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13645 SW SANDRIDGE DRIVE n� .z aUl cn cfl v CD j645 SW Sandridge Drive CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BLIP � - BUP ,leceived Date Requested AM PM BUP Location _ ?�o � yyu _�Lc co x Suite_--_._ MEC r Contact Person PLM A ``_ _ Ph( ) i �� Contractor-- -,_-- ( ) _ Ph SWR BUILDINGTenant/Owner _-_-_ ELC Footing Foundation ---r ELC Access: -� d Ftg Drain r ELS c�--0 / \l 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: SS )PART FAIL AffleftNICAL Post& Beam Rough-In Gas Line Smoke Dampers - Final PASS PART FAIL __EkECTRICAL -- Service Rough-In UG/Slab li.ow Voltagib Fire Alarm Flnah p I1 Reinspection fee of$_--___._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S3 PART FAIL -- sntr— _ ❑ Please call for reinspection Unable to inspect-no access Fire Supply LineADA Approach/Sidewalk Dab.�_L,L��'1 Inspector Other Final DO NOT REMOVE this Inspection record f-om the job site, PASS PART FAIL eaeeeee,�eaeeeeeeeeeeese��e,�ee�►eeeeeee�,eeeei� F ► 4 �) ► 4 M 7d No. 4 4 — ,` oil.g 44 4 � � No. 44 r44Boo. " ) 'i iS� a M ► g ► 4 Q- rr°, ro ► 4 d ell ► 4 o ``�+ ► 4 r, Uq ► 444 -+ ► 44"4 � �� ► 4rb cro ► 4 C" n - ► ft 4 -i o ► 4 Q44 ty �' M ► 4 �^ ► 4 4 J ► 4 b ► 4 ► 4 ► goil ► d ' ► .,4 ► 4 ► ITI o o 0 71 o (Oft) rl C-1 i; CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST �- INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received - __.—_Date Re uested AM _ PM BLIP S - Location /36�---- ��2 C/ - - Suite - _ MEC - Contact Person -- _ Ph(,_ ) PLM Contractor— -- _ - _ Ph( ) SWR BUILDING Tenant/Owner — _ ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain ' Slab Inspection Notes:.. SIT Post&Beam Shear Anchors _ Ext Sheath/Shear < < Q3 Int Sheath/Shear Framing — --- --- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: AS , PART FAIL `- - - -- -- _MBIRI'3 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 r3 Beam -------._.._....-- --------- -- ----- Rough-In ------- -- - - - -------- - - - — - - ------ .......------ Gas Line Smoke Dampers _ AR PART FAIL ICAL Service Rough-In _ UG/Slab Low Voltage ___—__—— —_-- -- -- -------.�. Fire Alarm Final Reinspection fee of g_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL SITE Please call for reinspection HE:_� __ E] Unable to Inspect-no access Fire Supply Line ADA I Z,1 -(� Approach/Sidewalk Date Inspector - Ext Other: Final - DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL D ELECTRICAL PERMIT - CITY OF T!GA R I RESTRICTED ANERGY DEVELOPMENT SERVICES PERMIT It: ELR2002-00196 13125 SW Hall Blvd.. Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 9/24/02 PARCEL: 2S105DD-05800 SITE ADDRESS: 13645 SW SANDRIDGE DR SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT: 034 JURISDICTION: TIG Proiect Description: AII-encompassing low voltage. A. RESIDENTIAL _ _ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANGSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: I4URSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS: �___ Owner: _�-- —_--�^--_-- Contractor: D.R. HORTON HOMES AZIMUTH COMMUNICATIONS INC 4386 SW MACADAM AVE P.O. BOX 508 SUITE 102 WILSONVILLE, OR 97070 PORTLAND, OR 97201 Phone: 503-22.2-4151 Phone: 503-639-0110 Reg #: ELE 36.94CLE SUP 2312JLE LIC 145828 FEES Required Inspections _ Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 9/24/02 $75.00 272002.0000 Elect'I Final 5PCT GTR 9/24/02 $6.00 2720020000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. ) / Issued b �. '`�,� 4 �L%J�- I Permittee 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 ATE: —,— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Ap►pficafion Date received: //�%0� Permit no.:r4j�g4oa_W I City of Tigard Pmject/appl.no.: Expire date: Ctlynffigard Address: 13125 SW Wall Blvd.Tigard,OR 97223 Date issued: _ py: I Receipt no.: Phone: (503) 639-4171 —� Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TYPE OIFPERMIT I L8;.2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement II t ew construction U Addition✓alteration/replacement U Other: U Partial l JOB SITF INFORMATION Job address: Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: Block_ Subdivision; _ Project name: Description and location of work on promises: W Estimated dale of completion/impertion: CONTRACTOR PAddii no: _ _ _ r Riax ness natrle: ZIIMM C rvIm T11J __ _ Ikytription Oil. (en) Total no.insp New re+irktistiat-single or awYi-family per ess: ,f' S, I n r7 dwellingrarit.Inclodesattached garage. : )A YI tE State:6'i ZIP: ?V Cu _ krvireincludea: ne:5'6 i 63 D 11 Fax• C 30f 01l mail: 1(1(1(1 a(.ft•or less a Each additional 500 sq.IL or portion thereof CCD no.: / LJL5$r.