Permit - - CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2005 -00328
111 DEVELOPMENT SERVICES DATE ISSUED: 9/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S115BD -00100
SITE ADDRESS: 11782 SW ROYAL VILLA DR ZONING: R - 12
SUBDIVISION: LOT: JURISDICTION: I.JRB
Project Description: Placement of new SFM.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SFM FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: THR13. sf RIGHT:
VALUE: 0.00
OCCUPANCY GRP: BDRM: BATH: TOTAL: 0 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W/SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: .
EA ADD'L 500SF: 201 - 400 amp: 201. 400 amp: 1st W/O SVCIFDR: 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 +ampe- 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:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
CAL AM PROPERTIES PRO HOMES INC and all other applicable laws. All work will be done in
12450 SW FISCHER RD #300 PO BOX 322 accordance with approved plans. This permit will expire
TIGARD, OR 97224 DONALD, OR 97020 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: 503 - 968 1280 Phone: 503 730 - 8220 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 103057 direct questions to OUNC by calling 503 -246 -6699 or
TOTAL FEES: $ 327.54 1- 800 - 332 -2344.
REQUIRED ITEMS AND REPORTS
Issued By : P Signature : . a I. �Jt / � _ . v
Call 503 - 6394175 by 7:00 a.m. for an inspection thab Mess day.
This permit card shall be kept in a conspicuous place on the job site . til completion of the project.
Approved plans are required on the job site at the time of each inspection.
ti •
Manufactured Dwelling
Placement Permit Applir E V . FOR OFFICE USE ONLY
City of Tigard r.
Daway _bz Pertnit 0.3.Z
13125 SW Hall Blvd., Tigard, OR 97223 0 ; ► Plan Review Other Permit: J
SEP 0 , , .,,; I ri, Date/By: /
Phone: 503.639.4171 Fax: 503.598.1960 ✓' e :Ail A V �{ - 19 S o
Inspection Line: 503.639.4175 Date Ready/By: w mss: " See Plan Submittal
Internet: www.ci.tigard.or.us CITY OF T .` - Notified/Method: ` 4 - lk_, ' � : • ulrementa
JOB SITE INFORMATION OWNER INFORMATION
}
Site Address: I 1 s ROyal Vl 1 1Q DY Name: a I ft m 1-bne 5 n
Park Name: Ravi; Villa Address: SW p s c4fQr i c� 47 ' 3oo -
Subdivision & '6t
Directions to inspection site: -04.4 v., 1.2.E -1 mud,. V2oA(oti City: - rjg I State: o I ZIP:CI 1 2 z r
'Turn kukie tin twee ' 1 . Lei- v+ Q.1.511+
o Phone: Fax:
503 q fog (280 I Fax 503 9 !oB I ZI S r
Is property inside city limits? !$ Yes ❑ No E -mail:
• V Ni 'N" _ " IV LS
Zoning Sanitation r
Signature: Signature:
Jurisdiction: - Jurisdiction:
Date: Date:
Cost (each) No. of Sum
(1) Installation/re-Inspection Items
(a) Placement (includes placement, electrical feeder, 30' of water /sewer connection) $ 275.50 $
(b) State surcharge at 8% $ 22.04 $
(b) Re- inspection (includes inspection and 8% state surcharge) $ 62.50 $
Placement permit to be obtained only by homeowner, or Oregon - licensed manufactured dwelling installer.
(2) Electrical
(a) Service and/or feeder (new service installation or alteration/relocation of existing service). $ See Electrical Permit Application
Electrical service permit to be obtained only by homeowner performing work or signing supervisor of Oregon - licensed electrical contractor
performing work.
(3) Plumbing 4
(a) New water service (for services over 30 lineal feet). $ See Plumbing Permit Application
(b) New sanitation/storm sewer or rain drain (for services over 30 lineal feet) $ See Plumbing Permit Application
Plumbing permit to be obtained only by homeowner performing work or Oregon- licensed plumbing contractor performing work.
(4) Miscellaneous fees
(a) Administrative fee. $ 30.00 $
(b) System development fees (sewer connection, storm water, parks development & traffic impact). $ See Permit & System Development Fees
SUB - TOTAL $
SET - UP OR INSTALLATION CONTRACTOR APPLICANT
Name: f f C . Name: u l Ptm \3
Address: b 32 2 Address: 12.45 � C, 1 �� I i s ' l .Qr d ,�
City: -Donald I State:/' /q I ZIP: -! 1020 City: � x C] State Z IP:g1lzo
Phone: zzo Faxb03 ID z i Phone5 963 I no I Fax: Eirii �7g I Zl7
503 130 R 7S eJ J
CCB No.: l 3 , 5 MDI No.: I E -Mail:
SKIR'T'ING CONTRACTOR
Name: I hereby certify that the information above is true and correct.
P ro ��Q 5 All work to be performed shall be in accordance with all
Address: - Po in x 32 2 //�� /] g' erning laws and rules. (fir
City: Yonal Ci I State:0 I ZIP: a 1n20 & _I ..L 1 1 . I -! IQ'ol '
Phone: 563 73n $2W I Fax: 503 675; 2 4 17 • thorized Signatur Date
CCB No.: I 01"a. I MDI /LSl No.: 1 'riot Name: 0 Ira (,00,A11/
I:\ Building \Permits`SFM- PermitApp.doc 1/04
CITY OF TIGARD , .
BUILDING DIVISION ' l PERMIT #: MST2005.00320
13125 SW Hall Blvd., Tigard, OR 97223 ; DATE ISSUED: 9121/200`5
Phone: (503) 639 -4171 -
Inspection Requests (24 Hrs.): (503) 639 -4175 s_ "
INSPECTION WORKSHEET FOR DATE: 10/31/2006 TIME: 7:01AM PAGE: 21
SITE ADDRESS: 11782 SW ROYAL VILLA DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ROYAL VILLA
DESCRIPTION: Placement of new SFM.
OWNER: CAL AM PROPERTIES, PHONE #: 503 - 966 -1280
CONTRACTOR: PRO HOMES INC PHONE #: 503.730 -8220
Inspection Request Scheduled For: Date: 10/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # M sage (.
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Corrections /Comments /Instructions: m 4A.yeAv ae_g&q-k
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PASS ❑ PARTIAL APPROVAL MI CANCEL V ❑ NO ACCESS
X FAIL ❑ CALL FOR INSPECTION IF, i ADDITIONAL FEES ASSESSED
Inspector: VtA (1t1( Date: / 6 /3 6 ( Phone #: (503) 718 - Z l Z 1
CITY OF TIGARD '410
BUILDING DIVISION PERMIT #: MST200S -00328
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2005
Phone: (503) 639 -4171 65.__-.
Inspection Requests (24 Hrs.): (503) 639 -4175 1 L.
INSPECTION WORKSHEET FOR DATE: 7/27/2006 TIME: 7:03AM PAGE: 106
SITE ADDRESS: 11782 SW ROYAL VILLA DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ROYAL VILLA
DESCRIPTION: Placement of new SFM.
OWNER: CAL AM PROPERTIES, PHONE #: 503 - 968.1280
CONTRACTOR: PRO HOMES INC PHONE #: 503 - 730 - 822()
Inspection Request Scheduled For: Date: 7127/2Q06 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comm
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Inspector: L /�� ✓ Date: 2) 7 6 �,y Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 003 `3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 912..1/2006,
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 ..! -_ IL.
INSPECTION WORKSHEET FOR DATE: 5117/2006 TIME: 7:06AM PAGE: 61
SITE ADDRESS: 11782 SW ROYAL VILLA DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ROYAL VILLA
DESCRIPTION: Placement of new SFM.
OWNER: CAL AM PROPERTIES, PHONE #: 503-960-1280
CONTRACTOR: PRO HOMES INC PHONE #: 503-7308220
Inspection Request Scheduled For: Date: 5/17 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
810 MFG - Structure sot -up 029999 -01 503-816.9143 N
Corrections /Comments /Instructions:
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V" PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑
FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: 5=/ 7 -a6 Phone #: (503) 718- 'L44 -c-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST200.;.0O326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ill). i /200:,
Phone: (503) 639-4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 s_' I I..
INSPECTION WORKSHEET FOR DATE: 4/12/2006 TIME: 7:04AM PAGE: 63
SITE ADDRESS: 11782 SW ROYAL VII. LA DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ROYAL VILLA
DESCRIPTION: Placement of new SFM.
OWNER: CAL AM PROPERTIES, PHONE #: 503968 1280
CONTRACTOR: PRO HOMES INC PHONE #: 5C)3730432J0
Inspection Request Scheduled For: Date: 4/12/2006 Pour Time: 0:00
Code # Inspection Description Confirm # Contact # Message
806 MFG Structwe grading/footing 027834 - 01 603 Y
Corrections/Comments/Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ¢ —/ Phone #: (503) 718-