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Permit a A CITY OF TI MASTER PERMIT PERMIT #: MST2005 -00119 I- 1 11 DEVELOPMENT SERVICES DATE ISSUED: 5/12/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CD 12700 SITE ADDRESS: 07704 SW CYPRESS LN ZONING: R - 12 SUBDIVISION: HAMBACH GROVE LOT: 025 JURISDICTION: TIG Project Description: New SF. BUILDING REISSUE: STEINBECK STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 724 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 1,000 sf GARAGE: 445 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: VALUE: 171, 356.10 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,724 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 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 FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL /PANEL: 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: ALL - ENCOMP BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes LEGEND HOMES LEGEND HOMES CORP and all other applicable laws. All work will be done in 12755 SW 69TH 12755 SW 69TH AVE #100 accordance with approved plans. This permit will expire SUITE 100 TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the PORTLAND, OR 97223 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 620 - 8080 Phone: 620 - 8080 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or Reg #: LIC 60563 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 8,914.64 1 -800- 332 -2344. . REQUIRED ITEMS AND REPORTS N. Issued By : Permittee Signature : k,, ' -L i 4 Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. , • Building Permit Application . . . • .. ;, • 9,FOR 0FFICE USEQNLY City of Tigard ����(��� D�1eB �` ' 13125 SW Hall Blvd., Ti Phone: 503.639.4171 Fax: 503.598.1960 ` PermitNo.:�C 7 (�1/9 Tigard, O 7E3 v - ~'= : ✓y G _ � _ " '"�'� � a g d (� � ` ° Plan Review y s '6' Date/By: .5 -,2 _o 5- Other Per mit: 6J o .�I y: MRv .S(a�o?0 " MIDI J 1 Inspection Line: 503.639.4175 �1 ¢ Date Read /B _ Jana: H See Attached Checklist for Internet: www.ci.tigard.or.us APR 0 200 W Notified /Method:4g � u' � — 1 — ) ( r Supplemental Information 5 0 0)C - 4-.`�;\ V� ,_.. , ".- 5 ,�.. D "t'.. D :2- . AlL1Cli ., � x[ ;�_- , �.- .tai y f .,.. . .� ,. ,....�. _ . Win i,x. .- &:iintr JittYN rt >ur, -.. uu,rt,,,, , ai . .. . ... _ � ' ® New construction ❑ Demolition Permit fees* are based on the value of the work performed. . — Indicate the value (rounded to the nearest dollar) of all MI Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the _ ' 1W ° <yr work indicated on this application- : C T Gil " U S „ C' ,. ll, ; " €is.;: Valuation: $170,111.10 ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: 3 , T ,,., ' > ,,:..,.;., . __ . ,,, , � ;i. , ,., ,,....... .,: JOB � .., ,,,.F(? � 'PION liO�ATIQN , 'T�... Total number of floors: 2 AND: Job site address: 7704 SW Cypress Lane New dwelling area: 1724 square feet City /State /ZIP: Tigard, OR 97224 Garage /carport area: 445 square feet Suite/bldg. /apt. no.: Project name: Hambach Grove Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet R EQU-I R ,EIi 1 iATA.. C' OiVI * IICIAL 1jSF GiiE YKI i ` r , Subdivision: Hambach Grove Lot no.: 025 Permit fees* are based on the value of the work performed. , Tax map/parcel no.: Indicate the value (rounded to the nearest dollar) of all -. map parce equipment, materials, labor, overhead, and the profit for the "IS A,* �':i ;% / I :. °4r= , •;i work indicated on this �•:?,�` � ;:,Y ;� „ :�,r: ,p GRII'TION:OF - WO' .,,r =:.: ;:,•�•' -�' application. Valuation: $ Existing building area: square feet New building area: square feet I10,+�1i NER-', + � �. �3 .. Number of stories: . T.ENp� - . ' "a Name: Legend Homes Type of construction: Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups: City /State /ZIP: Portland, OR 97223 Existing: Phone: (503)620 -8080 Fax: (503)598 -8900 New: t. k ,.,, ,�._ ARPLICAN'T.._...., ;... .._.. ;., ..., ..... : ": %C�.SOI�I CT ;,: PERSON .' _.._ _ Wiz, A , . - Y .. < . o�.. s. ,.. ... ..m . . Business name: Legend Homes All contractors and subcontractors are required to be Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 12755 SW 69 Avenue jurisdiction in which work is being performed. If the City /State /ZIP: Portland, OR 97223 apply: ppicant is exempt from licensing, the following reasons ,. ,,..Phone: (503) 620 -8080 Fax: : (503) 598 -8900 E -mail: slucas @legendhomes.com Y ';i \ ; > ON r ;: T..;... : y °: Business name: Legend Homes - ..,, ° ° °.r ,AA a z BLII D(NG - P , _: ,. , .. k sity, ".: 4 : \ g > " - ' Address: 12755 SW 69 Avenue, Suite #100 Please refer to fee schedule. City /State /ZIP: Portland, OR 97223 Fees due upon application Phone: (503) 620 -8080 Fax: (503) 598 -8900 Amount received CCB lie.: 060563 Date received: I Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted us complete. I Print name: Steve Lucas Date: 3/31/05 * Fee methodology set by Tri -County Building Industry Service Board. i \ Building \ Permits \BUP- PermitApp doe 12/03 440- 4613T(11/02/COM /WEB) 01/16/2003 00:15 6427925 • PAGE 01 �. DEC -01 -2004 WED 0430 PM Legeen � d�• i Hoomee FAX NO 5035988900 P. 02 ni= \1i1�D 1oR4,1lit: 11i >i i 1N ;.i 1 '. 1 Electrical Per'a>► ollcatiOn LLL��� . , ( , City of Tigard r r : P em004 , ,roZO 5 )I 9 13135 SW Hall 81vd„ 71Cerd, OR 97233 ?R 0 Li, Sa o , ' Odor Ninon Phone: 303,6394171 Prue: 503,5 ' �� e' °, `' 'II1 `':i` ai� 11 � lttad/ayt "" raaa itb bnspeot:sit Lino 101.520.41” i No t i bd/b iav Seppteleeawl fo ro►msd_ - ,_ tntornaa wrrwat,ligard,orua CITY OF TIGP+RD ,, � .. ,� r ��:� � .� , a� m ,� t + y't 'I I ( i it k,�'+� d l �'�r' hS it " E �i +�; ' �+ r : !r� l :. ,4144'..,',1;11, � + t J i 'I , ', 1 � : i0 1 1�1 p {' �� ,,,Ne , 1t t l��.nki ti :'J' l�. ( J ih i h'� ( 7�1 � it "i'i 5!�rl� tale .� .. _1�:: i , , _e f,�;F�����y�i� �.� �,ie , +.sr ,, ,1f I.tu1.Lc, �" � � "' t r � � � i h ,! Place check all • npplY Nt ow fouet{on Addfllan/aitaret S�" ever ia 130 etunm'1 Cl Neasrdo iouheplocurnont © Imps, w I000Nor, Ir Delos& ition ® Other ❑ env a aver amps -ire $ 44fWI g 0 ao 14n6 evnt 1 mw 0,040.q • ft., 1 n1 R� ti 1r '�.� 1 a ∎ o rl Vile , nS .?tija i �, f n}f clr1 } tlfr 1 +i"Mtl 2 I 4aidaetial is [, �" �!! b���1�, �: �;+ 1( r' 6" 1,, ���I: I�; ��i���, �y ���� „,P��.,�,I��Y,,, + +��i� ",, � + ������"���P ^ � ���r, r►y :�_.:�•'i a� ,•�+ try 4w011 building drawn ov 600 v4l1s nominal units In ono Maslen 1.11nd fattlilydu+allinS i CeeltnMfoiai/indt�tM81 1R• Accessory >i Sodding over dose dodos MItardere. 40 Qompb o r mare ❑Multt•tbmil ■ Master builder ■ Other ❑ occupant Ioad over 99palson. Monutboaredsn f i h, t t, , n 1v Y. ¢e - " , i i+ ^� a , l O RV perk Iii KI Ilurl'Vi� r . ' , a�!,� : r .'11n7 r `ftl r atttx ! ��i to Sarstilishung plan s:, . Oka 1 h-care inelliry 0Octter•• . Job no.: Yob site address: - 4104 - • S - GYl?R Lo .a submit j, sets er plans w SAY 07 — The Iowa. The above are not applicable tot oonrwuOIloe service. C {ty /Shsta/ZIP: Tigard, OR 91224 �' ir' �, �!° i� !h�l��;;i�l�illii��„�: "br'aa �, "'�1. ' 6111 9ttite►►bldg•/ to.: '40001 morns t3tttmbaelt C�aovc pumpd9r Croat etre t dlrect(one to job alto: New reddo ■dal aerate -or mWU -remi • waning OWL Isdu4ol enathe4 a►r16G 1,0D0 s0,1t• oe less 143.15 1 -� ga add`1500 sq, f! or portion 5141 8ubdlvieian: Satabttsh fatovc Loc no.; pZ$ 7S,�a Q Limitrd an � „ , resldantial Q Llmltad'ener:r , non- teddeonal 75.00 �p t rt �, , , 6 r rr g ' i ' 'CI ti r l ' i . ! l ""141 not a �n �r c ular e ��E��iillS�t �' + I' 8' iii{1�i i�.iilwda :n�,F +�,ll'�d' °l �j�;,iw.. �'ii Cll�l �iva�,{�I��..0 li�,�,i'U!�'1��� EW11i s 0.t1Y�eet dr t�d 9 .00 •v: iin� ee ndFarfiedor • Si:tykes or Deader! Inetaf4tlsn, altarntwn ondior reloasdon 100 • , i or Iles 50.30 � tth 1 t 1 1 p� 11 w i 1" l sr I( + i ( I d l u"'ti a• 1 ,rn r , ; . ZOt 1 1k' '^7`11P - rt„ f � • U 1, =-4 A:L +l...1is7 ; '' ^ J6 �:� �1�,' ... i i� ' , .1 Le'J. •.., i . � 4 4 ' . S3 j C , ( t+,+ , .. iu d> ..tN u..iJ Pill w ,. * Jci.w. u1_i 401 ,.wle 60DamD1 _ 10160 EI 601 a • a to 1,000 name 240.60 - Over 1.000 �• or volts � 454.65 _)� Address: 12755 SW 69'” Avenue, Suite 0100 Reconnect only , 66 .65 2 City/SW/ZIP: Pordamd, OR 97313 Temporary owlets or fullers Inatniti ion, alteration. andror rdotatloo Phone: (803)6144OM Pas: (503)5984900 200 antra or tote 66 Owner Taste i OR This iiratalletlon is being moue on Property thpe 1 own which Is not 20140,01 to gibing • II 100.30 MIMI intended for sale, lease, tent; or =banger aoaording to ORS 447, 449, 670, and 70 I, 401 mull 10 600 amps 133.79 j • 2 A. Rea for branch TON re Dom, l�xooh dreults - saw . alter den, or extmmt' . 'r Owner atgnaturo T t q , c "' h4 v ' n , i "r ' c ,, t i r d ". FF. WI , s� �r' .�tt4',e � �'�'.`'�.. ' t ' , ,r ,� e:d + 9 „�: ,1�:.:�- '._ . _ k� °Jt ?.�,.� t 1., ,t:ii acrviea or iSeaela he, doh banters e a Rte for branch .a rfrc iiill cents:04 t1MM Stn• 1.90118 wGNiaru'antics e feeder ilia. 2 i branch circuit Addrves:12105 SW 69x Avenue, bite 91041 hash add'1 broach circuit 641 lEll CleyiSrata/ZVP: ParpMnd, OR 97223 MIscdtaaseue (sarrlee or fosdw' set tneiadvd) Pulrq or !Mention circa _ 53.40 Phone: (S33)6104480 Fax: t (503) 69i1-8900 Sign or outline ligxun� 53 II e- n14111 alucnassia1endhamealoms Signal olrcuit(s) or limited { ilanLli Ei lllilitMl i,Fyfint11(i li g.A .4:4 1,M'Nll 14ai!;l tini1 IC N' i"'IN it I' {t g � ee t r emotion, or hoe .. .. 1 a Business mental Garner Eledrle Mack additional Iaspoetiva over al ble In a of the above Address: 2930 SW =17 Avenue* A leer inspection III 62.50 I . City/State/7.0c 1i11111bore, OR 97123 Invesdgedott per tour p Or mire Induatrial•lant•arhour 111 62.30 T3.73 Phone: (503 591.1320 ( I , c f 1 ,, (. ,. • cy”, i" , n, G r ri 1 our 1" .l h)s "i�k US� ii�L�!f1�D�il4l�l CCB Llc.: 111189 +-mi , Lao., 37074 aubtotel MOM Supra. E1ectridan signature, required: �� // Man review (?5 permit tea) • igmw `' / "'� Sin Plan te'rs, of permit fvay _ ► le .^16 Print name: iiia� - ro At. rumtrr mu 2Z8 1 ( Authorized signature; Tali porn* tppeartlm aapirtO It a >W: oatmeal WIWM ago cm Arkr a hut two e'attad n non e% Dowd a Faoi ediodeledyIetbyTri .CaalIYaulidlfa �y .. NNeiba 9 / a aid par pamtit snowed. moubuedrenolan0•0•PetweiAtode MCI 4404611TRAWrl MiliS Mechanical Permit A l ation j / fp® _ j .. < �Foicc F icEtus E ON. ,,.� -- . • - City of Tigard pp��jj nn w Received Permit No �pY\ 0 4 ° Date/By: /(}S' ad J I a 13125 SW Hall Blvd., Tigard, OR 97223 G OO D Plan Review Phone: 503.639.4171 Fax: 503.598.1960 G J 1 ' DateBy:• Other Permit: Inspection Line: 503.639.4175 C ITY it' i I I - ' _ Date Ready /By: Juris: ® See Page 2 for ' Internet: www.ci.tigard.or.us OF TI GARD . ' - -- Notified/Method: Supplemental Information BUILDING DIVISION ,,.i . r `iYi�r$�kr� ?av` °� * Nu . Tull S HE - HECKLIST `; , `TYI' � O i ' ME CIA C tiE�. I1� C ® New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. - ..,, Value: $ aCATE.G012 OF,: ,COi,-ST iI t ',� • �. c- '� �i', - � ti �; ,. ... ,. -,.. .. �.. �,:7: >.:z.s., «. �s . > RE 1A <' f AL EQU ME SYSTI M �F : ' ` ` ` ' ° ' a " " ° ' " '` "" " ° "` "" ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building i For special information use checklist. i, ❑,Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total Tt3B„SITE :IlYRUR "A IQNN'.<ANIi; ,� t7C „ ; r t, *' „ ',- ; ° Heating/cooling ;`Job site address: 7704 SW Cypress Lane Air conditioning or heat pump yp (requires site plan showing placement) 14.00 .City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: . • Project name: Hambach Grove Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) • 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Hambach Grove Lot no.: 025 Flue /vent for any of above 10.00 _. - Other: 10.00 Tax map /parcel no.: Other fuel appliances %;' °: _ ax=,r:::�z Water heater 10.00 DESCRl 1'T10N °irk:,; , ' ” Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 • • Log lighter (gas) 10.00 I rF.r:; ,a Wood /pellet stove 10.00 . 1' - :t Wood fireplace /insert 10.00 ,- ,,,,,!,:: ° � i ,i-.:;•,; ;.. , . Chimney /liner /flue /vent 10.00 PR OPER'TX .OW ° r : < ` ' a ' "'` "I;EN'A Ajee k,,.: :: • :,' � , ��,.. . -,_.- , .... ,, a'� �,,,,.,..�.u w: �� :.. s, Other: 10.00 Name: Legend Homes Environmental exhaust and ventilation Address: 12755 SW 69 Avenue Range hood /other kitchen equipment 10.00 City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (503)620 - 8080 Fax: (503)598 - 8900 toilet compartments, utility rooms) 6.80 ;.,, � ; m° ``,,` % \,;: x ` � ,W" i Attic /crawlspace fans 10.00 .,. - �/ ? _ f . ; ICAAT ;.; {J''CONsTAC°T P P� ., , :: .. ...- Oth er: 10.00 Business name: Legend Homes Fuel piping Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional Address: 12755 SW 69 Avenue, Suite #100 Furnace, etc. Gas heat pump City /State /ZIP: Portland, OR 972223 Wall /suspended/unit heater Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 Water heater ,. , Fireplace fE, mail: slucas @legendhomes.com Range ri Barbecue CONIRACTO,. • Business name: Sunglow Clothes dryer (gas) Other: Address: 2428 SE 105th CtAl ni .`� .. .E '7_ ,,; q ' ] YIEGFI;r3;1\1C,►INPGI(tIW1I'1' F �5 : - ' °'` City /State /ZIP: Portland, OR 97216 Subtotal Phone: (503) 253 - 7789 Fax: (503) 253 - 7693 Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: 48131 State surcharge (8% of permit fee) TOTAL PERMIT FEE • Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Steve Lucas Date: 3/31/05 * Fee methodology set by Tri- County Building Industry Service Board i \Building \Permits \MEC- PermitApp doe 12/03 440 -4617T (11 /02 /COM /WE13) .. t� " Plumbing Permit r FOR` O :iUSE. ONLY - ...City of Tigard APL' 0 4 2005 Received :, Pemit 13125 SW Hall Blvd., Tigard, OR 97223 Date /By: 5��j t9l�Jl Plan Review Phone: 503.639.4171 Fax: 503,598.1960 1 / tiWdl � ( Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639, "41'75 u TIGARD `• e� tei .. Date ReadyBy: luri5: See Page 2 for w Internet: ww.ci.tigard.or.us G,'GL!L ING DIVISION Notified/Method: Supplemental Information ,....,,,_..... : -,.:.; s �. ;.�.,,.: ,<. _ „_,.. a��.a,: ,»rtes �`. ,'., ' '.,air„ , .tt' - �.� T. �,a � ^;y OI C ® New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) '�..',`s��';, °� i, � � Ey , •ice'_ �. ' iV . bath 249.20 'CATGO X:'aOF %` ' NSTRUCTI SFR 1 b ® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building El Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder 2 „_. ,,. , .. ,,...: u,.,•... ".: >;.,.: Fire sprinkler ( Q ) g Ot her ��; °;a.., F" s . ft.) Page i SITE`11:TEE'1Ri!?AT�A* Q'N AB•Gp Ai1OPL`.':-= ;- `, :,:,r .... Site utilit Job site address: 7704 SW Cypress Lane Catch basin or area drain 16.60 • ' City/State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60 • ; ,Suite/bldg. /apt. no.: Project name: Hambach Grove Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 ' Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Hambach Grove Lot no.: 025 Water service (no. linear ft.: ) Page'2 ' Fixture or item Tax map /parcel no.: Absorption valve „ ..v.... ''DE CR'IPTI;()N OF•r ,. a .: i':'?5 ” " � �\ �� _ ,,. „��.. Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 *Drinking a: '• s • Drinking fountain 16,60 ® PROP rtMt ; > , s "s ``' isiIi\`T.� a�hiaiv: ;, .. .... , .. <.ax 4 -J : . ;, „ z . _.. ....�,., u, ,. ,i ' ka ,,', Ejectors /sump 16.60 Name: Legend Homes Expansion tank 16.60 • Address: 12755 SW 69 Avenue, Suite #100 Fixture /sewer cap 16.60 City /State /ZIP: Portland, OR 97223 Floor drain /floor sink/hub 16.60 Phone: (503)620 - 8080 Fax: (503)598 - 8900 Garbage disposal 16.60 ;- , r �a, ,F.,c� >; 5,,,, Hose bib 16.60 it , 1 1 =A 1CANT• Clal TAFGT3 °'E : - ice maker 16.60 Business name: Legend Homes Interceptor /grease trap 16.60 Contact name: Steve Lucas Medical gas (value: $ ) Page 2 Address: 12755 SW 69 Avenue, Suite #100 Primer 16.60 City /State /ZIP: Portland, OR 97223 Roof drain (commercial) 16.60 Sink /basin/lavatory 16.60 Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 Tub /shower /shower pan 16.60 E - mail: slucas @legendhomes.com Urinal 16.60 A: •_r- s =- CON � � = , aa °. � <' ': - < ° .: " -9- aT �, ,, r. , . � �,: Water closet 16.60 Business name: Wolcott Plumbing Contractors Water heater 16.60 Address: 1075 W. Historic Columbia River Other: City /State /Z1P: Troutdale, OR 97060 Subtotal Minimum permit fee: $72.50 • ' '= Phone: (503) 667 - 1781 Fax: (503) 667 - 9891 Residential backflow minimum permit fee: $36.25 :'CCB Lie.: 23847 Plumbing Lic. no.: 26 - 208PB Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Steve Lucas Date: 3/31/05 This permit application expires if a permit is not obtained within 180 days, after,it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i \Buiiding \Permits \PLM- PermitApp doc 12/03 440-46 I 6T( I 0/02/COM/WEB) ►A.AAAAA A AAAAAAAAAAAAAAAAAA AAAAAAA AAAAAAAAAAAA.....A....A►As.. • 0 4 . 4 4 . CERTIFICATION EE ► TR STREET iQ Al- 014,11 Pki , Owner /Agent f or 1,20yex A 4 P- r t 5 c,....,>3.9-4-5 or 1. I � �r-�1� �� �^ � -I (PERMIT H . (PLEASE PRINT) m • • . « Do hereby, certify thatthe following location . meets ; City of Tigard /Washington County . ■ a land use and development standards for street tree installa tion. o 0. • . . ADDRESS: 7 7Q (5`&1 C yp ss 1-a--/-7,_ - 1y . 0 4 LOT: 5 SUBDIVISION: ha&%' 4 / ` DATE: ��l (� ' �_S 1. . 0 . RECEIVED BY: -4 — :3)-(4 D ATE: C 1) 6.. ®ww®vvv®v®wee ®e ®eese ®e ®® CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00119 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 6 SITE ADDRESS: 07704 SW CYPRESS LN CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 025 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503-620-8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 - 9080 Inspection Request Scheduled For: Date: 10/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 01840407 503 - 849.5247 N Corrections /Comments /Instructions: f ./. 0) te- 6'4 'fk/Witi 6 44—C/ C PASS H PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ( Inspector: Date: Phone #: (503) 718- ! CITY OF TIGARD a BUILDING DIVISION PERMIT #: MST2005-00119 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/12/2005 Phone: (503) 639 -4171 u � � VI iil Inspection Requests (24 Hrs.): (503) 639 -4175 :��� INSPECTION WORKSHEET FOR DATE: 10114/2005 TIME: 7:02AM • PAGE: 7 SITE ADDRESS: 07704 SW CYPRESS LN . CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 025 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503 -620 -8000 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620-8080 Inspection Request Scheduled For: Date: 10/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final ✓ 018404 -06 503-849-5247 N Corrections/Comments/Instructions: 6n1-2/k— pAP 0 Ale- e.earktV M a L / � ! V OY t C � y k ,., e l G' ,a,.., 7,( ' Rp r.40 K PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ °((' - I v Date: Phone #: (503) 718- Y CITY OF TIGARD _ a . BI l:.D}NG DIVISION PERMIT #: MST2005 -00119 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 Phone: (503) 639 -4171 A Nn'lI' f 1 1 1 , . Inspection Requests (24 Hrs.): (503) 639 -4175 „..„._,. ``-_.. INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 74 • SITE ADDRESS: 07704 SW CYPRESS LW CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 025 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503 -620 -8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620-8080 Inspection Request Scheduled For: Date: 10/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 018061 -05 503- 849 -5247 N Corrections /Comments/ Instructions: • PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I i FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- 11 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00119 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2006 Phone: (503) 639- 4171040II Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7 :04AM PAGE: 75 SITE ADDRESS : - 07704 SW CYPRESS LN CLASS OF WORK: • SUBDIVISION: HAMBACH GROVE LOT #: 025 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503-620-8080 CONTRACTOR: LEGEND HOMES CORP PHONE #: 620 -8080 Inspection Request Scheduled For: • Date: 10/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 018061 -04 503- 849 -5247 N Corrections /Comments /Instructions: • PASS I I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: , 6J Phone #: 503 p � ) 718 -