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13665 SW SANDRIDGE DRIVE w rn rn ZA N U d a t0 cD 13665 SW Sandridge Drive CITY OF TIG,A,RD 24-Hour 77 7 BUILDING Inspection Line: (503) 639-4175 MST QG INSPECTION DIVISION Business Line: (503) 639-4171 BUN _---- Received _ ._ Date Requested__ l ✓�� AM__ _ PM BLIP — Location �. _ �� Suite. MEC Contact Person Ph(_ __) PLM Contractor _ Ph(� __) _ S W R BUILDING Tenant/Owner ELC ------ _ - Footing Founfir:�on ELC Ftg Drain Access: tttLfa) 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 Other:_ - - -- - -------- Final - -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: _ _ ASS PART FAILNFEVIT - ANICAL__ Post&Beam Rough-In --------_-____ - . --------------.__--_. Gas Line Smoke Dampers - Final PASS PRT FAIL --- ----------- IGCT AL _ Service Rough-In — -- —----- ------- — --— -_-- --- UG/Slab Low Vol"; -- --- -- - --- --------- -- Fire Alarm Fina Reinspection fee of$----_—required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. AS PART FAIL Please call for reinspection RE:— Unable to inspect-no access Fire Supply Line ADA D#ft / /�/ Inspector j,/ Ext Approach/Sidewalk t +�+fi -- Other: Final _ DO NOT REMOVE this inspection r:*cord from the)oke site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST �� INSPECTION DIVISION Business Line: (503)639-4171 SUP - Received / _Date Requested ' -� AM_ PM -- BUP -- Location / ✓ Suite MEC _ -- Contact Person _ --_-_ h( --) - _ PLM Contractor_._ ---____-- Ph( - ) - ___-._ SWR _ _-_-- BUILDING TenanVOwner ___-_- ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT _ Post&Beam __ eLAAtly TQC IN - Shear Anchors Ext Sheath/Shear Int Framing Sheath/Shear rc ' �c c�� l N� l�+ 1�3- E �,� ��_ l.C�c 9. "�--� Insulation 7.6 P_e'xn1'A Drywall Nailing Firewall Fire Sprinkler - - - ---"- Fire Alarm Susp'd Ceiling -- ---- Roof Other: -- --- A PART FAIL- PLUMBING _ -----�-�-- _-- --- Post&Beam Under Slab -- - - --- Rough-In Water Service - - - - - ----- ----- - - -------- Sanitary Sewer Rain Drains ---------- --- - -_ ---- - - ------ - ------------ Catch Basin/Manhole Storm Drain -- Shower Pan Other: ---------- -----__------ --___ -__- _____-- - -------- Final --T-- -- ---- - - _PASS PART FAIL -_ --- -- -- -_.-_ - ------------------------------ MECHANICAL - ------- -- -------- --- - ----- ------- - Post& Beam ;dough-In --- -- ----- -- --------- -- -----— --- -- Uas Line Srcoke Dampers --- - ------- - ---- -- ---- --- -- ---- BASSI PART_ FAIL ----- --- ------------------------------- ----- ------- -ft tftTRICAL -. ----- - ----------- - - --- ----- -- ---- Service Rough-In ----- - - --- - ----- - -- --- UG/Slab Low Voltage -- -- --- - -- - ------ - -- --- — Fire Alarm Final Reinspection fee of$___ -_required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd. PASS _PART FAIL � SITE Please call for reinspection RE: F] Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk - 1 v-- Inspector Other:__-__--- Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL AAAAAAAAAAAAI AAAAAAAAAAAAAAA LAAAAAAAAAAAAA d w r y �► ~ s 44 d - m ► ► d , v ► A ► d � lS' a � y ► ► P-O 1� f7 1 O � �' ► ' �P O ► ArD rD UQ ,� M r ` I rr � � G ► d ► d o orD v ► ► rvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvVI ,i b � ► ► d ► d � CTY O F w I GA R D - ` ELECTRICAL PERMIT - I RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00195 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 9/24/02 PARCEL: 2S105DD-05700 SITE ADDRESS: 13665 SW SANDRIDGE DR SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT: 033 JURISDICTION: TIG Proiect Description: All-encompassing low voltage. A.RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR L.ANDSC LITE: OTHER: ALL ENCOMP Y HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHEI. . TOTAL# OF SYSTEMS: Owner: _ Contractor: G.R. HORTON HOMES AZIMUTH CCMMUNICATIONS INC 4386 SW MACADAM AVE P.O. BOX 508 SUITE 102 WILSONVILLE, OR 97070 PORTLAND, OR 97201 Phone: 503-222-4151 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 2720020000 Elect'I Final 5PCT CTR 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) 246-1917. Issued by r ,�lw'�1 Permittee Signature _ 6 /;, 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 AlE:CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N —_—_ DATE:,______.