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13657 SW ASCENSION DRIVE
CITY OF TIGARD
DEVELOPMENT SERVICES
SW Hall Blvd., Tigard,OR 97223 (503)639-4171
CERTIFICATE OF
OCCUPANCY
DATE ISSUED: 03/11/97
SITE ADDRESS. . . 1365*7 SW ASCENSION DR PARCEL : 2S104CC--Hw0lj
CLASS OF WORK. eNEW
TYPE OF CONSTR:5N
OCCUPANCY GRP. -R3
OCCUPANCY L()ADc,:
THE RW FUL-LERTON CO
'4700 SW CAPITOL. HWY
,3UITE #0T5
[",IORILOND OR 97P19
rHE R. W. FULLERTON COMPANY
,DRTLnN1) 00 97219
grants o _ _-__, Of the ~,,_~ . e . =. ="c=" "u^ Ipxng or portion
LDING INSPECTOR SUC 4644F
POST IN CONSPICUoUr, PL.ACE
N '- '
CITY OF TIGARD
DEVELOPMENT SERVICES PI._UMBING PERMIT
13125 SW Nall Blvd., Tigard,OP.97223 (503)6394171 PERMIT #. . . . . . . : F=11_.M97--0055
DATE ISSUED: O2/25/97
PARCEL-: 251 O4CC-HWO1 i
I Tr.. ADDFIESS. . . : 131557 SW A)CENS I ON DR
i.IBDIVISIOM. . . . HILA-SHIRE WOODS ZONING: R-7 PD
BLOCV. . . . . . . . . . .. I_.OT. . . .. . . . . . . . . . :011
.I_ASS OF WORK.. . :Al T GARBAGE D I SPOSAI..S. c el MOR I I HOME' SPACES. : 0
TYPE 1]F' USE. . . . :SF WASHING MACH. . . . . „ 0 BACKFLOW FIREVNTRS. . : i
OCCUPANCY GRP. . ; R:3 FLOOR DRAINS. . . .. , 0 TF FPS. .. . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATER:i. . . . . 0 CATCI-i BASINE3. . . . . . . . N
F IXTURES- ______.. ....___--- LAUNDRY TRAYS. ,. . . . e 0 FiF RPIN DRAINS. . . . . . 0
SINKS. . . 0 URINALS. . 0 GREASE TRAPS. . . . . . . . 0
I.-AVATOR IE a. . . . .. -, 0 0144rR F T X T1.IRES. . . . : izi
TUB/SHOWERS. . . . : 0 SEWER LINE (ft) . . . : 0
WATER CL.OSFTS. . : 1l_1 WATER I..INE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN ( Ft ) . . . : 0
Rpmarks : Installing residential har..kflow prevention device.
GOwner: --- -_______--------____ _._______________.__________-__-_-• FEES
TI-11;= RW FUL.LF_'RTON CO type Amount by date r-e�cpt
9'00 SW CAPITOL.. HWY PRMT $ 15. 00 _1D 02/25/97 97-290790,
""JIJl TF #P75 PCI t 0. 75 ID 02/25/97 97-290799
DORTI._.AND OR 97219
'hone G. .'?93- 2 77
Contractor: --------------------------------
MICHAEL
----•----___.---------------_-_MICHAE'L & CO PI...UMB I NG
P O BOX 23008
T I GARD OR 97281
! ,hone #.. 639~3169 1 15, 75 TOTAL.
'>eg #. . : 6715177
- -- -- - RE OU I RCO INSPECTIONS
-- ----
Th:5 permi° is issued s+ibject to the regulations contained in the RP/Backflow Prov
`igard Muniripal Code, State of Ore. Specialty Codes and all other Final Inspection
,pplicable laws. All work will be done in accordance with
approved plans. This permit will expire if wort, is not started
within 18p days of issuance, or if work is Suspended for mere
than 188 days.
! I e r m i.t t e e a i t. �a r•aJ__Ne4
.�
Call for inspection - 639-41.75
"ITY OF TIGARD Plumbing Application Recd Byd��
3125 SW HALL BLVD. Commercial and Residential Date Recd-
Date to P E.
,'IGARD, OR 97223 Date to DST
503) 639-4171 Permit 0 fTI�(
Print or Type Related SWR#-
-Incomplete or illegible applications will not be accepted Called— —
Name of DevelopmenUProlect FIXTURES (Individual) QTY PRICE AMT
Sink 9.00
Job Lavatory 9.00
Address Street Address Suite --
%`s Tub or Tub/Shower Comb 9 00
Bldg 0 City/state Zip Sho-.-er Only -T 9.00
i lsA�
rt / r Water Closet 900
— Name Kibwater 9.00
/Ert/ 16,0✓itr -- Garbage Disposal - 900
Owner Marling Address Suite -
Washing Machine 9.00 I
CitylState Zip Phone Floor Drain 2" 900
3" 900
Name 4" 9.30
Marling Address — Suite Water Heater 9,00
Occupant
laundry Roum Tray 900
City/State Zip Phone — Urinal 900
Other Fixtures(Specify) 9.00
Name 9.00
f /( /AC( .�(' r1 �'(�
9.00
:nntractor M ding Address Suite
/1/� / . -) 306e _ —9.00
City/Slate Zip Phone `� 9 00
"/)/04 ,b/ j /Ji�/� L '1 _/t7 I --- -- 9.00
Oregon Const.Cont.Board Lic 0 Exp.Dater _ 900
Attach Copy of _ _-
Current Plumbing Lie.0 Exp.Date Sewer 1st 100" -- 30.00
Licenses r 3 % u` Sewer -each additional 100' 25.00
COT Business Tax or Metro S Exp.Date Water Service--1st 100 3000
1;7" /z -/ i 1
- Water Service-each adVional 200' 25.00
Name
Storm&Rain Drain-1st 100' X00
Architect
Mailing Address Suite Storm&Rain Drain-each additional 100' 2500
o Mobile Home Space 25 00
Engineer Cdy/Stale Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device _
3escnbe work New O Addition O Alteration O Repair O Re udential Backflow Prevention Device' 1500
o be done Residential O Non-res dentia: O Any Trap or Waste Not Connected to a Fixture 900
dditional description of work Catch Basin 900
//4 l G/ Insp.of Existing Plumbing 40.00
per/hr
Specially Requested Inspections 4000
rstinq use of per/hr
riding or propertyrt -i r ^/ - v Rain Drain,single family dwe!'nr 3000
"oposed use of Grease Traps 900
wlding or property- --� -- —— QUANTITY TOTAL
Are you capping mown, or replaGng any fixtures? Yes Cl No Isometnc or ns_er diagrams required 4 Ouanrty Total is >9 _
(lf yos see back of form)
'SUBTOTAL ��—
I hereby acknowledge that I have read this application,that the information -- -- 5°!° SURCHARGE.
givens correct.that I am the owner or authorized agent of the owner,and 7
;hat plans submitted are in compliance with Oregon State Laws — PLAN REVIEW 25%OF SUBTOTAL
signature of merfAgont Date
/ Requved onty A Gnure otv Loral is>_9
TOTAL
*Minimum permit fee is$25• 5%surcharge.except Residential Backflow
on-W/. P mon Name Phone
t'S 31 Prevention Device.which s S15-5%surcharge
t'7 i\dstslplmapp doc 8/96
P-LEA,9-E-reOMPLETE AS APPROPRIATE TO PROJECs: 1
v-
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher _
Garbage Disposal
Washing Machine
Floor Drain 2"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
t
ERMIT
CITY OF TIGARD MASTER
7MI T #... .. . . MST96-027tl
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/24/96
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
F IARCEI-: 2S 104rC-I-IW01 1.
'a I1 L. ADIDRLS:i. SW ASCENSION DR
'31J13DIVISI[]N. . . . : F4I1_.LSHIRE WOODS ZUNINU: R-7 f`1
BL-OL,l-. . . . . . . . . . s 1_01.. . . . . . . . . . . . . :011
Remarks: PATH I
--------------------------------------- ------------------------ BUILDING ---------------------------------------------------------------.
REISSUE: STORIES.......: 2 FLOOR AREAS----------- BASEMENT...: 0 if REQUIRED SETBACKS---- REQUIRED------------
CLASS OF WORK.:NEW HEIGHT........: 32 rIRST....: 160 if GARAGE.....: 830 if LEFT...,......: 5 SMOKE DETECIRS; Y
TYPE OF USE-0 FLOUR LOAD....: 40 SECOND...; 1270 s FRONT.........: 20 PARKING SPACES: 1
TYPE OF CONST.:5N DWELLING UNITS: I FINBSMENT: 0 if RIGHT.........: 5
OCCUPANCY GRP.,R3 BDRM: 4 BATH: 3 TOTAL------: 2C60 sf VALUE-$: 1797233 REAR..........: 89
--------------------------- ----------------•--------•------------- PLUMBING ---------------------------------------------------------------
SINKS.........: I WATER CLOSETS.: 3 WACHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 0 TRAP5.........: 0
LAVATORIES....: 5 DISHWASHERF...: I FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS.. : 0
TUB/SHtOWERS...; 3 GARB'iGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PRcVNTR: 1 GREASE TRAPS..: ti
OTHER FIXTURES; 0
-----------------------------------------... .------ ------ MECHANICAL ------------------•---------------------------------------
FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/LMP ( 3HP: 0 VENT FANS.....: 4 CLOTHES DRYERS: 1
/GAS/ / / TURN >=100K ..; 1 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 1
------------------------------------------------------------- ELECTRICAL -------- --------------------------------- -
-RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUS-- ----MISCELLANEOUS------ --ADD'L INSPECTIONS-
ION SF UR LESS: 1 0 - 2011 amp..: 0 0 200 amp.. : 0 W/SVC OR FDR 0 PUMP/IRRIGATION: 0 PER. INSPECTION: P
EA ADD'L 5009. ! 5 201 - 40P amp..: P 201 - 400 amp.. : 0 1st W/O SVC'l•0R+ 0 SIGN/OUT LIN LT: 0 PER HOUR...,..: 0
1-IMITED ENERGY.: 0 401 - 60@ amp..: 0 401 - 600 amp.. : 0 EA ADDL BR LIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: E1
MANF 141/SVC/FDR: 0 601 - 100" amp.: 0 601+a4ps-1000 v: 0 MINOR LABEL -10: 0
ION4 ampivoit.: d --- ------------ ------------------- PLAN REVIEW SECTION -------------•--------------------
Reconnect only.: 0 r=4 RES UNITS..i SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
------------------------------------ ELECTRICAL - RESTRICTED ENERGY ----------------_----__----------------------------
A. SF RESIDENTIAL---------------------------- B. CLW RCIAL-----------------------------------------------------------------------------
AUDIO I STEREO.; VACUUM SYSTEM..s AUDIO b SiERLO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: X BO;LER.........: HVAC...........: LANDSCAPEIIRR16: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK.....,....: INSTRUMENTATION: MEDICAL......... OTHR: ::
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL M SYSTEMS: @
Owner: -----------------------------------Contractor: ----------------------------- (OTAL FEES:$ 4685.20
THE RW FULLERTON CO R.W. FULLERTON
9700 SW CAPITOL HWY 9700 SW CAP;TOL HWl
SUITE M275 SUITE A 275
PORTLAND OR 97c19 PORTLAND OR 97219
Phone t: 293-2277 Phoae 0s 293-2277
Reg N..: 411611
Thic permit is issued subject to the regulations contained in the Tigard Municipal Lode, State of Ore. Specialty Codes and all other
applicable laws. All Mora will be done in accordance with approved plans. This permit will expire if wnr•k is not started within 160
days of issuance, or if work is suspended for vote than 18P days.
PEOUIP.ED INSPECTIONS -------------------------------------
Footing
-------------------------.---------Footing Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear- Wail Insp Irsulation Insp Appr/Sdwlk Insp Erosion Control
Post/Beam Struct Plumb lop Out Low Voltage Gyp Board Insp Electrical Final
Post/Beam Mechan Electrical Servi Fireplace Insp Rain drain Insp Mechanical Final
(yawl Drain Electrical Rough Gas Line Insp Water Line Insp Plumb Final
1-'ar•mi.ttee ignaitI-tr-e : `:. !_. issr-i ed By - „`�,� -. "' <�'•
('al l for inspection - 639--4175
SEWER CONNECTION
CITE' OF TIGARD PERMIT #PERMIT. . . . . . .
: SWR96-026°,
COMMUNITY DEVELOPMENT DEPARTMENT DATE. ISSUED: 06/24/96
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171
PARCEL: 2SI04CC—HWOII
ST TE ADDRESS. . . : 13657 SW ASCEN5I ON DR
SUBDIVISION. . . . : H I LLSH I RE: WOODS ZONING: R-7 PD
13LOCI.. . . . . . . . . . . LOT. . . . . . . . . . . . . :011
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . . . 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INS'T'ALL 1-YPE. . . . :BUSWR IMPERV SURFACE: 0 st
Rem r-ks : PATH I
Uwner,: ___________.---___.__-------______.______----__._._________ F=EES
THE RW FUL.LERTON CO type amol.tnt by date rer_pt
9"700 SW CAPITOL HWY F'RMT $ 2200. 00 JSD 06/24/96 96-280908
SUITE #275 INSP $ 35. 00 JSD 06/0-R4/96 96— '80908-
PORTL_AND OR 97219
Phone #: 293--227-7
Lontr•axctors --•--------•---•--------•--------
CONTRACTOR NOT ON F=ILE
------------------------------------------
Phone
_-.--__—_____—___--------.---------------
Phone #: $ 212 35. 00 TOTAL
Reg #. . :
------- REQUIRED INSPECTIUNS --------
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
pe+-!it expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "lap and Side Sewer" Permit and the Agency will install a latera;.
P e r m i t t e e S i y n a t.L r e: \ L v._.
1ssi_ied
Call l for inspect i on — 639-4175
I
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 7 Sw /1501.MS/OA/
Subdivision: 1,pt4.SH-IROffice Use Only
E- �UUt?S Lot#_�__
Contact Date ! / Initials ._
—
Valuation: ff-POU ' ' � Result
New Construction Oniy: (Square Footage) Planck/Rec # J�
Permit # 7 S
House. Garage:Garage: _ �� Reissue of
MapB >I '
Corner Lot? Y Flag Lot? Y �� Zo
Plat # T #ne
'l 7, L�
Owner: _ 7NF Rw ra -exrz,'-j Cao
Approvals Re ug ired
Address: 9'7t7D Sw CAPITOL /74W,/. t��-75-
Planning Setbacks 6, Solar
r(.I
I�o�CT L�9rJ�, Ute° • 7�'� Engineering '.,ri y- Pit^ -its FF01- s-lI 46
Phone: f S03 1
21)3 - 2-'7 7 x ! y I (7ewtj F,-M) Other
�� Items Required
Contractor: S/1221 E f�S JN—_
Subcontractors _
Address _ Truss Details _
Other_
r Notes
Phone:
Contractor's License #
(attach copy of current Oregon license)
Contact Name 1 L►-1 N 1 f-r K LC 6,KEy1=
Contact Phone. 1 r 31 2`13•- 2--Z-7-7 Wi• 101
Subcontractors: Architect/Engineer:
Plumbing: f i�`F'hC N t��v(�-1g,NG Address: 130c- Nib 18'1N LVF_ -
Mechanical: Sii4l-A N'E-:ATI t,-)C- 5 - ! - 9� Poe'F z 4A-)O , n? . 9.72-Oy
(attach copy of current OR Contractor's License)
�AR'�'APhone: i 50.3' ) 2 - S - `1 16
WIZ;`NT 1 ELE�TK'_ r (' l -GUFLG'W
JOB DESCRIPTION:
_ `�-5 t 2 91 -22'7_'7 YL
ApFlict ignature Applicant Phone number
0-- --r
'
Received by: �� 1 _ Date Received:
VegnO.Mvc.pO
Permit # Account De.cription Amount Amt. Pd. Bal. Due
F Bldg. Permit (BUILD) u u
Plumb. Permit (PLUMB) 1
Mech. Permit ;MECN)
g (
& 0 �U
Bldg:
Plumb:
Mech:
E'c c
63. 7
Plan Check j/
Bldg:
Plumb: p1mF1 N
Mech: 001 A/
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) loso
Residential TIF (TIF-R) L1 ` j u
Vass Transit TIF (TIF-MT) / ' !' 2 6)
Commercial TIF (TIF-C)
Industrial TIF (Tl--I)
Institutional TIF (TIF-IS)
Office TIF (TIF-0) �.
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) o lti'
Erosio, Planck]COT (EROSN) '21" 2
011"
TOTALS:
99 Mft 14 17:34 4p PiLTILTI IW, 4 AIm Mo r.mo pealpn (503,2:6 41GI
h90
2244A. .
�N 36 15 54" E ` _ h°�
70.00' BY
R W FULLERTON
h6
1 ( CITY OF TIGARD
115kv-T 'FQJ prS HILLSHIRE
I��J 112 c7 'F�(L,- E�¢. 1 OtJ GO►�� hbo� L 0 t 11
I I----------- ------ -----
--,
10,500 S0. iZ)
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00 "ole I ^I olo
9 -
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DECKlop
ti
1 ——
MAIN FLOOR
EL :600 0' h90
1 1
I GARAGE
EL :599.5' I
0
I
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0 4' CONC s
DRIVEWAY o Tn 1 a+
ID PaIJEvE
No
_ OIL-
l N 36'1554" E
70 00'
��----fib
05/14/96 TPW
ALAN MASCORb OESIdI ASSOcA NC O
IS N0
1"A"' FOR ,I ACCtMAC"OF tNF 13b S S.W. ASCENSION '.)R,
IOPOORAPNr Ni ORMAIION It t5 1N( SOLE
R[SRONSISAItr OF rNE BUApFR 10 YFRO,
All SITE CONOI I"S NCI U)NG AN,Ilu
REACED ON tNF SIT( AND NKORM OWNERS
OF ANr PO't
NtIAI FIELD MODNICAtIONS r
AAfI 11Af DD D C f I Aff0CIATE �
1305 N W 18TH AvENI!E POP 7LAND, OREGON 97709 15031 «5 91fi1 A L E U 0
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ANSPACH PLUMBING
MARK A LAW
12295 SE CRESTWAY
PORTLAND OR 97236
Plumbing Signature Form
Permit # . . . . : MIST96-0279
Date Issued. : 06/24/96
Parcel . . . . . . : 2S104CC--HW011
Site Address : 13657 SW ASCENSION DR
Subdivision. : HILLSHIRE WOODS
I Block . . . . . . . . i of 011
Zoning . . . . . : R-7 PD
Remarks
PATH I
Your company has been indicated as the piumbing contractor for the permit indicated above. In order
for the plumbing perrnit 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 receiverl.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER : PLUMBING CONTRACTOR :
THE RW FULLERTON C-0 ANSPACH PLUMBING
9700 SW CAPITOL HWY MARK A LAW
SUITE #275 12295 SE CRESTWAY
PORTLAND OR 97219 PORTLAND OR 97236
Phone # : 293-2277 Phone # :
Reg # • . : 037135
i
Signature of Authorized Plumber
Please return this completed form to the address Eibove.
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 # . . . . : MST96-0279
Date Issued. : 06/24/96
Parcel . . . . . . : 2S104CC--HW011
Site Address : 13657 SW ASCENSION DR
Subdivision. : HILLSHIRE WOODS
Plonk . . . . . . . : Lot : 011
Zoning. . . . . . . R-7 PD
Remarks :
PATH I
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 work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER : ELECTRICAL CONTRACTOR:
THE RW FULLERTON CO WRIGHT 1 ELECTRIC INC
9700 SW CAPITOL HWY 5618 SE 135TH AVE
SUITE #275
PORTLAND OR 97219 PORTLAND OR 97236
4 : 293-2277 Phone # :
Reg # . . : 97757
Signature of-Supervising ectrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-417 1 , ext. #310