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Permit
A CITY OF TIGARD . DEVELOPMENT SERVICES SEWER CONNECTION °NU PE RM I T `— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # • SW R97 —O 13 `' DATE ISSUED: 05 /13/97 PARCEL: 2 2S103BD —HG007 SITE ADDRESS...:12586 SW 116TH AVE SUBDIVISION -HUNTER'S GLEN ZONING: R -4.5 PD BLOCK LOT •007 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 1 6900 SW HAINES ST PRMT $ 2200.00 B 05/13/97 97- 294498 I TIGARD OR 97223 INSP $ 35.00 B 05/13/97 97- 294498 Phone #: Contractor: OWNER Phone #: $ 2235.00 TOTAL Reg #... REQUIRED INSPECTIONS This Applicant agrees to coeply with all the rules and regulations Sewer Inspection _ .,.. , of the Unified Sewage Agency. The persit expires 180 days free the date issued. The total mount paid will be forfeited if the pereit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the eeasureeent given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer' Permit and the Agency will install a lateral. Permittee S' n tu ..��;:,i , J . Issued By: ? Call for inspection — 639 -4175 Plan Check # v/ -/ � 2 � :ITY OF TIGARD Residential Building Permit Application Recd By 3125 SW'HALL BLVD. New Construction Additions or Alterations Date Rec'd O(( • . ci` 'IGARD, OR 97223 Single Family Detached or Attached Date to P.E. 3D 503) 639 -4171 Date to DST /,�'- .2 - 9 Print or Type Permit # 1 Y7- p / ,W 2 Called 1 7 -i7 9 7 -dl Incomplete or illegible applications will not be accepted Name of Subdivision Lot # Name Job HUNTER'S GLEN 07 LEGEND HOMES Architect Mailing Address Address S ite Address 6900 SW Haines St. 12586 SW 116th Avenue City /State Zip Phone Name Tigard, OR 97223 620 -8080 LEGEND HOMES Owner Mailing Address Name 6900 SW Haines St. EROELICH City /State Zi Phone En Mailing Address Tigard, OR 9/223 620 -8080 6969 SW Hampton St. — City /State Zip Phone { Name Tigard, OR 97223 624 -7005 General LEGEND HOMES Describe work new addition 0 alteration 0 repair 0 Mailing Address to be done: Contractor g 6900 SW Haines St. Additional Description of Work: City /State Zip Phone Tigard, OR 97223 620 -8080 Oregon Const. Cont. Board Lic.# Exp. Date - AttachCopyof 060563 6/19/97 Project �f�f� C / Current COT Business Tax or Metro # Exp D � Date Valuation / / v/ 774 / / 7' /7c Licenses - 4-3-7 -1 72- 2G3 3 / NEW CONSTRUCTION ONLY: Name '0 7 Mechanical SUNGLOW INC. Sq.Ft. House: � Sq.F Sub- Mailing Address 2 0 7 �{ �i b Contractor ; 2428 S E 105th Corner Lot - . Yes No Flag Lot Yes No City /State Zip Phone (check one) (check one) '— i Portland, O R 97216 2 5 3 - 7 7 8 9 Restricted ./Burglar Oregon Const. Cont. Board Lic.# Exp. Date Energy pd Audio/Stereo t System � V Jt Alarm Attach Copy of ; 48131 } cy 7 Installation , Garage Door HVAC Current COT Business Tax or Metro # 72 ■Me Licenses I-1-2-7 y7. V2A / uG etefi Opener Systems 1 Name (check all that Other: Plumbing , WOLCOTT PLUMBING app:y) SUb ' -.ailing Address Will the electrical subcontractor wire for all Yes 1, Contractor P O Box 2007 restricted energy installations? V, City /State Zip Phone Has the Subdivision Plat recorded? N/A Yep. No Gresham, OR 97030 667 -9891 4� Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# Solar Compliance Attach Copy of 7 3 , 9 4 7 10/19/97 (Calculation Attached) Current Plumbing Lic. # Exp. 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 12/96 State laws. . Name Signature of Owner /A • _ ;.- Daie Electrical GARNER ELECTRIC s. / L'�j Contact Person Name Phone Sub- Mailing Address CL gale) Contractor 21785 SW TV Highwa FOR OFFICE USE ONLY: City/State Zip Phone Plat # Map/TL #: Aloha, OR 97006 591 -1320 /�� j — / Oregon Const. Cont. Board Lic.# Exp. Date \ 0S 'r i / i 'l (( 4 o� 1 To 7j7 1 360 + 7 -ry' Attach Copy of 8 - 9 6 //40 72/ c9 //f s 7 Setbacks Zo e: Solar: Current Electrical Lic. #' E` xp. Date (*-67- � ' �� - FP • Licenses 34-305C /0 -97 [-lP CO Business Tax or Metro # Exp. sl ate Engineering Approval: Planning Approval: TIF: r/ 6-/- 9 7 i1 cf iv Pte- l sts\rnstapp.doc 4:1/7 Permit # Account Description AmOlint Amt. Pd. Bal. Due ' OW' dVMST. Permit (BUILD) 550. L. 55© 17 R Plumb. Permit (PLUMB) Z23 " 22.5, Mech. Permit (MECH) 45, -45 ELC /ELR Permit (ELPRMT) Z50," 2 50, State Tax (TAX) � jJ. 53. !_ Bldg: 27. 53 / Plumb: ii, 2)- Mech: ELC /ELR: / 2 , Sv ✓ Plan Check � ,./ MST: (BUPPLN) 357 - S3 f/ /of, -- Plumb: (PLMPLN) 2 z , � Mech: (MECPLN) / ///. ✓ CDC Review (LANDUS) -4 0, CAN ' !'�`� I 64_00- O Sewer Connection (SWUSA) 22 0Q, v -iaG? Sewer Inspection (SWINSP) 3S, Parks Dev Charge (PKSDC) /Q51 /Q 5 b , (. v u Residential TIF (TIF -R) 7 '- ii ?'O Mass Transit TIF (TIF -MT) /1 r Water Quality (WQUAL) Water Quantity (WQUANT) / 2O, ' tQQ, L Erosion Control Permit (ERPRMT) 6 " CO c. , ' Erosion Planck/USA (ERPLAN) ( 2-0 , � ? Erosion Planck/COT (EROSN) (2 i 0' Fire Life Safety (FLS) f / / TOTALS: �� �"/� �i./63 . 11— is \dsts\mstapp.dOC 5 O23, Rev. 7/96 / ��� \ 0. CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: 99—�/� 7 - ` 7 /)�,�p A.M. P.M. MST: / 7" 0/ 35 Location: / 553 , -(/t) /1 C) C (� Ct_o T BUP: Tenant: / Suite: Bldg: MEC: Contractor: ' .4 A _ ,_ / /` `�! _A /L Phone: 524-51 0 O PLM: Owner: ' of ELC: ELR: ‘ q ®f 3 � D STT. BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In Ceiling Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved )proved Approved Approved Approved Appr /Sdwlk Not Approved o pp, ved Not Approved Not Approved Not Approved FINAL CFINAL) FINAL FINAL FINAL O Call for reins tion O Reinspection fee of $ r equired before next inspection O Unable to inspect Inspector: Date: 4 7/ r / 2 Page of