___ LICENSE ATE:_— LICENSE NO: - Call 639-4175 by 7:00 P.M. for an inspection needed the next business day o 0 ° o rs ° I `9 � o e. n (a Con " N "-A. -� C ~ � N � N 0 a � U o � � p �C a 3 b x ti x m L r Electrical it lnit i 'kation �. --- �� 1 - Datereceived: y Pelrtitno. ( , �� / S ��lfy Of Tigard ProjPct/appl.no. Expire date: Cary of Tigard Address: I�125 SW Hall B14 4gatd,OR 97223 Date issued By: Receipt no.: Phone: (503) 639-4171 - Fax: (503)598-1960 J Case file no.: Payment type: -� Land use approval: r I &2 family dwelling or accessory O Commercial/industrial U Multi-family U Tenant improvement New crnlstntcnon U Add itiordalteration/replacement U Other:. U Partial 1 ' SITE INFORMATION Job address: �•1>p> - Bldg.nu.: Suite no.: Tax map/tax lot/account no.: Lot: _ Block: on: ---� Project name: 14W-1 Description and location of work on premises: J%,� (,, Estimated date of completion/inspection: 0 0R11E,,SU1l[EQULE Job no: I ev I Max Description (AY. (ea.) Total Ino.ins Business name: 21g11A COMM T! r✓S NewrhMknti.l gyp, per Address: X r I t� dwelftasrit.Inc ladeaattadredpra@ City: 1 v.)i)jLLlE Stated 7UP: 7v7U Serrkelwhided: Phone:563 fti_?- DIIU Fax• 03Lffof -mail: It100sq.It.orless CCB no.: Elec.bus.lic.no: 6- •teq:IZAm�il�eden-ergy, hditional 500 sq.ft.or portion thereof residential 2 City/mIc,no.: AO)MV0_1 Umiledenergy,non-maidenlial 2 Each manufactured hone or modular dwelling Si na urs of supervising elect' (required) Date Service and/or feeder 2 Sup.elect.name.(print): C (- License no: _ 2 j'j.,_ orfeeders—installation, allerstlon or relocation: 200 amps or leas 2 Name(print): D-IL N 1201 amps to 400 amps _--- 2 Mailing addms: -- - 401 amps to 600 amps 2 rr 601 ant s to 1000 ams 2 City: _ State: ZIP: Over 1000 amps ur volln 2 Phone:%.%L• 1 Fax: E-mail: Reconneclonly Owner installation:The installation is being made on property I own Temporary serrtcesorteeders- which is not intended for sale,lease,rent,or exchange according to lnstallation,■heMkm,orreloration: ORS 447,455,479,6 2t10 amps or leas 2 00 2 o t 4 m 01 amps amps Owner's si nature: Date: �� j. 2 201 a ps t 4 s 2 — — — Branch circuits-new,allerallon, or extension per panel: Name: _ A Fee for branch circuits with purchnsc of Address: service or feeder fee,each branch circuit 2 City: — State: _ ZIP: B Fee for branch circuits without purchase Photic:— —— I ax' t- Mail: -- -- of service or feeder fee,first branch circuit: 2 Each additional branch circuit: Mlac.(Se-lce or 1'eedernN Mciaded): U Service over 225 am-)s conmeervial U I lealth-care facility FAch pump or irrigation circle 2 ❑Service over 320 amps-rating of 1 R2 LA Ilax"ous location Each sign or outline lighting 2 fondly dwellings O Building over 10,000 square feel four or Signal circuit(&)or a limited energy panel. L3 System over fico volts nominal note residential units in one structure alteration,or extension* _ 2 U Building over three stories U Feeders,400 amps or more. *Description: _ Ll Occupant load over 91 persons U Manufactured structures en RV park FAch addllMnal Inspection over the allowable In any of the above: U Egress/lightingplan U(xher Perinspection Submit—Rrin of plans with any of the above. Investigation fox _ The above are not Applicable to temporary construction service. other No all lunwaciau accept cmdh arch.ptraw cart luriaac ia,for roam Information. Notice:This permit application Permit fee.....................S U Visa U MasterCard expires if a permit is not obinine:d Plan review(at — fir) $ T r mru card nnmMr __-( _1 within 180 days after it has leen State surcharge(R91r) ....