Permit CI TY OF TIGARD MASTER PERMIT
i , � DEVELOPMENT SERVICES d PERMIT #: MST2005 00329
chi
DATE ISSUED: 9/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 -63 -4171 PARCEL: 2S1156D -00100
SITE ADDRESS: 11576 SW ROYAL VILLA DR ZONING: R - 12
SUBDIVISION: LOT: JURISDICTION: URB
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: THRD: sf RIGHT:
VALUE: 0.00
OCCUPANCY GRP: R3 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 FDR: PUMP /IRRIGATION: PER INSPECTION:
EAADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W /OSVC!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: 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 Muniapal 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 3220 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 : / -c) 'i� Permittee Signature /_ J ..;
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that b , • ess 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.
'''Manufactured Dwellin
Placement Permit Applicat� v / ED FOR OFFICE USE ONLY
City of Tigard REU D ` `a — I - Q / V 6 I I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 0 9 2005 .4.7: ^' u 1 > � l '�" DaDate/8 : A V f ' - 0 Other Permit:
Inspection Line: 503.639.4175 SE
r P _ _ Date Ready/By: J ® See Plan Submittal
w
Internet: ww.ci.tigard.or.us Y OF TIGA- = Notified/Method: °_ 0 � oni: Requirements
JOB SITE INFORMATION OWNER INFORMATION
Site Address: I15)5 S • a 0 1 Villa Dr Name: 1t.a I tt m 143m
Park Name: Roma 1 V il(,>l Address: 12.450 &O Ftsc4i r Rd 0-30 t4
Subdivision & L t
Directions to inspection site: lin 12014 I +1.4.1r1 L-4 44 City: TI h a rd Stat O Q ZIP: q1 Z Zo •
Cio -to bacva (54 p .ek. oo n 1.
Phone: r 03 968 1280 I Fax: 3 90? i al 5
Is property inside city limits? jair Yes ❑ No E -mail:
LOCAL GOVERNMENT APPROVALS c)
Zoning Sanitation
Signature: Signature:
Jurisdiction: • Jurisdiction:
Date: Date:
MANUFACTURED DWELLING PLACEMENT PERMIT FEES
Cost (each)
(1) Installation/re - Inspection I eta Sum
(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 .
(a) New water service (for services over 30 lineal feet) $ See Plumbing Permit Application
(h) 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: 1 _ � Name: ct ( Pc /� 3 •
Address: I � A 32 2 d „�
Address: 12 C, C�IU1 5 c k - • - 300
City: ZtW) i d I S I ZIP: q -} City: � I TLJI . � State: ZIP: . zZI r .
Phone: 50 3 130 D �i zo Fax to7g - 1 2. 1 417 V Phone 6b 9 $ ( i no I Fax: Etta l eg 1 215
CCB No.: /03 e 5 • MDI No.: ' • E -Mail:
SKIRTING CONTRACTOR
Name: "Pro � I hereby certify that the information above is true and correct.
�Q 5 All work to be performed shall be in accordance with all
Address: p0 1 E , 1 x 32 /J • , v, ing laws pnd rules.
City: 0 AQ.L(� 1 S ZIP: 4 020 1 i Q' i d 1. { Aio r
Phone: 503 73n $220 Fax: Authorized Signature ' V Date
503 (n7 % 241
CCB No.: 1 03057 I MDI /LSI No.: 1 n2 Print Name: 1 ". I In V d
i:\ Building \Permits\SFM- PermitApp.doc 1/04 ` vG (LI.�J�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: M ST2005.00329
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ,--
INSPECTION WORKSHEET FOR DATE: 1/7412007 TIME: 7 :02AM PAGE: 12
SITE ADDRESS: 11576 SW ROYAL VILLA DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ROYAL VILLA ussw
DESCRIPTION: Placement of . av SFIvi.
OWNER: CAL AM PROPERTIES, PHONE #: 503.065 -1250
CONTRACTOR: PRO HOMES INC PHONE #: 503-730-8220
Inspection Request Scheduled For: Date: 1/2412007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
810 MFG - •S . ructure final 042461 -01 503-816-0143 N
Corrections/Comments/Instructions:
rr .-.2.1/4.1 .7 ;/ c_ • Tv 'Po S -R y 517? 4?
c . - 1.1 . � , AIL. - ' 6 - • a
_to •.-r (t S Liz S � � cr ••J fl4 o -- �Ls
Y
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /1, Date: I— 07 Phone #: (503) 718-
CITY OF TIGARD ,-
BUILDING DIVISION PERMIT #: MSI'200 &00329
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2112005
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 Jr10.
_
INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:06AM PAGE: 84
SITE ADDRESS: 11676 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 #: 603-901
CONTRACTOR: PRO HOMES INC PHONE #: 503 - 730 -8220
Inspection Request Scheduled For: Date: 8/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
810 MFG - Structure set -up 035014 -02 503 - 8161.9143 N
Corrections/Comments/Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 8 /lo -od Phone #: (503) 718 -
CITY OF TIGARD
A 4.
B
•
UILDING DIVISION PERMIT #: MST2005-00329
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 I I..
INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 135
SITE ADDRESS: 11576 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-V20
Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: 9:00
Code # Inspection Description Confirm # Contact # Message
805 MFG- Structure grading/footing 035014 -01 503- 816"9143 N
Corrections /Comments /Instructions:
y ASS PARTIAL APPROVAL E CANCEL NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 Phone #: (503) 718 -