�_t Elec.huslir.no: 7-b-IqCte Urnited energy,residential 2 City/mp%Fu lic.no.: UW S Limitcdenergy,non-residential 2 q D L Fach manufactured home or modular dwelling Sign arc of supervising c4xt (required) Date Service and/or fcerkr 2 Sup.elect.name(print): L�Z Jt` License no! ?,712 31 serrates or feeders-Installation, alterNion or relocation: 1 200 amps or less 2 Name(print): 201 a a to 400 amps 2 401 amps to 600 amps 2 Mailing address: BE 601 to 1000 amps 2 city: stale: ZIP: W over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnecionly I Owner installation:The installation is being made on property I own Temporary services orbeders- which is not intended for sale,lease,rent,or exchange according to illeflar,sherstifln,arrelocation: ORS 447,455,479,6 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Dale: 401 to 601)amps 2 Branch circuits-new,alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: 71l': — _— B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail Each additional branch circuit: PLAN REV111"'WO'ke.nie check all that 9PP19Mkt(9eVice orfeeder got included): U Service-over 225 nmps-commercial U Health-care facility Each pump or irrigation circle _ 2 U Service over 120 amps-rating of 182 U I lazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal eircuit(s)or a limited energy panel, U System over(AK)volts nominal "store residential units in one snvcturc alteration,or extension• 2 U Building over three stories U Fenders.400 amps or more *Drscri tion: U occupant load over 99 persons U Maroractured structures or KV park Each additional inspection over the allowable In any of the above: U fsgress/Ilghtingplan U Ww- -_— ----- Per Inspection — Submit—sets of plans wills any of life above. rinvestigation fee _ Tate above are not applicable to temporary construction service. Other Nd all)uriadktiora accept emar cads,please call ludidlethas fa mom;Mair;; Notice:This permit application Permit fee.......... . .......$ 7 s r U Visa U Mastercard expires if a permit is not obtained Ran review(at 96) $ -.-L._L_ within 180 days after it has been State surcharge(8%)....$ Expires accepted as complete. TOTAL...................... $ f 1 CA Nsme d rimer u drovm m t—COR S cardholdel siaoMwe AmoarN- 410.4613(tLtlaK.'oM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of inspections .r Permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.0.or less $145 15 4 KA Audio and Stereo Systems' Each additional 500 sq it or portion thereof $33.40 1 Burglar Alarm Limited Energy $75.00 _ Each Manufd Home or Modular ❑ Garage Door Opener' Dwelling Service or Feeder $90.90 'l _— Services or Feeders ❑ Heating,Ventilation and Alr Conditioning System* Installation,alteration,or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $106.85_ 2 401 amps to 600 amps $160.60 2 /� 601 amps to 1000 amps _ $240.60 2 Other J�dlct=s-1 l iY Over 1000 amps or volts $454.65 ^_ 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Feefor each system.......................................................... $75.00 Installation,allocation,or relocation 200 amps or less $66.85 -._ 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 _ 401 amps to 600 amps $133 75 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6 65 _ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46 85 HVAC Each additional branch circuit _ $6.65_____,__ ❑ Miscellaneous ❑ Instrumentation (Service or feeder not Included) Each pump or irrigation circle $53.40 _ tJ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s)or a limited energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 Medial Each additional Inspection