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CITY OF OFTIGARD
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PERMIT
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Tigard, '- ` PERMIT # ^ SWR97-0143
DATE ISSUED: 05/23/97
PARCEL: 2S103BD-HG017
SITE ADDRESS...:12712 SW 116TH AVE
SUBDIVISION....:HUNTER'S GLEN ZONING: R-4.5 PD
BLOCK LOT ~017 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 PRMT $ 2200.00 JMH 1215/23/97 97-295024
TIGARD OR 97223 INGP $ 35.00 JMH 05/23/97 97-295024
Phone #:
Contractor:
LEGEND HOMES CORPORATION • •
7160 SW HAZELFERN RD.
STE 100 '
TIGARD OR 97224
Phone #: 620-8080 $ 2235.00 TOTAL
Reg #..: 000605
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
of the Unified Sewage Agency. The permit expires 18N days from
the date issued. The total amoud 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 / inst'll a lateral.
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Permittee ignature: / • /��
Issued B ' /»�
ssue y : -� '/�m�
Call for inspection 639
� P - 4175 -
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;ITY OF TIGARD Residential Building Permit Application Recd By '
312.5 SW HALL BLVD. New Construction Additions or Alterations Date Recd 5-5
'IGARD, OR 97223 Single Family Detached or Attached Date to P.E. ijagi
503) 639 -4171 Date to DST .Y -/3 -
Permit # ' - PI 'Sufi -g7
Print or Type Called "5 I i -47 00 /3
Incomplete or illegible applications will not be accepted
I 5u.)
Name of Subdivision Lot # Name
Job HUNTER'S GLEN 17 LEGEND HOMES
Architect Mailing Address
Address Site Address
6900 S W Haines St. •
-1-2-703 -CW 116th Avenue
Name City /State Zip Phone
LEGEND HOMES • Tigard, OR 97223 620 -8080
Owner Mailing Address Name
FROELICH
6900 S W Haines St.
Engineer En i Mailing Address 6 9 6 9 S W Ham
City /state zi Phone g Hampton St .
Tigard, OR 9223 620 -8080 P
City /State Zip Phone
Name Tigard, OR 97223 624 -7005
General LEGEND HOM Describe work ne rvyq addition 0 alteration 0 repair 0
Mailing Address
Contractor g to be done:
6900 SW 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
Current COT Business Tax or Metro # Ex Date Valuation $ /88 88.1'2
Licenses ,..4&7 - 1 97- 2 Cj 3
Name / Z /f / NEW CONSTRUCTION'ONLY:
Mechanical SUNGLOW INC. Sq.Ft. House: 173 0o3.ga Sq.Ft.Garage:
Sub- Mailing Address .re C AtasztgAmari 7E S --- /52 rj. t►
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 Audio /Stereo /J Burglar
Oregon.Const. Cant. Board Lic.# Ex} Datt Energy re , r , ,A- System f , ew) , r ciAlarm
Attach Copy of i 48131 3 3(J/5 7 e Door HVAC
Current ' COT Business Tax or Metro # xp. Date Installation Garage
Licenses -4-2-7 Y7 y18/ / -/- 78 /�,,..,,, /,,.. Opener Systems
I Name (check all that Other:
Plumbing WOLCOTT PLUMBING app:y)
Sub •ailing Address Will the electrical subcontractor wire for all Yes No
P O Box 2 0 0 7 restricted energy installations? X
Contractor Has the Subdivision Plat recorded? N/A lAps No
City/State Zip Phone
Gresham, OR 97030 667 -9891 _
Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# Solar Compliance
Attach Copy of 9 3A 4 7 10/19/97 /v (Calculation .Attached) , 2
Current Plumbing Lic. # Exo. Date I hereby acknowledge that I have read this application, that t ' e
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 12/9 State law 'N
Name Signature of /Agent Dat
Electrical GARNER ELECTRIC -
Con ct Pe' on Narne Phone
Sub- Mailing Address •
Contractor 21785 SW TV Highwa FOR OFFICE U'S,E ONLY:
City/State Zip Phone Plat # \ Map/TL #:
Aloha, OR 97006 591 -1320
Oregon Const. Cont. Board Lic.# Exp. Date )CS-- L(? � c� P ,41 c
' v • ?7/ '$' 14(9m
Attach Copy of 244.9 //C7z/ 8 t 7 Setbacks ` Zone: Solar: i d . '
Current Electrical Lic. # 0 Exp. Date (� / ---`
Licenses 34 -305C /0 - - 97 � (' `''�
COT Business Tax or Metro # Exp. Date Engineering Approval: Planning Approval: TIF:
OA
IstsVrnstapp.doc
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Permit # Account Description Amount Amt. Pd, Bal. Due
1 /
iii/s/V o k/ I MST. Permit (BUILD) 650, .---(-•-' 65o.
., Plumb. Permit (PLUMB) 225. _ ZZ5,
Mech. Permit (MECH) 4 5,6° ,-.1,
45
ELC /ELR Permit (ELPRMT) 2 75. w 2 75 u '
State Tax (TAX) Sq 78 5?, LE-
Bldg: 3,2-
z,
Plumb: /7.
2>
Mech: • ✓
ELC /ELR: /3 '' /
Plan Check
MST: 1
BUPPLN 22, 63 756 7Z.
( ) 4
Plumb: (PLMPLN)
Mech: (MECPLN) 1/. z'
CDC Review (LANDUS) 4a, ""
CDC: x '°� •�
5447-010 Sewer Connection (SWUSA) 2200 220V
Sewer Inspection (SWINSP) 3S '
Parks Dev Charge (PKSDC) /O.So. /..50,
+ w
Residential TIF (TIF -R) kr ,' ° JAI
Mass Transit TIF (TIF -MT) 'Al k, \\° / 2
Water Quality (WQUAL)
Water Quantity (WQUANT) /DU, w la &
Erosion Control Permit (ERPRMT) ‘4j w -ci, "
a
Erosion Planck/USA (ERPL4N) (� If? Za J /
v oU
Erosion Planck/COT (EROSN) v� G ,2 0 , o
Fire Life Safety (FLS)
TOTALS: , ZC
is \dsts\rnstapp.doc � 2l I +6 ' y K%
Rev. 7/96
I D IL
5/30/00 Activities for Case #: SWR97 -00143
3:05:37 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received 5/5/97 B RECD BON 5/8/97
SWRA010 Plan check by 5/5/97 BON 5/8/97
SWRA705 Sewer Inspection 6/25/97 MS PASS J *H 6/27/97
SWRA080 (F) Issue permit 5/23/97 JMH PASS TAT 5/23/97
SWRA720 Case Finaled 6/27/97 MS PASS J *H 6/27/97
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