Cs1c file no.: Pnylncnt type D I R 2 fanilly dwelling or nec;essory J Cuinmercial/industrial 0 Multi-family 0 Tennat improvement 0 New construction DAddition/alteration/replacement O Fond aervlcc 0 Other Job address; 5q V jot! 111"Crl tion Qty- Total Bldg,no,: Suite no.; - et,1•and 2 turn y dwcllingF only: Tax map/tax lot/tceount no.: - Ontludnr loo n.forench u;llity cnmleciion) St-R(1)bath fool: 'L'j. Hlock: Subdivision: "- I'rnject name: SPR(a)bath City/county: ZIP: Hach ad itional both/kitchen Description and location of cork on premises: _ Siteutllltlet: Catch basin/area drain Est,date of completinn/inspection; - wells/lent i ineArenc 1 drain Footing no, lin.tt.) Business name Manufactured home utilities _ �- —_ l,�a"t C- Mento es Addross: 7_7q- r Ms m b r Rain drain connector CITY; Stnte:Q ZIP: _� Sanitary sewer(no.tin,ft,) Phone ((r FAAA yy-gR E-mail: -Storm sewer(no. I n.ft.) CCH no,; �j Plumb.bus.reg,no � Water service nu. Ian.t City/inclro lie.no.: ar / Fixture nr Item: -_ } Abso tion valve Contractor's representative signature: )lack flow prcvcnier Print name; / UaIe Backwater valve asins/lavatory, Name: Clothes washer_ Address___—-- - — Dishwns tccr __— --- T:- — Drinking fountain(A) Phone: Fax: t mall; xpansion tank ixture/sewer ca Name(print): Floor raihs/flonr sinks/hub Mailing address: Gar a cis_Los_n City: State: ZIP: -1 lost ibb b Ice maker Phone: FeA: L'•mail: hiterce torlrtes-trap Owner installnlion/residentinl maintenance only: The actual installation Primer(s) will be mnde by me or the maintenance and repair made by my rcgulnr Roo rain commerciuTj employee on the properly I own as per OILS Chapter 441, Sink(s),basin(s), ays(s Owneek signature; Date: Sump ,M]1010 0 Y 1•ubs/showerAhower pan Name: one -__-• - --- — -- Waterclo6et _ Address: _ water heater _City: _ _ _State: Zll': Otur. Phone: Fox F.-moil: Total Not All)urleAlctione Aeeepl endil atnle,plrnec toll Juriedlctinn rnr mate InrnrmelM, Notice: This permit spph11111111oln fee.......... ..... S hcation U Vml U MII"teIC1111 Nnn review(at_ lyn) $ cxpiisA if n permit It not ohtalned Credit enrd nombur'_,- 1414 A r,� / within 180 days oiler it hns been State surcharge ^+ n1R oF Cm tet Ae Ahnwn un era a[[Cplcl1A complete TOTAL � •••��• •• _ • r el er Il$nuture -+�-'•`- - -�IOunl un.a�ln Imm��cosn /\ Cl%#'Il'Y OF T!GA R D _MASTER PERMIT PERMIT#: MST2002-00413 DEVELOPMENT SERVICES DATE ISSUED: 10/16/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13590 SW SANDRIDCE DR PARCEL: 2S105DD-04600 SUBDIVISION: � ` &� ZONING: It-7 BLOCK: LOT: 022 JURISDICTION: III i REMARKS: New SF detached residence. path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,454 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: r TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,133 at GARAGE: 775 of FRONT: 20 PARKING SPACES: 21 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 14 71 30 OCCUPANCY GRP: R3 BDRM: 4 BATH 3 TOTAL: 2.587 of VALUE: 257,8REAR: !u T PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: IOU TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF r.AIN DRAINS 1 CATCH BASINS. TUB/SHOWERS: 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES. IOU BCKFLW PREVNTR i GREASE TRAPS: OTHER FIXTURES: MECHANICAL I uEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: I FURN>-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP. btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: W/SVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION: EA ADO'L 800SF• 5 201 400 amp: 201 400 amp: tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR LIMITED ENERGY: 401 - 000 amp: 401 600 amp: EA ADDS BR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 801 1000 amp: 6111.amps•1000v: MINOR LABEL: 1000+amp/volt: Reconnect only: PLAN REVIEW SECTION -4 RES UNITS: SVCIFDR> 225 A.: >800 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: x VACUUM SYSTEM: X AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT BURGLAR ALARM: x OTH: ALL ENCOMP BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: h ITRUMENTATION: MEDICAL: OTHR: HVAC. t DATAITELE COMM: NURSE CALLS TOTAL a SYSTEMS: Owner: Contractor' TOIAL FEES: $ 7,832.31 D R NORTON D R NORTON INC This permit Is subbed to the regulations contained in the Tigard MUn icipal Code.State of OR Specialty Codes and 5125 SW MACADAM#145 4386 SW MACADAM all other applicable laws. All work will be done in PORTLAND,OR 97201 SUITE#102 accordance with approved plans This permit will expire If PORTLAND,OR 97201 work is not started W,thin 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Oregon law requires YOU to follow rules adopted by the Phone: 244-5322 Phone: 501-222-4151 Oregon Utility Notification Center. Those rules are set forth in OAR 952001-0010 through 952-001.0080 You Reg": LIC 130859 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Underfloor insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundatlon Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final r , Issued By : � lCrtlC. _. Permittee SignatL!re :_ _ 1 Call (503) 639-4175 by 7.00 p.m. for an inspection needed the next business day ITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002.-00269 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/16/02 PARCEL: 2S105DD-04600 SITE ADDRESS; 13590 SW SANDRIDGE DR SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF residence Owner: _—_.----FEES ---- ------ ---- D R HORTON Description Date Amount 5125 SW MACADAM#145 PORTLAND, OR 97201 [SWUSA] Swr Connect 10/1e/02 $2,300.00 [SWINSP]Swi Inspect 10/16/02 $35.00 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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 Sewei" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6699. Issued by: { c�% �i ,' j c_ _ _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M.for an inspection needed the next bttsittess day asp z r3 i Building Permit Application — Date received: Permit no.: City of Tigard CiryofTigard Addr;ss: 11125 SW Hall Blvd.Tigard, OR 97223 ProJer.Vappl.no.: Expire date: Phone: (503) 639-4171 ► a Date issued: By: Receipt nu.: _v Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: I i )002 1&2 family:Simple Complex: OF PERMIT U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family XNew construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: 1 1 1 11 1 111 Job address: ? / Bldg. no.. Suite no.: Lot: Block: St bdivision: q ( Tax map/tax lot/account no.: Project name: I �^ Description and location of work on premises/special conditions: LJ LU) 1 1 1 1II �' 1 Name: YV1L 1-7 M El Mailing address: 12-* 11 &2 family dwelling; - City: State:p ZIP: Valuation of work...................... .. .... ......... $ Phone: 'Z ti I hax: - -�7(T-marl: No.of bedrooms/baths................................. ii' 3 Owner's representative. NaW Total number of floors................................. Phone: I�j Fax f: mail: New dwelling area(sq. ft.) .......................... - Garage/carport area(sq. ft.)......................... Name: v• Q Y V1 Covered porch area(sq. ft.) ......................... Mailingaddress: -- Deck area(sq. ft.) ........................................ City: Start: ZIP Other structure arca(sq. ft.)......................... Phone: Fax: Email: C.ommerciallindustrial/multi-family: Valuation of work........................................ $�- Existing bldg.area(sq. ft.) ..................... � Business name: V-m Vl New bldg.area(sq.ft.) ` Address: S ... ........... Number of stories. .. ,r........................ Y- City: r date:p ZIP: Type of constructigw:.............I.................... Phone: - �S Fax: l E-mail: _S - Occupancy p(s): Existing: CCB no.: G New: City/metro lic.no,: t ee:All contractors and subcontractors are required to be A1011TECTIDESIGNIER tcensed with the Oregon Construction Contractors Board under Name: Lt2L±b h _ provisions of ORS 701 and may be required to be licensed in the jurisdiction where work is being performed.If the applicant is Address: AS A lyD �� -_ exempt from licensing,the following reason applies: City: I State: ZIP: Contact person: IL an no.: 61F _ Phone:ItZ,141 ICA 11 Fax: F-mail: Name: ontact person: Fees due upon application ........................... $ Address: - f h Date received: City: State:p� ZIP. / Amount received .............. ...........I............... — Phone:�j - Fax:&Wf �y Email: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not all lunsdlctiom accept cremt tarda,please call iunsdrction rot mate Information. attached checklist.All provisions of laws and ordinances governing this U visa :3 MasterCard work will be complied witb,whether specified herein or not. Credit cud number —L-�-- L�piies �� Date; - -C11� Name of cardholder as shown on credit card Authorized signature: $ Print name: Cardholdet sixnaltre Amount Notice:This permit application expires if a permit is not obtained within Igo days after it has been accepted as complete. "O-•sw trrW/CoM► Electrical Permit.Application Date received: Permit no.: -C614Lf 3 City Of Tigard Project/appl.no.: Expire date: City gfTigard 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: TYPE OF PERMIT ❑ I &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family ❑Tenant improvement New construction ❑Addition/alteration/replacement ❑Other. ❑Partial t ' f Joh address: / Bldg. nu.: Suite no.: ITax map/tax lot/account no.: Lot: Block: Subdivision: -------------- - Project name: S _ bescription and location of work on premises: Estimated date of completion/inspection: ('f)N*I'RA(.TOR APPLICATION FEE SCUEDULE Job no: Fee Max Business name: G Description Qty. (ea.) Total no.imp - New nsirlentud-single or mull-family per Address: dwrllingunil.Includvw nituclnnl gnrage. City: I State:a ZIPAI Seniceincluded: Phone: - AM I Fax: E-mail: IWO sq.ft.or less _ 4 Each additional 500 sq.ft.or onion thereof CCB no.: EIeC.bus. lit.no: Limited ener ,residential 2 City/metro lic.no.: Z,� Limited energy,non-residential 2 Each manufactured home or modular dwelling Si naru Ttsu erv"elecrrician(required),__ Date Sery ice and/or feeder 2 Sup.elect.onme(print), Services or feeders-Installation, allerstion or relocation: PROPERTY OWNER 200 amps or less 2 201 amps to 4tH)amps 2 Name(print): n l '/1'7 � 401 amps to 600 amps � 2 Mailing address: �f P/05 601 amps to I(HH)amps _ 2 City: q`(a State: ZIP: Over 1000 nuips or volts 2 Phone: qt.5l I Fax: ( r-mail: Reconnectonly 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 installation,alteration,or relocation: ORS 447,455,479,670,701. 200 201 amamps or less ps to 4(H)amps 2 Owner's si mature: I!ale: 401 to 600 ams 2 Branch circuits-new,alterntion, ur extension per panel: Name: Her eai5 V K _. _ - _ A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP:- B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: Phone: 7 r Fax(�� E-niaiL L ach additional branch circuit PLAN REVIEW(Please clieck all flint apply) Mise.(Service or feeder not included): U Service over 225 amps-cummercial U Health-care facility Each pump or irrigation circle - U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting _ farnilydwellings U Building over 10.000 square feet four or Signal circuras)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension• U Building over three stones U Feeders,400 nmps or more *Description: _ U Occupant load over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable in any of the above: U Egressilighnngplan U Other Per ins ecton Submit`sets of pians with any of the above. Investigation fee The above are not applicable to temporary construction service. other Not all Judsdictiom accept credit cards,please toll junsdreuon for more information.' I`IOtICe:This permit application Permit fee.....................$ U visa U Mastercard expires if a permit is not obtained Plan review(at _ %) $ Credit card number: __— _ _� within 180 days after it has been State surcharge(8%) ....