over the allowable In any of the above Nurse Calls Per inspection _ $62.50_ _ Per hour $62.50 In Plant $73.75 L� Outdoor Landscape Lighting" Fees: ❑ Protective Signaling Enter total of above fees $ n Other 8%State Surcharge $ _ Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are regAted for all other Installations See"Plan Review"section on $ front of application. _. -- Fees: Total Balance Due $ �-7 �--�-- Enter total of above fees S f- ,) LJ Trust Account# __�_ 8%State Surcharge $ 91191— All �1�,0,,�4 Total Balance Due $-_91191 All New Commercial Buildings require 2 sets of plans. i:\dsts\fomnklc-fees.doc 08/30101 141 O F ICG- P�,R D MASTER PERMIT CITY PERMIT#: MST2002-00272 DEVELOPMENT SERVICES DATE ISSUED: 8/5/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13645 SW SANDRIDGE DR PARCEL: 2S105DD-05800 SUBDIVISION: PACIFIC CREST ZONING: R-7 61_OCK: LOT: 034 JURISDICTION: TIG REMARKS: New SF detached dwelling. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS _ REQUIRED CLASS OF WORK: NEW HEIGHT: 33 FIRST: 1,552 nl BASEMENT: 924.00 of LEFT: 6 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,590 of GARAGE: 746 of FRONT: 7O PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 6 VALUE: 5 455,651.20 OCCUPANCY GRP: R3 BDRW 4 BATH: 45 TOTAL: 3,14200 of REAR: 43 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 6 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: 'rUBISHOWERS: 6 GARB..GE UISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTW 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN c 100K: BOILICMP<3HP: VENT FANS: 6 CLOTHES DRYER: 1 GAS FURN+•10OK: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH:IRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 snip: 0 200 amp: WISVC OR FOR: I PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 8 201 400 amp: 201 400 amp: tsl W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amu: EA ADDL BR CIR: SIGNAUPANEL IN PLANT: MANU HMISVCIFDR: 601 1000 amp: 601+8mos•1000v: MINOR LABEL: 1000•amplvoll PLAN REVIEW SECTION _ Reconnect only: >•4 RES UNITS: SVCIFDR x•225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTLU ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNOSC LT: BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 9,407.19 This permit is subject to the regulations contained in the D.R. HORTON HOMES D.R.HORTON INC Tigard Municipal Code,State of OR. Specialty Codes and 4386 SW MACADAM AVE 4386 SW MACADAM all other applicable laws. All work will be done in SUITE 102 SUITE #102 accordance with approved plans. This permit will expire If PORTLAND,OR 97201 PORTLAND,OR 97201 work is not started within 180 days of Issuance,or if the work Is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rey M: LIC 130859 forth in OAR 952-001-0010 through 952-001.0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Wtr Proofing Bsm't Wa Footing/Foundation On Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Grading Inspection Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Sewer Inspection Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Underfloor Innulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Foundation Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection 1 Issued B y " Permittee Signature -------------- �03 639-4175 by 7:00 p.m. for an inspection needed the next business day SEWER PERMIT CITY OF �-IGARD __Y DEVELOPMENT SERVICES PERMIT#: SWR2002-00178 DATE ISSUED: 8/5/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S105DD-05800 SITE ADDRESS; 13645 SW SANDRIDGE DR SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT: 034 _ JURISDICI ION: TIG 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 detached dwelling. Owner: FEES _ D.R. HORTON HOMES Type By Date Amount Receipt 4386 SW MACADAM AVE SUITE 102 PRMT CTR 8/5/02 $2,300.00 27200200000 PORTLAND, OR 97201 INSP CTR 8/5/02 $35.00 27200200000 Phone: 503-222-4151 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" Perm Issued hy: l 1 �(r_l' �/��C% f,� Permittee Signature: CMI (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day C'. ZOO� Building Permit Application ��//yy��-- _ Datereceived: i r. - PernSitdd. ?cc 2 —/�0� (•1ty of Tigard — , Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no. 7-f 0 Z Expire date: City(if Tigard • - Y� Receipt Date issued: 8 no.: Phone: (SU3) 639-4)71 �� l � P Fax: (503) 598-1960 Case file no.: Payment type: ` Land use approval: __. 1&2 family:Simple Complex: U 1 &2 family dwelling or accessory U Commercial/industrial -1 Multi-family 4New construction U Demolition U Addition/alteration/replacement U Tenant improvement ❑Fire sprinkler/alarm U Other: 7 ,, JOB SITE INFORMATION Job address: 7 - ' Bldg. no.: Suite no.: Lot: Block: Subdivision: A Tax map/tax lot/account no.: ,ZS/OS1S1 Project name: l �f�' � J`, rr- Description and location of work on premises/special conditions: Name: h MC 47 C) ' ' Mailing address: 12-5 1 &2 family dwelling: a� City: � 4';� State:Q ZIP: Valuation of work......�5 S GS/, $ -- ................. . Phonr.:�Dh No,of bedrooms/baths................................. _ Owner's representative:_ Total number of floors................................. Phone: 17j I a>. E:-mail: New dwelling area(sq. ft.) ..... ....�....:!..:...... Garage/carport area(sq.ft.)......................... ?!!tT Name: p• 1_ • Covered porch area(sq.ft.) ......................... Ll r Mailing address:_L'&Y01C A5 A h o v t- Deck area(sq. ft.) ........................................ �3 — City: I I I State: I ZIP: Ocher structure area(sq.ft.)......................... Phone: Fax: E-mail Commercial/industrial/multi-famlly: /— Valuation of w �f Business name: H,y-" n Existing bldg.area(sq. ' .............. ....... Address: S -- New bldg.area(sq.ft.) .... . .................. Number of stone ....... City: State:p ZIP: -- Type of ruction.................................... Phone: �JITF_ax: 1 E-mail: Occ ancy group(s): Existing: _ CCB no.: New: City/metro lic.no.: Notice: All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Name: _�1. �-p Vi provisions of ORS 701 and may be required to be licensed in the Address: AS .v. jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing,the following reason applies: Contact person: kj rhjr( Plan no.: ^— Phone: ! f Fa, E-mail: Narne: .� (�&Ujy7 ontact person: Fees due upon application ........................... $ --- Address: Date received: City: State:p/e_ ZIP: / Amount received ......................................... Phone: Fax: mail: Please refer to fee schedule. 1 hereby certify I have read and examined this application and the Not ail)unediciions accept credit cards.please call)undtcuon for more mlormanon attached checklist. All provisions of laws and ordinances governing this o Visa U MasterCard work will be complied W1Uj, whether specified herein or not. Credo card number. Authorized signature: Date: 11-71112-- Name of cardholder as rhuwn on credo cud 1 11 S Print name: Itc DH Cardholder uEnaturt Amount Notice:This pemtit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 440-4611(6raorcOM) Electrical Permit Application Date received: Permit 110. City Of Tigard Project/appl.no.: Expire date: CitygTigrrrd 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 U 1 &2 family dwelling or accessory 0 Commercial/industial 0 Multi-family U Tenant improvement New consiniction 0 Additioit/alterition/replacement _I n i r I ,nti it tItlim Job address: 31dg. no: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: Project name: FAknL, S C)cscription and location of work on premises: Estimated date of completion/inspection: CONTRACTOR l Job no: Fee Max Business name: 6W7 �� 'til(� blew lon "Y.y. (ea.) 7otel no.lns -- New residential-single orinumulti-family per Address: va r1c dwelling unit.Includes anacht4i garagr. City: R1.1 I Stale:19F I ZIP: 3 Service.Included: Phone: Fax: E-mail: 1000 sq.ft.or less 4 - Foch addiuonal 500 sq.ft.or portion thereof CCD no.: _ Elec.has. lic.no: 1pq. RY I,toutedcner residential 2 Clly/Metro lic.no.: �'�Z ej' _ Limited energy,non-residential 2 F:uch mnnufaciured home or r,odufur dweiio..t Si an ruI[o r�u ervisin efeetrieianlre tired) Date Service and/or feeder —, 2 –� ___ -p--� "'4" ----`"u Servlceaorfeeders–Inalallottnn, `;til, deet nantc(pnnt) r•nseno: alteration or relocation: tZEN 200 amps or less 2 Name(print): r ,r� I y c— 201 amps to 400 amps i W 2 401 amps to 6011 amps 2 Moiling address: _ Q I 601 ampstu IUOUamps _ _ _ 2 City: State: ZIP: Over 1000 amps or volLs — 2 Phone: Fax: E-mail: Reconnect only _ I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: 20amps less 2 ORS 447,455,479,670,701. 201 I amps to 400 amps 2 Owner's signature: Date: 401 to 600 ams 2 Branch circuits-new,alteration, or extension per panel: Name: S V K A Fee for branch circuits with purchase of Address: �� 1& Avelservice or feeder fee,each branch circuli _ 2 City; State: 7111: Q B. Fee for branch circuits without purchase of service or feeder fee,first branch ctirutt 2 Phone: FaxVIS- r mail: - Each additional branch circuit PLAN RFVIF.W(Please che�k nil flint apply) Misc.(Service or feeder not included): U Service over 225 amps-commercial U Health-tate facility Each pump or imgatwn circle 2 U Service over 320 nmps-rating of 1&2 U hlazardous location Each sign or outline lighting t 2 farnilydwellings J Building over IO,Otx)square feet lour or Signal circuit(s)or a limited energy panel, U System over 60(1 volts nominal more residential units in one structure alteration,or extension" 2 ❑Building over threestories J Feeders,400 amps or more *Description. U Occupant load over 99 persons C:1 Manufactured structures at RV park Each additional inspection over the allowable In any of the afase: U FgresAi(thtingplan U Other _-_ Per inspection Submit_.sets of plans with any of the above. Investigation fee – 17he above are not applicable to temporary construction service. Other Not till Jurisdictions s rept credit cards,please call Jurisdiction for more inforrwuan. Notice:This permit application Permit fee................. $ — J visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Cirdo card number / / within 180 devs after it has been State surcharge(8%) ....$ Expires accepted as complete. TOTAL $ Name of cardholder u shown on credo cud Cudholder signature Amount 440-615(6mcoM) Mechanical Permit Application Date received: Permitno.'-"S'f;700J'd0,21 City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SVI Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: — Building permit no.: 1 ❑ 1 &2 family dwelling or accessory U Commercial/industrial ❑Multi-family U Tenant improvement U New construction U Addition/alteration/replacentent ❑Other: JOB SITE INFORMATIONCOMMERCIAL 1SCHEDULE Job address: i r , 7417e, P1, Indicate equipment quantities in boxes below, Indicate thr.dollar Bldg.no.: Suite value of all mechanical materials,equipment,labor,overhead, Tax ma /tax lot/account no.: profit. Value S Lot: Bloc k: Subdivision: Pa 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP; gaNgw"O[faing 011114 Description and ocation of work on premises _ 1 13A.1t i M1U 10 t 1111 Fee(ea.) total Est.date of completion/inspection: Description (pv. Res.only Res.only Tenant improvement or change of use: an Is existingspace heated or conditioned'!❑Yes U No Air handling unit CFM _ •P Air conditioning(site plan required) Is existing space insulated?U Yes ❑NoMECHANICAL CONTRACtq1t. teration o existing RVAC system of er/compressors State boiler permit no.: Business name: V Hp 1 ons BTU/H Address: lre/smo a ampers/ uct smoke etectors , City: State: ZIP: p Q eut pump(site plan required) Phone: - Fax: E-mail: nsta rep acefurnace/burncr_, Including ductwork/vent liner ❑Yes O No CCB no.: nsta rep ace/re ocate heaters-suspended, City/metro tic.no.: _ wall,or hoot mounted _ Name (plraw print) _ Vent orapplianceother than furnace CONTACT PERSON e gena on: Absorptionunits BTU/H Name: Nicole p Chillers HP _ Address: �y Com re.,u HP GJ r roMrierric ex ust an rent at on: State: ZIP: 11;f-101 Appliance vent _ Phone -2 y / Pax: Zjj1 E-mail: Dryerexhaust Hoods,Type U Ildres. itc a hazmat hood fire suppression system — Name: t2. 6_rf241___g/l<'1( Exhaust fan with single duct(bath fans) Mailing address: y A4 e-,* Exhaust systema am from heating or AC 7.1P: Ue p p ng and (up to outlets) City: r `{ Slate: Type LPG NG Oil Phone: /f 1 ax: 92 /7 Email -vel spin enc adduiona over4 outlets rocesspiping(schematicreguire ) Number of outlets _ Name: eaXW1,h pra Other I tied appliance or equipment:— Address: e' Decorative fireplace City: l State: Z11': -7,01 j_ Insert-type Phone: Fax: f E-mail: -Wovelpe et stove " Other: Applicant's signature: Date: , -, ter: Name Permit fee Not all jurisdiction,accept credit cards.please call lunedm tction for more infouuton. ........ ...... Notice:This permit application Minimumm feeee......... $......S O Visa O MasterCard expires if a permit is not obtained Credo cud number --/ /- _ Plan review(al _ 9i) Exptr , within 180 days after it has been State surcharge(8%) ....$ Now or cardhoidet i shown on credit cad : accepted as complete TOTAL .......................� Cardholder etprnure Amount 4404617 t&%COMi Plumbing Permit Application Date received: Permit no.:/'/ 7;00r 0 'l , (silty of 'Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no. Building permit no.:- Cagy of Tigard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT 0 I &2 family dwelling or accessory O Commercial/industrial ❑ Multi-family ❑Tenant improvement New construction J �.ddition/alteration/replacement 0 Food service J Other: . J611 SITE INFORMATIONIULE(for special Infonnation Job address: % i ,�' / ' 7; Description Qtv.I Fev(ea.) Total Bldg.no.: Suite no,: J-- New I-and 2-family dwellings only: Tax ma /tax lot/account no.: (includes 10011.for each utility connection) p - - - _ - -- Lot: Block: Subdivision: SFR(1)bath ls4' SFR(2)bath Project name:jTW14f171, /-- SFR(3)bath City/county: V ZIP: Each additional bath/kitchen Description and h1cation of work on premises: Siteutilities: Catch basin/area drain _ Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no. lin. ft.) Manufactured home utilities Business name: JVrA!;, ?jKM1QiVlj Manholes Address: 18116L Rain drain connector _ City: State: 7_ll': pp Sanitary sewer(no.lin. ft.) Phone: D Fax: G mail: Storm sewer(no, lin. ft.) CCB no.: I I I OD I Plumb.bus.reg.no:- -( Water service(no. Iin. ft 1 City/metro lic.no.: Fixture or item: Contractor's representative signature: Back tion valve Print name: - Date: Back flow preventer Backwater valve 1 1 Basins lavatory Name: � 1 Clothes washer Dishwasher Address: /2 A Drinking fountain(s) City: z,jwh StateD,< 1 Z1P: Ejectors/sump Phone ?lZ / Ix: 2f2 6,7 r7l E-mail: Expansion tank ;t. Fixture/sewer cap Name(print): fj. I—I`Dr ft-7ol-e S Fluor drains/floor sinks/hub Mailing address: 671 — Garbage disposal Hose bihb City: State: ZIP: Ice maker _ Phone: - Fax: 2 7/'j E-mail: Interceptor/grease trap Owner instal lation/residential maintenance only: The actual instailation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chnptet 447. Sink(s),basin(s), laysis) Owner's signature: _ Date: _ Sum Tubs/shower/shower pan /l (G Urinal Name: l L�_aA.1(-7H 'area closet Address: ater heater — City: 11C ( I State: ZIP: Other: Phone:�P:3 E-mail: Total Not all funschctions accept credit cods,please call)urisdicnon for more inforrtationNotice:This permit application Minimum fee................$ _O vise ❑MasterCard expires if a permit is not obtained plan review(at _ %) $ Credit cud number / within 180 days after it has been State surcharge(8%) ....$ — Nene of cereatolder u shown an credit crud Exptrcs accepted as complete. TOTAL .......................$ _ S Cerdholdetsignature Amount 44OA616(60U COM) PACIFIC CREST SUBIDIVISICUN I.-OT - 34 F Y OI' TIGARD LANDSCAPING FOR THE ENTIRE LOT - THE APPROACI4 5HALL BE SHALL BE FINISHED OR THE LOT A MINNMUM OF 8"xl2'x20' SURROUNDED BY ER05ION CONTROL CLEAN PIT GRAVEL PRIOR TO BREAK OUT OF COMMUNITY EROSION CONTROL, FINI51-IED 5LOPE5 5 t. SHALL BE LE55 THAN 2 TO I OEL-573' WA R TEMP. GRAVEL TATARIAN RIvEWAY h I t .o NOTE. I.ROOF DRAINS TO 5TC GA IE IN STREET. SOFT - ldb 2.FO ION DRAINS TO FIN EL. 13 5' BACKYARD KACiE TRENCH i SEE ATTACHED Il- 1 � U - 0 PLAN 39028 Q- LIVING 3902 Sa T co FIN EL 574.5' t\ a 1 -------__ CL` 7 5ETBACK REQUIREMENTS 13 4 FRONT YARD TO GARAGE 15' I , `J 6 C) SIDE T'YEA 15 REAR EARD 15' 1DQRF55; 3646-2i SW 5 UCRIDGE V P D.R. -toni��J1 omes-PLAN, 1-025 U-ALF. I' .70' 1K` DATE�5.15.02 5125 S.W. Macadam Aveneue REv15ED5ae•02 PW.e 503122A151 Fc�rtldnd Ore On PAx:5031223111