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Permit
• CITY OF TIGARD ,.,, {7 j D EVELOPMENT SERVICES R CONNECTION uN",n- �i� PERMIT !' t 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # .......: S W R97 - 0085 DATE ISSUED: 04! @3/97 PARCEL: 2S103BD -HG022 cir.'m ADDRESS. _ , : 1 7.58b SW 1 16TH AVE SUADTVISTON'.... : H JNTER' S GLEN ZONING: R-4.5 PD RLOCK...... , .. ,. LOT :022 JURISDICTION: TENANT NAME..... : LEGEND HOMES liSA Nt3... < < ..... : FIXTURE UNITS...: 0 LASS OF WORK... :NEW DWELLING UNITS..: 1. TYPE OF USE .... _ : SF NO. OF BUILDINGS: 1 INSTALL TYPE • LTPSWR IMPERV SURFACE: 0 sf Remarks: Path Owner: •- _, ----- FEES LEGEND HONES type amount by date recpt. 6900 SW HAINES ST PRNIT 5 2200.00 JMH 04/03/97 97-292697 TIGARD OR 97223 INS? $ 35.00 JMH 04/03/97 97- 292G97 Phone #: • . Contractor: - OW N ER Phone #: $ 2235.00 TOTAL Reg #.. . REQUIRED INSPECTIONS - This Applicant agrees to coaply with all the rules and regulations Sewer Tnsner.+ :_nr T . - _. of the Unified Sewage Agency. The per' it expires 189 days froc — , _ _ the date issued. The total vaunt paid will be forfeited if the -.._f- _. _--.. . pernit expires. The Agency does not guarantee the accuracy of the ------ __ ___ ___ side sever laterals. If the sewer is not located at the r^easurerTent given, the installer shall prospect 3 feet in all directions from . _ - the distance given. If not so located, the installer shall purchase T - � ______ — _ _____ a °Tap and Side Sever" Pernit and the Agency will in tall a lateral. _� _____ Perm; t +.pp Signa'' I) r, / _ / !�! i2 - -- __ _ Tc- .^tr�P4 P �' ' - /f -__ , . © Call for irlcpecti.rn - 619-4175 �9 -4175 -. • Plan Check # 3 2;? R :ITY OF TIGRD Residential Building ermit Application Recd By 3125 SW HALL BLVD. ew Construction Additions or Alterations D ate Recd / 'IGARD, OR 97223 la1 Single Family Detached or Attached Date to P.E. Mr'7 503) 639 -4171 " i p Date to DST Print or Type Permit #MhTR7 surK97 -up Called OL/019 � 9 V4 ncomplete or illegible applications will not be accepted 'V/n Pei Name of Subdivision Lot # Name Job ' LEGEND HOMES HUNTER'S GLEN 22 Address Site Ad ress Architect Mailing Address • _ ' 1258j SW 116th 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 Zip Phone En Mailing Address Tigard, OR 97223 620 -8080 6969 SW Hampton St. City /State Zip Phone Name Tigard, OR 97223 624 -7005 General LEGEND HOMES Describe work ne 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 9.7223 620 -8080_ Oregon Const. Cont. Board Lic.# Exp. Date Attach Copy of 060563 6/ 19 / 9 7 Project Current COT Business Tax or Metro # Exp. Date Valuation c /,3 - 2 / 2 Licenses 4 71 9 7- 0 24 3- 2, 6/1/97 Name /..) --(2 _ y7 NEW CONSTRUCTION ONLY: Mechanical SUNGLOW INC. Sq.Ft. House Sq.Ft.Garage: Sub Mailing Address (2 Y Contractor ; 2428 S E 105th Corner Lot . Yes k Flag Lot Yes No City/State Zip Phone (check one) (check one) i Portl a n d , O R 97216 2 5 3 - 7 7 8 9 Restricted Audio /Stereo Burglar Oregon Const. Coat. Board Lic.# Ex Date Energy System Alarm Attach Copy of , 4 8131 ' : %7 Current COT Business Ta r tfo # Exp. Date Installation Garage Door HVAC Licenses <1-276 7 7-- / /- / -I'd) Opener Systems , Name (check all that Other: Plumbing I WOLCOTT PLUMBING apply) Sub- ; '.'ailing Address Will the electrical subcontractor wire for all Yes No X. P O Box 2 0 0 7 restricted energy installations? Contractor Has the Subdivision Plat recorded? N/A Y No City/State Zip Phone o< Gresham, OR 97030 667 -9891 . Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# ' Solar Compliance Attach Copy of 73847 10 / 19 / 9 7 (Calculation Attached) Current Plumbing Lic. # Exo. Date I hereby acknowledge that I have read this application, that the Licenses 2 6 - 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 � tuure of o ner /Age Date Electrical GARNER ELECTRIC " / �°' / P ` -- Contact 7oftbarn e P hn S u b- Mailing Address v e e X Contractor 21785 SW TV Highwa FOR CE USE ONLY: City/State Zip Pt•one Plat # Map/TL #: Aloha, OR 97006 591 -1320 �1 1-1( Oregon Const. Cont. Board Lic.# Date IOC 14 4 2S' 6� Attach Copy of '7 i�4 g ../ /(p 702/ -/ j' 14-1,4, Setbacks ' Zone: )- Solar: Current Electrical Lic. #' Exp. Date (�}}11 Licenses 34 -305C /O - 9' 7 Ol i --1- , COT Business Tax r Metro # p. Date Engineering Approval: Planning Approval: TIF: 0 7./ 'y/ / - 77 SITE Fl sts\mstapp.doc — n , Permit # Account Description Amount Amt. Pd. Bal, Due Asi` MST. Permit (BUILD) 5 '15 ✓ 7 Gam) Plumb. Permit (PLUMB) . '' '/ 'S Mech. Permit (MECH) 36- ✓ -36- ELC/ELR Permit (ELPRMT) k ' v' S State Tax (TAX) 1Wg 6 bq Bldg: -(7:53-7 4aS Plumb: ! l'?(' ' ' Mech: (r q� ELC /ELR: [F06 06 Plan Check MST: (BUPPLN) . i F4 ° g Plumb: (PLMPLN) Mech: ( MECPLN ) 9w `/ q, u � c.,o V .., r CDC Review (L ) 2°:--- V C?`. 9 q .7 'Sewer Connection (SWUSA) 21-ve'' ✓ . &�00_____ Sewer Inspection (SWINSP) '3; - V .� Parks Dev Charge (PKSDC) /a <o ✓ /0130 Residential TIF \ (TIF -R) ..--e.? ' `� '� Mass Transit TIF r CJ ° � �, b (TI -MT) a ' / Water Quality (WQUAL) I �A Water Quantity (WQUANT) ) f -- ✓ /0-6 — Erosion Control Permit - ( ERPRMT) t v — �' Erosion Planck/USA (ERPLAN) 2° '� Erosion Planck/COT (EROSN) Fire Life Safety (FLS) TOTALS: ('j l5' F - -) ('(.n6nn?•F6 i:\dsts\rnstapp.doc Rev. 7/96 Gig , c'h