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13628 SW ASCENSION DRIVE ..�
t.
Page Vo. 2 CASK HISTORY FOR CASE NO.: kST96-0490
RW F+ULLERT'DN CO
13628 SPF ASChNSION DR
08/21/97
Action Descrip=ion Req/ Scho/ i,rid/ Action Nunn Disp By update Upd
Code Sent Done Dane Dato By
MSTA740 Insulation Inep / / / / 01/21/97 APP GS 01/21/97 GES
MSTA745 Gyp Board Inep / / / / 01/29/97 AAP GS 01/29/97 GEL
MSTA755 Rain drain Inep / / / / il/27/96 PASS MS 12/02/96 MRS
MSTA760 Water Tine Insp / / / / 11/27/96 PASS MS 12/02/96 MRS
MSTA765 Appr/Sdwlk Inap / / / / 03/16/97 1. FELT AROUND LIGHT POLE OR 1"X 4" BOX DIB PI 03/21/97 RB
AROUND POLE.
MSTA765 Appr/Sdwlk Inep 03/26/97 / / 03/19/97 APPPOVED DABn PI 03/26/97 RD
.l. BOARDS ON WINGS OF APPROACH.
2. BE NREPAPED TO PROTECT FINISH.
M82A770 Mi^c. Inspection / / / / 01/16/97 k-t.- slat on grade garage fl provide APP KS 01/16/97 ran
protective barrier at mechanical also
control ,pointe
NSTA770 Misr.. Inopecticv 06/26/97 / / 06/26/97 john of rw fullerton called. NOTE JT 06/26/97 JT
mechanical/framing failed inspectiono.
he said a letter from contractor was
faxed to us stating corrections had been
completed etc. and he doesn't feel there
should be a reinspection fee vosenaed.
i looked in fil.. there to a fax.
jeenne t.
MSTA790 Electrical Final / / / / 04/09/97 LOCKED DIS GS 04/06/97 GES
M.9TA790 Electrical Pinal / / / / 04/09/97 APP GS 04/09/97 OHS
MOTA795 Mechanical Final / / / / 04/24/96 see ti.ilding final this date FAIL RB 04/25/97 RB
MSTA'795 Mechanical r'inal 06;122/97 / / 06/20;97 SEE NQ-T!; FOR BLDG FINAL THIS DATE. FAIL KS 06/22/47 J•11
Mb1A795 Mechanical Final / / / / 06/30/97 No lock box an site, couldn't imter to FAIL KS 07/02/97 J*H
make inspection.
MSI'A795 Mechanical Final 07/11/97 / / 07/10/97 PASS RB 07/11/97 J*H
MSTA799 Mechanical Final 07/15/97 / / 07/14/97 No permit for AC unit. obtain new PASS RD 07/21/97 J*H
pet-mite and request separate inspections
(plot plan to be included showing AC
unit placement) for mechanical and
electrical (pertaining to AC only,.
No remaining building firal issues other
than above.
MSTA795 Mechanical Final 07'30/97 / / 07/08/97 see bldg final notes this date-Ra, FAIL RB 07/30/97 J*H
MSTAi97 Plumb Final / / / / 04/09/97 APP GB 94/09/41 GES
Page No. 3 :ASE HISTORY FOR CASE NO.: MST96-0490
RW FULLGPTON CO
13628 SW ASCI-21SION OR
08/21/97
Actior, Lenciiptian Reg/ Schd/ F.nd/ Action Noten Disp By Update Upd
Code Sent Dome Done Date By
MSTA799 Building Final / / / / 04/24/97 use erosion; plumbing/u/f-saititary PAIL RB 04/25/97 RB
sewer; framing/mechanical; front
porch-guardrail; brace deck posting; 4x6
beams over-spa used for deck; resupport
flex u/f; insulate wyea u/f; remove wood
debris; clear back water valve at low
point; seal thru penetrations; fireplace
inoperative; seal elect.. conduit at
garage furnace; caulk around dryer vent
in utility; plate on wall above base of
staiin need to cover open box.