$ ---- 6splrmr accepted as complete. TOTAL .......................$ ---i---- Narne of crraratdef as s—lawn on credit creed card _ _ S --- --- Cardholder sippur s s _ Arooanr _- �.. 1104615(600fYCOM) 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 per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total I Check Type of Work Involved: Residential-per unit � 777111 1000 sq fl or less _ $145 1.5_-- -- 4 1 � Audio and Stereo Systems' Uach addillonal 50U sq.ft.or Portion thereof _ _ $33.40 _ 1 (� Burglar Alarm Limited Energy $75.00 Each Manufd Ilome or Modular ❑ Garage Door Opener' Dwelling Service or Feeder _ $90.90 _ — _ 2 Services or Feeders F] Heating,Ventilation and Air Condilior.mg System* Installation,alteration,or relocation 200 amps or less _ $80.30 _ _ 2 �� 201 amps to 400 amps _ _ $106.85 _ _ _ 2 Vacuum Systems' 401 amps to 600 amps $16060 ^ 2 r 601 amps to 1000 amps — $24060 3 IT��mmm Other Over 1000 amps of vo4s _ _ $45465 2 Reconnect only $6685 _ 2 Tempordry services or Feeders TYPE OF WORE:INVOLVED-COMMERCIAL ONLY Installation,alteration,or reloration Fee for each system.......................................................... $75.00 200 amps or less $66.85_ 2 (SEE OAR 9113-260-260) 201 amps to 400 amps _ 5100.30 __ 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits L7 Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of servrr-q or ❑ Clock Systems feeder fee. Each branch circuit $6(,`, % ❑ Data Telecommunication Installation b)The fee for branch circuits without purrhase or service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 _ Each additional branch circuit —4 $6.65� -_ ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not inciud;ncl) Each pump or irrigation circle $53.40 Interoom and Paging Syutems Each sign or outline lighting $53.40 _ Signal circuil(s)or a limited energy panel,alteration or extension $75.00 _ U Landscape Irrigation Control Minor Labels(101 $125.00 _ Medical Each additional inspection over �— y ❑ the allowable In any of the above Per inspection $62.60 �_— �� Nurse Calls Per hour $62.50 In Plant $73.75_ ❑ Outdoor Landscape Lighting' Fees: [] Protective Signaling Enter total of above fees $ _ __-.----- F-1 Other 8%State surcharge $ —__ _ Number of Systems 25%Plan Review roe gr See'Plan Review'section on S ' No ricenses are roilred Licenses are required for all other installations front d application. __ -- - --__ -----.—_----._ Fee:.,. Total Balance Due $ C ---' Enter total of above fees $__ ❑ Trust Account N 81L State Surcharge $ ID.h� `- ----- - –�•------- � w_— Total Balance Due f All New Commercial Buildings require 2 ssits of plans. i:\dsts\fbnra\elc-feea.doc 08/30/01 �. MASTER PERMIT / \ CITY O F T I G A R D PERMIT#: NIST2002-00271 DEVELOPMENT SERVICES DATE ISSUED: 8/5/02 13125 SW Hall Blvd., Tigard, OR 9723 (503) 639-4171 SITE ADDRESS: 13665 SW SANDRIDGE DR PARCEL: 2S105DD-05700 SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT:033 JURISDICTION: TIG REMARKS: New SF detached dwelling. BUILDING REISSUE: STORIES, 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 31 FIRST: 1,454 of BASEMENT: O65 00 e1 LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,133 of GARAGE: 720 at FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N nWELLING UNITS; I FINSSMENT: of RIGHT: 5 VALUE•, S 355,024 00 OCCUPANCY GRP: R3 BDRM: 4 BATH: 4 TOTAL: 2.587.00 of REAR: 34 PLUMBING SINKS: I WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: I RAI14 DRAIN: IU0 TRAPS: LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES, 100 SF RAIN DRAINS: I CATCH BASINS: TUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN c 100K: BOILICMP<3HP: VENT FANS: 6 CLOTHES DRYER: 1 GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVcIrEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amu. 