Permit ...
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CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00078
� ; DEVELOPMENT SERVICES R J G J NALTE ISSUED: 04/13/2000
-- - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14176 SW 128TH PL PARCEL: 2S109AA -ER016
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7
BLOCK: LOT: 016 JURISDICTION: TIG
REMARKS: New SF - Path 1 - Special Note * * ** Special Inspections on this project include Structural
Observation - Slope 35%
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 33 FIRST: 1,906 sf BASEMENT: 0.00 sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,655 sf GARAGE: 800 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 1,429 sf RIGHT: 5
VALUE: $ 369,794.00
OCCUPANCY GRP: R3 BDRM: 5 BATH: 6 TOTAL: 4,990.00 sf REAR: 15
PLUMBING
SINKS: 2 WATER CLOSETS: 6 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 4 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 2 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 6 CLOTHES DRYER: 1
GAS FURN > =100K: 2 UNIT HEATERS: HOODS: OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 4 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 8 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,745.74
MASTERPIECE CONSTRUCTION MASTERPIECE CONSTRUCTION INCThis permit is subject to the regulations contained in the
14176 SW 128TH PL 15435 SW ASHLEY DR Tigard Municipal Code, State of OR. Specialty Codes and
TIGARD, OR 97224 TIGARD, OR 97224 all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LIC 00069010 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion 844 -8444 Post/Beam Structural Plumb Top Out Exterior Sheathing Insr Rain drain Insp Plumb Final
Grading Inspection Post/Beam Mechanical Electrical Service Special insp. required Roof Nailing Final inspection
Sewer Inspection Underfloor insulation Electrical Rough In Gas Line lnsp Water Line Insp
Footing lnsp PLM /Underfloor Framing Insp Gas Fireplace Electrical Final
Foundation Insp Mechanical Insp Shear Wall lnsp Insulation Insp Mechanical Final
Issued By : X RQA- G-,- -\ Permittee Signature : (! X-C.
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Page 1 of 1
Sherman: S -- g (- L1 3 1
Alan Danforth 524- 0, from Masterpiece V -tomes wants to cancel MST 2000 - 00078, please call and advise him of procedural
requirements, and hat fees he will lose.
Thanks 1. �� ,l/A linkjir
Bob P i
4C/41e- II) 6
Bob Poskin , 1 "03
- CITY OF TIGARD Residential Building Permit Application !) Plan Check# 3 - .?3
'13125 SW HALL BLVD. New Construction � '�� Rec'd By
Date Rec'd 3 / -OCj
TIGARD, OR 97223 Single Family Detached 5f' ''J Date to P.E. 7) --- 20 --- "e4.$70
V 503 - 639 -4171 Date to DST 4 I to I ZO19 RP
F 503 - 684 -7297 i Permit # 1A517-at - ow/
Print or Type Called
Incomplete or illegible applications will not be ac epted S�Kz - qD
Name of Project Name
Job I c G t K k 0 /-1,✓ /h is lC.- ST E c<- is
S 2r� ` Architect Mailing Address
S ite Address C
Address tj_C p`r
N i I i to t, 1 /Mae.:E_ City /St O Zip Phone
me
�
, A.�O„e " 7oul ail_it cro
V�-S �'C'k -Pt�tc <Al►�i7'
Owner Mai it ng Addres ame 0
/ S 3 SLJ II- Sk lc Engineer Mailing Address '
P g 0 7 - 0 V
City/State Zip L
T t 1 � zug. 1-i-1.1-4 R� ? -L? 30 SO_ > a lp
City /State Zip on
General Name ,'r i r o, 97Z I e' -0 `! , L°
Contractor A ET c-x,„ p - (A7 Cost/ t ,. c . Describe work New,t6 Addition 0 Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit / l.(''t; c ( L-- lit} S k (t N I Additional Description of Work:
' issuance, a copy City /State ip PtIone
of all licenses ' tel p K. OI 7'2,u( ')-L 7 -0 3 a
are required if Oregon Const. Cont. Board Exp. Date Z PROJECT
expired a in COT Litt �# A b I b O_� VALUATION $ 3 b 0 ( v 0 0
database
Mechanical Name c Z NEW CONSTRUCTION ONLY:
Sub- S L QA T' w A Sq. Ft. House: ,l Sq. Ft. Garage
Contractor Mailing Address !! ,50 ° V - 7 V 0
Prior to permit 0 . bZ Indicate the restricted energy installation by the electrical
issuance, a copy i ty /State Zip Phone subcontractor in the following areas
of all licenses 54) C'� OL !T7 303 140 - GS y..ti 2O Restricted ,/ Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# 2 q q� j' -3 l " 0 / Installations / Vacuum ..... .,,Irrigation
database J C System System
Plumbing Name ► (check all that s Oth r:
Sub- 1- t7 ) u Au ( K-1 apply) S �C.0 1 T
Contractor Mailing Address Number of Units in Building I Unit Number Designation
il l ii
l -7 T c SV e- r 6/(A- Has the Subdivision Plat recorded? N/A YY S NO
Prior to permit city/State Zip Phone
issuance, a copy 2 CLj! . 7 pi 0 l°2S'^') 0 lt
of all licenses are Oregon Cont. s Cont. Board Exp. Date
required if Lic.# "7 v 8 q 3 6 4 2,�o�
expired in COT ( V t 3
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
C- � information given is correct, that I am the owner or authorized agent
Li 2-21 r6 1-3( (g ( of the owner, and that plans submitted are in compliance with
Ninge Oregon State laws.
Electrical
'
19 X1, 1Z , oct's K- PR , S c s g g Signature of Owne gent Date
Sub- Mailing Address CI 9 p 7_13, #U
Contact Person Name Phone #
Contractor f b, ,6U XN21 n' Ni 'C x) o I, us CS- '( -\., 6'l. -C.`7 3 4
City/State Zip Phone
Prior to permit / CI" l t '5 t o J ( - Ol ‘(&
issuance, a copy
FOR OFFICE USE ONLY:
•
of all licenses are Oregon Const. Cont. � V Board Exp. pate/ Plat #: Map/TL#: G /
required if Lic.# 3 (( s LI - 1 9 l2' ' " i / ,' ! 2 - -, & oeb16
expired in COT ,
database Elec ical Lic. # Exp. Date Setbacks: Zone:
3 - ( 2- � ►o_ / (
Electrical Supervisor Lic. # Exp. Date Gri En ' eering Approval: landing Approval: TIF: 1
IR S / / / / It, V 3- 20-zcno j t . tt . 3 20 1e_5
^^,,� feet I r - ,7,/k J "/06
41154= �� k 7 .) 1 0 I i Il i roc(B. -t 7are t i:\dsts \ f d nevk doc 11/20/98
a_. Q-, /7
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223 1( ~ 174 :TVED
Q PR 1 8 2000
IMPORTANT PERMIT NOTICE
PETRA PLUMBING CO
14775 SUNSET BLVD
SHERWOOD, OR 97140
Plumbing Signature Form
Permit #: MST2000 -00078
Date Issued: 04/13/2000
Parcel: 2S109AA -ER016
Site Address: 14176 SW 128TH PL
Subdivision: ELK HORN RIDGE ESTATES
Block: Lot: 016
Jurisdiction: TIG
Zoning: R -
Remarks: New SF - Path 1 - Special Note * * ** Special Inspections on this project include
Structural Observation - Slope 35%
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
MASTERPIECE CONSTRUCTION PETRA PLUMBING CO
14176 SW 128TH PL 14775 SUNSET BLVD
TIGARD, OR 97224 SHERWOOD, OR 97140
Phone #: 503 - 267 -6730 Phone #: 625 -4018
Reg #: Lie 00070893
PLM 34 -221 PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
7- / D Ald/ /
Signature of Authorized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
s, �QMMUNITY RECEIVDEVELOPrf
GAGE ENTERPRISES INC
PO BOX 1429 App 18 2000 MENT
CLACKAMAS, OR 97015 -1429
Electrical Signature Form
Permit #: MST2000 -00078
Date issued: 04/13/2000
Parcel: 2S109AA -ER016
Site Address: 14176 SW 128TH PL
Subdivision: ELK HORN RIDGE ESTATES
Block: Lot: 016
Jurisdiction: TIG
Zoning: R -7
Remarks: New SF - Path 1 - Special Note * * ** Special Inspections on this project include
Structural Observation - Slope 35%
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
MASTERPIECE CONSTRUCTION GAGE ENTERPRISES INC
14176 SW 128TH PL PO BOX 1429
T IGARv, arc 97 224 CLACKA MII- O, OR 97015-1429
Phone #: 503 - 267 -6730 Phone #: 503 - 657 -0142
Reg #: uc 34544
ELE 3 -128C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervise g Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
05/03/2000 Fees Associated with Case # MST2000 -00078 •
10:51:52 AM
. I 2- 1 1 1 2& Pea-c--e--
Fee Case Start End Trans. Create Created
Type Type Date Date Case No. Dept. Description Code Revenue Account No. Date By Amount Due
BPLC MST 01/01/1990 12/31/2005 MST2000 -00078 [BUPPLN] Plck Deposit 245 - 0000 - 433000 03/20/2000 BON $250.00 $0.00
CDCB MST 01/01/1990 12/31/2005 MST2000 -00078 [CDCBLD] CDC Bld 245 - 0000 - 433060 04/10/2000 RDP $20.00 $0.00
Rev
CDCP MST 01/01/1990 12/31/2005 MST2000 -00078 [CDCPLN] CDC Pln 100 - 0000 - 433060 04/10/2000 RDP $20.00 $0.00
Rev
BPLD MST 01/01/1990 12/31/2005 MST2000 -00078 [BUPPLN] Plck 245 - 0000 - 433000 04/10/2000 RDP $839.73 $0.00
Balance --- 13
BPRT MST 01/01/1990 12/31/2005 MST2000 -00078 [BUILD] Bldg Permit 245 - 0000 - 432000 04/10/2000 RDP __$1,676.50 9,0 %o 'T00
B5PC MST 01/01/1990 12/31/2005 MST2000 -00078 [TAX] Build 8% St Tax 100 - 0000 - 207020 04/10/2000 RDP $134.12 $0.00
MPRT MST 01/01/1990 12/31/2005 MST2000 -00078 [MECH] MEC Permit 245 - 0000 - 431010 04/10/2000 RDP $94.25 $0.00
M5PC MST 01/01/1990 12/31/2005 MST2000 -00078 [TAX] MEC 8% St Tax 100 - 0000 - 207020 04/10/2000 RDP $7.84 $0.00
PPRT MST 01/01/1990 12/31/2005 MST2000 -00078 [PLUMB] PLM Permit 245 - 0000 - 431000 04/10/2000 RDP $577.50 $0.00
P5PC MST 01/01/1990 12/31/2005 MST2000 -00078 [TAX] PLM 8% St Tax 100 - 0000- 207Q20 04/10/2000 RDP $46.20 $0.00
ELCF MST 01/01/1990 12/31/2005 MST2000 -00078 [ELPRMT] ELC Permit 220- 0000 - 431510 04/10/2000 RDP $310.00 $0.00
ELC5 MST 01/01/1990 12/31/2005 MST2000 -00078 [TAX] ELC 8% St Tax 100 - 0000 - 207020 04/10/2000 RDP $24.80 $0.00
PARK MST 01/01/1990 12/31/2005 MST2000 -00078 [PKSDC] SF Parks 225 - 0000 - 450000 04/10/2000 RDP $1,050.00 $0.00
SDC
TIFR MST 01/01/1990 12/31/2005 MST2000 -00078 [TIF -R] TIF Resident 210 - 0000 - 448001 04/10/2000 RDP $1,860.00 $0.00
TIFM MST 01/01/1990 12/31/2005 MST2000 -00078 [TIF -MT] TIF Mass Tr 250 - 0000 - 448005 04/10/2000 RDP $150.00 $0.00
EROS MST 01/01/1990 12/31/2005 MST2000 -00078 [ERPRMT] Erosion 100 - 0000 - 207307 04/10/2000 RDP $112.00 $0.00
Cntl
ERPU MST 01/01/1990 12/31/2005 MST2000 -00078 [ERPLN] Ersn Plck 100 - 0000 - 207308 04/10/2000 RDP $36.40 $0.00
USA
ERPC MST 01/01/1990 12/31/2005 MST2000 -00078 [EROSN] Ersn Plck 245 - 0000 - 433010 04/10/2000 RDP $36.40 $0.00
COT
WQUL MST 01/01/1990 12/31/2005 MST2000 -00078 [WQUAL] Water 520 - 0000 - 445002 04/10/2000 RDP $210.00 $0.00
Quality
WQAT MST 01/01/1990 12/3112005 MST2000 -00078 [WQUANT] Water 520 - 0000 - 445001 04/10/2000 RDP $290.00 $0.00
Quant
$7,745.74 $0.00
33s - -0 %d
-S /V77
Page 1 of 1 /i•
05/03/2000 PAYMENT HISTORY FOR CASE
10:52.09 AM MST2000 -00078
Fee Type: B5PC Description: [TAX] Build 8% St Tax Total Fee: $134.12
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $134.12
Total Paid: $134.12 Due: $0.00
Fee Type: BPLC Description: [BUPPLN] Plck Deposit Total Fee: $250.00
Date Paid Receipt# Check# Recorded By Amount Paid
03/13/2000 0000616 BON $250.00
Total Paid: $250.00 Due: $0.00
Fee Type: BPLD Description: [BUPPLN] Plck Balance Total Fee: $839.73
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $839.73
Total Paid: $839.73 Due: $0.00
Fee Type: BPRT Description: [BUILD] Bldg Permit Total Fee: $1,676.50
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $1,676.50
Total Paid: $1,676.50 Due: $0.00
Fee Type: CDCB Description: [CDCBLD] CDC Bld Rev Total Fee: $20.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $20.00
Total Paid: $20.00 Due: $0.00
Fee Type: CDCP Description: [CDCPLN] CDC Pln Rev Total Fee: $20.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $20.00
Total Paid: $20.00 Due: $0.00
Fee Type: ELC5 Description: [TAX] ELC 8% St Tax Total Fee: $24.80
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $24.80
Total Paid: $24.80 Due: $0.00
Fee Type: ELCF Description: [ELPRMT] ELC Permit Total Fee: $310.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $310.00
Total Paid: $310.00 Due: $0.00
Fee Type: EROS Description: [ERPRMT] Erosion Cntl Total Fee: $112.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $112.00
Total Paid: $112.00 Due: $0.00
Page 1 of 3
05/03/2000 PAYMENT HISTORY FOR CASE
10:52.09 AM MST2000 -00078
Fee Type: ERPC Description: [EROSN] Ersn Plck COT Total Fee: $36.40
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $36.40
Total Paid: $36.40 Due: $0.00
Fee Type: ERPU Description: [ERPLN] Ersn Plck USA Total Fee: $36.40
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $36.40
Total Paid: $36.40 Due: $0.00
Fee Type: M5PC Description: [TAX] MEC 8% St Tax Total Fee: $7.84
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $7.84
Total Paid: $7.84 Due: $0.00
Fee Type: MPRT Description: [MECH] MEC Permit Total Fee: $94.25
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $94.25
Total Paid: $94.25 Due: $0.00
Fee Type: P5PC Description: [TAX] PLM 8% St Tax Total Fee: $46.20
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $46.20
Total Paid: $46.20 Due: $0.00
Fee Type: PARK Description: [PKSDC] SF Parks SDC Total Fee: $1,050.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $1,050.00
Total Paid: $1,050.00 Due: $0.00
Fee Type: PPRT Description: [PLUMB] PLM Permit Total Fee: $577.50
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $577.50
Total Paid: $577.50 Due: $0.00
Fee Type: TIFM Description: [TIF -MT] TIF Mass Tr Total Fee: $150.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $150.00
Total Paid: $150.00 Due: $0.00
Fee Type: TIFR Description: [TIF -R] TIF Resident Total Fee: $1,860.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $1,860.00
Total Paid: $1,860.00 Due: $0.00
Fee Type: WQAT Description: [WQUANT] Water Quant Total Fee: $290.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $290.00
Total Paid: $290.00 Due: $0.00
Page 2 of 3
05/03/2000 PAYMENT HISTORY FOR CASE
1'0:52`09 AM MST2000 -00078
Fee Type: WQUL Description: [WQUAL] Water Quality Total Fee: $210.00
Date Paid Receipt# Check# Recorded By Amount Paid
04/13/2000 0001412 KJP $210.00
Total Paid: $210.00 Due: $0.00
Totals for MST2000- 00078:
Fees: $7,745.74 Paid: $7,745.74 Due: $0.00
Page 3 of 3