$ _ Expires accepted as complete. TOTAL $ Name of cardholder u shown on credit card _ S Cardholder signature Amount 440•t615(61MCOM) Mechanical Permit Application Datereceivcd: Permit no. })[ City 44 Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl,no.: Expire date: City of Tigard __ Phone: (503) 639-4171 Date issued: By: Receipt nu.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: ❑ I &: family dwelling or accessory U Commercial/industrial ,J ' I„�,; t,u,;, ,, U New constriction U Tenant improvement U Addition/alteration/replacement _j I nli� r t � t 1 — Job address: Indicate equipment quantities in buxes bcluw.Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ _ Lot: Block: Subdivision: �(C/ 'See checklist for important application information and Project name: jurisdiction's fee schedule lir residential permit fee. City/county: ZIP: , i Description and ocatiun of work on premises: i 1 f r l.e r(ed.) ibtaf Est.date of completion/inspection: Ik�cripiion (1t Res-onlyRes onlvl Tenant improvement or change of use: Is existing space heated or conditioned'?J Yes U No Air handling unit CFM Is existing space insulated?❑Yes U Not it con ihoning(site plan required) leration of existing 11 AC system 1 ' Boilericompressori Busint tame: 'rj — State boiler permit no.: Address: HP Tons BTU/H smoke ampere/ uct emu a etectors City: State: ZIP: 0Q eatump(site pan require ) -- Phone: Fax: E.-mail: lnstaIVrcplacefurnac urner - ---STT/Tr-CCB no,: Q -- Including ductwork/vent liner U Yes O No City/metro lic.no.: — nsta repi ac re ocatetesters-suspen ed, - _ _ wall,or floor mounted Name(please rind): Vent orapp ianc•eother thanfurnace 1KCAC'T PERSON of rigerat1Un: Absorption units BTU/H Nance: Nicole 's Chillers _. HP Address: rJ g —� Com ressors HP City: I State: ZIP: Environmental ex ust an rent at un: Phone Appliance vent x-l/ Cax: 31/ E-mail: ryerexhaust 0o s, ype U /-Tf resTcitc er azrnat — — Name: hood fire a;,ppression system =__.�_ Exhan,,t fan with single duct(hath fans) PAailing address: 5 Z x aust systema art from eatin or AC City. � `{ State:Vr— � ue P Ping an r sae ut on(up to To—w,lets) Phone: /J” hax '3 / Type: LPCi NG Oil Uel piping each additional over 4 outlets rocesspiping(schematicrequire ) Name: h>`��y L *L Gl Number of outlets Address: Z Otherlistedspp ancil a oequipment: Decorative fireplace City: 1 State: ZIp: 'JQ/� nsert-type Phone: - I-ax:� - E-mail: oo stove/pet et stove [Applicant's signature: da1e; Ut er: Name (pent): 2e, _ Not all lurisdicuons accept credit cods,please cnn)unsdreaon for rnore inhxmauon Permit fee.....................$ ❑Visa 0 MoslerCard Notice This permit application Minimum fee ...............$ Credo card number _L expires if a permit is not obtained Plan review(at %) Expires within IAO days after it has been --- Name of cardholder as shown on credit card accepted as complete. State surcharge(8%) ....$ s _ TOTAL ....................... Cardholder sr)<rrattue Amoum -- Lf0-4417 Ifsl=OM) ___ m - - - - - - I PACIFIC CHEST SUBDIV ISI("�1V LOT — 22 CITY CSF "I'IGAHD EL-570' O�I ' LANDSCAPING FOR THE ENTIRE LOT v 516-4ALL BE FINI5NED OR ?NE LOT SURROUNDED BY EROSION CONTROL PRIOR TO BREAK OUT OF COMMUNITY EROSION CONTROL FINI5NED SLOPES 0 51-14LL BE _E55 W 13 z \ Q NOTE I.ROOF DRAINS TO STORM �-;T- --� LAT. IN STREET. 2. FOUNDATION DRAINS TO O O BACKYARD SOAKAGE TRENC- CD -LAN .581A al SEE aTTACNED DETAIL -0 F' `'bT N EL 56� W\\_- 00 Q I I /W ARAGE V 1 T. '144 FIN . 565 GRAVEL C: vEwAY I IL•quo �:.rl -5e• THE APPROAC-+ 4 2 ' 2 1/2" lATARi A MINNMUM OF 5-x12 x2C WA n OF CLEAN PIT GRAVEL stoll 11.04 944 Ar ,CALL 1'.2o'-o' 22 FRONT 1 ARD T,7 6.11PAGE _ -7 I- 7 SIDE YARD I! i J j2 REAR BEARD 5 AooREae PLAN 2ee:o D.R. Norton Homes, DATE S/16702 5'.:5 -.UJ. Md Cd Cl,3m 4veneue PWONE e03222,4,ei PCrtlard are or cAx CITY OF TIGARD _ PLUMBING PERMIT__ DEVELOPMENT SERVICES PERMIT#: PLM200'-00386 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 815/03 SITE ADDRESS: 13590 SW SANDRIDGE DR PARCEL: 2S105DD-04600 SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK— LOT: U22 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: U f HER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow prevention device for irrigation. Owner: FEES-- S —`- UIETERICH Description Date Amount — — 13590 SW SANDRIDGE DR \1111 P0r11111 I rr 8/5/03 $36.25 TIGARD, OR 97224 \I "Linc I'l 8/5/03 $2.90 Total v $39.15 Phone Contractor: ESEQUIEL ROBLES LANDSCAPING 7076 RIDGEMONT DR N KEIZER, OR 97303 REQUIRED INSPECTIONS Phone : s01-39(1-4353 RP/Backflow Preventer 4 Reg#: 1'1 11 771t•f r"ti)rf-c- This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: �� - c'��%�CI Permittee Signature: Call (503) 62§4175 by 7:00 P.M. for an inspection needed the nex=t(bu``siinnees–ss day Building Fixtures Plumbinu, Permit Application FOR OFFICE Received O�' Plumbing Date/B : Permit No.: Planning Approval Sewer Gty Or Tigard -Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review other - Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use *' Date/By: Case No.: Internet www.Ci.tigaid.Ui.us contact Juris.: 0, see Page 2 for 24-hour inspection Request: 503-639-4175 Namc/Method: I Supplemental Information. _ TYPE OF WORK FEE•SCHEDULE(forspecial Information use checklist _New construction _ Demolition Descri ttionQry. Fec(ca:► Addition/alteration/replacement Other: New i-&2-family dwellings _ CATEGORY OF CONSTRUCTION - includes 100 R.for each u ility connection SFR I bath 249.20 1 & 2-Family dwelling ❑Commercial/industrial SFR 2 bath _ 350.00 [:]Accessory Building F1, Multi-hamiy _ SFR 3 bath 399.00 _ [� Master Builder Other: Each additional bath/kitchen 45.00 _ JOB SITE INFORMATION and LOCATION Firesprinkler-sq. ft: Page 2 Job site address: _ Site Utilities Suite #: _�- Bldg./Apt.#: i Catch basin/area drain 16.60 Project Name: - Dr ell/leach line/trench drain 16.60 -- Footing drain no linear fl. Page 2 Cross street/Directions to job site: Manufactured home utilities _ 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer(no. linear fl.) Pa c 2 Subdivision: - -+ Lot#: Stonn sewer(no.linear fl.) Pae 2 _ - ---- -�� .Water service(nolinear 1l i Pae 2 Tax map/parcel #: _ - - -� DESCRIPTION OF WORK Fixture or Item Absorption valve _ I6.60 L+ , Abe V, br I Q/11 -�� _-- --- Backflow prevcnter _Page 2 Backwater valve 16.60 Clothes washer - - 16.60 Dishwasher 16.60 -- Drinkingfountain 16.60 _ PROPERTY OWNER -��TENANT E'cctors'swn I6.60 Name: j j ; � �� Expansion tank 16.60 _ Address: 13 r, -S L,-) Fixture/sewer cap 16.60 City/State/Zip:'`~; q a r Floor drain/floor sink/hub 16.60 Phone: � t', , " T�) .- -Tq-�7 Fax: Garbage disposal 16.60 _ Hose bib I6.60 APDL CANT 10 CONTACT PERSON Ice maker 16.60 Name: CTo e �_ )�o��C�--_ _ Interceptor/gtcasc trap 16.60 Address: Medical gas-value: S Pae 2 Cit /State/Zi _ Primer 16.60 y----� ---- Roof drain commercial 16.60 Phone: Fax: Sink/basin/lavator 16.60 --- ---------- ------ ---- E-mail: Tub/shower/shower pan 16.60 CONTRACTOR Urinal 16.60 Business Name: C.S Water closet _ 16.60 5v�9� ier.l Rc��iie� larrdsCe�,., Water heater 16.60 Other: TnZ� k� u d ikon E b '�.c�' Other: - - --- Cit /State/Zi 7 Q ��'3 other: - Phone: '• - :r t 7. Y Plumbing Permit Fees' Subtotal t CCB #: L Plumb. L1C,#: Minimum Pemtit Fee$72.50 $ Authorized zed (` .9 Residential Backflow Minimum Fee$36.25 �� f Signature: y__. ,. Date: ply Review 25410 of Permit Fee S State Surcharge(80b of Permit Fee) S (Please print nanx) TOTAL.PERAiIT FEE S Notice: This permit application expires If a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or 190 days after It has been accepted as complete. riser diagram for plan review. 