Permit CITY TIGARD SITE WORK PERMIT
o , DEVELOPMENT SERVICES PERMIT # : SIT2000 -00011
+L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 04/13/2000
SITE ADDRESS: 14176 SW 128TH PL PARCEL : 2S109AA -ER016
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING : R -7
BLOCK: LOT: 016 JURISDICTION : TIG
CLASS OF WORK: NEW PAVING ?: RESO. NO:
TYPE OF USE: SF GRADING ?: Y VALUE: $5,000.00
EXCV VOLUME: 100 cy LANDSCAPING ?:
FILL VOLUME: 200 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: IMPERV SURFACE: sf
Remarks: Grading for SFD- Note Special Inspections Required -
Owner:
FEES
MASTERPIECE CONSTRUCTION INC
15435 SW ASHLEY DRIVE Type By Date Amount Receipt
TIGARD, OR 97223 PRMT KJP 04/13/2000 $77.75 0001413
PLCK KJP 04/13/2000 $50.54 0001413
5PCT KJP 04/13/2000 $6.22 0001413
Phone: 503 - 267 -6730 EROS KJP 04/13/2000 $80.00 0001413
Contractor: ERPU KJP 04/13/2000 $26.00 0001413
MASTERPIECE CONSTRUCTION INC ERPC KJP 04/13/2000 $26.00 0001413
15435 SW ASHLEY DR Total $266.51
TIGARD, OR 97224
Phone: 524 -4371
Reg #: LIC 00069010
Required Inspections
Erosion Control Insp 844 -8444
Excavation Insp
Fill Inspection
Grading Insp
Strm Drain Insp
Misc. Inspection
Engineered grading final reprt
Final Inspection
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and 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 work is suspended for more than 180 days. 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.
Permittee Signature: y
Issued By: i(
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
i, 1-',A , • -
CITY OF TIGARD -t .5` Site Permit Application Plan Check# 3 -231
13125 SW HALL BLVD. 6 D ID , 111 ' . Commercial, Residential Recd By Gr
TIGARD, OR 97223 and Multi-Family Date Recd 3 - /3 - �
y Date to P.E.
(503) 6394171 x304 Date to DST 4 1 t lin 4
Permit #S /T. -060 //
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted Called
roject Name Utilities (Complete all that apply)
Job LtT Its 6S(ON
Address Address f Storm Sewer
iL/ri L. S It/ !2S �Iq/ kA 30 Linear Ft.
Na / Sanitary Sewer , J
fit 4-S T Clef i a cc CO —c T. 1 w c / Linear Ft.
Owner Mailing Address 1 Fresh Water �.
/ SL' �-s k I Q y d `t.- .23 Linear Ft.
City , Zip Phone 5 / Catch Basins
T g 7Z-IV 2 v7--t #
General Nam ,,, Clean Outs
i
Contractor � ST € (L P( e ce C O w- .1 1‘ t r C #
Prior to permit Mailing Address Describe work to be done:
issuance, a c ' - / NewO Addition❑ AlterationD Repair
copy of all / 5%1 3 4 U �- C_! 4 S L 1 t 1 ❑
licenses are City/State Zip Phone 1 e7- 0.3 0 Additional Description of Work:
required if -t- ( p 1 /.. /24) ai "?.- 5•2y- -
expired in COT State Const. Cont. Board Lic. # Exp. Date
database j � I G o t 0 / _ L/ - o (
Name \ f p t R K .S T C w /9- k7r Valuation $ L j 0 0 (S t 1 c: ' a Lk)
Architect Mailing Address Plans Required: See Matrix on back page
1 R 4 1 h g' ltl ] k l7 lit/ e The following, must accompany this application:
City/Sta a Zip Phone Site plan with Vicinity Map Parking (including
134fl6-1t14eTv., ' o t a 51- 9 i `f Q Showing ADA compliance ADA) & Lighting Plan
Name Grading Plan and details Landscaping Plan
7'1. FS D, r/nbRi
Engineer Mailing Address I Erosion Control Plan and Retaining Structures
�� 7 00 S L U e'en.. / Oi --C`S rgy, .- details including calculations
City/State Zip Phone 5'j - 2P-p/5 Site Utility Plan and details Soils Report
T I t � o/L l �! 5. ZLf Syt 7 ^C (showing pp to
a (if required)
roved system)
Excavation Volume I hereby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized
l 0 cu. yds. agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Grading Volume Signature of 0 ner /Agent Date
(Soils report required for >5,000 cu. Yds,) / O (; 01 3 Z((- 0 0
cu. cu yds. w
Fill Volume Contact Person Name Phone
(Fill exceeding 12" in depth shall be compacted tc\, < . ^ w f — V R. 7 k �- 61 3 a
To 90% of Maximum Density) 2,p 1 2�{.�(31
cu. yds.
Retaining structure? (check one) 'ock FOR OFFICE USE ONLY
❑ CMU Notes:
❑Concrete
['Other
Total new impervious area including all Land Use Case # Map/TL#
buildings, sidewalks, and paving col 0 0 0 Sq. Ft.
i :\dsts \forms\site- app.doc 3/17/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
0
2441ourinspection Line: 639 -4175 Business Line: 639 -4171 141
UP
_ Date Requested V7- 1 AM PM BLD
Location l ? 7- \ Z � Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: SI �� " �6 1
Slab
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear \� ``�V v�'S
Framing �c.-1
Insulation v �
Drywall Nailing S •
Firewall `
Fire Sprinkler v l� °v .
Fire Alarm
Susp'd Ceiling
Roof `
Misc:
Final 'NA � -4_.�Q T \--2-Q �, r ., t 3C-7) K� el. ... �_
PASS PART FAIL �
PLUMBING it /Lei cor \/ \ / r l 'P v-N
Post
r Slab Beam
_U
Under l
Top Out 1
Water Service ' 5 ��. ` � Q
Sanitary Sewer
Rain P -
R n Drains \r271+ ` � . \ , �A--,.
Final 1
PASS PART FAIL S W ■ .\--►•N 1/4 e_S N c...k k....:&'v•-__S
MECHANICAL.
Post & Beam Uf `
Rough In ‘ ) R � S
Gas Line
Smoke Dampers
Final • •
PASS PART FAIL h� l . - e ' A � � �v.--
ELECTRICAL
Service LA-- ,■/ a_ do e-- (.p -, Q a
Rough In
UG /Slab _
Low Voltage 1
Fire Alarm
Final
P ASS PART FAIL NIC127
Backfill /Grading
Sanitary Sewer
Storm Storm Drain !Y 1 /4 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ I Please call for reinspection RE: [ ] Unable to inspect - no access
ADA C1
A roac /Side Ik / �
Date IA-0 d \ Inspector Ext
Final
c f5 PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 4 - / : ' AM PM BLD
Location 1p 6L Z " Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing ..: ■t+ �'.�` ��,� . ,. f• f•,-4;2,; ,�,_ ...�t.. o
Foundation ...t� ` ,�, .�c+ ►�yY � � r ' �' o :� '. �, -1 ':1;� FP S
Ftg Drain ���E;�:'.`s'�? ,•, .�1 TL. '._
Crawl Drain Inspection Notes: SGN
Slab C L/` �--. — • SIT f7/0 V ' Q Q 0 /
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear - , • 1 t
Framing "IA --Q 4 A l/v
Insulation J J Y ?
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS 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 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By I 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 EL R - Restricted Energy Permit
Roof nailing I Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Inspection Description Date Passed By
Drywall nailing 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
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
‘-st,t—•c
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS
• CITY OF TIGARD SITE WORK PERMIT i I DEVELOPMENT SERVICES PERMIT # : SIT2000-00011
"L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 4/13/00
SITE ADDRESS: 14176 SW 128TH PL PARCEL : 2S109AA-05000
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING : R -7
BLOCK: LOT: 016 JURISDICTION : TIG
CLASS OF WORK: NEW PAVING ?: RESO. NO:
TYPE OF USE: SF GRADING ?: Y VALUE: $5,000.00
EXCV VOLUME: 100 cy LANDSCAPING ?:
FILL VOLUME: 200 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: IMPERV SURFACE: sf
Remarks: Grading for SFD- Note Special Inspections Required -
Owner:
FEES
MASTERPIECE CONSTRUCTION INC
15435 SW ASHLEY DRIVE Type By Date Amount Receipt
TIGARD, OR 97223 PRMT KJP 4/13/00 $77.75 0001413
PLCK KJP 4/13/00 $50.54 0001413
Phone: 503-267-6730 5PCT KJP 4/13/00 $6.22 0001413
EROS KJP 4/13/00 $80.00 0001413
Contractor: ERPU KJP 4/13/00 $26.00 0001413
MASTERPIECE CONSTRUCTION INC ERPC KJP 4/13/00 $26.00 0001413
15435 SW ASHLEY DR Total $266.51
TIGARD, OR 97224
Phone: 524 -4371
Reg #: LIC 00069010
Required Inspections
Erosion Control Insp 844 -8444
Excavation Insp
Fill Inspection
Grading lnsp
Strm Drain lnsp
Misc. Inspection
Engineered grading final reprt
Final Inspection
M
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and 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 work is suspended for more than 180 days. 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.
Permittee Signature:
Issued By:
Call (503) 639 -4175 by 7:00 for i
( ► y 00 P.M. fo an inspection needed the next business day
8/22/00 Activities for Case #: SIT2000 -00011
12:52:07 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SITA005 Application received 3/13/00 GEO RECD No Hold GEO 4/10/00
SITA008 Permit Created 4/10/00 GEO DONE No Hold GEO 4/10/00 ii
SITA010 Check for prcl. restrict. 4/10/00 GEO DONE No Hold GEO 4/10/00
SITA012 Plans Routed to Plans Examiner 4/10/99 GEO SENT No Hold GEO 4/10/00 '
SITA026 Plans approved by CPE 4/10/00 4/10/00 4/10/00 RDP DONE No Hold RDP 4/10/00
SITA030 Reviewed plans routed to DSTS 4/10/00 RDP DONE No Hold RDP 4/10/00
SITA700 Erosion Control Insp 844 -8444 No Hold RDP 4/10/00
SITA705 Excavation Insp NOTE No Hold RDP 4/10/00 Special Inspection
SITA710 Fill Inspection NOTE No Hold RDP 4/10/00 Special Inspection
SITA720 Grading Insp NOTE No Hold RDP 4/10/00 Special Inspection
SITA740 Strm Drain Insp No Hold RDP 4/10/00
SITA770 Misc. Inspection NOTE No Hold RDP 4/10/00 Keystone Walls - Special
Inspection
SITA775 Engineered grading final reprt No Hold RDP 4/10/00
SITA799 Final Inspection No Hold RDP 4/10/00
SITA032 DST Post - Review Completed 4/13/00 BON DONE No Hold BON 4/13/00
SITA070 (F) Ready to issue 4/13/00 BON DONE No Hold BON 4/13/00
SITA092 (F) Issue permit 4/13/00 KJP DONE No Hold KJP 4/13/00
SITA093 (F) Reprint Permit 8/15/00 ZZZ DONE No Hold ZZZ 8/15/00
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