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Permit - CITY TIGARD SEWER CONNECTION PERMIT M hbov , DEVELOPMENT SERVICES PERMIT #: SWR2000 -00124 „il 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/26/2000 SITE ADDRESS; 14455 SW 128TH PL PARCEL: 2S109AA -04000 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 006 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: SF PATH I Owner: FEES Type By Date Amount Receipt PRMT KJP 06/26/200C $2,300.00 0003256 INSP KJP 06/26/200C $35.00 0003256 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection ORIGINAL 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 located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. 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 co f these rules or direct questions to OUNC by calling (503) 2 : -'987. Issued by: Permittee Signature: ✓% ' 4g ---- Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Residential Building Permit Application Plan Check# -- /4" Rec'd By 13125 SW HALL BLVD. New Construction Date Rec'd G 1,--dcJ TIGARD, OR 97223 Single Family Detached Date to P.E. 6-H-0 0 V 503 - 639 -4171 1 e< Date to DST G - S- l' F 503 - 684 -7297 -\.' 1 Permit # hi s Print or Type Called o 3 4 QYO Incomplete or illegible applications will not be accepted -SwQ.' °emu - UU S L1 12(( Name of Project Name • Job ELK- 1 -loei RI oa,e06 rivres Az if/b9seoQp L s /G ocJ Architect Mailing Address Address Site Address i 3�� ,Uw �8 - /�U� LOT (a `/415,-- 5 /ag Pe_ 4306- Zip Phone Name - KOLTZ4ZI/ L 97261 2.26=-9/4 l Roe etrr 0 a tel-) Name Owner Mailing Address ieQCtiCSLL e 'a/A, eve-,eo /436 • 3Yic1 c/ -`3 CAL ADD /7 iep Engineer Mailing Address City /State Zip Phone 46 se, / 62,13- ZSy - ( z ell(L5Dilel /GLO 06G 9 70 7c) City /State Zip Phone_ General Name Po2.TL 19 9_ q7216, `ZO ,1 1 Contractor © 6 e/ex) /7 '41es Ave! Describe work New B- Addition 0 Alteration 0 Repair 0 Mailing Addres to be done: Prior to permit 3 e- q t{ t{ S GO I. P D D 1-4 I L- (, R p Additional Description of Work: issuance, a copy City /State Zip Phone of all licenses W( t$O&UiLLcf 9702o G2.S Y5/oo are required if Oregon Const. Cont. Board Exp. Date PROJECT expired �O 7 in COT Lic.# ! 936/ / O / /(� /OD VALUATION $ p9 0/ , database Mechanical Name NEW CONSTRUCTION - j , / ✓,j( • Sub - F S SDr)s /1e3W7 Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address 2. l084 8�6 Prior to permit 4 Z SE 3 KP Indicate the restricted energy installation by the electrical issuance, a copy Qty/State Zip Phone subcontractor in the following areas of all licenses tibdt44X ©Q 97Z90 7as---6-!/S Restricted Audio /Stereo are required if Oregon Const. Cont. Board Exp. Date Energy g System x Alarms expired in COT Lic. # Installations Vacuum Irrigation database 7� s 2 3 ////6/D c2 X System System Plumbing Name , n (check all that Other: p� Sub- s 10Gmer,B /U6 apply) Contractor Mailing Address Number of Units in Building Unit Number Designation PD,BOx 7/Go Has the Subdivision Plat recorded? N/A YES NO Prior to permit City /State Zip Phone /• issuance, a copy AZ '/6f 9z 4700? & -tio3 y of all licenses are Oregon Const. Cont. Board Exp. Date required if Lic.# 7/840 3`21 (D I expired in COT database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the �{' l��o Pe) `{(l Z `O 1 information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with Name Oregon State laws. Electrical 2ArluB eLb12..T , Sign a of Owner /A e bate /�// o a Sub- Mailing Address Con t Person Name Phone # Contractor 7¢p 3 74 y ,D8 c�_°> Q.B2i6 -ill 76/x'- 83�5 City /State Zip Phone Prior to permit issuance, a copy O F70/3 “'72.78 FOR OFFICE USE ONLY: of all licenses are Oregon onst. Cont. Bo- : Exp. Qate Plat #: Ma !TL #: required if Lic 6�- p expired in COT �7 �J° O l s °�I /T/ -641006 database Electrical Lic. # Exp. Date Setbacks: Zone: 3 -C �( p tVol / Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF: 5 2 / 2 '5 110 to(tolol is \dsts \forms\sfd - new.doc 11/20/98 CITY OF TIG,, RD BUILDING INSPECTION DIVISION I„1 -- , :; , ' :. °, ;, ' ' 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 W BUP � , Date Requested AM PM gLp i Location / 4 C4 4,4j l Z€' t 2 Suite 41E6 Contact Person Ph 4U11 • Zoo i — oo t 2 1 Contrac t Tenant/Owner C j Ph leei ' r3S 1 :y op-tr� , d d / a7 �, =UIL ELC \PA- 7 — -0k Retaining Wall ELR C/ CEO Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: 6N Ly SGN Slab SIT Post & Beam a l Ext Sheath /Shear Ina Framing Sheath/Shear o-a-ziool_000g, ( • l r { . ` v s , 6 Framing 4 & p v t R Insulation , Drywall Nailing t�l C ..4.4 �i ., , us _ IL ' , mur Firewall �C-A.` ,'tic 4e---n.A— ' Zv`,..-r„i••ryN ? 7 Fire Sprinkler Fire Alarm . /f n Susp'd Ceiling 1 j ► d (1) L -ti'/\ \7 62 - �.c,✓ '' GEC Mi IVA_Ic iz-e ,12_0_ 2u_i0 k9 (c,e D c ‹Cam[ it f a ir---C-a-Ss/e S PART AIL IIM: J Post & Beam Top Out I Water Servic. elja Sanitary Sewe 44. Rai *rains !M PART FAIL Post & Beam Rough In Gas Line Smoke Dampers Ina 4 ' AS PART FAIL ■ CTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm • Final PASS PART FAIL SITE - 1.'" Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA j> o Ass oach /Sidewalk � `' '� k \ •the JAS - n - 1.� Date 'I f 'q \ Inspector - Ext ' Fin - - ASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION Dr2 004 -- ©D/lo 24 -Hour Inspection Line: 639 -4 41 175 Business Line: 639-4171 BUP 4 Ca& P Date Requested D r ,/ � AM PM / 516 BLD Location ( 4 `/ ' 7 P-- 520 /2.2 Suite MEC Contact Person P Ph ° 7,9 gS7 PLM Contractor Ph SWR ¢,G Tenant/Owner ELC Retaining Wall ELR Footing Access (Z( x Z2 . 3) -t- 01.- x 14 - Z Foundation FPS Ftg Drain X '7 • & ) — Crawl Drain Inspection No - : SGN Slab n 6'. �,_ IT Ext ea /Shear r. Int Sheath /Shear _ ' ,a. I , ( 26" l f - " .4 " . : �1Ki ' 1 (Z2/060 001 2_4 Framing IP • - I� II ll Insulation v ` W16/00 (e H ) Drywall Nailing Fire Sp yyy Fire Sprinkler .AIL — Fire Alarm Susp'd Ceiling ' } 1 r^,� Ro of 4 9 g t Vl CQ/` /-� --�2 \ (!"� Misc: Fin - � � �~ FAIL � �_ c; B C--4 A"' 1 0 V l �.: � `�r Post & Beam ^n _ Under Slab v V `.> AZ-r /` VL_/1 Top Out Water Service Sanitary Sewer Rain Drains P C --1--.r� 0 q—,/ Vr.,/� -- Final PASS PART FAIL MECHANICAL cg, 31 £ , Post & Beam J , �'� Rough In Gas Line Smoke Dampers , r - ; Mg" i I Ma Final PASS PART FAI ELECTRICAL V 1 �� ( , Service Sx �l . Rough In --}�� ^ -�^ UG /Slab .a.S.Q V 1 Gt1Q L ` v� Cd 1 P S Low Varage ) � f ` ; 11 Q S ---L-Z Fire Alarm `�V Final ` -1& V�/` -G- + ck��\. s /�- e....---- PASS PART AIL SITE \ � S _ \ \ ILcC.1MA 6 Backfill /Grading - .}.. Sanitary Sewer C/�(i�l) c S 4 ,...e___ L)9-1 A ) �/t ti..-v.'' Nr , i ,',/ ,S , Storm Drain [ : -' nspection - of ref uired before next inspection. Pay at City 013125 SW Hall BIv • Catch Basin Fire Supply Line [ ] Please call for rei _ - - : - ble to ins, - - no access ADA Approach /Sidewalk 7 �j Other Date /6) d Inspector E xt., t r Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION del 2000 /6 3 24 -Hour Inspection Line: 6394175 Business Line: 6394171 u M/3 UP (��j Date Requested �3 U AM P BLD Location / tiq S / ,L / � Suite MEG Contact Person ,a1>4 Ph 7,1 g3 7 PLM Contractor Ph Pet() — d d I ._(/ DING ) Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT - ost :e. Ex eath /Shear Int Sheath /Shear ( l Framing O �� H. 1 T (^ Insulation �- Drywall Nailing k, , iy '' �� �` �-'�� • Firewall Fire Sprinkler Fire Alarm C_ .Q_ Susp'd Ceiling Roof , . • Misc: Final PASS PART FAIL— -G Under Slab , Top Out ‘pl J . Water Servic `^ ^ � ( p [ Sanitary Sewer V " Rain Drains Final PART FAIL L ea Rough In Gas Line Smoke Dampers Final e p - A - g0 PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach/Sidewalk Date proach /Sidewalk Ft-L:370 Inspector EX l Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit Inspection Description Date Passed By Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing � Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line • Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab d) /,-'" Catch basin /Manhole -- Sewer Permit Engineered soils J Inspection Description Dat Passed By Engineering acceptance Sanitary sewer / / i/o 4. ' Final inspection Final inspection / INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS CITY TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT #: SWR2000 -00124 � —� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/26/00 SITE ADDRESS; 14455 SW 128TH PL PARCEL: 2S109AA -04000 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 006 JURISDICTION; TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: SF PATH I Owner: FEES Type By Date Amount Receipt PRMT KJP 6/26/00 $2,300.00 0003256 INSP KJP 6/26/00 $35.00 0003256 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection 7its LA 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 O guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3feet 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. 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 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 8/22/00 Activities for Case #: SWR2000 -00124 1:16:55 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SWRA003 Application received 6/6/00 GEO No Hold BT2 6/8/00 SWRA008 Permit Created 6/8/00 BT2 DONE No Hold BT2 6/8/00 SWRA705 Sewer Inspection No Hold BT2 6/8/00 • SWRA032 DST Post - Review Completed 6/20/00 DLH DONE No Hold DLH 6/20/00 SWRA070 Ready to issue 6/20/00 DLH DONE No Hold DLH 6/20/00 SWRA080 (F) Issue permit 6/26/00 KJP DONE No Hold KJP 6/26/00 SWRA085 (F) Reprint Permit 8/15/00 ZZZ DONE No Hold ZZZ 8/15/00 ■ Page 1 of 1