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 7 201 40D amp, 201 400 amp: let W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: bill • 1000 amp: 601.ampe•1000y: MINOR LABEL: 10004 amplyoll PLAN REVIEW SEC tION Reconnect only: >=4 RES UNITS: 9VCIFOH>=225 A.: 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO A STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOWPAGING: UUTDOOR LNDSC LT. BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTFMS: Owner: Contractor: TOTAL FEES: $ 8,675.02 D.R.NORTON HOMES D.R.NORTON INC This permit is subject to the regulations contained in the D,R, O MACADAM AVE D.R. O MACADAM Tigard Municipal Code,State of OR. Specialty Codes and SUITE 102 SUITE M all other applicable laws. All work will be done in PORTLAND,OR 97201 PORTLAND,OR 97201 accordance with approved plans This permit will expire if work Is not started within 180 days of Issuance,or It the work is suspended for more than 180 days. Al TENTION: Phone. Phone Oregon law requires you to followrules adopted by the Oregon Utility Notification Center. Those rules are set Res 0: 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 9, Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Appr/Sdwlk Insp Grading Inspection Post/Bearn Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Mechanical Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Rain drain Insp Plumb Final Foundatlon Insp Footing/Foundation On Electrical Rough In Gas Line Insp Water Line Insp Final Inspection Issued By`/ /�. _ l_ - i Permittee Signature : rr 1 .__ ' Call (503) 639-4175 by 7:00 p.m. for all inspection needed the next business day CITYO F T I GA R D _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT #: SWR2002-00177 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/5/02 SITE ADDRESS; 13665 SW SANDRIDGE DF PARCEL: 2S105DD-05700 SUBDIVISION: PACIFIC CREST ZONING: R-7 BLOCK: LOT: 033 JURISDICTION: 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 4386 SW MACADAM AVP Type _ By Date Amount Receipt SUITF 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 Ionated, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral, ATT ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rp.iles 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: _. ' , ,.� ;�_- ' - �_ Permittee Signature: -- Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next business day 771 ds � if OAMG> ' Building Permit Application tt yy11 Date received: r1 - Perfifino..«](C '"/11i ('its of Tigard City r)(Tigard K Address: 13 125 SW Hall blA,Tigard,OR 97223 Project/appl.no.: P Me. 77 Phone: (503) 639-4171 1 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no. _ Payment type: Land use approval: 1&2 family simple Complex: TWE OF PERMIT U I &2 family dwelling or accessory U Commercial/industrial U N`111111-family flew construction U Demolition U Addition/alteration/replacement U Tenant improvement U f t� prinl:l1 r%,Loin U Other: JOB SITE INFORMATION Job address: r Bldg. no.: I Suite no.:_ Lot: Black: ISubdivision: _ Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: Name: PV—• 04, Mailing address: 4- 1 &2 family dwelling: y City: rr�'� State:0 21 P: Valuation of work..... Phone: �? '^ ti I Fax: - '� '-mail: No.of bedrooms/baths,.... ........ . ...... _ Owner's representative: ( Total number of floors.............. Phone: 13Z Fax: E-mail: New dwelling area(sq.ft.) .......................... Garage/carport area(sq. It.)......................... Name: f)• R ��r 1st Covered porch area s ft. po ' (•q ) ......................... Mailing address: G� t 41 r a k v V-,✓ Deck area(sq.ft.) .......... ... ......................... , ('uv: State:_ 7.11' Other structure area(sy u 1 ^-- Phone: Fax: v' I. tn,til- — - - trrnfinerciallindustrial/multi-family: Valuation of work..... . $ Business name: )r" h Existing bldg.area(sq. It.) .................I,,i... Jdress: >�� s Alt- New bldg.area(sq. ft,).....,...,,..,rte"......... City: State:p ZIP:!qJJ Number of stories. .................................. Phone: _ /S Fax: Z?Z F mail: Tyle of co ction.................................... _ 2LZ_ - CCB no.: p Occ cy group(s): Existing: _ City/metro lic.no — New; Notice:All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Name: Z n k_r provisions of ORS 701 and may he required to be licensed in the Address: dOV ^S jurisdiction where work is being performed. If the applicant is City: IState. TZIP; exempt from licensing,the following reason applies: Contact person: fLt� Plan no.: - Phone:2,2.qj --- Name• .CG C� u/� ont;+cI person: rAl— Fee,due upon application ........................... $ Address: X451 _ >`h01 _— Datt.received. City: _ Statr.:Q)1Z. ZIP: / Amount rNceived ......................................... $ __ Phone: Fax:&4 4' E-mail: Please refer to fee schedule. — I hereby certify I have read and examined this application and the Not all junxhcuons accept credit cards.please call junsdtnum for more mformauon attached checklist. All provisians of laws and ordinances governing this O Visa J MasterCard work will be complied wi , whether specified herein or riot. Credit card number -r Espirc; Authorized signature: ,/�-� Dater Name of cardholder u shown on credo card Print name: Cardholder uttnature s Amount Notice:'This permit application expires if a permit is not obtained within 180 days after it hes been accepted as complete. .a.461-1 J~'OM) Electrical PerinitApplication Date received: _ Permit no.:AIS7„0 d- '/ City of Tigard Project/appl.no.: Expire date: City nfTigard 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: _ TVPE OF PERMIT 7 U 1 &2 famil;,dwelling or accessory O Commercial/industrial U Mulli-family U Tenant improvement New construction U Addition/alteration/replacement U Other: U Partial tL"ILMt Job address: Bldg. nu.: I Suite no.: ITax map/tax lot/account no.: Lot: Block: Subdivision: ?" _ Project name: Description and location of work on premises: Estimated date of completion/inspection: CONTRACFOR APPLICA71ON FEE.Scumm Job no: Fee Max Business name: Description _ (try. (ea.) 'Total no.Ins New midenlial-single or multi-family per Address: dwelling unit.Includes attached garage. City State:Q ZIP' 3, Service included: Phone: Lh E-mail: 1000 sq It,or less 4 _ Each nddiunnal 500 sq.ft.or portion thereof CCB no.: Elec.bus, he.no: LIQ energy,Limited residential 2 CII)'/ntelro lic.no.: �)� _ Lt mi led energy,no".resiei:t.a! _ 2 _ Fach manufnclured hot-,n nwuutar o..Ilinp Si naru/io sue ury in elecrrkian/re uiredl Oate Service and/or feeder _�� Y 2 - --1—� -g'---""a----" Services or feeders—Instillation, Sup elect.name(print). license no alteration or relocation: 1 e 200 amps or less _ 2 Name(print) 201 amps to 40(1 Dips 2 401 amps to 61x1 amps 2 Mailing address: M.4wfm '1� 601 amps to 1001 amps 2 City: &174 If State: AA ZIP: Over 1000 snips or volts 2 Phone: Far: E-mail: Reconnecl only 1 Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amps or less 2 201 amps to 400 amps 2 Owner's Si nature: Date: 401 to 600 ams 2 an 1010 0 Branch circuits-nen,alteration, or extension per panel: Name: CONS V' A. Fee for branch circuits with purchase of Address: CY57J_5E / !7service or feeder fee,each branch circuit 2 City: state: X —�—� 9. Fee for branch circuits without purchase ZIP: p un of service or feeder fee,first branch circuit: 2 Phone: Af FaxllE-mail: Each additional branch circuit: PLAN REV,16W(Flease, check'all.that apply) Mlsc.(Service or feeder not Included): O Service over'25 amin-commercial J Health-carefat Ili,, Each pump or irrigation circle _ 2 U Service over 320 amps-rating of 1 del 0 Hazardous locatien Each sign or outline lighting 2 family dwellin3s U f:ilding over 10,txx1 square feet four or Signal circuuis)or a limited energy panel, 0 System over 600 volts nominal more residential units in one structure alteration,or exiensnen• 2 O Building over Uva storims U Feeders,401 amps or more •Descri tion ❑(kcuparu load over 99 persons 0 Manufactured structures or R%'park Fich additional inspection oyer the allowable in any of the above: 0 Egress/lighungplan 0 Other: _ Per Inspection Submit__sets of plans with any of the above. Investigation fee Thr above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards,please tali lurisdicuon for more iNannauun Notice.This permit application Permit fee................... .g _ 0 Visa 0 MasterCard expires if a permit is not obtained Plan review(at %) Credit cud numberL1— within 180 days after it has been State surcharge(8%) ....S Name of cu older v shown on credo card Esnires accepted as complete. TOTAL .......................$ , s Cardholder signature Amount 4404615(6000MI lcchanical Permit Application Datereceived: Permit no. City or TigardProject/appl.no.: Expire date: Cityo,'Tigard Address: 13125 SW 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 7ONewco:nstruction ily dwelling or accessory U Commercial/industrial U Multi-family 0 Tenant improvement U Addition/alteration/replacement 0 Other: _ SCHEDULE.110111 SITE INFORMATION CONINIF.RCIAL' VALUATION Job address: J� l I Indicate equipment quantities in boxes below. 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: *see checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: I 14 N Description and ocation of work on premises;_ 1lkA I'll DIN(Wil 11011111WIJUIX111a 01111114 i Nee(ea.) 'total Est.date of completion/inspection: Ihscrip(ion (Pty. Res.only Res.only Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?0 Yes U No it conditioning(s to an required) Is existing space insulated'U Yes 0 No teraiion o e ng system of er comprc , Business name: State batter pe no.: HP _Tons BTU/H Address: tr smo a ampers uct smoke detectors City: A WiA, I Slate: Heat pump(site plan require ) - Phone: Fax; E-mail: InstalUrcplace furnace/burner -- CCB no.: Including ductwork/vent liner U Yes O No nsta rep ac relocate heaters-suspen e , City/metro lic.no.: wall,or floor mounted Name (please print): Vent fora liance other than furnace PERSON e geral on: Absorption units BTU/H Name: N 01 e SC t.).,.,r-s HP --Address- Gj 11 �y •'mr.essots HP - 'v ronmenta exhaust and ventilation: City: /' State: I ZIP: D Appliance vent Phone Fax, 111 E-mail: Dryerexhaust Hoods,TypeIf/res tic en/hazmat hood fire suppression system Name: /Ws? Exhaust fan with single duct(hath fans) Mailing address: 51.ZCrv x taust systema art from eatin or AC City: r Q State:pIC Z1P: fuelpiping an s't ut on(up to outlets) Phone: Fax: / E-mail; Type: LPG NG Oil Fuel tptng ca�"� ilk tonal over 4 outlets Process piping(schematic required i _ Name: G° / f Number of outlets Other listed appliance or equipment:— Address: e Decorative firepla_u City: State: ZIP: ''Jp/5" nsert-type __ -- Phone: Fax i E-mail oo stove/pelletstove Applicant's signature: ZZ, _ Uate: h (ATer: Name (print); / � Not all Junsdicuonr wcept credit cards past call iunsdicuou fa more infornation. Permit fee.....................$ 0 visa 17 MasterCard Notice:This permit application Minimum fee................$ expires if a permit is not obtained —�- Credit card number, _. _ �._ Plan review(at _ %) $ tnpites within 180 days after it has been State surcharge(896) ....S ^ Nurse of cudhotdet as shown on credit card accepted as complete. Cudhoidei strnature -_-- - Amount 440-4617(60MtCOM) Numbing Permit Application ---- D.ttr recctved. Perinit noP51;40 A (V e,--'i City of Tigard Sewer permit no.. Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Cin u(Tigard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued By: Receiptno.: Land use approval _ Case file no Payment type: TYPE OF PERMIT ❑ 1 &2 family dwelimp or accessory ❑Commercial/industnal ❑ Multi-family ❑Tenant improvement New cnnstntclnm J Addition/alteration/replacement J Ftua) service ❑Other: JOB SrM INFORMATIONI Information Jul)address: �� 1-,/ i' 77Ucscription Qty. Fee(ea.) Total Bldg, no.: Suite no.: New 1-and 2-family driellings only: (includes 1(10 it.ror each utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: ? Block: Subdivision: !S�' SFR(2)bath Project name: SFR(3)bath City/county: r I ZIP: Each additional battl/kitchen Description and I cation of work on premises. Sileutilitiec: Catch basin/area drain Est,date of completion/inspection: -- --- Drywells/leach line/trench drain 1 1 Footingdrain(no. lin, it.) PLUMBING Manufactured home utilities Business name: &►'► lal Manholes _ Address: $� y� Rain drain connector City: State: ZIP: 11C)b Sanitary sewer(no. lin. ft.) Phone: - p' Fax: E-mail: Storm sewer(no.lin. ft.) CCB no.: Plumh.hus.reg.no:'3 -11 Water service(no.lin.It.) City/metro lic.no.: fixture or Item: _ Absorption valve Contractor's representative signature: ,._, _ , � Back flow preventer _ Print name: / Date: Backwater valve CONTACT1 Basins/lavatory �>% Clothes washer Name: Dishwasher _ Address: IVIDrinking fountain(s) City: I f%P!f Statev< I 71P: Ejectors/sum i one: -711 Fax E-mail: Expansion tank i" rt Fixture/sewer cap _ Name(print): 1-f zfri7ih h707f S Floor drains/noor sinks/hub Garbage disposal Mailing address: 67Z G' Al, Hose bibb City: v'11State: ZIP: Ice maker Phone: - Fax: Z /'] E-mail: Interne for/grease trap Owner installation/residential maintenance only: The actua' installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: _ Date: Sum Tubs/shower/shower pan Urinal M1111e �� l/�_ L�LH — Water closet Address: Water heater _ City: 142 j State: ZIP: 1 Other: Phone: Fax:PJj /l E-mail: Tota Not all junuticuons accept credit cards.please call jurisdiction far more information Notice:This permit application Plan reemum vievict fee................$ _ plw(at O Visa 0 MasterCard expires if a permit is not obtained credit card number -• within ISO days after it has been 'tate surcharge(8%) .... shown on credo cud $ E.ptrcs _ accepted as complete. TOTAL ....................... Name of cardholder u S Cardholder signature Amount—' 410-4616(610WOM) PACIFIC CKES"I' SUBIDIVISION Z917— LO"(' - 33 /ysTaoo.� ADO.??f CITY OF "TIGAP.ID stom 1.1 THE APPROACH SHALL BE A MINNMUM OF 8"xl2'x2O' SAN AT OF CLEAN PIT GRAVEL EL-573• WATER LANDSCAPING FOR THE ENTIRE LOT EL-577' SHALL BE FINISHED OR TWE LOT SURROUNDED BY EROSION CONTROL PRIOR TO BREAK OUT OF COMMUNITY 01 OSION CONTROL. FINISHED SLOPES 2 1 • TATA IAN P.GRAVEL SW LESS TWAIN 2 TO I ME DR AY ----- --------------------- Y ------- ---------- "` '' GARAGE NOTE: 5QFT120 I.ROOF DRAINS TO STORM FIN EL 511.5' LAT. IN STREET. 2, FOUNDATION DRAINS TO BACKYARD SOAKAGETRENGti SEE ATTACHED DETAIL •3h43B „ FIN EL 518. I _ I I I F7 ❑�' ❑ i � I I I I � I ' I --- --- ------- SETBACK LINE RrrLINE— L-S . EL- 's, ` SET5ACK REQUIREMENTS SCALE 1••25'-5• 3 3 FRONT YARD TO GARAGE IS. SIDE YARD 5' 3 6 REAR YEARD I5' .1CL KtF.55 13665 SW SANGQ'LtiE D FLAN 36438 D.F . I loi tun Homey SCALE I . 20 DATE 9.15.02 5125 E2.W. Macadam 4verbub REv16ED l-71,•C2 r-NONE 50)22.4151 FOrtIaTTd Orb Crl RAX 50)2223"