MSTA799 Building Final 06/22/97 / / 06/20/97 1. Framing of mach. not approved. PAI I. KS 06/22/9'7 J-H
2. Insulate voids, staircase, etc.
. Guardrail
4. Support gas piping at water litr.
S. Support range duct at crawl space
6. Ditto, crawl space-horizontal piping.
7. Provide landing at crawl space man
door.
6.
MSTA799 Elul'.iing Final / / / / 06/10/97 No 1 xk box on site, couldn't nter to FAIL RS 07/02/97 J-H
make iroipe tion.
M.91'A799 Building Final 07/11/97 / / 07/10/97 RASA RB 07/11/97 J-H
MS':1.799 Building Final 07/15/97 / / 07/14/97 see mach final this date NOTE RB 07/26/97 JT
latter in file from R.O.Stearns
Enterprise regarding framing cover
inspection, dons to code 6 they warrant
work for 1 year. also letter in file
from Brian Clopton excavating, they
warrant sewer for 1 year. Jeanne T.
MSTA799 Building Final 07/30/97 / / 07/00/97 1. Did George Steele chevk mach. rough FAIL RB 07;30/97 J-H
and framing issues when he did the
insulation .inspectionT Letters in files
In trie fut+lre, letters will not be
accepted as proof of inspection.
2. Fireplace inoperative at time of
inspection.
PLEASE NOTE: The max. breaker for AC
unit in 40/40, 50/50 is installed at
present time.
MSTA96o (P) Issue Cert. of Occupancy / / / / 07/10/97 mailed 8/21/97 LTRS JT 00/21/97 S*N
i
CITY MJF TIGARD
DEVELOPMENT SERVICES
1.1125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
C:E'RT'iFICATE OF
OCCUPANCY
PERMIT ##. . . . . . . : MST�16•-f1r4_tO
DA1'F ISSUED: 07/10/97
PARCLL_t c S 104CC-07600
a I TF ADDREG'S. . . a 136203 9W ASCENSION OR
9UBUIVISION. . . , s HILLSHIRE WOOD:=: ZONING:R-•7 POD
RLOCV. . . . . . . . . . . I_O'T. . . . .. . . . . . . . . tIA97 JURIGDICTIONc'TlG
CLASS OF WORK. :NEW
rYPL OF" USE. . . a Cir
rYPC OF CONSTR:5N
OCCUPANCY GRA'. : R.i
OCCUPANCY L.0(10:2
Oemarks : Path 1
Owner- a __..._ ... ..._. _.._._. .._ .._. ___._._..____ _..... ..
RW F ULLERTON
SW NVRTN--LIL.SDL. HWY
POMLAND OR 97221
''hone #i: x'97--44,33X 105
R FULLE'RTON COMPANY
0426 SW BEAVERTON HILLSDALE NIFTY
'ORTL_AND OR 97j'21 - 1128
'hone #a 297-443.3
e rj M. . a 000406
rhi a Cert i f ic.:m# a Rr,aent a occrupanc:y of the above referenced building or Front ion
(hereof wand r_onfir-m% that the building has Lar•aueen in, ec:ted for- compliance wi.tll
the State of O ppon 5peci<y Codes for- the
g f� ccr_rpancy, ;and use under
k,4hich the r^ef r er -d per-mit way+ i. aso.ted.