'Fee methodology set by Tri-County Building Industry service Board. g:\Dsts\Permit Forms\PImPermitApp.doc 01103 Plumbing Permit Application - City ofTigard Page 2-Supplemental Information Fee Schedule: Residential Fire Suppression Mems: Site Utilitles Qty. Fee(en) Total Square Footage: Permit Fee: Footing drum- I" 100' 55.00 0 to 2,(1(X) $115.00 Footing drain.cacti additional I(X)' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.110 _ Sewer- I st 1011' 55.00 7,201 anJ greater $309.00 Sewer-each additional 100' 46.40 Water Service-Ist 100' 55.00 Medical Gas S stems• Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Drain- Ist 100' 55.00 $L00 to$5,000.00 Minimum tec$72.50 Storni&Rain Drain-cacti additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000-00 and$1.52 for each additional$100.00 or fraction thereof,to and Fixture or Item Qty. Fee(ea) Total including$10,000.00. Commercial Hack Flow Prevention Device 46 40 $10,001.00 to$25,000.00 $14$.50 for the first$10,000.00 and$1.54 for Residential Backilow Prevention Device each additional$100.00 or fraction thereof,to mininwm permit lee$36.25 27.55 and including$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and including$50,(XX1.00. specially requested ins coons•pet hour 72.50 $50,001.00 and up $742.00 for the first$50,0(X,.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes",pleas:indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. uantlt b Fixture Work Performed Conpnpents regarding fixture work: Flxture'rype: Replace New _Moved Ezielln _Capped Baptistry/Font --- [lath -Tub/Shower -Jacuzzi/Whirlpool _ -- Car Wash -each Stall -Drive Thru Cuspidor/Water Aspirator --- - Dishwasher -Commercial - -- - -Domestic Drinking Fountain --- ----- ti a Wash - -- Floor Drain/sink -2" 4" Car Wash Drain *Note: It'tbe fixture work under this permit results in an Garbage -Domestic Disposal -Commercial _ increase of sewer F;UUs,a sewer permit will he issued and Industrial fees assessed for the sewer Inc,case must be paid before the Ice Much./Refri .Drains _ plumbing permit can be issued. oil separator (las Station Rec Vehicle Dump Station Shower -(fang -Stall Sink -Bar/[avatory -Bradlcv _ -Commercial -Service _ Swimming Pcwl Filter Washer-Clothes Water Extractor Water Closet-Toilet Urinal Other Fixtures: iADsts\Permit Forn s\PlmPrrmitAppPg2.doc 01103 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST .. BUP - Received _ Date Requested .__ � AM __ PM -_-__ __- BUP Location _ Z 3 Sof d l� ` Suite-- MEC Contact Person Ph(. ) PLM Contractor. _— _—__---_—. Ph( ) _- SWR BUILDING Tenant/Owner _ ELC Footing - — FLC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear -- Framing Insulation Drywall Nailing - - - -- --- --- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- — —_—__ Roof Other: -------- --- - — Final PASS PART FAIL _ — — PLUMBING Post& Beam --- — ----- Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: -- Final PASS PART FAIL -- --- MEC_HANICAL Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL - - --�—_. ELECTRICAL Service^ -- -- — Rough-In on _ UG/Slab- — - ire ATarm -_--`- 1.(nn � � [] Reinspection fee of$ _.required before next inspection. Pay at City Hall, 13125 SW Hall Blvd, PART FAIL Please call for reinspection HE:.-- Unable to inspect-no access Fire Supply Line ADA _ ; �_ c._3_s Approach/Sidewalk Datw-�% _ �nsp�Ct ��ext - -- Other: anal DO NOT REMOVE this Inspection record froifi the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received _ --- Date Requested__ _ r _. AM __ _ PM BLIP Location _— / 3 !D 3 s 6 _- _ Suite___... MEC Contact Person — ___ Ph(—_--__) - PLM - - Contractor `- c Ph(_---) _—_ _ __ SWR -- BUILDING Tenant/Owner _--- -_--_ ELC - Footing ELC Foundation Access: Ftg Drain ELF! Crawl Drain Slab Inspection Notes: SIT Post&Beam - - - --- - — Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -.. Insulation Drywall Nailing Firewall Fire Sprinkler - Fire Alarm Susp'd Coiling Roof Other: Final PASS_ PART FAIL PLUMBING Post& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS _PART FAIL MECHANICAL Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ��- ELEGTRICAL UG/Slab Mr 0 — Final PART FAIL Reint•pection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE - [] Please call for reinspection RE: e�—. _ [] Unable to inspect-no access Fire Supply Line _ ADA Approach/Sidewalk � Inspecter iD Ext Other:------- -- � Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL