Permit CITY OF TIGARD
•
�,� DEVELOPMENT SERVICES SEWER
PERMIT CONNECT ION
�� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PERMIT #.......: SWR97 -0127
DATE ISSUED: 05/05/97
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PARCEL: 281O3BD —HGO2O
SITE ADDRESS... •..i2.6- SW 116TH AVE
SUBDIVISION -HUNTER'S GLEN ZONING: R -4.5 PD
BLOCK LOT •020 JURISDICTION: TIG
TENANT NAME -LEGEND HOMES
USA NO FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: Path 1
Owner: FEES
LEGEND HOMES type amount by date recpt
6900 SW HAINES ST PRMT $ 2200.00 B 05/05/97 97- 294107
TIGARD OR 97223 INSP $ 35.00 B 05/05/97 97- 294107
Phone #:
Contractor:
OWNER
Phone #: $ 2235.00 TOTAL
Reg #..:
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 188 days froe
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a 'Tap and Side Sewer' Permit and the Agency will i , 11 a eral.
Permittee Si nature: A r-�
Issued By : - M /1r�
Call for inspection — 639 -4175
Plan Check -12-e
:ITY OF TIGARD Residential Building Permit Application Recd By
3125 SW HALL BLVD. New Construction Additions or Alterations Date Recd Lf — zz - 9f1
IGARD, OR 97223 Single Family Detached or Attached Date to P.E. ZL( - 11
503) 639 -4171 Date to DST •2q - 97
Print or Type Permit # ST' - 0( . .,,,1►q7 -
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. te, Incomplete or illegible applications will not be accepted
Z� Calle. r • /
Name of Subdivision Lot # Name
Job HUNTER'S GLEN 2 LEGEND HOMES
Address Site Address Architect Mailing Address
SW 1.1 6th Avenue 6900 SW Haines St.
Name City /State Zip Phone
LEGEND HOMES Tigard, OR 97223 620 -8080
Owner Mailing Address Name
6900 SW Haines St. FROELICH
City /State Zi Phone En Mailing Address
Tigard, OR 97223 620 -8080 6969 SW Hampton St.
Name City /State Zip Phone
LEGEND HOMES Tigard, OR 97223 624 -7005
General Describe work new 0 addition 0 alteration 0 repair 0
Contractor Mailing Address to be done:
6900 S W Haines St. Additional Description of Work:
City/State Zip Phone
Tigard, OR 97223 620 -8080
Oregon Const. Cont. Board Lic.# Exp. Date
Attach Copy of 060563 6/ 19 / 9 7 Project Q �
Current COT Business Tax or Metro # Exp. Date Valuation $ 4.5 3!.
Licenses -�l q '7 16x33 61/97 NEW CONSTRUCTION ONLY:
Name /2/5/7P 7
Mechanical SUNGLOW INC. !/ Sq.Ft. House: Sq.Ft.Garage:
Sub Mailing Address 2G' 7G' 7 7
Contractor ; 2428 S E 105th Corner Lot Yes j Flag Lot Yes No
City/State Zip Phone (check one) (check one)
( P o r t l a n d, OR 97216 2 5 3 - 7 7 8 9 Restricted Audio /Stereo q t.-Burglar
Oregon Const. Can � w
Cant. Board Lic.# Ex .Date Energy ' System Alarm
Attach Copy of ; 48131 U
Current ' COT Business Tax or Metro # xp. a 7 Installation n / ' �, Garag Door HVAC
Licenses — 7 � 77 _ f. e/ I Opener Systems
Name / (check all that Other:
Plumbing ; WOLCOTT PLUMBING appiy)
Sub- : Address Will the electrical subcontractor wire for all Yes No
restricted energy installations?
Contractor PO Box 2007
Has the Subdivision Plat recorded? N/A Yes No
City/State Zip Phone OL
Gresham, OR 97030 667 -9891 _
Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# Solar Compliance
Attach Copy of 9 3&4 7 10/19/97 (Calculation Attached)
Current Plumbing Lic. # Exo. Date I hereby acknowledge that I have read this application, that the
Licenses 26 - 2 0 8 P B 8/31/97 information given is correct, that I am the owner or authorized agent of
COT Business Tax or Metro # Exp. Date the owner, and that plans submitted are in compliance with Oregon
96 -4281 _.271-9t State laws.
Name /1/' Signature g oer /Agent Date
Electrical GARNER ELECTRIC ----c- �
Con et Name Phone
Sub- Mailing Address
Contractor 21785 SW TV Highway FOR OFFICE USE ONLY:
City/State Zip Phone Plat* ` Map/TL#:
A loha, OR 97006 591 -1320 (, r t 1 ,� �
Oregon Const. Cont. Board Lic.# Exp. Dat IOS — (41 u p 0 261 /I �� H,G� 0
Attach Copy of .x-9.6 x/672/ 8 X 97 Setbacks ' ' ) Z ne: Solar:
Current Electrical Lic. #
Licenses 34-305C /U�/ t 7 0 I I/01" V AS P\)
COT Business Tax or Metro # Ex . D to Engineering Approval: Planning Approval: TIF:
sts\mstapp.doc a 7 J y /v :� ( .1 1 ' e RACY*" Ab Val r` V ,A.An2 r
Permit # Account Description Amount Amt. Pd. Bal. Due
k
in MST. Permit (BUILD) .56.5 SG5, Y
. Plumb. Permit (PLUMB) 225 - � 22 5, �-"
Mech. Permit (MECH) 45 45
ELC /ELR Permit (ELPRMT) ZSO. ✓-'' 250.
State Tax (TAX) 54, 34,
Bldg: 28. 2.6 -y
Plumb:
2-S � --
ll.
2 s -7
Mech: 2.
u
ELC /ELR: / Z. '
Plan Check
MST: (BUPPLN) 3 ✓ p /
7 //7,:
Plumb: (PLMPLN)
Mech: (MECPLN) //, 2....._) °` / , z..i
,. ✓V CIVAW 10
CDC Review (LANDUS) 40. G-50 w.‘-
G ✓
St./AV-CM-7 Sewer Connection (SWUSA) Z2O0, 1-' ZZQO.
Sewer Inspection (SWINSP) 35. ,'S,
Parks Dev Charge (PKSDC) /0.50. /0 � c
Residential TIF (TIF -R) \l
Mass Transit TIF (TIF -MT)
Water Quality (WQUAL)
Water Quantity (WQUANT) /00 /U 0
Erosion Control Permit (ERPRMT) 64 ''✓' ./
Erosion Planck/USA (ERPLAN) Z0, 2 0 80
jg Erosion Planck/COT (EROSN) 20,g ` �U. u
G
Fire Life Safety (FLS) V
TOTALS: 5 L 7.r1 t 71, Z /
i:\dsts\mstapp.doc i /
Rev. 7/96
4/26/00 Activities for Case #: SWR97 -00127
2:04:46 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received 4/22/97 B RECD BON 4/24/97
SWRA705 Sewer Inspection 9/18/97 MS PASS MRS 9/18/97
SWRA080 (F) Issue permit 5/5/97 B PASS DST 5/5/97
SWRA720 Case Finaled 9/18/97 MS PASS MRS 9/18/97
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