11 ITLDING Ih -PECTOR BUILDING O - IC7AI_
PCISI I N C ON.r''P I CUOUS PLACE
E
CITY OF TIGARD
DEVELOPMENT SERVICES r+lA)TER FERMI T
13125 SIN Hall Blvd., Tigard,OR 97223 (503)635.4171 PERMIT #. . . . . . . : MST960490
DOTE ISSUED: 14. /28/91E,
f- ARCEL: 2S104CC—HWO9
51TF. ADDRE95. •. . l:tir., t] SW ASMISTON DR
:SLJBD I V 19 I Of%I. . . . : 1,111-L-SH I RF WOODS ZON I NI(3: R--7 P,D
RL_OC;I . . . . . . . L.0 T. . . . . . . . . . „ . :097
Remarks: Path 1
---------•--------------------------------------------- BUILDING
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 s' REQUIRED SETBACKS---- RE12UIRE.D--•-------
CLASS OF WORK.:NEW HEIGHT........: 21 FIRST....: 1786 sf GARAGE.....: 693 sf LEFT..........: 5 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....; 40 SECOND...: 894 sf FRONT......... 20 PARKING SPFCES: 1
TYPE OF CONST.:SN DWELLING JNITS: i FINBSMENT: 0 sf RIGHT.........: 5
OCCUPANCY GRP.:R3 9DRM: 3 BATH: 3 TOTAL-------: 2680 sf VALUE_$: 191544 REAR.:........ : 60
-------------------------------------------------------- PLUMBING
SINKS.........: 1 WATER C,OSETS.: 3 WASHING MACH.. : I LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TPsrPS—. 0
LAVATORIES....: 5 DISHWASHERS...: 1 FLOOR, DRAINS..: 0 SEWER LINE ft: 6 SF RAIN DRAINS: 1 CATCH BASII*i..; 0
TUB/SHOWERS...: 3 GARBAGE DISP..: 1 WATER HEATERS. : ! WATEP LINE ft: 100 BCY,FLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIIITUFES: 0
--------------------•------------------------------------------ MECHANICAL -------------------------------------------------------------
FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/CMN ! 3HP: 0 VENT FANS.....; 4 CLOTHES DRYERS: 1
/GAS/ / / FURri )=INK ..: 1 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...; 1
MAY INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 1
----- .._------
---------------------------- -------- _ - ELECTRICAL -------------------------------------------------___
--RESIDENT]AL UNIT--- ---SERVICE!FEEr)ER--- ---TEMP SRVC/FEEDERS-- --BRANCH CIRCUITS--- -----MISCELLANEOUS-- --ADD'L Ii,151I1710149--
1000 SF OR LESS: I 0 - 00 amp..: 0 0 200 amp..: 0 W/SVC OR FDP..: 0 PUNP!1RRIGATION: 0 PER INSPECTII,N: 0
EA ADD'L 5005F.: 5 201 - '•'a0 amp..: 0 201 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT I-IN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 600 amp., : 0 401 500 amp..: 0 EA ADDL OR C1R: 0 SIGNAL/PANEL...: 0 IN PLANT...... 0
MAW HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL ••10: 0
1000+ amp/volt.: 0 ----------------------------------- PLAN REVIE►I SECTION --------------------------
Reconnect
------------------------Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
_._-___-----------.-------------------__-_______------ ELECTRICAL - RESTRICTED ENERGY ------------------ --
A. SF RESIDENTIAL---------------------------- B. COMMERCIAL-----—-------------------------------------------------------------------
AUDiO rI STEREO.: VACUJM SYSTEM..; AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR RI.ARM..: 0TH: :: Y BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SI3NI_:
GARAGE OPENE:R..; CLOCK..........: INSTRU4ENTATION; MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL A SYSTEMS: 0
Owner: ---------------------------------Cnntractor: --- ---------------------- TO AL FEES:f 46%.20
RW FULLERTON R.W. FULLERTON
F462 SW BVRTN-HLSDL HWY 9700 SW CAPITOL HWY
SUITE w 275
PORTLAND OR 9722221 PORTLAND OR 97219
Chane N: 297-4433(105 Phone I1: 293-2217
Reg w..: 40671
This permit is issued subject to the regulations co~stained in the Tigard M•nicipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accore:n.,., with approved plans. This permit will expire if work is not starteu within 180
days of is31jar,,e, or if work is suspended far more than 180 Ways.
----- REQUIRED IIISPECTIONS -------------------------------------------- -- -
Footing Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appr/rdwlk Insp Erosion Control
Post/Beam Struct Plumb Top Out Low Vol+.age Gyp Board Insp Electrical Final
Dost/Beal Mechan Electrical Servi Fireplace Insp Rain drain Insp Mechanical Final
Crawl Drain Ele,trical Rough bas sp Water Line Insp PI b Final
C_�
/ Vel
l rar mi.ttee Si nature : , r issued Ely : a
CEil 1 fur, inspection 639 -4175
SEWER
CITY OF TIGARD CONNECTION
DEVELOPMENT SERVICES PERM.11
Pl=RM T. r #. . . . . . . : swR96--0490
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE_ T SSUED: 1.0128196
PARCEL,: 25104CC—HWO97
.- I TE ADDRLS5. . . : 13628 SW ASCENSION DR
51-113 D I V T S I ON. . . . : H I LL.SH I RE WOODS ZONING. R--7 PD
FLOCK. . . . . . . . . . . LOT. . . . . . . . . . .. . .097
TENANT NAME. . . . . :RW FULLERTON CO
U'S'A NO. . . . . . . . . . . FIXTURE LIMITS. . . . 0
CLASS OF WORK. . . :NEW DWELL I NO LIN I TS. . : 1
TYPE OF USE. . . . . -.SF NO. OF BIJ T LD I NGS: 1
T11STAL.1._. TYF,E. . . . :BusmR IMPERV SIJR.FACh: 0 sf
Remar^k s : Pai;h i
Owner; --_.__.___.._.____-__________.____________._.._.___....---.._____-- FEES
RW FUi .LERTON CO type nmol-tnt by clite •ecpt
64E,<<' GW HVRTN-41LSDL HWY PRMT $ 2200. 00 B 10/28/96 96-2,85753
I NSP $ 3`;. 00 8 IV-1/28/96 98-;-85753
PORTI.AND 0R -,•1722:1
PI-ione #: :='97-4433X105
CONTRACTOR NOT ON FI;..E
Phone #: f ?2.35. 00 T7TAI._
Reg #. .
REOU r RE9 I NSPECT I ONS -
This Applicant agrees to coaply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The pereit expires 188 days frog
the date issum The total aaount paid will he forfeited if the __ __�_�•
pereit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewir is not located at the aeasareaent
niven, the installer shall prospect 3 Feet in all directions frog
the distance given. If not so located, the installer Dell purchase
a "Tap and Side Sewer" pereit and the Agency will install a lateral.
Pet-mittee signatl.rve :
T s s i_r a ri By :
Call for inspection - 6374- 4175
Plan Chock
.IW OF T CARD Residential Building Permit Application Recd By
13125 TALL BLVD. New Construction Additions or Alterations Date Recd /O-��
IGAR OR 97'223 Single Family Detached or Attached Date to P.E,
503) 63-5-4171 Date to DST /0 iv
Print or Type Permit a ��
�-
Incomplete or illegible applications will not be accepted called
Name of Subdrvision Lot a Naml ,
I Job
�� t-lt t > Architect Marling Address
Address site lcjrxss
-- _ -+ G dylState Zip Phone
ams
OwnerMarling Address WIND47
Engineer Address
tats
Zip ,.. il►
?Z ] 1 r r 1 U (�gy►State Zip Phone
Name _
l ,'
\ General F-� �- Describe wort~ new'qaddMon o alteration O repair O
Contractor Haring Address to be done: —
_( G Additional nescnptwn of Work:
IQVIState Zip Phone
3
Oregon Const. Cont.Board Lic.O Oate
Attach copy of CJS; I �-. Projer-1
Current t;OT Busuess Tax or MetrosE4.Patel L Valuation
varve NEW CONSTRUCTION ONLY:
Mzcharr;cal ihnSq-Ft. House: Sq.Ft.Garage:_
Sub- Mag dress _ -- �, C)
Contractor I11v3 !�l it ►•.3r - �,t t , Comer Lot Yes No Flag Lot Yes No
-
�r�r hate Zip Phone —" (check one) � (check one)
t c,I�TLIrn,►.) W� 1 L c• �5 -9 rJ i~ Restricted Audiq/Scereo surgtar
Oregon Const Cortt.Board Lie# p. Date Energy System _�_-- Alar
Attach copy of L Installation Garage Moor HVAC
Currr+tt COT Business Tax or Metro a Exp.Date
uee Opener Systems
17
` Nartts (check all that Other.
I Plumbing `1�ovlc¢ Ii.��M� � _ _ L--� PN)
Sub- M""Address -- VMII the electrical subcontractor wire for all Yes No
Contractor �Q.F� restricted energy installations?
y "� _2344 - Phone the Subdivision Plat recorded? �t�UA Yes No
rstaa ZIP
Omyow Const Corn gab tkg p Da Reissue of MSTtr Solar Comnliance
Attach Copy of Q t L" ►�1 Z (Calculation Attached)
`J, "^- I hereby acknowledge that I have read this application,that the
Current PlurtGrg Lie.ar Exo"Da%e 9 PP
Ucertses Y • E�7; (a I <) ; information given is correct.that I ari the owner or authorized agent of
CC T Business Tax or Metro Mo.n s the owner, and that plans submitted are in compliance with Oregon
_ C-)UDD 41s 7 Z 17 State laws. _
Nar to SiWture of UwneN gent
!� Electrical . rc'1.-I t�� l Pr,`-
. r;tact Person Na
P ne
Sub- M riling Address ( %t 1 e Aj 9-)7
Contractor , ,�,+ FOR OFFICE USE ONLY:
_ itOfState Zip Phone Plat# MapITL#
t uta (-L
Oregon Const Cont Board Ur-O oto )+ _
Attach Copy of ]—I ` Setbacks Zone Solar. J
Current : rctrtealLic.K r
COT r Metro• Engineering ADpmwal: Planning Approval: TIF:
•afstsvrultspp.tloc 0
2A
7 1
l -'
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
l 7j Glt r �___
iTY OF TIGARD Plumbing Application Recd By_
'125 SYN HALL BLVD. Commercial and Residential Date Rec'(
GARD, OR 97223 Date to P E. _
73) 639-4171 Date to DSTPermit 0 P&P
Print or Type Related SWR 0
Incomplete or illegible applications will not be accepted Called
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Job /1,;/f,✓,�t � :/J Sink g00
Lavatory 900
Address Street Addre9 Suite
,/,j 4'.�� JJ�!f�Q,t/- Z Tub or Tub/Shower Comb 9 00
Bldg S City/Stale Zip Shower Only 476--
a�Q G,2 Water Closet ----- 9.00
Name � � —
ii• � y'tir j7 Dishwater 9.00
G r C Garbage Disposal 9 00
Owner Mailing Address Suite _
Washing Machine 9,00
CG"WSlate Zip Phone Floor Drain 2" 900
3" 900---7
Name n7 4^ 9.00
Jccupant Mailing Address Suite Water Heater 9.00
Laundry Room Tray 900
City/State Zip Phone Urinal 900
---- Other Fixtures(Specify) 900
Na/Me _
/r,( i,/)r c //•"i) �� �' 9.00
:ontractor Mailing Address Suite 900
/ /'c ,\).I CC)/I - -- -- 9.00
City/State Zip Phone --- - -
900
Oregon Const.Cont.Board Lic.# Exp.Date 900
Attach Copy of �'- ?,I 7 1 5-/"I % /
Curront Plumbing Lic.f Exp.Date Sewer-1st 100' 30,00
1
Licenses 2(. j J J�j-j 5'c�-`� 7
Sewer-each additional 100' 25.00
COT Business 4 '
Metro k Exp. Date,' Water Service- 1st 100' 3000
� '
Name - Water Service-each additional 200' 25.00
Architect
Storm&Rain Drain- 1st 100' --- 30.00 ~
_ _
or Mailing Address Suite Storin&Rain Drain-each additional 100' 25.00
Mobile Home Space 25.00
Engineer CityiState Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
=scribe work New O Addition O Alteration O Repair O Residential Backflow Prevention Device' 15.00 I
be done Residential O Non-residential O Any Trap or Waste Not Connected to a Fixture 900
ddilional description of work -- - _
1 Catch Basin 900 --^�
(/E►& ` Insp of Existing Plumbing — 40 00 -
_ I per/hr
sting use of -- Specially Requested Inspections 4000
ding or property_ }(Ji�I6+q[ _ — per/hr
---- --- Rain Drain.single family dwelling 3000
posed use of Grease Traps 900
.ding or property__ _ _ —
_ QUANTITY TOTAL ^
e you(:appmg . moving or replacing any fixtures? Yes O NoIsometric or riser magrarn is requxed a Ouan•ty Total u f 9
If see back of form) — 'QUBTOTAL „K
^ereby acknowledge that I have read this application,that the information
,en is correct,that I am the owner or authorized agent of the owner.and 5% SURCHARrE -7„
it plan,;submitted are in compliance with Oregon Slate laws _
.ria pf'e Owner/Ager. Data PLAN REVIEW 25%- OF SUBTOTAL
i 1' Required only d keure qty totals i
a__ ��' , v TOTAL
/fillict Pension Name Phone
_ Mlnlmum permit fees 525- 51e surcharge.except Residential Backflow
Prevention Devire,which is 515-5%surcharge
Odstsi pimapp.dor.3196
PLEASE COMPLEIE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
Fixtures
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet Y _
Dishwasher
Garbage Disposal _
Washing Machine
Floor Drain 2"�
Water Heater
Laundry Room Tray
Urinal _
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I
BRIANGLOPTONEXCAVATING, IN .
P.O. Box 472 • Wilsonville, OR 97070 • (503) 682-0420 • FAX (503) 682-0967
April 30th, 1997
City Of Tigard
Building Inspections Department
13125 SW Hall Blvd.
Tigard, OR 97223
RE: 13628 Ascension
4/24/97
Bu{lder: R.W. Fullerton
Dear sirs;
In reference to the above listed job, apparently the sewer was covered
before inspection.
We normally make every attempt to follow the required inspection procedure.
We first call for the inspection, then when approved, we backfill.
We appreciate your flexibility on this particular job and apologize for the
error.
Sincerely,
Brian Clopton
Brian Clopton Excavating Inc.
BC/ma
Roads Driveways Land C!earing Demolition Underground UtilitiP
CCBr `J337
BRIAN CLOPTON EXCAVATiNINC.
P.C. Box 472 • Wilsonville, OR 97070 • (503) 682-0420 • FAX (503) 682-0967
April 30th, 1997
City of Tigard
Building Inspection Dept.
13125 SW Hall Blvd.
Tigard, OR 97223
RF.: 13628 Ascension
4/24/97 Inspection
Builder: R.W. Fullerton Company
W A R R A N T Y
As is required by the Oregon Contractors Board we shall warranty the sewer
work on the above listed job for one year.
Signed:
i
Brian Clopton
Brian Clopton Excavating 'Inc.
cc, R.W. Fullerton Company
BC/ma
Roads • Driveways • Land Clearing • Demolition Underground Utilities
CCBN 50337
i.ITY OF TIGARD
131 ?5 ',.'v HALL 3LVD.
TIGARD, OR 9722.'
4V ^,4 i ANT PERMIT NOTICE
P'fjTJMBING
W '.Z A LAW
122^5 SE CRESTWAi
PORTI,.'NI) OR 97236
Plumbing Signature Form
Permit # . . . . : MST96-0490
Date Issued. : 10/28/96
Parcel . . . . . : 23104CC-HW097
Site Address : 1.3628 SW ASCENSION DR
Subdivision. : HILLSHIRE WOODS
131ock. . . . . . . . U)t . 097
Zoning. . . . . . . R-7 PD
Remarks :
Path 1
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 work. No plumbing inspections
will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER : PLUMBING CONTRACTOR:
RW FULLERTON ANSPACH PLI MBING
6462 SW BVRTN-HLSDL HWY MARK A LAW
12295 SE CRFSTWAY
PORTLAND OR 97221 PORTLAND OR 97236
Phone # : 297-4433X]-05 Phone # :
Reg # . . : 03', 135
signature of Authorized Plumber
Please return this completed form to the address ab(
ATTN: Building Dept.
If you have any questions, please call 639 4171 , ext. #310
I
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WRIGHT 1 ELECTRIC INC
5618 SE 135TH AVE
PORTLAND OR 97236
Electrical Signature Form
Permit # . • . . : MST96-0490
Date Issued. : 10/28/96
Parcel . . . . . . : 2S104CC-HW097
Site Address : 13628 SW ASCENSION DR
Subdivision. : HILLSHIRE WOODS
Block . . . . . . . . Lot : 097
Zoning. . . . . . . R-7 PD
Remarks :
Path 1
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 wor:,. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRIL:AL CONTRACTOR:
RW FULLERTON WRIG^T 1 ELECTRIC INC
6462 SW BVRTN-HLSDL HWY 5618 SF 135TH AVE
PORTLAND OR 97221 PORTLAND OR 97236
297-4433X105 Phone # :
Reg #ZC
97757
S ,
X-z
Signature of Supervisingg Electrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639 4171 , ext. #310
CITY OF TIGARD 24-Hour
Inspection Line: (503)639-4175
BUILDING �,l� MST
N DIVISION Business Line: (503)639-4171 BUP —
7- --
LocatIo � DateRequested -- AM g:�PM---- BUP
*)* SuiteMEC
-_—
___----_-
-�
Contact Person �jL - --- Ph( 5D ) -�- _7- - PLM -_--
Contractor _� _�-1i1L- t� l�_— _ Ph( _)� 1 �.�-��--- SWR ------- -
BUILDING Tenant/Owner - ____ -- ELC _ ---
Footing _ ELC M)n�6e1—
Foundation Access: ELR1PLd' r —
Ftg Drain } �j L. !Y& Ay-eALxLec&
-
Crawl Drain
Slab Inspection Notes: (�, -
Post& Beam —
;�i,•-r Anchors
Ext Sheath/Shear �L -4 "L'}I tY1 -_—_--._-----
Int Sheath/Shear
Framing -- --- - ---
Insulation —
Drywall Nailing --- ----- _-_------- -- —
Firewnl; —
Fire Sprinkler ---- _- -----_-- --
Fire Alarm -- _— --
Susp'd Ceiling ------------ -- -_— ---
Roof --_ ---
Other. ------_---
------- ----
_ __ -Final ---
PASS PART FAIL_
PLUMBING _ - _ ----- -
1 &Bearn _
Under Slab - - - -- -- -
R, ,.gh-In ----
Dater Service ------ — —
Sanitary Sewer
Rain Drains --- - -- —
Catch Basin/Manhole
Storm Drain ---"---
Shower Pan ------ -- ----- - -
Other: -
Final ---------- ------ --
PASS _PART FAIL
MECHANICAL_ __ - --- --- — -
Post& Beam - -
Gas Line
Smoke Dampers ------
Final
PASS PART FAIL - - - -- - -- —---
ELECTRIC_AL ---
Service
Rough-In
UG/Slab
Low Voltage -
Fire Alarm
i [] Reinspection fee of$ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS PART FAIL
- --------- l � Unable to inspect-no access Please call for reinspection RE:_.-_ --_-- -
Fire Supply Line [�
ADA Date_ I ! -'O Inspector `^ C, � �r_"�=L-- Ext ------
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL.